Willis环各部分变异与脑梗死发生的相关性

目的:利用计算机断层扫描血管成像(CTA)技术探讨Willis环各部分变异与脑梗死发生的相关性。方法:回顾性分析新乡医学院第三附属医院住院患者,根据急性缺血性脑卒中诊断标准,分为脑梗死组和对照组,根据Willis环的完整性,分为Ⅰ型、Ⅱ型、Ⅲ型和Ⅳ型4种类型,分析2组中Willis环类型及各部分变异与脑梗死的相关性。结果:与对照组相比,脑梗死组Ⅰ型所占比例较低,Ⅳ型比例较高,前交通动脉变异率差异有统计学意义,余部分变异率差异无统计学意义;前交通动脉变异与脑梗死发生有关,脑梗死组前交通动脉变异与前交通动脉正常的比值是对照组的3.176倍。脑梗死组左右两侧大脑前动脉交通前段变异率差异有统计学意义,余部分左右对比无明显差异。结论:Willis环前交通动脉变异与脑梗死的发生有密切相关性,是脑梗死的危险因素。     

The anterolateral ligament: A cadaveric study in fetuses

The aim of this study was to determine the presence and morphology of the anterolateral ligament (ALL) of the knee in a sample of fetuses. We hypothesized that the ALL is present in sample fetuses and its origin is not related to repetitive stresses throughout life. Forty fresh‐frozen knees from cadaveric fetuses were dissected using a standard technique. The ALL and other structures in the anterolateral compartment of the knee were identified. The details of the femoral and tibial attachments, course and relationships with anatomical structures of the ALL were identified, recorded, and quantitatively characterized. The ALL was identified in 100% of the dissected knees. We found three anatomical patterns regarding the femoral attachment: (1) Proximal and posterior to the fibular collateral ligament (55%); (2) Together with the fibular collateral ligament (25%); and (3). Anterior and distal to it (20%). The ALL was extracapsular with an oblique course attaching into the anterolateral aspect of the tibia, midway between the midpoint of Gerdy's tubercle and the fibular head. The ALL has a strong attachment to the lateral meniscus, creating two fascicles: proximal or meniscofemoral and distal or meniscotibial. The ALL is a constant, extracapsular anatomical structure in the anterolateral compartment of the knee, present from the later prenatal period of life. Its morphology shows three different patterns of femoral attachment in relation to the fibular collateral ligament position, a strong attachment in the lateral meniscus, and a constant tibial attachment. Clin. Anat. 30:625–634, 2017. © 2017 Wiley Periodicals, Inc.     

正常兔眼后房压强及前后房压强差值的在体监测

目的 寻求一种眼后房穿刺方法,并在体测量兔眼的前、后房压强差.方法 利用高精度压力传感器与空气差压传感器,采用＂从角巩膜缘外周1～1.5mm处进针穿透巩膜,使针水平滑行于虹膜下而进入后房＂的扎针方法,实现在体连续监测正常兔眼麻醉状态下的后房压强与前后房压强差值.结果 麻醉状态下兔眼后房压强的范围在839.93～2662.48Pa;前、后房压强差范围是46.15～85.52Pa,均值为59.73Pa,变化周期为11.17min.结论 扎针方法测量兔眼后房压强及前后房压强差值对眼球损伤较小,监测到的正常兔眼后房压强及前后房压强差值均在合理可信的范围内.监测方法的可行性为青光眼前后房压强差值的在体监测提供了新的思路.     

