Table of Content

25 September 2025 Volume 43 Issue 5

  

Study on the innervation and intraperiosteal nerve distribution pattern of the tibial periosteum  

Wu Junxi, Fan Rui, Yang Bo, Zeng Xue, Yu Hong, Xiong Xinxin, Li Xiaochi, Yang Shengbo

Chinese Journal of Clinical Anatomy. 2025, 43(5):  499-503.  doi:10.13418/j.issn.1001-165x.2025.5.01

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Objective    To reveal the innervation and intraperiosteal overall nerve distribution pattern of the tibial periosteum.   Methods   Twelve Chinese adult specimens were used to observe the origin and course of nerve of the tibial periosteum through gross dissection. The Modified Sihler's staining was used for showing the intraperiosteal overall nerve distribution pattern in tibial periosteum.   Results   The innervation of the tibial periosteum originated from multiple segments. The medial surface of tibial periosteum was mainly innervated by the saphenous nerve, lateral surface was mainly innervated by the direct branch of the deep peroneal nerve and the perforator nerve of the anterior tibial muscle, and posterior surface was innervated by the direct branch of the tibial nerve and the perforator nerve of the extensor hallucis longus muscle. The arborized branches of nerve after entering the periosteum were most densely distributed in the middle one-third of the medial and lateral surface of tibial periosteum and lower one-third of the posterior surface of tibial periosteum, with communication between the branches.   Conclusions These results may provide morphological guidance for region matching of nerve function reconstruction during tibial periosteum transplantation, avoiding surgical injury to the periosteal nerves, and selection of targets during intraperiosteal injection of analgesic drugs.

Applied anatomy of the nasolacrimal duct and the inner wall of the maxillary sinus

Zhang Shuxuan, Zou Xun, Zhang Yanghua, Wang Qianya, Zhou Fupeng, Yong Liujun

Chinese Journal of Clinical Anatomy. 2025, 43(5):  504-510.  doi:10.13418/j.issn.1001-165x.2025.5.02

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Objective    To provide anatomical basis for the clinical study of nasolacrimal duct and maxillary sinus diseases through the applied anatomy of the inner wall of nasolacrimal duct and maxillary sinus in Chinese individuals.    Methods    The 30 nasolacrimal ducts from 15 adult cadaveric specimens and the inner wall of maxillary sinus were dissected. The structures of nasolacrimal duct, the inner wall of the maxillary sinus and the interconnections between them were observed and measured.    Results   The upper end of the bony nasolacrimal duct arose from the dacryocyst fossa and it walked diagonally backward, inward and downward in the anterior superior 1/4 bone wall of the inner wall of the maxillary sinus, and stopped at the anterior middle 1/3 junction of the top of the lateral wall of the lower nasal meatus, the thinnest bone of the inner wall of nasolacrimal duct was (1.02±0.38) mm, the thinnest bone of the lateral wall of nasolacrimal duct was (0.62±0.50) mm. The membranous nasolacrimal duct had a thin wall and the upper segment was covered by the bony nasolacrimal duct, the lower segment passed through the nasal mucosa into the deep surface of the inferior turbinate. The ostium of maxillary sinus was located at 1/3 of the inner wall of maxillary sinus and opened in the middle nasal meatus. The distance from the center of the ostium to the superior boundary of the inner wall of the maxillary sinus was (3.88±2.13) mm, the vertical distance between the center of the ostium and the bone nasolacrimal duct was (8.97±4.52) mm. The posterior lower part of the sinus ostium was usually the area with the thinnest bone in the middle nasal meatus, its bone thickness was (0.44±0.30) mm. The lateral wall of the inferior nasal meatus at the middle of 1/3 was the region with weak bone structure and its bone thickness was (0.34±0.13) mm.   Conclusions    The thickness of the lateral wall of the nasolacrimal duct is generally smaller than that of the inner wall. The connection to the maxillary sinus through the lateral wall can reduce the trauma. The posterior lower part of maxillary sinus has thin bone and is far away from nasolacrimal duct, so it is easy to perform sinus dilatation here without damaging nasolacrimal duct. The bone at the middle third of the lateral wall of the lower nasal meatus is thin, which is the best place for fenestration of the lower nasal meatus.

