Cardiac Corpuscles: A "New" Morphofunctional Entity? / Corpúsculos Cardíacos: ¿Una "Nueva" Entidad Morfofuncional?

SUMMARY: The existence of "transitional muscular structures" between subendocardial branches (Purkinje fibers) and ventricular working muscle fibers (WF) was first described by the German anatomist, Kurt Goerttler, in 1964. He designated them as "subendocardial nucleus organs." He supposed such fibers functioned as mechanoreceptors, controlling of the intensity of contraction of the ventricular musculature. Brazilian anatomist Ferraz de Carvalho described similar structures in 1993. A thorough literature search failed to identify any other research articles confirming or denying their existence. The objective of this work was to find such structures in subendocardial ventricular walls in human hearts. We collected fifteen formalin-preserved hearts from the Anatomy Department of São Paulo University and sectioned the apical portions on the right and left ventricles according to method used by Goerttler. We utilized conventional histology (light microscopy- LM), scanning electron microscopy (SEM), and a new preservation method called micro- plastination (MP). At the anterior wall of the right ventricle in the subendocardial region between the interventricular septum and moderator band, we found several bundles of fusiform and helicoidal fibers of similar histology to the WF. The bundles measured between 400 and 1150 µm in length and were separated from adjacent muscular fibers by thin collagen fiber, thus acting as a "pseudo capsule." Some structures seemed to be linked to PF and were appeared to be lymphatic and blood vessels and nerves. We called those structures "cardiac corpuscles" (CC). The observation of the previously "unknown" CC in this initial study confirmed the previous descriptions and its discovery may contribute to new perspectives in the study of cardiac muscle structure and function.

La existencia de "estructuras musculares de transición" entre los ramos subendocárdicos (fibras de Purkinje) y las fibras musculares ventriculares activas(FMV) fue descrita por primera vez por el anatomista alemán Kurt Goerttler en 1964, quien las denominó "órganos del núcleo subendocárdico". Supuso que tales fibras funcionaban como mecanoreceptores, controlando la intensidad de la contracción de la musculatura ventricular. El anatomista brasileño Ferraz de Carvalho describió estructuras similares en 1993. Una búsqueda bibliográfica exhaustiva no logró identificar ningún otro artículo de investigación que confirmara o negara su existencia. El objetivo de este trabajo fue encontrar dichas estructuras en las paredes ventriculares subendocárdicas de corazones humanos. Recolectamos 15 corazones conservados en formalina del Departamento de Anatomía de la Universidad de São Paulo y seccionamos las porciones apicales de los ventrículos derecho e izquierdo según el método utilizado por Goerttler. Utilizamos histología convencional (microscopía de luz-LM), microscopía electrónica de barrido (SEM) y un nuevo método de conservación llamado microplastinación (MP). En la pared anterior del ventrículo derecho en la región subendocárdica entre el tabique interventricular y la banda moderadora, encontramos varios haces de fibras fusiformes y helicoidales de histología similar a la FMV. Los haces medían entre 400 y 1150 µm de longitud y estaban separados de las fibras musculares adyacentes por una fina fibra de colágeno, actuando así como una "pseudocápsula". Algunas estructuras parecían estar vinculadas a la fibras de purkinje y parecían ser vasos linfáticos, sanguíneos y nerviosos. Llamamos a esas estructuras "corpúsculos cardíacos" (CC). La observación del CC previamente "desconocido" en este estudio inicial confirmó las descripciones anteriores y su descubrimiento puede contribuir a nuevas perspectivas en el estudio de la estructura y función del músculo cardíaco.

The application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the coordination of multi-branches / 中华急诊医学杂志

Objective:To summarize the application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the cooperation of multiple hospitals and districts, and to provide a reference for medical institutions to improve the risk response ability.Methods:Based on the collaborative management of multi-branches, the "Trinity" emergency chain of pre-hospital-emergency-critical care, identification-triage-treatment, expansion-training-dispatch was implemented to optimize and integrate medical resources.Results:During the two months, 43,000 patients were admitted to the fever clinic, with an increase of 36.08%. The average waiting time for treatment was 19.83 min, and the average admission time to ICU was 25.35 min.Conclusions:The "Trinity" emergency chain treatment scheme under the coordination of multi-branches can effectively deal with the public health events of respiratory tract infectious diseases, improve the efficiency of rescue and treatment, and enhance the risk response ability of medical institutions.

Construction and application of the homogenous evaluation index system for public hospital branches / 中华医院管理杂志

Objective:To construct the homogenous evaluation index system for public hospital branches under the background of high-quality development, providing reference for improving the homogenization level of public hospital branches.Methods:By analyzing literature, relevant policies and the management practices of the public hospital branches, a preliminary screening index system for homogenization evaluation of public hospital branches was constructed. Two rounds of Delphi method were used to screen homogenization evaluation indicators for public hospital branches and determine the weights of the indicators. Taking the branches of a tertiary hospital as an example, the indicator system was empirically applied.Results:The homogenization evaluation index system for public hospital branches included 4 first level indicators, 8 second level indicators and 21 third level indicators. The weights of the first level indicators of medical homogeneity, management homogeneity, emergency conversion and satisfaction were 51.33%, 23.16%, 9.00% and 16.51%, respectively. Through empirical application, the homogenization coefficient of the public hospital branche was 0.833 5.Conclusions:The homogenization evaluation index system for public hospital branches was in line with the goals of the construction and development of multiple campuses of one hospital for public hospital. Indicators with low homogenization coefficients were the shortcomings of homogenization in hospital branches. This indicator system provided measurement standards and improvement directions for the homogenization of medical and management in hospital branches.

