Strain and stress variations in the human amniotic membrane and fresh corpse autologous sciatic nerve anastomosis in a model of sciatic nerve injury

A 10-mm long sciatic nerve injury model was established in fresh normal Chinese patient cadavers. Amniotic membrane was harvested from healthy maternal placentas and was prepared into multilayered,coiled,tubular specimens.Sciatic nerve injury models were respectively anastomosed using the autologous cadaveric sciatic nerve and human amniotic membrane.Tensile test results showed that maximal loading,maximal displacement,maximal stress,and maximal strain of sciatic nerve injury models anastomosed with human amniotic membrane were greater than those in the autologous nerve anastomosis group.The strain-stress curves of the human amniotic membrane and sciatic nerves indicated exponential change at the first phase,which became elastic deformation curves at the second and third phases,and displayed plastic deformation curves at the fourth phase,at which point the specimens lost their bearing capacity.Experimental findings suggested that human amniotic membranes and autologous sciatic nerves exhibit similar stress-strain curves, good elastic properties,and certain strain and stress capabilities in anastomosis of the injured sciatic nerve.

Autologous nerve anastomosis versus human amniotic membrane anastomosisA rheological comparison following simulated sciatic nerve injury

The sciatic nerve is biological viscoelastic solid,with stress relaxation and creep characteristics.In this study,a comparative analysis of the stress relaxation and creep characteristics of the sciatic nerve was conducted after simulating sciatic nerve injury and anastomosing with autologous nerve or human amniotic membrane.The results demonstrate that,at the 7 200-second time point,both stress reduction and strain increase in the human amniotic membrane anastomosis group were significantly greater than in the autologous nerve anastomosis group.Our findings indicate that human amniotic membrane anastomosis for sciatic nerve injury has excellent rheological characteristics and is conducive to regeneration of the injured nerve.

Stress and strain analysis on the anastomosis site sutured with either epineurial or perineurial sutures after simulation of sciatic nerve injury

The magnitude of tensile stress and tensile strain at an anastomosis site under physiological stress is an important factor for the success of anastomosis following suturing in peripheral nerve injury treatment. Sciatic nerves from fresh adult cadavers were used to create models of sciatic nerve injury. The denervated specimens underwent epineurial and perineurial suturing. The elastic modulus （40.96 ＋ 2.59 MPa） and Poisson ratio （0.37 ＋ 0.02） of the normal sciatic nerve were measured by strain electrical measurement. A resistance strain gauge was pasted on the front, back left, and right of the edge of the anastomosis site after suturing. Strain electrical measurement results showed that the stress and strain values of the sciatic nerve following perineurial suturing were lower than those following epineurial suturing. Scanning electron microscopy revealed that the sciatic nerve fibers were disordered following epineurial compared with perineurial suturing. These results indicate that the effect of perineurial suturing in sciatic nerve injury repair is better than that of epineurial suturing.

CROSSING ANASTOMOSIS OF NERVE BUNDLES NEAR INNERVATED ORGANS TO TREAT IRREPARABLE NERVE INJURIES

Objective To study the therapeutical effects of crossing anastomosis of nerve on the peripheral and central nerve injuries. Methods Twelve kinds of central and peripheral nerve disorders and their complications were treated with 11 kinds of crossing anastomosis of nerve bundles near the innervated organs. After nerve injury and repair, somatosensory evoked potentials (SEPs) and horseradish peroxidase (HRP) retrograde tracing studies were used to investigate the rabbit’s nerve function and morphology. Results The ulcers of all patients healed. Sensation, voluntary movement, and joint function recovered. Four weeks after the anastomosis of distal stump of radialis superficialis nerve and median nerve, pain sensation regained and SEPs appeared. HRP retrograde tracing studies demonstrated sensory nerve ending of medial nerve formed new connection with the body of neuron. Conclusion Crossing anastomosis of nerve is an effective method to treat peripheral and central nerve injuries.

