Table of Content

25 May 2016 Volume 34 Issue 3

  

Applied anatomy of the external laryngeal nerve and superior thyroid artery

ZHONG Yuan, SUN Shan-quan，GONG Rui，ZHANG Wei

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  241-244.  doi:10.13418/j.issn.1001-165x.2016.03.001

Abstract ( 1067 )  

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Objective　The topographic relationship between the external laryngeal nerve(ELN) and the superior thyroid artery (STA) were observed, in order to provide the anatomical foundations for protecting the ELN during surgery.　Methods　 Fifty-seven cadavers (114 sides) fixed with formalin were collected at random. The ELN and STA were carefully dissected and analyzed under a 6-power magnifier.　Results　The cervical sympathetic chain (CSC) of 90 sides was anastomosed with the ELN（CSC-ELN loop). For the 27.7% (25 sides) low-position CSC-ELN loops observed, the neurovascular relationship between the STA and ELN was classified into four types: ①the branches of the STA overlapped with the CSC-ELN loop; ② the glandular branch of the STA passed through the CSC-ELN loop; ③the muscular branch of the CSC-ELN loop and the laryngeal branch of the STA coursed together;④the branches of the STA and the CSC-ELN loop were interlaced.　Conclusion　Our study has shown a variable morphology of the CSC-ELN loop and its complicated topographic relationship to the STA, which should be kept in mind when attempting to avoid the nerve injury. Two special surgical procedures are recommended. First, the vessels should be individually isolated and then ligated during thyroidectomy. Second, a special attention should be paid to protect the coricothyroid branch of CSC-ELN loop from injury, when the anteriomedial branches of the STA are to be ligated during larynx surgery.

Anatomical study of the treatment of cubital tunnel syndrome by endoscope

GUO Quan, ZHUANG Yong-qing, WEI Rui-hong, XIONG Hong-tao, JIANG Hao-li, ZHANG Xuan

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  245.  doi:10.13418/j.issn.1001-165x.2016.03.002

Abstract ( 710 )  

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Objective　To provide clinical anatomy for the way of endoscopic anterior ulnar nerve subcutaneous transposition.　Methods　the length of ulnar nerve free in the forearm and the upper arm,the distance from the first motor branch to the ?exor carpi ulnaris muscle tothe medial epicondyle were measured in ten fresh limbs from fresh cadavers and twenty patients. Simulative surgery were performed on four limbs from cadavers.　Results　In this surgery ,the length of ulnar nerve free in the forearm was（3.90±0.145）cm（3.64~4.23 cm）,free in the upper arm was（4.21±0.18）cm（3.80~4.53 cm）,the first motor branch to the ?exor carpi ulnaris muscle was （2.18±0.38）cm（1.13~2.72 cm）away from the medial humoral epicondyle. In this surgery, the surgical incision was 2 cm longitudinal incision between the medial epicondyle and the olecranon,the forearm axis of the endoscopic operation was about 7 cm line on the line connecting the midpoint between the medial epicondyle and the olecranon to the pisiform,the upper arm axis was about an 8cm line on the line connecting the midpoint on the medial epicondyle and the olecranon to the midpoint on the medial septum of biceps;the suitable and the olecranon regional the endoscopic operation tissue level was the surface of arcuate ligament of Osborne , ?exor carpi ulnaris muscle in the forearm and deep fascia in the upper arm. Simulative surgery was successful.　Conclusion　This study confirmed this surgical approach was feasible, and could achieve the desired results.

The minimally invasive surgery positioning value and applied anatomy of lumbar zygapophysial joint

LIU Cong, YIN He-ping, LI Zhi-jun, HU Ji-ping, YANG Jian-guo, WU Hai-jun

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  249-253.  doi:10.13418/j.issn.1001-165x.2016.03.003

Abstract ( 1411 )  

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Objective　To explore the feasibility of lumbar zygapophysial joint is an important anatomical markers for minimally invasive posterior lumbar surgery by measurement and observation of the human anatomy specimens and the X-ray image data.　Methods　To collect 10 fresh adult human lumbar spine specimens (20 sides)，80 segments and 50 parts of the lumbar spine X-ray image data. From the focus point of applied anatomy, the highest point of lumbar zygapophysial joint（HP）was used as a center to observe and measure the lumbar facet joints and adjacent anatomy-structures.　Results　The distance of from HP to Rami ventrales nervorum lumbalium was lower and larger，and the angle was smaller. The distance of from HP to intervertebral disc of lumbar vertebrae was gradually increased. The difference in height of HP and Midplane of lumbar intervertebral disc was 0.8~1.5 mm, the height of HP variations on the vertical axis did not exceed the scope of thickness of lumbar intervertebral disc.　Conclusions　Through research, lumbar zygapophysial joint has some characteristics, including stable position、easy exposure、easy identification and high accuracy. It is an ideal anatomic landmarks. There is a good anatomical localization effect in the lumbar posterior minimally invasive operations.

