经颅重复针刺促进大鼠坐骨神经损伤再生修复的实验研究
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摘要
针刺能促进周围神经(PN)损伤的再生和功能恢复,效果肯定,大量的临床和实验研究已经证实。导师孙申田教授通过多年的临床实践,在对针刺经颅运动诱发电位的研究以及头针治疗面神经损伤、面肌痉挛等研究的基础上,提出经颅重复针刺(以下简称头针)治疗周围神经损伤的新观点。为进一步证实头针促进周围神经损伤再生和功能恢复的作用,探讨其作用机制,并为头针治疗周围神经损伤的推广应用提供实验依据,我们进行了头针促进周围神经损伤再生和功能恢复的实验研究。本实验采用大鼠坐骨神经钳夹伤的周围神经损伤模型,分三个时间段(7d、14d、28d),动态观察头针和头体针结合对大鼠坐骨神经损伤后神经再生和功能恢复的影响,从神经功能、电生理、形态学等方面对头针和头体针结合治疗周围神经损伤进行综合评价;并从对相应节段脊髓运动神经元GDNF、CNTF表达的影响和对运动神经元凋亡的影响方面,探讨头针的作用机制。研究结果表明:1、头针对大鼠坐骨神经损伤后的相应脊髓运动神经元具有一定的保护作用,可以促进损伤神经再生和功能恢复,头体针结合效果最佳。2、头针能提高坐骨神经损伤大鼠坐骨神经功能指数(SFI)的恢复率。3、头针能促进坐骨神经损伤大鼠运动神经传导速度(MNCV)的恢复。4、头针能提高坐骨神经损伤大鼠腓肠肌湿重的恢复率。5、头针能减轻大鼠坐骨神经损伤后神经和相应神经元肿胀、变性,减少神经元死亡,促进轴突再生。6、头针可以抑制坐骨神经损伤大鼠相应节段脊髓运动神经元GDNF、CNTF表达水平的降低,促进其恢复,从而保护相应神经元,促进神经再生。7、目前研究认为周围神经损伤后引起的神经元死亡其实质是凋亡,头针能抑制坐骨神经损伤诱导的脊髓运动神经元凋亡,从而对相应神经元起一定的保护作用。8、头针在周围神经损伤中的运用为周围神经损伤的治疗增添了一项新方法。
Acupuncture can promote the regeneration, repair and functional recover of peripheral nerve(PN)injury, which have been testified by a great deal of clinic study and experimental study. Professor Sun Shentian observed in the course of long treatment that the effect of both scalp and body acupuncture on the patients of PN injury was significantly superior to only body acupuncture. To testify the role of scalp acupuncture, study its functional mechanism and supply the evidence for its wide use, we set up the model of PN injury by crushing the sciatic nerve in rat .We observed the effect of scalp acupuncture as well as both scalp and body acupuncture on the regeneration and functional rehabilitation of injured PN on 7d, 14d, 28d of operative intervals. We value the role of scalp acupuncture as well as both scalp and body acupuncture in nerve function, electrophysiological ,histology as so on. We study the effect of scalp acupuncture on expression of GDNF, CNTF in spinal motor neurons and neurons apoptosis after PN nerve injured. The results show: 1. scalp acupuncture can protect corresponding neurons after PN injury, can promote the regeneration, repair and functional recover of PN injury. 2. It can improve the SFI recovery of rat injured sciatic nerve. 3. It can faster nerve conductive velocity (MNCV) of injured sciatic nerve. 4. It can enhance the recovery rate of wet weight of gastnocnemius. 5. It can lessen the pale and degeneration of injured sciatic nerve and corresponding neurons, decrease the death of neurons, promote nerve regeneration. 6. It can restrain the expressing level CNTF, GDNF from declining in spinal motor neurons of rat injured sciatic nerve so as to protect the corresponding neurons and promote regeneration. 7. It's accepted at present that the essence of motor neurons' death is apoptosis after PN injured Head-acupuncture can restrain corresponding neurons of injured PN from apoptosis so as to have protective effect on the corresponding neurons.8.The utilization of scalp acupuncture in PN injure supplies a new therapy for the treatment of PN injure.
引文
1.刘运泉,丁建新,徐达传.周围神经损伤与修复的解剖学研究.现代康复,2000,4(10):1444
    2.邵水金.周围神经损伤的针灸疗法.现代康复,2000,4(10):1616-1619
    3.邵水金,单宝枝.针灸治周围神经损伤临床概况.江西中医学院学报,1998,10(3):120-121
    4.王亚军,郭义.电针促进周围神经再生的实验研究进展.天津中医,2002,19(4):73-74
    5.孙忠人,梅晨健,宋春华,等.针刺对大鼠坐骨神经损伤模型组织形态学改变影响的实验研究.中国中医约科技,1998,1(5):1-3
    6.陈莲芳,缪兴华,葛林宝,电针促进小鼠坐骨神经损伤后修复.上海针灸杂忠,1994,13(4):174-175
    7.邵水金,单宝枝,严振国,等.电针促进大鼠坐骨神经再生的实验研究.现代康复,2000;4(8):1184-1186
    8.邵水金,单宝枝,严振国.电针中约促进大鼠坐骨神经损伤的神经再生研究.中国针灸,2003:23(7):417-420
    9.牙祖蒙,王建华,李忠禹,等.面神经损伤后穴位电针刺激对面神经核中几种神经营养因子mRNA表达的影响.中国中西医结合耳鼻咽喉科杂志.2001;9(5):209-211
    10.牙祖蒙,王建华,李忠禹,等.穴位电针刺激对面神经再生过程中神经营养因子-3mRNA表达的影响.中华理疗杂志.2000:23(2):99-101
    11.牙祖蒙,王建华,周渝,等.穴位电针刺激对面神经影响的动物模型制作.实验动物科学与管理.1999;16(1):15-117
    12.李澎涛,陶之理,蔡虹,等.电针、NGF影响周围神经再生形态与功能恢复的比较研究.中国针灸.1999;19(9):556-558
    13.李澎涛,陶之理.HRP法对再生周围神经运动功能康复机制的形态学分析.解剖科学进展,1999,5(1):48-52
    14.李澎涛,陶之理.电针、NGF对臂丛神经前索损伤再生过程中脊髓运动神经元 GAP-43表达的影响.神经解剖学杂志,2000,16(1):67-69
    15.牙祖蒙,王建华,李忠禹,等.穴位针刺对面神经再生影响的实验研究.针刺研究,1999,24(2):111~115
    16.邵水金,单宝枝,严振国.电针对大鼠坐骨神经损伤后的修复作用.中国康复医学杂志,1997,12(4):184~185
    17.小宫义章.轴索的再生上轴索输送.整形灾害外科,1982,10:10
    
