Chinese Journal of Clinical Anatomy

Anatomical study of the dorsal multi-grade advancing flap

Chen Jingguo, Qiu Shenqiang, Zhu Mingsheng, Hao Liwen, Wang Zengtao

Chinese Journal of Clinical Anatomy. 2022, 40(2): 121-125. doi:10.13418/j.issn.1001-165x.2022.2.01

Abstract ( 280 )

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Objective　To repair the dorsal wound by increasing the propulsion distance of the dorsal flap through the multi-grade effect of the ductility of the skin, the slip between the subcutaneous superficial fascia and the skin, the angular displacement of the dorsal branch from the proper digital artery and the elasticity of the proper digital artery.　Methods　The skin flaps of 34 fingers on 11 sides of fresh adult cadaveric hands were designed on the dorsal side of the middle and proximal segments of the finger respectively. The contents of the flap included the dorsal skin, the subcutaneous superficial fascia, the proper digital artery on one side of the finger and the dorsal branch of the proper digital artery. When the flap was pushed to the distal end of the finger, the ductility of the skin，the sliding of the subcutaneous superficial fascia,the angular displacement of the dorsal branch of the proper digital artery and the elasticity of the proper digital artery all played a certain role in the advancement of the dorsal finger flap respectively, the advancement distance of the flap can be increased by the multi-grade superposition of these four effects.　Results　The maximum propulsion distance of the dorsal flap simulated on the fresh specimens was 2.4 cm and the dorsal flap in the proximal segment of finger was 4.5 cm.　Conclusions　The advancing distance of the dorsal multi-grade advanced flap increases significantly. The maximum advancing distance is 4.5cm and the average distance is 2.5cm. The operation of the multistage advancing dorsal finger flap is safe and simple, it is one of the ideal flap for repairing small and medium-sized wounds of the dorsal finger.

Localization and significance of nerve entry points of the anterior forearm muscles in adults

Zhou Jiayu, Zhou Guoyan, Yang Shengbo

Chinese Journal of Clinical Anatomy. 2022, 40(2): 126-131. doi:10.13418/j.issn.1001-165x.2022.2.02

Abstract ( 211 )

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Objective To accurately localize the body surface position and depth of nerve entry points (NEPs) of the adult anterior forearm muscles. Methods Twelve adult cadavers were used in the supine position. The curve close to the skin connecting the lateral epicondyle and the medial epicondyle of humerus was designed as the horizontal reference line (H), and the curve between the lateral epicondyle and the radius styloid process was designed as the longitudinal reference line (L). The NEPs ware exposed by dissection and marked with barium sulfate, then spiral CT scan and three-dimensional reconstruction were performed. The projection point of NEP on the body surface was denoted as P point, and the point P through NEP projecting onto the posterior surface of the forearm was denoted as P' point. The position of P point projected on H line and L line was denoted as PH and PL respectively. The positions of PH and PL on H and L lines and the depth of NEPs were determined under Syngo system. Results The PH for the NEPs of the pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, flexor digitorum superficialis, flexor pollicis longus, flexor digitorum profundus (median nerve branch), flexor digitorum profundus (ulnar nerve branch), and pronator quadratus muscles were located at 58.08%, 64.17%, 75.14%, 61.14%, 62.26%, 52.07%, 50.81%, 63.38% and 51.37% on the H line, respectively. The PL were at 9.79%, 3.97%, 16.37%, 4.42%, 17.88%, 34.17%, 30.27%, 11.48% and 75.32% of the L line, respectively. The puncture depth were located at 26.80%, 25.06%, 27.68%, 28.13%, 37.30%, 39.85%, 49.26%, 70.86% and 44.25% of the PP' line, respectively. The above data were the average value. Conclusions The definition of the body surface location and depth of these NEPs can provide morphological guidance for improving the efficiency of target block of extra-muscular neurolysis, the design of minimally invasive incision for the treatment of muscle spasticity by surgical transection the neuromuscular branches, the evaluation of the function of the donor muscle, and the protection of nerves in muscle transplantation.

Morphological characteristics and clinical significance of the bone articular surface of the rib head joint

Hu Zhe, Wang Xing, He Yujie, Li Zhijun

Chinese Journal of Clinical Anatomy. 2022, 40(2): 132-137. doi: 10.13418/j.issn.1001-165x.2022.2.03

Abstract ( 297 )

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Objective　To explore the Influential factors for the position of abdominal aortic bifurcation (AB). Methods　The vertical distances between AB and the midline, between AB and the inferior margin of L4 vertebra were measured on CT images. Lumbar lordosis angles was measured at median sagittal plane by three different methods. Age of patients, gander and body?mass?index?(BMI) were recorded. Results With the increasing of age, AB gradually decreased and moved to the right side. Terminal of aorta in male continued to decline, but in female, there did not show a significant downward shift until the age of 65. There were no correlation between position of AB and lumbar lordosis, gender, BMI (P>0.05). There was significant correlation between age and lumbar lordosis (P<0.01).　Conclusions　The descending and rightward end of AB was associated with the age. The findings were helpful for low aorta block.

