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Anatomical classification of posterior superior iliac spine and its clinical significance Qi Ji, Li Jing, Wang Haizhou, Chen Ping, Lin Dingkun, Chen Haiyun, Ping Ruiyue, Xu Yanxiao, Li Yikai Chinese Journal of Clinical Anatomy    2022, 40 (4): 377-382.   DOI: 10.13418/j.issn.1001-165x.2022.4.01 Abstract （1004）      PDF（pc） （3716KB）（109）       Knowledge map    Save   Objective    To study the anatomical characteristics of posterior superior iliac spine and explore its clinical significance.    Methods    Two hundred and eighty dry hip specimens of humans were selected. The posterior superior iliac spine was point A, the anterior superior iliac spine was point B, the ischial tuberosity was point C, the highest point of the iliac spine was point D, the pubic tuberosity was point E, and the midpoint of the posterior edge of the articular surface was point F. The width of point A of the posterior superior iliac spine was W0, and the thickness of point A was H0. The maximum width of the posterior part of the iliac crest was Wmax, and the distance from point A to the posterior part of the iliac crest was D0. The width of the iliac crest was measured at 0.5 cm, 1.0 cm, 1.5 cm, and 2.0 cm from point A, which were recorded as W1, W2, W3, W4. The part of the iliac crest was taken as point G and the width of point G was denoted as W5. The lengths of AB, AC, AD, AE, AF, AG, and CD were measured, respectively.    Results    The morphology of the posterior superior iliac spine was roughly divided into the following 4 types: type I "V" (107 cases, accounting for 38.2%), type II "U" (121 cases, accounting for 43.2%), type III "W" (31 cases, accounting for 11.1%), type IV "Proliferative" (21 cases, accounting for 7.5%). The AB length of type Ⅰ was significantly shorter than that of type Ⅲ and Ⅳ, the AF distance of type Ⅰ was significantly shorter than that of type Ⅱ and Ⅲ. W0, W1 and H0 of type Ⅰ were significantly smaller than that of type Ⅱ, Ⅲ, and Ⅳ, and W0 of type Ⅲ was greater than that of type I, type II and type IV, all were statistically significant (P<0.05). Conclusions    There are 4 morphological variations of the posterior superior iliac spine, with a "U" shape as the main one, which has of certain clinical implication.  Reference | Related Articles | Metrics | Comments（0）

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Anatomical observation of pyramidalis muscle and anterior pubic ligament Yuan Jiajie, Yuan Zhirong, Chen Xiaomei, Su Minghao, Li Zelin, He Shanli, Liu Chang, Li Zeyu, Ouyang Jun, Dai Jingxing Chinese Journal of Clinical Anatomy    2022, 40 (5): 515-518.   DOI: 10.13418/j.issn.1001-165x.2022.5.03 Abstract （771）      PDF（pc） （1715KB）（78）       Knowledge map    Save Objective   To explore the adjacent relationship between pyramidalis muscle and anterior pubic ligament, so as to provide anatomical basis for further understanding the mechanism of maintaining the stability of the pubic symphysis.   Methods   Twenty-four specimens (19 males and 5 females) were selected to observe the length, width, thickness of the pyramidalis muscle and the adjacent relationship between the adjacent rectus abdominis, adductor longus and anterior pubic ligaments.   Results   In the 24 gross specimens, 23 cases of pyramidalis muscle existed bilaterally (accounting for 95.8%, 19 cases in males, 4 cases in females). One case lacked the right muscle (accounting for 4.2%, 1 case in female). The length of pyramidalis muscle was (70.64±13.48) mm in males and (71.81±11.27) mm in females on the right side, (69.60±12.01) mm in males, (64.25±19.79) mm in females on the left side. Width, on the right side: male (20.68±4.12) mm, female (20.65±2.04) mm, on the left side: male (20.02±2.99) mm, female (18.23±4.77) mm. Thickness, right: male (2.50±1.61) mm, female (1.49±0.40) mm, left: male (2.19±1.06) mm, female (1.50±0.56) mm.   There was no statistical difference in the length, width and thickness of the pyramidalis muscle (P>0.05). The width of anterior pubic ligament was (5.96±1.55)mm in males and (6.60±1.10) mm in the females on the right side, (6.35±1.58) mm in males and (6.16±0.69) mm in females on the left side. The pyramidalis muscle originated from the fibrous ligament anterior to the pubic bone and pubic symphysis with tendinous fibers. The origin of rectus abdominis tendon, adductor longus tendon, inguinal ligament and the starting point of the pyramidal muscle were intertwined with adjacent to the pubic crest, forming a distinct anterior pubic ligament.  Conclusions    The pyramidalis muscle originates from the anterior pubic ligament and forms the anterior pubic ligament together with the inguinal ligament and the adductor longus tendon. At the same time, with the anterior pubic ligament as the center, adjacent structures together form a complex, which provides important support for the stability of the pubic symphysis. Reference | Related Articles | Metrics | Comments（0）

