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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 November 2013 Volume 31 Issue 6
      
    Current controversies and consensus of perforator flap
    ZHANG Shi-Min
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  618-619. 
    Abstract ( 691 )  
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    Anatomic and clinical study of tumors in pterygopalatine fossa and its contiguous region
    LIAO Jian-Chun
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  620-623. 
    Abstract ( 692 )  
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    Variation of superficial palmar arch: a case report
    XU E-Nan, LI Kun, LIN Jun-Wei, WANG De-An
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  623. 
    Abstract ( 660 )  
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    A clinical analysis of different approach to tumors in pterygopalatine fossa and its contiguous region
    LIAO Jian-Chun, DENG Bin-Hua, CHEN Jin-Huang, HU Jian-Dao, LI Yong-De, LV Zheng-Gang, ZHANG Jian, LIU Huan-Hai, JI Zhen-Hua, BANG Hu, LIU Hai-Bin-
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  624-626. 
    Abstract ( 1333 )  
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    Objective To analyze the best approach for treatment of tumors in the pterygopalatine fossa and its contiguous region. Methods The data of 108 cases of tumors in the pterygopalatine fossa and its contiguous region were analyzed retrospectively. Results In 85 cases of benign tumors with 0.5 to 5 years follow-up, no recurrencewas  bserved. In 23 cases of malignant tumors with 0.5 to 5 years follow-up, survival times after radiotherapy were : less than one year for 6 cases, 1 to 4 years for 8 cases,more than 5 years for 11 cases. Conclusion  (1) Lateral rhinotomy with partial resection of maxilla can be adopted forprimary ethmoid and maxillary sinus tumors. (2) Extended maxillectomy can be adopted for primary maxillary sinus malignant tumors with pterygopalatine fossa or its contiguous region involvement. (3) Midfacial degloving operation issuitable for primary benign or low-grade malignant maxillary sinus t tumors with involvement of the pterygopalatine fossa or its contiguous region. (4) Temporal zygomatic approach can be adopted for tumors in the pterygopalatine fossa or its contiguous region with involvement of the infratemporal fossa (5) Transcervical maxillary approach can beadopted for  primary parapharyngeal space tumors with pterygopalatine fossa or its contiguous region involved. (6) Sagittal split ramus osteotomy can be adopted for tumors inpterygopalatine fossa and its contiguous region with the infratemporal fossa, the prevertebral space and the skull base involved. (7) Transoral approach can be adopted forobenign tumors in the nasopharynx and pterygopalatine fossa, and low-grade malignant tumors with the pterygopalatine fossa or its contiguous region involved. (8) Nasal endoscopeapproach can be adopted for benign tumors in the nasopharynx and pterygopalatine fossa, and low-grade malignant tumors with pterygopalatine fossa or its contiguous regioninvolved.


    Clinical significance of three-dimensional computed tomography anatomy study compared to endoscopic counterpart in pterygopalatine fossa
    LIU Hai-Bin, DENG Ban-Hua, BANG Hu, BANG Yu, LIU Huan-Hai, MO An-Yun, JI Zhen-Hua, MO Feng, SHU Qiu-Bei, LIU Xin, ZHOU Xian-Wei, LIAO Jian-Chun
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  627-630. 
    Abstract ( 1197 )  
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    Objective To study the multi-slice CT measurements about related anatomical marks of the pterygopalatine fossa and the endoscopic anatomical relationship, providing anatomical basis for clinical surgeryin the pterygopalatine fossa.    Methods    After dissection of the adult cadaveric specimens of five cases (10 sides), MSCT data were adopted for three-dimensional reconstruction for observation of the pterygopalatine fossa and measurement of a number of important anatomic structures  related to endoscopic surgery Finally, the head specimens were dissected in endoscopy, the outcome of whichwas compared to both anatomical measurements.    Results    Anatomical imaging methods and data measured are available, which conformed to the real anatomical situation. There was no significant difference between the two.    Conclusions    Radiological anatomical data about the pterygopalatine fossa are reliable and feasible, and can be used as guidelines for endoscopic surgery.

    Anatomic study and clinical significance of pterygopalatine ganglion
    JI Zhen-Hua, DENG Ban-Hua, BANG Hu, BANG Yu, LIU Huan-Hai, MO An-Yun, LIU Hai-Bin, MO Feng, SHU Qiu-Bei, LIU Xin, ZHOU Xian-Wei, LIAO Jian-Chun
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  631-633. 
    Abstract ( 1574 )  
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    Objective To study the anatomical characteristics of human pterygopalatine ganglion and its adjacent structures in order to offer anatomical evidence for surgical application. Methods Thirty sides of 15 adult cadaveric heads were used. The relationship of the pterygopalatine ganglion and its adjacent structures was observed using the microscope and endoscope. Results Pterygopalatine ganglion was a parasympathetic ganglion that was deeply located in the pterygopalatine fossa to which the vidian nerve, the maxillary nerve and the palatine nerve were connected. The vidian nerve was attached to the ganglion in its medial upper part, the maxillary nerve in its lateral lower part and the palatine nerve in its bottom part. The palatine nerve was given from the angle formed by the perpendicular plate of the palatine bone and the posterior wall of the maxilla. The average external diameter of the beginning of the palatine nerve was (1.23±0.32)mm. The palatine nerve then passed forward and medially and descended through pterypalatine canal, travelling medially to the descending palatine artery.  Conclusion The pterypalatine ganglion is in the immediate vicinity with l the palatine nerve and the vidian nerve, rendering it as an important anatomical landmark in vidian neurectomy.