Vascular pressurisation and super-reflux techniques applied in free anterolateral thigh flap / 中华显微外科杂志

Objective:To investigate the clinical effect of vascular pressurisation and super reflux on free anterolateral thigh flap (ALTF).Methods:From January 2017 to September 2021, the Department of Hand and Foot Microsurgery, the Second Affiliated Hospital of Hainan Medical College had treated 31 cases of soft tissue defects of the limbs. The patients were 23 males and 8 females, aged 4-76 years old at 40 years old in average. All the patients received transfer of free ALTFs carrying 2 groups of blood vessels of the descending and oblique branches of lateral circumflex femoral artery (LCFA). The vascular pressurisation and super-reflux techniques were applied in wound repair. Soft tissue defect area 7 cm × 5 cm-22 cm × 10 cm. The sizes of flaps were 8 cm×6 cm-23 cm×11 cm. All the donor sites were sutured directly. Fifteen patients had inner flap pressurisation (or super-reflux) and the rest of 16 patients had external flap pressurisation (or super-reflux). After surgery, scheduled follow-ups were conducted through outpatient clinic, telephone and WeChat reviews or home visits to evaluate the efficacy of wound repair.Results:All the 31 flaps survived, except 2 flaps that had mild infection after surgery. The wounds of donor and recipient sites healed completely. The time of follow-up was 3-55 months. The skin of flaps achieved good texture, colour, lustre and appearance. TPD of the flaps ranged 7-12 mm.Conclusion:Vascular pressurisation and super reflux technique are stable and reliable in the clinical application of free ALTF to repair soft tissue defects of limbs.

Clinical experience of off-pump arch branches preferential reconstruction and whole brain perfusion in the treatment of type A / 中华胸心血管外科杂志

Objective:To introduce the early results of total aortic arch replacement (TAA) without cardiopulmonary bypass (CPB) and without interruption of cerebral blood supply, using the technique of arch branches preferential reconstruction and whole brain perfusion for brain protection.Methods:Between June 2020 and March 2021, a total of 9 Stanford type A aortic dissection patients we performed total arch replacement by using the technique of arch branches preferential reconstruction and whole brain perfusion without cardiopulmonary bypass and without interruption of blood supply to the brain. The method of this reconstruction technique is as follows: A 24F aortic cannula was inserted into the true lumen at the root of the transverse innominate artery (IA) to connect one end of the artery for cardiopulmonary bypass. The access was connected to 14F artery via Y-connector and inserted into IA cavity to maintain blood supply to brain. Without cardiopulmonary bypass, the 10 mm branch of the four branch artificial blood vessel was anastomosed with the innominate artery IA. The perfusion collateral was connected to the second end of the artery of CPB (single pump and double tubes) to continue to supply blood for IA. The left common carotid artery (LCA) and left subclavian artery (LSCA) were reconstructed by the same method. When IA and LCA were anastomosed, the distal blood supply was not interrupted. After the three branches of the aortic arch were anastomosed, we started to turn the machine, then cooled down and blocked the ascending aorta to further complete the operation of the aortic root and arch. During the period of lower body circulatory arrest, the whole brain was perfused with low flow.Results:No intraoperative death or perioperative complications occurred in all patients, and they were discharged smoothly. The cardiopulmonary bypass time was (192.4±58.1) min, the aortic clamping time was (128.3±52.4) min, the lower body circulatory arrest time was (29.1±1.3) min, and the postoperative awake time was (8.2±3.7) h.Conclusion:Off-pump arch branches preferential reconstruction can provide physiological whole brain perfusion, shorten the cardiopulmonary bypass time and aortic occlusion time, and the operation is safe and effective.

The long-term outcomes of posterior nasal neurectomy with or without pharyngeal neurectomy in patients with allergic rhinitis: a randomized controlled trial / Os resultados no longo prazo da neurectomia nasal posterior com ou sem neurectomia faríngea em pacientes com rinite alérgica: um ensaio clínico randomizado

