Table of Content

25 March 2024 Volume 42 Issue 2

  

Anatomical measurement of the new double-threaded pedicle screw in the lower cervical spine

Liu Zihao, Liu Jiaming, Yan Jinxiang, Wu Jiabao, Huang Shanhu, Zhang Zhihong, Liu Zhili

Chinese Journal of Clinical Anatomy. 2024, 42(2):  121-125.  doi:10.13418/j.issn.1001-165x.2024.2.01

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Objective   To provide theoretical basis for the design of new double threaded pedicle screws, by measuring the anatomical parameters of cervical vertebrae in normal people.   Methods    A total of 100 healthy individuals were collected and the cervical spine CT scan were completed. The length of bilateral pedicle screw insertion path (including intra-vertebral length, pedicle length, and vertebral plate length, as reference for pedicle screw length design), insertion abduction angle, and width and height of pedicle isthmus (as reference for pedicle screw diameter design) of C3~7 on CT scan. The mean value and quartile of each measurement result were calculated.   Results   Basic information of 100 adult healthy volunteers, including height, age, weight, and comorbidities, including 54 males and 46 females, with an average age of 35.95 years were recorded. From the CT scan of C3~7, there was no statistical difference between the left and right sides of each parameter (P>0.05). There was no statistical difference in male and female (P>0.05). The average length of the vertebral body in the lower cervical pedicle screw insertion path was (15.85±1.20)~(19.40±1.50) mm. The average length of the pedicle was (5.42±1.06)~(6.03±0.84) mm. The average length of the vertebral lamina was (9.52±1.15)~(10.33±1.58) mm. The average range of nail insertion and abduction angle was (39.82±2.53) °~(42.56±2.50) °. The average width of the pedicle isthmus was (5.84±0.87)~(7.10±1.05) mm. The average height of the pedicle isthmus was (6.71±1.10)~(8.26±1.22) mm.   Conclusions    The measurement of the anatomical parameters related to C3~C7 pedicle screw fixation in normal people provides theoretical basis for the design of a new type of double-threaded pedicle screw.

Imaging measurement and feasibility analysis of C_2/3 transarticular transpedicular screw

Chen Junlin, Ma Xiangyang, Zou Xiaobao, Fu Suochao, Zhu Changrong, Deng Chenfu, Ma Rencai, Chen Zexing, Xia Hong

Chinese Journal of Clinical Anatomy. 2024, 42(2):  126-130.  doi:10.13418/j.issn.1001-165x.2024.2.02

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Objective    To measure the imaging indexes of C_2/3 transarticular transpedicular screw, and analyze the feasibility of this screw placement technique.    Methods   The CT data of 120 thin slice CT scan were collected, including 75 males and 45 females. The entry point of the C2/3 transarticular transpedicular screw was set, that is, the entry point was at the intersection of the horizontal midline and the mid-lateral 1/3 vertical line of the lateral mass of the axis. The screw passed through the facet joint of C_2/3 and the C3 lateral mass, from the lateral mass of the axis, and ended at the inferior edge of the pedicle of C3. The imaging data of C_2/3 transarticular transpedicular screw were measured, including C3 pedicle width and height, screw channel length, introversion angle, head tilt angle and the narrowest width. The relationship between the measurement results was analyzed.    Results    The average width of C₃ pedicle was 5.48mm, the average height was 6.82 mm, the average screw channel length was 18.68mm, the average introversion angle of screw channel was 20.46 °, the average head tilt angle was 50.1°, and the average width of the narrowest part was 2.80 mm. There was a positive correlation between C3 pedicle width and height (P=0.000). The length of screw channel was positively correlated with C₃ pedicle width and height (P=0.000; P=0.000 ). The width of the narrowest part of screw channel was positively correlated with C₃ pedicle width and height (P=0.000；P=0.000). In the measurement data of 240 cases, the screw placement could be completed if 3.5 mm diameter screws were used, and the screw was suitable for all patients.  Conclusions   C_2/3 transarticular transpedicular screw is anatomically feasible and can be used as a supplementary technique for posterior screw rod internal fixation of upper cervical spine.

Digital anatomic study of the secure placement of screw on posterior column wall of acetabulum

Zheng Yifan, Chen Jianan, Pei Xuan, Zhou Wei, Fang Zhixun, Cheng Yipeng, Liu Ximing

Chinese Journal of Clinical Anatomy. 2024, 42(2):  131-135.  doi:10.13418/j.issn.1001-165x.2024.2.03

