Bone marrow-derived mesenchymal stem cells versus adipose-derived mesenchymal stem cells for peripheral nerve regeneration

Studies have confirmed that bone marrow-derived mesenchymal stem cells(MSCs) can be used for treatment of several nervous system diseases. However, isolation of bone marrow-derived MSCs(BMSCs) is an invasive and painful process and the yield is very low. Therefore, there is a need to search for other alterative stem cell sources. Adipose-derived MSCs(ADSCs) have phenotypic and gene expression profiles similar to those of BMSCs. The production of ADSCs is greater than that of BMSCs, and ADSCs proliferate faster than BMSCs. To compare the effects of venous grafts containing BMSCs or ADSCs on sciatic nerve injury, in this study, rats were randomly divided into four groups: sham(only sciatic nerve exposed), Matrigel(MG; sciatic nerve injury + intravenous transplantation of MG vehicle), ADSCs(sciatic nerve injury + intravenous MG containing ADSCs), and BMSCs(sciatic nerve injury + intravenous MG containing BMSCs) groups. Sciatic functional index was calculated to evaluate the function of injured sciatic nerve. Morphologic characteristics of nerves distal to the lesion were observed by toluidine blue staining. Spinal motor neurons labeled with Fluoro-Gold were quantitatively assessed. Compared with sham-operated rats, sciatic functional index was lower, the density of small-diameter fibers was significantly increased, and the number of motor neurons significantly decreased in rats with sciatic nerve injury. Neither ADSCs nor BMSCs significantly improved the sciatic nerve function of rats with sciatic nerve injury, increased fiber density, fiber diameters, axonal diameters, myelin sheath thickness, and G ratios(axonal diameter/fiber diameter ratios) in the sciatic nerve distal to the lesion site. There was no significant difference in the number of spinal motor neurons among ADSCs, BMSCs and MG groups. These results suggest that neither BMSCs nor ADSCs provide satisfactory results for peripheral nerve repair when using MG as the conductor for engraftment.     

Reduced efficacy of nitrergic neurotransmission exacerbates erectile dysfunction after penile nerve injury despite axonal regeneration

Penile (cavernous) nerves are readily damaged during radical prostatectomy, invariably causing impotence. Erectile function can return, however this may take months or years and capacity often remains poor. Many studies have attempted to improve penile nerve regeneration but have not explored mechanisms underlying the delay in functional recovery. This is assumed to be due to slow growth of axons, although penile tissues also change following loss of erectile activity. We have asked whether delayed recovery of the nitrergic nerve-evoked erectile response is due to pre-synaptic (slow axonal growth) or post-synaptic (changes in tissue responsiveness) mechanisms. These components were dissected in vitro following penile nerve injury in adult rats. Following crush of both penile nerves, excellent regeneration of nitrergic axons occurred after 10-12 weeks but neurogenic relaxation of cavernosum muscle was still relatively poor. This was at least partly due to attenuated tissue responsiveness to nitric oxide (using sodium nitroprusside as a donor) from 3 weeks after injury. Western blotting also revealed a modest reduction of soluble guanylyl cyclase. A second model of penile nerve injury, unilateral cut, completely denervated one side but retained potential for penile erection. Some anatomical and functional recovery occurred after 9-11 weeks (probably due to sprouting from contralateral uninjured axons), but nitroprusside-evoked relaxations were unaltered from at least 3 weeks onward. These data suggest that erectile dysfunction following extensive nerve injury may be exacerbated by postsynaptic changes in nitric oxide signaling, even when nerve regeneration occurs. This may be prevented by continued activation of penile tissues to retain normal perfusion.     

