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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 March 2013 Volume 31 Issue 2
      
    The definition and terminology of some special form perforator flap
    TANG Ju-Yu, ZHANG Wei-Wen, ZHANG Shi-Min, ZHANG Yi-Xin, CHEN Hong, TANG Mao-Lin, HONG Hua-Jiao, XU Da-Chuan, MEI Jin, WANG Xin, ZHANG Chun, LI Xiao-Hua, XU Yong-Qing, WANG Chun-Mei, XIE Song-Lin, LIAO Hua, LIU Xiao-Lin, HOU Chun-Lin
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  121-122. 
    Abstract ( 1027 )  
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    Anatomic features of diaphragma sellae and its clinic implications
    LIANG Jin, QI Song-Chao, FAN Dun, DAN Jin, LIU Yun-Chao, YA Xiao-Rong
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  123-126. 
    Abstract ( 3091 )  
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    Objective To evaluate the anatomic characteristics of diaphragma sellae and its surrounding structures and discuss its clinical implications.  Method Fifteen heads of adult cadavers were observed and measured under the operative microscopy. Result  The midpoint of the optic chiasm (OC) was located on the midline in 66.7% (10 cases) and at the left and right sides of the sella turcica in 20%(3 cases) and 13.3%(2 cases), respectively. The foramen of diaphragma sellae (FDS) was completely covered by OC in 73.4%(11 cases), and was partially covered in 26.6%(4 cases). The position of FDS relative to OC was situated in the midline in 66.7 %(10 cases), in the left side in 26.7%(4 cases) and in the right side in 6.6% (1 case). Diaphragm sellae appeared concave in 80% (12 cases), convex in 13.3%(2 cases) and flat in 6.7%(1 case) when viewed from above. The average of anteroposterior diameter of FDS was 6.59 mm (range, 2.20 ~ 12.10 mm ) and the average transverse diameter was 7.32mm (range, 3.10 ~ 13.40 mm). we classified the diaphragm sellae into three types according to the FDS diameters variations: constricted type in 13.3%(2 cases); normal type in 73.4% (11 cases); and enlarged type in 13.3%(2 cases). Pituitary stalk was sited in front of dorsum sellae in 53.3% (8 cases), in the middle part in 40% (6 cases) and in the back of tuberculum sellae in 6.7% (1 case). Conclusion The variation in the diameter of FDS could exert influence on the growth pattern of pituitary adenomas and the detailed anatomic knowledge of diaphragma sellae and its ambient structures is helpful in improving the quality of operation in the sellar region.

    The applied anatomy and clinical application of the transoral approach with mandibulotomy and mandibuloglossotomy
    HE Yue, YIN Qiang-Shui, JIA Gong, AI Fu-Zhi, WANG Zhi-Yun
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  127-131. 
    Abstract ( 1159 )  
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    Objective This study was designed to investigate the anatomic foundation for the transoral approach with mandibulutomy and mandibuloglossotomy. Methods Transoral approach with mandubulutomy and mandibuloglossotomy were simulated in 6 fresh cadavers to cervical spinal cord; the cephalic and caudal limits of exposure  and the distances between the vertebral artery(VA) of each side to the midline and the vertical depth between the VA of each side to the fore-teeth of the two approaches were measured. Furthermore, the exploratory operational range and reconstructive operational range were described. Results The exposure angle of mandibulotomy and mandibuloglossotomy were 63.67°±3.50°and 74.14°±1.47°, respectively.The widest EOR of mandibulotomy and mandibuloglossotomy were the lower third of the clivus to the upper edge of C5 and the lower third of the clivus to the upper edge of C6, respectively.The widest ROR of mandibulotomy and mandibuloglossotomy were the lower half of axis to the upper edge of C5 and the lower half of axis to the upper edge of C6, respectively. The distance between the vertebral artery(VA) of each side to the midline is  (16.88±0.75)mm at C2/3, (16.48±1.47)mm at C3/4 and (16.30±1.09)mm at C4/5, respectively. Furthermore, the vertical depth between the VA of each side to the fore-teeth of the two approaches was (96.44±3.59)mm at C2/3,(97.94±4.51)mm at C3/4 and (99.83±4.77)mm at C4/5, respectively. Conclusions The transoral approach with mandibulotomy and mandibuloglossotomy is safe and effective in dealing with patients with limitation of mouth opening and long segmental ventral decompression of the cervical spine; However,whether glossotomy is performed or not depends on the particular range of the surgery.

