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102.
目的:通过研究精囊精道解剖学,掌握局部解剖结构,指导临床精道内镜手术。方法:收集并分析临床48例精囊镜手术资料,统计进入精囊路径方式及术后临床效果;同时选取12具成人骨盆段标本进行精囊精道局部解剖研究,并模拟手术路径。结果:解剖结果与临床术中所见相互印证,52. 1%(25/48)临床病例射精管开口无法探及,但93. 8%(45/48)临床病例可经不同途径进入精囊完成手术。结论:经尿道微创精道内镜技术治疗精道、精囊疾病是完全可行的,但仍有局限性,需要结合其他治疗才能取得更好的治疗效果。 相似文献
103.
目的评价基于跟骨前部外侧壁和载距突解剖分区的载距突精准置钉应用于Sanders Ⅱ、Ⅲ型跟骨骨折治疗的效果。方法按"四分法"把跟骨前部外侧壁分为前上区(S1)、前下区(S2)、后上区(S3)和后下区(S4), 用于标定进钉点;"三段法"把载距突分为前段、中段和后段, 用以标定置钉靶点。标本做CT扫描和Mimics建模, 在3D虚拟模型上从跟骨前部外侧壁每个区分别向载距突组配1枚螺钉, 其中S1和S2靶点是载距突内侧前段与中段交点P1, S3和S4靶点是中段与后段交点P2, 观察螺钉是否位于骨性通道内。回顾性分析2017年1月至2021年1月徐州医科大学附属宿迁医院收治的72例Sanders Ⅱ、Ⅲ型跟骨骨折患者资料, 根据不同的载距突置钉法把患者分为解剖分区组和3D打印组。解剖分区组32例, 男25例, 女7例;年龄24~60岁, 基于解剖分区法置钉。3D打印组40例, 男31例, 女9例;年龄25~58岁, 采用3D打印辅助置钉。比较解剖分区组置钉参数与实际值的差异, 比较两组间置钉总数、平均置钉数、螺钉分布和置钉准确率。结果在标本上从S1和S2向P1、S3和S4向P2虚拟置钉, 螺... 相似文献
104.
目的 调查远航舰艇官兵下腰痛发生情况,分析影响因素,为其防治提供理论依据。方法 选择2018年4月至2021年7月参加亚丁湾国际联合护航的海军舰艇官兵作为研究对象,采用问卷调查下腰痛的发生情况。按照是否下腰痛分为下腰痛组与对照组,调查2组人员一般情况以及下腰痛发病情况、影响因素等,通过单因素及多因素Logistic回归分析远航舰艇官兵下腰痛的独立影响因素。结果 678例调查对象中,下腰痛336例,发生率49.56%。单因素Logistic分析显示,下腰痛组全身振动、每周锻炼次数、工作姿势、睡眠状况、是否吸烟与对照组比较差异有统计学意义(P<0.05);多因素Logistic回归分析显示,每周锻炼≤1次、全身振动、固定姿势是远航舰艇官兵下腰痛发生的独立影响因素(P<0.01)。结论 远航舰艇官兵下腰痛发生率较高,每周锻炼≤1次、工作点位涉及全身振动、固定姿势均会增加下腰痛发生的风险。 相似文献
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106.
γ-氨基丁酸(GABA)是成年哺乳动物脑内主要的抑制性神经递质,但电生理的研究表明,GABA在成熟皮质神经元的树突部位可以产生兴奋性作用,但该现象的形态学基础,目前尚不清楚。GABA产生兴奋性作用的关键主要依赖于神经元胞内的氯离子浓度,其中Na+-K+-Cl-共转运体1(NKCC1)促进细胞内Cl-堆积,而K+-Cl-共转运体2(KCC2)则外排胞内的Cl-,降低胞内的Cl-浓度。本研究应用免疫荧光组织化学双重标记结合荧光强度分析,检测NKCC1和KCC2在成年大鼠脑皮质和培养的大鼠脑皮质神经元树突和胞体的表达和分布情况。结果显示:成年大鼠皮质神经元的胞浆和细胞膜均有NKCC1的表达,而KCC2主要表达在神经元胞体和树突膜上,其中NKCC1在神经元树突上的表达水平比胞体高,而KCC2的表达水平在树突和胞体膜上没有明显差异。皮质神经元经培养20d后,NKCC1和KCC2在树突和胞体的表达模式与在体的分布相类似。本研究结果提示,NKCC1在大鼠皮质神经元树突的表达较多,可能是GABA兴奋神经元树突的原因。 相似文献
107.
