神经导管生物材料修复周围神经损伤的动物实验

目的:通过动物体内神经导管生物材料移植实验,观察、测定再生神经功能恢复的程度和神经再生的数目。方法:应用计算机检索中国期刊全文数据库1996/2010文献,检索词为"神经导管,神经损伤,导管材料,生物材料"。纳入有关神经导管材料在周围神经损伤修复中应用的动物实验。结果:现有的任何材料都不能制备出理想的神经导管。在生物可降解前提下,往往天然材料具有更好的生物相容性,而合成高聚物可以通过调节组分的比例和相对分子质量及相对分子质量分布等条件,从而调节降解时间和材料的机械性能以及物理性能。外周神经修复理想的导管首先需要选择合适的生物材料和组装技术,制成具有良好物理特性(通透性、柔韧性、降解性等)的导管,尤其是对于较大的神经缺损通透性和柔韧性更为重要。结论:在单腔中空导管中填充不同材料能促进神经的再生,联合应用几种不同的填充物质可能更加有利于神经修复。     

用挤出工艺制造用于引导组织再生的多孔可降解聚合物导管

在修复神经损伤时,使用神经导管是一种有前途的方法。导管为神经生长提供通道。使用较多的材料包括肌肉、血管和合成材料。管壁具有通透性的导管可为细胞生长提供养料。本工作利用溶剂浇铸和挤出技术,制造出多孔可降解导管,并对制造工艺及导管性质进行了研究。所用聚合物包括聚左旋丙交酯（ＰＬＬＡ）和ＤＬ丙交酯与乙交酯的７５∶２５共聚物。制备过程是先将聚合物溶于二氯甲烷再加入粒径１５０～７１０μｍ的ＮａＣｌ颗粒,混合物浇铸在玻璃板上挥发切成小片,放入活塞式挤出装置,在２００℃～２７５℃以１ｃｍ／ｓ的速度挤出导管,…     

合成材料神经导管与自体神经移植修复周围神经缺损的比较

背景：生物可降解材料制成的神经导管可在体内降解,避免出现的神经卡压等问题,因而受到越来越多的关注。 目的：比较自体神经移植与3种合成可生物降解材料神经导管在修复周围神经损伤的效果差异。 方法：通过电生理学检测,形态学观察等神经恢复效果评价方法,对比分析近年来常用的胶原神经导管、DL-乳酸-ε-己内酯神经导管、聚乙醇酸神经导管与自体神经移植修复周围神经缺损的效果。 结果与结论：虽然神经导管与自体神经移植相比在理论上有其优势的一面,但不同合成材料的神经导管之间在神经功能恢复中存在明显差异性,DL-乳酸-ε-己内酯神经导管修复效果与自体神经移植无明显差异,是较为理想的神经导管材料,聚乙醇酸神经导管因自身的因素影响其降解性能,在3种神经导管中的修复周围神经损伤效果最差,胶原神经导管需要交联剂改善其机械性能,其修复周围神经损伤效果居于前两者之间,因此,这3种神经导管在神经功能再生方面还有潜在的缺陷,不能完全替代自体神经移植,而且3者之间的性价比,还缺少足够的大样本长期随机对照实验结果来验证,还需要进一步的实验观察。     

神经导管修复周围神经损伤的研究进展

随着神经修复技术特别是显微外科的发展，神经损伤修复的质量有了进一步的提高；利用神经导管桥接神经断端以实现修复周围神经损伤是目前的一个研究热点。本综述了神经导管修复周围神经损伤的发展历史，分析比较了非神经组织、非生物降解材料、可生物降解材料神经导管在神经损伤修复中的效果，讨论了导管的形态及导管内微环境对神经再生的影响。     

神经导管生物材料在神经修复中的应用

背景：神经导管是由天然或人工合成材料制成的、用于桥接神经断端的组织工程支架材料,具有引导和促进神经再生作用。 目的：总结近年来常用的神经导管生物材料在神经修复中的应用。 方法：由作者应用计算机检索维普数据库中与神经导管生物材料在神经修复中应用有关的文章,检索时限2002-01/ 2010-12。检索关键词：神经导管;生物材料;神经损伤;神经修复;神经再生。纳入标准：与神经导管生物材料在神经修复中应用有关的文章。排除标准：重复研究或较陈旧文献。根据纳入排除标准共保留相关文献30篇。 结果与结论：非生物降解材料由于其不可吸收性和对再生神经的远期不良影响使临床应用受到限制。生物降解材料在神经再生完成后可在体内降解吸收,无需二次手术取出,但目前未能利用生物降解材料完全仿制出具有天然神经结构的支架。生物衍生材料生物相容性好、排异反应小,可提供细胞外基质、胶原,起支架作用,但缺血后存在管形塌陷、再生不良、吸收瘢痕组织、增生及粘连等问题。神经导管生物材料在神经修复中的应用前景广阔,但单用一类材料难以制作出理想的神经导管生物材料,通过结合各类材料的优点,与神经营养因子、细胞外基质成分和许旺细胞等联合应用,制备新型具有生物活性的导管材料,将有利于神经修复进一步发展。     

