化学萃取去细胞异体神经修复颞骨内面神经缺损

目的为修复颞骨内面神经缺损提供一种理想的替代材料。方法20只兔随机分成实验组和对照组,制成颞骨内面神经缺损8mm模型,分别以化学萃取去细胞异体神经和自体神经移植修复,每组10只。术后3个月通过辣根过氧化物酶逆行示踪和再生神经纤维的组织学检测观察效果。结果两组均在术侧面神经核内发现被标记的神经元细胞,移植段内有大量的新生有髓神经纤维和新生血管等,移植段和移植远段内再生神经纤维具有正常的形态和结构。结论化学萃取去细胞异体神经很有可能成为自体神经的替代材料用于颞骨内面神经较长段缺损的修复。     

GM1对异种神经移植后再生和修复的研究

目的 :观察GM1 对异种神经移植后神经纤维再生和修复的效果。方法 :移植前将兔胫神经反复冻融处理。选大鼠30只 ,分GM1 组 (20只 ) :移植前将胫神经浸泡于0 1 %GM1 液中10min ;对照组 (10只 ) :未经任何处理 ,将兔胫神经移植于两组大鼠坐骨神经。术后第2、4、6、8和10周 ,将辣根过氧化物酶(HRP)注入大鼠坐骨神经吻合部远侧端。结果 :GM1 组术后第2周和第4周起分别在同侧L4～5脊神经节和腰段脊髓前角见到HRP标记细胞 ,而对照组从第4周和第6周起在同侧L4～5脊神经节和腰段脊髓前角见到标记细胞 ,术后动物不同存活期GM1组标记细胞数均明显多于对照组 (P<0 01) ,标记细胞数量随神经移植后存活期的延长而增加。术后10周有髓纤维再生率GM1 组明显高于对照组 (P<0 01)。结论 :GM1 可明显促进移植后神经纤维的再生和修复     

氯化镁对大鼠坐骨神经断端再生微结构的作用研究

目的：研究氯化镁对大鼠坐骨神经损伤后超微结构修复的作用。方法将90只SD大鼠随机分为氯化镁组（MgCl2组）,神经生长因子组（NGF组）,0．9％氯化钠组（NaCl ）组,每组30只。制作坐骨神经缺损模型,分别以硅胶管桥接坐骨神经缺损,构成神经再生室。分别将1 mmol／L MgCl2、NCF、0．9％氯化钠溶液分别注入神经再生室中。于术后4、8、12周处死动物,取出神经再生室中断端再生组织,固定处理后通过光镜观察再生神经纤维数目及再生纤维神经截面积,电镜观察神经再生室中雪旺细胞增殖和发育情况、髓鞘的超微结构。结果 MgCl2组和NGF组术后4、8、12周再生神经纤维数目和再生神经纤维截面积高于NaCl组,差异有统计学意义（ P ＜0．05）,而MgCl2组与NGF组比较,差异无统计学意义（ P ＜0．05）。 MgCl2组和NGF组新生神经纤维再生数量增多,雪旺细胞增生明显,形态接近正常,髓鞘厚度均匀增加,鞘层分离不明显,神经膜细胞及轴浆有轻度变性,NaCl组神经纤维再生不明显,髓鞘结构模糊,扭曲,雪旺细胞增生不明显,表型幼稚。结论氯化镁可促进大鼠坐骨神经损伤修复后超微结构的修复。     

神经电生理检查在评价大鼠坐骨神经缺损修复中的作用

目的研究应用神经电生理检查在评价大鼠坐骨神经缺损修复中的作用。方法取大鼠30只,随机分成正常组、自体神经组和硅胶管组,每组10只。自体神经组将剪断的10mm神经缝合于原处,硅胶管组用10mm医用硅胶管桥接神经缺损,正常组不手术。饲养4个月,行神经电生理检查。结果电生理检查坐骨神经动作电位潜伏期(ms)正常组<自体神经组<硅胶管组,动作电位波幅(mV)正常组>自体神经组>硅胶管组,且有显著性差异。结论应用神经电生理检查的动作电位潜伏期和波幅可以评价周围神经损伤的修复情况。     

