臂丛根性损伤C5、6残根功能评估及利用的临床与基础研究

The C5, 6 nerve root is usually spared from avulsion after brachial plexus injury, which can be used as a donor nerve for nerve grafting. However, in our clinical work, we found that about 30-50% of the patients with brachial plexus injury got a poor functional recovery after nerve grafting surgery. The most important reason for this condition is lack of understanding of the nerve stump, which further leading to improper treatment. In order to solve this problem, combined with traditional methods which including MR imaging and EMG, we are going to use MEPs, histochemistry and Enzyme activity measurement to evaluate the functional status of the nerve stimps and establish the relationship between results of these evaluation methods and postoperative functional recovery; and then we use miRNAs microarray to study the function of C5, 6 nerve stump with different functional status on the level of molecules, to make clear the molecular mechanism through which the key gene regulating the functional condition of the C5, 6 nerve stumps and its corresponding spinal cord motoneuron; On this basis, through establishing total or upper brachial plexus injury with C5, 6 nerve stumps animal model, we intend to study the methods to improve the utility value of the C5, 6 nerve stumps. The aim of this project is to provide a ccurate, simple, rapid and economic evaluation method to evaluate C5, 6 nerve stump function, and to provide sufficient, comprehensive, objective experimental basis and foundation theory for the treatment of human brachial plexus injury with C5, 6 nerve root ruptured.

臂丛损伤中C5、6神经根常表现为椎管外断裂，留有残根，可作为供体用于神经移植。本课题组在前期研究中发现30-50%的患者接受残根移植术后功能恢复差，其原因主要是缺乏对残根功能的准确评估及认识。针对这一难题，本课题拟通过对臂丛损伤患者C5、6残根行影像学、电生理、组织学、酶活性等检测全面评估残根功能，研究评估结果与功能恢复之间的联系，建立全面、准确的C5、6残根功能评价系统；通过miRNAs芯片筛选不同功能状态C5、6残根差异表达的miRNAs，研究差异表达miRNAs靶向关键基因调控C5、6残根及其对应脊髓运动神经元功能变化的分子机制；在此基础上，通过利用超声纳米泡介导关键基因转染技术，研究促进神经元再生轴突进而提高C5、6残根利用价值的方法，并在臂丛损伤合并C5、6根断裂及修复动物模型上进行验证；本课题的开展旨建立全面、系统的残根功能评估系统，并为提高臂丛损伤残根修复疗效提供实验依据。

臂丛损伤中C5，6神经根常表现为椎管外断裂，留有残根，可作为供体用于神经移植。本课题组在前期研究中发现30-50%的患者接受残根移植术后功能恢复差，其原因主要是缺乏对残根功能的准确评估及认识。针对这一难题，本课题通过对臂丛损伤患者C5，6残根行影像学 、电生理、组织学、酶活性等检测全面评估残根功能，研究评估结果与功能恢复之间的联系，建立了全面、准确的C5，6残根功能评价系统；通过模拟临床受伤机制，成功建立一个新的大鼠臂丛根性损伤后保留C5，6残根的动物模型，并证明C5，6残根及其相应脊髓的组织学结果表明C5，6残根的功能状态随神经损伤时间的增加而降低，且与受损运动神经元的存活相关。在此基础上，通过温敏性水凝胶在残根局部缓释神经保护药物促进神经元再生轴突进而提高C5、6残根利用价值。本课题通过建立全面、系统的残根功能评估系统，为提高臂丛损伤残根修复疗效提供实验依据。