Digital anatomical study of the oblique branch perforator flap of the lateral circumflex femoral artery

Zhang Xing, Tang Juyu, Wu Panfeng, Qing Liming, Fu Jinfei, Sun Nianzhe, Zhou Xiaobing , Wang Zhi

Chinese Journal of Clinical Anatomy. 2025, 43(5):  511-519.  doi:10.13418/j.issn.1001-165x.2025.5.03

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Objective    To provide an anatomical basis for the clinical application of the oblique branch perforator flap of the lateral circumflex femoral artery.   Methods    Fifty-two fresh adult cadaver specimens were selected for one-time whole-body vascular angiography and MDCT scanning, followed by reconstruction using the Mimics imaging workstation. Three-dimensional (3D) layered dissection was performed from superficial to deep layers, with a focus on the stereoscopic structure of the vascular tree of the lateral circumflex femoral artery. Combined with 3D visualization, layered dissection was conducted on the entire specimens according to the clinical flap design and harvesting procedures. The origin, external diameter at the initial point, course, length of the vascular pedicle, and the angle relative to the longitudinal axis of the limb were measured and recorded for the oblique branch.    Results   Among the 104 sides of the specimens, 4 sides showed poor imaging and 100 sides were valid. The oblique branch was present in 65% (65/100) of the valid specimens, with an external diameter of (2.0±0.9) mm at the origin and a length of (13.0±6.5) cm. The oblique branch coursed from superomedial to inferolateral, forming an angle of 20°~60° with the longitudinal axis of the limb, and gave off perforating branches.    Conclusions    The superficial emergence point of the oblique branch of the lateral circumflex femoral artery mostly locates within a lateral semicircular region centered 8 cm proximal to the midpoint of the iliac-patellar line, with a radius of 4 cm. Perforators within this region can be used as the pedicle for designing the perforator flap of the oblique branch of the lateral circumflex femoral artery.

Histological study of mediastinal membranous structures based on plastination 45 sectional plastination technique and hard tissue sectioning technique

Ma Xida, Chun Pu, Zhao Shilei, Sui Hongjin, Gu Chundong

Chinese Journal of Clinical Anatomy. 2025, 43(5):  520-528.  doi:10.13418/j.issn.1001-165x.2025.5.04

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Objective    To elucidate the dense connective tissue components of mediastinal region through micro-anatomical dissection, providing more detailed mediastinal anatomical data for clinical practice.   Methods   Two complete mediastinal cross-sectional human tissue specimens were collected. Plastination 45 sectioning plastination technology was used to prepare sections, along with hard tissue sectioning techniques and Masson's trichrome staining to determine the presence and location of film-like structures composed of dense connective tissue.   Results   In the upper mediastinum, visceral fascia was characterized by its integrity, enveloping esophagus and trachea centrally and transitioning into vascular sheaths peripherally. In the lower mediastinum, the distribution of visceral fascia was more dispersed, covering esophagus, bronchus, and descending aorta, forming esophageal sheath, bronchial sheath, and aortic sheath, respectively. Additionally, the right side of esophagus was in close proximity to the right mediastinal pleura, with a thin or absent esophageal sheath. On the left side of esophagus, the anterior and posterior layers of esophageal fascia were fused or approximated, forming an esophageal paragastric space between two layers, which contains nutritional vessels and lymph nodes of esophagus.   Conclusions   In micro-anatomical dissection, the thickness of mediastinal visceral fascia and fibrous membrane gradually decreases with descending height, and the interlayer spaces become more distinct. The paraesophageal space in the lower mediastinum can serve as an anatomical basis for guiding the complete mesoesophageal resection and lymph node dissection based on membrane structure anatomy.

Conical beam CT analysis of maxillary sinus anatomical structure in adults of Korean nationality and Han nationality 

Zhang Yize, Li Jingxu, Nan Zhenbin

Chinese Journal of Clinical Anatomy. 2025, 43(5):  529-535.  doi:10.13418/j.issn.1001-165x.2025.5.05

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Objective   A study using Conical beam CT (CBCT) to investigate the differences in anatomical structure of maxillary sinus between ethnicity and gender in Yanbian region's Korean nationality and Han nationality, providing a basis for clinical maxillary sinus lift procedures.    Methods    300 CBCT images of patients in Department of Stomatology at Affiliated Hospital of Yanbian University were gathered from January 2020 to December 2022. Statistical analysis of the data was conducted using SPSS 26.0 software.   Results   Type E2 accounted for the most (27.88%) and type E3 the least (2.88%) in maxillary sinus floor morphology of Korean nationality. Type C accounted for the most (26.04%) and type E3 the least (2.86%) in maxillary sinus floor morphology of Han population. There were statistical differences in morphological types of maxillary sinus floor between two nationalities in A, B, C, and D. The average thicknesses of lateral maxillary sinus wall of Korean and Han nationalities were (2.26±1.19) mm and (2.35±1.63) mm, respectively. There was no statistically significant difference between two nationality groups. The mean MSA of Korean and Han was (81.25±11.62)° and (82.12±11.71)°, respectively, and the two nationalities did not show a significant difference. The average distance between natural ostium and sinus floor was (32.09±5.52) mm in Korean nationality and (30.65±5.13) mm in Han nationality. There was significant difference between two nationalities.   Conclusions   In clinical work, attention should be paid to some differences in anatomy of maxillary sinus structure between Korean nationality and Han nationality adults in Yanbian area. CBCT can accurately assess the relevant anatomical structures of maxillary sinus, providing precise localization and analysis for clinical practice.

