Table of Content

25 January 2020 Volume 38 Issue 1

  

The anatomical relationship between the vertebral artery and the Ⅸ to Ⅻ cranial nerves and its clinical significance

DU Xin-ru, KONG Xiang-yu, GUO Sen, MA Quan, LIU Ying-dong

Chinese Journal of Clinical Anatomy. 2020, 38(1):  1-5.  doi:10.13418/j.issn.1001-165x.2020.01.001

Abstract ( 459 )  

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Objective　To observe the relationship between the vertebral artery and the 9th to 12th cranial nerve and to investigate the correlation between hypertension and cervical spondylopathy.    Methods   Fifteen cranial-neck specimens were dissected and stripped to observe the relationship between the intracranial segment of vertebral artery, posterior inferior cerebellar arteries and the Ⅸ to Ⅻ cranial nerves as well as the relationship between the intracranial segment of vertebral artery and medulla oblongata,  the corresponding data were measured.　Results　(1) the vertebral artery run obliquely after passing through the dura mater, and it lied in front of root filaments of the Ⅸ and Ⅻ cranial nerves near the lateral side of medulla oblongata, the root filaments crossed the vertebral artery posteriorly, the right vertebral artery in contact with the Ⅺ and Ⅻ cranial nerve, and not with the Ⅸ and 10th cranial nerves were 7 cases (7/15, 46.7%) in the right, 11 cases（11/15, 73.3%）in the left respectively. (2)  the Ⅸ and Ⅻ cranial nerves had no any contact with posterior inferior cerebellar artery in 1 case in the right , 5 cases（5/15，33.3%） in the left；the right posterior inferior cerebellar artery was in contact with the Ⅸ and Ⅹ cranial nerves without contacting with Ⅺ and Ⅻ cranial nerves in 4 cases (4/15, 26.7%); (3) the left vertebral artery was contacting with ventral side of medulla oblongata in 11 cases (11/15,73.3%), while the right vertebral artery had no any contacting with that in 4 cases (4/15, 26.7%);  The right vertebral artery located more inclined orientation and situated in the anterior aspect of medulla oblongata paralleling with right margin of it.　Conclusions　The contacting relationship between vertebral artery and the Ⅺ to Ⅻ nerve may be the morphological bases of hypertension accompanied by occipital pain. The posterior inferior cerebella artery is also in close relation with the Ⅸ to Ⅻ cranial nerve filaments with tortuously wind round each other. When suffering from hypertension, this complicated relationship would be an important factor to stimulate the root filaments of related cranial nerves and then produce both the corresponding occipital-neck pain. Therefore the neurotrophic drugs for nourishing nerves should be used properly and the corresponding treatment can also be used in treating hypertension simultaneously.

Anatomical study of the central tendon reconstruction by manipulation of the superficial flexor tendon through bone tunnel   

ZHANG Yu-jun, JU Ji-hui, XU Lei, JIN Qian-heng, ZHAO Qiang, LI Xiang-jun, CHENG He-yun, WANG Ben-yuan

Chinese Journal of Clinical Anatomy. 2020, 38(1):  6-9.  doi:10.13418/j.issn.1001-165x.2020.01.002

Abstract ( 462 )  

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Objective  To imitate the surgical methods of the central tendon reconstruction by manipulation of the superficial flexor tendon through bone tunnel，and to verify the feasibility and safety of the operation.  Methods　Eight fresh adult cadavers hand specimens , with a total of 24 fingers in index finger, middle finger and ring finger，were collected to dissect and observe the anatomic structure of superficial flexor tendon, central tendon and extensor tendon. Four index fingers, four middle fingers and four ring fingers, 12 fresh adult finger specimens were selected for imitated operation. The rupture of central tendon insertion was artificially designed. Tendon bundles on both sides of flexor digitorum were passed through base of the middle palmar segment to dorsal part by drilling through the phalanx，and the rupture of central tendon insertion was reconstructed by woven suture with central tendon rupture. Then the passive stretch angle and the passive buckling angle of PIP formed by different suture spacing were measured.　Results  When the suture spacing of superficial flexor tendon was large, the angle of passive extension and flexion were also large, but the central tendon and the superficial flexor tendon were loose obviously. When the suture spacing was small, the angle of passive extension and flexion were also small, the tension of the central tendon and the superficial flexor tendon were large. Therefore, none of them could ensure the flexion and extension of fingers. When the suture spacing of superficial flexor tendon was 1.5cm，the passive buckling angle of PIP was about 75°.When the suture spacing was 1.0cm，the passive buckling angle of PIP was about 30°. When the suture spacing was 1.0~1.5cm, that is, when cutting through the Camper tendon chiasma, the angle of passive stretch and flexion of PIP were closest to the functional angle of finger.  Conclusions  Central tendon insertion can be reconstructed when the superficial flexor tendon is removed to Camper tendon chiasma. The tendon injury in donor area is small, and the central tendon reconstruction is safe and feasible relatively.

