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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 July 2010 Volume 28 Issue 4
      
    Microanatomy of the orifice of cerebral bridging veins into the suprior sagittal sinus
    ZOU Li-Na, DENG Xue-Fei, CHEN Feng, HAN Hui
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  355. 
    Abstract ( 2643 )  
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    Objective To perform a microanatomy of the orifice of cerebral bridging veins (BVs) into the superior sagittal sinus (SSS), in order to provide a morphologic basis for the mechanism of cerebral venous thrombosis. Methods Thirty cadaveric head specimens were used in this study. The number, location, types and distribution of the orifice were recorded. Results A total of 367 outer orifices and 375 inner orifices were found. The outer orifice was the junction outside of the SSS between BV and dural mater. The inner orifice was the sinusal entrance inside of the SSS. For eight cases, two inner orifices drained one of BVs into the SSS with one outer orifice. The orifice mainly located in the anterior or posterior segments of the SSS. Most of outer orifices (70%) directly drained into the SSS, and the others drained into the SSS indirectly by the meningeal veins or parasagittal sinues. A part of outer orifices (37%) drained into the posterior segment of SSS indirectly, in which 85% of them changed the direction of the BVs from against the direction of blood flow in the sinus to along or at a right angle. Conclusions This study reveals the complexity of the orifice which commonly changed the direction of the BVs and played an important role for reducing the cerebral venous system thrombosis.

    Applied anatomy of neurocutaneous vascular flap pedicled with posterolateral mid-forearm perforators
    ZHENG He-Beng, CHEN  Feng, HONG Fa-Lan, CHEN Chao-Yong, ZHANG Fa-Hui
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  358. 
    Abstract ( 1942 )  
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    Objective To provide anatomical basis for the neurocutaneous vascular flap pedicled with posterolateral mid-forearm perforators. Methods 30 embalmed upper limbs of adult cadavers perfused with red latex were used for this anatomical study, and the followings were observed :①The course and distribution of the posterior antebrachial cutaneous nerve;②Anastomoses between posterolateral mid-forearm perforators and nutrient vessels of the antebrachial cutaneous nerve. Mimic operation was performed on one side of fresh specimen. Results ①The trunk of posterior antebrachial cutaneous nerve run on the dorsal forearm,descending to the wrist between the extensor digitorum and extensor carpi ulnaris, and innervated about 1/3 area of the posterolateral forearm. ②the nutrient vessels were made up by segmental perforators of multiple origins. The posterolateral mid-forearm perforators whose locations were relatively constant travelled in the intermuscular septum between the extensor digitorum and extensor carpi radialis brevis or the supinator and abductor pollicis longus , and pieced the deep fascia to the subcutaneous tissue (range: 12.5 ~ 15.8 cm below the lateral condyle of humerus). A large number of small arterial branches were given off by those perforators, which anastomosed with the perineural and intraneural nutrient-vessel links of the antebrachial cutaneous nerve, forming a longitudinal vascular plexus along the intermuscular septum between the extensor digitorum and extensor carpi radialis brevis and around the anterbrachial cutaneous nerve. Conclusions  The neurocutaneous vascular flap pedicled with posterolateral mid-forearm perforators can be developed to repair soft tissue defects of the forearm and wrist.

    The reconstruction of opposition function by partial pectoralis minor transplantation: neuroanatomic study
    CHANG Li-Feng, PENG Yong-Jing, XIONG Hong-Chao, FU  Jiang, JIANG Gao-Li, FANG Ti-Che
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  363. 
    Abstract ( 1955 )  
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    Objective To provide anatomic evidence for the reconstruction of the opposition function by pectoralis minor transplantation. Methods Dissecting and surveying on the medial pectoral nerves and the deep branches of the ulnar nerves were performed. The number of myelinated ulnar nerve fibers was compared for confirming the possible nerve fiber suture during the operation. Results The medial pectoral nerve was the dominant fiber for the innervation of pectoralis minor muscle, which pierced into the pectoralis minor at the midclavicular line from the third intercostal space, with the number of myelinated fibers of about 868±130. Through medial intermuscular septum, the deep branch of the ulnar nerve respectively gave rise to conspicuous branches in the fourth and third spatia interossea metacarpi. The numbers of myelinated fibers of these branches respectively were 708±78 and  394±49. The number of myelinated fibers of the P3L4 was as many as that of the medial pectoral nerve and the recurrent branch of median nerve. Conclusions During the operational process of reconstructing the opposition function by pectoralis minor muscle transplantation, the medial pectoral nerve can be taken as the donor nerve, which should be found at the junction of the midclavicular line and the third intercostal space. It's more match with each other by suturing the P3L4 with the medial pectoral nerve.

