Chinese Journal of Clinical Anatomy

Anatomical study of posterior pelvic ring injury combined with contralateral anterior pelvic ring injury treated with modified pararectus abdominis incision

Chen Zhuhong, Li Yanbing, Huang Huajun, Lin Xijiang, Zeng Canjun

Chinese Journal of Clinical Anatomy. 2023, 41(6): 633-639. doi:10.13418/j.issn.1001-165x.2023.6.01

Abstract ( 77 )

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Objective To validate the safety and feasibility of the modified pararectus abdominis approach in the treatment of posterior pelvic ring injury and contralateral anterior ring injury in one incision through anatomical experimentation. Methods Three specimens of cadaver were collected. A modified pararectus abdominis approach with a single incision was used to expose the ipsilateral anterior and posterior pelvic rings and extend to the contralateral anterior pelvic ring. The safety and efficacy of this method was evaluated by assessing the extent of exposure and potential risks to adjacent structures, such as the iliac vessels and corona mortis in the contralateral side, examining the structures exposed, simulating fixation, and collecting relevant data and images. Results The ipsilateral exposure range: This approach extended medially to the midline of the abdomen, reached posteriorly the contralateral edge of the S1 vertebral body, while anteriorly extended to the L5 vertebral body, while it reached the S1 foramen in the true pelvis when exposing caudally. The contralateral exposure range: the contralateral side of the incision could be accessed until reaching the opposite iliopubic eminence. Heading towards the quadrilateral area of acetabulum could expose the medial surface of the contralateral anterior upper part of it, and the depth of the approach extended to upper lateral half of the inner surface of the obturator formamen. Furthermore, the modified approach was effective in revealing the ipsilateral sacroiliac joint and the contralateral pubic ramus while treating the injury of the ipsilateral posterior and contralateral anterior rings under direct visualization. The total incision length was measured at (7.84±0.18) cm, and the distances from the pubic symphysis to the contralateral corona mortis and anterior superior iliac spine recorded as (57.07±1.04) cm and (67.43±0.87) cm, respectively. Conclusions The use of modified pararectus abdominis approach for treating ipsilateral posterior pelvic ring injury and contralateral anterior pelvic ring injury through one incision is a safe and an effective minimally invasive surgical technique that offers advantages in terms of visualization.

Applied anatomical study of anesthesia in vertebral ganglia

Wu Wenbin, Hu Yutian, Dai Linxi, Lv Wangxuan, Lv Fengjun, Yin Yuanjie, Yang Hongmeng, Chang Junda, Li Wenqi, Guo Yiwei

Chinese Journal of Clinical Anatomy. 2023, 41(6): 640-646. doi:10.13418/j.issn.1001-165x.2023.6.02

Abstract ( 78 )

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Objective To study the anatomical characteristics of vertebral ganglia, so as to provide the anatomic reference for anesthesia of cervical sympathetic ganglion. Methods Total 30 adult specimens (60 sides) were dissected. The vertebral ganglia and thyroid ganglion were distinguished according to their appearance forms. The morphology, location, size of the vertebral ganglia and the adjacent relationship with surrounding structures were observed. Results The occurrence rate of vertebral ganglia was 83.33%. The length of vertebral ganglia was (5.06±2.64) mm in males and (4.72±2.56) mm in females on the right side, (4.43±2.76) mm in males, (4.28±2.43) mm in females on the left side. The width of vertebral ganglia was (3.31±1.57) mm in males and (2.86±1.96) mm in females on the right side, (3.14±0.93) mm in males and (3.08±1.56) mm in females on the left side. The thickness of vertebral ganglia was (1.52±1.07) mm in males and (1.88±1.56) mm in females on the right side, (1.57±0.98) mm in males and (2.14±1.21) mm in females on the left side. There were no statistical differences in the length, width and thickness of both sides of vertebral ganglia. The vertebral ganglia was mostly oval in shape (50 %), which was mainly located slightly above the starting part of vertebral artery. Outgoing branches of vertebral ganglia were distributed in the corresponding parts with the postganglionic fibers of cervicothoracic ganglia. There was no statistical difference in the distance from the vertebral ganglion of both sides to the anterior midline cervical line and the depth from the vertebral ganglion of both sides to the skin (P>0.05). Conclusions The vertebral ganglion is an integral part of cervical sympathetic trunk, which may be the assistant of cervicothoracic ganglion and a part of middle ganglion (lower middle ganglion). Vertebral ganglion sends the postganglionic fiber to the target organ together. The incomplete block and adverse reaction of the cervicothoracic ganglion may be related to the fibrous connection of the vertebral ganglion.

