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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 November 2012 Volume 30 Issue 6
      
    The perforasome and vascular zone of the infra-abdominal area
    PENG Ti-Hong, HUANG Mei-Xian, XU Da-Chuan
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  599-604. 
    Abstract ( 1056 )  
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    Applied anatomy of the perforators of the upper lateral thoracic wall
    WANG Xu-Dong, PENG Ti-Hong, SONG Fu-Fang, CUI Fu-Rui, HUANG Mei-Xian, XU Da-Chuan
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  605-608. 
    Abstract ( 1038 )  
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    Objective To investigate the vasculature in the integument of the lateral thoracic wall, and provide anatomical guide for harvesting flap at this area. Methods 10 fresh cadavers with the vascular system injected with the lead oxide-gelatin mix were subjected to spiral CT scan, with the data obtained then imported into Mimics 13 for 3-dimentional reconstruction for the vasculature of the lateral thoracic wall. And then cadavers were dissected to explore the perforators of the lateral thoracic wall, followed with the parameters measurement, such as the caliber and suprafascial length etcd, in addition, the trunk integument of two cadavers was peeled off for X-ray radiography. Result The lateral perforators at the 3th and 4th intercostal spaces were small in diameter, or even absent. The integument of this region was supplied by perforators emitted from the circumflex scapular artery, the lateral thoracic artery and the thoracodorsal artery. In 10 cadavers, a total of 109 musculocutaneous perforators were explored. 1 dominant perforator could be found in 18 sides, with the diameter of about (0.9±0.3)mm. In 5 cadavers, communication existed between the dominant perforator and the branch from the anterior serratus artery.   Conclusions ①large extended thoracodorsal artery flap can be harvested at the upper lateral thoracic wall; ② Constant lateral perforators were given off from the 5th to 8th intercostal artery, constituting the anatomical basis for harvest perforator flap at the lateral thoracic wall for defects resurfacing of the trunk. 

    Applied anatomy of the island flap pedicled with lateral pedis dorsal artery chain
    SHI Ceng-Yuan, YIN Wei-Gang, MAO Hai-Jiao, TUN Fa-Ke, FAN Yong-Cheng
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  609-611. 
    Abstract ( 950 )  
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    Objective To offer anatomy basis for the lateral dorsal of pedis island flap by discussing the composition of the lateral dorsal artery chain. Methods Anastomosis, distribution and external diameters of calcaneus branch of lateral posteror malleolus artery, descending branch of the lateral anterior malleolus artery, the lateral tarsal artery and the fourth metatarsal dorsal artery were observed on 48 sides of adult cadaveric foot specimens. Results Calcaneus branch of lateral posteror malleolus artery was the terminal branch of the peroneal artery, with the external diameter of (1.0±0.3)mm. The external diameter of descending branch of lateral anterior malleolus artery was (1.3±0.3)mm. The descending branch was along the anterior edge of lateral malleolus which divided into anterior and posterior branch at the level of prominence of the malleolus. The posterior branch anastomosized with calcaneus branch of lateral posteror malleolus artery, with the occurrence rate of 97.9% and the external diameter of (0.8±0.3)mm. The anterior branch and lateral tarsal artery formed the arterial arch, with the occurrence rate of 91.6% and the external diameter of 0.6±0.2)mm. The lateral tarsal artery divided into 1 anastomotic branch with arcuate artery or the fourth metatarsal dorsal artery, with the occurrence rate of 95.8% and the external diameter of (0.6±0.2)mm. The sensation innervation of pedis island flap was as follows: the lateral edge of the foot was supplied by nervus cutaneus dorsalis lateralis pedis accompanied by lateral calcaneal artery, the anterolateral edge by skin branch from nervus cutaneus dorsalis intermedius pedis. Conclusions The artery chain of lateral dorsal on foot consists of lateral calcaneal artery, descending branch of the lateral anterior malleolus artery, lateral tarsal artery and the 4th metatarsal dorsal artery, which expand the dissection boundary of lateral foot flap and increase the flexibility of clinical application.

