Adenomyosis uterine innervation in mice correlates to nerve growth factor expression,inflammation,and vascularization

BACKGROUND： Studies have shown that abnormal innervation is an important factor impacting occurrence and development of pathological pain in endometriosis. OBJECTIVE： To observe uterine innervation of adenomyosis mice and to analyze the cause of innervation changes due to nerve growth factor （NGF） expression, inflammation, and vascularization. DESIGN, TIME AND SETTING： This randomized, controlled, animal experiment was performed at the Research Institute of Obstetrics and Gynecology Hospital, and Central Laboratory of Zhongshan Hospital, Fudan University from March to December 2008. MATERIALS： Tamoxifen was provided by Fudan Forward, China. Rabbit anti-mouse NGF was purchased from Santa Cruz Corporation, USA; rabbit anti-protein gene product 9.5 （PGP9.5） and rabbit anti-substance P （SP） were purchased from Chemicon, USA. METHODS： A total of 40 newborn ICR mice were randomly assigned to adenomyosis model and control groups, with 20 animals in each group. Mice in the adenomyosis model group were orally administrated 2.7 μmol/kg tamoxifen on days 2-5 after birth, while the controls were not treated. MAIN OUTCOME MEASURES： Both uteri from all mice were harvested at days 135-145 after birth Expressions of polyclonal PGP9.5 and SP were immunohistochemically detected to demonstrate pan- and sensory nerve fibers. Microvessel density was quantified in the endometrium and myometrium using immunochemical staining for polyclonal rabbit anti-CD31, which stained vessels. Gene expression for NGF, high-affinity tyrosine kinase receptor （trkA）, p75 neuretrophin receptor （p75NTR）, bradykinin receptor-1 （BKR-1）, and 2 （BKR-2）, as well as substance P receptor （neurokininl receptor, NK1-R）, were detected by reverse transcription-polymerase chain reaction. NGF-13 protein expression was detected by Western blot analysis. RESULTS： More nerve fibers were stained with PGP9.5 in the endometrium and myometrium, and with SP in the endometrium, in adenomyosis mice compared with controls （P 〈 0.01 and P 〈 0.05）. Microvessel density in the myometrium of adenomyosis mice was significantly greater than the controls （P 〈 0.01）. In the uterus of adenomyosis mice, mRNA expression of NGF and its two receptors （trkA and p75 NTR）, BKR-1, and NK1-R, as well as protein expression of NGF-β, were greater than the control mice （P 〈 0.01 or P 〈 0.05）. CONCLUSION： Uterine innervation in the adenomyosis mice was increased compared with the controls. Moreover, NGF expression, inflammation, and vascularization, which have been shown to be impact factors of innervation, were abnormal in the uteri of adenomyosis mice.

Surgical anatomy of innervation of the gallbladder in humans and Suncus murinus with special reference to morphological understanding of gallstone formation after gastrectomy

AIM： To clarify the innervation of human gallbladder,with special reference to morphological understanding of gallstone formation after gastrectomy.METHODS： The liver, gallbladder and surrounding structures were immersed in a 10 mg/L solution of alizarin red S in ethanol to stain the peripheral nerves in cadavers （n = 10）. Innervation in the areas was completely dissected under a binocular microscope. Similarly,innervation in the same areas of 10 Suncus murinus （S. murinus） was examined employing whole mount immunohistochemistry.RESULTS： Innervation of the gallbladder occurred predominantly through two routes. One was from the anterior hepatic plexus, the innervation occurred along the cystic arteries and duct. Invariably this route passed through the hepatoduodenal ligament. The other route was from the posterior hepatic plexus, the innervation occurred along the cystic duct ventrally. This route also passed through the hepatoduodenal ligament dorsally.Similar results were obtained in S. murinus.CONCLUSION： The route from the anterior hepatic plexus via the cystic artery and/or duct is crucial for preserving gallbladder innervation. Lymph node dissection specifically in the hepatoduodenal ligament may affect the incidence of gallstones after gastrectomy.Furthermore, the route from the posterior hepatic plexus via the common bile duct and the cystic duct to the gallbladder should not be disregarded. Preservation of the plexus may attenuate the incidence of gallstone formation after gastrectomy.