CT imaging anatomical observation of sacroiliac joint space in normal people with different ages

Xiao Ping, Li Yangtao, Yan Yiwen, Hou Demiao, Zhang Kunmu, Xu Zhun, Li Yikai

Chinese Journal of Clinical Anatomy. 2022, 40(2): 143-149. doi:10.13418/j.issn.1001-165x.2022.2.05

Abstract ( 122 )

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Objective　To observe the anatomical characteristics in the CT appearance of normal sacroiliac joint (SIJ) space in different age groups, and to provide basis for diagnosis of SIJ subluxation.　Methods　The statistical analysis of CT images of normal SIJ space was performed in 480 patients. The differences of SIJ space width in different ages, genders, levels and regions were compared.　Results　(1) There were significant differences in the widths of SIJ space in different age groups. With the increasing of age, the width of SIJ space decreased gradually. (2) The width of SIJ space in women was slightly greater than that in men, and there was no significant difference between them. (3) There were significant differences in the widths of SIJ space in different transverse levels. The lower part of SIJ had the minimum space width. (4) There were significant differences in the widths of SIJ space in the ipsilateral anterior, middle and posterior regions, while there was no significant difference between the left and right side of the same region.　Conclusions　The width of SIJ space is age-related, spatial heterogeneity and diversity. This study provides reference for imaging anatomy of sacroiliac joint space width in different age groups.

Morphological classification and clinical significance of glenoid based on CT three-dimensional reconstruction

Hu Dingxiang, Li Changhui, Chen Liang, Ma Chenxi, Huang He, Zheng Ruiqing

Chinese Journal of Clinical Anatomy. 2022, 40(2): 150-153. doi:10.13418/j.issn.1001-165x.2022.2.06

Abstract ( 279 )

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Objective　To explore the morphological classification and clinical significance of glenoid based on CT 3D reconstruction.　Methods　Data of 290 cases of scapular bones data were collected from People's Hospital of Lu Xian County. The morphological characteristics of the glenoid pelvis were observed, and the upper and lower diameters, anterior and posterior diameters of the glenoid pelvis, the depth of the glenoid fossa, the degree of tilt angle and torsion angle of the glenoid pelvis were measured. Results　The result of CT three- dimensional reconstruction showed that, the glenoid was classified into four types: namely, quotation marks-type (165 cases, accounting for 56.90%); oval-type(65 cases, accounting for 22.41%); water drops-type ( 51 cases, accounting for 17.59 %); gourd-type(9 cases, accounting for 3.10 %). There were statistical differences in the upper and lower diameters of the glenoid pelvis, the depth of the glenoid fossa, the degree of tilt angle and torsion angle of the glenoid pelvis between the oval-type and the quotation marks-type, water drops-type and gourd-type(P<0.05). The degree of tilt angle in water drops-type was greater than that of quotation marks-type. The upper and lower diameters of the glenoid pelvis in gourd-type were less than that of quotation marks-type and water drops-type. The anterior and posterior diameters of the glenoid pelvis in oval-type and water drops-type were greater than that of quotation marks-type and gourd-type. The anterior and posterior diameters of the glenoid pelvis in quotation marks-type was greater than that of gourd-type. The depth of the glenoid fossa in quotation marks-type was less than that of water drops-type and gourd-type. There were statistical differences in genders among the upper and lower diameters, anterior and posterior diameters of the glenoid pelvis, the depth of the glenoid fossa, the degree of tilt angle and torsion angle of the glenoid pelvis (all P<0.05).　Conclusions　Based on the results of three-dimensional CT reconstruction, the glenoid can be divided into four types, with the quotation marks-type as the main type and gourd-type as the rare type, and the morphology and classification of which are of certain clinical guiding significance.

MSCT manifestation and clinical significance of double inferior vena cava

Cheng Cheng, Zhao Mingze, Jiang Minrui, Zhang Chunlai, Wang Yi

Chinese Journal of Clinical Anatomy. 2022, 40(2): 154-158. doi:10.13418/j.issn.1001-165x.2022.2.07

Abstract ( 258 )

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Objective　To explore the multi-slice spiral CT (MSCT) manifestation and clinical significance of double inferior vena cava (IVC).　Methods　Eighteen patients with the double IVC found by multi-phase enhanced abdominal MSCT scans were collected. Three kinds of post-processing reconstruction methods including MPR, MIP and VR were used for analysis IVC variation . Their clinical and radiological data were analyzed retrospectively and the double IVC’ imaging features, embryological mechanisms and clinical significance were discussed in combination with literature.　Results　There were 3 types of MSCT manifestation in the 18 patients with the double IVC. 15 patients (accounting for 83.33%) of type I showed as that the left-sided IVC ascended vertically to the position where the left renal vein merged into, then travelled to the right in front of the aorta in a normal way of the left renal vein and merged into the normal right-sided IVC. Two patients (accounting for 11.11%) of type II showed as that the right-sided IVC ascended to the second lumbar level, then crossed the aorta posteriorly to drain into left-sided IVC, and next connected with the hemizygous vein and eventually drained into the right atrium via the azygos vein and superior vena cava. Right renal vein mainly drained into the right suprarenal IVC, but there were collateral branches connecting to the right infrarenal IVC. One patient (accounting for 5.56%) of type III showed as that the right-sided IVC travelled normally all the way, after the left IVC ascended vertically to the position where the left renal vein merged into, then it travelled right and upward behind the aorta and connected to the azygos vein.　Conclusions　Double IVC has many complex variant types, which has important clinical significance for retroperitoneal surgery and treatment of venous thrombosis of the lower body.

