Table of Content

25 July 2020 Volume 38 Issue 4

  

Anatomical study of laparoscopic sacral nerve stimulator implantation and its clinical significance  

WU Jie-shi, XU Rui-sheng

Chinese Journal of Clinical Anatomy. 2020, 38(4):  369-372.  doi:10.13418/j.issn.1001-165x.2020.04.001

Abstract ( 532 )  

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Objective　To discuss the surgical approach of anterior sacral nerve electrical stimulation electrode under laparoscope and its feasibility.　Methods　Mock laparoscopic operations on 2~4 sacral anterior nerves were conducted on twenty adult cadavers. The morphology of 2~4 sacral nerve anterior branch in front of the sacrum and the area around the sacral foramina where the important blood vessels may be damaged were observed and measured.　Results　The lengths of 2~4 sacral nerve anterior branch from the anterior sacral foramina to the sacral plexus were measured as followings respectively: left side of the S2 (32.62 ± 3.15) mm, right side of the S2 (31.46 ± 3.28) mm; S3 left (21.96 ± 2.59) mm, right (20.61 ± 3.14) mm; S4 left (15.04 ± 1.64) mm, right (16.09 ± 1.38) mm. The location of vertebral artery of lateral sacral artery on the 2~4 anterior sacral foramina was in the upper inner quadrant. The inferior gluteal artery passed through the nerves and laterally near the junction of the nerves. Sacral paravertebral veins were accompanied by the lateral sacral artery at the 2~4 anterior sacral foramina. The position of the spine vein out of the sacral foramina was consistent with the artery.　Conclusions　The length of the dissociative presacral S2~4 anterior branches could meet the requirements of the installation of epidural sacral nerve electronic stimulator. The medial side of the anterior sacral foramina was the dangerous area of vascular injury during surgery.

Applied anatomy study of female sacrospinous ligament 

LIU Ping, WANG Ke-jing, CHEN Chun-lin, CHEN Lan , TANG Lian, GUO Fei-yan, LUO Shi-wen

Chinese Journal of Clinical Anatomy. 2020, 38(4):  373-375.  doi:10.13418/j.issn.1001-165x.2020.04.002

Abstract ( 1046 )  

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Objective　To study the characteristics of the sacrospinal ligament （SSL） and its adjacent vessels and nerves, and to provide anatomical basis for the sacrospinal ligament fixation (SSLF).　Methods  24 female cadavers were dissected to measure the relevant anatomic parameters.　Results　The length of left was (5.10±0.36) cm, the right was (5.11±0.30) cm. There was no statistical difference between the length of left and the right SSL length. The inmost part of the pudendal canal was the pudendal nerve, The horizontal distance between the right pudendal nerve and the sciatic spine was (1.51±0.35) cm, the left side was (1.61 ±0.31) cm. SSL was thin but tough, the average thickness in all samples was about 0.2 cm. Coccygeus was located in the lateral side of SSL pelvic cavity. The thickness of the coccygeus was much larger than SSL with a wider cover. The inferior gluteal artery travelled dorsally through the SSL and leave of the pelvis, but 7 of them travelled through the sciatic spine. The sciatic nerve kept away from the SSL. There is no vessel and  nerve traveling on the pelvic surface of SSL.　Conclusions  1.51 cm away from the right sciatic spine and 1.61cm away from the left sciatic spine may be the best suspension point for SSLF.

Anatomical Study of fixing distal interphalangeal joint on treating bony mallet finger by absorption suture tying avulsion fracture fragment

TAN Zhou-yong, FU Xiao-kuan, TAN Liang, LIU Ying-nan, WEI Rui-hong, FANG Xi-chi, ZHUANG Yong-qing

Chinese Journal of Clinical Anatomy. 2020, 38(4):  376-380.  doi:10.13418/j.issn.1001-165x.2020.04.003

Abstract ( 481 )  

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Objective　To investigate the relationship between body surface marking line of distal finger and Kirschner's needle insertion point, and to provide anatomical basis for treating bony mallet finger by absorbable suture tying avulsion fracture fragment, including the entry point and angle of the needle for fixing distal interphalangeal joint, the position of the absorbable suture’s guiding hole.　Methods　16 fresh adult upper limb specimens were randomly selected, including 16 thumbs, 16 index fingers, 16 middle fingers, 16 ring fingers and 16 little fingers. The entry point and angle of Kirschner wire for fixing distal interphalangeal joint were measured. Bone mallet finger model group was built according to the angle between bone avulsion fracture line and the axis of the distal phalanx.　Results　When the distal interphalangeal joint extended at 0°, the fixation needle should be inserted from the side of the finger body. The optimal insertion point for the fixation of the distal interphalangeal joint was located at the junction of the base of the distal phalanx and the finger backbone. The included angle between insertion angle and the axis of the distal phalanx was 30°, and the distance from the insertion point to the plane of the distal phalanx of the finger was 13mm of the thumb, 12mm of the index finger, 13mm of the middle finger, 12mm of the ring finger, and 11mm of the little finger, respectively. The best insertion point of the absorbable guide hole was on the surface projection line of the midline lateral phalanx of the tendon insertion.　Conclusions　When the insertion point of the fixation needle and the guide hole are located in the positions of the above-mentioned fingers, the insertion point and the guide hole are fixed firmly, which will not damage the methyl matrix and will not affect the restoration of the avulsed bone slice.

