目的为颏下逆行带蒂岛状皮瓣修复颜面部皮肤软组织缺损的可行性及手术操作提供解剖学依据。方法解剖20例40侧福尔马林固定、颈总动脉灌注红色乳胶的成人头颈标本及4例灌注汞溴红、2例灌注亚甲蓝的新鲜成人头颈标本,测量相关动脉的外径...目的为颏下逆行带蒂岛状皮瓣修复颜面部皮肤软组织缺损的可行性及手术操作提供解剖学依据。方法解剖20例40侧福尔马林固定、颈总动脉灌注红色乳胶的成人头颈标本及4例灌注汞溴红、2例灌注亚甲蓝的新鲜成人头颈标本,测量相关动脉的外径及相关标志点之间的距离(以±s表示);观察两侧面动脉之间、面动脉与颞浅动脉及眼动脉终未之间的吻合情况,观察面动、静脉的行程要点及其与面神经各分支之间的位置关系,观察面静脉与相关静脉之间的吻合情况。结果颏下动脉、上唇动脉、下唇动脉起点处的外径(±s,以下同)分别为(1.42±0.30)mm、(1.34±0.35)mm、(1.34±0.27)mm。下唇动脉起点至颏下动脉起点直线距离为(35.19±9.18)mm,实际距离为(50.13±13.79)mm;上唇动脉起点至颏下动脉起点直线距离为(64.99±5.24)mm,实际距离为(92.09±8.73)mm。双侧面动脉之间、面动脉与颞浅动脉及眼动脉终末之间有丰富的吻合。在下颌缘水平,面动、静脉相贴伴行,面神经下颌缘支跨过其浅面;在下颌缘水平以上,面静脉行于面动脉后外约1 cm 处,面神经颊支经面静脉表面于面动、静脉之间入表情肌。面静脉通过内眦静脉与眼静脉、面深静脉与上颌静脉之间有良好的交通。结论以颏下逆行带蒂岛状皮瓣修复颜面部皮肤软组织缺损在解剖上具有可行性,建议皮瓣的旋转点选择在口角或口角以下平面。展开更多
Background： Both Parkinson＇s disease （PD） and multiple system atrophy （MSA） have associated sleep disorders related to the underlying neurodegenerative pathology. Clinically, MSA with predominant parkinsonism （...Background： Both Parkinson＇s disease （PD） and multiple system atrophy （MSA） have associated sleep disorders related to the underlying neurodegenerative pathology. Clinically, MSA with predominant parkinsonism （MSA-P） resembles PD in the manifestation of prominent parkinsonism, Whether the amount of rapid eye movement （REM） sleep without atonia could be a potential marker for differentiating MSA-P from PD has not been thoroughly investigated. This study aimed to examine whether sleep parameters could provide a method for differentiating MSA-P from PD. Methods： This study comprised 24 MSA-P patients and 30 PD patients, and they were of similar age, gender, and REM sleep behavior disorder （RBD） prevalence. All patients underwent clinical evaluation and one night of video-polysomnography recording. The tonic and phasic chin electromyogram （EMG） activity was manually quantified during REM sleep of each patient. We divided both groups in terms of whether they had RBD to make subgroup analysis. Results： No significant difference between MSA-P group and PD group had been tbund in clinical characteristics and sleep architecture. However, MSA-P patients had higher apnea-hypopnea index （AHI; 1.15 [0.00, 8.73]/h vs. 0.00 [0.00, 0.55]/h, P = 0.024） and higher tonic chin EMG density （34.02 [ 18.48, 57.18]% vs. 8.40 [3.11, 13.061%, P 〈 0.001 ） as compared to PD patients. Subgroup analysis found that tonic EMG density in MSA ＋ RBD subgroup was higher than that in PD ＋ RBD subgroup （55.04 [26.81,69.62]% vs. 11.40 [8.51,20.411%, P 〈 0.001 ）. Furthermore, no evidence of any difference in tonic EMG density emerged between PD ＋ RBD and MSA - RBD subgroups （P 〉 0.05）. Both disease duration （P = 0.056） and AHI （P = 0.051） showed no significant differences during subgroup analysis although there was a trend toward longer disease duration in PD ＋ RBD subgroup and higher AHI in MSA - RBD subgroup. Stepwise multiple linear regression analysis identified the presence of M展开更多