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Objective    To digitally measure the relevant anatomical parameters of safe screw placement for posterior column wall of the acetabulum, so as to provide data reference for the clinical treatment of screw placement for posterior wall and/or posterior column fractures.   Methods   3D hip-bone models of 100 normal adults were reconstructed by Mimics 20.0. The acetabular posterior wall was divided into high posterior wall area involving the acetabular roof and the low posterior wall area without involving the acetabular roof. Sections M, D, E and N were obtained by cutting the high posterior wall area of the acetabulum, and sections F, G, H, I and J were obtained by cutting the low posterior wall area of the acetabulum. The following parameters were measured on each section: the angle and the length of the screw. Results    In the entry points 5.0 mm away from the acetabular edge on sections M, D, E and N, the maximum safe entry angles of screws for men and women should not exceed 80°, 70°, 60° and 50°, respectively, and the entry lengths for men and women should not exceed 40.0mm and 35.0mm, respectively. On sections F, G, H, I and J, the screw angles of 5.0 mm, 10.0 mm, 20.0 mm and 30.0 mm away from the acetabular edge should be less than 50°, 60°, 80° and 90°, respectively. On sections F to J, the screw lengths of male should be less than 40.0 mm, 35.0 mm, 30.0 mm, 30.0 mm and 40.0 mm, respectively, the screw lengths of female should be under 35.0 mm, 30.0 mm, 25.0 mm, 25.0 mm and 35.0 mm respectively.    Conclusions   Different insertion angles and lengths should be adopted at different insertion points in the posterior column wall of the acetabulum to avoid the screw entering into the hip cavity.

Anatomical features of the posterior bundle of the ulnar collateral ligament and clinical significance

Yang Tao, Gao Zhuan, Liu Bingzhi, Li Wuchao, Sun Ruizhe, Lang Yuying, Li Jing

Chinese Journal of Clinical Anatomy. 2024, 42(2):  136-139.  doi:10.13418/j.issn.1001-165x.2024.2.04

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Objective   To clarify the morphological features of the posterior bundle (PB) of the ulnar collateral ligament of the elbow joint, so as to provide reference for anatomy of elbow joint and surgical repairs of ligaments.     Methods    A total of 82 adult elbow joints were dissected and the characteristics of the PB were noted. The length, widths of the origin and insertion of the PB were measured with a vernier caliber. Results    (1)The PB was divided into four types according to the relation with the elbow joint capsule: ① typeⅠ, the anterior and posterior edges were located on the surface of the capsule and could be separated as a single ligament in 61% of cases. There was significant difference in length between male (20.92±2.59) mm and female (17.28±2.07) mm in this type (P=0.000, t=5.531). ② typeⅡ, the anterior edge of PB was fused with elbow joint capsule, while the posterior edge was thickened and free in 16% of cases. ③ type Ⅲ, the posterior edge of PB was fused with elbow joint capsule,  while the anterior edge was thickened and free in 18% of cases. ④ type Ⅳ, the anterior and posterior edges of PB could not be separated from the elbow joint capsule in 5%  of cases. (2) Types Ⅰand Ⅱ were more commonly occurred in male, while types Ⅰand Ⅲ were observed in female frequently. There was significant difference in type composition (c2=8.096,P=0.035).    Conclusions The new classification of the PB was proposed based on the supplement to the anatomy of UCL, which emphasized the relation with the joint  capsule of the elbow TypeⅡ~Ⅳ of PB maybe an important factor causing morphological variation. Gender difference should be considered when treating PB injury, so as to facilitate structural and functional recovery.  

Anatomical parameter analysis of lumbar basivertebral foramen in middle-aged and elderly based on MRI

Zhuo Hang, Zhou Zelin, Wu Yu, Gong Yan, Song Zefeng, Yan Xianwei, Shen Zi, Lu Guoliang, Liang De, Jiang Xiaobing, Yu Xiang

Chinese Journal of Clinical Anatomy. 2024, 42(2):  140-144.  doi:10.13418/j.issn.1001-165x.2024.2.05

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Objective   To provide further anatomical basis for lumbar vertebra operations by measuring anatomical parameters of lumbar vertebra basivertebral foramen (BF) based on sagittal MRI images.  Methods  Sagittal MRI images of 172 vertebral bodies of 43 adult patients admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine and Dongguan Hospital of Guangzhou University of Chinese Medicine from February 2018 to December 2022 were retrospectively analyzed. The PACS imaging system was used to measure the BF depth (BFD), BF height (BFH), Vertebral width (VW), the upper end of BF between the upper boundary and the endplate (VH1), the lower end of BF between the lower boundary and the endplate (VH2), and calculate the ratio of BFD to vertebral body width (BFD/VW) and the ratio of BFH to vertebral body height (BFH/VH).   Results   After comparing lumbar vertebrae, the STIR sequence showed that BFD (3.93±1.58mm) of L1 vertebrae was lower than BFD of L3 (5.26±2.34) mm and BFD of L4 (5.82±2.99) mm，which was statistically significant (P<0.05). Also in the STIR sequence, BFD/VW of L1(0.12±0.05) was lower than that of BFD/VW of L4(0.17±0.09) (P<0.05). Moreover, there were statistical differences in the comparison of BFD/VW in L1-L4 among the four groups (P<0.05). There was no statistical significance in the BFH/VH of each vertebral body (P>0.05). In the comparison between male and female, BFH of male L3(7.95±2.84) mm was higher than that of female L3(6.30±1.93) mm on T2WI, which was statistically significant (P<0.05). With the increasing of the vertebrae sequence, BFD showed a gradually increasing trend, and it was more obvious in the STIR sequence. BFH had no obvious fluctuation with the increasing of vertebral body sequence.    Conclusions   STIR sequence in sagittal MRI image can be used as the clinical measurement standard of BF in middle-aged and elderly patients, which providing anatomical reference for the selection of lumbar surgical treatment.

