Table of Content

25 January 2019 Volume 37 Issue 1

  

Clinical application of triangular anatomy and area of cavernous sinus

ZHANG Wen-yi，GAO Feng, YI Zhi-qiang, LIU Ai-xian

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  1-4.  doi:10.13418/j.issn.1001-165x.2019.01.001

Abstract ( 1151 )  

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Objective　To observe the variations, and the relations between the cranial nerves travelling through the cavernous sinus by measuring the regions of the selected triangles of the cavernous sinus in order to provide anatomic data for microsurgical operation in cavernous sinus.　Methods　12 cases of adult cadaver heads were used to dissect, observe and measure the sizes of 8 selected triangles under the microscope.　Results　The selected cavernous sinus triangles included the Dolenc triangle, the oculomotor triangle, the supratrochlear triangle, the Parkinson triangle, the Mullen triangle, the anteriolateral triangle, the Kawase triangle and the Glasscock triangle. The sizes of the triangles were 77.75 mm2, 82.73 mm2, 45.00 mm2, 83.40 mm2, 66.38 mm2, 51.28 mm2, 121.65 mm2, and 161.67 mm2.　Conclusion　The area of the cavernous sinus triangle is the only route area of the neurosurgery cranial base surgery, and it is the operation range that can be referred in the surgery. Due to the variation of partial nerve and bone structure, it can lead to the reduction of partial triangular area and affect the operation. The measurement data of each triangle area can be used as a reference for the selection of surgical approach in clinical practice, and provide data support in the practice of virtual reality technology.

Localization of blocking targets based on intramuscular nerve distribution of the iliopsoas and quadratus lumborum muscle spasticity

ZHAO Hong-ming, YANG Xian, YANG Sheng-bo

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  5-8.  doi:10.13418/j.issn.1001-165x.2019.01.002

Abstract ( 1842 )  

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Objective　 To localize the blocking targets for botulinum toxin A injection in iliopsoas and quadratus lumborum muscles by exploring the intramuscular nerve distribution pattern.　Methods  Iliopsoas and quadratus lumborum muscles of 12 adult cadavers were collected from both sides. Modified Sihler's staining was used to reveal intramuscular nerve distribution.　Results　The innervation of the iliopsoas and quadratus lumborum originated from the branches of T12 and L1~L4 spinal nerves. There was a nerve branch dense region in the upper 1/2 of psoas major muscle. It was located about (12.1±0.65)%~(43.2±1.17)% of muscle length with a central point at （23.90±0.82）% of muscle length corresponding medially to the middle of L3 vertebral body. There was a broad bean-shaped nerve dense region parallel to the iliac crest in the center of the iliacus muscle. The central point of this region was at （58.0±1.61）% of iliopsoas muscle length corresponding laterally to iliac tubercle. There was an intramuscular nerve dense region in the superomedial 1/3 and inferior 1/3 of the quadratus lumborum muscle respectively, each having a central point medially corresponding to the lower part of the L1 and L3 vertebral bodies.　Conclusion　The localization study of these intramuscular nerve dense regions and centers of the iliopsoas and quadratus lumborum muscle can allow the clinician to inject BTX-A close to its site of action.

A modified nailing approach of INFIX and its application in the treatment of pelvic fracture

ZHOU Chun-kui1， ZENG Fei1， HUANG Hua-jian， LAI Zhong-ming， LI Ze-yu, LI Song-jian1ZHOU Chun-kui， ZENG Fei， HUANG Hua-jian， LAI Zhong-ming， LI Ze-yu, LI Song-jian

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  9-13.  doi:10.13418/j.issn.1001-165x.2019.01.003

Abstract ( 1011 )  

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Objective　To explore the feasibility of INFIX nailing into the space between sartorius and iliopsoas muscle, and to evaluate its clinical efficacy and complications.　Methods 　The distance from the medial and lateral margins of sartorius to the lateral femoral cutaneous nerve and femoral nerve were measured on gross specimens, and the differences among groups were compared with t-test. Then, the clinical data of 14 pelvic fracture patients treated with INFIX were collected from Zhujiang Hospital of Southern Medical University from August 2016 to December 2018. Evaluation of clinical efficacy depended on the pelvic deformity index (PDI) and the width of pubic symphysis, as well as the weighting time, the time to remove internal fixation and the Majeed score after INFIX. Complications included the injury to lateral femoral cutaneous nerve (LFCN), the injury to femoral nerve, and so on.　Results　Compared to the lateral margin of sartorius, the distance from medial margin to LFCN increased 7.71 mm (P<0.01), and to the femoral nerve still remained 22.36 mm. After INFIX, the PDI decreased 1.82%(P<0.01), the width of pubic symphysis decreased 6.98 mm (P<0.05), the average weighting time was 12.70 week, the time to remove internal fixation was 29.50 week, and the Majeed score was 90.80. There was no injury of LFCN and the femoral nerve, 2 patients had incisional infection, and 1 patient had subjective discomfort.    Conclusion    The INFIX nailing into the space between sartorius and iliopsoas muscle can reduce the risk of injury to LFCN, and does not interfere with the femoral nerve. It has several advantages for anterior pelvic ring fracture including minimal invasion, good curative effect, and few complications.