MSCT evaluation and clinical application of anatomical classification of left superior pulmonary vein

Wang Juan, Guo Longjun, Teng Jiaqi, He Wen

Chinese Journal of Clinical Anatomy. 2022, 40(2): 159-163. doi:10.13418/j.issn.1001-165x.2022.2.08

Abstract ( 193 )

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Objective To study the anatomic and drainage patterns of pulmonary veins in the superior lobe of left lung in healthy people with Muti-slice spiral CT (MSCT), which providing reference for anatomical segmental resection of lung. Methods Two hundred cases of normal chest CT plain scan data were collected, and the venous anatomy and drainage pattern map were obtained by volume reconstruction (VR), and the occurrence rate of each vein type was observed and counted. Combined with the reconstruction of 5 mm axial MIP map, the corresponding types were identified. Results The left superior pulmonary vein can be divided into:(1) V1 + 2 type, (2) V2 + 3 type, (3) V1+2a V2 +3bc according to the condition of common trunk, and the occurrence rates were 69% (138 /200), 17.5% (35/200) and 13.5% (27/200) respectively. Its characteristics were as follows: when V1 + 2 dries together, the branches then sent out were not related to each other; in V2+3 type, V2 and V3 dries together, and V1 and V2+3 respectively flowed into the left superior pulmonary vein stem; in V1 + 2a V2 + 3bc type, V2 mainly had a large variation; when V4 and V5 of the left upper lobe lingual segment vein dries together, their branches were not related to each other, and V4 had the same situation with V3b, and each had their different drainage characteristics. Conclusions The vein classification of the superior lobe of left lung is more complicated due to the presence of lingual segment. Venous anatomy and drainage pattern obtained by MSCT combined with 5 mm axial MIP can clearly show the pulmonary vein anatomical classification, which can be used as a routine method for its anatomical identification.

CT anatomical research of temporal bone in unilateral chronic otitis media

Hu Ruili, Zhang Xiaochen, Zou Dianjun, Zhang Qingjun, Lin Yantao, Liang Zhandong

Chinese Journal of Clinical Anatomy. 2022, 40(2): 164-167. doi:10.13418/j.issn.1001-165x.2022.2.09

Abstract ( 108 )

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Objective　To study the CT anatomical features and the clinical significance of temporal bone in unilateral chronic otitis media(COM).　Methods　The CT images of 35 patients with unilateral COM on the affected side (an experimental group) and the healthy side (a control group) of temporal bone were analyzed retrospectively. Auditory tube angle（ATA）, petroclival angle（PCA）, diameter of aditus mastoid（DA）, diameter（D）and length（L）of osseous segments of Eustachian Tube, the ratio of maximum diameter and length(D/L) of osseous segments of Eustachian Tube and mastoid pneumatization of the two groups were compared.　Results　In the experimental group, the ATA and the PCA of were (137.4±8.1)°, (52.5±3.8)°, respectively, DA and D were (0.29±0.08) cm, (0.18±0.07) cm, respectively, L was (1.07±0.15) cm and D/L was (17.1±5.4) %. In the control group, the ATA and the PCA of were (138.3±7.7)°, (53.1±4.3)°, respectively, DA and D were (0.35±0.07) cm, (0.21±0.07) cm, respectively, L was (1.17±0.17) cm and D/L was (20.9±14.3) %. There was significant difference in the result of DA, D and L of osseous segments of Eustachian Tube and mastoid pneumatization between experimental group and control group (t/χ2=4.37, 3.09, －3.17, 6.34, P<0.05). There was no significant difference in the result of ATA, PCA, D/L between experimental group and control group (P>0.05). Conclusions There is anatomic variation in the temporal bone of patients with unilateral chronic suppurative otitis media. The small osseous segments of Eustachian Tube, narrow entrance of aditus mastoid and poor mastoid pneumatization are associated with unilateral COM.