Cruciate ligaments of knee and patellar tendon of blood supply and clinical significance in reconstruction of damaged cruciate ligaments

WANG Shou-an, ZHUANG Zhi-qiang, WANG Hu

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  254-259.  doi:10.13418/j.issn.1001-165x.2016.03.004

Abstract ( 1222 )  

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Objective 　To study the characteristics of the flow of blood in patellar tendon(PT) and cruciate ligament in order to provide the morphological basic data for ligament reconstruction in clinical medicine.　Methods　42 cases of lower limb were selected, including 6 adults and 36 fetuses. The femoral artery of each limbs were first perfused with red latex and separated all the main blood vessels and other tissues (6 adults). Ink was injected into the arteries 30 fetuses, tissue sections were made and made transparent. The microvascular architecture of PT and cruciate ligament were observed and the blood capillary density of PT and cruciate ligament were measured under optical microscope. Ligaments of 6 fetal specimens were cut and made into HE sections, observed under optical microscope.　Results　The arteries of the PT comes from the branches of femoral artery; The microvascular density of foetal patella of different area varies. The distribution pattern of the arteries of the PT has the characteristic of low in intermediate while high on both sides. The artery of ACL and PCL is derived from the branch of the popliteal artery and patellar artery. Most of the blood vessels flow along the axis direction while some are crosswise, like a ladder and net-shaped at the same time.　Conclusion　①Both of PT and cruciate ligament have a  weak vascular area to the center; ②The most abundant blood supply are on the both ends of the ligament, and near side is better than distal one; ③The blood supply of the PT is better than cruciate ligament, PT has the better bloodsupply in cruciate ligament reconstruction

Applied anatomy of the rectosacral fasia for axial lumbar interbody fusion

WANG Jiang-shuan, DING Ran, ZHAO Qing-hao, WANG Feng-gang, WANG Jian-zhong, DING Zi-hai,WANG Fu-qing

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  260-262.  doi:10.13418/j.issn.1001-165x.2016.03.005

Abstract ( 608 )  

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Objective　To observe the applied anatomy of the rectosacral fasia (RSF) for axial lumbar interbody fusion(Axial LIF).　Methods　The pelvic region  of 10 human specimens were divided into 20 halves in the median sagittal plane. Related anatomical data of the RSF were collected from all specimens.　Results　(1) The RSF mostly originated from the level of the S2 in 44.4% which divided the presacral space into superior and inferior portions. (2) The RSF of men were across both sides of the rectum and connected to the parietal peritoneum of the pelvic, and the RSF of women were connected to the rectouterine fold. (3) The average length of the RSF was (23.14±1.41) mm, the average thickness was (1.25±0.13) mm, the average distance to surgical incision (66.10±7.03) mm, the  average distance to the midpoint of S1/S2 cable(23.09±1.87) mm.　Conclusion　(1) The RSF existed universally in the presacral space which should be dissected sharply in surgery to avoid the injury to the presacral venous plexus. (2)The RSF of women may be a part of the uterosacral ligament.

Anatomy and MRI study of the sacrospinous ligaments of normal pelvis

WANG Yi-ran， CAO Sheng-lu， LING Wei，FENG Kai，PENG Geng，XU Yi-kai，Wang Gang

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  263-267.  doi:10.13418/j.issn.1001-165x.2016.03.006

Abstract ( 1680 )  

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Objective　To obtain the angle of between the axis of the sacrospinous ligament and the human coronal plane in the human sagittal plane.　Methods　Eight fresh cadaveric specimen were disserted to find the insertion and the course of sacrospinous ligaments. 3D models were reconstructed from the pelvic CT scan data of 36 normal pelvis, the angle between the axis of the sacrospinous ligament and the human coronal plane in the human sagittal plane were calculated based on 3D coordinate of spatial points. 20 sacrospinous ligaments of 10 volunteers were conducted in the 3D MRI series and observed in the MPR(Multiple Planar Reconstruction) image. The MRI image findings of sacrospinous ligaments were compared among different views.　Results　The sacrospinous ligament passed from the sacrum to the ischial spine. A board range of insertion on the sacrococcygeal region were observed. We found in the CT data measurements that there was no significant differences between the left and the right sides in both genders (P>0.05). The differences between male and female were of no statistical significance (P>0.05). The mean angle of the 72 sides was (61.32±8.71)°. The mean angle measured on MRI data was （57.53±9.50）°. There was no statistical significant differences between the CT and MRI measurement results (P>0.05). We compared the MR imaging at the position of (60±5)° oblique coronal plane and the 3 normal planes and found that the ligaments can better be observed in oblique coronal plane (P<0.05).　Conclusions　The sacrospinous ligaments were well shown in (60.0±5)° oblique coronal plane.