    The clinical anatomy of maxillary nerve
    BANG Hu, DENG Ban-Hua, LIU Huan-Hai, BANG Yu, JI Zhen-Hua, MO An-Yun, LIU Hai-Bin, MO Feng, SHU Qiu-Bei, LIU Xin, ZHOU Xian-Wei, LIAO Jian-Chun
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  634-635. 
    Abstract ( 1057 )  
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    Objective To provide the anatomic basis the surgery of for maxillary nerve in the pterygopalatine fossa. Methods     The distances from foramen rotundum to the lateral wall of the nasal cavity and the median sagittal plane were measured in 15 adult skull specimens. The relative position between the maxillary artery and nerve was also observed. Results The distances from the foramen rotundum to the lateral wall of the nasal cavity and the median sagittal plane were (13.78±2.18)mm and (17.89±2.67)mm,  respectively. In 9 cases, the maxillary artery were located inferolateral to the maxillary nerve, accounting for 63.3%; in the remaining 4 cases, the maxillary nerve was located inferior to the maxillary nerve. Conclusion  Our study can provide the important anatomical parameters for surgery of the maxillary nerve.

    Anatomic study and clinical significance of the lateral nasal wall
    JI Zhen-Hua, DENG Ban-Hua, BANG Hu, BANG Yu, LIU Huan-Hai, MO An-Yun, LIU Hai-Bin, MO Feng, SHU Qiu-Bei, LIU Xin, ZHOU Xian-Wei, LIAO Jian-Chun
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  636-639. 
    Abstract ( 1307 )  
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    Objective To study the anatomical characteristics of several important structures in the human lateral nasal wall in order to offer anatomical evidence for surgical application. Methods Thirty sides of 15 adult cadaver heads were used. The relationship of the key structures in the lateral nasal wall was observed using microscope and endoscope. Results The sphenopalatine artery is the main blood supply of the lateral nasal wall. It divides into two major branches (the posterior lateral nasal artery and the septal artery) when passing through the sphenopalatine foramen. The posterior lateral nasal artery leaves the sphenopalatine artery by its inferior side in 24 cases (80%) and by its superior side in 6 cases (20%). The location where the sphenopalatine artery branches is right behind the ethmoidal crest. The septal artery divides into two branches at the anteroinferior wall of the sphenoid sinus in 26 cases (86.7%) and after entering the nasal septum in 4 cases (13.3%). The natural ostium of the maxillary sinus is at the hiatus semilunaris in the middle meatus, with 20 cases (66.7%) in the middle part of the hiatus semilunaris, 9 cases (30%) in the posterior part of the hiatus semilunaris and one case (3.3%) in the superior meatus. The superior margin of the ostium locates higher than the lowest orbital floor in 26 of 30 cases (86.7%). The average size of the nasal fontanelle is (14.81±4.28)mm (anteroposterior axis) ×(9.71±1.43)mm (inferosuperior axis). Conclusion The sphenopalatine artery and its branches, as well as the nasal fontanelle, are the key landmarks in the surgery relative to the lateral nasal wall. Better understanding of their anatomic relationships will guarantee efficacy and safety in endoscopic sinus surgery.

    Applied anatomy of the ulnar artery perforator flap
    CHEN Zhong-Fei, MEI Jin, CHEN Jia-Dun, XU Da-Chuan
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  640-642. 
    Abstract ( 1331 )  
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    Objective To provide morphological data that enables safe elevation of the ulnar artery perforator flap. Methods  The anteromedial forearm perforators were studied in 25 fresh cadavers and 10 cast preparations. Cadavers were injected with lead oxide for three-dimensiona reconstruction. The origin, course, and distribution of the perforators in the anteromedial forearm region were comprehensively documented. Results There were 7.0±2.0 ulnar artery perforators in the anteromedial forearm. The average e xternal diameter was 0.6±0.2 mm. Each perforator supplied an average area of (26.0±7.0) cm2. Extensive anastomoses were found between the ulnar artery perforators and multiple adjacent source arteries. Conclusions The main advantages of the proximal ulnar artery perforator flap is that it is a thin flap which is ideal for upper extremity reconstruction, either as a proximally or distally based local perforator flap or as a free flap. The donor site is excellent and the vascular anatomy is very consistent.

