Table of Content

25 September 2020 Volume 38 Issue 5

  

Advances in the understanding of intracranial venous anatomy and its circulatory disturbance

WANG Shou-sen, YIN Teng-kun

Chinese Journal of Clinical Anatomy. 2020, 38(5):  497-499.  doi:10.13418/j.issn.1001-165x.2020.05.001

Abstract ( 337 )  

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The imaging anatomical basis of meningioma in the superior sagittal sinus

YING Jian-bin, LI Ke-lei, WANG Shou-sen

Chinese Journal of Clinical Anatomy. 2020, 38(5):  500-505.  doi:10.13418/j.issn.1001-165x.2020.05.002

Abstract ( 388 )  

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Objective　To provide the anatomical basis for superior sagittal sinus (SSS) meningioma by analyzing the distribution of arachnoid granules (AG) in the superior sagittal sinus and the clinical data of parasagittal meningiomas (PSM).　Methods　Conventional MRI and enhanced MRI data of 100 patients of all ages excluding organic brain lesions were collected, which were named as AG group. The distribution and size of AG in SSS were analyzed . From January 2013 to August 2018, 30 cases of PSM patients information which including the corresponding patients imaging characteristics and origin location in SSS were recorded. This group was named as PSM group.　Results　There were 32 cases which can recognize AG in the superior sagittal sinus of the AG group, including 6 cases of AG in the anterior 1/3 SSS, 24 cases of AG in the middle 1/3 SSS and 11 cases of AG in the posterior 1/3 SSS. There were 5 cases with meningioma in the superior sagittal sinus of the PSM group, including 2 cases in the middle of the superior sagittal sinus and 3 cases in the back of the superior sagittal sinus. All patients were treated by surgery and followed up for 24~33 months, without tumor recurrence. The distribution of AG in the sinuses was similar to that of meningioma in the sinuses, and the imaging morphology of the tumor accorded with the growth rule in the sinuses. Conclusions　Not all PSM originates from the paranasal sinus, only a few of them may originate from the AG in the SSS. Parasagittal meningiomas, which are characterized by roughly symmetrical expansion to both sides, can be defined as “SSS meningiomas”.

MRV study of falcine sinus in parasagittal meningioma

YIN Teng-kun, WANG Shou-sen

Chinese Journal of Clinical Anatomy. 2020, 38(5):  506-510.  doi:10.13418/j.issn.1001-165x.2020.05.003

Abstract ( 356 )  

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Objective　To explore the incidence of falcine sinus in the patients with parasagittal meningioma (PSM) and its iconographical characteristics of magnetic resonance venography (MRV), which providing protection for intraoperative venous protection.　Methods　MRV data of 42 PSM patients were retrospectively analyzed and were observed the incidence of persistent falcine sinus and recanalized falcine sinus. Then the relationship of falcine sinus with the stenosis degree of the superior sagittal sinus (SSS) and its MRV imaging features were collected.　Results　In total 42 patients, 6 patients had falcine sinus. Three of them were persistent falcine sinus. In addition, three of them were recanalized falcine sinus. The recanalized falcine sinus showed a non-uniform high signal band with ununiform size, flake and blurred boundary on MRV, the range was larger than that of persistent sickle sinus, but its signal intensity was low. There were statistical difference between the incidence of recanalized falcine sinus and the occlusion degree of SSS (P=0.007). The incidence rate of recanalized falcine sinus occurring in meningioma in posterior 1/3 segment was 37.5%.　Conclusions　 Facline sinus is common in PSM, and its MRV manifestations are characteristic. In meningiomas invading the SSS, especially with complete posterior SSS occlusion, the falcine sinus should be evaluated preoperatively to avoid iatrogenic injury.

Imaging features of the anterior intercavernous sinus in MRI

XIE Jin-hua, ZHANG Jian-he, WANG Jia-xing, WEI Liang-feng, ZHANG Hui-jian, YUAN Bang-qing, WANG Shou-sen

Chinese Journal of Clinical Anatomy. 2020, 38(5):  511-517.  doi:10.13418/j.issn.1001-165x.2020.05.004

Abstract ( 463 )  

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Objective　To observe the imaging characteristics of the anterior intercavernous sinus（AICS）in MRI.　Methods　72 patients who took pituitary enhanced MRI examination were collected continuously, including 32 normal physical examinations and 40 pituitary adenomas. The imaging characteristics of AICS were observed by multi-slice MRI, and classified. In the sagittal plane of midbrain aqueduct, an extension line of the sphenoidal planum was line A, line B was a parallel line with line A passing through the highest signal of AICS, and line C was a parallel line with line A at the sellar floor. Value a was the distance between line A and line B, and Value b was the distance between line B and line C. Then the relative position of AICS between sphenoidal planum and sellar floor was analyzed.    Results    Among the 72 cases, the complete AICS group, the incomplete AICS group, and the non-AICS group were 47 cases (accounted for 65.28%), 19 cases (accounted for 26.39%), and 6 cases (accounted for 8.33%) cases, respectively. The complete AICS was located above the anterosuperior pituitary and below the apex of the tuberculum sellae on the T1WI TSE enhanced MRI. a/ (a+b) value of the complete AICS in the normal group was (0.31±0.10), and (0.20±0.16) in the pituitary adenoma group. There were statistical difference between the normal group and the pituitary adenoma group (P<0.05).　Conclusions　In T1WI TSE MRI, AICS imaging has higher imaging in normal medical examinations, but AICS imaging decreases and tends to be discontinuous in pituitary adenomas.

