儿童气管的解剖学观测和临床应用

目的研究支气管镜操作术的成功率和安全性。方法通过44例儿童尸体观测气管的解剖长度、临床长度和气管的横径、矢状径,并与儿童身高和上部量进行相关分析,另外分析临床资料85例,其中58例在使用支气管镜前做了气管横径、矢状和长度的预测。结果两性儿童的身高和上部量与气管的解剖长度、临床长度、气管内径之间密切相关。结论只要先测量儿童的身高和上部量就可根据他们之间的回归方程计算出气管的长度和内径大小,为临床准确选用气管镜型号和插管的深度提供可靠的依据,从而保证了气管插管的一次性成功率和安全性。     

CD44介导的透明质酸对单核细胞黏附和迁移的作用

目的研究透明质酸（HA）在单核细胞中的分布,HA受体CD44和细胞问黏附分子-1（ICAM-1）在单核细胞中的表达以及HA及其受体对单核细胞黏附和迁移的影响.方法用Percoll非连续密度梯度离心法分离狗外周血单核细胞,然后用免疫荧光染色法标记单核细胞的HA、CD44和ICAM-1.通过用透明质酸酶（HAase）消化细胞表面的HA、在培养皿底面和细胞培养池膜上涂布HA和在培养液中添加HA,观察细胞表面的HA、底物HA和游离HA对细胞黏附和迁移的影响.以抗体阻断剂抑制CD44或ICAM-1,研究HA受体的介导作用.结果单核细胞表面和细胞内存在HA,并表达CD44和ICAM-1.消化细胞表面HA后,黏附和迁移的单核细胞数减少.在培养皿底面和细胞培养池膜上铺HA,黏附和迁移的细胞数增加.培养液中加入HA,黏附和迁移的细胞数减少.阻断CD44后,HA底物上黏附和迁移的细胞数减少,而阻断ICAM-1后黏附和迁移的单核细胞数无明显变化.结论单核细胞内外分布有HA.单核细胞表面的HA和底物HA促进细胞的黏附和迁移,但游离HA阻碍单核细胞的黏附和迁移.CD44介导HA对单核细胞黏附和迁移的作用.     

儿童气管镜应用解剖学

目的：研究气管镜操作术的成功率和安全性。方法：观测儿童尸体气管的解剖长度、临床长度和气管的横径、矢状径，并与儿童身高和上部量进行相关分析，另外分析临床资料85例，其中58例在使用支气管镜前做了气管横径、矢状和长度的预测。结果：两性儿童的身高和上部量与气管的解剖长度、临床长度、气管内径之间密切相关。结论：测量儿童的身高和上部量就可根据他们之间的回归方程计算出气管的长度和内径大小，为临床准确选用气管镜型号和插管的深度提供可靠的依据。以保证一次性成功率和安全性。     

基于有限元模型的踝关节生物力学分析*

背景：有限元力学分析在生物力学领域广泛应用。 目的：采用大型有限元软件ANSYS对踝关节三维有限元数字模型进行生物力学分析,探讨踝关节各组成骨的应力分布规律及其发生形变、位移情况。 方法：把经MIMICS、Geomagic和ANSYS处理后生成的踝关节三维数字模型导入软件ANSYS中,经过约束条件、施加载荷、求解试算等阶段,对其各组成骨进行有限元分析。 结果与结论：①静止直立位时,踝关节各组成骨最大应力区集中在内踝与距骨相关节处、胫骨远端关节面髁间线前部、胫骨中下段前缘皮质区及距骨滑车外侧部;最小应力区集中在外踝、胫骨远端内侧皮质区、距骨头、距骨颈;最大位移发生在距骨头,位移自下而上逐步减小;最小位移发生在胫骨、腓骨中下段1/3处。②高空坠落时,最大应力区集中在胫骨中下段前缘皮质区、距骨滑车前外侧、内踝内侧皮质区以及胫骨远端关节面髁间线前部。其中胫骨中下段应力集中区随着压力的增加,稍向内侧移位。距骨滑车外侧部最大应力集中区位置无明显变化,范围逐渐加大。最小应力区集中在外踝、胫骨远端关节面外侧部、距骨头、内踝的外侧皮质;随着压力不断加大,内踝外侧皮质的小应力蓝色区域范围逐渐减小;外踝逐渐出现应力稍大的淡蓝色区域,提示所受应力加大。最大位移发生的部位自距骨头向上,经距骨颈、胫距关节面到胫腓骨中下段逐渐减小,到胫腓骨中下段时减到最小。     

