Table of Content

25 January 2023 Volume 41 Issue 1

  

The three-dimensional model construction of bronchial tree and the simulation of fiberoptic bronchoscopy surgery based on Chinese Visible Human dataset 

Yang Jingyi, Hu Xin, Yao Jie, Xu Zhou, Yang Zhi, Chen Zhi, Wu Yi

Chinese Journal of Clinical Anatomy. 2023, 41(1):  1-7.  doi:10.13418/j.issn.1001-165x.2023.1.01

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Objective    To construct detailed three-dimensional (3D) digital structures and apply to virtual simulation and 3D printing of the human lung bronchial trees, so as to provide accurate morphological data for the virtual simulation of fiberoptic bronchoscopy surgery.    Methods    The tomographic anatomical images of Chinese Visible Human CVH1,2,5,6 chest were selected. The lungs and bronchial trees were segmented and  reconstructed in 3D by using AMIRA software. Cinema 4D software was used to smooth, construct an interactive 3D-PDF model, and perform 3D printing to create virtual fiberoptic bronchoscopy surgery simulation model.    Results    Detailed 3D digital models of 4 lung bronchial trees were constructed, including 3 adults and 1 child, showing the branches of the human bronchial tree at 3-6 levels, the number of branches at level 4 and level 6 was about twice the number of branches of the upper level. The segment of left lung was 8, the number of bronchial branches at level 6 was (63.8±3.6), the segment of right lung was 10, the number of bronchial branches at level 6 was (63.8±3.6), and the bronchial branches number ratio of the left and right lungs was 0.79. The longest length of the bronchus was located in the left lobe, and the diameter of children’s lumen was smaller than that of three adults.   Conclusions    The 3D digital model, 3D printing model, 3D-PDF and virtual simulation software for surgery of the bronchial trees have improved the understanding of anatomy and developmental biology of bronchial tree. We believe that the B1+2 and B7+8 bronchopulmonary segments of the left lung are separate segmental bronchi, rather than two combined segmental bronchi, which provides morphological basis for clinical anatomy teaching and virtual simulation of fiberoptic bronchoscopy surgery.

Multi-slice spiral CT study on anatomical variations of pulmonary veins

Mei Yixuan, Liu Hailan, Liu Cheng, Zhang Yi, Liu Shuwei

Chinese Journal of Clinical Anatomy. 2023, 41(1):  8-14.  doi:10.13418/j.issn.1001-165x.2023.1.02

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Objective　To describe and classify the anatomic variations of pulmonary veins by multi-slice spiral CT (MSCT), so as to provide anatomic basis for radio-frequency ablation of atrial fibrillation and cardio-thoracic surgery.　Methods　Two hundred and fifty patients underwent coronary CT angiography with MSCT were respectively analyzed. The anatomical structure of pulmonary veins was observed by post-processing techniques such as multi-plane reconstruction (MPR), maximum density imaging (MIP) and volume reconstruction (VR). The frequency of each type was classified and counted.　Results　The incidence of common vein and accessory pulmonary veins was 38.8% and 15.2%, respectively, with no gender difference. The left atrium and pulmonary vein connection could be divided into 4 types: 130 cases in standard type (52%), 83 cases in common vein type, which was the most common variation type(33.2%), 23 cases in additional vein type ( 9.2%), and 14 cases in mixed type ( 5.6%). The variation rate of bilateral pulmonary vein drainage patterns was 54%, 26.8% on right side, 42% on left side, with no gender difference.　Conclusions　Pulmonary veins has great variability. MSCT can display pulmonary vein in detail, which is an effective tool to study its anatomical structure.    

MRI study of the effect of isolated unilateral ventriculomegaly on the volume of brain parenchyma

Sun Shanshan, Tian Mimi, Zhao Peng, Cai Shuo, Yang Tao, Yang Yongqing, Ma Wenjing, Lin Xiangtao

Chinese Journal of Clinical Anatomy. 2023, 41(1):  15-19.  doi:10.13418/j.issn.1001-165x.2023.1.03

