恒河猴旋前圆肌肌支神经套接修复尺神经：存在神经轴突再生的倍数扩增.doc

SICENCE新闻发布 作者：寇玉辉 稿号：NRR_281_14恒河猴旋前圆肌肌支神经套接修复尺神经：存在神经轴突再生的倍数扩增周围神经转位修复是临床常规神经修复技术无法实施的情况下采用的一种修复方法， 主要用于周围神经根性撕脱性损伤和长段神经缺损。在神经转位修复中，由于选用的供体神经多为细小的、非重要神经，而被修复的神经，则通常为粗大的、重要神经，既往的神经转位修复往往会存在供体神经纤维数量过少，引起修复神经的支配神经的动力不足，影响神经功能。周围神经修复再生过程中存在多芽再生的特性，近年来随着对周围神经这一特殊再生特性的重新认识，神经转位修复的临床意义和应用前景有了全新的认识和评估。来自中国北京大学人民医院和北京大学交通医学中心姜保国教授领导的团队前期系统地对周围神经多芽再生进行了研究，证实在一定供体/受体神经纤维比例情况下，可以使受体神经纤维得到绝大部分神经再支配。该团队在前期研究基础上，设计了以恒河猴为实验动物，建立旋前圆肌肌支修复尺神经缺损模型，小间隙套接缝合法将旋前圆肌肌支近端与尺神经远端套接缝合，6个月后恒河猴患肢尺侧可恢复2指屈曲运动和轻度的屈腕运动；神经电生理测量到恒河猴修复侧神经运动神经传导速度可达（22.636.34）m/s，锇酸染色发现供体旋前圆肌肌支神经有髓神经纤维为（1,657652）根，修复尺神经有髓神经纤维为（2,661843）根，再生有髓神经再生倍数扩增率为1.61。进一步证实旋前圆肌肌支神经再生的神经纤维可以有效再生，并在一定程度恢复受损尺神经功能，且在这种修复模式下，修复后的尺神经轴突存在再生倍数扩增现象。相关文献发表于中国神经再生研究（英文版）杂志2015年1月第1期。锇酸染色显示，旋前圆肌肌支修复尺神经损伤恒河猴模型，经小间隙套接缝合法缝合6个月后，近端旋前圆肌肌支内有髓神经纤维形态结构接近正常尺神经组织结构，神经纤维均匀密集排列Article: Sleeve bridging of the rhesus monkey ulnar nerve with muscular branches of the pronator teres: multiple amplifcation of axonal regeneration, by Yu-hui Kou, Pei-xun Zhang, Yan-hua Wang, Bo Chen, Na Han, Feng Xue, Hong-bo Zhang, Xiao-feng Yin, Bao-guo Jiang (Department of Trauma and Orthopedics, Peking University Peoples Hospital, Beijing, China)Kou YH, Zhang PX, Wang YH, Chen B, Han N, Xue F, Zhang HB, Yin XF, Jiang BG (2015) Sleeve bridging of the rhesus monkey ulnar nerve with muscular branches of the pronator teres: multiple amplification of axonal regeneration. Neural Regen Res 10(1):53-59.欲获更多资讯：Neural Regen Res Multiple amplification of axonal regeneration in regenerating nerve fibers Peripheral nerve transfer is a common method for treating peripheral nerve injury of proximal donor deficiency and has been extensively used to treat brachial plexus injury and long-segment nerve defects. For the nerve transfer, the majority of the selected donor nerves are tiny and not important ones, while the nerves to be repaired are often thick and important ones. In the previous nerve transfer, donor nerve fibers are not insufficient in amount, leading to poor neurological function. Multiple-bud regeneration, i.e., multiple amplification of nerve regeneration, has been shown in peripheral nerve regeneration. In recent years, with a thorough understanding of peripheral nerve regeneration, the clinical significance and application prospect of nerve transfer has been re-recognized. Bao-guo Jiang, Peking University Peoples Hospital, China and his colleagues confirmed that under optimal proportion of receptor to donor nerve fibers, the majority of receptor nerve fibers are re-innervated. Based on previous studies, they established rhesus monkey models of distal ulnar nerve defects and repaired using muscular branches of the right forearm pronator teres. Proximal muscular branches of the pronator teres were sutured into the distal ulnar nerve using the small gap sleeve bridging method. At 6 months after suture, two-finger flexion and mild wrist flexion were restored in the ulnar-sided injured limbs of rhesus monkey. Neurophysiological examination showed that motor nerve conduction velocity reached 22.63 6.34 m/s on the affected side of rhesus monkey. Osmium tetroxide staining demonstrated that the number of myelinated nerve fibers was 1,657 652 in the branches of pronator teres of donor, and 2,661 843 in the repaired ulnar nerve. The rate of multiple amplification of regenerating myelinated nerve fibers was 1.61. These data showed that when muscular branches of the pronator teres were used to repair ulnar nerve in primates, effective regeneration was observed in regenerating nerve fibers, and functions of the injured ulnar nerve were restored to a certain extent. Moreover, multiple amplification was subsequently detected in ulnar nerve axons. These results were published in Neural Regeneration Research (Vol. 10, No. 1, 2015).At 6 months after model establishment, osmium tetroxide staining results reveal that myelinated nerve fibers in the proximal muscular branches of the pronator teres were uniform and densely arranged, and their morphology and structure were similar to that of normal nerve tissue. Article: Sleeve bridging of the rhesus monkey ulnar nerve with muscular branches of the pronator teres: multiple amplifcation of axonal regeneration, by Yu-hui Kou, Pei-xun Zhang, Yan-hua Wang, Bo Chen, Na Han, Feng Xue, Hong-bo Zhang, Xiao-feng Yin, Bao-guo Jiang (Department of Trauma and Orthopedics, Peking University Peoples Hospital, Beijing, China)Kou YH, Zhang PX, Wan