Table of Content

25 November 2015 Volume 33 Issue 6

  

Applied anatomy and imaging study on genitofemoral nerve with respect to the XLIF approach

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  617-622.  doi:10.13418/j.issn.1001-165x.2015.06.001

Abstract ( 845 )  

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Objective　To investigate the position of genitofemoral nerve (GFN) in each vertebral space by dissection, then measure and calculate the data on lumbar magnetic resonance image to investigate GFN’s traveling position in the lumbar intervertebral space. Combined with the position of the great vessels and lumbar spinal nerve roots, the secure zone of each vertebral space in extreme lateral interbody fusion(XLIF) was located.　Methods　16 cases of adult cadavers were dissected, GFN’s position in the psoas major muscle and out the psoas major muscle was observed. The position of psoas major muscle and abdominal great vessels in 36 cases of lumbar magnetic resonance image was measured, the secure zone of XLIF approach in each vertebral space was analyzedand calculated.　Results　GFN was parabolic or nearly straight forward in the psoas major muscle, its position was above the line from its origin point in foramen to the point where it pierced out of the psoas major muscle. In samples that GFN pierce out of the psoas muscle at intervertebral space L3/4 or above, the distance from the posterior edge to GFN was (34.0±6.02)mm, and GFN was located in Zone A and I by Moro’s method. In samples that GFN exited the psoas muscle below intervertebral space L3/4, the distance from the posterior edge to GFN was not less than (16.0±2.16)mm, and GFN might be located in Zone I、II and III.　Conclusion　The security zone of XLIF approach at intervertebral space L2/3 is zone II and III, at intervertebral space L4/5 is Zone II. When GFN exitspsoas major muscle at intervertebral space L3/4 or above, the secure zone of XLIF approach at intervertebral space L3/4 is zone II. When GFN exits the psoas muscle below intervertebral space L3/4, approach from any zone at intervertebral space L3/4 has a chance to damage the blood vessels or nerve.

A mechanism study of clinical anatomy on suprascapular nerve entrapment

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  623-626.  doi:10.13418/j.issn.1001-165x.2015.06.002

Abstract ( 1069 )  

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Objective　To study the anatomical mechanism of the suprascapular nerve entrapment, to provide the basis for clinical diagnosis and treatment of this disease.　Methods　In 22 (male 13, female 9) 44 sides of cadaveric specimens, the anatomic features of the suprascapular notch, spinoglenoid notch, the branches and distribution of supraspinatus were observed. The data were analyzed statistically.　Results　The suprascapular notch could be divided into four types. U type 40.91%（18 sides）， shallow U type 22.73%（10 sides）, arc type 27.27% （12 sides）, square type 9.01%（4 sides）. The thickness of suprascapular notch was (1.55±0.36) mm; The angle of between the trunk of suprascapular nerve and the branch of the supraspinatus was ( 86.04±1.28)°. The position of the branches of infraspinatus that entered infraspinatus was located near the origin of the infraspinatus in 10 sides. The thickness of the spinoglenoid notch was (6.82±1.21) mm.The heights of suprascapular nerve from the suprascapular hole to the base of scapular averaged(11.13±0.21) mm. And the horizontal distance from the suprascapular hole to the spinoglenoid notch was (14.03±0.64) mm. The angle of the suprascapular nerve was (49.65±1.63)°.  Conclusion　The risk factors that can lead to suprascapular nerve entrapment include: the types of scapular notch, the thickness of the suprascapular notch and the spinoglenoid notch, the angles of suprascapular nerve, the angles between the trunk of suprascapular nerve and the branches of supraspinatus, the position of the branches of infraspinatus that enter it.

The pilot study of anatomy relationship between atlanto-axial joint misalignment with sternocleidomastoid and trapezius muscles pain

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  627-630.  doi:10.13418/j.issn.1001-165x.2015.06.003

Abstract ( 1085 )  

