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Chinese Journal of Clinical Anatomy 2020 Vol.38 Please wait a minute... For Selected: Download Citations EndNote Ris BibTeX Toggle Thumbnails Select The anatomical relationship between the vertebral artery and the Ⅸ to Ⅻ cranial nerves and its clinical significance DU Xin-ru, KONG Xiang-yu, GUO Sen, MA Quan, LIU Ying-dong Chinese Journal of Clinical Anatomy    2020, 38 (1): 1-5.   DOI: 10.13418/j.issn.1001-165x.2020.01.001 Abstract （473）            Knowledge map    Save Objective　To observe the relationship between the vertebral artery and the 9th to 12th cranial nerve and to investigate the correlation between hypertension and cervical spondylopathy.    Methods   Fifteen cranial-neck specimens were dissected and stripped to observe the relationship between the intracranial segment of vertebral artery, posterior inferior cerebellar arteries and the Ⅸ to Ⅻ cranial nerves as well as the relationship between the intracranial segment of vertebral artery and medulla oblongata,  the corresponding data were measured.　Results　(1) the vertebral artery run obliquely after passing through the dura mater, and it lied in front of root filaments of the Ⅸ and Ⅻ cranial nerves near the lateral side of medulla oblongata, the root filaments crossed the vertebral artery posteriorly, the right vertebral artery in contact with the Ⅺ and Ⅻ cranial nerve, and not with the Ⅸ and 10th cranial nerves were 7 cases (7/15, 46.7%) in the right, 11 cases（11/15, 73.3%）in the left respectively. (2)  the Ⅸ and Ⅻ cranial nerves had no any contact with posterior inferior cerebellar artery in 1 case in the right , 5 cases（5/15，33.3%） in the left；the right posterior inferior cerebellar artery was in contact with the Ⅸ and Ⅹ cranial nerves without contacting with Ⅺ and Ⅻ cranial nerves in 4 cases (4/15, 26.7%); (3) the left vertebral artery was contacting with ventral side of medulla oblongata in 11 cases (11/15,73.3%), while the right vertebral artery had no any contacting with that in 4 cases (4/15, 26.7%);  The right vertebral artery located more inclined orientation and situated in the anterior aspect of medulla oblongata paralleling with right margin of it.　Conclusions　The contacting relationship between vertebral artery and the Ⅺ to Ⅻ nerve may be the morphological bases of hypertension accompanied by occipital pain. The posterior inferior cerebella artery is also in close relation with the Ⅸ to Ⅻ cranial nerve filaments with tortuously wind round each other. When suffering from hypertension, this complicated relationship would be an important factor to stimulate the root filaments of related cranial nerves and then produce both the corresponding occipital-neck pain. Therefore the neurotrophic drugs for nourishing nerves should be used properly and the corresponding treatment can also be used in treating hypertension simultaneously. Reference | Related Articles | Metrics | Comments（0） Select Anatomical study of the central tendon reconstruction by manipulation of the superficial flexor tendon through bone tunnel    ZHANG Yu-jun, JU Ji-hui, XU Lei, JIN Qian-heng, ZHAO Qiang, LI Xiang-jun, CHENG He-yun, WANG Ben-yuan Chinese Journal of Clinical Anatomy    2020, 38 (1): 6-9.   DOI: 10.13418/j.issn.1001-165x.2020.01.002 Abstract （478）            Knowledge map    Save Objective  To imitate the surgical methods of the central tendon reconstruction by manipulation of the superficial flexor tendon through bone tunnel，and to verify the feasibility and safety of the operation.  Methods　Eight fresh adult cadavers hand specimens , with a total of 24 fingers in index finger, middle finger and ring finger，were collected to dissect and observe the anatomic structure of superficial flexor tendon, central tendon and extensor tendon. Four index fingers, four middle fingers and four ring fingers, 12 fresh adult finger specimens were selected for imitated operation. The rupture of central tendon insertion was artificially designed. Tendon bundles on both sides of flexor digitorum were passed through base of the middle palmar segment to dorsal part by drilling through the phalanx，and the rupture of central tendon insertion was reconstructed by woven suture with central tendon rupture. Then the passive stretch angle and the passive buckling angle of PIP formed by different suture spacing were measured.　Results  When the suture spacing of superficial flexor tendon was large, the angle of passive extension and flexion were also large, but the central tendon and the superficial flexor tendon were loose obviously. When the suture spacing was small, the angle of passive extension and flexion were also small, the tension of the central tendon and the superficial flexor tendon were large. Therefore, none of them could ensure the flexion and extension of fingers. When the suture spacing of superficial flexor tendon was 1.5cm，the passive buckling angle of PIP was about 75°.When the suture spacing was 1.0cm，the passive buckling angle of PIP was about 30°. When the suture spacing was 1.0~1.5cm, that is, when cutting through the Camper tendon chiasma, the angle of passive stretch and flexion of PIP were closest to the functional angle of finger.  Conclusions  Central tendon insertion can be reconstructed when the superficial flexor tendon is removed to Camper tendon chiasma. The tendon injury in donor area is small, and the central tendon reconstruction is safe and feasible relatively. Reference | Related Articles | Metrics | Comments（0） Select Applied anatomy of saphenous nerve block near to inferior foramen of adductor canal LI Xue-qian, LU Li-rong, LI Hong-peng, SUN Yun, ZHANG Hai-dong, ZHAO Zhen-mei Chinese Journal of Clinical Anatomy    2020, 38 (1): 10-13.   DOI: 10.13418/j.issn.1001-165x.2020.01.003 Abstract （762）            Knowledge map    Save Objective　To explore the details of anatomy and surface localization of saphenous nerve near to inferior foramen of adductor canal.　Methods　Twenty sides of lower limb from 12 cadaver specimen were dissected to measure the key structures adjacent to the adductor canal.　Results　Saphenous nerve, femoral artery and femoral vein located in the anteromedial, medial and posterior part of adductor canal, respectively. At the site of the inferior foramen of adductor canal, the descending genicular artery, vein and saphenous nerve penetrated through adductor tendon plate and appeared in adductor canal, which were accompanied by the great saphenous vein. Saphenous nerve passed through deep fascia between sartorius tendon and gracilis tendon on the medial surface of knee, and descended to the medial surface of leg and foot. The distances from inferior foramen of adductor canal to superior border of patella, to medial margin of the patella, and to the medial surface of thigh skin were (5.85±0.15) cm, (2.72±0.60) cm and (4.08±0.66) cm, respectively. Conclusions　Surface localization point of saphenous nerve block should be limited to a specific area, which is about 5.85 cm upper to the superior border of patella, 2.72 cm internal to medial margin of the patella, and 4.08 cm deep to the medial surface of thigh. For saphenous nerve blocking, femoral artery could be regarded as a localization mark above inferior foramen of adductor canal, while, the saphenous branch of the descending genicular artery as the localization mark below inferior foramen of adductor canal.  Reference | Related Articles | Metrics | Comments（0） Select Anatomical study on middle ear of New Zealand rabbits by transcanal endoscopy LIN Qiong-ping, LI Da-fei, YANG Jing-ya, XU Piao, ZHANG Shan-shan, TIAN Guang-yong Chinese Journal of Clinical Anatomy    2020, 38 (1): 14-18.   DOI: 10.13418/j.issn.1001-165x.2020.01.004 Abstract （669）            Knowledge map    Save Objective　To observe the anatomical structure of rabbit's middle ear under ear endoscope and explore the feasibility of the rabbit as endoscopic anatomical training model of middle ear, and then provide anatomic base for other experimental research on middle ear of rabbits.　Methods　Five (10 ears) New Zealand rabbits were killed immediately after anaesthesia, the structures of tympanic membrane and tympanic cavity were observed by endoscopic transcanal approach, and ossicles, epitympanum, mesotympanum, hypotympanum and facial nerve were distinguished.　Results　Compared with human, auditory ossicles were composed of malleus-incus complex and stapes, and part of the lateral epitympanic wall was replaced by the tympanic membrane. Rabbit’s bullae was similar to the mesotympanum and hypotympanum of human, including the eustachian tube, facial nerve, promontory, vestibular window, cochlear window and tympanic nerve. The mastoid process was a diploic bone, overlying the caudolateral aspect of the tympanic bulla. In the tympanum, facial nerve run horizontally below the epitympanum, passed through the pyramidal eminence, and then run vertically along the posterior wall of bullae, and left the auditory vesicle through stylomastoid foramen.　