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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 July 2012 Volume 30 Issue 4
      
    Microanatomy of the transition zone of the trigeminal nerve and related clinical issues
    XU Jia-Ming, QI Song-Chao, ZHANG Chi-An, DAN Jin, LIU Yun-Chao, BO Jun
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  367-370. 
    Abstract ( 1507 )  
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    Objective    To examine anatomic features of the central myelin, the peripheral myelin and the transitional zone of trigeminal nerve.    Methods    Anatomical and histological techniques were used to investigate 15 adult cadaveric head specimens. The different skull base approaches were performed on those specimens under surgical microscope. The cistern segment of the nerves were embedded in paraffin and sectioned,for Luxol fast blue staining. The photomicrographs were used to measure the length of central myelin and transition zone.    Results    The central myelin extended into the cistern. About  (2.34±0.81)mm from the pons, the central myelin gradually transferred to peripheral myelin. The transition zone terminated at (3.78±0.69)mm from the pons. (30.5±5.6)% of the cistern segment of the trigeminal nerve composed of cental myelin, whereas the peripheral myelin formed aboudt (81.1±8.1)% of the cistern part. The TZ located at the site from (18.8±6.5)% to (30.5±5.6)% of the cisternal segment.    Conclusions    The extension of the central myelin and transition zone into the cistern gives the conception that REZ and TZ are distinct areas. The vascular compression in this region might be contributive to the trigeminal neuralgia.

    Clinical anatomy of genifemoral nerve during the anterior approach of lumbar spine surgery
    WANG Yong-Wei, GAO E-Xian, MA Quan, KONG Xiang-Yu
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  371-374. 
    Abstract ( 1151 )  
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    The effects of entry points of femoral intramedullary nail on the blood supply of proximal femur: anatomic study
    HUANG Jie-Cheng, MEI Jiong, DOU Bang, OU Yi, ZHANG Feng, XIONG Wen-Feng
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  375-378. 
    Abstract ( 1087 )  
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    Objective    To explore the blood supply damage around the proximal femur during the process of femoral intramedullary nailing.    Methods    The study was performed on 68 adult antiseptic hip joint specimens. The distribution and location of medial femoral circumflex artery (MFCA), lateral femoral circumflex artery (LFCA), superior gluteal artery(SGA), inferior gluteal artery(IGA), and their relationship with adjacent muscles were exposed, as well, their anastomosis around proximal femur were measured.   Results  Anastomosis between LFCA's descending branch and MFCA's deep branch appeared in 7 cases (10.3%), and anastomosis between MFCA's deep branch and IGA in 61 cases (89.7%), anastomosis between MFCA's deep branch and SGA in 48 cases (70.6%).   Conclusions   Instead of LFCA, the deep branch of MFCA may be capable of being compensated by IGA and SGA together.

    The variation of precava: a case report
    JIAO Yi-Xian, LIU Ying, TAN Xie
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  378. 
    Abstract ( 952 )  
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    Anterior talofibular and the posterior intermalleolar ligaments: anatomy and clinical significance
    HU Chao, LIU Zhi-Gang, SONG Liang-Song, CHEN Lei
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  379-381. 
    Abstract ( 1314 )  
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    Objective To study anatomic characteristics of the anterior talofibular and the posterior intermalleolar ligaments, and explore their functions and clinic significance.    Methods 10 ankle joint specimens from adult fresh cadavers were used. The anterior talofibular and the posterior intermalleolar ligaments were carefully dissected. The origin, insertion points, coruse and the adjacent structures were observed. the functions of those ligaments were analyzed.    Results The anterior talofibular ligaments of 7 cases (70%)presented the double-banded shape, with the increased width of two bands compared to that of one-banded ligaments. the course of two bands formed the shape of "人". In plantar flexion, the inferior band of the ligament remains relaxed while the upper band became taut. In dorsiflexion, the upper band remains relaxed, and the inferior band became tight. The posterior intermalleolar ligament ran obliquely from lateral to medial. The medial arising sites of the ligament included the lateral border of the medial malleolar sulcus, the medial border of the medial malleolar sulcus through the septum between the flexor digitorum longus and posterior tibial tendons, the posterior distal margin of the tibia, and the posterior process of the talus through the joint capsule. This ligament was important to sustain the stabilization of the malleolar joint and to prevent the astragalar dislocation.    Conclusions The double-banded structure of anterior talofibular ligament can strengthen the intensity. It is worthy to do a further study about the mechanism that the posterior intermalleolar ligament involvement in the posterior soft tissue impingement syndrome of the ankle.

