Clinical analysis of delayed cardiac tamponade in atrial fibrillation patients with left atrial appendage closure / 中华急诊医学杂志

Objective:To investigate the relationship of delayed cardiac tamponade (CT) after left atrial appendage closure (LAAC) in atrial fibrillation (AF) patients and implanted occluders and adjacent anatomical structures.Methods:This study was a retrospective study. Thirteen AF patients with LAAC complicated with delayed CT and with concurrent emergency pericardiocentesis drainage in Zhoupu Hospital, Shanghai University of Medicine & Health Sciences from August 2016 to June 2021 were selected. The follow-up time was (16±12) months. The clinical data of these patients were retrospectively analyzed, including the relationship between the left atrial appendage and pulmonary artery, vein anatomy by left atrium computed tomography angiography (CTA) before and after LAAC.Results:Thirteen patients with delayed CT were treated by pericardiocentesis and drainage after LAAC and aged (72.1±8.3) years, and 7 patients were male, Six patients received cryoablation simultaneously. The classification types of left atrial appendage included cauliflower and chicken wing types were 8 and 5 respectively. The seal plate diameter of the lobe-and-disc devices was (29.5±2.8)mm; 10 patients had cardiac CTA reviewed. The occluder was attached to pulmonary artery in 8 patients, attached to left superior pulmonary vein only in one patient, and attached to pulmonary artery and left superior pulmonary vein in one patient. The prognosis was good except one patient who died 2 days after LAAC.Conclusions:Delayed CT after LACC is closely related to the location of left atrial appendage adjacent to pulmonary artery and left superior pulmonary vein, and is related to larger occluder and anchor hook.

Ultrasound anatomy and needle-knife insertion approach of common tendon lesions in knee osteoarthritis based on meridian sinew theory / 中国针灸

OBJECTIVE@#To explore the ultrasonic anatomical characteristics and needle-knife insertion approach of common tendon lesions in knee osteoarthritis (KOA), so as to provide the references for accurate release of KOA by needle- knife along tendon lesions based on meridian sinew theory.@*METHODS@#Sixty patients with one-knee KOA were selected. High-frequency musculoskeletal ultrasound was used to collect sonograms at the anatomical positions of "Hedingci" "Binwaixia" "Binneixia" and "Yinlingshang". The anatomic levels were marked on the sonograms. The anatomic levels and sonographic features of lesions were compared and analyzed, and the relevant data of needle-knife simulation approach was measured.@*RESULTS@#The "Hedingci" lesions were mainly located at the attachment of quadriceps tendon to patella and suprapatellar bursa. The "Binwaixia" and "Binneixia" lesions were mainly located at the attachment of retinaculum patellae laterale and retinaculum patellae mediale to patella and infrapatellar fat pad. The "Yinlingshang" lesions were mainly located at the attachment of goose foot tendon to medial tibial condyle and bursa of goose foot. With "Hedingci" as an example, when the needle-knife entry point was 1 cm above the patella, the attachment of quadriceps tendon to patella was released, and the average depth of needle-knife was (3.60±0.10) cm, and the needle body was perpendicular to the skin. The average depth of needle-knife for releasing suprapatellar bursa was (2.35±0.17) cm, and the needle body was 45° towards head.@*CONCLUSION@#The musculoskeletal ultrasound could clearly show the local detailed anatomical level, ultrasonic characteristics and anatomical level of common tendon lesions of KOA, and could improve the accuracy of needle-knife along tendon lesions with non-direct vision, which has important reference value for needle-knife medical standardization and standardized operation.

