OBJECTIVE: To observe the strength of thigh muscles after reconstruction of anterior cruciate ligament by autogenous bone-patellar tendon-bone graft. METHODS: Twenty-three patients, 9 males and 14 females, were followed up one year after reconstruction of the anterior cruciate ligament with autogenous bone-patellar tendon-bone graft. Through arthroscope, no intra-articular derangement was found. The strengths of isometric and isotonic contractions of the quadri ceps and the hamstrings muscles of the affected and contralateral thighs were recorded. RESULTS: The donor side for autogenous bone-patellar tendon-bone graft showed significant decrease (P lt; 0.01), but no effect on that of the hamstrings muscle(P gt; 0.05). CONCLUSION: To reconstruct the anterior cruciate ligament, harvest of the bone-patellar tendon-bone graft as a reparative material may markedly lower the strength of the quadriceps femoris muscle.
Objective To study and compare the effect of end-to-end and end-to-side neurorrhaphy between the reci pient’s musculocutaneous nerve and the donor’s ulnar nerve, and to observe the regeneration of peri pheral nerve and muscle refection. Methods Sixty male SD rats (weighing 200-250 g) were randomized into 2 groups (n=30 per group), and made the musculocutaneous nerve injury model. In group A, the donor’s nerve was transected for end-to-end neurorrhaphy.In group B, an epineurial window was exposed and the distal end of the muscle branch of musculocutaneous nerve was sutured to the side of the ulnar nerve. Electromyography was performed, biceps wet weight ratio, muscle fiber cross-sectional area, and count of myel inated nerve fiber (CMF) were measured at 4 and 12 weeks postoperatively. The behavior changes of the rats were observed. Results At 4 weeks, the nerve conduction velocity (NCV) and the latency ampl itude (AMP) of group A were significantly higher than those of group B (P lt; 0.05); at 12 weeks, there was no significant difference in the NCV and AMP between groups A and B (P gt; 0.05). At 4 and 8 weeks, there was no significant difference in biceps wet weight ratio and muscle fiber cross-sectional area between groups A and B (P gt; 0.05). At 4 weeks, the CMF was 230.15 ± 60.25 in group A and 160.73 ± 48.77 in group B, showing significant difference (P lt; 0.05); at 12 weeks, it was 380.26 ± 10.01 in group A and 355.63 ± 28.51 in group B, showing no significant difference (P gt; 0.05). Conclusion Both end-to-end and end-to-side neurorrhaphy have consistent long-term effect in repair of brachial plexus upper trunk injury.
To investigate the objective method for electrophysiological examination in evaluating the functional recovery in motor nerve regeneration, 30 rabbits were divided into 5 groups randomly. The common peroneal nerve on left side of every rabbit was sectioned and repaired by epineural suture, while that of the right side was left intact as control. In 2nd, 4th, 8th, 12th and 16th week after operation, the muscle power and the changes of the electrophysiological parameters of the nerve and the muscle were determined dynamically. The linear correlation analysis was used to assess their relationship. The results showed that the electrophysiological parameters and muscle contractibility revealed signs of recovery in parallel. There was a significant linear relationship among the amplitude of the muscle action potential, velocity of nerve-muscle conductivity and muscle contractibility. The conclusion was that the electrophysiological examination of motor nerve and muscle could be used to assess the regeneration of the motor nerve, and it would also reflect the recovery of muscle contactibility in the early stage.
Objective To investigate the early change of brain-derived neurotrophic factor (BDNF) in denervated red and white muscles and the regeneration of nerves innervating the muscles and to discuss the effect of the target organs on regeneration of the injured nerves.Methods Forty Wistar rats were divided into 5 groups. The sciatic nerves in 4 groups were sheared to make the models of the denervated muscles and the other one as control group. The amount of BDNF in muscles was measured with immunohistochemistry 1 day, 3 days, 7 days and 14 days after injury. The models of the regeneration of the nerves were made in another 15 rats whose sciatic nerves were disconnected with forceps. The nerve conduction velocity and electromyogram were tested with neuroelectrophysiology7 days and 14 days after injury. Results The expression of BDNF in soleus increased significantly on the 1st day, the 3rd day and the 7th day (P＜0.01); theexpression ingastrocnemius was lower, but there was no significant difference(P＞0.05) on the 1st day, the 3rd day,the 7th day and the 14th day when compared with control group. After 14 days of injury in the nerves innervating GAS and SOL, the nerve conduction velocities and the amplitudes of wave M recovered to (36.60±7.40)% and (19.9±6.4)% of normal value, and (42.50±3.50)% and (13.7±4.0)% of normal value respectively; there were no significant differences between the two muscles(P＞0.05).Conclusion There is- difference in BDNF amount between the denervated red and white muscles, but the recovery of the two kinds of the motornerves is similar,and the neurotrophism of denervated muscles was determined by all kinds of neurotrophic factors.
