Chinese Journal of Clinical Anatomy

Clinical anatomy grows healthily under the warm care of centennial Chinese Society for Anatomical Sciences

Zhong Shizhen, Ouyang Jun

Chinese Journal of Clinical Anatomy. 2021, 39(1): 1.

Abstract ( 419 )

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Anatomical study of pineal region via supracerebellar infratentorial (SCIT) approach under neuroendoscopy

Zhu Jiandong, Xu Ling, Xie Mingxiang, Xiao Shunwu

Chinese Journal of Clinical Anatomy. 2021, 39(1): 2-6. doi:10.13418/j.issn.1001-165x.2021.01.001

Abstract ( 768 )

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Objective　To observe the anatomic characteristics of pineal region and its adjacent structures by simulating midline and paramedian SCIT approach under neuroendoscopy, so as to provide anatomic basis for endoscopic treatment of lesions in this area.　Methods　Five adult cadaveric heads fixed with formalin were selected to simulate the midline and paramedian SCIT approachs under neuroendoscopy. The structure of pineal region was observed and measured, and the exposure of the two surgical approaches was compared.　Results　The distance from the dura mater midline and paramedian SCIT approachs under neuroendoscopy to the cerebellar fissure vein were (58.14±1.62) mm and (76.51±2.25) mm, and the relative degree of freedom were (0.09±0.01), (0.05±0.01). The relative degrees of freedom of pineal gland were (0.47±0.01) and (0.35±0.09), and the relative degrees of freedom of superior colliculus were (0.26±0.05) and (0.40±0.07). The left and right operable angles of the pineal gland were (14.85±0.35) and (17.86±1.03) degrees, respectively, and the anterior and posterior angles were (21.40±1.41) and (15.00±3.06) degrees. The left and right operable angles of the corpus callosum were (14.55±0.07) and (17.04±1.57) degrees, and the anterior and posterior angles were (14.60±0.71) and (18.76±2.83) degrees. The left and right operable angles of the ipsilateral superior colliculus were (15.63±5.08) and (21.62±2.19) degrees, and the anterior and posterior angles were (11.18±4.72) and (18.94±4.08) degrees. There were statistical difference between them (P<0.05).　Conclusions　Midline SCIT approach and paramedian SCIT approach have their own advantages. The surgical approach should be selected according to the specific location of the lesion.

Morphological characteristics of the first denticulate ligament and its clinical significance

Du Xinru, Kong Xiangyu, Guo Sen, Wang Jiajia, Liu Hongwei, Ma Quan, Liu Yingdong

Chinese Journal of Clinical Anatomy. 2021, 39(1): 7-11. doi:10.13418/j.issn.1001-165x.2021.01.002

Abstract ( 1602 )

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Objective　To observe the anatomical structure of the first denticulate ligament at the craniocervical junction and to discuss its clinical significance. Methods Eighteen cranial-neck specimens were dissected and were stripped to observe the structure of the first denticulate ligament. Its starting and finishing, adjacency, course and its morphology were observed. The histological characteristics of the ligament was detected by HE staining.　Results　The first denticulate ligament were found in left and right side of all specimens (occurrence rate: 100%), with the membrane type in 9 cases (accounting for 50%); dense type in 4 cases (accounting for 22.2%); loose type in 5 cases (accounting for 27.8%). The first denticulate ligament was located laterally to the superior medulla oblongata, the fibers converged outwards and upward in a long triangle, crossing behind the vertebral artery and ending in the epidural and fusing with the dura mater. The attachment part on the spinal cord was located between the anterior root and posterior root of the spinal nerve, the distal part was integrated with the 2nd ~ 8th dentate ligament, and the proximal part reached the level of the medulla oblongata. Histological result showed that the denticulate ligament was composed of collagen fibers. Conclusions　The first denticulate ligament plays an important role in maintaining the stability of the spinal cord. Subarachnoid space is divided into a front part and a back part by denticulate ligament. Cerebrospinal fluid pressure imbalance can lead to different stress on the anterior and posterior parts of the spinal cord. And the anterior spinal cord may be subjected to higher pressure stimulation to aggravate or induce the injury of the anterior horn cells of the spinal cord and the corticospinal tract, which may be one of the anatomical factors leading to amyotrophic lateral sclerosis (ALS).