    Microsurgical anatomy and clinical significance of liliequist and premesencephalic membranes
    SONG Hai-Min, ZHANG Shen-Yu, JIANG Qiu-Hua, FAN Dun, QI Song-Chao
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  612-616. 
    Abstract ( 1009 )  
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    Objective To describe microsurgical anatomy characteristics and clinical significance of liliequist membrane and premesencephalic membranes and their relationship. Methods 10 formalin-fixed cadaveric head specimens were dissected to observe features of liliequist membrane and premesencephalic membranes, as well their anatomic relationship. Results The liliequist membrane was composed of diencephalic and mesencephlic membranes. Anterior attachment of mesencephlic membrane presented 2 styles. Lateral border of mesencephlic membrane attached to the anterior of premesencephalic membrane. The perimesencephalic membrane originated from the reflexion of the arachnoidal membrane covered the lower surface of the temporo-occipital lobe and the upper surface of the cerebellum, which could be divided into anterior, medial and posterior parts. Lateral border of mesencephlic part of liliequist membranes connected with the anterior of premesencephalic membrane. Conclusions The structure, variation, relationship and clinical significance of liliequist membranes and premesencephalic membranes are explored and analyzed in this study.

    Anatomic basis on fetal intrauterine surgical repair of unilateral complete cleft lip and palate
    HUANG Hai-Long, CHEN Li-Juan, ZHONG Wei-Juan, JU Jin-Hui, LIANG En-Lai
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  617-619. 
    Abstract ( 783 )  
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    Objective To provide anatomic basis for fetal intrauterine surgical repair of complete cleft lip and palate. Methods Vascular cast specimens of the head and neck from 21~32W normal fetus and unilateral complete cleft lip and palate fetus were carried out. Blood supply source and arterial anastomosis of lip and palate were observed and compared. Results ①For  healthy fetus, blood supply of lip and palate mainly came from superior labial artery, nasal alar artery and greater palatine artery. The arterial arch formed by the anastomosis between the left and the right superior labial artery. The superficial and deep vascular networks were formed in nasal septum,and the nasal septum branch of superior labial artery anastomosed with the perforator branch of greater palatine artery. ② Due to the slit separation, The lip and palate vessels of unilateral complete cleft lip and palate fetus absent the anastomosis between the left and the right superior labial artery, however the greater palatine artery and nasal vessel anastomosed with each other through bone stump. Conclusions For fetus of cleft lip and palate, blood supply of the lip and palate was plentiful, especially for superior labial artery and greater palatine artery.

    Applied anatomy of the tibial nerve and its blood supply
    JUE Zhi-Gang, LIU Yo-Jie, DING Xiao-Hang, DIAO Feng-
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  620-624. 
    Abstract ( 1085 )  
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    Objective To explore anatomic features of the tibial nerve and its blood supply for nerve injury and nerve transplantation. Methods ① 26 fixed adult lower limber specimens were used in this study. The tibial nerve and branches were dissected. The diameter, length, origin location and the course of tibial nerve were measured and analyzed. ② 4 fresh adult lower limber  specimens were injected with red lactoprene and Indian ink, followed by the transparent procedure and dissociation of tibial nerve and its nutrient vessel for observing its blood supply pattern. ③ Tibial nerve and its branches were dissected quickly from another 4 fresh adult specimens. Cholinesterase staining was performed to identify sensory bundles and motor bundles respectively. Results The vital muscular branches of the tibial nerve originated from the upper part of the leg. The medial and lateral cords coursed a long distance. The blood supply of tibial nerve was sufficient, with the proximal 7/8-5/8 part from peroneal artery, and the distal 5/8-1/8 part from posterior tibial artery. Posterior tibial artery closed to the nerve during its course. Each bundle had it's own special vessel blood. Conclusions Our data provide anatomic basis for tibial nerve injury repairing. The distal segment of medial cord of tibial nerve is valuable for the vascularized nerve grafts, for its independent and complete blood supply.

    Anatomic study and clinical significance of the retinacula of femoral neck
    GU Li-Za-Er-·A-Bu-Dou-Re-Xi-Chi, TAN Wei, YANG Xiang, LIU Gui-Yang, HUANG Wen-Hua
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  625-628. 
    Abstract ( 1079 )  
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    Objective To explore anatomic features of retinacula of femoral neck, and provide anatomic basis for clinic application. Methods 4 fresh lower limb specimens and 60 adult lower limb specimens injected arterially with red emulsion were collected. The position, course, shape, distribution and the width of middle part of retinacula were dissected and analyzed.  Results The upper retinaculum, which was found in all specimens, and without anatomic variation, located from 11 o'clock to 1 o'clock position. The lower retinaculum, which was also found in all specimens, located from 6 o'clock to7 and a half o'clock. This retinacula was the strongest one among three retinaculum. The anterior retinaculum, which was only found in 60% specimens, located from 2 and a half o'clock to 4 o'clock position. Anatomic variation of the anterior one was common. Histological examination revealed that the blood vessel passed through the retinaculum, and mainly distributed to both of upper and lower retinaculum, followed by nerve distribution. For exposing femoral neck safely, the best site was from 8 o'clock to 10 o'clock position, where was absent for retinaculum. Conclusions The upper and the lower retinaculum have abundant blood supply and nerve innervation, with the stable distribution, which are the important source of femoral neck's blood supply. The surgical operation will be more safely and convenient through an posteromedial incision of the greater trochanter.

