Chinese expert consensus on emergency surgery for severe trauma and infection prevention during corona virus disease 2019 epidemic (version 2023) / 中华创伤杂志

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Clinical guideline on first aid for blast injury of the chest (2022 edition) / 中华创伤杂志

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.

A novel draw-bar skin stretcher for repair of full-thickness skin defects / 中华创伤骨科杂志

Objective:To evaluate a new type of draw-bar skin stretcher in repair of full-thickness skin defects.Methods:From May 2015 to January 2019, 52 patients with full-thickness skin defects were repaired with a new type of draw-bar skin stretcher at Daping Hospital, Army Medical University. They were 40 males and 12 females, aged from 4 to 61 years (average, 37.1 years). Their skin was stretched for primary wound closure. When primary wound closure failed, skin stretching was performed again to close the wound depending on the wound condition. When the Pinch test was negative after skin stretching, the wound was sutured directly. In cases of positive Pinch test, a skin graft or flap was used to repair the remaining wound. At 12 months after surgery, scar contracture and size of skin graft or flap were observed and wound healing after skin stretching was evaluated in comparison with the original wound.Results:After skin stretching, one-stage wound closure was achieved in 36 cases and multi-stage wound closure in 8 cases; of the remaining 8 cases, 2 were repaired by skin graft and 6 by skin flap after their wounds were reduced by skin stretching. In one-stage closed wounds, infection occurred in 3 cases and marginal necrosis in 5 cases; in the wounds repaired by skin graft or flap, no infection or necrosis was observed. The 12-month follow-up for all the patients showed fine healing of all the wounds after one-stage or multi-stage closure, linear scar, absence of scar contracture, and smaller wound sizes than the original ones after skin graft or flap repair.Conclusions:Skin stretching using our new type of draw-bar skin stretcher is an effective treatment for skin wounds. It can replace traditional skin grafting and flap surgery in some cases, but its indications should be strictly followed to avoid related complications.

Consensus on emergency surgery and infection prevention and control for severe trauma patients during epidemic of corona virus disease 2019 / 中华创伤杂志

Epidemic of corona virus disease 2019 (COVID-19) has occurred in Wuhan, Hubei Province since December 2019, caused by a novel coronavirus (2019-nCoV) never been seen previously in human. China has imposed the strictest quarantine and closed management measures in history to control the spreading of the disease. However, severe trauma can still occur in the COVID-19 patients. In order to standardize the emergency treatment and the infection prevention and control of severe trauma patients with hidden infection, suspected or confirmed infection of 2019-nCoV, Trauma Surgery Branch of Chinese Medical Doctors' Association organized this expert consensus. The consensus illustrated the classification of the COVID-19 patients, severe trauma patients in need of emergency surgery, emergency surgery type, hierarchical protection for medical personnel and treatment places. Meanwhile, the consensus standardized the screening, injury severity evaluation, emergency surgical treatment strategy and postoperative management strategy of severe trauma patients during the epidemic period of COVID-19, providing a basis for the clinical treatment of such kind of patients.

Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel coronavirus pneumonia / 中华创伤杂志

A novel coronavirus pneumonia (NCP) epidemic has occurred in Wuhan, Hubei Province since December 2019, caused by a novel coronavirus (2019-nCoV) never been seen previously in human. China has imposed the strictest quarantine and closed management measures in history to control the spreading of the disease. However, severe trauma can still occur in the NCP patients. In order to standardize the emergency treatment and the infection prevention and control of severe trauma patients with hidden infection, suspected or confirmed infection of 2019-nCoV, Trauma Surgery Branch of Chinese Medical Doctors' Association organized this expert consensus. The consensus illustrated the classification of the NCP patients, severe trauma patients in need of emergency surgery, emergency surgery type, hierarchical protection for medical personnel and treatment places. Meanwhile, the consensus standardized the screening, injury severity evaluation, emergency surgical treatment strategy and postoperative management strategy of severe trauma patients during the epidemic period of NCP, providing a basis for the clinical treatment of such kind of patients.

