Distinct brain remodeling has been found after different nerve reconstruction strategies,including motor representation of the affected limb.However,differences among reconstruction strategies at the brain network lev...Distinct brain remodeling has been found after different nerve reconstruction strategies,including motor representation of the affected limb.However,differences among reconstruction strategies at the brain network level have not been elucidated.This study aimed to explore intranetwork changes related to altered peripheral neural pathways after different nerve reconstruction surgeries,including nerve repair,endto-end nerve transfer,and end-to-side nerve transfer.Sprague–Dawley rats underwent complete left brachial plexus transection and were divided into four equal groups of eight:no nerve repair,grafted nerve repair,phrenic nerve end-to-end transfer,and end-to-side transfer with a graft sutured to the anterior upper trunk.Resting-state brain functional magnetic resonance imaging was obtained 7 months after surgery.The independent component analysis algorithm was utilized to identify group-level network components of interest and extract resting-state functional connectivity values of each voxel within the component.Alterations in intra-network resting-state functional connectivity were compared among the groups.Target muscle reinnervation was assessed by behavioral observation(elbow flexion)and electromyography.The results showed that alterations in the sensorimotor and interoception networks were mostly related to changes in the peripheral neural pathway.Nerve repair was related to enhanced connectivity within the sensorimotor network,while end-to-side nerve transfer might be more beneficial for restoring control over the affected limb by the original motor representation.The thalamic-cortical pathway was enhanced within the interoception network after nerve repair and end-to-end nerve transfer.Brain areas related to cognition and emotion were enhanced after end-to-side nerve transfer.Our study revealed important brain networks related to different nerve reconstructions.These networks may be potential targets for enhancing motor recovery.展开更多
BACKGROUND It is expected that transfer of spinal accessory nerve to suprascapular nerve,which is widely used in the restoration of the shoulder function in brachial plexus birth injury(BPBI),impairs the trapezius fun...BACKGROUND It is expected that transfer of spinal accessory nerve to suprascapular nerve,which is widely used in the restoration of the shoulder function in brachial plexus birth injury(BPBI),impairs the trapezius function.AIM To hypothesize that the lower trapezius muscle remains functional after this neve transfer.METHODS In a retrospective cross-sectional study,patients with BPBI who underwent nerve transfer from accessory nerve to supraclavicular were followed for at least six months following the operation and demographic data were extracted from the database.To assess the lower trapezius function,shoulder abduction and external rotation were examined,and electromyography and nerve conduction velocity(EMG-NCV)was performed.RESULTS A total of 19 patients with a mean age of 2.69±1.40 years and a mean follow-up of 10.5 months were included in the study.Shoulder abduction was disabled completely only in one patient(5.26%);10(52.63%)had good,3(15.78%)moderate,and 5(26.31%)had poor shoulder abduction.Regarding external rotation,one(5.26%)was unable to externally rotate the shoulder;among 18(94.73%)patients who had satisfactory results,8(42.10%)were evaluated to be good,5(26.31%)moderate,and 5(26.31%)poor.EMG-NCV showed functional lower trapezius in all patients;its function was evaluated to be good in 11(57.89%),moderate in 6(31.57%),and poor in 2(10.52%)cases.CONCLUSION This study supports the hypothesis that the lower trapezius muscle has a dual motor innervation which provides the possibility of further trapezius tendon transfer to restore a better shoulder function.展开更多
Dear Editor,Varicocele(VC)is a vascular condition characterized by abnormal tortuosity and dilation of the pampiniform plexus veins within the spermatic cord.VC is commonly observed in young adults,predominantly on th...Dear Editor,Varicocele(VC)is a vascular condition characterized by abnormal tortuosity and dilation of the pampiniform plexus veins within the spermatic cord.VC is commonly observed in young adults,predominantly on the left side;it is a frequent cause of male infertility and can lead to testicular hypofunction,pain,and discomfort.Microsurgical varicocelectomy is the gold standard for treating infertility caused by VC.VC repair is strongly recommended for couple infertility,oligoasthenoteratozoospermia(OAT),Grade 2 or 3 clinical VC,partner age<37 years,patient age<40 years,or testicular hypotrophy in children and adolescents.展开更多
AIM:To evaluate alterations in conjunctival vascular density(CVD)and macular capillary density(MCD)in female patients with type 2 diabetes mellitus(T2DM)and gestational diabetes mellitus(GDM)using optical coherence to...AIM:To evaluate alterations in conjunctival vascular density(CVD)and macular capillary density(MCD)in female patients with type 2 diabetes mellitus(T2DM)and gestational diabetes mellitus(GDM)using optical coherence tomography angiography(OCTA).METHODS:A total of 60 female participants were recruited,comprising 20 patients with T2DM,20 patients with GDM,and 20 healthy age-matched controls(HCs).OCTA was used to assess superficial and deep retinal and conjunctival capillary plexuses.Subsequently,changes in MCD were analyzed using a circular segmentation method(C1-C6),a hemispheric quadrant segmentation method[superior right(SR),superior left(SL),inferior left(IL),and inferior right(IR)],and the early treatment diabetic retinopathy study(ETDRS)segmentation method(S,I,R,L).RESULTS:OCTA unequivocally demonstrated that the variations in CVD among HCs,T2DM,and GDM groups were statistically significant(P<0.001).In the superficial retinal capillary plexus(sRCP),significant differences were observed in the densities of total microvascular(TMI),microvasculature(MIR),and macrovascular(MAR)between patients with T2DM and HCs(P<0.05).Furthermore,the GDM group exhibited a more substantial reduction in MIR density compared to the T2DM group(P<0.01).In the deep retinal capillary plexus(dRCP),significant differences in the densities of TMI and MIR were identified between the T2DM group and HCs(P<0.05),with a notable difference in TMI density also observed between the GDM and T2DM groups(P<0.01).In the receiver operating characteristic(ROC)curve analysis,the area under the ROC curve(AUC)for TMI in sRCP between the T2DM group and HCs was 0.975,with a 95%confidence interval(CI)of 0.941–1.The AUC for MIR was highest in dRCP,with an AUC value of 0.914 and a 95%CI ranging from 0.847 to 0.981.In comparing the GDM and T2DM groups,the AUC for I region was maximized in sRCP,achieving a value of 0.978 with a 95%CI of 0.953–1.Additionally,the AUC for R region was maximized in dRCP,reaching a value of 0.99 with a 95%CI of 0.975 to 1.CONCLUSION:The sRCP and dRCP densities show higher diagnostic sensitivity for T2DM and GDM.OCTA holds potential as a significant instrument for the early diagnosis and differentiation of T2DM and GDM.展开更多
Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularl...Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.展开更多
