Table of Content

25 September 2018 Volume 36 Issue 5

  

Microanatomy of A1 segment of anterior cerebral artery and perforating branch of communicating artery complex

ZHANG Guang-hui, WANG Yu-hai

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  481-485.  doi:10.13418/j.issn.1001-165x.2018.05.001

Abstract ( 1288 )  

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Objective　By microanatomy of the anterior communicating artery complex (ACoAC) and its perforation artery, the anatomic basis would be provided to reduce the perforator - related complications of the anterior communicating artery aneurysm (ACoAA).　Methods  15 cadaver heads(30 sides) were selected and fully exposed the A1 segment of the ACA and the ACoAC were performed. The number of perforating arteries, initial external diameter and distribution area were observed and measured under microscope. The A1 segment was divided into 6 regions (A~F area) according to the length. The characteristics of the perforating arteries in the 6 region were observed, to find the best temporary blocking area. 10 cadaver heads were filled with good perfusion of red latex in the arteries. The depth and distribution of the medullary branches of A1 segment and the Heubner returnee artery from the cerebral cortex to the cerebral pulp were observed and measured under the microscope.　Results　The length of the A1 segment of the ACA was （15.13±4.76）mm, from which the number of perforating artery was 244, including 63 in A area (25.82%), 54 in B area(22.13%), 51 in C area (20.90%), 31 in D area (12.70%), 20 in E area (8.20%), and 25 in F area (10.25%). There was no significant difference in the length, the number of perforating arteries and the external diameter of perforating artery between A1 segment and A2 segment of ACA.   Conclusion   Familiarity with the anatomic characteristics of the ACoAC and its perforating artery is the key to reduce or avoid perforating artery injury during operation. The E region of A1 segment can be used as the best temporary blocking area.

One case of levator of the thyroid gland

HUANG Min-chun, ZHAN Chao-ning1, FU Yin-yu, CHEN Ting, HE Shan-li

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  485.  doi:10.13418/j.issn.1001-165x.2018.05.025

Abstract ( 621 )  

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Morphological anatomy and histological assessment of acetabular labrum

ZHONG Ming-jin, QIU Zhi-he，LIANG Da-qiang,LIU Hai-feng,LI Kuo-kuo,OU Yang-kan, ZHU Wei-min,LU Wei,WANG Da-ping

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  486-491.  doi:10.13418/j.issn.1001-165x.2018.05.002

Abstract ( 1426 )  

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Objective  To study the morphological anatomy and histology of human acetabular labrum, and get better understanding of the acetabular labrum in clinic.　 Methods　12 Formalin embalmed and 8 fresh-frozen cadaveric hips were dissected. The width and thickness of labrum were measured based on the clock face method while the increased depth, surface area and volume of the acetabular fossa were measured. The labrum was stained by the H-E, toluidine blue and collagen immunohistochemically to study its histological characteristics.　Results　The acetabular labrum had some cartilage quality. The labrum was widest at the point of 2 clock (7.37±2.72) mm, and got the thickest at 9 clock (6.25±1.60) mm; the labrum increased the depth, surface area and volume of acetabular fossa and the means values were (5.30±0.83) mm, (4.98±0.94) cm2 and (7.69±2.03) ml, respectively. The section of the acetabulum was triangular. The acetabular labrum richly contained fibers, and lots of vascularized connective tissue was on the joint capsule side of the labrum. The transition zone of acetabular labral-chondral complex was between the labrum and hyaline cartilage of acetabulum.　Conclusions　Acetabular labrum is a fibrous tissue ring that covers on the acetabulum rim with cartilage quality, it can increase the depth of the acetabulum and enhance joint stability. The acetabulum labrum is nourished by the well-vascularized joint capsule. Histologically, the acetabular labrum merges with the articular hyaline cartilage of the joint surface of the acetabulum through a transition zone of acetabular labral-chondral complex, and it may render it more prone to damage, which is the anatomical basis for acetabular labrum injury.

Anatomy and clinical significance of the fourth bony fiber tunnel in the posterior wrist region

LI Bin, LIU Bo-wen,LI Jing-yu,ZHUANG Jun-jie,LU Ji-liang,WANG Hong-bin,DUN Ai-she, ZHANG Chun-ju

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  492-494.  doi:10.13418/j.issn.1001-165x.2018.05.003

Abstract ( 957 )  

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Objective　To further improve the anatomic structure of the the fourth bony fiber tunnel in the dorsal side of the wrist, and explore its clinical significance.　Methods　With the help of the head-mounted magnifier, the roof, bottom, entrance and exit, inner and outer walls and contents of the fourth bony fiber tunnel at the area of dorsal wrist from 15 cadavers (30 sides) were dissected, and the relevant data were measured.    Results    The extensor retinaculum constituted the roof of the fourth bony fiber tunnel at the area of dorsal wrist; The base consisted of the deep fascia at the proximal end of the distal limit of the distal joint and the dorsal joint capsule of the wrist joint; The inner and outer side walls were composed of muscular septum extending from extensor retinaculum to deeper; Entry was between the head of ulna and dorsal side of the distal radius, and exit was at the dorsal side of the wrist; 5 tendons, including index finger, middle finger , ring finger, little finger branches of extensor tendons and index finger extensor tendons, 1 vascular nerve bundles, which is terminal branch of the posterior interosseous nerve and terminal branch of the anterior interosseous artery.     Conclusion    The roof, bottom, entrance and exit, inner and outer side walls, the adjacent and the contents and levels of the tunnel were described in detail, which is of great significance for the diagnosis of clinical wrist pain and avoiding iatrogenic injury of the contents of the tunnel.

