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Regional anesthesia for orthopedic procedures:What orthopedic surgeons need to know

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World Journal of Orthopedics 2022年第1期13卷 11-35页

作者： Ihab Kamel Muhammad F Ahmed Anish Sethi Department of Anesthesiology Lewis Katz School of Medicine at Temple UniversityPhiladelphiaPA 19140United States

Regional anesthesia is an integral component of successful orthopedic *** anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative *** evaluation for regional anesthesia should include neurological,pulmonary,cardiovascular,and hematological *** blocks include spinal,epidural,and combined spinal *** extremity peripheral nerve blocks include interscalene,supraclavicular,infraclavicular,and *** extremity peripheral nerve blocks include femoral nerve block,saphenous nerve block,sciatic nerve block,iPACK block,ankle block and lumbar plexus *** choice of regional anesthesia is a unanimous decision made by the surgeon,the anesthesiologist,and the patient based on a risk-benefit *** choice of the regional block depends on patient cooperation,patient positing,operative structures,operative manipulation,tourniquet use and the impact of postoperative motor blockade on initiation of physical *** anesthesia is safe but has an inherent risk of failure and a relatively low incidence of complications such as local anesthetic systemic toxicity(LAST),nerve injury,falls,hematoma,infection and allergic *** should be used for regional anesthesia procedures to improve the efficacy and minimize *** treatment guidelines and rescue medications(intralipid)should be readily available during the regional anesthesia administration.

关键词： Orthopedic surgery Regional anesthesia Spinal Epidural Combined spinal epidural Peripheral nerve blocks Neuraxial blocks Upper extremity Lower extremity Interscalene Supraclavicular Infraclavicular Axillary Femoral Fascia iliaca Popliteal Sciatic Saphenous Adductor canal Lumbar plexus Brachial plexus Ankle iPACK Complication Local anesthetic systemic toxicity nerve injury Block failure Continuous nerve block catheters

State-of-the-art management for challenging complications in head and neck surgery

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Plastic and Aesthetic Research 2023年第1期10卷 18-27页

作者： Kiran Ganga Caitlin McMullen Department of Nutritional Sciences Cornell UniversityIthacaNY 14850USA Head&Neck-Endocrine Oncology Moffitt Cancer CenterTampaFL 33612USA

Head and neck surgical complications can result in significant morbidity for *** over the past few years have shown promise in mitigating these ***,new medications,bioactive agents,and bioengineered materials may reduce the resultant *** historic existing medical therapies,such as oxandrolone,tissue plasminogen activator,and royal jelly/honey,have new applications in the management of challenging head and neck surgical *** review describes some of the more common and challenging complications in head and neck surgery and modern techniques for management.

关键词： Chylous fistula venous thrombosis nerve injury microvascular free flap octreotide fistula

Surgical repair of a 30-mm-long human median nerve defect in the distal forearm by implantation of a chitosan/PGA nerve guidance conduit:a case study

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Surgical repair of a 30-mm-long human median nerve defect in...

Changes of auditory evoked magnetic fields in patients after acute cerebral infarction using magnetoencephalography

中国神经科学学会第四次会员代表大会暨第八届全国学术会议

作者： Wen HU~1,Jian-Hui GU~2,Ai-Dong DENG~2,Xiao-Song GU~(1,*) 1 Jiangsu Key Laboratory of Neuroregeneration,Nantong University,Nantong,226001 2 Department of Hand Surgery,Affiliated Hospital of Nantong University,Nantong,226001

Reconstruction of injured peripheral nerve by bridging neural defects with artificial nerve guidance conduits (NGCs),as an alternative to autologous nerve grafts,becomes one of the main concerns in the fields of microsurgery, plastic surgery,and regenerative *** have developed a novel design of artificial NGCs consisting of a chitosan conduit and longitudinally aligned filaments of polyglycolic acid(PGA) inserted in the conduit *** chitosan/PGA NGCs showed good biological properties,and yielded promising repair outcomes after they were used to bridge canine sciatic nerve defects as long as 30 *** also reported a case study in which a 35-mm-long human median nerve defect at elbow was repaired by the chitosan/PGA *** we describe another clinical case study in which a chitosan/PGA NGC was utilized to repair a 30-mm-long median nerve defect in the distal forearm of a 55-year-old ***-six months post-implantation,the function of the right abductor pollicis and opponens pollicis recovered to an M4 level. Static two-point discrimination measured 14,9,and 9 mm in the thumb,index and middle fingers of the right hand, indicating a S3 level sensory recovery for the injured median *** compound muscle action potentials were recorded on the right abductor *** ninnydrin test showed partial recovery in perspiration of the injured thumb,index and middle *** repair case suggests a potential strategy for clinical reconstruction of extended defects in peripheral nerve trunks by implantation of chitosan/PGA NGCs.