    Morphological study and clinical significance of popliteus tendon
    CHEN Shuai, ZHENG Xiao-Fei, LI Ping-Ti, HUANG Hua-Yang, JIA Gong, GOU Yong-Liang
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  629-632. 
    Abstract ( 1302 )  
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    Movement cecum and ascending colon with variation of root of mesentery:one cases report
    CAO Xiao-Meng, TU Xiu-Gui, JIANG Hui-Yong, LI Li-Xin, CHEN Hui, DIAO Yan
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  632. 
    Abstract ( 848 )  
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    Anatomy of proximal tibia and its effect on the entry point of intramedullary nailing 
    BO Xi-Qiang, NIE Chi-Ceng, ZHANG Jiang-Li, WANG Hua-Jun
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  633-636. 
    Abstract ( 888 )  
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    The personalized design of catheterization from femoral artery based on three dimensional reconstruction of CT data
    AN Gao, HONG Li, BANG Tian-Gong, YANG Qiong
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  637-640. 
    Abstract ( 862 )  
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    Objective To explore the method and clinical values of a digital 3D model of femoral artery and adjacent structures based on the data of CT strengthening scanning. Methods  CT strengthening scan images from a patient who was failed in catheterization from femoral artery were collected. The DICOM format was imported into Mimics10.01 software, followed by femoral artery reconstruction through the technique of the thresholding, Results According to organization layering, 3D models, involving skin, artery and bone, were reconstructed. This model could be zoomed and rotated randomly and displayed clearly the spatial positions and adjacent relationships of different anatomical structures, as well the reconstructed structures could be measured in details in 3D space. 3D models could be used to guide catheterization from femoral artery. Conclusions 3D digital models can be reconstructed conveniently and quickly with Mimics software on PC, which can provide morphological reference for image diagnosis and interventional therapy.

    Absence of left musculocutaneous nerve: one case report
    CHEN Hong
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  640. 
    Abstract ( 609 )  
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    Study of technical parameters of C1 lateral screws placement in Jefferson-fracture reduction plate
    JIA Gong, LIN Hong-Heng, HU Guo-Qiang, HE Xiao-Hua, YIN Qiang-Shui, WANG Zhi-Yun, HU Dun-Jie
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  641-645. 
    Abstract ( 819 )  
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    Objective To clarify the technical parameters of C1 lateral mass screw in anterior Jefferson-fracture reduction plate.  Methods Anatomic structure of C1 lateral mass using 1-mm CT scans were measured with MIMICS software in 80 C1 lateral mass of 40 cases. 2 entry points were selected for superior and inferior screw placement and screws (2.5mm in diameter) , and simulation procedure was performed at these entry points. Length, angle of screw and relation with adjacent anatomical structures were recorded. Results Distance from medial wall of vertebral artery hole to midline of atlas was 23.2 mm. Distance between medial wall of posterior arch junction with lateral mass and midline was 13.2 mm, and from entry point of superior screw to anterior edge of superior articular and midline were 6.2mm, 20.0mm respectively. The length of superior screw was 21.5 mm and the range of sagittal angulation was upward 1.5° to downward 11.6°. Distance from entry point of inferior screw to anterior edge of inferior articular was 8.9mm. Length of inferior screw was 15.2mm. The largest downward angulation for inferior screw was 20.7°. Distance from medial wall of vertebral hole to inferior screw was 1.9mm. The area of lateral mass (17.6~23.2) mm away from midline of atlas is relative safe for screw placement.  Conclusions It is feasible to place C1 lateral mass screws (superior and inferior screw) in anterior Jefferson-fracture reduction plate. Making final decision of entry points and screw direction must depend on preoperative 3-dimensional CT evaluation. According to our research, the angulation of superior screw below turn to downward, and the angulation of inferior screw turn to inside were recommended.