    Applied anatomy of fibular head flap pedicled with distal inferior lateral genicular artery
    CHEN Chao-Yong, ZHENG He-Beng, LIN Song-Qiang, XU  Hao
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  366. 
    Abstract ( 2538 )  
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    Objective To provide applied anatomical basis for designing of fibular head flap pedicled with distal inferior lateral genicular artery.  Methods Proximal and distal lengths and outer diameters of the inferior lateral genicular artery were observed and measured on 30 specimens of adult lower limb perfused with red latex. Simulating operation of the harvesting the flap was performed on one side of fresh specimen.  Results The inferior lateral genicular artery originated commonly from popliteal artery. Proximal length of it was about (4.1±0.5)cm, and the outer diameter about (1.8±0.2)mm. The distal length was about(5.3±0.4)cm,the outer diameter about (1.0±0.1)mm.  Conclusions Compared to that of proximal arterial pedicle, the fibular head flap pedicled with distal inferior lateral genicular artery is more reliable for operative procedure.

    Treatment of isolated posterolateral fracture of the tibial plateau via the posterolateral approach:anatomy and clinical implication
    XIA Jiang, SHU Guang-Rong, ZHOU Jia-Han, YUAN  Feng, ZHANG Shi-Min, ZHANG  Kai
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  369. 
    Abstract ( 1724 )  
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    Objective To provide anatomic basis for treating the isolated posterolateral fractures of the tibial plateau by posterolateral approach. Methods (1) The main vessels, nerves, muscles and ligaments relative to the posterolateral approach were observed and measured on 20 lower limbs of adult cadavers. (2) To make sure the practicality of the posterolateral approach, surgical simulations were performed on another 4 lower limbs of fresh adult cadavers. (3) The approach was clinically applied on 12 cases. The clinical characteristics and the treatment outcome were also analyzed. Results The operative incision of this approach can avoid to reach the common peroneal nerve trunk. The vascular nerve bundles were protected when the deep dissections were carried on in the intermuscular septum between the lateral side of lateral gastrocnemius muscle and the soleus muscle. The distal dissection should be restricted no more than (4.15±0.36) cm below the fibular head level, as the anterior tibial vessel passed through the interosseous membrane, and the space is enough for the reduction and fixation. Satisfied results were obtained in all 12 cases adopting this approach. Conclusions The posterolateral approach is an ideal way for the treatment of isolated posterolateral fractures of the tibial plateau. The advantages of this approach are as follows: the exposure is good and safe, the injury is limited and the clinical results are excellent, and it's with certain value for popularization.

    The variation horizontal fissure of right lung and horseshoe kidney: a case report  
    ZHONG  Hua
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  374. 
    Abstract ( 829 )  
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    The establishment of cadaver head model that simulates living surgery for nasal endoscopic surgery training under image guided navigation system
    SHAO Yong-Liang, TUN Pan-Qiao, LI Xiao-Meng, GU Feng-Chao, WANG Geng-Yin, MA Ji-Feng
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  375. 
    Abstract ( 2287 )  
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    Objective To establish a novel cadaver head model and do dissection in this model that simulates the living surgery. The objective is to use this model for nasal endoscopic surgical training under image guided navigation system (IGNS) and to improve rhinologist's surgical dissection skills. Methods We established a cadaver head model that simulates the living surgery. The common carotid arteries (CCA) and the internal jugular veins (JV) were exposed on the model. We connected a "heart-like" pump to the cadaver head, using plastic tube filled  with artificial blood (red fluid for arterial blood, blue fluid for venous blood. The pump rate and presser mimicked human conditions.) The blood flows from the CCA on the other side through the arterial circle in the skull base. When a blood vessel is cut in a dissection training session, the bleeding of the blood vessel can be stopped by bipolar diathermy or mono polar diathermy at the time of the dissection just as that in the living surgery. Results The cadaver head model creates a very realistic dissection scenario. We could distinguish the anatomical landmarks, and have a deeping understanding of the imaging. Conclusions This novel cadaver head model which simulates living surgery provides better nasal endoscopic surgery training with or without IGNS. This also made the nasal endoscopic dissection training significantly move forward. This model could be beneficial for all types of surgical training in the future with or without IGNS, not just nasal endoscopic surgical training.

    Quantitative study of the extent of dural de-stretching suture during the decompression of craniocerebral injury
    SI Wen, JIANG  Kun, JIANG  Man, NIU Guo-Sheng
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  379. 
    Abstract ( 2080 )  
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    Objective To explore the extent of dural de-stretching suture matched with the standard large trauma volume compensatory. Methods 20 cases of standard large decompressive craniectomy were measured and calculated the average adult compensatory volume of the decompression of the measurement window. The skull of the cadavers were used to simulate the process of dura mater defects tension, and found the volume of defects caused by the extent of dural tension (area to express), in order to quantify the reduce tension extent of dura mater. Results The average compensate volume of the adult standard large decompressive craniectomy was about 81ml, and the area caused dural tension defect was about 26.5cm2, which would be effected by the age, the range of bone flap, the degree of brain atrophy, delayed cerebral edema, intracranial hematoma, cerebral infarction, scalp tension and so on. Conclusions For dural de-stretching suture, the optimal repairing area of dura mater is about 26.5cm2, which should be revised according to the individual compensatory volume.

