Table of Content

25 July 2016 Volume 34 Issue 4

  

Comparative endoscopic anatomic study on endonasal transsphenoidal via anterior wall of sphenoid sinus approach and endonasal transsphenoidal via nasal septum-sphenoid sinus approach

WANG Hao, LI Yu, PENG Yu-ping, HAO Wen-wen, FAN Jun, SONG Wei-jian

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  361-365.  doi:10.13418/j.issn.1001-165x.2016.04.001

Abstract ( 559 )  

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Objective　To compare endonasal transsphenoidal via anterior wall of sphenoid sinus approach with endonasal transsphenoidal via nasal septum-sphenoid sinus approach by imitation of the endoscopic surgery.　Methods　 The head of 15 samples were dissected respectively via two above mentioned approaches as an imitation of the endoscopic surgery, and the distance between incision and external nostrils, maximum angle and range of swing were measured in the horizontal direction on operative route and other related anatomic parameters.　Results　Distances between incision and external nostrils of anterior wall of sphenoid sinus approach and nasal septum-sphenoid sinus approach are (5.19±0.15) cm versus (0.59±0.52) cm; maximum angle and range of swing in horizontal direction on operative route are (44.77±2.04)°versus (38.54±1.40)°, and (1.25±0.15) cm versus (0.68±0.05) cm. The correlation data of the two approaches were statistically significant（P<0.001）.　Conclusions　Endonasal transsphenoidal via nasal septum-sphenoid sinus approach incurs milder damage, enjoys short distance to the outside of the nose, clear positioning, wider operation space and larger perspective surgical approach, which is worthy of clinical promotion.

The lower branch of recurrent laryngeal nerve outside the laryngeal: a case report

ZHANG Li, LI Xiang

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  365.  doi:10.13418/j.issn.1001-165x.2016.04.027

Abstract ( 538 )  

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Study of pudendal nerve and its clinical significance

ZHANG Chi, YE Wen-lei, RAN Jian-hua

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  366-369.  doi:10.13418/j.issn.1001-165x.2016.04.002

Abstract ( 1491 )  

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Objective　This study aims to provide an anatomic basis for surgeries accompanied with the pudendal nerve and some explanations about the formation of thepudendal nerve.　Methods　The pudendal nerve was dissected from its origin to end branches in 16 human cadavers. Its formation, shape, tract, branches and relationship with vessels were observed. The data related to the pudendal nerve were also measured.　Results　The formation of pudendal nerve is discrepant from what we acknowledged before. The trunk of pudendal nerve is formed by the anterior branches of S2, S3 and S4 with S4 being absent in some cases. In the descending course, the trunk of the pudendal nerve is combined with some fibers from the posterior femoral cutaneous nerve and the sciatic nerve in its course. The intricate shape of the pudendal nerve owes to its relation with the posterior femoral cutaneous nerve and the sciatic nerve, and the relations among its branches also contribute to that. The relationship with vessels varies during its course in the inferior border of piriformis and the pudendal canal. The branches of the pudendal are divided into the branches in the pelvis and the branches out of the pelvis. The distance from the pudendal nerve in the Alcock’s canal to the bottom of the ischial tuberosity’s anterior border is (25.47±3.18) mm in male and (26.38±2.56) mm in female. The distance from the pudendal nerve at the ischial spine to the skin is (75.67±8.37) mm in male and (76.89±9.48) mm in female.　Conclusion　The detailed dissection of the pudendal nerve can guide clinician in the surgeries associated with pudendal nerve in some degree.    

The study on the measurement of related distance between the superior nuchal line and inferior nuchal line and their clinical application

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  370-374.  doi:10.13418/j.issn.1001-165x.2016.04.003

Abstract ( 889 )  

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Objective　To measure the relevant distance between the superior nuchal line, inferior nuchal line and the foramen magnum,  and provide the clinical application with scientific and reasonable data.　Methods　The following points in 113 cases of normal and dry skull specimens of Chinese adults were selected: the highest point of the external occipital protuberance and points 1cm and 2 cm left and right on the superior nuchal line; the middle point of the occipital crest and points 1cm  left and right on the inferior nuchal line. Straight lines from those selected points to the foramen magnum parallel to the skull posterior median line were drawn. Measure of the arc distance, straight distance, vertical distance and horizontal distance between the superior nuchal line and the inferior nuchal line,the superior nuchal line and the foramen magnum, the inferior nuchal line and the foramen magnum were made with an ordinary vernier caliper.　Results　The distance between the superior nuchal line and the inferior nuchal line was minimum in the posterior median line. The values of its straight distance, arc distance, vertical distance and horizontal distance were（18.11±2.99）mm,（19.18±2.83）mm,（11.11±3.44）mm and（14.65±3.19）mm respectively. The horizontal distance to the left or right diminished, but the other distances increased.  The distance between the midpoint of the occipital crest and the foramen magnum was minimum. The values ofits straight distance, arc distance, vertical distance and horizontal distance were（21.73±3.35）mm,（22.74±3.47）mm,（10.69±3.44）mm and （19.10±3.35）mm respectively. The distances to the left or right lengthens increased.　Conclusion　The location of the inferior nuchal line is the key to ensure the safety and effectiveness of clinical practice. It can determine the location of the nuchal line with the help of the external occipital protuberance and the superior nuchal line. In the posterior median line, the distance between the superior nuchal line and the inferior nuchal line is minimum, and the number is (11.11±3.44)mm.

