优化法去细胞神经移植修复大鼠坐骨神经缺损的研究
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摘要
周围神经损伤后,如果游离神经断端仍达不到无张力缝合,则需进行自体神经移植,它被认为是修复周围神经缺损的金标准。但自体神经来源有限并增加手术部位和创伤,造成来源神经支配区的功能障碍,所以需要等效于自体神经的理想神经移植物。同种异体或异种新鲜神经移植会因免疫排斥反应而失败,许旺细胞及组织间隙细胞、髓鞘是排斥反应的主要标靶,其它成分抗原性则非常弱。因此去除细胞及髓鞘等成分就能极大地降低其免疫原性,有效抑制免疫排斥反应。去细胞的方法较多,其中应用较多的有热法及化学法。但前者只是杀死细胞并不能去除细胞残留物从而不能较好地消除免疫原性,后者虽然能较彻底去除细胞碎片,但却对细胞外基质损伤较大,破坏了移植物的空间结构,而移植物的空间结构及某些天然组织蛋白对促进神经再生非常重要。针对此问题,Hudson等人开发了优化的去细胞方法。应用此优化方法处理同种异体神经,既清除了细胞、髓鞘及其崩解碎片,基本消除了神经移植物抗原性,同时很好地保留了神经的基管膜及板层结构而成为神经纤维再生的良好支架,使其具有与自体神经近似的引导神经再生的功能。然而其体内研究仍较初步且未对术后动物的功能恢复情况进行监测。而临床上同种异体神经来源也很有限,运用异种神经则不仅能解决来源问题,且不会产生伦理学问题。Hudson等人并未对优化法处理的异种神经移植修复大鼠坐骨神经缺损后的抗免疫排斥和促神经再生能力进行研究,若本实验发现优化法处理的异种神经修复神经缺损的能力与自体神经和去细胞同种异体神经相似将具有较大的临床意义。因此,本研究通过应用优化去细胞(Optimized acellular,OA)方法处理的同种异体(大鼠)及异种(兔)神经移植物移植修复大鼠坐骨神经缺损,术后检测实验动物移植物局部的免疫排斥情况、患肢功能恢复及神经再生情况,并将三种不同移植物的修复结果相互对比,来观察优化去细胞方法抑制免疫排斥、促神经再生及功能恢复的有效性,探讨同种异体及异种神经移植作为自体神经移植替代疗法的可能性。
首先,进行神经移植物制备及神经移植手术。参照Hudson等的优化去细胞方法处理所取兔臂丛神经分支和大鼠坐骨神经,然后分别移植修复大鼠1cm坐骨神经缺损,以自体神经移植和新鲜兔、大鼠神经移植作为对照。然后,分别于术后1个月和3个月行大体观察、坐骨神经功能指数(sciatic functional index,SFI)测量、神经电生理检测和组织学观察。
研究结果显示:术后1个月,自体神经、OA异体神经和OA异种神经移植组动物的坐骨神经功能恢复相似,大体观察亦无显著差异,但均优于新鲜神经移植组。电生理检测结果说明三组动物移植神经均已恢复电传导能力,在传导速度上差异无统计学意义,但均未恢复到正常神经水平。组织学观察则显示三组再生神经纤维均连续性良好,雪旺氏细胞在数量、形态和排列等方面无明显差异。巨噬细胞和CD8+T细胞免疫组化染色显示它们在染色阳性面积百分比上无明显差异,却显著低于新鲜神经移植组,直观地证明了优化去细胞方法有效抑制宿主免疫排斥反应的能力。3个月取材与1个月取材时相比,移植段神经的大体外观、电生理及组织学观察结果均无明显差异,但坐骨神经功能指数却明显优于后者,可能是因为术后1个月时,再生神经纤维已经通过移植段神经并长入远端,神经电传导能力已经恢复,故与3个月时相比,电生理及组织学观察结果无显著差异,如移植物中段轴突密度等指标。而随着时间推移,神经纤维向远端延伸,重建运动终板等结构,恢复对肌肉的支配,因此坐骨神经功能指数优于1个月时。
由于用天然神经代替人工材料移植修复周围神经缺损具有许多先天性优点,如完全天然的空间结构,以及轴突生长时会对神经移植物内的基膜管等具有倾向性等,因此,优化去细胞方法处理的天然神经移植物不仅有效解决了宿主免疫排斥的问题,还能提供较理想的促神经再生能力。本研究表明:用此方法处理的同种异体神经修复周围神经缺损效果较好,有望代替应用受限的自体神经。而此法处理的异种神经移植物则可以比拟自体神经和同样方法处理的同种异体神经移植物,且在供体来源和伦理学等方面甚至优于后两者,因此临床应用异种神经移植物修复周围神经缺损,特别是大段、多段或神经丛缺损是可行的。
The autologous nerve grafting, which is still the standard method to repair a nerve gap clinically, will be performed after the injury of peripheral nerves if the suture without tensility cannot be achieved. For the reason that there is a lack of nerve autografts and more injuries and new sensory dysfunction are unavoidable when a autologous cutaneous nerve having been harvested, it is essential to develop a new effective nerve graft instead of autografts. The repair by transplantation of fresh nerve allografts and xenografts will be a failure because of the transplant rejection reaction, which can be avoided by removal of cellular materials in the grafts. There are many kinds of ways to obtain acellular nerve, of which the most common ones are thermal and chemical processes. Although thermal decellularization does kill the cells and render the graft generally nonimmunogenic, the process does not extract the cell remnants. Several chemical treatments have been designed to render nerve grafts nonimmunogenic while also removing much of the cellular debris. However, chemical treatments cause more damage to the ECM than thermal decellularization. Hudson, etc. developed a new chemical decellularization process to create optimized acellular (OA) nerve grafts with an extracellular environment similar to that of native nerve tissue, but without the cellular material that is believed to elicit cell-mediated rejection. But their research in vivo is superficial and the functional recovery was not evaluated. For the lack of nerve allografts clinically, the xenogenic nerve grafts are needed, which will not cause ethical problems also. If we find the capacity of xenogenic nerve grafts to repair peripheral nerve defects is similar to those of nerve autografts and allografts, it will be of great clinical importance. So we observed in this research the immune rejection, nerve regeneration and functional recovery of rat sciatic nerve defect bridged by optimized acellular nerve and autologous nerve and compared them to each other.
Firstly, we obtained the optimized acellular nerve grafts and performed the transplant operation. The right sciatic nerve of adult Sprague-Dawley(SD) rats were exposed and 1.0cm long segment of the nerves were removed and repaired by optimized acellular rabbit and rat nerve. After 1 month and 3 months respectively, sciatic functional index(SFI), electrophysiological and histological studies were conducted to evaluate immune rejection, nerve regeneration and functional recovery and to compare those parameters in autograft group, allograft group, xenograft group and fresh nerve graft group.
1 month after the operation, the results showed that the immune rejection assessed by the levels of CD8+ T cells and macrophages infiltration, nerve regeneration assessed by axon density, and functional recovery evaluated by SFI in the optimized acellular xenograft group was similar to those in the autograft group and allograft group, but significantly better than those in the fresh nerve graft group. 3 months after the operation, the SFI was significantly better, while the others were not. The possible reason for this may be that the new axons had grown completely across the grafts 1 month after the operation. And the new axons had grown to the distal nerve end 3 months after the operation.
There are more advantages to repair peripheral nerve defect using natural nerve grafts instead of artificial grafts. And our research proves that the optimized acellular nerve xenografts and allografts are immunologically tolerated. They allow good nerve regeneration and functional recovery and can be potential substitutes for autografts in repairing peripheral nerve defect, especially in repairing extensive or multiple nerve defects or nerve plexus injuries.