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Objective　To observe the anatomic relationship of atlanto-axial joint with the accessory nerve and the second cervical nerve, and to observe the innervation of sternocleidomastoid and trapezius muscle, providing the anatomy basis of sternocleidomastoid and trapezius muscles’pain caused by atlanto-axial joint misalignment. 　Methods　Three adult cadaveric neck specimens(6 sides) underwent dissection. The anatomic relationship of atlas transverse process with accessory nerve and lateral atlantoaxial joint with second cervical nerve’anterior branch, the anatomy of atlanto-axial joint’extraforaminal ligament, and the innervation of sternocleidomastoid and trapezius muscle were observed. The minimum distance between atlas transverse process tip and accessory nerve was measured.    Results    (1)Sternocleidomastoid and trapezius muscles were innerved by both accessory nerve and cervical nerve (2th~4th), and accessory nerve had communicating branch with cervical nerve. (2)Accessory nerve was situated anteriorly to the transvers process of the atlas, and a close anatomic relationship between them could be observed. The minimum distance between the tip of atlas transverse process and accessory nerve was 4.84~7.60 mm (left side) and 3.22~6.80 mm(right side). (3) Extraforaminal ligament existed in the atlanto-axial joint intervertebral foramen, which was in contact with the second cervical nerve and adhered to atlas transverse process. (4)The anterior branch of second cervical nerve travelled forward in contact with lateral atlantoaxial joint.    Conclusion    Atlanto-axial joint misalignment may stimulate the accessory nerve and thesecondcervicalnerveor its anterior branch,which may cause  sternocleidomastoid,trapezius muscle tension and pain.

The variation of superficial circumflex iliac artery: one case report

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  630.  doi:10.13418/j.issn.1001-165x.2015.06.026

Abstract ( 410 )  

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Comparison between the morphology of Chinese people’s distal femurs and the parameters of knee joint prostheses

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  631-636.  doi:10.13418/j.issn.1001-165x.2015.06.004

Abstract ( 787 )  

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Objective　In the present study we compared the morphological parameters of distal femurs with the relevant parameters of knee prostheses, intending to obtain data for better-fit prosthesis design.　Methods　(1) One hundred adult femur samples from South China (left 51, right 49) with no evident bony defect are selected and photographed. (2) The magnification is corrected according to the photographed scale. Data of measured femoral mechanical axis lengths, angles between mechanical axis/anatomical axis, transverse diameters of the condyles, transverse diameters of distal condylar osteotomic surfaces, anteroposterior diameters of the medial and lateral condyles were obtained. (3) Meanwhile, the widths between the internal and external condylar, heights of the anterior and posterior condyles of the prostheses (both domestic and imported including Zimmer NexGen LPS, Stryker Scrorpio NRG Knee-Flexed, United-U1 and GKPS) were measured.　Results　(1) The average distal femoral transverse diameter was (7.60±0.60) cm; the average height of the lateral condyles was (5.90±0.76) cm; the average height of the medial condyles was (5.73±0.74) cm. No evident relativity existed e between these data. (2)The osteotomic lengths of the prostheses from all four brands fitted Chinese people’s distal femur. By comparing the ostotomic heights of anterior condyles and the heights of anterior prosthetic condyle, a coverage rate of 14%~21% was obtained which fell within the range of tolerance. Similarly, we got a coverage rate of only 24%~55% posteriorly.　Conclusions　Since the morphological data of Chinese people’s distal femur are dispersive, individualized replacement is required. The parameters of prostheses do not completely match the morphology of distal fumurs of Chinese people.

The correlation between the inclination of S1 pedicles and morphology of auricular surface of sacrum

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  637-640.  doi:10.13418/j.issn.1001-165x.2015.06.005

Abstract ( 740 )  

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Objective　In order to provide anatomic basis for percutaneous fixation using sacroiliac screw by analyzing the correlation between the inclination of S1 pedicles and morphology of auricular surface of sacrum was investigated.    Methods    The relevant parameters of S1 pedicles and auricular surface were measured in 42 dry adult sacra respectively, then the correlation of the parameters was analyzed statistically. Results    The ratio (R1) of long axis of the upper part and the lower part was 0.86±0.15. According to the value of R1, the auricular surface was classified into two types, type L （R1>1） and f （R1<1）. The inclination of S1 pedicles (θ) was (25.72±6.69)°, and the ratio R1 was correlated negatively with inclination θ. Conclusion  When the inclination of S1 pedicles is small, the auricular surface is type L, suggesting optimal angle of screw of S1 pedicle is smaller and the optimal point of surgical screws should be lower. When the inclination of S1 pedicles is larger, the auricular surface is type f, suggesting optimal angle of screw of S1 pedicle is larger and the optimal point of surgical screws should be higher.