Articular surface morphometry of distal femur based on magnetic resonance imaging

CAI Di-xin, YONG Sheng, TAN Hong-bo, DING Jing, YU Kai-fu, ZHANG Ying, ZHOU Tian-hua, YANG Jun, XU Yong-qing

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  268-272.  doi:10.13418/j.issn.1001-165x.2016.03.007

Abstract ( 514 )  

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Objective　To investigate a quantitative method to describe the morphometry of distal femur articular surface based on magnetic resonance imaging (MRI) and to provide morphometric data support for design of articular surface fixation and articular cartilage repairing of distal femur.　Methods　130 knees in healthy Chinese were included for MRI scanning from January 2010 to June 2014. Several reconstruction software were used to take curve or sphere fitting and measurements of distal femur articular surfaces including condyles and trochlea.　Results　The articular surfaces of the medial and lateral femoral condyles can be fitted by using several circular arcs respectively both in sagittal and coronal planes, a close-fit sphere was generated on the surface of the medial and lateral trochlear articular surfaces respectively.　Conclusion　We quantitatively describe the irregular profiles of the three portions forming the distal femur by using simple geometric parameters. the data are expected to provide morphometric support for design of articular surface fixation and articular cartilage repairing of distal femur.

Simulation of the surgery of posterior transcallosal approach to posterior thalamus on MRI

XU Min， WANG Cun-zu，ZHU Xun，CHEN Pin

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  273-277.  doi:10.13418/j.issn.1001-165x.2016.03.008

Abstract ( 671 )  

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Objective　To measure anatomical data for posterior transcallosal approach in dealing with tumors in posterior thalamus for normalization and optimization of the surgical approach.　Methods　One hundred and twenty midline sagittal T2-weighted magnetic resonance images (children group, 25 cases; adult group, 95 cases) were obtained. Taking lambda as a reference point, surgical schemes 1 and 2 were established. Two surgical plans of the posterior transcallosal approach to posterior thalamus on the images were simulated and the data of the related anatomical structures were obtained.　Results　(1)Data obtained from the scheme 1 and 2 showed that the skull window was located as follows: in children group, the skull window of scheme 1 was located before lambda (≤29.89±4.36 mm),while after lambda (≤37.04±3.22 mm); in adult group, the skull window of scheme 1 was located before lambda (≤31.20±7.36 mm),while after lambda (≤43.05±10.36 mm).In children group, the skull window of scheme 2 was located after lambda (≤37.04±3.22 mm); in adult group, the skull window of scheme 2 was located after lambda (≤43.05±10.36 mm). (2) The average length between lambda and posterior thalamus in children was (82.71±3.92) mm, while in adult group was (87.42±9.24) mm. The surgical angle of scheme 1 was shown as follows: in children group was less than (44.56±4.15)°, while in adult was less than (55.02±7.42)°. The surgical angle of scheme 2 was shown as follows: in children group was less than (24.28±3.25)°, while in adult was less than (31.33±8.25)°.　Conclusions　The sufficient evaluation of MRI is helpful to master the approach. Furthermore, to select, optimize the surgical approach and increase the clinical curative effects.

Study on childhood generalized tonic seizures using regional homogeneity analysis

GUO Hong-hua, HUANG Wen-hua, HUANG Li-jin，LI Yong-xin, HUANG Wei-jia, TAN Zhen

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  278-284.  doi:10.13418/j.issn.1001-165x.2016.03.009

Abstract ( 396 )  

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Objective　Regional homogeneity(ReHo) method of resting state functional MRI was applied to study abnormal brain activity of childhood generalized tonic seizures,and detect pathophysiological mechanisms of it.　Methods　Resting state fMRI scanning were performed to 8 patients with childhood generalized tonic seizures and 30 healthy children.The MRI data were compared and analyzed by using ReHo analysis method, the ReHo value were calculated between two groups and the correlation were studied between the ReHo value and seizure duration.　Result　  Compared with control group, the brain regions of increased ReHo value in experimental group are located in deep brain nuclei(cingulate gyrus，precuneus，thalamus，et al.)，motor related brain region, inferior frontal gyrus, occipital lobe，temporal gyrus，cerebellum;the brain regions of decreased ReHo value in experimental group are bilateral middle frontal gyrus, right middle temporal gyrus, left superior temporal gyrus, bilateral posterior central gyrus, lingual gyrus.The positive correlation between ReHo and epilepsy duration was found in the following brain regions: left precuneus, left superior parietal lobe, right precentral lobule, right postcentral lobule.At the same time negative correlation was found in the right precuneus, right angular gyrus, paracentral lobule.　Conclusion　ReHo analytical method can effectively reflect abnormal neurological functional change of the epilepsy patients, and help to investigate and explain the pathophysiology of idiopathic generalized tonic seizures.

