Comprehensive Review of Thyroid Embryology,Anatomy,Histology,and Physiology for Surgeons

Emil Theodor Kocher and Theodor Billroth pioneered the surgical management of thyroid disease. Their surgical techniques, knowledge of thyroid anatomy, embryology, histology, physiology, and antisepsis practices transitioned a life-threatening operation to one with acceptable morbidity. The modern head and neck surgeon should have a meticulous surgical technique, combined with a thorough understanding of thyroid embryology and anatomy that is central to the understanding and treatment of the different disease processes of the thyroid gland and the consequences of thyroid gland surgery. In this manuscript we will be examining thyroid gland embryology, anatomy, histology, and physiology that is essential to the practicing thyroid surgeon.

The rat eustachian tube:Anatomical, histological, and radiological features

Purpose: This study investigated the anatomical and histological characteristics of the rat Eustachian tube(E-tube)and the feasibility of Eustachian tubography in a rat model.Materials and methods: Fifteen male Wistar rats were used in this study, and the bilateral E-tubes of each rat were examined. Ten E-tubes were used for anatomical studies, another ten for histological analysis, and the other ten for Eustachian tubography. Five rats were euthanized and decapitated, and ten E-tubes were dissected to describe the anatomy of the E-tube. Ten E-tube specimens obtained from five other rats were sectioned to investigate Etube histology. Eustachian tubography was performed on the bilateral E-tubes of the other five rats using the trans-tympanic approach.Results: The rat E-tubes consisted of bony and membranous parts. Cartilage and bone tissue covered only the bony part. The E-tubes’ mean diameter and overall length were 2.97 mm and 4.96 mm, respectively. The tympanic orifices’ mean diameter was 1.21 mm. The epithelium of E-tubes was mainly composed of pseudostratified ciliated and goblet cells. Eustachian tubography was successfully performed on both sides of the E-tube for each rat.The technical success rate was 100%, the average running time was 4.9 min, and no procedure-related complications occurred. On tubography images, the E-tube, tympanic cavity, and nasopharynx could be identified because of the visualization of bony landmarks.Conclusion: In this study, we described the anatomical and histological features of rat E-tubes. With the aid of these findings, E-tube angiography was successfully performed using a transtympanic approach. These results will facilitate further investigation of E-tube dysfunction.

Colonoscopy in rats:An endoscopic,histological and tomographic study

AIM:To describe colon anatomy with colonoscopy and computed tomography(CT) to develop a rat model for future studies of therapeutic colonoscopy.METHODS:Eighteen male Sprague-Dawley rats,on average 400-420 g,underwent total colonoscopy,CT and histological examination.Colonoscopy was performed after bowel preparation with a baby upper gastrointestinal endoscopy with an outer diameter of 6.7 mm.CT obtained a 3D image of total colon after a rectal enema with radiological contrast.Macroscopic and microscopic examinations were examined with a conventional technique(hematoxylin and eosin).Colonic wall thickness,length and diameter measurements were taken from the anus,3,7,14 and 20 cm from the anal margin.RESULTS:The median colonoscope depth was 24 cm(range 20-28 cm).Endoscopic and tomographic study of colon morphology showed an easy access with tubular morphology in the entire left colon(proximal left colon and rectum).Transverse colon was unapparent on colonoscopy.Right colon,proximal to the splenic flexure,was the largest part of the colon and assumed saccular morphology with tangential trabecula.Radiological measurements of the colonic length and diameter substantiate a subdivision of the right colon into two parts,the cecum and distal right colon.In addition,histological measurement of the colonic wall thickness confirmed a progressive decrease from rectum to cecum.The muscular layer was thinner in the proximal left colon.CONCLUSION:The combination of colonoscopy,tomography and histology leads to a better characterization of the entire colon.These data are important for deciding when to perform endoscopic resections or when to induce perforations to apply endoscopic treatments.

Parathyroid Embryology,Anatomy,and Pathophysiology of Primary Hyperparathyroidism

Unregulated overproduction of parathyroid hormone (PTH) from an abnormal parathyroid gland is the origin of primary hyperparathyroidism (PHPT). Patients who have an elevated serum calcium concentration have a problem in one or more of their parathyroid glands. To understand this disease state adequately and provide appropriate treatment, a thorough understanding of parathyroid embryology, anatomy, physiology, and pathophysiology is essential. In this manuscript, we review our current understanding of parathyroid gland embryology, anatomy, histology, physiology, and pathophysiology.