Variation of arteries of liver: a case report

Ren Yihang, Fan Jingyuan, Xiao Junhao, Li Yan

Chinese Journal of Clinical Anatomy. 2023, 41(6): 646. doi:10.13418/j.issn.1001-165x.2023.6.24

Abstract ( 72 )

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Research on the three-dimensional dual source CT imaging of hepatic venous drainage

Chen Ruixin, Miao Jingyu, Zhang Yi, Liu Cheng, Meng Haiwei, Liu Shuwei

Chinese Journal of Clinical Anatomy. 2023, 41(6): 647-651. doi:10.13418/j.issn.1001-165x.2023.6.03

Abstract ( 50 )

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Objective To describe the types of hepatic venous drainage by 3D reconstructed CT images, so as to provide anatomical reference for preoperative preparation and intraoperative guidance of hepatic surgery. Methods A total of 406 contrast-enhanced CT images of the abdomen were collected randomly. The anatomic morphology of hepatic veins and the type classification were observed and analyzed by volume reconstruction (VR), multiplanar reformation (MPR), and maximum-intensity projection (MIP). Results The anatomic morphology of hepatic veins (HVs) draining into the inferior vena cava (IVC) was classified into the following four types. Type I: non-trunk type of the left, middle and right HVs, accounting for 23.2% (94). Type II: trunk type of left and middle HVs, accounting for 75.1% (305). Type III: trunk type of right and middle HVs, accounting for 0.7% (3). Type IV: trunk type of left, middle and right HVs, accounting for 1% (4). The left hepatic vein was classified into three types. Type I accounting for I7.1% (29), Type II accounting for 80.6% (327), Type III accounting for 12.3% (50). The middle hepatic vein was classified into four types. Type I accounting for 93.1% (378), Type II accounting for 3.5% (14), Type III accounting for 1.2% (5), Type IV accounting for 2.2% (9). The right hepatic vein was classified into three types. Type I accounting for 44.1% (179), Type II accounting for 50% (203), Type III accounting for 5.4% (22). Conclusions Hepatic veins have a variety of types. Venous tributaries could be displayed clearly by VR、MPR and MIP, which will provide reliable anatomical evidence for preoperative preparation and intraoperative guidance of hepatic surgery.

Imaging study on classification of pseudocysts of splenic hilum in chronic pancreatitis and its relationship with sinistral portal hypertation

Xu Haotong, Xu Wanyu, Wu Yi, He Mingjing, Lei Xiubing, Tian Fuzhou

Chinese Journal of Clinical Anatomy. 2023, 41(6): 652-656.

Abstract ( 50 )

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Objective　To avoid to mix pseudocysts of splenic hilum (POSH) with introsplenic pseudocysts or peripancreatic fluid collections, radiological images and the second Chinese Visible Human (CVH2) datasets were used to summarize the classification of the POSH, and to explore potential correlation between the POSH and the sinistral portal hypertation (SPH).　Methods　The classification of POSH was summarized on CT or MRI from 291 patients with chronic pancreatitis in 2019. The classification of the POSH discovered on radiological images was mimicked on CVH2 images. The potential correlation between the POSH and the SPH was explored by statistical analyses.　Results　The POSH might be classified into three categories: one was that pseudocysts of pancreatic tail (POPT) developed to the splenic hilum area and extended into the splenic parenchyma to form the POSH, another one was that the POSH developed from the fistula of the pancreatic duct, and the third one was that both the POPT and the pancreatic fistula formed the POSH. The presence of a POSH was a risk factor for the SPH (OR=7.88; P<0.001).　Conclusions　The classification of the POSH has been summarized and displayed virtually by visualization technology. Mastering the detailed types of the POSH will decide on the choosing of the therapeutic strategy.

Analysis on the features and relationship of falciform ligament pseudo lesions and drainage veins by MSCT

Zhang Haitao, Bai Jinsong, Shu Shengjie, Zhang Chi, Li Hongying, Zhang Guohua, Song Ruixiang, Zhu Wei

Chinese Journal of Clinical Anatomy. 2023, 41(6): 657-661. doi:10.13418/j.issn.1001-165x.2023.6.05

Abstract ( 41 )

