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    15 January 2015, Volume 10 Issue 1 Previous Issue    Next Issue
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    Serine-threonine protein kinase activation may be an effective target for reducing neuronal apoptosis after spinal cord injury
    Mu Jin, Yan-wei Yang, Wei-ping Cheng, Jia-kai Lu, Si-yu Hou, Xiu-hua Dong, Shi-yao Liu
    2015, 10 (1):  1-6. 
    Abstract ( 45 )   PDF (1839KB) ( 199 )   Save

    The signaling mechanisms underlying ischemia-induced nerve cell apoptosis are poorly understood. We investigated the effects of apoptosis-related signal transduction pathways following ischemic spinal cord injury, including extracellular signal-regulated kinase (ERK), serine-threonine protein kinase (Akt) and c-Jun N-terminal kinase (JNK) signaling pathways. We established a rat model of acute spinal cord injury by inserting a catheter balloon in the left subclavian artery for 25 minutes. Rat models exhibited notable hindlimb dysfunction. Apoptotic cells were abundant in the anterior horn and central canal of the spinal cord. The number of apoptotic neurons was highest 48 hours post injury. The expression of phosphorylated Akt (p-Akt) and phosphorylated ERK (p-ERK) increased immediately after reperfusion, peaked at 4 hours (p-Akt) or 2 hours (p-ERK), decreased at 12 hours, and then increased at 24 hours. Phosphorylated JNK expression reduced after reperfusion, increased at 12 hours to near normal levels, and then showed a downward trend at 24 hours. Pearson linear correlation analysis also demonstrated that the number of apoptotic cells negatively correlated with p-Akt expression. These findings suggest that activation of Akt may be a key contributing factor in the delay of neuronal apoptosis after spinal cord ischemia, particularly at the stage of reperfusion, and thus may be a target for neuronal protection and reduction of neuronal apoptosis after spinal cord injury.

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    Letter from the Editors-in-Chief
    Kwok-fai So and Xiao-ming Xu
    2015, 10 (1):  5-6. 
    Abstract ( 226 )   PDF (264KB) ( 829 )   Save
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    Fat cell-secreted adiponectin mediates physical exercise-induced hippocampal neurogenesis: an alternative anti-depressive treatment?
    Suk Yu,Ang Li,Aimin Xu,Kwok-fai So
    2015, 10 (1):  7-9.  doi: 10.4103/1673-5374.150637
    Abstract ( 247 )   PDF (247KB) ( 986 )   Save

    Psychological depression is drawing accumulating attention nowadays, due to the skyrocketing incidence worldwide and the enormous burdens it incurs. Physical exercise has been long recognized for its therapeutic effects on depressive disorders, although knowledge of the underlying mechanisms remains limited. Suppressed hippocampal neurogenesis in adult brains has been regarded, at least partly, contributive to depression, whereas physical exercise that restores neurogenesis accordingly exerts the anti-depressive action. Several recent publications have suggested the potential role of adiponectin, a protein hormone secreted by peripheral mature adipocytes, in mediating physical exercise-triggered enhancement of hippocampal neurogenesis and alleviation of depression. Here, we briefly review these novel findings and discuss the possibility of counteracting depression by modulating adiponectin signaling in the hippocampus with interventions including physical exercise and administration of pharmacological agents.

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    Induced pluripotent stem cell-derived neural stem cell therapies for spinal cord injury
    Corinne A. Lee-Kubli, Paul Lu
    2015, 10 (1):  10-16.  doi: 10.4103/1673-5374.150638
    Abstract ( 218 )   PDF (471KB) ( 902 )   Save

    The greatest challenge to successful treatment of spinal cord injury is the limited regenerative capacity of the central nervous system and its inability to replace lost neurons and severed axons following injury. Neural stem cell grafts derived from fetal central nervous system tissue or embryonic stem cells have shown therapeutic promise by differentiation into neurons and glia that have the potential to form functional neuronal relays across injured spinal cord segments. However, implementation of fetal-derived or embryonic stem cell-derived neural stem cell therapies for patients with spinal cord injury raises ethical concerns. Induced pluripotent stem cells can be generated from adult somatic cells and differentiated into neural stem cells suitable for therapeutic use, thereby providing an ethical source of implantable cells that can be made in an autologous fashion to avoid problems of immune rejection. This review discusses the therapeutic potential of human induced pluripotent stem cell-derived neural stem cell transplantation for treatment of spinal cord injury, as well as addressing potential mechanisms, future perspectives and challenges.

