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Chinese Journal of Clinical Anatomy
(Founded in July 1983 Bimonthly)
Responsible Institution: China Association for Science and Technology
Sponsor: Chinese Society of Anatomical Sciences
Editing and Publishing: Editorial Board of Chinese Journal of Clinical Anatomy
Advisor: ZHONG Shi-zhen
Editor-in-chief: OUYANG Jun
Former Editor-in-chief: XU Da-chuan
Overseas Distributor: China International Book Trading Corporation (P.O. Box 399, Beijing, China, Code No. BM5961)
Address: 1023 Shatainan Road, Guangzhou, 510515, China
Tel: (020)61648203
E-mail: journal@chjcana.com
CN: 44-1153/R
ISSN: 1001-165X

Table of Content

    25 December 2009 Volume 27 Issue 6
      
    Surgical strategies on the distal anterior cerebral artery aneurysms through interhemispheric approach: anatomic study
    WANG Yu-Hai- Wang-Chun-Chi- Ca-Hua-Jian- Shu-Jun- Yang-Li-Kun- Feng-Yi- Jin-Dong
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  635. 
    Abstract ( 2384 )  
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      Objective: To present a surgical strategy dealing with the distal anterior cerebral artery aneurysm(DACAA) by the microanatomy of distal anterior cerebral artery, focusing especially on the relationship between the pericallosal artery (PerA) and callosomarginal artery (CMA) located in the lower half of the A3 (infracallosal) segment. Methods: The microsurgical anatomy of the distal anterior cerebral artery region was examined on 20 adult cadaveric cerebral hemispheres after perfusing of the arteries and veins with colored silicone. The relationships of the infracallosal segment of the PerA to the CMA and the A2 segment of the PerA to the frontopolar artery were examined. The distance between the nasion and the site at which a parallel line directed along the long axis of the infracallosal PerA just proximal to the origin of the CMA artery crosses the forehead (which we have named the PC point) was also measured. In addition, the surgical approaches to DACAA were examined in stepwise dissections. Results: The pericallosal-callosomarginal artery junctions located at the supracallosal and infracallosal segments of A3 in accounting for 55 and 45% of cases, respectively. In the infracallosal region, it was difficult to gain proximal control of the artery with the tumor on it. The PC point was, on average, 31.52 mm and 34.64 mm away from the nasion in cadaveric cerebral hemispheres and T2RMRI, respectively. There was only a limited space in which to gain access to infracallosal DACAA below the PC point to establish proximal control by the anterior interhemispheric approach. Conclusions: When the approach is made above the PC point, an anterior callosotomy might be necessary to establish proximal control before final aneurysm dissection and clip placement is completed. The PC point is an important surgical landmark in planning the surgical strategy for treating infracallosal distal DACAA.

    Quantitative study of microsurgical anatomy in sellar region via the transpterional keyhole approach assisted by neuro-navigation
    MIAO Ceng-Li, LIN Yu-Chang, LU Xiao-Jie, XU  Nie, YAN Li-Wei, HONG  Jing, JIANG  Li
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  640. 
    Abstract ( 2300 )  
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      Objective: To explore quantitatively microsurgical anatomy in sellar region via the transpterional keyhole approach assisted by neuro-navigation. Methods: 15 silicone-injected adult cadaveric heads were dissected under operating microscope. The microstructures of sellar region were observed. The parameters of spaces ofⅠ,Ⅱ,Ⅲ,Ⅳ andⅤwere quantified by neuro-navigation. Results: The transpterional keyhole approach could expose five spaces very clearly. The areas of Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴspaces were (22.23±2.12)mm2,(63.42±7.84) mm2, (64.96±5.43) mm2,(26±5.85 )mm2, and(16.64±2.97 )mm2 respectively.  Bilateral optic nerve, optic chiasma, sellae diaphragma and stalk hypophysial, and controlateral internal carotid artery, ophthalmic artery and superior hypophysial artery were well observed. Transpterional keyhole approach was more advantageous to view the Ⅱ、Ⅲ andⅤspace, especially  the  exposure for PcoA and AchA. The bifurcation of A1、M1 and the course of oculomotornerve in cistern could be well observed through the Ⅱ、Ⅲ andⅤ space. Conclusions: The transpterional keyhole approach could well expose the interspaces in sellar region, which is reliable to view sellar and parasellar structures  through the Ⅱ、Ⅲ andⅤspace, as well the exposure of the origin and branches of PcoA and AchA.

    Anatomic investigation of modified operation for treating congenital torticollis
    CHAN Jian-Lin, JIANG , HENG , LI  Fang, SUN Tian-Qing, SHI Shu-Shan
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  644. 
    Abstract ( 3192 )  
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    【Abstract】 Objective: To improve the routine operation for treating congenital torticollis on the basis of characteristics of cervical fascia. Methods: 12 embalmed adult cadavers were used in this study. Anatomic relationship of the platysma muscle and the superficial layer of cervical fascia(envelope fascia) were dissected and observed. The envelope fascia were cut about 3cm longitudinally 1.5cm above the clavicle and 0.5cm medially to the medial boundary of the sternocleidomastoid muscle, and then, the lateral border of sternocleidomastoid were divided from the deeper of the posterior sheath of the muscle, for the exposure and observation of the deep layer of cervical fascia and carotid sheath. Results: The superficial layer of cervical fascia was intact and compact, which enveloped the sternocleidomastoid thoroughly and can be dissected from platysma muscle easily at the anterior part of the neck. At the middle and inferior part of the neck, the hind fascia sheath of the sternocleidomastoid can be separated from the carotid sheath easily. Conclusions: According to the anatomic features of cervical fascia, it's possible to improve the operation for treating congenital torticollis.

