Objective To clearly delineate the microanatomy of the upper thoracic sympathetic trunk and its syntopy in order to provide anatomical basis for the selection of precise clinical surgical approaches.Methods Totally 55...Objective To clearly delineate the microanatomy of the upper thoracic sympathetic trunk and its syntopy in order to provide anatomical basis for the selection of precise clinical surgical approaches.Methods Totally 55 sympathetic trunks available in 28 Chinese adult cadavers(18 males and 10 females)were investigated in this study.The thoracic cavity was thoroughly exposed and then sympathetic ganglia and its affiliated rami were observed and measured with microscopic instruments.Results Rami from thoracic nerve 1(T1)intercostal nerve entered the stellate ganglion above the upper border of the second rib in all specimens,The distance between the rami and the upper border of the second rib was(5.1±1.4)mm.The incidence that T2⁃T5 ganglions located at the corresponding intercostal space was 92.7%,85.5%,40.0%and 36.4%,respectively.The rami communicantes were classified into 3 types(type a,b and c)according to the anatomical relationship between the thoracic sympathetic ganglia and the intercostal nerves.The distance from 3 types of rami communicantes to lateral sympathetic trunk at the middle point of relative rib was(10.2±3.4)mm(type a),(9.5±2.6)mm(type b)and(8.4±2.0)mm(type c),respectively.We found that 74.5%superior intercostal artery crossed the neck of the first rib.The distance between the superior intercostal artery and the lateral sympathetic trunk was(3.4±1.3)mm.Conclusion Sympathectomy performed at rib level should be the ideal choice for clinical surgical treatment of palmar or craniofacial hyperhidrosis with less denervation scope to achieve more definite therapeutic effect.展开更多
Objective To explore how to organically integrate the human anatomy curriculum with medical imaging,thereby enhancing medical students'spatial understanding and 3D reconstruction skills,and strengthening their ana...Objective To explore how to organically integrate the human anatomy curriculum with medical imaging,thereby enhancing medical students'spatial understanding and 3D reconstruction skills,and strengthening their anatomical foundation and clinical competence.This approach aims to bridge the gap between basic science and clinical practice while cultivating clinical thinking abilities.Methods In this study,the medical imaging knowledge was introduced into the anatomy curriculum in Peking University,enabling students to better understand the human body structure and its relationship to the clinical practice with aid of the ultrasound and MRI method.After the course concluded,we evaluated the examination result and learning satisfaction data from the anatomy course.Results The result showed that students provided positive feedback,showing increased interest in learning,enhanced initiative,significant improvement in their anatomy grades(P<0.01),and a notable enhancement in their ability to apply basic knowledge to solve clinical problems(P<0.05).Conclusion The integrated teaching approach of medical imaging and human anatomy courses provides innovative ideas and practical method for medical students to learn the basic medical course and enhance their clinical skills in the future.展开更多
Rationale:This case report describes a couple with recurrent fertilization failure despite undergoing multiple cycles of intracytoplasmic sperm injection(ICSI).The principal clinical concern was suspected oocyte activ...Rationale:This case report describes a couple with recurrent fertilization failure despite undergoing multiple cycles of intracytoplasmic sperm injection(ICSI).The principal clinical concern was suspected oocyte activation deficiency(OAD),in which fertilization is impeded due to the oocyte’s inability to initiate embryogenesis,commonly attributed to inadequate intracellular calcium(Ca^(2+))release following sperm injection.Patient concerns:The couple repeatedly experienced complete or near-complete fertilization failure in previous ICSI cycles,raising suspicion of an underlying oocyte activation defect.Diagnosis:Based on the repeated absence of fertilization post-ICSI and clinical history,a diagnosis of suspected OAD leading to recurrent ICSI fertilization failure was considered.Interventions:Artificial oocyte activation(AOA)using the calcium ionophore A23187 was performed.After ICSI,unfertilized oocytes were exposed to the ionophore to induce Ca^(2+)influx,simulating physiological calcium oscillations essential for oocyte activation.The efficacy of intervention was evaluated through subsequent embryonic development,morphological grading,and chromosomal integrity.Outcomes:Following AOA treatment,successful oocyte activation occurred,resulting in the formation of high-grade embryos with normal developmental progression.Chromosomal analysis revealed no detectable abnormalities,indicating genomic stability.Lessons:Calcium ionophore–mediated AOA may serve as an effective adjunct in cases of recurrent ICSI failure attributed to OAD.This case highlights the importance of individualized therapeutic strategies in assisted reproduction;however,further research is needed to refine protocols,validate broader clinical efficacy,and assess long-term safety,including potential epigenetic risks.展开更多
SKI family transcriptional corepressor 1(SKOR1also known as LbxCor1, Fussel15, or CORL1), is a member of the SKI family of proteins and is transcribed from a protein-coding gene located on chromosome 15 in humans, tha...SKI family transcriptional corepressor 1(SKOR1also known as LbxCor1, Fussel15, or CORL1), is a member of the SKI family of proteins and is transcribed from a protein-coding gene located on chromosome 15 in humans, that has a molecular weight of approximately 100 kDa. Skor1 is highly expressed in neurons in the central nervous system of both humans and rodents.展开更多
Background:This study investigated the role of polydatin in regulating macrophage-epithelial cell(EC)interactions during asthma.An asthma model was induced in BALB/c mice using ovalbumin(20μg).Methods:The therapeutic...Background:This study investigated the role of polydatin in regulating macrophage-epithelial cell(EC)interactions during asthma.An asthma model was induced in BALB/c mice using ovalbumin(20μg).Methods:The therapeutic effects of polydatin(20 and 40 mg/kg)were evaluated in this asthmatic mouse model.To assess the underlying mechanisms,Bronchial Epithelium Adenovirus 12-SV402B(BEAS-2B)cells were cocultured with Tohoku Hospital for Pediatrics-1(THP-1)macrophages,in which toll-like receptor 4(TLR4)was either overexpressed or knocked down,and subsequently stimulated with lipopoly-saccharide(LPS)and ATP.THP-1 cells underwent a 1-h pretreatment with polydatin(50 and 100μmol/L),Class Lipid Inhibitor-095(CLI-095,TLR4 inhibitor,1μg/mL),or A438079(P2X7R antagonist,10μmol/L)prior to LPS/ATP challenge.Results:Findings from Western blotting,enzyme-linked immunosorbent assay,flow cytometry,real-time polymerase chain reaction,and immunofluorescence assays demonstrated that modulating TLR4 expression significantly altered interleukin-1β(IL-1β)secretion from THP-1 macrophages and mitochondrial reactive oxygen species(mtROS)production in BEAS-2B ECs.In the mouse asthma model,polydatin significantly alleviated airway inflammation,oxidative stress,and apoptosis,likely by interfering with TLR4/P2X7R-mediated signaling and suppressing the activation of the NOD-like receptor protein inflammasome.Additionally,polydatin significantly reduced IL-1βand IL-18 levels and inhibited the infiltration of macrophages and eosinophils.Correspondingly,polydatin significantly attenuated TLR4/P2X7R signaling in THP-1 cells stimulated with ATP and LPS,thereby reducing IL-1βand IL-18 secretion,calcium influx,mtROS production,and apoptosis in BEAS-2B ECs.Conclusions:Polydatin is a promising therapeutic candidate for asthma,possibly by targeting macrophage-epithelium cross-talk via the TLR4/P2X7R axis.Future formulations as capsules or sprays may effectively alleviate airway inflammation and remodeling.展开更多