Applied anatomy of saphenous nerve block near to inferior foramen of adductor canal

LI Xue-qian, LU Li-rong, LI Hong-peng, SUN Yun, ZHANG Hai-dong, ZHAO Zhen-mei

Chinese Journal of Clinical Anatomy. 2020, 38(1):  10-13.  doi:10.13418/j.issn.1001-165x.2020.01.003

Abstract ( 747 )  

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Objective　To explore the details of anatomy and surface localization of saphenous nerve near to inferior foramen of adductor canal.　Methods　Twenty sides of lower limb from 12 cadaver specimen were dissected to measure the key structures adjacent to the adductor canal.　Results　Saphenous nerve, femoral artery and femoral vein located in the anteromedial, medial and posterior part of adductor canal, respectively. At the site of the inferior foramen of adductor canal, the descending genicular artery, vein and saphenous nerve penetrated through adductor tendon plate and appeared in adductor canal, which were accompanied by the great saphenous vein. Saphenous nerve passed through deep fascia between sartorius tendon and gracilis tendon on the medial surface of knee, and descended to the medial surface of leg and foot. The distances from inferior foramen of adductor canal to superior border of patella, to medial margin of the patella, and to the medial surface of thigh skin were (5.85±0.15) cm, (2.72±0.60) cm and (4.08±0.66) cm, respectively. Conclusions　Surface localization point of saphenous nerve block should be limited to a specific area, which is about 5.85 cm upper to the superior border of patella, 2.72 cm internal to medial margin of the patella, and 4.08 cm deep to the medial surface of thigh. For saphenous nerve blocking, femoral artery could be regarded as a localization mark above inferior foramen of adductor canal, while, the saphenous branch of the descending genicular artery as the localization mark below inferior foramen of adductor canal. 

Anatomical study on middle ear of New Zealand rabbits by transcanal endoscopy

LIN Qiong-ping, LI Da-fei, YANG Jing-ya, XU Piao, ZHANG Shan-shan, TIAN Guang-yong

Chinese Journal of Clinical Anatomy. 2020, 38(1):  14-18.  doi:10.13418/j.issn.1001-165x.2020.01.004

Abstract ( 641 )  

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Objective　To observe the anatomical structure of rabbit's middle ear under ear endoscope and explore the feasibility of the rabbit as endoscopic anatomical training model of middle ear, and then provide anatomic base for other experimental research on middle ear of rabbits.　Methods　Five (10 ears) New Zealand rabbits were killed immediately after anaesthesia, the structures of tympanic membrane and tympanic cavity were observed by endoscopic transcanal approach, and ossicles, epitympanum, mesotympanum, hypotympanum and facial nerve were distinguished.　Results　Compared with human, auditory ossicles were composed of malleus-incus complex and stapes, and part of the lateral epitympanic wall was replaced by the tympanic membrane. Rabbit’s bullae was similar to the mesotympanum and hypotympanum of human, including the eustachian tube, facial nerve, promontory, vestibular window, cochlear window and tympanic nerve. The mastoid process was a diploic bone, overlying the caudolateral aspect of the tympanic bulla. In the tympanum, facial nerve run horizontally below the epitympanum, passed through the pyramidal eminence, and then run vertically along the posterior wall of bullae, and left the auditory vesicle through stylomastoid foramen.　Conclusions　The middle ear structures of New Zealand rabbits are similar to that of human, which can be used as the anatomical model for the junior otologists to practice endoscopic middle ear operation, or as a new educational model for the three-dimensional anatomical structure of the ear.

Clinical anatomical study on three-dimensional reconstruction of nutritional vessels of lunar bone

XU Yu-jian, XU Yong-qing, He Xiao-qing, LUO Hao-tian, ZHANG Xu-lin, Yang Xi, YUAN Li-bo, ZHAO Wan-qiu, WU Huan

Chinese Journal of Clinical Anatomy. 2020, 38(1):  19-24.  doi:10.13418/j.issn.1001-165x.2020.01.005

Abstract ( 482 )  

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Objective　To study the anatomical characteristics of blood supply of lunar bone by three-dimensional reconstruction of Micro-CT data of nutrient vessel of lunar bone, explore the anatomical mechanism of ischemic necrosis of lunar bone.　Methods　The study had passed the ethical review of Kunming General Hospital of Chengdu Military Region. Twelve fresh adult wrist specimens were perfused with red lead oxide contrast medium and scanned under Micro-CT. The blood supply of lunar bone was reconstructed by Mimics software to measure and analyze statistically the anatomical parameters of nutrient vessels.　Results　(1) The diameter of nutrient pore on the metacarpal side of the lunate was (0.62±0.11) mm, and the diameter of the vascular entrance was (0.59±0.17) mm in volar side of lunate. There was no significant difference between the dorsal side (0.59±0.13) mm and (0.61±0.12) mm (P>0.05). The mean number of nutrient foramen on the metacarpal surface of lunar bone was (3.67±2.74) and that on the dorsal side was (2.41±1.83). The difference was statistically significant (P<0.05). However, there were no statistical difference between the mean number of nutrient foramen, the diameter of nutrient pore and the diameter of the vascular entrance of Type I and Type II. (2) The distribution of nutrient vessels in lunar bone was classified into 3 types, which was Y-shaped in 50% (7 cases), I-shaped in 35.7% (5 cases) and X-shaped in 14.3% (2 cases).　Conclusions　The blood supply of the metacarpal face of lunar bone is abundant, and the ischemic necrosis of lunar bone is more likely to occur after injury. The distribution of nutrient foramen in the proximal ulnar part of the metacarpal surface of the lunar bone is concentrated, and the intervention of ligaments and soft tissues in this area should be minimized during the operation.

