肠系膜下动脉解剖分析

目的:分析结、直肠手术对肠系膜动脉的影响及肠系膜下动脉的分布情况,为进一步的临床研究奠定基础。方法:随机选取我院2011年12月—2013年12月手术治疗的92例乙状结肠癌和直肠癌患者作为研究对象,解剖其肠系膜下动脉主动脉及其分支,并对解剖具体情况进行分析,详细测量与记录肠系膜下动脉及分支的长度和吻合情况。结果:92例研究对象的腹主动脉发出肠系膜下动脉主动脉,其中46例由左结肠动脉单独发出,8例左结肠动脉缺失,28例与乙状结肠动脉共干;动脉平均长度为7.4cm,第一分支肠至系膜下动脉根部的长度为4.3cm。左结肠动脉干长为3.6cm。第一分支长为度4.7cm。第一、二分支间距离为2.5cm;经统计学分析,其长度较正常者差异显著(P0.05)。结论:正常人的肠系膜下动脉分支较患直肠癌和乙状结肠癌患者的差异显著,转移淋巴结残留和吻合口血循环张力等并发症在手术治疗过程中出现的几率很大。仔细分析结、直肠手术对肠系膜动脉的影响及肠系膜下动脉的分布情况,采取相应有效的措施,能够有效降低并发症的发生,改善患者预后。     

元谋古猿下颌臼齿三维立体特征

采用欧氏距离矩阵分析（EDMA）方法对72枚元谋古猿及作为对比样本的10枚禄丰古猿、现生大猿类和人类下颌臼齿齿冠13个测量标志点三维测量数据的统计分析显示：元谋古猿在下颌臼齿齿冠三维形态测量特征上与禄丰古猿最为接近。与现生大猿类及人类相比,元谋古猿和禄丰古猿均与人类之间呈现出非常显著的差异,而与猿类较为接近。它们两者及生大猿类均与人类之间具有许多共同的差异表现特点。元谋古猿在下颌臼齿三维测量特征方面与三种现生大猿类各自之间的差别表现相似。其中,元谋古猿与猩猩之间的牙齿形态特征上似乎更为接近。但目前对这些特征相似差异的含义尚难以确定。     

胎儿胃底后壁、贲门及食管腹段后壁的动脉解剖

目的:研究胎儿胃底后壁、贵门及食管腹段后壁的血液供应.方法:取30例胎儿尸体(6-10月),5%红色过氯乙烯填充胎儿胃的动脉血管,解剖观察胃底后壁、贲门及食管腹段的动脉血管的来源,测量动脉支数,血管长度,口径,分布.结果:胎儿胃底后壁、贲门及食管腹段后壁的血液由胃上动脉供给.胎儿胃上动脉起于左膈下动脉和胃左动脉,出现率为49.26%,1-3支不等,平均长(5.86±0.21)mm,起始点平均外径(0.32±0.08)mm.结论:胎儿胃底后壁、贲门及食管腹段后壁有1-3支动脉血管供应,即胃上动脉分支:食管支,胃底支,贲门支.动脉分布的研究为全胃切除和残胃血供提供形态学依据.     

腊玛古猿是人类的祖先吗?

凡是参观过博物馆的人类起源和进化的展览、或读过与此有关的科普书的人们,都会见过类似图1那样的人、猿进化系统图。从这个图上我们可以看出,腊玛古猿和西瓦古猿是两个完全不同的类型,前者代表人科的最早成员,是人类的直接祖先;后者属于猿科,是现代大猿类(黑猩猩,大猩猩和猩猩)的共     

肝脏移植术前受体64 排CT 血管成像临床应用价值

目的:探讨肝脏移植术前受体64排螺旋CT血管成像(computed tomography angiography CTA)在临床的应用价值。方法:对28例晚期肝病患者进行64排增强后动脉期、门脉期及静脉期扫描,使用多种重建方法,由两名以上有经验的医师对肝脏血管进行分析评价,并与18例移植术后结果比较,探讨64排CT血管成像对肝移植术前准备的意义。结果:发现肝动脉变异6例,腹腔干起始部狭窄2例,腹腔干动脉瘤1例,脾动脉瘤2例,肝脏主要供血动脉直径<3mm 3例,肝门静脉海绵样变3例,肝外门静脉主干栓塞5例,伴有肝内门静脉栓塞3例,肝外门静脉主干栓塞伴肠系膜上静脉广泛栓塞2例,下腔静脉癌栓3例,其中癌栓达右心房2例。结论:64排CT血管成像无创、可靠,通过多种重建方法,能清晰显示肝脏血管,对肝脏移植术前血管做出评价,具有可靠的临床指导意义。     

劳动创造人(1)

