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Chinese Journal of Clinical Anatomy
(Founded in July 1983 Bimonthly)
Responsible Institution: China Association for Science and Technology
Sponsor: Chinese Society of Anatomical Sciences
Editing and Publishing: Editorial Board of Chinese Journal of Clinical Anatomy
Advisor: ZHONG Shi-zhen
Editor-in-chief: OUYANG Jun
Former Editor-in-chief: XU Da-chuan
Overseas Distributor: China International Book Trading Corporation (P.O. Box 399, Beijing, China, Code No. BM5961)
Address: 1023 Shatainan Road, Guangzhou, 510515, China
Tel: (020)61648203
E-mail: journal@chjcana.com
CN: 44-1153/R
ISSN: 1001-165X

Table of Content

    25 September 2014 Volume 32 Issue 5
      
    Anatomical study of arachnoidal structures around sylvain fissure and it’s relationship to the branches of middle cerebral artery
    LIU Yun-Chao, QI Song-Chao, LIU Yi, CHEN Ming, BO Jun, DAN Jin, LIU E-Wei
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  505-509.  doi:10.13418/j.issn.1001-165x.2014.05.001
    Abstract ( 868 )  
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    Objective This study aims to investigate the layers of arachnoidal structures and illustrate the relationship between the arachnoid membranes with branches of middle cerebral artery (MCA). The related clinical issues are discussed.   Methods   Six cases of adult cadaveric heads (twelve sides) were dissected under the microscopy. The construction of Sylvain fissure cistern and the different layers of arachnoidal membranes were observed. The course of MCA’s branches and its relationship to the aforementioned membranes were analyzed.    Results    A total of four layers of membranes composed the sylvain fissure cistern. From outer to inner, it was far lateral sylvain arachnoid (FLSa), lateral sylvain arachnoid (LSa), middle sylvain arachnoid (MiSa) and median sylvain arachonid (MeSa) respectively. Among the 12 sides of specimens, four layers  of fully complete and intact membranes were observed in 6 cases. FLSa was always thin with covering among the superior sylvain vein and fusing with the vascular extima. After opening the FLSa, a related thicker membrane named LSa actually served as the lateral wall of sylvain fissure cistern. It existed in all cadavers and separated M3 and M4 segments of MCA. With deeper dissection along the distribution of M3 segment, the outer layer of MiSa was observed to fix artery in the sylvian cistern. A significant inner layer of MiSa was identified around the original part of M3, and divided sylvian cistern into anterior and posterior parts. In 3 cases, this membrane was thinner and cancellous-like in appearance. The deepest layer of membranes was MeSa, which separated M1 and M2 segments. It served as the inner wall of sylvain fissure cistern and lateral wall of internal carotid artery cistern. In five sides of specimens, this membrane was thin and cancellous.   Conclusion    Stratification distribution of sylvain arachnoidal membrane shows close relationship with different segments of MCA. Its individualized contribution might influence the bleeding characteristics of MCA aneurysm.

    Customized three-dimensional digital model for endoscopic anatomy of inferior clivus
    HE Hai-Yong, XIE Zhuo-Feng, LI Wen-Qing, WANG Hui, CA Mei-Qin, LUO Lun, ZHANG Bao-Shu, GUO Yang
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  510-514.  doi:10.13418/j.issn.1001-165x.2014.05.002
    Abstract ( 399 )  
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    Objective The aim of our study was to apply an customized three-dimensional digital model(3D-DM) to endoscopic endonasal approaches to analyze the bony anatomy of inferior third of the clivus, quantify preoperative bone removal, and optimize surgical planning. Methods Silicone dyes were respectively injected into the great vessels of the neck of 12 cadaveric specimens. Digital data acquired from 320-slices CT scan was imported to a 3DView system to form individual 3D-DM. With the 3D-DM support, an endoscopic endonasal dissection of the inferior clivus was completed under conditions that mimicked our operating suite. Bone removal of occipital condyle was quantified postoperatively by 3D-DM, which compared with the preoperative ones, to analyze physical percentage of bone excision. Results Customized 3D-DM was useful to de?ne the exact boundaries of the endoscopic endonasal approaches. The vision acquired by 3D-DM was consistent with the intraoperative findings. Preoperative measurement of related landmarks in 3D-DM showed no significant difference from the measurement data on cadaveric head specimens. Completion of a unilateral ventromedial condyle resection opened a wider lateral surgical corridor. The supracondylar groove was a reliable landmark for locating the hypoglossal canal. The transjugular tubercle approach was accomplished by drilling above the hypoglossal canal, and increasing of the vertical length of the lateral surgical corridor, which allowed for visualization of the distal cisternal segment of the lower cranial nerves. Conclusions The endonasal approach provides exposure of the brainstem in the ventromedial compartment. This 3D-DM is very effective in providing a depiction of surgical landmarks and visual feedback of the amount of bone removed.

    Applied anatomical study on transsphenoidal endoscopic optic nerve decompression
    JIN Xi-Chao, YANG Chao-Feng, NIE You-Hua
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  515-518.  doi:10.13418/j.issn.1001-165x.2014.05.003
    Abstract ( 496 )  
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    Objective To provide anatomical  basis for performing the transsphenoidal endoscopic optic nerve decompression. Methods Twelve heads of adult cadavers were dissected under the operative endoscopy imitating the trassphnoidal approach to observe the optic canal and its surrounding structures. Then the optic canals were removed and sheath was exposed in order to observe the optic nerve and ophthalmic artery.     Results Optic canal protuberance is a relatively consistent anatomical landmark in sphenoid sinus and the orbital aperture could be determined through the optic canal protuberance. Ophthalmic artery is always located in the ventromedial side of optic nerve and incision of sheath of optic nerve should be performed in the superolateral position. Conclusions Optic canal protuberance is an important anatomic landmark; incision of sheath of optic nerve should be performed in the the superolateral position.

