Table of Content

25 July 2014 Volume 32 Issue 4

  

Anatomical basis for design of the perforator-pedicled flap with nutritional vessels of the lateral dorsal cutaneous nerve and the lateral vein of the foot

LIANG Cheng, XIE Yun, ZHENG He-Beng, PENG Ti-Hong, XIE Zhi-Beng, TUN Ze-Dong, LI Lei, ZHANG Fa-Hui

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  377-380.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 414 )  

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Objective　To provide applied anatomical basis for design of perforator-pedicled flap with nutritional vessels of the lateral dorsal cutaneous nerve and the lateral vein of the foot to reconstruct the soft tissue defects of the forefoot.　Methods　30 specimens of adult human feet perfused with red latex have been used. The following contents were observed under surgical magnifier: ①The course and distribution of lateral dorsal cutaneous nerve of the foot, and the lateral vein of foot; ②The anastomoses among the dorsal perforator of lateral plantar artery and the nutritional vessels of the lateral superficial vein and the lateral dorsal cutaneous nerve of the foot. Simulated operation was performed on another fresh specimen． Results  ①The lateral dorsal cutaneous nerve of foot was the direct continuation of the trunk, and coursed along with the lateral vein of the foot, innervating lateral aspect of  the dorsal foot and the lateral skin of the fifth toe;  ②Nutritional vessels of the lateral dorsal cutaneous nerve of the foot and the lateral vein of the foot were of multiple segments and multiple origins. The perforator of the lateral plantar artery was relatively consistent in position, emerging superficially between the fifth metatarsal bone and lateral group of muscles of the fifth phalange. It gave off minute branches to anastomose with longitudinal nutritional vascular plexus of lateral dorsal superficial vein the foot.　Conclusion　The perforator-pedicled flap with nutritional vessels of the lateral dorsal cutaneous nerve and the lateral vein of the foot can be harvested to repair the defect of soft tissue on forefoot.

Applied anatomy of medial plantar island flap pedicled with the medial foot arch artery

WANG Shou-Dao, SHI Ceng-Yuan, YIN Wei-Gang, LIN Rong, MAO Hai-Jiao

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  381-383.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 414 )  

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Objective　To provide anatomical basis for repairing the skin defect about lateral plantar area.　Methods　The anatomic study was carried out on 35 sides of adult cadaveric foot which were perfused with red latex. With the help of surgical microscope (×10) , we observed the vessel which is the anastomosis of arterial arch at the superior border of hallucal abductor and the medial branch of deep branch of medial plantar artery , and then measured its location, diameter, length.　Results　The anastomosis of arterial arch at the superior border of hallucal abductor and deep branch of medial plantar artery at the medial border of the medial cuneiform bone, which we named the medial foot arcuate artery. The frequency of the medial foot arch artery was 82.8%（29 sides）.The external diameter was (0.65±0.21) mm. The length was （2.63±0.71）cm. The medial foot arcuacte artery was absent in six cases. The frequency was 17.2%(6 sides).　Conclusion　The medial plantar island flap pedicled with the medial foot arch artery can be used to repair the skin defect on the lateral plantar area.

Accessory extensor pollicis longus muscle: one case report

LIU Huan-Long, WANG Ceng-Chao, HUANG Wei-Ke, HOU Zhi-Dian, CHEN Gang

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  383.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 481 )  

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The anatomical study for the application of profunda artery perforator flap in breast reconstruction 

LIU Wen-Yue, MU Lan-Hua, ZHANG Han, CHEN Ru, ZHANG Yan, YAN Xi-Ping

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  384-386.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 381 )  

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Objective　To provide anatomic basis for the application of profunda artery perforator flap (PAP) in breast reconstruction.　Methods　Ten fresh human cadaveric thighs underwent a intraarterial injection of a lead oxide or latex preparation and dissected. The pattern of vascular distribution in the posterior thigh region was observed, and data relevant (the number of perforators, diameters of the arteries and veins accompanying, pedicle length) was measured. Results were reported as Mean±SD. Based on the anatomical basis above, Surgical simulation was proceeded.  Results 　The first perforating artery of the profunda femoris artery gave rise to 4 to 9 cutaneous perforators (most myocutaneous ), and most of the dominant perforators which were located in the posteromedial thigh descended from the descending branch of the first perforating artery. The pedicle length was (10.6±2.6) cm, the average external diameter was (2.2±1.0) cm, and the external diameter of concomitant veins were (1.8±0.8)mm and (2.1±1.8)mm.　Conclusions　Regardless of the vascular variety of PAP flap, the first perforating artery of the profunda femoris artery plays an important role on its blood supply. However, more research need to be conducted to guarantee the safety and accuracy of procedure.

Applied anatomic observation of fascia and fascial space surrounding the thyroid gland

LEI Chang-Tong, DING Zi-Hai, LI Guo-Xin

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  387-391.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 472 )  

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Objective　Through cadaveric dissection and intra-operative observation, the anatomical features of fascia and fascial space around the thyroid gland was redefined，which in combination with the metastasis path and the region of central compartment lymph node dissection, aims to provide anatomical basis for the dissection of the central compartment lymph nodes and the accurate surgical planes.　Methods　5 specimen with 10 sides were fixed in 10% formalin and used to study the fascia, fascial space around the thyroid gland. 10 patients with thyroid cancer are used to define the fascia and fascial space during the operation.　Results　Pretracheal fascia, sandwich-like in structures, was divided into two layers, the interspace of which had fat tissues, lymph nodes, lymphatic vessels, inferior thyroid vein, et al. There was a vessel-free space between the posterior layer of pretracheal fascia and the trachea, which was perteacheal space. The paratracheal fat tissue was connected to the pretracheal fat tissue and  also had a sandwich-like construction with two layers of fascia covering at the front and back, containing vessels, lymphatic system; The anterior and posterior fasciae were in continuation with the carotid sheath on the external surface and were in contact with the thyroid gland on the internal surface, which were similar to the mesentery in structure and function. There was a space between paratracheal fat tissue and thyroid, and between paratracheal fat tissue and prevertebral fascia, respectively.     Conclusions    The thyroid gland has mesentery which is located in the pretracheal and paratracheal areas. Mesothyroid excision can achieve the purpose of thoroughly removing the lymphoid tissue in the center. Fascial space between mesothyroid and viscera is the surgical plane of the operation.