    CT Three-dimensional reconstruction and clinical significance of the pterygopalatine space
    LI Pei, MAO Guang-Lan, FU Sheng-Qi, FAN Ti-Yi, DAO Jing, WANG Qiang-Zhi
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  646-650. 
    Abstract ( 1005 )  
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    Objective To provide anatomical data for imaging diagnosis and endoscopic operation of the diseases of pterygopalatine space communications and its adjacent structures.  Methods 40 volunteers were selected and scanned in series by spiral CT from canthomeatal line (CML). All original images were transferred to the CT three-dimensional reconstruction workstation, and the pterygopalatine space communications were reconstructed through its long axis and perpendicular axis to long axis by the multiplanar reformation (MPR) respectively. The position, shape and adjacent structures of pterygopalatine space communications were observed and measured. Results MPR reconstruction CT imaging could clearly display the position, shape and adjacent structures of pterygopalatine space communications, including the foramen rotundum, pterygoid canal, sphenopalatine foramen, inferior orbital fissure, pterygomaxillary fissure, pterygopalatine canal, greater palatine canal, lesser palatine canal, palatovaginal canal and vomerovaginal canal. Pterygopalatine space communications were symmetrical of left and right sides, there were no significant difference in the diameter (P>0.05). Foramen rotundum, pterygoid canal, palatovaginal canal and vomerovaginal canal located around the sphenoid sinus, slightly or obviously protruding into the cavity of sphenoid sinus. Foramen rotundum and pterygoid canal located in the superior and inferior of the cavity of sphenoid sinus, with the length of 4.05±0.81 mm and 14.49±1.60 mm respectively. It was clearly to show the adjacent relationship of pterygopalatine space communications on coronal imaging. Conclusions It is important for imaging diagnosis and endoscopic operation of the diseases of pterygopalation space communications and its adjacent structures, under CT reconstruction images.

    Imaging anatomy and clinical significance of the pyramidal lobe of thyroid gland
    SU Ying-Rui, CHA Jin-Shun, LI Jie-Lin, HUANG Jing-Shan, WANG Yao-Guo, QIN Guang-Meng, LI Zheng-Yi
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  651-654. 
    Abstract ( 2946 )  
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    Objective  To study the feasibility of imaging technology on exploring the shape and position of pyramidal lobe of thyroid,and its clinical significance. Methods We reviewed and analyzed the data of sonograms and scintigraphic images in 510 cases accepted thyroid operation, especially anatomic features of pyramidal lobe and accessory glands. 1500 volunteers were performed thyroid ultrasound, 120 of them received scintillation scanning. Scintigraphic images and sonograms were analyzed to evaluate the frequency, location and expansion of the pyramidal lobe. Results Scintigraphic analysis showed pyramidal lobe in 56 cases, 5 cases with accessory glands. 210 cases were found pyramidal lobe during the operation, 208 of them were identified under ultrasound. No difference appeared between ultrasound and intraoperative observation for size of pyramidal lobe. 35 cases with pyramidal lobe and 5 with accessory thyroid presented in scintigraphic detection in 120 volunteers. 285 pyramidal lobes originated from the left side of the isthmus, 233 lobes from the right of the isthmus, 112 from the middle part of the isthmus, and only two from the left lobe. Conclusions These observations support that, ultrasound and scintigraphy could demonstrate pyramidal lobe and ectopia glands, which is valuable for the accurate thyroidectomy.

    Diagnostic value of three-dimensional ultrasonographic surface rendering on the rarely fetal facial abnormalities
    JIAO Yang, FAN Hai-Bei, LIN Qi, ZHENG Jing, GAN Han-Jing, XIONG Yi
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  655-657. 
    Abstract ( 908 )  
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    Objective To explore the value of three-dimensional ultrasonographic diagnosis on the fetal facial rarely abnormalities. Methods In 11300 pregnant women of 16~37 gestational weeks from March 2011 to March 2012, the fetal faces were regularly imaged by three-dimensional ultrasonography. Results 34 cases with facial deformity were detected in all cases, with the detection rate of 0.3%. for those cases, 3 were congenital cataract, 7  microphthalmus, 11 single nostriland, 3 arrhinia,3 parasitus in oral cavity, 1 facial salivary gland cytoma,5 deformity of external ear, 1 anophthalmia. The detection results were finally confirmed by odinopoeia or birth. Conclusions Three-dimensional ultrasonography can directly display the fetal facial structures, and is the first choice in the diagnosis of fetal facial abnormalities. Prenatal regular ultrasound has important clinical significance.

