GLP-1受体激动剂Exenatide改善糖尿病大鼠心血管功能

目的 探讨胰高血糖素样肽1(GLP-1)受体激动剂Exenatide (Ex)治疗对糖尿病大鼠心血管功能的影响,为其临床应用提供实验依据.方法 用单因素四水平不等重复的完全随机实验进行研究,34只Wistar大鼠随机分成4组:对照组(C,n=7),糖尿病组(DM,n=9),小剂量Ex治疗组(Emin,n=9),大剂量Ex治疗组(Emax,n=9).检测大鼠空腹血糖水平;使用小动物超声仪观察大鼠左心室射血分数(EF)、左心室短轴缩短率(FS);观察腹主动脉血流速(AF),胸主动脉内膜扫描电镜观察血管内膜损伤.结果 DM组空腹血糖明显升高(P＜0.01),Exenatide治疗组空腹血糖较DM组显著降低(P＜0.05).DM组EF、FS较对照明显降低(P＜0.01),Exenatide治疗组EF、FS明显升高(P＜0.05).DM组腹主动脉血流速明显降低(P＜0.01),血管内膜出现明显损伤;Exenatide治疗组腹主动脉血流速较DM组明显升高(分别P＜0.05,P＜0.01),血管内膜损伤减轻.结论 Exenatide能够降低糖尿病大鼠血糖水平,并改善糖尿病心脏和血管功能.     

1型与2型糖尿病大鼠周围神经病变的比较

目的观察链脲佐菌素(STZ)诱导的1型与2型糖尿病大鼠周围神经病变的区别。方法 SD大鼠分组,每组各10只,腹腔注射STZ建立1型糖尿病(T1DM)模型;高脂高糖饲养6周后按体质量35 mg/kg单次腹腔注射STZ建立2型糖尿病(T2DM)模型;设立正常对照(Con)组。检测不同时间点大鼠的体质量、血糖水平。成模8周后,电子Von Frey仪检测机械痛阈值,热水甩尾试验检测甩尾潜伏期,并取坐骨神经进行病理形态学检查。结果成模后第1、8周,与对照组及T2DM组相比,T1DM组大鼠的体质量显著下降(P0. 01); T1DM组与T2DM组的血糖均显著高于对照组(P0. 01); DM组的甩尾潜伏期均较对照组延长(P0. 01),T2DM组较T1DM组延长更显著(P0. 05)。DM组的机械痛阈值均较对照组显著降低(P0. 01),T2DM组较T1DM组降低更明显(P0. 01); DM组大鼠的坐骨神经有髓神经纤维排列紊乱,轴索肿胀或皱缩,髓鞘密度不均匀,空泡变性,部分神经纤维髓鞘脱失; T2DM组的神经损害程度较T1DM严重。结论 STZ诱导的2型糖尿病大鼠的周围神经病变程度严重于1型糖尿病大鼠。     

内皮素与一氧化氮在2型糖尿病大鼠心肌缺血再灌注损伤中的变化及意义

目的 探讨血清内皮素(ET)-1、一氧化氮(NO)在2型糖尿病大鼠心肌缺血再灌注损伤过程中的变化及意义.方法 选择体重160 ～ 180 g的健康雄性Wistar大鼠,采用高脂饲养联合腹腔注射链脲佐菌素(STZ)的方法制备2型糖尿病模型,取造模成功后的糖尿病大鼠14只(D组),随机分为两组(n=7):糖尿病心肌缺血再灌注组(DI组)和糖尿病假手术组(DC组).年龄匹配的健康雄性Wistar大鼠14只作为对照(C组),随机分为两组(n=7):心肌缺血再灌注组(CI组)和假手术组(CC组).DI组和CI组采用结扎左冠状动脉前降支30 min再灌注120 min的方法制备心肌缺血再灌注模型.各组分别测定基础状态、再灌注120 min时血清NO、ET-1的含量.结果 与基础状态时比较,CI组、DI组在缺血再灌注120 min时血清NO水平降低、ET-1水平升高(t值分别为4.96、4.69、19.04和3.35,P＜0.05).与CC组比较,CI组NO水平降低、ET-1水平升高,差异具有统计学差异(F=18.07、11.97,P＜0.05);与DC组比较,DI组NO水平降低、ET-1水平升高具有统计学差异(F=4.15、8.04,P＜0.05).DC组基础状态时血清ET-1水平高于CC组,具有统计学差异(=9.47,P＜0.05).结论 血清中NO、ET-1在2型糖尿病大鼠心肌缺血再灌注损伤的病理生理过程中具有一定的意义.     