Anatomical measurement and clinical significance of line of apsides in glenoid

REN Zhong-kai, ZHANG Ying-ze, WANG Jian, ZHANG Yi, CHEN Jin-li, ZHANG Chun-jia, YU Teng-bo

Chinese Journal of Clinical Anatomy. 2020, 38(4):  381-384.  doi:10.13418/j.issn.1001-165x.2020.04.004

Abstract ( 1302 )  

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Objective　To measure the glenoid morphology of the shoulder, analyze the correlation between the data and to guide the prediction of glenoid defects.　Methods　A total of 50 pairs (100 cases) of shoulder specimens were collected from the anatomy department of Qingdao University. The specimens were divided into groups according to the left and right sides after numbering. The longitudinal diameter of the glenoid and the transverse diameter of the glenoid were measured respectively. Then the statistical analysis was conducted. Results　In the 100 scapular specimens, the mean values of the data were as followings: longitudinal diameter of the glenoid cavity was (35.46±3.29) mm and transverse diameter of the glenoid cavity was (26.11±3.20) mm, respectively. The average values of the left and right side were as followings: longitudinal diameter on the left side of the glenoid cavity was (35.28±3.81) mm; the right side was (35.24±3.31) mm, transverse diameter on the left side of the glenoid cavity  was (25.83±3.18) mm, and the right side was (26.38±3.23) mm. There was a correlation between transverse diameter on the left side of the glenoid cavity and transverse diameter on the right side of the glenoid cavity (P<0.05, r=0.882, R2=0.777). The linear relation was: y (transverse diameter on the right side of glenoid cavity) = 2.907+0.869x (transverse diameter on the left side of the glenoid cavity). There was a correlation between the longitudinal and transverse diameter of the glenoid joint (P<0.05, r=0.810，R2=0.657). The linear relationship was y (transverse diameter of the glenoid joint)= -1.816+0.787x (longitudinal diameter of the glenoid joint).　Conclusions　There are positive correlations between the longitudinal diameter of the glenoid joint and the transverse diameter of the glenoid joint, between transverse diameter on the left and right side of the glenoid cavity. The correlation can reduce the error of artificial subjective measurement of the best-fit circle diameter of the glenoid cavity, and can predict the area of anterior glenoid bone loss before clinical operation and improve the prognosis.

Comparison of three 3D magnetic resonance neurography sequences in displaying lumbar sacral plexus and imaging anatomy

YU Qin-qin, CHEN Yan-jun, ZHANG Xiao-dong, ZHOU Quan, YANG Yang, ZHONG Shi-zhen, HUANG Wen-hua

Chinese Journal of Clinical Anatomy. 2020, 38(4):  385-390.  doi:10.13418/j.issn.1001-165x.2020.04.005

Abstract ( 1435 )  

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Objective　To investigate the effect of 3D reconstruction, lumbosacral plexus's display and image anatomical measurement of 3D-T2W-FFE, 3D-STIR-TSE and DWIBS sequences.　Methods 　Data of 49 volunteers underwent conventional lumbar spine MRI and lumbosacral plexus neurography, including 48 cases of 3D-T2W-FFE, 47 cases of 3D-STIR-TSE and 43 cases of DWIBS sequence were collected. The contrast to noise ratio of nerve root and muscle (CNR N/M), the nerve root diameter and ganglion volume of the right sacral of the three sequences were calculated. The lumbosacral plexus's display effect and 3D reconstruction effect were evaluated and compared by different  grade 4 scores respectively.　Results　The CNR N/M of the three sequences were not identical, there were statistical differences among the 3D-T2W-FFE sequence, the 3D-STIR-TSE and DWIBS sequences (P<0.05), there was no significant difference in ganglion volume among the three sequences (P=0.050). The nerve roots diameter of the three sequences were not identical, there were statistical differences between the 3D-STIR-TSE sequence and the DWIBS sequence(P<0.05). There was no statistical difference in neural 3D reconstruction score of the three sequences (P=0.025).　Conclusions　There is no statistical difference in the neural display and imaging anatomical score of 3D-T2W-FFE sequence and 3D-STIR-TSE sequence, which is better than DWIBS sequence. There is no statistical difference in the neural 3D reconstruction score of the three sequences, which the DWIBS sequence is easiest to achieve during reconstruction.  

Imaging study of regional coordination function of cerebral motor in patients with ischemic stroke

LI Ding, WANG Ya, WANG Yan-fang, CHEN Yan-jun, LI Jing-ming, HUANG Wen-hua

Chinese Journal of Clinical Anatomy. 2020, 38(4):  391-395.  doi:10.13418/j.issn.1001-165x.2020.04.006

Abstract ( 344 )  

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Objective　To evaluate the correlation between craniocerebral neuroanatomy and regional brain function in patients with ischemic stroke, and to further explore the neural mechanism of ischemic stroke.　Methods　15 healthy patients in a control group and 19 patients with upper limb hemiplegia in subacute ischemic stroke were collected. The functional connection index of the internal craniocerebral hemisphere was calculated by using computational neuroimaging, and the clinical rehabilitation score before and after treatment was collected for statistical correlation analysis.　Results　(1) Compared with the control group, cerebral hemispheric functional connectivity significantly reduced in stroke patients, with statistically significant differences (T=-10.077, P<0.001). (2) The abnormal focus of lesions was in the supplementary motor area (P=0.02) and the anterior central gyrus (P=0.03), and the difference was statistically significant. (3) The functional connection value in the anterior central gyrus of the patient group before and after drug treatment was positively correlated with the rehabilitation scoring scale, and the difference was statistically significant (r=0.29, P=0.03).　Conclusions　The decrease of functional connections of hemispheres in cerebral motor areas in patients with subcortical ischemic stroke may provide a new approach for clinical diagnosis and rehabilitation evaluation.