An Experimental Study on the Optimal Timing for the Repair of Incomplete Facial Paralysis by Hypoglossal-facial‘Side'-to-side Neurorrhaphy in Rats

Objective To investigate the optimal timing for the repair of persistent incomplete facial paralysis by hypoglossal-facial ‘side＇-to-side neurorrhaphy in rats. Methods A total of 30 adult rats with crushed and bulldog-clamped facial nerve injury were randomly divided into 5 groups（n = 6 each） that were subjected to injury without nerve repair or with immediate repair, 2-week-delayed repair, 4-week-delayed repair, or 8-week-delayed repair. Three months later, the effects of repair in each rat were evaluated by facial symmetry assessment, electrophysiological examination, retrograde labeling, and axon regeneration measurement. Results At 3 months after injury, the alpha angle significantly increased in the group of rats with 4-week-delayed repair compared with the other four groups. Upon stimulation of the facial nerve or Pre degenerated nerve, the muscle action potentials MAPs were recorded in the whisker pad muscle, and the MAP amplitude and area under the curve in the 4-week-delayed repair group were significantly augmented at 3 months post-injury. Similarly, the number of retrograde-labeled motor neurons in the facial and hypoglossal nuclei was quantified to be significantly greater in the 4-week-delayed repair group than in the other groups, and a large number of regenerated axons was also observed. Conclusion The results of this study demonstrated that hemi HN-FN neurorrhaphy performed 4 weeks after facial nerve injury was most effective in terms of the functional recovery of axonal regeneration and activation of facial muscles.

Phrenic and intercostal nerves with rhythmic discharge can promote early nerve regeneration after brachial plexus repair in rats

Exogenous discharge can positively promote nerve repair. We, therefore, hypothesized that endogenous discharges may have similar effects. The phrenic nerve and intercostal nerve, controlled by the respiratory center, can emit regular nerve impulses; therefore these endogenous automatically discharging nerves might promote nerve regeneration. Action potential discharge patterns were examined in the diaphragm, external intercostal and latissimus dorsi muscles of rats. The phrenic and intercostal nerves showed rhythmic clusters of discharge, which were consistent with breathing frequency. From the first to the third intercostal nerves, spontaneous discharge amplitude was gradually increased. There was no obvious rhythmic discharge in the thoracodorsal nerve. Four animal groups were performed in rats as the musculocutaneous nerve cut and repaired was bland control. The other three groups were followed by a side-to-side anastomosis with the phrenic nerve, intercostal nerve and thoracodorsal nerve. Compound muscle action potentials in the biceps muscle innervated by the musculocutaneous nerve were recorded with electrodes. The tetanic forces of ipsilateral and contralateral biceps muscles were detected by a force displacement transducer. Wet muscle weight recovery rate was measured and pathological changes were observed using hematoxylin-eosin staining. The number of nerve fibers was observed using toluidine blue staining and changes in nerve ultrastructure were observed using transmission electron microscopy. The compound muscle action potential amplitude was significantly higher at 1 month after surgery in phrenic and intercostal nerve groups compared with the thoracodorsal nerve and blank control groups. The recovery rate of tetanic tension and wet weight of the right biceps were significantly lower at 2 months after surgery in the phrenic nerve, intercostal nerve, and thoracodorsal nerve groups compared with the negative control group. The number of myelinated axons distal to the coaptation site of the musculocutaneous nerve at 1 month after surgery was significantly higher in phrenic and intercostal nerve groups than in thoracodorsal nerve and negative control groups. These results indicate that endogenous autonomic discharge from phrenic and intercostal nerves can promote nerve regeneration in early stages after brachial plexus injury.

Sciatic nerve repair using adhesive bonding and a modified conduit

When repairing nerves with adhesives, most researchers place glue directly on the nerve stumps, but this method does not fix the nerve ends well and allows glue to easily invade the nerve ends. In this study, we established a rat model of completely transected sciatic nerve injury and re- paired it using a modified 1 cm-length conduit with inner diameter of 1.5 mm. Each end of the cylindrical conduit contains a short linear channel, while the enclosed central tube protects the nerve ends well Nerves were repaired with 2-octyl-cyanoacrylate and suture, which complement the function of the modified conduit. The results demonstrated that for the same conduit, the av- erage operation time using the adhesive method was much shorter than with the suture method. No significant differences were found between the two groups in sciatic function index, motor evoked potential latency, motor evoked potential amplitude, muscular recovery rate, number of medullated nerve fibers, axon diameter, or medullary sheath thickness. Thus, the adhesive method for repairing nerves using a modified conduit is feasible and effective, and reduces the operation time while providing an equivalent repair effect.

