小针刀对肌张力增高大鼠脊髓和背根神经节内P物质影响的研究

目的:探讨骨骼肌受压后初级感觉神经元兴奋性递质(substance P,SP)在背根神经节(dorsal root ganglion,DRG)内的合成、脊髓中枢端末梢的释放机制,观察小针刀针刺的影响。方法:采用大鼠股薄肌70kPa受压模型。24只大鼠随机均分为3组,分别为空白组、压迫组、针刀组。除空白组6只外,其余18只大鼠左侧设为压迫组,右侧设为针刀组,组内分1、2、3d不同组,每组6只。两组同时进行70kPa压强压迫,每天压迫1次,每次2h。同时于造模后对针刀组股薄肌进行小针刀针刺。用免疫组织化学方法结合图像分析技术检测各组大鼠股薄肌受压后及针刺后背根神经节和相应脊髓节段内P物质的表达变化。结果:在DRG中,空白组针刀侧阳性反应明显强于对侧,P0.01;针刀1、2d组SP表达整合光密度(integrated optical density,IOD)较压迫组低,P0.05。在脊髓中,与压迫组比较,针刀1、3d组SP阳性表达area和IOD数值较高,P0.01;2d组两指标则低于对侧。结论:小针刀针刺可明显减低骨骼肌受压后DRG内疼痛物质SP的合成,SP在中枢末梢的释放在短期内(3d)未见明显变化。     

大鼠股薄肌异位寄养后恢复神经再支配的组织学观察

目的探讨大鼠股薄肌异位寄养后恢复神经再支配的方法。方法取8月龄健康雄性SD大鼠60只,体重400～500g;随机分为三组,每组20只,分别为对照组、运动神经吻合组和感觉神经吻合组。将右侧股薄肌切取后寄养于左侧股部,对照组：离断的闭孔神经不作处理;运动神经吻合组：离断的闭孔神经与左侧股神经分支吻合;感觉神经吻合组：离断的闭孔神经与左侧隐神经吻合。术后25周观察股薄肌大体形态并测量肌湿重,组织学切片嗜银染色观察神经末梢情况及神经吻合口横断面的结构。结果对照组股薄肌萎缩明显,肌肉色泽苍白,肌湿重为204.0±15.3mg;运动神经吻合组和感觉神经吻合组股薄肌与神经连接佳,萎缩不明显,肌湿重分别为394.8±12.9mg和389.2±13.5mg,两组间比较差异无统计学意义（P〉0.05）,与对照组比较差异有统计学意义（P〈0.05）。感觉神经吻合组的组织学观察可见神经再生轴突弥散生长,无完整的运动终板;运动神经吻合组再生的神经轴突向肌纤维生长并终于运动终板。结论运动或感觉神经吻合能有效减轻异位寄养的骨骼肌失神经性萎缩,促进神经再支配的恢复。     

针刀干预对膝骨关节炎兔股直肌组织形态及超微结构的影响

目的:观察针刀干预对膝骨关节炎(knee osteoarthritis,KOA)兔股直肌组织形态及超微结构的影响,揭示针刀治疗KOA可能的疗效机制.方法:选取6月龄新西兰雄性兔24只,体质量(2.0±0.5)kg,采用随机数字表法分为空白组、模型组、针刀组,每组8只.改良Videman法左后肢伸直位石膏固定制动6周复制...     

小针刀通过足三里对肌痛共病抑郁大鼠行为学及海马NLRP3和IL-1β表达的影响

目的：观察小针刀刺激足三里穴对肌痛共病抑郁大鼠行为学及海马区Nod样受体蛋白3（Nod-likereceptor protein,NLRP3）和白介素1β（interleukin-1β,IL-1β）表达的影响。

方法：采用急性利血平腹腔注射法制备肌痛共病抑郁大鼠动物模型,将24只SD雄性大鼠随机分为正常组、模型组、小针刀组和阿米替林组,每组6只,分别给予对应处理。检测各组大鼠Open field行为学以及机械痛敏程度,智能热板仪检测各组大鼠热缩足阈值,应用Western blotting免疫印迹法检测大鼠海马NLRP3和IL-1β表达量。

