Table of Content

25 September 2026 Volume 44 Issue 5

  

Study on the distribution characteristics of the mandibular marginal branch of the facial nerve and their entry points into the muscles

Zhou Yan, Xing Jiaxuan, Tang Wei, Chun Pu, Wang Chengyuan, Cui Zhongkang, Xiang Mingqian, Sui Hongjin, Yu Shengbo

Chinese Journal of Clinical Anatomy. 2026, 44(5):  499-506.  doi:10.13418/j.issn.1001-165x.2026.5.01

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Objective    To observe the course, branch type and entry of the marginal mandibular branch (MMB) into the depressor anguli oris muscle and depressor labii inferioris muscle, so as to provide anatomical basis for symmetry adjustment of perioral microexpression and clinical surgery.   Methods   By dissecting 30 adult head and neck specimens and observing 3 P45 sheet plastination specimens, the relationship between the MMB and adjacent structures, the type of course, the location of branch points, and the entry points of the depressor anguli oris muscle branch and depressor labialis inferior muscle branch were observed.    Results    The main trunk of the MMB  arose from the anterior edge (96.7%) or lower edge (3.3%) of the parotid gland, ran beneath (30.0%) or on the surface (70.0%) of the lower end of the masseter muscle , and lay deep to (23.3%), superficial to (50.0%) form a deep facial type, or formed a neurovascular loop with the facial artery (26.7%). The MMB coursed above the mandibular margin (66.7%) and below the mandibular margin (33.3%). The course of the branches of the MMB could be divided into single-stem type, double-stem type, combined-stem type and pseudo-single-stem type. The entry point of the MMB into the angular ori muscle was (32.5±10.47) mm from the front edge of the masseter muscle and (16.8±5.91) mm from the mandibular edge, the entry point into the depressor labii inferioris muscle was (48.0±7.87) mm from the front edge of the masseter muscle and (16.5±6.06) mm from the mandibular edge.    Conclusions    The branches of the MMB exhibits significant variation, with four types identified. The course of the depressor anguli oris and depressor labii inferioris branches can be effectively localized based on the anterior border of the masseter and the mandibular border, providing an applied anatomical basis for reducing surgical risks and improving surgical results. 

Anatomical study of the acromioclavicular ligament and its clinical significance

Li Suyi, Jin Ruixi, Liu Zhenyuan, Ren Lina , Peng Zhiyi, Zhou Ye, Chen Cheng, Liu Xinyi, Cheng Yilin, Li Jing

Chinese Journal of Clinical Anatomy. 2026, 44(5):  507-510.  doi:10.13418/j.issn.1001-165x.2026.5.02

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Objective    To observe the morphological characteristics of the acromioclavicular ligament (ACL), and provide useful information for the surgical repair of the acromioclavicular joint (ACJ).    Methods A total of 85 upper limbs of human cadavers were dissected and the anatomical features of the ACL were noted. The angles between the supero-posterior bundle (SPB) and the long axis of the clavicle (ɑ), and between the SPB and ACJ facet (β) were measured.   Results    (1) According to the distributions of the SPB and anterio-inferior bundle (AIB), the ACL was classified into: ①In 29 cases, the SPB covered more than 70% of the superior facet of the ACJ for, while the AIB covered more than 50% of the inferior facet of the ACJ. ②In 26 cases, the SPB covered more than 70% of the superior facet of the ACJ r, while the AIB covered less than 50% of the inferior facet of the ACJ. ③ In 30 cases, the SPB covered less than 70% of the superior facet, while the AIB covered less than 50% of the inferior facet of the ACJ. (2) The angles between the posterosuperior bundle and the acromioclavicular joint surface (α), and the joint inclination were (61.5±8.9)°, and (70.1±6.5)°, respectively. There was no correlation between α and β (P>0.05).    Conclusions   The ACL consists of two parts: SPB and AIB. The classification of the ACL serves as a supplement to previous studies. Combining the characteristics and variations of the ACL, anatomical reconstruction for acromioclavicular joint dislocation can help improve treatment and reduce surgical complications. 

