[Tumor Mechanomedicine]

Malignant tumors represent a significant health challenge, critically impacting human well-being. Historically, the focus has been on leveraging the biochemical cues of tumors for both diagnosis and treatment. While valuable, this strategy does not capture the full complexity of tumor diagnosis and management. Recently, the integration of biomechanics and mechanobiology with oncology has highlighted the importance of mechanical cues, which have emerged as new hallmarks of tumors, opening potential novel routes for cancer diagnosis and therapeutic interventions. Despite the advances, a thorough literature review suggests a pronounced gap in our understanding of the mechanical properties of tumors. The clinical community has not yet completely recognized the diagnostic and therapeutic relevance of the mechanical cues of tumors. To bridge this knowledge gap, we propose and introduce the paradigm of "Tumor Mechanomedicine". We provide a comprehensive overview of the multi-scale mechanical characteristics of tumors, exploring their influence on tumor biology, from the aspects of tumor biomechanics, tumor mechanobiology, tumor mechanodiagnostics, and tumor mechanotherapeutics. By elucidating the diagnostic and therapeutic potential of these mechanical cues, we aim to furnish the oncology community with fresh insights, paving the way for innovative solutions to persistent clinical conundrums.

[Microanatomy and functional MRI study of arcuate fasciculus and superior longitudinal fasciculus]

Objectives: To explore the microanatomy and functional MRI(fMRI) of arcuate fasciculus(AF) and superior longitudinal fasciculus(SLF),and to analyze their functions. Methods: Ten normal adult cadaveric head specimens (20 cerebral hemispheres) were fixed with 10% methanal at the Translational Research Institute for Neurological Disorders of the Wannan Medical Collegefrom February to December 2022.The Klingler fiber dissection technique was utilized to perform white matter fiber dissection,with a magnification ranging from 6 to 40.The study focused on the microanatomical structures of the AF and SLF,aiming to explore their relationships with deep brain fibers.Furthermore, six healthy adult volunteers who underwent fMRI of the brain were included.The collected diffusion tensor imaging (DTI) data were processed and integrated with the microanatomical findings for a comprehensive analysis. Results: After removing the gray matter of the cerebral cortex,the superficial U fibers were exposed.The long association fibers that beneath the U fibers were the AF and SLF,which were the main long association fibers in the superficial layers of the brain.The AF could be divided into dorsal and ventral parts,while the SLF could be divided into Ⅰ,Ⅱ,and Ⅲ.SLF Ⅰ lied within the upper bank of the cingulate sulcus,travels medial to the callosal sulcus.The SLF Ⅱ,Ⅲ,and the AF were located on the lateral surface of the brain.By removing the gray matter of the insular cortex and the extreme capsule,exposing the external capsule and claustrum.Subsequently,the AF and SLF Ⅱ,Ⅲ were dissected,revealing the corona radiata and sagittal stratum,along with other deep brain fibers.During the dissection,it was observed that there was a close connection between the AF,SLF Ⅱ,and the deep brain fibers.Furthermore,in the regions above the lateral fissure of the cerebral hemisphere,there was no direct connection of long association fibers between the gray matter cortex and the deep U fibers in the coronal plane.These findings were further supported by DTI studies. Conclusions: The AF and SLF are the major long association fibers that located in the superficial layers of the brain,and closely connect to the gray matter cortex and U fibers,even closely relate with deep brain fibers.In the regions above the lateral fissure of the hemisphere,only the AF and SLF Ⅱ and Ⅲ serve as superficial long association fibers in the anterior-posterior direction.These fibers are likely involved in the transmission of brain functional information between the top and bottom gray matter cortex in the coronal plane above the lateral fissure.

Network pharmacologic analysis of molecular mechanism of Baohe Wan in treatment of diarrhea with gastrointestinal food stagnation syndrome combined with intestinal flora disorder

BACKGROUND

Network pharmacology integrates information such as drugs, targets, and diseases, effectively elucidating the potential interaction between multiple components of traditional Chinese medicine and multiple targets of diseases. However, in many network pharmacology studies, the effect of traditional Chinese medicine on disease targets is often emphasized, while the effect of the gut microbiota on disease targets is ignored. The inclusion of the gut microbiota in the study of network pharmacology can contribute a new idea for the multi-component, multi-target, and multi-approach study of traditional Chinese medicine.

AIM

To explore the possible molecular mechanism of Baohe Wan in the treatment of diarrhea with gastrointestinal food stagnation syndrome combined with intestinal flora disorder through network pharmacology.