HRP逆行示踪法评价周围神经缺损修复的实验研究

以大鼠作为实验模型，造成１０ｍｍ坐骨神经缺损，用硬脊膜桥接修复，术后１２周在腓总神经支配肌内注入３０％辣菜根过氧酶Ｃ（ＨＲＰ），在脊髓腰段前角腓总神经运动神经元池内出现标记细胞，证实硬脊膜桥能修复周围神经的连续性。     

同种异体神经与自体神经瘤联合修复周围神经缺损的运动功能研究

目的探讨通过以优化法处理后的脱细胞同种异体神经和自体神经瘤组成的联合体修复大鼠长段坐骨神经缺损,观察大鼠运动功能恢复情况。方法30只SD大鼠随机分为2组,A组实验组为异体神经与自体神经瘤联合移植组;B组对照组为自体神经移植组。Wistar大鼠作为神经供体,取单侧坐骨神经,制备脱细胞同种异体神经。在术后的不同时间段进行坐骨神经功能指数评价、神经电生理检查。结果A组术后8周电生理检测再生神经的传导速度明显慢于B组(P<0.05),术后16周两组差异无统计学意义(P>0.05)。A组和B组动物的坐骨神经功能指数差异无统计学意义(P>0.05)。结论同种异体神经与自体神经瘤的联合体可以修复周围神经缺损,是神经移植的一种良好替代体。     

白血病抑制因子促进大鼠坐骨神经再生的作用研究

目的探讨白血病抑制因子(LIF)对大鼠坐骨神经损伤后再生的作用。方法 60只SD大鼠随机分成2组,每组30只。按Lundborg方法制成神经再生室动物模型,实验组套接管内注入LIF 50μL(0.5μg),对照组注入等量的生理盐水。术后4、8、12周,每组分别取10只大鼠进行坐骨神经指数、神经电生理学检测,然后取出硅胶管内的神经和同侧的腓肠肌进行神经肌肉组织学检查。结果术后4、8、12周实验组的坐骨神经指数、神经传导速度、有髓神经计数,有髓神经的髓鞘厚度、肌湿重均较对照组有显著改善(P<0.001)。结论白血病抑制因子能够促进大鼠坐骨神经的再生,且有肌营养作用。     

非神经桥接周围神经缺损

长段的周围神经缺损,往往不能直接吻接,需要移植体的桥接才能修复。传统的神经组织移植术有很大的局限性。近年来,随着研究的不断深入,许多学者发现,一些非神经桥接物也能引导再生神经纤维的生长。已有不少文献报道,静脉、骨骼肌、腱桥及腱管桥、筋膜管、基底膜管以及硅胶管等材料桥接修复神经缺损获得了良好的实验结果,从而打破了神经缺损只能靠自体神经移植才能修复的传统观点,扩大了神经桥接物的选择范围。现就目前常用的非神经材料综述如下;     

青蒿素与过氧化物酶作用的荧光研究

目的:研究青蒿素与过氧化物酶间的作用关系,建立青蒿素荧光检测方法。方法:以吡罗红B为指示剂,用荧光降低法研究青蒿素与辣根过氧化物酶的相互作用。结果:青蒿素与辣根过氧化物酶之间的催化反应米氏常数Km为2.72×10-5mol/L,最大反应速度vmax为1.74×10-4mol/(L·s),催化常数Kcat为24.27s-1。反应作用位点分别是青蒿素内过氧基团与酶中心离子Fe。该反应可用于对黄花蒿药材中青蒿素含量的测定,测定工作曲线为c=0.1684?F-0.8143(cartemisinin单位为1.0×10-7mol/L),相关系数r=0.9965,3σ检出限为3.58×10-8mol/L。结论:青蒿素与辣根过氧化物酶之间的作用具有酶与底物反应的特征,该特征反应可用于对黄花蒿药材中青蒿素含量的测定。     