    Investigation of compartmentalization on human flexor digitorum longus and their clinical significance
    LI Shou-Tian, TUN Xiao-Yan, XUE Qian
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  382-384. 
    Abstract ( 1127 )  
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    Objective    To reveal morphologic features of human flexor digitorum longus (FDL) for clinical application. Methods Muscle architecture skill and modified Sihler's staining were used in this study. Results ①The FDL could be divided into tibial and fibula compartments by the instramuscular tendon; ②The values of muscle architecture of tibial compartment of FDL were bigger than those of the fibula compartment; ③Tibial compartment and fibula compartment were innervated respectively. Conclusions  ①The FDL can be divided into tibial and fibula compartments, with independent nerve innervation; ②Two compartments formed by the half pinnate muscle, however, muscle strength of tibial compartment is more strong than that of fibula compartment.

    Morphological measurement of the thalamus and thalamus-related structures
    ZHANG Hua, ZHOU Ting-Yong, JIAN Hua-Hua, ZHENG De-Ru, LIU Zhi-Hua, BAI Gui-Qin, LV Fa-Jin
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  393-397. 
    Abstract ( 1086 )  
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    Objective To provide morphological basis of the thalamus and thalamus-related structures for imaging diagnosis.    Methods    Totally 30 adult head specimens were used to make serial transverse sections along canthomeatal 1ine (CML), with the thickness of 5 mm. The three continuous sections involving thalamus and its relative structures were observed and statistically analyzed.   Results   After adjusting cerebral volume, the area, sagittal and transverse diameters of bilateral thalamus had no gender difference. Negative correlation appeared among thalamus area, caudate nucleus head area, and the transverse diameter of the caudate nucleus head(P<0.05). The transverse diameter of the thalamus and the area of the caudate nucleus head, as well as the sagittal diameter of the caudate nucleus head was negatively related (P<0.05). The length and width of the thalamus and the telencephalon were positively related, respectively (P<0.05). The distance between right trigone of the lateral ventricle and anterior horns was significantly related with the length of the thalamus (P<0.05).    Conclusions    Anatomic parameters of the thalamus and thalamus-related structures have linear relationships. The data of thalamus-related structures can provide information for exploring the features of thalamus.

    The pedicle and iliac screw fixation in treatment of sacroiliac dislocation and fracture: CT tomography study
    YANG Yun-Beng, CHEN Hong-Fen, WANG Fu-Meng, GU Yi, WANG Gang
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  404-407. 
    Abstract ( 1226 )  
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    Objective    To investigate the value of digital model on evaluating pedicle screw and iliac screw in treating sacroiliac dislocation and fracture.    Methods    The pelvic CT data from 40 healthy adults were imported into the Mimics 10.0 software for three-dimensional reconstructing of pelvis. The anatomic parameters concerning with inserting angles and the ilium screws at different directions were measured on the virtual pelvis.    Results    The distance between lateral and medial ilium lamella(the maximum diameter of ilium screw)was about(6.00±0.84)mm,or (6.95±0.50)mm. The length of screw inserting was (59.97±7.99)mm,or (106.69±8.74)mm. TSA was (12.48±7.16)° or (43.93±6.09)°,CSA(56.41±6.47)° or (39.25±6.11)°,and SSA(29.91±5.55)° or 19.24±3.78)° at the different inserting direction, respectively.   Conclusions    Digital pelvic model is a valuable tool to guide clinical treatment of sacroiliac dislocation and fracture through pedicle screw and iliac screws.