MRI study of growth and development of fetal cerebellum in the second and third trimester of pregnancy and its relationship with simple posterior fossa pool broadening

LI Guan, XIAO Lian-xiang, JIAN Nan, ZHAO Hui, TIAN Mi-mi, ZHANG Shuai, LIN Xiang-tao

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  495-499.  doi:10.13418/j.issn.1001-165x.2018.05.004

Abstract ( 934 )  

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Objective　To measure the transverse diameter and volume of normal fetal cerebellum by MRI, study its developmental rule with gestational age, and explore its clinical value in the diagnosis of simple posterior fossa pool broadening.　Methods　This study was a prospective study, involving 139 fetuses with normal brains ranging in age from 24 to 38 gestational weeks, fetal brain was performed 1.5T MRI , then we measured the cerebellum transverse diameter (TCD) and volume (CV) by a three-dimensional post-processing workstation (OsiriX software), and analyszed its developmental rule with gestational age; In addition, 45 cases of prenatal ultrasound and magnetic resonance diagnosis were included in the study. The fetus were divided into two groups according to gestational age (group I: 28~32 weeks, 20 cases; group II, 33~38 weeks, 25 cases), simultaneously according to the gestational age, the number of cases matched 45 normal fetus as a control group, quantitative analysis of fetal cerebellar development when the posterior fossa pool was widened.  Results  ①The fetal cerebellar transverse diameter was linearly positively correlated with gestational age. The linear equation was TCD=-1.746+0.182GA（R2=0.953，P<0.05）, the fetal cerebellar volume was exponential-dependent with gestational age, and the curve equation was CV=0.072exp(0.151GA)（R2=0.957，P<0.05)；②The analysis of the widened fetus in the posterior fossa pool compared with the normal fetus：In group I, there was no significant difference in the diameter and volume of fetal cerebellum between the study group and the control group（both P>0.05）；In group II, there was no significant difference in the transverse diameter and volume of fetal cerebellum between the study group and the control group (both P>0.05).　Conclusions　The transverse diameter and volume of the normal fetal cerebellum increased linearly and exponentially with the gestational age in the second and third trimester of pregnancy. This result is helpful to evaluate the degree of fetal cerebellum development. There is no significant correlation between the fetal posterior fossa pool broadening and the cerebellar transverse diameter and volume. This helps to re-recognize the clinical significance of the posterior fossa pool broadening.

Exploring the clinical correlation between tightness of cruciate ligaments and injury of patellofemoral joint surfaces through MRI

LIANG Jie,ZHUANG Ning, HUANG Shi-jia, WEN Si-ni, HE Xiao-en, LU Wei-zhi, LIU Cheng-long

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  500-506.  doi:10.13418/j.issn.1001-165x.2018.05.005

Abstract ( 619 )  

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Objective　To explore the correlation between tightness of cruciate ligaments and injury of patellofemoral joint surfaces, and provide new guidances for the prevention,diagnosis and cure for the diseases of patellofemoral articular surfaces by analyzing the influence of anatomical differences in the length of individual's cruciate ligaments on the injury of patellofemoral articular surfaces.　Methods　A（length of anterior cruciate ligament）, B（length of posterior cruciate ligament）, La（attachment distance of anterior cruciate ligament）and Lb（attachment distance of posterior cruciate ligament）were measured on the sagittal plane from MRI data of 110 knees from 100 patients in Zhujiang Hospital of Southern Medical University between October 2016 to December 2017, and then figured out the value of M which represented tightness of cruciate ligaments; the degree of injury of patellofemoral joint surfaces which were graded 0, I, II, III and IV were evaluated from sagittal and coronal plane, and were classified as 5 groups respectively. Data were analyzed with the methods of One-Way ANOVA and Spearman correlation analysis to explore the correlation between tightness of cruciate ligaments and injury of patellofemoral joint surfaces by SPSS20.0 statistical software.　Results　The M values which were obtained from One-Way ANOVA analysis of variance showed a significant difference between any two groups (P<0.05). Spearman correlation analysis suggested a positive correlation between M value and injury of patellofemoral joint surfaces.　Conclusion　The tightness of the cruciate ligaments has positive correlation with the injury of patellofemoral joint surfaces. The greater the M value is, the more severe the injury of patellofemoral joint surface is.