    Alteration of myelin basic protein expression and nerve fiber degeneration after compression injury of rat spinal cord
    WU Xiu-Yu, SUN Shan-Quan, ZHONG Xiao-Yan, ZHANG Bei, HONG Ke-Jian, HUANG Sai-Qin
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  658-662. 
    Abstract ( 817 )  
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    Objective To evaluate the changes of nerve fiber degeneration and myelin basic protein(MBP) expression in rat white matter after the compression spinal cord injury(CSCI).  Methods Eighty-four adult Sprague-Dawley rats were randomly divided into 3 groups: normal group(n=12), operation group(n=36) and the sham group(n=36). The CSCI model was established with a self-made device for animals of operation group. The operation process in the sham group was the same as the operation group except for the compression of spinal cord. The segments of compressed spinal cord were properly taken at an interval of 1, 3 and 7 day after operation. Luxol fast blue(LFB), immunofluorescence (IF) staining and western blot were performed to observe the pathological changes of white matters. Results LFB staining showed that after compression the degeneration of nerve fiber occurred in the white matter and a great number of fibers were lost. Compared with the normal and sham operation groups, the loss of myelinated fibers was markedly decreased in compressed segments of the model group (P<0.05). IF showed that MBP- positive fibers were degenerated and lost, coinciding with LFB staining. The expression of MBP was progressively significantly declined after compression. Conclusions Demyelination occurs, followed by the time-dependently reduced expression of MBP in white matter of model animals. Expression decrease of MBP may be related to the demyelination.

    Effects of prenatal stress on the development of dopaminergic neurons in the hypothalamus of offspring
    HAO Pan-Li, CHEN Yang-Hua, DONG Wei-Ren
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  663-666. 
    Abstract ( 1036 )  
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    Objective To investigate the effect of prenatal stress on the development of dopaminergic neurons in hypothalamus of rat offspring. Methods Restraint stress was performed three times each day for pregnant SD rats from embryonic day 12-19 in prenatal stress group. The day that the offspring was born was defined as the postnatal day 1. Dopamine expression in the hypothalamus of offspring was observed using the method of immunostaining on postnatal day 1, 7 and 30, respectively. Results Body weight of offspring rats in prenatal stress group significantly decreased, while the pixel intensity and level of dopamine in hypothalamus was up-regulated, compared with control group at the postnatal day 1(P<0.05). This change disappeared at the postnatal day 7 and 30. Conclusions Prenatal stress had an effect on the prenatal development of dopaminergic neurons in the hypothalamus, which may induce the long-term detrimental consequences for brain function.

    Expression of LC3B in rat hippocampal CA1 neurons after global cerebral ischemia-reperfusion 
    CENG Bin, WANG Jing-Wen, ZHANG Yu-Lin, LIN Dian-Huan, YING Zhi-Guo
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  667-669. 
    Abstract ( 960 )  
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    Objective To explore expression change of LC3B in hippocampus, and the hippocampal neuronal death after global cerebral ischemia/reperfusion in rats. Methods Transient global cerebral ischemia was induced by four-vessel occlusion method. The SD rats weighing 250~320 g were randomly divided into 2 groups: the sham-operated group and the ischemia/reperfusion group. The expression of LC3B was detected by immunohistochemistry analysis. Results The expression of LC3B in the ischemia/reperfusion group got increased after 2h of reperfusion, and the peak appeared at 12 h of reperfusion. Conclusions The occurred LC3B activation leads to the neuronal death of hippocampal CA1 induced by ischemia/reperfusion. The earlier high expression of LC3B occurred, the more severe neuronal death appeared after 20-min global cerebral ischemia. These results suggest that autophagy pathway play a more harmful role in neuron death after long time ischemia.