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    Synthetic neurosteroids on brain protection
    Mariana Rey, Héctor Coirini
    2015, 10 (1):  17-21.  doi: 10.4103/1673-5374.150640
    Abstract ( 269 )   PDF (214KB) ( 996 )   Save

    Neurosteroids, like allopregnanolone and pregnanolone, are endogenous regulators of neuronal excitability. Inside the brain, they are highly selective and potent modulators of GABAA receptor activity. Their anticonvulsant, anesthetics and anxiolytic properties are useful for the treatments of several neurological and psychiatric disorders via reducing the risks of side effects obtained with the commercial drugs. The principal disadvantages of endogenous neurosteroids administration are their rapid metabolism and their low oral bioavailability. Synthetic steroids analogues with major stability or endogenous neurosteroids stimulation synthesis might constitute promising novel strategies for the treatment of several disorders. Numerous studies indicate that the 3α-hydroxyl configuration is the key for binding and activity, but modifications in the steroid nucleus may emphasize different pharmacophores. So far, several synthetic steroids have been developed with successful neurosteroid-like effects. In this work, we summarize the properties of various synthetic steroids probed in trials throughout the analysis of several neurosteroids-like actions.

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    Clinical strategies to enhance nerve regeneration
    Thomas H. Tung
    2015, 10 (1):  22-24.  doi: 10.4103/1673-5374.150641
    Abstract ( 259 )   PDF (157KB) ( 739 )   Save
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    “Bad regenerators” die after spinal cord injury: insights from lampreys
    Antón Barreiro-Iglesias
    2015, 10 (1):  25-27.  doi: 10.4103/1673-5374.150642
    Abstract ( 263 )   PDF (607KB) ( 780 )   Save
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    Prediabetes and type 2 diabetes implication in central proliferation and neurogenesis
    Carmen Infante-Garcia, Juan Jose Ramos-Rodriguez, Monica Garcia-Alloza
    2015, 10 (1):  28-29.  doi: 10.4103/1673-5374.150646
    Abstract ( 301 )   PDF (144KB) ( 1148 )   Save

    高胰岛素血症和糖耐量异常是2型糖尿病的主要病理特征,并可能会加剧神经退行性变进程、突触丢失以及脑萎缩,导致认知功能障碍。因此,西班牙卡迪兹大学医学院的Monica Garcia-Alloza教授已经研究了经典的2型糖尿病db/db小鼠模型及长期C57B16小鼠高脂饲料喂养后建立的胰岛素抵抗的前期糖尿病模型中枢神经系统形态,细胞增殖和神经发生,他们还发现了代谢参数与脑萎缩以及中枢神经系统中细胞增殖的改变和神经发生间的关系。总而言之,这些数据证明老年患者的血糖控制可以帮助控制中枢脑神经元改变并改善老年痴呆症预后。

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    Can cinnamon bring aroma in Parkinson’s disease treatment?
    Priyanka Pahan, Kalipada Pahan
    2015, 10 (1):  30-32.  doi: 10.4103/1673-5374.150647
    Abstract ( 284 )   PDF (208KB) ( 1149 )   Save
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    Acupuncture: a potent therapeutic tool for inducing adult neurogenesis
    Min-Ho Nam, Kwang Seok Ahn, Seung-Hoon Choi
    2015, 10 (1):  33-35.  doi: 10.4103/1673-5374.150643
    Abstract ( 276 )   PDF (611KB) ( 877 )   Save
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    The human retinal stem niches could overlap a vascular anatomical pattern
    Mugurel Constantin Rusu, Alexandra Diana Vrapciu
    2015, 10 (1):  39-40.  doi: 10.4103/1673-5374.150651
    Abstract ( 291 )   PDF (872KB) ( 882 )   Save
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    A substrate scaffold for assessment of nerve regeneration and neurodegenerative diseases
    Wei-Hsin Chen, Yi-Wen Lin
    2015, 10 (1):  41-42.  doi: 10.4103/1673-5374.150650
    Abstract ( 476 )   PDF (184KB) ( 718 )   Save
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    LOTUS, a potent blocker of Nogo receptor-1 causing inhibition of axonal growth
    Yuji Kurihara, Kohtaro Takei
    2015, 10 (1):  46-48.  doi: 10.4103/1673-5374.150652
    Abstract ( 312 )   PDF (258KB) ( 1137 )   Save
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    Multiple facets of poly(ADP-ribose) polymerase-1 in neurological diseases
    Chandra Shaker Sriram, Ashok Jangra, Rajaram Mohanrao Madhana, Satendra Singh Gurjar, Pritam Mohan, Babul Kumar Bezbaruah
    2015, 10 (1):  49-51.  doi: 10.4103/1673-5374.150653
    Abstract ( 240 )   PDF (317KB) ( 1111 )   Save
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    Neural regeneration after peripheral nerve injury repair is a system remodelling process of interaction between nerves and terminal effector
    Pei-xun Zhang, Xiao-feng Yin, Yu-hui Kou, Feng Xue, Na Han, Bao-guo Jiang
    2015, 10 (1):  52-52.  doi: 10.4103/1673-5374.150705
    Abstract ( 462 )   PDF (123KB) ( 832 )   Save
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    Sleeve bridging of the rhesus monkey ulnar nerve with muscular branches of the pronator teres: multiple amplification of axonal regeneration
    Yu-hui Kou, Pei-xun Zhang, Yan-hua Wang, Bo Chen, Na Han, Feng Xue, Hong-bo Zhang, Xiao-feng Yin, Bao-guo Jiang
    2015, 10 (1):  53-59.  doi: 10.4103/1673-5374.150706
    Abstract ( 328 )   PDF (1348KB) ( 885 )   Save

