儿童气管镜应用解剖学

目的：研究气管镜操作术的成功率和安全性。方法：观测儿童尸体气管的解剖长度、临床长度和气管的横径、矢状径，并与儿童身高和上部量进行相关分析，另外分析临床资料85例，其中58例在使用支气管镜前做了气管横径、矢状和长度的预测。结果：两性儿童的身高和上部量与气管的解剖长度、临床长度、气管内径之间密切相关。结论：测量儿童的身高和上部量就可根据他们之间的回归方程计算出气管的长度和内径大小，为临床准确选用气管镜型号和插管的深度提供可靠的依据。以保证一次性成功率和安全性。     

基于有限元模型的踝关节生物力学分析*

背景：有限元力学分析在生物力学领域广泛应用。 目的：采用大型有限元软件ANSYS对踝关节三维有限元数字模型进行生物力学分析,探讨踝关节各组成骨的应力分布规律及其发生形变、位移情况。 方法：把经MIMICS、Geomagic和ANSYS处理后生成的踝关节三维数字模型导入软件ANSYS中,经过约束条件、施加载荷、求解试算等阶段,对其各组成骨进行有限元分析。 结果与结论：①静止直立位时,踝关节各组成骨最大应力区集中在内踝与距骨相关节处、胫骨远端关节面髁间线前部、胫骨中下段前缘皮质区及距骨滑车外侧部;最小应力区集中在外踝、胫骨远端内侧皮质区、距骨头、距骨颈;最大位移发生在距骨头,位移自下而上逐步减小;最小位移发生在胫骨、腓骨中下段1/3处。②高空坠落时,最大应力区集中在胫骨中下段前缘皮质区、距骨滑车前外侧、内踝内侧皮质区以及胫骨远端关节面髁间线前部。其中胫骨中下段应力集中区随着压力的增加,稍向内侧移位。距骨滑车外侧部最大应力集中区位置无明显变化,范围逐渐加大。最小应力区集中在外踝、胫骨远端关节面外侧部、距骨头、内踝的外侧皮质;随着压力不断加大,内踝外侧皮质的小应力蓝色区域范围逐渐减小;外踝逐渐出现应力稍大的淡蓝色区域,提示所受应力加大。最大位移发生的部位自距骨头向上,经距骨颈、胫距关节面到胫腓骨中下段逐渐减小,到胫腓骨中下段时减到最小。     

Dissecting the history of anatomy in the Third Reich--1989-2010: A personal account

This paper is a personal narrative of involvement with the revelations of the use of anatomical and pathological specimens of victims of Nazi terror. The narrative documents responses to the question of the retention and use of anatomical and pathological specimens from victims of Nazi terror by leading academic and scientific institutions and organizations in Germany and Austria including the government of the Federal Republic of (West) Germany, the University of Tübingen, the University of Vienna, the Max Planck Society and the Anatomische Gesellschaft. It begins with the public revelations of 1989 and concludes with the September 2010 Symposium on the History of Anatomy during the Third Reich at the University of Würzburg. The narrative documents a 22-year transition in attitude and responses to the investigation and documentation of the history of anatomy and pathology during the Third Reich. The chronicle includes the 1989 proposed "Call for an International Commemoration" by the author, together with the bioethicist Professor Arthur Caplan, on the occasion of the planned burial of the misbegotten specimens and the responses to that proposal.     

Flow Interactions with Cells and Tissues: Cardiovascular Flows and Fluid–Structure Interactions

Interactions between flow and biological cells and tissues are intrinsic to the circulatory, respiratory, digestive and genitourinary systems. In the circulatory system, an understanding of the complex interaction between the arterial wall (a living multi-component organ with anisotropic, non-linear material properties) and blood (a shear-thinning fluid with 45% by volume consisting of red blood cells, platelets, and white blood cells) is vital to our understanding of the physiology of the human circulation and the etiology and development of arterial diseases, and to the design and development of prosthetic implants and tissue-engineered substitutes. Similarly, an understanding of the complex dynamics of flow past native human heart valves and the effect of that flow on the valvular tissue is necessary to elucidate the etiology of valvular diseases and in the design and development of valve replacements. In this paper we address the influence of biomechanical factors on the arterial circulation. The first part presents our current understanding of the impact of blood flow on the arterial wall at the cellular level and the relationship between flow-induced stresses and the etiology of atherosclerosis. The second part describes recent advances in the application of fluid–structure interaction analysis to arterial flows and the dynamics of heart valves.     