A predictive study based on preoperative high-frequency ultrasound measurements of extra-laryngeal branching of the recurrent laryngeal nerve 

Li Xin, Yao Xiangyun, Huang Jiuping, Yu Bo, Song Shibing

Chinese Journal of Clinical Anatomy. 2025, 43(5):  536-539.  doi:10.13418/j.issn.1001-165x.2025.5.06

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Objective    To evaluate the predictive value of high frequency ultrasound on the extra-laryngeal branching of recurrent laryngeal nerve.   Methods    Preoperative ultrasound data of patients undergoing thyroidectomy from December 2023 to June 2024 were collected and cross-sectional ultrasound images of lower thyroid artery (ITA) and cricothyroid  joint (CTJ) were saved to measure the maximum diameter (SD) and cross-sectional area (CSA) of the recurrent laryngeal nerve area on the above planes. The results of exploration of recurrent laryngeal nerve during thyroidectomy were used as the gold standard, the cases were divided into extra-laryngeal branching group and non-extralaryngeal branching group. Statistical differences of parameters between the two groups were compared, and the cut-off between the groups was calculated according to the Youden index.    Results   A total of 95 nerves from 76 patients were included, 19 extra-laryngeal branching nerves (accounting for 20.0%) were confirmed intraoperatively. The SD, CSA on CTJ level and the ratio of the parameters to ITA level were significantly lower in the branching group than that of the non-extralaryngeal branching group (P<0.05). The cut-off value for predicting the extra-laryngeal branching was CSA of 1.4 mm2 of the nerve (AUC=0.823) and the ratio of this parameter to ITA level was 0.78 (AUC=0.875).  Conclusions  Preoperative high-resolution ultrasound could predict extra-laryngeal branching of recurrent laryngeal nerve, and have positive significance for surgical planning and nerve protection of thyroidectomy.

Augmentation on collateral vessel growth and functional recovery by Rho Kinase inhibitor GSK429286A in a lower limb ischemia model

Liao Xiaoheng, Pan Zhihao, Zhou Jingting, Hou Xindi, Ran Rong, Zhuang Yuehong

Chinese Journal of Clinical Anatomy. 2025, 43(5):  540-547.  doi:10.13418/j.issn.1001-165x.2025.5.07

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Objective    To evaluate the effects of Rho kinase inhibitor GSK429286A on collateral vessel growth and functional recovery after lower limb ischemia.   Methods   The right femoral artery was isolated, ligated, and transected. Animals were randomly assigned to receive 10 mg/kg GSK429286A or saline. 3D modelings of lower limb arteries were established via X-ray and Micro CT, and collateral vessel diameter was assessed using CD31 and α-SMA staining. VEGF and HO-1 protein levels in mouse gastrocnemius muscle were measured by Western blot. Blood flow in the affected footpad was monitored by laser speckle flowmetry. Muscle atrophy and vascular density in the gastrocnemius were evaluated by H&E staining and immunostaining. The foot function index was analyzed. Additionally, the effects of GSK429286A on HUVEC proliferation and migration were assessed using EdU and scratch assays.  Results On postoperative 14 days, rats in the GSK429286A group had significantly larger vessel diameter (P<0.01). On postoperative 3 days, VEGF levels were lower but HO-1 levels were higher in the GSK429286A group compared to the saline group. Blood perfusion recovery was significantly better in the GSK429286A group, with differences on postoperative 7 and 14 days (P<0.01). On postoperative 30 days, muscle atrophy was less severe (P<0.01) and vascular density was lower (P<0.05) in the GSK429286A group. The foot function index was significantly better in the GSK429286A group, with differences on postoperative 30 days (P<0.05). In vitro, GSK429286A promoted HUVEC proliferation and migration.  Conclusions   GSK429286A promotes collateral vessel formation and functional recovery in rodent models of lower limb ischemia.

