Table of Content

25 May 2011 Volume 29 Issue 3

  

Three dimensional visualisation of perforasome and its choke vessels

CHEN Shi-Xin, WU Dong-Fang, DING Mao-Chao, WANG Jian-Hong, CUI Huai-Rui, MAO YI-Hua, HU Si-Wang, TANG Mao-Lin

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  237-242. 

Abstract ( 1765 )  

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Objective　To determine anatomical characters of the perforasome and its choke vessels by using angiography in cadavers and software system MIMICS.　Methods　10 fresh cadavers were subjected to angiography and CT scan, and reconstructed in three dimensions. Focus was placed on the generation of digitalize visual model of inferior abdominal and the lateral peroneal region. Specimens were then dissected by layers to document the individual perforasomes.　Results　The layers of the anatomical model were distinctively displayed; the small blood vessels between adjoining perforator were illustrated in high clarity. The choke vessels between the neighboring perforators can be divided into three types, located among two layers. In addition through the program we can perform specialize application such as, transparency to each layer, labeling each perforator with different color and digitalize flap elevation stimulation.　Conclusions　①Through the use of Mimics integrative vascular analysis can be performed on the perforators and its choke vessels, therefore providing useful data such as vascular anatomy and its distribution, this could be of clinical significance and enables better understanding of perforator flaps. ② Blood supply of perforator flap is difference with the traditional axis flap.

Digital arterial perforator flap in forearm: anatomy and reconstruction

LIU Cheng-Shing, HUANG Chao-Tong, CHEN Long-Fu, LI Jing-Kuang, CHEN Dong-Sheng

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  243-248. 

Abstract ( 2492 )  

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Objective　To provide a three-dimensional (3D) model that reveals detailed architecture of the perforators in the forearm that enables secure elevation of the personal perforator flap for clinic.　Methods Four adult male fresh forearms underwent lead oxide-latex injection. Spiral computed tomographic scanning was then performed and three-dimensional reconstructions were finished using Mimics 13.1. Specimens were then dissected by layers to document the individual perforators. We had accurately measured the number, length, diameter and distance from the ulnar and radial styloid process of perforators by way of providing evidence in support of flaps. Based on perforator region, we had got digital perforator flaps by segmentation of images.    Results    3D reconstructed visualization images could perfectly display the arteries, their perforator and perforator flaps in forearm. The number of radial, ulnar, and posterior interosseous artery perforators were 12～17, 10～15, 5～11 respectively.　Conclusions　As result of origin, course and branches of perforator flaps were constant by way of the study of reconstructed 3D images and measurement data. According to the distribution of perforating posterior interosseous artery, radial and ulnar arteries, we had designed the area of perforator flap. The study could guide operative design and operative procedure.

Obturator artery origin from external iliac artery: a case report

SHENG Gao-Jian

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  248. 

Abstract ( 875 )  

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An applied anatomy of the island flap pedicled with anterior septocutaneous perforator of anterior tibial artery

YUAN Hui-Zong, SHI Zeng-Yuan, YIN Wei-Gang, LIN 　Rong, MAO Hai-Jiao, CHANG Xi-Hui

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  249-251. 

Abstract ( 2173 )  

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Objective　To provide anatomic basis for clinical application of island flap pedicled with perforator arising from middle-distal part of the anterior tibial artery and running through the anterior septum. Methods　The location, external diameters, concomitant venae, course, length, anastomosis and distribution were observed on 40 sides of adult cadaveric leg specimens fixed by Formalin and perfused with red latex; and 4 sides of fresh leg specimens perfused with Latex-BaSO4 were angiographied.　Results　The anterior tibial artery mainly gives off two perforators in the anterior septum: the anterior septocutaneous perforator from distal part of anterior tibial artery and superficial peroneal artery. The origin of the former perforator is（14.9±3.2）cm above the tip of the lateral malleolus，present in 70% of 40 specimens with an external diameter of (1.0±0.4)mm. 96.4% of them are accompanied by 2 venae comitantes with an external diameter of (1.1±0.4)mm and (0.8±0.2)mm, 3.6% of them are accompanied by 1 concomitant vena. The perforator ramifies into ascending and descending branches after coursing along the anterior septum for about (2.5±0.4)cm; both the ascending and descending branches run parallel with the superficial peroneal nerve, with the ascending branch anastomosing with the superficial peroneal artery; the external diameter of the anastomotic artery is (0.6±0.2)mm. The origin of the superficial peroneal artery is (4.9±2.6)cm below the head of fibula, which is present in 95% of cadaver dissections with an external diameter of(1.4±0.4)mm; 76.3% of them have 2 venae comitantes with the external diameter of (1.7±0.5)mm and (1.3±0.4)mm, 23.7% of them are accompanied by 1 concomitant vena with the external diameter of (1.7±0.8)mm. An arterial arch is formed by anastomosis of the superficial peroneal artery and the ascending branch of the anterior septocutaneous perforator from distal part of the anterior tibial artery. Conclusions　Three types of anterolateral island flaps of the lower leg can be designed to repair skin defects around the distal and the anteromedial part of the lower leg and the patellar region: Skin defects around the malleolus can be repaired with the flap pedicled with the anterior septocutaneous perforator from distal part of the anterior tibial artery by rotating its ascending branch distally; When rotating the perforator and its two branches medially, it can be used to repair large sized skin defects; Pedicled with either of the two perforators and rotate its branch proximally, skin defects around the knee can be repaired. The blood supply of the flap is definite and the main artery of the lower leg is not sacrificed.

Clinical anatomy of glabella muscles

GONG Yu-Zhan, XU Da-Chuan, LUO Sheng-Kang, WANG Hai-Bin, SUN Zhong-Sheng, XU 　Xiang, CHEN Guang-Ping, LIANG Dong-Zhu

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  252-255. 