Effect of papaverine on wound healing of full-thickness skin defect after skin stretching / 中华创伤杂志

Objective@#To investigate the effect of papaverine on wound healing of full-thickness skin defect after skin stretching in swine.@*Methods@#Eight Bama pigs were prepared. Standard full-thickness skin defect for 7 cm×7 cm was produced in the middle part of each pig's forelimb, and skin traction was used to close the wound. According to random number table method, the pigs were divided into experiment group and control group, with four pigs in each group. Percutaneous oxygen partial pressure (TcPO2) was compared preoperatively and postoperatively. Wound healing clinical score was evaluated four and 10 days after operation. Weidner counting method was employed to determine the microvascular density (MVD) of the wound edge tissue 0 and 10 days after operation. Immunohistochemistry was used to observe the expression of hypoxia inducible factor 1-α (HIF- 1α) and vascular endothelial growth factor (VEGF) 0, 4 and 10 days after operation.@*Results@#There was no statistically significant difference in TcPO2 between the experiment group [(55.1±5.4)mmHg] and the control group [(54.7±5.9)mmHg] before skin stretching (P>0.05), while statistically significant difference was found after stretching [(22.7±3.3)mmHg vs. (16.4±3.4)mmHg] (P<0.01). There was no statistically significant difference in clinical wound healing scores between the control group and experiment group 4 days after skin stretching [(2.6±0.7)points vs. (2.1±0.4)points] (P>0.05), but better result was found in experiment group compared with the control group in 10 days [(1.3±0.5)points vs. (4.6±0.7)points] (P<0.01). MVD of skin tissue showed no statistically significant difference between the control group (8.5±1.3) and the experiment group (9.3±1.2) immediately after skin stretching (P>0.05), while the MVD of wound skin tissue in the experiment group (29.5±4.8) was significantly higher than that in the control group (21.1±3.4) 10 days after skin stretching (P<0.01). After skin stretching, the HIF-1 alpha expression in experiment group was significantly higher than the control group 4 days after skin stretching [(50.0±7.0) vs. (38.6±7.0)] (P<0.01), but no statistical significance was found between that at 0 day and 10 days(P>0.05). The expression of VEGF in the wound skin tissues of the experiment group was significantly higher than that of the control group [(49.9±10.8) vs. (39.2±6.3)] at 4 days after skin stretching (P<0.05), while no statistically significance was found at 0 and 10 days (P>0.05).@*Conclusion@#For full-thickness skin defect after skin stretching in pigs, papaverine can alleviate small vessel spasm, improve skin edge oxygen supply, and promote the growth of microvessels, thus promoting the healing, which might be associated with the increase of HIF-1ɑ and VEGF expression.

Analysis on risk factors for deep venous thrombosis of lower extremities after hip fracture / 中华创伤杂志

Objective@#To investigate the risk factors of deep venous thrombosis (DVT) of lower extremities after hip fracture and provide reference for the prevention of DVT.@*Methods@#A retrospective case-control study was conducted to analyze the clinical data of 167 patients with hip fracture admitted to Daping Hospital of Army Medical University from January 2016 to December 2016, including 75 males and 92 females, aged 18.7-90.3 years [(70.4±17.7)years]. Using the positive results of ultrasound as the standard for confirming the diagnosis of DVT, 79 patients (47.3%) were assigned to the DVT group, and 88 patients (52.7%) to the non-DVT group. Patients' age, gender, body mass index (BMI), smoking history, D-dimer level, osteoporosis, venous thrombosis risk stratification score (RAPT), coronary heart disease, hypertension, diabetes history, anesthesia method (general anesthesia or nerve blocking), type of surgery (joint replacement or internal fixation), operation time were included in the analysis. The correlation between DVT and the above indices was explored through univariate analysis, followed by logistic regression analysis to determine the risk factors of lower extremities DVT after hip fracture.@*Results@#The univariate analysis showed that smoking history, D-dimer level, BMI, RAPT score, hypertension, diabetes, coronary heart disease, anesthesia method and operation time were significantly associated with lower extremities DVT after hip fracture. According to the logistics regression analysis, smoking (OR=9.403, P<0.05). D-dimer (OR=0.999, P<0.01), BMI(OR=0.603, P<0.01), RAPT score (OR=0.499, P<0.05), hypertension (OR=28.965, P<0.01), diabetes(OR=6.948, P<0.05), coronary heart disease (OR=17.185, P<0.01), operation time (OR=36.830, P<0.01) were significantly correlated with newly formed lower extremities DVT after hip fracture.@*Conclusions@#Smoking, D-dimer level, obesity (BMI≥25 kg/m2), RAPT score, hypertension, diabetes, coronary heart disease and operation time (≥150 minutes) are independent risk factors for lower extremities DVT after hip fracture. D-dimer level detection shows early diagnostic value for hip fracture with DVT. RAPT score can effectively evaluate DVT in trauma patients, thus guiding and preventing the occurrence of DVT.

