Anatomical variations of the cords of brachial plexus and the median nerve

The variations in formation, location, and courses of the cords of brachial plexus and the median nerve were studied in both axillae of 172 cadavers. The total prevalence of variation was 12.8% (CI, 7.6-17.4) and it was found in 13.2% (CI, 7.5-18) of male and in 10.7% (CI, -0.6-19.6) of female cadavers. These variations were divided into three groups. The first group was abnormal location of the cords, which was either posterolateral or anteromedial in relation to the axillary artery in 2.3% (CI, 0.1-4.5) cadavers. The lateral cord and the medial root of the median nerve had received communicating branches from the posterior cord in most of the cases of this group. The second group was absence of the posterior cord in 3.5% (CI, 0.7-6.1) of cadavers. The lateral and medial cords of this group were connected with the communicating branches, which had a course in front of the axillary artery. The third group was abnormal formation and course of the median nerve in 7% (CI, 3.1-10.6) of cadavers. In all cases of this group the medial root received communicating branch/branches either from the lateral or posterior cord. In eight (4.7%) cadavers, both roots of the median nerve were joined on medial side of the axillary artery to form a median nerve, which traveled medial to the artery. In four (2.3%) cadavers the roots of the median nerve did not join and both traveled separately anteromedial to the axillary and brachial arteries. This study indicates that all three cords and median nerve vary considerably in levels of origin, location and course in relation to the axillary artery and these variable cases were joined with the communicating branch/branches. The observed variations are of anatomical and clinical interest. These kinds of variations are more prone to injury in radical neck dissection and in other surgical operation of the axilla.     

The X-pointer: A forgotten anatomical relationship of spinal accessory nerve and great auricular nerve

IntroductionThe preservation of the spinal accessory nerve cannot be overlooked in neck dissection. Injury to the nerve results in shoulder dysfunction and other related morbidities. In this article, we describe a unique constant relationship between spinal accessory nerve and great auricular nerve, at the junction of the anterior and posterior triangles of the neck, eponymously labelled the X- pointer.MethodologyThis was an observational study conducted at a tertiary care cancer centre that runs a comprehensive surgical training program. A 100 cases of modified radical neck dissection performed for oral cavity squamous cell carcinoma from January 2017 to January 2019 in were included. The relationship was analyzed in 100 cases of neck dissection for its constancy.ResultIn all the 100 cases, the X-pointer was demonstrated as a constant anatomical relationship between the spinal accessory nerve and great auricular nerve. The crossing over of the nerve on the undersurface of the sternocleidomastoid muscle is constant and independent of the patient's body proportions.ConclusionsThe relationship between the spinal accessory nerve and great auricular nerve remains constant irrespective of the technique of neck dissection and body habitus of the patient. In our view, this relationship can be used as an additional confirmatory landmark to prevent inadvertent injury to the spinal accessory nerve.     

Tumorous manifestation of hairy cell leukemia after long-term treatment with interferon alpha

Tumorous-manifestation of hairy cell leukemia in a patient treated with IFN for 7 years is described. After this time, while the patient still was in hematological remission, a tumorous involvement of the lung by hairy cells developed and was successfully treated by surgery. No differences in the phenotype of hairy cells in the lung tumor, in the bone marrow, or in the blood could be detected.     

托盘根水煎剂降糖作用分析

目的:探讨托盘根水煎剂对四氧嘧啶诱导的糖尿病大鼠的降糖作用。方法:Wistar大鼠80只,采用大鼠尾静脉注射四氧嘧啶复制糖尿病大鼠模型。随机分为模型组(ig 13.5 m L·kg-1的蒸馏水),阳性药组(210 mg·kg-1的盐酸二甲双胍水溶液),托盘根低、高剂量组(分别ig 1.35,2.70 g·kg-1托盘根水煎剂),另设正常组,每组10只,每天ig 1次,共13 d。检测空腹血糖(FBG),一氧化氮(NO),丙二醛(MDA),超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)及脏器系数的影响。结果:与正常组比较,模型组FBG,SOD,GSH-Px水平明显升高,NO,MDA含量明显降低(P0.05);经托盘根治疗后,治疗组FBG水平较模型组降低(P0.05),低剂量组血清中NO和高剂量组血清中MDA含量较模型组升高(P0.05),而高剂量组血清中SOD和低、高剂量组血清中GSH-Px含量较模型组降低(P0.05),且托盘根水煎剂对所取脏器均有修复作用。结论:托盘根水煎剂可通过增强机体的抗氧化作用,促进胰岛功能恢复而发挥降血糖作用。     

