腓肠内外侧血管解剖特点及其在小腿创伤修复中的意义

目的：为小腿创伤皮瓣移植修复与腓肠内、外侧血管吻合提供解剖学基础。方法：在７０侧成人下肢标本上解剖观测了腓肠内、外侧血管的长度、外径、血管神经的毗邻关系及其形态特点。结果：①腓肠内、外侧动脉起于动脉，伴行静脉注入静脉；②动脉起点至入肌段的长度内、外侧分别为４．１±０．７（１．８～６．４）ｃｍ、３．７±０．５（２．０～６．５）ｃｍ；③肌门处内、外侧动脉的外径分别为２．２±０．１（１．１～３．４）ｍｍ、２．０±０．１（０．９～３．１）ｍｍ；④肌门处伴行静脉有１～２条，内、外侧静脉外径为２．５±０．３（１．８～４．５）ｍｍ，２．３±０．３（１．５～４．１）ｍｍ。结论：腓肠内、外侧血管恒定、径粗、较长，是小腿创伤皮瓣移植修复受区可供应用的吻合血管     

小腿后部各区穿支间的关系与皮瓣设计

Objective To study the anastomotic relationships of perforators in each zone of the poste-rior leg and design perforating flaps for clinic. Methods Six fresh cadavers underwent a whole body, intra-arterial injection of a lead oxide and gelatine preparation. The posterior part of leg is divided into upper, mid-die and below equal parts, Observe topography of the perforating branches in every district by layer, and mea-sured their location, diameter, course, branches and anastomosis pattern. Radiographs of tissue specimens were digitally analyzed. Results There were 13 perforators that diameter≥ 0.5 mm, the average external diameter was 0.8 mm. The areas of each perforator supplied was average 38 cm2. Perforators from popliteal artery was identified an area 4 cm wide, around the intersection of two lines, a line drawn between the medial and lateral epicondyles of the femurs, and the midline of posterior leg. The areas of the every perforator sup-plied was 55 cm2. These vessels were large in diameter and create multiple true anastomoses with the perfora-tors from the posterior tibial artery or fibular artery. Perforating branches were small in the below part, a long perforator chain comprised of two to three perforators accompanies the Achilles tendon. Conclusion The perforator flaps deviced by perforators from the posterior leg may be transplanted to the lower limbs and the other part of the body. The perforators located in the middle zone of the leg are larger. Free posterior tibial or peroneal perforator-based flaps are reliable, relatively large, and have thin flaps. The upper and lower zones were the larger donor site for the proximal or distally pedicled perforator flap harvest.     

Inside the lactating breast: the latest anatomy research

Although it is well recognized that a thorough understanding of the anatomy of an organ is essential to enable assessment of any abnormalities in that organ, there has been little investigation of the anatomy of the normal lactating breast since Sir Astley Cooper performed detailed dissections of the anatomy of the breast more than 160 years ago. Many mothers recognize that breast milk provides the ultimate nutrition and protection for the infant; however, a significant proportion of women experience difficulties breastfeeding, some of which lead to weaning the infant. Recently, a small number of studies have focused on the gross anatomy of the breast, and have found that the ductal system is comprised of fewer numbers of main ducts than previously thought. In addition, the ducts are compressible and do not contain large amounts of milk, the amount of fatty tissue in the breast is variable, and a proportion is situated within the glandular tissue. These findings add to our understanding of both the physiology and pathology of the lactating breast.     

以信息技术构建系统解剖学网络课程体系的实践和思考

为推动医学教育的信息化建设,进一步提升教师的信息化的认知,遵义医科大学积极推广数字化教学工具,创新教育教学管理,促进信息技术与教育的深度融合。为此选择临床专业系统解剖学进行网络课程体系的建立,利用Camtasia studio 9、Adobe After Effects CS6及格式工厂等视频软件制作系统解剖学的网络课程,并在超星学习通平台上打造专属的系统解剖学网络课程体系,进行线上教学模式的探索。通过对线上、线下教学的评估得知,此次线上教学改革达到了预期的教学效果,激发了学生学习的自主性,实现了系统解剖学的教学要求;但还有许多问题,如何将线上线下更好地融合,还有待进一步探索。     