    Juvenile muscular atrophy of the distal upper extremity: clinical anatomy and MRI study
    LIANG Qiu-Fa, WANG Wen-Jun, LIU Wen-Song, WANG Lu-Shan, MENG Gong-Qi, CHEN Ku-Long-
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  408-411. 
    Abstract ( 1207 )  
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    Objective    To study clinical characteristics of juvenile muscular atrophy of the distal upper extremity, for early diagnosis and treatment.    Methods    The clinical data, neuro-electrophysiological features, clinical anatomy and MRI features of 13 patients diagnosed by the criteria of Hirayama Disease were retrospectively analyzed.    Results    The mean age of onset was about 18.6 years old. Hirayama disease was characterized by muscular atrophy in the hand and forearm. The brachioradialis was spared (oblique amyotrophy). EMG indicated that the impairment of spinal anterior cells was limited to the arm relevant segments and both sides were involved. During neck flexion, the spinal cord was placed forward and flattened. The diameter of cervical spine cord in the sixth cervical vertebra along the horizontal in juvenile muscular atrophy of the distal upper extremity was smaller than that in normal volunteers significantly (P<0.05). Conclusions  Juvenile muscular atrophy of the distal upper extremity may be a special type of cervical myelopathy. The neuro-electrophysiological check and the neck flexion MRI check are valuable to the clinical diagnosis and differential diagnosis. Cervical collar therapy is recommended the sooner the better and avoiding long time neck flexion position is very important for the patients.

    Effects of L-NAME on the expression of VE-cadherin in human umbilical vein endothelial cell
    YANG Bao-Lin, WU Jiao-Qiong, LUO Meng-Yang, SHU Wu, XIE Feng, LIU Li-Hua, GUAN Ying-Lou, CA Wei-Jun
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  412-416. 
    Abstract ( 1001 )  
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    Objective    To investigate the effects of N-nitro-L-arginine methyl ester (L-NAME)as a nitric oxide synthase inhibitor on the expression of eNOS and VE-cadherin in human umbilical vein endothelial cell (HUVEC).   Methods   Subculturing HUVECs were identified with specific antibody to CD31. 3 groups (control group, 0.1mmol/L L-NAME group, 1.0 mmol/L L-NAME group) were designed to carry out in this study. The effects of L-NAME on HUVEC activity was assessed with MTT assay. Expression of eNOS and Ve-cadherin protein in HUVEV of all group were detected with immunocytochemistry staining or Western blot. Results   More than 95% subculturing HUVECs were CD31+ cell. MTT assay showed a L-NAME dose-dependent reduction in HUVEC activity when L-NAME was added into medium. The immunofluorescence intensity of eNOS positive staining in 0.1 mmol/L L-NAME group and 1.0mmol/L L-NAME group were obviously decreased as compared with control group(P<0.01). The immunofluorescence intensity and the relative expression of VE-cadherin positive staining in 0.1mmol/L L-NAME group and 1.0 mmol/L L-NAME group were obviously increased as compared with control group(P<0.01).   Conclusions  L-NAME suppresses the expression of eNOS and cell activity, but improves the expression of VE-cadherin in HUVEC.