    A misdiagnosis case caused by variation of nasal vestibular cyst
    YAN Xin, JIANG Nai-Xia, CAO Guang-Meng
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  518.  doi:10.13418/j.issn.1001-165x.2014.05.031
    Abstract ( 316 )  
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    Contrast analysis and microdissection of the exposure of the jugular foramen region via different surgical approaches
    SUN Shou-Yuan, BO E-Wen, LIN Jun, GAO Dun-Wei, ZHANG Hai-Lin, TANG Bo
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  519-522.  doi:10.13418/j.issn.1001-165x.2014.05.004
    Abstract ( 638 )  
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     Objective   To investigate the difference of the extent and structure of the foramen jugulare region from a far lateral inferior suboccipital approach, post aur presigmoid approach, improved post aur head and neck approach. Methods Six emblamed adult cadaveric heads were randomally and equally assigned to three groups (group A、B、and C). Jugular foramen operative approach was simulated under high power microscope. The far lateral inferior suboccipital approach was applied to A, the post aur presigmoid approach was applied to B, the improved post aur head and neck approach was applied to C to proceed microdissection studies;exposed structure and scope were compared among the above-mentioned surgical approaches.  Result The far lateral inferior suboccipital approach was better for jugular foramen area to exposeintracranial structures, post aur presigmoid approach was better to expose internal structures in the jugular foramen、tympanum、mastoid air cell and structures around cervical artery sheath; improved post aur head and neck approach was better for exposure of extracranial-intracranial(EC-IC) structures through multiple angles such as rear, outside, above and below.    Conclusion    The exposure range and structures of jugular foramen area vary in different surgical approaches.  Improved post aur head and neck approach with its multiple angles was better at exposure of intracranial and extracranial structures, so that total resecction of tumor can be achieved.

    Measurement and clinical significance on anatomic landmark of anterior cervical decompression
    LIN Yong-Rui, WANG Mo-Meng, ZHANG Fa-Hui, ZHENG He-Beng, WANG Chun
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  523-528.  doi:10.13418/j.issn.1001-165x.2014.05.005
    Abstract ( 589 )  
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    Objective The primary purpose of the current study is to provide more scientific landmarks for safe and efficient decompression within limited operating field in cervical anterior decompression. Methods Relative data were observed and measured at C3~7 of 15 adult cadaveric specimens and some data were calculated basing on above data: the ratio of anterior crus of uncinate process-medial border of longus colli muscle distance and medial border of longus colli muscle-median sagittal plane distance(AULD/MLPD), the ratio of anterior crus of uncinate process-medial border of foramen transversarium distance and anterior crus of uncinate process-medial border of longus colli muscle distance(AUTD/AULD), the ratio of anterior crus of uncinate process-lateral border of dural sac perpendicular distance and posterior crus of uncinate process-lateral border of dural sac distance(AUDD/PUDD), and the ratio of the nearest point of uncinate process and nerve root-anterior crus of uncinate process perpendicular distance and anteroposterior crus of uncinate process perpendicular distance(UNAD/APUD).  Results AULD/MLPD averaged 0.83 at C3, 0.55 at C4, 0.20 at C5, 0.34 at C6, and 0.27 at C7. AUTD/AULD averaged 2.71, AUDD/PUDD averaged 0.28, and UNAD/APUD averaged 0.34. Conclusion Anterior crus of uncinate process is a consistent anatomic landmark at anterior border of cervical vertebrae, which could serve as a stationary and reliable landmark in cervical anterior decompression, and facilitate the location of dural sac, cervical nerve root and vertebral artery during operation according to the ratios of AUDD/PUDD, UNAD/APUD and AUTD/AULD.

    Applied anatomic studies of cervical anterior transpedicular screw fixation
    LI Rui-Feng, TUN Yi-Min
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  529-532.  doi:10.13418/j.issn.1001-165x.2014.05.006
    Abstract ( 343 )  
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    Objective To provide relevant anatomic parameters for the promotion of the Cervical anterior transpedicular screw fixation(ATPS).  Methods 30 sets adult normal cervical specimens were randomly selected, and the scanned data were imported to the MIMICS 13.0 software;the related anatomical parameters and the pedicle screw parameters of ATPS were measured. Then the obtained data were subject to statistical anylysis. Rusults Through measurement the pedicle screw parameters, the best enterance point for screws and the best enterance channel for the screw could be determined. It could be found from the measurement that the height of the cervical vertebral pedicle was larger than the width and the the largest screw it can contain was 4.5 mm in diameter 30 mm in length. Conclusion ATPS can be applied to the treatment of cervical vertebra disease as a new fixation technology. It may provide a better help for the treatment of some cervical vertebral disease, such as tumor, serious osteoporosis and three-column injury of the cervical spine.

