Table of Content

25 November 2017 Volume 35 Issue 6

  

The research of morphological features and clinical applied anatomy of lacrimal canaliculis

YAN Shuai, HUANG Ming-yu, QI Cun-fang

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  601-606.  doi:10.13418/j.issn.1001-165x.2017.06.001

Abstract ( 1146 )  

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Objective　To investigate the relationship between the lacrimal canaliculi and the structures of the medial canthus according to the morphological data of Chinese lacrimal canaliculis. 　Methods 　To observe the relationship between lacrimal canaliculi and its surrounding structures, and to measure the relevant data of Chinese lacrimal canaliculi through dissecting the 31 sides of adult medial canthus region.  Results　①The length of the vertical canaliculus and horizontal canaliculus of upper canaliculus，vertical canaliculus and horizontal canaliculus of inferior canaliculus and common canaliculus of male was respectively (2.66±0.42)， (9.54±0.97)， (2.56±0.43)，(9.58±0.87) and (2.50±0.50) mm; The length of the vertical canaliculus and horizontal canaliculus of upper canaliculus, vertical canaliculus and horizontal canaliculus of inferior canaliculus and common canaliculus of famale was respectively (2.33±0.46), (9.73±1.13), (2.43±0.18), (9.67±1.10) and (1.97±0.84)mm. ②In 93.5% (29 sides), the upper and lower lacrimal canaliculis converged to form the common canaliculus; However, in 6.5% (2 sides) were opened together in the lacrimal sac. ③The muscle fibers of the tarsal plate part of orbicularis oculi muscle were divided into  two beams, namely the anterior and posterior, and the two beams were along the anterior and posterior nasal directions of the lacrimal canaliculi. The anterior beam joined into medial canthus and continues to become the anterior part of the medial canthus ligament; Moveover, the posterior beam merged to the Horner’s muscle and formed the posterior part of the medial canthus ligament. The terminations of the posterior part occurred in the posterior crest and posterior facial surface.　Conclusions　Knowledge of the morphological features and adjacent structures of the lacrimal canaliculis is of great significance for the treatment of canalicular injuries and for reshaping of the medial canthus.

Applied anatomy of using posterior-lateral forearm perforator flap to repair soft tissue defects in the finger

ZHAO Min, WU Jin-ying, YUAN Zuo-xiong, TIAN De-hu, SHAO Xin-zhong, LI Da-cun, LI Jian-feng, LIU Jing-da, ZHAO Liang, LI Hai-lei, WANG Xiao-lei, ZHANG Wen-tong, ZHANG Tao

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  607-609.  doi:10.13418/j.issn.1001-165x.2017.06.002

Abstract ( 728 )  

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Objective　To study the applied anatomical basis of using the posterolateral forearm free perforator flap to repair soft tissue defects in the finger.　Methods　Forty upper limb specimens were dissected. The origin, distribution and anastomosis of the vessels, nerves in the posterior-lateral forearm were observed with regional anatomy using surgical magnifying glass.　Results　At the midpoint of line from the radial Lister nodule and the humeral condyle , between the septum of extensor digitorum muscle and extensor carpi radialis muscle, there was an intermuscular septum cutaneous perforator constantly present with two accompanying veins. The posterior antebrachial cutaneous nerve innervated this area.  The length of perforator artery pedicle is （4.12±0.26）cm，and the diameter was （0.91±0.07）mm at the origin, which was similar to the digital artery.　Conclusion　The posterior-lateral forearm can be applied as a free perforator flap pedicled by the intermuscular septum cutaneous perforator artery to repair soft tissue defects in the finger.

Measurements of posterior arch of atlas and its significance

WANG Bin-bin, MA Xiang-yang, DUAN Ming-yang, YANG Jin-cheng, YANG Hao-zhi

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  610-614.  doi:10.13418/j.issn.1001-165x.2017.06.003

Abstract ( 861 )  

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Objective　 To acquire partial anatomical parameters of posterior arch of atlas, and to provide a reference for design of screw-plate fixation system.　Methods　A total of 60 3D CT and 30 dry atlas specimens were used to measure anatomical data．The parameters included anterior-to-posterior thickness and superior-to-inferior height of the posterior ring of C1 at the midline as well as at 5mm, 10mm, 15mm lateral to the midline, angle of the posterior arch, the semi-distance of vertebral artery groove in inner surface and the semi-distance of vertebral artery groove in outer surface. The data gained from CTs and specimens was then compared.　Results　CTs measurement: The height of the center of posterior nodule was(9.48±0.95)mm, and the respective thickness was (7.80±1.60)mm. The angle of posterior arch was (130.70±12.31) °. The semi-distance of vertebral artery groove in inner surface and the semi-distance of vertebral artery groove in outer surface was (11.08±1.28) mm and (20.13±1.53) mm, respectively. Specimens measurement: The height and thickness of the midline was (9.97±2.18) mm and (7.44±1.32) mm, respectively. The angle of posterior arch was（135.07±9.59）°. The semi-distance of vertebral artery groove in inner and outer surface was（11.33±0.52）mm and（20.86±0.84） mm, respectively. The data of the semi-distance of vertebral artery groove gained from CTs was smaller than that measured from specimens with statistical difference.　Conclusion　Data measured from CT can present anatomical structure precisely and anatomical study is of referable significance in clinical practice.