Three-dimensional digital measurement and gender differences of craniofacial anatomical parameters in Mongolian Youth in hohhot

Tian Bowen, Xi Linqiqige, Yang Haobo, Li Yumo, Yu Yang, Yang Xueying, Lin Xiaoyue, Wen Jiaxin, Wu Pengyu, Du Huiyu, Lu Xingcheng, Gan Lei, Li Xiaohe, Si Qin, Xi Linqiqige

Chinese Journal of Clinical Anatomy. 2026, 44(5):  511-518.  doi:10.13418/j.issn.1001-165x.2026.5.03

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Objective   To investigate the craniofacial characteristics and gender differences among Mongolian college youth aged 18-26 years in Hohhot, Inner Mongolia, and to provide relevant references for anthropological and medical research.    Methods    A total of 374 healthy Mongolian volunteers (134 males and 240 females) in Hohhot, Inner Mongolia, underwent 3D craniofacial scanning using the Zhixiang Optoelectronics POP3 scanner. E3D software was applied to conduct three-dimensional digital measurement of 20 craniofacial indicators including head length, head breadth and head height, and calculate 13 anatomical indices such as the length-breadth index of head and the length-height index of head. Gender differences in the above craniofacial indicators and indices were then compared.    Results   Among Mongolian college youth in Hohhot, there was no significant gender difference in head length (P>0.05), while there were significant gender differences in the other 19 indicators including head breadth and head height (P≤0.05). Four anatomical indices including the length-height index of head and the morphological facial index showed obvious gender differences (P≤0.05), whereas 9 indices such as the breadth-height index of head and the transverse frontoparietal index presented no significant gender differences (P>0.05). For the classification of craniofacial indices, males were predominantly characterized by hyperbrachycephaly (38.8%), hypsicephaly (85.1%), acrocephaly (53%), hyperleptoprosopy (46.3%) and mesorrhiny (36.6%), females were mainly brachycephaly (25%), hypsicephaly (72.5%), acrocephaly (49.2%), hyperleptoprosopy (41.3%) and mesorrhiny (36.3%).    Conclusions    There are significant gender differences in the craniofacial characteristics of Mongolian youth in Hohhot. Generally, female craniofacial anatomical parameters are smaller than those of males, males have wider and taller skulls compared with females, while females have broader nasal structures than males.

Morphological matching analysis of tibial prosthesis in Oxford unicompartmental arthroplasty based on different rotational alignments in the Southern Han Chinese population

Zhou Junhao, Hu Yihui, Lin Guotai, Feng Bolin, Lin Kewei, Luo Jiabao, Zhang Ziwei, Zhong Huan, Ouyang Hanbin

Chinese Journal of Clinical Anatomy. 2026, 44(5):  519-526.  doi:10.13418/j.issn.1001-165x.2026.5.04

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Objective    To evaluate the impact of different rotational alignment references for tibial osteotomy on the matching of the tibial component in Oxford unicompartmental knee arthroplasty (UKA) among the Southern Chinese Han population.   Methods   A retrospective analysis was conducted on computed tomography (CT) imaging data of both lower limbs from 40 cases of Southern Chinese Han adults (80 knees). Three-dimensional (3D) models of the lower limbs were reconstructed. Digital simulations of Oxford UKA were performed on all 80 knees. Tibial osteotomies in the sagittal and axial planes were performed using the sAP line, FAMA line, and the MIR line as references, respectively. 3D models of the resected tibiae were obtained, and morphological parameters of the axial resection plane were measured. A senior joint surgeon selected the appropriate tibial component for simulated implantation and conducted matching analysis. Statistical analysis was then performed on the measurement data.   Results   ICC analysis indicated excellent consistency between the independent measurements of two surgeons for 20 models (ICC= 0.984, P<0.05). The sAP group demonstrated an aspect ratio closest to the design ratio of the Oxford UKA tibial component. Correspondingly, the prosthesis matching rate was the highest in the sAP osteotomy group (88.8%), followed by the FAMA group (82.5%), and lowest in the MIR group (25.0%), with statistically significant differences among the groups (P<0.05). There was no significant difference in the matching rate between the sAP group and the FAMA group (P>0.05). However, both groups showed significantly higher matching rates compared with the MIR group (P<0.05). Under matching conditions, there was no significant differences between the sAP and FAMA groups in terms of prosthesis coverage or mismatch area across zones. However, the mismatch area in the medial zone for the sAP group was significantly smaller than that of the MIR group (P<0.05).    Conclusions    Among Southern Chinese Han patients, compared with the MIR line, using either the sAP line or the FAMA line for tibial sagittal osteotomy yields superior matching outcomes for the Oxford unicompartmental tibial prosthesis. The design of next-generation prostheses should be tailored to the tibial morphometry of the Chinese population, with particular attention to refining the parametric design of the anteroposterior dimension and posteromedial curvature.

