Chinese Journal of Clinical Anatomy

Anatomical study of anterior pedicle cortical bone screw in lower cervical spine

Peng Peng, Huang Gang, Zhu Meisong, Li Jianyi

Chinese Journal of Clinical Anatomy. 2022, 40(5): 505-510. doi:10.13418/j.issn.1001-165x.2022.5.01

Abstract ( 298 )

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Objective To investigate the feasibility of cortical bone trajectory for cervical anterior transpedicular screw fixation (ATPS) by measuring the anatomical characteristics of lower cervical pedicle. Methods Eighty sets adult healthy cervical specimens were randomly selected, and the scanned date were imported to the MIMICS 19.0 software. The following parameters in C3~C7 vertebrae: outer pedicle width (OPW) of vertebral body, outer pedicle height (OPH) of vertebral body, medial cortical shell thickness (MCT) of the pedicle, and the cortical bone screw parameters of ATPS were measured and analyzed statistically. Results There were significant differences in OPH and MCT between two sides of each segment (P<0.05). The OPH and OPW of each segment in males were greater than those of in females, with statistical differences (P<0.05). The entry point for C3 and C4 was 1.0-3.0 mm contralateral to the pedicle in the midsagittal plane of vertebra body, 1.0-3.5 mm from the upper end plate of vertebra body. The C5 entry point was 1.0-2.0 mm ipsilateral or contralateral to the pedicle in the midsagittal plane of vertebra body, 3.0-4.0 mm from the upper end plate of vertebra body. The entry point for C6 and C7 was 2.0-4.5 mm ipsilateral to the pedicle in the midsagittal plane of vertebra body, 4.5-7.0 mm from the upper end plate of vertebra body. At the cortical bone trajectory, the mean values of overall leaning angles from C3 to C7 were 39.13°, 41.00°, 40.91°, 37.28°,and 31.84° respectively, the mean values of overall sagittal angles from C3 to C7 were 90.85°, 97.23°, 108.97°, 111.60°, and 104.83° respectively. For ATPS, the diameters of cortical bone screw was 3.5 mm and the inserted length was 30 mm or 32 mm. Conclusions The cortical bone trajectory is a theoretically feasible option for ATPS, and the parameters inserting screw are established, which provides theoretical basis for its further clinical application.

Morphology and distribution characteristics of the intraforaminal anchor chain ligaments at the cervical level

Shao Yupu, Zheng Xuefeng, Shi Benchao, Ding Zihai , Zhao Qinghao

Chinese Journal of Clinical Anatomy. 2022, 40(5): 511-514. doi:10.13418/j.issn.1001-165x.2022.5.02

Abstract ( 343 )

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Objective To reveal the shape and distribution characteristics of anchor chain ligament in intervertebral foramina and to explore the relationship between anchor chain ligament and nerve entrapment in cervical spondylotic radiculopathy. Methods Twelve adult specimens of cervical spine were dissected with electric saw in midsagittal incision. The root cuff was cut from the root of the nerve root cuff. The anchor-chain ligaments around the nerve root cuff at the internal orifice of the intervertebral foramen C3/4 to C7/T1 were dissected under a surgical microscope. The morphology, distribution, starting and ending points and course of ligaments were recorded. Results A total of 560 anchor chain ligaments were found around the nerve root sleeve of 120 interforaminal foramen. All ligaments were radially connected to the periosteum wall around the nerve root sleeve and the interforaminal foramen. The number of interforaminal orifice ligaments in each vertebra was more than 4. The morphology of anchor chain ligament mainly included two types: band shape and cable shape. There were 258 band ligaments with a width of (4.5±2.6) mm (4.1~5.2 mm), and 302 cord-shaped ligaments with a diameter of (2.5±1.8) mm (1.2~3.8) mm. The ligaments in the interforaminal orifice of C3/4 and C7/T1 were loose and thin, and the number of ligaments was less. C4/5~C6/7 interforaminal ligaments were tough and strong, and the number of ligaments was much more. Conclusions Anchor chain ligaments exist around nerve roots in the interforaminal orifice of cervical vertebra. Anchoring nerve roots to the periosteum wall of the interforaminal orifice greatly limits the free movement range of nerve roots, which may lead to nerve root compression together with disc herniation, which is a potential anatomical factor of radiculopathy.

