大鼠阴茎包皮和包皮系带内nNOS免疫阳性神经末梢的分布与起源

目的观察成年SD大鼠阴茎包皮和包皮系带内神经型一氧化氮合酶(nNOS)免疫阳性神经末梢的分布和起源。方法免疫组织化学法观察nNOS免疫阳性神经末梢的分布,荧光金(Fluoro-gold,FG)逆行追踪和nNOS免疫荧光标记相结合法研究大鼠包皮系带内nNOS免疫阳性神经末梢的起源。结果成年SD大鼠阴茎包皮和包皮系带内均有nNOS免疫阳性神经末梢存在,这些神经末梢主要位于表皮基底层和真皮乳头层,呈树枝状或念珠状分布。阴茎系带处nNOS免疫阳性神经末梢的图像光密度值(3.4±0.38)明显大于阴茎包皮处(2.2±0.45)。FG逆标阳性细胞位于大鼠第六腰髓对应的背根神经节(L6-DRG)(9.6±1.2)个/mm2和第一骶髓对应的背根神经节(S1-DRG)(1.2±0.2个/mm2)内。阳性细胞大中小不等,大多沿神经束成行排列或散在分布。nNOS免疫荧光标记细胞在L6-DRG和S1-DRG内分别为(24.2±2.6)个/mm2和(24.1±2.1)个/mm2,细胞大多呈中小型。FG/nNOS双标阳性细胞均为中小型,其数量接近FG逆标阳性细胞总数的一半。结论大鼠阴茎包皮系带内含有浓密的nNOS免疫阳性神经末梢,这些神经末梢源自于L6-DRG和S1-DRG。     

背根神经节内P物质、降钙素基因相关肽免疫阳性神经元与阴茎包皮系带感觉信息的传递

目的:探讨背根神经节(DRG)内P物质(SP)、降钙素基因相关肽(CGRP)免疫阳性神经元与阴茎包皮系带感觉信息传递之间的关系。方法:通过荧光金(FG)逆行标记对大鼠阴茎包皮系带内神经末梢的来源作追踪定位,并结合SP、CGRP免疫荧光标记法,研究大鼠DRG内FG标记阳性神经元中SP、CGRP免疫阳性神经元的形态和分布。结果:FG逆行标记结果发现,大鼠阴茎包皮系带内的神经末梢起源于第6腰髓对应的背根神经节(L6-DRG)和第1骶髓对应的背根神经节(S1-DRG)的神经元。对这些神经元分别作SP、CGRP免疫荧光标记后发现,标记细胞大小不等,分别呈深红色和深绿色,沿神经束成行排列或散在分布。FG/SP、FG/CGRP双标记阳性细胞均为中小型,其数量分别占FG逆行标记阳性细胞总数的1/3和1/2,FG/SP/CGRP三标记阳性细胞占FG逆行标记阳性细胞总数的1/5。结论:大鼠L6-DRG和S1-DRG内的SP、CGRP免疫阳性神经元可能参与阴茎包皮系带感觉信息的传递。     

背根神经节内P物质、降钙素基因相关肽免疫阳性神经元与阴茎包皮系带感觉信息的传递

目的：探讨背根神经节（DRG）内P物质（SP）、降钙素基因相关肽（CGRP）免疫阳性神经元与阴茎包皮系带感觉信息传递之问的关系。方法：通过荧光金（FG）逆行标记对大鼠阴茎包皮系带内神经末梢的来源作追踪定位，并结合SP、CGRP免疫荧光标记法，研究大鼠DRG内FG标记阳性神经元中SP、CGRP免疫阳性神经元的形态和分布。结果：FG逆行标记结果发现，大鼠阴茎包皮系带内的神经末梢起源于第6腰髓对应的背根神经节（L6-DRG）和第1骶髓对应的背根神经节（S1-DRG）的神经元。对这些神经元分别作SP、CGRP免疫荧光标记后发现，标记细胞大小不等，分别呈深红色和深绿色，沿神经束成行排列或散在分布。FG／SP、FG／CGRP双标记阳性细胞均为中小型，其数量分别占FG逆行标记阳性细胞总数的1／3和1／2，FG／SP／CGRP三标记阳性细胞占FG逆行标记阳性细胞总数的1／5。结论：大鼠L6-DRG和S1-DRG内的SP、CGRP免疫阳性神经元可能参与阴茎包皮系带感觉信息的传递。     