The Protective Effect of Saposhnikovia divaricata Polysaccharide-Containing Serum on Neuronal Excitotoxicity and Neurotransmitter Release in PC12 Cells

Zhang Dan, Yang Xiaoqian, Song Rui, Sun Jinhao, Xu Tao, Li Wenjie

Chinese Journal of Clinical Anatomy. 2025, 43(5):  548-554.  doi:10.13418/j.issn.1001-165x.2025.5.08

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Objective    To investigate the neuroprotection of Saposhnikovia divaricata polysaccharides (SP) against glutamate (Glu)-induced excitotoxic injury and catecholamine (CA) neurotransmitters release in PC12 cells.   Methods    The cultured PC12 cells were treated with 15 mM Glu and the excitotoxicity injury model was established. SP-containing serum was prepared from rats administered with SP and added in culture plates. Cell viability was assessed via MTT assay. Intracellular ROS levels were detected with DCFH-DA probe. The effects of SP-containing serum on the single-vesicle CA storage, secretion, and exocytosis kinetics were detected using single-cell amperometry (SCA) and intracellular vesicle impact electrochemical cytometry (IVIEC). Vesicle ultrastructure was observed via transmission electron microscopy (TEM).   Results   SP-containing serum significantly improved the viability of Glu-damaged cells, reduced ROS content, increased CA storage and release at the single-vesicle level, and reversed the Glu - induced reduction in vesicle and dense core volumes.   Conclusions   SP exhibits obvious neuroprotective effect by alleviating oxidative stress, and SP can regulate CA release homeostasis by enhancing storage and release.

Regulation of Edaravone on TDP-43/cGAS/STING signaling in activated BV2 cells

Yang Yujia, Yin Qian, Fang Lanxi, Xu Dongyao, Duan Zhaoda, Wu Chunyun, Yang Li

Chinese Journal of Clinical Anatomy. 2025, 43(5):  555-563.  doi:10.13418/j.issn.1001-165x.2025.5.09

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Objective   To explore the effect of Edaravone on TDP-43/cGAS/STING signaling in lipopolysaccharide-activated BV2 microglia.   Methods   The SwissTargetPrediction, Superpred and TargetNet access to potential targets of Edaravone, the GeneCards, OMIM and TTD databases selected neuroinflammation related genes, get both intersection targets. The protein interaction network was constructed using STRING database and Cytoscape software. GO functional enrichment and KEGG pathway enrichment were analyzed using Metascape database. BV2 microglia were divided into control group, lipopolysaccharide activated group and lipopolysaccharide plus Edaravone group. The expression changes of TDP-43, cGAS, STING, TNF-α and IL-1β were detected by western blot and immunofluorescence staining. Results   Network pharmacology identified 70 potential targets of Edaravone in regulating neuroinflammation, with 1339 GO and 157 KEGG pathways enriched. Western blot and immunofluorescence staining showed that, compared with the control group, the expression of TDP-43, cGAS and STING, as well as inflammatory factors TNF-α and IL-1β were increased in activated BV2 microglia, while the expressions of these factors were decreased after Edaravone intervention.   Conclusions   Edaravone can inhibit TDP-43/cGAS/STING signaling in BV2 cells to reduce inflammation.

Experimental study on the effect of exosome combined acellular dermal matrix hydrogel on wound repair

Ren Li, Wang Fang, Peng Qian, Yang Zhiyong

Chinese Journal of Clinical Anatomy. 2025, 43(5):  564-572.  doi:10.13418/j.issn.1001-165x.2025.5.10

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Objective    To explore the effect and mechanism of exosome combined with acellular dermal matrix hydrogel on skin wound healing in rats.  Methods   The 4th~6th generation of rat skin fibroblasts were divided into 4 groups: PBS group, hydrogel group, exosome group, and exosome hydrogel group. CCK-8 was used to detect cell proliferation, scratch assay was used to detect cell migration, and RT-qPCR was used to detect mRNA expression of type I collagen, type III collagen, vascular endothelial growth factor, and α-smooth muscle actin. The full-thickness skin defect wounds of SD rats were established, and the rats were divided into blank control group, hydrogel group, exosome group and exosome hydrogel group. The wound healing rate was observed, and the histopathological changes were observed by HE staining and Masson staining. The protein expressions of type I collagen, type III collagen, vascular endothelial growth factor and α-smooth muscle actin were detected by Western blot.    Results    Compared with PBS group and exosome group, the proliferation and migration ability of exosome hydrogel composed fibrocytes were significantly enhanced (P<0.05), and the mRNA expression levels of type I collagen, type III collagen, vascular endothelial growth factor and α-smooth muscle actin were increased (P<0.05). Compared with the exosome group, the proliferation and migration of exosome hydrogel fibrocytes were significantly enhanced (P<0.05), and the mRNA expressions of type I collagen, type III collagen, vascular endothelial growth factor and α-smooth muscle actin were increased (P<0.05).Compared with the blank control group, the neoepithelial tissue of the wound in hydrogel group, exosome group and exosome hydrogel group was intact, the density of new collagen was higher, the wound healing was faster, and the protein expressions of type I collagen, type III collagen, vascular endothelial growth factor and α-smooth muscle actin were increased (P<0.05). Compared with the hydrogel group and the exosome group, the wound thickness of the exosome hydrogel group was increased, the collagen distribution was more uniform, the neoepithelial wound healing was faster, and the protein expressions of type I collagen, type III collagen, vascular endothelial growth factor and α-smooth muscle actin were increased in the exosome hydrogel group (P<0.05).    Conclusions   Exosome acellular dermal matrix hydrogel can promote wound repair by promoting the proliferation and migration of fibroblasts and the expression of type I collagen, type III collagen, vascular endothelial growth factor, α-smooth muscle actin and other factors.

