Addressing peripheral nerve defects remains a significant challenge in regenerative neurobiology.Autograftsemerged as the gold-standard management,however,are hindered by limited availability and potential neuromaform...Addressing peripheral nerve defects remains a significant challenge in regenerative neurobiology.Autograftsemerged as the gold-standard management,however,are hindered by limited availability and potential neuromaformation.Numerous recent studies report the potential of wireless electronic system for nerve defects repair.Unfortunately,few has met clinical needs for inadequate electrode precision,poor nerve entrapment andinsufficient bioactivity of the matrix material.Herein,we present an advanced wireless electrical nerve stimulator,based on water-responsive self-curling silk membrane with excellent bioabsorbable and biocompatibleproperties.We constructed a unique bilayer structure with an oriented pre-stretched inner layer and a generalsilk membrane as outer layer.After wetting,the simultaneous contraction of inner layer and expansion of outerlayer achieved controllable super-contraction from 2D flat surface to 3D structural reconfiguration.It enablesshape-adaptive wrapping to cover around nerves,overcomes the technical obstacle of preparing electrodes on theinner wall of the conduit,and prevents electrode breakage caused by material expansion in water.The use of forkcapacitor-like metal interface increases the contact points between the metal and the regenerating nerve,solvingthe challenge of inefficient and rough electrical stimulation methods in the past.Newly developed electronicstimulator is effective in restoring 10 mm rat sciatic nerve defects comparable to autologous grafts.The underlyingmechanism involves that electric stimulation enhances anterograde mitochondrial transport to matchenergy demands.This newly introduced device thereby demonstrated the potential as a viable and efficaciousalternative to autografts for enhancing peripheral nerve repair and functional recovery.展开更多
Background:Obstructed defecation syndrome(ODS)is a group of symptoms that are mainly caused by pelvic floor dysfunction concerning bowel symptoms.It is challenging in clinical practice.Acupuncture has advantages in th...Background:Obstructed defecation syndrome(ODS)is a group of symptoms that are mainly caused by pelvic floor dysfunction concerning bowel symptoms.It is challenging in clinical practice.Acupuncture has advantages in the treatment of complex symptoms because of its multi-target and bi-directional regulation of the human body.Since 2500 years ago,acupuncture has been applied empirically to the treatment of constipation.Does acupuncture have any effect on ODS?Objectives:By showing the clinical thoughts,methods,and achievements of acupuncture series in ODS in recent ten years by the author’s team,and two scientific papers published in English on acupuncture treatment of chronic intractable constipation and stress urinary incontinence,it is proved that the core scheme of acupuncture treatment of defecation disorder syndrome(ODS)is flexible.In order to raise awareness of the therapeutic effect of acupuncture in ODS,it can be integrated into existing practice to get opportunities for multidisciplinary cooperation and further research and development.Materials and Methods:By summarizing the diagnosis and treatment of ODS,the first-line selection of pelvic floor rehabilitation and the minimally invasive sacral neuromodulation were reviewed,and it was pointed out that there was a gap between the high demand of patients and the expectation of cost-effectiveness.Then,on the basis of modern eastern and western medical achievements,the holistic concept was introduced into the treatment of pelvic floor dysfunction,and an acupuncture scheme suitable for ODS was proposed.Results:Acupuncture is based on the idea of improving the patients’central nervous system,autonomic nervous system and intestinal nervous system,and is effective in treating ODS.The acupoints were set two groups when patient in supine position,which includes ST 25(Tianshu),SP 15(Daheng),SP 14(Fujie),CV 6(Qihai),CV 4(Guanyuan),ST 36(Zusanli),ST 37(Shangjuxu);When patient is in prone position,it includes BL 20(Pishu),BL 23(Shenshu),BL 25(Dachangshu),BL 33(Zhongliao),BL 34(Xialiao),and GV 20(Baihui).The key was the technique of deep needling of the ST 25(Tianshu)and deep needling of the BL 33(Zhongliao)&BL 34(Xialiao).It needs 2-15 Hz sparse-dense wave electrical stimulation,30 minutes each time,a total of 20 times,which was a scheme that could achieve satisfactory short-term and long-term effects.Conclusion:At present,clinical and basic experimental studies have proved that acupuncture plays a role in treating ODS in a multi-target way.This is a very promising research direction of pelvic floor integrated medicine.In the future,further study on optimizing the protocol and meeting the patient’s gap individually and cost-effectively.展开更多
基金supported by the National Natural Science Foundation of China(82172476,82172393).
