Table of Content

25 November 2018 Volume 36 Issue 6

  

Study on arterial distribution of extrahepatic bile duct by microvascular casting technique

XIAO Zhao-ming, LI Ze-yu, LIU Chang, MA Zi-wei, WU Kun-cheng, XU Guang-wei, LIANG Hai-bin, LUO Bao-hua, LUO Shi-wen, LUO Jian-heng, DAI Jing-xing, OUYANG Jun

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  601-605.  doi:10.13418/j.issn.1001-165x.2018.06.001

Abstract ( 785 )  

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Objective　The micro-arterial cast specimens of extrahepatic bile duct were used to elucidate the source and distribution of extrahepatic bile duct blood supply and the characteristics of multiple annular vascular networks between the anastomosis artery chains of the upper duodenal bile duct, providing a clinical anatomical basis for biliary surgery.　Methods　Six cases of extrahepatic bile duct arteries were injected with acrylic resin as arterial filler. Photoshop was used to measure the inner diameter of small blood vessels. The blood supply source and distribution of extrahepatic bile duct were observed and analyzed.  Results  The left and right branches of the proper hepatic artery had arcuate communicating branches above the hepatic duct. There were abundant transverse arteries between the anastomotic artery chains at the left and right edges of the upper duodenal bile duct. The blood supply of anastomotic arterial chain was about 53% from the bottom, 46% from the top and 1% from the middle hepatic artery. Through the measurement of the diameter of the middle segment of each transverse artery and the initial diameter of both sides, it was found that the middle and upper segments of the  transverse arteries of the hepatic duct were larger, with an average middle diameter of （0.26±0.02）mm and（0.24±0.04）mm, respectively. The ratio of inner diameter of the upper segment to the middle segment was 1.09. The ratio of the middle segment to the middle segment was 1. The average inner diameter of the middle part of the lower segment was（0.14±0.03）mm. The ratio of inner diameter to both sides was 0.74.　Conclusions　The blood supply at the upper and lower ends is relatively balanced. In order to alleviate the injury of extrahepatic bile duct blood supply, a small longitudinal incision should be made in the upper part of the duodenum of the common bile duct and the lower part of the small common hepatic duct with less arterial anastomosis as far as possible. The blood supply of the common hepatic duct is abundant, supporting the current proposition that the isolated site of orthotopic liver transplantation is above the confluence of the gallbladder.

Anatomical morphometry of the coracoid process and its clinical significance

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  606-610.  doi:10.13418/j.issn.1001-165x.2018.06.002

Abstract ( 2426 )  

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Objective　To measure the anatomical morphology and spatial relative position of the coracoid process, and to provide anatomical basis for diagnoses and treatments of shoulder joints diseases.   Methods　A total of 165 dry and intact scapulae of Chinese population were collected(61 left and 104 right). Morphological parameters of important structures of the coracoid process were measured: three widths, three thicknesses, three lengths, four distances and three angles. Measurement results underwent statistical analysis.  Results　The width and thickness of the coracoid tip was (13.40±3.09~14.42±2.84) mm and (8.41±1.51~9.07±1.63) mm, respectively. The length from coracoid tip to precipice and from coracoid precipice to base (38.77± 4.54~40.77±4.55) mm and (20.03±2.04~19.18±2.40) mm, respectively; The distance from coracoid tip to suprascapular notch (45.20±4.21~47.03±4.00) mm on the left and right sides was significantly different (P<0.05), while the remaining anatomical morphology and spatial relative position of the coracoid process had no significant difference (P>0.05).   Conclusions　The comprehensive measurement of anatomical morphology and spatial relative position of the coracoid process can provide an anatomical basis for diagnosis and treatment of the shoulder joints diseases, improving the safety and reducing the risk of surgery involving the shoulder joint diseases.

A case report of the anatomical variation in anterior branches of C5 nerve

AN Ming-jie, HAN Yue-yin, ZHUANG Zhuo-kai, CHEN Jun-yu, JIANG Mei-hua

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  610.  doi:10.13418/j.issn.1001-165x.2018.06.026

Abstract ( 589 )  

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X - ray performance and characteristics of cervical vertebral block

LI Jun-hua, WANG Zhi-hong, LI Yi-kai

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  611-614.  doi:10.13418/j.issn.1001-165x.2018.06.003

Abstract ( 2155 )  