Analysis of pharynx MRI in stroke patients with and without obstructive sleep apnea

WU Qi, ZHANG Li-xia, ZHANG Qian, LU Gan, YUAN Yong, WANG Tong

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  507-513.  doi:10.13418/j.issn.1001-165x.2018.05.006

Abstract ( 508 )  

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Objective　 Based on stroke patients with and without Obstructive Sleep Apnea (OSA) with pharyngeal morphological comparison, to understand the relationship of pharyngeal anatomy and OSA in stroke patients.　Methods　Patients within 30 days of stroke underwent nocturnal polysomnography, were divided into two groups based on whether had OSA or not. 3.0 weighted magnetic resonance imaging (MRI) performed for clinical purposes was used to measure retropalatal distance, soft palatal length, soft palatal thickness, retroglossal space, and tongue length, lateral pharyngeal wall thickness，high retropharyngeal area, low retropharyngeal area, minimum retropharyngeal area. The pharyngeal measured data of two groups were compared. Pearson correlation analysis was conducted between the retropalatal distance and other measurement indexes of pharyngeal, AHI, sub-water test score, age, course of disease, BMI and neck circumference in OSA patients with stroke. A receiver operating characteristic curve (ROC) was plotted and the area under it was calculated to assess the ability of retropalatal distance to discriminate OSA status.  Results　The retropalatal distance of stoke OSA patients was shorter than that of the compared group（P=0.002）.The retropalatal distance of stoke OSA patients was related with retroglossal space （R=0.502, P=0.017）. The sub-water test score of OSA patients with stroke was higher than that of non-OSA patients (P=0.049). The retropalatal distance of stoke OSA patients was related with AHI（R=-0.873, P=0.000）. The area under the ROC curve for retropalatal distance as a predictor of presence or absence of OSA was 0.888, which indicated moderate discrimination between groups.　Conclusion　The morphological changes of pharynx are associated with OSA in stroke patients. The retropalatal distance has certain diagnostic value for OSA in stroke patients, and the retropalatal distance is related to the severity of OSA in stroke patients. OSA patients with stroke have higher sub-water test score than non-OSA patients, and OSA in stroke patients may be related to dysphagia.

Effect of Carnosine on oxidative stress and NF-κB signaling pathway in hippocampus of diabetic rats

ZHAO Dan-ting, LIU Ying, ZHAO Yan, LU Mei-li, YANG Wen-qiang, HE Xin，YANG Jing

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  514-519.  doi:10.13418/j.issn.1001-165x.2018.05.007

Abstract ( 574 )  

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Objective     To investigate the effect of Carnosine (CAR) on cognitive function and oxidative stress and NF-κB signaling pathway in diabetic rats.   Methods    Fifty male SD rats, except the normal group (n=8), were given high fat and sugar diet, and intraperitioneal injection of STZ to establish type Ⅱ diabetes rats. The rats were randomly divided into the diabetic model group and Carnosine groups with different doses (100, 300 and 900 mg/kg). All drugs were administrated for 56 days.  The behavior tests were performed on the Morris water maze method. HE stain were used to observe the pathological changes of the hippocampus. The activity of SOD and the content of MDA in the hippocampus were detected by  respective commercial kits. The content of GSH and carnosine in hippocampus tissue were detected by HPLC. Western Blot were used to detect the expression of TNF-α, IL-1β in cytoplasm and NF-κB p65 in nucleus.   Results    Compared with diabetic group, Carnosine groups improved significantly learning and memory ability and the morphology of hippocampal neuronal cell in diabetic rats, enhanced the activity of SOD, the content of GSH and carnosine in the hippocampus of diabetic rats, inhibited the content of MDA, which, at the same time, reduced significantly the nuclear transfer of NF-κB with the nucleus of hippocampus in diabetic rats and down-regulated the expression of downstream inflammatory cytokines TNF-α and IL-1β.   Conclusion    Carnosine may prevent cognitive dysfunction in DM rats. The mechanism may be in connection with its function that it can inhibit oxidative stress, reduce NF-κB translocating into the nucleus and the expression of TNF-α and IL-1β.

The protective effect of diosmetin on non-alcoholic fatty liver disease of young rats

ZHENG Fang-fang, GUO Xin-ming, ZHONG Bei-long, JIANG Xiao-yun

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  520-526.  doi:10.13418/j.issn.1001-165x.2018.05.008

Abstract ( 294 )  

