Objective To detect the serum levels of tumor necrosis factor-alpha (TNF-α) and interferengamma (IFN-γ) in brucellosis patients and to study the Th1 immune response in acute and chronic patients.Method Serum levels of TNF-alpha and IFN-gamma of 110 brucellosis patients,including 58 acute brucellosis patients and 52 chronic brucellosis patients,were measured by enzyme linked immunosorbent assay (ELISA) from 2014 to 2015 in Zhangjiakou Infectious Disease Hospital.Results The serum levels of TNF-alpha and IFN-gamma of 58 acute brucellosis patients were (38.2± 3.6) pg/L and (31.3 ± 3.7) ng/L,respectively;the serum levels of TNF-alpha and IFN-gamma of 52 chronic brucellosis patients were (12.4 ± 2.6) pg/L and (8.8 ± 3.4) ng/L,respectively.The differences were statistically significant between acute and chronic patients (t =43.216,33.809,all P ＜ 0.05).The early cure rate,early base cure rate,improvement rate and inefficiency rate were 36.2％ (21/58),32.7％ (19/58),25.9％ (15/58)and 5.2％ (3/58),respectively in acute patients.Inversely,they were 17.3％ (9/52),13.5％ (7/52),15.4％ (8/52)and 53.8％ (28/52),respectively in chronic patients.The therapeutic effect was better in acutepatients than chronic patients (x2 =4.937,5.657,all P ＜ 0.05).Conclusion It seems that acute brucellosis patients have a higher serum levels of TNF-alpha and IFN-gamma and a better prognosis due to effective Th1 immune response,and chronic brucellosis patients are associated with poor outcome due to deficiency of Th1 immune response.

Objective To compare the infusion outcome of the posterior interbody autogenous micromor-selized bone graft and structure bone graft ,which were used to cure single-segment spinal tuberculosis. Methods The posterior focus debridement and bone graft fusion were conducted on 35 single-segment spinal tuberculosis patients who were cured by micromorselized bone graft and structure bone graft in the hospital from January 2010 to June 2015. Sixteen patients received micromorselized bone graft cases and 19 patients received structure bone graft. According to JOA and VAS,the fusion effects were compared and analyzed in the following aspects,such as opera-tion time,blood loss volume during the operation,kyphosis distorted Cobb angles before and after the operation and fusion time. Results Follow-up visits were paid to all 35 patients and lasted for 12 to 24 months with an aver-age visit time of 18.5 months. Spinal grafted bones showed desirable fusion without invalid screws and grated bones in the spinal canal.(1)No statistical differences were observed between two groups in terms of post-operation JOA and VAS scores.(2)The operation time and blood loss amount during the operation were smaller in the micromor-selized bone graft than those in the structure bone graft ,with significant differences between 2 groups.(3)No sig-nificant differences were observed between the two groups in terms of kyphosis distortion angle ,but regarding to loss of Cobb angles in different intervals after the operation ,it′s greater in the former group than that in the latter one. (4)No significant differences between the two groups in terms of fusion time were observed. Conclusions The two fusion approaches demonstrated no prominent difference in alleviation of the clinical symptoms and the fu-sion time. The micromorselized bone grafting was superior to the structure bone graft in aspects such as operation time and blood loss amount. However ,it′s more likely for the former to lose Cobb angles in the follow-up visits. Both of the two grafting methods were effective in the single-segment spinal tuberculosis operation. All patients ex-cept those with severely unstable spines and osteoporosis and those were too old can adopt the micromorselized bone grafting approach.