小儿胫骨皮质的血液供应

本文采用血管灌注、显微镜观察骨切片的方法,研究了40侧小儿胫骨皮质的血液供应。骨皮质血管主要由毛细血管和静脉窦组成。二者粗细不等,相互吻合成网。滋养动脉是骨皮质的主要血供来源,供应骨皮质深层的3/4左右。骨皮质浅层由骨膜动脉供应。两组血供来源在骨皮质内有广泛吻合。小儿胫骨皮质血管由骨干中部向两侧干骺端呈放射状分布。骨皮质的静脉血主要经皮质窦回流到骨髓静脉内。     

膝关节动脉的血液供应

本文通过动脉灌注,对120侧不同年龄(新生儿至87岁)尸体的膝关节骨性部和软组织的血液供应分别进行了研究。新生儿的膝动脉在软骨内分布呈节段性,软骨骨化后,骨骺和髌骨的动脉间建立广泛的吻合。骺软骨板分隔膝关节的骨骺与干骺端。随骺板的闭合,两者间有血管互相交通。骺板的血液供应来自骺动脉、干骺动脉和滋养动脉终末的毛细血管袢以及骨膜动脉网的小支。髌骨的动脉分3组,发自髌前丛和髌周动脉环。滑膜和髌下脂垫的血管分布丰富。肌睫和韧带在骨的附着处缺乏血管。成人半月板外1/5有血管分布,内4/5无血管。本文对膝关节血管分布的临床意义作了简要讨论。     

跖骨的动脉分布

通过动脉灌注研究了９０侧不同年龄（婴儿至８７岁）尸体跖骨的血液供应。分布于跖骨的动脉来自滋养动脉、骨膜动脉、骺－干骺动脉和假骺动脉。滋养动脉的近、远侧支供应皮质的内２／３￣３／４；骨膜动脉发出少量小支进入骨皮质，供应皮质的外１／３￣１／４；骺－干骺动脉呈轮辐状发自续于跖骨干的骨膜动脉浅丛，供应第１跖骨底和第２￣５跖骨头；假骺动脉从骺－干骺动脉发出后，穿过非关节面区，供应第２￣５跖骨底和第１跖骨头。     

指动脉静脉化在手指末节离断再植的疗效分析

目的　探讨指动脉静脉化重建手指再植血液回流的方法和疗效。 方法　应用离断手指远断端非优势侧指动脉与近断端指掌侧静脉或指侧方静脉吻合治疗手指末节离断病人18例,其中指动脉与指掌侧静脉吻合11例,与指侧方静脉吻合7例。 结果　成活16例,坏死1例,部分坏死1例。 结论　指动脉静脉化为断指再植提供了重建静脉回流的一种有效方法。     

双下腔静脉和借奇静脉回流的下腔静脉异常(共三例)

(一)在200例尸体解剖中发现2例双下腔静脉,为1±0.2％;一例借奇静脉回流的下腔静脉异常,为0.5±0.5％。 (二)双下腔静脉均系双侧上主静脉肾下段存留而成。借奇静脉回流的下腔静脉异常,系右上主静脉全部存留而成。 (三)双下腔静脉第一号的发生因素可能由右髂总动脉、右肾动脉压迫所致。双下腔静脉第二号因破坏较大未作描述。借奇静脉回流的下腔静脉异常可能由于下腔静脉肝后段的不发育,肝静脉与右下主静脉上端间失却联系而上主静脉肾下段的血液不得不循原路流经该静脉肾上段所成的奇静脉所致。     

颈阔肌肌皮瓣的显微外科解剖

本文采用解剖方法和X线造影法观测了成人颈阔肌肌皮瓣的血管和神经。该肌皮瓣的动脉分别来自颏下动脉、甲状腺上动脉、颈横动脉以及面动脉、颈外动脉和颈浅动脉。静脉主要通过颏下静脉、颈横静脉、颈浅静脉和颈外静脉回流。支配颈阔肌的是面神经颈支,管理皮肤感觉的是颈横神经。     

静脉血营养的静脉皮瓣

皮瓣移植后的正常循环方式是血液经动脉灌注毛细血管,代谢交换后由静脉回流。随着研究的深入,人们发现动、静脉对皮瓣的成活并非同等重要。Fujino 用钠廓清法研究狗轴型皮瓣的循环效能,发现损伤其引流静脉,皮瓣50%坏死,而损伤其供血动脉,无一例坏     