文摘Addressing peripheral nerve defects remains a significant challenge in regenerative neurobiology.Autograftsemerged as the gold-standard management,however,are hindered by limited availability and potential neuromaformation.Numerous recent studies report the potential of wireless electronic system for nerve defects repair.Unfortunately,few has met clinical needs for inadequate electrode precision,poor nerve entrapment andinsufficient bioactivity of the matrix material.Herein,we present an advanced wireless electrical nerve stimulator,based on water-responsive self-curling silk membrane with excellent bioabsorbable and biocompatibleproperties.We constructed a unique bilayer structure with an oriented pre-stretched inner layer and a generalsilk membrane as outer layer.After wetting,the simultaneous contraction of inner layer and expansion of outerlayer achieved controllable super-contraction from 2D flat surface to 3D structural reconfiguration.It enablesshape-adaptive wrapping to cover around nerves,overcomes the technical obstacle of preparing electrodes on theinner wall of the conduit,and prevents electrode breakage caused by material expansion in water.The use of forkcapacitor-like metal interface increases the contact points between the metal and the regenerating nerve,solvingthe challenge of inefficient and rough electrical stimulation methods in the past.Newly developed electronicstimulator is effective in restoring 10 mm rat sciatic nerve defects comparable to autologous grafts.The underlyingmechanism involves that electric stimulation enhances anterograde mitochondrial transport to matchenergy demands.This newly introduced device thereby demonstrated the potential as a viable and efficaciousalternative to autografts for enhancing peripheral nerve repair and functional recovery.
文摘Background:Obstructed defecation syndrome(ODS)is a group of symptoms that are mainly caused by pelvic floor dysfunction concerning bowel symptoms.It is challenging in clinical practice.Acupuncture has advantages in the treatment of complex symptoms because of its multi-target and bi-directional regulation of the human body.Since 2500 years ago,acupuncture has been applied empirically to the treatment of constipation.Does acupuncture have any effect on ODS?Objectives:By showing the clinical thoughts,methods,and achievements of acupuncture series in ODS in recent ten years by the author’s team,and two scientific papers published in English on acupuncture treatment of chronic intractable constipation and stress urinary incontinence,it is proved that the core scheme of acupuncture treatment of defecation disorder syndrome(ODS)is flexible.In order to raise awareness of the therapeutic effect of acupuncture in ODS,it can be integrated into existing practice to get opportunities for multidisciplinary cooperation and further research and development.Materials and Methods:By summarizing the diagnosis and treatment of ODS,the first-line selection of pelvic floor rehabilitation and the minimally invasive sacral neuromodulation were reviewed,and it was pointed out that there was a gap between the high demand of patients and the expectation of cost-effectiveness.Then,on the basis of modern eastern and western medical achievements,the holistic concept was introduced into the treatment of pelvic floor dysfunction,and an acupuncture scheme suitable for ODS was proposed.Results:Acupuncture is based on the idea of improving the patients’central nervous system,autonomic nervous system and intestinal nervous system,and is effective in treating ODS.The acupoints were set two groups when patient in supine position,which includes ST 25(Tianshu),SP 15(Daheng),SP 14(Fujie),CV 6(Qihai),CV 4(Guanyuan),ST 36(Zusanli),ST 37(Shangjuxu);When patient is in prone position,it includes BL 20(Pishu),BL 23(Shenshu),BL 25(Dachangshu),BL 33(Zhongliao),BL 34(Xialiao),and GV 20(Baihui).The key was the technique of deep needling of the ST 25(Tianshu)and deep needling of the BL 33(Zhongliao)&BL 34(Xialiao).It needs 2-15 Hz sparse-dense wave electrical stimulation,30 minutes each time,a total of 20 times,which was a scheme that could achieve satisfactory short-term and long-term effects.Conclusion:At present,clinical and basic experimental studies have proved that acupuncture plays a role in treating ODS in a multi-target way.This is a very promising research direction of pelvic floor integrated medicine.In the future,further study on optimizing the protocol and meeting the patient’s gap individually and cost-effectively.
