Effects of subcutaneous implant of peripheral nerve allograft on the regeneration of defected sciatic nerve

BAEKGROUND： Some experimental studies demonstrate that subcutaneous implant of allograft can significantly decrease lymphocyte infiltration and reduce immunological reaction. However, compared with autologous nerve grafting, what is the effect of nerve regeneration after repair？OB]EETIVE： To observe the local nervous status of the detected part of sciatic nerve repaired through subcutaneously implanting peripheral nerve allograft, and compare the effect with fresh autologous nerve grafting.DESTGN ： Contrast observation.SETTING ： Departments of Orthopaedics of Zhengzhou Fifth People＇s Hospital and First Hospital Affiliated to Chongqing Medical University.MATEREALS ： Totally 30 healthy adult Wistar male rats, with body mass of （200±20）g, were enrolled. Optical microscope （Olympus biological microscope BHS, Japan）, Electron microscope （H-600, Japan）,CM-2000 biomedical image analysis system （CM-2000,Beihang） and myoelectricity scanner （KEYPOINT, Denmark） were used in this experiment.METHODS ： This experiment was carried out in the Orthopaedic Laboratory of Chongqing Medical University between October 2000 and April 2002. ① Six rats were chosen as the donors for allogenic nerve grafting, and 15 mm sciatic nerve segment was chosen as graft. The other rats were randomly divided into two groups： allogenic nerve grafting group and autologous nerve grafting group, with 12 rats in each group. In the allogenic nerve grafting group, a skin incision was made on the posterior side of right thigh, and subcutaneous blunt dissection was performed prorsally a little, then allograft was implanted. Two weeks later, sciatic nerve was exposed at the posterior side of left thigh and cut respectively at 5 mm and another 10 mm away from pelvis. The donor nerve （with connective tissue veil） implanted subcutaneously on the right thigh was taken out. Sectioned connective tissue at the proximal end was trimmed and that at the distal end as done but reserved 10 mm in length, and inosculated antegradely at the nerve defect on the left side with 11/0 nylon line. Twelve rats in autologous nerve grafting group underwent a 10 mm sciatic nerve defect inci- sion on the right thigh and implant of fresh sciatic nerve from left thigh. The incision on the left thigh was repaired in situ. ②2,4,8 and 14 weeks after grafting, the nerve specimen of anastomosis segment was observed under optical microscope. Fourteen weeks after grafting, the ultrathin section of distal sciatic nerve was observed under transmission electron microscope. The number and size of regenerated axons at the cross section of anastomosis of proximal and distal sciatic nerve were analyzed with biomedical image analysis system. Neuroelectrophysiological change of in vivo sciatic nerve was detected with myoelectricity scanner.③ t test was used in the comparison of difference of measurement data.MAZN OUTCOME MEASURES ： ① Observation of anastomosis part of sciatic nerve under optical and electron microscopes in the two groups. ② Comparison of motor nerve conduction velocity, latent period and action potential peak as well as the number and size of cross-section of anastomosis part of proximal and distal sciatic nerve between two groups.RESULTS： ①Observation under optical microscope：Two weeks after grafting, neve axon of repaired region broke and medullary sheath denatured in the allogenic nerve grafting group and autologous nerve grafting group. At the same time, vascular engorgement and a little lymphocytes infiltration were found in the autologous nerve grafting group, but those were found worsened in the allogenic nerve grafting group. Four weeks after grafting, the intensity of the inflammatory reaction was similar between two groups, some collagen fibers at the proximal end proliferated; 8 weeks after grafting, the inflammatory reaction ended basically and the collagen fibers proliferated obviously in the two groups. ② Observation under electron microscope： Fourteen weeks after grafting, the structure of epineurium was in integrity and there were no obvious differences in perineurium and endonurium between two groups. A large number of myelinated nerve fibers and a few unmyelinated nerve fibers regenerated. The structure of myelin sheath was in integrity. ③The number and size of regenerated axons of anastomosis of proximal and distal sciatic nerve had no significant difference 14 weeks after grafting [（575.500±7.495） vs（585.700±11.172） axons/visual field ; （389.300±49.073） vs （407.600±0.283） axons/visual field;（6 423.830±119.911 ） vs （6 695.36± 84.287） μm^2/visual field = （ 5 980.110±74.572） vs（5 980.110±74.572） μm^2/visual field] （P 〉 0.05）. ④ Neuroelectrophysiological examination showed that there were no significant differences in motor nerve evoked potential latent pedod[（1.420±0.346）vs （1.237±0.250） ms] , motor nerve conduction velocity [（ 12.120±0.906 ） vs（13.020±0.599） m/s]and latent period of sciatic nerve [（0.500±0.380）vs （1.250±1.067） mV] of rats between two groups （P 〉 0.05）.CONCLUSTON： Although subcutaneous implant of peripheral nerve allograft has some inflammatory reactions, no obvious rejection is found. Repair results of two groups show that subcutaneous implant of allograft can promote nerve regeneration, which is similar to autologous nerve grafting.