    Anatomy and imageology of the vertebral artery foramen and its adjacency of the lower cervical vertebrae
    LIAO Xu-Yu,  Yang-Qiang-Guo,  Hua-Xin-Yi,  Zhang-Yin-Shun,  Han-Chun,  Xie-Yang-Lin
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  647. 
    Abstract ( 2453 )  
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            Objective: To provide anatomic basis of the vertebral artery foramen for protecting vertebral artery during the lower cervical vertebrae operation. Methods:(1)Anatomic parameters of 20 C3~7 cervical specimens of human cadavers were measured and analyzed, including the interforaminal distance, the width of vertebral body and pedicle, the distance from medial border of transverse foramen to external border of vertebral body, from medial border of transverse foramen to internal and external borders of uncinate process, from posterior border of transverse foramen to posterior border of vertebrae, from anterior border of transverse foramen to anterior border of vertebrae, and the anteroposterior diameter of transverse foramen and vertebrae. (2)Under CT, above parameters were measured for 30 CSM patients and 50 normal people. Results:(1) From C3 to C7, the interforaminal distance, the width of vertebral body, sagittal diameter of vertebrae, sagittal diameter of transverse foramen gradually increased. (2)The distance between medial border of uncinate process and medial border of transverse foramen was within 6mm, and the distance from medial border of transverse foramen to external border of vertebrae in C3~6 was within 3mm. (3)From C3 to C6, the ratio of sagittal diameter of transverse foramen to sagittal diameter of vertebrae was constant(30.32%~31.86%), however, the distance from anterior border of transverse foramen to anterior border of vertebrae gradually decreased, whereas, the distance from posterior border of transverse foramen to posterior border of vertebrae gradually increased. Conclusions: Our anatomic study provides useful information for the prevention of vertebral artery injury during operation.

    Relationship of the mandibular canal with the mandibular posterior teeth and its clinical significance
    FU Sheng-Qi, FAN Ti-Yi, LIU Heng-Xin, LI Min, DOU Wen-An, MA Hui-Jiang, OU Yang-Jun
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  651. 
    Abstract ( 3184 )  
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    Objective: To provide anatomic basis for the mandibular dental implant operation of the clinical oral surgery. Methods: 10 fresh mandibles, 18 adult mandibles with total teeth and 20 volunteers without agomphosis were selected and exposed the inferior alveolar neurovascular bundle, the mandibular canal and the dental root of mandibular posterior teeth, scanned in series by CT,and then its three-dimensional image were reconstructed. The relationship of the inferior alveolar nerve with the inferior alveolar vessels were observed, the dental root of mandibular posterior teeth to the superior wall of mandibular canal was measured with vernier caliper and three-dimensional reestablish working station respectively. Results: The mandibular canal was traveling through the bottom of alveolar fossa. Its lingual side was thick, the inferior alveolar vessels were laid above the inferior alveolar nerve in the mandibular canal. The distance was near from the distal root of mandibular molar to the mandibular canal than that of the mesial root. The distance from the dental root of first premolar, second premolar, first molar, second molar, third molar to the superior wall of mandibular canal were 8.36±2.34 mm, 8.42±2.42 mm, 7.36±2.21 mm, 7.52±2.18 mm, 3.22±1.40 mm, 3.36±1.85 mm, 2.96±1.54 mm, 2.84±1.55 mm, 3.64±1.72 mm and 3.88±1.76 mm in specimen and imaging separately. Conclusions: (1) The distance from the second molar to the mandibular canal was the nearest than that of the others, it was the second molar, first molar, third molar, second premolar and first premolar from the near to the far. (2) It is significant for choosing appropriate length of dental implantation, which avoid the injury for the inferior alveolar nerve.

    Applied anatomy of the total hip arthroplasty through the minimally invasive posterolateral approach
    CHU Zong-Hua, GUO Chao, XU Wen-Lian, LI Hua-Jie, ZHANG Fa-Hui, ZHENG He-Beng
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  654. 
    Abstract ( 2619 )  
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            Objective: To provide anatomic evidences for minimally invasive surgery of total hip arthroplasty through the posterolateral approcach. Methods: Gluteal region of 30 adult specimens were dissected and observed. A line was drawn between the highest point of the greater trochanter of femur's lateral border (point A) and the point 3 cm ahead of the posterior superior iliac spine (point C), while the middle point of the AC line was taken as point B. The line between A and B was minimally invasive incision, with the length of 8.0 cm, for total hip arthroplasty through the posterolateral approach. The relevant anatomic features dealing with minimally invasive incision, including superior/inferior gluteal vessels and nerves and sciatic nerve were dissected and analyzed. Results: At the site of suprapitiform foramen, the distance between the superior gluteal vessels and nerves and the insicion was about (3.69±0.79)cm, however, at the site of infrapiriform foramen, the distance between the inferior gluteal vessels and nerves and the incision was (5.83±1.21)cm. The nearest distance from sciatic nerve to the incision below the infrapiriform foramen was about (4.09±0.66)cm. Conclusions: It is reliable to protect important nerves and vessels of gluteal area adopting minimally invasive posterior lateral approach. It is easy to locate bony markers during the operation.