人工体神经-内脏神经反射弧传出神经元递质研究

目的研究大鼠人工体神经-内脏神经反射弧传出神经递质性质。方法将建立了人工体神经-内脏神经反射弧的8只模型大鼠随机分为2组(n=4)，1组大鼠的左侧盆神经节(MPG)内注射荧光金(FG)，2组大鼠的尿道外括约肌(EUS)注射辣根过氧化物酶(HRP)，通过免疫组织化学方法显示FG、HRP阳性标记细胞中的中的胆碱已酰转移酶((3hAT)。结果FG、HRP逆行追踪结果显示，FG、HRP阳性标记细胞主要分布于脊髓L3尾部至L5头侧左侧前角。FG标记和ChAT阳性双标细胞约占FG标记阳性细胞的88％(133／151)；HRP标记和ChAT阳性双标细胞约占HRP标记阳性细胞的91％(93／102)。结论人工体神经，内脏神经反射弧传出神经元的神经递质主要是乙酰胆碱，体神经和内脏神经(副交感节前神经)吻合后再生神经主要递质没有改变。     

硬膜外腔植入髓核对大鼠脊髓背根神经节SP和CGRP表达的影响

目的 观察硬膜外腔植入异体髓核对大鼠L6-S1,脊髓背根神经节细胞SP和CGRP表达的影响,以期为椎间盘源性疼痛发病机制提供细胞生物学基础.方法 18只雄性SD大鼠(体重260-280g)随机分为三组:脂肪组、髓核组、假手术组,每组n=6.另外3只雄性SD大鼠用来提供异体脂肪和髓核.术后第30d取L4-L6脊髓背根神经节和脊髓背角,采用免疫组织化学染色方法 观察髓核对脊髓背角和背根神经节细胞肽类神经递质SP和CGRP表达的影响.结果 术后30d脂肪组大鼠与假手术组相比,脊髓背角和背根神经节细胞SP和CGRP表达没有显著性差异(P>0.05);髓核组与脂肪组和假手术组相比脊髓背角和背根神经节细胞SP和CGRP表达显著增加(P<0.05).结论 硬膜外腔植入异体髓核可引起脊髓背根神经节细胞SP和CGRP表达增加.     

大鼠盆神经节NOS和VIP阳性神经元对阴茎海绵体的支配

目的：研究大鼠盆神经节(MPG)中一氧化氮合酶(NOS)、血管活性肠肽(VIP)阳性神经元对阴茎海绵体的支配。方法：应用辣根过氧化物酶(HRP)逆行示踪技术结合免疫组织化学和酶组织化学双标技术,观察大鼠MPD中还原型辅酶Ⅱ(NADPFI,NOS标志物)阳性和VIP阳性神经元对阴茎海绵体的支配。结果：HRP阳性标记神经元主要分布于MPG内靠近阴茎神经的区域。HRP阳性标记神经元中72％(210／292)为VIP免疫阳性,83％(268／323)为NADPH组化反应阳性。结论：大鼠盆神经节中NOS、VIP阳性神经元对阴茎海绵体有直接支配,NO和VIP作为神经递质或调质参与了阴茎勃起。     

人工体神经-内脏神经反射弧恢复截瘫后直肠功能的神经追踪研究

目的 研究正常和建立人工体神经-内脏神经反射弧脊髓损伤大鼠肛门外括约肌-脊髓、直肠-盆神经节-脊髓之间的神经通路。方法 正常及建立人工体神经-内脏神经反射弧后截瘫的(以下简称模型组)雄性SD大鼠，用荧光金(FG)注射至肛门外括约肌(EAS)、直肠壁内、盆神经节(MPG)，行逆行神经追踪；模型组大鼠，采用麦芽凝集素结合的辣根过氧化物酶(WGA-HRP)作为顺行神经示踪剂，在大鼠脊髓左侧L4前角注入WGA-HRP。结果 正常组和模型组大鼠直肠壁注入FG后，MPG主体部可见大量标记神经元。正常组将FG注射入MPG后。FG标记神经元位于脊髓L6～S1骶髓副交感核(SPN)、后联合灰质核。正常鼠FG注射入肛门外括约肌后．标记神经元主要位于L5～S1脊髓的背内侧核(DM)区．背外侧核(DL)区可见少量标记神经元。模型组大鼠将FG注入盆神经节或肛门外括约肌后，左L4前角均可见FG标记神经元；左L4前角注入WGA-HRP后，肛门外括约肌和左侧MPG中均可见HRP阳性神经末梢。结论 正常大鼠盆神经节支配直肠的神经元主要分布于MPG主体部；脊髓内支配盆神经节的神经元主要位于脊髓L6～S1节段SPN；支配肛门外括约肌的运动神经元主要位于L5～S1脊髓DM区。建立人工反射弧后。大鼠L5～S1脊髓L4前根与L6前根吻合后所形成的“异类神经纤维”在MPG换元后，支配直肠壁和EAS。     

