BackgroundTo evaluate by MRI intervertebral disc degeneration in patients with lumbar degenerative disease using the Pfirrmann grading system and to determine whether Modic changes correlated with the Pfirrmann grades and modified Pfirrmann grades of disc degeneration.MethodsThe clinical data of 108 surgical patients with lumbar degenerative disease were reviewed and their preoperative MR images were analyzed. Disc degeneration was evaluated using the Pfirrmann grading system. Patients were followed up and low back pain was evaluated using the visual analog scale (VAS) and the effect of back pain on the daily quality of life was assessed using Oswestry disability index (ODI).ResultsForty-four cases had normal anatomical appearance (Modic type 0) and their Pfirrmann grades were 3.77±0.480 and their modified Pfirrmann grades were of 5.81±1.006. Twenty-seven cases had Modic type I changes and their Pfirrmann grades were 4.79±0.557 and their modified Pfirrmann grades were 7.00±0.832. Thirty-six cases exhibited Modic type II changes and their Pfirrmann grades and modified Pfirrmann grades were 4.11±0.398 and 6.64±0.867, respectively. One case had Modic type III changes. Kruskal-Wallis test revealed significant difference in modified Pfirrmann grade among Modic type 0, I and II changes (P<0.01) but no significant difference between Modic type I and II changes (P>0.05). Binary regression analysis showed that Modic changes correlated most strongly with disc degeneration. Follow up studies indicated that the VAS and ODI scores were markedly improved postoperatively. However, no difference was noted in VAS and ODI scores among patients with different Modic types.ConclusionModic changes correlate with the Pfirrmann and modified Pfirrmann grades of disc degeneration in lumbar degenerative disease. There is no significant correlation between Modic types and surgical outcomes.

Berberine (BBR), an isoquinoline alkaloid, is a major pharmacological component of the Chinese herb Coptis chinensis , which has been listed in the Chinese Fisheries Pharmacopeia as a common drug for the control of bacterial fish diseases. However, BBR is poorly absorbed into the systemic circulation but is significantly accumulated in the intestine. It is difficult to explain the mechanism of clinical effects of BBR based on systemic genes and pathways; it has been proved that the function of BBR in mammals is associated with the host metabolic phenotypes mediated by the structural modulation of gut microbiota. The mechanism of pharmacological effects of BBR in fish remains unclear. Here, we fed grass carp ( Ctenopharyngodon idellus ) a diet supplemented with BBR at a dose of 30 mg/Kg body weight daily and compared them with grass carp fed a regular fish feed diet. Biochemical analysis revealed that fish fed BBR had significantly reduced serum glucose, total cholesterol (TC), and triglyceride (TG) levels, and increased TC ( p < 0.05) and TG ( p < 0.01) levels in the liver. Deep amplicon sequencing of the V4 region of 16S rRNA genes of the gut microbiota revealed: (i) the composition of gut microbiota after BBR feeding was more diverse than that in the control group; (ii)before fish were fed BBR, the enriched operational taxonomic units (OTUs) mainly belonged to Firmicutes while most enriched OTUs came from Proteobacteria, Planctomycetes, Bacteroidetes, and Firmicutes during BBR feeding and after BBR feeding stopped; (iii) the ratio of Firmicutes to Bacteroidetes was significantly decreased in fish fed BBR. Spearman’s rank correlation showed that 32 berberine-OTUs were significantly negative correlated with glucose ( p < 0.05). It indicates that BBR may affect the levels of serum glucose by the structural modulation of gut microbiota. Our results provide insight into the effect of BBR on fish metabolism and gut microbiomes, which would be beneficial for the fish welfare.

Esophageal anastomotic leak remains a lethal complication after esophagectomy for cancer. The aim of the present study is to describe an effective new management, nose fistula tube drainage (NFTD), to treat postoperative intrathoracic leaks. From July 2003 to August 2009, 41 of 4132 patients (0.99%) requiring transthoracic esophagectomy for esophageal and cardiac carcinoma had developed an intrathoracic esophageal anastomotic leak in our hospital as well as another three patients with similar conditions from other hospitals, excluding three patients with gastric necrosis (two) and tracheo-esophageal fistula (one); 23 patients were treated by NFTD, and the remaining 18 patients were treated by conventional chest tube drainage (CCTD). Clinical records of these patients were reviewed and analyzed, including the healing of the leak, mortality, and morbidity. In the NFTD group, 4 patients (17.4%) died, 1 patient (4.3%) required reoperation, and 18 patients (78.3%) healed. However, in the CCTD group, 3 patients (16.7%) died, 1 patient (5.5%) required reoperation, and 14 patients (77.8%) healed. As compared with the CCTD group, patients of the NFTD group had a shorter intensive care course (11.95 vs 33.62 days, P= 0.01) and hospital stay (39.74 vs 77.54 days, P= 0.02). Although this novel NFTD management did not significantly decrease mortality when compared with CCTD, it could gain more effective drainage than CCTD and eventually shorten hospital stay.