CT imaging observations of the basivertebral foramen for thoracic vertebrate

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  641-645.  doi:10.13418/j.issn.1001-165x.2015.06.006

Abstract ( 970 )  

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Objective　By digitizing the measurement of the basivertebral foramen for thoracic vertebrae to discuss the basivertebral foramen (BF) of thoracic spine (T1~12), including the anatomical location, the form and the differences between different vertebral bodies.　Methods　The 40 healthy adults underwent multi-slice CT thin-layer scan and sagittal CT reconstruction images, using Mimics 13.0 software measurement; the following indices were observed: BF wide (BFW), deep (BFD), high (BFH) in the absolute value; the distance of BF to the vertebral end plates and to the left and the right vertebral edges was measured;  the location and shape of the vertebral foramen was observed.　Results　（1）BFW assumed an overall V-shaped distribution. The min was T6;  BFH was steady in T1~3, gradually declining in T4~6, and gradually increasing in T7~11; BFD was graduallyincreasing in T1~3, steady T3~10 , and gradually decreasing in T10~12.（2）Vertebral body up(VHU) and vertebral body below(VHB) of BF are gradually increasing. The min was T1(VHU 7.05±1.27 mm,VHB 7.21±0.87 mm), the max was T12(VHU 11.00±1.10 mm,VHB 11.37±1.48 mm). Vertebral body left (VWL) and vertebral body right(VWR) were gradually decreasing in T1~4, gradually increasing in T5~12, the min was T4(VWL 10.50±1.40 mm,VWR 10.81±1.66 mm), the max was VWL in T12 (VWL 15.74±2.55 mm,VWR 16.23±2.82mm).　Conclusion　(1) There are many BF inequality of size existent in the middle of vertebral thoracic body; These construction are complex and have difference between each individual segments. (2)The shape of BF in sagittal and coronary sections are anomalism, triangle, rectangle and 11% visible osseous separation. (3)The BF in T1~8、T10、T11 adjoin the centre of vertebral body's posterior paries, and T9 and T12 have left deviation.

Anatomic distribution of basivertebral foramen and vertebral vein in vertebral bodies of T8~L5 and its clinical significance in PVP and PKP

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  646-650.  doi:10.13418/j.issn.1001-165x.2015.06.007

Abstract ( 1186 )  

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Objective　To provide anatomic data for less complications of bone cement leakage in PKP and PVP.　Methods　A total of 40 health adults underwent multi-slice CT thin slice scans and three-dimensional reconstruction. In the horizontal and sagittal CT reconstruction images, display frequency of basivertebral foramen （BF) and vertebral vein (VV）of the branches of basivertebral venous system in vertebral bodies of T8~L5 were calculated. The sagittal diameter of vertebral body (VD), BF weight (BFW), BF depth (BFD), BF high (BFH) were measured. The distance between the BF and each side inthe horizontal and sagittal CT images were also measured. The measured parameters were analyzed statistically.　Result　Display frequency of BF and VV was gradually increasing from T8 to L5. Display frequencies of BF and VV in vertebral bodies were no significantly different between male and female (P>0.05). The distance from the BF to left or right side in the horizontal CT images were not significantly different (P>0.05). The distance from the BF to the cranial or caudal endplate in the saggital CT images were significantly different (P<0.05). The distance from the BF to the cranial endplate was shorter than to the caudal endplate.　Conclusion　For clinic operators, the knowledge of anatomic distribution of BF and VV in vertebral bodies helps to reduce the occurrence of bone cement leakage in PVP and PKP.

Imaging anatomical study of abdominal aorta terminal blocking in vitro assisting in standard cardiopulmonary resuscitation

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  651-654.  doi:10.13418/j.issn.1001-165x.2015.06.008

Abstract ( 793 )  

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Objective　To supply imaging anatomical basis for abdominal aorta blocking assisting in standard cardiopulmonary resuscitation to improve coronary perfusion pressure.　Methods　CT images of 75 patients, 41 males and 34 females, were collected. The bellybutton was used as the landmark, and indexes as follows were measured:①The vertebral level of the bellybutton midpoint; ②The relationship between abdominal aorta termination and bellybutton midpoint;③The relationship among the vertical tracks of abdominal artery, lumbar vertebrae,and inferior vena cava.   Results   The markers for the end of abdominal artery,lumbar vertebrae and navel roughly overlapped at the human median line: ① The navel midpoint was located between 40.31 mm above and 32.82 mm below the inferior border of L4; ② The end of the abdominal artery was located between 35 mm above and 35 mm below the bellybutton midpoint; ③The end of abdominal artery was located slightly to the left of the lumbar spine, and inferior vena cava was located to right of the lumbar spine at the transverse section of the body at the level of the end of the abdominal artery.　Conclusions　According to the imaging study, navel can be adopted as the landmark for blocking in vitro the end of the abdominal aorta, assisting in the standard cardiopulmonary resuscitation. It could improve the hemodynamic indexes, ensure blood supply of the critical organs such as brain and heart, and improve coronary perfusion pressure with high success rate.