电针治疗对大鼠坐骨神经损伤功能修复的作用

目的:探讨电针治疗(EA)对大鼠坐骨神经损伤功能修复的作用机制。方法:40只大鼠随机分为模型组(Injury组)、损伤后EA治疗组(Injury+EA组),建立大鼠坐骨神经损伤模型,损伤模型成功后给予电针治疗。通过检测治疗前后展爪反射,趾间距,腓肠肌湿重的恢复率,以及脊髓诱发电位、运动诱发电位变化,观察电针治疗对大鼠坐骨神经损伤修复的作用机制。结果:大鼠坐骨神经损伤后给予电针治疗,能显著促进大鼠坐骨神经损伤后受损运动和感觉功能的恢复,降低肌肉萎缩。与Injury组比较,Injury+EA组展爪反射的恢复时间显著缩短(P0.01),各组大鼠1~5趾趾间距显著增加(P0.01),腓肠肌湿重的恢复率显著提高(P0.01),感觉诱发电位波形恢复显著(P0.01),消失的波形有部分恢复(95%),显著高于Injury组(86%)(P0.05)。结论:电针治疗能促进大鼠坐骨神经损伤后的功能修复,延迟肌肉萎缩。     

2.106 糖尿病动物模型血浆和肠道组织中P物质含量的变化及其意义

目的通过糖尿病动物模型检测血浆和肠道组织中P物质(SP)的含量,探讨糖尿病性胃肠病与胃肠激素的关系.方法雄性大鼠20只,随机分为正常组(n=10)和糖尿病组(n=10).按100mg/k g给造模大鼠单剂量腹腔注射链脲佐菌素(STZ),建立糖尿病模型.在造模后4周后采血,用放射免疫法(RIA)同批测定血浆和肠道组织中SP含量.结果 1.正常组血浆中SP含量显著高于糖尿病组(P＜0.05).2.正常组十二指肠中SP含量显著低于糖尿病组(P＜0.05).远端结肠SP含量正常组显著低于糖尿病组(P＜0.01),见表.结论糖尿病组十二指肠和远端结肠组织中的SP含量较正常组明显增高,说明P物质的变化对糖尿病胃肠病的发生发展有一定相关作用.表正常组和糖尿病组大鼠造模前后血浆和肠道组织中SP含量比较     

微囊化兔坐骨神经组织细胞移植对脊髓损伤后大鼠GDNF表达的影响

目的探讨微囊化兔坐骨神经组织细胞移植对脊髓半横断损伤后大鼠胶质细胞源性神经营养因子（GDNF）的表达影响。方法成年SD大鼠80只随机分为4组,微囊组（n=25）、细胞组（n=25）、单损组（n=25）、正常组（n=5）。术前制备兔坐骨神经细胞混悬液以及将其微囊化,微囊组、细胞组和单损组大鼠在脊髓半横断伤后,立即在损伤处分别植入10μl微囊化坐骨神经组织细胞1、0μl坐骨神经组织细胞以及10μl生理盐水。于术后2 d7、d1、4 d、21 d2、8 d（每个时相取5只大鼠）取出损伤部位脊髓组织,正常组（每个时相取1只大鼠）则取相应节段脊髓。组织石蜡包埋后切片,行免疫组织化学染色观察GDNF的表达变化。结果 GDNF阳性染色主要见于神经元细胞及胶质细胞的胞浆内。大鼠脊髓损伤后上述细胞2 d后表达开始上升2,1 d达到最高。微囊组与单损组、细胞组比较差异有显著性（P〈0.05）。结论微囊化兔坐骨神经组织细胞移植于大鼠损伤脊髓后,可以抑制炎症反应,促进GDNF的表达,有利于大鼠运动功能恢复。     

超低温冷冻及免疫抑制剂对异体神经移植的影响

目的:比较超低温冷冻预处理异体神经和宿主接受免疫抑制剂环孢素A(CSA)对异体移植后神经再生的影响.方法:SD大鼠80只随机分成4组.取Wistar大鼠坐骨神经2 cm为异体神经供体.A组为新鲜异体神经移植组,B组为超低温冷冻异体神经移植组,C组为新鲜异体神经移植应用CSA组,D组为自体神经移植组.术后6周、18周行大体观察、光电镜组织学观察及形态定量学分析、电生理等指标检测,来评价神经再生和局部免疫反应情况.结果:C、D两组比较,其运动神经传导速度恢复率、复合肌肉动作电位峰值恢复率、移植体再生神经纤维数量与直径、髓鞘厚度均无明显差异(P＞0.05),组织学变化相似;B组神经再生的各项指标优于A组(P＜0.01或P＜0.05),但组织学显示仍有较多单核细胞浸润,与C、D组比较仍存在差异(P＜0.01或P＜0.05).结论:超低温冷冻虽降低了异体神经抗原性,移植后神经再生仍不及宿主接受免疫抑制的异体移植.     

