Table of Content

25 May 2018 Volume 36 Issue 3

  

Anatomical localization of nerve entry points and intramuscular nerve distribution patterns in the human obliquus externus abdominis

ZHU Guang-qiong, LI Shou-tian，HE Bing，YANG Fang-jiu

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  241-244.  doi:10.13418/j.issn.1001-165x.2018.03.001

Abstract ( 812 )  

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Objective　To locate the nerve entry points to human obliquus externus abdominis and to observe the intramuscular nerve staining to provide morphological data for clinical application.　Methods　The nerve entry points to the muscles were located in 11 adult cadavers and Sihler’s staining technique was applied in  5 adult cadavers.    Results    The obliquus externus abdominis was innervated by the lateral muscular branches of the inferior 8 pairs of intercostal nerves. The nerve entry point to each extended muscle fiber was (1.54 ± 0.33) cm from the midpoint at where the corresponding fiber arose, and was located at the connecting line from the junction between the midclavicular line and the lower margin of the 5th rib to the junction between the posterior axillary line and the lower margin of the 11th rib cage. Sihler’s staining showed that the lateral muscular branches of the intercostal nerves innervating obliquus externus abdominis gave off small branches to the 1/3 beginning of each extended muscular fiber, and then divided into an upper branch and a lower branch, innervating the middle  third of  the serrated origin of each muscle. These 2 nerve branches branched out in the middle third of each fiber, with the upper and lower branches of two adjacent fibers anastomosed, forming a “U” shape at each mid-distal fiber, where small branches were distributed to the 1/3 of the end of each fiber. In the upper half of the external oblique muscle, the nerve branches supplied the corresponding fiber, whereas in the lower half, the distal part of upper fiber was supplied by the nerve branch (upper branch) of next fiber at the lower portion.    Conclusion   ①This study can provide clinical guidance for local anesthesia over the upper abdomen and nerve block for postoperative incisional pain; ②A “wavy” dense area with nerve branches is formed at mid-distal part of the obliquus externus abdominis from the top down; ③It is recommended that the abdominal surgical incision should not cross more than four extended muscular fibers.

Anatomical study on the distribution of deep neurovascular structures associated with pain in the dorsal side of the wrist

WANG Hong-bin, SUN Feng-gang, CHEN Guo-yong, WANG Hui, AN Shu-hong, DUN Ai-she

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  245-247.  doi:10.13418/j.issn.1001-165x.2018.03.002

Abstract ( 1146 )  

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　Objective　The origin, course and distribution of deep neurovascular structures in the dorsal side of the wrist were dissected to explore the relationship between neurovascular injury and wrist dorsal pain, and to provide anatomical basis for clinical diagnosis and treatment of wrist dorsal pain.　Methods　Under the head-mounted magnifying glass, the origin, couse and distribution of deep neurovascular structures in the dorsal side of 10 cadavers were studied on 20 sides of the upper limbs, and the relevant data were measured.　Results　The deep dorsal nerve of the wrist derived from the terminal branch of the posterior interosseous nerve, traveled through the fourth osseofibrous tunnel, and then distributed to the dorsal side of the wrist. The artery  derived from the terminal branch of the anterior interosseous artery. The anterior interosseous artery went through the anterior interosseous membrane of the arm to the back of the forearm. the terminal branch divided into the radial and ulnar branch, went through the fourth and fifth osseofibrous canal, respectively and distributed to the dorsal side of the wrist. The radial branch was associated with the posterior interosseous nerve endings in the fourth osseofibrous canal. The ulnar branch passed alone through the fifth osseofibrous canal.    Conclusion　It is of great significance to prevent, diagnose and treat pain of dorsal wrist by having a thorough understanding of the anatomy of deep neurovascular structures in dorsal aspect of the wrist.

Applied anatomy for transiliac screws: adjacent vessels and nerves in the pelvis

SHENG Wei-chao, GAO Yan-zheng，ZHONG Shi-zhen

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  248-251.  doi:10.13418/j.issn.1001-165x.2018.03.003

Abstract ( 809 )  

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Objective　To observe the location of the pelvic vessels and nerves on the pelvic sides, measure the vertical distance from vessels and nerves to pelvic sides to  give a light on the surgical procedures.　Methods　In accordance with the rules and regulations of the university, we used 12 embalmed cadaveric pelvises (6 male, 6 female) without any gross structural abnormalities to guarantee the conformity among anatomic measurement. All specimens underwent simulated surgery in the ventral decubitus. K-wire was drilled from the posterior superior iliac spine to the anterior inferior iliac spine and the spatial relation can be observed between the wire and the vessels and nerves. At last, the dangerous region on the pelvic wall can be located while the wire was drilled.　Results　The dangerous region was located on the lateral wall of pelvic and inguinal region. The K-wire may stick into acetabulum if the drilling angle is smaller. On the other hand, the obturator artery, obturator nerve and deep iliac circumflex artery will be injured while the drilling angle was larger or the screw is longer.　Conclusions　The screw can be implanted safely from posterior superior iliac spine to anterior inferior iliac spine with a suitable drilling angel and length. Importantly, the dangerous region is located on the lateral wall of pelvic and inguinal region.

