龙虎交战针法联合悬吊训练对腰椎间盘突出症患者腰背伸肌群功能、神经传导速度和血清炎症因子的影响

摘要 目的：观察龙虎交战针法联合悬吊训练对腰椎间盘突出症（LDH）患者腰背伸肌群功能、神经传导速度和血清炎症因子的影响。方法：纳入我院2018年4月-2021年8月期间接收的LDH患者82例。按照随机数字表法将患者分为对照组（悬吊训练,n=41）和实验组（龙虎交战针法联合悬吊训练,n=41）。观察两组患者腰椎功能恢复情况、疼痛症状改善情况以及腰背伸肌群功能、神经传导速度和血清炎症因子的变化情况。结果：实验组的临床总有效率高于对照组（P<0.05）。治疗后,两组日本骨科协会下腰痛评价表（JOA）评分升高,且实验组高于对照组（P<0.05）。治疗后,两组Oswestry功能障碍指数（ODI）、视觉疼痛模拟评分法（VAS）评分下降,且实验组低于对照组（P<0.05）。治疗后,两组平均功率、腰背伸状态下峰力矩升高,且实验组高于对照组（P<0.05）。治疗后,两组腰背屈伸比下降,且实验组较对照组低（P<0.05）。治疗后,两组腓总神经和胫神经的传导速度均升高,且实验组较对照组高（P<0.05）。治疗后,两组血清白细胞介素-1β（IL-1β）、白介素-1（IL-1）、基质金属蛋白酶 3（MMP-3）、肿瘤坏死因子-α（TNF-α）水平均下降,且实验组低于对照组（P<0.05）。结论：龙虎交战针法联合悬吊训练可促进LDH患者腰椎功能改善,减轻疼痛症状,改善腰背伸肌群功能和腓总神经、胫神经的神经传导速度,降低机体血清炎症因子水平,具有较好的临床应用价值。     

Lumbar spine angles and intervertebral disc characteristics with end-range positions in three planes of motion in healthy people using upright MRI

Understanding changes in lumbar spine (LS) angles and intervertebral disc (IVD) behavior in end-range positions in healthy subjects can provide a basis for developing more specific LS models and comparing people with spine pathology. The purposes of this study are to quantify 3D LS angles and changes in IVD characteristics with end-range positions in 3 planes of motion using upright MRI in healthy people, and to determine which intervertebral segments contribute most in each plane of movement. Thirteen people (average age = 24.4 years, range 18–51 years; 9 females; BMI = 22.4 ± 1.8 kg/m²) with no history of low back pain were scanned in an upright MRI in standing, sitting flexion, sitting axial rotation (left, right), prone on elbows, prone extension, and standing lateral bending (left, right). Global and local intervertebral LS angles were measured. Anterior-posterior length of the IVD and location of the nucleus pulposus was measured. For the sagittal plane, lower LS segments contribute most to change in position, and the location of the nucleus pulposus migrated from a more posterior position in sitting flexion to a more anterior position in end-range extension. For lateral bending, the upper LS contributes most to end-range positions. Small degrees of intervertebral rotation (1–2°) across all levels were observed for axial plane positions. There were no systematic changes in IVD characteristics for axial or coronal plane positions.     

Genistein protects intervertebral discs from degeneration via Nrf2-mediated antioxidant defense system: An in vitro and in vivo study

Oxidative stress has been reported to be closely associated with the development of intervertebral disc degeneration (IDD). IDD is one of the major causes of low back pain. Genistein (GES), one of the main isoflavones of soybean, has been shown to exert multiple biological functions on different diseases. Here, we tested the therapeutic potential of GES for IDD. In vitro experiments, we confirmed GES was nontoxic to rat nucleus pulposus cells (NPCs) within the concentration of 100 μM. Furthermore, GES was able to suppress apoptosis in tert-butyl hydroperoxide (TBHP)-treated NPCs. In the aspect of extracellular matrix (ECM), GES not only reduced metalloproteinase-13 (MMP-13) and a disintegrin-like and MMP thrombospondin type 1 motif 5 expression, but also increased aggrecan and type II collagen levels. Also, we found GES might rescue TBHP-induced NPCs degeneration by enhancing Nrf2-mediated antioxidant defense system. Silencing Nrf2 partly abolished the protective effects of GES on apoptosis and ECM disruption in TBHP-treated NPCs. Correspondingly, GES ameliorated IDD in a rat model by preserving morphology of degenerative intervertebral discs and promoting Nrf2 expression. To sum up, our study suggests that GES exerts protective effects in NPCs against degeneration and reveals the underlying mechanism of GES on Nrf2 activation in NPCs.     

Isofraxidin attenuates IL-1β-induced inflammatory response in human nucleus pulposus cells

Inflammation has been demonstrated to be the key factor for intervertebral disc degeneration (IVD), which remains a major public health problem. Isofraxidin is a coumarin compound that possesses strong anti-inflammatory activity. However, the role of isofraxidin in IVD remains unclear. The aim of this study was to evaluate the effects of isofraxidin on inflammatory response in human nucleus pulposus cells (NPCs) exposed to interleukin-1β (IL-1β). The results proved that isofraxidin attenuated the IL-1β-induced significant increases in inflammatory mediators and cytokines including nitric oxide (NO), inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), tumor necrosis factor alpha (TNF-α), and IL-6. Besides, isofraxidin also inhibited the induction effect of IL-1β on matrix metalloproteinases (MMP)-3 and MMP-13. Moreover, the NF-κB activation caused by IL-1β was significantly inhibited by isofraxidin treatment. These findings suggested that isofraxidin alleviates IL-1β-induced inflammation in NPCs. Our work provided an idea that isofraxidin might act as a novel preventive role in IVD.     

