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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 September 2011 Volume 29 Issue 5
      
    Anatomic basis and clinical application of the transpalatal-transpharyngeal approach
    CHEN Xiao-Lei, JIANG Li, LIU Ning
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  481-484. 
    Abstract ( 2051 )  
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    Objective To explore anatomic basis and clinical application of the transpalatal- transpharyngeal approach. Methods Simulated surgery via transpalatal-transpharyngeal approach was performed on 15 adult cadaveric heads injected red latex through arteries. The greater palatine foramen, incisor foramen, bone crest, palatine large artery and the soft tissue in hard palate were dissected and observed under microscope. The distances among important structures of skull base were measured and analyzed. The data of 18 cases with tumors in midline of skull base operated upon through transpalatal-transpharyngeal approach from March 2006 to July 2010 were analyzed retrospectively. Results The distance from the incisor foramen to the front alveolar crest was (5.18±2.44)mm.The proportion of bone crest was about 93.3%. 54 palatine large arteries coursed through the 2/3 half-width of the hard palate. The lateral limits of expose were found to be the optic nerves,carotid arteries,endostoma of hypoglossal canals and so on. Of the 18 patients, 12 were totally removed tumors, and 6 were subtotally removed tumors. The complications included rhinorrhea in 1 case and hypernasal in 1 case. There was no operative mortality and hemiplegia. Conclusions Transpalatal- transpharyngeal approach for resecting tumors in the midline part of skull base was an ideal approach, with satisfying exposure, alleviative operative trauma and fewer complications.

    Applied anatomy of the cranio-orbital foramen and the lateral orbital sulcus
    YU Hao, ZHANG Yi, JIN Guo-Hua, YANG Hong-Bin
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  485-488. 
    Abstract ( 1414 )  
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    Objective To provide anatomic data of the cranio-orbital foramen and the lateral orbital sulcus for the skull base surgery. Methods One hundred dry adult skulls (200 sides) and 30 cadaveric heads (60 sides) were observed and measured, for exploring anatomic features and variations of the cranio-orbital foramen and its adjacent structures. Results Incidence of the cranio-orbital foramen was 65.5% (131 sides). The cranio-orbital foramen located on the greater wing of the sphenoid bone, or on the frontal bone, at or near the spheno-frontal suture. Usually, 1-3 foramens could be observed. Incidence of the lateral orbital sulcus was 24% (48 sides). No artery was observed to pass through the sulcus of cadaveric heads. The course of the orbital branch of the middle meningeal artery could be divided into 3 types. For typeⅠ, the orbital branch of the middle meningeal artery entered the orbit through the cranio-orbital foramen and anastomosed with the lacrimal artery. For typeⅡ, the paired orbital branches of the middle meningeal artery entered the orbit through the superior orbital fissure and the cranio-orbital foramen and anastomosed with the lacrimal artery. For type Ⅲ, the orbital branch of the middle meningeal artery entered the orbit through the superior orbital fissure and anastomosed with the lacrimal artery. Conclusions The cranio-orbital foramen, the lateral orbital sulcus, and their adjacent structures are complex and variable, which need to be taken notice during the surgical procedure in this area.

    Anatomic observation of single left coronary artery:one case report
    XUE Zhi-Qin, YANG Wen-Qing, WANG Shui-Quan, LIU Xu, GAO Wen, GAN Zi-Meng
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  488. 
    Abstract ( 818 )  
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    Applied anatomy and radiologic study on transnasal endoscopic optic nerve decompression
    WANG Chao, KANG Peng, YANG Qin-Tai, LIU Xian, ZHANG Ge-Hua, LI Yuan
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  489-493. 
    Abstract ( 1364 )  
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    Objective To provide anatomic and radiologic basis for performing the transnasal endoscopic optic nerve decompression.    Methods    20 sides of cadaveric skulls were studied in this study. The optic canal and its related structures were dissected and measured, as well analyzed by three-dimensional images of workstations. The results of workstations were compared with that of gross anatomy. Results The optic canal could be classified as: the canal (1 side, 5%), the semicanal(2 sides, 10%), the impression (11 sides, 55%), and the non-impression (6 sides, 30%). According to its relationships with the sinuses, the optic canal could be further typed as: ethmoid sinus (3 sides, 15%), sphenoid sinus (7 sides, 35%), ethmoid and sphenoid sinus (9 sides, 45%), sella turcica (1 sides, 5%). For 60% (12 sides) specimens, the posterior ethmoid sinus closed to optic canals. For 80% (16 sides) specimens, ophthalmic arteries located in the interior inferior of the optic nerve at the intracranial opening, however, for 85%(17 sides) of ophthalmic arteries located in the lateral inferior of the optic nerve at the intraobtial opening. Obvious apophysis of the internal carotid artery could be found in 70% (14 sides) specimens on the lateral wall of sphenoid sinus. A recess between optic canal and internal carotid artery was found in 95% (19 sides) specimens. The mean length of the interior wall of optic canal was about (10.23±1.31) mm.  Anatomic survey concerning with the median distance between the joint of columella nasi and alae nasi, and landmark points, were similar to that of radiologic survey(P>0.05). Conclusions The findings provide detail data of optic canal, which is valuable reference for performing the transnasal endoscopic optic nerve decompression. By CT and images workstations technology, we can precisely observe and measure optic canal.