Comparative research of anatomical structures of human thoracic pedicle in different countries

HAN Hua, XIANG Yan, HAN Jia-xu, ZHANG Jian-shui, ZHOU Jin-song, GAO Zheng-chao, LIU Jian-tao

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  252-258.  doi:10.13418/j.issn.1001-165x.2018.03.004

Abstract ( 655 )  

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Objective　To compare the similarities and differences of human thoracic pedicle anatomical structures in different countries by literature review, and to provide a theoretical basis for the selection of pedicle screws in thoracic surgery and improve the operation success rate and safety.　Methods  To retrieve the related literature at home and abroad in CNKI, Pubmed, Web of knowledge and other database with the key words named "thoracic", "pedicle", "anatomy" and "measured", language limited to English or Chinese. Excluding the non-conforming literature, the remaining literature was divided into groups according to the origin of the experimental objects, and then the anatomical parameters of human thoracic vertebral pedicle in different countries were compared.　Results　A total of 20 articles were included after screening. The minimum value of pedicle height (PDH) was located at T1, and the maximum value was at T11 or T12, and the PDH varied relatively little at the middle levels of thoracic spine. In different countries, the pedicle width (PDW) decreased firstly and then increased from T1 to T12 and the minimum value was at T4 or T5. Although there were some differences in the numerical value of the pedicle horizontal (TPDA）angle in different countries, all of them were decreasing from T1 to T10.　Conclusions　The anatomical parameters of human thoracic vertebral pedicles in different countries show a similar trend with the change of vertebral body sequence, but there are some differences in anatomical parameters. Familiarity with the above anatomical differences is the key to improve the success rate and safety of surgery.

A primary imaging study on quantitative measurement of the supra-acetabular screw safe fixation zone

TAN Shan, GAO Shi-chang, ZHANG An-wei, CHEN Jian-fei

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  259-263.  doi:10.13418/j.issn.1001-165x.2018.03.005

Abstract ( 636 )  

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Objective　To investigate the entry point location and orientation of the supra-acetabular screw as well as its safe corridor size.     Methods    100 (male 50, female 50) CT data of pelvis were collected from our hospital. The three-dimensional model of supra-acetabular corridor (oriented from the anterior inferior iliac spine (AIIS) to posterior superior iliac spine (PSIS) was reconstructed by Mimics software. On the horizontal scan, the screw was placed along the two midpoints of the anterior and posterior narrowing in the corridor, and the relevant parameters of safe corridor were measured from inferior to superior at an interval layer thickness of 2.5 mm. On the middle layer, the orientations of the central virtual screws were measured and the position relation between the entry point and the center apex of AIIS was determined. The safe fixation zone was measured by moving the tip of the screw on the horizontal and sagittal planes.   Results　There were two narrowing in the supra-acetabular corridor. From inferior to superior, the width of the anterior narrowing had the characteristic of narrow-wide-narrow and the posterior narrowing became wider and wider. The width for safe fixation corridor from inferior to superior had the feature of narrow-wide-narrow. The width of the corridor on the middle layer was (10.61±2.10) mm for male and (8.44±2.03) mm for female (t=7.413，P<0.001). On the middle layer, the distances from the entry point to anterior narrowing, greater sciatic notch and posterior narrowing were about 50 mm, 70 mm and 100 mm, respectively. The whole length of the corridor was about 130 mm. The inward inclination angle was (29.50±4.05) degrees for male and (28.00±3.78) degrees for female (t=2.709, P=0.007), and the virtual screw had a safe rang about 5 degrees. The cranial inclination angle was (29.40±5.38) degrees for male and (28.57±6.01) degrees for female (t=1.025, P=0.306), and the safe rang was about 10 degrees. 97% of the entry points were located on the lateral area of the AIIS, and 71% in the lateral-inferior quadrant.   Conclusion    The entry point of the supra-acetabular screw are located on the lateral area of the AIIS. The inward and cranial inclination angles are both about 30 degrees.

Imaging study of the intersection area of right principal bronchus and right upper lobe bronchus based on MSCT

LI Lei, HAN Xin-wei, CAO Jing, WANG Su-ya, HUA Cheng-fei, KANG Tai

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  264-267.  doi:10.13418/j.issn.1001-165x.2018.03.006

Abstract ( 655 )  

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Objective　To explore and measure the dimensions of the intersection area of right principal bronchus and right upper lobe bronchus in normal adults and to analyze the correlation between the diameters of right principal bronchus, right upper lobe bronchus and intermediate bronchus. Methods The MSCT images of 300 healthy adult males and 300 healthy adult females were analyzed and measured, respectively. We used multiplanar reconstruction technique to measure the diameter, length, cross-sectional area and included angle of the right principal bronchus, right upper lobe bronchus and intermediate bronchus, and analyzed the correlation between them.　Results　The correlation between the long diameters of the right principal bronchus (Z), the right upper lobe bronchus (X), and the intermediate bronchus (Y) of male and female was Z=0.379X+0.955Y-0.691 (r=0.763, P<0.05) and Z=0.386X+0.358Y+6.340（r=0.745,P<0.05）, respectively.　Conclusion　The diameters of the right principal bronchus, the right upper lobe bronchus and intermediate bronchus have a high correlation. Correlation equation can provide a reference for accurate measurement and estimation the intersection area of the dismeter of the right principal bronchus and right upper lobe bronchus.

