Chinese Journal of Clinical Anatomy

Anatomical study and clinical significance of posterior atlantoaxial structure

Pan Baoshun, Chen Jinshui, Fang Zhen, Gao Mingjie

Chinese Journal of Clinical Anatomy. 2022, 40(6): 633-638. doi:10.13418/j.issn.1001-165x.2022.6.01

Abstract ( 343 )

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Objective To measure the anatomical parameters of posterior atlantoaxial structure, so as to provide anatomic basis for the design of posterior atlantoaxial internal fixation system. Methods The anatomical parameters of 30 atlantoaxial vertebra specimens, CT posterior structures of atlantoaxial vertebra of 50 males and 50 females were measured. The CT data of different genders, bone and CT measurements on the left and right side, and bone and CT measurements were compared for statistical significance. Results The height and thickness of the posterior midline of the bone specimens were (10.75±1.38) mm and (8.55±1.77) mm, and the distances from the medial edge of the vertebral artery sulci on both sides to the posterior midline of the bone specimens were (13.45±0.73) mm and (20.28±2.20) mm, respectively. The posterior arch angles of the inner and outer edges were (141.00±3.43) ° and (134.67±2.87) °, respectively. The height and thickness of the posterior midline measured by CT were (10.45±1.61) mm and (8.12±1.57) mm, and the distances between the inner and outer posterior midline and the medial edge of the vertebral artery sulci by CT measurement were (13.60±1.26) mm and (20.48±2.05) mm, respectively. The angle of posterior arch of the inner and outer edges by CT measurement were (141.23±9.64) ° and (135.47±9.02) °, respectively, the radius of the outer edge of posterior arch was (26.77±2.14) mm, the slope rate of the vertebral lamina of the axial vertebra was (58.34±7.60) °. The height from the lower edge of the posterior arch of the atlas to the upper edge of the spinous process of the axial vertebra was (19.07±2.73) mm. The height of posterior atlantoaxial space was (6.83±2.01) mm. There were statistical differences in most of gender in CT data (P<0.05). There was no significant difference in bone specimens and CT data on the left and right sides (P>0.05). There was no significant difference between bone specimens and CT data (P>0.05). Conclusions The anatomical characteristics of posterior atlantoaxial bone structure is relatively fixed. CT can better reflect the characteristics. This study can provide anatomical basis for the design of the posterior atlantoaxial internal fixation system.

Research on the visualization model of skull base and neck in digital children

Li Ziyu, Li Kun, Guo Yan, Yue Sa, Qu Xingyue, Liu Yuhang, Zhang Fengzhen, Wang Xing, Xu Yifa, Li Zhijun, Li Xiaohe, Zhang Shaojie

Chinese Journal of Clinical Anatomy. 2022, 40(6): 639-643. doi:10.13418/j.issn.1001-165x.2022.6.02

Abstract ( 139 )

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Objective To reconstruct the skull base and neck of children and create three-dimensional visual model. Methods The digital anatomical image dataset of a 6-year-old Chinese boy was obtained by freezing numerical control milling and digital photography. The cross sections from the skull base to the upper edge of T1 were selected and manually segmented by using PhotoShop.2021. The Digihuman Reconstruction System was used to directly reconstruct the manually segmented structure, and then imported into 3-Matic Research 13.0 software for adjustment and modification. Results The first three-dimensional visualization model of skull base and neck of a Chinese boy was established successfully. The three-dimensional morphology and spatial position of the segmented structures were clearly explained in multiple directions and multi-angles. And detailed observation of skull base, vertebrae, blood vessels, nerves and muscles of neck was completed. The anatomical characteristics and surgical precautions were preliminarily analyzed by measuring carotid and venous nerves and vertebral body data. Conclusions The three-dimensional visualization model of skull base and neck of digital children can display the detailed anatomical structure and adjacent relationship, which provides important reference for clinical diagnosis and treatment, virtual surgery and medical teaching of pediatrics.

Morphological classification and clinical significance of the third finger web based on 3D reconstruction of structured light scanner

Feng Peixun, Li Guijun , Zhao Yonghong, Cheng Mingliang, Li Liguo

Chinese Journal of Clinical Anatomy. 2022, 40(6): 644-648. doi:10.13418/j.issn.1001-165x.2022.6.03

Abstract ( 277 )

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Objective To explore morphological classification and clinical significance of the third finger web based on 3D reconstruction of structured light scanner, so as to provide data support for the reconstruction of finger webbed separation. Methods A total of 126 volunteers from of Zhengzhou University Science Park and Zhengzhou Health Vocational College were selected as research objects, aged from 18 to 42 years old, with an average age of (25.07±4.62) years old. The 3D surface structured light scanner was used to measure the proximal phalangeal length (PPL), web length (WL), metacarpals distance (MD) and free edge of web length (WW), such as 8 direct measurement indicators and 4 indirect indicators. Results The anatomical morphology of the third finger web reconstructed by 3D structured light scanner can be divided into 5 types: steep slope-type, micro arcuate-type, straight line-type, circular arc-type, and convex-type. The PPL3 and PPL4 in convex-type were less than those in the micro arcuate-type. The PPL3 in circular arc-type and convex-type were less than those of steep slope-type (P<0.05). The WH in convex -type was smaller than that of steep slope-type (P<0.05). The WHR in micro arcuate-type was smaller than that of steep slope-type and circular arc-type (P<0.05). The differences were statistically significant. Conclusions The third finger web can be divided into 5 types: steep slope-type, micro arcuate-type, straight line-type, circular arc-type, and convex-type. Different morphological types of the third finger web can provide anatomical basis for clinicians to choose the operation methods and design of flap shape.