Autonomie Control of Penile Erection: Modulation by Testosterone in the Rat

The role of testosterone on peripheral autonomie control of penile erection was studied in rats. Erectile response to cavernous nerve stimulation was measured by intracavernous pressure associated with arterial blood pressure monitoring in anesthetized adult males. Comparison was performed between control (Co), castrated (Ox) and castrated, testosterone-replaced (OxT) rats. Ox rats exhibited smaller erectile responses. Testosterone replacement restored these responses in OxT rats. To identify the peripheral target of testosterone, postganglionic neurons of the major pelvic ganglion, innervating the corpora cavernosa through the cavernous nerves, were separated from the spinal cord by preganglionic axotomy of the pelvic nerves in three other groups of rats (PNx). Erectile response was unchanged in PNx rats, decreased in OxPNx more than in Ox rats, and restored by testosterone replacement (OxPNxT rats). We ruled out the participation of a somatic component in the erectile response in this model as there was no difference between curarized and Co rats. We infer that testosterone enhances the erectile response of cavernous nerve stimulation, acting peripherally to the spinal cord. Arguments are provided that the sites of action for testosterone or its metabolites are situated on neurons rather than on penile erectile tissue. Proerectile postganglionic parasympathetic neurons seem to be the exact target for gonadal steroids.     

LIPUS-SCs-Exo promotes peripheral nerve regeneration in cavernous nerve crush injury-induced ED rats via PI3K/Akt/FoxO signaling pathway

Objective

Clinical treatment of erectile dysfunction (ED) caused by cavernous nerve (CN) injury during pelvic surgery is difficult. Low-intensity pulsed ultrasound (LIPUS) can be a potential strategy for neurogenic ED (NED). However, whether Schwann cells (SCs) can respond to LIPUS stimulation signals is unclear. This study aims to elucidate the signal transmission between SCs paracrine exosome (Exo) and neurons stimulated by LIPUS, as well as to analyze the role and potential mechanisms of exosomes in CN repair after injury.

Methods

The major pelvic ganglion (MPG) neurons and MPG/CN explants were stimulated with LIPUS of different energy intensities to explore the appropriate LIPUS energy intensity. The exosomes were isolated and purified from LIPUS-stimulated SCs (LIPUS-SCs-Exo) and non-stimulated SCs (SCs-Exo). The effects of LIPUS-SCs-Exo on neurite outgrowth, erectile function, and cavernous penis histology were identified in bilateral cavernous nerve crush injury (BCNI)-induced ED rats.

Results

LIPUS-SCs-Exo group can enhance the axon elongation of MPG/CN and MPG neurons compared to SCs-Exo group in vitro. Then, the LIPUS-SCs-Exo group showed a stronger ability to promote the injured CN regeneration and SCs proliferation compared to the SCs-Exo group in vivo. Furthermore, the LIPUS-SCs-Exo group increased the Max intracavernous pressure (ICP)/mean arterial pressure (MAP), lumen to parenchyma and smooth muscle to collagen ratios compared to the SCs-Exo group in vivo. Additionally, high-throughput sequencing combined with bioinformatics analysis revealed the differential expression of 1689 miRNAs between the SCs-Exo group and the LIPUS-SCs-Exo group. After LIPUS-SCs-Exo treatment, the phosphorylated levels of Phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) and forkhead box O (FoxO) in MPG neurons increased significantly compared to negative control (NC) and SCs-Exo groups.

Conclusion

Our study revealed that LIPUS stimulation could regulate the gene of MPG neurons by changing miRNAs derived from SCs-Exo, then activating the PI3K-Akt-FoxO signal pathway to enhance nerve regeneration and restore erectile function. This study had important theoretical and practical significance for improving the NED treatment.     

