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Clinical anatomy study of  cholecystic vein and distribution of its branches Ding Ran, Zheng Xuefeng, Ding Zihai, Wu Tao Chinese Journal of Clinical Anatomy    2023, 41 (3): 249-253.   DOI: 10.13418/j.issn.1001-165x.2023.3.01 Abstract （205）      PDF（pc） （5535KB）（104）       Knowledge map    Save Objective     To observe the reflux mode of cholecystic vein and the exact locations of venous confluence, so as to provide an anatomical understanding of the hematogenous metastasis in gallbladder carcinoma and surgical operation in laparoscopic cholecystectomy.    Methods    Thirty-two cases of fresh adult liver and gallbladder specimens were made into section specimens, in which the number of branches and tributaries of cholecystic vein were counted and the diameter of these vessels were measured. The patterns of reflux and the and the various locations of venous confluence were observed.  Results Normally, there were 2-4 chloeytic veins from the gallbladder. The average longitude the veins was about 1.6 (1.1-2.1) mm The average diameter of middle location was about 3.1(2.4-4.1) cm. The cholecystic vein had 3 (2-5) branches with a terminal diameter of 1.6 (0.8-2.8) mm.  There were 4 (3-5) branches of the cholecystic vein, with a diameter of 1.5 (0.8-2.2) mm at the beginning. About the various locations of cholecystic veins, it was observed in 10 cases that there was one single branch on both left and right side. Two branches on both sides were found in 6 cases, one branch on left side with two branches on right side were found in 7 cases, three branches on left side with one branch on right side in one single case.   The small tributaries of the cholecystic vein which arose from the body and fundus of the gallbladder were accompanied by the branches of the cholecystic artery, then went to both sides of the gallbladder, and formed 2-5 tributaries through 2-3 tiers of arcades, and merged into the cholecystic vein near the edge of the gallbladder bed. Further, the cholecystic vein g sent out 3-5 branches, ran 5~8 mm and anastomosed with the third to fifth tiers of the right branch of hepatic portal vein. At the bottom of the gallbladder bed, 3-5 small cholecystic veins anastomosed directly with the small branches of the right branch of the hepatic portal vein. Gallbladder jugular vein and the cholecystic duct met with the veins from the common bile duct or the hepatic duct, and went upward to flow into the right or left branch of the hepatic portal vein.    Conclusions    The veins from the body and fundus of the gallbladder anastomose with the right branch of the hepatic portal vein in the gallbladder portal vein pattern, that is, at first, the ends of the gallbladder capillary veins converges into venules, then each tributary merge into couple of cholecystic veins, and the cholecystic vein branches are divided into several tiers branches, which are anastomosed with the third to fifth tiers of the right hepatic portal vein.   Reference | Related Articles | Metrics | Comments（0）

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Study on anatomical parameters of low tibial tunnel in posterior cruciate ligament reconstruction based on 3D surgical simulation technology Chen Sijie, Guo Laiwei, Wang Zunlin, Tan Nian, Zhang Kangrui, Yun Xiangdong, Xia Yayi, Teng Yuanjun Chinese Journal of Clinical Anatomy    2023, 41 (5): 505-510.   DOI: 10.13418/j.issn.1001-165x.2023.5.01 Abstract （202）      PDF（pc） （1895KB）（69）       Knowledge map    Save Objective     To establish the low tibial tunnel based on the posterior cruciate ligament (PCL) 3D virtual technology to measure its anatomical parameters.    Methods    CT image data of 101 patients with healthy knee joints were selected, and PCL 3D virtual surgery model was established by using mimics21.0 (Materialise, Belgium) software. Low tibial tunnels of anteromedial and anterolateral approaches were established respectively. The anatomical parameters included the length of the posterior cruciate ligament tibial tunnel (LTT), the 3D included angle between tibial medial axis extension line and tibial plateau (3D ATPT) and perpendicular distance of the tunnel’s entry point to the tibial plateau (PTT). SPSS 25.0 was used for statistical analysis.    Results   The average length of PCL tibial tunnel was greater in the anteromedial group than the anterolateral group was (45.56±4.27) mm versus (43.93±4.10) mm, P<0.05. The average 3D angle between tunnel and tibial plateau was greater in the anterolateral than the anteromedial (54.49±5.81)° versus (48.17±6.12) °, P<0.05. The PTT in the anteromedial group and the anterolateral group were (61.86±6.80) mm and (63.51±6.32) mm, respectively (P<0.05). All the above parameters had statistical differences.   Conclusions    The parameters related to the low tibial tunnel measured in this study can provide theoretical reference for PCL reconstruction surgery in clinical practice. Reference | Related Articles | Metrics | Comments（0）

