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An update–tissue engineered nerve grafts for the repair of peripheral nerve injuries 被引量:11
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作者 Nitesh P.Patel Kristopher A.Lyon Jason H.Huang 《Neural Regeneration Research》 SCIE CAS CSCD 2018年第5期764-774,共11页
Peripheral nerve injuries(PNI) are caused by a range of etiologies and result in a broad spectrum of disability. While nerve autografts are the current gold standard for the reconstruction of extensive nerve damage,... Peripheral nerve injuries(PNI) are caused by a range of etiologies and result in a broad spectrum of disability. While nerve autografts are the current gold standard for the reconstruction of extensive nerve damage, the limited supply of autologous nerve and complications associated with harvesting nerve from a second surgical site has driven groups from multiple disciplines, including biomedical engineering, neurosurgery, plastic surgery, and orthopedic surgery, to develop a suitable or superior alternative to autografting. Over the last couple of decades, various types of scaffolds, such as acellular nerve grafts(ANGs), nerve guidance conduits, and non-nervous tissues, have been filled with Schwann cells, stem cells, and/or neurotrophic factors to develop tissue engineered nerve grafts(TENGs). Although these have shown promising effects on peripheral nerve regeneration in experimental models, the autograft has remained the gold standard for large nerve gaps. This review provides a discussion of recent advances in the development of TENGs and their efficacy in experimental models. Specifically, TENGs have been enhanced via incorporation of genetically engineered cells, methods to improve stem cell survival and differentiation, optimized delivery of neurotrophic factors via drug delivery systems(DDS), co-administration of platelet-rich plasma(PRP), and pretreatment with chondroitinase ABC(Ch-ABC). Other notable advancements include conduits that have been bioengineered to mimic native nerve structure via cell-derived extracellular matrix(ECM) deposition, and the development of transplantable living nervous tissue constructs from rat and human dorsal root ganglia(DRG) neurons. Grafts composed of non-nervous tissues, such as vein, artery, and muscle, will be briefly discussed. 展开更多
关键词 peripheral nerve injury peripheral nerve repair tissue engineered nerve graft nerve conduit stem cells Schwann cells dorsal root ganglia neurons axon stretch-growth autologous tissue graft
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神经电生理监测降低脊柱外科手术神经损伤风险的作用和影响因素 被引量:15
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作者 李芒来 杨学军 《中国组织工程研究》 CAS 北大核心 2019年第16期2560-2565,共6页
背景:近几十年术中神经电生理监测技术发展迅速,已成为神经外科、脊柱外科和手足外科等学科手术时不可或缺的一部分。合理应用术中神经电生理监测技术可以减少或避免术中对脊髓或神经根的损伤,但术中神经电生理监测技术的影响因素诸多,... 背景:近几十年术中神经电生理监测技术发展迅速,已成为神经外科、脊柱外科和手足外科等学科手术时不可或缺的一部分。合理应用术中神经电生理监测技术可以减少或避免术中对脊髓或神经根的损伤,但术中神经电生理监测技术的影响因素诸多,这些因素会对监测的准确性产生影响,导致监测结果的异常。目的:综述脊柱外科术中神经电生理监测机制和影响因素的研究现状。方法:检索PubMed数据库及CNKI中国期刊全文数据库等收录的有关脊柱外科术中神经电生理监测机制及术中神经电生理监测影响因素的文章。英文检索词为"neurophysiologicmonitoring,somatosensory evoked potential,motor evoked potential,electromyogram,propofol,muscle relaxants";中文检索词为"术中神经电生理监测,脊柱外科手术,体感诱发电位,运动诱发电位,肌电图,丙泊酚,肌松剂"。纳入与脊柱外科术中神经电生理监测技术及神经电生理监测影响因素相关性高的文献共计52篇。结果与结论:①对近年来脊柱外科术中神经电生理监护的研究进展及神经电生理监测的影响因素进行调查,发现对脊柱外科术中神经电生理监测机制及神经电生理各方面影响因素的研究较少,而关于单一影响因素的文献有限,但各研究直接关联性较大;②脊柱外科术中神经电生理监测技术目前已成熟且广泛应用于临床,该技术可以大幅度降低术中神经损伤的风险,但其影响因素众多,会对监测结果造成不良影响,影响手术进程及结果;③了解并对相关因素采取措施,可以提高术中神经电生理监测的准确性,降低神经损伤的风险。 展开更多
关键词 脊髓损伤 体感诱发电位 运动诱发电位 肌电图 神经根牵拉 丙泊酚 肌松剂 缺血再灌注损伤
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经皮椎间孔镜下髓核切除术与显微椎间盘镜下髓核切除术治疗腰椎盘突出症的临床价值比较 被引量:13
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作者 宇洪浩 原泉 +2 位作者 王欢 安春厚 林新鸿 《实用医院临床杂志》 2018年第5期57-60,共4页
目的比较经皮椎间孔镜下髓核切除术(PTED)与显微椎间盘镜下髓核切除术(MED)治疗腰椎间盘突出症的临床价值。方法收集98例腰椎间盘突出症患者的临床资料,按治疗方式分为PTED组(n=45)与MED组(n=53),比较两组手术、术后恢复情况及视觉模拟... 目的比较经皮椎间孔镜下髓核切除术(PTED)与显微椎间盘镜下髓核切除术(MED)治疗腰椎间盘突出症的临床价值。方法收集98例腰椎间盘突出症患者的临床资料,按治疗方式分为PTED组(n=45)与MED组(n=53),比较两组手术、术后恢复情况及视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、日本骨科学会量表(JOA)评分结果,对比两组手术前后腰椎曲度Cobb角及椎间隙高度的变化。结果 (1)PTED组切口长度、术后卧床时间、住院时间短于MED组,但MED组手术时间短于PTED组,透视次数少于PTED组(P<0.05)。(2)两组术后并发症发生率比较差异无统计学意义(P>0.05)。(3)术后3、6个月,两组腰痛腿痛VAS评分及ODI障碍指数均降低、JOA评分上升(P<0.05),但组间比较差异无统计学意义(P>0.05)。(4)MED组术后6个月Cobb角缩小,与PTED组比较差异有统计学意义(P<0.05)。结论 PTED与MED治疗腰椎间盘突出症疗效肯定,可减轻患者疼痛,促进腰椎功能恢复,但前者创伤更小,术后恢复速度快,对腰椎稳定性影响更小。 展开更多
