| Objective:It is investigated feasibility of using human biological amnion and peptide hydrogel to bridging a 10mm sciatic nerve gap.Methods:We divided randomly30 healthy SD white rats into three groups (each group,10). A 10mm defect of the right sciatic nerve were made and repaired randomly by different means.The repair site of the experimental A group were bridged by human amnion supplemented by peptide hydrogel, and the experimental B group were bridged by a piece of human amniotic membrane. The experimental C group was treated with standard epineurial suturation.The general observation of every group was made in 2,5,8 and 16 weeks postoperatively. And compared the conduction of velocity of the distal nerve and compound action potential of nerve-muscle, and histologic assessment of regeneration of sciatic nerves gap of 6 rats sacrificing of each group was made after surgery 4,8,12and16 weeks. The functional assessments of terminal organ connection and electrophysiology, SFI, the examination of the right gastrocnemius muscles wet weight were undertaken at 9 weeks postoperatively. It was observed and compared the results with a optical microscope and a transmission electron microscope among three groups 12 and 16 weeks postoperatively. All data were analyzed with the spss13.0 software.Results:1. General observationAfter surgery, each experiment extremity were paralysis immediately, and showed of symptom including ankle drooping, toes drooping and closing to each other and unable standing steady.Each suffered distension in two weeks postoperatively. In the A and C group, the time of swelling and distension regression and lameness was shorter than the B group. the cutaneous ulcer of the operative heel weight-bearing region recovered sooner than the B group, but the difference was not observed between the A and C group.2. Sciatic nerve function index (SFI)The numbers of SFI indicate that recovery of sciatic nerve function in B group is inferior to in A and C group (P< 0.05). And it is statistical significance, but not between A and C group.3. The detection of the right gastrocnemius muscles wet weightThe results of detection indicate that A and C group are better than B group (P< 0.05), and it is obviously statistical significance, but not between A and C group.4. Nerve electrophysiologyThe detection of conduction velocity of sciatic nerve stem and amplitude of evoked nerve-muscle potential:B group is lower than A and C group (P< 0.05):It is statistical significance. And it is not obviously difference between A and C group.5. Histological observationGeneral observation:The bridge grafting segment in the A and B group is not conglutination with surrounding soft issue, and its shape is similar to nervous issue. And the nerve is relaxation and the nerve's activity is acceptable. The grafting segment was completely absorbed after 8 weeks in the A and B group, but it was observed a little collapsing the bridged segment in B group. In the repaired cite of the C group, it was found conglutination and cicatrix after surgery, the nerve stem was jittery and the nerve's activity was unhealthy.Light microscope:in the bridge grafting segment of in A and B group and the repair cite of three groups, the regeneration nerve fibers and axons can be found. There are more amount and quality regeneration nerve fibers and axons in A and C group than B group. In the C group, there are more inflammatory cells and less desmocyte surrounding nerve fibers.Electron microscope:in the A and C group the regeneration nerve fibers and axons and Schwann cells are abundant compared to B group. But there are more amount collagen fibers and macrophages in the C group Conclusion:The application of human amnion supplemented by peptide hydrogel for peripheral nerve deficit can facilitate the regeneration of nervous tissue and functional rehabilitation. And it is alternative as autoallergic nerve grafts... |
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