Specific regulation of Th9 differentiation and its potential immunological applications of Xanthiazone

Qiu Yuhui, Gao Yuan, Wang Handuo

Chinese Journal of Clinical Anatomy. 2025, 43(5):  573-577.  doi:10.13418/j.issn.1001-165x.2025.5.11

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Objective   To investigate the effects of xanthiazone on T cell differentiation.   Methods Mouse T cells were sorted and cultured in vitro under conditions favoring differentiation into Th1, Th9, Th17, and Treg subsets. Xanthiazone was added to the cultures, and cytokine secretion and transcription factor expression were assessed by flow cytometry on the 3rd day. The pro-differentiation effects of xanthiazone on Th9 cells were further evaluated using a concentration gradient (10 nmol/L, 100 nmol/L, 200 nmol/L, 500 nmol/L, 1 μmol/L).   Results   Compared to the control group, xanthiazone selectively promoted Th9 differentiation without affecting Th1, Th17, and Treg differentiation. Furthermore, the concentration-dependent effects of xanthiazone on Th9 differentiation revealed that concentrations below 200 nM enhanced Th9 differentiation in a gradient-dependent manner. However, concentrations above 200 nM inhibited IL-9 secretion.  Conclusions  Higher concentrations of xanthiazone may suppress T cell activity, thereby antagonizing its pro-differentiation effects on Th9 cells.

Comparative study of TVF model and FRAX model for assessing the risk of osteoporotic vertebral fractures in postmenopausal women

Zhu Yongjian, Lin Shengliang, Yang Dehong, Feng Lan

Chinese Journal of Clinical Anatomy. 2025, 43(5):  578-583.  doi:10.13418/j.issn.1001-165x.2025.5.12

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Objective    To compare the predictive efficacy of the vertebral fracture risk model (TVF) and fracture risk assessment tool (FRAX) in stratifying fracture risk among osteoporotic patients.   Methods   A single-center prospective real-world study included 91 patients from the Osteoporosis Clinic of Nanfang Hospital (April-June 2022), with 73 cases of completing 1-year follow-up. After collecting the baseline data, the patients were classified into two groups based on the FRAX model: low-risk group (53 cases) and high-risk group (38 cases), classified into three groups based on TVF model: low- (n=9), medium- (n=39), and high-risk (n=25) groups. Fracture incidence was followed-up every 3 months.   Results   Among the two groups of models, there were significant differences  in bone mineral density T-scores  and fracture history between the risk stratification groups (P<0.05), and the age difference was significant in the FRAX group. The FRAX high-risk group showed lower EQ-5D-5L scores in mobility (2.1±0.8 vs 1.3±0.6), daily activities (2.4±0.7 vs 1.5±0.5), and total scores (8.2±1.9 vs 6.1±1.5, P<0.05). Actual fracture incidence: 22.6% in FRAX high-risk group  (7/31) vs 0%in low-risk group (0/42); 24% in TVF high-risk group (6/25) vs 2.5% in medium-risk group (1/39) vs 0% in low-risk group (0/9).   Conclusions   Both TVF and FRAX have the efficacy of stratifying fracture risk, to some extent, FRAX can distinguish the quality of life of patients, but there is also the possibility of underestimating the fracture risk. As a model that focuses on studying the risk of osteoporotic vertebral fractures, TVF's effectiveness and ease of application lay the foundation for future research.

