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Chinese Journal of Clinical Anatomy
(Founded in July 1983 Bimonthly)
Responsible Institution: China Association for Science and Technology
Sponsor: Chinese Society of Anatomical Sciences
Editing and Publishing: Editorial Board of Chinese Journal of Clinical Anatomy
Advisor: ZHONG Shi-zhen
Editor-in-chief: OUYANG Jun
Former Editor-in-chief: XU Da-chuan
Overseas Distributor: China International Book Trading Corporation (P.O. Box 399, Beijing, China, Code No. BM5961)
Address: 1023 Shatainan Road, Guangzhou, 510515, China
Tel: (020)61648203
E-mail: journal@chjcana.com
CN: 44-1153/R
ISSN: 1001-165X

Table of Content

    25 May 2020 Volume 38 Issue 3
      
    Anatomical observation and measurement of the thoracic extra-foramina ligaments 
    ZHANG Ru-sen, ZHAO Qing-hao, ZHAO Jian-jun, ZHU Wei-jia, MA Run-xun, LI Qing-chu, LIU Ze-zheng
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  241-245.  doi:10.13418/j.issn.1001-165x.2020.03.001
    Abstract ( 1034 )  
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    Objective To proceed the anatomical research on the ligaments in the exit regions of the T1~12 intervertebral foramina and to discuss its possible clinical significance.   Methods    Two hundred and forty T1~12 intervertebral foramina from 10 adult cadavers were dissected and observed. All the ligaments that appeared were identified. The number, morphology, distribution, starting and ending position and the adjacency of the ligaments were observed and recorded. The length, width and thickness of each ligament were measured by vernier calipers.    Results    564 extra-foramina ligaments were found in 229 intervertebral foramina, while there were no ligaments in the remaining 11 intervertebral foramina. The occurrence rate of extra-foramina ligaments was 95.42%. There were two types of ligaments: radiating ligaments accounting for 24.11%(136 cases) and transverse ligaments accounting for 75.89% (428 cases). It was relatively common for the radiating ligaments in the segment of T1 and T9~12, but sparse in the segment of T2~8. Of these, 43.44% ligaments (245 cases) were located in the anterior part of the exit regions of the intervertebral foramina, 39.89% ligaments (225 cases) in the posterior, 11.35% ligaments (64 cases) in the upper part, 5.32% ligaments (30 cases) in the bottom part.   Conclusions    There are two types of ligaments in the exit regions of thoracic intervertebral foramina. The radiating ligament may be a kind of protective mechanism against traction, which can fix and protect the spinal nerve. Transverse ligaments may be one of the potential causes of rib or chest pain after thoracic compression fracture.
    Anatomical study of posterior percutaneous endoscopic cervical discectomy and its clinical significance
    CAO Yu-wen, LIU You-jun, YUAN Jia, JIANG Kai-yan, XU Cong
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  246-249.  doi:10.13418/j.issn.1001-165x.2020.03.002
    Abstract ( 582 )  
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    Objective To explore the safety operation area of posterior percutaneous endoscopic cervical discectomy. Methods 20 adult cervical spine specimens were taken to measure the distances between the V-point and the lateral spine dura mater, the horizontal and vertical distances between the V-point and the vertebral artery, and the width of the facet joints on the left and right sides of C3/C4 to C6/C7 respectively. Statistical comparison of the data was made. Results The distance between the V point and the lateral spine dura mater was: left (1.31±0.32~2.46±0.60) mm; right (1.29±0.35~2.75±0.45) mm. There was no  statistical difference between left and right of the same level, but there was statistical difference among different segments. The horizontal distance between point V and vertebral artery was: left (2.17±0.42~5.10±0.93) mm, right (1.99±0.39~5.00±0.71) mm. There was no statistical difference between left and right of the same level, but there was statistical difference among different segments. The vertical distance between point V and vertebral artery was: left (11.05±1.06~13.47±1.12) mm, right (11.33±1.20~13.61±1.01) mm. There was statistical difference between left and right of the same level,but no statistical difference among the segment of C3/C4 and C4 /C5. The width of facet joints was: left (10.79±0.93~12.66±0.88)mm,right (10.86±0.68~12.54±0.70) mm. Conclusions The safety operation area of posterior percutaneous endoscopic cervical discectomy should be controlled within the range of 1.20~2.00 mm from C3/C4 to C6/C7 on the medial side of the V-point.  When the grinding range is more than 2.00~5.00 mm from the C3/C4 to C6/C7 on the lateral side of the V-point, it may reach the body surface projection of vertebral artery. Therefore the depth of surgical entry should be controlled at 11.00~14.00 mm from segments of C3/C4~C6/C7 to the V-point.