The anatomic study of relations between the lumbar pedicle-lengthening osteotomy site and the adjacent nerve roots

LI Feng, XIAO Zhao-Meng, JIAN Lei, FANG E-Feng, OU Yang-Jun

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  392-395.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 350 )  

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Objective　The purpose of this research was to determine the anatomic relations between the lumbar pedicle-lengthening osteotomy site and the adjacent nerve roots and to  provide anatomic parameters for the lumbar pedicle-lengthening osteotomy procedure.　Methods　Sixteen adult embalmed cadavers were used for this study of the lumbar spine. After removal of soft tissue, spinous processes, laminae, facets and transverse processes of T12~S1 vertebrae, the dural sac, nerve roots and lumbar pedicles were exposed. Lumbar pedicles were carefully ground to the junction of the pedicle and vertebral body. The direct measurements, including the distance from the superior border of the pedicle to inferior limit of the adjacent nerve root (PSRD), the distance from the inferior border of the pedicle to the superior limit of the adjacent nerve root (PIRD), the distance between the medial border of the pedicle and the lateral limit of the dural sac or adjacent nerve root (PMRD) and the distance from the lateral border of the pedicle to the medial limit of the adjacent nerve root (PLRD) were made bilaterally.    Results    Average distance from the lumbar pedicle to the adjacent nerve roots superiorly, inferiorly, medially and laterally at all levels ranged from 4.9 to 8.6 mm, 1.0 to 2.5 mm,0 to 1.6 mm, 0.7 to 11.5 mm, respectively. There was no significant difference between left and right for PSRD, PIRD, PMRD and PLRD (P>0.05). There was also no significant difference between the males and females (P>0.05).　Conclusion　Lumbar adjacent nerve roots medially and inferiorly were injured more easily than the superiorly and laterally. The osteotomic procedure to the medial and inferior pedicle bone edge should be performed more carefully under the fluoroscopic guidance.

Anatomical morphology study of cervical laminae as bone graft in anterior cervical discectomy and fusion

XIONG Xu, LIU Jia-Meng, ZHOU Yun-Fei, CHEN Xuan-Yin, SHU Yong, ZHOU Yang, HUANG Shan-Hu, LIU Zhi-Li

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  396-399.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 344 )  

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Objective　To explore the feasibility of using autologous cervical laminae as bone graft in anterior cervical discectomy and fusion during one-staged posterior-anterior cervical surgery.　Methods　60 healthy volunteers underwent CT scans and sagittal reconstruction images of the cervical spine were obtained, including 30 males and 30 females, with the age ranging from 25 to 40 years old. The length of the line which connects the bilateral intersection points of cervical laminae and pedicle, and the distance from the junction of bilateral lamina to the line which was mentioned above were measured. Then, the area of the triangle composed by the bilateral laminae from C3 to C7 was calculated and compared with the area of a commonly used PEEK cage. The heights of the laminae from C3 to C7 were measured and compared with the corresponding intervertebral space heights.　Results　The area of the triangle composed by the bilateral laminae from C3 to C7 was greater than that of the PEEK cage. The heights of the laminae from C3 to C7 were greater than those of the corresponding intervertebral spaces.　Conclusion　According to the anatomical measurement of the cervical spine, adotpion of the autologous cervical laminae as bone graft in anterior cervical discectomy and fusion is feasible.

The anatomic study on the function of crura of diaphragm in the surgical reduction of upper lumbar burst fracture

LIU Duan, DU Xin-Ru, KONG Xiang-Yu

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  400-404.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 430 )  

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Objective　To investigate the anatomical mechanism and function of crura of diaphragm during the reduction process in the fracture of L1~3 spinal vertebrae.　Methods　(1) 24 corpses were dissected to show diaphragm crura in front of L1~3 vertebrae. The origin and end of the two diaphragmatic crurae, the count of the vertebrae level covered by the diaphragm crura, the length, width and thickness in different level of the individual the diaphragm crus, and the length in a crus fused to the anterior longitudinal ligament were measured; (2) Four intact corpses were chosen to imitate the process of vertebral fracture and reduction. All specimens were managed to be operated from the posterior, using intermediate screws through the fractured vertebrae in short segment pedicular fixation. In the course of operation, the changes of vertebrae each step with X-ray were record.　Results　The overall length of right crus is (12.1±1.8) cm, with (7.0±1.1)cm fused with the anterior ligament, and the muscular length of the right crus is (6.4±1.4) cm, the tendon length is (5.6±1.1) cm; the overall length of left crus is (9.6±1.5) cm, with (5.3±1.1) cm fused with the anterior ligament, and the muscular length of right crus is (4.9±1.0) cm, the tendon length is (4.8±1.3) cm. The width and thickness of crura changes in different level. when the length and width, thickness of diaphragm crurae in the left and right sides were compared, there was significant difference, with the right crus being stronger than the left one. And there were significant differences between every step and the previous one.　Conclusions　(1) Strong diaphragm crura attached to the thoracolumbar vertebrae anteriorly, together with the longitudinal ligament forms “soft-tissue-splint”, which is helpful to reduce the bony fragments. (2) Every operational step makes some kind of reduction. the prone position is of the most significant importance in achieving the greatest reduction.

Anatomical study and clinical significance of the lumbar vertebral basivertebral vein foramen

MA Chun-Meng, JU Xiao-Hua, WANG Xiao-Wen, DU Xiao-Dong, LI Jin, LI Guo-Chao, TUN Lei

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  405-408.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 922 )  

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Objective　The morphology and relationship of the basivertebral vein foramen (BVF) of the lumbar vertebral body were studied to provide the reference to spine surgery.　Methods　About the number, area of BVF and its the shortest distances to the superior and inferior borders of the vertebral body and to the pedicles were studied in 115 adult lumbar vertebrae were studied. The configurations of the BVF in 13 adult cadavers were studied.　Results　In most cases, BVF was oval and round and distribution was concentrated; the number was very different in different persons (P<0.05); the distances to the superior border of the vertebral body and to the vertebral pedicles were different in different persons (P<0.05). In different lumbar vertebrae of the same person, the distances to the superior and inferior borders of the vertebral body and to the pedicles were very different (P<0.05). Vessels and soft tissues were observed in BVF through autopsy.　Conclusion　The BVF forms the bone defect which takes less pressure and easily causes bone fracture. There is some area without vessels between BVF and the nearby structures to provide for operation.