Conclusions　The middle ear structures of New Zealand rabbits are similar to that of human, which can be used as the anatomical model for the junior otologists to practice endoscopic middle ear operation, or as a new educational model for the three-dimensional anatomical structure of the ear. Reference | Related Articles | Metrics | Comments（0） Select Clinical anatomical study on three-dimensional reconstruction of nutritional vessels of lunar bone XU Yu-jian, XU Yong-qing, He Xiao-qing, LUO Hao-tian, ZHANG Xu-lin, Yang Xi, YUAN Li-bo, ZHAO Wan-qiu, WU Huan Chinese Journal of Clinical Anatomy    2020, 38 (1): 19-24.   DOI: 10.13418/j.issn.1001-165x.2020.01.005 Abstract （503）            Knowledge map    Save Objective　To study the anatomical characteristics of blood supply of lunar bone by three-dimensional reconstruction of Micro-CT data of nutrient vessel of lunar bone, explore the anatomical mechanism of ischemic necrosis of lunar bone.　Methods　The study had passed the ethical review of Kunming General Hospital of Chengdu Military Region. Twelve fresh adult wrist specimens were perfused with red lead oxide contrast medium and scanned under Micro-CT. The blood supply of lunar bone was reconstructed by Mimics software to measure and analyze statistically the anatomical parameters of nutrient vessels.　Results　(1) The diameter of nutrient pore on the metacarpal side of the lunate was (0.62±0.11) mm, and the diameter of the vascular entrance was (0.59±0.17) mm in volar side of lunate. There was no significant difference between the dorsal side (0.59±0.13) mm and (0.61±0.12) mm (P>0.05). The mean number of nutrient foramen on the metacarpal surface of lunar bone was (3.67±2.74) and that on the dorsal side was (2.41±1.83). The difference was statistically significant (P<0.05). However, there were no statistical difference between the mean number of nutrient foramen, the diameter of nutrient pore and the diameter of the vascular entrance of Type I and Type II. (2) The distribution of nutrient vessels in lunar bone was classified into 3 types, which was Y-shaped in 50% (7 cases), I-shaped in 35.7% (5 cases) and X-shaped in 14.3% (2 cases).　Conclusions　The blood supply of the metacarpal face of lunar bone is abundant, and the ischemic necrosis of lunar bone is more likely to occur after injury. The distribution of nutrient foramen in the proximal ulnar part of the metacarpal surface of the lunar bone is concentrated, and the intervention of ligaments and soft tissues in this area should be minimized during the operation. Reference | Related Articles | Metrics | Comments（0） Select Three-dimensional digital model of Ludloff osteotomy for treating hallux valgus LI Zhong-wan, HONG Jin-song, YANG Qin-meng, YAO Li-yun, YANG Guang-gang, FU Xiao-yong, PAN Yong-xiong Chinese Journal of Clinical Anatomy    2020, 38 (1): 25-28.   DOI: 10.13418/j.issn.1001-165x.2020.01.006 Abstract （647）            Knowledge map    Save Objective　To set up a 3D digital model of hallux valgus and provide theoretical support for Ludloff osteotomy in patients with hallux valgus to reduce the operation risk, increase the operation safety and improve the curative effect  by simulating Ludloff osteotomy, comparing the changes of preoperative and postoperative parameters, predicting the postoperative curative effect and complications Methods　11 cases of patients (13 feet)with hallux valgus who treated at department of foot and ankle surgery, Guangzhou orthopaedic hospital from January 2016 to January 2017 were retrospectively collected. A 3D digital model of the foot was set up based on CT data. 3D construction model was simulated to measure and statistically analyze the preoperative and postoperative the hallux valgus angel ( HVA), the intermetatarsal angel from the first to the second metatarsal (IMAI~II), the length of the first metatarsal, the relative length of the second metatarsal and the intermetatarsal angel from the first to the fifth metatarsal (IMAI~V).　Results  Preoperative and postoperative simulating osteotomy of HVA , IMAI~II, length of the first metatarsal, the relative length of the second metatarsal, IMAI~V were (35.62±6.54) °and (35.62±6.54) °, (16.43±2.41)°and (9.12±3.18）°, (63.58±4.17)mm and (59.87±3.83)mm,  (93.74±6.02)°and (86.85±5.36)°, (29.68±3.65)°and (19.45±2.46)°respectively. There were statistical significance of the above corresponding indicator changes of before and after simulating osteotomy (P<0.05).　Conclusions　Using 3D digital model technique to simulate Ludloff osteotomy and measure the parameters is a feasible way to evaluate the effect of Ludloff osteotomy and provide reference for formulating the operative plan. Reference | Related Articles | Metrics | Comments（0） Select  Sectional imaging study of the hippocampus in patients with alzheimer's disease BAI Gui-qin, XIAO Ru-hui, CHEN Li, HUANG Xiao-hua, YANG Zheng-wei, CAI Chang-ping Chinese Journal of Clinical Anatomy    2020, 38 (1): 29-34.   DOI: 10.13418/j.issn.1001-165x.2020.01.007 Abstract （317）            Knowledge map    Save Objective　To observe the morphological changes on sectional imaging of the hippocampal formation (HPF) in patients in the process of alzheimer's disease (AD).　Methods　According to the pathogenesis of AD, 34 cases of a normal control (NC) group, 34 cases of a mild cognitive impairment (MCI) group, 34 cases of an AD group, which a total of 102 cases were collected, with 17 cases of male and 17 cases of female in each group respectively. The hippocampal area, the transverse diameter, the sagittal diameter and the temporal lobe hook gyrus spacing, the temporal horn width were measured. The change trend of the measured values among the groups and the correlation between the hippocampal area and the scores of the neural rating scale were analyzed.　Results　There was no statistical difference of hippocampal area in the three groups. Compared with the measured values among the groups, the hippocampal area of the AD group was smaller than that of the NC group and the MCI group (P<0.05).The hippocampal transverse diameter of the AD group was smaller than that of the NC group and the MCI group, and the hippocampal transverse diameter of the MCI group was smaller than that of the NC group (all P<0.01). In AD group, the temporal lobe hook gyrus spacing was greater than that in  the NC group and the MCI group (all P<0.01), and in MCI group, the temporal lobe hook gyrus spacing was greater than that in  the NC group (P<0.05). Hippocampal area and hippocampal transverse diameter were negatively correlated with clinical dementia scale (CDR) and Hamilton depression scale (HAMD) scores, and positively correlated with Montreal cognitive assessment scale (MoCA) scores；the correlation between the distance of temporal lobe hook gyrus and the score of neuropsychological scale scores was opposite to that of hippocampal area and hippocampal transverse diameter.　Conclusions　With the progression of AD, the hippocampal area and hippocampal transverse diameter gradually decrease, while the temporal lobe hook gyrus spacing gradually increase. Changes in the hippocampus can damage its cognitive function. Reference | Related Articles | Metrics | Comments（0） Select Sternalis muscle: 2 case report Chinese Journal of Clinical Anatomy    2020, 38 (1): 34-.   DOI: 10.13418/j.issn.1001-165x.2020.01.025 Abstract （452）            Knowledge map    Save Reference | Related Articles | Metrics | Comments（0） Select MRI anatomic analysis of influential factors of normal mesorectal transverse diameter in adult REN An-li, WENG Ai-ting, LI Jin, CHEN Lan-fen, WANG Guang-zhi, DONG Peng Chinese Journal of Clinical Anatomy    2020, 38 (1): 35-38.   DOI: 10.13418/j.issn.1001-165x.2020.01.008 Abstract （694）            Knowledge map    Save Objective　To investigate the influential factors of transverse diameter of mesorectum in adults based on magnetic resonance imaging (MRI).　Methods　Clinical data of 100 patients who met the inclusion criteria and then treated with MRI on pelvic cavity were analyzed retrospectively. The 100 cases (42 males and 58 females) aged from 27~83 years old. On the axial MR T1WI, the following parameters were measured at the seminal vesicle/uterine body level: the maximal transverse diameter of mesorectum, bladder and rectum, and the interval of the bilateral femoral head, the thickness of anterior abdominal subcutaneous fat tissue, the uterus maximal transverse diameter of female. The correlation between the maximal transverse diameter of mesorectum and the above measured parameters was analyzed statistically.　