Chinese Journal of Clinical Anatomy

Advances in diagnosis and treatment of elbow joint fractures

Wang Lei, Zhong Biao

Chinese Journal of Clinical Anatomy. 2025, 43(4): 371-372. doi:10.13418/j.issn.1001-165x.2025.4.01

Abstract ( 136 )

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Modified anterior median neurovascular approach for the treatment of coronoid process fractures of elbow joint

Zhang Qing, Deng Mingyue, Li Yiping, Zheng Jinwen, Yang Jinsong, Dai Fei, Xiang Ming

Chinese Journal of Clinical Anatomy. 2025, 43(4): 373-378. doi:10.13418/j.issn.1001-165x.2025.4.02

Abstract ( 171 )

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Objective To explore the anatomical basis and clinical application of a novel anterior median neurovascular approach for the treatment of coronoid process fractures of elbow joint. Methods After brachial plexus block combined with general anesthesia, patients with elbow coronoid fracture were assessed of damage degree of the collateral ligament. An incision is made along the transverse crease of the skin in front of the elbow and the inner side of the elbow. The medial collateral ligament and the posterior structures, the coronoid process of the ulna, the anterior joint capsule, and the anterior bundle of the medial collateral ligament were exposed through the space between the brachial artery and the median nerve in front of the elbow joint, The anterior joint capsule is longitudinally cut to expose the fracture site of the coronoid process, and then the medial collateral ligament, anterior joint capsule, and other structures were repaired under direct visualization for reduction and fixation. Elbow joint stability was evaluated by postoperative stress tests and the anterior and posterior drawer tests. Results The improved median nerve vascular approach could provide a clear surgical field of view for surgical procedure. By this approach, the fracture area exposed clearly, protected the median nerve and brachial artery, and achieved precise recovery of the fracture fragment. Postoperative functional exercises was favorable for function recovery of elbow joint. Conclusions The modified anterior median neurovascular approach has significant advantages in treating coronal process fractures of the elbow joint, which can improve fracture healing, and promote early functional recovery of patients.

Reconstruction of massive coronoid defects associated with persistent elbow dislocation using autologous bone grafts

Xue Yiqing, Lu Jiuzhou, Li Shulin, Yang Kangqi, Xu Jianguang

Chinese Journal of Clinical Anatomy. 2025, 43(4): 379-386. doi:10.13418/j.issn.1001-165x.2025.4.03

Abstract ( 169 )

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Objective To evaluate the clinical efficacy of using autologous iliac bone and radial head grafts for the reconstruction of massive coronoid defects associated with persistent elbow dislocation to restore joint stability. Methods A retrospective analysis was conducted to evaluate the clinical outcomes of 6 patients who underwent reconstruction of severe coronoid defects using autologous iliac bone or radial head grafts. The patients had an average age of 36.2 years (28-57 years). All cases involved severe post-traumatic coronoid defects with chronic elbow dislocations, characterized by significant articular surface damage, collapse, and severe post-traumatic arthritis. Results The average interval between injury and reconstructive surgery for patients was 26.8 months (11-60 months). 5 patients received autologous iliac bone grafts, and one patient received an autologous radial head graft. Among them, 2 patients simultaneously underwent radial head replacement, 2 underwent Box-loop reconstruction of the collateral ligaments, and one underwent lateral collateral ligament reconstruction. The average follow-up duration was 26.5 months (1-88 months). 5 patients who were followed for more than 3 months, have achieved bony union according to CT scan. One case exhibited graft absorption. Residual elbow stiffness was observed in 5 patients postoperatively, 3 of whom underwent secondary arthroscopic elbow release, with 2 achieving satisfactory functional recovery. All patients demonstrated significant improvement in the Mayo Elbow Performance Score compared to preoperative values. Conclusions The use of autologous iliac bone and radial head grafts to reconstruct massive coronoid defects associated with persistent elbow dislocation has demonstrated reliable bone healing and joint stability, with a low incidence of joint re-dislocation or graft absorption. Combined with arthroscopic release procedures, this operation can restore elbow function to meet the demands of daily activities, obviate the need for joint replacement, and improve patient outcomes.

Clinical efficacy of coronoid fixation combined with lateral radial collateral ligament repair in the elbow posteromedial rotational instability

Pan Chao, Yan Bingshan, Liu Junyang, Han Lei, Zhang Bo, Tian Xu, Liu Lintao, Dong Jingming

Chinese Journal of Clinical Anatomy. 2025, 43(4): 387-391. doi:10.13418/j.issn.1001-165x.2025.4.04

Abstract ( 47 )