AIM:To compare the intravitreal brolucizumab and bevacizumab injections for chronic central serous chorioretinopathy(cCSC).METHODS:Patients with cCSC were classified into bevacizumab and brolucizumab group.The proport...AIM:To compare the intravitreal brolucizumab and bevacizumab injections for chronic central serous chorioretinopathy(cCSC).METHODS:Patients with cCSC were classified into bevacizumab and brolucizumab group.The proportion of complete resolution of subretinal fluid(SRF),best-corrected visual acuity(BCVA),central macular thickness(CMT),and subfoveal choroidal thickness(SFCT)were compared between the two groups.RESULTS:A total of 40 eyes from 40 patients with aged 34-59y were enrolled in the study.Twenty eyes in bevacizumab group(17 males)and 20 eyes(18 males)in brolucizumab group.Comparing the proportion of complete resolution of SRF,the brolucizumab group was statistically significantly higher than the bevacizumab group(P<0.05).In 1mo,CMT was significantly reduced in the brolucizumab group compared to the bevacizumab group(265±69 vs 319±70μm;P=0.021).However,there was no significant difference in CMT between the two groups at 2 and 3mo(P>0.05).CONCLUSION:Brolucizumab is anatomically and functionally superior to bevacizumab in the treatment of patients with cCSC.展开更多
AIM： To clarify the innervation of human gallbladder,with special reference to morphological understanding of gallstone formation after gastrectomy.METHODS： The liver, gallbladder and surrounding structures were imm...AIM： To clarify the innervation of human gallbladder,with special reference to morphological understanding of gallstone formation after gastrectomy.METHODS： The liver, gallbladder and surrounding structures were immersed in a 10 mg/L solution of alizarin red S in ethanol to stain the peripheral nerves in cadavers （n = 10）. Innervation in the areas was completely dissected under a binocular microscope. Similarly,innervation in the same areas of 10 Suncus murinus （S. murinus） was examined employing whole mount immunohistochemistry.RESULTS： Innervation of the gallbladder occurred predominantly through two routes. One was from the anterior hepatic plexus, the innervation occurred along the cystic arteries and duct. Invariably this route passed through the hepatoduodenal ligament. The other route was from the posterior hepatic plexus, the innervation occurred along the cystic duct ventrally. This route also passed through the hepatoduodenal ligament dorsally.Similar results were obtained in S. murinus.CONCLUSION： The route from the anterior hepatic plexus via the cystic artery and/or duct is crucial for preserving gallbladder innervation. Lymph node dissection specifically in the hepatoduodenal ligament may affect the incidence of gallstones after gastrectomy.Furthermore, the route from the posterior hepatic plexus via the common bile duct and the cystic duct to the gallbladder should not be disregarded. Preservation of the plexus may attenuate the incidence of gallstone formation after gastrectomy.展开更多
Pancreatic carcinoma is an extremely high-grade malignant tumor with fast development and high mortality.The incidence of pancreatic carcinoma continues to increase.Peripancreatic invasion and metastasis are the main ...Pancreatic carcinoma is an extremely high-grade malignant tumor with fast development and high mortality.The incidence of pancreatic carcinoma continues to increase.Peripancreatic invasion and metastasis are the main characteristics and important prognostic factors in pancreatic carcinoma,especially invasion into the nervous system;pancreatic nerve innervation includes the intrapancreatic and extrapancreatic nerves.A strong grasp of pancreatic nerve innervation may contribute to our understanding of pancreatic pain modalities and the metastatic routes for pancreatic carcinomas.Computed tomography(CT)and magnetic resonance imaging(MRI)are helpful techniques for depicting the anatomy of extrapancreatic nerve innervation.The purpose of the present work is to show and describe the anatomy of the extrapancreatic neural plexus and to elucidate its characteristics using CT and MRI,drawing on our own previous work and the research findings of others.展开更多
In the advent of knowledge economy and information society,the society urgently needs talents with high-quality,creativity and comprehensive development.School education plays an extremely important role in educating ...In the advent of knowledge economy and information society,the society urgently needs talents with high-quality,creativity and comprehensive development.School education plays an extremely important role in educating creative innovation.展开更多
The liver has a complex vascular anatomy with a unique dual blood supply.Clinical conditions of the liver vary widely and include disorders originating in the vascular and biliary systems as well as the parenchyma.In ...The liver has a complex vascular anatomy with a unique dual blood supply.Clinical conditions of the liver vary widely and include disorders originating in the vascular and biliary systems as well as the parenchyma.In most vascular disorders,the effects on the liver are generally subclinical because of its abundant blood supply.However,early diagnosis of such vascular diseases can significantly reduce patient morbidity and mortality.Because imaging findings of vascular disease are not always readily apparent,diagnosis can be difficult.Computed tomography angiography is an excellent imaging modality for visualizing the vascular anatomy of patients for treatment planning.In this review article,we focus on the vascular anatomy of the liver and the imaging findings in some acute hepatic vascular diseases.展开更多
AIM： To clarify the innervation of the antro-pyloric region in humans from a clinico-anatomical perspective. METHODS： The stomach, duodenum and surrounding structures were dissected in 10 cadavers, and immersed in a...AIM： To clarify the innervation of the antro-pyloric region in humans from a clinico-anatomical perspective. METHODS： The stomach, duodenum and surrounding structures were dissected in 10 cadavers, and immersed in a 10mg/L solution of alizarin red S in ethanol to stain the peripheral nerves. The distribution details were studied to confirm innervations in the above areas using a binocular microscope. Similarly, innervations in 10 Suncus murinus were examined using the method of whole-mount imm unohistochemistry. RESULTS： The innervation of the pyloric region in humans involved three routes： One arose from the anterior hepatic plexus via the route of the suprapyloric/supraduodenal branch of the right gastric artery; the second arose from the anterior and posterior gastric divisions, and the third originated from the posterior-lower region of the pyloric region, which passed via the infrapyloric artery or retroduodenal branches and was related to the gastroduodenal artery and right gastroepiploic artery. For Suncus murinus, results similar to those in humans were observed. CONCLUSION： There are three routes of innervation of the pyloric region in humans, wherein the route of the right gastric artery is most important for preserving pyloric region innervation. Function will be preserved by more than 80% by preserving the artery in pylorus-preserving pancreaticoduodenectomy （PPPD）. However, the route of the infrapyloric artery should not be disregarded. This route is related to several arteries （the right gastroepiploic and gastroduodenal arteries）, and the preserving of these arteries is advantageous for preserving pyloric innervation in PPPD. Concurrently, the nerves of Latarjet also play an important role in maintaining innervation of the antro-pyloric region in PPPD. This is why pyloric function is not damaged in some patients when the right gastric artery is dissected or damaged in PPPD.展开更多