    Clinical study of central venous catheterization using anatomic landmarks in patients undergoing liver transplantation
    WANG  Ban, HE Kai-Hua, CHENG  Bei, WEI  Ke, MIN  Su
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  382. 
    Abstract ( 1820 )  
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    Objective To compare the success rate and incidence of complications of central venous catheterization via internal jugular vein (IJV) versus subclavian vein (SCV) using anatomic landmarks, and to give suggestion for easy and safe choosing in clinic. Methods A randomized, crossover study in patients undergoing semi-selective liver transplantation were performed. After anesthesia induction, the IJV and SCV were punctured and catheterized using anatomic landmarks consecutively in a randomized crossover fashion by the same anesthesiologists. The data collected included the number of venipuncture and guidewire insertion attempts until success, the time from first venipuncture to successful guidewire insertion, and the associated complications. Results Cannulation via SCV required more attempts than via IJV (2.9±1.4 vs 2.3±0.7, n=42, P<0.05), however, cannualtion via SCV was more time comsuming than via IJV (2.24±1.01 vs 1.58±0.49 min, n=42, P<0.05). One patient developed a hematoma after accidental carotid artery puncture during the process of IJV catheterization. Arterial puncture did not occur during SCV catheterization, but a hematoma developed in one patient. Conclusions Central venous cannulation via IJV is more easier and quicker than via SCV.

    Morphologic features and clinic significance of the fallopian tube
    HAN Xiang-Jun, GUO Cheng-Gao, WANG Rui-Huang, WANG Lei-Guang, QIU  Yi, LI Xiang-Ying, CHEN Jian-Jiang
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  385. 
    Abstract ( 2078 )  
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    Objective To explore morphologic features of the fallopian tube of reproductive aged women and provide the basis for the study of tubal sterilization and fertility. Methods The length, diameter and the orifice of the fallopian tube were observed, measured and analyzed on the data from 100 cases of salpingography (HSG), 30 cases of hysteroscopy and 20 cadaveric specimens. Results HSG showed that, the diameter of internal orifice,the lengths of the middle and distal of interstitial parts were about (1.07±0.48) mm, (0.50±0.22) mmand (0.32±0.12) mm averagely, respectively. The internal diameter of the isthmus and the ampulla were (0.46±0.28 mm) and (2.43±1.45) mm respectively. the length of interstitial part, isthmus, ampulla and the total were (5.27±4.28 mm), (24.35±12.27) mm,(39.94±22.05)mm and (70.78±32.07) mm respectively. Hysteroscopy showed the round(76.7%) or oval(23.3%)internal orifices of fallopian tube. The perimeter of internal orifice was (5.87±1.46)mm, and of the isthmus (2.83±1.87) mm. The length of interstitial part, isthmus and the total were (6.73±2.49) mm, (20.56±7.61) mm and (85.42±22.93) mm, respectively on cadaveric specimens.    Conclusions    Fallopian tube is a tortuous channel with the dilated internal and external orifices. The interstitial part is funnel-shaped, with the narrowest part at the distal of it. It is necessary to understand morphologic features of fallopian tube for the study of sterilization and fertility.

    Applied Anatomy on the resuscitation of neonatal asphyxia
    FAN  Zhen, HE  Sheng
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  388. 
    Abstract ( 1671 )  
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    Objective To provide anatomic basis for neonatal asphyxia resuscitation. Methods: 32 neonatal cadavers were used to measure about the body length, the upper part length(from corona capitis to upper border of pubic symphysis). And then, a median sagittal cut on the bodies were performed for exposing and observing of larynx, trachea and bronchus, involving the shape and position of larynx, and the slope degree of laryngeal cartilages. At the position of tracheal intubation, the lengths from oral cavity, and nasal cavity to glottis vera, from glottis vera to bifurcation of trachea, and the inner diameter of trachea were measured and analyzed.   Results (1) The body length of neonates was about (50.87±2.02)cm, the upper part length about (33.81±1.06)cm, and there were no significant difference among different cadavers. (2) The angle between aperture of larynx and vocal cords was about (46.82±1.58)°, and opened posteriorly, with an obvious difference compared to that of the adults.  (3)The length from upper incisors to the glottis was (5.95±0.51)cm, from the anterior naris to the glottis (7.06±0.47)cm, and from the glottis to the bifurcation of trachea(4.94±0.74)cm, respectively, which appeared a linear correlation with the lengths of the body and the upper part. (4) The proximal tracheal diameters and sagittal diameter were (0.50±0.12)cm and (0.38± 0.04)cm, while the distal tracheal diameter and sagittal diameter(0.49±0.14)cm and (0.35±0.06)cm, respectively, without significant difference between them.   Conclusions    According to the body length or the upper part length of the neonates, the tube length can be estimated before the intubation. For the neonates, the insertion depth has to be considered carefully, with the oral tube length about 7~9cm, the nasal tube length about 8~10cm, and diameter about 0.25~0.40cm. (2) For the neonates, laryngoscope with direct lens should be selected, and the full attention should be paid to the acute angle between the aperture of larynx and vocal cords during the trachea intubation.