Variation of left lateral femoral cutaneous nerve: case report

TAN Guo-jing, CAO Qi-qi, HE Jia-cheng, XIAO Yue, XIONG Yin-ting, YU Shan-shan

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  614.  doi:10.13418/j.issn.1001-165x.2017.06.027

Abstract ( 368 )  

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Anatomical research of lumbosacral plexus around sacroiliac joint and its clinical significance

HUANG Wei-qi， YANG Xiao-dong， LI Tao

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  615-617.  doi:10.13418/j.issn.1001-165x.2017.06.004

Abstract ( 1201 )  

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Objective　Based on the anatomical study，position and variation of anatomical structure of the hypogastric abdominal wall and pelvic cavity were observed and the important neuroanatomical structure refinement measured. To perform an anatomical study on lateral-rectus to sacroiliac joint disruption complicated with lumbosacral plexus injury in an attempt to testify feasibility of the approach．Methods  Position and variation of anatomical structure of the hypogastric abdominal wall and pelvic cavity were observed in 10 cadaveric adults(20 sides), to expose the anterior rectus sheath, obliquus externus abdominis, inferior epigastric artery, arcuate line, the above superficial ring and the spermatic cord in male patients (or the round ligament in female patients) within the inguinal ligament. An adequate exposure included the pelvic ring from the quadrilateral plate to sacroiliac joints, quadrilateral plate, ala of ilium and most part of the medial side of the posterior column of acetabula is obtained by the lateral-rectus approach. Then horizontal distances between anterior branches of lumbar nerves 4，5，lumbosacral trunk(LST) and sacroiliac joint were measured with a caliper.    Results     According to the anatomical study and the anterior of sacroiliac joint, there was an operative window between femoral vessels, spermatic cord and the iliopsoas muscle to expose the sacroiliac joint, obturator nerve, umbosacral stem and internal iliac vessels while retracting abdominal muscles, iliac vessels and intraperitoneal tissues to the medial and iliopsoas to the lateral. The S1 vertebra was posterior to median sacral vessels and iliac vessels, which when retracted laterally can expose S1 and S2 foramen. The distance between the lumbar nerve 5 as it exits from the intervertebral foramen and the sacroiliac joint, the distance between anterior branches of lumbar nerve 4 branch and the sacroiliac joint at the level where the lumbar nerve 5 exits the intervertebral foramen, the distance between the beginning of the LST and the sacroiliac joint，the distance of the LST to the sacroiliac joint at the promontory, the proximity of the LST to the sacroiliac joint at the pelvic brim. There are no significant statistical difference between the left and right side(P＞0.05).    Conclusion    Based on the anatomical study， the author believes that there is enough space anterior to the sacroiliac joints for placement of internal fixation under the nerve root with minor effects on nerve. weconfirm that the lateral-rectus approach can be used for reduction and internal fixation of the sacroiliac joint fracture and dislocation. There exists security space of operation. what's more, the approach provides a new way for the treatment of nerve injury caused by sacroiliac joint damage.

Anatomic study and application of the cerebra venous sinus in adult CT angiography

SHENG Bo, Lü Fu-rong, LI Jia, LI Kang, Lü Fa-jin, LI Qian, XIAO Zhi-bo

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  618-622.  doi:10.13418/j.issn.1001-165x.2017.06.005

Abstract ( 1207 )  

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Objective  The purpose of this study was to determine the anatomical features of venous sinus in clinic using subtraction computed tomography angiography (CTA) technique.  Methods  A total of 105 images of venous sinus were obtained by three-dimensional reconstruction after CT angiography of head, to determine the anatomical information of the venous sinus.  Results  The superior sagittal sinus is below the coronal suture. The posterior segment of the superior sagittal sinus is most prominent in the partial right compared with the line lambda to the occipital protuberance. The deviation of the center of the sinus confluence is consistent with the deviation of the posterior segment superior sagittal sinus. The right side of transverse sinus, transverse-sigmoid sinuses transition and sigmoid sinus are larger than the left. With the increase of transverse-sigmoid sinuses transition and sigmoid sinus, the distance between venous sinus and skull or mastoid surface and external auditory canal is smaller.  Conclusions  Subtraction CTA and merged images provide a feasible method to identify the anatomical relation between venous sinus and surface landmarks of cranium. Subtraction CT angiography is a reliable method in the anatomical features of the venous sinus for surgical craniotomies.