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Morphological characteristics of nutrient foramina on femoral neck and its clinical significance Li Haiyan, Si Lina, Yao Xingchen, Du Xinru Chinese Journal of Clinical Anatomy    2023, 41 (3): 258-262.   DOI: 10.13418/j.issn.1001-165x.2023.3.03 Abstract （182）      PDF（pc） （6826KB）（75）       Knowledge map    Save Objective     To explore the distribution and morphological characteristics of nutrient foramina in femoral neck and to discuss its relation with the osteoporosis femoral neck fracture.    Methods Seventy-three cases of dry femoral specimens were collected in this study, among them, there were 12 cases in the osteoporosis group and 61 cases in the normal group. The location, number, diameter and square about the nutrient foramina in femoral neck were investigated and the proportion of the different diameters of the nutrient foramina was measured as well.     Results    The number and area percent of the nutrient foramina in superior area were the most both in normal group and in osteoporosis group. Compared with the normal group, the diameter and area percent of nutrient foramina in the posterior and superior area in osteoporosis group were obviously smaller, there was significant difference between these two groups.     Conclusions    The number of the nutrient foramina in the superior area is large, with large square, this may be an anatomical factor causing structural weakness in the area which resulting in the femoral neck fracture. The area percent and diameter of nutrient foramina in the same area in osteoporosis group is obviously smaller, it is possible that the osteoporotic femoral neck fracture has close relations with its poorly blood supply. Reference | Related Articles | Metrics | Comments（0）

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MRI anatomical differences of retroperitoneal blood vessels and psoas muscle in different body positions Yi Honglei, Chen Hu, Wang Xinhui, Zhu Changrong, Lian Peirong, Xia Hong Chinese Journal of Clinical Anatomy    2023, 41 (5): 511-515.   DOI: 10.13418/j.issn.1001-165x.2023.5.02 Abstract （153）      PDF（pc） （3169KB）（88）       Knowledge map    Save  Objective    To explore the changes of the abdominal aorta and vena cava in different lumbar intervertebral space levels in supine, prone, and lateral positions, and the thickness and displacement of the psoas muscle were noted as well to define the safe working zone for lateral lumbar interbody fusion. Methods    Fifteen volunteers underwent lumbar magnetic resonance imaging (MRI) examinations in different positions (supine, prone and lateral positions). The position of the abdominal aorta and inferior vena cava, the thickness, and displacement of the psoas major muscle at each intervertebral space level (L1/2~L4/5) on MRI were recorded and compared as well.    Results    In the same segment, the distribution of the inferior vena cava in different positions was similar. However, compared with the supine position, the abdominal aorta moved anteriorly to the anterior edge of the vertebral body in the lateral and prone positions at L1/2~L3/4 levels. There were differences in the thickness of the psoas muscle between different body positions in the same segment (L2/3 A zone, L3/4 A zone, IV zone and P zone, L4/5 II zone and IV zone) (P<0.05). In addition, there were differences in the anterior displacement of the psoas muscle between different segments. At the L1/2 level, the forward movement distances of the prone (-7.53±3.30 mm) and lateral positions (-7.25±3.96 mm) were significantly greater than that of the supine position（-10.90±3.31 mm) (P=0.012). At the L2/3 level, the forward displacement of the lateral position （-0.12±5.59 mm）was significantly greater than that of supine (-5.03±2.49 mm) and prone (-3.38±3.99 mm) positions (P=0.009). There was no significant difference in the L3/4 and L4/5 levels.    Conclusions    For right lateral position, it is safe and feasible to select zone I and II for puncture in the L1/2 and L2/3 levels. And zone II is suitable to puncture in L3/4 and L4/5 levels. Reference | Related Articles | Metrics | Comments（0）