miR-146a在大鼠神经病理性疼痛模型中的表达及其作用机制

目的 研究miR-146a对神经病理性疼痛的调控机制.方法 将大鼠随机分为:1)na(i)vve组(n=12);2)假手术组(n=12):进行大鼠双侧假手术;3)双侧慢性压迫损伤(bCCI)组(n=12):建立大鼠双侧坐骨神经结扎模型.在建模前1d及后第1、3、7和14天监测机械刺激诱发痛、热刺激诱发痛行为学指标;实时定量PCR法检测背根神经节(L4-L6) miR-146a及TNF-α受体相关因子6(TRAF6)、白介素1受体相关激酶(IRAK1)的mRNA表达水平;Western blot法检测TRAF6及IRAK1蛋白表达.结果 bCCI大鼠双足热刺激诱发痛痛阈、机械刺激诱发痛痛阈较na(i)ve组、假手术组显著降低(P＜0.05).术后第14天bCCI组miR-146a表达水平较na(i)ve组显著下降(P＜0.05).bCCI组TRAF6、IRAK1的mRNA表达水平较na(i)ve组升高(P ＜0.05);TRAF6、IRAKI蛋白表达水平较假手术组和na(i)ve组均显著增加(P＜0.05).结论 神经病理性疼痛大鼠背根神经节miR-146a表达水平下调,miR-146a可能通过过度激活其靶基因TRAF6和IRAK1发挥作用.     

左旋布比卡因在上肢骨折患者超声引导下腋路臂丛神经阻滞麻醉中的应用研究

目的:探究左旋布比卡因在上肢骨折患者超声引导下腋路臂丛神经阻滞麻醉中的应用.方法:按随机数表法将 2020年 1 月至2022 年1 月我院择期在腋路臂丛神经阻滞麻醉下行手术治疗的 122 例上肢骨折患者分为左旋布比卡因组(A组,0.375%左旋布比卡因)和布比卡因组(B组,0.375%布比卡因),每组 61 例.比较两组感觉和运动神经阻滞指标、给药 30 min后运动神经阻滞程度及不良反应.结果:两组感觉和运动神经阻滞指标差异、不良反应发生率(6.00%vs 10.00%)无统计学意义(P＞0.05);A 组给药 30 min 后改良 Bromage 分级优于 B 组(Z=2.239,P=0.025).结论:采用左旋布比卡因用于上肢骨折患者超声引导下腋路臂丛神经阻滞麻醉可提供较满意的运动神经阻滞效果.     

甲磺酸罗哌卡因用于颈臂丛阻滞效果观察

目的 观察比较甲磺酸罗哌卡因和布比卡因颈臂丛阻滞麻醉效果.方法 将拟行肩锁部手术60例,随机分为甲磺酸罗哌卡因组(A组)和布比卡因组(B组)各30例.A组颈臂丛注射0.3%甲磺酸罗哌卡因共30ml,B组颈臂丛注射0.25%布比卡因共30ml.观察两组感觉神经、运动神经阻滞起效时间和维持时间,常规监测麻醉前、手术开始、手术开始后5min、10min、30min、60min及术后1h的血压(BP)、心率(HR)和血氧饱和度(SaO2)的变化.结果 两组感觉神经阻滞起效、维持时间及运动神经阻滞起效时间相似,无显著差异(P＞0.05);两组运动神经阻滞时间A组显著长于B组(P＜0.05).两组BP、HR和SaO2变化与麻醉前比较,无显著差异(P＞0.05).结论 甲磺酸罗哌卡因和布比卡颈臂丛联合阻滞麻醉效果相当,而甲磺酸罗哌卡因毒性低,使用更安全.     

大鼠异体神经移植后再生神经生物力学性质研究

用Ｗｉｓｔａｒ鼠作为实验模型,切下１ｃｍ坐骨神经,再用同系Ｗｉｓｔａｒ鼠坐骨神经异体桥接,修复坐骨神经的缺损,术后２４周对Ｗｉｓｔａｒ鼠的手术侧与正常侧用指标抗张强度与弹性模量（ε＝１０％）进行测试,辅以电镜,光镜观察。     

Masseteric nerve: A possible donor for facial nerve anastomosis?

