非手术治疗破裂型腰椎间盘突出症5年随访研究

目的:探讨非手术治疗破裂型腰椎间盘突出症的近中期疗效及预后转归。方法:选取2011年2月至2014年2月接受非手术治疗的75例单节段破裂型腰椎间盘突出症患者进行前瞻性研究,男53例,女22例;年龄18～58(35.62±9.96岁);病程5 d～6个月,平均(46.45±40.66) d。突出节段:L_(3,4) 4例,L_(4,5) 29例,L_5S_1 42例。放射痛左侧46例,右侧29例。选取治疗前,治疗后3个月、6个月、1年、2年、5年6个时间点对患者JOA评分、直腿抬高角度(SLRT)、指地距统计分析。计算末次随访时(治疗后5年)JOA改善率,根据JOA评分评定疗效;分析治疗前、末次随访(治疗后5年)椎间盘突出物体积变化,计算突出物体积吸收率,观察突出物吸收情况;分析JOA改善率与突出物吸收率之间关系。结果:71例患者完成随访,非手术治疗后3个月、6个月、1年、2年、5年JOA评分、SLRT、指地距与治疗前比较,差异有统计学意义(P0.05)。治疗后5年与6个月、治疗后5年与2年、治疗后2年与6个月JOA评分比较,差异无统计学意义(P0.05),其余各时间点两两比较,差异均有统计学意义(P0.05);治疗后5年与6个月、治疗后5年与2年、治疗后2年与6个月SLRT、指地距比较,差异亦无统计学意义(P0.05),其余各时间点两两比较,差异均有统计学意义(P0.05)。末次随访JOA改善率为(62.69±2.47)%,按照JOA评分评定疗效,结果优26例,良26例,可14例,差5例,优良率73.24%;突出物体积由起始的(1 981.73±588.72) mm3减少至(1 011.82±395.47) mm3,总体吸收率(45.65±2.83)%,突出物发生明显吸收24例,部分吸收26例,未吸收19例,增大2例。JOA改善率与突出物吸收率作Spearman秩相关分析,发现两者呈中等以上正相关(r=0.679,P0.001)。结论:非手术治疗破裂型腰椎间盘突出症可取得良好疗效,明确了破裂型腰椎间盘突出症的病情特点及预后转归,同时部分患者发生"重吸收"现象。     

白细胞介素1刺激破骨细胞性骨吸收作用的实验研究

目的：了解白细胞介素1β（IL－1β）在破骨细胞性骨吸收中的刺激作用及其相应的作用机制。方法：分别将新生大鼠破骨细胞单独以及和成骨细胞联合接种于预置象牙片的培养板中。24h后培养液中加入不同浓度的IL－1β。继续培养48h,然后取出象牙片,超声处理后行甲苯胺蓝染色,光镜下观察骨吸收陷窝的数目并计算其部面积。结果：IL－1β能够明显增加坡骨细胞和成骨细胞联合培养组象牙片上吸收陷窝的数目和面前,且刺激作用呈剂量依赖性,但对单独培养的破骨细胞无明显刺激作用。结论：IL－1β的刺激骨吸收作用由成骨细胞所介导,而非直接作用于破骨细胞。     

Complete resorption of an impacted and inverted supernumerary tooth: Report of an unusual case

The presence of supernumerary teeth is a relatively frequent odontogenic disorder. Supernumerary teeth should be extracted immediately if any complications such as diastema and delayed eruption are present; early diagnosis is therefore crucial.A 6-year-old boy had an impacted and inverted supernumerary tooth in the anterior maxilla. Removal was recommended but was not performed, at the patient's request. The patient's condition was monitored using oral and radiographic examinations for a period of 2 years. During that time, the supernumerary tooth underwent extensive resorption. The resorption of an impacted supernumerary tooth is extremely rare. In this unusual case, resorption was complete.     

人胎盘脂多糖、地塞米松对椎间盘组织自发性吸收作用的研究

目的　探讨应用人胎盘脂多糖及地塞米松增强或抑制炎症反应后对bFGF、VEGF表达和突出腰椎间盘组织自发性吸收的影响。方法　将 2 4只健康新西兰大白兔制作成游离型椎间盘突出模型 ,随机分为 3组。人胎盘多糖组于术后第 2d开始腹腔内注射人胎盘脂多糖 2ml,每 1次 /4d ,共 3次。地塞米松组于术后第 2d开始按每日 1mg/kg标准静脉注射地塞米松共 14d。对照组按每日 3ml/kg标准静脉注射生理盐水共 14d。术后 12周将动物麻醉后 ,取出埋植的椎间盘称重。然后作组织学、免疫组化检查 ,分析其差异。结果　⑴地塞米松组植入的椎间盘的重量较植入前有所减轻 ,但差异无显著性 (P >0 0 5 ) ;对照组植入的椎间盘的重量减轻较明显 ,差异有显著性 (P <0 0 5 ) ;人胎盘脂多糖组植入的椎间盘的重量明显减轻 ,差异有非常显著性 (P <0 0 1)。脂多糖组植入的椎间盘的重量的减轻量明显高于对照组 ,差异有显著性 (P <0 0 1)。而在对照组植入的椎间盘的重量的减轻量又明显高于地塞米松组 ,差异有显著性 (P <0 0 5 )。⑵VEGF蛋白bFGF蛋白、CD68蛋白及MVD在对照组中的表达高于地塞米松组 ,低于人胎盘脂多糖组 ,均有显著性差异 (P <0 0 5 )。结论　自体椎间盘组织进入硬膜外腔后可以逐渐被新生血管和巨噬细胞浸润 ,然后溶解、     