首先,进行神经移植物制备及神经移植手术。参照Hudson等的优化去细胞方法处理所取兔臂丛神经分支和大鼠坐骨神经,然后分别移植修复大鼠1cm坐骨神经缺损,以自体神经移植和新鲜兔、大鼠神经移植作为对照。然后,分别于术后1个月和3个月行大体观察、坐骨神经功能指数(sciatic functional index,SFI)测量、神经电生理检测和组织学观察。
研究结果显示:术后1个月,自体神经、OA异体神经和OA异种神经移植组动物的坐骨神经功能恢复相似,大体观察亦无显著差异,但均优于新鲜神经移植组。电生理检测结果说明三组动物移植神经均已恢复电传导能力,在传导速度上差异无统计学意义,但均未恢复到正常神经水平。组织学观察则显示三组再生神经纤维均连续性良好,雪旺氏细胞在数量、形态和排列等方面无明显差异。巨噬细胞和CD8+T细胞免疫组化染色显示它们在染色阳性面积百分比上无明显差异,却显著低于新鲜神经移植组,直观地证明了优化去细胞方法有效抑制宿主免疫排斥反应的能力。3个月取材与1个月取材时相比,移植段神经的大体外观、电生理及组织学观察结果均无明显差异,但坐骨神经功能指数却明显优于后者,可能是因为术后1个月时,再生神经纤维已经通过移植段神经并长入远端,神经电传导能力已经恢复,故与3个月时相比,电生理及组织学观察结果无显著差异,如移植物中段轴突密度等指标。而随着时间推移,神经纤维向远端延伸,重建运动终板等结构,恢复对肌肉的支配,因此坐骨神经功能指数优于1个月时。
由于用天然神经代替人工材料移植修复周围神经缺损具有许多先天性优点,如完全天然的空间结构,以及轴突生长时会对神经移植物内的基膜管等具有倾向性等,因此,优化去细胞方法处理的天然神经移植物不仅有效解决了宿主免疫排斥的问题,还能提供较理想的促神经再生能力。本研究表明:用此方法处理的同种异体神经修复周围神经缺损效果较好,有望代替应用受限的自体神经。而此法处理的异种神经移植物则可以比拟自体神经和同样方法处理的同种异体神经移植物,且在供体来源和伦理学等方面甚至优于后两者,因此临床应用异种神经移植物修复周围神经缺损,特别是大段、多段或神经丛缺损是可行的。
The autologous nerve grafting, which is still the standard method to repair a nerve gap clinically, will be performed after the injury of peripheral nerves if the suture without tensility cannot be achieved. For the reason that there is a lack of nerve autografts and more injuries and new sensory dysfunction are unavoidable when a autologous cutaneous nerve having been harvested, it is essential to develop a new effective nerve graft instead of autografts. The repair by transplantation of fresh nerve allografts and xenografts will be a failure because of the transplant rejection reaction, which can be avoided by removal of cellular materials in the grafts. There are many kinds of ways to obtain acellular nerve, of which the most common ones are thermal and chemical processes. Although thermal decellularization does kill the cells and render the graft generally nonimmunogenic, the process does not extract the cell remnants. Several chemical treatments have been designed to render nerve grafts nonimmunogenic while also removing much of the cellular debris. However, chemical treatments cause more damage to the ECM than thermal decellularization. Hudson, etc. developed a new chemical decellularization process to create optimized acellular (OA) nerve grafts with an extracellular environment similar to that of native nerve tissue, but without the cellular material that is believed to elicit cell-mediated rejection. But their research in vivo is superficial and the functional recovery was not evaluated. For the lack of nerve allografts clinically, the xenogenic nerve grafts are needed, which will not cause ethical problems also. If we find the capacity of xenogenic nerve grafts to repair peripheral nerve defects is similar to those of nerve autografts and allografts, it will be of great clinical importance. So we observed in this research the immune rejection, nerve regeneration and functional recovery of rat sciatic nerve defect bridged by optimized acellular nerve and autologous nerve and compared them to each other.
Firstly, we obtained the optimized acellular nerve grafts and performed the transplant operation. The right sciatic nerve of adult Sprague-Dawley(SD) rats were exposed and 1.0cm long segment of the nerves were removed and repaired by optimized acellular rabbit and rat nerve. After 1 month and 3 months respectively, sciatic functional index(SFI), electrophysiological and histological studies were conducted to evaluate immune rejection, nerve regeneration and functional recovery and to compare those parameters in autograft group, allograft group, xenograft group and fresh nerve graft group.
1 month after the operation, the results showed that the immune rejection assessed by the levels of CD8+ T cells and macrophages infiltration, nerve regeneration assessed by axon density, and functional recovery evaluated by SFI in the optimized acellular xenograft group was similar to those in the autograft group and allograft group, but significantly better than those in the fresh nerve graft group. 3 months after the operation, the SFI was significantly better, while the others were not. The possible reason for this may be that the new axons had grown completely across the grafts 1 month after the operation. And the new axons had grown to the distal nerve end 3 months after the operation.
There are more advantages to repair peripheral nerve defect using natural nerve grafts instead of artificial grafts. And our research proves that the optimized acellular nerve xenografts and allografts are immunologically tolerated. They allow good nerve regeneration and functional recovery and can be potential substitutes for autografts in repairing peripheral nerve defect, especially in repairing extensive or multiple nerve defects or nerve plexus injuries.
引文
[1] 朱家恺.周围神经外科进展.第 1 版.广州:广东高等教育出版社,1991年.P66-84.
[2] Longo FM, Hayman EG, Davis GE,et al. Neurite—promoting factors and extracellular matrix components accumulating in vivo within nerve regeneration chambers[J].Brain Res,1984,309(1): 105—117.
[3] Varon S,Williams LR.Perpheral nerve regeneration in a silicone model chamber:cellular and molecular aspects. Peripheral Nerve Repair and Regenertion,1986,1:9.
[4] Kosaka M. Enhancement of rat peripheral nerve regeneration through artery-containing silicone tubing. Exp Neurol ,1990 ,107 :69.
[5] Francel PC, Francel TJ, Mackinnon SE,et al. Enhancing nerve regeneration across a silicone tube conduit by using interposed short-segment nerve graft. J Neurosurg ,1997 ,87 :887.
[6] Tong XJ , Hirai K, Shimada H,et al. Sciatic nerve regeneration navigated by laminin-fibronectin double coated biodegradable collagen grafts in rats. Brain Res,1994, 663(1) : 155-62.
[7] den Dunnen WF, van der Lei B,Robinson PH,et al. Biological performance of a degradable poly(lactic acid-epsilon-caprolactone) nerve guide: influence of tube dimensions. J Biomed Mater Res, 1995, 29 (6):757-66.
[8] Grijpma DW , Zondervan GJ. Polymer Bulletin, 1991, 25: 327.
[9] 李晓光,中村达雄,等.人工脏器, 1993, 22 (2) :364.
[10] 王身国,侯建伟,贝建中.组织工程及周围神经修复. 高技术通讯,1999,2:60-62.
[11] 杨吟野,李训虎,李国富,等.壳聚糖和 PHBHHX 用作神经修复导管材料的研究.生物医学工程学杂志,2002,19(1):25-29.
[12] Stanec S, Stanec Z.Ulnar nerve reconstruction with an expanded polytetrafluoroethylene conduit. Br J Plast Surg,1998,51(8): 637-9.
[13] 苟三怀,侯春林,王东荣,等.几丁质桥接周围神经缺损的实验研究及临床应用.中华骨科杂志,1996,16(3):148-151.
[14] 张森林,马捷.含神经生长因子的几丁质管桥接兔面神经缺损的实验研究.中国修复重建外科杂志,2000,14(6):340-342.
[15] 王平,彭学良,刘晋才.含神经生长因子的羊膜基质管桥接修复神经缺损的实验研究.中华显微外科杂志,2001,24(1):42-45.
[16] 赵立,李涛.实验性脊髓损伤的治疗进展.国外医学·神经病学、神经外科学分册,1996,23(4):172-175.
[17] 周佩兰,杨明富,赵凤仪,等.静脉体基底膜许旺细胞和 NGF 复合移植桥接神经缺损的实验研究.中华显微外科杂志,2001,24(2):124-26.
[18] Choi BH,Zhu SJ,Kim SH,et al.Nerve repair using a vein graftfilled with collagen gel.J Reconstr Microsurg,2005,21 (4):267-2.
[19] 朱家恺.周围神经外科学. 海口:三环出版社, 1991.P77.
[20] Chiu DTW, et al. Autogenous vein graft as a conduit for nerve regeneration. Surgery 1982,91:226-232.
[21] 洪光祥,王发斌,黄省秋,等.自体静脉移植修复周围神经缺损实验研究. 中华显微外科杂志,1991;14(4):220-2.
