正常人颈段脊柱结构内CGRP和SP阳性神经纤维的分布

目的 为深入探讨颈肩痛的发病机理。方法 用免疫组织化学方法观察人颈段脊柱结构内CGRP和SP阳性神经末梢存在的情况。结果 人颈段脊柱结构的纤维层内均有CGRP和SP免疫反应阳性神经末梢存在，多数神经末梢独立行走，呈树枝状或念珠状，少量神经末梢交织网状。结论 CGRP和SP可能参与了人颈段脊柱结构的伤害性感觉信息的传递。当人颈段脊柱结构的神经末梢受刺激时，可能引起CGRP和SP的释放和传递，这可能是引起原发性颈肩痛的原因之一。     

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。     

不同生理曲度下颈椎管容积的变化及临床意义

颈椎生理曲度的存在增加了颈椎的弹性，减轻和缓冲外力的震荡，保护脊髓和大脑以避免损伤。随着颈椎间盘髓核脱水、退变及其继发的一系列病理改变，可导致椎间隙的狭窄、椎间高度的降低和颈椎生理曲度减小、变直甚至反弓弯曲以及椎管和椎间孔的狭窄。不同的颈椎曲度下，颈椎椎管的有效容积、椎间孔的容积会发生变化。笔者对不同生理曲度下颈椎管容积的变化及临床意义作一综述。     

髂内动脉结扎对大鼠阴茎海绵体组织nNOS神经纤维及eNOS表达的影响

目的 研究髂内动脉结扎对大鼠阴茎海绵体组织神经型一氧化氮合酶(nNOS)神经纤维及内皮型一氧化氮合酶(eNOS)表达的影响。方法 45只Wistar雄性成年大鼠随机分为假手术组(21只)和手术组(24只)。其中手术组采用双侧髂内动脉结扎的方法制备动脉性勃起功能障碍(ED)大鼠模型,假手术组作为对照组只切开腹腔不结扎髂内动脉。于术后1周、3周、6周末分别取各组1/3大鼠,观察其勃起功能,并采用免疫组化SP法检测大鼠阴茎组织中nNOS神经纤维的数量及eNOS的表达。结果 手术组与假手术组相比,1周末、3周末和6周末在阴茎勃起次数和阴茎组织nNOS神经纤维数量及eNOS表达上均有显著差异(P<0.01)。手术组大鼠阴茎勃起次数3周末高于1周末,6周末高于3周末;eNOS的表达3周末明显低于1周末,而6周末高于3周末,差异均有显著性意义(P<0.001),并呈增加趋势。手术组大鼠阴茎组织nNOS神经纤维数量三者之间差异均有显著性(P<0.001),呈进行性下降。结论 髂内动脉结扎影响阴茎勃起功能和nNOS、eNOS的表达。阴茎组织中nNOS阳性神经纤维数量的减少,可能是髂内动脉结扎术后阴茎勃起功能障碍发生的原因之一。     

泌乳素瘤性ED大鼠阴茎组织nNOS表达及超微结构变化的初步研究

目的:采用已烯雌酚(DES)诱导建立大鼠垂体泌乳素瘤勃起功能障(P-ED)模型,并研究泌乳素瘤ED大鼠阴茎n NOS表达及超微结构的变化。方法:取雄性Wistar大鼠,分为生理盐水对照组10只、花生油对照组10只及模型组20只。模型组腹腔内注射DES建立泌乳素瘤模型,8周后进行阿扑吗啡(APO)试验测定阴茎勃起功能筛选出P-ED大鼠模型。取垂体行病理学检查,并测定垂体质量、血清泌乳素(PRL)及睾酮(T)浓度。免疫组化法测定阴茎组织n NOS表达的变化,透射电镜观察阴茎海绵体组织超微结构变化。结果:APO试验共筛选出P-ED大鼠模型15只。与生理盐水及花生油对照组相比,注射DES 8周时大鼠垂体质量显著升高[(46.7±15.5)mg vs(11.7±2.4)、(12.4±2.3)mg,P均0.05)];血清PRL浓度显著升高[(1 744.9±304.5)ng/ml vs(11.5±2.4)、(10.6±1.9)ng/ml,P均0.01)];FT浓度降低[(1.54±0.46)ng/ml vs(3.11±1.08)、3.04±1.11)ng/ml,P均0.05)]。与生理盐水及花生油对照组相比,注射DES 8周时大鼠阴茎勃起次数显著减少(16.7%vs 100%、vs 87.5%,P0.05)。透射电镜下,8周时阴茎海绵体内皮细胞、平滑肌细胞等均有显著改变。与生理盐水及花生油对照组相比,P-ED组8周时阴茎组织n NOS表达平均光密度值(MOD)显著减少(0.024±0.011 vs 0.066±0.019、0.058±0.021,P均0.05)。结论:阴茎组织超微结构的变化及n NOS表达减少可能是泌乳素瘤大鼠发生ED的主要机制。     