Comparison of the clinical outcomes of fresh cleavage embryo transfer and blastocyst transfer in the gonadotropin-releasing hormone antagonist protocol

Li Xinxin, Ge Shuqi, Ge Mingxiao, Zhang Longmiao, Sun Li

Chinese Journal of Clinical Anatomy. 2025, 43(5):  584-588.  doi:10.13418/j.issn.1001-165x.2025.5.13

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Objective    To compare the clinical outcomes of fresh cleavage embryo transfer and blastocyst transfer in the gonadotropin-releasing hormone (GnRH) antagonist protocol.    Methods   The clinical data of 1249 women undergoing GnRH antagonist protocol cycle were retrospectively analyzed, including 871 cases of fresh cleavage embryo transfer and 378 cases of fresh blastocyst transfer.   Results There was no significant difference in age, duration of infertility and BMI between the two group (P>0.05). The baseline FSH, total dosage of Gn and FSH level on trigger day in cleavage embryo transfer group were significantly higher than those in blastocyst transfer group (P<0.05). The baseline LH, AMH, AFC and E2, P level on trigger day in cleavage embryo transfer group were significantly lower than those in blastocyst transfer group (P<0.05). The total number of oocytes retrieved, matured oocyte, high-quality embryos in cleavage embryo transfer group were significantly lower than those in blastocyst transfer group, with significant difference (P<0.05). The number of embryos transfer and the multiple pregnancy rate in cleavage embryo transfer group was significantly higher than those in blastocyst transfer group, the implantation rate in cleavage embryo transfer group were significantly lower than that in blastocyst transfer group, with significant difference (P<0.05). There was no significant difference in the clinical pregnancy rate, miscarriage rate, ectopic pregnancy rate, live birth rate, the incidence of moderate-severe OHSS, GDM and hypertensive disorder complicating pregnancy and the singleton birth weight between the two groups (P>0.05).  Conclusions   In the GnRH antagonist protocol cycle, fresh blastocyst transfer can reduce the multiple pregnancy rate and achieve good clinical outcome.

A retrospective study on the appearance time of secondary ossification centers of elbow in children 

Yang Shaowei, Shao Jianbo, Peng Xuehua, Guo Yu, Xu Liangbo

Chinese Journal of Clinical Anatomy. 2025, 43(5):  589-594.  doi:10.13418/j.issn.1001-165x.2025.5.14

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Objective    To investigate the appearance time of six secondary ossification centers of elbow in children.    Methods    The radiological data of 8007 children with elbow trauma in our hospital were collected through Picture Archiving and Communications System (4960 males and 3047 females). Age was ranged from 2 months to 215 months, with a median age of 66 (43-97) months for boys and 56 (32-85) months for girls. Age groups were divided into 15 groups at 12-month intervals.    Results   In more than 50% of secondary ossification centers appeared, the youngest age group of girls was earlier than that of boys. The appearance of capitulum, radius head, internal epicondyle, olecranon, trochlea, and external epicondyle in girls was 13 months, 71 months, 64 months, 108 months, 112 months, and 122 months, respectively, earlier than that of boys at 19 months, 82 months, 95 months, 132 months, 135 months, and 145 months. The six secondary ossification centers appeared in the sequence of capitulum, radius head, internal epicondyle, olecranon, trochlea, and external epicondyle, while the appearance of internal epicondyle in girls was earlier than radius head.    Conclusions   The appearance of secondary ossification center of Children's elbow in girls is earlier than in boys, and there is a certain sequence of appearance, which is helpful for film reading and bone age evaluation of elbow.

Significance of 'butterfly-shaped' free prophylactic resection of the inferior thyroid artery on the intraoperative dissection of the parathyroid glands

Li Yongtian, Wang Rujuan, Cheng Danqing, Wang Wenping, Zhao Feng, Zhang Yi

Chinese Journal of Clinical Anatomy. 2025, 43(5):  595-598.  doi:10.13418/j.issn.1001-165x.2025.5.15

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Objective    To investigate the significance of 'butterfly-shaped' free dissection of the thyroid lobe and prophylactic resection of the inferior thyroid artery during the surgical treatment of secondary hyperparathyroidism.    Methods    From May 2020 to February 2024, 67 patients diagnosed with secondary hyperparathyroidism and underwent surgical treatment in our hospital were reviewed. All patients underwent total parathyroidectomy combined with autotransplantation, including 31 patients with resection of the inferior thyroid artery (study group) and 36 patients with preservation of the inferior thyroid artery (control group). The perioperative indicators and postoperative long-term conditions were compared to evaluate the surgical efficacy.    Results    There was no significant difference in thyroid function and imaging results between the study group before and after operation. There was no significant difference in the operation time, intraoperative blood loss, postoperative 1 d drainage volume and postoperative hospital stay between the two groups. There was no significant difference in parathyroid hormone results between the two groups at 10 min, 1 h, 1 d, 1 week and 1 month after operation. The parathyroid hormone in the study group was lower at 3 months and 6 months after operation (P<0.05).    Conclusions    The 'butterfly-shaped' free thyroid lobe is beneficial to expose the parathyroid gland in the conventional position, which is convenient to combine the preoperative imaging to locate the hyperplastic parathyroid gland. Whether to remove the inferior thyroid artery has no significant difference in the difficulty of surgery and postoperative recovery and will not affect the thyroid function of patients. Preventive resection of the inferior thyroid artery can reduce the possibility of long-term recurrence, and is more suitable for patients with ectopic parathyroid glands and difficult to identify the scope of dissection during the operation.

