羊胫骨微血管构筑

采用血管Ｘ线造影法和血管墨汁切片法，观察了８侧羊胫骨的微血管构筑。结果表明：（１）胫骨的血供求为滋养动脉，骺一干骺动脉和骨膜动脉；（２）骨皮质与骨膜之间的交通血管为微动脉，毛细血管，微静脉；（３）骨干骺皮质由滋养动脉和骨膜动脉共同供应，前者供应骨皮质深层２／３区域，而后者供应骨皮质浅层１／３区域，结果提示：骨干骨皮质的血流是“双向的”，既可由骨内膜流入骨皮质，亦可由骨外膜流入骨皮质。     

以第1或第2穿动脉为蒂骨瓣转位重建股骨距的应用解剖

目的：为带血管蒂骨瓣转位重建股骨距提供解剖学依据。方法：３０侧经动脉内灌注红色乳胶的成人下肢标本，对第１、２穿动脉起始、走行、分支分布和骨膜支进行详细的解剖学观察。结果：股深动脉在小转子尖下４．５±１．３ｃｍ、９．３±２．７ｃｍ处分别发出第１、２穿动脉，外径分别为２．８±０．７ｍｍ、２．４±０．６ｍｍ。穿动脉发出１～３支外径在１．０ｍｍ以上的肌骨膜支，分布于股骨后部中上段骨膜。结论：可以第１或第２穿动脉为蒂设计股骨瓣，可转位重建股骨距或修复股骨颈。     

兔胫骨骨折愈合微血管重建的研究

目的 为澄清骨折愈合微血管重建意见的分歧。方法 实验用兔２４只,４只用于正常胫骨血管观察,另２０只制成骨折模型,术后分别按３,８,１８,２８,４２天处死,观察微血管重建,结果：（１）微血管数量生长可分为三个时期,初期（约１周）骨折部位无或有少新生血管,中期（２－４周）血管形成达最高峰;后期（５周以后）血管数量减少并逐渐转为正常形成。（２）侧支循环的建立是多源的,包括从骨膜动脉到骨痂;从骺－干骺动脉     

第2跖趾关节,肌腱及皮瓣复合植物的显微外科解剖

目的：为第２跖趾关节、肌腱及皮瓣复合组织移植修复掌指关节、肌腱及皮肤缺损提供应用解剖学基础。方法：在２０侧灌注红色乳胶的新鲜足标本上，对第２跖趾关节、肌腱及邻近皮肤的血供进行了观测；２侧标本摹拟术式设计。结果：第２跖趾关节、肌腱及皮肤由第１、２跖背及跖底动脉供给，其分支间在关节周围和深浅筋膜间形成丰富吻合。其中第１跖背动脉沿途发４￣９支、外径０．１￣０．３ｍｍ（混合支０．５￣０．８ｍｍ）的分支，至     

旋股外侧血管横支大转子骨瓣修复股骨中上段的解剖及应用

目的：为股骨干骨缺损、骨折骨不连修复提供新的手术方法，方法：在４０侧标本上对旋股外侧动脉横支进行解剖学观察，设计了以该血管为蒂大转子骨瓣转位修复股骨干中、上段及股骨头颈部骨折、骨缺损。结果：该动脉外径２．５ｍｍ，长度５．１ｃｍ，在股外侧肌深面和外缘发出２～４支外径在０．４～１．１ｍｍ的骨膜支到大转子前外侧，供应范围３．５ｃｍ×２．０ｃｍ×３．５ｃｍ。结论：以旋股外侧动脉横支为蒂大转子骨瓣移位修复股骨中段或上段骨缺损具有可行性，临床应用１５例，疗效满意。     

足趾关节移植重建手指关节的应用解剖

在手术显微镜下解剖观察了２０例成人第２、３跖趾关节和近侧趾间关节的结构、动脉供应和神经支配。根据关节的结构特点，提出了供体关节的解剖学方法，移植关节动力系统和稳定系统的建立方法。每个关节有关节囊支、髁支和干骺支三种动脉分支分布。跖趾关节移植时可采用足背动脉－第１跖背动脉、大隐静脉－第１跖背静脉作为血管带，近侧趾间关节移植则利用趾底动脉或趾底固有动脉、趾背静脉作血管带。神经蒂选用趾背神经或趾底神经。     