人是由古猿转变来的,和现代猿有着共同的祖先。大约两千万年前,自然环境发生了变化,古猿由于身体结构和生活习性上的差异而进一步分化,其中一支通过长期劳动萌发了自觉能动性,发展为人类。近百年来世界各地发现的大量人类骨骼化石和石器,充分证明了马克思主义关于“劳动创造了人本身”这一科学论断的完全正确。现已发现的和人类进化有关的化石大致有:人类的早期祖先——拉玛猿类,大约1500-1000万年前生活在亚、非两洲;南方古猿类,能直立行走,某些类型已能制造工具,生活在一、二百万年前,主要发现于非洲与亚洲;直立人(或称猿人),已能用火,生活在约100-20万年前,发现于亚、非、欧;约20-5万年前广泛分布于旧大陆的古人以及大约在五万年前出现的新人(现代人)。     

牦牛眼的动脉分布

运用大体解剖学的方法研究了青藏高原牦牛(Bos grlznniens)眼的动脉供应。为了显示从颈总动脉到眼的血液供应情况,在6个牦牛的颈总动脉内灌注乙醚．红色油画颜料(15：1)。结果表明,眼的动脉供应主要来源于眼内动脉、眼外动脉、颞浅动脉和颧动脉。眼内动脉在眼眶内与眼外动脉相吻合,其为睫状长动脉的主要来源;眼外动脉产生的分支供应眼背侧斜肌、泪腺区、上下眼睑和眼外侧角,并且参与了前硬膜外异网和眼异网的形成;眼异网发出许多分支供应眼直肌、眼背侧斜肌、眼球缩肌、上眼睑提肌和脉络膜;颞浅动脉发出分支供应眼外侧角、上下眼睑、泪腺区,而且和眼异网发出的泪腺动脉相互吻合;颧动脉起自眶下动脉,其分支供应上下和第三眼睑、眼腹侧直肌及内侧眼角。在6个标本中,眼的动脉分布左右基本相同。     

对比分析多种介入途径治疗门静脉系统血栓的临床疗效

目的:对比分析多种介入途径治疗门静脉系统血栓的临床疗效。方法:收集从2001年1月至2009年3月经我科治疗的37例门静脉系统(包括门静脉、肠系膜上、下静脉及脾静脉)血栓形成患者,根据介入治疗途径的不同分为三组:A组(13例)行经TIPS途径门静脉行碎栓溶栓及置管溶栓术;B组(19例)行直接经皮穿肝门静脉碎栓和或置管溶栓术;C组(5例)行经肠系膜上动脉置管溶栓治疗。所有的患者术后定期随访1-12个月,复查CT或彩超了解门静脉系统的血流变化及临床症状恢复情况。结果:A组:经治疗出院时11例(85%)患者门静脉完全再通,;1例(8%)门静脉血流部分再通,1例(8%)术后第二天因出血死亡。术后随访1、3、6、12月门静脉通畅率分别为:85%,77%,77%,62%;所有患者的临床症状均明显缓解。B组:经治疗出院时7例(37%)门静脉完全再通,9例(47%)部分再通,3例(16%)因出血中止溶栓;随访1、3、6月、12月门静脉通畅率分别为:32%,26%,16%,16%。C组:经治疗出院时5例(100%)患者门静脉均未再通,通畅率为0%,术后随访1-3个月内4例患者临床症状得到部分缓解。结论:经TIPS途径治疗后门静脉的再通率及临床症状改善均好于直接经皮穿肝及经肠系膜上动脉途径。经肠系膜上动脉置管溶栓法无法使已有侧支形成的门静脉主干复通,仅能一定程度缓解患者的临床症状。     

家犬下腹部及盆 淋巴系统解剖

用１０％普鲁士蓝氯仿溶液,对１６只家犬的腹,盆部器官做淋巴管间接注射。结果表明：在肠系膜上动脉的左右侧,有两个最大的淋巴结,分别为左、右肠系膜淋巴结。左肠系膜淋巴结接受空肠、大部回肠的淋巴管和胰十二指肠淋巴结及结肠淋巴结的输出管。右肠系膜淋巴结接受回肠末段的淋巴管。两肠系膜淋巴结的输出管与肝总淋巴结、胰脾淋巴结的输出管汇合,组成肠干,注入乳糜池的右侧。盆部髂内淋巴结最大,接受来自乙状结肠淋巴结和盆     

家犬下腹部及盆部淋巴系统解剖

用１０％普鲁士蓝氯仿溶液，对１６只家犬的腹、盆部器官做淋巴管间接注射。结果表明：在肠系膜上动脉的左右侧，有两个最大的淋巴结，分别为左、右肠系膜淋巴结。左肠系膜淋巴结接受空肠、大部回肠的淋巴管和胰十二指肠淋巴结及结肠淋巴结的输出管。右肠系膜淋巴结接受回肠末段的淋巴管。两肠系膜淋巴结的输出管与肝总淋巴结、胰脾淋巴结的输出管汇合，组成肠干，注入乳糜池的右侧。盆部髂内淋巴结最大，接受来自乙状结肠淋巴结和盆部器官淋巴结的输出管。两侧骼内淋巴结的输出管分别组成左、右腰干，向头侧走行，注入乳糜池的尾端。     

