Chinese Journal of Clinical Anatomy

Anatomic study of the anchor points of anterior bundle isometric reconstruction of elbow ulnar collateral ligament

BO Zhao-Xun, CUI Yan, GUAN Qing-Li, WANG Ye-Xin, ZHANG Hong-Xin, WANG Chang-De

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 369-372.

Abstract ( 1076 )

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Objective　To find the optimal anchor points of anterior bundle isometric reconstruction of the elbow ulnar collateral ligament through anatomic study.　Methods　3 anchor points were marked near both proximal and distal ends of the anterior bundle of the elbow ulnar collateral ligament on 8 intact human adult elbow specimens. The distance variation was measured in each pair of points on both sides while flexing the elbow from 0 degree to 120 degree and was analysed statistically.　Results　Distance variation of the pair from the elbow rotation center on the humeral medial epicondyle to ulnar subcoronoid tubercle was minimal (P<0.0001). When proximal points were fixed on elbow rotation center, the distance variation was significantly less than the other 2 proximal points with significant difference (P<0.0001).　Conclusion　The optimal anchor points of the anterior bundle isometric reconstruction of the elbow ulnar collateral ligament is elbow rotation center on the humeral medial epicondyle and ulnar subcoronoid tubercle;

The measurement of anatomic data of the humerus body and relevant study of the new internal fixator of humerus

DI Wen-Liang, BAI Da-Jiang, CANG Zhen-Feng, HU Zhong-Wei

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 373-375.

Abstract ( 780 )

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Objective　 To provide anatomical basis for the design of a new internal humerus fixator and its application.　Methods　40 sides of adult upper limb specimens with were dissected, the course of the axillary nerve, radial nerve was observed and the distance from them to the related osseous landmarks were measured. Meanwhile, 30 adult dry humerus specimens were selected, the related diameter and circumference of the upper humerus were measured and the optimal radian was calculated.　Results　The maximum length of the humerus was (30.21±0.22) cm; The greater tubercle to the axillary nerve length was (5.48±0.09) cm; The greater tubercle to deltoid tuberosity length was (12.80±0.13) cm; The nearest end of humerus to the entry and exit of humerus muscle tube were (16.10±0.27) cm and (21.04±0.26) cm, respectively; The best radian of upper humerus was (3.90±0.03) rad.　Conclusion　When the radian of arched segment reach 3.9 rad, the new humerus internal fixation can achieve very good adherence as well as reducing the incidence of the radial nerve injury effectively.

Applied anatomy of modified anterolateral approach for type C fractures of the distal femur

JIA Song, DAI Min, ZHANG Bin, DAI Jiang-Hua, NIE Chao, QIU Beng

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 376-378.

Abstract ( 812 )

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Objective　To provide anatomic basis for treating type C fractures of the distal femur by the modified anterolateral approach of the thigh. Methods Main anterolateral muscles, ligaments were observed on 12 lower limbs of adult cadavers; the modified anterolateral approach was used, and the vessels and nerves related to the posterolateral approach were measured.　Results　The modified anterolateral approach could fully expose the distal femur without risk of injuring the important nerves and vessels. What's more, it did not affectthe iliotibial band and could attenuate the damage to the quadriceps femoris, which could effectivelyprotectthe extensor mechanism of the knee joint.　Conclusions　The treatment of the fracture of the distal femur by the modified anterolateral approach is safe, less traumatic and and greater in exposure.it is worth of further promotion.

Microanatomic and angiographic observation of the basilar artery and its clinical application

LI Pei, MAO Guang-Lan, FU Sheng-Qi, FAN Ti-Yi, WANG Hua, WANG Qiang-Zhi

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 379-383.

Abstract ( 880 )

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Objective　To provide anatomical basis for selecting the types and the placing parts of vascular stent.　Methods　(1)20 head specimens were selected and measured for the basilar artery , its branches, and perforators through the clivus approach. (2)100 angiographic images of the whole brains without diseases were selected, the course, branches of the basilar artery and the opening parts of its perforators were observed. (3)20 patients of basilar artery stenosis were selected and underwent stent angioplasty through puncture at the femoral artery, the changes of the vascular diameter in the stenosed parts of the basilar artery were measured.　Results　The basilar artery was (28.52±3.45) mm in length, (4.52±0.24) mm in external diameter in microanatomic observation, and (25.47±3.65) mm, (3.46±0.46) mm in length and diameter in angiographic observation. There were significant difference in length and diameter between the microanatomy and angiography,respectively (P<0.05). The perforators of basilar artery were fine, small and concentrated, which originated from the posterolateral wall of the basilar artery and enter the brain parenchyma in straight courses. There were significant difference in the transverse and anteroposterior diameter the basilar artery in angiographic view (P<0.05). The lumen of the the basilar artery was elliptical in shape. There were significant difference in length and diameter between males and females of the basilar artery in angiographic view, respectively (P<0.05), the male basilar artery were longer and thicker than that of the female. Operative success rate for stent angioplasty of the basilar artery was 100%; There was clear improvement in stenosis.of the blood vessels.　Conclusion　 It is of enormous clinical significance for selecting the types and the placing parts of the vascular stent so that postoperative ischemia of the supply area of perforators can be prevented

Preliminary research on the morphological classification of neonatal auricle

TUN Qing-Lin, JI Xiang-Dong, DIAO Hui, QIN Jian-Ceng, ZHONG Shi-Tian

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 384-388.