The imaging anatomy study of Zhuang population using transpsoas extreme lateral interbody fusion

NING Neng-jie, JIANG Hua, CHEN Qian-fen, ZHOU Ju-shi

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  285-288.  doi:10.13418/j.issn.1001-165x.2016.03.010

Abstract ( 472 )  

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Objective　To define the safe working zone using the extreme lateral interbody fusion(XLIF).　Methods　We retrospectively evaluated lumbar spine MRI. Relevant parameters were measured from axial magnetic resonance images and analyzed, including the vertebrae endplate and psoas muscle diameters, the overlap between the lumbar plexus, the endplate of the vertebral body, the psoas muscle, the retroperitoneal vessels, and the angle of the retroperitoneal vessels.　Results　The SWZ（safe working zone）of extreme lateral interbody fusion from L1~2 to L3~4 had no significant difference.  The SWZ of L4~5 level was smaller than that at L3~4 level. The right SWZ was significant smaller than the left SWZ; the SWZ of female was smaller than that of male.　Conclusions　(1)The left side and right side are suitable for the Zhuang population using XLIF. (2)The puncture point of the Zhuang population using XLIF lies in zone Ⅱand zone Ⅲat L1~L2,L4~L5 level (zone Ⅲ at L2~L3,L3~L4 level).

The experimental study on edentulous mandible implantation assisted by metal surgical guides based on computer numerical control technology

XU Chu, WU Bu-ling, LI Jian-yi, BAI Yu-zhe, SONG Ying, MA Li-chao, TANG Lei

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  289-292.  doi:10.13418/j.issn.1001-165x.2016.03.011

Abstract ( 457 )  

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Objective　To explore a new method for manufacturing customized edentulous mandible metal implant surgical guides using computernumerical control (CNC) machines.　Methods　Eight corpse edentulous mandibles were randomly divided into two groups, CNC metal guides and rapid prototyping (RP) resin guides were manufactured respectively. All guides were used to assist edentulous mandible implantations to analyze the accuracy in vitro.　Results　The absolute deviation on horizontal plane was (0.23±0.14) mm in the CNC group and (1.01±0.27) mm in the RP group, respectively, between which the difference was significant (P=0.000). The absolute deviation on sagittal plane was (0.30±0.24) mm in the CNC group and (0.95±0.24) mm in the RP group, respectively, between which the difference was significant (P=0.000).　Conclusions　In vitro implantations, CNC surgical guides assisted implantations have higher accuracy than RP guides.

Operative strategy for complicated pelvic fractures with digital design and three-dimensional printing technique

LIN Gang, LI Peng, PENG Guo-rui, HUANG Xu-ke, SUN Xiang-hua, WANG Wen-song, ZHANG Ting-shuai, LI Jian-yi

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  293-297.  doi:10.13418/j.issn.1001-165x.2016.03.012

Abstract ( 701 )  

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Objective　To explore the operative strategy of internal fixations for complicated pelvic fractures using Mimics14.11 digital software combining with three-dimensional (3D) printing technique. Methods　Thin slice CT scan data of one case of complicated pelvic fractures and the data of all the pelvic internal fixations were imported into Mimics14.11 software to construct 3D models, performed virtual fractures reductions, established standard parts library of pelvis internal fixations, and chosen the most appropriate plates and screws.The 1:1 3D pelvic model was printed to simulate the surgery based on the digital design. Comparisons were made on the plate positions, screw passage lengths and screw directions to determine the final internal fixations. Finally, the fractures reductions and internal fixations were performed in the reality surgery.　Results　In the simulated surgery, 2 reconstruction plates and 15 screws were implanted, the plate positions and the screw directions were in high accordance with those measured in Mimics 14.11 software. The comparisons between simulated surgery and digital design on screw length had no significant difference (P>0.05). The effectiveness of reality surgery was also consist with the simulated surgery.　Conclusion　By using digital design software and three-dimensional (3D) printing technique, we can realize the individual operation and precise treatment which can achieve less blood loss and shorter hospital stay.