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Risk factors and clinical effect of vertebral cavity formation after posterior short-segmental fixation for thoracolumbar and lumbar burst fractures Liang Changxiang, Liang Guoyan, Zheng Xiaoqing, Huang Yongxiong, Yin Dong, Chang Yunbing Chinese Journal of Clinical Anatomy    2022, 40 (6): 714-719.   DOI: 10.13418/j.issn.1001-165x.2022.6.15 Abstract （726）      PDF（pc） （3635KB）（34）       Knowledge map    Save Objective   To observe the vertebral body healing pattern after posterior short-segmental fixation for thoracolumbar and lumbar burst fractures, and to analyze the risk factors and clinical effect of vertebral cavity.    Methods    Fifty-two patients with posterior short-segmental fixation for thoracolumbar burst fracture were followed up for at least 2 years. The CT results of the last follow-up were analyzed to observe the morphological characteristics of the cavity in the vertebral body. The patients with and without obvious cavities in the vertebral body were divided into two groups. The clinical and imaging characteristics of the two groups were compared, and the risk factors leading to the cavities were analyzed to observe whether the vertebral cavity affects the clinical efficacy or not.    Results    There were 12 cases of complete healing of vertebral body (accounting for 23.1%) and 40 cases of cavity (accounting for 76.9%). The shape of the cavity in the vertebral body could be divided into the following types: small cavity in the endplate (n=9, accounting for 22.5%),  large cavity in the vertebral body (n=19, accounting for 47.5%), and  split in the vertebral body (n =12, accounting for 30%). The proportion of males in the vertebral cavity group was higher, and the spinal cord nerve injury was more serious. An average follow-up of 37.8 months after surgery showed that the two groups of patients had good back pain and lumbar function, and there was no statistical difference in the VAS and ODI scores between the two groups.   Conclusions    Vertebral cavities are commonly seen after posterior short-segmental fixation for thoracolumbar and lumbar burst fractures. The higher degree of fracture rupture, the easier to cause the vertebral cavity. The large degree of the vertebral body anterior edge reduction after the operation of screw placement is an important cause of the cavity.  Presence of a cavity in the vertebral body does not affect the patient’s lumbar pain and function in the short term.  Reference | Related Articles | Metrics | Comments（0）

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The whole-mount intramuscular nerve distribution pattern of intermediate plantar groupand dorsalis pedis muscles and its significance Deng Qun, Luo Linfen, Yang Shengbo Chinese Journal of Clinical Anatomy    2022, 40 (5): 523-529.   DOI: 10.13418/j.issn.1001-165x.2022.5.05 Abstract （663）      PDF（pc） （7242KB）（12）       Knowledge map    Save Objective  To reveal the whole-mount intramuscular never distribution pattern of intermediate plantar group and dorsails pedis muscles and to explore its significance.  Methods  The intermediate plantar group and dorsails pedis muscles from twelve adult cadavers fixed by formalin were removed. Modified Sihler's staining was used to display the whole-mount intramuscular nerve distribution pattern.   Results   The nerve branches of the flexor brevis digitorum, the first and second lunbrical muscles innervated by medial plantar nerve entered from deep and superficial surface respectively. The nerve branches of the quadrates, the third and fourth plantar lunbrical muscles innervated by lateral plantar never coursed from the insertion to the origin of the muscle. While the nerve branches of the interossei plantar muscles and the interossei dorsal muscles coursed from the origin to the insertion of the muscle. The nerve branches of the extensor hallucis brevis and the extensor brevis digitorum muscle shared one nerve trunk. The lumbrical muscles, the first and second interossei plantar muscles, the first interossei dorsal muscle, the extensor hallucis brevis and the extensor brevis digitorum muscle formed only one intramuscular nerve dense region in the middle of the muscle belly. The flexor brevis digitorum, the quadrates plantae, the third interossei plantar muscle and the second to fourth interossei dorsal muscles had two intramuscular nerve dense regions on both sides of the muscle, these muscles can be divided into two neuromuscular subdivisions.   Conclusions   These results may provide morphological guidance for surgical operation to avoid nerve injury and the selection and matching of muscle transplantation and the injection of botulinum toxin A to block the spasticity of these muscles.  Reference | Related Articles | Metrics | Comments（0）