    Multiple-bud regeneration, i.e., multiple amplification, has been shown to exist in peripheral nerve regeneration. Multiple buds grow towards the distal nerve stump during proximal nerve fiber regeneration. Our previous studies have verified the limit and validity of multiple amplification of peripheral nerve regeneration using small gap sleeve bridging of small donor nerves to repair large receptor nerves in rodents. The present study sought to observe multiple amplification of myelinated nerve fiber regeneration in the primate peripheral nerve. Rhesus monkey models of distal ulnar nerve defects were established and repaired using muscular branches of the right forearm pronator teres. Proximal muscular branches of the pronator teres were sutured into the distal ulnar nerve using the small gap sleeve bridging method. At 6 months after suture, two-finger flexion and mild wrist flexion were restored in the ulnar-sided injured limbs of rhesus monkey. Neurophysiological examination showed that motor nerve conduction velocity reached 22.63 ± 6.34 m/s on the affected side of rhesus monkey. Osmium tetroxide staining demonstrated that the number of myelinated nerve fibers was 1,657 ± 652 in the branches of pronator teres of donor, and 2,661 ± 843 in the repaired ulnar nerve. The rate of multiple amplification of regenerating myelinated nerve fibers was 1.61. These data showed that when muscular branches of the pronator teres were used to repair ulnar nerve in primates, effective regeneration was observed in regenerating nerve fibers, and functions of the injured ulnar nerve were restored to a certain extent. Moreover, multiple amplification was subsequently detected in ulnar nerve axons.

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    Large animal models of human cauda equina injury and repair: evaluation of a novel goat model
    Wen-tao Chen, Pei-xun Zhang, Feng Xue, Xiao-feng Yin, Cao-yuan Qi, Jun Ma, Bo Chen, You-lai Yu, Jiu-xu Deng, Bao-guo Jiang
    2015, 10 (1):  60-64.  doi: 10.4103/1673-5374.150707
    Abstract ( 181 )   PDF (975KB) ( 891 )   Save

    Previous animal studies of cauda equina injury have primarily used rat models, which display significant differences from humans. Furthermore, most studies have focused on electrophysiological examination. To better mimic the outcome after surgical repair of cauda equina injury, a novel animal model was established in the goat. Electrophysiological, histological and magnetic resonance imaging methods were used to evaluate the morphological and functional outcome after cauda equina injury and end-to-end suture. Our results demonstrate successful establishment of the goat experimental model of cauda equina injury. This novel model can provide detailed information on the nerve regenerative process following surgical repair of cauda equina injury.

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    Expression pattern of neuregulin-1 type III during the development of the peripheral nervous system
    Liang-liang Huang, Zhong-yang Liu, Jing-hui Huang, Zhuo-jing Luo
    2015, 10 (1):  65-70.  doi: 10.4103/1673-5374.150708
    Abstract ( 191 )   PDF (3341KB) ( 924 )   Save