双侧颈动脉鞘交感神经切除术联合颈部迷走神经孤立术治疗混合型脑瘫

目的探讨迷走神经孤立术在颈动脉鞘交感神经切除术治疗难治性混合型脑瘫中的作用。方法回顾性分析682例难治性混合型脑瘫患者的临床资料，57例采用双侧颈动脉鞘交感神经切除术治疗（A组），625例采用双侧颈动脉鞘交感神经切除术联合迷走神经孤立术治疗（B组）。B组85例术中取颈部迷走神经周围结缔组织行抗酪氨酸羟化酶免疫组化染色。对比分析两组间的手术疗效及并发症的差异。结果全部患者术后随访8-134个月，平均54．4个月。A、B组运动功能改善率分别为45．6％和67．4％，生活质量提高率分别为50．9％和73．9％，总显效率分别为77．2％和94．7％，已好转症状复发率分别为18．2％和6．76％。上述各项指标两组间比较均有统计学差异（P〈0．05），两组间术中及术后各种并发症的发生率无统计学差异（P〉0．05）。免疫组化染色显示85例术中所取的颈部迷走神经周围结缔组织的酪氨酸羟化酶表达阳性。结论迷走神经孤立术对提高颈动脉鞘交感神经切除术治疗难治性混合型脑瘫的疗效有重要作用，且不会增加手术并发症；免疫组化证实在颈部迷走神经周围结缔组织中含有交感神经成分。     

依托咪酯促进大鼠视神经损伤后再生的研究

目的探讨依托咪酯对成年大鼠视神经损伤后再生的影响。方法选取25只成年SD大鼠,按随机数字表法随机分为依托咪酯治疗组（腹腔注射依托咪酯脂肪乳注射液,15只）、治疗对照组f腹腔注射脂肪乳,5只）和空白对照组（5只）;治疗组又分为低（2mg／kg）、中（4mg／kg）和高（6mg／kg）剂量3个亚组,每亚组5只。采用自体坐骨神经移植模型和荧光金逆行标记再生视网膜神经节细胞（RGCs）。自体坐骨神经移植术后4周,采用视网膜平铺技术计数再生RGCs。结果空白对照组每张视网膜中再生RGCs数量平均为（1032±147）个,治疗对照组为（1114±179）个,两者之间无明显差异fP〉0．05）。低、中和高剂量依托咪酯治疗组每张视网膜中再生RGCs数量分别为（2054±349）个、（2853±498）个和（4118±615）个,与空白对照组和治疗对照组相比均显著增高（P〈0．01）,而且不同剂量之间均差异显著（P〈0．01）。结论依托咪酯能显著促进大鼠视神经损伤后轴突再生,且具有剂量依赖性。     

再程序化脂肪干细胞移植治疗大鼠脊髓损伤的机制

目的制备再程序化脂肪干细胞(ADSCs),并在体研究再程序化ADSCs移植入大鼠脊髓损伤模型后促进损伤脊髓神经功能恢复的作用和机制。方法体外培养、纯化和鉴定大鼠ADSCs,并利用慢病毒包装神经元生成素2(Ngn2)基因转染ADSCs制备再程序化干细胞。体内实验将48只雌性SD大鼠随机分成3组:SCI对照(A)组、单纯ADSCs移植(B)组和Ngn2-ADSCs移植(C)组。采用BBB评分评价大鼠运动功能,并通过HE染色、免疫组化和免疫荧光等方法检测脊髓组织学改变和相关蛋白的表达水平,进而观察实验动物脊髓功能恢复情况。结果 Ngn2-ADSCs移植组在运动功能评分、胶质瘢痕的形成、脊髓损伤后病理变化和分泌神经营养因子BDNF和VEGF蛋白含量明显优于其他组。结论 Ngn2-ADSCs移植后能有效地存活,并分化为神经细胞,抑制胶质瘢痕形成,减小脊髓损伤空洞,增加BDNF和VEGF表达,最终促进SCI大鼠的运动功能恢复,较单纯应用ADSCs能更好地促进SCI修复。     