Observation of CT imaging anatomy of normal sacroiliac joint space in adults and its clinical significance

ZHANG Shao-qun, FENG Zi-yu, CHEN Yan-ping, ZHANG Lei, QI Ji, LI Yi-kai

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  14-19.  doi:10.13418/j.issn.1001-165x.2019.01.004

Abstract ( 1887 )  

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Objective　To observe the anatomical characteristics in the CT appearance of normal sacroiliac joint (SIJ) space in adults, and to provide statistics for imaging diagnosis in sacroiliac joint subluxation.　Methods　The statistical analysis of CT images of normal sacroiliac joint space was performed in 56 patients, with no pathologic change in sacroiliac joint, to observe: ① sex difference of SIJ space in same position; ② difference of SIJ space in 6 transverse levels correlated to sacrum levels; ③ difference of SIJ space among anterior, middle and posterior area in transverse plane; ④ difference of SIJ space between left and right in the transverse plane.　Results　 ① Sex difference of SIJ space in LP area of S2-1 and S2-2 was statistically significant (P<0.05); ②Difference of SIJ space among anterior, middle and posterior area in the same side of each transverse level (from S1-1 to S3-2) was all statistically significant (P<0.05); ③In RA area, SIJ space in S1-1 was wider than S1-2, S2-1, S2-2 and S3-2, respectively (P<0.05); 4) In LM area, SIJ space in S2-1 was wider than S1-1, S1-2, S2-2 and S3-2, respectively (P<0.05); ④ In RM area, SIJ space in S2-1 was wider than S3-2 and S3-2, respectively (P<0.05); ⑥ In LP area, SIJ space in S2-1 was wider than S3-2 (P<0.05); ⑦ In RP area, SIJ space in S2-2 is wider than S3-2 (P<0.05).    Conclusions    This analysis offers a reference for imaging anatomy of normal sacroiliac joint space in adults. There are imaging anatomic differences in adult’s normal sacroiliac joint space on transverse and coronal plane.

The marginal curvature of the posterolateral tibial plateau: imaging study and clinical significance

YAO Xi-zhou, ZHANG Shi-min, HU Sun-jun, DU Shou-chao, MA Zhuo

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  20-24.  doi:10.13418/j.issn.1001-165x.2019.01.005

Abstract ( 793 )  

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Objective　To measure the angles and length of the curve on posterolateral tibial plateau, and to provide theoretical basis for the clinical plate shaping and the design of new horizontal plate.　Methods　CT data of fifty adult knees were collected (male 31, female 19, mean age 37.68±12.76). Then five points were marked A, B, C, D and E on the edge of posterolateral tibial plateau on the axial CT image when the fibular tip first appeared. The length and angles between each point were measured to provide clinical information on plate length and bending angles.　Results　The average length of the posterolateral tibial plateau curve was（44.04±11.33）mm (19.50~75.50 mm), and the average turning angles were (163.36±7.67) °,(127.95±20.85) ° and (160.50±11.99) °, from anterior to posterior. Clinically five cases were applied with this anatomic measurement, and the postoperative CT showed that the plate and plateau matched completely and contacted closely. 　Conclusion　Obtaining the marginal curve parameter can facilitate intra-operative bending of horizontal belt plate and design of new types of the anatomical plate to increase compatibility with the shape of the posterolateral tibial plateau.

One case of variation in the middle lobe vein of right lung

CHEN Yun，YANG Shao-jun，FU Xue-mei，CAO ZI-xi，XU chao，ZHOU Yu-yan

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  24.  doi:10.13418/j.issn.1001-165x.2019.01.027

Abstract ( 920 )  

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Digital study and code analysis of the left branch of hepatic portal vein 

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  25-29.  doi:10.13418/j.issn.1001-165x.2019.01.006

Abstract ( 827 )  

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Objective　To seek the new classification and research methods of the left hepatic portal vein, and to provide data and reference for the digital anatomic research of the liver.　Methods　Hisense CAS was used to reconstruct the liver vessels on upper abdomen enhanced CT data in 110 cases, and the three-dimensional images of the left branch of the portal vein were accurately displayed. The morphological characteristics and distribution of the left branch of the hepatic portal vein were investigated, and then encoded and statistically analyzed.　Results　According to the characteristics of the left branch of the portal vein, it can be divided into 6 types of codes: type I in 61 cases (55.45%), type II in 29 cases (26.36%) , type III in 13 cases (11.82%), type IV in 4 cases (3.64%), type V in 2 cases (1.82%), type VI in 1 case (0.91%).  Conclusions　Hisense CAS can accurately display the three-dimensional image of the hepatic portal vein, which is convenient for observing intrahepatic ducts. It provides excellent tools for digital anatomic study of hepatic portal vein branching. For large data observation, the coding method is very convenient for statistics analysis.