关键词 腰椎间盘突出症 神经根损伤 椎间孔镜 显微椎间盘镜
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Estrogen affects neuropathic pain through upregulating N-methyl-D-aspartate acid receptor 1 expression in the dorsal root ganglion of rats 被引量:8
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作者 Chao Deng Ya-juan Gu +1 位作者 Hong Zhang Jun Zhang 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第3期464-469,共6页
Estrogen affects the generation and transmission of neuropathic pain,but the specific regulatory mechanism is still unclear.Activation of the N-methyl-D-aspartate acid receptor 1(NMDAR1) plays an important role in t... Estrogen affects the generation and transmission of neuropathic pain,but the specific regulatory mechanism is still unclear.Activation of the N-methyl-D-aspartate acid receptor 1(NMDAR1) plays an important role in the production and maintenance of hyperalgesia and allodynia.The present study was conducted to determine whether a relationship exists between estrogen and NMDAR1 in peripheral nerve pain.A chronic sciatic nerve constriction injury model of chronic neuropathic pain was established in rats.These rats were then subcutaneously injected with 17β-estradiol,the NMDAR1 antagonist D(-)-2-amino-5-phosphonopentanoic acid(AP-5),or both once daily for 15 days.Compared with injured drug na?ve rats,rats with chronic sciatic nerve injury that were administered estradiol showed a lower paw withdrawal mechanical threshold and a shorter paw withdrawal thermal latency,indicating increased sensitivity to mechanical and thermal pain.Estrogen administration was also associated with increased expression of NMDAR1 immunoreactivity(as assessed by immunohistochemistry) and protein(as determined by western blot assay) in spinal dorsal root ganglia.This 17β-estradiol-induced increase in NMDAR1 expression was blocked by co-administration with AP-5,whereas AP-5 alone did not affect NMDAR1 expression.These results suggest that 17β-estradiol administration significantly reduced mechanical and thermal pain thresholds in rats with chronic constriction of the sciatic nerve,and that the mechanism for this increased sensitivity may be related to the upregulation of NMDAR1 expression in dorsal root ganglia. 展开更多
关键词 nerve regeneration peripheral nerve injury ESTROGEN 17Β-ESTRADIOL N-rnethyl-D-aspartic acid receptor 1 pain sciatic nerve chronic constriction injury neuropathic pain D(-)-2-amino-5-phosphonopentanoic acid dorsal root ganglion spinal cord IMMUNOREACTIVITY western blot assay neural regeneration
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神经根慢性嵌压损伤的动物模型建立 被引量:10
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作者 杨大志 王坤正 +2 位作者 陈君长 镇万新 王多 《中国脊柱脊髓杂志》 CAS CSCD 2004年第5期290-294,F003,共6页
目的:建立一种由自身骨性增生造成神经根慢性嵌压损伤的动物模型,为相关实验提供造模方法。方法:30只健康家猫,手术显露右侧C7、C8和L5、L6神经根及其椎间孔内口,用牙髓钻破坏椎间孔周围骨皮质后,将“V”形松质骨块沿骨壁嵌于神经根通... 目的:建立一种由自身骨性增生造成神经根慢性嵌压损伤的动物模型,为相关实验提供造模方法。方法:30只健康家猫,手术显露右侧C7、C8和L5、L6神经根及其椎间孔内口,用牙髓钻破坏椎间孔周围骨皮质后,将“V”形松质骨块沿骨壁嵌于神经根通道的骨性管道内及侧隐窝后方,左侧做正常对照。在造模术前和术后第2、4、8、12、24周行磁刺激运动诱发电位(MEP)检测,每次随机选6只,4~5只行影像学检查,以确定神经根通道的狭窄程度和神经根受压状态,6只均做病理组织学检查和椎间孔截面积测量。结果:术后早期实验侧肢体出现行为异常;而后有不同程度肌萎缩;后期部分肢体远端出现溃疡。影像学检查随着嵌压时间延长,实验侧椎间孔骨痂增多,狭窄加重,神经根受压变形,椎间孔骨性截面积8周后明显减小,与对照侧比较有显著性差异。术后2周,神经根组织学检查主要表现为神经束膜、内膜的水肿,髓鞘肿胀;4周后发生节段性脱髓鞘;8周时神经轴突增粗、断裂,远端瓦勒氏变性;12周后变性神经结构崩解、吸收,形成空洞;24周时整个神经干纤维化。术后4周时实验侧MEP开始出现潜伏期延长;8周时伴有波形分化不清;12周波幅明显下降;24周MEP的引出困难,部分电位消失。结论:采用椎间孔内自体松质骨植入,造成神经根慢性嵌压性损伤模型成功率高。 展开更多
关键词 神经根 慢性损伤 动物模型
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Is it necessary to use the entire root as a donor when transferring contralateral C7 nerve to repair median nerve? 被引量:5
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作者 Kai-ming Gao Jie Lao +1 位作者 Wen-jie Guan Jing-jing Hu 《Neural Regeneration Research》 SCIE CAS CSCD 2018年第1期94-99,共6页