    Anatomical foundation of the relationship between the lateral calcaneal nerve and neurogenic painful heel syndrome
    FENG Cheng-An, SUN Dun, XIE Bin, ZHANG Dong-Kui, FAN Wei
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  643-645. 
    Abstract ( 812 )  
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    Objective To investigate the relationship between the lateral calcaneal nerve(LCN) and the neurogenic painful heel syndrome (NPHS) and provide anatomicalevidence for its study, diagnosis and therapy.  Methods 32 sides formalin-fixed adult lower-limb specimens were used in the study. LCN was dissected to observe its origin,course, branches and distribution. Results In all cases, the LCN originated from the sural nerve. They existed in the form of a single principal trunk in 9.38% of cases,double trunks in 28.13%, three trunks in 43.75% and four trunks in 18.75%. They innervated the skin, the fat pad and the periosteum on the lateral calcaneus and the lateral onethird of the plantar calcaneus.  Conclusions The LCN can be compressed in the calcaneal tunnel and at the sharp border where the LCN run through the superficial layer of the lateral part of the plantar aponeurosis and the compression, leading to possible occurrence of NPHS.

    An anatomic study on the plantar plates of the lesser metatarsophalangeal joints
    YU Yao-Beng, CHEN Da-Wei, ZHANG Feng, SHU Guang-Rong, YANG Yun-Feng, LI Bing, ZHANG Kai
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  646-649. 
    Abstract ( 1189 )  
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    Objective To investigate the anatomical characteristics of the plantar plates of the lesser metatarsophalangeal joints and explore the repairing methods of the plantar plate injury.    Methods    Nineteen fresh-frozen cadaveric foot specimens were dissected. The plantar plates and surrounding soft tissues were observed andmeasured. The anatomic parameters (length, distal width, proximal width, central thickness and lateral thickness) of the plantar plates of the lesser metatarsophalangeal jointswere measured.    Results   The planter plate was an attaching point for the surrounding soft tissues of the metatarsophalangeal joint. The male plantar plates of length was(20.05±0.92)mm, (19.80±1.41)mm, (17.45±0.55)mm, (14.91±0.86)mm in less metatarsophalangeal joints, respectively; The male plantar plates of width was (11.63±1.01)mm, (10.72±1.13)mm, (10.34±1.24)mm, (9.26±0.86)mm; The male plantar plates of lateral thickness was (2.04±0.16)mm, (1.97±0.29)mm, (1.69±0.12)mm, (1.47±0.10)mm. The female plantarplates of length was (17.29±0.82)mm, (17.36±0.51)mm, (16.03±1.14)mm, (12.12±1.19)mm in less metatarsophalangeal joints, respectively; The female plantar plates of width was(10.74±0.62)mm, (10.53±0.39)mm, (10.23±0.67)mm, (9.35±0.79)mm; The female plantar plates of lateral thickness was (2.02±0.16)mm, (2.01±0.14)mm, (1.82±0.22)mm, (1.66±0.30)mm. The length, width and thickness of the plantar plates declined in sequence from the second plantar plate to the fifth. The parameter differences were statisticallysignificant (P<0.05). Conclusions The plantar plate maintains the stability of the metatarsophalangeal joint. It's necessary and feasible to repair the tore plantar plates.

    The preliminary exploration of combined flaps from bilateral big toes in treating degloved injuries of the thumb
    LIAO Guan-Xiang, JU Ji-Hui, LIU Xin-Yi, ZHOU Rong, ZHANG An-Liang, WANG Tian-Liang, HOU Rui-Xin
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  650-654. 
    Abstract ( 664 )  
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    Objective  To explore the feasibility of combined the free wrap-around flap of the ipsilateral big toe and the fibular flap of the contralateral big toe intreating degloved  injuries  of the thumb. Methods  Eighteen right thumbs of fresh cadaver specimens were  modeled to degloved injuries of thumbs. Wound surfaces of the thumb were divided into two parts : the dorsal aspect and the plantar aspect, measurement of the vertical length of the dorsal and plantar aspects and proximal circumference of the wound surfaces was carried out, with obtained data recorded.Then dorsal wound of the models of degloved injuries of the thumbs was covered with wrap-around flaps of theipsilateral big toes and palm wound  was covered by fibular flaps of the contralateral big toes. Results Among the measurement data of 36 models of degloved injuries of thethumbs,the largest vertical length of the dorsal aspect was 6.2cm, the plantar aspect 5.9cm and proximal circumference was 6.9 cm. All data above-mentioned were smaller than themaximum reported in the literature. Degloved juries of the right thumbs were repaired with combined free wrap-around flaps of the ipsilateral big toes and fibular flaps of thecontralateral big toes in 18 cases of surgical simulation,and the appearances were satisfactory and similar to the that of the contralateral normal thumbs. Conclusion Boththe wrap-around flapof the big toe and the fibular flap of the big toe can respectively provide a large enough flap to cover the wound surface of dorsal and volar surfaces ofthe thumb. The surgical approach of the combined free wrap-around flap of the ipsilateral big toe and the fibular flap of the contralateral big toe in treatment of deglovedjuries of the thumb is feasible.