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Objective To compare the clinical efficacy of coronoid fixation with or without lateral radial collateral ligament (LRCL) repair in the elbow posteromedial rotational instability (PMRI). Methods The data of 33 PMRI patients who met the criteria from January 2015 to June 2023 were retrospectively analyzed. Fifteen patients underwent simple internal fixation of coronal process fractures, while 18 patients underwent coronoid fixation combined with LRCL repairing. The perioperative data, elbow joint function, and incidence of complications were compared between the two groups. Results All patients were followed up for 16 to 52 months, with an average follow-up of 33.5 months. The fixed group was superior to the LRCL repair group in terms of surgical time and intraoperative blood loss, and the difference was statistically significant (all P<0.05). The LRCL repair group had better elbow flexion and extension angles than the simple fixation group (both P<0.05), but there was no statistically significant difference between the two groups in terms of pronation and supination angles (both P>0.05). At the last follow-up, the LRCL repair group had better MEPS and DASH scores than the fixed group, and the difference was statistically significant (both P<0.05). There was no significant difference in VAS scores between the two groups (P>0.05). One patient in the LRCL repair group experienced poor healing of the lateral wound, and two patients in each group showed symptoms of ulnar nerve numbness. There was no statistically significant difference in the incidence of complications and Hastings&Graham ectopic ossification grading between the two groups of patients (both P>0.05). Conclusions For PMRI patients with subluxation or dislocation in the humeroradial joint, LRCL repairing can significantly improve elbow joint range of motion and functional scores but not increasing the risk of complications and ectopic ossification.

Analysis of the efficacy of elbow arthroscopy in the treatment of Maison II radial head fractures

Lin Subin, Sun Shengxuan, Zhou Haibin, Xie Ye

Chinese Journal of Clinical Anatomy. 2025, 43(4): 392-395. doi:10.13418/j.issn.1001-165x.2025.4.05

Abstract ( 43 )

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Objective To explore the efficacy and safety of elbow arthroscopy in the treatment of Maison II radial head fractures, and evaluate its advantages and disadvantages as well as its application prospects. Methods This study retrospectively analyzed the clinical data of patients with Maison II radial head fractures treated by elbow arthroscopy, including age, gender, fracture type, surgical method, operation time, postoperative complications, etc. All patients were followed up to evaluate the postoperative treatment effect and complications. At the same time, a comprehensive analysis of domestic and foreign literature in the past 5 years was conducted to discuss the advantages and disadvantages of elbow arthroscopy in the treatment of radial head fractures. Results A total of 42 patients were included, and all patients underwent screw internal fixation under elbow arthroscopy. Postoperative X-ray examination showed satisfactory reduction and healing of fractures. The follow-up period was 12-36 months, with an average of 22.5 months. At 3 months postoperatively and at the end of follow-up, the elbow joint function of all patients improved significantly, and the VAS score and DASH score were significantly reduced. Complications included 2 cases of limited elbow joint function, which were relieved after rehabilitation treatment. Literature review showed that elbow arthroscopy in the treatment of Maison II radial head fractures has the advantages of minimally invasive, reduced soft tissue damage, quick recovery, and fewer postoperative complications. However, for some complex fractures and severe soft tissue injuries, its efficacy is limited. Conclusions Elbow arthroscopy is a safe and effective treatment method for radial head fractures, which can achieve satisfactory therapeutic effects and functional recovery. However, attention should be paid to surgical techniques and postoperative rehabilitation management. In addition, for patients with complex fractures and severe soft tissue injuries, reasonable surgical selection and postoperative management should be carried out.

Experimental study on mechanical properties of the new personalized radial head prostheses based on computer aided design

Yang Guang, Li Shangzhe, Chen Renjie, Zhang Hailong, Lu Yi

Chinese Journal of Clinical Anatomy. 2025, 43(4): 396-403. doi:10.13418/j.issn.1001-165x.2025.4.06

Abstract ( 39 )

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Objective To explore the differences of mechanical properties and the lateral stability among normal elbow joint, two new personalized radial head prostheses and two imported prostheses. Methods Three-dimensional CT and nuclear magnetic resonance images of elbow joints of 6 healthy subjects were collected. The finite element analysis was carried out on 12 positions of elbow joints, involving neutral position, pronation 50o, supination 50o, elbow flexion 0o, 30o, 90o , and 120o and others. The contact area and the lateral stress, among normal joint, the integrated prosthesis (type 1), the modular prosthesis (type 2), the Acumed prosthesis (type 3) and the Wright prosthesis (type 4) was investigated. explored. Stress values of elbow joint specimens from 6 fresh frozen cadavers was analyzed, and compared with that of four kinds of prostheses. Results There was no significant difference for stress values between type 1 or type 2 prostheses and normal joints at pronation and supination 50o under varus or eversion stress (P>0.05). For type 3 prosthesis, the values were significantly smaller than that of normal joints at the 10 position under varus stress, or eversion stress (P<0.05). For type 4 prosthesis, all values were markedly smaller than that of normal joints at all postures (P<0.05). In terms of finite element analysis, under the above 12 positions, there was no significant difference for joint contact area, peak stress of humeral and radial articular surfaces among type 1 or 2 prostheses and normal joints. For type 3 prosthesis, the contact area was significantly smaller than that of normal joint, at the 10 position. The humeral peak stress was significantly greater than that of normal joints at the 4 position. The radial stress was significantly greater than that of normal joints at the 2 position. For type 4 prosthesis, the contact area was significantly smaller than that of normal joints at the 7 position. The humeral peak stress was significantly greater than that of the normal joint at the 6 position. The radial stress was significantly greater than that of normal joints at the 5 position. Conclusions Comparing with the imported prosthesis currently used in clinic, the 3D printed personalized radial head prostheses are closer to the normal radial head in biomechanical performance, which makes a preliminary clues for the further clinical application of these new prostheses.

