Chinese Journal of Clinical Anatomy

Morphological study of lumbar intervertebral veins and its clinical significance

SU Zhi-hai, ZHAO Qing-hao, WANG Min, LIU En-qing, LIU Bin, DING Zi-hai, LV Hai

Chinese Journal of Clinical Anatomy. 2019, 37(4): 361-365. doi: 10.13418/j.issn.1001-165x.2019.04.001

Abstract ( 448 )

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Objective　To study the anatomy and clinical significance of lumbar intervertebral veins. Methods　12 embalmed cadavers were dissected to observe the tributaries and distribution of the lumbar intervertebral vein, and their relationship with nerve roots in the intervertebral foramina. The diameter and length of branches of the lumbar intervertebral vein were measured by the Vernier caliper (accuracy 0.01 mm). Results The branches of the intervertebral veins could be observed in all the 120 intervertebral foramina of 12 embalmed cadavers. According to the distribution and distribution of tributaries of the lumbar intervertebral vein, and their relationship with nerve roots can be divided into four types. The average diameter of 199 branches of the lumbar intervertebral veins was （2.13±0.58） mm and the maximum outer diameter was 4.16 mm. Conclusions The lumbar intervertebral veins are an important anatomical structure of the lumbar spine. When percutaneous transforaminal endoscopic disscectomy is performed in the safe triangle area, it may lead to the rupture of the intervertebral veins. Attention should be paid to the presence of the intervertebral veins, and early ligation or adequate hemostasis should be performed during operation, which may reduce postoperative complications such as nerve insensitivity. For minimally invasive spine surgeons, understanding of the anatomy of the lumbar intervertebral veins adequately may have some clinical implications.

The anatomic features of variant hepatic artery and its possible clinical significance

HOU Yan-hong, CUI Ai-ling, LIU Xue-min, LI Jian-bin, LI Ming, CAO Jing

Chinese Journal of Clinical Anatomy. 2019, 37(4): 366-370. doi:10.13418/j.issn.1001-165x.2019.04.002

Abstract ( 937 )

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Objective　To investigate the anatomical features of variant hepatic artery so as to provide morphological data for clinical operation, such as related vascular imaging examination, surgery and interventional therapy.　Methods　Twenty-five adult corpses were dissected in the routine method. The branches of the proper hepatic artery and their distributions were traced along the common hepatic artery, and the distributions were studied.　Results　The variant rate of proper hepatic artery and its branches was 28%. Some variant branches beyond the Hitta classification were found in 2 cases, in which the right gastric artery was not found as expected on the right wall of the proper hepatic artery；it originated from the left wall and was distributed in the liver and stomach, and was called "hepatogastric artery (HGA)" in the literature. In one of the two specimens, a branch was found originating from the posterior wall of HGA and also distributed in the liver and stomach, which was thus called "hepatogastric accessory artery".　Conclusion　HGA originates from the left wall of the proper hepatic artery in two of the specimens, and is the main arterial source of the right side of the lesser curvature of the stomach, and has branches to nourish the liver and other parts of the stomach as well. This research contributes to the morphological data of the variant hepatic artery, and may give some guide to the related clinic operation.

Characteristics of the inclined position of high-angle skeletal class III malocclusion

DING Qi, JIA Ying, LIU Juan, YANG Hua

Chinese Journal of Clinical Anatomy. 2019, 37(4): 371-376. doi:10.13418/j.issn.1001-165x.2019.04.003

Abstract ( 1033 )

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Objective　To investigate tip and torque characteristics of all teeth in patients with high-angle skeletal class III malocclusion in order to provide guidance for clinical treatment. Methods　Dicom data of cone-beam CT (CBCT) of 24 patients with high-angle skeletal class I (13 patients) and III malocclusion (11 patients) meeting the inclusion criteria were collected. Tip and torque of all teeth (except the third molar) were measured respectively by the software Invivo5.1.　Results　(1) Inclination angle of the same name teeth had a good consistency in high-angle skeletal class I class III, P＞0.05； the data of the same name teeth were processed together hereinafter. (2) Comparison of sagittal direction between class III and I. In class Ⅲ malocclusion: ① It was showing a trend of increase in the lingual root torque of the anterior upper teeth, but only the canines had significant differences, P＜0.05; ② Lingual root torque of anterior lower teeth had decreased with significant difference, P＜0.05.③ There was no significant difference in the trend of mesio-inclination of the upper posterior teeth and distal inclination of the lower posterior teeth, P＞0.05. (3)Horizontal comparison of direction of skeletal class I and Ⅲ: ①The distal inclination of the anterior teeth in the upper jaw increased with significant difference and only distal inclination of incisors of the lower jaw increased in significant differnce, P<0.05. ② Lingual root torque significantly increased in the upper posterior teeth but decreased in the lower posterior teeth without statistical differnce. (4) Comparison of high-angle skeletal I and III with normal sagittal and coronal inclination of Andrews: ① Sagittal direction: lingual root torque of the upper and lower anterior teeth of high-angle skeletal I and III increased and the upper and lower posterior teeth had significant mesio-inclination. ② Coronal direction: the distal inclination of the upper and lower anterior teeth of skeletal I and III with high angle increased, while the lingual torque of the upper and lower posterior teeth increased.　Conclusions　(1)The vertical compensation of high-angle skeletal class Ⅲ is more significant than that of sagittal compensation. (2) High-angle skeletal class Ⅲ of upper and lower anterior teeth have much higher risk of bucco (labial)-lingual tilting movement, and more attention should be paid to the overall movement of teeth when moving. (3) The posterior teeth of maxilla have obvious buccal inclination in high-angle skeletal class III and the lateral extension range of the upper dentition decreases, which may reduce the stability after arch expansion.