Digital assessment of prosthesis position in hip replacement in Inner Mongolia

Li Jiawei, Zhang Kai, Ding Liangjia, Wang Haiyan, Chen Qingwei, Liu Qi, Yu Xiaoming, Lan Wenjie, Li Xiaohe

Chinese Journal of Clinical Anatomy. 2024, 42(2):  145-152.  doi:10.13418/j.issn.1001-165x.2024.2.06

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Objective    To measure the position parameters of the prosthesis after hip arthroplasty in Inner Mongolia, and to understand the position distribution and anatomical reconstruction rate of the prosthesis in Inner Mongolia.   Methods   The X-ray data of  hip arthroplasty were collected from four tertiary hospitals in Inner Mongolia, aged 30-70 years, and 179 cases were finally. The image data was imported into the Mimics 21.0 software in JEPG format measured by multiple people’s repeated measurements and taking the average value, including acetabular prosthesis abduction angle, anteversion angle, hip rotation center position (vertical position, horizontal position), femoral offset, and leg length discrepancy, and the differences in the center of rotation of the hip joint and femoral offset between the operated side and the healthy side were compared, and the anatomical reconstruction rates of the above 6 parameters were counted.    Results   (1) The inter-observer and intra-observer correlation coefficients ranged from 0.84 to 0.99, showing good reliability. (2) There was no statistically significant difference in the femoral offset on the healthy side and the operated side, but there were statistically significant differences in the vertical position and horizontal position of the hip joint rotation center between the operated side and the healthy side (P<0.05), and compared with the healthy side, the center of rotation of the prosthesis on the operated side is shifted inwardly and upwardly. (3) The anatomical reconstruction rates of acetabular prosthesis abduction angle, anteversion angle, hip joint rotation center vertical position, horizontal position, femoral offset, and the leg length discrepancy were 79.90%, 77.70%, 43.02%, and 60.34%, 60.30%, 79.30%, respectively.   Conclusions   This study understands the distribution of prosthetic positions in hip arthroplasty in Inner Mongolia. It is difficult to achieve completely anatomical reconstruction after surgery. Among them, the anatomical reconstruction rate of the vertical position, horizontal position of the hip joint rotation center and femoral offset is low. Surgical methods need to be continuously improved to further narrow the difference between the two sides.

3D digital measurement of sacral shape and relative position of symphysis pubis in minors and its clinical significance 

Fang Yuan, Kang Zhijie, Wang Haiyan, Sha Lirong, Li Xiaohe, Jin Feng, Qi Xin, Wang Yanchao, Zhang Yunfeng

Chinese Journal of Clinical Anatomy. 2024, 42(2):  153-158.  doi:10.13418/j.issn.1001-165x.2024.2.07

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  Objective    To provide basic reference for the formulation of photographic positions in line with the characteristics of sacral development of minors, optimization of sacral X-ray images and diagnosis of diseases by investigating the change rules of sacral morphology parameters and pubic symphysis position of minors aged 0~18 years in different age groups and genders.   Methods   The collected total abdominal CT scans from 0 to 18 years old were divided into 3 age groups according to age: 0 to 6 years old, 7 to 12 years old, and 13 to 18 years old. The data was imported by mimics 21.0 and 3D digital image reconstruction technology was used to analyze sacral slope (SS), sacral 1-2 inclination Angle (S1~2T), sacral kyphosis Angle (sacral kyphosis, SK), S2 anterior margin and Sacro4 caudal-1 tilt line Angle (α Angle), S1 upper endplate and S2 anterior margin Angle (β Angle), S4Co1 oblique line and S1 upper endplate Angle (θ Angle), the line between the pubic union and the lower margin of the sacrum and the Angle between the vertical line of the long axis of the body (Angle B).  The parameters in different genders and ages were compared.    Results    Angle B of sacral morphometry was greater in females than in males, and there was no significant difference in other parameters. There were significant differences in SS, SK, α, β, θ between 0~6 years old and 13~18 years old, and between 7~12 years old and 13~18 years old, but no significant differences in other age groups.    Conclusions    There was no gender difference in sacral morphology during the growth and development of juveniles. The Angle between the lower sacral margin and the superior symphysis of pubis is greater in juvenile females than in males. With the increasing of age, the degree of sacral tilt increased gradually, the degree of lower sacral tilt decreased. In order to obtain a clearer image of the sacrum the X-ray incidence Angle should be adjusted according to gender, age, and examination purpose.