Changes in corneal innervation and pain responses in fungal keratitis

AIM: To characterize changes in the cornea nerve and pain responses in fungal keratitis(FK).METHODS: A retrospective analysis of in vivo confocal microscopy images of 11 FK corneas was performed, and the results were compared with those for 11 normal corneas. Subbasal corneal nerves were analyzed for total nerve number, main nerve trunk number, branching patterns and tortuosity. C57 BL/6 mice were infected with Aspergillus fumigatus. Disease severity was determined through clinical scoring and slit lamp photography. Corneas were harvested at 1, 3, 5, and 7 d post infection(p.i.) and assessed for β III tubulin. Corneal mechanical sensitivity thresholds were detected by von Frey test. β-endorphin(β-EP) and μ receptor protein expression was detected through Western blotting.RESULTS: Total nerve number, main nerve trunk number, and nerve branching were significantly lower in FK patients than in controls, but tortuosity was not significantly different. In infected mice, subbasal nerve density decreased from 1 d p.i., reaching a minimum at 5 d p.i. Clinical scores rose at 1 d p.i., peaked at 3 d p.i., and decreased at 5 d p.i. Mechanical sensitivity thresholds showed the same trends. β-EP and μ receptor protein expression increased after infection.CONCLUSION: Corneal nerve density is lower in FK patients and Aspergillus fumigatus-infected mice than in controls. Pain sensitivity decreases with postinfection corneal ulcer aggravation. β-EP and μ receptor proteins are both upregulated in infected mouse corneas.

Osteoblasts are inherently programmed to repel sensory innervation

Tissue innervation is a complex process controlled by the expression profile of signaling molecules secreted by tissue-resident cells that dictate the growth and guidance of axons.Sensory innervation is part of the neuronal network of the bone tissue with a defined spatiotemporal occurrence during bone development.Yet,the current understanding of the mechanisms regulating the map of sensory innervation in the bone tissue is still limited.Here,we demonstrated that differentiation of human mesenchymal stem cells to osteoblasts leads to a marked impairment of their ability to promote axonal growth,evidenced under sensory neurons and osteoblastic-lineage cells crosstalk.The mechanisms by which osteoblast lineage cells provide this nonpermissive environment for axons include paracrine-induced repulsion and loss of neurotrophic factors expression.We identified a drastic reduction of NGF and BDNF production and stimulation of Sema3A,Wnt4;and Shh expression culminating at late stage of OB differentiation.We noted a correlation between Shh expression profile,OB differentiation stages,and OB-mediated axonal repulsion.Blockade of Shh activity and signaling reversed the repulsive action of osteoblasts on sensory axons.Finally,to strengthen our model,we localized the expression of Shh by osteoblasts in bone tissue.Overall,our findings provide evidence that the signaling profile associated with osteoblast phenotype differentiating program can regulate the patterning of sensory innervation,and highlight osteoblast-derived Shh as an essential player in this cue-induced regulation.

Role of intrahepatic innervation in regulating the activity of liver cells

Liver innervation comprises sympathetic,parasympathetic and peptidergic nerve fibers,organized as either afferent or efferent nerves with different origins and roles.Their anatomy and physiology have been studied in the past 30 years,with different results published over time.Hepatocytes are the main cell population of the liver,making up almost 80%of the total liver volume.The interaction between hepatocytes and nerve fibers is accomplished through a wealth of neurotransmitters and signaling pathways.In this short review,we have taken the task of condensing the most important data related to how the nervous system interacts with the liver and especially with the hepatocyte population,how it influences their metabolism and functions,and how different receptors and transmitters are involved in this complex process.