    Clinical anatomical study of skin incision on treating bony mallet finger by absorption suture tying avulsion fracture fragment
    TAN Zhou-yong, TAN Liang, FU Xiao-kuan, LIU Ying-nan, WEI Rui-hong, FANG Xi-chi, ZHUANG Yong-qing
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  250-253.  doi:10.13418/j.issn.1001-165x.2020.03.003
    Abstract ( 582 )  
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    Objective  To provide anatomical basis for treating bony mallet finger by absorbable suture tying avulsion fracture fragment.  Methods 16 fresh adult upper limb specimens were randomly selected, including 16 thumbs, 16 index fingers, 16 middle fingers, 16 ring fingers and 16 little fingers. The important structures of distal phalanx were observed . The distance from the extensor terminal tendon to rear projection line of the distal finger grain and the distance from nail matrix proximal end to the distal tendon terminal and the width of the tendon terminal were measured to design suitable length and width for skin incision. Results (1)Tendon insertion width were as follow: thumb (10.72±0.42) mm, index finger (6.14±0.33) mm, middle finger (6.73±0.39) mm, ring finger (5.63±0.37) mm, little finger (4.64±0.38) mm, respectively; (2) proximal distance between tendon insertion and nail matrix were as follow: thumb (1.53±0.12) mm, index finger (1.46±0.08) mm, middle finger (1.48±0.07) mm, ring finger: (1.42±0.07) mm, little finger (1.42±0.08) mm; (3) the distance between the tendon insertion point and the dorsal projection line of the distal finger: thumb (6.12±0.55) mm; index finger (5.03±0.36) mm; middle finger (5.15±0.32) mm; ring finger (4.89±0.36) mm; little finger (4.02±0.24) mm. Conclusions When treat bony mallet finger by absorbable suture tying avulsion fracture fragment, we should perform U-shape incision at the distal interphalangeal joint, start from the streakline on the palm side. The width of the incision is 2.0 mm across the tendon insertion, which will not affect the blood supply and can fully expose the operative field. 
    Anatomical study on the microstructures of triquetral bone
    YUAN Li-bo, XU Yong-qing, ZHANG Xu-lin, LUO Hao-tian, XU Yu-jian, ZHAO Wan-qiu, WU Huan
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  254-258.  doi:10.13418/j.issn.1001-165x.2020.03.004
    Abstract ( 401 )  
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    Objective To investigate the location and distribution of triquetral bone nutrient foramen and the shape of the intraosseous vessels and analyze the micro-structure of the triquetral bone by perfusion. Methods Twelve specimens were perfused with gelatin powder and Pb3O4 mixed perfusion solution. After perfusion, scanning was performed by Micro-CT. The distribution of nutrient foramen in triquetral bone, the shape of intraosseous vessels, the diameter of blood vessels and the microstructure of bone were measured and analyzed by three-dimensional vascular reconstruction of the Mimics software after obtaining the result of tomography. Results The relatively constant nutrient foramen could be observed on the proximal volar of triquetral bone, dorsal ulnar side of the body and distal dorsal sides of triquetral bone. The numner of nutrient foramen on the proximal volar side was 1.42±0.51, the body ulnar dorsal side was 1.58±0.51, and the distal dorsal side was 3.25±0.87. The diameter of  intraosseous vessels in proximal volar side, the body ulnar dorsal side, the distal dorsal side were (0.52±0.07) mm, (0.48±0.11) mm and (0.48±0.12) mm, respectively. There was no significant difference in the diameter of the nutrient foramen between the two groups. The nutrient vessels on the proximal volar side of the triquetral bone extended deeply into the bone, paralleling to the long axis of the triquetral bone. There were many nutrient vessels on the distal dorsal side of the triquetral bone, but the vessels that continued into the bone were short and shallow. Conclusions (1)There are constant nutrient foramen and vessels in the proximal metacarpal, ulnar dorsal and distal dorsal sides of the triquetral bone. (2)The nutrient vessels in the proximal metacarpal are the main blood supply source of the triquetral bone, followed by the nutrient vessels in the ulnar dorsal side of the body. (3)The sparsity of the trabecula in the dorsal side of the triquetral bone may be related to the dorsal avulsion fracture, which need further verified.
    Digital anatomy study of the intra-arterial of scaphoid and clinical significance
    ZHANG Xu-lin, XU Yong-qing, HE Xiao-qing, LUO Hao-tian, XU Yu-jian, YUAN Li-bo, WU Huan, ZHAO Wan-qiu
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  259-262.  doi:10.13418/j.issn.1001-165x.2020.03.005
    Abstract ( 623 )  
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    Objective  To build a visual digital model of the scaphoid involving intra-arterial based on Micro-CT and analyze its clinical significance. Methods 12 cases of human forearm specimens were performed vessel perfusion. Micro-CT scan was performed and Mimics 20.0 software was used to reconstruct the blood vessels in three dimensions. The reconstructed data were collected and analyzed. Results (1) A clear digital model of the intra-arterial of scaphoid was reconstructed, which can freely measure the anatomical data of the scaphoid and blood vessels. (2)The branch number of nourishing vessels in the right-hand group and the left-hand group were (4.67±1.366) and (3.83±0.753), respectively. The branch number of palmar nourishing vessels were (1.67±0.516) and (1.33±0.516), respectively. The branch number of dorsal nourishing vessels were (3.00±1.095) and (2.50±0.548), respectively.  Conclusions The three-dimensional reconstruction of intraosseous  vessels can clearly show the source and spatial distribution of the nutrient arteries in the scaphoid bone, which providing a morphological basis for the clinical study of scaphoid fracture.
