Chinese Journal of Clinical Anatomy

Localization of the nerve entry points of the anterior leg muscles and its significance in blocking muscle spasticity

Hu Xiangnan, Hu Shuaiyu, Yang Shengbo

Chinese Journal of Clinical Anatomy. 2021, 39(3): 247-251. doi: 10.13418/j.issn.1001-165x.2021.03.001

Abstract ( 334 )

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Objective　To accurately localize the body surface location and depth of nerve entry points (NEPs) of the anterior leg muscles.　Methods　Twenty chinese adult cadavers were used. The curved line close to skin connecting the lateral femoral epicondyle and the lateral malleolus of fibula was designed as the longitudinal reference line (L line). A curved line connecting the lateral femoral epicondyle and medial femoral epicondyle was designed as the horizontal reference line (H line). Following dissection, the NEPs were labeled with barium sulfate and then subjected to spiral computed tomography scanning and three-dimensional reconstruction. Syngo system was used to identify the projection points (points P and P') of the NEPs on anterior and posterior skin surface of the leg, the location (points PL and PH) of point P projected on the L and H lines and the depth of NEPs.　Results　There was a constant NEP in tibialis anterior, extensor hallucis longus and extensor digitorum longus muscles, and the points PL were located at (23.63±2.43) %, (52.46±2.94) % and (36.07±2.99) % of the L line, respectively; the points PH were at (27.27±2.58) %, (34.41±2.38) % and (32.11±2.52) % of the H line, respectively; the depth of NEPs were at (45.32±3.06)%, (36.20±2.84)% and (33.72±3.18)% of the PP' line, respectively.　Conclusions　The identification of the surface position and depth of these NEPs will provide morphological guidance for improving the localizing efficiency of extramuscular neurolysis and the efficacy during anterior leg muscle spasticity.

Three-dimensional digital measurement of facial anatomy parameters of young Mongolian college students in Inner Mongolia

Chinese Journal of Clinical Anatomy. 2021, 39(3): 252-258. doi:10.13418/j.issn.1001-165x.2021.03.002

Abstract ( 781 )

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Objective　To analyze the facial anatomical parameters of normal Mongolian young college students in Inner Mongolia by digital three-dimensional reconstruction and measurement, and to evaluate the differences in facial gender, so as to provide anatomical references for surgical cosmetic surgery and maxillofacial orthodontics. The improvement of facial contours database is to provide aesthetic reference for facial shaping of young Mongolian men and women.　Methods　Sixty (30 males and 30 females) young Mongolian college students were subjected to three-dimensional facial scanning, and software was used to measure 12 indicators such as head width and morphological face length, as well as head and face indexes. Correlation analysis was performed to compare the indicators, and the facial differences were compared among ethnic groups in different regions. Results The eye slit breadth of the left and right of Inner Mongolian young college students were (31.76 ± 4.81) mm and (31.47 ± 4.34) mm, and there were no statistical significance (P>0.05). The eye slit breadth of the male and female were (35.49 ± 2.74) mm and (27.74±1.99) mm, respectively, and male was greater than female, the difference is statistically significant (P<0.05). There was a statistical difference in head breadth, physiognomic facial height, face breadth, morphological facial height, external biocular breadth between men and women. The differences were statistically significant (P<0.05). The nasal index in terms of gender was (72.55±1.63) and (73.14±1.21), with no significant difference (P>0.05). The breadth-height index of head，morphological facial index，fronto-facial index, lip index were statistically significant (P<0.05). According to the morphological facial index classification, male wide face type was more common (accounting for 46.67%) and the female ultra-wide face type was common (56.67%). According to the classification of nasal index, middle nasal type was more common in male and female, accounting for 50% and 53.33%, respectively.　Conclusions　Three-dimensional facial indicators of young Mongolian college students in Inner Mongolia are generally larger in males than females. Males are more likely to have wide type, while females are more likely to have ultra-wide types, mid-nasal type is more common in men and women. Compared with other ethnic groups, Mongolian men and women have the characteristics of wide breadth.

Study on the correlation between measurement parameters of lumbar transverse process and height

He Zubin , Huang Junyang , Lu Jili, Li Weijian , Li Wei, Lu Xiaosheng, Zhang Meichao

Chinese Journal of Clinical Anatomy. 2021, 39(3): 259-262. doi:10.13418/j.issn.1001-165x.2021.03.003

Abstract ( 521 )

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Objective　To measure the structural parameters of transverse process of lumbar spine and analyze the correlation between those parameters and individual height, which providing anatomic basis for the design the improved spinal correction system.　Methods　CT images of lumbar spine in 60 patients (30 cases in male and 30 cases in female) with different height were collected, then three dimensional models of vertebral for the 60 patients were reconstructed by Mimics software. By these models, the length, width, thickness, coronal angle and horizontal plane angle of vertebral transverse process were measured and recorded. Spearson correlation analysis was performed by SPSS22.0 to understand the correlation between transverse process parameters and height.　Results　The correlation coefficient r value of the length of L2, L5 and the thickness of L5 were between 0.2~0.4. The correlation coefficient r value of the width of L1, L3 ,L4 and the thickness of L1 were between 0.4~0.6. The correlation coefficient r value of the thickness of L2, L3 ,L4 and the width of L2 were between 0.6~0.8.　Conclusions　The width and thickness of L1~4 transverse process are positively correlated with height. The length of transverse process is weakly correlated with height. While the horizontal angle and coronal angle of transverse process has no significant correlation with height.

