自体脂肪源性干细胞与成纤维细胞联合尿道周围注射治疗大鼠压力性尿失禁☆

背景：干细胞增殖和分化形成成纤维细胞以及适当的结缔组织,从而实现组织的再生,治疗自体盆腔器官脱垂和压力性尿失禁是目前该领域的一个研究热点。 目的：观察自体脂肪源性干细胞与成纤维细胞治疗压力性尿失禁的可行性。 方法：建立压力性尿失禁大鼠模型,建模后1个月行自体脂肪源干细胞与成纤维细胞尿道周围注射,细胞移植后1个月测定大鼠腹压漏尿点压力,同时近端尿道组织采用苏木精-伊红染色、弹力纤维染色观察形态学改变。 结果与结论：干细胞治疗后的模型大鼠漏尿点压力升高(P < 0.01),膀胱排空正常。尿道壁肌层增厚(P < 0.01),弹力纤维、平滑肌含量增多(P < 0.01)。结果证实,自体脂肪源性干细胞与成纤维细胞联合尿道周围注射能明显提高压力性尿失禁大鼠腹压漏尿点压力,增强注射点尿道肌层压力,可用于压力性尿失禁的治疗。     

人脐带间充质干细胞移植治疗大鼠急性肺损伤

背景：间充质干细胞具有免疫调节特性,脐带间充质干细胞因其特有的优势,将在急性肺损伤和急性呼吸窘迫综合征的临床应用中有着光明的前景。 目的：探讨脐带间充质干细胞移植对内毒素性大鼠急性肺损伤模型的保护作用。 方法：将48只健康雄性SD大鼠随机均分为正常对照组、急性肺损伤组和脐带间充质干细胞移植组。后两组采用经气管内滴注内毒素建立急性肺损伤模型。成功造模1 h后,脐带间充质干细胞移植组,经气管内滴注脐带间充质干细胞混悬液,正常对照组和急性肺损伤组同法予以等量生理盐水。分别在干预后24,72 h,观察肺组织病理改变,检测病理组织评分、肺组织干湿质量比、髓过氧化物酶活性及血浆白细胞介素6、白细胞介素10及肿瘤坏死因子α水平。 结果与结论：脐带间充质干细胞移植可以减轻内毒素诱导的急性肺损伤模型的损伤程度;脐带间充质干细胞移植组在各时间点与急性肺损伤组比较,病理损伤评分、肺干湿质量比、肺组织髓过氧化物酶活性、血浆白细胞介素6和肿瘤坏死因子α水平均明显降低,血浆白细胞介素10水平明显升高。说明脐带间充质干细胞对内毒素性急性肺损伤模型有保护作用;其保护机制可能为脐带间充质干细胞移植维持肺内炎性递质和抗炎递质平衡。     

人脐带源间充质干细胞静脉移植治疗大鼠肝纤维化

背景：近来国内外研究证明,来自其他组织的干细胞能够归巢到肝脏,并可能参与肝组织的再生,这为发展干细胞治疗肝脏疾病提供了新的希望。 目的：探究人脐带源间充质干细胞的分离、培养方法,观察脐带间充质干细胞移植对大鼠肝纤维化模型的修复作用,为脐带间充质干细胞的临床应用提供可靠的理论依据。 方法：自然贴壁法分离、纯化人脐带间充质干细胞并进行体外培养和扩增,用皮下多点注射CCl₄制备肝纤维化大鼠模型。将22只模型大鼠随机分为模型损伤组(n=11)和细胞移植组(n=11)。细胞移植组在模型制备成功后的第1,2,3周经尾静脉给予1×10⁶脐带间充质干细胞治疗,4周后将大鼠处死,收集各组大鼠血液检测肝功能;摘取肝脏行苏木精-伊红染色,观察病理变化;免疫组化法观察库普弗细胞的数量及分布;免疫组化法观察治疗组脐带间充质干细胞的定位情况。 结果与结论：脐带间充质干细胞经尾静脉移植入肝硬化大鼠后,大鼠的肝功能均明显改善,与对照组比较,差异有显著性意义(P < 0.05);肝组织苏木精-伊红染色提示,肝纤维化程度明显改善;免疫组化法观察库普弗细胞的数量提示,库普弗细胞数量明显减少;免疫组化方法利用抗BrdU抗体在治疗组大鼠肝脏观察到BrdU标记的脐带间充质干细胞。说明脐带间充质干细胞移植可以改善大鼠外周血液的血生化特性和肝的组织学结构。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程全文链接：     