The neural butterfly effect The injury to peripheral nerves changes the brain

Regeneration of damaged innervations in the peripheral nervous system （PNS） has been well documented in both animals and human. After injury, the damaged neurite swells and undergoes retrograde degeneration. Once the debris is cleared, it begins to sprout and restore damaged connections. Damaged axons are able to regrow as long as the perikarya are intact and have made contact with the Schwann cells in the endoneurial channel[2]. Under appropriate conditions,

Effect of low-frequency pulse percutaneous electric stimulation on peripheral nerve injuries at different sites

BACKGROUND： The postoperative recovery of nerve function in patients with peripheral nerve injury is always an important problem to solve after treatment. The electric stimulation induced electromagnetic field can nourish nerve, postpone muscular atrophy, and help the postoperative neuromuscular function. OBJECTIVE： To observe the effects of low-frequency pulse percutaneous electric stimulation on the functional recovery of postoperative patients with peripheral nerve injury, and quantitatively evaluate the results of electromyogram （EMG） examination before and after treatment. DESIGN ： A retrospective case analysis SETTING： The Sixth People＇s Hospital affiliated to Shanghai Jiaotong University PARTICIPANTS： Nineteen postoperative inpatients with peripheral nerve injury were selected from the De- partment of Orthopaedics, the Sixth People＇s Hospital affiliated to Shanghai Jiaotong University from June 2005 to January 2006, including 13 males and 6 females aged 24-62 years with an average of 36 years old. There were 3 cases of brachial plexus nerve injury, 3 of median nerve injury, 7 of radial nerve injury, 3 of ul- nar nerve injury and 3 of common peroneal nerve injury, and all the patients received probing nerve fiber restoration. Their main preoperative manifestations were dennervation, pain in limbs, motor and sensory disturbances. All the 19 patients were informed with the therapeutic program and items for evaluation. METHODS： ① Low-frequency pulse percutaneous electric stimulation apparatus： The patients were given electric stimulation with the TERESA cantata instrument （TERESA-0, Shanghai Teresa Health Technology, Co., Ltd.）. The patients were stimulated with symmetric square waves of 1-111 Hz, and the intensity was 1.2-5.0 mA, and it was gradually adjusted according to the recovered conditions of neural regeneration following the principle that the intensity was strong enough and the patients felt no obvious upset. They were treated for 4- 24 weeks, 10-30 minutes for each time, 1-3 times a day, and 6 weeks as a course. ② EMG examination was applied to evaluate the recoveries of recruitment, motor conduction velocity （MCV） and sensory conduction velocity （SCV） before and after treatment. The patients were examined with the EMG apparatus （DIS- A2000C, Danmark） before and after the treatment of percutaneous electric stimulation. ③Standards for evaluating the effects included cured （complete recovery of motor functions, muscle strength of grade 5, no abnormality in EMG examination）, obviously effective [general recovery of motor function, muscle strength of grade 4, no or a few denervation potentials, motor conduction velocity （MCV） and sensory conduction velocity （SCV）], improved （partial recovery of motor function, muscle strength of grade 3, denervation potentials and reinneration potentials, slowed MCV and SCV, invalid （no obvious changes of motor function）. MAIN OUTCOME MEASURES： ① Ameliorated degree of the nerve function of the postoperative patients with peripheral nerve injury treated with percutaneous electric stimulation; ② Changes of EMG examination before and after treatment. RESULTS： All the 19 postoperative patients with peripheral nerve injury were involved in the analysis of results. ① Comparison of nerve function before and after treatment in 19 patients with peripheral nerve injury of different sites： For the patients with radial nerve injury （n=7）, the nerve functions all completely recovered after 8-week treatment, and the cured and obvious rate was 100% （7/7）; For the patients with brachial plexus nerve injury （n=3）, 1 case had no obvious improvement, and the cured and obvious rate was 67% （2/3）; For the patients with common peroneal nerve injury （n=3）, the extension of foot dorsum generally recovered in 1 case of nerve contusion after 4-week treatment, and the cured and obvious rate was 67% （2/3）; For the patients with median nerve injury （n=3）, muscle strength was obviously recovered, and the cured and obvious rate was 100% （3/3）; For the patients with ulnar nerve injury （n=3）, 1 case only had recovery of partial senses, and the cured and obvious rate was 67% （2/3）. Totally 9 cases were cured, 7 were obviously effective, 1 was improved, and only 2 were invalid. After 4 courses, the cured rate of damaged nerve function after four courses was 47% （9/19）, and effective rate was 89% （17/19）.② Comparison of EMG examination before and after treatment： Before and after percutaneous electric stimulation, he effective rates of recruitment, MCV and SCV were 89% （17/19）, 58% （11/19）, 47% （9/19） respectively, and there were extremely obvious differences （P〈 0.01）. CONCLUSION： ①Low-frequency pulse percutaneous electric stimulation can improve the nerve function of postoperative patients with peripheral nerve injury of different sites, especially that the injuries of radial nerve and median nerve recover more obviously. ②Percutaneous electric stimulation can ameliorate the indexes of EMG examination, especially the recruitment, in postoperative patients with peripheral nerve injury.

