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Effects of delayed repair of peripheral nerve injury on the spatial distribution of motor endplates in target muscle

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Neural Regeneration Research 2022年第2期17卷 459-464页

作者： Dong-Dong Li Jin Deng Bo Jin Shuai Han Xin-Yi Gu Xue-Feng Zhou Xiao-Feng Yin Department of Trauma and Orthopedics Peking University People’s HospitalBeijingChina Department of Orthopedics PLA Strategic Support Force Medical CenterBeijingChina

Motor endplates(MEPs) are important sites of information exchange between motor neurons and skeletal muscle, and are distributed in an organized pattern of lamellae in the muscle. delayed repair of peripheral nerve injury typically results in unsatisfactory functional recovery because of MEP degeneration. In this study, the mouse tibial nerve was transected and repaired with a biodegradable chitin conduit, immediately following or 1 or 3 months after the injury. Fluorescent α-bungarotoxin was injected to label MEPs. Tissue optical clearing combined with light-sheet microscopy revealed that MEPs were distributed in an organized pattern of lamellae in skeletal muscle after delayed repair for 1 and 3 months. However, the total number of MEPs, the number of MEPs per lamellar cluster, and the maturation of single MEPs in gastrocnemius muscle gradually decreased with increasing denervation time. These findings suggest that delayed repair can restore the spatial distribution of MEPs, but it has an adverse effect on the homogeneity of MEPs in the lamellar clusters and the total number of MEPs in the target muscle. The study procedures were approved by the Animal Ethics Committee of the Peking University People's Hospital(approval No. 2019 PHC015) on April 8, 2019.

关键词： degeneration delayed repair lamellar cluster light-sheet microscopy motor endplates peripheral nerve injury three-dimensional distribution tissue optical clearing

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The proteome of distal nerves: implication in delayed repair and poor functional recovery

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Neural Regeneration Research 2022年第9期17卷 1998-2006页

作者： Song Guo Raymond M.Moore M.Cristine Charlesworth Kenneth L.Johnson Robert J.Spinner Anthony J.Windebank Huan Wang Department of Neurologic Surgery Mayo ClinicRochesterMNUSA Biomedical Statistics and Informatics Mayo ClinicRochesterMNUSA Proteomics Core Mayo ClinicRochesterMNUSA Department of Neurology Mayo ClinicRochesterMNUSA

Chronic denervation is one of the key factors that affect nerve regeneration.Chronic axotomy deteriorates the distal nerve stump,causes protein changes,and renders the microenvironment less permissive for regeneration.Some of these factors/proteins have been individually studied.To better delineate the comprehensive protein expression profiles and identify proteins that contribute to or are associated with this detrimental effect,we carried out a proteomic analysis of the distal nerve using an established delayed rat sciatic nerve repair model.Four rats that received immediate repair after sciatic nerve transection served as control,whereas four rats in the experimental group(chronic denervation)had their sciatic nerve repaired after a 12-week delay.All the rats were sacrificed after 16 weeks to harvest the distal nerves for extracting proteins.Twenty-five micrograms of protein from each sample were fractionated in SDS-PAGE gels.NanoLC-MS/MS analysis was applied to the gels.Protein expression levels of nerves on the surgery side were compared to those on the contralateral side.Any protein with a P value of less than 0.05 and a fold change of 4 or higher was deemed differentially expressed.All the differentially expressed proteins in both groups were further stratified according to the biological processes.A PubMed search was also conducted to identify the differentially expressed proteins that have been reported to be either beneficial or detrimental to nerve regeneration.Ingenuity Pathway Analysis(IPA)software was used for pathway analysis.The results showed that 709 differentially expressed proteins were identified in the delayed repair group,with a bigger proportion of immune and inflammatory process-related proteins and a smaller proportion of proteins related to axon regeneration and lipid metabolism in comparison to the control group where 478 differentially expressed proteins were identified.The experimental group also had more beneficial proteins that were downregulated and more detrimental proteins that

关键词： chronic axotomy chronic denervation delayed repair distal nerve functional recovery nerve regeneration peripheral nerve prolonged denervation proteome sciatic nerve sciatic nerve transection

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Electrical stimulation does not enhance nerve regeneration if delayed after sciatic nerve injury: the role of fibrosis

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Neural Regeneration Research 2015年第1期10卷 90-94页

作者： Na Han Chun-gui Xu Tian-bing Wang Yu-hui Kou Xiao-feng Yin Pei-xun Zhang Feng Xue Department of Trauma and Orthopedics Peking University People’s Hospital

Electrical stimulation has been shown to accelerate and enhance nerve regeneration in sensory and motor neurons after injury, but there is little evidence that focuses on the varying degrees of fibrosis in the delayed repair of peripheral nerve tissue. In this study, a rat model of sciatic nerve transec- tion injury was repaired with a biodegradable conduit at 1 day, 1 week, 1 month and 2 months after injury, when the rats were divided into two subgroups. In the experimental group, rats were treated with electrical stimuli of frequency of 20 Hz, pulse width 100 ms and direct current voltage of 3 V; while rats in the control group received no electrical stimulation after the conduit operation. His- tological results showed that stained collagen fibers comprised less than 20% of the total operated area in the two groups after delayed repair at both 1 day and 1 week but after longer delays, the collagen fiber area increased with the time after injury. Immunohistochemical staining revealed that the expression level of transforming growth factor ~ （an indicator of tissue fibrosis） decreased at both 1 day and 1 week after delayed repair but increased at both 1 and 2 months after delayed repair. These findings indicate that if the biodegradable conduit repair combined with electrical stimulation is delayed, it results in a poor outcome following sciatic nerve injury. One month after injury, tissue degeneration and distal fibrosis are apparent and are probably the main reason why electrical stimulation fails to promote nerve regeneration after delayed repair.