Anatomical observation of pyramidalis muscle and anterior pubic ligament

Yuan Jiajie, Yuan Zhirong, Chen Xiaomei, Su Minghao, Li Zelin, He Shanli, Liu Chang, Li Zeyu, Ouyang Jun, Dai Jingxing

Chinese Journal of Clinical Anatomy. 2022, 40(5): 515-518. doi:10.13418/j.issn.1001-165x.2022.5.03

Abstract ( 771 )

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Objective To explore the adjacent relationship between pyramidalis muscle and anterior pubic ligament, so as to provide anatomical basis for further understanding the mechanism of maintaining the stability of the pubic symphysis. Methods Twenty-four specimens (19 males and 5 females) were selected to observe the length, width, thickness of the pyramidalis muscle and the adjacent relationship between the adjacent rectus abdominis, adductor longus and anterior pubic ligaments. Results In the 24 gross specimens, 23 cases of pyramidalis muscle existed bilaterally (accounting for 95.8%, 19 cases in males, 4 cases in females). One case lacked the right muscle (accounting for 4.2%, 1 case in female). The length of pyramidalis muscle was (70.64±13.48) mm in males and (71.81±11.27) mm in females on the right side, (69.60±12.01) mm in males, (64.25±19.79) mm in females on the left side. Width, on the right side: male (20.68±4.12) mm, female (20.65±2.04) mm, on the left side: male (20.02±2.99) mm, female (18.23±4.77) mm. Thickness, right: male (2.50±1.61) mm, female (1.49±0.40) mm, left: male (2.19±1.06) mm, female (1.50±0.56) mm. There was no statistical difference in the length, width and thickness of the pyramidalis muscle (P>0.05). The width of anterior pubic ligament was (5.96±1.55)mm in males and (6.60±1.10) mm in the females on the right side, (6.35±1.58) mm in males and (6.16±0.69) mm in females on the left side. The pyramidalis muscle originated from the fibrous ligament anterior to the pubic bone and pubic symphysis with tendinous fibers. The origin of rectus abdominis tendon, adductor longus tendon, inguinal ligament and the starting point of the pyramidal muscle were intertwined with adjacent to the pubic crest, forming a distinct anterior pubic ligament. Conclusions The pyramidalis muscle originates from the anterior pubic ligament and forms the anterior pubic ligament together with the inguinal ligament and the adductor longus tendon. At the same time, with the anterior pubic ligament as the center, adjacent structures together form a complex, which provides important support for the stability of the pubic symphysis.

Anatomical study and clinical significance on tibial collateral ligament of the knee and medial meniscus

Chen Shuai, Yi Chenpeng, Wang Jie, Gong Dawei, Jiao Feng, Huang Huayang, Zheng Xiaofei, Wang Haibin

Chinese Journal of Clinical Anatomy. 2022, 40(5): 519-522. doi:10.13418/j.issn.1001-165x.2022.5.04

Abstract ( 375 )

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Objective To provide anatomical basis for the diagnosis and treatment of tibial collateral ligament (TCL) and medial meniscus (MM) injuries under arthroscopy. Methods Eighteen adult cadaver knee specimens were dissected to observe the anatomical morphology of TCL and MM and the relationship between them. Results Deep layer of TCL formed a wide but firm connection between the posterior oblique ligament and the anterior medial capsule and the body and posterior angle of the MM. The contact length and contact area of the two were (8.12±0.44) mm and (36.39±4.45) mm2, respectively, which could maintain the stability of the MM during flexion and extension of the knee. Conclusions The TCL and MM are important components for the stability of medial knee joint. In-depth knowledge of their morphological characteristics are of great significance for the diagnosis, treatment and anatomical repair of TCL and MM injuries under arthroscopy.

