| Part one Discussion of the surgical method of spastic brain injury model induced by internal capsule injection of ethanol in adult SD ratObjective:To discuss the surgical method of spastic brain injury model in adult SD rat by internal capsule injection of ethanol and brain stereotaxic technique.Methods:One hundred and forty adult male SD rats were randomly divided into N0 group（n=35）,N1 group（n=35）,N2 group（n=35）and N3group（n=35）.By the brain stereotaxic technique,no reagent was injected into the right internal capsule target in N0 group,70μl ethanol was injected into the right internal capsule target in N1 group,80μl ethanol was injected into the right internal capsule target in N2 group,while 15μl ethanol was injected into the right pyramidal tract target in N3 group.After surgeries,the general conditions of the four groups of rats were observed,including diet,defecation,weight,mental state.The onset time,duration of symptoms and the mortality were recorded.Results:The typical spastic symptoms of contralateral limbs appeared on the 1st day after surgeries in N1,N2and N3group,and lasted at least for21 days.Two rats died in N0 group,5 rats died in N1 group,5 rats died in N2group,while 17 rats died in N3 group.The postoperative mortality in N0,N1and N2 group was significantly lower than that in N3 group respectively（P<0.05）.There was no significant difference in postoperative mortality between N0 group and N1 group,N0 group and N2 group,N1 group and N2 group（P>0.05）.Conclusion:The model of spastic brain injury in adult SD rat induced by 70μl and 80μl ethanol internal capsule injection combined with brain stereotactic technique is simple to establish,the symptom is typical,can last at least 21 days,the dose is safe,and the mortality rate is low.Part two Behavioral evaluation of the spastic brain injury model induced by internal capsule injection of ethanol in adult SD ratObjective:To evaluate the behavioristics of spastic brain injury model induced by internal capsule injection of ethanol in adult SD rat by brain stereotaxic technique.The grouping was the same as the first part.Methods:The NSS,Faden score and modified Ashworth score of the four groups were observed and recorded at 1,3,7,14 and 21 days after surgeries.Results:There was no significant difference in NSS between N1 group and N2 group,N1 group and N3 group,N2 group and N3 group after surgeries（P>0.05）.While there was significant difference in NSS between N0 group and N1 group,N0 group and N2 group,N0 group and N3 group after surgeries,and the scores of the latter were significantly higher than those of the former（P<0.05）.There was no significant difference in Faden score between N2 group and N3 group（P>0.05）,while there was significant difference in Faden score between N0 group and N1 group,N0 group and N2 group,N0 group and N3group,N1 group and N2 group,N1 group and N3 group after surgeries,and the scores of the latter were significantly lower than those of the former（P<0.05）.There was no significant difference in modified Ashworth score between N2group and N3 group（P>0.05）,while there was significant difference in modified Ashworth score between N0 group and N1 group,N0 group and N2group,N0 group and N3 group,N1 group and N2 group,N1 group and N3 group after surgeries,and the scores of the latter group were significantly higher than those of the former（P<0.05）.Conclusion:The NSS,Faden score and modified Ashworth score can effectively evaluate the model of spastic brain injury in adult SD rat induced by internal capsule injection of ethanol combined with brain stereotactic technique,the symptom is typical,and the symptom worsen with the increase of dose.Part three Morphological study on brain tissue of the spastic brain injury model induced by internal capsule injection of ethanol in adult SD ratObjective:To study the morphological changes of brain tissue in adult SD rats with spastic brain injury induced by injection of ethanol into internal capsule by stereotaxic technique.Methods:The grouping was the same as the first part.The brain tissues of the four groups were stained with HE on the 21st day after surgeries.Results:There was no obvious injury in the right internal capsule in N0group.It was found that there was cavity-like necrosis,nerve cells significantly decreased in right internal capsule and no injury in other brain regions in N1 group.In N2 group,the cavity-like necrosis in right internal capsule was larger than that in N1 group,while it was not involved in other brain regions.In N3 group,It was found that there was cavity-like necrosis,nerve cells significantly decreased in right pyramidal tract and no injury in other brain regions.Conclusion:The internal capsule is located accurately in the model of spastic brain injury in adult SD rat induced by ethanol injection combined with brain stereotactic technique.The HE staining of brain tissue showed the destruction of internal capsule,and the injury area increased with the injection dose increasing,which was consistent with the clinical symptom of rat.Part four Muscle histological study of the spastic brain injury model induced by internal capsule injection of ethanol in adult SD ratObjective:To study the muscle histological changes of adult SD rats with spastic brain injury induced by internal capsule injection of ethanol.Methods:The grouping was the same as the first part.On the 21st day after surgeries,the muscle fiber types of the contralateral limbs of rats in four groups were determined by immunofluorescence.Results:There was no significant difference in the percentage of type I muscle fiber in total flexor muscle of contralateral upper limb/gastrocnemius of contralateral lower limb between N2 group and N3 group（P>0.05）.After surgeries,there was significant difference in the percentage of typeⅠmuscle fibers in total flexor muscle of contralateral upper limb/gastrocnemius of contralateral lower limb between N0 group and N1 group,N0 group and N2group,N0 group and N3 group,N1 group and N2 group,N1 group and N3group respectively（P<0.05）,and the latter were significantly higher than those of the former.With the increase of ethanol injection dose,the percentage of type I muscle fiber in total flexor muscle of contralateral upper limb/gastrocnemius of contralateral lower limb gradually increased 21 days after surgeries.Conclusion:The percentage of type I muscle fiber in total flexor muscle of contralateral upper limb/gastrocnemius of lcontralateral lower limb can effectively evaluate the model of spastic brain injury in adult SD rat induced by internal capsule injection of ethanol combined with brain stereotactic technique.With the increase of ethanol injection dose,the degree of spasticity increased,and the percentage of type I muscle fiber in total flexor muscle of contralateral upper limb/gastrocnemius of lcontralateral lower limb gradually increased 21 days after surgeries.Part five Clinical study of contralateral C7 nerve transfer in the treatment of hand deformities caused by spastic brain injuryObjective:To investigate the efficacy of contralateral C7 nerve transfer in the treatment of hand deformities caused by spastic brain injury.Methods:The contralateral C7 nerve transfer was used to treat 8patients with hand deformity caused by spastic brain injury.The patients were followed up after surgeries.The movement and sensation of the affected limb and contralateral limb were recorded.The recovery of limb spasticity was evaluated by modified Ashworth score.Results:At the last follow-up,there was no obvious abnormality in the movement and sensation of the contralateral limb,and the modified Ashworth score of the affected hand was significantly lower than that before surgery（P<0.05）.Conclusion:The contralateral C7 nerve transfer surgery can effectively relieve the hand spasticity caused by spastic brain injury. |
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