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Best washing method for oligoasthenospermic patients by evaluating DNA integrity by using comet assay study 用彗星测定法评价DNA完整性是少弱精子患者的最佳洗涤方法
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/NJCA.NJCA_7_23
B. Ganesan, Sumathy Govindarajan
Background: Sperm is more than just a mere transporter of paternal genetic information, although serving purposes other than conception. DNA integrity (DI) is regarded as a crucial aspect of semen quality and has great significance in predicting male fertility. Washing sperm is a form of preparation of sperm which is essential before processing intra-uterine-insemination since it removes chemicals from semen that might cause adversarial reactions in the uterus. During the process of washing, sperm gets separated from seminal fluid, which gradually improves the fertilizing capability of sperm, and numerous existing methods have faced complications with the determination of effective integrity in washing methods. The objective of the present study was to find the DI of the sperms through three washing methods that, include the density gradient (DG) method, swim up (SU) method, and magnetically activated cell sorting (MACS) method after the cryo-preservation (CP) for 3 months. Methodology: Semen samples were obtained from 40 oligoasthenospermic patients with progressive motility <32%, who underwent assisted reproductive technology procedure in Sumathi fertility center in Madurai between October 2021 and December 2021. Sperm washing is performed through three different mentioned techniques. The grades of the comet reflected five different classes from class 0 to class 4. These data were analyzed using one-way ANOVA test, and multiple comparisons were performed between these groups using Tukey's test. Results: The results showed a high level of normal sperm (68%) in the DG method than the SU (47%) and MACS (42%) sperm preparation techniques that specified by significant elevation (P < 0.001) of class 0 comet tails. Conclusion: It was observed that the DG method has the best and success rates for intracytoplasmic sperm injection and in vitro fertilization was relatively high.
背景:精子不仅仅是父亲遗传信息的转运者,尽管它的作用不是受孕。DNA完整性(DI)被认为是精液质量的一个重要方面,对预测男性生育能力具有重要意义。清洗精子是一种精子制备方式,在进行子宫内受精之前至关重要,因为它可以去除精液中可能导致子宫对抗性反应的化学物质。在洗涤过程中,精子从精液中分离出来,这逐渐提高了精子的受精能力,许多现有的方法都面临着洗涤方法中有效完整性的确定问题。本研究的目的是通过三种洗涤方法,包括密度梯度(DG)法、向上游动(SU)法和磁激活细胞分选(MACS)法,在冷冻保存(CP)3个月后找到精子的DI。方法:从40名进行性运动<32%的弱精子症患者中获得精液样本,这些患者于2021年10月至2021年12月在马杜赖的Sumathi生育中心接受了辅助生殖技术手术。精子清洗是通过上述三种不同的技术进行的。彗星的等级反映了从0级到4级的五个不同等级。这些数据使用单因素方差分析检验进行分析,并使用Tukey检验在这些组之间进行多重比较。结果:DG方法的正常精子(68%)水平高于SU(47%)和MACS(42%)精子制备技术,这表明0级彗星尾显著升高(P<0.001)。结论:DG法是卵母细胞浆内精子注射和体外受精的最佳方法,成功率较高。
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引用次数: 0
Early clinical exposure – Effectiveness and attitude among MBBS students 早期临床接触——MBBS学生的有效性和态度
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/NJCA.NJCA_241_22
Dini Mathew, B. Lakshmi Kantha, P. Dhanasekar
Background: In the traditional method, students learn theory without contacting patients in the initial part of MBBS. Early clinical exposure creates a scope for students to correlate basic science and clinical application. Hence, there is a need to study the effectiveness of different forms of early clinical exposure (ECE). The objectives of the study were to compare the knowledge acquired and attitude toward ECE by the students after different forms of ECE. Methodology: An observational study was done with 1st-year MBBS (n = 150) students. Based on the National Medical Council (Then Medical Council of India) II ECE document for undergraduate medical education programs, 10 topics were selected. The first six ECE sessions were conducted in the classroom, the next two at the hospital, and the last two virtually. Phase-validated structured multiple-choice questions (MCQs) and feedback were given to students before and after every ECE. The MCQ scores and feedback conducted in three forms were statistically analyzed. Results: There was a notable disparity in the mean between pre- and posttest. The mean scores of the virtual mode were better than the other two forms. As per the feedback analysis, most of the students observed ECE aid to clear conceptualization, critical thinking, and correlate anatomical basis in clinical cases. However, students also felt that it is too early to understand the topic in such detail in 1st year. Conclusion: This longitudinal study on ECE showed there is an increase in the knowledge and analytical skills of students. Hence, we recommend continuing ECE and to have a blended learning environment along with limited content to be included for a better outcome.