Abstract ( 1033 )

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Objective　To understand morphological classification and the incidence of neonatal auricular deformities，and obtain neonatal auricular measurement data. Methods　With human body measurement instrument, we measured length, breadth and other items of newborns' Ear, and tookpictures of their both ears. In total we measured 321 newborns who were born in the Hospital of Dongguan Houjie within a week. According to the diagnostic criteria of auricular deformities, we determinde morphological classification, obtained the incidence of various types, differences between left and right, gender differences, and measurement data.　Results　There were eight morphological classifications in 321 newborns. They were Prominent ear, Cup ear, Lop ear , Stahl's ear, Constricted ear, Conchal crus, Helical rim deformity, and Mixed ear deformity. The incidence of Prominent ear was 3.74%, Cup ear 2.18%, Lop ear 5.61%, Stahl's ear 2.49%, Constricted ear 13.40%, Conchal crus 6.07%, Helical rim deformity 5.92%, Mixed ear deformity 4.05%. Compared with the left ear, the incidence of conchal crus of right ear was higher. The incidence of Helical rim deformity of female baby was higher than that of male baby.　Conclusion　The incidence of neonatal auricular deformities is high. There are differences of diagnostic classification of auricular deformities between home and abroad. We need to carry out multi-center cooperative research to determine the quantitative diagnosis of auricular deformities of Chinese newborns.

Three dimensional digitized dental model with root based on laser scanning and CT data

JIAO Pei-Feng, LIU Yang, BI Zhen-Yu

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 389-392.

Abstract ( 841 )

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Objective　To establish digitized dental model with the root based on the three-dimensional laser scanning of plaster dental models and the head CT data, and record the morphological structure of the teeth and the spatial location changes of the teeth during treatment course.　Method　The independent digital models with upper and lower dentition were established based on an adult female's head CT data in Mimics11.0.”. The plaster dental models were scanned with a 3D laser scanner and the data files were merged and saved as point clouds which contained spatial location coordinates of the crown surface and the relationship of the upper and lower dentition in the intercuspal occlusion (ICO).Based on the models from the point clouds, a dentition model with teeth roots was regrouped with independent teeth models built from CT data, and the real spatial position relationship of the upper and lower dentition was rebuilt.　Result　Upper and lower 3D digital full structure dentition models were rebuilt containing details of the anatomical structures of the crowns and roots of teeth, and the relative position of the dentition and occlusion were recovered.　Conclusion　In the orthodontic treatment, the dentitions models with roots from the CT data and 3D scanning can display the change of teeth crowns and roots, and the practitioners can easily evaluate the treatment process and the therapeutic effecacy.

The digital simulation of fracture reduction and fixation of complicated acetabular fractures

SONG Jun, MEI Yi-Zhang, TUN Ceng-Cheng, LI Meng-Jun, RUAN Yu-Ting, LI Jian-Die, LIN Li-Jun

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 393-396.

Abstract ( 854 )

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Objective　To investigate the fracture reduction and implant simulation of complicated acetabular fractures using digital medical technologies. 　Methods　CT image of one case of complicated acetabular fractures was obtained and imported into software Mimics. Geometry models of pelvis were three-dimensionally (3D) reconstructed. Fracture Reduction and implant simulation were performed in software Geomagic, which served as a surgical guidance. The CT images of the same patient were obtained again 3 months after the operation. The postoperative models were also reconstructed for comparison and evaluation. Results　According to the Tile classification, the case was type C2-3. By using Mimics software, the 3D model accurately reflected the structure of pelvis with complicated acetabular fractures. With bone fragments being moved and rotated in Geomagic, fracture reduction and implant simulation were performed. The post-operation effect was good after following-up. The positions of plates and screws in pre- and post-operation stages were very close.　Conclusions　The digital medical technologies are very useful for fracture reduction and implant simulation, which can improve the accuracy of the surgery.

Digital anatomical study of the superior pubic ramus screw channel

YANG Yong, WANG Lei, WANG Fu-Chuan, ZHANG Shao-Wu, DONG Yun

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 397-401.