    A case of variation of thyroid gland and inferior thyroid artery absense
    YUE Kai, JING Xiang, CHE Jia-Dong, DIAO Li-Wu, YANG Rui, TUN Yue
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  493. 
    Abstract ( 902 )  
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    Ulnar wrist pain induced by TFCC injurie: anatomy and its significance
    ZHANG Feng-Lei, LIU Zhi-Gang, CHEN Lei
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  494-497. 
    Abstract ( 1619 )  
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    Objective To investigate anatomic features of TFCC (Triangular Fibrocartilage  Complex) structure, for surgical treating of ulnar wrist pain induced by TFCC injuries. Methods 30 adult cadaveric wrist specimens were involved in this study. The innervation of ulnar carpal soft tissues and TFCC was observed. Structure, origin and attachment of the ligaments around TFC were also studied. Results (1) The ligaments around TFC included ulnounate ligament, ulnotriquetrum ligament, both attached to the volar side of the corresponding carpal bones, collateral ulnar ligament, distal radioulnar ligament, radioulnar triquetral ligament and the sheath of the extensor carpi ulnaris. In addition, dorsal ulnounate ligament and dorsal ulnotriquetrum ligament could be found. (2) The innervation of ulnar carpal soft tissues and TFCC was from the branches of ulnar nerve. Conclusions The ulnounate and ulnotriquetrum ligaments attach to both volar and dorsal side of corresponding carpal bones. The innervation of ulnar carpal soft tissues and TFCC is from dorsal branches of ulnar nerve. Ulnar wrist pain can be treated by the selected enervation.

    Applied anatomy of the cubital ulnar nerve and its blood supply
    HU Zhong-Lin, BANG Tian-Gong, WANG Chi, LV Yun-Cheng, CHEN Qing-Hua, WANG Ai-Beng, ZHOU Xiao-Bing
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  498-501. 
    Abstract ( 1964 )  
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    Clinical anatomy of the safe zone of volar wrist arthroscopic approach
    GENG Shu-Guo, XIE Ren-Guo, WANG Gu-Heng, XU Jing, SHANG Jin-Bei, HOU Jian-Wei, CHEN Yan-Rong
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  502-505. 
    Abstract ( 1457 )  
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    Anatomical factors on forming the popliteal cyst
    SHU Min, DING Jing, XU Yong-Qing, SHU Ti-Liang, LIU Zong-Liang, WU Jiang
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  506-507. 
    Abstract ( 1592 )  
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    Objective To explore the possible anatomic factors on forming the popliteal cysts. Methods 30 adult knee-specimens were dissected and measured.(1)To observe the occurrence of the gastrocnemius semimembranosus bursa (GSB), and explore the relationship of GSB and knee articular cavity; (2) To dissect and observe the channel between GSB and knee articular cavity; (3)To inject physiological saline into joint, and observe whether physiological saline reached to GSB as the result of articular cavity pressure rising.    Results  (1) GSB was observed in all specimens, and 40% (12 specimens) GSB communicated with knee articular cavity by a channel.(2) Joint fluid appered in GSB following the increased articular cavity pressure. Conclusions The gastrocnemius semimembranosus bursa is anatomical basis for forming popliteal cyst.

    Applied anatomy of the venous vascular structure in the superficial abdomen
    FANG Bai-Rong, WANG Xian-Cheng, WANG Ai-Li, LI Wen-Ting
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  508-512. 
    Abstract ( 1426 )  
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    Objective To explore the anatomy of the venous vascular structure in the superficial abdomen using the method of radiology and cadaveric anatomy. Methods Ten abdominal specimens harvested from fresh cadavers were cannulated with trocar and injected with contrast medium into the superficial inferior epigastric vein. During the perfusion of the contrast medium in the flap, the abdominal wall was scanned by three-dimensional CT (four-dimensional defined as three dimensional CT plus time). The CT data was sent to CT workstation and the images were processed and reformatted. The result was compared with that of specimen dissection after injection of blue dye from the vein. Results Originated from paraumbilical area, the superficial inferior epigastric vein coursed obliquely to great saphenous vein of femoral vein; The superficial inferior epigastric vein located longitudinally in a plane above the Scarpa's fascia, with a subcutaneous depth of 0.27~0.41; There were obvious anastomoses existing around the paraumbilical area between the superficial inferior epigastric vein and the largest vein perforator from deep inferior epigastric vein. Conclusions It is the main draining vein of the superficial anterior abdominal wall which is confirmed by its course, diameter and distribution. The knowledge of venous drainage in the superficial anterior abdomen helps to plan DIEP flap and guide flap thinning.