Three-dimensional digital model of Ludloff osteotomy for treating hallux valgus

LI Zhong-wan, HONG Jin-song, YANG Qin-meng, YAO Li-yun, YANG Guang-gang, FU Xiao-yong, PAN Yong-xiong

Chinese Journal of Clinical Anatomy. 2020, 38(1):  25-28.  doi:10.13418/j.issn.1001-165x.2020.01.006

Abstract ( 632 )  

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Objective　To set up a 3D digital model of hallux valgus and provide theoretical support for Ludloff osteotomy in patients with hallux valgus to reduce the operation risk, increase the operation safety and improve the curative effect  by simulating Ludloff osteotomy, comparing the changes of preoperative and postoperative parameters, predicting the postoperative curative effect and complications Methods　11 cases of patients (13 feet)with hallux valgus who treated at department of foot and ankle surgery, Guangzhou orthopaedic hospital from January 2016 to January 2017 were retrospectively collected. A 3D digital model of the foot was set up based on CT data. 3D construction model was simulated to measure and statistically analyze the preoperative and postoperative the hallux valgus angel ( HVA), the intermetatarsal angel from the first to the second metatarsal (IMAI~II), the length of the first metatarsal, the relative length of the second metatarsal and the intermetatarsal angel from the first to the fifth metatarsal (IMAI~V).　Results  Preoperative and postoperative simulating osteotomy of HVA , IMAI~II, length of the first metatarsal, the relative length of the second metatarsal, IMAI~V were (35.62±6.54) °and (35.62±6.54) °, (16.43±2.41)°and (9.12±3.18）°, (63.58±4.17)mm and (59.87±3.83)mm,  (93.74±6.02)°and (86.85±5.36)°, (29.68±3.65)°and (19.45±2.46)°respectively. There were statistical significance of the above corresponding indicator changes of before and after simulating osteotomy (P<0.05).　Conclusions　Using 3D digital model technique to simulate Ludloff osteotomy and measure the parameters is a feasible way to evaluate the effect of Ludloff osteotomy and provide reference for formulating the operative plan.

 Sectional imaging study of the hippocampus in patients with alzheimer's disease

BAI Gui-qin, XIAO Ru-hui, CHEN Li, HUANG Xiao-hua, YANG Zheng-wei, CAI Chang-ping

Chinese Journal of Clinical Anatomy. 2020, 38(1):  29-34.  doi: 10.13418/j.issn.1001-165x.2020.01.007

Abstract ( 314 )  

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Objective　To observe the morphological changes on sectional imaging of the hippocampal formation (HPF) in patients in the process of alzheimer's disease (AD).　Methods　According to the pathogenesis of AD, 34 cases of a normal control (NC) group, 34 cases of a mild cognitive impairment (MCI) group, 34 cases of an AD group, which a total of 102 cases were collected, with 17 cases of male and 17 cases of female in each group respectively. The hippocampal area, the transverse diameter, the sagittal diameter and the temporal lobe hook gyrus spacing, the temporal horn width were measured. The change trend of the measured values among the groups and the correlation between the hippocampal area and the scores of the neural rating scale were analyzed.　Results　There was no statistical difference of hippocampal area in the three groups. Compared with the measured values among the groups, the hippocampal area of the AD group was smaller than that of the NC group and the MCI group (P<0.05).The hippocampal transverse diameter of the AD group was smaller than that of the NC group and the MCI group, and the hippocampal transverse diameter of the MCI group was smaller than that of the NC group (all P<0.01). In AD group, the temporal lobe hook gyrus spacing was greater than that in  the NC group and the MCI group (all P<0.01), and in MCI group, the temporal lobe hook gyrus spacing was greater than that in  the NC group (P<0.05). Hippocampal area and hippocampal transverse diameter were negatively correlated with clinical dementia scale (CDR) and Hamilton depression scale (HAMD) scores, and positively correlated with Montreal cognitive assessment scale (MoCA) scores；the correlation between the distance of temporal lobe hook gyrus and the score of neuropsychological scale scores was opposite to that of hippocampal area and hippocampal transverse diameter.　Conclusions　With the progression of AD, the hippocampal area and hippocampal transverse diameter gradually decrease, while the temporal lobe hook gyrus spacing gradually increase. Changes in the hippocampus can damage its cognitive function.

MRI anatomic analysis of influential factors of normal mesorectal transverse diameter in adult

REN An-li, WENG Ai-ting, LI Jin, CHEN Lan-fen, WANG Guang-zhi, DONG Peng

Chinese Journal of Clinical Anatomy. 2020, 38(1):  35-38.  doi:10.13418/j.issn.1001-165x.2020.01.008

Abstract ( 659 )  