动静脉内瘘术后术侧肢体肿胀的预防和护理

动静脉内瘘术是将相邻的动脉和表浅的静脉连接,使静脉动脉化,从而提供充足的血流量,为维持性血液透析患者建立理想的血管通路。患者术后由于静脉回流被阻断或者动脉血流压力的影响,造成肢体远端静脉回流障碍,加上血液粘滞度的改变,静脉血流速度减慢,易致静脉血栓形成,肢体肿胀。自2005年5月-2007年5月,我科35例病人进行了动静脉内瘘手术,通过对患者的的健康教育,术后早期活动,抬高患肢,抗凝治疗等护理措施,收到了良好的效果。     

颅内静脉窦的解剖学结构及其临床意义

正颅内静脉窦是静脉汇集的部位,是静脉血回流经过的重要部位,对保障颅内血液流通、血供稳定具有重要作用。现代医学对颅内动脉疾病研究甚多,而对颅内静脉窦疾病研究相对较少。了解颅内静脉窦内部解剖结构的正常变化有助于在这一区域制定手术方案,避免手术过程中对静脉和窦的损伤,也有助于预测和避免手术中与这些结构相关的问题,还可能对所采用的神经外科手术方法有重要影响,因此对每个患者都应认真研究静脉窦的血管造影和外科解剖学。     

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。     

The microcirculation of bone and marrow in the diaphysis of the rat hemopoietic long bones.

The nature of the microcirculation of the diaphyseal portion of long bones and the adjacent bone marrow is poorly understood. The purpose of this study was to describe the blood supply in the diaphyseal cortex and the relationship of the bone vascular circulation to that of the bone marrow in the growing rat. India ink-gelatin was infused in the arterial system of 3-month-old rats and the vascularization was determined from histological sections. In some studies the periosteal circulation was blocked but the nutrient and metaphyseal arteriole systems were left intact. In the growing rat, most of the vascular flow appears to be centripetally through the diaphyseal cortex and this appears to be the primary blood supply for the adjacent bone marrow. The India ink traversed the cortex and entered the marrow through osteal canals at the endocortical surface. At the marrow-endocortical bone surface interface, ink exiting from the osteal canals filled the adjacent marrow sinusoids in what appeared as "bush-like" structures. From the bone marrow the ink appeared to drain into the central vein. Some arterioles from the nutrient system were found to penetrate the inner two thirds of the cortical bone and then re-enter the bone marrow. The centripetal flow of blood and the importance of the cortical flow for perfusion of the hemopoietic tissue was further documented when periosteal flow was obstructed. In this situation, the cortical bone and adjacent bone marrow were not perfused while the nutrient system and central vein were filled with ink.(ABSTRACT TRUNCATED AT 250 WORDS)     

胎儿和新生儿肾上腺的血管构筑

本文采用血管复型扫描电镜,注射墨汁切片光镜下观察和注射铅丹乳胶X线照像3种方法,研究了28例胎儿和新生儿肾上腺的血管构筑。发自膈下动脉、腹主动脉和肾动脉的肾上腺上、中、下动脉及其分支,在肾上腺囊表面和穿过囊的过程中逐级分支,最后形成毛细血管。动脉和毛细血管共同构成囊血管丛,从该丛发出的皮质动脉和髓质动脉,分别分支供给皮质和髓质。从囊血管丛发出的“V”型动脉在皮质中行一段距离后又返回囊中分支。永久性皮质毛细血管网是囊毛细血管的直接延续。在胎儿性皮质中,毛细血管有两个来源,其一是永久性皮质毛细血管的延伸;另一来源是由皮质动脉分支构成。它们共同构成胎儿性皮质毛细血管网。在胎儿性皮质的中部,毛细血管汇成小静脉。中央区的髓质由髓质动脉供血。在皮质中,正在迁移的髓质细胞团由与之伴行的动脉供应。在皮质中形成的小静脉呈向心性行走。其中一部分在近中央区又分为毛细血管,这些毛细血管相互吻合,最后入中央静脉的属支中。这种分布特点属于门脉形式的血管;另一部分属于中央静脉的第一级属支,它们逐级汇合后形成中央静脉主干。中央静脉系呈树枝状,其主干在腺的前面穿出腺后为肾上腺静脉。左侧肾上腺静脉人左肾静脉;右侧的人下腔静脉。而与动脉伴行的肾上腺上、中、下静脉的末级属支与囊毛细血管相连。本研究讨论了胎儿和新生儿肾上腺血管的分布规律,为胎儿内分泌学和肾上腺移植等方面提供了血管形态学基础。     