Short-term observations of the regenerative potential of injured proximal sensory nerves crossed with distal motor nerves

Motor nerves and sensory nerves conduct signals in different directions and function in different ways.In the surgical treatment of peripheral nerve injuries,the best prognosis is obtained by keeping the motor and sensory nerves separated and repairing the nerves using the suture method.However,the clinical consequences of connections between sensory and motor nerves currently remain unknown.In this study,we analyzed the anatomical structure of the rat femoral nerve,and observed the motor and sensory branches of the femoral nerve in the quadriceps femoris.After ligation of the nerves,the proximal end of the sensory nerve was connected with the distal end of the motor nerve,followed by observation of the changes in the newly-formed regenerated nerve fibers.Acetylcholinesterase staining was used to distinguish between the myelinated and unmyelinated motor and sensory nerves.Denervated muscle and newly formed nerves were compared in terms of morphology,electrophysiology and histochemistry.At 8 weeks after connection,no motor nerve fibers were observed on either side of the nerve conduit and the number of nerve fibers increased at the proximal end.The proportion of newly-formed motor and sensory fibers was different on both sides of the conduit.The area occupied by autonomic nerves in the proximal regenerative nerve was limited,but no distinct myelin sheath was visible in the distal nerve.These results confirm that sensory and motor nerves cannot be effectively connected.Moreover,the change of target organ at the distal end affects the type of nerves at the proximal end.

L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage

There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage.Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles,we investigated a potential method of nerve repair using the L4 nerve roots.Rat models of hindlimb hemiplegia after a hypertensive intracerebral hemorrhage were established by injecting autogenous blood into the posterior limb of internal capsule.The L4 nerve root on the healthy side of model rats was transferred and then anastomosed with the L4 nerve root on the affected side to drive the extensor and flexor muscles of the hindlimbs.We investigated whether this method can restore the flexible movement of the hindlimbs of paralyzed rats after hypertensive intracerebral hemorrhage.In a beam-walking test and ladder rung walking task,model rats exhibited an initial high number of slips,but improved in accuracy on the paretic side over time.At 17 weeks after surgery,rats gained approximately 58.2%accuracy from baseline performance and performed ankle motions on the paretic side.At 9 weeks after surgery,a retrograde tracing test showed a large number of fluoro-gold-labeled motoneurons in the left anterior horn of the spinal cord that supports the L4-to-L4 nerve roots.In addition,histological and ultramicrostructural findings showed axon regeneration of motoneurons in the anterior horn of the spinal cord.Electromyography and paw print analysis showed that denervated hindlimb muscles regained reliable innervation and walking coordination improved.These findings suggest that the L4-to-L4 nerve root transfer method for the treatment of hindlimb hemiplegia after hypertensive intracerebral hemorrhage can improve the locomotion of hindlimb major joints,particularly of the distal ankle.Findings from study support that the L4-to-L4 nerve root transfer method can effectively repair the hindlimb hemiplegia after hypertensive intracerebral hemorrhage.All animal experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Nanjing Medical University(No.IACUC-1906009)in June 2019.

Can lithium enhance the extent of axon regeneration and neurological recovery following peripheral nerve trauma?

The clinical"gold standard"technique for attempting to restore function to nerves with a gap is to bridge the gap with sensory autografts.However,autografts induce good to excellent recovery only across short nerve gaps,in young patients,and when repairs are performed a short time post nerve trauma.Even under the best of conditions,<50%of patients recover good recovery.Although many alternative techniques have been tested,none is as effective as autografts.Therefore,alternative techniques are required that increase the percentage of patients who recover function and the extent of their recovery.This paper examines the actions of lithium,and how it appears to trigger all the cellular and molecular events required to promote axon regeneration,and how both in animal models and clinically,lithium administration enhances both the extent of axon regeneration and neurological recovery.The paper proposes more extensive clinical testing of lithium for its ability and reliability to increase the extent of axon regeneration and functional recovery.