    The study on the classification of the Chinese dry atlas articular surface
    CHAI Yu, LI Shi, LI Xi-Kai
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  533-537.  doi:10.13418/j.issn.1001-165x.2014.05.007
    Abstract ( 858 )  
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    Objective To study the morphology of the atlas articular surface.  Methods The atlas articular surfaces were measured and classified in 125 atlases. The measurement projects included the major axis, minor axis, depth and the angle of the anterior posterior arch’ nodular connection. Results The form of the atlas articular surface could be divided into the following 4 types: both sides being elliptical, both sides being dumbbell-like, the left side being elliptical and the right-side being dumbbell-like, and the left side being dumbbell-like and right-side being elliptical. There were statistical differences in morphological data of each articular surface. Conclusion There are statistical morphological differences on the lateral mass of the atlas articular surface.

    Extra muscle bundle variation of latissimus dorsi muscle: a case report
    XU Yo, HE Shan-Li, WANG Xiao-Fang, LIU Yu-Yin, YANG Xiang
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  537.  doi:10.13418/j.issn.1001-165x.2014.05.032
    Abstract ( 283 )  
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    Morphological characteristics and its significance of the articular surface of costotransverse joint
    HU Zhe, ZHANG Shao-Jie, WANG Xing, LI Zhi-Jun
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  538-543.  doi:10.13418/j.issn.1001-165x.2014.05.008
    Abstract ( 575 )  
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    Objective Through the morphological measurement of the articular surface of adults’ costotransverse joint, its morphological features have been researched to provide the theoretical basis for clinical diagnosis, designs of the screw as well as the related biomechanics.  Methods 40 (80 sides) of adults’ thoracic dry bone specimens have been selected to observe the related index and then analyzed statistically according to different segments. Results Transverse costal fovea transverse groove could only be found in T1 and T2. Concave shape T1~4 increased gradually and plane shape T5~9 increased gradually. There is basically no costal fovea. The upper of transverse costal fovea T4~T8 increased gradually while the middle T1~4 increased step by step. T5~9 has decreased from 63.7% to 11.3% while the lower position T1~7 decreased gradually.  Flat type of the articular surface of tubercle of rib is distributed normally. Convex type accounted for 23.0%~50.0% except for R7; Concave type R1 accounted for 27.5% and concave type R2 accounted for 33.8%. The rest was distributed rarely. Basically, there was almost no articular surface in  R11、R12. Only articular surface of tubercle of rib R1 turned out to be the upper side, which accounted for 10.0% , while the middle part R1 accounted for 80.0%. Meanwhile, R3~11 accounted for 3.8%~26.3% and the lower part R2~10 accounted for 60%~96.2%. Conclusions Vertebral transverse costal fovea moves upward from concave to flat while articular surface of tubercle of rib moves downward from convex to flat. Suitable treatment plan should be made based on the related parameters of the rib 1~12 in clinical application.

    Origin variation of right subclavian artery: case report
    LI Yong-Qing, LI E-Na, ZUO Huan, LI Ge-Beng, XU Si-Yuan
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  543.  doi:10.13418/j.issn.1001-165x.2014.05.033
    Abstract ( 427 )  
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    Anatomical measurement and quantification of nerve fibers for femoral and obturator nerve muscular branches transfer
    ZHANG Yong, WANG Guo-E, YANG Qing-Bei
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  544-547.  doi:10.13418/j.issn.1001-165x.2014.05.009
    Abstract ( 397 )  
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    Objective To explore applied anatomy of femoral branch to obturator nerve transfer for repair of obturator nerve injury and obturator nerve transfer for femoral nerve repair. Methods The length of the muscular branches of the femoral and obturator nerves were measured in 20 emblamed cadavers using vernier caliper. In six fresh cadavers that died within three to ten hours,the femoral and obturator nerves were collected and stained by Karnovsky-Roots method for determination of the transection area and and the fibers by Leica image analyzer. Results The long muscular branch to vastus medialis was longest in length and the proximal transection area was largest among the muscular branches of femoral nerve; the gracilis branch was longest in length and the branch to adductor magnus was largest in transection area among muscular branches of obturator nerve. The number of somatic motor fibers was highest in each muscle branches. The number of somatic motor fibers of vastus medialis long branch was highest among muscular branches of femoral nerve, adductor magnus branch was highest and gracilis branch was second among muscular branches of obturator nerve. The content of γ - thin myelinated nerve fibers, vastus medialis short branch and rectus femoris branch were highest other in muscular branches of femoral nerve and adductor brevis branch were highest in muscular branches of obturator nerve. Conclusions Considering the length, proximal cross-sectional area and the number of the nerve fiber in each muscle branch, in the femoral and obturator nerve injury repair, the vastus medialis long branch and gracilis branch should be donor nerves; the vastus medialis short branch and rectus femoris branch and adductor magnus branch should be receptor nerves.

