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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 2012 Volume 30 Issue 5
      
    Applied anatomy of the nerve transfer to repair lumbosacral plexus nerve avulsion injuries
    YIN Gang, HOU Chun-Lin, CHENG Jun, LIN Gao-Dong
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  487-490. 
    Abstract ( 1160 )  
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    Objective To provide anatomic basis for clinical application of the obturator nerve and/or genitofemoral nerve transfering to repair the lumbosacral plexus nerves avulsion injuries. Methods The length, cross diameter, longitudinal diameter, cross-sectional area and the amount of myelinated nerve fibers of obturator nerve, genitofemoral nerve, femoral nerve, lumbosacral plexus and sacral plexus on both sides of 6 adult cadaveric specimens were exposed and measured respectively. Results The right proximal obturator nerve could be transfered to the left distal femoral nerve through anterior surface of vertebrae and posterior surface of the peritoneum, with the overlap of fiber terminals about 2~3 cm. The right obturator nerve and genitofemoral nerve could be transfered to ipsilateral S1 and S2 nerve root with the overlap of 2~4 cm respectively. The fiber number of the obturator nerve (4400~7800) was about 1/3 of the femoral nerve (13000~20000). The fiber number of genitofemoral nerve (3000~4500) was about 1/2 of the S2 nerve (4500~8500). The fiber number of obturator nerve (4400~7800) was roughly equal to that of the S1 nerve (5000~9000). Conclusions Obturator nerve and genitofemoral nerve can be used as donor nerves to repair the lumbosacral plexus nerve avulsion injuries.

    The variation of median nerve passing through brachial muscle: a case report
    YANG Juan, CHEN Rong-Ban, SHU Ban-Wei, DANG Rui-Shan, LIU Fang
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  490. 
    Abstract ( 856 )  
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    Medial calcaneal nerve and neurogenic painful heel syndrome:anatomic basis
    FENG Cheng-An, SUN Dun, LIU Zong-Liang, FAN Wei, ZHANG Dong-Kui, XIE Bin
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  491-493. 
    Abstract ( 909 )  
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    Objective To investigate the relationship between the medial calcaneal nerve (MCN) and neurogenic painful heel syndrome (NPHS), and provide anatomical evidence for study, diagnosis and therapy. Methods 32 formalin-fixed adult lower limb specimens were used in the study. MCN was dissected for demonstrating the origin, course, branches and the distribution.   Results 41.42% of MCN originated from the trunk of tibial nerve, however, 28.57% originated from the bifurcation site of tibial nerve, 18.57% from the medial plantar nerve, and 11.42% from the lateral plantar nerve. The distance from the origin of MCN to the middle point between the lowest margin of the medial malleolus and the medial process of calcaneal tuberosity was about (30.22±15.34)mm. MCN distributed to medial heel, the skin of footplate, and soft tissue of heel, after passing through flexor retinaculum. Conclusions MCN maybe compressed in the ankle canal, or the calcaneal tunnel, or at the site of passing from the flexor retinaculum, which are probably related to the occurrence of the plantar fasciitis and heel pain.

    Hepatic vascular control in laparoscopic hepatectomy: anatomic basis
    YAN Yi-Gai, LEI Bang-Yu, CA Xiao-Yong, LEI Yu, CHEN Yong-Jun, LI Jian-Jun
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  494-497. 
    Abstract ( 1096 )  
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    Objective To provide anatomic basis of hepatic vascular control in laparoscopic hepatectomy(LH) and design safe and convenient operative approach for vascular control. Methods  Antiseptic adult liver specimens were used in this study. Hepatic pedicle, hepatic artery, portal vein and hepatic vein were dissected. The length and angle of these vessels were recorded. Additionally, videos of LH were observed for identifying those structures. Results The plane of hepatic artery was lower than bile duct for 90% specimens. The site of portal bifurcation was always behind hepatic artery and bile duct. The left hepatic veins had common trunk with middle hepatic veins for most of specimens. A gap existed between the right hepatic vein and common trunk of left and middle hepatic vein, which filled by connective tissue and communicated with anterior surface of the retrohepatic inferior vena cava (IVC). The short hepatic veins located in the left and right borders of IVC. The number of the short hepatic veins was about 7±3. IVC ligament was a broad membranous connective tissue bridging the left and right side edges of the caval groove in which the IVC was embedded. This ligament was more easy to be identify in fresh specimens. The length and angles of each vessel was enough to be separated to keep space for hepatic vascular blocking during LH procedure. Conclusions Anatomic features of hepatic hilum area are helpful for vascular control performed in LH surgery.