Generation of a 3D printed tooth model and evaluation of the anatomic fidelity

SONG Ying1,2, TANG Lei1, WU Bu-ling2, LI Jian-yi1, WANG Wen-hao3, XU Chu1,2, BAI Yu-zhe4, YI Si1,XU Di-wei1

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  298-302.  doi:10.13418/j.issn.1001-165x.2016.03.013

Abstract ( 791 )  

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Objective　To generate a 3D printed tooth model with a specific focus on anatomic fidelity instead of extracted tooth for dental training and preoperative surgical rehearsal.　 Methods　Appropriate materials and machines of 3D printing were selected in this research. We made a test to explore the shaping ability of root canal among three kinds of materials. Intact human incisor of one root canal, premolar of bi root canals, molars of two and three root canals were screened out by Cone Beam Computed Tomography. Then we reconstructed the 3D models and generated 3D printed tooth models after scanning of the teeth by Micro-CT. The reconstruction of printed models to the reconstruction of real tooth was compared, we made an evaluation of the anatomic fidelity of the models by Geomagic Qualify 11.　Results　The printed tooth models are successfully produced. In terms of surface morphology, the absolute deviations were (0.008121±0.0480) mm in Wic300a models and (0.009554±0.0526) mm in E-Dent models. While the absolute deviations were (0.04518±0.1022) mm in Wic300a models and (0.056953±0.1995) mm in E-Dent models in pulp cavity morphology.　Conclusion　The printed tooth models are highly realisticin the terms of morphology and this model serves as an excellent replica of human teeth for training and preoperative surgical rehearsal.

RNA interference with CRMP5 inhibites outgrowth of neurite in rat hippocampal neurons

LI Su-mei, LI Bin, ZHANG Ji-feng, TAN Ming-hui, WU Feng-ming, GUO Guo-qing

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  303-307.  doi:10.13418/j.issn.1001-165x.2016.03.014

Abstract ( 433 )  

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Objective　To investigate positive effect of CRMP5 gene on neurite outgrowth in rat hippocampal neurons.　Methods　After selecting an effective siRNA that interfered CRMP5 gene, and fluorescence radix FAM was constructed upon 5′ terminal of the siRNA. The siRNA was then transiently transfected into hippocampal neurons with lipofection reagent. The formation of neurites and branches of hippocampal neurons were observed by confocal microscopy.　Results　After the siRNAs labeled by FAM were transfected into hippocampal neurons,the FAM was distributed in the neuron cell body and neurite; Then,CRMP5 siRNA confirmed by immunofluorescence could effectively silence CRMP5 protein expression. The neurons had shorter neurites and branches than the control group after silencing CRMP5 gene expression. Compared with the control group, the length of neurites became significantly shorter after the CRMP5 siRNA was transfected into hippocampal neurons (P<0.05). No significant difference was found in the number of primary neurites, while the number of secondary and above neurites had significant difference (P<0.05).　Conclusions　Silencing of CRMP5 gene was shown to inhibit neurite growth and branch formation of hippocampal neurons.

The effect of vitamin C on the neurite outgrowth of dorsal root ganglionic neurons

LI Yuan-yuan, WEN Jin-kun, PAN Meng-jie, LI Li-xia,WANG Xiang-hai, QIAN Chang-hui, GUO Jia-song

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  308-311.  doi:10.13418/j.issn.1001-165x.2016.03.015

Abstract ( 515 )  

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Objective　To study the effect of Vitamin C on the neurite outgrowth of dorsal root ganglionic neurons.　Methods　Neurons harvested from the dorsal root ganglion of newborn SD rat pups were cultured in a basic medium supplemented with a series of concentration of Vitamin C (0, 100, 200, 400μmol/L). 24 hours later, the cultures were immunostained with antibodies of βIII tubulin and RhoA. The βIII tubulin immunostained cultures were double stained with phalloidin. Then, the number and length of the neurites, number of pseudopodium in the growth cone of the cultured neurons, as well as the immunofluorence intensity of RhoA in the neuronal bodies were quantified.　Results　The number and length of the neurites, number of pseudopodium in the growth cone of the cultured neurons were all increased in Vit. C treated groups compared with the control group. Howerver， the RhoA level was decreased in the Vit. C treated groups.　Conclusion　Vit.C could promote the neurite outgrowth of cultured dorsal root ganglionic neurons which may result in reducing the expression of RhoA.