Background:Contrast-enhanced magnetic resonance neurography(ceMRN)can enhance brachial plexus visualization and quality of imaging.However,the interval between contrast injection and scanning that provides the highest...Background:Contrast-enhanced magnetic resonance neurography(ceMRN)can enhance brachial plexus visualization and quality of imaging.However,the interval between contrast injection and scanning that provides the highest-quality images is not known.Methods:Fifteen patients underwent brachial plexus imaging using the 3D T2-NerveView sequence with a scanning duration of 5 min.A consecutive six-phase scan was initiated immediately at the start of contrast agent injection.Subsequently,all patients'images were classified into six groups according to the phases:group A(phase 1,delay 0 min),group B(phase 2,delay 5 min),group C(phase 3,delay 10 min),group D(phase 4,delay 15 min),group E(phase 5,delay 20 min),and group F(phase 6,delay 25 min).The image quality in each group was assessed based on nerve signal(signalnerve),muscle signal(signalmuscle),lymph node signal(signallymph node),background noise(BN),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and subjective score.Results:Signalnerve,signalmuscle,BN,and SNR did not significantly differ among the six groups(p>0.05).However,significant differences(p<0.05)were observed in signallymph node(F=16.067),CNR(F=9.495),and subjective score(χ^(2)=23.586).As the scanning delay increased,signallymph node intensity gradually increased whereas the CNR gradually decreased.The subjective score was significantly higher in groups B(4.830.24),C(4.900.21),D(4.870.30),E(4.830.31),and F(4.830.31)than in group A(4.470.30).Conclusion:We recommend performing brachial plexus ceMRN 5 min after contrast injection.With this delay,the brachial plexus can be visualized optimally with minimal interference from background signals.展开更多
BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental heal...BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.展开更多
Objective To study the arrhythmia induced by stimulation of nicotine-sensitive neurons in cardiac ganglial plexuses. Methods When nicotine (100 μg ) was injected into canine right atrial ganglial plexus (RAGP) and ga...Objective To study the arrhythmia induced by stimulation of nicotine-sensitive neurons in cardiac ganglial plexuses. Methods When nicotine (100 μg ) was injected into canine right atrial ganglial plexus (RAGP) and ganglial plexus between aorta and pulmonary artery (A-PGP) in 33 anesthetized open-chest dog, electrocardiogram, atrial force and ventricular intramyocardial pressures (IMP) were recorded. The responses were also recorded following administration of atropine or propranolol and after heart acute decentralization. Results Ventricular arrhythmia (VA) was induced by injections of nicotine into A-PGP, but not by injections of nicotine into RAGP in 13 dogs. Atrioventricilar (A-V) block was induced by nicotine activating RAGP in 10 dogs, but not by nicotine activating A-PGP. Propranolol could reduce the frequency of VA elicited by stimulating A-PGP, atropine could reduce the frequency of A-V block elicited by stimulating RAGP. After acute decentralization, VA was still induced by activation of A-PGP in 9 dogs, but A-V block elicited by stimulating RAGP was decreased. Conclusion VA is induced by stimulating N receptor in cardiac nicotine-sensitive efferent sympathetic neurons of ventricular ganglial plexus (A-PGP), and then modifying β receptor of ventricles. A-V block is elicited by stimulating N receptor in atrial ganglial plexus (RAGP), then modifying M receptor of A-V node not only via efferent parasympathetic neurons, but also via afferent pathway.展开更多
Pain is a common symptom of pancreatic disease and is frequently difficult to manage. Pain relief provided by narcotics is often suboptimal and is associated with significant side effects. An alternative approach to p...Pain is a common symptom of pancreatic disease and is frequently difficult to manage. Pain relief provided by narcotics is often suboptimal and is associated with significant side effects. An alternative approach to pain management in pancreatic disease is the use of celiac plexus block (CPB) or neurolysis (CPN). Originally performed by anesthesiologists and radiologists via a posterior approach,recent advances in endoscopic ultrasonography (EUS) have made this technique an attractive alternative. EUS guided celiac plexus block/ neurolysis is simple to perform and avoids serious complications such as paraplegia or pneumothorax that are associated with the posterior approach. EUS guided CPN should be considered first line therapy in patients with pain due to pancreatic cancer. It provides superior pain control compared to traditional management with narcotics. A trend for improved survival in pancreatic cancer patients treated with CPN has been reported,but larger studies are needed to confirm this finding. At this time,the use of EUS guided CPB cannot be recommended as routine therapy for pain in chronic pancreatitis since only one-half of the patients experience pain reduction and the beneficial effect tends to be short lived. EUS guided CPB and CPN should be used as part of a multidisciplinary team approach for pain management.展开更多
Danshen-Chuanxiongqin Injection(DCI)is a commonly used traditional Chinese medicine for the treatment of cerebral ischemic stroke in China.However,its underlying mechanisms remain completely understood.The current stu...Danshen-Chuanxiongqin Injection(DCI)is a commonly used traditional Chinese medicine for the treatment of cerebral ischemic stroke in China.However,its underlying mechanisms remain completely understood.The current study was designed to explore the protective mechanisms of DCI against cerebral ischemic stroke through integrating whole-transcriptome sequencing coupled with network pharmacology analysis.First,using a mouse model of cerebral ischemic stroke by transient middle cerebral artery occlusion(tMCAO),we found that DCI(4.10 mL·kg−1)significantly alleviated cerebral ischemic infarction,neurological deficits,and the pathological injury of hippocampal and cortical neurons in mice.Next,the whole-transcriptome sequencing was performed on brain tissues.The cerebral ischemia disease(CID)network was constructed by integrating transcriptome sequencing data and cerebrovascular disease-related genes.The results showed CID network was imbalanced due to tMCAO,but a recovery regulation was observed after DCI treatment.Pathway analysis of the key genes with recovery efficiency showed that the neuroinflammation signaling pathway was highly enriched,while the TLR2/TLR4-MyD88-NF-κB pathway was predicted to be affected.Consistently,the in vivo validation experiments confirmed that DCI exhibited protective effects against cerebral ischemic stroke by inhibiting neuroinflammation via the TLR2/TLR4-MyD88-NF-κB pathway.More interestingly,DCI markedly suppressed the neutrophils infiltrated into the brain parenchyma via the choroid plexus route and showed anti-neuroinflammation effects.In conclusion,our results provide dependable evidence that inhibiting neuroinflammation via the TLR2/TLR4-MyD88-NF-κB pathway is the main mechanism of DCI against cerebral ischemic stroke in mice.展开更多
