Clinical significance of neurovascular contact of rostral ventrolateral medulla oblongata evaluated by using MRI in hypertension and normotensive subjects / 中华放射学杂志

Objective To evaluate the clinical usefulness of MR imaging(MRI) and MR tomography angiography(MRTA) in demonstrating the presence and degree of neurovascular contact of the rostral ventrolateral medulla oblongata(RVLM) in root entry zone of the 9th and 10th cranial nerves in patients with essential hypertension(EHT) and normotensive health volunteers(NTHV).Methods(Patients with) EHT(group 1,n=100) and NTHV(group 2,n=88) underwent high-resolution(axial and coronal) brain stem MRI and MRTA.Images were interpreted consensually by tow radiologists who were blinded to the patients hypertensive status.Neurovascular contact was graded as vessel contact without RVLM deformity(gradeⅠ),clear vessel contact in continuity with the brain stem but without apparent associated deformity(graded Ⅱ), and displacement contact of the RVLM(graded Ⅲ).Results(Neurovascular) contact of RVLM was found in 52.0%(52/100) of EHT and in 43.2%(38/88) of NTHV(?~2=1.459,P=0.230).The compression rate(gradeⅠ—Ⅲ) and affected side(left or right) showed no statistically significant differences between the EHT and NTHV(?~2=0.879,P=0.350;?~2=0.238,(P=0.628);?~2=0.733,P=0.390).Conclusion Neurovascular contact is not more frequently seen in patients with EHT than in normotensive contact subject.This result does no support the hypothesis that neurovascular contact at the RVLM is an etiology of EHT.Furthermore,thin-slice(3 mm) MRI may not be a reliable good screening method for detecting patients with neurovascular contact.Therefore,MRI cannot aid patient selection among hypertension patients lacking symptomatic cranial neuralgias.

Applied anatomy of the great/second toe web flap for reconstruction the defect in commissure of lips of mouth / 中华显微外科杂志

Objective To provide an ideal tissular flap for the soft tissue defects of the oral commissure. Methods The observation and measurement of the source of blood supply and nerve innervation to the great/second toe web was carried out on 40 sides of adult specimens lower limbs perfused with red latex in artery. Results The first dorsal metatarsal artery which originated from the dorsal pedal artery was the chief artery to this region. Its external diameter at the beginning was (l. 6 ? 0. 3) mm and was (4. 6?0. 6) cm in length. Sensory nerve of the flap is deep peroneal nerve Conclusion The great/second toe web flap was an ideal tissue defects of the oral commissure.