Neuregulin 1 isoforms could be an effective therapeutic candidate to promote peripheral nerve regeneration

Traumatic injuries of peripheral nerves represent common casualties and their social impact is considerably high. Although peripheral nerves retain a good regeneration potential, the clinical outcome after nerve lesion is far from being satisfactory and functional recovery is almost never complete, especially in the case of large nerve defects, that result in loss or diminished sensitivity and/or motor activity of the innervated target organs. Therefore, to improve the outcome after nerve damage, or in peripheral neuropathies, there is a need for further research in nerve repair and regeneration to identify factors that promote axonal regrowth, remvelination and target reinnervation.

Bridging long gap peripheral nerve injury using skeletal muscle-derived multipotent stem cells

Long gap peripheral nerve injuries usually reulting in life-changing problems for patients. Skeletal muscle derived-multipotent stem cells （Sk-MSCs） can differentiate into Schwann and perineurial/endoneurial cells, vascular relating pericytes, and endothelial and smooth muscle cells in the damaged peripheral nerve niche. Application of the Sk-MSCs in the bridging conduit for repairing long nerve gap injury resulted favorable axonal regeneration, which showing superior effects than gold standard therapy--healthy nerve autograft. This means that it does not need to sacrifice of healthy nerves or loss of related functions for repairing peripheral nerve injury.