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Objective To discuss the MSCT findings of falciform ligament pseudo-lesion (FLP) and drainage veins, and to explore the relationship between them. Methods An each of 96 patients who received plain and enhanced CT scans in our hospital from October 2021 to October 2022 were retrospectively collected. The main evaluation indicators were image findings and features of FLP and drainage vein. The drainage veins of Ⅲ and Ⅳ segments of liver in MSCT were divided into 3 types: type A, have upper branch and lower branch, the upper branch started from the fat area between the diaphragm and the liver and went forward and down into Ⅲ and Ⅳ segments of the liver, the lower branch started from the anterior abdominal wall or the fat area of local abdominal which slightly above the umbilical level, then moved backward and upward into Ⅲ and Ⅳ segments of the liver; Type B, was the same as the upper branch of type A; Type C, was the same as the lower branch of type A. Results The morphology of FLP was mainly wedge-shaped (57.1%, 63.4%) in both plain and enhanced CT images, and the anterior inner edge of Ⅳ segment of the liver was the most common location (93.8%). The highest detection rate of FLP was found in portal vein phase (42.7%). There was statistically significant difference in the detection rate of FLP between plain and enhanced CT (P<0.001), but there was no statistically significant difference in the detection rate of drainage venules in the Ⅲ and Ⅳ segments of liver (P>0.05). There was no significant difference in the detection rate of drainage venules between with and without FLP in plain CT images (P>0.05), but there was significant difference in the detection rate of drainage venules between with and without FLP in enhanced CT images (P<0.001). No drainage vein was observed in 5 cases of FLP in enhanced CT images, meanwhile no FLP was observed in 29 cases which showing drainage venules. Conclusions FLP is easy to distinguish from true lesions by certain CT features. Type C is the most common type of drainage venules in segment Ⅲ and Ⅳ of liver in MSCT. FLP of plain CT scan has no direct correlation with drainage venules, but associated with local histological abnormality of liver. FLP of enhanced CT scan associated with drainage venules, and was affected by both drainage venules and local blood supply of hepatic parenchyma.

CT characteristics and anatomical basis of lymphoma with solitary mass in retroperitoneal space

Gao Jun, Li Yubiao, Wu Hang, Ge Yanming, Li Yanran, Dong Peng

Chinese Journal of Clinical Anatomy. 2023, 41(6): 662-666. doi:10.13418/j.issn.1001-165x.2023.6.06

Abstract ( 54 )

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Objective To investigate the CT characteristics and anatomical basis of lymphoma with solitary mass in retroperitoneal space. Methods The CT data of 40 cases of lymphoma with solitary retroperitoneal mass confirmed by pathological diagnosis were reviewed retrospectively to study and explore the imaging anatomic features. Results The retroperitoneal lymphoma in this study could be divided into two types: (1) solitary retroperitoneal mass type (n=13) (2) single dominant retroperitoneal mass surrounded by enlarged lymph nodes type (n=27). There were statistical differences between the two types of masses in whether they were surrounded by blood vessels or not (P=0.004) and whether they had aortic floating signs or not (P=0.001). There was no statistical difference in terms of the short-axis diameter of the masses (P=0.230), the masses’ anatomic location (P=0.427), CT enhanced degree (P=0.184), homogeneous enhancement or heterogeneous enhancement (P=0.933), margin of the mass clear or not (P=0.408) between these two groups. Conclusions CT plays an important role in the diagnosis and anatomical details of solitary mass lymphoma in retroperitoneal space. It can provide imaging reference for the diagnosis and differential diagnosis of abdominal lymphoma.

The differences of neurovascular compression in patients with or without primary trigeminal neuralgia by three-dimensional observation

Liu Zhan, Tao Shengzhong, Lu Huipeng, Wang Zaibin, Sui Yubo, Niu Guangming

Chinese Journal of Clinical Anatomy. 2023, 41(6): 667-674. doi:10.13418/j.issn.1001-165x.2023.6.07

Abstract ( 49 )

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Objective To demonstrate that the neurovascular conflict or compression (NVC) is the primary cause of idiopathic trigeminal neuralgia (PTN) by imaging anatomy, so as to perfect the NVC theory. Methods The brain stem MRI of PTN group (n=48 sides) and painless group (n=84 sides) were reconstructed by multi-modal image fusion and three-dimension volume rendering. The contact ratio of blood vessel and nerve, the bending degree of compressing artery, compression site and angle degree between the arterial loop and the main axis of trigeminal nerve were measured and compared between the PNT group and the painless group. Results The contact ratio of artery and nerve in the pain side was higher than that in the non-pain side, the compression site was mostly located in the brain stem area of the trigeminal nerve. On the painful side of patients with PTN, the arterial curvature ( 0.21（0.07）mm^1) and angle degree ( 36.18（12.47）°and 36.68（15.67）°) between the artery and nerve were both significantly higher than those of them (0.12（0.03）mm^1, 24.56（12.09）°and 26.28（17.49）°) on the unaffected side of PTN and without PTN patients. On the painful side, distribution of compression site was significantly focused on root of entrance zone (REZ). There was no significant difference in the compression site, arterial curvature and angle degree between the artery and nerve amongst the healthy sides. Conclusions On the painful side of patient with PTN, there is a significantly curved artery pressing on the root of trigeminal nerve at a large angle degree, and this phenomenon is associated with PTN symptoms.