Anatomical features of the spinal canal in degenerative lumbar scoliosis and its correlation with spinal-pelvic parameters

Wu Jiabao, Sun Bolin, Xing Kai, Zhang Ning, Zhou Rongping, Chen Jiangwei, Liu Zhili, Liu Jiaming

Chinese Journal of Clinical Anatomy. 2024, 42(2):  159-167.  doi:10.13418/j.issn.1001-165x.2024.2.08

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Objective    To analyze the change pattern and its correlation with spinal-pelvic parameters by measuring morphological parameters of the spinal canal in patients with degenerative lumbar scoliosis (DLS).    Methods    Fifty cases of DLS patients were collected. Cobb angle of lumbar bending, anterior lumbar convexity angle, position of the parietal vertebra, distance of parietal offset, rotation of the parietal vertebra, distance of lateral and anterior slip of the parietal vertebra, pelvic parameters PI, PT, SS, height, width and cross-sectional area of the intervertebral foramen on the concave and convex sides, cross-sectional area of the dural sac, transverse diameter and anterior-posterior diameter were measured on X-ray, CT and MRI, respectively. The patterns of morphological changes in the spinal canal and their correlation with spinal-pelvic parameters were analyzed.    Results   The parietal vertebra of DLS patients were located in the L2~L3 vertebra. The lowest spinal canal parameters were located at L4/5 level, the lowest intervertebral foramen parameters were located at L2/3 level. Morphological parameters of the spinal canal and intervertebral foramen at the L2/3 level correlated with age, cobb angle of lumbar bending, and distance of parietal offset in patients with DLS (P<0.05); while morphological parameters of the intervertebral foramen at the L5/S1 level were correlated with PI and SS (P<0.05).    Conclusions    The most narrowed spinal canal in DLS patients is mostly located at the L4/5 segment, while the most narrowed intervertebral foramen is mostly located at the L2/3 segment. There is a correlation between the degree of spinal canal stenosis and foraminal stenosis in the parietal region and spinal-pelvic parameters.

Anatomic study of occlusive treatment of  scapulohumeral periarthritis 

Yang Xianwen, Wang Fei, Cheng Fubin, Liao Liqing

Chinese Journal of Clinical Anatomy. 2024, 42(2):  168-173.  doi:10.13418/j.issn.1001-165x.2024.2.09

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Objective    To provide anatomical basis for the treatment of scapulohumeral periarthritis using the local steroid injection.  Methods  The literature of the injection method for the treatment of scapulohumeral periarthritis by the local steroid injection were reviewed. The geometric relationship between the bone location markers and the lesion site was investigated by using 30 shoulder of three-dimensional models, and an improved method of local steroid injection was obtained. A modified method was used to perform closed injection on 34 antiseptic cadaver specimens, and the accuracy of the injection was verified by anatomy.   Results   1. The geometric relationship analysis showed that the needle was inserted into the anterior corner of the acromion, and the No.7 needle was fan-shaped, and the needle could reach almost the entire subacromial space. At the midpoint of the line between the apex of coracoid process and anterior corner of the acromion, the needle may be inserted into the joint cavity towards the humerus head. 2. Anatomically, it was found that there was a certain gap between the biceps brachii tendon and the anterior edge of greater tubercle, which could be the point of needle entry. 3. The accuracy of the improved injection method was 100%.   Conclusions   Familiarity with the geometric relationship and anatomical characteristics of the shoulder is helpful to improve the feasibility and accuracy of local steroid injection.

Screening and analysis of key genes in macrophages of head and neck squamous cell carcinoma 

Hou Xiaorui, Li Haokun, Song Yifang, Chang Ruoshui, Xue Xiaolei, Zhang Qianbing, Wu Sha, Wang Nisha

Chinese Journal of Clinical Anatomy. 2024, 42(2):  174-180.  doi:10.13418/j.issn.1001-165x.2024.2.10

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Objective   To analyze and screen potential key genes in macrophages of head and neck squamous cell carcinoma (HNSCC) by bioinformatics, and to provide a target for the prognosis of HNSCC. Methods    The macrophage population was captured by using uniform manifold approximation and projection (UMAP) dimensionality reduction based on online database. Furthermore, T-distributed random neighbor embedding (tSNE) clustering was used to analyze the changes of cell population distribution in tumor tissue and normal tissue, and to screen the expression of differential genes. Monocle package was used to analyze the expression of key risk genes in cells at different developmental stages. The survival curve was analyzed using Kaplan-Meier Plotter online data platform. Spatial transcriptome technology was used to verify the expression mapping of key genes in tissues. Clinical samples were validated by multicolor fluorescence immunohistochemistry.   Results   Seven macrophage subgroups were captured, of which the first subgroup existed only in tumor tissue and SPP1 gene was highly enriched. The high expression of SPP1 tended to the M2-type polarization of macrophages and was in the terminal stage of cell differentiation. SPP1+ macrophages had active functions such as glycolysis, hypoxia, epithelialization, and angiogenesis. The expression of SPP1+ macrophages was negatively correlated with the prognosis of HNSCC patients.    Conclusions   SPP1 may be a valuable prognostic biomarker in HNSCC.