氯胺酮对抑郁大鼠前额叶神经元nNOS活性及CAPON表达的影响

目的 评价氯胺酮对抑郁大鼠前额叶神经元神经型一氧化氮合酶(nNOS)活性及其羧基末端PDZ结构的接头蛋白(CAPON)表达的影响.方法 健康成年雄性SPF级SD大鼠,2.5～3.0月龄,体重210～260 g,采用慢性轻度不可预见性应激法制备抑郁大鼠模型,取模型制备成功的大鼠24只.采用随机数字表法,将其随机分为2组(n=12):抑郁组(D组)和氯胺酮组(K组).另取12只大鼠为对照组(C组).C组和D组腹腔注射生理盐水10 ml/kg,K组腹腔注射氯胺酮,10 mg/kg,1次/d,连续7d.于给药前和连续7d给药完成后1d采用旷场实验和糖水偏好实验测定抑郁状态,记录大鼠水平运动距离、站立次数及糖水偏好比.实验测试后1d,采用免疫组织化学法检测前额叶神经元nNOS和CAPON表达水平,采用RT-PCR法检测nNOS mRNA、CAPON mRNA的表达水平.结果 与C组比较,D组和K组水平运动距离缩短,站立次数减少,糖水偏好比降低,nNOS及其mRNA表达上调,CAPON及其mRNA表达下调(P＜0.05).与D组比较,K组水平运动距离延长,站立次数增多,糖水偏好比升高,nNOS及其mRNA表达下调,CAPON及其mRNA表达上调(P＜0.05).结论 氯胺酮可能通过促进抑郁大鼠大脑前额叶神经元CAPON的表达,进而抑制nNOS活性来改善大鼠抑郁状态.     

颈髓神经根硬膜性被膜内神经末梢分布的研究

目的 调查人颈髓神经根硬膜性被膜内神经末梢的数量分布,探讨颈神经根性疼痛的发病机制。 方法 对１８例病理解剖尸体３９个颈神经根、神经节及其远端的脊髓神经标本,采用铃木镀银染色法及Ｋｌｕｖｅｒ－Ｂａｒｒｅｒａ髓鞘染色法,制得２０μｍ连续切片２０６９张,用光学显微镜定量地观测了上述部位神经组织被膜中各种神经感受器的形态结构及其存在的部位、数量和分布的特点。 结果 神经根、神经节及脊髓神经被膜内存在游离     

大鼠前列腺增生模型阴茎海绵体内nNOS、eNOS表达研究

目的 分析引起阴茎勃起的主要神经递质NO合成的限速酶nNOS和eNOS在BPH模型大鼠阴茎海绵体中的表达.试探讨BPH引起ED的可能因素.方法 20只雄性SD大鼠随机分为正常对照组和BPH模型组.通过去势后丙酸睾酮注射建立BPH模型,10只老年大鼠为老年对照组.4周后处死大鼠,分析不同组前列腺湿质量与前列腺指数,并在光镜下观察前列腺组织病理学改变.应用免疫组化方法研究不同组间大鼠阴茎海绵体内nNOS和eNOS阳性表达情况并比较组间差异.结果 BPH模型组中前列腺湿质量和前列腺指数与正常对照组比较差异有统计学意义;显微镜下BPH模型组前列腺组织呈明显增生表现,大鼠BPH造模成功.免疫组化方法显示BPH模型组、老年对照组大鼠阴茎海绵体内的nNOS及eNOS阳性细胞表达率明显降低;nNOS及eNOS阳性表达与正常对照组的比较差异均有统计学意义.结论 nNOS及eNOS是调控阴茎勃起的神经递质NO合成的关键酶,BPH模型组的阴茎海绵体内nNOS、eNOS表达明显减少或活性降低,导致NO释放减少可能是BPH引起勃起功能障碍的重要原因.     