METHODS

The active ingredients and corresponding targets of Baohe Wan were screened based on the TCMSP and BATMAN-TCM databases. The GeneCards database was used to search related targets of diarrhea with gastrointestinal food stagnation syndrome and intestinal flora, and Venny platform was used to screen common targets of active ingredients and diseases. Cytoscape 3.9.1 was used to build disease-target-compound networks to screen effective targets for drug target and disease target interactions. The STRING database was used to construct the protein-protein interaction (PPI) network. The effective targets were analyzed using Gene Ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis based on the DAVID database.

RESULTS

A total of 549 chemical constituents were collected. According to OB ≥ 30% and DL ≥ 0.18, 45 active constituents were obtained, including quercetin, cortin, scutellarin, kaempferol, naringenin, etc. Venn diagram shows that there are 259 possible protein targets in the active ingredients of Baohe Wan, 34 targets that have effects on diarrhea with gastrointestinal food stagnation syndrome, 66 targets that have effects on intestinal flora, and 11 common targets, among which PTGS2, TNF, TP53, ICM1, and IL10 are key targets. A total of 121 biological processes were obtained through GO function enrichment analysis, and 49 pathways were obtained through KEGG pathway enrichment screening, including the TNF signaling pathway, IL-17 signaling pathway, NF-κB signaling pathway, etc.

CONCLUSION

The preliminary screening and prediction by network pharmacology suggested that Baohe Wan may improve diarrhea with gastrointestinal food stagnation syndrome combined with intestinal flora disorder through multiple ways and targets.

Study on Baohe Pills Regulating Intestinal Microecology and Treating Diarrhea of High-Fat and High-Protein Diet Mice

Objective

To investigate the effects of Baohe pills on intestinal microorganisms and enzyme activities in mice with a high-fat and high-protein diet.

Methods

45 KM male mice were randomly divided into the control group, the high-fat and high-protein diet group, and the Baohe pill intervention group. The mice in the high-fat and high-protein diet group and the Baohe pill intervention group were fed with the self-made high-fat and high-protein diet as the sole food source of the mice, and the mice in the control group were fed with the normal diet. Starting from the 7th day of the feed intervention, mice in the Baohe pill intervention group were given 0.28 g/mL of Baohe pill decoction twice a day at the dose of 6.67 g/(kg·day), each time of 0.35 mL for 6 days. Mice in the control group and the high-fat and high-protein diet group were given the same amount of distilled water by gavage. The general state of mice in each group was observed, and the changes of intestinal microorganisms and intestinal enzyme activities were analyzed by culturable microorganism technology and intestinal functional enzyme detection technology.

Results

The excrement of mice fed with a high-fat and high-protein diet was relatively thin and wet, and the Baohe pill intervention could not improve the symptoms well. In the high-fat and high-protein diet group, the number of bacteria, Escherichia coli, Lactobacillus, and Bifidobacterium, was significantly lower than that in the control group (P < 0.01). Baohe pills could obviously increase the high-fat, high-protein diet for the number of culturable microorganisms in mice, the total number of bacteria, and the number of Bifidobacteria in the most significant (P < 0.01), but the number of bacteria, Escherichia coli, and the Lactobacillus are still significantly lower than the control group (P < 0.01). In terms of enzyme activity, both contents and mucosa, the Baohe pill could improve the activities of amylase, protease, sucrase, and lactase in high-fat and high-protein diet mice, which were significantly different from the control group (P < 0.05). In terms of microbial activity, the intestinal contents of high-fat and high-protein mice were lower than those of the control group, while the intestinal mucosa was higher than that of the control group, but the difference was not significant (P > 0.05). Baohe pills could improve the intestinal contents and intestinal mucosal microbial activity of mice, and the difference was significant in the high-fat and high-protein diet group (P < 0.05). Discussion. A high-fat and high-protein diet can destroy the physiological balance of the body, which is mainly reflected in the disturbance of intestinal flora and the decrease of some enzyme activities and microbial activity. Baohe pills can restore the number of intestinal flora to a certain extent and improve the activities of various digestive enzymes including protease and amylase.

[Epidemic situation and diagnosis of imported malaria before and after malaria elimination in Nanjing City, Jiangsu Province]

OBJECTIVE

To analyze the epidemiological characteristics and diagnosis of imported malaria before and after malaria elimination in Nanjing City of Jiangsu Province, so as to provide the scientific evidence for formulating the malaria control strategy after malaria elimination.