    The application of individual three-dimensional digital manikin on transnasal endoscopic approach of petrous bone
    HE Hai-Yong, LI Wen-Qing, WANG Hui, CA Mei-Qin, LUO Lun, ZHANG Bao-Shu, GUO Yang
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  498-502. 
    Abstract ( 861 )  
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    Objective To investigate clinical value of individual three-dimensional digital manikin (3D-DM) on the transnasal endoscopic approach to petrous bone. Methods Ten adult cadaveric heads (20 sides) fixed with formalin were dyed through the artery with silicone rubber (RTV3110) and 12.5% Iopromide. Then specimens were scanned by 320-detector-row spiral CT with coronal, axial and sagittal positions. The images were stored in DICOM format, imported into 3D view software and reconstructed individual 3D-DM,on which the technology of "reverse bone window formed" were used to design and simulate the bone window formation of petrous bone. The anatomic marks of skull base related to the transnasal endoscopic approach to petrous bone in individual 3D-DM were observed and the distances between the related anatomic marks were measured. The endoscopic images were recorded, and the relationships of the surgical marks were observed and measured. Finally,The consistency between anatomy and 3D-DM data were explored. Results Individual 3D-DM of the samples was well reconstructed. The vision of individual 3D-DM was similar to that of endoscopic anatomy, as well the correlated parameters. Conclusions Individual 3D-DM can be used to simulate bone window formation of petrous bone preoperatively, which can improve the accuracy and security of the surgery. Individual 3D-DM can provide detailed information of bony structures, arteries supply and approach-related critical anatomical data, which had important clinical significance for transnasal endoscopic approach to petrous bone.

    Anatomy of anterior structures of vertebral canal at the level of lower cervical intervertebral disc
    ZHOU Su, SHI Ben-Chao, LI Hong-Liang, FANG Guo-Fang, DING Zi-Hai
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  503-505. 
    Abstract ( 990 )  
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    Objective To discuss the safety range of spinal canal decompression via intervertebral disc approach. Methods Cervical vertebra specimens from 18 embalmed adult cadavers were dissected for observing anatomic features of the dura mater, posterior longitudinal ligament and anterior epidural space. The thickness of dura mater, the width of posterior longitudinal ligament and the sagittal diameter of vertebral body at the intervertebral disc level were measured and analyzed. Results The posterior longitudinal ligament composed of deep and superficial layers, which separated from each other leaving the median line about 4 to 5 mm.  The anterior epidural space was composed of the superficial layer of posterior longitudinal ligament and dural mater. We also identified Hofmann ligament anterior to the dura mater, attaching the dura to the posterior longitudinal ligament. Deep and superficial layers formed a fusiform space, which was named as the posterior longitudinal ligament space. The distance from the middle of posterior margin of intervertebral disc to the lateral angle of each side of the space was about 10 mm. Conclusions The cervical anterior approach could reach the posterior longitudinal ligament through intervertebral disc, and enter the posterior longitudinal ligament space. This approach is valuable for protecting dura mater, spinal cord and spinal roots.

    Anterior cervical plating plus axial screw fixation for treating cervical flexion-distraction injury:anatomic study
    JI Dong-Bin, JU Lin, YANG Yong, XU Zhun, CHENG Yong-Quan
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  506-508. 
    Abstract ( 1115 )  
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    Objective To study the anatomical flexibility of anterior cervical plating plus axial screw fixation for treating cervical flexion-distraction. Methods Fifty cases of digital lateral X-ray films from adult healthy volunteers aged 24~48 years, with mean 28 years, were measured directly in the JW-PACS picture system. Measuring parameters included vertebral body height, intervertebral disc height and disc depth. The line started from anteroinferior point of the inferior vertebrae to posterosuperior point of the superior vertebrae was drawn to mimic the axial screw fixation in the lateral film. The maximal screw length, screw cephalic inclination angle and the distance between screw and anterior vertebral margin at disc level was recorded. Simulated anterior cervical plating and axial screw fixation was carried out in one preserved human specimen under the guidance of C-arm X-ray fluoroscope. Results The maximal length of anterior cervical axial screw was (41.18±3.92 )mm, and the axial screw inclination angle (25.21±3.58)°. The suitable depth of interbody graft was more than (11.69±1.63)mm, but less than (17.09±1.50)mm of disc depth. Simulated procedure in the preserved specimen demonstrated that axial screw fixation could be successfully completed at C2/3, C3/4, C4/5, and C5/6 levels, but difficult be performed at C6/7 due to obstacle of sternum. Conclusions The flexibility of axial screw fixation plus anterior cervical plating is confirmed from this study for managing of cervical flexion-distraction injuries.