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Objective　To explore the effect of diosmetin on non-alcoholic fatty liver disease of young rats induced by high-fat diet.　Methods　The rats models of non-alcoholic fatty liver disease were induced by high-fat diet. The levels of serum lipid and inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). The pathological changes and apoptosis of liver tissues were observed by hematoxylin- eosin (HE) staining and terminal deoxynucleotidyl transferase- mediated dUTP nick labeling (TUNEL). The levels of p-AMPKα1, AMPKα1, CPT-1, PPAR-α, SREBP-1c, FAS, p-P38, P38, p-AKT, AKT, p-AKT, AKT were tested by western blot.　Results　Compared with control group, the levels of TC, TG, LDL-c in high fat diet group were increased with declined levels of HDL-c (P<0.01). Compared with high fat diet group, the levels of TC, TG, LDL-c in diosmetin (10, 20, 50 mg/kg) groups were reduced with enhanced levels of HDL-c (P<0.01). The high fat diet-induced pathological changes of liver tissues were reliefed by diosmetin. The apoptosis of liver tissues in high fat diet group was higher than that of control group (P<0.01). The apoptosis of liver tissues in diosmetin (10, 20, 50 mg/kg) groups was lower than that of high fat diet group (P<0.01). The levels of p-AMPKα1, CPT-1 and PPAR-α in high fat diet group were lower than that of control group (P<0.01). Compared with high fat diet group, the levels of p-AMPKα1, CPT-1 and PPAR-α in diosmetin (20, 50 mg/kg) groups were elevated (P<0.01). The levels of SREBP-1c and FAS in high fat diet group were higher than that of control group (P<0.01). Compared with high fat diet group, the levels of SREBP-1c and FAS in diosmetin (10, 20, 50 mg/kg) groups were decreased (P<0.01). Moreover, the levels of IL-6, IL-1β and TNF-α in high fat diet group were higher than that of control group (P<0.01). Compared with high fat diet group, the levels of IL-6, IL-1β and TNF-α in diosmetin (20, 50 mg/kg) groups were reduced (P<0.01). In addition, the inhibitory effect of compound C on AMPK pathway was reversed by diosmetin.   Conclusion  Diosmetin alleviates the abnormal lipid metabolism, pathological changes of liver tissues, apoptosis and inflammatory response in high-fat diet-induced non-alcoholic fatty liver disease rats by activating AMPK pathway.

The effect of elevated shear stress on collateral vessel growth of aged rats

DONG Li-ping,LIU Guang-min, WANG Jia-jie, CAI Wei-jun

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  527-531.  doi:10.13418/j.issn.1001-165x.2018.05.009

Abstract ( 390 )  

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Objective　To investigate the effect of elevated shear stress on collateral vessel growth of aged rats by comparing the model induced by femoral artery ligation with femoral arteriovenous anastomosis and collateral vessel growth model with simple femoral artery ligation.　Methods　30 aged (24 months) rats were divided into sham group, ligation group and arteriovenous anastomosis group. The rats in the ligation group underwent femoral artery ligation, and the rats in the anastomosis group were subjected to femoral artery ligation and femoral arteriovenous anastomosis. The animals survived for 1 week after surgery. 5 rats in each group were taken to isolate the muscle with collateral vessels of the hindlimb for immunohistochemical for detecting expression of eNOS, Ki67 and MMP2; the other 5 rats were used for angiography, after which X-ray photography was performed to observe the growth of collateral vessels.  Results　Compared with the sham operated group, the number of collateral vessels increased in the ligation group (P<0.01), the number of Ki67-positive cells increased (P<0.01), and so as the expression of eNOS (P<0.001) and MMP2 (P<0.05). Compared with the ligation group, the number of collateral vessels in femoral artery ligation with femoral arteriovenous anastomosis group was increased（P<0.01）, the number of Ki67-positive cells increased significantly (P<0.01), which was the same with the expression of eNOS (P<0.001) and MMP2 (P<0.01).　Conclusion　Elevated shear stress can promote the growth of collateral vessels in the ischemic hindlimb of aged rats.

The effect of reduced glutathione on the ROS-mediated NETosis by neutrophils from patients with systemic lupus erythematosus

LIAO Pan，HE Yi，YANG Fang-yuan，ZHUANG Jian，LUO Gui-hu，ZHAI Ze-qing，SUN Er-wei

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  532-535.  doi:10.13418/j.issn.1001-165x.2018.05.010

Abstract ( 1182 )  

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Objective　Evidence has demonstrated that the formation of neutrophil extracellular traps (NETs) formation mediated by neutrophil plays an important role in the pathogenesis and progression of systemic lupus erythematosus (SLE). In this study, we aimed to investigate whether reduced glutathione (GSH) could decrease the level of intracellular reactive oxygen species (ROS) or inhibit NETs formation.  Methods　Neutrophils were isolated from peripheral blood of SLE patients by gradient centrifugation method dextran sedimentation and centrifugation, and then were stimulated with phorbol 12-myristate 13-acetate (PMA). The production of intracellular ROS and the formation of NETs were examined.   Results   Compared with the PMA group treated with PMA, the group preprocessing with GSH could markedly suppress formation of NET by neutrophils from SLE patients. Moreover, the production of intracellular ROS production was significantly decreased in GSH-treated neutrophils from SLE patients. Conclusion　GSH can significantly inhibit the process of neutrophils' NETosis from SLE patients through modulating the intracellular ROS production. These results indicates that GSH might be a potential therapeutic agent for SLE.