The whole-mount intramuscular nerve distribution pattern of intermediate plantar groupand dorsalis pedis muscles and its significance

Deng Qun, Luo Linfen, Yang Shengbo

Chinese Journal of Clinical Anatomy. 2022, 40(5): 523-529. doi:10.13418/j.issn.1001-165x.2022.5.05

Abstract ( 663 )

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Objective To reveal the whole-mount intramuscular never distribution pattern of intermediate plantar group and dorsails pedis muscles and to explore its significance. Methods The intermediate plantar group and dorsails pedis muscles from twelve adult cadavers fixed by formalin were removed. Modified Sihler's staining was used to display the whole-mount intramuscular nerve distribution pattern. Results The nerve branches of the flexor brevis digitorum, the first and second lunbrical muscles innervated by medial plantar nerve entered from deep and superficial surface respectively. The nerve branches of the quadrates, the third and fourth plantar lunbrical muscles innervated by lateral plantar never coursed from the insertion to the origin of the muscle. While the nerve branches of the interossei plantar muscles and the interossei dorsal muscles coursed from the origin to the insertion of the muscle. The nerve branches of the extensor hallucis brevis and the extensor brevis digitorum muscle shared one nerve trunk. The lumbrical muscles, the first and second interossei plantar muscles, the first interossei dorsal muscle, the extensor hallucis brevis and the extensor brevis digitorum muscle formed only one intramuscular nerve dense region in the middle of the muscle belly. The flexor brevis digitorum, the quadrates plantae, the third interossei plantar muscle and the second to fourth interossei dorsal muscles had two intramuscular nerve dense regions on both sides of the muscle, these muscles can be divided into two neuromuscular subdivisions. Conclusions These results may provide morphological guidance for surgical operation to avoid nerve injury and the selection and matching of muscle transplantation and the injection of botulinum toxin A to block the spasticity of these muscles.

Anatomy of the inferior mesenteric artery evaluated by three-dimensional CT angiography before radical resection of rectal cancer

Zhang Peng, Chen Xin, Zhang Lan, Lin Yao, Lv Jianbo, Zeng Xinyu, Wang Zheng, Li Xin, Jin Yao, Tao Kaixiong

Chinese Journal of Clinical Anatomy. 2022, 40(5): 530-535. doi:10.13418/j.issn.1001-165x.2022.5.06

Abstract ( 500 )

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Objective To evaluate and analyze the classification and anatomical characteristics of the inferior mesenteric artery (IMA) of patients with rectal cancer by three-dimensional CT angiography (CTA) in order to provide reference for the surgical management of rectal cancer. Methods A retrospective analysis was performed on the clinical and image data of rectal cancer patients received IMA CTA examinations in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2019. IMA images were reconstructed by three-dimensional CT angiography. Branch types of IMA were classified, and anatomical parameters of the inferior mesenteric vessel were measured and analyzed. Results Among the 266 cases, 187 were males and 79 were females. The left colon artery (LCA) arose independently from the common trunk in 111 cases (accounting for 41.7%). In 112 cases (accounting for 42.1%), the LCA and sigmoid colon artery (SA) had a common trunk, and in 33 cases (accounting for 12.4%), LCA, SA and superior rectal artery (SRA) forked at same point, whereas LCA disappeared in 10 cases (accounting for 3.8%). The length of the IMA (LIMA) was (39.1±10.1) mm, and the distance between the IMA root and iliac aortic bifurcation (DIMA) was (44.1±7.4) mm. The distance from the IMA root to the inferior mesenteric vein (IMV) and the IMA branch point to the IMV were (24.6±8.9) mm, (13.0±5.3) mm, respectively. In 122 cases (accounting for 47.6%), LCA ascended medial to the lateral border of left kidney, while in 46 patients (accounting for 18.0%), LCA arranged below the inferior border of left kidney. LCA located medial to IMV at the level of IMA root in 65 cases (accounting for 25.4%), just lateral to IMV in 136 cases (accounting for 53.1%), and lateral away from IMV in 55 cases (accounting for 21.5%). Conclusions Three-dimensional CT angiography before surgery can accurately assess the IMA branch types and anatomical parameters of the inferior mesenteric vessel, which can provide reference for vascular management in rectal cancer surgery.