Applied anatomical study of eyebrow fat pad based on the mechanism of upper eyelid skin ptosis

Ma Kun, Li Pingsong, Hou Tuanjie, Chen Xiao, Ma Le, Rong Kunjie, Chen Jiaxiang

Chinese Journal of Clinical Anatomy. 2022, 40(6): 649-654. doi:10.13418/j.issn.1001-165x.2022.6.04

Abstract ( 201 )

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Objective To provide anatomical basis for the replacement of eyebrow fat pad to improve the blepharoplasty of upper eyelid skin ptosis. Methods The eyebrow regions of 14 fresh frozen cadaver heads were dissected. The important adjacent relationship and anatomical parameters of eyebrow fat pad were recorded and measured. Results The eyebrow fat pad was located in the fascial fat layer between the frontalis muscle, the orbital part of the orbicularis oculi muscle and the periosteum, and it was closely connected with the orbicularis oculi muscle. While the connection between eyebrow fat pad and periosteum and orbital diaphragm was loose. The eyebrow fat pad gradually thinned upward to a fascia state, and moved downward into the fat layer under the orbicularis oculi muscle The medial side was the supra-trochlear neurovascular bundle, which continued outward with the fat layer of the superficial temporal fascia, showing a flat oval shape with a long transverse diameter. The mapping range on the body surface was located in the peak and tip of the eyebrow. The maximum thickness, vertical width, and horizontal length of eyebrow fat pad were (1.33±0.30) mm, (15.51±0.53) mm, (34.44±0.67) mm. Its main blood supply came from the branches of the supraorbital artery to the temporal side. The eyebrow fat pad formed a sliding space between the orbital septum and the muscle, which was conducive to eyebrow movement, but it would cause the lateral eyebrow to have insufficient support against gravity, resulting in the lateral orbital soft tissue sagging with the increasing of age. Conclusions The skin ptosis of the upper eyelid can be improved by replacing the eyebrow fat pad and fixing it on the periosteum of the orbital margin, which can not only adjust the position of the eyebrow, but also enhance the supporting structure of the soft tissue above the orbital margin, avoid the appearance of eyebrow ptosis, stabilize the surgical effect and improve the morphology of eyebrow and upper eyelid.

Ultrasound imaging measurement and analysis of paravertebral muscles in adolescent patients with idiopathic scoliosis at different positions

Yang Qiaohua, Yan Bin, Li Zhengyi, Du Bingran, Ru Shouhang, Jiang Jiang, Wang Fei, Jia Rui, Li Jianyi

Chinese Journal of Clinical Anatomy. 2022, 40(6): 655-659. doi:10.13418/j.issn.1001-165x.2022.6.05

Abstract ( 205 )

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Objective　To evaluate the symmetry and morphologic characteristics of the paravertebral muscle in adolescent idiopathic scoliosis (AIS) patients by ultrasound, so as to provide basis for the exercise treatment of AIS.　Methods 　A total of forty-six adolescents (23 with AIS as a patient group and 23 without AIS as a control group) were collected. The thickness of paravertebral muscle (erector spinae at T12~L5 vertebral levels, multifidus at T12~S1 vertebral levels, quadratus lumborum and transversus abdominis muscle) was measured by ultrasound in resting position (prone position of lumbar and back muscles, supine position of abdominal muscles) and standing position. The rate of muscle thickness change was calculated.　Results　At resting position and standing position, the convex side thickness of erector spinae at T12~L4 vertebral levels, the multifidus of T12~S1 vertebral levels, quadratus lumborum and transversus abdominis muscle (only the rest position) of the main bending line in AIS patients was lower than that of the concave side (P<0.05). At resting position and standing position, the change rates of spinal erector contraction thickness on convex side and concave side in AIS group was lower than that in the control group (P<0.05).　Conclusions　At resting position and standing position, compared with the control group, the paraspinal muscles of AIS patients were asymmetrical in multiple vertebral segments, and the thickness of the convex paraspinal muscles were thinner in the AIS patients.

Influence of pedicled artery position on the survival of multi-territory perforator flap

Qiu Yujun, Fu Yu, Su Hang, Yin Siyuan, Wang Yueqing, Tang Maolin, Xi Shanshan

Chinese Journal of Clinical Anatomy. 2022, 40(6): 660-664. doi:10.13418/j.issn.1001-165x.2022.6.06

Abstract ( 127 )