Applied anatomical study of adolescent cervical disc measured by MRI

WANG Zhen-feng, WU Qiong, LI Zhi-jun3, LI Jian-guo, WANG Xing, ZHANG Shao-jie, LIU Ying

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  375-377.  doi:10.13418/j.issn.1001-165x.2016.04.004

Abstract ( 609 )  

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Objective　To provide the theory evidence of artificial disc design, replacement and disc related diseases by measurement of the cervical intervertebral disc of adolescent using MRI.    Method    40 normal adolescent cases were used to measure the height and diameter of the sagittal plane of cervical intervertebral disc by SIGNA MR/1.5T MRI. 5 groups of the sagittal images were scanned with the cervical sagittal versine as the center, respectively to the two sides at intervals of 3 mm. The center height and diameter of intervertebral disc were measured in the center of the middle plane,and finally the average measurement data was chosen from two deputy chief physician of the MRI.    Result     (1) The anterior posterior cervical disc was (14.036±1.812)mm and center height was (4.111±0.813)mm. (2) No statistic difference was found between the center height and diameter from C2～3 to C6～7（P＞0.05）.(3) No statistic difference was found between males and females in the each group of the center height and diameter（P＞0.05）.    Conclusion    (1) The center height and diameter of C2 to C7 vertebrae in teenagers of 14~17 years old. There was no significant difference among the measured values. (2) MRI may directly display the cervical intervertebral disc shape, and the data may meet the the requirement of an artificial disc.

The pineal gland MRI study in Alzheimer's patients

DENG Ling，QIAN Xue-hua，GUO yi，XU Yu-yu，Lü Fa-jin

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  378-382.  doi:10.13418/j.issn.1001-165x.2016.04.005

Abstract ( 814 )  

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Objective　To observe morphological changes of pineal gland in the process of Alzheimer' s disease (AD) by MRI. 　Methods　According to the process of AD, brain MRI images of 24 cases, 18 cases, 16 cases and 20 cases from the normal control group, MCI group, mild AD group and moderate-severe AD group, respectively. Length, width, height and volume of the pineal gland had been measured, the change trend of the measurement between each group was then analyzed.　Results　The standardized height of pineal gland had an increase in the MCI and mild AD compared with NC group （P＜0.05）and had a reduction in the moderate-severe AD compared with the MCI and mild AD（P＜0.05）; The standardized length, width and volume of pineal gland had no significant change in the MCI, mild AD and moderate-severe AD compared with NC group（P＞0.05），but had a reduction in the moderate-severe AD compared with MCI（P＜0.05）.　Conclusion　The height of pineal gland has a growth tendency at the incipient stage of the process of AD, and then will shrink. Measurement the height of pineal gland by MRI was helpful in the diagnosis of MCI and mild AD patients.

Study of three-dimensional reconstruction of multi-slice spiral CT in the anatomical relationships between intrarenal arteries and the kidney collecting system in pigs

PENG Wei-hua， LIU Yun， LI Yuan， ZHANG Zhong-hua， FU Hai-hong， LIU Jun-hua， FAN Qian

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  383-387.  doi:10.13418/j.issn.1001-165x.2016.04.006

Abstract ( 670 )  

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Objective　To evaluate the feasibility of three-dimensional reconstruction of multi-slice CT in the anatomical relationships between intrarenal arteries and the kidney collecting system in pigs.Methods　Eighty-one pig kidneys were examined with MVCT. Each kidney was evaluated with three-dimensional reconstruction , from which MPR , MIP，VR of the renal artery and collecting system were documented. The anatomical relationships between intrarenal arteries and the kidney collecting system were observed.　Results　Three-dimensional images of all pig kidney could exactly show the anatomical relationships between the kidney arteries and collecting system. It was found that there was only 1 artery per kidney. The primary branch of this artery divided into two branches in 79 cases (97.53%) and three branches in 2 cases (2.47%). The two-branch artery divided into cranial and caudal branches in 72 cases (91.14%). In 7 cases (8.86%) the primary division of the two-branch artery was in a dorsal and ventral branches. In all cases 2 arteries (1 ventral and 1 dorsal) involved the cranial caliceal group. In the dorsal mid zone a dorsal artery originated from the cranial division of the renal artery, which was positioned in 48.15% of cases. The arterial supply related to the ventral mid zone of the kidney consisted of branches that coursed horizontally in the ventral surface of the renal pelvis in 82.72% of cases. The caudal division of the renal artery supplied the ventral and dorsal surfaces of the caudal caliceal group in 85.19% of cases, while in 14.81% a dorsal artery supplied its dorsal surface.　Conclusion　Three-dimensional reconstruction of multi-slice CT was an effective method in studying the anatomical relationships between the intrarenal arteries and kidney collecting system in pigs.