Correlation between thoracic diameter ratio and male primary spontaneous pneumothorax

LIU Yong, XU Jia-hang, YU Jun-jie, ZHAO Ke, CHEN Bao-jun

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  30-33.  doi:10.13418/j.issn.1001-165x.2019.01.007

Abstract ( 750 )  

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Objective　To investigate the correlation between the ratio of thorax diameter and spontaneous pneumothorax (PSP) in males.　Methods　Forty-four male patients with PSP were admitted in the department of thoracic surgery of the central hospital of Wuhan from July 2017 to June 2018. The control group was 30 healthy men of the same age. CT data of chest were collected, and the lung and thorax were reconstructed with Mimics Medical 20.0 software to calculate the lung height H. The maximum transverse diameter T (maximum distance between the left and right sides of the inner wall of the thorax) and the anterior and posterior diameter D (vertical distance from sternum to spine in the plane) were measured respectively at five planes (plane of first costal cartilage, sternal angle, carina, end of sternum and end of xiphoid). Flat index (FI=T/D), slim index (SI=H/D), height transverse ratio (HTR=H/T) were compared between the two groups. Correlation analysis of pneumothorax occurrence was performed on the values with significant differences, and binary logistic regression analysis was performed on the greatest related factor.　Results　Significant differences were showed in the diameter ratios between the two groups. According to age stratification, SI5 (the plane of the xiphoid end) was the most important risk factors for PSP (R=0.682, R2=0.465, P<0.01). The predictive accuracy of SI5 was 82.40%, OR was 276.49, 95% confidence interval was 21.20~3606.67(P<0.01).　Conclusion　The SI at the end of xiphoid is the most relevant factor for PSP. Compared with the degree of thoracic flatten, the slim degree is more correlated with PSP. Smaller anteroposterior diameter of the xphoid region is probably one of the pathogenic factors.

The role of skin base in perforator-plus flap survival

ZHUANG Jia-zheng, WANG Kai-fang, LIU Min-min, LIN Yi-nan, BAO Wen-zhen, WANG Feng, ZHENG Hai-bo, FANG Fang, ZHUANG Yue-hong

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  34-39.  doi:10.13418/j.issn.1001-165x.2019.01.008

Abstract ( 719 )  

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Objective　To investigate the exact role of a skin pedicle in serving arterial perfusion or venous outflow in flap survival.　Methods　40 male SD rats weighing 300g were used in this study and divided into the following 4 groups after harvesting of a flap with a size of 9×3cm on the back: perforator-complete group (perforator preserved in the pedicle), artery-deficit group (ligation of the perforating artery), vein-deficit group (ligation of the perforating vein), and perforator-deficit group（ligation of the perforator）. A laser Doppler flowmeter was used to monitor the flap perfusion after surgery, and the flap necrosis rate was calculated and the vascular diameter at the skin pedicle was measured at day 7.　Results　The data of the laser Doppler flowmeter indicated a similar perfusion pattern between the perforator-complete group and the vein-deficit group, as well as between the perforator-deficit group and the artery-deficit group. The perfusion in the perforator-complete group and the vein-deficit group was much stronger. The necrosis rate was (26±1) % in the perforator-deficit group, which was not significantly different from the necrosis rate of being (29±1) % in the artery-deficit group, both of which were significantly larger than the necrosis rate being (11±3)% and (12±4)%, respectively, in the perforator-complete group and the vein-deficit group（P<0.001）.　The venous network in the skin base was extremely dilated in the skin base in the vein-deficit and perforator-deficit group, whereas the arterial network was modestly dilated in the artery-deficit and perforator-complete group.  Conclusion　The skin base in the perforator-plus group is more important as an additional route for venous backflow than as an additional arterial input.

A cervical spinal cord hemi-contusion injury model in mice and its histological characterization

HUANG Zhi-ping, LIN Jun-yu, LIU Jun-hao, LI Rong, LIU Ya-pu, LIU Qi, ZHU Qing-an, HUANG Zu-cheng, WU Xiao-liang

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  40-44.  doi:10.13418/j.issn.1001-165x.2019.01.009

Abstract ( 577 )  

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Objective　To develop a hemi-contusive injury mice model of cervical spinal cord injury (SCI) with displacement control, and demonstrate unilateral cord tissue loss.   Methods　Every C57BL/6 mouse was under anesthesia, and the left spinal cord of C5 was exposed. A 0.75-mm-in-diameter cylinder impactor was driven to strike the left of C5 cord 0.9 mm at 50 mm/s by an electromagnetic-servo material testing machine. Spinal cord samples of all mice were harvested 1 week after injury and processed for EC staining for quantitative analysis.   Results　Average contusive displacement, speed and compressive force were (0.880±0.035) mm, (48.146±4.367) mm/s and (0.407±0.129) N respectively. Histological analysis showed that there were hematoma and tissue loss of ipsilateral dorsal funiculus, dorsal horn and partly ventral horns, while contralateral cord were intact. In epicenter, the average percentage of lesion area, spared white and gray matter area accounted for (19±7)%, (88±9)% and (28±4)% respectively.　Conclusions　This study establishes a cervical spinal cord hemi-contusion model in mice which achieves consistent biomechanical parameters, and results in typical ipsilateral spinal cord tissue loss. The present study can provide a SCI model for molecular mechanism and therapeutic research.