Morphological changes of paravertebral muscles in patients with lumbar degenerative scoliosis

Yang Bin, Zheng Minghui, Ling Duhua, Chen Weidong, Qu Dongbin

Chinese Journal of Clinical Anatomy. 2021, 39(3): 263-268. doi:10.13418/j.issn.1001-165x.2021.03.004

Abstract ( 358 )

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Objectives　To observe the morphological changes of paraspinal muscles on both sides of lumbar degenerative patients, and to analyze its clinical significance.　Methods　A retrospective analysis of 84 patients with lumbar degenerative lumbar stenosis who were hospitalized from January 2015 to December 2017 in our hospital was performed. The patients were divided into the following three groups: group A: the parietal vertebra was located at the L2-3 intervertebral disc, group B: the parietal vertebra was located at the L3 vertebral body, and group C: the parietal vertebra was located at the L3-4 intervertebral disc. The data of paraspinal muscles were measured by image pro PLus software.　Results　(1) In group A, the area of the multifissure muscle (MF) in the apical vertebra segment was larger than that in the concave side. The degree of MF fat infiltration in the convex side was smaller than that in the concave side. (2) The area ratio of the psoas major muscle (PS) in the convex side was smaller than that in the concave side, and the fat infiltration degree. (3) Groups A, B and C had similar results on the upper and next intervertebral disc plane of the parietal vertebra.　Conclusions　In patients with degenerative scoliosis, the degree of muscle degeneration in the convex and concave side is different, the concave side is larger than the convex side, and the degenerative segment mainly occurs in the upper and lower segments of the parietal vertebra. Muscle degeneration is mainly caused by the increasing of fat infiltration of muscle.

The anatomical study of superficial vein in right cubital fossa based on vascular instrument

Liu Xingli, Du Zihong , Zhang Xiangmin, Yin Junkun, Fu Dujuan, Li Zhi, Lv Liang

Chinese Journal of Clinical Anatomy. 2021, 39(3): 269-275. doi:10.13418/j.issn.1001-165x.2021.03.005

Abstract ( 712 )

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Objective　To assess non-invasively the patterns of superficial veins at the cubital fossa of the right upper limbs by using vein imaging instrument. Methods The superficial vein angiography images of 1000 subjects in the cubital fossa of the right upper limbs were prospectively collected in our hospital from November 2018 to January 2019. Morphological types and dominant classification were performed. Results According to the morphology of the median cubital vein, they were divided into 5 types and 10 subtypes, which were I (I0, I1, I2), II, Ⅲ (Ⅲ0, Ⅲ1), Ⅳ (Ⅳ0, Ⅳ1, Ⅳ2) and V type, respectively. Among them, type I was accounting for 70.2%, type II was 2.9%, type III was 2.5%, type Ⅳ was 23.2%, type V was 1.2%. They were divided into the following three advantage types according to the diameter, angel and number of sub-branch of the main superficial vein in the area of cubital fossa, basilic advantage type (B type) accounting for 19.3%, brachiocephalic advantage type (B type) accounting for 9.7%, median advantage type (M type) accounting for 71.0%. There were statistical differences in the gender (P<0.001), weight (P<0.001) and age (P=0.003) during the advantage classification. While there were statistical differences in the gender (P<0.001) and weight (P<0.001) the during the morphological classification. There were statistical differences in the diameter of basilic vein and basilic median vein in the subjects of different genders (P<0.001). There were statistical differences in the diameter of basilic vein among different age group (P=0.009). There were statistical differences in the diameter of brachiocephalic vein between the age of 31-50 years old and more than 70 years old (P=0.031). Conclusions Morphological classification can provide anatomic information of the superficial vein in the cubital fossa which can guide the vein related medical operation, and the advantage classification aims to better guide the vein selection of the upper extremity in the clinically relevant procedures (such as intravenous contract injection during enhanced CT examination)

Research on the reference values for ultrasonography of peripheral nerves and cervical nerve roots

Liu Li , Ye Yuqin, Qi Yajie, Wang Cuicui, Xing Yingqi

Chinese Journal of Clinical Anatomy. 2021, 39(3): 276-281. doi:10.13418/j.issn.1001-165x.2021.03.006

Abstract ( 492 )

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Objective　To determine normal reference values for cross sectional area (CSA) and the correlation between demographic factors and CSA in the peripheral nerves and cervical roots using ultrasonography.　Methods　High-resolution ultrasonography of median, ulnar, tibial, fibular, C5, C6 nerves roots of one hundred healthy volunteers were explored. The CSA was measured and each measurement points was repeated for 3 times, and the average value was taken. The correlation between nerve CSA and age, height, weight and body mass index was evaluated.　Results　Bilateral nerve CSA tended to be symmetrical, with male nerve CSA larger than female nerve CSA. The peripheral nerves of the limbs were positively correlated with height, weight and body mass index, among which the correlation with body weight was the most significant. The CSA in mid-forearm of ulnar nerve, tibial nerve, C5 and C6 nerves root were positively correlated with age. There was no correlation between the difference of bilateral measurement sites and the above demographic characteristics.　Conclusions　This study provides normative values of CSA in the peripheral nerve roots of the limb and neck, which can be used as the reference criteria for the diagnosis of peripheral nervous diseases.