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Objective　To investigate the X-ray performance and characteristics of cervical vertebral block.　Methods　The X-ray data of 125 patients with cervical vertebral block were retrospectively analyzed, including 45 males and 80 females, with an average age of 41.9 years old (male to female ratio was 1:1.77), ranging from 24 to 75. The number of nodes, fusion sites, the occurrence of callus, cervical lordosis curvature, and upper and lower vertebral space were analyzed.    Results    Cervical vertebrae block was involved 2 vertebrae in 100 cases, 3 vertebrae in 5 cases, 4 vertebrae in 17 cases, and 5 vertebrae in 3 cases. The single-segment fusion block was the most common in the C2~3 segment (43 cases, 43%), followed by the C3~4 segment (16 cases, 16%). Thirty-six cases (28.8%) of cervical curvature were straightened/anti-arched. Among the X-ray findings, vertebral anterior/posterior osteophytein  was found in 110 cases (88%); stenosis in the upper disc space was found in 7 cases (5.6%); stenosis in the lower disc space was found in 15 cases (11.7%); spinous process fusion was found in 52 cases (41.6%); calcification of the anterior longitudinal ligament was found in 19 cases (15.2%); ligament calcification was found in 17 cases (13.6%); skull base depression was found in 15 cases (12%).　Conclusions　Cervical vertebral block often shows single-segment fusion. Simultaneous fusion of the vertebral body and attachment is more common than the vertebral body fusion alone. Cervical vertebral block is often accompanied by adjacent segment degeneration and basilar invagination.

miR-210-3p suppresses autophagy and promotes apoptosis by targeting autophagy-related gene 7 in bladder cancer J82 cells

HAN Xing-tao, YANG Ling-bo, WEI Peng-tao, LI Xiao-hui, SUN Jian-tao, YANG Jin-jian

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  615-620.  doi:10.13418/j.issn.1001-165x.2018.06.004

Abstract ( 669 )  

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Objective　This paper mainly explored the regulatory mechanism of miR-210-3p in bladder cancer progression in J82 cell.　Methods　Quantitative real-time PCR (qRT-PCR) was applied to detect the expression of miR-210-3p and its target gene autophagy related gene 7 (ATG7) in J82 cells. The luciferase reporter assay was conducted to verify the biological relationship between miR-210-3p and ATG7. The biological functions of miR-210-3p and ATG7 in J82 cells were studied by in vitro experiments (CCK-8, hoechst staining, and Western blot).   Results   miR-210-3p expression significantly reduced the ATG7 expression level. Bioinformatics prediction and luciferase reporter assay demonstrated that miR-23-3p inhibited ATG7 by directly binding to ATG7 3’UTR. In J82 cells, miR-210-3p overexpression inhibited ATG7 expression, cell autophagy and cell proliferation, and induced cell apoptosis.　Conclusions　mir-210-3p can inhibit J82 cell proliferation, autophagy and promote apoptosis through negative regulation of ATG7, thereby promoting the death of cell J82 cells. Therefore, inhibition of autophagy in bladder cancer is essential for the development of autophagy targeting therapy for bladder cancer. This study further supports the mechanism of miR-210-3p in regulation of bladder cancer.

The study of neuropeptide Y in neural pathway between cervical spinal ganglia and cervical sympathetic ganglia in rabbit

HAN Jian-long, QIU Si-qiang, ZHU Xin-wei, LUAN Fang-hai, CHANG Gang, CHENG Ji-zu, ZUO Jin-liang

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  621-625.  doi:10.13418/j.issn.1001-165x.2018.06.005

Abstract ( 635 )  

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Objective　To study the neural pathway between cervical spinal ganglia and cervical sympathetic ganglia, and to explore the neural factors in the pathogenesis of cervical vertigo by detecting the neuropeptide Y (NPY) in cervical sympathetic ganglia after the cervical spinal ganglia electro-stimulated.   Methods　96 New Zealand rabbits were divided into C2, C3, C4, C5, C6, C7 and control groups randomly (n=8 in each group ). The electro-stimulations (width=0.5 ms, 30 Hz, 5 V, time=5 s, 1 time/1 min, and 5 times total) were given to specific spinal ganglia which were revealed. After 30 min, the rabbits were killed through perfusion and the superior cervical sympathetic ganglia (SCG) and inferior cervical sympathetic ganglia (ICG) of both sides were cut. Then the section were made after immunologic reaction and observed under the microscope.　Results　The content of NPY in the same side sympathetic ganglia was higher than the other side sympathetic ganglia and the control group sympathetic ganglia after the electro-stimulation was given to the cervical spinal ganglia, and the difference was statistic significance (P<0.05). When the electro-stimulation was given to the C2, C3 spinal ganglia, the change of the NPY content of sympathetic ganglia were found in SCG mainly; when the electro-stimulation were given to the C4, C5 spinal ganglia, the change of the NPY content of sympathetic ganglia were found in SCG and ICG; when the electro-stimulation were given to the C6, C7 spinal ganglia, the change of the NPY content of sympathetic ganglia were found in ICG mainly.   Conclusion　There is some kind of neural pathway between the cervical spinal ganglia and cervical sympathetic ganglia, and the characteristic of segment and homonymy in this kind of connection is also found, which provides a neuroanatomical basis for the hypothesis of reflex arc in cervical vertigo.