 

Effects of ginsenoside Rg1 on BMSCs proliferation and apoptosis after hypoxia-reoxygenation

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  655-661.  doi:10.13418/j.issn.1001-165x.2015.06.009

Abstract ( 609 )  

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Objective　To investigate the effects of ginsenoside Rg1 on BMSCs proliferation and apoptosis after acute hypoxia-reoxygenation（H/R）and the possible mechanism.　Methods　BMSCs were divided into normal control group，model group，ginsenoside Rg1 1×10-7，1×10-6 and 1×10-5 mol/L groups, Nimodipine 2.5×10-7 mol/L group（positive control group）. In the 12 hours before building H/R model，every groups were respectively added normal saline (normal control group, model group), ginsenoside Rg1 (ginsenoside Rg1 treated groups), Nimodipine ( positive control group). Acute H/R BMSCs model was established. TUNEL was used to count apoptosis rate of cell and IF and Western blot technique was used to observe the expression of PCNA、bcl-2、bax qualitatively and quantitatively.   Results   Normal control group showed no significant apoptotic cells，model group showed obvious apoptotic cells，compared with model group, the number of apoptotic cells of every groups decreased, Rg1 (1×10-5 mol/L) group was the most obvious. Compared with normal control group, the expression of PCNA and bcl-2 of model group decreased,but the expression of bax significantly increased, and the ratio of bcl-2/bax decreased; Compared with model group，the expression of PCNA and bcl-2 of ginsenoside Rg1 treated groups increased in a different degree,but the expression of bax showed the opposite trend; the ratio of bcl-2/bax increased , and ginsenoside Rg1 (1×10-5 mol/L) group was the most obvious.  Conclusion   Ginsenoside Rg1 can protect BMSCs after acute anoxia-reoxygenation by down-regulating the expression of bax and up-regulating the expression of PCNA and bcl-2 and by inhibiting apoptosis and promoting proliferation.

LFPEMFs effects on the proliferation and chondrocyte-like differentiation of BMSCs labeled with SPIO

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  662-666.  doi:10.13418/j.issn.1001-165x.2015.06.010

Abstract ( 1013 )  

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Objective　To explore the effects of low frequency pulsed electromagnetic fields（LFPEMFs）on the proliferation and chondrocyte-like cells differentiation of BMSCs labeled with superpar-amagnetic iron oxide nanoparticle（SPIO）.    Methods    Labeled BMSCs were developed and divided into four groups, followed by different treatments：LFPEMFs group, chondrocyte-induced group, LFPEMFs and chondrocyte-induced group, and control group. The proliferation and chondrocyte-like differentiation of cells were measured accordingly, adopting CCK8, PCR or immunofluorecence staining, respectively.　Results　Compared with control group, the proliferation of BMSCs increased significantly in LFPEMFs stimulated cells. The expression level of Aggrecan and Collagen Ⅱ mRNA and protein in groups with LFPEMFs stimulation was significantly higher (P<0.05).　Conclusions　This experiment proves that LFPEMFs can promote the proliferation and chondrocyte-like cells differentiation of SPIO labeled BMSCs.

An in vitro study on the effect of histone deacetylation on type Ⅱ collage expression

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  667-671.  doi:10.13418/j.issn.1001-165x.2015.06.011

Abstract ( 471 )  

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Objective　In the present study, we inhibited histone deacetylation of the chondrocytes by the treatment of TSA, aiming at investigating the effects of histone deacetylation on chondrocyte phenotype and related gene expression and the mechanisms，aiming at providing a new strategy to maintain the phenotype of chondrocytes from the perspective of epigenetics.　Methods　Human articular chondrocytes were cultured in vitro and a model of chondrocyte dedifferentiation was established first. Different concentrations of TSA were used for the stimulation and cells were collected at different time points for the extraction of total RNA. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed for the detection of the expression of Wnt-5a, collagen typeⅠ(TypeⅠcollagen, COL-Ⅰ), collagen typeⅡ(TypeⅡcollagen, COL-Ⅱ) and SOX-9. Immunofluorescence and western blot were used to detect the protein expression of COL-Ⅱ.　 Results　Comparing with control group, a concentration of 0.25~1.0 μmol/L TSA was sufficient to block protein and mRNA levels of typeⅠcollagen and typeⅡcollagen expression in primary culture chondrocytes, while it could promote the expression of Wnt-5a and SOX-9.   Conclusions   Inhibition of COL-Ⅱ expression which leads to the dedifferentiation of chondrocytes and the phenotype change might be mediated by the up-regulation of Wnt-5a and SOX-9. Therefore, histone deacetylation may elevate the expression level of COL-Ⅱ through down-regulation of Wnt-5a and SOX-9, which might play an important role in maintaining chondrocyte phenotype in vitro.