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Objective To investigate the influence of the pedicled artery position on the survival of multi-territory perforator flap. Methods Thirty-two Sprague-Dawley rats were randomly divided into two groups: a control group, only the right iliolumbar artery and vein were preserved; and an experimental group, only the right iliolumbar vein and the left iliolumbar artery were preserved. At 7 days after operation, the survival of the flap was counted. Arteriography was performed to observe the dilation of the choke arteries, and HE staining microscope was used to measure the intraluminal diameter of the choke artery. Results At 7 days after operation, the survival rate of the flap in the experimental group was significantly higher than that in the control group[ (85.5±2.9)% vs (68.9±2.6)%, P<0.001]. The dilation of the choke1 artery was comparable in both groups [(46.93±6.21) μm vs (46.79±6.69) μm, P>0.05], whereas the choke 2 artery in the experimental group was more dilated than that in the control group[(66.08±6.78) μm vs (46.00±6.90) μm, P<0.001]. Conclusions The position change of the pedicled artery can promote the dilation of the choke artery and the blood supply to the distal part of the flap, so as to increase the survival rate of multi-territory perforator flap.

rno-miR-161 inhibits ferroptosis by targeting EGLN2 in VD rat model frontal lobe

Zhou Xianxi, Zhou Liting, Ma Chunmei, Kong Jiechen, Su Junfang, Deng Rudong, Liu Aijun, Chen Dongfeng

Chinese Journal of Clinical Anatomy. 2022, 40(6): 665-670. doi:10.13418/j.issn.1001-165x.2022.6.07

Abstract ( 171 )

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Objective To explore the effect of rno-miR-161 on regulating egl-9 hypoxia-inducible factor 2(EGLN2) in frontal ferroptosis in vascular dementia (VD) rat. Methods Twenty-four adult male SD rats were randomly divided into a control group (sham), a model group (VD). The VD group was obtained by bilateral carotid artery ligation, while the sham group was not ligated with bilateral carotid artery. The Morris water maze test was applied to assess the symptoms of VD 4 weeks after surgery. RT-qPCR was used to detect the changes of rno-miR-161. RT-qPCR and Western blotting were used to detect the expression levels of EGLN2 and glutathione-dependent antioxidant enzyme glutathione peroxidase 4 (GPX4). The relationship between rno-miR-161 and EGLN2 was predicted by bioinformatics and luciferase reporter gene test. RT-qPCR and Western blotting were used to detect the effect of rno-miR-161-mimic and rno-miR-161-inhibitor on EGLN2 expression. The expression of EGLN2 was interfered by interference technology and the expression of GPX4 was detected by Western blotting and RT-qPCR. Results Compared with the control group, the expression of rno-miR-161 was down-regulated in the frontal lobe, the EGLN2 expression was increased while GPX4 was down-regulated. The EGLN2 was the direct target of rno-miR-161. rno-miR-161-minic inhibited the expression of EGLN2, rno-miR-161-inhibitor resulted in higher EGLN2 expression. siEGLN2 promoted GPX4. Conclusions rno-miR-161 inhibits ferroptosis by targeting EGLN2 expression in VD rat model frontal lobe.

Protective effect of tanshinone IIA on CCl4-induced acute liver injury in mice

Li Qingqing, Xiong Jiahui, Wen Yuqing, Yang Hongsheng, Li Jindou, Fang Meng, Liu Yuwei

Chinese Journal of Clinical Anatomy. 2022, 40(6): 671-676. doi:10.13418/j.issn.1001-165x.2022.6.08

Abstract ( 160 )

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Objective To investigate the antioxidant and protective effect of tanshinone IIA (Tan ⅡA) on CCl4-induced acute liver injury in mice and its possible mechanism. Methods C57BL/6J mice were randomly divided into a control group, a CCl4 group and a Tan ⅡA protective group (Tan ⅡA 20 mg/kg+CCl4), with 10 mice in each group. Acute liver injury model was induced by intraperitoneal injection of CCl4 in mice. The liver indices were calculated, the activities of serum AST and ALT were detected, the activity of SOD and the contents of GSH and MDA in liver tissue were measured, and the pathological changes of liver tissue were observed by HE staining. The expression levels of PI3K, p-PI3K, Akt, p-Akt, Nrf2 and HO-1 proteins in liver tissue were detected by immunohistochemistry and Western blot. Results Compared with the CCl4 group, in the Tan ⅡA protective group, the liver indices was significantly decreased (P<0.01), the activities of serum AST (P<0.01) and ALT (P<0.05) was reduced, the activity of SOD (P<0.01) and the content of GSH (P<0.05) were increased while decreasing the content of MDA (P<0.05) in liver tissue, and the pathological changes of liver tissue was significantly improved. In addition, Tan ⅡA could significantly increase the expression levels of p-PI3K and p-Akt (P<0.01) in liver tissue, while significantly inducing Nrf2 translocation into nucleus (P<0.01), which significantly increased the expression level of its downstream target protein HO-1 (P<0.01). Conclusions Tan ⅡA can significantly ameliorate CCl4-induced acute liver injury. Its mechanism may be related to PI3K/Akt/Nrf2/HO-1 signaling pathway.

