先天性三尖瓣畸形及其功能影响

在１５６例先天性心血管畸形标本的观察和测量中，检出先天性三尖瓣畸形２５例（１６．０２％），其中Ｅｂｓｔｅｉｎ＇ｓ畸形６例，三尖瓣发育不良１４例，三尖瓣缺如１例，三尖瓣瓣叶或／和腱索骑跨４例。用测量及比较解剖学的方法探求三尖瓣畸形与其功能的影响。结果显示：Ｅｂｓｔｅｉｎ＇ｓ畸形和三尖瓣发育不良的心脏构筑都有明显的变化，而且两者存在一定的差异，同时明确了Ｅｂｓｔｅｉｎ＇ｓ畸形的病理诊断标准和三尖瓣发育不良的分类。     

枕动脉的临床解剖学

在44例成人头颅材料上对枕动脉走行分三段调查.第一段位于颈动脉三角内.长2.9±0.4cm,分出脑膜支、肌支;第二段位于胸锁乳突肌和头夹肌深面,长5.8±0.5cm,分出乳突支、耳支、降支、颅后支,第三段是枕动脉浅出点至上横线的头皮支.长11.7±1.3cm,一般分为Ⅱ主支型(占75%).枕动脉起始部外径3.1±0.2mm;浅出点(A点)外径2.8±0.4mm;头皮支的B点外径2.1±0.2mm、C点1.7±0.4mm、D点2.0±0.3mm 、E点1.6±0.4mm.对头皮支的分型分布提出了体表定位方法.结合临床颅内、外动脉吻合术和动脉逆行插管术的应用进行了讨论.     

Gross anatomy: An outdated subject or an essential part of a modern medical curriculum? Results of a questionnaire circulated to final-year medical students

Final-year undergraduate medical students were given a questionnaire on the gross anatomy curriculum they had experienced in their first year at medical school 5 years earlier. They were asked to evaluate the relevance of the dissection course, lectures and seminars in gross anatomy for clinical courses, clerkships, and everyday practical work on the ward. About two-thirds of the students found the time spent on 10 different regions in anatomy to be adequate, and a considerable number of students would have liked even more details. The vast majority expressed a wish to repeat topographical anatomy during their clinical teaching. Furthermore, ～75% of the students showed interest in short, specialized dissection courses during the clinical curriculum. Medical students just before graduation ranked gross anatomy with the dissection course and integrated clinical topics as a keystone for their clinical courses. The results of such surveys should be taken into consideration when discussing modification to teaching gross anatomy or arguing about a balanced dissection course. © 1993 Wiley-Liss, Inc.     

Study on the anatomical dimensions of the human sigmoid colon

Although the sigmoid colon is commonly afflicted with disease, studies on its anatomical dimensions are scarce. It is suspected that dimensions of the sigmoid colon change with age. This study documents data on the anatomical measurements of the sigmoid colon in 70 Indian subjects (51 live and 19 cadavers). Seven parameters of sigmoid colon anatomy measured included length and width of the sigmoid colon and mesocolon at specific points. Three mesocolic indices (width to length ratios) were calculated. Comparisons of measurements in the live and cadaver subjects and in the two sexes were made. The relationship of change in parameters with age was assessed. Appropriate statistical methods were used and the differences were considered significant at P < or = 0.05. The study showed wide ranging variations in the values of various measured parameters of the sigmoid colon. Seven patterns of the shape of the sigmoid loop were identified. In the commonest pattern the sigmoid mesocolon was vertically longer than wide (dolichomesocolic), the sigmoid loop having its maximum convexity located just a little proximal to the apex. Patterns where the width of the mesocolon was greater than the vertical length (brachymesocolic) were also observed. The gender analysis showed that the sigmoid mesocolon of the female was brachymesocolic (wider than long), whereas that of the male was dolichomesocolic (longer than wide). This might explain the higher incidence of sigmoid volvulus in the male. This study also showed that the measurements of the sigmoid colon and its mesocolon do not change significantly within the age range of 16-60 years in the two sexes. Also noteworthy is the observation that in the cadaver the sigmoid colon shows considerable shrinkage, particularly of its mesocolon; consequently the data from cadaver subjects, though valuable for anthropometric use, have limitations when used for clinical applications.     

掌背动脉皮瓣的应用解剖

目的：手指软组织损伤，使用手背动脉皮瓣进行修复，手术简单，转移方便，并能很好满足手指修复中对于弹性，厚度，韧度，感觉和活动功能等诸多要求，方法：４３只上肢标本，色素动脉灌注，解剖掌背动脉及分支，结果：观测掌背动脉起源，形态，分支吻合，管径，并计算各吻合点的自比例定位，结论；提出掌背动脉轴形皮瓣应用范围及可行性，为临床提供解剖学资料和手术操作要点。     

Linear parameters of normal and abnormal cava septi pellucidi: a post-mortem study