    Internal fixation with reconstruction plate for anterior column fracture of the acetabulum: clinical anatomy
    LIU Zhao-Hua,  Wang-Da-Beng,   Xiong-Jian-Xi
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  658. 
    Abstract ( 3032 )  
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      Objective:To investigate geometric features of the acetabular anterior column, and provide basis for placing acetabular anterior column reconstruction plate. Methods: Fifteen adult pelvic specimens were harvested in this study. Serial cross-sections of the anterior column were performed and analyzed. Results: The shape of the transverse section of the anterior column from the obturator groove to the anterior superior iliac spine appeared as a subtriangle. The angle between the tangent line from the point about 10.0mm from the pelvic brim and the upside of the anterior column changed from (72.6±4.8)° to (44.6±4.7)°,and then enlarged to (82.4±3.2)°, however, the smallest angle neared to the iliopubic eminence. Conclusions: From the obturator groove to the anterior superior iliac spine,the thickness and the shape of the anterior column is different. Dealing the shape of transverse section as the triangle can help to judge the safe entry angle of inclination and the safe depth of the screw path.

    Cross-section anatomy of the rectovaginal septum (RVS)
    LIU Jin, DI Li-Dong, LI Yun-Sheng
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  663. 
    Abstract ( 2729 )  
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      Objective: To study the section anatomical features of the rectovaginal septum(RVS),  and provide anatomic basis for treating gynecologic and anorectal diseases. Methods: 10 adult pelvic specimens were sliced into continuous transverse sections with the thickness of 0.5mm after treating with celloidin, and then, anatomic observation were performed and analyzed. Results: ①The anterior surface of RVS closed to the posterior vaginal wall, which led to a wide anterior rectal space, therefore, RVS can be regarded as the anterior boundary of rectum vaginal space. ② RVS gradually narrowed and compacted from up downward. The upper part of RVS began from the bottom of rectovaginal pouch and closed to the posterior vaginal wall, while the lower part of it reached the perineal central tendon and mixed to it, which is the anatomic reason why rectocele easily occurred at the upper part of RVS. Conclusions: RVS is the key structure not only to support the vagina and rectum, but also to keep stability of pelvic cavity, which is weak on the upper part. The repair operation of rectocele should be concerning with the repair of the perineal body and surrounding ligments.

    Anatomy of fetal pancreaticobiliary
    CHEN  Feng, LV  Yi, HONG  Jian, HUANG Shun-Gen, WANG Xin-Dong
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  665. 
    Abstract ( 2313 )  
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      Objective: To investigate anatomic features of fetal pancreaticobiliary and duodenal papilla. Methods: 36 foetus with the fetal ages of 4 to 9 months, 6 hours after death by induction of labor with water bag, were studied. The gallbladder, common bile duct, pancreatic duct and duodenum of them were removed and preserved in 10% buffered formaldehyde solution for 24 hours. The location and shape of the greater duodenal papilla were observed, and then serial sections of the specimens, with the thickness of 6 μm, were performed and HE stained, and followed by the observation of the union of pancreatic and bile common ducts under the microscope. Results: 1) Major duodenal papilla showed the shapes of hemispheroid(58.1%), circular cylinder(25%) and applanation(16.9%), which located at the upper pars descendens duodenum (8.3%),the middle pars descendens duodenum(69.4%),the lower pars descendens duodenum(19.4%) or the farer(2.9%). 2)The types of pancreaticobiliary ductal union could be classified into four types: "Y" in 24 specimens(66.7%), "U" in 4 specimens(11.1%) ,"V" in 7 specimens(19.4%) and APBDU type in 1 specimens(2.8%). Conclusions: Pancreaticobiliary ductal union is variable and individual.

    The model of arterial vascular network of uterus with cervical cancer: the construction and its three-dimensional visualization
    OU Yang-Zhen-Bei, TU Yan-Gong, LIU  Ping, CHEN Chun-Lin, TANG Lei, LI Ze-Yu, HUANG Rui- , ZHONG Guang-Meng, LIANG Bei, QUAN Xian-Ti, LIU Chang, ZHONG Shi-Tian
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  668. 
    Abstract ( 2332 )  
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            Objective: To explore the method for constructing the model of vascular network of uterus with cervical cancer and discuss its clinical significance. Methods: A set of specimens, including uterus, vagina and uterine adnexa from a cervical cancer patient were infused with 15% perchloroethylene through the uterine artery and the ovarian artery, and then casted. The CT data of the specimen obtained before and after infusion were used to reconstruct 3D uterine arterial network, using the maximum intensity projection (MIP) and volume rendering (VR). Results:(1) The cast specimen and 3D model of uterine arterial vascular network can clearly display the major blood supply of diseased region. (2) The imaging features and anatomical structures of the uterine vascular network could be shown through different points of view on the reconstructed model.  Conclusions: It is an effective way to construct vascular network of uterus through vascular cast combined with CT scan. Basing on the uterine arterial vascular network of cervical cancer patient, we can understand the size of the lesion and its blood supply, which is useful for the diagnosis and treatment of cervical cancer.