人与其他动物椎间盘解剖和组织学结构的比较医学研究进展

《2023年中国退行性脊柱健康报告》提到35岁以下患者的腰椎手术比例近年来显著增加,颈、腰椎病有年轻化的趋势。腰椎间盘突出症成为最困扰大众的疾病之一,研究椎间盘退变的发病机制和治疗方法有着重要的临床意义。目前人类椎间盘相关疾病多采用影像学诊断,由于脊柱的组织样本不易得到,实验动物以成本低、周期短、易获取的优点,成为替代性研究对象。人与其他动物的椎间盘有着结构和生理上的差异,比较人与其他动物的椎间盘结构和病理生理特点是研究的基础和关键。本文综述了不同动物椎间盘解剖与组织学结构相关研究文献并进行比较分析,分别从椎间盘的高度、椎间盘的几何形状、腰椎间盘软骨终板特征、椎间盘内细胞外基质组分4个角度比较了不同动物的椎间盘特点。分析结果表明:人类、袋鼠、绵羊、猪、大鼠在第六颈椎至第七颈椎处的椎间盘相对高度数值最接近;与人类腰部椎间盘几何形状最为相似的是小鼠腰椎间盘;与其他动物相比,人类的软骨终板最厚,细胞密度最小;猪纤维环内部的胶原蛋白与人类的差异最大,但猪、绵羊、兔、大鼠的髓核含水量与人类相比无差异性。在此基础上,本文还阐述了人与其他动物之间椎间盘退变的共性和差异表现,也对不同实验动物椎间盘退变的造模方法进行了总结,旨在为椎间盘退变研究选择合适的实验动物模型提供基础数据。

免疫炎症指标对三阴性乳腺癌腋窝淋巴结负荷的预测价值分析

背景腋窝淋巴结负荷对乳腺癌患者预后具有一定的提示作用,腋窝高淋巴结负荷(axillary high nodal burden,AHNB)提示预后较差,通常需行腋窝淋巴结清扫和辅助治疗。免疫炎症指标被证明与多种肿瘤预后相关,但其与三阴性乳腺癌腋窝淋巴结负荷有无关联尚不确定。目的分析免疫炎症指标对三阴性乳腺癌发生腋窝淋巴结转移和AHNB的预测价值,探讨腋窝淋巴结转移及高负荷的关联因素。方法收集本中心乳腺外科2010年1月—2023年1月收治的可手术的三阴性乳腺癌患者,分析中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板/淋巴细胞比值(platelet to lymphocyte ratio,PLR)、淋巴细胞/单核细胞比值(lymphocyte to monocyte ratio,LMR)、系统性免疫性炎症指数(systemic immune-inflammation index,SII)和泛免疫炎症指数(pan immune-inflammation value,PIV)等免疫炎症指标与三阴性乳腺癌患者腋窝淋巴结转移和AHNB的关联性。结果纳入408例三阴性乳腺癌患者,其中包括255例(62.5%)腋窝淋巴结阴性的患者,153例淋巴结阳性患者,后者包括78例(19.12%)腋窝低淋巴结负荷(axillary low nodal burden,ALNB)患者和75例(18.38%)AHNB患者。单因素Logistic回归分析提示,组织学分级、病理类型、肿瘤大小、脉管侵犯、NLR与三阴性乳腺癌发生腋窝淋巴结转移相关;年龄、组织学分级、肿瘤大小、脉管侵犯与发生AHNB相关(P>0.05)。多因素Logistic回归分析提示,三阴性乳腺癌发生腋窝淋巴结转移的独立关联因素是组织学分级G3(OR=2.081,95%CI:1.334~3.245)、肿瘤≥2 cm(OR=1.658,95%CI:1.083~2.539)、有脉管侵犯(OR=2.884,95%CI:1.562~5.324)。AHNB的独立关联因素是组织学G3(OR=2.391,95%CI:1.310~4.366)、肿瘤≥2 cm(OR=1.968,95%CI:1.130~3.427)、有脉管侵犯(OR=4.592,95%CI:2.433~8.665)。结论组织学分级、肿瘤大小、脉管侵犯对三阴性乳腺癌患者的腋窝淋巴结转移和负荷水平具有一定的提示作用,而免疫炎症指标对腋窝淋巴结负荷的预测能力有限。

新医学背景下医学形态学教学实验室建设构想与实践

瞄准健康中国战略和新医学建设的需要,中国科学技术大学生命科学与医学部建立了医学实验教学中心。医学形态学主要包括人体解剖学、组织学与胚胎学、病理学等基础医学课程。医学形态学课程描述性语言相对较多,相关知识点之间联系不够紧密。为弥补理论教学不足,实验教学不容忽视。新形势下,医学形态学教学实验室作为实验教学的重要环节,其构想与建设,显然是医学教育教学改革的重要环节。文章通过对建设初期设想和具体教学实践相结合,经过不断教学反思,结合虚拟和现实资源,通过多资源融合、课程内容融合、信息化手段等措施,为努力打造内外兼修的医学形态学教学实验室开展了一定的实践与探索。