Does crossover innervation really affect the clinical outcome？ A comparison of outcome between unilateral and bilateral digital nerve repair

Digital nerve injuries are the mostly detected nerve injury in the upper extremity. However, since the clinical phenomenon of crossover innervation at some degree from uninjured digital nerve to the in- jured side occurs after digital nerve injuries is sustained, one could argue that this concept might even result in the overestimation of the outcome of the digital nerve repair. With this knowledge in mind, this study aimed to present novel, pure, focused and valuable clinical data by comparing the outcomes of bilateral and unilateral digital nerve repair. A retrospective review of 28 fingers with unilateral or bilateral digital nerve repair using end-to-end technique in 19 patients within 2 years was performed. Weber＇s two-point discrimination, sharp/dull discrimination, warm/cold sensation and Visual Analog Scale scoring were measured at final 12-month follow ups in all patients. There was no significant difference in recovery of sensibility after unilateral and bilateral digital nerve repairs. Though there is crossover innervation microscopically, it is not important in the clinical evaluation period. According to clinical findings from this study, crossover innervations appear to be negligible in the estimation of outcomes of digital neurorrhaphy.

Surgical anatomy of the innervation of pylorus in human and Suncus murinus, in relation to surgical technique for pylorus-preserving pancreaticoduodenectomy

AIM： To clarify the innervation of the antro-pyloric region in humans from a clinico-anatomical perspective. METHODS： The stomach, duodenum and surrounding structures were dissected in 10 cadavers, and immersed in a 10mg/L solution of alizarin red S in ethanol to stain the peripheral nerves. The distribution details were studied to confirm innervations in the above areas using a binocular microscope. Similarly, innervations in 10 Suncus murinus were examined using the method of whole-mount imm unohistochemistry. RESULTS： The innervation of the pyloric region in humans involved three routes： One arose from the anterior hepatic plexus via the route of the suprapyloric/supraduodenal branch of the right gastric artery; the second arose from the anterior and posterior gastric divisions, and the third originated from the posterior-lower region of the pyloric region, which passed via the infrapyloric artery or retroduodenal branches and was related to the gastroduodenal artery and right gastroepiploic artery. For Suncus murinus, results similar to those in humans were observed. CONCLUSION： There are three routes of innervation of the pyloric region in humans, wherein the route of the right gastric artery is most important for preserving pyloric region innervation. Function will be preserved by more than 80% by preserving the artery in pylorus-preserving pancreaticoduodenectomy （PPPD）. However, the route of the infrapyloric artery should not be disregarded. This route is related to several arteries （the right gastroepiploic and gastroduodenal arteries）, and the preserving of these arteries is advantageous for preserving pyloric innervation in PPPD. Concurrently, the nerves of Latarjet also play an important role in maintaining innervation of the antro-pyloric region in PPPD. This is why pyloric function is not damaged in some patients when the right gastric artery is dissected or damaged in PPPD.

A paracrine role for white thermogenic adipocytes in innervation: an evidence-based hypothesis

White adipose tissue(WAT) stores energy and also plays an important endocrine role in producing adipokines for communication with the peripheral and central nervous system. WAT consists of the major lipogenic unilocular adipocytes and the minor populations of beige and brite multilocular adipocytes. These multilocular adipocytes express thermogenic genes and have phenotypic similarity with thermogenic brown adipose tissue. According to a current paradigm, multilocular adipocytes have a thermogenic function in WAT. In this mini review, we discuss data revealing heterogeneity among multilocular cell subsets in WAT and their functions beyond thermogenesis. We propose a hypothetical neuroendocrine role for multilocular adipocytes subsets in the formation of adaptive sensory-sympathetic circuits between the central nervous system and adipose tissue, which activate lipolysis and thermogenesis in WAT in high energy demand situations.

Regenerating nerve fiber innervation of extraocular muscles and motor functional changes following oculomotor nerve injuries at different sites

In the present study, the oculomotor nerves were sectioned at the proximal （subtentorial） and distal （superior orbital fissure） ends and repaired. After 24 weeks, vestibulo-ocular reflex evaluation confirmed that the regenerating nerve fibers following oculomotor nerve injury in the superior orbital fissure had a high level of specificity for innervating extraocular muscles. The level of functional recovery of extraocular muscles in rats in the superior orbital fissure injury group was remarkably superior over that in rats undergoing oculomotor nerve injuries at the proximal end （subtentorium）. Horseradish peroxidase retrograde tracing through the right superior rectus muscle showed that the distribution of neurons in the nucleus of the oculomotor nerve was directly associated with the injury site, and that crude fibers were badly damaged. The closer the site of injury of the oculomotor nerve was to the extraocular muscle, the better the recovery of neurological function was. The mechanism may be associated with the aberrant number of regenerated nerve fibers passing through the injury site.

