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Chinese Journal of Clinical Anatomy
(Founded in July 1983 Bimonthly)
Responsible Institution: China Association for Science and Technology
Sponsor: Chinese Society of Anatomical Sciences
Editing and Publishing: Editorial Board of Chinese Journal of Clinical Anatomy
Advisor: ZHONG Shi-zhen
Editor-in-chief: OUYANG Jun
Former Editor-in-chief: XU Da-chuan
Overseas Distributor: China International Book Trading Corporation (P.O. Box 399, Beijing, China, Code No. BM5961)
Address: 1023 Shatainan Road, Guangzhou, 510515, China
Tel: (020)61648203
E-mail: journal@chjcana.com
CN: 44-1153/R
ISSN: 1001-165X

Table of Content

    25 January 2010 Volume 28 Issue 1
      
    Inspiration of  translational medicine on clinical anatomical research
    ZHONG Shi-Tian, XU Da-Chuan, OU Yang-Jun
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  1. 
    Abstract ( 1362 )  
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    The variation of right musculocutaneous nerve: a case report
    ZHANG Zuo-Feng, CI Dao-Wen, ZHANG Yu-Xin
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  2. 
    Abstract ( 1009 )  
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    Anatomy of perforating branch flap of descending genicular artery
    ZHENG He-Beng, LIN Jian, CHEN Chao-Yong, ZHANG Fa-Hui
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  3. 
    Abstract ( 2923 )  
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            Objective  To explore anatomic features of the perforating branch of descending genicular artery, and provide a new operative method for repairing soft tissue defects around knee joint.   Methods  The lower edge of medial femoral condyle and the adductor tubercle were taken as the marks to dissect 40 specimens of adult lower limb perfused with red latex. The courses,branches and distributions of the perforating branches of descending genicular artery, and its anastomosis with peripheral vessels were observed under magnifying glass. Meanwhile, simulated operation was performed on one side of fresh specimen.   Results  Perforating branches of descending genicular artery started from the lower edge of medial femoral condyle about 4cm, and passed through the deep fascia in which the triangle depression surrounded by the vastus medialis muscle, adductor tendon and the medial femoral condyle to the subcutaneous. They also separated large number of small blood vessels, which closely aligned with the adjacent vascular network around the patella, perforating branches of the sartorius leading-edge and trailing-edge, branches of the M.C. perineural and neural stem vascular chain. Then they formed along the sartorius muscle and femoral cutaneous nerve medial longitudinal axis of the vascular plexus in the upper part of the medial.   Conclusions  The axial pattern flaps or cross-regional blood supply skin flap pedicled with descending genicular artery can be formed to repair nonunion and defect around knee joint.

    Muscle architecture and distribution of muscle spindles of compartments of trapezius and their clinical significance
    YANG Fang-Jiu, XUE Qian, LI Ji-Rong
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  7. 
    Abstract ( 2157 )  
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            Objective  To provide morphological data for clinical application of compartments of trapezius.  Methods  (1) The muscle architecture method was used to evaluate the muscle architecture features of compartments of trapezius in 10 adult cadavers. (2) The stereology method was used to study muscle spindle distribution of compartments of trapezius in 6 adult cadavers.  Results  (1) The muscle weight (MW), muscle length (ML), fiber length(FL)and physiologic cross sectional area (CSA) of the descending part of trapezius were(30.71±7.40) g,(10.45±1.62)cm,(9.18±0.99) cm and (3.11±0.72) cm2 respectively. These indexes of the transverse part of trapezius were (44.14±10.61) g, (8.65±0.84) cm, (7.14±0.84) cm and (5.89±1.66) cm2 respectively. These index of the ascending part of trapezius were (44.89±11.67) g, (11.83±1.12) cm, (9.09±0.94) cm and (5.37±1.55) cm2 respectively. (2) Spindle density of the descending part of trapezius was 39.05±5.08 number/cm3. Spindle density of the transverse part of trapezius was (24.48±6.50) number/cm3. Spindle density of the ascending part of trapezius was (21.68±6.64) number/cm3.  Conclusions  (1) According to muscle architecture features of trapezius, the descending and transverse parts of trapezius are mainly maintain the position of scapula, and the descending and ascending parts of trapezius are most important in the rotation of scapula presumably. (2) The muscle spindle density of the descending part of trapezius is obviously more than that of the transverse and ascending parts.

    The radiographic study and clinical significance of femoral offset
    YAN Gao, HUANG Zhang, JIANG Hua, SUN Dun-Yang
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  10. 
    Abstract ( 4488 )  
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            Objective  To investage the range of femoral offset and explore its clinical significance. Methods  100 cases of normal anteroposterior hip joints radiographic image were measured. Parameters included femoral offset, abductor lever arm, body weight lever arm, femoral head diameter, neck-shaft angle, the width of bone medullary cavity at the plane of lesser trochanter,20 mm above and below the lesser trochanter, diameter of the narrow cavity and canal flare index (CFI). The correlation between femoral offset and other anatomical parameters in femur were explored by simple correlation analysis. The proximal femoral parameters between Chinese and the Western were compared.  Results   The range of femoral offset was (36.64±5.31)mm. Femoral offset and abductor lever arm was positively correlated(r=0.73, P<0.01). Femoral offset was negatively correlated neck-shaft angle(r=-0.46, P<0.01). There were no significance correlation between femoral offset and other anatomical parameters in femur. There was a significant difference in the diameter of the femoral head, neck-shaft angle, femoral offset, abductor lever arm between men and women (P <0.05). There was a significant difference in neck-shaft angle, femoral offset between Chinese and the Western (P<0.01). Conclusions   The range of femoral offset was (36.64±5.31) mm. Restoration of femoral offset can recover the length of abductor lever arm and restore the biomechanics of the hip.