结果：与模型组比较,小针刀组大鼠足底机械痛阈明显改善（P<0.01）;与阿米替林组比较,针刀刺激足三里可显著提高大鼠热缩足阈值（P<0.05）。在Open field行为学大鼠水平运动距离及穿格次数比较中,小针刀组大鼠旷场水平运动总距离明显增加（P<0.05）;与模型组比较,大鼠穿格次数有增多趋势,但差异无统计学意义（P>0.05）。模型组大鼠海马体NLRP3和IL-1β表达均明显升高（P<0.05）,小针刀组IL-1β表达明显降低（P<0.05）;针刺足三里可抑制大鼠海马NLRP3的表达,但与模型组比较,差异无统计学意义（P>0.05）。

结论：小针刀可以改善利血平导致的肌痛共病抑郁大鼠的病理状态,其作用机制可能与抑制中枢海马内NLRP3炎性小体和IL-1β的表达有关。     

杜仲腰痛丸对大鼠非压迫性髓核突出神经根损伤的组织形态学研究

目的：观察杜仲腰痛丸对大鼠非压迫性髓核突出神经根损伤的组织形态学变化。方法：取健康雄性Wistar大鼠50只，随机分为假手术组（A组）、模型组（B组）、伸筋丹组（C组）、杜仲腰痛丸高低剂量组（分别为D、E组），每组10只。将大鼠自身的尾椎髓核取出移植于左侧L5、L6神经根背侧，造成大鼠非压迫性髓核突出模型，观察2周时神经根组织形态学变化。结果：B、C、D、E组神经根均产生明显可见的组织形态改变，但C、D、E组改变程度较B组减轻。结论：杜仲腰痛丸可减轻非压迫性髓核突出神经根损伤所导致的组织形态病理学改变，改善或抑制炎症反应，有保护神经根的作用。     

蛛网膜下腔注射抗强啡肽A_（1～13）血清或nor－BNI对大鼠脊髓损伤后功能恢复的影响

以３５ｇ重量压迫裸露的大鼠胸Ｔ＿（７～８）脊髓背侧５分钟，造成脊髓的压迫性损伤。伤后立即向蛛网膜下注射抗强啡肽Ａ＿（１～１３）血清１０μｌ（滴度为１：３００００）或阿片ｋ受体桔抗剂ｎｏｒ－ＢＮＩ（１００ｎｇ），并在创伤１、２、３小时分别给上述剂量的半量，观察伤后恢复情况。结果表明，给予抗强啡肽Ａ＿（１～１３）血清后大鼠双后肢肌张力和运动功能的恢复明显快于ｎｏｒ－ＢＮＩ组或对照组；ｎｏｒ－ＢＮＩ组双下肢运动功能恢复快于对照组。组织学观察表明，强啡肽抗血清和ｎｏｒ－ＢＮＩ均可有效阻止或减轻脊髓受压损伤后产生的局部组织坏死，出血及神经细胞变性等病理改变，强啡肽抗血清作用更显著。     

组织工程小肠肌层发育形态学初探

目的采用改良方法构建组织工程小肠，初步从形态学上研究小肠肌层发育，探讨完善构建的条件。方法实验分4组：A组，空白管样多聚体支架植入近交系wistar大鼠体内，共4例，植入后第3、4周取材；B组，非改良方法分离小肠上皮类器官单位（Intestinal epithelium organoid units，IOUs）与多聚体支架复合植入大鼠体内，共4例，植入后第3、4周取材：C组，改良方法分离IOUs与多聚体支架复合植入大鼠体内，共8例，植入后第3、4、7、11周取材；D组，改良方法分离IOUs与细胞外基质胶（ECM胶）复合物注入裸鼠背部（每只注射4例，3例为复合物，1例为空白ECM胶注入），共16例，植入后第1、2、3、7周取材。取材后均行组织学、免疫组化染色进行组织形态学分析。结果改良方法分离IOUs构建的囊样小肠肠壁仅能见到类粘膜肌层发育，未见到典型的固有肌层发育。非改良方法可以见到团块样聚集的类固有肌层发育。空白支架植入未见小肠细胞发育。结论利用组织工程小肠模型研究大鼠肠道重构发育是一个较好的方法，粘膜肌层的重构可以不依赖环肌层和纵肌层肌细胞的存在。     