Endogenous automatic nerve discharge promotes nerve repair: an optimized animal model

Exogenous electrical nerve stimulation has been reported to promote nerve regeneration. Our previous study has suggested that endogenous automatic nerve discharge of the phrenic nerve and intercostal nerve has a positive effect on nerve regeneration at 1 month postoperatively, but a negative effect at 2 months postoperatively, which may be caused by scar compression. In this study, we designed four different rat models to avoid the negative effect from scar compression. The control group received musculocutaneous nerve cut and repair. The other three groups were subjected to side-to-side transfer of either the phrenic(phrenic nerve group), intercostal(intercostal nerve group) or thoracodorsal nerves(thoracic dorsal nerve group), with sural nerve autograft distal to the anastomosis site. Musculocutaneous nerve regeneration was assessed by electrophysiology of the musculocutaneous nerve, muscle tension, muscle wet weight, maximum cross-sectional area of biceps, and myelinated fiber numbers of the proximal and distal ends of the anastomosis site of the musculocutaneous nerve and the middle of the nerve graft. At 1 month postoperatively, compound muscle action potential amplitude of the biceps in the phrenic nerve group and the intercostal nerve group was statistically higher than that in the control group. The myelinated nerve fiber numbers in the distal end of the musculocutaneous nerve and nerve graft anastomosis in the phrenic nerve and the intercostal nerve groups were statistically higher than those in the control and thoracic dorsal nerve groups. The neural degeneration rate in the middle of the nerve graft in the thoracic dorsal nerve group was statistically higher than that in the phrenic nerve and the intercostal nerve groups. At 2 and 3 months postoperatively, no significant difference was detected between the groups in all the assessments. These findings confirm that the phrenic nerve and intercostal nerve have a positive effect on nerve regeneration at the early stage of recovery. This study established an optimized animal model in which suturing the nerve graft to the distal site of the musculocutaneous nerve anastomosis prevented the inhibition of recovery from scar compression.

Amniotic membrane covering for facial nerve repair

Amniotic membranes have been widely used in ophthalmology and skin injury repair because of their anti-inflammatory properties. In this study, we measured therapeutic efficacy and determined if amniotic membranes could be used for facial nerve repair. The facial nerves of eight rats were dissected and end-to-end anastomosis was performed. Amniotic membranes were covered on the anastomosis sites in four rats. Electromyography results showed that, at the end of the 3rd and 8th weeks after amniotic membrane covering, the latency values of the facial nerves covered by amniotic membranes were significantly shortened and the amplitude values were significantly increased. Compared with simple facial nerve anastomosis, after histopathological examination, facial nerve anastomosed with amniotic membrane showed better continuity, milder inflammatory reactions, and more satisfactory nerve conduction. These findings suggest that amniotic membrane covering has great potential in facial nerve repair.

A novel extradural nerve transfer technique by coaptation of C4 to C5 and C7 to C6 for treating isolated upper trunk avulsion of the brachial plexus

The study aimed to demonstrate the feasibility of an extradural nerve anastomosis technique for the restoration of a C5 and C6 avulsion of the brachial plexus.Nine fresh frozen human cadavers were used.The diameters,sizes,and locations of the extradural spinal nerve roots were observed.The lengths of the extradural spinal nerve roots and the distance between the neighboring nerve root outlets were measured and compared in the cervical segments.In the spinal canal,the ventral and dorsal roots were separated by the dura and arachnoid.The ventral and dorsal roots of C7 had sufficient lengths to anastomose those of C6.The ventral and dorsal of C4 had enough length to be transferred to those of C5,respectively.The feasibility of this extradural nerve anastomosis technique for restoring C5 and C6 avulsion of the brachial plexus in human cadavers was demonstrated in our anatomical study.

Berrettini Anastomosis Iatrogenic Injury Relating to Carpel Tunnel Syndrome Case Study

Some diseases require medical mitigation following the diagnosis, and sometimes the situation means that the patient has to undertake strong medication. However, this medicine is designed pharmacodynamically to interact with other organs before they reach the intended organ. Some mitigation imposes challenges on the involved organ. While the main organ will be healed, some drugs’ footprints will be left out to other organs. These are called iatrogenic injuries. In the case of anastomosis, it requires the alteration of surgical methods or the origin of iatrogenic injury in the arm;thus, the knowledge of anastomosis is very important to the field of medical practice. In addition, carpal tunnel release becomes vital in curing carpal tunnel syndrome. The paper focuses on a case of a 42-year-old woman found to have a complication to her middle finger. This case becomes important for studying Berrettini anastomosis iatrogenic injury, which relates to carpal tunnel syndrome. The Berrettini branch is a complication that facilitates communication between the superficial ulnar and median nerve. The analysis also provides the electro-diagnostic evidence of Berrettini anastomosis on how it can give a position three-finger and thus contribute to a force explanation of the median neuropraxia. Lastly, the paper provides information on the implication of the Berrettini branch for surgical use. The implication of pictures in the digital era can be used to analyze the varied connection and length between the median nerve and ulnar section. It’s easy to locate the position of high risk of iatrogenic injury in the palm due to the consistent location of Berrettini communication branches. The precaution is that operations have to be conducted moderately for a clear vision as the carefully mitigated practice ensures protection from the destruction and injury of the surrounding structures.