The regulatory effects of propofol on cell proliferation, apoptosis, invasion and migration of human glioma cell line U251

ZHAO Hua-yu, HUO Shu-ping, LIU Yan-hui, KANG Shu-feng

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  626-631.  doi:10.13418/j.issn.1001-165x.2018.06.006

Abstract ( 398 )  

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Objective　To investigate the effects and mechanism of propofol on cell proliferation, apoptosis, invasion and migration of human glioma cell line U251.   Methods　Cells were divided into Propofol (1 M), Propofol (2 M) and Propofol (5 M) group and treated with propofol bisides U251 group. Cell proliferation was determined by CCK8 assay, flow cytometry was performed for cell apoptosis. The invasion and migration abilities of U251 cell were determined by Transwell and wound healing assays. The expressions of Ki67, Caspase-3, vascular endothelial growth factor (VEGF), phosphoinositide 3-kinase (PI3K), Akt, p-PI3K and p-Akt were measured by western blot. 　Results　Compared with U251 group, the cell growth rate was decreased and cell apoptosis rate was increased in Propofol (1, 2, 5 M) groups. Meanwhile, the invasion cells in the propofol (1, 2, 5 M) groups were decreased compared with the U251 group, and wound closure rate was also down-regulated in the propofol (2, 5 M) groups. In addition, propofol inhibited the expressions of Ki67 and VEGF (proliferation- and migration-related proteins) and induced expression of apoptosis-related protein Caspase-3. Propofol also decreased the ratio of p-PI3K/PI3K and p-Akt/Akt significantly.　Conclusions　Propofol reduces the abilities of cell proliferation, invasion and migration of glioma cell line U251 and induces cell apoptosis, the mechanism of which may be related to inhibition of the activation of PI3K/Akt signaling pathway

Rhamnetin regulates the proliferation, invasion and migration of breast cancer MCF-7 via down-regulating the expression of Notch-1

ZHANG Shu-yan1, ZHANG Fang1, JI Ying-hua2

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  632-636.  doi:10.13418/j.issn.1001-165x.2018.06.007

Abstract ( 534 )  

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Objective　To explore the effect, and its molecular mechanism, of rhamnetin on cell proliferation, invasion and migration of MCF-7 cell which is a kind of breast cancer cell.   Methods　MCF-7 cells were divided into four groups: MCF-7 (control group) and rhamnetin (1, 2.5, 5 μM) groups. Cell proliferaion was detected by CCK-8. Cell invasion was measured by transwell. Cell migration was tested by wound healing. The expression of Notch-1, CSL, Hes1, Ki67 and VEGF were detected by western blot.   Results    Low concentration (< 5 μM) rhamnetin had no effect on the cell viability of MCF-7, while it was quite opposite under the circumstance of high concentration (> 5 μM) rhamnetin. The proliferation in rhamnetin (2.5, 5 μM) groups were lower than that of control group (P<0.05). Compared with control group, the invasion and migration in rhamnetin (1, 2.5, 5 μM) groups were decreased (P<0.05) with lower expression of Notch-1, CSL and Hes1 in rhamnetin (P<0.05). Moreover, the rhamnetin (5 μM)-induced declined expression of Notch-1, CSL, Hes1, Ki67 and VEGF were repressed by Notch-1 pathway activating agent Jagged1 (10 μM).   Conclusions　Rhamnetin can restrain the proliferation, invasion and migration of MCF-7 via down-regulating the expression of Notch-1.