    Applied anatomy of digital lymphatic vessels
    CENG Fan-Jiang, BO Wei-Ren, WANG De-An, CHEN Yuan-
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  548-552.  doi:10.13418/j.issn.1001-165x.2014.05.010
    Abstract ( 716 )  
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    Objective To determine the lymphatic anatomy in human digits. Methods xture of 6% hydrogen peroxide with ink was used to detect lymphatic vessels commencing on bilateral sides of each fingertip. A 30-gauge needle was inserted into the lymphatic vessel and injected with a radio-opaque barium sulphate or lead oxide mixture. Vessels were traced, photographed and radiographed to demonstrate the lymphatic pathways and the relationship with the surrounding tissues in each digit. Transverse sections were made in one specimen. Results Each digit contained two collecting lymphatic vessels, one on each side. The diameter of the vessels varied from 0.2 to 0.8 mm, being larger in the proximal side and smaller in the distal end. They originated underneath the dermis on sides of the distal phalanges and travelled tortuously along the midaxial lines in the subcutaneous tissue on each side of digits. Vessels of adjacent digits converged in web spaces of the hand except vessels on the lateral border of the thumb and the medial border of the little finger. They then traveled radially to merge with lymphatic vessels in the dorsum of the hand. Transverse section of the finger showed locations of the digital lymphatic vessels, arteries, veins, nerves and neighboring tissues. Conclusion Actual and accurate lymphatic anatomy of the human digits has been described. This information upgrades our lymphatic anatomical knowledge and the results will be of bene?t for clinical management and further studies in the region.

    Second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap for reconstruction of basic and clinical talofibular ligament
    SHU Li-Xin, FAN Qi-Shen, CHEN Hua-Jiang, TUN Qun-Feng, GUO Song-Hua, FENG Wei, XU Jian
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  553-556.  doi:10.13418/j.issn.1001-165x.2014.05.011
    Abstract ( 849 )  
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    Objective To provide anatomical basis for blood supply of second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap to reconstruction talofibular ligament. Methods In 6 embalmed adult cadavers and 6 fresh specimens the origin, insertion and course of the talofibular ligament, the origin, insertion and course of the 2nd dorsal tarsometatarsal ligament were observed. simulated reconstruction surgery were conducted on fresh specimens. Result  The tarsometatarsal ligaments was consistent and superficially located and easy to harvest, the second cuneiform bone- dorsal tarsometatarsal ligaments-dorsal metatarsal ligament flap was (4.1±0.4) cm in length, while the talofibular ligament length was (2.4±0.5) cm in length.(1)The dorsal ligaments from second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap had sufficient length to serve as a transplant donor site. (2) Second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap were fixed at both ends to the bone wounds, making it easy to survive and restore functions. (3) the flap was clinically applied in 12 cases. All patients were followed up for 4 months to 2 years ,and it was found that the reconstituted talofibular ligament can correct varus deformity of the ankle; the average bone healing time was 2 to 3 months; all patients were satisfied with the ankle function and no further fracture complications were encountered. Conclusion The second cuneiform bone - dorsal tarsometatarsal ligaments - metatarsal flap is similar in anatomical structure to talofibular ligamet. The reconstruction surgery is simple in procedure and minimal in donor site trauma. Using second cuneiform bone - dorsal tarsometatarsal ligaments -metatarsal flap for reconstruction of the talofibular ligament is feasible anatomically and clinically.

    Sectional anatomy and clinical significance of fronto-nasofrontal duct area
    TUN Ting-Ting, TUN Yue, WANG Gong-Guang, YANG Rui, XU Chong, WANG Beng
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  557-561.  doi:10.13418/j.issn.1001-165x.2014.05.012
    Abstract ( 486 )  
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    Objective  To provide accurate morphological basis for clinical surgery on fronto-nasofrontal duct area. Methods Three-dimensional continuous thin sections of 0.25 mm was prepared with improved celloidin embedding technique and the specimens of adult decalcified heads and dry cranium were observed. Results The morphology of nasofrontal duct included diagonal elongated line-shape, straight line-shape, arc-shape, inverted “L” shape and “S” shape. The bottom opening of nasofrontal duct was into frontal recess, ethmoidal infundibulum and the superior part of ethmoidal infundibulum, ethmoidal bulla and lateral sinus. The length of nasofrontal duct was (19.81±2.56) mm (left) and (19.90±2.60) mm (right). Frontal sinus was diverse morphology, but triangle is the main type. The thickness of anterior wall of frontal sinus was (22.48±1.72) mm (left) and (22.63±1.38) mm (right). Conclusion Frontal sinus surgery via nasofrontal duct can be carried out through the middle nasal meatus after the bottom opening is found. It is safe and feasible to operate on frontal sinus directly through nasofrontal duct.

    Three-dimensional CT reconstruction of the orbital cavity channel and its clinical significance
    LI Xiao-Feng, HAN Xiao-Gong, GAN Xin-Beng, LI Pei, FU Sheng-Qi, FAN Ti-Yi
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  562-566.  doi:10.13418/j.issn.1001-165x.2014.05.013
    Abstract ( 607 )  
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    Objective To provide anatomical basis for clinical diagnosis of lesion spread between the orbital cavity and its surrounding area.  Methods 100 cadaveric heads were selected with no diseases of the orbital cavity and the orbital cavity channel, and scanned in series by spiral CT from canthomeatal line (CML); all original images were transferred to the CT three-dimensional reconstruction workstation, and the orbital cavity channel were reconstructed through its long axis and perpendicular to the long axis. The position, shape and its adjacent structures of orbital cavity channel were observed and measured for diameter.  Results The length or longidudinal diameter of bony nasolacrimal duct, infraorbital canal, inferior orbital fissure, superior orbital fissure and optic canal in CT image were (13.72±1.56), (24.62±2.03), (28.16±1.03), (19.02±2.43) and (6.20±0.44) mm respectively. There were significant difference in the length and transverse diameter between bony nasolacrimal duct of the male and female (P<0.05), the length and transverse diameter of bony nasolacrimal duct were larger in male than in female. The size of the orbital opening, middle part and cranial opening of the optic canal was (25.22±4.89), (18.72±3.79) and (24.88±4.23) mm2 respectively. It was narrowest in the middle part of optic canal, which was the frequent location of optic canal stenosis. Conclusion    CT three-dimensional reconstruction could display micro-structure of the orbital cavity channel intuitively, making it an important tool for diagnosis of the malignant tumor and inflammation of orbital cavity and its surrounding area.

