Detection and analysis of protein gene product 9.5 positive nerve fibers in liver of patients with alveolar echinococcosis / 中国热带医学

@#Abstract: Objective　To explore the distribution characteristics of protein gene product 9.5 (PGP9.5) in the proximal and distal lesions of liver tissue in patients with alveolar echinococcosis (AE), and to clarify the relationship between the positive nerve fiber density of PGP9.5 in the proximal lesion of liver tissue of patients with AE and clinical pathological features and biochemical indexes. Methods　From July 2019 to July 2022, 59 patients with AE who were hospitalized in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xinjiang Medical University were selected, and their liver tissues at the proximal and distal ends of the lesion were collected, and their clinicopathological data and biochemical index information were collected at the same time. Immunohistochemical method was used to detect the density of PGP9.5 positive nerve fibers in the proximal and distal liver tissues of 59 patients with AE, and to analyze the difference between the density of PGP9.5 positive nerve fibers in the proximal and distal liver tissues of patients with AE, and to further analyze the relationship between the density of PGP9.5 positive nerve fibers in the proximal liver tissues of patients with AE and clinicopathological features and biochemical indexes. Results　The nerves in the proximal lesion of the liver tissue in patients with AE increased, mainly distributed in the outer layer of the fibrous capsule enclosing the lesion, and no obvious abnormalities were observed in the distal nerves. The density of PGP9.5 positive nerve fibers in the liver tissue of patients with AE was significantly higher than that in the distal part of the lesion, with statistical significance (Z=-4.237, P<0.05). The density of PGP9.5 positive nerve fibers in the liver tissue of patients with AE was correlated with the increase of liver volume (Z=-2.632, P<0.05). Conclusions　The area of PGP9.5 positive nerve fibers in the proximal liver tissue of patients with alveolar echinococcosis increases, suggesting that PGP9.5 positive nerve is involved in the pathogenesis of AE, and its specific role needs further study.

Recommendation of the best site based on the distribution pattern of extramuscular and intramusular nerves for gluteal muscle injection / Recomendación del mejor sitio para la inyección del músculo glúteo basado en el patrón de distribución de los nervios extramusculares e intramusculares

To reveal the extra- and intramuscular nerve distribution patterns of the gluteus maximus, medius, and minimus, and to provide guidance for gluteal muscle injection in order to avoid nerve injury. Ten adult and 10 child cadavers were used. The superior and inferior gluteal nerves innervating the gluteus maximus, medius, and minimus were dissected, exposed, and sutured in-situ on the muscle. The three gluteal muscles were removed, and the distribution patterns of the intramuscular nerves were revealed by modified Sihler's nerve staining. The nerve distribution pattern was returned to the corresponding position in the body, and the patterns in the four quadrants of the buttock were analyzed. There were 3-12 extramuscular nerve branches of the gluteus maximus, medius, and minimus. After entering the muscle, these nerve branches arborized and anastomosed to form an arc-shaped, nerve-dense zone. The nerve distribution was most dense in the inferomedial region of the superolateral quadrant and the inferolateral region of the superomedial quadrant of the buttocks. The nerve distribution was relatively dense in the inferolateral region of the superolateral quadrant, and the medial region of the inferomedial quadrant. An arc-shaped, nerve-sparse zone in the superolateral and superomedial quadrants near the lower iliac crest accounted for about two-fifths of the two quadrants' limits. The arc-shaped, nerve-sparse zone in the superolateral quadrant is the preferred injection site, and the superomedial quadrant near the lower iliac crest is also recommended as a gluteal intramuscular injection region, free from nerve injury.

El objetivo de este trabajo fue revelar los patrones de distribución nerviosa extramusculat e intramuscular de los músculos glúteo máximo, medio y mínimo y proporcionar orientación para la inyección en la región glútea con el propósito de evitar lesiones nerviosas. Se utilizaron diez cadáveres adultos y diez niños. Los nervios glúteos superior e inferior que inervan a los músculos glúteo máximo, medio y mínimo fueron disecados, expuestos y suturados in situ en el músculo. Se extirparon los tres músculos glúteos y se revelaron los patrones de distribución de los nervios intramusculares mediante la tinción nerviosa de Sihler modificada. El patrón de distribución nerviosa se devolvió a la posición correspondiente en el cuerpo y se analizaron los patrones en los cuatro cuadrantes de la región glútea. Se encontraron 3 a 12 ramos nerviosos extramusculares de los músculos glúteo máximo, medio y mínimo. Después de ingresar al músculo, estas ramas nerviosas se arborizaron y anastomizaron para formar una zona densamente nerviosa en forma de arco. La distribución nerviosa fue de mayor densidad en la región inferomedial del cuadrante superolateral y en la región inferolateral del cuadrante superomedial de la región glútea. La distribución nerviosa era relativamente densa en la región inferolateral del cuadrante superolateral y en la región medial del cuadrante inferomedial. Una zona en forma de arco en los cuadrantes superolateral y superomedial y con escasa inervación, cerca de la cresta ilíaca representaba una parte de los límites de los dos cuadrantes. La zona de poca inervación en forma de arco en el cuadrante superolateral es el sitio de inyección preferido, y el cuadrante superomedial próximo a la cresta ilíaca también se recomienda como una región de inyección intramuscular glútea, libre de lesión nerviosa.

