Low-frequency pulsed electromagnetic field pretreated bone marrow-derived mesenchymal stem cells promote the regeneration of crush-injured rat mental nerve

Bone marrow-derived mesenchymal stem cells （BMSCs） have been shown to promote the regeneration of injured peripheral nerves. Pulsed electromagnetic field （PEMF） reportedly promotes the proliferation and neuronal differentiation of BMSCs. Low-frequency PEMF can induce the neuronal differentiation of BMSCs in the absence of nerve growth factors. This study was designed to investigate the effects of low-frequency PEMF pretreatment on the proliferation and function of BMSCs and the effects of low-frequency PEMF pre-treated BMSCs on the regeneration of injured peripheral nerve using in vitro and in vivo experiments.In in vitro experiments, quantitative DNA analysis was performed to determine the proliferation of BMSCs, and reverse transcription-polymerase chain reaction was performed to detect S100 （Schwann cell marker）, glial fibrillary acidic protein （astrocyte marker）, and brain-derived neurotrophic factor and nerve growth factor （neurotrophic factors） mRNA expression. In the in vivo experiments, rat models of crush-injured mental nerve established using clamp method were randomly injected with low-frequency PEMF pretreated BMSCs, unpretreated BMSCs or PBS at the injury site （1 × 106 cells）. DiI-labeled BMSCs injected at the injury site were counted under the fluorescence microscope to determine cell survival. One or two weeks after cell injection, functional recovery of the injured nerve was assessed using the sensory test with von Frey filaments. Two weeks after cell injection, axonal regeneration was evaluated using histomorphometric analysis and retrograde labeling of trigeminal ganglion neurons. In vitro experiment results revealed that low-frequency PEMF pretreated BMSCs proliferated faster and had greater mRNA expression of growth factors than unpretreated BMSCs. In vivo experiment results revealed that compared with injection of unpretreated BMSCs, injection of low-frequency PEMF pretreated BMSCs led to higher myelinated axon count and axon density and more DiI-labeled neurons in the trigeminal ganglia, contributing to rapider functional recovery of injured mental nerve. These findings suggest that low-frequency PEMF pretreatment is a promising approach to enhance the efficacy of cell therapy for peripheral nerve injury repair.

Recombinant human fibroblast growth factor-2 promotes nerve regeneration and functional recovery after mental nerve crush injury

Several studies have shown that fibroblast growth factor-2 （FGF2） can directly affect axon regeneration after peripheral nerve damage. In this study, we performed sensory tests and histological analyses to study the effect of recombinant human FGF-2 （rhFGF2） treatment on damaged mental nerves. The mental nerves of 6-week-old male Sprague-Dawley rats were crush-injured for 1 minute and then treated with 10 or 50 μg/mL rhFGF2 or PBS in crush injury area with a mini Osmotic pump. Sensory test using von Frey filaments at 1 week revealed the presence of sensory degeneration based on decreased gap score and increased difference score. However, at 2 weeks, the gap score and difference score were significantly rebounded in the mental nerve crush group treated with 10 μg/mL rhFGF2. Interestingly, treatment with 10 μg/mL rhFGF had a more obviously positive effect on the gap score than treatment with 50 μg/mL rhFGF2. In addition, retrograde neuronal tracing with Dil revealed a significant increase in nerve regeneration in the trigeminal ganglion at 2 and 4 weeks in the rhFGF2 groups （10 μg/mL and 50 μg/mL） than in the PBS group. The 10 μg/mL rhFGF2 group also showed an obviously robust regeneration in axon density in the mental nerve at 4 weeks. Our results demonstrate that 10 μg/mL rhFGF induces mental nerve regeneration and sensory recovery after mental nerve crush injury.

Evaluation of Bilateral Mental Nerve Block as an Alternative to General Anesthesia for Resection of Lower Lip Tumors

Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center experience in performing various lip resections and reconstructive techniques using this technique. Patients and methods: sixty patients with lower lip tumors were enrolled into this study with exclusion of refusing, non-compliant and critically ill patients. A solution of 4 ml 2% Lidocaine and epinephrine was put in a 5 ml syringe. Half the solution (2 ml) was injected into each side with a 23 gauge needle and after 5 minutes the surgical resection was carried out after testing for anesthesia. Results: The mean age was 68 ± 6.2 years. The mean ASA score was 3 ± 0.75. There were 4 cases who expressed painful sensation and their operations were completed with fentanyl increments. Mean hospital stay was 1 ± 0.75 days. There were three cases of wound gaping who were treated with secondary closure in an outpatient basis. One patient expressed postoperative acute ischemic heart pain that was managed with anti-ischemic measurements. Conclusion: Bilateral mental nerve block is a safe and effective alternative to general anesthesia in lower lip tumors’ resection especially in older patients and those with poor tolerance for general anesthesia provided that there is no need for cervical nodal dissection.