BACKGROUND: This study aimed to describe the clinical and socio-demographic aspects of acute poisoning in 2010 in Duzce City, Northwest Anatolian Region of Turkey.METHODS: Acute poisoning was due to the intentional in...BACKGROUND: This study aimed to describe the clinical and socio-demographic aspects of acute poisoning in 2010 in Duzce City, Northwest Anatolian Region of Turkey.METHODS: Acute poisoning was due to the intentional ingestion of drugs in young and adult people(≥16), who were treated at the Emergency Service of Duzce University Medical Hospital, Turkey from January 1, 2010 to December 31, 2010. In this retrospective and descriptive study, 95 patients were diagnosed with intoxications and 30 of them intentionally ingested drugs to commit suicide. Records of the patients diagnosed with intoxication were obtained from the Clinical Archive of the hospital. Their diagnoses were established according to the International Statistical Classification of Diseases and Related Health Problems. Codes X60-X84 of this classification were used to classify self-infringed drug injuries and drug poisoning.RESULTS: In this series, 35(36.8%) patients were male and 60 patients(63.2%) female. The male/female ratio was 1.0/1.7. The mean age of the patients was 33.1±14.2 years; 17(17.9%) patients were below 20 years old and 9(9.5%) were older than 50 years. Of these patients, 29(30.5%) were single, 7(7.4%) divorced or separated, and 59(62.1%) married. Their mean time for admission to the emergency service after the incident was 208±180(15–660) minutes. The mean time for admission to the emergency service for patients with food intoxication after the incident was 142±160 minutes, for those with drug intoxication 173±161 minutes, for those with carbon monoxide(CO) intoxication 315±209 minutes, and for those with undefined intoxication 289±166 minutes(P=0.005). Most of the intoxication cases occurred in winter(41.1%, 39 of 95 patients). Admissions to the emergency service were most common in December and April(21 and 16 of 95 patients, respectively). Sixty-five(68.4%) cases were involved in non-deliberate poisoning, whereas 30(31.6%) were involved in deliberate poisoning. Twenty-six of the 95 patients with acute poisonings had mortality risk at admission, however only one died from CO intoxication in the emergency service(1.1%). Suicide attempts were more common in females than in males(21 of 30 patients, 70%, P<0.05). CONCLUSION: In Duzce City of Turkey, most intoxication cases occurred in winter, especially in December. They had non-deliberate poisoning, but deliberate poisoning in suicide attempts was more common in females than in males.展开更多
This article reviews the relationship between the spinal dorsal ramus system and low back pain, including the anatomy, clinical findings, pathogenesis and treatment of low back pain mediated by spinal dorsal ramus and...This article reviews the relationship between the spinal dorsal ramus system and low back pain, including the anatomy, clinical findings, pathogenesis and treatment of low back pain mediated by spinal dorsal ramus and zygapophysial (facet) joint syndrome. Each spinal dorsal ramus arises from the spinal nerve and then divides into a medial and lateral branch. The medial branch supplies the tissues from the midline to the zygapophysial joint line and innervates two to three adjacent zygapophysial joints and their related soft tissues. The lateral branch innervates the tissues lateral to the zygapophysial joint line. The clinical pain presentations follow these anatomic distributions, which can be used for localizing the involved dorsal ramus. The diagnosis can be confirmed by performing a single dorsal ramus block that results in relief of pain and muscle spasm. Etiologically, any factor that stimulates the spinal dorsal ramus can cause low back pain, which is distinct from zygapophysial joint syndrome. Clinically, L1 and L2 are the most common sites of dorsal rami involvement. Treatment includes spinal dorsal ramus injection therapy and percutaneous neurotomy. Summarily, irritation of the spinal dorsal ramus system is a potential source of low back pain. Based on the anatomy and clinical presentation, the involved spinal dorsal ramus can be localized and treated.展开更多
Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with...Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder.In addition,the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment.Evidence suggests that this condition is a multisystem disorder that affects many biological systems,raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder.We performed a PubMed search for microRNAs(miRNAs)in post-traumatic stress disorder(PTSD)that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023.These included four studies with whole blood,seven with peripheral blood mononuclear cells,four with plasma extracellular vesicles/exosomes,and one with serum exosomes.One of these studies had also used whole plasma.Two studies were excluded as they did not involve microRNA biomarkers.Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat,and only two were from recently traumatized adult subjects.In measuring miRNA expression levels,many of the studies had used microarray miRNA analysis,miRNA Seq analysis,or NanoString panels.Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls.The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood;miR-193a-5p,-7113-5p,-125a,-181c,and-671-5p in peripheral blood mononuclear cells;miR-10b-5p,-203a-3p,-4488,-502-3p,-874-3p,-5100,and-7641 in plasma extracellular vesicles/exosomes;and miR-18a-3p and-7-1-5p in blood plasma.Several important limitations identified in the studies need to be taken into account in future studies.Further studies are warranted with war veterans and recently traumatized children,adolescents,and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.展开更多
The macro-micro-anatomy of the lingual artery of 25 adult cadavers wasstudied.The origin of the artery is rather concentrated and the greater cornu of thehyoid bone can be used as the indicator.The entrance of the art...The macro-micro-anatomy of the lingual artery of 25 adult cadavers wasstudied.The origin of the artery is rather concentrated and the greater cornu of thehyoid bone can be used as the indicator.The entrance of the artery into the hyoglossusmuscle is almost constantly along the posterior border of the muscle,where the artery issuperficially located and easily to be exposed,and has a constant relationship with thevein and hypoglossal nerve.Thus the lingual artery can be used as the artery of a recipientarea in case of tongue reconstruction.The deep lingual artery has two types ofbranches;the short ones mainly supply the muscles of tongue while the long ones mainlysupply the mucosa by forming a submucosal network.In the muscles of tongue,minutearterioles run tortuously along the muscular fibers with abundant anastomoses betweeneach other,but no anastomosis is found to cross over the rnidline of the tongue.Be-neath the mucosa,there is an arterial network spreading all over the whole tongue notlimited to one side.The relationship of the arterial architecture to the structure and thefunctions of the tongue and its clinical significance were discussed.展开更多