脐带间充质干细胞移植可延缓大鼠失神经肌肉的萎缩

背景：周围神经断伤后生长缓慢,失神经支配的肌肉萎缩及运动终板纤维化,导致肢体功能不可逆障碍。脐带间充质干细胞已经广泛应用于多学科研究,但应用于周围神经损伤中延缓大鼠失神经肌肉萎缩鲜有报道。 目的：观察异种异基因脐带间充干细胞移植于大鼠离断坐骨神经断端,延缓失神经肌肉萎缩的效果。 方法：新鲜脐带采集于健康足月产妇,分离鉴定脐带间充质干细胞。制备大鼠坐骨神经SunderlandⅣ度损伤模型,去神经束5 mm,神经外膜修复,5 mm小间隙移植脐带间充质干细胞模型,对照组仅在小间隙内注入同体积生理盐水。测定大鼠坐骨神经功能指数,小腿三头肌湿质量,坐骨神经干潜伏期、动作电位传导速度、波幅,以及骨骼肌纤维横截面积维持率。 结果与结论：造模后4,8及12周,脐带间充质干细胞组大鼠坐骨神经功能指数、右侧小腿三头肌湿质量及骨骼肌纤维横截面积维持率均显著高于对照组(P < 0.05)。造模后12周肌电图显示,脐带间充质干细胞组大鼠坐骨神经干潜伏期显著低于对照组,动作电位传导速度及波幅显著高于生理盐水对照组(P < 0.001)。提示脐带间充质干细胞移植于大鼠离断的坐骨神经断端,可促进神经生长,延缓失神经肌肉萎缩,维持失神经肌肉形态及功能。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程全文链接：     

脐带源间充质干细胞移植治疗肝纤维化及肝硬化的相关机制

背景：肝硬化是多种原因引起的肝脏慢性病变,目前尚没有有效的治疗方法,很多研究表明,间充质干细胞对肝纤维化及肝硬化有一定的治疗作用。 目的：研究人脐带源间充质干细胞移植对大鼠肝纤维化及肝硬化的治疗作用及其作用机制。 方法：应用CCl4诱导制备肝纤维化及肝硬化模型,造模后经尾静脉注射人脐带间充质干细胞。细胞移植后采用Beckman Coulter analyzer检测人脐带源间充质干细胞移植对大鼠肝功能的影响;采用天狼猩红染色检测肝组织病理改变;应用免疫组织化学染色、Western blot和real-time Q-PCR方法检测Ⅰ、Ⅲ型胶原、基质金属蛋白酶2、基质金属蛋白酶抑制剂2蛋白与mRNA在大鼠肝组织中的表达。 结果与结论：人脐带源间充质干细胞移植可以改善肝纤维化及肝硬化大鼠的肝功能。人脐带源间充质干细胞移植后,除肝纤维化细胞移植1周组与对应模型组相比差异无显著性意义外,其余各细胞移植组肝脏组织中基质金属蛋白酶2 mRNA及蛋白表达水平明显升高,而Ⅰ、Ⅲ型胶原、基质金属蛋白酶抑制剂2表达水平明显降低。人脐带源间充质干细胞通过上调基质金属蛋白酶2表达,下调基质金属蛋白酶抑制剂2表达,对肝纤维化及肝硬化起到治疗作用;在致病因素持续存在的情况下,人脐带源间充质干细胞移植并不能逆转肝纤维化或者肝硬化,只能延缓肝纤维化或肝硬化的进程。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