Observation of the origin and diameter of cystic artery with 256 slice spiral CT

ZHANG Wu, XIN Ben-lei, XU Chuan-bin, XU Peng, LV Jia-nan

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  388-391.  doi:10.13418/j.issn.1001-165x.2016.04.007

Abstract ( 650 )  

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Objective　To study the clinical significance of the preoperative evaluation of the gallbladder by observing normal anatomy and origin variance of the gallbladder artery via 256 slice spiral CT angiography.　Methods　A retrospective analysis of imaging data of 215 cases of patients with upper abdominal enhanced CT scan or CTA angiography in our hospital was performed. Through observation of the origin of the gallbladder artery, its transverse diameter and origin distance could be measured.　Results　219 branches of gallbladder arteries in 215 cases were totally counted, including 128 in men and 91 in women, which mainly resulted from single-branch type in most cases and double-branch type in only 4 cases. And 183 branches normally originated from the right hepatic artery, accounting for 83.6%, while 36 branches had the origin variation, accounting for 16.4%. There was no significant difference in the normal origin and the origin variance of the gallbladder artery in different genders (P＞0.05). Of the 183 branches with normal origin of the gallbladder artery in the right hepatic artery,106 were in male while 77 were in female; and in terms of the origin distance, the average data was (33.15±11.75) mm and (27.54±12.94) mm in male and female, respectively. It showed a significant difference in the normal origin distance of the gallbladder artery in different genders (P<0.05). In the transverse diameter of the gallbladder artery, the relevant data were (1.95±0.34)mm in male and (1.92±0.34) mm in female, respectively. There was no significant difference in the transverse diameter of the normal gallbladder artery origin in different genders (P>0.05).　Conclusion　The 256 slice spiral CT could clearly observe the normal anatomy and its origin variance of the gallbladder artery so as to provide reference data for the gallbladder preoperative evaluation.

Left-sided gallbladder: a case report

LI Cai, HONG Li, AN Gao, PENG Tian-hong

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  391.  doi:10.13418/j.issn.1001-165x.2016.04.028

Abstract ( 500 )  

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The research of computer aided design and 3D printing in spinal deformity surgery

WANG Hong， DING Huan-wen, LIU Bao, HUANG Ming-qiang, SHEN Jian-jian

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  392-396.  doi:10.13418/j.issn.1001-165x.2016.04.008

Abstract ( 725 )  

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Objective　To investigate the value of computer aided design (CAD) in spinal deformity surgery.　Method　CAD operation group:32 patients with scoliosis, kyphosis, and spine hemivertebrae were enrolled from January, 2009 to July, 2011, underwent surgery with the help of computer aided design combined with 3D printing , and followed up for 12 months to 60 months. Control group：at the same period,  27 cases with scoliosis were cured by the conventional surgical methods with the surgery performed by the same doctors.The patients were also followed up. Surgical duration and other indicators were compared between the same groups by statistical analysis to demonstrate the superiority of the CAD.　Result　Compared with the CAD group, the surgical operation, amount of bleeding , accuracy of the screw placement,exposure time of X-ray, rectified rate of cobb angle has significant difference（P＜0.05）.　Conclusion　Surgical correction of scoliosis and kyphosis with the help of CAD can increase the accuracy and security of these operations and reduce the surgical duration.

The study of safe lag screw placement in the anterior column of acetabulum by the digital simulation technique

LI Jia-bing, XIANG Zhou

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  397-401.  doi:10.13418/j.issn.1001-165x.2016.04.009

Abstract ( 579 )  

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Objective　To find and measure the safe lag screw placement channel (SLSC) in the anterior column of acetabulum by the digital simulation technique (DST).　Methods　To find and measure the safe lag screw placement channel in the anterior column of the acetabulum under the standard 3D coordinate system and the three-dimensional coordinate system of the pelvis by establishing 96 cases of 3D finite element female die of the anterior column of acetabulum through 3D reconstruction of 48 cases of normal adult pelvic spiral CT data by Mimics 15.0.　Results　The parameters of SLSC of the anterior column of acetabulum: The max radius is （4.65±0.54） mm in male, and （3.71±1.68）mm in female; The depth is （114.91±6.52） mm in male, and （102.97±6.24） mm in female; The narrowest screw placement site is in the anterior wall of the acetabulum, and the distance between the narrowest screw placement site and direct penetrating site :Male is（34.57±2.16）mm, and female is （29.82±1.94）mm; The distance between the narrowest screw placement site and retrograde penetrating site: Male is （73.32±3.27）mm, and female is（69.49±2.52）mm; The angle with the horizontal plane is（45.22±1.54）° in male ,and（43.59±3.24）° in female; The angle with the sagittal plane is （41.65±5.37）° in male, and（47.82±4.12）in female; The angle with the coronal plane is（18.71±2.36）° in male, and （19.23±2.49）° in female. The max radius, the depth of the screw, the angle with the longitudinal sectional plane showed sex-related statistical differences (P＜0.05).  Conclusions: DST can accurately measure the SLSC of the anterior column of acetabulum.