    A study on the accuracy of humeral head retroversion angle measured by different methods used in clinical practice
    BO Zhao-Xun, ZHANG Zhi-Cheng, CUI Yan, SUN Chao, ZHANG Hong-Xin
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  567-570.  doi:10.13418/j.issn.1001-165x.2014.05.014
    Abstract ( 533 )  
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    Objective To verify the accuracy of humeral head retroversion angle with  two different methods commonly used in clinical practice and assess the value in the shoulder arthroplasty. Methods 20 dry humerus specimens (bones with closed growth plates and no signs of degenerative or post-traumatic alterations. No information about sex or age) were scanned with 64 slice spiral CT, using two methods-the traditional two-dimensional CT measurement and a simple two-dimensional CT measurement, to measure the humeral head retroversion angle; then use the anatomical measurement to obtain the standard data; At last, the three groups data on humeral head retroversion angle were statistically analyzed. Results The angle of retroversion was (32.1±13.9)° using  traditional two-dimensional CT method, (30.2±14.3)° using the simple two-dimensional CT method, and (32.1±13.6)° using anatomical dissection. There was no statistical difference between groups by statistics (P>0.05). Conclusion Both methods can assess the humeral head retroversion angle very accurately, but the new two-dimensional CT method is relatively simpler, faster, more intuitive and practical. The Humeral head retroversion angle has great individual differences, and it is of great significance to accurately assess its value before the individually surgery.

    A preliminary report of fast establishment of three-dimensional digital models of anterior cruciate ligament based on MRI
    TUN Bing, LIU Wei, TIAN Yi, WANG Da-Beng, SHU Wei-Min, OU Yang-Kan, LIU Hai-Feng, BANG Liang-Quan, LI Hao, FENG Wen-Zhe, XIE Jian-Beng, ZHANG Ji-Shuai
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  571-575.  doi:10.13418/j.issn.1001-165x.2014.05.015
    Abstract ( 497 )  
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    Objective To investigate the method of quickly establishing three-dimensional digital model of anterior cruciate ligament (ACL) using magnetic resonance imaging (MRI), and to evaluate authenticity and reliability of the model. Methods Contralateral knee joint MRI data of 20 cases of patients with clinical diagnosis of ACL rupture were selected. These data were imported into independent development of 3D-MIA software, and were segmented by the method of independent invention of ACL fast segmentation technology, and then three-dimensional substance digital models of ACL and the knee joint were established by carrying through three-dimensional reconstruction on the basis of surface rendering. The length, width, thickness, and the angle of ACL and the human body planes were measured on models. The results were compared with that of early anatomical results. Results Three-dimensional digital models included bones and cruciate ligaments of the knee joint . The average building time was 18 minutes. The mean length, width and thickness of ACL were (39.80±1.86), (5.80±1.83) and (9.96±1.26) mm respectively, and the angle formed by ACL and the coronal plane, sagittal plane, horizontal plane were (27.58±3.64)°, (39.82±4.01)° and (22.27±4.23)° respectively. Compared with the corresponding data of previous researches, by independent sample t-test, there was no significant difference (P>0.05). Conclusions A relatively reliable three-dimensional digital model of ACL and the knee joint can be quickly established using the novel ACL segmentation technology and 3D-MIA software, laying an foundation for establishing a complete set of computer aided ACL operation system and realizing the dream of simulational, individualized and anatomical reconstruction of ACL in the future.

    An image study on the plantar plates of the lesser metatarsophalangeal joints
    YU Yao-Beng, CHEN Da-Wei, SHU Guang-Rong, LI Bing, YANG Yun-Feng, ZHANG Feng, DAI Gong-Hua, SONG Ye
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  576-579.  doi:10.13418/j.issn.1001-165x.2014.05.016
    Abstract ( 366 )  
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    Objective To study and measure morphological feature of less plantar plates by MRI and ultrasound, and improve the understanding of its value on clinical diagnosis.    Methods   Nineteen fresh-frozen human cadaveric foot specimens (seventy-six less plantar plates) were scaned by MRI and ultrasound. The imaging morphology of less plantar plates was observed;the length, width, central thickness and lateral thickness of less plantar plate were measured. Results The planter plate was showed distinctly with Proton density and was smooth and curvilinear in MRI images. In addition, the planter plate was scanned dynamically and flexibly in ultrasound, showing slightly echoic band. The length of the less plantar plates in MRI was (18.36±1.30) mm,(17.88±0.89) mm, (16.67±1.22) mm,and (14.26±1.11) mm; The width in MRI was (10.98±0.71) mm,(10.10±2.21) mm,(10.07±0.52) mm,and (9.07±0.65) mm; The lateral thickness in MRI was (2.07±0.13) mm,(2.05±0.12) mm,(1.87±0.22) mm,and (1.79±0.24) mm; The central thickness in MRI was (1.34±0.16) mm,(1.32±0.14) mm,(1.13±0.14) mm, and (1.05±0.13) mm. The less plantar plates of length in ultrasound was (17.05±1.31) mm, (16.98±1.12) mm, (15.77±1.80) mm,and (12.18±1.38) mm; The width in ultrasound was (12.19±0.74) mm,(11.63±0.79) mm, (11.08±0.77) mm,and (10.44±0.86) mm; The lateral thickness in MRI was (1.83±0.17) mm, (1.76±0.21) mm, (1.61±0.27) mm, and (1.48±0.21) mm; The central thickness in MRI was (1.14±0.14) mm,(1.06±0.15) mm, (1.04±0.15) mm, and (0.94±0.12) mm. The measuring results of less plantar plates in MRI and ultrasound were different and the parameter differences were statistically significant (P<0.05). Conclusions Both MRI and ultrasound can show the planter plates distinctly and they play an important role for examination of plantar plates.