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Application of the individualized "Three-set" guide in  discectomy Lin Yuqian, Zhao Wei, Wang Jianlin, Wang Yujuan, Yu Qinglin, Rao Libing, Li Li Chinese Journal of Clinical Anatomy    2023, 41 (5): 599-602.   DOI: 10.13418/j.issn.1001-165x.2023.5.17 Abstract （142）      PDF（pc） （2288KB）（79）       Knowledge map    Save Objective   To explore the clinical effect of individualized "three-set" guide assisted endoscopic lumbar  discectomy in the treatment of lumbar disc herniation.    Methods    According to the inclusion and exclusion criteria, 16 patients with lumbar disc herniation from December to November were selected and randomly divided into two groups. The control group (n=8) was treated with traditional methods. The experimental group (n=8) was assisted by the individualized "three-set" guide in intervertebral foramen surgery. The CT data of patients were collected and imported into the software before operation to conduct individualized design, simulate the surgical puncture path, and determine the needle insertion position, needle insertion angle and needle insertion depth (referred to as "three-set"). The individualized "three-set" guider was placed on the body surface, and the puncture angle and direction were adjusted according to the correction value, and the accurate puncture was realized by the guider. The times of fluoroscopy, puncture timing and puncture frequency of the two groups were recorded and statistically analyzed.  Results  The times of fluoroscopy, puncture timing and puncture frequency of the experimental group were less than those of the control group, with statistical significance (P<0.01,P<0.01,P<0.05).    Conclusions    It is feasible and effective to use the individualized "three-set" guide to assist intervertebral foramen surgery in the treatment of lumbar disc herniation.  Reference | Related Articles | Metrics | Comments（0）

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Microdissection of the atrioventricular conduction axis of fresh porcine heart Wang Dechang, Gong Zheyi, Liao Chenghao, Zhi Shasha, Zou Xufei, Hu Yaohui, Wang Kai, Lou Yangyun, Li Ting Chinese Journal of Clinical Anatomy    2023, 41 (3): 254-257.   DOI: 10.13418/j.issn.1001-165x.2023.3.02 Abstract （130）      PDF（pc） （3017KB）（35）       Knowledge map    Save Objective    To observe the morphological characteristics of the atrioventricular conduction axis in fresh porcine heart by the microdissection and histological methods.   Methods  The anatomical data of the porcine cardiac atrioventricular conduction axis was observed, explored and measured by dissecting 30 cases of fresh porcine hearts under stereomicroscope, and their histological data were observed and analyzed by the conventional HE and Masson's staining techniques.    Results    The atrioventricular conduction axis was successfully detected in 22 of 30 porcine hearts, and it was found that the proximal portion of left bundle branch was arranged in fascicular, and the distal portion was flared. The capsules of his bundle, left bundle branch, and right bundle branch of porcine heart were relatively thick and easy to identify with the naked eye. The width of the atrioventricular bundle (AVB), the length of AVB, the proximal width of the left bundle branch were (1.58±0.75) mm, (17.56±7.79) mm, (2.40±1.11) mm, respectively, and the angle between the left bundle branch and the AV bundle was (114.46±13.06)°.    Conclusions    The position and morphological feature of AVB, left bundle branch and right bundle branch in pigs may be slightly different from other animals. Reference | Related Articles | Metrics | Comments（0）

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Localization of the nerve entry point of the suboccipital muscles  Xiong Wei, Wang Jie, Shu Hongyan, Yang Shengbo Chinese Journal of Clinical Anatomy    2023, 41 (4): 377-381.   DOI: 10.13418/j.issn.1001-165x.2023.4.01 Abstract （130）      PDF（pc） （2988KB）（50）       Knowledge map    Save Objective     To accurately localise the nerve entry points (NEPs) of the suboccipital muscles, in order to provide anatomical basis for extramuscular nerve blocks in diseases caused by hypertonia  of the suboccipital muscles.    Methods    Twenty-four adult cadavers were used. The NEPs of the suboccipital muscles (rectus capitis posterior minor muscle, rectus capitis posterior major muscle, obliquus capitis superior muscle and obliquus capitis inferior muscle) were dissected, exposed and labeled with barium sulfate, and then, dissections were sutured back in situ. Spiral CT scan and 3D reconstruction were performed. The curved line connecting the external occipital protuberance and the spinous process of 7th cervical vertebra was designed as the longitudinal reference line (L), and the curved line connecting the mastoid process and the spinous process of 7th cervical vertebra was designed as the horizontal reference line (H). The projection points of NEP on the napex and the opposite side skin were recorded as P point and P' point, respectively. Drawing vertical lines from point P to line H and line L respectively, created intersection points on lines H and L, and they were marked as points PH and PL, respectively. The percentage position of PH and PL on H line and L line respectively and the depth of NEP were determined by Syngo system.   Results   Each of the four suboccipital muscles (rectus capitis posterior minor muscle, rectus capitis posterior major muscle, obliquus capitis superior muscle and obliquus capitis inferior muscle) usually had only one NEP. The PH position of the NEPs were located at 46.29%, 35.85%, 28.88% and 32.29%, respectively on the H line. The PL were located at 27.39%, 39.06%, 35.06% and 40.42%, respectively on the L line. The depth of NEPs on PP' line were at 21.21%, 24.02%, 14.59% and 21.44%, respectively. The above percentage values were all mean values. There was no statistical difference between left and right side and between male and female (P>0.05).    Conclusions The accurate definition of the body surface percentage position and depth of these NEPs is conducive to improve the localization efficiency and efficacy for extramuscular nerve blocks when treating the diseases caused by hypertonia of suboccipital muscle. Reference | Related Articles | Metrics | Comments（0）