    Effects of bisphenol A on spermatogenic cell apoptosis of male offspring mice prior and postnatal to birth
    LIU Xiao-Li, CHEN Xiao-Yu, LI Yun, DING Song-Jun, DIAO Huan, CHEN Tong
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  670-674. 
    Abstract ( 790 )  
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    Duplication of inferior vena cave, one case report
    ZHANG Ji-Jing, WANG Wei, HU Xiao-Feng, ZHANG Feng, LIN Liang, CHE Le, WANG Yong, ZHANG Xiao-Dong
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  674. 
    Abstract ( 887 )  
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    Expression of Bax and NOS in neurons received excitatory neurotoxicity induced by NMDA
    SONG Hai-Yan, LI Na-Na, FU Sheng-Qi, LIN Ming-Xin
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  675-677. 
    Abstract ( 817 )  
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    Finite element analysis of NiTi Shape Memory Alloy STT Arthrodesis Concentrator (NT-STTAC)
    LI Chuan, XU Yong-Qing, YA Yi, ZHANG Mei-Chao, SHU Ti-Liang, SU Yong-Ti, JI Bao-Chen, LI Xia
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  678-682. 
    Abstract ( 1073 )  
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    Objective To analyze biomechanical characteristics of HNT-STTAC and NT-STTAC on digital images of scaphoid, trapezium and trapezoid finished by finite element software, and provide basis for clinical application.  Methods The three-dimensional maps of two kinds of NT-STTAC were loaded into the finite element software ANSYS, for analyzing mechanical properties of them. The difference of stress, strain value, distribution and compression stiffness were measured and compared, at the wrist position of palm flex and back-stretch. Results Under the simulation of NT-STTAC force, mechanical stability under the resistance of axial tensile force and axial compression, were analyzed. Stiffness value of Solid NT - STTAC in the certain scope, was better than HNT-STTAC. However, stiffness value had no difference at other positions. Conclusions According to our work, stiffness parameters and mechanical stability of HNT-STTAC and NT-STTAC have no difference. HNT - STTAC is reliable for clinical application.

    A case of Poland syndrome
    OU Yang-Hou-Gan, DIAO Zhi-Dong, LEI Wen-Jing
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  682. 
    Abstract ( 712 )  
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    The biomechanical study of severe intertrochanic fractures treated with cemented femoral stem
    HUANG Bing-Sheng, WANG Yong-Qing, CHEN Shun-Yi, CHEN Li-An, ZHONG Shi-Tian, DING Zi-Hai
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  683-686. 
    Abstract ( 741 )  
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    Objective To study the biomechanical stability of the comminuted intertrochanic fracture treated with cemented standard femoral stem prosthesis. Methods 18 cadaveric femurs were selected in this study and divided into three groups randomly as FHR, DHS and control group. The FHR group(A)(n=6) was simulated as comminuted intertrochanic fractures as four parts which were treated with cemented femoral prosthesis following standard hemiarthroplasty procedure and the four parts fractures in FHR group were fixed by wires additionally. The DHS group (B) (n=6) was also simulated as comminuted intertrochanic fractures as four parts which were treated with DHS internal fixation systems. The control group (C) (n=6) was raw cadaveric femur. The specimens were tested mechanically by universal testing machine through vertical and rotational loading. The displacement of loading were recorded and analyzed.  Results Vertical loading tests: No significant differences of displacement were found between group A and C either in vertical loading from 100N to 1000N or in rotational loading with torque of 8Nm. There was statistically significant difference between group B and C, also group A and B in vertical loading. In rotational loading test, there was statistically significant difference between group B and C, and no significant difference between group A and B. Conclusions The use of cemented standard femoral stem prosthesis is biomechanically acceptable in the treatment of comminuted intertrochanic fractures.

    A case of pancreatic duct stone associated with pancreatic cancer
    HAN Bing, WU Jin-Hu, HOU Li-Hua, MIAO Shan, GU Yuan-Li
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  686. 
    Abstract ( 738 )  
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    Initial curative effect comparision of ano-hydroxyapatite polyamide-66 cage and polyetheretherketone cage on anterior cervical intervertebral disc discectomy and fusion
    LIU Xian-Hong, OU Yun-Sheng, JIANG Dian-Meng, QUAN Zheng-Hua, ZHANG Le, CHEN Xin, HU Zhen-Meng
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  687-692. 
    Abstract ( 1361 )  
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    Objective To evaluate the preliminary efficacy using polyetheretherketone cage (PEEK Cage) and Nano-hydroxyapatite polyamide/66 cage (n-HA/PA66 Cage) composites for reconstruction following anterior cervical intervertebral discectomy and fusion (ACDF) in cervical spondylosis. Methods We performed a retrospective study of patients (57 cases, 31cases in n-HA/PA66 group, 26 cases in PEEK group) with cervical spondylopathy who underwent ACDF by two different cages between June 2008 and June 2011. Cervical pathologies included cervial spondylotic myelopathy and cervical radiculopathy. All patients were assessed clinically and radiologically. Clinical outcome was evaluated using Odom's criteria, radiology result included subsidence of the cages, the angle of cervical lordosis, the fusion rate and interspace height. Results There was no significant difference of fusion rate between both groups (97.7% vs. 100% , P>0.05 ). As well the loss of cervical lordosis (2.06±1.77° vs. 2.39±1.56°, P=0.384). The mean loss of interspace height (0.46±0.52 mm) in n-HA/PA66 group was a little higher than that (0.41±0.18 mm) in PEEK group, without significant difference in both groups(P=0.599). An interspace collapse of 3mm or greater was observed in 2.3% in n-HA/PA 66 cage group, compared with zero one in the PEEK group(P=0.372). The PEEK group achieved an 81% rate of successful clinical outcomes, compared with 77% in the n-HA/PA 66 group (P=0.757). Conclusions The n-HA/PA66 cage is as good as PEEK cage in preliminary outcomes for anterior cervical intervertebral disc discectomy and fusion.