Microsurgical anatomic study of posterior tympanum operation approach by endoscope-assisted

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

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  409-411.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 463 )  

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Objective　To study structures of the posterior tympanum and to provide theoretical reference for surgical approach related to the middle ear.    Methods    30 sides of 15 cadaveric heads had their mastoids outlined and the relationship between the posterior tympanum and the other structures were observed and measured.    Results    The average distances from the midpoint of pyramid segment of facial canal to the most salient point of lateral semicircular canal, the midpoint of the anterior margin of the sinus tympani, the midpoint of vestibular window, the midpoint of cochlear window, the lower end of the ponticulus, and the lower end of the pseudosubiculum were（3.21±0.41）mm,（2.79±0.25）mm,（3.97±0.37）mm,（6.48±0.53）mm, (4.85±0.39)mm, (6.21±0.57)mm,  respectively. The average distances from the midpoint of incual fossa to the top of the pyramidal eminence, the midpoint of pyramid segment of the facial canal, the midpoint of the head of stapes, the midpoint of cochlear window, the midpoint of the vestibular window, and the cochleariform process were（4.43±0.36）mm、（3.10±0.28）mm、(6.55±0.55)mm, (9.56±0.82)mm, (6.67±0.65)mm, (4.63±0.39)mm, respectively. The average depth of sinus tympani, the average short diameter of cross section, and the average long diameter of cross section were （3.10±0.27）mm,（1.05±0.10 ）mm,（1.89±0.19）mm, respectively. The average depth of posterior tympanic sinus, the average long diameter of cross section, and the short diameter of cross section were (1.15±0.10) mm, (0.83±0.29) mm, (0.63±0.51) mm, respectively. The average depth of lateral sinus tympani, the superior inferior diameter, and the anteroposterior diameter were (1.63±0.12)mm,（0.36±0.03）mm and (0.74±0.09）mm. The average diameter of lateral facial recess gas cell was (0.28±0.13) mm.    Conclusion   Posterior tympanum with fine structure which is easy to be potential regional residual lesion is narrow. It is very important to clearly understand the anatomical structure, so as to completely clear lesions and prevent the occurrence of postoperative complications.

Applied anatomy of the lymphatic vessels alongside the small saphenous vein

CHEN Yuan, BO Wei-Ren, WANG De-An, CENG Fan-Jiang

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  412-415.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 487 )  

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Objective　To determine the lymphatic anatomy around the small saphenous vein (SSV).  Methods　Six legs harvested from three unembalmed human cadavers were studied. Under a surgical microscope, a mixture of 6% hydrogen peroxide was used to detect the lymphatic vessels commencing in the skin between the lateral malleolus and the Achilles tendon. A 30-gauge needle was inserted into the lymphatic vessel and injected with a radio-opaque barium sulphate or lead oxide mixture. The vessels around SSV were traced, photographed and radiographed.　Results　Two collecting lymphatic vessels were found along SSV, one on each side. They originated beneath the dermis between the lateral malleolus and the Achilles tendon and some of them from the posteroinferior part of the leg. The vessels travelled tortuously in the subcutaneous tissue on each side of SSV and pierced the deep fascia in the posterosuperior part of the leg to enter the popliteal fossa. They then divided into small branches before entering the popliteal lymph nodes. The diameters of the vessels varied from 0.3 to 1.5 mm, larger in the proximal side and smaller in the distal end.  Conclusion　Actual and accurate lymphatic anatomy of the human extrimities has been described. This information can improve our anatomical knowledge and the results will be of bene?t for clinical management and further studies in the region.

Comparison of CT alpha angle Measurement Planes in a Young Population without Symptoms

FANG Ting-Song, KE Qi, YUAN Jian-Xiang, BANG Chao, LIANG Zhen-Hua

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  416-419.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 370 )  

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Objective　 To compare the alpha angle value measured on different planes and to determine the prevalence of cam-type femoroacetabular impingement(FAI) morphology in a young population without symptoms using computed tomography.　Methods　A retrospective review was performed on the data of 120 patients (age range, 20–40 years) with no current or previous hip disorder who underwent CT of the abdomen and pelvis from May 2009 to November 2013. Alpha angle were measured on both oblique axial plane images parallel to the long axis of the femoral neck and radial images in four planes obtained using the center of the femoral neck as the axis of rotation.Analysis of variance was used to evaluate differences between alpha angle values on the oblique axial plane and radial plane.Alpha angle greater than 55° was considered positive for cam-type FAI morphology.　Results　The mean alpha angle value on the oblique axial plane was (39.5±6.51)º，Alpha angles greater than 55° were found in 14 joints of 12 cases（10%，12/120） on the oblique axial plane image，10 cases were unilateral and 2 cases were bilateral. The mean alpha angle values at the 12,1,2,3 o’clock position were (42.8±7.3)º,(48.8±7.6 )º,(47.3±7.2)º,(40.2±6.7)º, respectively. 106 Alpha angles greater than 55° in total were found on the radial plane images. 54 abnormal alpha angles were measured at the 1:00 position, including 35% （42 /120）of the subjects.30 cases were unilateral and 12 cases were bilateral.The differences of the alpha angles between the oblique axial and the radial 12 o'clock, 1 o'clock, 2o'clock plane reached statistical significance（P<0.05）.　Conclusion　Alpha angle measurements on the radial plane images may be more accurate. The frequency of cam-type FAI morphology was high in a young population without symptoms.