    Neuregulin-1 type III is a key regulator in Schwann cell proliferation, committing to a myelinating fate and regulating myelin sheath thickness. However, the expression pattern of neuregulin-1 type III in the peripheral nervous system during developmental periods (such as the premyelinating stage, myelinating stage and postmyelinating stage) has rarely been studied. In this study, dorsal root ganglia were isolated from rats between postnatal day 1 and postnatal day 56. The expression pattern of neuregulin-1 type III in dorsal root ganglia neurons at various developmental stages were compared by quantitative real-time polymerase chain reaction, western blot assay and immunofluorescent staining. The expression of neuregulin-1 type III mRNA reached its peak at postnatal day 3 and then stabilized at a relative high expression level from postnatal day 3 to postnatal day 56. The expression of neuregulin-1 type III protein increased gradually from postnatal day 1, reached a peak at postnatal day 28, and then decreased at postnatal day 56. Immunofluorescent staining results showed a similar tendency to western blot assay results. Experimental findings indicate that the expression of neuregulin-1 type III in rat dorsal root ganglion was increased during the premyelinating (from postnatal day 2 to postnatal day 5) and myelinating stage (from postnatal day 5 to postnatal day 10), but remained at a high level in the postmyelinating stage (after postnatal day 10).

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    Biological conduit small gap sleeve bridging method for peripheral nerve injury: regeneration law of nerve fibers in the conduit
    Pei-xun Zhang, Li-ya A, Yu-hui Kou, Xiao-feng Yin, Feng Xue, Na Han, Tian-bing Wang, Bao-guo Jiang
    2015, 10 (1):  71-78.  doi: 10.4103/1673-5374.150709
    Abstract ( 245 )   PDF (6142KB) ( 822 )   Save

    The clinical effects of 2-mm small gap sleeve bridging of the biological conduit to repair peripheral nerve injury are better than in the traditional epineurium suture, so it is possible to replace the epineurium suture in the treatment of peripheral nerve injury. This study sought to identify the regeneration law of nerve fibers in the biological conduit. A nerve regeneration chamber was constructed in models of sciatic nerve injury using 2-mm small gap sleeve bridging of a biodegradable biological conduit. The results showed that the biological conduit had good histocompatibility. Tissue and cell apoptosis in the conduit apparently lessened, and regenerating nerve fibers were common. The degeneration regeneration law of Schwann cells and axons in the conduit was quite different from that in traditional epineurium suture. During the prime period for nerve fiber regeneration (2–8 weeks), the number of Schwann cells and nerve fibers was higher in both proximal and distal ends, and the effects of the small gap sleeve bridging method were better than those of the traditional epineurium suture. The above results provide an objective and reliable theoretical basis for the clinical application of the biological conduit small gap sleeve bridging method to repair peripheral nerve injury.

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    Use of nerve elongator to repair short-distance peripheral nerve defects: a prospective randomized study
    Lu Bai, Tian-bing Wang, Xin Wang, Wei-wen Zhang, Ji-hai Xu, Xiao-ming Cai, Dan-ya Zhou, Li-bing Cai, Jia-dong Pan,Min-tao Tian, Hong Chen, Dian-ying Zhang, Zhong-guo Fu, Pei-xun Zhang, Bao-guo Jiang
    2015, 10 (1):  79-83.  doi: 10.4103/1673-5374.150710
    Abstract ( 178 )   PDF (674KB) ( 966 )   Save

    Repair techniques for short-distance peripheral nerve defects, including adjacent joint flexion to reduce the distance between the nerve stump defects, “nerve splint” suturing, and nerve sleeve connection, have some disadvantages. Therefore, we designed a repair technique involving intraoperative tension-free application of a nerve elongator and obtained good outcomes in the repair of short-distance peripheral nerve defects in a previous animal study. The present study compared the clinical outcomes between the use of this nerve elongator and performance of the conventional method in the repair of short-distance transection injuries in human elbows. The 3-, 6-, and 12-month postoperative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group, but no significant difference in long-term neurological function recovery was detected between the two groups. In the nerve elongation group, the nerves were sutured without tension, and the duration of postoperative immobilization of the elbow was decreased. Elbow function rehabilitation was significantly better in the nerve elongation group than in the control group. Moreover, there were no security risks. The results of this study confirm that the use of this nerve elongator for repair of short-distance peripheral nerve defects is safe and effective.