逆行腓骨肌肌皮瓣设计的解剖学研究

目的　为逆行腓骨肌皮瓣的设计与临床应用提供解剖学依据。 方法 新鲜下肢标本20侧,动脉灌注红色乳胶,解剖观测腓动脉、腓骨长肌、腓骨短肌及其表面皮肤与营养血管的的起始、走行、分支、分布的情况;新鲜标本2具,动脉灌注乳胶、氧化铅混悬液,CT扫描后三维重建小腿与足部血管。 结果 腓动脉起始外径(3.7±0.7) mm,多条分支供给比目鱼肌、 长屈肌、腓骨长、短肌及表面皮肤。腓动脉穿支的血管蒂可游离长度为(3.5±1.3) cm。腓动脉终末穿支在胫腓骨骨间膜中穿出,外径(1.2±0.4)mm,分为升支和降支。腓骨短肌肌腹的上部有一支较粗的腓浅动脉发自胫前动脉,向前穿骨间膜行于腓骨长肌与小腿前群肌之间,管径(1.8±0.5) mm,行向下营养腓骨短肌、腓浅神经和小腿前外侧部皮肤。 结论 以腓动脉中、下部穿支或终末穿支与其它血管的吻合部为蒂,可以设计切取逆行腓骨长、短肌肌皮瓣,修复小腿下部及足背部软组织缺损。     

全髋关节置换术直接前入路改良切口与股外侧皮神经损伤的解剖学研究

目的 探讨全髋关节置换术直接前方入路(DAA)改良切口和经典切口的解剖特点,为术中避免股外侧皮神经(LFCN)损伤提供解剖学依据。方法 由蚌埠医学院解剖教研室提供成年国人尸体髋关节及股骨标本6具6侧,其中男2具2侧、女4具4侧,年龄48~72(61.7±8.2)岁。通过解剖标志定位的方式做DAA手术切口,切口起点均为髂前上棘最高点向下向外3 cm;DAA经典切口延长方向指向腓骨小头;改良切口将切口延长方向向经典切口外后方偏移,偏移角度为髂前上棘最高点分别与腓骨小头、股骨大粗隆顶点连线夹角的1/2。解剖显露LFCN以及所有分支:(1)观察LFCN走行及其与DAA经典切口、DAA改良切口的关系;(2)对LFCN进行分型;(3)测量DAA经典切口和改良切口与LFCN最短距离,判断LFCN与DAA经典切口和改良切口的解剖关系。结果 (1)LFCN由髂前上棘内侧0.8 cm经腹股沟韧带下方走向股骨前方,LFCN走行向前、向外近乎平行于髂前上棘最高点与腓骨小头连线。DAA经典切口远端与LFCN有交叉,有直接损伤LFCN可能,延长DAA经典切口会增加损伤LFCN概率;而DAA改良切口与LFCN无交叉。(2)6侧标本LFCN分型:缝匠肌型3侧,后向型2侧,扇形型1侧。(3)LFCN与DAA改良切口最短距离为1.2~2.4(2.0±0.40)cm,与经典切口最短距离为0~1.4(0.98±0.55)cm。缝匠肌型和后向型LFCN主干及分支与DAA改良切口的最短距离均＞2.0 cm;与DAA经典切口无交叉,且LFCN所有分支与DAA改良切口最短距离均＞0.7 cm。扇形型LFCN与DAA经典切口有交叉,而与DAA改良切口无交叉,最短距离为1.2 cm。结论 在解剖关系上,DAA改良切口比DAA经典切口距离LFCN更远,DAA全髋关节置换术中更不易发生LFCN损伤。     

