Table of Content

25 January 2022 Volume 40 Issue 1

  

Study on the anatomical factors of cervical sympathetic nerve and second cervical nerve in the occurrence of upper cervical vertigo

Song Zhanfeng, Wu Zhanyong, Ye Qibin, Lu Zhifang

Chinese Journal of Clinical Anatomy. 2022, 40(1):  1-3.  doi:10.13418/j.issn.1001-165x.2022.1.01

Abstract ( 233 )   PDF (2783KB) ( 68 )  

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Objective    To demonstrate the anatomical relationship between superior cervical ganglion (SCG) and second cervical nerve (C2) and the innervated branch from SCG to vertebral artery, for providing anatomical basis for the clinical diagnosis of the upper cervical vertigo.    Methods    Fifteen adult cadavers (total 30 sides) were dissected  to observe the communicating branches of SCG with C2 and the branches of the vertebral artery.   Results   There was no neural connection between SCG and C2 in 5 sides. There were neural connection between SCG and C2 in the remaining 25 sides, of which the vagus nerves were involved in 18 sides. The innervated branches were found from SCG to vertebral artery in 7 sides. After the SCG branch merged with the anterior branch of C2, the sympathetic nerve fibers were transferred to the anterior and posterior branches of C2 and the vertebral artery respectively.    Conclusions   The communicating branches of SCG and C2 and their dominant relationship to the vertebral artery can provide important anatomical basis for elucidating the pathogenesis of upper cervical vertigo and establishing effective treatment plan.

Morphological characteristics of femoral shaft and their influences on femoral valgus angle in southern China

Zhao Yiqi, Huang Guiwu, Li Wenchang, Zheng Linli, Zuo Nan, Ling Qianhui, Shi Guangyue, Wu Peihui

Chinese Journal of Clinical Anatomy. 2022, 40(1):  4-9.  doi:10.13418/j.issn.1001-165x.2022.1.02

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Objective　To explore the effects of rotation position change of lower limbs on the femoral valgus angel (FVA) measurement of different forms of femur and to improve the safety of knee replacement surgery based on the quantitative analysis of the FVA and femoral bending angel (FBA) in patients from southern China.    Methods    Computed tomography angiography (CTA) scan data of 75 patients (113 sides) without osteoarthritis (OA) in our hospital were collected. Femoral bowing angle (FBA) and femoral valgus angle (FVA) were measured by 3D reconstruction and location.. The following four groups were divided according to FBA: a severe varus deformity group: FBA>4°;  a mild varus deformity group: 1°0.05).    Conclusions　Valgus or varus deformity of femoral shaft has direct influences on the value of FVA. The measurement of FVA should always consider the influence of femoral shape and rotation angle.

The anatomical parameters of proximal humerus in Chinese measured by three-dimensional visualization

Liu Pengran, Shen Ao, Lv Jing, Chen Yufei , Yuan Jian, Liao Shenghui, Liu Lihong

Chinese Journal of Clinical Anatomy. 2022, 40(1):  10-16.  doi:10.13418/j.issn.1001-165x.2022.1.03

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Objective　To measure anatomical parameters of Chinese proximal humerus by 3D visualization, which providing guidance for fracture reduction, internal plants placement, and internal plants design matching for Chinese patients.　Methods　A total of 90 patients with shoulder trauma from 2013 to 2019 were selected, they were divided into a fracture group and a normal group according to the diagnosis of proximal humeral fractures. After simulated reduction of 60 patients in the fracture group by using E-3D digital medical software, the following parameters, including the humeral head parameters of the proximal humeral bones, humeral shaft medullary cavity parameters, humeral head-stem relationship parameters, humeral heads, large or small humeral head parameters and nodules related vertical distance parameters, were measured.  The parameters including head height of humeru (HH), diameter of the articular surface diameter of humeral head (ASD), radius of curvature of humeral head (ROC), neck shaft angle (NSA), medial offset (MO), posterior offset (PO), multiple level of diameter of medullary cavity of humeral shaft (L0, L20, L40) were measured together with other 30 patients in the normal group.　Results　HH on coronal plane and axial plane in the normal group were (15.5±2.0) mm and (15.7±2.3) mm, ASD were (42.0±3.5) mm and (40.0±3.5) mm, ROC were (22.3±2.0) mm and (20.8±1.9) mm, L0 were (26.0±3.1) mm and (23.3±2.9) mm, L20 were (15.2±2.5) mm and (13.3±2.0) mm, L40 were (12.0±2.4) mm and (10.6±2.1) mm. NSA was (132.1±4.9)° on coronal plane, MO was (4.2±1.2) mm on coronal plane, and PO was (3.4±1.4) mm on sagittal plane. There was no statistical difference in the measuring result between the fracture group and the normal group.　Conclusions　The method of measuring anatomical parameters of proximal humerus by 3D visualization is accurate and reliable. E-3D software has high accuracy and reliability in bone 3D reconstruction of bone, fracture simulation reduction, and parameter measurement.