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Objective　To investigate the influential factors of transverse diameter of mesorectum in adults based on magnetic resonance imaging (MRI).　Methods　Clinical data of 100 patients who met the inclusion criteria and then treated with MRI on pelvic cavity were analyzed retrospectively. The 100 cases (42 males and 58 females) aged from 27~83 years old. On the axial MR T1WI, the following parameters were measured at the seminal vesicle/uterine body level: the maximal transverse diameter of mesorectum, bladder and rectum, and the interval of the bilateral femoral head, the thickness of anterior abdominal subcutaneous fat tissue, the uterus maximal transverse diameter of female. The correlation between the maximal transverse diameter of mesorectum and the above measured parameters was analyzed statistically.　Results　(1) According to the data of 58 females cases, the maximal transverse diameter of mesorectum was (7.15±0.97) cm, uterine maximal transverse diameter was (5.86±0.61) cm. There was no statistical correlation between the maximum transverse diameter of the mesorectum and the transverse diameter of the uterus (P＞0. 05). (2) The data of male and female were combined for statistical analysis: the maximal transverse diameter of mesorectum was (7.15±0.87) cm. The maximal transverse rectum diameter was (2.84±0.74) cm, and the maximal transverse diameter of bladder was (8.58±1.66) cm. The interval of the bilateral femoral head was (12.79±0.96) cm. The thickness of anterior abdominal subcutaneous fat tissue was (2.01±0.76) cm at the same level. There was no statistical correlation between the transverse diameter of the mesorectum with gender, age, and the transverse diameter of the bladder (P＞0.05). It was positively correlated with the thickness of subcutaneous fat tissue in the anterior abdominal wall, the transverse diameter of the rectum, and the interval of the bilateral femoral head (t=3.807, 2.612, 2.002, P<0.05). Set the transverse diameter of mesorectum (Y) as the dependent variable, with the thickness of anterior abdominal fat tissue (X1), rectal transverse diameter (X2), the interval of the bilateral femoral head (X3) as the independent variables, the regression equation was: Y=3.500+0.389 X1+0. 275 X2+0.163 X3, P＜0.05, R2=0.522.　Conclusions　The mesorectal transverse diameter is related to the interval of the bilateral femoral head, the thickness of fat tissue in the anterior abdominal wall and the transverse diameter of the rectum. Observing and measurement of the mesorectal transverse diameter is helpful for the clinical diagnosis and treatment of the rectal lesions.

The CRISPR/Cas9 system optimization and construction of CHD1L conditional knockout liver cancer cell lines

HUANG Li, LIU Shan-shan, ZHANG Xiao-feng, BAI Yin-shan, LIU Ming

Chinese Journal of Clinical Anatomy. 2020, 38(1):  39-44.  doi: 10.13418/j.issn.1001-165x.2020.01.009

Abstract ( 359 )  

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Objective　To verify the effect of CHD1L QGY-7703 hepatoma cell line knockout and the effect on the cell biological functions and then to provide important cells models for studying the role of CHD1L in the development of mechanism of malignant phenotype in cancer cell by using the optimized pLV-Tet3G-CRISPR/Cas9 technology to construct a QGY-7703 hepatoma cell line.　Methods　pLV-Tet3G-Cas9 vector was optimized by point mutation technique to reduce its off-target effect and increase specificity. Cas9 was transformed into eSpCas9. Then, QGY-7703 cell line stably expressing eSpCas9 was obtained by screening. pLVX-mCherry-hU6-SgRNA vector carrying mCherry fluorescent gene was obtained by inserting mCherry gene into pLVX-hU6-SgRNA vector. The sgRNA sequence targeting the CHD1L gene was designed and screened, and the targeting sequence of Hu6-CHD1L-sgRNA was obtained by overlapping PCR method. Cloning the site with cleavage activity into the pLVX-mCherry-hU6-SgRNA vector. The vector was packaged as lentivirus by lentiviral packaging method and transfected into 7703 eSpCas9 cell line. The CHD1L knockout induced by Dox was verified by Western blot. The effects of Dox-induced CHD1L knockout on the biological function of hepatocellular carcinoma cells were detected by Wound Healing and Transwell assay. Results　In this experiment, vector Cas9 of pLV-Tet3G-Cas9 was successfully optimized as sequence eSpCas9. pLVX-mCherry-hU6-CHD1L-SgRNA vector was constructed. The QGY-7703 liver cancer cell line that conditional induction CHD1L gene knocking out was successfully constructed. Cell function experiments showed that the expression of eSpCas9 can be induced by Dox, the migration and invasion ability of these hepatoma cells were significantly decreased after knockout of CHD1L.　Conclusions　This study successfully constructed a conditional CHD1L knockout QGY-7703 liver cancer cell line. This model can be used as an effective tool to study the function and mechanism of specific genes targeting tumors.

Studying the effect of miR-382 on renal fibrosis in high glucose based on 3D culture system of renal mesangial cells

LI Xiang, YANG Zhi-feng, WANG Guo-bao

Chinese Journal of Clinical Anatomy. 2020, 38(1):  45-50.  doi:10.13418/j.issn.1001-165x.2020.01.010

Abstract ( 279 )  

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Objective　To explore the effect of miR-382 in diabetic nephropathy and renal fibrosis by constructing 3D renal mesangial cells spheroid with LBL.　Methods　LBL was utilized to construct 3D renal mesangial cells spheroid for studying the effect of different concentrations of glucose on renal mesangial cells and the effect of miR-382 on it. The experimental groups were divided into three groups according to the concentrations of glucose (5.6 mmol/L, 25 mmol/L, 40 mmol/L). qRT-PCR, Western blotting and immunofluorescence were used to detect the expression of TGF-β1, Fn, miR-382 and the level of its possible target gene the 10th chromosome deficiency phosphatase and tension of homologous gene (PTEN).　Results High glucose upregulated the expression of miR-382, downregulated secretion of PTEN, and significantly increased the expression of TGF-β1 and Fn.　Conclusions 　miR-382 may be involved in the pathology lesion of mesangial cells in the early state of diabetic nephropathy and renal fibrosis via negatively regulating the expression of PTEN.

miR-21 alleviates the cytotoxicity of mutant huntingtin through PTEN/AKT

LI Xi-fan, CHEN Tian, FANG Fang, LI He

Chinese Journal of Clinical Anatomy. 2020, 38(1):  51-56.  doi: 10.13418/j.issn.1001-165x.2020.01.011