Measurement and clinical significance of cervical spine physiological curvature in children and adolescents

Li Kun#, Zhang Boran#, Zhang Yu, Han Keming, Feng Jie, Wu Siyao, Su Xin, Su Na, Wang Chaoqun, Zhang Shaojie, Li Zhijun, Wang Xing

Chinese Journal of Clinical Anatomy. 2023, 41(6): 675-679. doi:10.13418/j.issn.1001-165x.2023.6.08

Abstract ( 94 )

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Objective To analyze the clinical significance of children and adolescents cervical curvature based on the CT measurement of related basic parameters. Methods The collected CT imaging data of 364 patients were divided into 6 groups by gender and age: 1~3 years old group, 4~6 years old group, 7~9 years old group, 10~12 years old group, 13~15 years old group, 16~18 years old group. The original cervical spine tomography data were stored in DICOM format and imported into Mimics 16.0. The method based on distance [①Borden's measurement; ② cervical curvature index (CCI); ③ vertebral body cardiogram (CCL) measurement method] and Angle [①C1-C7 Cobb Angle measurement method; ②C2-C7Cobb Angle measurement; ③Harrison's measurement (CSA)]. A total of 6 measurement methods were used to measure the cervical curvature of children and adolescents, and the measurement results were statistically analyzed. Results Borden's method and CCL method showed there were statistical differences between 13-15 year old group and the first four groups (P<0.05). C1-C7 Cobb Angle measurement showed that there were statistical differences between the 16-18 year old group and the first five groups (P<0.05). Harrison's method and CCL method showed that there were statistical differences between the five groups aged 4-18 years and the group aged 1-3 years (P<0.05). There was no statistical difference between the genders. The correlation coefficient of Angle-based curvature measurement method was poor, but there were significant differences among all indexes (P<0.05). Conclusions There are many measurement methods for cervical curvature, and each index has its own advantages. Different clinical measurement methods can be adopted according to the research object and content, so as to provide theoretical and technical support for the early diagnosis, prevention and treatment of cervical curvature in children and adolescents.

Multi-slice CT observation of renal artery variability in Tibetan adults

Cidanwangjiu, Luosangduoji, Lazi, Labadunzhu, Nima

Chinese Journal of Clinical Anatomy. 2023, 41(6): 680-683. doi:10.13418/j.issn.1001-165x.2023.6.09

Abstract ( 40 )

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Objective To observe the renal artery variation in Tibetan adults with multi-slice spiral CT (MSCT), and so as to provide anatomical data for clinical renal surgery. Methods The imaging data and clinical data of 1218 Tibetan patients who received whole-abdominal MSCT enhanced examination were retrospectively collected. By reading the MSCT images, the presence of accessory renal artery (ARA) and early branching of renal artery (EBRA) were determined and counted. Statistical analysis was conducted according to gender and side. Results ARA was found in 397 patients and the detection rate was 32.59% (95%CI 29.9%-35.22%). There were 247 males with a detection rate of 34.59% (95% CI 32.10%-38.08%) and 150 females with a detection rate of 29.76% (95% CI 25.77%～33.75%). There was no statistical difference in detection rate between males and females (Z=-1.771, P=0.077). There were 519 ARAs in 397 patients, 277 in the right kidney and 242 in the left kidney. The mean diameter of the right and left ARA were (0.3±0.89) cm and (0.3±0.9) cm, respectively. There was no significant difference in ARA diameter between two kidneys (t=0.045, P=0.964). EBRA was found in 315 patients and the detection rate was 25.86% (95%CI 23.40%-28.32%). There were 358 EBRA in 315 patients, 161 in the right kidney and 197 in the left kidney. Hilum was the most common location where ARA and EBRA entered the kidney, accounting for 50.29% and 55.87%, respectively. Conclusions The renal artery variation accounts for a certain proportion in Tibetan population. It is of great significance to identify the variation of renal artery anatomy before operation for renal surgery, renal transplantation and interventional surgery.

hERG potassium channels mediate the anti-proliferative effects of brucine and strychnine on cancer cells

Zeng Xian, Zhou Ying, Yin Yanan, Xie Ting, Li Shuji, Yuan Chunhua

Chinese Journal of Clinical Anatomy. 2023, 41(6): 684-691. doi:10.13418/j.issn.1001-165x.2023.6.10

Abstract ( 42 )