    Variation of high radial artery and ramus communicans ulnaris nervi radialis: one case report
    LIU Xin-Beng, XU Xu-Dong
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  131. 
    Abstract ( 756 )  
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    Observation on the relationship between the protuberance of parietal lobe convexity and parietal tuberosity of skull in human being
    HUANG Yi-Mei, QIN Dan-Lei, YU Hong-Rong, LA Ling, GONG Jian-Gu, LIAO Zhang-Ding, LAO Meng
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  132-134. 
    Abstract ( 1358 )  
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    Objective To investigate the relationship between the parietal tuberosity of skull and the corresponding structures inside tuberosity.    Methods  32 embalmed brains were observed to identify the location of the parietal tuberosity and the lateral protuberance the parietal lobe; vernier caliper and rule were used to measure the length between the left and right parietal tuberosities, and the left and right protuberances of the parietal lobes, respectively. the obtained data were then used for correlated analysis between the tuberosity and the protuberance. Results   There is a constant lateral protuberance in the parietal lobe, which was composed of  the supramarginal gyrus and its surrounding gyrus. The presence of the parietal tuberosity and the lateral protuberance of the parietal lobe was correlated.(r=0.639,P<0.05). Conclusions  A protuberance can be found on the lateral surface of parietal lobe of the cerebral hemisphere,deep to the parietal tuberosity.

    Three-dimensional visualization model and simulation operation of complex occipito-cervical deformity
    LI Sen, FU Dong, CAO Jia-Meng, WANG Qing
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  135-139. 
    Abstract ( 1084 )  
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    Objective To establish a three-dimensional visualization model and simulated operation of a complex occipito-cervical deformity. Methods We used continuous cross-sectional scans from computed tomography angiography and magnetic resonance myelography of a patient to demonstrate basilar invagination, medullary compression, and an old atlantoaxial dislocation. Half-auto cut and reconstruction were undertaken on the skeleton, arteriovenous system, trachea, thyroid, laryngeal cartilage, and spinal cord according to the different tissue thresholds using Mimics software. A three-dimensional model of occipito-cervical deformity and its related surrounding local anatomic structures were successfully displayed. Preoperative simulation included releasable reattachment of th atlantoaxial joint through the transoral approach and posterior occipital cervical fusion with bone graft and internal fixation was performed. Results A three-dimensional visualization model of the occipito-cervical deformity was established. The three-dimensional spatial relations were successfully displayed. An anteroposterior operation for a complex occipito-cervical deformity was simulated and was verified by the clinical operation. Conclusion A three-dimensional visualization model of an occipito-cervical deformity can provide intuitive anatomical morphology and a preoperative simulation reference for clinical operations.

    Left side inferior vena cava and azygous vein variation: one case report
    CUI Chun-Ai, CUI Lin
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  139. 
    Abstract ( 816 )  
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    The analysis of the optimum sacroiliac screw channel of the second sacral vertebra
    TAN Pei-Yong, XIANG Zhou, ZHANG Jia-Jin, SONG Ban, LI Jia-Bing, HUANG Zi-Xing
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  140-143. 
    Abstract ( 1332 )  
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    Objective Using Digital Simulation Technique(DST) to find and measure the optimum sacroiliac screw channel(OSSC) of the second sacral vertebra. Methods This study included 8 adult patients without pelvic disease admitted to the hospital In April 2011 to July 2011, and imports their pelvic CT scan data into Mimics for 3D reconstruction, and uses DST to establish the sacral cavity die, and uses the perspective of the sacral cavity die to determine the OSSC, and uses Space Analytical Geometry's (SAG) to measure it's parameters. Results All of the 8 cases (16 sides) can use DST to determine the OSSC of S2. The parameter of the OSSC of S2: The max radius is (6.38±0.54)mm in male, and(4.9±0.74)mm in female; The depth is (68.93±3.49)mm in male, and(58.43±8.16)mm in female; The angle with sagittal plane is (73.48±8.57)° in male, and(79.93±5.29)° in female; The angle with axial plane is (14.07±6.22)° in male, and(6.95±4.81)° in female; The angle with coronal plane is (7.12±7.11)° in male, and(5.87±5.01)° in female. The way to determine the initial point and the end point of OSSC: Draw a rectangle whose sides are horizontal or vertical to just right encircle the pelvic on the out-let pelvic X-ray films. Establish a 2-D rectangular coordinates whose origin is the lower left vertices of the rectangle, and point (0, 1) is the upper left vertices of the rectangle, and the point (1,0) is the lower right vertices of the rectangle. The coordinate of the initial point of OSSC is (0.5±0.26, 0.52±0.04) in male, and (0.49±0.24, 0.47±0.10) in female. The coordinate of the end point of OSSC is (0.5±0.01, 0.59±0.07) in male, (0.5±0.02, 0.49±0.14) in female. Use the same way to draw the rectangle and define the rectangular coordinates on the in-let pelvic X-ray films. The coordinate of the initial point of OSSC is (0.5±0.26, 0.52±0.04) in male, and (0.49±0.24, 0.47±0.10) in female. The coordinate of the end point of OSSC is (0.5±0.01, 0.78±0.01) in male, (0.5±0.02, 0.81±0.03) in female. Comparing between men and women, some parameters (the max radius, the depth, the angle with axial plane) have statistically significant difference(P<0.05),and the other have no statistically significant difference (P>0.05). Conclusions The DST can accurately determine the OSSC of S2.