    Blood supply to the head of the pancreas and the duodenum and its clinical application
    YAN Yong-Fang, HU Ji-Fan, GUO Chao, DAI Jue, LUO Shi-Qiao, SUN Shan-Quan
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  655-658. 
    Abstract ( 1864 )  
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    Objective  To study blood supply to the head of the pancreas and the duodenum, and provide anatomical basis for Kocher maneuver and protecting vessels of the duodenum during duodenum preserving pancreatic head resection (DPPHR). Methods A total of 40 cadavers were collected for the study. The superior mesenteric artery, the gastroduodenal artery, the anterior pancreaticoduodenal arterial arcade, the posterior pancreaticoduodenal arterial arcade,their branches and accompanying veins were completely exposed. The arterial branches between the head of the pancreas and the duodenum were observed. Results For 97.5% cases (n=39), the posterior pancreaticoduodenal arterial arcade and accompanying veins were found in pancreatic fascia. For 90% cases (n=36), it was easy to preserve the anterior inferior pancreaticoduodenal artery and accompanying veins lied in the pancreaticoduodenal groove. For 10% cases (n=4), the anterior pancreaticoduodenal arterial arcade was absent, and 2.5% (n=1) was absent for the posterior pancreaticoduodenal arterial arcade, but the arteries to the duodenum and their accompanying veins were found in pancreatic fascia. Conclusions Protecting the posterior pancreaticoduodenal arterial arcade and the part of the anterior pancreaticoduodenal arterial arcade are the key process for successful DPPHR. Kocher maneuver helps to expose and identify the posterior pancreaticoduodenal arterial arcade and drainage veins. The failure of DPPHR maybe caused by the absence of the anterior pancreaticoduodenal arterial arcade.

    Endoscope-assisted submandibular sialoadenectomy via retroauricular hairline approach: Anatomical study
    CHEN Liang-Si, HUANG Xiao-Meng, LUO Xiao-Ning, ZHANG Sai-Yi, LIANG Lu, SONG Xin-Han, LEI Zhong-Meng
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  659-663. 
    Abstract ( 936 )  
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    Objective To provide the anatomical basis for the endoscope-assisted submandibular sialoadenectomy via retroauricular hairline approach (EASSRHA) and assess its feasibility and safety.  Methods  The surgical anatomy of retroauricular hairline region and submandibular region was observed in 15 fresh human cadavers (30 halves). The submandibular gland resections were performed on 5 human cadavers(10 halves). After the procedure, the related vascular and neural structures were evaluated. Results Dissection in the retroauricular hairline region should be performed between the superficial musculoaponeurotic system and the investing cervical fascia. On the superficial surface of the upper sternocleidomastoid lied the lesser occipital nerve, the great auricular nerve and the external jugular vein.  The submandibular region extended between the deep surface of the platysma and submandibular sheath. The marginal mandibular branch emerging from the inferior border of parotid gland was found(7.21±0.50)mm above the inferior border of the mandible in 66.7%, along the inferior border in 23.3% and (9.43±0.32)mm below the inferior border in 10% of the cases. Near the antero-inferior angle of the masseter muscle, the marginal mandibular branches of the facial nerve crossed over the facial artery and facial vein (29.86±2.77)mm and (25.71±3.32)mm from the mandibular angle , respectively. The hypoglossal nerve passed through the deep surface of the stylohyoid muscle and posterior belly of digastric muscle to enter the submandibular region. On the superficial surface of hyoglossus lied the lingual nerve, the Wharton's duct and the hypoglossal nerve. In all cases, the resection of the submandibular gland was successful without the need for an additional incision. No major neurovascular damage was reported. Conclusions A thorough knowledge of the surgical anatomy of the retroauricular hairline region and submandibular region is an essential requirement in performing the safe and feasible submandibular sialoadenectomy.

    In vivo anatomical observation and clinical significance of myopectineal orifice to laparoscopic inguinal herniorrhaphy
    JIANG Ming, HONG Jie, JIANG You, ZHANG Jun, LU Dun, CHEN Hong-Cun, TAO Bao-Zhong, LI Wen-Bei, GE Jiang, LI Liang
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  664-667. 
    Abstract ( 1402 )  
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    Objective To explore the anatomical nature of the preperitoneal space during laparoscopic inguinal hernia repair, and provide us with anatomical basis for surgery. Methods Anatomic observation and analysis were carried out retrospectively on 30 patients undergoing laparoscopic inguinal hernia repair from January 2012 to December 2012 in our hospital.The surgical approaches, anatomic planes and technical tips were also elucidated by drawings and videos. Results Retzius space and Bogros space made up preperitoneal space. Transversalis fascia could be divided into superficial layer and deep layer. Between peritoneum and deep layer of transversalis fascia was avascular area. transversalis fascia thickened to form theiliopubic tract, which lied on the posterior aspect of the inguinal ligament. The iliopubic tract formed medial wall of femoral and inferior walls of the inguinal canal. The femoral branches of the genitofemoral nerve and the lateral femoral cutaneous nerve  trvelled through below the iliopubic tract. Conclusions The premise of laparoscopic inguinal hernia repair is that we are familiar with the mark point of Myopectineal orifice in preperitoneal space, it has important clinical significance.

