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Stability of motor endplates is greater in the biceps than in the interossei in a rat model of obstetric brachial plexus palsy

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Neural Regeneration Research 2020年第9期15卷 1678-1685页

作者： Bo Li Liang Chen yu-dong gu Department of Hand Surgery Huashan Hospital and Institutes of Biomedical SciencesFudan UniversityShanghaiChina Shanghai Key Laboratory of Peripheral Nerve and Microsurgery ShanghaiChina

The time window for repair of the lower trunk is shorter than that of the upper trunk in patients with obstetric brachial plexus palsy. The denervated intrinsic muscles of the hand become irreversibly atrophic much faster than the denervated biceps. However, it is unclear whether the motor endplates of the denervated interosseous muscles degenerate more rapidly than those of the denervated biceps. In this study, we used a rat model of obstetric brachial plexus palsy of the right upper limb. C5–6 was lacerated distal to the intervertebral foramina, with concurrent avulsion of C7–8 and T1, with the left upper limb used as the control. Bilateral interossei and biceps were collected at 5 and 7 weeks. Immunofluorescence was used to assess the morphology of the motor endplates. Real-time quantitative polymerase chain reaction and western blot assay were used to assess mRNA and protein expression levels of acetylcholine receptor subunits(α, β and δ), rapsyn and β-catenin. Immunofluorescence microscopy showed that motor endplates in the denervated interossei were fragmented, while those in the denervated biceps were morphologically intact with little fragmentation. The number and area of motor endplates, relative to the control side, were significantly lower in the denervated interossei compared with the denervated biceps. mRNA and protein expression levels of acetylcholine receptor subunits(α, β and δ) were significantly lower, whereas β-catenin protein expression was higher, in the denervated interossei compared with the denervated biceps. The protein expression of rapsyn was higher in the denervated biceps than in the denervated interossei at 7 weeks. Our findings demonstrate that motor endplates of interossei are destabilized, whereas those of the biceps remain stable, in the rat model of obstetric brachial plexus palsy. All procedures were approved by the Experimental Animal Ethics Committee of Fudan University, China(approval No. DF-187) in January 2016.

关键词： acetylcholine receptor subunits biceps interossei motor endplates nerve regeneration obstetric brachial plexus palsy peripheral nerve injury

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Characterization of structural and electrical properties of ZnO tetrapods

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International Journal of Minerals,Metallurgy and Materials 2011年第6期18卷 686-690页

作者： yu-dong gu Wen-jie Mai Peng Jiang Department of Advanced Materials and Nanotechnology College of Engineering Peking University Beijing 100084 China School of Materials Science and Engineering Georgia Institute of Technology Atlanta Georgia 30332-0245 USA Department of Physics Jinan University Guangzhou 510632 China National Center for Nanoscience and Technology Beijing 100190 China

ZnO tetrapods were synthesized by a typical thermal vapor-solid deposition method in a horizontal tube *** characterization was carried out by transmission electron microscopy （TEM） and select-area electron diffraction （SAED）,which shows the presence of zinc blende nucleus in the center of tetrapods while the four branches taking hexagonal wurtzite *** electrical transport property of ZnO tetrapods was investigated through an in-situ nanoprobe *** three branches of a tetrapod serve as source,drain,and ＂gate＂,respectively;while the fourth branch pointing upward works as the force trigger by vertically applying external force *** conductivity of each branch of ZnO-tetrapods increases 3-4 times under *** such situation,the electrical current through the branches of ZnO tetrapods can be tuned by external force,and therefore a simple force sensor based on ZnO tetrapods has been demonstrated for the first time.

关键词： zine oxide tetrapods electrical property piezoelectric materials semiconductors nanostructures

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Inflammation and apoptosis accelerate progression to irreversible atrophy in denervated intrinsic muscles of the hand compared with biceps: proteomic analysis of a rat model of obstetric brachial plexus palsy

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Neural Regeneration Research 2020年第7期15卷 1326-1332页

作者： Xiao-Heng yu Ji-Xin Wu Liang Chen yu-dong gu Department of Hand Surgery Huashan Hospital and Institutes of Biomedical SciencesFudan UniversityShanghaiChina Shanghai Key Laboratory of Peripheral Nerve and Microsurgery ShanghaiChina