    Anatomy and clinical significance of thoracic and lumbar vertebral laminae and interarticularis in adolescents
    LI Xiao-He, LI Shao-Hua, LI Zhi-Jun, CA Yong-Jiang, WANG Xing, CHEN Hai-Fang, XU Da-Chuan
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  14. 
    Abstract ( 3268 )  
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            Objective  To provide anatomic basis for clinical application and athletic medicine, by analyzing the thickness of superior and inferior border of interarticularis(STI and ITI ), the distance between superior and inferior border of interarticularis(DSII) and the thickness of vertebral laminae(TVL) on adolescent thoracic and lumbar spine.  Methods  25 specimens(T1~L5)from adolescents(aged from 14 to 19 years, averagely 16.5 year) were measured and compared, with the anatomic parameters of STI, ITI, DSII and TVL. Results  STI increased gradually, from T1 to T12 level(ranged from 2.96±0.69 mm to 3.74±0.55 mm), and then decreased from L1 to L5 level (ranged from 4.29±0.98mm to 4.83±0.80mm); ITI increased from T1 to L5 level(ranged from 4.52±1.00mm to 7.30±1.24mm); DSII increased from T1 to T12 level and decreased from L1 to L5 level(ranged between 17.51±3.55mm and 7.90±1.71mm); TVL ranged between (17.51±3.55)mm and (7.90±1.71)mm, and presented the shape of sella.  Conclusions  The results of thoracic and lumbar vertebral laminae and interarticularis in adolescents show that, ITI is always thicker than STI.

    Morphological characteristics and functional significance of lumbosacral multifidus muscle
    SHAO Shi-Ze, ZHANG En-Zhong, FU Song, TAN Yuan-Chao, HOU Hai-Chao, WANG Zheng
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  17. 
    Abstract ( 3879 )  
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            Objective  To study anatomic features of the lumbosacral multifidus muscle and provide reference for reducing spinal injury during posterior lumbar surgery.  Methods  25 corpses were dissected. The origin, insertion, the construction of muscle bundle, and the relationship with adjacent structures of multifidus muscle were observed and measured. Results   The superficial part of the multifidus muscle originated from long sacroiliac ligament, and the medial side of posterior superior iliac spine, however, the deep ones from the sacral plank and sacroiliac short ligament. The width of short tendon of L1-5 multifidus muscle were respectively (15.10±2.43), (15.68±2.79), (14.82±2.77), (14.16±3.62) and (11.58±2.46)mm. The width of it were respectively (4.72±0.99), (5.42±1.14), (5.86±0.99), (5.90±1.06) and (4.68±0.62)mm.  Conclusions   Multifidus muscle is one of key elements to keep the stability of the spine, for it participates in the dorsal extension of vertebral column and the maintenance of lumbar spine lordosis.

    Applied anatomy of hematorrhea control in fracture of pelvis by abdominal artery terminal oppression in vitro
    WU Gang, SANG Xian-Fu, BAO Guang-Xin, LI Xu, WANG Zan-Zhi
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  20. 
    Abstract ( 3170 )  
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            Objective  To supply applied anatomy basis for hematorrhea control in fracture of pelvis by abdominal artery terminal oppression in vitro.  Methods  14 cadaver specimens, 8 male and 6 female, were observed. Taking the superior border of L5 as the basic point, indexes as follows were measured: 1. The relationship between cleft hilum and the distal end of abdominal artery or lumbar vertebrae body; 2. The position of the initial point of the inferior mesenteric plexus. 3. The relationship between the vertic tracks of abdominal artery, lumbar vertebrae, and inferior vena cava. Results  The abdominal artery terminal located between 22 mm above and 15 mm below the superior border of L5. The marker for abdominal artery terminal oppression in vitro, according to the relationship between the body surface projection of cleft hilum and abdominal artery terminal lumbar vertebrae, roughly overlapped the human median line. Conclusions  According to the anatomy basis, cleft hilum can be regard as the marker for abdominal artery terminal oppression in vitro for hematorrhea control in fracture of pelvis.

    Anatomy of carotid artery and its relationship with carotid atherosclerosis
    CHAN Na-Na, ZHANG Yu-He, LIN Zhong-Yi, HU E-Nan, MA Xing, DONG Hua-Jiang, LIU Wei, GAO Fu-Ge, XU Xin-Wang, LI Ba-Sen, YANG De-Hui, CHAN Yun-Guan
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  23. 
    Abstract ( 2230 )  
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            Objective  To explore anatomic features of carotid artery and its relationship with carotid atherosclerosis, and provide morphologic basis for the diagnosis and treatment of common carotid and internal carotid stenosis.Methods  30 adult cadaveric specimens (24 males and 6 females) were used in this study. Carotid arteries were observed and measured, as well the situation of carotid atherosclerosis was recorded.Results  ①Outer diameter of the middle part of common carotid artery was about (8.75±1.56) mm and (8.31±0.99) mm for the left and right respectively.②Outer diameter of the root of internal carotid artery was (8.45±1.42) mm and (7.51±1.63) mm for the left and right respectively.③Outer diameter of the middle part of external carotid artery was (4.87±1.09) mm and (4.39±0.89) mm respectively.④18 cases appeared carotid atherosclerosis(60%) ,which happened mainly on the internal wall at the root of internal carotid.One case(3.33%) presented serious narrow, with the inner diameter of internal carotid of  only about 1.6mm. Conclusions  Carotid atherosclerosis is most likely to appear on the internal wall of carotid, which cause intraluminal narrow of internal carotid.