    The variation of right obturator artery, right inferior epigastric artery and right obturator vein: one case report
    SUN Feng-Gang, AN Chu-Gong, DU Ai-She, DIAO Zhen-Mei
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  391. 
    Abstract ( 1279 )  
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    Sectional anatomy of the lumbar spine and its clinical significance
    LI Lin-Hong, JIAN Hua-Hua, ZHOU Ting-Yong, LI Pan-Pan, LIU Ben-Ju, XU  Wei, ZHANG  Hui, LV Fa-Jin
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  392. 
    Abstract ( 2668 )  
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    Objective To explore sectional anatomy of lumbar spine, and provide morphologic basis for diagnosing and treating lumbar spinal diseases. Methods Vertebral body, the pedicle of vertebral arch, vertebral foramen and lamina of vertebral arch on 30 sectional lumbar spinal specimens were observed and analyzed. Results For different lumbar vertebrae, there was a significant sex difference(P<0.05 or P<0.0001)for transverse and sagittal diameters of vertebral body, transverse diameter of vertebral canal, spine index, transverse diameter of pedicle of vertebral arch, the length of OE, but not for sagittal diameter of vertebral canal and  the angle of Z. There was no significant difference among bilateral transverse diameter of pedicle of vertebral arch, and the length of OE in lumbar vertebrae. There was no significant difference for sex and position except that were between cross-sectional A and cross-sectional B at the angle of bilateral vertebral plate, which ranged from 70° to 90°. All of lumbar spinal indexes were less than 1:4. Conclusions The results show that, for different lumbar vertebrae, there is a significant sex difference for main morphologic parameters. Some parameters, such as the transverse diameter and sagittal diameter of vertebral body, the spine index, the angle of bilateral vertebral plate, the transverse diameter and sagittal diameter of vertebral canal, are valuable for evaluating the stenosis of vertebral foramen. It is vital to analyze imaging data before selecting optimal translaminar screw.

    Preoperative CTVE images of sphenoidal neurovascular structures and the applications for transsphenoidal pituitary surgery
    CA Mei-Qin, QIN  Feng, HU  Bing, LING  Cong, WANG  Hui, LI Wen-Qing, GUO  Yang
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  397. 
    Abstract ( 1540 )  
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    Sectional and imaging anatomy of the lateral cranial base and its three-dimensional reconstruction
    FU Sheng-Qi, WANG  Hua, MIAO Ying-Ying, JING Li-Min, FAN Ti-Yi, WEN Xiao-Jun
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  401. 
    Abstract ( 1741 )  
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    MRI diagnosis of cerebral enlarged perivascular space
    LIU Yin-She, YUAN  Fei, DIAO  Jun, YUAN  Bin, ZHANG Zhong-Jiang, AI Ke-Wen
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  405. 
    Abstract ( 1818 )  
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    The factors influencing the adjustment function of PI on spinal sagittal balance in normal subject
    FAN Guo-Meng, CHEN Ji-Cuan, GONG Sui-Liang, LI Fang-Cai
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  409. 
    Abstract ( 1573 )  
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    Objective To investigate the factors influencing the adjustment function of PI on spinal sagittal balance in normal subject. Methods 106 normal subjects were selected to perform a full standing spinal lateral radiograph including spine, pelvis and both hip joints from January 2008 to June 2008 in our outpatient department. The radiographs were digitized and 5 sagittal parameters were measured on lateral radiographs: pelvic incidence, sacral slope, pelvic tilt, lumbar lordosis and thoracic kyphosis, followed by the statistic analysis. Results 106 cases of normal subjects were separately divided into 38 cases, belonging to high SS/lower PT, with the mean value of PI and LL of (50.85±10.01)° and( 49.41±9.84)°respectively and the regression equation of LL=0.571PI+20.395 ; 68 cases, belonging to lower SS/high PT, with the mean value of PI and LL of (49.14±12.00)° and (39.17°±10.98)° respectively and the regression equation of LL=0.531PI+13.079°. The two groups demonstrated interclass positive correlation and linear regression between PI and SS, PT and LL, SS and LL respectively, while significant difference of SS, PT and LL between the two groups was showed except for that of PI. Conclusions (1)LL can't be concluded only by PI for the influence of pelvic posture.(2)Under the same PI, the more anteverted pelvis, the more large LL, otherwise, the more large PI, the more large LL under the same pelvic posture. 

