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<p><b>OBJECTIVES</b>To investigate the feasibility of establishing an individualized navigation template for occipital condyle screws insertion using a fused deposition modeling based three-dimensional printing forming technique, and to evaluate the accuracy and safety of template-assisted condyle screw insertion.</p><p><b>METHODS</b>Thirty adult occipitocervical specimens were selected to take a CT-scan. After original Dicom data imported into the Mimics software, the craniocervical junction models were created, which were used to evaluate anatomic structures and define the screw-related parameters. Design and generate the cavity models of the occipital condyle based on a three-dimensional printing forming technique. After using a free-hand procedure to create a navigation template with a well-established screw path, finish bilateral condyle screws insertion assisted by the navigation template. Anatomy study and CT-scan were taken postoperatively to access the position of the screws.</p><p><b>RESULTS</b>Sixty condyle screws were implanted assisted by 30 individualized navigation templates with an average time cost of (91.4 ± 8.2) s. The axial medial angle, sagittal cranial angle and distance between the entry point to atlantooccipital joint surface were (33.2 ± 6.4)°, (8.9 ± 3.4)°, (3.9 ± 0.9) mm, respectively. The variations due to different sex and sides resulted in a statistically insignificant difference of the parameters. Anatomy study and CT-scan indicated no intrusion of the vertebral artery, hypoglossal canal, condyle emissary vein canal or atlantooccipital joint. Fifty-nine condyle screws were completely contained within the condyle, while only 1 screw perforated lateral condyle wall.</p><p><b>CONCLUSIONS</b>Using the Mimics software for establishing the occipital condyle and related cavity model based on CT-scan images proves to be a feasible and precise method.Occipital condyle screws insertion assisted by a three-dimensional printing model is highly accurate and simple, which could be a new alternative to conventional technique.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Bone Screws , Cadaver , Occipital Bone , General Surgery , Printing, Three-Dimensional , Surgery, Computer-AssistedABSTRACT
Objective To explore the anatomy for transethmoidal-sphenoid optic nerve decompression under endoscopy and its significance in operation. Methods Fifteen cases (30 sides) of formalin-fixed adult optic canal specimens were dissected under the microscope. The anatomic characteristics of the optic canal and its adjacent were observed, and the relative parameters were evaluated according to nasal endoscopic approach. Results ①The relationship between the optic carotid triangle(OCT)with the optic canal, the ophthalmic artery, the cavernous sinus and the internal carotid artery were invariable, its present ratio were in 66.7%. ②The mean distance from the front margin of nasal columella floor to medial wall of the orbital opening, middle portion and the cranial opening in the optic canal were (72.79 ± 5.40)mm, (75.85 ± 5.10)mm and (79.34 ± 4.95)mm, respectively, and the elevation angles were (39.45 ± 3.68)°, (37.30±4.24)°and (35.45 ± 4.16)°, respectively. ③The mean thickness of sheath in the medial wall of the orbital opening,middle portion and the cranial opening were (0.70 ± 0. 18)mm, (0.51 ± 0.15)mm and (0.49-0.22)mm,respectively. The difference in thickness between the orbital opening and middle portion, the cranial opening were very remarkable(P ＜ 0.01 ). ④The lateral deviate distance from medial wall of the orbital opening, middle portion and cranial opening to sagittal median plane of cadaveric were 1/2 (12.69 ± 2.73)mm、1/2( 19.61± 3.47)mm and 1/2 (25.79 ± 3.23)mm, respectively. Conclusion OCT is the most reliable anatomic landmark to locate the optic canal, and the key point is at the orbital opening of the optic nerve in the optic nerve decompression. It is secure and feasible to cut the sheath from the place where the medial wall crosses the superior wall of the optic nerve.
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OBJECTIVE: To review the current research of tissue engineered venous valve at home and abroad, to analyze the developing trend of tissue engineered venous valve in the clinical application.METHODS: A computer retrieve was performed among PubMed, ProQuest Health & Medical Complete database, Springer English Academic Journal Full-text database, Elsevier Full-text database between January 2000 and August 2009, with the key words of "tissue engineering venous valve", and the language was limited to English. At the same time, Chongqing VIP database, Qinghua Academic Journals Database, Chinese Biomedical Literature database were also screened on computer by using the
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Based on the morphology and function of lymphatic vessel, and on the achievements of researches in the regulatory mechanism of lymphatic circulation, we fully considered the dynamic interaction of blood, interstitial fluid and lymph fluid; then we imitated and used Sungawa's method of analyzing the heart output, and finally set up a dynamic model for describing lymphatic circulation. Comparison of our calculating results with the data from Ikomi's experiment showed that they were identical, thus indicating that our model is of value in explaining the dynamic mechanism of lymphatic circulation. In this paper is especially calculated the relationship between lymph flow and massage frequency, which is useful for analyzing the effect of massage on the lymph flow rate with respect to this model.