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Objective   To investigate the effect of fetal isolated unilateral ventriculomegaly on the volume of brain parenchyma and its clinical value in fetal diagnosis and treatment.   Methods   Isolated unilateral ventriculomegaly confirmed by ultrasound underwent fetal brain examination at 1.5T MRI. The width of lateral ventricle, the thickness of adjacent lateral brain parenchyma, the volume of lateral ventricle and the volume of cerebral hemisphere were measured on the dilated side and the normal side, and the volume of brain parenchyma was calculated. The changes of the width of lateral ventricle with gestational age were followed up at an interval of 1 month.   Results   A total of 49 fetuses with isolated unilateral ventricular dilatation at 23-31 gestational weeks were finally included in the study. They were divided into three groups according to the degree of dilatation: 12 cases in the mild dilatation group, 27 cases in the moderate dilatation group and 10 cases in the severe dilatation group. The results of comparative study were as follows: ⑴ Compared with the normal side, the thickness of  adjacent brain parenchyma on the dilated side decreased, and the volume of brain parenchyma was no significant difference; ⑵ There were differences in the width and volume of the dilated lateral ventricle and the volume of the cerebral hemisphere among the three groups (P<0.05), and there was no significant difference in the thickness and volume of the brain parenchyma on the dilated side. ⑶ The follow-up showed that the width of lateral ventricle gradually decreased in 76% in the mild and moderate dilation groups, and the abortion rate in the severe dilation group was 80%.   Conclusions Isolated unilateral lateral ventricular dilatation has no effect on the volume of brain parenchyma, and the prognosis of fetuses with mild to moderate dilatation is good, which provides important imaging information for the evaluation, prognosis and intervention of fetuses with lateral ventricular dilatation.

CT features of NHL involvement of gastrocolic ligament

Wu Hang, Zhou Taohu, Li Yubiao, Huang Wenjun, Ding Ning, Dong Xiaohan, Dong Peng

Chinese Journal of Clinical Anatomy. 2023, 41(1):  20-22.  doi:10.13418/j.issn.1001-165x.2023.1.04

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Objective　To study the CT features of non-Hodgkin’s lymphoma (NHL) involvement of gastrocolic ligament (GCL) and its anatomic basis.    Methods    CT images of 26 patients with GCL involvement by the HNL were analyzed retrospectively. All cases were proved by pathology. Emphasis was placed on CT findings of the GCL.    Results    The main manifestation of GCL involvement was enlargement of lymph nodes in GLC. The enlarged lymph nodes were scattered and no lymph node fusion was observed. The enlarged lymph nodes showed uniform enhancement in 25 cases, and uniform enhancement combined with annular enhancement in 1 case. GCL thickened with local caked sign and peritoneal fluid collection in 2 cases. Conclusions  Familiarity with the anatomical features of GCL is helpful for the CT diagnosis of NHL involving GCL.

Study of accessory fissure of human liver based on CT images

He Xiangfa, Qiu Yinru, Wang Ru, Ye Lili, Liang Ming, Pang Yu, Pan Wei, Liu Sirun

Chinese Journal of Clinical Anatomy. 2023, 41(1):  23-27.  doi:10.13418/j.issn.1001-165x.2023.1.05

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Objective    To summarize and analyze the CT images of accessory fissure of liver, in order to improve the understanding of accessory fissure of liver and avoid misdiagnosis and surgical damage. Methods    One thousand four hundred and forty-nine cases of upper abdominal CT in Dongguan Kanghua Hospital from September to December 2020 were retrospectively analyzed. The detection rate and imaging manifestations of accessory fissure of liver were observed, and their distribution and morphology were recorded.    Results    A total of 205 cases of accessory fissure of liver were detected in 1449 cases, and the CT detection rate was 14.1% (205/1449), including 125 cases of male (61%) and 80 cases of female (39%). There was no statistical difference in the detection rate of accessory fissure of liver between different genders (c2=0.592, P[>]0.05). The highest incidence of accessory fissure was found in the lower segment of the right anterior lobe (55%). With the increasing of age, the number, length and width of accessory fissure of liver increased, with   statistical difference (P<0.05). The CT images of accessory fissure of liver showed wavy-type (24 cases), diaphragmatic muscular slip-type (5 cases), wedge-type (107 cases), groove-type (68 cases) and irregular type (1 case).    Conclusions    The accessory fissures of liver are widely distributed in human population. Multi-slice spiral CT can effectively observe the existence of accessory fissure of liver. With the understanding its morphology and distribution characteristics, we can reduce the misdiagnosis of accessory fissure of liver.

Imaging anatomical measurement and clinical significance of normal thoracic ratio

Li Zhiyan, Chen Xipu, Cai Minghui, Cheng Shuwen, Cen Shaoqin, Abudukhar kramu, Ma Dehua, Wang Chao, Li Yulu, Zhang Xinxin, Zou Wei, Zhu Chengchu, Yi Long

Chinese Journal of Clinical Anatomy. 2023, 41(1):  28-30.  doi:10.13418/j.issn.1001-165x.2023.1.06

