RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

Vascular endothelial growth factor promotes peripheral nerve regeneration after sciatic nerve transection in rat

Objective：To evaluate the local effect of vascular endothelial growth factor （VEGF） on transected sciatic nerve regeneration.Methods：Sixty male white Wistar rats were divided into four experimental groups randomly （n=15）.In transected group the left sciatic nerve was transected and the stump was fixed to adjacent muscle.In treatment group the defect was bridged using a silicone graft filled with 10μL VEGF.In silicone group the graft was filled with phosphate-buffered saline.In sham-operated group the sciatic nerve was exposed and manipulated.Each group was subdivided into three subgroups with five animals in each and nerve fibers were studied 4,8 and 12 weeks after operation.Results：Behavioral test,functional study of sciatic nerve,gastrocnemius muscle mass and morphometric indices confirmed a faster recovery of regenerated axons in VEGF group than in silicone group （P〈0.05）.In immunohistochemical assessment,reactions to S-100 in VEGF group were more positive than that in silicone group.Conclusion：Local administration of VEGF will improve functional recovery and morphometric indices of sciatic nerve.     

Quantification of nerve tension after nerve repair: correlations with nerve defects and nerve regeneration

This study tested the validity of a quantitative in vitro nerve-tension-measuring technique, by correlating the tension measurements with functional and morphologic assessments of nerve regeneration. Initially, harvested nerves were used in vitro to determine a K value for lateral displacement in this tissue. Next, this value was used to calculate the tension of nerve repair, following 0-, 3-, 6-, and 9-mm resections of nerves in groups of rats. After quantifying the nerve tensions following excision and repair, the authors determined a sciatic function index to evaluate functional recovery and axon diameter in the animals. Functional recovery was significantly impaired in animals with elevated measurable tension (9.04 +/- 0.74 g in a 6-mm defect, 27.76 +/- 8.86 g in a 9-mm defect), compared to animals with no or 3-mm excision and measured tension of 3.3 +/- 1.09 g or less. Increased tension was also associated with a significant decrease in axon diameter. This study succeeded, therefore, in quantitatively relating the elements of measured nerve tension, nerve gaps, functional nerve recovery, and morphologic regeneration. Quantification of nerve tension by lateral displacement in vivo offers a possible solution to clinical management of nerve gaps, when the choice between primary repair and nerve grafting is not a clear one.     

End-to-side nerve graft for facial nerve reconstruction

Reconstruction of multiple branches of the facial nerve by sural nerve graft using end-to-side nerve suture was performed successfully on a patient with advanced parotid tumor. In this technique, one end of the grafted nerve is sutured with the stump of the facial nerve trunk in an end-to-end manner. Epineural windows are made on the nerve graft, and the distal stumps of the facial nerve branches (temporal, zygomatic, and buccal branches) are sutured with the graft in an end-to-side manner. Functional recovery of all branches and satisfactory facial expression were obtained within 2 years postoperatively. Axonal regeneration through the graft was confirmed by electrodiagnosis. Regeneration through the anastomosis at the stump of the facial nerve trunk using this technique is more efficient than conventional cable grafting, and the length of the nerve required is minimal. This technique may be a useful option for facial nerve reconstruction managing multiple branches.     

Cavernous nerve regeneration using acellular nerve grafts

INTRODUCTION: The restoration of erectile function following complete transection of nerve tissue during surgery remains challenging. Recently, graft procedures using sural nerve grafts during radical prostatectomy have had favorable outcomes, and this has rekindled interest in the applications of neural repair in a urologic setting. Although nerve repair using autologous donor graft is the gold standard of treatment currently, donor nerve availability and the associated donor site morbidity remain a problem. In this study, we investigated whether an "off-the-shelf" acellular nerve graft would serve as a viable substitute. We examined the capacity of acellular nerve scaffolds to facilitate the regeneration of cavernous nerve in a rodent model. MATERIALS AND METHODS: Acellular nerve matrices, processed from donor rat corporal nerves, were interposed across nerve gaps. A total of 80 adult male Sprague-Dawley rats were divided into four groups. A 0.5-cm segment of cavernosal nerve was excised bilaterally in three of the four groups. In the first group, acellular nerve segments were inserted bilaterally at the defect site. The second group underwent autologous genitofemoral nerve grafts at the same site, and the third group had no repair. The fourth group underwent a sham procedure. Serial cavernosal nerve function assessment was performed using electromyography (EMG) at 1 and 3 months following initial surgery. Histological and immunocytochemical analyses were performed to identify the extent of nerve regeneration. RESULTS: Animals implanted with acellular nerve grafts demonstrated a significant recovery in erectile function when compared with the group that received no repair, both at 1 and 3 months. EMG of the acellular nerve grafts demonstrated adequate intracavernosal pressures by 3 months (87.6% of the normal non-injured nerves). Histologically, the retrieved regenerated nerve grafts demonstrated the presence of host cell infiltration within the nerve sheaths. Immunohistochemically, antibodies specific to axons and Schwann cells demonstrated an increase in nerve regeneration across the grafts over time. No organized nerve regeneration was observed when the cavernous nerve was not repaired. CONCLUSION: These findings show that the use of nerve guidance channel systems allow for accelerated and precise cavernosal nerve regeneration. Acellular nerve grafts represent a viable alternative to fresh autologous grafts in a rodent model of erectile dysfunction.     

End-to-side nerve repair in peripheral nerve injury

In peripheral nerve injury, end-to-side neurorrhaphy has been reported as an alternative in cases that the proximal nerve stump is not accessible. Several hypotheses have been proposed to explain peripheral nerve regeneration after end-to-side neurorrhaphy. Recent evidence suggests that nerve regeneration occurs by collateral sprouting. Although a great number of humoral factors have been identified, molecular mechanism of nerve regeneration after end-to-side neurorrhaphy has not been completely clarified yet. The goal of this technique is to provide satisfactory functional recovery for the recipient nerve, without any deterioration of the donor nerve function. End-to-side technique has been investigated in detail in both experimental and clinical studies. Only a limited number of reported cases in clinical practice, until today, can reveal that end-to-side technique may become a viable means of repairing peripheral nerves in certain clinical situations.     

内脏神经-体神经端侧吻合后神经纤维再生研究

目的 观察大鼠内脏神经-体神经端侧吻合后神经纤维的再生.方法 24只成年SD大鼠随机分为实验组(n=12)和正常对照组(n=12),实验组大鼠通过内脏神经-体神经端侧吻合建立人工体神经-内脏神经反射弧6个月后,在吻合口近端和远端分别截取10 mm的供体神经(L4VR)和受体神经(L6VR),在L6VR延续的盆副交感神经(PPN)和阴部神经(PN)分别截取10 mm的神经.正常对照组大鼠分别取相应节段的L4VR、L6VR、PPN和PN神经.标本经石蜡包埋切片并行甲苯胺蓝染色,比较实验组和对照组大鼠L6VR、PPN、PN神经纤维数量.结果 实验组大鼠横断面可见新生的有髓神经纤维,L4VR、L6VR、PPN和PN的神经纤维数量分别为1602.2±75.7、1037.9±123.6、817.0 ±52.2、510.4±29.1,吻合口远近端神经纤维通过率为64.8%,实验组和对照组大鼠相应的L6VR、PPN、PN神经纤维数目比率分别为70.2%、68.9%和62.2%.结论 大鼠内脏神经-体神经端侧吻合后体神经能够长入并替代内脏神经.