Polydopamine-modified chitin conduits with sustained release of bioactive peptides enhance peripheral nerve regeneration in rats

The introduction of neurotrophic factors into injured peripheral nerve sites is beneficial to peripheral nerve regeneration.However,neurotrophic facto rs are rapidly degraded in vivo and obstruct axonal regeneration when used at a supraphysiological dose,which limits their clinical benefits.Bioactive mimetic peptides have been developed to be used in place of neurotrophic factors because they have a similar mode of action to the original growth fa ctors and can activate the equivalent receptors but have simplified sequences and structures.In this study,we created polydopamine-modified chitin conduits loaded with brain-derived neurotrophic factor mimetic peptides and vascular endothelial growth fa ctor mimetic peptides(Chi/PDA-Ps).We found that the Chi/PDA-Ps conduits were less cytotoxic in vitro than chitin conduits alone and provided sustained release of functional peptides.In this study,we evaluated the biocompatibility of the Chi/P DA-Ps conduits.Brain-derived neurotrophic factor mimetic peptide and vascular endothelial growth fa ctor mimetic peptide synergistically promoted prolife ration of Schwann cells and secretion of neurotrophic factors by Schwann cells and attachment and migration of endothelial cells in vitro.The Chi/P DA-Ps conduits were used to bridge a 2 mm gap between the nerve stumps in rat models of sciatic nerve injury.We found that the application of Chi/PDA-Ps conduits could improve the motor function of rats and reduce gastrocnemius atrophy.The electrophysiological results and the microstructure of regenerative nerves showed that the nerve conduction function and re myelination was further resto red.These findings suggest that the Chi/PDA-Ps conduits have great potential in peripheral nerve injury repair.

Restorative effect and mechanism of mecobalamin on sciatic nerve crush injury in mice

Mecobalamin, a form of vitamin B12 containing a central metal element （cobalt）, is one of the most important mediators of nervous system function. In the clinic, it is often used to accelerate recovery of peripheral nerves, but its molecular mechanism remains unclear. In the present study, we performed sciatic nerve crush injury in mice, followed by daily intraperitoneal administra-tion of mecobalamin （65 μg/kg or 130 μg/kg） or saline （negative control）. Walking track analysis, histomorphological examination, and quantitative real-time PCR showed that mecobalamin signiifcantly improved functional recovery of the sciatic nerve, thickened the myelin sheath in myelinated nerve ifbers, and increased the cross-sectional area of target muscle cells. Further-more, mecobalamin upregulated mRNA expression of growth associated protein 43 in nerve tissue ipsilateral to the injury, and of neurotrophic factors （nerve growth factor, brain-derived nerve growth factor and ciliary neurotrophic factor） in the L4–6 dorsal root ganglia. Our ifndings indicate that the molecular mechanism underlying the therapeutic effect of mecobalamin after sciatic nerve injury involves the upregulation of multiple neurotrophic factor genes.

Comparason of Peri-Articular Multimodal Drug Injection with Femoral and Sciatic Nerve Block after Total Knee Arthroplasty

Good perioperative analgesia following total knee arthroplasty facilitates rehabilitation and may reduce hospital stay. We present the patient analgesic requirements and rehabilitation of a prospective single surgeon series after the introduction of a multimodal drug injection during his total knee arthroplasty. Basic epidemiological data as well as analgesic, antiemetic requirements and time to straight leg raised was collected on 27 consecutive patients (group 1) whom received the multimodal drug injection, consisting of levobupivacaine, ketorolac and adrenaline at the time of their total knee arthroplasty under spinal anaesthesia. Their rehabilitation was compared to a retrospective review of patients who were case matched by age and sex (group 2n = 26), whom had received the unit standard of spinal anaesthetic and a femoral and sciatic block at the time of their operation. Patients in group 1 had significantly lower analgesic and antiemetic requirements than group 2. Group 1 also had a significantly shorter hospital stay. We have demonstrated that periarticular multimodal drug injection can improve perioperative analgesia and mobilisation following total knee arthroplasty as well as reducing opioid requirements and side effects.

