Chinese Journal of Clinical Anatomy

Condense scientific questions to study virtual anatomy in-depth

Liu Shuwei

Chinese Journal of Clinical Anatomy. 2024, 42(4): 361-363. doi:10.13418/j.issn.1001-165x.2024.4.01

Abstract ( 2868 )

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Lateralization and sex differences of hippocampal subregions volume in adolescents

Liu Yuning, Teng Ye, Tang Qian, Lou Yunxia, Wang Yu, Tang Yuchun, Liu Shuwei

Chinese Journal of Clinical Anatomy. 2024, 42(4): 364-371. doi:10.13418/j.issn.1001-165x.2024.4.02

Abstract ( 2617 )

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Objective To make a detailed subdivision of the hippocampus in adolescents and to analyze the lateralization and sex differences in the volume of each subregion, so as to provide anatomical basis for the study of hippocampal function and related psychiatric diseases. Methods A total of 101 healthy adolescent subjects were collected for 3.0T brain magnetic resonance imaging. After whole-brain segmentation and subregion segmentation of bilateral hippocampus by using FreeSurfer software, intracranial volume and each hippocampal subregion volume were obtained. The volumes of hippocampal subregions were standardized by intracranial volume using Cendes methods. Finally, the lateralization and sex differences of hippocampal subregion volumes after standardization were statistically analyzed. Results Freesurfer software showed clear and good effect in automatic segmentation of hippocampal subregions. In terms of literalization, the HBT（head/body/tail) protocol showed that, except for the hippocampus tail, there were literalization in the volume of the hippocampus head, body and the whole hippocampus, right(R)>left(L). In FS60, there was no literalization in hippocampal tail, hippocampal fissure and subiculum; other subregions had literalization, the volume of CA1, CA3, CA4, GC-ML-DG, molecular layer, HATA, fimbria was R>L, while parasubiculum and presubiculum was L>R. In terms of sex difference, after data standardized by the Cendes method, there was sex difference in the volume of each part on the both sides of the HBT, and female (F)>male (M). For FS60, there was sex difference in parasubiculum, presubiculum, subiculum, CA4, GC-ML-DG, molecular layer, HATA, and hippocampal tail, F>M. Conclusions The volumes of different hippocampal subregions in adolescents have different lateralization and sex differences properties, reflecting the heterogeneous structural characteristics of the hippocampus in this period. This study provides basis for the study of the formation of functional lateralization of the brain and related clinical psychiatric disorders.

Virtual anatomical modeling of the pelvis of a 3-year-old girl

Yin Zhaozheng, Li Kun, Zhang Fengzhen, Zhao Jing, Yi Yuying, Li Lei, Chen Chengzhi, Wang Yu, Li Zhijun, Zhang Shaojie

Chinese Journal of Clinical Anatomy. 2024, 42(4): 372-377. doi:10.13418/j.issn.1001-165x.2024.4.03

Abstract ( 2503 )

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Objective To study the continuous ultra-thin slice anatomy and virtual three-dimensional model of the pelvic region in girls, to assist in anatomical research and simulated surgery. Methods The transverse section images were extracted from the perineum to the iliac crest area from the Digital Medical Center of Inner Mongolia Medical University. Adobe Photoshop software was used to interactively segment the region of interest from the images. Format conversion and segmentation were performed to process on the images. A digital 3D model of the region was extracted and reconstructed by using the Digihuman Reconstruction System. Results The high-resolution sectional anatomical images of the female pelvic region were obtained and the important structures were annotated. The digital 3D model of the virtual female pelvic region was established successfully, which accurately displayed the anatomical relationships between various structures providing a reliable three-dimensional model for pelvic surgery simulation systems. Conclusions The virtual 3D reconstruction and visualization of the female pelvic region can display realistic and three-dimensional representation of the area and its adjacent structures, providing morphological basis for anatomy, imaging diagnosis, and virtual surgery in this region.

Three-dimensional restoration research driven by craniomaxillofacial dataset

Jin Zewen, Zhang Xinkang, Wang Wensheng, Chen Xinrong

Chinese Journal of Clinical Anatomy. 2024, 42(4): 378-381. doi:10.13418/j.issn.1001-165x.2024.4.04

Abstract ( 3359 )

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Objective　To propose a learning-based automatic restoration method for craniomaxillofacial defects, which learning from a self-constructed dataset to automatically generate the shape of the defective parts, and providing reference for the restoration of complex craniomaxillofacial structures.　Methods　Based on the head CT data, 125 cases of skull data were reconstructed and annotated. Each case was categorized into 21 defect classes. Various techniques were used for data preprocessing, including image registration and threshold filtering. A novel craniomaxillofacial automatic restoration technique was introduced to generate shapes for the defective portions.　Results　The proposed method achieves the state-of-the-art results on the CMF Defects dataset, which can reconstruct shapes that combine aesthetics and protective functionality. Conclusions　Craniomaxillofacial bone have diverse shapes and complex anatomical structures. This study, combined with deep learning and data-driven methods, can effectively generate the generation of craniomaxillofacial bone defects, providing a reliable foundation for preoperative planning and intraoperative procedures in craniomaxillofacial restoration surgery.