Abstract ( 1494 )  

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Objective　To investigate the anatomic formation of the glabella muscles and provide anatomical basis for the use of Botulinum Toxin Injection.  Methods　6 adult cephalic specimens were anatomized. The landmarks of the glabella muscles, including the corrugator, the depressor supercilii and the procerus were measured. The weights and cross-sectional area of the muscle were also examined.　Results　The origin of the glabella muscles is constant, while the insertion is an area which is hard to define. Moreover, each pathetic muscle is connected closely to form a "combination complex", especially between the depressor supercilii and the procerus. The appearance of the glabellar wrinkle is formed by horizontal force generated through contraction of the corrugators and the depressor supercilii. The proportion of the physiological cross-sectional area is 6:1 between the corrugator and the depressor supercilii. The proportion of the clinical anatomy horizontal force is（8-10）:1 between the corrugator and the depressor supercilii.　Conclusions　The corrugators and the depressor supercilii are the potent targets for Botulinum Toxin Injection. Injection points was selected at originating 1/3 of the corrugator point and depressor supercilii combining parts .

Feasibility of the pedicled diaphragmatic flap on esophageal reconstruction

GUO Shao-Ming, WANG Wu-Jun, LI Jian-Yi, DENG 　Hui, WANG Hao-Fei

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  256-259. 

Abstract ( 2450 )  

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Objective　To explore the feasibility of the pedicled diaphragmatic flap on esophageal reconstruction through anatomic study.　Methods　To dissect and observe the origin, course, outer diameters, distribution, length and anastomosis of diaphragmatic neuro-vascularity in 12 adult antiseptic specimens perfused with red latex.　Results　The blood vessels of diaphragm were mainly from inferior phrenic artery, muscle phrenic artery, pericardiacophrenic artery, superior phrenic artery and the branches of the lower posterior intercostal artery. Inferior phrenic artery was the primary one among them, which mainly originated from the trunk of the celiac artery or the abdominal aorta, with the left and right outer diameters at their original site of (1.52±0.06)mm and (1.61±0.04)mm respectively. They passed through the both phrenic angle and reached the diaphragm, and given the anterior and posterior branches to diaphragm. The anterior one coursed anterolaterally, and supplied the center of the central tendon, the anterior part of the both lobes of the central tendon and the anterior costal part of diaphragm. The posterior one coursed posterolaterally, and supplied the posterior part of the both lobes of the central tendon, the posterior costal part and waist of diaphragm. Conclusions　It is absolutely anatomically feasible to reconstruct esophagus with pedicled diaphragmatic flap which takes the inferior phrenic artery as the vascular pedicle.

Applied anatomy of lag screw placement internal fixation in anterior column of acetabular bone via kocher-langenback surgical approach

CHANG Xi-Hui, YIN Wei-Gang, SHI Zeng-Yuan, YUAN Hui-Zong

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  260-263. 

Abstract ( 1654 )  

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Objective　To provide anatomic basis for lag screw placement internal fixation in anterior column of acetabular bone via kocher-langenback surgical approach.　Methods　(1)50 adult hip bones (32 males, 18 females) were observed and measured the direction of the long axis of acetabular anterior column, and then the point where the long axis penetrated the outside of the iliac wing was set as the entering point. A guiding pin (3.5mm in diameter) was inserted in the entering point along the long axis, and the penetration was below the pubic tubercle. α angle between the guiding pin and the sagittal plane, and β angle between the pin and coronal plane, the length of the longitudinal axis, the "weak zone" where the guiding pin may easily penetrated bone cortex, and the distance from the penetration point to the pubic tubercle, were measured and analyzed. (2) 34 cadaveric specimens were dissected to explore the distribution of the vessels and nerves around the entrance point of the guiding pin. The screw fixation of the anterior column was simulated and confirmed by X-ray and CT.　Results　The screw entrance point was at the intersection between the line from tubercle of iliac crest to the middle of the ischial tuberosity and the line from anterior superior iliac spine to greater sciatic notch vertex. The exit point of the screw was（6.62±2.79）mm and（11.71±1.66）mm below the pubic tubercle in male and female respectively. α angle was about （51.29±3.48）°, while β angle (22.32±3.66）° in males and（19.57±2.07）° in females, respectively. The length of longitudinal axis of the acetabular anterior column was（108.64±5.49）mm in males and（100.92±6.25）mm in females, respectively. All data presented remarkable sexual significance except for α angel. The simulated fixation showed satisfied effects.　Conclusions　It is convenient and safe to place the lag screw to fix the anterior column while fix the posterior column via kocher-langenback surgical approach in case of compound fracture of both anterior and posterior columns of acetabular bone.

Safe nail insertion area for treating distal radius fracture by minimally invasive surgery: anatomic investigation

CHEN Hao-Yu, GAO Jun-Qing, LI Xiang-Ming, HE Jie-Yun

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  264-267. 

Abstract ( 1733 )  

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Objective　To explore the relative safe nail insertion area, for manipulative reduction and the closed transcutaneous pining internal fixation microtrauma treatment of radius fracture, by measuring the distances from the wrist joint to radial styloid, tendon and blood-vessel at different wrist angles.　Methods　The wrist specimens of 20 adult forearm were fasted with external fixator. Under the palmar flexion positions of 0°, 20°, 40° and 60°, and the ulnar deviation of 0° and 30° respectively, the shortest distances between radius styloid vertex and carpi radialis longus muscle tendon, and that between radius styloid vertex and extensor pollicis brevis muscle tendon, between radius styloid vertex and the intersection point of carpi radialis longus muscle tendon, extensor carpi radialis brevis muscle tendon, extensor pollicis brevis muscle tendon and radial artery were measured respectively.　Results　Under the palmar flexion and ulnar deviation, the tendons surrounding radius styloid changed their position regularly. Safe nail insertion area amplified under the position of ulnar deviation about 30°, and palmar flexion 0° to 20°.　Conclusions　Taking radius styloid vertex as the surface landmark, with the wrist position of the ulnar deviation 30°, and palmar flexion about 0° to 20°, the treatment of radius fracture by Kirschner wire will be favorable for protecting the adjacent vessels and neves.

Applied anatomy of the internal fixation of proximal humeral fracture

CAI Jun-Feng, LI 　Xu, LIU 　Lin, MA 　Min, XU 　Xian, YIN 　Feng

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  268-271. 

