Table of Content

25 March 2014 Volume 32 Issue 2

  

Applied anatomy and guider research of lag screw placement for  internal fixation of posterior column via lesser sciatic notch

SHI Ceng-Yuan, YIN Wei-Gang, MAO Hai-Jiao, HONG Hai-Qing, ZUO Rong-Ti

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  121-124.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 1673 )  

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　Objective　To provide anatomy basis for the placement of lag screw in the acetabular posterior column via lesser sciatic notch.　Methods　The morphology of lesser sciatic notch was observed on 66 sides of innominatum bone specimens (36males and 30 females). Pelvic CT scanning data from 60 adults (30males and 30 females) were imported to Mimics 14.1 for 3D image reconstruction. On the basis of this result, the morphology of lesser sciatic notch was classified.　Results　According to skeleton classification, type “）” “C” “『” “丿” of each station were 44.4%, 30.6% ,16.7%, 8.3% in male respectively. Type“）”“C” “『”“丿”of each station were 73.3%, 3.3%,6.7%,1% in female respectively. According to three-dimensional reconstruction of Mimics classification, type “）” “C” “『” “丿” of each station were 56.7%, 26.7% , 13.3%, 3.3% in male respectively. Type “）” “C” “『” “丿” of each station were 76.7%, 10.0% , 6.7%,6.7% in female respectively.　Conclusion　If type “C”was encountered, the inferior extremity of lesser sciatic notch will affect placement of the lag screw and into a guide pin should be placed after osteotomy. The guide pin is easy to slip and a “step” should be made at pin- point of lesser sciatic notch if the type is “『”.

Applied anatomy of anterolateral intermuscular approach for intertrochanteric fracture

LI Bin-Hua, DAI Min, DING Zhi-Hui, ZHANG Bin, ZHOU Chu-Jian

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  125-128.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 569 )  

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Objective　To provide anatomic basis for treating intertrochanteric fracture through anterolateral intermuscular approach to hip joint.   Methods   12 adult cadaveric lower extremities were dissected to observe anatomical structures of relative nerves and vascularure according to the operational process.    Results   The distance from the intermuscular septum between gluteus medius and tensor fasciae latae to the anterior superior iliac spine was(5.13±0.52) cm(4.25~6.30 cm). the most inferior branch of the superior gluteal nerve and the gluteus medius branches of the lateral femoral circumflex artery often traveled across the intermuscular septum. The distance from the most inferior branch of superior gluteal nerve in the spatium intermuscular to the lateral protrusive point of greater trochanter was (8.15±0.67)cm (7.13~9.56 cm); and the distance from the gluteus medius branches of the lateral femoral circumflex artery in the intermuscular septum to the lateral protrusive point of the greater trochanter was (5.57±0.39)cm (5.05~6.62 cm).   Conclusions   The anterolateral intermuscular approach to the hip joint, which is safe, creates full exposure and imposes less damage, provides a new thinking and method for surgical treatment of the intertrochanteric fracture.

Anatomical study of reconstruction of upper extremity motor function by thecompound Latissimusdorsif lap

QIN Xiao-Yong, SHA Ke, DIAO Jin-Min, GUO Xiao-Wen, SUN Hong-Zhi, ZHANG Yin-Long

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  129-132.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 553 )  

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es of latissimusdorsi was observedand the relationship of the origin of the latissimusdorsi with the adjacentmuscles in the lower back was investigated . SPSS 13.0 statistical software was for data processing.　Results　Latissimusdorsi at the beginning of sarcoplasmic thin The latissimusdorsi was thin at the origin, and the muscle divided into two bundles with inconsistent directions respectively innervated by two branches of thoracodorsal nerve. Latissimusdorsi at origin united closely with thoracolumbar fascia, leading to the thickening the thoracolumbar fascia; blood vessels and nerves traveled between the latissimusdorsi and the deeper thoracolumbar muscles with consistent anatomical characteristics.　Conclusion　The anatomy characteristics the latissimusdorsi and thoracodorsal nerve are the main reason for the lack of forearm strength after muscle transposition; The latissimusdorsi composite flap containing at its origin other superficial lower back muscles can enhance the forearm muscle strength after flap transposition without vascular anastomosis.

Observation of clinical anatomy of ilioinguinal approach to avoid the neurovascular complications

WANG Yong-Wei, GAO E-Xian, WANG Xiao-Jie, FANG Liang, MA Quan, KONG Xiang-Yu

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  133-136.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 633 )  

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Objectives　To provide applied anatomic data for preventing the injury of the important structures in the ilioinguinal approach of surgical treatment forpelvic fracture. Methods the anterior superior iliac spine, the pubic tubercle and the inguinal ligament were chosen as the mark point for observing and measuring  morphologic features of lateral femoral cutaneous nerve, ilioinguinal nerve, pectineus branch of the femoral nerve and obturator artery in 15 adult cadaveric specimens (30 sides, 9 male, 6 female). The data were analyzed statistically.　Results　①LFCN traveled medial to anterior superior iliac spine through the inguinal ligament could be observed  in 29 sides (96.67%), (20.01 ± 0.32)mm; LFCN was surrounded by the fibers of the inguinal ligament could be observed in 10 sides(33.33%); LFCN was covered by a fascial sheath formed by the deep fascia could be observed 14 sides (46.67%). ② The distance between the point of ilioinguinal nerve passed through the obliquus internus abdominis and the center of the anterior superior iliac spine was (5.41± 0.50) mm, The distance between the point of ilioinguinal nerve penetrated from the aponeurosis of oblique externus abdominis and the center point of pubic tubercle was (18.04 ± 0.21) mm.　Conclusion　The LFCN must be protected in the exposure of the medial side of the iliac wing and sacroiliac joint by preventive release of the tensor fascia and the inguinal ligament . To prevent the injury to ilioinguinal nerve, incision of the aponeurosis of the oblique externus abdominis should be performed at 5cm superior to medial and lateral ends of the inguinal ligaments. Identification and ligation of the obturator vessels to ramus of pubis should be carried out prior to exposure of iliopectineal eminence  so that uncontrollable bleeding can be avoided

