局解与断层,CT解剖学三结合的教改体会

随着世界科学技术的飞速发展和以临床应用为导向的基础医学的改革,对传统的医学教育模式提出了严峻挑战.影像诊断学的迅猛发展和四大影像技术在临床上的应用及普及,使诊断学的水平达到飞跃性的高度,也对局解教学提出了新的更高要求.如何培养学生更好地获取知识,并用所学知识去解决临床实际问题是医学教育改革的关键,也是局解改革的根本宗旨.为了适应这一形势需要,近几年来经过充分的探讨和学术交流以及大胆的教学改革,于1992年正式成立了断层、 CT剖学实习室,现已发展成为研究生、留学生、本科生、函授生以及影像专业人员的培训基地.     

我国大体解剖学科研近况

中国解剖学会本次年会大体解剖学专业委员会收到的论文,在较大的程度上,能反映我国两年来大体解剖学的科研动态。通过管中窥豹,可见一斑,若加以剖析,能从一个侧面了解这一领域的科研近况。在收到的500多篇论     

浅谈利用计算机辅助断层解剖学教学的优点

随着X线计算机断层技术(CT)和磁共振成像技术(MRI)在医学领域的广泛应用，部分医学院校在原开设系统解剖学和局部解剖学课程的基础上增设了断层解剖学课程。如何做好断层解剖学教学工作已成为解剖学工作者所关心的话题。     

对进一步提高局部解剖学教学质量的探讨

尽力开拓尸源,争取分组人数少,多让学生获得操作机会,以及精选教材,无疑是提高局解教学质量的关键,然而教学法的不断改革,对教学质量的不断提高,不能不认为也是起决定作用的.1978年以来,我们对局解教学经改革实践,报道如下,以作抛砖引玉.1 教学方法1.1 局解教学历来多以下肢、上肢、头颈部、胸部、腹部、盆部及会阴等大局部中再分股前区和股内侧区,臀部和股后区等小局部来进行解剖教学,授以“解剖程序和方法”以及“内容提要”等总结指导,同时要求学生从实战出发,将尸解视同对病员进行手术,无非希望认真对待,从刀剪持切手法开始,要求轻柔细心操作直至“术”后清点以培养“爱伤观点”及良好习惯.这些沿用迄今的教学法,几获普遍采纳,但对进一步密切结合临床的教学法,则各有不同.我们体会:若在此基础上增加临床常用切口,待完成操作后,再延伸为常规切口,既不影响大局部的系统性,还可进一步密切局解与临床的关系,提高学生的操作能力,充分利用标本,激发学生更大的学习积极性,则教学效果必将进一步提高.     

断层影像解剖学的现状与未来：首届全国断层影像解剖学论坛总结

断层影像解剖学的现状与未来——首届全国断层影像解剖学论坛总结刘树伟①张绍祥②吴德昌③刘丰春④汪亚晴⑤赵斌⑥本世纪７０年代以来，超声、ＣＴ、ＭＲＩ、ＳＰＥＣＴ、ＰＥＴ、介入放射学及立体定向技术（γ—刀、Ｘ—刀）已成为医学影像学诊治的主流，是当代医学迈入...     

在系统解剖学教学中宜适当穿插断层解剖

人体解剖学区分为系统解剖学和局部解剖学，随着计算机技术的应用，新产生了断层解剖学。系统解剖学为临床医学专业所必修，断层解剖学为近年新开设的影像专业所必修。随着现代大型仪器的普及，断层解剖学知识应是每个医学生都必须掌握的。为了临床医学生能在学习系统解剖学的同时及早学到断层解剖学知识。对掌握器官的立体动态位置，为下一步的学习和将来工作打下坚实的基础，我们选择适当的标本断面逐步熔人系统解剖教学之中。     

Computer-based sessions in radiological anatomy: one year’s experience in clinical anatomy