Anatomical study on the application of peroneus tertius in ligament reconstruction

Liu Jinxin, Gao Jiake, Zhang Yi, Cheng Jinli, Zhang Yingze, Yu Tengbo

Chinese Journal of Clinical Anatomy. 2021, 39(1): 12-15. doi:10.13418/j.issn.1001-165x.2021.01.003

Abstract ( 1516 )

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Objective　To observe and measure the stop-point morphologic features of the peroneus tertius (PT), and provide anatomic basis for ligament reconstruction.　Methods　The distance from the tendon junction to the PT insertion point (D1), the distance from the PT insertion point to the extensor subservient distal band (D2) were measured. The width and thickness of the insertion point and the attachment of the muscle tendon were recorded in 34 cases of the isolated ankle joint specimens and were classified according to the type of insertion point. Results According to the PT insertion point pattern, the occurrence rate of the different patterns were 17.65 %, 35.29 %, 41.18 % and 5.88 %, respectively. The distance from the PT insertion point to the extensor subservient distal band was (58.12±6.82) mm. The distance from the tendon junction to the PT insertion point was (68.22±6.76) mm. The width of PT insertion point was (32.59±10.61) mm. The width of the PT tendon joint was (3.91±0.73) mm. The PT thickness was (1.12±0.18) mm. The D2 and the some PT patterns were not completely same, and there was statistical significance among them (H = 15.645, P<0.05). The D1 and the some PT patterns were not completely same, and there was statistical significance between them (H = 15.027, P<0.05). The width of PT terminal point in each pattern was not completely same, and there were statistical significance between them (H = 28.098, P<0.05). The width of the junction of the tendons in each PT pattern was not completely same, and there were statistical significance between them (H = 7.919, P<0.05). There was no statistical difference in the thickness of PT (H = 1.638, P>0.05). Conclusions The occurrence rate of type Ⅲ stop-point is the highest, and that of type IV stop-point is the lowest. There were no significant differences in length, width, body side and gender, but there were significant differences in the type of stop-point, which is helpful for clinical ligament reconstruction and other operations.

Anatomical observation and clinical significance of the arcuate line in totally extraperitoneal preperitoneal （TEP） herniorrhaphy

Wang Youhua, Huang Hai, Luo Jianhua, Zhang Huanbin, Zheng Fuqiang, Liang Shaocheng, Zhou Xuelu

Chinese Journal of Clinical Anatomy. 2021, 39(1): 16-21. doi:10.13418/j.issn.1001-165x.2021.01.004

Abstract ( 1166 )

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Objective　To study the position and morphological features of the arcuate line and get better understanding of its clinical significance, so as to provide the applied anatomical data and operation guide for the totally extraperitoneal (TEP) herniorrhaphy. Methods The arcuate line was dissected and observed during TEP in 60 cases of adult patients with primary inguinal hernia. The location and length of the arcuate line were determined by puncturing needle vertically through the skin, and its morphology and quantity data were recorded.　Results　The arcuate line was recorded and divided into four groups, namely, a classical group (4~5 cm) in 15 cases (accounting for 25.0%), a high level group (less than 3 cm) in one case (accounting for 1.7 %), a low level group (6~12 cm) in 43 cases（accounting for 71.6%）, an absent arcuate line group in one case (accounting for 1.7%). Twenty-two cases were single arcuate line (accounting for 36.7%), while 38 cases were multiple arcuate line (accounting for 63.3%). Two cases were the straight shaped arcuate line (accounting for 3.3%), 28 cases and 29 cases were the arc-shaped and the transition shaped arcuate line (accounting for 46.7% and 48.3 % respectively). Conclusions The arcuate line is the free margin formed by the absence of the posterior layer of the rectus sheath. There are great differences in its position, morphology and number. The variation of arcuate line not only increases the difficulty of the TEP surgery, but also increases the complications. The arcuate line has important clinical significance in the TEP operation.

Anatomical features of fetal thyroid artery and its significance

Lin Jinxian, Huang Hailong

Chinese Journal of Clinical Anatomy. 2021, 39(1): 22-25. doi:10.13418/j.issn.1001-165x.2021.01.005

Abstract ( 1402 )

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Objective　To explore the anatomical features of fetal thyroid artery and its application value by means of cast blood vessel specimen and three-dimensional reconstruction technique.　Methods The filler were perfused through the common carotid artery and subclavian artery, and the thyroid artery vessels of 17 fetuses at around 18~37 weeks were anatomically observed and measured. The CT scan data were imported into Mimics 21.0 software for three-dimensional reconstruction of thyroid artery.　Results　The variation of fetal thyroid artery originated from the first branch of external carotid artery (accounting for 79.4%) or originated from the common carotid artery (accounting for 14.7%) or from the bifurcation of the common carotid artery (accounting for 5.9%)，the fetal inferior thyroid artery may originate from the thyrocervical trunk (accounting for 76.5%) or originate from the subclavian artery (accounting for 23.5%). The fetal thyroid artery branches and distribution were constant. There was no significant difference in the initial position between the adult thyroid artery and the fetal thyroid artery. There were significant difference in the branches and distribution between them.　Conclusions　Understanding the origin of thyroid artery, its branch and distribution characteristics can provide a practical basis for intrauterine fetal development research or neonatal clinical surgery.