    Biological-safe patient-specific navigation template of posterior transpedicular fixation of lower cervical vertebrae: in vitro study
    SONG Ke, FU Mao-Qiang, KONG Xiang-Xue, LIANG Dong-Zhu, LIN Li-Jun, HUANG Zhi-Beng, LI Jian-Die, OU Yang-Jun
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  509-512. 
    Abstract ( 986 )  
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    Objective To develop a biological-safe patient-specific navigation template of posterior transpedicular fixation of lower cervical vertebrae and evaluate its accuracy in assisting screw inserting. Methods 4 formalin-fixed lower cervical spine specimens (C3-C7) were harvested and CT scanned. With the technologies of 3D reconstruction, rapid prototyping and molding, biological-safe patient-specific navigation templates of posterior transpedicular fixation of lower cervical vertebrae were developed. With the assist of the navigation template, Kirschner wires were inserted into the pedicles of cervical vertebrae. After second CT scan and 3D reconstruction, the positions of virtual and actual Kirschner wires were calculated and statistically analyzed by paired-sample T test to evaluate its feasibility. The position deviations were also calculated to evaluate its accuracy. Results There were no significant difference between the position of virtual and actual Kirschner wires in all displacement and rotation directions (P>0.05). The X, Y and Z axis displacement deviations were (1.58±0.66) mm, (1.96±0.84) mm and (2.33±1.15) mm, respectively. The X, Y and Z axis rotation deviations were (1.43±1.18)°, (2.43±1.67)° and (1.14±0.50)°, respectively. Conclusions The developed navigation template is feasible for posterior transpedicular fixation of lower cervical vertebrae, however, it's model shape and accuracy need further improvement.

    Anatomy of posterior interosseous nerve and its muscular branches to thumb and index
    LIAO Xin-Pin, CHANG Nai-Ban, LIAO Jue, GAO Yun, CHEN Bei, SUN Guo-Gang
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  513-516. 
    Abstract ( 1063 )  
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    Objective To explore the anatomic features of posterior interosseous nerve and its muscular branches to thumb and index fingers. Methods 86 upper limb specimens from 43 fixed cadavers were used in this study. Deep branches of radial nerve were dissected, for following the courses of  posterior interosseous nerve. As well, the origin, diameter, and other anatomic parameters of its muscular branches to thumb and index fingers were measured and analyzed. Results Posterior interosseous nerve and its branches presented as flat and thin nerve bundles. Its main trunk and muscular branches passed between intermuscular space at posterior and middle 2/4 part of forearm. Fusiform terminal fiber enlargement appeared at the dorsal side of the wrist. The diameter of the origin of the main trunk was about(3.79±0.64)mm,except for branches to extensor digitoium with the diameter of 2.0mm, the mean diameter of other branches was less than 1.0mm. The projection line of posterior interosseous nerve extended ulnarly or radially from radial condyle of humerus to ulnar malleolus, at the supination or semipronation positions, respectively. Conclusions Posterior interosseous nerve and its muscular branches are easy to be damaged during its course at the middle and posterior 2/4 segment of forearm.