    The bone architectures of distal fibula: anatomical features and clinical significance
    CHEN Zhen-Guang, ZHENG Xiao-Hui, DAO Ku-Xiang, YANG Yu-Hua, LIN Hai-Chao, KONG Jin-Song
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  672. 
    Abstract ( 4819 )  
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            Objective: To deepen the anatomical understanding on distal fibula and offer the reasonable evidences for clinical application. Methods: The morphologic features of the full length of fibula, emphasized on the distal one fourth, were studied and measured on 73 adult dry specimens of fibula (left 42, right 31). Results: The average full length of fibula was about(34.1±2.5)cm. The length from the bifurcate point on distal anterior border and the triangle tuberosity on distal medial surface to the tip of lateral malleolus were (8.5±1.2)cm and (5.9±0.8)cm respectively. The extraversion angle of the articular surface of lateral malleolus was (153.1±5.7)°.  Conclusions: (1) The bone architectues and their distinctive changes on distal 1/4 of fibula would give us a belief that the distal 1/4 of fibula could be defined as the lateral malleolus from broad definition. The bone defect on this segment is hard to be satisfactorily restored. (2) The harvested boundary of fibular flap should not be extended to the distal quarter.(3)The proximal migration of lateral malleolus is often observed on long term follow-up cases, especially in children. (4) The trans-fibular approach for ankle fusion is a convenient and reliable method.

    The posterior elbow vascular network and the flap design: anatomic study
    LUO  Bin
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  675. 
    Abstract ( 2245 )  
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            Objective: To investigate anatomic characteristics of the posterior elbow vascular network and its clinical discussion to the blood supply based flaps of the posterior elbow. Methods: Six fresh specimens and two injected upper limb were studied. Observations were emphasized on the posterior elbow vascular network and their connections with the blood supply based flaps of the posterior elbow. Results: The posterior elbow vascular network was abundant and formed by multiple source vessels, which were identified to the medial and the lateral vascular network of the posterior elbow. The diameter of the vascular network was 0.3~0.9 mm. Conclusions: According to the posterior elbow vascular network, different based flaps without the main vessels could be designed.

    Color-coded duplex sonography of cerebral bridging veins entering into superior saggital sinus
    CHEN Yong-Chao, DENG Xue-Fei, HAN Hui, LUO Fu-Cheng, LIAN Juan, CHEN Xun, ZHANG Ren-Pin
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  677. 
    Abstract ( 1862 )  
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      Objective: To observe the cerebral bridging veins (BVs) entering into superior saggital sinus (SSS) by color-coded duplex sonography, for provide new hemodynamic reference data for clinical application. Methods: Twenty patients undergoing selective craniotomy about one years and having a good recovery underwent color-coded duplex sonography. The number, diameter and angle of the BVs, the velocity of the SSS and BVs were measured through the surgical bone window. Results: The BVs formed two clusters along the SSS: anterior group and posterior group. The number of the anterior group BVs was (3.1±1.4), the diameter  (2.7±0.7) mm, the angle  (96±33)°, and the mean flow velocity  (10.0±2.8) cm/s. The number of the posterior group BVs was (5.8±1.0), the diameter  (3.2±1.2) mm, the angle  (41±24)°, and the mean flow velocity  (11.4±2.8) cm/s respectively. The number, diameter and the mean flow velocity of the posterior group BVs were larger than that of anterior group. Conclusions: The morphological feature and velocity of BVs entering into SSS can be measured through the surgical bone window under color-coded duplex sonography.

    Application of image postprocessing technique of multi-slice spiral computed tomography in dividing pulmonary segments in superior lobe of the left lung
    WANG Shou-An, ZHANG Zhao-Meng, LIU Shu-Wei, SUN Bo
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  681. 
    Abstract ( 2985 )  
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             Objective: To investigate the division method of pulmonary segments in superior lobe of the left lung in CT images. Methods: The MSCT images of 160 healthy males were reconstructed in a Volume Wizard Work Station. To investigate the division method of the superior lobe of the left lung, the branch numbers, the confluens types, and the distribution regularity of the pulmonary segmental and subsegmental veins were analyzed in CT images. Results: 1.The approximate occurrence rate of V1+2 was 71.2%, and V2+3 28.8%; V4 and V5 joining together into trunk (V4+5) was 61.2%, and the rate of them joining into left lung separately was 38.8%. 2.Trunk of V1+2, V1, external branch of V2, low-set V2, superior branch of V2, or apical branch of V2 can be the intersectional branches of anterior and apicoposterior segments. Inferior part of anterior branch, middle part, posterior part, anterointernal part, anteroleteral part of V3 can be the intersectional branches of superior lingular, and anterior segments. Apical branch of V3 was the intersectional branch of anterior and apicoposterior segments. V4 and trunk of V5 were the intersectional branches of superior and inferior lingular segments. Conclusions: Pulmonary segmental veins and their branches can be recognized well via the MSCT image postprocessing technique, which is helpful for the division method of pulmonary segments.

    Morphologic evaluation of pulmonary venous variations and pulmonary vein ostia with 64-slice spiral CT
    CHEN Guang-Xiang, QI Jun, TANG Guang-Cai, HE Xiao-Feng, HUANG Xin-Wen, GAO Li-Meng, LAN Yong-Shu
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  686. 
    Abstract ( 2929 )  
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      Objective: To document the variations in pulmonary venous drainage to the left atrium and the size and shape of pulmonary vein(PV) ostia adopting image skill. Methods: The data of one hundred and three patients without affecting PV disease were collected in this study. Pulmonary venous drainage patterns to the left atrium were analysed. The caliber of PV ostia were measured at workstation and venous ostial index(VOI) were calculated. Results: Most patients(n=81,78.6%) had four standard PVs. the caliber of the superior PV ostia was larger than that of the inferior PV ostia. The right superior PV ostia was larger than the left superior PV ostia and the right inferior PV ostia was larger than the left inferior PV ostia (P<0.05). The VOI of the right was larger than that of the left. The VOI between the left superior and inferior PV were similar (P=0.773>0.05) and the other data were different. The caliber of PV ostia in men was larger than that in women. The VOI between mem and women were similar (P>0.05). Conclusions: The PVs have great anatomic variations. There is significant variability in PV ostial caliber and shape. 64-slice spiral CT angiography can provide valuable information on pulmonary venous anatomy for ablation procedures and thoracic surgery.