    Researches on anatomical features of temporal bridging veins with three dimensional virtual reality technique and its clinical applications
    YANG De-Lin, GU Shi-Xin, SUN Bing, LIU Xiao-Dong, CHE Xiao-Meng, XU Qi-Wu, LI Wen-Sheng, QU Bao-Tian
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  668-672. 
    Abstract ( 1566 )  
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    Objective To evaluate the application of virtual reality technology in neurosurgical anatomy we compared the virtual three-dimensional (3D) microanatomy of the temporal bridging veins as part of the resection of tumors across the petrosal crest in 25 patients against the actual microanatomy of the temporal bridging veins on 20 cadaveric head sets. Methods The experiment was carried out using two groups of data: a virtual group (VR Group) made up by 25 clinical cases and a physical body group (PB Group) made up by 20 cadaveric head sets. In the physical body group, the temporal bridging veins on the cadaveric heads were examined under the microscope for number of their tributaries and measurement of the distance between emptying point on sinus of Labbé vein and sigmoid transverse sinus. In the virtual group, the dissection of the temporal bridging veins was simulated on Dextroscope. We compared the anatomical features of temporal bridging veins in two groups. Virtual reality technology was used in the planning of 25 cases for which the anatomy of temporal bridging veins was studied carefully by the neurosurgical team. Results Four basic configurations of veins were found: venous lakes running in the tentorium before emptying into the sinuses, accounting for 17.5%; candelabra of veins uniting to form one large drainage, accounting for 40%; single independent draining veins, accounting for 20% and multiple independent draining veins , accounting for 22.5% in physical body group. venous lake, accounting for 16%, candelabra of veins uniting to form one large drainage, accounting for 42%;  single independent draining veins, accounting for 18% and multiple independent draining veins, accounting for 24% in virtual group. 213 tributaries and 87 terminations of temporal bridging veins were found in cadaveric heads, whereas 167 tributaries and 81 terminations of temporal bridging veins were found in the virtual group. The distributions of anatomical terminations of temporal bridging veins were divided into three groups: transverse area 52.87%, tentorium area 24.13%  and petrosal area 23.0% in physical body group, whereas 54.35%,23.91% and 21.74% in virtual group, respectively. The proportion of fore-placed type veins of Labbé is 7.69% in physical body group and 8.33% in virtual group (P >0.05). The anatomical features of Labbé veins found during the operation of the 25 patients with tumors extended from middle fossa to posterior fossa and were consistent with what was seen in presurgical planning. Conclusions Virtual reality technology can accurately simulate the anatomical feature of the temporal bridging veins which facilitates the planning of individual operations in neurosurgery.

    Anatomical radiographic research of the teardrop and anteverted angle of the distal humerus in children
    LIAO Shi-Jie, DIAO Jin-Min, LIU Rong-Bin, SU Zhu-Cheng, DING Xiao-Fei
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  673-676. 
    Abstract ( 1620 )  
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    Objective To explore the anatomical structure of the teardrop of the distal humerus and anteverted angle of the capitellum and trochlea in children. Methods We explored the anatomical formation of teardrop of the distal humerus and observed the antevertion angle of the capitellum and trochlea by simulating their shape in the elbow cadavers through DR-X-ray radiography system. Results The anterior, posterior, and lower edges of the teardrop corresponded to the posterior edge of the coronary fossa, the front edge of the olecranon fossa and the sub-epiphyseal bone of humeral metaphysis facing the trochlea, respectively. The degree of anteverted angulation of the capitellum and trochlea was (42.63±2.24)° and (10.58±2.82)°, respectively. Conclusions The change of teardrop may be helpful in diagnosis of the occult supracondylar fractures of the humerus in children. And the anteverted angle of the capitellum and trochlea should be restored after reduction of the distal humeral fracture.

    Repetition of patella: one case report
    XU Zi-Jiang, HAO Pei-Yong
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  676. 
    Abstract ( 784 )  
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    MRI study of pelvic veins of healthy women in their reproductive years
    MENG Lian-Hui, LI Shu-Jing, WANG Gui-Yang, LIU Fu-Jun
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  677-679. 
    Abstract ( 920 )  
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    Objective To study MRI features of pelvic veins of healthy women in their reproductive years and to familiarize radiologists with anatomy of pelvic veins. Methods 62 healthy women in their reproductive years, 21~45 years, including 30 parous women and 32 nonparous women. MRI and MRA was performed, to measure the diameter of left ovarian vein and pelvic veins, analyses statistically, and investigate MRI appearance of healthy women in their reproductive years. Results Pelvic veins in 62 healthy women were showed by MRI and MRA. The mean diameter of left ovarian vein was(4.45±0.59)mm, (4.87±0.45) mm in the parous women group, (4.06±0.42)mm in the nonparous women group, There were significant differences between two groups (t=7.297, P<0.001).  The mean diameter of pelvic vein was (4.17±0.58) mm, (4.45±0.48) mm in the parous women group, (3.91±0.54) mm in the nonporous women group, There were significant differences between two groups (t=6.400, P<0.001). Conclusion Pelvic veins were showed by MRI and MRA clearly, There were significant differences between parous women and nonparous women.