Abstract Introduction Allergic rhinitis is a form of IgE mediated inflammation of the nasal mucosa in response to specific allergens, resulting in typical symptoms. Objectives This study was designed with the primary goal of comparing the clinical efficacy of posterior nasal neurectomy with or without pharyngeal neurectomy for the treatment of moderate-to-severe perennial allergic rhinitis. Secondary study aims included a comparison of the severity of comorbidities, including chronic cough and asthma, between patients in these two surgical treatment groups. Methods A total of 52 patients were enrolled in this randomized controlled trial and were assigned to either the control group (posterior nasal neurectomy) or the experimental group (posterior nasal neurectomy + pharyngeal neurectomy). The visual analog scale and rhinoconjunctivitis quality of life questionnaire were used to compare the differences in patient symptoms between baseline and 6-, 12-, and 24-months post-treatment. In addition, patient cough and asthma symptoms were monitored during follow-up via visual analog scale and asthma control test respectively. Results No significant differences in preoperative scores were evident between groups (p> 0.05). At 6-months post-treatment, there were significant differences in visual analog scale, rhinoconjunctivitis quality of life questionnaire, and asthma control test scores relative to baseline values in experimental group and control group patients (p< 0.05), and this remained true upon 12- and 24-month follow-up. No significant differences in visual analog scale, rhinoconjunctivitis quality of life questionnaire, or asthma control test scores were observed between the two treatment groups at any postoperative follow-up time point (p> 0.05), while coughing severity was found to be significantly reduced in the experimental group relative to the control group (p< 0.05). Conclusion posterior nasal neurectomy can be safely implemented with or without pharyngeal neurectomy in order to effectively treat allergic rhinitis. Combined posterior nasal neurectomy and pharyngeal neurectomy treatment may offer greater value than posterior nasal neurectomy alone for the treatment of allergic rhinitis patients with chronic cough.

Resumo Introdução A rinite alérgica é uma forma de inflamação da mucosa nasal mediada por IgE em resposta a alérgenos específicos, resulta em sintomas típicos. Objetivos Comparar a eficácia clínica da neurectomia nasal posterior com ou sem neurectomia faríngea para o tratamento da rinite alérgica perene de moderada a grave. Além disso, comparar a gravidade das comorbidades, inclusive tosse crônica e asma, entre os pacientes nesses dois grupos de tratamento cirúrgico. Método Foram incluidos neste ensaio clínico randomizado e designados para o grupo controle (neurectomia nasal posterior) ou para o grupo experimental (neurectomia nasal posterior + neurectomia faríngea) 52 pacientes. A escala visual analógica e o questionário de qualidade de vida na rinoconjuntivite (rhinoconjunctivitis quality of life questionnaire) foram usados para comparar as diferenças nos sintomas dos pacientes entre o período inicial e 6, 12 e 24 meses após o tratamento. Além disso, a tosse e os sintomas de asma dos pacientes foram monitorados durante o acompanhamento por meio da escala visual analógica e do teste de controle da asma (asthma control test ), respectivamente. Resultados Nenhuma diferença significante nos escores pré‐operatórios foi evidenciada entre os grupos (p > 0,05). Aos seis meses pós‐tratamento, houve diferenças significantes nos escores da escala visual analógica, no questionário de qualidade de vida na rinoconjuntivite e no teste de controle de asma em relação aos valores basais dos pacientes no grupo experimental e no grupo controle (p < 0,05), o que permaneceu verdadeiro após 12 e 24 meses de acompanhamento. Não foram observadas diferenças significantes nos escores da escala visual analógica e nem no questionário de qualidade de vida para conjuntivite ou no teste de controle da asma entre os dois grupos de tratamento em qualquer momento do acompanhamento pós‐operatório (p > 0,05), enquanto a gravidade da tosse foi significantemente reduzida no grupo experimental em relação ao grupo controle (p < 0,05). Conclusão A neurectomia nasal posterior pôde ser feita com segurança com ou sem neurectomia faríngea para o tratamento eficaz da rinite alérgica. O tratamento combinado com neurectomia nasal posterior e neurectomia faríngea pode oferecer mais benefício do que a neurectomia nasal posterior isolada para o tratamento de pacientes com rinite alérgica e tosse crônica.

Exploration and practice of integrated governance system in hospital with multi-branches / 中华医院管理杂志

Aiming at the problems of resource allocation, cost control, homogenization management of medical and nursing quality and so on in a hospital with multi-campuses, People′s Hospital of Ningxia Hui Autonomous Region explored an integrated governance system. It incorporated a series of aspects, such as the establishment of Internet hospital platform using payment and settlement as the link, the construction of operation and management mode for integrating information of multiple branches, the completion of " one hospital, multiple branches" organizational structure and integrated operation system, the innovation of personnel and post compensation system in line with features of medical industry, the implementation of new service mode of diagnosis teams and inpatient wards, the execution of budget management and cost accounting control, and the establishment of integrated online and offline epidemic prevention and control system for the joint prevention and control. These practices achieved good effects that quality and efficiency of medical services were greatly improved, cost of medical services was effectively controlled, and the efficiency of hospital operation and management were enhanced. It provided valuable experience for the integrated management of public hospitals with multi-campuses.