The protective effect of bone marrow-derived mesenchymal stem cells on acute lung injury after hip fracture in elderly rat

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  672-676.  doi:10.13418/j.issn.1001-165x.2015.06.012

Abstract ( 494 )  

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Objective　To investigate the protective effect of bone marrow-derived mesenchymal stem cells on acute lung injury (ALI) after unilateral hip fracture in elderly rat.　Methods　15 month old WISTAR rat were randomly divided into three groups: a control group (n=15)、a model group(hip fracture+NS, n=15) and a treated group (hip fracture+BMSCs, n=15). 1 ml BMSCs（2.5×106/ml）were injected through the caudal vein in the treated group, and the same volume of NS was injected into the model group Histologic changes were examined at 24 hours after fracture. And the concentration of MPO and related inflammatory factors in the impaired lung tissue and blood were examined through enzyme-linked immunosorbent assay (ELISA).　Results　Compared with the control group,the histopathological damage of lung, the concentration of MPO and related inflammatory factors were obviously enhanced（P<0.01）. Compared with the model group,application of BMSCs significantly ameliorated the inflammatory lesions of the lung, increased the concentration of IL-10, and further down-regulated the concentration of MPO and other inflammatory factors（P<0.01）.　Conclusions　ALI can be induced by hip fracture in aged rats. BMSCs shows a certain protective effect on ALI with down-regulation of inflammatory response in systemic and pulmonary as a possible mechanism.

The change of gamma aminobutyric acid A receptor on Parkinsons rat before and after L-dopa treatment

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  677-680.  doi:10.13418/j.issn.1001-165x.2015.06.013

Abstract ( 557 )  

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Objective　To investigate varying pattern of distribution of gamma aminobutyric acid A receptor (GABAAR) before and after treatment in the brain cortex, striatum, substantianigra on Parkinson's disease.   Methodes　First, the rat model of PD was made, after testing, were randomly divided into treatment group and control group. They were given normal saline and L-dopa methyl ester + Benserazide for 4 weeks. After treatment the behavioral tests were performed. Cerebral cortex, striatum, substantianigra were harvested from rats after treatment of 4, 8, 12 weeks respectively. By immunohistochemistry, the changes in distribution and expression of  content of GABAAR in the brain were compared before and after treatment.　Results　After treatment of 4, 8, 12 weeks immunohistochemical results was subjected through statistical analysis, which showed the content of the brain substantianigra and cortex GABAAR was decreased than before treatment, While the number of striatum showed no changes of GABAAR.　Conclusion　(1) With treatment of L-dopa methyl ester + Benserazide, the PD symptoms can be improve. (2) The changes of GABAAR are different on different parts of PD rats before and after treatment.

Application of Ara-C in rat hippocampal neuron purificationculture

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  681-684.  doi:10.13418/j.issn.1001-165x.2015.06.014

Abstract ( 1183 )  

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Objective　To investigate the optimum condition of Ara-C treatment in cell purifica-tionculture of rat primary hippocampal neurons.    Methods    Primary neurons in hippocampal region of new born (1 day after birth) SD rats were cultured for 48 h and then were treated with different doses (0 mol/L, 2.5 mol/L, 5.0 mol/L, 7.5 mol/L and 10 mol/L) of Ara-C for 0 h, 6 h, 12 h and 24 h. Cellular morphology was observed by microscope. Cell viabilities were determined by MTT assay and neuron purities were calculated by morphology. To further assess the neuron purities, MAP2 antibody were used by immunofluorescence and western blot and cell viability is measured by Trypan blue staining.    Results    Hippocampal neuron purity and cell viability was optimal when 5 mol/L Ara-C was added for 24 h. Neuron purity with Ara-C was better than control (74.28±10.13)% VS (34.82±8.15)%, (P=0.000)). MAP2 protein level in cells treated with Ara-C was higher than that in control cells (P=0.008). The cell viabilities in both conditions were similar ((93.2±3.82)% for Ara-C treatment VS (95.6±2.37)% for control treatment, (P=0.109)).     Conclusion    The optimum condition of Ara-C treatment in terms of neuron purity and cell viability was 5 mol/L for 24 h in cell culture of rat primary hippocampal neurons.

