中国成年人跟骨形态的观察

观察测量成人跟骨500例,平均长度为7.495±0.65(5.6～9.15)厘米,其中7.10～8.30厘米者占69.2±2.06%。左右跟骨长度之间无显著性差异。跟骨结节是足部承担重力的主要点之一。跟结节内侧突和外侧突之间,88.80%均被 V 形,I 形阳 L 形沟分开。内侧突宽度为外侧突宽度的1.5～3倍者占90.72±1.30%。内侧突的特大宽度,表明人类站立和行走时,跟结节主要承担重力的部份是内侧突。跟骨的肌腱沟比较明显的是跨过载距突的(足母)长屈肌腱和趾长屈肌腱沟。腓骨短肌腱沟的增深,与副腓骨肌滑车的出现密切相关。本文按前、中、后距关节面的存在和融合情况,将跟骨的距关节面分为六型,其中Ⅰ型占53.20±2.23%,而教科书描述的三个独立关节面的“类型”典型即Ⅱ型占40.60±2.20%。第Ⅴ型仅见于中国人。第Ⅵ型则未见到报道。     

国人腰椎管外骨纤维管与脊神经的关系——Ⅰ.腰神经后内侧支骨纤维管的观察及其临床意义

本文观察了80侧男女尸体的384个腰神经后内侧支骨纤维管的位置,组成和上关节突副突韧带的形成。对骨纤维管外口的长径、宽径进行了测量。将管外口分为:近圆形35.14％(151)侧、近椭圆形32.29％(124)侧、裂隙形28.39％(109)侧等三个类型。腰神经后内侧支骨纤维管由乳突、副突、乳突副突间沟和上关节突副突韧带组成。依其前、后壁的结构分为:骨腱膜韧带型29.43％(113侧),骨骨膜韧带型66.4％(255侧)、骨型4.17％(16侧)。测量了上关节突副突韧带的长度、宽度、厚度,其中腰_(1～5)韧带的长度,在男女有显著性差别。观测骶骨上关节突骶骨翼间沟的长度和宽度。并认为腰神经后内侧支骨纤维管的后壁韧带称作上关节突副突韧带为宜。     

腰骶移行椎椎体及椎板的形态学特点及临床意义

目的:研究腰骶移行椎椎体及椎板的形态学特点,为临床诊治疗提供依据.方法:对91例腰骶移行椎椎体上面矢状径/横径,椎体前高/后高,上关节突关节面的矢状径、横径及其与正中矢状面夹角等进行测量.结果:腰骶移行椎椎体上面矢状径与横径比为0.64,前/后比为1.21.上关节突关节面高度,左(14.1±2.1)mm,右(13.9±1.5)mm;宽度,左(16.0±1.8)mm,右(16.2±1.5)mm;与正中矢状面夹角,左(56.3°±7.8°),右(55.9°±7.3°).结论:(1)腰骶移行椎椎体的形态与正常L5椎体形态相近,故在腰椎正侧位片及CT、MRI片难以根据其椎体形态学特点推断是否为移行椎,后路手术时很难根据椎板及棘突上关节突的形态特点来判断腰骶移行椎.(2)腰骶移行椎的下关节突明显小于上关节突,说明小关节突很少或几乎不向下传导应力.     

肱骨结节间沟的解剖特点及其临床意义

目的了解肱骨结节间沟的解剖特点。方法在79例成人肱骨标本上,用角规、游标卡尺和量角仪观测结节间沟的形态。结果本组结节间沟长左侧(38.7±6.9)mm、右侧(39.6±8.2)mm,合计(39.2±7.6)mm;结节沟间深:左侧(4.2±1.8)mm、右侧(4.5±0.2)mm,合计(4.4±2.5)mm;水平段与垂直段夹角:左侧(117.0±11.4)°、右侧(122.4±13.1)°,合计(119.7±12.3)°。结节上嵴出现率8.9%(7/79),内、外侧骨嵴出现率15.2%(12/79)。结论肱骨结节间沟的局部形态与肱二头肌长头腱损伤关系密切。     