雄性大鼠大脑半球白质及其内有髓神经纤维老年改变的侧别差异

目的 探讨雄性大鼠左右大脑半球白质及其内有髓神经纤维是否存在显著性差异,以及每侧大脑半球白质及其内有髓神经纤维的老年性改变是否一致.方法运用透射电子显微镜和体视学方法分别对5只年轻(6～8月龄)和4只老年(18月龄)雄性Long-Evans大鼠左侧、右侧大脑半球白质体积及白质内有髓神经纤维体积、长度和直径进行定量研究.结果年轻组大鼠和老年组大鼠左右大脑半球白质体积及白质内有髓神经纤维体积、长度和直径均不存在显著性差异.每侧大脑半球白质及其内有髓神经纤维总长度和总体积均随年龄增加而降低,右侧半球白质体积、右侧半球白质内有髓神经纤维总体积和左侧半球白质内有髓神经纤维总长度随年龄增长分别显著性降低32.9%、28.6%和49.3%.结论正常年轻和老年雄性Tong-Evans大鼠两侧大脑半球的白质及其内有髓神经纤维均不存在显著性侧别差异.老年雄性Long-Evans大鼠右侧大脑半球白质体积、右侧大脑半球白质内有髓神经纤维的总体积和左侧大脑半球白质内有髓神经纤维总长度存在显著老年性改变.     

基于CT三维重建的肩胛骨关节盂形态学分型及临床意义

目的 探讨CT三维重建的肩胛骨关节盂形态学特点及其临床意义。 方法 搜集290例关节盂三维重建影像资料，观察关节盂形态特点，测量关节盂上下径、前后径及关节盂窝深度，关节盂倾斜角、扭转角的度数。 结果 CT三维重建图像显示，肩胛骨关节盂大致有4种类型：引号型56.90%（165例）、椭圆型22.41%（65例）、水滴型17.59%（51例）、葫芦型3.10%（9例）。椭圆型的关节盂上下径、盂窝深度及关节盂倾斜角、扭转角与引号型、水滴型及葫芦型有统计学差异；水滴型的关节盂倾斜角大于引号型；葫芦型的关节盂上下径小于引号型及水滴型；椭圆型及水滴型的关节盂前后径长于引号型及葫芦型；引号型的关节盂前后径长于葫芦型；引号型的关节盂窝深度小于水滴型及葫芦型；关节盂上下径、前后径、关节盂窝深度、关节盂倾斜角，不同性别有统计学差异，以上差异均P<0.05。 结论 基于CT三维重建结果，肩胛骨关节盂可分为4个类型，以引号型为主，葫芦型少见，其形态学分型具有一定的临床指导意义。     

Size of neurons and glial cells in the enteric ganglia of mice, guinea-pigs, rabbits and sheep

Summary A quantitative light microscopic study has been carried out on the myenteric and submucosal ganglia of the stomach, duodenum, ileum, proximal colon and rectum of the guinea-pig; the enteric ganglia of the ileum were studied also in the mouse, rabbit and sheep. The area of the profiles of nerve cells, of nerve cell nuclei and of glial nuclei, and the proportion of the area of ganglia occupied by neuropil were measured, and the relative numbers of neurons and glial cells were estimated. The myenteric ganglia were found to be firmly anchored to the stroma of the muscle coat; their shape and the shape of their component cells varied with contraction and distension of the musculature. The range of neuronal sizes in the myenteric ganglia was extremely wide. In the guinea-pig, the myenteric neurons were on average largest in the stomach and duodenum and smallest in the ileum, with intermediate values in the colon and rectum; the submucosal neurons showed little variation in average size along the length of the gut. The average size of ganglion neurons in the ileum was greatest in the sheep and smallest in the mouse, and had intermediate values in the guinea-pig and rabbit. The percentage volume of neuropil in the myenteric ganglia was 51% in the mouse, 65% in the guinea-pig, 70% in the rabbit, and 74% in the sheep. The number of glial cells relative to the number of neurons was also ranked in the same order. In all the species examined the submucosal ganglia, when compared with the corresponding myenteric ganglia, had a smaller percentage volume of neuropil, a much smaller number of glial cells and (except in the mouse ileum) neurons of smaller average size. In all the ganglia there was a positive correlation between size of neurons and size of glial cells. The results are discussed in the light of possible relations between body size (and length of the intestine), numerical density of ganglion neurons, average size of neurons, amount of musculature, average distance between neurons, and amount of neuropil.     