The improvement of paliperidone on social communication deficits and its effect on GSK3β phosphorylation in cerebral cortex

DONG Xiao-guang, HU Yan-lai, HU Tao, QU Bao-ming, CUI Gui-xiang, WANG Lan-dong, LI Tao

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  637-641.  doi:10.13418/j.issn.1001-165x.2018.06.008

Abstract ( 412 )  

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Objective　To investigate the effect of a new atypical antipsychotic drug paliperidone on social communication defects in schizophrenia and the possible mechanism of its effect on the GSK3β phosphorylation in the cerebral cortex.　Methods　Dizocilpine (MK-801) was given to mice by intraperitoneal injection continuously to establish the model of schizophrenia. The mice were divided into 3 groups: control group (mice were given by intraperitoneal injection with the same volume of 0.9% saline as other groups), MK-801 group (model group, 0.5 mg·kg-1·d-1 MK-801 was given to mice by intraperitoneal injection, for 7d ), and MK-801+Paliperidone group (paliperidone treatment group, 0.25 mg·kg-1·d-1 paliperidone and 0.5 mg·kg-1·d-1 MK-801 were given to mice by intraperitoneal injection, for 7d). The establishment of the schizophrenia model was evaluated with the stereotyped rotation experiment. Miceprofile software was used to analyze the changes of social communication behavior in the free activity of mice. Western blotting was used to detect the expression of the glycogen kinase 3 beta in the frontal cortex of the mice.　Results　MK-801 treatment significantly increased the stereotyped rotation of the experimental mice and successfully established schizophrenia mouse model. Miceprofile video analysis showed that the number of contact times and duration of the model mice was significantly lower than that of the control group (P<0.01). After treatment with paliperidone, the number and duration of contacts were obviously improved (P<0.01). The results of WB analysis showed that MK-801 significantly decreased the phosphorylation level of GSK3β in the cerebral cortex, and the phosphorylation level of GSK3β could be increased after paliperidone treatment. Conclusions This study shows that paliperidone as a new antipsychotic drug can improve the social communication deficits in animals, which may be related to increased phosphorylation of GSK3β in the cerebral cortex.

Triggering receptor expressed on myeloid cells-1 inhibits autophagy of macrophages under LPS stress

ZHU Ai-ping, LIANG Dao-miao, SU Qing, LI Li-fang, JIA Zhe, HE Li-ping, REN Xiang, SUN Guo-ying

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  642-647.  doi:10.13418/j.issn.1001-165x.2018.06.009

Abstract ( 695 )  

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Objective　To observe the effect of TREM-1 on the expression of autophagy related genes in macrophages.   Methods　The expression of TREM-1 protein in macrophages exposed to lipopolysaccharide (LPS) was observed. TREM-1 agonists (MAB1187) and TREM-1 antagonists (LR12) were used to regulate the activities of macrophage. qPCR was used to detect macrophage autophagy related protein ATG7, ATG5, ATG12, and microtubule associated protein 1 light chain 3 (LC3) mRNA, respectively. Expression of TREM-1, LC3 II/I, and ATG7 protein were detected by Western Blot. The expression of autophagy marker protein LC3 in macrophages under LPS stress and TREM-1 activation was detected by immunofluorescence.　Results　The expression of TREM-1 protein in macrophages was significantly increased under the stress of LPS (400 ng/mL, 1000 ng/mL), and the TREM-1 protein expression in macrophages reached a peak when LPS (1000 ng/mL) acted as macrophage 24 h. ATG7, ATG5, ATG12 and LC3 mRNA expression of macrophage were reduced by LPS stress. When TREM-1 antagonists were given, the expression of ATG7, ATG5, ATG12 and LC3 mRNA increased, and the autophagic gene expression of macrophage was reversed after the use of TREM-1 activator. Western Blot assay showed that TREM-1 inhibited the expression of LC3 II/I and ATG7 proteins in macrophages under LPS stress. Immunofluorescence assay showed that TREM-1 could reduce the content of LC3 protein in macrophages.  Conclusions　The macrophage autophagy is inhibited after the activation of TREM-1 on the membrane of macrophage, suggesting that the TREM-1 of macrophage under LPS stress may play an inflammatory magnification by inhibiting the normal autophagy of macrophages.

The influence of arterial flow resistance and venous flow resistance of the choke area on the survival of perforator flap

CHENG Sheng, XI Shan-shan, HE Yao-zhi, MEI Jin, DING Mao-chao

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  648-651.  doi:10.13418/j.issn.1001-165x.2018.06.010

Abstract ( 384 )  