预防性应用尼莫地平对面神经损伤大鼠BDNF及GDNF表达的影响

目的探讨预防性应用尼莫地平对面神经损伤大鼠脑源性神经营养因子(brain derived neurotrophic factor,BDNF)和胶质细胞源性神经营养因子(glial cell line-derived neurotrophic factor,GDNF)表达的影响。方法 96只SD大鼠随机分为假手术组、单纯损伤组、尼莫地平预处理组、尼莫地平后处理组,每组24只。假手术组不损伤面神经,单纯损伤组建立大鼠面神经损伤模型。尼莫地平预处理组在模型建立前给予尼莫地平,持续给药到术后2周。尼莫地平后处理组在模型建立后给予尼莫地平,持续给药2周。应用Western blot方法观察大鼠面神经损伤后1、3、6个月BDNF和GDNF的表达。结果与单纯损伤组相比,尼莫地平后处理组造模后1个月大鼠BDNF、GDNF的表达均升高(均P<0.05)。尼莫地平预处理组和后处理组BNDF和GDNF的表达在各时间点差异均有统计学意义(均P<0.05)。结论预防性应用尼莫地平可以调节面神经损伤大鼠GDNF和BDNF的表达,充分发挥其神经保护作用。     

Antioxidative mechanism of Lycium barbarum polysaccharides promotes repair and regeneration following cavernous nerve injury

Polysaccharides extracted from Lycium barbarum exhibit antioxidant properties. We hypothesized that these polysaccharides resist oxida-tive stress-induced neuronal damage following cavernous nerve injury. In this study, rat models were intragastrically administered Lycium barbarum polysaccharides for 2 weeks at 1, 7, and 14 days after cavernous nerve injury. Serum superoxide dismutase and glutathione peroxidase activities signiifcantly increased at 1 and 2 weeks post-injury. Serum malondialdehyde levels decreased at 2 and 4 weeks. At 12 weeks, peak intracavernous pressure, the number of myelinated axons and nicotinamide adenine dinucleotide phosphate-diaphorase-pos-itive nerve ifbers, levels of phospho-endothelial nitric oxide synthase protein and 3-nitrotyrosine were higher in rats administered at 1 day post-injury compared with rats administered at 7 and 14 days post-injury. These ifndings suggest that application of Lycium barbarum polysaccharides following cavernous nerve crush injury effectively promotes nerve regeneration and erectile functional recovery. This neu-roregenerative effect was most effective in rats orally administered Lycium barbarum polysaccharides at 1 day after cavernous nerve crush injury.     

Role of oxidative stress in surgical cavernous nerve injury in a rat model

This study investigates the role of oxidative stress in surgical cavernous nerve (CN) injury in a rat model. Eighty‐four male Sprague‐Dawley rats were randomly divided into three groups: group 1, sham‐operated rats; group 2, bilateral CN‐crushed rats; and group 3, bilateral CN‐transection‐and‐sutured‐immediately rats. Oxidative stress was evaluated by malondialdehyde levels, super oxide dismutase (SOD) activities, and glutathione peroxidase (GPX) activities in serum. Erectile function was assessed by CN electrostimulation at 3 months with mean maximal intracavernous pressure (ICP) and maximal ICP per mean arterial pressure. Nerve injury was assessed by toluidine blue staining of CNs and nicotinamide adenine dinucleotide phosphate (NADPH)‐diaphorase staining of penile tissue. GPX protein expression and nitrotyrosine‐3 (NT‐3) levels in penile tissue were measured. Erectile function and the number of myelinated axons of CNs and NADPH‐diaphorase‐positive nerve fibers were statistically decreased between groups, from sham to crush to transection. For markers, both nerve‐injury groups showed increased oxidative stress markers at early time points, with the transection group showing greater oxidative stress than the crushed group and values normalizing to sham levels by week 12. GPX expression and NT‐3 levels in penile tissue were in concordance with the results of SOD and GPX. These results show that oxidative stress plays an important role in injured CNs, and different methods of CN injury can lead to different degrees of oxidative stress in a rat model. © 2015 Wiley Periodicals, Inc.     