关键词： nerve injury peripheral nerve surgery median nerve nerve guidance conduits chitosan polyglycolic acid

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Neural Regeneration Research 2012年第24期7卷 1906-1913页

作者： Zhanyong Sun Chunfeng Song Jilin Sun Ling Li Yanhong Dong Jianhua Wang Jie Wu Wenzhu Cui Yujin Wu Peiyuan Lv Department of Neurology Hebei Medical UniversityShijiazhuang 050017Hebei ProvinceChina Institute of Basic Medicine Hebei Medical UniversityShijiazhuang 050017Hebei ProvinceChina Department of Magnetoencephalography Hebei General HospitalShijiazhuang 050051Hebei ProvinceChina Department of Neurology Hebei General HospitalShijiazhuang 050051Hebei ProvinceChina

Auditory evoked magnetic fields were recorded from 15 patients with acute cerebral infarction and 11 healthy volunteers using *** auditory stimuli of 2 kHz pure tone were binaurally presented with an interstimulus interval of 1 *** intensity of stimuli was 90 dB and the stimulus duration was 8 *** results showed that the M100 was the prominent response, peaking approximately 100 ms after stimulus onset in all *** originated from the area close to Heschl’s *** the patient group,the peak latency of M100 responses was significantly prolonged,and the mean strength of equivalent current dipole was significantly smaller in the affected *** three-dimensional inter-hemispheric difference of the M100 positions was increased in the patient *** experimental findings suggested that impairment of cerebral function in patients with acute ischemic stroke can be detected using magnetoencephalography with the higher spatial resolution and temporal *** could provide objective and sensitive indices to estimate auditory cortex function in patients with acute cerebral infarction.

关键词： acute cerebral infarction cerebral ischemia magnetoencephalography auditory evoked magnetic fields equivalent current dipole Heschl’s gyrus brain functional impairment nerve injury regeneration neural regeneration

Therapies for children with cerebral palsy A Web of Science-based literature analysis

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Neural Regeneration Research 2012年第33期7卷 2632-2639页

作者： Yaping Mu Na Li Lijun Guan Chunnan Wang Shuyun Shang Yan Wang Shenyang Children's Hospital Shenyang 110032 Liaoning Province China

OBJECTIVE： To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL： We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2002 to 2011 retrieved from Web of Science. SELECTION CRITERIA： Inclusion criteria：（a） peer-reviewed published articles on botulinum toxin, constraint-induced movement therapy, or acupuncture for children with cerebral palsy indexed in Web of Science; （b） original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and （c） publication between 2002 and 2011. Exclusion criteria：（a） articles that required manual searching or telephone access; （b） documents that were not published in the public domain; and （c） a number of corrected papers from the total number of articles. MAIN OUTCOME MEASURES：（1） Number of publications on the three therapies; （2） annual publication output, distribution by journals, distribution by institution, and top-cited articles on botulinum toxin; （3） annual publication output, distribution by journal, distribution by institution, and top-cited articles on constraint-induced movement therapy; （4） annual publication, distribution by journal, distribution by institution, and top-cited articles on acupuncture. RESULTS： This analysis, based on Web of Science articles, identified several research trends in studies published over the past 10 years of three therapies for children with cerebral palsy. More articles on botulinum toxin for treating children with cerebral palsy were published than the articles regarding constraint-induced movement therapy or acupuncture. The numbers of publications increased over the 10-year study period. Most papers appeared in journals with a focus on neurology, such as Developmental Medicine and Child Neurology and Journal of Child *** institutes publishing on botulinum toxin treatments for this population are mostly in the Neth

关键词： constraint-induced movement therapy botulinum toxin acupuncture cerebral palsy nerve injury infant children brain Web of Science bibliometric neural regeneration