If a partial contralateral C7 nerve is transferred to a recipient injured nerve, results are not satisfactory. However, if an entire contralateral C7 nerve is used to repair two nerves, both recipient nerves show goo... If a partial contralateral C7 nerve is transferred to a recipient injured nerve, results are not satisfactory. However, if an entire contralateral C7 nerve is used to repair two nerves, both recipient nerves show good recovery. These findings seem contradictory, as the above two methods use the same donor nerve, only the cutting method of the contralateral C7 nerve is different. To verify whether this can actually result in different repair effects, we divided rats with right total brachial plexus injury into three groups. In the entire root group, the entire contralateral C7 root was transected and transferred to the median nerve of the affected limb. In the posterior division group, only the posterior division of the contralateral C7 root was transected and transferred to the median nerve. In the entire root + posterior division group, the entire contralateral C7 root was transected but only the posterior division was transferred to the median nerve. After neurectomy,the median nerve was repaired on the affected side in the three groups. At 8, 12, and 16 weeks postoperatively, electrophysiological examination showed that maximum amplitude, latency, muscle tetanic contraction force, and muscle fiber cross-sectional area of the flexor digitorum superficialis muscle were significantly better in the entire root and entire root + posterior division groups than in the posterior division group. No significant difference was found between the entire root and entire root + posterior division groups. Counts of myelinated axons in the median nerve were greater in the entire root group than in the entire root + posterior division group, which were greater than the posterior division group. We conclude that for the same recipient nerve, harvesting of the entire contralateral C7 root achieved significantly better recovery than partial harvesting, even if only part of the entire root was used for transfer. This result indicates that the entire root should be used as a donor when transferring contralateral C7 ne 展开更多
关键词 nerve regeneration peripheral nerve injury brachial plexus injury avulsion injury contralateral C7 transfer nerve root entire root partial root median nerve ulnar nerve animal experiment neural regeneration
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Differential expression of microRNAs in dorsal root ganglia after sciatic nerve injury 被引量:5
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作者 Anjie Lu Zufa Huang +6 位作者 Chaoyue Zhang Xianfang Zhang Jiuhong Zhao Haiying Zhang Quanpeng Zhang Song Wu Xinan Yi 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第10期1031-1040,共10页
This study investigated the possible involvement of microRNAs in the regulation of genes that participate in peripheral neural regeneration. A microRNA microarray analysis was conducted and 23 microRNAs were identiife... This study investigated the possible involvement of microRNAs in the regulation of genes that participate in peripheral neural regeneration. A microRNA microarray analysis was conducted and 23 microRNAs were identiifed whose expression was signiifcantly changed in rat dorsal root ganglia after sciatic nerve transection. The expression of one of the downregulated microRNAs, microRNA-214, was validated using quantitative reverse transcriptase-PCR. MicroRNA-214 was predicted to target the 3′-untranslated region of Slit-Robo GTPase-activating protein 3. In situ hybridization veriifed that microRNA-214 was located in the cytoplasm of dorsal root ganglia primary neurons and was downregulated following sciatic nerve transection. Moreover, a com-bination of in situ hybridization and immunohistochemistry revealed that microRNA-214 and Slit-Robo GTPase-activating protein 3 were co-localized in dorsal root ganglion primary neu-rons. Western blot analysis suggested that Slit-Robo GTPase-activating protein 3 was upregulated in dorsal root ganglion neurons after sciatic nerve transection. These data demonstrate that mi-croRNA-214 is located and differentially expressed in dorsal root ganglion primary neurons and may participate in regulating the gene expression of Slit-Robo GTPase-activating protein 3 after sciatic nerve transection. 展开更多
关键词 nerve regeneration peripheral nerve injury sciatic nerve injury Slit-Robo GTPase-activating protein 3 microRNA-214 dorsal root ganglia gene expression MICROARRAY BIOINFORMATICS NSFC grant neural regeneration
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Biological characteristics of dynamic expression of nerve regeneration related growth factors in dorsal root ganglia after peripheral nerve injury 被引量:5
