Modified Sihler's staining showed nerve distribution in the ureter and ileum wall in adults
Objective To investigate the application of modified Sihler's staining to show the distribution of nerves in the ureter and ileum wall in adults.Methods 3 ureters and ileum were selected from teaching autopsy ca-davers,and 6 ureters and 3 segments of ileum were obtained for overall staining by modified Sihler's staining meth-od.The nerve branches,distribution and shape in the ureter and ileum wall were observed under X-ray reading lamp,tissue compression and immunohistochemistry,and the intramuscular nerve branches,distribution and mor-phological characteristics of both were summarized.Results It is difficult to identify the nerve source of the ureter on gross anatomy.Some fine white nerve branches in the ileocenteric mesentery can be seen entering the intestinal wall.After Sihler's staining,the ureter and ileum were hyaline jelly,the intramural nerve branches were dark blue,and the serous surface was more distinct.The nerves and blood vessels in the ureteral outer layer accompany,enter the tube wall approximately vertically,and gradually extend to the muscular layer and distribute along the longitudi-nal axis.As a whole,there were few nerves in the upper and middle parts of the tube wall,and the branches gradual-ly became thinner.The nerves in the lower segment of the ureter are relatively dense,and the thick nerve branches extending proximal to the lower segment of the ureter are clustered through the vesicoureteral junction,with dense distribution.The primary and secondary nerve branches gradually diverge upward,and there are staggered and con-current branches between adjacent nerves.The branches of each nerve are not fixed on the same plane,and no gan-glia can be found in the visual field.The ileum is complete in appearance,with dark blue nerve branches in the se-rous layer,which accompany the arteries,and branch out into primary and secondary nerve branches towards the in-testinal wall.Some of them are distributed directly across the vascular network to the lateral wall of the mesentery,and the intramural nerves reaching the intestinal wall are circularly distributed vertically to the intestinal wall,in the shape of branches.Adjacent nerve branches cross each other,and the branches of each nerve bundle are not fixed in the same plane.No definite ganglion can be seen in the visual field.Sihler's stained transparent ureter and ileum tis-sue compression film showed that nerve fibers of both were distributed from outside-in to mucosal layer,the ureter wall was distributed along the longitudinal axis,the intestinal wall was approximately vertical to the opposite mesan-gial side,in a network distribution,the branches gradually became thinner,the nerve fibers crossed obviously,and no clear ganglion-like structure was observed.Immunohistochemistry showed that the intramuscular nerve fibers of ureter were distributed in bundles and longitudinals,with little crossover.There were meshlike distribution of nerve fibers between muscles in the ileum wall,and there are a large number of ganglion structures between muscles.Con-clusion The nerve in ureter and ileum wall of adult can be stained.The extramural nerves were accompanied by their innervating arteries.The intramural nerves were accompanied by their innervating arteries,and their branches were gradually tapered and no definite ganglion was observed.In addition to the submucosa,the structure of the tube wall is similar,the circumferential muscle and longitudinal smooth muscle are innervated by visceral nerves,the pe-ripheral nerves run along the artery,and the intramural nerves have similar segmental distribution.This result may provide reference for the clinical nerve anatomy of ileal replacement ureter similar to the original ureter peristaltic rhythm and urination.