Clinical study of myelography CT combined with limited liability segmental decompression treatment for multi-segmental degeneration of lumbar spinal stenosis in the senile

JU Zhong-Bing, TUN Feng, HUANG Yong-Feng, LIN Wei-Feng, OU Rong-Tong

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  420-422.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 370 )  

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Objective　To investigate the clinical efficacy and valuation of myelography CT (CTM) in the surgical treatment of the senile multiple segmental lumbar spinal stenosis.　Methods　From March, 2009 to  July, 2011, there were 68 cases of multi-segmental degenerative lumbar spinal stenosis insenile patients who underwent posterior disc limited endoscopic decompression laminectomy or semi decompressive laminectomy surgery. All patients underwent CTM to confirm affected segments. VAS, JOA and ODI score were used to evaluate the efficacy of postoperative follow-up. 　Results　Unilateral single segments and bilateral single segments in CTM were significantly more than the number of segments liability section in MRI examination (P<0.01). The detection of bilateral double segments, three-segment and above unilateral, bilateral sections of three segments were significantly less than liability section MRI examination (P<0.01). Until March 2013, 63 patients were effectively followed up. Back and lower extremity VAS and ODI in 1 month after the surgery were significantly decreased (P<0.01), JOA was significantly increased (P<0.01). But no significant difference was detected in comparison between last follow-up and 1 month after the surgery. Efficacy was assessed by calculating the rate of JOA improvement in last follow-up, and the total efficiency was 96.83%.　Conclusion　CTM combined with limited liability segmental decompression is an effective way to treat elderly multi-segmental lumbar spinal stenosis, and its efficiency is significant. It can achieve an effective precise decompressionso that the surgeric trauma and impact to spinal stability can be minimized

Magnetic resonance angiographic study of the relationship between the development of A1 segment of anterior cerebral artery and communicating artery

SHU Xiao-Hua, CA Chang-Beng, HUANG Xiao-Hua, XIE Xin-Guo, SHU Jian-Jun

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  423-426.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 1110 )  

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　Objective　To investigate the relationship between the development of A1 segment of the anterior cerebral artery and the communicating artery.　Methods　A total of 107 subjects underwent 3.0 T magnetic resonance angiography (MRA) were involved in this study. The development of the anterior cerebral artery and the state of communicating artery were observed. The diameter of A1 segment of the anterior cerebral artery and the communicating artery, Correlation between them were analyzed.　Results　① Hypoplastic left and right anterior A1 segments of the cerebral artery were respectively 16.82%（18/107）and 22.43%（24/107）. Absence of the left and right anterior cerebral arteries were 1.87%（2/107）and 0.93%（1/107）. ② 51 patients with the anterior communicating artery was developed. ③ 39 patients with single or bilateral posterior communicating arteries were developed,  among them 21 cases developed bilaterally, 7 cases developed on the left and 11 cases on the right. ④ The development of the communicating artery was correlated with the development of A1 segment of anterior cerebral artery（r=0.654，P＜0.01).　Conclusions The hypoplasia of A1 segment of the anterior cerebral artery leads to compensatory development of the communicating artery.

MicroRNA-128 regulates differentiation of bone marrow strowal cells induced by Salvia miltiorrhiza

HUANG Chao, ZHANG Zhi-Jiang, TU Lei, XIE Cai-Jun, CHU Dong-An, BANG Zi-Zhuang, CHEN Cha-Han

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  427-431.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 354 )  

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Objective　To study the regulation of microRNA-128 on differentiation of rat BMSCs into neuron-like cells induced by Salvia miltiorrhiza.  Methods　Rat BMSCs were isolated, purified and identification in vitro. When the cells reached 80% confluence, microRNA-128 inhibitors were transfected by Lipofectamin 2000. Transfected and untransfected cells were pre-induced for 24h. Then the pre-induced cells induced for 5h by Salvia miltiorrhiza. According to the above experiment, cells were divided into four groups: a control group, an induced group, a transfected group, and an induced-transfected group. To identify the phenotypes, flow cytometry analysis was performed. The expression of microRNA-128 and mRNA for NSE, Nestin and β3-tubulin was detected by qPCR. NSE, Nestin and β3-tubulin protein expression were determined by western blot.　Results　Most cells showed the characteristic phenotypes of BMSCs positive for CD29 and CD90 (99.17%) and negative for CD11b and CD45 (99.21%). The microRNA-128 expression of the induced group and the transfected group were found to be significantly higher than the control group. The mRNA and protein expression of NSE, Nestin and β3-tubulin were found to be significantly higher in the induced group and in the transfected group (P<0.05).　Conclusions　Salvia miltiorrhiza can inhibit microRNA-128 expression of BMSCs to increase neural marker protein expression to promote differentiation of BMSCs into neuron-like cells.

Study on biological characterization of Wharton's jelly mesenchymal stem cells from human umbilical cord

LI Shi-Xin, HUA Yang-Kun, WANG Lin-Ping, YANG Hui, LU Dun, LV Chao-Chao, DONG Xu-Dong, SA E-Lian

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  432-436.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 190 )  

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 Objective To establish the culture methods of Wharton’s jelly mesenchymal stem cells from human umbilical cord（hWJ-MSCs）and observe the biological characteristics. Methods The umbilical cord organization of healthy full-term caesarean section was collected under sterile condition. The WJ was diced into cubes of approximately 0.5 mm3, and then plant them in culture flasks which kept still in 3 h before adding L-DMEM with 100 ml/L fetal bovine serum. The WJ-MSCs were passaged using 1.25 g/L Trypsin when they reached 90% confluence. Vimentin was tested by immunocytochemistry. The cell phenotype of WJ-MSCs was detected by flow cytometry. The hWJ-MSCs can differentiate into adipocytes like cell identified by oil-red stain. WJ-MSCs were cultured in medium containing 0.05 g//L Astragalus, then tested the expression of GFAP, NF, Nestin and NSE by immunocytochemical staining. Results Some cells swam out from the tissue block for 6 days or so, which belong to fibroblast-like cell appearing long spindle shaped fibroblast-like cells. WJ-MSCs after subculture presented in a uniform spindle morphology shape, showing parallel growth or vortex growth. The marks of MSCs such as CD90 were positive. The expression of CD34 was negative. Immunocytochemical staining showed WJ-MSCs expressed Vimentin with strong positive. After adipocyte like cells committed induction, these cells with lipid vacuoles accumulated in the cytoplasm gradually could be stained by oil-red O. After committed induction in 24 h by Astragalus, the differentiated cells were stained by Nestin and NF, but GFAP and NSE were negative. Conclusions WJ-MSCs can be effectively obtained from Wharton's jelly with the planting culture, which possess multi-differentiated capability.