    Pathological changes of sural arteries in ASO and the construction of collateral outflow tract
    HU Ji-Qiong, LIANG Shuang-Chao, CI Chun-Jiang, XUE Qing-Quan, JIA You-Chuan
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  27. 
    Abstract ( 2029 )  
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            Objective  To provide pathologic and anatomic basis for constructing outflow tract adopting sural arteries at the end stage of arterial sclerosis obstruction(ASO).  Methods   The red emulsion was infused into the arteries of 11 fresh upper leg specimens getting from knee amputation, after that, the pathologic changes of sural and popliteal arteries were dissected and analyzed. As well, the construction of collateral outflow tract was proposed. For 9 patients of ASO, lower extremity arteriography was undertaken, which proved that, femoral, popliteal arteries and their branches were nonvisulized, while sonography showed fundamental obstruction of those arteries. And then exploration of artery were carried out, followed by sural arteries forming and the by-pass between femoral and popliteal arteries.  Results  Anatomic dissection showed that, ① the wall of popliteal artery was rigid, with atheromatous plaque stuffing the lumens;②the opening of sural arteries appeared three types: open type, membrane obstruction type and pillar obstruction type;③the clinical symptom disappeared, skin temperature turn warm gradually,lower limb ulcer healed, and sural arteries dilated, after the operation of construction of collateral outflow tract.  Conclusions  The anatomy and clinical research proves that, the construction of collateral outflow tract adopting sural arteries is feasible.  

    Anatomic features and clinical significance of superficial branch of radial nerve
    WANG Pei, SUN Bo, DU Yuan-Liang, YANG Zhen-Jun, SUN He
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  31. 
    Abstract ( 3823 )  
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            Objective  To report anatomical features and clinical significance of subcutaneous segment of superficial branch of radial nerve.  Methods  42 adult upper limb specimens were applied in this study to dissect and observe the running and distribution of superficial branch of radial nerve.  Results   The superficial branch of radial nerve emerged from the brachioradialis at the distance of (8.33±1.16)cm before reaching styloid process of radius, then ran ahead between brachioradialis and flexor carpi radialis subcutaneously, at the distance of 4.58cm before reanching styloid process of radius, which divided into medial and lateral branch. The lateral branch ran ahead at the facies volaris of the styloid process of radius and became the sensory nerve of the thumb. At the distance of (1.32±0.26)cm and at the proximal end of styloid process of radius, the medial branch went dorsally divided into 2 branches at the midpiece of the first and second metacarpal bone, then became the sensory nerve of the hand dorsal. The angel between superficial branch of radial nerve and the brachioradialis was (20.7±3.16)°, The angel between medial and lateral branch was (18.0±4.4)°,and the length between them at the level of styloid process of radius was (1.4±0.23)cm.  Conclusions   In clinic, the superficial branch of radial nerve should be repaired as far as possible according to different injuried level. For elevating the operation quality, the wound surface should be repaired by skin flap containing superficial branch of radial nerve, and the superficial branch have to be put at the center of the skin flap.

    Comparison of the sagittal slices with HRCT image of the inner segment facial nerve in the temporal bone
    ZHANG Bo, YANG Jing-Wu, WANG Hang-Hui, DUAN Ju-Ru, ZHANG Jian-Guo, DONG Wei-Jia
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  34. 
    Abstract ( 2476 )  
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             Objective  To explore morphological and imaging features of the inner segment facial nerve in temporal bone on the sagittal plane, and provide sectional anatomic data for clinical image diagnosis and treatment of temporal diseases.  Methods   Temporal tissue of fifteen cadavers were sliced to sagittal sections with the thickness of 1.00 mm, using the celloidin embedding technique, and then analyzed and compared with the images of high resolution computerized tomography (HRCT).  Results   The sagittal images could preferably delineate anatomical details of the inner segment of facial nerve in the temporal bone and its adjacent structures, and display better the genu, the horizontal and vertical segments of the facial nerve and the vestibular aqueduct. The total length of the vertical segment of facial nerve was (14.95±1.31)mm. The included angle of the geniculate ganglion was about (108.01°±10.23°). A good overall correlation exited between the sagittal slices and HRCT images,as an addition to the discrepancy of the traverse and coronal scan.  Conclusions  The sagittal HRCT scan of the temporal bone is an important imaging method. The celloidin embedding slices, used in conjunction with the HRCT, and provides precise information to image diagnosis and operation of the temporal bone.