Up-regulation of electroacupuncture on the expression of neuroglobin in rats with septic encephalopathy

ZHENG Shu-ming， LIN Xin-feng

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  536-540.  doi:10.13418/j.issn.1001-165x.2018.05.011

Abstract ( 542 )  

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Objective    To observe and investigate the expression of neuroglobin (Ngb) in rats with septic encephalopathy and the effect of electroacupuncture at Baihui and Shuigou acupoints on the expression of neuroglobin (Ngb) in rats with septic encephalopathy.    Methods    In this study, a rat model of sepsis encephalopathy was established by observing neurobehavioral changes in rats with sepsis successfully established by CLP. The rats were divided into sham operation group, septic brain disease group and septic brain disease + electroacupuncture treatment group. Electroacupuncture for Baihui, Shuigou points along the skin prick into 2 mm were performed, and the other electrode was caught in the right ear tip of the rats. Density wave frequency was 2 Hz/15 Hz, current intensity was 1mA, and the rat’s right ear microfibrillation were taken as a sign of effective electroacupuncture stimulation. Treatment was performed 30 minutes after per 12 hours. The two groups lasted 24 h and 72 h respectively. The brain tissue of rats was obtained, Ngb was detected by immunohistochemistry at 24 h and 72 h, and expression of Ngb protein level was detected by Western blot, Ngb mRNA gene was detected by RealTime PCR.    Results     Compared with the sham-operated group, the expression of Ngb protein was significantly up-regulated in the 24-hour septic-encephalopathy group and the 72-hour group (P<0.01); the expression of Ngb protein was significantly increased in the 24-hour septic-encephalopathy group and the 24-hour non-electroacupuncture group (P<0.01); electro-acupuncture intervention 72 h septic brain disease group and non-electroacupuncture intervention 72 h group, Ngb protein expression was slightly down (P <0.01).    Conclusion    The expression of Ngb is up-regulated in septicencephalopathy, which means that electroacupuncture intervention has a therapeutic effect on septic brain disease, and it is most obvious at 24 hours. It shows that electroacupuncture is effective for the treatment of septic encephalopathy in time, mainly by up-regulating the expression of Ngb.

Intravitreal injection of estradiol to alleviate posterior vitreous detachment in rats

BAI Yue, ZHENG Ming, XU Guo-xing

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  541-544.  doi:10.13418/j.issn.1001-165x.2018.05.012

Abstract ( 406 )  

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Objective　To discuss the efficacy and safety of estradiol in relieving the posterior vitreous detachment（PVD）.　Methods　Forty-eight male Sprague-Dawley rats were randomly divided into group A (control), group B (balance salt solution, 2 μL), group C (plasmin，3 μg/2 μL) and group D (plasmin 3 μg + estradiol 10-6 mol/L, 2 μL), with 12 rats in each group. The eyeballs were selected 7 days after intravitreal injection, flash electroretinography (F-ERG)、pathological section、immunofluorescence staining and western blot were used to observe and evaluate morphologic and functional change of the retina，the effect of PVD and  the expression of opticin protein in vitreous body and retina among the groups.　Results　The morphology of retina in each group was complete. F-ERG showed no toxicity changes in any group. No PVD was found in group A and group B. All the eyes were induced complete PVD in group C. The partial PVD were observed in eight eyes of group D, PVD was not found in the rest four of the eyes in group D. The expression of opticin protein was the lowest in group C, and higher in group D compared with group C, the differences were statistically significant (P<0.05). 　Conclusion　Estradiol injection in the vitreous cavity has the capacity of restoration in rat’s posterior vitreous detachment.

Effects of ShaoYangShengGuFang Prescription on the distribution of 18F-NaF in rat tibial fracture bone

GUO Xiao-guang, GUAN Tai-yuan, ZHANG Lei, FU Shi-jie, ZHOU Xin, LIU Gang, CHEN Yue

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  545-550.  doi:10.13418/j.issn.1001-165x.2018.05.013

Abstract ( 342 )  

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Objective　To explore the application value of 18F-NaF in evaluation of early fracture healing, and the effects of ShaoYangShengGuFang Prescription on rat fracture healing.　Methods　72 SD rats were performed left tibial fracture modeling. The model rats were randomly divided into experimental group (intragastric administration of ShaoYangShengGuFang Prescription)，control group (intragastric administration of Ossotide Tablets) and blank group (intragastric administration of 0.9% saline). Every group included 24 rats. After 7, 15, 30, and 56 days, 6 rats were randomly selected from each of the three groups. The PET/CT scan was performed on the fractured ends of tibial fractures, and the uptake of 18F-NaF at the fracture end was calculated.　Results　The 18F-NaF uptake of experimental group and control group reached their peaks at the 15th day (9.00±0.42 %ID/g、8.10±0.71 %ID/g), while the 18F-NaF uptake of blank group reached its peak at the 30th day (4.25±0.35 %ID/g). At four different time points, there was no significant difference between the uptake of the experimental group and that of the control group in the 18F-NaF uptake of rat tibial fracture bone (P>0.05), while the 18F-NaF uptake of the experimental group or the control group was higher than that of the blank group, which was of remarkable statistical difference (P<0.05). Conclution　18F-NaF has some values in evaluating early fracture healing, and ShaoYangShengGuFang Prescription can promote the healing of tibial fractures in rats.