Effect of Curcumin on demyelination after compressed spinal cord injury

JIANG Jin, SUN Shan-Quan

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  437-441.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 185 )  

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Objective　To investigate the effect of Curcumin on Axonal demyelination after compressed spinal cord injury (CSCI).　Methods　The CSCI model was established with a self-made device. SD rats were randomly classified into three groups: a sham group（n=10）, a model group（n=10）and a treated group（n=10）. The treated group received intraperitoneal administration of curcumin 100 mg/kg 2 h after CSCI. The model and sham group received intraperitoneal administration of 0.1% PBS. BBB (Basso, Beattie and Bresnaham) scale was used to evaluate the functional outcome. The changes of myelinated nerve fibers in white matter were observed by Luxol fast blue (LFB), osmic acid staining and transmission electron microscope (TEM).  Results　The BBB scores for the affected hindlimb after CSCI were significantly improved in the curcumin-treated group compared with the model group (P<0.05). LFB staining showed the edema and spongy degeneration to different degrees in the white matter of the model and treated group (P<0.05). Osmic acid staining demonstrated that the nerve fiber degeneration in the model group was much more severe than that in the treated group. TEM showed that administration of curcumin 2h after CSCI significantly diminished splitting myelin sheath.　Conclusion　Curcumin can protect the axonfrom demyelination after compressed spinal cord injury.

Median artery originated from ulnar artery and anastomosed to the superficial palmar arch: a case report

CHEN Lou, ZHANG Ying, HU Fa-Liang, NIE Zheng

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  441.  doi:0.13418/j.issn.1001-165x.2014.

Abstract ( 107 )  

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The neural protection of total panax notoginseng saponins in rats with intracerebral hemorrhage

SHU Ji-Gong, WANG De-Ke, DONG Ke-Qi, DAI Xin-Wen, HE Ling-Feng

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  442-445.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 82 )  

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Objective　To study the protection of total Panax Notoginseng Saponins on neurons in the areas surrounding the lesion of intracerebral hemorrhage（ICH）in rats.　Methods　ICH model was established by injecting collagenase Ⅶ into the brain of rats. The ultrastructure of neurons that surround intracerebral hemorrhage in rats was observed by transmission electron microscope. Immunohistochemical staining technique was used to demonstrate expressions of Caspase-3 protein and TUNEL protein. Berderson score was adopted to evaluate behavioral change.　Results　The result of immunohistochemistry showed that the expression of Caspase-3 protein and TUNEL protein in the treatment group was significantly reduced (P<0.01). The ultrastructure of neuron in the normal group was common, which, however, was seriously destroyed in model group. The ultrastructure of neuron in treatment group improved obviously compared with that of the model group.　Conclusion　Total Panax Notoginseng Saponins could protect neurons located near the hemorrhagic area of the brain.

The effect of liver ChREBP on aerobic exercise preventing HFD-induced NAFLD in C57BL/6 mice

TUN Hao, LIU Chang, GUAN You-Fei, WANG Chun-Gui, LI Sha

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  446-450.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 139 )  

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Objective　To investigate the effect of ChREBP and its downstream target genes on 12-week aerobic exercise prevention C57BL/6 mice with nonalcoholic fatty liver.　Methods　Forty-two male C57BL/6 mice were randomized into four groups (n=8~13): the normal diet sedentary group (ND) (n=8), the normal diet exercised group (ND-Ex), the high-fat diet sedentary group (HFD) and the high-fat diet exercised group (HFD-Ex). After the simultaneous starting of high-fat diet feeding, the mice were submitted to an aerobic swimming training protocol (60 minutes/day) five days per week, for 12 weeks. At the end of the experiment, mice liver, blood triglycerides and total cholesterol, fasting blood glucose, oral glucose tolerance were determined. The expression of ChREBP and its downstream target genes were measured by RT-PCR. The level of Akt phosphorylation in liver was measured by Western blot.　Result　Compared with group ND, group HFD had significantly higher body weight, impaired oral glucose tolerance, dyslipidemia, liver steatosis and NAFLD. The expression of ChREBP and its downstream target genes in group HFD were significantly increased, and the level of Akt phosphorylation in liver was decreased. Compared with group HFD, aerobic exercise reduced overweight and all the other worst findings, especially NAFLD in group HFD-Ex. The expression of ChREBP and its downstream target genes in group HFD-Ex were decreased, and the level of Akt phosphorylation in liver was increased.　Conclusion　Aerobic exercise has a preventive effect on high-fat diet-induced NAFLD, and this may be related to aerobic exercise inhibition of ChREBP and its downstream target genes expression.

Experimental research of the relationship between tension adjusting and functional recovery in muscle transfer of rabbit

XIONG Hong-Chao, PENG Yong-Jing, GAO Qiang-Feng, TAN Zhou-Yong, JIANG Gao-Li, WEI Rui-Hong

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  451-454.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 230 )  

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Objective　To explore the relationship between muscle tension and recovery of function during muscle transfer，and attempt to demonstrate that the sarcomere length is also a reliable indicator of muscle tension, which can be used to optimize muscle function.　Methods　10 male SD rabbits were used. The flexor digitorum longus muscle was cut distally and transferred and woven into the tibialis anterior tendon. Resting and transferred muscle length, sarcomere lengths were measured during the operation. Both flexor digitorum longus muscles of 10 rabbits were harvested and muscle contractive capacity and muscle wet weight maintenance rate, architectural analysis were detected in comparison the group under normal condition without changing length and tension 3 months after operation. The micro pattern was observed by comparison.  Result　With the increase of the intraoperative sarcomere length and muscle length relative ratio, the value of muscle contractive capacity and muscle wet weight maintenance rate after 3 months increases in the early stages and then decreased; Sarcomere length increasesas along with muscle length relative ratio; the relationship between them demonstrated a linear correlation as shown by linear regression analysis.  Conclusion　Following a long-term recovery period, a muscle set with increased tension contracts with better recovery of muscle function and negligible adverse effects to muscle fibers; Muscles produce maximum tensions at just over resting length, at about 104%~105% of resting length. The sarcomere length can be used as a characterization of muscle tension and proved to be an excellent predictor of active muscle force generated.

Protection and mechanism of dexmedetomidine preconditioning against neuronal injury related to oxygen-glucose deprivation

LI Gong-Yang, ZHANG Jian-Xing, WANG Xing, XU Wei, ZHOU Guo-Bin

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  455-457.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 167 )  

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Objective　To study the protection and mechanism of dexmedetomidine preconditioning against neuronal injury related to oxygen–glucose deprivation(OGD).　Methods　Cortical neurons from the embryonic day 16~18 rats were cultured. With mimicking a cerebral ischemia in vitro, OGD was performed in the pretreated cells. Neuron injury was assessed by MTT. Protein expression of p-p38 was examined by Western blot.　Results　Dexmedetomidine preconditioning protected the dose-dependent cortical neurons from OGD injury.　Conclusions　Dexmedetomidine preconditioning protects the cortical neuron from OGD injury; inhibition of p38MAPK pathway maybe one of the mechanisms responsible for this effect.