Measurement of applied anatomical parameters of sacroiliac screw passing the back of sacrum by CT digital reconstruction technique

Li Dong, Ma Yunhong, Zhou Jinhua, Wang Xinming, Xi Bin, Yin Qudong, Jiang Yan

Chinese Journal of Clinical Anatomy. 2022, 40(1):  17-21.  doi:10.13418/j.issn.1001-165x.2022.1.04

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Objective    To measure the anatomical parameters of the innovative sacroiliac screw-sacroiliac screw passing the back of sacrum(SISPTBOS), so as to provide basis for clinical application.    Methods     The 3D CT reconstruction images of 32 cases of normal adult pelvis were analyzed to observe the range of SISPTBOS channel, by simulating placement of SISPTBOS, measuring the anatomical parameters including the length of the screw channel（L), the distance between the insertion point and the center of superior articular process of S1(M1), the distance between the exit point and the superior- posterior border of actabulium(M2), the anteversion angle between the central axis and the line parallel to the upper endplate of S1(e), the outward angle(f), the safety angle in the sagittal plane(a), the safety angle in the coronal plane(b), the minimum diameter in the sagittal plane(d1) and the minimum diameter in the coronal plane(d2).   Results    The medial boundary of the screw canal was the inner wall of the arcuate line. The lateral boundary was the posterior-lateral walls of the spinal canal of S1 and the ilium, the lower boundary was the line between the sacral hole of S1 and the ischial notch, the upper boundary was the sacral slope, surface of sacroiliac joint, and the bottom of the true pelvis. L was (11.90±1.62) cm, M1 was ((2.07±1.40) mm, M2 was (4.78±2.57) mm, e was (57.97±4.28) °, f was (54.89±5.13) °, a was (11.45±2.73) °, b was (7.46±1.34) °, d1 was (8.57±0.99)mm and d2 was (6.75±0.84) mm. There were significant differences in the anteversion angle between the central axis and the line parallel to the upper endplate of S1 (e) and the outward angle(f) between males and females (P<0.05).    Conclusions    Implanting of the SISPTBOS is feasible and safe, which may be selected by using screws with a diameter of 5.0 to 6.0 mm and a length of 9 to10 cm.

The application of multi-slice spiral CT in measuring the size and volume of thyroid gland in normal children 

Zhou Yu, Tang Shilong, Cheng Zhuo, He Ling, Dai Chunmei, Chen Wushuang, Liu Xianfan

Chinese Journal of Clinical Anatomy. 2022, 40(1):  22-27.  doi:10.13418/j.issn.1001-165x.2022.1.05

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Objective   To explore the application of multi-slice spiral CT in measuring the size and volume of thyroid gland in normal children.   Methods   A total of  240 children aged 8，9，10，11 years old were prospectively selected from the department of Radiology, Children’s Hospital Affiliated to Chongqing Medical University from June 2017 to September 2019, including 30 boys and 30 girls in each age group. The body surface area of children was calculated, the anterior and posterior diameters, inner and outer diameters, the S-I diameters and the volumes of thyroid glands on both sides of children were measured. The thyroid measurement values of children at all ages, the thyroid measurement values of boys and girls at the same age, the thyroid measurement values of left lobe and right lobe of children at the same age were compared. The relationship between the thyroid measurement values of children and its influencing factors was analyzed. Results    The thyroid volume in the right lobe was larger than that in the left lobe in children aged 8~11 years old groups (P<0.05). In the 8 years old group, the thyroid volume in male children was larger than that in female children (P<0.05). In other groups, the thyroid volume in female children was larger than that in male children (P<0.05). The thyroid volume was positively correlated with children's body weight, body mass index and body surface area in children aged 8~11 years old groups (P<0.05).   Conclusions    Multi-slice spiral CT can measure the size and volume of thyroid gland in children, which has clinical significance for the diagnosis and treatment of thyroid diseases in children.

Analysis of internal jugular venous plexus drainage pattern and its influencing factors

Chen Qizuan, Wei Liangfeng, Wang Shousen

Chinese Journal of Clinical Anatomy. 2022, 40(1):  28-32.  doi:10.13418/j.issn.1001-165x.2022.1.06

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Objective　To explore the drainage patterns of main venous plexus in internal jugular vein and the related influencing factors.  Methods   According to the DSA image data of 160 patients with cerebrovascular disease, the venous imaging of arteriography was analyzed. The main venous plexus of internal jugular vein was divided into anterior drainage mode (pterygoid plexus) and posterior drainage mode, and the posterior drainage mode was divided into plexus drainage mode (paravertebral venous plexus) and isolated venous drainage mode (dominated by deep jugular vein). The posterior plexus drainage mode could be subdivided into two groups: paravertebral venous plexus with obvious deep jugular venous drainage and paravertebral venous plexus without obvious deep jugular venous drainage. Based on the clinical data of the patients and related risk diseases, the factors affecting the drainage pattern of main venous plexus of internal jugular vein were analyzed by chi-square test.　Results　Bilateral internal carotid artery angiography showed a total of 320 internal jugular veins in 160 patients, of which 63 sides (accounting for 19.7%) as the wing plexus drainage, 54 sides (accounting for 16.9%) as the vertebral venous plexus near accompanied by obvious neck deep venous drainage, 50 sides (accounting for 15.6%) as the vertebral venous plexus with no apparent near the neck deep venous drainage, 10 sides (accounting for 3.1%) as the neck deep venous drainage, 13 sides (accounting for 5.7%) before and after the plexus drainage. The analysis of χ2 test  showed that age, abnormal internal jugular vein (hypoplasia, stenosis, occlusion), pressure trace of internal jugular vein and hypertension were independent risk factors for the pattern of internal jugular venous plexus drainage.　Conclusions　The drainage pattern of bilateral internal jugular vein plexus is mainly followed by posterior paravertebral venous plexus drainage, which can change the drainage pattern with relevant clinical influencing factors. This is of great value for the evaluation of skull base, neck surgery and nerve interventional therapy.