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作者 Yin-Ying Shen Xiao-Kun Gu +3 位作者 Rui-Rui Zhang Tian-Mei Qian Shi-Ying Li Sheng Yi 《Neural Regeneration Research》 SCIE CAS CSCD 2020年第8期1502-1509,共8页
The regenerative capacity of peripheral nerves is limited after nerve injury.A number of growth factors modulate many cellular behaviors,such as proliferation and migration,and may contribute to nerve repair and regen... The regenerative capacity of peripheral nerves is limited after nerve injury.A number of growth factors modulate many cellular behaviors,such as proliferation and migration,and may contribute to nerve repair and regeneration.Our previous study observed the dynamic changes of genes in L4–6 dorsal root ganglion after rat sciatic nerve crush using transcriptome sequencing.Our current study focused on upstream growth factors and found that a total of 19 upstream growth factors were dysregulated in dorsal root ganglions at 3,9 hours,1,4,or 7 days after nerve crush,compared with the 0 hour control.Thirty-six rat models of sciatic nerve crush injury were prepared as described previously.Then,they were divided into six groups to measure the expression changes of representative genes at 0,3,9 hours,1,4 or 7 days post crush.Our current study measured the expression levels of representative upstream growth factors,including nerve growth factor,brain-derived neurotrophic factor,fibroblast growth factor 2 and amphiregulin genes,and explored critical signaling pathways and biological process through bioinformatic analysis.Our data revealed that many of these dysregulated upstream growth factors,including nerve growth factor,brain-derived neurotrophic factor,fibroblast growth factor 2 and amphiregulin,participated in tissue remodeling and axon growth-related biological processes Therefore,the experiment described the expression pattern of upstream growth factors in the dorsal root ganglia after peripheral nerve injury.Bioinformatic analysis revealed growth factors that may promote repair and regeneration of damaged peripheral nerves.All animal surgery procedures were performed in accordance with Institutional Animal Care Guidelines of Nantong University and ethically approved by the Administration Committee of Experimental Animals,China(approval No.20170302-017)on March 2,2017. 展开更多
关键词 axon growth bioinformatic analysis dorsal root ganglia growth factors Ingenuity Pathway Analysis nerve regeneration peripheral nerve injury rat sciatic nerve crush injury transcriptome sequencing upstream regulators
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椎间孔镜治疗椎间隙塌陷的腰椎间盘突出症预防出口神经根损伤的措施 被引量:8
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作者 李莹 唐谨 +3 位作者 吴从俊 谢维 鲁齐林 李绪贵 《生物骨科材料与临床研究》 CAS 2022年第1期67-70,共4页
目的分析侧路椎间孔镜对椎间隙塌陷的腰椎间盘突出症患者的临床效果,探讨避免出口神经根损伤的手术技巧。方法回顾性分析2017年1月至2019年12月在本院行侧路椎间孔镜手术治疗的椎间隙塌陷的腰椎间盘突出症患者47例,观察并比较术中、术... 目的分析侧路椎间孔镜对椎间隙塌陷的腰椎间盘突出症患者的临床效果,探讨避免出口神经根损伤的手术技巧。方法回顾性分析2017年1月至2019年12月在本院行侧路椎间孔镜手术治疗的椎间隙塌陷的腰椎间盘突出症患者47例,观察并比较术中、术后出口根并发症,术前、术后24 h、术后1周、末次随访时视觉模拟评分(VAS)、日本骨科协会评估治疗(JOA)评分、功能障碍指数(ODI)等指标。结果10例(L_(3/4)1例,L_(4/5)5例,L_(5)/S_(1)4例)患者在穿刺、置管过程中出现明显出口根刺激症状(术侧下肢疼痛和/或麻木),2例患者(L_(4/5)1例,L_(5)/S_(1)1例)出现出口根支配区域感觉障碍,3例患者(均为L_(5)/S_(1))出现肌力下降,1例患者末次随访(术后1年)肌力仍未完全恢复。术后腰腿痛VAS、JOA、ODI明显改善(P<0.001)。结论对于椎间隙塌陷的腰椎间盘突出症患者,经皮椎间孔镜技术不失为一种可供选择的安全、有效的手术方式,但穿刺置管过程中,出口根刺激/损伤风险增大。术前认真评估,术中轻柔操作,注意与患者交流,避免粗暴操作,可在一定程度上避免出口神经根损伤。 展开更多
关键词 侧路椎间孔镜 椎间隙塌陷 腰椎间盘突出症 出口神经根 损伤
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The Achyranthes bidentata polypeptide k fraction enhances neuronal growth in vitro and promotes peripheral nerve regeneration after crush injury in vivo 被引量:5
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作者 Qiong Cheng Chunyi Jiang +4 位作者 Caiping Wang Shu Yu Qi Zhang Xiaosong Gu Fei Ding 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第24期2142-2150,共9页