Anti-inflammatory effect of Clerodendrum japonicum ethyl acetate parts and fractions on RAW264.7 cells induced by LPS

Wei Jiangcun, Qin Zujie, Cai Wenwei, Ma Xiumei, Qin Lipin, Ma Yan, Zheng Ling, Tan Yuping

Chinese Journal of Clinical Anatomy. 2022, 40(6): 677-682. doi:10.13418/j.issn.1001-165x.2022.6.09

Abstract ( 124 )

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Objective To screen the fractions with the strongest inhibitory effect on the inflammatory response from the ethyl acetate part of Clerodendrum japonicum (Thunb.) Sweet and the dichloromethane-methanol parts with different elution gradients. Methods The MTT method was used to determine the safe dose range of the Clerodendrum japonicum (Thunb.) Sweet ethyl acetate site and different elution gradients of dichloromethane-methanol to RAW264.7 cells, and the Clerodendrum japonicum (Thunb.) Sweet. ethyl acetate site and different elution gradient dichloride were determined by the ELISA method. The secretion of NO, TNF-a, IL-12, IL-6, and IL-1β were detected in RAW264.7 cells induced by LPS, and screened the fraction with the strongest inhibitory effect on the inflammatory response. Results The ethyl acetate parts and fractions of Clerodendrum japonicum (Thunb.) Sweet were within the concentration range of 0.06~2 mg/mL. The inhibitory effect of the ethyl acetate sections and fractions of Clerodendrum japonicum (Thunb.) Sweet on cell viability was gradually stronger, and the concentration above 0.5 mg/mL had obvious cytotoxicity. Below 0.5 mg/mL could enhance cell viability. The high dose of dichloromethane-methanol elution site could inhibit the release of inflammatory factors IL-12, IL-6, TNF-a, IL-1β, but had no inhibitory effect on the secretion of NO. Conclusions The anti-inflammation mechanism of the Clerodendrum japonicum (Thunb.) Sweet ethyl acetate site and the dichloromethane-methanol site with different elution gradients is through the inhibition of the secretion of NO, TNF-a, IL-12, IL-6, IL-1β inflammatory factors of cells, dichloride Methane-methanol (50:1) elution site and dichloromethane-methanol (30:1) elution site have strong anti-inflammatory ability.

Effects of resveratrol on brain damage in rats with lacunar infarction

Mi Xiaolu, Li Baiyan, Li Yaqin, Zhu Baoyue, Wang Weizhan

Chinese Journal of Clinical Anatomy. 2022, 40(6): 683-688. doi:10.13418/j.issn.1001-165x.2022.6.10

Abstract ( 125 )

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Objective To explore the effects of resveratrol (RES) on brain tissue damage in rats with lacunar infarction (LI). Methods Sixty SD rats were divided into a sham operation group, a model group, a RES group and a combination group (RES+LY294002) averagely. LI models were prepared by sodium laurate method. The nerve function was evaluated by Zea-Longa's method. The cerebral infarction volume was observed by TTC. The levels of oxidative stress and inflammatory factors in brain tissues were detected by enzyme linked immunosorbent assay. The microvessel density was observed by Weidener method. The levels of phosphateidylinositol 3 kinase/serine-threonine kinase (PI3K/Akt) signaling pathways related proteins and vascular endothelial growth factor (VEGF) in brain tissues were detected by Western blotting. Results RES could reduce neurological scores, cerebral infarction volume and levels of MDA, TNF-α, IL-6 and IL-1β in LI rats (P<0.05), increase microvessel density, levels of SOD, CAT, GSH-PX and IL-10, and expressions of VEGF, p-PI3K and p-AKT proteins (P<0.05). Compared with the RES group, the above indexes in combination group showed an opposite trend (P<0.05). Conclusions RES can improve brain damage and angiogenesis in LI rats, and PI3K/Akt signaling pathways participate in this process.

Rhizome panacis majoris total saponin inhibits human cytomegalovirus infection of human embryonic lung fibroblasts by up-regulating miR-216a

Gao Shan, Pang Jie, Li Zhanjie, Li Chenxi, Shang Qingyi

Chinese Journal of Clinical Anatomy. 2022, 40(6): 689-695. doi:10.13418/j.issn.1001-165x.2022.6.11

Abstract ( 144 )

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Objective To explore the effect of rhizome panacis majoris total saponin on the inflammatory response and apoptosis of human embryonic fibroblast (MRC-5) infected by human cytomegalovirus (HCMV) and its regulatory effect on miR-216a. Methods MRC-5 cells were infected with HCMV to establish a virus infection model. The cells were treated with panacis majoris rhizome total saponin at different concentrations (100, 200, 400 μg/mL). The miR-NC and miR-216a mimics were transfected into HCMV-infected MRC-5 cells. After transfecting anti-miR-NC and anti-miR-216a into HCMV-infected MRC-5 cells, rhizome panacis majoris total saponin was added to the cells. ELISA was used to detect the levels of TNF-α and IL-6. Flow cytometry was used to detect the apoptosis rate. qRT-PCR method was used to detect the expression of miR-216a. Results Rhizome panacis majoris total saponin could reduce the apoptosis rate and the levels of TNF-α and IL-6 in MRC-5 cells infected with HCMV (P<0.05), while increase the expression level of miR-216a (P<0.05). Transfection of miR-216a mimics could reduce the rate of apoptosis and the levels of TNF-α and IL-6 (P<0.05). Transfection of anti-miR-216a could reduce the effect of rhizome panacis majoris total saponin on the inflammation and apoptosis of MRC-5 cells infected with HCMV. Conclusions Rhizome panacis majoris total saponin can inhibit the inflammatory response and apoptosis by up-regulating the expression of miR-216a, thereby reducing the damage of MRC-5 cells infected by HCMV.