Experimental research on the expression of iNOS in the hippocampus of rats after pure cerebral concussion

LI Heng-xi, WU De-ye, LAI Jiang-hua, KANG Li, WUhai-ying, YU Jian-yun, LI Ping

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  402-406.  doi:10.13418/j.issn.1001-165x.2016.04.010

Abstract ( 508 )  

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Objective　To investigate the expression change pattern and its pathological link between iNOS and PCC though observing expression changes of iNOS (inducible nitric oxide synthase, iNOS) between hippocampus CA1-4 region and upper and lower dentate gyrus regions in the pure cerebral concussion (PCC) model rat.　Method　PCC model was established insober rats by using metal pendulum closed brain injury blow device, andthen the rats  were randomly divided into 3h, 12h, 1d, 2d, 3d, 7d six injury groups (n=5) and a normal control group (n=5). Location and quantitation of iNOS in hippocampal CA1-4 and superior and inferior dentate gyrus between the PCC groups and the normal group were detected immunohistochemical staining and Western Blot.　Result　Under normal physiological conditions, iNOS positive cells in hippocampus were few, poorly defined and the protein expression was weak. However, 3h after injury, iNOS and the positive protein expression levels in hippocampus increased and reached the peak on 3d and 2d, respectively. There was a significant difference with the normal group (P<0.05), after 2d, the expression of protein was decreased and the positive expression was also decreased after 3 d, but the expression was still higher than that of normal group until 7 d.　Conclusion　Expression of iNOS in the hippocampus increased at the early stage of PCC damage, suggesting that the inflammatory factor plays an important role in the pathological changes of PCC.

Abnormal activity of brain detected by functional magnetic resonance imaging in a rat model of diabetic neuropathic pain

WU Bo-lin, FA Zhi-qiang, LAI Chun-ren, GUO Sheng-wen, GUO Yan-wu

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  407-411.  doi:10.13418/j.issn.1001-165x.2016.04.011

Abstract ( 532 )  

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Objective　To construct the diabetic neuropathic pain rat model. To detect the functional activity changes of brain and explore the brain regions with abnormal function activities using functional magnetic resonance imaging.    Methods    Forty-eight male SD rats were chosen and randomly divided into two groups: a diabetes group (n=36) and a control group (n=12). Diabetes was induced by intraperitoneal injection of streptozotocin (60 mg/kg) with observation of the changes of fasting blood glucose level and body weight. Behavioral testing for paw 50% withdrawal threshold was performed at the same time. Tactile allodynia was defined as a 50% withdrawal threshold of less than or equal to 2.0 g. According to the tactile allodynia, the diabetes group was sorted into two groups: the pain group and painless group. Functional activity mapping of brain by manganese enhanced magnetic resonance imaging and voxel-wise t-test were then applied to statistically analyze the brain regions with abnormal function activities in diabetic neuropathic pain rat.    Results    Diabetic neuropathic pain rat was successfully induced. some brain regions, including the somatosensory cortex, ventromedial prefrontal cortex, anterior cingulate cortex, inferior olive, piriform cortex,and part of the cortexes of the amygdala and insula, were found with significantly enhanced activity in diabetic neuropathic pain rat.    Conclusions    The results suggest these brain regions with abnormal function activities probably take part in the regulation of diabetic neuropathic pain within central nervous system.

Ectopic osteogenesis evaluation of two kind of chitosan rhBMP-2 loaded microspheres in SD rats

YU Xiang, XIA Yuan-jun，ZHENG Xiao-hui, ZHANG Ying, CHEN Ze-peng, XIA Hong,YIN Qing-shui

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  412-418.  doi:10.13418/j.issn.1001-165x.2016.04.012

Abstract ( 490 )  

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Objective　To explore the ectopic osteogenesis introducing ability of recombinant human bone morphogenetic protein-2/chitosan/dextran sulfate composite microspheres and recombinant human bone morphogenetic protein-2/chitosan composite microspheres on SD rats.　Method　36 SD rats were randomly divided into three groups, in which the quadriceps muscle bag model of the rats were established; the bags were implanted respectively with rhBMP-2(group A), CS/DS microspheres (group B), and rhBMP-2/CS/DS microspheres (group C). Hardness of the implanted regions tissuesat the 4th,8th,12th weekend were observed, and four rats were sacrificed in each group, from which the ectopic bone tissues were harvested. The bone formation situation of plantation areas were generally observed, and the heterotopic ossification organization tissues were scanned by micro-CT, and were three-dimensionally reconstructed by using the Mimics software；parameters such astissue bone volume fraction (BVF), trabecular thickness (Tb.Th), bone mineral density (BMD) were detected; Some heterotopic ossification organization tissues were taken for histological observation and analysis of ALP activity and calcium content.　Results　At the 4th weekend, tissues around implanted regions of each group had slightly harder texture, and there was no significant difference among the three groups; at the 8th and 12th weekend, hardness of tissues around implanted regions of each group increased significantly, and the group C had harder tissues formed than group A and B. At the 4th weekend, HE staining showed that the three groups had a small amount of bone tissue formation, but not obviously; the BVF, Tb.Th, BMD, ALP activity and calcium levels of B, C groups were significantly higher than group A; there were no statistically significance on the above indicators of group B and C. At the 8th and 12th weekend, gradually-increased and marture bone tissues could be seen in the three groups under HE staining. However,there were more mature ectopic bone tissues in group B and C than group A; And the bone tissues of group C were more mature than group B. Meanwhile, the BVF, Tb.Th, BMD, ALP activity and calcium levels of group B and C were significantly higher than group A, and the above-mentioned indicators of group C were higher than that of group B.　Conclusion　rhBMP-2/CS/DS microspheres have stronger ability of inducing ectopic bone than rhBMP-2/CS microspheres and single rhBMP-2, and it mayhave good prospects for applicationin bone tissue engineering.