MRI study on the relationship between dural sinus arachnoid granulation and age  

LI Ke-lei, WEI Liang-feng, TAO Wei-wei, LI Jun, XIAN Liang, WANG Shou-sen

Chinese Journal of Clinical Anatomy. 2020, 38(5):  518-522.  doi:10.13418/j.issn.1001-165x.2020.05.005

Abstract ( 428 )  

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Objective　To study the relationship between the arachnoid granulation (AG) in dural sinus and age.    Methods    The clinical and imaging data of 360 patients with intracranial no abnormalities were collected according to the age. The distribution of AG in venous sinus and the shape, size, number and the changes of morphology in the same patients of AG in each age group were observed.    Results    MR examination showed that the most common site of AG was transverse sinus, followed by superior sagittal sinus, straight sinus, torcular, cavernous sinus. With the increasing of age in the juveniles patients group, the AG diameter became larger, the quantity and the number of lobulated of AG gradually increased. With the increasing of age in the middle-aged patients group, the diameter and number fluctuations in the fixed range, the shape remained basically unchanged. There were statistical difference in the number and diameter of patients who could detect AG between the juveniles group and the middle-aged group. With the increasing of age in the old-aged patients group, the AG diameter became small, number and the number of lobulated also reduced. There were statistical difference in the number and diameter of patients who could detect AG between the middle-aged group and the old-aged group.    Conclusions    The number, size and shape of the arachnoid granulation are variable in different age groups, and these changes may be closely related to growth and development, aging and regulation of cerebrospinal fluid reabsorption. 

Clinical diagnosis and treatment of intracranial deep venous thrombosis

ZHOU Jian, ZHONG Wang-wang, CHEN Wu-yan, CHEN Xian-fei, WANG Shou-sen

Chinese Journal of Clinical Anatomy. 2020, 38(5):  523-527.  doi:10.13418/j.issn.1001-165x.2020.05.006

Abstract ( 361 )  

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Objective　To investigate the clinical diagnosis and treatment strategy of deep cerebral venous thrombosis (DCVT).　 Methods　A total of 5 DCVT patients were enrolled during the past 10 years. The clinical manifestations, imaging features, treatment and prognosis were retrospectively analyzed.　Results　DCVT commonly was involved in the internal cerebral veins, vein of Galen, straight sinus, or basal vein of Rosenthal. However, the clinical manifestations of DCVT were atypical. Among patients seen in neurology clinics, headache, disturbance of consciousness, diplopia, and hemiplegia were common manifestations. Oral contraceptives, pregnancy, and puerperium were the common risk factors. Thalamic lesions were the common radiologic sign of DCVT. Heparin offered a simple and effective therapy to prevent blood clots in extended treatment after DCVT, leading to their gradual recovery, with recanalization of the deep venous system.　Conclusions　The clinical symptoms of DCVT patients are non-specific, and DCVT in the early stages is particularly hard to diagnose. Specific attention should be given to the specific imaging features which could help to diagnose DCVT. The DCVT patients will achieve a better outcome following timely anticoagulant treatment.

The anatomical variation of superior petrosal vein and superior petrosal sinus and its management and lesson during the surgery for petroclival meningioma

HUANG Hui-yong, LI Huan, YANG Xiu, WU Zhen

Chinese Journal of Clinical Anatomy. 2020, 38(5):  528-535.  doi:10.13418/j.issn.1001-165x.2020.05.007

Abstract ( 548 )  

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Objective　To investigate the anatomical variation of superior petrosal vein (SPV) and superior petrosal sinus (SPS) and its management during the surgery for petroclival meningioma.　Methods　19 cases of petroclival meningiomas from October 2017 to October 2019 were analyzed retrospectively. Different approach were used to perform the operation according to the classification of petroclival meningioma. The anatomical classification of SPV and SPS was observed and made category. The operative complications were treated.　Results　Total resection (Simpson I / II) was performed in 12 cases (accounting for 63.2%), and nearly total resection (Simpson III) in 7 cases (accounting for 36.8%).  During the operation, there were 12 cases (accounting for 63.2%) of type I in the anatomical variation of SPV and SPS, 7 cases (accounting for 21.1%) of type II and 11 cases (accounting for 15.8%) of type III. There were 10 cases of transpetrosal middle cranial fossa approach, 10 cases of disconnection SPS and 2 cases of injured SPV were . 4 cases of supratentorial and infratentorial presigmoid approach were performed, including 3 cases of disconnection SPS and 1 case of injured SPV . 5 cases of retrosigmoid approach were treated, including 1 case of injured SPV. In all cases, 13 cases (accounting for 68.4%) were injured SPS, 4 cases (accounting for 21.1%) were injured SPV, and 3 cases (accounting for 15.8%) were serious complications.　Conclusions　DSA examination before the operation of petroclival meningioma to understand the anatomical variation of SPV and SPS is helpful for the choice of operative approach, avoiding the unnecessary injury and reducing the postoperative complications.