Experimental Study of Corneal Innervation in Diabetic Mellitus

The morphology of corneal innervation was studied in rabbits with alloxan-induced diabetes.The experimental rabbits were killed after 6,8,10, 12weeks.Corneal innervation was studied by histochemical techniques and transimission electron microscopy.The results revealed that in diabetic rabbits,from 6 weeks,the density of nerve-nets was markedly sparser,the fibers were thinner and the activity of nerves was lower than those of the control group.Ultrastructural changes showed swelling of axons,irregular distribution of fibril and degeneration of mitochondria of varying degree.With the progress of disease the above changes were becoming more marked gradually.It may be assumed that these changes are related to hyperglycemia.

Investigation of Peri-implant Status and Risk Variables for Implant Failure in Body of Maxilla after Oral Tumor Surgery

The aim of this study was to assess the peri-implant parameters and evaluate the clinical status with the survival of dental implants in body of maxilla after treatments of oral tumor. A follow-up examination included 27 patients who underwent the ablative tumor and （or） reconstructive surgery during a 5-year period. The follow-up protocol included clinical examination, radiological evaluation, and an interview using a standardized questionnaire. The reasons related to implant failure were studied by comparing the amount of failure with the value of marginal bone resorption, probing pocket depth, and plaque index using statistical t-test. The relationship between smoking and implant failure was analyzed statistically by chi-square test. The results showed among the 112 implants observed after implant loading, 29 have failed with the failure rate being 22.14 %. There was no significant correlation between the peri-implant status and the implant failure （P〉0.05）, however, the association of smoking and implant failure was statistically tested （P〈0.05）. It was suggested that the association of peri-implant status and implant failure in the maxilla after tumor surgery can＇t be statistically tested, however smoking was still a mainly significant factor.

Anatomical Evidence for the Neural Connection from the Emotional Brain to Autonomic Innervation in the Anterior Chamber Structures of the Eye

Objective Previous studies have shown that the autonomic nervous system(ANS),which can be affected by emotions,is important in the occurrence or progression of glaucoma.The autonomic innervation distributed in the anterior chamber(AC)structures might play an efferent role in the neural regulation of intraocular pressure(IOP).This study aimed to investigate the anatomic neural connection from the emotional brain to autonomic innervation in the AC.Methods A retrograde trans-multisynaptic pseudorabies virus encoded with an enhanced green fluorescent protein(PRV531)and non-trans-synaptic tracer FAST Dil were injected into the right eye of mice,respectively.Fluorescent localization in the emotional brain and preganglionic nuclei was studied.Five and a half days after PRV531 injection into the right AC,fluorescent signals were observed in several emotional brain regions,including the amygdala,agranular insular cortex,lateral septal nuclei,periaqueductal gray,and hypothalamus.Autonomic preganglionic nuclei,including Edinger-Westphal nucleus,superior salivatory nucleus,and intermediolateral nucleus,were labeled using PRV531.Results The sensory trigeminal nuclei were not labeled using PRV531.The fluorescence signals in the nuclei mentioned above showed bilateral distribution,primarily on the ipsilateral side.Seven days after injecting FAST Dil into the AC,we observed no FAST Dil-labeled neurons in the central nervous system.Conclusion Our results indicate a neural connection from the emotional brain to autonomic innervation in the AC,which provides anatomical support for the emotional influence of IOP via the ANS.

Comparative Cytological and Histopathological Study of Peri-Implantitis and Periodontitis