In treating patients with obstetric brachial plexus palsy,we noticed that denervated intrinsic muscles of the hand become irreversibly atrophic at a faster than denervated *** a rat model of obstetric brachial plexus palsy,denervated intrinsic musculature of the forepaw entered the irreversible atrophy far earlier than denervated *** this study,isobaric tags for relative and absolute quantitation were examined in the intrinsic musculature of forepaw and biceps on denervated and normal sides at 3 and 5 weeks to identify dysregulated *** of pathways mapped by those proteins was analyzed by Kyoto Encyclopedia of Genes and Genomes *** 3 weeks,119 dysregulated proteins in denervated intrinsic musculature of the forepaw were mapped to nine pathways for muscle regulation,while 67 dysregulated proteins were mapped to three such pathways at 5 *** 3 weeks,27 upregulated proteins were mapped to five pathways involving inflammation and apoptosis,while two upregulated proteins were mapped to one such pathway at 5 *** 3 and 5 weeks,53 proteins from pathways involving regrowth and differentiation were *** 3 weeks,64 dysregulated proteins in denervated biceps were mapped to five pathways involving muscle regulation,while,five dysregulated proteins were mapped to three such pathways at 5 *** protein mapped to inflammation and apoptotic pathways was upregulated from one pathway at 3 weeks,while three proteins were downregulated from two other pathways at 5 *** proteins mapped to regrowth and differentiation pathways were upregulated from three pathways at 3 weeks,while two proteins were downregulated in another pathway at 5 *** results implicated inflammation and apoptosis as critical factors aggravating atrophy of denervated intrinsic muscles of the hand during obstetric brachial plexus *** experimental procedures and protocols were approved by the Experimental Animal Ethics Committee of Fudan Univ

关键词： apoptosis biceps denervation inflammation intrinsic muscles of the hand irreversible muscle atrophy isobaric tags for relative and absolute quantitation nerve regeneration proteomic rat models reversible muscle atrophy

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End-to-side neurorrhaphy repairs peripheral nerve injury：sensory nerve induces motor nerve regeneration

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Neural Regeneration Research 2017年第10期12卷 1703-1707页

作者： Qing yu She-hong Zhang Tao Wang Feng Peng dong Han yu-dong gu Department of Hand Surgery Huashan Hospital of Fudan UniversityKey Laboratory of Hand Reconstructionthe Ministry of HealthKey Laboratory of Peripheral Nerve and MicrosurgeryShanghaiChina Department of Rehabilitation Medicine Huashan Hospital of Fudan UniversityShanghaiChina

End-to-side neurorrhaphy is an option in the treatment of the long segment defects of a *** involves suturing the distal stump of the disconnected nerve（recipient nerve） to the side of the intimate adjacent nerve（donor nerve）.However,the motor-sensory specificity after end-to-side neurorrhaphy remains *** study sought to evaluate whether cutaneous sensory nerve regeneration induces motor nerves after end-to-side *** rats were randomized into three groups：（1） end-to-side neurorrhaphy using the ulnar nerve（mixed sensory and motor） as the donor nerve and the cutaneous antebrachii medialis nerve as the recipient nerve;（2） the sham group：ulnar nerve and cutaneous antebrachii medialis nerve were just exposed;and（3） the transected nerve group：cutaneous antebrachii medialis nerve was transected and the stumps were turned over and *** 5 months,acetylcholinesterase staining results showed that 34% ± 16% of the myelinated axons were stained in the end-to-side group,and none of the myelinated axons were stained in either the sham or transected nerve *** fluorescent tracing of spinal motor neurons and dorsal root ganglion showed the proportion of motor neurons from the cutaneous antebrachii medialis nerve of the end-to-side group was 21% ± 5%.In contrast,no motor neurons from the cutaneous antebrachii medialis nerve of the sham group and transected nerve group were found in the spinal cord *** results confirmed that motor neuron regeneration occurred after cutaneous nerve end-to-side neurorrhaphy.

关键词： nerve regeneration peripheral nerve injury end-to-side neurorrhaphy motor-sensory specificity rat dorsal root ganglion motor neuron axon cutaneous antebrachii medialis nerve ulnar nerve acetylcholinesterase staining retrograde neuron tracing neural regeneration

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Surgical treatment for severe cubital tunnel syndrome with absent sensory nerve conduction

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Neural Regeneration Research 2019年第3期14卷 519-524页

作者： Jin-Song Tong Zhen dong Bin Xu Cheng-Gang Zhang yu-dong gu Department of Hand Surgery Huashan Hospital Fudan University Key Laboratory of Hand Reconstruction Ministry of Health Shanghai Key Laboratory of Peripheral Nerve and Microsurgery