Study on the application of inertia principal axis in the precise positioning of the radial tuberosity

Wang Fasheng, Chen Jie, Xie Yun

Chinese Journal of Clinical Anatomy. 2022, 40(2): 168-172. doi:10.13418/j.issn.1001-165x.2022.2.10

Abstract ( 120 )

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Objective　To determine the rotation angle of the radial tuberosity relative to the major axis of the radius at the horizontal plane according to theits computed tomography(CT) image.　Methods　CT images of 44 independent radial specimens (17 on the left and 27 on the right) were scanned to observe the morphology of the radial tuberosity and select the marker points from it. The Mimics21.0 was used to construct the radial three-dimensional (3D) model based on the original CT image information. Then the inertia principal axis of radial was calculated and generated, and the reference coordinate frame of inertia principal axis was established. The rotation angles of the posterior ridge marks on the radial tuberosity on the horizontal plane relative to the major axis in each specimen were calculated and recorded.　Results　The posterior ridge of radial tuberosity was ubiquitous. The relative position between inertia principal axis and radius was stable. The rotation angle of the posterior ridge of the radial tuberosity relative to the major axis of the radius in the horizontal coordinate frame was (82.93±5.55)°.　Conclusions　The anatomical reference coordinate frame based on the principal axis of inertia is stable and can be used to precisely locate the radial tuberosity.

Analysis of skeletal muscle reactivity induced by CDMNP-PEG-CD magnetic nanoparticles

Jian Xiaoting, Wan Han, Huang Jingwen, Lan Haiqiang, Liao Zhaohong, Ke Yu, Liao Hua, Zhu Chunmin

Chinese Journal of Clinical Anatomy. 2022, 40(2): 173-180. doi:10.13418/j.issn.1001-165x.2022.2.11

Abstract ( 94 )

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Objective　To investigate the immunoreactivity induced by SOMNP, CDMNP and CDMNP-PEG-CD magnetic nanoparticles implanted into mouse skeletal muscle.　Methods　SOMNP was prepared by compounding magnetic Fe3O4 and SiO2. Polyethylene glycol (PEG) and cyclodextrin (β-CD) molecules were linked to SOMNP to synthesize CDMNP, and polypseudorotaxanes were further added to synthesize CDMNP-PEG-CD magnetic nanoparticles. particles. Three kinds of nanoparticles were placed into the gastrocnemius muscle of B6 mice, respectively. Histochemical staining, immunofluorescence and FACS analysis were used to evaluate the characteristics of myotoxicity and intramuscular inflammatory exudation induced by SOMNP, CDMNP and CDMNP-PEG-CD nanoparticles at different implantation periods.　Results　Linking of SOMNP to β-CD, PEG/β-CD and polypseudorotaxanes will limit the intramuscular diffusion of nanoparticles, resulting in prolonged intramuscular residence time of CDMNP and CDMNP-PEG-CD, myocyte necrosis in the vicinity of the material, intramuscular mononuclear/Macrophage aggregation. Compared with CDMNP-PEG-CD, CDMNP nanoparticles attracted more T cells into muscle tissue. Conclusion　SOMNP, CDMNP and CDMNP-PEG-CD nanoparticles are all potential immune inducers in vivo. The modification of polypseudorotaxanes endowed CDMNP-PEG-CD nanoparticles with better in vivo compatibility.

Effect of blocking the DLK/MKK4/JNK/c-JUN pathway on survival of retinal ganglion cells in ITON mice

Chu Xiaoqi, Wu Zheng, Fan Liting, Tao Chunmei, Ma Yue, Ge Yusong

Chinese Journal of Clinical Anatomy. 2022, 40(2): 181-186. doi:10.13418/j.issn.1001-165x.2022.2.12

Abstract ( 132 )

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Objective　To investigate whether blocking the DLK/MKK4/JNK/c-JUN pathway can promote the survival of retinal ganglion cells (RGCs) in mice with indirect traumatic optic neuropathy (ITON) and compare the blocking effects of different sites.　Methods　6-8 weeks old mice were treated with the impact acceleration (IA) model capable of generating traumatic axonal injury (TAI) to simulate indirect traumatic optic neuropathy (ITON), then eligible mice were screened out and divided into four groups: a sham-operation group, an IA group, an IA+sunitinib group and an IA+SP600125 group. Samples collected at different times of the experiment were detected by γ-synuclein or p-c-JUN immunofluorescence staining, TUNEL staining and Western blot, and the results were statistically analyzed. Results Immunofluorescence staining results showed that compared with IA group, the survival RGCs density of IA+sunitinib group and IA+SP600125 group increased significantly, while the density of p-c-JUN (+) RGCs decreased remarkably (P<0.05). TUNEL test results showed that compared with IA group, the apoptosis RGCs density in both IA+sunitinib group and IA+SP600125 group reduced dramatically (P<0.05). Western blot results showed that compared with the IA group, the expression of corresponding downstream proteins in the DLK/MKK4/JNK/c-JUN pathway in IA+ sunitinib group and IA+SP600125 group decreased noticeably (P<0.05).　Conclusions　The activation of the DLK/MKK4/JNK/ C-JUN pathway is related to the survival rate of RGCs in ITON mice. The application of DLK inhibitors or JNK inhibitors can effectively block the expression of the pathway and promote the survival of RGC, with the latter blocking method having a better effect.