生物材料构建神经导管修复周围神经损伤的临床应用

背景：显微外科技术及周围神经损伤修复技术的发展与神经导管材料密切相关。神经导管的构建特别是生物材料构建神经导管材料还有待进一步开发研究。 目的：探讨生物材料构建的神经导管在周围神经损伤修复中的应用及数据分析。 方法：SCI数据库中2001/2010检索有关神经导管在周围神经损伤修复中的应用的文献,检索词为“神经导管(nerve conduit);生物材料(biomaterials);周围神经损伤(peripheral nerve injury);神经再生(nerve regeneration);壳聚糖神经导管(chitosan/chitin nerve conduit);高分子神经导管(polymer/macromolecule nerve conduit);胶原神经导管(collagen nerve conduit)”,共检索文献183篇。 结果与结论：神经导管修复法是在神经断端之间留有一段间隙,利用神经导管在神经的远端和近端之间桥接,并创造相对密闭的环境,以充分发挥远端神经的趋化作用,同时阻隔外部的影响,减少瘢痕的产生。目前,已被用于制备神经导管材料分为非神经组织、非生物降解材料、可生物降解材料。随着分子生物学及其他相关技术的发展,探索寻找理想的材料构建神经导管来治疗周围神经损伤研究始终在进行中。     

干细胞及神经导管支架修复神经缺损

背景：组织工程的发展为神经缺损的修复提供了可能,种子细胞与导管支架制成的复合体是构建组织工程神经的核心。 目的：从干细胞的组织工程应用及构建具有良好生物相容性的导管支架材料角度,探索如何更好的修复神经损伤。 方法：以“干细胞,神经损伤,修复,神经导管,神经支架材料”为中文关键词,以“stem cells,nerve damage,repair,nerve guide conduit material,scaffold materials,nerve tissue engineering”为英文关键词,采用计算机检索CNKI和Medline数据库1996-01/2011-01有关不同来源干细胞和导管支架材料修复神经缺损的相关文章,排除重复研究或Meta分析类文章,筛选纳入30篇文献进行评价。 结果与结论：移植神经干细胞可以在神经系统存活、增殖、迁移,在不同部位分化为相应的细胞,因此给神经修复领域带来新的希望。另外,随着生物材料的发展,神经导管材料修复神经缺损也取得了优良的效果,具有良好的应用前景。将神经干细胞复合导管可降解生物材料有望能更好的满足神经支架的要求,达到修复和重建的目的。     

合成可生物降解神经导管修复损伤周围神经：生物相容性良好

背景：临床对周围神经损伤进行修复治疗的时候,可以利用自体神经进行治疗或者利用不同材质的神经导管进行治疗。 目的：探索合成可生物降解材料神经导管在周围神经损伤修复中的应用效果。 方法：48只新西兰大白兔,随机等分为3组,自体神经移植组、硅胶导管组和可降解神经导管组。各组动物切除10 mm坐骨神经,构建坐骨神经缺损动物模型,并分别利用自体神经、硅胶导管以及可降解神经导管进行坐骨神经修复。 结果与结论：造模后3周,硅胶导管组兔运动神经传导效果、小腿三头肌肌肉湿质量恢复率比自体神经移植组差,但可降解神经导管组兔运动神经传导效果、小腿三头肌肌肉湿质量恢复率与自体神经移植组接近。造模后12周时,自体神经移植组中存在大量呈均匀排列的有髓神经纤维,可降解神经导管组中可见大量分布不均匀的再生有髓神经纤维,而硅胶导管组中存在少量呈不均匀排列的髓神经纤维。表明合成可生物降解材料神经导管在周围神经损伤修复中可以获得与自体神经较为接近的良好效果。  中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

周围神经损伤与组织工程修复的研究进展

近年来 ,周围神经损伤组织工程修复的研究取得了很大的进展。动物实验与临床研究主要聚焦于寻找理想的人工神经移植替代物、神经导管和种子细胞。神经导管有非降解或可降解两种 ,神经移植物有自体神经、同种异体神经及异种神经移植物 ,作为桥接神经缺损的支架有各自的优点与缺点。同时 ,培养、种植一定数量与高纯化度的具有分泌多种神经营养因子活性的施万细胞也是提高修复神经损伤效果的关键。     