Abstract ( 2034 )  

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Objective　To provide anatomic basis for the internal fixation of proximal humeral fracture. Methods　20 shoulder joint specimens from 10 adult cadavers were dissected. Axillary nerves were isolated from the muscle bundle interspace of deltoid, and followed by the insertion of the plate between the nerve and humerus, under the apex of greater tuberosity and behind the intertubercular sulcus. The distances from the superior border of axillary nerve to the apex of greater tuberosity and the superior border of acromial bone were measured and analyzed. The proximal humerus connected with the plate were resected for observing the relationship of the head and neck of humerus with the plate, while, the distance from the upper border of the plate to the apex of greater tuberosity, from the anterior border of the plate to the intertubercular sulcus were measured.　Results　The distances from axillary nerve to the apex of greater tuberosity and the superior border of acromial bone were separately (3.44±0.38)cm and (5.44±0.62)cm；The distance from the upper border of the plate to the apex of greater tuberosity was (5.44±0.62) cm, as well from anterior border of the plate to the intertubercular sulcus (0.74±0.19) cm. The screws paralleled with the neck of humerus and located in the middle of it when the plate placed 0.5mm below the apex of greater tuberosity, and 0.5cm behind the intertubercular sulcus.　Conclusions　(1) The site below the greater tuberosity about 29~43.2 mm is the dangerous area for damaging axillary nerve during the anterolateral acromial approach. (2) The optimal plate inserting position is below the apex of greater tuberosity about 0.5cm, and behind the intertubercular sulcus about 0.5cm. (3) The screw holes of C，D and E of PHILOS, as well that of C and D of LPHP, are dangerous zones during the fixation approach.

Applied anatomy of cervical unilateral open-door laminoplasty with reconstruction lamina (titanium miniplate) fixation

SUN 　Jin, MIN Shao-Xiong, HUANG Xiao-Jun, AN Shu-Kang, LIU 　Yang, ZHOU Chu-Song

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  272-274. 

Abstract ( 1620 )  

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Objective　To provide anatomic parameters for the cervical unilateral open-door laminoplasty with reconstruction lamina(titanium miniplate) fixation.　Methods　50 sets of dry cervical vertebrae specimens were observed in this study. The width, height and thickness of lateral masses(LMW, LMH, LMT), the surface length from the external border of lateral masses to the plane of 5mm above the basilar part of spinal process(LSL), the height and thickness of the lateralis and median part of laminar(LH1, LH2, LT1,LT2), the height and width of the basilar part of spinal process(SPH1,SPW1) and the plane of 5 mm above the basilar part of spinal process(SPH2,SPW2) were measured and analyzed. 　Results　 LMW was about C3(9.89±0.97)mm, C7(12.09±0.93)mm. LMH C4(11.44±2.09)mm, C7(13.56±2.17)mm, which was linear correlated, increased gradually. LMT C3(9.03±1.46)mm and C7(6.66±0.78)mm, which decreased gradually. LSL C3(25.21±2.08)mm, C6(27.09±1.80)mm, C7 and C4  was similar. LH1 C3(11.54±1.66)mm, C7(16.83±1.77)mm and LH2 C3(10.91±1.58)mm, C7(14.86±1.48)mm, increased gradually. LT1 C5(4.44±0.81)mm, C7(5.28±0.76)mm and LT2 C4(3.00±0.86)mm, C7(4.92±0.96)mm. SPH1 C4(9.33±1.67)mm, C7(11.34±1.57)mm and SPH2 C4(7.10±1.76)mm, C7(9.82±1.46)mm, C3 and C5 was similar. SPW1 C5(8.59±1.81)mm, C7(11.13±1.76)mm and SPW2 C5(6.66±1.86)mm, C7(8.50±1.58)mm, which was the shortest in C5, the longest in C7.　Conclusions　Cervical unilateral open-door laminoplasty with reconstruction lamina (titanium miniplate) fixation is feasible anatomically. It can enlarge cervical vertebral canal and reconstruct the stability of lamina.

Fast reconstruction of bones and blood vessels in maxillofacial region

QU Reng-Mei, JIAO Pei-Feng, DENG 　Wei, HUANG Wen-Hua, DAI Jing-Xin, YUAN 　Lin

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  275-277. 

Abstract ( 1670 )  

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Objective　To evaluate significance of fast reconstruction of bones and blood vessels in maxillofacial region on maxillofacial region operation.　Methods　2 health volunteers and 2 patients suffered from maxillofiacial fracture performed CT scan with the thickness of 0.6 mm, followed by 3D reconstruction after transforming the CT data (Dicom data) into Mimics 10.01 and 3D-Doctor4.0.　Results　This method demonstrated clearly the 3D complex anatomy of bones and blood vessels in maxillofacial region, especially the distribution of blood vessels. By altering the viewing axis, the structures can be viewed and analyzed, using the drawing and deleting way, while, the location and motion condition of structures were showed clearly. Conclusions　The 3D-models are useful for surgical design and perform of maxillofacial region operation.

Anatomic study of the region of internal ring in laparoscopy

ZHANG Yu-Song, LI Xiang-Ming, HOU Zhi-Dian, DING Zi-Hai, WU 　Tao, LU　Wei

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  278-280. 

Abstract ( 1661 )  

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Objective　To provide anatomic data for laparoscopic repair of inguinal hernia in children.　Methods　16 child human cadaveric specimens（32sides）were observed to record the course, distribution and relations of vessels and nerves on the region of internal ring.　Results　（1）The average distance from internal ring to the intersections of iliohypogastric nerve and inferior epigastric artery: On the right side of the male, the distance was （16.77±1.36）mm, on the left side of the male, the distance was (17.70±2.39)mm; on the right side of the female, the distance was (16.41±2.23) mm, on the left side of the female, the distance was （15.81±0.57）mm. （2）The mean angle of iliohypogastric nerve and inferior epigastric artery: On the right side of the male, the angle was （106.29±8.87)°, on the left side of the male, the angle was (107.75±11.59) °; on the right side of the female, the angle was (110.23±9.42) °, on the left side of the female, the angle was （106.42±9.46)°. It was not significantly different in the measurement data in gender; there was no significant difference between two sides (P>0.05).　Conclusion　On the region of internal ring, there was a "safe region"without any important vessels and nerves, which were constituted by the inferior epigastric artery and the iliohypogastric nerve. Patch could be fixed in the "safe region". The inferior epigastric artery can be referred as an anatomical landmark to reduce the incidence of iliohypogastric nerve damage and ensuing chronic pain.