不同年龄大鼠坐骨神经损伤后脊髓中神经生长导向因子Slit-1及Robo-2受体的表达变化

目的观察不同年龄大鼠坐骨神经损伤后,轴突导向因子Slit-1及其Robo-2受体在脊髓中的表达,以探讨不同年龄大鼠外周神经损伤后再生神经具有靶向性差异的可能机制。方法老年、成年和幼年大鼠各20只,建立左侧坐骨神经横断、硅胶管桥接模型。通过免疫荧光染色观察Slit-1蛋白和Robo-2受体在腰段脊髓中表达的变化,计算其荧光强度值,并进行统计学分析。结果伤后2周和4周,3组大鼠脊髓前角Slit蛋白均有较高表达,但各组间无显著差异。伤后2周和4周各组Robo-2受体表达均升高,其中老年鼠脊髓前角Robo-2受体表达明显高于成年和幼年组,差异有统计学意义(P0.05)。结论大鼠坐骨神经损伤后能刺激脊髓前角Slit-1高表达,不同年龄大鼠脊髓组织中Robo-2受体表达的差异可能决定了Slit-1在再生神经中的靶向性调节作用。     

大鼠面神经缺血后面神经核磷酸化CREB水平的变化

目的探讨大鼠面神经缺血损伤后面神经元内环磷腺苷反应元件结合蛋白（CREB）磷酸化水平的变化及其与氧化应激的关系。方法 55只成年雄性SD大鼠随机分为正常组（5只）、假手术组（25只）和面神经缺血组（25只）,后两组又根据时间分为术后1、3、7、14、21 d 5个亚组,每亚组5只大鼠。显微手术阻断大鼠鼓室段岩动脉建立大鼠面神经缺血损伤模型。采用分光光度法测定面神经核丙二醛（MDA）含量;利用免疫印迹法测定面神经元内锰超氧化物歧化酶（Mn SOD）和磷酸化CREB（p-CREB）表达水平。结果面神经缺血后,面神经核MDA含量先增高,7 d达峰值,随后降低;而面神经元Mn SOD和p-CREB表达水平先降低,7 d达最低值,随后逐渐增高。面神经缺血组每个时间点MDA水平、Mn SOD和p-CREB表达水平均与正常组和假手术组差异显著（P〈0.05）,而假手术组与正常组之间无显著差异（P〉0.05）。结论面神经缺血损伤后造成面神经元氧化应激损伤,导致p-CREB水平先降低后增高,p-CREB水平的增高可降低ROS对面神经元的氧化损伤能力。     

高压氧预处理对大鼠急性脊髓损伤后神经细胞凋亡的影响

目的探讨高压氧预处理对急性脊髓损伤后不同时期神经细胞凋亡的影响及神经保护机制。方法将55只SD大鼠随机分为高压氧预处理组（25只）、正常损伤组（25只）及对照组（5只）。大鼠急性脊髓损伤模型制作采用改良Allen＇s法，分别于伤后1d、5d、7d、10d和14d在脊髓损伤部位取材，应用苏木精-伊红染色、原位缺口末端标记（TUNEL）方法检测大鼠脊髓损伤后的神经细胞凋亡情况。结果预处理组和单纯损伤组均见TUNEL阳性凋亡细胞，而预处理组凋亡细胞数减少；在各时间点预处理组与单纯损伤组差异均有统计学意义（P〈0．05）。结论高压氧预处理可减少继发性脊髓损伤细胞凋亡，因而可促进脊髓损伤后修复，对中枢神经系统损伤具有保护作用。     