    Applied anatomy of the first dorsoradial metacarpal island flap
    LI Gui-Dan, HAN Shi-Lian, YIN Meng-Fan, ZHOU Jiang, WANG Xiao-Gang, GAO Yan-Xin
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  144-146. 
    Abstract ( 1027 )  
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    Objective To provide anatomic basis for the first dorsoradial metacarpal  island flap. Methods The origin, diameter, length and anastomosis of the cutaneous branches from superficial radial artery were explored and observed . Arteriography was used in one side of a fresh adult hand specimen to observe the artery. Results A large cutaneous branch originated from the superficial radial artery  beneath the insertion of the abducter pollicis longus in 39 sides of fixed adult hand specimens,and originated from the radial artery in one side. This large cutaneous branch was located on the radial side of the extensor pollicis brevis tendon with a straight distance of 2mm.There were rich anastomoses between the large cutaneous branch and the palmar digital artery at metacarpophalangeal joint. Conclusions Taken as an axis artery, the large cutaneous branch from the superficial radial artery can be used to supply an island flap for soft tissue defect in hand .

    Muscular architecture and distribution of intramuscular nerves in popliteus of human
    LI Shou-Tian, TUN Xiao-Yan, TANG Qian, LONG Qing, XUE Qian
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  147-149. 
    Abstract ( 1032 )  
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    Objective To investigate the relationship between muscular architecture and distribution of intramuscular nerves of popliteus in human. Methods Gross anatomy method, muscle architecture method, modified Sihler's staining were used. Results Popliteus of human is a triangular flat muscle With two instramuscular tendons in muscle. it has a weigh of (15.13±0.41)g, a length of (1.93±0.09)cm, and a physiologic cross sectional area of (7.17±0.13)cm2. The nerve innervating the popliteus enters the muscle through its lateral margin and bifurcates in its substance into an upper branch and a lower branch. The upper branch, which is comparatively smaller, innervates the anterosuperior portion of the muscle, and the lower branch, which is comparatively larger, innervates the anteroinferior and posterior portions of the muscle. Conclusion Popliteus is pinnate in shape in human, indicating its function of mainly about power generation. The nerve innervating is mainly located in the middle and inferior portions of it.

    The variation of the internal pudendal artery’s origination and the branches :one case report
    YANG Lu-Lu, MA Jian-Jun, CEN Yan-Ling, YUE E-Hui, MA Xiang-Qun, WEI Shi-Xiang, GENG Yong-Jie, CHEN Hao
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  149. 
    Abstract ( 736 )  
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    Sectional and imaging sagittal anatomical research in abdominal and pelvic part of a pregnant woman cadaver in third trimester
    KONG Fan-Tian, DIAO Dong-Mei, WANG Xiao-Jing, JIN Chang-Zhu, LI Zhen-Beng, LIU Shu-Wei
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  150-153. 
    Abstract ( 1303 )  
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    Objective  To provide sagittal sectional anatomic data for guidance in  B- ultrasound and MRI diagnosis in abdominal and pelvic parts of pregnant women in the third trimester. Method After MRI scanning in abdominal and pelvic part of a pregnant woman cadaver in third trimester, the abdominal and pelvic parts was sectioned into serial sagittal 10-millimeter thick sections with equal intervals using a dynamoelectric beltsaw. Result The anatomic structures in sagittal sectional imaging and MRI in abdominal and pelvic parts of the cadaver with full term pregnance were well displayed,and the spatial relationship of the location of the placenta and fetal main organs to the materal vertebrae in sagittal sections of the specimen and the MR images was relatively constant. Conclusion The analytic results of the MR and serial sagittal sectional images of the cadaver can provide normal and useful anatomic  guidance for B- ultrasound and MRI diagnosis in abdominal and pelvic parts of  the pregnant women in the third trimester.

    Microanatomy and angiography control observation of M1 segment of middle cerebral artery and its clinical significance
    HAN Xiao-Gong, LI Xiao-Feng, LI Pei, FU Sheng-Qi, FAN Ti-Yi, NIU Jie
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  154-157. 
    Abstract ( 2772 )  
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    Objective To provide anatomical basis for selecting the type of intravascular stent and site for placing it. Methods (1)20 head specimens were selected and measured at the M1 segment of the middle cerebral artery, its branches and perforators through the left and right pterion approach, respectively. (2)100 angiography images of brains with no obvious diseases were selected, the course of the M1 segment of the middle cerebral artery and the openings of its perforators were observed.    Results   The length and caliber of the MI segment of middle cerebral artery was (13.14±3.62)mm and (3.41±0.38)mm through measurement in specimens, respectively, and  was (10.65±5.61)mm, (2.30±0.35)mm through measurement in angiography, respectively. There was significant difference in length and diameter between microanatomic measurement and angiographic measurement (P<0.05). Minute medial group of central branches originated from the superior and medial aspects of the the M1 segment of middle cerebral artery, whereas sizable lateral group of central branches originated from the superior and medial aspects of the arterial at its bifurcation. There was significant difference in length and diameter between  angiography of the M1 segment of the middle cerebral artery in male and female (P<0.05);  the M1 segment of the middle cerebral artery in male was longer and larger in diameter than that in female. Conclusion   This study can provide guidance for selecting the type and placing site of intravascular stent, avoiding obstruction the openings of central branches and thus preventing postoperative ischemia of the vascularized area of central branches.