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Objective To investigate the anti-tumor effect of brucine and strychnine based on their blockage of hERG channels. Methods The vector-transfected and hERG-transfected CHO cells were constructed by Lipofection and selective medium. After treated with brucine and its structural analogues for 24 h, 48 h, and 72 h, the effect in cell proliferation in cancer cells were evaluated by using CCK8 assay. After treated with brucine and its structural analogues for 48 h, the effect in cell proliferation in hERG-transfected CHO cells were evaluated by using CCK8 assay, and the vector-transfected CHO cells were as control. Flow cytometry was used to detect the cell cycle arrest of brucine and strychnine on HT29 and A549 cells. Western blot was used to detect the levels of hERG expression in HT29, PC9, and A549 cells. Results Brucine and strychnine time and dose-dependently inhibited the proliferation of HT29, PC9, and A549 cell lines, and the inhibitory potency was positively correlated with the expression level of hERG protein. Faint anti-proliferation activity was detected at high concentration for brucine N-oxide and strychnine N-oxide which showed weak inhibitory effect on hERG channel and tumor cell only at high concentration. Furthermore, brucine induced more growth suppression on the hERG-transfected CHO cells, when compared with vector-transfected CHO cells. Brucine and strychnine induced G0/G1cell cycle arrest in HT29 cells, and showed no significant effect on the cell cycle of A549 cells. Brucine showed no significant effects on hERG protein expression in the three cell lines. Conclusions Brucine and strychnine displayed their anti-tumor effect may through blocking hERG channels. This study may provide important clues for using the potential pharmacologic effects of hERG inhibitors in cancer treatment.

Loss of CaMKIV signaling aggravates muscle inflammation and affects muscle regeneration

Wang Han, Li Yangyang, Jian Xiaoting, Huang Jingwen, Lan Haiqiang, Hu Jijie, Liao Hua

Chinese Journal of Clinical Anatomy. 2023, 41(6): 692-697. doi:10.13418/j.issn.1001-165x.2023.6.11

Abstract ( 49 )

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Objective To explore the effects of CaMKIV signaling on muscle inflammatory response and muscle repair post-injury. Methods CaMKIV gene deletion (CaMKIV-/-) mice were constructed by using CRISPR/Cas9 technology and identified by PCR. Cardiotoxin (CTX) induced skeletal muscle injury was performed in wild B6 and CaMKIV-/- mice. HE staining was used to observe the inflammation and repair in injured muscles. Dystrophy immunofluorescence staining was used to identify the regenerating myofibers while F4/80 staining to present infiltrated macrophage in inflamed muscle. F4/80, Ly-6C, CD206, Ki67 staining and flow cytometry skill were used to analyze the number and proportion of M1 (F4/80+Ly6C+) and M2 ((F4/80+CD206+) macrophages in the injured muscle, as well proliferation capacity of macrophages (F4/80+Ki67+). Results CaMKIV-/- mice were successfully constructed and bred. HE and fluorescence staining showed that, the absence of CaMKⅣ signaling in mice resulted in increasing intramuscular inflammation and delaying muscle repair. The number of the regenerating central nuclear muscle fibers（Dystrophin+） in CaMKⅣ-/- mice was lower than that in WT mice. The number of macrophages (F4/80+) in inflamed muscle from CaMKⅣ-/- mice was significantly higher than that of WT mice, which was dominant by M1 cells, comparing with that of WT mice. In inflamed muscle of CaMKⅣ-/- mice, the number and proportion of proliferating macrophages (F4/80+Ki67+) was significantly higher than that of control mice, but the proliferating macrophages were mainly M1 cells (Ly6C+Ki67+). Conclusions The loss of CaMKⅣ signaling leads to the aggravation of muscle inflammation, promotes the exudation and proliferation of M1 macrophages in inflamed muscle, and delays muscle repair after injury.

Changes of Claudin-5 tight junction protein expression and ameliorative effects of CBD intervention in rats after traumatic brain injury

Kang Li, Cao Yan, Li Hengxi, Li Jiali, Ling Tenghan, Yin Aiping, Zhang Ruilin, Li Ping

Chinese Journal of Clinical Anatomy. 2023, 41(6): 698-703. doi:10.13418/j.issn.1001-165x.2023.6.12

Abstract ( 41 )

