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Factors predicting sensory and motor recovery after the repair of upper limb peripheral nerve injuries

Neural Regeneration Research 2014年第6期9卷 661-672页

作者： Bo He Zhaowei zhu qingtang zhu Xiang Zhou Canbin Zheng Pengliang Li Shuang zhu Xiaolin Liu Jiakai zhu Department of Microsurgery and Orthopedic Trauma the First Affiliated Hospital of Sun Yat-sen University

OBJECTIVE： To investigate the factors associated with sensory and motor recovery after the repair of upper limb peripheral nerve injuries. DATA SOURCES： The online PubMed database was searched for English articles describing outcomes after the repair of median, ulnar, radial, and digital nerve injuries in humans with a publication date between 1 January 1990 and 16 February 2011. STUDY SELECTION： The following types of article were selected：（1） clinical trials describ- ing the repair of median, ulnar, radial, and digital nerve injuries published in English; and （2） studies that reported sufficient patient information, including age, mechanism of injury, nerve injured, injury location, defect length, repair time, repair method, and repair materials. SPSS 13.0 software was used to perform univariate and multivariate logistic regression analyses and to in- vestigate the patient and intervention factors associated with outcomes. MAIN OUTCOME MEASURES： Sensory function was assessed using the Mackinnon-Dellon scale and motor function was assessed using the manual muscle test. Satisfactory motor recovery was defined as grade M4 or M5, and satisfactory sensory recovery was defined as grade S3＋ or S4. RESULTS： Seventy-one articles were included in this study. Univariate and multivariate logistic regression analyses showed that repair time, repair materials, and nerve injured were inde- pendent predictors of outcome after the repair of nerve injuries （P 〈 0.05）, and that the nerve injured was the main factor affecting the rate of good to excellent recovery. CONCLUSION： Predictors of outcome after the repair of peripheral nerve injuries include age, gender, repair time, repair materials, nerve injured, defect length, and duration of follow-up.

关键词： nerve regeneration peripheral nerve injury outcome predictors nerve repair upperlimb univariate analysis prognosis 863 Program neural regeneration

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Decellularized Extracellular Matrix Containing Electrospun Fibers for Nerve Regeneration:A Comparison Between Core–Shell Structured and Preblended Composites

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Advanced Fiber Materials 2022年第3期4卷 503-519页

作者： Rongli Deng Ziling Luo Zilong Rao Zudong Lin Shihao Chen Jing Zhou qingtang zhu Xiaolin Liu Ying Bai Daping Quan PCFM Lab GD HPPC LabSchool of ChemistrySun YatSen UniversityGuangzhou 510006China Guangdong Engineering Technology Research Centre for Functional Biomaterials School of Materials Science and EngineeringSun Yat-Sen UniversityGuangzhou 510006China Guangdong Peripheral Nerve Tissue Engineering and Technology Research Center Department of Orthopedic and MicrosurgeryThe First Afliated Hospital of Sun Yat-Sen UniversityGuangzhou 510080China Guangdong Provincial Soft Tissue Biofabrication Engineering Laboratory GuangdongGuangzhou 510080China

Advanced biomaterial-based strategies for treatment of peripheral nerve injury require precise control over both topological and biological cues for facilitating rapid and directed nerve *** a highly bioactive and tissue-specifc natural material,decellularized extracellular matrix(dECM)derived from peripheral nerves(decellularized nerve matrix,DNM)has drawn increasing attention in the feld of regenerative medicine,due to its outstanding capabilities in facilitating neurite outgrowth and *** induce and maintain sufcient topological guidance,electrospinning was conducted for fabrication of axially aligned nanofbers consisting of DNM and poly(ε-caprolactone)(PCL).Core–shell structured fbers were prepared by coaxial electrospinning using DNM as the shell and PCL as the *** to the aligned electrospun fbers using preblended DNM/PCL,the core–shell structured fbers exhibited lower tensile strength,faster degradation,but considerable toughness for nerve guidance conduit preparation and relatively intact fbrous structure after long-term *** importantly,the full DNM surface coverage of the aligned core–shell fbers efectively promoted axonal extension and Schwann cells *** DNM contents further triggered neurite bundling and myelin formation toward nerve fber maturation and ***,we not only pursue a multi-functional scafold design for nerve regeneration,a detailed comparison between core–shell structured and preblended electrospinning of DNM/PCL composites was also provided as an applicable paradigm for advanced tissue-engineered strategies using dECM-based biomaterials.