Thirty feet of Chinese adult cadavers were dissected under an operativemicroscope to observe the extensor hallucis brevis and extensor digitorum brevisand their vessels and nerves in order to design myocutaneous flaps...Thirty feet of Chinese adult cadavers were dissected under an operativemicroscope to observe the extensor hallucis brevis and extensor digitorum brevisand their vessels and nerves in order to design myocutaneous flaps.It was be-lieved that the lateral tarsal artery and the lateral branch of the deep peronealnerve are the best choice to be included in the pedicle when muscle flaps ormyocutaneous flaps are to be obtained from the dorsum of foot.The size of themuscles may be enlarged both laterally and medially as the clinicalcondition requires.展开更多
To provide practical and surgical anatomy for the imaging diagnosis and surgical treatment of the disease of the caudate lobe of the liver. Methods： Based on Chinese Visible Human 1-5 data sets and assisted by 3D vis...To provide practical and surgical anatomy for the imaging diagnosis and surgical treatment of the disease of the caudate lobe of the liver. Methods： Based on Chinese Visible Human 1-5 data sets and assisted by 3D visualization and reconstruction, the 3D models of the upper abdomen or the liver were reconstructed and the cross-sectional images were converted to the coronal and sagittal images. The anatomy of the caudate lobe of the liver on the coronal and sagittal planes was investigated on serial planes of the upper abdomen. Results： The caudate lobe was bordered on the left by the fissura ligamenti venosi, posteriorly by the IVC, superiorly by the hepatic veins and inferiorly by the hepatic hilum. Its right and ventral borders might be obscure, with only relative borders existent. The right wall of the IVC was a good landmark to judge the relative realm of paracaval portion, and the relative ventral plane might exist between the hepatic hilum and entrance of hepatic veins. The caudate lobe could be divided into two principal regions： the left Spiegel lobe and the right paracaval portion. The caudate process, and the right rear process occurring in some individuals belonged to the right paracaval portion. The caudate lobe was blood supplied by the portal vein, which directly drained into the IVC. Conclusion： There are not definite borders for the right part of the caudate lobe, and most of the knowledge on it is based on the cast study, which may not suit for the clinical diagnosis and practice. The coronal and sagittal sections can better show the anatomic relationships between the caudate lobe, the other parts of the liver and the adjacent structures. The 3D digital visualization is an accurate and convenient study method for clinical anatomy.展开更多
Anatomy, a foremost basic medical science (BMS) has evolved in content and context, while remaining the most fundamental BMS subject. Stakeholders have continually made efforts especially in recent time to achieve an ...Anatomy, a foremost basic medical science (BMS) has evolved in content and context, while remaining the most fundamental BMS subject. Stakeholders have continually made efforts especially in recent time to achieve an evolution of this subject. The primary aim of this work was to study the perceptions and experiences of Anatomists towards contributing to programme and career advancements. Following ethical approval, structured questionnaire was administered to Nigerian anatomists using a Google form. It is a total population study. The questionnaire had 13 sections, with each section addressing a theme that was integral to the subject of research interest. The last section collected free responses as qualitative information. After indicating informed consent, 106 anatomists properly completed and returned the questionnaires. Statistical and quantitative analyses of results were done. The most popular field amongst respondents was Neuroscience (60.9%);followed by Histology or Microscopic Anatomy (53.6%), Embryology or developmental anatomy (35.5%), Gross anatomy (34.5%) and Histochemistry (30.9%). About half of Nigerian anatomists involved in the study had a PhD degree. Training emphasized the cognitive domains the most. Consequently, emphasis should be laid on the psychomotor (skills) and the affective domain (attitude) to improve capacity, competences, and the job prospects of trainees. The consensus was that the programme trained students and prepared graduates as medical educators, scientists, and researchers. Anatomy has significant potential to contribute to development with proper programme design, emphasis on research, teaching and applied services competencies, effective policy formulation and implementation and adherence to best practices.展开更多
BACKGROUND Loss of motor function in the trapezius muscle is one complication of radical neck dissection after cutting the accessory nerve(AN) during surgery.Nerve repair is an effective method to restore trapezius mu...BACKGROUND Loss of motor function in the trapezius muscle is one complication of radical neck dissection after cutting the accessory nerve(AN) during surgery.Nerve repair is an effective method to restore trapezius muscle function,and includes neurolysis,direct suture,and nerve grafting.The suprascapular nerve(SCN) and AN are next to each other in position.The function of the AN and SCN in shoulder elevation and abduction movement is synergistic.SCN might be considered by surgeons for AN reanimation.AIM To obtain anatomical and clinical data for partial suprascapular nerve-to-AN transfer.METHODS Ten sides of cadavers perfused with formalin were obtained from the Department of Human Anatomy,Histology and Embryology,Peking University Health Science Center.The SCN(n = 10) and AN(n = 10) were carefully dissected in the posterior triangle of the neck,and the trapezius muscle was dissected to fully display the accessory nerve.The length of the SCN from the origin of the brachial plexus(a point) to the scapular notch(b point) and the distance of the SCN from the origin point(a point) to the point(c point) where the AN entered the border of the trapezius muscle were measured.The length and branches of the AN in the trapezius muscle were measured.A female patient aged 55 years underwent surgery for partial SCN to AN transfer at Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology.The patient suffered from recurrent upper gingival cancer.Radical neck dissection was performed on the right side,and the right AN was removed at the intersection between the nerve and the posterior border of the SCM muscle.One-third of the diameter of the SCN was cut off,and combined epineurial and perineurial sutures were applied between the distal end of the cut-off fascicles of the SCN and the proximal end of the AN without tension.Both subjective and objective evaluations were performed before,three months after,and nine months after surgery.For the subjective evaluation,the questionnaire included the Neck Dissection Impairment Index(NDII) and the Constant Shoulder Scale.Electromyography was used for the objective examination.Data were analyzed using t tests with SPSS 19.0 software to determine the relationship between the length of the SCN and the linear distance.A P value of < 0.05 was considered as statistically significant.RESULTS The whole length of the AN in the trapezius muscle was 16.89 cm.The average numbers of branches distributed in the descending,horizontal and ascending portions were 3.8,2.6 and 2.2,respectively.The diameter of the AN was 1.94 mm at the anterior border of the trapezius.The length of the suprascapular nerve from the origin of the brachial plexus to the scapular notch was longer than the distance of the suprascapular nerve from the origin point to the point where the accessory nerve entered the upper edge of the trapezius muscle.The amplitude of trapezius muscle electromyography indicated that both the horizontal and ascending portions of the trapezius muscle on the right side had better function than the left side nine months after surgery.The results showed that the right-sided supraspinatus and infraspinatus muscles did not lose more function than the left side.CONCLUSION Based on anatomical data and clinical application,partial suprascapular nerve-to-AN transfer could be achieved and may improve innervation of the affected trapezius muscle after radical neck dissection.展开更多