The comparative study on two tracing ways of bone marrow mesenchymal stem cells in repairing of the hepatic ischemia reperfusion injury

YANG Qing, QIN Shu-jian, BAO Cui-fen, SHAN Wei

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  312-317.  doi:10.13418/j.issn.1001-165x.2016.03.016

Abstract ( 557 )  

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Objective　To compare the difference of the time-validity of repairing and the fluorescence stability between BMSCs infected by a lentiviral vector carrying GFP and the BMSCs in GFP rats in treatment of hepatic ischemia reperfusion injury. 　Method　The two kinds of BMSCs were cultured and the method of MTT was used to detect the differences of the two cell growth curves. Healthy SD rats were randomly divided into a sham operation group、a lentiviral transfection GFP group(LV-GFP group)、a GFP transgene group(GFP-BMSCs group) and a model group. After operation, the rats of the LV-GFP group and the GFP-BMSCs group were immediately injected with the corresponding cell suspension of 200 μl (the number of 1×106) by portal vein, and the model group was injected with the same volume of PBS. After 1, 2, 3 and 4 weeks，the levels of AST、ALT and ALB were tested by the blood sampling in different groups. From 1 to 5 days after operation, the hepatic tissue from the experience groups were transected to observe the migrating of the GFP positive cells in the liver; At  week 4, the hepatic tissue was transected from the experience groups to detect the fluorescence stability of the BMSCs and its expression of the keratin 18 (CK18) in the liver.　Results　The proliferation of the BMSCs in GFP rats was significantly stronger than that of BMSCs infected by a lentiviral vector carrying GFP in logarithmic phase. At weeks 1 and 2, the levels of the aspartate amino transferase (AST) and alanine amino transferase (ALT) in GFP-BMSCs group were lower than those in LV-GFP group (P<0.05), and the level of serum albumin (ALB) in GFP-BMSCs group was higher than that in LV-GFP group at  weeks 2 and 3 (P<0.05). BMSCs labeled GFP in hepatic lobules were successively found in the GFP-BMSCs group and the LV-GFP group on the third and 5th day, respectively. The hepatic cells from BMSCs cells in the liver were found in the GFP-BMSCs group and the LV-GFP group at week 4 after operation, but the fluorescence intensity in GFP-BMSCs group was better than that in LV-GFP group.　Conclusion　The BMSCs in GFP rats show the better time-validity of repairing and fluorescence stability than the BMSCs infected by a lentiviral vector carrying GFP in treatment of hepatic ischemia reperfusion injury.

Developmental expression of calcium activated chloride ion channels Anoctamin5 in mouse skeletal muscle

SONG Hai-yan, ZHANG Yi-min, ZHOU Li, TIAN Yue-min, FU Sheng-qi

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  318-321.  doi:10.13418/j.issn.1001-165x.2016.03.017

Abstract ( 385 )  

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Objective　To study the possible role of the calcium dependent Anoctamin5 chloride ion channels in the process of skeletal muscle development.　Methods　RT-PCR was used to detect Anoctamin5 mRNA expression in skeletal muscle of different development periods in mice, and immunofluorescence and Western blot methods was used to detect Anoctamin 5 protein expression in different development periods of mice skeletal muscle.　Results　Anoctamin5 mRNA and protein expression in skeletal muscle in mice from 1 day to 6 months, but with the growth of the age, Anoctamin5 mRNA and protein expression underwent a trend of gradual reduction.　Conclusion　Anoctamin5 plays an important role in the development process of skeletal muscle in mice, which may participate in differentiation, proliferation, injury and repair of skeletal muscle. Our foundings are also with consistent with the patient developed symptoms later caused by Anoctamin5 mutations.

Effects of Platelet-rich Fibrin on mandibular distraction osteogenesis and its RANKL expression

FU Ying, DONG Qing-wen, WANG Zhi-ying

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  322-325.  doi:10.13418/j.issn.1001-165x.2016.03.018

Abstract ( 498 )  

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Objective　To investigate the effects of PRF on mandibular distraction osteogenesis and the expression of RANKL in the period of distraction osteogenesis, in order to provide a reference for its clinical research and application.　Methods　unilateral mandibular osteotomies were performed in 20 mature rabbits, the mandibles of 20 rabbits were lengthened by 4 mm using a distractor , PRF were implanted in the osteotomy side of mandibles. Another side of the mature rabbit was cut and a distractor was implanted in the mandible as a control group. The animals were killed on 1, 7, 14, 21 and 8 days of consolidation period. The distracted calluses were harvested and processed for histological and immunohistochemistric study of RANKL.　Results　The regenerated bone was found in the distraction gap after mandibular lengthening, and RANKL were co-localized in bone marrow lining cells, osteoblasts and newly embedded osteocytes. The RANKL expression increased on 1 and 14 days.  At the consolidation period of 1 and 14 days there was significant difference between the experiment group and control group(P<0.05). The comparison of positive cells rate and positive area percentage in distracted calluses on the 28th day after the distraction were performed, and the results showed weak RANKL staining in the distracted callus.　Conclusion　PRF could accelerate bone formation of mandibular distraction osteogenesis in rabbit. RANKL may play important roles at the early stage of mandibular distraction.

