Formation of new corticorubral synapses as a mechanism for classical conditioning in the cat

An electron microscopic quantitative study of corticorubral synapses was performed in the cat which acquired classical conditioning. Conditioned stimulus was applied to the cerebral peduncle and the unconditioned stimulus was an electrical shock to the forelimb skin. The proportion of corticorubral synapses contacting with somata and proximal dendrite was increased after conditioning. It was suggested that collateral sprouting and the formation of new synapses underlie classical conditioning.     

伴交感神经症状颈椎病临床评价初步探讨

目的报告伴交感神经症状颈椎病的临床评价方法及其初步结果。方法回顾性分析2002~2007年本治疗组伴交感神经症状的颈椎病患者47例,其中男19例,女28例,男女比例为1∶1.5;年龄为34~72岁,平均50.5岁。入选条件:①明确诊断为脊髓型或神经根型\脊髓神经根混合型颈椎病。②均有交感神经症状。③患者均行颈前路减压植骨融合内固定手术,术中均切除后纵韧带。其中8例术前影像学显示有椎节不稳,其余患者未见明显钩椎关节骨质增生及颈椎不稳。交感神经症状包括:眩晕,头痛,恶心呕吐,耳鸣,视物模糊,心慌,记忆力下降,心动过速或心动过缓或早搏等心电图异常,胃肠道症状,面部潮红,出汗等。交感神经症状评价采用20分评分法及患者主观满意度评定。患者主观满意度分为优、良、可、差4个等级。结果所有患者术后均获10~48个月随访,术前交感症状评分6.0分;术后2.8分;患者主观满意度19例为优,16例为良,8例为可,4例为差,有效率为87.5%。结论切除后纵韧带的颈前路减压植骨内固定术对交感神经症状具有一定治疗作用。     

Fact or Fiction? MRI of Alar Ligaments and Craniocervical Junction Joints in Whiplash Syndrome

Abstract Whiplash injury of the cervical spine is a frequent issue in medical expertises and causes enormous consequential costs for motor insurance companies. Some authors accuse posttraumatic changes of alar ligaments to be causative of consequential disturbances, although biomechanical experiments achieve contradictory results and neuropsychiatric studies do not support this thesis. MRI provides excellent visualization of alar ligaments. However, signal alterations of alar ligaments must be differentiated from common normal variants. Functional MRI provides no diagnostic yield.      

颈内动脉狭窄或闭塞侧支循环途径的DSA和MR血管成像研究

目的　研究DSA、MR血管成像 (MRA)对颈内动脉狭窄或闭塞后侧支循环途径评价的意义。方法　颈内动脉狭窄或闭塞者 74例 ,DSA和MRA上脑血管正常表现者各 6 0例为对照组 ,分析其DSA和MRA表现。结果　 74例患者均有颈内动脉分叉以上狭窄或闭塞。病变同侧后交通动脉在DSA上的出现率 ,疾病组低于对照组 (P =0 0 2 5 ) ;在时间飞跃 (TOF)法MRA上的出现率 ,疾病组明显高于对照组 (P =0 0 0 0 )。后交通动脉DSA、MRA测量值均较对照组增大 (P =0 0 0 0 )。眼动脉直径DSA测量值较对照组增大 (P =0 0 0 3)。疾病组后交通动脉出现率在DSA上高于MRA (P <0 0 5 )。结论　DSA对本病侧支途径评价有重要意义 ,为术前必要检查。MRA安全 ,可从形态和功能上评价侧支循环 ,可做为首选方法     