Quality Evaluation of Branches of Juglans mandshurica by HPLC-DAD Fingerprint Combined with HPLC-Q-TOF-MS/MS Characterization of Constituents / 中国实验方剂学杂志

Objective:To establish a high performance liquid chromatography （HPLC） fingerprint of branches of <italic>Juglans mandshurica</italic> and to evaluate the quality of the samples from different producing areas and in different harvest periods. Method:Chromatographic separation was performed on an Agilent Poroshell 120 SB-C₁₈ column （2.1 mm×100 mm， 2.7 μm） for gradient elution with mobile phase of 0.2% formic acid solution （A）-0.2% formic acid acetonitrile solution （B） （0-5 min， 5%-10%B； 5-25 min， 10%-16%B； 25-40 min， 16%-22%B； 40-45 min， 22%-45%B； 45-50 min， 45%-65%B； 50-52 min， 65%-100%B； 52-55 min， 100%B） at a flow rate of 0.3 mL·min^-1. The column temperature was 30 ℃ and the detection wavelength was 270 nm. The quality of branches of <italic>Juylans mandshurica</italic> was evaluated by similarity evaluation， cluster analysis， principal component analysis and partial least squares-discriminant analysis. The chemical constituents of the samples were identified by HPLC coupled with quadrupole time-of-flight mass spectrometry （HPLC-Q-TOF-MS/MS）. The mass spectrometry was conducted in negative ion mode with electrospray ionization（ESI）. Data were acquired over a range of <italic>m</italic>/<italic>z</italic> 100-1 700 for MS and <italic>m</italic>/<italic>z</italic> 50-1 700 for MS/MS. Result:A total of 19 common peaks were confirmed in 40 batches of samples， and the similarity ranged from 0.430 to 0.995， of which the similarity of samples collected in spring and winter seasons （April， May and December） was greater than 0.90， while the similarity of most samples collected in summer （July to September） was low. Multivariate statistical analysis showed that the samples were divided into two groups according to the harvest time， but there was no obvious classification rule for the samples from different producing areas. The contents of most constituents in the samples collected in spring and winter were higher than those collected in summer. The result illustrated that different harvest periods had great influence on the quality of branches of <italic>J</italic>.<italic> mandshurica</italic>. Compared with the samples collected in summer， the quality of samples collected in spring and winter was better. A total of 22 peaks were proved to be the main constituents that contributed to the difference between samples collected in different seasons. A total of 83 chemical components were identified by HPLC-Q-TOF-MS/MS， including 49 tannins， 7 organic acids， 14 naphthalene derivatives， 1 flavonoid， 6 anthracene derivatives， 2 lignans， 3 diarylheptanoids and 1 saccharide. Totally 13 common peaks were identified. Of the peaks that contributed to discriminate samples collected in different season， 19 peaks were identified and most of them were tannins. Conclusion:The established HPLC fingerprint can provide useful information for the quality evaluation of branches of <italic>J</italic>.<italic> mandshurica</italic>. Tannin is the main constituents in the samples. Harvest period has great influence on the quality of branches of <italic>J</italic>.<italic> mandshurica</italic>.

Macro- and Microelements in the Branches of some Salix Genus Species in the Flora of Ukraine

Determination of the mineral composition is important for further study and standardization of the dried branchesof the species from the Salix (willow) family genus and extracts from the plant material. The study aimed todetermine the qualitative and quantitative content of macro- and microelements in some representatives of theSalix spp. growing in Ukraine in comparison with soils and extracts of plant material. The elemental compositionof the branches of Salix cinerea L., S. incana Schrank, S. cаprea L., S. sachalinensis F. Schmidt, S. acutifolia L.,S. fragilis L., S. caspica Pall., S. rosmarinifolia L., and S. myrsinifolia Salisb was determined using atomicemission spectrometry with photographic registration for the first time. The method used allowed us to determinethe presence of 5 macro- (К, Na, Ca, Р, Mg) and 14 microelements (Fe, Si, Мn, Al, Sr, Zn, Ni, Mo, Cu, Co, Pb,Cd, As, Hg), and the content of 14 elements were quantified in the dried branches of the Salix spp. plants. Theability to accumulate and a relatively high content of micro- and macroelements, as well as low content of toxicmicroelements (Co, Pb, Cd, As, Hg) in willow branches, allow considering them as a promising but safe sourceof biologically available microelements. There were typically not correlations between concentrations of microand macroelements in plant material and soils. The maximum levels of macroelements and microelements werefound in Salix species collected in the Kharkiv region, and in the Zakarpatye region, respectively. The elementalcomposition in the Salix sachalinensis F. Schmidt was quite different if compared with all others.

Study On Primary Segmental Branches Of Splenic Artery In Cadaveric Spleens By Dissection Method

Introduction: Spleen plays an important function in immunity and haematological functions. So, nowadays totalsplenectomy is replaced by splenic conservative surgeries. Partial removal of spleen is possible, as the spleenis divided into various segments, supplied by its own artery. The present study was undertaken to know about thesegmental branches of splenic artery.Objectives: 1.To study the number of primary segmental branches of splenic artery. 2. to measure the distancebetween the termination of splenic artery and hilum.Materials and methods: The present study was conducted on 79 adult human cadaver spleens by dissectionmethod, irrespective of their age and sex, fixed in 10% formalin solution, collected from the Department ofAnatomy and Forensic Medicine, Mysore Medical College and Research Institute, Mysore.Results: Two primary segmental branches were seen in 56 (70.9%) specimens, three primary segmental brancheswere seen in 19 (24.1%) specimens and four primary segmental branches were seen in 4 (5.1%) specimens. Themean distance between termination of splenic artery and hilum of the spleen was 2.1 cm. and the range wasextending from 0.3 cm to 6.1 cm.Conclusion: The present study adds up to the existing knowledge regarding the segmental branches of splenicartery, the better anatomical knowledge about segmental distribution of splenic artery and its variations areimportant for the partial removal of the spleen.