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    Local administration of icariin contributes to peripheral nerve regeneration and functional recovery
    Bo Chen, Su-ping Niu, Zhi-yong Wang, Zhen-wei Wang, Jiu-xu Deng, Pei-xun Zhang, Xiao-feng Yin, Na Han, Yu-hui Kou
    2015, 10 (1):  84-89.  doi: 10.4103/1673-5374.150711
    Abstract ( 219 )   PDF (3071KB) ( 1134 )   Save

    Our previous study showed that systemic administration of the traditional Chinese medicine Epimedium extract promotes peripheral nerve regeneration. Here, we sought to explore the therapeutic effects of local administration of icariin, a major component of Epimedium extract, on peripheral nerve regeneration. A poly(lactic-co-glycolic acid) biological conduit sleeve was used to bridge a 5 mm right sciatic nerve defect in rats, and physiological saline, nerve growth factor, icariin suspension, or nerve growth factor-releasing microsphere suspension was injected into the defect. Twelve weeks later, sciatic nerve conduction velocity and the number of myelinated fibers were notably greater in the rats treated with icariin suspension or nerve growth factor-releasing microspheres than those that had received nerve growth factor or physiological saline. The effects of icariin suspension were similar to those of nerve growth factor-releasing microspheres. These data suggest that icariin acts as a nerve growth factor-releasing agent, and indicate that local application of icariin after spinal injury can promote peripheral nerve regeneration.

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    Electrical stimulation does not enhance nerve regeneration if delayed after sciatic nerve injury: the role of fibrosis
    Na Han, Chun-gui Xu, Tian-bing Wang, Yu-hui Kou, Xiao-feng Yin, Pei-xun Zhang, Feng Xue
    2015, 10 (1):  90-94.  doi: 10.4103/1673-5374.150714
    Abstract ( 245 )   PDF (1845KB) ( 1840 )   Save

    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 transection 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. Histological 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 β (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.

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    One-stage human acellular nerve allograft reconstruction for digital nerve defects
    Xue-yuan Li, Hao-liang Hu, Jian-rong Fei, Xin Wang, Tian-bing Wang, Pei-xun Zhang, Hong Chen
    2015, 10 (1):  95-98.  doi: 10.4103/1673-5374.150712
    Abstract ( 258 )   PDF (556KB) ( 749 )   Save

    Human acellular nerve allografts have a wide range of donor origin and can effectively avoid nerve injury in the donor area. Very little is known about one-stage reconstruction of digital nerve defects. The present study observed the feasibility and effectiveness of human acellular nerve allograft in the reconstruction of < 5-cm digital nerve defects within 6 hours after injury. A total of 15 cases of nerve injury, combined with nerve defects in 18 digits from the Department of Emergency were enrolled in this study. After debridement, digital nerves were reconstructed using human acellular nerve allografts. The patients were followed up for 6–24 months after reconstruction. Mackinnon-Dellon static two-point discrimination results showed excellent and good rates of 89%. Semmes-Weinstein monofilament test demonstrated that light touch was normal, with an obvious improvement rate of 78%. These findings confirmed that human acellular nerve allograft for one-stage reconstruction of digital nerve defect after hand injury is feasible, which provides a novel trend for peripheral nerve reconstruction.

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    Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery
    Lu Bai, Yan-ni Han, Wen-tao Zhang, Wei Huang, Hong-lei Zhang
    2015, 10 (1):  99-103.  doi: 10.4103/1673-5374.150713
    Abstract ( 561 )   PDF (479KB) ( 1012 )   Save

    Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Patients received oral vitamin B12 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory function in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months.

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    Biodegradable chitin conduit tubulation combined with bone marrow mesenchymal stem cell transplantation for treatment of spinal cord injury by  reducing glial scar and cavity formation
    Feng Xue, Er-jun Wu, Pei-xun Zhang, Li-ya A, Yu-hui Kou, Xiao-feng Yin, Na Han
    2015, 10 (1):  104-111.  doi: 10.4103/1673-5374.150715
    Abstract ( 228 )   PDF (3354KB) ( 630 )   Save

    We examined the restorative effect of modified biodegradable chitin conduits in combination with bone marrow mesenchymal stem cell transplantation after right spinal cord hemisection injury. Immunohistochemical staining revealed that biological conduit sleeve bridging reduced glial scar formation and spinal muscular atrophy after spinal cord hemisection. Bone marrow mesenchymal stem cells survived and proliferated after transplantation in vivo, and differentiated into cells double-positive for S100 (Schwann cell marker) and glial fibrillary acidic protein (glial cell marker) at 8 weeks. Retrograde tracing showed that more nerve fibers had grown through the injured spinal cord at 14 weeks after combination therapy than either treatment alone. Our findings indicate that a biological conduit combined with bone marrow mesenchymal stem cell transplantation effectively prevented scar formation and provided a favorable local microenvironment for the proliferation, migration and differentiation of bone marrow mesenchymal stem cells in the spinal cord, thus promoting restoration following spinal cord hemisection injury.

