Therapeutic potential of AIF-mediated caspase-independent programmed cell death

Resistance to anticancer drugs is often related to deficient cell death execution pathways in cancer cells. Apoptosis, which denotes a form of cell death executed by caspases, was traditionally considered as the only physiological and programmed form of cell death. However, recent evidence indicates that programmed cell death (PCD) can occur in complete absence of caspase activation. Indeed, a large number of caspase-independent models are now defined and a key protein implicated in this type of PCD, apoptosis-inducing factor (AIF), has been identified. AIF is a mitochondrial protein with two faces looking in opposite life/death directions. Recently, the identification of five different isoforms allowed a better characterization of AIFs life/mitochondrial versus death/nuclear functions, as well as definition of its pro-apoptotic region and some of its nuclear partners. Importantly, much work on caspase-independent PCD has revealed that AIF participates in more PCD systems than initially thought. A wider molecular knowledge of AIF, and of the caspase-independent PCDs in which it is involved, are key to provide new insights into the role of PCD. There is no doubt that these insights will lead to the development of more selective and efficient drugs against cancer, degenerative diseases, and other pathological disorders implicating AIF.     

腰椎关节突关节角度与峡部裂及退变性脊柱滑脱的关系探讨

目的探讨腰椎关节突关节面角度变化与退变性及峡部裂性脊柱滑脱的关系。方法对37例脊柱滑脱患者（L4-5，退变滑脱22例；L5-S1，峡部裂滑脱15例）与25例正常人进行对照检查。结果退变性滑脱患者关节突关节角度与对照相比明显偏向于矢状位（P〈0．01）；而峡部裂滑脱患者关节突关节角度与对照组相比无明显差异（P〉0．10）；退变性滑脱患者关节突关节不对称与对照组相比无明显差异（P〉0．05），峡部裂滑脱患者关节突关节不对称与对照组差异有统计学意义（P〈0．05）。结论退变性腰椎滑脱关节突关节面方向更接近矢状位，峡部裂腰椎滑脱患者关节突关节面无一定方向性，关节突关节角度的不对称可能对峡部裂的形成有一定影响。关节突关节角偏向矢状方向有早期出现滑脱的危险；关节突关节不对称提示峡部裂发生的可能。     

退行性腰椎侧凸手术适应证与方法选择

目的探讨退行性腰椎侧凸不同手术治疗方法的适应证，观察不同治疗方法的疗效。方法37例退行性腰椎侧凸患者，平均年龄55．3岁（51～67岁）。平均病程8．6年（4～17年）。根据临床表现及影像学检查选择治疗方法：椎管双侧多节段开窗减压、椎弓根螺钉器械长节段固定矫形、椎板关节突间植骨融合19例；椎管双侧多节段开窗减压、短节段椎弓根螺钉固定，椎间植骨融合13例；单纯椎管双侧多节段开窗减压术5例。术后2～4周配带腰背支具活动，支具佩带3～6个月。结果术后平均随访24．7个月（16～67个月），29例（79．8％）腰部疼痛消失或仅感轻微疼痛，术后疼痛VAS评分和Oswestry功能障碍指数的改善率分别为（83．5±2,4）％和（72．7±4．1）％。侧凸Cobb角平均剩余8．3°，无假关节，内植物失败及其他严重并发症。结论在充分减压的基础上，采用经椎弓根固定可以较好的恢复腰椎的生理序列，选择有利术式，降低手术并发症是提高疗效的关键。     

椎弓根内固定加椎体间与后外侧联合植骨融合治疗退变性腰椎不稳症

目的探讨采用椎弓根内固定加椎体间与后外侧联合植骨融合治疗退变性腰椎不稳症的临床效果。方法2002年以来,采用椎弓根内固定加椎体间与后外侧联合植骨融合治疗退变性腰椎不稳症26例。平均年龄49.3（41～65）岁。病史1.5～16年,平均3.8年。腰椎不稳节段为：第2～3腰椎者2例,第3～4腰椎者5例,第4～5腰椎者10例,第5腰椎～第1骶椎者9例。全部患者有腰痛或伴有下肢痛,长期保守治疗效果不佳。结果本组平均随访2.3（0.5～4.5）年,疼痛缓解,功能改善。无内固定物折断,无神经损伤,无感染。椎间植骨融合率100%。植骨愈合时间10～16周,平均12周。椎间隙高度恢复,融合节段稳定。按日本骨科学会（JOA）评分法进行评定,疗效结果为：优16例,良9例,可1例。总优良率96.2%。结论椎弓根内固定加椎体间与后外侧联合植骨融合是治疗退变性腰椎不稳症的较好方法。     

保留变性网状真皮皮片移植治疗小儿深Ⅱ度烧伤(附10例报告)