膝关节矢状断层影像解剖学

目的 为膝关节疾患的影像学诊断提供矢状断层解剖学基础。方法 用成年男尸右膝部标本5例(新鲜3，福尔马林固定2)，按解剖骨性标志画线，其中1例标本先行矢状位MRI扫描，所有标本冻硬后，切制矢状断层解剖标本，每例切5个断层，皆观察其内侧面。结果 观察了构成膝关节的主要结构，交叉韧带、半月板及其周围软组织的形态特征、位置、毗邻及其在连续断层的变化规律，并匹配同一断层之MRI。测量股骨内、外侧髁关节软骨厚为2．3mm和2．4mm，胫骨内、外侧髁关节软骨厚为2．5mm和2．6mm，髌骨关节软骨厚为5．3mm，前交叉韧带长36．1mm，前、后交叉韧带中部矢状径为6．32mm和6．51mm，内、外侧半月板矢状径为42．4mm和33．2mm，内侧半月板前、后部厚度为5．1mm和5．8mm，外侧半月板为6．5mm和7．1mm。结论 膝关节的矢状断层解剖各结构形态、位置及变化规律，对骨科及影像学诊断和治疗有重要的价值。     

Public health reforms and development of health service in the Dakovo sub-district and administrative county in the period 1850-1899

In the long-lasting struggle for national identity and modernization of Croatia, the Parliament of the Kingdom of Croatia and Slavonia has passed many laws and regulations from 1874 on, affecting thus the health care and the development of the public health system. The aim of those laws was to establish and achieve the same level of public health care that had already been instituted in some other countries of the Austro-Hungarian Empire. In order to clarify the consequences of these reforms for the development of the health care system on the county and district levels of Slavonia, we collected data on the town of Dakovo as a market center, home of the diocese, and seat of the sub-district and administrative county. The data were divided into several categories in order to examine (1) the reorganization of health care in the Kingdom of Croatia and Slavonia from 1848 to 1894; (2) the development of health care in the Dakovo sub-district and Dakovo administrative county; (3) number, structure, and distribution of medical practitioners from 1807 to 1899; (4) hospitals from 1859 to 1900; and (5) selected indicators of health and living condition and health needs of the county inhabitants in the period 1850-1900. The analysis of historical material showed that new regulations of health care initiated the process of "medicalization" that was understood as a part of European modernization in the field of state medicine and health care administration. It brought more accurate knowledge of the main causes of illnesses, deaths and disabilities but did not significantly improve health and health conditions in the Dakovo County at the entrance of the 20th century.     

Dissecting the history of anatomy in the Third Reich--1989-2010: A personal account

This paper is a personal narrative of involvement with the revelations of the use of anatomical and pathological specimens of victims of Nazi terror. The narrative documents responses to the question of the retention and use of anatomical and pathological specimens from victims of Nazi terror by leading academic and scientific institutions and organizations in Germany and Austria including the government of the Federal Republic of (West) Germany, the University of Tübingen, the University of Vienna, the Max Planck Society and the Anatomische Gesellschaft. It begins with the public revelations of 1989 and concludes with the September 2010 Symposium on the History of Anatomy during the Third Reich at the University of Würzburg. The narrative documents a 22-year transition in attitude and responses to the investigation and documentation of the history of anatomy and pathology during the Third Reich. The chronicle includes the 1989 proposed "Call for an International Commemoration" by the author, together with the bioethicist Professor Arthur Caplan, on the occasion of the planned burial of the misbegotten specimens and the responses to that proposal.     

Histoenzymology and morphometry of the masticatory muscles of tufted capuchin monkey (Cebus apella Linnaeus, 1758)

Samples of the anterior and posterior regions of the masseter and temporal muscles and of the anterior belly of the digastric muscle of 4 adult male tufted capuchin monkeys (Cebus apella) were removed and stained with HE and submitted to the m-ATPase reaction (with alkaline and acid preincubation) and to the NADH-TR and SDH reactions. The results of the histoenzymologic reactions were similar, except for acid reversal which did not occur in fibers of the fast glycolytic (FG) type in the mandibular locomotor muscles. FG fibers had a larger area and were more frequent in all regions studied. No significant differences in frequency or area of each fiber type were detected, considering the anterior and posterior regions of the masseter and temporal muscles. The frequency of fibers of the fast oxidative glycolytic (FOG) and slow oxidative (SO) types and of FOG area differed significantly between the anterior belly of the digastric muscle and the mandibular locomotor muscle. The predominance of fast twitch (FG and FOG) fibers and the multipenniform and bipenniform internal architecture of the masseter and temporal muscles, respectively, are characteristics that permit the powerful bite typical of tufted capuchin monkeys.     