    Study on 3D-reconstruction of hepatic artery based on 64-Slice Spiral Computed Tomography
    WANG Jian-Hua, ZHOU Ting-Yong, YANG Xin-Wen, LV Fa-Jin, ZHANG Ben-Shi, ZHANG Lin, DU Diao-Kang
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  690. 
    Abstract ( 2367 )  
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      Objective: To explore the feasibility of 64-Slice spiral computed tomography on presenting and reconstructing the shape and distribution of hepatic artery of living body. Methods: 153 cases underwent the upper abdomen 64 - MSCT scan. The test of the celiac levels of abdominal aorta was performed by the smart tracking technology (Smart Prep). The data was processed for imaging on the GE ADW4.2 workstations. Results: Hepatic arteries of 153 cases were classified by Michels standard as follows: ①type I, 80.4% (123 cases); ②type II, 2.0% (3 cases); ③type III, 2.6% (4 cases); ④type Ⅳ, 2.0% (3 cases); ⑤type V, 4.0% (6 cases); ⑥type VI, 1.3% (2 cases); ⑦type Ⅶ, 1.3% (2 cases); ⑧type Ⅷ: None; ⑨type IX, 2.61% (4 cases ); ⑩type X: None. In addition, 4.0% (6 cases) was difficult to judge adopting Michels classification. Conclusions: 64-Slice spiral computed tomography would be a useful skill to present anatomic features of hepatic artery, while 3D-reconstruction is valuable for demonstrating the distribution of hepatic artery during clinical application.

    The measurement, spatial stereotaxis and clinical significance of optical canal: Multi-slice spiral CT study
    YANG Qin-Tai, LI Feng, JU Yan, KANG Peng, CA Wei-Wei, LIU Xian, ZHANG Ge-Hua, LI Yuan
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  694. 
    Abstract ( 3182 )  
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      Objective: To investigate a accurate radiologic method for the measurement and spatial stereotaxis of optic canal. Methods:20 cadaveric skulls were scanned under Multi-slice spiral CT (MSCT) according to the baseline from nasal processus to clinoideus anterior. The imaging results of of optic canal and its adjacent structures were analyzed and compared with that of gross anatomy, for verifying the accuracy of the location of optic canal on CT. Results:①The scan plane from nasal processus to clinoideus anterior accorded with optic canal completely;②Locating mark of optic canal on MSCT images accorded with that of dissection results completely, which was all synchronously displayed by three-dimensional reconstruction images in the sagittal lateral wall of sinus;③The distances of orbital aperture to nasal columella, intracranial interior opening to nasal columella and the length of optic canal interior wall were (77.84±3.60)mm, (77.35±3.22)mm, (84.28±4.46)mm, (84.04±4.58)mm and (10.23±1.31)mm, (10.02±1.24)mm respectively. There was no significant difference for measured values between radiology and anatomy (P>0.05). Conclusions: By MSCT, the baseline from nasal processus to clinoideus anterior, and three-dimensional image workstations technology, we could precisely observe, measure and locate optic canal and it's adjacent structures.

    Anatomy and variations of hepatic portal vein: CT imaging and its clinical significance
    YAN Xiao-Beng, LI Cai-Yang, TIAN Xiao, LIANG An-Lu
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  698. 
    Abstract ( 3086 )  
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      Objective: To explore anatomic features and variations of intrahepatic portal vein adoting multi-slice CT. Methods: Enhancement scanning CT data of the portal and hepatic venous systems from 200 healthy volunteers were analyzed and classified according to their anatomic features, while, the parameters of portal system were analyzed quantitatively. Results:For all patients examined, the intrahepatic portal vein system of 163 patients (81.5 %) distributed normally, of 23 (11.5 %) , 13 (6.5 %) and 1 (0.5 %) appeared Ⅰ, Ⅱ and Ⅲ types of anatomic variations respectively, however, the absence of the horizontal segment of the left portal vein or right portal vein was not be observed. Dpv, Dsv and Dsmv had significant difference(P<0.05)between male and females. Conclusions:The anatomy and variations of the hepatic portal veins can be easily recognized under multi-slice CT portography(MSCTP).

    CT measurement and analysis of renal parenchyma volume of adult normal
    ZHANG Chi-Wang, WU Zhi-Feng
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  701. 
    Abstract ( 2558 )  
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      Objective: To decide 95% reference value of normal renal parenchyma volume(NRPV)in adults, and explore its relationship with the age, sexuality, body height and weight of the individual, and establish a simple formula for predicting NRPV. Methods: 200 cases without renal diseases underwent no-enhancement abdomen CT. Renal parenchyma volumes(RPV)obtained from CT data were measured adopting volume software. Result: 95% reference value of left,right and bilateral RPV were respectively (81.80, 166.66) cm3, (75.50, 168.64) cm3 and (160.57, 332.03) cm3 for women, and (102.57,193.71)cm3,(102.57,188.31)cm3 and(208.01,379.15)cm3 for men. There was no significant difference between left and right RPV between male and female (P>0.05), however, ipsilateral RPV value had statistical difference between male and female(P<0.001). There was no significant difference in the value of RPV among different age groups (P >0.05). Multiple linear regression analysis showed that RPV had linear regression relationship with height and weight, no relationship with age and sex. Using stepwise regression method can draw a formula: bilateral RPV (cm3)=3.264×body height(cm)+1.060×weight(kg)-335.909. Conclusions: The study suggests that NRPV in adult mainly relate to body height and weight, without direct relation to age and sex. There was no statistical difference between left and right RPV in adults. Bilateral RPV can be predicted by body height and weight regardless of age and sex.