The experiment study of geneX® bone cement augmentation of pedicle screw in animal model

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  685-689.  doi:10.13418/j.issn.1001-165x.2015.06.015

Abstract ( 612 )  

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Objective　To evaluate the long-term in vivo biomechanical effects of a newly developed biphasic calcium composite bone cement (geneX®)with a negative surface charge augmentation of pedicle screw.　Methods　Bilateral pedicles of lumbar vertebrae (L1~5) of 6 female sheep were ?xed with pedicle screws. One pedicle of each vertebral body was treated with a screw augmented with either geneX®（geneX® group) or PMMA (PMMA group) and the contralateral pedicle was treated with a screw without any augmentation (control group). Three months later, the sheep were killed and biomechanical tests, micro-CT analysis and histological observation were conducted on the isolated specimen vertebrae.　Results　Both the axial and vertical stabilities of the pedicle screws in geneX® group were signi?cantly enhanced compared with those in the control group (P<0.05). Micro-CT reconstruction and analysis showed that there were more bone trabeculae around the screws in geneX®　group compared with those in control group and PMMA group (P<0.05), and the bone trabeculae were signi?cantly denser than those in control group (P<0.05). Histological observation showed that geneX® was completely degraded and bone trabeculae around the screws in geneX® group were more and denser than that in the control group. Bone trabeculae held the screws tightly without any interspaces between screw and bone, which formed strong bonding between bone and screw.  Conclusions　geneX® cement augmentation of the pedicle screw increase the strength of screw-bone interface, geneX® cement augmentation of the pedicle screw may be a viable clinical option for the augmentation of pedicle screw fixation.

Biomechanical evaluation of three kinds of internal fixation methods for acetabular quadrilateral area fracture

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  690-695.  doi:10.13418/j.issn.1001-165x.2015.06.016

Abstract ( 601 )  

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Objective　The purpose of this study was to evaluate the best internal fixation methods of acetabular quadrilateral area fracture.    Methods    The quadrilateral area fracture models were created by 12 males hemipelves specimens, divided into three groups randomly. The fractures were treated respectively with the following internal fixaction methods, infrapectineal buttress reconstruction plate (group A), infrapectineal buttress locking compression plate (group B), reconstruction plate combined with trans-plate quadrilateral screws(group C). Then the willow leaf films were stuck on the femoral head and vertical compressing loading was continued via the fracture models, followed by measurement of physiological weight 600 N on intact acetabulum in group I(No fracture line was made) and internal fixation of acetabular dome contact characteristics and horizontal and vertical displacements in A, B, C groups.    Results    Under physiological weight of 600 N, acetabular dome contact characteristics in three groups failed to return to normal, There was a significant difference on the loading area, the mean pressure, the peak pressure, horizontal displacements and longitudinal displacements among groups (P<0.05，besides 200 N). With loads increasing, horizontal displacements and longitudinal displacements were larger，and under 1800 N the longitudinal displacements of group A reached failure criteria.　Conclusions　For the acetabular quadrilateral area fracture, the internal fixation stability and contact characteristic of reconstruction plate combined with trans-plate quadrilateral screw metho is w better than infrapectineal buttress plate, and it can reduce incidence rate of traumatic arthritis.

Anatomic variation of left external iliac vein and right testicular vein:one case report

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  695.  doi:10.13418/j.issn.1001-165x.2015.06.027

Abstract ( 475 )  

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Different C5/6 intervertebral distracting height on the adjacent intervertebral disc pressure analysis

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  696-699.  doi:10.13418/j.issn.1001-165x.2015.06.017

Abstract ( 528 )  

