内耳门周结构对内镜下脑桥小脑三角区手术的影响

目的：研究内耳门周结构对颞骨径路内镜下处理脑桥小脑三角区病变手术的影响，为临床开展相应手术提供参考。方法：在20例40侧成人尸头上模拟颞骨径路内窥镜手术，观察小脑下前动脉及内耳门后唇的变异，了解其对内窥镜导入及其手术的影响。结果：内耳门后唇隆起超过面神经脑桥小脑角段1／3以上者占27．5％(11侧)。小脑下前动脉在Ⅶ、Ⅷ脑神经外侧成袢者占22．5％(9侧)。内耳门后唇隆起合并小脑下前动脉袢在Ⅶ、Ⅷ脑神经之外侧者占7．5％(3侧)。结论：当内耳门后唇隆起超过面神经脑桥小脑角段1／3或小脑下前动脉弓在Ⅶ、Ⅷ脑神经之前时将对内窥镜导入有阻碍，当两种情况合并存在时要将内窥镜导入脑桥小脑三角区相当困难，不宜采用此种手术方式。     

股后区主要穿支的形态学分析与皮瓣设计

目的：为股后区穿支皮瓣的临床应用提供解剖学依据。方法：6具（12侧）动脉灌注明胶．氧化铅混悬液的新鲜成人整尸标本，解剖观测股后区外径≥0．5mm的穿支，测量其管径及其走行、分支与分布情况等。取下整个下肢被覆组织拍摄X线片，观测皮动脉的数量以及彼此间的吻合情况等。利用Photoshop与Scion Image分析穿支供血的趋向性及每个分支的供血面积等。结果：股后区共有穿支（外径≥0．5mm）27支，其中65％为皮穿支，35％为肌皮穿支。平均外径为0．8mm，平均蒂长为2．93cm。自股深动脉之穿动脉发出者平均长度为6．81cm。每侧穿动脉在股后区供血面积平均为229cm^2，平均每个穿支供血面积为43cm^2。结论：股后区的皮肤穿支管径较粗，营养皮肤面积较大，以股后诸穿支为蒂设计的穿支皮瓣可为下肢或身体其它部位皮肤移植提供：①游离皮瓣；②近端蒂皮瓣；③远端蒂皮瓣。     

脊神经后支形态特点及其阻滞麻醉下腰椎间盘手术4063例报告

目的 :介绍一种安全、简便、有效的腰椎间盘手术的局麻方法—脊神经后支阻滞法。方法 :0 .5 %普鲁卡因 10 0ml和 2 %利多卡因 2 0ml混合备用。先在切口处皮内注射 5ml麻药 ,再于开窗侧阻滞 5根脊神经后支主干 (上 3下 2 ) ,麻药用量 3～ 5ml。脊神经后支主干位于横突根部上缘。其体表投影点的确定方法是通过上下棘突连线的上中 1 3交界点作一水平线 ,该线是横突的上缘线的体表投影 ;旁开腰 1棘突 2cm取一点 ;再旁开腰 5棘突 3cm取一点 ;通过这两点作一直线 ,该线与各横线的交点即为各脊神经后支主干部的发出点。结果 :40 63例麻醉效果 :优 72 .2 % ,良 2 4.6% ,中 3 % ,差 0 .2 %。效果差者 ,经静脉使用镇痛镇静类药也取得较好效果。结论 :腰椎间盘手术采用脊神经后支阻滞麻醉经济安全可靠。     

脊髓动脉的显微解剖

在手术显微镜下观察了37例婴幼儿脊髓前(正中)动脉和脊髓后(外侧)动脉的分支,其主要结果如下:婴幼儿脊髓平均长度为14.08±1.49cm,脊髓前(正中)动脉外侧分支平均为76.17±18.64支,中央动脉平均为169.78±25.51支.中央动脉分布到灰质前角、侧角和后角底部及邻近灰质的深层白质,而白质浅层和后角大部,则由软膜动脉网发出的穿支供应.此外.还讨论了与临床应用有关的问题.     

前臂后皮神经营养血管远端蒂复合瓣的应用解剖

目的:为前臂后皮神经营养血管远端蒂复合瓣设计提供解剖学基础。方法:30侧动脉灌注红色乳胶成人上肢标本,解剖观测前臂后皮神经营养血管的来源、分支、吻合及其与尺、桡骨膜血管的关系。结果:前臂后皮神经营养血管来自:桡侧副动脉皮支2～6支,外径(0.6±0.3) mm;骨间后动脉皮支6～9支,外径(0.7±0.3) mm;骨间前动脉腕背支皮支3~5支,外径(0.8±0.2) mm;尺、桡动脉腕背支皮支2~6支,外径(0.6±0.1) mm。尺骨中上段骨膜血管来自骨间后动脉的肌骨膜支6～8支,外径0.3～1.0 mm;骨间后动脉桡侧骨皮支与桡骨中段裸区骨膜血管吻合。上述支发出皮支、筋膜支、骨膜支和神经营养血管,形成皮神经干血管链以及深、浅筋膜和骨膜血管网。结论:前臂后皮神经营养血管与肌、骨、皮营养血管同源,其远端蒂复合瓣,旋转轴点在腕关节平面,适宜手背远处的组织缺损修复。     

Electrode Positioning for Reliable Telemetry ECG Recordings During Social Stress in Unrestrained Rats

