本文選題：神經(jīng)移位 + 生殖股神經(jīng)生殖支��； 參考：《華中科技大學(xué)》2014年博士論文

【摘要】：目的：探討生殖股神經(jīng)生殖支移位海綿體神經(jīng)后,再生神經(jīng)形態(tài)學(xué)特點(diǎn)及新建立的勃起反射傳出通路的構(gòu)成。 方法：將30只成年雄性Sprague-Dawley大鼠(約250-300g)隨機(jī)分為三組,每組10只,假手術(shù)組：僅顯露雙側(cè)生殖股神經(jīng)及海綿體神經(jīng),不做離斷。損傷組：離斷雙側(cè)生殖股神經(jīng)生殖支及海綿體神經(jīng),斷端以絲線結(jié)扎防止再生。神經(jīng)移位組：離斷雙側(cè)生殖股神經(jīng)生殖支及海綿體神經(jīng)后,雙側(cè)生殖股神經(jīng)生殖支近端與海綿體神經(jīng)遠(yuǎn)端行端端吻合。術(shù)后12周,將熒光金溶液(Fluorogold,FG)分別注入各組大鼠右側(cè)陰莖腳內(nèi)行神經(jīng)逆行示蹤研究；再通過各組大鼠遠(yuǎn)端海綿體神經(jīng)半薄切片有髓神經(jīng)纖維計(jì)數(shù)及電鏡觀察來評(píng)估神經(jīng)再生情況,其中神經(jīng)移位組大鼠吻合口段神經(jīng)進(jìn)一步行縱切面HE染色,以了解吻合口段神經(jīng)的連續(xù)性。 結(jié)果：逆行神經(jīng)示蹤發(fā)現(xiàn)：損傷組和神經(jīng)移位組大鼠盆神經(jīng)節(jié)內(nèi)僅見極少量的FG陽(yáng)性神經(jīng)元,其平均數(shù)量分別為6.3±3.4和5.4±2.9,遠(yuǎn)少于假手術(shù)大鼠(106.7±15.9)；在各節(jié)段的脊髓切片中,假手術(shù)組和損傷組大鼠均未發(fā)現(xiàn)有FG陽(yáng)性神經(jīng)元存在,而神經(jīng)移位組大鼠脊髓L1,L2前角內(nèi)可見有FG陽(yáng)性神經(jīng)元,其平均數(shù)量分別為2.7±1.0,5.3±1.2。神經(jīng)橫斷面半薄切片甲苯胺藍(lán)染色顯示：假手術(shù)組的海綿體神經(jīng)和神經(jīng)移位組的再生神經(jīng)內(nèi)均可見豐富藍(lán)染的有髓神經(jīng)纖維,其數(shù)量分別為346.8±17.66和621.87±81.25,明顯高于損傷組遠(yuǎn)端海綿體神經(jīng)內(nèi)有髓神經(jīng)纖維的數(shù)量(16.68±6.08)(P0.05)；超微電鏡進(jìn)一步觀察到假手術(shù)組和神經(jīng)移位組有大量有髓和無髓神經(jīng)纖維存在,幾乎未見變性壞死的髓鞘；而損傷組可見髓鞘廣泛變性,膠原纖維大量增生。神經(jīng)移位組大鼠吻合口段神經(jīng)HE染色見生殖股神經(jīng)生殖支可以通過吻合口長(zhǎng)入海綿體神經(jīng)。 結(jié)論：生殖股神經(jīng)生殖支移位海綿體神經(jīng)后,生殖股神經(jīng)生殖支可以再生長(zhǎng)入陰莖海綿體,并建立新的勃起反射傳出神經(jīng)通路(脊髓L1,L2前角運(yùn)動(dòng)神經(jīng)元—生殖股神經(jīng)生殖支—再生神經(jīng)—陰莖海綿體)。 目的：運(yùn)用神經(jīng)電生理學(xué)和行為學(xué)方法,評(píng)估大鼠生殖股神經(jīng)生殖支移位海綿體神經(jīng)后陰莖勃起功能的恢復(fù)情況。 方法：將30只成年雄性Sprague-Dawley大鼠(約250-300g)隨機(jī)分為三組,每組10只：假手術(shù)組,僅顯露雙側(cè)生殖股神經(jīng)及海綿體神經(jīng),不做離斷。損傷組：離斷雙側(cè)生殖股神經(jīng)生殖支及海綿體神經(jīng),斷端以絲線結(jié)扎防止再生。神經(jīng)移位組：離斷雙側(cè)生殖股神經(jīng)生殖支及海綿體神經(jīng)后,雙側(cè)生殖股神經(jīng)生殖支近端與海綿體神經(jīng)遠(yuǎn)端行端端吻合。所有大鼠分別于術(shù)后4、8、12周行交配試驗(yàn),觀察并記錄大鼠的交配行為。術(shù)后12周,各組大鼠在熒光金注射一周后分別行海綿體內(nèi)壓測(cè)定,電刺激相應(yīng)神經(jīng)時(shí),監(jiān)測(cè)并記錄每只大鼠陰莖海綿體內(nèi)壓變化及動(dòng)脈血壓。 結(jié)果：術(shù)后12周,假手術(shù)組和神經(jīng)移位組分別可觀察到8只和7只大鼠有“插入”性行為；而損傷組中僅1只大鼠有“插入”性行為,明顯低于假手術(shù)組和神經(jīng)移位組(P0.05)。電刺激神經(jīng)移位組大鼠生殖股神經(jīng)生殖支(供體神經(jīng)),可見海綿體壓顯著升高,海綿體內(nèi)壓升高均值(AICP)為32.81±10.8mmHg,可達(dá)假手術(shù)組大鼠(62.11±7.67mmHg)的53%；而電刺激損傷組大鼠離斷的海綿體神經(jīng)近端,幾乎未見海綿體內(nèi)壓升高,測(cè)得AICP為5.41±2.02mmHg,明顯低于神經(jīng)移位組和假手術(shù)組(P0.05)。