    
    18.邵水金,单宝枝,余安胜,等.电针对人鼠坐骨神经损伤后轴突转运的影响.针刺研究,1998,(1):66~68
    19.李澎涛,陶之理.电针对周围神经再生过程中脊髓运动神经元树突形态的影响.中国针灸,1997,(4):237~240
    20.沈江宁,朱家恺.周围神经损伤与修复的电生理评价.中华显微外科杂忠,1993,(3):225
    21.邵水金,单宝枝,余安胜,等.电针对大鼠坐骨神经损伤后的电生理影响.上海针灸杂志,1998,(1):38~39
    22.陈晓东,顾玉东,徐建光,等.电针对大鼠坐骨神经再生影响的功能评价.中华手外科杂志,1998,(14)2:121~123
    23.孙忠人,金淑英,孙远征,等.针刺对周围神经损伤再生修复的机理研究.中国中医药科技,1996,(2):10~12
    24.邵水金,单宝枝,余安胜,等.电针、中约对大鼠坐骨神经损伤后SFI及肌肉影响的观察.中国针灸,1998,(4):249~251
    25. Hare GMT, et al . Walking track analysis :A longterm assessment of peripheral nerve recovery. Plast Reconstr Surg 1992,89:251
    26.沈宁江,朱家恺.坐骨神经功能指数在神经功能评价中的应用.中华显微外科杂志,1993,16:284~287
    27.余茜,中亚强,李晓红.电针促进周围神经功能康复的实验研究。中国修复重建外科杂志,2001(5):315~317
    28.李澎涛,陶之理,蔡虹.电针、神经生长因子影响周围神经再生形态与功能恢复的比较分析.中国针灸,1999,(9):556~560
    29.沈宁江,朱家恺.小腿三头肌肌力评价坐骨神经功能恢复的实验研究.中华显微外科杂志,1994,17:266~268
    30.陈德松.电刺激与被动活动对小鼠失神经支配肌肉萎缩的影响.中华实验外科学杂志,1991,(8):290
    31.马建,唐启华,郭容经.电针、推拿对周围神经损伤后神经末梢及运动终板形态的影响.中国运动医学杂志,1997,16(1):22
    32.马建,唐启华,郭容经.电针、推拿、红外线理疗治疗对周围神经损伤的比较研究Ⅰ:对神经损伤肌肉影响的组织形态学和组织化学改变.中国运动医学杂志,1995,14(4):210
    33.牙祖蒙,王建华,李忠禹,等.家兔面神经损伤后穴位针刺对神经生长因子及其受体表达的影响.中国中西医结合外科杂志,2000,6(4):234~236
    
    
    34.牙祖蒙,王建华,李忠禹,等.穴位电针刺激对面神经再生过程中表情肌组织神经生长因子mRNA表达的影响.中华物理医学与康复杂志,2000,22(3):157~159
    35.牙祖蒙,肖道宏,王建华,等.面神经损伤后穴位针刺对 NGFmRNA 表达影响.针刺研究,2000,(2):96~99
    36.牙祖蒙,王建华,李忠禹,等.穴位电针刺激对面神经再生过程中神经营养因子~3 mRNA表达的影响.中华理疗杂志,2000,22(3):157~159
    37.牙祖蒙,王建华,李忠禹,等.面神经损伤后穴位针刺激对神经组织中神经营养因子~3 及其受体表达的影响.中国中医基础医学杂志.2000,6(1):59~61
    38.陈晓东,顾玉东,杨毅.电针对神经损伤后神经生长因子 mRNA 及胰岛素样生长因子— 1mRNA的表达的影响.中国修复重建外科杂志,2000,14(6):328~331
    39.吴滨,何竟,高炳庆.电针对面神经损伤后再生室中神经生长因子的影响.针刺研究,2003,28(1):30~32
    40.李澎涛,陶之理.电针、NGF对臂丛前索损伤再生过程中脊髓运动神经元GAP~43表达的影响.神经解剖学杂志,2000,16(1):67~69
    41. kanimi~Abdolrexaee S ,verge VM , Schreyer DJ. Developmensal down~regwlation of GAP~43 expression and timing of target contract in rat corticospinal neusrons . EXP Neurol,2002,176(2):390~401
    42.余茜,李晓红,何成松,等.电针对坐骨神经损伤大鼠脊髓生长相关蛋白mRNA表达的影响.中国临床康复,2003,7(22):3064~3065
    43.孙忠人,等.针刺对神经损伤再生修复的探讨.中国中西医结合杂志,2001,6(6):12~14
    44.唐启华,马建,郭容经.电针、推拿对周围神经损伤肌肉酶组织化学改变的影响.成都体育学院学报,1997,2(3):59~64
    45. Rich KM.Nerve growth factor protects adult sensory neurens from cell death and atrophy caused by nerve inj uny [J]. J Neurocytol, 1987,16:261
    46.尹宗生,顾玉东.臂丛根性撕脱伤后脊髓前角α运动神经元超微结构改变的实验研究.中华手外科杂志,1992,8(1):28
    47. Fu SY ,Gordon T. The cellular and molecular basis of peripheral nerve regeneration[J]. Moi Neunobiol,1997,14(1-2):67~116.
    48. Bryan DJ,wany KK,Chakalis H,et al .Effect of schwann cells in the enhancement of peripheral-nerve regeneration[J].J Reconstr Microsurg, 1996,12(7):436~439
    49. Sulaiman OA, Gordon T.Effects of short-and long Schwann cell deneroation on peripheral
    