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Application of three-dimensional CT imaging technology in the determination of the "V" point in posterior cervical approach percutaneous spinal endoscopic surgery   Jian Wei, Xu Cong, Ai Wen, Yin Shengjiang, Bi Zhenyu, Wu Zebin Chinese Journal of Clinical Anatomy    2022, 40 (6): 720-724.   DOI: 10.13418/j.issn.1001-165x.2022.6.16 Abstract （588）      PDF（pc） （1655KB）（187）       Knowledge map    Save Objective    To evaluate the application value of three-dimensional computed tomography (3D-CT) in determining the "V" point in transforaminal decompression and nucleus pulposus enucleation of posterior cervical approach by using percutaneous spinal endoscopy.    Methods    A retrospective analysis was made on 50 patients who underwent transforaminal decompression and nucleus pulposus enucleation of posterior cervical spine approach by using percutaneous spinal endoscopy and followed up from January 2016 to June 2018. They all sufferred from cervical spondylotic radiculopathy with unilateral symptoms, conservative treatment for more than 6 weeks were ineffective for them. The dynamic X-ray film of cervical spine showed no instability of cervical spine. There were 27 males and 23 females, with an average age of 54.2 (40~75) years, 14 cases of C4/5 segment, 25 cases of C5/6 segment and 11 cases of C6/7 segment. Fifty patients were divided into groups A (26 cases) and group B (24 cases). The patients were positioned according to the intraoperative conventional "V" point positioning method using C-arm X-ray machine in group A, and the patients determined the "V" point using the 3D-CT technology method before the operation in group B. The average hospital stay, operation time, number of intraoperative fluoroscopy and surgical efficacy between the two groups were compared and statistically analyzed.   Results   All 50 patients were followed up for an average of (7.20±2.56) months (3-13 months), The average operation time and intraoperative fluoroscopy in group A were more than those in group B (P<0.05). There was no signiant difference in the average hospital stay, postoperative follow-up score, the curvature of the cervical spine, the height of the intervertebral space of the operation segment and the stability of the cervical spine between the two groups (P>0.05).    Conclusions 3D-CT technology plays an important role in determining the "V" point in posterior cervical approach percutaneous spinal endoscopic surgery.  Reference | Related Articles | Metrics | Comments（0）

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The surgical treatment strategy for adjacent segment disease after anterior cervical discectomy and fusion of multi-segments Chinese Journal of Clinical Anatomy    2023, 41 (2): 218-223.   DOI: 10.13418/j.issn.1001-165x.2023.2.17 Abstract （524）      PDF（pc） （3631KB）（30）       Knowledge map    Save Objective    To explore the surgical treatment strategy for adjacent segment disease (ASD) after anterior cervical discectomy and fusion of multi-segments.    Methods    From 2015 to 2019, 13 patients with ASD in our hospital were retrospectively analyzed. Eight patients were treated with anterior cervical Zero-P plate and 5 patients were treated with single-door laminoplasty. JOA, VAS, and NDI were noted to evaluate the clinical outcomes, and X-ray, CT, and MRI imaging were recorded and analyzed as well.   Results    All the patients were followed up for an average of 11.6 months (6~24 months). The JOA, VAS and NDI were significantly improved after both surgeries. In the anterior cervical operation group, the position of the internal fixation was good and no loosening of the plate screw was observed during follow-up. The average time of bone fusion was about 7.6 months. In patients who were treated with single-door laminoplasty, there were no complications such as C5 nerve root palsy, lamina re-closing and so on.   Conclusions   The selection of reoperation methods for ASD after multilevel anterior cervical fusion should follow the principle of individualization. For single-level ASD without severe posterior longitudinal ligament ossification, anterior decompression and fusion with the Zero-P system should be selected. For multi-levels ASD, the posterior single-door laminoplasty is preferred. Reference | Related Articles | Metrics | Comments（0）

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The three-dimensional model construction of bronchial tree and the simulation of fiberoptic bronchoscopy surgery based on Chinese Visible Human dataset  Yang Jingyi, Hu Xin, Yao Jie, Xu Zhou, Yang Zhi, Chen Zhi, Wu Yi Chinese Journal of Clinical Anatomy    2023, 41 (1): 1-7.   DOI: 10.13418/j.issn.1001-165x.2023.1.01 Abstract （500）      PDF（pc） （8102KB）（171）       Knowledge map    Save Objective    To construct detailed three-dimensional (3D) digital structures and apply to virtual simulation and 3D printing of the human lung bronchial trees, so as to provide accurate morphological data for the virtual simulation of fiberoptic bronchoscopy surgery.    Methods    The tomographic anatomical images of Chinese Visible Human CVH1,2,5,6 chest were selected. The lungs and bronchial trees were segmented and  reconstructed in 3D by using AMIRA software. Cinema 4D software was used to smooth, construct an interactive 3D-PDF model, and perform 3D printing to create virtual fiberoptic bronchoscopy surgery simulation model.    Results    Detailed 3D digital models of 4 lung bronchial trees were constructed, including 3 adults and 1 child, showing the branches of the human bronchial tree at 3-6 levels, the number of branches at level 4 and level 6 was about twice the number of branches of the upper level. The segment of left lung was 8, the number of bronchial branches at level 6 was (63.8±3.6), the segment of right lung was 10, the number of bronchial branches at level 6 was (63.8±3.6), and the bronchial branches number ratio of the left and right lungs was 0.79. The longest length of the bronchus was located in the left lobe, and the diameter of children’s lumen was smaller than that of three adults.   Conclusions    The 3D digital model, 3D printing model, 3D-PDF and virtual simulation software for surgery of the bronchial trees have improved the understanding of anatomy and developmental biology of bronchial tree. We believe that the B1+2 and B7+8 bronchopulmonary segments of the left lung are separate segmental bronchi, rather than two combined segmental bronchi, which provides morphological basis for clinical anatomy teaching and virtual simulation of fiberoptic bronchoscopy surgery. Reference | Related Articles | Metrics | Comments（0）