    Comparison of CEA value  between the Xinjiang Kazak and Han nationalities and its clinical significance
    WANG Meng-Li, AI Li-Jiang-·A-Shi-La, ZHANG Chi-Long, FANG Dui, LIU Zhen-Feng, JIA Heng
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  680-682. 
    Abstract ( 883 )  
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    Objective to measure and compare center edge angle (CEA) value between the Kazak and Han nationalities in Xinjiang region to provide reference for diagnosis of clinical hip diseases and design  design of the prosthesis. Methods Anteroposterior plain radiographs of adult pelvis from 114 patients with Han nationality and 93 patients with Kazak nationality were randomly selected, from which the value of the center edge angle was measured. Results The center edge angle t was (35.68±3.80)°on the left  and (35.94±3.74)° on the right in male with Kazak nationality, which corresponded to (33.76±3.93)° and  (33.77±3.93)° in male with Han nationality(P<0.05); The hip center edge angle was (33.45±4.34)° on the left and (33.41±4.64)° on the right in female with Kazak nationality, which corresponded to (31.41±3.57)° and  (31.42±3.57)°in female with Han nationality (P<0.05). Conclusion  The hip center edge angle of Xinjiang Kazak Male and female is larger than that of the Chinese male of Han and female.

    Classification systems for intra-articular calcaneal fractures based on the digitalized Re-construction
    TANG San-Yuan, YANG Hui, LI Yuan-Hui, DU Zhong-Li, SUN Fang, TANG Tian-Hua, MEI Ji-Wei, SHU Hua-Min
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  683-687. 
    Abstract ( 850 )  
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    Objectives To investigate the feasibility and value of digitalized visualization in the fracture classification of calcaneal fracture. Methods Seventeen cases of calcaneal fractures underwent multidetector CT scan. Three-dimensional reconstruction of visible models of these fractures were performed with the mimics 10.0 software on the basis of CT raw data. Two Senior orthopaedics surgeons class the fractures by Sander's criteria and digitalized criteria. The reliability between the criteria was compared using Kappa value. Results 17 three-dimensional visible models were established. The anatomic site, direction and degree of dislocation of fracture were demonstrated accurately. The Kappa value of digitalized criteria was 0.795(0.691~0.874), which was 0.641(0.591~0.701)in Sander's criteria. Conclusion Digitalized three-dimensional reconstruction can give intuitive and clear result in calcaneal fracture and classification. Its reliability is high. It will provide precise imaging basis for surgical plan.

    The effect of mechanical-stretch on the expression of TLR3 and myositis autoantigens in cultured C2C12 myoblasts
    FENG Li-Jiang, CHEN Rong, LIU Nie-Hui, HUANG Wei-Yi, CENG Hui-Jun, LIAO Hua
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  688-691. 
    Abstract ( 640 )  
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    Objective To investigate the effect of mechanical-stretch on the expression of myositis autoantigens and proinflammatory TLR3 in cultured C2C12 myoblasts. Methods C2C12 cells cultured on the surface of BioFlex flexible basement membrane in vitro were subjected to cyclic strain. The proliferation of C2C12 cells was detected usingflow cytometry. The mRNA expression of myositis autoantigens (HRS, Mi-2, DNA-PKcs, U1-70) and TLR3 were analyzed through Real-time RT-PCR. Results Cyclic  echanical-stretch about 2d stimulated C2C12 cell cycling and early down-regulation of mRNA levels of TLR3 and Mi-2, HRS,  DNA-PKcs and U1-70 under the strain of 10% lengthening, 0.25Hz frequencyfor 2h per day(P<0.05). Conclusions Mechanical stretch reduces expression of muscle autoantigens and of pro-inflammatory TLR3, which may provide new insight to understand howresistance exercise reduce the symptoms associated with myositis.

    Analyses on stereology of mitochondrion of neurons that surround intracerebral hemorrhage in rats and the neuroprotective effect of astragalus injection for intracerebral hemorrhage
    WANG De-Ke, ZHANG Hai-Yu, LIU Hai-Xiang, QIN Yi
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  692-695. 
    Abstract ( 829 )  
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    Objective To study the protective effect of astragalus to the ultrastructure of apoptotic neurons which surround the intracerebral hemorrhage (ICH).  Methods ICH model was established by injecting collagenase Ⅶ into the brain of rats.  Method of Narrow-alley Test was applied to study behavioral index. The ultrastructure of neurons around the intracerebral hemorrhage in rats was observed by transmission electron microscope and a stereology analysis was performed on the mitochondria. Results mpared with model group, stereology analysis of nerve mitochondria, volume density, numerical density, specific surface and specific membrane of the astragalus treatment group increased notably(P<0.05).    Conclusion   Astragalus could protect neurons located near the hemorrhage brain area and abate the neuronal apoptosis with this efficacy better at an early stage following hemorrhage.