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    Nerve biopsy findings contribute to diagnosis of multiple mononeuropathy: 78% of findings support clinical diagnosis
    Ying-shuang Zhang, A-ping Sun, Lu Chen, Rong-fang Dong, Yan-feng Zhong, Jun Zhang
    2015, 10 (1):  112-118.  doi: 10.4103/1673-5374.150716
    Abstract ( 260 )   PDF (2049KB) ( 865 )   Save

    Multiple mononeuropathy is an unusual form of peripheral neuropathy involving two or more nerve trunks. It is a syndrome with many different causes. We reviewed the clinical, electrophysiological and nerve biopsy findings of 14 patients who suffered from multiple mononeuropathy in our clinic between January 2009 and June 2013. Patients were diagnosed with vasculitic neuropathy (n = 6), perineuritis (n = 2), chronic inflammatory demyelinating polyradiculoneuropathy(n = 2) or Lewis-Sumner syndrome (n = 1) on the basis of clinical features, laboratory data, electrophysiological investigations and nerve biopsies. Two patients who were clinically diagnosed with vasculitic neuropathy and one patient who was clinically diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy were not confirmed by nerve biopsy. Nerve biopsies confirmed clinical diagnosis in 78.6% of the patients (11/14). Nerve biopsy pathological diagnosis is crucial to the etiological diagnosis of multiple mononeuropathy.

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    Dorsal root ganglion neurons promote proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells
    Pei-xun Zhang, Xiao-rui Jiang, Lei Wang, Fang-min Chen, Lin Xu, Fei Huang
    2015, 10 (1):  119-123.  doi: 10.4103/1673-5374.150717
    Abstract ( 247 )   PDF (575KB) ( 976 )   Save

    Preliminary animal experiments have confirmed that sensory nerve fibers promote osteoblast differentiation, but motor nerve fibers have no promotion effect. Whether sensory neurons promote the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells remains unclear. No results at the cellular level have been reported. In this study, dorsal root ganglion neurons (sensory neurons) from Sprague-Dawley fetal rats were co-cultured with bone marrow mesenchymal stem cells transfected with green fluorescent protein 3 weeks after osteogenic differentiation in vitro, while osteoblasts derived from bone marrow mesenchymal stem cells served as the control group. The rat dorsal root ganglion neurons promoted the proliferation of bone marrow mesenchymal stem cell-derived osteoblasts at 3 and 5 days of co-culture, as observed by fluorescence microscopy. The levels of mRNAs for osteogenic differentiation-related factors (including alkaline phosphatase, osteocalcin, osteopontin and bone morphogenetic protein 2) in the co-culture group were higher than those in the control group, as detected by real-time quantitative PCR. Our findings indicate that dorsal root ganglion neurons promote the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells, which provides a theoretical basis for in vitro experiments aimed at constructing tissue-engineered bone.

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    Bacterial melanin promotes recovery after sciatic nerve injury in rats
    Olga. V. Gevorkyan, Irina B. Meliksetyan, Tigran R. Petrosyan, Anichka S. Hovsepyan
    2015, 10 (1):  124-127.  doi: 10.4103/1673-5374.150719
    Abstract ( 199 )   PDF (322KB) ( 842 )   Save

    Bacterial melanin, obtained from the mutant strain of Bacillus Thuringiensis, has been shown to promote recovery after central nervous system injury. It is hypothesized, in this study, that bacterial melanin can promote structural and functional recovery after peripheral nerve injury. Rats subjected to sciatic nerve transection were intramuscularly administered bacterial melanin. The sciatic nerve transected rats that did not receive intramuscular administration of bacterial melanin served as controls. Behavior tests showed that compared to control rats, the time taken for instrumental conditioned reflex recovery was significantly shorter and the ability to keep the balance on the rotating bar was significantly better in bacterial melanin-treated rats. Histomorphological tests showed that bacterial melanin promoted axon regeneration after sciatic nerve injury. These findings suggest that bacterial melanin exhibits neuroprotective effects on injured sciatic nerve, contributes to limb motor function recovery, and therefore can be used for rehabilitation treatment of peripheral nerve injury. 