    The effects of melatonin on the activity of microglia in the brains of AD mice
    CUI Wei-Gang, LI Jun-Yan, WANG Qiang-Zhi, BANG Yu-Wen, LI Rui-Ti
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  417-420. 
    Abstract ( 231 )  
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    Involving of GAPDH in mechanism of EPO reducing neural damage induced by ischemia/reperfusion
    JIN Xiu-Dong, GUO Dan, NIAN Gong, GUAN Yan-Zhong
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  421-425. 
    Abstract ( 231 )  
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    Expression and significance of BMP-2 during rat NSCs induced by ATRA differentiating into neurons in vitro
    ZHONG De-Jun, LI Sen, KANG Min, XU Shuang, WEI Shu-Yi, WANG Qing, WANG Song
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  426-430. 
    Abstract ( 165 )  
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    Objective  To explore the expression and effect of  BMP-2 during the rat embryonic stem cells(NSCs) induced by all-trans-retinoic acid(ATRA)differentiating into neurons in vitro. Methods  The rat embryonic neural stem cells were differentially induced with 1.0 μmol/L ATRA in vitro. The expression of BMP-2 was respectively investigated by immunocytochemistry, real-time PCR and western blot at the time of inducing 3d, 5d, 7d and 9d, and compared with that of untreated cells in control group. Results The highest expression of BMP-2 was at the time of inducing 3d, and then it decreased from inducing 5d following the NSCs differentiating. There was no significant difference between 7d and 9d groups. Conclusions The expression of BMP-2 decreases in the progress of NSCS differentiating into neurons in vitro, which indicate that, the inhibition of BMP2 signal pathway participate the differentiation process of NSCs.

    Cervical vagus and sympathetic trunk and fiber components of external laryngeal nerve: comparative anatomy between human and dog
    HU Shi-Xie, DONG Jian-Beng, SUN Shan-Quan, Kannaiyan Vijesh, Ramnarayan, Joyeeta Sengupta
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  431-434. 
    Abstract ( 278 )  
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    Objective    To compare the differences of cervical vagus and sympathetic trunks between human being and dog, and identify the fiber components of the dog external laryngeal nerve (ELN).   Methods   50 adult human cadavers fixed with formalin and 10 fresh dog cadavers were randomly used. The superior laryngeal nerve and its branches, superior cervical sympathetic ganglion (SCSG) and nodose ganglion (NG) were exposed. The communications between the cervical sympathetic trunk and the superior laryngeal nerve (SLN) were identified. The tissues from ELN and NG together with a branch from dog SCSG were taken for AchE activity analysis.    Results    In dog, the nodosum of vagus and the SCSG were completely or partially fused. In human being, the nodosum of vagus and SCSG separated, and in the most cases (86%) the SCSG connected with the ELN. The AchE staining demonstrated the presence of three different types of fibers in dog ELN: AchE-positive myelinated fibers, AchE-negative myelinated fibers and AchE-positive unmyelinated fibers.    Conclusions    ELN is looped in shape and innervates the thyroid gland. ELN is a mixed nerve carrying somato-motor, post-ganglionic sympathetic and a few somato-sensory fibers.

    Experimental study of the modified double stem arterialized venous skin flap 
    LI De-Beng, LIU Hua-Gui, MAO Bei, ZHENG Qing, YANG Dun-Gui, CUI Jian-De, YANG Shuai-Zhi, HUANG Yu
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  435-437. 
    Abstract ( 362 )  
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    Objective    To explore survival rate and survival mechanism of the modified double stem arterialized venous skin flaps.    Methods    40 venous skin flaps of hind limbs with two vein trunks and size of 2.0cm×3.0cm were obtained from New Zealand white rabbits. The flaps were randomly divided into two groups: the control group and the study group. For heterotopic replanted arterialized venous skin flap in the control group, central artery and central vein at the  back of rabbits'ear were anastomosed. For study groups, "opening groove" were performed (fat tissues of flap were cut to reach subdermal vascular plexus and keep its integrity by ligating all communicating branches). Survival of all skin flaps was recorded.   Results   In study group, 14 skin flaps survived, while 4 skin flaps had partial necrosis and 2 complete necrosis. In the control group, 4 skin flaps survived, 5 skin flaps had partial necrosis and 11 complete necrosis. There was significant difference in the survival rate between two groups (P<0.05).    Conclusions   Modification of arterialized venous skin flap is useful to bleed into micro-circulation and reach the balance of arterial supply and venous drainage. It may improve the survival rate of arterialized venous skin flap.