Diffusion tensor imaging observation of the anterior cruciate ligament injury of knee joint

Mao Guanglan, Li Pei, Yang Rongli, Fu Shengqi, Wang Qingzhi

Chinese Journal of Clinical Anatomy. 2021, 39(1): 26-30. doi:10.13418/j.issn.1001-165x.2021.01.006

Abstract ( 673 )

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Objective　To provide a new imaging diagnostic basis for the classification of anterior cruciate ligament injury of the knee. 　Methods　One hundred cases of normal knee joint and one hundred cases of unilateral anterior cruciate ligament laceration were selected to perform diffusion tensor imaging scanning, the latter were divided into I grade, II grade, III grade and IV grade according to the damage degree. At the workstation, the regions of interest of the anterior cruciate ligament injury and the corresponding position of the normal group were divided, the fractional anisotropy(FA) values and apparent diffusion coefficient(ADC) values were measured, and the tractography images were generated.　Results There were significant differences in the FA values and ADC values between the anterior cruciate ligament injury and the normal group. The FA values of anterior cruciate ligament injury was lower than that of the normal group, while the ADC values was higher than that of the normal group. There were significant differences in the FA values and ADC values of the anterior cruciate ligament injure at I grade, II grade, III grade and IV grade, the FA values decreased gradually with the increasing of damage degree, which was negatively correlated with the damage degree. The ADC values increased gradually, which was positively correlated with the damage degree. There were significant difference in the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the FA values and ADC values, tractography imaging and MRI in the diagnosis of degree classification of the anterior cruciate ligament injury, it was the tractography imaging, FA values and ADC values, MRI in order from high to low.　Conclusions　The FA values and ADC values of anterior cruciate ligament injure of knee joint are closely related to the damage degree, the tractography imaging can improve the diagnostic rate of the degree classification of anterior cruciate ligament injury, and the diffusion tensor imaging can provide a more accurate imaging diagnostic basis for degree classification of anterior cruciate ligament injury.

Digital fine anatomy of bladder and urethra in rest state of young nullipara with a normal pelvic floor function

Chen Lan, Chen Chunlin, Liu Ping, Feng Jie, Wang Jianping, Tang Lian, Liao Kedan, Jiang Wenxuan, Liang Shiqi

Chinese Journal of Clinical Anatomy. 2021, 39(1): 31-36. doi: 10.13418/j.issn.1001-165x.2021.01.007

Abstract ( 495 )

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Objective　To study digital fine anatomy from 3D models of bladder and urethra of normal young nullipara in rest state.　Methods　The MRI data and general clinical information of gynecological patients in Nanfang hospital from January 2013 to October 2016 were collected and analyzed. 45 normal young nulliparas were selected according to the inclusion criteria, Mimics 10.01 software was used to reconstruct the 3D models, UG software was combined to measure most kinds of anatomy parameters, such as the length and the angle between bladder, urethra and pubic bone.　Results　3D models of 45 patients were successfully built, including pelvis, uterus, bladder, urethra, vagina and rectum. The related anatomic parameters of bladder urethra were measured as follows: the angle of bladder and urethra: (146.3±16.6) °, β angle: (144.5±14.1) °, the angle of urethra pubic : (47.9±15.2) °, the angle of urethra: (18.5±9.2) °, α angle: (87.2±15.1) °. Urethral striated muscle thickness was (2.58±0.60) mm. Retropubic space was (15.96±3.52) mm. The distance between the bladder neck and the midpoint of lower margin of symphysis pubis was (23.66±3.97) mm.　Conclusions　3D reconstruction technology is a good way to reproduce intuitively the three dimensional anatomical morphology of human bladder and urethra, providing a 3-D research platform for the fine anatomy of the bladder and urethra. By multiple diameters and angles measurement, it can reflect the functions of the bladder and urethra under normal conditions.

Imaging anatomical measurement and clinical significance in minimally invasive surgery of the lower lumbar laminae interval space

Zhang Haifeng, Zhan Xinhua, Fu Zeze, Wu Jianfeng, Fu Qiang

Chinese Journal of Clinical Anatomy. 2021, 39(1): 37-40. doi:10.13418/j.issn.1001-165x.2021.01.008

Abstract ( 823 )

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Objective　To measure the anatomical parameters of lumbar laminae interval space with lower lumbar disc herniation (LDH) by an imaging method and to explore the clinical significance in minimally invasive spinal surgery.　Methods　One hundred and forty-five anteroposterior X-ray films with single lumbar disc herniation (L4/5 and L5/S1) were enrolled. The morphological characteristics of the lumbar vertabral laminae interval space between affected side (a symptoms group) and healthy side (a control group) were compared. The height, width and the area of the bilateral vertebral laminae interval space in the segments of L4/5 and L5/S1 were measured by X-rays according to the gender. The available diameter of lumbar laminae interval space was measured by lumbar vertebra 3D CT. Then all data were analyzed statistically. 　Results From the anteroposterior X-ray films of lumbar laminae interval space, the shape of the vertebral laminae interval space in the segments of L4/5 and L5/S1 in the healthy side group was oval, while the shape in the affected side group were in triangle and oblate shapes. The incidence of lumber disc space stenosis in the affected side group was 68.1% in total, including 65.1% happened in L4/5 segment and the incidence of L5/S1 segment was 71%. With the changing in the width of lumbar laminae interval space, the height also changed. The 3D CT result showed that the available diameter of the vertebral laminae interval space in 76.5% of the patients was smaller than the diameter of the working channel. 72.3% of which were located in the L4/5 segment, and 80.6% in the L5/S1 segment. The mean height, width and the area as well as available diameter of the lumbar vertebral laminae interval space in male group were higher than those in female group, and the difference was statistically significant (P<0.05). The average height, width and the area as well as the available diameter in segment L5/S1 were larger than those in segment L4/5.　Conclusions　There was a closed association between lumbar disc herniation and the change of lumbar laminae interval space. With the understanding of the height, width, the area and available diameter of the lumbar vertebral laminae interval space would guide to select the minimally invasive surgical approach and the surgical procedure.