The effect on seizure susceptibility, learning, memory and injury of mice hippocampal neurons by disturbing zinc metabolism

LI Xia, LIU Ming-chen, JIA Yu-shan, LV Ming-pu, ZHANG Li

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  45-50.  doi:10.13418/j.issn.1001-165x.2019.01.010

Abstract ( 454 )  

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Objective　To study the effects of disturbed zinc metabolism on the epilepsy susceptibility, learning, memory ability and hippocampal neuron injury of the epilepsy mice by clioquinol pre-treatment.　Methods　Seventy-two CD-1 mice were randomly divided into a control group, an epilepsy group and a clioquinol group. Mice in clioquinol group were injected intraperitoneally with clioquinol 10 mg·kg-1·d-1. Mice in the control and epilepsy group were given saline instead. One week later, mice in the epilepsy and clioquinol group were treated intraperitoneally with pilocarpine 300 mg/kg to establish the epilepsy model. Mice in he control group were given saline instead. Afterwards, the period of incidence, incubation and seizure level were observed in 90 min after pilocarpine injection. Tissues were obtained on the 7th day. Autometallography was used to detect the distribution of zinc in hippocampus. Nissl staining was used to check the morphological changes of hippocampal neurons. ELISA detection was used to check the level of S-100β and neuronspecific enolase (NSE) protein in serum and cerebrospinal fluid. One month later, Mirror maze experiment was used to detect the escape latency and time in correct quadrant.　Results　Compared with the epilepsy group, the incidence and seizure level was increased and incubation period shortened in clioquinol group (P<0.01). The zinc level was lower in the clioquinol group than the epilepsy group (P<0.01). There were much more hippocampal neurons in the clioquinol group. The injury of neurons was remedied in the clioquinol group. The expression of S-100β and NSE protein in serum and cerebrospinal fluid decreased significantly in the clioquinol group (P<0.01). Mirror experiment showed that the escape latency was shorter and time in correct quadrant were longer than in epilepsy group (P<0.01).　Conclusion　Clioquinol can lower the zinc accumulation in the epilepsy mice hippocampus, increase the epilepsy susceptibility, inhibit the injury of neurons and improve the learning and memory capability.

The changes of adrenal gland and biochemical indicators in cynomolgus monkey models of Parkinson’s disease

TIAN Jing-hua，ZHU Ming-hui，ZHANG Zheng-hui， YU Lan

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  51-54.  doi:10.13418/j.issn.1001-165x.2019.01.011

Abstract ( 652 )  

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Objective　To investigate the changes of biochemical indicators and adrenal glands after chronic MPTP treatment in cynomolgus monkeys.   Methods　Eight male cynomolgus monkeys aged about 10 years old were randomly divided into two groups: a control group (n=3) and a model group (n=5) receiving MPTP administration for 30 days. The animal behavior was observed and recorded during animal modelling. After successful cynomolgus monkey modelling, blood was drawn to measure the kidney function, glucose, cholesterol, and triglycerides. After anaerobic animal anesthesia, the adrenal gland was taken for HE, α-synuclein, dopamine receptor D2 staining and pathological changes were observed.　Results　The PD model was successfully established in cynomolgus monkeys. There were significant differences in the biochemical indexes of glucose(GLU) and cholesterol(CH) between the groups (P<0.05). There was no significant difference in renal function. The adrenal gland was damaged. The inflammatory cells infiltrated. The boundary between the capsule and medulla was basically unclear. The cortical layer became thinner, and some of it underwent focal necrosis. The expression of α-synuclein in the adrenal gland was significantly higher than that in the control group, while the dopamine receptor D2 in the medulla was significantly reduced. There were statistically significant differences between the two groups in immunohistochemical semi-quantitative analysis(P<0.05).　Conclusions　The metabolic index of cynomolgus PD model is significantly decreased. The structural function of adrenal gland may be related to the pathogenesis of PD. The detection of peripheral biological indicators provides a new idea for the diagnosis of PD.

Effects of vasoactive intestinal peptide on the function of triggering receptor expressed on myeloid cells-1 in RAW264.7 murine macrophages

SONG Zhuo-hui, LI Shu-fen, LIU Yan, YUAN Li, HAN Ling-na, ZHANG Cui-ying

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  55-59.  doi:10.13418/j.issn.1001-165x.2019.01.012

Abstract ( 551 )  

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Objective　To observe the effect of vasoactive intestinal peptide (VIP) on the function of triggering receptor expressed on myeloid cells-1  (TREM-1) in mouse macrophages.　Methods　The mouse macrophage cell line RAW264.7 was used as the research object. After cells were seeded on the culture plates, TREM-1 was activated by the monoclonal agonistic antibody of TREM-1, and cells in the VIP pretreatment group was treated with 10 nM VIP. After 1 h, the intracellular PLC-γ phosphorylation and intracellular reactive oxygen species (ROS) were detected by Western blot and DCFH-DA, respectively. After 6 h, real-time PCR was used to detect the gene expression of tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein-1 (MCP-1) as the downstream target genes of TREM-1 activation. After 12 h, TNF-α and MCP-1 contentration in the cell culture supernatants were detected by ELISA.   Results  After treatment of TREM-1 monoclonal agonistic antibody, the intracellular PLC-γ phosphorylation level, ROS content, and mRNA and protein levels of TNF-α and MCP-1 were significantly increased in murine macrophages, while VIP pretreatment significantly inhibited the above reactions induced by monoclonal agonistic antibodies.   Conclusion  VIP can inhibit the functional changes induced by the activation of TREM-1 in murine macrophages RAW264.7, thereby exerting anti-oxidant and anti-inflammatory effects.