Through long-term observations and repeated practices of human body structure,anatomical knowledge in ancient China has gradually developed from the sprouting period when ancient Chinese hunted animals for survival,to...Through long-term observations and repeated practices of human body structure,anatomical knowledge in ancient China has gradually developed from the sprouting period when ancient Chinese hunted animals for survival,to anatomical exploration,which breaks the shackles of fear and religious rites.For example,Hua Tuo(华佗),a famous doctor in the period of The Three Kingdoms,did exquisite abdominal surgery;Yan Luozi(烟萝子),a Taoist priest in the period of The Five Dynasties,drew a map of human anatomy;Wang Weiyi(王唯一),a medical official in Northern Song dynasty,was responsible for casting acupuncture bronze figures,an anatomical mold for practicing acupuncture;Song Ci(宋慈),a forensic expert in Southern Song Dynasty,wrote Xi Yuan Ji Lu(《洗冤集录》Collected Cases of Injustice Rectified);Wang Qingren(王清任),a physician in Qing Dynasty wrote Yi Lin Gai Cuo(《医林改错》Correction on Errors in Medical Works).Ancient Chinese anatomy is far ahead of Western anatomy in understanding and describing human body structures.It has made great contributions to the emergence of Huang Di Nei Jing(《黄帝内经》Huangdi's Internal Classic)and laid a solid foundation for the establishment of visceral manifestation theory and meridian and collateral theory.Even now,it has served the basic theory of traditional Chinese medicine and clinical practices.Anatomical knowledges,such as relevant operation records,books,Atlas,models in ancient China,especially the names of Zangorgan and Fu-organ,bones and five sense organs,are still used in modern anatomy and modern medicine,making indelible contributions to the development of modern anatomy in China.展开更多
文摘Objective To clearly delineate the microanatomy of the upper thoracic sympathetic trunk and its syntopy in order to provide anatomical basis for the selection of precise clinical surgical approaches.Methods Totally 55 sympathetic trunks available in 28 Chinese adult cadavers(18 males and 10 females)were investigated in this study.The thoracic cavity was thoroughly exposed and then sympathetic ganglia and its affiliated rami were observed and measured with microscopic instruments.Results Rami from thoracic nerve 1(T1)intercostal nerve entered the stellate ganglion above the upper border of the second rib in all specimens,The distance between the rami and the upper border of the second rib was(5.1±1.4)mm.The incidence that T2⁃T5 ganglions located at the corresponding intercostal space was 92.7%,85.5%,40.0%and 36.4%,respectively.The rami communicantes were classified into 3 types(type a,b and c)according to the anatomical relationship between the thoracic sympathetic ganglia and the intercostal nerves.The distance from 3 types of rami communicantes to lateral sympathetic trunk at the middle point of relative rib was(10.2±3.4)mm(type a),(9.5±2.6)mm(type b)and(8.4±2.0)mm(type c),respectively.We found that 74.5%superior intercostal artery crossed the neck of the first rib.The distance between the superior intercostal artery and the lateral sympathetic trunk was(3.4±1.3)mm.Conclusion Sympathectomy performed at rib level should be the ideal choice for clinical surgical treatment of palmar or craniofacial hyperhidrosis with less denervation scope to achieve more definite therapeutic effect.
基金2024 Higher Education Science Research Planning Project(24KC0413)Peking University Health Science Center Medical Education Research Funding Project(2023YB43)+3 种基金The University-Industry Collaborative Education Program of the Ministry of Education(220903132204624)2022 Peking University Graduate Course Construction Funding2023 Peking University Medical Graduate Course Ideological and Political Construction ProjectZhejiang Natural Science Foundation Exploration Project Q-class Funding Project(242szhfhYB25)。
文摘Objective To explore how to organically integrate the human anatomy curriculum with medical imaging,thereby enhancing medical students'spatial understanding and 3D reconstruction skills,and strengthening their anatomical foundation and clinical competence.This approach aims to bridge the gap between basic science and clinical practice while cultivating clinical thinking abilities.Methods In this study,the medical imaging knowledge was introduced into the anatomy curriculum in Peking University,enabling students to better understand the human body structure and its relationship to the clinical practice with aid of the ultrasound and MRI method.After the course concluded,we evaluated the examination result and learning satisfaction data from the anatomy course.Results The result showed that students provided positive feedback,showing increased interest in learning,enhanced initiative,significant improvement in their anatomy grades(P<0.01),and a notable enhancement in their ability to apply basic knowledge to solve clinical problems(P<0.05).Conclusion The integrated teaching approach of medical imaging and human anatomy courses provides innovative ideas and practical method for medical students to learn the basic medical course and enhance their clinical skills in the future.
文摘Rationale:This case report describes a couple with recurrent fertilization failure despite undergoing multiple cycles of intracytoplasmic sperm injection(ICSI).The principal clinical concern was suspected oocyte activation deficiency(OAD),in which fertilization is impeded due to the oocyte’s inability to initiate embryogenesis,commonly attributed to inadequate intracellular calcium(Ca^(2+))release following sperm injection.Patient concerns:The couple repeatedly experienced complete or near-complete fertilization failure in previous ICSI cycles,raising suspicion of an underlying oocyte activation defect.Diagnosis:Based on the repeated absence of fertilization post-ICSI and clinical history,a diagnosis of suspected OAD leading to recurrent ICSI fertilization failure was considered.Interventions:Artificial oocyte activation(AOA)using the calcium ionophore A23187 was performed.After ICSI,unfertilized oocytes were exposed to the ionophore to induce Ca^(2+)influx,simulating physiological calcium oscillations essential for oocyte activation.The efficacy of intervention was evaluated through subsequent embryonic development,morphological grading,and chromosomal integrity.Outcomes:Following AOA treatment,successful oocyte activation occurred,resulting in the formation of high-grade embryos with normal developmental progression.Chromosomal analysis revealed no detectable abnormalities,indicating genomic stability.Lessons:Calcium ionophore–mediated AOA may serve as an effective adjunct in cases of recurrent ICSI failure attributed to OAD.This case highlights the importance of individualized therapeutic strategies in assisted reproduction;however,further research is needed to refine protocols,validate broader clinical efficacy,and assess long-term safety,including potential epigenetic risks.
基金supported by Science Foundation Ireland (Grant 19/FFP/6666),Cure Parkinson’s (Grant CP:GO01)a PhD studentship from the Anatomical Society。
文摘SKI family transcriptional corepressor 1(SKOR1also known as LbxCor1, Fussel15, or CORL1), is a member of the SKI family of proteins and is transcribed from a protein-coding gene located on chromosome 15 in humans, that has a molecular weight of approximately 100 kDa. Skor1 is highly expressed in neurons in the central nervous system of both humans and rodents.