颈前路带锁钢板联合植骨手术治疗颈椎骨折

目的探讨和评价颈前路带锁钢板联合钛网植骨治疗颈椎损伤的应用价值。方法自2003年6月至2009年5月经住院手术的13例颈椎骨折的患者行颈椎前路椎体次全切除术减压,同时带锁钢板内固定联合钛网植骨或自体髂骨植骨融合。结果全部病例得到随访,平均18个月,内固定牢靠无松脱,植骨融合,椎体高度无丢失。结论颈前路带锁钢板联合钛网植骨可即刻恢复节段高度,重建节段稳定性,手术操作简单,并发症少,解决了颈椎损伤重建的难题。     

脉络丛前动脉显微解剖结构的临床应用研究

目的研究脉络丛前动脉显微解剖结构的临床应用及其意义。方法用体视显微镜和手术显微镜对21例（42侧）成人脑标本进行观察,研究脉络丛前动脉显微解剖结构特点。结果脉络丛前动脉来源于颈内动脉者37侧（88.1%）;来源于大脑中动脉者3侧（7.2%）;来源于后交通动脉者2侧（4.8%）。左侧脉络丛前动脉比右侧粗大者占78.9%。脉络丛前动脉的起始处管径变异较大,平均（0.79±0.27）mm。管径从起始部发出随行程延伸越来越细,中段管径0.35~0.71 mm;末段管径0.16~0.33 mm。脉络丛前动脉主干长（2.88±0.48）cm。海马旁回钩前沟定位与交点的距离右侧为（11.17±1.78）mm,左侧为（10.93±2.13）mm。结论双侧脉络丛前动脉管径无明显差异,发生痉挛易导致视束的供血障碍。相关颞叶内侧附近手术时,海马旁回钩前沟定位比较准确,手术时要注意在以海马旁回钩前沟为标志的交点处保护脉络丛前动脉。     

Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome

Context:

Very few authors have investigated the relationship between hip-abductor muscle strength and frontal-plane knee mechanics during running.

Objective:

To investigate this relationship using a 3-week hip-abductor muscle-strengthening program to identify changes in strength, pain, and biomechanics in runners with patellofemoral pain syndrome (PFPS).

Design:

Cohort study.

Setting:

University-based clinical research laboratory.

Patients or Other Participants:

Fifteen individuals (5 men, 10 women) with PFPS and 10 individuals without PFPS (4 men, 6 women) participated.

Intervention(s):

The patients with PFPS completed a 3-week hip-abductor strengthening protocol; control participants did not.

Main Outcome Measure(s):

The dependent variables of interest were maximal isometric hip-abductor muscle strength, 2-dimensional peak knee genu valgum angle, and stride-to-stride knee-joint variability. All measures were recorded at baseline and 3 weeks later. Between-groups differences were compared using repeated-measures analyses of variance.

Results:

At baseline, the PFPS group exhibited reduced strength, no difference in peak genu valgum angle, and increased stride-to-stride knee-joint variability compared with the control group. After the 3-week protocol, the PFPS group demonstrated increased strength, less pain, no change in peak genu valgum angle, and reduced stride-to-stride knee-joint variability compared with baseline.

Conclusions:

A 3-week hip-abductor muscle-strengthening protocol was effective in increasing muscle strength and decreasing pain and stride-to-stride knee-joint variability in individuals with PFPS. However, concomitant changes in peak knee genu valgum angle were not observed.     

Beyond faithful conduction: short-term dynamics, neuromodulation, and long-term regulation of spike propagation in the axon

Most spiking neurons are divided into functional compartments: a dendritic input region, a soma, a site of action potential initiation, an axon trunk and its collaterals for propagation of action potentials, and distal arborizations and terminals carrying the output synapses. The axon trunk and lower order branches are probably the most neglected and are often assumed to do nothing more than faithfully conducting action potentials. Nevertheless, there are numerous reports of complex membrane properties in non-synaptic axonal regions, owing to the presence of a multitude of different ion channels. Many different types of sodium and potassium channels have been described in axons, as well as calcium transients and hyperpolarization-activated inward currents. The complex time- and voltage-dependence resulting from the properties of ion channels can lead to activity-dependent changes in spike shape and resting potential, affecting the temporal fidelity of spike conduction. Neural coding can be altered by activity-dependent changes in conduction velocity, spike failures, and ectopic spike initiation. This is true under normal physiological conditions, and relevant for a number of neuropathies that lead to abnormal excitability. In addition, a growing number of studies show that the axon trunk can express receptors to glutamate, GABA, acetylcholine or biogenic amines, changing the relative contribution of some channels to axonal excitability and therefore rendering the contribution of this compartment to neural coding conditional on the presence of neuromodulators. Long-term regulatory processes, both during development and in the context of activity-dependent plasticity may also affect axonal properties to an underappreciated extent.     