Abstract ( 931 )

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Objective 　To investigate the safe range of intramedullary screw channel of superior pubic ramus fractures with the methods of digital anatomy.　Methods　A retrospective analysis was conducted with computed tomography (CT) images of pelvis from17 adult patients (34 cases of hemipelvis). We built virtual cylinder of intramedullary screw channel with Mimics according to the common types of superior pubic ramus fracture. With three-dimensional measurement tools, we measured the maximum width, depth, range of entry points and angles of the screw channels, determined the patterns of them and the scope of the security.　Results For medial 1/2 fractures, the virtual cylindrical was of an average of (9.64±0.79) mm in maximum diameter, (67.88±6.07) mm in length and sagittal screw angle ranged from (44.03±2.29)° to (50.41±3.33)°; in terms of the lateral 1/2 fracture, the maximum diameter of the virtual cylindrical was (11.25±1.45) mm, (96.82±6.76) mm in length, the angle between the screw and the sagittal plane ranged from (36.12±2.76)° to (43.38± 3.30)°. The differences between men and women were statistically significant, the data of different location of fractures between the two groups were statistically significant.　Conclusion　Digital anatomical studies of the safe range of intramedullary screw channel of superior pubic ramus fractures increase the safety and accuracy of the intramedullary screws fixation.

Anatomy of the superior gluteal artery assessed by three-dimensional computed tomographic angiography

LONG Teng-Fei, ZHANG Han-Han, DIAO Hui, ZHANG Pi-Jun, WANG Gang

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 402-406.

Abstract ( 845 )

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Objective　The purpose of this study was to clarify the location and anatomy of superior gluteal artery(SGA) using three-dimensional computed tomographic angiography(3DCT-A). Methods　3DCT-A data of 114 subjects (228 hips) adopted and the following examinations were performed; (1) observation of the development rate of SGA; (2) observation of the origin, branch and course of the SGA; (3) definition of the main trunk of the extra-pelvic part of SGA(po-SGA) as the part of SGA from the point where SGA crossed through the greater sciatic notch to the end or the turning point (when there was only one deep branch) of the deep branch; the length of this main trunk was then measured, and comparison of the length between male and female was performed; (4) measurement of the length between this main trunk and bony landmarks (posterior superior iliac spine, ischial spine, greater sciatic notch starting point) of the pelvis, the lengths from this main trunk to the line between the bony landmarks(iliac tubercle, ischial spine) were carried out, and comparison of the lengths between male and female performed . Results (1)The SGA could be clearly observed in 94 subjects; (2)All SGAs originated from the internal iliac artery(IIA); (3)The SGA issued a branch in 28 hips before passing through the greater sciate notch. (4)There were statistical differences in the length between the starting point of po-SGA and the greater sciatic notch starting point, and in the length between the starting point of po-SGA and the ischial spine among male and female subjects. (5)The main trunk of po-SGA was approximatively paralleled to the line between the iliac tubercle and the ischial spine. Conclusion Understanding of the location and the anatomic relation of the SGA to the pelvis using 3DCT-A is helpful for preventing the SGA injury during surgery.

The reverse engineering of radial head prosthesis: based on three-dimensional digital anatomy of proximal radius on uninjured side

LIU Jian-Hua, WANG Zhi-Gang, HUANG Chi, ZHANG Xiao-Fei, SHI Xiao-Jian, SHU Jian-Wei, HUANG Xi

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 407-410.

Abstract ( 875 )

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Objective To study the reverse engineering of radial head prosthesis based on three-dimensional digital anatomy of proximal radius on uninjured side with the technique of computer aided design in order to help the clinical accurate replacement. Methods　The double elbow joints of a healthy adult was thin slice scaned by GE Speed Light 16 CT to obtain the CT dicom data , which were then imported into Mimics10.0 software for reconstruction of the 3D image of the elbow joints. Establish the mirror image of the proximal segment of the radius on the left side which was presumed unjuried. Then edit and cut it into the head and neck sections, configure the stem through measurement of the diameter and length of the neck intermedullary canal. Meanwhile, the head DXF file was imported into Geomagic studio 12 , Finally, the reverse engineering of the radial head prosthesis was finished. Results By 3D reconstruction, edit, measurement and manipulation of the CT image data of the proximal radius on uninjured side in Mimics10.0 and Geomagic studio 12 software can reversely design the individual radial head prosthesis and simulate to make it up. Conclusion Reverse engineering based on three-dimensional digital anatomy of the proximal radius on the uninjured side provides an effective method to produce an individual radial head prosthesis.

Three dimensional measurement and clinical significance of posterior slope angle of the tibial plateau in south Chinese

LI Jun, JING Jue-Hua, SHI Tie-Jun, DAN Dun-Feng

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 411-413.

Abstract ( 1223 )

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Objective　To provide references and evidences for design of the knee prosthesis suitable for south Chinese and optimal tibial osteotomy in total knee arthroplasty, posterior slope angle of the tibial plateau in adult south Chinese were measured.　Methods　80 adult volunteers were enrolled in this experiment. Their knees were scanned by spiral CT with obtained data imported into MIMICS for three-dimensional reconstruction; then both of posterior slope angle of the lateral tibial plateau and the medial tibial plateau were measured by Unigraphics NX software.　Results　The posterior slope angle of the medial tibial plateau in adult south Chinese was (6.86±1.92)° for the left, and (6.45±2.02)° for the right, (6.20±2.03)° for the male and (7.19±1.78)° for the female, with an average of (8.16±3.37)°; and posterior slope angle of the lateral tibial plateau was (6.89±3.42)° for the left, (6.82±2.78)° for the right, （6.84±2.82）° for the male and （6.87±3.01）° for the female, with an average of （6.85±2.90）°. There were no statistically significant differences between different genders and sides for posterior slope angle of the lateral tibial plateau or the medial tibial plateau（P>0.05）; However, the posterior slope angle of the medial tibial plateau was significantly greater than the lateral tibial plateau(P<0.05).　Conclusions　The posterior slope angle in adult south Chinese has a greater individual difference than the average in other area at home and abroad.

