ABSTRACT
Objective:To observe the effect that covering the nerve suture with CSPGs-gelatin sleeve after the sciatic nerve transection in SD rats, and evaluate its effect to improve nerve regeneration in peripheral nerve transection model.Methods:Covered and protected the sciatic nerve by end-to-end suture in the SD rats with CSPGs-gelatin sleeve. From July, 2019 to September, 2019, 24 SD rats were randomly and evenly divided into 3 groups, which were direct suture group, gelatin sleeve group without CSPGs (blank group), and CSPGs-gelatin sleeve group (CSPGs group). In each group, 3 rats were used to mark fluorescent gold at 5 weeks after operation. At 6 weeks after operation, histological and electrophysiological tests were performed to evaluate the tissue regeneration in the end to end suture and the effect of peripheral nerve regeneration after transection in the other 5 rats. One-way ANOVA was used for data analysis. If the difference between groups was statistically significant, LSD method would be further used for pairwise comparison. P<0.05 was considered statistically significant. Results:The escape distances in direct suture groups, blank group and CSPGs group groups were (787.19±213.77) μm, (547.17±167.71) μm and (350.60±68.58) μm, respectively; The numbers of the axons that grow into the distal basement membrane tube in 3 groups were (6 360±736.89) /mm 2, (8 040±673.05) /mm 2 and (9 000±644.20) /mm 2, respectively; The numbers of sensory nerve cells that were marked by fluorescent gold in the dorsal root ganglion were (124.35±25.88) /mm 2, (165.36±30.74) /mm 2 and (208.98±20.51) /mm 2 in 3 groups, respectively. The differences were significant compared with the CSPGs-gelatin sleeve group ( P<0.05). Thus, it led to a better nerve regeneration after transection in CSPGs-gelatin sleeve group according to the electrophysiological test and histological section observation of gastrocnemius muscles( P<0.05). Conclusion:CSPGs loaded in the gelatin sleeve can inhibit axons regeneration, and prevent the regenerated axons escaping from the end to end suture that may cause disorder axons regeneration or traumatic neuroma, and therefore improve the effective nerve regeneration after sciatic nerve injury in SD rat.
ABSTRACT
As continuous progressive improvement in microsurgery, the postoperative evaluation of severed limbs replantation has been developed from the survival to the functional recovery of replanted extremity. In 1978, Chen Zhongwei devised a system for the function evaluation of the replants, considering "the ability to work, range of motion, recovering of sensation, and recovering of muscle power". This system was called "CHEN’s criteria" and it is still internationally used. In recent years, new parameters and measuring methods have been created without an agreed international standard. This article serves the purpose to offer a reference in the standardization and promotion of a practical standard for the postoperative functional evaluation of severed limb replantation.
ABSTRACT
Objective To investigate the anatomical basic of extensor carpi radialis brevis (ECRB) tendon transferring to extensor pollicis longus (EPL) tendon.Methods Twelve sides of ECRB and EPL in fresh adult cadaver's forearms were collected,and the anatomical model of ECRB transferring to EPL was set up in all the forearms.The anatomical parameters of EPL were measured before and after anatomical model established.Results The effective transferring length of ECRB was (3.5±0.8)cm;the maximum circumferential of ECRB and EPL were (8.5±0.8)cm and (3.6±0.3)cm (P ＞0.05),the ratio of muscle cross-sectional area was 5.57;After the anatomical model setting up,anatomic angles of EPL was (30±7)°,which was a decrease of (20±5) ° comparing with the preoperative angel of (50±9) ° (P ＞0.05);Thumb extension angle was (50± 12) °,which was a decrease of (8±3) ° comparing with the preoperative angel of (58 ± 16) ° (P＜0.05);The dorsal extension angle of first metacarpal was (12±5)o,which was a decrease of (3± 2) o comparing with the preoperative angle (15±8)° (P＞0.05);Thumb tip lifting height was (2.3±0.9) c m,which was a decrease of (1.2±0.6)cm comparing with the preoperative height (3.5±1.2)cm (P ＞0.05).Conclusion Based on the measurement of the anatomic parameters of ECRB and EPL,the ECRB has enough length and muscle force to reconstruct the function of EPL.The thumb had a good extension appearance and accorded with the rule of biomechanics after setting up the anatomical model of ECRB transferring to EPL.This study will provide the anatomical evidence for further clinical application