Effect of papaverine on wound healing of full-thickness skin defect after skin stretching / 中华创伤杂志

Objective To investigate the effect of papaverine on wound healing of full-thickness skin defect after skin stretching in swine. Methods Eight Bama pigs were prepared. Standard full-thickness skin defect for 7 cm × 7 cm was produced in the middle part of each pig 's forelimb, and skin traction was used to close the wound. According to random number table method, the pigs were divided into experiment group and control group, with four pigs in each group. Percutaneous oxygen partial pressure ( TcPO2 ) was compared preoperatively and postoperatively. Wound healing clinical score was evaluated four and 10 days after operation. Weidner counting method was employed to determine the microvascular density (MVD) of the wound edge tissue 0 and 10 days after operation. Immunohistochemistry was used to observe the expression of hypoxia inducible factor 1-α ( HIF- 1α) and vascular endothelial growth factor (VEGF) 0, 4 and 10 days after operation. Results There was no statistically significant difference in TcPO2 between the experiment group [(55. 1 ± 5. 4)mmHg] and the control group [(54. 7 ± 5.9)mmHg] before skin stretching (P>0.05), while statistically significant difference was found after stretching[(22.7±3.3)mmHg vs. (16.4±3.4)mmHg] (P <0.01). There was no statistically significant difference in clinical wound healing scores between the control group and experiment group 4 days after skin stretching [(2.6 ±0.7)points vs. (2.1 ±0.4)points] (P>0.05), but better result was found in experiment group compared with the control group in 10 days [(1. 3 ± 0. 5)points vs. (4. 6 ± 0. 7)points] (P<0. 01). MVD of skin tissue showed no statistically significant difference between the control group (8. 5 ± 1. 3) and the experiment group (9. 3 ± 1. 2) immediately after skin stretching ( P>0. 05), while the MVD of wound skin tissue in the experiment group (29. 5 ± 4. 8) was significantly higher than that in the control group (21. 1 ± 3. 4) 10 days after skin stretching (P<0. 01). After skin stretching, the HIF-1 alpha expression in experiment group was significantly higher than the control group 4 days after skin stretching [(50. 0 ± 7. 0) vs. (38. 6 ± 7. 0)] (P < 0. 01), but no statistical significance was found between that at 0 day and 10 days(P>0. 05). The expression of VEGF in the wound skin tissues of the experiment group was significantly higher than that of the control group [(49. 9 ± 10.8) vs. (39.2 ±6.3)] at 4 days after skin stretching (P<0.05), while no statistically significance was found at 0 and 10 days (P>0. 05). Conclusion For full-thickness skin defect after skin stretching in pigs, papaverine can alleviate small vessel spasm, improve skin edge oxygen supply, and promote the growth of microvessels, thus promoting the healing, which might be associated with the increase of HIF-1ɑand VEGF expression.

Analysis on risk factors for deep venous thrombosis of lower extremities after hip fracture / 中华创伤杂志