Analysis of the relationship between the parameter measurement of acromial morphology and angle and the types of acromion

Lin Yuanxun , Zhang Yunaolong , Li Yikai

Chinese Journal of Clinical Anatomy. 2025, 43(4): 404-408. doi:10.13418/j.issn.1001-165x.2025.4.07

Abstract ( 51 )

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Objective To measure acromial morphology and the angles proposed by Aragão, providing a more objective measurement method for acromion classification in the Chinese population. Methods A total of 118 normal, dry scapula specimens from Chinese individuals, the acromion was classified into three types (type I, type II and type III) according to the Bigliani classification. Measured parameters included the following: the acromial length, acromial width, acromion-glenoid distance, acromion-coracoid distance, the acromial inclination angle formed by the line from the acromion tip to the acromial angle and the horizontal line, ∠a formed by the extension line from the acromion tip to the midpoint of the coracoid and the extension line from the midpoint of the coracoid to the superior glenoid tubercle, ∠b formed by the extension line from the acromion tip to the acromial angle and the extension line from the acromial angle to the superior glenoid tubercle, and ∠c formed by the line from the acromion tip to the acromial angle and the line from the acromion tip to the superior glenoid tubercle. Results There was no significant difference in the acromion classification of the left and right scapulae (P=0.460). There were no significant difference in the acromial length (P=0.374), acromial width (P=0.912), acromion-coracoid distance (P=0.536), and ∠a (P=0.107) among the different acromion types. However, there were significant differences in the acromion-glenoid distance (P<0.001), acromial inclination angle (P=0.005), ∠b (P=0.003), and ∠c (P<0.001) among the different acromion types. In ROC curve analysis, when differentiating between Type I and Type II acromion, only the distance from the acromion to the glenoid (EG) showed a P-value <0.05, with a truncation value of 31.09 cm. In distinguishing between Type II and Type III acromion, the acromion-glenoid distance (EG), ∠b, and ∠c all showed P-values <0.05, with respective truncation values of 28.26 cm, 37.46°, and 73.98°. Conclusions In distinguishing between Type I and Type II acromion, an acromion classified as Type I when the distance from the acromion to the glenoid is ≥31.09 cm. In the differentiation between Type II and Type III acromion, if the acromion-glenoid distance ≥28.26 cm, or ∠b≥37.46°, or ∠c≥73.98°, the acromion can be classified as Type II. These findings have reference value for clinical practice.

Correlation analysis of cervical facet joint degeneration with sagittal parameters and axial pain of cervical spine under CT image

Jiang Zehua, Cui Haojun, Ren Zhishuai, Zhang Boyu, Zhu Rusen

Chinese Journal of Clinical Anatomy. 2025, 43(4): 409-413. doi:10.13418/j.issn.1001-165x.2025.4.08

Abstract ( 45 )

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Objective To explore the relationship between cervical articular process joint degeneration and sagittal sequence changes as well as axial pain through CT and MR imaging. Methods A retrospective analysis was conducted on 156 patients with cervical spondylosis who visited our department from January 2019 to January 2022. Based on cervical CT imaging, patients were divided into an observation group (articular process degeneration group) of 72 patients with an average age of (51±12.3) years and a control group (normal articular process group) of 84 patients with an average age of (48±11.4) years. The incidence and severity of axial pain were recorded. Cervical MR images were used to measure the C2-C7 Cobb angle, sagittal vertical axis (SVA) distance from C2 to C7, T1 slope (T1S), thoracic inlet angle (TIA), neck tilt (NT), and thoracic kyphosis angle (TK). Additionally, the degree of intervertebral disc degeneration was recorded. Results In the observation group, 65 patients experienced axial pain with an average VAS score of (6.4±1.3), while in the control group, 30 patients experienced axial pain with an average VAS score of (3.3±0.9), with statistical difference (P=0.00). The intervertebral disc degeneration scores for the observation and control groups were (4.9±1.1) and (2.5±0.7), respectively, with a statistically significant difference between the two groups (P=0.00). Among the measured cervical sagittal parameters, the T1S angle was (27.5°±5.4°) in the articular process degeneration group and (22.1°±4.8°) in the control group, showing a significant difference of 5.4° (P=0.00). There was also a significant difference in the TK angle between the two groups difference of 4.1° (P=0.00). However, there were no statistically significant differences in TIA (P=0.18), NT (P=0.34), C2-C7 Cobb angle (P=0.08), and SVA (P=0.08) between the two groups. Conclusions Cervical articular process degeneration is positively correlated with the occurrence of axial pain. The increase in T1S and TK may be related to articular process joint degeneration.

