基底节脑出血开颅手术与钻颅抽吸治疗的疗效比较（附136例报告）

目的比较基底节脑出血开颅手术治疗与钻颅抽吸治疗的有效性与安全性。方法回顾性分析我院近5年来基底节出血行外科开颅治疗和钻颅抽吸治疗的所有病例，应用统计学方法进行疗效比较。结果共136例基底节出血病例，其中30例行外科开颅清除血肿治疗，106例行钻颅抽吸治疗。两组病例在年龄、出血量、意识状态等预后影响因素方面差异无统计学意义（P〉0．05）。基底节出血开颅手术治疗有效性与安全性与钻颅抽吸治疗相比差异无统计学意义（P〉0．05）。结论基底节出血外科开颅治疗有效性与安全性并不优于钻颅抽吸治疗。     

侧脑室计算机三维重建及理论分析

目的 :建立便于推广、功能齐全、价廉的三维医学图像重建系统及进行三维重建。方法 :利用目前较先进的数码摄片技术和自行编制的软件系统 ,对层距 1.0 mm的人体头部断面共 2 4 0层进行侧脑室的三维重建 ,同时对头部整体行三维重建以其进行相对定位和比较。结果 :重建后的侧脑室可和头部进行参照显示 ,行旋转、透明处理和不同方向的任意剖割。结论 :较以 CT、MRI断面图像重建的模型增加了轮廓的准确性和器官内组织的鲜明色彩     

Developmental and evolutionary significance of the mandibular arch and prechordal/premandibular cranium in vertebrates: revising the heterotopy scenario of gnathostome jaw evolution

The cephalic neural crest produces streams of migrating cells that populate pharyngeal arches and a more rostral, premandibular domain, to give rise to an extensive ectomesenchyme in the embryonic vertebrate head. The crest cells forming the trigeminal stream are the major source of the craniofacial skeleton; however, there is no clear distinction between the mandibular arch and the premandibular domain in this ectomesenchyme. The question regarding the evolution of the gnathostome jaw is, in part, a question about the differentiation of the mandibular arch, the rostralmost component of the pharynx, and in part a question about the developmental fate of the premandibular domain. We address the developmental definition of the mandibular arch in connection with the developmental origin of the trabeculae, paired cartilaginous elements generally believed to develop in the premandibular domain, and also of enigmatic cartilaginous elements called polar cartilages. Based on comparative embryology, we propose that the mandibular arch ectomesenchyme in gnathostomes can be defined as a Dlx1-positive domain, and that the polar cartilages, which develop from the Dlx1-negative premandibular ectomesenchyme, would represent merely posterior parts of the trabeculae. We also show, in the lamprey embryo, early migration of mandibular arch mesenchyme into the premandibular domain, and propose an updated version of the heterotopy theory on the origin of the jaw.     

New insights into the phenotypic covariance structure of the anthropoid cranium

In complex organisms, suites of non-random, highly intercorrelated phenotypic traits, organized according to their developmental history and forming semi-autonomous units (i.e. modules), have the potential to impose constraints on morphological diversification or to improve evolvability. Because of its structural, developmental and functional complexity, the cranium is arguably one of the best models for studying the interplay between developmental history and the need for various parts of a structure to specialize in different functions. This study evaluated the significance of two specific types of developmental imprints in the adult anthropoid cranium, those imposed by ossification pattern (i.e. ossification with and without a pre-existing cartilaginous phase) and those imposed by tissue origin (i.e. tissues derived principally from neural-crest vs. those derived from paraxial mesoderm). Specifically, this study tests the hypothesis that the face and the basicranium form two distinct modules with higher within-unit trait integration magnitudes compared with the cranium as a whole. Data on 12 anthropoid primate species were collected in the form of 23-dimensional landmarks digitized on cranial surface models that sample the basicranium as well as regions of functional importance during feeding. The presence of a significant modularity imprint in the adult cranium was assessed using a between-region within-species comparison of multivariate correlations (RV coefficients) obtained with partial least-squares, using within-module within-species eigenvalue variance (EV), and using cluster analyses and non-metric multidimensional scaling. In addition to addressing the validity of the cranial modularity hypothesis in anthropoids, this study addressed methodological aspects of the interspecific comparison of morphological integration, namely the effect of sample size and the effect of landmark number on integration magnitudes. Two methodological findings that are of significance to research in morphological integration are that: (i) a smaller sample size increases integration magnitude, but preserves the pattern of variation of integration magnitudes from block to block within species; and that (ii) the number of landmarks per cranial block does not significantly impact block integration magnitude measured as EV. Results from the analyses testing for cranial modularity imprints in the adult anthropoid cranium show that some facial landmarks covary more strongly with basicranial landmarks than with other facial landmarks. Cluster methods, non-metric multidimensional scaling and, to an extent, RV results show that the rostral and the zygomatic landmarks covary more strongly with the basicranial landmarks than they do with the molar landmarks. However, the rostral–zygomatic–basicranial block, the molar block, the facial block, the basicranial block and the other analyzed cranial and facial blocks are not more integrated than the cranium. Thus, the morphological variation in the adult anthropoid cranium is not significantly constrained by at least two of the potential developmental sources of its covariance structure.     