    nerve regeneration, myelination ,and size [J]. Glia ,2000,32(3):234~246.
    50. Zheng M,kuffier DP. Guidance of regenerating motor axons in vivo-by gradients of diffusible penpheral nerve-derived factors[J].J Neurabiol,2000,42(2):212~219.
    51. Goold RG ,ouen R, Gondon -weeks, PR.Glycogen synthase kinase 3 beat phosphorylation of microtubule-associated protein 1B repulates the stability of microtubules in growth cones [J].J Cell Sci ,1999,112(pt19):3373~3384.
    52. Ma D,chow S, obrocka M ,et al.Induction of microtubule associated protein 1B expression in schwan cells during nerve regeneration [J].Brain Res, 1999,823(1-2): 141~153
    53. Brusharttm .Preferential reinnervation of motor nerves by regener-ating motor axons .Neuroscience, 1998,81026
    54. Madison RD, Archibald SJ ,Brushart TM ,et al .Reinnervation ac-curacy of the rat femoral nerve by motor and sensory neuRons.Neuoscience. 1996,16:5698
    55. Kerching .The neurotrophic factor concept :A reexamination[J] .J Neutorosic 1993,13:27 93~2797
    56.刘大庸,胡耀民,钟世镇.周围神经系统的微环境.中国临床解剖学杂忠,1991,9:244
    57. Long FM, varon S,Manthorpe M.Neurite Promoting factors and extracellalal matrix components accumdating in vive with in nerve regeneration[J].Chambers,Brain Res,1984,309:105
    58. Thoenen H,Brade YA. physiology of nerve growth factor. Phsiology. Review,1980,1284
    59. Ibanez CF. Strcture-function relationships in the neurotrophin family, J Neurobiol 199 4,25:1349~1361.
    60. Anton ES, et al .Nerve growth factor and its low~affinity receptor promote Schwann cell Migration,Proc Natl Acad Sci U S A ,1994,91(7):2795~2799.
    61. Hantzopoulos PA et al. The low affinity NGF receptor p75 can collaborate with each of the Trks to potentiate functional responses to the neurotrophins Neuron 1994,13(1): 187~201.
    62.蔡文琴,等.发育神经生物学,北京,科学山版社,1999:263.
    63. Shirley DM,Williams SA , Santors PM.Brain derived newrotrophic factor and peripheral nerve rege neration:A function evaluation[J].Laryngoscope, 1996,106:629~632
    64. Lohof AM,IP NY, poo MM.Potentiation developing neuromuscular synapses by the neurttrophin-3 and BDNF[J].Nature, 1993,363:350~352
    65.江智红,等 细胞生物学杂志,1997,19:145~148
    
    
    66.郑宏良,等中华耳鼻咽科杂志,1999。34:321~324
    67. Leong J, et al. J Hard surg(Am),1999,24:37~45
    68. Richardson PM .Ciliary neurotrophic fator:a review.Pharmaco-logical Therapy, 1994,63:187
    69. Thompson SWN,vernallis AB, Heath JK ,et al .leukaemia in-hibitory factor is retrograde[y transported by a distinct population of adult sensory neurons.J European Neuros~cience,1997,9:1244
    70. Terenghi G, et aI.J Anat,1999,194:1~14
    71. Frostick SP, et al .Microsurgery,1998,18:397~405
    72. Kami K ,et al .Muscle Nerve,1999,22:1576~1586
    73. Leu-fen H Lin .GDNF:a glial cell line-derived neurotrophic factor for midbrain dopaminergic neurons .Science 1993,260:1130
    74. Henderson CE .GDNF:a protent survival factor for motoneurons present in peripheral ner ve and muscle .Science,1994,266:970
    75. Urphy M, Drago J,Bartfett G, etel,FGF stimct lares the proliferation and differentiation of neurol precursor cells in vitro[J],JNeursci Res,1990,25(4):463
    76. Iwasaki Y, Shiojina T ,Ikeda k ,et al. Acidic and basic fibnoblast growth factor enhance newrite outgrowth in cultured eat spinal cord newtons [J].Neurot Res, 1995,17:70.
    77. Caplan J ,et al ,J Reconser Microsurg ,1999.15:351~358
    78. Kami K,et al. Muscle Nerve ,1999,22:1576~1586
    79. Hansson HA .Evidence indicating trophic importance of IGF -Ⅰ in enerating peripheral nerves [J].Acta Physical scand,1986:126~609
    80. Meyer M ,et al.Enhanced synthesis of brain derived neurotrophic factor in the lesioned peripheral nerve :different mechanis ms are responsible for the regulation of BDNF and NGF mRNA .J Cell Biol 1992,119(1):45~54.
    81. Rende M,Hagg T ,Manthorpe M.Nerve growth faotor receptor mmunoreactirity in neurons of the normal about rat spinal cord and its modwation afte peripheral nerve lesions.J Comp Neurol,1992,319:285~290.
    82. Curtis R,Tonra JR.Neuronal injuny increases retrograde axonal transport of the neurotrophins to spinal sensory neurons and motor neurons via multiple receptor mechanisms Mol Cell Newosa ,1998.12(3):105~118
    83. Cho HJ,Kim SY, Park MJ et al Expression of mRNA for brain-erived neurotrophic fa-cto r
    