We have previously shown that Achyranthes bidentata polypeptides (ABPP), isolated from Achyranthes bidentata Blume (a medicinal herb), exhibit neurotrophic and neuroprotective effects on the nervous system. To ide... We have previously shown that Achyranthes bidentata polypeptides (ABPP), isolated from Achyranthes bidentata Blume (a medicinal herb), exhibit neurotrophic and neuroprotective effects on the nervous system. To identify the major active component of ABPP, and thus optimize the use of ABPP, we used reverse-phase high performance liquid chromatography to separate ABPP. We obtained 12 fractions, among which the fraction of ABPPk demonstrated the strongest neuroactivity. Immunocytochemistry and western blot analysis showed that ABPPk promoted neurite growth in cultured dorsal root ganglion explant and dorsal root ganglion neurons, which might be associated with activation of Erk1/2. A combination of behavioral tests, electrophysiological assessment, and histomorphometric analysis indicated that ABPPk enhanced nerve regeneration and function restoration in a mouse model of crushed sciatic nerve. All the results suggest that ABPPk, as the key component of ABPP, can be used for peripheral nerve repair to yield better outcomes than ABPP. 展开更多
关键词 nerve regeneration Achyranthes bidentata polypeptides neuroactive component dorsal root ganglion neurite outgrowth crush injury sciatic nerve peripheral nerve regeneration neural regeneration
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Galanin and its receptor system promote the repair of injured sciatic nerves in diabetic rats 被引量:5
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作者 Xiao- feng Xu Dan-dan Zhang +3 位作者 Jin-chi Liao Li Xiao Qing Wang Wei Qiu 《Neural Regeneration Research》 SCIE CAS CSCD 2016年第9期1517-1526,共10页
Various studies have reported that galanin can promote axonal regeneration of dorsal root ganglion neurons in vitro and inhibit neuropathic pain. However, little is known about its effects on diabetic peripheral neuro... Various studies have reported that galanin can promote axonal regeneration of dorsal root ganglion neurons in vitro and inhibit neuropathic pain. However, little is known about its effects on diabetic peripheral neuropathy, and in vivo experimental data are lacking. We hypothesized that repeated applications of exogenous galanin over an extended time frame may also repair nerve damage in diabetic peripheral neuropathy, and relieve pain in vivo. We found that neuropathic pain occurred in streptozotocin-induced diabetic rats and was more severe after sciatic nerve pinch injury at 14 and 28 days than in diabetic sham-operated rats. Treatment with exogenous galanin alleviated the neuropathic pain and promoted sciatic nerve regeneration more effectively in diabetic rats than in non-diabetic rats after sciatic nerve pinch injury. This was accompanied by changes in the levels of endogenous galanin, and its receptors galanin receptor 1 and galanin receptor 2 in the dorsal root ganglia and the spinal dorsal horn when compared with nerve pinch normal rats. Our results show that application of exogenous galanin daily for 28 days can promote the regeneration of injured sciatic nerves, and alleviate neuropathic pain in diabetic rats. 展开更多
关键词 nerve regeneration peripheral nerve injury DIABETES sciatic nerve GALANIN galanin receptor 1 galanin receptor 2 neuropathicpain dorsal root ganglion spinal dorsal horn neural regeneration
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微创通道下减压结合经皮椎弓根螺钉复位内固定治疗胸腰椎骨折伴神经根损伤 被引量:8
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作者 熊怀风 丁超 +4 位作者 梁甜 王敏 刘庆波 李传望 詹义兵 《中国现代医生》 2021年第14期92-94,98,共4页
目的探讨在微创通道下减压结合经皮椎弓根螺钉复位内固定治疗伴有神经根损伤的胸腰椎骨折疗效。方法选取2019年6月至2020年6月于本院就诊的胸腰椎骨折伴神经根损伤患者60例,按照单双日分成A组与B组,每组各30例。A组予以传统开放椎弓根... 目的探讨在微创通道下减压结合经皮椎弓根螺钉复位内固定治疗伴有神经根损伤的胸腰椎骨折疗效。方法选取2019年6月至2020年6月于本院就诊的胸腰椎骨折伴神经根损伤患者60例,按照单双日分成A组与B组,每组各30例。A组予以传统开放椎弓根螺钉复位内固定治疗,B组在微创通道下减压结合经皮椎弓根螺钉复位内固定治疗。并比较治疗前后伤椎Cobb角,伤椎椎体前缘高度比值变化,术后疼痛程度及相关手术指标。结果术后两组患者各时间节点伤椎Cobb角,伤椎椎体前缘高度比值比较,差异无统计学意义(P>0.05)。术后24 h疼痛程度评分比较,A组高于B组,差异有统计学意义(P<0.05)。A组手术时间、术中出血、切口长度及术后引流量为(147.61±10.36)min,(344.46±40.56)mL,(12.34±1.79)cm,(224.10±9.89)mL;B组分别为(121.23±7.78)min,(91.28±5.98)mL,(7.71±1.28)cm,(54.56±6.78)mL;B组均低于A组,差异有统计学意义(P<0.05)。结论对胸腰椎骨折伴神经根损伤患者在微创通道下减压结合经皮椎弓根螺钉复位内固定治疗,可取得与传统开放手术相同的疗效,但其创伤性更低,安全性更高,有助于减轻患者术后疼痛,并加快患者康复,具有推广应用价值。 展开更多
关键词 微创通道 减压 经皮椎弓根螺钉复位内固定 神经根损伤 胸腰椎骨折 疼痛度
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Contralateral C7 transfer combined with acellular nerve allografts seeded with differentiated adipose stem cells for repairing upper brachial plexus injury in rats 被引量:3
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作者 Jian-Tao Yang Jin-Tao Fang +3 位作者 Liang Li Gang Chen Ben-Gang Qin Li-Qiang Gu 《Neural Regeneration Research》 SCIE CAS CSCD 2019年第11期1932-1940,共9页