In-utero Diagnosis of Double Encephalocele - Imaging Features and Review of Literature

Encephalocele is protrusion of brain parenchyma through a defect in the cranium. It is classified into various types based on the defect location: sincipital (fronto-ethmoidal), basal (trans-sphenoidal, spheno-ethmoidal, trans-ethmoidal, and spheno-orbital), occipital and parietal. Double encephaloceles are very rare with only a handful of cases reported in the literature and most of these cases involved either occipital or sub-occipital region. All, except one, cases of double encephaloceles were diagnosed postnatally. We present a case of double encephalocele with parietal and occipital components diagnosed in utero. To the best of our knowledge, this is the first case of double encephalocele involving the parietal and occipital skull bones diagnosed in-utero.     

Cranial shape variation in mink: Separating two highly similar species

European and American minks (Mustela lutreola and Neovison vison, respectively) are very similar in their ecology, behavior, and morphology. However, the American mink is a generalist predator and seems to adapt better to anthropized environments, allowing it to outcompete the European mink in areas where it has been introduced, threatening the survival of the native species. To assess whether morphological differences may be contributing to the success of the American mink relative to the European mink, we analyzed shape variation in the cranium of both species using 3D geometric morphometrics. A set of 38 landmarks and 107 semilandmarks was used to study shape variation between and within species, and to assess how differences in size factored into that variation. Sexual dimorphism in both size and shape was also studied. Significant differences between species were found in cranial shape, but not in size. Relative to American mink, European mink have a shorter facial region with a rounder forehead and wider orbits, a longer neurocranium with less developed crests and processes, and an antero‐medially placed tympanic bullae with an anteriorly expanded cranial border. Within species, size‐related sexual dimorphism is highly significant, but sexual dimorphism in shape is only significant in American mink, not in European mink. Additionally, two trends common to both species were discovered, one related to allometric changes and another to sexual size dimorphism. Shape changes related to increasing size can be subdivided into two, probably related, groups: increased muscle force and growth. The first group somewhat parallels the differences between both mink species, while the second group of traits includes an anterodorsal expansion of the face, and the neurocranium shifting from a globous shape in small individuals to a dorsoventrally flattened ellipse in the largest ones. Finally, the sexual dimorphism trend, while also accounting for differences in muscle force, seems to be related to the observed dietary differences between males and females. Overall, differences between species and sexes, and shape changes with increasing size, seem to mainly relate to differences in masticatory‐muscle volume and therefore muscle force and bite force, which, in turn, relate to a wider range of potential prey (bigger prey, tougher shells). Thus, muscle force (and dietary range) would be larger in American mink than in European mink, in males than in females, and in larger individuals than in smaller ones.     

锥颅穿刺血肿抽吸引流术治疗脑出血43例临床分析

目的探讨锥颅穿刺血肿抽吸引流术治疗脑出血的临床疗效。方法回顾性分析43例脑出血患者(出血量30-120ml)行锥颅穿刺血肿抽吸引流术治疗的临床资料。结果穿刺成功率100％，存活35例，死亡8例，死亡率18．6％。结论锥颅穿刺血肿抽吸引流术治疗脑出血，简便易行，创伤小，安全可靠，降低死亡率。     

国人卵圆孔穿刺深度X线解剖测量的研究

目的 :为探讨国人卵圆孔穿刺深度提供X线解剖依据。方法 :35例颅骨 (70侧 )标本 ,将卵圆孔涂钡后 ,摄取球管向头侧倾斜 2 0°角度的头颅侧位片 ,测量卵圆孔与内耳门中心点到前床突尖端连线 (耳—床线 )之间的距离 (孔—线距 ) ,进行统计学处理。结果 :左右各组孔—线距值均不能拒绝总体为正态的假设 (P >0 0 5 ) ;左右两侧之间孔—线距值有差别 ,具有统计学意义 (P <0 0 5 )。左侧孔—线距参考值为 (14 .71± 1.4 6 )mm ,右侧为 (15 .5 7± 1.80 )mm。结论 :在X线图像上以耳—床线为基线、孔线距参考值为标准 ,可间接测算卵圆孔的位置 ,推算卵圆孔穿刺时穿刺针进针的深度。     

From the Cover: Out of Africa: Modern Human Origins Special Feature: The meaning of Neandertal skeletal morphology

A procedure is outlined for distinguishing among competing hypotheses for fossil morphology and then used to evaluate current views on the meaning of Neandertal skeletal morphology. Three explanations have dominated debates about the meaning of Neandertal cranial features: climatic adaptation, anterior dental loading, and genetic drift. Neither climatic adaptation nor anterior dental loading are well supported, but genetic drift is consistent with the available evidence. Climatic adaptation and activity patterns are the most discussed explanations for Neandertal postcranial features. Robust empirical relationships between climate and body form in extant humans and other endotherms currently make climatic adaptation the most plausible explanation for the wide bodies and relatively short limbs of Neandertals, and many additional postcranial features are likely secondary consequences of these overall skeletal proportions. Activity patterns may explain certain Neandertal postcranial features, but unlike the situation for climate, relationships in extant humans between morphology and activities are typically not well established. For both the cranium and the postcranium, changes in diet or activity patterns may underlie why Neandertals and Pleistocene modern humans tend to be more robust than Holocene humans.     

CT三维重建在颌面整形外科的应用

目的探讨CT三维在颌面整形外科临床的应用价值。方法对五列下颌角肥大的患者行螺旋CT扫描后进行三维重建。将图像进行任意旋转以选择最佳观察方向和角度，按临床要求切割、测量。结果CT三维影像在显示下颌骨内侧缘的下颌神经孔及下颌角切割的大小，提供了较为理想的空间信息。结论下颌骨三维成像帮助整形外科医生在制定手术计划和所需要切除部位的准确位置，提供了较理想的立体图像。