Biopolymer-nanotube nerve guidance conduit drug delivery for peripheral nerve regeneration:In vivo structural and functional assessment

Peripheral nerve injuries account for roughly 3%of all trauma patients with over 900,000 repair procedures annually in the US.Of all extremity peripheral nerve injuries,51%require nerve repair with a transected gap.The current gold-standard treatment for peripheral nerve injuries,autograft repair,has several shortcomings.Engineered constructs are currently only suitable for short gaps or small diameter nerves.Here,we investigate novel nerve guidance conduits with aligned microchannel porosity that deliver sustained-release of neurogenic 4-aminopyridine(4-AP)for peripheral nerve regeneration in a critical-size(15 mm)rat sciatic nerve transection model.The results of functional walking track analysis,morphometric evaluations of myelin development,and histological assessments of various markers confirmed the equivalency of our drug-conduit with autograft controls.Repaired nerves showed formation of thick myelin,presence of S100 and neurofilament markers,and promising functional recovery.The conduit’s aligned microchannel architecture may play a vital role in physically guiding axons for distal target reinnervation,while the sustained release of 4-AP may increase nerve conduction,and in turn synaptic neurotransmitter release and upregulation of critical Schwann cell neurotrophic factors.Overall,our nerve construct design facilitates efficient and efficacious peripheral nerve regeneration via a drug delivery system that is feasible for clinical applications.

腰硬联合麻醉复合髋关节囊周围神经阻滞在老年髋部骨折患者中的应用效果

目的分析老年髋部骨折患者联合腰硬复合麻醉、髋关节囊周围神经阻滞的作用。方法非随机选取2021年1月—2023年1月新疆生产建设兵团第十三师红星医院收治的120例老年髋部骨折患者为研究对象,均予以外科手术治疗,按照不同麻醉方式分为两组,各60例。对照组采取腰硬联合麻醉,观察组采取腰硬联合麻醉复合髋关节囊周围神经阻滞,比较两组患者应用效果。结果观察组术后中枢神经特异蛋白、β-淀粉样蛋白1-40水平分别为(94.28±13.23)mg/L、(6.52±0.94)mg/L,均较对照组的(130.54±23.89)mg/L、(9.81±1.55)mg/L低,差异有统计学意义(t=9.044、7.837,P均<0.05);观察组术后2、4、6、12 h的VAS评分较对照组低,差异有统计学意义(P均<0.05)。结论联合腰硬复合麻醉、髋关节囊周围神经阻滞用于老年髋部骨折患者,能够减轻患者术后疼痛,并降低术后中枢神经系统的损伤。

电针干预周围神经损伤效应及机制的研究

周围神经损伤(PNI)是临床常见病,属于中医“痹证”“痿证”范畴。本着“评价疗效、探寻规律、阐明机制、指导临床”为研究总体思路,天津中医药大学实验针灸学研究中心郭义教授团队与日本铃鹿医疗科学大学石田寅夫教授团队合作,围绕电针治疗周围神经损伤开展了系列研究。明确了电针刺激可促进外周神经再生,早期干预效果更佳,低频电针效果更佳,且对失神经支配所造成的肌肉萎缩也有一定的疗效,肯定了经皮穴位电刺激治疗可显著改善糖尿病患者的临床症状,提高生命质量,可改善病变神经的运动和感觉功能。并从形态学、分子生物学角度明确了其干预机制。研究为临床更好使用电针治疗周围神经损伤提供了科学依据,推动了电针治疗神经损伤的临床应用。

促周围神经再生中药复方--复方红芪

周围神经损伤是临床常见问题[1],尽管目前周围神经修复技术已经有了很显著的进步,但即使新鲜、清洁的周围神经断裂伤,能及时运用显微外科技术进行修复,也往往不能完全再生,患者神经功能恢复不能令人满意[2].因此,如何促进周围神经损伤后的再生,恢复其功能已日益成为相关研究的重点.

神经妥乐平对周围神经损伤的治疗作用

目的 :观察神经妥乐平对周围神经损伤病人的疗效。方法 :86例周围神经损伤病人在常规治疗基础上随机分为神经妥乐平治疗组 44例 ,给神经妥乐平wk 1～ 2 ,6mL ,iv,qd或 3mL ,im ,qd ,wk3～4改为口服 ,2片 ,bid ;对照组 42例仅进行常规治疗。治疗前后观察疼痛、麻木、感觉减退、感觉过敏、乏力等指标的改善情况。结果 :神经妥乐平组的改善率分别为 87% (疼痛 )、88% (乏力 )、88% (感觉减退 )、62 % (麻木 )、5 6% (感觉过敏 )。疼痛与乏力和对照组相比 ,差异有显著意义 (P <0 .0 5 )。神经妥乐平组总有效率在治疗 4wk时为 1 0 0 % ,对照组为 69% ,2组间比较经Ridit分析差异有非常显著意义 (P <0 .0 1 )。结论 :神经妥乐平可安全。