Objective To investigate the risk factors of deep venous thrombosis ( DVT) of lower extremities after hip fracture and provide reference for the prevention of DVT. Methods A retrospective case-control study was conducted to analyze the clinical data of 167 patients with hip fracture admitted to Daping Hospital of Army Medical University from January 2016 to December 2016, including 75 males and 92 females, aged 18. 7-90. 3 years [(70. 4 ± 17. 7)years]. Using the positive results of ultrasound as the standard for confirming the diagnosis of DVT, 79 patients (47. 3％) were assigned to the DVT group, and 88 patients (52. 7％) to the non-DVT group. Patients' age, gender, body mass index ( BMI), smoking history, D-dimer level, osteoporosis, venous thrombosis risk stratification score ( RAPT ) , coronary heart disease, hypertension, diabetes history, anesthesia method ( general anesthesia or nerve blocking), type of surgery (joint replacement or internal fixation), operation time were included in the analysis. The correlation between DVT and the above indices was explored through univariate analysis, followed by logistic regression analysis to determine the risk factors of lower extremities DVT after hip fracture. Results The univariate analysis showed that smoking history, D-dimer level, BMI, RAPT score, hypertension, diabetes, coronary heart disease, anesthesia method and operation time were significantly associated with lower extremities DVT after hip fracture. According to the logistics regression analysis, smoking (OR=9. 403, P<0. 05). D-dimer (OR=0. 999, P<0. 01), BMI(OR=0. 603, P<0. 01), RAPT score (OR=0. 499, P<0. 05), hypertension (OR=28. 965, P<0. 01), diabetes (OR=6. 948, P<0. 05), coronary heart disease (OR=17. 185, P<0. 01), operation time (OR=36. 830, P<0. 01) were significantly correlated with newly formed lower extremities DVT after hip fracture. Conclusions Smoking, D-dimer level, obesity ( BMI≥25 kg/m2 ) , RAPT score, hypertension, diabetes, coronary heart disease and operation time (≥150 minutes) are independent risk factors for lower extremities DVT after hip fracture. D-dimer level detection shows early diagnostic value for hip fracture with DVT. RAPT score can effectively evaluate DVT in trauma patients, thus guiding and preventing the occurrence of DVT.

The role of Osterix in controlling bone volume in vertebral body / 重庆医学

Objective To observe the role of Osterix in controlling bone volume in vertebral body and to investigate the possible mechanism .Methods X-ray radiology ,micro CT and HE staining were used to evaluate the change of bone volume in both Osterix knockout and transgenic mice .TRAP staining was used to assess the activity of osteoclasts and immunohistochemistry was used to examine the expression level of RANKL .Results No obvious changes were found in Osterix transgenic mice ,while X-ray examina-tion ,micro CT and HE staining showed that the bone density and bone volume in the lumbar vertebral body increased significantly in OSX null mice 12 weeks after birth .TRAP staining showed that the number of osteoclasts decreased in OSX null mice .IHC re-vealed that the expression level of RANKL was down-regualted in OSX null mice .Conclusion Osterix play an important role in controlling bone volume of vertebral body in mice .

Tissue-engineered neural complex seeded in modified collagen scaffold for treatment of acute spinal cord injury in adult rats / 中华创伤杂志

Objective To repair the injured spinal cord in adult rats using tissue-engineered neural complex constructed in vitro by tissue engineering techniques and discuss the treatment effect.Methods Neural stem cells (NSCs) from rats were cultured separately and modified collagen scaffold was also prepared to construct complex of NSCs /modified collagen scaffold in vitro.Embryo spine cord extract was administered to induce differentiation of NSCs,the structure of which was revealed by histochemical technique and scanning electron microscope.The rat models of hemisected spinal cord injury were built and grafted with tissue-engineered neural complex.Functional recovery of the models was evaluated every two weeks postoperatively.Effect in repair of spinal cord injury was assessed by histological method at postoperative three and eight weeks.Results After tissue-engineered neural complex planted in the modified collagen scaffold was grafted into the injured spinal cord in adult rats,the seed cells survived and further differentiated into functionally active neurons.The differentiated glia cells presented quite regular reticular structure.Motor function below the level of the injured spinal cord in adult rats obtained obvious recovery.Conclusion Tissue-engineered neural complex seeded in the modified collagen scaffold takes effect in structural reconstruction and functional recovery of the injured spinal cord in adult rats.