Immunolocalization of MMP-19 in the human intervertebral disc: implications for disc aging and degeneration

Matrix metalloproteinases (MMPs) degrade components of the extracellular matrix of the disc, but the presence of MMP-19 has not been explored. In other tissues, MMP-19 is known to act in proteolysis of the insulin-like growth factor (IGF) binding protein-3, thereby exposing this protein to make it available to influence cell behavior. MMP-19 also has been shown to inhibit capillary-like formation and thus play a role in the avascular nature of the disc. Using immunohistochemistry, normal discs from six subjects aged newborn through 10 years and 20 disc specimens from control donors or surgical patients aged 15-76 (mean age 40.2 years) were examined for immunolocalization of MMP-19; six Thompson grade I discs, five Thompson grade II, eight Thompson grade III, five Thompson grade IV, and one Thompson grade V discs were analyzed. The results indicate that in discs from young subjects, MMP-19 was uniformly localized in the outer annulus. In discs from adult donors and surgical patients, outer and inner annulus cells only occasionally showed MMP-19 localization. The greatest expression of MMP-19 was observed in young discs, and little expression was seen in older or degenerating discs. Because MMP-19 has been shown to regulate IGF-mediated proliferation in other tissues, its decline in the aging/degenerating disc may contribute to the age-related decrease in disc cell numbers.     

铜绿假单胞菌体外对肠上皮细胞骨架的影响

为探索铜绿假单胞菌粘附肠上皮细胞后,细胞骨架特性的变化规律及可能的机制。采用微管吸吮实验技术并结合细胞ELISA、图像分析等方法研究体外绿脓杆菌粘附肠上皮细胞后细胞骨架的变化。结果显示细菌粘附后1h肠上皮细胞活力即开始下降,3h后IEC面积明显减小,而细胞周长无明显变化;胞内骨架蛋白减少,且随孵育时间的延长愈趋明显;细胞弹性系数K1、K2在粘附后3h明显降低,同时伴有粘性系数μ也明显下降。以上结果表明绿脓杆菌粘附肠上皮细胞后,细胞骨架成分改变,细胞骨架功能受损害,最终导致细胞损伤。     

人NK细胞对猪/人血管内皮细胞的差异粘附

采用^51Cr标记法和^3H-TdR摄入法研究了人外周血NK细胞（PBNK）和人NK细胞系－－NK92对猪主动脉内皮细胞（PAEC）和人脐静脉内皮细胞（HUVEC）的粘附作用。结果表明,NK92和PBNK对PAEC的粘附率显著高于对HUVEC的粘附率;rhTNF－α预刺激PAEC／HUVEC后,PBNK的粘附率呈现TNF－α剂量依赖性的增高;rhIFN－γ预刺激NK92／PBNK后,两者对PAEC粘附率的增幅均高于对HUVEC的增幅;CD11a（LFA－1）单抗可以以不同程度地抑制PBNK对静息和TNF－α激活的PAEC的粘附作用。这些结果显示,NK细胞在细胞介导的异种移植排斥反应中起重要作用。     

Structure,function, aging and turnover of aggrecan in the intervertebral disc

Background

Aggrecan is the major non-collagenous component of the intervertebral disc. It is a large proteoglycan possessing numerous glycosaminoglycan chains and the ability to form aggregates in association with hyaluronan. Its abundance and unique molecular features provide the disc with its osmotic properties and ability to withstand compressive loads. Degradation and loss of aggrecan result in impairment of disc function and the onset of degeneration.

Scope of review

This review summarizes current knowledge concerning the structure and function of aggrecan in the normal intervertebral disc and how and why these change in aging and degenerative disc disease. It also outlines how supplementation with aggrecan or a biomimetic may be of therapeutic value in treating the degenerate disc.

Major conclusions

Aggrecan abundance reaches a plateau in the early twenties, declining thereafter due to proteolysis, mainly by matrix metalloproteinases and aggrecanases, though degradation of hyaluronan and non-enzymic glycation may also participate. Aggrecan loss is an early event in disc degeneration, although it is a lengthy process as degradation products may accumulate in the disc for decades. The low turnover rate of the remaining aggrecan is an additional contributing factor, preventing protein renewal. It may be possible to retard the degenerative process by restoring the aggrecan content of the disc, or by supplementing with a bioimimetic possessing similar osmotic properties.

General significance

This review provides a basis for scientists and clinicians to understand and appreciate the central role of aggrecan in the function, degeneration and repair of the intervertebral disc.     

Intercellular communication via gap junctions affected by mechanical load in the bovine annulus fibrosus

Cells in the intervertebral disc, as in other connective tissues including tendon, ligament and bone, form interconnected cellular networks that are linked via functional gap junctions. These cellular networks may be necessary to affect a coordinated response to mechanical and environmental stimuli. Using confocal microscopy with fluorescence recovery after photobleaching methods, we explored the in situ strain environment of the outer annulus of an intact bovine disc and the effect of high-level flexion on gap junction signalling. The in situ strain environment in the extracellular matrix of the outer annulus under high flexion load was observed to be non-uniform with the extensive cellular processes remaining crimped sometimes at flexion angles greater than 25°. A significant transient disruption of intercellular communication via functional gap junctions was measured after 10 and 20 min under high flexion load. This study illustrates that in healthy annulus fibrosus tissue, high mechanical loads can impede the functioning of the gap junctions. Future studies will explore more complex loading conditions to determine whether losses in intercellular communication can be permanent and whether gap junctions in aged and degenerated tissues become more susceptible to load. The current research suggests that cellular structures such as gap junctions and intercellular networks, as well as other cell–cell and cell–matrix interconnections, need to be considered in computational models in order to fully understand how macroscale mechanical signals are transmitted across scales to the microscale and ultimately into a cellular biosynthetic response in collagenous tissues.