同期神经化腓骨瓣用于下颌骨重建及下唇感觉恢复的术式初探

目的:探讨下颌骨及下牙槽神经因肿瘤截除后,同期颌骨重建及感觉恢复的新方法,为临床提供参考。方法:对1例下颌骨成釉细胞瘤患者行下颌骨节段性切除,术中一并切除与病灶密切的下牙槽神经,同期行神经化血管化腓骨游离皮瓣移植修复。术后通过影像学观察其移植骨吸收情况,应用两点辨别觉和感觉测试丝评估感觉保存效果。结果:术后随访9个月,患者颜面自然对称,皮瓣存活良好,移植骨稳定未见明显吸收,下唇感觉功能良好,颏部稍次,无咬唇、流涎等问题;受区及供区未见并发症。结论:同期重建神经的新方法对腓骨瓣移植重建下颌骨时恢复下唇感觉及预防移植骨术后吸收具有较好效果。

不同供区带神经同指指动脉背侧支侧方血管链皮瓣修复指端或指腹缺损效果比较

目的探讨不同供区带神经同指指动脉背侧支侧方血管链皮瓣修复指端或指腹缺损临床效果。方法选取2017年6月至2021年4月,唐山市第二医院急诊采用指动脉背侧支侧方血管链皮瓣修复第2-5指端或指腹缺损患者49例(57指),进行前瞻性研究。采用抽签法分为近节背侧组23例(25指),其中男13例,女10例,年龄18~55岁,平均37岁,中节背侧组26例(32指),其中男15例,女11例,年龄20~53岁,平均35岁。术中两组均将皮瓣携带的皮神经与创面内指固有神经残端行端端外膜吻合。两组患者供区创面取前臂近端或上臂内侧全厚皮片游离植皮修复。术后观察两组患者皮瓣及植皮成活情况。比较两组术式的性别、年龄、伤指数、侧别、缺损面积、皮瓣切取面积、手术时间、随访时间。末次随访时,测量两组患者伤指掌指关节和近指间关节活动度情况,参照Michigan手部功能问卷评定标准评估患者对伤指皮瓣外观满意度,供区外观采用温哥华瘢痕量表评定,测量皮瓣静态两点辨别觉。结果术后两组皮瓣及植皮全部成活。两组在性别、年龄、伤指数、侧别、缺损面积、手术时间、随访时间比较,差异无统计学意义(P>0.05),在皮瓣切取面积方面差异有统计学意义(P<0.05)。末次随访时,中节背侧组与近节背侧组伤指掌指关节活动度和近指间关节活动度之和比较差异无统计学意义(P>0.05)。中节背侧组患者伤指皮瓣外观满意度、供区外观及皮瓣静态两点辨别觉显著优于近节背侧组(P<0.05)。结论以近或中节背侧为供区的指动脉背侧支侧方血管链皮瓣解剖恒定,操作简便,适用于急诊修复手指指端或指腹缺损,但与近节背侧组相比,中节背侧组患者皮瓣切取面积较小、伤指外观及皮瓣感觉更好。