Application of silk fibroin / chitosan scaffold combined with total flavonoids of Drynaria fortunei on repair of articular cartilage injury

Yu Yang, Song Yongcai, Yang Lifeng

Chinese Journal of Clinical Anatomy. 2022, 40(6): 696-703. doi:10.13418/j.issn.1001-165x.2022.6.12

Abstract ( 103 )

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Objective To observe the repair effect of cartilage injury, Drynaria total flavonoids was applied to the cartilage injury site by using silk fibroin/chitosan scaffold as the carrier, and provide experimental data for clinical application. Methods Silk fibroin / chitosan scaffolds, Drynaria total flavonoids sustained-release microspheres and silk fibroin / chitosan scaffolds loaded with Drynaria total flavonoids sustained-release microspheres were prepared. The microstructure of scaffolds was observed under scanning electron microscope, and the in vitro sustained-release ability of silk fibroin / chitosan scaffolds loaded with Drynaria total flavonoids sustained-release microspheres was detected. Twenty-four New Zealand white rabbits were randomly divided into three groups. A cartilage injury model with a diameter of 3.5 mm and a depth of 1.5 mm was established in the trochlear region of femur by electric drill. In the blank group, no material was implanted in the cartilage defect. In the control group, a simple Silk Fibroin / chitosan scaffold was implanted. In the experimental group, a silk fibroin / chitosan scaffold loaded with osteoclast total flavonoids sustained-release microspheres was implanted. At 12 and 24 weeks after operation, gross and histological observations were performed. The mRNA expressions of Sox-9, type II collagen and aggrecan were detected by RT-PCR, and the expression of type II collagen was detected by Western blot. Results Silk fibroin / chitosan scaffolds had good three-dimensional pore structure, and the pores connected with each other. The surface of the microspheres was smooth. The drug loaded microspheres were evenly dispersed in the silk fibroin / chitosan scaffold matrix. Silk fibroin / chitosan scaffolds could release Drynaria flavonoids in vitro. The results of gross and histological observation showed that the cartilage injury repair effect of the experimental group was better than that of the control group, and the corresponding ICRs score and Wakitani histological score were higher than those of the control group (P<0.05). The expressions of Sox-9, collagen II and collagen aggregation in the experimental group were higher than those in the control group (P<0.05), and the expression of collagen II was higher than that in the control group (P<0.05). Conclusions The silk fibroin / chitosan scaffold loaded with total flavonoids of osteoclast can release the total flavonoids of osteoclast slowly and continuously after being implanted into the damaged part of cartilage, which provides suitable microenvironment for the growth and differentiation of seed cells and effectively promotes the regeneration of cartilage tissue.

Application of adipose-derived stem cell aggregate-extracellular matrix composite patch to repair full-thickness skin trauma in external ear canal of New Zealand rabbits

Ma Hongfeng, Ren Qing, Zheng Mo, Cheng Wanmin, Lian Mei

Chinese Journal of Clinical Anatomy. 2022, 40(6): 704-709. doi:10.13418/j.issn.1001-165x.2022.6.13

Abstract ( 153 )

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Objective To explore the application of an adipose-derived stem cell （ADSC）aggregate-extracellular matrix （ECM） composite patch in full-thickness skin repair of the external auditory meatus of rabbits. Methods New Zealand white rabbits were randomly divided into 3 groups of 10 rabbits each: a blank group, a control group, and an experimental group. A full-thickness skin defect of the inner wall of the external auditory meatus was created at the ventral root of the ear. In the control group and experimental group, the ECM scaffold and the ADSC aggregate-ECM scaffold were laid between the gelatin sponge and the edge of the wound surface using the in-plant method to ensure that the scaffold completely covered the wound surface before the wound was sutured. The blank group underwent no treatment. After postoperative 14 days , the wound healing rate and the positive ratio of bacterial colonies in the wound tissues were compared among the groups. Immunohistochemical examination was used to detect the expression of proliferating cell nuclear antigen（ Ki-67）in the wound tissues of each group, and Western blot was used to detect the expression of the inflammatory factors interleukin 1β（IL-1β） and tumor necrosis factor-α （TNF-α）in the wound tissues of each group. Results The wound healing rate and the proportion of Ki-67–positive cells were significantly higher in the experimental group and control group than those in the blank group, whereas the positive ratio of bacterial colonies and the expression of IL-1β and TNF-α in the wound tissue were significantly lower. Compared with the control group, the wound healing rate and proportion of Ki-67-positive cells were significantly higher whereas the positive ratio of bacterial colonies and the expression of IL-1β and TNF-α in the wound tissue were significantly lower in the experimental group. These differences were also statistically significant （P< 0.05）. Conclusions The ADSC aggregate-ECM composite patch can effectively promote the repair of full-thickness skin defects of the inner wall of the external auditory meatus of rabbits.