Expression and correlation of long non-coding lncRNA-MEG3 in steroid-induced femoral head necrosis

Cai Hao, Chen Chun

Chinese Journal of Clinical Anatomy. 2022, 40(2): 187-191. doi:10.13418/j.issn.1001-165x.2022.2.13

Abstract ( 106 )

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Objective To investigate the expression and significance of long non-coding RNA-MEG3(lncRNA-MEG3) in steroid-induced femoral head necrosis. Methods Real-time fluorescence quantitative PCR was used to detect the expression of lncRNA-MEG3 in femoral head tissues of patients with femoral neck fracture (30 cases) and femoral head and its adjacent tissues of patients with steroid-induced femoral head necrosis (30 pairs), and its clinical significance was analyzed. Results The content of lncRNA-MEG3 was the highest in the femoral head bone tissues with steroid-induced necrosis, its adjacent tissues was followed, and the lowest was the bone tissues of patients with femoral neck fracture, the difference was statistically significant (P<0.05). There was no significant difference in the ratio of gender and age(less than 60 years old or more than 60 years old) between the two groups(P>0.05). In the femoral head necrosis group, there was no significant difference in lncRNA-MEG3 content among patients taking different hormone types (meprednisone or dexamethasone) (P>0.05). In patients with different ARCO stages (stage Ⅲ orⅣ), the relative expression of lncRNA-MEG3 in stage IV was higher that of stage Ⅲ (P<0.05). Conclusions The expression of long non-coding RNA-MEG3 is closely related to steroid-induced femoral head necrosis, and its expression is related to ARCO stage of steroid-induced femoral head necrosis.

The mechanism of HMGB1 inhibitor on T lymphocytes and monocytes in the sepsis mice

Zhao Xu, Chen Zhaofang

Chinese Journal of Clinical Anatomy. 2022, 40(2): 192-197. doi:10.13418/j.issn.1001-165x.2022.2.14

Abstract ( 319 )

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Objective To investigate the mechanism of the high mobility group box protein 1 (HMGB1) inhibitor on T lymphocytes and monocytes in sepsis. Methods Thirty C57BL/6 male mice were randomly divided into 3 groups, 10 in each group, followed by a sham operation group, a model group, and an inhibitor group. In the model group and inhibitor group, a mouse model of sepsis was replicated by cecal ligation and puncture (CLP). In the sham operation group, the wound was sutured only after exposure to the cecum, and no ligation was performed. The mice in the inhibitor group were intraperitoneally injected with glycyrrhizic acid, a specific inhibitor of HMGB1 (10 mg/kg), and injected once every 6 hours for 4 times. The mice in the sham operation group and the model group were intraperitoneally injected with the same amount of normal saline. After the mice were sacrificed, the thymus tissue of the mice was aseptically isolated, and the T lymphocytes and monocytes in the thymus were routinely extracted. MTT assay and flow cytometry were used to detect the proliferation activity and apoptosis of T lymphocyte. Transwell chemotaxis assay and ELISIA method were used to detect the chemotactic activity of monocytes and the expression levels of TNF-α, IL-6 and IL-10. Western blot was used to detect the expression levels of HMGB1 and phosphatase and tensin homolog deleted onchromosometen (PTEN) in each group. Results Compared with the sham operation group, the proliferation activity and the apoptosis rate of T lymphocytes in the thymus tissue of the model group, the chemotactic activity of monocytes and the expression levels of TNF-α, IL-6, IL-10 and the expression of HMGB1 and PTEN significantly increased (all P<0.05). Compared with the model group, the apoptosis rate of T lymphocytes, the expression levels of TNF-α, IL-6, HMGB1 and PTEN significantly reduced in inhibitor group mice, the proliferation activity of T lymphocytes, the chemotactic activity of monocytes, and the expression of IL-10 protein significantly increased (all P<0.05). Conclusions HMGB1 inhibitor can reduce the apoptosis rate of thymic T cells in septic mice, enhance the proliferation activity of T cells and the chemotactic activity of monocytes, increase the secretion of monocyte anti-inflammatory factor IL-10, and inhibit the pro-inflammatory factor TNF -α, IL-6 secretion.

Finite element analysis of three kinds of internal fixation method of posterior axis in the condition of severe osteoporosis

Yao Wenjun, Li Cai , Xu Gang , Ye Yuchen , Zhu Kun , Wang Yanli , Zhang Changchun

Chinese Journal of Clinical Anatomy. 2022, 40(2): 198-203. doi:10.13418/j.issn.1001-165x.2022.2.15

Abstract ( 128 )