Effects of skeletal class Ⅲ malocclusion with different vertical facial types on the cranio-lingual plane

Wang Zhihui, Jia Ying, Ding Qi

Chinese Journal of Clinical Anatomy. 2021, 39(3): 282-285. doi:10.13418/j.issn.1001-165x.2021.03.007

Abstract ( 296 )

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Objective　To study the effect of skeletal class Ⅲ malocclusion with different vertical facial types on the cranio-lingual plane, so as to provide guidance for clinical treatment. Methods Cranial lateral imaging data were collected from 186 patients with Class Ⅲ alocclusion ,and hyoid bone related data were measured using winceph 8.0 software for statistical processing.　Results　Horizontal distance of hyoid bone class Ⅲ malocclusion: low angle> average angle> high angle; Vertical distance of hyoid bone class Ⅲ malocclusion: high angle> average angle> low angle. The high angle of transverse and longitudinal slope was significantly smaller than that of the average angle and low angle. The latter two were close. There were statistical difference in the vertical distance between the group under 12 years old and other age groups (P<0.05). With the increasing of age, the horizontal and vertical positions of the hyoid bone tended to be constant after 12 years of age. There was no statistical difference in value of horizontal distance and slope among the four different age groups (P>0.05).　Conclusions 　 (1) There is no difference in the horizontal distance of the hyoid bone among people after 4 years of age. The vertical distance shows a little growth change, gradually increases to about 12 years old before the peak period, and no longer changes with the increasing of age. (2) When the vertical bone type is high angle, the vertical distance of the hyoid bone is higher. The lower the mandibular plane is, the larger the horizontal distance tends to.

MR venographic study of the tentorial sinus and bridging veins of tentorium based on three-dimensional visualization technology

Fan Yacao, Wei Liangfeng, Zhao Lin, Yuan Bangqing, Wang Shousen

Chinese Journal of Clinical Anatomy. 2021, 39(3): 286-291. doi:10.13418/j.issn.1001-165x.2021.03.008

Abstract ( 384 )

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Objective　To observe the morphological characteristics of tentorial sinus and bridging veins of tentorium using three-dimensional visualization technology based on CE-MRV, and to explore its clinical significance. 　Methods　Eighty patients who underwent 3D CE-MRV examination in our hospital from January 2016 to November 2019 were randomly selected, and a 3D reconstruction model of the tentorium-veins was established by the StealthViz program in the Stealth Station S7 neuronavigation system. The morphological characteristics of tentorial sinus and bridging veins of tentorium were analyzed.　Results The tentorial sinus can be divided into a medial group, a middle group, and a lateral group. Their common confluence sites from more to less were the transverse sinus, torcular herophili, straight sinus, and superior petrosal sinus. The bridging veins from above the tentorium can be divided into single stem type, multiple stem type, candelabra type, and venous lakes type. Among them, the multiple stem type was the most common type. The cerebellar bridging veins below the tentorium can be divided into a tentorial group, a torcular herophili group, and a petrosal group. The distribution of the bridging vein joining the torcular?herophili was relatively concentrated. 　Conclusions　Three-dimensional visualization technology can effectively display the venous anatomy in the tentorium region of the cerebellum, help to understand the anatomy and drainage characteristics of the cerebral vein in the tentorium area, which is of guiding significance to the design of surgical approach and the protection of the adjacent bridging veins.

Clinical application of 320-slice spiral CT in 3D reconstruction of anterior cerebral artery

Li Lanzhe, Mou Kelin, He Meinan, Liu Weihao, Zhang Hui, Chen Wei

Chinese Journal of Clinical Anatomy. 2021, 39(3): 292-298. doi:10.13418/j.issn.1001-165x.2021.03.009

Abstract ( 487 )

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Objective　To observe the origin、travel、and branch distribution of the anterior cerebral artery, which provides imaging basis for the diagnosis and treatment of cerebrovascular related diseases.　Methods　Brain Multilayer spiral CTA (MSCTA) imaging data of 100 patients without vascular disease were collected randomly, and the imaging anatomical structure of anterior cerebral artery was observed by using their own workstation for image post processing.　Results　(1) The values of each segment of the anterior cerebral artery were measured. There were statistical differences in length, inner diameter of segment A1 of the anterior cerebral artery, and the angle between A1 and A2 on the left and right sides. (2) The travel variation rate of the anterior cerebral artery was 20%, in which the dominant sign of the left A1 segment was 9 %, while the right A1 segment was 5 %. The absence rate of A1 segment on the left side was 1 %, the dysplasia rate of bilateral anterior cerebral artery was 1 %, and the A4-A5 segment on the left side of compensatory blood supply was 1 %. The dominant sign of right A1 segment combined with ipsilateral A2-A5 segment stenosis (compensated blood supply by the left A2-A5 segment) was 1 %. 1 % of A4 segment and A5 segment joint stenosis, 1% of bilateral A1 segment malformation. (3) There were 71 % of the anterior cerebral artery with single trunk type, and 29 % with double trunk type.　Conclusions　MSCTA can display the full length and main branches of anterior cerebral artery and its anatomical variations in a clear and three-dimensional manner. The variation of anterior cerebral artery is complex and the difference between left and right sides is significant, which can provide a reliable basis for early detection and interventional treatment of clinical lesions.