文摘目的为颏下逆行带蒂岛状皮瓣修复颜面部皮肤软组织缺损的可行性及手术操作提供解剖学依据。方法解剖20例40侧福尔马林固定、颈总动脉灌注红色乳胶的成人头颈标本及4例灌注汞溴红、2例灌注亚甲蓝的新鲜成人头颈标本,测量相关动脉的外径及相关标志点之间的距离(以±s表示);观察两侧面动脉之间、面动脉与颞浅动脉及眼动脉终未之间的吻合情况,观察面动、静脉的行程要点及其与面神经各分支之间的位置关系,观察面静脉与相关静脉之间的吻合情况。结果颏下动脉、上唇动脉、下唇动脉起点处的外径(±s,以下同)分别为(1.42±0.30)mm、(1.34±0.35)mm、(1.34±0.27)mm。下唇动脉起点至颏下动脉起点直线距离为(35.19±9.18)mm,实际距离为(50.13±13.79)mm;上唇动脉起点至颏下动脉起点直线距离为(64.99±5.24)mm,实际距离为(92.09±8.73)mm。双侧面动脉之间、面动脉与颞浅动脉及眼动脉终末之间有丰富的吻合。在下颌缘水平,面动、静脉相贴伴行,面神经下颌缘支跨过其浅面;在下颌缘水平以上,面静脉行于面动脉后外约1 cm 处,面神经颊支经面静脉表面于面动、静脉之间入表情肌。面静脉通过内眦静脉与眼静脉、面深静脉与上颌静脉之间有良好的交通。结论以颏下逆行带蒂岛状皮瓣修复颜面部皮肤软组织缺损在解剖上具有可行性,建议皮瓣的旋转点选择在口角或口角以下平面。
文摘Background： Both Parkinson＇s disease （PD） and multiple system atrophy （MSA） have associated sleep disorders related to the underlying neurodegenerative pathology. Clinically, MSA with predominant parkinsonism （MSA-P） resembles PD in the manifestation of prominent parkinsonism, Whether the amount of rapid eye movement （REM） sleep without atonia could be a potential marker for differentiating MSA-P from PD has not been thoroughly investigated. This study aimed to examine whether sleep parameters could provide a method for differentiating MSA-P from PD. Methods： This study comprised 24 MSA-P patients and 30 PD patients, and they were of similar age, gender, and REM sleep behavior disorder （RBD） prevalence. All patients underwent clinical evaluation and one night of video-polysomnography recording. The tonic and phasic chin electromyogram （EMG） activity was manually quantified during REM sleep of each patient. We divided both groups in terms of whether they had RBD to make subgroup analysis. Results： No significant difference between MSA-P group and PD group had been tbund in clinical characteristics and sleep architecture. However, MSA-P patients had higher apnea-hypopnea index （AHI; 1.15 [0.00, 8.73]/h vs. 0.00 [0.00, 0.55]/h, P = 0.024） and higher tonic chin EMG density （34.02 [ 18.48, 57.18]% vs. 8.40 [3.11, 13.061%, P 〈 0.001 ） as compared to PD patients. Subgroup analysis found that tonic EMG density in MSA ＋ RBD subgroup was higher than that in PD ＋ RBD subgroup （55.04 [26.81,69.62]% vs. 11.40 [8.51,20.411%, P 〈 0.001 ）. Furthermore, no evidence of any difference in tonic EMG density emerged between PD ＋ RBD and MSA - RBD subgroups （P 〉 0.05）. Both disease duration （P = 0.056） and AHI （P = 0.051） showed no significant differences during subgroup analysis although there was a trend toward longer disease duration in PD ＋ RBD subgroup and higher AHI in MSA - RBD subgroup. Stepwise multiple linear regression analysis identified the presence of M