[22] 丛国辉,鲁开化. 不同性质骨骼肌复合材料桥接周围神经缺损的比较研究.中华显微外科杂志,1995;18(4):275-6.
[23] 韩岩,鲁开化,马福成,等. 含有Ⅰ、Ⅳ型胶原的静脉管腔对周围神经缺损修复作用的影响.中华显微外科杂志,1999;22(3):198-200.
[24] 利春叶,曹代成. 碱性成纤维细胞生子因子结合静脉套接法修复周围神经缺损的实验研究. 中国修复重建外科杂志,2000;14(1):14-16.
[25] 韩岩,鲁开化.游离神经片段延长静脉桥接周围神经缺损长度的实验研究.中华外科杂志, 1993;31(12): 726-9.
[26] Tang JB. Vein conduits with interposition of nerve tissue for peripheral nerve defects. J Reconstr Microsurg. 1995;11(1): 21-6.
[27] Brunelli GA, Battiston B, Vigasio A, et al. Bridging nerve defects with combined skeletal muscle and vein conduits.Microsurgery. 1993; 14(4): 247-51
[28] Tang JB, Gu YQ, Song YS. Repair of digital nerve defect with autogenous vein graft during flexor tendon surgery in zone 2. J Hand Surg Br. 1993; 18(4):449-53.
[29] Tang JB. Group fascicular vein grafts with interposition of nerve slices for long ulnar nerve defects: report of three cases. Microsurgery. 1993;14(6): 404-8.
[30] 尹维田,王国居.小间隙静脉桥吻合神经断裂临床研究.中华显微外科杂志,1993,16:249.
[31] 杨振祥,刘志斌,孔吉明.神经组织匀浆对面神经再生影响的实验研究.中国临床解剖学杂志,1994,12:214.
[32] Machinnon SE.A study of nerve regenerntion across synthetic nerve conduit for gap up to 5cm in the primate.J Reconstr Microsurg,1990,16:117.
[33] Willims LR. Rat aorta isografts possess nerve regeneration promoting properties in sililone Ychambers. Exp Neurol ,1987 ,93 :555.
[34] Ochi M, Ikuta Y,Miycamato Y,et al. Experimental evidence of selective axonal regeneration in allogenic and isogenic chambers. Exp Neurol, 1992,115 :260.
[35] 陈书连,贺长清,吴学建. 翻转静脉桥接修复周围神经缺损的实验研究. 中华显微外科杂志,1998 ,21 :208.
[36] Wang KK,Costas PD ,Bryan DJ ,et al. Inside2out vein graft promotes improved nerve regeneration in rats. Microsurgery ,1993 ,14 :608.
[37] Walton RL, Brown RE, Matory WE, et al. Autogenous vein graft repair of digital nerve defects in the finger: a retrospective clinical study. Plast Reconstr Surg 1989,84:944-949.
[38] Chiu-DT. Autogenous venous nerve conduits. A review. Hand Clin. 1999,15(4):667-71.
[39] Suematsu N, Atsuta Y, Hirayama T. Vein gaft for repair of peripheral nerve gap. J Reconstr Microsurg 1988,4:313-318.
[40] Chiu DTW, et al. Comparative electrophysiologic vein grafts as nerve conduits:an experimental study. J Reconstr Microsurg 1988,4:303-310.
[41] 罗永湘,等.静脉桥接正中神经、尺神经缺损四例的教训.中华显微外科杂志,1990;13:229.
[42] Tang JB, Shi D, Zhou H. Vein conduits for repair of nerves with a prolonged gap or in unfavourable conditions: an analysis of three failed cases. Microsurgery. 1995; 16(3): 133-7.
[43] Chiu DTW and Strauch B. A prospective clinical evaluation of autogenous vein grafts used as a nerve conduit for distal sensory nerve defects of 3 cm or less. Plast Reconstr Surg 1990,86:928-934.
[44] Rice DH and Berstein FD. The use of autogenous vein for nerve grafting. Otolaryngol Head Neck Surg 1984,92:410.
[45] 卫晓恩,韩西城. 多种移植体修复周围神经的比较实验研究. 中国修复重建外科杂志,1996 , 11(1):12.
[46] 孔吉明,钟世镇.用骨胳肌桥接周围神经的研究.中华显微外科杂志,1986,9(2):68.
[47] Glasby MA, Gschmeissner S, Hitchcock RJ, Huang CL. Regeneration of the sciatic nerve in rats. The effect of muscle basement membrane.J Bone Joint Surg [Br] 1986; 68(5): 829-33.
[48] Glasby MA, Gschmeissner SG, Hitchcock RJ, Huang CL.The dependence of nerve regeneration through muscle grafts in the rat on the availability and orientation of basement membrane. J Neurocytol 1986;15(4): 497-510.
[49] 孔吉明,钟世镇. 用骨骼肌桥接神经缺损的实验研究. 中华显微外科杂志,1986;9(1):63-65.
[50] 张爱华,朱家恺.血管植入变性骨骼肌修复周围神经缺损进一步实验研究.中华显微外科杂志,1992,15:27.
[51] Gulati AK.Evaluation of and ceuular nerve graft in repair of rat peripheral nerves.J Neurosurg,1988,68:117.
[52] Keynes RJ, Hopkins WG, Huang LH. Regeneration of mouse peripheral nerves in degenerating skeletal muscle: guidance by residual muscle fibre basement membrane. Brain Res 1984;295(2): 275-81.
[53] Fawcett JW, Keynes RJ. Muscle basal lamina: a new graft material for peripheral nerve repair. J Neurosurg 1986 ; 65(3): 354-63.
[54] Glasby MA, Gschmeissner SE, Huang CL, De Souza BA. Degenerated muscle grafts used for peripheral nerve repair in primates. J Hand Surg [Br] 1986; 11(3):347-51.
[55] Lawson GM,Glasby MA. A comparison of immediate and delayed nerve repair using autologous freeze-thawed muscle grafts in a large animal model.The simple injury. J Hand Surg Br. 1995; 20(5): 663-700.
[56] Hems TE, Glasby MA. Comparison of different methods of repair of long peripheral nerve defects: an experimental study. Br J Plast Surg. 1992; 45(7):497-502.
[57] Lenihan DV, Carter AJ, Glasby MA. An electrophysiological and morphological comparison of the microwave muscle graft and the freeze-thawed muscle graft.Br J Plast Surg. 1998 ;51(4):300-6.
[58] Santo Neto H, Teodori RM, Somazz MC, Marques MJ. Axonal regeneration through muscle autografts submitted to local anaesthetic pretreatment. Br J Plast Surg. 1998; 51(7): 555-60.
[59] Houstava L, Dubovy P, Haninec P, Grim M. An alternative preparation of the acellular muscle graft for reconstruction of the injured nerve morphological and morphometric analysis. Anat Anz. 1999;181(3):275-81.
[60] 张爱华,朱家恺.血管植入变性骨骼肌与自体神经移植修复周围神经缺损的比较.中华显微外科杂志,1992;15(3):172-3.
[61] 张爱华,朱家恺.骨骼肌修复周围神经缺损的研究进展.中华显微外科杂志,1992;15(2):114-116.
[62] Cheng M, Cao W, Gao Y,et al. Studies on nerve cell affinity of biodegradable modified chitosan films [J] .J Biomater Sci Polym Ed,2003, 14(10):1155-1167.
[63] 匡勇,侯春林,苟三怀,等.几丁质及几丁糖与雪旺氏细胞相容性的研究.中国修复重建外科杂志,1998;12(2):90-92.
[64] 苟三怀,侯春林.几丁质桥接周围神经缺损的实验研究,中国修复重建外科杂志,1993,7(3):169
[65] Kohn J. M R S Bulleting, 1996, Nov:17.
[66] Hudson TW,Evans GR ,Schmidt CE. Engineering strategies for peripheral nerve repair. Clin Plast Surg ,1999 ,26:617.
[67] 朱庆棠,朱家恺,程钢. 人工神经的研究进展. 中国修复重建外科杂志,2000;14(6):369-371.
[68] Jenq CB. and Coggeshall R.E. Permeable tubes increase the length of the gap that regenerating axons can span. Brain Res. 1987, 408:239-242.