    Sectional anatomy of the gastric peripheral space and its application in imageology
    GUO Yu, WU Bing, MIN Feng-Qiu, YANG Kai-Qing
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  37. 
    Abstract ( 3070 )  
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           Objective   To investigate anatomic features of perigastric space and gastric bare area, and explore their clinical values.  Methods   Perigastric space and gastric bare area were dissected and analyzed on 65 adult cadavers, while continuous cross sections of 46 cadaveric abdomens were performed and observed the appearance plane and scope of extraperitoneal space in posterior gastric bare area under diaphragm. 2 specimens of epigastrium were perfused red latex into pararenal space from the site of the tail of pancreas and observed the distribution of it.  Results   For all specimens, gastric bare area was behind abdominal esophagus, near the posterior wall of stomach, without peritoneal covering. Gastric bare area was divided by internal gastrophrenic ligament, external gastrophrenic ligament and gastropancrestic ligament. Left extraperitoneal space under diaphragm was the space between gastric bare area and left diaphragm. Perigastric space could be divided into hepatogastric recess, superior recess of lesser sac, left extraperitoneal space under diaphragm, inferior recess of lesser sac, and gastrosplenic recess. Left extraperitoneal space under diaphragm had connection with left anterior pararenal space.  Conclusions (1) Gastric bare area is divided by internal gastrophrenic, external gastrophrenic and gastropancrestic ligaments, which are marks for the division of perigastric space area. (2)Perigastric space can be divided into hepatogastric recess, superior recess of lesser sac, left extraperitoneal space under diaphragm, inferior recess of lesser sac, and gastrosplenic recess.(3)Left extraperitoneal space under diaphragm connects with left anterior pararenal space.

    The variation of hepatic duct: a case report
    LIU Fu-Xiang, LI Hua-Jun, LUO Shou-Yi
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  40. 
    Abstract ( 1473 )  
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    Microanatomy and imageology of cerebellar bridging veins below the tentorium and its clinical significance
    DENG Xue-Fei, DAO Wei, LIU Bin, CHEN Fang-Hong, JIA Chun-Hua, HAN Hui
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  41. 
    Abstract ( 2840 )  
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            Objective   To correlate microanatomy of cerebellar bridging veins below the tentorium with its venograms,and provide anatomic basis for the preservation of cerebellar bridging veins during the infratentorial supracerebellar route.  Methods  A total of 20 human cadavers (40 sides) and 62 patients (120 sides) were examined in this study. Each head of the cadavers was injected with blue-coloured latex via the superior sagittal sinus and internal jugular veins. The venograms of each patient was obtained from the venous phases of digital subtraction angiography (DSA) (40 sides out of 22 patients) or computed tomographic venography (CTV) (40 sides out of 20 patients) or magnetic resonance venography (MRV) (40 sides out of 20 patients). Results  Compared to the cadavers, DSA, CTV and MRV revealed 89%, 40% and 38% of the cerebellar bridging veins because the veins depicted by the imageology were 11%, 17% and 33% larger than that of the cadavers. The cerebellar bridging veins entered into TS and petrosal sinus either directly or indirectly via meningeal "lake". The lumen of the meningeal "lake" was flattened, and discontinuity, weaken or intensive signal was often observed on neuroimagings. The dural entrence of cerebellar bridging veins were clustered along the medial end of transverse sinus, the tentorial sinus and the antero-medial segment of the petrosal sinus.  Conclusions  The preoperative venogram is useful to design the individualized surgical approach for the preservation of cerebellar bridging veins below the tentorium.

    Variations of pulmonary fissure:The study of 64-slice MSCT and multiplanar reformation 
    HUANG Hao, WANG E-Fei, CHAN Xiu-Gong, CHEN Ye-Rong, HU Shu-Dong, NI En-Zhen
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  45. 
    Abstract ( 2306 )  
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            Objective  To provide variation data of pulmonary fissure for imaging diagnosis. Methods   451 patients without obvious lesions and operation history were performed a 64-slice multidetector CT scan with the thickness of 0.6 mm, and then the raw data were reformed at the sagital and coronal orientation with the slice thickness of 3mm. All of the reformed images were observed and the features of the pulmonary fissure were counted and analyzed.  Results  Variations of pulmonary fissures appeared in 312 cases (69.18%), among them, 282 cases (62.53%) were right variation, in which 177 cases were single variation, 105 were complex variation. While 82 cases (18.18%) were left variation, in which 25 cases were single and 57 were complex. Three types of variations were observed: type 1, incomplete pulmonary fissures, 45.45% in right horizontal fissure and 19.51% in right oblique fissure, and 16.41% in left oblique fissure; type 2, pulmonary fissure absence, 0.89% in the right horizontal fissure, 0.22% in the right oblique fissure and the horizontal fissure, 0.44% in the left oblique fissure; type 3, accessory fissure, with the occurrence rate of 13.97%, 11.97% in the right, 2.44% in the left.  Conclusions  It is an efficient method to observe and classify the variations of the pulmonary fissures adopting 64-slice MSCT scan combined with MPR technique, which will provide reliable and useful imaging information for correlative subjects.

    Anatomy and MSCT imageology of eustachian tube from 61 cases of otitis media
    YAN Jing-Jing, LIANG Yong, CHEN Yan-Ping, WANG Jun
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  50. 
    Abstract ( 2762 )  
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            Objective    To explore anatomic relationship between normal eustachian tube and that of otitis media, through multi-plane reformation of the multi-slice helical CT (MSCT), and provide anatomic basis for clinical application. Methods   The Otitis media group consisted of 85 ears of 61 patients with otitis media. The control group consisted of 30 ears of 15 volunteers without symptoms of otitis media or abnormal findings in ET function tests. Both groups were scanned under MSCT, and then imaging data were reconstructed adopting multi-plane reformation. The bony part distance, the opening tubal distance, the closing tubal distance and the utility closing tubal distance were measured and compared in both groups.  Results   For control and otitis media groups, the diameters of pre-tympanic segment, of junctional portion of cartilaginous and bony, and the length of bony portion were (9.95±1.29) mm and (9.85±0.83) mm, (3.89±0.50)mm and (3.92±0.37) mm, (20.89±1.81)mm and (20.51±2.13) mm respectively. For static CT images, the length of open zone and occlusive zone were (10.99±0.87) mm and (8.50±0.55) mm, (36.90±6.73) mm and (42.26±7.19) mm respectively, however, the length of occlusive zone were (10.20±3.96) mm and (33.32±9.44) mm respectively for dynamic CT images. Conclusions  There are no significant differences of the length of bony portion between otitis media and the control groups. The occlusive zone is longer in otitis media group than that in control group (P<0.05) under the static CT, however, which is significantly longer in otitis media group than that in control under the dynamic CT.