甲状腺下动脉起自颈总动脉1例

作者在解剖一具成年男尸时，发现右颈总动脉发出甲状腺下动脉，现报道如下： 右颈总动脉自头臂干发出后３．５ ｃｍ处发出甲状腺下动脉，该动脉料向内下，行程２．５ ｃｍ，管径２ ｍｍ，到达同侧甲状腺侧叶下方，供应甲状腺下部（附图）。同侧的甲状腺上动脉发自颈外动脉，右锁骨下动脉未发出甲状颈干，但椎动脉、肩肿上动脉、胸廓内动脉存在。左侧甲状腺下动脉发自甲状颈干，与一般文献描述相似。左、右甲状腺下静脉均注入同侧的头臂静脉，两者注入处相距３．５ｃｍ。 另外，此例标本甲状腺分离为两部，下端达第 ６气管软骨环，其间没有甲…     

带血管蒂下颌骨瓣转位上颈椎融合术的应用解剖

目的：为上颈椎植骨融合术提供带血供骨瓣转位的应用解剖基础。方法：在３０侧成人头颈标本上，对颏下动脉的走行、分支及分布进行观测，并在标本上进行摹拟术式设计；②测量３０块成年干燥下颌骨有关数据。结果：①颊下动脉恒定由面动脉在下颌骨下级附近发出，起始外径为１．８±０．４ｍｍ、长度２．５±０．５ｃｍ，沿下颌骨下缘前行，在正中线处与对侧同名动脉吻合，沿途发出皮支、肌支、腺支及骨膜支等。其中下颌骨膜支２～５支，外径０．３±０．１ｍｍ，供骨面积为２．６ｃｍ×５．４ｃｍ。结论：可以面动脉为蒂带颏下动脉设计下颌骨瓣转位行上颈椎植骨融合的术式。     

中国人C4Qo表型的C4DNA限制性片段长度多态现象：静息基因的机制初探

对１７例中国人Ｃ４Ａ／Ｃ４Ｂ表型中含有Ｑ０的个体的基因组ＤＮＡ进行了ＨｉｎｄⅢＲＦＬＰ的检测。从五型Ｃ４Ａ／Ｃ４Ｂ（３，０／１，１；３；０／２．１；３．３／１．０：３．２／１．０；３．０／１．０）中共检出５种ＲＦＬＰ片段组合Ａ：３２－２５－１５ｋｂ；Ｂ：３２－１５ｋｂ；Ｃ：２５－１５ｋｂ；Ｄ：３２－１５－８．５ｋｂ；Ｅ：２５－１５－８．５ｋｂ）。根据代表Ｃ４Ａ基因缺失的８．５ｋｂ片段的有无，测出大约５０％的Ｃ４ＡＱ０是由基因缺失造成的。此外，本文还对Ｃ４ＡＱ０时Ｃ４Ｂ长、短基因的分配，Ｃ４ＢＱ０时Ｃ４基因的变动情况等进行了分析与讨论。     