Morphological research of anterior inferior cerebellar artery loop and jugular bulb in patients with sudden deafness

YANG Jing-ya, TIAN Guang-yong, XU Piao

Chinese Journal of Clinical Anatomy. 2019, 37(4): 377-380. doi:10.13418/j.issn.1001-165x.2019.04.004

Abstract ( 678 )

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Objective　To investigate the association between sudden deafness (SD) and morphological character of anterior inferior cerebellar artery loop and jugular bulb.　Methods　MRI scanning and three-dimensional reconstruction of inner ear was observed in 80 patients with sudden deafness of unilateral outset (80 ears) and 36 healthy adults (72 ears). The SD group consisted of patients with SD of unilateral outset (80 ears) and the control group consisted of healthy adults (72 ears). The primary endpoints: (1) whether anterior inferior cerebellar artery loop juts out into the internal auditory canal (IAC), (2) the spatial relationship between the anterior inferior cerebellar artery loop, the facial nerve and the cochleovestibular nerve, (3) the spatial relationship between the jugular bulb and surrounding structures. Results　(1) Proportion of anterior inferior cerebellar artery loop jutting out into IAC did not differ in both groups: 35 ears (43.8%) in the SD group and 29 ears (40.3%) in the control group, P=0.665. (2) Neither did the proportion of different types that were classified by spatial relationship between the anterior inferior cerebellar artery loop, the facial nerve and the cochleovestibular nerve. 9 superior type (11.3%), 53 medial type (66.3%) , 11 inferior type (13.8%), 7 anterior type (8.8%) and no posterior type could be observed in the SD group. 8 superior type (11.1%) , 46 medial type (63.9%), 11 inferior type (15.3%), 7 anterior type (9.7%) and no posterior type could be observed in the control group, P=0.771. (3) The proportion of jugular bulb types differed significantly between two groups. 2 were type I (2.5%) , 40 medial type Ⅱ(50.0%), 36type Ⅲ (45.0%) , 2 type Ⅳ(2.5%) in SD group. There were no type I, 19 type Ⅱ(26.4%) , 46 type Ⅲ (63.9%), 7 type Ⅳ (9.7%) in the control group( P＜0.001). Conclusion Different jugular bulb subtypes are associated with higher risk of SD. Jugular bulb type Ⅱ is associated with high risk of SD among type I, Ⅲ and Ⅳ. Whether the anterior inferior cerebellar artery loop juts out into IAC and the relationship among the anterior inferior cerebellar artery loop, the facial nerve and the cochleovestibular nerve are not associated with higher risk of SD.

Diffusion tensor imaging observation and clinical application of the cisternal segment of trigeminal nerve

LI Pei, LI Pin-pin, ZU Xiang-yang, FU Sheng-qi

Chinese Journal of Clinical Anatomy. 2019, 37(4): 381-385. doi:10.13418/j.issn.1001-165x.2019.04.005

Abstract ( 652 )

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Objective　To provide the imaging basis on microstructure changing for the clinical diagnosis of trigeminal neuralgia.　Methods　There were 150 normal persons and 100 patients with primary trigeminal neuralgia selected by diffusion tensor imaging (DTI) scanning of the cranial brain, and all patients were unilateral. The patients were divided into group A (close or contact group), group B (mild compression group), group C (severe compression group) and group D (compression deformation and atrophy group) according to the degree of lesion. The region of interest was divided into the cisternal segment of trigeminal nerve and the lesion site of trigeminal neuralgia at workstation, and the apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value of the region of interest were measured. ADC values and FA values of different ages, sites, the affected and healthy sides of trigeminal neuralgia, and different lesions of the trigeminal cerebral cistern were compared.　Results　There was no statistical differences in other ADC values and FA values between the groups under 35 years old, 35~55 years old and over 55 years old except the ADC value at 6 mm and 9 mm from the brainstem (P＞0.05). Apart from the FA values at 6 mm and 9 mm, statistical differences in other FA values and ADC values between the 0 mm, 3 mm, 6 mm and 9 mm length from brainstem of the cisternal segment of trigeminal nerve were found (P＜0.05). statistical differences in the ADC values and FA values among the affected-side group, the healthy-side group of trigeminal neuralgia and the normal group were found(P＜0.05), and no statistical difference in ADC values and FA values between the healthy-side group of trigeminal neuralgia and normal group was found (P＞0.05). Statistical differences in ADC values and FA values among the A, B, C and D groups on the affected side of trigeminal neuralgia were found (P＜0.05).　Conclusions　The ADC values and FA values of the cisternal segment of trigeminal nerve are closely related to the age, position and the degree of vascular compression on the affected side of trigeminal neuralgia. DTI can provide an objective imaging diagnostic basis for the changes in the microstructure of the trigeminal cistern.

