ObjectiveTo review the related studies on the application of nanomaterials in the treatment of osteomyelitis, and to provide new ideas for the research and clinical treatment of osteomyelitis.MethodsThe literature about the treatment of osteomyelitis with nanomaterials at home and abroad in recent years was reviewed and analyzed.ResultsAt present, surgical treatment and antibiotic application are the main treatment options for osteomyelitis. But there are many defects such as antibiotic resistance, residual bone defect, and low effective concentration of local drugs. The application of nanomaterials can make up for the above defects. In recent years, nanomaterials play an important role in the treatment of osteomyelitis by filling bone defects, establishing local drug delivery system, and self-antibacterial properties.ConclusionIt will provide a new idea and an important research direction for the treatment of osteomyelitis to fully study the related characteristics of nanomaterials and select beneficial materials to make drug delivery system or substitute drugs.
ObjectiveTo summarize the regulatory role of long non-coding RNA (lncRNA) in peripheral nerve injury (PNI) and neural regeneration.MethodsThe characteristics and mechanisms of lncRNA were summarized and its regulatory role in PNI and neural regeneration were elaborated by referring to relevant domestic and foreign literature in recent years.ResultsNeuropathic pain and denervated muscle atrophy are common complications of PNI, affecting patients’ quality of life. Numerous lncRNAs are upregulated after PNI, which promote the progress of neuropathic pain by regulating nerve excitability and neuroinflammation. Several lncRNAs are found to promote the progress of denervated muscle atrophy. Importantly, peripheral nerve regeneration occurs after PNI. LncRNAs promote peripheral nerve regeneration through promoting neuronal axonal outgrowth and the proliferation and migration of Schwann cells.ConclusionAt present, the research on lncRNA regulating PNI and neural regeneration is still in its infancy. The specific mechanism remains to be further explored. How to achieve clinical translation of experimental results is also a major challenge for future research.
Objective To investigate the feasibility of selenium-methylselenocysteine (SMC) to promote peripheral nerve regeneration and its mechanism of action. Methods Rat Schwann cells RSC96 cells were randomly divided into 5 groups, which were group A (without any treatment, control group), group B (adding 100 μmol/L H2O2), group C (adding 100 μmol/L H2O2+100 μmol/L SMC), group D (adding 100 μmol/L H2O2+200 μmol/L SMC), group E (adding 100 μmol/L H2O2+400 μmol/L SMC); the effect of SMC on cell proliferation was detected by MTT method, and the level of oxidative stress was detected by immunofluorescence for free radicals [reactive oxygen species (ROS)] after determining the appropriate dose group. Thirty-six 4-week-old male Sprague Dawley rats were randomly divided into 3 groups, namely, the sham operation group (Sham group), the sciatic nerve injury group (PNI group), and the SMC treatment group (SMC group), with 12 rats in each group; the rats in the PNI group were fed with food and water normally after modelling operation, and the rats in the SMC group were added 0.75 mg/kg SMC to the drinking water every day. At 4 weeks after operation, the sciatic nerves of rats in each group were sampled for neuroelectrophysiological detection of highest potential of compound muscle action potential (CMAP). The levels of inflammatory factors [interleukin 17 (IL-17), IL-6, IL-10 and oxidative stress factors catalase (CAT), superoxide dismutase (SOD), and malondialdehyde (MDA)] were detected by ELISA assay. The luxol fast blue (LFB) staining was used to observe the myelin density, fluorescence intensity of glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) was observed by immunofluorescence staining, and myelin morphology was observed by transmission electron microscopy with measurement of axon diameter. Western blot was used to detect the protein expressions of p38 mitogen-activated protein kinases (p38MAPK), phosphorylated p38MAPK (p-p38MAPK), heme oxygenase 1 (HO-1), and nuclear factor erythroid 2-related factor 2 (Nrf2). ResultsMTT assay showed that the addition of SMC significantly promoted the proliferation of RSC96 cells, and the low concentration could achieve an effective effect, so the treatment method of group C was selected for the subsequent experiments; ROS immunofluorescence test showed that group B showed a significant increase in the intensity of ROS fluorescence compared with that of group A, and group C showed a significant decrease in the intensity of ROS fluorescence compared with that of group B (P<0.05). Neuroelectrophysiological tests showed that the highest potential of CMAP in SMC group was significantly higher than that in PNI and Sham groups (P<0.05). ELISA assay showed that the levels of IL-6, IL-17, and MDA in PNI group were significantly higher than those in Sham group, and the levels of IL-10, SOD, and CAT were significantly lower; the levels of IL-6, IL-17, and MDA in SMC group were significantly lower than those in PNI group, and the levels of IL-10, SOD, and CAT were significantly higher (P<0.05). LFB staining and transmission electron microscopy showed that the myelin density and the diameter of axons in the SMC group were significantly higher than those of the PNI group and the Sham group (P<0.05). Immunofluorescence staining showed that the fluorescence intensity of GFAP and MBP in the SMC group were significantly stronger than those in the PNI group and Sham group (P<0.05). Western blot showed that the relative expressions of Nrf2 and HO-1 proteins in the SMC group were significantly higher than those in the PNI group and Sham group, and the ratio of p-p38MAPK/p38MAPK proteins was significantly higher in the PNI group than that in the SMC group and Sham group (P<0.05). Conclusion SMC may inhibit oxidative stress and inflammation after nerve injury by up-regulating the Nrf2/HO-1 pathway, and then inhibit the phosphorylation of p38MAPK pathway to promote the proliferation of Schwann cells, which ultimately promotes the formation of myelin sheaths and accelerates the regeneration of peripheral nerves.