Sparing of the flexor carpi ulnaris in ulnar neuropathy at the elbow

A common misconception attributes sparing of the flexor carpi ulnaris (FCU) in ulnar neuropathy at the elbow (UNE) to its innervating branch arising "at or above the elbow." We examined the relationship of FCU branches to the medial epicondyle (ME) and humeroulnar aponeurotic arcade (HUA) in 30 cadaver elbows. In only three did the first FCU branch arise at or proximal to the ME. In 36 UNE cases with fibrillations in the first dorsal interosseous, the FCU was normal in 10, mildly abnormal in 11, and severely abnormal in 15. FCU involvement correlated with the severity of the neuropathy and with whether compression was retroepicondylar or at the HUA. We conclude that sparing of the FCU in UNE is unrelated to the level of origin of its innervating branch, but rather is related to the internal neural topography and to the severity and level of compression.     

Severe rhinosinusitis

Rhinosinusitis is diagnosed frequently in clinical practice, but the term may in fact encompass a wide spectrum of diseases. Inflammation of the nasal and sinus mucosa can arise from various causes and lead to different sequelae. Moreover, the term rhinosinusitis is more accurate than sinusitis. Causes range from a viral infection leading to the common cold to an invasive, fungal infection. An accurate diagnosis is important because effective therapy is available if recognized early and if specific therapy is used. Importantly, there is a close relationship between upper and lower airway disease and each have unique structural and functional differences that make an understanding of rhinosinusitis important not only for upper airway disease, but also for the management of asthma. All too often, rhinosinusitis becomes chronic and this becomes a challenge because medical therapy may not be sufficient to control disease. Finally, we should note that the differential diagnosis of rhinosinusitis is extensive and physicians should place heavy emphasis not only on the history, but also on appropriate imaging studies. A normal exam does not rule out the possibility or rhinosinusitis. Finally, we should emphasize that effective treatment is dependent on the etiology of the symptoms but also dependent on whether it is acute or chronic.     

先天性高肩胛症的局部解剖特征及手术治疗

目的 :报道先天性高肩胛症的病理及局部解剖特征及其手术疗效。方法 :临床观察了 12例先天性高肩胛症软组织和骨骼的局部解剖特点 ,并采用肩胛骨上部切除和改良Woodward手术联合治疗。结果 :随访 12～ 3 0个月 ,肩胛骨下移 1～ 2肋间隙 ,平均 1.7肋间隙 ,肩部外观、肩关节功能均明显改善。结论 :先天性高肩胛症为软组织和骨骼的复合病变 ,联合手术可明显改善畸形和关节功能     

Willis环形态与功能对照研究

目的：从不同角度分析Willis环的形态学变异及其功能状况。方法：分别采用脑尸解标本、血管铸型标本及动态血管造影资料进行Willis环的对比分析。结果：正常成人组尸体与活体Willis环分型无差异；活体正常组与活体病理组Willis环的比较有差异；活体正常组与活体病理组PCA供血类型有差异。结论：胎儿与成人、尸体与活体、静态与动态、正常与异常的有机结合能全面评价Willis环的形态学变异及其功能状况，为临床正确诊治脑血管病提供基础依据。     

腰丛神经的数字化解剖及其临床意义

目的:对腰丛及其周围的组织结构进行可视化的研究,为微创手术提供更精确的数据和解剖学资料.方法:利用“虚拟中国人“Ⅰ号女性数据集,重建腰丛及其周围组织结构的三维可视化模型.结果:通过数字人数据集重建的三维图片显示腰丛神经及其主要分支与主要血管和椎体及肾脏之间的关系,又可清楚的显示腰丛神经与腰大肌之间的关系.结论:数字人数据集可提供腰丛和周围组织器官的断层图片,为腰丛的解剖学位置及腰椎前路手术提供了形态依据.     

IMMUNOHISTOCHEMICAL DISTRIBUTION OF CANNABINOID CB 1 RECEPTOR IN THE RAT CENTRAL NERVOUS SYSTEM

IMMUNOHISTOCHEMICAL DISTRIBUTION OF CANNABINOID CB 1 RECEPTOR IN THE RAT CENTRAL NERVOUS SYSTEM@邹冈