On Growth and Morphology of TiO2 Nanotubes on CP-Ti by Anodic Oxidation in Ethylene Glycol Electrolyte: Influence of Electrolyte Aging and Anodization Parameters

Anodic oxidation of CP-Ti, for production of TiO₂ nanotubes, has been extensively described in terms of the electrochemical mechanism of tubular growth or the effect of the parameters on the final tube morphology. Recently, a kinetic growth model was proposed to describe the distinct morphologies of the anodic oxide layer as phases of the nanotubular development process, offering a new perspective for the tuning of nanotube production. In this work, the anodizing behavior of a CP-Ti alloy in an ethylene glycol electrolyte was investigated in light of this new model. The final morphology of the nanotubes was characterized by SEM, considering the effects of electrolyte aging, the microstructure, the applied potential difference and time on the morphological development of nanotubes. Electrolyte aging was shown to lead to a decreased dissolution effect on the oxide. The applied potential difference was shown to lead to an increased dissolution effect and more rapid nanotube growth kinetics, while time resulted in extended dissolution. Moreover, the obtained results were analyzed considering a previous study focused on the anodizing behavior of the α- and β-phases of Ti6Al4V alloy. Overall, the tube morphology resembled that obtained for the Al-containing α-phase of the Ti6Al4V alloy, but the growth kinetics were considerably slower on CP-Ti.     

腹部局部解剖学与临床知识相结合的几点体会

把腹部局部解剖学与临床知识相结合，特别是与急腹症和腹部外科手术相结合，可以提高学生的学习兴趣和热情，提高教学质量；也可以为学生下一步学习临床学科及将来的临床工作奠定坚实的基础，架起方便的桥梁.     

期门穴在数字人体上的可视化研究

目的:建立期门穴三维形态结构的可视化人体模型。方法:以VOXEL-MAN为操作平台,结合腧穴解剖学知识,利用计算机图形图像学技术进行期门穴相关解剖结构的辨认、分割以及可视化。结果:实现了期门穴在可视人体中的定位与表达,完成了相关解剖结构的分割与可视化,建立了相关医学知识库,生成了QTVR格式的智能动画。结论:期门穴三维形态能多层次、多角度显示期门穴的解剖结构和针刺全过程,有助于提高针刺疗效和安全性。     

RESEARCH BASIC TO MEDICAL EDUCATION: Pimping: Perspectives of 4th Year Medical Students

Background: A well-known phenomenon among U.S. medical students known as pimping, or the pedagogical device of questioning students in the clinical setting, receives virtually no attention in medical literature. Purpose: Identifying 4th-year medical students' relevant knowledge and attitudes about pimping may help educators understand the range of beliefs about pimping and the role it plays in the socialization process into the medical community. Methods: Over a 2-month period, 11 fourth-year medical students at a Midwest medical school were asked 6 open-ended questions focusing on pimping as understood and experienced in the clinical setting. Investigators individually analyzed the interview data using qualitative methods to characterize students' experiences and recurring ideas and concepts. Results: All students noted the hierarchical nature of pimping, viewing it as a tool for attendings or residents to assess students' levels of knowledge. Although some students experienced malignant pimping, humiliated by incessant questioning or questions inappropriate to their level of training, all the students in the sample were positive about pimping and its effectiveness as a pedagogical tool. Investigators found that location within the clinical setting determines how students define and understand the motives for pimping. Conclusions: Understanding how students define and experience the pimping phenomenon prepares medical educators to scrutinize pimping as a pedagogical tool and to provide the most effective and encouraging environment for students.     

Anatomical phantom CT study of surgical approaches for 3-D and VR in neurosurgery

Summary. In eight specimens a spiral CT and 3-D reconstruction with postprocessing at an Allegro work station were done. In all specimens approaches of neurosurgical interest were dissected. For example, a transnasal and a trans-oral approach as computer aspects and real anatomy aspect are presented in parallel by photography. The limits of the computer reconstruction are directly visible by comparison with the real anatomy. Additionally, one endoscopic aspect and one ‘virtual reality’ aspect are presented to be compared with real actual anatomy. The problems and possibilities of using 3-D spiral CT developed anatomy are discussed.     

额眉部除皱术的应用解剖学研究

目的:为额眉部除皱术提供解剖学基础。方法:在100个成人颅骨和30具成人尸体标本上解剖和观测了额眉部与除皱术有关的组织结构。结果:眶上和滑车上切迹(孔)至正中线的距离分别为22.8mm±5.3mm和16.5mm±2.8mm,至眶上缘的距离分别为3.5mm±1.4mm和3.2mm±1.5mm。额眉部薄的皮下组织与皮肤和深面的肌组织连接紧密,肌组织与深面的额骨外膜以疏松组织相连,其内走行有眶上、滑车上、颞浅和面血管神经支。眶上动脉神经从眶上缘内、中1/3交界处几近垂直上行,其入肌点是眶上缘上方1.4cm±0.3cm;滑车上动脉神经行于内眦与额正中线之际上1cm点连线的深面,分支入肌点在该线的上2/3部;颞浅动脉额支从鬓角穿出行向额肌,入肌点是外眦上方4.5cm±0.8cm。面神经颞支行于额支动脉的下方,在额肌与眼轮匝肌交角处先交织成网,由网再分支入肌。结论:额眉部除皱术宜于额肌下分离,避免损伤相关的血管神经。     