    Anatomy and clinical investigation on the pinpoint of footprint in the in-situ anterior cruciate ligament reconstruction
    LIU Wei, WANG Da-Beng, XIAO De-Meng
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  513-516. 
    Abstract ( 1512 )  
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    Objective To study the pinpoint of footprint during the individual in-situ reconstructing of anterior cruciate ligament(ACL). Methods The footprints of femur were detected on 15 healthy knee specimen, and 15 cases with ACL rupture and underwent ACL reconstruction procedure by navigation. The angle between the axis of ACL footprint and the shaft of femur, the distance from the center of AM to posterior margin of femoral condyle, PL to the inferior margin of cartilage were detected, both in specimen and ACL reconstruction cases. Results The angle between the axis of ACL footprint and the shaft of femur was about (18.5±2.5)° and (19.3±3.1)° for specimens and patients respectively; The distance from the AM to medial surface of lateral condyle of femur was (6.1±1.8)mm and (5.8±1.2)mm; The distance from PL to the edge of inferior cartilage was about (6.2±2.2)mm and (5.9±2.5)mm respectively; The values of parameter were different for different samples and cases. Conclusions The footprints of ACL on the femur and the tibia are variant both in specimens and patients. During in-situ ACL reconstruction procedure, individual ACL footprint measurement should be performed.

    Abnormal of the first common palmar digital artery combined thumb principal artery:one case report
    YANG Xiu-Lin, DU Hun-Feng, WANG Gang-Yang, FU Hai-Zhen, MA Jian-Jun
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  516. 
    Abstract ( 944 )  
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    A feasibility study to a new therapeutics to bromhidrosis: the resection of intercostobrachial nerves
    YI Guo-Bing, GUO Dan, LIU Chang-An, TUN Cheng-Xi, YANG Lou, FAN Cheng-Gao, LIN Zi-Jing
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  517-519. 
    Abstract ( 1243 )  
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    Objective To explore the feasibility of a new therapeutics to bromhidrosis: the resection of intercostobrachial nerves (ICBN), and to provide associated anatomic basis. Methods Axillary region dissection was performed on 25 adult embalmed cadavers (50 sides), including the observation of the innervations of axillary hairs regional skin. In addition, 20 breast cancer patients with bromhidrosis underwent mastectomy removing or retaining ICBN for further exploring the effect of ICBN resection on bromhidrosis. Results ICBN can be divided into five types, including vacancy type(4%) , single trunk type(10%), single trunk with branches type(50%), two trunks type(28%) and three trunks type(8%). For 95.83% specimens, ICBN dominated the axillary hairs region. Among the total, single trunk type ICBN dominated axillary hairs region completely, however, only inferior trunks or branches of the other types ICBN dominated the same region, meanwhile, the upper trunks or branches entered the inner part of upper arm singly or joined with medial brachial cutaneous nerve. 34% of lateral cutaneous branch of the third intercostal nerve dominated a part of axillary hairs region. Resecting of ICBN can eliminated bromhidrosis, retaining of ICBN has no effect on brohidrosis. Conclusions Resecting ICBN or it's inferior trunks or branches will terminate secretion of sweat glands in axillary hairs regional skin, it can be used as a new method to treat bromhidrosis.

    The treatment of lumbosacral transitional vertebra using sacroiliac screws: clinical anatomic survey
    LIU Wei, DU Xin-Ru, YANG Li-Hui, WANG Rui, ZHANG Ji-Zong, KONG Xiao-Chuan, AN Li-Kun
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  520-523. 
    Abstract ( 1003 )  
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    Objective To study morphologic characteristics of S1 and S2 pedicles of sacrum co-existing lumbosacral transitional vertebra, and provide anatomic basis for sacroiliac screw fixation. Methods 79 specimens were selected and measured in this study. Anatomic measurements included the anteroposterior diameter of S1, the height and transverse diameter of S1 and S2, the anterior and posterior heights of S1and S2 pedicles, the width of S1 and S2 pedicles, and the depth and the angle of screw in S1 and S2. Results For normal specimens, anterior heights of S1 and S2 pedicles were about (18.1±3.8)mm and (12.4±2.3)mm,the posterior heights (20.6±3.6)mm and (14.34±2.9)mm, the width (27.7±3.1)mm and (22.2±3.1)mm;For typeⅡ specimens, anterior heights of S1 and S2 pedicles were about (19.9±2.0)mm and (10.4±1.5)mm,the posterior heights (19.2±2.6)mm and (14.4±2.4)mm,the width (29.9±2.2)mm and (19.5±2.7)mm;For type Ⅲ specimens, anterior heights (18.5±3.0)mm and (9.5±2.0)mm,the postreior heights (16.9±3.1)mm and (14.0±3.0)mm,the width (27.8±2.2)mm and (18.6±3.4)mm respectively. The size of normal S1 pedicle was less than type Ⅱ,however, that of type Ⅲ was similar to the normal. The size of normal S2 pedicle exceeded that of type Ⅱ and type Ⅲ. Conclusions sacroiliac screws fixation is reliable for treating lumbosacral transitional vertebre. One or two screws can be hold in S1 pedicle, however, only one screw can be hold in S2 pedicle.