Study on the accurate T-stage diagnosis and prediction of cervical cancer based on MRI and anatomical measurement

Zou Yuxin, Wang Ruiwei, Wu Zhe, Hou Wenjing, Xu Shanshan, Fan Rutao, Wang Yanzhou, Wu Yi

Chinese Journal of Clinical Anatomy. 2024, 42(4): 382-392. doi:10.13418/j.issn.1001-165x.2024.4.05

Abstract ( 2431 )

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Objective To determine whether the measurement of three-dimensional morphological parameters based on magnetic resonance imaging (MRI) can accurately predict the T-stage diagnosis of cervical cancer (CC) tumors or not after three-dimensional reconstruction. Methods Preoperative MRI images from 108 patients with pathologically confirmed cervical cancer were retrospectively collected and divided into four groups: T1, T2, T3 and T4. T1 and T2 were further divided into four subgroups: T1a, T1b, T2a and T2b. The Amira2019 software was used to segment and 3D reconstruct the tumor, uterus, vagina, bladder, urethra, and rectum. The surface area, volume, longitudinal diameter, anterior posterior diameter, transverse diameter, longest diameter, roughness, texture uniformity and degree of vaginal invasion of tumor were measured. The statistical differences were evaluated by using Kruskal-Wallis test, [χ2]-test, receiver operating characteristic (ROC) curve, etc., and the cut-off values for different T-stages were calculated based on Youden's index. Results There were statistical differences in the surface area, volume, longitudinal diameter, anterior posterior diameter, transverse diameter, longest diameter and degree of vaginal invasion of tumor between T1-T4 and T1a-T2b (P<0.05), while there was no statistical difference in roughness and texture uniformity between T1-T4 and T1a-T2b (P<0.001). Among them, the longitudinal average diameters of T1-T4 tumors were 2.82 cm, 3.78 cm, 4.82 cm and 6.61 cm (P<0.001), respectively, with cut-off values of 3.17 cm , 4.24 cm and 6.57 cm (AUC=0.699, 0.73, 0.708). The longitudinal average diameters of T1a-T2b tumors were 2.31 cm, 2.84 cm, 3.63 cm and 4.09 cm (P=0.008), respectively, with cut-off values of 2.32 cm, 3.12 cm and 3.94 cm (AUC=0.597, 0.689, 0.561). Conclusions The morphological parameters of cervical cancer tumors on MRI include surface area, volume, longitudinal diameter, anterior posterior diameter, transverse diameter, longest diameter, and degree of vaginal invasion of tumor, which are valuable diagnostic factors for predicting T-stage in cervical cancer patients. This study contributes to the accurate diagnosis, prognostic evaluation, and treatment decision-making of cervical cancer.

Preliminary study on the application of tissue transparency technology in organ visualization

Tang Qian, Hou Lanwei, Liu Yuning, Lou Yunxia, Teng Ye, Zhou Wenjuan, Liu Shuwei

Chinese Journal of Clinical Anatomy. 2024, 42(4): 393-398. doi:10.13418/j.issn.1001-165x.2024.4.06

Abstract ( 2456 )

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Objective To explore the adaptability of clear, unobstructed brain imaging cocktails and computational analysis (CUBIC) tissue transparency techniques in different organs of mice, and explore the compatibility of tissue transparency technology with nuclear staining and virus tracer neuron labeling technology. Methods （1） The brains, hearts and livers of freshly injected mice were extracted and dissected. Tissue blocks of 1.0cm×1.5cm×0.5cm were taken respectively, clear, unobstructed brain imaging cocktails and computational analysis-L (CUBIC-L) and clear, unobstructed brain imaging cocktails and computational analysis-R (CUBIC-R) tissue cleaning solution were used for transparency treatment. （2） The whole brain of mice was treated with transparency, and the nucleus of mouse brain neurons was stained with propidium iodide (PI). Three-dimensional nuclear volume images of the left and right hemispheres and cerebellar brainstem were obtained by light sheet fluorescence microscopy (LSFM). （3） Adeno-associated virus (AAV) -U6-enhanced green fluorescent protein (EGFP) was microinjected into the hippocampus and substania nigra of rat brain, respectively, to label neurons at specific anatomical sites. The rat brain after virus transfection was treated transparently. LSFM performs 3D stereoscopic imaging. Results The brain tissue, liver tissue and heart tissue all showed a transparent gel-like state after transparent treatment. However, the removal efficiency of different tissue blocks was different, and the removal efficiency of brain tissue was the highest, followed by liver tissue and heart tissue. LSFM could perform whole-volume three-dimensional imaging of transparent and nucleated brain tissue. AAV can clearly mark neurons in different parts, after transparent processing, the spatial distribution of these neurons could be observed, and the physical projection of neurons in different parts could also be observed. Conclusions CUBIC tissue transparency technology has universal application in brain tissue, heart tissue and liver tissue of mice, and the transparency efficiency of brain tissue is the highest. CUBIC tissue transparency method has good compatibility with nuclear staining and virus tracer neuron labeling technology.

