胎儿盲肠微血管构筑特点及其相互关系

目的为盲肠微循环提供形态学基础资料。方法通过墨汁灌注组织切片、揭层透明、微血管铸型扫描电镜等方法,观察30具胎儿尸体盲肠微血管构筑并探讨其相互关系。结果盲肠浆肌层在系膜缘侧毛细血管网眼呈与盲肠长轴平行的矩形,而靠近对系膜缘侧的毛细血管网眼多为不规则的五边形;环肌层可见环行肌束间动脉多呈"叶脉状"分为二支,分支间有横行粗短的多曲状吻合支,并由吻合支发蚓状血管;黏膜下层血管较粗网眼密度低。黏膜的毛细血管围绕结肠腺构成毛细血管丛,腺周毛细血管围成椭圆形,腺口毛细血管环均呈四边形。结论胎儿盲肠各层毛细血管网眼形状和密度均有所不同,说明盲肠血供存在部位的差异。     

胎儿十二指肠黏膜层毛细血管构筑

目的　通过对十二指肠黏膜层毛细血管的定性、定量研究 ,为十二指肠黏膜层微循环提供形态学基础。方法　采用组织透明揭层铺片、组织切片及微血管铸型扫描电镜观察 3种方法 ,观测了 2 0例足月胎儿十二指肠壁黏膜层的毛细血管构筑。结果　黏膜层内有腺底毛细血管网和腺周毛细血管网 ,绒毛接受黏膜下微动脉及腺周毛细血管丛发出的交通支的血液。十二指肠球部黏膜层血管出入缘与前后壁毛细血管的网眼密度值及面密度值有差异 ,其余 3部此层无显著性差异。结论十二指肠球部血管出入缘血液循环贫乏可能是该区易发生溃疡穿孔和术后易发生吻合口瘘的原因之一     

胎儿横结肠的微血管构筑

用组织透明揭层铺片,组织切片及微血管铸型扫描电镜观察三种方法,观察了足月新鲜胎儿横结肠肠壁的微血管构筑,血管配布可分为四个层次,浆肌层血管丛主要由缘动脉的长支,短支及粘膜下丛一级血管网发的返支构成,环行有层血管丛有特定的构筑形式,依次形成肌束间,肌束内及肌纤维血管,肌纤维血管呈细小的波浪状称为蚓状血管,粘膜下层血管丛呈“层状”分布,形成三级血管,其一级血管网为结肠器官内血管三维空间联系的交通枢纽,     

胎儿结肠粘膜下层的微血管构筑

用墨汁灌注组织透明辅片及组织切片光镜方法,观测了30例足月新鲜胎儿结肠粘膜下层的微血管构筑。粘膜下血管分支复杂形态各异,吻合方式多样,呈“层状”分布,形成三级血管网,其中一级血管网为结肠器官内血管三维空间联系的交通枢纽,其分支分别参与构成浆肌丛、环行肌丛及粘膜丛。不同结肠段和不同部位血管网的网眼密度均有差异。网眼密度由壁外向壁内逐渐增加。     

食管壁微动脉及毛细血管的观测

目的;观察食管壁内动脉血供及微血管构筑的基础性研究资料。方法：随机选取新鲜胎尸25具,墨汁灌注,组织切片;家兔5只,钙钴法碱性磷酸酶染色。光学显微镜下观测。结果;食管壁内各层均存在动脉网,粘膜下层动脉网丰富,分深浅两层;各层毛细血管特点各异,外膜层稀,肌层有肌束间血管网,粘膜下层呈丛状,粘膜层最丰富;食管各段毛细血管密度差异不大,但颈段前壁纵形肌、胸上段后壁粘膜层有相对毛细血管贫乏区。结论：食管的各段各层均存在动脉网,毛细血管密度差异不大,能有限代偿食管壁外供血动脉的阻断。     

胎儿直肠黏膜下层微血管构筑的研究

目的研究胎儿直肠黏膜下层器官内微血管的分布特点。为临床直肠相关疾病病机的分析及术式改进提供血供方面的基础资料。方法胎儿尸体20例,墨汁灌注,组织切片及组织揭层透明蒲片,光镜下观察直肠黏膜下层微血管的构筑情况,测量黏膜下层毛细血管分部密度。结果上半直肠黏膜下层微动脉多呈环状分布,下半直肠黏膜下层微血管多呈纵行的丛状分布。在上半直肠前壁及直肠颈后壁中线部位存在毛细血管"相对低密度区"。结论直肠黏膜下层的微血管网、丛在整个直肠血供中起核心作用,在上半直肠前壁及直肠颈后壁中线部位存在毛细血管"相对低密度区"。     