    Application of 64-Slice spiral CT on the measurement of the simulated puncture angle during intrahepatic portosystemic shunt
    WANG Jian-Hua, ZHOU Ting-Yong, YANG Xin-Wen, LV Fa-Jin, ZHANG Ben-Shi, ZHANG Lin, LIU Ben-Ju
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  54. 
    Abstract ( 2328 )  
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            Objective  To provide anatomic data for intrahepatic portosystemic shunt, by simulating puncture channel and measuring the angle between right branch of portal vein and intermediate hepatic veins or right hepatic veins. Methods  40 cases without liver diseases and 14 cases of cirrhosis underwent the upper abdomen 64-MSCT scan, which was initiated after the test of the celiac levels of abdominal aorta by the smart tracking technology (Smart Prep). The imaging data was processed on the GE ADW4.2 workstations. Results Despite of normal or cirrhosis Child-Pugh A, B grade group, the puncture channels of right hepatic vein or middle hepatic vein about 1cm, 2cm, 3cm and right branch of portal vein about 1cm and 2cm , and the average angle between the hepatic veins, showed a decreased tendency, however, the puncture channel between the right branch of portal vein showed a increased tendency. There was no significant difference for puncture channels and angles among normal group and liver cirrhosis Child-Pugh A, B grade group.  Conclusions   The angle between the intermediate hepatic veins and right hepatic veins or right branch of portal vein is the opposite direction, compared to the simulated puncture channel. It is suitable to puncture between intermediate hepatic veins 2cm and right branch of portal vein 2cm.

    One case of morphological abnormality of sternum
    XIE Yong-Jun, LI Xin, NIE Zheng, LIU Xin-Guo
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  57. 
    Abstract ( 1438 )  
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    Application of CR and DR postprocessing in investigating styloid process in Vivo
    DIAO Yong, LI Shen-Jiang, SHU Feng, LIU De-Bin, LIANG Wen-Jie, CUI Hua-Feng, SHU Yan
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  58. 
    Abstract ( 2676 )  
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            Objective  To explore the application of image post-processing techniques after X-ray computer (computed radiography, CR) and direct digital X-ray photography (digital radiography, DR) in investigating anatomic features of styloid process in vivo.  Methods  210 volunteers with normal styloid processes underwent CR and DR. Based on the initial film, 4 kinds of postprocessing skills, including reversing, margin sharpening, window technique, magnifying and one combination with the other were performed. The length and inclination angle of styloid processes were measured. Results  The average length of styloid processes was (24.34±3.55)mm,  the average anterior inclination angle (19.21±3.08)°, and the medial anterior inclination angle (24.16±4.28)° respectively. Conclusions  CR and DR combination postprocessing demonstrates styloid processes in vivo clearly and accurately,among which film reversing is the most valuable.

    The choice and the significance of the ideal cervical pedicle screw by the computed tomography of the three-dimensional reconstruction
    GAO Meng, LIU Qiang-Tu, CHEN Jian-Yu, YANG Ze-Hong, LIN Xiao-Feng
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  61. 
    Abstract ( 2753 )  
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             Objective   To study the choice and the significance of the ideal cervical pedicle screw by the computed tomography of the three-dimensional reconstruction.  Method  A total of 56 cases were performed cervical pedicle screw fixation of cervical spine by the computed tomography of three-dimensional reconstruction, and measured the ideal shapes of the cervical pedicle screw, including the length, the width, the pedicle transverse angle and the pedicle sagittal angle.  Results   The ideal length of the cervical pedicle screw from C3 to C7 were (28.2±1.9), (27.9±2.1), (29.7±2.0), (30.8±2.3) and (30.6±2.4)mm; The ideal  width were (4.3±0.8), (4.5±0.8), (4.9±0.8), (5.4±0.9) and (6.2±0.9)mm; The ideal  pedicle transverse angle were (48±4)°, (50±5)°, (48±4)°, (43±4)° and (36±3)°; The ideal pedicle sagittal angle were (9±5)°, (6±4)°, (1±3)°, (-1±4)° and (-1±3)° respectively.  Conclusions   The shape of cervical pedicle was very variable. The ideal shapes of the cervical pedicle screw are measured and evaluated by the computed tomography of the three-dimensional reconstruction using the simulation of the operation of the cervical pedicle, having a large significance in selection of the angles and the shapes of the cervical pedicle screw.