大鼠盆神经节胆碱乙酰转移酶和一氧化氮合酶阳性神经元对尿道外括约肌的支配

目的 观察大鼠盆神经节(MPG)中胆碱乙酰转移酶(ChAT)、一氧化氮合酶(NOS)阳性神经元对尿道外括约肌(EUS)的支配.方法 24只成年SD大鼠随机分为A组(n=12)和B组(n=12).应用辣根过氧化物酶(HRP)逆行示踪技术结合免疫组织化学和酶组织化学双标技术,观察A组大鼠MPG中ChAT阳性神经元和还原型辅酶Ⅱ(NADPH,NOS标志物)阳性神经元对EUS的支配.B组大鼠MPG内注射麦芽凝集素-辣根过氧化物酶(WGA-HRP)进行顺行神经追踪.结果 A组大鼠HRP标记神经元散在分布于MPG内.HRP标记神经元中43.3%(155/358)为ChAT免疫反应阳性,14.5%(49/339)为NADPH组化反应阳性.B组大鼠EUS内有HRP阳性神经末梢.结论 大鼠盆神经节中的神经元对EUS有直接支配,其神经递质有乙酰胆碱和一氧化氮.     

家兔阴茎皮肤和阴茎背神经躯体感觉神经元的示踪定位

目的:明确家兔阴茎感觉神经躯体纤维来源及其节段性分布规律。方法:健康成年雄性新西兰家兔8只,随机均分为A、B两组,采用辣根过氧化物酶(HRP)逆行神经示踪技术,A组用微量注射器将50%HRP多点注射于阴茎皮下,B组注射于右侧阴茎背神经近侧断端内,留针时间30 m in,动物存活5 d后,4%多聚甲醛心脏灌注,取出腰骶段脊髓及相应背根神经节(DRG),对躯体传入和传出纤维来源的节段分布进行观察。结果:A组S2~S4节段脊神经节内出现大量HRP阳性标记感觉神经元,以S2和S4为多,呈明显节段性分布,各节段阳性神经元计数分别为:S2(215.0±10.2)、S3(242.2±8.3)、S4(109.7±8.4),组间差异具有统计学意义(P<0.01)。B组同侧S2-S4节段脊髓灰质前角腹外侧部出现部分阳性标记细胞,同侧S2~S4DRG内也出现了大量的HRP阳性细胞。结论:家兔阴茎皮肤感觉神经躯体传入和传出纤维投射来源与阴茎背神经一致,均源自骶髓前角及相应的脊神经节,并呈现明显的节段性分布。     

大鼠盆神经节胆碱乙酰转移酶和一氧化氮合酶阳性神经元对尿道外括约肌的支配

目的 观察大鼠盆神经节(MPG)中胆碱乙酰转移酶(ChAT)、一氧化氮合酶(NOS)阳性神经元对尿道外括约肌(EUS)的支配.方法 24只成年SD大鼠随机分为A组(n=12)和B组(n=12).应用辣根过氧化物酶(HRP)逆行示踪技术结合免疫组织化学和酶组织化学双标技术,观察A组大鼠MPG中ChAT阳性神经元和还原型辅酶Ⅱ(NADPH,NOS标志物)阳性神经元对EUS的支配.B组大鼠MPG内注射麦芽凝集素-辣根过氧化物酶(WGA-HRP)进行顺行神经追踪.结果 A组大鼠HRP标记神经元散在分布于MPG内.HRP标记神经元中43.3%(155/358)为ChAT免疫反应阳性,14.5%(49/339)为NADPH组化反应阳性.B组大鼠EUS内有HRP阳性神经末梢.结论 大鼠盆神经节中的神经元对EUS有直接支配,其神经递质有乙酰胆碱和一氧化氮.     

