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Published data on earthquake-associated peripheral nerve injury is very limited. Ultrasonography has been proven to be efifcient in the clinic to diagnose peripheral nerve injury. The aim of this study was to assess the role of ultrasound in the evaluation of persistent peripheral nerve injuries 1 year after the Wenchuan earthquake. Thirty-four patients with persistent clinical symptoms and neurologic signs of impaired nerve function were evaluated with sonography prior to surgi-cal repair. Among 34 patients, ultrasonography showed that 48 peripheral nerves were entrapped, and 11 peripheral nerves were disrupted. There was one case of misdiagnosis on ultrasonogra-phy. The concordance rate of ultrasonographic ifndings with those of surgical ifndings was 98%. A total of 48 involved nerves underwent neurolysis and the symptoms resolved. Only ifve nerves had scar tissue entrapment. Preoperative and postoperative clinical and ultrasonographic results were concordant, which veriifed that ultrasonography is useful for preoperative diagnosis and postoperative evaluation of injured peripheral nerves.
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Tissue engineering technologies offer new treatment strategies for the repair of peripheral nerve injury, but cell loss between seeding and adhesion to the scaffold remains inevitable. A thermo-sensitive collagen hydrogel was used as an extracellular matrix in this study and combined with bone marrow mesenchymal stem cells to construct tissue-engineered peripheral nerve compos-ites in vitro. Dynamic culture was performed at an oscillating frequency of 0.5 Hz and 35° swing angle above and below the horizontal plane. The results demonstrated that bone marrow mesen-chymal stem cells formed membrane-like structures around the poly-L-lactic acid scaffolds and exhibited regular alignment on the composite surface. Collagen was used to ifll in the pores, and seeded cells adhered onto the poly-L-lactic acid ifbers. The DNA content of the bone marrow mesenchymal stem cells was higher in the composites constructed with a thermosensitive colla-gen hydrogel compared with that in collagen I scaffold controls. The cellular DNA content was also higher in the thermosensitive collagen hydrogel composites constructed with the thermo-sensitive collagen hydrogel in dynamic culture than that in static culture. These results indicate that tissue-engineered composites formed with thermosensitive collagen hydrogel in dynamic culture can maintain larger numbers of seeded cells by avoiding cell loss during the initial adhe-sion stage. Moreover, seeded cells were distributed throughout the material.
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The tooth belongs to the trigeminal sensory pathway. Dental damage has been associated with impairments in the central nervous system that may be mediated by injury to the trigeminal nerve. In the present study, we investigated the effects of damage to the inferior alveolar nerve, an important peripheral nerve in the trigeminal sensory pathway, on learning and memory be-haviors and structural changes in related brain regions, in a mouse model of Alzheimer’s disease. Inferior alveolar nerve transection or sham surgery was performed in middle-aged (4-month-old) or elderly (7-month-old) senescence-accelerated mouse prone 8 (SAMP8) mice. When the middle-aged mice reached 8 months (middle-aged group 1) or 11 months (middle-aged group 2), and the elderly group reached 11 months, step-down passive avoidance and Y-maze tests of learn-ing and memory were performed, and the cholinergic system was examined in the hippocampus (Nissl staining and acetylcholinesterase histochemistry) and basal forebrain (choline acetyltrans-ferase immunohistochemistry). In the elderly group, animals that underwent nerve transection had fewer pyramidal neurons in the hippocampal CA1 and CA3 regions, fewer cholinergic ifbers in the CA1 and dentate gyrus, and fewer cholinergic neurons in the medial septal nucleus and vertical limb of the diagonal band, compared with sham-operated animals, as well as showing impairments in learning and memory. Conversely, no signiifcant differences in histology or be-havior were observed between middle-aged group 1 or group 2 transected mice and age-matched sham-operated mice. The present ifndings suggest that trigeminal nerve damage in old age, but not middle age, can induce degeneration of the septal-hippocampal cholinergic system and loss of hippocampal pyramidal neurons, and ultimately impair learning ability. Our results highlight the importance of active treatment of trigeminal nerve damage in elderly patients and those with Alzheimer’s disease, and indicate that tooth extraction should be avoided in these populations.
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The current use of hearing aids and artificial cochleas for deaf-mute individuals depends on their auditory nerve. Skin-hearing technology, a patented system developed by our group, uses a cutaneous sensory nerve to substitute for the auditory nerve to help deaf-mutes to hear sound. This paper introduces a new solution, multi-channel-array skin-hearing technology, to solve the problem of speech discrimination. Based on the ifltering principle of hair cells, external voice sig-nals at different frequencies are converted to current signals at corresponding frequencies using electronic multi-channel bandpass ifltering technology. Different positions on the skin can be stimulated by the electrode array, allowing the perception and discrimination of external speech signals to be determined by the skin response to the current signals. Through voice frequen-cy analysis, the frequency range of the band-pass iflter can also be determined. These ifndings demonstrate that the sensory nerves in the skin can help to transfer the voice signal and to dis-tinguish the speech signal, suggesting that the skin sensory nerves are good candidates for the replacement of the auditory nerve in addressing deaf-mutes’ hearing problems. Scientiifc hearing experiments can be more safely performed on the skin. Compared with the artificial cochlea, multi-channel-array skin-hearing aids have lower operation risk in use, are cheaper and are more easily popularized.