MRI manifestations of intrahepatic portal-systemic venous shunt

YOU Yun-feng, WANG Ming-liang, ZENG Meng-su

Chinese Journal of Clinical Anatomy. 2020, 38(4):  396-400.  doi:10.13418/j.issn.1001-165x.2020.04.007

Abstract ( 768 )  

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Objective　To investigate the MRI features of intrahepatic portal-systemic venous shunt. Methods　Upper abdominal plain scan and dynamic contrast-enhanced scan were performed with 1.5T or 3.0T MRI. A retrospective research was carried out to analyze the imaging data of 36 patients with IPSVS (PHVS 29 cases, PIVCS 7 cases).　Results　The first subtype of the first type (72.2%) in Tanoue classification and Park II (58.3%) classification were the most common types of IPSVS. The site of PHVS except the segment I of the liver existed, and the segments III, VI, and VIII were more common. The distribution was similar in the liver and the perihepatic and subcapsular, with one lesion as the main lesion and two or more lesions rare. The morphology was mainly nodular, followed by aneurysm, and the sinusoidal and mixed forms were rare. The lesion size was mostly larger than 1.0 cm, and a few were less than 1.0 cm: PIVCS  located in the liver I, VI, VII segment, distributed in the liver-perihepatic-extrahepatic more common, intrahepatic-perihepatic and capsular next, rare in the liver. T1-weighted image, IPSVS showed that the low signal in the upper and lower continuous layers of the liver was connected with the intrahepatic vessels. T2-weighted image showed that most of the flow was low signal and a little high signal. The characteristic manifestation was the blood supply portal vein, drained hepatic vein and inferior vena cava.　Conclusions MRI can show clearly and well the vascular abnormalities of IPSVS . 

The effects of SETD4 knockout on the function of macrophages and differentiation of immune cells

NIU Shi-xian, HUANG Sui, LI Shan, CAI Jun-wei, CHANG Ruo-shui, ZHENG Zhao-ping, JIANG Yong, LIU Jing-hua

Chinese Journal of Clinical Anatomy. 2020, 38(4):  401-407.  doi:10.13418/j.issn.1001-165x.2020.04.008

Abstract ( 304 )  

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Objective　To investigate the effects of SETD4 (SET-domain containing protein 4) knockout on the differentiation, maturity and function of pMφ (peritoneal macrophages), differentiation of immune cells in peripheral blood and spleen, and development of thymus and spleen in mice.　Methods　The expression of CD31 on pMφ was detected by flow cytometry. The release of both TNF- α and IL-6 from LPS-treated pMφ in SETD4-/- and SETD4+/+ mice were examined and compared by liquid chip technology. The phagocytosis of pMφ was detected by flow cytometry and the migration of pMφ was measured by Transwell system. The number and proportion of immune cells in blood and spleen from SETD4-/- and SETD4+/+ mice were detected by flow cytometry. Difference on the structure of thymus and spleen from SETD4-/- and SETD4+/+ mice was compared by HE staining.　Results　(1)Compared with SETD4+/+ cells, the release of TNF- α and IL-6 decreased in SETD4-/- pMφ in response to LPS stimulation, while there were no significant difference in  ratio, differentiation and maturity of pMφ. (2)There were no significant difference in phagocytosis and migration between SETD4-/- and SETD4+/+ pMφ. (3)There were no significant difference in number and proportion of immune cells in peripheral blood and spleen from SETD4-/- and SETD4+/+ mice. (4)SETD4 knockout had no significant effect on the structure of thymus and spleen from SETD4-/- and SETD4+/+ mice.　Conclusions　(1)SETD4 has a positive role in the production of TNF- α and IL-6 from LPS stimulated pMφ, while no significant effect on the differentiation, maturity, phagocytosis and migration of pMφ. (2)SETD4 knockout has no obvious effect on the differentiation of immune cells in peripheral blood and spleen, and the development of thymus and spleen.

Neuroprotection of GDNF gene-modified NSCs on temporary ischemic stroke in rats

LIU Fang, MAO Zhi-rong, DENG Li, CHEN Bo, YUAN Qiong-lan, GAO Xiao-qing

Chinese Journal of Clinical Anatomy. 2020, 38(4):  408-413.  doi:10.13418/j.issn.1001-165x.2020.04.009

Abstract ( 379 )  