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Objective　To analyze the biomechanical characteristics of posterior axis different planting methods in upper cervical vertebra under severe osteoporosis (SOP). Methods A CT scanning on cervical vertebra was performed on a healthy adult man. Combined with the finite element pre-processing software, the atlantoaxial instability model (C1~C2) of SOP was stimulated by setting material properties. According to the surgical plan, posterior bilateral atlas pedicle screw (B-C1PS)+ Axis of three different ways of planting nail fixation was established: axis bilateral pedicle screw (B-C2PS, model A) fixation, axis bilateral laminar screw (B-C2TL, model B) fixation, B-C1PS combined with B-C2TL fixation(model C). The range of motion of C1-C2 joint, C1 displacement and C2 screw stress distribution of the three internal fixation methods were analyzed under the bending extension, lateral bending and axial rotation conditions of the finite element model. Results The finite element model of C1-C2 instability in the SOP, Model C had the lowest range of motion of C1-C2 joint, C1 displacement in different conditions. Fixed screw under the maximum stress of C2 joint combined fixation was smaller than that of single fixation. The maximum stress of pedicle screw of the axis in the Model C was less than that of Model B under various working conditions, that of pedicle screw in the Model C was less than that of Model A. In Model C, the stress was mainly concentrated at C2PS roots and the joint between atlanto-axial vertebral pedicle screw and screw rod. Conclusions The inner fixation stability of Model C is better than that of Model A and Model B under SOP condition. The stress of axis is dispersed, and the axis screw is less prone to postoperative fatigue loosening and prolapse.

Study on the curative effects of granular bone graft, titanium mesh bone graft and iliac bone graft in single-segment lumbar tuberculosis focus debridement by posterior approach

Jiang Guanyin, Ou Yunsheng, Zhu Yong, Luo Wei, Du Xing, Zhang Wei, Qin Wanyuan

Chinese Journal of Clinical Anatomy. 2022, 40(2): 204-210. doi:10.13418/j.issn.1001-165x.2022.2.16

Abstract ( 76 )

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Objective　To compare the clinical outcomes of iliac bone graft, titanium mesh bone graft and granular bone graft in the surgical treatment of single segment lumbar tuberculosis.　Methods　A retrospective analysis was performed on 98 patients who underwent one stage posterior debridement, bone graft and internal fixation for single segment lumbar tuberculosis from July 2015 to September 2020, involving 32 case in autologous iliac bone graft group, 32 case in titanium mesh bone graft group and 34 cases in granular bone graft group. The operative time, intraoperative blood loss, postoperative hospital stay, visual analogue scale (VAS) score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ASIA grade, Cobb angle correction and loss, and bone graft fusion time were recorded and analyzed.　Results　The average follow-up time was 28 months (14~53 months). The operation time and bone graft fusion time in the granular group were (192.6±42.1) min, (5.2±1.1) months, which were better than those in the iliac bone group (229.2±61.6) min, (8.0±2.9) months and titanium mesh group (233±51.5) min, (8.6±5.6) months (P<0.05). The amount of intraoperative blood loss in the granular group (385.3±251.8) mL was less than that in the titanium mesh group (660.9±486.4) mL (P<0.05), but there was no significant difference in the amount of intraoperative blood loss between the granular group and the iliac bone group (534.4±395.4) mL, (P=0.122). After operation, the Cobb angle of lumbar segmental kyphosis significantly improved in the three groups at the last follow-up, but there was no significant difference in loss and correction of Cobb angle among the three groups (P>0.05). There were no statistical difference in the other indicators among the three groups.　Conclusions　Compared with iliac bone graft and titanium mesh bone graft, granular bone graft has the advantages of simple and feasible operation, shorter operation time, less blood loss and faster postoperative bone graft fusion. It is a safe and effective bone graft method for single segmental lumbar tuberculosis via posterior approach.

Analysis of clinical efficacy and nonunion risk factors of closed reduction and intramedullary nailing in the treatment of ipsilateral femoral shaft with intertrochanteric fracture

Ma Zhihua, Fu Hongwei, Chen Xiaohua

Chinese Journal of Clinical Anatomy. 2022, 40(2): 211-215. doi:10.13418/j.issn.1001-165x.2022.2.17

Abstract ( 74 )

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Objective　To evaluate the clinical efficacy of closed reduction intramedullary nailing in the treatment of ipsilateral femoral shaft fracture with intertrochanteric fracture and to analyze the risk factors for fracture nonunion.　Methods　A retrospective analysis was performed on 31 patients (23 males and 8 females, aged from 21 to 73 years old who underwent closed reduction and intramedullary fixation for ipsilateral femoral shaft fracture with intertrochanteric fracture in our hospital from January 2010 to December 2016. The intramedullary nail type, number of blocking nails, operation time, blood loss, healing time, limb shortening and hip joint HHS function score in femoral shaft patients with intertrochanteric fractures were observed and recorded. The possible factors of fracture nonunion were analyzed by single factor and multiple factors.　Results　All patients were followed up for 12 to 48 months, with an average of 20.1 months. Possible causes of fracture nonunion were analyzed. There were statistical significance in the number of blocking nails and fracture type (P<0.05), while there was no statistical significance in other factors such as injury mechanism, and operation time (P>0.05). Multivariate analysis was conducted for the above two factors. The number of blocking nails (OR=2.845, 95% CI 2.164-3.741) and fracture type (OR=3.388, 95% CI 1.966~5.840) were the independent risk factors. Conclusions The independent risk factors of fracture nonunion are the small number of blocking nails and the comminuted fracture of femoral shaft. Closed reduction intramedullary nailing in the treatment of ipsilateral femoral shaft with intertrochanteric fracture is safe and effective and can improve the quality of life.