    The study of stress radiograph in the evaluation of trapeziometacarpal joint laxity
    ZHANG Bei, HAN Shi-Lian
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  158-160. 
    Abstract ( 961 )  
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    Objective Modified stress-positioned radiograph technique was used to measure carpometacarpal joint laxity with its consistence evaluated. Method   Stress -positioned radiographs were obtained from 66 patients whose carpometacarpal joint had no trauma, arthritis and surgeric history. Two measurements were performed by two hand surgeons: the width of radial subluxation of the first metacarpal base and the width of the first metacarpal articular surface; the ratio between them was calculated. T-test were performed to assess the reliability and difference between male and female.  Result   The average of the RS measurement is (4.27±1.83) mm (range 1~8mm)and the AW measurement is (13.52±1.89)mm (range 10~17.3 mm). The average RS/AW subluxation ratio is (0.32±0.11). Women showed greater value of the ratio than men(P=0.026). The measurements of two hand surgeon showed high consistence (P=0.23).   Conclusion The stress-positioned radiograph could evaluate joint laxity of the trapeziometacarpal articulation with high consistence.

    Anatomical observation of Toldt's gap in CT images and clinical significance
    OU Yang-Man-Zhao, CHEN Xiao-Wu, DING Zi-Hai, SHU Da-Jian, JU Yong-Le, WU Jin-Gao, LIU Guang-Sheng, LI Yong
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  161-164. 
    Abstract ( 804 )  
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    Objective To choose the optimal surgical plane through preoperative anatomical observation and recognition of Toldt's gap in CT images, so that perspective customized surgical approach can be made. Methods 246 patients underwent laparoscopic surgery for colorectal cancer in Shunde First People's Hospital affiliated to Southern Medical University from January 2010 to June 2012 were chosen, location, communication and adjacent structures of Toldt's gap in preoperative CT images and direct intraoperative laparoscopy images was observed and compared. Results The fusion of the posterior wall of the ascending and descending mesocolon to the anterior renal fascia was identified in the CT images as the Toldt 's line. Good consistency of Toldt's fascial spacein preoperative CT images and intraoperative view was obtained (Kappa = 0.718). By incising along this line while referencing to the retromesenteric plane during the laparoscopic surgery for colorectal cancer, correct surgical plane can be established. Conclusion ①Preoperative CT scan can be adopted to identify the correct Toldt's space as the surgical plane and preserve the integrity of the prerenal fascia. ② CT scan can indicate whether there is any tumor invasion to Toldt 's space, which is of great perspective significance in formulating customized surgical plan and assessing the prognosis.

    Secondary spinal cord injury of cervical spine fracturedislocation in rats
    JIANG Jie, DING Yin, ZHOU Jian, HUANG Zhi-Beng, TUN Xiu-Hua, CHEN Jian-Ting, SHU Jing-An
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  165-169. 
    Abstract ( 310 )  
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    Objective    To establish a model of secondary SCI of cervical fracture dislocation in rats. Methods    11 male rats were randomly assigned into the cervical fractured islocation group (n=11), the sham group (n=6)。Rats in the experiment group was subjected to fracture dislocation of 1.65 mm at C4/5 at speed of 200 mm/sec, and then stabilized 8 weeks with a custom designed cervical spinal fixation. Behavior was evaluated using the forelimb locomotor and grooming tests. Histology examination was conducted at the lesion epicenter using HE stain.    Results    The behavior scores of the experiment group were both lower than the sham group. There was rupture of grey mater, cavity in the cord and the cord shrink in the experiment group at 8 weeks after injury. The spared area of the cord at epicenter was (2.79±0.98)mm2 in the experiment group, and lower than the area in the sham group (6.36±0.08) mm2 (P=0.034).    Conclusions    The present study established the secondary SCI of cervical fracture dislocation in rats. The injury was characterized with the cord damage and locomotor function impair. 

    The influence of down-regulation of TAp73 expression by short hairpin RNA on the proliferation and invasion of osteosarcoma
    XUE Jian, JIN An-Min, LV Hai, MIN Shao-Xiong
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  170-173. 
    Abstract ( 330 )  
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    Objective To  investigate  the  pro-apoptosis,  anti-migration  and anti-proliferation of Saos-2 cells in osteosarcoma through genetic inhibition of expression of TAp73 protein. Methods Human osteosarcoma cell line Saos-2 was cultured.A short hairpin RNA targeting TAp73 was constructed and transfected into Saos-2 cell line.The expression of TAp73 protein were examined by Western blot method.The proliferation was assayed by CCK-8.Flow cytometry was used to detect the cell cycle.Transwell test was used to detect the invasion ability of Saos-2. Results Western blot revealed notably down-regulated expression at protein levels of Tap 73.The cellular proliferation in the treatment group detected by CCK-8 was active after siRNAtreatment(P<0.05).The proportion of the cells in the S phase increased.The invasion ability increased from( 84.17±1.35) to (92.67±2.80 )(P<0.01). Conclusions TAp73 is necessary for human osteosarcoma cell proliferation and invasion.It is probably a potential target for osteosareoma treatment.