中医表型组学的数据特征与研究方法展望

人类表型组学构建了跨尺度组学数据的关联,对精准医学的实现具有重要价值。中医学与表型组学都关注人体复杂系统中各种表型的变化规律,二者的理念与技术可以相互促进和补充,中医表型组学研究将有助于实现中西医融合协同发展和促进。本研究首先总结了现有中医特色表型的数据特征、表型收集和量化的方法,随后从大数据和人工智能角度简述中医表型的数据处理、跨尺度关联和精细调控机制的手段,最后提出了现存的挑战与未来的研究方向,以期为中医表型组学研究者提供参考。     

Flow Interactions with Cells and Tissues: Cardiovascular Flows and Fluid–Structure Interactions

Interactions between flow and biological cells and tissues are intrinsic to the circulatory, respiratory, digestive and genitourinary systems. In the circulatory system, an understanding of the complex interaction between the arterial wall (a living multi-component organ with anisotropic, non-linear material properties) and blood (a shear-thinning fluid with 45% by volume consisting of red blood cells, platelets, and white blood cells) is vital to our understanding of the physiology of the human circulation and the etiology and development of arterial diseases, and to the design and development of prosthetic implants and tissue-engineered substitutes. Similarly, an understanding of the complex dynamics of flow past native human heart valves and the effect of that flow on the valvular tissue is necessary to elucidate the etiology of valvular diseases and in the design and development of valve replacements. In this paper we address the influence of biomechanical factors on the arterial circulation. The first part presents our current understanding of the impact of blood flow on the arterial wall at the cellular level and the relationship between flow-induced stresses and the etiology of atherosclerosis. The second part describes recent advances in the application of fluid–structure interaction analysis to arterial flows and the dynamics of heart valves.     

Advances in synthesis of calcium phosphate crystals with controlled size and shape

Calcium phosphate (CaP) materials have a wide range of applications, including biomaterials, adsorbents, chemical engineering materials, catalysts and catalyst supports and mechanical reinforcements. The size and shape of CaP crystals and aggregates play critical roles in their applications. The main inorganic building blocks of human bones and teeth are nanocrystalline CaPs; recently, much progress has been made in the application of CaP nanocrystals and their composites for clinical repair of damaged bone and tooth. For example, CaPs with special micro- and nanostructures can better imitate the biomimetic features of human bone and tooth, and this offers significantly enhanced biological performances. Therefore, the design of CaP nano-/microcrystals, and the shape and hierarchical structures of CaPs, have great potential to revolutionize the field of hard tissue engineering, starting from bone/tooth repair and augmentation to controlled drug delivery devices. Previously, a number of reviews have reported the synthesis and properties of CaP materials, especially for hydroxyapatite (HAp). However, most of them mainly focused on the characterizations and physicochemical and biological properties of HAp particles. There are few reviews about the control of particle size and size distribution of CaPs, and in particular the control of nano-/microstructures on bulk CaP ceramic surfaces, which is a big challenge technically and may have great potential in tissue engineering applications. This review summarizes the current state of the art for the synthesis of CaP crystals with controlled sizes from the nano- to the macroscale, and the diverse shapes including the zero-dimensional shapes of particles and spheres, the one-dimensional shapes of rods, fibers, wires and whiskers, the two-dimensional shapes of sheets, disks, plates, belts, ribbons and flakes and the three-dimensional (3-D) shapes of porous, hollow, and biomimetic structures similar to biological bone and tooth. In addition, this review will also summarize studies on the controlled formation of nano-/microstructures on the surface of bulk ceramics, and the preparation of macroscopical bone grafts with 3-D architecture nano-/microstructured surfaces. Moreover, the possible directions of future research and development in this field, such as the detailed mechanisms behind the size and shape control in various strategies, the importance of theoretical simulation, self-assembly, biomineralization and sacrificial precursor strategies in the fabrication of biomimetic bone-like and enamel-like CaP materials are proposed.     