MDCT angiographic study anatomic variation and classification of Willis ring of skull base in minority areas of Qiannan

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  623-627.  doi:10.13418/j.issn.1001-165x.2017.06.006

Abstract ( 580 )  

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Objective　To explore the anatomical variation and classification of Willis ring in the southern Guizhou province, and to provide a control for the cerebrovascular diseases of ethnic minorities in Qiannan area.　Methods　In this study, retrospective study was carried out continuously in the Qiannan People's Hospital from December 2011 to February 2017. CT and MRI were normal and CTA was used to check the 513 of the Buyi or Miao adults in Qiannan. The data were examined by Siemens signo workstations, row VR, MIP and MPR，multi-modal and multi-angle observation of the Willis ring development were used for classification and type analysis.　Results　According to the development of arterial arteries, 513 cases of normal cerebral artery Willis ring were divided into four types, typeⅠ3.7% (19 cases), typeⅡ0.1% (5 cases), and type Ⅲ 65.5% (336 cases), according to the development situation of the posterior circulation is divided into 5 subtypes: IIIa 18.9% (97 cases), IIIb 32.2% (165 cases), IIIc 2.5% (13 cases), Ⅲd 4.5% (23 cases), Ⅲe 7.4%(38 cases) and  Type IV 29.8% (153 cases); according to the development situation before and after the circulation of type IV combination will be divided into 5 subtypes: IVa 21% (108 cases), IVb 1.2% (6 cases), IVc, 1.6% (8 cases), IVd, 1.9% (10 cases), and  IVe, 4.1% (21 cases).　Conclusion　CTA is a noninvasive and effective method for evaluation of the basilar artery type. It is possible to evaluate the basilar artery ring in the Qiannan area by CTA. It can provide normal control for other diseases related to cerebrovascular type. The symmetrical type Willis ring display rate is low, whereas type Ⅲ is the main type followed by type Ⅳ.

Study on the correlation between the tightness of cruciate ligament and meniscus injury based on MRI measurement

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  628-632.  doi:10.13418/j.issn.1001-165x.2017.06.007

Abstract ( 433 )  

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Objective　This study was aimed to explore the correlation between tightness of cruciate ligaments and meniscus injuries anatomically. 　Methods　260 knee-joint MRI were collected from Southern Medical University, Zhujiang hospital during January 2014 to December 2016. Then, the critical data according to MRI containing a[length of anterior cruciate ligament(ACL)], p [length of posterior cruciate ligament(PCL)], la (attachment distance of ACL) and lp (attachment distance of PCL)were measured to figure out the tightness coefficient R=(a+p)/(la+lp). t-Test and spearman correlation analysis were used to study these samples.　Results　t-Test presented significant difference between patients with and without meniscus injuries (P<0.05). Spearman correlation analysis showed the relatively strong correlation between R and meniscus injuries in non-osteoarthritis patients (rs=0.620) and weak correlation in osteoarthritis patients (rs=0.313).    Conclusion    The tightness of cruciate ligaments hasevident impact on the suffering of meniscus injury especially for youth without osteoarthritis. Nevertheless, it is probably not a major determinant resulting in meniscus injury for the elderly with osteoarthritis.

Characteristics of anatomic remodeling of pelvic diaphragm hiatus in postpartum women with constipation detected dynamically by transperineal three-dimensional ultrasonography

MU Liang, LIU Li, WEI Ai-hua, NAN Shu-liang, HAO Rui, LI Bin, HU Ying

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  633-636.  doi:10.13418/j.issn.1001-165x.2017.06.008

Abstract ( 524 )  

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Objective　To have a dynamic observation about the morphological characteristics of pelvic diaphragm hiatus in postpartum women with constipation by transperineal three-dimensional ultrasonography.　Methods　From Jul.2014 to Jun. 2017, 110 postpartum women underwent transperineal 3-D ultrasound investigation at Department of Obstetrics and Gynecology，including 45 postpartum women with constipation and the other 65 postpartum women without constipation．In the mean time，100 normal nulliparous healthy women without constipation were chosen as control group．The morphological characteristics of pelvic diaphragm hiatus，the perimeter and area of pelvic diaphragm hiatus，levatorani thickness were measured at rest, on maximum pelvic floor contraction and maximum Valsalva by 3-D ultrasound, respectively.   Results    Loose connective tissue was observed in postpartum women．The perimeter and area of pelvic diaphragm hiatus and levatorani thickness were significantly increased than those in control group, at rest, on maximum pelvic floor contraction and maximum Valsalva respectively (P＜0.05).And the perimeter and area of pelvic diaphragm hiatus in postpartum women with constipation were increased than those without constipation at three maneuvers，respectively (P＜0.05)．Levatorani thickness in postpartum women with constipation was significantly thinner than those without constipation at maximum pelvic floor contraction (P＜0.05), but there was no significant difference between postpartum women with constipation and without constipation at rest and on maximum Valsalva in pubovisceral muscle thickness (P＞0.05)．Conclusions    Pelvic diaphragm hiatus anatomic remodeling is identified in postpartum women. Transperineal three-dimensional ultrasonography is of great value for　pelvic diaphragm hiatus change in postpartum women ,especially those with constipation．

