Experimental And Clinical Study Of Nerve Growth Factor Gradient Release System On Treatment Of Peripheral Nerve Injuries

Objective:To prepare nerve groowth factor gradient release system, and explore the promotion of the morpholgic effects and electrophysiological function of peripheral nerve regeneration.Methods:Sixty-four Sprague-Dawley healthy rats with10mm gap of sciatic nerve, were randomly divided into two groups which had been bridged with single-channel medical silicone tube. The NGF was partial inject to Gelatin sponge surrounding peripheral nerve in group A, the same amount of NGF was used to partial release by using the homemade gradient release system in group B. At8,12and16week after operation, we evaluated the morphology of regenerative nerve by Homes silver staining and hematoxylin-eosin staining, the number of myelinated fibre, the myelin sheath of regenerative nerve, the myelinated fiber diameter and myelin thickness were counted by transmission electron microscope. The electrophysiologic effects were evaluated by detect compound muscle active potential(CMAP) or cortical somatosensory evoked potential(CSEP) and nerve conduction velocity(NCV) at12and16weeks after operation. Meanwhile we conducted the clinical research of nerve growth factor gradient release system on treatment of peripheral nerve transection and neurolysis, and observed the cinical function.Results:The number of motor and sensitive fibres of regenerative nerve in group B was much more than the number in group A after8and16week (P<0.05). The myelin sheath of regenerative nerve, the myelinated fiber diameter and myelin thickness in group B was much more than those in group A, there were significant difference between them (P<0.05). Compared with the group A after12and16week, the peak latency of the CSEP, CMAP was shortened significantly and the Volatility was increased significantly in group B, the NCV was faster significantly in group B (P<0.05). Meanwhile compared with control group in the clinical research, the peak latency of the SEP, MAP was shortened significantly and the Volatility was increased significantly in group B, the NCV was faster significantly in the group using homemade gradient release system (P<0.05). The good rate in BMRC sensory and motor function score were higher than control group, there were significant difference between the (P<0.05).ConclusionGradient release of nerve growth factor can significantly improve the regeneration of peripheral nerve fiber morphology, promote the recovery of electrophysiological and clinical function.