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Objective　To investigate the arterial resistance and venous resistance of blood flow across the choke vessels and their effects on the survival of perforator flap, through comparative study of the arterial and venous resistance in the same group of flaps.　Methods　Thirty-four Sprague-Dawley rats were randomly divided into two groups: group A preserved the right intercostal posterior artery and the left intercostal posterior vein, and group B preserved the right intercostal posterior artery and the right iliolumbar vein. The distance between the reserved artery and vein was measured. At day 7 after surgery, the survival rate of the flap was measured and the microvascular morphology was observed through lead oxide-gelatin angiography;  Tissues were harvested from the choke area, which then underwent H＆E staining to measure the average microvascular density; Moreover, blood was collected from the tail vein for detection of the contents of lactate.　Results　The distance between the preserved artery and vein in group A was shorter than that in group B, the difference was statistically significant (P<0.05). At day 7 after surgery, the survival rate of group A was 100 percent, while in group B the survival rate of angiosome 1, angiosome 4 and the whole flap was（67.0±13.1）%, 100% and （88.0±6.8）%, respectively; the angiogenesis was more obvious in group A than that in group B, and the difference was statistically significant (P<0.05); the lactate contents in group A and group B were both close to the preoperative level, and the difference was not statistically significant (P>0.05). 　Conclusion　① The venous resistance of blood flow across the choke vessel is greater than that of the arterial resistance; ② It is helpful to reduce the venous resistance of blood flow across the choke vessel and improve the survival rate of the flap by shortening the unilateral distance of the arterial and venous blood flow across the choke area.

Effect of endurance exercise on microstructure changes of femoral tissue in young and old mice

CHEN Yan-hua, SHU Bin, YANG Zhong, BU Fan

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  652-656.  doi:10.13418/j.issn.1001-165x.2018.06.011

Abstract ( 471 )  

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Objective　To observe the changes of femoral microarchitecture in young and old mice after moderate intensity endurance exercise by atomic force microscope (AFM), and explore the appropriate age range of improving osteoporosis and preventing fracture by exercise.　Methods　Twenty clean male C57 mice aged 3 months were used in the youth group, and 20 clean male mice in the old age group were 16 months old. Each group was divided into a control and an exercise group, with 10 mice in each. The mice in the exercise group run on the rotary stick for 12 weeks, and the motion parameters were 15 r/min, and 25 min/day. The control group was raised normally. After the experiment, the femur of each mice was taken for paraffin-embedded sections, and the microarchitecture of femoral cortical bone was observed by AFM.　Results　In the control young group, Haversian systems were regularly surrounded by bone fossae, communicating with each other through canaliculus. Some calcium and phosphorus crystals were distributed in small column, and some in clusters. Compared with the control young group, the number and size of the bone depression in the exercise young group showed a significant decrease in the roughness ( P < 0.05), which suggested that the smoothness of the bone tissue surface increased. Compared with the control young group, there was a change in the number and size of bone depression in the control old group, the number of calcium and phosphorus crystals decreased, and the surface roughness increased significantly (P<0.05), which indicated that there was osteoporosis. Compared with the control old group, there was no significant change of the number and size of bone depression and the number of calcium and phosphor crystals in the exercise old group, and the surface roughness change was not statistically significant, too.　Conclusions　Moderate intensity endurance exercise can optimize the bone microarchitecture and improve bone quality in young mice. But there is no significant improvement in bone microarchitecture in elderly mice with osteoporosis. It suggests that exercise prevention in elderly osteoporosis may need to start from adulthood.

Comparative study of solid and subsolid solitary pulmonary nodules

DOU Yu, LU Xing-ru, MA Xian, YIN Liang, ZHANG Hao, YU Qin

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  657-661.  doi:10.13418/j.issn.1001-165x.2018.06.012

Abstract ( 740 )  

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Objective　 To explore pathological features of solid and subsolid nodules and identify the radiological characteristic differences between them.　Methods　A total of 804 patients with solitary pulmonary nodules (SPNs) were studied retrospectively following surgical resection treatment with a definite postoperative pathology. The SPNs were classified as either solid or subsolid nodules depending on the presence of ground-glass lesion based on thoracic CT scan results. Pathological causes of SPNs were also evaluated and compared between solid and subsolid nodule groups. Demographic (gender and age) and clinical data (smoking and cancer history, the maximum diameter and location of lung nodule) were retrieved to determine difference between solid and subsolid nodules.　Results　Of the 804 SPN patients, 393 (48.9%) cases were identified as benign SPNs and 411 (51.1%) as malignant, while 544 (67.7%) cases were solid nodules and 260 (32.3%) subsolid nodules. In solid nodules group, 333 (61.2%) cases were diagnosed as benign and 211 (38.8%) cases as malignant. In the subsolid nodules group, 60 (23.1%) cases were benign and 200 (76.9%) cases malignant. The proportion of benign lesions in solid nodules was significantly higher than those in subsolid nodules (P<0.001). In addition, there were significant differences in the subtypes of adenocarcinoma between solid and subsolid nodules (P<0.001). The ratios of female patients, nonsmokers and upper lobe locations were much higher in subsolid nodules than solid nodules.   Conclusion   Lung adenocarcinoma related subsolid nodules but not the solid nodules are more inclined to be developed in female and non-smokers (passive smoker) than male and smokers. In most cases, the nodules are found to be presented in upper lobe of the human lungs.