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Objective To observe the expression of Claudin-5 in brain microvascular endothelial cells after traumatic brain injury (TBI), and to investigate the intervention effect of cannabidiol (CBD). Methods TBI model of SD rats was established by modified Feeney free-fall impingement method. After modeling, the rats were randomly divided into a sham group (sham group), a TBI + Vehicle group and a TBI+CBD group (intervention group), and each group was divided into 6 subgroups (n=3) at 8 h, 1 d, 2 d, 3 d, 5 d and 7 d. RT-PCR, Immunohistochemistry staining and immunofluorescence double-standard staining were used to observe the effect of the CBD intervention on positive Claudin-5 expression of and the astrocytes (AST) activation after TBI. Results The mRNA expression of Claudin-5 decreased at different time periods after TBI, while the mRNA expression of Claudin-5 increased significantly after CBD intervention. Claudin-5 protein expression was located at the junction of brain microvascular endothelial cells, and the AST cell body was small, with few protrusions and elongated in the sham group. After TBI, Claudin-5 positive cell lines were broken, and the expression of Claudin-5 was significantly decreased and showed a downward trend, and the expression of them was the lowest in the 2 d group (P<0.05). In addition, ATS were activated, and the cell bodies became larger, the protrusions became increased and swollen. After CBD intervention, the positive expression of Claudin-5 was significantly increased, the AST activation state was significantly weakened, the cell body was increased, and the foot plate swelling was reduced. It was also observed that there was no co-expression between GFAP positive AST and Claudin-5 protein, but the foot plate extended by AST was directly attached to microvascular endothelial cells. Conclusions AST is activated and involved in the regulation of Claudin-5 protein expression after TBI. CBD may indirectly regulate the positive expression of Claudin-5 by regulating the activation state of AST, thus improving the permeability of blood brain barrier.

Effects of BH4 on proliferation, migration and apoptosis of pancreatic cancer cells

Ma Wenting, Zhang Chen, Xie Qing

Chinese Journal of Clinical Anatomy. 2023, 41(6): 704-708. doi:10.13418/j.issn.1001-165x.2023.6.13

Abstract ( 39 )

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Objective To investigate the effect of tetrahydrobiopterin (BH4) on the biological behavior of pancreatic cancer cells and its possible mechanism. Methods The cells were divided into a control group and an experimental group. The experimental group was divided into 4 subgroups according to the concentration of BH4 (2 μM, 4 μM, 8 μM, 12 μM BH4 groups). The ability of cell proliferation, apoptosis and migration were detected by CCK-8 assay, Hoechst assay and scratch assay. The expression of Notch1 mRNA was detected by RT-qPCR and the expressions of E-cadherin and N-cadherin were detected by Western blotting. Results Compared with the control group, with the increasing of BH4 concentration, the activity and migration ability of HPAC and Bxpc-3 cell decreased and the apoptosis rate increased, and the effect of BH4 was significant at 8 μM and 12 μM (P<0.01，P<0.05). Compared with the control group, Notch1 mRNA was significantly decreased in experimental group (BH4 12 μM) (P<0.05), the expression level of E-cadherin increased (P<0.01, P<0.05) , while that of N-cadherin decreased (P<0.05). Conclusions BH4 can inhibit the proliferation, migration and promote the apoptosis of pancreatic cancer cells. The mechanism may be related to the inhibition of epithelial-mesenchymal transition (EMT) process, while Notch1 changes during EMT. It suggests that the Notch1 signaling pathway may be involved in the regulation of this process.

Electroacupuncture activates autophagy and improves behavioral responses mechanism in Parkinson's rats brain by regulating PI3K/AKT/mTOR signaling pathway

Wang Fei, Li Ya’nan, Zhang Xiaolei, Hu Mengni, Li Hanzhang, Ma Jun

Chinese Journal of Clinical Anatomy. 2023, 41(6): 709-715. doi:10.13418/j.issn.1001-165x.2023.6.14

Abstract ( 39 )