中国人的腰神经丛

观察了320侧中国成年人的腰神经丛。以分叉神经为标准,将腰丛分为八型,其中以分叉神经为L_4,加入腰丛的纤维量多于骶丛的Ⅰ型出现率最高,占69.37％。分析了腰丛各神经的组成型式和参加组成各神经的神经纤维量。各神经组成的常见型如下:股神经由L_(1-4)组成的占73.75％,闭孔神经由L_(2-4)组成的占84.06％,股外侧皮神经以L_(1,2)(40.63％)或L_(2,3)(39.37％)组成的较多,生殖股神经由L_(1,2)组成的占72.19％。依髂腹下神经与髂腹股沟神经合、分情况分为三型:分干型占36.87％,共干型占50.63％,合并型占12.5％。讨论了副股神经和副闭孔神经的命名问题,本文副股神经的出现率为7.5％,副闭孔神经出现率为3.44％。     

下颌骨观察性状的时代间比较

目的:分析中国现代人群下颌骨几项观察性状的表现及时代变异特点.方法:下颌骨干骨379例,其中新石器时代56例,青铜铁器时代210例,近代113例,将髁突冠突高低,颏孔开口方向,舌骨沟桥,舌骨沟宽,舌骨沟深,下颌前翘,摇椅式下颌等分为几个类型,统计各个类型的主要形态表现、在不同时代间的出现率,比较时代间的差异.结果:冠突主要表现为不低于髁突(85.8％);颏孔的开口主要朝后上(70.9％);舌骨沟桥(明显)的出现率6.2％;舌骨沟宽大多为细(47％)和中(36.1％);下颌前翘的出现率为35.5％,摇椅式下颌的出现率很低(4.6％),以上观察性状无明显时代差异.舌骨沟宽的宽度在“中”以上的比例,在新石器时代、青铜铁器时代和近代,左侧分别为24％、45.8％、59.6％,右侧分别为36.7％、46.8％、55.6％.结论:舌骨沟宽随时代而增宽,可能反映了走行其中的神经、血管随时代而增粗.其他观察性状没有整齐规律性的时代变化.     

上颌第一前磨牙X线法髓腔物理量

目的:探讨上颌第1前磨牙X线片法髓腔物理量方面的数据.方法:用X线平行投照法拍摄实体牙颊舌向和近远中向X线片牙影像,根据本研究对髓腔根管定的分型标准对根管进行分型.用电脑配套的柯达成像系统测量X线片牙的髓高、髓宽、根中颊径、根中舌径、根尖颊径和根尖舌径.用SPSS17.0软件统计处理X线片牙的髓腔物理量值.结果:100颗上颌第1前磨牙中X线片牙根管有6种类型,Ⅰ-1-1型占33％,Ⅰ-2-2型占17％,Ⅰ-2-1型占13％,Ⅰ-1-2型占4％,Ⅰ-2-1-2型占3％,Ⅱ-2-2型占30％.X线片牙的测量值(mm)显示,髓高3.09±1.18,髓宽3.88±0.61,根中颊径1.76±1.18,根中舌径0.59±0.34,根尖颊径0.79±0.39,根尖舌径0.35±0.28.髓腔物理量各测值差异均存在统计学意义.结论:上述结果说明,湖北地区上颌第1前磨牙根管类型主要是Ⅰ-1-1型,Ⅰ-2-2型,Ⅱ-2-2型.X线片牙物理量测值经相关及回归分析,如果有相关性的配对项,可用回归方程中的自变量值(X)来推测因变量的值(Y),为口腔临床实践提供髓腔物理量方面的未知数据.     

湖南瓦乡人头面部十项形态特征

目的:探讨湖南瓦乡人头面部形态特征.方法:采用活体观测法调查湖南瓦乡人291例(男为142例,女为149例)的上眼睑皱褶、鼻尖类型、红唇厚度、前额发际、鼻孔形状、鼻梁侧面观、耳垂、蒙古褶、达尔文结节、下颏突度10项头面部形态特征.结果:与中国其他族群相比,湖南瓦乡人有上眼睑皱褶、薄型红唇、三角形发际、凸型鼻梁、凸型下颏出现率较高;勾鼻尖、阔鼻孔、有耳垂、有蒙古褶出现率较低;有达尔文结节率中等.10项特征出现率性别间无差异,10项特征显性基因频率整体较低,10项特征之间彼此相关不明显,聚类分析表明,湖南瓦乡人与湖南苗族的头面部形态特征最接近.结论:湖南瓦乡人有较独特的头面部形态特征.     