Anatomy and clinical significance of laparoscopic extended radical resection and simple radical resection of transverse colon cancer

Zeng Jun, Zhang Yue, Liu Qi, Liu Chunsheng, Liu Zhiyuan, Su Jiarui, Wu Jiawei, Yao Xueqing

Chinese Journal of Clinical Anatomy. 2024, 42(4): 399-405. doi:10.13418/j.issn.1001-165x.2024.4.07

Abstract ( 19 )

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　Objective　To explore the relationship between anatomy and biological characteristics of middle transverse colon cancer, to study the relationship between the choice of operation and prognosis, and to determine the best mode of operation.　Methods　Using anatomical and imaging data, gross specimens and three-dimensional vascular reconstruction maps were studied, and the clinical effects and survival of patients with middle transverse colon cancer treated by different laparoscopic operations were analyzed retrospectively.　Results　(1)The primary and secondary vascular ligation can ensure the blood supply of the anastomotic colon; (2)The coincidence rate of preoperative three-dimensional vascular reconstruction and intraoperative vascular exploration was more than 90%; (3)There was no statistical difference in the intraoperative bleeding volume, operation time, postoperative complications and overall survival rate between the transverse colectomy group and the expanded colectomy group. There was significant difference in the number of lymph node dissection between the two groups.　Conclusions　Laparoscopic transverse colectomy alone has a tendency to reduce the risk of postoperative complications compared with extended radical resection of colon cancer, and there is no statistical difference in prognosis between them. Transverse colectomy is the best surgical method for middle transverse colon cancer.

Anatomical and design application of the gluteal epithelial neurovascular flap pedicled with perforator of the fourth lumbar artery

Wu Fuzhang, Zhang Pengli, Zhang Zhenhua, He Yongbin, Guo Tao, Sun Heyan

Chinese Journal of Clinical Anatomy. 2024, 42(4): 406-410. doi:10.13418/j.issn.1001-165x.2024.4.08

Abstract ( 19 )

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Objective　To observe and design the gluteal epithelial neurovascular flap pedicled with perforator of fourth lumbar artery, so as to provide anatomical and morphological basis for the clinical application.　Methods　Anatomical observation of 15 cases (30 sides) adult Chinese specimen of waist-hip region were performed. The distribution of posterior branch of the fourth lumbar artery, gluteal epithelial nerve and its subdivision branch were observed at the position of deep fascial perforation point. Measure The outer diameter of the posterior branch of the fourth lumbar artery, and the length of middle branch of the gluteal epithelial nerve were measured. On the basis of applied anatomy, the gluteal epithelial neurovascular flap pedicled with perforator of fourth lumbar artery was designed and applied to repair huge wounds in sacrococcygeal tracts in 12 cases.　Results　The external diameter of the fourth lumbar artery's posterior branch penetrated the deep fascia was (1.16±0.43) mm, with 63.3% represented by single branches in 19 out of 30 instances. In 11 cases, the artery was divided into 2~3 branches before penetrating the deep fascia, accounting for 27.7%. The length of the intermediate branch of gluteal epithelial nerves was (147.82±16.37) mm. The design area of the gluteal fascial flap were the following the superior boundary was 2~4 cm from the rotation point, the inferior boundary was the superior part of the gluteus maximus, the inside of superior boundary was the posterior median line, the lateral side was posterior axillary line. The flap size was 17.4 cm×12.5 cm~25.4 cm×18.3 cm. Length-width ratio of the flap was (3~5): 1. Twelve cases of large sacrococcygeal wounds were repaired by the 4th lumbar artery perforated gluteal neurotrophic vascular flap. All the flaps survived and the effects were satisfactory.　Conclusions　The blood supply of the flap is mainly from the posterior branch of the fourth lumbar artery, the gluteal epithelial nerve and its branch innervation, which has certain regularity and predictability. This flap is easy to design, constant and clear anatomy, covers a large area, and is easy to operate, making it an ideal method for repairing huge wounds in the sacrococcygealgeal.