The expression of nestin in human fetal digestive tract

DONG Li-ping, WU Chang-chu, LI Jian-ming, LIU Guan-lan, YUAN Heng, WU Gan-qiu

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  419-422.  doi:10.13418/j.issn.1001-165x.2016.04.013

Abstract ( 450 )  

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Objective　To investigate the function of nestin during digestive tract development by analyzing expression of nestin in human fetal digestive tract.　Methods　Human fetal esophagus, stomach, and small intestine of 3-8 months old were obtained and fixed for paraffin sections. Immunohistochemical staining was used to determine the expression and distribution of nestin in fetal esophagus, stomach and small intestine.　Results　Nestin was expressed in the blood capillaries of lamina propria, submucosa and muscularis layers in digestive tract. The expression of nestin in these tissues was decreased with the development of fetus. There was statistical difference between nestin expression in early development stage and medium or late stage (P<0.05), but no statistical difference between medium and late development stages (P?0.05). 　Conclusion　Nestin is expressed in capillary of different tissues; however, the expression levels are decreased with the fetal development which indicates that nestin might play a role in angiogenesis.

Observe the expression of c-kit gene in intestinal cells of Cajal by establishing incomplete small intestinal obstruction models of guinea pig with silk method

YANG Zheng, LI Xin-rui, WANG Qiang, LIU Shuang, HUANG Qian, JI Zhen-hua

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  423-427.  doi:10.13418/j.issn.1001-165x.2016.04.014

Abstract ( 833 )  

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Objective　To investigatethe expression of c-kit gene in intestinal cells of Cajal by establishing incomplete small intestinal obstruction models in guinea pig with the silk method.　Methods　43 adult healthy guinea pigs were selected and randomly divided into the normal group A, sham-operated group B, model groups（C, D, E）. Model groups were established for incomplete small intestinal obstruction by the means of silk method for 3 days. After taking out of the silk and closing the abdominal cavity, the abdominal cavity was opened and the intestinal contractility was measured，respectively at 1st（C group）, 3rd（D group）,7th（E group）. Meanwhile, the contractility of intestinal tissue was measured, the degree of intestinal mucosal membrane injury was evaluated and the expression of c-kit was observed.　Results　The comparison of normal and model groups in every data’s measurement were significant on statistics (P<0.05),but the comparison of intestinal mucosal membrane injury between E and A group had no significant difference (P>0.05). The contractility of intestinal tissue of E group was higher than D group (P<0.05), and the degree of intestinal mucosal membrane injury was less serious than D group (P<0.01). Besides, the expression of c-kit in E group wass significantly higher than D group (P<0.01).     Conclusion　Incomplete intestinal obstruction with down-regulated c-kit could be established by the silk method.

Histological characteristic observations of the nasal structure in normal BALB/c mice

WANG Shui-bin,ZHANG Han-wu,YANG Ya-qi，LIU Meng-zhi，NIE Jun,ZHOU Bin，LI Li，TAO Ze-zhang

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  428-431.  doi:10.13418/j.issn.1001-165x.2016.04.015

Abstract ( 1401 )  

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Objective　This study provides researchers with histological characteristics of the nasal structure in normal BALB/c mice.　Methods　The heads of BALB/c mice were sectioned and imaged in the coronal or parasaggital planes. Hematoxylin-eosin and periodic acid-Schiff were used to further identify the nasal microstructures including turbinates, sinuses, and nasal epithelia.　Results　The nasal structure in normal BALB/c mice included vomeronasal organ and olfactory epithelia, nasoturbinate and maxilloturbinate, nasopharynx, osteomeatal complex, and anterior and posterior ethmoid sinuses formed by ethmoid labyrinth. Normal mice might not have frontal sinuses or sphenoid sinuses. Moreover, mice maxillary sinuses were characterized by an accumulation of submucosal glands.　Conclusions　Histological characteristics of the nasal structure in normal BALB/c mice are markedly different from that of human beings. Understanding these histological structures of normal mice shall provide an important anatomic basis for laboratories seeking to use mice in allergic rhinitis or rhinosinusitis studies.