Human calcitonin has the same inhibitory effect on osteoclastic bone resorption by human giant cell tumor cells as salmon calcitonin

Human calcitonin (hCT) has been reported to have a less hypocalcemizing effect on rats and to have a lower binding affinity for the receptor of mouse osteoclasts than salmon CT(sCT). In this study we comparatively examined the effect of hCT and sCT on osteoclastic boneresorbing activity of unfractionated cells obtained from human giant cell tumor of bone and from rabbit and mouse long bones. We found that hCT had the same inhibitory effect as sCT on the bone-resorbing activity of human and rabbit osteoclastic cells, but a different one on that of mouse cells. These results indicate that the activity of drugs should be assayed using human cells if possible.     

Effects of changing hydrogen ion,carbonic acid,and bicarbonate concentrations on bone resorption in vitro

Summary We have examined the effects of H⁺, CO₂, and HCO₃ ⁻ concentrations during metabolic and respiratory acidosis and alkalosis on bone resorption in vitro. Rat fetal bones prelabeled with⁴⁵CaCl₂ were cultured at 2%, 5%, and 10% CO₂ for up to 120 h, and the release of⁴⁵Ca was measured in devitalized bones (non-cell-mediated⁴⁵Ca release) and in live bones (cell-mediated⁴⁵Ca release) cultured with or without PTH and 1,25(OH)₂D₃. Non-cell-mediated mineral loss was linearly related to H⁺ concentration but not to CO₂ or HCO₃ ⁻ concentration. This effect was observed on both labeled and stable calcium. Over a wide pH range (6.9–7.5) H⁺, CO₂, or HCO₃ ⁻ concentrations did not influence cell-mediated bone resorption in control or in PTH-and 1,25(OH)₂D₃-stimulated cultures. However, inhibition of cell-mediated bone resorption was observed at higher or lower pH irrespective of CO₂ or HCO₃ ⁻ concentrations. These observations demonstrate that the bone mineral mobilizing effect of acidosis in vitro is mainly due to the effect of changing H⁺ concentration on devitalized bone. Effects on cell-mediated bone resorption and hormonal response were observed only at extremes of pH. The effects of H⁺ were independent of changes in CO₂ or HCO₃ ⁻ concentration and could be responsible for the negative calcium balance and increased urinary loss observed in metabolic acidosis in vivo, but do not explain the reported differences in effects on calcium metabolism between respiratory and metabolic acidosis.     

Resorption time and tissue reactions with magnesium rods in rats and rabbits

Summary Studies in rats and rabbits show that pure (99.8+%) magnesium wires with a diameter of 0.25 and 0.50 mm, which are implanted subcutaneously and intramuscularly, will be totally resorbed within 20 weeks but will be dissolved completely within 10 weeks if they are treated with 10% acetic acid before implantation. According to morphologic and electromyographic studies magnesium rods cause only a very mild foreign body reaction in normal tissue and do not harm the function or structure of neighbouring nerves and muscle fibres. This suggests that a refill of haemangioma with magnesium seeds is advisable at intervals of 8 weeks and allows the conclusion that magnesium implants can safely be used also in close proximity to facial nerve branches and delicate muscle fibres.     

The incisal edge bracket for gold chain attachment to unerupted teeth.

Abstract

A method is described to reduce the morbidity involved in direct bonding of unerupted incisors by use of a precontoured bracket. Increased bracket stability during placement is an additional advantage.     

Embryotoxicity and fetotoxicity of orally administered hexavalent chromium in mice

The embryotoxic and fetotoxic potential of hexavalent chromium (Cr⁺⁶) in mice was investigated by administering 250, 500, and 1000 ppm of potassium dichromate daily through drinking water during the entire gestation period. An increase in embryonic deaths was observed; however, in the mothers treated with the highest dose, there was complete absence of implantation sites. No major abnormality was observed in the fetuses except that Cr⁺⁶ exposure increased the incidences and types of external and skeletal malformations. It is concluded that oral exposure to Cr⁺⁶ causes dose-dependent embryolethal effects in mice.     