内侧楔骨与第2跖骨底间韧带的解剖研究及临床意义

目的 测量内侧楔骨至第2跖骨底间韧带的相关参数,为临床治疗Lisfranc损伤提供解剖学依据。 方法 20例新鲜成人足部标本,解剖测量背侧韧带、Lisfranc韧带和跖侧韧带的长、宽,并观测Lisfranc韧带的走行方向和其在内侧楔骨的起点位置。 结果 背侧韧带长为（5.44±0.83）mm,宽为（4.20±0.64）mm;跖侧韧带长为（7.07±1.05）mm,宽为（5.23±1.10）mm;Lisfranc韧带长为（9.33±1.34）mm,宽为（8.00±1.23）mm,其与第2跖骨干中轴近端夹角为（61.45±5.03）°,其在内侧楔骨外侧面起点距关节面背侧（10.89±0.84）mm,跖侧（8.31±0.92）mm,远端（5.35±0.60）mm,近端（12.04±0.85）mm。 结论　Lisfranc韧带最为粗大,跖侧韧带次之,背侧韧带最为薄弱。内固定治疗Lisfranc损伤,可参照Lisfranc韧带起点位置和走行方向的解剖数据。     

Morphology of the metopic suture during the fetal period

Assessment of the position and size of the metopic suture and anterior fontanelle is important in the routine examination during fetal period and in newborn infants. The aim of this study is to clarify the average size and its developmental changes of the anterior fontanelle and metopic suture by morphometry. Fifty-one cases were examined over a developmental period ranging from fetus of 14 weeks gestation to full term neonate. The width, and length of heads as well as head circumference of all fetuses were measured. The metopic suture and anterior fontanelle sizes were determined. The nearest distances between the parietal bones to the opposite frontal bones, and the distances between the nasion and lower angle of the anterior fontanelle, bregma and upper angle of the anterior fontanelle were measured. The averages of longitudinal and transverse diameters and areas of anterior fontanelle were calculated. Significant correlation was found between all the parameters and gestational ages, and between the sizes of the metopic suture and of skulls. There was no difference between male and female in any of the parameters. In our study, closed metopic suture was not observed. The anterior fontanelle is easy to palpate, and its enlargement might occasionally be helpful in the clinical examination of the newborn infants. The presence of a wide metopic suture may indicate the possibility of additional defects and anomaly in the newborn.     

Biomechanically important articular surfaces in the talocrural joint.

The authors investigated the influence of relations between the utile areas of the articular faces in ankle joint in medial twisting of the foot. For their investigation they used the material from the Institute of Anatomy "Drago Perovi?", Institute of Pathology and Institute for Forensic medicine of the Medical Faculty of Zagreb. Investigations were performed in articular faces of the tibia, fibula and talus on the left and right legs of the adults. Mutual comparing of the joint faces, their areas and altitudes, angles between the medial malleolus and tibia, and the altitudes of the medial and lateral malleolus has shown great individual differences. According to these results the authors concluded that the disproportion of the articular bodies caused habitual medial twisting of the foot. The importance and the role of ligaments, muscles and joint capsule were not the object of this investigation. The obtained results are a contribution to the functional anatomy of the ankle joint, and to the clinical pathology of this region.     

Age-related structural changes in the rat cerebellar cortex: effect of choline alfoscerate treatment.