Anatomical structure of intracranial venous sinus and its clinical significance

CHEN Qi-zuan, WANG Shou-sen

Chinese Journal of Clinical Anatomy. 2020, 38(5):  536-539.  doi:10.13418/j.issn.1001-165x.2020.05.008

Abstract ( 823 )  

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The whole-mount distribution pattern of femoral cutaneous nerve and its significance in sensory reconstruction

WANG Qing, ZHU De-yi, LI Xiao-peng, YANG Sheng-bo

Chinese Journal of Clinical Anatomy. 2020, 38(5):  540-544.  doi: 10.13418/j.issn.1001-165x.2020.05.009

Abstract ( 465 )  

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Objective　To reveal the whole-mount distribution pattern of the cutaneous nerve of the thigh by the modified Sihler's staining method, so as to provide morphological basis for the sensory reconstruction of flap transplantation.　Methods　Twelve Chinese adult cadavers and 12 children cadavers were fixed with formalin. The skin of the thigh closed to the muscle surface with subcutaneous fat was removed. The modified Sihler's staining method was used to show the distribution pattern of cutaneous nerve in the thigh.　Results　The specimens were light purple after Sihler's staining, and the cutaneous nerves and their branches were black. We could see macroscopically the arborized branches and distribution patterns of the lateral femoral cutaneous nerve, the anterior cutaneous branch of the femoral nerve, the femoral branch of the genitofemoral nerve, the medial cutaneous branch of the femoral nerve, the cutaneous branch of the obturator nerve and the posterior femoral cutaneous nerve. There were obvious connection among the lateral femoral cutaneous nerve, the anterior cutaneous branch of the femoral nerve and the posterior femoral cutaneous nerve.  The nerve branches at all levels were densely distributed in the middle part of anteromedial femoral region and the middle band of posterior femoral region, and there was connection between these branches.　Conclusions　The middle part of anteromedial femoral region and the middle band of posterior femoral region should be recommended as the preferred donor regions for sensory reconstruction in flat transplantation.

Anatomical study on puncture depth of thoracic paravertebral nerve block

CHEN Wei-dong, QIAN Lei, QU Dong-bin, He Shan-li, LI Ze-yu, TAN Wei-hao, ZHONG Jin-tao, Yang Hang, OU-YANG Jun, ZHENG Ming-hui

Chinese Journal of Clinical Anatomy. 2020, 38(5):  545-548.  doi:10.13418/j.issn.1001-165x.2020.05.010

Abstract ( 451 )  

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Objective　To improve the safety and effectiveness of ultrasound-guided paravertebral block through observing the relationship between the spinal nerve and the transverse process or the lateral costotransverse ligament in adult cadavers.     Methods    Eighteen cadavers with normal thoracic spines were collected in this study. The cross point between the lateral edge of the lamina and the thoracic spinal nerve root was taken as the starting point for measurement. The distances between the starting point and the midpoint of the posterior inferior border of transverse process and the midpoint of the inferior border of the lateral costotransverse ligament were measured. According to Mitchell FL's "Three Groups" principle, the adjacent three thoracic segments were divided into 1 group and 12 segments were divided into 4 groups, which were named as T1~3 group, T4~6 group, T7~9 group and T10~12 group, respectively. The one-way ANOVA were performed between the intervals of spinal nerve-transverse process and the intervals of spinal nerve- lateral costotransverse ligament in different groups.    Results    （1）Intervals of spinal nerve-transverse process：average distance was (16.13±5.59) mm. It showed a trend of increasing first and then decreasing from the segment T1 (16.62±3.67) mm to the segment T12（9.76±3.75) mm. The T5 segment was the largest, which was(18.88±5.78) mm. The upwards or downwards from T5 segment gradually decreased. The distance of spinal nerve-transverse process of T1~3 group, T4~6 group, T7~9 group and T10~12 group were (17.50±4.67) mm、(18.19±5.62) mm、(16.92±5.28) mm、(12.00±4.42) mm respectively. There were significant differences among T10~12 and T1~3 (P<0.01), T4~6 (P<0.01), T7~9 group (P<0.01). (2) Intervals of spinal nerve-lateral costotransverse ligament: average distance was (17.67±3.76) mm. The distances of spinal nerve-lateral costotransverse ligament of T1~3 , T4~6 , T7~9 and T10~12 group were (16.95±3.82) mm、(17.55±3.89) mm、(17.81±3.83) mm、(18.30±3.43) mm, respectively. There was no significant difference between each two groups (P>0.05).     Conclusions　It is important to pre-estimate the puncture depth before and during ultrasound-guided thoracic paravertebral nerve block to avoid spinal nerve injury and even spinal anesthesia.

Imaging evaluation of sagittal curvature of subaxial cervical spine in 150 normal population and its clinical significance

YANG Sheng, TANG Chao, ZHONH De-jun

Chinese Journal of Clinical Anatomy. 2020, 38(5):  549-553.  doi:10.13418/j.issn.1001-165x.2020.05.011

Abstract ( 607 )  