Comparison of the imaging transsphenoidal anatomies

CA Mei-Qin, CHEN Hai-Yan, HE Hai-Yong, HU Bing, QIN Feng, LING Cong, GUO Yang

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 414-416.

Abstract ( 925 )

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Objective　To provide basic data for the application of CTVE to transsphenoidal surgery. Methods　In fifteen injected adult cadaveric heads, the CTVE images of sphenoid sinus were reconstructed by Navigator Guide software, and then compared with the endoscopic images.　Results　CTVE and endoscope could display the superficial anatomic landmarks such as the sphenoid ostia, optic prominence, carotid prominence, opticocarotic recess and clival indentation of sphenoid sinus in a three-dimensional mode. The difference between the display rates of CTVE and endoscope are not statistically significant（P>0.05）. CTVE could display all the anatomies of the underlying carotid ateries by Transfer Functions. By gradual heightening of the threshold, CTVE could display the underyling optic canals and simulate the procedures of sellar floor exposure and optic nerve decompression, which were similar to the endoscope.　Conclusion　CTVE can display the superficial and underlying anatomies involved in transsphenoidal surgery in a three-dimentional mode. CTVE can be a valuble imaging tool for transsphenoidal sugery.

Anatomical evaluation of the venous sinuses in the region of the confluence of sinuses using digital subtraction angiography

CHENG Dao-Bin, LI Ning-Hu, HUANG Wei-Chao, ZHANG Jie-De-

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 417-421.

Abstract ( 976 )

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Objective　The aims of this study were to evaluate the anatomy of the confluence of sinuses and to assess their clinical significance using digital subtraction angiography(DSA).　Method　The confluence of sinuses and its relevant venous sinuses were analyzed using bilateral carotid and vertebral artery angiography in 203 adults. We evaluated the anatomy of the sinuses near the confluence, including the patterns of drainage of the superior sagital sinus(SSS) into the transverse sinus(TS) and the drainage of the straight sinus(SS) into the TS, the drainage type of the bilateral TS, the comparison of size between the bilateral TS , the communication type of the bilateral TS and the occurrence rate of the occipital sinus(OS).　Results　The drainage pattern of the SSS into the TS could be classified into four types: Sc typein 61 cases, accounting for 30.0%, Sd type in 58 cases, accounting for 28.6%, Sr type in 71 cases, accounting for 35.0%, and Sl type in 13 cases, accounting for 6.4%. The drainage pattern of the SS into the TS could be classified into three types: Rc type in 138 cases, accounting for, 68.0% (138 cases), Rr type in 37 cases, accounting for 18.2%, and Rl type in 28 cases, accounting for 13.8%. The drainage type of the bilateral TS could be classified into five types: equal drainage in 74 cases, accounting for 36.4%, drainage mainly from the right side in 99 cases, accounting for 48.8%, drainage mainly from the left side in 12 cases, accounting for 5.9%, drainage limited to the right side in 14 cases, accounting for 6.9%（14 cases）, drainage limited to the left side in 4 cases, accounting for 2.0%. Conclusion　DSA is an accurate and reliable method to evaluate the confluence and its relevant venous sinuses. It can provide useful information for the diagnosis and differential diagnosis of cerebral venous disease and certain surgical intervention.

Clinical significance of tomographic ultrasound and MRI imaging observation on pelvic floor anatomy of nulliparous women

JIA Xun, GUO Fei-Yan, DUAN Gang, LI Ding-Fu

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 422-425.

Abstract ( 1128 )

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Objective　To evaluate tomographic imaging in pelvic floor anatomy of nulliparous woman both at rest and during pelvic strain and discuss the clinical significance.　Methods　Thirty asymptomatic nulliparous volunteers were enrolled for 3D sonography and dynamic MRI； all tomographic imagings were used to observe position and movement of pelvic organs and the shape of pelvic floors, and to measure the thickness of muscle 1ayers and the dimensions of the levator hiatus．Results　A normal pelvic floor could be demonstrated by tomographic image in the axial , coronary and sagittal planes. Measurements of levator ani and the hiatal area was (8.2±1.8) mm and (11.82±2.25) cm2 at rest, respectively．Compared with the rest state, the bladder neck, cervix and the anorectus were lower during maximaI pelvic strain (the difference is 6.1±2.0、8.9±4.2and 14.9±6.1mm, respectively ). Conclusions Tomographic imaging can show the morphological characters of the pelvic floor both at rest and during pelvic strain and may be useful in the diagnosis of female pelvic floor disorders.