Anatomical study on the relationship between the edge of the acetabular cup and the edge of the osseous acetabulum

Zhou Xueming, Huang Guiwu, Liu Bin, Xie Rentang, Wu Peihui , Wu Runbai

Chinese Journal of Clinical Anatomy. 2021, 39(3): 297-301. doi:10.13418/j.issn.1001-165x.2021.03.010

Abstract ( 269 )

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Objective　To explore the anatomical positional relationship between the edge of the acetabular cup and the edge of the osseous acetabulum by utilizing the imaging data to reconstruct pelvis 3D model, and to improve the accuracy of intraoperative freehand acetabular cup orientation. Methods Based on the CT data of normal acetabulum and Crowe Ⅱ/Ⅲ DDH acetabulum, 3D planning software was used to stimulate the implantation of target acetabular cup in total hip arthroplasty (orientation: anteversion angle was 20°, abduction angle was 40°, acetabular bony coverage rate was more than 75%). In the 1，4，7，10 o’clock four directions of the right acetabulum, the exposed length of the acetabulum cup, which was the distance between the edge of the acetabular cup and the bony edge of the acetabular, was recorded and statistically analyzed. Results The optimal vertical height of the cup implantation for normal acetabulum and Crowe type Ⅱ/Ⅲ DDH acetabulum were (16.26±0.93) mm and (22.09±4.10)mm, respectively. There was statistical differences (P<0.05) between the normal group and the DDH group of exposed length in four directions. The exposed length of the posterior inferior wall of the normal acetabulum (7 o 'clock direction in the right hip, 5 o 'clock direction in the left hip) was (9.71±1.68) mm. The coefficient of variation of the exposed distance in other directions has no obvious difference in different genders and ages. Conclusions The exposed length of the posterior inferior acetabular wall is relatively constant to be utilized as an anatomical reference landmark for THA in normal acetabulum, while for Crowe type II/III patients, there is a great variation in the length of the acetabulum edge exposure in all directions.

Research on the microglial cell autophagy induced by bone marrow stromal cells and its potential molecular mechanism

Yuan Fengying, Zhang Mingxing, Shi Yihua, Li Meihui, Ou Jiayuan, Zhang Mingsheng , Bai Wenfang

Chinese Journal of Clinical Anatomy. 2021, 39(3): 302-310. doi: 10.13418/j.issn.1001-165x.2021.03.011

Abstract ( 176 )

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Objective　To explore the possibility of bone marrow derived neural progenitor cells inducing microglia autophagy, and to identify the molecular mechanisms that might affect microglia growth through the identification of its metabolites and the isolation of exosomes.　Methods　The effects of exosomes on microglia were observed by cell biology and electron microscopy. The liposome metabolite types were identified by chemical reagent extraction and LCMS/MS detection technology.　Results　Molecular experiments have shown that this exosome can induce autophagy in microglia. The potential substances with the ratio of 4597 kinds of germplasm nuclei were detected in the culture medium of bone marrow-derived nerve progenitor cells, 304 kinds of known liposome metabolites were detected in the culture medium and bone marine-derived nerve progenitor cells. After excluding the inherent liposome metabolites in the culture medium, 51 kinds of potentially metabolized and secreted liposomes in the growth process of bone marrow derived nerve progenitor cells were obtained. These were all substances that can potentially cause autophagy in microglia.　Conclusions　Bone marrow derived nerve progenitor cells can induce autophagy in microglia and promote the initiation of immune response, during which liposome metabolites carried in exosomes of bone marrow derived nerve progenitor cells may play an important role.

Animal experimental study of new spinal external fixation surgery on paraspinal muscle injury

Li Shan, Peng Wen, Yan Yiguo, Wang Cheng, Song Xizheng, Li Xuelin, Ouyang Zhihua, Xue Jingbo, Wang Wenjun

Chinese Journal of Clinical Anatomy. 2021, 39(3): 311-318. doi:10.13418/j.issn.1001-165x.2021.03.012

Abstract ( 159 )

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Objective　To verify the advantages of spinal external fixation surgery in reducing paraspinal muscle injury.　Methods　Ten goats were randomly divided into a spinal external fixation surgery group and an open internal fixation surgery group. The experimental animals were sacrificed at 3 months after operation. The lumbar vertebrae of the surgical segment were scanned by 3.0T MRI, and the paraspinal muscle tissue was completely dissected for quasi-static tensile test and pathological section. The effects of the two surgical methods on paraspinal muscle were analyzed.　Results　The goat animal model was successfully constructed. MRI showed that compared with the open internal fixation surgery group, there were only a small amount of muscle injury around the screw in the spinal external fixation surgery group. Quasi-static tensile mechanical tests, tissue section staining (HE staining, Masson staining) all suggested that there was less muscle injury in the spinal external fixation surgery group. There are statistical differences. Conclusions　The method of spinal external fixation through percutaneous nail implantation and external orthopedic fixation was verified to reduce the paraspinal muscle injury caused by postoperative internal fixation device compression and interference.