Four emergency fixation methods for multiple trauma patients combined with open tibiofibular fractures: a comparative study / 中华创伤杂志

Objective To comparethe effects of four different emergency fixation methods for the open tibiofibular fractures on the treatment and prognosis of the multiple trauma patients. Methods A comparative study was carried out on the effect offour different early fixation methods on the fracture and the multiple trauma in aspects of the short-term indicators including mortality rate,acute respiratory distress syndrome(ARDS),fat embolism syndrome(FES),multiple organ dysfunction syndrome (MODS),ICU stay and the long-term indicators including wound healing time,fracture healing time,rate of joint function recovery and fracture complications in 43 multiple trauma patients. Results The locked intramedullary nail wag better than the other fLxation methods including the calcaneal traction,the gypsum external fixation and the internal fixation with steel plate and extemal fixation support in most indexes(P<0.05,0.01). Conclusion The locked intramedullary nail can significantly decrease the incidence rate of complications and obtain sound fracture healing for the patients with multiple trauma combined with open tibiofibular fractures(types Gnstilo Ⅰ,Ⅱ and Ⅲa).

The study of using standardized patients acted by teachers to clinical practicing teaching in traumato-osteology / 中华医学教育探索杂志

Objective To explore the effects of using standardized patients(SP)to clinical practicing teaching in traumato-osteology. Methods The records of theory exam, case aggregate analysis ability and clinical technical skills of the SP teaching group (SP group) and traditional teaching group(T group) were compared. Results The records of theory exam of the two groups had no significant difference (86.5 ±9.5 VS 82.3 ± 11.7,P>0.05). However, the case aggregate analysis ability of SP group (78.3 ±9.7) was obviously higher than that in control group (65.3 ±7.7), and the records of clinical technical skills of SP group were not significantly higher than control group (85.6 ±9.4 VS72.4 ± 11.6,P>0.05) . More of the students were generally satisfied with SP teaching model. Conclusion The using of SP acted by teachers is helpful to enhancing the clinical skills and thinking and maybe a considerable assisting teaching method in traumato-osteology.

Risk factor analysis of traumatic fractures combined with lower limb deep vein thrombosis / 中华创伤杂志

Objective To explore the risk factors of lower limb deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT. Methods A total of 1 068 patients with traumatic fractures were involved in the study to analyze the incidence of DVT under 43 risk factors including general state, injury type, fracture condition and operation and screen significant factors for multiple factor analysis. Results The total incidence rate of DVT in 1 068 patients was 12.0%. The univariate analysis showed that male patients at age ＞60 years, with BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension, coronary artery disease and cerebrovascular disease had higher incidence rate of DVT. In different injury types, the fall injury caused the highest incidence rate of DVT (45.6%). There were different DVT rates for different fracture position,with the highest incidence rate of DVT for femur shaft fracture (20.5%). The incidence rate of DVT was 51.7% for fractures of more than three parts, 14.2% for fractures of two parts and only 3.7% for sole part. The incidence rate of DVT for comminuted fractures was higher than the overall rate. The operation duration, massive transfusion during operation and epidural anesthesia were related with the increase of incidence of DVT. Multivariate analysis found nine independent risk factors and showed that the more risk factors were, the higher incidence of DVT was. Conclusions The risk factors of DVT for traumatic fractures include age ＞60 years, BMI≥25 kg/m2, history of smoking, fall injury, more than three parts of fractures, comminuted fractures, operation duration ＞ 2 hours, massive transfusion during operation and epidural anesthesia.

Extremity-preserving efficacy of vascular prosthesis grafting in repairing arterial injuries of extremities / 中国组织工程研究