Clinical anatomical study of chain-link island flap based on the descending branches of supracarpal cutaneous branches of the ulnar artery

LIU Feng, ZHENG Wei-Mao, LI Hong-Liang, ZHENG Xue-Feng, WANG Yu-Long, DING Zi-Hai-

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  137-140.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 659 )  

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Objective　To provide the anatomical information for covering the defect on the hand and forearm with the chain-link island flap pedicled with the descending branches of supracarpal cutaneous branch of the ulnar artery.　Methods　A total of 12 fresh cadaveric upper extremities that were divided from the elbow joint were used in the research:10 specimens were perfused with red latex for microanatomy, 2 specimens were perfused with plastic and eroded to be vascular cast mold to observe the origin，course, diameter and linking form of the descending branches of supra carpal cutaneous branch of the ulnar artery. Results　The distance from the ulnar styloid process to the fifth metacarpophalangeal joint on the ulnar dorsum of hand was assumed as a unit, the two cluster points of cutaneous clusters of the descending branches of supra carpal cutaneous branch of the ulnar artery were in the location of 18.2%±7.0% that contain 2.3 perforators and 66.4%±16.7% that contain 4.4 perforators. There was no significant difference on the radial and ulnar side distribution of the cutaneous branches arising from the descending branches of supracarpal cutaneous branches of the ulnar artery. The cutaneous branches extended from the descending branches of supra carpal cutaneous branch of the ulnar artery linked each other to form a vascular chain paralleled to the main blood and provided the blood to the skin. 　Conclusions　The chain-link flap is available to repair the small tissue defect in hand or forearms  with the reservation the main vessel.

The anatomical basis of design of medial pedis perforator flap

OU Yang-Hai-Xiang, MAO Yong, TUN Wei-Chi, HUANG Dong, BI Zhi-Wei, NIU Guo-Qiang

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  141-144.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 737 )  

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Objective  To provide anatomical foundation for clinical application of themedial pedis perforator flap. 　Methods　The number，length，origin， exteriordiameter and anastomosis of the perforators of the medial plantar artery which were distributed to the area of medial pedis were observed and measured on 8 adult fresh lower limb specimens perfused with red latex.　Results　The blood supply of the medial pedis area included medial plantar artery, medial anterior malleolar artery, medial tarsal arteries and tibia toe lateral artery. 5.3 perforators in average were identified in the medial intermuscular septum between abductor hallucis and flexor digitorum brevis, which were sent out to the non weight bearing area of medial plantar aspect. Among these the first and second perforators were larger and longer in external diameter and length of pedicle. The medial branches of medial plantar deep artery sent out cutaneous branches to the medial pedis area at (1.92±0.61) cm ahead of Scaphoid tuberosity. The tibial artery of hallux went through to the medial pedis area at (2.03±0.56) cm proximal to the fist plantar toe joint and formed anastomotic arch on the abductor muscle.　Conclusions　The medial pedis perforator flap can be designed as pedicle flaps for resurfacing defects around the heel and forefoot, and free perforator flaps can be harvested forresurfacing pulp defects of digits.

A case concerned with initial anomaly of the ulnar palmar artery of the digitus minimus

LI Yi-Ting, MA Jian-Jun, JIAN Yu, ZHOU Xiao-Dan, SONG Jia-Rui, GAO Xiao, DIAO Hai-Long, WANG Ge

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  144.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 677 )  

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Exploring study on flap coefficient of degloving finger injuries

ZHANG An-Liang, JU Ji-Hui, JIN Guang-Zhe, LI Xiang-Jun, TANG Lin-Feng, LIAO Guan-Xiang, SONG Er-Fa, HOU Rui-Xin

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  145-147.  doi:0.13418/j.issn.1001-165x.2014.

Abstract ( 484 )  

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Objective　To explore a kind of both simple and accurate method of designing skin flaps for repairing degloving finger injuries.　Methods　The middle fingers were made to the models of degloving injury of the whole finger in twenty flesh cadaveric specimens. We divided the wound and the degloved skin into two parts: the dorsal part and the volar part. The length, the proximal and distal width of the wound and degloved skin were measured. Flap coefficient(=length of skin/length of wound) was calculated from the above data according to flap coefficient. 　Results 　There is a constant proportional relationship between skin and wound, which was named flap coefficient. The length coefficient was 1.2, and the width was 1.6. Conclusion　The flap coefficient is beneficial for us to simply and accurately design skin flaps for repairing degloving finger injuries.