A case of superior and inferior of mesenteric artery through the abdominal artery ring anastomosis variant

YI Chuan-An, TU Zhong-Hua, XIE Zheng-Lan, YANG Yi-Nong, XIANG Chang-He, RAO Li-Bing

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 426.

Abstract ( 727 )

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CT features of transverse mesocolon involvement in colonic carcinoma and the anatomic basis

WANG Wen-Juan, DING Na, YANG Chun-Bei, CHEN Hua-Cheng, GAO Qi-Min, DONG Feng

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 427-429.

Abstract ( 908 )

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Objective　To evaluate multiple-slice computed tomographic (MSCT) features of colonic carcinoma involving the transverse mesocolon (TM) and its anatomic basis. Methods　The MSCT images of 28 cases with colonic carcinoma were compared with surgical and pathological findings, retrospectively. Results　Among the 28 cases, the sensitivity, specificity and accuracy of judging TM infiltration by mass forming, nodular and wedge-shaped shadow, short bars and increased fat density in the TM were 16.7%，61.1%，5.6%，33.3%; 100%，80%，30%，50%; 46.4%，67.9%，14.3 %，39.3%. Five cases showed enlarged lymph nodes in the TM.　Conclusion　The involvement of TM by colonic carcinoma can show some special CT features. MSCT images are helpful for preoperative imaging evaluation of TM involvement and lymphatic spread.

Role of PET/CT and MRI in describing anatomy of tonsillar ring and evaluating oropharyngeal Non-Hondgkin's lymphoma (NHL)

ZHANG Shui-Xin, CHEN Wen-Bei, LIU En-Chao, LIANG Chang-Gong

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 430-434.

Abstract ( 1802 )

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Objective　To study the anatomy and imaging features of Oropharyngeal in non-Hondgkin's lymphoma (NHL) by PET/CT and MRI to improve the diagnosis of NHL.　Methods　The 30 cases diagnosed as NHL through clinical and pathologic tests were retrospectively analyzed in regard to appearance, location, signal, enhanced features, SUVmax and metastasis by PET/CT and MRI.　Results　Of 30 cases, 21 cases of Oropharyngeal NHL originated from B-cell（76.7%）, 5 cases from T-cell （16.7%），and four cases from NK/T-cell （6.7%）. The tonsil was the most vulnerable site （n=19）. Three types in appearances of lesions could be observed. Specifically, 10 cases were mass type, 8 cases diffusion type, 12 cases mixed type. On plain CT scans, the lesions manifested as iso-or slightly hyper-density masses, and showed homogeneous and even enhancement after contrast injection. On T1WI, the lesions were isointense or slightly hypointense signal while on T2WI those were isointense or slight hyperintese signa1. SUVmax of primary tumors was increased significantly(n=25). All cases showed narrowing of the parapharyngeal space, but the high signal of the fat was showed on MRI; Coincidently, mucosae of pharynx oralis was continuous. Cervical lymph nodes were involved in 25 cases, and the density was homogeneous in 22 cases, a few metastases (3 cases) appeared as necrosis or cyst.　Conclusion　Oropharyngeal NHL have some characteristic imaging features of the position, SUVmax, shape and range of lymphoma of Oropharyngeal and metastases in lymph nodes and infilatration changes of its surrounding tissue. PET/CT and MRI are of crucial importance in the diagnosis and treatment of oropharyngeal NHL.

Transsynaptic tracing of CNS neural circuitry involved in the innervation of bladder function in the adult rat brainstem and spinal cord

CHENG Jun, XIAO Liao-Yuan, ZHANG Ru-Lei, LIN Gao-Dong, HOU Chun-Lin

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 435-440.

Abstract ( 1069 )

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Objective　To identify the CNS neural circuitry involved in the innervation of bladder function in the adult rat brainstem and spinal cord using pseudorabies virus，a transsynaptic tracer，so as to lay down the basis for further studying of brain functional reorganization after bladder function reconstruction. Methods　GFP-PRV 4.5ul（1×108 PFU /ml）was injected into the bladder wall of 15 adult female SD rats at 3 different sites. The distribution of virus-infected neurons in the brainstem, spinal cord and dorsal root ganglion were observed under fluorescent microscope at various intervals (72h, 84h, 96h, 108h, 120h) following the PRV injection.　Results　Fluorescence positive neurons were mainly present in L6~S1, L1~L2 dorsal root ganglion; sacral parasympathetic nucleus, intermediolateral cell column and dorsal commissural in L6~S1 and L1~L2 spinal cord segments; Barrington's nucleus, nucleus raphe magnus, the gigantocelluar reticular nucleus, the parapyramidal reticular formation, noradrenergic cell groups A5 and A7, locus coeruleus, periaqueductal gray and the ventral region of red nucleus in brainstem.　Conclusion　The structures labeled in spinal cord and brainstem are synaptically connected with the bladder and presumably involved in the neural control of the bladder.