METHODS

Data pertaining to the epidemic situation and individual investigation of malaria in Nanjing City before (from 2012 to 2016) and after malaria elimination (from 2017 to 2020) were captured from the National Notifiable Communicable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention and were analyzed statistically.

RESULTS

A total of 178 malaria cases were reported in Nanjing City from 2012 to 2020, and all were imported cases. There were 99 malaria cases reported before malaria elimination in Nanjing City, including 78 cases with Plasmodium falciparum malaria (78.79%), 5 cases with P. vivax malaria (5.05%), 10 cases with P. ovale malaria (10.10%), 3 cases with P. malariae malaria (3.03%) and 3 cases with mixed infections (3.03%), and 79 malaria cases reported after elimination, including 63 cases with P. falciparum malaria (79.75%), 5 cases with P. vivax malaria (6.33%), 9 cases with P. ovale malaria (11.39%), 2 cases with P. malariae malaria (2.53%). There was no significant difference in the proportion of each type of malaria cases in Nanjing City before and after malaria elimination (χ² =2.400, P > 0.05). Malaria cases mainly acquired Plasmodium infections in African regions, and no significant difference was seen in the proportion of malaria cases returning to Nanjing City from African countries before and after malaria elimination (χ² = 0.093, P > 0.05). The number of malaria cases peaked in Nanjing City in January and during the period from May to July before elimination, and there was no apparent seasonal variation in the distribution of malaria cases after elimination. The proportion of malaria cases living in Nanjing City was significantly greater after malaria elimination than before elimination (72.15% vs. 55.56%; χ² = 5.187, P = 0.023). The proportions of businessmen and international students were both 5.05% before malaria elimination, and increased to 15.19% and 13.92% after elimination, respectively (χ² = 5.229 and 4.229, both P values < 0.05). The percentage of definitive diagnosis of malaria at initial diagnosis was 18.75% in county-level hospitals before malaria elimination and increased to 61.11% after elimination (χ² = 6.275, P = 0.012), while the proportion of malaria cases with definitive diagnoses in county-level hospitals was 4.04% before malaria elimination and increased to 13.92% after elimination (χ² = 5.562, P = 0.018). During the period from 2012 to 2020, the proportion of malaria cases with definitive diagnoses within 1 to 3 days post-admission increased from 27.27% in Nanjing City before malaria elimination to 45.57% after elimination (χ² = 6.433, P = 0.011).

CONCLUSIONS

The epidemic situation of imported malaria remains serious in Nanjing City during the post-elimination stage, and malaria parasite infections predominantly occur in African regions. In addition, there are changes in regional and occupational distributions of malaria cases and the diagnostic capability of malaria increases in county-level hospitals in Nanjing City after malaria elimination. Further improvements in the malaria surveillance system and the diagnostic and treatment capability of malaria in medical institutions at each level are required to consolidate malaria elimination achievements in Nanjing City.

[Effect of integrated schistosomiasis control measures on Oncomelania snails in river channels connecting the Yangtze River in Nanjing City]

OBJECTIVE

To evaluate the effectiveness of Oncomelania snails control following the implementation of integrated schistosomiasis control measures in river channels connecting the Yangtze River in endemic areas of Nanjing City.

METHODS

The river channels connecting the Yangtze River with snails in Nanjing City were selected as the study pilots. The integrated schistosomiasis control measures implemented in the study pilots were investigated by means of retrospective analyses and field surveys from 1998 to 2019, and the effectiveness of snail control was evaluated.

RESULTS

Integrated control measures with emphases on environmental improvements including water resource projects for schistosomiasis control were implemented in the study pilots during the period from 1998 to 2019, including river bank concretion with 84.51 km in length, marshland cutting and dredging with 50.41 km in length, building 2 sluices and 3 overflow dams, digging one floodway and snail control with chemical treatment that covered an area of 3 370.80 hm². No Schistosoma japonicum infection had been detected in snails since the completion of the integrated control measures. In addition, snails had been eliminated in 6 river channels connecting the Yangtze River until 2019, with the snail habitats reducing from 214.33 hm² to 52.22 hm² in 10 river channels connecting the Yangtze River and the snail density reducing to below 0.1 snails/0.1 m² in snail-breeding river channels connecting the Yangtze River.

CONCLUSIONS

The integrated schistosomiasis control measures with emphases on environmental improvements may effectively control snail breeding and spread in rivers connecting the Yangtze River in endemic areas of schistosomiasis; however, the maintenance of the project and snail surveillance and control should be intensified following the completion of the integrated schistosomiasis control measures.