3D-model and finite element analysis: study of human coronary artery

MA Yan-Shan,XIE Ying-Hua,REN Guo-Shan,ZHANG Zhi-Kun

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  551-556.  doi:10.13418/j.issn.1001-165x.2018.05.014

Abstract ( 1002 )  

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Objective　To investigate the hemodynamic characteristics of different degrees of stenosis in coronary artery under pulsating flow, which was performed with the help of accurate anatomical 3D models about coronary arteries having different degrees of stenosis, the models was established with CCTA data from living body. The contrast of hemodynamic parameters is obtained at different observation points; the contrast and changes of hemodynamic parameters and its influence on AS were also obtained.　Methods  Selecting cases from typical coronary stenosis ones, and then the CCTA data was obtained by  using the multiplies spiral CT. After that, FEM Models about coronary stenosis were estabilished with the software. At last the calculation and analysis were performed and the results were output in a variety of intuitive graphical forms.　Results　The flow velocity of the coronary artery stenosis accelerated, while it slowed down at the area behind the narrow and the eddy current was produced. This kind of change can have a great effect on plaques. Conclusion　The change of velocity played an important role in the development of AS, it can accurate the growth of atherosclerotic plaque and affect the stability.

Finite element analysis of the effect of acetabular cup horizontal displacement on the stress distribution in cementless femoral prosthesis-bone interface in total hip arthroplasty

QIU Wei-hua，LI Jian-yi，LIN Li-jun

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  557-564.  doi:10.13418/j.issn.1001-165x.2018.05.015

Abstract ( 495 )  

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Objective　Using the three dimensional finite element analysis, the effect of acetabular cup horizontal displacement on the stress distribution in cementless femoral prosthesis-bone interface in total hip arthroplasty was studied.　Methods　Pelvis and femur of a normal human were scanned by sprial CT. Using the computer simulation technology, the three-dimensional model of the pelvis and femur was reconstructed, after which the total hip arthroplasty in the model was simulated. The horizontal position of the acetabular cup varied from -10 mm to +10 mm，compared to hip joint center, which was divided into 11 consecutive experimental groups averagely, each group was 2 mm in width. When a simulated load was applied, the Von Mises stress distribution in cementless femoral prosthesis-bone interface was observed and analyzed.　Results　The distribution pattern of the Von Mises stress in femur did not change with the horizontal displacement of acetabular cup. The stress mean of each group varied from (4.728±2.152)MPa to (5.431±2.465)MPa. The difference of mean was statistically significant. The mean, range and standard deviation of stress decreased with cup medialization, which showed that they were highly negatively correlated. The changes of stress in proximal prosthesis stem-bone interface were similar to those in the whole femoral prosthesis-bone interface.　Conclusion　The horizontal ingression of prosthesis decreases the stress in cementless femoral prosthesis-bone interface, and makes the stress more well-distributed as well.

Application of the distal ulnar perforator minitype flap with anastomosed sensory nerve to repair the full pulp defect

WU Jian-long, XIE Qing-ping, TANG Lin-feng, JU Ji-hui

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  565-568.  doi:10.13418/j.issn.1001-165x.2018.05.016

Abstract ( 564 )  

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Objective　To introduce the surgical effect of free transplantation of distal ulnar perforator minitype flap with sensory nerve to repair finger pulp soft tissue defect.　Methods　From April 2006 to February 2012 in our hospital, 32 patients, including 34 fingers, with finger pulp soft tissue defect were repaired by free transplantation of forearm distal perforator flap with sensory nerve. The area of skin flaps differed from1.5 cm×2.0 cm to 3.0 cm×4.5 cm.　Results　1 case had partial necrosis of distal flap after operation, and the scabs healed after dressing change. The remaining 31 cases all survived. Except for 5 cases of grafted skin for survival, the remaining donor sites were directly sutured, and healed well without obvious scar contracture. Follow-up ranged from 6 to 36 months with an average of 16 months, and the shape and function of the fingers were restored satisfactorily. The outcomes were graded as excellent in 26 cases, good in 5 cases, and fair in 1 case according to the functional assessment criteria for upper extremities issued by the Hand Society of the Chinese Medical Association. Achieving a 96.8% good and excellent rate. Two-point discrimination of the flaps was 6 to 12 mm.　Conclusion　The forearm distal ulnar perforator has constant perforating point, which carry sensory nerves to repair finger pulp defects. The texture of the skin flap is close to the affected area, the shape of finger recoverd well, the flap sensation recovery is good. The distal ulnar perforator minitype flap with sensory nerve is one of the effective surgical procedures to repair the defect of finger pulp.