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Anatomical relationship between the accessory nerve and the cervical fascia and its clinical significance Nie Zheng, Jiang Heng, Chen Mengmeng, Shan Jianlin Chinese Journal of Clinical Anatomy    2023, 41 (4): 382-384.   DOI: 10.13418/j.issn.1001-165x.2023.4.02 Abstract （122）      PDF（pc） （2282KB）（29）       Knowledge map    Save Objective    To explore the anatomical relationship between the accessory nerve and the investing fascia of the posterior border of the sternocleidomastoid, so as to provide a safe and reliable method for avoiding injury of accessory nerve in the posterior cervical triangle surgery.    Methods    Twenty-one formalin-fixed adult cadavers were dissected to expose the sternocleidomastoid and the posterior cervical triangle. The investing fascia of the posterior edge of sternocleidomastoid was cut and observed to identify its integrity and compactness. The anatomical relationship between the investing fascia and the accessory nerve was observed to identify whether the accessory nerve could be easily identified and separated from the tissue structure.    Results    The posterior investing fascia covering sternocleidomastoid muscle was intact and dense. There was no direct contact, fiber connection or other tissues between the accessory nerve and the investing fascia. After the investing fascia was cut and opened at the posterior edge, the accessory nerve could not be observed directly on both sides in the 18 specimens. The accessory nerve was separated from the investing fascia by adipose tissue. In other 3 specimens, the accessory nerve could be seen directly after cutting open investing fascia. There was no direct contact or fibrous connection between the accessory nerve and the investing fascia in all specimens. All accessory nerves were located above the great auricular nerve with a distance of (12.6±5.2) mm.   Conclusions    The investing fascia of the posterior edge of the sternocleidomastoid is intact and dense without significant connection with the accessory nerve. It is easy to identify accessory nerve after sharp dissection with clear surgical field in the posterior cervical triangle surgery. Reference | Related Articles | Metrics | Comments（0）

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Protective effect and mechanism of baicalin on vascular injury in diabetic rats Fang Xibo, Zhang Yingjie, Wang Hongxin Chinese Journal of Clinical Anatomy    2023, 41 (3): 324-329.   DOI: 10.13418/j.issn.1001-165x.2023.3.13 Abstract （118）      PDF（pc） （6803KB）（11）       Knowledge map    Save Objective    To investigate the protective effect and mechanism of baicalin on vascular injury in diabetic rats.    Methods    Forty rats were randomly divided into 4 groups: a control group, a diabetes group, a baicalin 50 mg·kg-1 group, and a baicalin 100 mg·kg-1 group. A single intraperitoneal injection of streptozotocin (65 mg·kg-1·d-1) was used to establish a diabetic model. After injection of streptozotocin, baicalin was perfused. The control group and the model group were given the same amount of carboxymethyl cellulose sodium, once a day for 28 days. Vascular endothelial function of rats was detected by in vitro vascular ring assay. ELISA method was used to detect the serum levels of IL-8, IL-1β, TNF-α, IL-6, malondialdehyde (MDA) and glutathione reductase (GSH-px). HE staining was used to observe the morphology of aorta in each group. The level of NO in serum was measured by nitrate reductase method. The expression of eNOS and NF-κB protein in aorta of rats in each group was detected by Western blotting. The formation of reactive oxygen species (ROS) in aorta of rats in each group was observed by DHE staining. Results    After baicalin treatment, the vasodilatory dysfunction of diabetic rats was improved, the levels of IL-β, IL-8, IL-6, and TNF-α in the serum of rats were decreased, the levels of NO, MDA and GSH-px were increased, the expression of eNOS protein and NF-κB protein in aorta tissue were increased, and the formation of ROS was decreased.    Conclusions    Baicalin may protect streptozotocin-induced vascular injury in diabetic rats through the NF-κB/ROS signaling pathway. Reference | Related Articles | Metrics | Comments（0）