    Anatomic basis and CT image features of transverse mesocolon involvement by pancreatic carcinoma
    XIN Shun-Bao, MA Gui-Feng, CUI  Hui, XU  Min, DONG  Feng
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  413. 
    Abstract ( 2874 )  
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    Objective To study the CT image features of transverse mesocolon (TM) involvement by pancreatic carcinoma based on the anatomy. Methods (1) 4 patients, underwent the upper abdominal surgery and without transverse mesentric diseases were selected and observed. (2) CT images of 64 cases of pancreatic carcinoma with TM involvement were reviewed retrospectively. Emphasis was placed on the follows: (1) the anatomical relationship of TM and pancreas, and the course, distribution and attachment of TM's vessels. (2) The size, shape and location of the mass, and the appearance, density, vascular involvement of the TM, the lymph nodes in the TM and the extent of the TM involvement. Results (1) Middle colic vessels coursed between the two layers of the TM, and its' TM region attached to the posterior layer of the TM. (2) Mesenteric mass, increased mesenteric density, mesenteric vessels involvement and the enlarged lymph nodes in the transverse colon appeared in patients suffered from pancreatic carcinomas. The incidence of mesenteric masses was always concerned with the size of the pancreatic mass (p<0.01). (3) Pancreatic carcinomas usually invaded the root, body and margin of the TM. The tumor spread along the subperitoneal space and the anterior layer of the TM, and furthermore invaded into the small mesentery. Conclusions Specific CT images and anatomic features appeared once the TM involved by pancreatic carcinoma. CT is valuable for evaluating of TM involvement by pancreatic carcinoma.

    Imageology and clinical significance of cervical spondylotic vertebral artery insufficiency
    HE Zhen-Rong, DIAO  Liang
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  417. 
    Abstract ( 1854 )  
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    Objective  To explore imaging features and pathomechanism of cervical spondylotic vertebral artery insufficiency. Methods Sixty cases with cervical spondylotic vertebral artery insufficiency were included in this study, with the average age of 52(from 35 to 68), the average medical record of 4 months (the longest of 2 years), and the 2 times' of intermittent vertigo at least. Systematic imaging examinations were carried out for every case, including cervical anteroposterior, lateral and dynamic X-ray films, MRI, MRA and transcranial doppler (TCD) scan. Results X-ray films showed the healthy cases(3), the cases of straightforward changes of cervical curve(10) , the cases of degenerative changes(44), and the cases of cervical instability(3) respectively. However, MRI showed degenerative changes in 42 cases, and the compression of cervical dura resulting from cervical intervertebral disc hernia or the fold of ligamentum flavum in 18 cases. MRA examinations showed the normal ones in 38 cases, the slim change of unilateral vertebral artery in 10 and  the tortuosity in 12 cases,without obvious vertebral artery occlusion. TCD examination showed the normal flow velocity of vertebrobasilar artery in 8 cases and the significant abnormal in others. Conclusions The underlying mechanism of cervical spondylotic vertebral artery insufficiency focuses on the vessel contraction or spasm of vertebral artery caused by nerve irritation resulting from degenerative cervical segmental hypermobility and inflammatory reaction.

    The absence of the horizontal fissure of the right lung and the aberrance of the right principal bronchus branch, on case report
    XU Nian-Xiang, LIU Ceng-Xu, CHU Gui-Lin
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  420. 
    Abstract ( 1375 )  
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    Repairing bone defects of rabbit femur adopting injectable nano-Hydroxyapatite/chitosan composite compounded with bone marrow stromal cells
    LIU Yang, SHU Li-Xin, WANG Qiang-Bei, TIAN  Jing, HU  Yong, WEN Yong-Fu, SUN  Jin, HUANG  Zhi
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  421. 
    Abstract ( 1490 )  
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    Objective To explore the ability of injectable nano-Hydroxyapatite/chitosan composite compounded with bone marrow stromal cells (nHA/CS-BMSCs) for repairing large bone defects of rabbit femoral condyle. Methods Animal models of bone defects were induced in 18 New Zealand white rabbits by drilling holes in bilateral femoral lateral condyles, and treated as follows: for all animals, the right defects were filled with the nHA/CS-BMSCs compounded, however, the left defects of 16 rabbits were filled with CS material, while, left defects of another 2 animals were untreated and taken as the control. The repairing effects were evaluated by gross observation, X-ray and CT scan 12 weeks after operation. Results The gross observation, X-ray lateral projection, the measurement and analysis of CT values, and the results of three dimensional reconstruction revealed that, the bone defects filled with nHA/CS-BMSCs had been repaired completely, with the better repairing effects compared to that of CS. nHA/CS-BMSCs prompt to  the new bone formation, compared to CS material(P<0.05).    Conclusions     The nHA/CS-BMSCs is effective on repairing bone defects, which maybe a promising bone repairing material for clinical application.