Neuromuscular subdivision and central localization of intramuscular nerve dense region in extraocular muscles based on Sihler's staining

Yuan Ling, Zhou Guoyan, Wu Junxi, Yang Shengbo

Chinese Journal of Clinical Anatomy. 2024, 42(4): 411-418. doi:10.13418/j.issn.1001-165x.2024.4.09

Abstract ( 18 )

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Objective To reveal the neuromuscular subdivision of extraocular muscle and the body surface projection position, angle and depth for puncture of center of intramuscular nerve dense region (CINDR). Methods Twenty-four Chinese adult.cranial specimens were used. The arc line (orbital edge line) on the skin close to the edge of the orbit was designed as the reference line, and the acute angle formed between the puncture needle and the eyelid skin was θ. The Modified Sihler's staining was used for showing the distribution pattern of intramuscular nerves in the extraocular muscles. The CINDRs were labelled with barium sulfate, and the spiral CT scanning and three-dimensional reconstruction was performed. The percentage position of the surface projection point (P point) of CINDR on the reference line, the angle and depth required to penetrate CINDR through P point were measured. Results During gross dissection, it was found that there were no blood vessels accompanying at the nerve entry points of the seven extraocular muscles (levator palpebrae superioris, superior rectus, inferior rectus, medial rectus, lateral rectus, superior oblique and inferior oblique muscles). After the nerve entered the muscle, it was often divided into two independent primary nerve branches, and then followed by arborized branches. According to their nerve distribution pattern, each muscle could be divided into two neuromuscular compartments. The intramuscular arborized nerve branches formed nerve dense regions, and the body surface projection points of the CINDR were located at 68.42%, 53.43%, 53.21%, 11.76%, 98.56%, 30.15%, and 43.73% on the orbital edge line (medial to lateral), respectively. The puncture angles were 83.54°, 69.75°, 74.15°, 82.98°, 80.58°, 83.69°, and 71.52°, respectively. The puncture depths were 3.05 cm, 2.71 cm, 2.82c m, 3.02 cm, 3.00 cm, 3.09 cm, and 2.18 cm, respectively. There were no statistical differences between left and right sides and between males and females (P>0.05). Conclusions These results may provide morphological guidance for correcting strabismus by compartmentalized transplantation of extraocular muscle and intramuscular injection of botulinum toxin A.

Anatomical study and clinical significance of central venous catheterization via the internal jugular vein

Chen Yongzheng, Liu Wei, Zhou Xuru, Li Keyang, Zhang Gongming, Liang Weixu, Zhang Yurui, Zhang Ziqing, Chen Fei, Chen Zhiguo

Chinese Journal of Clinical Anatomy. 2024, 42(4): 419-423. doi:10.13418/j.issn.1001-165x.2024.4.10

Abstract ( 21 )

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Objective 　To measure the length of internal jugular vein puncture and catheterization and its transvascular radius, so as to provide morphological basis for central venous puncture and catheterization through the internal jugular vein in clinical practice.　Methods　Thirty-one adult gross cadavers were selected, and the entire course of the veins and their tributaries were dissected to determine the puncture entry point and the end point of the catheterization. The length from the left and right approach points to each tributary and to the end point, as well as the flattening diameter of the vessels were measured. The radius was calculated based on the flattening diameter.　Results　For the left approach, the average length to the subclavian vein was (20.47±9.08) mm; to the junction of the left and right brachiocephalic veins (91.17±14.12) mm; and to the end point (148.27±17.25) mm. For the right approach, the average length to the subclavian vein was (21.59±7.32) mm; to the junction of the left and right brachiocephalic veins (61.06±9.74) mm; and to the end point (123.22±12.68) mm. On the left side, the average radius of the internal jugular vein was (3.85±1.29) mm; subclavian vein (4.64±1.07) mm; and brachiocephalic vein (5.08±1.01) mm. On the right side, the average radius of the subclavian vein was (4.79±0.89) mm; internal jugular vein (5.03±1.65) mm; and brachiocephalic vein (5.23±0.91) mm. The average radius of the superior vena cava was (7.92±0.97) mm; and the azygos vein (4.16±1.21) mm.　Conclusions 　The right approach for internal jugular vein puncture and catheterization has greater advantages than the left side; a 20 cm catheter on the left side and a 15 cm catheter on the right side can basically meet clinical needs.