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Objective 　To obtain the basic parameters of sagittal curvature of subaxial cervical spine in normal population and analyze its clinical significance.　Methods　150 healthy volunteers who underwent standing neutral cervical spine lateral X-ray in our hospital were selected and divided into different groups according to age and gender. The data of cervical spinal angle (CSA) ,T1-Slope (TS) and C2~7sagittal Vertical Axis (C2~7 SVA）were measured and recorded.　Results　The CSA, TS and C2~7 SVA values of 150 healthy subjects were (20.28±6.86)°, (25.81±5.54)° , (15.74±5.96) mm, respectively. The independent sample T-test showed that there were significant differences in CSA and TS between male and female groups (P<0.05), and there was no significant difference in C2~7 SVA (P>0.05). One-way ANOVA showed that the values of CSA, TS, C2~7 SVA increased gradually with the increasing of age and the differences of TS, C2~C7 SVA in different age groups were statistically significant (P<0.05). The differences of CSA in different age in female group were statistically significant (P<0.05), but there was no statistical significance in male group (P>0.05). Person correlation analysis showed that TS was positively correlated with CSA and C2~7 SVA (r= 0.592, P<0.01; r= 0.308, P<0.01).　Conclusions　There are differences in CSA and TS between different genders. CSA, TS, C2~7 SVA show an increasing trend with the increasing of age. The values of CSA, TS,  C2~7  SVA in normal population and TS are positively correlate with CSA and C2~7 SVA, which can provide reference for the fixation of sagittal curvature of subaxial cervical spine during cervical surgery.

Anatomic observation of accessory renal artery by 256-slice spiral CT imaging

SUN Feng-tao, ZHANG Hou-ning, YU lu, SHENG Jia-xi, FU Yu

Chinese Journal of Clinical Anatomy. 2020, 38(5):  554-558.  doi:10.13418/j.issn.1001-165x.2020.05.012

Abstract ( 872 )  

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Objective　To explore the application value of 256-slice spiral CT angiography (CTA) in displaying the anatomical structure of the accessory renal artery.　Methods　The data of 115 patients performed CT angiography of abdominal artery were collected. The number of branches, its diameter, length and location of the accessory renal artery were recorded. The differences of the anatomical characteristics of the accessory renal artery were compared.　Results　There were Ⅰ type branch, Ⅱtype  branch andⅣ type  branch in the collected accessory renal artery. There was statistical difference in the incidence of bilateral accessory renal artery, and the incidence of the left side was higher than that of the right side. There was statistical difference in the incidence of accessory renal artery between male and female, while the incidence of male was higher than that of female. There was no statistical difference in the diameter of accessory renal artery between the sexes and sides. There was significant difference between the upper and lower poles when entering the kidney, and the upper pole entering the kidney was more common.　Conclusions　256-slice spiral CT can clearly and accurately display the anatomical features of accessory renal artery, which can provide a more simple and effective examination for clinical diagnosis.

Intrahepatic ramification of the umbilical fissure vein based on the visual three-dimension imaging

XIE Yu, WANG Zhen-hai, ZHANG Dong-po, WANG Zheng

Chinese Journal of Clinical Anatomy. 2020, 38(5):  559-561.  doi:10.13418/j.issn.1001-165x.2020.05.013

Abstract ( 2355 )  

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Objective　To investigate the ramification of the umbilical fissure vein based on the visual three-dimension imaging.　Methods　A total of 60 patients diagnosed with hepatobiliary diseases who had been received CT angiography scanning from Jun.2017 to Dec.2018 were observed and analyzed retrospectively. The incident rate, the form and afflux way of the umbilical fissure vein and the relationship between the umbilical fissure vein and the IVb hepatic vein were analyzed based on the visual 3D imaging. Results　UFV was observed in 55 patients (incidence rate: 91.6%), while there were 49 cases arising from left hepatic vein (LHV) in the 55 cases of UFV (incidence rate: 89.1%), 4 cases arising from the middle hepatic vein(MHV) (incidence rate: 7.3%), 2 cases from the common trunk of the LHV and MHV(3.6%). There was 17 cases occurring segment IVb hepatic vein afflux into UFV.　Conclusions　There is great help for the visual 3D imaging to distinguish UFV and make surgery planning preoperative, which can avoid operative side injuries. 

COX-2/sEH dual inhibitor PTUPB alleviates non-alcoholic fatty liver disease in mice by inhibiting endoplasmic reticulum stress

ZHANG Jun, ZHANG Chen-yu, SUN Chen-chen, TIAN Qing, YANG Hui-hui, LIU Yu-biao, YANG Jin-tong, ZHOU Yong, LIU Shao-kun

Chinese Journal of Clinical Anatomy. 2020, 38(5):  562-567.  doi:10.13418/j.issn.1001-165x.2020.05.014

Abstract ( 249 )  

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Objective　To investigate the protective role and mechanism of cyclooxygenase-2 (COX-2) and soluble epoxide hydrolase (sEH) dual inhibitor PTUPB in non-alcoholic fatty liver disease (NALFD) in mice.     Methods    Thirty-two male C57BL/6 mice were randomly divided into the following groups: a control group, a PTUPB group, a HFD group, and a HFD + PTUPB group. Mice in the PTUPB group and the HFD + PTUPB group were subcutaneously injected with COX-2/sEH dual inhibitor PTUPB (5 mg/kg/d). Mice in the control group and the HFD group were subcutaneously injected with PEG400. After 12 weeks, the weight change of mice was observed. HE, Oil red O, and Masson staining were used to observe liver tissue pathology morphologic changes, lipid accumulation, and collagen deposition, respectively. The protein expression of IRE-1α and XBP-1s in the liver of NAFLD mice was detected by Western blot. The expression of genes related to endoplasmic reticulum stress (Perk，Ire-1α，Xbp-1s  and Aft-6) in AML-12 treated with palmitic acid (PA) was detected by Real-time PCR.    Results    Compared with the HFD group, the body weight and weight change rate of mice in the HFD + PTUPB group significantly reduced. The liver pathological damage, lipid accumulation, and collagen deposition significantly ameliorated, and the protein expressions of IRE-1α and XBP-1s significantly down-regulated in the HFD + PTUPB group. In vitro, PTUPB pretreatment could reduce the expression levels of genes related to endoplasmic reticulum stress in AML-12 cells PA-induced.    Conclusions   Dual inhibition of COX-2 and sEH attenuates HFD-induced NALFD by suppressing endoplasmic reticulum stress in mice.