格列齐特、甲钴胺及其联合用药对糖尿病大鼠周围神经形态学改变及神经生长因子含量的影响

目的观察格列齐特、甲钴胺及其联合用药对糖尿病大鼠周围神经形态学改变及神经生长因子含量的影响。方法采用链脲佐菌素致糖尿病大鼠模型,以组织学方法观察药物对糖尿病大鼠坐骨神经形态学改变的影响;以酶联免疫方法测定血清中神经生长因子含量;以免疫组织化学法观察坐骨神经组织内神经生长因子的含量变化。结果格列齐特、甲钴胺及其联合用药对糖尿病大鼠坐骨神经形态学改变有保护作用;对血清神经生长因子含量减少有提高作用;对坐骨神经组织中神经生长因子的含量虽无明显影响,但对坐骨神经轴突内神经生长因子的减少有提高作用。格列齐特与甲钴胺联合应用对以上指标的改善均未发现有明显性提高。结论格列齐特、甲钴胺及其联合用药对糖尿病大鼠周围神经病变具有保护作用;与单独用药相比,格列齐特与甲钴胺联合应用未见有明显性疗效增强作用。

白藜芦醇抗癫痫作用机制的初步研究

目的评价白藜芦醇(Res)的抗癫痫效果并初步分析其作用机制,为开发新型抗癫痫药物提供理论依据。方法建立颞叶癫痫大鼠模型后,以Res干预10d,丙戊酸钠(VPA)作为阳性对照,观察Res对颞叶癫痫大鼠的行为学、电生理学和病理学指标的影响。结果模型组自发性发作率增加,海马内神经元大量死亡,苔藓纤维出芽(MFS)至颗粒细胞层和内分子层;Res能抑制癫痫大鼠自发性发作,对并海马CA1和CA3a区神经元有保护作用和抑制MFS(P<0.05)。结论Res具有较强的抗癫痫作用。

血塞通定向透药导入疗法联合甲钴胺治疗糖尿病周围神经病变疗效观察

目的观察血塞通定向透药导入疗法联合甲钴胺治疗糖尿病周围神经病变的临床疗效。方法选择2018年9月—2019年9月辽宁中医药大学附属医院内分泌康复科收治的糖尿病周围神经病变患者70例,采用随机数字表法分为试验组和对照组,每组35例。对照组给予糖尿病基础治疗及口服甲钴胺片,试验组在对照组治疗基础上给予血塞通定向透药导入治疗,2组观察周期均为4周。比较2组患者中医症状积分、多伦多临床评分(TCSS)、神经传导速度、血液流变学(血浆黏度、高切黏度、低切黏度、血细胞比容)、炎症相关因子水平[同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)]及临床疗效,同时进行安全性评估。结果治疗后,2组中医症状积分、TCSS评分及血液流变学各指标均明显降低(P均<0.05),且试验组均明显低于对照组(P均<0.05);2组胫神经、腓总神经的感觉传导速度及运动神经传导速度均加快(P均<0.05),且试验组均快于对照组(P均<0.05);2组血清Hcy及hs-CRP水平均明显降低(P均<0.05),但组间比较差异无统计学意义(P>0.05)。试验组总有效率为88.6%(31/35),对照组为66.7%(23/35),试验组明显高于对照组(P<0.05);2组均无明显不良反应发生。结论血塞通定向透药导入疗法联合甲钴胺治疗糖尿病周围神经病变疗效显著优于单纯西药治疗,有保护神经功能、改善血液循环、减轻炎症反应的作用,且安全。