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The increase in neurotrophic factors after craniocerebral injury has been shown to promote fracture healing. Moreover, neurotrophic factors play a key role in the regeneration and repair of peripheral nerve. However, whether craniocerebral injury alters the repair of peripheral nerve injuries remains poorly understood. Rat injury models were established by transecting the left sciatic nerve and using a free-fall device to induce craniocerebral injury. Compared with sciat-ic nerve injury alone after 6-12 weeks, rats with combined sciatic and craniocerebral injuries showed decreased sciatic functional index, increased recovery of gastrocnemius muscle wet weight, recovery of sciatic nerve ganglia and corresponding spinal cord segment neuron mor-phologies, and increased numbers of horseradish peroxidase-labeled cells. These results indicate that craniocerebral injury promotes the repair of peripheral nerve injury.
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Peripheral nerve injury impairs motor, sensory, and autonomic function, incurring substantial ifnancial costs and diminished quality of life. For large nerve gaps, proximal lesions, or chronic nerve injury, the prognosis for recovery is particularly poor, even with autografts, the current gold standard for treating small to moderate nerve gaps. In vivo elongation of intact proximal stumps towards the injured distal stumps of severed peripheral nerves may offer a promising new strategy to treat nerve injury. This review describes several nerve lengthening strategies, in-cluding a novel internal ifxator device that enables rapid and distal reconnection of proximal and distal nerve stumps.
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Propagated sensation along the meridian can occur when acupoints are stimulated by acupuncture or electrical impulses. In this study, participants with notable propagated sensation along the me-ridian were given electro-acupuncture at the Jianyu (LI15) acupoint of the large intestine meridian. When participants stated that the sensation reached the back of their hand, regular nervous system action discharge was examined using a physiological recording electrode placed on the superficial branch of the radial nerve. The topographical maps of brain-evoked potential in the primary cortical somatosensory area were also detected. When Guangming (GB37) acupoint in the lower limb and Hegu (LI4) acupoint in the upper limb were stimulated, subjects without propagated sensation along the meridian exhibited a high potential reaction in the corresponding area of the brain cortical so-matosensory area. For subjects with a notable propagated sensation along the meridian, the reac-tion area was larger and extended into the face representative area. These electrophysiological measures directly prove the existence of propagated sensation along the meridian, and the periph-eral stimulated site is consistent with the corresponding primary cortical somatosensory area, which presents a high potential reaction.
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经络疏通仪与电针仪治疗周围性面瘫100例
周围性面瘫是一种常见病,古人认为本病是由于中了风邪所致.风邪中人之后,留于经络之间而不去,阻碍了经络中的气血循行,受风邪的一面机能上产生了丛缓现象,被无病的一面所牵引发生了口眼歪斜症状称之为面瘫.该病好发于青壮年,以春秋多见,多发于男性,左侧面瘫多见.我科采用经络疏通仪与电针仪治疗本病100例,对照分析如下.
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MK-801和L-NAME对急性外周神经切断后脊髓背角内fos表达的影响:免疫细胞化学研究
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周围神经侧侧缝合治疗痉挛性脑性瘫痪的初步观察
Objective To discuss a new method and its mechanism for the treatment of spastic cerebral palsy. Methods 6 cases were treated.The injurious nerve trunk was kept abreast of neighbor donor nerve at suitable segement, the epineurium and fascicu of two neighboring area were incised to appear nerve fibers,then side to side anastomosed each other through the epineurium and fascicu. Result All cases were followed up for 4~ 15 months.The spastic limb and deformity of all cases have obvious relieve, 5 cases had no spasm without extra stimulation and have the main function recovered.Conclusion Side to side neurorrhaphy is a new method to treat spastic cerebral palsy.After operation, the spastic muscle could obtain normal never control,thereby,the cervical orientation area was changed.
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脑超声扫描仪及生物电反馈对颅脑损伤后持续性植物状态的康复作用
BACKGROUND: Persistent vegetable state(PVS) means a special vegetable state. Brain ultrasonic wave scaning apparatus can improve the activity of enzyme, strenthen the permeability of cellular membrane and stimulate peripheral nerve to expand cerebral blood vessels. It also can add brain emtabolism, increase cerebral blood quantity and benefit the building of collateral circulation.