Clinical significance of imaging observation on spinous process and interspinous space anatomy of subaxial cervical spine

MAO Yi, CUI Xin-gang

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  637-640.  doi:10.13418/j.issn.1001-165x.2017.06.009

Abstract ( 1300 )  

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Objective　The applied anatomy of the spinous process and interspinous space of subaxial cervical spine was studied, and the anatomic parameters were quantified to provide an anatomical basis for further biomechanical studies and for the preparation of interspinous dynamic fixing device.　Methods　Imaging data of a total of 46 persons (22 males and 24 females) who underwent cervical spine CT scans were imported to GE AW4.4 workstation for measurements of  the length, width, height, tilt angle, and interspinous space of the spinous process.　Result　There is a significant difference between males and females. For subaxial spinous process of males, the largest value of length is in C7, and the smallest one is in C3; the largest value of width is in C7, and the smallest one is in C3; the largest value of height is in C7, and the smallest one is in C5; the largest value of tilt angle is in C6, and the smallest one is in C3; the largest value of interspinous space is in C3/C4, and the smallest one is in C6/C7. For subaxial spinous process of females, the largest value of length is in C7, the smallest one is in C3; the largest value of width is in C7, and the smallest one is in C4; the largest value of height is in C7, and the smallest one is in C3; the largest value of tilt angle is in C7, and the smallest one is in C3; the largest value of interspinous space is in C3/C4, and the smallest one is in C6/C7.　Conclusion　This study comprehensively surveyed the related indexes of subaxial cervical spine, including the length, width, height, tilt angle, and interspinous space, which provides the data to support and guide interspinous dynamic fixing device of subaxial cervical spine.

Lycium barbarum polysaccharide degrades the mutant huntingtin by ubiquitin-proteasome pathway

FANG Fang, CHEN Tian, PENG Yun-tao, LI He

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  641-644.  doi:10.13418/j.issn.1001-165x.2017.06.010

Abstract ( 558 )  

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Objective　To detect the degradation pathway of the mutant huntingtin (mHtt) after treating Lycium barbarum polysaccharide (LBP).　Methods　HEK293 cells that stably expressed mHtt containing 160 glutamine repeats was treated with LBP of various doses, CCK8 assay was used to detect the cell viability, and caspase-3 activity assay kit was used to detect the caspase-3 activity; the mHtt in HEK293-160Q cells was observed under fluorescence microscope after treatment with LBP and the images were analyzed by Image Pro Plus 6.0, at the same time, to detect its mRNA; LBP, MG132 and chloroquine were used to treat HEK293-160Q cells separately, and the changes of the mHtt were determined by Western Blot.  Results　LBP could increase the viability and decrease the caspase-3 activity in HEK293-160Q cells; LBP could reduce the mHtt and did not change its mRNA levels; after treating HEK293-160Q cells with the different medicines , the Western Blot results showed that compared to cells receiving only LBP treatment, the degeneration of mHtt was significantly reduced after treating LBP and MG132.  No influence on mHtt after treating LBP and chloroquine was observed.　Conclusions　LBP can degrade the mHtt by ubiquitin-proteasome pathway, increase the cell viability and decrease the apoptosis by alleviating the cytotoxicity of mHtt.

Changes of PPAR γ, UCP1 and β3-AR mRNA expression of HFD-induced mice with EPO injection

MIAO Ying-ying, LU Ming, ZHAO Jun-qiang

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  645-649.  doi:10.13418/j.issn.1001-165x.2017.06.011

Abstract ( 561 )  

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Objective　Erythropoietin (EPO) has been reported to have a beneficial effect on obesity. The aim of the study is to investigate the changes of body weight and fat content of EPO in high fat diet (HFD) mice, the expression of PPAR γ, UCP1, β3-AR mRNA in white adipose tissue (WAT) and brown adipose tissue (BAT).    Methods    20 HFD-fed C57BL/6J male mice were randomly divided into control group (HFD-Con) and EPO group (HFD-EPO). The expression of PPAR γ, UCP1 and β3-AR mRNA in subcutaneous fat, epididymal fat and brown fat were detected by real-time quantitative RT-PCR.   Results  Compared with the control group, the body weight of the EPO mice was (24.53±2.03) g and the control group was (31.78±1.68) g. The weight of subcutaneous fat and epididymal fat in HFD-EPO group were significantly decreased. HE staining showed that the size of adipocytes of HFD-EPO group was decreased compared with HFD-Con group. Quantitative real-time PCR results showed that the expression of PPAR γ, UCP1 and β3-AR mRNA in subcutaneous adipose tissue and epididymal adipose tissue did not change significantly, while the expression of PPAR γ, UCP1 and β3-AR in brown fat were significantly increased.   Conclusion　The expression of PPAR γ, UCP1 and β3-AR in brown fat may be related to the weight loss caused by EPO injection after high fat diet.

