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Objective To explore the clinical efficacy of PRGD composite nerve conduit in the treatment of human large-diameter,critical peripheral nerve defect in upper extremity.Methods From December,2011 to August,2014,19 patients with large-diameter,critical peripheral nerve defect in upper extremity were treated with PRGD composite nerve conduit.The patients were followeded-up periodically.The sensory and motor function recovery,high frequency ultrasound,and EMG were employed to assess the efficacy.Results The patients were followed up for an average time of 12-32 months(mean 21.75 ± 6.86 months),sensory and motor function recovered excellent in 7 patients,satisfactory in 7 patients,tolerable in 3 patients and no improvement in 2 patients were obtained according to the peripheral nerve function assessment standard built by British medical research council,the rate excellent and satisfactory results was 73.7%.Conclusion It is clinically promising to use PRGD composite nerve conduit to repair large-diameter,critical peripheral nerve defect in upper extremity,thus laying a foundation for its further application in clinical practice.
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CONTEXT: Both tacrolimus (FK506) and nerve growth factor (NGF) enhance peripheral nerve regeneration, and in vitro experimental results demonstrate that the combination of FK506 and NGF increased neurite outgrowth compared with either treatment alone. AIM: To determine if the combination of FK506 and NGF benefits peripheral nerve regeneration compared with either treatment alone in vivo. SETTINGS AND DESIGN: Rat sciatic nerves were cut off to form a 10 mm defect and repaired with the nerve conduits. All of the 32 Wistar rats were randomly divided into 4 groups: Group A: RGD peptide modification of poly{(lactic acid)-co-[(glycolic acid)-alt-(L-lysine)]} (PRGD)/FK506/NGF; Group B: PRGD/FK506; Group C: PRGD/NGF; and Group D: autologous nerves. MATERIALS AND METHODS: At 3 months after surgery, the regenerated rat sciatic nerve was evaluated by electrophysiology, calf triceps wet weight recovery rate, and histologic assessment. STATISTICAL ANALYSIS USED: The SPSS 10.0 software (Bizinsight, Beijing China) was used for statistical analysis. RESULTS: The compound muscle action potentials (CMAPs) of groups A and D were significantly stronger than those of groups B and C. The calf triceps wet weight recovery rate of groups A and D were higher than those of groups B and C. The regenerated nerves of groups A and D were more mature than those of groups B and C. There was no significant difference between groups A and D. CONCLUSIONS: PRGD/FK506/NGF sustained-release nerve conduits are more effective in regenerating nerves than both PRGD/FK506 sustained-release nerve conduits and PRGD/NGF sustained-release nerve conduits. The effect is as good as that of an autograft.
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Antineoplásicos/uso terapéutico , Inmunosupresores/uso terapéutico , Factor de Crecimiento Nervioso/uso terapéutico , Regeneración Nerviosa/efectos de los fármacos , Oligopéptidos/uso terapéutico , Neuropatía Ciática/fisiopatología , Tacrolimus/uso terapéutico , Potenciales de Acción/efectos de los fármacos , Animales , Modelos Animales de Enfermedad , Sistemas de Liberación de Medicamentos , Estimulación Eléctrica/métodos , Microscopía Electrónica de Transmisión/métodos , Conducción Nerviosa/efectos de los fármacos , Neuritas/efectos de los fármacos , Neuritas/patología , Neuritas/ultraestructura , Células PC12/citología , Células PC12/efectos de los fármacos , Distribución Aleatoria , Ratas , Ratas Endogámicas BB , Tiempo de Reacción/efectos de los fármacos , Neuropatía Ciática/tratamiento farmacológicoRESUMEN
OBJECTIVE@#To investigate a new way to yield plenty of high purity olfactory ensheathing cells (OECs) and its biocompatibility with appropriate scaffolds.@*METHODS@#OECs were prepared from neonatal Wister rats and co-cultured with poly [LA-co-(Glc-alt-Lys)] (PLGL). Its contact angle, adherent rate, and activity rate were tested.@*RESULTS@#The contact angle of poly (D, L-lactic acid) (PDLLA) (84.5 degree+/-1.5 degree) was significantly higher than that of PLGL (52.6 degree+/-0.8 degree), the adherent rate of PLGL (80%) was significantly higher than that of the PDLLA (57%), and the activity rate of PLGL (88%) was much higher than that of the PDLLA (76%).@*CONCLUSION@#PLGL possesses better hydrophilicity and biocompatibility than PDLLA, and it can provide a better cell growth circumstance which is helpful for the effective treatment of nerve injury.