The design and preliminary tests of posterior dynamic stabilization of lumbar vertebrae by percutaneous placement

CHEN Yuan-Meng, JIN An-Min, FAN Fan, HUANG Bao-Hua, LIU Yong-Gong

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  458-461.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 71 )  

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Objective　To design a posterior dynamic stabilization of lumbar vertebrae by percutaneous placement and evaluate its biomechanical propertiesby experiments.　Methods　Medical titanium alloy was usedto design a set of pedicle screw rod fixation system. The combining site of body with U screw tail was similar to joint structure. There were 2° range of motion (typeⅠ) and 10° (typeⅡ) range of screw, and hollow screw, and cylindrical connecting rods. Seven adult fresh pig lumbar spine specimens were used for mechanical testing: six lumbar vertebrae were tested three dimensional motion, and all 7 specimens underwent compression test. When tested three dimensional motion, five patterns of state of every specimen were tested in sequence, respectively. The five patterns of state was as followings: complete state (group A), instability state (group B), stiff fixation state (group C), dynamic fixation stateⅠtype (group D), dynamic fixation stateⅡtype (group E). Motions of flexion/extension, lateral bending and axial rotation were produced by six pure moments with maximum of 10.0 N·m and measured with stereo photogrammetry.　Results 　(1)The results of the three dimensional motion test: ①After fixation with typeⅠor typeⅡ, motions of flexion was (1.577±0.177)° and (1.988±0.096)°, respectively. Extension was (1.900±0.119)° and (2.135±0.143)°, respectively. Left lateral bending was (2.549±0.280)° and (2.712±0.215)°, respectively. Right lateral bending, respectively was (2.454±0.201)° and (2.590±0.203)°. Left axial rotation was (1.458±0.294)° and (1.694±0.250)°, respectively. Right axial rotation was (1.666±0.221)° and (1.842±0.163)°, respectively, which was significantly decreased when compared with that the complete state and the state of instability（P<0.05）and were significantly enhanced when compared with that of the stiff fixation state（P<0.05）.②Two kinds of dynamic state of fixed type (ⅠandⅡ) between each other, Ⅱ more thanⅠproneness activity (P<0.05)，but there was no obvious difference of extension, lateral bending and axial rotation (P>0.05). (2)Stiffness measurement results: the maximum load of the two dynamic typeⅠfixed specimens was 3571 N and 2839 N, respectively; The maximum load of the two specimens with dynamic typeⅡ fixed was1961 N and 2365 N, respectively. dynamic fixedⅠandⅡ, and strong fixation stiffness were greater than complete state, and typeⅡless rigid than typeⅠstate.　Conclusion　The posterior dynamic stabilization of lumbar typeⅠand typeⅡ can ensure stability of the spine, and keep a range of motion，10° of screw motion closer to the spinal physiological activities. The range of motion of screw has effects on the strength of the internal fixator.

The clinical application of total mesorectal excision with pelvic autonomic nerve preservation under the laparoscope for the male patients

ZHONG Dao-Meng, TAO Hua-Qing

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  462-466.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 264 )  

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Objective　To discuss the clinical application value and operative skills of conducting total mesorectal excision (TME) with pelvic autonomic nerve preservation（PANP） under the laparoscope for male patients, and provide reference for the radical resection of rectal carcinoma.　Method　According to retrospective study, 92 cases of male rectal carcinoma patients in our hospital were divided into 2 groups according to operation methods. 47 cases as the patients of the observation group are treated with TME with PANP under the laparoscope. 45 cases of the control group are treated with TME with PANP under the laparotomy. the operation-related index, sexual function, urination dysfunction and postoperative local recurrence of the patients in the two groups were compared.　Results　① intraoperative volume of blood loss, recovery time of postoperative intestines functions, time of postoperative recovery of eating and drinking, along with time of postoperative activity of the patients of the observation group are evidently lower than patients in the control group (P<0.05). While the whole operation time of the former group was longer than the latter group (P<0.05). There were not significant differences of incidence of postoperative complications between the two groups (P>0.05). ② the patients were followed up after their operations for one year. The occurrence rates of erectile dysfunction, and dysfunction of ejaculation and urination of the observation group patients were significantly lower than patients in  the control group（P<0.05）.There were not significant differences of local recurrence rate of the patients of the two groups one year after the operation（P>0.05）.　Conclusion　Performance of TME with PANP under the laparoscope is beneficial for the radical resection of rectal carcinoma. This method effectively reduces the influence on the urination and sexual function of the patients on the basis of radical treatment. So it is worthy of further promotion.

Ilio-inguinal and Kocher-Langenbeck (K-L) approach for internal fixation and reduction of complex acetabular fractures

FENG Hua-Jie, TUN Chao-Feng, GUAN Mo-Ning, LI Zhen-Ke, KUANG Guang-Zhi

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  467-470.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 219 )  

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Objective    To evaluate the clinic effect of ilio-inguinal and Kocher-Langenbeek (K-L) approach for internal fixation and reduction in the treatment of complex acetabular fractures.    Methods    A retrospective study was done on 65 patients with complex acetabular fractures who received treatment ofinternal reduction and fixation from January 2006 to August 2012 through ilio-inguinal and K-L approach. surgical length, intra-operative blood loss, degree of postoperative reduction，results of Merle d’Aubigne-Pestel scores were recorded.    Results     All patients were followed up for 15~42 months. The surgical length was (186±21) minutes, the intra-operative blood loss was (820±21) ml．According to Mata-analysis standard，the rate of good and excellent postoperative fracture reduction was 93.8%．The modified Merle d’Aubigne-Pestel score system showed rate of excellence and good joint function was 90.8%．Conclusions    The clinical efficacy of combined ilio-inguinal and K-L approach for internal fixation and reduction in the treatment of complex acetabular fractures is good．

Clinical analysis on minimally invasive operations for  thoracolumbar fracture of 58 cases through Quadrant passage

