小鼠骨髓基质细胞Kusa-A1体外成骨活性评价

目的:检测骨髓基质细胞系Kusa-A1体外成骨活性,分析其用于成骨细胞功能和分化机制研究的价值。方法:培养Kusa-A1细胞,在常规培养和成骨诱导培养条件下,分别检测细胞的体外成骨活性,包括碱性磷酸酶(ALP)活性、细胞钙沉积能力、体外矿化结节(CN)形成能力、骨桥蛋白(OPN)和骨钙素(OC)表达水平、NF-κB受体激活因子(RANKL)水平。结果:常规培养下,Kusa-A1细胞表现出较高碱性的ALP活性(约为0. 75IU/mg)、一定的钙沉积能力,并可检测到OPN和OC表达,但无CN形成,RANKL蛋白低于可检测水平。诱导培养条件下,细胞ALP活性先升高后降低、钙沉积量持续升高、OPN和OC表达水平后期显著提高,汇片后3~7d检测到大量CN形成,汇片后24h可检测到RANKL蛋白。结论:Kusa-A1可能是一种成骨前体细胞,经诱导可以向成骨细胞分化,在体外表现出良好的成骨细胞活性。Kusa-A1细胞可作为成骨细胞功能及其分化机制研究的模型细胞。     

Infection-stimulated infraosseus inflammation and bone destruction is increased in P-/E-selectin knockout mice

Infections of the dental pulp commonly result in infraosseus inflammation and bone destruction. However, the role of phagocytic leucocytes in the pathogenesis of pulpal infections has been uncertain. In this work we used P/E-/- selectin-deficient mice, which lack rolling adhesion of leucocytes to endothelium and mimic the human syndrome, leucocyte adhesion deficiency II (LAD-II), to test the hypothesis that phagocytic leucocytes protect against pulpal infection and subsequent periapical infraosseus bone resorption. P/E-/- mice and P/E+/+ wild-type controls were subjected to surgical pulp exposure, and both groups were infected with a mixture of pulpal pathogens including Prevotella intermedia, Fusobacterium nucleatum, Peptostreptococcus micros and Streptococcus intermedius. Animals were killed after 20 days, and the extent of infraosseus bone destruction was quantified by histomorphometry. In two separate experiments, P/E-/- mice had significantly greater bone resorption than P/E+/+ controls. The increased bone destruction correlated with a twofold decrease in polymorphonuclear (PMN) infiltration into periapical inflammatory tissues of P/E-/- mice. P/E-/- mice had higher tissue levels of the bone resorptive cytokine, interleukin (IL)-1alpha. Tissue levels of IL-2, IL-4, IL-10, tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) were all higher in P/E-/- mice, but the increases were not statistically significant. Only IL-12 was higher in P/E+/+ mice, possibly reflecting a greater number of infiltrating monocytes in wild-type mice. These findings demonstrate that phagocytic leucocytes are protective in this model, and suggest that elevated expression of inflammatory cytokines is responsible for the observed bone destruction.     

Case of localized scleroderma successfully treated with bath psoralen and ultraviolet A therapy

The patient was a 12-year-old girl with linear scleroderma distributed on the right abdomen, dorsal aspect of the right thigh, lower leg and foot. The initial regimen of oral prednisolone and methotrexate, or i.v. methylprednisolone failed in the treatment of the scleroderma. Then bath psoralen and ultraviolet A therapy (bath-PUVA) therapy of 0.2 J–4.0 J/cm² daily to total doses 62.8 J/cm² combined with oral prednisolone was started. After bath-PUVA therapy, regression of the skin sclerosis was observed, the possible mobile range of the right ankle was increased and histological examination confirmed improvement of the sclerosis. The successful results of bath-PUVA therapy in this case suggest its utility for localized scleroderma.     

Challenges in the Treatment of Severe Traumatic Brain Injury Based on Data in the Japan Neurotrauma Data Bank

The Japan Neurotrauma Data Bank is a source of epidemiological data for patients with severe traumatic brain injury (TBI) and is sponsored by the Japan Society of Neurotraumatology. In this report, we examined the changes in the treatment of severe TBI in Japan based on data of the Japan Neurotrauma Data Bank. Controlling and decreasing intracranial pressure (ICP) are the primary objective of severe TBI treatment. Brain-oriented whole-body control or neurocritical care, including control of cerebral perfusion pressure, respiration, and infusion, are also increasingly considered important because cerebral tissues require oxygenation to improve the outcomes of patients with severe TBI. The introduction of neurocritical care in Japan was delayed compared with that in Western countries. However, the rate of ICP monitoring increased from 28.0% in 2009 to 36.7% in 2015 and is currently likely to be higher. Neurocritical care has also become more common, but the functional prognosis of patients has not significantly improved in Japan. Changes in the background of patients with severe TBI suggest the need for improvement of acute-phase treatment for elderly patients. Appropriate social rehabilitation from the subacute to chronic phases and introduction of cellular therapeutics are also needed for patients with TBI.     

谷胱甘肽对顺铂致大鼠肾小管上皮细胞毒性的影响

目的 探讨顺铂对不同年龄大鼠肾小管上皮细胞的毒性及谷胱甘肽(GSH)对其影响。方法 从不同年龄的雄性大鼠分离的肾小管上皮细胞接种于96孔培养板，培养24h后加入一系列浓度的顺铂，或在加入顺铂前16和4h。分别加入GSH合成抑制剂：BSO和GSH的前体物半胱氨酸，再培养24h后用MTT方法检测细胞存活率。结果 顺铂对5、2月龄和3周龄大鼠肾小管上皮细胞半数抑制浓度(IC50)分别为243．42、178．16和159．06μmol／L；BSO能使3组IC50分别降低到1．62、1．30和1．47μmol／L，而半胱氨酸则可使3组IC50均大于5000μmol／L。结论 顺铂对不同年龄大鼠肾小管上皮细胞均具有明显的毒性，BSO和半胱氨酸可分别增强和减弱顺铂的毒性，间接证明细胞内GSH对顺铂所致大鼠肾小管上皮细胞毒性有保护作用。     

Technique of laparoscopic cholecystectomy combined with percutaneous papillary balloon dilatation under general anesthesia for cholecystocholedocholithiasis

Since the introduction of laparoscopic cholecystectomy (LC), the treatment of cholecystocholedocholithiasis has become a controversial issue among surgeons and endoscopists all over the world. We evaluated the effectiveness of LC combined with percutaneous papillary balloon dilatation (PPBD) under general anesthesia in the treatment of cholecystocholedocholithiasis in 22 patients. All stones in the bile duct were successfully evacuated into the duodenum in all patients. The PPBD was feasible in all patients under general anesthesia. The mean postoperative stay was 9 days. The overall length hospital stay and the duration of PTBD were 19 ± 7 days and 16 ± 8 days, respectively. There were no deaths nor major complications, although a transient hyperamylasemia was found in 10 patients (45%). Cholecystocholedocholithiasis was able to be treated by means of LC combined with PPBD under general anesthesia without laparotomy, sphincterotomy or choledochotomy. This technique can be a choice for the treatment that enables a patient to avoid any discomfort arisen as a result of papillary dilatation.