    Construction and expression of eukaryotic expression vector of human SYNOVIOLIN gene
    CHEN Gang, ZHANG Zheng-Chi
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  704. 
    Abstract ( 1856 )  
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      Objective: To construct eukaryotic expression vector containing the EGFP-SYNOVIOLIN gene. Methods: According to the sequence of SYNOVIOLIN gene and the multiple clone sites of the expression vector pIRES2-EGFP plasmid, a specific pair of primers were designed and synthesize.PCR amplification of SYNOVIOLIN gene from the pCDNA3-syno plasmid was performed, and an approximate 1900bp objective fragment was achieved.The fragment was then cloned into T-A vector. The recombined vector confirmed by sequencing was digested by SalⅠ/BamHⅠ to obtain SYNOVIOLIN cDNA fragment, then the fragment was subcloned into the multiple sites of pIRES2-EGFP vector. The recombinant plasmid pIRES2-EGFP-syno was transfected into HEK293 cell by lipofectamine 2000. The result was examined using confocal microscopy. The expression of SYNOVIOLIN was detected by Western blotting. Results: PCR, DNA sequencing and restriction enzyme digestion analysis indicated that the eukaryotic expression vector pIRES2-EGFP-syno was constructed successfully. The expression of EGFP can be seen under confocal microscopy. Western blotting proved the protein expression of SYNOVIOLIN in HEK 293 cells. Conclusions: The SYNOVIOLIN cDNA is acquired and the eukaryotic expression vector, pIRES2-EGFP-syno is successfully constructed with efficient expression in HEK293 cells, which provide a good experimental basis for further study on the gene therapy of anti-tendon adhesion.

    Effects of CD44s on the pathogenesis of nasal polyps
    NI Bing-Hua
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  708. 
    Abstract ( 1435 )  
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      Objective: To investigate the expression of CD44s in the nasal polyps and its role in pathogenesis of nasalpolyps. Methods: The polypus tissue from twenty cases of nasal polyps and inferior turbinate mucosa from fifteen healthy adults were collected. Immunohistochemical staining for CD44s and EGF protein, and HE staining for the nasal polyps and inferior turbinate mucosa were performed. Results:①The expression of CD44s protein in epithelium, vascular endothelial cells and inflammatory cells were 0.24±0.07,0.28±0.05,0.36±0.08 in nasal polyps and 0.11±0.02,0.13±0.03,0.22±0.04 in inferior turbinate mucosa respectively(P<0.05). ②The number of Eos in nasal polyps was associated with CD44s protein in vascular endothelial cells (r=0.56,P<0.05). ③ The expression of EGF protein in nasal polyps was higher than that in inferior turbinate (P<0.05). Conclusions: CD44s may play an important role in facilitating the transmigration of CD44s+ inflammatory cell and the epithelialization after epithelial damage.

    Experimental study of injectable nano-hydroxyapatite/ chitosan composite on repairing of bone defect
    HU Yong, SHU Li-Xin, TIAN Jing, HUANG Dui, XU Bo, LI Zhi-Gao, FU Guo-Jian, LIU De-Jun, FENG Qiang-Ling, HUANG Zhi
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  712. 
    Abstract ( 2132 )  
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            Objective: To explore repair effects of  injectable nano-hydroxyapatite/ chitosan(nHA/CS) composite on radius bone defect. Methods: Bone defect with the length of 10 mm were created on the middle of each radius of 18 New Zealand white rabbits. the defects was filled with the nHA/CS composite as treatment group, while the others were filled with hydroxyapatite(HA) as control. The ability of repairing bone defect was evaluated by gross observation, X-ray, histopathological and SEM 4, 8, 12 weeks after operation. Results: ① The gross and X-ray showed that, in treatment group, the callus grew well and bone defect was repaired completely, oppositely, in control group, bone defect was repaired partly, with some nonunion. ② Histomorphology showed that, the new formed bone in treatment group was confirmed integral and the medullary cavity recanalized after 12 weeks, however, a little of  new  bone formed in the control group, accompanied with connective tissues growing into the defects. ③ Under the SEM, materials was replaced by newly formed bone after 12 weeks in treatment group. Conclusions: The nHA/CS has better ability of bone repairing than that of the HA.