    in the dorsal root ganglion following peripheral infla m mation. Brain Res, 1997,749:58
    84. Meyei M,Mesuoka I ,wetmore C ,et al .J cell Bio, 1992, 119:45
    85. Michael GJ Averill S Nitkunan A, et al. J Neurosu, 1997,117:8476~8490.
    86. Michael GJ ,Averill S, Nitkunan A, et al. Nerve growth factor treatment increases brained-rived neurotrophic factor selectively in trkA-xprpssing dorsal root ganglion cells and in their central ter-inations within the spinal cord.J Neuroscience, 1997,17:76
    87. Sterne GD,Coulton GR, Brown RA,et al .Neurotrophin-3 en-hanced nerve regeneration selectively improves recorvery of muscle fibres ezpressing myosin heavey chains 2b .Journal of Cell Biolohy, 1997b,139:709
    88. Hiruma S,Shimizu T, Huruta T, et al.ciliary neurotrophic factor im munoreactivity in rat intra muscular nerve during reinnervation through a silicone tube after severing of the rat sciatic nerve Experimental Molecular Pathology, 1997,64:23
    89. Sun Y, Zigmond RE. Leukacmia inhibitory factor induced in the sciatic nerve after axotomy is involved in the induction of galanin in sensory neurons. J European Neuroscience, 1996,8:2213
    90. Kurek JB ,Bower JJ,Romanella M,et al. The role of leukae miainhibitory factor in skeletal muscle regeneration. Muscle &Nerve, 1997,20:1
    91. Hoke A,cheng C,zochodne DW.Expression of glial cell linederived neurotrophic factor family of growth factors in periphersl nerve injury in rats. Neuroreport, 2000,11:1651~1654.
    92. Naveihan P, Elashamy WM,Ernfors P. Differential regulation of mRNAS for GDNF and its receptors Ret and GDNFR alpha after sciatio nerve lesion in tremouse.Eur J Neurosci, 1997,9:1450~1460.
    93. Mendell LM. Neurotrophins and sensory :role in development ,maintenance and injury. Biology Sciences, 1996,351:463
    94. Gold BG. Axonal regeneration of sensory nerves is delayed by con~tinwous intRathecal infusim of neve growth factor. Neuroscitnce 1997,76:1153
    95. Kaechi K,Ikegami R ,Nakamur, N,et al.4-ethylcatechol,an inducer of nerve growill factor synthesis ,enhances peripheral nerve regeneration a ross merve gaps. J Pharmacol Exp Ther,1995,272(3):1300~1304
    96. Munson JB ,Shelton DE ,Mcmahon B,et al. Adult mam malian sensory and motor neurons :roles of endogenous neurotrophins and rescue by exogenous neurotrophin after
    
    sxotomy. J Neuroseience, 1997,9:1450
    97. Nobikov L,Novkova L ,Kellerth JO. Effects of meurotransplants and BDNF on the survival and regeneration of injured oult spinal motoneuons. Euro J Neu-rosci ,1997,9(12)2774~2777.
    98. Utlcy DS, Lewin SL,Ch.engET, et al. Brain -derived neurotrophic factor and collagen tubulization enhance functional recovery after psripberal nerve transaction and repair .Arch Otlaryngol Head Neck Surg,1996,122(3):407~409
    99. Lewin SL ,Vtley DS,Vekity AN ,et al. S imultanecustreat ment with BDNF and CNTF after peripheral nerve transectior and repair enhances rate of funtionalrecovery compared with BDNF treat ment alone. Larngoscope, 1997,107:992
    100. Anand P, Terenghi G, Brich R,et al. Endogenous NGF and CNTF levels in hu man peripher-al nerve injury .Neuroreport, 1998,8:1935
    101. Yah Q ,Matheson C, lopezo, neurotrophic effects of GDNF on neonatal and adufaoid motor neurons .Nature, 1995,373(2):341~344.
    102. Chen ZY ,Chai YF Cao L,et al. clial cell line -derived neurotrophic factor enchances axoral legeneration following sciatic nerve transaction in adult rats. Brain Res, 2001,902(2):272~276.
    103. Gruner JA,Wagner L,Chiu AY ,et al .RHIGF-1 Protects against moteneurons loss following nerve transaction in adult mice. Sce Neurosci Abst, 1996,22(10): 1961~1964.
    104. Thanos PK ,Okajima S Tiangco DA ,et al. Insulin -like growth factor-1 promotes nerve regeneration through a nerve graft in an experimental model of facial paralysis. Restor Neurosci ,1998,33(9):1176~1180
    105. Mcallister AK, Katz LC,Lo DC,et al .Opposing roles forendoge-nous BDNF and NT-3 in zegulating coctical dendritic growth. Neuron 1997,18:767
    106. Arce V ,Pollock ,Philippe JM, et al. Synergistic effects of Schwann-nd muscle derived factors on motoneurvival involve GDNF and CT-1 .J Neuroscience, 1998,18:1440
    107.罗永湘,方煌,庞清江,等.神经生长因子对周围神经运动纤维再生的影响.中华手外科杂志,1997,13:3~5
    108. Sakurai M ,Hayashi T, Abe K ,et at .Delayed and selective motor neuron death after transient spinal selective moter neuren death aftet transient spinal cordl ,schemia:a sole of apotosis .J Thoral Cardiovase Surg,1998,115:1310~1315
    