Digital three-dimensional anatomy of abdominopelvic ureter and adjacent structures

ZHENG Li-mei, YU Hong-rong, XU Xiao-wu, PAN Zhi-yue, LI Yan-bing, HUANG Wen-hua

Chinese Journal of Clinical Anatomy. 2019, 37(4): 386-389. doi:10.13418/j.issn.1001-165x.2019.04.006

Abstract ( 1040 )

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Objective　To provide the anatomic basis for ureteral dissociation in radical hysterectomy by studying the anatomical characters of ureter in abdominopelvic cavity.　Methods　The CTA data of 65 female pelvic patients were collected from Apr.2017 to Dec.2018. Through the 3D reconstruction with ureters, pelvic artery and uterus, the pathway of abdominopelvic ureters was observed. We measured the distance from the ureter to the pelvic artery and the ureter to uterus, then observed the adjacent structures around ureters. Results　There were three types of the iliac artery across the ureter. On the left side, the common iliac artery (33.84%), the bifurcation of common iliac artery (13.85%) and the external iliac vein (55.38%) crossed with the ureter; on the right side, the common iliac artery (27.69%) the bifurcation of the common iliac artery (20.00%), and the external iliac vein (52.30%) crossed with the ureter. The entrance of the “ureteric tunnel” corresponded to the cervix (66.15%) and the entrance of the ureter into the bladder corresponded to the vagina (70.7%). The distance between the bifurcation of the abdominal aorta and the ureter was (32.45±6.24) mm on the left and (39.3±5.78) mm on the right. The distance between the bifurcation of the common iliac artery and the ureter was (10.55±4.85) mm on the left and (13.34±5.49) mm on the right. The distance between the ureteric tunnel entrance and the uterine was (16.94±6.83) mm on the left and (18.11±6.53) mm on the right. The distance between the ureter and the lateral margin of the inner cervical was (19.26±7.62) mm on the left and (22.5±7.41) mm on the right. The distance between the ureter and the lateral margin of the external cervical was (17.06±6.19) mm on the left and (22.49±4.94) mm on the right. There were statistical differences between the above mentioned two sides (P<0.05).　Conclusion　These findings provide novel and important references to the anatomic relationship of the ureter in abdominopelvic cavity and adjacent structures. It may help surgeons reduce the risk of ureteric injury in radical hysterectomy.

N-acetylcysteine ameliorates learning and memory abilities via the Notch1/hes1 signaling pathway of the hippocampus in a valproic acid-induced rat model of autism

XIANG Zhe, ZHANG Ying-hua, HE Xue-ling, WANG Li-jun, CUI Wei-gang

Chinese Journal of Clinical Anatomy. 2019, 37(4): 390-396. doi: 10.13418/j.issn.1001-165x.2019.04.007

Abstract ( 423 )

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Objective　To investigate the effects of N-acetylcysteine (NAC) on learning and memory abilities, as well as the molecular mechanisms underlying the therapeutic roles in a valproic acid (VPA)-induced rat model of autism.　Methods　After prenatal exposure to VPA, the three-chamber test was used to identify the autism modeling, the expression of the signaling molecules of the Notch1/hes1 signaling pathway Notch1, Notch intracellular domain (NICD), Jagged1 and Hes1 in the hippocampus (HC) of autistic rats was determined using Western blot, the expression of Hes1 was determined using the immunohistochemical technique. Then, the roles of NAC in learning and memory abilities and the Notch1/hes1 signaling pathway in the VPA-induced autism model were investigated.　Results　Compared with the control group, VPA increased the time spent in finding the platform, decreased the number of crossing platform and the time spent in the platform. However, compared with the VPA group, VPA+NAC group lowered the time spent in finding the platform, increased the number of crossing platform and the time spent in the platform. Simultaneously, the expression levels of NICD and Hes1 in VPA+NAC group decreased in the HC of autism model, and NAC ameliorated learning and memory abilities in the autism model rats.　Conclusion　The beneficial effects of NAC in ameliorating learning and memory abilities of autism model may be mediated by attenuating the Notch1/hes1 pathway activity.

Regulatory effect of sodium tanshinone IIA sulfonate on cardiac function and immune response in rats with myocardial ischemia-reperfusion injury

LI Man, WANG Zhen-jun, LIU Jie-yun, QIN Lei

Chinese Journal of Clinical Anatomy. 2019, 37(4): 397-402. doi:10.13418/j.issn.1001-165x.2019.04.008

Abstract ( 396 )

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Objective To investigate the effects of sodium tanshinone IIA sulfonate on cardiac function and immune response in rats with myocardial ischemia-reperfusion (I/R) injury and its mechanism. Methods The model of myocardial ischemia-reperfusion was established by coronary artery ligation. The rats were randomly divided into five groups: Ctrl group, I/R group, I/R+TIIA (0.5 mL), I/R+TIIA (1 mL) group and I/R+TIIA (2 mL) group. The mean ventricular systolic pressure (MAP), left ventricular systolic pressure (LV) and heart rate (HR) were measured. The expression of heart damage markers and the content of oxidative stress indicators were detected by Elisa test. HE staining and TUNEL staining were used to evaluate myocardial injury. The changes of CD4+iNOS+ and CD4+IL-10+ apoptosis in peripheral blood were evaluated by flow cytometry. Western blotting was used to detect the expression of apoptosis-related proteins and P65, IL-8 and TNF-α. Results Sodium tanshinone II A sulfonate injection could up-regulate the levels of MAP, HR and LVSP to improve the cardiac function of I/R model rats (P<0.01), reduce the expression of CK-MB, cTnΙ and MB in serum, and reduce the expression of MDA and LDH while increase SOD, improve the pathological changes of myocardial tissue, inhibit myocardial apoptosis, and up-regulate Bcl-2 and down-regulate the Bax (P<0.01), decrease apoptosis of iNOS+ and increase IL-10+ in order to improve Th1/Th2 balance (P<0.01), inhibit the down-regulation of P-P65, IL-8 and TNF-α expression induced by I/R injury (P<0.01). Conclusions Sodium tanshinone IIA sulfonate injection has protective effect on myocardial ischemia-reperfusion injury which is related to improving cardiac function and regulating immune response.

