眼神经与上颌神经夹角的探讨

目的　比较胎儿和成人的眼神经与上颌神经的夹角 ,为婴幼儿上睑手术局部麻醉的进针提供解剖学依据。方法通过对 1 5例胎儿和 1 5例成人颅骨的眶上孔 (切迹 )、三叉神经压迹、眶下孔之间的连线的长度的测量 ,根据公式计算出眼神经与上颌神经的夹角。结果胎儿左右侧、成人左右侧的夹角分别为 33 .2± 4 .0°、34 .1± 3 .0°、32 .9± 2 .6°、32 .6± 1 .7°。结论成人左右侧无显著差异 ,胎儿左右侧无显著差异 ,成人与胎儿比较左右侧无显著差异 ,因此 ,婴幼儿眶上切迹麻醉可参照成人的操作     

Chronic Response of the Rat Sciatic Nerve to the Flat Interface Nerve Electrode

The chronic effects of a reshaping nerve electrode, the flat interface nerve electrode (FINE), on sciatic nerve physiology, histology, and blood–nerve barrier (BNB) are presented. The FINE electrode applies a small force to a nerve to reshape the nerve and fascicles into elongated ovals. This increases the interface between the nerve and electrode for selective stimulation and recording of peripheral nerve activity. The hypothesis of this study is that a small force applied noncircumferentially to a nerve can chronically reshape the nerve without effecting nerve physiology, histology, or the blood–nerve barrier permeability. Three FINE electrode designs were implanted on rat sciatic nerves to examine the nerve's response to small, moderate, and high reshaping forces. The chronic reshaping, physiology, and histology of the nerve were examined at 1, 7, and 28 days postimplant. All FINEs significantly reshape both the nerve and the fascicles compared to controls. FINEs that applied high forces caused a neurapraxia type injury characterized by changes in the animal's footprint, nerve histology, and the BNB permeability. The physiological changes were greatest at 7 days and fully recover to normal by 14 days postimplant. The moderate force FINE did not result in changes in the footprint or BNB permeability. Only a minor decrease in axon density without accompanying evidence of axon demyelination or regeneration was observe for the moderate force. The small force FINE does not cause any change in nerve physiology, histology, or BNB permeability compared to the sham treatment. An electrode that applies a small force that results in an estimated intrafascicular pressure of less than 30 mm Hg can reshape the nerve without significant changes in the nerve physiology or histology. These results support the conclusion that a small force chronically applied to the nerve reshapes the nerve without injury. © 2003 Biomedical Engineering Society. PAC2003: 8717Nn, 8719Nn, 8780Xa, 8719Uv     

神经导管修复周围神经损伤的研究进展

随着神经修复技术特别是显微外科的发展，神经损伤修复的质量有了进一步的提高；利用神经导管桥接神经断端以实现修复周围神经损伤是目前的一个研究热点。本综述了神经导管修复周围神经损伤的发展历史，分析比较了非神经组织、非生物降解材料、可生物降解材料神经导管在神经损伤修复中的效果，讨论了导管的形态及导管内微环境对神经再生的影响。     

胸背神经移位修复肌皮神经损伤的临床应用

根据100侧上肢标本的解剖研究,我们对1例肌皮神经损伤的患者作了胸背神经移位和其缝接术,获得满意的结果。术后9个月,肱二头肌肌力收缩时在4级以上,屈肘关节时能提起2kg 的重物。     

神经导管修复周围神经损伤的研究进展

对神经导管在周围神经损伤的修复和再生的应用及研究进展作一综述。主要包括两方面内容：神经导管材料设计及导管内微环境构建。     

Microsurgical Anatomy of the Oculomotor Nerve

The oculomotor nerve supplies the extraocular muscles. It also supplies the ciliary and sphincter pupillae muscles through the ciliary ganglion. The nerve fibers leave the midbrain through the most medial part of the cerebral peduncle and enter the interpeduncular cistern. After the oculomotor nerve emerges from the interpeduncular fossa, it enters the cavernous sinus slightly lateral and anterior to the dorsum sellae. It enters the orbit through the superior orbital fissure, after exiting the cavernous sinus, to innervate the extraocular muscles. Therefore, knowledge of the detailed anatomy and pathway of the oculomotor nerve is critical for the management of lesions located in the middle cranial fossa and the clival, cavernous, and orbital regions. This review describes the microsurgical anatomy of the oculomotor nerve and presents pictures illustrating this nerve and its surrounding connective and neurovascular structures. Clin. Anat. 30:21–31, 2017. © 2016 Wiley Periodicals, Inc.     

Nerve compression syndromes of the arm

Among neural lesions of the arms, the most common one is the medianus lesion in the carpal tunnel, followed by the ulnar nerve lesion in the elbow, while the ulnar nerve compression in the Guyon tunnel is found rarely. Besides the history and the clinical picture, the electromyoneurographic analyses make an early and accurate diagnosis possible. The characteristics of the evoked muscle potential and distal latencies in the diagnosis of the carpal tunnel syndrome are of utmost importance. In diagnosing the cubital syndrome, the multisegmental determination of the motor conduction velocity of the ulnar nerve and the features of the M-potential obtained by means of stimulation above the compression are very important. Generally speaking, the slowing down of the motor conduction velocity remains localised to the entrapped segments. The neural potential over the compression in the elbow cannot be evoked, and it is hardly evoked in the wrist. Within the period of the last five years, the author examined 154 patients clinically and electrophysiologically. 132 had the carpal tunnel syndrome, 20 the ulnar groove syndrome, and 2 Guyon's canal syndrome. The patients were treated conservatively and operatively. The success in the conservative treatment of the carpal tunnel syndrome was evident in the first three months by the absence of sensory symptoms in more than 50% of cases. The constant effect was achieved after six months. In that period the EMG findings were not essentially changed, and motor symptoms were also stationary. With the operative treatment the unpleasant symptoms, pain and shudder, disappeared after a relatively short period. Definitive results were achieved after six months. Motor symptoms were less improved and the EMG findings were showing a tendency to improvement. The ulnar groove syndromes were not remarkably influenced by the conservative therapy. Half the operated patients lost their sensory symptoms. Within six months the other half remained with the same or even more trouble.     