Behavior of male and female eclectus parrot (Eclectus roratus) in an artificial environment

The eclectus parrot (Eclectus roratus) is a species of parrot native to the Solomon Islands, Sumba, New Guinea and nearby islands, northeastern Australia, and the Moluccan Islands. The wide range of behaviors emphasizes the existence of knowledge of only a mere fraction of the significant behavioral parameters of these birds. The objective of this study is to identify the behavior of the eclectus parrot kept in captivity and to check the frequency of these birds in certain places of the nursery, comparing the results to other studies about parrots and the behavior in nature. This is a study about the behavior of a bird with a very pronounced sexual dimorphism, where the males have a predominantly green color, and the females are mainly red-colored. In the wild, while the male perches on the outer branches of the trees, thefemale usually perches close to tree trunks. This location, together with her red and blue plumage, provides the ideal camouflage in the dark interior of the trees.

Anatomical variations of sensory nerve branches of the cervical plexus

Introduction: The cervical plexus is formed by the union of the anterior branches of the cervical nerves from C1to C4. These nerves originates sensory fibers and motor that will innervate the skin, muscles, glands and regionsof the head and neck.Objective: In literature, it has been a frequent description of findings of anatomical variations of peripheralnerves of the cervical plexus. A study of descriptive type anatomical design was carried out by observing theformation of the cervical plexus of its peripheral nerve branches, and search of possible anatomic variations ofthese nerve branches.Methods: This study was conducted with Bilateral dissections were performed in 32 stillborns, formalin- fixed,all males with a mean age of 26.5 weeks (SD = 2.121). The fetuses were meticulously dissected and the formationof cervical plexus and its branches were observed. Results and Discussion: Among the 32 fetuses dissected, itfound a variation of the CTN and an anastomosis between CTN and SCN and an anatomical variation was foundin the form of anastomosis between the roots C1 to C4, forming a common trunk from which emerge some othernerve branches.Conclusion: The most frequent anatomical identifications were confirmed, some variations already describedand verification of new variations of the sensory branches in the cervical plexus. The identification of thesensory branches of the cervical plexus, and anatomical variants may help in clinical, therapeutic, surgical anddiagnostics

Study of variations in profunda femoris artery and its circumflex femoral branches in thiel embalmed cadavers

Introduction: Studying the possible variations of the profunda femoris artery and its circumflex femoral brancheswill guide surgeons and other health professionals during surgical and radiological procedures.Methods: The study investigated variations in the vascular patterns of origin of the profunda femoris artery, themedial circumflex femoral and the lateral circumflex femoral artery in 20 (7 males and 13 females) Thielembalmed cadavers of the Centre for Anatomy and Human Identification (CAHID), University of Dundee, DundeeUnited Kingdom. Distances were measured between the origin of the PFA and midpoint of the inguinal ligament,between the origins of the MCFA and PFA and from the origin of LCFA to the origin of PFA. The data were analysedwith IBM SPSS.Results: The PFA originated mostly from posterolateral aspect of the FA and the PFA was found to also originatefrom anteromedial side of the FA. The medial and lateral circumflex femoral arteries originated from the PFA withincidences of 47.5% and 87.5% respectively, both originated separately as a common origin with PFA and fromthe femoral artery.Conclusion: Variation research can potentially reduce complications that may arise from ignorance of theramifications in the vascular patterns. An awareness of PFA variations will help to carry out radiologicalinterventions, to define vascular patterns, helps during orthopaedic procedures in the femoral region such aship replacement and is also a basic requirement during femoral artery puncture to minimise cases of severesecondary bleeding

The applied anatomy of posterior tibial artery cutaneous branches-chain flap / 中华显微外科杂志