    Study on enlargement law of choke vessels between bilateral iliolumbar perforators in rat
    HU Shi-Wang, PENG Ti-Hong, CUI Fu-Rui, HUANG Mei-Xian, TANG Mao-Lin, XU Da-Chuan
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  580-584.  doi:10.13418/j.issn.1001-165x.2014.05.017
    Abstract ( 370 )  
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    Objective To design direct observation model of choke vessels between bilateral iliolumbar perforators in rats and explore the enlargement law of choke vessels. Methods skinfold chamber was designed and produced, then anastomotic vessels (known as choke vessels) were chosen as observation area between the right and left iliac lumbar perforasomes. The changes of choke vessel in the observation area were photographed at different time points by using stereomicroscope. The enlargement ratio of choke vessel was measured and calculated in each time point, with the law of enlargement drawn. Results  The enlargement course of the choke vessels between the bilateral iliolumbar perforators can be observed by the skinfold chamber, whose size can be adjusted to observe choke vessels  in different animals. After observation,we found that the enlargement-ratio of choke vessels in 1h, 1d, 2d, 3d, 4d, 6d, 10d, 16d were (1.00±0.00), (1.11±0.08), (1.25±0.17), (1.36±0.22), (1.85±0.33), (1.82±0.38), (1.54±0.39) and (1.83±0.45) respectively.  Conclusions The skinfold chamber is a convenient, effective and direct way to observe cutaneous microvessels in rats alive using stereomicroscope. The choke vessels between the iliolumbar perforasomes in rat gets a highest enlargement ratio in 4 d to 6 d, then recedes gradually until 10 d to 16 d when it gets a second boost.

    Synthesis and characterization of nano-hydroxyapatite/collagen scaffolds incorporating ADM-PLGA microspheres and observation of its inhibition on MG63 cells
    YANG Lian-Jun, RONG Zi-Jie, ZHANG Zan-Jie, WU Guo-Feng, ZHANG Xi-Bing, WANG Jian, SHU Li-Xin
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  585-589.  doi:10.13418/j.issn.1001-165x.2014.05.018
    Abstract ( 301 )  
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    Objective To study preparation and characteristics of nano-hydroxyapatite/collagen scaffolds incorporating ADM-PLGA microspheres(ADM-PLGA-NHAC) and observe its in-vitro anti-tumor effect.    Method  ADM-PLGA-NHAC were prepared by freezing and lyophylization of composite solution.The characteristic and morphology of the scaffolds were observed by scanning electron microscope, and the release behavior of ADM was investigated in vitro. The antitumor activities of ADM-PLGA-NHAC against human MG63 cell lines were detected by CCK8 colorimetric assay and live/dead cell staining. Result The ADM-PLGA microspheres couldbe uniformly distributed in nano-hydroxyapatite/collagen scaffolds to form ADM-PLGA-NHAC scaffolds, which had 100-200 μm pore diameter and over 82% porosity. The release study indicated that the ADM-PLGA-NHAC show sustained release behavior in vitro. The leaching liquor of ADM-PLGA-NHAC could inhibit MG63 cell lines proliferation in a dose-dependent manner. Conclusion The ADM-PLGA-NHAC shows sustained release characteristics and anti-tumor effect, and it will have a wide application prospect in the fields of osteosarcoma.

    Study of the effect of Nix and miR-520h on glioma
    HU Xiao-Fang, WANG Yong-Kuai, QIU Xiao-Zhong, WANG Guo-Bao
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  590-594.  doi:10.13418/j.issn.1001-165x.2014.05.019
    Abstract ( 463 )  
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    Objective To evaluate the biological function of Nix and its relation to microRNA miR-520h in glioma. Methods 46 glioma specimens were selected to detect the expression of Nix by Western blotting and the microRNA expression by traditional RT-PCR.The shRNA were used to knockdown Nix of U251 glioblastomacell line, and the protein level of Nix was detected by Western blotting. In the presense of miR-520h inhibitor.The protein level of Nix and NF-κB was  detected to evaluate their interaction in the U25l cell. Results Both RT-PCR analysis and Western blotting showed that high expression of miR-520h was always accompanied with high expression of Nix proteins. Under hypoxic conditions, Western blotting showed that levels of both Nix and p-NF-κB/p65 in Nix-wt U251 glioblastoma cells were significantly higher than those in Nix-kn U251 glioblastoma cells. Furthermore,200 nmol/L of has-miR-520h inhibitor caused low expression of Nix and high expression of p-NF-κB/p65 under hypoxic conditions. Conclusion MiR-520h is related to the expression of Nix protein in the tumorigenesis of glioma. MiR-520h may be a strong tumor activator through promoting Nix biosynthesis .