An endoscopic anatomic study of navigation-assisted extended transsphenoidal approach to clival region

CHEN Gao-Dong, LUO Zheng-Xiang, YANG Kun, DIAO Feng-Lai, JIAN Chun-Fa

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  148-152.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 415 )  

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Objective　To study the exposure of clival region by navigation-assisted extended transsphenoidal approach and provide microanatomical data for incision of lesions in petroclival region by transsphenoidal approach. 　Methods　10 adult wet cadaveric heads were used to simulate endoscopic extended transsphenoidal approach under assistance of navigation, and important anatomical exposure in petroclival region was observed.　Results　After the anterior wall of thesphenoid sinus was opened, bone structure in the dorsum sellae and clival region was grinded out and dura was cut open, the bilateral oculomotor nerves, trigeminal gangliae, basilar artery and its branches, the posterior inferior cerebellar artery and lower cranial nerve were exposed; under the assistance of navigation, accurate data measurement and positioning could be performed. The clival region could be completely exposed by extended transsphenoidal approach and the shortest distance was (88.90±2.62) mm. The grinding territory for the anterior wall of the sphenoid sinus and lower clivus were respectively determined with bilateral pterygoid canals and breakdown holes as the border, with a distance to the middle line at (9.22±0.48) mm and (10.60±0.82) mm respectively. Conclusions  Endoscopic extended transsphenotidal approach is an appropriate approach for lesions in petroclival region. Navigation assistance that can provide higher securityis beneficial for positioning of important structure.

The superficial branch of radial nerve defect by the lateral cutaneous nerve of forearm instead of a case

BO Yong-Hua, WANG Miao, BO Ai-Hua

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  152.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 405 )  

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Anatomical study of transoral thyroidectomy

HUANG Yi-Xiang, CA Cheng-Zhong, ZHANG Ti, CHAI Li, WANG Gang, CHANG Chao, DAN Lin-Xiang, FANG Lin

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  153-157.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 878 )  

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　Objective 　Endoscopic Minimally Invasive Trans-oral Thyroidectomy (eMIT) and Trans-oral Partial Parathyroidectomy(TOPP）are the two main techniques of trans-oral thyroidectomy. An anatomical study of eMIT and TOPP was made to evaluate the safety and feasibility of trans-oral thyroidectomy.　Methods　In this study, 5 fresh human cadavers were dissected for better understanding of the anatomic structures of the anterior cervical region, mandible region and suprahyoid bone muscles. eMIT and TOPP were subsequently performed on 2 human cadavers.　Results　The anterior region of neck could be easily reached through midline of the suprahyoid bone muscles by eMIT, but the upper pole of the thyroid lobe was difficult to dissected. Distinctively, TOPP set up the space at the dorsal side of the thyroid gland and adjacent to the trachea. The upper pole of the thyroid lobes, the recurrent nerve and parathyroid gland could be easily identified. The operation space was more limited in TOPP and longer surgical duration was needed for TOPP (3h) than eMIT (1h). Special equipments and surgeons with experience were required for this technique. No injury to related muscles as well as vascular and neural structures were found by subsequent anatomical dissection.　Conclusions　By anatomical study, we believe that eMIT and TOPP are save and feasible. For now, eMIT is more suitable for clinical applications.

The variation of a single muscle bundle accompany with common peroneal nerve：a case report

HONG Yi-Lian, CHEN Chong-Chuan, CHAN Shi-Chong, LE Meng-Na, DAI Qiao-Ai, LIU Wen-Qiang

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  157.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 477 )  

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Applied anatomy of the triangle of ductus arteriousus

TAO Guo-Qiang, SUN Shan-Quan, ZHONG Yuan, ZHANG Hu-Qi, ZUO Yao-Ban

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  158-161.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 868 )  

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Objective　To investigate the anatomical features of the triangle of ductus arteriosus, so as to provide morphologic data for clinical operation in this region.　Methods　Fifty cadavers fixed by formalin were collected randomly. The arterial ligament(AL)、the left vagus nerve and the left recurrent laryngeal nerve(LRLN) were dissected and observed. The angle between the AL and the left pulmonary artery (LPA) was measured, and the data were statistically analyzed.　Results　(1) The AL was located between the aortic arch and LPA, namely in a typical triangle of ductus arteriosus in 47 cadavers, and between LPA and descending aorta in remaining 3 cadavers.  (2) The attachment sites of AL on the aortic arch and LPA varied greatly. According to the different sites, all of the cases could be divided into 6 types. (3) The LRLN originated from the left vagus nerve at the inferior margin of the aortic arch in 36% cases, at the lower 1/3 of the anterior wall of the arch in 30% cases, at the middle 1/3 of the anterior wall of the arch in 14% cases, at the upper 1/3 of the anterior wall of the arch in 14% cases, and at the medial margin of the descending aorta in 6% cases.  (4)The angle between the median axis of the AL and the LPA was（45.08±19.06）° . In 3 cadavers the angle was 0°，and in 2 cadavers was 90°.  (5) The LRLNs hooked around the upper end of the AL and aortic arch in all 50 cadavers.　Conclusion　The results reveal that the morphology of the AL is different from the classical description. The attachment sites of AL on the aortic arch and LPA vary greatly, which makes the relations of the AL to the surrounding structures more complicated. Surgeons should keep the variations in mind to avoid the occurrence of complications during the operation of ductus arteriosus ligation and other operations in this region.

