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国家自然科学基金(30700875)

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体神经-内脏神经吻合术修复脊髓损伤大鼠排便功能及机制研究
2010年
目的 应用肛肠动力学和神经形态学技术观察体神经-内脏神经吻合术后,在脊髓损伤(SCI)大鼠的所形成的再生异类神经通路对肛管直肠的支配功能及直肠平滑肌-肛门外括约肌的协同,并探讨其机制.方法 在成年雄性SD大鼠(250~300 g)的L4~L6椎管内,将左侧L4前根(L4VR)与左侧L6前根(L6VR)分别离断后,通过端端显微吻合技术,人工建立L4VR~L6VR异类神经前根.保留L4背根(L4DR)来传导传人信号.术后12周行T9~T10椎间脊髓横断,8周后将12只模型大鼠随机分为2组(n1=8,n2=4).取1组8只模型大鼠进行肛肠动力学研究;取2组4只模型大鼠进行神经形态学研究.结果 (1)电刺激吻合口近端神经及左侧坐骨神经,在引起直肠压力升高的同时出现肛门外括约肌的肌电活动大幅减弱;而电刺激自身对照侧L6VR,在引起直肠压力升高的同时出现肛门外括约肌肌电活动明显增强.(2)主要在模型鼠脊髓L4节段左侧前角(脊髓L3尾部至L5头侧均有阳性神经元)可见FG与TMR双标神经元及FG、四甲基罗丹明单标神经元;正常鼠神经逆行追踪未见双标神经元.结论 体神经-内脏神经吻合术可有效修复脊髓损伤大鼠肛管直肠功能,改善脊髓损伤后的直肠平滑肌-肛门括约肌协同失调.在模型大鼠脊髓L4节段新出现的双标神经元同时支配着盆神经节和肛门外括约肌,这可能是体神经-内脏神经吻合术修复模型大鼠排便功能主要神经解剖学基础.
孙丰银陈敏李文成
关键词:脊髓损伤
Effect of the Artificial Somato-Autonomic Neuroanastomosis on Defecation after Spinal Cord Injury and Its Underlying Mechanisms
2010年
A new artificial somatic-autonomic neuroanastomosis has been established in male rats with spinal cord injury (SCI). Anorectal manometry and neural retrograde tracing were conducted in this animal model to analyze the mechanisms and the effects on recovery of anorectal function. The left L4 ventral root (L4VR) was intradurally micro-anastomosed to the L6 ventral root (L6VR) to establish the new regenerated neural pathway. Three months later the spinal cord was completely transected at the T9-10 level. Eight weeks later the model rats were randomly divided into two groups. The rats in the group 1 (n=8) were applied for anorectal manometry, and those in the group 2 (n=4) were used for neural retrograde tracing study with fluorogold (FG) and dextran tetramethylrhodamine (TMR). The results of anorectal manometry showed the new reflex pathway could induce rectum to contract and simultaneously electric activity of external anal sphincter (EAS) to become weak or disappearing (indicating synergetic relaxation of EAS). FG and TMR dual labeled neurons with round and elliptical shape were mainly observed in L4 angulus anterior of model rats. The regenerated neural pathways were effective to improve the rectum external sphincter synergetic status and restore the anorectal function.
孙丰银陈敏李文成肖传国
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