Experimental study on bone formation potential of the intervening tissue at the hypertrophic nonunion site

LIU Lian-Song, XU Jia, KANG Qiang-Lin, XUE Feng, ZHANG Chang-Jing, CHAI Yi-Min

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 441-446.

Abstract ( 693 )

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Objective　To observe the structure of the intervening and surrounding tissue at the hypertrophic nonunion site, to assess the potential of bone formation.　Methods　Tissue from the nonunion site and its surroundings was extracted from 25 patients with hypertrophic nonunion. Tissue structure and microscopic characteristics of these regions were investigated by optical microscope, transmission electron microscopy. Expression of BMP-2 was detected by immunohistochemistry. The positive cells were observed, counted and analyzed statistically.　Results　The area of hypertrophic nonunion ends displayed different non-uniform histological features. The center area mainly displayed fibrotic tissue which contained a large number of fibroblast-like cells; the marginal area contained masses of chondrocytes without neovascularization; the scar area contained a certain amount of osteoblasts with rich neovascularization. The results of immunohistochemistry showed the expression of BMP-2 was more intense in the callus area than in the center area or in the marginal area(P<0.05).　Conclusion　Different area of hypertrophic nonunion ends displays different histological features and cytological characteristics. The decreasing of BMP-2 in the nonunion ends results in different potential of bone formation.

Effects of vitamin C on PC12 cells apoptosis in MPP+ induced cell model of Parkinson's Disease

CAO Jian, WANG Rui, WANG Qian, WANG Shuang

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 453-456.

Abstract ( 245 )

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Objective　To investigate the effect and the related mechanism of Vitamin C (Vit C) on PC12 cells apoptosis in MPP+ induced cell model of Parkinson's disease (PD).　Methods　PC12 cells were divided to MPP+ induced cell model of PD group (MPP+ group) and Vit C treatment group (Vit C group). Firstly, Vit C group was incubated with 250 μmol/L Vit C 6 h, and then the two groups were treated with 100 μmol/L MPP+ 12 h. The LDH concentration was measured by LDH kit. The TUNEL method was performed to measure PC12 cells apoptosis in two groups. The expression of Caspase3 and c-Caspase3 was detected by Western-blot. Results Compared with MPP+ group, Vit C significantly inhibited LDH concentration and decreased apoptosis of PC12 cells, indicating that Vit C could down-regulate the expression of c-Caspase3 (P<0.05).　Conclusion　Vit C can decrease apoptosis of PC12 cells in vitro significantlyand play important protection role in PD via down-regulation of the expression of c-Caspase3

Sciatic nerve associated with piriformis variation and second sacral nerve abnormal branch：a case report

SHU Wu-An, MA Jian-Jun, LIAO Fu-Bing, DIAO Xiao-Nan, GU Jiu-Lian, YUAN Jia-Yang, CUI Zhen-Jie, GUO Lei

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 456.

Abstract ( 239 )

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Expression of Smac and Caspase-9 and its relationship with apoptosis in esophageal squamous cell carcinoma

LIU Chang, GAO Feng-Lan, HE Xin, LIU Chun-Ling, WANG Xian-Yuan, GUO Bao-Jiang

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 457-460.

Abstract ( 380 )

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Objective　To investigate the expression of Second mitochodria-derived activator of caspase (Smac) and Caspase-9 in esophageal squamous cell carcinoma (ESCC) and its relationship with apoptosis. Methods　Immunochemistry(SP-method) was applied in semi-quantitive analysis on protein of Smac and Caspase-9 in cancer tissues, normal tissues and adjacent tissues of 80 cases of ESCC. Apoptosis of tumor cells in paraffin sections was observed with the method of TUNEL.　Results　(1) The positive expression rate of Smac were 92.50% , 63.75%and 77.50% in normal tissues, ESCC tissues, adjacent tissues and respectively, the positive expression rates of Caspase-9 were 85.00%, 72.50% and 58.75% respectively in normal tissues, ESCC tissues and adjacent tissues. The differences were of statistical significance. (2) 47 cases with Caspase-9 positive expression were detected in 51 cases of ESCC with positive expression of Smac, accounting for 92.16%; the correlation between Smac and Caspase-9 expression was strong and positive. (3) The average apoptotic index (AI%) in Smac positive group (19.186±1.331) was apparently higher than that in Smack negative group (8.316±1.661), which has no significant difference from the Caspase-9 positive expression group. The average apoptotic index of 47 cases with positive co-expression of Smac and Caspase-9 was statistically significantly higher than that with negative expression of Smac and Caspase-9.　Conclusions　The expression of Smac and Caspase-9 protein are positively related and both of them are involved in the genesis and development of ESCC, which also play a positive feedback regulation in the apoptosis of ESCC cells.

Development of a new screw with porous sides and its long-term efficacy for internal fixation of lumbar spondylolysis

ZHANG Fa-Hui, SONG Yi-Beng, ZHANG Chuan-Kai, CHEN Hui-Ping, ZHENG He-Beng, LI Beng, SHU Yun, SUN Yang, HAN Bing

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 461-466.