Dual origin of the left vertebral artery and many branches of the left vertebral vein in one case

SUN Zhao-Xia, GU Fang-Hua, SONG Yo-Ze

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  161.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 458 )  

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A novel quantitative ultrasound technique for osteogenesis evaluation of the injectable chitosan/nano-hydroxyapatite/ collagen scaffold

YAN Yu-Ting, LI He, YUAN Ru, LI Song-Jian, CHEN Pan

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  162-166.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 516 )  

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Objective　An injectable scaffold based on nano-hydroxyapatite (nHA), collagen (Col) and chitosan (CS) was synthesized in a preliminary study. In this study, we proposed a novel quantitative noninvasive technique for osteogenesis evaluation of the scaffold.　Methods　The CS and CS/nHAC scaffold was respectively subcutaneously injected into Sprague-Dawley rats mediated by ultrasound. After 1h, 14d and 28d, the gray-scale value, volume and blood flow of the scaffold were measured using diagnostic technique software. The animals were evaluated by type-B ultrasonic and color doppler ultrasonography. Results　Under mediation of ultrasound, the scaffold was accurately injected in. With evaluation of 28 days, we found the ROI gray-value of CS/nHAC was increasingly faster than CS/nHAC and the volume of CS/nHAC reduced slower.　Conclusions　CS/nHAC is more appropriate for fracture repairing than CS. And the ultrasound is proved a novel noninvasive technique for osteogenesis evaluation.

Pathological characteristicanalysis of congenialcorrected transposition of great arteries

DAO Zi-Yu

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  167-169.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 495 )  

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ition of great arteries (CCTGA) by color doppler echocardiography (CDE).　Methods　Forty patients with CCTGA established by surgery or CT or angiocardiography were analyzed retrospectively.  Results　28 cases were S.L.L, all of these were levocardia，12 cases were I.D.D，8 cases were mirror image dextrocardia and the other were levocardia. Tricuspid valve anomaly was the most common accompanied malformations, ventricular septal defect(VSD) was the second and the left ventricular outflow tract obstruction (LVOTO) was third. 25 cases with intact ventricular septum had tricuspid valve anomaly, none of these had LVOTO, most of 15 cases with VSD had  LVOTO, an only 2 cases had tricuspid valve anomaly.　Conclusion S.L.L was the most common type in CCTGA, tricuspid valve anomaly was the most common accompanied malformations, VSD was the second and LVOTO was the third. Tricuspid valve anomaly is always accompanied by CCTGA with intact ventricular septum, left ventricular outflow tract obstruction was always accompanied by CCTGA with ventricular septal defect.

Effect of different hydroxyapatite shapes on osteoclastogenesis of RAW264.7 cells in vitro

CENG Hui-Jun, CAO Biao, LIU Nie-Hui, CHEN Rong, SHI Dan-Dan, SHU Rong, OU Yang-Jun, LIAO Hua

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  170-173.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 670 )  

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Objective    To investigate the effect of different hydroxyapatite shapes on osteoclastogenesis of RAW264.7cells.   Methods   Hydroxyapatite with different shapes was synthesized through a hydrothermal treatment with further pH adjustments, and characterized by filed scanning electron microscope(SEM).Live/Dead staining was performed to evaluate the cell viability of different hydroxyapatites co-cultured with RAW264.7 cells. Tartrate-resistant acid phosphatase (TRAP) staining and quantitative RT-PCR (qRT-PCR) analysis were used to identify osteoclastogenesis and investigate transcriptional changes of osteoclastogenesis-related genes, under the stimulation of the receptor activator of nuclear factor-κB ligand (RANKL) in vitro.   Results   Live/Dead staining validated that the microrod and microsphere HAp particles were biocompatible and no difference of cell viability was detected between two particles after 24h co-culture. The qRT-PCR results showed that the two shaped HAp particles significantly inhibited the RANKL-induced osteoclastogenesis of RAW264.7 cells, especially for micrord particles compared to that of microsphere ones. Conclusions    Hydroxyapatites with different shapes could initiate different degree on osteoclastogenesis of RAW264.7cells.

Experimental study of ZHX3 gene transfected BMSCs and osteogenesis in vitro

LI Ji, QIN Shu-Jian, BAO Cui-Fen, SANG Yao-Cai, JUE Hui-Ying

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  174-178.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 494 )  

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Objective　To investigate the influence of zinc fingers and homeoboxes 3 gene (ZHX3) transfected BMSCs and osteogenesis induced in vitro.　Method　Transfect the rat BMSCs with lentivirus overexpressing of ZHX3 genet. At the same time, BMSCs transfected with no-load virus serves as the negative control group and BMSCs without any treatment as the blank control group. Fluorescent microscope were used to count cell number and calculate the rate of transfection. Western blot was used to detect the protein expression of ZHX3 gene in the transected cells. The cells received In-vitro inducement of for 21d, after which  alkaline phosphates staining and alizarin red staining were performed to observe osteogenic ability.　Results　(1) Cells express BMSCs phenotype could be obtained by adherent method.(2) After transfection, the ZHX3 gene overexpression group and the negative control group both expressed green fluorescence, blank control group do not express, and ZHX3 gene expression in overexpression group is higher than the negative control group.(3) cells in each group were found to be positive with expression of alkaline phosphatase. Kaplow show that the score of overexpression group is higher than the other two groups( P≤0.05 ). And mineralized nodules were visible among all groups, But the number and volume of mineralized nodules in overexpression group was larger than the others.　Conclusion　ZHX3 gene may promote BMSCs in vitro osteogenesis.