Applied anatomy of external iliac artery and its adjacent structures in transvaginal endoscopic Nephrectomy

LU 　Wei, NIU Zeng-Zhi, ZHENG 　Wei, ZHANG Yu-Song, BI Zhen-Yu, TAN Wei, JIANG Xiao-Rong, HUANG Wen-Hua

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  281-283. 

Abstract ( 1458 )  

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Objective　To provide anatomy basis for the clinical application of transvaginal endoscopic nephrectomy, by anatomic research on the position relationship between external iliac artery，ovarian vessel of the pelvic part, genitofemoral nerve and psoas major muscle under the endoscope.　Methods　Eight samples of abdomen-pelvis obtained from female adults were gross dissected and observed under the endoscope. Taken the intersecting point of ovarian vessel and external iliac artery as the landmark point under the endoscope, its distance to the genitofemoral nerve was measured. Then the relative safe area of the operative approaching through vagina to pelvic cavity and then to retroperitoneal space under the endoscope was provided.　Results　（1）The intersecting point of ovarian vessel and external iliac artery was taken as the anatomic landmark point. It was found that the angles of the intersecting point between the external iliac artery and the left, respectively the right, ovarian vessel were (20.68±3.14)° and (29.48±2.47)°, respectively.（2）The distances between the intersecting point and the left, respectively the right, genitofemoral nerve were (11.84±0.80) mm and (12.60±1.32) mm, respectively.　Conclusions　On the plane of the intersection of ovarian vessel and external iliac artery, entering the retroperitoneal space from the lateral of the external iliac artery and psoas major muscle is a relative safe area.

Anatomic features and clinical significance of the descending duodenum

TIAN 　Dong, ZHONG 　Li, TUN 　Yi, WANG Jia-Wei, WANG 　Yu, HU Dan-Dan, DIAO Guo-Gang, FU Mao-Yong

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  284-286. 

Abstract ( 2147 )  

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Objective　To provide applied anatomic data for the diagnosis and treatment of the descending duodenal diseases and reducing iatrogenic endoscopic injury.　Methods　Forty adult cadaveric specimens fixed with formalin were dissected. The shape and the length of descending duodenum, the shape and location of major duodenal papilla, and the inner diameter, outside diameter, wall thickness at the superior, inferior flexure duodenum and major duodenal papilla were observed respectively.　Results　The descendent duodenum shaped as vertical, curved or irregular. Most specimens showed the thin upper and thick lower parts, and the narrow part. The mucosa of longitudinal, sparse circular and flat folds could be observed separately. The average length of the descending duodenum was about (8.2±1.9) cm, and the inner diameter at the superior, inferior flexure duodenum and major duodenal papilla (4.8±1.7)cm,(5.8±1.3)cm, and (6.9±2.3)cm, respectively. The average outside diameter was (7.0±1.3)cm, (8.8±1.2)cm,(9.2±1.6)cm, respectively, and inner wall thickness (2.29±0.63)mm,(1.91±0.49)mm, and (1.75±0.73)mm, the outer wall thickness (1.63±0.53)mm, (1.42±0.37)mm, and(1.54±0.40)mm. The major duodenal papilla showed the irregular shape. The distance between the major duodenal papilla and the superior flexure duodenum was about(4.3±1.9) cm.　Conclusions　It is necessary to understand the anatomic features of descending duodenum for treating the diseases of this area.

The Correlation of pancreaticobiliary maljunction and extrahepatic biliary carcinoma

ZHAO Xin, LI De-Chun, CAI 　Wu, LIU Yong-Gao, SHU Dong-Meng, DIAO 　Hua, ZHANG Zi-Xiang

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  287-290. 

Abstract ( 1353 )  

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Objective　To explore the correlation between pancreaticobiliary maljunction (PBM) and biliary carcinoma, including gallbladder carcinoma and extrahepatic biliary duct carcinoma.　Methods　We retrospectively analyzed clinical data and magnetic resonance cholangiopancreatographic results of 857 patients underwent magnetic resonance cholangiopancreatography (MRCP) in our hospital from January 2008 to December 2009. The length of common ducts and the confluence angle were measured. Eventually, 67 cases were diagnosed as PBM. In order to evaluate the correlation between PBM and extrahepatic biliary carcinoma, we randomly drew 78 cases from the 790 cases without PBM as the controls.　Results　38 cases (56.72%) were diagnosed as biliary carcinoma from 67 cases of PBM, while 11 cases (14.10%) were diagnosed as biliary carcinoma in controls. The incidence of biliary carcinoma in PBM cases was significantly higher than that in no-PBM cases（χ2=22.27, P<0.05）. In cases of PBM complicated with biliary carcinoma, no correlation was found between PBM confluence types and the differentiation of biliary carcinoma（χ2=2.70, P>0.05）. Conclusions　PBM is closely related to extrahepatic biliary carcinoma, however, there was no correlation between PBM confluence types and the differentiation of biliary carcinoma.

Role of CT and MRI on preoperative evaluation of hepatic hilum cholangiocarcinoma

LUO Chao-Jun, ZHANG Shui-Xin, LIANG Zhi-Gang, ZHANG 　Ying, LUO Hai-Ying, JIN Gao-Sheng

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  291-295. 

Abstract ( 1573 )  

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Objective　To explore the value of CT and MRI on preoperative evaluation of hepatic hilum cholangiocarcinoma.　Methods　CT/MRI and CTA, MRCP findings in 23 patients of hepatic hilum cholangiocarcinoma proved pathologically were retrospectively analyzed. Imaging classification and clinical classification were compared, as well preoperative evaluations and operative results were compared.　Results　All patients were found to have soft tissue mass at porta hepatis with delayed enhancement, and intrahepatic biliary duct dilation was seen. CT/MRI and CTA, MRCP imaging could find infiltrated bile duct and blood vessel objectively, metastatic tumor also could be seen availably. The classification was of no significant difference between CT/MRI and operation findings（P＞0.05）. The sensitivity and specificity and accuracy of preoperative evaluation in all patients of hepatic hilum cholangiocarcinoma were 81.8％ and 91.6％ and 86.9％ in our study.　Conclusions　CT combined with MRI was valid method in the anatomical analysis of hilar cholangiocarcinoma, and they were helpful in clinical classification and preoperative evaluation.