膝关节后外侧结构的解剖与MRI研究

目的 改进膝关节后外侧结构MRI定位方法，提高后外侧结构损伤的诊断准确率。方法 解剖膝关节标本，辨认后外侧各结构起止点及走行，明确它们之间的解剖关系。以注水的输液器缝合标记各结构进行MRI扫描，测量各结构在矢状面和冠状面上与腓骨颈长轴之间的夹角。按照这些角度定位扫描正常膝关节，观察各结构在MRI中完整显示的情况。结果 （1）测得矢状面上腓侧副韧带和胴肌腱关节囊内部分与腓骨颈长轴的夹角分别为（11．5±1.7）°和（39．5±6，4）°冠状面上胴肌腱关节囊外部分和胴腓韧带与腓骨颈长轴夹角为（39.5±3．9）°和（31．9±3．9）°。（2）腓侧副韧带在11°后斜冠状位1个层面上完整显示占90％，胴肌腱关节囊内部分在40°后斜冠状位1个层面上完整显示占80％，胭肌腱关节囊外部分在内斜40°矢状位1个层面上完整显示占90％，胭腓韧带在外斜30°矢状位1个层面上完整显示占90％。此外，胴腓韧带在11°后斜冠状位1个层面上完整显示的占75％，股二头肌腱和髂胫束在常规冠状面均能够很好显示.结论 选择完整显示腓骨茎突和腓骨颈的冠状面和矢状面为基准面，按照后外侧各结构与腓骨颈长轴所呈角度进行定位，层厚2mm的MR扫描能很好地显示膝关节后外侧解剖结构。     

The Hyperplantarflexion Ankle Fracture Variant

Various patterns of ankle fractures that are not accounted for by common classification systems have been the subject of case reports. The first difficulty with these variant patterns is recognizing all associated pathology, followed by the successful application of stable fixation. The purpose of this study was to describe the common morphologic features and ligamentous injuries of a unique variant fracture pattern, as well as the surgical treatment technique and the short-term functional and radiographic outcomes. Of 121 consecutive unstable ankle fractures over a 2-year period, 7 patients were found to have a similar constellation of injuries around the ankle. A vertical shear fracture of the posteromedial tibial rim was the main feature. Six of the 7 also had a fracture of the posterior malleolus. On magnetic resonance imaging, the deltoid and posterior tibiofibular ligaments were intact in all cases. Fractures were treated with open anatomic reduction of the posteromedial and posterior fragments with antiglide plate fixation. All fractures healed at 2 months without loss of reduction, fixation failure, or surgical complications. The average American Academy of Orthopaedic Surgeons lower extremity score was 79 at an average of 8 months' follow-up. The common radiographic and morphologic features associated with this posteromedial fracture indicate that it likely occurs through a common mechanism that involves hyperplantarflexion. The characteristics of this fracture pattern have not been fully described previously, but this ankle fracture variant may occur in up to 6% of cases. Unstable ankle fractures should be evaluated carefully for evidence of posteromedial involvement so appropriate treatment may proceed.     

血管内皮生长因子定向转染诱导缺血心肌血管生成的研究

目的观察血管内皮生长因子（VEGF）质粒直接心肌注射对兔急性心肌缺血后侧支循环形成的影响。方法建立兔左冠状动脉结扎的急性心肌缺血模型，取缺血边缘区以先期构建的真核表达质粒pcDNA3／VEGF165和真核载体pcDNA3的DNA分别多点心肌注射，给药后2、4周取材分别行逆转录-聚合酶链反应（RT-PCR）和蛋白浓度分析、苏木素-伊红（HE）染色、VEGF染色。结果治疗组VEGF165 mRNA含量较对照组明显增多；蛋白浓度分析转染后VEGF165显著增多，高峰出现于实验后2周；治疗组缺血心肌新生血管数目明显多于对照组。结论VEGF165外源性基因能在转染心肌细胞后成功表达，促进了缺血心肌血管新生和侧支循环形成。     

Base anatomique d'un nouveau concept de stabilité du carpe

Résumé Le concept de stabilité du carpe repose sur l'anatomie et la biomécanique. Celles-ci nous permettent de constater que le lunatum est le centre de deux axes fonctionnels: l'un longitudinal, mécanique, l'autre transverse, dynamique. Le lunatum est fermement stabilisé au radius et au complexe ligamentaire cubital par le V proximal: il devient ainsi un élément porteur; il est de plus fermement uni aux os voisins, le scaphoideum et le triquetrum, avec lesquels il forme une unité fonctionnelle intercalaire différenciée. Le guidage de cette unité est assuré par le V distal et le ligament radio-triquetrum dorsal.