高选择性神经损伤对大鼠创面愈合的影响

目的 建立大鼠高选择性神经损伤联合皮肤缺损模型,研究单纯运动神经或感觉神经损伤对大鼠创面愈合的影响. 方法 雄性SD大鼠90只按随机数字表法分为三组,每组30只.包括A组:后根感觉神经切断+后肢皮肤缺损组;B组:前根运动神经切断+后肢皮肤缺损组;C组:假神经切断+后肢皮肤缺损组.伤后2,7,14,21 d测定各组大鼠创面愈合率;伤后1,3,7,14 d取创面皮肤组织采用RT -PCR检测降钙素基因相关肽(CGRP) mRNA的表达情况;3,7,14,21 d取创面皮肤组织免疫组织化学染色检测Bcl -2蛋白的表达水平. 结果 伤后2dA、C组创面愈合率高于B组(P＜0.05),A、C组比较差异无统计学意义(P＞0.05);7,14dC组创面愈合率高于A、B组(P＜0.05),A、B组比较差异无统计学意义(P＞0.05); 21 dB、C组创面愈合率高于A组(P＜0.05),B、C组比较差异无统计学意义(P＞0.05).伤后各组均可见CGRP mRNA的表达,并逐渐增强,伤后1,3dB、C组表达均较A组高(P＜0.05),B、C组比较差异无统计学意义(P＞0.05);伤后7dC组＞B组＞A组(P＜0.05);14 d B组＞A组＞C组(P＜0.05).免疫组化染色显示,伤后3d各组Bcl -2蛋白表达差异无统计学意义,伤后7dC组表达较A、B组强(P＜0.05),A、B组比较差异无统计学意义(P＞0.05);伤后14dC组＞B组＞A组(P＜0.05);21 dB组表达高于A、C组(P＜0.05),A、C组比较差异无统计学意义(P＞0.05). 结论 在创面愈合过程中,感觉神经纤维对创面愈合的影响较运动神经纤维显著,神经损伤(尤其是感觉神经)不利于创面愈合,完整的神经支配是创面正常愈合的必需条件.     

大剂量黄芪注射液治疗缺血性脑卒中临床分析

目的观察大剂量黄芪注射液和葛根素注射液治疗脑梗死的疗效及安全性.方法采用病例对照研究方法,对105例脑梗死病人采用不同的治疗方法,对其疗效进行分析.分组方案为:对照组使用香丹注射液静脉输注;治疗组采用黄芪注射液和葛根素静脉输注.均以7 d为1个疗程,两组共治疗3个疗程后评定疗效.结果经治疗后两组总有效率对照组为84.00%、治疗组94.55%,两组差别有统计学意义(P＜0.01),且病人无不良反应.结论使用大剂量黄芪、葛根素注射液治疗缺血性脑卒中安全有效,作用平稳.     

7th Meeting on Hypertension and Atherosclerosis

The 7th Meeting on Hypertension and Atherosclerosis was organized in collaboration with the Society of Hypertension and Atherosclerosis and endorsed by the European Society of Hypertension. From basic sciences to clinical aspects, the congress covered the wide spectrum of cardiovascular health, providing a venue for the conversation of scientists from all around the world. At the end of the 5 days, participants had the opportunity discuss the main topics and updates on hypertension and atherosclerosis.     

成人脊髓应用解剖学研究

在20具(男10,女10)成人尸体上,测量观察了脊髓节段及其与椎骨的位置关系,各脊神经根间交通支的连系情况及脊髓圆锥下极的位置,其结果与现今教科书及国内其他作者所得的数据有出入,这可为临床工作者及从事本项研究的其他工作者提供参考。     

Selective degeneration of dorsal root ganglia and dorsal nerve roots in methyl mercury-intoxicated rats: a stereological study

The components of the nervous system of rats that are most critically affected by methyl mercury are still a matter of debate. A recent stereological study of rats with typical symptoms resulting from methyl mercury intoxication demonstrated that the morphology of cerebellar granule cells and Purkinje cells were unchanged at the light microscopic level, even though there was pronounced degeneration of myelinated axons in dorsal nerve root nerves. In the present study, unbiased stereological methods were used to quantify morphological changes in the dorsal root ganglion, and dorsal and ventral nerve roots of the rats used in the previous study. The rats were treated with methyl mercury (2 mg daily/kg, per os) for a 19-day period that was followed by a 32-day period without treatment. The means of the total numbers of A-cell and B-cell perikarya in the dorsal root ganglion of the intoxicated rats were reduced by 60% and 24%, respectively. The mean volume of A-cell perikarya in rats of the experimental group was reduced by 22%, whereas the mean volume of B-cell perikarya was the same in the two groups. In the experimental group, the total number of myelinated axons in the dorsal nerve roots was reduced by 60%, whereas no difference was found in the ventral nerve roots. The areas of axon and myelin sheath, dorsal and ventral nerve roots were not affected. This study demonstrates that extensive loss of dorsal root ganglion cells and myelinated axons in dorsal nerve roots precedes light microscopical changes in the ventral nerve roots and the cerebellum of rats intoxicated with methyl mercury. Received: 16 January 1998 / Revised, accepted: 23 February 1998