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Anatomy of the inferior mesenteric artery evaluated by three-dimensional CT angiography before radical resection of rectal cancer Zhang Peng, Chen Xin, Zhang Lan, Lin Yao, Lv Jianbo, Zeng Xinyu, Wang Zheng, Li Xin, Jin Yao, Tao Kaixiong Chinese Journal of Clinical Anatomy    2022, 40 (5): 530-535.   DOI: 10.13418/j.issn.1001-165x.2022.5.06 Abstract （500）      PDF（pc） （4182KB）（82）       Knowledge map    Save  Objective   To evaluate and analyze the classification and anatomical characteristics of the inferior mesenteric artery (IMA) of patients with rectal cancer by three-dimensional CT angiography (CTA) in order to provide reference for the surgical management of rectal cancer.    Methods    A retrospective analysis was performed on the clinical and image data of rectal cancer patients received IMA CTA examinations in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2019. IMA images were reconstructed by three-dimensional CT angiography. Branch types of IMA were classified, and anatomical parameters of the inferior mesenteric vessel were measured and analyzed.    Results    Among the 266 cases, 187 were males and 79 were females. The left colon artery (LCA) arose independently from the common trunk in 111 cases (accounting for 41.7%). In 112 cases (accounting for 42.1%), the LCA and sigmoid colon artery (SA) had a common trunk, and in 33 cases (accounting for 12.4%), LCA, SA and superior rectal artery (SRA) forked at same point, whereas LCA disappeared in 10 cases (accounting for 3.8%). The length of the IMA (LIMA) was (39.1±10.1) mm, and the distance between the IMA root and iliac aortic bifurcation (DIMA) was (44.1±7.4) mm. The distance from the IMA root to the inferior mesenteric vein (IMV) and the IMA branch point to the IMV were (24.6±8.9) mm, (13.0±5.3) mm, respectively. In 122 cases (accounting for 47.6%), LCA ascended medial to the lateral border of left kidney, while in 46 patients (accounting for 18.0%), LCA arranged below the inferior border of left kidney. LCA located medial to IMV at the level of IMA root in 65 cases (accounting for 25.4%), just lateral to IMV in 136 cases (accounting for 53.1%), and lateral away from IMV in 55 cases (accounting for 21.5%).   Conclusions Three-dimensional CT angiography before surgery can accurately assess the IMA branch types and anatomical parameters of the inferior mesenteric vessel, which can provide reference for vascular management in rectal cancer surgery. Reference | Related Articles | Metrics | Comments（0）

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Applied anatomy of the umbilical artery of adult male Huo Jiechao, Yang Mei, Zheng Yin, Zhang Gaoli, Wan Shanshan, Liu Hui Chinese Journal of Clinical Anatomy    2022, 40 (4): 383-386.   DOI: 10.13418/j.issn.1001-165x.2022.4.02 Abstract （490）      PDF（pc） （3229KB）（422）       Knowledge map    Save Objective    To study the anatomical characteristics of umbilical artery in male specimens, so as to provide theoretical support for ligation of umbilical artery in clinical bladder cancer resection. Methods    Nineteen adult male cadavers (38 sides) fixed by formalin were collected randomly. The starting point, course, external diameter and branches of the umbilical artery were observed and analyzed.    Results    The umbilical artery originated from the internal iliac artery. The outer diameter of umbilical artery was (3.02±0.30) mm. We found there were five branch types of the umbilical artery. Ⅰ. several superior vesical arteries, accounting for 52.6% (20 sides). Ⅱ. several superior vesical arteries and one inferior vesical artery, accounting for 28.9% (11 sides). Ⅲ. two superior bladder arteries and one common trunk vessel of the inferior bladder artery and the obturator artery, accounting for 5.3% (2 sides). Ⅳ. several superior vesical arteries and one obturator artery, accounting for 7.9% (3 sides). Ⅴ. two superior vesical arteries and one seminal vesicle artery, accounting for 5.3% (2 sides).    Conclusions    The starting site of the umbilical artery is fixed, the diameter of the starting end is narrow and the number of branches is varied. Reference | Related Articles | Metrics | Comments（0）