    Biomechanic evaluation of lumbar laminoplasty in Vitro
    CHEN Liang, CHEN Ji-Cuan, LONG Qing-Jiang, ZHANG Jian-Fa, ZHANG Mei-Chao, DIAO Wei-Dong
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  716. 
    Abstract ( 270 )  
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            Objective: To investigate reliability and immediate stability of single lumbar laminoplasty. Methods: 6 lumbar specimens from L1~5 were used in this study. 6 different models were made: A,control(intact);B,laminoplasty fixation with titanium miniplate;C,laminoplasty fixation with cross Kirschner wire;D,laminoplasty fixation with double 1-0 suture silk;E,laminoplasty fixation with titanium miniplate, without the posterior ligament complex, and F, posterior vertebral canal decompression, without the posterior ligament complex. the specimens were placed on the 3-D spine motion test machine loaded with 10N to get the range of motion (ROM)of 6 freedom degrees(flexion and extension, left and right bending, left and right axial rotation) of L3~4 segments. Results: ROM of six models were 7.03±2.24,7.16±2.95,7.4±2.47,8.55±3.31,11.1±2.81,10.82±2.82 for bending and extension, 8.8±2.68,8.81±2.42,8.76±1.81,9.55±3.15,9.12±1.97,9.49±2.78 for left and right bending, and 3.96±2.03, 5.04±2.82,4.99±2.6,5.56±2.47,6.03±2.62,6.03±2.73 for left and right rotation respectively. Laminoplasty without the posterior ligament complex and posterior decompression increased spine ROM compared with that of other three laminoplasty keeping the posterior ligament, especially for bending and extension status (P<0.05). Suture silk fixation increased the ROM of spine compared with that of control and other two fixation groups (P<0.05). Conclusions: Tatanium miniplate and cross Kirschner wire fixation during laminoplasty with keeping or repairing posterior ligaments can maintain the better spine stability compare to that of laminoplasty without keeping the posterior ligaments .

    Biomechanical research on the stability of lumbar spine with implantation of neotype artificial nucleus pulposus
    TAO Nv-Zhao, ZHANG Zhong-Min, ZHOU Rong-Beng, LIANG Dong-Zhu, DIAO Wei-Dong, JIN Da-De
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  720. 
    Abstract ( 263 )  
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            Objective: To evaluate the biomechanical properities of Pectin/ PVA composite(CoPP) hydrogel prosthetic nucleus,and provide scientific data for its clinical application. Methods: L4/5 functional spinal units from six fresh cadavers were used in the test. Under three different conditions (intact,  nucleotomy and  implantation of the prosthetic nucleus), the range of motion, netrol zone and intervertebral disc height were analyzed in axial compression, flexion, extension, left and right bending positions. Results: For nucleotomy group, the ROM and NZ were significantly increased and the disc heights were reduced. Once CoPP prothesis was implanted, the stability and height of the intervertebral disc restored to that of the intact disc group. Conclusions: The new CoPP prostheses can restore the stability and height of the intervertebral disc after nucleotomy, and this new kind of hydrogel prosthetic nucleus is hopeful in clinical application.

    The replacement of damaged metacarpophalangeal joint with metatarsophalangeal joint:  microdissection and clinical application
    ZHANG Xiang-Yi, MO Ku-Xiang, XIAO Ying-Feng, LI Jin-Miao, JIANG Chang-Jing, BANG Yan-Bin, ZHOU Zhe-Gang
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  723. 
    Abstract ( 325 )  
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      Objective:To provide anatomic basis for reconstructing of metacarpophalangeal joint by total metatarsophalangeal joint and semi-joint transplantation, and summarize the clinical experience of the improved replacement skills.Methods:Anatomic features and blood supply of the second metatarsophalangeal joints were observed and measured in 30 adult cadaveric limbs perfused with red latex. For 14 cases, the second metatarsophalangeal joint transplantation was conducted to reconstruct metacarpophalangeal joint: total metatarsophalangeal joint transplantation in 8 cases, semi-joint transplantation in 6 cases. Early systematic rehabilitation was carried out after the operation. Results: There were rich blood supply and special anatomic features for the second metatarsophalangeal joint. The location of blood vessels and nerve were constant. The follow-up of 5 to 38 months in 12 out of 14 cases showed satisfactory functional recovery was achieved.The movement of second metacarpophalangeal joint was excellent.The result of semi-joint transplantation with joint capsule was the best, total joint transplantation the good. Conclusions:The function of the second metacarpophalangeal joint can be effectively recovered by the improved transfer of the vascularized second metatarsophalangeal joint.The elements for succeed operations including the knowledge of anatomic features of the joints, modified transplantation methods, the repairing of articular branches of nerve, and total reconstruction of joint functions.

    The primary repair of the foot dorsum soft tissue defect adopting the sural neurovascular retrograde flap
    LI Meng-Xin, HAN Shi-Lian, ZHANG Jian-Guo
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  728. 
    Abstract ( 316 )  
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           Objective: To report clinical effects of the sural neurovascular retrograde flap on repairing the soft tissue defects of the foot dorsum. Methods: From January 2004 to January 2008, 15 cases of soft-tissue defects of the foot dorsum, involving the exposure of tendons, vessels or bones of foot, were treated by the sural neurovascular retrograde flap. The functions of the alocrural joint and the bone healing conditions were evaluated after operations. Results: All cases were followed-up about 6 to 18 months (13. 6 months averagely). All flaps survived well. The necrosis of distal part of flap was observed only in 1 case. The results of follow-up proved that, the repaired flap showed satisfied shape and functions of foot and ankle. There was no case appeared incision infection. Conclusions:The blood supply of this flap is reliable. The curative effects of the flap is easy to be evaluated, while, the size of the flap is large enough to repair skin defects of the foot. 

