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Objective To discuss MRI diagnositic value and evaluation of the treatment of cervical Brucella spondylitis(BS).Meth-ods MRI data of 39 cases with cervical BS in our hospital were collected.Non-operative treatment,minimal invasive surgery and the open surgery were selected according to the MRI manifestations.The correlation was analyzed by consistensy check,imaging score and clinical effect evaluation.The data were analyzed by SPSS15.0.Results 39 cases of patients were examined by MRI before the treatment.37 cases were reviewed after 6 months treatment and 33 cases were reviewed after 12 months treatment.All of the Kappa values were more than 0.75 by imaging consistency check.MRI of cervical BS possessed characteristic expressions.The treatment effect according to MRI classification before the treatment:(1)drug therapy was performed in 14 cases (Group A);(2)minimal inva-sive surgery was performed in 7 cases (Group B);(3)focus clearance and bone graft were performed in 18 cases (Group C);(4)the clinical effects showed the healing rate in every group at different time point was different and the difference had statistical signifi-cance(P0.05). Conclusion MRI classification for cervical BS has important value and guiding significance in the selection of clinical conservative treatment,minimal invasive surgery or the open surgery.
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BACKGROUND:Studies have suggested that interleukin-6 is crucial for inducing cel apoptosis after acute spinal cord injury. OBJECTIVE:To observe the effect of interleukin-6 receptor monoclonal antibody combined with bone marrow mesenchymal stem cel s to treat acute spinal cord injury in rats. METHODS:Thirty Sprague-Dawley rats were randomly divided into sham group, model group (spinal cord injury group), treatment group 1 (interleukin-6 receptor monoclonal antibody transplantation group), treatment group 2 (bone marrow mesenchymal stem cel transplantation group), treatment group 3 (bone marrow mesenchymal stem cel+interleukin-6 receptor monoclonal antibody group), with six rats in each group. In the sham group, the spinal cord was only exposed with no injury, and in the other four groups, rat models of acute spinal cord injury were made using modified Al en’s method. Local injection treatment was performed in al the groups at 28 days after modeling. Basso, Beattie and Bresnahan (BBB) scoring and improved Tarlov scoring were used at 1 day before treatment and 1, 3, 7, 14, 28 days after treatment to test the hindlimb function. At 28 days after treatment, TUNEL method was used to detect cel apoptosis in the spinal cord. RESULTS AND CONCLUSION:Compared with the sham group, BBB scores and improved Tarlov scores were decreased significantly in the other four groups (P<0.05). At 7 days after treatment, the BBB scores and improved Tarlov scores in the treatment group 3 were significantly higher than those in the model group (P<0.05). At 14 days after treatment, the BBB scores and improved Tarlov scores in the treatment groups 1 and 2 were significantly higher than those in the model group (P<0.05);compared with the treatment group 2, the BBB score and improved Tarlov score were significantly increased in the treatment group 3 (P<0.05). Compared with the sham group, the number of apoptotic cel s was significantly increased in the other four groups (P<0.05);compared with the model group, the number of apoptotic cel s was significantly decreased in the three treatment groups (P<0.05);compared with the treatment group 2, the number of apoptotic cel s was significantly lower in the treatment group 3 (P<0.05). These findings indicate that the combined use of interleukin-6 receptor monoclonal antibody and bone marrow mesenchymal stem cel transplantation is better than bone marrow mesenchymal stem cel transplantation alone in the treatment of spinal cord injury, and interleukin-6 receptor monoclonal antibody reduces cel apoptosis in spinal cord injury, which is of positive significance for preventing against acute spinal cord injury.
ABSTRACT
A total of 38 cases of senile brucella spondylitis disease at our hospital during January 2002 and March 2012 were analyzed .After admission , all of them were definitely diagnosed on the basis of epidemiological history , clinical manifestations , laboratory tests , imaging and pathological examinations . Over a follow-up period of 12 months, 17 cases were cured after standardized drug treatment .Among 21 surgical cases, there were curing (n=17) and improving (n=2).Senile brucellosis spondylitis has distinct serological and pathological characteristics .And formulating the diagnostic criteria may improve its diagnostic rate and reduce its misdiagnostic rate .And standardized drug therapy achieves a better curing rate and a proper timing of surgical intervention improves its clinical outcomes .