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Objective　To study the impact of C5/6 intervertebral distraction height of adjacent disc pressure, so as to select the appropriate height of intervertebral distraction and provide the basis for clinical work.　Methods　Six fresh adult corpses were selected and the cervical spines were prepared and mounted to BOSE dynamic/static load testing machine. Neutral position, flexion and extension, lateral bending, multi-dimensional movement of rotation, were tested under different loads. neck movement of C5/6 before intervertebral distraction, C5/6 intervertebral distraction reference height of 100%, 120%, 140%, 160% and C4/5、C6/7 disc pressure changes. The measured pressure values were subjected for multiple comparative statistical analysis.　Results　Installation of all distraction position was satisfactory. Statistical analysis showed that: the average height of C5/6 in the six specimens was 6.8 mm; under the condition of different intervertebral distraction, the disc pressure was minimal with 30° cervical extension(P<0.05); under the condition of 120% of the reference height, C4/5 and C6/7 disc pressure values were larger when cervical spine was extended for 30°, laterally bended for 30°than the pressure values measured when the cervical spine was at any other reference height (P<0.05);  when the cervical spine was in neutral position measured pressure values of C6/7  and C4/5 disc pressure was less than those of 100%, 140%, 160% reference height；When the cervical spine was in both the left and right lateral bending, the C4/5, C6/7 disc pressure value at 120% of the average height was less than 140% of the average height (P<0.05); while the former was not greater than the intervertebral disc distraction measured pressure value compared with the other three were between two highly significant difference (P<0.05); left rotation: each state was no significant difference (P>0.05); ligament of facet joint capsule was slightly teared in 1 specimens,when specimens at 160% of the benchmark distraction and the height of the line 30° flexion position.   Conclusion    C5/6 cervical interbody disc when the removal of the line, select the reference level of 120% of intervertebral distraction as the height of the adjacent intervertebral disc pressure changes less affected intervertebral distraction for proper height.

Simulation study of total knee arthroplasty assisted by digital navigation templates 

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  700-705.  doi:10.13418/j.issn.1001-165x.2015.06.018

Abstract ( 526 )  

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Objective　To investigate the accuracy and feasibility of total knee arthroplasty assisted by the navigation templates in clinic.   Methods   Twenty patients (8 male, 12 female) with knee arthritis requiring arthroplasty were recruited. Volumetric MRI scan was performed on each desired lower limb and a 3D reconstruction model was generated from the scan data. Using reverse engineering technique, anavigational template is designed with a surface that matches the distal femur and proximal tibia. The templatewas manufactured using rapid prototyping technique for clinical use. The operation was designed by the same doctor with experience in joint replacement. The compatibility of the navigation template with tibial and femoral condyles was examined preoperatively. After surgery, the positions of the prosthesis were evaluated using CT scan.    Results    Each navigational template was found to fit its corresponding biomodel appropriately, and there was no significant free motion of the template. All the cut surfaces were nearly perpendicular to the mechanical alignment, the rotating axis was located accurately and resection of posterior surface was parallel to the transepicondylar axis.  Conclusion   Total knee replacement assisted digital navigation template is safe and feasible, simple in operation, and accurate in osteotomy

3D digital preoperative design on adolescent idiopathic scoliosis and its application

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  706-711.  doi:10.13418/j.issn.1001-165x.2015.06.019

Abstract ( 427 )  

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Objective　To study the methods of 3D digital preoperative  design on adolescent idiopathic scoliosis and the application value of it.　Methods　One adolescent idiopathic scoliosis patient was chosen，Mimics16.01 was used to reconstruct 3D model，and measure the parameter of the pedicle rib complex screw angle，screw length and width of screw，and parameter was applied in operation.  Results　The 3D model of adolescent idiopathic scoliosis was reconstructed，and the screw and pedicle rib complex was positioned，and the screw was prevented to penetrate the pedicle and vertebral body；the plan of operation was carried out, and the screw didn’t penetrate the pedicle and vertebral body.　Conclusion　The digitalized visualization of adolescent idiopathic scoliosis could increase the success ratio.

Analysis of the change and influencing factors of cervical sagittal curvature in adolescent idiopathic scoliosis patients

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  712-716.  doi:10.13418/j.issn.1001-165x.2015.06.020

Abstract ( 616 )  

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Objective　Summarize the radiographic data of 48 patients with adolescent idiopathic scoliosis (AIS) to analyze the characteristics and influencing factors of cervical sagittal alignment in AIS  patients.　Methods　For AIS patients, The angle of the main thoracic curve (TC), the proximal thoracic curve (PTC), the thoracolumbar curve (TLC), and the lumbar curve (LC), C2~7 Cobb angle, T5~12 Cobb angle, L1~5 Cobb angle, pelvic incidence (PI), pelvic tilt (PT), sacrum slop (SS), C2~7 sagittal vertical axis (C2~7 SVA), C7~S1 sagittal vertical axis (C7~S1 SVA) were included in radiographic measurements. In addition, the C2~7 Cobb angle was measured for the young volunteers. Lenke classification was used for AIS curve type classification. Pearson correlation coefficients and T-test were used for statistical analysis.   Results   The incidence of cervical deformity,cervical kyphosis and cervical imbalance was 75.0%, 47.9 and 10.4% respectively. The C2~7  Cobb angle of AIS patients significantly increased than the volunteers (P=0.008). In the cervical kyphosis group, T5~12 Cobb angle was significantly lower than that of the normal group (P=0.011). The C2~7 Cobb angle of the T5~12 Cobb angle＞30°group increased significantly than the T5~12 Cobb angle≤30°group(P=0.021).The C2~7 Cobb angle was significantly correlated with T5~12 Cobb angle (P=0.009) and L1~5 Cobb angle(P=0.005). There was no significant relevance between C2~7 Cobb angle and TC，PTC，TLC，LC，Lenke Curve Type，PI，PT，SS，C7~S1 SVA（P＞0.05).    Conclusion    The cervical sagittal alignment is only related with TK and LL, especially with TK. It has no relationship with Lenke curve type, coronal angle of thoracic and lumbar spine, and pelvic parameters(PI，PT，SS).