The application of Dyna CT with Embolization Guidance technology on the prostate gland artery embolization

LI Meng, CHEN Jian, SHU Shu-miao, GAO Wei, SI Tong-guo, XING Wen-ge

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  268-271.  doi:10.13418/j.issn.1001-165x.2018.03.007

Abstract ( 434 )  

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Objective　To investigate the application of Dyna CT and Embolization Guidance technology in prostate artery embolism.　Methods　The data of 38 patients who underwent prostatic artery embolism were collected, in which images of digital subtraction angiography were acquired by SIEMENS Artis Zeego vascular examination. Dyna CT technology was applied to confirm the prostate arteries and the other collateral arteries, and Embolization Guidance was applied for the safety of prostate artery embolism.   Results   38 patients underwent prostate artery embolism by two high-seniority physicians. Dyna CT combined with DSA confirmed the prostate artery in 65 sides, with a ratio of 85.5% (65/76). Among them, bilateral prostate arteries were confirmed in 24 patients, and unilateral prostate arteries in 10 patients. 38 prostate arteries originated from the iliac artery, 11 from the obturator artery, 9 from the inferior bladder artery, 5 from the internal pudendal artery, and 2 from inferior rectal artery. Using Embolization Guidance technique, embolization was completed in 58 prostate arteries (89.2%, 58/65), in which 24 cases with complete bilateral embolism, 10 cases with complete unilateral embolism, 4 cases were failed because of vascular tortuosity.　Conclusion   Combined Dyna CT and Embolization Guidance technique can accurately confirm the origination of prostate arteries, and contribute to prostate artery embolization.

One case of iliac vessel variation

SU Bao-ke, WANG Jian-zhong, XU Yang-yang, FENG Hui-mei, WANG Hai-yan, LI Xiao-he

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  271.  doi:10.13418/j.issn.1001-165x.2018.03.028

Abstract ( 465 )  

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Effect of neonatal endotoxemia on ovary development of rats

QU Li-hua, HU Jue, YANG Hong-xia, QIN Jia-jun, LI Yue, LI Mei-xiang, MO Zhong-cheng, SHI Jin-feng，HUANG Yuan-zhen

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  272-276.  doi:10.13418/j.issn.1001-165x.2018.03.008

Abstract ( 261 )  

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Objective　To investigate the effects of endotoxemia in neonatal rats on ovarian development.　Methods　A total of 60 neonatal Sprague-Dawley female rats were used in this study. The litters were randomly divided into either LPS-treated or saline control groups. These rats were administered 75 μg/kg LPS or an equivolume of non-pyrogenic saline via subcutaneous injection on alternate day from postnatal days 4 to 12. All the rats were then fed conventionally and their body weight, the day of vaginal opening (dVO), the day of first vaginal estrus and estrous (sexual) cycle were monitored dynamically. The rats were sacrificed on postnatal day(PND)14，dVO and PND77, respectively after the weight was measured. bilateral ovaries were harvested and weighted for calculation of organic coefficient. Histological changes of ovaries were observed by means of conventional paraffin sectioning.　Results 　① LPS-treated rats exhibited a decrease in the weight of body and ovary, and a significant delay in both the day of vaginal opening and the day of first vaginal estrus. ②LPS treatment could cause vasocongestion and angiectasis, interstitial edema in the ovaries of female rats in the immediate term，and contributed to a decrease in normal follicles, an increased in atretic follicles and prolonged estrous cycle in the late period.　Conclusion　Neonatal endotoxemia may affect the growth and development of female rats, and result in a delayed puberty, sexual cycle disorder and a decreased follicular reserve in female rats.

Conductive and elastic cryogel for enhancing the proliferation of C2C12 cell

HUANG Shi-jia，WU Wei-le，CHEN Xiao-xing，WANG Le-yu，LIU Cheng-long

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  277-281.  doi:10.13418/j.issn.1001-165x.2018.03.009

Abstract ( 551 )  

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Objective　In this study, the mussle-inspired polypyrrole (Ppy)-methacrylated gelatin (GelMA) cryogel（DOPA-base Ppy-GelMA） was investigated as a scaffold to enhance the proliferation of C2C12 cell.　Methods　The material structure and cell adhesion were investigated by scanning electron microscopy. The influence of cryogel on C2C12 cells was confirmed by live/dead staining, CCK-8 test and Ki-67 immunofluorescence staining.　Result　The Ppy-GelMA cryogel had the uniform and interconnected porous structure. Interestingly, myoblasts in Ppy-GelMA cryogel were oriented aligned. Both the GelMA cryogel and the Ppy-GelMA cryogel were suitable for the attachment and spread of C2C12 myoblasts, while the cell viability in Ppy-GelMA hcryogel was significantly better than that in GelMA cryogel. Furthermore, the Ki67 positive myoblasts rate in Ppy-GelMA cryogel was significantly better than that in GelMA cryogel.   Conclusion　This Ppy-GelMA cryogel can enhance the proliferation of C2C12 myoblasts.