Objective To investigate the effects of chitosan/polyvinyl alcohol (PVA) nerve conduits for repairing radial nerve defect in Macaques. Methods Twelve adult Macaques weighing 3.26-5.35 kg were made the models of radial nerve defect (2 cm in length) and were randomly divided into 3 groups according to nerve grafting, with 4 Macaques in each group. Chitosan/PVA nerve conduit, non-graft, and autografts were implanted in the defects in groups A, B, and C, respectively. And the right radial nerves were used as normal control. At 8 months postoperatively, the general observation,electrophysiological methods, and histological examination were performed. Results At 8 months postoperatively, theregenerated nerve bridged the radial nerve defect in group A, but no obvious adhesion was observed between the tube and the peripheral tissue. The regenerated nerve had not bridged the sciatic nerve defect in group B. The adhesions between the implanted nerve and the peri pheral tissue were significant in group C. Compound muscle action potentials (CMAP) were detected in group A and group C, and no CMAP in group B. Peak ampl itude showed a significantly higher value in normal control than in groups A and C (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). Nerve conduction velocity and latency were better in normal control than in groups A and C, and in group C than in group A, all showing significant differences (Plt; 0.05). The density of myl inated fibers in groups A and C was significantly lower than that in normal control (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). The diameter and the myel in sheath thickness of the myl inated fibers in normal control were significantly higher than those in groups A and C, and in group C than in group A, all showing significant differences (P lt; 0.05). Conclusion The chitosan/PVA nerve conduits can promote the peripheral nerve regeneration, and may promise alternative to nerve autograft for repairing peripheral nerve defects.
Objective To investigate the sensation of the fingers innervated by the brachial plexus roots and provide the theoretic basis for diagnosis of a brachial plexus injury. Methods From June 2003 to January 2005，10 patients (8 males, 2 females; age,18-47 years) with complete brachial plexus avulsion were involved in this study, who underwent thecontralateral C7 nerve root transfer. The latency and amplitude of the sensory nerve actiopotential(SNAP) were record at the C5 T1 nerve roots when stimulation was given at the fingers.Results When the thumb and the index finger were stimulated and SNAP was recorded at all the roots of the brachial plexus in all the patients, we found that there was a higher amplitude and a shorter latency at the C5-7 roots than at the C8 and T1 roots(P＜0.05). When the middle finger was stimulated and SNAP was recorded at the C7,8 and T1 roots, we found that there was the highest amplitude and the shortest laency at the C7 root(P＜0.01). When the ring finger was stimulated and SNAP was recorded at the C7,8and T1 roots, we found that there was a higher amplitude and a shorter latency at the C8 and T1 roots than at the C7 root(P＜0.01). When the little finger was stimulated and SNAP was recorded at the C7,8and T1 roots, we found that there was the highest amplitude and the shortest latency at the T1 root(P＜0.01). ConclusionThe sense of the thumband the index finger is mainly nnervated by the C5-7 roots, the middle finger sense is mainly innervated by the C7 root, the ring finger sense is mainly innervated by the C8 and T1 roots, and the little finger sense is mainly innervated by the T1 root.