    Selection of reference genes for expression studies in the jugular-nodose ganglion of a mouse model of asthma
    LIN Min-Juan, LIU Xiao-Yan, MA Hong-Meng, LIU Sheng-Meng
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  438-442. 
    Abstract ( 225 )  
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    Objective To investigate the expression stability of 12 common housekeeping genes (HKGs) in jugular-nodose ganglion complex (JNC) from control and asthmatic mice.  Methods Female BALB/c mice were randomly divided into control group and asthma group. Expression levels of 12 candidate HKGs, CYC1, UBC, RPL13, YWHAZ, 18srRNA, B2M, SDHA, ATP5B, CANX, ACTB, EIF4A2 and GAPDH, were measured by quantitative real-time PCR in JNCs from 5 normal mice and 5 asthmatic mice. Gene expression stability was subsequently determined using geNorm and Normfinder applets. Results GAPDH, 18srRNA, CANX, ACTB and EIF4A2 were relative stably expressed. However, the expression levels of CYC1, UBC and RPL13 were significantly different between the two groups. GAPDH was ranked the most stable by geNorm and Normfinder. Conclusions The results suggest that GAPDH is the most suitable housekeeping gene analyzed for expression studies in JNCs from normal and asthmatic mice, and provide the evidence of the importance of validating housekeeping genes for different experimental model.

    The inferior tibiofibular syndesmosis ligaments' injury and the ankle position: biomechanical study
    JU Meng, ZHANG Yan, BAI An-Fu, JIA Yu-Chun, LIU Shu-Kun, DIAO Wei-Dong
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  443-446. 
    Abstract ( 204 )  
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    Objective    To explore biomechanical features of the tibiofibular syndesmosis ligaments, and the ankle position which induce the injury of ligaments easily.    Methods    8 (left 4, right 4) fresh adult leg specimens were used in this study. The tibiofibular syndesmosis ligaments were completely exposed and cut horizontally above the ankle about 20cm. The top of ligaments was embedded with denture powder for simulating the top tibiofibular joint, as well, the bottom was also embedded and fixed on material experimental machine, after cutting from calcaneal bone, keeping subtalar, talonavicular and calcaneocuboid joints. At the different positions, involving neutral position, dorsiflexion (15°), plantarflexion (20°), varus (15°), valgus (20°), internal rotation (10°) and external rotation (5°), the length and stress changes of ligaments after loading with the axial 500N and external rotation torque (5N.m), were analyzed.   Results    At the position of introversion and plantarflexion, the significant stress changes of inferior and anterior tibiofibular ligaments, the interosseous ligament, and the posterior ligament( Including the deep transverse ligament) appeared, as  (0.1294±0.0030) and (0.1150±0.0018),(0.1331±0.0030) and (0.1138±0.0053), (0.0427±0.0016) and(0.0285±0.0015) respectively.    Conclusions    At the position of introversion and plantarflexion, the inferior and anterior tibiofibular ligament, the interosseous ligament, and the posterior ligament easy to be damaged, for those ligaments endure the largest stress.

    Unimproved versus newly-improved four-corner arthrodesis concentrator: a finite element analysis
    JI Bao-Chen, TANG Hui, FAN Xin-Yu, ZHANG Mei-Chao, SHU Ti-Liang, LI Chuan, XU Yong-Qing
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  447-451. 
    Abstract ( 248 )  
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    Objective    To evaluate biomechanical properties of NiTi shape memory alloy four-corner arthrodesis concentrator (NTMA-FCAC) by the method of finite element analysis and provide theoretical basis for it's clinical application.    Methods    With the analysis function of Ansys8.0, the models of NTMA-FCAC were built. Under the same loading condition as the arthrodesis concentrator devices encountering in fatigue test, the models were stricted and loaded. Through structure analysis, the strain/stress distributions, compression and tension stiffness were processed.    Results    The result showed that, in addition to several stress-bearing areas located in the junctional zones between body and arms, the stress distribution of other parts are even. The stiffness of two models was similar. Within the scope of certain the NTMA-FCAC can satisfy wrist functional exercise postoperatively.   Conclusions  The result shows the newly-improved NTMA- FCAC have excellent biomechanical properties. It can meet clinical application.