Results　(1) According to the data of 58 females cases, the maximal transverse diameter of mesorectum was (7.15±0.97) cm, uterine maximal transverse diameter was (5.86±0.61) cm. There was no statistical correlation between the maximum transverse diameter of the mesorectum and the transverse diameter of the uterus (P＞0. 05). (2) The data of male and female were combined for statistical analysis: the maximal transverse diameter of mesorectum was (7.15±0.87) cm. The maximal transverse rectum diameter was (2.84±0.74) cm, and the maximal transverse diameter of bladder was (8.58±1.66) cm. The interval of the bilateral femoral head was (12.79±0.96) cm. The thickness of anterior abdominal subcutaneous fat tissue was (2.01±0.76) cm at the same level. There was no statistical correlation between the transverse diameter of the mesorectum with gender, age, and the transverse diameter of the bladder (P＞0.05). It was positively correlated with the thickness of subcutaneous fat tissue in the anterior abdominal wall, the transverse diameter of the rectum, and the interval of the bilateral femoral head (t=3.807, 2.612, 2.002, P<0.05). Set the transverse diameter of mesorectum (Y) as the dependent variable, with the thickness of anterior abdominal fat tissue (X1), rectal transverse diameter (X2), the interval of the bilateral femoral head (X3) as the independent variables, the regression equation was: Y=3.500+0.389 X1+0. 275 X2+0.163 X3, P＜0.05, R2=0.522.　Conclusions　The mesorectal transverse diameter is related to the interval of the bilateral femoral head, the thickness of fat tissue in the anterior abdominal wall and the transverse diameter of the rectum. Observing and measurement of the mesorectal transverse diameter is helpful for the clinical diagnosis and treatment of the rectal lesions. Reference | Related Articles | Metrics | Comments（0） Select The CRISPR/Cas9 system optimization and construction of CHD1L conditional knockout liver cancer cell lines HUANG Li, LIU Shan-shan, ZHANG Xiao-feng, BAI Yin-shan, LIU Ming Chinese Journal of Clinical Anatomy    2020, 38 (1): 39-44.   DOI: 10.13418/j.issn.1001-165x.2020.01.009 Abstract （363）            Knowledge map    Save Objective　To verify the effect of CHD1L QGY-7703 hepatoma cell line knockout and the effect on the cell biological functions and then to provide important cells models for studying the role of CHD1L in the development of mechanism of malignant phenotype in cancer cell by using the optimized pLV-Tet3G-CRISPR/Cas9 technology to construct a QGY-7703 hepatoma cell line.　Methods　pLV-Tet3G-Cas9 vector was optimized by point mutation technique to reduce its off-target effect and increase specificity. Cas9 was transformed into eSpCas9. Then, QGY-7703 cell line stably expressing eSpCas9 was obtained by screening. pLVX-mCherry-hU6-SgRNA vector carrying mCherry fluorescent gene was obtained by inserting mCherry gene into pLVX-hU6-SgRNA vector. The sgRNA sequence targeting the CHD1L gene was designed and screened, and the targeting sequence of Hu6-CHD1L-sgRNA was obtained by overlapping PCR method. Cloning the site with cleavage activity into the pLVX-mCherry-hU6-SgRNA vector. The vector was packaged as lentivirus by lentiviral packaging method and transfected into 7703 eSpCas9 cell line. The CHD1L knockout induced by Dox was verified by Western blot. The effects of Dox-induced CHD1L knockout on the biological function of hepatocellular carcinoma cells were detected by Wound Healing and Transwell assay. Results　In this experiment, vector Cas9 of pLV-Tet3G-Cas9 was successfully optimized as sequence eSpCas9. pLVX-mCherry-hU6-CHD1L-SgRNA vector was constructed. The QGY-7703 liver cancer cell line that conditional induction CHD1L gene knocking out was successfully constructed. Cell function experiments showed that the expression of eSpCas9 can be induced by Dox, the migration and invasion ability of these hepatoma cells were significantly decreased after knockout of CHD1L.　Conclusions　This study successfully constructed a conditional CHD1L knockout QGY-7703 liver cancer cell line. This model can be used as an effective tool to study the function and mechanism of specific genes targeting tumors. Reference | Related Articles | Metrics | Comments（0） Select Studying the effect of miR-382 on renal fibrosis in high glucose based on 3D culture system of renal mesangial cells LI Xiang, YANG Zhi-feng, WANG Guo-bao Chinese Journal of Clinical Anatomy    2020, 38 (1): 45-50.   DOI: 10.13418/j.issn.1001-165x.2020.01.010 Abstract （288）            Knowledge map    Save Objective　To explore the effect of miR-382 in diabetic nephropathy and renal fibrosis by constructing 3D renal mesangial cells spheroid with LBL.　Methods　LBL was utilized to construct 3D renal mesangial cells spheroid for studying the effect of different concentrations of glucose on renal mesangial cells and the effect of miR-382 on it. The experimental groups were divided into three groups according to the concentrations of glucose (5.6 mmol/L, 25 mmol/L, 40 mmol/L). qRT-PCR, Western blotting and immunofluorescence were used to detect the expression of TGF-β1, Fn, miR-382 and the level of its possible target gene the 10th chromosome deficiency phosphatase and tension of homologous gene (PTEN).　Results High glucose upregulated the expression of miR-382, downregulated secretion of PTEN, and significantly increased the expression of TGF-β1 and Fn.　Conclusions 　miR-382 may be involved in the pathology lesion of mesangial cells in the early state of diabetic nephropathy and renal fibrosis via negatively regulating the expression of PTEN. Reference | Related Articles | Metrics | Comments（0） Select miR-21 alleviates the cytotoxicity of mutant huntingtin through PTEN/AKT LI Xi-fan, CHEN Tian, FANG Fang, LI He Chinese Journal of Clinical Anatomy    2020, 38 (1): 51-56.   DOI: 10.13418/j.issn.1001-165x.2020.01.011 Abstract （215）            Knowledge map    Save Objective　To detect the mechanism of miRNA-21 in reducing cytotoxicity of mutant Huntingtin (mHtt).　Methods　The changes of miRNA-21 in brain tissues of Huntington's disease (HD) transgenic mice and HEK293-160Q cells were detected by quantitative real-time polymerase chain reaction (qRT-PCR) ; Whether PTEN was the target gene of miRNA-21 or not was identified by double luciferase test; after transfected the miRNA-21 mimics, cell viability was detected by CCK8, caspase-3 activity was determined by caspase-3 activity assay kit; PTEN, phosphorylated-Ser-473 AKT and AKT were detected by Western Blotting.　Results　qRT-PCR result showed that the levels of miRNA-21 in brain tissues of HD transgenic mice and HEK293-160Q cells were significantly decreased compared with wild-type mice and HEK293-20Q cells; PTEN was the target gene of miRNA-21 which was confirmed by double luciferase test; Western Blotting showed that PTEN decreased significantly and p-AKT-Ser 473 AKT/AKT significantly increased in HEK293-160Q cells after transfected the miRNA-21 mimics.　Conclusions　miR-21 can increase the p-AKT-Ser 473/AKT by decreasing the PTEN, increase the cell viability and inhibit the apoptosis by alleviating the cytotoxicity of mHtt. Reference | Related Articles | Metrics | Comments（0） Select Expression and significance of Runx2, Osterix and MMP-13 in steroid-induced necrosis of femoral head in rats YAN Xue-liang, CHEN Xiao-ming, TANG Guo-jun, CAO Qi Chinese Journal of Clinical Anatomy    2020, 38 (1): 57-61.   DOI: 10.13418/j.issn.1001-165x.2020.01.012 Abstract （667）            Knowledge map    Save Objective　 To study the dynamic changes in gene expression and protein synthesis of runt-related transcription factor-2(Runx2), Osterix and MMP-13 in the femoral head of steroid-induced osteonecrosis (SANFN) in rats.　Methods　Forty adult Wistar rats were randomly divided into two groups: a model group (n = 30) and a control group (n=10). Rats in the model group were treated with dexamethasone 20 mg/kg intramuscularly injection once a week. After the injection, the animals were trained on the treadmill. The model group was divided into 3 groups according to the training time (10 cases each): A group for 8 weeks; B group for 10 weeks; C group for 12 weeks. The expression of Runx2, Osterix and MMP-13 and protein synthesis in femoral heads were detected by PCR and Western blot.    