腰椎后路术后骶棘肌损伤的实验研究

目的 观察腰椎后人路手术时骶棘肌不同程度的外科创伤与其组织形态学之间的相关性。方法 将成年新西兰大白兔20只随机均匀地分为五组：A组(对照组)，B组(假手术组)，C组(低张力组)，D组(高张力短时间组)，E组(高张力长时间组)。每组分别于术中骶棘肌牵开前、术后即刻、术后2d、1周、2周、1月、2月取压力感应片下的深层骶棘肌肌肉，分别送石蜡、冰冻及透射电镜检查。结果 各后路手术实验组随骶棘肌剥离、牵拉和持续时间的逐渐加大而呈现逐渐加剧的病理改变，总的结果是呈现变性、坏死和修复反应的顺序演变。在损伤早期，主要呈现不同程度的横纹肌细胞间水肿、炎细胞浸润和核内移；严重者可出现腊样变性及液化性坏死，腊样变性肌细胞。从术后第1周起，肌组织的坏死越来越明显，并逐渐向修复反应过渡，可出现片状的小群状肌萎缩或肌纤维同型化；后期最主要的是纤维组织大量增生并替代大片萎缩的肌纤维。电镜的病理改变与光镜结果相一致，后期可见大量的胶原纤维和成纤维细胞增生，有大量脂滴聚集现象。结论 不同程度的骶棘肌剥离、牵拉能造成不同程度的骶棘肌损伤，其牵拉力和持续时间的大小与组织学结果相平行，电镜与光镜组织学结果是相一致的；多种损伤机制(压迫、缺血、代谢紊乱、失神经支配)参与了后路手术时对骶棘肌的损伤反应。     

颈前动力失衡致兔颈肌及颈间盘变化的组织形态学研究

目的：观察颈前肌短缩痉挛所致颈椎动力失衡状态下,颈肌及颈间盘的组织形态学变化。方法：健康成年大耳白兔30只,体重(2.75±0.25) kg,雌雄各半。单纯随机法分成模型组、假手术组,每组15只。采用手术方法制备动物模型,模型组将双侧胸锁乳突肌肌束中部,用医用硅胶硬管垫起致其短缩,建立颈椎动力失衡模型;假手术组仅切开暴露双侧胸锁乳突肌。于术后2个月同一时间,观察两组颈肌及颈间盘的大体及组织形态学变化,同时对两组肌纤维的数量及横截面积进行比较。结果：术后2个月,模型组颈肌及颈间盘发生明显的组织形态学变化。假手术组未见明显形态学改变。模型组颈前肌与颈后肌肌纤维数量较假手术组均明显减少(P<0.05);同样,模型组颈前肌与颈后肌肌纤维横截面积亦变小(P<0.05),颈前肌变化较颈后肌明显。结论：颈前肌短缩痉挛所致颈椎动力失衡可导致颈肌及颈间盘组织发生病理改变,为研究颈前肌异常动力失衡引发的早期颈椎病发病提供实验证据。     

大腿内收肌神经肌支的终支的应用解剖学

1978年Ｓｕｎｄｒｌａｎｄ[1] 对闭孔神经的形态及内部神经束的配布作过报道。司心成[2 ] 对闭孔神经进行过显微外科解剖学观察。但都没有神经肌支在入肌处分支特点的详细记载。这些结果大都是为提供解剖学数据。本文着重对神经肌支及其在肌门处的终支作显微外科解剖学观察。为临床行肌门处选择性神经终支切断术 ,解除脑瘫下肢肌痉挛 ,提供形态学依据。1　材料和方法采用经甲醛防腐固定 ,动脉灌注红色乳胶的成人尸体下肢标本 42侧 (男 2 6,女 16)。其中 40侧标本 ,在股内侧中上段清除皮肤、脂肪、筋膜组织 ,显露闭孔神经前、后支。将至股薄…     