    Actin polymerization affects osteogenic differentiation of human fibroblast by regulating mitochondrial dynamics
    JIANG Xin, FAN Ting-yu, SUN Bing, DAI Jing-xing, OUYANG Jun, ZHONG Shi-zhen
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  263-269.  doi:10.13418/j.issn.1001-165x.2020.03.006
    Abstract ( 433 )  
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    Objective To explore the affects of actin on osteogenic differentiation of human fibroblast by regulating mitochondrial dynamics. Methods  Cytochalasin D (Cyto D) and Jasplakinolide (JAS) were added to be the growth medium and osteogenic differentiation medium respectively, then the changes of cell characters and mitochondrial dynamics were detected by Immunofluorescence staining and western blot experiments in the treatment of 1 d, 4 d and 7 d. Results Cyto D reduced the effect of osteogenic induction media, but JAS increased the effect of it. JAS enhanced significantly the effect of mitochondrial dynamics in fibroblast than Cyto D. Conclusions Actin polymerization motivates the osteogenic differentiation; Actin polymerization and depolymerization affects the colocalization ratio between mitochondrial and actin in osteogenic differentiated cells. The results can provide important biological information for studying the mitochondrial and differentiation mechanism.
    Study on the biosynthesized silver nanoparticles using extractive orange juice and their biocompatibility 
    WEN Feng, SONG Chen, XIONG Wei-rong, WANG Guo-bao, WANG Xiao-xian, QIU Xiao-zhong, WANG Le-yu
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  270-276.  doi:10.13418/j.issn.1001-165x.2020.03.007
    Abstract ( 624 )  
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    Objective To explore the conditions for maximizing the yield of silver nanoparticles synthesized by extractive orange juice, and to evaluate the biocompatibility of such silver nanoparticles. Methods The yield of silver nanoparticles was measured under different pH values, temperature and reaction time, and the optimal reaction conditions were explored. The biocompatibility and antibacterial properties of silver nanoparticles were evaluated by CCK-8 kit, scanning electron microscopy and antibacterial experiments.  Results  When the pH value was 8.0, temperature was 0 ℃, reaction time was 4 h, the yield of silver nanoparticles was highest. The synthesized silver nanoparticles were spherical or ellipsoidal, with an average particle size of 15.54 nm and a zeta potential of -34.46, which was well dispersed. Silver nanoparticles with a concentration between 6.25-50 μg/ml had no toxic effects on rat skin fibroblasts and red blood cells. Silver nanoparticles at 12.5 μg/ml and above had significant inhibitory effects on E. coli, and silver nanoparticles at 100 μg/ml and below did not significantly inhibit S. aureus. Conclusions The silver nanoparticles synthesized by the extractive orange juice at pH=8.0, temperature of 0 ℃ and reaction time of 4 h have the highest yield. These silver nanoparticles have small particle size, uniform dispersion, and are not easy to agglomerate, and have good biocompatibility and antibacterial properties. 
    Effects of cordycepin on brain damage and oxidative stress of rats with middle cerebral artery focal cerebral ischemia
    MA Jing, HE Wen-long, GAO Chong-yang, YU Rui-yun, XUE Peng, NIU Yong-chao
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  277-282.  doi:10.13418/j.issn.1001-165x.2020.03.008
    Abstract ( 383 )  
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    Objective To investigate the effects of cordycepin on oxidative stress and expression of caspase-3 and P53 in brain tissue of rats with middle cerebral artery occlusion (MCAO). Methods First, rats in the drug-administered group were intraperitoneally injected with 5, 10, and 20 mg/kg of cordycepin for 10 days. Then, the middle cerebral artery occlusion  model was prepared by modified Zea Longa suture method. The neurological function was scored by blind method after the MCAO was prepared for 24h. The brain water content was detected by weighing method. The pathological damage of brain tissue was observed by HE staining and Tunnel staining was used to detect the apoptosis of brain cell. The expression of Bcl-2, Bax, Caspase-3 and p53 mRNA was detected by RT-PCR. The protein expression of Bcl-2, Bax and Caspase were detected by Western blotting. The expression of SOD, MDA, GSH levels were detected by kit. Results Compared with the MCAO group, the neurological function score, the brain water content, the cell damage and the apoptosis rate of the drug-administered group  significantly reduced. The Bax mRNA and protein expression, the expression of Caspase-3 and p53 mRNA and protein expression significantly down-regulated, and the Bcl-2 mRNA and protein expression significantly up-regulated. The content of MDA decreased, the content of SOD and GSH increased significantly.  With the increasing of cordycepin, the effects were much more effective. Conclusions Cordycepin can relieve neurological dysfunction caused by focal cerebral ischemia in the middle cerebral artery and reduce brain water content caused by cerebral ischemia, and can also inhibit apoptosis and oxidative stress in rats with focal cerebral ischemia, which slows the damage caused by focal cerebral ischemia in the middle cerebral artery.