Results    The maximal diameter of adipocyte and the ratio of empty bone lacuna in model group were higher than those in control group. With the increasing of training time, the maximal diameter of adipocyte and the percentage of empty bone lacuna gradually increased (P<0.00). The area of trabecular bone in the model group was lower than that in the control group, and the area of trabecular bone decreased gradually with the increasing of training time (P< 0.00). The expression of Runx2, Osterix protein and gene in the model group was lower than that in the control group. With the extension of time, the expression level decreased gradually (P<0.05). The expression level of MMP-13 protein and gene in the model group was higher than that in control group. With the extension of time, the expression level increased gradually (P<0.05).　Conclusions　The mRNA and protein expression level of Runx2, Osterix in steroid-induced osteonecrosis of femoral head is lower than that in normal femoral head tissue and the mRNA and protein expression level of MMP-13 is higher than that in normal femoral head tissue. Reference | Related Articles | Metrics | Comments（0） Select Spermidine alleviates acute lung injury induced by lipopolysaccharide in mice SU Qing, CAO Li, PENG Zhuo, LI Qi, YI Liu-xiang, GUO Xian-xian, LIU Fang-ting, SUN Guo-ying Chinese Journal of Clinical Anatomy    2020, 38 (1): 62-66.   DOI: 10.13418/j.issn.1001-165x.2020.01.013 Abstract （408）            Knowledge map    Save Objective  To observe the effects of spermidine on acute lung injury (ALI) induced by lipopolysaccharide (LPS).  Methods  ALI mice model was established by intratracheal drip of LPS ( 5 mg/kg ) . Effects of spermidine on respiratory function of ALI mice were detected by small animal ventilator, the effects of spermidine on lung tissue morphology of ALI mice were observed. The total protein, total cell number and neutrophil number in bronchoalveolar lavage fluid (BALF) of ALI mice were detected, and the level of myeloperoxidase (MPO) was tested. The expression of TREM-1 mRNA in lung tissue of ALI mice was detected by qPCR, and the protein level of sTREM-1 in BALF of ALI mice was measured by ELISA.  Results  Spermidine could improve the respiratory function of ALI mice, alleviate LPS-induced lung pathological damage, decrease protein exudation and neutrophil infiltration, and reduce the expression of TREM-1, an inflammatory amplification receptor in the lungs of ALI mice.  Conclusions  Spermidine may reduce the infiltration of inflammatory cells, inhibit the expression of inflammatory factors and alleviate LPS-induced ALI. The mechanism may be related to the inhibition of TREM-1 expression in lung tissue of ALI mice by spermidine. Reference | Related Articles | Metrics | Comments（0） Select Clinical analysis of a 3D-printing technique assisted with opening wedge high tibial osteotomy combined with arthroscopy in the treatment of knee varus deformity LIU Yang, LIANG Tao, ZHANG Lei, LIU Gang, YI Gang, GUO Xiao-guang, ZHOU Xin, FU Shi-jie Chinese Journal of Clinical Anatomy    2020, 38 (1): 67-72.   DOI: 10.13418/j.issn.1001-165x.2020.01.014 Abstract （205）            Knowledge map    Save Objective　 To investigate the clinical efficacy of 3D printing osteotomy guide plate assisted with opening wedge high tibial osteotomy (OWHTO) combined with arthroscopic debridement for treating knee varus deformity.　Methods　15 cases patients (16 knees) with knee varus deformity in orthopedics department of our hospital from January 2017 to May 2018 were analyzed retrospectively. 3D printing osteotomy guide plate was used to simulate OWHTO before operation. According to the ideal postoperative weight-bearing line (WBL), the osteotomy site, the osteotomy hinge, the height, the width, and the posterior tibial slope (PTS) were determined to fix the osteotomy. The preoperative and postoperative WBL, Lysholm score, PTS, and patella height index (Caton index) were compared.　Results　After 15 to 24 months of follow-up, the WBL changed from preoperative (19.27±1.55) % to postoperative (60.54±0.84) % (P<0.05). There was statistical difference between the WBL before operation and the WBL after operation. The 3D printing design before operation was (61.91±0.24) %, the PTS before operation and after operation were (10.01±2.89)°, (10.06±0.09)°respectively. There were no statistical difference between the preoperative and postoperative 3D printing design and the PTS. The Lysholm score of 1 year after operation was (82.31±1.22), before operation was (34.75±1.87), there was statistical significance between the Lysholm score of 1 year after operation and after operation.　Conclusions　3D-printing technique assisted with opening wedge high tibial osteotomy combined with arthroscopy can achieve accurate osteotomy, improve the weight-bearing line significantly, reduce intraoperative perspection, save operation time, it is a safe and effective treatment of varus knee deformity. Reference | Related Articles | Metrics | Comments（0） Select Clinical effect of different arthroscopic repairs on rotator cuff injury CHEN Wei-xiong, XUE Hou-jun, LIU Qing-hua, PAN Lei Chinese Journal of Clinical Anatomy    2020, 38 (1): 73-77.   DOI: 10.13418/j.issn.1001-165x.2020.01.015 Abstract （357）            Knowledge map    Save  Objective    To compare the clinical effects of arthroscopic total arthroscopy of rotator cuff repair and small incision rotator cuff repair on rotator cuff injury.    Methods    A study of 56 patients with rotator cuff injury treated in Sanshui District People's Hospital from February 2015 to December 2017 was retrospectively divided into two groups: an observation group (27 cases) and a control group (29 cases). The observation group was given arthroscopic rotator cuff repair under arthroscopy, the control group was given arthroscopic assisted small incision rotator cuff repair. The pain visual analogue scale (VAS), the American Elbow Surgeon (ASES), and the University of California, Los Angeles (UCLA) shoulder joint function scores, shoulder joint mobility, and shoulder joint muscle strength grading of the two groups patients were compared.   Results    After treatment, the observation group [VAS (1.14±0.28), ASES (91±5), UCLA (34.8±2.7)] was significantly better than the control group [VAS (1.36±0.43), ASES (88±5), UCLA (32.5±3.1)], the difference was statistically significant (t=2.250, 2.544, 2.956, all P<0.05). After treatment, the observation group [internal rotation (67±6)°, external rotation (45 ± 16)°, abduction (133 ± 12)°] was higher than the control group [internal rotation (64±5)°, external rotation (62±6)° and abduction (133±12)°], the difference was statistically significant (t=2.040, 2.027, 2.064, P<0.05); and the observation group [internal rotation (4.62±0.64), external rotation (4.81±0.62), abduction (4.87±0.56)] was superior to the control group [internal rotation (4.26±0.67), external rotation (4.47±0.60), abduction (4.51±0.62)], the difference was statistically significant (t=2.053, 2.085, 2.274, all P<0.05).   Conclusions  Arthroscopic total arthroscopic rotator cuff repair is more effective in the treatment of rotator cuff injury, which has rapid postoperative recovery and high value in promotion and application. Reference | Related Articles | Metrics | Comments（0） Select Effect of Huaier granule combined with postoperative chemotherapy on recurrence and survival after curative resection of colorectal liver metastasis HUANG Liang, HU Huan-xin, LUO Shuang-ling, LIN Hong-cheng Chinese Journal of Clinical Anatomy    2020, 38 (1): 78-82.   DOI: 10.13418/j.issn.1001-165x.2020.01.016 Abstract （966）            Knowledge map    Save Objective　To investigate the clinical effects of Huaier granule combined with postoperative chemotherapy on recurrence and survival after curative resection of colorectal liver metastasis (CLM).　Methods　One hundred and twenty-eight patients with CLM who underwent curative resection at the sixth affiliated hospital, Sun Yat-sen University from January 2012 to December 2017 were followed up and analyzed retrospectively. Patients were divided into two groups according to the postoperative adjuvant therapy schedule. An experimental group: Huaier granule combined with chemotherapy (72 cases); a control group: only chemotherapy (56 cases). The following variables of two groups were analyzed: gender, age, carcinoembryonic antigen (CEA) lever, tumor depth, N stage, size of liver metastases, number of liver metastasis, chemotherapy before operation. The patients were followed up to November 2019. The followed up data were used to calculate the survival rate, and analyze the univariate factor and multivariate factor which affecting recurrence and long-term survival.　