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Objective    To investigate the neuroprotective effects of transplantation of glial cell-derived trophic factor (GDNF) gene-modified neural stem cells (NSCs) on temporary cerebral ischemia in rats.    Methods    Primary neonatal rat NSCs were transfected with GDNF plasmid (GDNF/NSCs). After 7 days they were induced to differentiate, immunohistochemistry staining was used to detect the expression of MAP2+ positive cells. Rats were subjected to two-hour middle cerebral artery occlusion and reperfusion, followed by infusion of saline, NSCs or GDNF/NSCs after reperfusion respectively. All rats were sacrificed at 1, 2, 3, 5, and 7 weeks after reperfusion. Immunohistochemistry staining was performed to identify the neuronal differentiation from implanted cells and to assess glia limitans perivascularis formed by astrocyte. Luxol fast blue（LFB）staining was used to observe nerve fiber damages.    Results    MAP2+ cells from GDNF/NSCs were higher than those from NSCs in vitro. Implanted cells differentiated into MAP2+ cells, which reached the peak at 5 weeks after reperfusion. MAP2+ cells from grafted GDNF/NSCs at 3~7 weeks after reperfusion were higher than those from grafted NSCs. The glia limitans perivascularis in ischemic areas encountered varying degrees of damages in all groups, and the damages in control group at different time points were serious, while the damages in two transplantation groups were gradually repaired over time, and the repair in GDNF/NSCs group was earlier than that in NSCs group. Furthermore, the recovery of nerve fiber in GDNF/NSCs group was stronger than that in NSCs group.   Conclusions   GDNF/NSCs provide better neuroprotective effect for temporary cerebral ischemia than NSCs, which may be related to GDNF enhancing neuronal differentiation and restoration on glia limitans and nerve fibers of NSCs. 

Effects of LncRNA PVT1 on the growth and migration of cervical cancer HeLa cells via targeting miR-190

DENG Yong-hong, ZHANG Li, WANG Jing, YAN Ai-hua

Chinese Journal of Clinical Anatomy. 2020, 38(4):  414-420.  doi:10.13418/j.issn.1001-165x.2020.04.010

Abstract ( 417 )  

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Objective　To investigate the effects and mechanism of lncRNA PVT1 on the growth and migration of cervical cancer Hela cell via targeting miR-190.　Methods　The expression levels of lncRNA PVT1 and miR-190 in normal cervical cells and different cervical cancer cells were identified by qRT-PCR. The targeting relationship between lncRNA PVT1 and miR-190 was predicted by bioinformatics software. Cell proliferation was detected by MTT, cell growth was detected by clone formation assays, apoptosis was identified by Hoechst staining and flow cytometry, cell invasion was detected by Transwell, cell migration was detected by a scratch test; proliferation, apoptosis and epithelial-mesenchymal transition (EMT)-related molecular expression were verified by Western Blot. Cervical cancer HeLa cell was inoculated with subcutaneous xenografts of the nude mice after treated with sh-PVT1, and the related molecules expression of proliferation and apoptosis- in tumor tissues and tumor volume were detected.　Results　Compared with the normal cervical cells, lncRNA PVT1 was highly expressed in various cervical cancer cells. After interfering with PVT1, the expression level of miR-190 significantly up-regulated. LncRNA PVT1 and miR-190 had strong associativity, which was verified by bioinformatics and luciferase reporter system. Sh-PVT1 could effectively inhibit the proliferation, invasion and migration of cervical cancer cells and promote apoptosis (P<0.01). LncRNA PVT1 could effectively inhibit the related molecules expression of EMT- and reduce the transformation of cervical cancer cells into EMT. The above phenomenon was effectively reversed after the miR-190 inhibitor (P<0.01). In vivo experiments confirmed that PVT1 knockdown could effectively reduce tumor cell proliferation and promote cell apoptosis (P<0.01).　Conclusions　LncRNA PVT1 is highly expressed in cervical cancer. PVT1 knockdown can effectively relieve the inhibitory effect of PVT1 on miR-190, thereby reducing proliferation, invasion and migration of cervical cancer cells and promoting apoptosis. 

The mechanism of Celastrol in inhibiting cell biological behavior of cervical cancer cells 

JIA Ying, ZHAO Wei, ZHANG Xin-yuan, WU Rui, XIAO Bing-bing

Chinese Journal of Clinical Anatomy. 2020, 38(4):  421-427.  doi:10.13418/j.issn.1001-165x.2020.04.011

Abstract ( 242 )  

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Objective　To explore the mechanism of Celastrol in inhibiting proliferation and invasion ability of cervical cancer cells.　Methods　Normal cultured HeLa cells were divided into the following groups: a control group, a low-dose Celastrol group, a medium-dose Celastrol group and a high-doses Celastrol group (final concentrations of Celastrol were 4 μmol/L, 8 μmol/L and 12 μmol/L, respectively), a positive control group (cisplatin, final concentration of 10 μmol/L), a LY294002 group (LY294002, final concentration of 20 μmol/L) and a Celastrol with LY294002 group ( final concentrations of Celastrol and LY294002 were 12 μmol/L and 20 μmol/L, respectively). The cell survival conditions of each group were detected by MTT assay. The apoptosis of each group were detected by flow cytometry. The cell invasion of each group were detected by Transwell. The expression of PI3K/AKT/NF-κB signaling pathway were detected by Western Blot. HeLa cells were subcutaneously injected to establish nude mice models to observe the effects of Celastrol (120 mg/kg) on volume and weight of transplanted tumors in nude mice.　Results　Compared with the control group, relative proliferation rate of HeLa cells and number of invasive cells in Celastrol group, positive control group and LY294002 group significantly decreased (P<0.001), while apoptosis rates significantly increased (P<0.001), and expression of p-PI3K, p-AKT and NF-κB p65 protein significantly down-regulated (P<0.001). Moreover, with increasing of Celastrol concentration, its effects increased. Compared with the LY294002 group, relative proliferation rate of HeLa cells and number of invasive cells in the Celastrol with LY294002 group significantly decreased (q=10.182, q=10.217; P<0.001), while apoptosis rate significantly increased (q=23.636, P<0.001). Compared with the control group, weight of nude mice, volume and weight of transplanted tumors of nude mice significantly decreased in the Celastrol groups (q=4.100, P<0.020; q=13.501, P<0.001; q=5.078, P=0.005).　Conclusions　Celastrol may inhibit its malignant biological behaviors through inhibiting the PI3K/Akt/NF-κB signaling pathway of HeLa cells