Nerve grafting has always been necessary when the contralateral C7 nerve root is transferred to treat brachial plexus injury. Acellular nerve allograft is a promising alternative for the treatment of nerve defects, an... Nerve grafting has always been necessary when the contralateral C7 nerve root is transferred to treat brachial plexus injury. Acellular nerve allograft is a promising alternative for the treatment of nerve defects, and results were improved by grafts laden with differentiated adipose stem cells. However, use of these tissue-engineered nerve grafts has not been reported for the treatment of brachial plexus injury. The aim of the present study was to evaluate the outcome of acellular nerve allografts seeded with differentiated adipose stem cells to improve nerve regeneration in a rat model in which the contralateral C7 nerve was transferred to repair an upper brachial plexus injury. Differentiated adipose stem cells were obtained from Sprague-Dawley rats and transdifferentiated into a Schwann cell-like phenotype. Acellular nerve allografts were prepared from 15-mm bilateral sections of rat sciatic nerves. Rats were randomly divided into three groups: acellular nerve allograft, acellular nerve allograft + differentiated adipose stem cells, and autograft. The upper brachial plexus injury model was established by traction applied away from the intervertebral foramen with micro-hemostat forceps. Acellular nerve allografts with or without seeded cells were used to bridge the gap between the contralateral C7 nerve root and C5–6 nerve. Histological staining, electrophysiology, and neurological function tests were used to evaluate the effect of nerve repair 16 weeks after surgery. Results showed that the onset of discernible functional recovery occurred earlier in the autograft group first, followed by the acellular nerve allograft + differentiated adipose stem cells group, and then the acellular nerve allograft group;moreover, there was a significant difference between autograft and acellular nerve allograft groups. Compared with the acellular nerve allograft group, compound muscle action potential, motor conduction velocity, positivity for neurofilament and S100, diameter of regenerating axons, myelin sheath thickness, 展开更多
关键词 nerve REGENERATION peripheral nerve injury brachial plexus injury CONTRALATERAL C7 nerve root acellular nerve adipose stem CELLS Schwann CELLS tissue engineering nerve nerve grafting nerve defect neural REGENERATION
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Mechanism of persistent hyperalgesia in neuropathic pain caused by chronic constriction injury 被引量:4
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作者 Qin-Yi Chen Chao-Yang Tan +3 位作者 Yang Wang Ke-Tao Ma Li Li Jun-Qiang Si 《Neural Regeneration Research》 SCIE CAS CSCD 2019年第6期1091-1098,共8页
Transmembrane member 16 A(TMEM16 A) is involved in many physiological functions, such as epithelial secretion, sensory conduction, nociception, control of neuronal excitability, and regulation of smooth muscle contrac... Transmembrane member 16 A(TMEM16 A) is involved in many physiological functions, such as epithelial secretion, sensory conduction, nociception, control of neuronal excitability, and regulation of smooth muscle contraction, and may be important in peripheral pain transmission. To explore the role of TMEM16 A in the persistent hyperalgesia that results from chronic constriction injury-induced neuropathic pain, a rat model of the condition was established by ligating the left sciatic nerve. A TMEM16 A selective antagonist(10 μg T16 Ainh-A01) was intrathecally injected at L5–6. For measurement of thermal hyperalgesia, the drug was administered once at 14 days and thermal withdrawal latency was recorded with an analgesia meter. For measurement of other indexes, the drug was administered at 12 days,once every 6 hours, totally five times. The measurements were performed at 14 days. Western blot assay was conducted to analyze TMEM16 A expression in the L4–6 dorsal root ganglion. Immunofluorescence staining was used to detect the immunoreactivity of TMEM16 A in the L4–6 dorsal root ganglion on the injured side. Patch clamp was used to detect electrophysiological changes in the neurons in the L4–6 dorsal root ganglion. Our results demonstrated that thermal withdrawal latency was shortened in