Role of calpain-1 in the inhibition of simvastatin on myocardial inflammation in diabetic rats

HAN Qian-qian, LU Mei-li, WANG Hong-xin, TANG Fu-tian, ZHANG Ying-jie

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  60-63.  doi:10.13418/j.issn.1001-165x.2019.01.013

Abstract ( 573 )  

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Objective　To investigate the role of calpain-1 in the inhibition of simvastatin on myocardial inflammation in diabetic rats.　Methods　Forty SD rats were randomly divided into 4 groups: blank control group (CON group), streptozotocin group (STZ group), simvastatin high dose (20 mg/kg) treatment group (STZ+SIM20 group) and low dose (10 mg/kg) treatment group (STZ+SIM10 group). After 12 weeks, the pathological change of myocardial tissue was observed by HE staining. The expression of p65 was detected by immunohistochemistry. The expression of calpain-1, p65 and IκBα was detected by Western Blot. Serum TNF-α, IL-6 content was detected by ELISA.　Results　Compared with the STZ group, the SIM treatment group had neatly arranged cardiomyocytes and decreased inflammatory cell infiltration. The expression of p65 and IκBα protein in the cytoplasm was increased, and the expression of calpain-1, TNF-α, IL-6 and nucleus p65 in the nucleus was decreased.　Conclusion　Simvastatin has a protective effect on myocardial inflammation in diabetic rats, and its mechanism may be related to the inhibition of myocardial calpain-1 expression.

Golgi Matrix Protein 130 promotes papillary thyroid carcinoma cell TPC-1 invasion and migration through regulating epithelial-to-mesenchymal transition

CHEN Jie, TANG Li-hua, LI Zheng-ming

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  64-70.  doi:10.13418/j.issn.1001-165x.2019.01.014

Abstract ( 531 )  

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Objective　To investigate the effect and mechanism of Golgi Matrix Protein 130(GM130) on the abilities of invasion and migration in papillary thyroid carcinoma cells.　Methods　The mRNA levels of GM130 in thyroid cell Nthy-ori 3-1 and papillary thyroid carcinoma cell BCPAP, K1 and TPC-1 were measured by RT-PCR. Cells were divided into Control, scramble siRNA(si-scramble), and GM130 siRNA(si-GM130) groups. CCK8 was performed to evaluate cell proliferation. Wound healing assay was performed to evaluate migration. Transwell was performed to evaluate invasion. The expression of GM130, Ki67, Proliferating cell nuclear antigen(PCNA), Matrix metalloproteinase-4(MMP-4), MMP-9, calcium-dependent adhesion protein E (E-cadherin), Snail, N-cadherin and Vimentin were measured by Western blot.  Meanwhile, immunofluorescence assay was performed to evaluate the expression of Vimentin.　Results　GM130 in TPC-1 cells was higher expressed than in other papillary thyroid carcinoma cell lines. Therefore, TPC-1 cells were used for further study. Compared with the control group, the expression of GM130 was decreased in si-GM130 group, which resulted in the cell proliferation rate. And the expression of Ki67, and PCNA were decreased markedly. The wound closure rate was lower notably. The invasive cells and the expression of MMP-4, and MMP-9 declined significantly. Additionally, the expression of E-cadherin in si-GM130 group  increased compared with that in control group, whereas the expression of Snail, N-cadherin and Vimentin  decreased significantly. Meanwhile, the fluorescent value of Vimentin in si-GM130 group decreased significantly.　Conclusions　GM130 can promote papillary thyroid carcinoma cell TPC-1 invasion and migration through inducing epithelial-to-mesenchymal transition.

Experimental study on genipin crosslinking improved the biological performance of rat kidney decellularized matrices

LIU Dan, DU Ao-ling, WANG Xin-wang, ZHANG De-ming, TANG Hui-li, WANG Yu-hang, CHEN Sheng-hua

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  71-76.  doi:10.13418/j.issn.1001-165x.2019.01.015

Abstract ( 611 )  