    Developing intervertebral disc degeneration at rabbit lumber spine by using low-temperature plasma radiofrequency ablation 
    ZHOU Wei, XU Xi-Chun, JIA Yin-Xing, WANG Ji-You, TU Dong-Jing, HUI Jia-Dong, TU Hao-Chao, DIAO Fei
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  696-701. 
    Abstract ( 848 )  
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    Objective To develop a new intervertebral disc(IVD) degeneration animal model by plasma radiofrequency ablation. Methods 24 New Zealand white rabbits were equally divided into the experimental group and control group. L3/4~L5/6 IVDs were punctured and ablated for 30 seconds in the experimental group and t were just punctured in the control group. DR imaging studies, MR imaging studies and histological analysis were performed prior to surgery and 4, 8, 12 weeks after surgery to monitor progression of IVDs degeneration. Results The DR and MR examinations showed degeneration signs like lost of IVD height and T2 density. The control group showed no significant changes in DR and MR scan after 4 weeks. Both groups showed no lost of nucleus pulposus in the early time points and the experimental group showed lost of nucleus pulposus and derangement of the IVD structure. Conclusions The practicable and reproducible animal IVD degeneration model proposed in this paper is more stable than the previous puncture model.

    The left ascending lumbar vein into the left renal vein with the accessory hemiazygos vein agenesis
    CUI Ying-Chun, CHENG Juan-Juan, JI Qing-Feng
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  701. 
    Abstract ( 679 )  
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    Protection and mechanism of isoflurane preconditioning against oxygen-glucose deprivation neuronal injury
    ZHOU Guo-Bin, JI Jin-Quan, WANG Zhi-Feng, SUN Ke
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  702-705. 
    Abstract ( 732 )  
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    Objective To study the protection and mechanism of isoflurane preconditioning against oxygen-glucose deprivation(OGD) neuronal injury. Methods Cortical neurons from rats at embryonic day 16 to 17 were cultured. With simuation of a cerebral ischemia in vitro, OGD was performed in the pretreated cells. Neuron injury was assessed by MTT. Protein expressionof pERK and HIF-1α was determined by Western blot. Results Isoflurane preconditioning protected dose-dependently the cortical neuron from OGD injury. The hypoxia inducible factor (HIF-1α) in the OGD injured neurons was increased by isoflurane preconditioning, which was partially abolished by ERK inhibitor PD98059. Conclusions Isoflurane preconditioning protects the cortical neuron from OGD injury, possibly through activating HIF-1α mediated by pERK.

    The finite element testing of the magnesium alloy Jerp system for unstable jefferson fracture
    YANG Qiang-Lei, YIN Qiang-Shui, HUANG Jin-Long, MA Xiang-Yang, JIA Gong
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  706-711. 
    Abstract ( 658 )  
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    Objective To compare the stability and stress distribution of titanium alloy and magnesium alloy Jefferson-fracture reduction plate(JeRP) system for fixation of unstable Jefferson fracture. Methods The spatial structure information of atlas was obtained through CT scanning, and the geometry model of JeRP system for t fixation of unstable Jefferson fracture was established in Solidworks system. The internal structure changes, and the stress distribution of titanium alloy and magnesium alloy JeRP system and atlas were imitated and analyzed in Ansys13.0 system under physiological load in neutral, anteflexion, extension, lateral bending and rotation positions. Results (1) There were high geometric similarity and qualified stress distribution on the finite element model of JeRP system for fixation of unstable Jefferson fracture. (2) In different positions under physiological load, the stress of JeRP system was located mainly at the mid-part of the JeRP, the root and top of screws in anteflexion and extension position and, at the mid-part of screws in lateral bending position. (3) The maximum stress of JeRP system was less than the yield strength of titanium alloy and magnesium alloy under physiological load. The elastic strain of JeRP system and deformation of fracture were quite small. The fracture surface stress of magnesium alloy group was larger than the titanium alloy group. Conclusion Both the titanium alloy and magnesium alloy JeRP system have enough strength and effect of fixation for the treatment of unstable Jefferson fracture in physiological load, but magnesium alloy JeRP system is better than titanium alloy JeRP system in promoting fracture healing.