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Establishment of a highly efficient method for β-thalassemia CD17 (A > T) point mutation in HEK293T cell line Liu Yongxiang, Cai Bing, Xu Yan, Zeng Yanhong, Zhou Shaohu, Mai Qingyun Chinese Journal of Clinical Anatomy    2022, 40 (5): 581-586.   DOI: 10.13418/j.issn.1001-165x.2022.5.14 Abstract （455）      PDF（pc） （4739KB）（96）       Knowledge map    Save Objective   To establish an efficient method for constructing HEK293T cell line of β-thalassemia CD17 (A>T) point mutation.   Methods    Using a modified CRISPR/Cas9 gene editing technology, termed ‘CORRECT’ (consecutive re-Guide or re-Cas steps to erase CRISPR/Cas-blocked targets) for scarless genome editing. Firstly, the cleavage of HBB gene in HEK293T cells was induced by electro-transfection of CRISPR/Cas9 plasmid. Then, single-stranded oligo DNA nucleotides (ssODNs) with CD17 (A>T) point mutation and synonymous mutation (G>T) were used as homologous templates for repair. The HEK293 T cell line with β-globin CD17 (A>T) point mutation was obtained by monoclonal screening and sequencing analysis.    Results    A HEK293T cell line with point mutation of β-thalassemia CD17 (A>T) genotype was successfully obtained by 'CORRECT' technique. The introduction of synonymous mutation might reduced re-editing of Cas9 protein to the target, which greatly improved the efficiency of single base mutation.    Conclusions    The point mutation HEK293T cell line can be efficiently obtained by 'CORRECT' technique, which is of great significance for the establishment of single base mutation cell lines and animal models. Reference | Related Articles | Metrics | Comments（0）

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Anti-inflammatory effect of sargentodoxa cuneata decoction promotes the recovery of motor function in mice after spinal cord injury Yang Dan, Song Haiwang, Liang Yinhua, Liu Guoxiang, Luo Yi, Zeng Zhu Chinese Journal of Clinical Anatomy    2023, 41 (2): 172-177.   DOI: 10.13418/j.issn.1001-165x.2023.2.09 Abstract （442）      PDF（pc） （2126KB）（25）       Knowledge map    Save Objective   To investigate the anti-inflammatory effect of sargentodoxa cuneata decoction (SCD) after spinal cord injury (SCI) and its effect on the recovery of motor function.    Methods    Thirty-six SPF grade mice were randomly divided into a sham operation group, a SCI group and a SCD group. The recovery of hindlimb motor function was detected by BMS (Basso mouse scale), and the expression levels of interleukin (IL) -6, IL-12A, tumor necrosis factor (TNF) -α and brain-derived neurotrophic factor (BDNF) were detected by Western blot. Immunofluorescence staining of NeuN was performed to observe the changes of neurons in anterior horn of spinal cord. The distribution of spinal cord motoneurons related to tibialis anterior muscle (TA) was observed by rAAV-retro retrograde tracing.    Results    Compared with SCI group, the BMS score of SCD group was significantly higher at 7 days after injury (P<0.05), and IL-6, IL-12A and TNF-α were significantly higher at 14 days after injury, while the expression of BDNF was significantly higher than that in SCI group (P<0.05). Compared with SCI group, the number of spinal cord anterior horn neurons in SCD group was significantly increased (P<0.05), and the number of rAAV-retro retrograde labeled TA related motor neurons was also significantly increased (P<0.05).    Conclusions    The sargentodoxa cuneata decoction can significantly down-regulate the levels of inflammatory factors IL-6, IL-12A and TNF- α to play an anti-inflammatory role and up-regulate the expression of BDNF, so as to protect motor neurons and promote the recovery of motor function in mice after spinal cord injury. Reference | Related Articles | Metrics | Comments（0）

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Anatomical study and clinical significance on tibial collateral ligament of the knee and medial meniscus Chen Shuai, Yi Chenpeng, Wang Jie, Gong Dawei, Jiao Feng, Huang Huayang, Zheng Xiaofei, Wang Haibin Chinese Journal of Clinical Anatomy    2022, 40 (5): 519-522.   DOI: 10.13418/j.issn.1001-165x.2022.5.04 Abstract （375）      PDF（pc） （2444KB）（37）       Knowledge map    Save Objective    To provide anatomical basis for the diagnosis and treatment of tibial collateral ligament (TCL) and medial meniscus (MM) injuries under arthroscopy.    Methods    Eighteen adult cadaver knee specimens were dissected to observe the anatomical morphology of TCL and MM and the relationship between them.     Results    Deep layer of TCL formed a wide but firm connection between the posterior oblique ligament and the anterior medial capsule and the body and posterior angle of the MM. The contact length and contact area of the two were (8.12±0.44) mm and (36.39±4.45) mm2, respectively, which could maintain the stability of the MM during flexion and extension of the knee.    Conclusions    The TCL and MM are important components for the stability of medial knee joint. In-depth knowledge of their morphological characteristics are of great significance for the diagnosis, treatment and anatomical repair of TCL and MM injuries under arthroscopy. Reference | Related Articles | Metrics | Comments（0）