Imaging classification characteristics of persistent trigeminal artery and its correlation with posterior circulation ischemia

Chen Ya, Zhang Wei

Chinese Journal of Clinical Anatomy. 2026, 44(5):  527-533.  doi:10.13418/j.issn.1001-165x.2026.5.05

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Objective    To analyze the imaging classification characteristics of persistent trigeminal artery (PTA), explore its correlation with posterior circulation ischemia (PCI), and identify the independent risk factors for PCI, so as to provide reference for clinical risk assessment and intervention.   Methods     The clinical and imaging data of 63 patients diagnosed with PTA by magnetic resonance angiography (MRA) were retrospectively collected. The imaging classification, blood supply patterns and their association with PCI were analyzed, and independent risk factors for PCI were determined by multivariate statistical analysis.   Results    The prevalence rate of PTA was 0.16% in a total of 39,257 subjects. Type Ⅰ was the most prevalent according to the Weon classification (35 cases, 55.6%), while the lateral type predominated under the Salas classification (41 cases, 65.1%). Basilar artery (BA) hypoplasia was observed in 41 patients (65.8%), with the highest proportion found in Type Ⅰ PTA. PCI occurred in 47 patients (74.6%), and the incidence was highest in Type Ⅰ (91.4%). Multivariate analysis showed that smoking, alcohol consumption, hypertension, hyperlipidemia, hyperglycemia and hyperhomocysteinemia were independent risk factors for PCI in patients with PTA (P<0.05).    Conclusions    MRA can clearly display the anatomical morphology and classification of PTA. Combined the evaluation of BA developmental status helps to assess the risk of PCI. Strict management of these risk factors is critical for the prevention of secondary PCI in patients with PTA.

The protective effect and mechanism of bacterial lipoprotein training in endotoxemic mice via upregulation of citraconic acid levels

Xu Xiujuan, Wan Yantong, Chen Wenhan, Hong Yinghao, Huang Xiaolan, Yan Zhengzheng, Liu Jinghua

Chinese Journal of Clinical Anatomy. 2026, 44(5):  534-542.  doi:10.13418/j.issn.1001-165x.2026.5.06

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Objective    To investigate the metabolic characteristics of macrophages trained by bacterial lipoprotein (BLP) and the protective effect of the upregulated metabolite citraconic acid against endotoxemia in mice and its underlying mechanism.  Methods   Using metabolomic profiling, we characterized the metabolic rewiring of BLP‑primed macrophages in response to S.aureus infection, and dissected the mechanisms by which citraconic acid exerts direct antibacterial effects, potentiates macrophage killing and clearance, and mitigates inflammatory cascades, ultimately conferring survival benefit in endotoxemic mice.   Results   BLP training significantly enhanced the mitochondrial spare respiratory capacity and glycolytic rate of macrophages, accompanied by elevated levels of glycolytic and tricarboxylic acid (TCA) cycle metabolites. Anti-inflammatory metabolites, including itaconic acid and citraconic acid, were also increased. citraconic acid exerted direct bacteriostatic effects, potentiated the phagocytic and bactericidal capacities of macrophages, and suppressed LPS-induced inflammatory cytokine production. Furthermore, citraconic acid markedly improved the 7-day survival rate in endotoxemic mice, and reduced serum levels of inflammatory cytokines, as well as ALT, AST, BUN, and Cr.    Conclusions    BLP training induces metabolic reprogramming in macrophages. Citraconic acid protects endotoxemic mice through mechanisms involving anti-inflammatory, anti-infective, and anti-organ damage activities.

CaMKⅣ signaling affects muscle injury repair by regulating muscle fiber function and intramuscular inflammation

Wang Han, Li Yangyang, Jian Xiaoting, Huang Jingwen, Lan Haiqiang, Wang Qisen, Duan Wenbiao, Liao Hua

Chinese Journal of Clinical Anatomy. 2026, 44(5):  543-549.  doi:10.13418/j.issn.1001-165x.2026.5.07