[69] Kim D.H., Connolly S.E., Zhao S., Beuerman R.W., Voorhies R.M. and Kline D.G. Comparison of macropore, semipermeable, and nonpermeable collagen conduits in nerve repair. J. Reconst. Microsurg. 1993, 9:415-420.
[70] Kline D.G. and Hayes G.J. The use of a resorbable wrapper for peripheral nerve repair. J. Neurosurg. 1964, 21:737-750.
[71] 戴传昌,商庆新,王炜,等. 用组织工程方法桥接周围神经缺损的实验研究.中华外科杂志,2000;38(5):388-390.
[72] Schugens CH, Maquet V, Gandfiles C, et al. Bioabsorbable and macroporous polylactide implants for cell transplantion:Preparation of macroporous polylactide supports by solid-liquid phase separation[J]. Polymer,1996,37(6):1027-1038.
[73] Rutkowski GE,Heath CA. Development of a bioartificial nerve graft.II. Nerve regeneration in vitro[J]. Biotech Prol, 2002, 18(2):373-379.
[74] Lundborg G, Dahlin L, Dohi D, Kanje M, Terada N. A new type of "bioartificial" nerve graft for bridging extended defects in nerves. J Hand Surg [Br]1997,2(3):299-303
[75] 蒋良福,劳杰. 周围神经组织工程研究. 中华创伤杂志,2003,19:254-256.
[76] Todd C.Holmes. Novel peptide- based biomaterial scaffolds for tissue engineering. TRENDS in Biotechnology,2002,20:16-21.
[77] Ve'ronique Maquet, Didier Martin. Peripheral nerve regeneration using bioresorbable macroporous polylactide scaffolds MAQUET ET AL,2000,3: 639-652.
[78] Andreas Gravvanis, Markos Karvelas. The use of silicone tubes in end- to-side nerve grafting: an experimental study. European Journal of Plastic Surgery,2003,26:111-115.
[79] Keeley R, Atagi T, Sabelman E, Padilla J, Kadlcik S, Keeley A, Nguyen K,Rosen J. Peripheral nerve regeneration across 14-mm gaps: a comparison of autograft and entubulation repair methods in the rat. J Reconstr Microsurg 1993,(5):349-58.
[80] Mackinnon SE, and Dellon AL. Clinical nerve reconstruction with a bioabsorbable polyglycolic acid tube. Plast Reconstr Surg.1990; 85(3): 419-424.
[81] Dunnen WF, Vander LB, Schakenrad JM, et al. Poly(DL-lactide- epsiloncaprolactone) nerve guides perform better than autologous nerve grsfts.Microsurgery, 1996;17(7):348.
[82] 沈华、沈尊理、张佩华、贾万新、王永春、张兆锋、黄一雄. 壳聚糖神经导管修复犬胫神经缺损的实验研究。中国美容医学,2006,15(6):635-637.
[83] 沈尊理、张菁、沈华、陈皓、张佩华、王文祖、陈南梁、黄一雄、张兆锋、贾万新、黄倩.脉冲等离子体涂层神经导管修复周围神经缺损实验研究.组织工程与重建外科杂志.2005,1(2):94-97.
[84] Fansa H, Keilhoff G, Wolf G, et al. Cultivating human Schwann cells for tissue engineering of peripheral nerves. Handchir Mikrochir Plast Chir. 2000,32:181-186.
[85] Keilhoff G, Fansa H, Smalla KH, et al. Neuroma: a donor- age independent source of human Schwann cells for tissue engineered nerve grafts. Neuroreport,2000,11:3805-3809.
[86] Dezawa M, Takahashi I, Esaki M, et al. Sciatic nerve regeneration in rats induced by transplantation of in vitro differentiated bone marrow stromal cells. Eur J Neurosci,2001,14:1771-1776.
[87] 侯赛云, 朱家恺. 大鼠骨髓基质干细胞体外诱导分化为类许旺细胞.中华显微外科杂志,2003,26:39-41.
[88] 苟三怀,侯春林,臧鸿声,等.几丁质室内植入雪旺氏细胞对神经再生影响的实验研究.中国修复重建外科杂志,1995;9(2):108-110.
[89] 王光林, 杨志明, 解慧琪, 等. 周围神经组织工程材料的预构. 中国修复重建外科杂志, 2000;14(2):110-114.
[90] Jenq CB. and Coggeshall R.E. Nerve regeneration through holey silicone tubes.Brain Res. 1985, 361:233-241.
[91] Levi AD, Guenard V, Aebischer P, Bunge RP.The functional characteristics of Schwann cells cultured from human peripheral nerve after transplantation into a gap within the rat sciatic nerve. J Neurosci. 1994; 14(3 ):1309-19.
[92] Levi AD, Sonntag VK, Dickman C, Mather J, Li RH, Cordoba SC, Bichard B,Berens M . The role of cultured Schwann cell grafts in the repair of gaps within the peripheral nervous system of primates. Exp Neurol. 1997; 143(1): 25-36.
[93] Mackinnon SE, Hudson AR, Bain JR, et al. An assessment of nerve regeneration in the immunosuppressed host. Plast Reconstr Surg 1987;79: 436-444.
[94] Keilhoff G, Fansa H, Schneider W, et al. In vivo predegeneration ofperipheral nerves: an effective technique to obtain activated Schwann cells for nerve conduits. JNeurosciMethods,1999,89:17-24.
[95] 劳杰,熊良俭,顾玉东, 等. 应用激活态的 SC 填充导管修复周围神经缺损的初步研究. 中华手外科杂志, 2000,16:236-240.
[96] Arai T, Lundborg G, Dahlin LB.Bioartificial nerve graft for bridging extended nerve defects in rat sciatic nerve based on resorbable guiding filaments.Scand J Plast Reconstr Surg Hand Surg 2000;34(2):101-8.
[97] Yoshii S, Oka M, Lkeda N, Akagi M, Matsusue Y, Nakamura T.Bridging a peripheral nerve defect using collagen filaments. J Hand Surg [Am] 2001 Jan;26A(1):52-59.
[98] Matsumoto K, Ohnishi K, Sekine T, Ueda H, Yamamoto Y, Kiyotani T, Nakamura T, Endo K, Shimizu Y.Use of a newly developed artificial nerve conduit to assist peripheral nerve regeneration across a long gap in dogs. ASAIO J 2000,46(4):415-20.
[99] Matsumoto K, Ohnishi K, Kiyotani T, Sekine T, Ueda H, Nakamura T, Endo K,Shimizu Y.Peripheral nerve regeneration across an 80-mm gap bridged by a polyglycolic acid (PGA)-collagen tube filled with laminin-coated collagen fibers: a histological and electrophysiological evaluation of regenerated nerves. Brain Res 2000,868(2):315-28.
[100] Suzuki Y, Tanihara M, Ohnishi K, Suzuki K, Endo K, Nishimura Y.Cat peripheral nerve regeneration across 50 mm gap repaired with a novel nerve guide composed of freeze-dried alginate gel. Neurosci Lett 1999;259(2): 75-8.
[101] Levi AD, Bunge RP.Studies of myelin formation after transplantation of human Schwann cells into the severe combined immunodeficient mouse.Exp-Neurol.1994,130(1): 41-52.
[102] 许绍芬.神经生物学(第二版).上海:上海医科大学出版社,1999.
[103] Chen Yueh Sheng, Hsieh Ching Liang, Tsai Chin Chuan, et al.Peripheral nerve regeneration using silicon rubber chamber filled with collagen, laminin and fibronection. Biomaterials,2000,21:1541-1547.
[104] 赵立国,姚康德. 神经导管修复周围神经损伤的研究进展.生物医学工程与临床,2003,7:120-123.
[105] simon P,Frostick, MA.Schwann cells, neurotrophic factors, and peripheral nerve regeneration.,Microsurgery,1998,18:397-405.
[106] Gregory RD Evans. Peripheral nerve injury:a review and Approach to tissue engineered constructs. The Anatomical Record,2001,63:396- 404.
[107] H.Fansa,Dodic. Tissue engineering of peripheral nerves: epineurial grafts with application of cultured Schwann cells. Microsurgery,2003,23:72-77.
[108] Keeley R,Atagi TY,Sabelman E,et al.peripheral nerve regenration across 14 mm gaps:a comparision of autograft and entubulation repair menthods in the rat.J Reconstr Micro,1993,9(1):5.