抗高血压药物对自发性高血压大鼠勃起功能和nNOS神经纤维的影响

目的 :研究抗高血压药物对自发性高血压大鼠 (SHR)勃起功能和神经元型一氧化氮合酶 (nNOS)神经纤维的影响。　方法 :18只 6周龄雄性SHR随机均分为 3组 :缬沙坦 [30mg (kg·d) ]干预组、螺内酯 [2 0mg (kg·d) ]干预组和对照组。 12周后 ,观察大鼠阴茎勃起功能 ,并用免疫组化SP法检测阴茎组织中nNOS神经纤维的数目。　结果 :缬沙坦干预组勃起次数与另外两组相比差异有显著性 (P <0 .0 5 ) ,后两组之间差异无显著性 (P >0 .0 5 ) ,勃起率 3组之间差异不明显 (P >0 .0 5 ) ,阴茎组织中nNOS神经纤维数目 ,两干预组与对照组之间差异有显著性 (P <0 .0 1) ,而两干预组之间差异无显著性 (P >0 .0 5 )。　结论 :缬沙坦能改善SHR的勃起功能 ,而螺内酯无改善作用 ,这种差异与nNOS神经纤维数目无关 ,可能与血管紧张素Ⅱ(AngⅡ)受体阻滞剂引起血管重构等其他作用有关     

豚鼠膀胱组织内Cajal样间质细胞及NOS表达阳性神经元的分布

目的探讨Cajal样间质细胞和一氧化氮合酶2（NOS2）表达阳性神经元在成年豚鼠膀胱组织内的分布。方法成年豚鼠膀胱冰冻切片,c—Kit免疫荧光和n—NOS2免疫荧光染色。结果膀胱肌层内可见c—Kit表达阳性细胞的存在,n-NOS2免疫荧光染色显示其阳性神经元广泛分布于膀胱组织内。c—Kit免疫荧光和n-NOS2免疫荧光双重染色虽未发现两者的共存,但可见c—Kit表达阳性细胞存在于NOS表达阳性神经元的附近。结论豚鼠膀胱的Cajal样间质细胞可能参与膀胱自主节律性运动的调控,提示二者可能共同参与膀胱自主节律性运动的调控,为“神经-Cajal样问质细胞-肌肉”作用单元的形成提供结构基础。     

Distribution of nerve endings in the human dorsal radiocarpal ligament

PURPOSE: The purpose of this investigation was to evaluate the nerve-ending apparatus populations within a large number of adult human dorsal radiocarpal (DRC) ligaments to test the hypothesis that the majority of nerve endings could be grouped into established classifications and that the nerve endings could be found in predictable locations within the substance of the ligament. METHODS: The DRC ligaments were harvested from 20 wrists of 10 fresh cadavers with an average age of 75.6 years within 12 to 18 hours of death. Before the tissues were harvested, radiographs were taken to exclude any arthritic conditions of the wrists. Tissues were fixed, sectioned with a cryostat, and serial sections were collected on glass slides. Slides were processed for fluorescence immunohistochemistry using antibody to protein gene product 9.5 and a secondary antibody conjugated to a fluorescent tag (Alexa Fluor 488). The sections were evaluated with an LSM-510 confocal laser microscope and a Kontron KS 400 image analyzer. Labeled nerve endings were counted, mapped, and reconstructed. RESULTS: The average number of nerve endings in each DRC ligament was 10.1+/-4.7. More than 76% of the nerve endings were found in the 2 ends of the ligament with 23.3% in the central third and approximately 80% distributed in the superficial layer. More than 80% of the nerve endings were discovered in the epiligamentous sheath rather than in the perifascicular spaces. CONCLUSIONS: The distribution of the nerve endings follows a consistent pattern. These results will provide a foundation of morphologic information useful in understanding normal and abnormal neural control of wrist joint mechanics.     