The researchon rat nerve growth factor in the treatment of tibial fracture nonunion

LIU Yu-tao，HUANG Chao-tong，CHEN Long-fu， HU Wang-shan，LI Yu-hui，LIN Fang-zhu

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  326-330.  doi:10.13418/j.issn.1001-165x.2016.03.019

Abstract ( 528 )  

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Objective　To study therapeutic effect of rat nerve growth factor (NGF) on rabbit tibial nonunion treatment and provide a reference for its clinical application.　Method　40 healthy adult male New Zealand white rabbits underwent establishment of transverse fracture nonunion model about 3~5 cm under the right tibial tuberosity，and were divided randomly and equally into the experimental group and the control group：the experimental group received injection of NGF at the fracture site once a week for 12 weeks; the control group received injection of normal saline at the fracture site once a week for 12 weeks. Both groups received X-ray and histological observation in the same time to observe callus growth and bone healing during the experiment.　Results　In the experimental group, callus appeared in (2.0±0.5) weeks, the fracture line became blurred in (8.2±1.2) weeks, and bone healed in (12±1.7) weeks; in the control group, callus appeared in more than 8 weeks, no fracture line became blurred or bone healed. Fracture healing in the experimental group was much better than that in the control group. According to the statistics processing,the difference had statistical significance(P<0.05). 　Conclusion　NGF has a strong promotion of bone nonunion callus growth and healing, and its broad application prospect in the clinical treatment of nonunion might be viewed.

Finite element analyses of unilateral and bilateral pedicle screw fixation plus interbody fusion in lumbar spine

WANG Peng， WANG Jian， HU Yong， CHENG Hai-feng， JIAO Pei-feng， ZHANG Mei-chao

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  331-337.  doi:10.13418/j.issn.1001-165x.2016.03.020

Abstract ( 568 )  

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Objective　To analyze biomechanical characteristics of pedicle screws and lumbar under different pressure loads between unilateral and bilateral pedicle screw fixation plus interbody fusion after discectomy by creating a normal L4~5 spinal segment finite element model.　Methods　A three-dimensional finite element model was created by using CT sectional images of an intact L4~5 segment of a healthy male and then model A and model B were established. Model A was unilateral pedicle screw fixation plus interbody fusion after lumbar discectomy, and model B was bilateral pedicle screw fixation plus interbody fusion after lumbar discectomy. The lumbar variation, the changes of lumbar stress and the apex stress of pedicle screw under flexion, extension, left/right lateral bending and left/right rotation were observed in the two models.　Results　The maximum displacement and stress of pedicle screws in model A reached max under the operating models of fixed-side flexion，and the maximum stress of lumbar reached max under extension. While in model B the maximum displacement reached max under extension,and the maximum stress of screws and lumbar reached max under rotation. There was significant difference between model A and B under fixed-side flexion and extension. 　Conclusion　Compared with bilateral and unilateral fixation plus fusion, the possible potential risk of instability, screw loosening and metal breakage of unilateral fixation plus fusion was greatly increased. The movement of extension, fixed-side flexion and rotation should be reduced before bone union after unilateral fixation plus fusion.

Impact of graft height on zygapophyseal joint pressure and range of motion adjacent to segment following cervical anterior fusion

LUO Chun-shan, OUYANG Bei-ping, LIANG Dong-zhu, LU Ting-sheng, YAO Shu-dan, ZHAO Guo-quan

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  338-342.  doi:10.13418/j.issn.1001-165x.2016.03.021

Abstract ( 745 )  

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Objective　To discuss impact of graft height on zygapophyseal joint pressure and range of motion of adjacent segments following the cervical anterior fusion and to guide the choice of optimal graft height in clinic.　Methods　Eight fresh-frozen human cadaveric cervical spines were used in this series, specimens were tested in five conditions, normal(specimens with intact discs)and different graft height(120％,140％,160％of mean height) after Smith-Robinson discectomy between the fifth and sixth cervical vertebrae.Each specimens were subjected to flexion-extension. Lateral bending and axial rotation in material test system(BOSE ELECTROFORCE) were adopted to measure zygapophyseal joint pressure and rotation of the fourth to fifth segments and the sixth to seventh segments. Finally, The data for each state was used to determine the statistical significance of differences.　Results　The height of bone graft had little effect on the zygapophysial joints pressure values in neutral position with no statistical significance noted among each groups(P>0.05); The zygapophysial joints pressure value was the highest increase in extension position,but 120%M increased minimum of zygapophysial joints pressure value, and statistical significance were noted among each groups（P<0.05); the zygapophysial joints pressure value increased in various degrees under flexion and rotation positions, and statistical significance were noted among each groups（P<0.05）; but 120%M  increased minimum of zygapophysial joints pressure value.The range of motion at the upper and lower adjacent segments were not significantly changed between 120%M and complete condition (P>0.05), and statistical significance were noted in others groups（P<0.05）;The range of motion at the upper and lower adjacent segment  were not significantly changed among each groups (P>0.05).　Conclusion　The appropriate graft height after single discectomy may be 120％mean height.