The influence of ageing and of 3 months choline alfoscerate treatment on age-related microstructural changes in cerebellar cortex was studied in 3-, 12- and 24-month-old male Sprague-Dawley rats. The number of Purkinje and granule neurons, the density of Nissl bodies in the cytoplasm of Purkinje and granule neurons and the density of silver-gold impregnated fibres within molecular and granule cells layers were assessed by neurohistological and neurohistochemical techniques associated with microdensitometry and quantitative image analysis. The number of Purkinje and granule neurons was approximately the same in rats of 3 and 12 months and significantly decreased in 24-month-old animals. The density of Nissl bodies and of fine processes of silver-gold impregnated fibres were greatest in the cerebellar cortex of rats of 12 months of age, followed in descending order by 3- and 24-month-old rats. Both the density of Nissl bodies and of silver-gold impregnated fibres were significantly lower in the cerebellar cortex of the oldest age group considered in comparison with the young and middle age groups. Treatment with choline alfoscerate, a precursor in the biosynthesis of brain phospholipids which increases bioavailability of choline in the nervous tissue, noticeably reduced the loss of Purkinje and granule neurons in rats of 24 months. Moreover, it restored the density of Nissl bodies in the cytoplasm of Purkinje and granule neurons as well as the density of silver-gold stained fibres in the molecular and in the granule cells layers to values not significantly different from those found in rats of 3 months. These findings suggest that choline alfoscerate treatment may be effective in counteracting the age-dependent disarrangement of rat cerebellar cortex. The possible mechanisms of action of the compound on the microstructural changes of cerebellar cortex occurring with age are discussed.     

Histological Organization in Hepatocyte Organoid Cultures

Hepatocytes and other cellular elements isolated by collagenase perfusion of the liver and maintained in defined culture conditions undergo a series of complex changes, including apoptosis and cell proliferation, to reconstruct tissue with specific architecture. Cultures in collagen-coated pleated surface roller bottles, with hepatocyte growth medium medium and in the presence of hepatocyte growth factor (HGF) and epidermal growth factor (EGF), form characteristic and reproducible tissue architecture composed of a superficial layer of biliary epithelial cells, an intermediate layer of connective tissue and hepatocytes, and a basal layer of endothelial cells. Dexamethasone, EGF, and HGF are required for the complete histological organization. Analysis of the structures formed demonstrates that the receptor tyrosine kinase ligands HGF and EGF are required for the presence, growth, and phenotypic maturation of the biliary epithelium on the surface of the cultures and for the formation of connective tissue in the cultures. Dexamethasone, in the presence of HGF and EGF, was required for the phenotypic maturation of hepatocytes. The results demonstrate the role of these molecules for the formation and phenotypic maturation of specific histological elements of the liver and suggest roles for these signaling molecules in the formation and structure of the in vivo hepatic architecture.     

Restricted cortical termination fields of the midline and intralaminar thalamic nuclei in the rat.

The projections from the midline and intralaminar thalamic nuclei to the cerebral cortex were studied in the rat by means of anterograde tracing with Phaseolus vulgaris-leucoagglutinin. The midline and intralaminar nuclear complex taken as a whole projects to widespread, predominantly frontal, cortical areas. Each of the constituent thalamic nuclei has a restricted cortical projection field that overlaps only slightly with the projection fields of adjacent midline and intralaminar nuclei. The projections of the intralaminar nuclei cover a larger cortical area than those of the midline nuclei. The laminar distributions of fibres from individual midline and intralaminar thalamic nuclei are different and include both deep and superficial cortical layers. The parataenial, paraventricular and intermediodorsal midline nuclei each project to circumscribed parts of the prefrontal cortex and the hippocampal and parahippocampal regions. In the prefrontal cortex, the projections are restricted to the medial orbital, infralimbic, ventral prelimbic and agranular insular fields, and the rostral part of the ventral anterior cingular cortex. In contrast to the other midline nuclei, the rhomboid nucleus projects to widespread cortical areas. The rostral intralaminar nuclei innervate dorsal parts of the prefrontal cortex, i.e. the dorsal parts of the prelimbic, anterior cingular and dorsal agranular insular cortical fields, the lateral and ventrolateral orbital areas, and the caudal part of the ventral anterior cingular cortex. Additional projections are aimed at the agranular fields of the motor cortex and the caudal part of the parietal cortex. The lateral part of the parafascicular nucleus sends fibres predominantly to the lateral agranular field of the motor cortex and the rostral part of the parietal cortex. The medial part of the parafascicular nucleus projects rather sparsely to the dorsal part of the prelimbic cortex, the anterior cingular cortex and the medial agranular field of the motor cortex. Individual midline and intralaminar thalamic nuclei are thus in a position to directly influence circumscribed areas of the cerebral cortex. In combination with previously reported data on the organization of the midline and intralaminar thalamostriatal projections and the prefrontal corticostriatal projections the present results suggest a high degree of differentiation in the convergence of thalamic and cortical afferent fibres in the striatum. Each of the recently described parallel basal ganglia-thalamocortical circuits can thus be expanded to include projections at both the cortical and striatal levels from a specific part of the midline and intralaminar nuclear complex. The distinctive laminar distributions of the fibres originating from the different nuclei emphasize the specificity of the midline and intralaminar thalamocortical projections.     

