术中面神经诱发肌电位（EEMG）监测是避免医源性面神经损伤的重要手段，而肌松药是影响EEMG监测的关键因素。我们研究发现：面肌和肢体骨骼肌对肌松药敏感性存在差异，其机制包括乙酰胆碱受体（nAChR）密度以及乙酰胆碱（ACh）释放的差异;受损面神经支配的肌肉对肌松药发生了抵抗，其机制与nAChR表达量和表达位置改变及ACh释放量及释放模式改变有关。本项目拟关注nAChR表达和聚集的信号通路，neuregulin1是否通过介导agrin/Lrp4/MuSK信号通路影响了nAChR亚基的表达和肌肉收缩，进而影响不同肌肉对肌松药的敏感性；以及外源性agrin和neuregulin1在发生交互作用后，是否对受损面神经神经肌接头功能恢复有影响。本项目对临床上实施EEMG监测的手术中肌松药的合理使用，探索面神经损伤基因治疗可能性有重要意义。

The intraoperative facial nerve evoked electromyography (EEMG) is an important method to avoid iatrogenic facial nerve injuries, while muscle relaxant is an essential factor to influence the monitoring. Our research indicated that differences in sensitivities to muscle relaxants existed between facial-nerve-innervated muscles and somatic-nerve-innervated muscles, which might be related to the density of nicotinic acetylcholine receptors (nAChR) and the quantal release of acetylcholine. Facial nerve injury caused resistance to muscle relaxants, which might be due to the changes in the expression and distribution of nAChR as well as the changes in the amount and mode of acetylcholine release. The current research is designed to focus on the signaling pathway for the expression and accumulation of nAChR. To investigate whether neuregulin1 influences the expression of nAChR and muscle contraction by mediating agrin/Lrp4/MuSK signaling pathway, leading to the different sensitivities to muscle relaxants between different muscles. Meanwhile, to investigate the interaction between ectogenic agrin and neuregulin1 on the recovery of the function of injuried facial nerve innervated nueromuscular junctions. The results of the study are of significant importance to determine a proper strategy for rational usage of muscle relaxants in the surgeries requiring EEMG monitoring, as well as to explore the possibility of gene therapy for the facial nerve injuries.