背景:在传统的方法中,学生在MBBS的初始阶段学习理论而不接触患者。早期临床接触为学生提供了将基础科学与临床应用联系起来的机会。因此,有必要研究不同形式的早期临床暴露(ECE)的有效性。本研究的目的是比较不同形式的幼儿教育后,学生对幼儿教育的知识和态度。方法:对一年级MBBS学生(n = 150)进行观察性研究。根据国家医学委员会(当时的印度医学委员会)II ECE本科医学教育项目文件,选择了10个主题。欧洲经委会前六次会议是在教室里进行的,接下来的两次是在医院进行的,最后两次是在网上进行的。在每次ECE之前和之后,向学生提供阶段性验证的结构化选择题(mcq)和反馈。对三种形式的MCQ得分和反馈进行统计分析。结果:测前与测后均数有显著差异。虚拟模式的平均得分优于其他两种模式。根据反馈分析,大多数学生观察到ECE有助于明确概念,批判性思维,并在临床病例中关联解剖基础。然而,学生们也觉得在大一的时候对这个话题有如此详细的了解还为时过早。结论:本纵向研究显示,学生的知识和分析能力有所提高。因此,我们建议继续进行欧洲经委会,并在有限的内容中加入混合学习环境,以获得更好的结果。
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引用次数: 0
Study of the histomorphology of human pineal gland 人类松果体的组织形态学研究
Q4 Medicine Pub Date : 2023-04-01 DOI: 10.4103/NJCA.NJCA_36_23
G. Singh, S. Sethi, Sudeepa Das, C. Mohapatra
Introduction: Histologically, the pineal gland shows pinealocytes, glial cells, and sometimes calcific concretions. Age-related changes in these three components have been reported by various workers. However, a statistically significant difference between the two sexes has not been found. This study was conducted to find out morphological and histological changes in human pineal gland in relation to advancing age and in relation to gender. Methodology: Forty pineal glands were taken for the study. The pineal glands were fixed in 10% formol saline and processed. Slides for microanatomical study were prepared and observed under microscope. Results: The size of the pinealocytes, size of their nuclei, and number of glial cells increased with age, but it was not significant. The number of pinealocytes decreased with age (P = 0.02). The size of the calcific concretions increased with age (P = 0.02). The difference in size of pinealocytes, nuclei of the pinealocytes, and the number of pinealocytes between genders was not significant. The difference in the number of glial cells between genders was significant (P = 0.03). The difference in the number of concentric lamellated type of calcific concretions between genders was significant (P = 0.03). Conclusion: A histological study of pineal gland in human is an area of interest for anatomists, radiologists, and neurologists. This study has paved a way for us for further research using immunohistochemistry and electron microscopy.
