腰骶部脊神经后根的显微外科解剖学研究

目的：为临床ＳＰＲ提供可靠的后根分束的形态学依据。方法：对２０例（４０侧）Ｌ１～Ｓ２节段的脊神经后根的自然分束和后根间纤维联系进行显微外科解剖学观察。结果：一个脊神经后根是由前后２股神经束构成的，每股神经束又含有１～２束神经亚束，一个神经亚束由２～３支神经小束组成，神经小束进入脊髓。各节段脊神经后根的所含神经束的数目基本一致。脊神经后根间神经纤维联系出现率为６６．９％，根据神经纤维联系的形状，可分为“Ｎ”或反“Ｎ”、“人”、“Ｙ”、“Ｘ”、“Ｈ”五型；根据神经纤维联系的位置，可分为近端、中部和远端三型；根据神经纤维联系的粗细，可分为神经小束的分支、神经小束和神经亚束三型。结论：选择性脊神经后根切断术的后根分束应达到神经亚束水平。高选择性脊神经后根切断术的后根分束应达到神经小束水平，以９～１０束为宜。同时对后根间的神经纤维联系作了形态学观察和系统的形态学分类。     

腰骶部SPR术中脊神经前后根定位的应用解剖

目的：为ＳＰＲ提供可靠的术中脊神经前、后根鉴别的解剖学依据。方法：在２０例成人脊柱标本上,去除后部结构,暴露整个马尾神经,对Ｌ１～Ｓ２节段的前后根进行形态学观察和测量。结果：脊神经后根位于马尾的后半部,前根则位于前半部。脊神经后根较相应的前根粗大,后根从Ｌ１～Ｓ１逐渐增大,以Ｓ１为最粗大;前根则以Ｌ３最粗大。相应前后根出硬脊膜前,有一段相互贴附并紧贴硬脊膜侧壁。结论：在多椎板切除ＳＰＲ术中前、后根的定位及鉴别,暴露时可根据前、后根出硬脊膜前的相互贴附;在限制性椎板切除时则可通过脊髓外侧索和Ｌ１前、后根之间的最下端的齿状韧带加以鉴别     

腰骶部脊神经前后根会合段与椎板关系的解剖观察及临床意义

腰骶段选择性脊神经后根切断术，是在腰2～骶。每根脊神经前后根会合段解剖、分离后根，选择性的神经束切断：笔在足月婴儿尸解的基础上，通过骶椎板单开门切开显露选择性神经根切断术中解剖观察；对腰2-骶1脊神经前后根会合段的距离进行测量，对每条脊神经前后根会合段与相应椎板的关系，进行了临床解剖学观察。目的是为了保护脊柱稳定性采用椎板节段开窗施行选择性神经后根切断手术提供进一步的解创学资料。     

91例胎儿胃粘膜组织学及组织化学研究

胎儿胃粘膜的组织学及粘液的组化特点,国内尚未见到系统的研究报告。本文收集胎胃91例,重点观察胎胃粘膜的光镜下组织学特征及粘液合成性质,为进一步研究胃的疾病提供一组胃胚胎发育的形态学对照资料。材料与方法本组89例材料来自正常妊娠水囊引产之胎儿,胎龄4～8月,2例来自足月死     

腰骶部脊神经根的临床解剖学

通过临床选择性脊神经后根切断术中观察与测量,为临床提供了重要的参考数据。腰骶神经前、后根解剖会合点至椎间孔距离平均为1.5～2.0cm。前后两根相比,后根明显较前根粗,其中以L_5后根最粗、L_2～S_1各后根内小束的数目为4～18束,平均为7束,临床分离后根时可分为7束,以便进行电刺激选择。这些资料为腰骶部选择性脊神经后根切断术和马尾神经的手术提供了重要依据。     

腰骶神经根的组织化学研究

采用动物腰骶神经根和人体新鲜腰骶神经后根标本进行组织学和组织化学研究,发现电刺激诱发痉挛的后根小束的神经纤维为 AchE 反应阳性,高位后根内感觉和肌支传入纤维相混合,不利于手术中进行电刺激选择。本研究结果为临床选择性腰骶神经后根切断术的手术部位和电刺激选择的必要性等问题提供了依据。     