Objective To discuss the optimal approach to treat suprascapular nerve compression syndrome. Methods From January 2000 to June 2003, 8 cases of suprascapular nerve compression syndrome were treated by surgical intervention to cut the transverse scapular ligament through posterior approach. Of the 8 patients, there were 2 males and 6 females (age ranged from 21 to 53) with duration of 6 months to 3 years. The change of symptom, muscle power, and muscle atrophy after operation were observed. Results One week after operation, pain around the scapular disappeared, muscle power of supraspinatus and infraspinatus muscles recovered to normal. One, 6, 12 and 16 months after the operation, the patients were followed up. No recurrence was observed. Muscle atrophy didn’t recover.Conclusion To treat suprascapular nerve compression syndrome with operation through posterior approach is easy to operate. When the suprascapular nerve is entrapped in scapular notch, this approach is a good choice.
【Abstract】 Objective To establ ish an artificial physiological reflex arc with reconstruction of the sensory and themotorial functions of atonic bladder simultaneously after the conus medullary injury in rats. Methods Twenty 3-month-oldmale SD rats, with the weight of 250 to 300 g, were included. The right side was the experimental side, while the left side served as a control. Intradural microanastomosis of the right L5 ventral root to S2 ventral root and L5 dorsal root to S2 dorsal root wasperformed to reconstruct the sensory and the motorial functions of atonic bladder. After axonal regeneration, the new motor-tomotor and sensory-to-sensory artificial bladder reflex pathway was establ ished. At 5 months postoperatively, the early function of the reflex arc was observed by electrophysiological examinations, and the bladder pressure was tested. Results Eighteen rats survived for 5 months after the operation. Single stimul i (3 mA, 0.3 ms) of the S2 dorsal root of the experimental side resulted in evoked potentials recorded from the right vesical plexus before and after the spinal cord was destroyed horizontally between L6 and S4 segmental levels. The ampl itudes of the evoked potentials were (0.10 ± 0.02) mV and (0.11 ± 0.03) mV, respectively, before and after paraplegia, and there was no statistically significant difference (P gt; 0.05). The figures of the evoked potentials were similar to those of the control side. Bladder contraction was initiated by trains of stimul i (3 mA, 20 Hz, 5 s) of the S2 dorsal root of the experimental side. The bladder pressures were (6.55 ± 1.33) cmH2O and (6.11 ± 2.01) cmH2O, respectively, and the ampl itudes of bladder smooth muscle complex action potential were (0.11 ± 0.02) mV and (0.11 ± 0.03) mV, respectively, beforeand after paraplegia. There was no significant difference (P gt; 0.05). These figures were similar to those of the control side before paraplegia. Before paraplegia, when the S2 dorsal root of the control side was stimulated, the ampl itude of the evoked potential was (0.14 ± 0.02) mV, the bladder pressures was (10.77 ± 1.78) cmH2O and the ampl itude of bladder smooth muscle complex action potential was (0.17 ± 0.02) mV. There was statistically significant difference bewteen the experimental side and the control side (P lt; 0.01). All the results of electrophysiological examinations and bladder pressure were negative when the left S2 dorsal root was stimulated after paraplegia. Conclusion Suprasacral nerve motor-to-motor and sensory-to-sensory transfers after the spinal cord injury to reconstruct the bladder autonomic reflex arc by intradural microanastomosis of ventral root and the dorsal root between L5 and S2 simultaneously is practical in a rat model and may have potential in cl inical appl ication.