    Repair of ankle skin defect with upper perforator flap of the medial malleolus
    ZHOU Rong, JIN Guang-Zhe, JU Ji-Hui, LI Jian-Ning, DIAO Jiang, LIU Ti-Fei, LI Lei, HOU Rui-Xin
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  693-695. 
    Abstract ( 1191 )  
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    Objective To report clinical effects of the upper perforator flap of the medial malleolus pedicled with the posterior tibial artery on repairing skin and soft tissue defect of foot and ankle. Methods From Feb. 2003 ~ Feb. 2010, 22, patients with skin and soft tissue defect of foot and ankle were treated with the upper perforator flap of the medial malleolus pedicled with the posterior tibial artery. Flap area was about 10cm ×7cm ~ 15cm×11cm, and the donor field was treated with the lower abdomen area full-thickness skin graft. Results The flaps of 22 patients primarily survived, as well donor wounds primarily healed. The follow-up extended 6 to 36 months, averagely 12 months. Flaps appeared well, with sensory recovery of S2~S3+, and satisfied function recovery of foot walking. Donor areas recovered well, without cicatricial contration. Conclusions The upper perforator flap of the medial malleolus pedicled with the posterior tibial artery can be used to repair skin and soft tissue defects of foot and ankle, for its stable anatomic features and convenient operative procedure.

    The surgical therapy of ankle fracture combined with the deltoid ligament damage
    SHEN Kuan-Hong, HUANG Dong, TUN Wei-Chi, HUANG Yong-Jun, MAO Yong-
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  696-697. 
    Abstract ( 1223 )  
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    Objective To explore surgical repairing of ankle fracture accompanied with the deltoid ligament damage. Methods 17 patients with ankle fracture accompanied with the deltoid ligament rupture were treated by open reduction, intensified internal fixation, and restoration of broken ligaments.After the surgery, patients were followed up and analyzed. Results The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used to evaluate clinical results of the treatment. In all cases, 6 were excellent, 7 good, 3 passable, and only 1 poor. The rate of good and excellence was about 76.47%. Conclusions For cases of ankle fracture combined with deltoid ligament rupture, surgical treatment is helpful for recovering mechanical stability of ankle joint.

    The application of hemicircular external fixator for knee joint arthrodesis with tuberculosis 
    CENG Wei-Na, ZHOU Zong-Ke, YANG Jing, CHEN Ban, KANG Feng-De, FEI Fu-Xin
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  698-700. 
    Abstract ( 940 )  
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    Objective To discuss the efficacy and complications of hemicircular external fixator for joint fusion of the knee with tuberculosis. Medthods A total of 8 patients with late total knee tuberculosis treated by hemicircular external fixator were retrospectively analyzed between February 2007 and January 2009. 6 men and 2 women were investigated, with the average age of 35.4 years (28~40 years), and the average duration of disease of 3.1 years (9 months to 5.1 years). An anterior median incision was performed for all patients, then followed by the fusing of knee joint in functional position using hemicircular external fixator after complete debridement, taking osseous fusion as the end point of observation. Regular chemotherapy was applied post-operation for 18 months. Results Osseous fusion were achieved in all 8 patients post-operation, with the mean fusion period of 20.5 weeks(16~24 weeks), the length of affected limb of 4.9cm (3 cm~5 cm) shorter than the unaffected limb post-operation, the mean knee joint valgus angle of 5.2°( 4°~7°), and the mean knee joint flexion angle of 15.3°(10°~20°). No patient had significant rotational deformity. There was no incision infection, nonunion, delayed union, external fixation failure happened, however, 3 patients appeared pin infection. Conclusions Hemicircular external fixator is an effective method to treat late total knee tuberculosis.