面神经下颌缘支的应用解剖

目的了解面神经下颌缘支的正常层次解剖位置,为涉及面侧区和颌下区的美容外科手术提供临床应用解剖学资料。方法解剖33具（共66例）成人尸体标本的头颈部标本,观察了面神经下颌缘支的分支类型、走行、与面动脉的位置关系以及穿出腮腺处和与面动脉的交叉处的体表位置。结果面神经下颌缘支为1-2支,以单干型居多,约占58%,大多行于下颌骨下缘上方约占44%,行于骨下缘下方者占5%。未发现面神经下颌缘支不与面动脉交叉,位置在均下颌角下缘上、下方约0.5-1 cm范围内。面神经下颌缘支经过面动脉的浅面和深面者分别占89%和6%;面神经下颌缘支穿出腮腺处的体表位置分别在下颌角上方和下颌支后缘前方1 cm交点附近,面神经下颌缘支与面动脉交处距下颌支后缘约4 cm,距下颌骨下缘约1 cm。结论面神经下颌缘支的毗邻和行程关系较为复杂,了解其与周围结构的重要位置关系,可以减少美容外科手术因神经损伤造成下唇及口角功能障碍的发生。     

人工髋关节置换后假体松动原因分析

背景：人工髋关节置换已被广泛开展,假体无菌性松动是人工关节置换后的常见并发症,亦是造成人工髋关节置换失败的重要原因之一,假体松动的原因与多种因素有关。 目的：对人工髋关节置换后假体松动的原因进行分析,比较国内外研究文献的发展趋势进行多层次探讨分析。 方法：从人工髋关节置换后的磨损颗粒和相关细胞因子的角度分析与假体松动的相关性,并对中国CNKI数据库学术期刊和Web of Science数据库2002年至2011年收录有关人工髋关节置换后假体松动研究的文献进行分析,运用数据库的分析功能和Excel软件图表的功能分析数据特征。 结果与结论：人工髋关节置换后假体的无菌性松动与关节磨损颗粒、细胞因子、生物力学、患者自身因素、术中操作和术后指导等相关因素有关。CNKI数据库2002年至2011年共收录66篇与人工髋关节置换后假体松动研究相关的文献,Web of Science数据库共收录891篇相关文献,文献数量均处于逐渐上升的发展趋势。国内相关文献的发表数量、被引频次等方面与国外有较大差距。《骨与关节外科杂志：美国卷》是人工髋关节置换后假体松动研究的核心杂志。了解导致人工髋关节置换后假体松动的原因,可以更好指导临床医生预防假体松动的发生,提高患者术后的生活质量。     

Morphological and physiological properties of neostriatal neurons: An intracellular horseradish peroxidase study in the rat

The physiological and morphological (light and electron microscopic) properties of four categories of neostriatal neurons (two types of medium spiny cells and two types of aspiny cells) were analyzed using the technique of intracellular recording and intracellular labeling with horseradish peroxidase. All of the neurons in this study had excitatory responses following stimulation of the cortex and substantia nigra except for the large aspiny neuron for which only substantia nigra inputs were tested. Morphologically, these neurons differed with respect to the size and shape of their somata, density and distribution of dendritic spines and distribution of their axons and axon collaterals. Ultrastructurally, observed somatic differences included the quantity and distribution of organelles and conformation of the nuclear envelope.The axons of one type of medium spiny neuron and the large aspiny neuron were myelinated. Unmyelinated axon collaterals arose from the axons of both types of medium spiny neurons and formed synapses on the dendritic shafts and possibly with the necks of spines of other neostriatal neurons. The parent axons of the most common type of medium spiny neurons were followed to the globus pallidus and, in some cases, to the internal capsule.