针刀松解法治疗第3腰椎横突综合征的 随机对照试验

目的:从生物力学角度探讨针刀松解法对第3腰椎横突综合征的治疗效果.方法:2007年3～12月,采用随机数字表将第3腰椎横突综合征患者分为针刀治疗组34例和电针对照组35例,分别进行针刀、电针治疗,各治疗3周.治疗组男12例,女22例;平均年龄(42.33±7.86)岁.对照组男16例,女19例;平均年龄(44.73±10.34)岁.治疗前、后分别对下肢生物力学、局部张力及压痛指数进行观察,按"JOA下腰痛评分系统"进行疗效评价.结果:完成试验者共60例,治疗组经针刀治疗,其软组织局部张力明显低于对照组(P=0.000 04),治疗组患者步态稳定性明显强于对照组,压痛指数治疗组改善较大.在疗效评价上,治疗组治疗结果为优18例,良9例,可3例,差0例.结论:针刀松解法可明显起到减张、镇痛作用,对第3腰椎横突综合征症状及体征的改善优于电针对照组,且疗效安全可靠.     

Motor reinnervation of a denervated muscle by using a sensory nerve: an experimental study on gluteus maximus muscle of the rat

PURPOSE: This study aimed at developing a new muscle reinnervation technique using a sensory nerve. METHODS: We attempted innervation of the rat gluteus maximus muscle using the lateral femoral cutaneous nerve (LFCN). We placed the gluteus maximus muscle into the fibroadipose tissue in the distribution of the LFCN in 24 rats. In one group, the original innervation remained intact. In the second and third groups, the muscles were denervated, and in the third group, the proximal end of the nerve to the gluteus maximus was sutured to the distal end of the divided LFCN. We compared muscle reinnervations of the groups by using electrophysiologic evaluation of the muscle contractions, light microscope evaluation of the axonal regenerations, and scanning electron microscope evaluation of the actin-myosin structures of the muscles at the end of an elapsed waiting period. RESULTS: At the end of electrophysiologic evaluation, the mean area of compound muscle action potentials measured in group 1 was 3.8 ms/mV; in group 2, 0.0; and in group 3 (experimental group), 0.5. Axonal regeneration was observed distal to the coaptation, and actin-myosin structures were mostly spared in group 3. CONCLUSIONS: This study explored the feasibility of a new flap prefabrication method that aims at developing reinnervation of a denervated muscle by means of a sensory nerve. In light of histologic and electrophysiologic findings, this type of reinnervation is possible.     

Influence of extensive muscle injury on fracture healing in rat tibia

OBJECTIVES: The treatment of tibial fractures associated with severe soft tissue injury remains a challenge. The objective of our experiment was to ascertain the influence of standardized muscle injuries on fracture healing in a nailed rat tibial fracture model. We hypothesized that a severe crush injury of leg muscles might not be as deleterious to fracture healing as total loss of a large muscle segment. STUDY DESIGN: A randomized study in male Wistar rats with a diaphyseal osteotomy. METHODS: Three separate, but complementary experiments were done in 51 rats. The first experiment involved 30 rats randomly assigned to three increasingly severe soft tissue interventions in a nailed tibial osteotomy model. The second experiment involved 14 rats divided into two groups to study blood flow measurements of the muscle envelope after soft tissue injury. Seven rats were used in the third experiment to provide biomechanical data and dimensions of the rat tibia. The protocol for the first experiment was intramedullary nailing after a middiaphyseal osteotomy of the left tibia. In group A, the soft tissue injury was minimal, while the muscles in the anterolateral compartment were crushed in group B. Resection of the anterolateral compartment muscles, resulting in only skin coverage at the fracture site, was performed in group C. The fibular nerve was resected in all three groups so that the animals were non-weight bearing on the operated extremity. At 4 weeks, the healing bones in each group were studied clinically, radiographically, and biomechanically. RESULTS: Radiographs in two planes revealed a clearly visible fracture line in the three intervention groups at 4 weeks. The callus area following muscle resection in group C was significantly reduced compared with the minimal soft tissue injury in group A. Biomechanically, resection of the anterolateral compartment muscles in group C reduced maximum bending load and fracture energy compared with fractures with minimal soft tissue injury in group A, while bending rigidity and fracture energy was reduced compared with muscle crush in group B. No difference in mechanical characteristics was detected between the healing bones in groups A and B. CONCLUSION: This animal study indicates that crushing of the leg muscle envelope with reduced blood flow does not influence the quality of bone healing at 4 weeks to a significant degree. Resection of a large muscle segment impairs tibial fracture healing significantly.     