    The expression of Bax and Bcl-2 in cultured neonatal rat cortical neurons and the role of L-NAME intervention
    SONG Hai-Yan, GAO Zhi-Chao, DENG Xiao-Hui, LIAN Hui, LIN Ming-Xin, FU Sheng-Qi
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  595-598.  doi:10.13418/j.issn.1001-165x.2014.05.020
    Abstract ( 372 )  
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    Objective To investigate the expression of Bcl-2 and Bax in cultured cortical neurons after NMDA injury and intervention effect of L-NAME. Methods  The primary cortical neurons were identified by polyclonal antibody against NSE. The neurons were randomly divided into 3 groups: control group, NMDA-injured group, L-NAME pretreatment group. ELISA was employed to explore the expression of NOS, and the expression of Bcl-2 and Bax was detected by RT-PCR and  Western blot.  Results  Immunofluorescence test showed that the most cells were NSE positive staining cells. NOS in L-NAME group were higher than that in control group, but lower than that in NMDA group; the expression of Bcl-2 mRNA and protein in L-NAME group were lower than in control group, but higher than that in NMDA group. The expression of Bax was in contrast with Bcl-2. Conclusion L-NAME plays an important protective role in neuronal apoptosis induced by NMDA, the possible mechanism of which may be related with up-regulation of Bcl-2 expression and down-regulation of Bax expression.

    Expression of p62 and ubiquitin in dexamethasone-induced rat critical illness myopathy
    JUE Hui-Ying, BAO Cui-Fen, XU Di, LI Ji, SONG Ou-Di, QIN Shu-Jian
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  599-603.  doi:10.13418/j.issn.1001-165x.2014.05.021
    Abstract ( 332 )  
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    Objective To investigate the expression of critical illness myopathy on autophagy-related factors p62 and ubiquitin in rat skeletal muscle. Method SD rats were divided into control and experimental groups; Experimental groups were divided into groups of 7, 9, 11d time points (n=10. Rats in experimental groups recerved intraperitoneal injection of dexamethasone 5 mg/kg once daily, and the healthy control group received intraperitoneal injection of normal saline. Muscle function were determined by muscle function impairment score. By immunohistochemistry and Western blot analysis the expression of skeletal muscle autophagy-related factors p62 and ubiquitin were determined. Results Compared with rats in the control group, rats in the experimental group demonstrated a varying degrees of muscle function impairment symptoms, with impairment most serious in rats in 11d point group. Immunohistochemistry showed visible expression of ubiquitin-positive cells and no p62-positive cells in a small group of skeletal muscle fibers. In the experimental group, a small amount of p62 and ubiquitin were expressed in the muscle fibers; the expression of p62 and ubiquitin was reduced the most obviously at 11d point. Western blot confirmed the same trend. Conclusion p62 and ubiquitin may play an important role in cell autophagy of skeletal muscle in critical illness myopathy in rats.

    The variation of superficial ulnar artery: a case report
    XU Jin-Shan, JIAN Yang-Yang, WANG Yi-Ran, WANG Kang-An, YUAN Shu, DANG Rui-Shan, LIU Fang
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  603.  doi:10.13418/j.issn.1001-165x.2014.05.034
    Abstract ( 411 )  
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    Tea polyphenol alleviates the chronic alcoholism induced sperm damage
    SHANG Yin-Juan, WANG Jian-Jun, WANG Xiang-Hai, WEN Jin-Kun, BO Meng-Jie, JIAN Chang-Hui, KANG Wei-Xiang, CHEN Zhuo
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  604-608.  doi:10.13418/j.issn.1001-165x.2014.05.022
    Abstract ( 416 )  
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    Objective To explore the preventive role of tea polyphenol (TP) on the chronic alcoholism induced sperm damage and the potential mechanisms. Methods Forty male Kunming mice were randomly divided into chronic alcoholism (CA) group, TP low-dosage (TP-L) group, TP high-dosage (TP-H) group and normal control (NC) group. Eight hours after daily alcohol administration, the mice in CA, TP-L and TP-H groups were treated with water, 1% TP or 2% TP respectively. The mice in NC group were administered with water twice a day. 90 days later, sperm suspension was prepared to detect sperm density, activity ratio and malformation ratio; Bcl-2 and Bax expression were observed in testicular tissue via immunohistochemistry. Results In CA group, the density, activity ratio of sperm and ratio of Bcl-2 positive cells in testicular tissue were lower, the ratios of sperm malformation and Bax positive cells in testicular tissue were higher than that of NC group. Above changes were reversed in the TP-L and TP-H groups. Moreover, this benign effect showed a positive correlation with dosage. Conclusion Tea ployphenol could alleviate alcoholism induced sperm damage. This effect might relate with the Bcl-2 and Bax expression during spermatogenesis.