Peri-implant diseases, such as peri-implant mucositis and peri-implantitis, pose significant challenges to the long-term prognosis of dental implants. This study aimed to comprehensively compare peri-implantitis with periodontitis from cytological and histopathological perspectives, shedding light on the morphological characteristics associated with peri-implantitis. Thirteen patients, including six with peri-implantitis and seven with periodontitis, were included in the study. Cytological examination of affected gingival mucosa revealed distinct differences between the two conditions. Peri-implantitis exhibited an inflammatory background predominantly composed of neutrophils with lobulated nuclei, accompanied by stratified squamous epithelial cells showing signs of keratinization. In contrast, periodontitis showed a similar neutrophilic inflammatory background but with non-keratinized epithelial cells. Histopathological examination further confirmed these differences, with peri-implantitis showing keratinized epithelium in the inner epithelial layer. This histological finding aligns with the notion that peri-implantitis has a distinct mucosal profile compared to periodontitis. Additionally, cytological analysis revealed that peri-implantitis had a lower occurrence rate of Light green-positive cells, indicating a tendency toward keratinization. This finding suggests that the presence of keratinized mucosa might be associated with peri-implant health, although further research is needed to clarify this relationship. Overall, this study demonstrates the potential of cytological examination and Papanicolaou staining for assessing mucosal inflammatory conditions and distinguishing between keratinized and non-keratinized cells. These findings underscore the utility of oral mucosal smears as a valuable tool for diagnosing peri-implantitis and enhancing our understanding of its pathogenesis.

Investigation of Bacteria Species Most Involved in Peri-Implantitis

Purpose: Currently, bacteriological examinations of implant treatments target periodontopathic bacteria such as red complex bacteria, including Porphyromonas gingivalis, and detect them qualitatively or quantitatively. However, it seems that those examinations do not reflect the peri-implant tissue conditions precisely, because periodontopathic bacteria are also frequently detected from healthy peri-implant sites. The purpose of the present study was to investigate bacteria species most involved in peri-implantitis using a PCR method. Methods: Polymerase chain reaction (PCR) primers in this study were designed based on partial sequences of 16S rDNA of bacteria species involved in peri-implantitis that were described in numerous previous studies. Peri-implant sulcus fluid (PISF) samples were collected from thirty periodontally healthy patients with implants (HI) and thirty patients with peri-implantitis (PI). Each detection frequency of bacteria species in PISFs of both groups was investigated using a PCR method, and was compared using Fisher’s exact test. Results: In PI group, detection frequencies of Corynebacterium durum, Fretibacterium fastidiosum and Slackia exigua were significantly higher than those of HI group (p P. gingivalis and Tannerella forsythia belonging to red complex were frequently detected in the PISF samples of HI group (p > 0.05). Conclusion: It was suggested that monitoring C. durum and F. fastidiosum levels in PISF samples was useful as a clinical indicator for the evaluation of peri-implant tissue conditions.

Is There an Incremental Prognostic Value of Evaluating Left Ventricular Dyssynchrony by Gated SPECT in Patients with Systolic Heart Failure and Altered Myocardial Sympathetic Innervation as Evaluated by Cardiac I-123 mIBG Imaging?

Background: Altered myocardial sympathetic innervation activity (AMSI) is known to be present in systolic heart failure patients (SHF) and recently SPECT imaging using I-123 mIBG heart to mediastinum (H/M) ratio <1.6 has been shown to predict MACE in the ADMIRE-HF trial. Left ventricular mechanical dyssynchrony (LVMD) is known to be present in a substantial number of SHF patients and has been studied mainly to guide CRT therapy. Recently gated SPECT has shown promise to provide an accurate assessment of LVMD. It remains unclear how the combination of AMSI and LVMD collectively affect clinical outcomes and other cardiovascular parameters. Objectives: The objectives are to examine the clinical characteristics and incremental prognostic value for MACE of LVMD determined by SPECT in SHF patients with or without abnormal cardiac MIBG uptake (H/M ratio < 1.6). Methods: Out of 30 SHF patients who participated from our institution in the ADMIRE-HF trial studying MIBG based AMSI, we included 22 patients with abnormal MIBG H/M ratio of <1.6. We performed gated SPECT LVMD analysis on these patients using the Emory Cardiac Toolbox. The 2 SPECT variables for LVMD assessed were histogram bandwidth and phase standard deviation both of which assess the extent of dispersion of LV activation during contraction as a marker of LVMD. Patients were followed up for a mean period of 6 years. The primary end point was mortality from any cause and secondary end point was heart failure admission or myocardial infarction or ICD shock. Results: 2 Groups were defined: Group A: n = 17 with H/M MIBG ratio < 1.6 and +LVMD and Group B, n = 5 H/M MIBG ratio &minus;LVMD. Baseline characteristics, cardiac risk factors and medications were comparable between both groups. LVEF was lower and RBBB was less common in Group A. There was no statistical difference in achievement of primary or secondary end points in the two groups including death heart failure readmissions, ICD shocks or MI. Conclusions: In our pilot study, we did not find definitive value of adding SPECT based LVMD to abnormal cardiac MIBG imaging in SHF patients with regards to predicting outcomes. Although our sample size is too small to make any definitive conclusions, it is possible that LVMD works independently through different pathways in the progression of SHF and hence may not necessarily add incremental value to AMSI determination using MIBG.