    Protective effects of L-carnitine on testicular injury induced by cyclophosphamide in rats through β-catenin signaling
    ZENG Peng, QI Rui, WANG Jin, SUN Xiao, DAI You-guo, ZHANG Peng-fei, YANG Li, GUO Ze-yun
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  283-288.  doi:10.13418/j.issn.1001-165x.2020.03.009
    Abstract ( 483 )  
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    Objective To investigate the protective effects and possible mechanisms of L-carnitine (LC) on cyclophosphamide (CP) induced testicular injury in rats. Methods Eighteen male rats were randomly divided into three groups and received intraperitoneal injection of appropriate drug(a Normal saline group, a CP group, a CP+LC group).  General conditions, weight and testicular weight of rats were recorded. The testicular injury condition was detected by HE staining, and the expression of β-catenin in testis was detected by immunohistochemistry and western blotting. Results The testicular weight in the CP group was lower than that of the NS group(P<0.05). While the testicular weight recovered in the CP+LC group(P<0.05). HE staining result showed that the number of spermatogenic cell layers in CP group decreased significantly than that of the NS group(P<0.05), but the number of spermatogenic cell layers of the CP+LC group was higher than that of the CP group(P<0.05). Immunohistochemistry and Western blot result showed that the expression of β-catenin in the CP group was higher than that of the NS group(P<0.05)while the expression of β-catenin in the CP+LC group was lower than that of the CP group(P<0.05).    Conclusions    L-carnitine can protect testicular injury in rats which induced by Cyclophosphamide through down-regulated β-catenin signaling, which makes a potential therapeutic significance for male fertility disorder caused by antitumor drugs.
    Effects of carnosine on oxidative stress and NF-κB signaling pathway in rats with diabetic nephropathy
    HE Xin, YANG Wen-qiang, LI Zong-ze, YU Lu, ZHAO Yan, LU Mei-li, YANG Jing
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  289-294.  doi:10.13418/j.issn.1001-165x.2020.03.010
    Abstract ( 473 )  
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    Objective To investigate the protective effects of carnosine (CAR) on diabetic nephropathy(DN) in rats and its effects on oxidative stress and NF-κB signaling pathway. Methods Sixty SD male rats of 8-week-old, except the normal group (n=12), were given high fat and sugar diet, and intraperitoneal injection of STZ to establish diabetes rats model. Three days after the injection of STZ, the rats that conform to pre-determined criterion were randomly divided into a diabetic nephropathy group and a carnosine (100, 300, 900 mg/kg) group. The carnosine groups were intragastrically administered with 100, 300, and 900 mg/kg carnosine once a day. After 8 weeks of carnosine administration, fasting blood glucose (FBG), serum creatinine (Scr), blood ureanitrogen (BUN), and 24-hour micro albumin (mAlb) were measured. Morphological changes of rat kidney were observed by PAS staining. The activity of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and the content of malondialdehyde (MDA), glutathione (GSH) in the nephropathy were detected by respective commercial kits. Renal tissue phosphate NF-κB P65 protein expression were detected by immunochemistry and Western blot. Results The carnosine can effectively alleviate the pathological damage of kidney tissue. Compared with the diabetic nephropathy group, carnosine could decrease the levels of 24h urine protein, FBG, Scr and BUN, with a dose-effect manner (P<0.05). Carnosine also could increase the contents of SOD, MDA, GSH, GSH-Px and decrease phosphate NF-κB P65, and the content of MDA in kindey. Conclusions Carnosine had a protective effect on rats of DN model, and its protective mechanism may relate to the inhibition of oxidative stress and NF-κB signaling pathway.
    LncRNA MALAT1/miR-30a/SOX4 pathway regulates proliferation, invasion and migration of bladder cancer cells
    LUO Qian, LV Jie, WANG Ning
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  295-300.  doi:10.13418/j.issn.1001-165x.2020.03.011
    Abstract ( 227 )  
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    Objective To elucidate the molecular mechanism and potential therapeutic targets of bladder cancer and explore the regulatory mechanism of MALAT1-miR-30a-5p-SOX4 axis in bladder cancer. Methods Quantitative real-time PCR (RT-PCR) was used to detect the expressions of mir-30a-5p, MALAT1 and SOX4 in bladder cancer cells. Luciferase reporter assay was used to verify the biological relationship between mir-30a-5p and SOX4.The biological functions of mir-30a-5p and SOX4 in T24 cells were studied by in vitro experiments, including the detection of cell proliferation by CCK-8 method, cell invasion by Transwell and cell migration by wound healing method. Western blot was used to detect protein expression. Results  In bladder cancer cells, MALAT1 expression was up-regulated and mir-30a-5p expression was down-regulated (P<0.01). Sh-MALAT1 inhibited the proliferation, invasion and migration of T24 cells. Further studies showed that MALAT1 can directly interact with mir-30a-5p, and SOX4 is the target of miR-30a-5p, and SOX4 can be down-regulated by over-expression mir-30a-5p. Conclusions MALAT1 knockout can relieve the inhibition of mir-30a-5p by MALAT1 and thus inhibiting SOX4. MALAT1 may regulate the proliferation, invasion and metastasis of bladder cancer by regulating the mir-30a/SOX4 pathway.