The variation of flexor pollicis longus :two cases report

WANG Dan-Dan, MA Jian-Jun, CHEN Liu-Yi, DAN Jing-Bao, LI 　Hui, ZHOU Zhi-Shuai, YANG Zhi-Kui, CAO 　Teng

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  295. 

Abstract ( 1004 )  

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Clinical application of 3D-FS-SPGR sequence on the disease of knee articular cartilage

LIN Zhi-Chun, DI 　Lei, CHEN Yan-Ping, ZHANG Xue-Lin

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  296-300. 

Abstract ( 1542 )  

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Objective　To detect cartilage thickness and pathological progress at various phases of osteoarthritis (OA) happened in articular genus using MR 3D-FS-SPGR sequence.　Methods　62 cases of OA were included in this study for detecting articular cartilage thickness by MR 3D-FS-SPGR sequence, followed by MRI scan. 20 young healthy volunteers were taken as controls and performed MRI detection.　Results　For gentle OA cases, there was no statistical difference of articular cartilage thickness with that in normal volunteers, however, articular cartilage in serious OA cases was significant different from that in the normal volunteers. In addition, multiple factors, such as sex, age, weight and BMI, might affect the thickness of knee articular cartilage.　Conclusions　By comparing of articular cartilage thickness between OA cases and healthy volunteers, the articular cartilage thickness in a bulk of cartilage weigh-loading surface attenuated gradually, following with the aggregated OA disease. Except for the degree of disease, it might be affected by multiple factors, such as weight, age, sex, and so on. 

The diagnosis and treatment of the syndrome of lumbar spinal nerve posterior rami: imaging anatomic study

ZHANG Shun-Li, YOU Zhao-Xiong, LI Xiao-He, JIAO Jian-Ye, LI Zhi-Jun

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  301-303. 

Abstract ( 1545 )  

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Objective　To provide imaging anatomic data of lumbar spinal nerve posterior rami for diagnosing and treating lumber and back pain and confirming the local anesthesia points.　Methods　30 adult volunteers were taken as the subjects. Multi-slice spiral CT scans (T12-S1) was performed, and then the data were analyzed and 3D reconstructed by Mimics software.　Results　The left and right distances of transverse root point from L1 to L5 were (20.86±6.00)mm，(21.19±4.71)mm，(22.86±4.53)mm，(24.56±5.10)mm and (26.68±5.98)mm, as well the depth of transverse root point from L1 to L5 were (27.55±4.42)mm，(29.02±5.39)mm，(32.64±5.03)mm，(33.92±4.74)mm，and (35.65±4.89)mm respectively, and the height of transverse root points were (8.12±5.84)mm，(8.22±4.87)mm，(8.61±4.60)mm，(8.40±6.13)mm and (8.49±4.67)mm respectively. There was significant difference of the length, thickness and height of L1~L5 transverse processus between the gender and the bilateral sides.　Conclusions　Anatomic features and diversities of lumber vertebra and adjacent structures can be presented by three-dimensional reconstruction skill, which is valuable for the diagnosis and treatment of the lumbodorsal diseases.

Application of 64-slice spiral CT on the measurement of puncture channel of simulated direct intrahepatic portacaval shunt

WANG Jian-Hua, ZHOU Ting-Yong, ZHANG Ben-Shi, CHENG Jia-Mao, LI Pan-Pan, LI Lin-Hong, DU Diao-Kang

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  304-307. 

Abstract ( 1398 )  

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Objective　To measure related parameters of the puncture channel of simulated direct intrahepatic portacaval shunt (DIPS) adopting 64-Slice spiral CT, and provide clinical guidance.　Methods　39 healthy volunteers, and 16 cases with cirrhosis underwent the upper abdomen 64-MSCT scan. The puncture points about 1cm and 2cm under the left and right portal branches, and that connected to intermediate retrohepatic segment of inferior vena cava were measured and scored according to Child-Pugh grades. In order to offer clinical applicable information for DIPS, the smart tracking technology (Smart Prep) were used to scan and further process on the GE ADW4.2 workstations.　Results　There was no significant difference between healthy volunteers and cirrhosis patients for the internal diameters of the left and right branches of portal vein under Child-Pugh grade. The shortest distance appeared between the left branch of portal vein and inferior caval vein.　Conclusions　For obtaining puncture parameters, 64-MSCT is valuable. This study demonstrates the appropriate length and type of the stents.

The relationship of physiological rotation of vertebral body and individual development

HOU 　Gang, CHEN Meng-Juan, RENG Li-Min, CHEN Jian-Ting, CHEN Chang-Yan

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  308-310. 

Abstract ( 1375 )  

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The feasibility of esophagus repair using diaphragm: animal anatomy

DENG 　Hui, WANG Wu-Jun, WANG Xin-Hai, ZHANG 　Zhen, GUO Shao-Ming, HAO Fei

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  311-315. 

Abstract ( 1577 )  

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Objective　To investigate the architecture and arterial blood supply of porcine diaphragm, and explore the feasibility of esophagus repair using diaphragm.　Methods　6 anesthetized mongrel Landrace were perfused with gelatin-lead oxide mixture and underwent CT scanning. The acquired images were input into the computer to perform 3-dimensional reconstruction. The origin, course and branches of the diaphragmatic arteries were analyzed. After that, diaphragms were incised and underwent X-ray for exploring the phrenic distribution of different arteries and their anastomosis with each other, and compared with that of anatomic measurement of diaphragm.　Results　The location and structure of the porcine diaphragm was different with that of human being. It's blood supply was mainly from the musculophrenic artery, posterior intercostal artery, pericardiacophrenic artery and phrenic artery. Their trunks and major branches can be clearly disclosed by the 3D images. X-ray images disclosed their abundant diaphragmic distribution and anastomosis. Conclusions　Considering the architecture and blood supply of porcine diaphragm, it is possible to take diaphragm tissue flap pedicled with phrenic artery to repair esophagus.