Sortilin alters lipid efflux from lipid-laden THP-1 macrophage by regulating ABCA1 protein

ZHONG Li-yuan, ZHANG Ming-xin, LV Yun-cheng, TAO Shui-ying, HU Yang, WANG Xi, TANG Zhi-hua, PENG Tian-hong

Chinese Journal of Clinical Anatomy. 2020, 38(5):  568-573.  doi:10.13418/j.issn.1001-165x.2020.05.015

Abstract ( 260 )  

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Objective　To investigate the effect of Sortilin on protein level of macrophage ABCA1 and intracellular lipid efflux.     Methods    The protein and mRNA levels of lipid-laden macrophage ABCA1 were detected by western blot (WB) and quantitative real-time polymerase chain reaction (qRT-PCR) respectively; the combination of Sortilin with ABCA1 was detected by co-immunoprecipitation (Co-IP); macrophage cholesterol efflux was measured by liquid scintillation counting. Total cholesterol (TC), free cholesterol (FC) and cholesterol ester (CE) were determined by high performance liquid chromatography (HPLC). Intracellular lipid droplets were observed by oil red O staining.    Results    Sortilin overexpression significantly decreased protein level of ABCA1, while Sortilin silence obviously raised cellular level of ABCA1 protein in lipid-laden macrophage. ABCA1 mRNA has no significant change in these three groups. Co-IP assay showed that Sortilin combined with ABCA1 protein. Compared to control group, Sortilin overexpression decreased cholesterol efflux from lipid-laden macrophage, resulting in macrophage cholesterol accumulation and lipid droplet generation. Sortilin silence dramatically enhanced cholesterol efflux and decreased lipid droplet formation. Co-treatment with chloroquine can partially abolish the inhibitory role of Sortilin overexpression in ABCA1 protein and lipid efflux of lipid-laden macrophage.　Conclusions　Sortilin reduces protein level of macrophage ABCA1 and intracellular cholesterol efflux, causes the accumulation of intracellular lipid. 

Effects of Runzao Zhiyang capsule on gut microbiota and inflammatory response in rats with psoriatic lesions

HU Hui-ying, HU Yin-xia, LIU Chang-shun, SU Xiao-ting, DAI Hui

Chinese Journal of Clinical Anatomy. 2020, 38(5):  574-577.  doi:10.13418/j.issn.1001-165x.2020.05.016

Abstract ( 639 )  

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Objective　To explore the effects of Runzao Zhiyang capsule (RZC) on psoriatic lesions from the perspective of regulation on gut microbiota and immune inflammation.　Methods　Effect of RZC on rat model with psoriatic lesions was studied. Levels of inflammatory cytokines (IL-6、TNF-α、IL-17 and IL-10) in the plasma were detected. The number of major bacterial colonies in feces was analyzed.　Results　After treatment with RZC for two weeks, symptoms of psoriatic lesions in rats were significantly improved. The levels of IL-17, IL-6, and TNF-α in the plasma were down-regulated by RZC, but the IL-10 level was up-regulated by RZC, respectively, which indicating the amelioration of inflammatory response. RZC also reduced the amounts of escherichia and enterococcus, and increased the number of lactobacillus and bifidobacteria in the gut.　Conclusions　RZC treats psoriatic lesions, which maybe related to modulating gut microbial structure, and ameliorating immune inflammatory response of the host. 

The preliminary study of tongue pictures based on diseases-symptoms in cynomolgus monkey subjects by PeriCam PSI blood flow perfusion speckle imager 

LI Shu-ting, ZONG Li-li, HE Wei-feng, RAO Jun-hua, LI Bi-hai, LIU Yi-yan, LIU Yu-jie, WANG Ting-wei, LIU Ling-zi, WU Ting-feng, WANG Bi-yun, NIE Wei-zhe

Chinese Journal of Clinical Anatomy. 2020, 38(5):  578-582.  doi: 10.13418/j.issn.1001-165x.2020.05.017

Abstract ( 183 )  

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Objective　To explore how to use PeriCam PSI blood perfusion speckle imager to detect the blood perfusion in tongues of cynomolgus monkey subjects and analyze its feasibility and application values.　Methods　1. Five female cynomolgus monkeys were subjected to cervical cerclage in preparation for their endometriosis (EMs) models. One of them only served as an indicator of pelvic conditions after its laparotomy. 2. PeriCam PSI blood flow perfusion speckle imager was used to measure the blood perfusion on the surfaces and bases of tongues of all cynomolgus monkeys for their preoperative conditions, in the very month of the coming surgery, and s.p. 1th, 2nd and 3rd months respectively. PIMSoft, the matched software, was used in data collection and analysis.　Results　1. Blood perfusion volume on tongues of the 6 subjects at different phases was successfully captured and five out of them s.p. cervical cerclage were seen to undergo significant ups/downs of their blood perfusion volume with statistical significance in their discrepancy. 2. The blood perfusion volume of tongue surfaces and bases of cynomolgus monkeys with s.p. 2 months mild-moderate pelvic adhesion was significantly higher than that of non-adhesion counterparts, the difference being statistically significant.　Conclusions　The method of PeriCam PSI blood perfusion speckle imager to detect the blood perfusion in tongues of cynomolgus monkey subjects is stably feasible and might be incorporated in one of the quantitative evaluation methods for modeled tongue pictures based on diseases-symptoms.