引言:组织学上,松果体显示松果体细胞、神经胶质细胞,有时还有钙化结核。不同的工人报告了这三个组成部分中与年龄相关的变化。然而,还没有发现两性之间有统计学上的显著差异。本研究旨在了解人类松果体的形态学和组织学变化与年龄的增长和性别的关系。方法:取40个松果体进行研究。将松果体固定在10%甲醛盐水中并进行处理。制备用于显微解剖学研究的载玻片并在显微镜下观察。结果:松果体细胞的大小、细胞核的大小和胶质细胞的数量随着年龄的增长而增加,但并不显著。松果体细胞数量随着年龄的增长而减少(P=0.02),钙化结核的大小随着年龄的增加而增加(P=0.02。神经胶质细胞的数量在性别之间存在显著差异(P=0.03)。钙化结核的同心片层类型在性别之间具有显著差异(P=0.03)。结论:人类松果体的组织学研究是解剖学家、放射科医生和神经学家感兴趣的领域。这项研究为我们进一步利用免疫组织化学和电子显微镜进行研究铺平了道路。
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引用次数: 0
Haglund's syndrome: Radiographical evaluation and its clinical relevance 哈格伦德综合征:影像学评价及其临床意义
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.4103/njca.njca_228_22
A. Sanga, R. Kushwaha, Rakesh Vidrohi, P. Sanga, Saikat Dey
Background: Haglund's syndrome an important cause of posterior heel pain presents with a prominent bony contour, a retrocalcaneal bursitis or achillis tendinitis these can also occur in isolation hence for the diagnosis of etiology of Haglund's disease certain radiological parameters and soft tissue parameters have been created to evaluate the anatomical variations which will assist in its exact diagnosis. Study aims to distinguish between the bony and soft tissue causes of Haglund's disease radiologically. Methodology: After Institutional ethical committee clearance an observational cross-sectional study was conducted with subjects coming to radiology OPD for X-ray foot with complains of posterior heel pain fulfilling inclusion and exclusion criteria were examined for X-ray lateral view of foot. Parameters like calcaneal inclination angle (CIA), Fowler Philip angle (FPA), parallel pitch line (PPL), Steffenson & Evenson angle (SEA) measured, posterior/calcaneal spur and posterior calcaneal step were noted. The data obtained was analyzed for mean, Standard deviation, sensitivity % and false negative %. Result: Sensitivity of the parameters were analyzed to find CIA, SEA &PPL to be 63.3%, 55% and 55% sensitive respectively. CIA could be assigned most sensitive but regarding soft tissue parameters none were sensitive. Conclusion: CIA, SEA & PPL were found to be sensitive among bony parameters. But none of the soft tissue parameters were sensitive radiologically highlighting a need for its correlation with clinical symptom in peripheral health centers where MRI is not available. Sensitivity of bony and soft tissue parameters were analyzed to find CIA, SEA & PPL to be sensitive. CIA could be assigned most sensitive among bony parameter but with regards to soft tissue parameters none were sensitive.
背景:Haglund综合征是引起足跟后部疼痛的重要原因,跟骨后滑囊炎或跟腱炎,这些也可以单独发生,因此为了诊断Haglund病的病因,已经创建了某些放射学参数和软组织参数来评估解剖变化,这将有助于其准确诊断。该研究旨在从放射学角度区分Haglund病的骨组织和软组织病因。方法:在机构伦理委员会批准后,对前来放射学门诊部接受X光足部检查的受试者进行了一项观察性横断面研究,这些受试者抱怨脚后跟疼痛,符合纳入和排除标准,并检查了足部X光侧视图。记录了跟骨倾角(CIA)、Fowler-Philip角(FPA)、平行节距线(PPL)、Steffenson&Evenson角(SEA)、跟骨后棘和跟骨后台阶等参数。对获得的数据进行平均值、标准差、灵敏度%和假阴性%分析。结果:CIA、SEA和PPL的敏感性分别为63.3%、55%和55%。CIA可以被认为是最敏感的,但关于软组织参数,没有一个是敏感的。结论:CIA、SEA和PPL对骨参数敏感。但在没有MRI的外围健康中心,软组织参数在放射学上都不敏感,这突出了其与临床症状相关性的必要性。分析骨和软组织参数的敏感性,发现CIA、SEA和PPL是敏感的。CIA可以被认为是骨参数中最敏感的,但就软组织参数而言,没有一个是敏感的。
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引用次数: 0
Implications of evidence-based anatomy 循证解剖学的意义
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.4103/njca.njca_199_22
Vasudha Kulkarni
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引用次数: 0
A rare case of two superior vena cava with two azygos veins in a cadaver 尸体中罕见的双上腔静脉伴奇静脉病例
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.4103/njca.njca_166_22
Archana Singh, Rakesh Gupta, Priya Adhaya, Aleeza Muneer