    Three-dimensional finite element model of posterior fusion surgery for L4~S1 and analysis of stress distributions
    LI Su-Huan, LIU Bin, ZHANG Guo-Qiao, HE Fang, ZHANG Mei-Chao, JIAO Pei-Feng
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  609-612.  doi:10.13418/j.issn.1001-165x.2014.05.023
    Abstract ( 332 )  
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    Objective    To develop a three-dimensional finite element model for posterior fusion surgery of L4~S1 and evaluate the stress distributions of the pedicle screw and cage.   Method    The finite element model of normal lumbosacral vertebral L4~S1 segments with removal of L5~S1 intervertebral disc was established through CT scan,three-dimensional reconstruction by using Mimics,surface treatment by using Freeform and analysis by using Ansys, respectively. The model was fixed by the posterior pedicle screws and intervertebral fusion. The model was analyzed under different conditions such as flexion,extension,bending and rotation under the same load. Results All the stress mostly concentrated on the screw tail and junction between the arch bar and the screw. The stress on the Cage was mainly located in the anterior part except under the condition of rotation, which is located at the middle. The peak stress on screw and cage are 2.96×107  N/m2 ,  5.65×106 N/m2  in flexion, 2.98×107 N/m2 , 6.08×106 N/m2  in extension, 3.06×107 N/m2 ,9.71×106 N/m2 in bending, 2.96×107 N/m2, 1.00×106 N/m2 in rotation. Conclusion Three-dimensional finite element model of posterior fusion surgery of L4~S1 has been developed successfully and the stress distribution of pedicle screw and cage are close to clinical record, which can provide a significant guidance for clinical practice.

    Short-segment pedicle screw fixation with bone grafting and non-fusion through fracture vertebra in treatment of thoracolumbar burst fractures
    CHEN Zi-Hua, CHEN Jian-Wei, CHEN Xin-Ying, LIU Dan, CENG Gong-Sheng, LIU Jun, FANG Lei
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  613-615.  doi:10.13418/j.issn.1001-165x.2014.05.024
    Abstract ( 419 )  
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    Objective To evaluate the clinical effect of the Short-segment pedicle screw fixation with bone grafting and non-fusion in treatment of thoracolumbar burst fractures. Method 51 patients with thoracolumbar burst fractures between January 2011 and August 2013 included for treatment by hort-segment pedicle screw fixation with bone grafting and non-fusion of fractured vertebra. Result The 51 patients were followed up for 3~26 months (mean 18 months). The vertebral height and kyphosis angle in all patients showed no significant loss; There was no no loosening of fixations or breakage of screws and rods. Postoperative CT scan demonstrated further improvement of the spinal canal narrowing, there was  an average improvement of 2-3 grade in the degree of recovery of spinal cord injury according to Frankel assessment criteria. Conclusion Adopting of the injured vertebra fixation for thoracolumbar burst fractures can increase postoperative spinal stability, facilitate kyphosis correction, retain the thoracic and lumbar motion segment, which can effectively prevent the occurrence of traumatic disc degeneration and help restoration of spinal cord function.

    Risk factors analysis of perioperative mortality in ruptured bleeding of hepatocellular carcinoma
    LIN Gao-Ming, SHU Jia, LI Guo-Lin, MIN Jun
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  616-619.  doi:10.13418/j.issn.1001-165x.2014.05.025
    Abstract ( 380 )  
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    Objective Rupture of hepatocellular carcinoma (HCC) is a catastrophic emergency with high mortality. The aim of this study is to determine the factors associated with the prognosis and to assess the outcome of different management strategies. Methods Clinical and biochemical factors of 60 consecutive patients with rupture of HCC from 2005 to 2013 were studied. Univariate logistic regression analysis was performed to determine the relative factors leading to 30-day motality. Significant factors then entered into a multivariate logistic regression to determine independent factors associated with 30-day motality. Results In our study, 30-day mortality rate was 28.3% (n=17). Child’s C status, shock on admission, higher blood transfusion requirement and larger tumor size were with statistical significance on univariate analysis. On multivariate analysis, only shock on admission (P=0.001) and higher blood transfusion requirement (P=0.01) were significant independent factors affecting early post-operative mortality. A larger tumor size was identified as an independent factor related to post- TAE mortality. Curative resection was associated with a better 30-day survival as compared with conservative therapy or palliative operation. Conclusions Rupture of HCC is a salvageable complication of HCC. Poor prognosis is associated with poor liver reserve, advanced disease and severity of haemorrhage. Curative resection and TAE are better choices in selected patients.

    Application and research progress of allogeneic bone transplantation for the treatment of bone defect
    BI Zhi-Wei, HUANG Dong, OU Yang-Hai-Xiang
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  623-625.  doi:10.13418/j.issn.1001-165x.2014.05.027
    Abstract ( 340 )  
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    Problems and countermeasure analysis of the body donation work in our country basing on comparison to that in foreign countries
    CHEN Dan, LI Jian-Beng, HUANG Ju-Fang, Daniel O Graney, BO Ai-Hua
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  626-629.  doi:10.13418/j.issn.1001-165x.2014.05.028
    Abstract ( 564 )  
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    Supernumberary teeth in right side of maxillary and mandibular molar area:one case report
    DONG Wei, BANG Hong-Feng, CU Meng-Chun
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  630.  doi:10.13418/j.issn.1001-165x.2014.05.029
    Abstract ( 443 )  
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    The abnormity of multiple branches of right renal artery and multiple right accessory renal arteries : a case report
    LIN Jian-Liu, MA Jian-Jun, ZHUO Jing-Jing, GAO Xiao, CHEN Fei-Xiong, BAI Yu-Lin, SUN Ru-Ru, WANG Chang-Shao
    Chinese Journal of Clinical Anatomy. 2014, 32(5):  631.  doi:10.13418/j.issn.1001-165x.2014.05.030
    Abstract ( 550 )  
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