Study of re-beating effect after preservation and transplantation of rabbit heart with three different methods of HTK solution

WEI Xue-mei, GUO Yi-long, XU Zhi-xin

Chinese Journal of Clinical Anatomy. 2020, 38(5):  583-587.  doi:10.13418/j.issn.1001-165x.2020.05.018

Abstract ( 435 )  

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Objective　To compare re-beating effect after preservation and transplantation of isolated rabbit heart with simple low temperature immersion, continuous or intermittent perfusion of Histidine-tryptophan-ketoglutarate (HTK) solution.　Methods　36 healthy New Zealand rabbits, with 2 months old, with mean weight 2.15 kg , were chosen and divided randomly into the following three groups: a simple low temperature immersion group (simple group, n=10), a continuous group (n=10) and an intermittent 2h perfusion (intermittent group, n=16). The rabbits were taken out the isolated heart after anesthetization to establish HTK solution through aortic root, the hearts were suspended on Langendorff perfusion model. K-H buffer solution was perfused for 5~10 minutes to stable heart pulsation. HTK solution was perfused about 5 ~ 6 ml (30ml/kg) according to the grouping to store heart at 4 ℃ for 8 hours. Then pressure transducer and coronary effluent were collected  Cardiac resuscitation time, the difference of myocardial histomorphology and other related indexes among the three groups were compared.　Results　The isolated hearts were re-beating successfully in the three groups. The resuscitation time, arrhythmia score after 1 minute and 5 minutes, average heart rate, arrhythmia incidence and time of epinephrine injections in the intermittent group were all significantly lower than those of the continuous group and the simple group (P<0.05). CK-MB and cTnI levels in the intermittent group were less than those of the continuous group and the simple group (P<0.05). The LVSP and CSF values after re-beating 5min in the intermittent group were higher than those of the continuous group and the simple group (P<0.05). The degrees of myocardial cellular edema and inflammatory cell infiltration in the intermittent group were the lowest, but the above indexes in the simple group were the highest.　Conclusions　Intermittent 2 hours perfusion of HTK solution may be more effective in reducing arrhythmia and myocardial injury, improving left ventricular hemodynamics after cardiac resuscitation in isolated rabbit hearts than continuous perfusion or simple hypothermic immersion, which is expected to be a simple, efficient and safe method for preserving transplanted hearts.

Effect of low-dose ultrashort wave on functional recovery and expression of serum iNOS, TNF-α, VEGF, and BDNF in patients with spinal cord injury

LIANG Ai-ping, LI Wen-hui

Chinese Journal of Clinical Anatomy. 2020, 38(5):  588-592.  doi:10.13418/j.issn.1001-165x.2020.05.019

Abstract ( 448 )  

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Objective　To investigate the effect of low-dose ultrashort wave on functional recovery and serum inducible nitric oxide synthase (iNOS), tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), and brain-derived neurotrophic factor (BDNF) expression.　Methods　Sixty patients with spinal cord injury were enrolled and randomly divided into a treatment group and a control group, with 30 cases in each group. The control group was given basic rehabilitation treatment, and the treatment group was treated with small dose ultrashort wave therapy for a total of 3 courses of treatment. Efficacy was assessed and factors affecting spinal function recovery were analyzed.　Results　The total effective rate of the treatment group was higher than that of the control group (P<0.05). After rehabilitation treatment, the motor function and sensory function scores of the ASIA scale in the treatment group were higher than those in the control group (P<0.05). The levels of serum VEGF and BDNF in the treatment group were higher than those in the control group (P<0.05). The expression levels of iNOS and TNF-α in the treatment group were lower than those in the control group (P<0.05). Low dose ultrashort wave therapy was a protective factor for prognosis of patients with spinal cord injury (P<0.05).　Conclusions　Low-dose ultrashort wave adjuvant therapy can significantly promote the recovery of spinal cord function in patients, which may be related to down-regulation of serum iNOS, TNF-α expression and up-regulation of VEGF and BDNF expression.

Peroneal perforator-plus pedicled sural neurofasciocutaneous flap for repairing lower leg and ankle soft-tissue defects

LIU Wei, YANG Zhi, TANG Shi-ting, SHA Ke, TAN Zhen, Cheng Jian-wen, SHI Xiao-rong, ZHAO Jin-min

Chinese Journal of Clinical Anatomy. 2020, 38(5):  593-596.  doi:10.13418/j.issn.1001-165x.2020.05.20

Abstract ( 279 )  