In the last curricular review (1995/96) radiological anatomy was introduced as an innovation in the program of the course of clinical anatomy of the Medical School. Since computer-based media are known to facilitate the understanding of the human body, computer technology was selected in the academic year of 1997/98 as an elective educational tool to teach radiological anatomy. CD-ROMs were introduced as additional instructional resources in 1997/98. This technology aimed to provide educational support to the program, namely, to the sessions of radiological anatomy in each section of the course head, neck, thorax, abdomen, pelvis and perineum. A questionnaire was designed to evaluate the opinion of the students enrolled in this course, focusing on the teaching sessions of radiological anatomy. Of 152 students, 135 (88.8%) returned the questionnaire. To describe the relationship between the value of this technology and several aspects of its organisation and adequacy, the Spearman rank correlation coefficient was used canonical correlation was used for the various practical sessions. The comments of students were very positive emphasising the quality of the media, organisation of the course, immediate feedback, degree of interactivity and simplicity of use they suggested a larger facility for the computers and acquisition of more programs and hardware. The positive evaluation of the use of the CD-ROMs in clinical anatomy allows us to foresee the formal integration of these instructional tools in the whole course, and not to restrict its use to specific units within the course.     

A reappraisal of pediatric thoracic surface anatomy

Accurate knowledge of surface anatomy is fundamental to safe clinical practice. A paucity of evidence in the literature regarding thoracic surface anatomy in children was identified. The associations between surface landmarks and internal structures were meticulously analyzed by reviewing high quality computed tomography (CT) images of 77 children aged from four days to 12 years. The results confirmed that the sternal angle is an accurate surface landmark for the azygos‐superior vena cava junction in a plane through to the level of upper T4 from birth to age four, and to lower T4 in older children. The concavity of the aortic arch was slightly below this plane and the tracheal and pulmonary artery bifurcations were even lower. The cardiac apex was typically at the 5^th intercostal space (ICS) from birth to age four, at the 4^th ICS and 5^th rib in 4–12 year olds, and close to the midclavicular line at all ages. The lower border of the diaphragm was at the level of the 6^th or 7^th rib at the midclavicular line, the 7^th ICS and 8^th rib at the midaxillary line, and the 11^th thoracic vertebra posteriorly. The domes of the diaphragm were generally flatter and lower in children, typically only one rib level higher than its anterior level at the midclavicular line. Diaphragm apertures were most commonly around the level of T9, T10, and T11 for the IVC, esophagus and aorta, respectively. This is the first study to provide an evidence‐base for thoracic surface anatomy in children. Clin. Anat. 30:788–794, 2017. © 2017Wiley Periodicals, Inc.     

Anatomical Variation of the Tarsus in Common Inbred Mouse Strains

Rodent models are used for a variety of orthopedic research applications; however, anatomy references include mostly artistic representations. Advanced imaging techniques, including micro‐computed tomography (microCT), can provide more accurate representations of subtle anatomical characteristics. A recent microCT atlas of laboratory mouse (Mus musculus) anatomy depicts the central and tarsal bone III (T3) as a single bone, differing from previous references. Fusion of tarsal bones is generally characterized as pathological secondary to mutations associated with growth factors, and normal variation has not been documented in the mouse tarsus. Therefore, it is unclear if this fusion is a normal or a pathological characteristic. The aim of this study is to characterize the tarsus of the laboratory mouse and compare it to the rat and selected outgroup species (i.e., white‐footed mouse) via microCT and histology to determine if the central and T3 are separate or fused into a single bone. Laboratory mice (C57/Bl6 [n = 17] and BalbC [n = 2]) and rats (n = 5) were scanned with microCT. A representative laboratory mouse from each strain was evaluated histologically via serial sagittal sections through the mid‐tarsus. General pedal anatomy was similar between all species; however, the central and T3 bones were fused in all laboratory mice but not the rat or white‐footed mouse. A band of hyaline cartilage was identified within the fused bone of the laboratory mice. We conclude that the fusion found is a normal characteristic in laboratory mice, but timing of the fusion remains ambiguous. Anat Rec, 300:450–459, 2017. © 2016 Wiley Periodicals, Inc.     