STA-MCA+EDMS和EDAMS血管融合术治疗烟雾病的疗效比较研究

目的比较颞浅动脉-大脑中动脉分支吻合术结合脑-硬脑膜-肌肉-血管融合术(STA-MCA+EDMS)和脑-硬脑膜-动脉-肌肉血管融合术(EDAMS)治疗烟雾病患者的临床疗效。方法选取2020年1月至2022年1月复旦大学附属华山医院东院神经外科收治的92例烟雾病患者为研究对象,按照随机数表法分为观察组(应用STA-MCA+EDMS术)和对照组(应用EDAMS术),每组46例。比较两组患者治疗后的临床疗效;于术后1 d和术后3个月,采用改良Rankin评分法评价两组患者神经功能恢复情况;分别在术前及术后3个月使用经颅多普勒超声测量脑血流量、脉压及血流峰值;于术前3 d及术后1周采用简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评估两组患者的认知功能;比较两组患者的术后并发症情况。结果观察组患者的治疗总有效率为93.47%,明显高于对照组的76.09%,差异具有统计学意义(P<0.05);术后3个月,观察组患者的改良Rankin评分为(1.11±0.12)分,明显低于对照组的(1.67±0.26)分,差异具有统计学意义(P<0.05);术后1周,观察组患者的脑血流量、脉压、血流峰值分别为(13.54±2.33)mm/s、(35.63±15.33)mmHg、(172.59±19.35)cm/s,明显高于对照组的(11.35±1.58)mm/s、(26.34±10.55)mmHg、(150.68±18.74)cm/s,差异均有统计学意义(P<0.05);术后1周,观察组患者的MMSE得分、MoCA得分分别为(27.49±0.12)分、(27.98±0.41)分,明显高于对照组的(25.68±0.11)分、(25.68±0.11)分,差异均有统计学意义(P<0.05);观察组患者术后心律失常、肾功能衰竭、术后感染的发生率分别为6.52%、4.34%、6.52%,明显低于对照组的21.74%、17.39%、23.91%,差异均有统计学意义(P<0.05)。结论STA-MCA+EDMS治疗烟雾病能够增加患者脑血流量、脉压以及血流峰值,改善患者的神经功能和认知功能,减少术后并发症,临床应用效果较好。

神经束膜吻合术治疗腕部尺神经损伤的效果观察

目的观察神经束膜吻合术治疗腕部尺神经损伤的效果。方法104例腕部尺神经损伤患者随机分为两组,各52例。对照组应用神经外膜吻合术治疗,观察组应用神经束膜吻合术治疗。比较两组的治疗效果以及尺神经传导速度、复合肌肉动作电位波幅。结果观察组的优良率为96.15%,显著高于对照组的76.92%(P<0.05)。术后3、6、12个月,两组的尺神经传导速度和复合肌肉动作电位波幅均显著高于术前,且观察组均显著高于对照组(P<0.05)。结论神经束膜吻合术治疗腕部尺神经损伤的效果显著,可有效提高患者术后尺神经传导速度和复合肌肉动作电位波幅。

天麻素通过调节PI3K/AKT信号通路减轻大鼠坐骨神经离断吻合后的损伤

目的观察天麻素(Gas)对坐骨神经离断吻合模型大鼠神经功能修复的影响,并初步探讨其作用机制。方法32只雄性SD大鼠随机分为对照组(Control)、模型组(Model)、天麻素组(Gas)和甲钴胺组(Cob)。除Control组外,均距梨状肌下缘1 cm处锐性离断左侧坐骨神经,随即使用9-0显微外科缝合线进行端端吻合以建立坐骨神经离断吻合模型。Gas组每天灌胃给予Gas(15 mg/kg)1次,Cob组每天灌胃给予Cob(0.15 mg/kg)1次,Control组和Model组每天灌胃给予等体积双蒸水。60 d后,采用坐骨神经指数(SFI)观察坐骨神经功能恢复情况;计算腓肠肌湿重恢复率;HE与Masson染色观察坐骨神经远端有髓神经纤维的形态学变化,计数完整有髓神经纤维数;HE染色观察腓肠肌的形态学变化,统计腓肠肌横截面积;Western blot检测腓肠肌中PI3K、AKT和mTOR蛋白水平;药物亲和反应的靶点稳定性(Darts)实验检测Gas与PI3K p110 gamma的相互作用。结果与Control组相比,Model组SFI明显降低(P<0.01),腓肠肌萎缩严重,湿重显著降低(P<0.01);与Model组相比,Gas组和Cob组SFI明显升高(P<0.01,P<0.05),腓肠肌湿重增加;HE与Masson染色显示Gas和Cob可以改善坐骨神经离断所致的神经纤维排列稀疏,连续性差,增加了有髓神经纤维数量;HE染色显示Gas和Cob增加了腓肠肌纤维横截面积(P<0.01);WB结果显示,Gas和Cob增加了腓肠肌中PI3K、AKT和mTOR蛋白水平(P<0.05);药物亲和反应的靶点稳定性(Darts)实验显示,Gas可以与PI3K p110 gamma结合(P<0.01)。结论Gas通过靶向结合PI3K,上调PI3K/AKT/mTOR信号通路,发挥促进大鼠坐骨神经损伤后修复的作用。