Protective effects of inhibiting NLRP3 mediated pyroptosis on traumatic brain injury mice

ZHUANG Jian, LUO Xiao-qing, WU Shu-fan, HE Yi, LI Jie

Chinese Journal of Clinical Anatomy. 2020, 38(4):  428-433.  doi: 10.13418/j.issn.1001-165x.2020.04.012

Abstract ( 242 )  

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Objective　To investigate the protective effects of MCC950 on traumatic brain injury (TBI) mice by inhibiting pyroptosis via suppressing NLRP3 inflammasome.　Methods　A total of 36 BALB/c mice were randomly divided into the following groups: a sham injury group, a TBI model group, a MCC950 1-day and 7-day treatment group. The TBI model of mice was induced by free fall method, and MCC950 was intraperitoneally injected into the treatment group after modeling. HE staining and nissl staining were used to evaluate the brain tissue injury conditions of each group. The expressions of NLRP3, Caspase1 and GSDMD in each group were detected by the immunofluorescence.　Results　H&E staining showed that compared with the sham injury group, the number of neurons in the injured area in the TBI model group decreased, and the nuclei of neurons were consolidated and hyperchromatic, with a large number of vacuoles around the nuclei. The neuron status of the TBI+MCC950 treatment group (1-day and 7-day treatment group) were significantly better than that of the TBI model group. Nissl staining showed that compared with the TBI model group, the neuron loss and injury in the TBI+MCC950 treatment group (1-day and 7-day treatment group) attenuated. Immunofluorescence showed that compared with the TBI model group, the expression levels of NLRP3, caspase1 and GSDMD in frozen sections of brain tissues of the TBI+MCC950 group (1-day and 7-day treatment group) significantly reduced.　Conclusions　Application of MCC950 in the treatment of TBI mice can effectively inhibit NLRP3-mediated pyroptosis and alleviate the damage of brain tissue and cell structure at the wound site.

Effect and histological analysis of minimally invasive traction of rabbit mandibles with simple screws

LI Ze-yu, WU Zhang , MA Hui-qing, YAO Yu-sheng

Chinese Journal of Clinical Anatomy. 2020, 38(4):  434-437.  doi:10.13418/j.issn.1001-165x.2020.04.013

Abstract ( 228 )  

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Objective　To investigate the effect and histological analysis of using simple screws to pull the rabbit mandibles.　Methods　Eight New Zealand female rabbits were studied and randomly divided into the left side or the right side of the experimental side. The experimental sides of mandibles were implanted with two fixing screws and one traction screw respectively. When the traction screw was rotated downwards, the cutting bone end was moved into the opposite direction to increase the bone mass, while the control side was not treated. After 20 days of traction, the bone mass of the experimental side was measured. Then, the bone tissue of the experimental side and the control side were taken for histological examination. Histiocytic change of the two each sides was compared.　Results　The bone height of the experimental side increased by nearly 2.5 mm. HE staining showed that the number of osteoblasts on the experimental side (598.5±130.01) were significantly higher than that on the control side (80.75±14.29). Immunohistochemical staining showed that the IOD of the bone morphogenetic protein-2 of the experimental side (0.13±0.011) were significantly higher than that of the control side (0.061±0.013).　Conclusions　Screws could be minimally and effectively increase bone mass. The mechanical force generated by the rotation of the screws can increase the cells viability of the stressed area, and animate the bone formation .

The chronic stress induced expression of DPP-4 and its role in adipose inflammation and glucose metabolism

ABULAIKEMU·Mahemuti, MAIMAITI·Yisireyili, AIKEBAIER·Aili, LI Yi-liang, AZIGULI -Alimujiang, YAN Jing, KELIMU·Abudureyimu

Chinese Journal of Clinical Anatomy. 2020, 38(4):  438-443.  doi:10.13418/j.issn.1001-165x.2020.04.014

Abstract ( 483 )  

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Objective　To analyze chronic stress induced dipeptidyl peptidase-4 (DPP-4) expression and its role in adipose inflammation and glycometabolism.　Methods　20 male SPF mice were randomly divided into two groups: a stress group and a control group. Mice in the stress group were restrained in our own restraint device for 2 hours per day and lasted for 14 days. The expression of macrophage surface marker (CD11b) in adipose tissue was detected by immunohistochemistry. The expression of DPP-4, adipocytokines (Adiponectin, MCP-1, IL-6, TNF-α) in adipose tissue and the expressions of glucose metabolism molecules (IRS-1, GLUT-4) were further detected by RT-PCR. The enzymatic activity of DPP-4 and the concentration of GLP-1 were detected by ELISA.　Results　The white adipose tissue (WAT) of the stress group mice significantly retracted and WAT weight significantly reduced (P<0.001). WAT in the stress group showed a large number of monocytes, neutrophils infiltration and inflammatory changes. Mice in the stress group significantly decreased the expression of Adiponectin and significantly increased the expression of MCP-1, IL-6 and TNF-α (P<0.001). DPP-4 expression in WAT tissues and its activity in blood increased significantly in the stress group, but the concentration of serum GLP-1 decreased significantly (P<0.001). The mRNA level of IRS-1 and mRNA level of GLUT-4 in WAT of the stress group were significantly lower than that of the control group (P<0.001). Conclusions　Chronic stress induced abnormal expression of DPP-4 in adipose tissue, which can lead to adipose inflammation and abnormal glycometabolism.