Correlation between patellofemoral morphology and chondromalacia patellae

JIA Meng-yan，SHI Zhan-jun，XIAO Jun，YANG De-sheng，HUANG Zhi-fa

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  343-347.  doi:10.13418/j.issn.1001-165x.2016.03.022

Abstract ( 790 )  

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Objective　To measure the morphological parameters of patellofemoral joint on MRI and analyze the etiological correlation between patellofemoral morphology and chondromalacia patellae (CP).　Methods　371 adult patients undergoing MRI examination were enrolled and those diagnosed with CP were included in the CP group（n=124）and others in the control group（n=247）. Prevalence rates of CP were recalculated and grouped according to gender. The lateral patellofemoral angle, sulcus angle, trochlear depth and lateral trochlear inclination angle were measured in the MRI images on axial slices. The CP group was further divided into a mild and severe CP subgroup according to the degree of cartilage damage. The difference of patellofemoral morphology parameters among the CP group and control group, CP group (mild) and CP group (severe) were compared and the relationships among patella tilt, trochlear dysplasia and CP were further analyzed.　Results　The prevalence rate of CP was 33.42%, of which 49.35%was in women  and  22.12%was in men. Significant differences in the lateral patellofemoral angle (P=0.00), sulcus angle (P=0.00), trochlear depth (P=0.00) and lateral trochlear inclination angle (P=0.02)  could be found in the CP group and control group. However, there were no significant differences between patients in mild CP group and severe CP group in the lateral patellofemoral angle, sulcus angle, trochlear depth and lateral trochlear inclination angle（all P>0.25）. Considered gender or not, patellar tilt and trochlear dysplasia were significant correlated with chondromalacia patellae（P=0.00）.　Conclusion　Patellar tilt and trochlear dysplasia are significantly correlated with CP but not the degree of CP.

Application of right bronchial occluder in thoracic operation of single lung ventilation

CHEN Jie-yuan，YANG Wei，WANG-Gang，LI Wen-cheng

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  348-351.  doi:10.13418/j.issn.1001-165x.2016.03.023

Abstract ( 753 )  

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Objective　To evaluate the safety and feasibility of the application of bronchial occluder in the right lobe one-lung ventilation in thoracic surgery.　Methods　From July 2012 to August 2013, 36 consecutive patients who need the right lobe one-lung ventilation in thoracic surgery were enrolled and were randomly divided into two groups: group A and group B, 18 cases in each group. The traditional double lumen bronchial method was used in group A and the bronchial occluder was used in group B intubation time. Changes of vital signsbefore and after intubation,the qualityof lung collapse during operation, pH, arterial partial pressure of CO2, partial pressure of oxygen and airway pressure Paw were recorded 20 min, 40 min,and 60 min after intubation or one-lung ventilation. The number of patients with hypoxia in the operation and postoperative complications in each group were also recorded.　Results　The airway pressure in group B was significantly lower than that in group A, and the number of patients with postoperative complications such as hypoxia and postoperative hoarseness was significantly lower (P<0.05).　Conclusion　Bronchialoccluder method could solve intraoperative blood oxygen desaturation caused by the double lumen endobronchial malalignment, and airway irritation was mild. Consequently，it is a safe and effective method for single lung ventilation in the right lobe one-lung ventilation in thoracic surgery.

The anatomy of umbilical vein and clinical application

SHI Qing, GUO Wu-hua

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  352-354.  doi:10.13418/j.issn.1001-165x.2016.03.024

Abstract ( 907 )  

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Development of anatomical structure of the thoracolumbar fascia

ZHU Wei-kai1, SUI Hong-jin2, FU Yuan-shan2, YU Sheng-bo2,WANG Cheng-ming1，SHEN Hui1

Chinese Journal Of Clinical Anatomy. 2016, 34(3):  355-358.  doi:10.13418/j.issn.1001-165x.2016.03.025

Abstract ( 738 )  

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