Objective To investigate the effect of extract of ginkgo biloba leaves (EGb50) on the prol iferation of SCs cultured in vitro. Methods The SCs were isolated from 3-day-old SD rats’ sciatic nerves by the method of enzyme gradationdigestion (n=20) and the purified 2nd passage of SCs were divided into 2 groups: the experimental group, in which SCs were cultured in FBS-DMEM medium with EGb50 (terminal concentration: 50 μg/mL); the control group, in which SCs were cultured in the FBS-DMEM medium without EGb50. The absorbance (A) value was detected by the 2, 3-bis- (2-methoxy-4-nitro-5- sulfophenyl)-2H-tetrazol ium-5-carboxanil ide (XTT) method 1, 3, 5, 7 and 9 days after culture, then the growth curves was drawn. Cell cycle was detected by flow cytometry (FCM). Disintegration per minute (DPM) of SCs was detected by the method of 3H-thymine nucleoside (3H-TdR) 2 and 3 days after culture and nerve growth factor (NGF) synthesis in SCs culture media was detected by ELISA method. Results Most SCs were spindle-shaped with a purity above 90%. XTT detection showed that A value of SCs in the control group was gradually increased 3 days after culture, reached the peak 5 days after culture and gradually decreased from then; the A value in the experimental group experienced the similar changes, but it was higher than that in the control group at each time point (P lt; 0.01). 3H-TdR showed that the DPM of the experimental group was 1 961.78 ± 231.13 and 4 601.51 ± 605.08 at 2 and 3 days after culture, while for the control group, the A value was 1 347.15 ± 121.57 and 3 740.42 ± 158.73 at the same time point, indicating a significant difference between two groups (P lt; 0.01). FCM observation indicated that the SCs prol iferation index of the experimental group and the control group was 18.6% ± 3.2% and 9.7% ± 2.9%, indicating a significant difference between two groups (P lt; 0.01). ELISA observation showed that the NGF concentration in the experimental and the control group was (0.065 6 ± 0.003 9) ng/mL and (0.038 6 ± 0.003 6) ng/mL, indicating a significant difference (P lt; 0.01). Conclusion EGb50 is capable of enhancing the prol iferation of SCs cultured in vitro, which may be one of the important mechanisms to promote peripheral nerve regeneration.
Objective To investigate the expression change of endogenous Spastin after sciatic nerve injury in rats, and to discuss the role and significance in the peripheral nerve regeneration. Methods Thirty-six adult male Sprague Dawley rats weighing 180–220 g were randomly divided into the experimental group (n=30) and the control group (n=6). Sciatic nerve compression damage model was established in the experimental group, and the sciatic nerve was only exposed in the control group. The L4-6 spinal cord tissue was obtained to detect Spastin mRNA and protein levels by real-time fluorescence quantitative PCR and Western blot at 1, 3, 7, 14, and 28 days after operation in the experimental group (n=6) and at 7 days in the control group. Meanwhile, the sciatic nerve at 5 mm distal to the injured site was obtained to observe the ultrastructure of the distal axon by transmission electron microscope (TEM). Results The expression trends of Spastin gene and Spastin protein in L4-6 spinal cord tissue of 2 groups were basically identical. In the experimental group, the expressions of Spastin gene and protein decreased at the beginning, and then increased; the expressions reduced to the minimum at 7 days after operation, and came back to the initial level at 28 days. The expression levels of Spastin mRNA and protein at 3, 7, and 14 days were significantly lower in the experimental group than the control group (P<0.05), but no significant difference was noted between 2 groups at 1 and 28 days (P>0.05). The expression levels of Spastin mRNA and protein at 3, 7, and 14 days were significantly lower than those at 1 and 28 days in the experimental group (P<0.05), but no significant difference was noted between at 1 day and 28 days (P>0.05). At 1, 3, and 7 days after operation, the myelin damage was observed by TEM; at 14 days, there were regenerating Schwann cells; at 28 days, a large number of myelinated nerve fibers were seen, which were closed to normal form. Conclusion In the process of sciatic nerve regeneration after injury, a complex succession of changes take place in the expression of endogenous Spastin protein in rats, indicating that Spastin protein plays an important role in the process.
Objective To investigate the feasibility of the anastomosis of the anterior branch of obturator nerve and the muscular branch of femoral nerve. Methods Five fresh frozen cadavers, including 3 males and 2 females, were included. Both of the obturator nerve, femoral nerve and their branches were dissected, then their routes and anatomical positions were observed. The diameter and the number of myelinated nerve fiber of the anterior branch of obturator nerve and femoral nerve muscular branches were measured, as well as the overlap distance between them. Results The diameter of myelinated nerve fiber of the anterior branch of obturator nerve was (3.80±1.22) mm; the number of myelinated nerve fiber was 11 358±800. The diameters of the rectus femoris branch and the medial femoral branch were (1.60±0.54) mm and (2.20±0.66) mm, respectively; the number of myelinated nerve fiber were 4 961±655 and 6 666±466. Both the diameter and number of myelinated nerve fiber were close to the anterior branch of obturator nerve. The anterior branch of obturator nerve could be directly anastomosed with each nerve branch of femoral nerve in nontension, and the overlap distance was about 30 mm. Conclusion It is feasible to repair the femoral nerve by transposed the anterior branch of obturator nerve and anastomosed with the femoral nerve muscular branches. And the rectus femoris branch and the medial femoral branch should be taken as the recipient nerve.