褪黑素在鸡脊柱侧凸模型中的影响

目的　通过鸡松果体蒂部切断的方法 ,研究褪黑素在松果体切除鸡脊柱侧凸动物模型中的作用。方法　 10只刚孵育出的WhiteLeghorn鸡作为对照组 ,未行任何处理 ,控制白天 12h光照 (强度 5 0 0Lux)、夜间 12h完全黑暗 (强度 0 - 5lux)条件下饲养 ;2 0只WhiteLeghorn鸡在鸡龄 3d时行松果体切除 ,控制光照条件同对照组 ;2 0只WhiteLeghorn鸡 3d时行松果体蒂部切断术 ,控制光照同对照组。 5周时留取所有鸡白天 (mid -day)和夜间 (mid -night)的血清 ,用RIA试剂盒测定血清中褪黑素含量。所有的鸡处死后 ,取骨骼标本 ,行脊柱前后位平片检查。结果　 5周时 ,对照组褪黑素含量呈现明显白天低 (5 7.2 5± 7.4 3)pg/ml,夜间高 (2 5 7.92± 2 6 .0 9)pg/ml的周期性变化。松果体切除组褪黑素含量 ,白天为 (6 0 .0 5± 5 .4 8)pg/ml,夜间为 (5 5 .0 9± 8.35 )pg/ml,其分泌维持低水平。松果体蒂部切断组褪黑素含量 ,白天为 (5 8.77± 8.4 4 )pg/ml,夜间为 (2 4 8.4 7± 2 7.2 1)pg/ml,仍呈白天低 ,夜间高的周期性变化。X线检查 :对照组 10只鸡无脊柱侧凸发生 ;松果体切除组 2 0只鸡中 9只鸡发生了脊柱侧凸 ,发生率为 4 5 % ;松果体蒂部切断组 2 0只鸡中有 11只发生了侧弯 ,发生率为 5 5 %。结论　松果体切除和松果体蒂部     

褪黑素在鸡脊柱侧凸模型中的作用

目的应用松果体切除和持续光照来抑制褪黑素的分泌,验证褪黑素在鸡脊柱侧凸模型中的作用。方法刚孵育出的WhiteLeghorn鸡50只,随机分为三组。(1)10只作为对照,未行任何处理,在控制白天12h光照(光照度为500lx)、夜间12h完全黑暗(光照度为0～5lx)条件下饲养。(2)20只在出生后3d时行松果体切除术,抑制褪黑素的分泌,制造鸡脊柱侧凸模型。控制光照条件同对照组。(3)20只行持续光照(光照度为500lx),抑制褪黑素的分泌,达到“生理性松果体切除”的目的。(4)每月行X线检查,观察所有鸡脊柱的改变。(5)3个月时,留取所有鸡白天和夜间的静脉血,用ELISA试剂盒测定血清中褪黑素含量。结果(1)3个月时,对照组均无脊柱侧凸发生。松果体切除组中,术后第1个月X线检查时即发现4只鸡出现明显的脊柱侧凸,侧凸在随后的2个月中进行性加重。在2个月时共有7只鸡出现明显侧凸。3个月时,11只鸡发生侧凸,发生率为55%,Cobb角为11°～85°,平均30.63°。持续光照组3个月时仍无脊柱侧凸发生。(2)对照组血清褪黑素呈现明显的白天低(平均10.6pg/ml),夜间高(平均110.4pg/ml)的周期性变化;松果体切除组血清褪黑素白天平均为8.4pg/ml、夜间平均为6.9pg/ml,其白天低、夜间高周期性变化消失;持续光照组中,血清褪黑素平均为10.8pg/ml。松果体切除     

腹腔注射褪黑素受体拮抗剂对鸡脊柱发育的影响

[目的]探讨鸡腹腔内注射褪黑素受体拮抗剂对鸡脊柱发育的影响.[方法]刚孵育出的国产绍兴小鸡45只,随机分为3组,每组15只.(1)对照组:在孵化3 d后控制白天12 h光照(光照度为500 lx)、夜间12 h完全黑暗(光照度为0～5 lx)条件下饲养.(2)手术组:在孵化后3 d时施行松果体切除术,光照条件同对照组.(3)拮抗剂组,在孵化3 d后,每天腹腔注射褪黑素受体拮抗剂30 mg/kg,光照条件同对照组.[结果]3个月时对照组及拮抗剂组未发生脊柱侧凸,手术组共有7只小鸡发生了脊柱侧凸.[结论]松果体切除可以减少褪黑素的分泌,并诱导部分鸡发生脊柱侧凸.给予褪黑素MELl-a受体的拮抗剂Luzindole阻止褪黑素的作用并不能产生实验性脊柱侧凸.     