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Objective    To investigate the effects of CaMKⅣ signaling on muscle fiber function and intramuscular inflammation.   Methods   Wild C57BL/6 mice (control group) and CaMKⅣ knockout mice (CaMKⅣ-/-) were selected. Cardiotoxin (CTX) was injected into the anterior tibial muscle to induce acute muscle injury in mice. The repair speed of injured muscle fibers and the infiltration of inflammatory cells in the muscle were compared between the two groups of animals. Primary WT or CaMKⅣ-/- myogenic progenitor cells (MPCs) were differentiated and cultured in vitro, and co-cultured with macrophages. The functional differences of macrophages were compared.   Results   Compared with WT mice, CaMKⅣ-/- mice had delayed muscle fiber regeneration and significant inflammatory infiltration, mainly dominated by M1 macrophages, with significantly decreased M2 cell numbers and proliferation ratios. In the inflammatory environment in vitro, the number and proliferation ratio of M2 macrophages in the CaMKⅣ-/-- MPCs co-culture system were significantly lower than those in the WT-MPCs (P<0.05).   Conclusions    The endogenous CaMKⅣ signaling activates muscle fibers to participate in regulating the phenotype of macrophages, promoting the proliferation and differentiation of M2-type macrophages in the injured muscle, facilitating inflammation resolution and accelerating muscle repair.

A modified MCAO model via common carotid artery approach and its application in cervical sympathetic trunk transection studies

Lin Li, Lin Yanting, Tang Shunv, Xie Yixiang, Chen Yiqing, Lin Jiafu, Zhuang Yuehong, Zhou Shujun

Chinese Journal of Clinical Anatomy. 2026, 44(5):  550-558.  doi:10.13418/j.issn.1001-165x.2026.5.08

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Objective    To establish a more advantageous and suitable middle cerebral artery occlusion (MCAO) model for the study of cervical sympathetic trunk transection in ischemic stroke through the common carotid artery (CCA) approach.   Methods   Forty rats were randomly allocated into the ECA group and the modified CCA group, and MCAO models were prepared in each group. The operative time, model success rate, Longa grade, infarct rate, and postoperative survival were assessed. Then twelve rats were randomly allocated into the CCA group and the CCA+CSB group. The latter group underwent cervical sympathetic nerve trunk transection. The Longa grade, infarct rate, and protein expression of BCL-2, BAX, and Caspase-3 were evaluated postoperatively in both groups.   Results    Compared with the ECA group, the modified CCA group showed higher model success rate (P<0.05), higher Longa score (P<0.01), and higher infarct rate (P<0.01), while shorter total operative time (P<0.001). There was no significant difference in postoperative survival between the two groups. Compared with the CCA group, the CCA+CSB group exhibited a lower Longa score (P<0.05) and lower infarct rate (P<0.05), increased BCL-2 expression (P<0.01), and decreased BAX (P<0.05) and Caspase-3 (P<0.05) expression.   Conclusions    The modified CCA model demonstrates significant advantages over the classic ECA model and is expected to serve as an ideal model for the study of cervical sympathetic trunk transection in ischemic stroke.

GATA2 enhances malignant biological behaviors of cervical cancer cells by promoting activation of FAK/STAT3 signaling pathway

Chen Xianying, Wang Ruohan, Xia Yu, Wang Yongjun

Chinese Journal of Clinical Anatomy. 2026, 44(5):  559-564.  doi:10.13418/j.issn.1001-165x.2026.5.09

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Objective    To investigate the effects of GATA2 on the malignant behaviors of cervical cancer cells and activation of the FAK/STAT3 signaling pathway.    Methods    GATA2 expression in cervical cancer cell lines (HeLa, CaSki) and normal cervical epithelial HUCEC cells was examined by qRT-PCR and Western blot, respectively. Small interfering RNA targeting GATA2 (si-GATA2) and its negative control (si-NC) were transfected into HeLa and CaSki cells to knock down GATA2, and the knockdown efficiency was verified by qRT-PCR and Western blot. The effects of GATA2 knockdown on the expression of FAK/STAT3 pathway-related proteins (p-FAK, FAK, p-STAT3, STAT3) were assessed by Western blot. HeLa and CaSki cells were divided into 3 groups: si-NC (control), si-GATA2, and si-GATA2+ZINC40099027 (FAK activator). Colony formation assay was used to evaluate cell proliferation, flow cytometry to detect apoptosis rate, and Transwell assay to measure cell migration and invasion.    Results    Compared with HUCEC cells, the mRNA and protein expression levels of GATA2 were significantly elevated in HeLa and CaSki cells. Following transfection with si-GATA2, GATA2 mRNA and protein levels were markedly reduced in both HeLa and CaSki cells. Knockdown of GATA2 significantly decreased the expression levels of p-FAK and p-STAT3 proteins, but had no significant effect on total FAK and STAT3 protein levels. Functional assays revealed that GATA2 knockdown significantly inhibited colony formation, induced apoptosis, and suppressed the migration and invasion of HeLa and CaSki cells. However, these tumor-suppressive effects mediated by GATA2 knockdown were partially reversed upon the addition of the FAK activator ZINC40099027.    Conclusions GATA2 expression is significantly elevated in cervical cancer cells and may enhance tumor cell proliferation, migration and invasion while inhibiting apoptosis by promoting activation of the FAK/STAT3 signaling pathway.