    Morphologic study on spatial structure of ossicles
    WANG Dun-Kuai, MA Jian-Jun, WANG Feng, BO Zi-Han, CHEN Gong-Gao, WANG Xiao-Fang, ZHANG Pei-Pei, MA Xiao, LI Hui-Zhen
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  517-519. 
    Abstract ( 983 )  
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    Objective To investigate spatial structure of ossicles in tympanum, and provide anatomic data for spatial localization and digital reconstruction of auditory ossicular chain. Methods 20 (40 sides) adult male skull specimens fixed by formalin were dissected. The angles between long axis of the handle of malleus, the head and neck of malleus, the long crus of incus, the stapes and the horizontal, sagittal planes were measured respectively, as well the angles between the handle of malleus and the long axis of head and neck of malleus, malleoincudal joint, and the angle between incus and stapes. Results The angles between the long axis of handle of malleus and horizontal plane, the sagittal plane were (44.89±11.66)°,(41.92±11.68)° respectively; that between long axis of head and neck of malleus and horizontal plane, sagittal plane were(41.94±11.14)°,(39.48±10.11)°respectively; that between long crus of incus and  horizontal plane, sagittal plane were(43.50±11.27)°,(35.84±12.39)°respectively; that between long axis of stapes and horizontal plane, sagittal plane were(25.93±10.39)°,(58.19±8.19)°respectively; that between the handle of malleus and long axis of head and neck of malleus was (140.93±10.43 )°, that between malleoincudal joint was (96.19±13.82)°, and that between incus and stapes was (104.27±9.22)°. Conclusions Auditory ossicular chain in tympanic cavity arranges as italic "N" .

    Anatomical changes of lip and nasal organ in unilateral cleft lip: the initial observation
    JIA Chun-Bei, WANG Ba-Jun, QIN Xiao-Yun
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  520-522. 
    Abstract ( 940 )  
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    Objective To investigate morphological characteristics of unilateral cleft lip nasal deformity,and provide a theoretical basis for the surgery.  Methods Structural changes in lip and nose of 60 children with unilateral cleft lip nasal deformity were observed. The upper lip area and the main line were measured and analyzed. Results The area of philtrum and lateral lip,the distance from labrum peak to angle of mouth and the angle of vermilion border were less than those of normal side(P<0.05); The distance from nasal tip to nasal floor and the columella skewness in cased of Ⅲ degree were larger than that in cases of Ⅱ degree(P<0.05),as well the labrum peak shift,but the difference was not statistically significant (P>0.05). Conclusions For cases of unilateral cleft lip nasal deformity, morphological differences between Ⅱ degree  and Ⅲ degree, healthy side and abnormal side are significant, which have to be dealt during surgical treating process.

    Imaging and sectional anatomy of corpus striatum
    BAI Gui-Qin, JIAN Hua-Hua, ZHOU Ting-Yong, ZHANG Hua, LI Lin-Hong, ZHI Hua, ZHENG De-Ru, LV Fa-Jin
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  523-528. 
    Abstract ( 1275 )  
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    Objective To discuss anatomic features of corpus striatum on cross section and MRI data. Methods 31 cross-sectional specimens of adult head and 50 cases of MRI data were used in this study. Corpus striatum and its related structures were observed and analyzed. Results For striatum area, there was gender difference on cross-sectional specimens (women>male); but there was no difference on MRI data. On the contrary, bilateral areas of globus pallidus were different on MRI data (left > right). Other anatomic parameters of striatum and its related structures had no difference between sections and MRI data. The area of telencephalon positively related to that of striatum, regardless of cross-section or MRI. The head area of caudate nucleus was negatively related to dorsal thalamus area on cross-section, and negatively related to putamen area on MRI. The distance of anterior horn of lateral ventricle was negatively related to the putamen area on cross-section, but positively correlated with the head area of caudate nucleus on MRI. Conclusions MRI can better reflect the striatum and its related structures. The changes of the adjacent structures can be used as a reference for exploring morphological changes of corpus striatum.

    Sonographic exploration of fetal retronasal triangle during the first trimester of pregnancy
    JIA Xun, CHEN Cui-Hua, GUO Fei-Yan, QIU Yu-Wen, HUANG Chi-Ping, WEN Hua-Han, LI Zheng-Yi
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  529-532. 
    Abstract ( 4497 )  
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    Objective To investigate and compare two-dimentional and multiplanar sonograms of fetal retronasal triangles during the first trimester of pregnancy. Methods Sonographic data from 89 healthy pregnant women at the time of first-trimester period were collected. The mid-sagittal, coronal, transverse and multiplanar views of fetal retronasal triangle were evaluated and analyzed. Results Both 2D and TUI views showed the retronasal triangle clearly. The fetal nasal bone and palate showed clearly on the mid-sagittal views, retronasal triangle composed with processus frontalis maxillae and palate showed on coronal views, the relationship of retronasal triangle and palate showed clearly on the transverse views. The qualified rate and scores in the mid-sagittal and coronal views showed no difference between 2D and TUI views (P>0.05), but  was more better on TUI than 2D, for transverse views (P<0.05). Conclusions Both 2D and TUI could determine the retronasal triangle during the first trimester of pregnancy. The sonographic examination of retronasal triangle may be useful in the early diagnosis of cleft palate.