踝跖部神经显微断层解剖及其临床意义

目的：为不同部位断足再植提供理论基础和有关数据。方法：用体视学方法对６６例成人踝跖部胫神经及其重要分支进行观测。结果：胫神经的平均横径和面积分别为：第１断层５．８ｍｍ，１４．１ｍｍ２，足底内侧神经的平均横径和面积分别为：第１断层４．０ｍｍ，７．２ｍｍ２，第２断层４．１ｍｍ，６．８ｍｍ２；第３断层４．３ｍｍ，６．５ｍｍ２；第４断层３．７ｍｍ，５．４ｍｍ２；第５断层３．１ｍｍ，４．４ｍｍ２；第６断层３．２ｍｍ，４．４ｍｍ２；第７断层２．９ｍｍ，４．７ｍｍ２。足底外侧神经的平均横径和面积分别为：第１断层３．０ｍｍ，４．８ｍｍ２；第２断层３．１ｍｍ，４．５ｍｍ２；第３断层３．５ｍｍ，４．７ｍｍ２；第４断层４．０ｍｍ，４．４ｍｍ２；第５断层４．５ｍｍ，４．６ｍｍ２。结论：提出了“三段”断足分型法。不同断层平面断足再植吻接神经时要首选吻接主干，但断层１１和１２应根据足部感觉功能需要首选吻接胫侧神经。     

The microvascular anatomy of the metatarsal bones: a plastination study

Purpose  The purpose of this study was to categorize and systematize the arterial supply of the metatarsal bones and furthermore the observation of arterial lesions after frequently performed forefoot surgeries. Materials and methods  Twenty-two cadaver feet were analyzed by two plastination methods and the enzyme maceration method. Five forefoot surgeries were performed after arterial injections. Results  The bases of the metatarsal bones were primarily supplied by dorsal and plantar arteries. The arterial supply of the metatarsal diaphysis was given by a frequently observed nutrient artery. The first plantar metatarsal artery was the main supply of the first metatarsal head. The plantar and dorsal metatarsal arteries supplied the lesser metatarsals heads. The forefoot surgeries revealed lesions of arteries in all cases. Conclusions  The plastination methods were excellent methods to analyze the arterial supply. In addition arterial damage after forefoot surgeries could be analyzed with these methods.     

Arterial anatomy of the hallucal sesamoids

The aim of this study was to analyze the arterial supply of the sesamoid bones of the hallux. Twenty‐two feet from adult cadavers were injected with epoxide resin or an acrylic polymer in methyl methacrylate (Acrifix®) and subsequently processed by two slice plastination methods and the enzyme maceration technique. Afterwards, the arterial supply of the sesamoid bones was studied. The first plantar metatarsal artery provided a medial branch to the medial sesamoid bone. The main branch of the first plantar metatarsal artery continued its course distally along the lateral side of the lateral sesamoid and supplied it. The supplying arteries penetrated the sesamoid bones on the proximal, plantar, and distal sides. The analysis and cataloging of the microvascular anatomy of the sesamoids revealed the first plantar metatarsal artery as the main arterial source to the medial and lateral sesamoid bones. In addition, the first plantar metatarsal artery ran along the lateral plantar side of the lateral sesamoid bone, suggesting that this artery is at increased risk during soft‐tissue procedures such as hallux valgus surgery. Clin. Anat. 22:755–760, 2009. © 2009 Wiley‐Liss, Inc.     

第1跖骨颈部跖侧动脉分布及吻合的临床解剖研究

目的:研究足底第1跖骨颈部附近的动脉吻合特点,为临床涉及该部位动脉的手术提供解剖学依据。方法:随机选取12侧成人足标本,动脉乳胶灌注,制作血管显微解剖标本,对第1跖骨颈部跖侧的动脉分布及吻合进行观察。结果:在第1跖骨颈部跖侧,由第1跖底动脉向胫侧和腓侧分为两支,两者与第1跖底动脉主干呈‘Y'型分布。两个支在长屈肌腱下,分别向胫侧和腓侧分为上行支和下行支,两侧的上行支和下行支分别与各自的发起动脉又各自形成一个‘Y'型。以上三者相互联系形成立体型的"3Y吻合"。第1跖骨中远1/3交界附近,还有第1跖骨胫侧动脉自第1跖底动脉发出,该动脉也分为上行支和下行支,形成第4个"Y",考虑到该处则共形成"4Y吻合"。结论:第1跖骨颈部跖侧的动脉吻合的参与血管较多,结构较复杂,本文中作者引入"3Y吻合或4Y吻合",能够较形象地描述该处的动脉结构特点。     

Deep plantar arteries of some mammals, with special reference to the plantar metatarsal arteries