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Reason and strategies of intraoperative complications of minimally invasive hip arthroplasty using SuperPATH approach in the treatment of elderly patients with femoral neck fracture  Liu Yu, Gu Sanjun, Xu Yaozeng, Li Haifeng, Wei Changbao, Yin Qin Chinese Journal of Clinical Anatomy    2023, 41 (4): 465-469.   DOI: 10.13418/j.issn.1001-165x.2023.4.16 Abstract （116）      PDF（pc） （4026KB）（25）       Knowledge map    Save Objective   To investigate the reason and strategies of intraoperative complications of minimally invasive hip arthroplasty through SuperPATH approach in the treatment of elderly patients with femoral neck fracture.     Methods    From June 2015 to December 2018, total of 120 patients with femoral neck fracture treated by SuperPATH approach were retrospectively analyzed. There were 74 males and 56 females, with an average age of 74.5 years (range 65-98). All the cases underwent SuperPATH approach hip arthroplasty, including 63 cases of total hip arthroplasty (THA) and 57 cases of hemiarthroplasty (HA). Results     All of the patients were followed up for at least 24 months, among them, intraoperative complications occurred in 12 cases, including acetabular abrasion and fracture, femoral lateral fissure fractures, too small anterior angle of the femoral components or placed internally and externally. Normal hip function was restored after corresponding treatment. There were no complications such as infection and dislocation, and no secondary operation.    Conclusions    SuperPATH minimally invasive hip arthroplasty in the treatment of elderly patients with femoral neck fracture adopts intermuscular interspace approach, which has the characteristics of less trauma, less bleeding, quick functional recovery and good patient satisfaction. At the same time, due to the small visual field of operation and the non-standard operation, it is easy to make surgical mistakes, so we must pass through strict formal training and standardized operation to effectively avoid the occurrence of surgical complication. Reference | Related Articles | Metrics | Comments（0）

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The specimen preparation for a modular brain complex  Li Mingzhe, Wang Tao, Cong Peijie, Wang Chengtao, Liu Xiaoliu Chinese Journal of Clinical Anatomy    2023, 41 (3): 365-366.   DOI: 10.13418/j.issn.1001-165x.2023.3.20 Abstract （108）      PDF（pc） （1650KB）（56）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Three-dimensional reconstruction of superior petrosal vein by multi-modal fusion technology Wu Shiyuan, He Haoqiang, Chen Zhenghe, Mou Yonggao, Li Yanbing, Huang Wenhua, Zhong Shizhen Chinese Journal of Clinical Anatomy    2023, 41 (3): 270-276.   DOI: 10.13418/j.issn.1001-165x.2023.3.05 Abstract （105）      PDF（pc） （4080KB）（27）       Knowledge map    Save  【Abstract】    Objective   To reflect the morphological characteristics of SPV and its adjacent bone structures objectively, contrast enhanced magnetic resonance angiography (CEMRA) and computer tomography (CT) were used by combining with multi-modal fusion technology to reconstruct the normal anatomical structure of the superior petrosal vein complex and its surrounding skull, which providing reference for anatomical research and clinical surgery.   Methods   By adjusting the concentration of the contrast agent, the injection speed of the contrast agent, the start time of scanning, the scanned 3D CEMRA  was judged to be developed successfully  by the MIP post-processing of image processing workstation. The original data of 3D CEMRA and 3D-CT were imported into 3Dslicer software together. After image registration, threshold segmentation, structure pruning and data package storage, the packaged data of these two modalities were imported together and 3D fusion was performed at the same time. The related anatomical parameters were measured by using the module of 3Dslicer software.    Results  ①The relevant angiographic parameters of the sigmoid sinus, superior petrosal sinus (SPS), SPV, and SPV tributary was obtained, but the success rate was not stable; ②Through the three-dimensional reconstruction of the DICOM data from the head CEMRA and  cranial CT, SPV and its branch, SPS, sigmoid sinus, transverse sinus and cavernous sinus, bone anatomical landmarks of skull base such as  internal auditory canal, petrosal sinus groove and transverse sinus groove near the petrosal area were obtained; ③ Three-dimensional fusion map of venous structure and osseous structure after multi-modal fusion was obtained; ④The measurement diagram was obtained by using the measurement module in the 3Dslicer software.   Conclusions    The combination of imaging  and 3Dslicer software can realistically display the anatomical structure of multi-modal fusion, providing a new possibility for the study of anatomical morphology, and also providing personalized reference for clinical surgery. Reference | Related Articles | Metrics | Comments（0）