The anatomical structure of fused renal pyramid and its imaging findings in ultrasound and computed tomography / 中华泌尿外科杂志

Objective@#To analyze the anatomical structure and distribution of the fused renal pyramid (FRP) in cadaveric kidney, and discuss its appearances by CT and ultrasonic examinations.@*Methods@#From June 2018 to September 2018, 108 cadaveric kidneys were proceeded for regional anatomy. The distribution and anatomical manifestations of FRP was recorded. The renal pyramid was sliced and HE stained to explore the vascular distribution in FRP. From October 2018 to January 2019, ultrasound imaging data of 112 patients with 224 kidneys were collected, including 60 males and 52 females, age (39.0±15.1), ranging from 16 to 73 years old. The renal imaging data of 89 patients and 178 patients with enhanced renal CT were collected, including 48 males and 41 females. Age (45.4±13.6), ranging from 23 to 69 years old. The imaging findings of FRP in ultrasound and enhanced CT was summarized.@*Results@#In cadaver kidneys, the proportion of FRP in upper and lower calyces was 68.6% (74/108) and 64.8% (70/108), respectively, higher than that in middle calyces 34.3% (37/108). In the middle group, the incidence of mild fusion was 39.0% (16/41) and severe fusion was 48.8% (20/41). The incidence of fusion of two renal pyramidal structures was 90.2% (37/41). HE staining showed that the boundary between the artery in FRP and the surrounding renal pyramidal was unclear, and the protection of connective tissue was lacking. In Ultrasound, the FRP presented as a large trapezoidal hypo-echoic area with red and blue color signals in doppler mode. In ultrasound, the incidence of FRP was 18.8% (42/224). In enhanced CT, the FRP presented as enhanced cord-like high density shade in large low density area in cortex phase. In enhanced CT, the incidence of FRP 27.5%(49/178).@*Conclusions@#The FRP is a common structure in human kidney. The arteries localize within the FRP and are absence of sufficient connective tissue protection which are different from normal arteries. Ultrasound and enhanced CT have recognition ability for FRP.

The anatomical structure of fused renal pyramid and its imaging findings in ultrasound and computed tomography / 中华泌尿外科杂志

Objective To analyze the anatomical structure and distribution of the fused renal pyramid (FRP) in cadaveric kidney,and discuss its appearances by CT and ultrasonic examinations.Methods From June 2018 to September 2018,108 cadaveric kidneys were proceeded for regional anatomy.The distribution and anatomical manifestations of FRP was recorded.The renal pyramid was sliced and HE stained to explore the vascular distribution in FRP.From October 2018 to January 2019,ultrasound imaging data of 112 patients with 224 kidneys were collected,including 60 males and 52 females,age (39.0 ± 15.1),ranging from 16 to 73 years old.The renal imaging data of 89 patients and 178 patients with enhanced renal CT were collected,including 48 males and 41 females.Age (45.4 ± 13.6),ranging from 23 to 69 years old.The imaging findings of FRP in ultrasound and enhanced CT was summarized.Results In cadaver kidneys,the proportion of FRP in upper and lower calyces was 68.6％ (74/108) and 64.8％ (70/108),respectively,higher than that in middle calyces 34.3％ (37/108).In the middle group,the incidence of mild fusion was 39.0％ (16/41) and severe fusion was 48.8％ (20/41).The incidence of fusion of two renal pyramidal structures was 90.2％ (37/41).HE staining showed that the boundary between the artery in FRP and the surrounding renal pyramidal was unclear,and the protection of connective tissue was lacking.In Ultrasound,the FRP presented as a large trapezoidal hypo-echoic area with red and blue color signals in doppler mode.In ultrasound,the incidence of FRP was 18.8％ (42/224).In enhanced CT,the FRP presented as enhanced cord-like high density shade in large low density area in cortex phase.In enhanced CT,the incidence of FRP 27.5％ (49/178).Conclusions The FRP is a common structure in human kidney.The arteries localize within the FRP and are absence of sufficient connective tissue protection which are different from normal arteries.Ultrasound and enhanced CT have recognition ability for FRP.

The development of spinal cord injuries without radiologic abnormality in chlidren / 国际儿科学杂志

Spinal cord injuries without radiologic abnormality (SCIWORA) refers to the violence caused by spinal cord injury and radiological examination such as X-ray or CT no visible spine fracture and dislocation,abnormal findings,19％ to 34％ of children traumatic spinal cord disease.After SCIWORA occurs,there was no fever or low heat,and the progress period was short,and the disease of the spinal cord was more than normal,and the disease was less subjective.It should be identified with acute myelitis and other diseases.To improve pediatrician's understanding of SCIWORA,this review summarizes the etiology,clinical characteristics and imaging manifestations of SCIWORA in children in recent 10 years.