The continued need to develop less invasive alternatives to surgical and radiologic interventions has driven the development of endoscopic ultrasound(EUS)-guided treatments.These include EUS-guided drainage of pancrea...The continued need to develop less invasive alternatives to surgical and radiologic interventions has driven the development of endoscopic ultrasound(EUS)-guided treatments.These include EUS-guided drainage of pancreatic fluid collections,EUS-guided necrosectomy,EUS-guided cholangiography and biliary drainage,EUSguided pancreatography and pancreatic duct drainage,EUS-guided gallbladder drainage,EUS-guided drainage of abdominal and pelvic fluid collections,EUS-guided celiac plexus block and celiac plexus neurolysis,EUSguided pancreatic cyst ablation,EUS-guided vascular interventions,EUS-guided delivery of antitumoral agents and EUS-guided fiducial placement and brachytherapy.However these procedures are technically challenging and require expertise in both EUS and interventional endoscopy,such as endoscopic retrograde cholangiopancreatography and gastrointestinal stenting.We undertook a systematic review to record the entire body of literature accumulated over the past 2decades on EUS-guided interventions with the objective of performing a critical appraisal of published articles,based on the classification of studies according to levels of evidence,in order to assess the scientific progress made in this field.展开更多
AIM: To investigate the effect of Ginkgo biloba extract on the enteric neurons in the small intestine of diabetic rats. METHODS: Fifteen Wistar rats were divided into three groups: control group (C), diabetic group (D...AIM: To investigate the effect of Ginkgo biloba extract on the enteric neurons in the small intestine of diabetic rats. METHODS: Fifteen Wistar rats were divided into three groups: control group (C), diabetic group (D) and diabetic-treated (DT) daily with EGb 761 extract (50 mg/kg body weight) for 120 d. The enteric neurons were identified by the myosin-V immunohistochemical technique. The neuronal density and the cell body area were also analyzed. RESULTS: There was a significant decrease in the neuronal population (myenteric plexus P = 0.0351; submucous plexus P = 0.0217) in both plexuses of the jejunum in group D when compared to group C. With regard to the ileum, there was a significant decrease (P = 0.0117) only in the myenteric plexus. The DT group showed preservation of the neuronal population in the jejunum submucous plexus and in the myenteric plexus in the ileum. The cell body area in group D increased significantly (P = 0.0001) in the myenteric plexus of both segments studied as well as in the ileum submucosal plexus, when compared to C. The treatment reduced (P = 0.0001) the cell body area of the submucosal neurons of both segments and the jejunum myenteric neurons. CONCLUSION: The purified Ginkgo biloba extract has a neuroprotective effect on the jejunum submucous plexus and the myenteric plexus of the ileum of diabetic rats.展开更多
Electroacupuncture has traditionally been used to treat pain, but its effect on pain following brachial plexus injury is still unknown. In this study, rat models of an avulsion injury to the left brachial plexus root ...Electroacupuncture has traditionally been used to treat pain, but its effect on pain following brachial plexus injury is still unknown. In this study, rat models of an avulsion injury to the left brachial plexus root （associated with upper-limb chronic neuropathic pain） were given electroacupuncture stimulation at bilateral Quchi （LIll）, Hegu （LI04）, Zusanli （ST36） and Yanglingquan （GB34）. After electroacupuncture therapy, chronic neuropathic pain in the rats＇ upper limbs was significantly attenuated. Immunofluorescence staining showed that the expression of β-endorphins in the arcuate nucleus was significantly increased after therapy. Thus, experimental findings indi- cate that electroacupuncture can attenuate neuropathic pain after brachial plexus injury through upregulating β-endorphin expression.展开更多
AIM: To study the distribution of nitric oxide synthase (NOS) in rat stomach myenteric plexus. METHODS: The distribution of NOS in gastric wall was studied in quantity and location by the NADPH-diaphorase (NDP) histoc...AIM: To study the distribution of nitric oxide synthase (NOS) in rat stomach myenteric plexus. METHODS: The distribution of NOS in gastric wall was studied in quantity and location by the NADPH-diaphorase (NDP) histochemical staining method and whole mount preparation technique. RESULTS: NOS was distributed in whole stomach wall, most of them were located in myenteric plexus, and distributed in submucosal plexus.The shape of NOS positive neurons was basically similar, most of them being round and oval in shape. But their density, size and staining intensity varied greatly in the different parts of stomach. The density was 62+/-38 cells mm(2) (antrum), 43+/-32 cells/mm(2) (body), and 32+/-28 cells mm(2) (fundus), respectively. The size and staining intensity of NOS positive neurons in the fundus were basically the same, the neurons being large and dark stained, while they were obviously different in antrum. In the body of the stomach, the NOS positive neurons were in an intermediate state from fundus to antrum. There were some beadlike structures which were strung together by NOS positive varicosities in nerve fibers, some were closely adherent to the outer walls of blood vessels. CONCLUSION: Nitric oxide might be involved in the modulation of motility, secretion and blood circulation of the stomach, and the significant difference of NOS positive neurons in different parts of stomach myenteric plexus may be related to the physiologic function of stomach.展开更多
The microvascular supply of the biliary tree, the peribiliary plexus （PBP）, stems from the hepatic artery branches and flows into the hepatic sinusoids. A detailed three-dimensional study of the PBP has been perform...The microvascular supply of the biliary tree, the peribiliary plexus （PBP）, stems from the hepatic artery branches and flows into the hepatic sinusoids. A detailed three-dimensional study of the PBP has been performed by using the Scanning Electron Microscopy vascular corrosion casts （SEMvcc） technique. Considering that the PBP plays a fundamental role in supporting the secretory and absorptive functions of the biliary epithelium, their organization in either normalcy and pathology is explored. The normal liver shows the PBP arranged around extra-and intrahepatic biliary tree. In the small portal tract PBP was characterized by a single layer of capillaries which progressively continued with the extrahepatic PBP where it showed a morecomplex vascular network. After common duct ligation （BDL）, progressive modifications of bile duct and PBP proliferation are observed. The PBP presents a three-dimensional network arranged around many bile ducts and appears as bundles of vessels, composed by capillaries of homogeneous diameter with a typical round mesh structure. The PBP network is easily distinguishable from the sinusoidal network which appears normal. Considering the enormous extension of the PBP during BDL, the possible role played by the Vascular Endothelial Growth Factor （VEGF） is evaluated. VEGF-A,VEGF-C and their related receptors appeared highly immunopositive in proliferating cholangiocytes of BDL rats. The administration of anti-VEGF-A or anti-VEGF-C antibodies to BDL rats as well as hepatic artery ligation induced a reduced bile duct mass. The administration of rVEGF-A to BDL hepatic artery ligated rats prevented the decrease of cholangiocyte proliferation and VEGF-A expression as compared to BDL control rats. These data suggest the role of arterial blood supply of the biliary tree in conditions of cholangiocyte proliferation, such as it occurs during chronic cholestasis. On the other hand,the role played by VEGF as a tool of cross-talk between cholangiocytes and PBP endothelial cells suggests that manipulation of VEGF release and function could represent a therapeutic strategy for human pathological conditions characterized by damage of hepatic artery or the biliary tree.展开更多