Effects of contusion velocity on the cervical primary spinal cord injury in rats

ZHOU Jian, WANG Xiao-Meng, LIU Qi, JIANG Jie, HUANG Zhi-Beng, TUN Xiu-Hua, SHU Jing-An

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  179-183.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 460 )  

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Objective　To verify the contusion velocity as a factor of spinal cord injury and determine cervical primary spinal cord injury in rats at different contusion speed.　Methods　Twenty adult and male Sprague-Dawley rats were divided randomly into the fast group (500 mm/s, n=8), the slow group (5 mm/s, n=8) and the sham control group (n=4). The contusion tip was a cone-shape flat head with a diameter of 4 mm, and driven by a servo-electromagnetic material testing machine to perform a 1.5 mm contusion at the dorsal cord of C5. All rats were perfused intracardially right after injury. The spinal cord sample with 15 mm in length and the epicenter in the middle was sectioned for histological test. Serial parasagittal sections of the spinal cord were cut and then stained with Hematoxylin and Eosin for inspection of the gross morphology and quantification of hemorrhage volume. The axonal injury was detected with β-amyloid precursor protein by immunohistochemistry.　Results　Hemorrhage was observed on all spinal cords after contusion. The hemorrhage looked darker in the fast group. The contusion displacement for the fast and slow contusion groups was (1.50±0.05) mm and (1.51±0.04) mm, and the maximal force (5.3±1.2) N and (2.8±0.6) N, respectively.  There was significant difference in the maximal force between the groups (P=0.001). The hemorrhage was mainly located in the gray matter and few in the white matter. Total hemorrhage, the hemorrhage in the gray and white matter were 0.94 mm3, 0.71 mm3 and 0.23 mm3 for the fast group, and 0.55 mm3, 0.43 mm3  and 0.12 mm3 in the slow group, respectively. There was significant difference in total hemorrhage and hemorrhage in the gray matter between two contusion groups (P＜0.05). Axonal disruption seemed more serious after contusion at higher speed. 　Conclusion　The present study suggested that the contusion velocity is a factor of primary spinal cord injury. Contusion at higher speed results in severer primary spinal cord injury, more hemorrhage and axonal disruption.

BMP-2 induced up-regulation of RBP4 that is a positive regulator of osteoblast differentiation

JU Hua-Jun, HONG Jin-Sheng, ZUO Cuan, MI Hai-Feng

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  184-188.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 449 )  

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Objective 　To explore the function of retinol binding protein 4 (RBP4) on BMP-2 induced BMSCs osteogenic differentiation in mice. 　Methods　RBP4 expression was detected by western-blot and qPCR during osteogenic differentiation of BMSCs induced by rhBMP-2. Osteogenic differentiation of mouse BMSCs was detected after RBP4 down-expressed by RNA interference.　Results　Osteogenic differentiation of BMSCs was significant after being induced by rhBMP-2 cells for 7 d, with RBP4 increasing significantly. Mice BMSCs osteogenic differentiation was significantly inhibited after RBP4 siRNA transfection for 24 h followed with rhBMP-2 inducing for 7 d.　Conclusions　BMP-2 induced up-regulation of RBP4 is a positive regulator of osteoblast differentiation.

The study of the composite conduit containing nerve growth factor and alginate gel-polylactic acid for repair of facial nerve injury in rabbit

DUAN Yong-Chang, TIAN An-Yong, ZHENG Wei, ZHANG Shan-Shan

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  189-191.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 476 )  

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Objective　To observe the effect of the composite conduit containing the nerve growth factor (NGF) and alginate gel-polylactic acid for repair of facial nerve injury in the rabbit.    Methods   Firstly, rabbit facial nerve injury model was established. The facial nerve stump was implanted into the prepared composite conduit containing NGF and alginate gel-polylactic acid for 2 mm, to keep the two facial nerve stumps for 10 mm. Then, the two ends of the catheter with nerve and were fixedand the skin sutured.  The 12 rabbits were randomly divided into 3 groups: 4, 8 or 12 weeks after operation. After the experiment, the anastomotic site of facial nerve was cut and near, middle and distal tissue of the nerve conduit were selected for HE staining.  Results  The experimental rabbits showedprimary surgical wound healing, with no local necrosis, graft discharge or systemic adverse reactions observed. There was macrophage infiltration in catheter wall 4 weeks after operation; meanwhile, there were rich Schwann cells, fibroblasts and new small blood vessels in catheter proximal in this group. For 8 weeks after operation, fibroblasts and macrophages attaching to the catheter wallwas thinner than 4 weeks. Moreover, there was nerve bundle-like structure and separated fiber bundles within the conduit. The outer fibrous capsule was thickened and the small blood vessels reduced. For 12 weeks after operation, the nerve conduit wall was further decomposed associated with collagen fibers hyperplasia. The intraductal nerve fiber was close to normal, which showed thickening axon-like structure and thinning outer fibrous capsule. Conclusion   The composite conduit containing NGF and alginate gel-polylactic acid shows good histo-compatibility and can effectively induce the facial nerve regeneration.