    Effects of tea polyphenol  on peripheral nerve injury and repair
    TANG Yin-juan, CHEN Long, DUAN Yan-zhi, LI Shu, ZHU Bin, ZUO Zhi-min, WANG Xiang-hai, LI Zhen-lin
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  301-307.  doi:10.13418/j.issn.1001-165x.2020.03.012
    Abstract ( 396 )  
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    Objective  To explore the effects of tea polyphenol (TP) on peripheral nerve injury and repair. Methods 48 adult BALB/c mice were randomly divided into three groups: a TP treatment group,  a saline control group and a sham group. The right sciatic nerve of each mouse in the TP treatment group and the saline control group was injured by crush and then the mice were intragastrically administrated with TP or saline twice per day for successive 14 days. The mice in sham group were only exposed their right sciatic nerve without other treatment. The motor function of each mouse was detected by footprint assay and the sensory function was evaluated with acupuncture assessment 14 days after the surgery. Subsequently, the sciatic nerves of 6 mice in each group were collected for qPCR assay. The other 10 mice of each group were subjected to perform the NF-200 / MBP double immunostaining to show the regenerated axons and myelin in the distal trunk of the injured nerves. The gastrocnemius muscle was weighed and then to prepare the HE stained section. Results Compared with the saline control group, the TP treatment resulted in significantly improved functions of motor and sensory, higher wet weight ratio of gastrocnemius muscle and bigger area size of cross-section of myofibers, as well as more regenerated axons and myelin in the injured nerves. Conclusions This study show that tea polyphenols could improve the behavioral functional loss and neuropathologic changes caused by nerve injury. 
    Effect and mechanism of plumbagin on reducing podocyte injury in rats with IgA nephropathy by regulating ROS and inhibiting NLRP3
    LIU Chang-ming, HUANG Xiang-chen, DU Bin
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  308-313.  doi:10.13418/j.issn.1001-165x.2020.03.013
    Abstract ( 329 )  
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    Objective To investigate the role and mechanism of plumbagin in IgA nephropathy. Methods First, the IgA nephropathy model was constructed according to the modified BSA+LPS+CCl4 method of Ying et al. Then, the rats in the administration group were intraperitoneally injected with 10 mg/kg, 20 mg/kg or 50 mg/kg of plumbagin per day. The normal group and the model group were intraperitoneally injected with the same amount of normal saline per day, after 8 weeks later, 24 h urine protein, serum creatinine, and blood urea were detected by a fully automatic chemical analyzer, and the ROS content was detected by flow, and the SOD activity and MDA content were detected. Pathological damage was observed by HE staining, TNF-a, IL-18, IL-1β were detected by Elisa, and NLRP3, ASC, caspase-1 p20, P13K, protein expression of AKT and NF-kB were detected by Western blotting. Results Compared with the model group, the proteinuria, serum creatinine and urea nitrogen levels of the administration group significantly reduced, ROS levels significantly decreased, SOD  levels increased, MDA, IL-1b, IL-18 and TNF-a levels were significantly increased. Protein expression of NLRP3, ASC, caspase-1 p20, P13K, AKT and NF-kB was significantly down-regulated, with the increasing of dose, the effect was more pronounced. Conclusions Plumbagin mainly reduces IgA nephropathy by reducing urinary protein, serum creatinine and blood urea, reducing pathological damage, inhibiting oxidative stress, inflammatory response and activation of NLRP3 / P13K / AKT / NF-kB pathway.
    Discussion on the method of reverse engineering knee prosthesis with mirror data and the analysis of the matching degree
    XIE Yu-shan, LIN Ze-yu, XIE Pu-sheng, HUANG Wen-hua
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  314-320.  doi: 10.13418/j.issn.1001-165x.2020.03.014
    Abstract ( 209 )  
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    Objective To evaluate the effectiveness of reverse reconstruction of knee prosthesis using image method, by comparing the morphological parameters of bilateral knee joints. Methods This experiment designed a personalized prostheses insteading of defect data by matching and analyzing the morphological similarity of the bilateral  knee joint. The experiment harvested 18 cases of bilateral tibias and 69 cases of bilateral femurs. Carried out three-dimensional reconstruction, calculated the volume and area of the bilateral knee joints, and then evaluated the difference of the morphological data of the bilateral knee joints.    Results The results of deviation analysis showed that more than 85% regional differences were less than 1mm, and bilateral knee joints were highly similar. Before the optimization with geomagic, there was no significant difference between the bilateral femurs (P=0.197) and the tibias (P=0.798) in area. And the deviation interval of femur was 0.3427±0.9956 mm and tibia was 0.4165±1.0714 mm. Conclusions The analysis shows that there is a high similarity in the area of the knee joint surface. Areas with large differences are mainly distributed at the metaphysis. The mirror model of intact distal femur surface can be used to design personalize prosthesis.