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Objective　To evaluate the clinical efficacy of peroneal perforator-plus pedicled sural neurofasciocutaneous flap  in the reconstruction of lower leg and ankle soft-tissue defects.　Methods　Clinical data were collected from January 2017 to January 2019. Total 15 cases were involved in this study, all including the lower leg and ankle soft-tissue defects and were treated with the peroneal perforator-plus pedicled sural neurofasciocutaneous flap. The patients involves 11 males and 4 females. Range of age was from 14 to 65 (average 39 years). There were 6 cases of lower leg wound and 9 cases of ankle wound. Repair of wounds was with peroneal perforator-plus pedicled sural neurofasciocutaneous flap. The size of the soft-tissue defects ranged from 9 cm×4 cm to 26 cm×5 cm. The donor area site was sutured directly. If the tension of donor site was large, the skin graft was done to the site. After surgery, patients were taken routine treatment manners of immobilized, intravenous antibiotic, antithrombotic, antivasospasm, antiinflammatory and keep flap site warming. The flap survival and the effect of the reparations of the skin and soft tissue defect were observed during follow- up period.　Results　The flap size ranged from 10 cm×5 cm to 27 cm×7 cm. The patients were followed up for 6 to 22 months, with a mean of 13 months. 14 cases of the flap survived, 1 case with the venous reflux, the distance portion of the flap suffered from necrosis and second time wound debridement done, and the skin graft applied, the repair site healed well. 9 cases of ankle and foot ulcers represented as ankle joint dorsiflexion and plantar flexion slightly limited. 2 cases of tibial open fracture were treated with external fixation, and non-union occurred and changed to internal plate fixation and fracture union. 2 cases affected flap extruded from the wound site and inconvenient for shoeing, and the flap transformed and improved.　Conclusions　The peroneal perforator-plus pedicled sural neurofasciocutaneous flap in the reconstruction of the lower leg and foot defect is a good surgical intervention.

Application of handheld Doppler ultrasound in repairing foot defect with anterolateral thigh flap

ZHANG Guo-lei, LI Wen-qing, ZHU Xiao-di, WANG Wen-sheng, TAN Rong-zhi

Chinese Journal of Clinical Anatomy. 2020, 38(5):  597-599.  doi:10.13418/j.issn.1001-165x.2020.05.021

Abstract ( 271 )  

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Objective　To provide reference for anterolateral thigh flap (ALTF ) design by using handheld Doppler ultrasound to observe the surface position and number of the ALTF perforating vessels.　Methods　Before the operation, line α was the connection between the anterior superior iliac spine and the upper superior patella. Line β was the connection between the point  A and the pulsation point (B) of the pulse point of femoral artery under  inguinal ligament,    which was the surface projection of the descending branch of the lateral femoral circumflex artery. The handheld Doppler ultrasound was used to find the perforating branches in the circular area with the radius of 3 cm centered on the point A, and the anterior anterolateral thigh flaps were designed with the most obvious perforator pulsation. There was 8 cases of clinical applying in our department from Apr. 2016 to Sep. 2019, all of which were soft tissue defects of lower limbs, the largest flap size was 21cm × 10cm, the smallest 8 cm×6 cm.　Results　Most of the anterolateral thigh flaps were located around point A, and the thick perforators were located outside the point A. For 8 cases of flaps, 7 cases all survived, 1 case had partial epidermal necrosis at the distal end of the flap,  and which healed after dressing change. After 5~12 months of outpatient follow-up, the flap survived well, the shape and function were good.　Conclusions　Preoperative application of handheld Doppler ultrasound can effectively locate the reliable perforating branch of the anterolateral thigh flap, thereby improving the accuracy and safety of flap removal and reducing the operation time.

The efficacy and safety of the surgical treatment of recurrent lumbar disc herniation with anterior lumbar interbody fusion

YAN Hui-bo, JIN Da-di, LI Qing-chu, QIU Yi-yan, WU Yi, YANG Chang-sheng

Chinese Journal of Clinical Anatomy. 2020, 38(5):  600-604.  doi:10.13418/j.issn.1001-165x.2020.05.022

Abstract ( 483 )  

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Objective　To observe the clinical effect and safety of anterior lumbar interbody fusion in the surgical treatment of recurrent lumbar disc herniation.　Methods　12 patients of recurrent lumbar disc herniation treated with anterior lumbar interbody fusion were included and analyzed retrospectively. VAS (visual analogue scale), ODI (Oswestry disability index), height of disc space and foramina, the cobb angle of the operated level in the sagittal plane, lumbar lordosis (LL), the status of interbody fusion and the related complications were recorded.　Results　Osphyalgia and skelagia with VAS score and ODI of 3 months after the operation and the final follow-up had improved. The anterior height of postoperative intervertebral space increased significantly by 3.6 mm (P<0.05). The height of foramina, the Cobb angle of the postoperative intervertebral space and LL also had improved.  The posterior lumber intervertebral fusion were good in all patients. Fusion cage subsidence occurred in 2 patients.　Conclusions　Surgical treatment for recurrent lumbar disc herniation with anterior lumbar interbody fusion was effective and safe, which had the advantages of minimal trauma, less blood loss during the operation and less complications in perioperative period.