    Morphologic features of myocardial bridge and its relationship with coronary atherosclerosis
    LIU Yun, TANG Lin-Kuan, LI Jian-Bei
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  524-526. 
    Abstract ( 1235 )  
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    Objective To investigate the relationship of coronary myocardial bridge (MB) and the coronary atherosclerosis. Methods Pathological changes of coronary artery and morphologic features of MB from autopsy specimens were retrospectively analyzed. Results MB was detected in 87 speciemns from all 251 autopsy cases, especially in aged cases, with the detection rate of 34.7%. MBs were mainly found on the anterior interventricular branch of the left coronary artery and right coronary artery. One bridge was found in 79 (90.8%) of these hearts. 38 MB cases(43.7%)appeared coronary atherosclerosis of the proximal segment of myocardial bridge,33 cases of them (86.8%) exceeded Ⅲ degree of stenosis. The atherosclerosis of the distal segment of myocardial bridge appeared in 7 cases (8%), with the stenosis degree of Ⅱ. No atherosclerosis appeared in the inferior segment of myocardial bridges. Usually the length of MB occurred atherosclerosis exceeded 20mm. Conclusions Myocardial bridges can be recognized as an anatomical variation of the human coronary circulation, in which an epicardial artery lies in the myocardium for part of its course. For aged people, it is easy to appear proximal and distal myocardial bridges, which are predilection site of atherosclerosis, especially the proximal segment.

    The changes of the intervertebral foramen following the degeneration of lower cervical spine intervertebral space evaluated by 3D laser scan and multiple planar dynamic measurement
    YANG Rui, HUANG Lin, LI Wei-Beng, TANG Yong, WANG Feng, SONG Bin, CHEN Keng, YAN De-Zhen, CHEN Hui-Yong
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  527-531. 
    Abstract ( 1112 )  
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    Objective To observe the changes of the intervertebral foramen following the degeneration of lower cervical spine intervertebral space evaluated by 3D laser scan and multiple planar dynamic measurement (MPDM). Methods Six cadaver specimens of cervical spine were used in this study. Preoperative disc space height was measured radiographically, and regarded the mean disc space height of C4/5 and C6/7 as the baseline height of C5/6. The spatial information of C5/6 FSU on the state of baseline height was collected by 3-D laser scanner. Single C5 and C6 without soft tissue were scanned overall. C5/6 FSU was reconstructed in Geomagic Studio 8.0 by splicing the spot and cloud image to simulate six heights(10%, 20%, 30%, 40%, 50% and 60%)degeneration of lower cervical spine . Intervertebral foramen volume, the middle area, internal and external aperture area were measured respectively on seven states above using MPDM. Results As space height losing, the intervertebral foramen volume and area decreased gradually. When space height lose 30% of baseline height, the middle area of the intervertebral foramen decreased significantly than baseline height state (P=0.003). Conclusions Using 3-D laser scanner, the highly dummy 3-D surface image of bone can be exhibited accurately. MPDM is objective, accurate and repeatable for evaluating intervertebral foramina. The middle area of intervertebral foramen decreased significantly compared to the baseline height state, especially at the lose of space height about 30% of baseline height, which is possible to induce corresponding clinical symptom.

    Morphological measurement of human hippocampal formation
    LIU Zhi-Hua, JIAN Hua-Hua, ZHOU Ting-Yong, LI Lin-Hong, XU Wei, ZHANG Hui, ZHENG De-Ru, LV Fa-Jin
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  532-535. 
    Abstract ( 1362 )  
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    Objective To provide a linear measurement for the disease associated with the hippocampus morphological changes. Methods The area, the sagittal diameter, the transverse diameter of hippocampi, and the spacing of the temporal lobe uncus were observed on 31 specimens, as well the correlation of them was analyzed after standardized processing. Results There was a significant sex difference (P<0.01) for the HPF transverse diameter around standardization. Homogeneity test of variance process and standardized processing, with Pearson correlation analysis, showed the remarkable positive correlation between area and the sagittal diameter of HPF around standardized processing(P<0.01), remarkable positive correlation between area and the transverse diameter of HPF (P<0.05), and remarkable positive correlation between area and the spacing of the temporal lobe uncus(P<0.01). Conclusions The hippocampus diameter, the sagittal diameter, the hook spacing can be used as linear indexes for exploring of hippocampus morphological changes. 

    Experimental study of canine skin flap pedicled with perforating branches of saphenous neurocutaneous vessels
    YUE Su-Qin, CHEN Chao-Yong, HUANG Lian-Hua, ZHENG He-Beng, ZHANG Fa-Hui
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  536-540. 
    Abstract ( 1088 )  
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    Objective To explore the relationship of arterial vascular caliber and flap survival area of skin flap.    Methods    Bilateral hind limbs of adult dogs were used to make flap model pedicled with perforating branches of saphenous neurocutaneous vessels. The diameters of the pedicled arterial vessel were measured. On one side, the flap survival at different time points were measured and compared, as well, another side was perfused black ink for measure the proportion of perfusion. Results The diameter of perforating branches of peroneal artery on the medial malleolus was (1.0±0.1) mm, and the flap area (287.0±44.2) cm2. The survival area was  about (287.0±44.2) cm2, which accounted for (55.9±9.1)% of the total flap area. The perfusion imaging area was (168.2±16.4) cm2, which accounted for (59.9±10.0)%. Conclusions The survival of the flap will be supported by the wide vessels, abundant blood flow, and extensive blood supply scope. By evaluating perfusion area, the pedicled vessels and corresponding flap survival can be estimated. 