空回肠器官内各层微血管构筑特点及相互关系

目的:为空回肠疾病的机制、手术治疗以及肠移植等提供微血管构筑的解剖学基础.方法:通过墨汁灌注、组织切片、揭层透明、微血管铸型扫描电镜等方法,观察空、回肠肠壁各层微血管构筑特点并探讨其相互关系.结果:空、回肠直动脉进入肠壁后分别向浆膜和肌层发出分支,其中浆膜层微血管较稀疏;肌层微动脉走行与肌纤维方向一致,相互间吻合成网;黏膜下动脉分别向肌层和黏膜层发出返支和分支,构成黏膜层和肌层动脉网;黏膜层微血管形态大体与肠绒毛的轮廓和肠腺窝结构相似;空肠在环肌层、黏膜下层和黏膜层毛细血管密度均大于回肠.结论:黏膜下动脉是肠壁的血供枢纽;空肠壁内各层血供均优于回肠.     

成人和胎儿回肠器官内微血管构筑

目的探讨成人和胎儿回肠微血管构筑的异同,为回肠生理机能和病理改变提供解剖学依据。方法通过墨汁灌注、揭层透明、微血管铸型扫描电镜等方法,观察成人和胎儿回肠肠壁各层微血管构筑情况。结果回肠直动脉进入肠壁后分别向浆膜和肌层发出分支,其中浆膜层微血管较稀疏;肌层微动脉走行与肌纤维方向一致,相互间吻合成网;黏膜下动脉分别向肌层和黏膜层发出返支和分支,构成黏膜层和肌层动脉网;黏膜层微血管形态大体与肠绒毛的轮廓和肠腺窝结构相似。结论黏膜下动脉是回肠肠壁的血供枢纽,成人和胎儿回肠微血管形态基本一致。     

空肠和回肠微血管分布特点及其临床意义

目的:为小肠疾病的病机和手术治疗以及小肠移植提供微血管构筑的解剖基础。方法:对30例正常成人尸体小肠标本动脉红色乳胶灌注并解剖剥离,体视显微镜下观察入壁动脉形态并测量其管径;6例新鲜成人游离空回肠标本墨汁灌注,组织揭层透明铺片及组织切片,光镜下观察粘膜下层微动脉配布规律并测量毛细血管密度。结果:①空肠和回肠前后长入壁动脉入肌点位置和管径均不同;②入壁动脉终支-粘膜下动脉形成三级动脉网,并分别向肌层和粘膜层发出返支和分支,构成粘膜层和肌层动脉网。结论:入壁动脉是肠壁动脉主干,粘膜下动脉则是肠壁的血供枢纽。     

胎儿肛管微血管分布特点及其临床意义

目的：研究胎儿肛管微血管的分布特点,为探讨肛门缺血性改变提供微血管的形态依据。方法：墨汁灌注,组织揭层透明铺片及组织切片,光镜下测量胎儿肛管肛门内括约肌及肛膜下区毛细血管网眼密度。结果：胎儿肛管在后中线处肛门内括约肌和粘膜下层存在毛细血管低密度区;肛门内括约肌里微动脉网的干动脉—肌束间动脉走行方向与肌纤维走行方向相垂直,括约肌强度收缩易压迫肌束间动脉,致血供不足。结论：肛管后中线处血供不良和肛门内括约肌痉挛也许是原发性肛裂好发于后连合处的主要原因。     

Scanning electron microscopy of esophageal microvasculature in human infants and rabbits

Summary The microvasculature of the esophagus was studied by scanning electron microscopy of vascular corrosion casts in human infants and rabbits. In both species, segmental circumferential arteries arise from main longitudinal arteries, the latter giving off numerous perforating arteries. The tunica muscularis is supplied by branches of circumferential and perforating arteries, the submucosa and its glands by branches of perforatings. Terminal arborizations of perforating arteries feed a subepithelial capillary network. These capillaries are drained by a venous plexus in the lamina propria which is connected to a submucosal venous plexus. Perforating veins, running parallel to the corresponding arteries, connect the submucosal plexus with circumferential veins, and finally empty into main longitudinal veins. Valves were not present in any of the veins. Submucosal veins were less numerous in man than in rabbit. The number and caliber of equivalent vessels in human submucosal plexus decreased from the pharyngoesophageal to the gastroesophageal junction, suggesting the latter to be at particular risk in portal hypertension. The subepithelial capillary network reveals a longitudinal arrangement in rabbits, while the same network shows no preferential organization in human infants. The microvascular architecture of the esophagus in humans and rabbits is comparable, especially in the lay-out of the venous plexuses and the absence of venous valves. Therefore the rabbit could serve as an experimental model for studies on portal hypertension. The present results strongly suggest particular significance of the venous plexus in the lamina propria for the genesis of esophageal varices.     