Objective To observe the expressions of CXC chemokine receptor 4 (CXCR4) in muscle satell ite cells in situ of normal and cardiotoxin-intoxicated muscle tissues so as to further investigate the molecular mechanism involving inmuscle regeneration such as progressing muscular dystrophy (PMD) for seeking the way to cure muscle retrogression. Methods The muscle injured model of 12 C57 male mice was made by injecting cardiotoxin (5 μg per mouse) in left quadriceps femoris, their right quadriceps femoris was used as control without any injection. The histological, immunohistochemical analysis and RT-PCR were done to investigate the expression of CXCR4 in the quadriceps femoris in situ after 1 day, 4 days, 1 week, 2 weeks, 4 weeks and 6 weeks. Results HE staining results demonstrated that the muscle tissues experienced the process from muscle injury, repair to regeneration. The result of immunohistochemistry showed that the expressions of CXCR4 in injured muscle tissue were 1 955.6 ± 150.3, 2 223.2 ± 264.3, 2 317.6 ± 178.7, 3 066.5 ± 269.6, 1 770.9 ± 98.7 and 1 505.7 ± 107.1 at 1 day, 4 days, 1 week, 2 weeks, 4 weeks and 6 weeks after injection of cardiotoxin, there was significant difference when compared with normal muscle (640.3 ± 124.0, P lt; 0.001). The RT-PCR showed that the expressions of CXCR4 mRNA in injured muscle tissue were0.822 ± 0.013, 0.882 ± 0.025, 1.025 ± 0.028, 1.065 ± 0.041, 0.837 ± 0.011 and 0.777 ± 0.015 at 1 day, 4 days, 1 week, 2 weeks, 4 weeks and 6 weeks after injection of cardiotoxin, there was significant difference when compared with normal muscle (0.349 ± 0.006, P lt; 0.001). Conclusion CXCR4 may be the critical protein in the process of muscle impairment and reparation.
Objective To observe the influence of the transforming growth factor β1(TGF-β1) on the denervated mouse musclederived stem cells（MDSCs） producing the connective tissue growth factor（CTGF）at different time points in vitro. Methods MDSCs from the primarycultureof the denervated mouse skeletal muscle were isolated and purified by the preplate technique, and they were identified before the culture and after the culturein vitro with TGF-β1 (10 ng/ml) for 24 hours. Then, MDSCs were randomlydivided into 6 groups (Groups A, B, C, D, E and F) according to the different time points, and were cultured in vitro with TGF-β1 (10 ng/ml) for 0, 3, 6, 12, 24 and 48 hours, respectively. The levels of CTGF mRNA in MDSCs were measured by the real time RT-PCR and the expression of CTGF protein was detected by the CTGF Western blot. Results The immunohistochemistry revealed that before the adding of TGF-β1, MDSCs highly expressed Sca-1, with a positivityrate of 96%; however, after the adding of TGF-β1, the positive expression of Sca-1 decreased greatly, with a negativity rate gt;99%. The Western blot test showed that the ratios of CTGF to the average absorbance of βactin in Groups A-F were 0.788±0.123, 1.063±0.143, 2.154±0.153, 2.997±0.136, 3.796±0.153 and 3.802±0.175, respectively. In Groups AD，the absorbance increased gradually, with a significant difference between the abovementioned groups (Plt;0.05). However, in Groups D-F, there was no significant difference between the groups as the promotive tendency became less significant (P＞0.05). The RT-PCR test showed that the △Ct values in GroupsA-F were 1.659±0.215, 1.897±0.134, 2.188±0.259, 2.814±0.263,2.903±0.125 and 3.101±0.186, respectively. In Groups A-D, the increase in the △Ct value was gradual, but the differences were significant between the groups (Plt;0.05). But in Groups E and F, the promotive tendency became less significant（Pgt;0.05）. Conclusion TGF-β1 can promote the production of CTGF inthe mouse MDSCs cultured in vitro and the time-dependent relation exists for 3-12 hours.
Objective To provide the anatomical basis of contralateral C7 root transfer for the recovery of the forearm flexor function. Methods Thirty sides of adult anti-corrosion specimens were used to measure the length from the end of nerves dominating forearm flexor to the anastomotic stoma of contralateral C7 nerve when contralateral C7 nerve transfer was used for repair of brachial plexus lower trunk and medial cord injuries. The muscle and nerve branches were observed. The length of C7 nerve, C7 anterior division, and C7 posterior division was measured. Results The length of C7 nerve, anterior division, and posterior division was (58.8 ± 4.2), (15.4 ± 6.7), and (8.8 ± 4.4) mm, respectively. The lengths from the anastomotic stoma to the points entering muscle were as follow: (369.4 ± 47.3) mm to palmaris longus, (390.5 ± 38.8) mm (median nerve dominate) and (413.6 ± 47.4) mm (anterior interosseous nerve dominate) to the flexor digitorum superficialis, (346.2 ± 22.3) mm (median nerve dominate) and (408.2 ± 23.9) mm (anterior interosseous nerve dominate) to the flexor digitorum profundus of the index and the middle fingers, (344.2 ± 27.2) mm to the flexor digitorum profundus of the little and the ring fingers, (392.5 ± 29.2) mm (median nerve dominate) and (420.5 ± 37.1) mm (anterior interosseous nerve dominate) to the flexor pollicis longus, and (548.7 ± 30.0) mm to the starting point of the deep branch of ulnar nerve. The branches of the anterior interosseous nerve reached to the flexor hallucis longus, the deep flexor of the index and the middle fingers and the pronator quadratus muscle, but its branches reached to the flexor digitorum superficials in 5 specimens (16.7%). The branches of the median nerve reached to the palmaris longus and the flexor digitorum superficial, but its branches reached to the deep flexor of the index and the middle fingers in 10 specimens (33.3%) and to flexor hallucis longus in 6 specimens (20.0%). Conclusion If sural nerve graft is used, the function of the forearm muscles will can not be restored; shortening of humerus and one nerve anastomosis are good for forearm flexor to recover function in clinical.
Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with transurethral resection of bladder tumor (TURBT) for muscle-invasive bladder cancer (MIBC). Methods China National Knowledge Infrastructure, Chongqing VIP, Wanfang, SinoMed, PubMed, Web of Science, and Cochrane Library were searched from the establishment of databases until December 2023. All randomized controlled trials of TACE combined with TURBT for MIBC were collected and subjected to meta-analysis using RevMan 5.4 software. Results A total of 7 studies were included, involving 490 patients, with 246 in the TACE+TURBT group and 244 in the TURBT group. The meta-analysis results showed that compared with TURBT, TACE+TURBT had certain advantages in reducing recurrence rate [relative risk (RR)=0.49, 95% confidence interval (CI) (0.35, 0.68)], improving survival rate [RR=1.16, 95%CI (1.07, 1.27)], shortening surgical time [standardized mean difference (SMD)=−4.97, 95%CI (−7.54, −2.40)], reducing intraoperative bleeding [SMD=−4.19, 95%CI (−5.78, −2.60)], and improving quality of life [SMD=4.51, 95%CI (2.15, 6.86)]. The adverse reactions of the two groups were similar. Conclusions Existing evidence suggests that TACE may reduce intraoperative bleeding and shorten surgical time to help achieve maximum TURBT. TACE combined with TURBT may be superior to simple TURBT in terms of tumor recurrence rate and survival rate. TACE combined with TURBT can benefit MIBC patients in bladder-preserving treatment plans.
Objective To evaluate the application value of repairing the defects of the chest wall with the thoracico-abdominal skin flap and the muscle flap of the musculus rectus abdominis. Methods From January 2002 to June 2005, five patients with defects in the chest wall underwent the prothesis with the thoracico-abdominal skin flap and the muscle flap of the musculus rectus abdominis under general anesthesia. Focal cleaning was performed first; then, the skin flap was designed and taken (15 cm ×10 cm); and finally, the defects of the chest wall were repaired with the muscle flap of the musculus rectus abdominis. Results Of the 5patients, 4 had the flap healing by the first intention, and 1 had the delayed healing, with no complication. The skin flap had a good appearance, without edema orpigmentation. The X-ray examination showed that the shadow of the sternal sequestrum disappeared. There was no recurrence or complication during the follow-upfor 1-3 years (average, 18 mon). Conclusion The repairing of the defects in the chest wall with the thoracico-abdominal skin flap and the muscle flap of the musculus rectus abdominis is a simple and effective surgical treatment for defects of the chest wall around the sternum, and this kind of treatment is worth applying extensively in clinical practice.
ObjectiveTo evaluate the effects of nerve growth factor (NGF) on angiogenesis and skeletal muscle fiber remodeling in ischemic hindlimbs, and study the relationship of NGF and vascular endothelial growth factor (VEGF) to angiogenesis. MethodsEighteen mice were randomly allocated to normal control group (n=6), blank control group (n=6), and NGF gene transfection group (n=6). The left hindlimb ischemia model was established by ligating the femoral artery. NGF plasmid (125μg) was injected into the mouse ischemic gastrocnemius in the NGF gene transfection group. The same volume of normal saline (200μL) was injected into the mouse ischemic gastrocnemius in the blank control group. The gastrocnemius of left hindlimb was harvested under the condition of peritoneal cavity anesthesia on the 21th day after operation, and then the mice were sacrificed. The gastrocnemius of three groups were tested by hematoxylin-eosin staining, proliferating cell nuclear antigen (PCNA) and CD34 were determined by immunohistochemistry staining. Skeletal muscle fiber type was tested by myosin ATPase staining. NGF and VEGF protein expression were detected by enzyme linked immunosorbent assay. ResultsOn the 21th day after surgery, compared with the blank control group, the skeletal muscle atrophy degree was weaker, the functional assessment score was significantly lower (P < 0.05), the endothelial cell proliferation index, capillary density, the typeⅠskeletal muscle fiber proportion, NGF and VEGF expression were significantly higher (P < 0.05) in the NGF gene transfection group. ConclusionsNGF gene transfection could promote NGF and VEGF expression and angiogenesis in ischemic hindlimbs, and induce typeⅠskeletal muscle fibers formation in ischemic hindlimbs. The molecular regulation mechanism still needs to be further studied.