    One case of an unusual branch of right costocervical trunk
    LI Can-Feng, LAI Li-Dan, HE Yong, BO San-Jiang
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  540. 
    Abstract ( 1119 )  
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    Construction and identification of RhoA-GTPase lentivirus
    LI Liang-Beng, GU Jing-Jing, WANG Bin, LI Juan, ZHANG Lei, ZHANG Lin, ZHANG Lu
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  541-545. 
    Abstract ( 1100 )  
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    Objective    To construct lentiviruses carrying dominant negative mutant of RhoA-GTPase (RhoAN19) or the constitutive active mutant of RhoA-GTPase (RhoAL63) and expressing enhanced green fluorescent protein (EGFP) bicistronically.    Methods    The lentiviral expression plasmid Plenti6/v5- RhoAN19 and Plenti6/v5- RhoAL63 were constructed and identified by restriction enzyme digestion and DNA sequence analysis. The two plasmids were packaged using the ViraPowerTM lentiviral expression system to produce replication-incompetent lentiviruses RhoAL63 and RhoAN19, which were used to infect the prefrontal cortex neurons (PFCs) from neonatal SD rats. The transfection efficiency and biological activity of different RhoA mutants were evaluated and the morphology of the transfected PFCs was observed.    Results    The results of DNA sequencing and restriction enzyme analysis demonstrated correct plasmid construction. The packaged lentiviral titer was 1×106 TU/ml. Analysis of RhoA biological activity showed that RhoAN19 lentivirus particles infection significantly inhibited lysophospatidic acid stimulated RhoA activity in the PFCs, while RhoAL63 lentivirus particles enhanced the RhoA activity. The transfection efficiency of these RhoA mutant lentivirus particles exceeded 80% in the PFCs. Morphologically, the PFCs exhibited distinct dendritic branches after infection by these lentiviruses.    Conclusions    The lentiviruses carrying RhoA dominant negative mutant and constitutive active mutant have been successfully constructed. The lentiviral particles can efficiently infect neonatal rat PFCs. Thus providing important support for the study of RhoA signaling.

    Inflammatory pain induced CBP expression change in rat hippocampus
    LI Hua, CAO Wen-Yu, XU Yang, LUO Yan-Wei, ZHONG Xiao-Lin, ZHANG Jian-Wei, LI Chang-Qi, LUO Hua-Gang, DAI Ru-Ping
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  546-549. 
    Abstract ( 1937 )  
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    Objective To explore expression changes of CBP(CREB Binding Protein) in rat hippocampus followed by Complete Freund's Adjuvant(CFA) induced inflammatory pain.   Methods    Rats were received plantar subcutaneous injection of CFA and saline mixed solvent 100ul, for establishing inflammatory pain model. Model rats were randomly divided into normal group, CFA 6h, 1d, 3d, 7d and 14d groups. The change of paw withdrawal threshold (PWT) was observed by Von Frey fibers in rats at different time points; the expression of CBP was detected using immunohistochemistry.    Results    PWT decreased quickly at 1h after CFA injection, and to the lowest value at 6h. PWT gradually rose at 3d and was still lower than baseline at 14d. A number of CBP positive products can be seen in hippocampus. CBP was significantly decreased at 6h and 1d after CFA injection; and increased at 3d, then decreased again from 7d to 14d after CFA injection,especially in CA1 and DG.    Conclusions    CFA can induce inflammatory pain about 2 weeks. CBP in hippocampus shows biphasic expression following inflammatory pain,which indicate gene transcription change in hippocampus plays an important role in the induction and maintenance of persistent pain.

    Characterization and biocompatible evaluation of nHA/RHLC/PLA composite scaffold
    LV Yu-Meng, CHENG Li-Meng, FEI Guo-Xian, WANG Yu, CUI Fu-Zhai
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  550-556. 
    Abstract ( 1241 )  
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    Objective To explore the characteristics and biocompatibility of nano-hydroxyapatite/ recombinant human-like collagen/polylactic acid (nHA/RHLC/PLA ) composite scaffold. Methods The morphologic features of nHA/RHLC/PLA scaffold were observed under scanning electron microscopy.The porosity of the scaffold was determined via isopropyl alcohol displacement method. The canine BMSCs were separated and cultured in vitro. The third passage of cells was seeded into the scaffold for analyzing the adhesion and proliferation ability of BMSCs on scaffold. Results Scan electron microscopy showed that, the surface of scaffold was porous.BMSCs infiltrated into the pores of scaffold, adhered, spread, and proliferated on the surface of scaffold pore within one week. However, we did not detected the significant difference of adhesion and proliferation of BMSCs between nHA/RHLC/PLA scaffold culture and normal culture (P>0.05). Conclusions The nHA/RHLC/PLA composite scaffold has favourable microstructure, which is biocompatible to BMSCs.