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CT anatomic study of normal left posterior pararenal space Li Yubiao, Ren Anli, Ding Ning, Zhao Zhe, Dong Xiaohan, Li Zhimin, Dong Peng Chinese Journal of Clinical Anatomy    2022, 40 (4): 414-417.   DOI: 10.13418/j.issn.1001-165x.2022.4.08 Abstract （369）      PDF（pc） （1682KB）（113）       Knowledge map    Save Objective    To study the computed tomography (CT) manifestations of normal left posterior pararenal space (LPPrS).    Methods    (1) One cadaver was perfused with latex into the left anterior pararenal space. The anatomical characteristics of the bilateral posterior pararenal space was observed  and the diffusion of perfusion agent in the LPPrS was recorded. (2) The abdominal CT data of 50 normal adult were analyzed to observe the morphology and fat thickness of LPPrS, the vascular display of LPPrS and its relationship with the left posterior renal fascia. The maximal fat thickness of LPPrS at the level of left renal vein and the subcutaneous fat area at the level of the second lumbar vertebra were measured, and their correlation was analyzed.    Results     (1) After entering into the interfacial planes of the left posterior renal fascia, the axial tomography perfusion agent spread along the fiber separation of LPPrS. The posterior pararenal space was menisus in shape with multiple vessels. (2) On the axial CT images, multiple vascular shadows were detected in the LPPrS and mainly located in the lateral and posterior left kidney. The blood vessels passed through the left posterior renal fascia. CT images showed slender separation in the LPPrS. The average maximal fat thickness at the left renal vein level and the subcutaneous fat area at the second lumbar vertebra level were 0.77 cm and 112.37 cm2. The relationship of them was positive (r=0.283, P<0.05). Conclusions     The LPPrS has its own anatomical features. Paying attention to the CT manifestation of the LPPrS is helpful to the imaging diagnosis and treatment of LPPrS lesions and adjacent organs. Reference | Related Articles | Metrics | Comments（0）

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Comparison of clinical efficacy of cystic plate approach and traditional approach in laparoscopic cholecystectomy for gallstone patients Xiao Le, Jiang Zongxing, Luo Hao, Wang Tao, Tan Zhen, Wang Tao Chinese Journal of Clinical Anatomy    2022, 40 (4): 480-484.   DOI: 10.13418/j.issn.1001-165x.2022.4.20 Abstract （362）      PDF（pc） （3039KB）（144）       Knowledge map    Save Objective   To explore the safety, feasibility and advantages of cystic plate approach in laparoscopic cholecystectomy.    Methods    The clinical data of 110 cases of laparoscopic cholecystectomy via cystic plate approach (experimental group) and 170 cases of traditional laparoscopic cholecystectomy (control group) who went to our center from July 2016 to December 2019 was retrospectively analyzed. The gender, age, size and number of stones, operation time, conversion rate, intraoperative blood loss, the number of clips used, postoperative hospital stay, complication rate, the amount of postoperative drainage fluid were compared between the two groups to evaluate the therapeutic effect and clinical value of different techniques. Results   There was no statistical difference in general conditions, operation time, conversion rate, postoperative hospital stay, and complication rate between the two groups (P>0.05). The intraoperative blood loss (P=0.004), the number of clips used (P=0.000), the amount of postoperative drainage fluid (P=0.005), the postoperative pain (P=0.015) in the experimental group were less than those in the control group.  Conclusions   Laparoscopic cholecystectomy via the gallbladder plate approach is safe and feasible, and theoretically has the advantage of avoiding the risk of intraoperative biliary tract injury. Reference | Related Articles | Metrics | Comments（0）

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Morphology and distribution characteristics of the intraforaminal anchor chain ligaments at the cervical level Shao Yupu, Zheng Xuefeng, Shi Benchao, Ding Zihai , Zhao Qinghao Chinese Journal of Clinical Anatomy    2022, 40 (5): 511-514.   DOI: 10.13418/j.issn.1001-165x.2022.5.02 Abstract （343）      PDF（pc） （2532KB）（46）       Knowledge map    Save  Objective    To reveal the shape and distribution characteristics of anchor chain ligament in intervertebral foramina and to explore the relationship between anchor chain ligament and nerve entrapment in cervical spondylotic radiculopathy.    Methods    Twelve adult specimens of cervical spine were dissected with electric saw in midsagittal incision. The root cuff was cut from the root of the nerve root cuff. The anchor-chain ligaments around the nerve root cuff at the internal orifice of the intervertebral foramen C3/4 to C7/T1 were dissected under a surgical microscope. The morphology, distribution, starting and ending points and course of ligaments were recorded.    Results    A total of 560 anchor chain ligaments were found around the nerve root sleeve of 120 interforaminal foramen. All ligaments were radially connected to the periosteum wall around the nerve root sleeve and the interforaminal foramen. The number of interforaminal orifice ligaments in each vertebra was more than 4. The morphology of anchor chain ligament mainly included two types: band shape and cable shape. There were 258 band ligaments with a width of (4.5±2.6) mm (4.1~5.2 mm), and 302 cord-shaped ligaments with a diameter of (2.5±1.8) mm (1.2~3.8) mm. The ligaments in the interforaminal orifice of C3/4 and C7/T1 were loose and thin, and the number of ligaments was less. C4/5~C6/7 interforaminal ligaments were tough and strong, and the number of ligaments was much more.    Conclusions    Anchor chain ligaments exist around nerve roots in the interforaminal orifice of cervical vertebra. Anchoring nerve roots to the periosteum wall of the interforaminal orifice greatly limits the free movement range of nerve roots, which may lead to nerve root compression together with disc herniation, which is a potential anatomical factor of radiculopathy. Reference | Related Articles | Metrics | Comments（0）