荧光逆行示踪法定位神经端侧缝合后再生来源的实验研究

目的 应用荧光逆行示踪法研究神经端.侧缝合修复臂丛神经损伤的有效性及再生神经的脊髓定位.方法 雌性SD大鼠24只,随机分为4组,造成臂丛神经上干损伤模型,分别以膈神经、同侧颈,神经根为供体神经,按照端.侧和端.端两种缝合方式修复肌皮神经.术后3个月,对大鼠肌皮神经和供体神经分别采用真蓝和双脒基黄进行逆行示踪.3、7、14 d后进行灌注固定,取颈段脊髓连续切片,荧光显微镜观察.结果 各观察点背根节及脊髓前角均出现荧光标记细胞,并逐渐增多.以同侧颈,为供体神经组,标记细胞仅出现在该节段,而以膈神经为供体神经组,标记细胞出现在颈_(3-5)节段.端一侧缝合组在相应脊髓前角或背根神经节出现,同时具有两种荧光剂的双标细胞或在同一脊髓节段同时出现分别以两种荧光剂标记的单标细胞.结论 采用不同供体神经进行端.侧缝合联合神经移植修复臂丛神经可使神经再生,荧光逆行示踪可以准确定位端.侧缝合后再生神经的来源.     

Possible function of the frenulum of prepuce in penile erection

Fremulum of prepuce was the ruffle of foreskin while there was little about the function of fremulum. This study discusses the possible function of the frenulum of prepuce in penile erection. Twelve patients had premature ejaculation (PE) whose frenula were short. Two patients suffered unsatisfied intercourse whose frenula were damaged and departed 12 or 6 months earlier. We prolonged the short frenulum and reconstructed the ruptured frenulum. All patients reported satisfied sexual intercourse after 3-6 months. It is concluded that the frenulum is important in penile erection. PE might be treated by lengthening the frenulum.     

Characterization of the induced neuropeptide Y-like immunoreactivity in primary sensory neurons following complete median nerve transection

In this study, we examined characteristics of the neuropeptide Y-like immunoreactive (NPY-LI) dorsal root ganglion (DRG) neurons after complete median nerve transection (CMNT). With fluorogold (FG) injection into normal median nerves, numerous FG-labeled DRG neurons were localized predominantly in the C6 and C7 DRGs, where the focal regions were examined after CMNT. With NPY immunohistochemistry, a few NPY-LI neurons were detected in the ipsilateral but not contralateral DRGs after FG injection into the nerve. As early as 3 days after CMNT a few NPY-LI neurons could be detected, reaching a maximum in the DRGs at 4 weeks, subsiding thereafter over 20 weeks. The NPY-LI DRG neurons were primarily medium-sized and large neurons. With FG injection into the transected median nerve, we found that approximately 99% of NPY-LI neurons were labeled for FG, suggesting that they were derived from the injured but not intact DRG neurons. Using double fluorescent dyes tracing, we detected that some of the injured DRG neurons were NPY-LI neurons that projected to the cuneate nucleus (CN). Following dorsal rhizotomy, our data indicated that after CMNT the induced NPY-LI fibers in the ipsilateral CN originated exclusively from the injured DRG neurons. Taken together, these findings suggest that injury-induced NPY-LI fibers in the CN may originate from the injured DRG neurons via the median primary afferent fibers, affect the excitability of cuneothalamic projection neurons (CTNs), and involve neuropathic sensation following CMNT.     

Epispadias with complete prepuce: A rare anomaly

Epispadias with complete prepuce is a very rare anomaly. It is often associated with late presentation because it is a very rare condition and the penis appears grossly normal, thus, the diagnosis is easily missed during the neonatal period. We report a case of a boy presenting at seven years of age with epispadias and complete prepuce. The diagnosis should be suspected in any child presenting with incontinence, short penis, ballooned prepuce on voiding and absence of penile raphe or frenulum. The established procedures for repair of classic epispadias are equally effective and bladder neck reconstruction may be required to achieve continence.     

包皮系带处理的临床经验总结——附150例报告

目的：总结先天性或者继发性包皮系带过短或异常的临床处理经验。方法：回顾2005年2月～2008年12月间,因先天性或者继发性包系皮带过短或异常来我院手术治疗的患者150例,对围手术期的处理经验进行总结。结果：以“横切纵缝”为原则进行整形修复,从而达到延长包皮系带、使阴茎勃起外形美观的目的,并且患者的性功能问卷调查结果没有显著差异。结论：包皮系带并不是包皮手术的禁区,对于先天性或继发性包皮系带过短或异常的患者,可以“横切纵缝”的整形原则进行设计和修复。     

Primary sensory neurons with dichotomizing axons projecting to the facet joint and the sciatic nerve in rats.