Clinical application of resorbable plate in orbital fracture surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical application of resorbable implants in orbital fracture repair surgery.<p>METHODS: A retrospective analysis of 48 eyes in 48 cases of orbital fracture, all patients were treated with resorbable implants for orbital fracture repair. During operations we exposed fully fracture defect range and returned the tissues that entered the paranasal sinus. A resorbable implant was trimmed to proper sizes according to the fracture defect range and fixed with 2 absorbable screws. The accuracy of plate positioning of the reconstructed orbit and the practicability of clinical use of resorbable implant were judged by the ophthalmic examination and computed tomography(CT)scan before and after operation. <p>RESULTS: All the patients completed the operation successfully and had no serious complications during or after surgery. All the patients had a good anatomical restoration by the postoperative CT scan. One year re-examination after operation, among 18 eyes with limitation of extraocular muscle movement(EOM)before operation 1 eye(6%)with limitation of EOM improved after surgery,17 eyes(94%)with limitation of EOM got cured. Among 30 cases with diplopia before operation 12 cases(40%)with diplopia improved after surgery, 18 cases(60%)with diplopia got cured. Among 32 eyes with enophthalmos before operation 10 eyes(31%)with enophthalmos improved after surgery, 22 eyes(69%)with enophthalmos get cured. Among 40 eyes with suborbital skin numbness before operation 33 eyes(82%)with suborbital skin numbness improved after surgery, 7 eyes(18%)with suborbital skin numbness got cured. Only one eye got lower eyelid entropion after surgery and was resolved by the second correction of entropion.<p>CONCLUSION: The resorbable implant can repair the fractures of orbital wall well. It is a better material of orbital fracture repairment.

Topography and Morphology of the Medial Pterygoid Muscle for the Surgical Approach of the Mandibular Ramus / 체질인류학회지

It has been known that the medial pterygoid muscle influences the mandibular functions related to mandibular movements. In addition, the muscle bundle of the medial pterygoid muscle influences the stability of a complete denture. Therefore, the topography of this muscle is clinically important. However, researches on the clinical anatomy related to the insertion area, and innervation, of this muscle were rare. Therefore, authors investigated the morphological and topographic characteristics of the medial pterygoid muscle by dissection of 31 Korean cadavers. The following are the results:The middle portion of the medial pterygoid muscle was the longest with the length of 59.4 degrees +/-7.1mm, and upper one third of the total length of the muscle was composed of tendon. When comparing the morphology of the insertion area of the medial pterygoid muscle and the masseter muscle in the mandibular angle region, there was no difference of the length of the insertion from the gonion to the superior margin of the insertion on the ramus. However, the length from gonion to the anterior margin of the insertion on the ramus in the masseter case was twice as long as the medial pterygoid muscle case. Insertion of the medial pterygoid was morphologically classified into six groups based on the insertion pattern and the mylohyoid groove. Type V, which the muscle fibers in the insertion of the medial pterygoid muscle were divided and did not invade the mylohyoid groove, were found the most (26.6%). Most of pterygoid branch of trigeminal nerve entered the medial pterygoid muscle through the posterior one third area or the posterior marginal area. The average length between hamulus and the region where the pterygoid branch of mandibular nerve entered the medial pterygoid muscle was 10.1mm. In conclusion, the anatomical relationship between the medial pterygoid muscle and the surrounding structures will be able to provide useful data for clinical applications.

Comparative Nerve Distribution of the Pylorus in Infantile Hypertrophic Pyloric Stenosis

Infantile hypertrophic pyloric stenosis (IHPS) a common childhood disorders characterized by nonbilious projectile vomiting, an olive shaped mass in the right upper quadrant of the abdomen and visible gastric peristaltic wave in the upper abdomen. Its etiology and pathogenesis are not clear but abnormal nerve distribution of the pylorus has been postulated2-6. We performed immunocytochemical staning to the pyloric muscle from 10 IHPS and 3 controls patients, utilizing specific monoclonal antibody to NCAM(neural cell adhesion molecule). In IHPS patients, the number of NCAM protein immunoreactive nerve fibers were less than that in normal subjects. Auerbach myenteric plexuse was well developed and interbundle nerve plexuse was present but nerve fibers supplying individual muscle cells in smooth muscle bundles were poorly developed. These results indicate reduction of innervation in smooth muscles in IHPS patients that possibly contributes to the pathogenesis of IHPS.

Study on neural and vascular distribution in triceps surae of rabbits / 第二军医大学学报

Objective:To study the neural and vascular distribution in the triceps surae of rabbits for reconstructing the muscles of motor function.Methods: Triceps surae on one side was stained with the standard method of Sihler’s nerve staining, and the blood vessels on the other side were injected with a mixture of 30% barium sulfate and gelatin, and then they were X-photographed. The resulting pictures were compared to study the intramuscular nerve and blood vessel distribution. Results: Tricep surae on the first side became transparent or semi-transparent, and its shape kept intact after being stained. The intramuscular nerve branches were clearly visualized after being stained. The muscle was divided into 3 neuromuscular compartments and Lateral gastrocnemius (LG) was subdivided into 3 subunits. The intramuscular vascular configuration on the other side was also clear on soft X-ray films. The distribution maps of the nerves and blood vessels were grossly consistent.Conclusion: Sihler’s nerve staining is able to show the original 3-dimensional picture of the intramuscular nerve branches in the triceps surae of rabbits and can be used to observe the relation between the blood vessels and nerves in the muscle in combination with intramuscular angiography. According to the neurovascular distribution, tricep surae of rabbits can be divided into different subunits (compartments) as independent function units. The design and application of the subunit as a compartment can meet the need of muscular function after transplantation.