Abstract ( 210 )  

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Objective　To detect the mechanism of miRNA-21 in reducing cytotoxicity of mutant Huntingtin (mHtt).　Methods　The changes of miRNA-21 in brain tissues of Huntington's disease (HD) transgenic mice and HEK293-160Q cells were detected by quantitative real-time polymerase chain reaction (qRT-PCR) ; Whether PTEN was the target gene of miRNA-21 or not was identified by double luciferase test; after transfected the miRNA-21 mimics, cell viability was detected by CCK8, caspase-3 activity was determined by caspase-3 activity assay kit; PTEN, phosphorylated-Ser-473 AKT and AKT were detected by Western Blotting.　Results　qRT-PCR result showed that the levels of miRNA-21 in brain tissues of HD transgenic mice and HEK293-160Q cells were significantly decreased compared with wild-type mice and HEK293-20Q cells; PTEN was the target gene of miRNA-21 which was confirmed by double luciferase test; Western Blotting showed that PTEN decreased significantly and p-AKT-Ser 473 AKT/AKT significantly increased in HEK293-160Q cells after transfected the miRNA-21 mimics.　Conclusions　miR-21 can increase the p-AKT-Ser 473/AKT by decreasing the PTEN, increase the cell viability and inhibit the apoptosis by alleviating the cytotoxicity of mHtt.

Expression and significance of Runx2, Osterix and MMP-13 in steroid-induced necrosis of femoral head in rats

YAN Xue-liang, CHEN Xiao-ming, TANG Guo-jun, CAO Qi

Chinese Journal of Clinical Anatomy. 2020, 38(1):  57-61.  doi:10.13418/j.issn.1001-165x.2020.01.012

Abstract ( 624 )  

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Objective　 To study the dynamic changes in gene expression and protein synthesis of runt-related transcription factor-2(Runx2), Osterix and MMP-13 in the femoral head of steroid-induced osteonecrosis (SANFN) in rats.　Methods　Forty adult Wistar rats were randomly divided into two groups: a model group (n = 30) and a control group (n=10). Rats in the model group were treated with dexamethasone 20 mg/kg intramuscularly injection once a week. After the injection, the animals were trained on the treadmill. The model group was divided into 3 groups according to the training time (10 cases each): A group for 8 weeks; B group for 10 weeks; C group for 12 weeks. The expression of Runx2, Osterix and MMP-13 and protein synthesis in femoral heads were detected by PCR and Western blot.    Results    The maximal diameter of adipocyte and the ratio of empty bone lacuna in model group were higher than those in control group. With the increasing of training time, the maximal diameter of adipocyte and the percentage of empty bone lacuna gradually increased (P<0.00). The area of trabecular bone in the model group was lower than that in the control group, and the area of trabecular bone decreased gradually with the increasing of training time (P< 0.00). The expression of Runx2, Osterix protein and gene in the model group was lower than that in the control group. With the extension of time, the expression level decreased gradually (P<0.05). The expression level of MMP-13 protein and gene in the model group was higher than that in control group. With the extension of time, the expression level increased gradually (P<0.05).　Conclusions　The mRNA and protein expression level of Runx2, Osterix in steroid-induced osteonecrosis of femoral head is lower than that in normal femoral head tissue and the mRNA and protein expression level of MMP-13 is higher than that in normal femoral head tissue.

Spermidine alleviates acute lung injury induced by lipopolysaccharide in mice

SU Qing, CAO Li, PENG Zhuo, LI Qi, YI Liu-xiang, GUO Xian-xian, LIU Fang-ting, SUN Guo-ying

Chinese Journal of Clinical Anatomy. 2020, 38(1):  62-66.  doi:10.13418/j.issn.1001-165x.2020.01.013

Abstract ( 393 )  

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Objective  To observe the effects of spermidine on acute lung injury (ALI) induced by lipopolysaccharide (LPS).  Methods  ALI mice model was established by intratracheal drip of LPS ( 5 mg/kg ) . Effects of spermidine on respiratory function of ALI mice were detected by small animal ventilator, the effects of spermidine on lung tissue morphology of ALI mice were observed. The total protein, total cell number and neutrophil number in bronchoalveolar lavage fluid (BALF) of ALI mice were detected, and the level of myeloperoxidase (MPO) was tested. The expression of TREM-1 mRNA in lung tissue of ALI mice was detected by qPCR, and the protein level of sTREM-1 in BALF of ALI mice was measured by ELISA.  Results  Spermidine could improve the respiratory function of ALI mice, alleviate LPS-induced lung pathological damage, decrease protein exudation and neutrophil infiltration, and reduce the expression of TREM-1, an inflammatory amplification receptor in the lungs of ALI mice.  Conclusions  Spermidine may reduce the infiltration of inflammatory cells, inhibit the expression of inflammatory factors and alleviate LPS-induced ALI. The mechanism may be related to the inhibition of TREM-1 expression in lung tissue of ALI mice by spermidine.