假手術(shù)組、損傷組和神經(jīng)移位組大鼠海綿體壓升高的均值與平均動(dòng)脈血壓比值(△ICP/MAP)分別為：0.63±0.08,0.05±0.02和0.32±0.10,其中神經(jīng)移位組和假手術(shù)組測(cè)得的比值顯著高于損傷組(P0.05)。 結(jié)論：生殖股神經(jīng)生殖支移位海綿體神經(jīng)后,部分大鼠可恢復(fù)自主交配行為,電刺激大鼠生殖股神經(jīng)生殖支可引起海綿體內(nèi)壓顯著升高,表明神經(jīng)移位可部分修復(fù)大鼠的勃起功能。 目的：探討生殖股神經(jīng)生殖支移位海綿體神經(jīng)后陰莖海綿體NOS的表達(dá)以及組織形態(tài)學(xué)的改變。 方法：將30只成年雄性Sprague-Dawley大鼠(約250-300g)隨機(jī)分為三組,每組10只：假手術(shù)組,僅顯露雙側(cè)生殖股神經(jīng)及海綿體神經(jīng),不做離斷。損傷組：離斷雙側(cè)生殖股神經(jīng)生殖支及海綿體神經(jīng),斷端以絲線結(jié)扎防止再生。神經(jīng)移位組：離斷雙側(cè)生殖股神經(jīng)生殖支及海綿體神經(jīng)后,雙側(cè)生殖股神經(jīng)生殖支近端與海綿體神經(jīng)遠(yuǎn)端行端端吻合。術(shù)后12周,行功能學(xué)評(píng)估后,分別截取三組大鼠的陰莖海綿體組織,并分為兩段,其中一段采用NADPH染色,于光學(xué)顯微鏡下觀察并計(jì)數(shù)大鼠每側(cè)陰莖背神經(jīng)中藍(lán)染的NOS陽(yáng)性神經(jīng)纖維。另一段則用于Masson染色以了解各組大鼠陰莖海綿體組織形態(tài)學(xué)的改變。 結(jié)果：術(shù)后12周,神經(jīng)移位組大鼠每側(cè)陰莖背神經(jīng)中均可見大量NOS陽(yáng)性神經(jīng)纖維,平均數(shù)量為58.67±13.3,明顯高于損傷組(15.53±7.0)(P0.05),但低于假手術(shù)組(128.02±18.1)(P0.05)。陰莖海綿體Masson染色可見紅染的為平滑肌細(xì)胞,藍(lán)染的為膠原成分；三組大鼠陰莖海綿體切片內(nèi)平滑肌和膠原的面積比分別為0.106±0.015,0.048±0.008和0.086±0.013,其中假手術(shù)組和神經(jīng)移位組的比值顯著高于損傷組(P0.05)。 結(jié)論：生殖股神經(jīng)生殖支移位海綿體神經(jīng)后,大量NOS陽(yáng)性的再生神經(jīng)纖維重支配陰莖海綿體,可以明顯減輕海綿體組織的纖維化。
[Abstract]:Objective: To investigate the morphological characteristics of the regenerated nerve after the transposition of the generative branch of the genital nerve to the cavernous nerve and the formation of the new erection reflex passage.
Methods: 30 adult male Sprague-Dawley rats (about 250-300g) were randomly divided into three groups, 10 in each group. The sham operation group was only exposed to the bilateral reproductive and cavernous nerve, and did not break off. The injured group was separated from the bilateral reproductive and cavernous nerves, and the broken ends were ligated with silk thread to prevent regeneration. After the lateral reproductive branch of the femoral nerve and the cavernous nerve, the proximal end of the bilateral reproductive branch of the reproductive nerve anastomosed with the distal end of the cavernous nerve. 12 weeks after the operation, the fluorescent gold solution (Fluorogold, FG) was injected into the right penis foot of the rats in each group, and the distal cavernous nerve was sectioning in each group. The nerve regeneration was evaluated by the myelinated nerve fiber count and electron microscopy, in which the anastomotic segment of the nerve in the nerve translocation group was further stained with the longitudinal section of the nerve to understand the continuity of the anastomotic segment of the nerve.