Construction and accuracy test of lumbar intelligent medical image modeling system

LIN Ze-yu, XIE Yu-shan, XIE Pu-sheng, LING Qin-jie, HUANG Xue-cheng, HUANG Wen-hua

Chinese Journal of Clinical Anatomy. 2020, 38(4):  444-449.  doi:10.13418/j.issn.1001-165x.2020.04.015

Abstract ( 331 )  

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Objective　To construct a lumber intelligent medical image modeling system and replace the analyst to finish the calculation work of lumbar mobility during finite element modeling.　Methods　Echo system including recording programs and playback programs were built by using the python language. In addition, the Geomagic deviation analysis function was used to evaluate the deviation distribution of intelligent modeling and artificial modeling. The nonlinear finite element model of the lumbar spine was constructed respectively to verify the influence of the model on the finite element analysis results.　Results　The intelligent lumbar reduction system was established and the 3D model of lumbar vertebral body was successfully constructed. Deviation analysis was carried out between the  intelligent modeling and artificial modeling.  More than 98% of the region achieved zero deviation. There were some differences in the finite element activity at first, but after paired t-test, there was no statistical difference (P=0.2).　Conclusions　The 3D lumbar spine model constructed by the intelligent modeling system has high accuracy and no impact on the analysis results of finite element.

True anastomosis connections of sural neuro-vascular flap and outcomes of the flap for reconstructing soft tissue defect in forefoot

TAO Shi-bin, DONG Zhong-gen, WEI Jian-wei, LIU Li-hong, ZHOU Ling-li, LUO Zhao-biao, PENG Ping

Chinese Journal of Clinical Anatomy. 2020, 38(4):  450-454.  doi:10.13418/j.issn.1001-165x.2020.04.016

Abstract ( 318 )  

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Objective　To discuss the clinical effects of the true anastomosis connections between  the sural neuro-vascular flap and outcomes of the flap for reconstructing the soft tissue defect in the forefoot. Methods　Five amputated lower limbs were obtained from 5 patients with recurrent malignant bone tumor in the middle and/or upper femur. After being acquired, these specimens were irrigated and then perfused with a barium sulfate/red latex mixture immediately. The integuments of these limbs were stripped and radiographed. Anatomic observation focused on the true anastomosis connections within the arterial chain around the sural nerve, among the peroneal perforators and between these perforators and the arterial chain. Fifty-two sural neuro-vascular  flaps were used to perform the soft tissue defects in the forefoot.　Results　The arterial chain surrounding the sural nerve was linked by true anastomoses from the intermalleolar line to popliteal crease. The distal 2 to 3 peroneal perforators were connected by true anastomoses of their longitudinal branches. Forty-two flaps survived. Partial necrosis occurred in 10 (19.2%) flaps, the remnant defects were successfully performed by secondary suture (n=1), skin grafting (n=8) and local flap transposition (n=1).　Conclusions　The true anastomosis connections within the arterial chain around the sural nerve, among the distal 2 to 3 peroneal perforators and between these perforators and the arterial chain, are the vascular anatomical basis of the sural neuro-vascular flap which survives with greater length. This flap is a better option for reconstruction of the soft tissue defect in the forefoot.

Clinical efficacy of MIS-TLIF assisted with microscope in treatment of lumbar single-segment degenerative diseases

CHEN Peng-cheng, ZHONG Hai-lin, WANG Le, ZHANG Hai-ying, LIU Yi-heng, LIAN Xiao-feng

Chinese Journal of Clinical Anatomy. 2020, 38(4):  455-460.  doi:10.13418/j.issn.1001-165x.2020.04.017

Abstract ( 425 )  

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Objective　To investigate the safety and efficacy of microscope-assisted minimal invasive posterior transforminal lumbar interbody fusion (MIS-TLIF) in the treatment of single segmental degenerative diseases of lumbar vertebrae.　Methods　Clinical data of 42 patients (minimally invasive group) treated with microscope-assisted MIS-TLIF and 50 patients (traditional group) treated with PLIF were retrospectively analyzed.  At the same time perioperative parameters, imaging and clinical efficacy of the two groups were compared.　Results　All patients were followed up, and 1 case of dorsal root ganglion irritation was found in the minimally invasive group. One case of dural tear and one case of superficial wound infection occurred in the traditional group. There was no statistical difference in the incidence of complications between the two groups (P>0.05). The incision length, intraoperative blood loss, postoperative drainage volume, postoperative hospital stay, creatine kinase level of 1 day after surgery, ODI score of 3 months after surgery, VAS score of 1 day after surgery and 3 months after surgery in the minimally invasive group were all lower than that of the traditional group (P<0.05). The operation time and time of intraoperative X-ray irradiation in the minimally invasive group were longer than that of the traditional group (P<0.05). There was no statistical difference between the ODI scores and VAS scores of 6 months after the operation and the last follow-up (P>0.05). At the last follow-up, there was no statistical difference in the rate of bone graft fusion (P>0.05).　Conclusions　Compared with PLIF surgery, microscope-assisted MIS-TLIF has the advantages of less trauma and satisfactory short-term efficacy in the treatment of lumbar degenerative diseases.