Comparison between Wiltse approach and conventional approach for lumbar instrumentation and fusion

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  717-720.  doi:10.13418/j.issn.1001-165x.2015.06.021

Abstract ( 463 )  

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Objective  To compare the influence of Wiltse approach and conventional approach on short-term postoperational recovery and muscle injury for patients received lumbar instrumentation and fusion.　Method　This is a Random Control Trial. Patients were randomized into bilateral Wiltse approach group (Group A) or bilateral conventional approach group (Group B). Decompression and fusion was performed unilaterally. Baseline Creatine kinase (CK), Aspartate aminotransferase (AST), Visual Analog Scale (VAS), Oswetry Disability Index (ODI) were measured. Drainage was placed on both side, and removed 48 hours after surgery. Operation duration and blood loss were recorded. CK and AST on postoperational Day 1 and Day 3, bilateral drainage volume within 48 hours after surgery, wound fluid volume measured by Ultrasonogram on postoperational Day 3, VAS and ODI on postoperational Day 5 and 3-month were recorded. Result　There were 57 patients in total, with 27 patients in Group A and 30 patients in Group B. There were no significant difference between the two groups in age, baseline CK, AST, VAS and ODI (P>0.05). Operation duration and blood loss were similar. There was no significant difference in drainage volume on fusion side within 48 hours after operation, but significant difference in contralateral drainage volume (P<0.05). There was significant difference in CK and AST on postoperational Day 1 but not on Day 3. There were significant differences in VAS and ODI between two groups on postoperational Day 5 and 3-month.　Conclusion　It is plausible to complete lumbar instrumentation and intervertebral fusion through Wiltse approach. Wiltse approach could reduce muscle injury during operation, which is favorable for short-term recovery of patients. 

Surgical treatment of proximal humeral fractures through extended anterolateral acromial approach of deltoid-splitting

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  721-724.  doi:10.13418/j.issn.1001-165x.2015.06.022

Abstract ( 532 )  

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Objective　To investigate the methods and clinical outcomes of the proximal humeral fracture treatment through extended anterolateral approach of deltoid-splitting approach.　Methods　From October 2010 to February 2014, 35 patients with proximal humeral fractures were treated through deltoid-splitting approach. According to the Neer classification: there were 12 cases of two-part fracture, 21 three-part fracture and 4 four-part fracture. The deltoid muscle was split from the gap of the front and middle and the axillary nerve was revealed and protected, thenthe fracture was fixed with anatomic locking plate after reduction.　Result　Thirty of 35 patients were followed up from 8 to 24 months. All fractures healed up. Axillary nerve injury was not found. According to Neer criteria for shoulder joint function: excellent in 16 cases, good in 8, fair in 3 cases, bad in 3 cases. The excellent and good rate was 80%.　Conclusion　The extended anterolateral acromial approach of deltoid-splitting can reveal and protect the axillary nerve effectively, and open reduction and plate fixation can be performed under direct vision. It has the advantage of the little trauma, less bleeding and convenient operation.

Cutaneous nerve entrapment syndrome of lateral femoral caused by osteotylus of the right anterior superior iliac spine fracture :a case report

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  725.  doi:10.13418/j.issn.1001-165x.2015.06.023

Abstract ( 532 )  

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The progress of study in intracranial arachnoids and cisterns

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  726-727.  doi:10.13418/j.issn.1001-165x.2015.06.024

Abstract ( 530 )  

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Research progress of the molecular mechanisms and signaling pathways in ischemic brain injury

Chinese Journal Of Clinical Anatomy. 2015, 33(6):  728-731.  doi:10.13418/j.issn.1001-165x.2015.06.025

Abstract ( 627 )  

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