To provide anatomy information for harvesting the posterior tibial artery cutaneous branches-chain flaps. Methods The research was performed from January, 2017 to January, 2018. Anatomic ob-servation on 10 legs from fresh human cadaver were performed. The location of cutaneous branches of the posterior tibial artery was observed and its diameter and length was measured. Five legs were prepared to investigate the cuta-neous branches of posterior tibial artery.The anastomosis of cutaneous branches of posterior tibial artery was observed by PVA-bismuth oxide perfusion for molybdenum target X-ray arteriography in 5 perfused legs. The cutaneous branches with diameter over 0.2 mm in 10 legs of latex perfusion microdissection were included in the statistical analysis.The data were clustered and analyzed to find the location of distant and near cutaneous branches, which was called the gathering point of cutaneous branch vascular plexus. Secondly, the measured data of distal and near seg-ments containing cutaneous branches were compared by t-test.Then the distribution of cutaneous branches of posteri-or tibial artery on the tibiofibular side was compared by Chi-square test.It was considered to be significant if P value was under 0.05. Results ①There were 4.3 cutaneous branches raised from the posterior tibial artery.There was no significant difference on the tibial and ribula side distribution of the cutaneous branches from the posterior tibial artery (P＞0.05).②The distal cutaneous branch clusters was located at about 1/5 of the distal leg and there were 3.6 cutaneous branches raised from the posterior tibial artery. While the proximal clusters was located at 1/3 of the proximal leg and there were 0.7 cutaneous branches raised from the posterior tibial artery.There were no significant differences in the di-ameters (P=0.28) and pedicle length (P=0.14) between distal and proximal cutaneous branches. ③There were the large cutaneous perforators (≥1.0) mm from the posterior tibial artery at (6.37±1.22) cm proximal to the medial malleolus.The diameter and pedicle length of the distal perforators were (1.11±0.09) mm and (6.53±1.51) mm respectively.④The vas-cular chains parallel to the posterior tibial artery were formed via anastomosis of the adjacent cutaneous perforators. Conclusion The cutaneous expenditure of posterior tibial artery is constant, with a certain pedicle length and diameter. There are 2 relatively dense vascular plexus of cutaneous branches. The proximal and distal vascular flaps can be de-signed with these 2 vascular dense points as rotation points.

Study Of M1 Segment Of Middle Cerebral Artery In Human Cadaveric Brains With Clinical Implications Of Its Early Branches

Background: Human brain gets its nutrition from carotido and vertebro-basilar system of vessels. MCA, being thelarger terminal branch of ICA supplies the cortical areas of brain concerned with speech and language. It is themost commonly involved artery in cerebro-vascular accidents as in stroke which is characterised by suddenonset of focal neurological deficit. The anatomical study is of utmost important to neurovascular surgeons.Materials and methods: The present study was undertaken in 140 cadaveric human brain hemispheres of 70formalin fixed brains from Department of Anatomy and Forensic medicine of Mysore medical college and ESICMC and PGIMSR, Bangalore. Fixed brains were sagitally bisected into right and left halves by brain cutting knife.Meninges were cleared and MCA was identified which was the larger and direct branch of ICA. Measurements ofICA and MCA was taken using thread and measuring scale. LSAs arising from MI segment MCA were counted usinghand lens. Any early branch if present was noted. Angle was noted between M1 and M2 segment. Presence of anyanomalies were studiedResults: The mean of length of M1 was found slightly more on the left side (2.09 cms) in comparison to right side(1.90 cms). The mean diameter of M1 segment of MCA was more on the left side (0.352 cms), in comparison toright side (0.317 cms). The mean diameter of left MCA (0.352 cms) and left ICA (0.359 cms) were of the same size.The mean diameter of right MCA (0.317 cms) and right ICA (0.323 cms) were almost of the same size. The numberof LSAs were more on left side (5.9) in comparison to right side (5.67). Early branches were found to be more onright side (5) than left side (3). The angle was observed to be acute in all specimens.Conclusion: This study was undertaken due to its clinical significance to stroke. Observations made on MCArevealed greater length of MCA carrying greater proportion of blood flow to the left side – a feature whichsupports the concept of vascular asymmetry. The knowledge of early branch arising from proximal segment ofMCA is helpful for neurovascular surgeons to make a fairer decision in planning the treatment for any neurovsculardisorders. The authors felt the necessity of documentation of data inferred by our study as there are very fewarticles on MCA found published in Indian literature.

Inervación del músculo extensor radial corto del carpo en individuos brasileños: biometría de su origen y distribución / Innervation of the extensor carpi radialis brevis muscle in Brazilian individuals: biometry of its origin and distribution

El ramo de inervación para el músculo extensor radial corto del carpo (MERCC) ha sido utilizado para restablecer funciones de la musculatura del miembro superior en pacientes con lesiones medulares, del plexo braquial o de sus ramos terminales. El origen del nervio para el MERCC es variable, pudiendo originarse desde el tronco del nervio radial (NR), del ramo profundo de este nervio (RPNR) o del ramo superficial del mismo (RSNR). Con el propósito de complementar la anatomía sobre el origen y distribución del ramo para el MERCC, se utilizaron 30 miembros superiores, formolizados, de cadáveres de individuos Brasileños, localizados en los laboratorios de Anatomía de la Universidad Estadual de Ciencias da Saude, Maceió, Brasil. A través de disección se localizó el músculo y su inervación, determinando su origen, así como su distribución. Para efectuar la biometría, se consideró como referencia una línea transversal que pasaba entre las partes más prominentes de los epicóndilos lateral y medial del húmero (LBE), registrando la distancia entre esta línea y el punto de origen de este ramo muscular, así como la distancia entre la LBE y los puntos motores. El nervio para el MERCC se originó del RPNR en 50 % de los casos; desde el tronco principal del NR en 26, 7 % y desde el RSNR en 23, 3 %. La distancia entre el origen del ramo en estudio y la LBE fue en promedio de 23 ± 12 mm; la distancia entre el 1º, 2º y 3º punto motor respecto a la LBE fue de 55 ± 17 mm, 66 ± 17 mm y 79 ± 11 mm, respectivamente. La distribución de la inervación fue clasificada en 4 tipos en relación a sus puntos motores. Los resultados obtenidos son un importante aporte al conocimiento anatómico, así como a la neurocirugía en las transferencias nerviosas con propósitos de restauración de las funciones de músculos lesionados en el miembro superior.