Results　The perioperative chemotherapy completion rate of the experimental group was higher than that of the control group. The 3-year and 5-year overall survival rates of the experimental group and the control group were 83.5%, 60.7% and 65.3%, 48.2%, respectively, with a significant difference (p=0.015).The recurrence free survival rates of the two groups were 77.8%, 53.5%, 59.7% and 35.7%, respectively, with a significant difference (p=0.003). Univariate and multivariate analysis showed that CEA level, lymph node metastasis, number of liver metastases and chemotherapy with perioperative completion affecting the postoperative recurrence of patients with CLM, primary tumors with lymph node metastasis, the number of liver metastases and Huaier Granule therapy affecting the overall survival.　Conclusions　The recurrence and overall survival of CLM after radical resection depend on the tumor burden and chemotherapy. The patients with single liver metastasis, no-lymph node metastasis and Huaier Granule combined with adjuvant chemotherapy, may have long-term survival. Reference | Related Articles | Metrics | Comments（0） Select Imaging comparison of two kinds of die-punch fractures of the distal radius DING Ling, TANG Wen, GAO Hui-qiu, YANG Ying, RUI Yong-jun, GU San-jun, YIN Qu-dong Chinese Journal of Clinical Anatomy    2020, 38 (1): 83-87.   DOI: 10.13418/j.issn.1001-165x.2020.01.017 Abstract （916）            Knowledge map    Save Objective　To investigate the characteristics and differences of two kinds of die-punch fractures of the distal radius on imageology.　Methods　Images and clinical data of 498 cases with die-punch fractures of the distal radius from January 2007 to January 2016 were studied. According to the “three-column theory” and the location of fractures involved, die-punch fractures were divided into a single-column fracture and a double-column fracture. The differences in incidence, age, gender, treatment method and functional recovery between the two kinds of die-punch fractures were compared.　Results　The incidence, mean age and excellent and good rate of functional recovery of single-column fractures were 15.66%, 35.42 years old and 96.15% respectively, while as 84.34%, 54.69 years old and 80.00% respectively for double column die-punch fractures, showing significant differences between the two groups (P=0.000); the male or female ratio was 48/30, the operation or conservation ratio was 62/16 of single-column die-punch fractures, while as 223/197 as the male or female ratio and 344/76 as the operation or conservation ratio for double-column die-punch fractures, respectively, showing no significant differences between two groups (P=0.169 and P= 0.613 respectively).　Conclusions　Die-punch fractures of the distal radius are fractures resulting from an axial load through the lunate to the lunate fossa. However, due to different nature and size of violence, different position of wrist when injured and different bony quality of patient, resulting single-column and double-column die-punch fractures, which making significant difference in category and classification, degree of severity, occurrence mechanism, violence nature and level, incidence, age and prognosis of the fractures.  Reference | Related Articles | Metrics | Comments（0） Select The clinical application values of magnetic resonance T2-Mapping imaging in myocardial damage in patients with respiratory failure LIU Zhen-hua, YANG Li, AO Feng, Hu Pei, ZENG Zhao-jun, ZHANG Zi-li Chinese Journal of Clinical Anatomy    2020, 38 (1): 88-91.   DOI: 10.13418/j.issn.1001-165x.2020.01.018 Abstract （578）            Knowledge map    Save 目的　探讨磁共振T2-Mapping成像对呼吸衰竭患者心肌损害的临床应用价值。  方法　选择2016年8月到2018年12月本院内科诊治的呼吸衰竭患者122例作为研究组，同期无呼吸衰竭病史的78例内科患者作为对照组。所有患者给予超声心动图与磁共振T2-Mapping成像，记录成像参数并进行相关性分析。  结果　衰竭组的DT值高于对照组（P<0.05）；两组E/A与Pulmonary S/D ratio值对比无统计学差异（P>0.05）；两组心磁共振图像质量Ⅲ级与Ⅳ级分别占比80.3%、9.8%和76.9%和12.8%，对比均无统计学差异（P>0.05）；衰竭组短轴位与长轴位的左心室前壁、后壁T2值均大于对照组（P<0.05）；衰竭组患者中，Pearson相关性分析显示短轴位、长轴位的左室前壁、后壁T2值与DT值均呈正相关性（P<0.05）。  结论　磁共振T2-Mapping成像能反映呼吸衰竭患者心肌损害情况，通过定量评估心肌T2值可有效评估左心室心肌功能，对指导临床治疗方案的抉择和预后判断具有重要作用。 Reference | Related Articles | Metrics | Comments（0） Select Surgery for urinary calculi during pregnancy and report of 26 cases ZHANG Ji-qing, XIA Jian-jun, ZHU Hui-dong, YANG Ming, PENG Qiu-ping, ZHANG Jun-hui Chinese Journal of Clinical Anatomy    2020, 38 (1): 92-96.   DOI: 10.13418/j.issn.1001-165x.2020.01.019 Abstract （395）            Knowledge map    Save Objective    To  improve clinicians' understanding,  clinical diagnosis and treatment of urinary calculi during pregnancy.　Methods　The clinical data of 26 patients with urinary calculi during pregnancy from April 2017 to May 2019 were analyzed retrospectively. Patients’ median age was 29.5 (23~39) years, pregnancy time was 24 (11~33) weeks and stone diameter was 10.5 (5~20) mm. The 19 cases of ureteral stent placement were set on the first operation, 2 cases of percutaneous fistulation, and 5 cases of direct ureteroscopy.    Results   5 cases were replaced ureteral stent and till postpartum regularly and 2 cases were changed nephrostomy tube regularly. Definite calculi surgical treatment was successfully performed in 19 cases. Semi-rigid ureteroscopy (URS) was performed in 4 cases, flexible ureteroscopy (FURS) in 6 cases, miniPCNL in 7 cases, microperc in 2 case, respectively. Hospital stay of FURS was shorter than that of miniPCNL , 3（3~5）days vs 5（4~6）days，P<0.05 , while the operation time of miniPCNL was shorter 50 (40~60) min vs 35(30~60) min，P<0.05. There was no major urological and obstetric complications during and after operation.   Conclusion   Definite calculi treatment can improve the quality of life during pregnancy and avoid reoperation after postpartum. Reference | Related Articles | Metrics | Comments（0） Select Accuracy of ischiofemoral space as a diagnostic index for ischiofemoral impingement syndrome: a meta-analysis QIAN Lei, WANG Yi-ning, LIANG Wen-jie, FENG Zheng-kuan, MA Dong, OUYANG Jun Chinese Journal of Clinical Anatomy    2020, 38 (1): 97-101.   DOI: 10.13418/j.issn.1001-165x.2020.01.020 Abstract （518）            Knowledge map    Save 目的　评价坐骨股骨间隙作为影像学诊断指标诊断坐骨股骨撞击综合征的准确性。 方法　检索Pubmed、Embase、CNKI、维普期刊及万方资源等数据库，获得坐骨股骨撞击综合征MRI影像学研究的中文文献，对国内已发表的相关研究进行异质性分析及发表偏倚、敏感性分析；采用逐一剔除相关研究的方法，降低纳入研究的异质性，分析最终保留的相关研究中坐骨股骨间隙值大小。 结果　共纳入16篇研究，包括1027例健康髋，828例IFIS患髋，所纳入研究存在较大异质性（I2=88.5%，P<0.001），进行发表偏倚和敏感性分析后，保留9篇研究，共352例健康髋，323例患髋，异质性检验I2=44.5%，P=0.072。9篇研究统计分析得到，IFIS患者的IFS均值为11.355 mm，标准误为0.503，95%可信区间为10.194~12.517 mm，健康志愿者的IFS均值为23.373 mm，标准误为0.362，95%可信区间为22.539~24.207 mm。 结论　MRI影像学中IFS作为诊断坐骨股骨撞击综合征的指标，因研究方法不同，其值的大小存在差异，更加标准化的测试和诊断方法有待进一步完善。 Reference | Related Articles | Metrics | Comments（0） Select The variations of origin of deep brachial artery and long head of right biceps: a case report SUN Liu-di, HU Bao-shi, ZHAO Yuan-hui, DU Yao-wu Chinese Journal of Clinical Anatomy    2020, 38 (1): 101-.   DOI: 10.13418/j.issn.1001-165x.2020.01.026 Abstract （413）            Knowledge map    Save Reference | Related Articles | Metrics | Comments（0） Select A case report of Bosworth fracture combined with dislocation and literature review  WU Ming-jie, WU Jia-chang, ZHENG Jie, FAN Xiao-hai, ZHOU Zhen-quan, LI Qing, XU Xiao, SANG Hong-xun Chinese Journal of Clinical Anatomy    2020, 38 (1): 102-105.   DOI: 10.13418/j.issn.1001-165x.2020.01.021 Abstract （274）            Knowledge map    Save Reference | Related Articles | Metrics | Comments（0） Select The applied study of protease etching in vascular casting of the retained tendon XIAO Zhao-ming, LI Ze-yu, LUO Bao-hua, LIU Chang, LI Zhong-hua, DAI Jing-xing, OUYANG Jun Chinese Journal of Clinical Anatomy    2020, 38 (1): 106-109.   DOI: 10.13418/j.issn.1001-165x.2020.01.022 Abstract （403）            Knowledge map    Save Objective　To enrich the clinical anatomical research methods related to tendon by using protease digestion technique to make vascular casting of retained tendon.　Methods　0.5%, 1.0%, 1.5% and 2.0% concentrations of protease mixture were used respectively to decompose palmaris longus muscle and the suitable basic concentration was selected. The forearm vascular casting specimens were filled with acrylic resin and perfused to make casting specimen. After the filler was coagulated, the forearm vascular casting specimens were soaked into the protease solution mixture with the 1.0 % initial concentration and then during the soaking period, 35 g of alkaline protease powder was added to the mixture every 24 h, after 5 days corrosion, the forearm vessel casting of  the retained tendon was made. Results　Through the decomposition of the palmar longus muscle tissue，we found that the protease solution mixture with a 1.0 % concentration  could decompose adequately muscle tissue before the tendon fractured. We found that the skin, adipose tissue and muscle tissue basically disappeared. Bones, tendons and cast blood vessels  well preserved, the skin, the source and distribution of blood supply in the superficial layer, tendon and muscle, the relationship between cast blood vessels and skin, superficial layer, tendon and muscle can be clearly observed.　