Comparison of compressive ability and compression-induced damage to the pilot hole between the two-segmental lag screw and AO lag screw

Xu Daqiang, Sun Peidong, Zhao Jiali, Yang Huilin, Ouyang Jun

Chinese Journal of Clinical Anatomy. 2022, 40(6): 710-713. doi:10.13418/j.issn.1001-165x.2022.6.14

Abstract ( 151 )

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目的比较不同医生拧紧两段式拉力螺钉和AO拉力螺钉加压力和加压后钉道拔出强度。方法 4个0.12 g/cm3的Sawbone松质骨块，每个松质骨块均匀打24个孔并随机分为两组，4名医生根据临床经验在松质骨块上拧紧相同规格的两段式拉力螺钉和AO拉力螺钉，测量螺钉加压力和加压后钉道拔出强度。结果两段式拉力螺钉加压力显著高于AO拉力螺钉（P<0.05），两段式拉力螺钉加压后钉道拔出强度高于AO拉力螺钉（医生I，P=0.875；医生II、III、IV，P<0.05）；不同医生拧紧螺钉后的加压力差异显著（P<0.05）。结论医生均因两段式拉力螺钉获益：相对于AO拉力螺钉，两段式拉力螺钉的加压性能好，加压后钉道损伤程度轻；医生个体差异影响两段式拉力螺钉和AO拉力螺钉加压性能。

Risk factors and clinical effect of vertebral cavity formation after posterior short-segmental fixation for thoracolumbar and lumbar burst fractures

Liang Changxiang, Liang Guoyan, Zheng Xiaoqing, Huang Yongxiong, Yin Dong, Chang Yunbing

Chinese Journal of Clinical Anatomy. 2022, 40(6): 714-719. doi:10.13418/j.issn.1001-165x.2022.6.15

Abstract ( 817 )

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Objective To observe the vertebral body healing pattern after posterior short-segmental fixation for thoracolumbar and lumbar burst fractures, and to analyze the risk factors and clinical effect of vertebral cavity. Methods Fifty-two patients with posterior short-segmental fixation for thoracolumbar burst fracture were followed up for at least 2 years. The CT results of the last follow-up were analyzed to observe the morphological characteristics of the cavity in the vertebral body. The patients with and without obvious cavities in the vertebral body were divided into two groups. The clinical and imaging characteristics of the two groups were compared, and the risk factors leading to the cavities were analyzed to observe whether the vertebral cavity affects the clinical efficacy or not. Results There were 12 cases of complete healing of vertebral body (accounting for 23.1%) and 40 cases of cavity (accounting for 76.9%). The shape of the cavity in the vertebral body could be divided into the following types: small cavity in the endplate (n=9, accounting for 22.5%), large cavity in the vertebral body (n=19, accounting for 47.5%), and split in the vertebral body (n =12, accounting for 30%). The proportion of males in the vertebral cavity group was higher, and the spinal cord nerve injury was more serious. An average follow-up of 37.8 months after surgery showed that the two groups of patients had good back pain and lumbar function, and there was no statistical difference in the VAS and ODI scores between the two groups. Conclusions Vertebral cavities are commonly seen after posterior short-segmental fixation for thoracolumbar and lumbar burst fractures. The higher degree of fracture rupture, the easier to cause the vertebral cavity. The large degree of the vertebral body anterior edge reduction after the operation of screw placement is an important cause of the cavity. Presence of a cavity in the vertebral body does not affect the patient’s lumbar pain and function in the short term.

Application of three-dimensional CT imaging technology in the determination of the "V" point in posterior cervical approach percutaneous spinal endoscopic surgery

Jian Wei, Xu Cong, Ai Wen, Yin Shengjiang, Bi Zhenyu, Wu Zebin

Chinese Journal of Clinical Anatomy. 2022, 40(6): 720-724. doi:10.13418/j.issn.1001-165x.2022.6.16

Abstract ( 736 )

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Objective To evaluate the application value of three-dimensional computed tomography (3D-CT) in determining the "V" point in transforaminal decompression and nucleus pulposus enucleation of posterior cervical approach by using percutaneous spinal endoscopy. Methods A retrospective analysis was made on 50 patients who underwent transforaminal decompression and nucleus pulposus enucleation of posterior cervical spine approach by using percutaneous spinal endoscopy and followed up from January 2016 to June 2018. They all sufferred from cervical spondylotic radiculopathy with unilateral symptoms, conservative treatment for more than 6 weeks were ineffective for them. The dynamic X-ray film of cervical spine showed no instability of cervical spine. There were 27 males and 23 females, with an average age of 54.2 (40~75) years, 14 cases of C4/5 segment, 25 cases of C5/6 segment and 11 cases of C6/7 segment. Fifty patients were divided into groups A (26 cases) and group B (24 cases). The patients were positioned according to the intraoperative conventional "V" point positioning method using C-arm X-ray machine in group A, and the patients determined the "V" point using the 3D-CT technology method before the operation in group B. The average hospital stay, operation time, number of intraoperative fluoroscopy and surgical efficacy between the two groups were compared and statistically analyzed. Results All 50 patients were followed up for an average of (7.20±2.56) months (3-13 months), The average operation time and intraoperative fluoroscopy in group A were more than those in group B (P<0.05). There was no signiant difference in the average hospital stay, postoperative follow-up score, the curvature of the cervical spine, the height of the intervertebral space of the operation segment and the stability of the cervical spine between the two groups (P>0.05). Conclusions 3D-CT technology plays an important role in determining the "V" point in posterior cervical approach percutaneous spinal endoscopic surgery.