    The expression of Toll-like receptors 2 and 4 in the macrophages of hip synovium
    CENG Zhan-Feng, DING Yue, HU Jie, HUANG Jian-Bin, QIN Chu-Jiang, WEN Chu-Ping, Barden Bertram
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  557-560. 
    Abstract ( 1388 )  
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    Objective To explore the expression of TLR2 and TLR4 in the macrophages of hip synovium.    Methods Hip synovium tissues were collected from 47 cases during hip surgery in our hospital from 2007 to 2010 and divided into three groups. 24 cases of femoral neck fracture were in group A, 18 cases of femoral head necrosis were in group B, and 5 cases of aseptic loosening were in group C. TLR2 and TLR4 were detected in synovial tissues of three groups by immunohistochemistry (sp), and the positive macrophages were observed, counted and analyzed  statistically.    Results The histoscore of TLR2 was 0.27±0.33/HP in Group A, 0.31±0.19/HP in Group B and 1.78±0.18/HP in the Group C. The histoscore of TLR4 was 0.69±0.18/HP in Group A, 0.71±0.31/HP in Group B and 2.00±0.39/HP in Group C. The expression of TLR2 and TLR4 in group C was significantly higher than that in group A and group B(P<0.001). The expression of TLR4 was significantly higher than TLR2 among the three groups(P<0.001).    Conclusions TLR2 and TLR4 significantly increases in the macrophages of hip synovium around the prosthesis, which may be involved in macrophage-mediated process of aseptic joint loosening.

    Effect of recombinant adenovirus vector carrying human KGF gene on the proliferation of human epidermal stem cells
    LI Xin-Beng, BAI Li-Meng, BAI Wen-Fang, TUN Zhi-Dong, TUN Bo, ZHANG Ming-Sheng
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  561-564. 
    Abstract ( 1033 )  
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    Objective To construct a recombinant adenovirus vector carrying human keratinocyte growth factor(KGF) gene, and investigate its proliferative effect on the transferred primary human epidermal stem cells. Methods RT-PCR was used to amplify the sepuence of human keratinocyte growth factor. Recombinant adenoviral vector containing the sequence was prepared using pAD-easy-I system. The primary human epidermal stem cells were transfected with the recombinant virus vector. Under the fluorescence microscope, the transfection efficiency was determined. MTT assay was used to analyze the proliferation of hESCs. Cell cycle of hESCs was evaluated by flow cytometry. Results KGF gene was amplified as expected. The recombinant adenoviral plasmid could be digested with Pac I to produce a fragment of 4.5kbp. The transfection efficiency of the recombinant virus at the MOI of 50 was 90%. The proliferation of transgenic cells significantly increased compared to that of controls, evaluated by MTT and the ratio of G2/M cell of the transgenic group. Conclusions The recombinant adenovirus vector containing KGF gene was successfully constructed. The KGF transgenic hESCs showed favourable proliferative potential.

    The protection of salvia miltiorrhiza compostita to blood brain barrier on severe burn injuried rats
    LIU Ceng-Xu, TU Qiang, WANG Xiang-Dong, ZHOU Cong-Fa, LI Yao-Bin, LIU De-Meng
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  565-567. 
    Abstract ( 1265 )  
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    Objective To explore the effects of salvia miltiorrhiza compositita on blood-brain barrier permeability and ZO-1 expression in burn injuried rats. Methods In this research, healthy Sprague-Dawley rats were separated into three groups as follows: sham scald group, scald group, scald and salvia miltiorrhiza group. Changes in BBB permeability were determined by detected Evans blue (EB) content in rats' brain with chemical method. Furthermore, in order to explore the molecular mechanism of BBB disruption in rats' brain after severe burn, the expression levels of ZO-1 mRNA was analyzed by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Results Expression of brain ZO-1mRNA significantly decreased during 3 to 48h after burn. The contents of Evan's bluedye (EB) in brain significantly improved at the 3h and reached the highest level during 6 to 24h after burn injury. After treating with salvia miltiorrhiza, EB content in the brain of burned rats was corrected obviously, especially at the time points of 3, 6h after burn injury. As well, ZO-1mRNA in brain increased after drug treating, and reached the highest level at 3h after burn injury. Conclusions Salvia miltiorrhiza will prevent the decrease of ZO-1 level in brain after burn injury, which is helpful for alleviating the burn damage on blood-brain barrier.

    Three-dimensional digital reduction of jaw opening and closing movement
    WANG Hui, LIU Yang, DIAO Wei-Dong, JIAO Pei-Feng, OU Yang-Jun, HUANG Wen-Hua, BI Zhen-Yu
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  568-571. 
    Abstract ( 1553 )  
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    Objective To explore a three dimensional digital displayed method of mandibular movement, and provide a basis for the virtual reality of mandibular motion. Methods 1 case of male adult, with the integrated dentition, and no temporomandi-bular joint disorders was used in this study. The independent three-dimensional digital jaw model was reconstructed with CT image in Mimics11.0. The three-dimensional digital reduction of jaw opening and closing movement with six degrees of freedom was set up in Autodesk 3dsmax 8.0. Results Through the three-dimensional digital jaw opening and closing movement, the location between the upper and lower jaw, dentition, occlusion and the structures of the temporomandibular joint could be demonstrated clearly. Conclusions Adopting autodesk 3dsmax 8.0, virtual reality of jaw movement with six degree-of-freedom and 3D digital jaw models can be built, which is feasible to quantify and visualize the course of the mandibular movement.