    Antigenic differences of  allogeneic BMSCs,ADSCs after transplantation
    LI Lei, QIN Shu-Jian, BAO Cui-Fen, MA Gang, LI Ji, LIU Yu-Zhuo
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  174-179. 
    Abstract ( 415 )  
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    Objective  to investigate the antigenic difference of allogeneic bone marrow-derived mesenchymal stem cells( BMSCs) and adipose tissue-derived mesenchymal cells (ADSCs) after their transplantation.   Method    BMSCs, ADSCs from WKY rats were cultured in vitro and were transplanted into the radial osseous defects in Wistar rats after osteogenic induction; 1、2、4、8 weeks after implantation, tissues from the defective areas was taken for HE staining,  IL-2, TGF- β, TNF- α, CD4, CD8 were detected using immunohistochemical staining and quantity of IL-2, TGF- β, TNF- α was determined in supernatant of spleen cell culture using ELISA.   Results  1~2 weeks after transplantation of BMSCs, ADSC, mild lymphocyte, leukocyte infiltration can be observed in the defective areas, a small amount of IL-2, TGF- β, TNF- α, CD4, CD8 can be detected; there was no significant difference in the 2 groups.    Conclusion   No significant difference can be found in BMSCs, ADSCs after transplantation.

    Protection and mechanism of tetrahydroxy stilbene glucoside on hippocampal ischemia-reperfusion injury in gerbils
    WANG Ji, CHEN Xiao-Yu, LIU Mei-Mei, WANG Dong, SUN Yu-Hua, CHEN Xiao-Rong
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  180-183. 
    Abstract ( 419 )  
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    Objective To investigate the protective effects of tetrahydroxy stilbene glucoside (TSG) on ischemia-reperfusion (I/R)-induced hippocampal injury and the underlying mechanisms in gerbils. Methods Gerbil global I/R model was established by clamping bilateral carotid arteries for 30 min followed by reperfusion for 5 days. Animals were divided into 6 groups randomly: Sham, I/R, I/R+TSG high, middle, low (6, 3, 1.5 mg/kg) and edaravone injection group (3 mg/kg). The functions of learning and memory were detected by Morris water maze 5 days after reperfusion. The number and structure of neurons and neuronal apoptosis in hippocampal CA1 region were evaluated by Nissl and TUNEL staining, respectively. In addition, the expression of active-caspase-3 in cerebral tissues was measured by Western blot. Results Compared to Sham group, learning and memory capacity of gerbils in I/R group declined significantly, the number of functional neurons in hippocampal CA1 region decreased dramatically. Furthermore, the apoptotic neurons indicated by TUNEL staining as well as caspase-3 activation increased remarkably. TSG administration at middle and high dose (3, 6 mg/kg) and edaravone injection significantly reversed aforementioned changes induced by I/R. In contrast, TSG administration at low dose (1.5 mg/kg) had no effect. Conclusion TSG had therapeutic effects on I/R induced cerebral injury, especially on delayed neuron apoptosis in hippocampal CA1 region, which may be related to its suppression effect on caspase-3 activation.

    Brain cell death mechanism induced by high-dose dexamethasone
    BAO Cui-Fen, YUAN Jing, LIANG Jia, DIAO Rong
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  184-187. 
    Abstract ( 602 )  
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    Objective To investigate the brain cell death mechanism induced by high-dose dexamethasone. Methods SD rats were randomly divided into the control group and the experimental group. The experimental group was divided into 7d, 9d, 11d three subgroups. The experimental group received intraperitoneal injection of DX 5mg/kg while the control group received injection with equal volume of physiological saline. light microscopy, electron microscopy, immunohistochemistry and western blot were used to observe the morphological changes of the brain tissue and detect the expression of Active Caspase-3, PARP-1, pULK1 of the brain tissue. Results (1) rat brain tissue structure was clear and normal in the control group. In the 7d experimental group, the brain tissue had no significant pathological changes. Apoptosis and oncosis of the brain cells were observed in the 11d experimental group. (2) In the control group, expression of active Caspase-3, PARP-1, pULK1 was negative. Compared with the control group, expression levels of active Caspase-3, PARP-1,pULK1 were gradually increased with the treatment time in the brain tissue of the experimental group. Conclusion Brain cell death in dexamethasone-induced may be through the activation of Caspase-3 ,PARP-1, pULK1.

    Effects of acute hypoxia on TH expression in sympathetic ganglion of WKY rats
    HUI Chu-Ping, XU Jian, CHAN Na-Na, LIU Wei, WANG Yong-Kuo, YANG De-Hui, CHAN Yun-Guan, XU Feng-Xiao
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  188-191. 
    Abstract ( 266 )  
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    Objective  To discuss the effects of tyrosine hydroxylase (TH) in the occurrence and development of high altitude hypertension by observing the changes of the ultramicrostructure of the sympathetic nerve cells and the expression TH in superior cervical ganglion of rats. Methods WKY rats were randomly divided to be raised at plain or in the altitude chambers imitating the environment at 5000 m for 1 d, 3 d and 7 d, respectively. Electron microscopy was used to examine the changes of the ultramicrostructure of the sympathetic nerve cells. Real-time PCR and Western blot method were used to examine the mRNA and protein expression of TH. Results The blood pressure of hypoxia rats was obviously higher than C group(P<0.05);the results of Real-time PCR and Western blot showed that mRNA and protein expression of TH in superior cervical ganglion of H1 and H3 groups were lower than C group(P<0.05), but the expression in H7 group were higher than C group. The results of electron microscopy showed that the morphology of sympathetic nerve cells, quantity and structure of cell organelle were changed in the circumstance of plateau. Conclusions   TH may participate in the occurrence of high altitude hypertension through certain complex mechanisms.