Characteristical analysis and comparison of the high flexion movement of human normal and artificial patellofemoral joints

WANG Jian-ping, FU Long, ZHANG Yan-ru, LIANG Jun, ZHANG Pan-pan, WANG Meng

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  432-438.  doi:10.13418/j.issn.1001-165x.2016.04.016

Abstract ( 665 )  

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Objective　The purpose of this work was to analyze the kinematics of the human normal and artificial patellofemoral joints during squat. Reference for the study of the patellofemoral joint kinematics of the knee was provided.　Method　Dynamic finite element (FE) models of knee before and after total knee arthroplasty (TKA), which included the bone tissues and main soft tissues were developed in this research, to simulate the kinematics of patellofemoral joint during squat by the way of three beams quadriceps femoris myodynamia being asynchronously loaded, and were compared with related researches.　Result　The dynamic 3D relative movement data of patellofemoral joint during deep flexion were obtained. The results showed that the relative motion of the nature knee were similar to that of the TKA knee. At the same time, there has partial difference, in low flexion the TKA knee showed lateral tilt and then medial tilt, but the normal knee showed continued medial tilt.　Conclusions　Through simulation and comparative analysis, in general, patellofemoral joint kinematics data were approximate. And there was a difference for the normal knee, and the main reason for the difference was the changes of the degree of restraint of the knee patella in each direction and different degrees of flexion; for the artificial knee, the main reasons for the difference were the change of the profile and structure of the knee, simultaneously, related to the difference of the definition of the coordinate system, in vivo and in vitro, and the way of load being loaded.

The principles of mathematical analysis for vertebral sections and the research of spinal lesions

LIU Xiao-yong, YANG Hui-lin, LUO Zong-ping

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  439-443.  doi:10.13418/j.issn.1001-165x.2016.04.017

Abstract ( 740 )  

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Objective　To analyze stress transmission rule of spinal vertebral body - intervertebral disc with mathematical and physical principles; to analyze the correlation between stress transmission rule of spinal vertebral body - intervertebral disc and clinical pathology.  Methods  The transverse diameter (L) and sagittal diameter (H) of the upper and lower sections on each vertebral body of C2~S1 in 10 intact spinal specimens were measured. Similarity principle of geometry was used: the area changes of upper and lower sections of vertebral body/intervertebral disc could be expressed in mathematical equations S1/S2=(a*b)/(A*B) and S=π/4*L*H to analyze the structure law of upper and lower sections of vertebral bodies; According to the structure of the intervertebral disc, principle of hydrostatic pressure F1/F2=S1/S2 was used to analyze the law of intervertebral disc pressure change.   Results  With regard to the spinal vertebral body section structure, the area increased in a S-shaped curve from the lower section of C2 to lower section of L4. The section area decreased from the lower section of L4 to the upper section of S1. The transverse diameter and sagittal diameter of the vertebral body - intervertebral disc determined the section area of the vertebral body and pressure coefficient K, K=L*H.    Conclusion   The structure of spinal vertebral body-intervertebral disc itself determines the specific mechanical transmission and distribution characteristics of the spine; Establishment of mathematical equations to recognize the structure and mechanical transmission law of the spine can help more intuitively understand and observe spinal mechanical characteristics and patterns of clinical spinal lesions.

The clinical observation about percutaneous pedicle screws in treatment of Type A3 thoracolumbar fracture

LI Xiao-dong, WANG Su-wei, YIN Hong, HUANG Wei, XIAO Hong-wei, HUANG Sheng-jia

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  444-449.  doi:10.13418/j.issn.1001-165x.2016.04.018

Abstract ( 690 )  

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Objective　To compare the clinical effects of type A3 thoracolumbar fracture percutaneous pedicle screws fixation and open pedicle screw fixation．Methods  35 patients who had AO classification type A3 thoracolumbar spine fracture and without neurological symptoms in our department were enrolled in the research.18 patients in the observation group accepted short segment combined with intermediate percutaneous pedicle screws fixation;17 patients in the control group accepted open pedicle screw fixation. The VAS score、overall satisfaction、radiographic follow-up （VBI score、VBA score、Cobb’s Angle）were compared between two groups with the clinical effect.  Results  The average surgical duration in the observation group(percutaneous pedicle screws fixation) was (53±10) min, in the control group(open pedicle screw fixation) was (90±9) min（P＜0.05）.The bleeding during the operation of the observation group was (56±17) ml, the control group was (331±149) ml（P＜0.001）. There was no significant difference in the VBI score、VBA score and Cobb’s Angle at postoperative follow-up (P > 0.05 )． Conclusion    This research is showing that the short segment combined with intermediate percutaneous pedicle screws fixation is a preferred treatment of Type A3 thoracolumbar spine fracture，which has the advantages of less bleeding, light pain, quick recovery and short surgical duration.