Effect of SETD4 on LPS-induced IL-6 transcription in AML12 cells

SUN Jiang, LI Yue, NIU Shi-xian, HUANG Meng-yi, ZHONG Yu-yun, ZHAO Shu-qi, LUO Hai-hua, JIANG Yong, LIU Jing-hua

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  282-287.  doi:10.13418/j.issn.1001-165x.2018.03.013

Abstract ( 485 )  

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Objective　To explore the effect of SETD4 (SET-domain containing protein 4) in IL-6 transcription in AML12 cells (murine hepatocyte line) stimulated with LPS.　Methods　Recombination plasmids encoding SETD4 or IL-6 promoter luciferase were constructed and cotransfected into AML12 cells. After LPS stimulation, the luciferase activity of IL-6 promoter was detected by Dual-luciferase reporter assay system. The LPS-induced IL-6 mRNA in AML12 cells with SEDT4 over-expression was also measured. Results　The plasmids of pcDNA3.0/HA-SETD4 and pGL3.0/IL-6 promoter were constructed successfully, evidenced by double restriction enzyme digestion identification and DNA sequencing. The results showed that SETD4 have no effect on luciferase activity when IL-6 promoter luciferase plasmid and SETD4 plasmid were cotransfected into the AML12 cells following LPS stimulation. Over-expression of SETD4 could up-regulate the LPS-induced IL-6 mRNA transcription in AML12 cells.　Conclusion　SETD4 expression plasmid and IL-6 promoter luciferase plasmid were constructed successfully. SETD4 may play a positive effect on LPS-induced IL-6 transcription in AML12 cells.

Expression of IL-6 and PRL in breast cancer tissue and its clinical significance

GAO Yan-xin，SUN Jing-bo，DENG Yun-yao，LIU Li-xin，LIU Xiao-long

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  288-293.  doi:10.13418/j.issn.1001-165x.2018.03.010

Abstract ( 634 )  

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Objective　To investigate the expression of interleukin-6 (IL-6) and prolactin (PRL) in breast invasive ductal carcinoma (BIDC) and its clinical significance.   Method　Immunohistochemistry was used to detect the expression of IL-6 and PRL in 63 cases of breast cancer and its paraneoplastic tissues and 17 cases of breast fibroadenoma. The clinical pathological parameters and event-free survival were analyzed statistically.   Results　The positive rates of IL-6 and PRL in infiltrating ductal carcinoma were higher than those in adjacent tissues and fibroids (P<0.05). The expressions of IL-6 and PRL in the adjacent tissues were higher than those in paratumor tissues (P<0.05). The expression of IL-6 and PRL were correlated with tumor size and TNM stage (P<0.05). There was a significant positive correlation between IL-6 and PRL expression (rs= 0.842, P<0.05). Event-free survival showed that the event-free survival of patients with high expression of IL-6 and PRL was lower than that of patients with low expression (IL-6, Log- rank= 5.186, P= 0.023; PRL, Log- rank= 5.743, respectively. P= 0.017). The univariate Cox risk model showed that lymph node metastasis, high TNM stage, positive IL-6 expression, and positive PRL expression all had influence on the event-free survival of patients.  Conclusion　The detection of PRL and IL-6 expression in breast cancer is beneficial to its prognosis diagnosis; Reducing the patient's stress, promoting emotional regulation, improving sleep quality and other factors can, to some extent, reduce the risk of breast cancer, progression and poor prognosis. 

Expression of EphA2 in breast cancer and its relationship with EMT

LI Yan-jiao,ZHANG Ben-si, LI Zhuang, BIAN Si-yuan, YANG Gui, HUANG Yu

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  294-298.  doi:10.13418/j.issn.1001-165x.2018.03.011

Abstract ( 423 )  

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Objective　To study the expression and significance of EphA2 and epithelial mesenchymal transition (EMT) in breast cancer, and to explore the relationship between EphA2 and EMT in the process of invasion and metastasis of breast cancer.　Methods　The expression of EphA2, E-cadherin protein, β-catenin protein and vimentin protein in 110 cases of breast cancer and 30 cases of breast fibroma tissue were detected by immunohistochemical method. The relationship between EphA2, E-cadherin protein, catenin protein, vimentin protein expression was analyzed.　Results　The positive rates of EphA2, E-cadherin, β-catenin and vimentin were 20%, 90%, 26.67%and 13.33%, respectively, in 30 cases of breast fibroma tissue. The positive rates of EphA2, E-cadherin, β-catenin and vimentin were 61.82%, 34.54%, 64.54% and 68.18%, respectively, in 110 cases of breast cancer. The expression of EphA2, the low expression of E-cadherin protein, the expression of β-catenin protein and vimentin protein were significantly correlated with the clinical stage, lymph node metastasis and histological grade (P<0.05). The expression of EphA2 was lower than that of E-cadherin (P<0.05). There was a positive correlation between the expression of β-catenin and vimentin (P<0.05).　Conclusion　EphA2, E-cadherin protein, β-catenin protein and vimentin proteins are associated with invasion and metastasis of breast cancer. EphA2 may promote EMT by regulating the expression of E-cadherin protein, β-catenin protein and vimentin protein, thus playing an important role in the process of invasion and metastasis of breast cancer.