Localization and regulation of cytoskeleton associated proteins PDLIM5 in human fibroblasts

Huang Xiaolan, Peng Yan, Yang Yuchao, Fan Tingyu, Sun Bing, Asmat Ullah Khan, Dai Jingxing, Ouyang Jun, Zhong Shizhen

Chinese Journal of Clinical Anatomy. 2022, 40(5): 536-540. doi:10.13418/j.issn.1001-165x.2022.5.07

Abstract ( 93 )

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Objective To investigate the localization and regulation of cytoskeleton-related proteins PDLIM5 in human fibroblasts． Methods After the expression of PDLIM5 was down-regulated by lentivirus transfection in human fibroblasts, CCK8 cell proliferation assay, cell scratch assay and Transwell migration assay were performed to detect the effect of PDLIM5 on cell proliferation and migration ability. Immunofluorescence staining was used to observe the cellular localization of PDLIM5. Results Down-regulating of PDLIM5 expression inhibited, the proliferation and migration ability of human fibroblasts. Immunofluorescence staining showed that PDLIM5 was mainly expressed in the cytoplasm and localized in the microfilament. Conclusions PDLIM5 is localized in cytoskeleton microfilaments and down-regulation of PDLIM5 expression can inhibit cell proliferation and migration ability of human fibroblasts.

Expression and clinical significance of p-mTOR, p-4EBP1 and p-S6K1 in colorectal adenocarcinoma

Cao Li, Chen Peng, Li Dingchang, Dong Guanglong

Chinese Journal of Clinical Anatomy. 2022, 40(5): 541-547. doi:10.13418/j.issn.1001-165x.2022.5.08

Abstract ( 143 )

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Objective To study the expression of p-mTOR, p-4EBP1 and p-S6K1 in colorectal adenocarcinoma and adjacent tissues and analyze their relationship with relevant clinicopathological data, and explore their occurrence and development in colorectal adenocarcinoma and the possible role and clinical significance. Methods Immunohistochemistry was used to detect the expression of p-mTOR, p-4EBP1 and p-S6K1 in 60 cases of colorectal adenocarcinoma tissues and 40 cases of adjacent normal tissues, compare the differences of each group, and analyze their relationship with relevant clinicopathological characteristics. The positive rate correlation analysis was performed by Spearman correlation analysis, and the test level α=0.05. Results The expression levels of p-mTOR, p-4EBP1 and p-S6K1 in colorectal adenocarcinoma tissues were higher than those in adjacent tissues on average, with statistically significant differences (P<0.05). The expression of p-mTOR was related to the stage of patients with lymph node metastasis, TNM stage and differentiation degree (P<0.05). The expression of p-S6K1 was related to the TNM stage and differentiation degree of the patient (P<0.05). The expression of p-mTOR and p-4EBP1 in colorectal adenocarcinoma tissue has a certain positive correlation (P<0.05), and the expression of p-mTOR and p-S6K1 in colorectal adenocarcinoma tissue has a significant positive correlation (P<0.05). Conclusions The overexpression of p-mTOR, p-4EBP1 and p-S6K1 in the mucosal tissue of colorectal adenocarcinoma may be one of the important mechanisms for the occurrence of colorectal adenocarcinoma. These three phosphorylated proteins may be related to the occurrence and development of colorectal adenocarcinoma.

Klotho protein inhibits FGF23/NF-κB p65 expression in aged rats and microglia of POCD

Duan Haixia, Wang Chonghe, Wang Qinghui, Jiang Wanwei, Huang Xuezhu

Chinese Journal of Clinical Anatomy. 2022, 40(5): 548-554. doi:10.13418/j.issn.1001-165x.2022.5.09

Abstract ( 102 )

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Objective To explore the therapeutic effect and mechanism of Klotho protein on POCD by selecting the POCD aged rats and BV2 microglia as research objects. Methods Forty-five SD aged rats were divided into a control group, a sevo group and a sevo+surgery group, randomly. The rats cognitive status were assessed by water maze. HE staining, TUNEL staining and ELISA were used to detect the pathological changes, apoptosis and expression levels of inflammatory factors in rat hippocampus. Western blot was used to detect the related proteins expression of the rat hippocampal tissue and BV2 cells. Cell immunofluorescence was used to detect the NF-κB p65 expression in BV2 cells. Results Aged rats in the sevo and sevo+surgery groups showed significant cognitive impairment, hippocampal region damage, increased expression of inflammatory factors, apoptosis of a large number of neuronal cells, down-regulation of Klotho protein expression, and up-regulation of FGF23/NF-κB pathway protein expression. LPS and sevoflurane induced increased expression of inflammatory factors and up-regulated expression of FGF23/NF-κB pathway protein in BV2 cells, while treatment with Klotho decreased the expression levels of inflammatory factors and the above proteins. Conclusions Klotho may become a new target in the prevention and treatment of POCD, and its mechanism may be related to the inhibition of FGF23/NF-κB expression in microglia by Klotho peotein.