Mechanism of METTL3-mediated NR4A2 m6A methylation in microglial neuroinflammation during Parkinson's disease

Chen Mengxuan, Li Mengzhu, Duan Kexin, Li Haiyan, Li Yuqaun, Zhao Lijun, Zhu Meiling

Chinese Journal of Clinical Anatomy. 2026, 44(5):  565-574.  doi:10.13418/j.issn.1001-165x.2026.5.10

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Objective   To investigate the m6A modification of nuclear receptor NR4A2 (Nuclear Receptor Subfamily 4, Group A, Member 2) mRNA by METTL3 and its mechanism of action in microglial M1 polarization and neuroinflammation in Parkinson's disease (PD).   Methods   A PD mouse model was established by unilateral medial forebrain bundle (MFB) injection of 6-hydroxydopamine (6-OHDA). Motor function was evaluated by apomorphine-induced rotation test, rotarod test, and pole test. Immunofluorescence, HE staining, and Western blot were used to detect dopaminergic neuron damage in the substantia nigra, expression of inflammatory factors, and related molecules. ELISA was employed to measure the global m⁶A modification level in tissues. An in vitro inflammatory model was constructed by stimulating BV2 microglia with lipopolysaccharide (LPS). METTL3 was knocked down or overexpressed using siRNA and overexpression plasmids, respectively. RNA immunoprecipitation (RIP) was used to verify the binding of METTL3 to NR4A2 mRNA, with binding sites predicted by SRAMP. The effect of METTL3 on NR4A2 mRNA stability was assessed using the actinomycin D assay.   Results   Compared with the control group, PD model mice exhibited impaired motor function, nuclear pyknosis in the substantia nigra, and a reduced number of tyrosine hydroxylase (TH)-positive neurons (P<0.05). Expression of M1 phenotype markers (IL-1β, iNOS, TNF-α), global m⁶A modification levels, and METTL3 expression were increased, while NR4A2 expression was decreased (P<0.05), consistent trends were observed in the LPS-stimulated BV2 cells. In the METTL3 knockdown group, expression of M1 phenotype markers decreased and NR4A2 mRNA half-life was shortened (P<0.05). RIP confirmed that METTL3 directly binds to NR4A2 mRNA (P<0.05), with potential binding sites predicted by SRAMP. In the METTL3 overexpression group, expression of M1 phenotype markers increased and NR4A2 mRNA stability was extended (P<0.05).    Conclusions   METTL3-mediated m⁶A modification of NR4A2 plays a crucial pro-inflammatory role in PD by regulating microglial M1 polarization.

Effects of kidney-tonifying and blood-activating compound on a rat model of teratozoospermia with kidney deficiency and blood stasis based on the AKT1/STAT3/FOXO1 signaling axis

Liu Yongxiang, Shan Xiongwei, Li Yunshi, Qiu Shiting, Weng Zhiwei, Huang Xuekun, Zhou Shaohu, Zhang Shuting

Chinese Journal of Clinical Anatomy. 2026, 44(5):  575-581.  doi:10.13418/j.issn.1001-165x.2026.5.11

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Objective   To investigate the therapeutic effect of kidney-tonifying and blood-activating compound (KBAC) on a rat model of teratozoospermia with the pattern of "kidney deficiency and blood stasis" and its underlying molecular mechanism focusing on the AKT1/STAT3/FOXO1 signaling pathway.   Methods   The rat model, mimicking the aforementioned pattern, was established by inducing experimental varicocele. Rats were randomly assigned to VC model, low, medium, and high-dose KBAC, and sham-operated control groups. After intervention, comprehensive evaluations were conducted, including syndrome manifestations (testicular index, spermatic vein diameter), sperm quality (motility, morphology), testicular histopathology, oxidative stress markers (ROS, MDA, SOD). The expression of key proteins in the AKT1/STAT3/FOXO1 pathway in testicular tissue was detected.    Results    Compared with the model group, medium and high-dose KBAC significantly ameliorated the syndrome manifestations, including increasing the testicular index and reducing the diameter of the spermatic vein, improved sperm motility and normal morphology rate, and alleviated testicular oxidative damage. Mechanistically, KBAC directionally modulated the dysregulated AKT1/STAT3/FOXO1 signaling network: it downregulated the abnormally elevated expressions of p-AKT1 and STAT3 proteins while upregulating the suppressed FOXO1 expression and reducing its phosphorylation level observed in the model group.   Conclusions    KBAC exerts a therapeutic effect on teratozoospermia with the "kidney deficiency and blood stasis" pattern. The mechanism may involve correcting the overactivation of the AKT1/STAT3 signaling and activating the FOXO1-mediated antioxidant defense, providing a pharmacological basis for treating this condition with the “Tonifying Kidney and Activating Blood” principle in traditional Chinese medicine.