Effect of passive movement on hind limb motor function and skeletal muscle in rats with spinal cord injury

YANG Xuan, LI Xian, ZHANG Peng, LIN Sen, YU Hong-yu

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  299-303.  doi:10.13418/j.issn.1001-165x.2018.03.012

Abstract ( 342 )  

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Objective　To observe the effect of passive motion on the recovery of the motor function of the hind limbs and the improvement of the skeletal muscle atrophy in the rats with spinal cord injury(SCI), and to explore the effect of brain derived neurotrophic factor (BDNF) on the functional recovery of passive motion and the treatment of muscular atrophy.　Methods　36 healthy adult female SD rats were randomly divided into a sham operation group, a control group (no exercise), and a passive exercise group (1 week after injury, passive motion, for 4 weeks). A modified Allen’s method was used to establish the spinal cord injury model. The rats' motor function was detected by the Basso-Beattie-Bresnahan (BBB) behavior score of rats at 1 d, 1, 2, 3, 4, 5 week after SCI. HE staining was used to compare the pathological changes of spinal cord tissue in each group, and the cross section area, diameter and morphology of the gastrocnemius muscle in the hind limbs of the rats were observed. The wet weight of gastrocnemius, weight, and muscle weight / weight were measured. The expression of BDNF in the gastrocnemius muscle was detected by Western blots.   Results　The motor function of passive movement group was significantly higher than the control group (P<0.05). After SCI 5 weeks, the spinal cord tissue of the control group and passive movement group lost normal morphology, the number of neurons were reduced, a large number of cysts were formed in lesion area, but passive movement group were better than the control group when it came to the above mentioned parameters. The gastrocnemius muscle weight, muscle weight / body weight, cross-sectional area and diameter were smaller in the control group. Therefore the passive movement group improved the situation of muscle atrophy (P<0.05). Compared with sham operation group, the expression of BDNF in control group and passive movement group gastrocnemius muscle were increased (P<0.05), and it was higher in gastrocnemius muscle of the passive movement group than that of the control group (P<0.05).　Conclusion　Passive motion might promote the recovery of motor function and improve the atrophy of denervated muscle by increasing BDNF in the gastrocnemius muscle after SCI.

HuR induces bone marrow mesenchymal stem cells into chondrogenic differentiation

LI Yong-jin, WU Hui-mei, LIN Yong-peng, HOU Yu,CHEN Bo-lai

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  304-308.  doi:10.13418/j.issn.1001-165x.2018.03.014

Abstract ( 408 )  

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Objective　To observe the effect of HuR on chondrogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and to explore its mechanism.　Methods　BMSCs were extracted from 4-week-old SD rats. The third generation BMSCs were divided into a HuR group, and a NC group, and were respectively treated with pAdEasy-HuR-GFP virus solution and pAdEasy-GFP virus solution. After intervention, the cells were fixed 14 days after induction, paraffin-embedded and sectioned. Toluidine blue staining, QPCR and IHC detection of XIAP, HuR, Col2a1 expression differences were performed.　Results Toluidine blue staining showed that positive signals of proteoglycan staining by HuR staining were more than NC and cartilage ball diameter was larger than NC. QPCR revealed that cartilage HuR, XIAP was significantly increased, Col2a1 up-regulation was not obvious. Immunohistochemical results showed that XIAP, HuR, Col2a1 gradually increased with the increase of drug-containing serum concentration, XIAP upward trend more obvious, HuR and Col2a1 upregulation is not obvious. QPCR detected cartilage HuR, XIAP was significantly increased, Col2a1 up-regulation is not obvious.　Conclusion　Overexpression of HuR facilitates the differentiation of BMSCs into cartilage, which may be related to the regulation of XIAP transcription after HuR over-expression.

Changes of MCT2 expression in cerebral cortex of rats with acute heart failure

SONG Kai-qin1, KANG Cheng-qiao2, SUN Shan-quan3

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  308-312.  doi:10.13418/j.issn.1001-165x.2018.03.015

Abstract ( 275 )  

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Objective　To observe the changes of monocarboxylate transporters 2( MCT2) expression in the rat cerebral cortex under the stimulation of acute heart failure syndrome, so as to detect the alterations of energy metabolism of the cerebral cortex under the condition of acute heart failure, and to provide experimental basis for the best rescue time of acute heart failure.　Methods　The model was established by intravenous injection of 1.5% pentobarbital sodium.To estimate whether acute heart failure model was successful or not, the left ventricular systolic pressure（LVSP）and increased rate of left ventricular pressure maximum（+dp/dt max）were recorded. Immunohistochemical staining(IHC) and Western blot(WB) were used to explore the alteration of MCT2 expression in rat cerebral cortex. 　Results　Compared with the normal group, the number and the integral optical density（IOD）of MCT2-positive neurons were increased in the cerebral cortex of the acute heart failure model，reaching the highest level on 5 min and declined on 10 min, but still higher than those in the control group (P<0.05).　Conclusion　Our results involved that MCT2 is enhanced under the case of acute heart failure, which might indicate that MCT2 is involved in the process of self-compensation in the absence of cerebral ischemia.

Selective laser melting printing of titanium implants and surface optimization for osseointegration

YAN Ling-ling, ZHENG Li-mei, GAO Jie, YANG Cheng-feng, LI Yan-bing, HUANG Wen-hua

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  313-318.  doi:10.13418/j.issn.1001-165x.2018.03.016

Abstract ( 325 )  