In embryonic life developmental malformation of thoracic veins can lead to anomalies of the Superior vena cava and major thoracic veins like Azygos system. Double superior vena cava and double azygos vein are rare congenital anomaly with the incidence of 0.3%. These types of congenital anomalies may or may not be presented with clinical symptoms. This case was noted during the routine cadaveric dissection of thoracic region and heart for medical students in department of Anatomy, we found double superior vena cava (persistent left superior vena cava) along with double (paired) azygos vein in a female cadaver. Right superior vena was formed by the union of right subclavian and right internal jugular vein which receives the arch of right azygos before it opened into the right atrium. Left superior vena cava was formed by the union of left subclavian and left internal jugular vein and it also receives the arch of left azygos vein before it entered into the right atrium. In present case coronary sinus was separated from left persistent superior vena cava and it opened in the persistent left superior vena cava. There was no communication between both the superior vena cava. On right side Azygos vein was normal and open into right superior vena cava. On the left side hemiazygos was in continuation with the accessory azygos vein and it also forming the arch and opened into persistent left superior vena cava. There were no other congenital anomalies present in the heart. These types of congenital anomalies extremely very rare where the left superior vena cava opens into the right atrium directly and coronary sinus opens in to this left superior vena cava. Majority of such types of cases remain asymptomatic. Some cases may be detected accidently during diagnostic or surgical procedures like cardiac angiography, cardiac catheterization, by- pass and dialysis or during autopsy or institutional cadaveric dissection.
胚胎期胸静脉发育畸形可导致上腔静脉和胸大静脉(如奇静脉系统)异常。双上腔静脉和双奇静脉是一种罕见的先天性畸形,发生率为0.3%。这些类型的先天性异常可能有临床症状,也可能没有临床症状。在为解剖学系的医学生进行的胸部和心脏的常规尸体解剖中注意到了这个病例,我们在一具女性尸体中发现了双上腔静脉(持续性左上腔静脉)和双(成对)奇静脉。右上静脉由右锁骨下静脉和右颈内静脉合并形成,右颈内静脉在进入右心房之前接受右奇静脉弓。左上腔静脉由左锁骨下静脉和左颈内静脉合并而成,在进入右心房之前还接受左奇静脉弓。在本例中,冠状窦与左持续性上腔静脉分离,并在持续性左上腔静脉中开放。两个上腔静脉之间没有连通。右侧的奇静脉是正常的,通向右上腔静脉。在左侧,半奇静脉与副奇静脉相连,并形成拱形,通向持久的左上腔静脉。心脏没有其他先天性异常。这些类型的先天性异常极为罕见,左上腔静脉直接通向右心房,冠状窦通向左上腔。大多数此类病例仍然没有症状。有些病例可能是在诊断或手术过程中偶然发现的,如心脏血管造影术、心导管插入术、旁路和透析,或尸检或机构尸体解剖。
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引用次数: 0
Foot morphology and its relationship to arch height index in asymptomatic adults versus adults presenting with foot pain (nontraumatic) 无症状成年人与有足部疼痛的成年人的足部形态及其与足弓高度指数的关系(非创伤性)
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.4103/njca.njca_218_22
A. Agrawal, A. Siddiqui, H. Sakale, M. John
Background: The uniqueness of the human foot, in performing various functions, is intricately associated with different morphological parameters, and arch height index (AHI) is an important parameter for the same. The measurement of AHI has putative clinical implications in correcting the underlying causative factors, which contribute to foot pain. This study was an attempt to investigate these parameters as a correlation among asymptomatic versus patients complaining of foot pain (due to nontraumatic causes). Methodology: One hundred asymptomatic and 50 symptomatic adults were engaged in the study after taking prior consent. Various measurements (such as foot length, truncated foot length, foot breadth, arch height – [AH], and AHI) were taken in a standing position. In this study values of foot length, truncated foot length, foot breadth, AH and AHI were compared amongst the two groups . Comparison was done with earlier studies. Results: The difference in AH and AHI (P < 0.05) among the asymptomatic versus the foot pain patients, was significant. There was a considerable difference in body weight and Body Mass Index (BMI) affecting AH and AHI. AHI in the case of the symptomatic foot pain adults was 0.18 in both feet, with a standard deviation (SD) of 0.07. Conclusion: The AHI has been considered an essential parameter in defining and identifying the potential structural factors that predispose an individual to injuries of the foot. Our results indicate that the mean AHI in the case of foot pain adults (nontraumatic) was 0.18 in both feet, with an SD of 0.07. This is lower as compared to other studies. This can be attributed to the fact that earlier studies have been done on asymptomatic patients only. The present study was done to correlate between normal asymptomatic versus foot pain patients. There was a significant difference in the AH and AHI between our two study groups.
