Genipin‐crosslinked decellularized annulus fibrosus hydrogels induces tissue‐specific differentiation of bone mesenchymal stem cells and intervertebral disc regeneration

Biomaterial‐based therapy that can restore annulus fibrosus (AF) function in early stage and promote endogenous repair of AF tissues is a promising approach for AF tissue repair. In this study, we established a genipin‐crosslinked decellularized AF hydrogels (g‐DAF‐G) that are injectable and could manifest better in situ formability than noncrosslinked decellularized AF hydrogel, while preserving the capacity of directing differentiation of human bone mesenchymal stem cells (hBMSCs) towards AF cells. Hematoxylin and eosin staining, 4',6‐diamidino‐2‐phenylindole staining, and so forth showed that the majority of cellular components were removed, whereas extracellular matrix and microstructure were largely preserved. The storage modulus increased from 465.5 ± 9.4 Pa to 3.29 ± 0.24 MPa after 0.02% genipin crosslinking of decellularized AF hydrogels (DAF‐G) to form g‐DAF‐G. AF‐specific genes (COL1A1, COL5A1, TNMD, IBSP, FBLN1) were significantly higher in DAF‐G and g‐DAF‐G groups than that in control group after 21 days of culturing. g‐DAF‐G significantly restored nucleus pulposus water content and preserved intervertebral structure in vivo. Summarily, we produced a novel AF regeneration biomaterial, g‐DAF‐G, which exhibited well biocompatibility, great bioactivity, and much higher mechanical strength than DAF‐G. This study will provide an easy and fast therapeutic alternative to repair AF injuries or tears.     

兔纤维环细胞和骨髓间充质干细胞共培养的初步研究

目的:初步探讨骨髓间充质干细胞(BMMSCs)与纤维环(AF)细胞的共培养对细胞增殖及主要细胞外基质的影响,进一步确定BMMSCs移植对椎间盘退变的预防和治疗作用。方法:分别培养兔的BMMSCs与AF细胞,将两种细胞按1∶1的比例混匀,利用离心管培养技术培养3周后取材,大体观察并行HE染色;使用荧光染料Hoechst33258检测细胞增殖;通过实时荧光PCR对Ⅱ型胶原、蛋白多糖含量进行测定。结果:在体外培养3周后,细胞团体积达到最大,涂片染色显示共培养组细胞致密,细胞增殖较对照组明显,实时荧光PCR检测结果显示Ⅱ型胶原及蛋白多糖mRNA表达增强。结论:在离心管内三维培养条件下,BMMSCs与AF细胞共培养能够促进增殖,增加Ⅱ型胶原和蛋白多糖的含量。     

应用腹膜缝缘跳跃式戳孔法预防急腹症术后切口感染的探讨──附274例临床观察

本文观察我科１９９３年４月～１９９５年７月收治的２７４例急腹症手术病例，均应用腹膜缝缘跳跃式戳孔法关闭腹膜，切口不冲洗，不放置引流物，术后切口感染率为３．６５％，本法预防急腹症术后切口感染效果较为理想     

Backstabbing—a report of an unusual case

A case of a 25-year-old male with a deep knife stab injury in the back is reported. The stab wound penetrated the left thorax and the left lung was injured, a thoracotomy was performed and the patient survived. The injured man could not remember what had happened, his bag was missing and the incident was therefore considered to be due to a robbery. Further results of the police investigations and the forensic pathology inspection revealed an extremely unusual accident constellation.     

Integrin expression in cells of the intervertebral disc

In this study, we investigated the profile of integrin expression in human and porcine intervertebral disc tissue. Differences in extracellular matrix composition between anulus fibrosus (AF) and nucleus pulposus (NP) regions of the disc, as well as differences in cellular responses to environmental stimuli, suggest a role for integrins in presenting matrix signals that may mediate these responses. Human disc tissue and porcine AF and NP tissue were stained with antibodies to alpha integrin subunits 1-6, V and IIb, and beta integrin subunits 1-6 and graded for evidence of positive staining on a scale from 0 (no staining) to 3 (high incidence of staining). Human tissue expressed alpha and beta integrin subunits shown to be present in articular cartilage, including alpha(1), alpha(5) and alpha(V). Porcine AF tissue expressed similar integrin subunits to human disc, with both expressing alpha(1), alpha(5), beta(1), beta(3) and beta(5) subunits, whereas porcine NP tissue expressed higher levels of alpha(6), beta(1) and beta(4) than AF tissue. The expressed subunits are known to interact with proteins including collagens, fibronectin and laminin; however, additional studies will be required to characterize the interactions of the integrin subunits with specific matrix constituents, as well as their specific involvement in regulating environmental stimuli.     

