大鼠坐骨神经切断后经皮低频高强度电刺激相应脊髓节段中GAP-43表达的变化

目的探讨成年Wister大鼠在坐骨神经切断后GAP-43于相应脊髓节段前角运动神经元内的表达变化.方法选取健康成年雄性Wister大鼠60只,将坐骨神经切断,随机分为实验组和对照组,实验组给予经皮低频高强度电刺激,分别于术后1,2,4,8,12,16周处死,取其L4~L6脊髓,利用免疫组织化学技术检测GAP-43在相应脊髓节段中的表达变化,并利用影像分析系统进行统计学分析.结果对照组:1周时前角细胞胞体内GAP-43有明显表达,4周时达到高峰,5~8周时逐渐下调,9~16周时GAP-43在前角细胞胞体内中仍有少量表达,并呈弱阳性.实验组:1周时前角细胞胞体内GAP-43有明显表达,2周时达到高峰,且在4~16周时在神经元中仍有表达,并呈阳性.结论坐骨神经切断可导致成年大鼠相应脊髓节段中前角运动神经元GAP-43表达明显增加,可证明在周围神经损伤后神经元的再生能力增强,但时效很短.而给予低频高强度电刺激疗法后,GAP-43的表达在时长和量上都有明显增加.     

大鼠急性脊髓损伤后肝癌衍生生长因子的表达

目的:观察大鼠受损伤脊髓组织中肝癌衍生生长因子(Hepatoma-derived growthfactor,HDGF)表达的变化.方法:将40只成年大白鼠随机分成对照组(A组)和脊髓损伤组(B组),每组20只.脊髓损伤组采用改良的Allen’s打靶法制备,并于术后24 h处死大鼠,取损伤脊髓节段进行免疫组织化学染色.观察HDGF在正常对照组以及脊髓损伤后表达情况.以表达指数作为统计学指标,采用X2检验分析各组间的变化.结果:HDGF主要表达在神经细胞核中.15例损伤脊髓标本表现为HDGF表达指数为Ⅱ组,对照组中表达指数为Ⅱ组仅4只(P<0.05).结论:HDGF高表达于损伤脊髓组织中,提示HDGF可能参与脊髓损伤的修复.     

神经营养因子联合治疗促进脊髓轴索再生的研究现状

神经营养因子（neurotrophic factors,NTFs）在急性脊髓损伤（spinal cord injury,SCI）后神经细胞的生长发育、保护和修复的过程中发挥重要作用。然而,单一的治疗尚不足以激活神经元内源性的再生程序;其次,再生抑制因子限制了NTFs对SCI后结构和功能恢复。因此,越来越多的学者选择以联合的方式探索NTFs对再生的促进作用。本文归纳了NTFs以联合的方式治疗轴索再生的基本原理和最新进展,旨在为联合治疗的进一步研究提供科学指导。     

Chondroitinase ABC promotes functional recovery after spinal cord injury

The inability of axons to regenerate after a spinal cord injury in the adult mammalian central nervous system (CNS) can lead to permanent paralysis. At sites of CNS injury, a glial scar develops, containing extracellular matrix molecules including chondroitin sulphate proteoglycans (CSPGs). CSPGs are inhibitory to axon growth in vitro, and regenerating axons stop at CSPG-rich regions in vivo. Removing CSPG glycosaminoglycan (GAG) chains attenuates CSPG inhibitory activity. To test the functional effects of degrading chondroitin sulphate (CS)-GAG after spinal cord injury, we delivered chondroitinase ABC (ChABC) to the lesioned dorsal columns of adult rats. We show that intrathecal treatment with ChABC degraded CS-GAG at the injury site, upregulated a regeneration-associated protein in injured neurons, and promoted regeneration of both ascending sensory projections and descending corticospinal tract axons. ChABC treatment also restored post-synaptic activity below the lesion after electrical stimulation of corticospinal neurons, and promoted functional recovery of locomotor and proprioceptive behaviours. Our results demonstrate that CSPGs are important inhibitory molecules in vivo and suggest that their manipulation will be useful for treatment of human spinal injuries.     