脐带间充质干细胞移植治疗大鼠糖尿病

背景：脐血间充质干细胞具有很强的增殖能力和分化能力,在趋向分化作用下可以分化成胰岛β细胞,进而起到治疗糖尿病的作用。 目的：观察移植脐带间充质干细胞对大鼠糖尿病的治疗效果。 方法：30只雄性SD大鼠中随机取6只作为对照组,注射生理盐水;其中24只按45 mg/kg的剂量注射链脲霉素建立糖尿病模型后,随机等分为移植组和糖尿病组,移植组大鼠尾静脉注射移植脐带间充质干细胞。 结果与结论：造模后30 d,糖尿病组大鼠空腹血糖维持在较高水平,且高于对照组(P < 0.05)。造模后,与糖尿病组相比,移植组大鼠空腹血糖水平显著下降(P < 0.05),体质量显著增加(P < 0.01),45 d时移植组大鼠空腹血糖水平与体质量接近对照组水平(P > 0.05),而糖尿病组大鼠空腹血糖维持较高水平,且体质量持续下降。提示脐带间充质干细胞移植能有效治疗大鼠糖尿病。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程全文链接：     

缬沙坦诱导人脐带间充质干细胞向心肌样细胞分化

目的 探讨缬沙坦诱导人脐带间充质干细胞（hUCMSCs）向心肌样细胞分化的潜能。方法 hUCMSCs经缬沙坦诱导后培养1～3 周, 应用心肌肌钙蛋白T（cTnT）和GATA结合蛋白4重组蛋白（GATA4）抗体进行免疫细胞化学和免疫荧光染色,鉴定分化后的细胞。通过RT-PCR检测心肌肌钙蛋白I(cTnI)基因、心肌相关转录因子和心肌细胞发育相关基因的mRNA表达,进行hUCMSCs的心肌分化潜能和缬沙坦诱导能力的分析。结果 人脐带间充质干细胞形态为均一的纤维状细胞,呈漩涡状排列。缬沙坦诱导后明显变小呈短梭形且不规则排列。免疫细胞化学和免疫荧光结果显示,诱导组细胞有心肌特异蛋白cTnI和心肌相关转录因子GATA4蛋白表达,对照组较少。RT-PCR结果显示,人脐带间充质干细胞自发的、持续性表达心肌相关转录因子Tbx5、GATA4和Nkx2.5的mRNA,经缬沙坦诱导1周时其mRNA表达水平略有上升,随后逐渐下降。cTnI的mRNA在诱导第3周时出现,未见心肌发育相关基因心房利钠肽（ANP）和β-心肌肌球蛋白重链（β-MHC）的mRNA表达。 结论 人脐带间充质干细胞具有心肌分化潜能但无法自发分化;缬沙坦具有诱导人脐带间充质干细胞向心肌样细胞分化的能力。     

转肝细胞生长因子的脐带间质干细胞移植促进大鼠脑出血后髓鞘再生

目的： 研究转人肝细胞生长因子（hHGF）人脐带间质干细胞(hUCMSCs)移植对脑出血后脱髓鞘再生和神经功能恢复的影响。方法：SD大鼠60只,随机分为3组：脑出血＋hUCMSCs-HGF组、脑出血＋hUCMSCs 组和脑出血＋PBS组,每组20只。胶原酶诱导建立脑出血模型,据不同组别于术后7 d 立体定向下进行侧脑室相应的移植。分别于移植前1 d 和移植后1、7、14、21、28、35 d 利用mNSS (modified neurological severity scores)评分检测大鼠神经功能情况,应用劳克坚牢蓝检测脑损伤区的神经纤维恢复情况,利用免疫组化和Western blotting检测髓鞘碱性蛋白（MBP）的表达变化。结果：脑出血模型大鼠术后3周（即移植术后2周）mNSS评分检测的神经功能,hUCMSCs-HGF组和hUCMSCs组的神经功能改善较PBS组明显提高（P＜0.05）,而且hUCMSCs-HGF组较hUCMSCs组神经改善更加显著（P＜0.05）。hUCMSCs-HGF组的神经纤维修复较其它组明显改善,髓鞘碱性蛋白的表达较其它组亦明显提高（P＜0.01）。结论：转hHGF人脐带间质干细胞移植较单纯细胞移植能明显提高神经纤维髓鞘再生能力,促进脑出血后神经功能缺失的修复。     