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Objective　To analyze of the selective laser melting(SLM) printing titanium implant specimens' biocompatibility with surface characterization and in vitro cell experiment, to provide theoretical and experimental basis for what the eventual application of 3D printing implant in clinical therapy.　Methods 60 SLM printing titanium implant wafer specimens underwent sandblasting polishing, 5% hydrofluoric acid pickling and then ultrasonic cleaning, and drying in fluid N2. 20 pieces were randomly selected and allocated into group S; The remaining 40 specimens were treated by anodic oxidation (AO) for 30 min, flushed by deionized water, and underwent heat treatment at 500℃ for 3h. 20 pieces  of the remaining 40 were randomly selected and allocated into group SA; 0.1% BMP-2 solution  was prepared as the surface modification solution. Afterwards, the remaining 20 specimens treated by ultrasonic shock were soaked in the solution for 10s and then allocated as group SAB; Field emission scanning electron microscopy (FE-SEM) and atomic force microscope (AFM) were used to observe the surface topography and roughness of each specimen. Contact angle was adopted for measurement of hydrophilicity; Bone marrow mesenchymal stem cells (BMMSCs) were seeded onto the surface of specimens, and gold was sprayed for observation of the adhesion of BMMSC by SEM; CCK-8 was used to detect the proliferation of the BMMSCs at the surface of each group. 　Results　The SEM pictures showed that the specimens in group SA treated by anodic oxidation had a layer of uniform titania nanotubes on the surface, about 100 nm in diameter. The AFM pictures showed that the surface of group S and group SA had similar roughness values of 300 nm. Contact angle measurement showed the surface of specimens group S and group SA had super hydrophilicity, and specimens in untreated group S also had hydrophilicity. The SEM and CCK-8 kit results showed that the adhesion and proliferation of BMMSCs was better in the group SAB than in group SA and group S.　Conclusions　SLM printing implant specimens in the untreated group and treatment group both have high biocompatibility, and processing methods such as anode oxidation and load with BMP-2 can effectively promote the adhesion and proliferation of BMMSCs.

A abnormal tendon of anterior horn of medial meniscus of knee joint: a case report

PU Yong-hua, FENG Ling, ZHONG Guang-ming

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  318.  doi:10.13418/j.issn.1001-165x.2018.03.029

Abstract ( 416 )  

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Biomechanical study on the reconstruction of anterior bundle of ulnar collateral ligament of elbow joint using suture anchor combined with bone tunnel technique

CAI Hui,XU Shi-ming,DENG Zi-wen,HUANG Dong,LIU Xiao-chun,YU Chao-qun

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  319-324.  doi:10.13418/j.issn.1001-165x.2018.03.017

Abstract ( 498 )  

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Objective　To explore the valgus stability of the elbow joint when the anterior bundle of ulnar collateral ligament (UCL) in three states of complete, fracture and reconstruction, and to evaluate the effectiveness of suture anchor combined with bone tunnel technique.    Methods　8 fresh adult upper limb cadavers were adopted to establish samples of the bone-ligament of the elbow joint, and the anterior bundle of UCL of each sample was simulated as three states of intact, fracture and reconstruction, then the biomechanical indexes of the elbow joint at 0°, 30°, 60°, 90°and 120°, including valgus laxity, contact area and pressure in the humeroradial joint. The samples were divided into 3 groups according to the different state of the anterior bundle of UCL: the intact group, the fracture group, and the reconstruction group. There were 8 cases in every group. The data were obtained and statistic analysis was made.　Results　In each group, the biomechanical indexes of each group at 0° were significantly different when those under (P＜0.05）； among the three groups，there was no statistical difference in the biomechanical indexes of each group at 0 °（P＞0.05）, whereas significant difference would be found at the other angles between the intact and fracture groups and the fracture and reconstruction groups（P＜0.05）.    Conclusion　The anterior bundle of UCL is an important structure to maintain the valgus stability of the elbow joint. The elbow joint at the straight position is relatively stable compared with the flexion position. The elbow joint after reconstruction of anterior bundle of UCL using suture anchor combined with bone tunnel technique not only has sufficient stability, but also has the same excellent biomechanical properties as the normal elbow.

Evaluation of the effect of the two kinds of the adjustable neck bracket on the morphological parameters of intervertebral foramen based on 2D/3D registration technique

ZENG Yi-jun，ZHANG Xin-tao，YE Qiang，LI Jian-yi，LI Wen-rui

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  325-328.  doi:10.13418/j.issn.1001-165x.2018.03.018

Abstract ( 462 )  

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Objective　To investigate the effect of the two kinds of the adjustable neck bracket on the morphological parameters of the intervertebral foramen based on 2D/3D registration technique. And compare the two to discuss which kind of neck bracket can better provide traction treatment for patients with cervical spondylosis.　Methods　The 2D/3D registration technique was used to measure the bilateral intervertebral foramen area of C2/3, C3/4, C4/5 and C5/6. The intervertebral foramen area growth rates of different angles were calculated. The d-value of intervertebral foramen area and area growth rate of different angles between the first and the second generation of the neck bracket were statistically compared.　Results　By contrast, the effect of the second generation of the adjustable neck bracket was statistically significant in most cervical vertebrae（P<0.05）. In particular, the C5/6 segment was significant at 4 angles.　Conclusion　The effect of the second generation of the neck bracket in the enlargement of the area of the intervertebral foramen is better than that of the first generation. And the traction therapy for patients with cervical spondylosis is more effectively.