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Summary Based on anatomical and biomechanical evidence, we conclude that the stability of the carpus relies on the lunate bone which is the centre of the longitudinal as well as the transverse functional axis. The lunate is firmly stabilised proximally to the radius and the radio-ulnar ligament complex by the proximal V-ligament, and so becomes a weight bearing structure. It is anchored by strong ligaments to the scaphoid on one side and the triquetrum on the other, thus forming a 3-bone intercalary system, which is in turn guided by the palmar distal V-ligament and the dorsal radio-triquetral ligament.

     

掌指关节的三维解剖及形态分析

目的：观测掌指关节关节面的几何形态,为人工关节的设计和应用提供解剖学依据。方法：10只成人手标本,解剖掌指关节,测量侧副韧带起点距掌骨头关节面的直线距离,三维数据检测仪获得关节面三维坐标数据,应用SPSS软件进行统计分析和成像。结果：掌骨头有双髁结构,桡侧髁略大,第1掌骨头形态特殊;各掌骨头高度的比较无显著差异;其掌侧关节面大于背侧,第2、3掌骨头关节面面积明显较大。近节指骨底在形态、高度和面积方面各序列相似;各序列侧副韧带起点桡侧较尺侧距离掌骨头关节面远。结论：手指人工关节的设计应符合解剖形态,并根据各序列形态的差异进行个体化设计,尤其拇指更应区别对待;手指人工关节的设计和应用中应注意软组织保护,关节的切除范围应注意保留侧副韧带的起止点。     

Anatomy of spontaneous splenorenal and gastrorenal venous anastomoses: Review of the literature

Summary Portal hypertension is characterised by the development of a collateral portocaval circulation. Among these venous reroutings, some are situated posteriorly in the left subphrenic compartment. These are the spontaneous splenorenal and gastrorenal anastomoses. Their incidence is estimated at around 16%. On the one hand, there are the direct shunts, which anastomose the spelling v. to the left renal v., of an anecdotal nature, and on the other the spontaneous indirect splenorenal shunts, characterised by the presence of a complete neurovascular pedicle traversing the gastrophrenic ligament. This relates to the gastric collateral v., which is connected to the left renal v. via the inferior v. of the left crus of the diaphragm and the middle capsular v., hence the name gastro-phreno-capsulorenal shunt. At an advanced stage of portal hypertension these splenorenal shunts may acquire a major caliber and behave like actual surgical shunts.

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Anatomie des anastomoses veineuses spléno-rénale et gastro-rénales spontanées: revue de la littérature

Résumé L'hypertension portale se caractérise par le développement d'une circulation collatérale porto-cave. Parmi ces dérivations veineuses, certaines ont une topographie postérieure, localisée dans la loge sous-phrénique gauche. Ce sont les anastomoses spontanées splénorénales et gastro-rénales. Leur prévalence est estimée aux alentours de 16%. On distingue, d'une part, les shunts directs, qui anastomosent la v. splénique à la v. rénale gauche, de constatation anecdotique, non systématisés sur le plan anatomique ; d'autre part, les shunts splénorénaux spontanés indirects caractérisés par l'existence d'un pédicule complet vasculo-nerveux, cheminant dans le ligament gastro-phrénique. Il s'agit de la v. collatérale gastrique qui est reliée à la v. rénale gauche par l'intermédiaire de la v. inférieure du pilier gauche du diaphragme et de la v. capsulaire moyenne, d'où le nom de shunt gastro-phrénocapsulo-rénal. A un stade avancé de l'hypertension portale, ces shunts splénorénaux peuvent acquérir un calibre important et se comporter alors comme de véritables shunts chirurgicaux.