Experimental study on the treatment of distal ureteral obstruction by magnetic compression technique

Deng Bo, Xu Shuqin, Wang Fangzhou, Shi Yuhang, Li Yixing, Lin Yi, Fan Qian, Ji Lin, Chen Wenwen, Lv Yi, Yan Xiaopeng

Chinese Journal of Clinical Anatomy. 2021, 39(3): 319-322. doi:10.13418/j.issn.1001-165x.2021.03.013

Abstract ( 738 )

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Objective　To explore the feasibility of using magnetic compression technique to treat distal ureteral obstruction.　Methods　Six New Zealand rabbits were ligated to the distal ureter of the right ureter with silk thread to simulate the model of distal ureteral obstruction after kidney transplantation. After 4 weeks, the ureteral dilatation was observed by laparotomy. It was confirmed that the model was successfully prepared when the ureter dilatation was 5 mm or more. The ureter was cut longitudinally about 5 mm in the upper ureter, where the daughter magnet was placed, and the daughter magnet was slowly pushed to the distal end of the ureter with a soft catheter. Another side, the body of bladder was opened and the incision was stitched by purse-string suture. The incision was about 5 mm long. The parent magnet was placed through the bladder incision, and the parent magnet was pushed to approach the daughter magnet. The parent and daughter magnets could be automatically aligned to absorb and compress the ureter and bladder wall. After a period time of operation, the daughter and parent magnets were detached into the bladder, and the ureter-bladder anastomosis was established. Specimens were obtained and the gross specimens of the anastomosis were observed with naked eyes.　Results　All the experimental animals were successfully operated and survived well after surgery. After 9-16 days, the daughter and parent magnets were detached into the bladder, and the ureter-bladder anastomosis was established. Obtaining anastomotic specimen showed that the anastomosis healed well.　Conclusions　Magnetic compression technique (MCT) is safe and feasible for the treatment of distal ureteral obstruction, which can be used clinically to treat distal ureteral obstruction after kidney transplantation.

Interleukin-10 affects the recovery of motor function of spinal cord contusion rats via glyoxalase-1

Niu Yingjie, Dong Yuejiao, Wang Ruoyao, Zhao Xinxin, Mu Shuqi, Zhang Xiao, Rong Cheng

Chinese Journal of Clinical Anatomy. 2021, 39(3): 323-329. doi:10.13418/j.issn.1001-165x.2021.03.014

Abstract ( 264 )

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Objective　To inhibit the expression of IL-10 and to observe IL-10 affected the recovery of motor function of spinal cord contusion rats by glyoxalase-1 by using lentivirus mediated RNA.　Methods　The model of spinal cord contusion (SCC) was established in 66 Sprague-Dawley rats with Allen's method. The rats were randomized into a Sham group (n=9); a SCC group (n=27)、a Vector group (n=15) and a IL-10 SH group (n=15), which were injected blank lentivirus vector and vector of IL-10 siRNA respectively and then divided into 3 days, 7 days and 28 days subgroups. Basso, Beattie, Bresnahan (BBB) score was used to evaluate the motor function recovery of hind limbs in rats. The localization and expression of GLO1 were examined by immunohistochemistry and real-time quantitative polymerase chain reaction (qRT-PCR) respectively. The inhibition of IL-10 (IL-10-SH-LV) mediated by lentivirus transduction was used to elucidate the function of IL-10 and GLO1. GeneMANIA was used to predict the relationship between IL-10 and GLO1.　Results　The motor capability of hind limbs disappeared after SCC and followed by recovery at 1d, 3d, 7d and 14d as evaluated by BBB score, but it still could not reach the normal level. The expression of IL-10 decreased obviously in spinal cord tissue after SCC was detected by qRT-PCR, and the immunoreactive positive reactant of IL-10 was located in neurons and neuroglial cells of ventral horn in spinal cord by immunofluorescence. Inhibition of IL-10 mediated by lentivirus reduced motor function (evaluated by BBB score), but increased in the next time with the upregulation of GLO1. Futher more, GeneMANIA result showed that GLO1 contacted with IL-10 through Hpd and Klk1c2/Kcns1/Proc, which were co-expression in rats.　Conclusions　IL-10 promotes functional recovery of spinal cord contusion rats, which may be associated with upregulation of GLO1.