Microsurgical resection of lumbar intraspinal cysts through unilateral hemilaminectomy approach using percutaneous tubular retractor system

YU Bo-fei,XU Jie, ZHENG Wu, XIAO Yu-hua, LIN Yuan, TIAN Jian-ping

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  569-573.  doi:10.13418/j.issn.1001-165x.2018.05.017

Abstract ( 669 )  

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Objective 　To investigate the clinical effect of using percutaneous tubular retractor system on microsurgical resection of lumbar intraspinal cysts via unilateral hemilaminectomy.　Methods　We performed a retrospective analysis of the clinical data of 13 patients with lumbar intraspinal cysts treated via a unilateral hemilaminectomy approach using percutaneous tubular retractor system from June 2014 to January 2018, including synovial cyst (n=5), ganglion cyst (n=3), meningeal cyst (n=3) and epithelioid cyst (n=2). Clinical outcomes were assessed using the visual analog scale (VAS) and the Japanese Orthopedic Association (JOA) scale. Computed tomography (CT) three-dimensional reconstruction of lumbar vertebrae was performed l week postoperatively, MRI plain scan and enhanced scan of lumbar vertebrae were conducted during  the follow-up period.   Results　Mean operative time was 119.2 min (ranging from 74 to 200 min). Mean blood loss during surgery was approximately 61.5 mL (ranging from 40 to 105 mL). The mean duration of hospital stay was 6.7 days (ranging from 5 to 10 days). Patients were followed-up for a period of between 4 months and 47 months, with a mean follow-up time of 23.8 months.  Complete resection was achieved in all patients without nerve root injury or cerebrospinal fluid leakage. Postoperative scores of VAS and JOA improved significantly versus preoperative ones(P<0.05). No postoperative spinal instability was identified by CT three-dimensional reconstruction of lumbar vertebrae, and no evidence of recurrence or secondary spinal deformity was observed in any patients during the postoperative follow-up period.　Conclusion　Unilateral hemilaminectomy approach using percutaneous tubular retractor system can be used to treat lumbar intraspinal cysts, such surgical procedures have characteristics of less trauma, faster recovery, reliable clinical effect and good postoperative spinal stability, which is worth of clinical promotion.

The clinical effect of arthroscopic assisted reconstruction with three in one methodology on the treatment of patellar fixation dislocation

SONG Wei-yi，WU Yu-feng，LIN Xiao-hang，HUANG Zi-qi

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  574-577.  doi:10.13418/j.issn.1001-165x.2018.05.018

Abstract ( 316 )  

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Objective　To investigate the clinical effect of arthroscopy assisted reconstruction of medial patellofemoral ligament (MPFL), lateral retinaculum with Y-shaped release, and femoral medial muscle formation on the treatment of patellar fixation dislocation.　Methods　10 patients  with 12 knees were treated with patellar fixation dislocation from January 2014 to January 2017 were retrospectively reviewed, including 6 males with 8 knees and 4 females with 4 knees. The age was from 4 to 9 years (mean 6.6 years). All patients underwent arthroscopy assisted reconstruction of the medial patellofemoral ligament (MPFL) with allogeneic ligaments, Y-shaped dissection of the lateral retinaculum, combined with femoral medial muscle formation in the treatment of patellar fixation dislocation. Postoperative follow-up was performed to assess knee functional recovery based on patellar stability and Kujala score. Degree and Kujala score were applied to assess functional recovery of knee joint.　Results　10 patients were followed up for 6 to 18 months (mean follow - up of 12 months). The Kujala score increased from (42.12±14.37) to (95.68±9.42), the difference was statistically significant (P<0.05).　Conclusion　The use of allograft ligament in the reconstruction of medial patellofemoral ligament (MPFL), lateral retinaculum with Y-shaped release, combined with femoral medial muscle formation treatment of children with patellar fixation dislocation clinical efficacy is satisfactory, and can effectively improve patellar stability, the knee function, and the epiphyseal is not damaged, which is an effective treatment of children with patellar fixation dislocation of the surgical method.

Short-medium outcomes of the head-acetabularplasty efficacy in the treatment of femoroacetabular impingement (FAI) with hip arthroscopy

LI Jie, LI Fei-long, FENG Wen-jun, ZENG Jian-chun, CHEN Jin-lun, ZENG Yi-rong

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  578-581.  doi:10.13418/j.issn.1001-165x.2018.05.019

Abstract ( 374 )  

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Objective　To investigate the head-acetabularplasty efficacy in the treatment of femoroacetabular impingement (FAI) with hip arthroscopy.　Methods　A total of 30 patients (30 hips) who were diagnosed as FAI between January 2012 and December 2016 FAI were retrospectively reviewed , which consisted of 19 men and 11 women at an average of 34.91 years old (ranging from 22 years old to 50 years old). According the types of impingement, there were three types among them, which include 18 cases of Cam, 6 cases of Pincer and 6 cases of both. Clinical outcomes were assessed through the Harris Hip Score (HHS) of per-and post-operation and postoperative follow-ups were also performed.　Results　All patients were followed up completely, the mean follow-up time in the arthroscopy group were 43.2 months (ranging from 34 months to 51 months). The preoperative HHS was (65.7±6.3), which was improved to (74.5±6.0), (79.2±6.1), (82.5±6.1) and (83.1±8.2) 3 months, 6 months, 12 months after the surgery and final follow-up, respectively. All the postoperative improvements were of statistical significance (P <0.05). No major complications occurred during perioperative period and follow-up, and no cases converted to total hip arthroplasty.　Conclusions　The hip arthroscopy procedure shows advantages of minimal invasion with certain efficacy of relieving pain, improving hip function and modified OA progression aimed to delay THA surgeries. Thus, we recommend that mini-invasive hip arthroscopy surgery might be an optimal procedure in treating FAI.