In the medical treatment of facial nerve paralysis a large number of different techniques have been developed to restore the function of the facial nerve. These include (a) the ipsilateral nerve grafting (e.g., partial hypoglossal-facial, spinal accessory-facial, partial glossopharyngeal-facial), (b) crossfacial nerve grafting and (c) temporal muscle flaps or even free muscle transfers. None of these techniques uses the masseteric nerve as a graft for reconstruction of the facial nerve. This preliminary report deals with the anatomical basis, which could lead to a new technique. The masseteric nerve leaves the infratemporal fossa through the mandibular notch, accompanied by the masseteric artery. At this level the nerve consists in nine of 36 cases studied of only one branch (25.0%), in 17 cases of two branches (47.0%), in nine cases of three (25.0%), and in the remaining case of four branches (2.8%). There are three main reasons for considering the masseteric nerve as a possible donor for at least the orbicular branch of the facial nerve: (1) The approach to the mandibular notch is quite simple; (2) since the nerve consists of two or more branches in 75.0% of the cases, severe dysfunction of the masseter muscle should not occur; (3) if there is complete denervation of the masseter muscle, its function may be taken over by the temporalis muscle. Clin. Anat. 11:396–400, 1998. © 1998 Wiley-Liss, Inc.     

bFGF对同种异体神经移植后周围神经再生的影响

目的 :探讨bFGF对同种异体神经移植后周围神经再生的影响。方法 :将反复冻融的大鼠神经移植于另一大鼠的坐骨神经 ,实验组注射bFGF 1 0 0u/d共 1 0d ,对照组注射生理盐水 1 0d。术后大鼠存活 1 2周 ,光镜下用体视学方法测试再生神经纤维的面数密度 (NA)、面积密度 (AA)、横切面面积 (AE)、脊髓前角运动细胞和脊神经节细胞的体密度 (VV)、数密度 (NV)。结果 :两组均可见再生神经纤维长入异体移植神经并向远段延伸。实验组再生神经纤维的NA、AA、脊髓前角运动细胞和脊神经节细胞的VV、NV 与对照组的比较 ,有显著性差异。结论 :bFGF能促进周围神经再生 ,对脊髓前角运动细胞和脊神经节细胞的存活有保护作用。     

Sural-tibial nerve communications in humans

We investigated the occurrence of a communication between the sural and tibial nerves in 49 legs of 28 Japanese cadavers. In front of the calcanean tendon, we found the communication in 7 legs (14.3%) or in 5 cadavers (18.9%). The sural nerve gave rise to a number of medial and lateral branches, including the lateral calcanean branch at the lateral side of the ankle. The communicating branch with the tibial nerve arose from the first medial branch and pierced the deep fascia of the leg. In 4 cases, the U-shaped communication was formed between the sural and tibial nerves, and in 3 cases, the Y-shaped communication. Electrophysiologi-cal evidence of an anomalous motor function of the sural nerve has been reported recently. We consider that the U-shaped communication between the sural and tibial nerves gives a morphological basis to the motor function of the sural nerve.     

Martin-Gruber anastomosis revisited

Based on a study of 70 human cadavers (31 male, 39 female) and on cases described previously, we propose a new classification of the Martin-Gruber anastomosis, a neural connection between the median and ulnar nerves in the forearm. The anastomosis was found in 16 (22.9%) cadavers, being bilateral in three (18.7%) and unilateral in 13 (81.3%), five right and eight left. It occurred in eight (25.8%) of the 31 male cadavers and in eight (20.5%) of the 39 females. Therefore, the anastomosis was found in 19 (13.6%) of the 140 forearms. In Pattern I (89.5%) the anastomosis was made by only one branch, whereas in Pattern II (10.5%) it was made by two. The individual branches were classified as Types a, b, and c based on the nature of their origin from the median nerve. Type a (47.3%) arose from the branch to the superficial forearm flexor muscles, Type b (10.6%) from the common trunk, and Type c (31.6%) from the anterior interosseous nerve. Pattern II was a duplication of Type c (10.5%). The anastomotic branch took an oblique or arched course before joining the ulnar nerve, undivided in 15 cases, but divided into two branches in four cases. The anastomosis passed in front of the ulnar artery in four cases, behind it in six, and in nine cases it was related to the anterior ulnar recurrent artery.     

