Objective To introduce the research of cell transplantation for treating intervertebral disc degeneration. Methods The original articles in recent years about cell transplantation for treating intervertebral disc degeneration were extensively reviewed, and retrospective and comprehensive analysis was performed. Results Transplantation of intevertebraldisc-derived cells or BMSCs by pure cell transplantation or combined with collagen scaffold into intervertebral disc couldexpress nucleus pulposus-l ike phenotype. All the cells transplanted into intervertebral disc could increase extracellular matrix synthesis and rel ieve or even inhibit further intervertebral disc degeneration. Conclusion Cell transplantation for treating intervertebral disc degeneration may be a promising approach.
目的 比较拉米夫定+阿德福韦酯联合治疗与阿德福韦酯单药治疗对阿德福韦酯停药后出现病毒学反弹而无基因型耐药变异患者的疗效及安全性。 方法 回顾研究2007年1月－2012年1月在传染科门诊就诊的67例阿德福韦酯治疗获得病毒学应答但停药后出现病毒学反弹的e抗原阳性慢性乙型肝炎患者，分别给予拉米夫定+阿德福韦酯联合治疗（联合组，n=35）和阿德福韦酯单药治疗（单药组，n=32）。 结果 治疗1年后，联合组（32例，85.7%）较单药组（21例，65.6%）有更多的患者重新获得了丙氨酸转氨酶复常（P=0.009），联合组34例（97.1%）乙型肝炎病毒DNA阴转，单药组22例（68.8%）阴转，两组差异有统计学意义（P=0.002）；在血清学转换方面，联合组和单药组分别有4例（11.4%）和1例（3.1%）患者获得了e抗原的血清学转换。在治疗中所有患者均未发生任何严重不良反应。 结论 阿德福韦酯停药后出现病毒学反弹，选择拉米夫定与阿德福韦酯联合治疗可使患者重新获得较好的生化学和病毒学应答。
The competing endogenous RNA (ceRNA) hypothesis is a new pattern of gene posttranscriptional regulation. Encoding mRNA, long noncoding RNA (lncRNA), pseudogene transcript, circular RNA (circRNA), etc. can regulate gene expression by binding microRNA (miRNA). According to the research, ceRNA regulatory network participates in the maintenance of normal physiological state, occurrence and development of diseases. This paper reviewed ceRNA with the following respects: the proposal of ceRNA hypothesis, members of ceRNA regulatory network, research status, limitations and future development directions of this hypothesis. It will contribute to clarify the pathogenesis of much diseases including tumor and provide a new strategy for the diagnosis and treatment of disease.
To investigate cl inical outcomes of percutaneous kyphoplasty with balloon in the treatment of severe osteoporotic thoracic vertebral compression fracture (SVCF). Methods From May 2006 to July 2007, percutaneous unilateral kyphoplasty with single balloon was performed in 7 vertebras of 6 SVCF patients, with 2 injured vertebras in 2 malesand 5 in 4 females, who were from 64 to 83 years old. The injured vertebras included 1 in T5, 2 in T8, 3 in T10 and 1 in T12 and the compression rates were 60% to 75% in 5 vertebras and gt; 75% in 2 vertebras. All the injured vertebras were old fractures and caused severe back pain, but without any neurotic symptoms and signs. The visual analogue scale (VAS) ranged from 6.5 to 9.0, 7.7 on average. The posterior vertebral walls were all intact in all patients under CT scan. The balloon was inset into the vertebra through pedicle of vertebral arch by percutaneous puncture under the guidance of C-type arm X-ray unit. The balloon was then extended to restore the vertebral body which was filled with bone cement later. The average volume of cement required was 3.5 mL (2.6 to 4.4 mL). Results The pain was alleviated or completely rel ieved after the operation. The mean vertebral body height restoration was 9.7% ±1.4% on the anterior border. Two cement leakages were found on X-ray. One month after the treatment, the VAS was from 0 to 2.45, 1.32 on average, and there was significant difference compared with preoperation (P lt; 0. 05). Three months after the treatment, the VAS was from 0 to 3, 2.13 on average, and there was no significant difference compared with 1 month after the treatment (P gt; 0.05). It was not found that the injured vertebras were compressed or deformed, and no new compressed fracture was found in consecutive vertebras. Conclusion Unilateral posterior-lateral puncture kyphoplasty with single balloon can rel ieve the pain and restore part of the vertebral height effectively with better outcomes.