    Initial exploration of pelvic lymph node detection with MR whole-body diffusion-weighted imaging
    DIAO Xiao-Chun, SUN Xi-He, WANG Bin, SUN Shi-Hang, DONG Feng, ZHANG Ying-Ying, GUAN Yue, GE Yan-Meng
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  65. 
    Abstract ( 2945 )  
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            Objective   To explore the value of MR whole-body diffusion-weighted imaging (WB-DWI) in detecting pelvic lymph nodes.  Methods   30 cases of informed consent healthy men were selected randomly and 66 cases of pre-operative initial treatment men with pelvic malignant tumors were selected from June 2007 to November 2008 in our hospital. MR WB-DWI, T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) performed to observe the pelvic lymph nodes respectively. It was confirmed by surgery and pathology in patients with pelvic malignancies. Pelvic lymph nodes were counted and their size and ADC values were calculated according to their anatomical site.  Results   The normal pelvic lymph nodes could not show in the WB-DWI images. Contrast with T1+T2, the detection rate was 0.3% on WB-DWI sequence for pelvic lymph node whose short-axis diameter <0.5 cm, but the detection rate was 94.2% for the pelvic lymph node whose short-axis diameter ≥ 0.5 cm and <1.0 cm. The coincident rate of lymph node metastasis whose short-axis diameter ≥ 0.5cm was 89.3% between preoperative detection on WB-DWI and postoperative detection on pathology. There was no significant difference in the ADC values between metastatic and non-metastatic lymph nodes (P>0.05). Diagnostic time for the WB-DWI images was less than the time for the traditional MR images significantly (P<0.01).  Conclusions   The abnormal lymph nodes could be found quickly on WB-DWI sequence. There is a high value on WB-DWI sequence in determining pelvic lymph node involved by malignant tumors, and could be a relatively accurate method for preoperative evaluation.

    The expression of parvalbumin and calretinin in cerebral cortex of model rat of cortical dysplasia
    HUANG Min, YAN Yong, FENG Tie-Hui, ZHANG Jian-Gang, HUANG Hua, ZHANG Yi
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  69. 
    Abstract ( 1924 )  
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            Objective  To explore the expression of parvalbumin(PV) and calretinin(CR) in cerebral cortex of cortical dysplasia (CD) rats, and investigate their effects on pathogenesy of intractable epilepsy caused by CD.  Methods  Sprague-Dawley pregnant rats were given intraperitoneal injection of 1-3-bis-chloroethyl- nitrosourea (BCNU) on embryonic day 15 (E15) for inducing CD in the offspring. The growth and development of rat brain and praxiology change of the offspring were analyzed adopting the warm-water-hyperspasmia inducing method. Cortical histopathology was examined in the resulting pups at postnatal 30 day (P30), at the same time, the expression of PV and CR in the cortex were explored by immunocytochemistry, Immunofluorescence and RT-PCR respectively.  Results   ① The latency period of hyperspasmia of CD animals was shorten; ② The density of PV positive cells in the cortex of model rats and controls were (37.28±2.72 )cells/ field and (77.50±4.49) cells/ field respectively, with the significance between them (P<0.05), followed by the altered spatial distribution, the appearance of PV positive cell aggregation or disappearence at the superficial layers of the cortex. However, there were no difference appeared between model and control animals for CR expression; ③The number of PV positive cells decreased, and the size of which increased in the Ⅳ layer of the cortex of CD rats; ④Relatively reduced expression of PV mRNA in cortex was detected in CD rat.  Conclusions  The PV can be used as a index to identify CD. Abnormal density and distribution of GABAergic interneurons which express PV in the CD model rats may play a pivotal role in the pathophysiologic mechanisms of intractable epilepsy .

    The experimental study of C57BL/6 mouse skin hair follicle development
    ZHANG Min, SHU Xiao-Wen, WANG Xue-Er, ZHANG Lin
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  74. 
    Abstract ( 1779 )  
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            Objective  To investigate hair follicle pattern of fetal, neonatal and adult mouses. Methods  The different development process of hair follicle in C57BL/6 mice were observed using several methods, including paraffin and frozen ultrathin sections, HE staining, AP activity staining, oil red O staining and apoptotic cells identification. Results  The hair follicles section started to develop in the E15.5 fetal mouse of C57BL/6 and the back skin became thicker gradually in the E18.5 fetal mouse with more hair follicles appeared. The most of hair follicles of the 1st day suckling mice born would grow into the fourth stage of hair follicle development with the numbers of hair follicles increasing quickly. At the 4th day after born of immature mice, the most of hair follicles continued to develop, but the number of hair follicles remained unchange. The hair follicles of the 9th day suckling mice would grow into the 8th stage of hair follicle development. For 9d adult mouse after depilation, 95% of the hair follicles entered the growth stage Ⅳ, in the first 17d, 63.3% of the hair follicles entered the degradation period and in the first 22d of, 85% of the hair follicles grew into the degradation period.  Conclusions  The hair follicle of fetal mouse starts at E15.5 and from E17.5 to 3 days after birth. The number of hair follicles will increase rapidly, therefore, this period can be used to explore the mechanism of hair follicle regeneration.