骨髓基质干细胞移植对脑损伤大鼠神经行为学和血管再生的影响

目的探索移植骨髓基质干细胞(BMSCs)对局灶性脑损伤大鼠的神经功能修复的作用及血管再生的影响,探讨BMSCs移植促进大鼠脑损伤修复的机制。方法 30只大鼠制备大鼠局灶性脑损伤动物模型,随机分为假手术组、脑损伤组和BMSCs移植组,每组10只大鼠。取供体鼠BMSCs,体外扩增,DAPI荧光标记。在脑立体定向仪引导下将BMSCs移植到脑损伤大鼠局部损伤灶边缘,于3d、7d及14d通过观察大鼠神经行为能力的变化,评价移植细胞后大鼠神经功能的修复情况;14d后取脑组织荧光显微镜观察移植细胞存活的情况,采用免疫组化法检测脑组织微血管密度(MVD)来评估血管再生情况、血管内皮生长因子(VEGF)、血管内皮生长因子受体(Flt-1、Flk-1)的蛋白表达情况。结果脑损伤组和BMSCs移植组于移植后3d时神经行为学评分差异无统计学意义(P>0.05),而在移植后7d、14d,BMSCs移植组与脑损伤组在神经行为学评分指标上差异有统计学意义(P<0.05)。BMSCs移植组与脑损伤组比较,脑组织微血管密度明显增加,VEGF和Flt-1、Flk-1表达明显增加。结论骨髓基质干细胞移植后可促进脑损伤大鼠神经功能的恢复,其机制可能与其增加VEGF和Flt-1、Flk-1表达促进血管再生有关。     

龙心素胶囊对大鼠脑缺血再灌注损伤后p53蛋白表达的影响

目的观察龙心素胶囊对大鼠脑缺血再灌注损伤后p53蛋白表达的影响,探索龙心素胶囊神经保护作用的分子机制。方法采用SD大鼠局灶性脑缺血再灌注模型（transientmiddle cerebral arteryocclusion,MCAO）,将大鼠随机分为3组：假手术组、缺血再灌注组、龙心素胶囊（Longxinsu Jiaohang）组。各组按实验设计给药造模,分时点对各组动物造模后神经功能缺陷进行评分,应用免疫组织化学法研究缺血再灌注损伤脑组织凋亡相关蛋白p53的表达情况。结果龙心素组其缺血再灌注后神经功能缺陷评分和脑组织p53蛋白表达均明显少于缺血再灌注组（P〈0．05）。结论龙心素胶囊能减轻脑组织的缺血再灌注损伤,改善神经功能缺失。其作用机制可能与其抑制脑组织p53蛋白表达有关。     

西维来司他钠在大鼠急性脊髓损伤中的保护作用

目的探讨脊髓损伤后早期使用西维来司他钠(Sivelestat sodium)抑制细胞凋亡,对大鼠脊髓损伤的保护作用及机制。方法将60只SD大鼠随机分成5组,每组12只,Allen's脊髓损伤模型后,立即腹腔注射Sivelestat sodium 1.6 mg/kg,4.8 mg/kg,10 mg/kg,50 mg/kg,并连续7 d(1次/d),对照组给等量生理盐水,并采用脊髓运动功能评分(BBB scale)对大鼠进行双下肢神经功能评分。原位末端标记法(TUNEL)观察脊髓损伤后脊髓神经细胞凋亡情况。酶联免疫吸附法(ELASA)检测炎症因子。免疫印迹法检测甘油醛-3-磷酸脱氢_E3泛素连接酶-1(GAPDH-Siah1)细胞凋亡序列。结果以BBB标准评价大鼠的双下肢运动功能,治疗组的下肢活动功能明显好于对照组。4.8 mg/kg和10 mg/kg剂量组双下肢神经功能学评分与对照组比较具有明显差异(P0.01);50 mg/kg剂量组未见明显保护作用,因此未加入统计结果。TUNEL染色显示,sivelestat sodium明显减少了脊髓损伤后神经细胞凋亡,抑制脊髓损伤后炎症因子表达。sivelestat sodium显著抑制GAPDH-Siah1凋亡序列的表达。结论 sivelestat sodium通过抑制GAPDH-Siah1凋亡序列,减少脊髓损伤后脊髓神经细胞的凋亡,从而改善脊髓损伤大鼠后肢运动神经功能。     