大口黑鲈肠道结构及分区特性

为了解大口黑鲈肠道的形态结构及分区特点,采用解剖学、石蜡切片—显微技术,研究大口黑鲈肠道形态及组织学结构特征。大口黑鲈肠道呈“S”形盘曲,比肠长为0.76±0.06。HE染色显示肠道组织由黏膜层、黏膜下层、肌层及外膜构成。肠管直径、肠绒毛高度和数量由前到后渐减,前肠前段管径、绒毛高度最长,平均管径和高度分别为(5 043.60±108.69)μm和(1 479.86±45.84)μm;后肠末端管径、绒毛高度最短,分别为(2 877.10±57.21)μm和(790.28±62.57)μm。肌层厚度前、后肠比中肠厚,前、后肠肌层最厚值分别为(339.76±22.56)μm和(251.59±26.94)μm,中肠肌层最厚值为(199.91±25.16)μm(P<0.05)。前肠末端的组织学结构特征,如肌层厚度、绒毛高度等与中肠结构特征相似。AB-PAS染色结果显示,大口黑鲈后肠杯状细胞密度显著高于前肠杯状细胞的密度(P<0.05)。该研究丰富了对大口黑鲈的肠道生理学认识,并为其肠道分区提供参考。

Assessment of Knowledge,Attitude,and Practice in Forensic Dental Anatomy and Histology among Dental Practitioners

Dental anatomy and histology is one of the fundamental subjects and a key to comprehend the act of dentistry.Dental features such as tooth morphology and variations in shape and size play a vital role in the area of forensic odontology.Forensic odontology is a challenging field that involves the application of such knowledge of dental sciences in the identification of deceased individuals.The aim and objective was to assess and evaluate the knowledge,attitude,and practice regarding dental anatomy and histology in forensic investigation among dental practitioners.A cross-sectional survey was carried out among 217 dental practitioners from Maharashtra who in their day-to-day life may experience instances of forensic interest.The information was collected through telephonic interview by means of a pretested,close-ended questionnaire.In our stud%the general awareness about forensic odontology was found to be more among MDS dental practitioners than BDS dental practitioners.Overall,there is a lack of adequate legal knowledge and forensic practices among the dentists of Mumbai and Nagpur.However,the practitioners did have a positive attitude toward the field and were keen to learn more about it.The study is the first of its kind to be conducted in Maharashtra state of India regarding dental anatomy and histology with respect to forensic odontology.The dental practitioners were also aware about the dental anatomy and dental histology with respect to forensic investigation.

翼腭窝骨性结构的解剖学观测及其临床意义

目的 通过对翼腭窝及其通道骨性结构的测量为临床鼻颅底外科手术提供解剖学依据。方法 观察 30例 (6 0侧 )成人干性颅骨标本的翼腭窝及其通道的形态、大小 ,以及与毗邻结构的关系 ,并进行相关数据的测量。结果 翼管前口的宽度为 (3 5 3± 0 6 4 )mm ,后口的宽度为 (1 72± 0 5 0 )mm ,翼管的长度为 (14 74± 1 6 4 )mm。圆孔、蝶腭孔与前鼻棘的距离分别为 (6 2 90± 3 81)mm、(5 2 99± 4 95 )mm。2 2侧 (36 6 7% )位于蝶窦侧壁的外下方 ,11侧 (18 33% )位于蝶窦侧壁的外侧 ,9侧 (15 0 0 % )位于蝶窦底的下方 ,18侧(30 0 0 % )凸入窦内 ,翼管的顶壁与窦底壁的骨质融为一体 ,3侧 (5 0 0 % )翼管上壁缺如 ,与蝶窦相通。