ObjectiveTo describe the imaging and clinical features of vaccinia virus induced pneumonia by long-term follow-up.MethodsThe clinical data, imaging features and long-term follow-up of 5 patients with vaccinia virus pneumonia admitted to Wuxi People's Hospital Affiliated to Nanjing Medical University were analyzed.ResultsAll the 5 patients were male, aged between 21 and 54 years. The latent period of the disease was 2 to 5 days. All the patients had fever and pneumonia, while 3 of them had herpes. Two patients with severe pneumonia showed extensive patchy and nodular shadows in both lungs. Chest CT findings of the other three patients showed scattered small nodules in both lungs. All patients were followed up by telephone every half a year for 3 years. The prognosis of all patients was good. The patients reported in the English literature were clinically clustered, with fever, vomiting and rash as the main symptoms.ConclusionsVaccinia virus may cause different clinical symptoms through different transmission routes, and its infectivity is strong. Biological protection should be strengthened in laboratory and working environment.
为实现培养实用型与创新性相结合人才的教育目标,我们对传统的预防医学实验教学模式进行了改革,包括实验内容、考核方式、学生参与实验准备等环节。通过改革,充分激发了学生的积极性和自主性,提高了学生的实际动手能力,增强了学生的团队合作精神和创新意识,有利于学生综合素质的提高。
【Abstract】ObjectiveTo evaluate the clinical value of magnetic resonance cholangiopancreatography (MRCP) in diagnosis of extrahepatic bile duct obstruction. MethodsMRCP images of 42 patients presented clinically with obstructive jaundice were retrospectively reviewed to assess the lumen morphological abnormalities of benign versus malignant bile duct obstructions, with clinicalpathological correlation. ResultsThe bile duct of the 30 cases of benign biliary obstruction presented regular and symmetric dilation, gradual tapering,regular thickening and had a “beaklike” tip. The accuracy of MRCP for evaluating the site and the etiology of the benign biliary obstruction were 100%(30/30) and 97%(29/30) respectively. The bile duct of the 12 cases of malignant biliary obstruction presented irregular and asymmetric dilation,abrupt narrowing or iterruption,irregular thickening and had “dualduct sign”. The accuracy of MRCP for evaluating the site and the etiology of the malignant biliary obstruction were 100%(12/12) and 92%(11/12) respectively. ConclusionMRCP is the noninvasive technique of choice with excellent accuracy for the evaluation of obstructive biliary pathology.
OBJECTIVE: To investigate the diagnostic criteria and therapeutic method of the Klippel-Trenaunay syndrome. METHODS: Among 5 cases, there were 2 males and 3 females aged from 11 days to 73 years. Vasography was carried out in all five patients and MRA was performed in one patients. RESULTS: After operation, the symptoms improved in 4 cases: the portine-like erythemas on their limbs got unclear; the focuses diminished obviously; the circumferences of the suffered limbs shrank and the ulcer healed. For following-up period was not long enough, the long term therapeatic result was still uncertain. CONCLUSION: Once the diagnosis of the Klippel-Trenaunay syndrome was made, operation should be performed as early as possible. If the surgical time is selected in prepuberty, optimal result can be expected.