[109] 朱盛修.周围神经显微修复学.北京:北京科学出版社,1991:201.
[110] 吴梅英.周围神经缺损的自体神经移植.中华显微外科杂志,1991,14(1): 39.
[111] 姜永冲, 路来金,王玉发,等.带贵要静脉前臂内侧皮神经移植修复周围神经缺损.中华显微外科杂志,1995,18(1):55.
[112] 钟汉柱,周长满. 吻合血管移植腓浅神经修复缺损 25cm 的正中神经.临床应用解剖学杂志,1983,11(2): 21.
[113] 顾玉东,吴敏明. 静脉蒂动脉化游离腓肠神经移植.中华外科杂志,1985,23(4):128.
[114] George Bonny MS. Experience with vascularized nerve grafts. Clin Plas Surg, 1984,11(2):137.
[115] 孟庆刚,战华.同种异体周围神经移植进展.实用手外科杂志,1999,13(4):225.
[116] Gulati, A.K., and Cole, G.P. Immunogenicity and regenerative potential of acellular nerve allografts to repair peripheral nerve in rats and rabbits. Acta Neurochir. (Wien)126, 158, 1994.
[117] Zalewski, A.A., and Gulati, A.K. Evaluation of histocompatibility as a factor in the repair of nerve with a frozen nerve allograft. J. Neurosurg. 56, 550, 1982.
[118] Danielsen N , Kerns J M , Holmquist B , Zhao Q , Lundborg G , and Kanje M. Predegeneration enhances regeneration into acellular nerve grafts. Brain Res. 681, 105,1995.
[119] Osawa T , Tohyama K, and Ide C. Allogeneic nerve grafts in the rat, with special reference to the role of Schwann cell basal laminae in nerve regeneration. J. Neurocytol.19, 833, 1990.
[120] Pollard JD, and Fitzpatrick L. An ultrastructural comparison of peripheral nerve allografts and autografts. Acta Neuropathol. (Berl) 23, 152, 1973.
[121] Ide C, et al. Long acellular nerve transplants for allogeneic grafting and the effects of basic fibroblast growth factor on the growth of regenerating axons in dogs: A preliminary report. Exp. Neurol. 154, 99, 1998.
[122] Hall SM. Regeneration in cellular and acellular autografts in the peripheral nervous system. Neuropathol Appl. Neurobiol.12, 27, 1986.
[123] Krekoski CA, Neubauer D, Zuo J, and Muir D. Axonal regeneration into acellular nerve grafts is enhanced by degradation of chondroitin sulfate - 61 -proteoglycan. J Neurosci21, 6206, 2001.
[124] Johnson PC, Duhamel RC, Meezan E, and Brendel K. Preparation of cell-free extracellular matrix from human peripheral nerve. Muscle Nerve 5, 335, 1982.
[125] Sondell M, Lundborg G, and Kanje M. Regeneration of the rat sciatic nerve into allografts made acellular through chemical extraction. Brain Res. 795, 44, 1998.
[126] Hudson TW, Evans GR, and Schmidt CE .Engineering strategies for peripheral nerve repair. Orthop Clin.North Am,2000,31(3): 485-98.
[127] Hudson TW,Zawko S,Deister C,et al. Optimized acellular nerve graft is immunologically tolerated and supports regeneration.Tissue Engineering, 2004,10(11-12):1641-51.
[128] Mackinnon SE, Miclha R, Bain J. An assessment of regeneration across peripheral allografts in rats receiving short courses of cyclosporin a immunosuppression[J]. Neuroscience, 1992, 46(4): 585.
[129] Asselin AD, Pollard JD, Davey DF. Immunosupression in nerve allografting is it desirable[J]. Neurol Sen, 1992, 112(9): 160.
[130] Muramatsu K, Doi K, Kawai S. Nerve regenerating effect of short administration of cyciosporine affer frash peripheral nerve allotransplation in the rat: comparition of nerve regeration using different forms of donor nerve allografts[J]. Microsurg, 1995, 16(11): 496.
[131] 田立杰,战 杰,王淑华,等.胎儿神经移植修复感觉神经缺损.中国修复重建外科杂志.1998,12(3):138.
[132] 丁文龙,刘德明,王桂芳,等.刀豆球蛋白 A 处理异种移植神经对神经再生的影响.解剖学报,1995,26:265.
[133] 国生辉,金岩,张勇杰,王彦亮,沈楠,刘 鹏。化学萃取异种组织工程化神经支架的方法和组织学研究。牙体牙髓牙周病学杂志(Chin J Conserv Dent)2005,15(5):P255-258.
[134] 沈宁江, 朱家恺. 坐骨神经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.
[135] Bain J, Mackinnon S, and Hunter DA. Functional evaluation of complete sciatic, peroneal, and posterior tibial nerve lesions in the rat. Plast Reconstr Surg, 1989,83(1): 129-38.
[136] Dument CE,Hentz VR.Enhancement of axon growth by detergentextracted peripheral nerve grafts[J].Transplantation.1997,63(8):1210-215.
[137] 佟晓杰。刘承吉,张彩顺。等.脱细胞同种异体神经移植物修复大鼠坐骨神经缺损的实验研究[J].解剖学报,2004。35(3):23O-33.
[138] Wang GY. Hirai KI,Shimada H.The role of laminin,a component of Schwann cell basal lamina 。 in rat sciatic nerve regeneration with antiserum-treated nerve.Brain Res,1992,570(suppl1):116-25.
[139] Tong XJ,Hirai K,Shimada H,et a1.Sciatic nerve regeneration navigated by laminin-fibronectin double coated biodegradable collagen grits in rats[J].Brain Res。1994,663(1):155-62.
[140] Bunge MB,Bunge RP,Kleitman N,et a1.Role of peripheral nerve extracellular matrix in Schwann cell function and in neurite regeneration[J].Dev Neuresci,1989,11(4-5):348-60
[141] Meek MF,Dijkstra JR,Den Dunnen WF,et a1.Functional assessment of sciatic nerve reconstruction : biodegradable poly(DLLA—epsilon— CL)nerve guides versus autologous nerve grafts.Microsurgery,1999,19(8):381-388.
[142] Zhu SHX.The Microprosthetics of Peripheral Nerves[M].Beijing:Science Press,1991:90-105.朱盛修.周围神经显微修复学[M].北京:科学出版社,1991:90-105.
[143] 李跃军, 陈绍宗, 李学拥等. 猴指神经皮下植入后中远期再生效果的电生理研究.中华显微外科杂志, 1999; 22(1): 43-44.
[2] Longo FM, Hayman EG, Davis GE,et al. Neurite—promoting factors and extracellular matrix components accumulating in vivo within nerve regeneration chambers[J].Brain Res,1984,309(1): 105—117.
[3] Varon S,Williams LR.Perpheral nerve regeneration in a silicone model chamber:cellular and molecular aspects. Peripheral Nerve Repair and Regenertion,1986,1:9.
[4] Kosaka M. Enhancement of rat peripheral nerve regeneration through artery-containing silicone tubing. Exp Neurol ,1990 ,107 :69.
[5] Francel PC, Francel TJ, Mackinnon SE,et al. Enhancing nerve regeneration across a silicone tube conduit by using interposed short-segment nerve graft. J Neurosurg ,1997 ,87 :887.
[6] Tong XJ , Hirai K, Shimada H,et al. Sciatic nerve regeneration navigated by laminin-fibronectin double coated biodegradable collagen grafts in rats. Brain Res,1994, 663(1) : 155-62.
[7] den Dunnen WF, van der Lei B,Robinson PH,et al. Biological performance of a degradable poly(lactic acid-epsilon-caprolactone) nerve guide: influence of tube dimensions. J Biomed Mater Res, 1995, 29 (6):757-66.
[8] Grijpma DW , Zondervan GJ. Polymer Bulletin, 1991, 25: 327.
[9] 李晓光,中村达雄,等.人工脏器, 1993, 22 (2) :364.
[10] 王身国,侯建伟,贝建中.组织工程及周围神经修复. 高技术通讯,1999,2:60-62.
[11] 杨吟野,李训虎,李国富,等.壳聚糖和 PHBHHX 用作神经修复导管材料的研究.生物医学工程学杂志,2002,19(1):25-29.