Clinical study on repairing large tissue defect of lower limbs with the perforator flaps in anterolateral wall abdominal

Wang Yining, Fan Xinyu, Bi Xin, Peng Yufeng, Bi Zhenyu

Chinese Journal of Clinical Anatomy. 2022, 40(6): 725-729. doi:10.13418/j.issn.1001-165x.2022.6.17

Abstract ( 155 )

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Objectives To investigate the clinical effect of the extended perforator flaps in anterolateral wall abdominal in repairing large tissue defects of lower limbs. Methods From January 2017 to December 2020, 13 patients with large skin and soft tissue defects of lower limbs were repaired with the extended perforator flaps in anterolateral wall abdominal. The defect area of the wound was 5.0 cm× 8.0 cm~17.0 cm×20.0 cm, and the cut area of the flap was 6.0 cm×9.0 cm-18.0 cm×21.0 cm. The donor area of the skin flap was sutured directly. The wound closure, flap survival and donor site healing were observed after operation. The appearance, texture of the flap and the affected limb function were followed up regularly. Results In this group, 12 cases of flaps survived successfully. The color of flaps was close to the surrounding normal skin, and the appearance of flaps was basically satisfactory. One case of venous crisis occurred after inferior epigastric artery perforator flap surgery, and survived after exploratory surgery with the necrosis in the distal part of the flap, which healed after dressing. The other flaps healed well and the color of the flaps was normal. Both recipient site and donor site healed in primary union. Among this group, 8 patients had good limb function, and 5 patients had joint dysfunction due to long-term immobilization and restrict by the flaps. Conclusions The extended perforator flaps in anterolateral wall abdominal has the advantages of stable blood supply, concealed location and large amount of skin and tissue in the donor area, it is reliable in repairing large tissue defects of lower extremities.

Clinical observation of the treatment of wrist scar contracture deformity by Ilizarov technique

Zhang Ziyang, Jin Wenhu, Quan Hui, Wu Xiangkui, Qi Jianping, Wei Zairong

Chinese Journal of Clinical Anatomy. 2022, 40(6): 730-732. doi:10.13418/j.issn.1001-165x.2022.6.18

Abstract ( 237 )

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Objective To explore the therapeutic effect of Ilizarov technique on wrist scar contracture deformity. Methods Seven patients with wrist scar contracture deformity were treated with Ilizarov technique from April 2017 to January 2020(3 males and 4 females). The age ranged from 12 to 52, with an average of 24 years old. There were 2 cases of left hand, 1 case of left wrist, 4 cases of right wrist. Scar hyperplasia occurred in 2 cases due to wound infection, 1 case due to boiling water scald and 4 cases due to flame burn. Scar formation last from 6 months to 34 years, with an average of 7 years. The wrist function was evaluated according to Mayo score, the function was good in 5 cases and poor in 2 cases before operation. Results The deformity of wrist was corrected. The measurement of neutral position of the wrist was 0°. The carpal flexion could reach 55~70°, and the dorsi extension could reach 0~55°. The postoperative follow-up was conducted for 5 to 24 months, with an average of 15 months. There were no complications such as needle tract infection and extremity numbness . At the last follow-up, wrist function was evaluated according to Mayo score. The function was good in 4 cases, fair in 3 cases, which were significantly improved compared with preoperative results. Conclusions Ilizarov technique is safe and effective in the treatment of wrist scar contracture deformity, which provides a new method for limb function reconstruction after burns.

Application of descending branch of lateral circumflex femoral artery Flow-through flap combined with MIPPO in emergency treatment of Gustilo type IIIC fracture of tibiofibula

Chang Shusen, He Chunnian, Chen Wei, Zhou Jian, Zhang Fang, Nie Kaiyu, Deng Chengliang, Wei Zairong

Chinese Journal of Clinical Anatomy. 2022, 40(6): 733-737. doi:10.13418/j.issn.1001-165x.2022.6.19

Abstract ( 140 )

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Objective To investigate the feasibility and efficacy of descending branch of lateral circumflex femoral artery Flow-through flap combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) in the emergency treatment of Gustilo type IIIC fracture of tibiofibula. Methods A retrospective analysis was performed on 6 patients with Gustilo IIIC fractures of tibiofibula admitted to our department from October 2019 to September 2020, including 5 males and 1 female. The age ranged from 24 to 54 years, with an average of 35 years. Causes of injury: 4 cases of traffic accidents, 1 case of falling, 1 case of heavy objects. Limb severity score: more than 7 scores in 2 cases, 6-7 scores in 3 cases, less than 7 scores in 1 case. All patients were accompanied by skin and soft tissue defects with an area of 15 cm×7 cm to 28 cm×12 cm. All patients were treated with the flow-through flap of descending branch of lateral circumflex femoral artery combined with MIPPO. Results The hospitalization time of patients in this group was 10 to 20 days, with an average of 14.2 days. All flaps survived successfully in stage I. All patients were followed up for 7-12 months, with an average of 10.1 months. During the follow-up period, there were no complications such as bone infection and osteomyelitis, and the bone healing time was 7-9 months, with an average of 8.3 months. The skin flap was of good color and texture, and there were linear scars in the donor site. The limbs were in good shape and functional satisfaction (no pain, good sensory recovery, weight-bearing walking, and no obvious lameness). Conclusions The flow-through flap with the descending branch of lateral circumflex femoral artery combined with MIPPO in emergency treatment of Gustilo IIIC fracture of tibiofibula can significantly shorten the treatment period, reduce complications, clear fresh wound anatomy and simpler operation, which is conducive to the early recovery of limb function.