聚四氟乙烯膜管内植入自体神经组织匀浆桥接面神经缺损

目的评价聚四氟乙烯(e-PTFE)膜空管单纯桥接及e-PTFE膜管内植入自体神经组织匀浆修复面神经缺损的修复效果。方法切除8 mm长兔左侧面神经上颊支造成面神经缺损,以e-PTFE膜管内植入自体神经组织匀浆和e-PTFE膜空管单纯桥接修复面神经缺损,分别于术后8周、12周行神经电生理、组织形态学检查。结果术后12周时,自体神经组织匀浆组面神经传导速度为(28.55±3.21)m/s,而空管组为(21.30±3.64)m/s;组织学上,自体神经组织匀浆组膜术后12周神经纤维排列整齐,延续连贯;空管组神经纤维排列较紊乱,结缔组织增生明显。结论使用自体神经组织匀浆进行神经再生室内移植可获得比单纯空管桥接组更好的神经修复效果。     

模具成型法构建多分支壳聚糖导管

目的制作可用于面神经趋向性再生研究的多分支壳聚糖导管。方法根据兔面神经设计并制作多分支导管模具,改进模具成型法的制作工艺,得到多分支壳聚糖导管,检测导管的溶胀系数及微观结构。结果制成的多分支壳聚糖导管外形光滑,各分支的长轴在同一平面内,管道通畅,溶胀系数为368±13.2。结论模具成型法可以根据实验需要构建出复杂形状的壳聚糖导管,所制导管可用于面神经趋向性再生研究。     

Nerve conduits based on immobilization of nerve growth factor onto modified chitosan by using genipin as a crosslinking agent

Incorporation of nerve growth factor (NGF) into a nerve conduit can improve peripheral nerve regeneration. Here, genipin, a natural and low toxic agent, was used to crosslink chitosan, a natural polysaccharide, and concurrently to immobilize NGF onto modified chitosan, followed by fabrication of chitosan (CS)-genipin (GP)-NGF nerve conduits. MTT test showed that the cell viability of Schwann cells cultured in the conduit extract was not significantly different from that in plain medium. The neurite outgrowth measurement and immunocytochemistry with anti-growth-associated protein-43 and anti-neurofilament indicated that NGF released from CS-GP-NGF nerve conduits retained the bioactivity of stimulating neuronal differentiation of PC12 cells. Fracture strength measurements and vitamin B12 release analysis confirmed that CS-GP-NGF nerve conduits possessed good mechanical properties and adequate permeability. We also investigated the in vitro release kinetics of NGF from CS-GP-NGF nerve conduits by ELISA. The continuous release profile of NGF, within a 60-day time span, consisted of an initial burst that was controlled by a concentration gradient-driven diffusion, followed by a zero-order release that was controlled by a degradation of chitosan matrix. Collectively, CS-GP-NGF nerve conduits had an integrated system for continuous release of NGF, thus holding promise for peripheral nerve repair applications.     

Nanofiber scaffolds facilitate functional regeneration of peripheral nerve injury

Peripheral nerve injury still remains a refractory challenge for both clinical and basic researchers. A novel nanofiber conduit made of blood vessel and filled with amphiphilic hydrogel of self-assembling nanofiber scaffold (SAPNS) was implanted to repair a 10 mm nerve gap after sciatic nerve transection. Empty blood vessel conduit was implanted serving as control. Results showed that this novel nanofiber conduit enabled the peripheral axons to regenerate across and beyond the 10 mm gap. Motoneuron protection, axonal regeneration and remyelination were significantly enhanced with SAPNS scaffold treatments. The target reinnervation and functional recovery induced by the regenerative nerve conduit suggest that SAPNS-based conduit is highly promising application in the treatment of peripheral nerve defect.From the Clinical EditorIn this paper by Zhan et al, a novel self-assembling nanofiber scaffold is reported to promote regeneration of peripheral nerves in a sciatic nerve injury model. The promising results and the obvious medical need raises hope for a clinical translation of this approach hopefully in the near future.     