The prenatal development of the human femur

The study reported here is the result of a detailed investigation of the changes in shape of the femur with growth and torsion, the type, rate and character of ossification, and the onset, subsequent course, and general features of remodeling. Forty pairs of femurs, from a series of embryos and fetuses ranging from 26 to 342 mm in crown-rump length, were measured, radiographed, and sectioned for microscopic study. A primary bony collar was present before the end of the embryonic period, and in a 27 mm embryo it extended for about one-fifth of the length of the femur. Erosion of the collar was evident at 34 mm. and invasion and destruction of calcified cartilage were occurring by 37 mm. Cartilage canals first appeared in the proximal epiphysis at 57 mm and in the distal epiphysis at 61 mm. Along with the progression of endochondral ossification proximally and distally and the establishment of growth zones, periosteal bone formation also proceeded in both directions, and, until 275 mm, extended about 1 mm beyond the zones of cartilage destruction. After 275 mm, the extents of periosteal and endochondral ossification were the same and at term occupied almost four-fifths of the length of the femur. Trabeculation of the bony collar was first noted at 37 mm. Fusion of endochondral trabeculae with the inner aspect of the periosteal shell began by 61 mm. A central marrow cavity free of trabeculae was present at 86 mm and thereafter. Evidence of reconstruction appeared in both proximal and distal ends by 92 mm, and was consistently present in both ends in all specimens of 111 mm and larger.     

The normal menisci: in vivo MRI measurements

The aim of this study was to determine dimensions of the normal menisci in 174 healthy subjects by using MRI. The menisci were divided into three zones (anterior horn, mid-body, posterior horn). The height and width of the both menisci were measured. For the medial meniscus; the height and width of the anterior horn were 5.32 mm and 7.78 mm, the height and width of the mid-body were 5.03 mm and 7.37 mm, and the height and width of the posterior horn were 5.53 mm and 11.71 mm, respectively. For the lateral meniscus, the height and width of the anterior horn were 4.33 mm and 8.88 mm, the height and width of the mid-body were 4.94 mm and 8.37 mm, and the height and width of the posterior horn were 5.36 mm and 9.70 mm, respectively. Three cases (1.7%) of discoid lateral meniscus were encountered. The results of this study should help to establish standard measurements, and to differentiate between normal and pathologic conditions of the menisci of the knee joint.     

小腿外侧群肌神经入肌点和肌梭丰度最高区中心的定位及其意义

目的　准确定位小腿外侧群肌的神经入肌点（NEP）和肌梭丰度最高区中心（CHRMSA）的位置。 方法　12具成人尸体,侧卧。经皮肤连接股骨外上髁与内上髁和股骨外上髁与外踝的连线分别为横向参考线（H）和纵向参考线（L）。解剖暴露NEP;Sihler's染色显示肌内神经分支密集区;HE染色肌梭,计算肌梭丰度;硫酸钡标记NEP和CHRMSA,CT扫描。NEP在体表的投影点为P,P通过NEP后投射至相反侧皮肤上的点为P',经P的垂线与H线、水平线与L线的交点分别记为PH 和PL,确定PH和PL在H和L线上的百分位置及NEP的深度。 结果　腓骨长、短肌的NEP的PH分别位于H线的13.41%和10.35%处,PL分别位于L线的21.81%和52.6%处;深度分别位于PP'线的50.89%和25.7%处。腓骨长、短肌的CHRMSA的PH分别位于H线的14.45%和12.86%处,PL分别位于L线的35.11%和71.49%处;深度分别位于PP'线的18.16%和20.40%处。 结论　这些结果可为小腿外侧群肌痉挛治疗中准确定位阻滞靶点提供解剖学指导。     

逆行腓骨肌肌皮瓣设计的解剖学研究

目的　为逆行腓骨肌皮瓣的设计与临床应用提供解剖学依据。 方法 新鲜下肢标本20侧,动脉灌注红色乳胶,解剖观测腓动脉、腓骨长肌、腓骨短肌及其表面皮肤与营养血管的的起始、走行、分支、分布的情况;新鲜标本2具,动脉灌注乳胶、氧化铅混悬液,CT扫描后三维重建小腿与足部血管。 结果 腓动脉起始外径(3.7±0.7) mm,多条分支供给比目鱼肌、 长屈肌、腓骨长、短肌及表面皮肤。腓动脉穿支的血管蒂可游离长度为(3.5±1.3) cm。腓动脉终末穿支在胫腓骨骨间膜中穿出,外径(1.2±0.4)mm,分为升支和降支。腓骨短肌肌腹的上部有一支较粗的腓浅动脉发自胫前动脉,向前穿骨间膜行于腓骨长肌与小腿前群肌之间,管径(1.8±0.5) mm,行向下营养腓骨短肌、腓浅神经和小腿前外侧部皮肤。 结论 以腓动脉中、下部穿支或终末穿支与其它血管的吻合部为蒂,可以设计切取逆行腓骨长、短肌肌皮瓣,修复小腿下部及足背部软组织缺损。     