The transplantation of embryonic stem cells can effectively improve the creeping strength of nerves near an injury site in animals. Amniotic epithelial cells have similar biological properties as em-bryonic stem cells...The transplantation of embryonic stem cells can effectively improve the creeping strength of nerves near an injury site in animals. Amniotic epithelial cells have similar biological properties as em-bryonic stem cells; therefore, we hypothesized that transplantation of amniotic epithelial cells can repair peripheral nerve injury and recover the creeping strength of the brachial plexus nerve. In the present study, a brachial plexus injury model was established in rabbits using the C6root avulsion method. A suspension of human amniotic epithelial cells was repeatedly injected over an area 4.0 mm lateral to the cephal and caudal ends of the C6 brachial plexus injury site （1 × 106 cells/mL, 3μL/injection, 25 injections） immediately after the injury. The results showed that the decrease in stress and increase in strain at 7,200 seconds in the injured rabbit C6 brachial plexus nerve were mitigated by the cell transplantation, restoring the viscoelastic stress relaxation and creep properties of the brachial plexus nerve. The forepaw functions were also signiifcantly improved at 26 weeks after injury. These data indicate that transplantation of human amniotic epithelial cells can effec-tively restore the mechanical properties of the brachial plexus nerve after injury in rabbits and that viscoelasticity may be an important index for the evaluation of brachial plexus injury in animals.展开更多
AIM: To determine the expression of c-fos in gastric myenteric plexus and spinal cord of rats with cervical spondylosis and its clinical significance. METHODS: A cervical spondylosis model was established in rats by d...AIM: To determine the expression of c-fos in gastric myenteric plexus and spinal cord of rats with cervical spondylosis and its clinical significance. METHODS: A cervical spondylosis model was established in rats by destroying the stability of cervical posterior column,and the cord segments C4-6 and gastric antrum were collected 3, 4 and 5 mo after the operation. Rats with sham operation were used as controls. c-fos neuronal counter-staining was performed with an immunohistochemistry method. Every third sections from C4-6 segments were drawn. The 10 most labeled c-fos-immunoreactive (Fos-IR) neurons were counted, and the average number was used for statistical analysis. The mean of Fos-IR neurons in myenteric plexus was calculated after counting Fos-IR neurons in 25 ganglia from each antral preparation, and expressed as a mean count per myenteric ganglion.RESULTS: There were a few c-fos-positive neurons in the cervical cord and antrum in the control group. There was an increased c-fos expression in model group 3, 4 and 5 mo after operation, whereas there was no significant increase in c-fos expression in the control group at 3, 4 and 5 mo.More importantly, there was a significant difference in c-fos expression between rats followed up for 3 mo and those for 5 mo in the model group (11.20±2.26 vs 27.68±4.36,P＜0.05, for the cervical cord; and 11.3±2.3 vs 29.3±4.6,P＜0.05, for the gastric antrum). There was no significant difference between rats followed up for 3 mo and those for 4 mo and between rats followed up for 4 mo and those for 5 mo in the model group.CONCLUSION: c-fos expression in gastric myenteric plexus was dramatically associated with that in the spinal cord in rats with cervical spondylosis, suggesting that the gastrointestinal function may be affected by cervical spondylosis. If this hypothesis is confirmed by further studies, functional gastrointestinal diseases such as functional dyspepsia and irritable bowel syndrome could be explained by neurogastroenterology.展开更多
AIM: To compare the effects of neurolytic celiac plexus block (NCPB) and videothoracoscopic splanchnicectomy (VSPL) on pain and quality of life of chronic pancreatitis (CP) patients.METHODS: Forty-eight small duct CP ...AIM: To compare the effects of neurolytic celiac plexus block (NCPB) and videothoracoscopic splanchnicectomy (VSPL) on pain and quality of life of chronic pancreatitis (CP) patients.METHODS: Forty-eight small duct CP patients were treated invasively with NCPB (n = 30) or VSPL (n = 18) in two non-randomized, prospective, case-controlled protocols due to chronic pain syndrome, and compared to a control group who were treated conservatively (n = 32). Visual analog scales were used to assess pain and opioid consumption rate was evaluated. In addition, the quality of life was measured using QLQ C-30 for NCPB and FACIT for VSPL.Although both questionnaires covered similar problems,they could not be compared directly one with another.Therefore, the studies were compared by meta-analysis methodology.RESULTS: Both procedures resulted in a significant positive effect on pain of CP patients. Opioids were withdrawn totally in 47.0% of NCPB and 36.4% of VSPL patients,and reduced in 53.0% and 45.4% of the respective patient groups. No reduction in opioid usage was observed in the control group. In addition, fatigue and emotional well-being showed improvements. Finally, NCPB demonstrated stronger positive effects on social support, which might possibly be attributed to earlier presentation of patients treated with NCPB.CONCLUSION: Both invasive pain treatment methods are effective in CP patients with chronic pain.展开更多
基金supported by the National Natural Science Foundation of China,Nos.81871836(to MZ),82172554(to XH),and 81802249(to XH),81902301(to JW)the National Key R&D Program of China,Nos.2018YFC2001600(to JX)and 2018YFC2001604(to JX)+3 种基金Shanghai Rising Star Program,No.19QA1409000(to MZ)Shanghai Municipal Commission of Health and Family Planning,No.2018YQ02(to MZ)Shanghai Youth Top Talent Development PlanShanghai“Rising Stars of Medical Talent”Youth Development Program,No.RY411.19.01.10(to XH)。
文摘Distinct brain remodeling has been found after different nerve reconstruction strategies,including motor representation of the affected limb.However,differences among reconstruction strategies at the brain network level have not been elucidated.This study aimed to explore intranetwork changes related to altered peripheral neural pathways after different nerve reconstruction surgeries,including nerve repair,endto-end nerve transfer,and end-to-side nerve transfer.Sprague–Dawley rats underwent complete left brachial plexus transection and were divided into four equal groups of eight:no nerve repair,grafted nerve repair,phrenic nerve end-to-end transfer,and end-to-side transfer with a graft sutured to the anterior upper trunk.Resting-state brain functional magnetic resonance imaging was obtained 7 months after surgery.The independent component analysis algorithm was utilized to identify group-level network components of interest and extract resting-state functional connectivity values of each voxel within the component.Alterations in intra-network resting-state functional connectivity were compared among the groups.Target muscle reinnervation was assessed by behavioral observation(elbow flexion)and electromyography.The results showed that alterations in the sensorimotor and interoception networks were mostly related to changes in the peripheral neural pathway.Nerve repair was related to enhanced connectivity within the sensorimotor network,while end-to-side nerve transfer might be more beneficial for restoring control over the affected limb by the original motor representation.The thalamic-cortical pathway was enhanced within the interoception network after nerve repair and end-to-end nerve transfer.Brain areas related to cognition and emotion were enhanced after end-to-side nerve transfer.Our study revealed important brain networks related to different nerve reconstructions.These networks may be potential targets for enhancing motor recovery.