    Application of three-dimensional visualization combined with ultrasound-guided percutaneous transhepatic one-step biliary fistulation lithotripsy with rigid choledochoscope for treating complex hepatolithiasis
    FANG Zhao-shan, HUANG Hai, YANG Jian
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  321-326.  doi:10.13418/j.issn.1001-165x.2020.03.015
    Abstract ( 321 )  
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    Objective To explore the value of three-dimensional (3D) visualization technique combined with ultrasound (US) guided percutaneous transhepatic  one-step biliary fistulation lithotripsy for the treatment of complex hepatolithiasis. Methods Sixty-five patients with complex hepatolithiasis were collected, which were divided into 2 groups randomly: an observation group and a control group. 33 cases were the observation group (3D+US group), which were treated by 3D technique combined with US-guided percutaneous transhepatic  one-step biliary fistulation lithotripsy with rigid choledochoscope; and the other 32 cases were the control group (US group) which were treated by US. The surgery time, surgical bleeding loss, stone clearance rate, postoperative hospitalization time, postoperative complications of the two groups were compared and analyzed. Results The surgery time of the 3D+US group  (65.6±12.9 min vs 74.5±13.6 min, t=2.686, P=0.009)were shorter than that of the US group, which  the differences were statistically significant (P<0.05); but compared with two groups of surgical bleeding loss(22.2±5.4 ml  vs  25.7±10.2 ml,t =-1.748,P=0.085), clearance of stones (93.9%  vs  90.6%,χ2=0.251,P=0.616), postoperative hospitalization time(6.8±2.1d  vs 7.2±2.4d,t=0.751,P=0.456) and postoperative complications(9.1%  vs  12.5%, χ2=0.196 ,P=0.658), there were no statistical difference (P>0.05).  Conclusions 3D visualization combined with US-guided percutaneous transhepatic one-step biliary fistulation is a safe, minimally invasive and highly efficient method for the treatment of complex hepatolithiasis, which may have its potential application in clinical prospects.
    Application of digital simulation in intramedullary nailing for treating femoral shaft fracture
    DAI Hai , HUANG Zong-gui, WU Yong-xiang, BI Zhen-yu, LI Yu-ming, XU Ying-long
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  327-330.  doi:10.13418/j.issn.1001-165x.2020.03.016
    Abstract ( 336 )  
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    Objective To investigate the effects of closed reduction anterograde locking intramedullary nailing in the treatment of femoral shaft fractures with digital 3D model virtual surgical scheme. Methods From January 2013 to December 2016, 80 cases of femoral shaft fractures were treated with closed reduction and anterograde interlocking intramedullary nail. They were randomly divided into two groups: a treatment group and a control group. The treatment group underwent three-dimensional digital reconstruction of CT images, simulated the operation process, determined the selection of instruments and the location of nailing, and operated according to the virtual simulation scheme. The control group was given routine examination and surgical treatment. The operation time, X-ray time, intraoperative bleeding volume and prognosis were observed and followed up. Results There were statistical difference in the operation time and X-ray irradiation time of the treatment group from those in the control group, but there was no significant difference in the amount of bleeding during the operation. All the incisions healed in the first stage without any complications such as infection. The follow-up period ranged from 16 to 38 months. All patients recovered completely without pain and abnormal gait, and resumed normal daily life and hip joint activities. Conclusions Preoperative 3D reconstruction and virtual surgery for femoral shaft fracture with intramedullary nailing can significantly guide the surgical process, it is valuable for clinic application.
    The application of DSA technique combined with color Doppler ultrasound in the location of the perforating branch of the anterolateral thigh flap
    LI Lei, JU Ji-hui, ZHOU Zheng-hu, FANG Li-ping, XU Jun, DENG Wei
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  331-334.  doi:10.13418/j.issn.1001-165x.2020.03.017
    Abstract ( 300 )  
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    Objective To evaluate the accuracy of location and clinical effect of the DSA technique combined with color Doppler ultrasound on the perforator of the anterolateral thigh flap.  Methods From July 2017 to June 2019, the application of DSA technique combined with color Doppler ultrasound was used in 154 cases of 160 anterolateral thigh flaps to perform the preoperative perforator and locate the distribution of lateral circumflex femoral artery. The data were used to guide the design of the lobulated flap and the cutting of blood vessels in the operation. The accuracy of localization, the cutting time and survival rate of skin flap was analyzed statistically. Results The perforator of the skin flaps in our group were located through DSA combined with color Doppler ultrasound before operation. The location and distribution of perforator during operation were no difference from the pre-operation.154 cases of 160 skin flaps were all successfully survived, and the cutting time of skin flap was 10~60 min, with an average of 25 min.Conclusions DSA technique combined with color Doppler ultrasound in the location of the perforating branch of the anterolateral thigh flap can be used selectively in clinic. It can seek the skin flap perforator during the operation accurately and effectively, reduce the donor site damage and shorten the operation time.