Relationship between olfactory function and the number of mature olfactory neurons in olfactory epithelium of the adult mouse

CENG Xian-Beng, CHEN Ge-Xin, FU Qing-Ling, XU Rui, WEN Wei-Beng, SHI Jian-Bei, HU Geng

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  192-195.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 534 )  

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Objective　To explore the sufficient amount of mature olfactory receptor neurons(ORNs) in olfactory epithelium for maintaining normal olfactory function and to investigate the relationship between a simple olfactory test outcome and the mature olfactory neuronal population.　Methods　The anosmia model was induced in 8- to 10-week-old mice by intranasal irrigation with 0.7% Triton X-100 . The“buried food pellet” test was conducted at 3, 7, 21, 49, 56 days a after the anosmia model was established. The olfactory marker protein(OMP) olfactory epithelia(OE) was detected with immuno?uorescence to analyze the relationship“buried food pellet” test outcome and the mature olfactory neuronal population of OE.    Results  Olfactory marker protein(OMP) was physiologically expressed in mature olfacotry receptor neurons(ORNs) body, dendrites, and submucosa axons bundles. At 3rd,7th day after nose-irrigation with TritonX-100, time spend to find food was prolonged obviously(F =32.04，P <0.01)and was longer than that at 21th,49th,56th and control group when compared within each two groups with Bonferroni methode(P <0.01).The mature ORNs in OE was minimal at 3rd,7th after treatment (F =223.97, P <0.001). The food-?nding time was signi?cantly correlated with the number of mature ORNs in OE(r =－0.757, P <0.001).The anosmia mice begin to recover at 21th day after nasal irrigation, when the OMP(+) recovered to 28.66%.   Conclusions    Our studies confirmed that mice olfactory function is signi?cantly correlated with the number of mature ORNs in OE. The adult mice with anosmia could regain olfactory function when the mature ORNs in OE recovered to 28.66% of the control group.  

Revascularization study of the hollow hydroxyapatite composite rhBMP-2 in repairing the bone defect

LUO Feng-Gang, XIONG Long, CENG Jian-Hua, XIONG Gao, TUN Ceng-Zhi, LING Hua-Jun, JIA Xiong-Chao

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  196-200.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 549 )  

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Objective　To study and observe the revascularization process of the hollow hydroxyapatite composite rhBMP-2 in repairing the bone defect.　Methods　48 adult male New Zealand rabbits with artificially-established radius defect were randomly divided into 3 groups, each group were implanted with the following materials: hollow HA/ rhBMP-2 composite artificial bone(A groups), hollow HA(B groups),rhBMP-2(C groups). After implantation in 4、8、12、16 weeks, the process was  observed using radionuclide bone imaging, X ray, histological observation.　Results　Different time after the operation, X-ray and histological score, bone radionuclide-gathering strength of the rabbits in the hollow HA/ rhBMP-2 composite artificial bone group in the were higher than that of hollow HA artificial bone (P＜0.05). In the control group, synostosis and bone sclerosis were observed in bone defect area bone defect failed to heal. Conclusion　Hollow HA/ rhBMP-2 composite artificial bone has good ability in revascularization and repairing segmental bone defect and is expected to be an ideal material for bone defect repair.  

Nonlinear finite element simulations of perforator vessels twist in perforator pedicled propeller flaps

DAO You-Lun, ZHANG Shi-Min, CHEN Wen-Long, ZHANG Yang-Qi, WANG Xin, LIU Tian-Yi, MA Fei, GU Yu-Dong

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  201-205.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 501 )  

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Objectives　To investigate the effects of some parameters (tension-stretch, number of concomitant vein and interval between perforator artery and vein) on the vascular patency after twisting of the perforator pedicle in perforator pedicled propeller flaps.　Methods　LSDYNA software was used to establish a three-dimensional nonlinear digital model of perforator consisting of an artery and a vein with both ends fixed. In Group 1, the perforator pedicle was twisted in isometric and isotonic conditions; in Group 2, the perforator pedicle was twisted with 1 concomitant vein and 2 concomitant veins; and in Group 3, the pedicle was twisted in the interval of 0 mm, 2 mm, 4 mm and 6 mm between the perforator artery and vein, respectively. In each group, all perforator pedicles were rotated from 0° to 180°. The effective strain was obtained to represent the perforator patency. 　Results　In Group 1, the effective strain of perforator pedicle in isotonic condition was smaller (more patency) than that in isometric; in Group 2, the effective strain of perforator pedicle with 2 concomitant veins was larger than that of 1 concomitant vein, but the total lumen open area of the 2 veins was still greater than 1 vein; in Group 3, the effective strain of perforator pedicle increased (less patency) as the interval increased from 0 mm to 6 mm. 　Conclusions　(1) The patency of the twisted perforator vessels is decreased when tension-stretching is added on the perforator pedicle. (2) The venous patency of preserving 2 concomitant veins is better than that of only 1 vein after the perforator-pedicle torsion. (3) The patency of the perforator is decreased when the interval between perforator artery and vein is increased.

Clinical application study of Nano-Hydroxyapatite artificial bone in bone defect repair

WANG Da-Beng, XIONG Jian-Xi, SHU Wei-Min, HUANG Jiang-Hong, DUAN Chi, CHEN Ji-Lin, ZHANG Ju-Feng

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  206-209.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 552 )  

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Objective　To study the clinical effect of nano-hydroxyapatite(Nano-HA) artificial bone on repairing bone defects.　Methods　From Sep. 2009 to Jun. 2012, 27 cases of bone defect were collected retrospectively. The bone defect ranged from 0.3cm×1.0cm to 3cm×6.5cm, which including the bone defects of humerus, radius, ulna, femur, tibia, and calcaneus. Among them, 22 cases suffered from fractures and 5 cases tumors. All patients were treated with Nano-HA artificial bone. Observation was applied on healing of wounds and X-ray exams preoperatively and postoperatively.　Results　The patients were followed up from 11 month to 26 months （averagely 18.5 months）. X-ray photo showed an integrity interface between Nano-HA and bone. Primary healing was obtained in all cases without any complication.　Conclusions　The Nano-HA artificial bone has a good biocompatibility. It may be an ideal artificial material to reconstruct bone defect.