文摘BACKGROUND It is expected that transfer of spinal accessory nerve to suprascapular nerve,which is widely used in the restoration of the shoulder function in brachial plexus birth injury(BPBI),impairs the trapezius function.AIM To hypothesize that the lower trapezius muscle remains functional after this neve transfer.METHODS In a retrospective cross-sectional study,patients with BPBI who underwent nerve transfer from accessory nerve to supraclavicular were followed for at least six months following the operation and demographic data were extracted from the database.To assess the lower trapezius function,shoulder abduction and external rotation were examined,and electromyography and nerve conduction velocity(EMG-NCV)was performed.RESULTS A total of 19 patients with a mean age of 2.69±1.40 years and a mean follow-up of 10.5 months were included in the study.Shoulder abduction was disabled completely only in one patient(5.26%);10(52.63%)had good,3(15.78%)moderate,and 5(26.31%)had poor shoulder abduction.Regarding external rotation,one(5.26%)was unable to externally rotate the shoulder;among 18(94.73%)patients who had satisfactory results,8(42.10%)were evaluated to be good,5(26.31%)moderate,and 5(26.31%)poor.EMG-NCV showed functional lower trapezius in all patients;its function was evaluated to be good in 11(57.89%),moderate in 6(31.57%),and poor in 2(10.52%)cases.CONCLUSION This study supports the hypothesis that the lower trapezius muscle has a dual motor innervation which provides the possibility of further trapezius tendon transfer to restore a better shoulder function.
文摘Dear Editor,Varicocele(VC)is a vascular condition characterized by abnormal tortuosity and dilation of the pampiniform plexus veins within the spermatic cord.VC is commonly observed in young adults,predominantly on the left side;it is a frequent cause of male infertility and can lead to testicular hypofunction,pain,and discomfort.Microsurgical varicocelectomy is the gold standard for treating infertility caused by VC.VC repair is strongly recommended for couple infertility,oligoasthenoteratozoospermia(OAT),Grade 2 or 3 clinical VC,partner age<37 years,patient age<40 years,or testicular hypotrophy in children and adolescents.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)The Science and Technology Innovation Program of Changde City(No.2023YD25).
文摘AIM:To evaluate alterations in conjunctival vascular density(CVD)and macular capillary density(MCD)in female patients with type 2 diabetes mellitus(T2DM)and gestational diabetes mellitus(GDM)using optical coherence tomography angiography(OCTA).METHODS:A total of 60 female participants were recruited,comprising 20 patients with T2DM,20 patients with GDM,and 20 healthy age-matched controls(HCs).OCTA was used to assess superficial and deep retinal and conjunctival capillary plexuses.Subsequently,changes in MCD were analyzed using a circular segmentation method(C1-C6),a hemispheric quadrant segmentation method[superior right(SR),superior left(SL),inferior left(IL),and inferior right(IR)],and the early treatment diabetic retinopathy study(ETDRS)segmentation method(S,I,R,L).RESULTS:OCTA unequivocally demonstrated that the variations in CVD among HCs,T2DM,and GDM groups were statistically significant(P<0.001).In the superficial retinal capillary plexus(sRCP),significant differences were observed in the densities of total microvascular(TMI),microvasculature(MIR),and macrovascular(MAR)between patients with T2DM and HCs(P<0.05).Furthermore,the GDM group exhibited a more substantial reduction in MIR density compared to the T2DM group(P<0.01).In the deep retinal capillary plexus(dRCP),significant differences in the densities of TMI and MIR were identified between the T2DM group and HCs(P<0.05),with a notable difference in TMI density also observed between the GDM and T2DM groups(P<0.01).In the receiver operating characteristic(ROC)curve analysis,the area under the ROC curve(AUC)for TMI in sRCP between the T2DM group and HCs was 0.975,with a 95%confidence interval(CI)of 0.941–1.The AUC for MIR was highest in dRCP,with an AUC value of 0.914 and a 95%CI ranging from 0.847 to 0.981.In comparing the GDM and T2DM groups,the AUC for I region was maximized in sRCP,achieving a value of 0.978 with a 95%CI of 0.953–1.Additionally,the AUC for R region was maximized in dRCP,reaching a value of 0.99 with a 95%CI of 0.975 to 1.CONCLUSION:The sRCP and dRCP densities show higher diagnostic sensitivity for T2DM and GDM.OCTA holds potential as a significant instrument for the early diagnosis and differentiation of T2DM and GDM.
文摘Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.
基金supported by the National Natural Science Foundation of China(Grant No.82302173).