Conclusions　Using 1.0 % protease mixture as the starting concentration and adding protease mixture with 50% of the alkaline protease powder every 24 h is an appropriate corrosion method for making the vascular casting of the retained tendon. The vascular casting of retained tendons is a new type of anatomical skill, can enrich the clinical anatomical research methods related to tendon. Reference | Related Articles | Metrics | Comments（0） Select Application research of artificial intelligence in medical image diagnosis LI Ding, WANG Yan-fang, LI Yong-xin, HUANG Wen-hua Chinese Journal of Clinical Anatomy    2020, 38 (1): 110-113.   DOI: 10.13418/j.issn.1001-165x.2020.01.023 Abstract （708）            Knowledge map    Save Reference | Related Articles | Metrics | Comments（0） Select An updated review of clinical anatomy of interfascial plane blocks in trunk LI Chun-yu, QIN Zhi-xiang, NIU Xiang-lan, LIU Yan, FAN Qin, CUI Ya-nan, XING Bai-chun, LI Qing-qing, JIA Jin-tai Chinese Journal of Clinical Anatomy    2020, 38 (1): 114-117.   DOI: 10.13418/j.issn.1001-165x.2020.01.024 Abstract （421）            Knowledge map    Save Reference | Related Articles | Metrics | Comments（0） Select Basic research on privileged sites and special types of perforator flap ZHENG He-ping Chinese Journal of Clinical Anatomy    2020, 38 (2): 121-122.   DOI: 10.13418/j.issn.1001-165x.2020.02.001 Abstract （375）            Knowledge map    Save Related Articles | Metrics | Comments（0） Select One case of variation of left median nerve  WANG Hong-bin, SUN Feng-gang, LI Feng-juan, ZHANG Chun-ju, WANG Hui, DUN Ai-she Chinese Journal of Clinical Anatomy    2020, 38 (2): 122-.   DOI: 10.13418/j.issn.1001-165x.2020.02.030 Abstract （395）            Knowledge map    Save Reference | Related Articles | Metrics | Comments（0） Select Anatomical study of the buccal mucosal flap based on the facial artery perforator for reconstruction of lacrimal duct WEI Xu-dong, LIN Neng-ben, LI Xiao-jing, NING Jin-long Chinese Journal of Clinical Anatomy    2020, 38 (2): 123-126.   DOI: 10.13418/j.issn.1001-165x.2020.02.002 Abstract （174）            Knowledge map    Save Objective　To provide anatomical basis for reconstructing the lacrimal duct by the buccal mucosa flap based on the facial artery perforator.　Methods　20 sides of 10 adult head specimens were perfused with red latex and were dissociated to observe the following contents: ①The origin, branches and distribution of the facial artery perforators; ②The origin, branches and distribution of the buccal artery. ③The anastomosis of the facial artery and the buccal artery. In addition, mimic operation design was performed on one side of the fresh specimen.　Results　The blood supply of the buccal mucosa was multi-source, which was mainly composed of the perforating branches from the facial artery, buccal artery and posterior superior alveolar artery. ① The facial artery commonly arose from the external carotid artery, then crossed over the mandibular bone at the front edge of the masseter muscle and arrived at the face, and finally ran obliquely towards the medial canthus to anastomose with the dorsal nasal artery. The facial artery sent out several branches to nourish the neck region and face region on its way. It also sent out 1~3 buccal branches at (1.10 ± 0.31) cm lateral to the angulus oris, innervating the buccal muscle and the front-middle part of mucosa and anastomosing with the buccal branches of buccal artery and the buccal branches of the posterior superior alveolar artery; ②The buccal artery originated from the pterygoid segment of the maxillary artery and ran anteriorly and inferiorly under the deep surface of the temporal muscle. It sent out branches, which distributed at the postero-middle part of the buccal mucosa, and anastomosed with the perforators of the facial artery. When the maxillary artery sent out thin and short buccal branches, the thick posterior superior alveolar artery buccal branches with a 5% occurrence rate  compensated them.　Conclusions　The buccal mucosal flap based on the facial artery perforator is abundant in blood supply and may become a supplement for the reconstruction of the lacrimal duct. Reference | Related Articles | Metrics | Comments（0） Select Anatomical basis of the dorsal perforating extended flap based on the palmar artery at the site between the thumb and the index finger  WANG Tian-quan, HU De-qing, LIN Hai-qing, WEN Fu-li, XUE Lai-en Chinese Journal of Clinical Anatomy    2020, 38 (2): 127-130.   DOI: 10.13418/j.issn.1001-165x.2020.02.003 Abstract （650）            Knowledge map    Save Objective　To explore the morphological characteristics of the dorsal perforators from the palmar artery at the site between the thumb and the index finger, and provide the anatomical basis for the design of the dorsal perforator flap based on the palmar artery.　Methods　Thirty adult upper limb specimens injected with red latex were dissociated to observe the following contents by means of vascular cast and macro-micro-anatomy: ①The origin, courses and distribution of the dorsal nutrient vessels at the site between the thumb and the index finger; ②The anastomotic characteristics of the dorsal perforators of the palmar artery and the dorsal vessels at the site between the thumb and the index finger. One fresh specimen perfused with red latex was performed as a mimic operation.　Results　The blood supply at the site between the thumb and the index finger was multi-sources, which was provided by the dorsal perforators from the palmar artery (the radial palmar digital artery of the index finger and the ulnar palmar digital artery of the thumb) and the branches from the dorsal artery (the first dorsal metacarpal artery). ①The first dorsal metacarpal artery constantly originated from the radial artery and ran in the first metacarpal bone interval, and finally divided into three terminal branches: radial branch, ulnar branch, and intermediate branch，accompanied with homonymous dorsal digital cutaneous nerve from the superficial branch of radial nerve. ②The palmar artery sent out the radial, ulnar, and intermediate perforators towards the dorsum, which formed constant anastomosis with the branches of the first dorsal metacarpal artery to nourish the dorsal skin.　Conclusions　The dorsal perforator flap based on the palmar artery at the site between the thumb and the index finger possessed cross regional blood supply and could be transposed to repair the defects in the proximal part of the index finger, the thenar region, as well as the thumb. Reference | Related Articles | Metrics | Comments（0） Select Anatomical study of the V-Y advancement flap based on the cubital fossa perforators HU De-qing, ZHOU Xiao, CHEN Peng, ZHANG Wen-ming Chinese Journal of Clinical Anatomy    2020, 38 (2): 131-134.   DOI: 10.13418/j.issn.1001-165x.2020.02.004 Abstract （627）            Knowledge map    Save Objective　To investigate the morphological characteristics of the cubital fossa perforators, providing anatomical basis for restoring the antecubital defects by using the V-Y advancement flap based on the cubital fossa perforators.　Methods　30 sides of adult cadaveric upper extremities were collected to perform red latex perfusion, macro-micro-anatomy, and mimic operation. The following contents were observed under a surgical magnifier: ①The morphology of the cubital fossa; ②The origin, branches, and distribution of the cubital fossa perforators. ③The anastomosis of the cubital fossa perforators and the peripheral rete  vasculosum.　Results　①The cubital fossa was a triangle lacuna in the anterior aspect of the elbow, which was a passing portal for antebrachial vessels and nerves. ②The blood supply for the skin of the cubital fossa was multi-source, which was commonly composed of the brachial artery and the perforators from the branches of the brachial artery. The perforators had a large variation and could be classified into three types according to the number and outer diameter: A. Thick and concentrated type (13/30, accounting for 43.33%): this type had 1 perforator (inferior cubital artery) with an average outer diameter of 0.6~1.2 mm. B. Tiny and dispersive type (11/30, accounting for 36.67%): this type had 3~4 perforators with an average outer diameter of 0.3~0.6 mm; C. Moderate and balanced type (6/30, accounting for 20%): this type had 2 perforators with an average outer diameter of 0.4~0.7 mm; ③ The perforators punctured out of the deep fascia along either side of the cutaneous antebrachial lateralis nerve or cephalic vein towards the antecubital skin, which also anastomosed with each other and with adjacent vessels to form the fascial vascular network of cubital fossa.　