颈椎横突孔和椎动脉的观测及其临床意义

本文观察150个正常成人离体颈椎（C3－C6）的横突孔和30具成人尸体（男18、女12）的椎动脉，测量两侧横突孔的内径、横突孔-钩突间距和椎动脉在第六颈椎横突孔下方的外径。观察结果，横突孔的横径左侧为6．82±0.75mm，右侧为6．71±0．86mm；横突孔的失状径左侧为5．68±0．82mm，右侧为5．45±0．76mm。椎动脉的外径左侧为3．80±0．65mm，右侧为3．20±0．45mm。结果表明，正常横突孔的内径明显大于椎动脉的外径，但横突孔内壁骨质增生或钩突增生突入孔内，并压迫椎动脉时，会引起椎动脉型颈椎病。     

侧颅底应用解剖学研究

目的：通过对侧颅底解剖学结构的观察与测量,为临床侧颅底手术的定位、导航提供解剖学依据。方法10％甲醛浸泡的成人尸头10个（20侧）,观测颈静脉球区域神经血管、颈内动脉毗邻的解剖关系。结果颈静脉球,其形态可分为隆起型和低平型,舌咽神经多位于颈静脉球前内侧者,迷走神经和副神经多位于颈静脉球内侧者,颈内动脉岩骨段距离鼓膜张肌的长度平均为2．2mm,距离下颌神经和脑膜中动脉的平均长度分别为6．9mm和6．8mm。结论侧颅底血管和神经分布密集,术者了解侧颅底血管和神经的解剖关系,有利于手术中安全扩大手术视野,避免术中损伤血管、神经。     

A study of the nutrient foramina in human long bones

Summary The present study analyzed the location and number of the diaphysial nutrient foramina in six long bones of adult human skeletons of unknown age and sex from a statistical view point. The diaphysial nutrient foramina in the humerus, are located at between 50 and 65 % of the total length; in the radius and ulna, at between 25 and 50 %; in the femur, at between 25 and 58 %; in the tibia, at between 30 and 40 %; and in the fibula at between 35 and 67 %, i.e. the middle third of the bone. Also studied were the anatomical position and number of the diaphysial nutrient foramina in each bone.

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Etude des trous nourriciers des os longs humains

Résumé Ce travail est une étude statistique du siège et du nombre des trous nourriciers de la diaphyse des six os longs de sujets adultes d'âge et de sexe non connus. Le niveau du trou nourricier de la diaphyse humérale se situe entre 50 et 65 % de la longueur totale de l'os; au niveau du radius et de l'ulna, il est entre 25 et 50 %; au niveau du fémur, entre 25 et 58 %; au niveau du tibia entre 30 et 40 % et au niveau de la fibula entre 35 et 67 %, c'est-à-dire au tiers moyen de l'os. La situation anatomique exacte et le nombre de trous nourriciers a été également Précisé pour chaque os.

     

免气腹单孔腹腔镜在普外科疾病治疗中的应用

目的评价免气腹单孔腹腔镜在普外科相关疾病治疗中的临床应用效果。方法 2011年1月至2010年11月为开展免气腹单孔腹腔镜胆囊切除术15例,开展免气腹单孔腹腔镜阑尾切除术5例,开展免气腹单孔腹腔镜疝修补术3例。观察手术可行性、安全性、微创性及美容效果。结果 18例均获成功。手术时间平均52min,术中无并发症发生。术后无并发症。结论免气腹单孔腹腔镜技术上可行且相对安全,瘢痕得到较好隐藏是其主要优势。适于对美容效果有较高要求的患者。     

眶下孔相关径线测量及定位研究

目的　测量完整人颅骨的眶下孔的相关径线,为临床应用提供数据。 方法　用游标卡尺测量60例（120侧）成人眶下孔内径的长径和短径,并观察孔的形状,观察副孔的数量。测量眶下孔到眶下缘的距离,切此线与面部前正中线平行。测量眶下孔到梨状孔外缘的距离,切此线与面部前正中线垂直。 结果　① 眶下孔为圆孔（10%）和椭圆形孔（90%）;②左右两侧眶下孔副孔总的出现率为2.5%。③眶下孔的长径为（4.24±0.91）mm（2.48~7.59 mm）。④眶下孔的短径为（2.55±0.48）mm（1.37~3.63 mm）。⑤眶下孔到眶下缘的距离为（8.54±1.60）mm（5.16~13.63 mm）。⑥眶下孔到梨状孔外缘的距离为（16.55±2.01）mm（11.73~23.17 mm）。 结论　完善人颅骨眶下孔的形态学资料,为临床开展眶下孔的应用研究提供数据。     