Abstract ( 440 )

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Objective　To investigate the long-term efficacy of using internal fixation of lumbar vertebral spondylolysis by screws with porous sides.　Methods　Applied of the new screw 237 patients with bilateral lumbar vertebral spondylolysis underwent internal fixation by the screws with porous sides; among the patients, 117 cases were followed up for a mean period of 8.2±7.8 cases. The spondylolysis was located at L3 in 17 cases, in L4 in 31 cases, in L5 in 69 cases; The spondylolysis was not accompanied by spondylolisthesis in 100 cases and was accompanied by I-degree spondylolisthesis and II-degree spondylolisthesis in 20 cases, respectively. All cases underwent decompression of nerve-root canal, excision of osteosclerosis at the lumbar pars and scar tissue, adhesion release of the nerves, bone implant at the bars and internal fixation by the screws with porous sides. Outcomes In the clinical study, 112 among the 117 cases who were followed up claimed total disappearance of symptoms, returning to daily work with no restriction of lumbar activity. Scores of Oswestry functional impairment index was reduced to 5.33±2.70 during the follow up from 28.37±3.99 before the treatment, suggesting significant statistical difference. ( P<0.01). JOA assessment scores improved from 19.00±2.78 before the treatment to 28.08±1.04 during the follow-up, suggesting significant statistical difference. The rate of improvement of symptoms, union of spondylolysis and correctness of spondylolisthesis was 90.34%, 99% and 80%, respectively. In all cases, no screw loosening, beak and degradation of adjacent lumbar segments were found.　Conclusions　The screws with porous sides can reconstruct the integrity of the motor unit of the spine through direct fixation of the fracture of the lumbar bar and stay safely in the human body in long term. Furthermore, loosening and break of the screws, and degradation of the adjacent segments after fixation can rarely happen.

A case concerned with variation of running and injection point of the right cephalic vein

CHEN Hao, MA Jian-Jun, WANG Zhi-Shen, ZHOU Xiao-Dan, YANG Lu-Lu, OU Xiang, MA Xiang-Qun, HUANG Rui-Chao

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 466.

Abstract ( 365 )

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Microanatomy of the relationship between acoustic neuroma and the arachnoid

HUANG An-Long, QI Song-Chao, ZHANG Chi-An, DAN Jin, BO Jun, QIU Xiao-Yu

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 467-471.

Abstract ( 331 )

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Objective　To review microsurgical techniques and facial nerve preservation issues in resection of acoustic neuroma. 　Methods　Clinical data of 121 patients with acoustic neuroma who were surgically treated in our hospital from Jan 2009 to Oct 2012 were retrospectively analyzed. Acoustic neurinomas were removed by microsurgical technique through the suboccipital retrosigmoid approach accompanied by face nerve EMG monitoring.　Results　Total separation was achieved in 100% (121cases)． The facial nerve was preserved anatomically in 93.4% (113 cases) and the cochlear nerve in 90.1% (109 cases). There was no surgery-related fatality. In a 3-month follow-up, according to House-Brackmann, the function of facial never was I-II level in 71.9% (87 cases), III-IV in 25.6% (31cases), V-VI in 3.3% (4 cases).　Conclusion　Profound understanding of the relationship between the acoustic neuroma and the arachnoid can drastically reduce the incidence of acial nerve damage during resection of acoustic neuromas.

Clinical evaluation of surgical trauma through measurements of the cross-section area of paravertebral muscles

DENG Gong-Beng, CHEN Ji-Cuan, ZHANG Chun, WANG He-Nian, HU Hao, LIN Ge-Sheng, FANG Ji-Dan, DONG Chun-Fu

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 472-476.

Abstract ( 340 )

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Objective　To assess the paravertebral muscle cross section measurement for evaluation of the impact of surgery on the paravertebral muscle structure and function provided by it.　Method　95 cases of patients with thoracic or lumbar vertebral fracture underwent CT scan, anatomic landmarks were marked on the horizontal sections. Measurements involving the largest coronary diameter, the largest sagittal diameter and the area of paravertebral muscles were carried out, and analysis of the correlations of the abovementioned parameters to paraspinal muscle injury, postoperative residual pain and dysfunction were performed. Results There was statistically significant difference among the preoperative, the postoperative, and the last paravertebral muscle area measured during the following-up; Moreover, the last horizontal section area measured was smaller than the preoperative one(P<0.01), which in turn was smaller than the postoperative one(P<0.05) The difference between postoperative and preoperative largest coronary and sagittal diameter of the paravertebral muscles, and the differnce between the last and preoperative largest coronary and sagittal diameter of the paravertebral muscles were both correlated to the VAS pain score and the postoperative Oswestry dysfunction index evaluated 4 days postoperativelly (b'= -0.521).　Conclusion　Can accurately identify the anatomical landmarks, the largest coronary and sagittal diameter and the horizontal area of the paraspinal muscles can all be accurately identified and measured in CT cross section, which together can provide an objective evaluation of the surgical paraspinal muscle damage.