BACKGROUND: Vascular injuries of the extremitiesy are frequently concomitant with vascular defects and are usually repaired by autologous vessel grafting. However, the source of autologous vessels is limited and the preparation of them is traumatic.OBJECTIVE: To retrospectively evaluate the extremity-preserving efficacy of vascular prosthesis grafting in repairing major vascular injuries of the extremities in 29 cases.DESIGN: A retrospective study.SETTING: Department of Orthopedics and Traumatic Surgery, Center for Battle Wound and Trauma of Chinese PLA, Research Institute of Surgery,Daping Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: We selected 29 patients with major vascular injuries of the extremities repaired by vascular prosthesis grafting who received the treatment at the Department of Orthopedics and Traumatic Surgery of the Center for Battle Wound and Trauma of the Chinese PLA of the Research Institute of Surgery of, Daping Hospital of the Third Military Medical University of Chinese PLA between January 1989 and December 2000. There were 23 males and 6 females. Injury sites: 9 cases were at subclavian artery, 6 at axillary artery, 2 at brachial artery, 10 at femoral artery, 1 at femoral vein and 1 at popliteal artery. 11 of these 29 cases (37.9%) were complicated with shock, 8 with fractures and dislocations, 5 with peripheral nerve injuries and 3 with infections.METHODS: The vascular prosthesis was anastomosed end to end with the trimmed culprit vessels. As for the 3 cases with infective arterial injuries,the vessels were placed away from the infected region and were bridged together in a non-inf1ammatory region and then muscles or musculo-cutaneous flaps were used to cover the infected regions.The functions of the extremities of the patients were evaluated according to MAS at week 2 and 1 year after the operation.MAIN OUTCOME MEASURES: The vascular patency rate and the extremity-preserving outcomes..RESULTS: All 29 patients entered the stage of result analysis. Extremitypreserving efficacy: All the patients who underwent vascular prosthesis grafting had their extremities preserved. Only 1 patient had the late sequelae of ulcers in the foot sole due to extended extremity ischemia and nerve damage. The rate of 2-week patency rate of the grafted vessels was 100% and the 1-year rate of patency was 96.5%, as revealed by Doppler blood stream scanning. The excellent and good rate of the function of extremity was 89%.CONCLUSION: Vascular prosthesis grafting is the one of the methods for repairing the major vascular injuries so as to preserve the extremities and their functions.

Application of Evidence-based Medicine in Clinical Teaching / 中华医学教育探索杂志

Evidence-based medicine(EBM)advocates finding problems in clinical practice,searching for the best evidence,appraising and analyzing comprehensively the acquired evidence,and then applying the evidence to direct the diagnosis,therapy and prognosis of diseases.Our experiences showed that the application of EBM in clinical teaching could help the students improve their clinical intellection,clinical skills and innovation ability.

Experience of Clinical Education in Orthopedics / 中华医学教育探索杂志

In our 6 years experience of clinical education,we think that sufficient preparation of the teachers and the interaction with the students is very important.Especially,the improvement on education method and the applications of multimedia are also a helpful technique.

The effect of vascular pediceled peripheral nerve tissue grafting in repair spinal cord injury / 中国康复医学杂志

Objective:To observe the repairment effects of vascular pediceled nervous tissue on adult rat＇s spinal cord injury. Method:A 5mm cord defect of the left lateral column was made at Ti-3 vertebral level,and then the defect was grafted randomly using vascdarized peripheral nerve (Group VPN),embryonic day 14 fetal spinal cord(Group FSC) or vascular pediceled peripheral nerve and fetal spinal cord(Group V + F).8 weeks after surgery, the survival,differentiation of the grafts, and the ability of repaired host spinal cord were assessed. Result: In VPN-FSC co-graft group, peripheral nerve segment was extensively vascularized and well innervated,plenty of Schwann cells survived and proliferated. In this group, anti-NF, S-100 positives fibers were significantly greater than group VPN (P＜0.01). The fetal implant was intimately fused with the host CNS parenchyma, the volume, nerve fibers and neurons density of the fetal implant were significantly higher than Group FSC(P＜0.01). The majority of neurons in this group were well differentiated, well-developed and synapses were scattered throughout the neuropil. SEP assessments showed that the latgncy of P1 ,N1 wave was significantly decreased in this group (P＜0.01).Conclusion:The vascular pediceled peripheral nerve could prompt the development of fetal implant and support the regeneration of central injured axons to certain degrees.

The survival and migration of Schwann cells after peripheral nerve grafted into spinal cord / 中华显微外科杂志

Objective To compare the survival of Schwann cells and the effects of induce axon regeneration after peripheral nerve grafted into spinal cord Methods A total of 30 adult,female Wistar rats were used in this study,and a 5 mm cord defect of the left lateral column was made at T 1 3 vertebral level The defect was grafted randomly using vascularized (group VN) or free peripheral nerve (group PN) respectively 8 weeks after surgery,the survival and proliferation of Schwann cells were assessed by histological,histomorphometric analysis Results In group VN,peripheral nerve segment was well innervated,plenty of Schwann cells were survived and proliferated In this group,anti NF,S 100 positives fibers were significantly greater than group PN Conclusion The vascularized peripheral nerve could prompt the survival and proliferation of Schwann cells and support the regeneration of central injured axons to certain degrees