腹腔镜下间隙解剖观察阴道三水平理论的关键解剖结构

目的:在宫颈癌腹腔镜手术中观察并验证阴道三水平理论的关键解剖结构,为盆腔器官脱垂患者手术提供依据。方法:20例宫颈癌患者C型子宫切除及盆腔淋巴结清扫手术时在腹腔镜下基于自然间隙暴露阴道三水平理论相关解剖结构,观察分析其结构特征及承力方向。结果:Ⅰ水平主要的坚韧韧带样结构是子宫骶韧带,其作用力方向在骶骨方向,起主要的顶端固定作用,而主韧带区域主要是血管淋巴管及周围疏松结缔组织,缺乏坚韧结缔组织结构,其连接于髂内血管系统;Ⅱ水平阴道侧方未发现坚韧结缔组织连接于盆筋膜腱弓,盆筋膜腱弓是盆膈上筋膜的边缘,与闭孔内肌筋膜交界,表面光滑,紧贴肛提肌于近阴道中下三分之一交界处融合于阴道筋膜。游离输尿管隧道时可以发现输尿管子宫动脉交叉附近位置前后壁均有致密结缔组织结构,即膀胱宫颈韧带,固定膀胱三角的两个侧角,起自宫颈阴道而终止于膀胱肌层。结论:肛提肌上方的盆底筋膜韧带支撑主要围绕阴道而成,而肛提肌以上的筋膜韧带结构呈两个平行面,可基于"阴道核心"和"双层吊床"解剖特征进行盆底重建手术设计。

广东客家人头面部形态特征的年龄变化

目的:研究广东客家人头面部形态特征随年龄增长而变化的规律。方法:对广东省梅州市客家人头面部形态进行了调查。其中,城市332人(城男151人,城女181人),乡村339人(乡男162人,乡女177人)。本次调查共采用38项头面部指标,并计算了12项头面部体质指数,初步分析了广东客家人头面部形态特征的年龄变化。结果:①随年龄增长广东客家人上眼睑皱褶率增加,蒙古褶率下降,眼裂趋于水平,鼻根变低,颧部更突出,眼色变浅,上红唇变薄,鼻翼宽的宽型率增加,中等型率下降。②广东客家人口裂宽、形态面高、鼻高、上唇皮肤部高度、容貌耳长、容貌耳宽、面颊皮褶与年龄呈正相关,额最小宽、面宽、下颌角间宽、眼内角间宽、眼外角间宽、唇高、红唇厚度、头围与年龄呈负相关。③广东客家人形态面、头面高指数与年龄呈正相关,头长高、额顶宽、颧额宽、口指数与年龄呈负相关。结论:广东客家人头面部形态特征随年龄增长呈现一定的变化规律。

黄斑篮子鱼消化道组织学和组织化学研究

采用HE和AB—PAS染色方法分别从组织学和组织化学方面对黄斑篮子鱼（Siganus oramin）消化道进行了研究。结果显示，黄斑篮子鱼口小，口咽腔不宽阔。上颌具细长、尖锐齿，下颌齿短，排列紧密。犁骨、腭骨和舌上无齿。鳃耙齿分叉，食道细长，胃部稍膨大，“V”型，幽门盲囊5～6条，肠长比为2．73。胃腺发达，为管状腺体，开口于胃小凹。幽门部粘膜褶高度降低，褶皱上开始出现类似肠绒毛结构。前肠均分布有许多长条形粘膜褶，空泡状杯状细胞丰富。依据AB—PAS的染色结果将该鱼}肖化道的粘液细胞分为4种类型：I型呈红色，Ⅱ型呈蓝色，Ⅲ型呈紫红色，Ⅳ型呈蓝紫色。食道以Ⅱ型和Ⅲ型为主，胃、肠道和幽门盲囊主要以Ⅱ型和Ⅳ型为主，后肠中Ⅱ型〉III型〉IV型，其中中肠和后肠Ⅱ型占总粘液细胞的比率最大。

上颌前牙与前磨牙唇侧骨壁厚度的CBCT测量分析

目的:通过锥形术射线计算机控制断层扫描(cone beam computed tomography,CBCT)测量分析,研究上颌前牙区及前磨牙区各个位点的唇侧骨壁厚度,为上颌前牙与前磨牙的种植修复提供一定的参考依据。方法:选取浙江大学附属口腔医院118例患者的CBCT资料,测量上颌前牙区和前磨牙区各受测牙在釉牙骨质界根方4 mm处(位点1)和牙根中点处(位点2)的唇侧骨壁在与牙长轴垂直方向上的厚度。结果:中切牙、侧切牙和尖牙的唇侧骨壁厚度大多集中在0.5～1.5mm,其在位点1处唇侧骨壁厚度不足1.0 mm的分别达到了44.1%、65.2%和45.8%,位点2处唇侧骨壁厚度不足1.0 mm的分别达到了56.8%、89.8%和61.0%;而第一前磨牙和第二前磨牙的唇侧骨壁厚度大多在1.0 mm以上,分别达到了77.1%和94.1%(位点1),68.7%和94.1%(位点2)。结论:上颌前牙区唇侧骨壁厚度不足的情况普遍存在,建议使用CBCT等技术手段对上颌前牙区的种植患者进行严格的术前评估,选择合适的治疗方案,从而获得理想的美学效果与远期功能。