甲壳素衍生物神经导管的制备及其性质研究

目的 制备通透性良好的甲壳素衍生物神经导管,并研究其基本理化性质和生物相容性。方法 以碱化甲壳素为原料,涂层法制备不同醋酸钾含量的甲壳素衍生物神经导管;测定导管的吸水性、机械强度、通透性、降解性等;以 SD大鼠和RSC96细胞,评价神经导管的生物相容性。结果 神经导管的吸收性、机械强度、通透性因醋酸钾含量不同而变化。神经导管具备良好的组织相容性,降解炎症反应轻,对RSC96细胞具有较好的细胞相容性。     

局部应用促红细胞生成素对周围神经再生的实验研究

目的探讨局部应用人重组促红细胞生成素（recombinant human ythropoietin,rh-EPO）对大鼠坐骨神经断裂后神经再生的作用。方法选用健康雄性Wistar大鼠16只,显露其左侧坐骨神经,于梨状肌出口1.0 cm处切除坐骨神经5 mm,两端用硅胶管桥接形成神经再生室。实验动物随机分为2组,每组8只,EPO组：再生室内注入重组人促红细胞生成素5 000 U/kg;对照组：注入同体积的0.9%氯化钠溶液。术后第8周分别进行坐骨神经功能指数（SFI）、电生理检测、小腿三头肌湿重测定。结果术后第8周2组SFI、运动神经潜伏期延迟比、运动神经波幅恢复比及小腿三头肌湿重恢复比测定结果差异均有统计学意义（P〈0.05）。结论局部应用rh-EPO能促进周围神经再生和功能恢复。     

Drug stimulation of the peripheral nerve regeneration

A comparative study of the effects of xymedone, riboxin, and piracetam upon the regeneration of myelinated axons and the number of surviving sensory neurons in spinal ganglia L4-L5 was studied on the model of sciatic nerve transection in rats. The three drugs decrease the number of neurons entering the posttraumatic apoptosis. Riboxin and xymedone stimulate the regeneration of myelinated axons, the latter drug being more effective and producing a 21.3 and 14.7% increase in the number of regenerated myelinated axons and a 29.3 and 37.7% increase in the relative number of sensory neurons (the transected/contralateral side ratio) in spinal ganglia L4-L5 relative to control by the 60th and 90th day upon transection, respectively.     

桡神经浅支作为供体神经功能重建的解剖学研究

目的为桡神经浅支切取后供区功能重建提供解剖学基础。方法成人前臂防腐标本30侧,测量桡神经浅支分支点与前臂外侧皮神经及正中神经尺侧缘的垂直距离;取6侧新鲜尸体与此水平分别将上述神经作病理切片,观察神经束数目。结果桡神经浅支浅段分支点到前臂外侧皮神经及正中神经尺侧的垂直距离分别为（6.0±1.5）mm及（35.7±2.8）mm。其在此平面附近桡神经浅支内有6～10个神经束;前臂外侧皮神经神经束数目为1～3束;正中神经神经束数目为19～27束。结论可通过端侧吻合的方式将桡神经浅支远断端与正中神经或前臂外侧皮神经吻合,以重建供区的感觉功能。     

Effect of Ga-as laser on the regeneration of injured sciatic nerves in the rat

Laser irradiation is one of the therapeutic methods for the recovery of degenerated peripheral nerves. The aim of the present study was to determine if low-power laser treatment stimulates the regeneration process of damaged nerves. A standardized crush to the sciatic nerve was applied to cause extensive axonal degeneration. After this procedure, low-power infrared laser irradiation was administered transcutaneously to the injured sciatic nerve, 3 minutes daily to each of four treatment groups for 1, 3, 5 and 7 weeks, respectively. A nerve conduction study was done, and a morphological assessment was performed using both light and electron microscopy. With trauma of the nerve, both amplitude of compound motor action potential and nerve conduction velocity decreased significantly compared to the pre-trauma state. Morphologically, the numbers of myelinated axons and degenerated axons were decreased and increased, respectively, compared with the control. Typical aspects were of onion skin-type lamellation, fragmentation, edematous swelling and rarefaction in the myelin sheath. All these parameters recovered almost to the level of the pre-trauma state with laser irradiation, in direct proportion to the time spent for treatment. These results suggest that low-power infrared laser irradiation can relieve the mechanical damage of sciatic nerves and stimulate the regeneration of peripheral nerves.