Biomechanical study on V-Y extending terminal tendon of extensor tendon for distal attachment inhuman cadaver hands

Wang Gaofei, Zhang Zhufeng, Wei Zhuang

Chinese Journal of Clinical Anatomy. 2021, 39(3): 330-335. doi:10.13418/j.issn.1001-165x.2021.03.015

Abstract ( 389 )

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Objective　To discuss the biomechanics of V-Y extending terminal tendon (TT) for distal attachment to treat chronic mallet fingers (tendon-bone or partial bony).　Methods　Twelve fingers were randomly divided into the following two groups based upon the repair technique. A control group: 1mm TT was removed at the insertion, the distal TT was attached by pull-out; an experimental group: 1mm TT was removed at the insertion, the proximal portion of the TT was cut with a “V” incision which was then repaired in a “Y” fashion, and the distal TT was attached by pull-out. Biomechanics experimental outputs were calculated and statistically analyzed.　Results　As the rupture (load failure) occurred, the experimental group: 2 specimens (accounting for 33.3%) failed by suture breakages and 4 cases (accounting for 66.7%) failed by suture pulled out from the tendon at V-Y suture and all sutures were prolonged at attachment. Suture breakages happened in all specimens of the control group. There was significant difference between the two groups (P<0.05) in the load failure while no significant difference (P>0.05) in the maximum displacement. All sutures were prolonged at the attachment when the tendon-bone gap reached 1mm in both groups and the tendon-tendon was closely sticked at V-Y suture. There was significantly different between the two groups (P＜0.05) in the displacement while no significant difference (P>0.05) in the load and stiffness. Conclusions The load, displacement and stiffness of 1mm tendon-bone gap were more clinically meaningful than the repair failure force and maximum displacement. Reattachment with V-Y suture effectively extended TT and repaired tendon-bone gap, while unaffected the biomechanical properties of TT.

Comparative study of arthroscopic double row suture bridge " without knot" repair technology in the treatment of elderly rotator cuff injury

Liu Weile, Zheng Shaowei, Li Xu, Wang Yin, Shi Zhanjun, Sun Chunhan, Xie Fujie, Zhong Haobo

Chinese Journal of Clinical Anatomy. 2021, 39(3): 336-341. doi:10.13418/j.issn.1001-165x.2021.03.016

Abstract ( 401 )

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Objective　To compare the effect of double-row suture bridge " without knot" and "with knot" repair technology under the arthroscopy for the treatment of elderly rotator cuff injury.　Methods　Sixty-nine elderly patients with rotator cuff injury admitted to Huizhou people’s Hospital from January 2016 to February 2019 were prospectively collected and 35 cases were randomly asigned into a control groups (articular endoscope double-row suture bridge "with knot" repair technique ) and 34 cases were into an observation group (arthroscope double-row suture bridge "without knot" repair technique). The joint function and the retear rate with different degree of injury were compared between the two groups 3 months and 6 months after operation.　Results　There were no significant differences in the baseline characteristic, UCLA, ASES, and Constant-Murley scores between the observation group and the control group before treatment (P> 0.05). However, at 6 months after operation, the UCLA, ASES, and Constant-Murley scores of the two groups were better than those before operation (P<0.001). There was no significant differences in the UCLA、ASES、Constant-Murley scores between the observation group and control group after operation from all the patients in the whole group and light-moderate tears degree subgroups. Among the subgroups with heavy-large tears, the UCLA, ASES, and Constant-Murley scores of the observation group were significantly better than those of the control group (P<0.05). There was no significant differences in the antexion of the shoulder joint and the degree of external rotation of the two groups after operation (P＞0.05). The incidence of re-tearing in the control group was higher than that in the observation group (17.1% vs. 2.9%, P = 0.051). Conclusions Both double-row suture bridge "with knot" and "without knot" repairs are effective and feasible in elderly patients with rotator cuff injury. For patients with heavy-large tears degree, the "without-knot" technique may be more advantageous.

Efficacy and prognosis of arthroscopic-assisted MIPPO technique in the treatment of elderly Schatzker II-III tibial plateau fractures

Ge Xinjiang, You Jianjun, Liu Xiaofeng, Ma Ying

Chinese Journal of Clinical Anatomy. 2021, 39(3): 342-345. doi:10.13418/j.issn.1001-165x.2021.03.017

Abstract ( 454 )

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Objective　To analyze the efficacy and prognosis of arthroscopy-assisted minimally invasive percutaneous plate osteosynthesis (MIPPO) technology in the treatment of elderly Schatzker type II-III tibial plateau fractures. Methods　Forty-three patients with Schatzker type II-III tibial plateau fracture in our hospital were divided into an observation group (arthroscopy-assisted MIPPO technique, 19 cases) and a control group (traditional incision and reduction and internal fixation, 24 cases) according to the surgical method. The short-term effects after operation, short-term complications, and long-term quality of life in two groups were compared.　Results　Compared with the control group, the incision length, length of hospital stay, and bone healing time of the observation group were much shorter, the intraoperative blood loss and postoperative drainage volume significantly reduced (all P<0.05). The rates of incision infection, skin necrosis, delayed healing, joint stiffness, and traumatic arthritis of the observation group were much lower than those of the control group (all P<0.05). The Rasmussen function and radiological scores of the observation group were much higher than those of the control group (all P<0.05). The scores of the two groups of patients after treatment were significantly higher than those before the treatment (both P<0.05).　Conclusions　Arthroscopy-assisted MIPPO technique for the treatment of elderly Schatzker type II-III tibial plateau fractures effectively reduces trauma and near-term complications, significantly accelerates recovery, and significantly improves quality of life.

