Design Characteristics for the Tissue Engineering of Cartilaginous Tissues

Tissues like the temporomandibular joint (TMJ) disc and the knee meniscus are often mistakenly viewed as a tantamount to hyaline cartilage, largely due to the absence of a comprehensive understanding of the distinguishing properties of cartilaginous tissues. Because of this confusion, fibrocartilaginous tissue engineering attempts may not be based on suitable experimental designs. Fibrocartilaginous tissues are markedly different than hyaline cartilage; however, the dearth of knowledge related to their cellular and biochemical composition, as well as their biomechanical characteristics, is stunning. Hyaline articular cartilage is exclusively composed of chondrocytes that produce primarily type II collagen, whereas the TMJ disc and the knee meniscus have a mixed cell population of fibroblasts and cells similar to chondrocytes, which predominantly secrete type I collagen. Additionally, fibrocartilaginous tissues have a low glycosaminoglycan content, a low compressive modulus, and a high tensile modulus when compared to hyaline cartilage. Therefore, it is crucial for fibrocartilaginous tissue engineering attempts to be tissue-specific, utilizing the knowledge of the distinct and unique properties of these tissues. At the same time, advances and insights related to the science and engineering aspect of hyaline cartilage regeneration must be carefully considered for the in vitro engineering of fibrocartilaginous tissues.     

Current understanding of cellular and molecular events in intervertebral disc degeneration: implications for therapy

Until recently, material removed from the intervertebral disc (IVD) at surgery consisted either of 'loose bodies' from the centre of the IVD or discal tissue displaced (prolapsed) into the intervertebral root or spinal canals. This material is best regarded as a by-product of disc degeneration and therefore not representative of the disease process itself. Recent advances in surgical techniques, particularly anterior fusion, in which large segments of the anterior part of the IVD are excised with the anatomical relationships between different components intact, have generated material that can be investigated with modern molecular and cell biological techniques. This is an important area of study because degeneration of the lumbar IVDs is associated, perhaps causally, with low back pain, one of the most common and debilitating conditions in the West. 'Degeneration' carries implications of inevitable progression of wear-and-tear associated conditions. Modern research on human IVD tissue has shown that this is far from the case and that disruption of the micro-anatomy described as degeneration is an active process, regulated by locally produced molecules. The exciting consequence of this observation is the possibility of being able to inhibit or even reverse the processes of degeneration using targeted therapy.     

伴颈5/6椎间孔狭窄神经根型颈椎病影像学特点及临床意义

目的 观测伴C5/C6椎间孔狭窄神经根型颈椎病患者的颈椎间孔形态及三维空间下的各相关径值,分析并探讨其临床意义。方法 随机选取492例伴C5/C6椎间孔狭窄,在上海长征医院于2014年9月至2019年7月期间行手术治疗的神经根型颈椎病患者,行颈椎正侧位X线、颈椎CT、颈椎磁共振等检查,数字骨科系统重建后观测椎间孔形态并测量最佳投射角度下的纵径、上前后径、下前后径、横截面积、椎间隙高度等径值并对其进行统计学处理,比较病例组与正常成人组C5/C6椎间孔之间、病例组病变椎间孔与对侧椎间孔以及病例组中男女患者之间的差异。结果 病例组C5/C6椎间孔形态因骨赘增生等,以纺锤形、不规则形为主,病例组C5/C6椎间孔横径均值、纵径、横截面积、椎间隙平均高度分别为（5.81±1.40）mm、（10.45±1.70）mm、（50.02±15.46）mm2、（4.99±0.89）mm,均比正常成人组减小,且差异有统计学意义（P<0.01）;男女间比较差异无统计学意义（P>0.05）。结论 伴C5/C6椎间孔狭窄神经根型颈椎病患者的颈椎间孔的形态发生改变,导致椎间孔的横径均值及横截面积值均明显减小;椎间孔的横径在诊断颈椎间孔狭窄方面敏感性及特异性高;术中减压时应更加注重椎间孔横径的有效扩大,以提高手术效果。     

Microsurgical cordotomy in 20 patients with epi-/intradural fibrosis following operation for lumbar disc herniation

Summary Using an improved microsurgical technique, cordotomy was carried out by the cervicothoracic route in 20 patients with persistent radicular pain due to epi-/intradural fibrosis following operation for lumbar disc herniation. 65% of them had good long-term results with respect to radicular pain (follow-up period 6–132 months; mean 66 months). Permanent severe motor impairment was not observed. In patients with severe pain of benign organic origin microsurgical cordotomy can be considered as a last resort.     