去细胞肌肉生物支架与人脐带间充质干细胞的相容性

背景：去细胞肌肉生物支架联合人脐带间充质干细胞移植将是治疗脊髓损伤的一项重要措施。但两者是否具有良好的相容性,人脐带间充质干细胞能否在去细胞肌肉生物支架中长期存活并均匀分布,尚未得到证实。 目的：观察大鼠去细胞肌肉生物支架与人脐带间充质干细胞的相容性。 方法：改良化学法制备大鼠去细胞肌肉生物支架,将第3代人脐带间充质干细胞Hoechest33342荧光标记后分为3组进行实验,细胞+支架组、细胞+支架大鼠体内组和单纯细胞组。分别应用苏木精-伊红、Masson染色方法观察去细胞肌肉生物支架的组织形态,以荧光倒置相差显微镜和扫描电镜观察人脐带间充质干细胞的吸附和生长情况。 结果与结论：人脐带间充质干细胞与去细胞肌肉生物支架充分附着,生长增殖活跃,细胞在支架内分布均匀。细胞+支架体内组与细胞+支架组相比在移植后1-7 d人脐带间充质干细胞数量差异无显著性意义(P > 0.05),在移植14 d细胞+支架体内组人脐带间充质干细胞数量大于细胞+支架组(P < 0.05)。提示去细胞肌肉生物支架与人脐带间充质干细胞有较好的相容性,体内环境更有利于细胞增殖和两者融合。     

骨髓间充质干细胞移植治疗失神经肌萎缩

背景:外科显微镜手术和一些辅助治疗方法均无法通过修复损伤的神经细胞来有效延缓或治疗失神经肌萎缩。研究发现骨髓间充质干细胞具有定向分化潜能,并且在一定环境因素下能对损伤的组织进行修复,由此推测其可以对失神经萎缩肌肉起到一定的修复作用。目的:探讨移植骨髓间充质干细胞是否能够减轻和延缓失神经肌肉组织萎缩。方法:分离培养SD大鼠骨髓间充质干细胞,取第3代骨髓间充质干细胞经BrdU标记后用于移植治疗。将30只SD大鼠分为3组,每组10只,对每只大鼠左后肢进行手术。假手术组只暴露坐骨神经主干,不钳夹神经,移植治疗组、模型对照组钳夹坐骨神经主干后,向其支配的腓肠肌注射骨髓间充质干细胞悬液和不含胎牛血清的DMEM培养液。骨髓间充质干细胞移植后1,2周,采用BBB评分评价各组大鼠左后肢运动功能;骨髓间充质干细胞移植后14 d,取腓肠肌组织进行苏木精-伊红染色和BrdU免疫组化染色。结果与结论:第3代骨髓间充质干细胞BrdU标记为阳性;标记的骨髓间充质干细胞能在移植治疗组失神经损伤的肌肉组织中存活并起修复作用;相对于模型对照组,移植治疗组失神经肌纤维由相互融合重新恢复规整。结果表明移植骨髓间充质干细胞能够减轻和延缓失神经肌肉组织萎缩。     

Human amniotic fluid stem cell injection therapy for urethral sphincter regeneration in an animal model