Significance of cricothyroid space in endoscopic thyroid surgery

Zhang Wanyu, Chen Junxing, Tang Shilong, Lu Qiang, Chen Zhanhui, Chen Rongjun, Qi Songxu, Chen Guixing, Qiu Cheng

Chinese Journal of Clinical Anatomy. 2021, 39(3): 346-350. doi:10.13418/j.issn.1001-165x.2021.03.018

Abstract ( 961 )

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Objective　To investigate the significance of the cricothyroid space in protecting external branch of superior laryngeal nerve (EBSLN), recurrent laryngeal nerve (RLN) and parathyroid gland（PT）during scarless in the neck endoscopic thyroidectomy(SET) and the importance of treating upper pole of the gland in endoscopic thyroidectomy.　Methods　A retrospective analysis was performed based on clinical information of 128 cases of scarless in the neck endoscopic thyroidectomy(SET) from April 2014 to July 2018，including unilateral or bilateral subtotal thyroidectomy and unilateral or bilateral partial thyroidectomy. The thyroid gland was partially or completely excised with the operation of upper pole of the gland through cricothyroid space combining the operation of lower pole gland and the outside of the gland.　Results　All the 128 cases were treated with the upper thyroid vessels after entering the cricothyroid space. The EBSLN were exposed in 76 cases (59.3%), the RLN were exposed in 106 cases in the lower thyroid pole at first, and the other 22 cases were exposed by the cricothyroid l thyroid space approach. UPT was found in 106 cases (83%) near the cricothyroid joint and in 22 cases (17%) on the dorsal surface of the upper pole. 84 cases were followed up to now. 2 patients had postoperative hoarseness and unilateral recurrent laryngeal nerve paralysis. There was no voice blunt, no cough when eating and drinking, or no permanent low calcium detected.　Conclusions 　The cricothyroid space plays an important role in safely severing of the superior thyroid vessels and the effectively protecting the EBSLN, the RLN and the upper parathyroid gland（UPT）in endoscopic thyroidectomy. Therefore, the surgical operation on the upper pole of thyroid gland can combine with the operation on thyroid isthmus, the lower pole and the lateral side, to form a routine surgery procedure of the endoscopic thyroid gland, which improves the safety of the operation and facilitates the popularization of the operation.

Clinical application of the perforator flap based on the first perforating branch of profunda femoral artery in reconstruction of patients with IV degree pressure ulcers in the region of buttock and thigh

Deng Changhua, Kong Fanfu, Wu Zhen, Nie Meng, Liu Chao

Chinese Journal of Clinical Anatomy. 2021, 39(3): 351-354. doi:10.13418/j.issn.1001-165x.2021.03.019

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Objective　To investigate the feasibility of the perforator flap based on the first perforating branch of profunda femoral artery in reconstruction of patients with IV degree pressure ulcers in the region of buttock and thigh.　Methods　From January 2016 to February 2019, nine patients with IV degree pressure ulcers in the region of buttock and thigh were admitted to the department of Trauma and Orthopaedics, the Second people's Hospital of Xining city, including 3 males and 6 females, aged from 26~68 years, with an average age of 46 years. The causes of paraplegia were fall injury in 4 cases, traffic accident injury in 3 cases and cerebral infarction in 2 cases. After debridement, the wound area was 8 cm×5 cm~18 cm×9 cm. According to the shape, size and location of the wound, the perforator flap was designed to repair the pressure ulcers wound based on the first perforating branch of profunda femoral artery. The flap area was 10 cm×7 cm~20 cm×10 cm.　 Results　All flaps survived completely, including 2 cases with more local inflammatory exudates, and the flap recovered well after active conservative treating. 9 cases were followed up for 6 to 24 months, with an average of 13 months. The skin flap was good in color, soft in texture, and it did not affect daily life. No recurrence of pressure ulcers was found.　Conclusions　The perforator flap based on the first perforating branch of profunda femoral artery is easy to operate, reliable in blood supply and large amount of tissue supply. It is a better choice for the repair of patients with IV degree pressure sore in the region of buttock and thigh.

Research on the serum hepcidin and iron metabolism indicator in intracerebral hemorrhage and its application in assessment of early conditions and prognosis

Sun Yu, Yang Shuiquan, Hu Zhaohui, Liang Wenjun, He Xingling

Chinese Journal of Clinical Anatomy. 2021, 39(3): 355-358. doi:10.13418/j.issn.1001-165x.2021.03.020

Abstract ( 416 )