Comparison of the clinical outcomes between fresh embryo transfer and frozen-thawed embryo transfer in the gonadotropin-releasing hormone antagonist protocol

Sun Li, Li Xinxin, Li Yue, Ge Mingxiao, Ou Jianping, Ge Shuqi

Chinese Journal of Clinical Anatomy. 2024, 42(2):  181-185.  doi:10.13418/j.issn.1001-165x.2024.2.11

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Objective   To compare the clinical outcomes of fresh embryo transfer and frozen-thawed embryo transfer (FET) in the gonadotropin-releasing hormone antagonist (GnRH-A) protocol.   Method   The clinical data of 2575 women undergoing GnRH antagonist protocol cycle, including 1328 cases of fresh embryo transfer and 1247 cases of FET were retrospectively analyzed.    Results    The AMH level and AFC in the FET group were significantly higher than those in the fresh embryo transfer group (P<0.05), and there was no significant difference in other baseline characteristics between the two group (P>0.05). The FSH level on hCG day in the FET group was significantly lower than that in the fresh embryo transfer group, and E2, P level on hCG day in the FET group were significantly higher than those in the fresh embryo transfer group (P<0.05). The total number of oocytes retrieved, matured oocyte, high-quality embryos in the FET group were significantly higher than those in the fresh embryo transfer group (P<0.05). The mean number of embryos transfer in the FET group was significantly lower than that in the fresh embryo transfer group, the clinical pregnancy rate, implantation rate and live birth rate in the FET group were significantly higher than those in the fresh embryo transfer group, the ectopic pregnancy rate and the multiple pregnancy rate in the FET group were significantly lower than those in the fresh embryo transfer group (P<0.05). There was no significant difference in the incidence of moderate-severe OHSS, miscarriage rate, incidence of GDM and gestational hypertension between the two groups (P>0.05). The singleton birth weight in the FET group was significantly higher than that in the fresh embryo transfer group, with statistical difference (P<0.05).    Conclusions   In the GnRH antagonist protocol cycle, FET can obtain good clinical outcome and can be used as an effective supplemental regimen.

Effect and mechanism of Phillyrin on acute lung injury in septic shock mice

Zhang Fan, Wei Huanjie, Li Long, Ouyang Tao, Cai Juan, Liang Qiuling, Zeng Yuhui

Chinese Journal of Clinical Anatomy. 2024, 42(2):  186-190.  doi:10.13418/j.issn.1001-165x.2024.2.12

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Objective    To investigate the impact of phillyrin on acute lung injury (ALI) in septic shock mice through autophagy mediated by adenosine monophosphate activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR)/p70 S6 kinase(p70S6K) signal pathway.    Methods    Twelve mice were randomly selected as the control group, and the rest of the mice were injected intraperitoneally with 20 mg·kg-1 LPS to construct the model of septic shock, the mice with septic shock were randomly divided into a model group, an Experimental-L, -M, -H group (5 mg·kg-1, 10 mg·kg-1, 20 mg·kg-1 phillyrin), and an Experimental -H+compound C group (20 mg·kg-1 phillyrin+20 mg·kg-1 AMPK inhibitor compound C), there were 12 mice in each group. The lung dry weight and wet weight were weighed, and the W/D ratio was calculated; the levels of inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) in BALF, serum endotoxin (ET) and myeloperoxidase (MPO) of lung tissue were detected by ELISA; HE staining was applied to detect pathological changes of lung tissue; Western blot was applied to detect the expression of autophagic proteins microtubule-associated protein -light chain 3 (LC3-II/I), Beclin 1, Ras-associated GTP binding protein 7 (Rab7), lysosomal associated membrane protein 2 (LAMP2) and AMPK/mTOR/p70S6K signaling pathway proteins.    Results    In control group, model group, Experimental-L,-M,-H group and Experimental-H+compound C group LC3-II/I ratios were 1.43±0.14, 0.73±0.07, 0.81±0.07, 1.12±0.10, 1.39±0.13, 0.76±0.08, respectively. Beclin1 protein levels were 1.05±0.11, 0.43±0.05, 0.50±0.05, 0.76±0.08, 0.98±0.10, 0.46±0.05, respectively. Rab7 protein levels were 1.53±0.17, 0.67±0.06, 0.70±0.07, 1.04±0.10, 1.41±0.14, 0.69±0.06, respectively. LAMP2 protein levels were 1.47±0.15, 0.72±0.07, 0.81±0.08, 1.09±0.11, 1.35±0.13, 0.74±0.07, respectively. p-AMPK/AMPK protein levels were 0.95±0.05, 0.33±0.03, 0.39±0.04, 0.68±0.07, 0.91±0.09, 0.36±0.04, respectively. p-mTOR/mTOR protein levels were 0.28±0.02, 0.94±0.06, 0.88±0.07, 0.57±0.05, 0.30±0.03, 0.87±0.09, respectively. The protein levels of p70S6K were 0.32±0.07, 0.96±0.04, 0.90±0.07, 0.69±0.06, 0.38±0.04, 0.92±0.06, respectively. There were statistical differences between the model group and the control group (all P<0.05). There were statistical differences between Experimental-M, -H group and model group (all P<0.05). There were significant differences between Experimental-H+compound C group and Experimental-H group (all P<0.05).   Conclusions   Phillyrin may improve ALI in septic shock mice by regulating autophagy mediated by AMPK/mTOR/p70S6K signaling pathway.