[12] Stanec S, Stanec Z.Ulnar nerve reconstruction with an expanded polytetrafluoroethylene conduit. Br J Plast Surg,1998,51(8): 637-9.
[13] 苟三怀,侯春林,王东荣,等.几丁质桥接周围神经缺损的实验研究及临床应用.中华骨科杂志,1996,16(3):148-151.
[14] 张森林,马捷.含神经生长因子的几丁质管桥接兔面神经缺损的实验研究.中国修复重建外科杂志,2000,14(6):340-342.
[15] 王平,彭学良,刘晋才.含神经生长因子的羊膜基质管桥接修复神经缺损的实验研究.中华显微外科杂志,2001,24(1):42-45.
[16] 赵立,李涛.实验性脊髓损伤的治疗进展.国外医学·神经病学、神经外科学分册,1996,23(4):172-175.
[17] 周佩兰,杨明富,赵凤仪,等.静脉体基底膜许旺细胞和 NGF 复合移植桥接神经缺损的实验研究.中华显微外科杂志,2001,24(2):124-26.
[18] Choi BH,Zhu SJ,Kim SH,et al.Nerve repair using a vein graftfilled with collagen gel.J Reconstr Microsurg,2005,21 (4):267-2.
[19] 朱家恺.周围神经外科学. 海口:三环出版社, 1991.P77.
[20] Chiu DTW, et al. Autogenous vein graft as a conduit for nerve regeneration. Surgery 1982,91:226-232.
[21] 洪光祥,王发斌,黄省秋,等.自体静脉移植修复周围神经缺损实验研究. 中华显微外科杂志,1991;14(4):220-2.
[22] 丛国辉,鲁开化. 不同性质骨骼肌复合材料桥接周围神经缺损的比较研究.中华显微外科杂志,1995;18(4):275-6.
[23] 韩岩,鲁开化,马福成,等. 含有Ⅰ、Ⅳ型胶原的静脉管腔对周围神经缺损修复作用的影响.中华显微外科杂志,1999;22(3):198-200.
[24] 利春叶,曹代成. 碱性成纤维细胞生子因子结合静脉套接法修复周围神经缺损的实验研究. 中国修复重建外科杂志,2000;14(1):14-16.
[25] 韩岩,鲁开化.游离神经片段延长静脉桥接周围神经缺损长度的实验研究.中华外科杂志, 1993;31(12): 726-9.
[26] Tang JB. Vein conduits with interposition of nerve tissue for peripheral nerve defects. J Reconstr Microsurg. 1995;11(1): 21-6.
[27] Brunelli GA, Battiston B, Vigasio A, et al. Bridging nerve defects with combined skeletal muscle and vein conduits.Microsurgery. 1993; 14(4): 247-51
[28] Tang JB, Gu YQ, Song YS. Repair of digital nerve defect with autogenous vein graft during flexor tendon surgery in zone 2. J Hand Surg Br. 1993; 18(4):449-53.
[29] Tang JB. Group fascicular vein grafts with interposition of nerve slices for long ulnar nerve defects: report of three cases. Microsurgery. 1993;14(6): 404-8.
[30] 尹维田,王国居.小间隙静脉桥吻合神经断裂临床研究.中华显微外科杂志,1993,16:249.
[31] 杨振祥,刘志斌,孔吉明.神经组织匀浆对面神经再生影响的实验研究.中国临床解剖学杂志,1994,12:214.
[32] Machinnon SE.A study of nerve regenerntion across synthetic nerve conduit for gap up to 5cm in the primate.J Reconstr Microsurg,1990,16:117.
[33] Willims LR. Rat aorta isografts possess nerve regeneration promoting properties in sililone Ychambers. Exp Neurol ,1987 ,93 :555.
[34] Ochi M, Ikuta Y,Miycamato Y,et al. Experimental evidence of selective axonal regeneration in allogenic and isogenic chambers. Exp Neurol, 1992,115 :260.
[35] 陈书连,贺长清,吴学建. 翻转静脉桥接修复周围神经缺损的实验研究. 中华显微外科杂志,1998 ,21 :208.
[36] Wang KK,Costas PD ,Bryan DJ ,et al. Inside2out vein graft promotes improved nerve regeneration in rats. Microsurgery ,1993 ,14 :608.
[37] Walton RL, Brown RE, Matory WE, et al. Autogenous vein graft repair of digital nerve defects in the finger: a retrospective clinical study. Plast Reconstr Surg 1989,84:944-949.
[38] Chiu-DT. Autogenous venous nerve conduits. A review. Hand Clin. 1999,15(4):667-71.
[39] Suematsu N, Atsuta Y, Hirayama T. Vein gaft for repair of peripheral nerve gap. J Reconstr Microsurg 1988,4:313-318.
[40] Chiu DTW, et al. Comparative electrophysiologic vein grafts as nerve conduits:an experimental study. J Reconstr Microsurg 1988,4:303-310.
[41] 罗永湘,等.静脉桥接正中神经、尺神经缺损四例的教训.中华显微外科杂志,1990;13:229.
[42] Tang JB, Shi D, Zhou H. Vein conduits for repair of nerves with a prolonged gap or in unfavourable conditions: an analysis of three failed cases. Microsurgery. 1995; 16(3): 133-7.
[43] Chiu DTW and Strauch B. A prospective clinical evaluation of autogenous vein grafts used as a nerve conduit for distal sensory nerve defects of 3 cm or less. Plast Reconstr Surg 1990,86:928-934.
[44] Rice DH and Berstein FD. The use of autogenous vein for nerve grafting. Otolaryngol Head Neck Surg 1984,92:410.
[45] 卫晓恩,韩西城. 多种移植体修复周围神经的比较实验研究. 中国修复重建外科杂志,1996 , 11(1):12.
[46] 孔吉明,钟世镇.用骨胳肌桥接周围神经的研究.中华显微外科杂志,1986,9(2):68.
[47] Glasby MA, Gschmeissner S, Hitchcock RJ, Huang CL. Regeneration of the sciatic nerve in rats. The effect of muscle basement membrane.J Bone Joint Surg [Br] 1986; 68(5): 829-33.
[48] Glasby MA, Gschmeissner SG, Hitchcock RJ, Huang CL.The dependence of nerve regeneration through muscle grafts in the rat on the availability and orientation of basement membrane. J Neurocytol 1986;15(4): 497-510.
[49] 孔吉明,钟世镇. 用骨骼肌桥接神经缺损的实验研究. 中华显微外科杂志,1986;9(1):63-65.
[50] 张爱华,朱家恺.血管植入变性骨骼肌修复周围神经缺损进一步实验研究.中华显微外科杂志,1992,15:27.
[51] Gulati AK.Evaluation of and ceuular nerve graft in repair of rat peripheral nerves.J Neurosurg,1988,68:117.
[52] Keynes RJ, Hopkins WG, Huang LH. Regeneration of mouse peripheral nerves in degenerating skeletal muscle: guidance by residual muscle fibre basement membrane. Brain Res 1984;295(2): 275-81.
[53] Fawcett JW, Keynes RJ. Muscle basal lamina: a new graft material for peripheral nerve repair. J Neurosurg 1986 ; 65(3): 354-63.
[54] Glasby MA, Gschmeissner SE, Huang CL, De Souza BA. Degenerated muscle grafts used for peripheral nerve repair in primates. J Hand Surg [Br] 1986; 11(3):347-51.
[55] Lawson GM,Glasby MA. A comparison of immediate and delayed nerve repair using autologous freeze-thawed muscle grafts in a large animal model.The simple injury. J Hand Surg Br. 1995; 20(5): 663-700.
[56] Hems TE, Glasby MA. Comparison of different methods of repair of long peripheral nerve defects: an experimental study. Br J Plast Surg. 1992; 45(7):497-502.
[57] Lenihan DV, Carter AJ, Glasby MA. An electrophysiological and morphological comparison of the microwave muscle graft and the freeze-thawed muscle graft.Br J Plast Surg. 1998 ;51(4):300-6.
[58] Santo Neto H, Teodori RM, Somazz MC, Marques MJ. Axonal regeneration through muscle autografts submitted to local anaesthetic pretreatment. Br J Plast Surg. 1998; 51(7): 555-60.