Long-term effect of radiofrequency ablation in the treatment of early glottic cancer in the elderly and its effect on voice acoustics

Tai Yong, Ji Yuzi, Ma Jiqing, Zang Yanzi, Liu Fei, Xu Dingyuan, Pei Yingying, Hao Huijuan

Chinese Journal of Clinical Anatomy. 2022, 40(2): 216-220. doi:10.13418/j.issn.1001-165x.2022.2.18

Abstract ( 93 )

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Objective　To investigate the long-term effect of radiofrequency ablation in the treatment of early glottic cancer (EGC) in the elderly and its effect on voice acoustics.　Methods　The clinical data of 95 patients with EGC admitted to our hospital from May 2010 to May 2011 were analyzed retrospectively. Patients were divided into two groups according to the different treatment methods. Control group (n=46) received the CO2 laser surgery, and study group (n=49) received the radiofrequency ablation. Then various indexes were compared between groups, including operation time, hospitalization time, VAS score, total effective rate, voice acoustics indexes [Jitter, normalized noise energy (NNE), amplitude perturbation (Shimmer)], quality of life (bodily pain, physiological function, general health score), and long-term efficacy (5-year survival rate, local recurrence).　Results　There were no statistical difference in the VAS score between the study group and the control group (P>0.05), and the total effective rate of the study group was significantly higher than that of the control group (P<0.05). Jitter, NNE and Shimmer in the study group were lower than in the control group (P<0.05). The postoperative quality of life scores in the study group were slightly higher than those in the control group, with no statistic difference (P>0.05). There were no statistical difference in 5-year survival rate and local recurrence rate between the two groups(P>0.05).　Conclusions　The application of radiofrequency ablation in the treatment of EGC in the elderly has the advantages of fast voice recovery, which is worthy of clinical promotion.

3D printing the affected hand model to guide the individualized selection of flap in the treatment of contracture of the first web space

Guo Liping, Ju Jihui, Zhou Rong, Wang Jian, Yu Xinshui

Chinese Journal of Clinical Anatomy. 2022, 40(2): 221-224. doi:10.13418/j.issn.1001-165x.2022.2.19

Abstract ( 128 )

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Objective　To investigate the clinical application of individualized skin flap in the treatment of contracture of first web space by 3D printing the model of the affected hand.　Methods　From March 2018 to October 2019, 10 cases of moderate and severe contracture of first web space were treated with 3D printing of the affected hand model before operation. The appropriate flaps were selected to repair the wound individualized according to the shape and area of the wound after opening the first web space of the model. Intraoperative comparison and verification, postoperative follow-up were performed to observe the treatment effect.　Results　The shape and area of the wound and the flap selection were basically in accordance with that of the preoperative simulation design. All the 10 cases of flaps survived, and the donor and recipient wound were healed at I stage. All flaps were followed up for 6~12 months. The appearance of the flaps was satisfactory, the sensation was partial recovered the abduction and opposition function of the thumb were restored. The angle of first web space increased by 50°-60°(with an average of 53.4°), and the width increased by 18mm-35 mm (with an average of 31.3 mm). The repair evaluation of the first web space were excellent in 7 cases, good in 2 cases, medium in1 case.　Conclusions　The 3D printing of the affected hand model before operation can guide the individualized skin flap, so that the enlarged wound with contracture can be repaired accurately, the operation time can be reduced, and the shape and function of the first web space can be recovered well after operation.

Clinical application on improved arterial free venous flap

Liu Xuegui, Yang Jungui

Chinese Journal of Clinical Anatomy. 2022, 40(2): 225-227. doi:10.13418/j.issn.1001-165x.2022.2.20

Abstract ( 89 )

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Objective　To explore the operative method of improving the survival of arterialized venous flap. Methods Ditching was made between the double dry veins, the adipose layer was cut into the subdermal vascular network, and the traffic branch fracture between the double dry veins was ligated. According to the size of the flap, selective ligation of the arterial vein branch was carried out to control the amount of blood supply from the skin flap to make the blood supply uniform. Results In the group, there were 48 flaps and 25 cases were ruddy after operation. A small amount of scattered blisters occurred in 16 cases, and congestion and swelling occurred in 7 cases 3~7 days after operation. All 48 flaps survived, the excellent and good rate was 85% (41 cases). Conclusions The survival quality of arterialized venous clap by the double modified design is further improved, which has the significance of clinical application.