    Research for modification of intracavernous pressure monitoring in establishing rat model with diabetic erectile dysfunction
    TUN Zi-Yun, HE Shu-Hua, ZHANG Chao, LIU Lu-Gao, HUI An-Yang
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  192-195. 
    Abstract ( 415 )  
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    Objective To evaluate the modified method of intracavernous pressure(ICP) monitoring in establishing rat model with diabetic erectile dysfunction. Methods Forty male rats were randomized equally into 2 groups (control group and diabetic group). ICP and arterial pressure (AP) were monitored with the improved method and the traditional method, respectively. The modified method used improved intravenous infusion needle puncture in the crus of penis.   Results    There was no significant difference in measurement of  the ICP and AP between the modified method and the traditional method(P>0.05), both in the control group and diabetic group. The modified method used improved intravenous infusion needle puncture in the crus of penis can improve the success rate significantly (the traditional method being 75% and the modified method being 100%). Conclusion The modified method of intracavernous pressure monitoring has characteristic of stable、accurate、higher success rate. It is of great significance for establishing rat model with diabetic erectile dysfunction and evaluating rat penile erectile function.

    Applied anatomic research of rabbit liver and its affiliated conduit
    CA Jiang, GAO Ze-Hai, YU Zhi-Yong
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  196-199. 
    Abstract ( 640 )  
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    Objective To investigate the applied anatomy of the rabbit liver and its affiliated conduit. Methods   Twenty livers of Japanese rabbits were observed in vivo and studied in vitro;corrosive vascular cast of the portal vein and hepatic vein was made and the weight of the each lobe was measured with its proportion to the whole liver calculated.    Results    According to the hepatic shape, fissure and branches of the portal vein, the rabbit liver is divided into five lobes : the caudate lobe, the left lateral lobe, the left middle lobe, the right middle lobe, the right lateral lobe; the average weight of each lobe is (g):3.93 ±1.13;15.93±3.50; 14.83±3.31; 15.08±4.34; 12.08±3.55, respectively. The rabbit liver has the relatively independent lobes with exception made for the left middle lobe and the right middle lobe, whose parenchyma are partially connected. In addition, the caudate lobe includes the caudate process and the papillary process. Each hepatic lobe has its relative independent hepatic pedicle containing the Glisson system and the hepatic vein.   Conclusion    Applied anatomy of rabbit liver has similarities to other major laboratory mammals, but it has some of its own characteristics. The rabbit is a suitable model for experimental liver surgery

    Biomechanical evaluation of flexible and dynamic pedicle screw instrumentations under compressive axial loads
    LIN Zhou-Qing, HUANG Zhi-Beng, CHEN Jian-Ting, TONG Jie, ZHOU Re-Zhou, SHU Jing-An
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  200-204. 
    Abstract ( 263 )  
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    Objective To evaluate the intervertebral disc heights of porcine lumbar spines implanted with 3 flexible /dynamic pedicle screw fixations under axial compressive force at 8 locations, and compare it with conventional pedicle screw fixation.   Methods  Eight fresh porcine spine specimens (L2~L5) were collected. 3 flexible /dynamic and 1 conventional pedicle screw fixations were applied to L3-L4 segment following resection of the posterior structures. Each specimen was subjected to flexion-compression, extension- compression, lateral-bending-compression, lateral-flexion-compression and lateral-extension-compression with a compressive force of 400N on the top of the specimen at 8 locations. 3D motion was measured using the Optotrak, and the L3-L4 anterior disc height was calculated. The specimen conditions included the intact and instrumentation with 5.5 mm rod, 3mm rod and sliding rod, and with ball-socket joint pedicle screws.   Results  Under the flexion-compression, lateral-bending-compression and lateral-flexion compression, there were no significant differences in the disc height change between the intact and each fixation condition(P>0.05). In extension-compression, the disc height change with the 3.0 mm rod was significantly different from the intact or the fixations with 5.5mm rod(P<0.05),while no significant difference among other groups were detected; In lateral-extension-compression, there was significant difference in the disc height change between each fixation and intact status (P<0.05), and between fixations with 3.0mm rod and the ball-socket joint screw fixation (P<0.05). Conclusions Flexible/dynamic fixations enhanced the compressive stability of lumbar spine when compared to the intact status. The fixation with sliding rods achieved compressive stability close to the conventional pedicle screw fixation. The compressive stability with ball-socked joint screw fixation was comparable to the conventional fixation in extension-compression and lateral- extension-compression, but was poor in flexion-compression or lateral-flexion- compression. Fixation with thinner rods was not strong enough in extension-compression or lateral-extension-compression.