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Application of customized traction table in hemiarthroplasty through the direct anterior approach  Li Junran, Liang Junsheng, Li Dongmei, Zhai Jingxiu, Xu Ying, Wang Hongrun, Deng Fukuan, Li Ligeng Chinese Journal of Clinical Anatomy    2023, 41 (3): 349-353.   DOI: 10.13418/j.issn.1001-165x.2023.3.17 Abstract （104）      PDF（pc） （2719KB）（18）       Knowledge map    Save Objective   To explore the clinical value of customized traction table in hemiarthroplasty through the direct anterior approach (DAA) for the treatment of femur neck fractures in elderly patients. Methods  A retrospective analysis of 75 elderly patients with femur neck fractures treated with hemiarthroplasty through DAA were involved in our hospital from September 2018 to December 2019. According to with or without using the traction table, the patients were divided into two groups: Group A (39 cases, DAA hemiarthroplasty with assistance of traction table) and Group B (36 cases, DAA hemiarthroplasty without traction table). There was no significant difference in gender, age, Garden classification, fracture side and other general date between the two groups (P>0.05). The operation indexes, efficacy, postoperative Harris hip score and complications were compared between the two groups.   Results    Group A had longer preoperative preparation time and less operation time than Group B (P<0.05). There was no significant difference in  anesthesia time, intraoperative blood loss and incision length between groups A and B (P>0.05). The central fixation ratio of femoral prosthesis in Group A was higher than that of Group B (P<0.05). The ratio of limb length discrepancy shortened than 10mm, time of first postoperative standing, time of first postoperative walking with crutch, time of first postoperative walking independently, and the Harris score in 1 month and 1 year after the operation were not significantly different (P>0.05). The complication rate was 12.8% (5/39) in Group A and 19.4% (7/36) in Group B (P>0.05). In Group A, lateral femoral cutaneous nerve injury was found in 2 patients, greater trochanteric fracture in 2, and incisional drainage in 1. In Group B, there were 3 patients with lateral femoral cutaneous nerve injury, 2 with greater trochanteric fracture, and 2 with incisional drainages.    Conclusions    For the treatment of femur neck fractures in elderly, hemiarthroplasty via DAA with assistance of customized traction table has remarkable effectiveness. It can significantly shorten the operation time and improve the central fixation ratio of femoral prosthesis, but it also can prolong the preoperative preparation time. Reference | Related Articles | Metrics | Comments（0）