Protective effects of clioquinol on the hippocampal neuronal apoptosis and learning and memory functions of epileptic mice

Dou Xiaona, Li Xia, Li Xinyu, Zhang Li

Chinese Journal of Clinical Anatomy. 2022, 40(1):  33-38.  doi:10.13418/j.issn.1001-165x.2022.1.07

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Objective   To study the protective effects of clioquinol on the hippocampal neuronal apoptosis and learning and memory functions of epileptic mice.    Methods    The epileptic mice model were built by pilocarpine in this study. Mice were divided into 3 groups: a control group (saline), an epilepsy group (pilocarpine and saline) and a clioquinol group (pilocarpine and clioquinol). Then the distribution of zinc in hippocampus was observed by autometallography. The morphological changes and the number of neurons were checked by Nissl staining. The expression of Bcl-2 and Bax protein were detected by immunoblotting. Enzyme linked immunosorbent assay was used to check the expression of caspases-9 and caspases-3 protein. The seizure times, seizure level and seizure duration were checked by behavioral observation. The learning and memory ability was shown by T maze and Y maze.    Results    In the clioquinol group, the distribution of zinc in hippocampus reduced significantly, the damage of hippocampal neurons was improved and the number of neurons increased, the expression of Bcl-2 protein increased, while the expression of Bax, caspases-9 and caspases-3 protein decreased. The ratio of Bcl-2 to Bax increased. The seizure times, seizure level and seizure duration decreased. The ability of learning and memory was improved (P<0.01).    Conclusions   Clioquinol can protect hippocampal neurons and improve the learning and memory functions of epileptic mice. 

Long-term exercise ameliorates cognitive disorder induced by Aβ1-42 in middle-aged and elderly mice

Zhang Weiguo, Yang Na, Yang Jing, Liu Xueqin, Zhao Yunhe

Chinese Journal of Clinical Anatomy. 2022, 40(1):  39-44.  doi:10.13418/j.issn.1001-165x.2022.1.08

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Objective　To observe the mechanism of cognitive dysfunction caused by Aβ-amyloid 1-42 (Aβ1-42) in middle-aged and elderly mice by long-term exercise.　Methods 　12-month-old BABL/c mice were randomly divided into the following four groups:①a vehicle control sedentary group (VS),②a vehicle control long-term voluntary running wheel exercise group (VR), ③an Aβ1-42 sedentary group (AS),④an Aβ1-42 long-term voluntary running wheel exercise group (AR). Voluntary running wheel exercise or sedentary for 6 months was performed according to the grouping conditions. The bilateral hippocampus was injected with Aβ1-42 or equivalent solvent for 6 months.  Tests were performed two weeks after injection.    Results　Western blotting results showed that the accumulation of ubiquitinated protein in the hippocampus of 12-month-old BABL/c mice after long-term voluntary exercise was significantly lower than that in the sedentary group by about 0.2 times (P<0.05). The novel object recognition experiment showed that the preference index in the AR group was 0.42 times higher than that in the AS group（P<0.05). The spontaneous alternation experiment of Y maze showed that the correct rate of arm entry in AR group increased than that in AS group by about 0.21 times (P<0.05). The proteasome activity of AR hippocampus was significantly higher than that of AS group by about 0.18 times (P<0.05). Western blotting results showed the accumulation of ubiquitinated protein in the hippocampus in the AR group was significantly lower than that of AS group by about 0.21 times (P<0.05).  Immunohistochemical results showed that Aβ1-42 deposition in AR group was lesser（P<0.01).　Conclusions Middle-aged and elderly mice can maintain hippocampal proteasome activity and improve the cognitive dysfunction caused by Aβ1-42 through long-term voluntary running wheel exercise. 

Phenotypic change of macrophages in lung tissue during the development of hepatopulmonary syndrome

Li Xujiong, Zhang Huiying, Chen Yunxia, Tian Xiaoxia, Lai Lina

Chinese Journal of Clinical Anatomy. 2022, 40(1):  44-48.  doi:10.13418/j.issn.1001-165x.2022.1.09

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Objective　To investigate the phenotypic change of macrophages in lung tissue during the development of hepatopulmonary syndrome (HPS).　Methods　The HPS model was induced by multiple pathogenic factors in Sprague-Dawley rats and divided into HPS groups of the 4th week，the 6th week and the 8th week. Normal control groups at the corresponding time points were also set up. Liver and Lung tissue histology was observed by HE staining. VG staining method was used to observe the liver fibrosis. Immunofluorescence method was used to observe the macrophage marker (CD68). The expressions of M1/M2 macrophage markers (CD86 and CD206) were detected by real-time PCR assay, while the expressions of corresponding secretions iNOS, TNF-α, Arg-1 and IL10 were detected by Elisa.　Results　With the progress of the disease, the expression of CD86, iNOS and TNF-α gradually increased in the lung tissue of model group. After reaching the peak in the 6th weeks, CD86 and iNOS fell back. While the expression of CD206, Arg-1 and IL10 began to increase significantly at the 6th week. There was a positive correlation between iNOS and CD86 in the lung tissue of the model group. Arg-1 was positively correlated with CD206. IL10 was positively correlated with CD206.　Conclusions　During the pathogenesis of HPS, macrophages in lung tissue underwent a series of phenotypic changes, with M1 predominating at 6 weeks and M2 predominating at 8 weeks.   