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Protection and anatomical basis of recurrent laryngeal nerve and parathyroid glands in microwave ablation of benign thyroid nodules Li Ninglei, Liu Chuqin, Jin Yiyi, Xie Fengjiao Chinese Journal of Clinical Anatomy    2022, 40 (5): 615-618.   DOI: 10.13418/j.issn.1001-165x.2022.5.20 Abstract （331）      PDF（pc） （3019KB）（10）       Knowledge map    Save Objective   To investigate the damage and protective measures of recurrent laryngeal nerve and parathyroid glands during ultrasound-guided microwave ablation of benign thyroid nodules.   Methods   A total of 52 patients with thyroid diseases who underwent radiofrequency ablation from January 2017 to June 2019 were selected. Postoperative follow-up was performed to observe the nodule size, blood flow signal changes, thyroid hormone levels and complications.  Results   Postoperative follow-up ultrasound result showed that the volume of nodules was reduced in different degrees compared with that before treatment (P<0.05).    Conclusions    Strengthening the isolation band technique can effectively protect the recurrent laryngeal nerve and parathyroid glands and reduce the risk of injury. Related Articles | Metrics | Comments（0）

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Explore the long-term axial changes of vagina after radical hysterectomy by three-dimensional visualization Lu Yijia , Chen Chunlin , Liu Yunlu, Feng Jie , Liu Ping Chinese Journal of Clinical Anatomy    2023, 41 (2): 137-142.   DOI: 10.13418/j.issn.1001-165x.2023.2.04 Abstract （321）      PDF（pc） （4378KB）（27）       Knowledge map    Save Objective    To explore the axial changes of vagina before, 1 year and 5 years after radical hysterectomy (RH) by MRI visualization.    Methods    A total of 30 cervical cancer patients who received RH in Nanfang Hospital of Southern Medical University from October 2015 to October 2016 underwent pelvic MRI examination 1 year and 5 years after operation respectively were included.  Mimics 23.0 software was used to reconstruct the pelvis and vagina, the preoperative and posterior pelvis and vagina were matched and corrected by pelvic tilt correction system and placed in the same space. The axial stress points of vagina were named P1~P3 before surgery, 1 year and 5 years after surgery, respectively. The length of vagina, the angle and coordinates of upper and lower sections of P1~P3 were measured, and the differences of axial changes of vagina after operation were compared.    Results    The angle of P2 was (19.99±4.26) °higher than that of P1 and the vagina shortened by (5.55±0.6) cm one year after operation, The angle of P3 was (24.50±4.33)°  higher than that of P1 and the vagina shortened by (5.95±1.13) cm five years after operation. The angle of P3 was (4.51±0.33) ° higher than that of P2, and the vagina was shortened (0.42±0.53) cm 5 years after surgery compared with 1 year after surgery (P<0.05). Stress point coordinates of P1 (3.19±0.69, 1.59±0.52), P2 (2.52±0.38, 0.94±0.87), P3 (2.39±0.46, 0.69±0.59).    Conclusions    After RH, the angle between the upper and lower segments of the vagina is gradually blunt and forward, and the force point is closer to the pubic symphysis in the forward direction and to the vaginal opening in the downward direction, which may be one of the reasons for the long-term rare occurrence of pelvic organ prolapse. Reference | Related Articles | Metrics | Comments（0）

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The research progress of medial meniscus root tear (mmprt)：autogenous tendon reconstruction is a better option Li Anxu, Tan Hongbo, Qiu Xiong, Yuan Libo, Zhang Ying, Hu Qing, Xu Yongqing Chinese Journal of Clinical Anatomy    2022, 40 (5): 627-630.   DOI: 10.13418/j.issn.1001-165x.2022.5.24 Abstract （313）      PDF（pc） （554KB）（45）       Knowledge map    Save Reference | Related Articles | Metrics | Comments（0）