视神经不完全损伤动物模型视神经TrkA表达及局部缓释NGF对其表达的影响

目的 观察TrkA在不完全损伤视神经上的表达及医用生物蛋白胶局部缓释神经生长因子对其表达的影响.方法 雄性SD大鼠按随机数字表法分为3组,损伤组双侧视神经均用动脉瘤夹临时阻断夹钳夹30 s,神经生长因子组双侧视神经均用动脉瘤夹临时阻断夹钳夹30 s后局部应用含有神经生长因子的医用生物蛋白胶,正常组不做任何处理.以RT-PCR方法检测各组伤后3、5、7、10d视神经TrkAmRNA的表达情况.结果 正常组相对值为0.44±0.06.损伤组和神经生长因子组3 d后表达有明显增高,其中损伤组第3、5、7、10天分别增高至正常的7.1、35.0、19.6和9.5倍,NGF组第3、5、7、10天分别增高至正常的8.0、32.4、20.4和8.5倍;两组之间不同时间测定值差异均无统计学意义(P>0.05).结论 视神经不完全损伤后TrkA表达短期内增高,局部应用医用生物蛋白胶缓释神经生长因子不影响其表达.     

Acute pathological changes of facial nucleus and expressions of postsynaptic density protein-95 following facial nerve injury of varying severity★ A semi-quantitative analysis

BACKGROUND： Previous studies have demonstrated that postsynaptic density protein-95 （PSD-95） is widely distributed in the central nervous system and is related to the development of the CNS and sensory signal transmission as well as acute or chronic nerve cell death following ischemic brain injury. OBJECTIVE： To semi-quantitatively determine the pathological changes of apoptotic facial neurons and the expression of PSD-95 in the facial nucleus following facial nerve injury of varying extents using immunohistochemical staining methods. DESIGN, TIME AND SETTING： Randomized, controlled animal experiments were performed in the Ultrasonic Institute of the Second Affiliated Hospital of Chongqing University of Medical Sciences from September to December 2007. MATERIALS： Sixty-five healthy, adult, Sprague-Dawley （SD） rats, both male and female, were used for this study. Rabbit anti-rat PSD-95 polyclonal antibody was purchased from Beijing Biosynthesis Biotechnology Co., Ltd. METHODS： SD rats were randomly assigned into a control group with five rats and three injured groups with 20 rats per group. Exposure, clamp and cut for bilateral facial nerve trunks were performed in the rats of the injury groups, and no injury was inflicted on the rats of the control group. MAIN OUTCOME MEASURES; The brainstems of all the rats were excised on days 1, 3, 7, and 14 post injury, and then the facial nuclei were stained with hematoxylin-eosin to observe any pathological changes due to apoptosis in facial neurons. PSD-95 expression in facial nuclei was detected by immunohistochemistry and the number of PSD-95 positive cells was counted under a light microscope. RESULTS： The expression of PSD-95 in the facial nucleus and morphology of the facial neuron within the exposure group had no obvious changes at various points in time tested （P 〉 0.05）. However, the expressions of PSD-95 in the facial nucleus of the clamp group and cut group increased on day 1 post injury （P 〈 0.05）, and showed further increase on d     

依帕司他与甲钴胺联合治疗糖尿病周围神经病变疗效观察

目的探讨依帕司他联合甲钴胺治疗糖尿病周围神经病变（DPN）的疗效。方法对96例DPN患者随机分为治疗组48例和对照组48例。在控制血糖血脂等治疗的基础上,治疗组采用依帕司他联合应用甲钴胺,对照组单用甲钴胺,8周后比较2组治疗前后症状、体征变化及神经传导速度（包括腓总神经和正中神经运动神经传导速度（MNCV）和感觉神经传导速度（SNCV）。结果治疗组总有效率87.50%,明显优于对照组64.58%（P〈0.01）;正中、腓总神经传导速度（MNCV和SNCV）2组间和组内进行比较,差异均有统计学性意义（P〈0.05）。结论采用依帕司他联合甲钴胺治疗DPN能明显改善患者症状、体征、传导功能,从而达到良好的治疗效果。