The response of mouse bones to calcitonin preparations from different species

Anin vitro method has been used to investigate the relative effectiveness of calcitonin preparations from different species. It is based on the finding that calcitonin has a marked inhibitory effect on the release of⁴⁵Ca from prelabelled half-calvariae from 6-day-old mice; this effect is due to the suppression of the endogeneous resorption that is in progress when the bones are explanted, and which continuesin vitro in the absence of calcitonin.Striking differences have been found in the inhibitory effect of calcitonin preparations from either ultimobranchial bodies or from mammalian thyroids. Human calcitonin and porcine standard A calcitonin behave similarly and are about ten times more potent than porcine standard B calcitonin in terms of units based on the rat assay. The calcitonins of ultimobranchial origin are more effective at lower doses for a longer period of time than the thyroid preparations, and are at least ten times more potent than porcine standard A calcitonin or 100 times more potent than porcine standard B.Explants treated with calcitonin release isotope into the medium in a similar manner to that of dead bones, as long as the calcitonin remains effective; for salmon calcitonin there is a twenty-hour period in which the release of isotope from living bones treated with this preparation exchange isotope with the calcium in the medium like frozen-thawed bone. This finding should be very useful in quantitative studies on the mode of action of other compounds that influence bone resorption and accretion, since the addition of calcitonin will enable the exchange component of the isotope released from treated bones, to be measured at any stage without killing the tissue or resorting to less specific inhibitors of metabolism.

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Zusammenfassung Ein quantitativerin vitro-Versuch wurde angewandt, um die relative Wirksamkeit von Calcitonin-Präparaten aus verschiedenen Spezies zu untersuchen. Der Versuch beruht auf der Feststellung, daß Calcitonin einen ausgeprägten Hemmeffekt auf die Freisetzung von⁴⁵Ca aus markierten Calvarien-Hälften von 6tägigen Mäusen hat. Dieser Effekt kommt wegen der Unterdrückung der endogenen Resorption zustande, die im Moment der Knochenexplantation im Gange ist, undin vitrobei Abwesenheit von Calcitonin weiter fortschreitet.Auffallende Unterschiede des Hemmeffektes konnten bei Calcitonin-Präparaten sowohl von Ultimobranchialkörpern als auch von Säuger-Thyreoideae festgestellt werden. Menschliches Calcitonin sowie Standard A Schweine-Calcitonin verhalten sich gleich und sind ungefähr 10mal wirksamer als Standard B Schweine-Calcitonin, ausgedrückt in Einheiten bezogen auf den Rattenversuch. Die von Ultimobranchialkörpern stammenden Calcitonin-Präparate sind wirksamer in niedrigerer Dosierung und während einer längeren Zeitspanne als die Thyreoidea-Präparate. Sie wirken zudem mindestens 10mal stärker als Standard A Schweine-Calcitonin und 100mal stärker als Standard B Schweine-Calcitonin.Explantate, welche mit Calcitonin behandelt wurden, geben das Isotop auf die gleiche Weise wie totes Knochengewebe in das Medium ab, solange das Calcitonin wirksam ist. Für Calcitonin vom Lachs besteht eine Zeitpsanne von 20 Std, während welcher die lebenden, mit diesem Präparat behandelten Knochen das Isotop mit dem Calcium des Medium austauschen, in gleicher Weise wie durch Einfrieren und Auftauen getöteten Knochens.Diese Methode wird vermutlich sehr nützlich sein für quantitative Untersuchungen über den Aktionsmodus anderer Stoffe, welche Knochenresorption und-wachstum beeinflussen, da der Calcitonin-Zusatz es ermöglicht, die Austauschkomponente des aus dem behandelten Knochen freigesetzten Isotopes jederzeit zu messen, ohne daß dabei Gewebe zerstört oder weniger spezifische Inhibitoren des Metabolismus herangezogen werden müssen.

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Résumé Une méthode quantitativein vitro est utilisée pour étudier l'efficacité relative des préparations de calcitonine, provenant de diverses espèces. La méthode est basée sur le fait que la calcitonine inhibe de façon nette la libération de⁴⁵Ca de moitiés de calottes craniennes de souris, âgées de 6 jours, ayant été marquées auparavant; cet effect est lié à la suppression de la résorption endogène, qui se déroule, lorsque les os sont explantés et qui se continuein vitro en l'absence de calcitonine.Des différences nettes de l'effect d'inhibition des préparations de calcitonine ont été trouvées, qu'elles proviennent de corps ultimobranchiaux ou de thyroides de mammifères. La calcitonine humaine et la calcitonine porcine, standard A, se comportent de façon identique et sont environ dix fois plus actifs que la calcitonine porcinek standard B, en se basant sur les critéres unitaires utilisés au cours de cette étude chez le rat. Les calcitonines de corps ultimobranchiaux sont plus efficaces à doses faibles, pendant des périodes plus longues, que les préparations thyroidiennes et elles sont au moins dix fois plus efficaces que la calcitonine porcine standard A et cent fois plus actives que la calcitonine porcine standard B.Les explants traités par la calcitonine libère l'isotope dans le milieu d'une manière identique à celle de l'os mort, tant que la calcitonine reste active: pour la calcitonine de saumon, on observe pendant 20 heures un échange d'isotope entre l'os vivant, traité avec ce produit et le calcium du milieu, ainsi que cela se produit pour des fragments d'os congelé.Ces résultats sont utiles pour des études quantitatives, devant déterminer le mode d'action d'autres produits influençant la résorption et l'apposition osseuse. L'adjonction de calcitonine permet, en effet, de mesurer l'échange d'isotope libéré de l'os, ainsi traité à tous les stades, sans tuer les tissus ou sans avoir recours à des inhibiteurs spécifiques du métabolisme.