Subject(s)
Animals , Humans , Rabbits , Computer Simulation , Endothelium, Lymphatic , Cell Biology , Physiology , Lymph , Physiology , Lymphatic Vessels , Physiology , Models, Biological , Nonlinear Dynamics , Pressure , RheologyABSTRACT
BACKGROUND: It has been widely accepted that both bone marrow-derived mesenchymal stem cells (MSCs) and hematopoietic stem cells (HSCs) have the capacity to differentiate into neural lineages. Some scholars believe that in addition to HSCs and MSCs, bone marrow (BM) also harbors a highly mobile population of CXCR4+ tissue committed stem cells (TCSCs), including skeletal muscles, heart, liver, and neural tissue. OBJECTIVE: To make sure that neural tissue-committed stem cells (NTCSCs) reside in the bone marrow, and to establish a purification and culture method for bone marrow-derived NTCSCs.DESIGN: Opening animal study.SETTING: Department of Anatomy, the Second Military Medical University of Chinese PLA. MATERIALS: Adult Sprague-Dawley (SD) rats (pathogen-free) were provided by the Animal Center of the Second Military Medical University of Chinese PLA. Dulbecco's modified eagle's medium (DMEM)/F12, B27, N2 and epidermal growth factor (EGF, Invitrogen Company), basic fibroblast growth factor (bFGF, CytoLab Ltd), rabbit anti-rat Nestin,CXCR4, β-Tublin Ⅲ, glial fibrillary acidic protein (GFAP, Santa Cruz Company), mouse anti-rat microtubule associated protein 2ab (MAP2ab) (Clone11-5B), cyclic nucleotide 3'phosphohydrolase (CNPase, Clone AP20, NeoMarkers Company), fluorescent(fluorescein isothiocyanate, Cy3) marker reagents (Wuhan Boster Bioengineering Co., Ltd), nuclear fluorescent dyes 4,6-diamidino-2-phenylindole(DAPI)(Sigma), immunohistochemistry reagents (Vector Laboratories Company) , and NycoPrepTM separation liquid (1.077A, Axis-Shield Company) were used in this study.METHODS: This study was performed in the Department of Anatomy, the Second Military Medical University of Chinese PLA from January 2004 to December 2006. Bone marrow was harvested from bilateral femurs and tibias of 2-3 weeks SD rats. Mononuclear cell layer was isolated by NycoPrepTM separation liquid and suspended in DMEM/F12(1:1)serum-free medium supplemented with 2% B27,1% N2, 20 μg/L bFGF, 20μg/L EGF, 1×105 U/L penicillin and 100 mg/L streptomycin. NTCSCs were isolated and propagated by suspensive growing from adherent cells in bone marrow in DMEM/F12 free-serum medium. MAIN OUTCOME MEASURES: NTCSCs were identified by immunocytochemistry for CXCR4, a marker of TCSCs and nestin, a marker of neural stem cells, and neural lineages marker protein after differentiation of cellular spheres. RESULTS: The NTCSCs spheres expressed nestin, a neural stem cell marker as well as CXCR4, a marker of TCSCs. The NTCSCs' spheres were naturally differentiated in DMEM medium with 15% fetal bovine serum. The differentiated cells expressed β-Tublin Ⅲ, MAP2ab, CNPase and GFAP, markers of neural lineages. CONCLUSION: NTCSCs reside in bone marrow and naturally differentiate into neural lineages in vitro.
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BACKGROUND: Independent urination and defection functions do not exist in patients with paraplegia above T12 because the injury disrupts the connection to the brain.OBJECTIVE: To reconstruct urination and defecation functions in patients with paraplegia with vascularized intercostal nerve transfer to sacral nerve roots with selected interfascicular anastomosis.DESIGN: Self-control observation.SETFING: Department of Orthopedics, Changhai Hospital of the Second Military Medical University of Chinese PLA.PARTICIPANTS: We recruited 30 patients with traumatic paraplegia at T9-L2 who received treatment in the Department of Orthopedics,Changhai Hospital of the Second Military Medical University of Chinese PLA, from January 1990 to December 2000. Paraplegia plane at T9-T11was found in 17 cases and paraplegia plane at T12-L2 in 13 cases. All the cases had undergone vertebral lamina decompression and internal fixation, 24 of whom had an additional operation to remove the internal fixation.METHODS: Two normal vascularized intercoastal nerves and artery and vein (intercostals nerves were generally at ribs 7 and 8 or 9 and10)above the spinal cord injury site were harvested by cutting in at their distal ends at the midclavicular line and separating the proximal ends from the levatores costarum. The nerves were then transferred to the vertebral canal through a submuscular tunnel. A sural nerve segment that had been harvested and sheared into two segments was sutured to the intercostal nerves by epiperineurial neurorrhaphy and then to the S2-4nerve roots by interfascicular neurorrhaphy. For patients with spinal injury plane below T11, intercostal nerve or subcostal nerve among the 10th and 11th ribs were harvested from the incision of abnormal wall. The nerves were transferred to the lumbar part through the channel of lateral abdominal wall. The transplanted sural nerve was conrected to S2-4 nerve root of partial nerve tract cut alternatively and exposed from S1,2 plane posterior. Defecation function of the patients was evaluated at postoperative 1, 3, 6, 12 and 24 months and follow-up; urodynamic examination was performed before and after operation.patients.RESULTS: A total of 30 patients were followed up for 5 years on average,tion and defecation functions of the patients: 26 (86.6%) had recovered defecation and urination sensation, 23 (76.7%)regained the micturition reflex and uriesthesis; 19 (63%) had recovered function of the detrusor The postoperative maximum urine flow ratio, surplus urine volume, and the maximum systolic pressure of detrusor muscle were obviously improved as compared with those before operation [(12.0±3.0) vs (2.0±0.3) mL/s,(80±12) vs (150±30) mL, (11.76±3.43) vs (5.88±1.47) kPa, P ＜ 0.05]. Postoperative low compliance was found in 9 cases, and detrusor areflexia in 7cases. The number was both significantly decreased as compared with that of preoperative cases (26 and 27 respectively).CONCLUSION: Transfer of vascularized intercostal nerve to S2-4 nerve roots with selected interfascicular anastomosis can reconstruct partial urination and defecation functions, and sensation in buttock, perineal region and cunnus region in paraplegia.