目的探讨治疗小儿功能部位深度烧伤的新手术方法。方法选择小儿深Ⅱ度和混合度烧伤患者,削痂手术时保留创面变性网状真皮,取大张薄自体刃厚皮片移植覆盖创面,加压包扎8～10d。结果10例(12部位)移植皮片成活良好,外形功能恢复满意,供皮区愈合快,不留瘢痕。结论保留变性网状真皮与刃厚皮片复合移植是治疗小儿深度烧伤的一种有效新方法。     

一期后路VCR技术治疗活动期胸腰段脊柱结核伴严重后凸畸形

目的:评估一期后路全脊椎截骨(VCR)技术治疗活动期胸腰段脊柱结核伴严重后凸畸形的疗效.方法:自1998至2006年活动期胸腰椎结核伴严重僵硬角状后凸畸形患者36例,均应用VCR技术行一期后路全脊椎截骨矫形脊髓减压术,术后外支具制动3个月.所有病例随访至少2年,随访期间每6个月进行l临床评估和放射学检查.结果:无围手术期死亡发生,平均手术时间208(145～385)min,后凸Cobb角从术前平均57.2°(17°～86°)矫治到术后平均为8.9°(-6°～27°),C7-S1水平距离术前平均为13.6(8～19)mm,术后平均为3.6(-11～9)mm.术前有神经症状功能障碍者19例,术后神经功能改善率89.5%(17/19).围手术期并发症发生率为8.3%(3/36),包括肺炎和表层伤口感染,随访期并发症发生率为5.5%(2/36),表现为内固定植入物松动,25例(69.4%)获得良好的骨性融合.随访期间,25%(9/36)的患者对治疗结果非常满意,66.7%(24/36)的患者对治疗结果满意,2例一般,1例不满意.结论:一期后路VCR技术是一种治疗活动期胸腰段脊柱结核伴严重后凸畸形安全有效的外科手术方法,该手术技术要求高,外科医师必须熟练病理解剖并谨慎实施.     

益气化瘀法防治椎间盘退变性疾病的应用与发展

根据中医气血理论,经过长期的临床实践,确立了“调和气血防治椎间盘退变性疾病”的学术思想,创立了防治椎间盘退变性疾病的经验方——“益气化瘀方”。开展一系列临床和实验研究,对“益气化瘀方”的有效性和作用机制进行了系统观察和深入探索,进而验证了“益气化瘀方”的科学性及可靠性,丰富并发展了中医气血理论。     

Familial osteochondritis dissecans: A dysplasia of articular cartilage?

Two cases of osteochondritis dissecans in a boy and his mother are described. In the son only the knee and elbow joints and the epiphysis of the right second metacarpal were involved, whereas the mother showed early generalised degenerative joint disease associated with many large loose bodies in one knee. The authors speculate that familial osteochondritis dissecans is a dysplasia of articular cartilage caused by abnormal chondrocyte metabolism.     

Ultrastructural aspects of degenerative tendinopathy

Summary The authors describe changes in the ultrastructure of degenerate tendon that has undergone spontaneous rupture.The cellular elements show alteration of shape and widespread fatty degeneration. The cytoplasmic organules (mitochondria, rough endoplasmic reticulum, Golgi apparatus) are often completely absent, proof of a reduced metabolic activity of the cells.The matrix also shows serious degenerative phenomena with irregular orientation of the collagen fibrils frequently with variation in diameter, fraying and absence of periodicity.

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Résumé Les auteurs décrivent les modifications de la structure microscopique des tendons dégénérés qui ont été le siège d'une rupture spontanée.Les éléments cellulaires sont déformés et témoignent d'une dégénérescence graisseuse étendue. Les organes cytoplasmiques (mitochondries, réticulum endoplasmique granuleux, appareil de Golgi) ont souvent disparu, ce qui est la preuve d'une diminution de l'activité métabolique des cellules.Il existe également d'importants phénomènes dégénératifs au niveau de la matrice, avec orientation irrégulière des fibres de collagène, qui présentent des variations de diamètre, un aspect effiloché et une absence de périodicité.

     

(1)H magnetic resonance spectroscopy of autosomal ataxias

Multiple forms of autosomal ataxia exist which can be identified by genetic testing. Due to their wide variety, the identification of the appropriate genetic test is difficult but could be aided by magnetic resonance data. In this study, magnetic resonance spectroscopy (MRS) and imaging (MRI) data were recorded for 20 ataxia patients of six different types and compared to 20 normal subjects. Spectra were acquired in the pons, left frontal lobe, left basal ganglia, left cerebellar hemisphere and vermis. Both metabolite spectra and absolute metabolite concentrations were determined. Differences in metabolite levels were observed between ataxia patients and control subjects and between ataxia patients of different types. A number of correlations were found between metabolite ratios, atrophy levels, number of repeats on the small and large allele, age at examination, symptoms duration and age at symptoms onset for ataxia patients. These MR characteristics are expected to be useful for the identification of the ataxia type.