    Complex of collagen sponge seeded rat amniotic epithelial cells promotes survival and revascularization of rat prefabricated flap
    WANG Ying-Qian, WANG De-Wei, HU Jia-Jun, LI Ling-Qiao, ZHOU Gong, WEI Zhen-Bang, WANG Tian-Hao
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  533-538. 
    Abstract ( 973 )  
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    Objective To investigate the effects of amniotic epithelial cells/collagen sponge complex on promoting survival of rat prefabricated flap. Methods The 3rd passage of SD rat amniotic epithelial cells (AECs) or chondrocyte line was seeded into the collagen sponge scaffold. ELISA was taken to detect angiogenesis factors VEGF, TGFβ1, bFGF in the supernatant fluid of the AECs complex. SD rats were divided into normal control group, blank control group, chondrocyte group and AECs group. Angiogenesis factors in the flaps of each group were detected at the day 7 and 14 after the first-stage surgery. The survival of the flaps and microvasculature density were compared and evaluated by HE staining, vWF immunohistochemistry and digital image analysis system respectively one week after the second-stage surgery. Results The level of VEGF, TGFβ1 and bFGF in the supernatant fluid of the AECs complex increased gradually, and the highest concentration was detected in flap tissue of AECs group. The survival rate of the flap in the AECs group was higher than that in the blank control group and chondrocyte group. Both subcutaneous microvascular area ratio and vWF positive area ratio in the AECs group were higher than those in the other groups. Conclusions AECs/collagen sponge complex can increase the survival of prefabricated flap evidently. Angiogenesis factors secreted by the AECs promote the revascularization in the prefabricated flap.

    Effect of cyclopamine on Nurr1 gene expression in LN229 cells
    WANG Di, CHEN Yan, LIU Fei-Fei, LENG Shui-Long, LONG Da-Hong, HONG Le-Feng
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  539-542. 
    Abstract ( 1247 )  
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    Objective To investigate the effect of cyclopamine on the expression of  Parkinson-related gene Nurr1 in malignant glioma cell line LN229. Methods Upon LPS stimulation, real time PCR was used to detect contents of SHH relational gene PTCH, Gli1and Nurr1 mRNA in LN229 cell. Western blotting was used to detect the impact of LPS on Nurr1 protein expression. Furthermore, the contents of both of Nurr1 and the downstream Inflammation factor IL-1β were detected after blocking SHH Signaling pathway with cyclopamine. Results   Upon the LPS stimulation, the relational gene mRNA and Nurr1mRNA in LN229 cell elevated. LPS significantly elevated the expression of nurr1 protein. Contrast with the control group, it was significantly promoted on the expression of Nurr1 gene and the downstream Inflammation factor IL-1β at the level of transcription and translation after cyclopamine blocking. Conclusions The effects of cyclopamine on the Nurr1 gene expression in LN229 cell may be related to the activation of glial cells during the pathogenesis process of Parkinson's disease.

    PLLA\β-TCP scaffold guided chondrocyte differentiation of rabbit BMSCs induced by TGF-β1
    CHEN Kang, WANG Da-Beng, XIONG Jian-Xi, SHU Wei-Min, LIU Jian-Quan, LEI Ming, HU Wen, ZHANG Xiao-Li, LIU Bi
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  543-547. 
    Abstract ( 889 )  
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    The effect of human umbilical cord plasma on the growth of human foreskin fibroblast
    DING Yan, LEI Zhi-Yong, YUAN Ya-Gong, MENG Chu-Yan, FENG Jing-Bei, LI Dong-Sheng, CENG Yi
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  548-551. 
    Abstract ( 827 )  
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    Objective To investigate whether human umbilical cord plasma (HUP) can be used to culture human foreskin fibroblast (HFF) cell. Methods Surplus HUP were collected in this study. After being treated by salting out and diasysis, the HUP were used to culture HFF as 10% volume, and compared the effects with FBS. The features, growth curve, cell cycle and reproductive activity of HFF were observed. Results compared to fetal bovine serum (FBS), the morphous, reproductive activity and fibroblast characteristic of HFF cell cultured in HUP were not distinctively different. Conclusions HUP can be used to culture HFF. 