    The bilateral supernumerary-head gastrocnemius with abnormal origin: a case report
    HAN Jia-Yi, YANG Rui, WANG Yu, WANG Shi-Na, TUN Yue
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  451. 
    Abstract ( 349 )  
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    The flap based on the dorsal branch of the digital artery: anatomy and clinical application
    JIN Guang-Zhe, JU Ji-Hui, LI Lei, ZHOU Rong, HOU Rui-Xin
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  452-455. 
    Abstract ( 376 )  
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    Objective To investigate blood supply features of the flap based on the dorsal branch of the digital artery and summarize clinical experience. Methods 5 fresh adult upper limb specimens were injected with red latex via artery and were dissected. The origin outer diameter, the course and anastomosis of the dorsal branch of the digital artery were measured and observed. Distribution features of dorsal branch of the digital artery was further explored on X-ray images collected from one fresh adult upper limb specimen injected with lead oxide. Free flaps of dorsal branch of the digital artery were used to repair soft tissue defects of finger pulp (6 fingers of 6 patients). Results The origin of the dorsal branch of the digital artery was relatively constant, and respectively located at the middle of proximal phalanx, the middle distal 1/3 of proximal phalanx, the middle of second phalanx and the distal of interphalangeal joints. Among them, the origin branch in the middle distal 1/3 of proximal phalanx was constant, with the outer diameter of 0.2mm. 6 to 18 months' follow-up proved that, 6 flaps survived well, with good blood supply, texture, flexibility and appearance. The sensory recovery reached S3 level. Conclusions The dorsal branch of the digital artery is less variant. It is an ideal selection for prepare free flaps to repair soft tissue defect of finger pulp.

    Anatomy and clinical significance of the false thyroid capsule
    SHAN Yi-Hong, DU Guo-Nai, XIAO Yu-Gen, CHEN Long-Zhou, YAN Guo-Biao, TAN Dong-Xin, WANG Hun
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  456-458. 
    Abstract ( 500 )  
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    Objective To investigate anatomic features of the false thyroid capsule, and discuss it's clinical significance.    Methods In 95 cases of unilateral total thyroid lobectomy, the anatomical structures of the false thyroid capsule and its relationship with thyroid vessels, parathyroid, recurrent laryngeal nerves were observed.    Results At the sites of inferior thyroid vein, middle thyroid veins and superior thyroid vessel attached to thyroid gland, false thyroid capsule showed a meso-like structure attached to the thyroid glands. After removing the gland lobe, a continuous platform of false thyroid appeared, with the shape of "C", and the thyroid vessels emerged from the edge of meso-like fascia respectively. Among the circle of "C"- like fascia, recurrent laryngeal nerve, inferior thyroid artery, the parathyroid glands located in it.    Conclusions The anatomy awareness of the false thyroid capsule is benefit to safety thyroid surgery, especially in capsular dissection.

    The treatment of acromioclavicular dislocation adopting arthroscopic TightRope stumbles steel plate
    BANG Liang-Quan, SHU Wei-Min, OU Yang-Kan, LIU Hai-Feng, LI Hao, FENG Wen-Zhe, LIU Wei, WANG Da-Beng
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  459-461. 
    Abstract ( 379 )  
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    The surgery approaches of mamotome operation: clinical analysis and anatomic basis
    LIU Xiao-Long, JIN Yi-Yi, XIAO Gang, XU Xiao-Wan, LIU Li-Xin
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  462-465. 
    Abstract ( 217 )  
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    Objective To explore effects of different surgical approaches of mammotome operation on reducing postoperative complications. Methods 30 female patients with nursing needs received the radial approach based on proximity principle. 11 cases without nursing needs received the horizontal approach based on proximity and beauty principles. We recorded bleeding during the operation, skin ecchymosis and breast hematoma within 72 hours after mamomtome operation. At postoperative Day 6, Breast skin sensation was detected in all cases. Postoperative mammary gland secretion was observed in 5 cases. Results The radial approach can effectively reduce the injury to mammary gland and keep postoperative lactation function. However, horizontal approach was more effective to protect blood vessels and nerves of the breast. Conclusions The operative complications could be effectively limited by selecting special mammotome approach, however, further focus is necessary to treat tumor nearing to mammary areola.