双侧颞骨茎突过长一例

<正> 颞骨茎突起始于颞骨鼓部的后下面,茎乳孔的前方,呈园锥形细长突起,近端较粗大,远端较细长,伸向内、前、下方,位于颈内、外动脉之间。有的远端伸向外、下方,靠近下颌骨内侧,偶而可见茎突向后至颈椎横突。根据国内、外颅骨测量资料统计,颞骨茎突出现率为92.4％,有的较长,有的缺如,正常茎突平均长度,国内约为2.5厘米;国外约为2.5—3厘米(Dwight),现在一般认为超过2.5厘米者即为颞骨茎突过长。临床X线片上见茎突尖端向下抵达或超过第二颈椎横突水平,而且斜向内侧者,即可诊断为颞骨茎突过长。     

颈椎骨测量在临床上的应用

本文对102例国人颈椎骨,从应用解剖学观点进行比较全面的测量,并提出测量方法。测量结果:1.颈椎椎管内径平均值:矢状径为15.47±1.11毫米,左右径为22.58±1.22毫米。2.椎体平均值:前后径为上面15.66±1.12毫米,下面16.28±1.14毫米,左右径:上面为24.16±1.21毫米,下面为22.85±1.24毫米。3.椎间孔平均值:长(宽度)为6.68±0.50毫米,高为7.85±0.54毫米。4.颈椎椎动脉沟宽度为5.71±0.48毫米。5.环椎椎动脉沟间距(后弓)平均值为38.83±1.92毫米。6.上关节突间距平均值为23.12±1.23毫米。7.齿突平均值:高为18.40±1.20毫米,宽为10.09±1.02毫米。8.椎动脉孔有多种变异,从骨性测量推测椎动脉由第六横突孔进入,本组占98％。颈椎各部测量与各类型颈椎病在诊治上有密切关系,掌握颈椎骨正常数值有助于获得更好疗效。     

A fixation-decalcification procedure for bone biopsies

A procedure for the simultaneous fixation and decalcification of bone biopsies is described. Mild acidic fixatives (such as Bouin's fluid) are effective decalcifying agents when made calcium-free by a continuous circulation through a column of anion-binding ion exchange resin. The procedure has been found relatively fast, safe, economic and to provide excellent histology of biopsies containing cancellous bone.     

Long bone histomorphogenesis of the naked mole-rat: Histodiversity and intraspecific variation

Lacking fur, living in eusocial colonies and having the longest lifespan of any rodent, makes naked mole-rats (NMRs) rather peculiar mammals. Although they exhibit a high degree of polymorphism, skeletal plasticity and are considered a novel model to assess the effects of delayed puberty on the skeletal system, scarce information on their morphogenesis exists. Here, we examined a large ontogenetic sample (n = 76) of subordinate individuals to assess the pattern of bone growth and bone microstructure of fore- and hindlimb bones by using histomorphological techniques. Over 290 undecalcified thin cross-sections from the midshaft of the humerus, ulna, femur, and tibia from pups, juveniles and adults were analyzed with polarized light microscopy. Similar to other fossorial mammals, NMRs exhibited a systematic cortical thickening of their long bones, which clearly indicates a conserved functional adaptation to withstand the mechanical strains imposed during digging, regardless of their chisel-tooth predominance. We describe a high histodiversity of bone matrices and the formation of secondary osteons in NMRs. The bones of pups are extremely thin-walled and grow by periosteal bone formation coupled with considerable expansion of the medullary cavity, a process probably tightly regulated and adapted to optimize the amount of minerals destined for skeletal development, to thus allow the female breeder to produce a higher number of pups, as well as several litters. Subsequent cortical thickening in juveniles involves high amounts of endosteal bone apposition, which contrasts with the bone modeling of other mammals where a periosteal predominance exists. Adults have bone matrices predominantly consisting of parallel-fibered bone and lamellar bone, which indicate intermediate to slow rates of osteogenesis, as well as the development of poorly vascularized lamellar-zonal tissues separated by lines of arrested growth (LAGs) and annuli. These features reflect the low metabolism, low body temperature and slow growth rates reported for this species, as well as indicate a cyclical pattern of osteogenesis. The presence of LAGs in captive individuals was striking and indicates that postnatal osteogenesis and its consequent cortical stratification most likely represents a plesiomorphic thermometabolic strategy among endotherms which has been suggested to be regulated by endogenous rhythms. However, the generalized presence of LAGs in this and other subterranean taxa in the wild, as well as recent investigations on variability of environmental conditions in burrow systems, supports the hypothesis that underground environments experience seasonal fluctuations that may influence the postnatal osteogenesis of animals by limiting the extension of burrow systems during the unfavorable dry seasons and therefore the finding of food resources. Additionally, the intraspecific variation found in the formation of bone tissue matrices and vascularization suggested a high degree of developmental plasticity in NMRs, which may help explaining the polymorphism reported for this species. The results obtained here represent a valuable contribution to understanding the relationship of several aspects involved in the morphogenesis of the skeletal system of a mammal with extraordinary adaptations.     