Effect of NPK, Bio and Organic Fertilizers on Growth, Herb Yield, Oil Production and Anatomical Structure of (Cymbopogon citratus, Stapf) Plant

This study was carried out at the Department of Ornamental Horticulture, Faculty of Agriculture, Cairo University, in Egypt during the two successive seasons of 2015 and 2016. The experiment was designed using a complete randomized blocks design. Eco-friendly agriculture has its priority for safe products, so the objective of this study was to investigate the effect of bio fertilizers (Nitrobien and Phosphorien) at 1, 2 and 4 g/plant, compost and poultry manure at the rates of 5, 10 and 15 ton/ feddan (feddan= 4200 m2) as alternative to NPK (recommended dose), on growth and anatomical characters of Cymbopogon citratusplants. The results showed that the highest number of tillers per plant (49.07) and leaf area (83.99 cm2) obtained by the high rate of poultry treatment (15 ton/feddan) at the second cut in the second season. Thus the result obtained showed that the organic fertilizers had a better effect on total herb fresh and dry weights per plant than bio fertilizer treatments. The poultry manure at the rate of 10 ton/feddan resulted in the maximum total herb fresh yield with value 56.53 ton per feddan and total herb dry yield with value 16.94 ton per feddan, in the second season. The essential oil production per feddan at the first cut (in August) was more than at the second cut (in October) in both seasons. The highest oil yield per feddan was recorded in the second season by the poultry manure at the rate of 10 ton/feddan with values 82.26 and 51.85 l/feddan at the first and second cut, respectively. The anatomical study showed that the best thickness of the leaf sheath at the midrib region was due to treating the lemongrass plants by poultry at the rate of 10 ton/feddan. The increasing ratio was 16.7% compared to control. This treatment showed the best results in the total number of vascular bundles, in addition to the No. of large bundles and their dimensions. From these results, it could be recommended that poultry manure was the best treatment for lemongrass growth and getting highly clean yield.

Effects of soil water content on growth and accumulation of active ingredients of Notopterygium incisum / 中国中药杂志

To investigate the adaptive mechanism of Notopterygium incisum to water changes, one-year-old seedlings were used as test materials. The characteristics of growth, physiology, and active ingredients of N. incisum were studied at different soil water content by pot experiments. The result showed that: ①The water content at 100% field capacity is conducive to the growth and accumulation of biomass of N. incisum. The leaf length, petiole length, petiole diameter, root diameter, root length and biomass of underground dry of N. incisum were all significantly increased at the 100% field capacity, and they slightly declined at 70% field capacity. 20% field capacity could not provide the necessary water to growth of N. incisum, all N. incisum withered and died. ②With the extension of moisture treatment time, the relative content of chlorophyll (SPAD) in leaves and the activity of peroxidase (POD) in rhizome showed a trend of increasing firstly, decreasing then; the tendency of activity of superoxide dismutase (SOD) in rhizome increased; the content of malondialdehyde (MDA) in rhizome decreased firstly and increased then;. For the late test, the SPAD value, the activity of POD and SOD in N. incisum at the 40% field capacity were lower than 70% field capacity and 100 field capacity, while the content of MDA in rhizome were higher than 70% field capacity and 100% field capacity. ③ At 70% field capacity, the active ingredients accumulated most in the N. incisum. At the 70% field capacity, the notopterol and isoimperatorinwerehigher than100 field capacity and 40 field capacity. In summary, the soil water content at 70%-100% field capacity would contribute to the growth and accumulation of active ingredients of N. incisum.