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Rare variation of inferior gluteal nerve originating from sciatic nerve: a case report Cui Junjia, Liu Huanyu, Fang Zhiying, Li Jiafeng, Lin Xing, Quan Guihong Chinese Journal of Clinical Anatomy    2023, 41 (3): 295-.   DOI: 10.13418/j.issn.1001-165x.2023.3.23 Abstract （102）      PDF（pc） （1310KB）（25）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Short-term clinical efficacy comparison of unilateral biportal endoscopic discectomy and percutaneous endoscopic interlaminar discectomy for L5/S1 lumbar disc herniation Chen Wenjin, Zhang Shujun, Peng Wei, Zhuang Yin, Cui Wei, Sun Zhenzhong Chinese Journal of Clinical Anatomy    2023, 41 (5): 593-598.   DOI: 10.13418/j.issn.1001-165x.2023.5.17 Abstract （94）      PDF（pc） （3800KB）（55）       Knowledge map    Save Objectives   To compare the short-term clinical efficacy of unilateral biportal endoscopic discectomy(UBED) and percutaneous endoscopic interlaminar discectomy(PEID) in the treatment of L5/S1 lumbar disc herniation(LDH).    Methods    From January 2020 to August 2022, 39 patients with L5/S1 LDH were treated with UBED or PEID in our hospital, including 24 cases in UBED group and 15 cases in PEID group. The operation time, incision length, intraoperative fluoroscopy times, intraoperative blood loss, volume of lavage fluid, changes in creatine kinase (CK) before and after surgery, postoperative hospital stay and complications were recorded and compared between the two groups. Visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate and compare the quality of life of patients in the two groups before operation, 3 days after operation, 1 month after operation and 6 months after operation.    Results    In UBED group, 1 patient had dural sac rupture during operation and 1 patient had headache after operation. One patient in PEID group had burning pain in S1 nerve root innervation area in the early postoperative period. The incision length in UBED group was longer than that in PEID group (32.6±3.9 mm vs 9.8±1.3 mm, P<0.05), and the volume of lavage fluid used was more than that in PEID group (11.1±2.3 L vs 6.5±1.1 L, P<0.05). The postoperative CK was higher than that in PEID group (351.8±99.9 U/L vs 241.4± 49.6 U/L, P<0.05), and the operation time was shorter than that in PEID group (91.5±14.8 min vs 130.4±13.8 min, P<0.05). There was no significant difference between the two groups in intraoperative fluoroscopy times, intraoperative blood loss, postoperative hospital stay and complications (P>0.05). VAS score and ODI at 3 days, 1 month and 6 months after operation were significantly lower in both groups than those before operation (P<0.05), and there was no statistical difference between the two groups (P>0.05).    Conclusions UBED and PEID are both safe and effective minimally invasive surgical methods for the treatment of L5/S1 LDH, which can effectively reduce the number of intraoperative fluoroscopy and obtain similar pain relief, and improve the quality of life of patients. UBED has wider surgical field and larger operating space, while PEID has less trauma. Reference | Related Articles | Metrics | Comments（0）

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Comparison of the effect of two kinds of nerve functional reconstruction operation on the recovery of lower limb motor function in rats  Jiang Mengnan , Zhang Ziju , Zhang Qianling, Su Huan, Gao Yifan , Lu Wei, Yang Lin Chinese Journal of Clinical Anatomy    2023, 41 (4): 428-433.   DOI: 10.13418/j.issn.1001-165x.2023.4.10 Abstract （93）      PDF（pc） （3387KB）（34）       Knowledge map    Save Objective    To compare the clinical efficacy of "targeted muscle reinnervation (TMR)" and "targeted nerve function replacement (TNFR)" for neurological reconstruction in patients with amputation. Methods     SD rats were randomly divided into a Sham group, a simple tibial nerve dissection (TNT) group, a TMR group and a TNFR group. The two operative efficacy were evaluated by footprint blotting, electromyography (EMG), and Sihler's intramuscular nerve staining.    Results    (1) Analysis of the footprint blotting results showed that the tibial nerve index in the TMR group (-13.79±5.289) was slightly smaller than that in the TNFR group (-12.30±4.06). (2) at  the 8th week,  compared with the TNT group, the amplitude of EMG on the affected side was greater in the TMR and TNFR groups (P<0.05). The amplitude of EMG on the affected side in the TNFR group was greater than that of the TMR group.(3) Sihler's intramuscular nerve staining results showed that the degree of nerve and muscle atrophy in the TNFR and TMR groups was less severe than that in the TNT group. The medial head of the gastrocnemius muscle in the TNFR group inherited the original function of the tibial nerve, and its nerve branches were denser compared with those in the TMR group.   Conclusions   Both TNFR and TMR can delay muscle atrophy and promote motor function reconstruction, and the long-term efficacy of TNFR is better than that of TMR. Reference | Related Articles | Metrics | Comments（0）