The effect of tui na rolling on post-injury inflammation and fibrosis in rabbits in a model of blunt contusion of skeletal muscles

Ruan Lei, Huang Bo, Wang Lanlan, Xue Huitian, Sun Menglong, Duan Miaomiao, Peng Liang

Chinese Journal of Clinical Anatomy. 2024, 42(2):  191-195.  doi:10.13418/j.issn.1001-165x.2024.2.13

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Objective   To investigate the effect of tui na rolling method on the expression of relevant fibrosis proteins after blunt contusion injury of skeletal muscle in rabbits, and to explore the mechanism of action of tui na rolling method on the repair of blunt contusion injury of skeletal muscle.   Methods   Fifteen healthy adult New Zealand rabbits were randomly divided into three groups of blank (A), model (B) and treatment (C), with five rabbits in each group. Blunt contusion of skeletal muscle was modelled in rabbits of groups B and C using a self-constructed modified gravity hammer percussion device. The rabbits in group C were given the intervention 7 d of tui na rolling after successful modelling, at a frequency of 140 beats/min, 2 times/d, 3 min/session, for a total of 3 d of treatment. Tissue sampling was performed 1 d after the end of the intervention. Histological changes of rabbit quadriceps femoris muscle were observed by HE and Masson staining, and MMP-9, TIMP-1, TGF-β1, and COL-I expression of quadriceps femoris muscle of rabbits in each group were detected by Western-Blot.   Results   The muscle tissue of the blank group was of regular structure, the muscle tissue of the model group was of very distinct shape, with blurred margins, significantly enlarged gaps, significant invasion of inflammatory cells, and increased collagen fiber production in the surrounding area, the muscle tissue of the treatment group was relatively more intact in structure, with the gaps narrowed, and a small amount of invasion of inflammatory cells and collagen fiber production could be seen, and the degree of its pathological repair was significantly better than that of the model group. Compared with the blank group, the expression of MMP-9, TIMP-1, TGF-β1, and COL-I in quadriceps femoris muscle of rabbits in the model group and the treatment group were significantly increased (P<0.01). However, the expression of MMP-9, TIMP-1, TGF-β1, and COL-I in quadriceps femoris muscle of rabbits in the treatment group was significantly lower than that in the model group (P<0.01).   Conclusions   Tui na rolling method is ability to inhibit skeletal muscle fibrosis by reducing the excessive deposition of extracellular matrix, and then inhibit skeletal muscle fibrosis, and its mechanism of action maybe related to the suppression of the expression of MMP-9, TIMP-1, TGF-β1, and COL-I.

Muscle synergy analysis during the sit-to-stand movement in elderly individuals with a history of falling

Liu Ruiping, Qian Lei, Liu Yanyan, Wan Xinzhu, Chen Chunyan, Wang Yining, Yu Wanqi, Ouyang Jun

Chinese Journal of Clinical Anatomy. 2024, 42(2):  196-200.  doi:10.13418/j.issn.1001-165x.2024.2.14

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Objective   To explore the change of muscle recruitment mechanisms during sit-to-stand (STS) movements in elderly individuals with a history of falls.    Methods    A total of 17 healthy young adults, 17 healthy elderly adults, and 9 elderly individuals with a history of falls were recruited. Surface electromyography (sEMG) signals and the trajectory of the center of pressure (COP) from 16 muscles of the right lower limb were collected. Falls Efficacy Scale-International (FES-I) was used to assess fall risk, and muscle synergies were extracted by non-negative matrix factorization (NNMF). Results There was no significant difference in the number of muscle synergies among the three groups. In the elderly individuals with a history of falls, early activation of the hamstring and ankle plantar flexors at the beginning of sit-to-stand movement was transformed into additional muscle activity at the later stage of movement, in contrast to the healthy group. Furthermore, COP offsets and FES-I scores were significantly increased, indicating a lack of movement stability.   Conclusions    Abnormal activation of hamstrings and ankle dorsiflexion in elderly individuals with a history of falls during STS movements may affect lower limb stability and changes in muscle recruitment strategies.