The value of influencing factors in predicting air enema failure in children with intussusception

Yang Shaowei, Chen Yu, Xiao Xia, Liu Fan, Huang Sui

Chinese Journal of Clinical Anatomy. 2022, 40(6): 738-742. doi:10.13418/j.issn.1001-165x.2022.6.20

Abstract ( 168 )

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Objective To explore the value of various influencing factors in predicting air enema failure in children with intussusception. Methods Clinical data of children with intussusception admitted to Wuhan Children's Hospital from January 2012 to December 2019 were retrospectively analyzed, including gender, age, duration of disease, paroxysmal crying or abdominal pain, bloody stool, vomiting, fever, diarrhea, abdominal mass, hospital stay, intestinal obstruction, intussusception position, intussusception type, and results of air enema and surgery treatment. Mann-Whitney U test or Chi-square test was used in univariate analysis. Independent influencing factors were determined by binary logistic regression analysis, and the value of various factors to predict the enema failure was analyzed by the AUC value of the ROC curve. Results There were statistical differences in age, duration of disease ≥ 48h, paroxysmal crying or abdominal pain, bloody stool, vomiting, fever, diarrhea, abdominal mass, intestinal obstruction, intussusception located in the left colon and hospitalization time between the successful and failed groups (P<0.05). There was no statistical difference in the gender distribution between the two groups (P>0.05). Regression analysis result showed that age was a protective factor for enema failure, while the duration of disease≥48 h, blood stool, vomiting, fever, abdominal mass, intestinal obstruction, and intussusception in the left colon were risk factors. ROC analysis result showed that intussusception located in the left colon, age, blood stool, and intestinal obstruction had certain predictive accuracy; and the best cut-off point for age was 10.5 months. Joint prediction with intestinal obstruction, bloody stool, age, and intussusception located in the left colon could improve the accuracy. Conclusions Age≤10.5 months, blood stool, intestinal obstruction, and intussusception located in the left colon have certain accuracy in predicting enema failure, and the accuracy will be higher when joint prediction.

Modified single incision and multi-channel extraperitoneal robot-assisted laparoscopic radical prostatectomy (additional report of 120 cases)

Chen Zhengjun, Nie Yu, Wei Yi, Zhou Fang, Ren Shangqing, Fan Shida, Lv Qian, Tian Jingzhi, Wang Dong

Chinese Journal of Clinical Anatomy. 2022, 40(6): 743-747. doi:10.13418/j.issn.1001-165x.2022.6.21

Abstract ( 212 )

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Objective To investigate the efficacy and safety of modified single incision multi-channel (There is no need to use a multi-channel laparoscopic surgical approach device) extraperitoneal robot-assisted laparoscopic radical prostatectomy. Methods The clinical data of 120 patients with prostate cancer in Sichuan Provincial People's Hospital from November 2020 to June 2021 were analyzed retrospectively. There were 60 cases in group A (modified single incision extraperitoneal approach) and 60 cases in group B (multi-incision transabdominal approach). The average age of group A was 67.5 (60~78) years old. Among them, Gleason score was ≤ 7 in 50 cases and 8 in 10 cases. The volume of prostate was 62.4 (25.0~200.0) ml. The average age of group B was 68.3 (57~80) years. Among them, Gleason score was ≤ 7 in 48 cases and 8 in 12 cases. The volume of prostate was 63.2 (29.5~120.0) ml. The operation time, blood loss, postoperative hospital stay, postoperative exhaust time, incisal margin positive rate and urine control satisfaction rate were compared between the two groups. Results The operation was completed successfully in both groups. The postoperative exhaust time in group A and group B were 25 h (12 h~50 h) and 81.5 h (48 h~160 h), respectively, with statistical difference (P<0.05). The satisfaction rate of urine control in 24 hours and 3 months after operation were 20 cases (accounting for 33.33%), 55 cases (accounting for 91.67%) and 6 cases (accounting for 10.0%), 18 cases (accounting for 30.0%) respectively, the differences were statistically significant (P<0.05). Conclusions Modified single incision and multi-channel extraperitoneal robot-assisted laparoscopic radical prostatectomy has good tumor control effect and rapid recovery of urinary continence and intestinal function after operation. It is not restricted by special PORT and is easy to be popularized.

Application of a red label paper in frozen section of small thyroid lesions

Li Mingxian, Zhou Na, Zheng Xirun, Du Xiaohua, Li Xiao, Zheng Guangjuan, He Qinglian, Tang Lipeng

Chinese Journal of Clinical Anatomy. 2022, 40(6): 748-750. doi: 10.13418/j.issn.1001-165x.2022.6.22

Abstract ( 94 )

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Advances in the treatment of lymphedema on lymph node flap

Zhang Lin, Li Li, Li Liangchang, Qin Xiangzheng, Yu Chunbo, Ding Zihai

Chinese Journal of Clinical Anatomy. 2022, 40(6): 751-753. doi:10.13418/j.issn.1001-165x.2022.6.23

Abstract ( 125 )

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Anatomical features and clinical applications of upper eyelid fat

Chen Zhaoyang, Li Fangwei, Hong Weijin, Wang Haibin

Chinese Journal of Clinical Anatomy. 2022, 40(6): 754-756. doi:10.13418/j.issn.1001-165x.2022.6.24

Abstract ( 272 )

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