The Anatomical Research on the Mental Foramen Related to the Mental Nerve Block

Objective: The aim of this study was to observe and investigate the location of mental foramen, providing scientific and reasonable anatomic basic for clinical mental nerve block. Methods: The shape, orientations, relationship with teeth and number of accessory mental foramina in 50 (100 side) adult mental foramina were observed. The long and short diameters of the mental foramen and the distance between the mental foramen and the peripheral anatomical markers were measured by a vernier caliper, and statistical analysis of the data was performed to obtain the final results. Results: The probability of mental foramen being elliptical in shape accounted for 27%, circular for 73%;10% of the mental foramen openings are outward and 90% are outward and upward;The mental foramina were located under the first premolars in 20%, under the second premolars in 75%, and 5% situated in the bottom of the first molars. The incidence of accessory mental foramina was 1%;the long diameter of the mental foramen was (2.42 ± 0.71) mm, and the short diameter of the mental foramen was (2.15 ± 0.14) mm;the vertical distance from the mental foramen center to the alveolar crest and the lower margin of the mandible were (14.09 ± 3.23) mm and (14.56 ± 1.74) mm;the distance between the midpoints of the vertical line to the center of the mental foramen was (1.26 ± 0.97) mm;the horizontal distance from the center of the mental foramen to the anterior median line was (23.57 ± 1.82) mm. Conclusion: The point of mental nerve block was selected below and behind the second premolars, above the midline of the mandible. The distance from the anterior median line was 2.5 cm, and the mental foramen was explored forward and downward after the insertion.

基于集束化的循证护理对高血压脑出血病人心理状态、神经功能及日常生活能力的影响

目的:探究集束化循证护理对高血压脑出血病人的影响。方法:选取常熟市第一人民医院2018年1月—2020年8月收治的130例高血压脑出血病人为研究对象,采用随机数字表法分为对照组和试验组,各65例。对照组实施常规护理,试验组在对照组基础上实施集束化循证护理,比较两组心理状态、神经功能、日常生活能力、并发症发生情况及生活质量。结果:干预后试验组病人焦虑评分、抑郁评分、美国国立卫生研究院卒中量表评分、并发症发生率均低于对照组;日常生活活动能力评定量表评分、生活质量各维度评分高于对照组,差异均有统计学意义(P<0.05)。结论:对高血压脑出血病人进行循证护理干预,可有效改善病人心理状态,减轻病人神经功能缺损,提高病人日常生活能力,减少并发症,改善病人生活质量。

精神障碍类疾病神经调控新进展

精神障碍类疾病是一类涉及认知、情感、思维和行为的疾病,其临床表现各异,致病机制复杂,病因尚未被彻底阐明,目前仍无有效的针对性治疗方案,是当前医学领域的难点之一。近年研究结果表明,以电、磁、光、声为基础开发的新型神经调控手段可以有效的治疗或缓解各类药物难治性精神类疾病的临床症状。因此本文将聚焦于总结和回顾各类新型神经调控手段的研发与应用进展,为精神障碍类疾病治疗方案的更新提供新思路。

双侧会阴神经阻滞联合助产护理对产妇产程及心理状态的影响

目的分析双侧会阴神经阻滞联合助产护理对产妇产程及心理状态的影响。方法选取66名待产产妇为研究对象,使用随机数字表法分为对照组和观察组,每组33名。对照组接受双侧会阴神经阻滞,观察组在对照组基础上联合助产护理模式干预。比较两组产妇的干预效果。结果干预后,观察组第一产程、第二产程、总产程时间均短于对照组,差异有统计学意义(P<0.05)。干预后,观察组各项心理状态评分均低于对照组,差异有统计学意义(P<0.05)。观察组会阴Ⅰ度、Ⅱ度、Ⅲ度撕裂发生率均低于对照组,会阴侧切发生率为6.06%,低于对照组的30.30%,差异有统计学意义(P<0.05)。结论双侧会阴神经阻滞联合助产护理不仅能缩短产程时间,有效缓解产妇的负性情绪,还能降低其会阴侧切率及会阴撕裂率,临床效果显著,可予以推广。