Influence of dominant vertebral arteries on the three-dimensional morphological characteristics of axis pedicle: an imaging study based on CTA multi-plane reconstruction

Li Ning, Xie Liangli, Liu Qi, Yi Bingkui

Chinese Journal of Clinical Anatomy. 2025, 43(4): 414-420. doi:10.13418/j.issn.1001-165x.2025.4.09

Abstract ( 41 )

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Objective To analyze the three-dimensional imaging characteristics of the linear and angular parameters of the C2 pedicle in patients with dominant vertebral artery. Methods The cervical computed tomography angiography (CTA) imaging data of 186 patients from March 2022 to February 2023 were retrospectively reviewed. Vertebral artery dominance (VAD) was defined as a difference in the cross-sectional diameter of the bilateral vertebral arteries at the C2 transverse foramen greater than 0.8 mm. Patients with VAD were classified as the VAD group, and those without VAD were the normal control group. Multi-planar reconstruction (MPR) was performed using the RadiAnt DICOM Viewer software. The pedicle outer width (POW), pedicle transverse angle (PTA), and isthmic-pedicle sagittal angle (IPSA) of C2 were measured. The proportion of narrow pedicles (POW<4.0 mm) in both groups was recorded. The influence of VAD on the morphology of the C2 pedicle was analyzed. Results Among the 186 patients, 49.5% (92/186) were accompanied by VAD, with the left side accounting for 67.4% (62/92); the incidence of VAD in females was higher than that in males (P<0.05). Intra-group comparison showed that in the VAD group, the POW (4.2± 1.3) mm and IPSA (32.6±4.9)° on the dominant side of C2 were smaller than those on the non-dominant side [(5.8±1.4) mm and （36.4±5.5）°, P<0.001], but the PTA (36.7±6.4)° on the dominant side was greater than that on the non-dominant side [(30.6±7.1)°, P<0.001]. There was no statistical difference in POW, PTA and IPSA on the left and right sides of C2 in the control group (P>0.05). The overall proportion of narrow pedicles in the VAD group (26.6%) was higher than that in the control group (10.6%, P<0.001); the proportion of narrow pedicles on the dominant side in the VAD group was higher than that on the non-dominant side (44.6% vs. 8.7%, P<0.001). Multivariate Logistic regression analysis showed that VAD was an independent risk factor for narrow pedicles (Odds Ratio [OR]: 7.076, 95% CI: 3.176-15.764, P<0.001). Conclusions There is a correlation between VAD and the morphological changes of the C2 pedicle. The pedicle on the dominant side is thinner, has a greater medial inclination and a smaller caudal inclination. The above morphological characteristics have guiding significance for the safe screw placement of the C2 pedicle.

Arterial spin labeling perfusion weighted imaging observation of the elderly brain structure and its clinical application

Miao Yingying, Fu Yulei, Li Pei, Li Pinpin, Yue Xueqiang, Fu Shengqi

Chinese Journal of Clinical Anatomy. 2025, 43(4): 421-425. doi:10.13418/j.issn.1001-165x.2025.4.10

Abstract ( 133 )

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Objective To provide new imaging diagnostic basis for the early diagnosis of Alzheimer's disease (AD). Methods Sixty normal old people with check of different ages and 60 elderly AD of different degrees were selected by arterial spin labeling(ASL) perfusion weighted imaging examination. At the image post-processing workstation, the regions of interest (ROI) of brain structure were divided, and the cerebral blood flow (CBF) value of ROI was measured. The CBF values of brain structure ROI among the different old ages groups and its corresponding ROI in AD group were compared. Results There were statistically significant in the CBF values among of the different old ages group of the cingulate gyrus, parahippocampal gyrus, hippocampus, orbital part of frontal lobe, temporal pole of temporal lobe, insula lobe and amygdaloid body in all age groups (P<0.05), and the CBF value of ROI decreased gradually with the increase of age. The CBF values in the observation group of the cingulate gyrus, parahippocampal gyrus, hippocampus, orbital part of frontal lobe, temporal pole of temporal lobe, insula lobe and amygdaloid body were (56.49±5.73) mL/100g·min, (49.40±3.51) mL/100g·min, (46.57±4.27) mL/100g·min, (58.59±4.67) mL/100g·min, (57.66±4.80) mL/100g·min, (56.47±3.79) mL/100g·min, (45.61±3.53) mL/100g·min, respectively. There were statistically significant in the CBF value of ROI among the observation group and the mild, moderate, severe old AD group (P<0.05), and the CBF value of ROI decreased gradually with the severity of AD lesion. Conclusions The hippocampus and cingulate gyrus of limbic system are the hypoperfusion sites in the brain structure of AD patients, the CBF value of ASL perfusion weighted imaging before cerebral cortex atrophy can reflect the function of brain structure in AD patients.