隐神经卡压征的临床解剖学研究

目的 :探讨隐神经卡压征的解剖学基础。方法 :利用 2 0具成人尸体和 1 5条游离下肢 ,解剖、观测了隐神经在股部穿收肌腱板裂孔和在膝部穿缝匠肌—股薄肌下端间隙处的形态参数 ,并定位。结果 :在股部的收肌腱板裂孔处 ,隐神经宽 (2 .7± 0 .4)mm ,厚(1 .2± 0 .3)mm(厚 /宽 :0 .46) ;裂孔宽 (5 .2± 0 .7)mm ,高 (1 4 .1± 2 .4)mm ,孔远大于穿行其内的隐神经。在膝部的缝匠肌—股薄肌腱间隙处 ,神经宽 (2 .2± 0 .3)mm ,厚 (0 .8± 0 .2 )mm(厚 /宽 :0 .37) ;膝部隐神经更扁薄 ,且当膝关节屈伸时 ,神经在缝匠肌—肌薄肌间隙中受挤压 ,并与两肌内面的腱组织产生摩擦。另为隐神经卡压征的定位提供了一些参数。结论 :就股部收肌腱板裂孔和膝部缝匠肌—股薄肌间隙而言 ;隐神经更易在膝部的肌间隙内受挤压和摩擦而损伤。     

根性撕脱的臂丛前根再植入脊髓的显微解剖

目的：探讨臂丛根性撕脱伤前极再植入脊髓的手术入路解剖。方法：在15例颈胸段尸体标本上，观测臂丛根及其前根解剖，测量椎动脉与颈椎、脊髓的关系，以及各脊髓节段与对应椎间盘的相对位置。另4例标本采用侧前方入路行臂丛前根再植入术。结果：由上至下臂丛根长度、脊髓节段长度、脊髓半径、前根根丝数及其起始处至中线距离逐渐减小，椎体半径、椎动脉至中线距离及前根长度逐渐增大；C5-7脊髓节对应C3-4、C4-5、C5-6椎间盘，C8、T1脊髓节对应C6、C7椎体。结论：侧前方入路可使臂丛前根再植入至最佳位点。     

Glisson蒂横断式肝切除术10例报告

目的总结应用Glisson蒂横断式肝切除术的经验。方法回顾性分析10例行Glisson蒂横断式肝切除术病人的临床资料,其中肝胆管结石7例,胆囊癌1例,肝癌2例。采用Glisson蒂横断式技术分别行右肝后叶切除术(Ⅵ+Ⅶ段)3例,右肝前叶(Ⅴ+Ⅷ段)切除1例,左外叶(Ⅱ+Ⅲ段)切除2例,Ⅲ段切除1例,左半肝(Ⅱ+Ⅲ+Ⅳ段)切除2例,局部肝切除(Ⅳb+Ⅴ段)1例。结果本组病例均成功实施Glisson蒂横断式肝切除术,术中无肝蒂Glisson鞘内管道损伤。手术时间平均4.6(3.2～6.5)h,术中失血量平均440(150～800)ml。术后无严重手术并发症和死亡病例,均痊愈出院。结论 Glisson蒂横断式肝切除术的理论基础在于对肝脏解剖分段新的认识,其操作简单、快速、安全,值得普遍推广应用。     

寰椎椎弓根进钉通道的数字解剖学研究

目的:探讨寰椎椎弓根进钉通道在矢状面角(SSA)为0°时不同水平面角(TSA)方向投影的变化规律。方法:将20例健康成年志愿者(男12例,女8例;年龄24~68岁,平均45岁)的寰椎CT连续断层扫描数据导入Mimics 10.01软件,三维重建寰椎数字解剖模型,将重建的结果以.stl格式保存,再将寰椎数字模型导入UG Imageware 12.0,建立寰椎椎弓根进钉通道数字化分析方法,确定三维参考平面,分析在SSA为0°时左右椎弓根TSA分别从0°～30°,均匀间隔5°,观察280个寰椎椎弓根进钉通道的长度和内切圆半径的变化规律。结果:280个寰椎椎弓根进钉通道的长度为20.54～33.21mm,其中11个通道长度小于最短椎弓根螺钉长度(22mm);TSA为0°进钉时左右通道长度均最大,左右侧比较无显著性差异(P0.05),5°～30°进钉时同一进钉角度左右侧比较有显著性差异(P0.05);同侧不同进钉角度比较无显著性差异(P0.05)。280个寰椎椎弓根螺钉通道的内切圆半径为1.38～2.51mm,其中有42个内切圆半径小于最小椎弓根螺钉半径(1.75mm);同一进钉角度右侧内切圆半径与左侧比较及同侧不同进钉角度比较均无显著性差异(P0.05)。结论:不同个体甚至同一个体的左右两侧椎弓根形态之间有较大差异。部分寰椎椎弓根进钉通道长度和内切圆半径小于椎弓根螺钉最小长度和最小半径,椎弓根进钉通道内切圆半径小于最小椎弓根螺钉半径时置钉会穿破椎弓根的皮质骨,不适合采用经寰椎椎弓根螺钉内固定技术。术前用数字化技术测量寰椎椎弓根进钉通道可以实现个体化置钉。