Changes in brain activation in stroke patients after mental practice and physical exercise: a functional MRI study

Mental practice is a new rehabilitation method that reters to the mental rehearsal ot motor imagery content with the goal of improving motor performance. However, the relationship between activated regions and motor recovery after mental practice training is not well understood. In this study, 15 patients who suffered a firstever subcortical stroke with neurological deficits affecting the right hand, but no significant cognitive impairment were recruited. 10 patients underwent mental practice combined with physical practice training, and 5 patients only underwent physical practice training. We observed brain activation regions after 4 weeks of training, and explored the correlation of activation changes with functional recovery of the affected hands. The results showed that, after 4 weeks of mental practice combined with physical training, the Fugl-Meyer assessment score for the affected right hand was significantly increased than that after 4 weeks of practice training alone. Functional MRI showed enhanced activation in the left primary somatosensory cortex, attenuated activation intensity in the right primary motor cortex, and enhanced right cerebellar activation observed during the motor imagery task using the affected right hand after mental practice training. The changes in brain cortical activity were related to functional recovery of the hand. Experimental findings indicate that cortical and cerebellar functional reorganization following mental practice contributed to the improvement of hand function.

Accessory Mental Foramen Misdiagnosed as Radiolucent Tumour by Conventional Dental Radiography

The mental foramen is an important landmark for identifying the mental nerve, and the accessory mental foramen is a rare anatomical variation. This article describes the use of computed tomo- graphy (CT) to detect an accessory mental foramen that was initially misdiagnosed as a radiolu- cent tumour in the right premolar region of a 39-year-old woman by panoramic radiography. The case suggests that preoperative CT should be performed to detect any anatomical variations. This knowledge would help in diagnosis, preoperative planning and prevention of intraoperative nerve or vascular injury.

Dynamic Analysis of Mental Sweating by the Time-Sequential Piled-Up En-Face OCT Images

In this paper, the dynamic analysis of mental sweating for sound stimulus of a few tens of eccrine sweat glands is performed by the time-sequential piled-up en-face optical coherence tomography (OCT) images with the frame spacing of 3.3 sec. In the experiment, the amount of excess sweat can be evaluated simultaneously for a few tens of sweat glands by piling up of all the en-face OCT images. Strong non-uniformity is observed in mental sweating where the amount of sweat in response to sound stimulus is different for each sweat gland. Furthermore, the amount of sweat is significantly increased in proportion to the strength of the stimulus.

同期神经化血管化髂骨瓣修复下颌骨及神经缺损

颌骨大型缺损的功能性重建是口腔颌面外科临床的重点问题,自体骨移植是主要的方法。然而,自体骨移植后的骨质易吸收,即使通过吻合血管,移植骨的自发性疏松化仍然严重影响牙种植及功能恢复。因此,血管化自体骨移植的疏松化成为颌骨重建的重要并发症之一,尚无预防措施。血供充足的自体骨无法避免自身疏松化的问题提示:血供之外被长期忽略的神经等系统因素可能调控移植骨内环境。笔者基于前期神经微环境调控间充质干细胞的系列研究,通过构建神经化血管化髂骨瓣动物模型及尸体解剖,提出了同期神经支配的血管化髂骨瓣修复下颌骨缺损的新术式。神经化血管化髂骨瓣移植是在髂骨瓣(骨肌皮瓣)植入受区并行血管吻合后,对同时获取的支配髂骨的髂腹股沟神经(传统方法一般忽略并牺牲)与下牙槽神经近心端及颏神经行显微缝合。笔者团队通过开展临床回顾性研究和前瞻性随机对照试验,证实同期神经化血管化髂骨瓣移植的新方法不仅抵御骨质吸收,而且能够恢复唇等周围软组织的感觉,可解决颌骨重建后感觉缺失及疏松化的关键问题,保证了牙种植义齿的成功,并提出“血供+神经”双系统骨移植的新理念。