Development and validation of nonlinear finite element model of the whole lumbar spine

LING Qin-jie, LIN Hu, XIE Pu-sheng, DENG Yu-ping, HUANG Wen-hua

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  662-667.  doi:10.13418/j.issn.1001-165x.2018.06.013

Abstract ( 531 )  

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Objective 　To develop the whole lumbar spine finite element model and to validate the model by comparison with the previous vitro experiments. results.　Methods　The CT images of the whole lumbar spine were from a 25 years old male volunteer. The finite element model was established by six software: Mimics 17.0, Geomagic Studio 2013, UG8.5, Hypermesh 13.0 and Abaqus 6.14-4. After finishing a grid convergence test, six lumbar movements (flexion, extension, left bending, right bending, left axial rotation, right axial rotation) were simulated by applying different moment loads to the model. Then the range of motion (ROM) of each lumbar spine functional spinal unit (FSU) was recorded.　Results　The simulating results obtained by the model were similar to those obtained from the in-vitro experiments, and the trend of the two was consistent.　Conclusions　The establishment and validation of the nonlinear finite element model of the whole lumbar spine used in this study can be used to model and analyze future spine-related diseases.

Variation of femoral nerve: one case report

TAO Wei, ZHANG Po, WU He-lin, ZHOU Wang

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  668.  doi:10.13418/j.issn.1001-165x.2018.06.027

Abstract ( 419 )  

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Experimental study on the grouped individual guide template assisted C2  transoral pedicle placement

ZHU Mei-song, PENG Peng, ZHOU Xiao-qi, SU Ze-xin, LI Si-jing,LI Jian-yi, LIN Li-jun

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  669-673.  doi:10.13418/j.issn.1001-165x.2018.06.014

Abstract ( 575 )  

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Objective　Using of 3D reconstruction, computer aided design and rapid prototyping(RP)technology to design and manufacture a novel grouped individual guide template for assisting C2 transoral pedicle placement.　Methods　After CT scanning of 4 adult cadaveric cervical specimens, 3D reconstruction models of upper cervical vertebrae were obtained by Mimics. Then 3D models of C1, C2 and the TARP were imported into Solidworks 2014 to design a grouped individual guide template for AAD. With the technology of rapid prototyping, the grouped individual guide template for AAD was manufactured. The templates were used for C2 transoral pedicle placement in cadavers. Subsequently, CT scan was performed to evaluate the screw position.　Results　All 8 K-wires were inserted into the cervical pedicles. The absolute deviations were (0.85±0.70) mm in axial plane and (0.88±0.53) mm in sagittal plane. No significant differences of the absolute deviations was observed on both the axial and sagittal planes（P>0.05）. In the classification of screw position, 7 screws position were in Type I, and 1 screw was in Type II.　Conclusion　C2 transoral pedicle placement assisted by the grouped individual guide template is highly accurate and simple. It is a new alternative to C2 transoral pedicle placement.

Flexor carpi median: a case report

JIA Cheng-xuan, XU Xu-dong， LIU Xin-ping, YANG Feng, SHI Yan-hui，CHENG Wen-zhi

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  673.  doi:10.13418/j.issn.1001-165x.2018.06.028

Abstract ( 293 )  

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Impact of fixiation spondylolysis using the aerofoil–shaped Ni-Ti alloy on the intervertebral disc

WANG Jian, ZHU Li-xin，YANG Hui，GU Qin-wen，PENG Dao-hu，LI Sen

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  674-677.  doi:10.13418/j.issn.1001-165x.2018.06.015

Abstract ( 533 )  

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Objective　Application of Ni-Ti alloy fixation (AEROFOIL FIXATION) in spondylolysis has been successful. The aim of this study was to analyze its impact on the intervertebral disc using the finite element model.　Methods　A three-dimensional non-linear finite element(FE) model of spondylolysis has been developed. Von Mises stresses and distributions of intervertebral disc were analyzed in flexion, extension, left lateral bending and left axial rotation.　Results　Under different conditions, the maximum stresses of affected disc were increased to 105%、102%、101% and 111%，respectively. After direct repair by AEROFOIL FIXATION technique, the affected disc stresses decreased to 67%, 55%, 88% and 83%, respectively.　Conclusions  AEROFOIL FIXATION, due to  its reasonable structure and excellent biomechanical properties that can prevent the anterior degeneration intervertebral disc and, should be promoted in clinical application, providing another choice for the treatment of lumbar spondylolysis.