Conclusions　The V-Y advancement flap based on the cubital fossa perforators could become a good supplement for restoring the antecubital defects. Reference | Related Articles | Metrics | Comments（0） Select Anatomical study of the semimembranosus popliteal perforator flap HU De-qing, ZHOU Xiao, CHEN Peng, ZHANG Wen-ming Chinese Journal of Clinical Anatomy    2020, 38 (2): 135-137.   DOI: 10.13418/j.issn.1001-165x.2020.02.005 Abstract （582）            Knowledge map    Save Objective　To explore the anatomical characteristics of the semimembranosus popliteal perforators, providing morphological basis for the reconstruction of soft tissue defects around the knee joint. Methods　After 30 sides of adult lower extremity specimens were perfused with red latex,  the following contents were observed emphatically under a surgical magnifier：①The origin, courses, branches, and distribution of the nutrient vessels of the semimembranosus muscle. ②The anastomosis characteristics of semimembranosus popliteal perforators and adjacent perforators.　Results　The semimembranosus popliteal perforators, with an outer diameter of (0.7±0.3)mm and a length of (1.1±0.4)cm on average, commonly originated from the semimembranosus muscular branch at 13.5cm proximal to the tibial condyle, and then punctured out of the deep fascia towards the subcutaneous plane, and finally sent out numerous tiny vessels to form anastomosis with the direct cutaneous perforators of the popliteal artery as well as the medial popliteal cutaneous arteries.　Conclusions　The flap pedicled with the semimembranosus popliteal perforators could become a supplement for repairing the soft tissue defects around the knee joint in the form of transposition or V-Y advancement. Reference | Related Articles | Metrics | Comments（0） Select Anatomical study of the axillary hair-bearing perforator flap QI Rui-lin, LIN Hai-qing, XUE Lai-en, XIONG Zhi-gang Chinese Journal of Clinical Anatomy    2020, 38 (2): 138-141.   DOI: 10.13418/j.issn.1001-165x.2020.02.006 Abstract （88）            Knowledge map    Save Objective　To investigate the anatomical characteristics of the axillary fossa perforator, providing the hair-bearing perforator flap for reconstruction of the mons pubis defects.　Methods　30 sides of adult cadaveric specimens were managed by methods of red latex perfusion, macro-micro-anatomy. The following contents were observed emphatically: ①The origin, branches, and anastomosis of the axillary fossa perforators; ②The outer diameter and length of the axillary fossa perforators.　Results　There were three types of perforating vessels in the axillary region: the first cutaneous perforator of the thoracodorsal artery (occurrence rate: 96.7%), the first cutaneous perforator of the lateral thoracic artery (occurrence rate: 90%), and the direct perforator of the axillary artery (occurrence rate:93.3%), with an average original outer diameter of (1.2±0.3) mm, (1.2±0.2) mm, and (1.4±0.3) mm, respectively.　Conclusions　Due to the rich blood supply and constant anatomy, there was at least one cutaneous perforator to be taken as the vascular pedicle for the design of a hair-bearing perforator flap in this axillary region, which could be a supplementary choice for repairing the hairy skin defects caused by tumor radical resection, burns, as well as trauma and other reasons. Reference | Related Articles | Metrics | Comments（0） Select Clinical anatomy of the pubic hair-bearing perforator flap LIN Hai-qing, QI Rui-lin, XUE Lai-en, WEN Fu-li, XIONG Zhi-gang Chinese Journal of Clinical Anatomy    2020, 38 (2): 142-145.   DOI: 10.13418/j.issn.1001-165x.2020.02.007 Abstract （545）            Knowledge map    Save Objective　To investigate the anatomical characteristics of the perforating vessels in the pubic area, providing anatomical basis for reconstruction of soft tissue defects in the maxillofacial hairy region.　Methods　30 sides of adult cadaveric specimens (18 sides of male, 12 sides of female) were fixed by 10% formaldehyde conventionally, followed by managements of red latex artery perfusion, microscopic anatomy, and mimic operation. The following contents were observed: ①The origin, course, branch, and distribution of the perforating vessels in the pubic area; ②The anastomosis of the perforators in bilateral pubic area.　Results　The skin blood supply of the pubic region was mainly provided by the superficial external pubic artery, which originated from the femoral artery, and then bifurcated into the superior branch and the inferior branch when arriving at the terminal segment of the great saphenous vein. The superior branch crossed over the inguinal ligament and entered into the pubic area, and finally anastomosed with the contralateral homonymous artery near the anterior midline. Along the way, it sent out cutaneous branches to nourish most of the hairy skin in the pubic area. The inferior branch entered into the pubic proparea horizontally and sent out branches to nourish the medial-superior thigh, the pubic proparea and the scrotum (labium). The average starting outer diameter of the superior branch and the inferior branch were (1.2±0.2) mm and (1.1±0.3) mm, respectively.　Conclusions　The pubic area was abundant and reliable in blood supply, which allowed to design a hair-bearing perforator flap based on the superficial external pubic artery for reconstruction of skin and soft tissue defects in the maxillofacial hairy region. Reference | Related Articles | Metrics | Comments（0） Select Design and clinical application of anterior malleolus perforating extended flap WANG Zheng-li, ZHANG Tian-hao, WANG Zhi-jiang, LIN Jian Chinese Journal of Clinical Anatomy    2020, 38 (2): 146-149.   DOI: 10.13418/j.issn.1001-165x.2020.02.008 Abstract （645）            Knowledge map    Save Objective　To investigate the anatomical basis and clinical efficacy of the anterior malleolar perforator flaps, so as to provide a supplementary choice for repairing the soft tissue defects of ankle and foot.　Methods　15 cases of foot and ankle defects were repaired to use the anterior malleolar perforator flaps, which were designed based on the anatomical study of the anterior malleolar perforator flaps, the size and shape of the wound defects. The size of the flaps ranged from 4.0 cm×3.5 cm to 15.0 cm×6.0 cm.　Results　All the flaps survived successfully except for 1 case which appeared necrosis at the distal edge of flap and healed after dressing change. After a follow-up of 3 to 24 months, the flaps presented an excellent appearance and color and the donor sites healed without any ulcer, meanwhile, the function of weight-bearing walking was good.　Conclusions 　Four types of perforator flaps or a perforating extended flap could be designed based on the anterior malleolar perforating vessels which were constant and reliable in blood supply．The anterior malleolar perforator flaps might become a desirable choice for the repair of soft tissue defects in ankle and foot. Reference | Related Articles | Metrics | Comments（0） Select Clinical application of the first metatarsal proximal perforator-based neurocutaneous vascular flap ZHANG Fei, LIN Jian, HONG Xu, LIN Hai-qing, XUE Lai-en, ZHENG He-ping Chinese Journal of Clinical Anatomy    2020, 38 (2): 150-152.   DOI: 10.13418/j.issn.1001-165x.2020.02.009 Abstract （560）            Knowledge map    Save Objective　To explore the clinical efficacy of the first metatarsal proximal perforator-based neurocutaneous vascular flap for repairing the forefoot soft-tissue defects.　Methods　From March 2014 to November 2019, eight patients with forefoot defects were reconstructed by the first metatarsal proximal perforator-based neurocutaneous vascular flaps with an average size from 6.0 cm×4.9 cm to 3.0 cm×2.1 cm.　Results　All flaps survived completely and the donor sites healed uneventfully. After a follow-up of 3 to 12 months, the flaps presented an excellent texture, a fine elasticity, and a similar skin color. And the patients were satisfied with both the functions and appearances of the donor and recipient regions.　Conclusions　Due to the good and reliable blood supply and the simple and practical surgical procedure, the first metatarsal proximal perforator-based neurocutaneous vascular flap might become a new choice for the repair of forefoot soft-tissue defects. Reference | Related Articles | Metrics | Comments（0） Select Clinical application of posterior interosseous artery bilobate flap in repairing hand skin defect ZENG De-qing, JIANG Ji-yong, WANG Qing-hong, YU Chun-bin, ZHONG Shao-kai, LU Wen-jing, LI Pei, WANG Hai-wen, GU Rong Chinese Journal of Clinical Anatomy    2020, 38 (2): 153-156.   