Clinical and anatomical factor analysis of the proximal humerus fracture in humeral head replacement

LI Ju-Gen, SHI Qun-Wei, XIE Chu-Hai

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 477-479.

Abstract ( 358 )

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Objective　To investigate the clinical and anatomical factors including brachial plexus and posterior humeral circumflex artery in humeral head replacement of the proximal humerus fractures.　Methods 15 patients with displaced 4-part fractures of the proximal humerus were treated. The mean age was 63.5 years. The brachial plexus and posterior humeral circumflex artery were protected and the humeral head were replaced in all patients.　Results　All patients were followed. The mean follow-up period was 16.2 months. The average ConstantScores was 80.5 (range 61-89) in the last follow-up.　Conclusion　Humeral head replacement is an effective therapy for complex fractures of the proximal humerus. Meticulous surgical operation is essential to the prevention of complications and achievement of good results.

The prevalence and related risk factors of hemorrhagic transformation in different subtype of cerebral infarction

GUO Wen-Chao, BO Su-Ti

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 480-483.

Abstract ( 341 )

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Objective　To analyze the prevalence and related risk factors of hemorrhagic transformation (HT) in patients with different subtype of acute cerebral infarction. Methods The Clinical data of 977 patients with cerebral infarction were analyzed retrospectively. They were divided into HT group ( n=142) and non-HT group ( n=835) according to whether they had HT or not．TOAST classification in both groups was observed. The risk factors for HT were identified by univariate chi-square test and multivariate logistic regression analysis, and the incidences of HT in various types of cerebral infarction in the TOAST classification were compared． Results The results of multivariate logistic regression analysis showed that massive cerebral infarction (OR=10.498,95%CI 6.520～17.131,P=0.000), atrial fibrillation(OR=1.718, 95%CI 1.217～2.941, P=0.005), anticoagulation (OR=7.748, 95%CI 2.416～25.847, P=0.000), and diabetes (OR=1.817, 95%CI 1.135～2.903, P=0.012) were the independent risk factors for HT. Hypertension, high cholesterol, and the history of anti-platelet aggregation were not the independent risk factors for HT. In the TOAST classification, the HT incidence in patients with cardio embolic cerebral infarction was the highest (31.1%, 88/283), the HT incidence of small artery occlusion was lower (6.6%, 17/257), and the HT incidence of large artery atherosclerosis was (12.8%, 24/187). Conclusion Massive cerebral infarction, atrial fibrillation, anticoagulation, diabetes are the independent risk factors for HT. Cardioembolic cerebral infarction is one of the major reasons for the occurrence of HT．

Analysis of the causes of the venous drainage problem of different pedicled flaps

MAO Chi-Ying, HUANG Dong, JIANG Yi-Heng, ZHANG Hui-Ru, TUN Wei-Chi, LIN Gao, MAO Yong, HUANG Guo-Yang

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 484-486.

Abstract ( 407 )

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Objective　To investigate the causes of the venous drainage problem of different pedicled flaps adopted for resurfacing of the defects in the hand as well as the methods to improve the condition. Methods　56 patients various kinds of hand skin defects were treated with flaps pedicled on the nutrient vessels of the distal thumb dorsal cutaneous nerve,the retrograde dorsal metacarpal flaps and flaps based on the nutirent vessels of the dorsal branch of the hand according to the type of the defect. Results Falps in all cases survived. 3 cases treated with flaps pedicled on the nutrient vessels of the distal thumb dorsal cutaneous nerve suffer marginal necrosis in early stage, which was cured by dressings change. Conclusions The treatment of the pedicle is the key to the surival of different pedicled flaps. Superficial vein ligation of pedicle flaps can effectively reduce the incidence of venous crisis after flap transplantation.

A case of an abnormal branch of posterior tibial artery running rear of lateral malleolus

OU Xiang, MA Jian-Jun, DI Xue-Jia, WEI Jing-Jing, KONG Meng-Dan, YUAN Jia-Yang, ZHUO Yi-Ran, LIU Xin-Jian

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 486.

Abstract ( 143 )

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A method of making ultra-thin electron microscopy sections for brain tissue based on positioning technology

ZHANG Lei, GU Jing-Jing, XIE Min-Juan, ZHANG Lu

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 487-488.

Abstract ( 158 )

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Anatomical study on the connections between the suboccipital structures and the spinal dura mater

DUO Hong-Jin, XU Qing-Bei, YU Xiao-Ying, GAO Hai-Bin, XU Jiang, LI Yun-Fei, CHI Pan-Yan

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 489-490.

Abstract ( 286 )

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The progress of approaches to thyroid minimally invasive surgery and section anatomy of the neck

WANG Hui, TUN Chao

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 491-494.

Abstract ( 436 )

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Bilateral ulnar nerves traveling exception at the elbow: a case report

FU Jiang, FU Xiao-Kuan

Chinese Journal Of Clinical Anatomy. 2013, 31(4): 495.

Abstract ( 263 )

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