Radiographic anatomical study of median arcuate ligament compression in the celiac artery based on abdominal CTA

Li Jingjing, Gong Shenchu, Yin Jianbing

Chinese Journal of Clinical Anatomy. 2024, 42(4): 424-428. doi:10.13418/j.issn.1001-165x.2024.4.11

Abstract ( 27 )

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Objective　The epidemiologic and anatomic features of the median arcuate ligament (MAL) causing celiac artery (CA) compression were retrospectively investigated.　Methods　The starting position and distance of MAL and CA, the degree of compression of the celiac trunk, the angle of emergence (AE) and the fold angle (FA) of CA were measured. The anatomical and baseline characteristics of the compression of the CA caused by the MAL wereanalyzed.　Results　The levels of MAL and CA vertebral body initiation were negatively correlated with BMI. There were statistical differences in BMI, MAL and CA vertebral body initiation between the MAL/CA overlap group and non-overlap group. Abdominal trunk AE and FA were correlated with BMI. MAL caused abdominal trunk compression in 9.7% of cases, which was consistent with MALS in 4.6% of cases. There were statistical differences in BMI, AE, and FA angles between the abdominal trunk compression group and the non-compression group.　Conclusions　This study provides basis for the study of anatomy, pathology and clinical diagnosis and treatment of median arcuate ligament syndrome (MALS).

Study on the fiber architecture of the ureteral smooth muscle and the mechanism and countermeasure of the difficulty in descending ureteral calculi

Li Lijuan, Zhang Wenjing, Zhang Xiaowei, Liu Yukun, Liu Taohong, Liu Xuejun

Chinese Journal of Clinical Anatomy. 2024, 42(4): 429-434. doi:10.13418/j.issn.1001-165x.2024.4.12

Abstract ( 15 )

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Objective To study the fiber architecture and distribution of smooth muscle in each segment of the ureter and provide morphological basis for the treatment of ureteral stones．Methods Thirty fresh adult ureters were fixed by formalin with tissue sections to observe the morphology and distribution pattern of smooth muscle of the ureter under optical microscope The thickness and inner diameter of ureter smooth muscle by micrometer were measured. Results The smooth muscle at the beginning of the ureter was divided into four layers, and the maximum thickness of the smooth muscle was 1.59 mm on the left and 1.51 mm on the right. The maximum diameter on the left was 2.22 mm and 2.05 mm on the right. The abdominal smooth muscle was divided into three layers, and the left maximum thickness was 1.49 mm and 1.69 mm on the right. The smooth muscle in the ureter at the entrance of the small pelvis was divided into three layers, most of which were longitudinal muscle,the maximum thickness of smooth muscle on the left side was 2.38 mm, 1.98 mm on the right side. The inner diameter of the ureter was 2.11 mm on the left and 2.28 mm on the right. The ureter in the pelvic segment has four layers of smooth muscle, mostly longitudinal muscle and annular muscle, the maximum thickness of smooth muscle was 1.69 mm on the left and 1.58mm on the right.The smooth muscle of the inner wall segment was divided into three layers, the smooth muscle was the thickest, the maximum thickness on the left was 3.18mm and 3.21 mm on the right. The longitudinal muscle was the most developed, and the annular muscle was associated with the urethral sphincter. The ureteral inner diameter was 1.25 mm on the left and 1.70 mm on the right. The interrelationship between ureteral smooth muscle construction and urodynamics was discussed. Conclusions The main reason for the difficulty in the reduction of ureteral calculi may be related to the arrangement of longitudinal muscle and circular muscle of ureteral smooth muscle.

Effect of cAMP/PKA/CREB signaling pathway on bone microstructure in rats with osteoporosis secondary to premature ovarian failure

Zhang Yanru, Yang Yue, Dong Jiaqi, Xu Jiingchao, Han Daozheng, Su Jiazi

Chinese Journal of Clinical Anatomy. 2024, 42(4): 435-442. doi:10.13418/j.issn.1001-165x.2024.4.13

Abstract ( 20 )