    Anatomy and clinical significance of elbow arteriovenous fistulas
    LAI Pan-Hua, TUN Ji-Hua, SUN Xiu-Yong
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  701-704. 
    Abstract ( 1240 )  
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    Objective To investigate the use of vascular access in maintenance hemodialysis and the complications of elbow arteriovenous fistulas (AVF). Methods From our database of consecutive vascular access operations, we reviewed 22 patients from May 2006 to May 2012 for all elbow arteriovenous fistulas. A transverse skin incision was made 2-3cm below the elbow crease. Radial artery and brachial artery were used as the in-flow conduit in 19 patitens and 3 patients respectively. The median cubital vein was anastomosed to the radial artery in end-to-side fashion in 17 cases and side-to-side fashion in 2 cases, the cephalic vein and the basilic vein were anastomosed to the brachial artery in side-to-side fashion in 2 cases and 1 case respectively. All patients were evaluated with preoperative ultrasound imaging by the operating surgeon. Results Mean operative time was 120±16.15min. There were no major intraoperative complications. Immediate patency and a palpable distal radial pulse were presented in all the patients. Mean time to fistula maturation was 41±8.15 days. Early fistula failure was seen in one patient because of thrombosis. Early transient arm edema were seen in two patients. No patient developed a vascular steal syndrome, pseudoaneurysm, infection and bleeding during the perioperative time. Conclusions An elbow AVF is a reasonable and safe alternative for maintenance hemodialysis access when a radiocephalic AVF is not possible. There are various valid options from which to choose to best accommodate each patient's antecubital anatomy.

    Arterio-venous anastomosis in the treatment of distal segment severed fingers: analysis of 18 cases
    TAO Bao-Bing, HU Liang, YIN Cheng-Guo, WANG Ye-Ben, DIAO Liang, HAO Zuo-Bin
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  705-707. 
    Abstract ( 898 )  
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    Objective To explore effects of anastomosis of arteries and veins on blood backflow after finger replantation. Methods Distal end of the nondominat side finger artery of amputated finger were anastomosed with the proximal end of the palmar digital veins or finger lateral vein for treating 18patients with distal segment severed fingers. In which, 11 cases received anastomosis of finger artery and palmar digital vein, 7 cases received anastomosis of finger artery and finger lateral vein. Results Replanted fingers survived well for 16 patients, however, finger necrosis appeared in 1 case, and partial necrosis in 1 case. Conclusions Arterio-venous anastomosis is effective method for treating amputated fingers.

    The application of subclavicular brachial plexus block with localized puncture at the apex of the axilla on the treating of traumatic brachial plexus injury
    ZHANG Yuan-Shen, ZHANG Jing, HE Xu, HOU Shu-Jian, WANG De-Meng, QU Pan-Liang, WU Chun-Min, WEN Bao-Lei
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  708-711. 
    Abstract ( 994 )  
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    Objective To investigate the feasibility of subclavicular brachial plexus block with localized puncture at the apex of the axilla on treating of traumatic brachial plexus damage. Methods 60 patients were randomly divided into group A (subclavicular brachial plexus block with localized puncture at the apex of the axilla), group B (tracheal intubation anesthesia), and group C (subclavicular brachial plexus block with localized puncture at the apex of the axilla together with tracheal intubation anesthesia). Patient-controlled intravenous analgesia (PCIA) was used to evaluate the degree of analgesia by visual analog scale (VAS) after operation, as well the cost of anesthesia technique, material and medicines except common project was evaluated.  Results There were no statistically difference among the three groups in generic index (P>0.05). The every hour dosage of propofol and remifentamil of group B were higher than group C (P<0.01). The postoperative awakening time and orientation time of group B were longer than group C (P<0.01). There were no significant difference between two groups for preparing time, and performing time (group A< group B< group C). The duration of anesthesia of group A and C were significantly longer than group B (P<0.01). There were significantly difference in VAS score at 5 time points after operation, the total dosage of Lornocines for 24 hour, anesthesia technique, material and the total cost of drugs among 3 groups (A

    The anatomy of perirenal fascia and it's space and development of related laparoscopic surgery 
    MEI Ao-Bing, QIU Jian-Guang, GU Ben-Zhong
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  712-714. 
    Abstract ( 881 )  
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    Mechanical stress and inflammatory myopathies
    CHEN Rong, LIAO Hua
    Chinese Journal Of Clinical Anatomy. 2012, 30(6):  715-717. 
    Abstract ( 789 )  
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