Rui Jing, Xu Ya-Li, Zhao Xin, Li Ji-Feng, Gu Yu-Dong, Lao Jie
Department of Hand Surgery, Huashan Hospital, Fudan University; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China.
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.
Neural Regen Res. 2018 May;13(5):862-868. doi: 10.4103/1673-5374.232482.
Exogenous discharge can positively promote nerve repair. We, therefore, hypothesized that endogenous discharges may have similar effects. The phrenic nerve and intercostal nerve, controlled by the respiratory center, can emit regular nerve impulses; therefore these endogenous automatically discharging nerves might promote nerve regeneration. Action potential discharge patterns were examined in the diaphragm, external intercostal and latissimus dorsi muscles of rats. The phrenic and intercostal nerves showed rhythmic clusters of discharge, which were consistent with breathing frequency. From the first to the third intercostal nerves, spontaneous discharge amplitude was gradually increased. There was no obvious rhythmic discharge in the thoracodorsal nerve. Four animal groups were performed in rats as the musculocutaneous nerve cut and repaired was bland control. The other three groups were followed by a side-to-side anastomosis with the phrenic nerve, intercostal nerve and thoracodorsal nerve. Compound muscle action potentials in the biceps muscle innervated by the musculocutaneous nerve were recorded with electrodes. The tetanic forces of ipsilateral and contralateral biceps muscles were detected by a force displacement transducer. Wet muscle weight recovery rate was measured and pathological changes were observed using hematoxylin-eosin staining. The number of nerve fibers was observed using toluidine blue staining and changes in nerve ultrastructure were observed using transmission electron microscopy. The compound muscle action potential amplitude was significantly higher at 1 month after surgery in phrenic and intercostal nerve groups compared with the thoracodorsal nerve and blank control groups. The recovery rate of tetanic tension and wet weight of the right biceps were significantly lower at 2 months after surgery in the phrenic nerve, intercostal nerve, and thoracodorsal nerve groups compared with the negative control group. The number of myelinated axons distal to the coaptation site of the musculocutaneous nerve at 1 month after surgery was significantly higher in phrenic and intercostal nerve groups than in thoracodorsal nerve and negative control groups. These results indicate that endogenous autonomic discharge from phrenic and intercostal nerves can promote nerve regeneration in early stages after brachial plexus injury.
外源性放电可积极促进神经修复。因此，我们推测内源性放电可能具有类似作用。由呼吸中枢控制的膈神经和肋间神经可发出规律的神经冲动；因此，这些内源性自动放电神经可能促进神经再生。检测了大鼠膈肌、肋间外肌和背阔肌的动作电位放电模式。膈神经和肋间神经呈现出与呼吸频率一致的节律性放电簇。从第一肋间神经到第三肋间神经，自发放电幅度逐渐增加。胸背神经没有明显的节律性放电。对大鼠进行了四组实验，以肌肉神经切断并修复作为空白对照。其他三组分别与膈神经、肋间神经和胸背神经进行端侧吻合。用电极记录由肌皮神经支配的肱二头肌的复合肌肉动作电位。用测力位移传感器检测同侧和对侧肱二头肌的强直收缩力。测量湿肌肉重量恢复率，并用苏木精-伊红染色观察病理变化。用甲苯胺蓝染色观察神经纤维数量，用透射电子显微镜观察神经超微结构变化。与胸背神经组和空白对照组相比，膈神经和肋间神经组术后1个月复合肌肉动作电位幅度显著更高。与阴性对照组相比，膈神经、肋间神经和胸背神经组术后2个月右侧肱二头肌强直张力和湿重恢复率显著更低。术后1个月，膈神经和肋间神经组肌皮神经吻合部位远端的有髓轴突数量显著高于胸背神经组和阴性对照组。这些结果表明，膈神经和肋间神经的内源性自主放电可促进臂丛神经损伤后早期的神经再生。