Acupuncture activates signal transduction pathways related to brain-tissue restoration after ischemic injury

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Neural Regeneration Research 2012年第24期7卷 1866-1872页

作者： Haomei Tian Hong Zhang Junbao Zhu Juan Zhang Hening Cai Yuchen Zhang Chutao Chen Key Laboratory of Meridians and Viscera Hunan University of Traditional Chinese MedicineChangsha 410007Hunan ProvinceChina Liuzhou Hospital of Traditional Chinese Medicine Liuzhou 545001Guangxi Zhuang Autonomous RegionChina Ningxiang Hospital of Traditional Chinese Medicine Ningxiang 410600Hunan ProvinceChina Postgraduate College Hunan University of Traditional Chinese MedicineChangsha 410007Hunan ProvinceChina Laboratory of Acupuncture Bioinformatics Hunan University of Traditional Chinese MedicineChangsha 410007Hunan ProvinceChina

A middle cerebral artery occlusion-model was established in rats using the improved thread embolism *** were treated with acupuncture at either Dazhui（DU14）,Renzhong（DU26）, Baihui（DU20）,or a non-meridian *** with protein-chip technology showed that the level of protein phosphorylation in both groups was upregulated or downregulated depending on the signaling pathway compared with the model group that did not receive *** of proteins showing downregulated phosphorylation revealed that five signaling pathways were activated in the acupuncture-treatment group,while only two were activated in the acupuncture-control *** contrast,analysis of proteins showing upregulated phosphorylation revealed only one pathway was activated in the acupuncture-treatment group,whereas four pathways were activated in the acupuncture-control ***,the number of activated proteins in the acupuncture-treatment group was not only higher than the acupuncture-control group,but unlike the acupuncture-control group,the majority of activated proteins were key proteins in the signaling *** findings indicate that acupuncture at specific points can activate multiple signaling pathways to promote the restoration of brain tissue following ischemic injury,and that this is based on a combination of effects resulting from multiple pathways,targets,and means.

关键词： acupuncture cerebral ischemia Dazhui Baihui Renzhong protein-chip technology signal-transduction pathways nerve injury brain injury ischemic injury neural regeneration

Effect of midazolam on the proliferation of neural stem cells isolated from rat hippocampus

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Neural Regeneration Research 2012年第19期7卷 1475-1482页

作者： Sanjun Zhao Yajing Zhu Rui Xue Yunfeng Li Hui Lu Weidong Mi Department of Anesthesiology the General Hospital of Chinese PLA Beijing 100853 China Department of Obstetrics and Gynecology Luhe Teaching Hospital Capital Medical University Beijing 101100 China Beijing Institute of Pharmacology and Toxicology Beijing 100853 China The 254 Hospital of Chinese PLA Tianjin 300142 China

In many recent studies, the inhibitory transmitter gamma-aminobutyric acid has been shown to modulate the proliferation, differentiation and survival of neural stem cells. Most general anesthetics are partial or allosteric gamma-aminobutyric acid A receptor agonists, suggesting that general anesthetics could alter the behavior of neural stem cells. The neuroprotective efficacy of general anesthetics has been recognized for decades, but their effects on the proliferation of neural stem cells have received little attention. This study investigated the potential effect of midazolam, an extensively used general anesthetic and allosteric gamma-aminobutyric acid A receptor agonist, on the proliferation of neural stem cells in vitro and preliminarily explored the underlying mechanism. The proliferation of neural stem cells was tested using both Cell Counting Kit 8 and bromodeoxyuridine incorporation experiments. Cell distribution analysis was performed to describe changes in the cell cycle distribution in response to midazolam. Calcium imaging was employed to explore the molecular signaling pathways activated by midazolam. Midazolam （30-90 IJM） decreased the proliferation of neural stem cells in vitro. Pretreatment with the gamma-aminobutyric acid A receptor antagonist bicuculline or Na-K-2CI cotransport inhibitor furosemide partially rescued this inhibition. In addition, midazolam triggered a calcium influx into neural stem cells. The suppressive effect of midazolam on the proliferation of neural stem cells can be partly attributed to the activation of gamma-aminobutyric acid A receptor. The calcium influx triggered by midazolam may be a trigger factor leading to further downstream events.