Distribution of neurofilament-positive nerve fibres and sensory endings in the human anterior cruciate ligament

The present immunocytochemical study describes the distribution of neurofilament-containing nerve fibres and corpuscular-like endings in the human anterior cruciate ligament. The entire anterior cruciate ligament of a non-injured knee joint from a child was cut into serial 15-m-thick frozen sections, which were processed for immunofluorescence staining with a monoclonal antibody against the 68-kDa neurofilament subunit. Numerous neurofilament-positive fibres were found in bundles. These bundles were mostly located near blood vessels in the subsynovial layer and in interfascicular gaps. Only a few single nerve fibres were found independent of blood vessels in interfascicular gaps and between collagen bundles. Neurofilament-containing nerve fibres were preferentially located near the bony attachments of the anterior cruciate ligament. Two types of corpuscular-like endings were found, i.e. spiral-like (type I) and spray-like (type II) endings. Similary to nerve fibres, both types of corpuscular-like endings were found mainly near the tibial and femoral attachment sites (15 of 17), whereas only two were found in the middle third of the ligament. Most likely, the type I and type II corpuscular-like endings serve a mechanoreceptive function involved in the sensory control of normal movements and in stress protection.     

Injury biomechanics of the human cervical column

In this study, the authors have developed a technique to replicate clinically relevant traumatic cervical spine injuries and determined the injury biomechanics. Because of the importance of compressive forces in neck injuries, this research was conducted using compression as the primary load vector. Six fresh human cadaveric head-neck complexes were prepared by fixing the distal end in methylmethacrylate. Tests were done with varying loading rates to include quasistatic and dynamic conditions. For quasistatic experiments, the proximal end was fixed to the piston of the testing device. In dynamic tests, the cranium was unconstrained, and to maintain stability, the effects of the spinal musculature were simulated by means of pulleys, deadweights, and springs in the anterior and posterior parts of the head-neck complex. Quasistatic tests conducted at a rate of 2.0 mm/sec produced cervical spine trauma at forces ranging from 1.7 to 2.3 kN, with deformations ranging from 2.2 to 3.7 cm. The specimens were deep-frozen at the level of injury, preserving the local deformation of the tissues to enable a detailed evaluation immediately after the injury. Dynamic tests conducted at velocities of 3.2 to 5.7 m/sec resulted in impact injuries at one level of the head-neck complex. The applied forces at the vertex were considerably higher than those recorded at the distal end. The failure deformations for both the quasistatic (2.2-3.7 cm) and dynamic (1.7-3.2 cm) tests, however, were found to be similar, suggesting that the human head-neck complex is a deformation-sensitive structure.     

Mechanoreceptors and nerve endings of the triangular fibrocartilage in the human wrist

PURPOSE: To increase our understanding of the mechanism of pain and the sensation of wrist instability by studying the distribution of the mechanoreceptors in the triangular fibrocartilage (TFC). METHODS: The distribution and density of the nerve endings were investigated in 34 TFC specimens obtained from human cadavers. We studied the dorsal, palmar, ulnar, radial, and central areas after staining by a modified gold chloride technique. RESULTS: The free nerve endings, responsible for sensing pain, predominate in the ulnar and dorsal areas. The Vater-Pacini corpuscles predominate in the radial and dorsal area, promoting perception of the onset or cessation of movement and mechanical stress change. The Golgi-Mazzoni corpuscles were more frequent in the ulnar and ventral areas, linking these areas to function of slow adaptation and sensation of extreme movements. The proprioceptive function receptors were found in all areas of TFC because Ruffini corpuscles have homogeneous distribution in this fibrocartilaginous tissue. CONCLUSIONS: Our results showed that the nerve endings were distributed at the periphery of TFC and showed different concentrations of each type of mechanoreceptors per topographic area, suggesting that they play specific roles in the proprioceptive and nociceptive reflexes of the wrist.     

手术治疗无骨折脱位型颈脊髓损伤

目的 探讨不同类型无骨折脱位型颈脊髓损伤手术方式选择,观察治疗效果.方法 本组24例,短节段(≤2个节段)椎间盘突出6例行前路手术.多节段(≥3个节段)颈椎管狭窄18例行后路手术,其中1例合并C5～6髓核游离于椎管,二期再行前路手术.结果 JOA评分术前平均5.70分,术后6周评分平均8.47分,术后12周10.26分,术后24周为12.02分.所有病例均获骨性融合.结论 根据不同的病理类型,选择适当的手术方式,彻底减压,可靠融合及内固定,可取得较满意疗效.