The value of cardiac MRI in diagnosis of Ebstein anomaly / 中华放射学杂志

Objective To evaluate the value of cardiac MRI in the diagnosis of Ebstein anomaly (EA). Methods Twenty patients from February 2014 to April 2017 with EA confirmed by surgery were enrolled into this study. The analysis in all patients was made according to preoperative cardiac MRI, 2D TTE and surgical data, including the changes of tricuspid valve leaflets, Carpentier classification, the size and function of atrioventricle, late Gadolinium enhancement, the total right/left-volume index and cardiopulmonary bypass time,etc.The numbers of apicaldisplaced leaflets and development condition of all the leaflets were compared using the R×C χ2among the three groups.With surgical results as the reference standard, the diagnostic accuracy of the two groups for the development condition of all the leaflets were evaluated. One-way ANOVA was performed to compare the differences of the apicaldisplaced distance of septal leaflet, using these three methods. Comparisons of the total right/left-volume index, surgery-related data between patients with or without late gadolinium enhancement were performed by independent t test.Results (1) The results in anatomicalstructures, such as distance of apicaldisplacedseptal leaflet,displacement of each leaflet and the Carpentier classification, showed nostatistical difference among MRI,2D TTE and operational findings. The leaflet dysplasia defined by MRI and 2D TTE areequivalent to surgically defined severe dysplasia, and surgically defined mild to moderate dysplasia can't be identified by the former two methods. The overall diagnostic accuracy of MRI and 2D TTE to identify leaflet dysplasia were 41.3%(19/46) and 34.7%(16/46), respectively.(2) Functional right ventricular volume index decreased in 1 case, normal in 8 cases, increased in 11 cases;functional right ventricula rejection fraction decreased in 15 cases. Six patients' left ventricular volume index decreased, 13 remained in normal range, 1 showed increased;left ventricula rejection fraction decreased in 14 cases. (3)LGE was identified in 8 patients and non-LGE in 12. Difference of the total right/left-volume index [(7.12 ± 4.06) vs. (3.84 ± 2.10), P=0.029] between two groups was statistically significant. However, there was no statistical difference in extracorporeal circulation time, aorticcross-clamping time, intubation time, ICU residence time and postoperative hospital staybetween the LGE and non-LGE groups.Conclusions Cardiac MRI can relatively accurately evaluate the apicaldisplacement of leaflets and the morphological changes of the atria and ventricles, as well as quantitatively evaluate the ventricular function, which can rovide references for clinical diagnosis and severity evaluation of EA.

Research on 3-D anatomical structure of the pancreas blood vessel / 重庆医学

Objective To explore the 3-D anatomical structure of blood vessel around the pancreas and its clinical significance.Methods Fifty objects were scanned by 64-slice CT of GE,the artery,portal vein,spleen vein,superior mesenteric vein and inferior mesenteric vein were 3-D reconstructed by Myrian system,and the scientific data were recorded.Results The artery,portal vein,spleen vein,superior mesenteric vein and inferior mesenteric vein were all reconstructed;the length of portal vein was(44.28±10.23)mm and the length of post-pancreas trunk was(32.13±7.08)mm;the angle between portal vein and spleen vein were classified into three types:the angle of type Ⅰ was90 °.30％of the inferior mesenteric vein fed into the spleen vein,56％fell into the superior mesenteric vein and 14％came into the the meeting point of the spleen vein and superior mesenteric vein.Conclusion The 3-D reconstruction of blood vessels around the pancreas can provide the anatomical basis for surgeon and reduce the risk of pancreatic surgery before operation.

Research progress of Shenshu (BL 23) / 中国针灸

In order to accurately understand the location of Shenshu (BL 23) and to improve the efficacy of acupuncture, a discussion is performed in this paper from aspects of acupoint function, anatomical structure, experiment research, clinical application, etc., hoping to provide benefit for future animal experiments and clinical selection of acupoint. The characteristics of rat spine is different from that of human, and the reliability and authenticity of acupoint location would be compromised if the anatomical characteristics of human was inflexibly applied on animals. "Shenshu" (BL 23) belongs to the bladder meridian of foot, and is located 1.5lateral to the lower border of the spinous process of the second lumbar vertebra. It is close to kidney, therefore deep insertion or repeated lifting and thrusting of needle would damage kidney and causes acupuncture accident. Therefore, to locate "Shenshu" (BL 23) in rat, the 6th lumbar vertebra is located firstly based on tuber coxae of rat, and then 11th thoracic vertebra is located by upward 4 vertebral bodies or locate 9th to 11th thoracic vertebra which are tight, and finally 2nd lumbar vertebra is located by downward 4 vertebral bodies, and "Shenshu" (BL 23) is 5 mm lateral to it. During clinical treatment, the technique should be gentle; oblique and outward insertion of needle is not allowed; the maximum depth of needle insertion is 1.6(approximately 4.30 cm); the vertical or oblique insertion with needle 45° towards spine is appropriate; the depth of 0.8 to 1.2(2.00 to 3.10 cm) is suitable. In cases of too thin or fat patients, the depth of needle insertion should be adjusted for safety.