    Right brachial plexus pass through medial scalenus muscle: one case report
    TUN Guo-Yun, LI Ze-Yu, LIU Chang, XIAO Zhao-Meng, TUN Kun-Cheng
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  551. 
    Abstract ( 907 )  
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    Expression of CK19 and PCNA in fibrosis rat regenerating liver after partial hepatectomy
    FANG Fang, LIU Jian-Jin, YUE Hua-Jiang, LI Na-Na, LIU Heng-Xin
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  552-555. 
    Abstract ( 1218 )  
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    Objective To detect the expressions of CK19 and PCNA in fibrosis rat regenerating liver after partial hepatectomy (PH) at the different time phase, for evaluating the bile duct regeneration in fibrotic liver. Methods Male SD rats were divided into two groups: the control group (42 rats) and the experimental group (42 rats). The rats of experimental group were injected CCl4 to establish the hepatic fibrosis model, and then the two groups was endured PH operation. HE, immunohistochemical and double-label immunofluorescence were used to detect  and analyze expressions of CK19 and PCNA in regenerating liver. Results The expression of CK19 increased gradually after PH in both groups, however, expression intensity in experimental animals was significantly higher than control ones at the same time point. As well, the expression of PCNA increased gradually after PH in both groups, however, expression level in experimental groups rose slowly, extended and the peak appeared later than the control. Conclusions (1) PH process of fibrotic rat liver can stimulate proliferation of OCs and the differentiation to BECs, which mainly originate from compensatory hyperplasia in normal rats regenerating liver. (2) Before PH, liver cells in fibrosis rats have already proliferated, after PH, the effective regenerating cells are lower than the other liver injury.

    Effects of ischemic acute kidney injury on ultrastructure of rat lung
    LIU Yu-Ling, GUO Min, SHAO You-Zhi, BAO Cui-Fen
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  556-559. 
    Abstract ( 988 )  
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    Objective  To observe the ultrastructural changes of damaged lung induced by ischemic acute kidney injury (IAKI) in rats. Methods Transmission Electron Microscopy and morphometric analysis were used in this study. Results Both type I and II alveolar cells undergoing necrosis could be seen in the lungs damaged by IAKI. Disappeared osmiophilic multilamellar bodies of damaged type II cells could be found. In addition, endothelial cells undergoing apoptosis were also noted in the lungs damaged by IAKI. Neutrophilic leukocyte infiltration was evident in alveolar septum with IAKI. Conclusions Both necrosis and apoptosis are involved in the lungs damaged by IAKI, but necrosis is more evident than apoptosis. Leukocyte infiltration is also involved in the lungs of RIRI animals.

    Extrusion abnormality at pyramid segment of facial nerve in Chinese
    LI Jian-Dong, HONG Hua-Yong, DIAO Liang, LIU Yong-Liang, GUO Liang-Rong, DAI Chuan-Fu, SONG Zhi-Yao, LI Yang
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  560-563. 
    Abstract ( 1049 )  
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    Objectives To reveal the occurrence rate of extrusion abnormality at pyramid segment of facial nerve by observation on vivisection and high-resolution CT scanning of temporal bone, and provide anatomic data for safer development of otologic surgery. Methods Extrusion abnormality at pyramid segment of facial nerve among 302 adult Han cases with peripheral facial palsy, who received unilateral facial nerve decompression surgery in our department from April, 2005 to April, 2011, was observed and analyzed under operating microscope. The value of CT in the discovery of the abnormality was evaluated by the comparison of preoperative high-resolution CT data. Results Extrusion abnormality at pyramid segment of facial nerve was found to be presented among 14 cases during the surgery, accounting for 4.6% among all cases. Only one case with such abnormality was discovered by preoperative axial CT scanning of temporal bone, while 100% of the abnormality could be found by coronal reconstruction preoperatively. Conclusions Extrusion abnormality at pyramid segment of facial nerve is available among 4.6% Han adults. High-resolution CT scanning of temporal bone should be performed routinely prior to mastoid surgeries, and it's necessary to perform coronal reconstruction to find such abnormality. During mastoidectomy, the traditional skill with horizontal semicircular canal plane as the deep plane for safe dissection is not reliable for Han population, with the risk of iatrogenic facial nerve injury. 