Effects of levosimendan on myocardial fibrosis and cardiac function following myocardial infarction in rats

Liu Yali, Li Chunyan, Li Yali, Kou Huifen, Xu Xiaowei, Li Xinjun

Chinese Journal of Clinical Anatomy. 2022, 40(1):  49-54.  doi:10.13418/j.issn.1001-165x.2022.1.10

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Objective  To investigate the effect of levosimendan on myocardial infarction (MI) myocardial fibrosis and its mechanism.   Methods   MI model was induced by ligation of left anterior descending coronary artery. Thirty surviving MI rats were randomly divided into a model group and a Levo group (15 rats in each group). Rats in the sham group (n=10) underwent the same surgical procedure, except for no arterial ligation. Levosimendan (4.67 μg·kg-1·d-1) was infused into stomach for 28 days in Levo group. At the same time, rats in sham group and model group were given equal amount of distilled water. 2D echocardiography was adopted to evaluate the cardiac function. Masson-trichrome were used to evaluate the degree of myocardial fibrosis. The expression of COL1A1, COL3A1 mRNA and SIRT1/TGF-β1/Smad3 signaling pathway proteins were detected by quantitative reverse transcription PCR (RT-qPCR) and Western blot, respectively.    Results   Compared with the model group, 2D echocardiography result showed that the LVED of Levo group decreased significantly (P<0.05), while the EF and FS increased significantly (P<0.01). Masson-trichrome result showed that levosimendan treatment significantly reduced necrosis and the content of collagen deposition and inhibited infiltration of inflammatory cells. RT-qPCR analysis result showed that levosimendan treatment significantly reduced the content of type Ⅰ and type Ⅲ collagen in the heart tissue of MI rats (P<0.01). Western blot showed that  levosimendan treatment could significantly up-regulate SIRT1 protein expression  and down-regulate TGF-β1(60%) and p-Smad3 (47%) protein expression (P<0.01).  Conclusions   Levosimendan has anti-fibrotic and cardio-protective effects. These effects are potentially mediated by SIRT1/TGF-β1/Smad3 signaling pathway.

The mechanism of dexmedetomidine reducing myocardial ischemia-reperfusion injury and inhibiting apoptosis based on JAK2 / STAT3 signaling pathway

Wu Yahui, Wang Taofu, Lin Hongqi

Chinese Journal of Clinical Anatomy. 2022, 40(1):  55-61.  doi:10.13418/j.issn.1001-165x.2022.1.11

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Objective    To explore the mechanism of dexmedetomidine reducing myocardial ischemia-reperfusion injury and inhibiting apoptosis and its regulation signaling of janus kinase 2/signaltransducer and activator of transcription 3 (JAK2/STAT3) signaling pathway.   Methods    Rat were randomly divided into the following 4 groups: a sham operation group, a model group, an experimental group, and a control group. The anterior descending branch of the left tubular artery was ligated to construct an ischemia-reperfusion rat model. The sham operation group only threaded without ligation. The rats in the experimental group and in the control group were intraperitoneally injected with 5.0 μg/kg dexmedetomidine and JAK2/STAT3 signaling pathway agonist SC-39100 1 h before surgery, and the rats in the sham group and model group were injected with equal doses of normal saline. Cardiac ultrasonography was used to examine the left ventricular systohc pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), and left ventricular pressure rise rate (1eft ventricular pressure rise, +dp/dtmax) and the maximum rate of left ventricular pressure drop (1eft ventricular pressure drop, -dp/dtmax). TUNEL staining was used to detect the apoptosis of myocardial cells. DCFH-DA staining was used to detect the level of ROS in the myocardium. Western blot was used to detect the expression levels of p-JAK2 and p-STAT3 in rat myocardium. Results   Compared with the sham group, the LVSP, +dp/dtmax, -dp/dtmax of the model group significantly reduced, and the LVEDP, the myocardial apoptosis rate, the fluorescence intensity of ROS, the expression of p-JAK2, and p-STAT3 significantly increased, with statistical differences  (P<0.05). Compared with the model group, the LVSP, +dp/dtmax, -dp/dtmax, the expression of p-JAK2, p-STAT3 in the experimental group and the control group obvious increased, the LVEDP, the myocardial apoptosis rate, the fluorescence intensity of ROS significantly decreased, with statistical differences (P<0.05).    Conclusions   Pretreatment with dexmedetomidine can significantly reduce myocardial ischemia-reperfusion injury and reduce cardiomyocyte apoptosis, which may be related to the activation of JAK2 / STAT3 signal and inhibition of oxidative stress.