    
    109. Tong JX, Rich KM.Diphenyliperzines enhance regeneration after facial nerve injuruy.J Neurocytology, 1997,26(5):339~347
    110. Majno G, Joris I.Apoptosis oncosis and necrosis :an overview of cell death .Am J pathol, 1995,146(1):3~15.
    111. Lo AC ,Houenou LJ,Oppenheim RW. Apoptosis in the nervous system Lmorphological features,meth,ods ,pathology ,and prevention.Arch Histol Cytol, 1995,58:139~149
    112. Farlie PG, Drigen R, Rees SM, et al. Bcl-2 transgene expression can protect neurons against developmental and induced cell death. Proc Natl Acad Sci USA,1995,92:4397~4401.
    113. Cheung NS Beart PM ,Pascoe CJ ,et al .Human bel-2 ptotects against AMPA reccptor -mediated apoptosis. J Neurochem ,2000,74:1613~1620.
    114. Murphy AN ,Bredesen DE ,Cortopassi G, et al. Bcl-2 potentiaates the maximal calcium uptake capacity of neural cell mitochondria. Proc Natl Acad Sci USA, 1996,93:9893~9898
    115. Satch T ,Sakai N ,Enokido Y ,et al .Free radical -independent protection by nerve growth factor and bcl -2 of PCI 2 cells from hydrogen peroxide -triggered apoptosis. J Biochem Tokyo, 1996,120:540~546.
    116. Bar PO Knudson M,Korsmeyer SJ, et al. Motor neuron degeneration is attenuated in bax~deficient neurons in vitro .J Neurosci Res,1999,55:542~556.
    117. Gillardon F Klimaschewski L ,Wiekert H,et al.Expression pattern of candidate cell death effector proteins Bax,bcl-2,bcl-Ⅹ,and c-Jun in sensory and motor neutrons following sciatic nerve transaction in the rat. Brain Res,1993,739:244~250.
    118. Bernard R, Dieni S ,Recs S ,et al. Physiolcaical and induced neuronal death are notaffccted in NSE-bax transgenic mice .J Neurcsci Res ,1998,52:247~259.
    119. Chaudhary P ,Ahmed F Quebada P, et al. Caspsse ,inhibitors block the retinal ganglion cell death following optic nerve transaction. Brain Res Mol Brain Res,1999,67:36~45.
    120. Tan SA, Deglon N,zwRn AD,et al. Rescue of motoneurons from axotomy induced cell death by polymer encapsulated cells genetically engineered to release CNTF. Cell Trans-plant, 1996,5:577~587.
    121. Houenou LJ ,Oppenheim RW ,Li L ,et al. Regulation of spinal motoncuron survival by GDNF during development and following injury. Cell Tissue Res ,1996,286:219~223.
    122. Curtis R ,Adryan KM ,Zhu Y ,et al .Relrograde axonal transport of ciliary neurotrophic factor is increased by peripheral nerve injury .Nature,1993,365:253~255.
    
    
    123. Li L ,Wu W, Lin LH ,et al. Rescue of adult mouse motoneurons from injury induccd cell death by glial cell line derived neurotrophic factor. Proc Natl Acad Sci USA, 1995,92:9771~9775.
    124. Iwasaki Y, Shiojima T ,Tagaya N, et al .Basic fibroblast growth factor and platelet derived growth factor prevent the death of spinal motor neurons after sciatic nerve transaction in the neonatal rats .Neurol Res, 1997,19:555~557.
    125. Watabe K, ohashi T, sakamoto T, et al. Rescue of lesiond adult rat spinal motoneurons by adenoviral gene transfer of glial cell line-derived neurotophic factor. J Neurosci Res ,2000,60:511~519.
    126. Iwasaki Y, Ikeda K. Prevention by insulin like growth factor Ⅰ and riluzole in motor ncuron death after meonaal axotomy .J Neurol Sci ,1999,169:148~155.
    127. Iwasaki Y ,Ikeda K,Shiojima T, et al. CNQX prevents spinal motoneuron death following sciatic nerve transaction in newborn rats. J Neurol Sci, 1995,134:21~25
    128. Orrenius S ,Nicotera P The calcium ion and cell death. J Neural Transm ,1994,43 Suppl:1~11
    129. Bizezinska SE, pietras B.The protective role of some aneioxidant and scalengers on the free radicals-induced inhibitin of the liver iodothym hire 5-monodeiodinase activity and thiols content [J].J physiol pharincol, 1997,48 (3):451~459
    130. Ghafourifar P, Schenk U,klein S D,et al. Mitochon-drial nitric-oxider syn thase stim-uation causes cytochrome C release from isolated mitochondria, Evidence for intrami tochondrial peroxynierite formation [J].J Biol Sem, 1999,274(44):31185~31188
    131.王贵波,李兵仓,王建民,等.兔坐骨神经火器伤后腰段脊髓脂质过氧化反应及意义.中国急救医学,2002,22:1~3.
    132. Love S. Oxidative stress in brain ische mia. Brain Pathol, 1999,9:119~131.
    133. Wu W, Li L. Inhibition of nitric axide synthase reduces motoneuron death due to spinal root avulsion. Neurosci Lett, 1993,153:121~124
    134. Aronica EM Gorter JA ,Grooms S,et al. Aurintricarbaxylic acid prevents GLUR2 mRNA down - regulation and delayed neuronsof gerbil after global ischemia Proc Natl Acad Sci USA,1998,95:7115~7120.
    135. Vejsada R ,Sagot Y ,Kito AC.Quantitative comparison of the transient rescue effects of neurotrophic factors on axotomized motoneurons in vivo .Eur J Neurcosci, 1995,7:108~115.
    