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Anatomical study of anterior pedicle cortical bone screw in lower cervical spine Peng Peng, Huang Gang, Zhu Meisong, Li Jianyi Chinese Journal of Clinical Anatomy    2022, 40 (5): 505-510.   DOI: 10.13418/j.issn.1001-165x.2022.5.01 Abstract （298）      PDF（pc） （1282KB）（90）       Knowledge map    Save Objective    To  investigate the feasibility of cortical bone trajectory for cervical anterior transpedicular screw fixation (ATPS) by measuring the anatomical characteristics of lower cervical pedicle. Methods    Eighty sets adult healthy cervical specimens were randomly selected, and the scanned date were imported to the MIMICS 19.0 software. The following parameters in C3~C7 vertebrae: outer pedicle width (OPW) of vertebral body, outer pedicle height (OPH) of vertebral body, medial cortical shell thickness (MCT) of the pedicle, and the cortical bone screw parameters of ATPS were measured and analyzed statistically. Results    There were significant differences in OPH and MCT between two sides of each segment (P<0.05). The OPH and OPW of each segment in males were greater than those of in females, with statistical differences (P<0.05). The entry point for C3 and C4 was 1.0-3.0 mm contralateral to the pedicle in the midsagittal plane of vertebra body, 1.0-3.5 mm from the upper end plate of vertebra body. The C5 entry point was 1.0-2.0 mm ipsilateral or contralateral to the pedicle in the midsagittal plane of vertebra body, 3.0-4.0 mm from the upper end plate of vertebra body. The entry point for C6 and C7 was 2.0-4.5 mm ipsilateral to the pedicle in the midsagittal plane of vertebra body, 4.5-7.0 mm from the upper end plate of vertebra body. At the cortical bone trajectory, the mean values of overall leaning angles from C3 to C7 were 39.13°, 41.00°, 40.91°, 37.28°,and 31.84° respectively, the mean values of overall sagittal angles from C3 to C7 were 90.85°, 97.23°, 108.97°, 111.60°, and 104.83° respectively. For ATPS, the diameters of cortical bone screw was 3.5 mm and the inserted length was 30 mm or 32 mm.    Conclusions   The cortical bone trajectory is a theoretically feasible option for ATPS, and the parameters inserting screw are established, which provides theoretical basis for its further clinical application. Reference | Related Articles | Metrics | Comments（0）

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Effects of Shenggu Zaizao Pills on related indexes of bone morphometry in steroid-induced necrosis of the femoral head in rabbits Ma Xueqiang, Cao Linzhong, Jiang Wei, Zhang Qi , Liu Mengchu, Wang Duoxian Chinese Journal of Clinical Anatomy    2022, 40 (5): 555-561.   DOI: 10.13418/j.issn.1001-165x.2022.5.10 Abstract （286）      PDF（pc） （4233KB）（63）       Knowledge map    Save Objective    To observe the intervention effect of Shenggu Zaizao Pills on steroid-induced necrosis of the femoral head (SONFH) rabbit femoral head histomorphology and related indexes of osteometry.    Methods    Twenty female New Zealand rabbits were randomly divided into a normal group, a model group, a Shenggu Zaizao pill group and a positive control drug Xianling Gubao capsule group, 5 in each group. Except the normal group, the other three groups received endotoxin combined with methylprednisone sodium succinate injection to modeling. After 28d, Shenggu Zaizao Pills group was given 2.4 g/kg Shenggu Zaizai Pills, Xianling Gubao Capsule group was given 0.4 g/kg Xianling Gubao Capsule, normal group and model group were given 10mL of normal saline, 1 time/d. After 28d, the bilateral femoral heads of the rabbits in each group were taken to perform Micro-CT scanning to analyze osteometric parameters. HE staining was used to observe the pathological changes of the femoral head tissue morphology.  Results    Compared with the normal group, Micro-CT scan analysis showed that the femoral head bone mineral density (BMD),bone volume fraction (BV/TV), trabecular bone number (Tb.N), trabecular bone thickness (Tb.Th) and connectivity density (Conn.D) in the model group significantly decreased, while trabecular bone separation (Tb.Sp) and structural model index (SMI) significantly increased (P<0.05). Microscopic observation of HE stained pathological sections showed that the rate of empty bone lacunae and the area of adipocytes in the model group significantly increased, the epiphysis was deformed, and the trabecular bone was hyperplasia, narrowed or broken. Compared with the model group, the osteometric and histopathological changes of the femoral head of the rabbits in the Shenggu Zaizao Pills group and Xianling Gubao Capsule group significantly improved (P<0.05). There was no significant difference in curative effect between Shenggu Zaizao Pills group and Xianling Gubao Capsules group (P>0.05).   Conclusions    Shenggu Zaizao Pills can significantly increase the level of SONFH osteometric indexes in rabbits and improve histopathological morphology, thereby achieving the effect of treating SONFH. Reference | Related Articles | Metrics | Comments（0）