    Biological properties of EDC cross-linking xenogeneic(porcine)acellular tendon
    JIE Chuan-Biao, LIN Ru-Qiu, RUAN  Mo, LENG Yuan-Xi, CENG Yang-Zhi
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  425. 
    Abstract ( 1725 )  
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    Objective  To study the biological properties of 1-ethyl-3-3-dimethyl-aminopropylcarbodiimide hydrochloride(EDC)cross-linking xenogeneic(porcine) acellular  tendon(EPAT) as biological scaffold materials for tendon grafting.   Methods   The fresh porcine tendons were treated with trypsin and Triton X-100 to remove all cell components, then crosslinked with EDC. The features of histomorphology,biomechanics, degradation,immunogenicity and cell biocompatibility were assayed and compared with fresh tendon, freezed tendon and acellular tendon. Results Immunogenicity of EPAT declined significantly, conversely, biomechanics, degradation and cell biocompatibility of EPAT were not statistically significant compared with freezed tendon and acellular tendon. The biocompatibility in vitro had no difference among different treated materials.  Conclusions   EPAT could be the promising tendon graft for its optimal biological properties.

    The effects of Panaxydol on the cultured RSC96 cell lines in vitro
    MO Li-Dan, DING Wen-Long, LIN Xue-Qun, LIU De-Meng, HUA  Ping, WU Hong-Hao
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  430. 
    Abstract ( 2027 )  
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    Objective To investigate the effects of Panaxydol (PND) on the expression of NGF and myelin protein in cultured RSC96 cells. Methods RSC96 cells were cultured and decided the optimal culture condition by adjusting the serum concentration. After detecting the proliferation of RSC96 cells by MTT assay, the cultures were added with PND (10 μmol/L), or without PND as the control. After 24 h, the expression and secretion of NGF and BDNF in cultured cells were examined by RT-PCR, western blot and ELISA. For exploring the possible intracellular signals involved in PND effects, N-type Ca2+ channel blocker - Nifedipine was co-cultured for 4 h before the addition of PND. Results The result showed that, 4 mmol/L serum in the culture medium was the best concentration for the growth of RSC96 cells. PND significantly enhanced the expression and release of NGF and BDNF of RSC96 cells. However, the effects of PND on the RSC96 cells can be partly eliminated by Nifedipine. Conclusions The results indicate that RSC96 cells cultured in an optimal serum medium could replace primary Schwann cells as the subject for in vitro researches, furthermore, the effect of PND on the RSC96 cells is mediated partly via Ca2+ signal.

    The construction of the recombinant PDGF-BB adenovirus vector and its expression in epidermal stem cells
    LI Xin-Beng, ZHANG Ming-Sheng, BAI Li-Meng, QIU Jia-Qi, BAI Wen-Fang, TUN Zhi-Dong, TUN  Bo
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  434. 
    Abstract ( 1279 )  
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    Objective To construct the recombinant adenovirus vector containing PDGF-BB gene and detect its expression in human epidermal stem cells (hESCs). Methods The core sequence of human PDGF-BB was amplified by PCR from pCMV-SPORT6, and then was cloned to pAd track-CMV. The linearized shuttle plasmid was homogenously recombined with pAdeasy-l in BJ5183, and the potential clone was analyzed by restriction endonuclease digestion. The correct clone was linearized and transfected into HEK293 cells for packing and amplifying so as to obtain adenovirus rAD-PDGF. hESCs were separated from the human prepuce, cultured in vitro, and identified by flow cytometry. hESCs were infected by the harvested virus, and the protein expression of PDGF-BB in hESCs was respectively detected by Western blot. Results PDGF-BB was correctly cloned into the adenovirus vector, and the percentage of putative epidermal stem cells showed expression of the molecular marker was about 88%. The recombinant adenovirus vector containing human PDGF-BB gene was constructed successfully, which could infect hESCs efficiently, with the expression of the PDGF-BB in the infected hESCs detected by Western blotting. Conclusions  The human ESCs infected by constructed adenovirus vector rAD-PDGF could express PDGF-BB successfully.

    Finite element analysis of lumbar interspinous dynamic fixation by Coflex
    CHEN Zhao-Hui, LI Zhong-Hai, FU  Jiang, YAN  Ning, HOU Tie-Qing
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  437. 
    Abstract ( 1971 )  
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    Objective To perform the biomechanical evaluation of Coflex system by comparing the ranges of intervertebral motion and intervertebral disc stress among dynamic fixation adopting Coflex, decompression by fenestration or pedicle screw system respectively. Methods Three-dimensional finite element model of normal adult's lumbosacral vertebrae was established, as well the models of decompression by fenestration, dynamic fixation with Coflex and fixation with pedicle screw system separately. 500N preload and 7.5 Nm bending moment were performed on the models, while, the range of motion (ROM) and intervertebral disc stress (IDS) were measured. Results The ROM and IDS of Coflex model were recorded respectively as follows: on the surgical segment (L4/5), flexion (FLE) 3.15, 2.571MPa and extension(EXT) 1.21°, 2.109MPa. On the upper adjacent segment (L3/4): FLE 3.46°, 2.001MPa and EXT 2.75°,3.149MPa. On the lower adjacent segment (L5S1), FLE 3.22°, 2.681MPa and EXT 2.46°, 3.812 MP respectively. Conclusions Dynamic fixation with Coflex could keep some ROM and reduce IDS on the surgical segment, and has no significant effects on ROM and IDS of the adjacent segments.