Personalized surgical treatment of kidney stones based on colour 3D printing technology

GUO Wen-bin, GUO Xiao-bin, ZHANG Wan-song, YANG Cheng, BIAN Jun, YANG Jian-kun, LIU Cun-dong

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  329-332.  doi:10.13418/j.issn.1001-165x.2018.03.019

Abstract ( 659 )  

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Objective　To explore the application and clinical significance of colour 3D printing technology in percutaneous nephrolithotomy lithotripsy (PCNL).　Methods　Sixteen renal calculi patients with colour 3D printing were selected randomly as group A. Reverse engineering and color 3D printing were used to reconstruct and produce 1:1 colour 3D models of kidneys, renal vascular and renal calculi. 23 cases of traditional PCNL were selected as B group. The surgical duration, the amount of bleeding, hospitalization length, the complications and the clearance rate of the two groups were observed and compared. The surgeons filled in the model to evaluate the questionnaire, and the patients filled in the questionnaire and scored.   Results　The patients' color 3D stone models were successfully printed. There was no significant difference in age, stone size and casting stone volume between the two groups. The puncture depth of preoperative estimation and actual operative depth of the two groups were as follow: group A (6.5±0.8)cm vs (6.8±1.1)cm (P>0.05); group B:( 6.5±1.5)cm vs (7.6±1.8)cm (P<0.05). The scores of the two groups of physicians were (8.4±0.4), (6.5±0.5) (P<0.05) respectively, and the patients' scores were (9±0.7), (7.2±0.6) (P<0.05). The comparison of the two groups for stone clearance rate, the surgical duration, haemorrhage, hospitalization length, the number of complications were: 81.25% vs 73.91% (P<0.05), (52.27±9.64)min vs (67.39±10.81)min (P<0.05), (55.49±18.16)mL vs (92.92±22.17)mL (P<0.05), (6.48±1.51)d vs (7.32±1.43)d (P>0.05), 1 case vs 3 cases (P<0.05). Those results suggested that the punctures and depth of puncture predicted by the color 3D lithiasis model were basically consistent with the actual operation, with less bleeding, shorter surgical duration and less complications. The surgeons were satisfied with the color 3D printing lithiasis model, and the patients were satisfied with preoperation talk.   Conclusion　Colour 3D printing technology enables urologists to accurately and intuitively understand the status of kidney stones before operation, guides the development of surgical plans and simulates surgical operations. The doctors gain higher accuracy and safety than traditional surgery. Using the colour 3D printed stone model to explain the condition and preoperative conversation can improve the patients' sunderstanding of kidney stones and surgical complications, and help to build a good doctor-patient relationship.

Autogenous morselized bone garft versus autogenous iliac bone graft in the treatment of thoracic and lumbar spinal tuberculosis

LI Jian-xiao, OU Yun-sheng, GAO Yong-jian, ZHAO Zeng-hui, ZHU Yong, DU Xing, CHEN Yan-yang

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  333-337.  doi:10.13418/j.issn.1001-165x.2018.03.020

Abstract ( 398 )  

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Objective　Retrospectively evaluate the clinical outcomes of autogenous morselized bone graft and autogenous iliac bone graft for single-segment thoracic and lumbar spinal tuberculosis.　Methods  Between August 2012 to June 2016,58 cases of thoracic or lumbar spinal tuberculosis were treated by the surgery of interbody bone graft after debridement and fusion combined with posterior instrumentation.31 patients in group A underwent autogenous morselized bone graft and 27 cases in Group B underwent autogenous iliac bone graft. The surgical duration, blood loss, visual analog scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-Reactive protein (CRP), The intervertebral height, segment-kyphotic angle were recorded and compared. The loss of segment kyphotic angle and intervertebral space height，and the bone fusion time on X-ray or CT scanning at the time point of post-operation and follow-ups were recorded and compared.　Results　Final follow-up time ranged from 15 to 38 months，with an average of 26 months. The operation time was 194.2±34.9 min in group A and 240.0±61.5 minutes in group B（P<0.05）. The blood loss was 282.2±130.0 ml in group A and 540.7±276.6 ml in group B（P<0.05）. The bone fusion time was 5.8±1.0 months in group A and 8.3±3.6 months in group B（P<0.05）. Both groups got good kyphosis correction and intervertebral height restoration. The loss of kyphosis correction and intervertebral height in group A were found to be more than those in group B, but with no significant difference between group A and group B (P>0.05).　Conclusions　Based on this retrospective study, autogenous morselized bone graft has a shorter surgical duration, lower blood loss and shorter bone fusion time compared with the autogenous iliac bone graft. The autogenous morselized bone graft is a safe and effective approach in treating single-segment thoracic and lumbar tuberculosis.

Clinical research of diversion colitis in patients after rectal cancer surgery

OUYANG Man-zhao, LIAO Tian-you, WU Jin-hao, ZHANG Wei-jie, LUO Zhen-tao, TANG Li, YAO Xue-qing

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  338-342.  doi:10.13418/j.issn.1001-165x.2018.03.021

Abstract ( 822 )  

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Objective　To investigate the occurrence, clinical symptoms and colonoscopy characteristics of diversion colitis after rectal cancer, so as to improve the clinical understanding of it.  Methods　The clinical symptoms and endoscopic data of 89 cases and 375 cases with or without protective ostomy after rectal cancer surgery were retrospectively analyzed.　Results　In the ostomy group, 30 cases showed the clinical symptoms of diversion colitis, and the incidences of abdominal pain, excreting mucus or mucous bloody stools were14.6%, 23.6% and 12.4% respectively, which were all higher than those without ostomy 2.9% 5.1% and 1.9% respectively (P<0.05). The positive rates of erythema swelling, erosion and ulcers, inflammatory follicular hyperplasia, inflammatory polyps and anastomotic stenosis in ostomy group were 93.3%，29.2%，15.7%，29.2%，15.7% respectively, significantly higher than those without ostomy (14.1%, 7.5%, 0.5%, 6.7% and 4.5% respectively). However, the absolute count of CD3+ (980±475) / μl, CD4+ (550±243) / μl, CD8+ (342±206) / μl, and CD4+ / CD8+ ratio (1.94±1.44) in ostomy group showed no statistical difference when compared with those without ostomy (P>0.05).　Conclusion　Diversion colitis has a high incidence in about 3 months after colorectal diversion. Endoscopy enables early clinical diagnosis of the disease for early symptomatic treatment.

