后房型人工晶状体植入术后的超声生物显微镜观察

目的：探讨后房型人工晶状体植入术后眼前节结构的改变。确切定位人工晶状体襻的位置。观察人工晶状体襻对于周围组织的影响。方法：白内障摘除及后房型人工晶状体植入术的50名患者（50眼）于术前，术后1周及三个月进行超声生物显微镜观察。结果：术后前房深度，房角宽度押送术前显著增加。人工晶状体中囊袋内植入者36枚（72%）。睫状沟植入者6枚（12%），不对称植入者8枚（16%）。人工晶状体光学部倾斜1眼（2%）。人工晶状体襻推挤虹膜根部2眼（4%）。人工晶状体襻睫状沟侵蚀3眼（6%）。术后1周2眼（4%）眼压升高。皮质少量残留5眼（10%）。结论：囊袋内为后房型人工晶状体植入的理想位置。可保证人工晶状体的良好位置。避免人工晶状体襻对于色素膜组织的干扰及对血-房水屏蔽的损伤，从而减少并发症的发生。     

Does a tensioning device pinned to the tibia improve knee anterior–posterior load‐displacement compared to manual tensioning of the graft following anterior cruciate ligament reconstruction? A cadaveric study of two tibial fixation devices

Devices that are pinned to the tibia to tension an anterior cruciate ligament (ACL) graft produce joint reaction loads that in turn can affect the maintenance of graft initial tension after tibial fixation and hence knee anterior-posterior (AP) load-displacement. However, the effect of these devices on AP load-displacement is unknown. Our objectives were to determine whether tensioning by device versus tensioning by hand causes differences in AP load-displacement and intraarticular graft tension for two commonly used tibial fixation devices: a bioresorbable interference screw and a WasherLoc. AP load-displacement and intraarticular graft tension were measured in 20 cadaveric knees using a custom arthrometer. An initial tension of 110 N was applied to a double-looped tendon graft with the knee at extension using a tensioning device pinned to the tibia and a simulated method of tensioning by hand. After inserting the tibial fixation device, the 134 N anterior limit (i.e., anterior position of the tibia with respect to the femur with a 134 N anterior force applied to the tibia) and 0 N posterior limit (i.e., AP position of the tibia relative to the femur with a 0 N force applied to the tibia) were measured with the knee in 25 degrees flexion. Intraarticular graft tension was measured at extension. These limits and intraarticular graft tension were also measured after cyclically loading the knee 300 times. Compared to a simulated method of tensioning by hand, tensioning with a device pinned to the tibia did not decrease the 134 N anterior limit and did not cause posterior tibial translation. However, intraarticular graft tension was maintained better with a tensioning device pinned to the tibia for the Washerloc, but not the interference screw. For two commonly used tibial fixation devices, a tensioning device pinned to the tibia does not improve AP load-displacement at 25 degrees flexion over tensioning by hand when the graft is tensioned at full extension, but does improve the maintenance of intraarticular graft tension for the Washerloc.     

Development of the rat thalamus: II. Time and site of origin and settling pattern of neurons derived from the anterior lobule of the thalamic neuroepithelium