    The measurement of bone density based on three-dimensional reconstruction and finite element analysis
    ZHANG Guo-Dong, MAO Wen-Yu, LIAO Wei-Jing, CHEN Jian-Qiao, LUAN Jia-Gang, ZHENG Xiao-Hui, DAO Ku-Xiang
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  78. 
    Abstract ( 2165 )  
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            Objective  To explore a method for measuring bone density base on three- dimensional reconstruction and finite element analysis.  Methods  One spine specimen (C3~L5) were used for this experiment. It was treated with thin-slice high resolution CT scan and three-dimensional reconstruction in Mimics, volume meshing in Ansys, assigned with 10 and 400 kinds of material attributes Mimics, then exported to Ansys to calculate the volumes of the block elements of every type of material attributes. The mass and the density of the specimen could be harvested according to the empirical formula concerning the gray value and the bone mineral density. The mass of control group (C3~L5) was measured with an electronic balance. All results were statistically treated with one-way ANOVA.  Results   The apparent densities of C3~L5 of control group, group of 10 and 400 kinds of material attributes were 0.62±0.09, 0.5813±0.0806 and 0.5813±0.0805 g/cm3 respectively. P value was more than 0.1 when the density of control group compared with that of experimental groups which were assigned with 10 and 400 kinds of material attributes, while it was 0.997 within experimental groups. Conclusions   Firstly, this method was able to measure the mass and the bone density quantitatively, as well as that of compact bone and cancellated bone; Secondly, to assign 10 kinds of material attributes to three-dimensional model of spine could match the needs for measurements; Thirdly, our experience could be used as an initial preparation for the unification of bone mineral density and finite element analysis.

    Special Meckel's diverticulum : a case report
    LIU Jian-Zhong, LIU Heng-Xin, MA Hui-Jiang, LI Kun-Feng, WANG Ning
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  84. 
    Abstract ( 1201 )  
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    Biomechanical efficiency of single-level unilateral pedicle screw fixation on the instrumented lumbar segment and adjacent segments
    DONG Jian-Wen, QIU Yi-Yan, DIAO Wei-Dong, FENG Feng, RENG Li-Min
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  85. 
    Abstract ( 2314 )  
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            Objective   To evaluate the biomechanical efficiency of single-level unilateral pedicle screw fixation on the instrumented lumbar segment and adjacent segments. Methods  Six fresh-frozen human cadaveric lumbar spines of simulated instability at L4~5 were conducted to a serial of biomechanical tests including flexion, extension, lateral bending and axial rotation. The range of motion in each specimen was tested in sequence according to such four groups: intact in group A, L4-5 segmental instability in group B, unilateral pedicle screw fixation combined with single cage in group C and bilateral pedicle screw fixation combined with single cage in group D.  Results  Apart from the ROM of left lateral bending, there was no significant difference of ROM at L4-5 between group C and group D (P>0.05). Apart from the ROM of left and right lateral bending, there was no significant difference of ROM at L3-4 and L5-S1 between group C and group D (P>0.05). Conclusions  All tested single-level unilateral pedicle screw fixation can achieve similar initial biomechanical stability and cause less lateral bending motion at adjacent segments in comparison with bilateral pedicle screw fixation.

    Clinical significance and surgical treatment of lumbar disc herniation associated with separation of the ring apophysis in adolescents
    CHEN Jian, LONG Hou-Qing, LIU Shao-Yu, XIE Gan-Hu, LI Gao-Miao, WEI Fu-Xin, HUANG Yang-Liang, LI Bi-Bao
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  90. 
    Abstract ( 3073 )  
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            Objective  To evaluate the clinical significance and surgical results of lumbar disc herniation associated with separated ring epiphysis in adolescents.  Methods  From September 1998 to March 2009, 82 cases(range 9~20y,mean 15.9 y)of adolescent lumbar disc herniation were reviewed by clinical data and CT. 22 cases of lumbar disc herniation associated with separated ring apophysis was group A. Location, size, and shape were analyzed. Discectomy and separate ring apophysis resection were carried out at the same time. 30 in 60 cases with disc herniation were group B, and discectomy was performed only. JOA and VAS were used for clinical evaluation. Clinical features and surgical outcomes were compared between group A and group B. Results   22 cases (28%) suffered from lumbar disc herniation associated with separated ring apophysis. Clinical symptom and neurological status of group A were more serious than that of group B according to VAS and JOA(P<0.05). Pre-operative endurable periods of group A was shorter than that of group B significantly(P<0.05). There was no significant difference between the two groups regarding post-operative results by JOA and VAS(P>0.05). Operation time and blood lost were much higher in group A(P<0.05). Conclusions Adolescent lumbar disc herniation associated with separated ring apophysis with more serious symptoms should be performed operation when diagnosis was determined. Bone block resection should be carried out when performing discectomy for sequestrated, large, central type, or lateral recess separated bone.

    The changes of intervertebral contact area during lumbar spondylolisthesis
    CHEN Ai-Dong, XU Rui-Sheng, TUN Ji-Dan, WANG Xue-Song, XUE Jun, BAO Ju-Liang
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  94. 
    Abstract ( 2137 )  
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            Objective   To study the changes of intervertebral contact area during lumbar spondylolisthesis and discuss its clinical effects.   Methods   The images of superior surface of L5 vertebras and inferior surface of L4 vertebras from 25 cases were taken by a digital camera, and then spondylolisthesis procedure in 2D plane was simulated by computer with the step of  fourteen, while intervertebral contact area (Sn) of every step was measured by Image-Pro Plus software. Results  During lumbar spondylolisthesis procedure,  Sn% (Sn%=Sn/S*100%)showed a hyperbola changes. Sn% lost slowly during the rate of 0~23%, then lost quickly during 23%~44%, finally slowly once again after the rate of 44%. The inflection points appeared at the rates of (23±2.02)% and (44±1.46)%.  Conclusions   The intervertebral contact area presents a non-linear change, which is helpful to judge the stability of lumbar spine and guide stable reduction during spondylolisthesis operation.