Research on the application of three-dimensional visualization technology based on CT image data fusion and digital urology virtual diagnosis and treatmen in adrenal tumors

Zhang Yunhao, Fan Kai, Huang Congjun, Cheng Qiangqiang, Wang Guanyan, Xiao Youping, Mei Aobing

Chinese Journal of Clinical Anatomy. 2024, 42(2):  201-207.  doi:10.13418/j.issn.1001-165x.2024.2.15

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Objective    To explore the application value of 3D reconstruction technology of CT scanning and digital virtual surgery diagnosis and treatment system in adrenal tumors.    Methods    Data on 20 patients diagnosed with adrenal tumors and completed 3D reconstruction in The Second People′s Hospital of Guiyang from September 2016 to April 2023 were reviewed. A total of 19 cases were collected, including 12 cases of three-dimensional reconstruction adrenal tumors (3D group), 3 males and 9 females, with the mean age of (44.92±13.28) year. All the 12 patients in 3D group were three-dimensional reconstructed with enhanced CT image data before operation, and the reconstructed model was used to understand the tumor and its occupying position, as well as the relationship between the tumor and blood vessels and surrounding tissues and organs.  The operation plan, intraoperative guidance and doctor-patient communication was made according to the 3D reconstruction image. There were 7 cases without three-dimensional reconstruction (CT group), the mean age was (35.14±11.25) years. There were 3 males and 4 females in the CT group. The general information, surgical methods and perioperative data of the two groups were compared. The data were analyzed by using SPSS 26.0.    Results    Among the 19 cases, 18 cases were successfully completed. One case in the CT group was converted to open surgery due to insufficiently accurate preoperative evaluation, which resulted in the discovery of a huge tumor and complex anatomical relationship during the operation, and the inability to expose the complete tumor, central vein and renal vein. The operation time in the 3D group was shorter than that in the CT group, with a statistically significant difference (P<0.05). There were no significant differences in general information(age and gender), intraoperative bleeding volume, postoperative length of stay, and drainage tube removal time between the two groups (P>0.05).   Conclusions   3D visualization and realistic reconstruction technology is an important foundation for construction of virtual diagnosis and treatment of digital  urology. 3D reconstruction models can reduce anatomical disorientation in adrenal tumor surgery to achieve accurate intraoperative resection, thereby shortening the surgical time. It is beneficial to reduce surgical risk and has high clinical application value in urology surgery, which is worth of further clinical application and promotion.

Clinical observation of primary trigeminal neuralgia treated by neuroendoscopy  combined with microvascular decompression under microscope  

Shen Jiangjiang, Liu Zhihong, Liu Baohui

Chinese Journal of Clinical Anatomy. 2024, 42(2):  208-212.  doi:10.13418/j.issn.1001-165x.2024.2.16

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Objective    To evaluate the clinical effect of primary trigeminal neuralgia treatment by neuroendoscopy combined with microvascular decompression under microscope.    Methods    A retrospective analysis was made on 78 patients with primary trigeminal neuralgia treated by microvascular decompression, with 36 cases were treated by microvascular decompression under microscope (group A), and the other 42 cases were treated under neuroendoscopy  combined with microscope (group B).The discovery rate of offending vessels, complications rate, and therapeutic efficacy were compared in the two groups after treatment.    Results    The discovery rate of offending vessels in the group B (95.2%) was significantly higher than that of the group A (80.6%); The total effective rate of the group B (97.6%) was higher than that of the group A (83.3%). There were statistical differences in the discovery rate of offending vessels and total effective rate  in the two groups (P<0.05). There was no statistical difference in the postoperative complications between group A (30.6%) and group B (14.3%) (P>0.05).    Conclusions    The treatment of primary trigeminal neuralgia with neuroendoscopy combined with microvascular decompression microscope is of high clinical application value to improve the discovery rate of offending vessels and cure rate.