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X-ray measurement and clinical significance of height and anterior-posterior diameter of lower cervical vertebral body in elderly patients with Kashin-Beck disease Wu Xueyuan, Yi Zhi, Ling Ming, Liu Shizhang, Sun Zhengming, Xie Limin Chinese Journal of Clinical Anatomy    2023, 41 (4): 395-400.   DOI: 10.13418/j.issn.1001-165x.2023.4.05 Abstract （86）      PDF（pc） （3988KB）（23）       Knowledge map    Save Objective    To measure the X-ray related parameters of lower cervical vertebral body in elderly patients with Kashin-beck disease (KBD), so as to clarify the influence of KBD on the development of lower cervical vertebral body.   Methods   Sixty-two patients with KBD (KBD group) and sixty-seven healthy people (control group) were treated with lateral cervical radiographs to observe the imaging manifestations of the lower cervical vertebral body. The anterior, middle and posterior heights of the vertebral body and anterior-posterior diameters from C3 to C7 in neutral position were measured and statistical analysis was performed. Results    The results of this study showed that the superior and inferior margins  of the vertebral endplate were uneven, depressed and sclerosis in some KBD patients. The heights of anterior and posterior margins of vertebral body were higher than that of the middle margin, and there was no significant difference between the height of anterior and posterior margins (P>0.05). In the KBD group, the median heights of C4-6 in males and C4-7 in females were smaller than that of anterior and posterior margin, and the difference was statistically significant (P<0.05). The median heights of C4-7 in males and C3-7 in females in the control group were higher than that in the KBD group, with statistically significant difference(P<0.05). There were significant differences in anterior-posterior diameters between male and female groups in the KBD patients (P<0.05). The anterior -posterior diameters of males and females in the control group were larger than those in the KBD group, but there was no statistical difference (P>0.05).   Conclusions    KBD can cause the depression, uneven and sclerosis of endplate cartilage, lead to the reduction of the middle height of cervical vertebral body, but do not affect the development of anterior -posterior diameters of the vertebral body. Reference | Related Articles | Metrics | Comments（0）

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Application of three-dimensional visualization technology in the anatomical variations of hilar bile ducts in Chinese population  Jiang Jianhong, Duan Renpeng, Li Xiaofeng Chinese Journal of Clinical Anatomy    2024, 42 (1): 1-4.   DOI: 10.13418/j.issn.1001-165x.2024.1.01 Abstract （85）      PDF（pc） （1975KB）（61）       Knowledge map    Save Objective    This study is aimed to explore the walking of biliary system and the characteristics of anatomic variation, by reconstructing the three-dimensional model of biliary system in Chinese people.     Methods    According to the abdominal CT data of 100 patients who suffer from obstructive disease of biliary tract, three-dimensional models were reconstructed by using the Hisense computer-aided surgery (CAS) system，and were used to analyze the movement of intrahepatic biliary system. The biliary tract was classified according to Huang’s classification, that is the confluent mode of right posterior bile duct, right anterior bile duct and left hepatic duct, and the presence or absence of accessory hepatic duct.   Results   The three-dimensional models of bile ducts were successfully reconstructed in 100 Chinese patients. Seven types of biliary ducts can be observed. 54 cases (54%) had typical biliary tract anatomy (type I). 46 cases (46%) had anatomical variations, of which 10 cases (10%) were type II variants, 14 cases (14%) were type III variants, 10 cases (10%) were type IV variants, 2 cases (2%) were type V variants, and 2 cases (2%) were type VI variants. In addition, 8 cases (8%) had accessory hepatic ducts, of which 6 cases were accompanied by other variants.    Conclusions   The path and variation characteristics of biliary system can be identified clearly, by reconstructed Chinese biliary system in three dimensions. To discover news types of biliary tract variation can guide clinical diagnosis and treatment. Reference | Related Articles | Metrics | Comments（0）

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Treatment strategies for the Altemeier procedure in incarcerated rectal prolapse from a laparoscopic anatomical perspective Hua Wei, Li Yanzhu, Lei Tin, Zhou Furong, Liu Yonggan Chinese Journal of Clinical Anatomy    2023, 41 (4): 487-489.   DOI: 10.13418/j.issn.1001-165x.2023.4.20 Abstract （84）      PDF（pc） （2352KB）（8）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Angiofibroma of abdominal wall: a case report Hu Fangang, Liu Jinfeng, Liu Debin Chinese Journal of Clinical Anatomy    2023, 41 (4): 503-.   DOI: 10.13418/j.issn.1001-165x.2023.4.25 Abstract （84）      PDF（pc） （1789KB）（28）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）