ABSTRACT: BACKGROUND: Stem cell injection therapies have been proposed to overcome the limited efficacy and adverse reactions of bulking agents. However, most have significant limitations, including painful procurement, requirement for anesthesia, donor site infection and a frequently low cell yield. Recently, human amniotic fluid stem cells (hAFSCs) have been proposed as an ideal cell therapy source. In this study, we investigated whether periurethral injection of hAFSCs can restore urethral sphincter competency in a mouse model. METHODS: Amniotic fluids were collected and harvested cells were analyzed for stem cell characteristics and in vitro myogenic differentiation potency. Mice underwent bilateral pudendal nerve transection to generate a stress urinary incontinence (SUI) model and received either periurethral injection of hAFSCs, periurethral injection of Plasma-Lyte (control group), or underwent a sham (normal control group). For in vivo cell tracking, cells were labeled with silica-coated magnetic nanoparticles containing rhodamine B isothiocyanate (MNPs@SiO2 (RITC)) and were injected into the urethral sphincter region (n = 9). Signals were detected by optical imaging. Leak point pressure and closing pressure were recorded serially after injection. Tumorigenicity of hAFSCs was evaluated by implanting hAFSCs into the subcapsular space of the kidney, followed two weeks later by retrieval and histologic analysis. RESULTS: Flow activated cell sorting showed that hAFSCs expressed mesenchymal stem cell (MSC) markers, but no hematopoietic stem cell markers. Induction of myogenic differentiation in the hAFSCs resulted in expression of PAX7 and MYOD at Day 3, and DYSTROPHIN at Day 7. The nanoparticle-labeled hAFSCs could be tracked in vivo with optical imaging for up to 10 days after injection. Four weeks after injection, the mean LPP and CP were significantly increased in the hAFSC-injected group compared with the control group. Nerve regeneration and neuromuscular junction formation of injected hAFSCs in vivo was confirmed with expression of neuronal markers and acetylcholine receptor. Injection of hAFSCs caused no in vivo host CD8 lymphocyte aggregation or tumor formation. CONCLUSIONS: hAFSCs displayed MSC characteristics and could differentiate into cells of myogenic lineage. Periurethral injection of hAFSCs into an SUI animal model restored the urethral sphincter to apparently normal histology and function, in absence of immunogenicity and tumorigenicity.     

Stem cell therapy for stress urinary incontinence: a critical review

Stress urinary incontinence (SUI) is a prevailing health problem that severely impacts quality of life. Because SUI is mainly due to urethral sphincter deficiency, several preclinical and clinical trials have investigated whether transplantation of patient's own skeletal muscle-derived cells (SkMDCs) can restore the sphincter musculature. The specific cell type of SkMDCs has been described as myoblasts, satellite cells, muscle progenitor cells, or muscle-derived stem cells, and thus may vary from study to study. In more recent years, other stem cell (SC) types have also been tested, including those from the bone marrow, umbilical cord blood, and adipose tissue. These studies were mostly preclinical and utilized rat SUI models that were established predominantly by pudendal or sciatic nerve injury. Less frequently used animal models were sphincter injury and vaginal distension. While transurethral injection of SCs was employed almost exclusively in clinical trials, periurethral injection was used in all preclinical trials. Intravenous injection was also used in one preclinical study. Functional assessment of therapeutic efficacy in preclinical studies has relied almost exclusively on leak point pressure measurement. Histological assessment examined the sphincter muscle content, existence of transplanted SCs, and possible differentiation of these SCs. While all of these studies reported favorable functional and histological outcomes, there are questions about the validity of the animal model and claims of multilineage differentiation. In any event, SC transplantation appears to be a promising treatment for SUI.     

Implantable Systems for Stress Urinary Incontinence

Stress urinary incontinence (SUI), the involuntary urine leakage due to failure of the urethral closure mechanism, is a global health challenge with substantial human suffering and socioeconomic costs. Approximately 167 million male and female patients are predicted to suffer from SUI in 2018, worldwide. A wide range of surgical interventions are available for the treatment of SUI. Severe cases, however, usually require the implantation of artificial urinary sphincter devices. This review comparatively presents and analyzes the working principles, as well as the challenges, associated with the current implantable SUI systems in clinical use. These include slings, urethral bulking agents, artificial urinary sphincters, and adjustable continence devices. It further reports on recent research progress and state-of-the-art in the field of SUI implants, including an original approach proposed by the authors with a pressure feedback sensory mechanism. The new emerging field of artificial muscle devices, including electroactive polymers, provides a promising innovative solution for replacing the weakened urethral sphincter in SUI patients.     