    
    136. Eriksson NP ,Lindsay RM, Aldskogius H.BDNF and NT -3 rescue sensory but not metoneurones following axotomy in the neona. Nearoreport, 1994,5:1445~1448.
    137.张蜂,顾玉东,徐建光,等.复方中药对坐骨神经损伤大鼠神经元保护作用的实验研究.中华手外科杂志,1999,15(3):163~165
    138.张蜂,顾玉东,徐建光,等.中药 EGb24/6 对大鼠坐骨神经损伤后神经元保护的实验研究,中华医学杂志,2000,80(3):
    139.张蜂,顾玉东,徐建光,等.银杏叶提取物 EGb24/6对受损神经元的保护作用及其对神经元超微结构的影响.中华骨科杂志,2001,21(4):250~253
    140.吴阶平,裘法祖.黄家驷外科学(第五版).北京:人民卫生出版社,1992:2259
    141.许家军,等.周围神经外膜缝合后再生轴突胞体形态学的实验研究,解剖学杂志.1993,16(3):247~249
    142.冯传汉.现代骨科诊疗手册.北京:北京医科大学.中国协和医科大学联合出版社,1997:530
    143. Mackinnom SE ,Hudson AR,Hunter DA.Histology assessment regeneration in the rat .Plast Relonstr Surg, 1985,75:384~389
    144. Terzis JK,Smith KJ.Repair of stvered peripheral nerves:Comparition of the "De Medinaceli "and standard microsuturemethords .Exp Neurol,1987,96:672~684
    145. Hare GMT, Evans PJ,Mackinnon SE,et al .Walking track anyasis:A long-term assessment of peripheral nerve recovery. Plast Reconstr Surg, 1992,89:251~258
    146.卢世壁,徐仕墒,刘郑生,等.神经节苷脂对损伤神经再生作用的动物实验.中华骨科杂志,1988,8(2):134
    147.王德春,陈中伟,陈峥嵘,等.纤维酶原激活物(t-PA)促进挤压伤大鼠坐骨神经再生.中华显微外科杂志,2000,23(2):83
    148. De Medinaceli L,Freed WJ and Wyatt RJ. An index of the functional condition of rat sciatic nerve based on measurement made from walking tracks.Exp Neurol,1982,77:634
    149. Bain JR,mackinnon SE and Hunter DA .Functional evaluation of complete scia- tic,peroneal and posterior tibial nerve lesions in the rat.Plast Reconstr Surg, 1989,83:129
    150.沈宁江,朱家恺.坐骨神经功能指数在神经功能评价中的应用.中华显微外科杂志,1993,16(4):284~287
    151.候之启,朱家恺.电生理方法评价周围神经再生的初步研究.中华显微外科杂志,1994,17(21):126~130
    152. Berry CM,et al. The electrtcal activity of regenerating nerves in the cat. J
    
    Nenrophysiology, 1944,7:103
    153. Hodes R,et al .The human electromyogram in response to nerve stimulation and the conduction velocity of motor axons. Arch Neurol Psychia, 1948,60:340
    154.王敏,杨志焕.周围神经损伤修复方法研究进展.中华创伤杂志,2002,4(1):51~54
    155. Dehon AL,Mackinnon SE.Selection of the appropriate parameter to measure neural regeneration.Annals Plastic Surgery, 1989,2:197
    156.邵水金,单宝枝,余安胜,等.电针、中药对大鼠坐骨神经损伤后 SFI 及肌肉影响的观察.中国针灸,1998,(4):249~251
    157.朱家恺,卢传新,王书成,等.周围神经外科学.长沙:三环出版社.1991:12~19
    158.陈中伟.周围神经损伤基础与临床研究[M]山东:山东科学技术出版社,1998:343.
    159.叶剑.睫状神经营养因子在视神经损伤修复中的作用.中华创伤杂志,2001,15(1):59~60
    160. Ebadi M, Bashir RM, Heidrjek ML,et al.Neurotrophins and their receptors in nerve injuny and repair. Neurochem Int, 1997,(4-5):347~374
    161.宋海涛,贾连顺,田万成,等.胶质细胞源性神经营养因子在坐骨神经切断后的表达变化.现代康复,2001,5(9下):46~47
    162.王栓科,张致英,洪光祥,周围神经损伤与轴突诱向因子.现代康复,2001,5(9下):54~55
    163.蔡文琴,陈怀珍,黎海蒂.医用神经生物学基础.重庆:西南师范大学出版社,2001:416~420
    164.孙忠人,梅晨健,宋春华,等,针刺对大鼠坐骨神经损伤模型组织形态学改变影响的实验研究.中国中医药科技,1998,5(1)3
    165. Lewin GR, Band YA. Physiology of neurotrophins. Annu Rcv Neurosci, 1996,19:289~317
    166. Vejsada R, Sagot Y, kato AC. Quantistive comparison of transient rescue effects of neurotrophic factors on axotomizde motoneurons in vivo.Eur J Neurosci,1995,7:108~114
    167. Stockli KA, Lillen LE, Naher Noe M, et al. Regional distribution development changes and protein in the rat brain. J CellBiol, 1991,115:447
    168. Sendter M, Stockli KA, Thoenen H. Sythesis and localization of ciliary neurotrophic factor in the sciatic nerve of the adult rat after lesion during regeneration. J Cell Biol, 1992,118:139
    169.王特为,王廷毕,刘芬,等.睫状神经营养因子的研究进展,中国组织化学与细胞化学杂志,2002,11(4):489~494
    170. Mayer M, Matsuoka L, Wetmore C, et al. Enhaned synthesis of brain-derived neurotrophic factor in the lesioned peripheral herve: Different mechanisms an responsible for the regulation of BDNF and NGF mRNA. J Cell Bio,1992,119:45
    