Intramuscular Martin-Gruber anastomosis

The incidence and morphology of the intramuscular Martin-Gruber anastomosis are presented based on the study of 118 human cadavers (55 male, 63 female). The Martin-Gruber anastomosis was found in 25 (21.2%) of the 118 cadavers. It occurred in 11 (20%) of the 55 male cadavers (4 bilateral, 7 unilateral; 5 left and 2 right) and in 14 (22.2%) of the 63 female cadavers (2 bilateral, 12 unilateral; 8 left and 4 right). Therefore, the Martin-Gruber anastomosis was found in 31 (13.1%) of the 236 upper limbs. According to a recent classification (Rodríguez-Niedenführ et al., 2000), pattern I was found in 29 cases (93.5%), corresponding to Type A in 13 (41.9%), Type B in 3 (9.7%) and Type C in 13 (41.9%), whereas pattern II was found in 2 cases (6.5%), both being a duplication of Type IC. Intramuscular Martin-Gruber anastomosis was a single anastomosis that originated in all cases from the anterior interosseous nerve (pattern IC) and then passed through a muscle bundle of the flexor digitorum profundus and behind the ulnar artery to join the ulnar nerve as a single connecting branch. It did not send branches to the flexor digitorum profundus. This intramuscular course was observed in 3 of the 13 cases of Type C anastomosis (23.1%) or 3 cases out of 31 Martin-Gruber anastomoses (10%).     

The normal and variant clinical anatomy of the sensory supply of the orbit

Orbital and retro‐orbital pain are relatively common clinical conditions that are associated with such disorders as trigeminal, lacrimal, and ciliary neuralgia, cluster headaches, paroxysmal hemicrania, inflammatory orbital pseudotumor, trochleitis, and herpetic neuralgia ophthalmicus, thus making the nerves supplying the orbit of great clinical importance. Surprisingly, how pain from this region reaches conscious levels is enigmatic. Classically, it has been assumed that pain reaches the ophthalmic division of the trigeminal nerve (V₁) and travels to the descending spinal trigeminal nucleus. However, exactly where the receptors for orbital pain are located and how impulses reach V₁ is speculative. In this project, we reviewed all of the reported connections between the orbital nerves and V₁ in order to understand how pain from this region is transmitted to the brain. We found reported neural connections to exist between cranial nerve (CN) V₁ and CNs III, IV, and VI within the orbit, as well as direct neural branches to extra‐ocular muscles from the nasociliary, frontal, and supraorbital nerves. We also found reported neural connections to exist between the presumed carotid plexus and CN VI and CN V₁, CN VI and CN V₁ and V₂, and between CN V₁ and CN III, all within the cavernous sinus. Whether or not these connections are sympathetic or sensory or some combination of both connections remains unclear. An understanding of the variability and frequency of these neural connections could lead to safer surgical procedures of the orbit and effective treatments for patients with orbital pain. Clin. Anat. 27:169–175, 2014. © 2014 Wiley Periodicals, Inc.     

神经生长因子对周围神经损伤后再生和修复的实验研究

手术切除５ｍｍ兔的尺神经，在两断端间连接肌桥并套装硅胶管，形成一个封闭腔，向腔内注入神经生长因子。间隔不同时间取尺神经桥接区、桥接区近段、远段、尺神经的脊髓投射节段和相应脊神经节，用光镜和电镜观察神经溃变和再生情况并作图像分析；用酶标示踪和电生理方法检测神经通路的重建状况。结果显示，周围神经离断后，肌束桥接并用硅胶管套装后注入外源性神经生长因子，可明显地促进离断神经的再生和修复。     

骨间前神经转位重建鱼际肌功能

前臂或腕部正中神经断裂,直接吻合后鱼际肌功能的恢复常常令人失望,为了解决这一难题,本文在120侧成人上肢解剖学研究的基础上,采用骨间前神经转位术修复鱼际肌支9侧,获得成功.     

红白肌纤维为肌桥缝接狗神经缺损的实验形态学研究

目的 :试图从作肌桥的肌肉条件 (红、白肌、长、短肌纤维和肌纤维排列等 )方面 ,能探讨出最适宜神经再生长条件的肌肉 ,作为临床应用的肌桥。方法 :根据文献肌纤维分型记载和本实验用SDH染色 ,确定的的红白肌纤维肌桥 ,再分别给狗股神经和正中神经缺损 3cm外缝接上 ,待术后 3 0 0d ,切取桥接神经部位 ,并将它分成神经近段、肌桥段、神经远段和远、近端缝合段五个部分。常规制成光电镜标本最后镜下观察和Luzex -F图像分析仪测定。结果 :红肌纤维为主的肌桥明显较白肌纤维为肌桥的再生效果好 (P <0 .0 5 )特别是缝匠肌尾侧部 (红肌纤维为主 )为肌桥更明显较其颅侧部 (白肌纤维为主 )的神经纤维再生数量多 (P <0 .0 5 )。结论 :并非机体肌肉为肌桥都有同样神经再生效果 ,缝匠肌尾侧部可能是一个适宜神经再生条件的肌肉。