Anatomical variations in the dimensions of different brain structures have been correlated with clinical syndromes. This study on the parameters of normal and abnormal cavum septi pellucidi (CSP) can be of clinical significance. We obtained 479 brains from autopsied persons (310 males and 169 females, 377 normal or asymptomatic and 102 abnormal or symptomatic persons, aged 22-89 years) and observed that 110 brains (75 males and 35 females) had CSP. These cava were classified into two groups depending on the past medical histories of the autopsied person: 40 asymptomatic and 70 symptomatic cava. We have defined symptomatic cava as those in autopsied persons who had known past medical history of psychiatric or neurological disease. Asymptomatic cava were in autopsied persons who had no known past medical history of psychiatric or neurological disease. The CSP parameters (length, width, depth) of the symptomatic and asymptomatic groups were measured and were statistically analyzed. Analysis showed that the cava in the symptomatic group were significantly longer and wider. Discriminant function analysis was used to derive a mathematical formula to classify CSP into an asymptomatic or symptomatic group based on length and width measurements of the cavum.     

乙状窦后进路内窥镜手术解剖学研究

目的：为乙状窦后进路相关内窥镜手术提供解剖学依据。方法：测量30例干颅骨表面标志位置关系，准确定位乙状窦后进路骨窗；利用10具甲醛固定成年头标本模拟内窥镜下乙状窦后进路，验证其可行性。结果：(1)以星点至乳突点连线中点为中心作直径2．0cm的骨窗适于暴露桥脑小脑角区结构；(2)内镜下乙状窦后进路可在尽量减少压迫小脑的情况下充分暴露桥脑小脑角区神经、血管等重要结构。结论：精确定位乙状窦后进路骨窗能够最大限度减少牵托小脑，对临床开展锁孔手术有指导意义。     

不同节段椎弓根内部结构的测量和比较

目的:提供国人椎弓根内部结构的量化数据以及随节段变化的规律.方法:20具成人防腐C3～L5脊柱标本,螺旋CT扫描后行多平面重建,在椎弓根峡部横截面上测量椎弓根高度(PH),宽度(PW),内、外、上、下缘皮质厚度(MCT、LCT、SCT、ICT),及椎弓根内部松质骨的宽度和高度(SBW、SBH).运用统计软件系统比较椎弓根内部各个参数的变化.结果:椎弓根左右两侧没有显著性差异,男女间除LCT外,各参数均无显著性差异.LCT/PW为(20.72±5.77)%,MCT/PW为(32.87±7.47)%,SCT/PH为(24.33±6.07)%,ICT/PH为(22.51±5.17)%,SBW/PW为(46.41±11.76)%,SBH/PH为(53.17±10.15)%.MCT绝对值及所占的比例在各个节段上均显著大于LCT.各个节段椎弓根皮质骨与松质骨的比例有所不同.C6～T1,T8～T12为椎弓根内部结构变化较大的区域.结论:(1)薄层螺旋CT可较好的呈现椎弓根内部的情况;(2)上胸椎椎弓根是置入椎弓根螺钉的危险区域;(3)椎弓根外侧皮质较内侧皮质薄,在置入椎弓根螺钉时外侧更容易破裂.     

家猪心脏纤维支架的大体解剖

目的　观察猪心纤维支架 ,为猪心的研究和比较解剖学积累资料。方法　取甲醛固定后的猪心2 7例 ,液态塑料浸渍的塑化猪心 5例 ,解剖显示纤维支架后用游标卡尺进行观测。结果　猪心左纤维三角的三边分别平均为 17 4 1± 1 99mm、18.96± 3.2 6mm和 17.6 4± 2 .4 4mm ;右纤维三角三边分别为 15 .83± 2 .11mm、16 .19± 1.94mm和 2 0 .96± 2 .6 2mm ;二尖瓣环、三尖瓣环的周长平均为 73.0 0± 9.71mm ,6 8.89±7.2 4mm ;主动脉瓣环和肺动脉瓣环直径分别为 18.4 4± 2 .89mm和 16 .0 3± 2 .6 3mm ;猪Todaro腱呈扁带状 ,走行部位较深 ,且分支较人心多 ,长度为 2 0 98± 4 2 0mm。结论　猪心纤维支架与人类形态结构相似 ,但瓣环周长和Todaro腱形态有一定差别。     

脊柱胸腰段薄层断层解剖及临床意义

目的：明确脊柱胸腰段冠状、矢状和横断面解剖学特点，探索薄层断层切片在观测各髓节及脊神经根走行过程的临床应用价值。方法：采用40具成人脊柱胸腰段标本经改良火棉胶包埋法处理，制作16具冠状、8具矢状和16具横位的0．25mm厚连续切片，观察脊神经根走行于侧椎管和椎间管不同区段的解剖关系和椎间孔韧带分布特征，并直接测量相关结构参数。结果：观测了脊柱胸腰段A、B、C、D经4区横断层面、经椎间管内口矢状层面、经两侧椎弓根中心冠状层面的形态和相关参数。结论：三种方位断层切片可较好显示诸多结构位置关系，对脊髓或脊神经源性疾病诊疗和正确辨认手术视野所见具有重要价值。