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Objective To explore the effect of electroacupuncture participating in the behavioral response and brain autophagy of Parkinson's rats by regulating phosphatidylinositol 3-kinase (PI3K), protein kinase B (AKT) and mammalian target of rapamycin (mTOR). Methods Sixty rats were randomly separated into a control group, a Parkinson's group, an electroacupuncture group, a sirolimus group, an electroacupuncture + PI3K activation group, with 12 rats in each group. The Parkinson's rat model was prepared, and the motor behavioral function of the rats was evaluated by the inclined plate test and the open field test. The expression of tyrosine hydroxylase (TH) and α-synuclein (α-syn) in substantia nigra was measured by immunohistochemistry. Brain tissue mitochondria were extracted, ATP synthase activity was measured by luciferase labeling method, and mitochondrial activity was measured by mitochondrial respiration detector. The expression levels of PI3K, AKT, mTOR, p-PI3K, p-AKT, p-mTOR and autophagy-related protein microtubule-associated protein 1 light chain 3 (LC3) B-II/LC3B-I, and Beclin1 in brain tissue were measured by Western blot. Results Compared with the control group, the Parkinson's group showed a significant decrease in the maximum angle of sloping plate stay, times of crossings lattice, times of standing, RCR in brain tissue, ATP synthase activity, and the average optical density of TH in the substantia nigra, and a significant increase in α-syn, Beclin1 protein expression, LC3B-II/LC3B-I and PI3K, AKT, mTOR protein phosphorylation (P<0.05). Compared with the Parkinson's group, the EA group and the sirolimus group showed significant increase in the maximum angle of sloping plate stay, times of crossings lattice, times of standing, RCR in brain tissue, ATP synthase activity, Beclin1 protein expression, LC3B-II/LC3B -I, and average optical density of TH in the substantia nigra, and significant decrease in the expression of α-syn protein and the protein phosphorylation of PI3K, AKT and mTOR (P<0.05). Compared with the electroacupuncture group, the rats in the electroacupuncture + PI3K activation group had a significant decrease in the maximum angle of sloping plate stay, times of crossings lattice, times of standing, RCR in brain tissue, ATP synthase activity, Beclin1 protein expression, LC3B-II/LC3B -I, and average optical density of TH in the substantia nigra, and a significant increase in the expression of α-syn protein and the protein phosphorylation of PI3K, AKT and mTOR (P<0.05). Compared with the electroacupuncture group, there was no significant difference in the indicators in the sirolimus group (P>0.05). Conclusions Electroacupuncture can inhibit the phosphorylation of PI3K, AKT and mTOR proteins, activate autophagy, and improve the motor behavioral function of rats, so as to treat the clinical symptoms of Parkinson's disease.

Effect of Xiaoyanzhitong Ointment on C2C12 myofibers induced by lipopolysaccharide

Zhong Weixing, Chen Zujiang, Li Junhua, Kuang Shanshan, Wang Ning, Zhang Xuan, Li Yikai

Chinese Journal of Clinical Anatomy. 2023, 41(6): 716-720. doi:10.13418/j.issn.1001-165x.2023.6.15

Abstract ( 40 )

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Objective To study the effect mechanism of Xiaoyanzhitong ointment on lipopolysaccharide-induced C2C12 myofibers. Methods C2C12 skeletal muscle cells were cultured in vitro and differentiated into mature muscle tubes with 2% horse serum. The blank group, model group, diclofenac sodium group and Xiaoyanzhitong group were set. LPS was added on the non-blank groups to explore the optimal inflammatory concentration and duration of LPS on C2C12, and to replicate the optimal inflammatory cell model of skeletal muscle in vitro, thus to explore the optimal intervention concentration of Xiaoyanzhitong ointment and diclofenac sodium on C2C12 cell inflammation model. Cell activity was detected by CCK-8 method. The concentrations of IL-1β and IL-6, SOD and MDA content in LPS treated C2C12 cells were detected by ELISA after the addition of Xiaoyanzhitong ointment. Results ① The results of differentiation experiment showed that C2C12 differentiation was obvious on the 4th~5th day. ② C2C12 inflammatory model results showed that the inflammatory reaction of C2C12 cells was the most obvious after 24h treatment with 1 μg/ml LPS, and CCK-8 result showed there was no significant change in cell activity. ③ The results of drug concentration exploration showed that the inflammatory reaction of C2C12 was the lightest under the treatment of 1.25 mg/ml Xiaoyanpain-relieving ointment solution and 6.25 μg/ml diclofenac sodium solution for 24 h, and CCK-8 result showed no significant change in cell activity. ④ Compared with model group, 1.25 mg/ml Xiaoyanzhitong ointment significantly inhibited IL-1β level and MDA level, and increased SOD level in LPS-induced C2C12. Compared with diclofenac sodium group, There was no significant difference of 1.25 mg/ml Xiaoyanzhitong ointment in the inhibition of IL-1β level in LPS-induced C2C12 cells (P=0.188), but there were significant differences in the enhancement of SOD level (P=0.0001) and inhibition of MDA level (P=0.014). Conclusions The composition of Xiaoyanzhitong ointment can reduce the levels of IL-1β, IL-6 and MDA in C2C12 cells under LPS administration, and increase the level of SOD, which may be related to the reduction of tissue inflammation and the alleviation of oxidative stress damage.