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Objective　To explore the relationship between serum hepcidin and iron metabolism indicator in intracerebral hemorrhage and its application in assessment of early conditions and prognosis. Methods　According to the selection, 92 patients were enrolled into an intracerebral hemorrhage (ICH) group and 92 healthy individuals into a control group. The levels of serum hepcidin（Hep）、 serum ferritin（SF）、interleukin-6（IL-6) were measured at 1, 3, 5, 7, 14 days after onset of ICH. ICH group were further divided into a mild ICH group，a moderate ICH group，and a severe ICH group according to their NIHSS score on the third day of admission. The modified Rankin Scale (mRS) score was evaluated at 3 months after ICH. According to the mRS scores, the patients was divided into a good outcome group (mRS≤2) and a poor outcome group (mRS>2). In the observation group, the volume coefficient of relative edema at the time of admission and 3 days after admission was calculated according to the CT data. The levels of Hep、 SF、IL-6 in the observation group and control group were compared at each time points. The relationship between the levels of Hep、 SF、IL-6 and the neurologic impairment and prognosis were analyzed.　Results　The levels of serum Hep、SF、IL-6 at each time points in the observation group were higher than those inthe control group, which were statistical differences in them (P<0.05, P<0.01). There were statistical differences in the levels of serum Hep、SF、IL-6 at each time points among the mild, moderate and severe ICH groups (P<0.01). There were statistical differences in the levels of serum Hep、SF、IL-6 at each time points among the good outcome group and the poor outcome group (P<0.01). The serum level of Hep in the observation group was positively correlated with those of SF, IL-6 and the relative volume coefficient of edema on the third day after admission (P<0.01). Conclusions The levels of serum hepcidin、SF、IL-6 are closely related to the occurrence, severity and prognosis of ICH , which can be used as a bioindicator of the severity and prognosis of ICH.

Application value of prenatal ultrasound in the diagnosis of congenital valgus foot

Lan Jiafu, Zhong Qiuhong, Lu Qisheng, Zhang Qiuyan

Chinese Journal of Clinical Anatomy. 2021, 39(3): 359-362. doi:10.13418/j.issn.1001-165x.2021.03.021

Abstract ( 392 )

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Objective　To explore the application value of prenatal ultrasound in the diagnosis of congenital valgus foot. 　Methods　To select thirty-eight children (44 affected feet) with congenital horseshoe varus treated in our hospital from January 2016 to January 2019 as the observation group, and the screening time is 20 to 26 weeks of pregnancy. Another 35 cases of fetuses (70 feet) who were normal in our hospital during the same period were selected) as a control group. Color ultrasound diagnostic equipment was used to measure the foot length (FL) and foot width (FW) of the two groups, and the FL / FW value was calculated the children's disease severity was evaluated using the Dimeglio method, and their relationship with FL, The correlation between FW and FL / FW. The clinical value of FL, FW and FL / FW in the diagnosis of congenital varus equivatus were analyzed by ROC method. Results Compared with the control group, the children in the observation group had smaller FL and FL / FW values, while the FW values were larger, and the differences were statistically significant (P<0.05); there were differences in FL, FW, and FL/FW between different Dimeglio grades. All were statistically significant (P<0.055). FL and FL/FW values gradually decreased with the increase of Dimeglio classification (P<0.05), while FW values gradually increased with the increase of Dimeglio classification (P<0.05); Spearman analysis showed that FW was positively correlated with Dimeglio score, while FL and FL/FW were negatively correlated with Dimeglio score (P<0.05); ROC curve analysis showed that FL, FW and FL/FW diagnosed congenital valgus. The areas under the curve are 0.723 (95% CI: 0.591 to 0.926, P = 0.005), 0.661 (95% CI: 0.522 to 0.849, P=0.017), and 0.835 (95% CI: 0.709 to 0.984, P<0.001). The best diagnostic cutoff values are 4.01, 2.49 and 1.92, respectively, and the diagnostic sensitivity and specificity are 80.73 and 81.26, 81.07 and 78.93, 90.13, and 90.74. FL / FW has the largest diagnostic value for congenital valgus. Conclusions Prenatal ultrasound has important reference value for clinically accurate diagnosis of congenital horseshoe varus.

The application and research progress of periosteum grafting in scaphoid nonunion

Liu Zhidong, Zhuang Yongqing

Chinese Journal of Clinical Anatomy. 2021, 39(3): 363-365. doi:10.13418/j.issn.1001-165x.2021.03.022

Abstract ( 353 )

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Research progress of myodural-bridges

Xu Qiang, Yu Shengbo, Sui Hongjin, Lin Xiangtao

Chinese Journal of Clinical Anatomy. 2021, 39(3): 366-368. doi:10.13418/j.issn.1001-165x.2021.03.023

Abstract ( 264 )

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Effect of miRNA on the TGF-β/smad signal pathway in hepatic fibrosis

Ma Chuhan, Yu Yanan, Lui Qiwen, Che Huasong, Zhao Jiamei, Hu Qiuxia, Cheng Jiamao

Chinese Journal of Clinical Anatomy. 2021, 39(3): 369-372. doi:10.13418/j.issn.1001-165x.2021.03.024

Abstract ( 237 )

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A case of variation left accessory renal artery and run through left ovarian vein

Hua Wenxi, Chen Yangjia

Chinese Journal of Clinical Anatomy. 2021, 39(3): 251. doi:10.13418/j.issn.1001-165x.2021.03.025

Abstract ( 289 )

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