Effects of Shenggu Zaizao Pills on related indexes of bone morphometry in steroid-induced necrosis of the femoral head in rabbits

Ma Xueqiang, Cao Linzhong, Jiang Wei, Zhang Qi , Liu Mengchu, Wang Duoxian

Chinese Journal of Clinical Anatomy. 2022, 40(5): 555-561. doi:10.13418/j.issn.1001-165x.2022.5.10

Abstract ( 286 )

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Objective To observe the intervention effect of Shenggu Zaizao Pills on steroid-induced necrosis of the femoral head (SONFH) rabbit femoral head histomorphology and related indexes of osteometry. Methods Twenty female New Zealand rabbits were randomly divided into a normal group, a model group, a Shenggu Zaizao pill group and a positive control drug Xianling Gubao capsule group, 5 in each group. Except the normal group, the other three groups received endotoxin combined with methylprednisone sodium succinate injection to modeling. After 28d, Shenggu Zaizao Pills group was given 2.4 g/kg Shenggu Zaizai Pills, Xianling Gubao Capsule group was given 0.4 g/kg Xianling Gubao Capsule, normal group and model group were given 10mL of normal saline, 1 time/d. After 28d, the bilateral femoral heads of the rabbits in each group were taken to perform Micro-CT scanning to analyze osteometric parameters. HE staining was used to observe the pathological changes of the femoral head tissue morphology. Results Compared with the normal group, Micro-CT scan analysis showed that the femoral head bone mineral density (BMD),bone volume fraction (BV/TV), trabecular bone number (Tb.N), trabecular bone thickness (Tb.Th) and connectivity density (Conn.D) in the model group significantly decreased, while trabecular bone separation (Tb.Sp) and structural model index (SMI) significantly increased (P<0.05). Microscopic observation of HE stained pathological sections showed that the rate of empty bone lacunae and the area of adipocytes in the model group significantly increased, the epiphysis was deformed, and the trabecular bone was hyperplasia, narrowed or broken. Compared with the model group, the osteometric and histopathological changes of the femoral head of the rabbits in the Shenggu Zaizao Pills group and Xianling Gubao Capsule group significantly improved (P<0.05). There was no significant difference in curative effect between Shenggu Zaizao Pills group and Xianling Gubao Capsules group (P>0.05). Conclusions Shenggu Zaizao Pills can significantly increase the level of SONFH osteometric indexes in rabbits and improve histopathological morphology, thereby achieving the effect of treating SONFH.

The expression of CBX3 in brain glioma and its influence on the apoptosis of glioma cell

Li Chiyang, Yang Fan, Yang Yue, Lu Yuntao, Zhou Qiang

Chinese Journal of Clinical Anatomy. 2022, 40(5): 562-568. doi:10.13418/j.issn.1001-165x.2022.5.11

Abstract ( 92 )

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Objective To clarify the correlation between CBX3 and the prognosis of glioma by analyzing the expression of CBX3 in the glioma public database. Flow cytometry and the detection of apoptosis indexes were used to analyze its effect on the apoptosis level of glioma cell lines. Methods By analyzing the data of glioma patients gene chip in TCGA and CGGA, the expression of CBX3 in different grades of glioma was compared and the relationship between CBX3 expression and prognosis of glioma patients was analyzed. Functional annotation of the CBX3 gene by GO and Pathway analysis. Finally, the effect of CBX3 gene on the apoptosis level of glioma cell lines was explored in cell lines. Results The expression of CBX3 in high-grade gliomas was significantly higher than that in low-grade gliomas (P<0.01). The prognosis of patients with high CBX3 expression was worse than that of patients with low CBX3 expression (P<0.05). At the same time, flow cytometry experiments showed that overexpression of CBX3 could significantly reduce the apoptosis level of glioblastoma cell lines U87MG and T98G. Conclusion The expression level of CBX3 is negatively correlated with the survival time of glioma. High expression of CBX3 can reduce the apoptosis level of glioblastoma cell lines, so CBX3 may be an effective indicator for judging the prognosis of glioblastoma.