The effect of maxillary sinus septa on osteogenesis after localized management of sinus floor

WANG Qiu-zi, XU Pu,CHEN Zhuo-geng, LU Li-ying

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  343-345.  doi:10.13418/j.issn.1001-165x.2018.03.022

Abstract ( 640 )  

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Objective　To investigate the effect of maxillary sinus septa on osteogenesis after maxillary sinus floor separation.　Methods　7 cases who got maxillary sinus floor separation with maxillary sinus septa (septum group), another 8 cases who got maxillary sinus floor separation without maxillary sinus septa were collected (non-septum group), total 15 cases. The bone height and density were measured by Cone Beam Computed Tomography(CBCT) and Simplant, and the data was statistically analyzed by SPSS19.0.  Results　There was no significant difference between the two groups in the lifting height, the height difference between the apical and root, the height difference of the buccal side, the ratio of the bone density of the apical area to the bone density of the buccal bone（P>0.05）.　Conclusions　The maxillary sinus septa has no significant effect on the osteogenesis after localized management of sinus floor.

Clinical efficacy analysis of 3D printing as assisted therapy for youth Salter-HarrisⅡ distal fracture of radius

ZHAO Jing-xin, MA Ya-chang, ZHU Ya-wen, YANG Zhao-xin, QIU Yu-chen, MIAO Wei, WANG Yu, JIN Yu

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  346-348.  doi:10.13418/j.issn.1001-165x.2018.03.023

Abstract ( 597 )  

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Objective　To investigate the value of 3D printing technology in the treatment of unstable distal radius fractures of children and adolescents with Salter-Harris II type.    Methods    The clinical data of 19 cases with unstable distal radius fractures of Salter-Harris type II with 3D printing technique were retrospectively analyzed. The basic parameters such as operation time and intraoperative blood loss were recorded. The growth of the affected limb, recovery of wrist joint function, and complications after follow-up were recorded. The clinical efficacy was preliminarily evaluated.    Results    The direction, length, and diameter of the needle in the 19 patients were consistent with the preoperative simulation. Operating time was 17~39 min, with an average of 21.6 min; intraoperative blood loss was 0~10 ml, with an average of 4.5 ml; intraoperative fluoroscopy was used 4 to 6 times, with an average of 5 times; anatomical reduction of fractures were achieved in 17 cases, and postoperative fracture displacement less than 2 mm was achieved in 2 cases. All 19 patients were followed up for 12 to 20 months with an average of 14.5 months. All the affected limbs reached bone healing. Postoperative assessment of wrist function was performed using the Gartland-Werley scoring system 12 months after surgery: excellent in 18 cases, and normal in 1 case.    Conclusion    3D printing technology as an auxiliary technique has certain clinical application value for children and adolescents with unstable Salter-Harris type II distal humeral fracture.

Repairing of small-sized soft tissue defect of finger with transverse wrist crease perforator flap

WU Wen-qiang, GUO Jun-guang, LIU Shi-hao, WANG Xu-dong, WANG Wen-gang, LING Su-fang

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  349-351.  doi:10.13418/j.issn.1001-165x.2018.03.024

Abstract ( 609 )  

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Objective　To explore the clinical therapeutic effect of  transverse wrist crease perforator flaps repairing small-sized soft tissues defects of the fingers.　Methods　From January 2016 to June 2017, 11 cases of small-sized soft tissue defects of the fingers, ranging from 1.5cm×3.0cm to 2.0cm×4.0cm,  were treated with transverse wrist crease perforator flaps.　Results　All patients were followed up  about 6 to 12 months, and all of the flaps survived. The flaps possessed soft texture without bulky appearance. The repaired fingers gained satisfactory recovery of both appearance and function. Donor site morbidity was minor, with only linear scar formation. The flexion and extension function of the wrist was not hindered. 　Conclusion　The transverse wrist crease perforator flap has the advantages involving of protecting the main vessel, reliable blood supply, high survival rate and minor donor site morbidity, which is an ideal option for repairing small soft tissue defects in fingers.

Progress on anatomy of the angular artery regarding its clinical application

ZHAO Wei-rui,LUO Sheng-kang

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  352-353.  doi:10.13418/j.issn.1001-165x.2018.03.025

Abstract ( 1206 )  

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Anatomical differences between core region and shell region of human nucleus accumbens and the clinical correlation

QUAN Zi-fang, WU Heng, HE Dong-gang, WEI Nai-li, JIA Yan-fei, ZHANG Yi-nian

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  354-356.  doi:10.13418/j.issn.1001-165x.2018.03.026

Abstract ( 1057 )  

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The role of Notch signaling pathway in Autism spectrum disorders

XIANG Zhe,HE Xue-ling,CUI Wei-gang,ZHANG Ying-hua

Chinese Journal Of Clinical Anatomy. 2018, 36(3):  357-359.  doi:10.13418/j.issn.1001-165x.2018.03.027

Abstract ( 783 )  

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