XU Luo, XIAO Wu, XIAO Jian-Chun, CHEN Zi-Hua

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  471-475.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 214 )  

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Objective　To explore the indications and methods of minimally invasive operation for thoracolumbar fracture through Quadrant passage．Methods　From April 2010 to October 2012，58 selected patients with thoracolumbar fracture received internal fixation with pedicle screw-rod system through Quadrant passage in our department．They were treated with minimally invasive operation through posterior midline surgical approach between multifidus muscle and longissimus. Decompressions were performed on the some cases. The curative effect was assessed by clinical and radiographical indexes.　Results　All patients underwent successful operations and the following-up ranged from 18 to 36 months. Compared with  the conventional surgical approaches，the minimally invasive surgical approach have the advantages of minimal invasion，less blood loss，shorter operation time and less back pain，and they also have similar or even better outcome on reduction, decompression，internal fixation，fusion and motor function recovery of the thoracolumbar fracture.　Conclusion　Minimally invasive operations via Quadrant passage have good effect on thoracolumbar fracture and the indications of minimally invasive operation can be properly broadened by using Quadrant passage.

A case report of left plantaris tendon

LI Shen-Xiao, ZHANG Gui-Beng, SUN Feng-Fei, FU Feng, YANG Xin, LIU Guan-Nan, FU Sheng-Qi

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  476-479.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 265 )  

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Comparative analysis of vertebrae strengthened by two ways of bone cement injection with the addition of pedicle screws fixation in the treatment of osteoporosis

CHEN Chao, GOU Xing-Qi, GUAN Hong-Gang, WANG Gang, BI Zhi-Wei

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  476-479.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 4 )  

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Objective　To compare the clinical effects of two types of approach in the treatment of osteoporosis.　Methods　38 cases of patients with osteoporosis underwent thoracolumbar pedicle screw fixation surgery. The vertebrae of the 21 patients in group I were strengthened by the direct approach of polymethyl methacrylate (PMMA) bone cement with the addition of pedicle screws. The vertebrae of 17 patients in group II were strengthened by the posterior approach of polymethyl methacrylate (PMMA) bone cement with the addition of pedicle screws. the rate of symptom improvement, the rate of bone graft fusion and fusion time, the postoperative plain radiograph, the condition of the pedicle screws, the bright line surrounding the screws, and  the complications were compared between the two groups.　Results　38 patients were followed up for 9~36 months(averaging 16 months). The rate of bone graft fusion significantly increased and symptoms significantly eased in patients of both groups. No pedicle screw has been found to loosen or prolase in both groups. The bright line was found around the pedicle screws from 3 patients in group I . Bone cement leakage in 3 patients occurred in the second group.　Conclusion　The vertebral strengthened by PMMA and pedicle screws fixation in patients with osteoporosis has the advantages of enhancing the holding of the pedicle screws, which could effectively prevent the pedicle screws from loosening and prolapsing.

Comparative study and nursing care of dysphagia of anterior cervical discectomy

XU Cong, XIE Xiao-Hua, CHEN Xue-Ping, YANG Shi-Wei, GU Hong-Sheng

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  480-483.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 367 )  

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Objective　To comparatively study the clinical efficacy and dysphasia of anterior cervical discectomy with plate fixation and Zero-profile implantation in a prospective study method.　Methods　134 cases had been divided randomly into two groups from December, 2009 to February, 2013 according to the inclusion criteria. 71 cases in ACDF group underwent anterior discectomy and interbody fusion with plate internal fixation; 63 cases in group Zero-Profile underwent anterior discectomy and Zero-Profile implantation. All patients had different degrees of neck and shoulder pain, limb pain and numbness and weakness, of which 68 cases complained of feeling of trunk banding and double lower limbs on cotton, and 12 cases complained of mild defecation dysfunction. Single segment operation time, intraoperative bleeding volume, images of pre-operation and post-operation in both groups were compared; VAS, JOA, D value and SWAL-QOL score were assessed.　Results　All cases were followed up. Follow-up time was 8-24 months with an average (13±2.5) months. The average operation time of each segment in the ACDF and Zero-p groups was (65±11.3) min and (47±7.6) min, respectively; the average bleeding volume of each segment was (68.5±21.1) ml and (42.7±14.4) ml, respectively; the average hospital stay was 5.4 days and 4.2 days, respectively. Display: Zero-p group were lower than that in the ACDF group and there was significant difference. no implant subsidence or collapse, screw loosening was found in the two groups;, all patients showed evidence of bony fusion.　Conclusions　The model of zero notch implant system has the advantages of being simple in operation, short in operation time, mild in bleeding and early in clinical curative effect; this fixation system theorectically can effectively reduce complications caused by the steel structure, especially the common postoperative dysphasia; Hence, it is an effective alternative implant fixation for the anterior cervical plate.

Clinical study of the surgical treatment on obstructive sleep apnea hypopnea syndrome

XU Qiao-Lian, TIAN An-Yong

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  484-486.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 133 )  

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Objective　To explore surgical treatment methods we analyse OSAHS cases of inpatien department.　Methods　40 cases underwent 3 different surgical treament methods.  According to surgerical methods， 40 cases were divided into 3 groups: low temperature coblation-assisted uvunlopalatopharyng oplasty (first group, 24 cases), low temperature coblation-assisted uvunlopalatopharyngoplasty and nasal endoscopic surgery at one time (second group, 8 cases), low temperature coblation-assisted uvunlopalatopharyngoplasty and nasal endoscopic surgery at two times (third group, 8 cases). Patient charts were reviewed and preoperative and postoperative apnea-hypopnea index 3 months after the surgery (AHI), minimum oxygen saturation were evaluated.　Result　In the first group， the effect was successful in 3cases, excellent in 15 cases, good in 6 cases. In the second group， the effect was successful in 6 cases, excellent in 2 cases. In the third group before second operation， the effect was excellent in 2 cases, good in 4 cases and useless in 2 cases. After the second operation， the effect increased to bieng successful in 6 cases, excellent in 2 cases.　Conclusions　A significantly high operation success rate can be expected after surgical correction with low temperature coblation-assisted uvunlopalatopharyngoplasty for soft palate obstruction after whereas a low operation success rate can be found in the third group before their second operation. Both low temperature coblation-assisted uvunlopalatopharyngoplasty and nasal endoscopic surgery are needed when nasal and palate obstructions are present.