Research on the influencing factors of the ultrasound diagnosis of nutcracker syndrome

Zhang Xiaoli, Fu Gansui, Wang Ping

Chinese Journal of Clinical Anatomy. 2025, 43(5):  599-605.  doi:10.13418/j.issn.1001-165x.2025.5.16

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Objective    To study the effect of ultrasound in the diagnosis of the nutcracker syndrome, so as to optimize examination process.    Methods    Fifty-five NCS were collected as the observation group, forty-one healthy patients were included in the control group. These two groups were in the supine position, dorsal extension (divided into four groups: 0 min-5 min, 5 min-10 min, 10 min-15 min, and 15 min-20 min). In calm breathing, end of inhalation and end of breath, 2D ultrasound and spectral Doppler measuring angle (θ), inner diameter (D1), distal heart inner diameter (D2), peak flow velocity (PVN), distal heart peak flow velocity (PVD) and other parameters were recorded and they were performed a comparative analysis.   Results   In the observation group, the D2/D1 of dorsal extension of the spine for 15 min-20 min and when calm breathing was slightly greater than that of 5min-10min and 10min-15min (P<0.05). However, the diagnostic sensitivity differences among the three time periods are not significant, and there was no statistically significant difference in D2/D1 between the above four time periods. Inhalation during the test resulted in a decrease in angle θ and an increase in D2/D1, and exhale was the opposite.   Conclusions    In the course of examining patients with nutcracker syndrome, the length of back extension has little effect on the examination results, ultrasound in the process of examination in patients with nutcracker syndrome, inhale can lead to positive rate increase, breathing out can lead to positive rate decline, and the positive rate is in the middle when breathing calmly. Therefore, the back extension time can be shortened during the inspection process, then tell the patients not to inhale or exhale, try to calm breathing in the examination.

Study on the cochlear implantation efficacy in adults with enlarged vestibular aqueduct syndrome

Hu Yunlong, Chen Qi, Chen Shiqin, Zhang Wenjin, Wang Gang

Chinese Journal of Clinical Anatomy. 2025, 43(5):  606-611.  doi:10.13418/j.issn.1001-165x.2025.5.17

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Objective    To assess the efficacy of cochlear implantation (CI) in adult patients with enlarged vestibular aqueduct syndrome (LVAS).    Methods    A retrospective analysis was conducted on clinical data from 32 patients who underwent cochlear implant surgery between January 2019 and December 2021. Patients were categorized into the LVAS group (16 cases) and the control group (16 cases) based on the presence of LVAS. Audiometric testing, speech recognition rate assessment, category of auditory performance-II (CAP-II), speech intelligibility rating (SIR), self-confidence, and satisfaction scores were compared between the two groups before surgery and at 12 and 18 months post-cochlear implantation. The relationship between the auditory-oral conditions of the two groups and the timing of cochlear implantation were evaluated.   Results    Successful electrode implantation was achieved in both groups, and no postoperative complications such as facial paralysis, infection, or electrode displacement were observed. At 12 months postoperatively, there were no significant differences between the postlingual deaf patients of LVAS group and the control group in aided audiometric thresholds (P=0.554), speech recognition rates (P=0.425), CAP-II scores (P=0.288), SIR scores (P=0.105), self-confidence scores (P=0.301), and satisfaction scores (P=0.618) (P>0.05). Similarly, at 18 months postoperatively, there were no significant differences in the mentioned parameters between the two groups (P>0.05) in aided audiometric thresholds (P=0.682), speech recognition rates (P=0.501), CAP-II scores (P=0.555), SIR scores (P=0.192), self-confidence scores (P=0.631), and satisfaction scores (P=0.618). CAP-II scores and satisfaction scores in both groups were negatively correlated with the duration of deafness at one year postoperatively (P<0.05). The CAP-II scores of LVAS group showed a positive correlation with the age of onset of hearing loss (P<0.05), while there was no significant correlation with the age of implantation and hearing aid wearing time in either group (P>0.05).   Conclusions    Cochlear implantation in adult patients with severe or profound LVAS can yield auditory-oral rehabilitation outcomes comparable to those of adult patients with normal inner ear development. Cochlear implantation serves as a primary means for auditory rehabilitation in adult LVAS patients with severe or profound sensorineural hearing loss.