[59] Houstava L, Dubovy P, Haninec P, Grim M. An alternative preparation of the acellular muscle graft for reconstruction of the injured nerve morphological and morphometric analysis. Anat Anz. 1999;181(3):275-81.
[60] 张爱华,朱家恺.血管植入变性骨骼肌与自体神经移植修复周围神经缺损的比较.中华显微外科杂志,1992;15(3):172-3.
[61] 张爱华,朱家恺.骨骼肌修复周围神经缺损的研究进展.中华显微外科杂志,1992;15(2):114-116.
[62] Cheng M, Cao W, Gao Y,et al. Studies on nerve cell affinity of biodegradable modified chitosan films [J] .J Biomater Sci Polym Ed,2003, 14(10):1155-1167.
[63] 匡勇,侯春林,苟三怀,等.几丁质及几丁糖与雪旺氏细胞相容性的研究.中国修复重建外科杂志,1998;12(2):90-92.
[64] 苟三怀,侯春林.几丁质桥接周围神经缺损的实验研究,中国修复重建外科杂志,1993,7(3):169
[65] Kohn J. M R S Bulleting, 1996, Nov:17.
[66] Hudson TW,Evans GR ,Schmidt CE. Engineering strategies for peripheral nerve repair. Clin Plast Surg ,1999 ,26:617.
[67] 朱庆棠,朱家恺,程钢. 人工神经的研究进展. 中国修复重建外科杂志,2000;14(6):369-371.
[68] Jenq CB. and Coggeshall R.E. Permeable tubes increase the length of the gap that regenerating axons can span. Brain Res. 1987, 408:239-242.
[69] Kim D.H., Connolly S.E., Zhao S., Beuerman R.W., Voorhies R.M. and Kline D.G. Comparison of macropore, semipermeable, and nonpermeable collagen conduits in nerve repair. J. Reconst. Microsurg. 1993, 9:415-420.
[70] Kline D.G. and Hayes G.J. The use of a resorbable wrapper for peripheral nerve repair. J. Neurosurg. 1964, 21:737-750.
[71] 戴传昌,商庆新,王炜,等. 用组织工程方法桥接周围神经缺损的实验研究.中华外科杂志,2000;38(5):388-390.
[72] Schugens CH, Maquet V, Gandfiles C, et al. Bioabsorbable and macroporous polylactide implants for cell transplantion:Preparation of macroporous polylactide supports by solid-liquid phase separation[J]. Polymer,1996,37(6):1027-1038.
[73] Rutkowski GE,Heath CA. Development of a bioartificial nerve graft.II. Nerve regeneration in vitro[J]. Biotech Prol, 2002, 18(2):373-379.
[74] Lundborg G, Dahlin L, Dohi D, Kanje M, Terada N. A new type of "bioartificial" nerve graft for bridging extended defects in nerves. J Hand Surg [Br]1997,2(3):299-303
[75] 蒋良福,劳杰. 周围神经组织工程研究. 中华创伤杂志,2003,19:254-256.
[76] Todd C.Holmes. Novel peptide- based biomaterial scaffolds for tissue engineering. TRENDS in Biotechnology,2002,20:16-21.
[77] Ve'ronique Maquet, Didier Martin. Peripheral nerve regeneration using bioresorbable macroporous polylactide scaffolds MAQUET ET AL,2000,3: 639-652.
[78] Andreas Gravvanis, Markos Karvelas. The use of silicone tubes in end- to-side nerve grafting: an experimental study. European Journal of Plastic Surgery,2003,26:111-115.
[79] Keeley R, Atagi T, Sabelman E, Padilla J, Kadlcik S, Keeley A, Nguyen K,Rosen J. Peripheral nerve regeneration across 14-mm gaps: a comparison of autograft and entubulation repair methods in the rat. J Reconstr Microsurg 1993,(5):349-58.
[80] Mackinnon SE, and Dellon AL. Clinical nerve reconstruction with a bioabsorbable polyglycolic acid tube. Plast Reconstr Surg.1990; 85(3): 419-424.
[81] Dunnen WF, Vander LB, Schakenrad JM, et al. Poly(DL-lactide- epsiloncaprolactone) nerve guides perform better than autologous nerve grsfts.Microsurgery, 1996;17(7):348.
[82] 沈华、沈尊理、张佩华、贾万新、王永春、张兆锋、黄一雄. 壳聚糖神经导管修复犬胫神经缺损的实验研究。中国美容医学,2006,15(6):635-637.
[83] 沈尊理、张菁、沈华、陈皓、张佩华、王文祖、陈南梁、黄一雄、张兆锋、贾万新、黄倩.脉冲等离子体涂层神经导管修复周围神经缺损实验研究.组织工程与重建外科杂志.2005,1(2):94-97.
[84] Fansa H, Keilhoff G, Wolf G, et al. Cultivating human Schwann cells for tissue engineering of peripheral nerves. Handchir Mikrochir Plast Chir. 2000,32:181-186.
[85] Keilhoff G, Fansa H, Smalla KH, et al. Neuroma: a donor- age independent source of human Schwann cells for tissue engineered nerve grafts. Neuroreport,2000,11:3805-3809.
[86] Dezawa M, Takahashi I, Esaki M, et al. Sciatic nerve regeneration in rats induced by transplantation of in vitro differentiated bone marrow stromal cells. Eur J Neurosci,2001,14:1771-1776.
[87] 侯赛云, 朱家恺. 大鼠骨髓基质干细胞体外诱导分化为类许旺细胞.中华显微外科杂志,2003,26:39-41.
[88] 苟三怀,侯春林,臧鸿声,等.几丁质室内植入雪旺氏细胞对神经再生影响的实验研究.中国修复重建外科杂志,1995;9(2):108-110.
[89] 王光林, 杨志明, 解慧琪, 等. 周围神经组织工程材料的预构. 中国修复重建外科杂志, 2000;14(2):110-114.
[90] Jenq CB. and Coggeshall R.E. Nerve regeneration through holey silicone tubes.Brain Res. 1985, 361:233-241.
[91] Levi AD, Guenard V, Aebischer P, Bunge RP.The functional characteristics of Schwann cells cultured from human peripheral nerve after transplantation into a gap within the rat sciatic nerve. J Neurosci. 1994; 14(3 ):1309-19.
[92] Levi AD, Sonntag VK, Dickman C, Mather J, Li RH, Cordoba SC, Bichard B,Berens M . The role of cultured Schwann cell grafts in the repair of gaps within the peripheral nervous system of primates. Exp Neurol. 1997; 143(1): 25-36.
[93] Mackinnon SE, Hudson AR, Bain JR, et al. An assessment of nerve regeneration in the immunosuppressed host. Plast Reconstr Surg 1987;79: 436-444.
[94] Keilhoff G, Fansa H, Schneider W, et al. In vivo predegeneration ofperipheral nerves: an effective technique to obtain activated Schwann cells for nerve conduits. JNeurosciMethods,1999,89:17-24.
[95] 劳杰,熊良俭,顾玉东, 等. 应用激活态的 SC 填充导管修复周围神经缺损的初步研究. 中华手外科杂志, 2000,16:236-240.
[96] Arai T, Lundborg G, Dahlin LB.Bioartificial nerve graft for bridging extended nerve defects in rat sciatic nerve based on resorbable guiding filaments.Scand J Plast Reconstr Surg Hand Surg 2000;34(2):101-8.
[97] Yoshii S, Oka M, Lkeda N, Akagi M, Matsusue Y, Nakamura T.Bridging a peripheral nerve defect using collagen filaments. J Hand Surg [Am] 2001 Jan;26A(1):52-59.
[98] Matsumoto K, Ohnishi K, Sekine T, Ueda H, Yamamoto Y, Kiyotani T, Nakamura T, Endo K, Shimizu Y.Use of a newly developed artificial nerve conduit to assist peripheral nerve regeneration across a long gap in dogs. ASAIO J 2000,46(4):415-20.
[99] Matsumoto K, Ohnishi K, Kiyotani T, Sekine T, Ueda H, Nakamura T, Endo K,Shimizu Y.Peripheral nerve regeneration across an 80-mm gap bridged by a polyglycolic acid (PGA)-collagen tube filled with laminin-coated collagen fibers: a histological and electrophysiological evaluation of regenerated nerves. Brain Res 2000,868(2):315-28.