黄芪注射液超声透入防治奥沙利铂相关神经毒性临床观察

目的观察通过超声透入黄芪注射液对含奥沙利铂的化疗方案引起的神经毒性的防治作用,并探讨其机制。方法将60例诊断符合消化道恶性肿瘤并接受含奥沙利铂方案化疗的患者,按随机数字表法分为两组。实验组30例,在每次接受化疗当天,给予超声药物透入黄芪注射液治疗。对照组30例,单纯接受化疗。两组患者实验过程中发生神经毒性,均接受口服甲钴胺治疗。按Levi′s奥沙利铂专用感觉神经毒性分级标准,观察两组患者化疗后外周神经毒性,同时行化疗前后生活质量评定。结果实验组发生外周神经毒性发生率93.33%,对照组外周神经毒性发生率100%。实验组外周神经毒性分级情况显著优于对照组(P<0.05)。治疗后,实验组患者生活质量状况优于对照组(P<0.05),但两组患者治疗后KPS评分均较治疗前有明显降低(P<0.05)。结论超声波经穴位导入黄芪注射液可以减轻奥沙利铂所致周围神经毒性,减轻化疗不良反应,相对提高患者生活质量。

加味补阳还五汤对周围神经再生的形态学实验研究

用钳夹法造成大鼠腓总神经损伤动物模型,灌胃给加味补阳还五汤进行治疗。研究结果显示:用药组再生神经轴索数和损伤神经再生率明显高于对照组P<0.05～0.01;用药组类似正常结构的髓鞘数目多;雪旺氏细胞增殖活跃;失神经肌萎缩程度轻。表明加味补阳还五汤对神经纤维再生、雪旺氏细胞活跃增殖、髓鞘形成及结构完整有明显促进作用。对失神经性肌萎缩有改善作用。为用中医中药治疗神经损伤提供了科学依据。

中药合剂神经生长液的促神经生长作用

目的观察中药合剂神经生长液对神经元生长的促进作用,为神经生长液用于治疗神经损伤、促进损伤神经修复提供实验依据。方法新生大鼠背根神经节无血清培养,在基础培养液中加入神经生长液,观察实验组与空白对照组背根神经节细胞生长状况和突起生长的长度。胎鼠大脑皮质神经元无血清培养,在基础培养液中加入神经生长液,采用3-(4,5-dimethylthiaz-2-y1)-2,5-dijohenyltetrazoliumbromide(MTT)法,观察实验组、神经生长因子(阳性对照)、空白对照组大脑皮质神经元的生长状态。结果与对照组相比,实验组背根神经节细胞突起生长明显,突起长度(314±43)μm显著大于对照组(76±26)μm(F=313.69,P<0.01);与对照组相比,神经生长因子、神经生长液均可显著提高无血清培养条件下大脑皮质神经元对MTT的代谢率(F=82.54,P均<0.01),且存在明显的剂量效应关系。结论神经生长液在体外可促进背根神经节和大脑皮质神经元生长。

空气波压力治疗仪对糖尿病下肢周围神经病变的疗效

目的综合评价空气波压力治疗仪(intermittent pneumatic compression,IPC)对糖尿病下肢周围神经病变的疗效。方法按照随机数字表将80例糖尿病下肢周围神经病变患者随机分为研究组和对照组,每组40例。2组患者均给予降压、降糖、降脂,营养神经,改善循环等药物治疗,研究组在此基础上加用IPC治疗。干预时间14 d,比较2组患者的症状、足底振动感觉阈值测定(vibrating perception threshold,VPT)及下肢神经传导速度(nerve conduction velocity,NCV)有无统计学差异。结果干预前2组患者症状、足底VPT、下肢NCV比较,差异无统计学意义(P>0.05)。干预14 d后研究组患者的症状、足底VPT、腓肠神经和腓浅神经NCV较对照组改善明显,差异有统计学意义(P<0.05);2组患者胫神经和腓总神经NCV比较,差异无统计学意义(P>0.05)。结论IPC治疗可改善糖尿病下肢周围神经病变患者微循环,促进感觉神经修复,有效缓解患者下肢症状,提高患者生活质量。