Objective To introduce the research advances of scaffold materials of intervertebral disc tissue engineering. Methods The recent original articlesabout the scaffolds in intervertebral disc tissue engineering were extensively reviewed. Results At present, agarose, alginate gel, collagentype Ⅰ, PLA, PGAare still major scaffold materials for intervertebral disc tissue engineering because of their good biocompatibility. Conclusion It is one of the popular studies on current intervertebral disc tissue engineering to explore the ideal scaffold materials.
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 research the biological feature of intervertebral disc nucleus pulposus cells (NPCs) by observing cell morphous, phenotype and ultramicrostructure. Methods The NPCs from 2-week-old healthy rabbit werecultured in DMEM/F12 medium with 15% FBS. The cell biological features were observed by inverted phase contrast microscope, l ight microscope, electron microscope, cell vital ity assay, cell growth curve and cells staining after harvest and during the periods of culturing the primary, the 1st passage and 2nd passage. Results The results of inverted phase contrast microscope showed that the primary passage adhered at 5 days, grew exponentially at 6-8 days, and were subcultured after covering the bottom at 17 days. The phenotype of the NPCs changed from polygon to long fusiform with passage increased; the vital ity assay showed that there was about 95%-97%, 98%-100%, 100% and 75%-80% NPCs survived just after isolation from intervertebral disc, during the period of culturing the primary, the 1st passage and the 2nd passage, respectively. The toluidine blue staining of the NPCs was bly positive, and HE staining showed clear cell nucleus and cytoplasm. The I collagen immunohistochemical staining showed negative results in the 1st passage, but II collagen immunohistochemical staining and safranin O staining showed positive results. However, the I collagen immunohistochemical staining showed positive result in the 2nd passage, and II collagen immunohistochemical staining and safranin O staining showed weakly positive results. The cell growth curve showed the same as the growth course of cell cultured in vitro. The results of TEM showed that there were many glycogen particles and less chondriosomes in the primary passage. With the increased passage, the glycogen particles decreased and the chondriosomes increased, and cell organ became swell. Conclusion This study clarifies the biological feature of NPCs in vitro, providing the experimental basis for the seed cell research of the nuclues pulposus tissue.
目的 总结大型灾害情况下，急诊伤员信息收集流程，为制定大型灾害救援提供证据支持。 方法 回顾性分析汶川地震（2008年5月12日－6月2日）和玉树地震（2010年4月14日－5月1日）伤员信息收集方法，总结两次地震伤员信息收集管理过程中发现的问题及取得的经验。 结果 通过制作地震伤员登记表、调整病历收集与管理模式、分诊提前、伤员信息登记提前，调整急诊功能分区、头像采集技术的使用、成批伤员信息资料袋和分诊信息卡的应用，最大限度地保证了伤员信息收集的完整性。 结论 地震伤员信息资料的准确性、完整性、及时性在伤员的救治、伤员的查找、伤员的转归和各类医疗信息的收集，以及制定大型灾害事故应急预案等方面起着非常重要的作用。
Objective To retrospectively analyze the effectiveness of percutaneous anterior odontoid and transarticular screw fixation for type II odontoid fracture treated in the elderly patients. Methods Between October 2009 and March 2012, 5 patients with odontoid fracture were treated with anterior triple screws fixation. There were 4 males and 1 female with an average age of 69.4 years (range, 65-74 years). Fracture was caused by falling injury from height in all cases. The average time between injury and operation was 6.8 days (range, 3-12 days). According to Anderson-D’Alonzo classification system, all 5 cases were classified as type II odontoid fractures; 1 case accompanied by anterior arch fracture. Four cases were rated as grade E and 1 case as grade D on the basis of Frankel classification system on nerve function evaluation. Percutaneous anterior odontoid and transarticular screw fixation were used in all cases. The operation time, intra-operative blood loss, X-ray exposure time, and complications were recorded. The X-ray films were taken to observe atlantoaxial stability and implant conditions. Results All patients were successfully complete the surgery, and no open operation was needed. The average operation time was 103.6 minutes (range, 93-114 minutes). The average intra-operative blood loss was 5.6 mL (range, 3-10 mL). The average X-ray exposure time was 24.2 seconds (range, 17-32 seconds). Good reduction of atlantoaxial joint and primary healing of incision were obtained in 5 patients. The average follow-up duration was 21.4 months (range, 12-35 months). Transient dysphagia occurred in 3 cases, and was cured after 5 days of expectant treatment. No major complications of carotid artery laceration, spinal cord injury, esophageal perforation, airway obstruction, and implant failure occurred. The X-ray films showed odontoid bony union, atlantoaxial stability and good position of screws. The average time of odontoid fracture union was 7 months (range, 5-10 months). Five patients had normal neurological function (Frankel grade E) at last follow-up. Three patients complained of neck discomfort and movement limitation and had normal daily activities without special therapy; the other 2 patients had no clinical symptom of discomfort. Conclusion Percutaneous anterior odontoid and transarticular screw fixation is a safe and effective procedure for treatment of type II odontoid fractures in the elderly patients with minimally invasive surgical advantages.