[100] Suzuki Y, Tanihara M, Ohnishi K, Suzuki K, Endo K, Nishimura Y.Cat peripheral nerve regeneration across 50 mm gap repaired with a novel nerve guide composed of freeze-dried alginate gel. Neurosci Lett 1999;259(2): 75-8.
[101] Levi AD, Bunge RP.Studies of myelin formation after transplantation of human Schwann cells into the severe combined immunodeficient mouse.Exp-Neurol.1994,130(1): 41-52.
[102] 许绍芬.神经生物学(第二版).上海:上海医科大学出版社,1999.
[103] Chen Yueh Sheng, Hsieh Ching Liang, Tsai Chin Chuan, et al.Peripheral nerve regeneration using silicon rubber chamber filled with collagen, laminin and fibronection. Biomaterials,2000,21:1541-1547.
[104] 赵立国,姚康德. 神经导管修复周围神经损伤的研究进展.生物医学工程与临床,2003,7:120-123.
[105] simon P,Frostick, MA.Schwann cells, neurotrophic factors, and peripheral nerve regeneration.,Microsurgery,1998,18:397-405.
[106] Gregory RD Evans. Peripheral nerve injury:a review and Approach to tissue engineered constructs. The Anatomical Record,2001,63:396- 404.
[107] H.Fansa,Dodic. Tissue engineering of peripheral nerves: epineurial grafts with application of cultured Schwann cells. Microsurgery,2003,23:72-77.
[108] Keeley R,Atagi TY,Sabelman E,et al.peripheral nerve regenration across 14 mm gaps:a comparision of autograft and entubulation repair menthods in the rat.J Reconstr Micro,1993,9(1):5.
[109] 朱盛修.周围神经显微修复学.北京:北京科学出版社,1991:201.
[110] 吴梅英.周围神经缺损的自体神经移植.中华显微外科杂志,1991,14(1): 39.
[111] 姜永冲, 路来金,王玉发,等.带贵要静脉前臂内侧皮神经移植修复周围神经缺损.中华显微外科杂志,1995,18(1):55.
[112] 钟汉柱,周长满. 吻合血管移植腓浅神经修复缺损 25cm 的正中神经.临床应用解剖学杂志,1983,11(2): 21.
[113] 顾玉东,吴敏明. 静脉蒂动脉化游离腓肠神经移植.中华外科杂志,1985,23(4):128.
[114] George Bonny MS. Experience with vascularized nerve grafts. Clin Plas Surg, 1984,11(2):137.
[115] 孟庆刚,战华.同种异体周围神经移植进展.实用手外科杂志,1999,13(4):225.
[116] Gulati, A.K., and Cole, G.P. Immunogenicity and regenerative potential of acellular nerve allografts to repair peripheral nerve in rats and rabbits. Acta Neurochir. (Wien)126, 158, 1994.
[117] Zalewski, A.A., and Gulati, A.K. Evaluation of histocompatibility as a factor in the repair of nerve with a frozen nerve allograft. J. Neurosurg. 56, 550, 1982.
[118] Danielsen N , Kerns J M , Holmquist B , Zhao Q , Lundborg G , and Kanje M. Predegeneration enhances regeneration into acellular nerve grafts. Brain Res. 681, 105,1995.
[119] Osawa T , Tohyama K, and Ide C. Allogeneic nerve grafts in the rat, with special reference to the role of Schwann cell basal laminae in nerve regeneration. J. Neurocytol.19, 833, 1990.
[120] Pollard JD, and Fitzpatrick L. An ultrastructural comparison of peripheral nerve allografts and autografts. Acta Neuropathol. (Berl) 23, 152, 1973.
[121] Ide C, et al. Long acellular nerve transplants for allogeneic grafting and the effects of basic fibroblast growth factor on the growth of regenerating axons in dogs: A preliminary report. Exp. Neurol. 154, 99, 1998.
[122] Hall SM. Regeneration in cellular and acellular autografts in the peripheral nervous system. Neuropathol Appl. Neurobiol.12, 27, 1986.
[123] Krekoski CA, Neubauer D, Zuo J, and Muir D. Axonal regeneration into acellular nerve grafts is enhanced by degradation of chondroitin sulfate - 61 -proteoglycan. J Neurosci21, 6206, 2001.
[124] Johnson PC, Duhamel RC, Meezan E, and Brendel K. Preparation of cell-free extracellular matrix from human peripheral nerve. Muscle Nerve 5, 335, 1982.
[125] Sondell M, Lundborg G, and Kanje M. Regeneration of the rat sciatic nerve into allografts made acellular through chemical extraction. Brain Res. 795, 44, 1998.
[126] Hudson TW, Evans GR, and Schmidt CE .Engineering strategies for peripheral nerve repair. Orthop Clin.North Am,2000,31(3): 485-98.
[127] Hudson TW,Zawko S,Deister C,et al. Optimized acellular nerve graft is immunologically tolerated and supports regeneration.Tissue Engineering, 2004,10(11-12):1641-51.
[128] Mackinnon SE, Miclha R, Bain J. An assessment of regeneration across peripheral allografts in rats receiving short courses of cyclosporin a immunosuppression[J]. Neuroscience, 1992, 46(4): 585.
[129] Asselin AD, Pollard JD, Davey DF. Immunosupression in nerve allografting is it desirable[J]. Neurol Sen, 1992, 112(9): 160.
[130] Muramatsu K, Doi K, Kawai S. Nerve regenerating effect of short administration of cyciosporine affer frash peripheral nerve allotransplation in the rat: comparition of nerve regeration using different forms of donor nerve allografts[J]. Microsurg, 1995, 16(11): 496.
[131] 田立杰,战 杰,王淑华,等.胎儿神经移植修复感觉神经缺损.中国修复重建外科杂志.1998,12(3):138.
[132] 丁文龙,刘德明,王桂芳,等.刀豆球蛋白 A 处理异种移植神经对神经再生的影响.解剖学报,1995,26:265.
[133] 国生辉,金岩,张勇杰,王彦亮,沈楠,刘 鹏。化学萃取异种组织工程化神经支架的方法和组织学研究。牙体牙髓牙周病学杂志(Chin J Conserv Dent)2005,15(5):P255-258.
[134] 沈宁江, 朱家恺. 坐骨神经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.
[135] Bain J, Mackinnon S, and Hunter DA. Functional evaluation of complete sciatic, peroneal, and posterior tibial nerve lesions in the rat. Plast Reconstr Surg, 1989,83(1): 129-38.
[136] Dument CE,Hentz VR.Enhancement of axon growth by detergentextracted peripheral nerve grafts[J].Transplantation.1997,63(8):1210-215.
[137] 佟晓杰。刘承吉,张彩顺。等.脱细胞同种异体神经移植物修复大鼠坐骨神经缺损的实验研究[J].解剖学报,2004。35(3):23O-33.
[138] Wang GY. Hirai KI,Shimada H.The role of laminin,a component of Schwann cell basal lamina 。 in rat sciatic nerve regeneration with antiserum-treated nerve.Brain Res,1992,570(suppl1):116-25.
[139] Tong XJ,Hirai K,Shimada H,et a1.Sciatic nerve regeneration navigated by laminin-fibronectin double coated biodegradable collagen grits in rats[J].Brain Res。1994,663(1):155-62.
[140] Bunge MB,Bunge RP,Kleitman N,et a1.Role of peripheral nerve extracellular matrix in Schwann cell function and in neurite regeneration[J].Dev Neuresci,1989,11(4-5):348-60
[141] Meek MF,Dijkstra JR,Den Dunnen WF,et a1.Functional assessment of sciatic nerve reconstruction : biodegradable poly(DLLA—epsilon— CL)nerve guides versus autologous nerve grafts.Microsurgery,1999,19(8):381-388.
[142] Zhu SHX.The Microprosthetics of Peripheral Nerves[M].Beijing:Science Press,1991:90-105.朱盛修.周围神经显微修复学[M].北京:科学出版社,1991:90-105.
[143] 李跃军, 陈绍宗, 李学拥等. 猴指神经皮下植入后中远期再生效果的电生理研究.中华显微外科杂志, 1999; 22(1): 43-44.