SD大鼠腰骶部脊神经前根显微外科解剖学观察

目的:为实验性高选择性腰骶神经前根小束切断术治疗圆锥上损伤的痉挛性膀胱提供可靠的神经根分束的形态学依据.方法:对6只雄性SD大鼠L1-S4节段的脊神经前根自然分束进行形态学观察和显微测量.结果:粗细不一的神经小束从脊髓发出,几个神经小束形成一个神经亚束.2～6个神经亚束构成一个神经束,或由神经小束直接形成神经束.腰骶部脊神经前根一般含有1股神经束,3～13支神经小束.L5-S2节段前根的小束数目在5支以上.每一前根内有一支神经小束较粗大,直径0.1～0.2 mm左右,其余较细小,最小可至0.01 mm左右,粗细程度存在较大差异.结论:实验性高选择性腰骶部前根神经小束切断术的分束可达到神经小束水平,以7～8支为宜.     

小鼠脾发育分化的组织学及组织化学观察

观察了ＢＡＬＢ／ｃ小鼠胚胎至成年脾发育分化的组织学和组织化学变化。（１）胚胎１２天，胃背系膜内出现由间充质细胞形成的脾原基。此后，脾窦、网状细胞及淋巴细胞相继出现；生后１天出现动脉周围淋巴鞘；以后逐渐形成脾小结。（２）胚胎１３天时脾中出现糖原和ＲＮＡ颗粒，并渐增多，生后１周糖原量骤减，２周至成年为阴性。ＲＮＡ则在白髓中少，红髓中多。（３）碱性磷酸酶在１７天胚胎脾内出现阳性细胞，以后增多。（４）酸性     

胎儿房室结的组织学和组织化学研究

利用光镜观察了２０例胎儿室房结、房室束和左、右束支的组织结构和组织化学特征。结果如下：１、胎儿房室结位于三尖瓣隔侧瓣上方，中心纤维体右侧。结石侧有普通心肌组成的覆盖层。房室结可分深浅两部。浅部纤维平行排列，垂直下行，止于结的下端。深部可分为上和下部。深部向后延伸与房间隔肌相连，向前延续为房室束。深部向右深入中心纤维体内形成许多细胞岛。２、房室束横断面大多为三角形，外包有疏松结缔组织鞘。房室束的前部     

小白鼠十二指肠发育分化的组织学和组织化学观察

用组织学和组织化学的方法观察了ＢＡＬＢ／Ｃ小鼠胚胎（Ｅｄ１４）至成年十二指肠的发育分化过程。结果如下：１．Ｅｄ１４￣１５，肠壁上皮细胞增殖并突间肠腔（原发腔），同时上皮内出现小腔隙（继发腔）。Ｅｄ１６￣１７，上皮表面纹状缘逐渐明显，间充质向上皮基底面突入，继发腔与原发腔相通，形成原始绒毛。Ｅｄ１９时，原始绒毛发育成指状绒毛。生后２周末，肠壁形态结构接近成年。２．生后１周末，可见潘氏细胞，所含颗粒较     

股骨颈轴向控制髓内钉与A—P型GAMMA钉的生物力学研究

目的研究股骨颈轴向控制髓内钉(axialcontrolledintramedullarynailofthefemoralneck,即ACINFN钉)的生物力学性能,为临床应用提供力学依据.方法24具新鲜尸体股骨标本随机分为对照组和两个实验组.对照组不作任何处理;实验组制成EvansⅠ型粗隆间骨折模型,分别用材料、规格相同的ACINFN钉和A-P型GAMMA钉固定.各组均在双轴液压伺服生物材料测试实验机上做抗压和抗扭转实验.结果在300N的压力下,对照组、ACINFN钉组和A-P型GAMMA钉组的压缩刚度分别为(1568.06±365.81)、(1166.53±91.8)和(224.11±66.45)N/mm,差异有显著性意义(P＜0.01);扭角为5°时,对照组、ACINFN钉组和A-P型GAMMA钉组的扭转刚度分别为(1.14±0.19)、(1.076±0.125)和(0.114±0.065)N@m/deg,差异有显著性意义(P＜0.01).结论ACINFN钉在抗压和抗扭转性能方面明显优于A-P型GAMMA钉,具有良好的生物力学性能.     