For severe cubital tunnel syndrome, patients with absent sensory nerve action potential tend to have more severe nerve damage than those without. Thus, it is speculated that such patients generally have a poor prognosis. How absent sensory nerve action potential affects surgical outcomes remains uncertain owing to a scarcity of reports and conflicting results. This retrospective study recruited one hundred and fourteen cases(88 patients with absent sensory nerve action potential and 26 patients with present sensory nerve action potential) undergoing either subcutaneous transposition or in situ decompression. The minimum follow-up was set at 2 years. Primary outcome measures of overall hand function included their McGowan grade, modified Bishop score, and Disabilities of the Arm, Shoulder, and Hand Questionnaire(DASH) score. For patients with absent sensory nerve action potential, 71 cases(80.7%) achieved at least one McGowan grade improvement, 76 hands(86.4%) got good or excellent results according to the Bishop score, and the average DASH score improved 49.5 points preoperatively to 13.1 points postoperatively. When compared with the present sensory nerve action potential group, they showed higher postoperative McGowan grades and DASH scores, but there was no statistical difference between the modified Bishop scores of the two groups. Following in situ decompression or subcutaneous transposition, great improvement in hand function was achieved for severe cubital tunnel syndrome patients with absent sensory nerve action potential. The functional outcomes after surgery for severe cubital tunnel syndrome are worse in patients with absent sensory nerve action potential than those without. This study was approved by the Ethical Committee of Huashan Hospital, Fudan University, China(approval No. 2017142).

关键词： nerve regeneration absent sensory nerve action potential cubital tunnel syndrome disease severity electrodiagnostic testing in situ decompression subcutaneous transposition surgical outcomes prognostic factors peripheral nerve compression neural regeneration

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Phrenic and intercostal nerves with rhythmic discharge can promote early nerve regeneration after brachial plexus repair in rats

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Neural Regeneration Research 2018年第5期13卷 862-868页

作者： Jing Rui Ya-Li Xu Xin Zhao Ji-Feng Li yu-dong gu Jie Lao Department of Hand Surgery Huashan Hospital Fudan University Shanghai China Key Laboratory of Hand Reconstruction Ministry of Health Shanghai China Shanghai Key Laboratory of Peripheral Nerve and Microsurgery Shanghai China

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 d

关键词： nerve regeneration endogenous automatic discharge side-to-side nerve anastomosis peripheral nerve regeneration phrenic nerve intercostal nerve peripheral nerve injury neural regeneration

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Endogenous automatic nerve discharge promotes nerve repair: an optimized animal model

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Neural Regeneration Research 2019年第2期14卷 306-312页

作者： Jing Rui Ying-Jie Zhou Xin Zhao Ji-Feng Li yu-dong gu Jie Lao Department of Hand Surgery Huashan Hospital Fudan University Key Laboratory of Hand Reconstruction Ministry of Health Shanghai Key Laboratory of Peripheral Nerve and Microsurgery

Exogenous electrical nerve stimulation has been reported to promote nerve regeneration. Our previous study has suggested that endogenous automatic nerve discharge of the phrenic nerve and intercostal nerve has a positive effect on nerve regeneration at 1 month postoperatively, but a negative effect at 2 months postoperatively, which may be caused by scar compression. In this study, we designed four different rat models to avoid the negative effect from scar compression. The control group received musculocutaneous nerve cut and repair. The other three groups were subjected to side-to-side transfer of either the phrenic(phrenic nerve group), intercostal(intercostal nerve group) or thoracodorsal nerves(thoracic dorsal nerve group), with sural nerve autograft distal to the anastomosis site. Musculocutaneous nerve regeneration was assessed by electrophysiology of the musculocutaneous nerve, muscle tension, muscle wet weight, maximum cross-sectional area of biceps, and myelinated fiber numbers of the proximal and distal ends of the anastomosis site of the musculocutaneous nerve and the middle of the nerve graft. At 1 month postoperatively, compound muscle action potential amplitude of the biceps in the phrenic nerve group and the intercostal nerve group was statistically higher than that in the control group. The myelinated nerve fiber numbers in the distal end of the musculocutaneous nerve and nerve graft anastomosis in the phrenic nerve and the intercostal nerve groups were statistically higher than those in the control and thoracic dorsal nerve groups. The neural degeneration rate in the middle of the nerve graft in the thoracic dorsal nerve group was statistically higher than that in the phrenic nerve and the intercostal nerve groups. At 2 and 3 months postoperatively, no significant difference was detected between the groups in all the assessments. These findings confirm that the phrenic nerve and intercostal nerve have a positive effect on nerve regeneration at the

关键词： nerve regeneration peripheral nerve regeneration endogenous automatic discharge side-to-side nerve anastomosis phrenic nerve intercostal nerve animal model electrical treatment rats nerve compression neural regeneration

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Distally based perforator sural flaps for foot and ankle reconstruction

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World Journal of Orthopedics 2015年第3期6卷 322-330页

作者： Shi-Min Chang Xiao-Hua Li yu-dong gu Department of Orthopedic Surgery Yangpu Hospital Tongji University School of Medicine Department of Hand Surgery Huashan Hospital Fudan University Key Laboratory of Hand Reconstruction Ministry of Health Shanghai Key Laboratory of Peripheral Nerve and Microsurgery

Distally based perforator sural flaps from the posterolateral or posteromedial lower leg aspect are initially a neurofasciocutaneous flap that can be transferred reversely to the foot and ankle region with no need to harvest and sacrifice the deep major artery. These flaps are supplied by a perforating artery issued from the deep peroneal artery or the posterior tibial artery, and the chainlinked adipofascial neurovascular axis around the sural/saphenous nerve. It is a versatile and reliable technique for soft-tissue reconstruction of the heel and ankle region with 180-degrees rotation. In this paper, we present its developing history, vascular basis, surgical techniques including flap design and elevation, flap variations in pedicle and component, surgical indications, and illustrative case reports with different perforating vessels as pivot points for foot and ankle coverage.