双足直立诱导低褪黑素水平雌性小鼠脊柱侧凸模型的观察

【摘要】　目的：观察双足直立诱导低褪黑素水平雌性C57BL/6j小鼠脊柱侧凸的发生情况,为选择理想的特发性脊柱侧凸模型提供依据。方法：选取低褪黑素水平C57BL/6j小鼠雌、雄各20只,分为低褪黑素雌性小鼠组（A组）、低褪黑素雄性小鼠组（B组）,另选C3He/ej雄性小鼠20只作为对照组（C组）。将三组小鼠均于３周龄时施行双上肢截肢合并鼠尾切除术建立双足直立小鼠模型,然后进行直立体态诱导。术后4个月,采用X线片评估三组小鼠脊柱侧凸发生情况,比较三组间脊柱侧凸发生率和侧凸严重程度。结果：三组小鼠建模后经直立体态诱导均可长时间保持直立体态。A组19只发生脊柱侧凸,侧凸小鼠Cobb角17°~36°,平均24.6°±6.0°;B组16只发生脊柱侧凸,侧凸小鼠Cobb角13°~31°,平均20.8°±4.3°;C组9只发生脊柱侧凸,侧凸小鼠Cobb角13°~23°,平均18.3°±2.7°。A、B组小鼠脊柱侧凸发生率均明显高于C组（χ2=11.904,P=0.005;χ2=5.2267,P=0.023）,A、B两组脊柱侧凸发生率无显著性差异（P<0.05）。A组脊柱侧凸Cobb角明显高于B组（t=2.096,P=0.044）和C组（t=3.646,P=0.001）;B组与C组Cobb角无显著性差异（P>0.05）。结论：雌性低褪黑素双足直立小鼠脊柱侧凸发生率高,脊柱侧凸更严重,可以较好模拟特发性脊柱侧凸的发生发展过程,为特发性脊柱侧凸相关研究提供良好平台。     

特发性脊柱侧凸双侧椎旁肌褪黑素受体含量的差异性比较研究

目的研究特发性脊柱侧凸椎旁肌中褪黑素受体含量的变化,并探讨其与特发性脊柱侧凸病因学的关系。方法本实验共分3组:特发性脊柱侧凸组:20例,平均Cobb角56°±16°,顶椎位于T6-11。其中Cobb角>50°10例,Cobb角≤50°10例。先天性脊柱侧凸组:12例,平均Cobb角59°±33°,顶椎位于T7-12。对照组:取10例非脊柱侧凸病例作为对照。采用RT-PCR方法检测所有病例两侧椎旁肌中褪黑素受体两种亚型MT1、MT2mRNA的表达量。结果特发性脊柱侧凸和先天性脊柱侧凸组顶椎区凹侧椎旁肌MT2mRNA的表达量明显小于凸侧(P<0·05),MT1mRNA的表达量两侧无显著差异(P>0·05)。特发性脊柱侧凸组中Cobb角>50°的病例顶椎区凹凸侧椎旁肌MT2mRNA表达量的比值与Cobb角≤50°的病例无显著差异(P>0·05)。对照组两侧椎旁肌MT1、MT2mRNA的表达量无显著差异(P>0·05)。结论特发性脊柱侧凸患者两侧椎旁肌MT2mRNA的表达量存在差异,这种差异可能为继发性改变,在特发性脊柱侧凸的发病中不起主要作用。     

褪黑素在特发性脊柱侧凸发病中作用的研究进展

近年来,学者们对褪黑素在特发性脊柱侧凸发病中的作用进行了全面深入的研究,取得了不少令人鼓舞的成就,也出现了不少的争论。笔者就此作一综述。1松果体切除与褪黑素及脊柱侧凸的关系松果体切除术可以造成鸡脊柱侧凸模型,但很多研究显示并不是所有进行松果体切除的动物一定会发生脊柱侧凸。Machida等[1]报道切除松果体的小鸡均发展成脊柱侧凸,而其他学者报道发生率为48%~70%。Machida认为,这种差异是由于术后观察时间不同造成的。不管怎样,鸡松果体切除后可产生脊柱侧凸是一个实验事实。由于松果体的基本功能是产生褪黑素,因此,学者们认为…     