Ancient and Modern Studies on Point Weiwanxiashu(Ex-B3) / 上海针灸杂志

Point Weiwanxiashu(Ex-B3)is an empirical acupoint for treating diabetes effectively. It pertains to extraordinary points in “The National Standard–Acupuncture Points” and is located at 1.5 cunlateral to the lower border of the spinous process of the eighth thoracic vertebra. This article explores the anatomical structure, functional characteristics, experimental study andclinical application of point Weiwanxiashu in order to provide a theoretical and experimental basis for clinical acupuncture point selection and treatment of diabetes.

Design and Application of Computer-assisted Distal Radial Anatomic Splint / 世界科学技术-中医药现代化

This study was aimed to design the distal radial anatomic splint which was more in line with the human anatomy and treatment characteristics using the computer design software 3D-MAX. According to ergonomic design principles, the forearm and wrist plaster splint were selected from volunteer models. Then, data of the plaster was measured and input into the computer for the design of the three-dimensional model of distal radial anatomic splint with 3D-MAX software. Finally, the blueprint was drawn for the factory to make the distal radial anatomic splint. The results showed that the distal radial anatomic splint was more in line with human anatomy, which did not require shaping in clinical using. It did not affect the biomechanical properties. And the patients never complain the squeez-ing discomfort of the splint. It was concluded that the three-dimensional model of the distal radial anatomic splint, which designed with 3D-MAX software, provided key parameters of the important part of the distal radial anatomic splint. Therefore, the produced splint was more in accordance with the human anatomy and the clinic treatment re-quirements. It avoided the loss of biomechanical properties after shaping, which was more convenient and effective in the clinical using. Its clinical promotion has a broad prospect.

Revisión anatómica del músculo bíceps femoral del canino / Anatomical review of canine biceps femoris muscle

El músculo bíceps femoral (BF) desempeña un rol fundamental en la biomecánica del miembro pelviano de los caninos, actuando en la flexoextensión de la articulación femorotibiorotuliana y la abducción del miembro. La evaluación correcta de su función es importante en la clínica veterinaria. Existen puntos controversiales entre los autores consultados acerca de la morfología de este músculo. El presente estudio tiene como objetivo discutir las distintas descripciones, reparando en las inserciones, la estructura e inervación del músculo. Se han realizado las disecciones bilaterales en 12 animales. La conservación de las piezas se realizó por inmersión en piletas, con una dilución de formol al 10 por ciento y ácido fenico al 4 por ciento en agua. Se utilizaron diferentes técnicas de abordaje al músculo en cuestión, para obtener distintas observaciones de las estructuras. Se halló que el músculo BF se origina por medio de dos cabezas, como queda implícito en su denominación, una cabeza craneal, más voluminosa y una cabeza caudal más pequeña. La primera originada en el ligamento sacrotuberal y en la superficie lateral de la tuberosidad isquiática. La cabeza caudal, se origina de la tuberosidad isquiática. Estas partes a pesar de hallarse estrechamente unidas se individualizan a nivel de los vientres musculares por medio de una delgada lámina de tejido conectivo que se extiende hasta el tercio distal del músculo. Respecto a la inervación, no se encontraron ramas del nervio glúteo caudal que inerven las partes al músculo.