Various forms of the celiac trunk and its anastomoses with the superior mesenteric artery]

Three rare varieties of upper abdominal arteries were compared with similar cases in the anatomical literature. An attempt was made to obtain a classification of the supernumerary branches of the celiac trunk and of the anastomoses between the celiac trunk and the superior mesenteric artery. One or more supernumerary branches of the celiac artery can be observed: (1) the superior mesenteric artery; (2) an accessory hepatic artery; (3) a posterior pancreatic artery; (4) a colic artery; (5) an accessory splenic artery; (6) a connecting branch to the superior mesenteric artery, and (7) an inferior phrenic artery. The following types of anastomoses between the celiac artery and the superior mesenteric artery can be distinguished: (1) direct connection; (2) anastomoses within the hepatic artery; (3) anatomoses following pre- or postnatal stenosis, and (4) the pancreatic arcades. For the first type the theory of TANDLER (longitudinal anastomosis) is abandoned. The development of the second type is as yet unresolved. In the case of the last two types a postembryonal formation is possible.     

Accessory arteries supplying the human transverse colon

An accessory colic artery which arose from the superior mesenteric artery more proximally than the first jejunal artery and met the marginal artery at the splenic flexure was observed in 32 of 65 subjects (49.2%). Considering its constant morphological features, this accessory colic artery was given the new nomenclature 'superior left colic artery (arteria colica sinistra superior; CSS)'. The unusual middle colic artery arising from the celiac trunk was supposed to be caused by the anastomosis between the dorsal pancreatic artery from the CSS and that from the celiac trunk. An additional epiploic branch derived from the pancreatic branch (posterior epiploic branch) also sent an accessory colic artery in 2 subjects. But judging from its origin and area of distribution which overlaps with that of the middle colic artery, this accessory colic artery is not equivalent to CSS.     

Features of the development of the arteries of the human liver and their practical significance

By means of roentgenography and preparation methods 145 specimens of the hepatic arteries filled with roentgenopaque latex have been studied. An essential individual changeability is peculiar for the celiac trunk structure and for formation of the hepatic arteries. A "typical" structure of the celiac trunk is observed in 66%. In other cases either "noncompleteness" of the celiac trunk, or increasing number of the branches up to 4-6 are observed. As a rule, the common hepatic artery gets of the celiac trunk (93%), but sometimes it can take its origin from the aorta, the superior mesenteric artery and some other sources (7%). The hepatic artery proper only in 73% divides into the right and left branches, in other observations the latter have their independent formation. It is necessary to distinguish the independent separation of the right and left lobar hepatic arteries from some sources and presence of additional arteries. The additional arteries are the branches that are formed from any arteries when there is present the hepatic artery proper, or substituting it independent right and left branches. The additional arteries appear from the left gastric, superior mesenteric, gastro-duodenal arteries, from the aorta, the right renal artery and other sources. The peculiarities of formation of the hepatic arteries discussed can be used in clinical practice and can make the terminology more precise.     

Arterial vascularization of the gastrointestinal tract in Macaca fascicularis (cynomologus monkey)

Abstract: We describe the origin, course, and distribution of the arteries responsible for vascularization of the subdiaphragmatic gastrointestinal tract of Macaca fascicularis as well as the characteristics of the celiac trunk and the superior and inferior mesenteric arteries, studied in a series of 50 animals. Detailed knowledge of these systems is an essential requirement if experimental surgery is to be successfully performed in these laboratory animals.     

Topographical mapping of sites of enhanced HRP permeability in the normal rabbit aorta.

The spatial distribution of sites of enhanced permeability to the macromolecule horseradish peroxidase (HRP) in the normal rabbit aorta after one min circulation was studied using image analysis. These sites, referred to as "HRP spots," exhibit a nonuniform distribution that is qualitatively similar in all rabbits studied. The density of HRP spots is highest in the aortic arch, decreases distally, reaches a minimum in the lower descending thoracic aorta, and then increases again in the abdominal aorta. The region of highest spot density follows a clockwise helical pattern in the aortic arch and outside the arch occurs in streaks largely oriented in the bulk flow direction. The streaks in the abdominal aorta localize along the anatomical right lateral wall and occasionally along the left lateral wall proximal to the celiac artery and along the ventral wall between the celiac and superior mesenteric arteries. The density of spots is high in the immediate vicinity of aortic ostia with the most elevated density being distal to ostia in most cases. At a short distance from the ostium edge of the celiac and superior mesenteric branches the proximal density is comparably high, and no preferred spot orientation is observed around the brachiocephalic vessel. These results are consistent with an influence of localizing factors such as detailed hemodynamic phenomena and/or arterial wall structural and/or functional variations.     