Minimally invasive versus conventional method repair of acute Achilles tendon rupture

CHEN Chuan-Huang, YANG Chao, LI Wen-Qiang, SHU Xiao-Di, WANG Zhi, LI Chu-Tan, TAO Hai-Bei, MAO Ren-Qun, ZHANG Guo-Lei, WANG Li

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  487-490.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 651 )  

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Objective　To evaluate minimally invasive versus conventional methods for repair of acute Achilles tendon rupture.    Methods    40 cases of patients with acute achilles tendon rupture, broken end in the calcaneal tuberosity of proximal 2~8 cm, were divided into two groups, of which 20 patients in the experimental group were treated with minimally invasive surgery with small incision 3 cm in length using the oval forceps and epidural needle while 20 patients in the control group adopted conventional surgical treatment of tendon with a medial incision 8 cm in length. Polymer splint immobilization was used to keep the foot in a position of plantar flexion 4 weeks after surgery, and in the neutral position for 2 weeks. ALL cases need hydrotherapy and stretching and isometric contraction training after removal of external fixation 6 weeks later.   Results     After operation, 17 cases in the experimental group and 16 cases in the control group were followed up for 16~24 months, averaging 21 months. The therapeutic efficacy of the two treatment modalities was evaluated according to the Arner-indholm score standard six months after surgery.  The excellent and good rate and skin necrosis rate of observation group were significantly higher than that in the control group (P<0.05).    Conclusion    For acute Achilles tendon rupture, the small–incision approach carried out with oval forceps and epidural needle is simple in operation, reliable in anastomosis, milder in trauma, lower in skin necrosis rate, better in functional recovery than the control group. Minimally invasive surgery performed with the oval forceps and epidural needle for treatment of rupture of the Achilles tendon has good efficacy, and it is worthy of wider promotion for its application in grassroot hospitals.

Clinical studies of novel suture method for re-attaching terminal part of tendons of digital extensors

YANG Shuai-Zhi, CHEN Lu, LIU Hua-Gui

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  491-493.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 196 )  

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Objective　To introduce a new method for reattachment of the terminal part of the tendons of digital extensors.　Method　The distal interphalangeal joint was fixed in the straight position by Kirschner wire with a diameter of 1.0 mm; a transverse bone tunnel in the base of the distal phalanx was drilled by Kirschner with 1.0 mm in diameter, through which 3/0 double-strand nylon lines were passed through; And the terminal part of the tendons of digital extensors were reattached to the distal phalanx by using the nylon lines. The fingers were maintained in a straight position for 4 to 6 weeks.　Results Postoperative following-up 3 months to 2 years was carried out, no case of tendon rupture again was found. Finger total active movement (TAM) evaluation: Excellent in 20 cases, Good in 6 cases, Excellent rate was 100%.　Conclusion　The suture in reconstruction of terminal extensor tendon insertion is simple in operation, reliable at curative effect.

A new clinical classification and the corresponding treatment of Mallet finger

DU Dong, PENG Yong-Jing, FU Xiao-Kuan, FU Jiang, FANG Ti-Che

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  494-496.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 319 )  

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Objective　To analyze various clinical parting of mallet finger, put forward different views of parting, and practice corresponding treatment method with their curative effects analyzed.　Methods  Along with the treatment advances of the mallet finger, we put forward new clinical classification by modification on the past classification, and determines the corresponding treatment measures according to the different classfication. From February 2009 to December 2013, 52 cases with mallet finger deformity were treated. 20 cases received conservative treatment, 6 cases were successful and others need surgical correction. 52 cases were operated according to the new classificaion:36 cases were treated by mini Anchors;4 cases were treated by pullout steel wire with button;3 cases were treated with Single screw;6 cases were treated by direct suture;3 case was treated by fusion of joint.　Results　The patients were followed from 4 months to 30 months. The results were excellent in 28 patients, better in 21, good in 6, and fair in 3 according with Palel’s evaluation standards.　Conclusion　It can determine clinical classification and operation method of the mallet finger before operation according to the medical history and X-ray, clinical cases confirmed that new cliassification is practical and satisfactory.

The variation of absence of inferior gluteal artery: a case report

HAO Lu, XU Guan-Yu, NIAN Xin-Wen, GU Shen-Yu, DANG Rui-Shan, LIU Fang

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  496.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 125 )  

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Comparation of clinical effect of two methods for treating distal radius fracture involving articular surface

HUANG Mei-Jun, LI Quan-Meng, LIANG Zhi-Jian, TANG Yang-Wei, KONG Xiang-Quan

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  497-499.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 117 )  

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Objective　To compare clinical effect of anatomical locking plate fixation and ordinary steel fixation for treating distal radius fracture involving articular surface.　Methods　From June 2010 to September 2013，a total of 96 cases of patients who suffered distal radius fracture involving articular surface in our hospital were divided into the control group and the observation group according to the degree of fracture, with 50 patients in the control group, 46 patients in the observation group. Patients in the observation group was treated by anatomical locking plate fixation, while patients in the control group was treated by ordinary steel fixation. Time for beginning of postoperative rehabilitation, fracture healing time and clinical effect of the two groups were compared.　Results　Time for beginning of postoperative rehabilitation in the observation group was significantly earlier than that of the control group (1.22±0.71 d vs 2.34±1.07 d, P<0.05). Fracture healing time of observation group was significantly shorter than that of control group( 66.67±12.43 d vs 74.47±15.63 d, P<0.05). The excellent-good rate of observation group (94.0%) was higher than that of control group (71.7%), the difference being statistically significant (P<0.05).　Conclusion　Compared with ordinary steel fixation, anatomical locking plate was more reliable in fixation and had better clinical result on patients sustain distal radius fracture involving articular surface.

Progress in basic study and applications of suralneurocutaneous flap

LIU Jiang, LIU Hui-Ren

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  500-502.  doi:10.13418/j.issn.1001-165x.201

Abstract ( 181 )  

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Inferior vena cava renal segment variation into double inferior vena cava: a case report

ZHANG Yong, CHEN Fei, YANG Qing-Bei, XUE Qian

Chinese Journal Of Clinical Anatomy. 2014, 32(4):  503.  doi:10.13418/j.issn.1001-165x.2014

Abstract ( 212 )  

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