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    Improvement in acupoint selection for acupuncture of nerves surrounding the injury site: electro-acupuncture with Governor vessel with local meridian acupoints
    Guan-heng He, Jing-wen Ruan, Yuan-shan Zeng, Xin Zhou, Ying Ding, Guang-hui Zhou
    2015, 10 (1):  128-135.  doi: 10.4103/1673-5374.150720
    Abstract ( 360 )   PDF (1504KB) ( 1061 )   Save

    Peripheral nerve injury not only affects the site of the injury, but can also induce neuronal apoptosis at the spinal cord. However, many acupuncture clinicians still focus only on the injury site, selecting acupoints entirely along the injured nerve trunk and neglecting other regions; this may delay onset of treatment efficacy and rehabilitation. Therefore, in the present study, we compared the clinical efficacy of acupuncture at Governor vessel and local meridian acupoints combined (GV/LM group) with acupuncture at local meridian acupoints alone (LM group) in the treatment of patients with peripheral nerve injury. In the GV/LM group (n = 15), in addition to meridian acupoints at the injury site, the following acupoints on the Governor vessel were stimulated: Baihui (GV20), Fengfu (GV16), Dazhui (GV14), and Shenzhu (GV12), selected to treat nerve injury of the upper limb, and Jizhong (GV6), Mingmen (GV4), Yaoyangguan (GV3), and Yaoshu (GV2) to treat nerve injury of the lower limb. In the LM group (n = 15), only meridian acupoints along the injured nerve were selected. Both groups had electroacupuncture treatment for 30 minutes, once a day, 5 times per week, for 6 weeks. Two cases dropped out of the LM group. A good or excellent clinical response was obtained in 80% of the patients in the GV/LM group and 38.5% of the LM group. In a second study, an additional 20 patients underwent acupuncture with the same prescription as the GV/LM group. Electomyographic nerve conduction tests were performed before and after acupuncture to explore the mechanism of action of the treatment. An effective response was observed in 80.0% of the patients, with greater motor nerve conduction velocity and amplitude after treatment, indicating that electroacupuncture on specific Governor vessel acupoints promotes functional motor nerve repair after peripheral nerve injury. In addition, electromyography was performed before, during and after electroacupuncture in one patient with radial nerve injury. After a single session, the patient’s motor nerve conduction velocity increased by 23.2%, indicating that electroacupuncture at Governor vessel acupoints has an immediate therapeutic effect on peripheral nerve injury. Our results indicate that Governor vessel and local meridian acupoints used simultaneously promote functional repair after peripheral nerve injury. The mechanism of action may arise from an improvement of the local microenvironment in injured nervous tissue, as well as immediate effects of Governor vessel and local meridian acupoint stimulation to ensure the continuity between the peripheral and central nervous systems.

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    Allograft pretreatment for the repair of sciatic nerve defects: green tea polyphenols versus radiation
    Sheng-hu Zhou, Ping Zhen, Shen-song Li, Xiao-yan Liang, Ming-xuan Gao, Qi Tian, Xu-sheng Li
    2015, 10 (1):  136-140.  doi: 10.4103/1673-5374.150722
    Abstract ( 211 )   PDF (1310KB) ( 975 )   Save

    Pretreatment of nerve allografts by exposure to irradiation or green tea polyphenols can eliminate neuroimmunogenicity, inhibit early immunological rejection, encourage nerve regeneration and functional recovery, improve tissue preservation, and minimize postoperative infection. In the present study, we investigate which intervention achieves better results. We produced a 1.0 cm sciatic nerve defect in rats, and divided the rats into four treatment groups: autograft, fresh nerve allograft, green tea polyphenol-pretreated (1 mg/mL, 4°C) nerve allograft, and irradiation-pretreated nerve allograft (26.39 Gy/min for 12 hours; total 19 kGy). The animals were observed, and sciatic nerve electrophysiology, histology, and transmission electron microscopy were carried out at 6 and 12 weeks after grafting. The circumference and structure of the transplanted nerve in rats that received autografts or green tea polyphenol-pretreated nerve allografts were similar to those of the host sciatic nerve. Compared with the groups that received fresh or irradiation-pretreated nerve allografts, motor nerve conduction velocity in the autograft and fresh nerve allograft groups was greater, more neurites grew into the allografts, Schwann cell proliferation was evident, and a large number of new blood vessels was observed; in addition, massive myelinated nerve fibers formed, and abundant microfilaments and microtubules were present in the axoplasm. Our findings indicate that nerve allografts pretreated by green tea polyphenols are equivalent to transplanting autologous nerves in the repair of sciatic nerve defects, and promote nerve regeneration. Pretreatment using green tea polyphenols is better than pretreatment with irradiation.