Clinical application of three kinds of functional free muscle transplantation to reconstruct partial upper limb function

LIU Ying-nan, ZHUANG Yong-qing, Wei Rui-hong, XIONG Hong-tao, FANG Xi-chi, WEN Gui-fen, ZHONG Shi-ru, KE Yan-na, LI Ping, TANG Qiong

Chinese Journal of Clinical Anatomy. 2020, 38(4):  461-466.  doi:10.13418/j.issn.1001-165x.2020.04.018

Abstract ( 287 )  

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Objective　To explore the clinical effect and experience of three kinds of functional free muscle transplantation in the reconstruction of partial upper limb function.　Methods　From January 2010 to December 2018, functional free gracilis , latissimus dorsi  and pectoralis minor muscle transplantation were applied to reconstruct upper limb function in 39 cases, including reconstructing elbow flexion and finger flexion function in 6 cases, finger flexion function in 11 cases, and thumb opposable function in 22 cases. Different dynamic nerves and blood supply vessels were selected according to the conditions of the limbs, and the transplanted muscles were adjusted in the optimal position of muscle tension during the operation to rebuild the nerve and blood supply of the transplanted muscles.　Results　In 37 cases, the functional free muscle survived completely, and the reconstructed upper limb recovered well.  Excellent and good rates were 94.8%. In 2 cases, the reconstructed function did not get recovered, and 1 case occurred partially necrotic in the transplanted muscle and flap.　Conclusions　The functional free gracilis, latissimus dorsi and pectoralis minor muscle transplantation  have a satisfactory result in the reconstruction of upper limb function, which is an effective method for the treatment of various causes of upper limb muscle defects and severe limb disorders.

Therapeutic effect of Wiltse muscle interstitial approach combined with vertebral screw placement for the treatment of thoracolumbar fractures

PU Zhi-chao, HUANG Kun-bing, XUE Jian, XIE Wei-yong

Chinese Journal of Clinical Anatomy. 2020, 38(4):  467-470.  doi:10.13418/j.issn.1001-165x.2020.04.019

Abstract ( 326 )  

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Objective　To investigate the clinical effect of the Wiltse muscle gap approach combined with vertebral screw placement on treating of thoracolumbar fractures.　Methods　53 patients with thoracolumbar fractures were admitted to our department from October 2015 to October 2018, which were divided into a Wiltse muscle gap approach group (group A) and a traditional posterior median group (group B) according to the surgical approach. Based on Frankel Graded to grade E, there was no need for the patients to perform the spinal decompression and bone graft fusion. 28 patients in the group A were treated with Wiltse muscle gap approach, and 26 patients in the group B were treated with conventional posterior surgery. The operation time, intraoperative blood loss, postoperative drainage volume, postoperative ground time were observed. Visual analog scale (VAS) was used to evaluate the pain, and the height of the vertebral body leading edge and Cobb angle were measured and compared.　Results　All patients were followed up for 6 to 18 months, with an average of 12.5 months. The operation time, intraoperative blood loss, postoperative drainage volume, postoperative ground time and other indicators in the group A were better than that of the group B (P<0.05). There was statistical difference in VAS scores between 3 days and 1 month after operation of the two groups (P<0.05). There was no significant difference in the height and Cobb angle between the two groups.　Conclusions　The Wiltse muscle gap approach combined with the vertebral screw placement for the treatment of thoracolumbar fractures is simple to operate and pale the screw, which can reduce the operation time, bleeding volume and the degree of postoperative low back pain, shorten the recovery time, with little effect on the paravertebral muscles and high clinical application value.

Applied anatomy and clinical efficacy of high ilioinguinal approach in the treatment of tile C-type pelvic fractures

JIANG Hua-cai, LONG Li, LI Sen

Chinese Journal of Clinical Anatomy. 2020, 38(4):  471-475.  doi:10.13418/j.issn.1001-165x.2020.04.020

Abstract ( 395 )  

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Objective　To study the applied value of high ilioinguinal approach in the clinical treatment of Tile C type pelvic fractures. 　Methods　In this study, 35 patients with Tile C type pelvic fractures were selected as subjects of group A, which were treated by high ilioinguinal approach, while other 35 patients with Tile C type pelvic fractures were selected as subjects of group B, which were treated by simple posterior approach. After the treatment, the excellent and good rate, satisfaction rate, intraoperative blood loss, incision length, operation time, length of stay, time of hospitalization and incidence of complications were compared between the two groups. 　Results　In terms of excellent and good rate, group A was 88.57%, group B was 65.71%, group A was higher than group B (P<0.05). In terms of satisfaction rate, group A was higher than that of group B (P<0.05) (Group A was 97.14%, group B was 74.29%). The volume of intraoperative blood loss, the length of incision, the time of operation, the time of going to the ground and the time of hospitalization in group A were all lower than that in group B (P<0.05). In terms of the incidence of complications, group A was 2.86%, group B was 22.86%, thus group A was lower than group B (P<0.05). Conclusions　In the treatment of Tile C type pelvic fractures, the treatment with the high ilioinguinal approach has the advantages of significant effect and high safety, so it has a high clinical application and promotion value.