Effects of TRPC broad-spectrum inhibitor SKF96365 combined with cisplatin on human gastric cancer HGC-27 cells and related mechanisms

Feng Na, Dong Sheng, Shi Dandan, Huang Xiaomin, Kang Pengju, Li Wenchun, He Xiju

Chinese Journal of Clinical Anatomy. 2025, 43(4): 426-435. doi:10.13418/j.issn.1001-165x.2025.4.11

Abstract ( 44 )

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Objective To explore SKF96365 combined with cisplatin on human gastric cancer HGC-27 cells and its molecular mechanism. Methods HGC-27 cells were treated with 2.5, 5, 7.5, 10 μmol/L SKF96365 combined with cisplatin. CCK-8 and scratch healing assay were used to detect cell viability and migration. JC-1, MitoROS, Rhod-2/AM fluorescent probes were used to detect the changes of mitochondrial membrane potential, reactive oxygen species and Ca2+ concentration. Hoechst staining and flow cytometry were used to detect cell apoptosis. The expressions of apoptosis, autophagy protein and PI3K/AKT/BAD signaling pathway were detected by Western blot. Results Compared with the control group, the combined treatment group could significantly inhibit the proliferation and migration of HGC-27 cells, induce cell mitochondrial dysfunction, and promote the increase of cell apoptosis rate (P<0.05). Western blot results showed that the combined treatment could promote apoptosis and the autophagy related proteins expression in gastric cancer cells, and significantly inhibit the phosphorylation of PI3K/AKT/BAD signaling pathway in cells. Conclusions SKF96365 combined with cisplatin induces gastric cancer cells to initiate mitochondrial apoptosis pathway and protective autophagy by inhibiting the phosphorylation level of PI3K/Akt/Bad pathway.

Origin of Sympathetic innervation of rat femoral artery and its potential clinical significance

Wu Zhihai, Wu Cuimin, Fang Fang, Zhuang Zhiyong

Chinese Journal of Clinical Anatomy. 2025, 43(4): 436-443. doi:10.13418/j.issn.1001-165x.2025.4.12

Abstract ( 44 )

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Objective to clarify the exact route of sympathetic axons reaching the peripheral artery, and pave the way for the development of new surgical strategies for sympathetic denervation. Methods Firstly, femoral neurovascular bundles from 10 neonatal Sprague-Dawley rats were harvested for whole-mount immunostaining to show sympathetic innervation pattern of the artery. Secondly, 40 Sprague-Dawley male rats weighing 350~400 g were assigned to five groups, receiving either sham, perivascular sympathectomy, nerve-artery separation, nerve transection in the femoral neurovascular bundle or lumbar sympathectomy surgery that removes the lumbar sympathetic trunks. Immediately after surgery, the arterial perfusion and diameter were measured using Laser speckling contrast imaging, and one week later the femoral neurovascular bundles were harvested for immunostaining using antibodies against TH, neuron-specific β-tubulin (Tuj 1) , and α-SMA to show the presence or not of the TH immuopositive staining in the adventitia. Finally, 30 rats were divided into the above five groups and underwent corresponding surgery. The abdominal flap was haverstedand the necrotic area of the flap was measured 7 days later. Differences between the five groups were determined using one-way ANOVA. Results For the neonatal rats, an average of (2.8±0.8) branches with a diameter of (4.8±1.2) μm derived from the femoral nerve that morphed into a primary and a scondary sympathetic chains for innervation the femoral artery. Nerve-artery separation, nerve transection, and lumbar sympathectomy could eradicate sympathetic nerves of the artery, resulting, respectively, in a 22.5 %, 36.7 % and 59.2 % increase in diameter (P<0.05), and a 51.5%、63.4% and 201.3% increase in perfusion compared to sham surgery (P<0.01). In contrast, perivascular sympathectomy did not have a significant impact on the sympathetic nerves, the diameter and perfusion of the distal part of the artery (P>0.05). Corresponding to the changes of blood perfusion, nerve-artery separation, nerve transection and lumbar sympathectomy could significantly reduce the necrosis rate of abdominal flap (P<0.001). Conclusions sympathetic innervation of the femoral artery originates from the segmental sympathetic branches emanating from the accompany femoral nerve. There are three potential ways that can eradicate the sympthetic innervation of an artery.

Molecular mechanisms of mechanical stretching in regulating lung cancer cell behavior

Li Xiangtian, Wen Xiaohui, Wang Ruolin, Cheng Yunshui, Liu Zhaoru, Lv Ying, Fan Tingyu, Gong Fengying

Chinese Journal of Clinical Anatomy. 2025, 43(4): 444-459. doi:10.13418/j.issn.1001-165x.2025.4.13

Abstract ( 45 )

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Objective To elucidate the potential mechanisms linking cyclic mechanical stress to lung tumorigenesis. Methods The GEO dataset GSE272292 was re-analyzed to investigate the effects of cyclic tensile stress (15% strain, 0.2 Hz, applied for 7 days) on gene expression in A549 lung adenocarcinoma cells under stiff matrix conditions. Results Functional enrichment analysis revealed that differentially expressed genes were significantly enriched in "mitochondrial inner membrane" (a hub for energy metabolism) and "collagen-containing extracellular matrix". Key candidate genes, including mitochondrial ribosomal protein (MRPL13) and collagen type V (COL5A1), were identified as regulators of these dual phenotypes. GSEA further highlighted activation of "CD22-mediated B-cell receptor signaling regulation" pathway. Conclusions These findings suggest that mechanical signals may drive phenotypic alterations in mitochondrial energy metabolism and extracellular matrix (ECM) remodeling via MRPL13 and COL5A1, offering novel insights into lung cancer mechanobiology.