Microvascular architecture of the human urinary bladder wall: a corrosion casting study

The vascular system of the urinary bladder wall effectively performs its function in spite of considerable spatial changes due to the filling/voiding cycle. However, only a few studies have dealt with the microvascular architecture of the bladder wall and only two, using old-fashioned techniques, were devoted to the human bladder. This study presents the microvasculature of the human bladder wall visualized by scanning electron microscopy of vascular corrosion casts. Postoperative bladder specimens obtained from patients with advanced bladder tumors were filled with small amount (80 ml) of saline and perfused via at least four largest arteries with anticoagulant-containing saline followed by paraformaldehyde/glutaraldehyde fixative and Mercox resin. After polymerization of the resin, the vascular casts were macerated with potassium hydroxide, cleaned with formic acid and water and freeze dried. Only regions of the bladder wall distant to the tumor were examined in light and scanning electron microscopes. The almost empty state of the bladder was manifested by extensive folding of the mucosa and tortuosity of almost all vessels other than capillaries. The branches of main arteries and veins formed an adventitial/serosal plexus which directly supplied/drained the capillary network of the muscularis and sent long perpendicular vessels to the mucosal plexus. These vessels had straight or coiled course depending on whether they terminated at the top or at the base of the mucosal folds. The rich mucosal plexus followed the folds parallel to their surface and gave off short, straight, mostly perpendicular twigs communicating with the subepithelial capillary network. Apart from very few vascular interconnections between the mucosal plexus and the muscularis, the submucosa was generally avascular. The subepithelial capillary network showed extreme density and uneven contours of the capillaries, only in less folded areas of trigone and urethral orifice the network was looser and capillaries thinner. The capillary system of the muscularis was poorly developed. Due to its architecture, tortuosity, and coiling/uncoiling capabilities, the microvasculature of the human urinary bladder wall seems to efficiently accommodate changes associated with cyclic contraction and stretching. Disturbances in blood flow induced by overdistension of the bladder reported in several studies may be due to pressure of the urine affecting the patency of the vessels rather than to the spatial insufficiency of the vascular system.     

Ulceration of the ileum in Crohn's disease: correlation with vascular anatomy.

BACKGROUND: Ileal ulcers in Crohn's disease tend to lie along the same side of the bowel wall as the mesenteric attachment; the mesenteric and antimesenteric borders are supplied by short and long arteries, respectively. AIM: To examine the localisation of ileal Crohn's ulcers and to test the hypothesis that predilection of Crohn's ulcers for the ileal mesenteric margin is explained by the existence of end arteries that supply the mesenteric margin. METHODS: The localisation of ulcers in the bowel wall was examined in eight resection specimens of Crohn's disease of the terminal ileum. The vascular anatomy of normal terminal ileum (n = 8) and proximal jejunum (n = 8) postmortem specimens was studied; isolated long and short vessels were ligated before perfusion in four of these specimens. RESULTS: All eight specimens of Crohn's disease of the terminal ileum showed longitudinal ulceration along the mesenteric margin. In the postmortem study, the submucosal vascular plexus derived from ileal, but not jejunal short vessels, comprised end arteries with little or no communication with the submucosal plexus arising from long vessels. Prior ligation of ileal, but not jejunal, short vessels resulted in a filling defect of the submucosal plexus along the mesenteric margin in three of the four specimens. Ligation of ileal and jejunal long vessels did not affect carbon ink perfusion of the bowel wall. CONCLUSIONS: In the human terminal ileum, the short vessels supplying the mesenteric margin are end arteries, and their pathological occlusion might cause ischaemia of this region. These findings support a vascular hypothesis for Crohn's disease and may explain, in part, both the ileal and mesenteric distribution of Crohn's disease ulcers.     

人食管壁内血管和神经的分布特点

目的探讨人食管壁内血管和神经的分布特点及两者之间的关系。方法幼年尸体标本14例和成人标本4例,共计18例,采用硅胶血管灌注和再改良Sihler神经染色法相结合来显示人食管壁内血管及神经。结果人食管壁内血管整体分布以胸下段及腹段较密集,而颈段和胸上段相对较稀疏,整体前壁内血管较后壁内稀疏,壁内血管的细小分支间形成广泛的网状吻合。人食管壁内神经整体分布以腹段分布最稀疏,胸段壁内神经分布最多密集,但颈胸段壁内神经均衡分布,颈段上部可与来自于咽丛的神经分支形成吻合,食管壁内神经形成网状环路吻合。食管壁内血管与神经之间无明显的伴行关系。结论人食管壁内血管和神经分布均呈现网状吻合,但两者之间无明显伴行关系。     

Architecture of blood vessels in human fetal gastric corpus: a corrosion casting study.