the model rats compared with control rats.Additionally, TMEM16 A expression and the number of TMEM16 A positive cells in the L4–6 dorsal root ganglion were higher in the model rats, which induced excitation of the neurons in the L4–6 dorsal root ganglion. These findings were inhibited by T16 Ainh-A01 and confirm that TMEM16 A plays a key role in persistent chronic constriction injury-induced hyperalgesia. Thus, inhibiting TMEM16 A might be a novel pharmacological intervention for neuropathic pain. All experimental protocols were approved by the Animal Ethics Committee at the First Affiliated Hospital of Shihezi University School of Medicine, China(approval No. A2017-170-01) on February 27, 2017. 展开更多
关键词 nerve REGENERATION TMEM16A calcium-activated chloride channels T16Ainh-A01 NEUROPATHIC pain dorsal root GANGLIA HYPERALGESIA action potential rheobase chronic constriction injury peripheral nerve injury neural REGENERATION
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后路椎弓根内固定术联合椎体成形术治疗胸腰椎骨折患者的效果 被引量:7
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作者 张斌 蒲昊 +2 位作者 王明忠 刘团江 郝定均 《实用临床医药杂志》 CAS 2020年第20期15-17,21,共4页
目的观察后路椎弓根内固定术联合椎体成形术治疗胸腰椎骨折患者的效果。方法将80例胸腰椎骨折患者随机分为2组,每组40例。对照组接受后路椎弓根内固定术,观察组接受后路椎弓根内固定术联合椎体成形术。比较2组治疗效果。结果观察组术中... 目的观察后路椎弓根内固定术联合椎体成形术治疗胸腰椎骨折患者的效果。方法将80例胸腰椎骨折患者随机分为2组,每组40例。对照组接受后路椎弓根内固定术,观察组接受后路椎弓根内固定术联合椎体成形术。比较2组治疗效果。结果观察组术中出血量、术后引流量低于对照组,差异有统计学意义(P<0.01)。治疗后,2组后凸Cobb’s角、视觉模拟评分法(VAS)评分均低于治疗前,且观察组后凸Cobb’s角、VAS评分低于对照组,差异有统计学意义(P<0.01)。对照组发生神经根损伤1例,感染2例;观察组发生感染1例。2组并发症发生率比较,差异无统计学意义(P>0.05)。治疗后,观察组健康调查量表(SF-36)各项目评分均优于对照组,差异有统计学意义(P<0.05)。结论后路椎弓根内固定术联合椎体成形术是一种高效的胸腰椎骨折治疗术式,可显著改善患者的生活质量和活动功能。 展开更多
关键词 胸腰椎骨折 后路椎弓根内固定术 椎体成形术 Cobb’s角 神经根损伤
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益气化瘀方对腰神经压迫模型大鼠背根节神经细胞凋亡和caspase-3表达的影响 被引量:7
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作者 徐乐勤 李晓锋 +4 位作者 张有为 舒冰 施杞 王拥军 周重建 《中西医结合学报》 CAS 2010年第12期1174-1179,共6页
目的:观察益气化瘀方对腰神经根压迫损伤大鼠背根节神经细胞凋亡及半胱氨酸天冬氨酸蛋白酶3(caspase-3)的影响。方法:雄性SD大鼠40只随机分为假手术组、模型组、弥可保组和益气化瘀方组,每组10只。造模各组用自制胶块压迫于大鼠右侧L_4... 目的:观察益气化瘀方对腰神经根压迫损伤大鼠背根节神经细胞凋亡及半胱氨酸天冬氨酸蛋白酶3(caspase-3)的影响。方法:雄性SD大鼠40只随机分为假手术组、模型组、弥可保组和益气化瘀方组,每组10只。造模各组用自制胶块压迫于大鼠右侧L_4神经根背根节处,假手术组仅切开皮肤和椎旁肌。造模后假手术组和模型组大鼠给予生理盐水灌胃,益气化瘀方组大鼠给予益气化瘀方煎剂灌胃,弥可保组大鼠肌肉注射弥可保。于造模10 d后取右侧受压神经根,采用原位末端脱氧核苷酸转移酶标记法检测神经细胞的凋亡情况;分光光度法结合考马斯亮蓝法检测受压迫神经根caspase-3活性;实时荧光定量聚合酶链式反应法检测神经根组织caspase-3mRNA表达变化。结果:腰神经根受压迫后背根节的神经细胞凋亡明显增加,模型组大鼠神经细胞的凋亡指数高于假手术组(P<0.01);益气化瘀方和弥可保可减少背根节神经细胞的凋亡,两组大鼠神经细胞的凋亡指数低于模型组(P<0.05)。模型组大鼠神经根组织caspase-3活性和mRNA表达明显增高,与假手术组比较差异有统计学意义(P<0.05或P<0.01);益气化瘀方和弥可保可降低造模后大鼠神经根组织caspase-3活性及其mRNA表达,二者与模型组比较差异均有统计学意义(P<0.01)。结论:腰神经根压迫可导致受压神经根组织caspsae-3的过表达和神经细胞凋亡的增加。益气化瘀方可抑制神经根组织caspase-3的过表达,减轻背根节神经细胞的凋亡。 展开更多
关键词 神经根损伤 中草药 细胞凋亡 半胱氨酸天冬氨酸蛋白酶3 大鼠
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Prolonged electrical stimulation causes no damage to sacral nerve roots in rabbits 被引量:3
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作者 Peng Yan Xiaohong Yang +2 位作者 Xiaoyu Yang Weidong Zheng Yunbing Tan 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第12期1217-1221,共5页
Previous studies have shown that, anode block electrical stimulation of the sacral nerve root can produce physiological urination and reconstruct urinary bladder function in rabbits. However, whether long-term anode b... Previous studies have shown that, anode block electrical stimulation of the sacral nerve root can produce physiological urination and reconstruct urinary bladder function in rabbits. However, whether long-term anode block electrical stimulation causes damage to the sacral nerve root re- mains unclear, and needs further investigation. In this study, a complete spinal cord injury model was established in New Zealand white rabbits through T9_10 segment transection. Rabbits were given continuous electrical stimulation for a short period and then chronic stimulation for a longer period. Results showed that compared with normal rabbits, the structure of nerve cells in the anterior sacral nerve roots was unchanged in spinal cord injury rabbits after electrical stimu- lation. There was no significant difference in the expression of apoptosis-related proteins such as Bax, Caspase-3, and Bcl-2. Experimental findings indicate that neurons in the rabbit sacral nerve roots tolerate electrical stimulation, even after long-term anode block electrical stimulation. 展开更多