骨移植体及骨移植替代物在体内的血管化

探讨了骨移植体及骨移植替代物在体内血管化的机理、意义及过程,以更好地促进骨缺损移植修复的效果.通过对近期有关文献所作相关研究的综述,总结出各类骨移植体及骨移植替代物体内血管化的特点及影响因素.骨移植体及骨移植替代物体内血管化过程是移植手段能够奏效的重要保障.组织工程化人工骨作为一种日益重要的骨移植替代物,进一步提高其在体内的血管化进程,是更好发挥其生命活力的关键.     

Does the degree of laminarity correlate with site‐specific differences in collagen fibre orientation in primary bone? An evaluation in the turkey ulna diaphysis

de Margerie hypothesized that preferred orientations of primary vascular canals in avian primary cortical bone mediate important mechanical adaptations. Specifically, bones that receive habitual compression, tension or bending stresses typically have cortices with a low laminarity index (LI) (i.e. relatively lower cross-sectional areas of circularly (C) orientated primary vascular canals, and relatively higher areas of canals with radial (R), oblique (O) or longitudinal (L) orientations. By contrast, bones subject to habitual torsion have a high LI (i.e. relatively higher C-orientated canal area) [LI, based on percentage vascular canal area, = C/(C + R + O + L)]. Regional variations in predominant collagen fibre orientation (CFO) may be the adaptive characteristic mediated by LI. Using turkey ulnae, we tested the hypothesis that site-specific variations in predominant CFO and LI are strongly correlated. Mid-diaphyseal cross-sections (100 +/- 5 micro m) from subadult and adult bones were evaluated for CFO and LI using circularly polarized light images of cortical octants. Results showing significant differences between mean LI of subadult (40.0% +/- 10.7%) and adult (50.9% +/- 10.4%) (P < 0.01) bones suggest that adult bones experience more prevalent/predominant torsion. Alternatively, this relationship may reflect differences in growth rates. High positive correlations between LI and predominant CFO (subadults: r = 0.735; adults: r = 0.866; P < 0.001) suggest that primary bone can exhibit potentially adaptive material variations that are independent of secondary osteon formation.     