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Objective To explore cyclicadenosine monophosphate (cAMP)/ protein kinase A(PKA)/cAMP response element binding effect of proteins protein, CREB) signaling pathway in the process of osteoporosis secondary to premature ovarian failure on bone microstructure and bone marrow mesenchymal stem cells mineralized nodules activity in rats. Methods Bioinformatics methods were used to analyze the cAMP/PKA/CREB signaling pathway. The model of osteoporosis secondary to premature ovarian failure was established by intraperitoneal injection of cyclophosphamide (50mg/kg for the first time, followed by 8mg/kg for two weeks) in adult female rats. At the same time, the normal saline group and the aged group were set as controls, and 1mg/kg PKA inhibitor H89 was injected intraperitoneally for two weeks after modeling. The femoral head and condyle were stained with HE and Safranin fast green. The bone marrow mesenchymal stem cells of the three groups were stained with osteogenic induction alizarin red. Results Cyclophosphamide successfully induced osteoporosis secondary to premature ovarian failure in female rats. When PKA was inhibited, the activity of bone mineralized nodules of stem cells was significantly decreased, and the bone microstructure of the three groups was significantly decreased, mainly in the epiphysis, the cartilage proliferation area and cartilage calcification area of the epiphyseal plate, and the trabecular bone, especially in the saline group. Conclusions The cAMP/PKA/CREB signaling pathway plays an important role in regulating the physiological activities of ovarian granulosa cells, osteogenic differentiation and cartilage growth. Inhibition of PKA significantly decreases the bone microstructure in rats.

Analysis of factors influencing early pregnancy loss in husband intrauterine insemination

Liu Yan, Li Xinxin, Gao Jing, Li Tao, Sun Li

Chinese Journal of Clinical Anatomy. 2024, 42(4): 443-448. doi:10.13418/j.issn.1001-165x.2024.4.14

Abstract ( 13 )

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Objective　To investigate the factors influencing early pregnancy loss following husband intrauterine insemination (IUI). Methods A retrospective analysis was conducted on the clinical data of 426 IUI cycles from 405 couples who tested positive for HCG and received IUI treatment at our center between January 2015 and December 2023. Based on pregnancy outcomes, the patients were divided into two groups: the early pregnancy loss group (n=85) and the ongoing pregnancy group (n=341). Basic patient characteristics, endometrial thickness on the day of HCG administration, and semen parameters were compared between the two groups. Univariate and multivariate analyses were performed to identify factors associated with early pregnancy loss. Results The early pregnancy loss rate in the reviewed cycle was about 19.95% (85/426). Univariate analysis showed there were no significant differences in female age, BMI, basal FSH, duration of infertility, total motile sperm count after processing, treatment protocol, number of cycles, male smoking status, normal sperm morphology rate, duration of abstinence, male factors, PCOS, and pelvic tubal factors (P>0.05). There were significant differences in the FSH/LH ratio, type of infertility, and endometrial thickness on the day of HCG administration between the two groups (P<0.05). Multivariate regression indicated that FSH/LH ratio (P<0.05), type of infertility (P<0.05) and PCOS (P<0.05) were independent factors influencing early pregnancy loss in IUI. Conclusions FSH/LH ratio≥2, type of infertility, and PCOS are significant factors influencing early pregnancy loss in intrauterine insemination.

Analysis of COL4A1 expression in cholangiocarcinoma

Tang Ting, Shi Yulian, Liu Yanling, Li Meilian, Dai Jingxing, Fan Tingyu

Chinese Journal of Clinical Anatomy. 2024, 42(4): 448-452. doi:10.13418/j.issn.1001-165x.2024.4.15

Abstract ( 16 )

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Objective To explore the molecular mechanisms underlying the development of cholangiocarcinoma. Methods The dataset GSE89749 was downloaded from the GEO database, and differential gene analysis, GO/KEGG enrichment analysis, and protein-protein interaction (PPI) analysis were sequentially performed to identify key genes. The expressions of COL4A1 in 16 types of cancers, including adrenocortical carcinoma, bladder urothelial carcinoma, and invasive breast carcinoma, were analyzed in the TCGA database. Results Differential gene and GO/KEGG enrichment analysis showed that differential genes were significantly enriched in the extracellular matrix containing collagen. PPI analysis identified the gene COL4A1 as a key gene. COL4A1 was found to be highly expressed in cholangiocarcinoma, colorectal cancer, and esophageal cancer among 8 types of cancers. Conclusions COL4A1 is significantly over-expressed in cholangiocarcinoma tissues, providing new perspective and experimental basis for exploring the molecular mechanisms of cholangiocarcinoma development.

Comparative study of two different lumbar fusion under microendoscope

Zhang Yang, Wang Peng, Bai Ming, Wang Junfeng, Li Shuwen, Li Zhijun, Wu Yimin

Chinese Journal of Clinical Anatomy. 2024, 42(4): 453-456. doi:10.13418/j.issn.1001-165x.2024.4.16

Abstract ( 2364 )