Antioxidant and neuroprotective effects of Codonopsis pilosula polysaccharides on hypoxic-ischemic brain injury induced by Nrf2 pathway

MA Jing, HE Wen-long, GAO Chong-yang, YU Rui-yun, XUE Peng, NIU Yong-chao

Chinese Journal of Clinical Anatomy. 2019, 37(4): 403-408. doi:10.13418/j.issn.1001-165x.2019.04.009

Abstract ( 481 )

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Objective　To study the antioxidant and neuroprotective effects of Codonopsis pilosula polysaccharides (CPP) and its possible mechanism.　Methods　Rice method was used to establish HIBI rat model. Normal saline was given to the sham group and the HIBI group, and corresponding doses of CPP solution were given to the drug groups. The neurological function, cerebral water content of rats, histopathologic changes, apoptosis in the rat hippocampus, the level of lipid peroxide, the expression of antioxidant and neuroprotective proteins were evaluated.　Results　Compared with the model group, the neurological function, cerebral water content and the pathological injury of brain tissue were significantly reduced (P<0.01). The apoptosis rate, expression of Bax, content of LDH and MDA also decreased significantly (P<0.01). Expression of Bcl-2 and activity of SOD were up-regulated (P<0.01). In addition, the expressions of bFGF, BDNF, PSD95, SYP, Nrf2 and HO-1 were significantly up-regulated (P<0.01). Conclusion　CPP has antioxidant and neuroprotective effects on hypoxic-ischemic brain injury, and its function may be related to mediating Nrf2 signal pathway.

Correlation analysis of VEGF/FGF2 expression in the hemorrhoidal mucosa and vascular epithelial cells with hemorrhoids staging

WANG Qi, JING Fang-yan , DENG Yong-jian

Chinese Journal of Clinical Anatomy. 2019, 37(4): 409-413. doi:10.13418/j.issn.1001-165x.2019.04.010

Abstract ( 509 )

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Objective　To investigate pathogenetic mechanism and progression of hemorrhoids at different stages by analyzing the expression of endothelial growth factor (VEGF) and basic fibroblast growth factor (FGF2).　Methods　134 hemorrhoids specimen were collected from the out-patients of Nanfang Hospital, and there were 42 cases of hemarrhoids in gradeⅠ, 45 in grade Ⅱ, 47 in grade Ⅲ . Normal tissues of 40 cases among these patients were used as controls. Histopathological changes were obtained from HE stained slide of the disease tissues, as well as the expression of vascular endothelial cell growth factor (VEGF) and basic fibroblast growth factor (FGF2) with immunohistochemical staining.　Results　The epithelial cells were not injured and intact covering in the mucosa of the normal group and grade Ⅰ hemorrhoids, and no dilated blood vessels were found in these tissues. In grade Ⅱ hemorrhoids, they showed injury of the covering epithelial cells and mucosal muscularis, and neovascularization had been found in the mucosae propria. Grade Ⅲ hemorrhoids showed destructive cells of the covering epithelia in the mucosa, newly formed vessels with thickened wall, tortuous and dilated lumen in the mucosae propria. In comparison with the normal mucosa, expression of VEGF in fibroblasts was significantly increased along with hemarrhoids grading (F=883.961, P<0.01), and so did FGF2 (F=656.013, P<0.01); the same changes were observed with examination of VEGF (F=776.561, P<0.01) and FGF2 (F=1066.458, P<0.01) in vascular endothelial cells. Conclusion VEGF and FGF2 can promote the proliferation of vascular endothelial cells and fibroblasts in the formation of hemorrhoids, and can also be used as progression biomarkers of hemorrhoids.

The effects of miR-30a-3p on Hypoxia/Reoxygenation induced injury of cardiomyocytes by targeting NOD1

LIU Jian-hua, LEI Da-zhou, ZHOU Fan, QI Jun-jie, LI Shi-xun

Chinese Journal of Clinical Anatomy. 2019, 37(4): 414-420. doi:10.13418/j.issn.1001-165x.2019.04.011

Abstract ( 503 )