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Objective　To improve the biological properties of the rat kidney acellular biological scaffold by genipin crosslinking.　Methods　Eighty healthy SD rats were divided into a normal group, an uncrosslinking group, a glutaraldehyde crosslinking group and a genipin crosslinking group. Rat kidneys and renal arteries were isolated and connected with peristaltic pumps. Rat kidneys were successively infused with heparinized PBS solution, 1% Triton X-100, 1% sodium dodecyl sulfate (SDS), deionized water to complete the preparation of rat kidney acellular biological scaffolds. The glutaraldehyde crosslinking  group was infused with  1500 ml 0.625% glutaraldehyde (GA)，and the genipin crosslinking group was immersed in 0.5% genipin solution at 37 ℃ for 24 hours. Non-glutaraldehyde and non-genipincrosslinking renal acellular biological scaffolds served as the uncrosslinking group. Four groups of kidneys were stained with HE, Masson and immunofluorescence, respectively. The morphology and ultrastructure of scaffolds were observed by immunofluorescence and electron microscopy, and mechanical properties were tested by tensile test.    Results  After crosslinking with genipin, HE and Masson staining showed that collagen fibers arranged more tightly and orderly, glomerular fibers were aggregated, Collagen I and Collagen IV fluorescence staining enhanced, and the honeycomb-like pore structure in the cross-linked acellular scaffold was more stereoscopic and typical. The structure of glomerular niche was clearer, and the elastic modulus of kidney in crosslinking group was significantly higher than uncrosslinking group.　Conclusion　Genipin crosslinking rat renal decellularized scaffold can greatly improve the biological properties of the scaffold and lay a foundation for cell implantation and organ regeneration.

Effects of forsythoside on oxidative stress and renal function in aged rats

YANG Jie-ling, LI Chen, LIU Qing, HUANG Qiu-yan, FENG Ying

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  77-82.  doi:10.13418/j.issn.1001-165x.2019.01.016

Abstract ( 934 )  

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Objective　To investigate the effects and related mechanisms of forsythoside on oxidative stress and renal function in aged rats.   Methods    Fifteen SD female aged rats (24 months old) were randomly divided into three groups with 5 rats in each: the old control group (Aged rats), the low dose forsythia group [Aged rats+FA (20 mg/kg)] and the high dose forsythia group [Aged rats+FA (100 mg/kg)]. Another 5 female SD rats (12 weeks old) served as the young control group (Young rats). Rats in low and high dose forsythiaside groups were administered for 60 days by gavage. Coomassie brilliant blue was used to detect the total protein of 24 h urine. And the levels of serum creatinine and urea nitrogen were detected by related kits. Renal injury was detected by HE staining and TUNEL staining. Western Blot was used to detect the expression of Caspase-3 and Caspase-9. The levels of SOD, MDA and GSH were detected by related kits. ELISA was used to detect the levels of inflammatory cytokines IL-18 and IL-1 beta in serum.    Results   Compared with the young control group, the content of protein in urine increased significantly in the aged control group. The content of creatinine and urea nitrogen in the serum increased significantly. The arrangement of renal tissue cells was irregular. A large number of inflammatory cells were infiltrated. The ratio of apoptotic cells increased significantly. The expression level of Caspase-3 and Caspase-9 increased significantly. The activity of SOD decreased significantly. MDA content increased significantly. GSH content decreased significantly. Serum IL-18 and IL-1 beta increased significantly. The expression of Nrf 2, HO-1 and NQO-1 decreased significantly（P<0.01）. In the low and high dose group, the content of protein in urine decreased significantly. The content of creatinine and urea nitrogen in the serum decreased significantly. The arrangement of renal tissue cells tended to be regular. The infiltration of inflammatory cells decreased significantly. And the ratio of apoptotic cells decreased significantly. The expression level of Caspase-3 and Caspase-9 decreased significantly. The activity of SOD increased significantly. The content of MDA decreased significantly. The content of GSH increased significantly. The contents of IL-18 and IL-1 beta in serum decreased significantly. The expression of Nrf 2, HO-1 and NQO-1 increased significantly（P<0.01）.   Conclusions    Forsythin inhibits oxidative stress and improves renal function in aged rats，and the mechanism may be related to the activation of Nrf 2-ARE pathway.

A finite element study on the stress and strain of lumbar intervertebral disc in side bending - rotary manipulation

TIAN Qiang, ZHONG Qiao-lin, ZHAO Jia-you, FAN Zhi-yong, GUO Ru-song, WU Shan, ZHANG Mei-chao

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  83-86.  doi:10.13418/j.issn.1001-165x.2019.01.017

Abstract ( 596 )  

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Objective　To observe the change rule of intervertebral disc stress and strain in the operation of tilting rotation by the method of finite element analysis, and to explore the scientificalness and safety of the method to treat lumbar spine disease.　Methods　Simulated loading of “Side bending -rotation manipulation” was loaded on lumbar L4~5 model. The distribution and change of technique effect in the process of intervertebral disc stress, displacement and strain of nucleus pulposus and annulus were observed.　Results  The changes of the stress in the intervertebral disc began to appear from the right rear, and spread around the arc, and the change of stress was reduced. Disc strain minimum position occurred in the nucleus and increased from the center to the periphery in an arched shape. The position of the maximum strain increment occurred mainly in fiber ring, especially in the right edge of intervertebral disc.　Conclusions　The stress in manipulation is mainly concentrated on the posterior small joints. The stress changes of the intervertebral disc are relatively small, suggesting that the manipulation is safe. There are obvious strains in the posterolateral operation of the annulus fibrosus, and the change of local displacement may be one of the mechanisms of therapeutic effect of manipulation.