Functional regeneration of respiratory pathways after spinal cord injury

Spinal cord injuries often occur at the cervical level above the phrenic motor pools, which innervate the diaphragm. The effects of impaired breathing are a leading cause of death from spinal cord injuries, underscoring the importance of developing strategies to restore respiratory activity. Here we show that, after cervical spinal cord injury, the expression of chondroitin sulphate proteoglycans (CSPGs) associated with the perineuronal net (PNN) is upregulated around the phrenic motor neurons. Digestion of these potently inhibitory extracellular matrix molecules with chondroitinase ABC (denoted ChABC) could, by itself, promote the plasticity of tracts that were spared and restore limited activity to the paralysed diaphragm. However, when combined with a peripheral nerve autograft, ChABC treatment resulted in lengthy regeneration of serotonin-containing axons and other bulbospinal fibres and remarkable recovery of diaphragmatic function. After recovery and initial transection of the graft bridge, there was an unusual, overall increase in tonic electromyographic activity of the diaphragm, suggesting that considerable remodelling of the spinal cord circuitry occurs after regeneration. This increase was followed by complete elimination of the restored activity, proving that regeneration is crucial for the return of function. Overall, these experiments present a way to markedly restore the function of a single muscle after debilitating trauma to the central nervous system, through both promoting the plasticity of spared tracts and regenerating essential pathways.     

基因重组碱性成纤维细胞生长因子对大鼠脊髓损伤神经保护作用

目的 :探索碱性成纤维细胞生长因子 (bFGF)对大鼠脊髓损伤的神经保护作用 方法 :将吸入bFGF的胶原蛋白海绵或空白海绵贴敷于大鼠脊髓损伤处 ,术后 1、2、3周 ,对大鼠机能进行评分 ,并对大脑运动皮质进行电镜观察分析 结果 :术后 1、2、3周 ,bFGF组大鼠运动评分均明显优于对照组 (Ρ <0 .0 5) ,运动皮质电镜结果显示bFGF组线粒体、内质网轻度肿胀 ,神经毡结构正常 ,无明显胶质细胞增生 程度较对照组明显减轻 结论 :bFGF对大鼠脊髓受损神经纤维起源脑区—运动皮质的神经细胞具有明显的保护作用 ,进而使大鼠运动功能受损明显减轻     

体育功能锻炼对截瘫患者康复影响及评价分析

目的:探讨体育功能锻炼对截瘫患者后期康复治疗的影响及康复评价.方法:76例在脊髓损伤后出现截瘫患者,进行体育功能锻炼的康复治疗,追踪记录,采用美国脊髓损伤学会(ASIA)脊髓损伤神经功能分类国际标准评价康复效果.结果:经统计,胸腰髓不完全损害者康复锻炼前后ASIA损伤评分运动、感觉评分均有显著意义(P<0.05).胸腰髓完全损伤者运动、感觉ASIA评分好转较明显(P<0.05).结论:体育功能锻炼能帮助截瘫患者后期恢复,显著改善和提高患者的综合功能.     

Regenerating the damaged central nervous system

It is self-evident that the adult mammalian brain and spinal cord do not regenerate after injury, but recent discoveries have forced a reconsideration of this accepted principle. Advances in our understanding of how the brain develops have provided a rough blueprint for how we may bring about regeneration in the damaged brain. Studies in developmental neurobiology, intracellular signalling and neuroimmunology are bringing the regeneration field closer to success. Notwithstanding these advances, clear and indisputable evidence for adult functional regeneration remains to be shown.     

硫酸镁对大鼠继发性脊髓损伤保护作用的实验研究

为探讨硫酸镁对大鼠继发性脊髓损伤的保护作用及机制.用30只体重280±20g wister成年大白鼠随机分为三组:A组(对照组),仅行T10阶段椎板减压;B组(损伤组),C组(治疗组),均行T10阶段椎板减压和Allen's重物打击致脊髓损伤,伤后30min时B组腹腔注射蒸馏水1600mg/kg,C组腹腔注射硫酸镁1600m//kg.48h后切去伤段脊髓组织分别测定H2O、Ca2+、Mg2+离子含量,观察局部组织病理学改变,超微结构及单位面积的凋亡细胞数.结果显示跟A组比较,B、C组损伤段脊髓组织H2O、ca2+含量增多,Mg2+含量减少,组织病理学及超微结构破坏严重,凋亡细胞数升高,而且C组较B组轻.由此可知,病程早期应用硫酸镁可以减轻脊髓损伤后的继发性损伤,从而对受损脊髓起到保护作用.     

Studies on repairing of hemisected thoracic spinal cord of adult rats by using a chitosan tube filled with alginate fibers

A chitosan tube filled with alginate fibers was implanted into the injured spinal cord of a rat for repairing the damaged tissue. Twelve months after the operation, the morphological observation demonstrated that this chitosan tube could induce regeneration of myelinated and non-myelinated axons and blood vessels. The Basso-Beattie-Bresnahan (BBB) behavioral evaluation confirmed that the implants played a key role in the long-term restoration of rats motor functions. It is a promising start in the treatment of the patients with the injury of the spinal cord.     

