Limited open reduction combined with percutaneous medial locking plate for treatment of Rüedi-Allg(o)wer type Ⅱ and Ⅲ closed tibial pilon fractures / 中华创伤杂志

Objective To evaluate the clinical efficacy of limited open reduction combined with percutaneous medial locking plate in treatment of Rüedi-Allg(o)wer type Ⅱ and Ⅲ closed tibial pilon fractures.Methods A retrospective case-control analysis was made on 45 cases of closed tibial pilon fractures treated surgically between June 2008 and December 2015.There were 33 males and 12 females,aged from 26-66 years (mean,44.6 years).All cases were unilateral tibial pilon fractures,among which 18 were on the left while 27 were on the right.Thirty-four cases were combined with fibular fractures.There were 14 cases of type Ⅱ fractures and 31 type Ⅲ fractures according to the Rüedi-Allg(o)wer classification.Using the Tscheme-Gotzen system to evaluate soft tissue injury,two patients were in grade 1,29 patients in grade 2,and five patients in grade 3.On the basis of surgical methods,the cases were divided into Group A,limited open reduction with percutaneous medial locking plate and Group B,conventional open reduction.The operation time,reduction quality,fracture healing time,American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale at final follow-up visit and complications were recorded and compared between the two groups.Results The operation time of Group A was shorter than that of Group B (P ＜ 0.05).All patients had been followed up for 12-24 months,among which Group A was 22.5 months and Group B was 20.0 months (P ＞ 0.05).Compared with Group B,Group A was superior in fracture healing time (P ＜ 0.05) and AOFAS ankle-hindfoot scale(P ＜0.05),but was inferior in reduction quality (P ＜ 0.05).Poor wound healing was observed in two cases in each group,yet there was no nonunion in all cases.Conclusion Compared with conventional open reduction,the limited open reduction combined with percutaneous medial locking plate has more advantages in operation time and fracture healing,which can achieve better ankle functions for closed tibial pilon fractures.

Long non-coding RNA Gm15577 is involved in mouse cerebellar neurogenesis / 中华病理学杂志

<p><b>OBJECTIVE</b>To identify novel lncRNAs involved in cerebellar neurogenesis using neuronal specific Nbs1-deficient (Nbs1(CNS-del)) mouse model.</p><p><b>METHODS</b>Microarray analysis was performed to identify differentially expressed lncRNAs between Nbs1(CNS-ctr) and Nbs1(CNS-del) mice. Expression profiles of lncRNA Gm15577 and coding gene Negr1 in mice, primary cerebellar culture and cell lines were measured using RT-qPCR. Subcellular fractionation was performed to determine the subcellular localization of Gm15577.</p><p><b>RESULTS</b>Gm15577 was specifically expressed in mice cerebellum in a developmentally regulated manner, which could be abolished upon Nbs1-deficiency. Gm15577 was located in the intronic region of Negr1 in a reversed orientation. Gm15577 modulated the RNA expression of Negr1, Shh and β-catenin. NEGR1 had a distinct expression pattern between normal and medulloblastoma patients.</p><p><b>CONCLUSION</b>Gm15577 may modulate cerebellar granule cell proliferation and differentiation by targeting Negr1, and their dysfunctions or abnormal expression may be related to tumorigenesis of medulloblastoma.</p>

MICROANATOMY OF THE MIDDLE CEREBRAL ARTERY / 解剖学报

The middle cerebral artery and its branches were examined in 110 adult and child brains under 6-40 magnification. The following results were obtained.The main stem of the left middle cerebral artery was larger and longer than that of the right. The anomalies of the middle cerebral artery occurred less frequently than anomalies of the other major intracranial arteries. In this study, only one case of duplication of the middle cerebral artery was encountered.The patterns of the branching of the middle cerebral artery could be classified into 3 types. Double trunk type was the most common one, occurred in 76.37?2.86％. Single trunk type and triple trunk type occurred in 12.73?2.24％ and 10.90?2.10％ respectively. The latter two types could be further classified into some subtypes.The cortical branches of the middle cerebral artery consisted of frontalis orbitalis, precentralis, centralis, postcentralis, parietalis inferior, temporalis polaris, temporalis anterior, temporalis media, temporalis posterior and gyri angularis arteries. Each of these branches were usually 1～2 in number, and could originate independently or in common trunk with other branches. The average outer diameter of these branches were larger than 1.0 mm, except the temporalis polaris artery.The central branches of the middle cerebral artery consisted of medial perforating arteries and lateral perforating arteries. The medial perforating arteries were short, small, and 2-3 in number. They usually originated from the main stem of the middle cerebral artery at right angle, and then ascended to penetrate the brain through the anterior perforated substance. The lateral perforating arteries were 2～3 in number too, but they were larger than the medial perforating arteries. They originated at an acute angle from the main stem of the middle cerebral artery, or from a point of division of the middle cerebral artery, and from one of the cortical branches of the middle cerebral artery. Immediately after arising from the middle cerebral artery, they always passed medially and upward in a recurrent direction to the parent vessel after which they turned upward and laterally to penetrate the anterior perforating substance.The clinical significances of the middle cerebral artery and its branches were briefly discussed.

THE MICROANGIOARCHITECTURE OF HUMAN THALAMUS / 解剖学报

The microangioarchitecture of human thalamus was studied by the ink-gelatin injection, thick section transparency, histochemical staining and methacrylate cast under the stereoscope and scanning electron microscopy. There were some impressions of smooth muscular cells on the arteriole, precapillary arteriole, origin of capillary, larger venule, and converging region of each venula. Some circular impressions presented at the course of capillary regularly and discontinuously, which might be caused by contraction of pericytes of capillary. The microvascular anastomoses were rich and complex. Besides capillary anastomoses of different shape, there were many anastomoses occurred between two arterioles, or between several arterioles. The form of venular anastomoses was similar to arterioles. The anastomosis between arteriole and venule was observed occasionally. The relationship of characteristic of vertical branches of arterioles to thalamic hemorrhage was discussed.