Mechanical responses of the arterial wall under multi-ratio stretching of the abdominal aorta

Gu Xiaolong, LI Mingyu, Sun Xiaoting, Liu Aoling, Zhang Heng, Hu Qingkun, Zhu Yiwei, Cai Renye, Chen Yinghua

Chinese Journal of Clinical Anatomy. 2026, 44(5):  582-587.  doi:10.13418/j.issn.1001-165x.2026.5.12

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Objective    In this study, multi-ratio biaxial tensile tests are conducted on abdominal aortic specimens, aiming to systematically clarify the mechanical response rules of blood vessels in axial and circumferential directions, and verify the applicability of the polyconvex polynomial hyperelastic constitutive model for arterial tissue.   Methods   Healthy abdominal aortic specimens collected from Wuzhishan pigs were taken as research objects, which were commonly adopted in cardiovascular biomechanical studies due to their high similarity to human vascular anatomy and physiology. Planar biaxial tensile tests were carried out under three stretch ratios of 1:1, 1:3 and 3:1 to obtain complete mechanical response data under multi-axial loading conditions. A four-fiber hyperelastic constitutive model based on polyconvex invariants was adopted to fit the experimental stress-stretch data from each loading case. The nonlinear least squares method was used to calibrate the material parameters of the model, and the coefficient of determination R2 was employed as the index to quantitatively evaluate the fitting accuracy.   Results   Experimental results shown that the abdominal aorta presented obvious nonlinear anisotropic hyperelastic characteristics. Under equibiaxial tensile loading, the circumferential stiffness of the vessel wall was significantly higher than the axial stiffness, presenting a distinct directional difference in load-bearing capacity. Under asymmetric loading conditions, the stress response in the high-strain direction significantly enhanced, and the tangent stiffness risen remarkably with the increase of stretch degree. The overall average coefficient of determination R2 reached as high as 0.9457, reflecting favorable global fitting performance. Especially under asymmetric loading, the model achieved higher fitting accuracy, with the maximum R2 up to 0.9871.   Conclusions   The polyconvex constitutive model can accurately describe the complex multi-axial mechanical behavior of abdominal aorta under various loading conditions, and possesses good numerical stability and predictive ability. This study provides reliable experimental data and theoretical support for vascular biomechanical simulation, finite element analysis and structural optimization of interventional devices, and also offers a mechanical reference for further research on the pathological mechanism of vascular diseases.

Evaluation of the mid-to long-term value of treating irreparable massive rotator cuff tears using arthroscopic long head of biceps tendon transfer bridging technique

Zhang Yongming, Zheng Xiaodong, Wan Lei, Ye Feng

Chinese Journal of Clinical Anatomy. 2026, 44(5):  588-596.  doi:10.13418/j.issn.1001-165x.2026.5.13

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Objective    To evaluate the mid-to long-term efficacy of arth roscopic (long head of biceps tendon, LHBT) transposition bridging technique in the treatment of irreparable massive rotator cuff tears.    Methods    A retrospective analysis of 27 patients with irreparable massive rotator cuff tears admitted to our hospital from March 2020 to May 2022 was performed. The patients had an average age of (64.47±10.30) years and all underwent rotator cuff repair using the LHBT transfer bridging technique under shoulder arthroscopy. Preoperatively, at 1-year postoperatively, and at 3 years postoperatively, patients were assessed by using the visual analog scale (VAS), University of California, Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley shoulder function score, and shoulder range of motion. At 1 year and 3 years postoperatively, MRI of the shoulder was used to evaluate the integrity of the repair. According to the Sugaya classification at 1 year and 3 years postoperatively, 21 patients (6 of the 27 patients were lost to follow-up) were divided into an intact tendon group (n=17) and a tendon tear group (n=4), and the differences in the aforementioned indices were compared.   Results   Compared with preoperative values, the 21 patients showed significant improvements in visual analog scale scores, UCLA scores, ASES scores, Constant-Murley shoulder function scores, and shoulder joint range of motion at 1 year and 3 years postoperatively (P<0.05). There were differences in preoperative Goutallier grading between the intact tendon group and the tear tendon group (P<0.05), but there was no significant difference in visual analog scale scores, UCLA scores, ASES scores, Constant-Murley shoulder function scores, and shoulder joint range of motion at 1 year and 3 years postoperatively (P>0.05). At 3 years postoperatively, MRI of the affected shoulder showed that the repaired tendon had healed well in 17 patients, with a healing rate of 80.9%.   Conclusions   The LHBT transposition bridging technique under shoulder arthroscopy can provide reliable repair for irreparable massive rotator cuff tears, significantly relieve shoulder pain, and restore shoulder joint function. After up to three years of follow-up, the re-tear rate is low, effectively promoting tendon-bone healing of the rotator cuff.