褪黑素对青少年特发性脊柱侧凸骨代谢的影响

褪黑素（Melatonin，MEL）为吲哚类激素，主要由松果体分泌，与其受体结合后发挥作用。褪黑素的分泌随着年龄的增长变化显著，出生时分泌很少，3个月后迅速增加并出现规律的昼低夜高节律，在1～3岁时达分泌高峰，以后逐渐下降，至成人时约为高峰的20％。近年来，有关褪黑素对骨代谢影响的研究很多，笔者就此及褪黑素与青少年特发性脊柱侧凸（adolescent idiopathic scoliosis，AIS）患者骨量减低的关系作一综述。     

特发性脊柱侧凸褪黑素信号传导通路的研究进展及其临床意义

青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)是一个复杂的三维脊柱畸形,常累及青春期10～16岁的女孩.AIS的病因尚小清楚,近来褪黑素信号传导通路的深入研究使得褪黑素(melatonin)与侧凸之间的相关性再次成为AIS病因学研究的一个热点.     

不同剂量褪黑素对松果体切除鸡脊柱侧凸发生率的影响

目的探讨不同剂量褪黑素在切除松果体鸡脊柱侧凸产生中的作用,阐明脊柱侧凸的发生率与给药方式及给药剂量的关系。方法刚孵化的雌性国产绍兴鸡50只,随机分为5组,每组10只。孵化后第3d行松果体切除术。(1)10只作为对照,在控制白天12h光照(光照度为500lx)、夜间12h完全黑暗(光照度为0～5lx)条件下饲养;(2)其余40只分为4组,每组10只,即M-5、M-10、M-20及M-40组,每天分别腹腔注射5mg/kg、10mg/kg、20mg/kg与40mg/kg的褪黑素制剂,控制光照条件同对照组。3个月后对所有动物行X线检查,观察脊柱的变化。结果3个月时共有25只发生了的脊柱侧凸。对照组、M-5、M-10、M-20以及M-40组中脊柱侧凸的发病数分别为6只(66.7%)、5只(50.0%)、5只(62.5%)、4只(50.0%)和5只(50.0%)。平均Cobb角为26.7°、23.5°、21.7°、24.5°和23.2°。M-5、M-10、M-20、M-40与对照组在脊柱侧凸的发生率和平均Cobb角上无明显差异。结论给予不同剂量的褪黑素并不能降低切除松果体鸡脊柱侧凸的发生率和侧凸的严重程度。     

褪黑素在特发性脊柱侧凸发病中作用的研究进展

特发性脊柱侧凸（idiopathic scoliosis，IS）是指无其他器质性疾病的脊柱结构性侧凸。褪黑素是松果体唯一分泌的激素，同睡眠等多种人体节律活动的调节相关。IS的病因至今仍不明确，深入认识IS的病因和发病机理，从该方面人手综合判断、治疗IS，将避免目前由于对其病因和发病机理认识不清而带来的误诊、误治以及并发症，进一步提高IS临床诊疗效果。本文将对褪黑素在IS发病中作用的研究进展作一综述。     

Radiographic evaluation of scoliosis: a reassessment and introduction of the scoliosis Chariot

Serial evaluation of scoliosis relies on measurement of curvature on radiographs. Progression or improvement is based solely on the assumption that the radiograph gives a true picture of the configuration of the spine in the AP projection, and that patient position remains constant with serial radiographs. Slight rotation of the patient allows the kyphosis or lordosis normally present in the spine to either increase or decrease the measured scoliosis curve, depending on the direction of rotation. Reliance on technician positioning of the patient introduces a random error of such a magnitude as to make serial evaluations invalid. The use of the Scoliosis Chariot as a positioning device guarantees reproducibility of patient position, thus eliminating the problem of random error.     

Pathological mechanism of idiopathic scoliosis: experimental scoliosis in pinealectomized rats

The pathological mechanism of curve progression in idiopathic scoliosis is still obscure. In this study we investigated the pathological mechanism of idiopathic scoliosis in experimentally induced scoliosis in rats. A total 30 rats were divided into three groups: ten bipedal rats with a sham operation, which served as the control; ten quadrupedal rats with pinealectomy; and ten bipedal rats with pinealectomy. Scoliosis developed only in pinealectomized bipedal rats and not in pinealectomized quadrupedal rats. Cervicothoracic lordosis developed in bipedal rats with or without pinealectomy. These deformities of lordoscoliosis in pinealectomized bipedal rats were similar to human idiopathic scoliosis. Lordosis or lordotic tendency was sufficient to cause the spine to rotate to the side. Rotational instability of the spine with rotation of lordotic segment appears to produce a characteristic scoliotic deformity as a secondary phenomenon. Our findings suggest that lordosis may develop in bipedal rats, but pinealectomy is required for the development of lordoscoliosis. Balanced muscle tone controlled by the postural reflex is important to maintain normal posture with a straight spine in the bipedal condition. The disturbance of equilibrium and other postural mechanisms secondary to a deficiency of melatonin after pinealectomy may promote development of lordoscoliosis with vertebral rotation especially in the bipedal posture.     