Clinical analysis of a 3D-printing technique assisted with opening wedge high tibial osteotomy combined with arthroscopy in the treatment of knee varus deformity

LIU Yang, LIANG Tao, ZHANG Lei, LIU Gang, YI Gang, GUO Xiao-guang, ZHOU Xin, FU Shi-jie

Chinese Journal of Clinical Anatomy. 2020, 38(1):  67-72.  doi: 10.13418/j.issn.1001-165x.2020.01.014

Abstract ( 198 )  

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Objective　 To investigate the clinical efficacy of 3D printing osteotomy guide plate assisted with opening wedge high tibial osteotomy (OWHTO) combined with arthroscopic debridement for treating knee varus deformity.　Methods　15 cases patients (16 knees) with knee varus deformity in orthopedics department of our hospital from January 2017 to May 2018 were analyzed retrospectively. 3D printing osteotomy guide plate was used to simulate OWHTO before operation. According to the ideal postoperative weight-bearing line (WBL), the osteotomy site, the osteotomy hinge, the height, the width, and the posterior tibial slope (PTS) were determined to fix the osteotomy. The preoperative and postoperative WBL, Lysholm score, PTS, and patella height index (Caton index) were compared.　Results　After 15 to 24 months of follow-up, the WBL changed from preoperative (19.27±1.55) % to postoperative (60.54±0.84) % (P<0.05). There was statistical difference between the WBL before operation and the WBL after operation. The 3D printing design before operation was (61.91±0.24) %, the PTS before operation and after operation were (10.01±2.89)°, (10.06±0.09)°respectively. There were no statistical difference between the preoperative and postoperative 3D printing design and the PTS. The Lysholm score of 1 year after operation was (82.31±1.22), before operation was (34.75±1.87), there was statistical significance between the Lysholm score of 1 year after operation and after operation.　Conclusions　3D-printing technique assisted with opening wedge high tibial osteotomy combined with arthroscopy can achieve accurate osteotomy, improve the weight-bearing line significantly, reduce intraoperative perspection, save operation time, it is a safe and effective treatment of varus knee deformity.

Clinical effect of different arthroscopic repairs on rotator cuff injury

CHEN Wei-xiong, XUE Hou-jun, LIU Qing-hua, PAN Lei

Chinese Journal of Clinical Anatomy. 2020, 38(1):  73-77.  doi:10.13418/j.issn.1001-165x.2020.01.015

Abstract ( 342 )  

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 Objective    To compare the clinical effects of arthroscopic total arthroscopy of rotator cuff repair and small incision rotator cuff repair on rotator cuff injury.    Methods    A study of 56 patients with rotator cuff injury treated in Sanshui District People's Hospital from February 2015 to December 2017 was retrospectively divided into two groups: an observation group (27 cases) and a control group (29 cases). The observation group was given arthroscopic rotator cuff repair under arthroscopy, the control group was given arthroscopic assisted small incision rotator cuff repair. The pain visual analogue scale (VAS), the American Elbow Surgeon (ASES), and the University of California, Los Angeles (UCLA) shoulder joint function scores, shoulder joint mobility, and shoulder joint muscle strength grading of the two groups patients were compared.   Results    After treatment, the observation group [VAS (1.14±0.28), ASES (91±5), UCLA (34.8±2.7)] was significantly better than the control group [VAS (1.36±0.43), ASES (88±5), UCLA (32.5±3.1)], the difference was statistically significant (t=2.250, 2.544, 2.956, all P<0.05). After treatment, the observation group [internal rotation (67±6)°, external rotation (45 ± 16)°, abduction (133 ± 12)°] was higher than the control group [internal rotation (64±5)°, external rotation (62±6)° and abduction (133±12)°], the difference was statistically significant (t=2.040, 2.027, 2.064, P<0.05); and the observation group [internal rotation (4.62±0.64), external rotation (4.81±0.62), abduction (4.87±0.56)] was superior to the control group [internal rotation (4.26±0.67), external rotation (4.47±0.60), abduction (4.51±0.62)], the difference was statistically significant (t=2.053, 2.085, 2.274, all P<0.05).   Conclusions  Arthroscopic total arthroscopic rotator cuff repair is more effective in the treatment of rotator cuff injury, which has rapid postoperative recovery and high value in promotion and application.

Effect of Huaier granule combined with postoperative chemotherapy on recurrence and survival after curative resection of colorectal liver metastasis

HUANG Liang, HU Huan-xin, LUO Shuang-ling, LIN Hong-cheng

Chinese Journal of Clinical Anatomy. 2020, 38(1):  78-82.  doi:10.13418/j.issn.1001-165x.2020.01.016

Abstract ( 947 )  

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Objective　To investigate the clinical effects of Huaier granule combined with postoperative chemotherapy on recurrence and survival after curative resection of colorectal liver metastasis (CLM).　Methods　One hundred and twenty-eight patients with CLM who underwent curative resection at the sixth affiliated hospital, Sun Yat-sen University from January 2012 to December 2017 were followed up and analyzed retrospectively. Patients were divided into two groups according to the postoperative adjuvant therapy schedule. An experimental group: Huaier granule combined with chemotherapy (72 cases); a control group: only chemotherapy (56 cases). The following variables of two groups were analyzed: gender, age, carcinoembryonic antigen (CEA) lever, tumor depth, N stage, size of liver metastases, number of liver metastasis, chemotherapy before operation. The patients were followed up to November 2019. The followed up data were used to calculate the survival rate, and analyze the univariate factor and multivariate factor which affecting recurrence and long-term survival.　Results　The perioperative chemotherapy completion rate of the experimental group was higher than that of the control group. The 3-year and 5-year overall survival rates of the experimental group and the control group were 83.5%, 60.7% and 65.3%, 48.2%, respectively, with a significant difference (p=0.015).The recurrence free survival rates of the two groups were 77.8%, 53.5%, 59.7% and 35.7%, respectively, with a significant difference (p=0.003). Univariate and multivariate analysis showed that CEA level, lymph node metastasis, number of liver metastases and chemotherapy with perioperative completion affecting the postoperative recurrence of patients with CLM, primary tumors with lymph node metastasis, the number of liver metastases and Huaier Granule therapy affecting the overall survival.　Conclusions　The recurrence and overall survival of CLM after radical resection depend on the tumor burden and chemotherapy. The patients with single liver metastasis, no-lymph node metastasis and Huaier Granule combined with adjuvant chemotherapy, may have long-term survival.