Polarization of primary afferent terminals of lumbosacral cord elicited by the activity of spinal locomotor generator

The changes of electrical polarization of primary afferent terminals in the lumbosacral spinal cord have been investigated on immobilized, decorticated and spinal cats during fictive locomotion. Fictive locomotion was spontaneous or provoked by stimulation of either dorsal root or dorsal funiculi in the lumbar segments. The activation of the locomotor generator and appearance of fictive locomotion were always associated with a sustained dorsal root hyperpolarization. On the background of this positivity periodic negative dorsal root potential oscillations appeared synchronously with efferent discharges in motor hind-limb nerves. These periodic waves of primary afferent depolarization occurred in phase in different ipsilateral lumbosacral segments. On the contralateral side the periodic changes in dorsal root potential were out of phase during fictive stepping and in phase during fictive galloping. The use of Wall's technique has shown that tonic and periodic changes in dorsal root potential reflect the changes occurring in polarization of central terminals of cutaneous and muscle (Ia and Ib) groups of afferent fibres. It is concluded that the level of electrical polarization of primary afferent terminals is determined directly by the activity of the spinal locomotor generator; activation of the generator is followed by hyperpolarization of primary afferent terminals. By so modulating the polarization of afferent terminals, the locomotor generator can perform tonic and phase-dependent selection of afferent information.     

Rat muscle spindles deficient in elements of the static system

Motor nerve supplies to 15 poles of rat lumbrical spindle were reconstructed from serial, 1-micron transverse sections of muscle embedded in resin. Neural and muscular elements associated with the modulation of static sensitivity of afferents were deficient in these spindles relative to cat tenuissimus and rat soleus spindles. Rat lumbrical spindles contained fewer static fusimotor axons, fewer static chain intrafusal fibers, fewer motor-innervated static bag2 and chain fibers and fewer secondary afferents. The sparsity of static elements in spindles of the rat lumbrical muscle may correlate with the distal location or with the delicate motor tasks performed by the muscle.     

前后联合入路治疗多节段腰骶椎结核的临床研究

目的探讨前后联合入路治疗多节段腰骶椎结核的干预方法及效果。方法将我院自2004年3月至2011年3月确诊收治的70例多节段腰骶椎结核患者随机分为2组,其中实验组38例行前后联合入路术,对照组32例行经前路病灶清除植骨融合固定术。随访2～3个月,采用Frankel分级评估脊髓神经功能损伤,并对比两组患者的总体健康（GH）、生理功能（PF）、生理职能（RP）、社会功能（sF）、情感职能（RE）、精神健康（MH）等生活质量指标变化。结果治疗后,患者的Frankel分级及生活质量指标均优于治疗前（P〈0．05）,而两组间相比,实验组优于对照组（P〈0．05）。结论经前后联合入路手术治疗多节段腰骶椎结核,可显著改善患者的生活质量,减轻其脊髓神经功能损伤。     

Sensory innervation of the suprarenal gland in the albino rat: A fluorescent tract tracer study

The afferent innervation of the suprarenal gland was studied by using a fluorescent tract tracer in the adult albino rat. The left suprarenal gland was injected slowly with 5 μl of 2% aqueous suspension of Fast blue. After a survival period of 4–5 days, the dorsal root ganglia were dissected out and 15-μm-thick plastic (JB 4) sections were examined under the fluorescent microscope. The labelled neurons were seen from the third thoracic to second lumbar dorsal root ganglia, ipsilateral to the site of injection with maximum concentration from T₆ to T₁₁. These primary sensory neurons were round to oval in shape, varied from 7 μm to 40 μm in size, and were distributed randomly in the dorsal root ganglia. The labelling of the primary sensory neurons in the dorsal root ganglia confirms the presence of sensory nerve endings in the suprarenal gland that may be responsible for the vascular distension and hormonal release. Clin. Anat. 11:29–32, 1998. © 1998 Wiley-Liss, Inc.     

Variations in the lumbosacral ligament and associated changes in the lumbosacral region resulting in compression of the fifth dorsal root ganglion and spinal nerve