Study on matrix metalloproteinase-2, 9 in peri-implant sulcular fluid

Objective: To study the expression of matrix metalloproteinases-2, 9 (MMP-2, MMP-9) of healthy implant and peri-implant sulcular fluid (PISF) by enzyme-linked immunosorbent assay (ELISA) method, and evaluate the level of MMP-2 and MMP-9 in sulcular fluid as an objective indicator of tissue inflammation around implants. Methods: A total of 40 implants were selected from 30 patients who were treated with dental implants and were divided into two groups: the inflammatory group and the healthy control group with 20 pieces respectively. ELISA double antibody sandwich method was used to detect the levels of MMP-2 and MMP-9 in PISF. Results: The MMP-2 and MMP-9 expressions were significantly different between the healthy implant group and the peri-implant group (p < .05). The concentration of MMP-2, MMP-9, and the amount of sulcular fluid in the inflammatory implant group were positively correlated with the clinical parameters (probing depth [PD], modified sulcus bleeding index [mSBI]). Conclusions: Under physiological conditions, the levels of MMP-2 and MMP-9 were low. When the periodontal tissue was stimulated by inflammation, the expression levels of MMP-2 and MMP-9 were increased, which could reflect the severity of inflammation. The increase levels of MMP-2 and MMP-9 in PISF could better reflect the health status of peri-implant tissues, which could be used as an objective indicator to assist in the diagnosis of peri-implant inflammation.

腰骶神经背外侧支的解剖学研究

目的:描述腰骶神经背外侧支的解剖学特征,为腰骶神经侧支射频消融术提供解剖学资料。方法:取7具正常成人腰骶部防腐大体标本(年龄42~68岁,平均54.3±8.0岁),其中男性标本5具,女性标本2具。所有标本均来源于南方医科大学。常规从L3/4椎间盘平面向标本尾端进行解剖,依次去除标本表面皮肤、多裂肌、臀大肌、臀中肌、臀小肌等,在手术显微镜下去除腰骶神经背外侧支周围的软组织,显露L3~S4神经背外侧支。用量角器测量距骶后孔8mm处S1~S4神经背外侧支与坐标轴纵轴的夹角以及L4~L5神经背外侧支与冠状轴所成夹角。使用游标卡尺测量骶神经背外侧支在距骶后孔8mm处与后正中线之间的距离。结果:在7具防腐大体标本中共发现65条骶神经背外侧支,S1~S4神经背外侧支的数量分别为16条、19条、19条和11条。S1~S4神经背外侧支在距骶后孔8mm处与纵坐标所成夹角分别为38°±9°,45°±13°,40°±10°,以及45°±7°。S1~S4神经背外侧支在距骶后孔8mm处与后正中线之间距离分别为21.3±3.0mm、24.0±3.5mm、21.7±2.8mm以及22.7±3.0mm。本研究还发现12条L4神经背外侧支和14条L5神经背外侧支,L4神经背外侧支的主干长度约为26.5±2.6mm,L5神经背外侧支的主干长度约为25.7±5.8mm。L4和L5神经背外侧支分别与冠状轴所成夹角分别为72°±2°,66°±4°。结论:骶髂关节背侧主要由L5~S4神经背外侧支支配,偶尔还存在L4神经背外侧支支配。