Digital holographic microscopy (DHM) and its application in monitoring three-dimensional dynamics of human spermatozoa

SUN Li, HUANG Gui, GONG Xiang-jun , OU Jian-ping

Chinese Journal of Clinical Anatomy. 2020, 38(4):  476-480.  doi:10.13418/j.issn.1001-165x.2020.04.021

Abstract ( 276 )  

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Objective　To apply digital holographic microscopy (DHM) as a tool for monitoring three-dimensional (3D) dynamics of human spermatozoa.　Methods　Sperm samples collected from healthy male participants were diluted to 2×107/mL by artificial human tubal fluid (HTF). These suspensions were injected for further observations. 3D dynamics of human spermatozoa were recorded by DHM with holograms. Background images were obtained by averaging holograms in each subgroup. Background removal was performed and the back-free hologram was applied for 3D localization of the sperm according to Rayleigh-Sommerfeld back propagation algorithm. Instantaneous 3D coordinates of human spermatozoa were linked to form trajectories. Subsequently, 3D motion patterns, density distribution, spatial distribution of 3D velocity and 3D orientation of human spermatozoa were determined.　Results　3D motility parameters, 3D motion patterns as well as information reflecting sperm-surface interactions including density distribution, spatial distribution of 3D velocity and 3D orientation of human spermatozoa were available by utilizing DHM. Conclusions　DHM can provide a comprehensive assessment of sperm fertilizing capacity. 

Analysis of factors influencing the prognosis of diabetic foot amputation and evaluation of prognosis ability

CAO Zhi-yuan, HE Ai-yong, XIAO Bo

Chinese Journal of Clinical Anatomy. 2020, 38(4):  481-485.  doi:10.13418/j.issn.1001-165x.2020.04.022

Abstract ( 375 )  

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Objective　To explore the influence of different laboratory indexes for different prognosis of diabetic foot amputation and evaluate its predictive value for poor prognosis.　Methods 　The clinical data of 69 patients with diabetic foot amputation at the Second Xiangya Hospital of Central South University from January 2016 to March 2018 were retrospectively collected. All the patients were followed up for 1 year. The patients were classified into a poor prognosis group (patients with exacerbation) and a favorable prognosis group (patients with on exacerbation and good wound healing). Kaplan-Meier survival curve was drawn to observe the one-year poor prognosis rate. Univariate and multivariate analysis were used to screen out the independent influencing factors that lead to poor prognosis. The predictive ability of the adverse reactions after diabetic foot amputation was calculated and evaluated by the ROC curve. In the prognostic group, patients were sub-grouped according to the number of debridement to screen out the independent risk factors that affecting the number of debridement before amputation surgery.　Results　Univariate analysis showed that for diabetic foot amputation, D-dimer、CRP、ESR、NLR、ALB of the poor prognosis group have better statistical difference than that of the favorable prognosis group (P<0.05). Multivariate analysis showed D-dimer、CRP and NLR were the independent factors that influencing the prognosis of diabetic foot amputation. Kaplan-Meier survival curve showed that one-year poor prognosis rate was 40.6%. Area under the curve of the combined diagnosis of D-dimer, CRP and NLR was 0.902, which was higher than that of D-dimer or CRP or NLR. Delong test showed there were statistical difference between the area under the curve and D-dimer (P<0.05). CRP was the independent risk factor that affecting the number of debridement before amputation in the favorable prognosis group (P<0.05).　Conclusions　D-dimer, CRP, NLR and the combined diagnosis of the three have favorable predictive ability for the prognosis of diabetic foot amputation. The efficiency of the combined diagnosis was higher than that of D-dimer, but not significantly better than that of CRP and NLR. CRP was the independent risk factor that affecting the number of debridement before amputation in the favorable prognosis group.

Improvement method on making of gastric vascular cast specimen

LUO Bao-hua, LIU Chang, LUO Jian-heng, LI Ze-yu

Chinese Journal of Clinical Anatomy. 2020, 38(4):  486-487.  doi:10.13418/j.issn.1001-165x.2020.04.023

Abstract ( 219 )  

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Progress in the treatment of lumbar disc herniation by percutaneous intervertebral foramen microscopy

WANG Yi-dan, XU Yang-yang, SU Bao-ke, Dai li-na, XU Xue-bin, HE Yu-jie, WANG Hai-yan, LI Xiao-he, LI Zhi-jun

Chinese Journal of Clinical Anatomy. 2020, 38(4):  488-491.  doi:10.13418/j.issn.1001-165x.2020.04.024

Abstract ( 283 )  

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Research progress in nanocarrier systems of bortezomib

WAN Li-dan, WU Hong-hao

Chinese Journal of Clinical Anatomy. 2020, 38(4):  492-493.  doi:10.13418/j.issn.1001-165x.2020.04.025

Abstract ( 148 )  

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Ultrasound combined with anatomy and casting in the diagnosis of right isomerism:a case report 

ZENG He, WANG Yu, SONG Juan, FENG Wei, ZHANG Jia-qi, LIU Ya , HE Qiao-yue

Chinese Journal of Clinical Anatomy. 2020, 38(4):  494-495.  doi:10.13418/j.issn.1001-165x.2020.04.026

Abstract ( 330 )  

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