基金National Natural Science Foundation of China,Grant/Award Number:82260007Jilin Province Health Commission,Grant/Award Number:2024A062+1 种基金Jilin Provincial Department of Education,Grant/Award Number:JJKH20240698KJJilin Province Science and Technology Department,Grant/Award Number:20240404025ZP and 20240602100RC。
文摘Background:This study investigated the role of polydatin in regulating macrophage-epithelial cell(EC)interactions during asthma.An asthma model was induced in BALB/c mice using ovalbumin(20μg).Methods:The therapeutic effects of polydatin(20 and 40 mg/kg)were evaluated in this asthmatic mouse model.To assess the underlying mechanisms,Bronchial Epithelium Adenovirus 12-SV402B(BEAS-2B)cells were cocultured with Tohoku Hospital for Pediatrics-1(THP-1)macrophages,in which toll-like receptor 4(TLR4)was either overexpressed or knocked down,and subsequently stimulated with lipopoly-saccharide(LPS)and ATP.THP-1 cells underwent a 1-h pretreatment with polydatin(50 and 100μmol/L),Class Lipid Inhibitor-095(CLI-095,TLR4 inhibitor,1μg/mL),or A438079(P2X7R antagonist,10μmol/L)prior to LPS/ATP challenge.Results:Findings from Western blotting,enzyme-linked immunosorbent assay,flow cytometry,real-time polymerase chain reaction,and immunofluorescence assays demonstrated that modulating TLR4 expression significantly altered interleukin-1β(IL-1β)secretion from THP-1 macrophages and mitochondrial reactive oxygen species(mtROS)production in BEAS-2B ECs.In the mouse asthma model,polydatin significantly alleviated airway inflammation,oxidative stress,and apoptosis,likely by interfering with TLR4/P2X7R-mediated signaling and suppressing the activation of the NOD-like receptor protein inflammasome.Additionally,polydatin significantly reduced IL-1βand IL-18 levels and inhibited the infiltration of macrophages and eosinophils.Correspondingly,polydatin significantly attenuated TLR4/P2X7R signaling in THP-1 cells stimulated with ATP and LPS,thereby reducing IL-1βand IL-18 secretion,calcium influx,mtROS production,and apoptosis in BEAS-2B ECs.Conclusions:Polydatin is a promising therapeutic candidate for asthma,possibly by targeting macrophage-epithelium cross-talk via the TLR4/P2X7R axis.Future formulations as capsules or sprays may effectively alleviate airway inflammation and remodeling.
基金Supported by research fund from Chosun University Hospital,2022.
文摘AIM:To compare the intravitreal brolucizumab and bevacizumab injections for chronic central serous chorioretinopathy(cCSC).METHODS:Patients with cCSC were classified into bevacizumab and brolucizumab group.The proportion of complete resolution of subretinal fluid(SRF),best-corrected visual acuity(BCVA),central macular thickness(CMT),and subfoveal choroidal thickness(SFCT)were compared between the two groups.RESULTS:A total of 40 eyes from 40 patients with aged 34-59y were enrolled in the study.Twenty eyes in bevacizumab group(17 males)and 20 eyes(18 males)in brolucizumab group.Comparing the proportion of complete resolution of SRF,the brolucizumab group was statistically significantly higher than the bevacizumab group(P<0.05).In 1mo,CMT was significantly reduced in the brolucizumab group compared to the bevacizumab group(265±69 vs 319±70μm;P=0.021).However,there was no significant difference in CMT between the two groups at 2 and 3mo(P>0.05).CONCLUSION:Brolucizumab is anatomically and functionally superior to bevacizumab in the treatment of patients with cCSC.
基金Supported by Ministry of Education, Culture, Sports, Science and Technology of Japan, Grant No. 16590139
文摘AIM： To clarify the innervation of human gallbladder,with special reference to morphological understanding of gallstone formation after gastrectomy.METHODS： The liver, gallbladder and surrounding structures were immersed in a 10 mg/L solution of alizarin red S in ethanol to stain the peripheral nerves in cadavers （n = 10）. Innervation in the areas was completely dissected under a binocular microscope. Similarly,innervation in the same areas of 10 Suncus murinus （S. murinus） was examined employing whole mount immunohistochemistry.RESULTS： Innervation of the gallbladder occurred predominantly through two routes. One was from the anterior hepatic plexus, the innervation occurred along the cystic arteries and duct. Invariably this route passed through the hepatoduodenal ligament. The other route was from the posterior hepatic plexus, the innervation occurred along the cystic duct ventrally. This route also passed through the hepatoduodenal ligament dorsally.Similar results were obtained in S. murinus.CONCLUSION： The route from the anterior hepatic plexus via the cystic artery and/or duct is crucial for preserving gallbladder innervation. Lymph node dissection specifically in the hepatoduodenal ligament may affect the incidence of gallstones after gastrectomy.Furthermore, the route from the posterior hepatic plexus via the common bile duct and the cystic duct to the gallbladder should not be disregarded. Preservation of the plexus may attenuate the incidence of gallstone formation after gastrectomy.
基金Supported by National Nature Science Foundation of China,No.30370436
文摘Pancreatic carcinoma is an extremely high-grade malignant tumor with fast development and high mortality.The incidence of pancreatic carcinoma continues to increase.Peripancreatic invasion and metastasis are the main characteristics and important prognostic factors in pancreatic carcinoma,especially invasion into the nervous system;pancreatic nerve innervation includes the intrapancreatic and extrapancreatic nerves.A strong grasp of pancreatic nerve innervation may contribute to our understanding of pancreatic pain modalities and the metastatic routes for pancreatic carcinomas.Computed tomography(CT)and magnetic resonance imaging(MRI)are helpful techniques for depicting the anatomy of extrapancreatic nerve innervation.The purpose of the present work is to show and describe the anatomy of the extrapancreatic neural plexus and to elucidate its characteristics using CT and MRI,drawing on our own previous work and the research findings of others.
基金Graduate education innovative projects in Shandong province(SDYY09051)Technology project of Binzhou medical university(BY2009KJ12)
文摘In the advent of knowledge economy and information society,the society urgently needs talents with high-quality,creativity and comprehensive development.School education plays an extremely important role in educating creative innovation.
文摘The liver has a complex vascular anatomy with a unique dual blood supply.Clinical conditions of the liver vary widely and include disorders originating in the vascular and biliary systems as well as the parenchyma.In most vascular disorders,the effects on the liver are generally subclinical because of its abundant blood supply.However,early diagnosis of such vascular diseases can significantly reduce patient morbidity and mortality.Because imaging findings of vascular disease are not always readily apparent,diagnosis can be difficult.Computed tomography angiography is an excellent imaging modality for visualizing the vascular anatomy of patients for treatment planning.In this review article,we focus on the vascular anatomy of the liver and the imaging findings in some acute hepatic vascular diseases.
基金Supported by Ministry of Education, Culture, Sports, Science and Technology of Japan Grant, No. 14570008
文摘AIM： To clarify the innervation of the antro-pyloric region in humans from a clinico-anatomical perspective. METHODS： The stomach, duodenum and surrounding structures were dissected in 10 cadavers, and immersed in a 10mg/L solution of alizarin red S in ethanol to stain the peripheral nerves. The distribution details were studied to confirm innervations in the above areas using a binocular microscope. Similarly, innervations in 10 Suncus murinus were examined using the method of whole-mount imm unohistochemistry. RESULTS： The innervation of the pyloric region in humans involved three routes： One arose from the anterior hepatic plexus via the route of the suprapyloric/supraduodenal branch of the right gastric artery; the second arose from the anterior and posterior gastric divisions, and the third originated from the posterior-lower region of the pyloric region, which passed via the infrapyloric artery or retroduodenal branches and was related to the gastroduodenal artery and right gastroepiploic artery. For Suncus murinus, results similar to those in humans were observed. CONCLUSION： There are three routes of innervation of the pyloric region in humans, wherein the route of the right gastric artery is most important for preserving pyloric region innervation. Function will be preserved by more than 80% by preserving the artery in pylorus-preserving pancreaticoduodenectomy （PPPD）. However, the route of the infrapyloric artery should not be disregarded. This route is related to several arteries （the right gastroepiploic and gastroduodenal arteries）, and the preserving of these arteries is advantageous for preserving pyloric innervation in PPPD. Concurrently, the nerves of Latarjet also play an important role in maintaining innervation of the antro-pyloric region in PPPD. This is why pyloric function is not damaged in some patients when the right gastric artery is dissected or damaged in PPPD.