背景:人类足部在执行各种功能时的独特性与不同的形态学参数有着复杂的关系,足弓高度指数(AHI)是一个重要的形态学参数。AHI的测量在纠正导致足部疼痛的潜在致病因素方面具有假定的临床意义。本研究旨在探讨这些参数在无症状足部疼痛与主诉足部疼痛(由于非创伤性原因)患者之间的相关性。方法:100名无症状和50名有症状的成年人在事先同意后参与研究。各种测量(如脚长,截脚长,脚宽,足弓高度- [AH]和AHI)在站立位置进行。本研究比较两组患者的足长、截脚长、足宽、AH和AHI值。与早期的研究进行了比较。结果:无症状足部疼痛患者与足部疼痛患者AH、AHI差异有统计学意义(P < 0.05)。影响AH和AHI的体重和身体质量指数(BMI)有相当大的差异。有症状足部疼痛的成年人的AHI为双足0.18,标准差(SD)为0.07。结论:AHI被认为是定义和识别潜在结构因素的重要参数,这些因素使个体易患足部损伤。我们的研究结果表明,足部疼痛成人(非创伤性)的平均AHI为0.18,SD为0.07。与其他研究相比,这一比例较低。这可能是因为早期的研究只对无症状患者进行了研究。本研究的目的是研究正常无症状足部疼痛患者与足部疼痛患者之间的相关性。两个研究组之间AH和AHI有显著差异。
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引用次数: 0
Variations of branching pattern of the dorsalis pedis artery: A cadaveric study 足背动脉分支形态的变化:一项尸体研究
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.4103/njca.njca_239_22
Dinesh L. Patel, A. Shinde
Background: Dorsalis pedis artery (DPA) is the chief artery of foot. It provides nutrition to the dorsum of the foot. Palpation of DPA is essential for the diagnosis of peripheral vascular diseases. Cutaneous flaps supplied by branches of DPA are used in various reconstruction surgeries. Methodology: 50 meticulously dissected lower limbs of both sides and known sex were observed for morphometry, asymmetry and sexual dimorphism of DPA and its branches. Variations like absent arcuate artery and extra lateral tarsal arteries were looked for. Results: Absent arcuate artery was seen in 12%. Three tarsal metatarsal arteries and two tarsal metatarsal arteries were seen in 4% and 16%, respectively. An extremely rare case of U-shaped loop joining two tarsal metatarsal arteries was seen in two limbs. Conclusion: Rare variations like multiple tarsal arteries joined by U-shaped loop and absent arcuate artery seen in our study are of importance for reconstruction surgeries using DPA flaps.