关键词： Fasciocutaneous flap Distally based flap Foot and ankle Perforator flap Neurocutaneous flap Sural flap Propeller flap

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Supplementary motor area deactivation impacts the recovery of hand function from severe peripheral nerve injury

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Neural Regeneration Research 2016年第4期11卷 670-675页

作者： Ye-chen Lu Han-qiu Liu Xu-yun Hua yun-dong Shen Wen-dong Xu Jian-guang Xu yu-dong gu Department of Hand Surgery Huashan HospitalFudan University Department of Radiology Huashan HospitalFudan University State Key Laboratory of Medical Neuroscience Fudan University

Although some patients have successful peripheral nerve regeneration,a poor recovery of hand function often occurs after peripheral nerve *** is believed that the capability of brain plasticity is crucial for the recovery of hand *** supplementary motor area may play a key role in brain remodeling after peripheral nerve *** this study,we explored the activation mode of the supplementary motor area during a motor imagery *** investigated the plasticity of the central nervous system after brachial plexus injury,using the motor imagery *** from functional magnetic resonance imaging showed that after brachial plexus injury,the motor imagery task for the affected limbs of the patients triggered no obvious activation of bilateral supplementary motor *** result indicates that it is difficult to excite the supplementary motor areas of brachial plexus injury patients during a motor imagery task,thereby impacting brain *** of the supplementary motor area is likely to be a serious problem for brachial plexus injury patients in terms of preparing,initiating and executing certain movements,which may be partly responsible for the unsatisfactory clinical recovery of hand function.

关键词： nerve regeneration peripheral nerve injury brachial plexus injury neuronal plasticity supplementary motor area premotor area magnetic resonance imaging motor preparation motor imagery clinical restoration of hand function cortical remodeling block design neural regeneration

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Contralateral C7 Nerve Root Transfer for Function Recovery in Adults： A Meta-analysis

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Chinese Medical Journal 2017年第24期130卷 2960-2968页

作者： Wen-Jun Li Li-yue He Shan-Lin Chen Yan-Wei Lyu Shu-Feng Wang Yang Yong Wen Tian guang-Lei Tian yu-dong gu Department of Hand Surgery Beijing Jishuitan Hospital Beijing 100035 China Department of Health Policy and Management School of Public Health Peking University Health Science Center Beijing 100191 China Department of Hand surgery Huashan Hospital Fudan University Shanghai 200040 China

Background：Root avulsion to all 5 roots of the brachial plexus is a common presentation and keeps a major reconstructive *** contralateral C7 （CC7） nerve transfer has been used in treating brachial plexus avulsion injury （BPAI） since ***,the effectiveness of the procedure remains a subject of *** aim of this meta-analysis was to study surgical outcomes regarding motor and sensory recovery after CC7 nerve ***：Chinese or English （i.e.,＂contralateral c-7＂,＂contralateral c7＂,＂c7 nerve root＂,and ＂seventh cervical nerve root＂） keywords were used for a literature search for articles related to CC7 nerve transfer in several databases （i.e.,PubMed,Cochrane,Embase,CNKI,CQVIP,and Wanfang Data）.Clinical research articles were screened,and animal studies as well as duplicate publications were *** strength and sensory recovery were considered to be effective only when the scores on the United Kingdom Medical Research Council scale were equal to or higher than M3 and S3,***：The overall ipsilateral recipient nerve recovery rates were as follows：the efficiency rate for muscle strength recovery after CC7 nerve transfer was 0.57 （95% confidence interval [CI]：0.48-0.66） and for sensory recovery was 0.52 （95% CI：0.46-0.58）.When the recipient nerve was the median nerve,the efficiency rate for muscle strength recovery was 0.50 （95% CI：0.39-0.61） and for sensory was 0.56 （95% CI：0.50-0.63）.When the recipient nerve was the musculocutaneous nerve and the radial nerve,the efficiency rate for muscle strength recovery was 0.74 （95% CI：0.65-0.82） and 0.50 （95% CI：0.31-0.70）,***：Transfer of CC7 nerves to musculocutaneous nerves leads to the best ***7 is a reliable donor nerve,which can be safely used for upper limb function reconstruction,especially for entirely *** modifying procedures,musculocutaneous nerves and median nerve can be combined as recipient nerves.

关键词： Contralateral C7 Functional Recovery Meta-analysis Nerve Transfer

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