异种神经脱细胞移植物修复周围神经缺损的实验研究

目的 探讨异种神经脱细胞移植物桥接大鼠坐骨神经缺损后的神经再生及其再生过程中免疫排斥反应. 方法用脱细胞兔周围神经作为移植物桥接大鼠坐骨神经1 cm缺损;术后3、5、8、11、15天检测血液中淋巴细胞占白细胞百分比;3个月后取移植物及腓肠肌,用甲苯胺蓝、乙酰胆碱酯酶（AchE）、琥珀酸脱氢酶（SDH）组化染色,光、电镜观察神经再生及腓肠肌运动终板的恢复情况. 结果术后大鼠血液中淋巴细胞占白细胞的百分比与正常大鼠相比较无显著性差异,3个月后大鼠术侧下肢足趾能分开,行走时后蹬动作有力,针刺足底有逃避反应,桥接物内见有大量再生的坐骨神经纤维,腓肠肌肌纤维上见有呈AchE阳性的运动终板和神经纤维.结论 异种神经脱细胞移植物桥接大鼠坐骨神经缺损具有促进其再生的作用.     

Fabrication Techniques of Nerve Guidance Conduits for Nerve Regeneration

Neuronal loss and axonal degeneration after spinal cord injury or peripheral injury result in the loss of sensory and motor functions. Nerve regeneration is a complicated and medical challenge that requires suitable guides to bridge nerve injury gaps and restore nerve function. Due to the hostility of the microenvironment in the lesion, multiple conditions should be fulfilled to achieve improved functional recovery. Many nerve conduits have been fabricated using various natural and synthetic polymers. The design and material of the nerve guide conduits were carefully reviewed. A detailed review was conducted on the fabrication method of the nerve guide conduit for nerve regeneration. The typical fabrication methods used to fabricate nerve conduits are dip coating, solvent casting, micropatterning, electrospinning, and additive manufacturing. The advantages and disadvantages of the fabrication methods were reported, and research to overcome these limitations was reviewed. Extensive reviews have focused on the biological functions and in vivo performance of polymeric nerve conduits. In this paper, we emphasize the fabrication method of nerve conduits by polymers and their properties. By learning from the existing candidates, we can advance the strategies for designing novel polymeric systems with better properties for nerve regeneration.     

Nerve endings in the human prostate

The ultrastructure of nerve endings in the human prostate was studied using glutaraldehyde-OsO₄ and KMnO₄ fixation. The nerve endings were classified into three categories according to the size of the vesicles and the contents of the synaptic profiles. In addition to the conventional adrenergic and cholinergic axons, a third type of axon profile containing a predominance of large granular vesicles was constantly found. Synaptic contacts were found only on smooth muscle cells. No epithelial innervation could be demonstrated. The functions and possible transmitters of the various types of axon terminals are discussed.     

Nerve endings in the human endocardium

The endocardium of 12 human hearts was studied following methylene blue perfusion and immersion within eight hours after death. Photomicrographs presented show two major types of endings: complex unencapsulated endings, and end-nets. Complex unencapsulated endings are discrete, much branched, highly variable “bush-like” endings, which originate from myelinated fibers. These structures were found only in the atria, and particularly at atrio-venous junctions. The close resemblance of complex unencapsulated endings to stretch receptors seen in other tissues suggests that they serve as “baroreceptors” in the heart. End-nets are composed of repeatedly branching and anastomosing fine beaded fibers. The fine, beaded fibers originate from myelinated fibers, but the number and origin of the parent fibers is not known. In this study, end-nets were found in the atria, on the atrioventricular valves, and in the ventricular endocardium. The function of the end-net is unknown, and while most evidence suggests that it is sensory, motor function cannot be ruled out.     

股外侧皮神经骨盆出口处的应用解剖与神经卡压综合征

目的：研究股外侧皮神经骨盆出口处的位置及变异情况.方法：取20例成年国人尸体,男13例,女7例.大体解剖出双侧股外侧皮神经的骨盆出口处的骨纤维管道,测量股外侧皮神经的横径,以髂前上棘为基点,测量股外侧皮神经及其纤维管道的位置.结果：股外侧皮神经骨盆出口位点介于髂前上棘后2 cm以远与腹股沟韧带外1/3之间.结论：股外侧皮神经骨盆出口位点存在变异,55.0%经髂前上棘前（内）侧、腹股沟韧带（外1/3）的深面出骨盆.     

尺神经中第七颈神经成份的行径及临床意义

用神经束追踪分离法解剖观察100侧成人第七颈神经分布至尺神经内的纤维行径。结合临床观察认为,尺神经内部有来自颈七的纤维,主要经4个交通部位加入到尺神经分布区内。证明脊神经相应节段与骨骼肌或肌群的支配关系是恒定的,只是由于在胚胎发生上臂丛组合的不同,使脊神经的分支到所支配的骨骼肌间的行径出现差异。上述研究结果,对臂丛中、下干损伤准确定位诊断有重要意义。