Tropic1808基因重组蛋白对损伤坐骨神经脊髓细胞凋亡的影响

探讨Tropic1808基因重组蛋白对损伤坐骨神经的新生大鼠脊髓细胞凋亡影响,将新生SD大鼠一侧坐骨神经切断后,用无菌止血海绵包裹断离的神经近侧端,海绵内加入Tropic1808基因重组蛋白,阳性用神经生长因子、阴性用生理盐水作为对照;术后3、6、12h经TUNEL法染色,在光镜、电镜和图像分析系统下,了解L4－L5段脊髓细胞凋亡情况。得到生理盐水组的脊髓出现大量绸亡细胞;Tropic1808基因重组蛋白组凋亡细胞数量较生理盐水组显减少;Tropic1808基因重组蛋白组与神经生长因子组之间凋亡细胞数量的差别无显性意义。说明Tropic1808基因重组蛋白有保护受损神经组织,减少细胞凋亡的作用。     

大白鼠坐骨神经再生轴突可塑性的研究——辣根过氧化物酶(HRP)示踪观察

用HRP逆行示踪法,对成年大白鼠两侧坐骨神经端端吻合术后,再生轴突可塑性作了研究。术后1—12月不同时间内,在吻合端左侧0.8cm处,再横断坐骨神经,放入HRP,存活2天,取材观察。结果表明:所有动物脊髓腰骶段两侧前角均出现HRP标记细胞。标记细胞数量随吻合术后时间增长而增加。左侧前角较右侧前角标记细胞多。说明受损的坐骨神经轴突能再生,各自进入对侧的坐骨神经,向脊髓方向延伸。但是,仅部分再生轴突能延伸过缝合处的组织痂。本实验提示再生轴突的可塑性,它受环境因素的影响。     

肽-DNA纳米颗粒用于HIF-1αΔODD转染脊髓损伤动物模型的研究

为了探讨肽-DNA纳米颗粒技术用于转染脊髓损伤动物模型的可能性,本研究在克隆得到氧浓度非敏感性的HIF-1α突变体基因(HIF-1αΔODD)并构建其真核重组表达载体(pEGFPC1-HIF-1αΔODD)的基础上,构建用于转染动物模型的肽-DNA纳米颗粒,将其转染脊髓损伤大鼠模型,用组织免疫荧光方法检测内/外源性HIF-1α在动物模型中的表达情况.结果显示,外源性HIF-1α在实验组脊髓组织中正确表达,说明构建的pEGFPC1-HIF-1αΔODD的肽-DNA纳米颗粒成功转染了稳定的脊髓损伤大鼠模型,肽-DNA纳米颗粒技术可作为中枢神经系统损伤动物模型的分子干预研究的一种新的选择.     

bFGF对自体神经移植后神经再生和神经元相关性的影响

目的探讨bFGF对自体神经移植后神经再生和神经元相关性的影响。方法切断大白鼠右侧坐骨神经10mm,在原位作神经外膜缝合,实验组注射bFGF100u/d,共10d,对照组注射生理盐水10d,术后12周取材。光镜观察,并计数再生神经纤维和神经元的绝对值,得出恢复率以及用统计学方法得出它们的相关性。结果两组均可见再生神经纤维通过吻合口,并向远端延伸。两组神经再生率与脊髓前角运动细胞或者脊神经节细胞存活率的相关系数均非常接近1,但实验组和对照组的组间相关系数无显著性差异。结论周围神经再生率与相应的脊髓前角运动细胞或者脊神经节细胞存活率之间的正相关关系是固有的,不会随bFGF的使用而改变     

不同断面神经束组吻合对周围神经再生影响的实验研究

目的 观察不同断面神经束组吻合对大鼠坐骨神经再生的影响。方法 将32只大鼠随机分为4组,各组大鼠均切断双侧坐骨神经后立即在显微镜下左侧施行不同断面神经束组吻合,右侧施行同一断面神经束组吻合。分别于第,2,4,6,8周检测两侧坐骨神经运动诱发电位的潜伏期和波幅,有髓神经纤维数。结果 各指标经统计学处理,术后第2周,实验侧和对照侧之间差异无统计学意义。结论 不同断面神经束组吻合在神经恢复后期有加速神经再生作用,优于同一断面神经束组吻合。     

Morphological and electrophysiological evidence for regeneration of transected spinal cord fibers and restoration of motor functions in adult rats

The evoked potentials are regarded as an efficientindex to evaluate the functional status of a nervoussystem[1]. When stimulating the motor area of cerebralcortex with transcranial magnetic stimulation, elec-tronic signals can be obtained at the spinal co…     