HIF-VEGF-Notch signaling pathway may be involved in the occurrence of equinovarus deformity

Zhang Zhenyi, Chen Xi, Wang Qian

Chinese Journal of Clinical Anatomy. 2022, 40(1):  62-66.  doi:10.13418/j.issn.1001-165x.2022.1.12

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Objective　To study the molecular mechanism of equinovarus deformity.　Methods　HE staining was used to observe the difference of foot and ankle tissue structure in model group and control group. The expressions of hypoxia inducible factor 1 (HIF-1), vascular endothelial growth factor (VEGF) and Notch-1 in the tissues of foot and ankle of rats in model group and control group were detected by immunohistochemical staining, Western Blot and qRT-PCR.　Results　Microscopic observation results showed that compared with the control group, the tissue structure of the foot and ankle in the experimental group was relatively disordered, with enlarged tissue space, loose soft tissue and aggregation contracture of local soft tissue. Immunohistochemical staining, Western Blot and qRT-PCR results showed that compared with the control group, the expression of HIF-1 down-regulated in ankle tissue of the experimental group, and the expression of VEGF and Notch-1 decreased.　Conclusions 　HIF-VEGF-Notch signaling pathway may be related to the occurrence of varus foot deformity.

Establishment of a new mechanical traction vasospasm model

Ma Qiming, Cao Chenxin, Chen Shaofeng, Xie Yun

Chinese Journal of Clinical Anatomy. 2022, 40(1):  67-71.  doi:10.13418/j.issn.1001-165x.2022.1.13

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Objective　To establish a mechanical traction vasospasm model, for simulating vasospasm post-surgery. 　Methods　Forty-eight Sprague-Dawley rats were randomly divided into 6 groups: Group 1-5 was vascular traction groups (traction force was 5,10,15,20 and 25g, respectively); Group 6 was blunt vascular dissection group (control group). Laser Speckle contrast imaging was used to monitor the average blood flow perfusion, and to collect the duration of spasm and the time needed to achieve hyperperfusion as statistical parameters.　Results　Group 5 had hyperspasticity and was not included in the study. The duration and hyperperfusion time of vasospasm in group 1 and group 2 were relatively short, which was statistically significant compared with the control group (P<0.05). There was no significant difference between the third group and the control group (spasm duration P=0.801; hyperperfusion time P=0.629). Compared with the control group, the fourth group showed statistically significant difference in spasm duration (P=0.014), but no statistically significant difference in hyperperfusion duration (P=0.081). Conclusions　Vasospasm induced by bidirectional tension of 15g can well simulate clinical vascular dissection, and it is a reliable model with high success rate.

Biomechanical research on posterior flexible fixation at atlantoaxial joint

Tong Jie, Ji Wei, Huang Zhiping, Zhou Ruozhou, Fang Zuozhong, Zhu Qingan

Chinese Journal of Clinical Anatomy. 2022, 40(1):  72-77.  doi: 10.13418/j.issn.1001-165x.2022.1.14

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Objectives   To analyze the influence of thin rod and PEEK rod on the stability of the atlantoaxial joint.   Methods   A series of in vitro biomechanical tests were performed using six fresh adult cervical spines (occipital bone-C4 segment) to simulate different conditions in surgery including the (1) intact state; (2) injury state: type II odontoid process fracture; (3) rigid fixation: All atlantoaxial pedicle screws were connected by titanium rods with a diameter of 3.5 mm; (4) PEEK rod: atlantoaxial pedicle screws were connected by a PEEK rod with a diameter of 3.5 mm; (5) thin rod: atlantoaxial pedicle screws were connected by a thin rod with a diameter of 2.0 mm. Biomechanical studies of samples were performed under intact, injury and various fixation statements using a spinal testing machine, while applying a constant moment of 1.5 Nm in flexion-extension, left-right lateral bending, and left-right axial rotation directions. A repeated measurement design was employed in all tests. Movement were measured consecutively by an Optotrak Certus 3D measurement system in order to analyze the range of motion (ROM) and neutral zone (NZ) of atlantoaxial joint.    Results    In the atlantoaxial joint, ROM of fixation segments were significantly reduced in all directions when a 3.5 mm diameter titanium rod, a 2.0 mm diameter titanium rod, and a 3.5 mm diameter PEEK rod was used (P<0.05). There were no significant differences in ROM of fixation segments for rigid fixation and 2.0 mm diameter titanium rod in all directions (P>0.05). In lateral bending, ROM of the PEEK rod was significantly larger compared with rigid fixation (P=0.005). NZs of fixation segments for rigid fixation, 2.0 mm diameter titanium rod, and a 3.5 mm diameter PEEK rod fixation were significantly reduced (P<0.05). There were no significant differences among these fixations (P>0.05).  Conclusions   In the atlantoaxial joint, stability of using 2.0 mm diameter titanium rod fixation was comparable to rigid fixation, but stability of using PEEK rod fixation was weaker in the lateral bending direction.