Comparison of the direct anterior and posterolateral piriformis-sparing approach in bipolar hemiarthroplasty for the elderly patients with femoral neck fracture

ZHANG Ying-jian，LI Zhi-yong，WU Shu-wen，FANG Guang-wen，SHANG Fu-qing，LIU Wei

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  678-682.  doi:10.13418/j.issn.1001-165x.2018.06.016

Abstract ( 981 )  

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Objective　The aim of this study is to compare the clinical efficacy after bipolar hemiarthroplasty（BHA） via the direct anterior approach（DAA）or posterolateral piriformis-sparing approach（Mis-PLA） following the elderly patients with femoral neck fracture.　Methods　44 elderly patients with femoral neck fracture were divided into a DAA group (n =22) and a Mis-PLA group (n=22) according to the surgical approach. The two groups of patients were followed up for 2 years after the operation. The clinical data，postoperative pain and complications，the time to keep the seat for 1 hour and walking independently，the postoperative Harris score of functional activity in 6 weeks and 2 years and the death rate of patients 2 years after operation were compared between the two groups.　Results　（1）Compared with the Mis-PLA group, the patients in group DAA had longer surgical duration, but the number of patients with pneumonia 72 hours after the operation was less，the VAS score of DAA patients decreased after 24 hours of operation, and the time of keeping the seat for 1 hour and walking independently was earlier than that of the Mis-PLA group (P < 0.05).（2）6 weeks after the operation, the Harris score of Climbing stairs and wearing socks and shoelaces in the DAA group was better than that in the Mis-PLA group (P < 0.05), but there was no statistical difference in the Harris score of the staircase (P >0.05). After 2 years, there was no significant difference in Harris scores between the two groups (P>0.05).（3）After 2 years of follow-up, there was no significant difference in mortality between the 2 groups (P>0.05).　Conclusions　In the elderly patients with femoral head replacement, DAA approach can be more effective than Mis-PLA approach for reducing the incidence of complications associated with long-term bed rest, relieving postoperative pain, and improving the postoperative hip function.

Gluteal muscle contracture release combined with patellar reticulum tension reconstruction for the treatment of springing hip combined with anterior knee pain

JIA Chuan, XU Jian-da, XIE Zi-kang, QU Yu-xing

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  683-689.  doi:10.13418/j.issn.1001-165x.2018.06.017

Abstract ( 590 )  

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Objective　To investigate the necessity of restoring the normal trajectory of the humerus in the treatment of gluteal muscle spasm and anterior knee pain.　Methods　Thirty patients with orthopedic gluteal muscle contracture and anterior knee pain were randomly divided into a control group (n=16) (arthroscopic arthritis gluteal muscle contraction release) and an experimental group (n=14) (arthroscopic gluteal muscle contracture release combined with tightening of the medial patellofemoral reticulum and release of the lateral patellofemoral reticulum). Then the patients with different surgical methods were observed for postoperative recovery, and the WOMAC score, Kujala score, iliac bone harmony angle, lateral humeral angle and complications were compared before and after surgery.　Results　All the 30 patients in the 2 groups were followed up. The average follow-up period was 14.3 months. All incisions healed well. There were no significant difference between the control group and the experimental group in terms of the WOMAC score, Kujala score, iliac bone harmony angle, and lateral humeral angle (P>0.25). The WOMAC scores and tibia harmony angles of the patients in the two groups were significantly lower in the first month, third month, and sixth month after the operation (P<0.05). The Kujala score and lateral tibia angle were significantly higher than before (P<0.05). Compared with the control group, the WOMAC score, Kujala score, iliac bone harmony angle and lateral tibia angle of the experimental group were better than those of the control group in the first month, third month, and sixth month after the operation (P<0.05).　Conclusions　Arthroscopic gluteal muscle contraction released combined with patellofemoral reticulum can better relieve the symptoms of anterior knee pain caused by long-term gluteal muscle contracture and reduce the lateral displacement of the tibia.

Application of screw placed under direct vision in lumbar degenerative disease treated with pedicle screw fixation

YIN Qu-dong, GU San-jun, SUN Zhen-zhong, SONG Shen, ZHOU Zi-hong, CHEN Li

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  690-693.  doi:10.13418/j.issn.1001-165x.2018.06.018

Abstract ( 420 )  