    A case of cisterna chyli with positional variation
    GUAN Qing, LI Shen-Xiao, LIN Chao, ZHOU Chao, MA Lin-Lu, FU Sheng-Qi
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  563. 
    Abstract ( 1021 )  
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    The anatomical features, fracture types and treatment of ulnar styloid process
    YANG Huan-You, WANG Bin, LI Gao, CHEN Ru, ZHANG Jian-Feng, JIANG Wen-Beng
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  564-567. 
    Abstract ( 1935 )  
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    Objective To investigate fracture type and surgical treatment of ulnar styloid process according to its anatomic features. Methods Based on different attachment points of ulnar collateral ligament(UCL) and triangular cartilage plate on ulnar styloid process, the fracture of ulnar styloid process were divided into tip fracture (typeⅠ) and base fracture (typeⅡ) . based on fracture type, special surgical methods were performed: Kirschner wire combined with steel wire, mini-screw, fine steel wire or absorptive thread, Kirschner and other surgical methods. Results 106 patients were followed up about 8-42 months, averagely 15 months. All patients healed well. According to the Garland and Werley score, 76 cases were excellent, 22 good, 6 fair and 2 poor, with the excellent and good rates of 92.4%. 2 cases suffered from ulnar styloid fracture combined with distal radial fractures, received rigid internal fixation. However, fracture position lost and resulted little deformity and the pain of ulnar wrist. Wire breakage appeared in 3 cases. Conclusions detailed understanding of anatomical features, accurate judging of fracture type,  suitable surgical fixation, and early functional exercises, are favorable for functional recovery of wrist fractures.

    Posterior limited spinal decompression associated with short and long segments fusion for treating degenerative lumbar scoliosis: a comparative study
    XIE Jin, LONG Hou-Qing, CHEN Ying-Dong, XIE Wen-Han, LI An-Cheng, LIU Shao-Yu, LI Bi-Bao
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  568-572. 
    Abstract ( 1967 )  
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    Objective To compare clinical and radiographic outcomes of patients with degenerative lumbar scoliosis, treated by two kinds of posterior surgery. Methods Clinical and radiographic outcomes of 46 patients with degenerative lumbar scoliosis, and treated by two kinds of posterior surgery, were analyzed retrospectively. short-segment fixation was taken as group A(2.7±0.6, n=26), and long-segment fixation as group B(5.6±1.4, n=20). The lumbocrural pain and activity function were evaluated by JOA and VAS scores. The Cobb's angles were measured to assess the lumbar scoliosis and kyphosis. The clinical and radiographic outcomes, including surgery time, blooding and surgery complications were compared between two groups. Results The mean follow-up was 2.8 years (2~6.5) for all patients. The blooding and surgery time of group A was significantly more than that of group B(Pt<0.001, Pb<0.001);The scoliosis angles of pre-operative was 22±4.6°(group A) and 28±7.3°(group B) respectively, and 11±3.8°(group A) and 12±5.9°(group B) at the end of follow-up. The recovery rate of group A was better than that of group B(P<0.001). The lumbar lordosis angles of the preoperative was 19±4.6°(group A) and 18±7.3°(group B), and improved to 29±3.8°(group A) and 32±5.9°(group B) at final follow-up. The correction rate of two groups had no significant difference(P=0.17). The JOA score of the preoperative and fellow-up was 14±3.6, 23±4.7(group A) and 13±3.8, 21±5.9(group B)respectively, and both improved after surgery. The improve rate of two groups have no difference(P=0.24). The VAS score of the preoperative and fellow-up was 8±0.16, 3±0.07(group A) and 8±1.8, 4±2.7(group B), and both improved after surgery. The improve rate of two groups had no difference(P=0.22). The complication incidence of group B was significant higher than group A(P<0.001). Conclusion Although the scoliosis correction rate of long-segment fixation group is higher, the lumbar lordosis correction rate and clinical outcome have no significant difference compared to short one. Furthermore, long-segment fixation causes a higher complication rate and worse lumbar functional activity after surgery.