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Objective　To explore the targeting relationship between miR-30a-3p and NOD1, and its effect on Hypoxia/Reoxygenation induced injury of cardiomyocytes and its mechanism.　Methods　Cells were divided into Ctrl, H/R, miR-30a-3p mimic and miR-30a-3p inhibitor groups. After treatment with Hypoxia/Reoxygenation, cells in each group were transfected with corresponding miRNA. RT-PCR was performed for measuring the gene levels of miR-30a-3p and NOD1, luciferase reporter assay was performed for measuring the relationship between miR-30a-3p and NOD1, Western blot was used to determine the protein levels of NOD1, p-RPI2, p38 MAPK, NF-κB (p65), cl-caspase-3, cell viability was measured by CCK8, cell apoptosis was determined by Hoechst, and LDH, CK, MDA, T-SOD levels were detected by kit. Results　The expression level of miR-30a-3p decreased with the hypoxia-reoxygenation treatment time, and the expression level of NOD1 gene increased with the hypoxia-reoxygenation treatment time. In the luciferase reporter assay, the luciferase activity of NOD1 WT+miR-30a-3p mimic group was significantly lower than that of the NOD1 WTR+NC group. Compared with the Ctrl group, the gene level of miR-30a-3p, cell viability, T-SOD level were decreased, and the protein levels of NOD1, p-RPI2, p38 MAPK, NF-κB (p65), cl-caspase-3, expression levels of LDH, CK, MDA, cell apoptosis rate were increased in the H/R group. Compared with the H/R group, the gene level of miR-30a-3p, cell viability, T-SOD level were increased, and the protein levels of NOD1, p-RPI2, p38 MAPK, NF-κB（p65）, cl-caspase-3, expression levels of LDH, CK, MDA, and cell apoptosis rate were decreased in the miR-30a-3p mimic group. Meanwhile, the gene level of miR-30a-3p, cell viability, and T-SOD level were decreased, and the protein levels of NOD1, p-RPI2, p38 MAPK, NF-κB（p65）, cl-caspase-3, expression levels of LDH, CK, MDA, cell apoptosis rate were increased in the miR-30a-3p inhibitor group.　Conclusion　miR-30a-3p can target NOD1, alleviate the Hypoxia/Reoxygenation induced injury of carddiomyocytes, and the mechanism may be related to regulation of the NF-κB signaling pathway.

Role of NF-κB in pathogenesis of allergic rhinitis

ZHANG Min, WU Dan, LIU Li-xing, HOU Sai-rong, CAI Li-xi

Chinese Journal of Clinical Anatomy. 2019, 37(4): 421-424. doi: 10.13418/j.issn.1001-165x.2019.04.012

Abstract ( 252 )

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Objective　To experimentally investigate a potential mechanism of the TLR-NF-κB signaling pathway in the pathogenesis of allergic rhinitis (AR), and the role of NF-κB in eosinophil aggregation.　Methods　A total of 50 rats were randomly divided into five groups with A (control group), B (AR group), C (group of AR+PGN), D (group of AR+PGN+Pam3CSK4), and E (group of AR +PGN+BEL). AR model was established with ovalbumin. Hematoxylin and eosin (H&E) staining was used to detect the morphologic change of nasal mucosa and count the number of infiltrated inflammatory cell. The contents of IFN-γ, IL-4, MBP and IgE in nasal cleanser were detected by ELISA. Expression of NF-κB and TLR2 was measured by Real-Time polymerase chain reaction (PCR) and Western blot.　Results　Obvious allergic injury was observed in AR rats (B group). The number of infiltrated eosinophils in nasal mucosa in group B was higher than in other groups. The expressions of IL-4, MBP and IgE in group B were higher than in group A (P＜0.05). Neutrophil infiltration was predominant in nasal mucosa of group C, and the expression of IFN-γ, TLR2 and NF-κB was higher in group B (P＜0.05). Inflammatory cell infiltration, IL-4, MBP and IgE expression in group D and E were lower than in group B (P＜0.05).　Conclusions　Regulating the expression of TLR-NF-κB pathway and inhibiting the over-expression of NF-κB is beneficial to regulating the aggregation of eosinophils in the pathogenesis of allergic rhinitis.

Regulatory effects of miR-138 overexpression on proliferation, apoptosis and movement of thyroid carcinoma cell line CAL-62 through inhibiting TCF-4

WU Min, HOU Hui-zhen, SI Ting-lin

Chinese Journal of Clinical Anatomy. 2019, 37(4): 425-430. doi:10.13418/j.issn.1001-165x.2019.04.013

Abstract ( 602 )

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Objective　To explore the mechanism of regulatory effects of miR-138 overexpression through inhibiting TCF-4 expression on the proliferation, apoptosis and movement of thyroid carcinoma cell line CAL-62.　Methods　miR-138 mimic was transfected into CAL-62 cells, and detected by RT-PCR. After overexpression of pcDNA vector, TCF-4 was transfected into CAL-62 cells, and Western blot was used to detect the expression levels of TCF-4, proliferating nuclear antigen 67 (Ki67), proliferating cell nuclear antigen (PCNA), caspase-3, caspase-9, E-cadherin, Vimentin and target genes cycD and c-Myc. EDU staining was used to detect the cell proliferation. Hoechst staining was used to detect the cell apoptosis, and transwell was used to detect the cell invasion ability.　Results　Compared with the control group, the protein expression levels of caspase-3, caspase-9 and Vimentin in miR-138 transfection+TCF-4 group were significantly decreased (P<0.01). The protein expression levels of Ki67, PCNA, E-cadherin, cycD and c-Myc were significantly increased (P<0.01). And the apoptosis of thyroid tumor cells was significantly inhibited (P<0.01), and the proliferation and invasion were significantly promoted (P<0.01). Compared with TCF-4 group, the protein expression levels of caspase-3, caspase-9 and Vimentin in miR-138 transfection+TCF-4 group were significantly increased (P<0.01). The protein levels of Ki67, PCNA, E-cadherin, cycD and c-Myc were significantly decreased (P<0.01). Proliferation and invasion of thyroid tumor cells were significantly inhibited (P<0.01), as well apoptosis was significantly promoted (P<0.01).　Conclusions　miR-138 overexpression can significantly inhibit the proliferation and invasion and significantly promote the apoptosis of thyroid cancer cell line CAL-62, by inhibiting TCF-4 expression.