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Objective　To investigate the application effect of screw placed under direct vision in lumbar degenerative disease treated with pedicle screw fixation.　Methods　120 patients with lumbar degenerative disease were treated with pedicle screw fixation by an open posterior approach. According to the placement method of pedicle screw, they were divided into group A with 80 cases using the traditional method adopting the crista lambdoidalis as anatomical marker for screw placement (group A, 80 cases), and group B with 40 cases using the media-inferior edge of the pedicle as the anatomical landmark for screw placement under direct vision after laminectomy or fenestration as anatomical mark. There was no statistically significant difference in general data between the two groups (P>0.05). The fluoroscopy time, placement time of pedicle screw, intraoperative blood loss, position of screw, fusion rate, functionary recovery (JOA score) and incidence of complications were recorded and compared between the two groups.　Results　The fluoroscopy time, placement time, intraoperative blood loss and the position of screw in group B were less or better than those in group A, and the differences were statistically significant (P<0.05); the functional recovery and complications in group B were better than those in group A, but the differences were not statistically significant (P>0.05); the fusion rate was 100% in both groups.　Conclusions　The method of pedicle screw placed under direct vision is simple and effective, which can be used as a supplement to traditional methods in some cases for degenerative diseases of lumbar spine.

Clinical application of free descending genicular artery perforator flap for coverage of soft tissue defect of foot

BAO Jing-jing, JIANG Lei, HUANG Xian-jun, PAN Zhi-jun

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  694-696.  doi:10.13418/j.issn.1001-165x.2018.06.019

Abstract ( 515 )  

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Objective　To summarize the method and clinical efficacy of using the descending genicular artery perforator flap for resurfacing foot wounds.　Methods　The descending genicular artery perforator flap was adopted for coverage of soft-tissue defects over the foot in 8 cases between Mar, 2014 to Dec, 2016. The area of the skin flap ranged from 7.0cm×9.0 cm to 9.0 cm×20.0 cm, The perforator flaps included the genicular artery perforator flap in 5 cases, and the musculocutaneous perforator flap in 3 cases.  Result　 In the 8 cases of clinical application, all flap survived uneventfully. Patients were followed up 3 to 10 months with an average of 8 months. The appearance, texture, and colour of the flaps were similar to those of the donor site.　Conclusions　The descending genicular artery perforator flap, being consistent in perforator location, moderate in vascular caliber, appropriate in skin thickness, is an effective method to repair the soft-tissue defects of the hand and foot.

Clinical outcomes of XLIF through small incision approach combined with lateral pedicle screw fixation for degenerative lumbar segmental instability

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

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  697-700.  doi:10.13418/j.issn.1001-165x.2018.06.020

Abstract ( 547 )  

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Department of Orthopedic Surgery，Sanshui Hospital，Foshan 528100, China

Application of pig bladder training model with bilateral ureteral in hysteroscopic training procedure

LIU Dan,SHUAI Ru-zhen, MA Zhao, LI Dan-dan, WU Xue，LV Chun-ling，HA Chun-fang

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  701-704.  doi:10.13418/j.issn.1001-165x.2018.06.021

Abstract ( 762 )  

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Objective　To get a model similar enough to “human uterine” for the training of elaborated hysteroscopy skills.　Mathods　Ready-made pig bladder training models with partial bilateral ureteral were used in this study. Training with the pig heart with four chambers were used as the control group. A two-way evaluation was performed for both the trainees and trainers.　Results　There were statistical significance between the two groups in all three training stations including basic hysteroscopic skill training，operating skill training and electrical operation hysteroscopic skill training due to the great similarity between the pig bladder  and the human uterus, giving the trainees with its realistic tactile feeling，better anatomy recognition，simulated conditions in the surgical environment（P<0.05）.    Conclusions    Pig bladder is the ideal realistic and lifelike uterine model for the training of hysteroscopy skills on account of simulating real conditions in the surgical environment.

Study on the application of fluorescent materials in ducts cast specimens

ZHONG Guang-ming, YAU huo-sheng, FENG ling, PU Yong-hua

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  705-707.  doi:10.13418/j.issn.1001-165x.2018.06.022

Abstract ( 515 )  

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Treatment progress of the fingers degloving injuries

SHAO Mu,JU Ji-hui,HOU Rui-xin

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  708-710.  doi:10.13418/j.issn.1001-165x.2018.06.023

Abstract ( 681 )  

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Research progress of the excretion drainage mechanism of the mastoid cavities mucosa in the middle ear

TIAN Guang-yong, LI Jun-zheng

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  711-713.  doi:10.13418/j.issn.1001-165x.2018.06.024

Abstract ( 476 )  

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Prevention and treatment of pelvic lymphocele after gynecologic cancer surgery

DONG Meng, LU Xiao-yuan

Chinese Journal Of Clinical Anatomy. 2018, 36(6):  714-716.  doi:10.13418/j.issn.1001-165x.2018.06.025

Abstract ( 502 )  

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