STUDY DESIGN: Dorsal root ganglion (DRG) neurons that have dichotomizing axons to the lumbar facet joint and to the sciatic nerve were investigated in rats using a double fluorescent labeling technique. OBJECTIVES: To clarify the existence of DRG neurons with dichotomizing axons projecting to the lumbar facet joint and to the sciatic nerve in rats. SUMMARY OF BACKGROUND DATA: DRG neurons having dichotomizing axons have been reported in several species and are considered to be related to referred pain. However, such DRG neurons have not been investigated in the lumbar spine. Clinically, pain from the lumbar facet joint is sometimes referred to the lower extremities innervated by the sciatic nerve. METHODS: Two kinds of neurotracers (DiI and FG) were used in the present double-labeling study. DiI crystals were placed in the left L5-L6 facet joint, and FG was applied to the ipsilateral sciatic nerve or along the midline of the L5 dermatome. Bilateral DRGs T13-S1 were observed by fluorescence microscope. RESULTS: DRG neurons double labeled with DiI and FG were recognized only in the ipsilateral DRGs from L3 to L6 levels. Approximately 3% of DRG neurons innervating the L5-L6 facet joint had other axons to the sciatic nerve. By contrast, no double-labeled neurons were observed after FG was applied to the L5 dermatome. CONCLUSIONS: In rats approximately 3% of DRG neurons innervating the lumbar facet joints have dichotomized axons projecting to the sciatic nerve.     

包皮系带异常与阴茎勃起时间的关系(附14例报告)

目的:探讨包皮系带与阴茎勃起时间的关系.方法:对12例早泄伴有包皮系带过短的患者,行系带延长术;2例系带断裂后自然愈合,房事时间延长,勃起不满意,行系带重建术.结果:术后随访3～6月,12例早泄伴系带过短者阴茎勃起时间由不足2 min延长至(10±3)min;系带断裂者自感勃起充分,勃起时间由(26±6)min缩短为(18±4)min.结论:包皮系带异常可能与勃起时间有关,系带过短可能是早泄的一个解剖学因素,可以通过系带延长增加勃起时间,治疗早泄.     

Buried penis: congenital syndrome of a short penile shaft and a paucity of penile shaft skin

PURPOSE: The term "buried penis" has been applied to a variety of penile abnormalities and includes an apparent buried penis that is obvious at birth. The purpose of this study was to examine prospectively the congenital buried penis and to evaluate an operative technique for its management. MATERIALS AND METHODS: A total of 31 males 2 to 28 months old (mean age 12.3 months) with a congenital buried penis underwent surgical correction of the anomaly. Measurements were made of the penile shaft skin, inner leaf of the prepuce, glans length and stretched penile length. Observations of the subcutaneous tissue of the penis were made. The outer leaf of the prepuce was resected, following which covering of the penile shaft was accomplished with a combination of the penile shaft skin and the inner leaf of the prepuce. RESULTS: Stretched penile lengths ranged from 2.3 to 4.1 cm (mean 3.1). The glans length from the tip of the glans dorsally to the corona ranged from 0.9 to 1.6 cm (mean 1.2). The inner leaf of the prepuce ranged from 0.9 to 2.2 cm (mean 1.5) in length, while the dorsal penile skin lengths were 1 to 1.6 cm (mean 0.8). In all patients complete shaft coverage was accomplished using a combination of varying degrees of penile shaft skin and inner leaf of the prepuce. In no case was there a requirement for either unfurling of the inner and outer leaf of the prepuce or mobilization of scrotal flaps to accomplish shaft coverage. All patients healed well and have done well with a followup of 6 months to 1 year. CONCLUSIONS: Congenital buried penis is a syndrome consisting of a paucity of penile shaft skin and a short penile shaft. The anomaly may be successfully repaired by carefully preserving a length of inner leaf of the prepuce sufficient to cover, in some instances, the length of the penile shaft. Anchoring of the penile skin to the shaft is not recommended.     

内板切除在包皮环切术中的应用及评价

目的探讨内板切除法在包皮环切术中的应用及疗效评价。方法对96例包皮过长患者采用内板切除法行包皮环切术;同期对108例患者采用传统手术方法,对两组术后出血、感染、系带水肿及阴茎外形满意度进行对比。结果两组术后出血均为2例（P〉O．05）两组术后均无感染发生。内板切除组术后发生2例系带水肿,而传统手术组术后22例系带水肿．两组的差异有统计学意义（P〈0．01）。内板切除组阴茎外形满意度96．9％,传统手术组为89．8％,两组的差异有统计学意义（P〈O．05）。结论内板切除应用于包皮环切术疗效理想,优于传统手术。