目的 研究人体指淋巴管的解剖特征为临床提供解剖学基础。 方法 2具新鲜成人尸体4例手标本,指尖两侧皮内,注入少量双氧水墨水混合剂。于真皮下找到淋巴管,将显影剂经30G注射针注入。追踪指淋巴管的行程并进行照像和X线记录。1例标本作指截面研究。 结果 各指两侧皮下各分布淋巴管1支,近指根处偶见多支。它们始于远侧指间关节两侧真皮下、沿指中轴两侧皮下组织蜿蜒起伏地行走。管径0.2~0.8 mm,近端较粗,远端较细。除拇指桡侧和小指尺侧淋巴管各自在掌背尺、桡侧汇入手背淋巴管外,其他指淋巴管在指蹼处与邻近淋巴管吻合,再汇入掌背淋巴管。指横截面显示指淋巴管与周围组织的解剖关系。 结论 详细描述了各指淋巴管的解剖形态,以及与周围组织、血管神经的关系,为临床和科研提供解剖学基础。 相似文献
108.
Objective To evaluate our novel path based on anatomical division of the anterior lateral wall of calcaneus and the sustentaculum tali for precise sustentacular screw placement in the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ. Methods The anterior lateral wall of the calcaneus was divided into the anterior-superior zone S1, the anterior-inferior zone S2, the posterior-superior zone S3 and the posterior-inferior zone S4 for demarcation of the screw insertion points by our method of Four Zones, and into the front, middle and rear sections by our method of Three Sections for demarcation of the screw target points. The specimens were scanned by CT and modeled by Mimics. On the 3D virtual model of the calcaneus, one screw was placed from each zone of the anterior lateral wall of the calcaneus to the sustentaculum tali body. The screw placement target for S1 and S2 was the medial intersection point P1 of the front and middle sections of the sustentaculum tali, and that for S3 and S4 was the medial intersection point P2 of the middle and rear sections of the sustentaculum tali. It was observed whether the screws were placed in the bone channel. A total of 72 patients were included who had been admitted to Department of Orthopaedics, Suqian Hospital Affiliated to Xuzhou Medical University for calcaneal fractures of Sanders types Ⅱ and Ⅲ from January 2017 to January 2021. They were divided into an anatomical division group and a 3D printing group according to their screw placement method for the sustentaculum tali. In the anatomical division group of 32 patients subjected to screw placement based on our anatomical division, there were 25 males and 7 females, aged from 24 to 60 years; in the 3D printing group of 40 patients subjected to screw placement assisted by 3D printing, there were 31 males and 9 females, aged from 25 to 58 years. The disparities between the parameters of sustentacular screw placement and the actual values were compared in the anatomical division group, and the total number of screws, screws on average, distribution of screws, and accuracy of screw placement were compared between the 2 groups. Results All the screws which were virtually placed in the specimens of the calcaneus from S1 and S2 to P1 and from S3 and S4 to P2 passed through the bony channel, with no perforation into the tarsal sinus. There was no significant difference in the general date between the anatomical division group and the 3D printing group, showing they were comparable (P > 0.05). In the anatomical division group, a total of 52 screws were placed to the sustentaculum tali with an average of (1.63 ± 0.48) screws per patient, and 2 screws were placed in 20 patients, yielding an accuracy rate of screw placement of 92.3% (48/52). There were no statistically significant differences between the parameters and the actual values of screw placement in the anatomical division group (P > 0.05). In the 3D printing group, a total of 63 screws were placed to the sustentaculum tali with an average of (1.58 ± 0.49) screws per patient, and 2 screws were placed in 23 patients, yielding an accuracy rate of screw placement of 93.7% (59/63). There were no significant differences in the above comparisons between the anatomical division group and the 3D printing group (P > 0.05). Conclusion In the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ, the sustentacular screw placement based on our anatomical division of the anterior lateral wall of the calcaneus and the sustentaculum tali can lead to similar clinical accuracy as 3D printing-assisted screw placement does. © 2022 Chinese Journal of Orthopaedic Trauma. All rights reserved. 相似文献