DOI: 10.13418/j.issn.1001-165x.2020.02.010 Abstract （573）            Knowledge map    Save Objective　To investigate the clinical effects of posterior interosseous artery bilobate flap on repairing multiple or large skin and soft tissue defects of the hand.　Methods　4 cases of multiple skin and soft tissue defects and 5 cases of large area skin and soft tissue defects, who were treated with forearm posterior interosseous artery bilobate flap transformation from March 2011 to December 2018, were selected. All patients' wounds were accompanied by deep tissue exposure. The cutting area of flap was 4.5 cm× 5.5 cm ~ 7.0 cm× 9.0 cm in size and the donor area was directly stitched together.　Results　All flaps survived successfully. Four patients were followed up for 2 months to 2 years, with an average of 10 months.  Among them, 2 patients had overstaffed flap and underwent flap plasty half a year after operation. The flap had a good texture and the skin color was similar to the recipient area. The two-point discrimination perception of the  flap was 11~20 mm, with an average of 14 mm. The wrist joint function was not affected.　Conclusions　The application of posterior interosseous artery bilobate flap in repairing hand skin defects has the advantages of no damage to forearm main blood vessels, constant vascular anatomy, simple and convenient cutting, high survival rate, direct suture of part of donor site, similar color and texture compared with recipient site, good late function, which was an ideal method to repair hand skin defects. Reference | Related Articles | Metrics | Comments（0） Select Anatomical study and significance of the middle temporal vein in Chinese population SONG Li-ling, SONG Hui-min, SUN Ya-zhen, HAN Ke-xin, LV Hai-lin, LUO Peng, XU Yun Chinese Journal of Clinical Anatomy    2020, 38 (2): 157-159.   DOI: 10.13418/j.issn.1001-165x.2020.02.011 Abstract （1661）            Knowledge map    Save Objective　To study the anatomical characteristics and mark of the middle temporal vein(MTV), providing anatomical basis for clinical application.　Methods　Twenty-six（ 12 cases on the left , 14 cases on the right ）human head specimens perfused with 10% formalin solution were collected, and the middle temporal vein and its tributary were dissected. The distribution of the MTV was observed. The distance from the trunk of the MTV to each anatomical landmark and pipe diameter were measured. The number of tributaries was accounted. The difference between the left side and right side was compared.　Results　All specimens had middle temporal veins, with an average trunk diameter of 2.91 mm (0.72~5.88 mm), had 0~7 tributaries , with an average tributary diameter of 2.05 mm (0.54~5.30 mm). There were 2 levels of tributary in 1 case (accounting for 3.8 %). The locations of the confluence points that the trunk merging into the superficial temporal vein were not exactly the same. The high confluence points were located at the root of the zygomatic arch in 11 cases (accounting for 42.3% ) and the low were at the lower edge of the zygomatic arch 9.02~21.00 mm.  Trunk had three types according to the distribution: ① 14 cases of classic type (accounting for 53.8%) ② 8 cases of split aggregation type (accounting for 30.8%) ③ 4 cases of right-angled type (accounting for 15.4%). The average vertical distance from the turning point to the interior edge of the tragus was 18.69 mm. The mean distance of the left side from the trunk to the midpoint of zygomatic arch, the junction of the orbital outer edge and the zygomatic arch, the outer canthus, and the outer end of eyebrow were (17.23±7.29)、(18.82±9.00)、(21.14±6.96)、(9.62±8.87) mm respectively and the right of those  were (17.28±5.74)、(18.34±7.63)、(19.40±6.98)、(8.17±5.53) mm respectively. The corresponding mean diameter of the vein in the left were (3.75±1.63)、(3.34±1.00)、(3.08±1.18)、(2.81±1.23) mm respectively, the right were (4.29±2.93)、(2.90±1.29)、(2.89±1.20)、(2.57±1.21) mm respectively. There were no statistical difference between the left side and the right side.　Conclusions　The anatomical knowledge of the middle temporal vein is of crucial importance for  reconstructive scalp surgery in the temporal region. Reference | Related Articles | Metrics | Comments（0） Select Anatomical basis of the morphology and blood supply of the capitate bone WU Huan, XU Yong-qing, LUO Hao-tian, FAN Xin-yu, HE Xiao-qing, ZHANG Xu-lin, ZHAO Wan-qiu, XU Yu-jian, YUAN Li-bo Chinese Journal of Clinical Anatomy    2020, 38 (2): 160-165.   DOI: 10.13418/j.issn.1001-165x.2020.02.012 Abstract （1655）            Knowledge map    Save Objective     To provide the anatomic basis for the clinical treatment of advanced Kienb?ck disease by transposition of the capitate bone through observing the morphology of the capitate bone and blood supply pattern and exploring the mechanism of avascular necrosis of the capitate bone.  Methods 　Twelve fresh wrist joint specimens were selected, gelatin-lead oxide solution was perfused from the ulnar artery or radial artery. After scanned by Micro-CT, the image was reconstructed by Mimics software to observe the morphology of the capitate bone and the main blood supply source. The length, width, thickness of the capitate bone and lunate bone and diameter, arc length, arc height of the proximal joint surface were measured. The number and distribution of the capitate bone nourished blood vessels were recorded, and the relevant data were statistically analyzed. 　Results　(1) There were 9 cases of F-shaped capitate bone (accounting for 75%), and 3 cases of S-shaped (accounting for 25%); (2) Blood supply of capitate bone originated from the volar surface and the dorsal surface, with the dorsal surface mainly; (3) Compared the length, width, thickness, the diameter, arc length and arc height of the capitate bone and the lunate bone, there were  significant correlation among them; (4) The nourishing vessels of the capitate bone were distributed at 2.2mm from the base, the number of nourishing vascular foramina on the distal pole was more than that of the proximal pole, the difference was statistically significant (P<0.05).　Conclusions　The proximal capitate bone is mainly dominated by the distal retrograde blood supply, which is the main cause of avascular necrosis in the capitate bone. It is feasible to treat  the advanced Kienb?ck disease by transposition of the capitate bone. Reference | Related Articles | Metrics | Comments（0） Select Feasibility study of axial laminar screw fixation in children aged 1~6 years LI Kun, LI Zhi-jun, ZHANG Shao-jie, WANG Xing, LI Xiao-he, GAO Shang, CHEN Jie, HE Yu-jie Chinese Journal of Clinical Anatomy    2020, 38 (2): 166-170.   DOI: 10.13418/j.issn.1001-165x.2020.02.013 Abstract （503）            Knowledge map    Save Objective　To investigate the feasibility of axial lamina fixation with 3.5mm screw in children aged from 1 to 6 years.　Methods　The original CT data of 45 children aged from 1 to 6 years old were collected into three groups of A, B and C. The age difference of children in each group was within 2 years old . The CT data were 3D- reconstructed to measure the following parameters: the width of upper edge, middle edge, lower edge of the lamina, the height and length of the lamina, the obliquity and the inclination of the lamina.　Results　With the increasing of age, the indexes of lamina were on the rise. The main factors limiting axial lamina screw placement were lamina midline width (LWM) and distance from the entering point to the lamina outer edge (ELE). The LWM  of the A group, the B group and the C group was (4.69±0.45) mm, (7.13±1.61)  mm; (7.72±1.28) mm ,respectively. The ELE of the A group, the B group and the C group was (15.44±6.98) mm, (23.67±1.86) mm, (27.75±2.39) mm, respectively. In the simulation of lamina screw placement, the entering point of the A group, the B group and the C group was the junction of the right and left branches of the ipsilateral spinous process, the middle edge of spinous process branch on the opposite side of vertebral plate where the screw was located,  the upper edge of spinous process branch on the opposite side of the vertebral plate where the screw was located, respectively.　Conclusions　It is feasible to insert 3.5 mm screw in the axial lamina of children aged 1 to 6 years, but the screw placement method should be different according to the age. Reference | Related Articles | Metrics | Comments（0）