Mechanism of herb-pair Trachelospermum jasminoides and Achyranthes bidentata treating Arthritis based on network pharmacology

Pang Ting, Tang Qiulian, Chen Yong, Wei Jiangcun, Liang Cao, Wang Zhiqiang, He Huan, Zeng Chao

Chinese Journal of Clinical Anatomy. 2022, 40(5): 569-574. doi:10.13418/j.issn.1001-165x.2022.5.12

Abstract ( 133 )

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Objective To analyze the potential mechanism of herb-pair “Trachelospermum jasminoides and Achyranthes bidentata” based on network pharmacology in Arthritis. Methods The effective components and target genes of “Trachelospermum jasminoides and Achyranthes bidentata” were screened by searching the pharmacological database platform of Chinese herbal medicine system (TCMSP). Setting “Arthritis” as the key word, human gene retrieval was performed in GeneCards database, NCBI gene database and OMIM database to obtain genes, which were related to Arthritis. The selected drug pair targets and disease targets were input into Venny 2.1 software to obtain common targets. The STRING database was used to construct PPI network, and the “herb-component-target-disease” network was constructed by Cytoscape. The gene ontology (GO) functional enrichment analysis and KEGG pathway analysis of key target genes were carried out by R language software. Results Totally, 9 compounds and 94 targets of Trachelospermum jasminoides were obtained from TCMSP, while 21 compounds and 205 targets got from Achyranthes bidentata. Venny mapping obtained 128 common targets, and a total of 5 gene clusters and 4 core genes were screened out from the STRING database to construct PPI network. The GO functional enrichment analysis showed that the herb-pair “Trachelospermum jasminoides and Achyranthes bidentata” involved 2329 biological processes, 150 molecular function correlations and 60 cell composition correlations. Through KEGG pathway enrichment analysis, “Trachelospermum jasminoides and Achyranthes bidentata” herb-pair in the treatment of Arthritis enriched a total of 154 signal pathways. Conclusions Based on network pharmacology, the possible mechanism of herb-pair “Trachelospermum jasminoides and Achyranthes bidentata” in the treatment of Arthritis was preliminarily verified from the aspects of active components, gene targets and signal pathways.

Expression changes of Hippo signaling pathway core protein at different time points of postnatal mice cortex

Chen Yu, Li Xifan, Li Kaixuan, Chen Chen, Huang Xishi, Fang Fang

Chinese Journal of Clinical Anatomy. 2022, 40(5): 575-580. doi:10.13418/j.issn.1001-165x.2022.5.13

Abstract ( 95 )

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Objective To explore the expression changes of Hippo signaling pathway core protein at different time points of postnatal mice cortex. Methods Brain weight and transverse diameter were measured at 3 d, 6 d, 9 d, 3w and 8w postnatal (P) mice cortex of C57BL/6 to detect the growth and development of mice brain tissue. Western Blot was used to detect the expression of MST1 and LATS1. Tyramide Signal Amplification (TSA) was used to detect the changes of microglia numbers and the location of Yes-associated protein (YAP) in microglia at five different time points. Results The brain weight and transverse diameter in the early postnatal period was significantly increased. Western blot result showed that MST1 and LATS1 were significantly decreased from P9d, and there was no statistical difference in P3w and P8w. The proportion of IBA1 positive microglia in cortex were increased with the increasing of age, with a significant increase in the early postnatal period. With the increasing number of microglia, YAP aggregation transferred from extranuclear to intranuclear. Conclusions Hippo signaling pathway is activated in early postnatal mice cortex, which may be involved in volume regulation during postnatal brain development.