Sixty-five lumbosacral regions from adult cadavers were dissected and the position and relations of the lumbosacral ligament noted. The lumbosacral ligament was present in all specimens; in 22 (34%) it extended medially across the ventral ramus of the fifth lumbar nerve, and in six (9%) of these the underlying nerve was compressed and visibly flattened. On two of these specimens the nerve, together with its dorsal root ganglion, was removed, processed, and stained with Masson's trichrome. The compressed nerve showed increased thickness of endoneurial and perineurial connective tissue, and the cells of the dorsal root ganglion were smaller and surrounded by increased connective tissue, particularly at the periphery of the ganglion. Observation of the lumbosacral ligament and surrounding anatomical structures suggests that anatomical variation in this region may be attributed to the health of the lumbosacral articular elements. In those specimens showing compression of the fifth lumbar spinal nerve there was also narrowing of the lumbosacral interspace. In these the disc itself was compressed and showed degenerative changes. The articular processes at the lumbosacral joint were irregular, with thinning and fissuring of the articular cartilage. It is suggested that the processes which lead to the further development of the ligament, by the formation of additional fibrous bands, are mechanical in nature and result from instability at the lumbosacral region itself. Instability subsequently leads to the initiation of a chain of degenerative changes, involving pathology at the lumbosacral disc and zygapophyseal joints. Compression of the dorsal root ganglion occurs either within a narrowed inter vertebral foramen, or in the case described here just external to the foramen, while compression of the nerve occurs in the accessory ligamentous bands formed to resist the instability. A mechanism by means of which compression of the ganglion may give rise to pain is suggested. © 1995 WiIey-Liss, Inc.     

Morphological study of two human facial muscles: Orbicularis oculi and corrugator supercilii

Human facial muscles are unique in that they do not cross joints and they function either to open and close the apertures of the face or to tug the skin into intricate movements producing facial expressions. Compared to other skeletal muscles of the body, little is known about the microscopic architecture and organization of facial muscles. It was hypothesized that facial muscles with different roles would possess differences in their cellular organization and morphology that would reflect their unique function. The palpebral orbicularis oculi (oo) and the corrugator supercilii (cs) were studied because they are in close topographical proximity to one another and share the same nerve supply and embryonic origin. This study compared the two muscles which were procured as biopsies from cosmetic surgery procedures. Architectural and morphological features were elucidated using a combination of conventional histological stains, immunocytochemistry and histochemistry. Quantitative measures of fiber sizes, shapes, and fiber‐type distributions were performed along with measures of capillary area per unit of contractile area (capillary index). Fiber‐type profiles and motor end‐plates were demonstrated by using antibodies to fast and slow myosins, as well as to neurofilament protein. The oo was shown to differ significantly from the cs on the basis of fiber shapes, sizes, and types. The oo muscle fibers were small, rounded, and 89% of them were of the fast‐twitch (Type II) variety. The muscle fibers in the cs were larger, polygonal, and only 49% of them were of the fast‐twitch variety. The capillary index of the cs was 2.4 times that of the oo. Clin. Anat. 12:1–11, 1999. © 1999 Wiley‐Liss, Inc.     

Morphology and histochemistry of myogelosis

Myogelosis is a common diagnosis in the case of chronic pain conditions, especially in the region of the pectoral girdle musculature, the glutei muscles, and the erector spinae muscle. Although such indurative areas continue to be palpable even on the cadaver, few studies concerning the morphological substrate of these areas have been undertaken. Selected biopsies as well as larger tissue samples were taken from 11 corpses and prepared for histological study. Following staining, the frozen sections were examined morphometrically. A histologically constant, significant morphological alteration was found in the areas of concern. The spaces between the individual muscle fibers of healthy muscle tissue appear relatively wide, the endomysium of the myogelotic area are clearly narrowed. Split fibers, ragged red fibers, Type II fiber atrophy, and fibers with a moth‐eaten appearance have been detected. The morphometry shows considerable increase in thickness of the affected muscle fibers, suggestive of a pathological, local hypertrophy. The changes described may well represent a fixed condition, so that it should not be surprising that myogelosis therapy is difficult and protracted. Clin. Anat. 12:266–271, 1999. © 1999 Wiley‐Liss, Inc.     

Benign vaginal polyp: a histological, histochemical and immunohistochemical study of 20 polyps with comparison to normal vaginal subepithelial layer

Twenty benign vaginal polyps from 18 patients, together with sections from normal vaginal epithelium, were studied histologically, histochemically using elastic van Gieson stain and immunohistochemically using monoclonal antibodies against vimentin, desmin and actin. The striking finding was the similarity, both histologically and immunohistochemically, of the stroma of vaginal polyps to that of the loose subepithelial layer found in normal vagina. The important difference was the marked degeneration of the elastic tissue, increased number of stellate and giant fibroblasts and subepithelial condensation of fibroblasts in the polyps. These findings support the hypothesis that vaginal polyps may represent a reactive hyperplasia of the loose subepithelial zone of the vaginal wall.