Retrospective study for CT predicting of pelvic lymph node metastasis in muscle-invasive bladder urothelial carcinoma

KANG Li-li, CHEN Jun-hong, HE Xue-ting, LI Ting-jie, GAO Fei, YANG Mei

Chinese Journal of Clinical Anatomy. 2019, 37(4): 431-435. doi:10.13418/j.issn.1001-165x.2019.04.014

Abstract ( 493 )

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Objective　To evaluate the diagnostic accuracy of computed tomography (CT) for pelvic lymph node metastasis in muscle-invasive bladder urothelial carcinoma (MIBUC).　Methods　The present study retrospectively assessed the clinical and imaging characteristics of 40 MIBUC patients who underwent radical cystectomy and pelvic lymphadenectomy. The relationship between CT imaging characteristics and pathological examination for pelvic lymph node metastasis was assessed in MIBUC patients.　Results　(1) Compared to pathological diagnosis, CT imaging examination for pelvic lymph node metastasis had an accuracy of 90%, a sensitivity of 75%, and a specificity of 93.8%. (2) The pelvic lymph node metastasis rate increased along with more advanced tumor stage (T1, 0; T2, 9.1%; T3, 45.5%; T4, 100%).　Conclusions　(1) CT imaging characteristics are of great importance for evaluating pelvic lymph node metastasis in MIBUC patients. (2) The probability of metastatic pelvic lymph nodes significantly increases with more advanced T stages in MIBUC patients (P<0.05).

Impact of sperm parameters on the outcome of intrauterine insemination cycles

LI Qing, HU Shao-fei, WANG Li-hua, HUANG Yi, DENG Zhu-xiu, ZHU Mao-ling

Chinese Journal of Clinical Anatomy. 2019, 37(4): 436-441. doi: 10.13418/j.issn.1001-165x.2019.04.015

Abstract ( 146 )

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Objective　To evaluate the sperm parameters in semen analysis and before/after preparation that can affect the clinical pregnancy rate after intrauterine insemination (IUI).　Methods　A single centre retrospective observational cohort study included 696 IUI cycles among couples in unexplained and male subfertility treated with gonadotrophins. Results　The clinical pregnancy rate in women inseminated with 30×106/mL in the native semen was higher than those inseminated with＜15.0×106/mL or 15.0×106~29.9×106/mL (15.2% vs 6.1%, 8.3%, respectively)(P<0.05). When the motility in the native semen was 21%~30%, the clinical pregnancy rate after IUI was noted higher than those inseminated with semen motility of 11%~20% or＞30% (21.6% vs 4.2%, 12.6%, respectively)(P<0.05). The clinical pregnancy rate was influenced by total motile spermatozoa count in the native semen (TMSC) and inseminating motile count after washing (IMC), with the cut-off value of 10 million and 5 million, respectively. And 42.9% of sperm was evaluated with the same result in its morphology by 4 andrologists. There were no strong correlations between sperm parameters at the time of semen analysis and clinical pregnancy rates after IUI. By multivariate logistic regression analysis three factors were identified to be associated significantly with clinical pregnancy rate: the sperm concentration in the native semen, the number of preovulatory follicles (≥18 mm), and the endometrial thickness.　Conclusions　The concentration in the native semen is significantly associated with the clinical pregnancy rate after IUI and is an independent factor to affect IUI outcome. Various sperm parameters in semen analysis are not correlated with IUI outcome.

Effects of different root canals wettability on root filling after root canal irrigation

MA Hui-qing, ZHENG Qian-kun, ZHANG Quan, FU Ying, GU Yi-fu

Chinese Journal of Clinical Anatomy. 2019, 37(4): 442-445. doi: 10.13418/j.issn.1001-165x.2019.04.016

Abstract ( 823 )

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Objective　To compare the effect of different root canal wettability on root canal filling. Methods　A total of 50 intact single-tube teeth were collected. The crown of the tooth was removed at the neck to make the distance between the root tip and the cross section being 10 mm. Root canal was prepared to 30#. After routine irrigation combined with ultrasonic washing, root canal moisture was measured by different root canal drying methods. Root canal moisture meter was used to measure root canal moisture. The measured data were divided into five groups according to measurement data of the moisture meter. A group: completely dry, display data 0; B group: display data 0.1~5; C group：display data 5.1~10; D group：display data 10.1~15; E group：completely wet, display data＞15 (15 was the saturation value of the root canal moisture meter). The root canals were filled by the lateral compression method immediately, and X-ray film found that the root canal filling was perfect. Scanning electron microscopy was used to observe the consistency of gutta percha point and root canal side wall after transverse spiting. The filling clearance was measured by gap width measurement.　Results　Under different humidity conditions, the gutta-percha tip and the lateral wall of the root canal consistently had gaps. There was no statistical difference in gap width A and B (P＞0.05). C, D and E were statistically significant compared with A and B (P＜0.05).　Conclusions　The gap width of 0.1~5 is small, the tightness is high, and the root canal filling effect is the best.