Neuronal regeneration in denervated muscle following sensory and muscular neurotization

Background and purpose?Neurotization of denervated muscles has been shown to improve muscle bulk, but the neuronal regeneration response has not been compared previously in different surgical techniques of neurotization. Thus, using a rat model of experimental skeletal muscle denervation, we studied neuronal regeneration following sensory neurotization by two methods: sensory nerve to motor branch of muscle and direct sensory nerve implantation to muscle.

Material and methods?The lateral head of the gas-trocnemius muscle was denervated in 36 rats, of which the first 12 served as denervated controls. In the second group of 12, the sural nerve was anastomozed to the motor branch of the gastrocnemius muscle (sensory-to-motor nerve neurotization) and in the remaining 12 rats the sural nerve was split into 4 fascicles and embedded into 4 quadrants of the muscle (direct sensory nerve-to-muscle neurotization). Immunohistochemistry was used to examine nerve fibers in muscle containing the sensory neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP), and general neuronal marker protein gene product 9.5 (PGP 9.5).

Results?Semiquantitative analysis showed that, compared to the control side, the number of nerve fibers on the experimental side was highest (p < 0.01) for group III (direct sensory nerve-to-muscle neurotization) for all 3 markers. The difference was 71%, 298%, and 254% for PGP 9.5, CGRP, and SP, respectively.

Interpretation?This method may be a good option for inducing neuronal regeneration in denervated muscles, and has therapeutic implications for prevention of atrophy of denervated muscles and as an adjunct for reconstruction of soft tissue defects.     

电针结合有氧运动对自然衰老大鼠骨骼肌IGF-I/Akt通路的作用

目的:探索低频电针结合有氧运动对增龄性骨骼肌萎缩的效应,以及IGF-I/Akt及其下游蛋白质合成相关通路信号蛋白的影响。方法:以自然衰老SD大鼠为研究对象,将6月龄雄性SD大鼠32只,体重400～450 g,饲养至大鼠12月龄,根据体重随机分为4组。对照组(YC,只抓取、固定、放回,不做其他干预),电针组(YA,电针干预),运动组(YE,运动干预),电针+运动组(YEA,电针结合运动干预),自SD大鼠12月龄开始持续干预至18月龄,实验结束时观察各组自然衰老大鼠:骨骼肌湿重/体重比;光学显微镜下比目鱼肌HE染色形态;Real-time qPCR法检测骨骼肌中IGF-I mRNA的表达水平;Western印迹法测定的大鼠腓肠肌中AKT、mTOR、p70S6K和p-p70S6K相关蛋白表达情况。结果:与YC组相比,YA组、YEA组皆明显增加18月龄大鼠腓肠肌湿重/体重比(P0.05);YEA组能明显增加比目鱼肌湿重/体重比,高于YC组和YA组(P0.05)。与YC组相比,各个干预组大鼠的腓肠肌IGF-I mRNA表达水平皆有上升趋势,其中YEA组IGF-I mRNA表达增加更为明显(P=0.051)。与YC组相比,电针组(YA)p-Akt,p-mTOR表达升高(P0.05),电针+运动组(YEA)p-Akt,p-mTOR,p-p70S6K表达也显示出升高趋势(P0.05)。结论:电针结合有氧运动可延缓18月龄自然衰老大鼠增龄性骨骼肌萎缩,其分子机制可能与通过激活IGF-I/Akt通路,促进蛋白合成有关。     