Biomechanical study on the changes of pressure and displacement in the different tibiofibular syndesmosis injury model

XU Si-liang, LU Wei, HUANG Gang, XIE Wei-yong, HE Yue, XU Jian

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  87-90.  doi:10.13418/j.issn.1001-165x.2019.01.018

Abstract ( 485 )  

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Objective　To explore the relationship between the reduction pressure and displacement after the tibiofibular syndesmosis injury and find out the best  reduction force.　Methods　Ten fresh frozen-thawed calf specimens were selected. The tibiofibular syndesmosis was exposed. then the anterior structures (anterior tibiofibular ligament), posterior structures including the posterior tibiofibular ligament, the transverse tibiofibular ligament, and the interosseous membrane 10 cm proximally were dissected respectively. Each model underwent CT scans, and the distances from the point A on the lateral malleolus ridge to the point B on the center of the medial tibia were then measured. Meanwhile, the reduction was performed and the relationship between distance and pressure was recorded.   Results    The Mimics software was used to measure the distance of AB in different models. After  disruption of the anterior tibiofibular syndesmosis, anteroposterior tibiofibular syndesmoses, anteroposterior tibiofibular syndesmoses combined with the interosseous membrane 10 cm proximally, the average distance of AB increased significantly compared with that with the intact tibiofibular syndesmosis (P<0.05), but the corresponding distances between each model were not statistically significant (P>0.05). Using the biomechanical stress tester, the magnitude of stress was detected to be 40~70 N. There was no significant difference in the magnitude of the restoring force between anterior tibiofibular syndesmosis and anteroposterior tibiofibular syndesmoses injury models (P>0.05). There was no significant difference in the magnitude of the restoring force between anteroposterior tibiofibular syndesmoses and anteroposterior tibiofibular syndesmoses combined with the interosseous membrane 10 cm proximally injury models (P>0.05), but there was a significant difference in the magnitude of the restoring force between anterior tibiofibular syndesmosis and anteroposterior tibiofibular syndesmoses combined with the interosseous membrane 10 cm proximally injury models (P<0.05).　Conclusions　In different degree of tibiofibular syndesmosis injuries, there is a significant difference in the deviation distance of the tibiofibular syndesmosis, and different forces must be chosen to reduce the different stages of tibiofibular syndesmosis displacement.

Matrix-induced autologous chondrocyte implantation of talus cartilage defect

LIU Hai-feng, WU Bing, LIANG Da-qiang, LI Hao, LU Wei

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  91-96.  doi:10.13418/j.issn.1001-165x.2019.01.019

Abstract ( 970 )  

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Objective　To evaluate clinical outcomes of Matrix-induced autologous chondrocyte implantation (MACI) in the treatment of talus cartilage defects.　Methods　From March 2012 to September 2014, a retrospective analysis of MACI was performed on eleven patients who had sustained talus cartilage lesion. 17 cases (12 male and 5 female) were enrolled into the study with a mean age of (32.6±1.4) years old ( ranging from 21 to 48 years old) and a mean defective area of (3.4±0.8) cm2( ranging from 1.6 to 5.8 cm2). Hepple classification: 5 cases of HeppleⅠ，9 cases of HeppleⅡ and 3 cases of Hepple Ⅲ. Arthroscopy, debridement and cartilage harvesting procedure were performed in the first operation. After 2 to 4 weeks of preparation of tissue engineering cartilage, autologous grafting and sealing of the defect with fibrin glue were performed. All patients were regularly followed up. VAS score, AOFAS score and magnetic resonance observation of cartilage repair tissue ( MOCART) were adopted for assessment of clinical outcomes.　Results  All surgeries were performed successfully with a mean follow-up time of (52.3±5.6 ) months( ranging from 38 to 72 months). The VAS score, AOFAS score and MOCART score at the final follow-up were significantly improved compared with those prior to operation, i.e, (0.8±0.6) vs (7.8±1.4) points, (94.8±1.9)vs(69.2± 2.7) points, (6.5± 0.4)vs(3.6± 0.8) points, P<0.05). Complete filling of the defect at the level of the surrounding cartilage was found in 11 cases, and complete filling with a hypertrophic cartilage layer was found in 6 cases of the patients. Normal signal intensity of the repair tissue compared with the adjacent native cartilage was seen in 4 cases, with nearly normal activity in 13 cases.　Conclusions　MACI therapy for talus cartilage defects with normal subchondral bone can obtain good clinical outcomes, while the long term clinical outcomes remains to be seen.