A case report of abnormal brachinl piexus

WANG Wan-Li, PAN Fu-Qi, LIU Jian-Hui

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  315. 

Abstract ( 962 )  

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Significance of Stat3 signaling pathway on esophageal squamous cell carcinoma assessed by tissue microarray 

LI Su-Mei, ZHONG Xue-Yun, SU Bao-Gui, PAN San-Qiang

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  316-320. 

Abstract ( 1432 )  

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Objective　To investigate the roles of Stat3, CyclinD1 and Bcl-2 in the tumorigenesis and early diagnosis of esophageal squamous cell carcinoma (ESCC).　Methods　Using tissue microarray (TMA) technique and immunohistochemistry (IHC) method, Stat3, CyclinD1 and Bcl-2 protein expression were detected in tissue specimens of ESCC (860 cases), dysplasia (198 cases), basal cell hyperplasia (201 cases) and normal mucosa adjacent to cancer tissue (467 cases).　Results　(1) Stat3, CyclinD1 and Bcl-2 proteins were respectively detected in ESCC and dysplasia, which were significantly higher than that of other control group (P<0.05). (2) The expression of Stat3 and Bcl-2 protein were gradually increased, but CyclinD1 reduced, from the well to poorly differentiated ESCC. (3) The expression of Stat3, CyclinD1 and Bcl-2 significantly related to lymph node metastasis and infiltration depth (P<0.05), but not correlated with the age, gender, primary location, the size of tumor and gross appearance type (P>0.05). (4) There was significantly negative association between Stat3 and CyclinD1 (r=-0.699, P=0.000), however, the expression of Stat3 was positive related to the Bcl-2 expression(r=0.660, P=0.000).　Conclusions　Stat3, CyclinD1 and Bcl-2 may play important roles in tumorigenesis and progression of ESCC. Detection of CyclinD1 and Bcl-2 proteins may be helpful for the early diagnosis of ESCC.

The expression of HCN2 and HCN4 in the left ventricle of type 1 diabetes rat

WANG Qing-Zhi, ZHOU 　Li, WANG Zhi-Yong, GUO Zhi-Kun

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  321-324. 

Abstract ( 1475 )  

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Objective　To investigate the expression of HCN2 and HCN4 in the left ventricles of type 1 diabetes rat.　Methods　60 rats were randomly divided into control group (N, n=20) and diabetes group (T1DM, n=40). For T1DM group, streptozotocin was injected into peritoneal cavity of the animals to establish the model of type 1 diabetes. At the 90d after injecting, the expression of HCN2 and HCN4 were detected by immunofluorescent staining, Western-blot and RT-PCR respectively.　Results　Immuno-fluorescent staining presented the discontinuous punctiform or linear expression of HCN2 in cardiomyocytes membrane, but not for HCN4. However, Both HCN2 and HCN4 were up-regulated at protein(western-blot) and RNA (RT-PCR) levels compared to that of controls.　Conclusions　The over expression of HCN2 and HCN4 maybe participate in the electrical remodeling in DM rats and the developing of ventricular arrhythmia.

FE analysis of the position of acetabular prosthesis in total hip arthroplasty

LIAO Sheng-Hui, LI Ling-Zhi

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  325-329. 

Abstract ( 1393 )  

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Objective　To investigate the effects of acetabular prosthesis position on the reconstructed hip funcion after the total hip arthroplasty by 3D finite element analysis.　Methods　Using a special designed biomechanical semi-automatic mesh generator, a high quality specific 3D finite element model of the hip bone was generated from the CT scan data of a patient with hip joint dysplasia. And then the acetabular prosthesis was integrated at the true acetabular position, compared with penetration position, and the position above the true acetabular, to investigate the position infuence of acetabular prosthesis for the total hip arthroplasty. Finally, all models were simulated under same loading conditions.　Results　(1) The model with acetabular prosthesis placed at the true acetabular position provided the optimal silumation result, with smallest principal stresses and sheer stresses; (2) The model with penetration position resulted some bigger stresses than the true acetabular position; (3) The model with position above the true acetabular resulted much bigger stresses. Conclusions　The acetabular prosthesis for the total hip arthroplasty should be placed at the true acetabular position as possible, to provide the optimal stresses distribution and functinal repair.

Establishment and motion simulation of postoperative digital model with Scandinavian Total Ankle Replacement

XU Hong-Zhang, YU Bin

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  330-334. 

Abstract ( 1352 )  

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Objective　To investigate simulating motions of postoperative digital model with Scandinavian Total Ankle Replacement (STAR).　Methods　3D postoperative digital model with STAR was established through the software of Mimics 10.01, Geomgic studio 10.0 and PRO/E 2.0, and then its motions were simulated through the software of PRO/E 4.0.　Results　Motion simulation videos of postoperative digital model with STAR were successfully established, including plantar flexion, dorsal flexion, adduction, abduction, inversion and eversion. All motions were iconically presented, while, postoperative theoretical range of all motions were obtained.　Conclusions　Motion simulation of postoperative digital model with STAR is beneficial to prevent operative failure and improve the operative accuracy by preoperatively presumption of the postoperative theoretical range of motion (ROM) of joint prosthesis.

Fatigue experiment on expansive unilateral open-door laminoplasty of the cervical spine with OsteoMed M3 plate and screws

HU Kong-He, JIN An-Min, DUAN 　Yang, LIU Cheng-Long, MIN Shao-Xiong, ZHANG 　Hui, ZHAO Wei-Dong, WU　Qiang

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  335-338. 