    Anatomy of scapula and internal fixations in scapular fractures: analysis of curative effects
    LI Jian-Chi, HUANG Bi-Liu, LIANG Jiang-Qing, TAN Jia-Qun, XU Zi-Jiang
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  573-575. 
    Abstract ( 1067 )  
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    Objective To explore surgical effects of different internal fixation on treating scapular fractures. Methods From July 2007 to January 2012,36 cases of scapular fractures treated with surgical fixation were summarized and analyzed. For all patients, 19 treated with ordinary steel, 15 with locking plate, and 2 with lag screw fixation. Results All patients were followed up, averagely (17.5±6.5) months. Nonunion was not happened. According to the Hardegger's evaluation, 24 cases were excellent, 7 good,4 better, and only 1 poor. The rate of excellent functional recovery was about 86.1%. Conclusions Accurate diagnosis of fracture type, detailed understand of anatomical features of scapula, optimal internal fixation, and early functional exercises, are key elements of functional recovery of scapular joint after surgical process.   

    The sartorius perforator flap repair soft tissue defect around knee: clinical research
    HUANG Dong, SUN Feng, TUN Wei-Chi, ZHANG Hui-Ru, MAO Yong, HUANG Guo-Yang
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  576-578. 
    Abstract ( 1030 )  
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    Objective To investigate the clinical skill and effects of the sartorius perforator flap on treating soft tissue defects around knee. Methods The sartorius perforator flaps were selected carefully and applied to repair soft tissue defects around knee. In all patients, 6 received pedicle flap grafting, and 2 free flap. Results All flaps survived. The grafted skin patches were similar to healthy skin, and the scar of the flap donor area was well hided. Conclusions Ideal effects of the sartorius perforator flap on repairing soft tissue defects suggest that, it is a valuable donor selection.

    A comparative study of homemade single multichannel port retroperitoneal laparoscopic renal cyst unroofing and the open renal cyst unroofing
    LI Chuan-Yi, ZHENG Shao-Bei, LIU Chun-Xiao, LI Hu-Lin, FANG Beng, HU Kai, DIAO Peng-Peng
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  579-581. 
    Abstract ( 952 )  
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    Objective To compare the therapeutic effects and evaluate the feasibility and advantages of the homemade single multichannel port retroperitoneal laparoscopic renal cyst unroofing and open renal cyst unroofing. Methods The clinical data of 212 cases receiving homemade single multichannel port retroperitoneal laparoscopic renal cyst unroofing (retroperitoneal laparoscopic group) and 186 cases receiving open renal cyst unroofing (open surgery group) were retrospectively analyzed. The indications of operating time, amount of bleeding during operation, drainage quantity, acesodyne dosage, ambulation after operation and hospitalization were compared between the two groups. Results The operating time, amount of bleeding during operation, drainage quantity, acesodyne dosage, ambulation after operation and hospitalization of retroperitoneal laparoscopic group were significantly lower than those of open surgery group (P<0.05). Conclusions Single-port laparoscopic surgery is safe and feasible in the treatment of renal cyst. It has the advantages of less trauma, effectiveness, and more cosmetic benefit than traditional laparoscopic surgery.

    Analysis of related factors of deep vein thrombosis after laparoscopic surgery
    TAO Wen, LIU Min
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  582-583. 
    Abstract ( 921 )  
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    Segond fracture- A easily missed diagnosis disease
    HU Shou-Hui, ZHANG Xiao-Na, LI Hong-Bei, XU Feng, DU Xin-Ru
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  584-586. 
    Abstract ( 711 )  
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    Recent advances in experimental and clinical study of arti?cial nerve conduits
    XIANG Jie, HUANG Ji-Feng
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  587-589. 
    Abstract ( 868 )  
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    Development of clinical application of translaminar facet screw fixation
    CENG Zhong-You, YAN Wei-Feng
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  590-593. 
    Abstract ( 781 )  
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    Vascular perfusion technology for 3D model building of placental blood vessels
    CHEN Chu-Ying, DAI Jing-Xin, ZHONG Mei, WANG Zhi-Jian, LIU Chang, JIA Cheng-En, HU An-Wei, HE Yan-Gong, CHEN Rui-Ying, QU Reng-Mei
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  594-595. 
    Abstract ( 934 )  
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    Variations of iliohypogastric,ilioinguinal and genitofemoral nerves: a case report
    LIU Jia-Li, WANG Xun, WANG Jing-Ru, BO San-Jiang-
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  596-597. 
    Abstract ( 816 )  
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    Variation of azygos vein: one case report
    LIU Hong, XIE Yong-Jun, LIU Xin-Guo
    Chinese Journal Of Clinical Anatomy. 2012, 30(5):  597. 
    Abstract ( 746 )  
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