全髋关节置换术直接前入路改良切口与股外侧皮神经损伤的解剖学研究

目的 探讨全髋关节置换术直接前方入路(DAA)改良切口和经典切口的解剖特点,为术中避免股外侧皮神经(LFCN)损伤提供解剖学依据。方法 由蚌埠医学院解剖教研室提供成年国人尸体髋关节及股骨标本6具6侧,其中男2具2侧、女4具4侧,年龄48~72(61.7±8.2)岁。通过解剖标志定位的方式做DAA手术切口,切口起点均为髂前上棘最高点向下向外3 cm;DAA经典切口延长方向指向腓骨小头;改良切口将切口延长方向向经典切口外后方偏移,偏移角度为髂前上棘最高点分别与腓骨小头、股骨大粗隆顶点连线夹角的1/2。解剖显露LFCN以及所有分支:(1)观察LFCN走行及其与DAA经典切口、DAA改良切口的关系;(2)对LFCN进行分型;(3)测量DAA经典切口和改良切口与LFCN最短距离,判断LFCN与DAA经典切口和改良切口的解剖关系。结果 (1)LFCN由髂前上棘内侧0.8 cm经腹股沟韧带下方走向股骨前方,LFCN走行向前、向外近乎平行于髂前上棘最高点与腓骨小头连线。DAA经典切口远端与LFCN有交叉,有直接损伤LFCN可能,延长DAA经典切口会增加损伤LFCN概率;而DAA改良切口与LFCN无交叉。(2)6侧标本LFCN分型:缝匠肌型3侧,后向型2侧,扇形型1侧。(3)LFCN与DAA改良切口最短距离为1.2~2.4(2.0±0.40)cm,与经典切口最短距离为0~1.4(0.98±0.55)cm。缝匠肌型和后向型LFCN主干及分支与DAA改良切口的最短距离均＞2.0 cm;与DAA经典切口无交叉,且LFCN所有分支与DAA改良切口最短距离均＞0.7 cm。扇形型LFCN与DAA经典切口有交叉,而与DAA改良切口无交叉,最短距离为1.2 cm。结论 在解剖关系上,DAA改良切口比DAA经典切口距离LFCN更远,DAA全髋关节置换术中更不易发生LFCN损伤。     

雄性大鼠大脑半球白质及其内有髓神经纤维老年改变的侧别差异

目的 探讨雄性大鼠左右大脑半球白质及其内有髓神经纤维是否存在显著性差异,以及每侧大脑半球白质及其内有髓神经纤维的老年性改变是否一致.方法运用透射电子显微镜和体视学方法分别对5只年轻(6～8月龄)和4只老年(18月龄)雄性Long-Evans大鼠左侧、右侧大脑半球白质体积及白质内有髓神经纤维体积、长度和直径进行定量研究.结果年轻组大鼠和老年组大鼠左右大脑半球白质体积及白质内有髓神经纤维体积、长度和直径均不存在显著性差异.每侧大脑半球白质及其内有髓神经纤维总长度和总体积均随年龄增加而降低,右侧半球白质体积、右侧半球白质内有髓神经纤维总体积和左侧半球白质内有髓神经纤维总长度随年龄增长分别显著性降低32.9%、28.6%和49.3%.结论正常年轻和老年雄性Tong-Evans大鼠两侧大脑半球的白质及其内有髓神经纤维均不存在显著性侧别差异.老年雄性Long-Evans大鼠右侧大脑半球白质体积、右侧大脑半球白质内有髓神经纤维的总体积和左侧大脑半球白质内有髓神经纤维总长度存在显著老年性改变.     

Dynamics of the activity of lysosomal and membrane-transport enzymes of human coronary arteries in atherosclerosis (based on specimens of early autopsy

The time course of the activity of lysosome (LE) and membrane-transport (MTE) enzymes in the cells of human coronary arteries was studied histochemically and lipid metabolism in the plasma was studied biochemically. it is shown that the formation of atherosclerotic lesions and exacerbation of the disease in the endothelium and macrophages is followed by the enhancement of positive correlation between the atherogenic ration and the activity of LE and MTE and the alteration of this correlation between these enzymes. In the sedentary mesenchymal cells the progress of atherosclerosis results in the alteration of positive correlation between both LE and MTE and between these enzymes and atherogenic ration. Atherosclerosis remission is followed by partial restoration of the above correlations between the activity of LE and MTE in the cells of atherosclerotic lesions of the coronary arteries intima.