New anatomical profile of the nasal musculature: dilator naris vestibularis, dilator naris anterior, and alar part of the nasalis

The aim of this study was to clarify the morphology and topography of the dilator naris vestibularis, dilator naris anterior, and alar part of the nasalis. Anatomical variations in the topographic relationships are also described to provide critical data for understanding nasal muscular functions. Anatomical and histological examinations were performed on 40 specimens of embalmed Korean adult cadavers. The dilator naris vestibularis muscle (named by the present authors) was located between the external and vestibular skin of the alar lobule. The muscle fibers radiated along the dome-shaped nasal vestibule. The dilator naris anterior muscle originated from the frontal surfaces of the lateral half of the lateral crus and the accessory alar cartilage adjacent to the lateral crus. The extent of the lower insertion of the dilator naris anterior muscle was at the alar groove. The alar part of the nasalis originated with the transverse part of nasalis from the maxilla. It ascended to attach to the alar crease and the adjacent deep surface of external skin of the alar lobule. These findings may provide anatomical knowledge required to understand the structure and function of these nasal muscles such as during rhinoplasty or other surgery of the face.     

颈动脉肿瘤术前大脑Willis环状况判定的临床研究

目的:探讨颈动脉瘤和颈动脉体瘤手术治疗前大脑Willis动脉环侧支循环状况判定的方法和标准,评价DSA全脑血管造影方法判定一侧颈动脉(颈内动脉)术中永久性阻断的安全性.方法:本组颈动脉瘤和颈动脉体瘤患者共14例,均行CT平扫、CT增强扫描和CTA血管成像三维重建,9例行DSA全脑血管造影检查.8例行手术治疗,3例保留颈总动脉和颈内动脉剥除肿瘤、5例颈总动脉(颈内动脉)连同肿瘤一并切除;4例术中同步行脑电图监测.分析术前颈动脉压迫训练后DSA全脑血管造影、术中脑电图监测等方法评价大脑侧支循环的可行性和可靠性.结果:8例手术患者中,无死亡病例,切口均一期愈合.术后均获随访3月～5 a,肿瘤相关症状消失,无肿瘤复发,其中1例术后出现偏瘫、失语,半年后康复.结论:DSA全脑血管造影检查是颈动脉肿瘤术前判断大脑Willis环侧支循环状况的重要方法,但不能作为判定一侧颈动脉结扎、切除安全性的"金标准".     

Canine cruciate ligament ruptures: Implications for financial costs and human health

The cranial cruciate ligament (CCL) in dogs is homologous to the anterior cruciate ligament (ACL) in humans. Factors that place an individual at-risk for noncontact ruptures are not clearly defined in humans or dogs. Cyclic variation in human females as well as early spay/neuter in canines has frequently implicated hormonal variation, however these factors do not fully explain the human dimorphic or canine breed rupture rates. The present study examined dogs as a proxy model for humans to better understand the covariance. A random clinical data sample from the Oklahoma State University Veterinary Hospital was obtained on (n = 29) CCL surgical cases and nonsurgical (n = 28) controls. A statistical test for association of spay/neuter with CCL rupture was significant (chi-square = 21.7, p < .01). Sex balance between the groups was not significantly (p > .01) different. Data on other variables related to morphometric variability such as the tibial plateau angle was not available on the nonsurgical sample and comparisons could only be made to values from the literature. Though there may have been sample bias, this preliminary study found that more large than small dogs were represented in the surgical sample. Our results also support the claim that spayed/neutered dogs are more likely to rupture their CCL than intact dogs. Given the high costs of surgical repair, both for canines and humans, we argue for multivariate studies that investigate the interaction of variables in a larger subject sample which can provide comparable data on all parameters.