文摘BACKGROUND: This study aimed to describe the clinical and socio-demographic aspects of acute poisoning in 2010 in Duzce City, Northwest Anatolian Region of Turkey.METHODS: Acute poisoning was due to the intentional ingestion of drugs in young and adult people(≥16), who were treated at the Emergency Service of Duzce University Medical Hospital, Turkey from January 1, 2010 to December 31, 2010. In this retrospective and descriptive study, 95 patients were diagnosed with intoxications and 30 of them intentionally ingested drugs to commit suicide. Records of the patients diagnosed with intoxication were obtained from the Clinical Archive of the hospital. Their diagnoses were established according to the International Statistical Classification of Diseases and Related Health Problems. Codes X60-X84 of this classification were used to classify self-infringed drug injuries and drug poisoning.RESULTS: In this series, 35(36.8%) patients were male and 60 patients(63.2%) female. The male/female ratio was 1.0/1.7. The mean age of the patients was 33.1±14.2 years; 17(17.9%) patients were below 20 years old and 9(9.5%) were older than 50 years. Of these patients, 29(30.5%) were single, 7(7.4%) divorced or separated, and 59(62.1%) married. Their mean time for admission to the emergency service after the incident was 208±180(15–660) minutes. The mean time for admission to the emergency service for patients with food intoxication after the incident was 142±160 minutes, for those with drug intoxication 173±161 minutes, for those with carbon monoxide(CO) intoxication 315±209 minutes, and for those with undefined intoxication 289±166 minutes(P=0.005). Most of the intoxication cases occurred in winter(41.1%, 39 of 95 patients). Admissions to the emergency service were most common in December and April(21 and 16 of 95 patients, respectively). Sixty-five(68.4%) cases were involved in non-deliberate poisoning, whereas 30(31.6%) were involved in deliberate poisoning. Twenty-six of the 95 patients with acute poisonings had mortality risk at admission, however only one died from CO intoxication in the emergency service(1.1%). Suicide attempts were more common in females than in males(21 of 30 patients, 70%, P<0.05). CONCLUSION: In Duzce City of Turkey, most intoxication cases occurred in winter, especially in December. They had non-deliberate poisoning, but deliberate poisoning in suicide attempts was more common in females than in males.
文摘This article reviews the relationship between the spinal dorsal ramus system and low back pain, including the anatomy, clinical findings, pathogenesis and treatment of low back pain mediated by spinal dorsal ramus and zygapophysial (facet) joint syndrome. Each spinal dorsal ramus arises from the spinal nerve and then divides into a medial and lateral branch. The medial branch supplies the tissues from the midline to the zygapophysial joint line and innervates two to three adjacent zygapophysial joints and their related soft tissues. The lateral branch innervates the tissues lateral to the zygapophysial joint line. The clinical pain presentations follow these anatomic distributions, which can be used for localizing the involved dorsal ramus. The diagnosis can be confirmed by performing a single dorsal ramus block that results in relief of pain and muscle spasm. Etiologically, any factor that stimulates the spinal dorsal ramus can cause low back pain, which is distinct from zygapophysial joint syndrome. Clinically, L1 and L2 are the most common sites of dorsal rami involvement. Treatment includes spinal dorsal ramus injection therapy and percutaneous neurotomy. Summarily, irritation of the spinal dorsal ramus system is a potential source of low back pain. Based on the anatomy and clinical presentation, the involved spinal dorsal ramus can be localized and treated.
文摘Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder.In addition,the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment.Evidence suggests that this condition is a multisystem disorder that affects many biological systems,raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder.We performed a PubMed search for microRNAs(miRNAs)in post-traumatic stress disorder(PTSD)that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023.These included four studies with whole blood,seven with peripheral blood mononuclear cells,four with plasma extracellular vesicles/exosomes,and one with serum exosomes.One of these studies had also used whole plasma.Two studies were excluded as they did not involve microRNA biomarkers.Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat,and only two were from recently traumatized adult subjects.In measuring miRNA expression levels,many of the studies had used microarray miRNA analysis,miRNA Seq analysis,or NanoString panels.Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls.The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood;miR-193a-5p,-7113-5p,-125a,-181c,and-671-5p in peripheral blood mononuclear cells;miR-10b-5p,-203a-3p,-4488,-502-3p,-874-3p,-5100,and-7641 in plasma extracellular vesicles/exosomes;and miR-18a-3p and-7-1-5p in blood plasma.Several important limitations identified in the studies need to be taken into account in future studies.Further studies are warranted with war veterans and recently traumatized children,adolescents,and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.
文摘The macro-micro-anatomy of the lingual artery of 25 adult cadavers wasstudied.The origin of the artery is rather concentrated and the greater cornu of thehyoid bone can be used as the indicator.The entrance of the artery into the hyoglossusmuscle is almost constantly along the posterior border of the muscle,where the artery issuperficially located and easily to be exposed,and has a constant relationship with thevein and hypoglossal nerve.Thus the lingual artery can be used as the artery of a recipientarea in case of tongue reconstruction.The deep lingual artery has two types ofbranches;the short ones mainly supply the muscles of tongue while the long ones mainlysupply the mucosa by forming a submucosal network.In the muscles of tongue,minutearterioles run tortuously along the muscular fibers with abundant anastomoses betweeneach other,but no anastomosis is found to cross over the rnidline of the tongue.Be-neath the mucosa,there is an arterial network spreading all over the whole tongue notlimited to one side.The relationship of the arterial architecture to the structure and thefunctions of the tongue and its clinical significance were discussed.
文摘Thirty feet of Chinese adult cadavers were dissected under an operativemicroscope to observe the extensor hallucis brevis and extensor digitorum brevisand their vessels and nerves in order to design myocutaneous flaps.It was be-lieved that the lateral tarsal artery and the lateral branch of the deep peronealnerve are the best choice to be included in the pedicle when muscle flaps ormyocutaneous flaps are to be obtained from the dorsum of foot.The size of themuscles may be enlarged both laterally and medially as the clinicalcondition requires.