以填充胶原、白蛋白和丝蛋白的硅橡胶管引导周围神经组织再生

对于较小的神经缺损可以采用直接缝合的方法进行修复 ,但较大的缺损就需进行神经移植或使用导管连接神经断端。由于神经移植存在供体不足的问题 ,使用导管连接神经断端受到较多重视。已有许多种材料被研究用于制备导管 ,硅橡胶是研究较多的材料。为了能修复更大的神经缺损 ,多种神经营养因子和促进神经再生的因子被使用 ,如何使这些因子能较长时间发挥作用是很重要的研究课题。本工作在鼠坐骨神经上形成 1 cm的缺损 ,用硅橡胶导管连接神经断端 ,并注入含有胶原、白蛋白和丝蛋白的凝胶。凝胶是由胶原溶液、白蛋白溶液和丝蛋白溶液按一定比例…     

壳聚糖及相关材料用于神经修复的前景

壳聚糖（Chitosan）是一种具有优良的生物相容性的生物可降解材料,我们从壳聚糖的带正电性、吸附蛋白的能力、对神经细胞的特异性及表面的粗糙程度、孔径和表面形貌等方面叙述了壳聚糖的神经亲和性及壳聚糖与相关材料用于神经修复的进展和前景。     

Evaluation of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) conduits for peripheral nerve regeneration

Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) was investigated for possible application in repairing damaged nerves. Porous nerve conduits with both uniform wall porosity and non-uniform wall porosity were prepared using a particle leaching method. Adult Sprague-Dawley (SD) rats weighing 200-250 g were used as the animal model. The conduits were employed to bridge the 10mm defects in the sciatic nerve of the Sprague-Dawley (SD) rats. Mechanical tests showed that the PHBHHx nerve conduits had proper mechanical properties including maximal loads of 3.1N and 1.3N for the conduits with non-uniform wall porosity and with uniform wall porosity, respectively, and maximal stresses of 2.3 MPa and 0.94 MPa for the conduits with non-uniform wall porosity and with uniform wall porosity, respectively. At the same time, both types of conduits were permeable to three compounds tested including glucose, lysozyme and bovine serum albumin, indicating the suitability of the conduits for free exchanges of nutrients. Compound Muscle Action Potentials (CMAPs) were clearly observed in both types of the PHBHHx nerve conduits after 1 month of implantation, indicating a rapid functional recovery for the disrupted nerves. The results of histological sections demonstrated that the internal sides of the conduits with non-uniform wall porosity were compact enough to prevent the connective tissues from ingrowth penetration. After implantation for 3 months in the rats, the conduits with uniform wall porosity and those with non-uniform wall porosity lost 24% and 20% of their original weight average molecular weights, respectively. Combined with the strong mechanical properties, good nerve regeneration ability and non-toxicity of its degradation products, PHBHHx nerve conduits can be developed into a useful material to repair nerve damage.     

Studies on nerve cell affinity of biodegradable modified chitosan films

Chitosan, a natural polysaccharide that has excellent biocompatibility and biodegradability,can be used as nerve conduit material. The purpose of this work was to study the ability of chitosan and some chitosan-derived materials to facilitate nerve cell attachment, differentiation and growth. The biomaterials studied were chitosan, poly-L-lysine-blended chitosan (CP), collagen-blended chitosan (CC) and albumin-blended chitosan (CA), with collagen control material. Culture of PC12 cells and fetal mouse cerebral cortex (FMCC) cells on these biomaterials was used to evaluate their nerve cell affinity. The composite materials, including CP, CC and CA, had significantly improved nerve cell affinity compared to chitosan, as established by increasing attachment, differentiation and growth of PC12 cells. FMCC cells could also grow better on composite materials than on chitosan. CP exhibited the best nerve cell affinity among these three types of composite material. CP is an even better material in promoting neurite outgrowth than collagen, a substrate that is widely used in tissue engineering, suggesting that CP is a promising candidate material for nerve regeneration.     

Studies on nerve cell affinity of biodegradable modified chitosan films

Chitosan, a natural polysaccharide that has excellent biocompatibility and biodegradability, can be used as nerve conduit material. The purpose of this work was to study the ability of chitosan and some chitosan-derived materials to facilitate nerve cell attachment, differentiation and growth. The biomaterials studied were chitosan, poly-L-lysine-blended chitosan (CP), collagen-blended chitosan (CC) and albumin-blended chitosan (CA), with collagen control material. Culture of PC12 cells and fetal mouse cerebral cortex (FMCC) cells on these biomaterials was used to evaluate their nerve cell affinity. The composite materials, including CP, CC and CA, had significantly improved nerve cell affinity compared to chitosan, as established by increasing attachment, differentiation and growth of PC12 cells. FMCC cells could also grow better on composite materials than on chitosan. CP exhibited the best nerve cell affinity among these three types of composite material. CP is an even better material in promoting neurite outgrowth than collagen, a substrate that is widely used in tissue engineering, suggesting that CP is a promising candidate material for nerve regeneration.     