关键词： nerve regeneration peripheral nerve injury electrical stimulation bioabsorbableconduit delayed repair fibroblast collagen fibers transforming growth factor ~ Masson staining neuroprotection immunohistochemistry NSFC grants neural regeneration

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Timing of surgical repair of bile duct injuries after laparoscopic cholecystectomy: A systematic review

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World Journal of Hepatology 2022年第2期14卷 442-455页

作者： Patryk Kambakamba Sinead Cremen Beat Möckli Michael Linecker Department of HPB and Transplant Surgery St.Vincent’s University Hospital DublinDublin d04 T6F4Ireland Department of Surgery Cantonal Hospital GlarusGlarus 8750Switzerland Department of Visceral and Transplantation Surgery University of Geneva HospitalsGeneva 1205Switzerland Department of Surgery and Transplantation University Medical Center Schleswig HolsteinKiel 24105Germany

BACKGROUND The surgical management of bile duct injuries(BDIs)after laparoscopic cholecystectomy(LC)is challenging and the optimal timing of surgery remains unclear.The primary aim of this study was to systematically evaluate the evidence behind the timing of BDI repair after LC in the literature.AIM To assess timing of surgical repair of BDI and postoperative complications.METHODS The MEDLINE,EMBASE,and The Cochrane Library databases were systematically screened up to August 2021.Risk of bias was assessed via the Newcastle Ottawa scale.The primary outcomes of this review included the timing of BDI repair and postoperative complications.RESULTS A total of 439 abstracts were screened,and 24 studies were included with 15609 patients included in this review.Of the 5229 BDIs reported,4934(94%)were classified as major injury.Timing of bile duct repair was immediate(14%,n=705),early(28%,n=1367),delayed(28%,n=1367),or late(26%,n=1286).Standardization of definition for timing of repair was remarkably poor among studies.Definitions for immediate repair ranged fromrepair ranged fromdelayed(>24 h to>12 wk after LC)and late repair(>6 wk after LC)showed a broad overlap.CONCLUSION The lack of standardization among studies precludes any conclusive recommendation on optimal timing of BDI repair after LC.This finding indicates an urgent need for a standardized reporting system of BDI repair.

关键词： Bile duct injury Major bile duct injury Laparoscopic cholecystectomy Surgical repair Immediate repair Early repair delayed repair Late repair Biliary reconstruction Standardization of bile duct injury repair reporting

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delayed Management of Popliteal Artery Injury Following Knee Dislocation—A Case Report

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Open Journal of Orthopedics 2023年第10期13卷 427-434页

作者： Olomi Jimmy Said Abdulmajid Department of Orthopedics Traumatology University of Dar es Salaam Dar es Salaam Tanzania Department of Orthopedics Trauma Mnazimmoja Referral Hospital Zanzibar Tanzania

Knee dislocations frequently involve vascular injuries that demand early diagnosis and timely intervention. Time of ischemia is pivotal in determining the outcome for the limb, delays in treatment beyond 8 hours significantly increase the risk of limb loss. Unfortunately, this critical window is often missed in resource-limited settings. Here we report a 25-year-old female sustained a left knee injury after falling into a trench. She was diagnosed with an open knee dislocation accompanied by a popliteal artery injury. However, revascularization was delayed for 18 hours due to limited resources, including the unavailability of a thrombectomy catheter. Postoperatively, the patient received anticoagulation therapy with serial limb assessments and after 3 weeks the laceration healed and the limb was still viable. Knee dislocations frequently result in vascular injury (popliteal artery most common), making prompt diagnosis and intervention essential for limb preservation. In settings with limited resources, like ours, delayed presentation and transfer to specialized centers contribute to prolonged ischemic times. Nonetheless, viable limbs should be revascularized in stable patients, even with prolonged ischemia. This case highlights the importance of limb revascularization despite delay. Efforts should be made to improve prompt diagnosis, timely referral, and availability of necessary equipment for vascular repair to optimize outcomes in similar cases.

关键词： Knee Dislocation Popliteal Artery Injury delayed repair Vascular Injury Limb Salvage Ischemic Time

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A Geometric Process Maintenance Model of a repairable System with a Replaceable repair-Facility

A Geometric Process Maintenance Model of a Repairable System...

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2010 Chinese Control and Decision Conference

作者： Bing Zhao~1,Dequan Yue~2,Ruiling Tian~1 1.College of Science,Yanshan University,Qinhuangdao,066004,China 2.College of Science,Yanshan University,Qinhuangdao,066004,China

＜正＞In this paper,we studied a simple repairable system with delayed repair and a replaceable repair-facility. The successive working times and the consecutive repair times are distributed according to geometric processes.There is a delayed repair time before each repair and the repair-facility is not completely eliable.We derive some important reliability indicates and the explicit expression of the long-run expected cost per unit time of the system.

关键词： delayed repair Geometric Process Replacement Policy Renewal Process

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