关键词： general anesthetics gamma-aminobutyric acid A receptor midazolam hippocampus neural stemcells proliferation nerve injury neural regeneration

Neuronal differentiation effects of vascular endothelial factor on bone marrow stromal cells

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Neural Regeneration Research 2010年第9期5卷 657-661页

作者： Li Yi Qiaoyun Liu Jinling Han Jing Ye Fangting Zhang Guanghui Cui Zhuqing Zhou Department of Neurology Peking University Shenzhen HospitaI Shenzhen 518036 Guangdong Province China Medical College of Shantou University Shantou 515041 Guangdong Province China Central Laboratory Peking University Shenzhen Hospital Shenzhen 518036 Guangdong Province China Laboratory of Male Reproductive Medicine Peking University Shenzhen Hospital Shenzhen 518036 Guangdong Province China

BACKGROUND：Studies have demonstrated that bone marrow stromal cells （BMSCs） undergo neuronal differentiation under certain in vitro ***,very few inducers of BMSC differentiation have been used in clinical *** effects of vascular endothelial growth factor （VEGF） on in vitro neuronal differentiation of BMSCs remain poorly ***：To investigate the effect of VEGF on neuronal differentiation of BMSCs in vitro,and to determine the best VEGF concentration for experimental ***,TIME AND SETTING：In vitro comparative study was performed at the Central Laboratory and Laboratory of Male Reproductive Medicine,Shenzhen Hospital of Peking University from October 2008 to August ***：Recombinant human VEGF165 was purchased from Peprotech Asia,Rehovot,***-specific enolase （NSE） was purchased from Beijing Biosynthesis Biotechnology,***：BMSCs were harvested from adult Sprague Dawley *** passaged cells were pre-induced with 10 ng/mL basic fibroblast growth factor for 24 hours,followed by differentiation induction with 0,5,10,and 20 ng/mL VEGF,*** OUTCOME MEASURES：Morphological changes in BMSCs prior to and following VEGF *** of NSE following induction was determined by ***：Shrunken,round cells,with a strong refraction and thin bipolar or multipolar primary and secondary branches were observed 3 days after induction with 5,10,and 20 ng/mL ***,these changes were not observed in the control *** 10 days after induction,the number of NSE-positive cells was greatest in the 10 ng/mL VEGF-treated group （P〈 0.05）.The number of NSE-positive cells was least in the control group at 3 and 10 days post-induction （P〈 0.05）.Moreover,the number of NSE-positive cells was greater at 10 days compared with at 3 days after induction （P〈 0.05）.CONCLUSION：Of the VEGF concentrations tested,10 ng/mL induced the greatest number of neuronal-like cells in vitr

关键词： vascular endothelial growth factor bone marrow stromal cells neuronal-like cells cell differentiation nerve injury neural regeneration

Neurofilament proteins in axonal regeneration and neurodegenerative diseases

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Neural Regeneration Research 2012年第8期7卷 620-626页

作者： Haitao Wang Minfei Wu Chuanjun Zhan Enyuan Ma Maoguang Yang Xiaoyu Yang Yingpu Li Department of Spine Surgery China-Japan Union Hospital Jilin University Changchun 130033 Jilin Province China Department of Orthopedic Surgery Beihua University Affiliated Hospital Jilin 132000 Jilin Province China

Neurofilament protein is a component of the mature neuronal cytoskeleton, and it interacts with the zygosome, which is mediated by neurofilament-related proteins. Neurofilament protein regulates enzyme function and the structure of linker proteins. In addition, neurofilament gene expression plays an important role in nervous system development. Previous studies have shown that neurofilament gene transcriptional regulation is crucial for neurofilament protein expression, especially in axonal regeneration and degenerative diseases. Post-transcriptional regulation increased neurofilament protein gene transcription during axonal regeneration, ultimately resulting in a pattern of neurofilament protein expression. An expression imbalance of post-transcriptional regulatory proteins and other disorders could lead to amyotrophic lateral sclerosis or other neurodegenerative diseases. These findings indicated that after transcription, neurofilament protein regulated expression of related proteins and promoted regeneration of damaged axons, suggesting that regulation disorders could lead to neurodegenerative diseases.

关键词： axonal regeneration nerve injury neurodegenerative diseases neurofilament protein post-transcriptional regulation reviews