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背景:研究表明:应用化学消化剂处理同种异体神经可以有效地清除细胞、髓鞘而不出现宿主免疫排斥反应,但目前这种方法仅在小动物及低等哺乳类实验中取得成功,离临床应用尚有差距。目的:清除人类周围神经中的细胞和髓鞘,萃取粗大和长段的去细胞神经移植物。设计:非随机非对照实验研究。地点和对象:实验在解放军第三○四医院骨科完成,对象为急性脑外伤死亡者,男,26岁,体质量75kg,死者家属同意遗体捐献。干预:切取年轻男性遗体捐献者的长段尺神经,以TritonX-100和脱氧胆酸钠溶液按一定浓度和程序进行化学处理。萃取神经及新鲜神经行HE染色、髓鞘染色及纤维素染色,以观察细胞、髓鞘及神经基底膜;免疫组织化学染色以显示许旺细胞基底板层;行半薄切片及超薄切片透射电镜检查,观察超微结构。主要观察指标:去细胞神经的物理形状,组织学观察和超微结构。结果:去细胞神经的延展性及神经外膜的韧弹性良好。细胞和髓鞘被彻底清除,神经基底膜被保留;许旺细胞基底板层保留完好;去细胞神经为一种没有细胞髓鞘及其碎片的空的神经基质管。结论:TritonX-100及脱氧胆酸钠化学处理方法,可有效清除人类周围神经中的细胞及髓鞘,萃取粗大和长段的去细胞神经;该神经移植物保持了网管柱状组织结构,保留了许旺细胞基底板层及其主要?
BACKGROUND: Studies have shown that the use of chemical digestive agents to treat allogeneic nerve can effectively eliminate cells and myelin without host immune rejection, but this method is only successful in small animals and lower mammals. There are still gaps in clinical application. OBJECTIVE: To remove cells and myelin from human peripheral nerve and extract coarse and long acellular nerve grafts. Design: Non-randomized non-controlled experimental study. Location and Subject: The experiment was completed in the Department of Orthopedics, the 340th Hospital of People’s Liberation Army. The object was an acute traumatic brain injury. The male, 26 years old, had a body weight of 75kg. The deceased’s family members agreed to donate the remains. Intervention: Cut the long ulnar nerve of young male remains donors and chemically treat with Triton X-100 and sodium deoxycholate solution at a certain concentration and procedure. Extracts nerves and fresh nerves were stained with HE staining, myelin staining and cellulose staining to observe the cells, myelin and nerve basement membrane; immunohistochemical staining to show basal lamina of Schwann cells; semi-thin section and ultra-thin section transmission Electron microscopy to observe the ultrastructure. MAIN OUTCOME MEASURES: Physical shape of acellular nerve, histological observation and ultrastructure. RESULTS: The ductility of acellular nerve and the flexibility of the epineurium were good. The cells and myelin are completely eliminated, the nerve basement membrane is retained; the basal lamina of Schwann cells remain intact; the acellular nerve is an empty neural matrix tube without cell myelin and its fragments. Conclusion: TritonX-100 and sodium deoxycholate chemical treatment can effectively remove the cells and myelin in human peripheral nerve, extract the large and long acellular nerve; the nerve graft to maintain the network structure of the columnar structure, retained Schwann cell basal lamina and its main?