    Free anterolateral thigh perforator flap: in situ one-stage thinning for the coverage of the distal foot defects.
    SHU Ti-Liang, XU Yong-Qing, LI Jun, MEI Liang-Bin, WANG Yi-
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  572-574. 
    Abstract ( 1357 )  
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    Objective To explore the feasibility of the in situ one-stage thinning of the anterolateral thigh perforator flap for repairing the distal foot defects. Methods From Jun. 2009 to Aug. 2010, 9 cases with distal foot defects were treated with anterolateral thigh perforator flap. During the harvesting of the flap, either the deep layer of the subcutaneous fat and the deep fascia were preserved in situ (6 cases) or the whole layer of the subcutaneous fat and the deep fascia were preserved in situ (3 cases) according to the wound requirements. The donor sites were directly closed or covered with split-thickness skin grafts. The average operating time was 4.0 hours. The flap size ranged from 12×8cm~16cm×10cm. Results One flap had vein thrombosis postoperatively and the complication was solved after the re-exploration. The other 8 flaps healed uneventfully without any marginal necrosis. There was no skin grafts loss on the donor sites. At a 3~16 months follow up, the flaps took well with good contours. The thickness of these flaps was half of those harvested with common ways. The patients could wear the same size shoes postoperatively, and none of them required the thinning or debulking of the flaps. Conclusions In situ one-stage thinning of the anterolateral thigh perforator flap is a good technique for the distal foot defects. It has the advantages of the reliable blood supply, more satisfactory contours and requires no secondary thinning.

    Repair of soft tissue defect in forefoot with the distally based saphenous neurocutaneous flap
    LIU Yong-Beng, CENG Hai-Bin, LIN Song-Qiang, ZHANG Fa-Hui
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  575-577. 
    Abstract ( 1106 )  
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    Objective To explore clinical effects of the distally based neurocutaneous saphenous island flap on the repairing of soft tissue defects in the dorsum of foot. Methods According to the size and site of the defect and the rotation point, the flap was designed, based on the arterial axis associated with the saphenous nerve and the greater saphenous vein. 11 patients received surgical flap transplantation. Results For all of cases, neurocutaneous saphenous island flaps survived well. The area of lived flaps ranged from 7.0cm×4.0cm to 11.0 cm×6.0 cm. The patients were followed up for 6 to 10 months. All the flaps survived completely, with the satisfied appearance and functions. Conclusions The blood supply of medial-distal leg is abundant, which is the anatomic basis for designing and using of neurocutaneous flap, furthermore, the distally based saphenous neurocutaneous flap is useful for repairing of soft tissue defect in forefoot.

    Repair of Achilles tendon composite defect using osteocutaneous flap of adductor magnus tendon pedicled with descending genicular artery
    WANG Hai-Wen, GU Rong, JIANG Xin-Meng, CENG De-Qiang, JIANG Ji-Yong
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  578-580. 
    Abstract ( 1345 )  
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    Objective To evaluate clinical effects of osteocutaneous flap of adductor magnus tendon pedicled with descending genicular artery on repair of Achilles tendon composite defect. Methods Osteocutaneous flap of adductor magnus tendon pedicled with descending genicular artery were individually designed and surgically used on 3 cases with traumatic Achilles tendon defects, combined with soft tissue and calcaneal bone damage. The area of skin defect was ranged from 7 cm×9 cm to 5 cm×7 cm, and the length of Achilles tendon defect was 6 ~ 8 cm. During the operation , the flaps was designed as 8cm×10cm to 6cm× 8cm, with the cutting length of the adductor magnus tendon 7~ 9 cm . Results: All 3 cases were followed-up for 6 to 12 months. The transplanted tissue flap survived well. The texture, appearance and function of the flap were excellent. Conclusions It is a ideal way to repair of Achilles tendon composite defect, using osteocutaneous flap of adductor magnus tendon pedicled with descending genicular artery, which avoiding the severe surgical trauma and the extended isolation of vessels.

    The comparision of two methods for placing translamina facet screw
    CENG Zhong-You, CHEN Guo-Jun, SHANG Yong-Hua, YAN Wei-Feng, TUN Feng, ZHANG Jian-Jiao
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  581-584. 
    Abstract ( 1351 )  
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    Objective To compare advantage and disadvantage of two different methods for placing the translamina facet screw. Methods The study reviewed 47 patients of low lumbar vertebra diseases underwent the surgery. 21 cases were placed screw by opening procedure, the others were placed screw by the percutanous gunsight guiding. There was no difference among the gender, age, history time, diseased type, diseased region and severity in two groups. Results All cases underwent the surgery successfully, with no complication occurred intraoperatively and postoperatively. There was significant differences among the times of intraoperative guide pin puncture, length of incision, operative time, intraoperative bleeding, postoperative incisal draining and postoperative screws location in two sets. All cases were followed-up for 12 to 36 months, averagely 19 months. 44 cases got bony fusion, only 3 suffered from poor bony fusion. Improving rate of the JOA grades was insignificant different in two sets. Conclusions Compared to that of opening fixation, the screw placing through percutanous gunsight guiding is more prevalent, such as the small surgery trauma, simple operation, high intraoperational safety, and short manipulation time. Therefore, gunsight is a good choice for translamina facet screw fixation.