Establishment of a highly efficient method for β-thalassemia CD17 (A > T) point mutation in HEK293T cell line

Liu Yongxiang, Cai Bing, Xu Yan, Zeng Yanhong, Zhou Shaohu, Mai Qingyun

Chinese Journal of Clinical Anatomy. 2022, 40(5): 581-586. doi:10.13418/j.issn.1001-165x.2022.5.14

Abstract ( 455 )

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Objective To establish an efficient method for constructing HEK293T cell line of β-thalassemia CD17 (A>T) point mutation. Methods Using a modified CRISPR/Cas9 gene editing technology, termed ‘CORRECT’ (consecutive re-Guide or re-Cas steps to erase CRISPR/Cas-blocked targets) for scarless genome editing. Firstly, the cleavage of HBB gene in HEK293T cells was induced by electro-transfection of CRISPR/Cas9 plasmid. Then, single-stranded oligo DNA nucleotides (ssODNs) with CD17 (A>T) point mutation and synonymous mutation (G>T) were used as homologous templates for repair. The HEK293 T cell line with β-globin CD17 (A>T) point mutation was obtained by monoclonal screening and sequencing analysis. Results A HEK293T cell line with point mutation of β-thalassemia CD17 (A>T) genotype was successfully obtained by 'CORRECT' technique. The introduction of synonymous mutation might reduced re-editing of Cas9 protein to the target, which greatly improved the efficiency of single base mutation. Conclusions The point mutation HEK293T cell line can be efficiently obtained by 'CORRECT' technique, which is of great significance for the establishment of single base mutation cell lines and animal models.

The clinical application of superficial circumflex iliac artery perforator flaps in repairing soft tissue defects of extremities under the concept of "swimming trunks donor area"

Sun Yu, Yang Lixue, Wang Guanlin, Zhu Wei, Qiu Yongfeng , Liang Haohao

Chinese Journal of Clinical Anatomy. 2022, 40(5): 587-591. doi:10.13418/j.issn.1001-165x.2022.5.15

Abstract ( 167 )

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Objective To investigate the reliability and clinical efficacy of the superficial circumflex iliac artery perforator flap (SCIP) designed on the concept of "swim trunk donor site" in repairing skin and soft tissue defects of extremities. Methods Thirty-eight patients with skin and soft tissue defects of extremities admitted to the department of Traumatology and Orthopedics of our hospital from September 2018 to June 2020 were analyzed retrospectively, including 26 males and 12 females. The injury site included hand defects in 17 cases and foot defects in 21 cases. Soft tissue defect area was 1.3 cm×1.7 cm~12 cm×8 cm. All patients were repaired with free SCIP. The area of the skin flap was 1.6 cm×2.1 cm~15 cm×11 cm. Anti-infection, anticoagulation, anti-spasm, and heat preservation treatments were routinely given after the operation and regular follow-ups were performed. Results Thirty-eight cases of skin flaps were followed up for 8-14 months, with an average of 10.4 months; all skin flaps survived successfully. Two cases had vascular crisis after flap operation, and 1 case survived smoothly after activating blood circulation and antispasmodic treatment, one case relieved spontaneously after raising the affected limb. The remaining flap had good blood circulation, and the appearance and function recovered satisfactorily. Only linear scars remained in the donor area of the flap. Conclusions Under the concept of "swimming trunks supply area", free SCIP is designed to repair soft tissue defects of limbs, which integrates the function and appearance of the transplanted area, and also takes into account the location and aesthetic degree of the donor area, with few complications. As a better choice for repairing soft tissue defects in limbs, it is worthy of further clinical application.

Postoperative effect and influencing factors of the reconstruction of the anterior cruciate ligament with four hamstring tendon autograft under arthroscopy

Yin Shuai , Liu Yuanyuan , Pang Yin , Sui Yuelin, Zhang Xinyue, Li Bing, Chen Yajun

Chinese Journal of Clinical Anatomy. 2022, 40(5): 592-598. doi:10.13418/j.issn.1001-165x.2022.5.16

Abstract ( 125 )