腹壁悬吊式单孔腹腔镜胆囊切除临床研究

目的:探讨腹壁悬吊式单孔腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床效果。方法:选取我院符合腹腔镜胆囊切除术标准的患者70例,实验组(30例)行腹壁悬吊式单孔腹腔镜胆囊切除术,对照组(40例)行三孔腹腔镜胆囊切除术,对两组的手术时间,术后出血、术后并发症,胃肠功能恢复时间,术后疼痛,住院时间进行比较。结果:两组手术时间、术中出血量比较均无统计学差异(P>0.05),而术后恢复情况,包括下床活动时间、进食时间、住院天数,实验组均少于对照组,差异均具有统计学意义(P<0.05)。两组均无严重术后并发症的发生。结论:腹壁悬吊式单孔腹腔镜胆囊切除术安全可行,术后恢复更快,尤其适用于心肺功能差的患者,值得推广,但因手术操作范围窄和器械的限制,手术操作难度大,需要进一步改进手术器械。     

The First Korean Patient with Potocki-Shaffer Syndrome: A Rare Cause of Multiple Exostoses

Potocki-Shaffer syndrome (PSS, OMIM #601224) is a rare contiguous gene deletion syndrome caused by haploinsufficiency of genes located on the 11p11.2p12. Affected individuals have a number of characteristic features including multiple exostoses, biparietal foramina, abnormalities of genitourinary system, hypotonia, developmental delay, and intellectual disability. We report here on the first Korean case of an 8-yr-old boy with PSS diagnosed by high resolution microarray. Initial evaluation was done at age 6 months because of a history of developmental delay, hypotonia, and dysmorphic face. Coronal craniosynostosis and enlarged parietal foramina were found on skull radiographs. At age 6 yr, he had severe global developmental delay. Multiple exostoses of long bones were detected during a radiological check-up. Based on the clinical and radiological features, PSS was highly suspected. Subsequently, chromosomal microarray analysis identified an 8.6 Mb deletion at 11p11.2 [arr 11p12p11.2 (Chr11:39,204,770-47,791,278)×1]. The patient continued rehabilitation therapy for profound developmental delay. The progression of multiple exostosis has being monitored. This case confirms and extends data on the genetic basis of PSS. In clinical and radiologic aspect, a patient with multiple exostoses accompanying with syndromic features, including craniofacial abnormalities and mental retardation, the diagnosis of PSS should be considered.     

前屈后伸载荷下颈椎间孔的孔径变化：Bryan颈人工椎间盘置换与颈椎钢板植骨内固定的比较

背景：诸多针对脊椎椎体间固定融合后相邻节段应力变化的生物力学测试结果并不尽相同,载荷控制与位移控制试验模式下所反映出的相邻节段应力状况其结果也相差甚远。 目的：分析椎间盘完整、椎间盘切除、Bryan颈人工椎间盘置换和前路颈椎植骨融合钢板内固定后,成人尸体颈椎标本分别在前屈后伸载荷下C5/6椎间孔孔径和面积的变化情况。 方法：分别测量C5/6椎间盘完整、椎间盘髓核摘除、Bryan颈人工椎间盘置换和前路钢板植骨内固定4种状态下以0.25,0.50,0.75,1.00,1.25,1.50 N•m的分级载荷加载于标本的前屈后伸状态时C5/6椎间孔孔径和面积的变化情况。 结果与结论：前屈后伸各级加载时,C5/6椎间孔上下径、上前后径、下前后径和面积椎间盘完整组、Bryan颈人工置换组和钢板植骨内固定组高于椎间盘髓核摘除组,差异有显著性意义(P < 0.05),Bryan颈人工置换组高于钢板植骨内固定组,差异有显著性意义(P < 0.05),可见颈椎间盘髓核摘除后C5/6椎间孔有效空间明显减少。     

Scapular foramina

Although foramina in the scapula are a rare occurrence, they produce radiolucent defects that simulate those related to skeletal metastasis or multiple myeloma. In order to define the typical location and appearance of these foramina, we initiated a radiographic and pathologic examination of macerated modern and ancient scapulae. Of 93 macerated scapulae that were examined, foramina were observed in 27 specimens (29%). These occurred at four sites: (a) at the superior border of the bone at its junction with the coracoid process, caused by ossification of the superior transverse ligament (21 specimens); (b) in the body of the bone inferior to the scapular spine, resulting from a disturbance in ossification during fetal development (five specimens); (c) in the superior fossa, as a clasp-like defect (one specimen); and, (d) at the superomedial border above the scapular spine (one specimen).The radiographic features of these foramina were compared to those produced by normal vascular channels, anatomic thinning of the bone, and skeletal metastasis or multiple myeloma. Knowledge of the typical appearance and site of scapular foramina assures accurate diagnosis.