    Treatment of humeral proximal fractures with minimal invasive technique by lateral deltoid approach
    LI Song-Jian, CHEN Pan, XU Bo
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  585-587. 
    Abstract ( 1276 )  
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    Reconstruction of anterior cruciate ligament with autogenous bone-patellar eendon-bone under knee arthroscopy 
    XIE Jin, DONG Wei-Jiang, JU Zhong-Bing, BAI Bei, YAN An-Bin
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  588-590. 
    Abstract ( 1255 )  
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    Objective To evaluate the technique and outcome of arthroscopic anterior cruciate ligament(ACL) re-construction with autogenous bone-patellar tendon-bone. Methods From Jan. 2003 to Jan. 2010, 35 knees with ACL tear in 35 patients were verified with arthroscopy in this department. Of them, there were 22 males and 13 females, and the average age was 23.0 years (ranged from 20.0~28.0 years). The lesions were left knees in 18 and right knees in 17, and all were acute injuries and all the damaged ACLs were reconstructed with autogenous bone-patellar tendon-bone under knee arthroscopy. All patients were keen participants in sports. Results All patients were followed up for 1 to 6 years with an average of 3.0 years. The patients were evaluated according to the Lysholm knee scoring scale.The score was remarkable improvement from 45~81 points (mean 59.40 points) preoperatively to 72~100 points ( mean 91.80 points) at follow up (P<0.0001). Of the 35 patients, 34 patients returned to the same preinjury sports level and only 1 was below the preinjury sports level. There was no patellar fracture and loosing of the screws. Only one patient feel little pain in knee. Conclusions The autogenous bone-patellar tendon-bone with advantage of minimal trauma in surgery, reliable satisfactory outcome especially good for the youth who are keen participants in sports.

    Breast cancer radical mastectomy preserving intercostobrachial nerve: improve the quality of life for postoperative patients
    HAN Zhong-Bao, ZHOU Hu, HAN Kou-Lan
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  591-593. 
    Abstract ( 1166 )  
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    Objective To explore the effects of breast cancer radical mastectomy preserving intercostobrachial nerve (ICBN), on the quality of life for postoperative patients.    Methods    150 patients, suffered from breast carcinoma (stage I or II), were performed Anchincloss surgery preserving ICBN or not. All cases were followed up and analyzed. Results For postoperative patients preserving ICBN, it's less to occur paresthesia and pain of the post-medial upper arm, compared to that of patients removing ICBN (P<0.01). However, no difference appeared between two kinds of surgery procedures for local recurrence rate and distant metastasis rate. Conclusions For patients underwent breast cancer radical mastectomy preserving ICBN, it's better to relieve postoperative pain and improve quality of life.

    Application and experience in radical excision of hilar cholangiocarcinoma by regional blocking of hepatic hilum:a report of 49 cases
    ZHANG Guo-Wei, ZHOU Jie
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  594-596. 
    Abstract ( 1167 )  
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    Objective  To summarize the experience in radical excision of hilar cholangiocarcinoma by regional blocking of hepatic hilum. Methods: The clinical data and long-term outcome of 49 cases of hilar cholangiocarcinoma were analyzed retrospectively, from 2002 to 2009. 24 cases (treatment team) were resected radically after anatomizing and blocking hepatic hilum. 25 cases (contrast team) were resected radically by normal way. Results In treatment team, 2 cases of bile leak and 2 cases of pulmonary infection were found and cured by non-operation ways. In contrast team, 2 cases of dead, 1 cases of bleeeding in hepatic cross-section, 2 cases of bile leak, 2 cases of pulmonary infection were found. 40 cases were visited. The average survival time was 26 months (2~65 months). Complications of the cases with high total bilirubin (≥300μmol/L)were higher than the lower (P<0.05). Conclusions The cases with high total bilirubin(≥300 u mol/L)should be treated before operation. The best prognosis can be achieved by radical excision for patient with hepatic hilar cholangiocarcinoma. The methods of regional blocking of hepatic hilum could decrease the volume of hemorrhage, death rate and occurrence of complications after operation.

    The research progress of damage of cervix surrounding tissues
    HAN Fei-Fei, LI Re-Bao
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  597-598. 
    Abstract ( 939 )  
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    A case report of symmetric polydactyly of both hands and feet
    JIN De-Shan, CUI  Hu
    Chinese Journal Of Clinical Anatomy. 2011, 29(5):  598. 
    Abstract ( 739 )  
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