The biceps femoris (BF) muscle plays a fundamental role in the biomechanics of the canine pelvic limb, acting in flexion ­ extension on knee articulation and abduction of the limb. Correct evaluation plays an important role in veterinary clinic. There are controversial issues among the authors consulted about the morphology of this muscle. The present study aims to discuss the various descriptions proposed for this muscle, considering insertions, structure and innervation. Bilateral dissections of 12 animals were carried out. Pieces conservation was done by immersion in pools with 10 percent formaldehyde and 4 percent carbolic acid in water. Different techniques were used in order to achieve various observations of muscle structures. It was found that BF muscle originates by two heads, as is implicit in its name, a craneal head, bulkier and a smaller caudal head. The first takes origin in the sacrotuberal ligament and the lateral surface of the ischial tuberosity. The caudal head, originates from the ischial tuberosity. These parts are closely linked but they can be identified at the level of the muscle bellies through a thin layer of connective tissue that extends to the distal part of the muscle. Regarding the innervation, we found that no caudal gluteal nerve branches reach this muscle.

Clinical Application of Neck Acupoints in Acupuncture / 针灸推拿医学（英文版）

This paper deals with the regional anatomy of the neck and some common acupoints. Acupoint Renying (ST 9) is taken as an example to elaborate the needling techniques and needling precautions of neck acupoints.

Anatomical Structures related to the Fixation Screw of Acetabular Cup in Total Hip Arthroplasty / 대한정형외과학회잡지

PURPOSE: This study was conducted to obtain anatomical data useful for transacetabular screw fixation in total hip arthroplasty. MATERIAL AND METHODS: Using 67 hemipelvises of Korean adults cadaver, the variations of external iliac vessels and obturator neurovascular bundle were observed. Forty-nine pelvises were used for the study of vulnerable structures to transacetabular screw inserted through 8 points and 25 pelvises for measuring the thickness of articular cartilage, cortical bone and cancellous bone at each screw penetration site. RESULT: The lengths of S-pin inserted at the inferior, posterior and posteroinferior portion of the acetabulum were more than 20mm. The length of entire bone and thickness of cortical bone measured at the mid point of the posterosuperior portion were longest. The external iliac vessels showed variations in their spatial relationship. At anterosuperior portion, the bone and muscle layer were very thin. The cortical bone of articular side became thicker from center to periphery. The thickness of cortical bone in the pelvic cavity showed different values at different sites. CONCLUSION: The authors suggest that the structural varieties can be injured when inserting the fixation screw of acetabular cup, and the thickness of cortical and cancellous bone may be useful in total hip replacement.

Microsurgical Study on the Circle of Willis in Korean Adults

Anatomical information of the circle of Willis is important in evaluating the various cerebrovascular diseases and surgical procedures. In this study, we present the anatomical structures of the circle of Willis in 54 Korean adults. The authors observed the morphological characteristics of the vasculature, the incidence of deficiency or incompleteness in the circle and clinical considerations. Measurements of the outer diameter and the length of each arterial segments were performed. Number and the origin of perforators from individual arteries were also oserved. Results of this study were as followings. Normal circles of Willis was oserved in 35 cases(64.81%) and abnormal circles in 19 cases(35.9%). 2) Incidental detection of aneurysms occurred in 5 cases(9.26%). 3) Frequency of anomalies were most commonly observed in the anterior communicating arteries(N=16, 20.37%). 4) A string-like artery was most frequently observed in te post-erior communicating artery(N=11, 20.37%). 5) Anomalous origin of the P1 segment of the posterior cerebral artery was observed, fetal type was in 12 cases(22.2%) and transitional typ was in 3 cases(5.55%) respectively. 6) The longest artery was the A1 segmnt of the anterior cerebral artery;the second, posterior communicating artery;the third, P1 segment of the posterior cerebral artery;and the shortest, anterior communicating artery. 7) The outer diameters of the basilar artery and internal carotid artery were almost, equal, A1 segment was half of ICA, AcoA was two thirds of A1 segment, PcoA was half of P1 segment and P1 segment was two thirds of the basilar artery. There were difference the anterior and posterior portion of the circle Willis. In the anterior communicating arteries, duplicated structure were frequently found. And also, inequality in the outer diameter of both A1 segmnts was observed. String-like arteries were often revealed in the posterior communicating arteries. Anomalous origin of P1 segments that may be persistant embryonic derivatives were frequently demonstrated in posterior cerebral arteries.