Results: the retrograde nerve tracer found that only a few FG positive neurons in the pelvic ganglion of the injured group and the nerve transfer group were only 6.3 + 3.4 and 5.4 + 2.9, respectively, far less than the sham operation rats (106.7 + 15.9), and the FG positive neurons were not found in the sham operation group and the injured group in the sections of the spinal cord. There were L1 and FG positive neurons in the spinal cord of the nerve translocation group, and the average number of FG positive neurons in the anterior horn of L2 was 2.7 + 1.0,5.3 + 1.2. nerve transect semi thin section of toluidine blue staining: the regenerated nerve of the cavernous nerve and the nerve transfer group of the sham operation group were all rich in blue stained myelinated nerve fibers. The number of myelinated nerve fibers in the distal cavernous nerve was significantly higher than that of 346.8 + 17.66 and 621.87 + 81.25 (16.68 + 6.08) (P0.05). Ultrastructural electron microscopy further observed that there were a large number of myelinated and unmyelinated nerve fibers in the sham operation group and the nerve translocation group, and almost no myelin sheath was found in the degeneration and necrosis, but the myelin sheath was widely changed in the injured group. In the nerve translocation group, the HE staining of the anastomotic segment of the rat showed that the genital branch of the genital nerve could grow into the cavernous nerve through the anastomotic stoma.
Conclusion: the reproductive branch of the reproductive femoral nerve translocation the cavernous nerve, the reproductive branch of the reproductive femoral nerve can grow into the corpus cavernosum, and establish a new erectile reflex efferent nerve pathway (spinal cord L1, L2 anterior horn motoneuron - reproductive nerve reproductive branch - regenerative nerve to penis corpus cavernous body).
Objective: To evaluate the recovery of erectile function after transposition of the genital nerve of reproductive system in rats.