Anatomical variations of the arterial pattern in the right hemiliver

The arterial supply to the right hemiliver was studied in 80 liver casts. The arteries were divided into 10 groups according to their origin and branching pattern. The right hemiliver was supplied by one artery in 96% of cases and by two arteries in 4%. When there was only one artery it originated from the proper hepatic artery in 73/77 cases and from the superior mesenteric artery in 4/77 cases. The replacing right hepatic artery which originated from the superior mesenteric vessel supplied the whole right hemiliver in 5% of cases. The incomplete replacing right hepatic artery which supplied only a part of the right hemiliver was found in 4% of cases. The anterior section (segments 5 and 8) was supplied by one artery in 61%, by two arteries in 30% and by three arteries in 9% of cases. The posterior section (segments 6 and 7) was supplied by one artery in 66%, by two arteries in 31% and by three arteries in 3% of cases. Segments 5 and 7 were predominantly supplied by one artery, whereas segments 6 and 8 by two arteries.     

Systematisation of the arteries in the splenic hilus

156 abdominal preparations were explored by arteriography, corrosion and dissection. Within the meanders of the splenic artery a basic pattern can be traced. The division of the artery can easily be summarized by introducing the term of a truncus lienogastroepiploicus. The short gastric arteries are always present, and usually they are longer and more important than may appear from their name. In nearly half of the preparations (52%) an artery for the extremitas lienalis posterior is found; an artery for the extremitas lienalis anterior is very exceptional. A posterior gastric artery can be identified (36%) but it must be distinguished from several other vessels. The arteria colli pancreatis (for the neck of the pancreas) is a constant vessel that may have a superior (usually arteria lienalis) or an inferior origin (arteria mesenterica superior). It commonly supplies the transverse pancreatic artery and often the prepancreatic arcade. The arteria corporis pancreatis, too, is a constant artery. The pancreatic tail is thoroughly irrigated by usually more than one arteria caudae pancreatis. An important part of the greater curvature is not accompanied by the left gastroepiploic artery, but is supplied by the arteriae gastricae breves.     

Organization of cells and extracelluar matrix in mesenteric arteries of spontaneously hypertensive rats

Summary Biochemical studies have been used to assess the quantitative changes in elastin and collagen in hypertensive vs. normotensive arteries. However, the relative distribution and organization of these fibrous proteins is likely to be equal in importance to their absolute amounts. In this study we have used scanning electron microscopy in association with selective digestion techniques to assess the organization of cellular and extracellular components of the tunica media of mesenteric arteries of spontaneously hypertensive rats. Superior and small mesenteric arteries were digested with acid, alkali, or bleach to exposure cells, collagen, or collagen and elastin, respectively. We observed that hypertension does not cause a qualitative change in the 3-dimensional arrangement of cells, collagen, or elastin in spontaneously hypertensive arteries when compared to normotensive arteries. However, cells in the superior artery are significantly different in overall shape and surface features when compared to cells of small arteries. These differences in surface morphology of cells are present in hypertensive and normotensive vessels and suggest that superior and small mesenteric artery cells transmit load to the isotropic matrix in different ways. In the elasto-muscular superior artery, force is transmitted across digitations throughout the cell surface. In the muscular small artery, force is transmitted across the tapered, smooth cell surface.     

Stability of methylnicotinate in aqueous solution as utilized in the 'niacin patch test'

Background

Animal models and observations in human neonates suggest fetal exocrine pancreas vulnerability to reduced maternofetal blood flow. We investigated the relationship between superior mesenteric artery blood flow velocity (sma bfv) and exocrine pancreatic function, in a cohort of very low birth weight (VLBW) babies. Group 1: 9 babies < 3rd percentile for birth weight. Antenatally, all had absent or reversed diastolic flow on Doppler ultrasound of the umbilical artery (UA). Group2: 18 babies > 10th percentile for birth weight.

Findings

All had Doppler ultrasound scan of the superior mesenteric artery (sma), by same operator (RMN), on day 1 of life before commencement of enteral feeding. Stool samples assayed for faecal chymotrypsin and weekly serum samples assayed for amylase and lipase (kinetic colorimetric assay) from days 1 to 14 of life. Growth restricted babies had significantly lower sma bfv values compared with appropriately grown preterm babies. Faecal chymotrypsin levels were also lower but this difference did not achieve statistical significance. Both groups had serum lipase levels detectable in adult concentrations. Serum amylase was undetectable in either group.

Conclusion

Babies with previous in-utero blood flow redistribution may exhibit altered gut ontogeny with re-setting of mesenteric blood flow velocities and altered exocrine pancreatic function.