Effects of acupuncture on serum Leptin level and neuronal activity in rats with spinal cord injury

Zhou Bin, Li Zhantao, Zuo Yanli

Chinese Journal of Clinical Anatomy. 2025, 43(4): 450-455. doi:10.13418/j.issn.1001-165x.2025.4.14

Abstract ( 39 )

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Objective To explore the mechanism of acupuncture on serum Leptin level and neuronal activity in rats with spinal cord injury based on PI3K /Akt signaling pathway. Methods Thirty SD rats were randomly divided into Sham group, model group and acupuncture group, with 10 rats in each group. Spinal cord injury (SCI) rat models were established in all groups except Sham group. After successful modeling, acupuncture treatment was performed in the acupuncture group, while no intervention for other 2 groups. Results Compared with model group, nerve function scores of rats in acupuncture group was decreased (P<0.05). Compared with the Sham group, the serum Leptin level of rats in model group increased (P<0.05), and the serum Leptin level of rats in acupuncture group was higher than that in the model group (P<0.05). The apoptosis rates of neurons in Sham, model and acupuncture groups were (4.20±0.69) %, (26.81±4.59) % and (18.41±3.54) %, respectively, with statistically significant difference (F=115.000, P<0.001). Compared with Sham group, the levels of PI3K, p-PI3K, AKT and p-Akt protein in neurons of rats in model group decreased (P<0.05). Compared with model group, the levels of PI3K, p-PI3K, AKT and p-Akt increased in acupuncture group (P<0.05). Conclusions Acupuncture can reduce neuron apoptosis and improve nerve function in SCI rats. Acupuncture can up-regulate Leptin level and improve the repair of spinal cord injury, which may be related to the regulation of PI3K /Akt activity.

Biomechanical study of different fixation methods for posterior atlantoaxial rod constructs

Chen Qiling, Ouyang Beiping, Luo Chunshan, Liang Dongzhu, Lu Tingsheng

Chinese Journal of Clinical Anatomy. 2025, 43(4): 456-459. doi:10.13418/j.issn.1001-165x.2025.4.15

Abstract ( 32 )

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Objective To explore the biomechanical stability of different rod constructs in posterior atlantoaxial fixation. Methods Six fresh human occipitocervical specimens were divided into the intact group (Group A). An atlantoaxial instability model with type II odontoid fracture was established based on the intact group (Group B). Different fixation methods were used for posterior atlantoaxial (C1) lateral mass and (C2) pedicle screw fixation on the instability model. This included lateral mass and pedicle screw parallel rod fixation (Group C), cross-rod fixation (Group D), lateral mass and lamina parallel rod fixation (Group E), and cross-rod fixation (Group F). Three-dimensional motion analysis was used to measure the range of motion (ROM) of the atlantoaxial specimens in flexion, extension, lateral bending, and rotation states, and the biomechanical characteristics of each group were evaluated by repeated measures analysis of variance. Results ① In all states, the ROM of the intact group and internal fixation group was less than that of the instability group, with statistical significance (P<0.05); ② There was no statistical difference in ROM among the four internal fixation groups in flexion, extension, and lateral bending states (P>0.05); ③ In the rotation direction, the ROM of the parallel rod internal fixation group was less than that of the cross-rod internal fixation group, with significant difference (P<0.05), but the ROM of Group F was equivalent to Group C, with no statistical difference (P>0.05), ROM: Group D<Group F=Group C<Group E<Group A<Group B. Conclusions The rotational stability of the short-segment parallel rod fixation system composed of C1 lateral mass and C2 pedicle screws is slightly insufficient, while cross-rod fixation can better compensate for it.

Biomechanical comparison of miniature steel plates and Kirschner wires fixation for metacarpal fractures

Lin Zejin, Zhang Meichao , Deng Kai, Du Xuehua, Xie Xihong, Wu Haidong

Chinese Journal of Clinical Anatomy. 2025, 43(4): 460-465. doi:10.13418/j.issn.1001-165x.2025.4.16

Abstract ( 29 )

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Objective To conduct mechanical analysis on three different fixation methods for metacarpal fractures so as to provide experimental data for clinical application. Methods By applying different fixation methods for metacarpal fractures, conducting three-point bending tests and compression tests, the bending stiffness and compression stiffness were calculated respectively. The change of load-displacement loading was monitored. The stiffness of different fixation methods was compared. Results Compared with the standard cross Kirschner wire fixation method, the titanium locking plate (4/6 screws) posterior fixation showed a significant difference in the three-point bending test (palmar compression). There was no significant difference in the three-point bending test (lateral compression) and compression test. In the three-point bending test and compression test, there was no significant difference in the fixation effect between the titanium locking plate with 4 locking screws or 6 locking screws. Conclusions The main force causing the displacement of the metacarpal fracture comes from the flexion side, and the dorsal plate fixation is consistent with the biomechanics of the human body, which is the best choice for treating the metacarpal instability fracture.