Abstract ( 1764 )  

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Objective　 To evaluate the effects of OsteoMed M3 titanium plate and screws on the initial stability of cervical vertebrae after expansive unilateral open-door laminoplasty.　Methods　OsteoMed M3 plate and screws and silk ligation were used for an simulated expansive unilateral open-door laminoplasty in six fresh human cervical spine specimens respectively，and fatigue experiment were measured in positions of flexion and extension on three-dimension motional stability test. The cessation of testing would be and the incidence of thread rupture and of loosening of thread and plate and screws were recorded.　Results　Partial rupture of joint capsule and easy move of the hinge side were seen in all of the specimens in the silk ligation. It were easily seen that rupture of joint capsule and cast of silk thread and reclose of the opened laminate as clinical widely used device for suture of joint capsule. There was no trauma on joint capsule in the OsteoMed M3 plate and screws, and no plate and screw loosening and rupturing and no reclose of the opened laminate. Conclusions　Unilateral open-door laminoplasty using OsteoMed M3 titanium plate and screws fixation is good for posterior cervical surgery because of its biomechanical advantage of maintaining signi?cant stabilization of the spine.

A case of ovarian artery origin from renal inferior polar artery

LIU 　Juan

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  338. 

Abstract ( 695 )  

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Biomechanics of internal fixation for treating floating shoulder injury

DUAN Lian-Hong, HUANG Ji-Feng, ZHAO Wei-Dong, LIANG Dong-Zhu, XIA Ping-Guang, LIU Xin-Yuan

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  339-342. 

Abstract ( 1835 )  

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Objective　To evaluate biomechanic effects of commonly used internal fixation methods on the treatment of floating shoulder injury.　Methods　The superior suspensory shoulder complex (SSSC) were dissected for simulating floating shoulder injury in 7 antiseptic upper limb specimens including collarbone and scapula. The testing included the normal specimens, simple clavicle fixation, single plate fixation of clavicle and scapula neck, and double plate fixation of clavicle and scapula neck. The ROMs of scapula neck under different states were measured by spinal motion analysis system, as well, the stability of different fixation methods for instable SSSC was compared.　Results　The biomechanical testing showed that, the ROMs of simple clavicle fixation were respectively (12.60±1.86)° for flexion,(8.53±1.17)° for extension,(12.47±1.43)° for left bending,(12.32±1.35)° for right bending,(10.17±1.16)° for left tortion, and (11.42±1.21)° for right tortion, which increased more obviously compared to that of other groups (P<0.05). ROMs of double plate fixation were respectively (5.53±1.12)° for flexion, (2.63±1.06)° for extension, (3.17±0.82)° for left bending, (7.03±0.60)° for right bending,(3.88±0.64)° for left tortion, and (5.33±1.54)° for right tortion, which decreased more significantly compared to that of other fixation methods (P<0.05).　Conclusions　Double plate fixation of clavicle and scapula neck is the best way to treat floating shoulder injury, which is helpful for avoiding scapula malunion and the instability of the shoulder.

Hepatic artery variation and accessory cystic duct: one case report

CHEN Hong-Hao, YANG Jian-Hua, LIU Xue-YA, HU Wei-Li, WANG Jun-Kui, PAN Zi-Han, ZHOU Chuan-Kun, ZHANG Pei-Pei, MA Jian-Jun

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  342. 

Abstract ( 1020 )  

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Perforator-based neurocutaneous vascular flap of superficial peroneal nerve for ankle reconstruction

QIN 　Yi, JIANG Jian-Ming, QIN 　Jie

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  343-345. 

Abstract ( 1538 )  

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Objective　To report the perforator-based neurocutaneous nutritional flap of the superficial peroneal nerve for covering soft-tissue defects around the lateral malleolus.　Methods　The portable Doppler ultrasound was employed to locate the perforators from the peroneal artery, and the most appropriate one was adopted as the vascular pedicle; based on this perforator, the retrograde perforator-based neurocutaneous nutritional flap of the superficial peroneal nerve was harvested for coverage of soft-tissue defects around the lateral malleolus complicated by exposure of the tendon and the bone, with its axis based on the direction of the nutritional plexus of the superficial peroneal nerve.　Results　9 cases were included in this group, with 6 of them being male, 3 of them being female; their ages fell between 20 and 45 years old, with an average of 32 years old. The size of the defect ranged from 3cm×5 cm to 7cm×11cm, and the size of the flap ranged from 4cm×6 cm to 8cm×12 cm. All flaps survived well, with excellent color and reparative outcome. After an average 2-month follow-up, all patients were pain-free and can ambulate with normal gaits.　Conclusions　The perforator-based neurocutaneous nutritional flap of the superficial peroneal nerve is a versatile flap that can be manipulated to resurface the complicated soft-tissue defects around the lateral malleolus. It is a pliable flap with a reliable blood supply and an optimal combination of the perforator flap and the neurocutaneous nutritional flap.

Arthroscopic Acromioplasy and Rotator Cuff Repair for the Treatment of Subacromiai Impingement and Rotator Cuff Tear

YU Xiao-Bing, ZHAO De-Wei, WANG Wei-Ming, ZHONG Shi-Zhen, LIU Yu-Peng, ZHANG Yao

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  346-349. 

Abstract ( 1409 )  

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Objective　To observe the clinical effects of arthroscopicacromiaoplasty and rotator cuff repair for treatment of Subacromiai Impingement and Rotator Cuff Tear.　Methods　from  2007 ,20 cases of Subacromiai Impingement and Rotator Cuff Tear, there were 8 male and 12 female,aged 25～72 years old，with an average of 45 years old. 16 cases had nontraumatic history，and 4 cases had traumatic history．Patients had the symptoms of shoulder pain at night, and Restricted activities，positive Neer sign ,positive pain arc and impact injection test．Preoperative MRI scans showed high signal in the rotator cuff in T2:10 cases with massive large rotator cuff tear,6 eases with middle tear，4 cases with small tear can be seen under the scope. They are treated with arthroscopic acromiaoplasty. 13 cases of rotator cuff tears were repaired with suture anchor．In preoperative and final follow-up，shoulder ASES score and Constant-Mureley score were used for function evaluation.　Results　The follow-up of 24 months(10 to 32)months．The excellent and good rate of ASES score was 85％，the excellent and good rate of Constant-Murley score was 90％．Postoperative scores were significantly different(ASES：P<0.001，t=11.343；Constant-Murley：P<0.001,t=14.356). Conclusion Subacromiai Impingement and Rotator Cuff Tear is the common casue of shoulder pain and dysfunction, which can be effectively treated with Arthroscopic Acromioplasy and Rotator Cuff Repair.