早期抚触联合游泳对新生儿行为神经、智力发育、心理运动发育的影响

目的 探讨早期抚触联合游泳对新生儿主动肌张力、行为能力、身长、体质量的影响。方法 选取2019年1月至2021年12月于平顶山市妇幼保健院出生的100例新生儿作为研究对象,随机分为观察组和对照组,各50例。对照组新生儿接受常规保健及早期抚触,观察组新生儿在对照组的基础上接受游泳干预。比较两组新生儿不同时期行为神经评分[新生儿行为神经测定(NBNA)量表]、智力发育指数(MDI)、心理运动发育指数(PDI)、身长及体质量变化。结果 出生时,两组新生儿NBNA量表各项评分比较,差异无统计学意义(P>0.05);出生1个月,两组新生儿被动肌张力、一般性评价评分比较,差异无统计学意义(P>0.05),但观察组主动肌张力、行为能力、原始反射能力及总分均高于对照组(P<0.05)。两组新生儿出生1个月MDI、PDI评分比较,差异无统计学意义(P>0.05);出生3个月,两组新生儿MDI、PDI评分均升高,且观察组高于对照组(P<0.05)。出生时,两组新生儿身长、体质量比较,差异无统计学意义(P>0.05);出生1、3个月观察组新生儿身长长于对照组,体质量大于对照组(P<0.05)。结论 早期抚触联合游泳可促进新生儿神经智力及体格发育。

颏神经神经鞘瘤1例及文献回顾

神经鞘瘤(schwannoma)好发于头颈部,但源于颏神经的神经鞘瘤则较为罕见。本文报道1例颏神经神经鞘瘤,并结合文献进行回顾其诊断与治疗。

基于循证理念的精准护理在脑梗死患者中的效果分析

目的探讨基于循证理念的精准护理对脑梗死患者神经功能、认知功能、心理状态及运动能力的影响。方法选取2019-06—2022-06宣城市人民医院神经内科收治的脑梗死患者70例为研究对象,采用随机数字表法分为常规护理组(n=35)与循证精准护理组(n=35)。常规护理组给予常规护理,循证精准护理组在常规护理的基础上实施基于循证理念的精准护理,2组均干预至患者出院,比较2组患者干预前后美国国立卫生研究院卒中量表(NIHSS)评分、中文版简易智力状态检查量表(MMSE)评分、简化Fugl-Meyer运动功能量表(FMAS)评分、非精神科住院患者心理状态评定量表(MSSNS)评分。随访3个月,统计2组患者出院后不良反应发生率,采用卒中影响量表(SIS)评估患者出院后的整体恢复情况。结果干预后2组MMSE评分均升高,且循证精准护理组高于常规护理组,差异均有统计学意义(P<0.05);2组FMAS、MSSNS评分均升高,且循证精准护理组高于常规护理组,差异均有统计学意义(P<0.05)。出院3个月后循证精准护理组不良反应发生率为2.86%(1/35),低于常规护理组的22.86%(8/35),差异有统计学意义(χ^(2)=4.590,P=0.032)。2组SIS评分均高于干预前,且循证精准护理组高于常规护理组,差异均有统计学意义(P<0.05)。结论基于循证理念的精准护理有助于促进脑梗死患者神经功能、认知功能及肢体功能的恢复,缓解负性情绪,降低出院后不良事件的发生率,具有较高的临床价值。

评价精细化护理模式对急性脑梗死患者的应用效果研究

目的:分析精细化护理模式对急性脑梗死患者的应用效果。方法:选取2020年1月—2022年12月雷山县人民医院收治的急性脑梗死患者88例作为观察对象,根据随机数字表法分为观察组(给予精细化护理模式)与对照组(给予常规护理),各44例。比较两组患者神经功能、日常生活能力、运动功能、心理状态、并发症发生率。结果:护理后,观察组Barthel、Fugl-Meyer运动功能评分量表评分均高于对照组,美国国立卫生研究院卒中量表评分低于对照组,差异均有统计学意义(P<0.001);观察组焦虑自评量表、抑郁自评量表评分均低于对照组,差异有统计学意义(P<0.001);观察组并发症发生率低于对照组,差异有统计学意义(P=0.014)。结论:对急性脑梗死患者实施精细化护理模式能改善其神经缺损情况,增强日常生活能力、运动能力,调节心理状态,降低并发症发生率。