    A new clinical classification and therapy analysis of the central slip injury in extensor tendon
    CHEN Chun-ling, ZHUANG Yong-qing, ZHANG Xuan, LIU Zhao-kang
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  335-338.  doi:10.13418/j.issn.1001-165x.2020.03.018
    Abstract ( 1022 )  
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    Objective To evaluate different classification of the central slip injury, put forward a new classification and analyze its curative effect. Methods A new clinic classification was put forward based on the former classification and new material studies, and the corresponding treatment measures before operation  were confirmed according to the different classification of the central slip injury. 25 patients with boutonniere deformity were treated from March 2013 to June 2018. Conservative treatment was successful in 2 patients.  And other 23 patients received surgical treatment. 18 of them were underwent Mitek bone anchor reattachment surgery and 5 of them were underwent traction wire surgery. Results According to the Dargan function rating method, 6~38 months clinical follow up revealed that excellent in 16 patients, good in 6, fair in 2, poor in 1. Excellent rate was 88% and efficacy was satisfactory. Conclusions  Based on the medical history and X-ray, judging the new clinical classification of the central slip injury before operation and determining the surgical method are practicable for the central slip injury management with satisfactory outcome.
    Effect and mechanism of yin deficiency constitution on radio sensitivity of nasopharyngeal carcinoma 
    GONG Feng-ying, LIU Zhao-ru, WANG Cong-rong, FAN Qin, LIU Shi-ya, LI Ai-wu, LV Ying
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  339-342.  doi:10.13418/j.issn.1001-165x.2020.03.019
    Abstract ( 482 )  
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    Objective To investigate the effect and mechanism of yin deficiency constitution on radio sensitivity of nasopharyngeal carcinoma. Methods 150 patients with nasopharyngeal carcinoma who were treated in the traditional  Chinese medicine department of Nanfang Hospital were selected for grouping and constitutional identification. Methylation-specific PCR (MSP) was used to detect the methylation status of CpG islands in the promoter region of tumor suppressor gene (RASSF1A, TP53, PTEN) and real-time fluorescence quantitative (qPCR) detection of its expression. Results According to the TCM Constitution Questionnaire and the four diagnoses of TCM, the constitution of the patients was identified. Among the 112 patients with radio sensitivity, 20 were yin deficiency constitution, accounting for 17.86% of the total number. Among the 38 patients who were relapsed (radiation resistance), 28 were yin deficiency constitution, accounting for 73.68% of the total number. Compared with other constitution patients, the proportion of methylation of tumor suppressor genes (RASSF1A, TP53, PTEN) in patients with yin deficiency constitution increased significantly, and gene expression was down-regulated. Conclusions Yin deficiency constitution is more likely to have radio resistance, and the inactivation of tumor suppressor gene caused by hypermethylation may be an intrinsic mechanism of radiation resistance in patients with yin deficiency constitution and nasopharyngeal carcinoma. 
    Comparison and analysis of pregnancy outcome of intrauterine insemination in natural cycles and ovulation cycles of advanced age women
    SUN Li, GE Ming-xiao, XING Wei-jie, CAI Liu-hong, TAO Xin, LI Xiao-li, OU Jian-ping
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  343-347.  doi: 10.13418/j.issn.1001-165x.2020.03.020
    Abstract ( 163 )  
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    Objective To compare the pregnancy outcomes of intra-uterine insemination (IUI) in natural cycles and ovulation cycles of advanced age women and analyze the influencing factors. Methods The clinical data and pregnancy outcomes of 580 IUI cycles in advanced age women were retrospectively analyzed, including 201 natural cycles and 379 ovulation cycles. The mature follicle number, pregnancy rate, abortion rate were compared, and the effects of different ovulation induction protocols and different infertility causes were analyzed. Results There was no significant difference in the biochemical pregnancy rate (8.45% vs 11.60%), clinical pregnancy rate (7.46% vs 10.29%), and ectopic pregnancy rate (0% vs 2.56%) between the natural cycles and the ovulation cycles (P>0.05), but the abortion rate of natural cycles (8/15, 53.33%) was significantly higher than that of ovulation cycles (7/39, 17.95%) (P<0.05). In different ovulation induction protocols, the number of mature follicles of CC group (1.87±0.85), CC+HMG group ( 1.80±0.75) were significantly higher than those of LE group (1.29±0.53), LE+HMG group (1.38±0.63), HMG group (1.35±0.60) and rFSH group (1.35±0.48) (P<0.05). The clinical pregnancy rate of the CC group (1/23,4.35%) was significantly lower than that of the other groups (P<0.05). There was no significant difference in the abortion rate between those ovulation induction groups (P>0.05). There was no statistical difference in the clinical pregnancy rate between the natural cycles and the ovulation cycles (P>0.05). Conclusions The abortion rate of natural cycles of advanced age women is significantly higher than that of ovulation cycles. The appropriate methods of ovulation induction for advanced age women can improve the IUI live birth rate.