Effects of relatively low dose of X-rays irradiation on adult cognition and hippocampal neurogenesis in juvenile mice

Zeng Lei, Ji Taotao, Zhou Lin, Ke Xiangjie, Zhao Yansheng, Yang Bo, Ren Boxu, Tang Fengru

Chinese Journal of Clinical Anatomy. 2021, 39(1): 41-48. doi: 10.13418/j.issn.1001-165x.2021.01.009

Abstract ( 173 )

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Objective　To investigate the effects of relatively low dose of ionizing radiation on adult cognition and hippocampal neurogenesis in juvenile mice, and to illuminate the relationship between relatively low dose of irradiation, cognitive function and neurogenesis.　Methods　20 Kunming mice were randomly divided into two groups at postnatal 21 days: a radiation group and a control group (P21) (n = 10 each group). The radiation group was exposured with an acute whole body irradiation with a dose of 5 Gy at P21, the normal control group was sham irradiated. The two groups of mice were weighed before being exposured, at 2 months old and 4 months old, respectively. At 4-month-old, each mouse was experimented with open field test (OPT), new object recognition experiment (NOR), fear conditioning test (FC) and Morris Water Maze test (MWM). Brain sections were then immunostaining for different markers including Ki67 (mark proliferation neuron), doublecortin (DCX, mark differentiation and migration neuron), calbindin (CB, mark interneuron), and parvalbumin (PV, mark interneuron) in hippocampal dentate gyrus (DG).　Results 　(1) In the body weight test, both at 2 and 4 months of age, the percentage of mice’ body weight gain in the radiated group was significantly lower than that of the control group (t=3.02, P<0.05; t=4.22, P<0.01). (2) There were no significant differences in the distance traveled within 5 min in OPT ( t=-1.672, P＞0.05), the DI in NOR (t=0.753, P>0.05), the contextual memory related freezing time ( t=-0.885，P>0.05) and the clued memory related freezing time (t=0.15, P>0.05) in FC, the average escape latency (F=2.30，P>0.05) in MWM and the times of crossing platform (t=-1.07, P>0.05) between the two groups. (3) However, Ki67, DCX, CB and PV labeled neurons number in DG in irradiation group were significantly lower than that of the control group (Ki67, t=2.80, P<0.05; DCX, t=6.63, P<0.001;CB, t=3.75, P<0.01; PV, t=5.39, P<0.001).　Conclusions (1) Relatively low doses (5 Gy) of ionizing radiation in juvenile stage cause slow body weight gain in mice. (2) Relatively low doses (5 Gy) of irradiation exposure to juvenile mice do not cause learning and memory disorder when mice were tested in adult, but it resulted in declining of neurogenesis in SGZ. (3) The decreasing of neurogenesis induced by irradiation includes injury of a series of processes such as proliferation, division, differentiation, migration and maturation of neurons.

The lipid droplet distribution and expression of heart type fatty acid binding protein in the myocardium of hyperlipidemic rat heart

Sun Xiaopeng, Guo Kang, Guo Zhikun

Chinese Journal of Clinical Anatomy. 2021, 39(1): 49-54. doi:10.13418/j.issn.1001-165x.2021.01.010

Abstract ( 471 )

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Objective　To observe the changes of lipid droplet in cardiomyocytes and cardiac function of hyperlipidemia rats, and the expression changes of heart type fatty acid binding protein (H-FABP). Methods　High fat diet SD male rats was established hyperlipidemia rat model. After feeding for 4 weeks, 8 weeks and 12 weeks, the cardiac function of the rats was detected and the heart was removed. Frozen sections were stained with oil red O, and the distribution of lipid droplets in the myocardium was observed under light microscope. The changes of lipid droplets in myocardium were observed by transmission electron microscope. The expression of H-FABP in cardiomyocytes and myocardium was detected by immunohistochemistry, immunofluorescence and Western blotting.　Results　Compared with the normal diet rats, the serum triglyceride and total cholesterol increased significantly in the high-fat diet rats, the most obvious was in the 12 week, accompanied by a significant reduction in ejection fraction, increasing of lipid droplets in myocardial cells. The number of H-FABP in myocardium and myocardium increased significantly at the 8th week and the 12th week.　Conclusions　The myocardium of hyperlipidemia rats occurs fatty degeneration. With the increasing concentration of blood lipid, the fatty degeneration and the heart function decrease, which may be related to the increasing of H-FABP expression and the increasing of fatty acid oxidation in cardiac myocytes.