Imaging comparison of two kinds of die-punch fractures of the distal radius

DING Ling, TANG Wen, GAO Hui-qiu, YANG Ying, RUI Yong-jun, GU San-jun, YIN Qu-dong

Chinese Journal of Clinical Anatomy. 2020, 38(1):  83-87.  doi:10.13418/j.issn.1001-165x.2020.01.017

Abstract ( 882 )  

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Objective　To investigate the characteristics and differences of two kinds of die-punch fractures of the distal radius on imageology.　Methods　Images and clinical data of 498 cases with die-punch fractures of the distal radius from January 2007 to January 2016 were studied. According to the “three-column theory” and the location of fractures involved, die-punch fractures were divided into a single-column fracture and a double-column fracture. The differences in incidence, age, gender, treatment method and functional recovery between the two kinds of die-punch fractures were compared.　Results　The incidence, mean age and excellent and good rate of functional recovery of single-column fractures were 15.66%, 35.42 years old and 96.15% respectively, while as 84.34%, 54.69 years old and 80.00% respectively for double column die-punch fractures, showing significant differences between the two groups (P=0.000); the male or female ratio was 48/30, the operation or conservation ratio was 62/16 of single-column die-punch fractures, while as 223/197 as the male or female ratio and 344/76 as the operation or conservation ratio for double-column die-punch fractures, respectively, showing no significant differences between two groups (P=0.169 and P= 0.613 respectively).　Conclusions　Die-punch fractures of the distal radius are fractures resulting from an axial load through the lunate to the lunate fossa. However, due to different nature and size of violence, different position of wrist when injured and different bony quality of patient, resulting single-column and double-column die-punch fractures, which making significant difference in category and classification, degree of severity, occurrence mechanism, violence nature and level, incidence, age and prognosis of the fractures. 

The clinical application values of magnetic resonance T2-Mapping imaging in myocardial damage in patients with respiratory failure

LIU Zhen-hua, YANG Li, AO Feng, Hu Pei, ZENG Zhao-jun, ZHANG Zi-li

Chinese Journal of Clinical Anatomy. 2020, 38(1):  88-91.  doi:10.13418/j.issn.1001-165x.2020.01.018

Abstract ( 536 )  

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目的　探讨磁共振T2-Mapping成像对呼吸衰竭患者心肌损害的临床应用价值。  方法　选择2016年8月到2018年12月本院内科诊治的呼吸衰竭患者122例作为研究组，同期无呼吸衰竭病史的78例内科患者作为对照组。所有患者给予超声心动图与磁共振T2-Mapping成像，记录成像参数并进行相关性分析。  结果　衰竭组的DT值高于对照组（P<0.05）；两组E/A与Pulmonary S/D ratio值对比无统计学差异（P>0.05）；两组心磁共振图像质量Ⅲ级与Ⅳ级分别占比80.3%、9.8%和76.9%和12.8%，对比均无统计学差异（P>0.05）；衰竭组短轴位与长轴位的左心室前壁、后壁T2值均大于对照组（P<0.05）；衰竭组患者中，Pearson相关性分析显示短轴位、长轴位的左室前壁、后壁T2值与DT值均呈正相关性（P<0.05）。  结论　磁共振T2-Mapping成像能反映呼吸衰竭患者心肌损害情况，通过定量评估心肌T2值可有效评估左心室心肌功能，对指导临床治疗方案的抉择和预后判断具有重要作用。

Surgery for urinary calculi during pregnancy and report of 26 cases

ZHANG Ji-qing, XIA Jian-jun, ZHU Hui-dong, YANG Ming, PENG Qiu-ping, ZHANG Jun-hui

Chinese Journal of Clinical Anatomy. 2020, 38(1):  92-96.  doi:10.13418/j.issn.1001-165x.2020.01.019

Abstract ( 383 )  

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Objective    To  improve clinicians' understanding,  clinical diagnosis and treatment of urinary calculi during pregnancy.　Methods　The clinical data of 26 patients with urinary calculi during pregnancy from April 2017 to May 2019 were analyzed retrospectively. Patients’ median age was 29.5 (23~39) years, pregnancy time was 24 (11~33) weeks and stone diameter was 10.5 (5~20) mm. The 19 cases of ureteral stent placement were set on the first operation, 2 cases of percutaneous fistulation, and 5 cases of direct ureteroscopy.    Results   5 cases were replaced ureteral stent and till postpartum regularly and 2 cases were changed nephrostomy tube regularly. Definite calculi surgical treatment was successfully performed in 19 cases. Semi-rigid ureteroscopy (URS) was performed in 4 cases, flexible ureteroscopy (FURS) in 6 cases, miniPCNL in 7 cases, microperc in 2 case, respectively. Hospital stay of FURS was shorter than that of miniPCNL , 3（3~5）days vs 5（4~6）days，P<0.05 , while the operation time of miniPCNL was shorter 50 (40~60) min vs 35(30~60) min，P<0.05. There was no major urological and obstetric complications during and after operation.   Conclusion   Definite calculi treatment can improve the quality of life during pregnancy and avoid reoperation after postpartum.