Complications analysis of percutaneous endoscopic interlaminar discectomy in the treatment of lumbar disc herniation 

WANG Shi-cheng, PAN Lei, XUE Hou-jun, LEI Yu

Chinese Journal of Clinical Anatomy. 2020, 38(5):  605-608.  doi:10.13418/j.issn.1001-165x.2020.05.023

Abstract ( 360 )  

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Objective　To evaluate the surgical complications and prevention methods of percutaneous endoscopic interlaminar discectomy(PEID) for lumbar disc herniation.　Methods　Total of 56 cases with single-segment lumbar disc herniation underwent PEID surgery in our hospital were analyzed. The levels of herniation were L4/5 in 30 cases, L5/S1 in 26 cases. The visual analogue scale (VAS) scores, Oswestry disability index (ODI) scores and JOA scores at preoperative and postoperative were observed to evaluate the clinical effects. The complications during operation and post-operation were studied respectively. 　Results　All cases were followed up, the VAS scores, ODI scores and JOA scores at 24 hours, 3 months and 12 months after operation were significantly improved as compared to those of pre-operative. The complications were found in 12 cases, with the incidence rate of 21.43%. In 3 cases, the neck pain was relieved by changing the pressure of the washing liquid, numbness of perineum was noted in 1 case, lumbago was noted in 4 cases and postoperative dysesthesia and weakness in 2 cases. Dural tear was found in 1 case, who recovered after posterior open lumbar discectomy immediately. 1 case had partial nerve root injury. All of the patients were recovered. There were no infection, no peritoneal and abdominal organ damage, no cauda equina nerve damage, no bad wound healing and no recurrence 1 year after operation.　Conclusions 　PEID has a good short-term effect in the treatment of lumbar disc herniation, but also has related complications. The operator should understand the possible complications and take corresponding preventive measures.

Comparative study of femoral intertrochanteric fracture treated by wire bound cemented bipolar femoral head replacement and sliding hip screw internal fixation

MA Hai-zhao, FENG Xin-xia, FU Hong-wei, MA Zhi-hua, HAN Wen-lin

Chinese Journal of Clinical Anatomy. 2020, 38(5):  609-613.  doi:10.13418/j.issn.1001-165x.2020.05.024

Abstract ( 368 )  

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Objective　To explore the clinical effects and advantages of femoral intertrochanteric fracture treated by wire bound cemented bipolar femoral head replacement and sliding hip screw internal fixation.　Methods　 80 cases of patients with femoral intertrochanteric fracture were included in our study. All the patients were  divided into the following two groups according to the surgical method: 42 cases in an experiment group and 38 cases in a control group, which were treated wire bound cemented bipolar femoral head replacement and sliding hip screw internal fixation, respectively. Some parameters such as surgical time, intraoperative blood loss, bed time, VAS score, Harris functional score and complications were evaluated. Results　The surgical time, intraoperative and postoperative blood loss of the experimental group were higher than those of the control group, there was statistical difference between the two groups (P<0.05). The bed time of the experimental group was shorter than that of the control group, there was significant difference between the two groups (P<0.05). The VAS score and Harris score of patients in the experimental group during the follow-up at 6 months and 12 months were better than those of  the control group. There was statistical difference in the complication rate, the VAS score and Harris score between two groups(P＜0.05). The complication rate of the experimental group and the control group were 28.6% and 63.2%  (χ2=9.13，P=0.003).    Conclusions    Compared with dynamic sliding hip screw internal fixation, wire bound cemented bipolar femoral head replacement has intraoperative trauma, but short bed time, thus can be carried out early functional exercises, which has better clinical effect and is worthy of clinical promotion.

The sub-palmar aponeurotic transverse carpal ligament incision by the guidance of safe angle through a small incision

WANG Yan, LIU Hui-ren, ZHANG Yan-mao, YU Zhan-yong, WU Xue-qiang, WANG Li, SUN Ru-tao, LIU Jian-hua, ZHU Peng-fei, LIU Jia-yin

Chinese Journal of Clinical Anatomy. 2020, 38(5):  614-617.  doi:10.13418/j.issn.1001-165x.2020.05.025

Abstract ( 832 )  

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 Objective   The small incision sub-palmar aponeurotic transverse carpal ligament incision under the guidance of safe angle is a treatment of carpal tunnel syndrome. This article is aimed to discuss this treatment’s clinical therapeutic effect.   Methods    From June 2015 to June 2018, 105 cases (112 sides) of carpal tunnel syndrome were treated by small incision sub-palmar aponeurotic transverse carpal ligament incision under the guidance of safe angle. 14 sides had lysis of adventitia of median nerve under direct vision.  Results   All incisions had primary healing, the palm scars were mild, and no operative complications happened. We followed 112 sides after the surgery. The follow-up time was 6-24 months. Result showed that   according to Kelly classification, 93 sides were ranked to excellent, 15 were good and 4 were fair. The excellent and good rate was 93.1%.  Conclusions   Small incision sub-palmar aponeurotic transverse carpal ligament incision under the guidance of safe angle is one of the ideal minimal invasive operations to treat carpal tunnel syndrome. This operation is simple, safe and can meet the needs of carpal tunnel decompression and neurolysis  

New progress of the morphological study in ventricular conduction system 

CHEN Xiao-yu, HU Min-xia, XU Yi-ming, SHI Yang-dong, LOU Yang-yun, AN Guo-fang

Chinese Journal of Clinical Anatomy. 2020, 38(5):  618-620.  doi:10.13418/j.issn.1001-165x.2020.05.026

Abstract ( 431 )  

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Etiology diagnosis and treatment of avascular necrosis of the capitate

WU Huan, XU Yong-qing

Chinese Journal of Clinical Anatomy. 2020, 38(5):  621-623.  doi:10.13418/j.issn.1001-165x.2020.05.027

Abstract ( 350 )  

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