    
    171. Sendtner M , Stockli KA, Thoenen H . Synthesis and localization of ciliary neurotrophic factor in the sciatic nerve of the adult rat after lesion and during regeneration .J Cell Biol, 1992,118:139
    172. Smith GM , Rabinovsky ED ,Mc Manaman JL ,et al .Temporal and spatial expression of ciliary neurotro-phic factor after peripheral nerve injury. Exp Neurol, 1993,121:239~245
    173.石向群,范明,陆兵勋,等.周围神经损伤对脊髓运动神经元睫状神经营养因子表达的影响.中华创伤杂志,2000,16(6):365~358
    174.郑宏良,山振东,周水淼,等.长喉返神经损伤后疑核运动神经元睫状神经营养因子的表达.第二军医大学学报,2000,21(12):1120~1123
    175. Ho PR, Coan GM, Cheng ET, et al. Repair with collagen tubules linked with BDNF and CNTF in a rat sciotic nerve injury model. Arch Otolayngol Head Neck Surg, 1998,124(7):761~766
    176. Sendtner M, Gotz R, Holtmann B, et al. Endogenous ciliany neurotrophic factor is ltsion factor for axotomized motoneuron in adult mice. J Neurosci, 1997,17(18):6999~7006
    177. Ishiyama T, Klinkosz B, Pioro EP, et al. Genetic transfer of the wobbler gone to a C57B1/61 X NZB hybrid stock:natural histoly the motor neuron disease and response to CNTF and cotreatment. Exp Neurolk, 1997,148:247~255
    178. A rakawa Y, Sendtner M, Thoenen H. Survivale effect of ciliary neurotrophic factor(CNTF) on chick em bryonic m otoneurons in culture: corn parison with other neurotrophic factors and cytokimes[J].J Neurosci, 1990,10:3507~3515
    179. Sahenk Z. Seharaseyon J.Mendell JR. CNTF potentiates peripheral nerve regeneration[J]. Brain Res, 1994,655:246~250
    180. Sendtner M, Stockli KA, Thoenen H. Synthes is and localization of ciliary neurotrophic factor in the sciatic nerve of the adult rat after lesion and during regeneration[J]. J Cell Biol,1992.118:139~148
    181. Blottner D, Bruggemann W, Unsicker K. Ciliary neurotrophic factor supports target-deprived pregang lion ic sym pathetic spinal cord neu rons[J]. NeurosciLett, 1989,105:316~320.
    182. Gurney ME, Yamamoto H, Kwon Y. Induction of motor neuron sprouting in vivo by ciliary nerotrophic factor and basic fibroblast growth factor[J]. J Neurosci, 1992,12:3241~3247.
    183. Zurn AD, Bactge EE, Hammang TP, et al.Glial cell line derived neurotrophic factor(GDNF), a new neurotrophic factor for motoneurones. N
    
    euroreport,1994,6(1): 113
    184. Bujbello A, Buchanan VL, Horton A, et al.GDNF is anage specific survival factor for sensory and autonomic neurons. Neuron, 1995,15(4):821
    185. Bennett DL, Boucher TJ, Amanini MP, et al. The glial cell line-drived neurotrophic factor family receptor components are differentially regulated within sensory neurons after nerve injury. J Neurosci,2000,20(1):427
    186. Lin HL, Doherty DH, Like DJ, et al. GDNF:a glial cell line derived neurotrophic factor for midbrain dopamine rgic neurons. Science, 1993,260:1130~1132
    187. Trupp M, Belluarelo N, Funakoshi H, et al. Complementary and overlapping expression of glial cell derived newrotrophic factor(GDNF). J Neurosci, 1997,17(10):3554-3567
    188. Lin L-FH, Doherty DH, Lile JD, et al. GDNF : glial cell line derived neurotrophic factor (GDNF). Micros Res Tech ,1999,45(4-5):292-302
    189. Trupp M, Belluardo N, Funakoshi H,et al.Complementary and overlapping expression of glial cell line-derived neurotrophic factor(GDNF),c-ret proto-oncogene, and GDNF receptoralpha in-dicates multiple mechanisms of trophic actions in the adult rat CNS[J]. J Neurosci, 1997,17(10):3554~3567
    190. Springer JE,Mu X,Bergmann LW, et al. Expression of GDNF mRNA in rat and human nervous tissuep[J]. Exp-Neurol. 1994,127(2):167~170
    191. Sagot Y, Rosse T, Vejsada-R, et al. Differential effects of neu-rotrophic factors on motoneuron retrograde labeling in a routine model of motoneuron disease[J]. J Neurosci. 1998,18(3):1132~1141.
    192. Suzuki H, Hase A,Miyata Y, et al. Prominent expression of glial cell line-derived neurotrophic factor in human skeletal muscle[J]. J Comp Neurol, 1998,402(3):303~312
    193.周雪,章为,邹晓菊,等.胶质源性神经营养因子在成年大鼠中枢神经系统中的表达.华西医科大学学报,1998,29(3):289~291
    194. Naveihan P, Wnel ME, patrik E. Differential regulation of mRNA for GDNF and its receptors Ret and GDNFR & alpha after sciatic nerve lebion in the mouse. Eur J Neurosci,1997,9:1450~1460
    195.宋海涛,贾连顺,陈哲宇,等.大鼠坐骨神经切断后 GDNF mRNA在其向心端及脊髓表达的变化.第二军医大学学报,2002,(6):602~604
    196.宋海涛,贾连顺,陈坚,等.坐骨神经切断后 GDNF mRNA在两侧断端表达变化.中华骨科
    