基金Supported by the National Natural Science Fund Aided Project (60473128)
文摘To provide practical and surgical anatomy for the imaging diagnosis and surgical treatment of the disease of the caudate lobe of the liver. Methods： Based on Chinese Visible Human 1-5 data sets and assisted by 3D visualization and reconstruction, the 3D models of the upper abdomen or the liver were reconstructed and the cross-sectional images were converted to the coronal and sagittal images. The anatomy of the caudate lobe of the liver on the coronal and sagittal planes was investigated on serial planes of the upper abdomen. Results： The caudate lobe was bordered on the left by the fissura ligamenti venosi, posteriorly by the IVC, superiorly by the hepatic veins and inferiorly by the hepatic hilum. Its right and ventral borders might be obscure, with only relative borders existent. The right wall of the IVC was a good landmark to judge the relative realm of paracaval portion, and the relative ventral plane might exist between the hepatic hilum and entrance of hepatic veins. The caudate lobe could be divided into two principal regions： the left Spiegel lobe and the right paracaval portion. The caudate process, and the right rear process occurring in some individuals belonged to the right paracaval portion. The caudate lobe was blood supplied by the portal vein, which directly drained into the IVC. Conclusion： There are not definite borders for the right part of the caudate lobe, and most of the knowledge on it is based on the cast study, which may not suit for the clinical diagnosis and practice. The coronal and sagittal sections can better show the anatomic relationships between the caudate lobe, the other parts of the liver and the adjacent structures. The 3D digital visualization is an accurate and convenient study method for clinical anatomy.
文摘Anatomy, a foremost basic medical science (BMS) has evolved in content and context, while remaining the most fundamental BMS subject. Stakeholders have continually made efforts especially in recent time to achieve an evolution of this subject. The primary aim of this work was to study the perceptions and experiences of Anatomists towards contributing to programme and career advancements. Following ethical approval, structured questionnaire was administered to Nigerian anatomists using a Google form. It is a total population study. The questionnaire had 13 sections, with each section addressing a theme that was integral to the subject of research interest. The last section collected free responses as qualitative information. After indicating informed consent, 106 anatomists properly completed and returned the questionnaires. Statistical and quantitative analyses of results were done. The most popular field amongst respondents was Neuroscience (60.9%);followed by Histology or Microscopic Anatomy (53.6%), Embryology or developmental anatomy (35.5%), Gross anatomy (34.5%) and Histochemistry (30.9%). About half of Nigerian anatomists involved in the study had a PhD degree. Training emphasized the cognitive domains the most. Consequently, emphasis should be laid on the psychomotor (skills) and the affective domain (attitude) to improve capacity, competences, and the job prospects of trainees. The consensus was that the programme trained students and prepared graduates as medical educators, scientists, and researchers. Anatomy has significant potential to contribute to development with proper programme design, emphasis on research, teaching and applied services competencies, effective policy formulation and implementation and adherence to best practices.
基金Supported by Beijing Municipal Science and Technology Commission,No. Z201100005520055Education Research Project of Peking University School and Hospital of Stomatology,No. 2013-ZD-03。
文摘BACKGROUND Loss of motor function in the trapezius muscle is one complication of radical neck dissection after cutting the accessory nerve(AN) during surgery.Nerve repair is an effective method to restore trapezius muscle function,and includes neurolysis,direct suture,and nerve grafting.The suprascapular nerve(SCN) and AN are next to each other in position.The function of the AN and SCN in shoulder elevation and abduction movement is synergistic.SCN might be considered by surgeons for AN reanimation.AIM To obtain anatomical and clinical data for partial suprascapular nerve-to-AN transfer.METHODS Ten sides of cadavers perfused with formalin were obtained from the Department of Human Anatomy,Histology and Embryology,Peking University Health Science Center.The SCN(n = 10) and AN(n = 10) were carefully dissected in the posterior triangle of the neck,and the trapezius muscle was dissected to fully display the accessory nerve.The length of the SCN from the origin of the brachial plexus(a point) to the scapular notch(b point) and the distance of the SCN from the origin point(a point) to the point(c point) where the AN entered the border of the trapezius muscle were measured.The length and branches of the AN in the trapezius muscle were measured.A female patient aged 55 years underwent surgery for partial SCN to AN transfer at Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology.The patient suffered from recurrent upper gingival cancer.Radical neck dissection was performed on the right side,and the right AN was removed at the intersection between the nerve and the posterior border of the SCM muscle.One-third of the diameter of the SCN was cut off,and combined epineurial and perineurial sutures were applied between the distal end of the cut-off fascicles of the SCN and the proximal end of the AN without tension.Both subjective and objective evaluations were performed before,three months after,and nine months after surgery.For the subjective evaluation,the questionnaire included the Neck Dissection Impairment Index(NDII) and the Constant Shoulder Scale.Electromyography was used for the objective examination.Data were analyzed using t tests with SPSS 19.0 software to determine the relationship between the length of the SCN and the linear distance.A P value of < 0.05 was considered as statistically significant.RESULTS The whole length of the AN in the trapezius muscle was 16.89 cm.The average numbers of branches distributed in the descending,horizontal and ascending portions were 3.8,2.6 and 2.2,respectively.The diameter of the AN was 1.94 mm at the anterior border of the trapezius.The length of the suprascapular nerve from the origin of the brachial plexus to the scapular notch was longer than the distance of the suprascapular nerve from the origin point to the point where the accessory nerve entered the upper edge of the trapezius muscle.The amplitude of trapezius muscle electromyography indicated that both the horizontal and ascending portions of the trapezius muscle on the right side had better function than the left side nine months after surgery.The results showed that the right-sided supraspinatus and infraspinatus muscles did not lose more function than the left side.CONCLUSION Based on anatomical data and clinical application,partial suprascapular nerve-to-AN transfer could be achieved and may improve innervation of the affected trapezius muscle after radical neck dissection.
文摘Through long-term observations and repeated practices of human body structure,anatomical knowledge in ancient China has gradually developed from the sprouting period when ancient Chinese hunted animals for survival,to anatomical exploration,which breaks the shackles of fear and religious rites.For example,Hua Tuo(华佗),a famous doctor in the period of The Three Kingdoms,did exquisite abdominal surgery;Yan Luozi(烟萝子),a Taoist priest in the period of The Five Dynasties,drew a map of human anatomy;Wang Weiyi(王唯一),a medical official in Northern Song dynasty,was responsible for casting acupuncture bronze figures,an anatomical mold for practicing acupuncture;Song Ci(宋慈),a forensic expert in Southern Song Dynasty,wrote Xi Yuan Ji Lu(《洗冤集录》Collected Cases of Injustice Rectified);Wang Qingren(王清任),a physician in Qing Dynasty wrote Yi Lin Gai Cuo(《医林改错》Correction on Errors in Medical Works).Ancient Chinese anatomy is far ahead of Western anatomy in understanding and describing human body structures.It has made great contributions to the emergence of Huang Di Nei Jing(《黄帝内经》Huangdi's Internal Classic)and laid a solid foundation for the establishment of visceral manifestation theory and meridian and collateral theory.Even now,it has served the basic theory of traditional Chinese medicine and clinical practices.Anatomical knowledges,such as relevant operation records,books,Atlas,models in ancient China,especially the names of Zangorgan and Fu-organ,bones and five sense organs,are still used in modern anatomy and modern medicine,making indelible contributions to the development of modern anatomy in China.