异种煅烧骨材料修复骨缺损：特点、优势与问题

文题释义： 拔牙位点保存：当由于各种原因拔除牙齿后,其周围的牙槽骨在前6个月将会发生水平向和垂直向上的严重吸收,导致种植手术时骨量不足,严重影响种植修复的成功率。许多学者建议在彻底拔除牙齿的同时,于拔牙窝内放置骨粉和骨膜进行保护和修复性干预,将会显著减少周围牙槽嵴生理或病理性的骨吸收、阻断周围龈缘和龈乳头的退缩,保存牙槽窝周围软硬组织的高度和形态,并改善新生软硬组织的质量,为后期的种植美学修复创造良好条件。 爬行替代：在具有良好血供的骨损伤区域植入骨移植材料后,将会激活骨再生程序：破骨细胞开始活动,并在植骨材料上进行骨吸收,形成一条条“沟”状缺损,引导骨原细胞进入,随之分化为成骨细胞,成骨细胞分泌大量的类骨质,钙化成骨基质,成熟为骨单位。即在骨移植材料逐渐吸收的部位新生骨组织逐渐形成,充填骨吸收的凹陷。 背景：牙种植区域的牙槽骨骨量不足增加了种植手术难度,植骨材料的出现成功解决了此类难题。在所有单一植骨材料中,异种煅烧骨被广泛用于治疗骨缺损,但单独使用煅烧骨时仍然存在一些缺点。 目的：结合最新的相关研究动态,对异种煅烧骨材料修复骨缺损的相关研究进展作以综述。 方法：第一作者以“calcined bone,xenogeneic bone,bone augmentation,bone substitute”为英文检索词,以“煅烧骨、异种骨、骨增量、骨替代材料”为中文检索词,应用计算机检索 PubMed、维普、万方、知网数据库中1986年1月至2019年11月已发表的相关文献,并进行筛选、归纳与总结,最终纳入69篇相关文献进行综述。 结果与结论：在所有骨移植材料中,异种煅烧骨的结构与人类骨骼相似,具有良好的互连孔性,便于血管因子和骨原细胞进入,为新骨形成提供了通道和支架作用,同时具有良好的生物相容性及一定的降解作用,受到临床医生们的青睐。但其本身仍然存在溶解度较低、吸收缓慢、机械性能较差等不足,这就促使研究者们研发出将煅烧骨与陶瓷、聚合物、骨诱导因子及金属离子等其他材料复合,发挥出所参与材料的优点,从而使复合材料成为骨增量材料的首选。 ORCID: 0000-0002-0313-7462(李芳) 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

人胚胎长骨中骨形态发生蛋白的免疫组化研究

目的：探讨骨形态发生蛋白与人胚胎骨发生及发育的关系。方法：用免疫组化技术和图像分析系统研究了第9－24周人胚胎股骨中骨形态发生蛋白的分布规律及胎龄性变化。结果：第9周胚胎股骨为软骨锥形,雏形的软骨膜,软骨基质及其两端的软骨细胞骨形态发生蛋白呈阳性反应,第10－24周胚胎股骨中,骨形态发生蛋白阳性反应主要见于成骨细胞,骨膜内层细胞,新生骨细胞及骨基质中,破骨细胞及骨髓细胞骨形态发生蛋白也呈阳性反应,骺软骨为阴性,但其内的软骨管为阳性反应,图象分析测定表明：人胚胎股骨内成骨细胞及骨小梁的平均灰度值随胎龄增加而逐渐下降,同一股骨内不同部位的骨小梁和成骨细胞的平均灰度值有所不同,结论：骨形态发生蛋白与胚胎骨的发生及发育密切相关。     

骨钉和脱钙骨在骨创伤和骨缺损中的应用

目的：探讨同种异体冻干骨钉固定关节内骨折和脱钙骨移植治疗骨缺损的实用价值。方法：应用骨钉治疗关节内骨折７例，其中股骨头骨折４例，距骨骨折１例，内踝骨折２例；应用脱钙骨皮质骨条、松质骨粒移植治疗四肢骨折骨不连６例、骨良性病变切除术后骨缺损６例。结果：术后随访３～１２个月，骨钉固定者８个月后骨钉与宿主骨融合，脱钙骨皮质骨条和松质骨粒植骨者２～６个月愈合，无一例发生免疫排斥反应，近期效果满意。结论：认为骨钉为临床治疗关节内骨折提供了一种新的内固定材料，避免再次手术取内固定物，脱钙骨皮质骨条或骨粒适宜于骨不连和骨缺损的填充植骨治疗。     

豌豆骨移位代月骨的应用解剖

在15只成年上肢标本和57套腕骨标本上观察了豌豆骨的形态和血供。豌豆骨的骨内、外血管网发达,吻合丰富,有3～5支营养血管。以尺侧腕屈肌腱为蒂进行移位代替月骨,血供有保证。豌豆骨的纵径刚好与月骨的横径相近,故将纵置的豌豆骨改为横置方位:适当保留豌豆骨周围部分软组织,可以填补月骨空间,又能保存骨周围血管网。     

