| Anterior cruciate ligament(ACL)is one of the critical structures in maintaining the stability of the knee.ACL injury will lead to proprioception disturbance of ACL,resulting in the instability of the knee.Clinically,it is found that even though the injured ACL is histologically reconstructed,and its physical stability has been fundamentally improved,many patients still suffer from the instability of the knee joint.Meanwhile,if the unilateral ACL is injured,the proprioception of bilateral knees will also be affected.Therefore,people start to pay attention to the effect of ACL's proprioception function for the maintenance of joint stability,and studies on how to recover the proprioception of injured ACL effectively have become research hotspots.The First Chapter Establishment of ACL Injury Model on Cynomolgus MonkeysThe cynomolgus monkeys' 1/4 ACL were cut off under the arthroscope,and magnetic resonance imaging(MRI)examination was performed preoperative and 2 weeks after the operation,respectively.The operative side's thigh and calf circumference,joint flexion and extension degree,Anterior Drawer test,Lachman test and Pivot-shift test were also measured to get a comprehensive evaluation of the model.Ultimately,we have established a new animal model of ACL injury and an effective method of modeling surgery.The Second Chapter The Change of ACL's and Hamstring Muscle's Proprioceptor in Cynomolgus Monkeys ACL Unilateral Knee Injury ModelThe cynomolgus monkeys were divided into three groups:the normal group(3 normal knee joints),the model A group(3 healthy side knee joints of the models)and the model B group(3 injured side knee joints of the models).The ACL and hamstring muscle were isolated respectively,then the hematoxylin-eosin(HE)and gold chloride staining were performed.Results:The injury of the affected side of ACL could cause the reduction in the number of the ipsilateral proprioceptor,or even the morphological variation.Through the reflection effect of the ACL-hamstring reflex arc,proprioceptor in the ipsilateral hamstring muscle also had corresponding changes,but in a short period of time,the contralateral proprioceptor's morphology and quantity were not affected.The Third Chapter The Effect of NT-3/TrkC Signaling Pathway in ACL Proprioception InjuryThe cynomolgus monkeys were divided into three groups:the normal group(select 1 normal knee joint from each of the 3 normal cynomolgus monkeys,3 total),the model A group(9 healthy side knee joints of the models)and the model B group(9 injured side knee joints of the models).The model A group and model B group belonged to the model group.At 4,8 and 12 weeks after modeling,nerve electrophysiology[somatosensory evoked potentials(SEPs)and motor nerve conduction velocity(MCV)]were detected firstly,and then,stained with gold chloride.Finally,the expression level of neurotrophin-3(NT-3),tyrosine protein kinase C(TrkC)of the second lumbar(L2)-the first sacrum(S1)dorsal root ganglion(DRG)and growth associated protein-43(GAP-43)gene,protein of the ACL in the 3 groups was detected.Results:Unilateral ACL injury could affect the proprioception of bilateral knee joints,which became more serious with the increase of time.In addition,when ACL was injured,the expression of local GAP-43 increased and the expression of NT-3,TrkC in DRG decreased.The Fourth Chapter The Effect Mechanism of Electroacupuncture Reverse Intervention on ACL-hamstring Reflex Arc to Activate Proprioception's NT-3/TrkC Signaling PathwayThe cynomolgus monkeys were divided into four groups:the normal group(3 normal cynomolgus monkeys),the blank model group(9 unilateral ACL injury models),the electroacupuncture A group(9 cynomolgus monkeys with injury sides electroacupuncture)and the electroacupuncture B group(9 cynomolgus monkeys with bilateral sides electroacupuncture).At 4,8 and 12 weeks after intervention,the electrophysiology(SEPs and MCV)was detected in the blank model group,the electroacupuncture A group and the electroacupuncture B group.Meanwhile,the expression level of NT-3,TrkC of the L2-S1 DRG and GAP-43 gene,protein of the ACL was detected.Results:Electroacupuncture could activate proprioception's NT-3/TrkC signaling pathway by reversing intervention on ACL-hamstring reflex arc,leading to the expression of NT-3 and TrkC in the DRG and local GAP-43 increased.What's more,the mode of bilateral knees intervention was better than that of unilateral knee intervention. |
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