Methods: 30 adult male Sprague-Dawley rats (about 250-300g) were randomly divided into three groups, 10 rats in each group: sham operation group, only bilateral reproductive femoral nerve and cavernous nerve were exposed. The injured group was separated from bilateral reproductive and cavernous nerve, and the broken ends were ligated with silk thread to prevent regeneration. The reproductive branches of the lateral reproductive and the cavernous nerve were anastomosed to the end end of the bilateral reproductive branch of the reproductive branch and the distal cavernous nerve. All rats were tested and recorded the mating behavior at 4,8,12 weeks after the operation. 12 weeks after the operation, the rats in each group were measured by the pressure of the sponge in the body after a week of injection of fluorescent gold. During the stimulation of the corresponding nerve, the pressure changes and arterial blood pressure in the corpus cavernosum of each rat were monitored and recorded.
Results: 12 weeks after operation, 8 and 7 rats in the sham operation group and the nerve transfer group were observed to have "insertion" behavior, while only 1 rats in the injured group had "insertion" behavior, obviously lower than the sham operation group and the nerve translocation group (P0.05). The mean pressure of body pressure increased significantly (AICP) was 32.81 + 10.8mmHg, which could reach 53% of the sham operation group (62.11 + 7.67mmHg), while the electrical stimulation injury group had almost no elevation of the cavernous nerve in the broken cavernous nerve, and the AICP was 5.41 + 2.02mmHg, obviously lower than that of the nerve translocation group and the sham operation group (P0.05). The mean and mean arterial pressure ratio (delta ICP/MAP) was 0.63 + 0.08,0.05 + 0.02 and 0.32 + 0.10 in the injury group and the nerve translocation group, respectively. The ratio between the nerve shift group and the sham operation group was significantly higher than that of the injury group (P0.05).
Conclusion: after the reproduction of the reproductive branch of the reproductive femoral nerve translocation the cavernous nerve, some rats can recover the spontaneous mating behavior. The reproductive branch of the reproductive femoral nerve can cause a significant increase in the internal pressure of the cavernous body, indicating that the nerve transfer can partially repair the erectile function of the rat.
Objective: To investigate the expression and histomorphology of NOS in corpus cavernosum after transferring the genital nerve to the cavernous nerve.
Methods: 30 adult male Sprague-Dawley rats (about 250-300g) were randomly divided into three groups, 10 rats in each group: sham operation group, only bilateral reproductive femoral nerve and cavernous nerve were exposed. The injured group was separated from bilateral reproductive and cavernous nerve, and the broken ends were ligated with silk thread to prevent regeneration. After 12 weeks of functional evaluation, the penis corpus cavernosum tissue of three groups of rats were divided and divided into two segments after 12 weeks of functional evaluation, and one of them was stained with the optical microscope and counted each rat under the optical microscope. The NOS positive nerve fibers in the dorsal penile nerve of the lateral penis were used. The other section was used for Masson staining to understand the histomorphological changes of corpus cavernosum in each group.
Results: 12 weeks after the operation, a large number of NOS positive nerve fibers in the dorsal nerve of the penis were found in the nerve translocation group, the average number was 58.67 + 13.3, which was significantly higher than that in the injury group (15.53 + 7) (P0.05), but lower than the sham operation group (128.02 + 18.1) (P0.05). The Masson staining of the penis corpus cavernosum showed that the red dye was the smooth muscle cells and the blue dye was collagen. The area ratio of smooth muscle and collagen in the cavernosum section of three groups of rats was 0.106 + 0.015,0.048 + 0.008 and 0.086 + 0.013 respectively, and the ratio of the sham operation group and the nerve translocation group was significantly higher than that of the injury group (P0.05).
Conclusion: a large number of NOS positive regenerative nerve fibers redominate the corpus cavernosum of the cavernous nerve after the reproduction of the reproductive branch of the reproductive femoral nerve, which can obviously reduce the fibrosis of the cavernous tissue.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R699.8

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本文編號(hào)：1981016