    Analysis of the correlation between chronic rhinosinusitis and nasal septum deviation in 1910 junior middle school students 
    ZHENG Zhen-yu, DING Yi-ge, LI Hao-ran, WANG Hai-wei, ZHANG Yu, LI Ling-ling, REN Fang-fang, WANG Su-jie, WANG Chong-jian, TIAN Guang-yong
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  348-350.  doi:10.13418/j.issn.1001-165x.2020.03.021
    Abstract ( 393 )  
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    Objective To investigate the relationship between the incidence of chronic rhinosinusitis and the deviation of nasal septum in junior middle school students. Methods A total of 1910 junior middle school students aged 12~15 years in Zhengzhou city were randomly selected as the object of investigation by questionnaire, sino-nasal outcome test (SNOT-22), visual analogue scale (VAS) and nasal examination. According to the statistical results and the signs of examination, the prevalence of chronic rhinosinusitis and nasal septum deviation in junior middle school students were investigated, and the correlation between nasal septum deviation and the incidence of chronic rhinosinusitis was analyzed by statistical methods. Results  The prevalence rate of chronic rhinosinusitis of the junior middle school students was 6.2%(119/1910). In patients with chronic rhinosinusitis, the prevalence rate of mild-to-moderate nasal septum deviation was 27.7% (33/119). In patients without chronic rhinosinusitis, the prevalence rate of nasal septum deviation was 31.2% (559/1791). There was no statistical difference between the prevalence of two groups(x2=0.632,P>0.05).  In patients with chronic rhinosinusitis, the prevalence rate of severe nasal septum deviation was 13.4% (16/119). In patients without chronic rhinosinusitis, the prevalence rate of nasal septum deviation was 8.0% (144/1791). There was statistical difference between the prevalence of two groups(x2=4.248,P<0.05). Conclusions The incidence of chronic rhinosinusitis is associated with severe nasal septum deviation in junior middle school students.
    Modified rabbit model of right coronary artery ischemia-reperfusion injury
    MA Chang-rong, LIU Yan, JIANG Ju-quan
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  351-354.  doi:10.13418/j.issn.1001-165x.2020.03.022
    Abstract ( 398 )  
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    Objective To explore the feasibility of a simple rabbit model of right coronary artery ischemia-reperfusion injury by threading ligation. Methods 20 New Zealand white rabbits, male or female, weighing (2.5±0.3) kg, were divided into two groups: an ischemia-reperfusion group (14 rabbits) and a sham operation group (6 rabbits).  Threading without ligation were treated in the sham operation group, a model of rabbit right coronary artery ischemia-reperfusion injury was constructed after loosening the thread of 30 min preset suture ligation. The electrocardiogram was recorded, the changes of creatine kinase isoenzyme (CK-MB) before and after ligation, and the condition of postoperative hose insertion into the right crest were compared. Results The ST segment significantly elevated, the hose inserted into the right coronary artery was difficult to drag out and the creatine kinase isoenzyme increased in 8 cases. The success rate of the model was 57% (8/14). There were no significant changes among the above indicators in the sham operation group. Conclusions This study explores the model of right coronary artery ischemia-reperfusion-reperfusion injury, and the modeling is basically successful.
    Application of rapid refrigerant R-134a in paraffin section production
    YAN Chun, LI Qing-yun, YE Qiao-na, CAO Wei, XIAO Ling
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  355-358.  doi:10.13418/j.issn.1001-165x.2020.03.023
    Abstract ( 389 )  
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    Research status of sensory nerve function reconstruction in upper limbs
    WANG Ping, LI Yuan-heng , LI Da-yu , LU Ying, YE Sheng-qin , YANG Ling
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  359-362.  doi:10.13418/j.issn.1001-165x.2020.03.024
    Abstract ( 432 )  
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    Research progress of oxidative stress and disc degeneration
    LIU Qi, YANG Zhou, ZHU Qing-an
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  363-366.  doi:10.13418/j.issn.1001-165x.2020.03.025
    Abstract ( 552 )  
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    Radial artery high position variation:a case report
    SONG Bing-qi, ZHANG Xin-yue, GU Yan-ling, WANG Xiao-jie, JUAN Kang, DENG Guang-yao
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  347.  doi:10.13418/j.issn.1001-165x.2020.03.028
    Abstract ( 350 )  
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    A case of variation right renal vessels and right ovarian vein
    LIN Jian-sheng, NIE Juan, YU Qing-ping, CHEN An, LI Xin-hua
    Chinese Journal of Clinical Anatomy. 2020, 38(3):  367.  doi:10.13418/j.issn.1001-165x.2020.03.029
    Abstract ( 443 )  
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