Effecacy analysis of new allograft posterior lumbar fusion cage of anatomical shape in patients with lumbar disc herniation

WANG Xiao-gang, LUO Jian-ping，YANG Bin, WANG Ya-han, CUI Li-yang

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  450-453.  doi:10.13418/j.issn.1001-165x.2016.04.019

Abstract ( 691 )  

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Objective　To discuss the effecacy of new allograft posterior lumbar fusion cage of anatomical shape in patients with lumbar disc herniation.　Methods　32 patients with lumbar disc herniation were enrolled and all patients were given treatment of new allograft posterior lumbar fusion cage of anatomical shape. Visual analogue scale（VAS） was applied to evaluate the degree of lumbago and leg pain before and after operation and  Oswestry disability index（ODI）was applied to evaluate the postoperative recovery of patients.The VAS of lumbago and leg pain,ODI score and average intervertebral disc height before and after operation of all patients were compared.    Results    all 32 patients were followed up for a mean follow-up period (9.2± 3.7) months. All patients achieved bony fusion and no serious adverse reactions occurred 6 months after the operation. 6 months after the operation and the last follow-up lumbago and leg pain VAS and ODI score was significantly lower than that before operation, and the differences were statistically significant (P<0.05). 6 months after the operation and the last follow-up, the average height of the intervertebral space was significantly higher than that before the operation, and the difference was statistically significant (P<0.05).　Conclusion　The new allograft posterior lumbar fusion cage of anatomical shape can obviously improve the clinical symptoms of patients with lumbar disc prolapse and it is worth popularization and application.

Anatomical analysis and correlation on treating cervical vertigo by acumicroprobe loose solution combined with traditional Chinese acupuncture

ZHANG Chong, HUANG Yong

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  454-456.  doi:10.13418/j.issn.1001-165x.2016.04.020

Abstract ( 810 )  

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Objective　To observe efficacy of acumicroprobe loose solution combined with traditional Chinese acupuncture for cervical vertigo.  Methods  100 patients with cervical vertigo were randomly divided into an observational group and a control group with 50 cases in each group. Patients in the control group were only loosened by acumicroprobe， while patients in the observational group were treated by Acumicroprobe combined with traditional Chinese acupuncture. Visual analogue scales and effective rates were observed before and two weeks after treatment in two groups.　Results　The scores of visual analogue scale (VAS) after treatment in observational group and control group [(2.14±0.83)、(3.78±1.30)] were decreased compared with those  before treatment[(7.17±2.83)、(7.25±2.48)]，the differences were statistically significant(P＜0.05); There was a statistically significant difference of VAS scores after treatment between the two groups(P＜0.05). The effective rate of the observational group and control group was 72% and 56% respectively, and the difference was statistically significant（P＜0.05）.  Conclusion　Acumicroprobe  loose solution combined with traditional Chinese acupuncture can gain the apparent better efficacy on cervical vertigo in comparison with the simple acumicroprobe loose solution， making it worthy of clinical popularization and application.

Comparative study of postoperative analgesia effect with ultrasound guided fascia iliaca compartment nerve block used in arthroscopically-assisted knee operation

ZHANG Jian-xing，WANG Yan, ZHOU Guo-bin

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  457-459.  doi:10.13418/j.issn.1001-165x.2016.04.021

Abstract ( 1144 )  

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Objective　To research the efficacy of postoperative analgesia with ultrasound guided fascia iliaca compartment nerve block used in arthroscopically-assisted knee operation.　Method　Sixty patients undergoing arthroscopically-assisted knee operation were divided randomly into two groups of thirty: a normal group (A, n=30) and a research group (B, n=30). All of the patients were operated undergeneral anesthesia. Patients in group B received ultrasound-guided fascia iliaca compartment block before operation and patients in group A were received none. the analgesia effect (VAS) on postoperative 6h,12h, 24h and analgesia drugs consumption, incidence of side effects, degree of comfort in 24 hours after operation in all patients were observed.　Results　Compared with group A，analgesic effect was significantly better with less extra drugs consumption and higher degree of comfort in group B. Group B had fewer complications but no statistical difference was detected.　Conclusion　Ultrasound guided fascia iliaca compartment nerve blockused in arthroscopically-assisted knee operation can bring better postoperative analgesia and reduce the adverse effects. It can make patients feel comfortable.

Flexible ureteroscope for management of calyceal diverticulum calculi with ultrasound guided puncture for 16 cases and literature review

ZHANG Ji-qing, KANG Ning, QIU Zhi, ZHANG Jun-hui

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  460-463.  doi:10.13418/j.issn.1001-165x.2016.04.022

Abstract ( 558 )  