Role of intestinal flora characteristics in traditional Chinese medicine-based diagnosis and treatment of spleen and stomach diseases

Abnormal rise and fall of spleen and stomach Qi will lead to a series of spleen and stomach diseases. Spleen-deficiency syndrome and damp-heat syndrome are important traditional Chinese medicine (TCM) syndromes of spleen-stomach diseases, and they also correlate with imbalance of intestinal flora. Given the correlation between spleen and stomach diseases and intestinal flora, this paper discusses the changes of intestinal flora in common spleen and stomach diseases by reviewing the relevant literature, in order to demonstrate the role of intestinal flora in the diagnosis and treatment of TCM syndromes and promote the objectification of TCM syndromes.

Preparation methods for animal models of diarrhea with gastrointestinal food stagnation syndrome: A review

Gastrointestinal food stagnation syndrome, also known as dyspeptic retention syndrome, is a syndrome that some high-protein, high-calorie food cannot be digested normally and is retained in the gastrointestinal tract. Food retention in the gastrointestinal tract is likely to cause internal heat, resulting in diarrhea or constipation. This paper provides an overview of gastrointestinal food stagnation syndrome, its animal models, intestinal microecological characteristics, and treatment of diarrhea with gastrointestinal food stagnation syndrome, in order to provide a reference for the clinical diagnosis and treatment of this disorder.

[Report and analysis of 2 cases of nerve paralysis with aspiration pneumonia after infection of herpes zoster virus]

Two cases of patients were hospitalized for sore throat with Dysphagia.Check:Wall of the pharynx,tongue and epiglottis scattered the ulcer.The patients were loss of pharynx reflex.Oropharynx and piriform fossa has a lot of saliva retention.Posterior pharyngeal wall was drooping like waterfull.CT scan showed may be the aspiration pneumonia in right lower lung.The admission diagnosiswere pharyngeal herpes zoster virus infection,pharyngeal side muscle paralysis,and inhalation pneumonia.The patients' clinical data were retrospectively analyzed,and the report is as follows.

First Report of Gray Mold of Rhizoma paridis Caused by Botrytis cinerea in China

Rhizoma paridis is a perennial, traditional Chinese medicinal herb. In May 2013, a disease was observed in an approximately 10 ha cultivated field in Enshi, Hubei Province, China. Approximately 80% of plants in the field were affected. Symptoms were visible on the basal leaves of affected plants. Chlorosis followed by necrosis started at the leaf tips and margins and gradually spread inward until the entire leaf was necrotic. Thick, gray mycelium and conidia were visible on both sides surface of leaves under wet, humid conditions. The leading edge of the chlorotic leaves was excised from 20 plant samples surface disinfested with 1% NaOCl solution for 1 min, rinsed in sterile water, air dried, and placed on potato dextrose agar (PDA). Plates were incubated at 22°C in the dark. Mycelia were initially hyaline and white, and became dark gray after 72 h. Mycelia were septate with dark branched conidiophores. Conidia were smooth, hyaline, ovoid, aseptate, and ranged from 8 to 14.5 × 7 to 8.5 μm. Numerous hard, small, irregular, and black sclerotia that were 1 to 3 × 2 to 5 mm were visible on PDA plates after 12 days. The fungus was identified as Botrytis cinerea on the basis of these characters (1). The internal transcribed spacer (ITS) region of rDNA was amplified using the ITS1 and ITS4 primer and sequenced (GenBank Accession No. KF265499). BLAST analysis of the PCR product showed 99% identity to Botryotinia fuckeliana (perfect stage of B. cinerea) (EF207415.1, EF207414.1). The pathogen was further identified to the species level as B. cinerea using gene sequences from glyceraldehyde-3-phosphate dehydrogenase (G3PDH), heat-shock protein 60 (HSP60), and DNA-dependent RNA polymerase subunit II (RPB2) (2) (KJ638600, KJ638602, and KJ638601). Pathogenicity was tested by spraying the foliage of 40 two-year-old plants with a suspension of 10⁶ conidia per ml of sterile distilled water. Each plant received 30 ml of the inoculum. Ten healthy potted plants were inoculated with sterilized water as control. All plants were covered with plastic bags for 5 days after inoculation to maintain high relative humidity and were placed in a growth chamber at 22°C. The first foliar lesions developed on leaves 7 days after inoculation and were similar to those observed in the field. No symptoms developed on the control plants. B. cinerea was consistently re-isolated from all artificially inoculated plants. The pathogenicity test was completed twice. To our knowledge, this is the first report of gray mold of R. paridis caused by B. cinerea in China. The root of R. paridis is the most commonly used Chinese herbal medicine to treat viper bites. In recent years, cultivation of this herb has increased in China because of its high value. Consequently, the economic importance of this disease is likely to increase with the greater prevalence of this host species. References: (1) H. L. Barnett and B. B. Hunter. Illustrated Genera of Imperfect Fungi. Burgess Publishing Company, Minneapolis, MN, 1972. (2) M. Staats et al. Mol. Biol. Evol. 22:333, 2005.