    The finite element analysis of NI-TI anterior screw elasticity fixation on lower thoracic vertebrae
    LI Xiao-He, LI Zhi-Jun, GAO Chang, WANG Hai-Yan, CA Yong-Jiang, XU Da-Chuan
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  712-717. 
    Abstract ( 876 )  
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    Objective To develop a 3-D finite element(FE) model of NI-TI anterior screw elasticity fixation on lower thoracic vertebrae and evaluate the stress of screw,stick stress. Methods The geometrical model was created by Mimics13.0 based on CT data of T11~12 motion segments from a male patient , which was imported into the Ansys11.0 in order to establish the 3-D FE of anterior screw fixation on lower thoracic vertebrae. The 3D FE models were imported into Ansys11.0 with 500N pressure and 10 Nm moments loaded on the upper surface of T11 to simulate thoracic axial compression,anteroflexion, extension, lateral bending and rotation. The Von mises stress of screws and stick was recorded and input to SPSS11.0 to analyze the difference of different stress distribution of the screws and sticks. Results It was obvious that the Von mises of the screw concentrated on the tail of screws and "U" segment with inferior bearing larger load than superior surface;the lower segment of stick depressed was larger stress. Rotation mayresult in the Von mises concentration on tails of screw and"U"segment,but were lower than yield strength. Conclusions NI-TI anterior screw elasticity fixation on lower thoracic vertebra would not break on usual motion.

    A case of communicating branch between proper palmar digital nerve and dorsal branch of ulnar nerve
    HUANG Rui-Chao, MA Jian-Jun, GUO Lei, WANG Zhi-Shen, CHENG Xue-Mei, YANG Rui-Huan, TU Chuan, DIAO Hai-Long
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  717. 
    Abstract ( 573 )  
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    The modified radical orchiectomy of clinical stage-Ⅰ seminoma of the testis
    TAN Shuo-Guan, LIANG Wei-Bei, BO Bin
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  718-720. 
    Abstract ( 647 )  
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    Objective To study the effect of modified radical orchiectomy. Methods The clinical data of 28 cases of adult patients of clinical stage-Ⅰseminoma from January 2009 to August 2012 were retrospectively presented and analyzed. Among 28 cases of adult patients, 13 cases were cured by modified radical orchiectomy and 15 cases were cured by radical inguinal orchiectomy. The two ways of surgery were evaluated by the surgical duration, length of incision, hospitalization length after surgery, surgical complications, and neoplasm recurrence. Results The modified radical orchiectomy of 13 cases of adult patients of clinical stage-Ⅰseminoma was successfully  rformed. There was not significant difference in modified radical orchiectomy and the radical inguinal orchiectomy with regard to the surgical duration, the surgical complication and the neoplasm recurrence, but the former was significantly lower than the latter in visual analogue scale(VAS), and significantly shorter in the length of incision and in hospitalization length Conclusions The modified radical orchiectomy of the clinical stage-Ⅰseminoma is advisable and safe. To contrast with traditional radical inguinal orchiectomy, this way of surgery has the characteristics of the smaller incision and themilder pain after the surgery.

    To analyse the therapeutic effects of nasal endoscopy in the surgery of the Inverted papilloma of the nasal cavity and the paranasal sinuses
    FENG Chun-Yang, KE Chao-Yang, LIU Qian, ZHOU Jing-Chun, ZHANG Bo, HAN Ling
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  721-723. 
    Abstract ( 917 )  
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    Objective To investigate the value of application and the therapeutic effects of nasal endoscopic surgery combined with the nasal anatomy for treatment of inverted papilloma in the nasal cavity and the paranasal sinuses. By the anatomy of nasal and sinus neoplasma. Methods 26 cases of patients with inverted papilloma in the nasal cavity and the paranasal sinuses  treated with nasal endoscopic surgery were analysed retrospectively.  According to the Krouse scores, there were 5, 15, 6 and 0  ases inI to IV stages, respectively.  There were 11 patients receiving only nasal endoscopic surgery, 12 patients receiving endoscopic surgery combined with Caldwell-Luc surgery, 3patients receiving combination of nasal endoscopic surgery, Caldwell-Luc surgery and lateral rhinotomy. Results Among those 26 patients, 3 cases had suffered recurrence, butthey were cured after a secondnasal endoscopic surgery. Quite a few cases had nasal cavity dryness,apart from which no other complication were observed. Conclusions Forpatients of stage I, the nasal cavity and the paranasal sinuses inverted papilloma could be radically removed by nasal endoscopic surgery. For patients of stage II and III,however, endoscopic surgery only may not be sufficient, some cases need Caldwell-Luc operation and even lateral rhinotomy as well. Thus, it is important to accurately assesspatient's condition before surgery. In a word, the high-definition of nasal endoscopic surgery has small trauma, less recurrence rate and could remove tumor radically forpatients of stage I to III.

    Characteristics of miRNA in fibrosis diseases
    SHEN Kuan-Hong, HUANG Dong
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  724-726. 
    Abstract ( 735 )  
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    Research progress of generating organ decellularization scaffold by perfusion method
    DIAO Li-Na, MEI Jin, ZHANG Jian-Se, TANG Mao-Lin
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  727-730. 
    Abstract ( 599 )  
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    Juvenile cervical rib syndrome: one case report
    WANG Shen, LUO Yan, ZHANG Jian, LUO Qian, LIAO Wen-Bei
    Chinese Journal Of Clinical Anatomy. 2013, 31(6):  731. 
    Abstract ( 670 )  
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