多学科协作护理路径对急性脑梗死恢复期患者心理弹性、神经功能及自我护理能力的影响

目的:分析多学科协作护理路径对急性脑梗死恢复期患者心理弹性、神经功能及自我护理能力的影响.方法:选取2020年1月至2022年12月本院收治的急性脑梗死患者98例为研究对象.根据护理路径不同,将其分为观察组(n=51,予以多学科协作护理)和对照组47例(n=47,仅予以常规护理).比较两组患者护理前、后的心理弹性状态、神经功能恢复状态以及自我护理能力.结果:护理后,观察组患者的心理弹性量表(CD-RISC)评分、欧洲卒中量表(ESS)评分、自我护理能力测定量表(ESCA)评分均高于对照组,差异均有统计学意义(P<0.05).结论:多学科协作护理路径对急性脑梗死恢复期患者的护理影响显著,能提高患者心理弹性及自我护理能力,且改善神经功能,值得临床推广应用.

颏孔区域的解剖学研究

目的 研究国人下颌管前端的位置及其延续关系 ,为临床手术提供解剖学依据。方法 打磨 6 0侧湿下颌骨标本 ,暴露下颌管前端及其延续部分并直接观察和测量。结果 下颌管前端分出同一方向前行的切牙神经管和向后、上、外转弯的颏管。颏管开口于颏孔 ,其管径为 (2 .2 6± 0 .6 0 )mm ,管长 (4 .0 1± 1.2 0 )mm。切牙神经管的管径为 (1.76± 0 .2 6 )mm ,其下缘至下颌骨下缘的垂直距离为 (9.5 3± 1.43)mm ,其始端对应颏孔前缘的水平距离为 (3.5 4± 0 .72 )mm。下牙槽神经的终末支颏神经和切牙神经分别走行与上述两管内。结论 颏管和切牙神经管由下颌管发出 ,其内分别为同名神经。

电刺激颏神经诱发三叉神经皮层电位的研究

目的 以电生理手段客观评价三叉神经的功能状态。方法 通过刺激 18名健康成人颏神经 ,在T3、T4部位收集本侧及对侧的三叉神经诱发电位 (TSEP)。结果 ①在刺激发生 16ms左右 ,出现第一个阳性波即P1,依次为N1～N5等 10个波峰 ;②其中P3,N3,P4,N4潜伏期较为稳定 ,N3～P4为一个陡降的高振幅波且图形稳定 ;③对于刺激的反应 ,在同一个体双侧具有同等的程度 ;④波幅随刺激强度的加大明显增高。结论 各波的潜伏期、图形特点、峰峰电位差并结合图形整体形态及参数可以作为临床判定TSEP的指标。

锥形束CT对83例中国人下颌神经管的位置测量研究

目的:探究下颌神经管与下颌骨的位置关系,为种植及植骨手术提供理论依据。方法:收集83名中国人下颌神经管的锥形束CT扫描数据,对其双侧下颌神经管的数据进行测量分析。结果:下颌神经管到下颌骨颊侧壁的距离为(5.32±1.29)^(7.24±1.29)mm,到下颌骨舌侧壁的平均距离为(3.43±0.99)^(3.93±1.17)mm,到下颌骨下缘的平均距离为(8.81±1.90)^(10.02±2.19)mm,内径的平均值为(2.27±0.44)^(2.61±0.40)mm。男性与女性在下颌管距下颌骨颊侧壁、下颌下缘以及下颌骨内径的平均值上差异有显著性(P<0.05)。前襻的出现率是70.9%,长度为(2.76±1.14)mm。下颌管分支的出现率为10.84%,长度为(10.72±5.29)mm。结论:中国人下颌管在下颌骨内的位置变异较大,前襻和下颌管分支在下颌骨中发生率较高,植骨及种植手术前应仔细检查,减小神经损伤的风险。

系统心理干预对老年脑卒中后抑郁程度及神经功能康复的影响

目的探讨系统心理干预对老年脑卒中患者抑郁程度及神经功能康复的影响。方法首次脑卒中患者,同时存在抑郁症及神经功能缺损的106例分为A、B组;167例神经功能缺损患者分为C、D组。所有患者给予常规药物治疗,B组及D组作为干预组加以心理干预治疗。采用汉密尔顿抑郁量表(HAMD)及中国脑卒中患者临床神经功能缺损程度评分标准(NFDS)分别于治疗前、后对患者进行疗效评定。结果治疗后的HAMD、NFDS评分均明显低于治疗前,且B、D组均优于A、C组,差异有统计学意义。结论系统心理干预能明显缓解老年脑卒中患者的抑郁症状、提高神经功能康复效果。