关键词： Decellularized extracellular matrix Coaxial electrospinning Core–shell structure Preblended composites Nerve regeneration

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A simple model of radial nerve injury in the rhesus monkey to evaluate peripheral nerve repair

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Neural Regeneration Research 2014年第10期9卷 1041-1046页

作者： Dong Wang Xijun Huang Guo Fu Liqiang Gu Xiaolin Liu Honggang Wang Jun Hu Jianhua Yi Xiaofeng Niu qingtang zhu Department of Orthopedics and Microsurgery the First Affiliated Hospital of Sun Yat-Sen University

Current research on bone marrow stem cell transplantation and autologous or xenogenic nerve transplantation for peripheral nerve regeneration has mainly focused on the repair of peripher-al nerve defects in rodents. In this study, we established a standardized experimental model of radial nerve defects in primates and evaluated the effect of repair on peripheral nerve injury. We repaired 2.5-cm lesions in the radial nerve of rhesus monkeys by transplantation of autografts, acellular allografts, or acellular allografts seeded with autologous bone marrow stem cells. Five months after surgery, regenerated nerve tissue was assessed for function, electrophysiology, and histomorphometry. Postoperative functional recovery was evaluated by the wrist-extension test. Compared with the simple autografts, the acellular allografts and allografts seeded with bone marrow stem cells facilitated remarkable recovery of the wrist-extension functions in the rhesus monkeys. This functional improvement was coupled with radial nerve distal axon growth, a higher percentage of neuron survival, increased nerve fiber density and diameter, increased myelin sheath thickness, and increased nerve conduction velocities and peak amplitudes of compound motor action potentials. Furthermore, the quality of nerve regeneration in the bone marrow stem cells-laden allografts group was comparable to that achieved with autografts. The wrist-extension test is a simple behavioral method for objective quantification of peripheral nerve regeneration.

关键词： nerve regeneration peripheral nerve injury rhesus monkeys bone marrow stem cells allogeneic nerve transplantation wrist-extension test electrophysiology neurological function NSFC grant neural regeneration

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A comparative study of human and porcine-derived decellularised nerve matrices

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Biomaterials Translational 2023年第3期4卷 180-195页

作者： Rui Li Shuai Qiu Weihong Yang Zilong Rao Jiaxin Chen Yuexiong Yang qingtang zhu Xiaolin Liu Ying Bai Daping Quan Guangdong Engineering Technology Research Centre for Functional Biomaterials School of Materials Science and EngineeringSun Yat-sen UniversityGuangzhouGuangdong ProvinceChina Key Laboratory for Polymeric Composite&Functional Materials of Ministry of Education School of ChemistrySun Yat-sen UniversityGuangzhouGuangdong ProvinceChina Guangdong Engineering Technology Research Centre for Peripheral Nerve Tissue Department of Orthopaedic and MicrosurgeryThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong ProvinceChina Guangzhou Zhongda Medical Equipment Co. Ltd.GuangzhouGuangdong ProvinceChina

Decellularised extracellular matrix(dECM)biomaterials originating from allogeneic and xenogeneic tissues have been broadly studied in the field of regenerative medicine and have already been used in clinical *** dECMs are considered more compatible,but they have the drawback of extremely limited human tissue *** availability is also restricted by the health and age of the *** investigate the viability of xenogeneic tissues as a substitute for human tissues,we fabricated both porcine decellularised nerve matrix(pDNM)and human decellularised nerve matrix for a comprehensive *** showed that both dECM scaffolds retained the ECM microstructures of native human nerve *** analysis demonstrated that the protein compositions of both dECMs were also very similar to each *** functional ECM contents effectively promoted the proliferation,migration,and maturation of primary human Schwann cells in ***,pDNM contained a few antigens that induced severe host immune responses in humanised ***,after removing theα-galactosidase antigen,the immune responses were highly alleviated and the pre-treated pDNM maintained a human decellularised nerve matrix-like pro-regenerative ***,we believe that anα-galactosidase-free pDNM may serve as a viable substitute for human decellularised nerve matrix in future clinical applications.