背景:足背动脉是足的主要动脉。它为足背提供营养。DPA的触诊对于诊断外周血管疾病至关重要。由DPA分支提供的皮肤皮瓣用于各种重建手术。方法:对50例双侧和已知性别的下肢进行仔细解剖,观察双下肢及其分支的形态计量学、不对称性和两性异形。寻找缺失的弓形动脉和跗骨外侧动脉等变异。结果:弓形动脉缺失率为12%。跖骨三动脉和跖骨二动脉分别占4%和16%。一个极为罕见的U形环连接两个跗骨跖骨动脉的病例出现在两个肢体上。结论:在我们的研究中发现的罕见变异,如U形环连接的多条跗动脉和缺失的弓形动脉,对使用DPA皮瓣进行重建手术具有重要意义。
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引用次数: 0
The prevalence, classification, and potential clinical implications of anatomical variations of first cervical vertebra: A computed tomographic study 第一颈椎解剖变异的流行、分类和潜在临床意义:一项计算机断层扫描研究
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.4103/njca.njca_217_22
Priyanka Pandey, Swati Yadav, N. Pasricha, S. Narayan
Background: First cervical vertebra has different anatomical features than other cervical vertebrae. It holds globe of skull and lacks body and spine. It is composed of 2 lateral masses linked by anterior and posterior arches. Posterior atlanto-occipital membrane is attached to posterior arch whose lateral edge sometimes ossifies thus converting groove into canal. Consequently, neurovascular groove gets converted into a bony ring “ponticulus posticus”. It can cause of neck pain and headache. Knowledge of this variation is important during various orthopedic procedures involving atlas including C1 lateral mass screw placement.Congenital defects of atlantal arch a developmental failure of chondrogenesis is a rare anomaly. These defects are a benign variation discovered incidentally. Detection of these anomalies is clinically important as they can cause acute neurologic deficits, which is associated with neck extension. Study was done: To determine the prevalence of Ponticulus Posticus and to report the frequency of various types of congenital malformations of the atlantal arch. Methodology: 250 computerized tomography (CT) head and neck in axial and sagittal sections from Picture Archiving and Communication System (PACS) of Dr RMLIMS, Lucknow was studied as CT is the best method to study the bony landmarks and any anomaly. Prevalence of variations was calculated. Data was analyzed statistically using SPSS version 21 by Chi-square test. Result: Prevalence of ponticulus posticus was 32.4%. Males had higher prevalence (20.4%) than females (12%). Incomplete ponticulus posticus (24.4%) was more than complete variant (8%). There was predominance of left sided ponticulus posticus(12% vs 8.4%) Deficient posterior arch was found in 9(3.6%) cases. 6 were of type A 3 were of type B. Conclusion: This study will help in determining cause of neurological deficit in patients due to presence of above variations.
背景:第一颈椎与其他颈椎具有不同的解剖特征。它拥有头骨,缺少身体和脊椎。它由两个由前后足弓连接的侧面肿块组成。寰枕后膜附着在后弓上,后弓的外侧边缘有时会骨化,从而将凹槽转化为椎管。因此,神经血管沟被转化为骨环“桥后”。它会引起颈部疼痛和头痛。在涉及寰椎的各种骨科手术中,包括C1侧块螺钉的放置,了解这种变化是重要的。先天性寰枢椎缺损软骨形成发育失败是一种罕见的异常。这些缺陷是偶然发现的良性变化。检测这些异常在临床上很重要,因为它们会导致急性神经功能缺损,这与颈部伸展有关。研究目的:确定后桥的患病率,并报告各种类型的先天性寰枢椎畸形的发生率。方法:对勒克瑙RMLIMS医生的图像存档和通信系统(PACS)的250个轴位和矢状位头颈部计算机断层扫描(CT)进行了研究,因为CT是研究骨标志和任何异常的最佳方法。计算变异的患病率。数据采用SPSS 21版卡方检验进行统计学分析。结果:桥后病变的患病率为32.4%,男性患病率(20.4%)高于女性(12%)。不完全后桥(24.4%)多于完全变异(8%)。左侧桥后桥占优势(12%vs 8.4%),后弓缺损9例(3.6%)。6例为A型,3例为B型。结论:本研究将有助于确定由于存在上述变异而导致患者神经功能缺损的原因。
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引用次数: 0
Role of visualization techniques in learning anatomy 可视化技术在解剖学学习中的作用
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.4103/njca.njca_201_22
A. Priyadarshini
Anatomy reveals the human body and its architecture. Right from the intricate turn of an artery, loop of a duct, fold of the skin to the microscopic change in epithelium are studied through anatomy. These nuances are appreciated in a precise and accurate manner when a scalpel is laid on one's body. Today, learning anatomy complemented with new age techniques, enables us to visualize a structure along with their surrounding environment.
解剖学揭示了人体及其结构。从动脉的复杂转弯、导管的环路、皮肤的褶皱到上皮的微观变化,都通过解剖学进行了研究。当一把手术刀放在一个人的身上时,这些细微差别会被精确而准确地理解。如今,学习解剖学并辅以新时代的技术,使我们能够将结构及其周围环境可视化。
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引用次数: 0
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National Journal of Clinical Anatomy
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