The effect of fluid shear stress on expression of Pim-1 in human umbilical vein endothelial cells 

SUN Yu, WANG Xiao-bo, WANG Han-qin, YU Jian-xin

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  650-654.  doi:10.13418/j.issn.1001-165x.2017.06.012

Abstract ( 377 )  

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Objective 　To investigate the effect of fluid shear stress(FSS) on the expression of Pim-1 in human umbilical vein endothelial cells (HUVECs) and the molecular mechanism of Pim-1 induced by FSS.  Methods　HUVECs were isolated from the fresh umbilical cord of healthy mothers by 0.125% trypsin digestion. FSS under different time phase (1h, 4h, 6h) and at different magnitude (0.5Pa, 1.5Pa, 3.0Pa) were loaded by parallel plate flow chamber system. The expression of Pim-1 gene was detected by real-time RT-PCR at mRNA level and the levels of p-Akt and p-STAT3 were measured by Western Blot. The signaling inhibitors, Wortmannin (PI3K specific inhibitor), Deguelin (Akt inhibitor) and AG490 (JAK specific antagonist), were used to investigate possible signal transduction pathway.　Results　The expression of Pim-1 gene was significantly increased in HUVECs at 4h after 1.5Pa FSS. All FSS with different magnitude could increase Pim-1 expression, especially at high FSS(3.0Pa). Meanwhile, FSS can significantly activate the expression of p-Akt and p-STAT3. JAK inhibitor (AG490) significantly inhibited the expression of Pim-1, whereas PI3K inhibitor (Wortmannin) and Akt inhibitor (Deguelin) enhanced Pim-1 expression.    Conclusions    FSS can induce the expression of Pim-1 and its expression is closely related to the intensity of stimulation time and FSS. This effect may be mediated by JAK/STAT3 and PI3K/Akt signaling pathway.

Effects of ShaoYangZhuGuFang on p16/Rb signaling pathway of naturally degenerative cynomolgus monkeys knee osteoarthritis model

ZHOU Xin, ZHANG Lei, FU Shi-jie, LIU Gang, GUO Xiao-guang, WANG Guo-you

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  655-660.  doi:10.13418/j.issn.1001-165x.2017.06.013

Abstract ( 415 )  

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Objective　 The aim of this study was to investigate the mechanism of ShaoYangZhuGuFang(SYZGF) in delaying the cell senescence and degeneration of articular chondrocytes according to the theory of "ShaoYangZhuGu". Method  13 cynomolgus monkeys with degenerative knee joints were selected by X-ray. One of the monkeys was selected randomly for pathologic observation, and the other cynomolgus monkeys were randomly divided into SYZGF group, Ammonia Moxime group and Saline group. There were four cynomolgus monkeys in each group. All cynomolgus monkeys were executed after 8 consecutive weeks of intragastric administration. Pathological observation of articular cartilage was made and the expression of p16, Rb gene and protein in articular cartilage was detected by RT-qPCR and Western-blot technique.　Result　Articular cartilage pathological changes of elderly cynomolgus monkey KOA models was consistent with the characteristics of KOA pathological changes. Mankin scores of cynomolgus monkeys in three groups were as follows: 7.5 ± 0.53 in SYZGF group, 7.75 ± 0.71 in Ammonia Moxime group, 8.25 ± 0.46 in Saline group, and there was significant difference between SYZGF group and Saline group (P<0.05). The expression of p16 was lowest in SYZGF group, which in middle in Ammonia Moxime group, and  highest in Saline group. There was significant difference in the three groups (P<0.05). The expression of Rb was highest in SYZGF group,  middle in Ammonia Moxime group, and lowest in Saline group. There was significant difference in the three groups (P<0.05).　Conclusion　SYZGF could delay chondrocyte senescence by p16/Rb pathway and delay articular cartilage degeneration.

Upper site abnormal radial artery: 2 cases report

LI Song-yu, TIAN Xin, QIN Xiang-zheng

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  660.  doi:10.13418/j.issn.1001-165x.2017.06.028

Abstract ( 525 )  

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Protective role of sulphur-containing amino acids on sinoatrial node dysfunction in type 1 diabetes rat model

ZHOU Li, WANG Qing-zhi, WANG Zhi-yong

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  661-664.  doi:10.13418/j.issn.1001-165x.2017.06.014

Abstract ( 318 )  

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Objective　To explore the effects of cysteine or taurine on sinoatrial node dysfunction in diabetic rats and the underlying mechanism.　Methods　SD rats were randomly divided into four groups:control group(C) diabetes mellits group(DM), diabetes mellits+cysteine group(DM+Cys), diabetes mellits+taurine group(DM+Tau). The blood content of SOD and MDA were assessed. The sinoatrial node function was detected by SNRT, CSNRT, SACT and IHR. We also measured the expression of SOD2, HO-1, Nox2, Nox4, HCN2 and HCN4.　Results 　Compared with C group, the levels of SOD decreased, whereas MDA increased in DM group. The IHR was reduced with the prolonging of SNRT, CSNRT and SACT. The DM group exhibited down-regulated expression of SOD2, HO-1, HCN2 and HCN4 but up-regulated expression of NOX2 and NOX4 (P<0.05). Compared with DM group, DM+Cys and DM+Tau group showed increased SOD, prolonged IHR, up-regulated expression of SOD2, HO-1, HCN2 and HCN4, down-regulated expression of NOX2 and NOX4 (P<0.05). 　Conclusion　Cysteine or taurine supplementation can reduce the oxidative stress, increased the expression of HCN2 and HCN4, improve the sinoatrial node dysfunction in diabetic rats.