关键词： allogeneic decellularised nerve matrix immune response xenogeneic α-Gal

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严重肢体创伤综合保肢原则--一个中心两个阶段四个重点八项技术

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中华显微外科杂志 2021年第4期44卷 361-363页

作者：朱庆棠顾立强中山大学附属第一医院显微创伤手外科广州510080

严重肢体创伤往往危及肢体成活甚至危及生命,须争分夺秒地进行恰当地处理。然而,对如此复杂的肢体创伤进行修复重建不仅耗时费力,对救治团队的技术要求也高,需要不断努力以降低并发症发生率、截肢率和致残率。

关键词：修复重建并发症发生率肢体创伤截肢率保肢耗时费力致残率四个重点

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硫酸软骨素蛋白多糖对周围神经有序再生作用的研究进展

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中华创伤骨科杂志 2019年第12期21卷 1097-1100页

作者：何富林杨东朱庆棠中山大学附属第一医院显微创伤手外科广东省周围神经组织工程技术研究中心广东省软组织生物制造工程实验室广州510080 中山大学附属肿瘤医院华南肿瘤学国家重点实验室广州510060

周围神经损伤后再生常会出现错配、卷曲及迷乱等新生轴突无序再生的情况,这是限制周围神经损伤后有效再生的重要原因之一,因此实现周围神经损伤后的有序再生,有助于提高再生的效率与功能恢复。硫酸软骨素蛋白多糖(CSPGs)作为传统的轴突... 详细信息

周围神经损伤后再生常会出现错配、卷曲及迷乱等新生轴突无序再生的情况,这是限制周围神经损伤后有效再生的重要原因之一,因此实现周围神经损伤后的有序再生,有助于提高再生的效率与功能恢复。硫酸软骨素蛋白多糖(CSPGs)作为传统的轴突再生抑制性分子,在周围神经系统正常发育过程中具有重要作用。本文从CSPGs的分类、作用特点及其时空分布等方面来探讨其在促周围神经有序再生过程中所扮演的角色及应用转化的可能性,有助于增加轴突再生数量的神经移植物的设计,进一步指导周围神经移植物的仿生构建,从而促进周围神经损伤后的有序及有效再生。

关键词：蛋白硫酸软骨素类周围神经神经再生

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陈氏标准在断肢再植术后功能评价的研究进展

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中华显微外科杂志 2020年第1期43卷 97-100页

作者：顾凡彬(综述) 刘小林朱庆棠(审阅) 中山大学附属第一医院显微创伤手外科广州510080

随着显微外科技术的发展,断肢再植的术后评价从肢体的成活情况发展到肢体的功能恢复情况。1978年,陈中伟从工作能力、关节活动度、感觉恢复、肌力恢复情况等方面对术后肢体功能提出评价标准,在国际上被称为"陈氏标准",至今仍然在国内、... 详细信息

随着显微外科技术的发展,断肢再植的术后评价从肢体的成活情况发展到肢体的功能恢复情况。1978年,陈中伟从工作能力、关节活动度、感觉恢复、肌力恢复情况等方面对术后肢体功能提出评价标准,在国际上被称为"陈氏标准",至今仍然在国内、外使用。近年来有文献报道新的评价指标与方法,但尚未形成国际共识。本文总结相关文献进展,希望规范并推广断肢再植术后功能评价标准,为制定更完善的评价标准提供参考。

关键词：断肢再植上肢再植功能评价陈氏标准评价标准

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传承创新做好显微外科学科建设

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中华显微外科杂志 2024年第1期47卷 1-3页

作者：顾立强汪华侨刘小林朱庆棠《中华显微外科杂志》编辑部广州510062 中山大学附属第一医院显微创伤手外科广州510080

显微外科不仅是一项技术,更是一门科学。1992年显微外科学成为国家临床医学三级学科(学科代码320.2715)。新时代的显微外科学科建设要传承创新,求真务实;依托外科各专科平台,拓展显微外科阵地;坚持显微外科技术核心竞争力,勇扛显微外科... 详细信息

显微外科不仅是一项技术,更是一门科学。1992年显微外科学成为国家临床医学三级学科(学科代码320.2715)。新时代的显微外科学科建设要传承创新,求真务实;依托外科各专科平台,拓展显微外科阵地;坚持显微外科技术核心竞争力,勇扛显微外科特色大旗,服务各临床手术专科;医、教、研并重;团结协作,加强国内外学术交流;注重人才建设(培养大国工匠、领军人物);支持和帮助社会办显微外科特色医院发展;加强《中华显微外科杂志》对学科建设支撑作用,促进显微外科高质量发展。