The human cytomegalovirus UL97 protein is a protein kinase that autophosphorylates on serines and threonines

The product of the human cytomegalovirus (CMV) UL97 gene, which controls ganciclovir phosphorylation in virus-infected cells, is homologous to known protein kinases but diverges from them at a number of positions that are functionally important. To investigate UL97, we raised an antibody against it and overexpressed it in baculovirus-infected insect cells. Recombinant baculovirus expressing full-length UL97 directed the phosphorylation of ganciclovir in insect cells, which was abolished by a four-codon deletion that confers ganciclovir resistance to CMV. When incubated with [gamma-32P]ATP, full-length UL97 was phosphorylated on serine and threonine residues. Phosphorylation was severely impaired by a point mutation that alters lysine-355 in a motif that aligns with subdomain II of protein kinases. However, phosphorylation was impaired much less severely by the four-codon deletion. A UL97 fusion protein expressed from recombinant baculovirus was purified to near homogeneity. It too was phosphorylated upon incubation with [gamma-32P]ATP in vitro. This phosphorylation, which was abolished by the lysine 355 mutation, was optimal at high NaCl and high pH. The activity required either Mn2+ or Mg2+, with a preference for Mn2+, and utilized either ATP or GTP as a phosphate donor, with Kms of 2 and 4 microM, respectively. The phosphorylation rate was first order with protein concentration, consistent with autophosphorylation. These data strongly argue that UL97 is a serine/threonine protein kinase that autophosphorylates and suggest that the four-codon deletion affects its substrate specificity.

[Exploration of nursing diagnosis with a cognitive reasoning model]

One of the important topics in theoretic studies on nursing diagnosis, still a new concept in China, is to explore the logical reasoning process from collecting data to making diagnoses. This paper introduced an epistemological model which mentions every step in detail on how to make a nursing diagnosis. The model was built on the basis of analyzing the knowledge structure of nursing diagnosis and applying the methodology of cognitive psychology.

An M13 phage library displaying random 38-amino-acid peptides as a source of novel sequences with affinity to selected targets

We have examined the potential of isolating novel ligands from a library of M13 pIII-fusion phage displaying peptides composed of 38 random amino acids (aa). The library was panned with streptavidin (SA) and a polyclonal goat antimouse IgG Fc antibody (Ab) preparation coupled to paramagnetic beads. SA selected two classes of phage from the library. One class exhibited the aa motif, HP(Q/M) theta (where theta signifies a non-polar aa), similar to the motif identified by Devlin et al. [Science 249 (1990) 404-406] using a 15-aa random peptide library displayed on phage. The other class of phage had no discernible motif. In binding experiments, the non-HP(Q/M) theta phage had a slightly higher affinity for SA than did the motif phage. Both classes of SA-binding phage failed to bind native and non-glycosylated forms of avidin, even though SA and avidin are structurally similar and both proteins possess extraordinary affinities for biotin. The polyclonal goat anti-mouse IgG Fc Ab preparation selected phage displaying sequences similar to a region of the mouse IgG Fc. Thus, a single immunodominant epitope on the mouse IgG Fc was identified. Furthermore, a second phage displaying peptides with no discernible sequence similarities to mouse IgG Fc was isolated. Thus, an M13 library displaying 38-aa peptides can yield phage with affinity for various targets. Finally, we have observed a biological bias against odd numbers of Cys residues in the displayed peptides.