We describe a surgical procedure for optimizing the location of telemetry ECG leads in rats. The new location was aimed at obtaining an accurate representation of ECG features throughout the cardiac cycle by limiting the voltage instability usually observed during intense somatomotor activity and improving the signal-to-noise ratio. The two electrodes (wire loops) were fixed on the dorsal surface of the xiphoid process and in the anterior mediastinum close to the right atrium. The implantation procedure was fast, little invasive, and allowed animals to completely recover from intervention. The performance of the “improved” location (IL, n = 10) with respect to two subcutaneous (SC) positionings (“conventional positioning,” CSP, n = 5; “updated location,” USL, n = 5) was evaluated by comparing ECGs obtained in baseline, stress and recovery conditions and during different behavioral activities (immobility and grooming). The resident-intruder test (emotional/physical challenge) was chosen as experimental stress paradigm. The noise level of ECGs obtained from IL rats was lower than in CSP and USL animals, in all recording conditions. Percentages of correctly recognized beats (CRBs) over the total number of beats (TBs) were significantly higher in IL rats than in CSP and USL animals, both in baseline conditions (99% vs. 11% and 40%) and situations involving high somatomotor activity (stress: 97%, 5% and 16%; recovery: 97%, 7%, and 15%) (p < 0.01). The performance of IL as compared to CSP and USL was also better when percentages during grooming and immobility were considered (grooming: 93% vs. 4% and 23%; immobility: 97%, 6%, and 33%; p < 0.01).     

带蒂股后皮神经营养血管皮瓣的解剖与临床应用

目的：报道股后皮神经营养血管带蒂皮瓣的解剖特点与临床应用疗效。方法：在10侧经动脉灌注红色乳胶成人新鲜下肢标本上，解剖观测股后皮神经血供及其筋膜皮支的分布范围，设计股后皮神经营养血管岛状皮瓣转移修复腘窝、髋关节周围软组织缺损6例。结果：股后皮神经营养血管主要来源臀下动脉、穿动脉和腘动脉后侧穿支的升皮支，并在股后区形成网状吻合营养股后侧皮肤。皮瓣5例全部成活，1例皮瓣远端少量坏死，换药后愈合。经12～44个月随访，皮瓣无破溃，膝、髋关节功能活动良好。结论：股后皮神经营养血管岛状皮瓣转位是一种修复腘窝、髋关节周围软组织缺损良好的方法。     

Development of the retinal pathway to the pretectum of the cat

The development of retinal projections to the pretectal complex of prenatal and early postnatal cats has been examined using the anterograde transport of horseradish peroxidase and tritiated amino acids. As early as embryonic day 38, the entire dorsal pretectum is penetrated by retinal ganglion cell axons. At this stage the bilateral complement of retinal efferents appears to be dispersed uniformly within the pretectal anlage. A week later, on embryonic day 46, indistinct foci of peroxidase reaction product can be discerned within 2 of the primordial nuclei: the nucleus of the optic tract and the olivary nucleus. By embryonic day 56, five distinct bilateral fields of retinal fiber termination are apparent within the following regions:

(i) the nucleus of the optic tract;

(ii) the pretectal olivary nucleus;

(iii) the posterior pretectal nucleus;

(iv) the anterior pretectal nucleus; and

(v) the medial pretectal nucleus. Four days before birth, on embryonic day 61, crossed and uncrossed retinal arbors are partially segregated within the nucleus of the optic tract and the pretectal olivary nucleus.

The early postnatal retinal connection to the pretectum has an overall pattern virtually indistinguishable from that of the mature cat. The ontogeny of the retinal influx to the pretectum is similar to that of the retinocollicular projection.⁶¹ However, the development of retinal projections to the pretectum and superior colliculus appears to lag behind those to the dorsal lateral geniculate nucleus.⁴⁹ These differences may reflect temporal and spatial gradients in the maturation of three major classes of retinal ganglion cells.     

大鼠肝再生过程中碱性磷酸酶活性变化及其超微细胞化学研究

目的 研究2／3肝切除后大鼠肝再生过程中碱性磷酸酶(AKP)活性的变化及其细胞定位。方法 利用比色法对AKP活性进行定量分析；用酶的原位复性电泳技术分析再生肝中AKP的种类和活性变化；用电镜细胞化学方法研究酶定位。结果 在肝部分切除后的肝再生期间，AKP出现两个活性高峰(16h和19h)，在每个活性高峰后，AKP均有显著下降；获得3种肝型AKP同工酶(140、160和180kD)，其中180kD的AKP只在肝再生过程中出现；随着肝再生的进展，AKP活性出现在细胞的不同部位。结论 AKP在肝再生过程中起重要作用，可能参与细胞代谢、物质转运、DNA合成和细胞分化。     

The relationship between the electromyogram-amplitude and isometric extension torques of neck muscles at different positions of the cervical spine

A group of 12 healthy men volunteered for the experiment. Electromyograms (EMG) were obtained from semispinalis capitis, splenius capitis, levator scapulae, and trapezius muscles. The flexion angle of the cervical spine was precisely adjusted to 0°, 10°, 20°, and 30° relative to the horizontal, with a constant angle of the atlanto-occipital joint. The subjects made eight short (about 2 s) vertical extension forces (6%, 12%,18%, 24%, 30%, 36%, 42%, and 48% of maximal voluntary peak contraction force). For each position, the centre of pressure under the head was determine as the basis for the calculation of the external lever arm. The presence of motor endplate regions was ascertained by multiple surface electrodes. The slopes of individual linear regression lines for the root mean square (rms)-values were dependent on the existence of endplates in the area of the electrodes — endplates caused smaller rms values per Newton metres of external torque. Significant intersubject differences between regression equations could not be eliminated by the normalization of EMG-parameters and/or torques. The elimination of gravity, the continuous monitoring of positions, and the consideration of localization of motor endplate regions were essential prerequisites for the acquisition of reliable relationships between EMG of different neck muscles and external torques. Two important conclusions were derived for the prediction of torques from EMG measurements: firstly, individual regression equations which take into account the position of the head and neck should be used; secondly, normalization procedures do not justify the application of average regressions to a group of subjects.