The branch of the innervation for the extensor carpi radialis brevis muscle (ECRBm), has been used to reestablish muscle functions in the upper limbs of patients who have spinal cord injury, of the brachial plexus or its terminal branches. The origin of the ECRBm varies, and can originate from the trunk of the radial nerve (RN), from the deep branch of the radial nerve (DBRN), or from the superficial branch of the radial nerve (SBRN). In order to further complement the anatomy related to the origin and distribution of the ECRBm branch, 30 formolized upper limbs from Brazilian individuals, from the Universidad Estadual de Ciencias da Saude, Maiceió, Brazil were used. Through dissection, the muscle and its innervations was located, determining the origin of the branch as well as distribution. To determine biometry, a transversal reference line, which passed through the most prominent areas of the epicondyles of the humerus (BEL) was considered. The nerve for ECRBm originated from DBRN in 50 % of cases; from the main trunk of RN in 26.7 % and from SBRN in 23.3 %. The distance from the origin of the branch studied and the BEL was an average of 23 ± 12 mm; the distance from the first, second and third motor point to the BEL was 55 ± 17 mm, 66 ± 17 mm and 79±11 mm, respectively. The distribution of the innervation was classified in four types in relation to the motor points. The results are an important contribution to anatomical knowledge, as well as neurosurgery during nerve transfers to restore functions of damaged muscles in the upper limb.

Anatomical branches of right upper lobe pulmonary arteries in Chinese patients / 中国胸心血管外科临床杂志

@#Objective     To observe and describe anatomical types of the pulmonary arteries to keep safety of lung resection. Methods     Between November 25, 2005 and January 22, 2013, 194 patients who underwent right upper lobectomy/sleeve lobectomy or combined lung resection including right upper lobectomy were included in Peking University Cancer Hospital. There were 128 males with a median age of 59 (37-86) years and 66 females with a median age of 60 (42-77) years. We separated the pulmonary arteries and recorded the number and positions of them. Some patients were recorded photographically. Results     There were 10 types of right upper lobe pulmonary artery branches in this study. Type 1: 1 apicoanterior segmental artery, 1 ascending segmental artery, 96 patients (49.5%); Type 2: 1 apicoanterior segmental artery, 2 ascending segmental arteries, 48 patients (24.7%); Type 3: 2 apicoanterior segmental arteries, 1 ascending segmental artery, 28 patients (14.4%); Type 4: 2 apicoanterior segmental arteries, 2 ascending segmental arteries, 9 patients (4.6%); Type 5: 1 apicoanterior segmental artery only, 6 patients (3.1%); Type 6: 1 apicoanterior segmental artery, 3 ascending segmental arteries, 3 patients (1.5%); Type 7: 4 apicoanterior segmental arteries, 1 ascending segmental artery, 1 patient (0.5%); Type 8: 3 apicoanterior segmental arteries, 1 ascending segmental artery, 1 patient (0.5%); Type 9: 2 apicoanterior segmental arteries, 1 patient (0.5%); Type 10: 3 apicoanterior segmental arteries, 2 ascending segmental arteries, 1 patient (0.5%). Conclusion     The types of pulmonary artery branches are predictable in some way. It would be helpful to reduce the risk of pulmonary artery injury and improve the operation safety by following   the rules. Variations of pulmonary artery should be noticed to avoid the major bleeding due to the pulmonary artery injury.

Clinical analysis of repairing the defect of hand with reverse island skin flap of upper carpal cutaneous branches of ulnar artery / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effect of repairing soft tissue defect after hand wound using reverse island skin flap of upper carpal cutaneous branches of ulnar artery.</p><p><b>METHODS</b>From June 2010 to November 2016, 12 patients with hand soft tissue defects were repaired by reverse island skin flap of upper carpal cutaneous branches of ulnar artery, including 9 males and 3 females with an average age of (35.2±9.4) years old ranging from 22 to 58 years. The defect area varied from 7.0 cm×3.0 cm to 12.0 cm×7.0 cm. Time interval from injury to operation ranged from 3 to 15 days with an average of (8.4±2.6) days. The flap was designed beforehand according to the size of the defect, sharply dissected the aponeurotic fascia from the proximal to the distal, abscised the communicating branch between the flap and the ulnar artery at the wrist epithelial branch, repairing the defect of flap with method of metastasis retrograde. The sensation, shape of the flap and hand function were observed, and the upper extremity function was evaluated according to the standard of hand surgery branch from Chinese Medical Association to assessment of functional recovery.</p><p><b>RESULTS</b>The flaps in 10 patients obtained primary healing, the healed time was 14 to 18 days with an average of(15.0±1.5) days. Two patients occurred distal flap necrosis, and wound surface healed after change dressing and skingrafting cover. All patients were followed up from 3 to 15 months with an average of(7.0±3.8) months. According to the upper extremity functional evaluation standard by hand surgery branch of Chinese Medical Association, 2 cases got excellent results, 7 good, 2 fair and 1 poor.</p><p><b>CONCLUSIONS</b>Reverse island skin flap of upper carpal cutaneous branches of ulnar artery for the treatment of soft tissue defect caused by hand wound has advantages of concealed donor area, no need sacrifice the main blood vessel, flap thin and no need repair it for thick and thin.</p>