Microelectronics-embedded channel bridging and signal regeneration of injured spinal cords

Due to the difficulty in spinal cord regeneration with biological methods, the microelectronic neural bridge, a new concept based on microelectronic technology, is presented. The microelectronic system has been realized in the forms of hybrid and integrated circuits. The integrated circuits for neural signal detection, stimulation, and regeneration are realized in a CMOS process. In animal experiments with 100 toads, 48 rats, and 3 rabbits, nerve signals have been successfully detected from spinal cords and sciatic nerves, and functional electrical stimulation has been carried out for spinal cords and sciatic nerves. When the microelectronic system is bridged between the controlling and stimulated nerve, the relevant motion of legs and nerve signal waveforms, which are stimulated by the evoked or spontaneous nerve signal through such a system, have been observed. Therefore, the feasibility of the presented method was demonstrated.     

降钙素基因相关肽在受损SD大鼠面神经运动神经元中的表达与定位

目的：研究降钙素基因相关肽（calcitonin gene—related peptide。CGRV）在面神经损伤后再生过程中面神经运动神经元中的表达变化．方法：健康SD大鼠分别行左侧面神经茎乳孔压榨术,术后饲养3、7、14、21、28、35d,取出脑干含面神经核团部分,用免疫组化及图像分析技术,观察面神经核中的CGRP在面神经再生中的变化．结果：CGRP分布于正常SD大鼠面神经各亚核。面神经损伤后3d。损伤侧的面神经核中CGRP比对照侧增强．图像分析CGRP灰度值与对照侧比较,差异显著（P〈0．05）;损伤后7d达最高峰（P〈0．05）,以后尽管显著表达但渐减．结论：损伤导致CGRP在面神经运动神经元中的表达增加,提示CGRP在面神经再生修复过程中发挥调理作用．     

Same impact momentum causes different degrees of spinal cord injury

The weight-drop impact is widely used in making animal model of spinal cord injury （SCI）. But there has not yet been an appropriate unit for the quantification of the impact. In this study, we compared the degrees of the spinal cord injury caused by weight-drop impact with the same momentum but different combinations of drop weight and drop height, in order to test whether ＂momentum＂ is capable of being the unit for the quantification of weight- drop impact. Thirty adult rats were randomly allocated to three groups and were injured with 5 g-10 cm （group A）, 10g-2.5 cm （group B） and 15 g-l.ll cm （group C） impacts with the same momentum to the spinal cord, respectively. Open-field locomotor function was evaluated using the Basso-Beattie-Bresnahan （BBB） locomotor rat- ing scale. The percentage of spared tissue area （STA） at the epicenter, and 500, 1000 and 1500 gm from the epicenter was calculated using serial sections stained by hematoxylin and eosin. As a result, the behavioral recovery （BBB scores） and the STA percentage were similar in group B and group C. However, the BBB score in group A was significantly lower than that in groups B and C at the same time point post injury. The STA percentage was signifi- cantly less and the lesion/cavity length was significantlygreater in group A than in groups B and C. These suggested that the 5 g-10 cm weight-drop impact, compared with the other two impacts with different weights and heights, caused a greater damage of the spinal cord when the momentum was the same. So, these impacts with the same momentum but different weights and drop heights cause different degrees of spinal cord injury. Momentum alone is inadequate to be the unit for the qualification of weight- drop impact and to be used to predict the extent of injury.     

P2X4 receptors induced in spinal microglia gate tactile allodynia after nerve injury

Pain after nerve damage is an expression of pathological operation of the nervous system, one hallmark of which is tactile allodynia-pain hypersensitivity evoked by innocuous stimuli. Effective therapy for this pain is lacking, and the underlying mechanisms are poorly understood. Here we report that pharmacological blockade of spinal P2X4 receptors (P2X4Rs), a subtype of ionotropic ATP receptor, reversed tactile allodynia caused by peripheral nerve injury without affecting acute pain behaviours in naive animals. After nerve injury, P2X4R expression increased strikingly in the ipsilateral spinal cord, and P2X4Rs were induced in hyperactive microglia but not in neurons or astrocytes. Intraspinal administration of P2X4R antisense oligodeoxynucleotide decreased the induction of P2X4Rs and suppressed tactile allodynia after nerve injury. Conversely, intraspinal administration of microglia in which P2X4Rs had been induced and stimulated, produced tactile allodynia in naive rats. Taken together, our results demonstrate that activation of P2X4Rs in hyperactive microglia is necessary for tactile allodynia after nerve injury and is sufficient to produce tactile allodynia in normal animals. Thus, blocking P2X4Rs in microglia might be a new therapeutic strategy for pain induced by nerve injury.