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药物中毒性周围神经病变肌电图分析
INTRODUCTION Peripheral nerve lesion resulting from drug toxicity is caused by drugs which interrupt some enzymes in process of nervous metabolism and lead to loss of myelin sheath or axis- cylinder degeneration. Some drugs used in clinic can lead to peripheral nerve lesion. Patients showed symptoms such as numbness, asthenia.
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连续外周神经阻滞的研究进展
连续外周神经阻滞(continuous peripheral nerve blocks,CPNBs)是一种中长效的镇痛方法.与静脉镇痛及硬膜外镇痛相比,CPNBs的镇痛效果更好而不良反应少,增加了患者的舒适度,并能促进术后功能恢复、减少术后慢性疼痛综合征的发生率.大量的实践证明,CPNBs技术用于成人和儿童都同样安全有效,甚至患者在家中也能使用这一技术进行疼痛控制.本文综述CPNBs在定位、注药方法、临床应用范围和并发症等方面的研究进展.
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开展骨骼肌及周围神经活检的一些思考
骨骼肌活组织检查(简称肌活检)作为神经肌肉疾病的诊断措施始于1865年[1](Charriere和Duchenne; Gnesinger);周围神经活组织检查(简称周围神经活检)也是自上世纪60年代以来才大量开展的诊断技术;如Dyck和Lofgren(1966)[2]认为活检取材以腓肠神经为适宜.该神经不但可以观察成束周围神经的直径及其结构,还可同时观察小动脉及微动脉等神经间质组织的病理变化如淀粉样变性、肉芽肿及肿瘤侵润等病变[3].近20余年来国内临床应用这两种活检技术进行疾病诊断发展较快,同时也引发如下几方面的相关问题,值得思考.
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前列腺素E1治疗糖尿病周围神经病变
周围神经病变是糖尿病常见的慢性并发症之一,目前缺乏特效治疗,且发病机制复杂,一般认为与代谢障碍及微血管障碍有关.前列腺素E1(PGE1)可扩张末梢血管、抑制血小板凝集,从而改善微循环,治疗末梢血管病变.作者观察了48例用PGE1治疗糖尿病周围神经病变患者的疗效,以间接了解微血管障碍在糖尿病神经病变发病中的作用.
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周围神经修复中Schwann细胞与轴突间作用的分子机制
近年来随着再生医学的兴起,神经损伤和修复日益受到人们的关注,与之相关的分子机制研究也越来越多.神经再生的过程受到很多分子和细胞的调控,Schwann细胞与轴突间的相互作用是一个重要调节因素,二者相互协调,共同起着调控作用[1].
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Schwann细胞发生发育过程中和周围神经损伤后的表型表达及其影响因素
Schwann细胞(SCs)起源于胚胎的神经嵴细胞[1],是周围神经系统(PNS)的髓鞘形成细胞,包绕或包裹PNS的轴突形成有髓或无髓神经纤维.SCs不仅在整个发育过程中与PNS存在着密切联系,如对发育中周围神经元的存活、成熟有髓纤维的跳跃式传导等,而且在周围神经损伤后,还可逆分化为幼稚状态形成Büngner带,分泌神经营养因子,促进离断轴突的出芽再生,并重新包绕再生的轴突形成髓鞘,从而在中枢及周围神经的损伤再生及修复中发挥重要作用.因此,SCs具有广阔的研究及应用前景.本文就SCs的生长发育过程以及各阶段的表型表达和影响因素加以综述.
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周围神经MRI影像学研究进展
周围神经系统主要由分布于身体各处的神经、神经节、神经丛和神经终末装置等构成.周围神经疾病是临床常见病变,一直是临床研究的重点.自1895年Roentgen发现X线以来,普通平片、CT和超声等医学影像学技术在显示周围神经的解剖及病变方面虽然有一定的临床应用,但均存在较多的限度及不足,应用价值有限[1,2].
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MSCT多平面重组技术在显示膝关节周围神经中的应用研究
膝关节是人体负重大的关节,又是人体复杂的关节之一,相关病变及损伤较多,如果膝关节病变或损伤累及周围神经,影像学成像显示神经形态并明确周围毗邻关系具有重要的意义[1-3]。对膝关节周围神经 CT 成像方面的研究,国内相关文献较少。笔者利用多层螺旋 CT(MSCT)对110例正常的膝关节进行多平面重组(MPR),通过 MPR 同层显示膝关节周围神经,观察其解剖学特点,为临床诊断相关疾病提供影像解剖依据。
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恶性周围性神经鞘瘤1例报告
恶性周围性神经鞘瘤(malignant peripheral nerve sheath tumors,MPNSTs)是来源于周围神经或神经鞘膜细胞(如雪旺氏细胞,神经周细胞或纤维母细胞)的一类较少见的恶性肿瘤,年发病率约0.001%,占软组织肉瘤的5%~10%。