    Applied anatomy of the dorsal metacarpal and digital fasciocutaneous flap pedicled with the dorsal cutaneous branch of the proper digital artery
    XIE Song-Lin, TANG Ju-Yu, DAO Ke-Ai, HUANG Xiong-Jie, JIA Xiao-Dan, LIU Chang-Xiong
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  97. 
    Abstract ( 2714 )  
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            Objective   To provide applied anatomic evidences for the application of the dorsal metacarpal and digital fasciocutaneous flap pedicled with the dorsal cutaneous branch of the proper digital artery.  Methods  14 fresh adult cadaveric hands were injected with red latex. The dorsal digital and metacarpal vessels of the cadaveric hands were dissected layer by layer, and their course, distribution, connection and external diameter were observed and measured with the aid of an operating microscope.  Results   There were 1 to 7 indirect dorsal cutaneous branches and 2 to 8 direct dorsal cutaneous branches of the proper digital artery in each side of proximal and middle phalanx, respectively. There was a relatively large dorsal cutaneous branch of the digital artery in each side of the middle and distal third of the proximal phalanx, the proximal or middle third of the second phalanx, respectively, whose external diameters were more than 0.3 mm usually. The dorsal digital branches of the terminal segment of dorsal metacarpal artery and distal dorsal perforator of deep palmar arch anastomosed with the dorsal cutaneous branches of the digital artery. The dorsal cutaneous branches of the digital artery in different segments anastomosed with each other at the dorsolateral aspect of phalanx, where a arterial link was formed.  Conclusions   The reverse dorsal metacarpal and digital fasciocutaneous flap pedicled with the dorsal cutaneous branch of the proper digital artery is more suitable for repairing comparatively large-area soft tissue defects of middle and distal phalanx, for their advantages of easy and secure harvest, and the longer arch of rotation.

    One example of deformed and calcified thyoid cartilage
    LEI Shi-Jun
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  100. 
    Abstract ( 1082 )  
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    The modification of lateral gastrocnemius myocutaneous flap with extended anterior margin and its clinical application
    DONG Zhong-Gen, LIU Li-Hong, NI Jiang-Dong, HE Ai-Yong, LI He-Jun, MA Bing-Dong, WU Wen
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  101. 
    Abstract ( 2916 )  
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            Objective   To introduce the modified lateral gastrocnemius myocutaneous flap with extended anterior margin and its clinical features. Methods   The anterior margin of the flap was extended from the overlying of fibula to the crista anterior tibiae, and anterior border located in lateral border of defects. 21 cases were treated with modified lateral gastrocnemius myocutaneous flaps, with 9 cases in upper 1/3 segment of the cnemis, 7 in anteriomedialis of middle 1/3 segment of the cnemis, and 5 in anteriolateral of middle 1/3 segment of the cnemis. The anterior border of all flaps exceeded crista anterior fibulae, and that of 2 flaps reached to the crista anterior tibiae. The width of flap on anterial compartment of the cnemis ranged from 2.5cm to 7.0cm, averagely 4.0 cm. Results  19 flaps survived well, however, marginal necrosis of distal end above external malleolus about 5cm and 3cm respectively, occurred in 2 cases.  Conclusions  With the extension of the effective width and length, the modified lateral gastrocnemius myocutaneous flaps are reliable for repairing soft tissue defect.

    Modified Barium Sulfate-latex injection technique for angiography
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  104. 
    Abstract ( 3190 )  
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             Objective  To improve the angiographic images of barium sulfate-latex injection technique and replace toxic lead oxide as the standard contrast medium. Methods  45 SD rats underwent angiography compared with different concentrations and types of latex, and the proportion of barium sulfate to latex, and adjusted radiographic parameters for the injection of barium sulfate. Results  The perfusate was prepared as follows: 10ml of latex was diluted in 20ml of water(20℃), with 27 grams of barium sulfate (used in clinical medicine) added. The average amount of barium sulfate mixture injected was 20-30ml/300g, which provided high quality angiograms. Conclusions  Modified Barium Sulfate-latex technique provides high-quality angiograms. Besides, barium sulfate does no harm to the health of researchers, which makes it a good method for the study of cutaneous artery and perforator flap.

    The application of Hoffen P45 bio-technique for sheet plastination in sectional anatomy specimens
    BAI Jian, GAO Hai-Bin, LIU Jie, LUAN Bing-Yi, MENG Wen-Jian, ZHANG Jian-Fei, XU Qing-Bei, GONG Jin, ZHANG Cheng-Hong, DUO Hong-Jin
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  107. 
    Abstract ( 1329 )  
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    A discussion on definition of accessory renal artery
    ZHANG Ji-Jing, Zhang-Xiao-Dong
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  109. 
    Abstract ( 1428 )  
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    The microanatomy of root exit zone of facial nevers(review)
    LI Jin-Xing, LIU Ru-En
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  111. 
    Abstract ( 1922 )  
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    Atrioventricular node and sudden unexpected natural death
    HONG Dao-Xin, FANG Xi-Hu, DONG Wu-Zhong, HONG Wei
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  114. 
    Abstract ( 1063 )  
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    One case of pentalogy of fallot combined hemitruncus deformity of right and left coronary artery and anomalous origin of coronary artery
    DIAO Qi-Meng, GAO Bing-Ren, YANG Kun, DAI Tu-Lei, SONG Tie-Niu
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  116. 
    Abstract ( 1368 )  
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    The right nonrecurrent laryngeal nerve: report of a case and review of the literature
    BO San-Jiang, LV Lai-Qing
    Chinese Journal Of Clinical Anatomy. 2010, 28(1):  117. 
    Abstract ( 1062 )  
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