Objective To investigate the therapeutic effect of BMSCs- chitosan hydrogel complex transplantation on intervertebral disc degeneration and to provide experimental basis for its cl inical appl ication. Methods Two mill il iter of bone marrow from 6 healthy one-month-old New Zealand rabbits were selected to isolate and culture BMSCs. Then, BMSCs at passage 3 were labeled by 5-BrdU and mixed with chitosan hydrogel to prepare BMSCs- chitosan hydrogel complex. Six rabbitswere selected to establ ish the model of intervertebral disc degeneration and randomized into 3 groups (n=2 per group): control group in which intervertebral disc was separated and exposed but without further processing; transplantation group in which 30 μL of autogenous BMSCs- chitosan hydrogel complex was injected into the center of defected intervertebral disc; degeneration group in which only 30 μL of 0.01 mol/L PBS solution was injected. Animals were killed 4 weeks later and the repaired discs were obtained. Then cell 5-BrdU label ing detection, HE staining, aggrecan safranin O staining, Col II immunohistochemical staining and gray value detection were conducted. Results Cell label ing detection showed that autogenous BMSCs survived and prol iferated after transplantation, forming cell clone. HE staining showed that in the control and transplantation groups, the intervertebral disc had a clear structure, a distinct boundary between the central nucleus pulposus and the outer anulus fibrosus, and the obviously stained cell nuclear and cytochylema; while the intervertebral disc in the degeneration group had a deranged structure and an indistinct division between the nucleus pulposus and the outer anulus fibrosus. Aggrecan safarine O stainning notified that intervertebral disc in the control and transplantation groups were stained obviously, with a clear structure; while the intervertebral disc in the degeneration group demonstrated a deranged structure with an indistinct division between the nucleus pulposus and the anulus fibrosus. Col II immunohistochemical staining showed that the tawny-stained region in the control group was located primarily in the central nucleus pulposus with a clear structure of intervertebral disc, the central nucleus pulposus in the transplantation group was positive with obvious tawny-stained intercellular substances and a complete gross structure, while the stained color in the degeneration group was l ighter than that of other two groups, with a indistinct structure.Gray value assay of Col II immunohistochemical staining section showed that the gray value of the control, the ransplantation and the degeneration group was 223.84 ± 3.93, 221.03 ± 3.53 and 172.50 ± 3.13, respectively, indicating there was no significant difference between the control and the transplantation group (P gt; 0.05), but a significant difference between the control and transplantation groups and the degeneration group (P lt; 0.05). Conclusion The rabbit BMSCs-chitosan hydrogel complex can repair intervertebral disc degeneration, providing an experimental foundation for the cl inical appl ication of injectable tissue engineered nucleus pulposus complex to treat intervertebral disc degeneration.
Objective To detect the cell density, apoptotic rate, and the expressions of BNIP3 in nucleus pulposus of degenerative intervertebral disc of rabbits, so as to further understand the mechanism of intervertebral disc degeneration. Methods Thirty male New Zealand white rabbits, aging 3 months and weighing (2.3 ± 0.2) kg, were divided into sham operation group (control group, n=10) and intervertebral disc degeneration model group (experimental group, n=20). Interbertebral disc degeneration models were establ ished by puncture of L3,4, L4,5, and L5,6 intervertebral discs in the experimental group; intervertebral discs were exposed only and then sutured in the control group. The degree of intervertebral disc degeneration was evaluated according to Pfirrmann classification by MRI at 4 and 8 weeks after establ ishing models. Apototic cells were determined by TUNEL and histological methods, and the immunohistochemical staining was performed to detect the expressions of BNIP3 in nucleus pulposus of intervertebral disc. Results MRI examination showed that the signal intensity decreased gradually at 4 and 8 weeks in the experimental group. There wassignificant difference in the degree of intervertebral disc degeneration between at 4 weeks and at 8 weeks in the experimental group (P lt; 0.05). The histological observation and TUNEL test showed that high density of nucleus pulposus cells and only a few apoptotic cells were observed in the control group; at 4 and 8 weeks, the density of nucleus pulposus cells decreased gradually with more apoptotic cells in the experimental group. There were significant differences in the nucleus pulposus cell density and positive rate of TUNEL staining between 2 groups, and between at 4 weeks and at 8 weeks in the experimental group (P lt; 0.05). The expression of BNIP3 of nucleus pulposus was negative in the control group; however, in the experimental group, the positive expression rates of BNIP3 of nucleus pulposus (the gray values) were 13.45% ± 1.16% and 32.00% ± 1.82% (194.32 ± 4.65 and 117.54 ± 2.11) at 4 and 8 weeks respectively, showing significant differences (P lt; 0.05). Conclusion The decrease of cell density in nucleus pulposus is involved in the development of intervertebral disc degeneration. Cell apoptosis is one of reasons in the decrease of nucleus pulposus cell; BNIP3 is involved in nucleus pulposus cell apoptosis in the degenerative intervertebral disc.