Application value of knee joint closure test in minimally invasive treatment of knee osteoarthritis

HU Zong-yuan, ZHANG Liang, ZHANG Ji-cheng, HUO Yu-hui, YANG Ying

Chinese Journal of Clinical Anatomy. 2019, 37(4): 446-449. doi:10.13418/j.issn.1001-165x.2019.04.017

Abstract ( 567 )

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Objective　To investigate the application value of block experiment in the treatment of knee osteoarthritis.　Methods　The clinical data of 71 patients with KOA undergoing minimally invasive therapy were retrospectively analyzed. These patients were divided into a valid group and an invalid group according the block effect. The VAS scores at different time were compared in two groups, the clinical efficacy were observed in the two groups. The differences of limb swelling, joint activity function and SF-36 score were analyzed in two groups after operation.　Results　The VAS score in the valid group was significantly lower than in the invalid group after block experiment and 1 month after operation (P<0.05). The clinical efficacy, Lysholm score and SF-36 score in the valid group were better than in the invalid group after treatment(P<0.05) . The degree of joint swelling in the valid group was less than in the invalid group, with statistic difference (P<0.05). The block index in the valid group was negatively correlated with the degree of joint swelling and was positively correlated with the Lysholm score and the SF-36 score(P<0.05). Conclusions Effective block treatment can improve the clinical efficacy of the minimally invasive surgery in KOA patients. It can reduce pain degree, improve the joint function and living quality after operation.

Effect of quadratus lumborum block on postoperative acute pain of patients that received laparoscopic hepatectomy: a retrospective study

FAN Jun-yun, CHEN Bing-sha, ZHOU Quan, QIN Zai-sheng

Chinese Journal of Clinical Anatomy. 2019, 37(4): 450-453. doi:10.13418/j.issn.1001-165x.2019.04.018

Abstract ( 817 )

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Objective To retrospectively analyze the effect of quadratus lumborum block on postoperative acute pain of patients undergwent laparoscopic hepatectomy.　Methods　Twenty-four patients who underwent selective laparoscopic hepatectomy under total intravenous general anesthesia in our hospital from January to August 2018 were selected. Patients who only accepted total intravenous general anesthesia were assigned to the control group. Patients who accepted total intravenous general anesthesia (TIVA) combined with quadratus lumborum block (QLB) were assigned to the QLB group. All patients accepted patient controlled intravenous analgesia (PCIA) for postoperative analgesia. Heart rate, blood pressure, and pulse oximetry were routinely monitored during anesthesia. The blocked area of patients was tested and recorded 15 min after quadratus lumborum block. VAS scores were obtained before surgery, and 2 h, 8 h, 12 h, 24 h, and 48 h after surgery. Opioids consumption during the operation and PCIA were also recorded. Additionally, postoperative complications such as nausea and vomiting, urinary retention, itching and respiratory depression during 48 h after surgery were also recorded. Results VAS scores in QLB group were significantly lower than those in the control group at 2, 8 and 12 h postoperatively. And the difference was statistically significant (P<0.05). The highest and the lowest block plane of the 12 patients in QLB group was T6 (T6~10) and L1 (T12~L1), respectively. Compared with the control group, the opioids consumption during the operation and PCIA of QLB group was significantly decreased and the difference was statistically significant (P<0.05).　Conclusions　Quadratus lumborum block can effectively relieve postoperative acute pain in patients undergoing laparoscopic hepatectomy and reduce the opioids consumption during perioperative period.

Repair of skin and soft tissue defects around ankle with modified mid-low propeller perforator flap of peroneal artery

DENG Chang-hua, KONG Fan-fu, WU Zhen, NIE Meng, QI Zhan-jun

Chinese Journal of Clinical Anatomy. 2019, 37(4): 454-456. doi: 10.13418/j.issn.1001-165x.2019.04.019

Abstract ( 271 )

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Objective　To investigate the clinical effect of the modified mid-low propeller perforator flap of the peroneal artery in repairing skin and soft tissue defects around the ankle.　Methods　From September 2016 to January 2018, 18 patients with soft-tissue defects around the ankle underwent the modified mid-low propeller perforator flap of the peroneal artery to repair the wound. Preoperative detection and localization of the perforator were achieved using the portable Doppler, and the modified propeller flap was harvested. The main trunk of the peroneal artery was used as the axis of the flap. The perforator was used as the boundary to divide the flap into a large head (large paddle) and a smaller head (small paddle). The distance from the perforator to the wound was used as the length of the large paddle. The width of the flap was 1/2~2/3 of the length of the large paddle, and the length-width ratio of the large paddle was not more than 2:3. Large heads were used to repair soft tissue defects around ankle and small heads were used to repair wounds resulted from the harvest of large heads. The sural nerve and the small saphenous vein were preserved during operation. The area of the soft tissue defects around the ankle ranged from 3.0 cm×3.0 cm to 10.0 cm×4.5 cm. And the area of the modified mid-low propeller perforator flap was 5.0 cm×3.0 cm to 23.0 cm×5.0 cm. The clinical effect was evaluated by observing the shape and function of the recipient site and donor site.　Results All 18 cases survived successfully in the first stage of the flap, and 16 cases were followed up. The follow-up time ranged from 7 to 21 months (mean 13 months). The flap was good in luster and texture. The two-point discrimination perception ranged from 7 to 11 mm. The appearance of the affected area was satisfactory. The patients' shoes and ambulation were not affected. The lateral sensation of foot and foot reflex were normal. The AOFAS score of the affected foot was 92 to 97, with an average of 94.　Conclusions　The modified mid-low peroneal propeller perforator flap is an ideal way to repair the skin and soft-tissue defects around the ankle. It can avoid the distal necrosis of the flap and protect the donor area as much as possible.