A retrospective study on the fixation of the greater trochanter with an ulnar hawksbill locking plate in femoral head replacement for intertrochanteric fractures in the elderly

Hu Xiunian, Lan Weibin, Chen Rijiang, Wang Weitao, Liao Yuanjun, Li Longjian, Hu Zhilong, Qiu Jianbin

Chinese Journal of Clinical Anatomy. 2025, 43(4): 466-470. doi:10.13418/j.issn.1001-165x.2025.4.17

Abstract ( 38 )

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Objective To compare the efficacy of artificial femoral head replacement for intertrochanteric fracture in elderly patients using ulnar hawksbill plate and wire binding to fix the greater trochanter. Methods Retrospective analysis of 46 patients with intertrochanteric femur fracture who underwent artificial femoral head replacement in our hospital from January 2018 to December 2022 was performed, which were divided into 24 cases in the wire binding group and 22 cases in the titanium plate fixation group. The operation time, bleeding amount, patients' first time to get down to the ground, and the difference of VAS and Harris scores of hip function at 1 month, 6 months and 12 months after operation in the two groups were compared. Results The operation time and bleeding amount in the wire group were better than those of plate group, with statistically significant differences (P<0.05). There was no statistically significant difference in the patients' first time to get down to the ground between the two groups (P>0.05). There was no statistically significant difference in Harris score of 1 month after operation (P>0.05). Harris scores of 6 months and 12 months after operation in the plate group were better than those of the wire group, with statistically significant differences (P<0.05).VAS score of 1 month after operation in the plate group was better than that of the wire group, with statistically significant difference (P<0.05). There was no statistically significant difference in the VAS score of 6 months and 1 year after surgery (P>0.05). Conclusions Compared with wire fixation of greater trochanteric fractures, plate fixation has better early joint function.

Effects of 3D reconstruction technique combined with segmentectomy on tumor markers, inflammatory response, and lung function in patients with non-small cell lung cancer

Li Wenbin, Yang Bing, Wang Xinyang

Chinese Journal of Clinical Anatomy. 2025, 43(4): 471-477. doi:10.13418/j.issn.1001-165x.2025.4.18

Abstract ( 30 )

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Objective To analyze the effect of three-dimensional (3D) reconstruction technique combined with anatomical segmentectomy (SA) on tumor markers, inflammatory response, blood gas indexes, and lung function in patients with non-small cell lung cancer (NSCLC). Methods From January 2022 to October 2024,74 patients with NSCLC who video-assisted thoracoscopic surgery SA (SA-VATS) in Fuyang People's Hospital were selected as the SA-VATS group, and 31 patients with NSCLC who underwent 3D three-dimensional reconstruction combined with SA-VATS were selected as the 3D group. The operation-related indexes and postoperative complications during hospitalization were statistically analyzed. The levels of serum tumor markers, inflammatory factors, and blood gas indexes before and 7 d after operation, and lung function before and 1 month after operation were compared between SA-VATS group and 3D group. Results The improvement of operation related indexes in 3D group was better than that in SA-VATS group (P<0.05). The levels of serum vascular endothelial growth factor, heat shock protein 90α, carcinoembryonic antigen, and cytokeratin 19 fragment in SA-VATS group and 3D group at 7 d after operation were lower than those before operation, and those in 3D group were lower than those the SA-VATS group (P<0.05). The levels of serum interleukin-8, interleukin-10, and tumor necrosis factor-α in the SA-VATS group and 3D group at 7 d after operation were higher than those before operation, but those in 3D group were lower than those in SA-VATS group (P<0.05). The changes of blood gas indexes in SA-VATS group and 3D group were improved at 7 d after operation, and 3D group was better than SA-VATS group (P<0.05). The pulmonary function indexes of SA-VATS group and 3D group at 1 month after operation were lower than those before operation, but those in 3D group were higher than those in SA-VATS group (P<0.05). During hospitalization after operation, there was no significant difference in the incidence of total complications between 3D group and SA-VATS group (P>0.05), but 3D group was lower than SA-VATS group. Conclusions 3D reconstruction technique combined with SA-VATS in the treatment of patients with NSCLC could effectively shorten operation time, reduce intraoperative blood loss, promote postoperative recovery of patients, reduce the level of serum tumor markers, alleviate inflammatory response, improve blood gas index and lung function, and might‌‌ help to reduce the occurrence of complications.

Diagnostic value of MRI T2-weighted DIXON TSE sequence in lumbar interspinous ligamentitis

Zhang Zebo, He Jie

Chinese Journal of Clinical Anatomy. 2025, 43(4): 478-482. doi:10.13418/j.issn.1001-165x.2025.4.19

Abstract ( 36 )