Effect of miR-146a on the sensitivity of nasopharyngeal carcinoma cells HNE-1 / DDP to cisplatin by targeting CCNJ

Zhou Lanzhu, Zhao Bao, Zhang Mingjie, Cui Yixuan, Wu Jun, Sun Zhe, Liu Shencheng, Wang Wenzhong

Chinese Journal of Clinical Anatomy. 2021, 39(1): 55-59. doi:10.13418/j.issn.1001-165x.2021.01.011

Abstract ( 309 )

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Objective　To investigate the effect of miR-146a on cisplatin sensitivity of nasopharyngeal carcinoma HNE-1 / DDP cells and its possible mechanism.　Methods　The experiment was divided into three groups: a blank control group, a negative control group and a mimics-miR-146a group. MTT assay was used to detect the proliferation inhibition of cells after different treatments. Annexin V-FITC / PI assay was used to detect apoptosis. Western blot was used to detect the relative expression levels of cyclin CCNJ, MRP1, P-gp. RT-qPCR was used to detect the relative expression level of CCNJ mRNA.　Results Compared with other two groups, the survival rate, the relative protein expression levels of MRP1, P-gp, CCNJ and the relative expression level of CCNJ mRNA of mimics-miR-146a reduced, while the apoptosis rate increased. There were statistical differences in the survival rate, the relative protein expression levels of MRP1, P-gp, CCNJ, the relative expression level of CCNJ mRNA and the apoptosis rate among the three groups (P<0.05).　Conclusions　miR-146a can increase the sensitivity of HNE-1/DDP to DDP which mechanism may be through miR-146a inhibiting the expression of CCNJ to regulate downstream proteins MRP1,P-gp,and then to reduce cell resistance.

Imaging and histology research of citrate-based biodegradable screws

Li Zhen, Huang Hai, Liao Jianwen, Fan Shicai, Yang Cheng

Chinese Journal of Clinical Anatomy. 2021, 39(1): 60-64. doi:10.13418/j.issn.1001-165x.2021.01.012

Abstract ( 432 )

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Objective　To evaluate the applicability and mechanism of citric acid copolymer - hydroxyapatite (POC-click-HA) screws in treatment of lateral femoral condyle fracture of canine.　Methods　Nine adult male Beagles (weighing 9~12 kg) were selected to prepare the models (AO classification type B1) of bilateral lateral femoral condyle fracture, the right side was fixed with POC-click-HA absorbable cannulated screws as an experimental group and left side with Poly-DL-Lactic acid(PDLLA) screws as a control group. At 4 weeks, 8 weeks, and 12 weeks after operation，Micro-CT and histological analysis were taken to observe the fracture healing. The osteogenesis effect of MC3T3 E1 cell were observed by the Kreb’s cycle inhibitors of the CPI-613 and exogenous citric acid (CA).　Results Micro-CT result showed that the combination of POC-click-HA screw and bone was weaker than PDLLA screw at 4 weeks after surgery. At 8 weeks, the two groups of screws were gradually integrated with the surrounding bone tissue, with no significant difference. At 12 weeks, the screw-bone tissues of both groups were well bonded. Histological staining analysis result showed that new bone was gradually formed around the screws in experimental group. The screws were degrading and new bone was growing in. However, there were still more collagen fibers around the screws in the control group, only a few new bones were seen, and the screws were not degraded. The results of cell culture showed that the citric acid in the medium significantly reduced after the addition of cpi-613 inhibitor. The higher concentration of inhibitor, the fewer ALP positive cells were formed. The higher the citric acid concentration, the more calcium nodules formed. Conclusions　Compared with PLLA screw, POC -click-HA bone screw has stronger bone induction ability and faster bone degradation，which can be better utilized for Beagles’ lateral femoral condyle B1 fractures. The mechanism for Citric acid material to promote fracture healing may be related to the TCA cycle.

Comparison of effects of atomizing inhalation and intratracheal instillation on model establishment of asthma in mice

Hu Jie, Zhou Wenjing, Wang Yunting, Niu Chao, Fu Zhou, Dai Jihong

Chinese Journal of Clinical Anatomy. 2021, 39(1): 65-70. doi:10.13418/j.issn.1001-165x.2021.01.013

Abstract ( 457 )