Finite element analysis of two nonanatomic reductions of Pauwels Ⅲ subcapital femoral fractures fixation

ZHENG Xiang, XU Jin-huang, HUANG jian-rong

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  665-670.  doi:10.13418/j.issn.1001-165x.2017.06.015

Abstract ( 418 )  

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Objective　To explore and compare the biomechanical properties of two nonanatomic reductions of Pauwels Ⅲ subcapital femoral fractures fixation using finite element analysis, therefore to provide theoretic reference for clinic application.　Methods　Using a CT scan from a 25-year-old healthy male femur and the measuring data of a PH Nail (Physiological Hip Nail) and screws, positive buttress reduction and negative buttress reduction models of Pauwels Ⅲ subcapital femoral fracture fixation were developed using finite element soft wares. The maximum displacement of the fracture sites, the maximum Von Mises strain on femur, the maximum von Mises stress on implants were compared under two loading conditions simulating “stance” and “walking” respectively. 　Results　The maximum displacement of the fracture sites of two models under “stance” and “walking” conditions were 0.87 mm and 1.38 mm, 1.27 mm and 1.98 mm, respectively. The maximum Von Mises strains on femur were 1.77e-2 and 2.47e-2, 1.89e-2 and 2.12e-2, respectively. The maximum von Mises stresses on implants were 304.47 Mpa and 359.03 Mpa, 362.24 Mpa and 391.52 Mpa, respectively.  Conclusions  The reduction of positive buttress has better biomechanical properties than negative buttress under the same loading conditions for Pauwels Ⅲ subcapital femoral fracture fixation. Results of this study support the Yechiel Gotfried theory for Pauwels Ⅲ subcapital femoral fracture fixation from a biomechanical perspective.

Study of the clinical effects of two improved autogenous bone fusion methods

ZHONG Zhi-hong, ZHOU Wei, YU Hao-tao, ZHANG Liang, ZHANG Zhi, ZHANG Pin, LI Jian

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  671-675.  doi:10.13418/j.issn.1001-165x.2017.06.016

Abstract ( 428 )  

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Objective　To retrospectively study the clinical effect of two improved autologous bone lumber interbody fusion methods (autogenous bone interbody fusion cage(ABIF) and autogenous morselized bone graft impaction(AMBI)) compared with the PEEK cage fusion.　Methods　The clinical data of 110 cases of patients who took the lumber fusion surgery from 2010 to 2016 were collected. All the cases were divided into three groups by the fusion method: AMBI:36 cases, ABIF:35 cases, PEEK:39 cases. The VAS score, ODI score at the time point of pre-operation, 6 months post-operation and 12 months post-operation were evaluated, the loss of intervertebral space height on X-ray and the relative fusion rate on CT scanning at the time point of 24 h post-operation, 6 months post-operation and 12 months post-operation was evaluated. The general information of three groups had no statistical significance, indicating good comparability of the three groups.　Result　All three groups had no serious complications. The loss of intervertebral space height 6m and 12 m post-operation of each group: AMBI:(6.1±2.5、6.5±3.8)%, ABIF:(5.6±2.9、5.8±3.7)%；PEEK:(5.4±3.3、5.9±4.1)%,the relative fusion rate 6 months and 12 months post-operation of each group: AMBI:(27.5±10.5、26.5±9.1)%, ABIF:(31.2±8.7、28.1±8.7)%, PEEK:(28.4±7.1、29.3±8.2)%。Statistical results showed VAS score, ODI score, loss of intervertebral space height and the relative fusion rate 6m and 12m post-operation of each group have no statistical significance (P＞0.05).    Conclusion　All three groups have the same clinical effect and fusion rate, the result indicate a good promise of clinical application of AMBI and ABIF.

Flow-through anterolateral thigh flap for the treatment of lower limbs wounds

DENG Wei，JU Ji-hui，LI Lei，ZHOU Zheng-hu，ZHENG Bin-bing，ZHAO Dong-yang

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  676-680.  doi:10.13418/j.issn.1001-165x.2017.06.017

Abstract ( 723 )  