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Objective　To evaluate the value of flexible ureteroscope (FURS) for management of renal calyceal diverticulum calculi with ultrasound guided punctureof diverticulum.　Methods　Combined with reviewing the relevant literature, we retrospectively analyzed the clinical data of 16 cases of diverticular calculi. From August 2014 to July 2015, 7 men and 9 women with an median age 48 years among them, 14 patients sustained symptomatic caliceal diverticulum calculi while 2 patients were symptoms free. Those patients were treated by FURS. FURS recognition of diverticulum ostium with ultrasound guided puncturing intodiverticular cavity in lateral lithotomy position was performed. After the needle entered diverticular cavity, saline-diluted methylthioninium chloride was injected or guidewires were inserted gently through needle sheaths. At the same time, the orifice or wall of the diverticular cavity was recognized under FURS. A 200-mm holmium laser fiber was used to incise the stenotic infundibulum or diverticular wall. Diverticular calculi was fragmented and washed out of the diverticulum.  Larger fragments were extracted with basket.　Results　Of the 16 cases, calyceal diverticulum necks leading to calyx were identified in 10 cases, and another 6 cases were not found but their locations were determined. The diverticular walls of the later 6 cases were incised with laser. The stone free rate, fragment success rate and symptom free rate was 75%（12/16）, 87.5%（14/16）and 100%（14/14）, respectively. Two cases underwent repeated procedure for the residual fragments, and the fragments were all cleared successfully after second surgery. Diverticula became disappeared or shrunk in 6 and 10 cases 3 months after the operation, respectively.    Conclusion　Flexible ureteroscope combined with the ultrasound guided puncture of diverticular cavity for management of caliceal diverticulum calculimay provide a safe and an effective option. Ultrasound guided needle puncture into calyceal diverticulum may facilitate flexible ureteroscopic treatment of calyceal diverticulum calculi.

Application of Single side open bone cement injection device in the operation of percutaneous vertebral plasty

XUE Hou-jun, PAN Lei, HUANG Bi-liu, LIU Qing-hua, CHEN Wei-xiong, LI Jie, WANG Shi-cheng

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  464-468.  doi:10.13418/j.issn.1001-165x.2016.04.023

Abstract ( 1259 )  

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Objective　To investigate clinical application of a unilateral opening bone cement injection device in percutaneous vertebral plasty(PVP).　Methods　Using a unilateral opening bone cement injection device, channels were established by the side of the pedicle, and under DSA perspective,low-viscosity vertebral bone cement was introduced into the channel. Continuous injection of bone cement and adjustment of the opening direction under DSA monitoring were performed for osteoporotic compression fractures in 25 cases (33 vertebral bodies). The surgical duration, leakage of bone cement and its complication were recorded; the distribution of bone cement in the vertebral body were observed by X-ray. 　Results　25 patients were followed up for 6~12 months. The average surgical duration was (27.75±5.29) min, each injection of bone cement was (3.8±0.92) ml, VAS score points were (7.12±0.78) preoperatively and (2.2±0.57) 3 d postoperatively, and (1.44±0.71) 12 month spostoperatively. Compared with those before operation significant differences could be detected (P<0.01). Timely termination of 4 cases of bone cement leakage under intraoperative DSA monitoring, 2 cases of leakage in the vertebral body and intervertebral space, and 2 cases of lateral vertebral leakage were observed; no leakage into spinal canal causing nerve and vascular complications, and no serious complications such as pulmonary embolism occurred.   Conclusions　Single side open bone cement injection devicecan effectively change the intraoperative dispersion direction of bone cement, effective control of further outward leakage of bone cement. By adjusting the opening direction, bilateral distribution of bone cement can be achieved through unilateral pedicle approach.

Post-operative rehabilitation therapy of Mitek bone anchor reattachment surgery in extensor tendon injury

CAI Miao-xia, WEN Gui-fen，TANG Qiong, ZENG Bao-yi, ZHUANG Yong-qing

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  469-471.  doi:10.13418/j.issn.1001-165x.2016.04.024

Abstract ( 776 )  

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Objective　To observe post-operative rehabilitation therapy effectiveness in patients underwent extensor tendon surgical repair, using Mitek bone anchor.　Method　Early rehabilitation and nursing care intervention applied in 67 patients with an average age of 32.3 years, were enrolled in this study. Rehabilitation effect in follow-up assessment was collected.　Results　Patients with mallet finger and boutonniere deformity recovered without infection and tendon adhesion. According to Dargen scale, clinical follow-up revealed that the efficacy was excellent in 52 patients, better in 10, good in 5, fair in 0. 　Conclusion　Post-operative rehabilitation therapy and nursing care after surgery exert positive influence on functional recovery in patients with extensor injury. Incidence of tendon adhesion and anchyloses could be reduced and hand function rehabilitated with satisfactory result.

Research progress in diagnosis and treatment of adolescent idiopathic scoliosis

HUANG Ren, WANG xing, LI Zhi-jun, ZHANG Shao-jie, LIN Peng

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  472-475.  doi:10.13418/j.issn.1001-165x.2016.04.025

Abstract ( 629 )  

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Morphological character, biomechanics and its clinical significance of calcar femorale

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  476-478.  doi:10.13418/j.issn.1001-165x.2016.04.026

Abstract ( 850 )  

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Extra muscle bundle variation of pectoralis major and latissimus dorsi muscle: a case report

CHEN Yan-hong, WANG Xiao-hong，GUO Jin-hua, LI xue, LAI quan-na, LI lin-ke

Chinese Journal Of Clinical Anatomy. 2016, 34(4):  479.  doi:10.13418/j.issn.1001-165x.2016.04.029

Abstract ( 864 )  

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