The mechanical properties and in vitro biodegradation and biocompatibility of UV-treated poly(3-hydroxybutyrate-co-3-hydroxyhexanoate)

Strong mechanical properties and controllable biodegradability, together with biocompatibility, are the important requirement for the development of medical implant materials. In this study, an ultraviolet (UV) radiation method was developed to achieve controlled degradation for bacterial biopolyester poly (3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) which has a low biodegradation rate that limits its application for many implant applications required quick degradation. When UV radiation was applied directly to PHBHHx powder, significant molecular weight (Mw) losses were observed with the powder, Mw reduction depended on the UV radiation time. At the same time, a broad PHBHHx Mw distribution was the result of inhomogeneous radiation. Interestingly, this inhomogeneous radiation helped maintain the mechanical properties of films made of the UV-radiated powder. In comparison, the PHBHHx films subjected to direct UV radiation became very brittle although their degradation was faster than that of the PHBHHx powders subjected to direct UV radiation. After 15 weeks of degradation in simulated body fluid (SBF), films prepared from 8 and 16h UV-treated PHBHHx powders maintained 92% and 87% of their original weights, respectively, while the untreated PHBHHx films lost only 1% of its weight. Significant increases in growth of fibroblast L929 were observed on films prepared from UV-radiated powders. This improved biocompatibility could be attributed to increasing hydrophilic functional groups generated by increasing polar groups C-O and CO. In general, UV-treated PHBHHx powder had a broad Mw distribution, which contributed to fast degradation due to dissolution of low Mw polymer fragments, and strong mechanical property due to high Mw polymer chains. Combined with its improved biocompatibility, PHBHHx is one more step close to become a biomedical implant material.     

壳聚糖材料在脊髓损伤后神经再生的研究与作用

背景：组织工程支架材料壳聚糖能复合多种种子细胞和神经因子,维持受损组织正常的解剖结构,防止胶质瘢痕挤压,对脊髓损伤后神经再生具有重要的意义。 目的：介绍壳聚糖材料在修复脊髓损伤后神经再生领域的研究现状。 方法：由第一作者检索1990至2012年 PubMed数据库、CNKI数据库及万方数据库有关壳聚糖材料特性、壳聚糖导管移植治疗脊髓损伤的相关文献。 结果与结论：壳聚糖具有良好的物理、化学性能,并且具有良好的生物相容性、生物降解性,免疫抗原性小和无毒性等特殊生物医学特性,与嗅鞘细胞、骨髓间充质干细胞及神经干细胞具有良好的亲和性。壳聚糖材料制备的神经导管、支架能在脊髓损伤后桥接神经断端,维持神经再生的正常解剖结构,提供种子细胞及细胞因子载体,为损伤后神经再生提供良好的微环境,但目前对于壳聚糖导管的研究仍不够全面,仍有很多问题待解决。     

Properties of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) films modified with polyvinylpyrrolidone and behavior of MC3T3-E1 osteoblasts cultured on the blended films

A series of composite films of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) modified with polyvinylpyrrolidone (PVP) was prepared by varying the ratio of constituents, and their properties and cytocompatibility were evaluated. The hydrophilicity of the blended materials surfaces increased and the amounts of fibronectin and laminin adsorbed on the materials surface increased remarkably compared with PHBHHx. FT-IR spectra of the blended films showed a new band, implying that a surface physical interpenetrating network structure had formed. Scanning electron microscopy showed that there were dense pits and holes on the blended films surface. For the films of PHBHHx with 20 wt% and 40 wt% PVP, MTT assay indicated that PVP enhanced cell adhesion and proliferation, but that the effects were impaired by excessive PVP. The results suggested that proper addition of PVP increased the cytocompatibility of PHBHHx because the material surface had increased hydrophilicity and presented an appropriate morphology.     

Properties of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) films modified with polyvinylpyrrolidone and behavior of MC3T3-E1 osteoblasts cultured on the blended films

A series of composite films of poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) modified with polyvinylpyrrolidone (PVP) was prepared by varying the ratio of constituents, and their properties and cytocompatibility were evaluated. The hydrophilicity of the blended materials surfaces increased and the amounts of fibronectin and laminin adsorbed on the materials surface increased remarkably compared with PHBHHx. FT-IR spectra of the blended films showed a new band, implying that a surface physical interpenetrating network structure had formed. Scanning electron microscopy showed that there were dense pits and holes on the blended films surface. For the films of PHBHHx with 20 wt% and 40 wt% PVP, MTT assay indicated that PVP enhanced cell adhesion and proliferation, but that the effects were impaired by excessive PVP. The results suggested that proper addition of PVP increased the cytocompatibility of PHBHHx because the material surface had increased hydrophilicity and presented an appropriate morphology.