Changes in the coronal plane angle of the ankle mortise and prediction of talus osteochondral lesions after autologous semitendinosus tendon reconstruction of the anterior talofibular ligament

Zhang Wanxi, Song Chen, Han Biao, Xing Jie, Wang Hui

Chinese Journal of Clinical Anatomy. 2026, 44(5):  597-606.  doi:10.13418/j.issn.1001-165x.2026.5.14

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Objective    To investigate the changes of coronal angle of the ankle mortise before and after autologous semitendinosus tendon reconstruction of the anterior talofibular ligament (ATFL) in patients with lateral ankle instability and its predictive value for postoperative osteochondral lesion of the talus (OLT).   Methods    A total of 124 patients treated in our hospital from June 2022 to June 2024 were selected. Repeated measures analysis of variance, multiple linear regression, LASSO regression, multivariate Logistic regression, locally weighted scatterplot smoothing (LOWESS) and receiver operating characteristic (ROC) curve were used to analyze the changes of coronal and sagittal angles of the ankle mortise and joint stability, as well as their predictive value for postoperative OLT.    Results   Patients in the OLT complication group had higher coronal and sagittal angles and passive position sense, and lower other joint stability indicators before and after treatment, with significant time effect, inter-group effect and interaction effect (P<0.001). Both coronal and sagittal angles of the ankle mortise were independently correlated with joint stability indicators (P<0.05), the coronal angle at 1 month after treatment was a risk factor for OLT, and the AUC of the coronal angle alone and combined with the sagittal angle in predicting OLT was 0.879 and 0.937, respectively.    Conclusions   The coronal angle is an influencing factor for postoperative OLT in patients with lateral ankle instability, and has a certain predictive value for postoperative OLT.

3D-printed anterior superior iliac spine guide improves the accuracy and safety of sacroiliac screw placement

Li Hanfeng, Liu Dong, Chen Lin, Lan Jiaping, Wen Yang, Wang Zhiqiang

Chinese Journal of Clinical Anatomy. 2026, 44(5):  607-614.  doi:10.13418/j.issn.1001-165x.2026.5.15

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Objective    To design a novel 3D-printed guide plate attached to the anterior superior iliac spine (ASIS) and evaluate its efficacy and safety in assisting sacroiliac screw placement for the treatment of unstable posterior pelvic ring injuries.   Methods    A retrospective analysis was conducted on 60 patients with posterior pelvic ring injuries treated with sacroiliac screw fixation in our hospital from March 2021 to March 2024. Among them, 27 patients underwent sacroiliac screw placement assisted by the 3D-printed ASIS guide plate (study group), while 33 patients received conventional fluoroscopy-guided percutaneous manual screw placement (control group). There were no statistically significant differences in baseline characteristics such as gender, age, time from injury to surgery, injury mechanism, or fracture classification between the two groups (P>0.05). Comparisons were made regarding intraoperative blood loss, screw placement time per screw, number of fluoroscopic exposures, number of guidewire adjustments, and incidence of postoperative complications. Postoperative CT scans were reviewed to assess the excellent rate of screw placement using the Smith criteria and the quality of pelvic reduction using the Matta score. The accuracy of screw placement was evaluated by measuring the deviation of the actual screw trajectory from the planned trajectory preoperatively and postoperatively. Functional recovery at the final follow-up was assessed using the Majeed score.   Results Intraoperative blood loss was greater in the study group than in the control group (P<0.05). The screw placement time, number of fluoroscopic exposures, and number of guidewire adjustments were all significantly lower in the study group (P<0.05). There was no statistically significant difference between the two groups regarding postoperative screw placement according to the Smith classification, pelvic reduction quality according to the Matta score, or functional recovery according to the Majeed score (P>0.05). However, one case in the control group experienced screw penetration into the sacral foramen, resulting in neurological symptoms. In the study group, the deviations between the actual entry and target points of the screws and their virtual planned positions were (3.91±1.88) mm and (4.37±2.53) mm, respectively, the deviation angle was (4.10±2.05)°.   Conclusions    The application of the 3D-printed ASIS guide plate technique for sacroiliac screw placement in posterior pelvic ring fractures can reduce screw placement time, decrease the number of intraoperative fluoroscopic exposures and guidewire adjustments, and lower the risk of screw penetration through the bone cortex, thus improving surgical efficiency and screw implantation safety.