Evaluation of mechanical stability of new horizontal screw-screw crosslink in posterior C1-C2 pedicle screw-rod fixation by three-dimensional finite element

Ouyang Beiping, Ma Xiangyang, Luo Chunshan, Zou Xiaobao, Lu Tingsheng, Chen Qiling

Chinese Journal of Clinical Anatomy. 2023, 41(6): 721-727. doi:10.13418/j.issn.1001-165x.2023.6.16

Abstract ( 43 )

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Objective To explore the biomechanical characteristics of different modes of new horizontal screw-screw crosslink (hS-S CL) in C1-C2 pedicle screw-rod fixation (C1-C2 PSR) by three-dimensional finite element, which provided theoretical basis for clinical selection of the optimal hS-S CL. Methods The atlantoaxial finite element models were established respectively: the normal group was group A , the unstable group was group B, C1-C2PSR group was C, C1-C2PSR+ upper/lower hS-SCL , C1-C2PSR+ dS-SCL and C1-C2PSR+xS-SCL groups were D-H group respectively. The Range of motion (ROM) and Von Miss Stresses in flexion and extension, lateral flexion and rotation of the normal group, the unstable group and the six kinds of internal fixation groups were calculated by applying 1.5 Nm torque to each finite element model, and the stress cloud was extracted. Results ①Under the 6 working conditions, the ROM in the normal group and the internal fixation group was significantly lower than that in the unstable group. In flexion and extension state: the ROM of all internal fixation groups was basically the same. Under the conditions of lateral flexion and rotation, compared with that in the without crosslink group, the ROM in the D-H group was reduced by 34-44% and 79%, 36-46% and 76-80%, 39-47% and 78-79%, 40-46% and 78-79%, 49-50% and 91-93%, respectively, and the ROM in the H group decreased most obviously in the rotation state. ② The stress peak of internal plant model: the maximum stress of the crosslink group was generally smaller than that of the non-crosslink group, and the stress peak value of all the internal fixation groups was the lowest when the extension was carried out. ③ The stress cloud of internal plants showed that the stress distribution areas of the internal fixation in the crosslink fixation group were basically the same, and there was no obvious stress concentration phenomenon in the internal fixation, and the main stress distribution areas were the screw root and bone joint, and the crosslink ends were the screw tail groove or the joint rod joint. Conclusions The new hS-S CL in posterior C1-C2 pedicle screw-rod fixation has the strongest anti-rotation stability, but the stress distribution at both ends of the transverse connection is obvious, which may be prone to transverse fracture.

Application and clinical effect analysis of lateral anterior rectus approach in the treatment of acetabular fractures in pediatric

Ye Shuxi, Yang Xiaodong, Li Tao, Mai Qiguang, Wang Hua, Fan Shicai

Chinese Journal of Clinical Anatomy. 2023, 41(6): 728-732. doi:10.13418/j.issn.1001-165x.2023.6.17

Abstract ( 59 )

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Objective To analyze the feasibility, surgical method and clinical effect of lateral rectus approach (LRA) in the treatment of acetabular fractures in pediatric. Methods The clinical data and follow-up of 4 pediatric patients with acetabular fracture treated by lateral rectus incision in the Trauma Department of the Third Affiliated Hospital of Southern Medical University from January 2016 to December 2021 were retrospectively analyzed, including 3 females and 1 male, with an average age of 12.5 years (10~15 years old), 3 severe car accident injuries and 1 fall injury from height. Based on Judet-Letournel classification, There were 1 case of transverse fracture, 2 cases of double-column fracture, 1 case of anterior column combined with posterior hemi transverse fractures, 2 cases of sacroiliac joint dislocation, 1 case of sacral fracture and 3 cases of symphysis pubis dissociation. The indications and timing of operation were evaluated. Four cases were treated with lateral rectus approach. The reduction effect was evaluated according to Matta imaging reduction evaluation criteria, and the hip joint function was evaluated according to the modified Merle d'Aubigne-Postel score system. Results The 4 patients completed the operation successfully. No perioperative complications occurred. During the follow-up of 24~72 months, 4 cases were anatomically reduced according to Matta imaging reduction evaluation criteria, and 4 cases of fractures reached clinical and imaging healing standards within 2 months. Hip joint function was evaluated according to the modified Merle d'Aubigne-Postel score system: excellent in 4 cases. During the last follow-up, the morphology and structure of acetabulum in 4 cases were normal, the development was not significantly affected, and there was no abnormality in walking and daily life, and the fracture internal fixation was removed. Conclusions The incidence of acetabular fracture in children who need surgical treatment is very low, and the surgical method should be minimally invasive as far as possible. Four cases in this group were operated by lateral rectus abdominis incision, and a good short-term clinical effect was obtained.

Study on the new "open + bridge base" 3D guide in the puncture of hypertensive cerebral hemorrhage

Wang Jiani, Guo Wenjie, Peng Rongyang, Xia Yuan, Liu Jingjing, Rao Libing, Wan Xingguang, Li Li

Chinese Journal of Clinical Anatomy. 2023, 41(6): 733-737. doi:10.13418/j.issn.1001-165x.2023.6.18

Abstract ( 37 )

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