The plantar metatarsal arteries of some mammals were studied. In the dog, raccoon dog and cat, the second proximal perforating branch was fully developed and produced the plantar metatarsal arteries. These plantar metatarsal arteries ran on the plantar surfaces of the interosseous muscles along the metatarsal bones or intermetatarsal spaces, and gave rise to the digital arteries of the second to fifth toes. In the rabbit, a branch of the medial plantar artery ran transversely on the plantar surfaces of the metatarsal bones at a level distal to the bases of these bones, and produced the plantar metatarsal arteries. These plantar metatarsal arteries ran deep in the interosseous muscles along the metatarsal bones or intermetatarsal spaces, and joined with the digital arteries which were derived from the medial plantar artery. The plantar metatarsal arteries could be classified into four kinds of arteries (sM, sI, dM and dI) in relation to the interosseous muscles and metatarsal bones. This classification largely coincides with that of the human hand and foot (Murakami, 1969, 1971), the monkey hand and foot (Nakai et al., 1987; Hinenoya et al., 1987), and the forepaws of some animals, including the dog and cat (Murakami et al., 1987).     

第二、三跖趾关节移植的应用解剖学

在30只足标本上观察了第二、三跖趾关节的动脉供应,其中20只足标本还观察了关节的神经支配。每个关节规律地有背胫、腓侧,跖胫、腓侧和跖趾关节后五部分动脉关节支。作关节移植时,若以一条跖背动脉为蒂可有胫侧6支以上或腓侧7支以上的动脉关节支供血。神经蒂可选用趾背总神经或趾底总神经。     

第1跖趾关节及趾趾间关节的血供特点及其临床意义

目的：弄清第１跖趾关节和趾趾间关节的血供。方法：正常动脉灌注红色乳胶成人足２４只,观测第１跖趾关节和趾趾间关节的结构,各关节血管及神经的分布情况。结果：第１跖趾关节的动脉关节支来源于第１跖背动脉、第１跖底动脉以及它们的分支趾趾背动脉、趾底动脉和横动脉。它有背胫侧、背腓侧、跖胫侧、跖腓侧、关节前和关节后６部分关节支。趾趾间关节的动脉关节支来源于趾趾背动脉、趾底动脉和横动脉。它有背胫侧、背腓侧、跖胫侧、跖腓侧和关节后５部分关节支。结论：第１跖趾关节和趾趾间关节的血供丰富,但跖侧多于背侧,腓侧多于胫侧,故这些部位手术时,切口尽可能在背胫侧,以减少对关节血供的影响。     

Pedal arteries of monkeys, with special reference to the plantar metatarsal arteries

In the Japanese, Formosan and crab-eating monkeys, the dorsal metatarsal arteries and their lateral distal perforating branches were well developed and supplied, directly or via the catella plantaris distalis, the plantar digital arteries. In the black ape, the plantar digital arteries arose from the medial plantar artery. The plantar metatarsal arteries of these monkeys, including the black ape, arose from the catella plantaris proximalis or deep plantar arch and were classified into the superficial plantar metatarsal (sM), superficial plantar intermetatarsal (sI), deep plantar metatarsal (dM) and deep plantar intermetatarsal (dI) arteries in relation to the interosseous muscles and metatarsal bones. This classification largely coincides with that of the human hand and foot (Murakami, 1969, 1971) and the monkey hand (Nakai et al., 1987).     

跟骨血供及其临床意义

通过动脉灌注,对56侧不同年龄(新生儿至67岁)尸体跟骨的血液供应进行了研究。跟骨的动脉分散发自胫后动脉、足底内、外侧动脉、腓动脉、跗外侧动脉、跗骨管动脉和跗骨窦动脉,围绕跟骨组成致密的骨膜动脉网。此网发辐射状动脉至骨内,籍吻合支互连成丛。随骺(软骨)板闭合,于骺动脉与骺动脉之间建立广泛吻合。对跟骨血管分布的临床意义进行了讨论。