Idiopathic scoliosis: prognostic value of the profile

Summary A study was undertaken to establish the significance of the sagittal shape of the spine in 138 consecutively treated girls with early idiopathic thoracic scoliosis. All were treated in a Boston brace. Two groups were formed: group I consisted of 120 girls whose scoliosis remained stable in the brace, group II of 18 girls who required a spinal fusion for progressive curves despite the brace. For each spine, the orientation of each vertebra to the horizontal in the sagittal plane was measured on the earliest lateral radiogram, taken when the anterior curve still had a Cobb angle of less than 20°. A significant difference in spinal profile was found between the two groups. Progressive curves showed a more retroverted orientation of mid- and high thoracic vertebrae than stable curves.     

Surgical treatment for severe and rigid scoliosis: a case-matched study between idiopathic scoliosis and syringomyelia-associated scoliosis

Background Context

Treatment guidelines for severe and rigid syringomyelia-associated scoliosis (SRSMS) are limited. Typically, surgeons apply practice guidelines for severe and rigid idiopathic scoliosis (SRIS) to treat SRSMS. No study has directly compared the results of surgical treatment between patients with SRSMS and those with SRIS.

Intraspinal anomalies in scoliosis: An MRI analysis of 177 consecutive scoliosis patients

Background:

The association of intraspinal neural anomalies with scoliosis is known for more than six decades. However, there are no studies documenting the incidence of association of intraspinal anomalies in scoliotic patients in the Indian population. The guide lines to obtain an magnetic resonance imaging (MRI) scan to rule out neuro-axial abnormalities in presumed adolescent idiopathic scoliosis are also not clear. We conducted a prospective study (a) to document and analyze the incidence and types of intraspinal anomalies in different types of scoliosis in Indian patients. (b) to identify clinico-radiological ‘indicators’ that best predict the findings of neuro-axial abnormalities in patients with presumed adolescent idiopathic scoliosis, which will alert the physician to the possible presence of intraspinal anomalies and optimize the use of MRI in this sub group of patients.

Materials and Methods:

The data from 177 consecutive scoliotic patients aged less than 21 years were analyzed. Patients were categorized into three groups; Group A - congenital scoliosis (n=60), group B -presumed idiopathic scoliosis (n=94) and group C - scoliosis secondary to neurofibromatosis, neuromuscular and connective tissue disorders (n=23). The presence and type of anomaly in the MRI was correlated to patient symptoms, clinical signs and curve characteristics.

Results:

The incidence of intraspinal anomalies in congenital scoliosis was 35% (21/60), with tethered cord due to filum terminale being the commonest anomaly (10/21). Patients with multiple vertebral anomalies had the highest incidence (48%) of neural anomalies and isolated hemi vertebrae had none. In presumed ‘idiopathic’ scoliosis patients the incidence was higher (16%) than previously reported. Arnold Chiari-I malformation (AC-I) with syringomyelia was the most common neural anomaly (9/15) and the incidence was higher in the presence of neurological findings (100%), apical kyphosis (66.6%) and early onset scoliosis. Isolated lumbar curves had no anomalies. In group-C, incidence was 22% and most of the anomalies were in curves with connective tissue disorders.

Conclusion:

The high incidence of intraspinal anomalies in presumed idiopathic scoliosis in our study group emphasizes the need for detailed examination for subtle neurological signs that accompany neuro-axial anomalies. Preoperative MRI screening is recommended in patients with presumed ‘idiopathic’ scoliosis who present at young age, with neurological findings and in curves with apical thoracic kyphosis.     