MICROANATOMY OF THE POSTERIOR PORTION OF CIRCLE OF WILLIS / 解剖学报

The posterior portion of the circle of Willis was examined in 125 adult and child brains under 6～40 magnification. The following results were obtained:The terminal segments of the two internal carotid arteries were mostly equal in size (47.20?4.46%). An average of 2.5 perforating branches commonly arose from this segment distal to the origin of the posterior communicating artery. They penetrated into the anterior perforating substance, optic tract, tuber cinerum and the medial surface of the temporal lobe.The anterior choroid artery was found to originate from the internal carotid artery in 99.20?0.56% of 250 hemispheres. It usually originated laterally to the optic tract, crossed it twice, and then entered into the choroid fissure. Along its course, it sent off branches penetrating into the anterior perforating substance, temporal lobe, optic tract, hypothalamus-tractus furrow, lateral geniculate body and the uncus.The configuration of the posterior communication artery could be grouped into 4 types: straight, curved, looped and plexiform of the posterior portion. The curved type was more common in adults. The PCOA gave rise to an average of 8.1 perforating branches which emerged into tuber cinerum, optic tract, hypothalamustractus opticus furrow, mammillary body, crus cerebri, and the region located between optic tract and crus cerebri laterally, and mammillary body medially. According to the variety of calibres of the PCOA, the Willis' circle could be classified into modern, primitive, transitional and mixed type.The calibre of proximal portion of the posterior cerebral artery was equal in size bilaterally in 57.60?4.4%. There was an average of 3.1 posterior perforating arteries arising from P_1. They entered into the mammillary body, interpeduncular fossa, posterior perforating substance and crus cerebri.The collicular artery and the blood supply of mammillary body were observed and briefly discussed.

MICROANATOMY OF THE ANTERIOR PORTION OF CIRCLE OF WILLIS / 解剖学报

The anterior portion of the circle of Willis was examined in 106 adult and child brains under 6～40 magnifications. In this study,the proximal portion of the left anterior cerebral artery(A_1 segment) was larger and shorter than that of the right.The hypoplastic A_1 were found in 8.49?1.91%,mostly on the right side.In approximately 50% cases,A_1 were curved in their courses.A_1 passed across the optic nerve or optic chiasma to the longitudinal fissure where they communicated with the opposite ant.cereb,art.by the short anterior communicating artery(AGOA)lying in front of the optic chiasma(56.19?4.74%). In most of the cases,the recurrent artery belonged to one-branch type or two-branch type.It arose from the ant.cereb,art.at the level of the AGOA in 52.53?2.89%, usually coursing anterior to A_1 segment.This artery had many perforating branches (average 4.5)which perforated into the ant.perforated substance.Some of these branches may be traced to the inf.surface of frontal lobe,the olfactory sulcus,Sylvian fissure and suprachiasmatic area. In most cases,the anterior perforating artery belonged to one-branch type or two- branch type too,most frequently arising from the lat.portion of A_1.It was usually divided into perforating branches to the ant.perforated substance.Some of them may be traced to the olfactory tract,olfactory trigone,gyrus rectus,subcallosal gyrus and optic chiasma. The hypothalamic branches mainly arose from the lat.portion of A_1.The average number was 8.6.These branches may be traced to the optic tract,the dorsal surface of the optic chiasma,the ant.perforated substance,subcallosal gyrus and the genu of corpus callosum. The AGOA had many variations.In this study,the normal type was seen in 43.39 ?4.71%.The AGOA frequently gave rise to perforating arteries terminating in the suprachiasmatic area,the dorsal surface of the optic chiasma,lamina terminalis,subcal- losal gyrus,and the septic area.The number of perforating branches ranged from 1～8 (average 4.7).The frequent variations such as double or triple branches were encoun- tered. The third or median ant.cereb,art.arising from the ACOA was found in 17 cases (16.0?3.5%).Most of them were small and short,while only a few were large and coursing upward and backward over the dorsum of corpus callosum,and gave branches to the anteriomedial surface of the hemisphere.

A STUDY ON THE HUMAN INTRACEREBRAL SEGMENTS OF THE CENTRAL BRANCH OF THE MIDDLE CEREBRAL ARTERY / 解剖学报

The origin, diameter, arrangement pattern, distribution and microvascular architecture of the intracerebral segments(IS) of the central branches of the middle cerebral artery(MCA) were examined and pictured in 27(10 infants, 5 newborns, 12 fetuses) unfixed brains under stereoscopic microscope and scanning electron microscope. 1. The extracerebral segments(ES) of the central branches run toward the anterior perforated substance in S-shaped curves. The IS arise from ES or their collateral branches. They form the fan-shaped appearance in rostromedial and caudolateral state after entering brain. 2. The IS give rise collateral branches in right or acute angles, and they are of two kinds: the longitudinal and the transverse branches. The mean diameter of the IS in original site is 0.21?0.18mm for the medial group; 0.36?1 0.21mm for the lateral group. 3. The medial group mainly distribute in the rostal part of the internal capsule and basal nucleus; the lateral group mainly distribute in the caudal part. 4. Some circular impressions of the precaillary sphincters were observed at the beginning of precapillary arteriole and capillary, converging point of tributary branches of venule. The relationship between the IS of the central branches and the hemodynamics was discussed.