沿病变腰椎神经支配区域电针对退变性腰椎滑脱症术后功能恢复的影响

目的探究沿病变腰椎神经支配区域电针对退变性腰椎滑脱症术后功能恢复的影响。方法采用随机分组法将山东省文登整骨医院2019年1月—2022年2月收治的150例退变性腰椎滑脱症患者分为观察组(75例)与对照组(75例)。对照组采用Cage椎间融合椎弓根螺钉固定术治疗。治疗组则在此基础上联合使用电针治疗。观察两组患者手术前与手术2 d、2周、3个月日本矫形外科协会(Japanese Orthopaedic Association,JOA)评分、视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry Disability Index,ODI)评价患者的生活质量和血清炎症因子金属蛋白酶3(matrix metalloproteinase-3,MMP-3)、白细胞介素-1β(interleckin,IL-1β)、C反应蛋白(C-reactive protein,CRP)。结果两组患者术后2 d、2周、3个月JOA评分显著高于手术前(P<0.05)。术后2周、3个月治疗组JOA评分显著高于对照组(P<0.05)。两组患者术后2周、3个月VAS评分显著低于手术前(P<0.05)。术后2周、3个月治疗组VAS评分显著低于对照组(P<0.05)。两组患者手术后2 d、2周、3个月ODI评分显著低于手术前(P<0.05)。术后2周,3个月治疗组ODI评分显著低于对照组(P<0.05)。两组患者术后2周、3个月MMP-3、CRP、IL-1β水平显著低于手术前(P<0.05)。术后2周、3个月治疗组MMP-3、CRP、IL-1β水平显著低于对照组(P<0.05)。结论沿病变腰椎神经支配区域进行电针治疗能有效降低术后炎症反应、降低术后疼痛程度、改善腰部功能、提升患者生活质量。

手部神经支配参照卡联合概念构图教学法在上肢骨折合并周围神经损伤护理培训中的应用效果

目的:探讨手部神经支配参照卡联合概念构图教学法在上肢骨折合并周围神经损伤护理培训中的应用效果。方法:选取2022年1—12月广州市正骨医院收治的上肢骨折合并周围神经损伤患者20例以及15名护理人员作为对照组,选取2023年1—12月收治的上肢骨折合并周围神经损伤患者20例以及15名护理人员作为观察组。对照组护理人员接受常规培训后进行护理工作,观察组护理人员接受手部神经支配参照卡联合概念构图教学法培训后进行护理工作。比较两组培训效果及患者护理满意度。结果:观察组护理人员理论与实践考核成绩、分析、评价、推理、归纳推理、演绎推理评分及总分,学习动机、自我管理、学习合作、信息素养评分高于对照组(P<0.05)。观察组患者护理总满意度高于对照组(P<0.05)。结论:手部神经支配参照卡联合概念构图教学法在上肢骨折合并周围神经损伤护理培训中的应用效果显著,可以提高护理人员理论考核成绩、实践能力、临床判断性思维能力、主动学习能力,从而为患者提供优质护理服务,提高患者护理满意度。

骨骼肌失神经和再神经化时肌卫星细胞的变化

目的探讨骨骼肌失神经和再神经化时肌卫星细胞的变化规律，了解肌肉相应形态功能变化的细胞学机制。方法取1月龄Wistar大鼠27只制成失神经肌萎缩模型，于术后1～6个月，逐月取3只大鼠双侧小腿三头肌行组织学、组织化学等形态学检测；同时于术后1、2、3周和1～6个月逐月各取1只大鼠双侧小腿三头肌行细胞生物学检查。取1月龄Wistar大鼠35只制成神经再生模型，分别于失神经即时、术后1～6个月逐月取5只大鼠行神经植入手术，动态观察电生理指标变化至植入术后8周，然后进行形态学指标检测。结果骨骼肌失神经组显示肌湿重、肌细胞截面积迅速减少，胶原纤维含量逐渐增加，失神经后3～4个月DNA增殖期核所占百分比最高，后迅速减少，肌卫星细胞失神经3周数量开始明显增加，但2个月后急剧下降，至4个月时含量已极低。神经再生组神经植入后4～5周可引出肌诱发动作电位，以萎缩2～3个月后神经植入再生效果好，此时肌卫星细胞的分化能力较强。结论骨骼肌失神经支配4个月后卫星细胞数量极少导致肌肉进入萎缩的不可逆期；当失神经2～3个月时再神经化，增殖能力活跃的肌卫星细胞促使此时的萎缩肌功能恢复较好。