    Three hepatic arteries and the variation of the origin and course of cystic arteries: one case report
    DAO Wei, WANG Can, WANG An-Min, JI Shao-Xiang
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  204. 
    Abstract ( 227 )  
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    Finite element analysis of magnesium alloy hollow screw for treatment of type II fractures of the odontoid process
    WANG Zhi-Kun, JIA Gong, ZHANG Tu, MA Li-Min
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  205-209. 
    Abstract ( 222 )  
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    Objective    To set up the finite element(FE) model of type II odontoid fracture screw fixation and analyze the stability of fixation on postoperative type II odontoid fracture using different material.   Methods    Atlantoaxial spatial structure information was obtained through CT scanning and 3D finite element model was established. Simulation of stress situation after screw fixation of odontoid fractures was performed; Then comparison of the displacement of the fracture surfaces and stress the fracture surfaces and the screw should take after fixation with screws using two materials(the magnesium alloy and the titanium alloy) were measured; the results were analyzed by t test statistical analysis. Results (1)The finite element model of the axis  that consists of 32929 elements and 59265 nodes is of object-like appearance and excellent geometric similarity; ( 2 ) under the circumstance of head extension and flexion, the maximum stress of the titanium alloy screws were 42.3MPa and 62.8 MPa, and the maximum displacement of fracture ends were 0.028mm and 0.040mm respectively; the maximum stress of the magnesium alloy screws was 33.6 MPa and 52.1 MPa and the maximum displacement of fracture ends was 0.036mm and 0.056mm, respectively. Conclusion Information of the spatial structure of the axis obtained through CT scanning and utilized for model building can be used in biomechanical experiment; the maximum stress of the screws with two type of materials used for fixation of the pattern-II odontoid fracture is smaller than the yield strength of the material; the stress the fracture ends in the magnesium alloy group was higher than that of the titanium alloy group.

    The variation of double cystic arteries coming from the middle hepatic artery in one case
    GENG Yong-Jie, MA Jian-Jun, CAO Hua-Hui, CHEN Hao, MA Hai-Yan, WANG Feng, WEI Shi-Xiang, FANG Jian-Chao
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  209. 
    Abstract ( 226 )  
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    Nail transplantation with blood supply for reconstruction of thumb or finger nail defect
    LI Xiu-Beng, JU Ji-Hui, LIU Xin-Yi, HOU Rui-Xin
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  210-213. 
    Abstract ( 383 )  
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    Objective To summarize the clinical effects of nail transplantation with blood supply for reconstruction of thumb or finger nail defect. Methods From February, 2003 to February, 2011, we carried out 23 cases of toenail transplantation with blood supply to reconstruct thumb nail defect and 40 cases of toenail transplantation from the second  digit of the foot with blood supply to repair nail defect of the second to the fourth finger. And skin grafting or the pedicled local flap was carried out at the donor site of the foot. Results The wound healing of the patients were all primary, and all 23 transplanted thumb nails and 40 transplanted nails from the second digit of foot were all successful. We followed up 63 patients for 5~30 months and the average of follow-up time was 13 months. The patients we followed up were satisfied with the appearance of their reconstructed fingers. The nails grew well with good touch sensation, which could assist the finger pulp to do some actions such as grasping, pinching, or picking up a needle. The flexion of interphalangeal joint of the patients with repaired thumbs could reach 50°~90°,  with an average of 65°. And the distal interphalangeal joint flexion of the patients with repaired 2~4 fingers reached 30°~70° with an average of 50°. Two of the 48 donors for skin grafting had linear cicatricial contracture in feet. The contracture was relieved after a second surgery for cicatricle resection, and the texture of other skin grafting area was good with loose and soft skin.  Conclusion  Nail transplantation with blood supply from from the thumb and the second digit of the foot can can notably repair the appearance of the fingers and also rebuild the functions of nails.

    The clinical application of the fibula side flap of great toe
    WANG Xu-Dong, YANG Ying-Yan, WU Wen-Jiang, HU Xiang-Yuan, WANG Wen-Gang, CHEN Wei-Lian
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  214-216. 
    Abstract ( 228 )  
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    Objective To discuss the surgical approach and the clinical curative effect of using the fibula side flap of the great toe to repair the soft-tissue.defect of the palmar side finger. Method   A retrospective analysis was conducted on patients with soft-tissue defect on the palm side of the finger treated by the fibula side flap of the great toe between August 2005 to August 2011. Result In the study period of 12 to 36 months, all of the 17 flaps survived with good texture and appearance, and two point discrimination of 4~6 mm.  And the functional recovery the fingers was satisfactory and The patients' gait was not affected. Conclusion Using the fibula side flap of the great toe to repair the soft-tissue defect of the palmar side of the finger is a preferential choice which delivers excellent clinical curative effect.