文摘Background:Contrast-enhanced magnetic resonance neurography(ceMRN)can enhance brachial plexus visualization and quality of imaging.However,the interval between contrast injection and scanning that provides the highest-quality images is not known.Methods:Fifteen patients underwent brachial plexus imaging using the 3D T2-NerveView sequence with a scanning duration of 5 min.A consecutive six-phase scan was initiated immediately at the start of contrast agent injection.Subsequently,all patients'images were classified into six groups according to the phases:group A(phase 1,delay 0 min),group B(phase 2,delay 5 min),group C(phase 3,delay 10 min),group D(phase 4,delay 15 min),group E(phase 5,delay 20 min),and group F(phase 6,delay 25 min).The image quality in each group was assessed based on nerve signal(signalnerve),muscle signal(signalmuscle),lymph node signal(signallymph node),background noise(BN),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and subjective score.Results:Signalnerve,signalmuscle,BN,and SNR did not significantly differ among the six groups(p>0.05).However,significant differences(p<0.05)were observed in signallymph node(F=16.067),CNR(F=9.495),and subjective score(χ^(2)=23.586).As the scanning delay increased,signallymph node intensity gradually increased whereas the CNR gradually decreased.The subjective score was significantly higher in groups B(4.830.24),C(4.900.21),D(4.870.30),E(4.830.31),and F(4.830.31)than in group A(4.470.30).Conclusion:We recommend performing brachial plexus ceMRN 5 min after contrast injection.With this delay,the brachial plexus can be visualized optimally with minimal interference from background signals.
基金Supported by National Key Research and Development Plan,No.2022YFC2504303National Natural Science Foundation of China,No.82072411+1 种基金Guangzhou Area Clinical High-tech and Major Technology Projects,No.2024PL-GX11Internal Medicine Research Fund Project of Huadu District People's Hospital,Guangzhou(Excellent Youth Project),No.2020B06.
文摘BACKGROUND The surgical treatment of pelvic fractures is challenging,particularly after lum-bosacral plexus injuries.Such impairments affect a patient's physiological function and can cause significant mental health problems.In recent years,the new transrectus lateral approach has favorably treated pelvic fractures and possibly preserved patients'physiological and psychological conditions.There-fore,investigating its clinical efficacy for treating pelvic fractures plus lum-bosacral plexus injuries is of great clinical significance.AIM To investigate the clinical effect of the transrectus lateral approach on pelvic fractures complicated by lumbosacral plexus injuries as well as anxiety and depression.METHODS Data of 136 patients with pelvic fractures complicated by lumbosacral plexus injuries treated by the transrectus lateral approach(January 2011 to May 2024)were retrospectively analyzed.The patients'general data were collected via questionnaire.The Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess anxiety and depression,respectively.We adopted a numerical rating scale(NRS)to evaluate pain degree,the Pittsburgh Sleep Quality Index(PSQI)to assess sleep quality,and Medical Research Council(MRC)Scale for Muscle Strength to evaluate treatment efficacy and complications.RESULTS The 136 included patients(92 male,44 female)were a mean 48.02±15.72 years old.The mean SAS score was 66.36±5.15 preoperatively vs 42.15±4.36 postoperatively,while the mean SDS score was 65.61±5.02 preoperatively vs 43.83±4.54 postoperatively,showing statistically significant differences(P<0.05).The mean NRS and PSQI scores were significantly lower pre-vs postoperatively(P<0.05).Postoperatively,67 patients with fresh pelvic fractures plus nerve injuries achieved an MRC of M5,22 achieved an M1-M4,and four achieved an M0.Postoperative motor function improved by a mean 4.20 grades(scale,0-5).Among the patients with old pelvic fractures and nerve injuries,19 achieved an M5,16 achieved an M1-M4,and eight achieved an M0.Motor function improved significantly by a mean 3.30 grades(scale,0-5;P<0.05).No serious postoperative complications occurred.CONCLUSION The transrectus lateral approach to treating pelvic fractures plus lumbosacral plexus injuries can safely alleviate anxiety and depression,relieve pain,improve sleep quality,reduce intraoperative blood loss,and improve postoperative recovery.
文摘Objective To study the arrhythmia induced by stimulation of nicotine-sensitive neurons in cardiac ganglial plexuses. Methods When nicotine (100 μg ) was injected into canine right atrial ganglial plexus (RAGP) and ganglial plexus between aorta and pulmonary artery (A-PGP) in 33 anesthetized open-chest dog, electrocardiogram, atrial force and ventricular intramyocardial pressures (IMP) were recorded. The responses were also recorded following administration of atropine or propranolol and after heart acute decentralization. Results Ventricular arrhythmia (VA) was induced by injections of nicotine into A-PGP, but not by injections of nicotine into RAGP in 13 dogs. Atrioventricilar (A-V) block was induced by nicotine activating RAGP in 10 dogs, but not by nicotine activating A-PGP. Propranolol could reduce the frequency of VA elicited by stimulating A-PGP, atropine could reduce the frequency of A-V block elicited by stimulating RAGP. After acute decentralization, VA was still induced by activation of A-PGP in 9 dogs, but A-V block elicited by stimulating RAGP was decreased. Conclusion VA is induced by stimulating N receptor in cardiac nicotine-sensitive efferent sympathetic neurons of ventricular ganglial plexus (A-PGP), and then modifying β receptor of ventricles. A-V block is elicited by stimulating N receptor in atrial ganglial plexus (RAGP), then modifying M receptor of A-V node not only via efferent parasympathetic neurons, but also via afferent pathway.
文摘Pain is a common symptom of pancreatic disease and is frequently difficult to manage. Pain relief provided by narcotics is often suboptimal and is associated with significant side effects. An alternative approach to pain management in pancreatic disease is the use of celiac plexus block (CPB) or neurolysis (CPN). Originally performed by anesthesiologists and radiologists via a posterior approach,recent advances in endoscopic ultrasonography (EUS) have made this technique an attractive alternative. EUS guided celiac plexus block/ neurolysis is simple to perform and avoids serious complications such as paraplegia or pneumothorax that are associated with the posterior approach. EUS guided CPN should be considered first line therapy in patients with pain due to pancreatic cancer. It provides superior pain control compared to traditional management with narcotics. A trend for improved survival in pancreatic cancer patients treated with CPN has been reported,but larger studies are needed to confirm this finding. At this time,the use of EUS guided CPB cannot be recommended as routine therapy for pain in chronic pancreatitis since only one-half of the patients experience pain reduction and the beneficial effect tends to be short lived. EUS guided CPB and CPN should be used as part of a multidisciplinary team approach for pain management.
基金supported by the National S&T Major Project(No.2018ZX09201011)the National Youth Topnotch Talent Support Program(No.W02070098).