Vascular architecture of the gastric corpus was investigated in 16-24 wk human fetuses using a corrosion casting technique and the scanning electron microscopy. The general distribution of blood vessels seen in adults has already been established in the fetus, with three major vascular plexuses located in the serosa, submucosa and mucosa. The serosal plexus, supplied and drained by large extramural vessels, contained anastomosing, arcade-like arrays of arteries and veins with their branches piercing the muscularis and communicating with the compact submucosal plexus. Vertical arterioles and capillaries were sent by submucosal arteries to supply a very dense capillary plexus which surrounded the gastric pits and consisted of wide, sinusoidal vessels showing morphological manifestations of angiogenesis by intussusceptive growth. The plexus was drained by vertical venules emptying into submucosal veins. In contrast to the richly vascularized upper half of the mucosa, the lower half showed a relative paucity of blood vessels, probably due to the thinness of the fetal mucosa allowing an effective diffusion of oxygen and nutrients from the upper half. Neither arteriovenous anastomoses, nor end-arteries were found in the fetal stomach. Results of this study support one of the two existing models of mucosal vascularization in the human stomach: i.e. the model postulating the presence of short and long arterioles and two distinct, albeit interconnected capillary networks in the upper and lower zones of the mucosa respectively. In human fetuses, the latter network is absent; it probably develops by remodelling of the preexisting vertical capillaries in the last phase of pregnancy, prior to the onset of gastric gland function.     

Structural and biophysical simulation of angiogenesis and vascular remodeling.

The purpose of this report is to introduce a new computer model for the simulation of microvascular growth and remodeling into arteries and veins that imitates angiogenesis and blood flow in real vascular plexuses. A C++ computer program was developed based on geometric and biophysical initial and boundary conditions. Geometry was defined on a two-dimensional isometric grid by using defined sources and drains and elementary bifurcations that were able to proliferate or to regress under the influence of random and deterministic processes. Biophysics was defined by pressure, flow, and velocity distributions in the network by using the nodal-admittance-matrix-method, and accounting for hemodynamic peculiarities like Fahraeus-Lindqvist effect and exchange with extravascular tissue. The proposed model is the first to simulate interdigitation between the terminal branches of arterial and venous trees. This was achieved by inclusion of vessel regression and anastomosis in the capillary plexus and by remodeling in dependence from hemodynamics. The choice of regulatory properties influences the resulting vascular patterns. The model predicts interdigitating arteriovenous patterning if shear stress-dependent but not pressure-dependent remodeling was applied. By approximating the variability of natural vascular patterns, we hope to better understand homogeneity of transport, spatial distribution of hemodynamic properties and biomass allocation to the vascular wall or blood during development, or during evolution of circulatory systems.     

国人皮肤微血管的三维构筑及其规律性

应用墨汁灌注、光镜观察和ＡＢＳ血管铸型、扫描电镜观察方法，研究成人、儿童和６个月人胚胎皮肤微血管三维构筑的形态学特点，阐释了国人皮肤微血管构筑的普遍性与特殊性规律。结果发现，无论是直接皮肤动脉还是间接皮肤动脉在从深筋膜层进入皮肤各层组织的整个过程中，一边逐渐上升，一边在深、浅筋膜层，真皮网状层，乳头下层及乳头层内形成具有鉴别性特征的五级血管网，为皮肤微循环血管树的五级血管分支。而在指纹、趾纹、鱼际、甲床、包皮、阴囊及龟头等一些特殊皮肤区，微血管构筑则具有其各自特殊的规律性。这种特殊规律性主要表现在皮肤血管树的各级分支的配布特点上。     

内踝区动脉网的显微解剖与隐神经营养血管远端蒂皮瓣的设计

目的：为隐神经营养血管远端蒂皮瓣设计提出解剖学依据。方法：30侧经动脉灌注红色乳胶成年下肢标本，解剖观测内踝区动脉来源、分支、分布及吻合。结果：内踝区动脉有9个来源，构成3条纵向的血管网：(1)内踝前动脉和踝上支的前纵向血管网；(2)骨皮穿支的中纵向血管网；(3)胫后动脉肌间隙支和踝管动脉穿支的后纵向血管网。形成3个层面的血管网：(1)骨膜血管网；(2)深筋膜血管网；(3)皮神经浅静脉血管网。内踝区骨膜、筋膜、大隐静脉、隐神经和皮肤的营养血管同源。结论：内踝区血供来源为多源性，有明显的方向性，吻合十分丰富，可以设计3种包含浅深筋膜、皮神经、浅静脉及其营养血管的小腿内侧远端蒂皮瓣：(1)以胫后动脉肌间隙支为蒂，旋转轴点在内踝最凸出点上3cm；(2)以内踝前动脉筋膜穿支为蒂；(3)以踝管区动脉穿支为蒂，旋转轴点在内踝最凸出点平面。