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Objective To investigate the effect of different surgical methods and different rehabilitation training methods in the treatment of ACL injury by arthroscopic anterior cruciate ligament (ACL) reconstruction with autologous hamstring tendon (ST/G). Methods From January 2017 to March 2018, 80 patients (80 knees) with ACL injury in our hospital were retrospectively analyzed. They were divided into four groups according to the operation and rehabilitation training methods, 20 cases in each group (20 knees), including a remnant-preserving professional rehabilitation group, a remnant-preserving routine rehabilitation group, a remnant-eliminating professional rehabilitation group and a remnant-eliminating routine rehabilitation group. The knee function score, stability test and proprioception measurement results of the four groups at the last follow-up were compared. Results All patients were followed up for 12 months. The Lysholm and IKDC scores of the four groups at the last follow-up were significantly higher than those before operation (P<0.001), and there were significant differences among the four groups (P<0.001). There were significant differences in position perception between the affected side and the healthy side in the four groups after operation (P<0.001). Based on Lysholm and IKDC scores, the increment of difference between the last follow-up and preoperative, the difference of position perception between the affected side and the healthy side were the dependent variables, and the operation mode and rehabilitation training mode were the independent variables for two-way ANOVA. The two independent variables had significant effects on knee function score and proprioception recovery (P<0.001). In addition, the increment of two scores in the remnant-preserving group was significantly higher than that in the remnant-eliminating group (P<0.001). The increment of two scores in the professional rehabilitation group was significantly higher than that in the routine rehabilitation group (P<0.001). The difference of position sense in the remnant-preserving group was significantly lower than that in the remnant-eliminating group (P<0.001), and the difference of position sense in the professional rehabilitation group was significantly lower than that in the routine rehabilitation group (P<0.001). Conclusions Arthroscopic reconstruction preserving the tibial remnant with four strand ST/G is an ideal surgical plan for the treatment of ACL injury. Postoperative rehabilitation of segmented and individualized professional kinesiotherapy can promote the recovery of knee function and proprioception, and can help patients recover and return to exercise as soon as possible.

Effect of different fusion methods on stress response in patients with multi segmental lumbar spinal stenosis combined with lumbar disc herniation

Li Rui, Zhang Renzan, Liu Zhengpeng, Sun He, Zhang Yilong

Chinese Journal of Clinical Anatomy. 2022, 40(5): 599-604. doi:10.13418/j.issn.1001-165x.2022.5.17

Abstract ( 103 )

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Objective To investigate the effect of multi-segmental spinal decompression combined with different fusion methods on bone graft fusion and stress response in patients with multi-segment lumbar spinal stenosis (LSS) combined with lumbar disc herniation (LDH). Methods A total of 85 patients with multi-segment LSS and LDH in our hospital from February 2017 to February 2019 were selected and divided into group A (n=43) and group B (n=42) according to different treatment plans. Group A was treated with multi-segment spinal canal decompression combined with internal fixation with bone grafting and fusion between transverse processes, and group B was treated with multi-segment spinal canal decompression combined with intervertebral bone grafting and fusion. The conditions of related indexes of operation and related indexes of serum stress response [angiotensin II (Ang II), renin (R), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6)] levels before operation, 1 d and 3 d after operation, complications, curative effects, and bone graft fusion were compared between the two groups, as well as the visual analogue scale (VAS) score, the Japanese Orthopaedic Association (JOA) score, and the dysfunction index (ODI) scores before operation, 1 week, 12 months and 24 months after operation. Results The operation time and hospitalization time of group A were shorter than those of group B, and the blood loss and hospitalization expenses during operation were lower than those of group B (P<0.05). The levels of serum AngⅡ, R, hs-CRP, and IL-6 at 1 and 3 days after operation in the two groups were higher than those in the group before operation (P<0.05). The above-mentioned serum index levels in group A were lower than those in group B on the 1st and 3rd day after operation (P<0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05). There was no statistically significant difference in the excellent and good rate of surgery and the rate of bone graft fusion between the two groups (P>0.05). The VAS scores and ODI scores of low back pain at 3 months, 12 months, and 24 months after operation in the two groups were lower than those of this group before surgery, and the JOA score was higher than that of this group before operation (P<0.05), but the difference between the groups was not statistically significant (P>0.05). Conclusions Multi-segment spinal canal decompression combined with intertransverse process bone grafting and internal fixation or intervertebral bone grafting and fusion are both affirmative surgical procedures for the treatment of multi-level LSS combined with LDH, and the clinical effect is satisfactory. The intertransverse process bone graft fusion and internal fixation has the advantages of less trauma, less bleeding, faster recovery, and low hospitalization costs.

Development and clinical application of three-dimensional closed reduction device for femoral shaft fracture

Peng Changgui, Luo Ying, Lan Guohu, Li Riwang, Yuan Zhikun, Bao Guoqing, Li Xuming, Pan Jianying

Chinese Journal of Clinical Anatomy. 2022, 40(5): 605-609. doi:10.13418/j.issn.1001-165x.2022.5.18

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