Retrospective cohort study on the accuracy and learning curve of sacroiliac screw implantation assisted by 3D printing during pelvic acetabular fracture

Chen Lin, Li Lei, Lan Jiapin , Wen Yang, Zhang Xulin, Liu Dong

Chinese Journal of Clinical Anatomy. 2024, 42(2):  213-219.  doi:10.13418/j.issn.1001-165x.2024.2.17

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Objective    To explore the accuracy and learning curve of sacroiliac screw implantation assisted by 3D printing technique in pelvic acetabular fracture.   Methods    A total of 112 patients with pelvic acetabular fractures treated in our hospital from January 2020 to January 2023 were selected and divided into a conventional group (n = 56) and a 3D printing group (n=56) according to whether 3D printing technique was used or not before operation. The clinical data of the two groups were compared. The correlation between the placement time of single sacroiliac screw and the number of surgical cases was analyzed by linear regression, and the learning curve of 3D printing technique was evaluated.    Results    The surgical time, insertion time of a single sacroiliac screw, and fracture healing time of the 3D printing group were significantly shorter than those of the conventional group. The intraoperative bleeding volume, perioperative blood transfusion volume, number of needle punctures, and intraoperative X-ray fluoroscopy frequency were significantly lower than those of the conventional group. The excellent and good rate of sacroiliac screw insertion position, postoperative fracture reduction, and hip joint function recovery were significantly higher than those of the conventional group (P<0.05). The results of linear regression analysis showed that there was a significant negative correlation between the insertion time of a single sacroiliac screw and the number of surgical cases in the 3D printing group and regular group (r=-0.842, -0.590, P<0.001). The regression equation of 3D printing group was insertion time of a single sacroiliac screw=69.839-4.413×Number of surgical cases, R2=0.709, and that of regular group was 16.243-0.111×Number of surgical cases, R2=0.348.    Conclusions   The application of 3D printing technology in the operation of pelvic acetabular fracture can significantly improve the accuracy of sacroiliac screw placement and increase the safety of operation, and with the increasing of the number of surgical cases, the nail placement time assisted by 3D printing technology is significantly shortened.

Effect of preoperative evaluation on the prevention of postoperative ipsilateral shoulder pain in patients undergoing thoracoscopic surgery

Lin Yixin, Lin Zishi, Liu Weishan, Ye Jing

Chinese Journal of Clinical Anatomy. 2024, 42(2):  220-224.  doi:10.13418/j.issn.1001-165x.2024.2.18

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Objective   To investigate the efficacy of Oxford Shoulder Score（OSS）for preventing postoperative ipsilateral shoulder pain (ISP) in patients undergoing thoracoscopic surgery.    Methods   A total of 500 patients who underwent selective thoracoscopic surgery in the lateral position with general anesthesia were enrolled. Complete OSS data were questioned using in-depth interviews in the afternoon before the operation and the first postoperative day, and telephone was follow-up at 4-6 weeks after the operation. Special protections and statistical analysis were designed for the patients with preoperative OSS ≥19.   Results A total of 465 patients were included in the study, 16 cases presented ISP with a longer operative duration and higher postoperative OSS compared to those without ISP, and shown limitation of range of motion of ipsilateral shoulder in the first postoperative day (P<0.05 or 0.01). However, 9 cases with preoperative OSS ≥19 didn’t develop ISP.   Conclusions   The protective procedures of the lateral posture can minimize postoperative ISP for the patients with a high preoperative OSS.

Roles of mTOR and ERK/MAPK signaling pathways regulating autophagy in the pathogenesis of autism

Li Yanfang, Deng Yanan, Wang Ting, Zhang Yinghua

Chinese Journal of Clinical Anatomy. 2024, 42(2):  225-228.  doi:10.13418/j.issn.1001-165x.2024.2.19

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Research progress of the application of nanometer materials in the treatment of bone metastasis of lung cancer

Qian Xin, Li Mei, Ma Limin, Zhang Yu

Chinese Journal of Clinical Anatomy. 2024, 42(2):  229-232.  doi:10.13418/j.issn.1001-165x.2024.2.20

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Research progress of genetic engineering in promoting osteogenic differentiation of adipose-derived stem cells

Xue Zhixin, Li Ye, Lu Feng, Liao Yunjun

Chinese Journal of Clinical Anatomy. 2024, 42(2):  233-235.  doi:10.13418/j.issn.1001-165x.2024.2.21

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Research progress on the Biomechanics and application of transversus abdominis

Luo Xiang, Leng Xiaohui, Wang Yang, Jiang Ping, Li Yuefeng, Ma Rui

Chinese Journal of Clinical Anatomy. 2024, 42(2):  236-238.  doi:10.13418/j.issn.1001-165x.2024.2.22

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Variant of left cephalic vein:one case report

Tang Chunxiao, Wang Wenjie, Pan Chenglong, Yang Lin

Chinese Journal of Clinical Anatomy. 2024, 42(2):  212.  doi:10.13418/j.issn.1001-165x.2024.2.24

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Absence of bilateral deep femoral arteries: one case report

Wang Siqing, Huang Zhifa, Xu Zhiliang, Chen Yongrun, CaiNanxi, Ren Qian, Jiang Suna, Xu Ying, Zhang Peng

Chinese Journal of Clinical Anatomy. 2024, 42(2):  239.  doi:10.13418/j.issn.1001-165x.2024.2.23

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