Governor Vessel combined with local acupoints electroacupuncture improves the therapeutic effect of nerve conduit transplantation bridging long segment defects of the median nerve

Nerve defect is a relatively serious injury in peripheral nerve injury, which often leads to the neuron apoptosis of the corresponding spinal cord segment and the difficulty of long-distance regeneration of the damaged nerve fibers, collectively resulting in poor recovery of nerve function after surgery. All experimental rats were randomly assigned to the following groups: Control, Conduit, Local acupoints electroacupuncture (EA) (Local-EA), and governor vessel (GV) combined with local acupoints electroacupuncture (GV+Local-EA) groups. A 10-mm defect model was established in the left median nerve, and a chitosan nerve conduit was used to bridge the defect. After 4 weeks, nerve regeneration and functional recovery were evaluated using immunofluorescence histochemistry, behavioral assays, and electrophysiological measurements. Results showed that the GV+Local-EA group exhibited significantly elevated the number of ChAT-positive motor neurons and enhanced the GDNF expression within the C8 spinal cord anterior horn compared with other experimental groups (P < 0.01). Furthermore, the density of NF-positive nerve fibers and S100β-positive Schwann cells in the middle and distal parts of the transplanted conduits was significantly higher in the GV+Local-EA group than in other groups (P < 0.05). The behavioral improvements and the median nerve conduction complex action potential were significantly better in the GV+Local-EA group (P < 0.05). These results suggest that GV combined with local acupoints electroacupuncture can prevent the loss of spinal motor neurons and upregulating the GDNF expression, and then facilitates the regeneration of damaged median nerve fibers along the Schwann cell-formed Bungner band toward the distal end, thereby accelerating functional recovery of the affected forelimb and demonstrating superior therapeutic efficacy compared with conventional local acupoint protocols.