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Objective　By comparing the modeling effect and stability of the mouse asthma model, to determine the best way to model.　Methods　BALB/c female mice of SPF grade for 6-8 weeks were randomly divided into 5 groups, including 20 μg sensitized atomizing inhalation challenge group (20-INH), 100-INH group, 20 μg sensitized intratracheal instillation challenge group (20-ITI) and 100-ITI group ,control group. Mice were sensitized and challenged with ovalbumin（OVA）to make asthmatic models . The mice were sensitized with 20 μg and 100 μg OVA on 0, 7 and 14 days respectively. From day 21, challenged by atomizing inhalation way or intratracheal instillation way. Within 24 h following the last challenge, the airway hyper responsiveness（AHR） of the mice was assessed. Bronchoalveolar lavage fluid (BALF) was taken for cells count and the left lung were examined pathologically. ELISA was used to detect the levels of serum total immunoglobulin E (IgE).　Results　The AHR, the total cells of BALF, the eosinophil count of BALF and serum total IgE level significantly increased in the groups of 20-INH, 100-INH and 100-ITI. All asthma groups had obvious airway inflammation infiltration and high mucus secretion. Among the groups, the 100-ITI was good at showing asthma characteristics. The standard deviation of each data of the model of intratracheal instillation was lower than that of the atomizing inhalation model. Conclusions The stimulation mode of intratracheal instillation can successfully establish a mouse asthma model at the sensitizing dose of 100 μg OVA, and the increasing of the airway mucus secretion and serum total IgE are more obvious. The model has high stability and is worthy of recommendation.

Comparison of chondrogenic effects of three kinds of chondrogenic induction media on human adipose-derived stem cells in monolayer and microsphere cultured

Yu Qinghe, Qu Rongmei, Zhang Guowei, Li Xin, Qiu Xianshuai, Ouyang Jun, Dai Jingxing, Min Shaoxiong

Chinese Journal of Clinical Anatomy. 2021, 39(1): 71-75. doi: 10.13418/j.issn.1001-165x.2021.01.014

Abstract ( 508 )

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Objective　To compare the chondrogenic differentiation of human adipose mesenchymal stem cells (hASCs) in vitro by three components of chondrogenic induction medium.　Methods　hASCs were extracted from human adipose tissues and then performed in monolayer culture and microsphere culture respectively. Three kinds of different components of chondrogenic induction medium (group A: Fetal bovine serum (FBS) + high concentration TGF-β3, group B: Insulin, Transferrin, Selenium Solution (ITS) + low concentration TGF-β3, group C: ITS + high concentration TGF-β3) were added. After 3 weeks, the cell proteins in monolayer culture were extracted for detection of cartilage-related markers, and the cell microspheres were stained with Toluidine blue, Alcian blue, Sirius red to compare the effect of cartilage formation. Results 　After 3 weeks, the expression of cartilage markers was the highest in the group C of monolayer culture system, and the staining of microspheres was also the deepest in the group C.　Conclusions　As a medium additive, ITS has a better effect than FBS in inducing chondrogenic differentiation of hASCs. As an important growth factor stimulating chondrogenesis of hASCs, the concentration of 10 ng/ml TGF-β3 has a stronger effect than the concentration of 1 ng/ml.

The expression and localization of p-PDGFR alpha at different stages after substantia nigra striatum injury in mice

Pei Dan, Liu Xue

Chinese Journal of Clinical Anatomy. 2021, 39(1): 76-81. doi:10.13418/j.issn.1001-165x.2021.01.015

Abstract ( 532 )

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Objective To investigate the expression and localization of platelet-derived growth factor receptor alpha (PDGFRα) at different stages after substantia nigra striatum injury in mice. Methods The substantia nigra striatum pathway was unilaterally transected in 8 weeks old BALB/c mice. According to the method of Baidan, brain tissues of 2 mm around the injury brain were examined on the 1st, 4th, 7th and 14th day after operation. The expression of p-PDGFR alpha protein was detected by immunohistochemical staining and Western blot. Immunofluorescence double staining was used to detect the localized expression of p-PDGFR alpha. Results Immunohistochemical staining and Western blot showed that the expression of p-PDGFR alpha reached its peak level 4 days after injury. Double immunofluorescence staining showed that p-PDGFR alpha was expressed in astrocytes, microglia, leukocytes and oligodendrocytes. Conclusions Brain injury can activate PDGFR alpha and express around the injury. Activated PDGFR alpha may be related to the proliferation of astrocytes, microglia, leukocytes and oligodendrocytes.

The prognostic role of immunoscore in patients with hepatocellular carcinoma

Zhang Haonan, Zhang Linzhi, Gao Wei, Xu Yan, Yang Xueling, Yu Haipeng, Xing Wengeng, Si Tongguo

Chinese Journal of Clinical Anatomy. 2021, 39(1): 82-89. doi:10.13418/j.issn.1001-165x.2021.01.016

Abstract ( 997 )