Progressive subcutaneous pedicle double V-Y flap combined with surgery of nail bed augmentation to repair the transverse defect of fingertip and nail bed defect

Li Shujun, Chang Shusen, Wang Dali, Jin Wenhu, Sun Guangfeng, Wei Zairong

Chinese Journal of Clinical Anatomy. 2022, 40(1):  78-80.  doi:10.13418/j.issn.1001-165x.2022.1.15

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Objective    To investigate the clinical effect of progressive subcutaneous pedicle double V-Y flap combined with nail bed augmentation in the repair the transverse defect of fingertip and partial nail bed defect.    Methods    From June 2015 to June 2019, 17 patients with transverse defect of fingertip and nail bed defect were treated with progressive subcutaneous pedicle double V-Y flap combined with nail bed augmentation. The area of the affected finger wound was 1.0 cm× 0.8 cm ~ 1.6 cm× 1.5 cm. The fingers were followed-up in function, appearance and incidence of hook nail deformity.    Results   The postoperative follow-up period was 8 to 24 months, 13 months on average. All the 19 flaps survived well. The sensory recovery of 19 flaps reached S4 grade. The reconstructive fingers formed arc-shaped fingertips with nails of good appearance and texture. The appearance of the fingers was satisfactory and the joint movement was normal. The length of the nail bed increased by 2~4 mm, 3.3 mm on average. There was no hook nail deformity in each finger. The excellent rate of nail regeneration was 94%.    Conclusions    Progressive subcutaneous pedicle double V-Y flap combined with nail bed augmentation can repair the transverse defect of fingertip and nail bed defect, and reduce the incidence of hook nail deformity while reconstructing the shape of fingertip and nail. It is an effective and simple surgical method for injured finger to reconstruct the shape and function to the maximum extent.

Sternocleidomastoid muscle flaps reconstruction to improve the facial deformity of parotidectomy

Zeng Xianping, Li Juan, Tang Sucheng, Li Jingjia, Zhang Jianli, He Fayao, Chen Weixiong, Chen Hexin

Chinese Journal of Clinical Anatomy. 2022, 40(1):  81-84.  doi:10.13418/j.issn.1001-165x.2022.1.16

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Objective　To investigate the effect on facial deformity and complications of sternocleidomastoid flaps(SCM) in the resection of benign parotid tumors.　Methods　Sixty-eight patients with benign parotid tumors were randomly divided into a control group and an experimental group. Thirty-four patients in the control group were treated with traditional parotidectomy, while other 34 patients in the experimental group with sternocleidomastoid flap transferred to fill sunken operative area for repair after routine resection of parotid lesions. All the patients were followed for at least 6~12 months. The incidence of postoperative complications and facial deformity were compared and evaluated between the two groups. Results　The complained of postoperative facial palsy, Frey syndrome,  numbness in the ear, tumor recurrence rate were roughly same between the two groups. The incidence of salivary fistula in the experimental group (accounting for 15%) was significantly lower than that in the control group (accounting for 27%), with the statistical difference (P<0.05). The cosmetic result on the experimental group, the patient completed scores was (1.25±0.96), and the scores from the blinded health care staff was (1.11±0.99), while those in the control group were (2.45±1.33) and (2.26±0.87), respectively. There were statistical differences  in the subjective and objective scores of patients cosmetic result between the two groups (P<0.05). Conclusions　SCM parotid gland filling can improve postoperative facial deformities and provide a reasonable aesthetic choice for parotid gland reconstruction. 

Treatment of supracondylar fracture of humerus with pulseless hands in children 

Yu Tieqiang, ZuoYuming, Wang Yueguang, Lian Xiaojing, Li Fei, Wan Guangliang, Li Xiaoliang

Chinese Journal of Clinical Anatomy. 2022, 40(1):  85-88.  doi:10.13418/j.issn.1001-165x.2022.1.17

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Objective　To summary the therapeutic method and clinical effect of supracondylar fractures of the humerus with pulseless hand in children.　Methods　A total of 45 patients of humeral supracondylar fracture with pulseless hands were hospitalized and followed up for more than one year from January 2010 to June 2018.  There were 23 boys, with an average age of 5 years and 8 months. There were 22 girls, with an average age of 5 years and 6 months. There were 36 cases of fall injury, 4 cases of electric vehicle falls, 3 cases of high fall, and 1 case of traffic accident. All cases were Gartland type III fractures. Closed reduction and Kirschner wire fixation were performed in 18 cases, and open exploration of blood vessels and fracture reduction with Kirschner wire fixation in 27 cases. Arterial pulse and the presence or absence of perfusion were evaluated by Doppler. Plaster and Kirschner wire were removed 4 weeks after surgery.　Results　The children were followed up for 12 to 15 months, with an average follow-up of 13 months. The fractures all healed around 4-12 weeks. According to Flynn evaluation standard of elbow performance score: excellent in 42 cases and good in 3 cases. At the last follow-up, the radial artery pulsation was good, and there were no complications such as redisplacement, pin tract infections and cubitus varus. Conclusions　The pale hand should be explored the vessels immediately, and the failed closed reduction.  Radial arterial pulsation should be closely observed within 48 h after closed reduction and Kirschner wire fixation for pink hand.  Blood vessels should be opened for exploration, fracture reduction and fixation for those who failed closed reduction or had differences between preoperative and postoperative Doppler examination. After reduction of the supracondylar fracture of the humerus, attention should be paid to the presence or absence of radial artery pulsation.