Study on the role of whole-body vertical vibration in ureteral calculus excretion

Bai Wenfang, Cao Jianmin, Li Weikun, Xie Shanmin, Liang Jingli, Li Guanqun, Chen Wu

Chinese Journal of Clinical Anatomy. 2026, 44(5):  615-620.  doi:10.13418/j.issn.1001-165x.2026.5.16

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Objective   To explore the effectiveness and safety of vertical rhythm therapy in the natural discharge process of ureteral stones, so as to provide a new physical therapy plan for ureteral stone treatment.    Methods    A total of 144 ureteral stone patients treated at the Department of Urology of Yingde People's Hospital from January 2019 to March 2020 were enrolled. Using PEM3.1 software, the patients were randomly divided into a control group (72 cases) and an experimental group (72 cases) in a 1:1 ratio. The control group received conventional treatment, while the experimental group received 7 Hz vertical rhythmic training in addition to standard therapy. Statistical analysis was conducted on the time to stone expulsion, expulsion rate, and pain levels between the two groups.  Results   There was no statistically significant differences in the comparison of gender, age, stone size, and distribution between the two groups (P>0.05). The stone expulsion efficacy rates within 1 week and 2 weeks in the experimental group were 54.17% (39/72) and 98.61% (71/72), respectively, significantly higher than that of the control group's 19.44% (14/72) and 84.72% (61/72), with a statistically significant difference (P<0.01). The stone expulsion time in the experimental group was notably shorter than that in the control group (P<0.05). In terms of pain relief, the numerical rating scale (NRS) scores showed that the experimental group experienced significantly less pain during stone expulsion compared to the control group (P<0.05). The pain scores before and after rhythmic therapy in the experimental group also showed statistically significant differences (P<0.05). There was no statistically significant difference in pre-treatment pain scores between the two groups (P>0.05), and no adverse events were reported.   Conclusions   7 Hz vertical rhythm therapy can promote natural stone discharge in ureteral stones safely and effectively.

Research progress on the regulatory mechanism of bone-fat balance

Wang Wei, Chen Sihui, Li Ou, Jiang Yuxin, Zhu Jinyu

Chinese Journal of Clinical Anatomy. 2026, 44(5):  621-624.  doi:10.13418/j.issn.1001-165x.2026.5.17

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Osteoporosis (OP) is a skeletal disease caused by bone remodeling imbalance, where bone-fat balance-defined as the dynamic equilibrium between bone marrow adipose tissue (BMAT) and bone mass is crucial for normal bone remodeling. This article reviews the research progress on various regulatory mechanisms of bone-fat balance, with signaling pathways such as PPAR-γ serving as the regulatory foundation. Hormones and metabolic factors, including leptin and osteocalcin, regulate the differentiation of bone marrow mesenchymal stem cells through endocrine and paracrine pathways. Additionally, multiple factors such as oxidative stress, ferroptosis, aging, and the nervous system are deeply involved in this regulatory process. Multi-omics technologies provide novel approaches for elucidating regulatory mechanisms, while the development of novel targeted drugs is evolving toward multi-target and precision therapies. As a key regulatory node, BMAT interacts bidirectionally with the aforementioned regulatory processes through complex mechanisms, collectively driving the onset and progression of OP. Further research is needed to elucidate the regulation of bone-fat balance, thereby formulating more effective prevention and treatment strategies and providing theoretical foundations for improving human skeletal health.

High bifurcation and short variation of bilateral common iliac artery: one case report

Cui Zhenzhe, Zhang Tingkai, Wang Yiyao, Chen Hao, Zong Wenzhao, Cui Chunai, Qin Xiangzheng

Chinese Journal of Clinical Anatomy. 2026, 44(5):  625.  doi:10.13418/j.issn.1001-165x.2026.5.18

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