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    Applied anatomical study of the vascularized ulnar nerve and its blood supply for cubital tunnel syndrome at the elbow region
    Mei-xiu-li Li, Qiong He, Zhong-lin Hu, Sheng-hua Chen, Yun-cheng Lv, Zheng-hai Liu, Yong Wen, Tian-hong Peng
    2015, 10 (1):  141-145.  doi: 10.4103/1673-5374.150723
    Abstract ( 241 )   PDF (489KB) ( 964 )   Save

    Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. In the present study, the ulnar nerve and its blood vessels were examined in the elbows of 18 adult cadavers, and the external diameter of the nutrient vessels of the ulnar nerve at the point of origin, the distances between the origin of the vessels and the medial epicondyle of the humerus, and the length of the vessels accompanying the ulnar nerve in the superior ulnar collateral artery, the inferior ulnar collateral artery, and the posterior ulnar recurrent artery were measured. Anterior transposition of the vascularized ulnar nerve was performed to treat cubital tunnel syndrome. The most appropriate distance that the vascularized ulnar nerve can be moved to the subcutaneous tissue under tension-free conditions was 1.8 ± 0.6 cm (1.1–2.5 cm), which can be used as a reference value during the treatment of cubital tunnel syndrome with anterior transposition of the vascularized ulnar nerve.

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    Neuroprotective effects of daidzein on focal cerebral ischemia injury in rats
    Adem Bozkurt Aras, Mustafa Guven, Tarık Akman, Adile Ozkan, Halil Murat Sen, Ugur Duz, Yıldıray Kalkan, Coskun Silan, Murat Cosar
    2015, 10 (1):  146-152.  doi: 10.4103/1673-5374.150724
    Abstract ( 170 )   PDF (2367KB) ( 1106 )   Save

    Daidzein, a plant extract, has antioxidant activity. It is hypothesized, in this study, that daidzein exhibits neuroprotective effects on cerebral ischemia. Rat models of middle cerebral artery occlusion were intraperitoneally administered daidzein. Biochemical and immunohistochemical tests showed that superoxide dismutase and nuclear respiratory factor 1 expression levels in the brain tissue decreased after ischemia and they increased obviously after daidzein administration; malondialdehyde level and apoptosis-related cysteine peptidase caspase-3 and caspase-9 immunoreactivity in the brain tissue increased after ischemia and they decreased obviously after daidzein administration. Hematoxylin-eosin staining and luxol fast blue staining results showed that intraperitoneal administration of daidzein markedly alleviated neuronal damage in the ischemic brain tissue. These findings suggest that daidzein exhibits neuroprotective effects on ischemic brain tissue by decreasing oxygen free radical production, which validates the aforementioned hypothesis.

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    The pathways by which mild hypothermia inhibits neuronal apoptosis following ischemia/reperfusion injury
    Chun Luo, Su-yue Pan
    2015, 10 (1):  153-158.  doi: 10.4103/1673-5374.150725
    Abstract ( 258 )   PDF (1042KB) ( 847 )   Save

    Several studies have demonstrated that mild hypothermia exhibits a neuroprotective role and it can inhibit endothelial cell apoptosis following ischemia/reperfusion injury by decreasing casp-ase-3 expression. It is hypothesized that mild hypothermia exhibits neuroprotective effects on neurons exposed to ischemia/reperfusion condition produced by oxygen-glucose deprivation. Mild hypothermia significantly reduced the number of apoptotic neurons, decreased the expression of pro-apoptotic protein Bax and increased mitochondrial membrane potential, with the peak of anti-apoptotic effect appearing between 6 and 12 hours after the injury. These findings indicate that mild hypothermia inhibits neuronal apoptosis following ischemia/reperfusion injury by protecting the mitochondria and that the effective time window is 6–12 hours after ischemia/reperfusion injury.

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    Therapeutic effects of different durations of acupuncture on rats with middle cerebral artery occlusion
    Chao Zhang, Yan Wen, Xiao-nong Fan, Guang Tian, Xue-yi Zhou, Shi-zhe Deng, Zhi-hong Meng
    2015, 10 (1):  159-164.  doi: 10.4103/1673-5374.150727
    Abstract ( 181 )   PDF (601KB) ( 755 )   Save

    Acupuncture is regarded as an effective therapy for cerebral ischemia. Different acupuncture manipulations and durations may result in different therapeutic effects. In the present study, the Neiguan (PC6) acupoint of rats with occluded middle cerebral arteries was needled at a fixed frequency (3 Hz) with different durations, i.e., 5, 60 and 180 seconds under a twisting-rotating acupuncture method. Results showed that different durations of acupuncture had different therapeutic effects, with 60 seconds yielding a better therapeutic effect than the other two groups. This duration of treatment demonstrated rapid cerebral blood flow, encouraging recovery of neurological function, and small cerebral infarct volume. Experimental findings indicated that under 3 Hz frequency, the treatment of needling Neiguan for 60 seconds is effective for ischemic stroke.

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