Accuracy of ischiofemoral space as a diagnostic index for ischiofemoral impingement syndrome: a meta-analysis

QIAN Lei, WANG Yi-ning, LIANG Wen-jie, FENG Zheng-kuan, MA Dong, OUYANG Jun

Chinese Journal of Clinical Anatomy. 2020, 38(1):  97-101.  doi:10.13418/j.issn.1001-165x.2020.01.020

Abstract ( 482 )  

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目的　评价坐骨股骨间隙作为影像学诊断指标诊断坐骨股骨撞击综合征的准确性。 方法　检索Pubmed、Embase、CNKI、维普期刊及万方资源等数据库，获得坐骨股骨撞击综合征MRI影像学研究的中文文献，对国内已发表的相关研究进行异质性分析及发表偏倚、敏感性分析；采用逐一剔除相关研究的方法，降低纳入研究的异质性，分析最终保留的相关研究中坐骨股骨间隙值大小。 结果　共纳入16篇研究，包括1027例健康髋，828例IFIS患髋，所纳入研究存在较大异质性（I2=88.5%，P<0.001），进行发表偏倚和敏感性分析后，保留9篇研究，共352例健康髋，323例患髋，异质性检验I2=44.5%，P=0.072。9篇研究统计分析得到，IFIS患者的IFS均值为11.355 mm，标准误为0.503，95%可信区间为10.194~12.517 mm，健康志愿者的IFS均值为23.373 mm，标准误为0.362，95%可信区间为22.539~24.207 mm。 结论　MRI影像学中IFS作为诊断坐骨股骨撞击综合征的指标，因研究方法不同，其值的大小存在差异，更加标准化的测试和诊断方法有待进一步完善。

A case report of Bosworth fracture combined with dislocation and literature review 

WU Ming-jie, WU Jia-chang, ZHENG Jie, FAN Xiao-hai, ZHOU Zhen-quan, LI Qing, XU Xiao, SANG Hong-xun

Chinese Journal of Clinical Anatomy. 2020, 38(1):  102-105.  doi:10.13418/j.issn.1001-165x.2020.01.021

Abstract ( 261 )  

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The applied study of protease etching in vascular casting of the retained tendon

XIAO Zhao-ming, LI Ze-yu, LUO Bao-hua, LIU Chang, LI Zhong-hua, DAI Jing-xing, OUYANG Jun

Chinese Journal of Clinical Anatomy. 2020, 38(1):  106-109.  doi:10.13418/j.issn.1001-165x.2020.01.022

Abstract ( 374 )  

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Objective　To enrich the clinical anatomical research methods related to tendon by using protease digestion technique to make vascular casting of retained tendon.　Methods　0.5%, 1.0%, 1.5% and 2.0% concentrations of protease mixture were used respectively to decompose palmaris longus muscle and the suitable basic concentration was selected. The forearm vascular casting specimens were filled with acrylic resin and perfused to make casting specimen. After the filler was coagulated, the forearm vascular casting specimens were soaked into the protease solution mixture with the 1.0 % initial concentration and then during the soaking period, 35 g of alkaline protease powder was added to the mixture every 24 h, after 5 days corrosion, the forearm vessel casting of  the retained tendon was made. Results　Through the decomposition of the palmar longus muscle tissue，we found that the protease solution mixture with a 1.0 % concentration  could decompose adequately muscle tissue before the tendon fractured. We found that the skin, adipose tissue and muscle tissue basically disappeared. Bones, tendons and cast blood vessels  well preserved, the skin, the source and distribution of blood supply in the superficial layer, tendon and muscle, the relationship between cast blood vessels and skin, superficial layer, tendon and muscle can be clearly observed.　Conclusions　Using 1.0 % protease mixture as the starting concentration and adding protease mixture with 50% of the alkaline protease powder every 24 h is an appropriate corrosion method for making the vascular casting of the retained tendon. The vascular casting of retained tendons is a new type of anatomical skill, can enrich the clinical anatomical research methods related to tendon.

Application research of artificial intelligence in medical image diagnosis

LI Ding, WANG Yan-fang, LI Yong-xin, HUANG Wen-hua

Chinese Journal of Clinical Anatomy. 2020, 38(1):  110-113.  doi:10.13418/j.issn.1001-165x.2020.01.023

Abstract ( 567 )  

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An updated review of clinical anatomy of interfascial plane blocks in trunk

LI Chun-yu, QIN Zhi-xiang, NIU Xiang-lan, LIU Yan, FAN Qin, CUI Ya-nan, XING Bai-chun, LI Qing-qing, JIA Jin-tai

Chinese Journal of Clinical Anatomy. 2020, 38(1):  114-117.  doi:10.13418/j.issn.1001-165x.2020.01.024

Abstract ( 405 )  

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Sternalis muscle: 2 case report

Chinese Journal of Clinical Anatomy. 2020, 38(1):  34.  doi:10.13418/j.issn.1001-165x.2020.01.025

Abstract ( 427 )  

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The variations of origin of deep brachial artery and long head of right biceps: a case report

SUN Liu-di, HU Bao-shi, ZHAO Yuan-hui, DU Yao-wu

Chinese Journal of Clinical Anatomy. 2020, 38(1):  101.  doi:10.13418/j.issn.1001-165x.2020.01.026

Abstract ( 388 )  

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