神经营养因子-3基因移植的雪旺细胞延缓肌萎缩的实验研究

目的 探讨神经营养因子-3(neurotrophic factor-3,NT-3)基因修饰的雪旺细胞(Schwann cells,SC)延缓失神经性肌肉萎缩的作用.方法 采用双酶消化法和贴壁法培养、纯化与传代SC.应用阳离子脂质体以NT-3基因修饰SC,免疫组织化学S-100染色检测NT-3基因转入前后SC的纯度.切断右侧胫神经建立腓肠肌失神经支配的动物模型.将104只SD大鼠按注射药物的不同随机分为4组,每组26只.A组,细胞外基质(extracellular matrix,ECM)凝胶组;B组,SC-ECM凝胶组;C组,NT-3基因-ECM凝胶组;D组,NT-3基因修饰的SC-ECM凝胶组.术后12周进行腓肠肌肌肉电生理,8周和12周做肌湿重、肌纤维横截面积的检测.结果 NT-3转染前后SC纯度分别为(94.7±2.1)%及(95.6±2.5)%,两者比较差异有统计学意义(P＜0.05).术后12周用电刺激腓肠肌,均可引出肌肉收缩活动;且随着时间的延长,单次收缩的波幅、速度,及强直收缩的时间和强直收缩波幅的恢复率均增加.D组均优于B、C组,B、C组均优于A组(P＜0.05),而B、C组相比差异无统计学意义(P＞0.05).术后8周和12周的肌湿重与肌纤维横截面积D组均优于B、C组,B、C组均优于A组(P＜0.05),而B、C组相比差异无统计学意义(P＞0.05).结论 转染NT-3基因的SC移植能够实现失神经骨骼肌的神经再支配,并且能与骨骼肌建立起功能性突触连接,有延缓失神经性骨骼肌萎缩的作用.     

Effect of administration of antibodies against nerve growth factor in a rat model of muscle injury

IntroductionAlthough muscle injury is a common source of pain, the mechanism causing such pain is not completely known. We have previously reported nerve growth factor (NGF) as a proinflammatory mediator involved in acute pain, and clinical trials have shown the effectiveness of anti-NGF antibodies for management of low back pain. Here, we aim to examine the effects of anti-NGF antibodies on muscle-derived pain by studying their effects on sensory innervation in a rat muscle injury model.MethodsA nervous system tracer, Fluoro-Gold, was applied to both gastrocnemius muscles of 24 male Sprague Dawley rats to stain the sensory nerves. Then, the drop-mass method was used to damage the right gastrocnemius muscle of the posterior limb. Anti-NGF antibodies (50 μL) were injected into the injured muscles in 12 rats. Tissues were evaluated 1, 3, and 7 days post-injury by performing haematoxylin-and-eosin (HE) staining. The percentage of the total number of FG-positive cells that were also positive for a pain-related neuropeptide, calcitonin gene-related peptide (CGRP), was determined for the bilateral dorsal root ganglia from L1 to L6 7 days post-injury.ResultsHE staining showed active inflammation, indicated by increased basophil and eosinophil accumulation, at the injury site 1 and 3 days post-injury, as well as scar tissue formation 7 days post-injury. Injection of anti-NGF reduced muscle necrosis 1 and 3 days post-injury, and resulted in replacement of granulation tissue and muscle fibre regeneration 7 days post-injury. Anti-NGF also significantly inhibited CGRP among FG-positive cells (treatment group 38.2%, control group 49.6%; P < 0.05).DiscussionThis study found active inflammation induced by NGF, which may contribute to pain after muscle injury. Anti-NGF antibodies successfully suppressed the pain mediator NGF and inhibited inflammation, suggesting NGF as a target for control in pain management.     