    Biomechanics of the motion compensation of the adjacent segments after double cervical segment fusion
    ZHOU Wen-Yu, BAI  Bei, LI Zhen-Yu, GU Hong-Sheng
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  442. 
    Abstract ( 2022 )  
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    Objective To explore the motion compensation features of the lower adjacent segments after the procedure of double cervical segment fusion through biomechanic test. Methods Fresh specimens of human cervical spine were used in this study. Double segment fusion surgery of cervical 3-5, 4-6 or 5-7 vertebrae were simulated under the ideal non-destructive state. The effects of fusion procedure on the motion of the lower segments were analyzed under the movement conditions of flexion, extension and lateral bend.  Results Every kind of fusion method would effect on the motion range of the lower adjacent vertebrae at the different degree, with about 20% motion compensation between the fused and adjacent segments. Conclusions The motion of the lower segments will be disturbed after the double cervical segments fusion, which will increase the incorrect compensation and cause the degeneration of adjacent segment after the fusion.

    Image-based three-dimensional reconstruction of human casting specimen
    NIE Lan-Yang, TANG  Lei, LI Ze-Yu, OU Yang-Jun, DIAO Wei-Dong, ZHANG Mei-Chao, LI Jian-Die
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  445. 
    Abstract ( 2800 )  
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    Objective To reconstruct the three-dimensional models of anatomical duct casting specimens. Methods The anatomic casting models of a lung along with a trachea, artery and vein, and a leg along with bone artery were harvested and scanned by CT scan. The CT data were imported into the software Mimics to reconstruct the three-dimensional models of every part of the anatomic casting models using the function "Threshold", "Edit", "Region growth", etc. Results The three-dimensional models of casting specimens of lung and leg were well reconstructed. The detailed structures, such as artery, vein and trachea of casting specimen of lung, arteries of casting specimen of leg could be clearly shown. Conclusions The three-dimensional reconstruction can help the anatomical casting specimens to be more useful for medical study and work. Further these three-dimensional reconstructed models can be used to rapid prototype production and other digital medical research.

    Applied anatomy of retrohepatic inferior vena cava and extrahepatic vessels in hemibepatectomy
    QIN  Qian, LI Ai-Hui, LI  Hong, WANG Li-Bin, LEI  Jiang, OU Yang-Jie, LIANG Zhuo-Gong, XIE Shu-Qi
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  448. 
    Abstract ( 1678 )  
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    Objective To explore anatomic data of the anterior lacune between the retrohepatic inferior vena cava (RHIVC) and the liver and extrahepatic vessels, and provide clinical reference for the procedure of hemibepatectomy. Methods 43 patients were divided into 2 groups. 21 patients underwent selective hepatic vascular exclusion (SHVE) by dissecting the lacune between the RHIVC and the liver, while 22 patients underwent Pringle's hepatic vascular occlusion for hemihepatectomy. Meanwhile, the RHIVC distribution and the number of short hepatic veins (SHVs) were also analyzed during the operation. Results For patients of group SHVE, the exploration of the lacune, the isolation and ligation of hepatic artery, hepatic vein, and hepatic portal vein of tumor involved side were smoothly during the process, with no injury of RHIVC or hepatic veins. For all patients who underwent hemihepatectomy, there were 3 to 4 branches of SHVs(44.2%), or 6 to 8(55.6%). For 11.6% patients, the SHVs located at the medial axis of the anterior wall of the lacune between the RHIVC and the liver. Conclusions Since there is a potential nonvascular zone at the longitudinal axis of the lacune between the RHIVC and the liver, it is important to anatomize the lacune between the RHIVC and the liver and apply the SHVE technique in giant hepatic carcinoma resection.