文摘Danshen-Chuanxiongqin Injection(DCI)is a commonly used traditional Chinese medicine for the treatment of cerebral ischemic stroke in China.However,its underlying mechanisms remain completely understood.The current study was designed to explore the protective mechanisms of DCI against cerebral ischemic stroke through integrating whole-transcriptome sequencing coupled with network pharmacology analysis.First,using a mouse model of cerebral ischemic stroke by transient middle cerebral artery occlusion(tMCAO),we found that DCI(4.10 mL·kg−1)significantly alleviated cerebral ischemic infarction,neurological deficits,and the pathological injury of hippocampal and cortical neurons in mice.Next,the whole-transcriptome sequencing was performed on brain tissues.The cerebral ischemia disease(CID)network was constructed by integrating transcriptome sequencing data and cerebrovascular disease-related genes.The results showed CID network was imbalanced due to tMCAO,but a recovery regulation was observed after DCI treatment.Pathway analysis of the key genes with recovery efficiency showed that the neuroinflammation signaling pathway was highly enriched,while the TLR2/TLR4-MyD88-NF-κB pathway was predicted to be affected.Consistently,the in vivo validation experiments confirmed that DCI exhibited protective effects against cerebral ischemic stroke by inhibiting neuroinflammation via the TLR2/TLR4-MyD88-NF-κB pathway.More interestingly,DCI markedly suppressed the neutrophils infiltrated into the brain parenchyma via the choroid plexus route and showed anti-neuroinflammation effects.In conclusion,our results provide dependable evidence that inhibiting neuroinflammation via the TLR2/TLR4-MyD88-NF-κB pathway is the main mechanism of DCI against cerebral ischemic stroke in mice.
文摘The continued need to develop less invasive alternatives to surgical and radiologic interventions has driven the development of endoscopic ultrasound(EUS)-guided treatments.These include EUS-guided drainage of pancreatic fluid collections,EUS-guided necrosectomy,EUS-guided cholangiography and biliary drainage,EUSguided pancreatography and pancreatic duct drainage,EUS-guided gallbladder drainage,EUS-guided drainage of abdominal and pelvic fluid collections,EUS-guided celiac plexus block and celiac plexus neurolysis,EUSguided pancreatic cyst ablation,EUS-guided vascular interventions,EUS-guided delivery of antitumoral agents and EUS-guided fiducial placement and brachytherapy.However these procedures are technically challenging and require expertise in both EUS and interventional endoscopy,such as endoscopic retrograde cholangiopancreatography and gastrointestinal stenting.We undertook a systematic review to record the entire body of literature accumulated over the past 2decades on EUS-guided interventions with the objective of performing a critical appraisal of published articles,based on the classification of studies according to levels of evidence,in order to assess the scientific progress made in this field.
文摘AIM: To investigate the effect of Ginkgo biloba extract on the enteric neurons in the small intestine of diabetic rats. METHODS: Fifteen Wistar rats were divided into three groups: control group (C), diabetic group (D) and diabetic-treated (DT) daily with EGb 761 extract (50 mg/kg body weight) for 120 d. The enteric neurons were identified by the myosin-V immunohistochemical technique. The neuronal density and the cell body area were also analyzed. RESULTS: There was a significant decrease in the neuronal population (myenteric plexus P = 0.0351; submucous plexus P = 0.0217) in both plexuses of the jejunum in group D when compared to group C. With regard to the ileum, there was a significant decrease (P = 0.0117) only in the myenteric plexus. The DT group showed preservation of the neuronal population in the jejunum submucous plexus and in the myenteric plexus in the ileum. The cell body area in group D increased significantly (P = 0.0001) in the myenteric plexus of both segments studied as well as in the ileum submucosal plexus, when compared to C. The treatment reduced (P = 0.0001) the cell body area of the submucosal neurons of both segments and the jejunum myenteric neurons. CONCLUSION: The purified Ginkgo biloba extract has a neuroprotective effect on the jejunum submucous plexus and the myenteric plexus of the ileum of diabetic rats.
基金supported by the Project of Ministry of Health(Comprehensive Research on Brachial Plexus Injury),No.13D22270800 from the National Natural Science Foundation of China2011 Shanghai Medical College Young Scientist Fund of Fudan University,No.11L-24
文摘Electroacupuncture has traditionally been used to treat pain, but its effect on pain following brachial plexus injury is still unknown. In this study, rat models of an avulsion injury to the left brachial plexus root （associated with upper-limb chronic neuropathic pain） were given electroacupuncture stimulation at bilateral Quchi （LIll）, Hegu （LI04）, Zusanli （ST36） and Yanglingquan （GB34）. After electroacupuncture therapy, chronic neuropathic pain in the rats＇ upper limbs was significantly attenuated. Immunofluorescence staining showed that the expression of β-endorphins in the arcuate nucleus was significantly increased after therapy. Thus, experimental findings indi- cate that electroacupuncture can attenuate neuropathic pain after brachial plexus injury through upregulating β-endorphin expression.
文摘AIM: To study the distribution of nitric oxide synthase (NOS) in rat stomach myenteric plexus. METHODS: The distribution of NOS in gastric wall was studied in quantity and location by the NADPH-diaphorase (NDP) histochemical staining method and whole mount preparation technique. RESULTS: NOS was distributed in whole stomach wall, most of them were located in myenteric plexus, and distributed in submucosal plexus.The shape of NOS positive neurons was basically similar, most of them being round and oval in shape. But their density, size and staining intensity varied greatly in the different parts of stomach. The density was 62+/-38 cells mm(2) (antrum), 43+/-32 cells/mm(2) (body), and 32+/-28 cells mm(2) (fundus), respectively. The size and staining intensity of NOS positive neurons in the fundus were basically the same, the neurons being large and dark stained, while they were obviously different in antrum. In the body of the stomach, the NOS positive neurons were in an intermediate state from fundus to antrum. There were some beadlike structures which were strung together by NOS positive varicosities in nerve fibers, some were closely adherent to the outer walls of blood vessels. CONCLUSION: Nitric oxide might be involved in the modulation of motility, secretion and blood circulation of the stomach, and the significant difference of NOS positive neurons in different parts of stomach myenteric plexus may be related to the physiologic function of stomach.