Short-survival, sequential, and long-survival thymidine radiograms of rat embryos, fetuses, and young pups were analyzed in order to examine the time of origin, settling pattern, and neuroepithelial site of origin of the anterior thalamic nuclei--the lateral dorsal (lateral anterior), anterodorsal, anteroventral and anteromedial nuclei--and of two rostral midline structures--the anterior paraventricular and paratenial nuclei. The neurons of the lateral dorsal nucleus are generated over a 3-day period between days E14-E16 and their settling pattern displays a combined lateral-to-medial and dorsal-to-ventral neurogenetic gradient. The bulk of the neurons of the anteroventral nucleus are generated over a 3-day period between days E15-E17 and settle with an oblique lateral-to-medial and ventral-to-dorsal neurogenetic gradient. The bulk of the neurons of the anteromedial nucleus are generated over a 2-day period between days E16-E17 and show the same settling pattern as the anteroventral nucleus. The neurons of the anterodorsal nucleus are generated over a 3-day period between days E15-E17 and show a lateral-to-medial neurogenetic gradient. The bulk of the neurons of the central part and lateral part of the paraventricular nucleus are generated over a 2-day period (E16-E17 and E17-E18, respectively) and each part displays a ventral-to-dorsal neurogenetic gradient. Finally, the bulk of the neurons of the paratenial nucleus are generated over a 4-day period between days E15-E18 and settle with a lateral-to-medial neurogenetic gradient. Observations are presented that the anterior thalamic nuclei, constituting the distinct "limbic thalamus," derive from a discrete neuroepithelial source. This is the crescent-shaped germinal matrix lining the diencephalic (medial) wall of the hitherto unrecognized anterior transitional promontory, which we call the anterior thalamic neuroepithelial lobule. On day E16 three migratory streams leave the anterior neuroepithelial lobule and, on the basis of their labeling pattern in relation to the neurogenetic gradients of the anterior thalamic nuclei, they are identified, from dorsal to ventral, as the putative migratory streams of the anterodorsal, anteroventral, and lateral dorsal nuclei. On day E17 the putative migratory stream of the anteromedial nucleus appears to leave the same neuroepithelial region that on the previous days was the source of the anteroventral nucleus. Dorsally, two neuroepithelial patches persist after day E17 and these are identified as the putative cell lines of the anterior paraventricular and paratenial nuclei.     

Spontaneous arterial baroreflex control of the heart rate during head-down tilt in heat-stressed humans

The purpose of this study was to elucidate the effect of raised body temperature per se during acute heat stress on the spontaneous arterial baroreflex control of heart rate (f _c) in humans. To investigate whether unloading of cardiopulmonary baroreceptors during whole-body heating would alter the arterial baroreflex control of f _c, we controlled loading of the cardiopulmonary baroreceptors by head-down tilt (HDT) at angles of 5°, 10°, 15°, and 30° during heat stress produced by hot-water-perfused suits. The sensitivity of the arterial baroreceptor-cardiac reflex was calculated from the spontaneous changes in beat-to-beat arterial pressure and f _c. As an index of cardiopulmonary baroreceptor loading, the left atrial diameter (LAD) was measured by echocardiography. During whole-body heating, the LAD decreased with the rising body core temperature and increased with the HDT. The decreased LAD during heating almost recovered to the normothermic control level by 10° HDT. In the supine position, cardiac baroreflex sensitivity remained unchanged during heating. Arterial pressure, f _c and cardiac baroreflex sensitivity were not changed by HDT ranging from 5° to 30° during heating. These results suggest that cardiac baroreflex sensitivity remain unchanged during graded loading of the cardiopulmonary baroreceptors in heat-stressed humans. Also, we conclude that the sensitivity of the spontaneous arterial baroreflex controlling the f _c is not influenced by raised body temperature per se during acute heat stress. Electronic Publication     

尺神经深支,骨间前神经旋前方肌支的应用解剖

尺神经深支向近侧无损伤分离后,可超越旋前方肌上缘以上26.58mm,此时宽1.80mm、厚1.00mm,可与宽1.35mm、厚0.89mm的旋前方肌支缝合。     

线扫描直接数字化X线摄影原理与应用

目的 探讨线扫描直接数字化X线摄影的工作原理与实用价值。方法 以多丝正比室线扫描X线摄影系统为基础，分析线扫描直接数字化X线摄影的适用性。结果 线扫描成像技术克服了散射线造成的干扰，且探测灵敏度和精密度分辨率高。结论 线扫描成像技术适合于除了动态摄影以外的各种数字X线摄影，对我国常规X线摄影逐步实现数字化开辟了美好的前景。     

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。     

平行平板流动腔的合理设计和使用

高度远小于横向和纵向几何尺寸的平行平板流动腔，是当前用以体外研究细胞力学行为，特别是细胞粘附特性的主要工具之一。本文从目前常用的平行平板流动腔内流体定常流动时的切应力表达式出发，指出该切应力表达式仅适用于小雷诺数条件，由此确定平行平板流动腔几何尺寸的合理选择；通过对小孔入流和出流的平行平板流动腔流场的分析，指出该切应力表达式只在远离孔口边界一定距离，即达到均匀流动后成立。     

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.