    Clinical significance of the retrograde facial nerve striping along marginal mandibular branch on parotid tumour resection
    TUN Wen-Yi, ZHANG Li-Ting, WANG Chao-Yang, SHU Shi-Ze
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  466-468. 
    Abstract ( 184 )  
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    Stemless hip prosthesis replacement in the treatment of middle and young-aged patients with femoral head necrosis: the short-term curative effects analysis
    TUN Chun-Hui, DENG Ji-Yu, LI Jian-Chi, CHEN Xiao-Lei, CA Ti-Bei, LUO Yu-Chen
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  469-472. 
    Abstract ( 236 )  
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    Objective    To explore the short-term effects of the stemless hip prosthesis replacement on treating middle and young-aged patients with femoral head necrosis.   Methods   19 cases (middle or young-aged) suffered from femoral head necrosis received the stemless hip replacement surgery, and followed by the evaluation of clinical effects.    Results    The follow up time was about 6 to 65 months. All patients recovered, with the Harris score of 89.4± 6.5 points averagely ( excellent in 13 cases, good in 5 cases, medium in 1 case). Excellent and good rate was about 94.7%.   Conclusions    The stemless hip arthroplasty is suitable for treating middle and young-aged patients with avascular necrosis, for its excellent short-term curative effects. However, the long-term effects need to be revealed.

    The absence of common hepatic artery and celiac trunk: one case report
    FANG Jian-Chao, MA Jian-Jun, LI De-Yuan, HE Wei, CAO Hua-Hui, LI E, DUAN Jia, YANG Lu-Lu
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  472. 
    Abstract ( 209 )  
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    Primary total knee arthroplasty for complex distal femur fracture in old patient: a case report and review of literature
    ZHOU Zhi-Sen, TAN Beng-Xian, CHEN Jing-Na, HOU Zhi-Qi, XIE Gan-Hu, LIN Chao-Dong, ZHOU Guo-Xin
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  473-475. 
    Abstract ( 170 )  
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    Development of Clinical treatment in cartilage injury
    CHEN Kang, WANG Da-Beng, SHU Wei-Min
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  476-478. 
    Abstract ( 169 )  
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    The research progress of the meningovertebral ligaments (Hofmann ligaments) in epidural space of spine
    SHI Ben-Chao, DING Zi-Hai
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  479-481. 
    Abstract ( 494 )  
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    The design and fabrication of ossicles specimen through the relatively protuberant area of the anterior and inferior wall
    CHEN Gong-Gao, MA Jian-Jun, BO Zi-Han, WANG Dun-Kuai, WANG Xiao-Fang, WANG  Feng, ZHANG Pei-Pei, CAO Hua-Hui
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  482-483. 
    Abstract ( 303 )  
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    The bilateral multi-belly detoids with the abnormal attachment: a case report
    YANG Rui, HAN Jia-Yi, WANG Shi-Na, WANG Yu, TUN Yue
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  483. 
    Abstract ( 274 )  
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    Principal artery of thumb 1 cases of variation
    XIONG Qing, JU Ji-Hui, LI You, HOU Rui-Xin
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  484. 
    Abstract ( 153 )  
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    Aberrant Right Sub-clavian Artery:a case report and literature review
    CHENG Gong-Wen, JIANG Hui-Yong, ZHANG La-Chi, XIANG Hai-Hong, HUANG Ji-Mu, GAO Hua
    Chinese Journal Of Clinical Anatomy. 2012, 30(4):  485. 
    Abstract ( 248 )  
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