人体腕骨显微骨硬度分布特征的研究

目的 探讨人体腕骨显微骨硬度的分布特征及其临床意义。方法 纳入3具新鲜冰冻成人尸体标本(62岁男性、58岁男性、45岁女性),将右侧腕骨软组织剥离后,用慢速锯分别在舟骨、月骨、头状骨、钩骨、大多角骨和小多角骨切取厚3 mm的骨组织标本。舟骨选取舟骨结节、腰部内外侧和舟骨体部,月骨选取腕关节面、掌侧面、背侧面和远端,头状骨、钩骨、大多角骨和小多角骨选取外层皮质不同区域,应用德国KB-5型显微维氏硬度仪测试标本不同区域的硬度值,采用50 gf力加载50 s、维持12 s的标准操作方法进行硬度值测定,每个区域选取 5 个有效值,全体有效值的平均值作为该部位的骨硬度值。观察不同骨骼间及骨骼内部不同区域的骨硬度值差异。结果 3具标本中共取得舟骨、月骨、头状骨、钩骨、大多角骨和小多角骨标本切片18片,测量位点255个。腕骨不同骨骼骨硬度从高到低依次为钩状骨(39.04±5.79)HV、头状骨(38.98±6.17)HV、舟骨(37.72±5.85)HV、大多角骨(35.89±4.75)HV、月骨(33.65±5.42)HV及小多角骨(31.82±5.54)HV,不同骨骼间总体骨硬度差异有统计学意义(F=10.783,P＜0.01)。舟骨、月骨内部不同区域骨硬度分布近似,舟骨结节、腰部外侧、腰部内侧和舟骨体部骨硬度分别为(37.07±5.77)、(37.51±6.39)、(40.00±5.64)、(36.31±5.47)HV,其中腰部内侧骨硬度最大,舟骨体部骨硬度最小,4部位间骨硬度比较差异无统计学意义(F=1.129,P＞0.05)。月骨腕关节面、掌侧面、背侧面和远端骨硬度分别为(33.57±3.61)、(34.58±6.04)、(35.47±5.24)、(30.97±5.88)HV,其中背侧骨硬度最大,远端骨硬度最小, 4个部位间骨硬度比较差异无统计学意义(F=2.040,P＞0.05)。结论 健康人腕骨不同骨骼间硬度各有不同,舟骨和月骨内部各部位骨硬度分布均匀一致。测量腕骨显微骨硬度值,了解其分布特征,有助于了解腕骨微观生物力学性能,亦可指导腕骨骨折内固定方法的选择,设计制作更加符合人体生理状态下的腕部骨骼假体及建立腕部肌骨组织的有限元模型。临床试验注册 中国临床试验注册中心,注册号为ChiCTR-BPR-17010818。     

The structure of pedicle and hard antler bone in the European roe deer (Capreolus capreolus): a light microscope and backscattered electron imaging study

Deer antlers are deciduous bony structures that develop from permanent frontal outgrowths, the pedicles. While growth and bone architecture of antlers have been studied in greater detail, information on pedicle formation and structure is scarce. The present study provides information on the structure of pedicle and hard antler bone in the European roe deer. A pronounced seasonal variation in pedicle architecture was observed, with high porosity around antler casting and a very compact bone structure during the hard antler stage. These observations suggest a corresponding marked variation also in the biomechanical properties of the pedicles. The seasonally alternating extensive resorption and formation processes make the pedicles of older deer heavily remodeled structures. Pedicles increase in thickness by apposition of primary bone that subsequently becomes replaced by secondary osteons. The antler cortex of roe deer is largely composed of a tubular framework of woven bone trabeculae with some remnants of mineralized cartilage, and primary osteons that have filled in the intertrabecular spaces. Secondary osteons are scarce, denoting little remodeling in antlers, which can be related to their short lifespan. The occurrence of cement lines around primary osteons indicates resorption on the trabecular scaffold prior to infilling of the intertrabecular spaces. The outer cortex showed a higher autofluorescence and a more immature structure than the main cortex, suggesting that it was secondarily formed by periosteal activity. Pedicles and antlers constitute a functional entity, and future histological and/or biomechanical studies should therefore consider both components of the cranial appendages.