Characterization of human cytomegalovirus UL84 early gene and identification of its putative protein product

The DNA sequence and transcription pattern of human cytomegalovirus early gene UL84 were analyzed. This gene was mapped within a 2.6-kb PstI fragment located between 0.534 and 0.545 map unit of the large unique segment of the human cytomegalovirus genome, which is adjacent to the pp65 and pp71 genes. A 2.0-kb mRNA was transcribed from this region in the same leftward direction as the mRNAs of the pp65 and pp71 genes. The message was first detected at 2.5 h postinfection and reached a maximal level between 72 and 96 h postinfection. The nucleotide sequences of the 2.6-kb PstI genomic DNA fragment and the cDNA derived from this region were determined. The resulting data revealed a polyadenylation signal (AATAAA) located 14 nucleotides upstream from the poly(A) tail of the cDNA and a 1,761-bp open reading frame capable of encoding a 65-kDa polypeptide. A potential leucine zipper was found in the N-terminal half of the peptide molecule between amino acids 114 and 135. In addition, a different periodic leucine repeat with leucine at every eighth position was found between amino acids 325 and 373. The transcriptional initiation site of this early gene was determined by primer extension analysis. A putative TATA box (TATTTAA) located 24 bp upstream of the cap site and several inverted repeats were found in the region further upstream of the TATA box. To test whether the open reading frame of this cDNA encodes a virus-specific protein, the cDNA was overexpressed in Escherichia coli as a fusion protein used to generate antibodies in rabbits. A protein with a molecular size of 65 kDa was detected in the infected-cell extracts harvested at 6 to 72 h postinfection, but not in purified virions, using immunoblot analysis. Both nuclear and cytoplasmic fluorescences were found at late stages of virus infection. From the results obtained, we postulate that UL84 may be a stable, virus-specific, nonstructural protein capable of forming a homo- or heterodimeric molecule.

Dextran sulfate as an inhibitor against the human immunodeficiency virus

Dextran sulfate (DS) is a potent inhibitor of the growth of human immunodeficiency virus type 1 (HIV-1) in the H9 cell. Its minimal inhibitory concentration is about 1 microgram/ml. Its therapeutic index is greater than or equal to 200 which is higher than that of 38 for zidovudine. At the ID100 range, DS blocks the synthesis of HIV-1 antigens completely for at least 21 days; zidovudine at the subtoxic concentration of 3 micrograms/ml is incapable of achieving such a complete blockage. DS is still active when added to H9 cell cultures 4 hr after the addition of HIV-1. DS does not inactivate extracellular HIV-1 and is incapable of inducing interferons. It interferes partially with the infection of the H9 cells by the HIV-1. It inhibits the activity of HIV-1 reverse transcriptase. These activities may account, at least in part, for the inhibitory activity of dextran sulfate against the HIV-1. DS has a narrow antiviral spectrum; it is noninhibitory to the herpes simplex, vesicular stomatitis, polio, or adeno viruses. Dextran is not inhibitory to HIV-1. After sulfonation, the sulfonated dextran is highly inhibitory. Therefore, the sulfate group in the DS molecule appears to be essential for its anti-HIV-1 activity. The molecular weights of DS within the range 4000 to 12,000 do not appear to influence its anti-HIV potency.

Acetylcholinesterase: a histochemical identification of motor and sensory fascicles in human peripheral nerve and its use during operation

To evaluate the precision of acetylcholinesterase histochemical identification of motor and sensory fascicles, this study presents a systematic observation of human peripheral nerves by Karnovsky and Roots' histochemical method. The results indicate that either of the enzymatic activities of myelinated and unmyelinated fibers was different between motor and sensory fascicles. Fifty-seven percent of the myelinated fibers showed enzymatic activity in the motor fascicles, while none of the myelinated fibers in the sensory fascicles showed enzymatic activity. The unmyelinated fibers showing enzymatic activity in the sensory fascicles were far denser than those in the motor fascicles. Our study demonstrated that the unmyelinated fibers were sympathetic postganglionic unmyelinated fibers. From these results it is concluded that the motor and sensory fascicles may be identified not only according to the enzymatic activities of the myelinated fibers, but also according to the enzymatic activities of the sympathetic postganglionic unmyelinated fibers. An improved histochemical method was suggested for its applicability as a method of intraoperative nerve fascicle identification. Simulated experiments were done on the radial nerves and the median nerves in human cadavers. This improved histochemical process can be completed within 50 minutes and can be used in intraoperative nerve fascicle identification.

The relationship between structural features of peripheral nerves and suture methods for nerve repair

Based on techniques for identifying and distinguishing motor, sensory, and mixed fasciculi in peripheral nerves, the authors propose guidelines for selecting suture methods for nerve repair. When many mixed fasciculi are known to exist at the nerve lesion, epineurial repair is preferable; fascicular (perineurial) repair is more suitable when pure motor and sensory fasciculi are clearly recognized. Generally, epineurial repair is indicated for more proximal injuries, with fascicular repair most appropriate for more distal sites. A greater ratio of epineurial connective tissue to intrafascicular nervous tissue implies an inclination toward fascicular repair.