STUDY DESIGN: Case report and literature review. OBJECTIVES: Gouty arthritis of the spine is rare. Gout presenting as back pain and quadriplegia may be difficult to distinguish from a spinal tumor. Symptoms vary, and the diagnosis is often delayed. We report an unusual case of thoracic spinal cord compression caused by extradural tophaceous deposits whose initial diagnosis had been lymphoid malignancy. To the best of our knowledge, this is only the second report of using single-photon emission computed tomography (SPECT) to diagnose spinal tophus. METHODS: We retrospectively reviewed the medical records, operative reports and radiographic imaging studies of a single patient. RESULTS: A 26-year-old man with severe tophaceous gout presented with a 4-month history of progressive weakness and dyschesia of both lower extremities. Coronal bone slices evaluated by SPECT indicated increased methylene diphosphonate uptake in the T9 and T10 pedicles. Pathology assessment revealed areas of amorphous substance containing urate crystals surrounded by inflammatory cells. The diagnosis was gouty tophus. CONCLUSION: The position of the spinal tophus may be related to the 'S' type of spinal anatomical structure. Obesity and inactivity may be the two risk factors for spinal tophus. Every effort should be made to lower the serum uric acid level by maximizing the pharmacological regimen. We believe that laminectomy can effectively relieve spinal cord compression. It also improves the longterm prognosis for spinal gouty tophus. SPECT may be a viable method for differentiating spinal gout and a malignant tumor. Spinal Cord Series and Cases INTRODUCTIONWe report a case of gouty arthritis affecting the thoracic spine in a 26-year-old man with thoracic spinal cord compression caused by extradural tophaceous deposits that had initially been diagnosed as lymphoid malignancy.

Background Colorectal cancer (CRC) is related to gut microbiota dysbiosis, especially butyrate-producing bacteria reduction. Our previous study suggested administration of Clostridium butyricum (C. butyricum), a butyrate-producing bacterium, exerts a crucial effect against CRC. Methyltransferase-like 3 (METTL3) contributes to tumorigenic epigenetic regulation. We aimed to investigate the effects of C. butyricum on METTL3 in the prevention of CRC. Methods TCGA and CancerSEA databases were used to investigate METTL3 co-expressed genes, and the GO and KEGG enrichment analysis was conducted on METTL3. Tissue specimens of human normal colonic tissue, adenoma and carcinoma were obtained and examined the expression of METTL3, EMT-associated markers, and VM formation. We overexpressed METTL3 in CRC cells to assess cell migration and tube formation. Meanwhile, the effects of C. butyricum on METTL3, epithelial-mesenchymal transition (EMT), and vasculogenic mimicry (VM) formation in CRC cells were evaluated. Furthermore, a murine xenograft model was established to provide further evidence of the inhibition of C. butyricum on tumor growth. Results Database analysis suggested that METTL3 showed a positive correlation with proliferation, EMT, DNA repair, metastasis, and invasion. The expression of METTL3 gradually increased from human normal colon tissue, adenoma to carcinoma, and was positively correlated with VM formation and EMT. METTL3 overexpression promoted the proliferation, migration, and invasion of CRC cells and induced VM formation. C. butyricum could downregulate METTL3 expression in CRC cells and decrease the expression of vimentin and vascular endothelial growth factor receptor 2 to reduce EMT and VM formation. Moreover, C. butyricum alleviated the pro-oncogenic effect of METTL3 overexpressing plasmid in CRC cells. Accordingly, C. butyricum downregulated the expression of METTL3 in tumors and prevented EMT in nude mice. Conclusion C. butyricum could inhibit EMT and VM of intestinal carcinogenesis through downregulating METTL3. These findings broaden our understanding of probiotics supplement in the prevention and treatment of CRC.