山羊腰椎间盘损伤后P物质免疫染色阳性神经纤维的分布

目的 研究山羊椎间盘损伤后的组织学改变及P物质(substance P,SP)免疫染色阳性神经纤维在损伤纤维中的分布.方法 15只山羊,用直径1.2 mm的穿刺针刀刺伤L5/L6椎间盘前纤维环全层和L6/L7后部纤维环内侧,以L4/L5椎间盘作为完整对照椎间盘.分别于损伤后3周、3个月、6个月随机处死5只山羊.观察实验...     

腰椎间盘损伤后MRI表现及组织学改变的实验研究

目的：探讨山羊腰椎间盘损伤后不同时间点MRI表现和组织学改变。方法：15只山羊．人为刺伤L5／6椎间盘前纤维环全层和L6／7后部纤维环内层，在伤后3周、3个月、6个月进行腰椎MRI检查观察髓核和纤维环的信号改变，光镜下观察实验椎间盘后部纤维环组织学改变。结果：L6H椎间盘损伤后部纤维环内层后．在实验期间未发生愈合，通过MRI定性、定量分析发现，椎间盘出现退变，并随时间进行性加重（3周，3、6个月）．且退变过程较L5／6加速。他像上未发现一例出现HIZ。结论：经山羊椎间盘前方损伤后部纤维环内层后．纤维环内层很难愈合，早期出现椎间盘退变。     

胆囊良恶性病变组织中蛋白基因产物9.5的表达及临床意义

目的研究胆囊腺癌、癌旁组织、慢性胆囊炎组织中蛋白基因产物9.5(PGP9.5)表达及其临床病理意义。方法108例胆囊腺癌、46例癌旁组织和35例慢性胆囊炎切除标本常规石蜡包埋切片,PGP9.5染色方法为EnVisionTM免疫组化法。结果胆囊腺癌PGP9.5表达阳性率(45.4%)和评分(1.94±1.84)明显高于癌旁组织(17.4%,!2=10.83,P<0.01;0.86±1.41,t=3.60,P<0.01)和慢性胆囊炎组织(11.4%,!2=13.06,P<0.01;0.58±1.29,t=4.08,P<0.01);PGP9.5阳性良性病变胆囊上皮均呈中至重度不典型增生。患者年龄≤45岁、腺瘤癌变或高分化腺癌、肿块最大径<2cm、无淋巴结转移和未侵犯周围组织病例PGP9.5表达阳性率及其评分明显低于年龄>45岁、低分化腺癌、肿块最大径≥2cm、淋巴结转移和侵犯周围组织病例(P<0.05或P<0.01)。结论PGP9.5表达可能是反映胆囊腺癌发生、进展和预后的重要生物学标志物,检测胆囊良性病例PGP9.5表达水平对于预防和早期发现胆囊癌可能有重要临床意义。     

The nerve supply of the lumbar intervertebral disc

The anatomical studies, basic to our understanding of lumbar spine innervation through the sinu-vertebral nerves, are reviewed. Research in the 1980s suggested that pain sensation was conducted in part via the sympathetic system. These sensory pathways have now been clarified using sophisticated experimental and histochemical techniques confirming a dual pattern. One route enters the adjacent dorsal root segmentally, whereas the other supply is non-segmental ascending through the paravertebral sympathetic chain with re-entry through the thoracolumbar white rami communicantes. Sensory nerve endings in the degenerative lumbar disc penetrate deep into the disrupted nucleus pulposus, insensitive in the normal lumbar spine. Complex as well as free nerve endings would appear to contribute to pain transmission. The nature and mechanism of discogenic pain is still speculative but there is growing evidence to support a 'visceral pain' hypothesis, unique in the muscloskeletal system. This mechanism is open to 'peripheral sensitisation' and possibly 'central sensitisation' as a potential cause of chronic back pain.     

人工腰椎间盘置换术在腰椎间盘突出症治疗中的应用

目的 探讨人工椎间盘置换术治疗腰椎间盘突出症的方法。方法 应用德国LINK公司的人工腰椎间盘置换手术治疗6例腰椎间盘突出症患者,其中腰4.5椎间盘置换5例,腰5骰1椎间盘置换1例,全部病例均有神经根压迫症状,经MR或CT确诊。结果 6例患者术后经半年以上随诊,腰腿痛症状完全消失,术后4天下床活动,术后3个月检查置换椎间盘恢复活动。结论 人工腰椎间盘置换术适合55岁以下1～2个腰椎间盘病变的治疗,具有临床症状缓解迅速、彻底,能保持脊柱稳定和恢复腰椎间的活动,但应严格掌握手术适应证及手术的操作方法。     

微载体立体培养腰椎间盘细胞蛋白多糖表达的研究

目的研究腰椎间盘细胞在微载体培养与单层培养中细胞表达蛋白多糖含量的差别。方法椎间盘疾病手术病例的术中切除组织采用酶消化法分别进行微载体三维细胞培养和单层细胞培养;取胎儿椎间盘组织,显微镜下区分髓核细胞和纤维环细胞,分别进行培养,同成入组对照。利用^35S放射标记渗入放免定量测定的方法进行蛋白多糖含量的检测。结果①椎间盘细胞胞内的蛋白多糖含量（cpm）,细胞单层培养组为101．909±11．439,微载体立体培养组为136．607±10．792,P〈0．05;②椎间盘细胞表达的蛋白多糖含量（cpm）,细胞单层培养组为105．119±13．040,微载体立体培养组为174．231±17．676,P〈0．05;③各组椎间盘细胞表达的蛋白多糖含量均高于细胞内的含量;④胎儿腰椎间盘细胞蛋白多糖的含量及表达量均高于成人退变椎间盘细胞,胎儿髓核细胞蛋白多糖的表达量高于纤维环细胞的表达量。结论椎间盘细胞的微载体三维立体培养相对单层培养具有较高细胞蛋白多糖的表达量,是一种较好的细胞培养方式。     

P物质阳性神经纤维在退变腰椎间盘的分布及意义

目的研究P物质（substance P,SP）阳性神经纤维在腰椎间盘中的出现及分布,以探讨其在椎间盘退变中的潜在作用。方法收集16例患者的21个病变腰椎间盘和来自于新鲜尸体的12个正常对照椎间盘,行组织学检查和SP免疫组织化学染色检查。结果SP阳性神经纤维偶见于正常椎间盘,在病变椎间盘内可见较多的SP免疫反应阳性神经纤维分布,阳性神经纤维数量与腰椎间盘退变程度呈正相关。结论腰椎间盘退变程度和SP阳性神经纤维数量有明显的相关性,SP可能作为神经炎性介质加速了腰椎间盘的退变。     

Substance P-immunoreactive and protein gene product 9.5-immunoreactive nerve fibres in bone marrow of rat coccygeal vertebrae

Previous investigations have focused mainly on the nerve terminals in soft tissues surrounding the vertebrae to determine the source of spinal pain. Our study on rat coccygeal vertebrae compared intramedullary immunostaining for substance P with that of a more generally distributed neural marker, protein gene product 9.5, to suggest another source of spinal pain. Free intramedullary fibres staining for protein gene product 9.5 were rare compared with the abundant staining associated with intramedullary vessels. Shortly after entering the marrow with the nutrient vessels, substance P-immunoreactive fibres parted from the vessels and then proceeded longitudinally and terminated on the end-plates. Other (although fewer) substance P-immunoreactive fibres entered the marrow at enthetic aspects of the vertebrae. The presence of free substance P-immunoreactive fibres innervating endplates and penetrating entheses suggests that they may represent a novel source of spinal pain.