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BACKGROUND: It is proved that acupuncture can remarkably promote recovery of nervous function after spinal cord injury (SCI). Previous studies in our groups have been proved that electro-acupuncture can inhibit apoptosis in early period of SCI, but the mechanism is unclear yet.OBJECTIVE: To study the effect of electro-acupuncture on expressions of apoptosis inhibitory gene Bcl-2 mRNA and protein with hybridization in situ and immunohistochemistry and discuss the possible mechanism of apoptosis inhibited by electro-acupuncture in early SCI.DESIGN:Opening animal study.SETTING: Department of Anatomy, the Second Military Medical University of Chinese PLA; Shanghai Acupuncture & Moxibustion and Meridian Research Center.MATERIALS:Adult male SD rats of pathogen-free aged 2-3 months were selected in this study. Bcl-2 hybridization in situ kit was provided by Wuhan Boshide Biotechnology Company Limited and Bcl-2 antibody (1:200) was provided by Santa Cruz Biotechnology Company.METHODS: The experiment was completed at the Laboratory of Anatomy of the Second Military Medical University of Chinese PLA from July 2004 to December 2005. All experimental rats were randomly divided into model group, electro-acupuncture group, methylprednisolone group and sham operation group. T10 spinal cord was injuried by the modified Allen's method and treated with electro-acupuncture immediately, and then the expressions of Bcl-2 mRNA and protein were evaluated with hybridization in situ and immunohistochemistry combined with image quantitative analysis.MAIN OUTCOME MEASURES: ① Expressions of Bcl-2 mRNA and protein in early SCI; ② effect of electro-acupuncture on expressions of Bcl-2 mRNA and protein.RESULTS: The rats were supplied when they died during the experiment,and all 42 rats were involved in the final analysis. ① Moderate expression of Bcl-2 mRNA and protein was observed in the sham operation group.Expression of Bcl-2 mRNA was increased in model group at 6 hours after SCI, but expression ofBcl-2 protein was not changed. At 24 hours after SCI, both expressions of Bcl-2 mRNA and Bcl-2 protein were increased.Expression of Bcl-2 mRNA and protein was higher in electro-acupuncture group than that in mo del group (P ＜ 0.05), and there was no significant difference from that in methylprednisolone group. ② Amount of positive Bcl-2 mRNA cells was increased in electro-acupuncture group and methylprednisolone group at 6 hours after treatment, and gray value was decreased.There was significant and remarkably significant difference from those in sham operation group and model group, respectively (P ＜ 0.05-0.01). After 24-hour treatment, amount of positive Bcl-2 mRNA cells was increased in electro-acupuncture group and gray value was decreased.There was significant and remarkably significant difference from those in sham operation group and model group, respectively (P ＜ 0.05-0.01). ③ After 24-hour treatment, amount of immunohistochenistry positive Bcl-2 cells was increased in electro-acupuncture group and gray value was decreased. There was significant and remarkably significant difference from those in sham operation group and model group, respectively (P ＜ 0.05-0.01).CONCLUSION: Electro-acupuncture can up-regulate the expressions of Bcl-2 mRNA and protein so as to inhibit apoptosis in early SCI.
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Objective: To provide data for exploring the material basis of Acupoints and the relation of accumulation of calcium and vessels at Acupoints .Methods: (1) The distribution characteristics of vessels on tibial side of the interosseous membrane (ST channel 3rd, 4th, 5th, 7th cun ) were observed on Chinese ink vascular perfusion adults legs. (2) The content of calcium on ST channel were determined by proton induced X ray emission analysis. Results: (1) The average density (Aa%) of vessels at the 3rd, 4th, 5th, 7th cun areas of ST channel was significantly higher than that between them ( P