Clinical efficacy of minimally Juvara combined with Akin osteotomy on severe hallux valgus

Shen Guodong, Zou Yunxuan, Zhang Hongning, Yang Kangyong, Lai Zhibin, Zhu Yongzhan

Chinese Journal of Clinical Anatomy. 2022, 40(1):  89-92.  doi:10.13418/j.issn.1001-165x.2022.1.18

Abstract ( 173 )   PDF (1797KB) ( 41 )  

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Objective　To study the clinical efficacy of minimally Juvara combined with Akin osteotomy on severe hallux valgus.　Methods　Forty-five patients (50 feet) with severe hallux valgus treated by minimally Juvara combined with Akin osteotomy in Eight Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine from August 2016 to August 2018 were collected in this study. Hallux valgus Angle (HVA), intermetatarsal angle (IMA), distal metatarsal angle (DMAA), distal metatarsophalangeal angle (DASA), interphalangeal angle (IPA) were measured by X-ray examination preoperatively and 3, 6 and 12 months after operation. The efficacy was evaluated in accordance with the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Olerud-Molander Ankle (OMA) Score. Results All patients were followed up within 12～17 months (mean, 14.20±1.55 months). There was no recurrence during follow-up period. In terms of HVA, IMA, DMAA, DASA, IPA, AOFAS and OMA, there were significant differences in postoperative 3, 6 and 12 months and before operation (P<0.01). There were no significant differences among before operation and 3, 6 and 12 months postoperatively (P>0.01).　Conclusions　For severe hallux valgus, minimally Juvara combined with Akin osteotomy can effectively correct the hallux valgus deformity with small surgical incision, high safety and curative effect, which is worthy of popularization and application in clinical.

Therapeutic evaluation of CalliSpheres drug-loaded microsphere uterine artery embolization in the treatment of cervical cancer

Gao Wei , Zou Qiang, Liao Jun, Xing Wenge, Yang Xueling , Ni Hong

Chinese Journal of Clinical Anatomy. 2022, 40(1):  93-97.  doi:10.13418/j.issn.1001-165x.2022.1.19

Abstract ( 139 )   PDF (1737KB) ( 105 )  

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Objective　To evaluate the efficacy of CalliSpheres drug-loaded microsphere uterine artery embolization in the treatment of locally advanced cervical cancer.　Methods　Forty-eight patients (average age was 49 years old) with cervical cancer admitted to our department from February 2016 to September 2018 were randomly divided into two groups: normal microsphere uterine artery embolization + 24 cases of epirubicin uterine arterial infusion chemotherapy (group A); 24 cases of drug-loaded microspheres (epimycin) uterine artery chemoembolization (group B). Each group was treated with the same procedures three weeks apart, total two times. The reduction in bleeding was recorded, and tumor size changes were evaluated by CT, and bone marrow suppression and digestive tract reactions were analyzed.　Results　(1) Both groups of patients had reduced vaginal bleeding. The duration of postoperative bleeding in the conventional microsphere group was (6±1.5) days, and that in the drug-loaded microsphere group was (3±0.8) days, the difference was statistically significant (P<0.01). (2) Tumor reduction rate: The objective remission rate of the ordinary microsphere group was 83.8%, and that of the drug-loaded microsphere group was 95.8%. The difference was statistically significant (P<0.01). (3) Abdominal pain occurred in both groups. The VAS score of the general microsphere group was (8±2), and the VAS score of the drug-loaded microsphere group was (3±1). There were statistical difference in the VAS score (P<0.01). Myelosuppression occured only in the normal microsphere group.　Conclusions　CalliSpheres drug-loaded microspheres have higher tumor shrinkage rate for cervical cancer, shorter postoperative vaginal bleeding, no bone marrow suppression and controllable abdominal pain.

Analysis of endometrial receptivity after implantation of biological amniotic products to improve intrauterine adhesions

Cui Shuling, Zhang Yingzhi, Zhang Jing, Lao Peiwei

Chinese Journal of Clinical Anatomy. 2022, 40(1):  98-102.  doi:10.13418/j.issn.1001-165x.2022.1.20

Abstract ( 152 )   PDF (1852KB) ( 102 )  

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 Objective　To investigate the endometrial receptivity of biological amniotic products after hysteroscopic intrauterine adhesion separation (TCRA).    Methods    A retrospective analysis for clinical data of 64 cases of women who received TCRA because of medium or heavy IUA in the Affiliated Hospital of Medical School, Ningbo University from November 2019 to November 2020 was performed. The 64 cases were divided into the following two groups according to the method of TCRA postoperative readhesion prevention:  an experimental group (biological amniotic products were placed after TCRA with chitosan), and a control group (chitosan was placed after TCRA). Each group was 32 cases. The Chinese Intrauterine Adhesion Grating and Scoring Standard proposed by Chinese Clinical Diagnostics Experts of Intrauterine Adhesion in 2015 was used to diagnose the degree of intrauterine adhesions. All patients received artificial cycle treatment of estrogen progesterone for 2 months. The endometrial thickness, uterine artery resistance parameters and pregnancy rate were compared between the two groups.   Results   One month after operation, the endometrial thickness of the experimental group and the control group were (5.89±0.84) mm and (4.37± 0.52) mm, respectively, the differences were statistically significant (T=8.689,P<0.01). Two months after operation, the endometrial thickness of the experimental group and the control group were (8.38±0.84) mm, (7.17±1.00) mm, the differences were statistically significant (t＝5.215, P<0.01). At the second hysteroscopy, the readhesion rate of the experimental group was 6.25%, and that of the control group was 18.75%, with statistical significance (P<0.05). There were statistical differences in the arterial blood flow parameters and pregnancy rate between the two groups.   Conclusions    The implantation of biological amniotic membrane products after the separation of moderate or severe intrauterine adhesions can increase the thickness of the endometrium and improve the blood circulation of the uterus and the receptivity of the endometrium, ultimately increase the pregnancy rate. Therefore, the implantation of biological amniotic membrane products can be an effective and feasible neoadjuvant treatment for clinical treatment of intrauterine adhesions.