Anatomy and surgical approaches of medium-to-severe congenital scoliosis caused by hemivertebrae

LI Bei, TU Yu, WANG Qun-Bei, JUE Yi-Ming, JIAN Bang-Beng

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  210-213.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 681 )  

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Objective　To study anatomy of imaging technology on medium-to-severe congenital scoliosis caused chiefly by single hemivertebrae and evaluate the early clinical outcome of surgical approaches based on anatomy.　Methods　A total of 16 cases with medium-to-severe congenital scoliosis underwent X-ray and spiral CT reconstruction preoperatively, which were taken as the basis for surgical approaches, including location and growth potential and type of hemivertebrae, kyphoscoliosis Cobb angle and flexibility of spine. Techniques of posterior osteotomy or posterior osteotomy and anterior bone graft fusion were performed to correct the scoliosis. And clinical outcome of surgical approaches were analyzed.   Results　All surgeries were finished successfully. The surgical duration was 4.0~8.5 hours (mean, 5.8 hours), and the perioperative bleeding was 500~4000 mL (mean, 1350 mL). There was no occurrence of neurological deficit, infection or deep venous thrombosis. The scoliosis Cobb's angle was (67.8±8.4)° preoperatively, and (25.3±6.8)° postoperatively respectively, the correction rate of being (63.1±6.1)%. The kyphoscoliosis Cobb's angle was (73.5±10.7)°preoperatively, and (29.1±5.6)° postoperatively, the correction rate of being (60.1±6.2)% . Bony fusion was achieved in all patients and no pseudoarthrosis and implant failure occurred after the last follow-up. No obvious correction loss was observed either in coronal or sagittal plane.  Conclusions  Anatomy of spine are helpful for guidance of surgical program. Posterior surgical correction is a feasible and an effective procedure in the treatment of medium-to-severe congenital scoliosis. Anterior bone graft fusion will be a necessary procedure  if adjacent wedge-shaped vertebral bodies are severe.

Influence of different fusion methods in intervertebral height of patients with cervical spondylotic myelopathy after cervical anterior corpectomy

GUAN Dun-Jie, ZHANG Feng, DIAO Jian, CHEN Xiao-Qiang

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  214-216.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 658 )  

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　Objective　To study the influence of different fusion methods in intervertebral height of patients with cervical spondylotic myelopathy after cervical anterior corpectomy.　Methods　65 patients with cervical spondylotic myelopathy who accepted cervical anterior corpectomy during May, 2010 to July, 2012 were selected. 20 patients accepting autogenous iliac bone grafting were divided into the control group. 20 patients accepting titanium mesh cages without end caps were divided into the non-caps group while 25 patients accepting titanium mesh cages with modular end caps were divided into the modular caps group. The change of intervertebral height of patients before and after the surgery and the incidence of the complication of all the patients were compared.　Results　The difference of height of the anterior border and posterior border before and after the surgery was not statistically significant (P>0.05). The loss of the height of the anterior and posterior borders of the intervertebral height of the modular caps group in 1 year after the surgery was statistically less than that of the other two groups(P<0.05). The incidence of the modular caps group after the surgery was statistically less than that of the other two groups (8% vs 45%, 40%；χ2=8.236, 6.583 P=0.004, 0.010).　Conclusion　The application of modular end caps in cervical anterior corpectomy could maintain the cervical intervertebral height postoperatively and reduce the postoperative subsidence rate of titanium mesh cage, which is worth further promotion.

Comparative study of expandable interbody cage and pedicle screw fixationin treating  lumbar instability disease

LIU En-Zhi, YIN Qiang-Shui, GUO Dong-Meng

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  217-220.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 434 )  

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Objective　To investigate the surgical outcome of expandable interbody cage and pedicle screw fixation with intervertebral body fusion for  lumbar instable   disease by  comparative  study.    Methods ninety-three patients with degenerative lumbar instability were reviewed retrospectively from Jan．2007 to Jan. 2010. Forty-three patients underwent an expandable interbody cage (group A), while fifty cases underwent a pedicle screw fixation with intervertebral body fusion (group B). operation and follow-up data of the two groups  and  were evaluated and compared.    Results    All patients were followed up for 3 years. Reduced operative time, blood loss , postoperative complications of patients could be found in Group A  can and  JOA score at postoperative 14d and followed up for 1-3 years of patients in the two groups , intervertebral fusion rate, intervertebral height showed no significant difference(P>0.05).   Conclusion    Two surgical methods are both optional in lumbar spine instabable disease. When patients were carefully chosen prior to operation and the posterior lumbar structure was retained  in operation, expandable interbody fusion can achieve good therapeutic effect.