Effectiveness of medial ankle branches propeller "Tennis racket-like" flap in repair of heel-ankle tissue defects / 中国修复重建外科杂志

Objective: To investigate effectiveness of the medial ankle branches propeller "Tennis racket-like" flap in repair of heel-ankle tissue defect. Methods: Between June 2011 and June 2016, 50 patients with heel-ankle tissue defects were treated. There were 40 males and 10 females, with a median age of 35.6 years (range, 6-58 years). The defects were caused by trauma in 44 cases, scar deformity after trauma in 2 cases, chronic ulcer in 2 cases, and squamous cell carcinoma in 2 cases. The defects located at heel in 20 cases, ankle in 15 cases, and heel-ankle in 15 cases. The size of heel-ankle tissue defect ranged from 3.5 cm×2.0 cm to 13.0×10.0 cm. The course of disease ranged from 3 hours to 2 months (mean, 28 days). All wounds were repaired by the medial ankle branches propeller "Tennis racket-like" flap in a size of 3.8 cm×2.2 cm-13.4 cm×10.3 cm. The donor site was directly sutured in 5 cases or repaired by skin grafting in 45 cases. Results: All flaps survived and wounds healed by first intention. Partial necrosis of skin grafting occurred in 1 case, and the wound recovered by change dressing. The other skin grafting survived and wounds healed by first intention. Forty-eight patients were followed up 12 months after operation. The appearance, sensory, and function of repaired heel-ankle flaps were satisfactory. Conclusion: For heel-ankle tissue defect repair, the medial ankle branches propeller "Tennis racket-like" flap has advantages of the high survival rate, reliable blood supply, and sensory recovery.

Modelos de regresión para estimar el peso seco de órganos y área del limbo del duraznero, variedad jarillo / Regression models for the estimation of the dry weights of organs and the limbo area of the peach variety jarillo

Los métodos no destructivos y confiables para estimar el área del limbo y el peso seco de los órganos de durazno de la variedad Jarillo están limitados para el investigador. Por el contrario, en este estudio, se desarrollaron unos modelos estadísticos para estimar el área y el peso seco del limbo, de frutos y de ramas de la variedad Jarillo, para ser utilizados, como herramientas, para facilitar la recolección de datos. El estudio, se realizó en las montañas de Pamplona, noroeste de Colombia. Se seleccionaron 240 hojas, de 2,5 meses; 240 frutos, de 3,5 y 7 meses y 240 ramas, de 9 meses de edad, para desarrollar los modelos. Los resultados del análisis de regresión indicaron que varios modelos son adecuados para estimar el área del limbo y el peso seco de los órganos de durazno de la variedad Jarillo. Los datos observados y estimados se compararon estableciendo la relación, mediante una regresión lineal simple, para la rama y el limbo. La relación para el fruto fue de tipo cuadrático. El número de yemas, de volumen, de longitud y el diámetro basal/medio de las ramas mixtas, el peso seco del fruto, el muestreo, el diámetro longitudinal del fruto, la altitud, la longitud del limbo, el peso seco del limbo, el producto de la longitud por el ancho del limbo, el ancho del limbo, el peso seco del limbo, están involucrados en la estimación del área del limbo y el peso seco de los órganos de Prunus persica (L.), variedad Jarillo.

Non-destructive, rapid and reliable methods for estimating the area of limb and dry weight of peach organs for the Jarillo variety are limited. Therefore, the aim of the present study was to produce a statistical model to estimate the area and dry weight of limb fruit and branches of this specific variety that can be used as a tool to facilitate data collection. The study was performed in the mountains of Pamplona, Northwest of Colombia. Two Hundred and forty leaves (240) from 2.5 months old limb, 240 fruits of 3.5 and 7 months old fruits and 240 branches of 9 months old branches were selected and used to develop the model. Results of the regression analysis indicated that several models were suitable to estimate the area limb and the dry weight. The observed and estimated data were compared by establishing the relationship by means of a simple linear regression for the branch and limb. The relation for the fruit was quadratic type. The number of buds, volume of branches, length of mixed branches and basal/mean diameter, dry weight of fruit, sampling, longitudinal diameter of the fruit, altitude, length of limb, dry weight of limb, the product of the length by the width of the limb, width of the limb, should be considered in the estimation of the area limb and dry weight of the peach organs of P. persica (L.) Jarillo variety.