MMP-9和TIMP-1在高血压合并糖尿病周围神经病大鼠坐骨神经的表达

目的探讨高血压(HTN)合并糖尿病周围神经病(DPN)大鼠模型坐骨神经中基质金属蛋白酶-9(MMP-9)和组织金属蛋白酶抑制剂-1(TIMP-1)的表达。方法实验大鼠分为正常组、HTN组、DPN组和DPN+HTN组。造模后4w检测各组血糖、血压及坐骨神经传导速度,RT-PCR检测坐骨神经MMP-9mRNA和TIMP-1mRNA表达。结果与正常组和HTN组比较,DPN组和HTN+DPN组血糖显著增高,神经传导速度显著降低(0.01),坐骨神经MMP-9mRNA和TIMP-1mRNA表达显著上调(0.01)。与DPN组比较,HTN+DPN组血压显著增高,神经传导速度显著降低,坐骨神经MMP-9mRNA表达较DPN组上调,TIMP-1 mRNA表达显著下降(0.01)。。结论高血压合并糖尿病周围神经病坐骨神经MMP-9mRNA表达上调,TIMP-1mRNA表达下调,可能与抑制施万细胞和髓鞘形成加剧周围神经损伤相关。     

脂肪源性干细胞移植对糖尿病周围神经病大鼠坐骨神经TNF-α和MBP表达的影响

目的研究脂肪源性干细胞(ADSC)移植对糖尿病周围神经病(DPN)大鼠坐骨神经中肿瘤坏死因子-α(TNF-α)和髓磷脂碱性蛋白(MBP)表达的影响。方法大鼠随机分为正常组、模型组和ADSC组。链脲佐菌素腹腔注射制备实验DPN大鼠模型,ADSC组尾静脉注射ADSC细胞悬液,造模后14 d检测各组血糖及坐骨神经传导速度,实时荧光定量PCR检测坐骨神经TNF-α和MBP mRNA表达。结果与正常组比较,模型组和ADSC组血糖显著增高,神经传导速度显著降低,坐骨神经TNF-α和MBP mRNA表达显著上调。与模型组比较,ADSC组神经传导速度显著增高,坐骨神经TNF-α和MBP mRNA表达显著下降。结论脂肪源性干细胞下调糖尿病周围神经病坐骨神经TNF-α和MBP mRNA表达。     

补中益气汤加味改善压力性尿失禁患者生存质量的研究

目的评估补中益气汤加味改善压力性尿失禁（SUI）患者生存质量的效果。方法将58例女性压力性尿失禁患者随机分为A组和B组,采用两阶段交叉设计,A组先行运动疗法后服用中药,B组先服用中药后行运动疗法,比较分析两组治疗后的疗效。结果两组受试者的年龄、体重指数（BMI）、病程、怀孕生育次数及经产史、Gullen分度、中医证型分布差异无统计学意义（P〉0.05）;第一阶段治疗后,运动组的失禁程度、ICI-Q-SF、I-QOL评分在治疗前后差异有统计学意义（P〈0.05）,失禁频率和夜尿次数差异无统计学意义（P〉0.05）;中药组的各项指标在治疗前后差异有统计学意义（P〈0.05）;疗效评价：两种治疗方法治疗后两组的失禁频率、失禁程度、夜尿次数差异有统计学意义（P〈0.01）,两种治疗方法间ICI-Q-SF、I-QOL评分差异均有统计学意义（P〈0.01）。结论补中益气汤加味与盆底肌运动法都是治疗SUI的有效方法,补中益气汤加味治疗SUI较盆底肌运动法疗效更佳,并且能更好的改善SUI患者的生存质量。     

Changes in the extracellular matrix in periurethral tissue of women with stress urinary incontinence