Repairing the finger wound with digital proper artery defect with flow-through flap based on the descending branch of supracarpal cutaneous branch of ulnar artery

XIAO Rong, WANG Jian-hua, WU Yu-qiang

Chinese Journal of Clinical Anatomy. 2019, 37(4): 457-459. doi: 10.13418/j.issn.1001-165x.2019.04.020

Abstract ( 251 )

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Objective　To report the clinical efficacy of flow-through flap based on the descending branch of supracarpal cutaneous branch of ulnar artery for repairing the soft tissue defect of finger pulp with digital proper artery defect.　Methods　From January 2017 to February 2018, 6 patients with skin and soft-tissue defects of finger pulp with digital proper artery and nerve defects were repaired with flow-through flap based on the descending branch of supracarpal cutaneous branch of ulnar artery. The wound area ranged from 2.0 cm×1.0 cm to 3.5 cm×2.4 cm. The length of arterial defect ranged from 0.8 cm to 2.2 cm. The length of nerve defect ranged from 0.8 cm to 2.7 cm. The flap size ranged from 2.3 cm×1.2 cm to 4.3 cm×2.8 cm. Results　All flaps survived completely. There were 5 cases followed up for 8~24 months. At the last follow-up, the flaps were satisfactory in appearance with slight bulkiness, soft in texture, and good in elasticity. The flap sensation recovered from S2 to S3+. The two-point discrimination was 5~11 mm. According to the evaluation criteria of upper limb function of hand surgery society of Chinese medical association, the function was excellent in 3 fingers, good in 2 fingers, and the functional recovery were satisfactory. Only a linear scar was left on the donor site in all patients. The wrist flexion and extension, muscle strength and sensation were normal.　Conclusions　The flow-through flap based on the descending branch of supracarpal cutaneous branch of ulnar artery can be used to repair the soft tissue defect of finger with digital proper artery defect. It can reconstruct the blood flow and sensation of finger.

Arteriovenous bypass combined with nail extraction for the treatment of finger amputation injury in Ishikawa II area of children

YIN Fei, RUI Yong-jun, SHEN Xiao-fang, LU Zheng-feng, LIN Wei-feng

Chinese Journal of Clinical Anatomy. 2019, 37(4): 460-462. doi:10.13418/j.issn.1001-165x.2019.04.021

Abstract ( 558 )

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Objective　To explore the effect of arteriovenous bypass combined with nail extraction on replantation of amputated finger in Ishikawa II area of children.　Methods　From July 2013 to November 2018, 27 children with 29 severed fingers in Ishikawa II area without venous anastomosis conditions were replanted by arteriovenous bypass and nail extraction. Venous transplantation for venous repair was performed in 9 cases and arterial repair in 5 cases.　Results　All of 29 fingers were survived, but 6 fingers had venous drainage problem which survived through lateral incision. All cases were followed up for 5~18 months (average 10.2 months). The shape of fingertips was acceptable, the pulps were full, and the nails grew nearly flat in the last follow-up. Two of them had mild finger atrophy. Conclusions　The combination of arteriovenous bypass and nail extraction has good clinical effect in the treatment of amputated finger in Ishikawa II area of children without venous anastomosis conditions, which is worthy of clinical promotion.

A technique for removing soft tissue from human bone specimens with alkaline protease

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, LI Zhong-hua, DAI Jingxing, OUYANG Jun

Chinese Journal of Clinical Anatomy. 2019, 37(4): 463-465. doi:10.13418/j.issn.1001-165x.2019.04.022

Abstract ( 433 )

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Perfusion and anatomy of superficial forearm veins

PU Yong-hua, TAN Ke, OUYANG Si-qi ZHOU Zhang-fu

Chinese Journal of Clinical Anatomy. 2019, 37(4): 466-468. doi:10.13418/j.issn.1001-165x.2019.04.023

Abstract ( 872 )

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The research progress of endoscopic treatment of adolescent lumbar disc herniation

SU Bao-ke, WANG Wei, ZHANG Yun-feng, LI Zhi-jun, XU Yang-yang, WANG Hai-yan, LI Xiao-he

Chinese Journal of Clinical Anatomy. 2019, 37(4): 469-470. doi:10.13418/j.issn.1001-165x.2019.04.024

Abstract ( 710 )

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Anatomic and surgical risk assessment of the anterior loop of the inferior alveolar nerve

WU Yuan, WAN Xiao-Wen, WANG Wei, JIANG Lin, LI Wan-Qing, SHAO Yi-Sen

Chinese Journal of Clinical Anatomy. 2019, 37(4): 471-472. doi:10.13418/j.issn.1001-165x.2019.04.025

Abstract ( 833 )

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Progress of extralevator abdominoperineal excision for advanced low rectal cancer

ZHENG Zhen-mu, LUO Zhan-bin

Chinese Journal of Clinical Anatomy. 2019, 37(4): 473-475. doi: 10.13418/j.issn.1001-165x.2019.04.026

Abstract ( 325 )

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The role of astrocytes in central nervous system diseases

LIU Xiao-yu, LI Juan-juan

Chinese Journal of Clinical Anatomy. 2019, 37(4): 476-477. doi:10.13418/j.issn.1001-165x.2019.04.027

Abstract ( 582 )

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The variation of the branches of the axillary artery: one case report

SUN Wei-jie, WU Lin-sui, WEN Min, HE Gui-qiong

Chinese Journal of Clinical Anatomy. 2019, 37(4): 478. doi: 10.13418/j.issn.1001-165x.2019.04.028

Abstract ( 283 )

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