    杂志,2002,22(3):176~178
    197.马雪梅,黄兼仁,蔡良婉.胶质细胞源生的神经营养因子与神经退变性疾病.国外医学分子生物学分册,1996,18(4):157
    198. Beck KD, Valverde J Alexi T, et al Mesen ceophalic dopaminergic neurons protected by GDNF from axotomy-induced degeneration in the adult brain. Nature,1995,373(6512):339
    199. Yah Q, Matheson C, Lopez O. In vivo neurotrophic offect of GDNF on neonatal and adult facial motor newrons. Nature, 1995,373:341
    200. Naveilhan P, Elshamy WM, Ernfors P. Differential regulation of mRNA for GDNF and its receptors Ret and GDNFR alpha after sciatic nerve lesion in the mouse . Eur J Neurosci 1997,9(7): 1450-1460
    201.张文明,朱维饮,林建华.细胞凋亡与周围神经损伤后运动神经元死亡.中华创伤杂志,2000,16:51~52
    202. Oliveira AL,Risling M,Deckner M,et al. Neonatal Sciatic nerve transaction induces TUNEL labeling of neurons in the rat spinal cord and DRG. Neurorep-ort ,1997,8:2837~2840
    203. Majno G, Joris I. Apoptosis , oncosis and necrosis is :an overview of cell death. Am J Pathol, 1995,146(1):3~15
    204. Lo AC ,Houenou LJ,oppenheim RW. Apoptosis in the nervous systerm :morphological features ,methods. Pathology ,and prevention .Arch Histol cytol, 1995,58:139~149
    205. Wijsman JH,Jonker RR ,keijzer R, et al .A new method to detect apoptosis in paraffin sections:in situ end-labeling of fragmented DNA. J Histochem Cytochem, 1993-41:7~12
    206. Garrah JM, Bisby MA,Rossiter JP .Immunolabelling of the cytoplasm and processes of apoptotic facial motoneurons fouawing axotomy in the neonatal rat. Acta Neuropathol Berl ,1998,95:223~228
    207. Gaviieli Y, Sherman Y ,Berrsasson SA .Identificntion of programmed cell death in still via specific labeling of muclear fragmentation. J Cen Biolongy, 1992,119:493~501
    208.矫毓娟,刘江红,许贤豪.细胞凋亡的检测方法.中国神经免疫学和神经病学杂志,2004,11(1):53~56
    209.陈晓东,顾玉东,徐光建.损伤大鼠坐骨神经诱导运动神经元凋亡的初步报告.中华手外科杂志,1999,15:111~113
    210.李陶,陈意生,王禾,等.大鼠坐骨神经损伤后脊髓组织中Caspase-3、Bcl-xl表达变化的实验研究中华创伤杂志,2001,17(9):536~539.
    
    
    211. Groves MJ,Christopherson T, Giometlo B.Axotomy-induced apoptosis in adult rat primary sensory neurons. J Neurocytol. 1997,26:615~624
    212.刘黎军,朱家恺,顾熊飞,许旺细胞源神经营养因子对脊髓前角运动神经元的保护作用.中华显微外科杂志,2000,23:39~41
    213.韩济生.神经科学原理.北京:医科大学.中国协利医科大学出版社.1999:1020~1037
    214.王常利,周长满,苏剑斌,等.GDNF及HSV-GDNF对体外培养大鼠脊髓运动神经元受损后凋亡的影响.解剖学报,2001,32(2):136~139
    215. Rossiter JP, Riopelle RJ ,Bisby MA .Axotomy-induced apoptotic all death of neonatal rat facial motonurons:time course analysis and rat lation to NADPH-diaphorase activity.Exp Neurol ,1996,138:33~44.
    216.张志英,严振国.电针对脊髓损伤后一氧化氮合酶表达的影响.中国临床康复,2002,6(2):206~208
    217.董裕,李荣,程介士.针刺对暂时性脑缺血脑内一氧化氮合酶及神经细胞死亡的影响.针刺研究,2000,25(1):8~12
    218. Yan O Matheson C ,Lopez OT, et al. The biological response of axotomied adult motoneurons to brain-derived neurotrophic factor ,J Neuro, 1994,14(9:5281)
    219. Barker TA et al. Non-invasive magnetic stimulation of the human motor cortex. Lancet,1985,1:1106~1107
    220.许虹,吴雯珠,翁武昭,等.脑血管病患者经频磁刺激运动诱发电位的研究.临床神经病学杂志,1998,11(1):23~25
    221.朱幼丽.脑卒中患者跨颅磁刺激运动诱发电位与预后的关系.中国病理生理杂志,1999,15(10):905
    222. Ravnborg M, Liguori R, Christiansen P, et al. Neurology 1996,42:1296
    223. Maegaki Y, Inagaki M, Takeshita K. Electroenceph Clin Neurophysiol 1994,93:318
    224.赵沂敏,方定华.运动诱发电位在脑血管病运动功能康复中的应用.北京医学,2002,24(5):307~309
    225.钮竹,张通,方定华,等.经颅磁刺激在急性脑梗死运动功能康复中的作用.中国康复理论与实践,2001,7(1):16~18
    226.孙忠人,霍立光,刘丽莉,等.头皮针刺运动诱发电位的研究.中国中医药科技,1994,1(6):14~16

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