关键词：显微外科学科建设传承创新中国

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体外冲击波治疗桡骨远端骨折复杂区域疼痛综合征的疗效观察

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现代医学 2020年第10期48卷 1254-1258页

作者：李成东朱庆堂茂名市中医院骨三科广东茂名525000 中山大学第一附属医院创伤显微手外科广东广州510000

目的:探索体外冲击波治疗桡骨远端骨折复杂区域疼痛综合征的疗效。方法:选择92例桡骨远端骨折保守治疗后出现复杂区域疼痛综合征患者,按治疗意愿分为治疗组(47例)和对照组(45例)。入组时应用双能X线吸收法检测患者骨密度,依据骨密度值... 详细信息

目的:探索体外冲击波治疗桡骨远端骨折复杂区域疼痛综合征的疗效。方法:选择92例桡骨远端骨折保守治疗后出现复杂区域疼痛综合征患者,按治疗意愿分为治疗组(47例)和对照组(45例)。入组时应用双能X线吸收法检测患者骨密度,依据骨密度值对两组患者进行分层。治疗组给予体外冲击波治疗,对照组不给予体外冲击波治疗;两组患者均接受相同的康复方案。测定干预后2周的骨转换相关指标,随访2个月内不同时点的视觉模拟量表(VAS)评分,按骨密度值分层分析。结果:正常骨密度分层中不同时点的VAS评分两组间差异无统计学意义(P>0.05);低骨密度分层中,治疗组接受治疗后第1天VAS评分均值为(4.68±1.07)分高于对照组的(3.16±1.17)分,治疗后第2周及第2月时的VAS评分均值[(2.42±117)、(1.90±1.27)分]低于对照组的(3.04±084)和(2.76±1.12)分,差异具有统计学意义(P<0.05)。治疗后第2周时,治疗组的抗酒石酸酸性磷酸酶5b(TRAP5b)、β-胶原特殊序列(β-CTX)均低于对照组;在低骨密度分层中,治疗组BAP高于对照组,以上差异均具有统计学意义(P<0.05)。结论:体外冲击波治疗有助于缓解合并低骨密度的桡骨远端骨折复杂区域疼痛综合征患者的疼痛症状,该作用可能与冲击波治疗抑制了局部骨吸收反应有关。

关键词：桡骨远端骨折复杂区域疼痛综合征体外冲击波治疗骨质疏松骨吸收

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Clinical guidelines for indications,techniques,and complications of autogenous bone grafting

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Chinese Medical Journal 2024年第1期137卷 5-7页

作者： Jianzheng Zhang Shaoguang Li Hongying He Li Han Simeng Zhang Lin Yang Wenxing Han Xiaowei Wang Jie Gao Jianwen Zhao Weidong Shi zhuo Wu Hao Wang Zhicheng Zhang Licheng Zhang Wei Chen qingtang zhu Tiansheng Sun Peifu Tang Yingze Zhang Senior Department of Orthopedics PLA General HospitalBeijing 100048China The National Clinical Research Center for Orthopedics Sports Medicine&RehabilitationBeijing 100048China The Trauma Orthopedic Branch of Chinese Orthopedic Association ShijiazhuangHebei 050051China Department of Orthopedic Surgery The Third Hospital of Hebei Medical UniversityShijiazhuangHebei 050051China Department of Microsurgical Trauma The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510080China

Autogenous bone grafts have long been considered the“gold standard”and most effective material in bone regeneration procedures.[1]Autogenous bone grafts are used to repair bone defects caused by nonunion,infection,tumor resection,and spinal and joint fusion.[2]It has been reported that more than 200,000 autologous bone grafts are performed in the United States each year.[3]Although there are no specific statistics on the annual number of bone grafts performed in China,autologous bone grafting is the most common surgical technique in *** iliac crest remains the most common donor site,along with the fibula,ribs,tibial metaphysis,proximal humerus,distal radius,and greater trochanter.[4,5]Various bone-graft options provide different amounts and qualities of cortical,cancellous,and corticocancellous bone.[6,7]Autogenous bone graft is osteogenic,histocompatible,provides structural support.

关键词： grafting graft union

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