Morphology of scoliosis: three-dimensional evolution

The clinical examination of the scoliotic child's profile shows that it does not correspond to the physiological curvatures. This three-dimensional study of scoliosis shows evidence of the existence of three components, frontal, sagittal, and axial. Each generates a pathological displacement of the vertebrae maximal at the apical vertebral level. Because of rotation, in order to analyze each of the components, radiographs must be taken along the frontal or sagittal plane of the vertebrae. A comparative study of the sagittal and frontal components during progression of scoliosis indicates that the apical vertebrae are displaced not only laterally but also forward and then backward. The apical vertebrae are situated anteriorly with respect to the end vertebrae. If the scoliotic curves progress, the apical vertebrae eventually become displaced backward. During this displacement at a given moment they are situated in the frontal plane of the child at the same level as the upper end vertebra; then they come to lie behind this if the scoliosis continues to progress. This explains why, when observed from the side, the appearance changes and passes through three successive stages, lordosis, flat back, and kyphosis.     

单胸弯及单腰弯特发性脊柱侧凸的躯体生长参数研究

 目的 探讨单胸弯及单腰弯青少年特发性脊柱侧凸(adolescent idiopathic scoliosis, AIS) 女性患者的躯体生长发育特点。方法 研究对象包括 339例 AIS女性患者和 3914位同龄健康女孩, 实 足年龄 10~17岁。单胸弯 AIS女孩(端椎位于 T₁~T₁₂之间)220例, 单腰弯 AIS女孩(端椎位于 T₁₂~L₅之 间)119例;Cobb角为 32°±10°(15°~63°)。测量所有 AIS组和对照组女孩的身高、体重及臂长, 计算体重 指数(body mass index, BMI)及下肢长度, 并根据 Bjure校正公式计算 AIS女性患者的校正身高及校正 坐高。结果 单胸弯与单腰弯 AIS患者的身高及坐高在各年龄段间差异均无统计学意义;而两组 AIS 女性患者的校正身高及坐高均明显高于同龄对照组女孩。同时两组 AIS患者的臂长及下肢长度也显著 长于正常青少年。在 15岁年龄段, 单胸弯 AIS患者的体重显著低于正常青少年, 而单腰弯 AIS患儿的 体重在各年龄段均与正常青少年相似。结论 与同年龄段正常青少年相比, 单胸弯和单腰弯 AIS患者 可能具有共同的异常生长模式;此外, 与正常女孩及单腰弯 AIS女孩相比, 单胸弯 AIS患者体内脂肪含 量偏低的趋势更为明显。     

特发性与先天性脊柱侧凸患者肺功能障碍的差异性比较

目的：比较特发性脊柱侧凸（idiopathic scoliosis，IS）与先天性脊柱侧凸（congenital scoliosis．CS）患者肺功能参数的差异性。方法：术前检测214例脊柱侧凸患者的肺活量（vital capacity，VC）、用力肺活量（forced vital capacity，FVC）、第1秒用力呼气容积（forced expiratory volume in one second，FEV1）、最大呼气中期流量（maximal mid-expiratory flow，MMEF）、最大自主通气量（maximal voluntary ventilation，MVV），计算实测值占预计值百分比（实／预％），其中IS 141洌（IS组），CS73例（CS组），将肺功能指标与Cobb角进行相关分析。依据主弯顶椎所在位置分为胸段及非胸段侧凸两组，胸段侧凸依据Cobb角大小分为：Cobb角〈600（A组）、60&#176;≤Cobb角〈90&#176;（B组）、Cobb角≥90&#176;（C组）3组。分析胸段及非胸段IS、CS患者术前肺功能参数的差异．同时比较年龄≤10岁的IS、CS患者各参数的差异。结果：脊柱侧凸患者VC、FVC、FEV1、MMEF及MVV的实／预％与Cobb角呈显著性负相关（r=-0．40--0.55）。在胸段侧凸患者中，CS组的FEV1实／预％为64．2％，明显低于IS组患者的80．0％（P〈0．05）；不同Cobb角CS组患者的VC、FVC、FEV1、MVV实／预％值都较相应Cobb角的IS组患者低（P〈0．05）。非胸段侧凸患者中，CS组的VC、FVC、MVV的实／预％较IS组患者低（P〈0．05）。年龄≤10岁的CS与IS患者肺功能指标比较也具有显著性差异（P〈0．05）。结论：IS和CS患者均存在肺功能损害，但损害模式不同，IS以限制性通气功能障碍为特征，CS表现为混合性通气功能障碍；年龄和Cobb角相匹配时．无论在胸段还是非胸段，CS患者的肺功能损害均较IS患者严重；且两者肺功能损害的差异性在青春期前就存在。