The differentially expressed proteins of spinal cord tissues after ASCI will provide scientific foundation for further study to explore the secondary injury mechanism of ASCI.

AIM:To determine the expression of c-Fos, caspase-3 and interleukin-1β (IL-1β) in the cervical cord and stomach of rats with cervical spondylosis, to analyze their relationship, and to offer an explanation of one possible cause for functional dyspepsia (FD) and irritable bowel syndrome (IBS) caused by cervical spondylosis. METHODS:The cervical spondylosis model in rats was established by destroying the stability of cervical posterior column. The cord segments C4-6 and gastric antrum were collected 3 mo and 5 mo after the operation. Rats with the sham operation were used as controls. The expressions of c-Fos, caspase-3 and IL-1β in the cervical cord and gastric antrum were determined by immunohistochemistry and/or Western blot. RESULTS:Immunohistochemical staining showed a few c-Fos, caspase-3 and IL-1β-positive cells in the cervical cord and antrum in the control. There was a significant increase in c-Fos, caspase-3 and IL-1β expression in model groups compared to the control groups at 3 mo and 5 mo after operation. More importantly, there was a significant (P < 0.05) increase in c-Fos, caspase-3 and IL-1β expression in the model group rats at 3 mo compared to those at 5 mo after the operation (c-Fos:11.20 ± 2.26 vs 27.68 ± 4.36 in the cervical cord, 11.3 ± 2.3 vs 29.3 ± 4.6 in the gastric antrum; caspase-3: 33.83 ± 3.71 vs 36.32 ± 4.01 in the cervical cord, 13.23 ± 3.21 vs 26.32 ± 4.01 in the gastric antrum; IL-1β: 42.06 ± 2.95 vs 45.91 ± 3.98 in the cervical cord, 26.56 ± 2.65 vs 32.01 ± 2.98 in the gastric antrum). Western blot analysis showed time-dependent changes of caspase-3 and IL-1β protein in the cervical cord and gastric antrum of rats with cervical spondylosis; there was no significant expression of caspase-3 and IL-1β protein in the control group at 3 mo and 5 mo after the sham operation, whereas there was a significant difference in caspase-3 and IL-1β protein levels between the model group rats followed up for 3 mo and those for 5 mo (P < 0.05). CONCLUSION:There is a significant association of c-Fos, caspase-3 and IL-1β expressions in the gastric antrum with that in the spinal cord in rats with cervical spondylosis, suggesting that the gastrointestinal function may be affected by cervical spondylosis.

Rationale:Alveolar echinococcosis (AE) is a rare but highly malignant form of echinococcosis caused by Echinococcus multilocularis. There have been very few reports on multiple-organ AE, especially AE in bones. Here we report 3 rare cases of disseminated multiple-organ AE from western China and its neighboring areas.Patient concerns:Patient 1 had back and left hip pain, headache, and weakness in left lower limb, often with minor epilepsy and fluctuation of blood pressure. Lower limbs Babinski sign was positive and muscular tension was above normal range. The second patient had pain in lower limbs and chest discomfort without fever, cough, sputum, chest tightness, or hemoptysis. Patient 3 had masses and pain in the back side of his right shoulder.Diagnoses:The patients had been treated for AE multiple times and were positive for serum hydatid antigens. They were diagnosed as multiorgan AE involving liver, spinal cord, and many other organs.Interventions:The patients had undergone surgeries to decompress the spinal cord, remove lesions from tissues as required, and were put on albendazole for at least 2 years.Outcomes:The patients responded well and AE recurrence has not occurred.Lessons:All 3 cases experienced multiple recurrences of AE due to missed diagnosis, misdiagnosis, or inappropriate treatment, which resulted in metastatic multiorgan AE. These cases demonstrated the need for more policy attention to battle AE endemic in western China.

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