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Objective　To investigate the clinical effect of flow-through anterolateral thigh flap in repairing skin and soft tissue defect of lower limbs.　Methods　From August 2014 to December 2016, 12 cases of lower limbs skin and soft tissue defect with bone or internal fixation exposed patients were treated in our department. They were 8 men and 4 women, aged from 7 to 66 years. Application of flow-through anterolateral thigh flap transplantation of leg wound in 8 cases, 3 cases of ankle wounds, 1 cases of foot wound, The mean artery defect was 10cm in length(from 5 to 16cm),The proximal and distal end of the quadriceps artery were respectively anastomosed to the proximal and distal end of the recipient artery. The area of the flap was from 5 cm×6 cm to 12cm×30cm, The donor site were directly sutured or repaired by full-thickness skin grafting.　Results　All patients were followed up from 3 months to 24 months (average 8 months); all of the flaps survived completely with a soft tissue texture, and the flow-through artery was unobstructed. One case developed venous thrombosis on the first day of postoperation, one developed local flap necrosis after the operation, which all were treated with operative exploration or dressing change, cured with none of the performance of venous insufficiency.　Conclusion　The flow-through anterolateral thigh flap is an ideal method to repair the skin and soft tissue defects of the lower limbs, and do not sacrifice the main artery of the recipient area.

High origin of right ulnar artery: a case report

LIU Hai-liang, YU Wen-jing, LI Xiang-jun, JU Ji-hui

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  680.  doi:10.13418/j.issn.1001-165x.2017.06.029

Abstract ( 373 )  

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Peroneal perforator-plus pedicled sural neurofasciocutaneous flap for foot and ankle reconstruction

HUO Xing-chen, LIU Hui-ren, GAO Shuang-quan, MU fu-lin，YU Zhan-yong, ZHANG Yan-mao, WANG Li, LIU Jian-hua, GAO Shuo

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  681-683.  doi:10.13418/j.issn.1001-165x.2017.06.018

Abstract ( 561 )  

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Objective　To investigate the clinical effects of peroneal perforator-plus pedicled sural neurofasciocutaneous flapfor retrograde repair of ankle and foot soft-tissue defects.　Methods　31 patients with soft-tissue defects in ankle and foot were treated by peroneal perforator-plus pedicled sural neurofasciocutaneous flaps from November 2011 to March 2014. The defects were in anterior ankle areas (12 cases), lateral malleolus(10 cases) and heel(9 cases). The wound area was 4.5 cm×4.0 cm～18.0 cm×10.0 cm.The flap area was 5.0 cm×4.5 cm～21.0 cm×12.0 cm. The donor areas are closed directly or in split-thickness skin grafts.　Results　29 of total 31 cases healed by first intention, and 2 cases with some distal superficial skin necrosis healed after dressing change. After an averagefollow-up of 19 months, all wounds healed well without any recurrence, and there was no ulceration in the weight-bearing area of the flap. The color and texture of the flaps were good and the shape of the pedicle was satisfactory. All patients could wear shoes and ambulate well.　Conclusion　The blood supply of this flap is reliable without sacrifice of major arteries，and the flap survival rate is not reduced. This flap is an ideal choice for repair of tissue defectsover foot and ankle.

Digital technology assisted arthroscopic individualized greater tuberosity plasty for treatment of subacromial impingement syndrome

PAN Zhao-xun, DU De-kai, DU Ben-cai, SUN Chao, YANG Xiao-ming, MIN Xiao-jun

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  684-687.  doi:10.13418/j.issn.1001-165x.2017.06.019

Abstract ( 664 )  

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Objective　To investigate the clinical effect of digital measurement based on the relative height of humeral head in the treatment of acromion impingement syndrome.　Methods　From February 2014 to March 2016, 89 patients with impingement syndrome were admitted. The relative height of the humeral head was measured by CT before the operation, andwe used C-type-arm to determine grinding position during the operation.We compared CT data，CMS andVAS between preoperation and postoperation to evaluate the clinical efficacy.　Results 　During an average follow-up of 15.5 months,88 patients were followed-up. At the last follow-up, all patients’ shoulder function has fully recovered. The relative height of humeral head was increased from (0.73±0.15) cm to (1.08±0.08) cm (P<0.05). The CMS was increased from (46.7±3.99) to (91.8±2.32) (P<0.05),and the VAS decreased from (5.3±1.1) to (0.6±0.3) (P<0.05).　Conclusion　The clinical efficacy of arthroscopic greater tuberosity plasty based on digital measurement of the relative height of humeral head for the treatment of acromion impingement syndrome was reliable.

Clinical effect of treating volar marginal rim fractures with arthroscopy-assisted combined variable angle lcp volar rim distal radius plates

YIN Fei, RUI Yong-jun, LI Fen-feng, LIU Jun, WU Yong-wei, MA Yun-hong, SUN Zheng-zhong

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  688-690.  doi:10.13418/j.issn.1001-165x.2017.06.020

Abstract ( 866 )  

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Objective　To investigate the clinical effect of treating volar marginal rim fractures with arthroscopy-assisted combined variable angle lcp volar rim distal radius plates.　Methods　From January 2016 to November 2016, 19 patients who suffered from extreme distal radial fractures were treated in Department of Orthopedics. The assessments included fracture healing time,function of wrist according to DASH scores and Mayo scoresplate.　Results　All of the 19 cases were followed up for 6~16 mouths,with average of 12.1 months．All fractures healed and no loss of reduction occurred in 9~13weeks，with anaverage of 11.2 weeks.The Mayo score was 86 to 95 points(average 92.8 points). the DASH score was from 6 to 11points(average 9.7 points).    Conclusions    Arthroscopy-assisted combined variable locking compression plate may be an effective way to treat extreme distal radial fractures with compound internal fixation on the basis of morphological feature of fractures and the situation of soft tissue because of  easiness of the fixation,early functional training and excellent wrist joint function, it is worth clinical promotion.