软骨膜环及其微循环的观察

本文用微血管造影及组织切片的方法,观察人及家兔发育期管状骨软骨膜环的结构及血液供应。软骨膜环位于干骺端及骺软骨板周围,由3层结构构成,从内向外分別为骨环、间充质细胞带及软骨膜。间充质细胞带内有丰富的血管,它们来自干骺端骨膜。周围的软骨膜很厚,其内也有较丰富的血管,这些血管是骺与干骺血管在骨外交通的桥梁,有些血管可穿过软骨膜环的间充质细胞带供应骺软骨板。本文还对软骨膜环在骨生长发育过程中的功能进行了讨论。     

Vascular regeneration of rabbit femoral bone marrow after curettage (author's transl)

The curettage of a section of bone marrow in rabbit femur entails the destruction of the corresponding vascularization. Starting on the first day the undistroyed interadipocytic network is widely open. It is fed: 1. via those branches of the nutrient artery that stay connected; 2. via branches of the nutrient artery that become disconnected and then form anastomosis with the epiphysial arteries or compact bone arteries and thus become revascularized; 3. via the arteries vascularizing compact bone. By the thirds of fourth day after intervention, both poles of the hematoma are lined by vascular caps. This is composed of a rich network neo-vessels showing three distinct levels. After four or five weeks these networks will have come together and anastomosed. Between the hematoma and the compact bone tissue large vascular lacunae are formed. They receive blood from the arteries of the compact bone. The vascular networks drain into the veins of diaphyseal compact bone or are drained via intact vestiges of the central venous sinus. In those areas where the hematoma is reabsorbed, a partially reconstructed vascular tree appears. Peripheral longitudinal arteries send out centripetal rami towards the central vascular buds as well as centrifugal rami towards subcortical vascular buds. The interdipocytic network also regains its normal morphology. The central venous sinus extends from one epiphysis to the other and is usually drained into the veins of the trochanteric fossa proximally and into the popliteal veins and supra-trochlear veins distally.     

Blood vascular beds of rat adrenal and accessory adrenal glands, with special reference to the corticomedullary portal system: a further scanning electron microscopic study of corrosion casts and tissue specimens

Blood vascular casts of the rat adrenal glands were observed with a scanning electron microscope. The cortical capillary plexus drains, through the corticomedullary venous radicles, into the subcortical veins continuous with the medullary collecting veins. The medullary capillary plexus drains into the corticomedullary venous radicles, subcortical veins and medullary collecting veins. No portal vessel was noted between the cortical and medullary capillaries. These findings indicate that the cortical blood rich in glucocorticoids preferentially and continuously flows into the corticomedullary venous radicles, subcortical veins and medullary collecting veins all three of which are fenestrated in type, and also suggest that the vascular route from the cortical capillaries to the medullary collecting veins functions as a substitute for the portal system, controlling the biosynthesis of catecholamines in the adrenal medulla. The vascular bed of the accessory adrenal gland (extra-adrenal cortical or chromaffin body) is sometimes annexed to that of the adrenal gland. On rare occasions, the vascular beds of the extra-adrenal cortical and chromaffin bodies fuse with each other. Additional scanning of tissue samples confirmed the direct drainage of cortical capillaries into the medullary veins and also the endothelial fenestrations of these capillaries and veins.     

胰腺静脉的临床解剖学研究

在50具成人尸体上观察研究了胰腺静脉。胰头、胰颈的静脉血由胰十二指肠上下静脉和胰颈静脉引流。胰体下1/3由胰下静脉引流;上2/3由5～10条小静脉引流入脾静脉。胰尾多见1～4条小静脉,大都汇入脾静脉。胰腺静脉均汇入门静脉系。文中对胰腺静脉的临床应用进行了探讨。     

The skeleton as a unique environment for breast cancer cells

Bone is a favored location for several cancer metastases especially breast, prostate and myeloma. This review evaluates various properties of the skeleton that contribute to its successful colonization by breast cancer cells. The first consideration is the unique aspects of the vasculature of metaphyseal bone, which may account for the initial lodging of breast cancer cells in specific regions of the skeleton. Metasphyseal bone, found at the ends of long bone, in ribs and in vertebrae, is comprised of trabecular bone interspersed with marrow and a rich vasculature. The chemotactic factors that arise from bone marrow and bone cells are discussed in terms of cancer cell migration out of the vasculature and entry of cancer cells into the marrow cavity. Once the breast cancer cells have migrated into the metaphysis, they interact both directly and indirectly with bone cells and other cells in the marrow. As tumor growth progresses, functional bone cells are lost, most likely through apoptosis. This revised version was published online in July 2006 with corrections to the Cover Date.