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Objective To analyze and compare the clinical efficacy of two different lumbar interbody fusion techniques under microendoscope in the treatment of single level lumbar degenerative diseases. Methods A total of 136 patients who met the criteria in our hospital from December 2020 to December 2023 were selected for retrospective study. Seventy-five patients received microendoscopic tranforaminal lumbar interbody fusion (ME-TLIF) and 61 patients received microendoscopic posterior lumbar interbody fusion (ME-PLIF). The perioperative data and the incidence of neurological complications were compared between the two groups. Pain (VAS) and function (ODI) scores within and between groups were compared before and after surgery. Suk criteria were used to evaluate postoperative fusion. Results The indexes of intraoperative blood loss, postoperative drainage volume and operation time in ME-PLIF group were better than those in ME-TLIF group. There were 3 cases of neurological complications in the ME-PLIF group and no neurological complications in the ME-TLIF group. Postoperative VAS and ODI scores in the same group were significantly different from those before surgery (P<0.05); Postoperative VAS and ODI scores were not significantly changed between groups (P>0.05). There was no difference in the fusion rate between the two groups at the last follow-up. Conclusions ME-PLIF technique has more advantages in reducing operation time, intraoperative and postoperative blood loss, and is easier to learn and master. During the operation, attention should be paid to adequate lateral decompression to prevent the occurrence of neurological complications.

Talonavicular‑cuneiform arthrodesis for the treatment of Müller‑Weiss: mid‑term follow-up of 20 cases after 5 years

Zou Baoli, Bai Wenbo, Zhang Kaiting, Mo Fangdong, Li Zhuo, Shen Guodong, Lai Zhibin, Zhu Yongzhan

Chinese Journal of Clinical Anatomy. 2024, 42(4): 457-462. doi:10.13418/j.issn.1001-165x.2024.4.17

Abstract ( 23 )

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Objective To investigate the clinical effect of talonavicular-cuneiform (TNC) arthrodesis in the treatment of Müller-Weiss disease (MWD) for at least 5 years mid-term follow-up. Methods A total of 20 patients undergoing TNC arthrodesis for MWD were retrospectively reviewed between January 2015 and August 2018. The radiographic parameters (preoperative, three months after the operation, and final follow-up), clinical results (preoperative, two years after the operation, and final follow-up) and complications were evaluated and analyze. Results The mean follow up period was 72.05±8.86 months (range 60 to 93). There were significant differences in the calcaneal pitch angle (CPA), Tomeno-Meary's angle (TMA), anteroposterior (AP) Meary's angle and talonavicular coverage angle (TCA) before operation and three months after operation (P<0.05). There was no significant difference in the radiographic results between three months after the operation and the final follow-up (P>0.05). The scores of AOFAS and VAS at the final follow-up were significantly improved compared with those before and two years after the operation (P<0.05). Three patients had early complications, five had late complications, and one patient was treated with a second operation (calcaneal osteotomy). Conclusions The treatment of MWD with talonavicular-cuneiform arthrodesis combined with iliac bone autograft is effective and can be maintained until mid-term follow-up.

Analysis of misdiagnosis in the diagnosis and treatment of capitulum cartilage injury fragments interposed into the gap of the radial head fractures

Chen Qun, Du Shihao, Liu Jun, Wu Yongwei, Ma Yunhong, Wang Jianbing, Qian Jun, Yin Qudong

Chinese Journal of Clinical Anatomy. 2024, 42(4): 463-467. doi:10.13418/j.issn.1001-165x.2024.4.18

Abstract ( 19 )

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Objective To investigate the clinical characteristics and misconceptions in the diagnosis and treatment of capitulum cartilage injury (CCI) fragments interposed into the gap of the radial head fractures (RHFs). Methods A retrospective study was conducted on 9 patients with concomitant CCI fragments interposed into the gap of the RHFs, which were confirmed by intraoperative exploration from January 2011 to December 2022. There were 6 males and 3 females. The age ranged from 17 to 69 years old, with an average of 36.1 years. The clinical characteristics were analyzed. RHF was classified according to Mason's classification and CCI was classified according to Wang Jian's method. The follow-up time ranged from 13 to 30 months, with an average follow-up of 14.2 months. The function of the affected limb was evaluated by Mayo Elbow Score (MEPS). Results This fracture accounted for 6.8% of RHF, and accounted for 25% of RHS with CCI. 6 cases caused by falls and 3 cases by falls from height. All had significantly limited range of movement (ROM) of flexion-extension and rotation of the forearm, and 4 cases had local crepitus. 6 cases underwent surgery because of severe RHS and 3 cases because of positive physical examination test after local anesthesia with light RHF. RHF included 1 case of Mason type I, 7 type II and 1 type III. CCI included 3 cases of type I, 4 type II and 2 type III. CCI was diagnosed by preoperative MRI in 1 case with type III, and the remaining 8 cases were negative by radiology examinations. CCI was located on the lateral side of the humeral head in 4 cases, posterolateral in 3 cases, and anterolateral in 2 cases, its size ranged from 12 mm2 to 100 mm2, with an average of 19.8 mm2. All RHFs were internally fixed. CCI was removed in 8 cases, sutured in 1 case, and microfracture performed for type II in 2 cases. All fractures healed. At the last follow-up, the excellent and good rate was 88.9% according to MEPS. Conclusions CCI fragments interposed into the gap of RHFs is rare and easy to be missed, but obviously limited ROM, local crepitus and a positive physical examination after local anesthesia suggest possibility of this fracture. Surgical exploration remains the gold standard for diagnosis and deserves attention. CCI should choose different treatment methods according to its type.