Fabrication of cast specimen of internal femoral head artery by microperfusion combined with 3D printing

Zhang Xiangnan, Deng Wei, Zhang Songqiang, Wang Hongyu, Li Lei, Ju Wen, Zhou Guangliang, Ju Faxin, Zhou Zhenghu, Li Guanxing, Ju Jihui, Hou Ruixing

Chinese Journal of Clinical Anatomy. 2022, 40(1):  103-106.  doi: 10.13418/j.issn.1001-165x.2022.1.21

Abstract ( 127 )   PDF (3742KB) ( 119 )  

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Objective　To explore the vascular display method of making cast specimens of internal femoral head artery in pigs.　Methods　The arterial trunks of three retinacular artery of pig femoral heads in 3 pigs were perfused with epoxy resin red essence mixture. After solidification, the soft tissues were removed by alkali corrosion. The femoral head contour was scanned in 3D and the mold was printed. Acid corroded and flushed the femoral head until the internal cephalic artery was completely exposed. The 3D printing die was placed on the femoral head exposed to blood vessels and filled with epoxy resin. After solidification, the die was removed and the surface of the femoral head was polished to make a transparent femoral head exposing the vascular network in the femoral head.    Results    Porcine femoral head internal artery casting specimen was successfully made by pouring epoxy resin red essence mixture casting agent and washing with acid and alkali corrosion. The femoral head was successfully restored by 3D printing technology, and a transparent femoral head was made to reveal the vascular network in the femoral head.　Conclusions　Micro-perfusion corrosion method can successfully make femoral head artery cast specimen, which provides morphological basis for studying femoral head blood supply. The transparent femoral head vascular specimen was successfully established by 3D printing filling technology, which can preserve the contour of femoral head and blood vessels in the head.

Design and application of an improved embedding die and an improved glass slide

Li Mingxian, Dong Xingmei, Tang Lipeng, Yang Haifeng, Zheng Guangjuan, He Qinglian

Chinese Journal of Clinical Anatomy. 2022, 40(1):  107-108.  doi:10.13418/j.issn.1001-165x.2022.1.22

Abstract ( 111 )   PDF (736KB) ( 54 )  

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Anatomy of the cervical foraminal ligament and its clinical significance

Yu Sheng, Pang Qingjiang

Chinese Journal of Clinical Anatomy. 2022, 40(1):  109-112.  doi:10.13418/j.issn.1001-165x.2022.1.23

Abstract ( 223 )   PDF (2936KB) ( 182 )  

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New progress of the roles of NLRP3 inflammasomes in central nervous system diseases

Zhang Pengfei, Yu Chunze, Yu Jianyun, Yang Li

Chinese Journal of Clinical Anatomy. 2022, 40(1):  113-116.  doi:10.13418/j.issn.1001-165x.2022.1.24

Abstract ( 123 )   PDF (515KB) ( 72 )  

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Abnormal course of bilateral vertebral artery and the left vertebral artery’s compression of left inferior sympathetic ganglion

Wang Qing, Wan Jiangtong, Wang Lingman, Wang Jing, Gan Shengwei, Sun Shanquan, He Guiqiong

Chinese Journal of Clinical Anatomy. 2022, 40(1):  117.  doi:10.13418/j.issn.1001-165x.2022.1.28

Abstract ( 226 )   PDF (2166KB) ( 104 )  

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Terminal branch of maxillary artery supplies blood to the eye： a  case  report

Ma Hong

Chinese Journal of Clinical Anatomy. 2022, 40(1):  21.  doi:10.13418/j.issn.1001-165x.2022.1.25

Abstract ( 145 )   PDF (467KB) ( 29 )  

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The variation of musculocutaneous nerve: a case report

Duan Shuo, Xu Bingyang, Cheng Xinhao, Wu Yu, Wang Li

Chinese Journal of Clinical Anatomy. 2022, 40(1):  27.  doi:10.13418/j.issn.1001-165x.2022.1.26

Abstract ( 119 )   PDF (973KB) ( 42 )  

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A absence of peroneus tertius and a variation of the third extensor digitorum 

Zhong Weixing, Chen Zujiang, Chen Taijun, Kuang Shanshan, Li Yikai

Chinese Journal of Clinical Anatomy. 2022, 40(1):  66.  doi:10.13418/j.issn.1001-165x.2022.1.27

Abstract ( 114 )   PDF (663KB) ( 48 )  

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