Short-term efficacy and technical strategy of single-incision plus one assist port laparoscopic complete mesorectal excision (CME) of right colon cancer

Hu Weixian, Wang Junjiang, Wu Deqing, Wu Wulin, Lv Zejian, Li Yong, Cai Guanfu, Yao Xueqing

Chinese Journal of Clinical Anatomy. 2022, 40(2): 228-233. doi:10.13418/j.issn.1001-165x.2022.2.21

Abstract ( 110 )

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Objective　To investigate the feasibility and safety of single-incision plus one assist port laparoscopic complete mesorectal excision (CME) in the treatment of right colon cancer.　Methods　The clinical data of 17 patients with right-sided colon cancer who underwent single-incision plus one assist port laparoscopic complete mesorectal excision in the department of Gastrointestinal Surgery of Guangdong Provincial People's Hospital from March 2019 to December 2019 were retrospectively analyzed. The surgical indicators and efficacy were evaluated.　Results　In this group of 17 patients, the incision length was (5.6±3.1) cm, the operation time was (126.0±27.8) min, the intraoperative blood loss was (21.2±14.9) mL, the number of detected lymph nodes was (33.8±11.2), and the 75th percentile of positive lymph nodes was 1（range: 0-9). The time of first exhaustion after surgery was (1.5±0.6) d. The first time for consumption of liquid was (1.3±0.6) d, and the time of first meal semifluid was (4.1±2.3) d. There were five postoperative complications including lymphatic fistula in 3 cases, abdominal bleeding in 1 case, and pulmonary infection in 1 case, the average postoperative hospitalization was (7.9±4.5) d.　Conclusions　Single-incision plus one assist port laparoscopic complete mesorectal excision for the treatment of right colon cancer is safe and feasible. During the lymph nodes dissection operation, attention should be paid to avoid injury on the gastro-colonic vein.

Assessment of 4D-HyCoSy combined with contrast media in uterine pressure measurement for the evaluation of tubal patency

Chang Ye, Wang Linlin, Lin Chunhong

Chinese Journal of Clinical Anatomy. 2022, 40(2): 234-238. doi:10.13418/j.issn.1001-165x.2022.2.22

Abstract ( 140 )

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Objective　To investigate the diagnostic value of four-dimensional hysterosalpingography (4D-Hycosy) combined with contrast media in intrauterine pressure measurement for the evaluation of tubal patency.　Methods　A total of 150 infertile patients who underwent 4D-Hycosy examination in our hospital from January 2018 to December 2019 were selected to observe the sonographic characteristics of patients with countercurrent. The incidence of countercurrent and the injection pressure of contrast media in patients with different tubal patency were compared.　Results　The coincidence rate between 4D-Hycosy in the diagnosis of tubal patency and laparoscopic liquid was 74.67%. 4D-Hycosy was consistent with laparoscopy in the diagnosis of tubal patency (P<0.05). Among the 150 cases, 56 cases (accounting for 37.33%) had countercurrent, including 38 cases (accounting for 67.86%) of myometrial countercurrent and 18 cases (accounting for 32.14%) of parauterine venous plexus countercurrent. There were statistical differences in tubal injection pressure by pairwise comparison of bilateral patency, bilateral obstruction, incomplete patency or obstruction on one side (P<0.05). ROC curve showed that AUC, sensitivity and Yoden index of combined diagnosis were higher than those of single 4D-Hycosy (P<0.05).　Conclusions　4D-Hycosy combined with contrast media in intrauterine pressure measurement can improve the diagnostic value of tubal patency.

The research progress of TIVS for the peripheral vascular injuries

Shan Changmeng, Xu Yongqing

Chinese Journal of Clinical Anatomy. 2022, 40(2): 239-241. doi:10.13418/j.issn.1001-165x.2022.2.23

Abstract ( 203 )

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Research progress of the mechanism of mechanical stimulation induced heterotopic ossification of ligament and tendon

Zhu Zhengya, Liu Shaoyu

Chinese Journal of Clinical Anatomy. 2022, 40(2): 242-245. doi:10.13418/j.issn.1001-165x.2022.2.24

Abstract ( 104 )

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A common case of common carotid artery bifurcation, lingual artery and facial artery

Chen Ao

Chinese Journal of Clinical Anatomy. 2022, 40(2): 142. doi:10.13418/j.issn.1001-165x.2022.2.25

Abstract ( 120 )

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A case of suprascapular nerve aberration caused by absence of upper trunk of brachial plexus

Zhang Song, Fang Jie, Dong Ziqiang, Wu Yao, Zheng Dawei, Zhu Hui, Chen Buguo

Chinese Journal of Clinical Anatomy. 2022, 40(2): 149. doi:10.13418/j.issn.1001-165x.2022.2.26

Abstract ( 108 )

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A case report of median artery symmetrical variation and palmaris longus absence

Chen Yiru, Pang Wanxia, Guo Jinhua, Zhang Jiankai

Chinese Journal of Clinical Anatomy. 2022, 40(2): 246-247. doi:10.13418/j.issn.1001-165x.2022.2.27

Abstract ( 113 )

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