基金MIUR grants PRIN 2005 (prot. 2005067975_001) to E. Gaudio and Biomedicina, Cluster C04, Progetto n. 5 to E.Gaudio-P.Onori MIUR grants PRIN 2005 (prot.No: 2005067975_002) to D. Alvaro and a VA Research Scholar Award, a VA Merit Award and the NIH grants DK58411 and DK062975 to Gianfranco Alpini
文摘The microvascular supply of the biliary tree, the peribiliary plexus （PBP）, stems from the hepatic artery branches and flows into the hepatic sinusoids. A detailed three-dimensional study of the PBP has been performed by using the Scanning Electron Microscopy vascular corrosion casts （SEMvcc） technique. Considering that the PBP plays a fundamental role in supporting the secretory and absorptive functions of the biliary epithelium, their organization in either normalcy and pathology is explored. The normal liver shows the PBP arranged around extra-and intrahepatic biliary tree. In the small portal tract PBP was characterized by a single layer of capillaries which progressively continued with the extrahepatic PBP where it showed a morecomplex vascular network. After common duct ligation （BDL）, progressive modifications of bile duct and PBP proliferation are observed. The PBP presents a three-dimensional network arranged around many bile ducts and appears as bundles of vessels, composed by capillaries of homogeneous diameter with a typical round mesh structure. The PBP network is easily distinguishable from the sinusoidal network which appears normal. Considering the enormous extension of the PBP during BDL, the possible role played by the Vascular Endothelial Growth Factor （VEGF） is evaluated. VEGF-A,VEGF-C and their related receptors appeared highly immunopositive in proliferating cholangiocytes of BDL rats. The administration of anti-VEGF-A or anti-VEGF-C antibodies to BDL rats as well as hepatic artery ligation induced a reduced bile duct mass. The administration of rVEGF-A to BDL hepatic artery ligated rats prevented the decrease of cholangiocyte proliferation and VEGF-A expression as compared to BDL control rats. These data suggest the role of arterial blood supply of the biliary tree in conditions of cholangiocyte proliferation, such as it occurs during chronic cholestasis. On the other hand,the role played by VEGF as a tool of cross-talk between cholangiocytes and PBP endothelial cells suggests that manipulation of VEGF release and function could represent a therapeutic strategy for human pathological conditions characterized by damage of hepatic artery or the biliary tree.
基金financially supported by grants from the Science and Technology Development Plan Program of Jilin Province of China,No.20110492
文摘The transplantation of embryonic stem cells can effectively improve the creeping strength of nerves near an injury site in animals. Amniotic epithelial cells have similar biological properties as em-bryonic stem cells; therefore, we hypothesized that transplantation of amniotic epithelial cells can repair peripheral nerve injury and recover the creeping strength of the brachial plexus nerve. In the present study, a brachial plexus injury model was established in rabbits using the C6root avulsion method. A suspension of human amniotic epithelial cells was repeatedly injected over an area 4.0 mm lateral to the cephal and caudal ends of the C6 brachial plexus injury site （1 × 106 cells/mL, 3μL/injection, 25 injections） immediately after the injury. The results showed that the decrease in stress and increase in strain at 7,200 seconds in the injured rabbit C6 brachial plexus nerve were mitigated by the cell transplantation, restoring the viscoelastic stress relaxation and creep properties of the brachial plexus nerve. The forepaw functions were also signiifcantly improved at 26 weeks after injury. These data indicate that transplantation of human amniotic epithelial cells can effec-tively restore the mechanical properties of the brachial plexus nerve after injury in rabbits and that viscoelasticity may be an important index for the evaluation of brachial plexus injury in animals.
基金Supported by the Medical Research Fund of Guangdong Province, No. A2004434
文摘AIM: To determine the expression of c-fos in gastric myenteric plexus and spinal cord of rats with cervical spondylosis and its clinical significance. METHODS: A cervical spondylosis model was established in rats by destroying the stability of cervical posterior column,and the cord segments C4-6 and gastric antrum were collected 3, 4 and 5 mo after the operation. Rats with sham operation were used as controls. c-fos neuronal counter-staining was performed with an immunohistochemistry method. Every third sections from C4-6 segments were drawn. The 10 most labeled c-fos-immunoreactive (Fos-IR) neurons were counted, and the average number was used for statistical analysis. The mean of Fos-IR neurons in myenteric plexus was calculated after counting Fos-IR neurons in 25 ganglia from each antral preparation, and expressed as a mean count per myenteric ganglion.RESULTS: There were a few c-fos-positive neurons in the cervical cord and antrum in the control group. There was an increased c-fos expression in model group 3, 4 and 5 mo after operation, whereas there was no significant increase in c-fos expression in the control group at 3, 4 and 5 mo.More importantly, there was a significant difference in c-fos expression between rats followed up for 3 mo and those for 5 mo in the model group (11.20±2.26 vs 27.68±4.36,P＜0.05, for the cervical cord; and 11.3±2.3 vs 29.3±4.6,P＜0.05, for the gastric antrum). There was no significant difference between rats followed up for 3 mo and those for 4 mo and between rats followed up for 4 mo and those for 5 mo in the model group.CONCLUSION: c-fos expression in gastric myenteric plexus was dramatically associated with that in the spinal cord in rats with cervical spondylosis, suggesting that the gastrointestinal function may be affected by cervical spondylosis. If this hypothesis is confirmed by further studies, functional gastrointestinal diseases such as functional dyspepsia and irritable bowel syndrome could be explained by neurogastroenterology.
文摘AIM: To compare the effects of neurolytic celiac plexus block (NCPB) and videothoracoscopic splanchnicectomy (VSPL) on pain and quality of life of chronic pancreatitis (CP) patients.METHODS: Forty-eight small duct CP patients were treated invasively with NCPB (n = 30) or VSPL (n = 18) in two non-randomized, prospective, case-controlled protocols due to chronic pain syndrome, and compared to a control group who were treated conservatively (n = 32). Visual analog scales were used to assess pain and opioid consumption rate was evaluated. In addition, the quality of life was measured using QLQ C-30 for NCPB and FACIT for VSPL.Although both questionnaires covered similar problems,they could not be compared directly one with another.Therefore, the studies were compared by meta-analysis methodology.RESULTS: Both procedures resulted in a significant positive effect on pain of CP patients. Opioids were withdrawn totally in 47.0% of NCPB and 36.4% of VSPL patients,and reduced in 53.0% and 45.4% of the respective patient groups. No reduction in opioid usage was observed in the control group. In addition, fatigue and emotional well-being showed improvements. Finally, NCPB demonstrated stronger positive effects on social support, which might possibly be attributed to earlier presentation of patients treated with NCPB.CONCLUSION: Both invasive pain treatment methods are effective in CP patients with chronic pain.