    Less invasive treatment for aseptic femoral head necrosis with Ficat II and III A patterns using core decompression and fibula strut graft
    CA Shu-Feng, LIU Chang-Li, TANG Yong, CHEN Yan-Chao
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  217-219. 
    Abstract ( 252 )  
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    Objective To investigate the clinical value of core decompression and non-vascular fibula strut graft for treatment of aseptic femoral head necrosis. Methods Core decompression, debridement and fibula strut graft were performed for treatment of 46 patients with Ficat II and III A-pattern aseptic femoral head necrosis. Results During two to five years of following-up, the Harris scale was used the assess the therapeutic efficacy and good and excellent rate was determined as being 83%. The average score by Harris scale was raised to 85 points postoperatively from 61 points preoperatively. Conclusion Using core decompression and fibula strut graft for treatment of aseptic femoral head necrosis could be valuable in delaying the hip joint replacement.

    A comparison of three nerve-localization techniques on axillary brachial plexus block
    WANG De-Meng, HOU Shu-Jian, ZHANG Yuan-Shen, JUE Zhi-Gang, SUN Le-Tian, HE Xu
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  220-224. 
    Abstract ( 1919 )  
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    Objective To compare the clinical effect of axillary brachial plexus block performed by using three methods of nerve localization: variable posture and angle two-point method, the traditional one point method and peripheral nerve stimulation method. Methods Seventy-five emergency patients (ASAⅠ-Ⅱ) undergoing the forearm and hand surgery were selected and randomly divided into three groups (n=25):the variable posture and angle two-point method group (VTP) and the traditional one point method group (TOP) and peripheral nerve stimulator group (PNS) . Axillary brachial plexus block was performed with 45 ml of 0.375% ropivacaine in three groups. Success was defined as a sensory block of 5 nerves (median nerve, ulnar nerve, radial nerve, musculocutaneous nerve, medial brachial cutaneous nerve) with territories distal to the elbow 20 minutes after performing the block. The block success rate, onset time of analgesia, tourniquet tolerance and occurrence of complication were compared in three groups.   Results The success rate of group VTP and PNS was higher than that of group TOP(96.0%,100% vs72.0%,P<0.01).The success rate of blocking of the radial and the musculocutaneous nerves in group VTP and PNS was obviously higher than that in group TOP( P<0.05).Onset time (T2) of group VTP and PNS was shorter than that of group TOP. Time to achieve readiness for surgery (T3) was shorter in group VTP than that in group TOP and PNS (P<0.05); Performance time(T1) of  group PNS was longer than that of group TOP and PNS. Conclusions  The technique of VTP is a good block method to make up for the shortcomings of the traditional one point method .Its advantage is a better block the radial and the musculocutaneous nerves and reduction of patients' discomfort caused by tourniquet. It can provide for hands and forearms operation a fast, simple, effective and relatively affordable anesthesia. 

    The clinical curative effect of primary pterygium's postoperative  recurrence by Angiostatin combined with Mitomycin C
    HU Dan-Dan, LIU Hai-Dun, LI Yan, LIU Zi-Ban
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  225-228. 
    Abstract ( 315 )  
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    Objective To study the clinical curative effect of primary pterygium's postoperative  recurrence by Angiostatin combined with Mitomycin C.  Methods 365 cases (369 eyes) with primary pterygium were divided into three random groups : A  group (121 eyes) was treated with retrograde resection combined with M MC; B group (122 eyes) was treated with retrograde resection combined with AS and C group (126 eyes) was treated with retrograde resection combined with AS and MMC. Follow-up of 12~18 months was carried out , the recurrence rate was then compared. Results The difference among the 3 groups was significant (P<0.05). Group C recurrence rate (0.8%, 1/126)was minimum, the next  was group B (5.7%, 7/122), and the last was group A (7.4%, 9/121). Conclusions The retrograde resection combined with AS and MMC is a distinct effective remedy in treatment of primary pterygium. It can achieve good result reduced the recurrence rate and is , therefore, worth spreading.

    The anatomy and imaging significance of intracranial venous sinus and related veins
    LI Shi-Qing, WANG Shou-Sen
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  229-231. 
    Abstract ( 196 )  
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    The research progress on rotational alignment of the distal femur
    LI Hu, LI Jun, SHI Tie-Jun
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  232-235. 
    Abstract ( 360 )  
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    Skeleton decalcification was used for making central nerve total preparation
    HU An-Wei, LI Ze-Yu, LIU Chang, HONG Hui-Wen, TUN Kun-Cheng, XIAO Zhao-Meng, HE Shan-Li, JIA Cheng-En
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  236. 
    Abstract ( 245 )  
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    The abnormal opening of left coronary artery: one case report
    WANG Lian-Xiang, DONG Shao-Feng, LI Chu-Yang, HOU Ying-Long
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  237-238. 
    Abstract ( 317 )  
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    The multiple variations of the arteries of thumb and index finger merging the superficial palmar arch and deep palmar arch:one case report
    HE Wei, MA Jian-Jun, LI E, YANG Lu-Lu, FANG Jian-Chao, WANG Yi-He, WANG Feng
    Chinese Journal Of Clinical Anatomy. 2013, 31(2):  239. 
    Abstract ( 254 )  
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