Anatomy of the upper eyelid and its significance in correction of eyelid ptosis

TANG Jian-Bing, CHENG 　Biao, LI 　Qin, YU Wen-Lin, WU Yan-Gong, ZENG 　Dong, QI Xiang-Dong

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  350-352. 

Abstract ( 1437 )  

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Objective　To explore anatomic features of the upper eyelid for improving clinical effect on the ptosis correction.　Methods　132 patients with mild or moderate ptosis were followed up during 3 years. Most cases were treated with surgical levator shortening or folding. Levator muscle flap was dissected carefully intraoperatively, which was shortened or folded according to the degree of ptosis. The aortic arch, lacrimal gland and other important structures were protected during the operation. Whitnall ligament was cut or not according to the specific conditions.　Results　The correction was satisfied for most patients, except for 3 cases of under-correction, one case of over-correction, and 2 cases of asymmetrical eyelid lines.　Conclusions　 The key process for the correction of eyelid ptosis is to isolate levator muscle flap, and evaluate the shorten degree of the levator, according to the anatomic features of the upper eyelid.

Barrier resection of the buttock soft tissue sarcoma

JIANG Ren-Bing, BAI Jing-Peng, XI Lin-Bao-Le-Ri, GONG 　Lei, HE Zhu-Sheng, ZHOU 　Yang

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  353-355. 

Abstract ( 1345 )  

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Objective　To explore the feasibility of barrier resection to treat the buttock soft tissue sarcoma and prevent the related surgical complications.　Methods　(1)The gluteal fascia, the walls of the subgluteus maximus space, superior gluteal artery and sciatic nerve of the pelvic extius were observed on the six specimens. (2) The therapeutic results were analyzed on 15 cases suffered from soft tissue sarcoma of the buttock.　Results　(1) The muscle, tendon, ligaments and fascia on the subgluteus maximus space have barrier effects on stopping the development of the soft tissue sarcoma of the buttock. (2) The gluteal artery on the pelvic extius was surrounded by fibrous connective tissue at the internal edge of the greater sciatic formaen about 1cm. (3) The loosed space between sciatic nerve and infrapiriform foramen was surrounded by adipose tissue. （4）In 15 cases followed up about 6 to 36 months, averagely 24 months, 12 were free of disease , 2 died from pulmonary metastasis, 1 given up the treatment after recurrence. All patients appeared lower limb claudication, 3 suffered from superior gluteal artery damage and followed hemostasis treatment.　Conclusions　(1) Barrier resection is an ideal method for treating soft tissue sarcoma of the buttock. (2) Iliac bone incision is the suitable way to prevent the bleeding of superior gluteal artery during the operation.

Transpedicular intracorporeal grafting combined with posterior short-segment pedicle screw via the injured vertebra for treatment of thoracolumbar fractures

LI 　Jia, OU Yun-Sheng, QUAN Zheng-Xue, JIANG Dian-Ming, TANG 　Ke, AN 　Hong

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  356-360. 

Abstract ( 1652 )  

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Objective　 To explore the clinical efficacy of transpedicular intracorporeal grafting combined with posterior short-segment pedicle screw via the injured vertebra for thoracolumbar fractures treatment.　Methods　A total of 52 patients of thoracolumbar fractures were treated with transpedicular intracorporeal grafting combined with posterior short-segment pedicle screw via the injured vertebra from June 2006 to December 2009. According to the AO classification, all of them are type A fracture. Preoperative, postoperative and follow-up X-ray were performed for evaluating anterior heights of the injured vertebra(AHIV) and Cobb's  angle, as well, preoperative and postoperative CT scans were taken to measure the sagittal canal diameter(SCD). Postoperative complications and neurofunctional recovery of the spinal cord were evaluated. Results　All cases were followed up about 12 to 30 months, averagely 16.5±7.8 months. There was no infection of incision and no aggravation of spinal cord function. There was no implant failure and no loss of spinal curvatures. After surgery and at final follow-up, anterior heights of the injured vertebra showed good recovery, and Cobb's angel appeared smaller. The sagittal canal diameter significantly reduced compared to that before surgery. In patients with incomplete injury, neurofunctions showed 1 to 2 grade improvement compared with the findings before operation.　Conclusions　Transpedicular intracorporeal grafting is effective to repair fractured vertebrae in the vertebral body defects, posterior short-segment pedicle screw via the injured vertebra can reconstruct the stability of thoracolumbar fractures, stable reconstruction of the anterior and middle columns and secured fixation of the posterior column. This technique is an effective method for treatment of A type thoracolumbar fractures.

Clinical significance of rectovesical/rectouterine folds to prevent pelvic ureteral injury during operation of rectal carcinoma

ZHENG Zhen-Mu, LUO Zhan-Bin, WU Yi-Ai, FAN Xiao-Hua, ZHANG Si-Fen

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  361-362. 

Abstract ( 1473 )  

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Objective　To evaluate clinical significance of rectovesical/rectouterine folds to prevent pelvic ureteral injury during the operation of rectal carcinoma with respect to its anatomic characteristics. Methods　The anatomic location of rectovesical/rectouterine folds and their relationships with the pelvic ureter and mesorectum were carefully observed in all the 56 cases studied from January 2005 to January 2011. Total mesorectal excision was performed consistently inside the rectovesical/rectouterine folds.　Results　No pelvic ureteral injury occurred in all cases. The anatomic structures of rectovesical/rectouterine folds could be clearly identified in all the 56 cases of rectal carcinoma operation studied. Their location between the pelvic ureter and mesorectum was comparatively constant.　Conclusions　Rectovesical /rectouterine folds can be used as an anatomic landmark to prevent pelvic ureteral injury during the operation of rectal carcinoma.

Ciliary zonule specimen with the improved method

LI Wen-Qi, FANG Ling-Ling, REN Tong-Ming, HE Xiao-Jing, FAN Zi-Yu, LIU Heng-Xing, MA Hui-Qiang

Chinese Journal Of Clinical Anatomy. 2011, 29(3):  362. 

Abstract ( 974 )  

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