Dynamic stabilization system between Wallis spines treatment the clinical effect of the treatment onlumbar spinal stenosis

ZHENG Xiao-Jing, GU Hong-Lin, ZHENG Chao, ZHENG Qiu-Jian, DAN Shi-Jiang, CENG Shi-Xin, CHANG Yun-Bing

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  221-224.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 492 )  

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Objective　To study the clinical curative effect of dynamic stability system between the Wallis spine (hereinafter referred to as Wallis system) oon lumbar spinal stenosis.　Methods　From October 2010 to May 2012, Wallis system was adopted for treatment of lumbar spinal stenosis in 27 cases. The surgical duration, blood loss, postoperative hospitalization length, postoperative complications was recorded. The JOA score of low back pain, VAS score of lumbocrural pain, oswestry disability index (ODI), and the change of the intervertebral height of the surgery-corrected segment prior to surgery, 1 week, 3 week, 1 year after surgery were analyzed and compared.　Results　The average surgical duration was of 70 min (50~130 min), intraoperative blood loss 100 ml (30~250 m1), postoperative hospitalization length 4 days (3-7 days). No prosthetic complication such as shift, spine fractures was found postoperatively. Preoperative symptoms were reduced in all patients . Improvement was found in JOA score of low back pain, VAS score of lumbocrural pain, oswestry disability index (ODI) at 1 week postoperative, 3-month and 1-year follow-up when compared with those preoperatively. (P < 0.01). The intervertebral height of  the surgery-corrected segment was larger at 1 week postoperatively than that prior to surgery. (P<0.01). No statistical significance was found in the intervertebral height of  the surgery-corrected segment at 3-month and 1 year follow-up(P>0.05). Conclusion　Little trauma, quick recovery, satisfactory clinical effect can be achieved y Wallis system for treatment of lumbar spinal stenosis, providing a new option.

Morphological observation of the inferior orifice of the nasolacrimal duct of the patients with presaccular lacrimal obstruction

WANG Ting-Ting, DAO Hai

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  226-227.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 646 )  

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Objective　To observe the morphology of the inferior orifice of the nasolacrimal duct of the patients with presaccular lacrimal obstruction by using 30o ear endoscope and provide the basis for the CT retrograde intubation dacryosystography.　Methods　54 patients (75 eyes) with presaccular lacrimal obstruction from May 2011 to March 2012 were involved in this study, including 3 cases (5 eyes) of upper and lower lacrimal punctum atresia, 15 cases (24 eyes) of superior and inferior canalicular obstruction, 18 cases (28 eyes) of common canaliculus obstruction, 18 cases (18 eyes) of previous laceration of superior and inferior canalicular. All patients underwent the endoscopy by using 30o ear endoscope and the imaging characteristics of the inferior orifice of nasolacrimal duct was obtained.     Results    54 subjects (75 eyes) participated in the study, 66 eyes were confirmed that the inferior orifice of nasolacrimal duct was opening, the opening rate being88% (Of  the 66 eyes, stimulated Hanser valve of 1 case covered the orifice of nasolacrimal duct and led to linear closure of the orifice) . 9 eyes were confirmed the atresia orifice of nasolacrimal duct，accounting for 12%. According to the shape of the inferior orifice, it was divided into three types: oval large (30 eyes, 45.45%), triangular fissure (12 eyes, 18.18%), strip fissure (24 eyes, 36.36%).In the 21 cases (42 eyes ) of the binocular sick patients, 15 cases  (30 eyes, 71.42% ) of different forms and 6 cases （12 eyes，28.57%）of the same forms of bilateral opening inferior orifice of the nasolacrimal duct.    Conclusion　It is practicable to observe the location and morphology of the opening inferior orifice of the nasolacrimal duct for the patients

Stress fracture of pedicle of the lumbar vertebra: one case report and literature review

SUN Zhen-Zhong, GU San-Jun, YAN Ju-Dong

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  228-230.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 493 )  

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Objective　To investigate the characteristics of diagnosis and treatment for pedicle stress fracture of the lumbar vertebra.　Methods　One case of stress fracture of the pedicle of the fifth lumbar vertebra was retrospectively studied. a 36-years old man, a Judo enthusiast, had low back pain and limitation on lumbar activity but demonstrated no symptom of nerve root irritation in a judo training. Diagnosis of incomplete stress fracture of the right pedicle of the fifth lumbar was missed on plain radiograph but established on CT. The ODI score was 46%, and conservative treatment with the spine brace was advised. Results　The fracture healed, low back pain disappeared, the spine restored the normal function and the ODI score recovered to 4% in 6 months. Follow-up of 24 months revealed no change of ODI score.　Conclusion  Pedicle stress fracture of lumbar occurs in young people with repetitive and large quantity of spinal activity. the main force leading to pedicle stress fracture of lumbar is torsion. For incomplete pedicle stress fracture of lumbar without syndrome of nerve root irritation, conservative treatment with spine brace with acceptable efficacy should take precedence.

The clinical application and progress on posterior tibial artery perforator flap

ZHANG Tian-Hua, WEI Zai-Rong

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  231-233.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 551 )  

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Research progress of umbilical cord mesenchymal stem cells transplantation on repair of spinal cord injury

LU Dun, SA E-Lian, YAN Xin-Min

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  234-236.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 665 )  

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The anatomical study of suture pathway in focal cerebral ischemia model

FANG Ying-Ying, XIAO Zhao-Meng, LIU Chang, WANG Yi-Yuan

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  237-238.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 470 )  

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Absence of left inferior thyroid artery and multibranch of right subclavian artery: one case report

YANG Hao-Chen, MA Jian-Jun, DIAO Xiao-Nan, TU Chuan, LI E, SHU Wu-An, LU E-Meng, CHENG Xue-Mei

Chinese Journal Of Clinical Anatomy. 2014, 32(2):  239.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 504 )  

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