Changes in structural support of the urethra and bladder neck have been proposed as important factors in the pathogenesis of stress urinary incontinence (SUI). In this context, we undertook an ultrastructural study on the periurethral connective tissue with an emphasis on incontinent women with normotonic and hypotonic urethras. Small specimens of periurethral connective tissue were obtained by dissection during a tension-free vaginal tape-implantation procedure in 34 stress urinary incontinent postmenopausal women with a normotonic urethra and 9 stress urinary incontinent postmenopausal women with a hypotonic urethra. In the samples taken from stress-incontinent women with a normotonic urethra, intact elastic fibers were closely connected with collagen fibers, smooth muscle cells and fibrocytes. In the samples taken from stress-incontinent women with a hypotonic urethra, we detected irregular fragmented distribution of the elastin within the tissue. We assume that these structural changes lead to functional consequences, such as diminished tissue extensibility and loss of stability surrounding the female urethra. These altered connective tissue properties may affect the mechanism of urethral closure under stress (e.g., coughing) and therefore contribute to the occurrence of SUI with a hypotonic urethra.     

Tissue engineered bulking agent with adipose-derived stem cells and silk fibroin microspheres for the treatment of intrinsic urethral sphincter deficiency

In this study we developed a tissue engineered bulking agent that consisted of adipose-derived stem cells (ADSCs) and silk fibroin microspheres to treat stress urinary incontinence caused by severe intrinsic sphincter deficiency (ISD). ISD models were established by completely transection of the bilateral pudendal nerve (PNT) and confirmed by the decreased leak-point pressure (LPP) and increased lumen area of urethra. Injection of silk fibroin microspheres could recover LPP and lumen area at 4 weeks but its efficacy disappears at 8, 12 weeks. Moreover, it was exciting to find that tissue engineered bulking agent brought long-term efficacy (at 4, 8, 12 weeks post-injection) on the recovery of LPP and lumen area. Concomitantly with the function, tissue engineered bulking agent treated group also improved the urethral sphincter structure as exhibited by better tissue regeneration. The findings showed that silk fibroin microspheres alone could work effectively in short-term, while tissue engineered bulking agent that combined silk fibroin microspheres with ADSCs exhibited promising long-term efficacy. This study developed a new strategy of tissue engineered bulking agent for future ISD therapy.     

A Novel Method of Urinary Sphincter Deficiency: Serial Histopathology Evaluation in a Rat Model of Urinary Incontinence

In this study, a novel technique of irreversible sphincter deficiency by pudendal nerve transection (PNT) using 40 female rats for studying the pathophysiology of stress urinary incontinence associated with childbirth was developed. Of the 40 rats, 10 served as controls and the remaining underwent bilateral PNT at the anastomotic lumbosacral trunk level. Urethral morphological changes following bilateral PNT were assessed with serial hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining methods at 50, 90, and 130 days post‐intervention. Leak point pressure (LPP) measurement was used to determine the effect of pudendal injury on urethral outlet resistance after the transection. H&E and IHC staining showed irreversible loss of striated muscle mass of the sphincter region and increase in collagen deposition compatible with muscle atrophy. LPP measurements also significantly decreased following bilateral PNT. In conclusion, a novel method of irreversible sphincter insufficiency was developed. This model effectively decreased urethral outlet resistance and caused irreversible striated muscle atrophy. It was suggested that this technique can be used to develop a permanent sphincter deficiency model for the preclinical testing of treatment modalities exclusively triggering the pudendal nerve. Anat Rec, 299:173–180, 2016. © 2015 Wiley Periodicals, Inc.     

硬膜外应用虎纹镇痛肽-Ⅰ对自体神经移植大鼠脊髓背角c-fos表达的影响

目的通过观察硬膜外给予虎纹镇痛肽-Ⅰ对大鼠自体神经移植模型机械痛阈与脊髓背角c-fos表达的影响,探讨虎纹镇痛肽-Ⅰ对再生神经神经性疼痛的影响。方法雄性Wistar大鼠60只随机分成A、B、C组,A组为自体神经移植模型组;B组为自体神经移植模型加虎纹镇痛肽-Ⅰ治疗组;C组为假手术组。分别制成模型后,术后27 d起检测机械刺激阈值及c-fos表达计数。结果 A、B组各项指标与C组比较有显著差异;A组与B组比较c-fos表达阳性细胞计数及机械痛阈均有显著差异。结论虎纹镇痛肽-Ⅰ能有效减轻再生神经的神经性疼痛程度,促进神经的完善修复。