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Objective To explore the diagnostic value of MRI T2-weighted DIXON TSE sequence in lumbar interspinous ligamentitis. Methods A total of 80 patients with lumbar interspinous ligamentitis treated in our hospital from March 2020 to April 2023 were collected. According to the pain degree of patients, 26 cases were in the mild group, 29 cases in the moderate group, and 25 cases in the severe group. Baseline data and MRI T2-weighted DIXON TSE sequence of the three groups were compared, and the correlation between MRI T2-weighted DIXON TSE sequence and pain degree was analyzed by Spearman method. The area under receiver operating characteristic (ROC) curve (AUC) was used to analyze the diagnostic value of MRI T2-weighted DIXON TSE in the diagnosis of moderate and severe lumbar interspinous ligamentitis. Results The FF-T2 TSE-Dixon value in severe group was higher than that in mild group and moderate group, and the moderate group was higher than that in mild group (P<0.05). FF-T2 TSE-Dixon value was positively correlated with pain degree (P<0.05). The AUC value of FF-T2 TSE-Dixon in the diagnosis of lumbar interspinous ligamentitis was 0.903. Conclusions MRI T2-weighted DIXON TSE sequence may have a better diagnostic value for lumbar interspinous ligamentitis, and the FF-T2 TSE-Dixon value may be positively correlated with the degree of pain. The more severe the degree of pain, the higher the FF-T2 TSE-Dixon value.

Method of casting forearm artery with shape and embedding of original shape

Xiao Zhaoming, Ma Ziwei, Li Zeyu, Liu Chang, Xu Guangwei, Liang Haibin, Zhou Xianxi, Dai Jingxing, Ouyang Jun

Chinese Journal of Clinical Anatomy. 2025, 43(4): 483-485. doi:10.13418/j.issn.1001-165x.2025.4.20

Abstract ( 40 )

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Objective To make the forearm and palm artery cast with shape and to provide an intuitive vascular prototype embedding model for clinical diagnosis and treatment, anatomy teaching, scientific research and popular science, and to provide experience and basis for the prototype embedding of different forms of other cast specimens. Methods Using the palm of the hand as the mold and silica gel and gypsum as the material, the silicone embedding mold of Yin and Yang surface was made, and then the specimen was poured and corroded, and finally the mold was put into the silicone mold, and the crystal AB glue was used to cast. Results The crystal model has high transparency, no bubbles, consistent design. It allows for a clear observation of flow and distribution of the internal blood vessel mold, as well as the spatial adjacency between the blood vessel mold and the skin and the joint. Conclusions The model is low production cost and high cost performance. The blood vessel casting is real and precise. This method can reflect the spatial proximity between blood vessels, epidermis and joints in different poses, provide an intuitive vascular prototype embedding model for clinical diagnosis and treatment, anatomy teaching, scientific research and popular science, and provide experience and basis for the prototype embedding of different forms of other cast specimens.

Differential expression and clinical significance of DNA methylation in skin cancer

Tang Yaping, Huang Yixiao, Wang Lumei, Chen Yinghua

Chinese Journal of Clinical Anatomy. 2025, 43(4): 486-490. doi:10.13418/j.issn.1001-165x.2025.4.21

Abstract ( 36 )

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Recent epigenetic studies demonstrate that DNA methylationa key regulatory mechanism modulates tumor related gene expression and drives the development, progression, and metastasis of skin cancer. This review summarizes evidence on how methylation levels of key genes (CLDN11, MGMT, PTCH1, ID4) drive progression in melanoma, basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (cSCC) the three predominant skin malignancies-and evaluates the clinical utility of methylation detection techniques for diagnosis and treatment. The article also discusses emerging therapeutic strategies targeting DNA methylation and elucidates critical methylated genes with their underlying mechanisms, providing a theoretical foundation for early detection, molecular subtyping, and targeted therapy of skin cancer.

Biomechanical differences between Hangman's fracture and its various surgical treatment strategies

He Yinghua, Liu Yansong, Liang Zhongbiao, Sun Hao, Chen Hu, Xie Ningling, Tu Qiang

Chinese Journal of Clinical Anatomy. 2025, 43(4): 491-497. doi:10.13418/j.issn.1001-165x.2025.4.22

Abstract ( 40 )

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To systematically evaluate the biomechanical characteristics of various types of Hangman's fractures and their corresponding treatment strategies, thereby providing an evidence-based foundation for clinical decision-making. Relevant literature was retrieved and analyzed from databases such as PubMed and CNKI (China National Knowledge Infrastructure) using the keywords "Hangman" and "biomechanics."The results indicated that non-surgical treatment for stable fractures (Type I) and surgical intervention for unstable fractures (Types II, IIa, and III) can achieve favorable biomechanical stability and long-term outcomes, provided the fracture is accurately classified. Hangman's fractures can be divided into stable and unstable types, and both anterior and posterior surgical approaches are effective in restoring cervical spine stability.Biomechanical analyses have demonstrated that in cases involving injuries to the anterior longitudinal ligament and intervertebral disc, C2~3 anterior cervical discectomy and fusion (ACDF) offers superior immediate stability. Posterior single-segment physiological fixation preserves C1~2 rotational function to the greatest extent but fails to address C2~3 instability. In contrast, posterior C2~3 fixation and fusion provides higher mechanical stiffness and more effectively stabilizes the fracture site. C1~3 long-segment fixation and fusion offers greater stiffness and multidirectional stability in flexion-extension, lateral bending, and rotational movements. However, it compromises atlantoaxial mobility-a drawback that can be mitigated by employing temporary long-segment fixation.

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