关键词 nerve regeneration spinal cord injury sacral nerve root electrical stimulation anodeblock spinal cord reconstruction bladder function nerve prosthesis neural regeneration
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大鼠腰神经根损伤后PGP_(9.5)在运动终板再生修复过程中的形态表现 被引量:5
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作者 周重建 施杞 +3 位作者 王拥军 沈培芝 刘梅 徐宇 《安徽医科大学学报》 CAS 2002年第4期272-275,共4页
目的 研究腰神经根损伤后 ,神经肌肉接头部神经再支配过程中的形态变化。方法 采用免疫组织化学方法和激光共聚焦 (Confocallaserscaningmicroscopy)技术 ,使用多克隆蛋白基因产物 (PGP9 5)作为神经原标记 ,观察了大鼠L5神经根受压后... 目的 研究腰神经根损伤后 ,神经肌肉接头部神经再支配过程中的形态变化。方法 采用免疫组织化学方法和激光共聚焦 (Confocallaserscaningmicroscopy)技术 ,使用多克隆蛋白基因产物 (PGP9 5)作为神经原标记 ,观察了大鼠L5神经根受压后 10、2 0、30和 6 0d比目鱼肌神经肌肉接头部末梢神经变性及再生修复过程 ,运用α bungarotoxin(α BTX)萤光结合剂显示运动终板 ,NIH技术测定末梢神经与运动终板重叠面积。结果 肌肉失神经支配后 10天 ,神经肌肉接头部末梢神经大幅度消失 ,运动终板形态结构紊乱 ,随着神经再支配的进行 ,通过末梢外突起的延伸并与邻近的运动终板相连 (终板间连接 ) ,在神经肌肉接合部形成一个多神经支配复杂的制作过程。结论 神经再生修复过程中 ,神经纤维与后突触受体区域的变化有一个时空关系 ,同时PGP9 5免疫组织化学标记 ,结合激光共聚焦在正常与再生的神经肌肉接合部 ,能清晰地显示精致的神经末梢 ,因此 ,PGP9 5抗体可用于研究各种不同情况下肌肉神经支配。 展开更多
关键词 腰神经根损伤 PGP9.5 运动终板再生修复过程 形态表现
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Substance P and calcitonin gene-related peptide expression in dorsal root ganglia in sciatic nerve injury rats 被引量:4
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作者 Changma Fu Zongsheng Yin +1 位作者 Defu Yu Zuhua Yang 《Neural Regeneration Research》 SCIE CAS CSCD 2013年第33期3124-3130,共7页
The neuropeptides, substance P and calcitonin gene-related peptide, have been shown to be involved in pain transmission and repair of sciatic nerve injury. A model of sciatic nerve defect was prepared by dissecting th... The neuropeptides, substance P and calcitonin gene-related peptide, have been shown to be involved in pain transmission and repair of sciatic nerve injury. A model of sciatic nerve defect was prepared by dissecting the sciatic nerve at the middle, left femur in female Sprague Dawley rats. The two ends of the nerve were encased in a silica gel tube. L5 dorsal root ganglia were harvested 7, 14 and 28 days post sciatic nerve injury for immunohistochemical staining. Results showed that substance P and cal- citonin gene-related peptide expression increased significantly in dorsal root ganglion of rats with sci- atic nerve injury. This increase peaked at 7 days, declined at 14 days, and reduced to normal levels by 28 days post injury. The findings indicate that the neuropeptides, substance P and calcitonin gene- related peptide, mainly increased in the early stages after sciatic nerve injury. 展开更多
关键词 neural regeneration peripheral nerve injury sciatic nerve NEUROPEPTIDES calcitonin gene-related peptide substancesupported paper neuroregenerationdorsal root ganglion spinaP PAIN neuroprotectionI cord grants-
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Gene expression changes in dorsal root ganglia following peripheral nerve injury: roles in inflammation,cell death and nociception 被引量:4
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作者 Sarah L.Martin Adam J.Reid +2 位作者 Alexei Verkhratsky Valerio Magnaghi Alessandro Faroni 《Neural Regeneration Research》 SCIE CAS CSCD 2019年第6期939-947,共9页
Subsequent to a peripheral nerve injury, there are changes in gene expression within the dorsal root ganglia in response to the damage. This review selects factors which are well-known to be vital for inflammation, ce... Subsequent to a peripheral nerve injury, there are changes in gene expression within the dorsal root ganglia in response to the damage. This review selects factors which are well-known to be vital for inflammation, cell death and nociception, and highlights how alterations in their gene expression within the dorsal root ganglia can affect functional recovery. The majority of studies used polymerase chain reaction within animal models to analyse the dynamic changes following peripheral nerve injuries. This review aims to highlight the factors at the gene expression level that impede functional recovery and are hence are potential targets for therapeutic approaches. Where possible the experimental model, specific time-points and cellular location of expression levels are reported. 展开更多
关键词 Gene expression polymerase chain reaction dorsal root GANGLIA INFLAMMATION NOCICEPTION cell death peripheral nerve injury Schwann CELLS satellite GLIAL CELLS nerve regeneration
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