肩胛肌筋膜炎软组织张力与颈椎生理曲度改变相关性探讨

目的：探讨肩胛肌筋膜炎患者颈椎曲度改变与软组织张力之间的相关性。方法：2012年2月至2012年12月门诊确诊肩胛肌筋膜炎患者29例,男10例,女19例;年龄22~40岁,平均27．77岁。常规拍摄颈椎正侧位X线片,并采用Borden测量法对颈椎生理曲度进行测量,用软组织张力仪测量患者痛点张力。最后对上述数值进行统计分析。结果：29例肩胛肌筋膜炎患者的侧位X线表现：颈椎生理曲度正常者9例,颈椎生理曲度减小者18例,颈曲颈椎生理曲度增大者2例。颈椎生理曲度改变D值（Y）对软组织张力位移D0.5kg（X）的回归方程Y=-15．069＋3．673X。结论：颈椎生理曲度改变与软组织张力之间具有相关性,可用线性回归方程表示。随着软组织张力的增加,颈椎生理曲度有减小的趋势。     

中枢神经提取液对失神经肌肉的作用

目的：研究中枢神经的有效物质对失神经肌肉的作用。方法：在ＳＤ大鼠失神经趾长伸肌中，应用中枢神经提取液（ｃｅｎｔｒａｌｎｅｒｖｅｅｘｔｒａｃｔ，ＣＥ），并观察肌肉萎缩的生理学指标。结果：肌肉失神经后的最大强直收缩力（ｔｅｔａｎｉｃｔｅｎｓｉｏｎ，ＰＯ）及强直收缩后动作电位（ｐｏｓｔｅｔａｎｉｃｔｗｉｔｃｈｐｏｔｅｎｔｉａｔｉｏｎ，ＰＴＰ）下降，舒张期时程（ｒｅｌａｘａｔｉｏｎｔｉｍｅ，ＲＴ）延长，肌湿重、肌肉总蛋白及肌纤维截面积（ｃｒｏｓｓ－ｓｅｃｔｉｏｎａｒｅａ，ＣＳＡ）的减少，均可被中枢神经提取液有效地缓解。结论：中枢神经提取液可减缓失神经肌肉的萎缩     

Phonomyography as a non-invasive continuous monitoring technique for muscle ischemia in an experimental model of acute compartment syndrome

BackgroundIn acute compartment syndrome (ACS), clinicians have difficulty diagnosing muscle ischemia provoked by increased intra-compartmental pressure in a timely and non-invasive manner. Phonomyography records the acoustic signal produced by muscle contraction. We hypothesize that alterations in muscle contraction caused by muscle ischemia can be detected with phonomyography, serving as a potential non-invasive technique in the detection of ACS.MethodsThe left hind limb of 15 Sprague-Dawley rats was submitted to a reversible ischemic model of limb injury for 30 min and 1, 2, 4, 6 h (3 rats in each group). The right limb served as control. Phonomyography microphones were placed over the posterior calf of both limbs and the sciatic nerve was stimulated percutaneously at 10-min intervals to evaluate muscle contraction. Histopathological analysis of muscles and nerves biopsies was performed and correlation was made between duration of injury, phonomyography output and degree of muscle and nerve necrosis.ResultsThere was a statistically significant decrease in the phonomyography signal output in the ischemic limb that correlated with the duration of ischemia and histological findings of muscle and nerve necrosis. The phonomyography signal decrease and histological findings were respectively: 55.5% (n = 15;p = 0.005) with rare muscle and nerve necrosis at 30 min, 65.6% (n = 12;p = 0.005) with 5–10% muscle necrosis at 1 h, 68.4% (n = 9;p = 0.015) with 100% muscle necrosis and little nerve damage at 2 h, 72.4% (n = 6;p = 0.028) with 100% muscle necrosis and severe nerve damage at 4 h, and 92.8% (n = 3;p = 0.109) with 100% muscle necrosis and severe nerve degeneration at 6 h.ConclusionChanges in phonomyography signal are observed in early ischemic injury prior to the onset of nerve or muscle necrosis. Therefore, phonomyography could serve as a non-invasive technique to detect early ischemic muscle changes in acute compartment syndrome.Clinical relevanceThe detection of abnormal muscle contraction in a timely fashion and non-invasive manner is of interest in clinical settings where the presence of ischemia is not easy to diagnose.