脉红螺消化系统的形态学研究

脉红螺消化系统由十二个器官组成。其消化管壁都由粘膜层、粘膜下层、肌层和外膜四层结构构成。作者对消化腺的细胞进行了较详细的描述,并利用组化方法测定消化腺细胞中含有的酶类。作者还对部分器官的超微结构进行了观察。

人工养殖曼氏无针乌贼生殖系统的解剖学与组织学研究

采用解剖学和组织切片技术对人工养殖曼氏无针乌贼(Sepiella maindroni)成熟个体的生殖系统进行观察。曼氏无针乌贼为雌雄异体,其雄性生殖系统包括精巢、输精管、精囊(精囊I、精囊II、精囊II的桃核体和精囊III)、副性腺和精荚囊;雌性生殖系统包括卵巢、输卵管、输卵管腺以及附属腺(缠卵腺和副缠卵腺)。光镜下,精巢属于小叶型,由精巢壁和实质部分组成,实质部分由精小叶和小叶间质构成;卵巢呈葡萄串状,由卵巢壁、不同时相的卵母细胞和卵巢基质构成。

双团棘胸蛙消化道解剖学及组织学观察

双团棘胸蛙的肠分为十二指肠、回肠、大肠和直肠.口腔顶壁为复层纤毛上皮,底壁为复层扁平上皮,食道为假复层纤毛柱状上皮,胃和肠均为单层柱状上皮,泄殖腔为复层扁平上皮.各段皱褶丰富,仅食道和胃本体有巨型的树枝状皱褶.口腔顶壁、食道、胃及泄殖腔有发达的腺体,肠的各段无多细胞腺体分布但杯状细胞丰富,其中大肠最少,直肠部最多.在口腔顶壁、食道及十二指肠均有丰富的巨型杯状细胞,胃各部及泄殖腔均无杯状细胞分布.

牦牛适应青藏高原环境的组织解剖学研究进展

高寒、缺氧和牧草营养短缺是高原地区主要的生态限制因子,高原土著动物在长期的适应进化过程中形成了独特的低氧适应策略。牦牛对青藏高原低氧的适应,主要通过特定的生理、代谢及解剖学特征表现出来。近年来,随着低氧环境下从器官到细胞器水平研究的不断深入,牦牛高寒低氧适应在基因水平上的成果较多,但受分析方法和样本数量的限制,低氧适应的候选基因不尽相同,其明确的生理生化表型仍不是很确定。本文从牦牛对氧的运转和利用、高寒胁迫的适应以及应对牧草营养短缺等组织解剖学形态方面的适应性研究进行综述,以期为高原畜牧业的发展、高原动物和人群的疾病防治及揭示高原人群的生理生态适应机制提供重要的借鉴作用。

平鲷消化系统形态学、组织学及组织化学研究

对平鲷（Rhabdosargus sarba）消化系统结构进行观察，采用HE和AB—PAS染色方法分别从组织学和组织化学方面进行研究。结果表明，平鲷口咽腔宽大，具不同类型发达齿；食道粗短，内表面分布纵行粘膜褶；胃分为贲门、胃盲囊和幽门，贲门胃小凹和胃腺最多，胃盲囊厚度最大；肠道具丰富粘膜褶；幽门与前肠交界处有幽门盲囊8—10个。肝小叶分界不明显，管状结构丰富。胰腺腺泡和胰岛分布于肝脏内大静脉周围，腺泡细胞染色深蓝色。根据AB—PAS染色结果将消化道粘液细胞分为4型，Ⅰ型为红色，Ⅱ型为蓝色，Ⅲ型为紫红色，Ⅳ型为蓝紫色。胃部可见极少量Ⅱ型及Ⅲ型粘液细胞，其余部位均以Ⅱ型粘液细胞为主。结果表明，粘液细胞消化系统不同部位的分布密度与对应部位消化功能相关。

南海北部野生斑节对虾卵巢解剖结构及组织学的研究

运用解剖学、组织学观察,研究了南海北部野生斑节对虾卵巢结构及组织学,结果表明,(1)卵巢的解剖结构:卵巢可分为1对前叶、8对侧叶、1对向后延伸的尾叶,成熟卵巢8对侧叶以第2对侧叶最大,第6对侧叶末端可见一半透明小管穿过所对应的胸腔体壁通到同侧第3对步足基部的产卵孔。(2)卵巢的组织学结构:卵巢由卵巢壁、中央卵管和卵室组成;卵巢壁由外向内依次由上皮层、疏松结缔组织、基膜和分化上皮构成;中央卵管分化出大量卵原细胞;卵室内含有不同发育阶段的卵母细胞。