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Objective　To investigate the expression of immunoscore and PD-L1 in hepatocellular carcinoma(HCC), and to analyze the relationship between the expression of PD-L1 and immunoscore and the clinicopathological characteristics and prognosis of HCC.　Methods　Immunohistochemical staining was used to detect the expression of immunoscore and PD-L1 in 61 cases of hepatocellular carcinoma tissue, and to analyze the relationship between the expression of immunoscore and PD-L1 in hepatocellular carcinoma and different clinicopathological features and prognosis．Results　The expression rate of high-immunoscore was 26.2%, the low-immunoscore expression rate was 73.8%. In clinical indicators，the positive expression rate of immunoscore was negatively related to patient's preoperative AFP level (P<0.005), and intrahepatic recurrence (P<0.05), but not to factors of patient’s age, gender, tumor size, differentiation, and non-vascular invasion correlated (P>0.05). Kaplan–Meier analysis presented that the immunoscore showed good stratification between high-immunoscore and low-immunoscore groups in both overall survival (P<0.01) and progression-free survival (P<0.01), respectively. The positive expression rate of PD-L1 in hepatocellular carcinoma was 44.3%, which was significantly higher than that in normal control group (P<0.01).Kaplan-Meier analysis presented that the PD-L1-positive patients was significantly lower in patients with negative PD-L1-negative patients. In clinical indicators，the positive expression rate of PD-L1 was negatively related to patient’s immunoscore (P<0.01)．Conclusions　The expression of immunoscore can be used as an important prognostic maker for patients with hepatocellular carcinoma. Patients with high-immunoscore are significantly associated with a prolonged OS and PFS, however patients with low-immunoscore are more likely to occur early recurrence, prognosis is even worse. The positive expression rate of PD-L1 is negatively related to patient’s immunoscore.

Application of digital biliary tract system in the operation of complex cholelithiasis

Wang Sangui, Wang Haifeng , Chen Haibo, Ye Xiyin, Feng Xiaohui

Chinese Journal of Clinical Anatomy. 2021, 39(1): 90-94. doi:10.13418/j.issn.1001-165x.2021.01.017

Abstract ( 701 )

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Objective　To explore the clinical application value of digital biliary system in minimally invasive surgery for complex gallstone disease.　Methods　41 patients with complex cholelithiasis were selected from April 2018 to July 2019. They were randomly divided into an experimental group and a control group. In the experimental group, the hepatobiliary model which established by their CT data was introduced to the digital biliary tract system, and then were applied in preoperative evaluation, surgical simulation, and lithotripsy extraction plan for intraoperative guidance. Minimally invasive surgery was performed on the two groups. Reexamination of stones and recurrence were detected by ultrasound or CT.　Results　The biliary tract and stones in the experimental group were consistent with those in the digital biliary system. The actual surgical method was consistent with the preoperative simulation and planning. The mean operation time was (160.10 ± 78.82) min, the intraoperative bleeding volume was (2.95±2.28) ml, and the intestinal recovery time was (1.13±0.70) days, all were less than those in the control group. No severe perioperative complications, residual stones and recurrence occurred. In the control group, there were 2 cases of residual stones, 1 case of gastrointestinal bleeding, and 2 cases of recurrence of stones.　Conclusions　The digital biliary system showed good guiding significance and application value for minimally invasive surgery for complex cholelithiasis. It could decrease the operation time and intraoperative bleeding and shorten intestinal recovery time and would be safe and efficient.

Study on the characteristics of infrared thermography in children with cerebral palsy

Bai Wenfang, Yang Wanxin, Yu Xiaotang, Huang Hongliang, Xu Weicheng, Liu Lanren, Fan Yangang, Huang Xuming, Zhang Mingsheng

Chinese Journal of Clinical Anatomy. 2021, 39(1): 95-100. doi:10.13418/j.issn.1001-165x.2021.01.018

Abstract ( 621 )

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Objective　To observe and compare the infrared thermogram of children with cerebral palsy and normal children, and to explore and analyze the characteristics of the thermogram of children with cerebral palsy, so as to provide reference for clinical application.　Methods　Children with cerebral palsy (n=42) and normal children (n=42) were selected as an observation group and a control group respectively. The whole body thermal images of children were collected by TMI-BX1 portable infrared thermal image temperature measurement system. The average temperature values of 11 points which included forehead, chest, upper abdomen, lower abdomen, fourth thoracic vertebra(T4), twelfth thoracic vertebra(T12), fourth lumber vertebra(L4), left and right palms, dorsum pedis of each child were grabbed and analyzed by computer. Results　There was no significant difference in the temperature of the left and right extremities between the two groups (P>0.05). The head and trunk temperatures of the two groups were higher than the extremities (P < 0.01). The extreme difference between the highest temperature and the lowest temperature was greater in the observation group than that of the control group (P<0.05). The temperature of the forehead was significantly lower than that of abdomen(P<0.01) in both of the two groups. The temperature of the abdomen was significantly higher in the observation group than that in the back　(P<0.01), but significantly lower in the control group (P<0.01).　Conclusions　The abdominal temperature of children with cerebral palsy is higher than that of children with back, but that of normal childrem is lower than that of children with back. The characteristics of thermal imaging can provide reference for clinical research.