Circumpatellar denervation prevents anterior knee pain after total knee arthroplasty

CHEN Yang, LI Hong-xing, ZHU Wei-hong, MAO Xin-zhan

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  97-101.  doi:10.13418/j.issn.1001-165x.2019.01.020

Abstract ( 526 )  

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Objective　According to the anatomy around the patella, the clinical effect of peripatellar electrocautery denervation in total knee arthroplasty (TKA) was investigated.　Methods　Eighty-two patients diagnosed with osteoarthritis (91 knees) were included, and bilateral or unilateral TKA without patella replacement was performed. Patients were divided into two groups according to the method of randomized controlled trials. A total of 41 patients (45 knees) in the experimental group received peripatellar denervation during total knee replacement, while 41 patients in the control group (46 knees) did not receive this treatment. All surgical operations were performed by the same orthopaedic surgeon using the same knee prosthesis system. The main evaluation items included knee KSS score, Western Ontario and McMaster Universities (WOMAC score), Feller patella score and VAS score.　Results　All of the 82 patients were followed up postoperatively, the average follow-up time was 12 months. knee patella KSS score, WOMAC, Feller score and VAS score in the two groups of patients had no significant difference (P>0.05).　Conclusion　It is considered that circumpatellar denervation in TKA cannot significantly improve the prognosis of patients.

Clinical study on anterior cruciate ligament reconstruction assisted by 3D-printed navigational templates of tibial tunnel

CHEN Guo-li, HU Hong-xin, WU Xian-wei, LIN Mei, DAI Yu-lin, LIN Hai-bin

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  102-106.  doi:10.13418/j.issn.1001-165x.2019.01.021

Abstract ( 631 )  

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Objective　To investigate the feasibility and effect of  3D-printed navigational templates of tibial tunnel on the anterior cruciate ligament reconstruction.　Methods　56 patients of anterior cruciate ligament reconstruction from January 2015 to May 2016 in the orthopaedics department of the Affiliated Hospital of Putian University were selected and randomized into two groups: the control group and the 3D-printed group. The surgical duration and the number of intraoperative tibial tunnel location were recorded and analyzed. The IKDC knee function score, the Lysholm score on the postoperative 6th and 9th months, and the range of motion(ROM) of knee 9 months after operation were examined. The data were analyzed by chi-square test and two-sample t-tests.　Results　Fifty-two patients were included in the analysis(27 case in control group and 25 cases in the 3D-printed group). There were significant differences in the surgical duration and the number of intraoperative tibial tunnel location（t=4.186，P<0.05；t=3.069，P<0.05）. The IKDC knee function score ,the Lysholm score on the postoperative 6th  and 9th months, and ROM of knee 9 months after operation showed no significant difference between the two groups（P>0.05）.　Conclusion　It was a viable alternative to use the 3D-printed navigational template of tibial tunnel for anterior cruciate ligament reconstruction.

The significance of Zuckerkandl’s tubercel in thyroid surgery

LIU Jia-feng

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  107-109.  doi:10.13418/j.issn.1001-165x.2019.01.022

Abstract ( 1416 )  

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Objective　To study the occurrence rate of tubercle of Zuckerkandl (ZT) in thyroid surgery and the anatomic relationship between ZT and recurrent laryngeal nerve(RLN) and superior parathyroid gland (SPG).　Methods　Data of 120 patients with thyroid tumor underwent unilateral or bilateral thyroid gland lobe resection in the department of otolaryngology - head and neck surgery of the first affiliated hospital of Gannan medical college between December 2016 to December 2017 were retrospectively analyzed. One hundred and forty six glandular lobes were recorded, ZT was analyzed and the size of ZT was measured. The relationship between ZT and recurrent laryngeal nerve and superior parathyroid gland was observed.　Results　ZT was identified in 76 cases (63.3%) of patients and its longest diameter was >1 cm in 54 cases (45.0%). In 87 cases (92.6%) of patients with an enlarged ZT, the RLN laid medial to it and the nerve was found lateral to the ZT in 7 cases (7.4%). The SPG was usually cranial to the ZT and posterior to the recurrent laryngeal nerve.　Conclusions　ZT is a distinct feature of the thyroid gland that can be recognized during most thyroidectomies. The size and position of the ZT have no constant relationship to preoperative symptoms. An understanding of the consistent anatomical relationship between the ZT and RLN and SPG is crucial for safe thyroidectomy.

Clinical application of thin anterolateral thigh flap in reconstructive surgery

LIU Xiao-jun，WANG Zhi-xue，SU Jian-dong，JIN Ji

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  110-112.  doi:10.13418/j.issn.1001-165x.2019.01.023

Abstract ( 449 )  

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Research progress in anatomical characteristics and clinical application of the bare area of liver with peripheral structures

DU Bin, FU Yuan-shan, DUAN Wei-hong

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  113-115.  doi:10.13418/j.issn.1001-165x.2019.01.024

Abstract ( 686 )  

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Variation of gastroduodenal artery: a case report

ZHANG Yan, LU De-bin, LIU Shi-qun, PANG Hua-jin

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  116.  doi:10.13418/j.issn.1001-165x.2019.01.025

Abstract ( 604 )  

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The variation of superficial and deep palmar arch: a case report

CAO Xiang-xiang, LIN Meng, WU Hao, HE Liu

Chinese Journal Of Clinical Anatomy. 2019, 37(1):  117.  doi:10.13418/j.issn.1001-165x.2019.01.026

Abstract ( 637 )  

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