Respiratory electrical stimulation training improves diaphragmatic and abdominal muscle function that could treat functional constipation

YE Yun-yi, ZHANG Ming-sheng， LIANG Gui-ying， LI Xin-ping， ZHANG Lei

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  691-694.  doi:10.13418/j.issn.1001-165x.2017.06.021

Abstract ( 718 )  

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Objective    To use the ultrasound to detect the diaphragm thickening rate, the abdominal muscle thickening rate, and diaphragmatic activity. Constipation scoring system is used to evaluate the curative effect, so as to make clear how does the respiratory electric stimulation training play a part in the functional improvement of diaphragm and abdominal muscle.  Methods  46 patients with functional constipation were included in the study for two weeks of treatment. According to the random number, the method is divided into the treatment A group, the treatment B group and the control group. The treatment A group with 15 cases given Lactulose 2 times /day, also underwent pelvic floor muscle biofeedback therapy and respiratory stimulation training 20 minutes each day，3 times/week. In the treatment group B with 16 cases given Lactulose 2 times /day were treated with biofeedback therapy of pelvic floor muscle 20 minutes each day. In the control group, 15 cases were treated with Lactulose 2 times /day. Both at the beginning and end of the treatment, all patients were evaluated by the constipation scoring system, and ultrasonography was used for detection of the diaphragm thickening rate, the abdominal muscle thickening rate, and diaphragmatic activity.　Results　After 2 weeks, in the three groups, the scoring of constipation decreased before treatment (P<0.05). And A group had a score lower than the treatment B group and the control group (P<0.05).The diaphragm thickening rate, the abdominal muscle thickening rate, and the diaphragmatic activity of patients from the treatment of A group were improved than prior to treatment (P<0.05), and there was a statistical difference compared with treatment B group and control group(P<0.05).    Conclusion　Respiratory electric stimulation training can effectively improve the contraction strength of the diaphragm and the abdominal muscle, which can enhance the treatment of pelvic floor muscle biofeedback therapy and improve the effect to functional constipation.

The clinical value of homocysteine in acute cerebral infarction with carotid artery lesions

YIN Wen-ming, YAO Yi-qin, ZOU Rong-cheng

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  695-699.  doi:10.13418/j.issn.1001-165x.2017.06.022

Abstract ( 484 )  

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Objective　The purpose of this study was to investigate the correlation between homocysteine levels and carotid artery lesion in acute cerebral infarction. 　Methods 　A total of 215 patients with clinically diagnosed acute cerebral infarction were divided into two groups, the high Hcy group (n=103) and the low Hcy group (n=112).　Results　Plaques and severe arterial stenosis are more likely to occur in high Hcy group. The level of plasma Hcy positively correlated to the number of plaque and soft plaque (Kendall correlation coefficient=0.145, P=0.006<0.05); the relation between plasma Hcy levels and the incidence of severe arterial stenosis was positive (Kendall correlation coefficient=0.359, P=0.000<0.05).　Conclusion　Plasma Hcy levels in the patients with acute cerebral infarction were positively correlated with the incidence of carotid plaques and stenosis, suggesting active intervention of hyperhomocysteinemia might be of help for the prevention of carotid artery plaques and stenosis.

Synthetic specimen of vestibular apparatus via anterior semicircular canal perfusion

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  700-702.  doi:10.13418/j.issn.1001-165x.2017.06.023

Abstract ( 555 )  

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Horseshoe kidney associated vascular variant

PENG Min, ZHOU Kang-jie, LUO Yun-feng, CHEN Shu-rong，LIU Juan

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  702.  doi:10.13418/j.issn.1001-165x.2017.06.030

Abstract ( 412 )  

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The anatomic features and clinical significance of non-recurrent laryngeal nerve

ZHANG Rui, LI Xing-rui

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  703-704.  doi:10.13418/j.issn.1001-165x.2017.06.024

Abstract ( 1642 )  

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The research progress of treatment for anterior cruciate ligament  tibial  eminence  avulsion  fracture

ZHANG Hong-yi, CHEN Shuai, JIAO Feng

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  705-707.  doi:10.13418/j.issn.1001-165x.2017.06.025

Abstract ( 549 )  

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Research progress on 3D printing medical material to repair bone defect

LIN Jia-yi, YUAN Wei-zhuang, ZHANG Hong-wu

Chinese Journal Of Clinical Anatomy. 2017, 35(6):  708-712.  doi:10.13418/j.issn.1001-165x.2017.06.026

Abstract ( 733 )  

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