Modified dorsal branch flap of digital artery for repair of fingertip defect

Wang Kai, Ju Jihui, Jin Guangzhe, Guo Liping, Li Yadong

Chinese Journal of Clinical Anatomy. 2021, 39(1): 101-104. doi:10.13418/j.issn.1001-165x.2021.01.019

Abstract ( 371 )

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目的　报道应用带指固有动脉的指固有动脉背侧支皮瓣游离移植修复指端皮肤缺损的临床效果。方法　2014年1月至2018年10月，23例23指指端皮肤软组织缺损，均伴有指骨外露，应用带指固有动脉的指固有动脉背侧支皮瓣游离移植修复。术中不用特意寻找指固有动脉背侧皮支，保留指固有动脉近节中远1/3处1cm往背侧的筋膜组织，连同指固有动脉一并切取，切除的指固有动脉予以指背静脉桥接修复，切取皮瓣面积为1.5cm×1.0cm～2.5cm×2.0cm，供区取前臂全厚皮片植皮修复。结果　23例皮瓣全部成活，术后随访3～18个月，平均10个月，皮瓣质地佳，手指外形及感觉恢复良好，两点辨别觉为 8～14mm。皮瓣供区植皮愈合良好。结论　运用改良指固有动脉背侧支皮瓣，可降低了切取难度，减少背侧支损伤可能，增加供血动脉吻合口径，降低吻合难度，是修复指端缺损一种较好的方法。

Curative effect of the percutaneous Kirschner wires external fixation combined with bone cements fixation in the treatment of the fifth metacarpal neck fracture

Fan Hui, Chen Daiquan, Zhang Qin, Wu Qilong, Shi Jianxing, Gao Fei, Bao Qineng, Wu Weichang

Chinese Journal of Clinical Anatomy. 2021, 39(1): 105-107. doi:10.13418/j.issn.1001-165x.2021.01.020

Abstract ( 527 )

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Objective　To investigate the curative effect of percutaneous Kirschner wires external fixation combined with bone cements fixation in the treatment of the fifth metacarpal neck fracture. 　Methods　From June 2017 to January 2019, patients with the fifth metacarpal neck fracture were treated with percutaneous Kirschner wires external fixation combined with bone cements, including 11 males and 2 females, with an average age of 32.6 years old (ranged 20-43 years). The causes of fracture were heavy pound injury in 4 cases, fall injury in 4 cases and clenched fist hammer in 5 cases. The time from injury to being operation was 3 hours less than 5 days, with an average of 9.8 hours. According to the AO classification of fractures, there were 5 cases of B1 type, 4 cases of B2 type, 3 cases of B3 type and 1 case of C1 type.　Results　All the patients were followed up for 6 to 14 months, with an average of 8.4 months. 1 patient was loosened with external fixation. Bone union was achieved in all the patients, and the healing time ranged from 9 to 13 weeks, with an average of 11.2 weeks. One of the patient was accidently injured again 10 weeks after the operation and the external fixation became loose. When the fracture healing examination was well, Kirschner wires was removed immediately. At the last follow-up, there was no significant difference in the range of motion between the metacarpophalangeal joint and the contralateral metacarpophalangeal joint. There was no collapse deformity of the fifth metacarpal bone and no rotation deformity of the little finger.　Conclusions　The treatment of the fifth metacarpal neck fracture with percutaneous Kirschner wires external fixation combined with bone cements fixation has the advantages of less trauma, simple operation and early movement of metacarpophalangeal joint, and the curative effect is definite.

One case of laparoscopic parastomal hernia repairs and literature review

Luo Zhijian, Hu Weixian, Huang Chengzhi, Wang Junjiang, Hu Shixiong, Li Weihao, Yao Xueqing

Chinese Journal of Clinical Anatomy. 2021, 39(1): 108-110. doi:10.13418/j.issn.1001-165x.2021.01.021

Abstract ( 459 )

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Objective　To analyze the types and surgical management of parastomal hernia.　Methods　The case reports and literature analysis was used to explore the surgical procedures for patients with paratomal hernia reports to the past years. Results　In a retrospective report, on 1 case of laparoscopic parastomal hernia repaired patients, with EHS classification type Ⅳ, sugarbaker operation procedure, and patient eating 3 days after the repair, 5 days of discharge. Conclusions　Laparoscopic parastomal hernia repairs with lower complications and shorter hospital stay but still need more high-quality data support.

Research progress of thoracic paravertebral block

Chen Weidong, Tan Weihao, Zhong Jintao, Yang Bin, Chen Zhimin, Ma Chunling, Qu Dongbin, Zheng Minghui

Chinese Journal of Clinical Anatomy. 2021, 39(1): 111-114. doi:10.13418/j.issn.1001-165x.2021.01.022

Abstract ( 539 )

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Research progress of nerve injury related to supracondylar humerus fractures in children

Zhan Yi, Bei Chaoyong

Chinese Journal of Clinical Anatomy. 2021, 39(1): 115-117. doi:10.13418/j.issn.1001-165x.2021.01.023

Abstract ( 290 )

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Left musculocutaneous nerve absence and biceps brachii abnormal origin: a case report

Sun Fenggang, Dun Aishe, Wang Hui, Wang Hongbin

Chinese Journal of Clinical Anatomy. 2021, 39(1): 21. doi: 10.13418/j.issn.1001-165x.2021.01.024

Abstract ( 261 )

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