    Anatomic mechanism and therapeutic choice for the dislocated cervical cord injury without fracture
    CHEN  Zhe, LI Zhen-Yu, YAN Hong-Yi, GU Hong-Sheng, TU  Zheng, TIAN Chang-Qiang, CHEN  Yang, ZHOU Wen-Yu, XU  Cong
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  452. 
    Abstract ( 1796 )  
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    Objective To investigate anatomic mechanism and therapeutic choice for the dislocated cervical cord injury without fracture. Methods A retrospective case-control study in our hospital from 2000 to 2009 with 43 cases of the dislocated cervical cord injury without fracture was performed. 43 patients were divided into group A (15 cases), treated with drugs and physical method, and group B (28 cases), treated with surgical operation. Group A was further divided into A1(6 cases), with no compression of cervical spine and the normal spinal sagittal diameter; A2 (9 cases), with the compression of cervical canal, and the sagittal diameter <15 mm. Group B was further divided into B1 (7 cases), with no compression of the cervical spine, and the spinal sagittal diameter ≥ 15 mm; B2 (21 cases), with the compression of cervical canal, and the sagittal diameter less than the normal range. The JOA score were compared between A1 and B1, B1 and B2, A2 and B2 before and after the treatment respectively. Results For all patients, both sensory and motor functions improved significantly after the treatment (P<0.05). The therapy effects of group B was better than that of group A (P <0.05). However, there were no difference of JOA scores appeared between A1 and B1, B1 and B2 (P> 0.05). Group B2 was better than the effects of A2 (P<0.05), and A1 was better than that of A2 (P< 0.05). Conclusions For treatment of the dislocated cervical cord injury without fracture, the individual therapeutic choice should be considered according to the injury mechanism and the results of imaging examination.

    Surgical treatment for single-level cervical spondylotic radiculopathy
    LUO  Jian, YANG  Yong, JI Dong-Bin
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  455. 
    Abstract ( 1889 )  
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    Objective To study the clinical efficacy of surgical treatment for single-level cervical spondylotic radiculopathy. Methods Thirty-four patients with single-level cervical spondylotic radiculopathy, including twenty-six males and eight females with average age of thirty-six years old ( 22 to 58 years), and ten of them with muscular atrophy and strength decrease of upper limb, received surgical treatment. Duration between onset of radicular pain and the surgery were two days to six months (mean 2.6 months). Single-level of cervical intervertebral disc herniation was determined by MR scan in all patients. Anterior cervical discectomy and fusion (ACDF) was carried out in 26 cases, and non-fusion procedures including cervical artificial disc replacement or posterior key-hole decompression in other eight cases. Results All patients were followed up about one to four years, with obvious decrease of radicular pain and numb after surgery. Post-operational VAS improved from 8.5±1.2 to 3.1±0.5. Seven of ten cases with muscular atrophy and strength decrease recovered and other three cases partly recovered. All patients were satisfied with the outcome of surgical treatment. Conclusions Non-fusion procedures show a favorable prospective over ADCF in surgical treatment for single-level cervical spondylotic radiculopathy.

    The effects of internal fixation with locking intramedullary nail on the fracture of femoral shaft revision
    OU Yang-Zhen-Hua, HUANG Jian-Rong, XIANG Xu-Jin, HUANG  Bin
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  458. 
    Abstract ( 1775 )  
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    Objective To analyze the reasons of the failure treatment on fracture of femoral shaft, and explore the effects of overhaul method by locking intramedullary nail. Methods 29 patients suffered from the fracture of femoral shaft underwent revisional procedure, through the internal fixation of locking intramedullary nail, and then, 19 of them were given by self-iliac bone grafting. Results With 8-25 months' follow-up survey, all patients healed from the fracture during 5-12 months, accompanied with the well recovery of the functions of knee joint. There were no complications, such as infections, disunion of fracture or broken-nail happened. Conclusions Internal fixation with locking intramedullary nail is reliable for fracture fixation and functional recovery.  The locking intramedullary nail is one of ideal internal fixation materials especially in the revision for femoral shaft fracture.

    One case report of two plantarises of right popliteal fossa
    HE Dong-Sheng, LI  Liang, ZHANG  Meng
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  460. 
    Abstract ( 1066 )  
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    A case with synchronization operation of medial orbital wall repair and optic fasciculus decompression
    CHEN Ge-Xin, MA Cheng-Han, TUN Wen-Can, WEN Wei-Beng, SHI Jian-Bei
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  461. 
    Abstract ( 1453 )  
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    A modified rat model of orthotopic liver transplantation model: two-cuff method
    WANG  Yu, GAN He-Beng, JIANG Xiao-Jing
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  463. 
    Abstract ( 1688 )  
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    The variation of Right sigmoid colon: one case report
    TU Xiu-Gui, JIANG Hui-Yong, HUANG Xiao-Lin, DIAO Yan, LV Qiu-Gong, LIN Hong-Liang
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  466. 
    Abstract ( 957 )  
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    Anatomy of submandibular duct system on corrosion casts perfused whith plasticized self-curing plastic
    WU Da-Ming, SHU Chuang-Ai, XIE Wei-Min
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  467. 
    Abstract ( 1472 )  
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    The application of CTA in flap surgery
    PENG Ti-Hong, XU Da-Chuan, TANG Mao-Lin
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  469. 
    Abstract ( 1206 )  
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    A case corcerned with variation of splenic artery and inferior phrenic
    LI Wen-Ai, FANG Ling-Ling, HE Xiao-Jing, FAN Zi-Shu, LIN Tong-Meng, FU Sheng-Qi
    Chinese Journal Of Clinical Anatomy. 2010, 28(4):  473. 
    Abstract ( 2352 )  
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