Monitoring of the effect of intervertebral disc nucleus pulposus ablation by MRI

In order to investigate intervertebral disc (IVD) degeneration and repair, a quantitative non‐invasive tool is needed. Various MRI methods including qCPMG, which yields dipolar echo relaxation time (T_DE), magnetization transfer contrast (MTC), and ¹H and ²H double quantum filtered (DQF) MRI were used in the present work to monitor changes in rat IVD after ablation of the nucleus pulposus (NP), serving as a model of severe IVD degeneration. In the intact IVD, a clear distinction between the annulus fibrosus (AF) and the NP is obtained on T₂ and T_DE weighted images as well as on MTC maps, reflecting the high concentration of ordered collagen fibers in the AF. After ablation of the NP, the distinction between the compartments is lost. T₂ and T_DE relaxation times are short throughout the disc and MTC is high. ¹H and ²H DQF signal, which in intact discs is obtained only for the AF, is now observable throughout the tissue. These results indicate that after ablation, there is an ingression of collagen fibers from the AF into the area that was previously occupied by the NP, as was confirmed by histology. Copyright © 2010 John Wiley & Sons, Ltd.     

Annulus fibrosus calcification in the cervical spine: radiologic — pathologic correlation

Intervertebral disc calcification can be secondary to a variety of pathologic processes including some of the arthritidies, metabolic diseases, and trauma. The annulus fibrosus is the most commonly calcified component and may mimic vertebral body fracture, limbus vertebra, or a persistent ring apophysis. We describe two young patients who developed calcification in the anterior annulus fibrosus and present radiologic-pathologic correlation in this condition in another case. This calcification may actually be secondary to subclinical or chronic stress on the involved intervertebral disc.     

腰椎间盘臭氧注射压力与纤维环损伤程度的关系

目的研究腰椎间盘臭氧注射压力与纤维环破损程度的关系。方法自制压力监测装置,记录腰椎间盘内注射臭氧时的压力增高值,再根据椎间盘气体造影结果对椎间盘纤维环破损程度进行分型,利用统计学方法研究注射压力与纤维环破损程度间的关系。结果根据腰椎间盘气体造影结果将椎间盘纤维环破损程度分为A型(无破裂型)、B型(纤维环后缘破裂型)、C型(纤维环多发破裂型);A型6例患者8个椎间盘记录压力为700～900mmHg,平均(821±61)mmHg;B型9例患者10个椎间盘记录压力为400～800mmHg,平均(602±145)mmHg;C型2例患者2个椎间盘记录压为100mmHg和320mmHg,均数(268±94)mmHg。各组压力均数差异有统计学意义(F=8047.02,P<0.01)。结论腰椎间盘内注射臭氧气体时的压力增加值与腰椎间盘纤维环破损程度相关,纤维环破损越严重注射压力越小,不同破损程度的纤维环盘内注射压力存在一定的分布范围。     

COX-2 inhibitor for the treatment of idiopathic stabbing headache secondary to cerebrovascular diseases

The idiopathic stabbing headache (ISH) is characterized by a stabbing pain of short duration, variable localization and an errant evolution pattern. As its biological mechanisms are unknown and the treatment options are little effective, this disorder shows a strong impact on the patient's life. Two females and one male, aged 76, 66 and 72 years, respectively, started presenting ISH within 20 days after the onset of a stroke. All the patients were treated for the ISH with celecoxib, a COX-2 specific inhibitor, with full recovery from ISH up to 6 days after it was first administered. The interruption of the drug 60 days after the treatment with celecoxib induced again the appearance of algic symptoms in two patients. We concluded that cerebrovascular diseases (CD) can lead to ISH and that the COX-2 inhibitor can be an effective prophylactic drug for ISH after CD.