    Clinical application of wrist arthroscopy through volar approach
    OU Yang-Kan, WANG Da-Beng, LIU Wei, ZHANG Hong, BANG Liang-Quan
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  731. 
    Abstract ( 487 )  
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      Objective:To describe clinical application of wrist arthroscopy through volar approach, and evaluate its therapeutic effects on IB, ID TFCC and dorsal radiocarpal ligament(DRCL) tear.Methods: From 2005 to 2008,13 patients suffered from IB, ID TFCC or DRCL tear were treated with arthroscopic surgery through volar approach, and assessed by the Green and O'Brien wrist scoring system.The follow-up period was about 20 months averagely. Results: Pain disappeared nearly for all patients, except for one case with mild pain occasionally. According to the Green and O'Brien wrist scoring system,  11 of 13 patients were excellent, 1 good and 1fair.Conclusions: Arthroscopic surgery through volar approach is reliable for treating dorsal wrist structures, reaching operating field quickly and safely during the operational process of IB, ID TFCC or DRCL tears.

    The repair of dorsal skin and tendon defects in fingers with modified arterialized venous flap of palmaris longus
    ZHANG Jun, LIU Hua-Gui, YANG Dun-Gui, ZHENG Qing, BO Ji-Bei, BI Jing-Ming, LI De-Beng
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  735. 
    Abstract ( 587 )  
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      Objective: To report the curative effects of modified arterialized venoous flap of palmaris longus on dorsal skin and tendon defects in fingers. Methods: Two parallel veins of palmaris longus identified at the distal end of the ipsilateral forearm were taken as the blood supply of the flap. The anastomosis between arteries and veins were ligated, accompanied with the protecting of peritendinous vascular net. Antrorse transplantation of the flap was performed.  Results: All flaps of 6 cases survived well. The results of follow-up of 4 to 14 months, averagely 8.5 months, proved that, the transplanted flaps was soft and elastic, which fitted to the level of fine, according to TAM standard. Conclusions: Modified arterialized venoous flap of palmaris longus is valuable for treating finger defects, for its satisfied blood supply and repair effects.

    The treatment of ingrown toenails of the hallux adopting anatomy reconstruction of nail groove: clinical study
    SHU Xiao-Di, WANG Li, ZHANG Feng, LI Wen-Qiang, GONG Yun-Xia, YANG Chao, CHEN Chuan-Huang, TAO Hai-Bei
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  737. 
    Abstract ( 901 )  
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            Objective: To investigate  the  curative effects of anatomy  reconstruction  of  nail  groove on ingrown toenails of the  hallux, and explore anatomic relationship between  ingrown  toenail  and  nail groove.  Methods: From April  2001  to  December  2007,  126  patients   with  ingrown  toenails  in  hallux  were  treated with wedge resection  of nail  fold  and  nail bed, and then nail groove was reconstructed. At the same time, the depth of nail groove of 40 cases was measured. Results: 110 cases (87.3%) healed by first intention, 12 cases (9.5%) by second intention, and  4 cases (3.2%) by third intention. The toenails grew well, with no pain and recurrence of panaritium. The nail groove depth of ingrown toenails  was  about (5.73±0.49 )mm in male and  (4.99±0.63)mm in female respectively, which presented significant sex difference(P<0.01).Conclusions: The depth of nail groove deals with the occurrence of ingrown toenails of the hallux closely. Anatomy reconstruction of nail groove is an effective method to treat ingrown toenails of the hallux.

    Clinical value of three-dimensional imaging of complex renal calculi with CT data for the access of percutaneous nephrolithotomy
    TONG Hong-Hua, WANG Gong-Xian
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  739. 
    Abstract ( 484 )  
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            Objective: To explore the clinical value of three-dimensional imaging of complex renal calculi with CT data for the access of percutaneous nephrolithotomy (PCNL). Methods: 41 cases of complex renal calculi and 29 cases of simple renal calculi underwent CT scan before PCNL. Image were collected and dealt with the technique of multiplanar reconstruction (MPR) and three-dimensional reformation. The stone distribution and relation with adjacency were observed and optimal performance channel was planned. The renal stone clearance rate and the residual fragments rate among the different choice of the access channel were statistical analysis by SPSS. Results: (1) The stone distribution of two groups and the effect of PCNL treatment were statistical significance. (2) There were no statistical significance between two positions in simple renal calculi group when PCNL was through the access location of the 11th intercostal or 12th subcostal. But there were statistical significance in complex renal calculi group. (3) There were no statistical significance between two calices in simple renal calculi group when PCNL was through the access location of the posterior group of upper renal calices or middle renal calices. But there were statistical significance in complex renal calculi group. Conclusions: (1) The pre-operation plan of CT scan, MPR and three-dimensional reformation may be needed especially in the management of complex stones which achieved a success clinical value. (2) From the observing of PCNL, we could directly view the relationship of the kidney collecting system and the surrounding organs, and select the ideal access location to the stone and pelvicalyceal collecting system (PCS),and significantly decreases complication rates.

    The missed diagnosis of complete lumbarization under lumbar radiograph: two cases report
    HOU Li-Sheng, BAI Xue-Dong, RUAN Di-Ke, SHI Li-Jing, CUI Hong-Feng, LIN Jing-Fu, HE Qing, ZHANG Yan-Qun, JI Wei, LI Wei, HUI Zhan-Jiang, XU Cheng
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  743. 
    Abstract ( 452 )  
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    Surgical treatment for thoracic myelopathy caused by ossification of the posterior longitudinal ligament
    LI  Chen, LI Yang-Pu, WANG Jin-Cheng
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  747. 
    Abstract ( 613 )  
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    Progress in nerve staining of rectum and it's mesentery
    WANG Feng-Yan, LIAO  Hua, TAO Hua-Qing
    Chinese Journal Of Clinical Anatomy. 2009, 27(6):  749. 
    Abstract ( 263 )  
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