视神经管手术入路断层与应用解剖学研究

目的为开展视神经管新型手术提供精细的解剖学基础。方法在大体解剖学研究基础上,应用改进的火棉胶包埋技术对前颅底区域进行连续的三维薄切片,通过两者的有机结合,深入研究视神经管区域精细的解剖结构与复杂的毗邻关系。结果对视神经管区域解剖结构与毗邻关系显示良好精确。中鼻甲根部上缘至视神经管距离左侧为(28.0±5.0)mm,右侧为(29.0±6.0)mm。蝶窦下壁厚度左侧为(3.0±0.9)mm,右侧为(2.7±0.9)mm,视神经管与蝶窦或(和)筛窦间壁厚度左侧为(1.0±0.3)mm,右侧为(1.0±0.4)mm。结论经鼻、蝶窦或(和)筛窦入路行视神经管手术安全可行。     

颅脑断层标本和图像上的皮质机能定位和动脉区域配布

在灰质染兰的脑断层标本上辨认其沟回后,在连续断层标本上追踪其沟回,以校验结构观察的正确性.依据相同层面的脑和颅脑标本上的脑表沟回,内部特征性结构和颅底骨性标志进行标本的层回定位.在断层标本的层次定位后,且在层面上正确认识结构,则每个断层标本上的机能定位和大脑动脉的分布区域得以确定.同样的方法亦应用于CT.MR和ECT图像.标志动脉配布界线的沟和侧脑室各部的连结虚线作为断层标本或图像上的大脑动脉区域配布的分界线.     

翼腭窝手术入路的断层与应用解剖学研究

目的:用改进火棉胶包埋技术,为翼腭窝新型手术入路提供应用解剖学依据.方法:固定成人尸头标本30例,取其前颅底.标本经脱钙、脱水等系列处理,分别行三维连续薄切片,厚度0.25 mm.同时对80侧干燥骨进行测量.结果:翼腭窝形态多样,除有三角形外,还有弧形、横置"S"形、楔形、"L"形、哑铃形、短棒状或斜向外上的窄长条形.翼腭窝在中鼻道处内侧壁厚度为(1.95±0.66)mmm(左),(1.97±0.74)mm(右).在中鼻道处上颌窦口后缘至翼腭窝距离(11.25±1.95)mm(左),(11.22±1.96)mm(右).结论:新型手术入路不经过上颌窦,运用器械从中鼻道深入至翼腭窝的内侧壁深度,打开薄骨板,直接进入翼腭窝,由此处入路手术创伤小、出血少、安全、术后并发症少.     

Books,bones and bodies: The relevance of the history of anatomy in Nazi Germany for medical education today

The history of anatomy in Nazi Germany highlights the consequences to humanity when the destructive potentials immanent to all science and medicine are enabled by an anti-democratic, totalitarian regime. Anatomy presents an example of ethical transgressions by scientists and health care professionals that were amplified in the criminal political climate of the Nazi regime. This can happen anywhere, as science is never apolitical. This article gives a short account of anatomy in Nazi Germany, which is followed by an outline of the tangible and intangible legacies from this history, to then discuss implications for anatomy education today. While Jewish and politically dissident anatomists were forced out of their positions and country by the Nazi regime, the majority of the remaining anatomists joined the Nazi party and used bodies of Nazi victims for education and research. Some anatomists even performed deadly human experiments. Patterns and legacies that emerge from this history can be traced into the present and concern research ethics in general and anatomical body procurement specifically. They shed light on current practices and controversies in the anatomical sciences, including anthropology. It will be argued here that the history of anatomy in Nazi Germany can inform current anatomy education in a concept of anatomy as the first “clinical discipline.” By integrating insights from the history of anatomy into the learning process, anatomy education can model an approach to medicine that includes a full appreciation of the shared humanity of medical practitioners and patients.