Objective To compare the growth and extracellular matrix biosynthesis of nucleus pulposus cells (NPCs)and bone marrow mesenchymal stem cells (BMSCs) in thermo-sensitive chitosan hydrogel and to choose seed cells for injectable tissue engineered nucleus pulposus. Methods NPCs were isolated and cultured from 3-week-old New Zealand rabbits (male or female, weighing 150-200 g). BMSCs were isolated and cultured from bone marrow of 1-month-old New Zealand rabbits (male or female, weighing 1.0-1.5 kg). The thermo-sensitive chitosan hydrogel scaffold was made of chitosan, disodium β glycerophosphate, and hydroxyethyl cellulose. Then, NPCs at the 2nd passage or BMSCs at the 3rd passage were mixed with chitosan hydrogel to prepare NPCs or BMSCs-chitosan hydrogel complex as injectable tissue engineered nucleus pulposus. The viabil ities of NPCs and BMSCs in the chitosan hydrogel were observed 2 days after compound culture. The shapes and distributions of NPCs and BMSCs on the scaffold were observed by scanning electron microscope (SEM) 1 week after compound culture. The histology and immunohistochemistry examination were performed. The expressions of aggrecan and collagen type II mRNA were analyzed by RT-PCR 3 weeks after compound culture. Results The thermo-sensitive chitosan hydrogel was l iquid at room temperature and sol idified into gel at37 (after 15 minutes) due to crossl inking reaction. Acridine orange/propidium iodide staining showed that the viabil ity rates of NPCs and BMSCs in chitosan hydrogel were above 90%. The SEM observation demonstrated that the NPCs and BMSCs distributed in the reticulate scaffold, with extracellular matrix on their surfaces. The results of HE, safranin O histology and immunohistochemistry staining confirmed that the NPCs and BMSCs in chitosan hydrogel were capable of producing extracellular matrix. RT-PCR results showed that the expressions of collagen type II and aggrecan mRNA were 0.564 ± 0.071 and 0.725 ± 0.046 in NPCs culture with chitosan hydrogel, and 0.713 ± 0.058 and 0.852 ± 0.076 in BMSCs culture with chitosan hydrogel; showing significant difference (P lt; 0.05). Conclusion The thermo-sensitive chitosan hydrogel has good cellular compatibil ity. BMSCs culture with chitosan hydrogel maintains better cell shape, prol iferation, and extracellular matrix biosynthesis than NPCs.
Objective To investigate the feasibil ity of using thermo-sensitive chitosan hydrogen as a scaffold to construct tissue engineered injectable nucleus pulposus (NP). Methods Three-month-old neonatal New Zealand rabbits (male or female) weighing 150-200 g were selected to isolate and culture NP cells. The thermo-sensitive chitosan hydrogel scaffold wasmade of chitosan, disodium β-glycerophosphate and hydroxyethyl cellulose. Its physical properties and gross condition were observed. The tissue engineered NP was constructed by compounding the scaffold and rabbit NP cells. Then, the viabil ity of NP cells in the chitosan hydrogel was observed 2 days after compound culture and the growth condition of NP cells on the scaffold was observed by SEM 7 days after compound culture. NP cells went through histology and immunohistochemistry detection and their secretion of aggrecan and expression of Col II mRNA were analyzed by RT-PCR 21 days after compound culture. Results The thermo-sensitive chitosan hydrogel was l iquid at room temperature and sol idified into gel at 37 (15 minutes) due to crossl inking reaction. Acridine orange-propidiumiodide staining showed that the viabil ity rate of NP cells in chitosan hydrogel was above 90%. Scanning electron microscope observation demonstrated that the NP cells were distributed in the reticulate scaffold, with ECM on their surfaces. The results of HE, toluidine blue, safranin O and histology and immunohistochemistry staining confirmed that the NP cells in chitosan hydrogel were capable of producing ECM. RT-PCR results showed that the secretion of Col II and aggrecan mRNA in NP cells cultured three-dimensionally by chitosan hydrogen scaffold were 0.631 ± 0.064 and 0.832 ± 0.052, respectively,showing more strengths of producing matrix than that of monolayer culture (0.528 ± 0.039, 0.773 ± 0.046) with a significant difference (P lt; 0.05). Conclusion With good cellular compatibilities, the thermo-sensitive chitosan hydrogel makes it possible for NP cells to maintain their normal morphology and secretion after compound culture, and may be a potential NP cells carrier for tissue engineered NP.
【Abstract】 Objective To detect the expression of Bcl-2/adenovirus E1B 19-kDa-interacting protein 3 (BNIP3)in cell death induced by nutrition deprivation in nucleus pulposus cells so as to further understand the mechanism of deathin nucleus pulposus cells. Methods Two adult Sprague Dawley rats, male or female, weighing 150-200 g, were involvedin this experiment. The cells isolated from rat caudal disc were cultured under the condition of L-DMEM culture media,10%FBS, and 21%O2 (control group) and under the condition of DMEM-free glucose culture media, no serum, and 1% O2(experimental group). The expressions of BNIP3 gene and protein were detected by real-time fluorescent quantitative PCR,immunofluorescence staining, and Western blot. The cell apoptosis rate and mitochondrial membrane potential were measuredby flow cytometry at 24, 48, and 72 hours after culture. Results The expression of BNIP3 decreased in the control group;the expressions of BNIP3 showed an increasing tendency with time in the experimental group, and BNIP3 combined withmitochondria. Significant differences were observed in the expressions of BNIP3 gene and protein between 2 groups at the othertime (P lt; 0.05) except that no significant difference was observed in the expression of BNIP3 gene at 24 hours (P gt; 0.05). Thecell apoptosis rate and mitochondrial membrane potential were significantly lower in the experimental group than those in thecontrol group (P lt; 0.05). Conclusion Upregulation of BNIP3 and translocation to mitochondria may be involved in nucleuspulposus cell death in nutrition deprivation.