Observation on the therapeutic effect of acupuncture on the gallbladder contraction function of patients after gallbladder-preserving cholecystolithotomy

Wang Sangui, Chen Lifang, Wang Haifeng, Yan Bowen, Wang Zhi, Wang Ni, Li Jiahao, Li Yun, Wang Quanlei

Chinese Journal of Clinical Anatomy. 2025, 43(5):  612-617.  doi:10.13418/j.issn.1001-165x.2025.5.18

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Objective    To investigate the effect of acupuncture on the gallbladder contraction function in patient after gallbladder-preserving cholecystolithotomy (GPC).   Methods   Total seventy cases of GPC patients, including acupuncture group (n=41) and non-acupoint (sham-acupuncture) group (n=29) were enrolled in this study. In acupuncture group, acupuncture was applied to Yanglingquan (GB34), Dannangxue (EX-LE6), Qimen (LR14), Zusanli (ST36), while the filiform needle was touched but not inserted skin 2 cun around the corresponding acupoints for the sham-acupuncture group, and the needles were retained for 30 min. Acupuncture was preformed once daily and total for consecutive 7 days in these two groups. A color Doppler ultrasound scanner was used to detect the gallbladder ejection fraction (GBEF) before and 1, 3, 6 months after acupuncture operation. Serum cholecystokinin-A receptor (CCKAR) and gastrin were detected by enzyme-linked immunosorbent assay at 1 months after acupuncture stimulation.   Results   The GBEF were markedly increased compared to the baseline. Compare to sham-acupuncture group, the GBEF were significantly higher at 1 month and 3 months (P<0.001), while that were similar at 6 months in acupuncture group. Serum CCKAR were increased but not significant (P>0.05), whereas gastrin significantly decreased in the acupuncture group (P<0.01).   Conclusions    Acupuncture can effectively promote GBEF which might be regulated though CCKAR/gastrin signals.

Experimental study on enhancing the quality of ex vivo placental tissue computed tomography angiography imaging using a self-setting barium sulfate composite material casting technology

Feng Ruizhi , Hu yang, Chen Yuhua, Lv Yang, Wu You, Dai Jingxing, Wu Zhixin, Wang Yu

Chinese Journal of Clinical Anatomy. 2025, 43(5):  618-621.  doi:10.13418/j.issn.1001-165x.2025.5.19

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Objective    To optimize the imaging of computed tomography angiography (CTA) of ex vivo placental tissue by using a self-curing barium sulfate composite material for arteriovenous casting. Methods   Normal full-term placentas were selected and randomly divided into two groups. Each group underwent CT scanning and 3D reconstruction using either traditional contrast agents or the self-curing barium sulfate composite material.   Results   The self-curing barium sulfate composite significantly enhanced the vascular filling and branch clarity in the CTA images. Blinded visual scoring demonstrated that the quality of CTA images obtained with the casting method surpassed those obtained with traditional methods, validating its effectiveness in ex vivo placental vascular studies.   Conclusions    The self-curing barium sulfate composite material shows significant advantages in ex vivo placental vascular research, improving the accuracy of placental pathology studies and clinical diagnoses. It provides new methodologies for diagnosing and treating related diseases.

Analysis of the diagnostic value of anatomical casting in fetal persistent left superior vena cava malformation: a case series of five and literature review

Huang Ruiling, Wang Yu, Ai Haidong, Ou Hongping, Hu Yang, Lv Yang, Jia Yongmei

Chinese Journal of Clinical Anatomy. 2025, 43(5):  622-625.  doi:10.13418/j.issn.1001-165x.2025.5.20

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This article reports on five cases of fetal persistent left superior vena cava (PLSVC) diagnosed through anatomical casting techniques. By utilizing an improved dental plaster-barium sulfate infusion method, three-dimensional cardiovascular casting models were created and validated against ultrasound imaging. The cases were between 22 to 30 weeks of gestation. Among them, three presented with the absence of the left brachiocephalic vein type of PLSVC, while two exhibited the bridging type, complicated by various anomalies such as double outlet right ventricle (four cases), pulmonary artery stenosis (three cases), and right aortic arch (two cases). The casting technique clearly illustrated the course of the PLSVC and its spatial relationships with intracardiac malformations, particularly revealing the “Y” shaped blood flow pathway characteristic of the bridging type PLSVC, which is often misinterpreted in routine ultrasound examinations. This research indicates that anatomical casting can accurately reconstruct complex cardiovascular structures, providing precise anatomical references for prenatal ultrasound, thereby enhancing the accuracy of prenatal diagnosis, and improving clinical decision-making quality.