Complications analysis of hemiarthroplasty through direct anterior approach assisted by the traction table

Li Junran, Li Dongmei, Zhai Jingxiu, Yang Haitao, Liu Hongyang, Liang Junsheng, Li Ligeng

Chinese Journal of Clinical Anatomy. 2024, 42(4): 468-471. doi:10.13418/j.issn.1001-165x.2024.4.19

Abstract ( 15 )

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Objective To explore the complications and prevention methods of hemiarthroplasty(HA) through direct anterior approach(DAA) assisting by the traction table for the treatment of femur neck fractures in elderly patients. Methods A The clinical data of 196 elderly patients with femur neck fractures treated with HA through DAA were retrospectively analyzed in our hospital from June 2019 to August 2021. The causes, treatment and prognosis of complications were analyzed in each case. Results All patients were followed up for 12 to 30 months, averagely 21.6 months, and complications were occurred in 25 cases. Among them, 11 cases (5.6%) had lateral femoral cutaneous nerve (LFCN) injury, 6 cases (3.1%) had incisional oozing, 5 cases (2.6%) had periprosthetic fractures, 3 cases (1.5%) had limb length discrepancy. There was no dislocation, prosthesis loosening, infection or other complications during the follow-ups. Conclusions There are many complications such as LFCN injury, incisional oozing, periprosthetic fracture, limb length discrepancy during the treatment of femoral neck fractures in elderly with DAA-HA by assistance of the traction table. Standardization of surgical procedures, improving the surgical technique, paying attention to patient's condition and rehabilitation can reduce its complications.

Krackow suture combined with suture bridge technique in the treatment of children's inferior patellar fracture

Yin Qin, Yin Fei, Gu Jun, Wang Jun, Lin Weifeng

Chinese Journal of Clinical Anatomy. 2024, 42(4): 472-474. doi:10.13418/j.issn.1001-165x.2024.4.20

Abstract ( 24 )

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Objective To investigate the clinical efficacy of Krackow suture combined with suture bridge technique in the treatment of children's inferior patellar fracture. Methods Nine children with inferior patellar fracture admitted from January 2017 to June 2022 were treated with Krackow suture and suture bridge technology to fix the patellar inferior pole bone block. Early postoperative rehabilitation exercise were performed. The outcome measures included complications, fracture healing time, knee pain, range of motion (ROM) and Bostman score. Results All patients were followed up for an average of 12.6 months. No wound infection, internal fixation failure, nonunion of fracture occurred after operation. Fracture healing time were (3.1±0.1) months. The Bostman score of the knee joint was (29.1±1.1), and the VAS score was (0.2± 0.4). Conclusions The Krackow suture method combined with suture bridge technique in the treatment of children's inferior patellar fracture is simple in operation and reliable in fixation, which is conducive to early functional exercise and does not require secondary internal fixation. It is widely applicable to children's patellar lower pole fracture and is worthy of clinical promotion.

Anatomical variant types and clinical significance of suprascapular artery

Chinese Journal of Clinical Anatomy. 2024, 42(4): 475-479. doi:10.13418/j.issn.1001-165x.2024.4.21

Abstract ( 18 )

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Research status and prospect of 3D printing in spinal cord injury repair

Kong Yueying, Wang Yilin, Zhao Hong, Tan Sijie, Huang Wenhua

Chinese Journal of Clinical Anatomy. 2024, 42(4): 480-483. doi:10.13418/j.issn.1001-165x.2024.4.22

Abstract ( 3034 )

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Research Progress of MCU in Nervous System

Jiang Chen, Wang Chun, Huang Yongjie, Yang Yiran, Hu Wen, Wu Haiying

Chinese Journal of Clinical Anatomy. 2024, 42(4): 484-487. doi:10.13418/j.issn.1001-165x.2024.4.23

Abstract ( 13 )

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A case of rectus capitis posterior minor of suboccipital muscle group variation

Zhong Weixing, Chen Zujiang, Li Yikai

Chinese Journal of Clinical Anatomy. 2024, 42(4): 479. doi:10.13418/j.issn.1001-165x.2024.4.24

Abstract ( 28 )

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