Diagnosis and surgical treatment of multiple disruptions of superior shoulder suspensory complex

XIANG Jie, YANG Zhi-jun, ZHANG Hao-wei, HUANG Ji-feng

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  582-585.  doi:10.13418/j.issn.1001-165x.2018.05.020

Abstract ( 928 )  

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Objective　The purpose of this study is to demonstrate diagnosis and treatment of patients with multiple disruptions of superior shoulder suspensory complex (SSSC).　Methods　Between 2012 and 2016, we treated 15 patients with multiple disruptions of the SSSC, which were diagnosed according to the theory of two columns and single rings. All patients had more than two lesions to the SSSC and were treated by double fixation of superior shoulder suspensory complex.　Results 　All the patients were followed up for 6 to 48 months﹙16 months on average﹚. According to Herscovici shoulder scale, the shoulder function was excellent in 8 cases, good in 4 cases, fair in 3 cases, poor in 1 cases, which means excellent and good rate was 80%. Final pain was reported as minimal (6 cases; 1-3 VAS), moderate (1 case; 4-6 VAS), and high (1 case; 7-10VAS).　Conclusions 　The restoration of the stability and integrity of superior shoulder suspensory complex is the key to achieve satisfactory outcome.

Four hepatic arteries and the variation of the origin and course of cystic arteries：one case report 

ZHANG Jia-ang,DONG Man,YIN Chu-fan,ZHANG Da,BO Zhi-hao,FENG Chen,MA Hui-hui

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  585.  doi:10.13418/j.issn.1001-165x.2018.05.026

Abstract ( 512 )  

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High expression of transmembrane protein 81 is bad for prognosis of breast cancer patients

ZHANG Hu, DU Xin-na, ZHUANG Ying, SUN Hai-yan, FAN Wei-ping, ZHAO Xiao-fang

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  586-589.  doi:10.13418/j.issn.1001-165x.2018.05.021

Abstract ( 538 )  

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Objective　To investigate the expression of transmembrane protein 81 (TMEM81) in breast cancer and its correlation with the prognosis of breast cancer.   Methods　The cBioPortal, UALCAN, and the cancer multi-omics and clinical database LinkedOmics were used to analyze changes of TMEM81 gene in breast cancer and its relationship with clinical prognosis. 　Results　Analysis by cBioPortal showed that TMEM81 gene was changed in 26% invasive breast cancer patients including mutation, copy number alteration and mRNA up-regulation, in which 18% patients’ TMEM81 mRNA level was higher than default threshold (EXP≥2). Besides, up-regulation of TMEM81 mRNA was bad for prognosis (P<0.05).   Results  From UALCAN showed that level of TMEM81 mRNA increased significantly in invasive breast cancer tissues compared with normal breast tissues (P<0.01). Results from LinkedOmics showed that TMEM81 expression was significantly affected by PAM50, ER, PR, pathologic stage, pathology T stage, histological type, race and age respectively (P<0.01, P<0.01, P<0.01, P<0.01,P<0.01, P<0.05, P<0.01, P<0.05). TMEM81 mRNA level was positively correlated with its gene copy-number alteration (P<0.01), and was negatively correlated with its DNA methylation (P<0.01).   Conclusion　The alteration of gene copy number and the level of DNA methylation promote the expression of TMEM81 , the higher level of its mRNA is, the worse it is for prognosis, beyond that TMEM81 could become a candidate marker for prognosis of breast cancer.

The anatomical basis and clinical application on sensory reconstruction of the sural neurocutaneous vascular flap

LAI Bai-an，YANG Sheng-bo

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  590-592.  doi:10.13418/j.issn.1001-165x.2018.05.022

Abstract ( 538 )  

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Application of the chitosan nerve catheter combined with schwann cell bridge in repairing the peripheral nerve defects

JI Lin-lin, WEI Zai-rong

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  593-595.  doi:10.13418/j.issn.1001-165x.2018.05.023

Abstract ( 481 )  

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The progress on study of injury mechanism of brachial plexus root avulsion

WANG Yu, WANG Wen-sheng，CHEN Long-ju

Chinese Journal Of Clinical Anatomy. 2018, 36(5):  596-599.  doi:10.13418/j.issn.1001-165x.2018.05.024

Abstract ( 373 )  

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