The R-zero line: a new kinematic concept of the lumbar spine

Summary A new kinematic concept is described that relates to the notion that the lumbar spine behaves as a complete structure. This concept is called the R-zero line and represents kinematically the neutral position of the lumbar spine between anteflexion and retroflexion. The clinical significance of this parameter is evaluated in normal individuals and in patients with a symptomatic herniated disc at L4–5, with a symptomatic herniated disc at L5–S1, and with spondylolysis/spondylolisthesis. The results of this study show that the R-zero line has a characteristic configuration in all four test groups.     

骶管阻滞配用周围神经阻滞治疗腰椎间盘突出症的疗效

[目的 ]探讨非手术方法治疗腰椎间盘突出症的疗效 .[方法 ]将 98例腰椎间盘突出症患者分成腰痛组和腿痛组 ,前者采用骶管阻滞加严氏椎间隙阻滞法 ,后者采用骶管阻滞加腰大肌肌沟阻滞法 .[结果 ]两组治疗前后分值相比较均有显著性差异 ,其优良率分别为 88%和 84% .[结论 ]采用骶管阻滞加严氏椎间隙阻滞或腰大肌肌沟阻滞法治疗腰椎间盘突出症具有疗效     

中年人上颌前突错 的修复正畸疗效评价

目的　评价修复正畸法对中年人上颌前突错治疗的疗效。方法　应用修复正畸法在短时间内对 18例中年人 (女性 16例 ,男性 2例 ,平均年龄 45 .6岁 )上颌前突进行治疗 ,并以X线头颅侧位定位片分析方法 ,对其疗效进行评价。结果　经过修复正畸法治疗 ,上中切牙长轴明显舌侧倾斜 ,上下中切牙构成角度趋于正常 ,覆、覆盖关系基本接近正常 ;上下唇软组织最前点明显后退 ,侧貌形态显著改善。结论　修复正畸法为不适合正畸治疗的中年人错畸形提供了行之有效的治疗手段。     

女性输卵管结扎术后腰痛病机及医疗体育疗法

对女性输卵管结扎术后腰痛进行调查和病理分析 ,以中药配合医疗体育康复治疗术后腰痛 ,取得较好疗效 ,并提出预防措施。     

多节段颈椎间盘脱出的脊髓型颈椎病治疗的回顾性分析

目的：研究多节段颈间盘脱出症术式选择、减压范围及植骨的处理。方法：对48例患者的发病因素、病程及影像学表现特征进行分析。本组均采用颈椎前路减压自体髂骨植骨融合术,术后随访最平均4．7年。结果：治疗效果优：28例（58．3％）良：11例（22．9％）。可：6例（12．5％）,差：3例（6．3％）。结论多节段间盘脱出症减压手术应首先考虑前路手术。如临床症状不缓解,可待植骨愈合后再后后路减压手术。一般两个节段的间盘摘除基本可以解决多间盘脱出的颈椎病。有的原则是务必保持椎间高度。     

腰椎间盘突出症继发马尾神经综合征手术治疗的疗效

目的：研究腰椎间盘突出症继发马尾神经综合征手术治疗的疗效。方法：对６７例腰椎间盘突出症并发马尾神经综合征的患者发病因素、病程、影像学的表现特征、手术时机的选择同其治疗的随访结果进行综合分析。随访时间３个月至３．５年,平均１年４个月。结果：急性发病的患者其手术时机的选择同患者功能恢复的优良率有关,发病１周、２周、１个月、１个月以上疗效优良率分别为７２．２２％,６３．６４％,５０．００％,３３．３３％