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Objective   To measure the anatomical parameters of the thorax by an imaging method,  calculate the thoracic ratio, and explore the clinical significance.    Methods    The computed tomography films of 560 people undergoing medical examinations and 368 patients with primary spontaneous pneumothorax (PSP) were selected in Zhejiang Province and Jiangsu Province. They were grouped according to gender and age. The anteroposterior diameter and the transverse diameter of the thoracic cage were measured at the level of the sixth thoracic vertebra, and the thoracic ratio was calculated for statistical analysis.   Results   The reference range of normal thoracic ratio was (1.62±0.14). There were significant differences in thoracic ratio between male (1.60±0.14) and female (1.67±0.18) (P<0.01) according to the result of one-Way ANOVA. The thoracic ratio decreased with the increasing of age, and there was prominent difference in thoracic ratio between different age groups (P<0.01). The thoracic ratio of patients with primary spontaneous pneumothorax was (1.79±0.20). There were significant differences in the thoracic ratio between patients with primary spontaneous pneumothorax and normal thoracic ratio among different age groups (P<0.05).    Conclusions    The establishment of the reference value of normal thoracic ratio can provide a reliable reference for the related diseases of thoracic deformity.

Diffusion tensor imaging of common peroneal nerve and tibial nerve in knee and its clinical application 

Li Pinpin, Li Pei, Guan Wenhuan, Li Pan, Fu Shengqi

Chinese Journal of Clinical Anatomy. 2023, 41(1):  31-35.  doi:10.13418/j.issn.1001-165x.2023.1.07

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Objective    To provide new imaging basis for the early diagnosis of common peroneal nerve and tibial neuropathy in the knee.    Methods    Sixty patients with normal knee of different ages and twenty hospitalized patients with unilateral Guillain Barre syndrome were selected, the regions of interest of different parts of common peroneal nerve and tibial nerve were divided at the workstation. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured and generated tractography imaging.     Results    There was no significant difference in FA and ADC values of common peroneal nerve and tibial nerve in the left and right sides, different age stages and different parts of knee (P>0.05). The FA and ADC values of common peroneal nerve and tibial nerve were (0.65±0.05), (1.04±0.12)×10-3mm2/s and (0.63±0.04), (1.09±0.13)×10-3mm2/s respectively by consolidation. The FA and ADC values of common peroneal nerve and tibial nerve of the knee in the lesion group were (0.55±0.06), (1.26±0.19)×10-3mm2/s and (0.50±0.07), (1.36±0.18)×10-3mm2/s respectively, which was satistically different from the normal group (P<0.05). The FA values of common peroneal nerve and tibial nerve of the knee in the lesion group were lower than those in the normal group, while the ADC values were higher than those in the normal group.    Conclusions  Diffusion tensor imaging can early diagnose the common peroneal nerve and tibial nerve lesion of the knee, and tractography imaging can show the morphological changes of nerve fibers, so as to improve the diagnosis rate of common peroneal nerve and tibial nerve lesion of the knee.

Effect of Scutellarin on M2-type polarization in activated BV-2 microglia via STAT3 signaling

Jia Qiuye, Zhang Xiaolina, Chen Haolun, Yuan Yun, Wu Chunyun

Chinese Journal of Clinical Anatomy. 2023, 41(1):  36-44.  doi:10.13418/j.issn.1001-165x.2023.1.08

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Objective    To investigate the role of scutellarin on the polarization of M2 microglia under the action of lipopolysaccharide (LPS) and the regulation mechanism of signal transducers and activators of transcription 3 (STAT3).    Methods   BV-2 microglia were divided into a control group (Con), a STAT3 inhibitor α-cyano-(3,4-dihydroxy)-N-benzylmycin-nicotinamide group (AG490), a LPS group (LPS), a LPS+AG490 group, a LPS+scutellarin pretreatment group (LPS+S), a LPS+S+AG490 group. The expression of STAT3, phosphorylated STAT3 (P-STAT3) and the M2 microglia marker interleukin 10 (IL-10) were detected by Western Blot and immunofluorescence staining.    Results    Western Blot results showed: the expression of P-STAT3 and IL-10 in the LPS group was significantly enhanced, compared with that in the control group (P<0.05); the expression of P-STAT3 was significantly reduced, the expression of IL-10 was obviously increased after pretreatment with scutellarin; both were significantly different from the LPS group (P<0.05). AG490 enhanced the effect of scutellarin. In addition, there was no statistical difference s in STAT3 in each group (P>0.05). Immunofluorescence staining results showed that scutellarin intervention reduced protein level of P-STAT3 in LPS-activated BV-2 microglia, enhanced protein level of IL-10. There was no statistical difference in protein level of STAT3 in each group.   Conclusions Scutellarin promotes the polarization of BV-2 microglia to M2 type by inhibiting the activation of STAT3, which may be related to the effect of scutellarin in reducing neuro-inflammatory responses.

The role of Kv7.3 of prelimbic cortex in Methamphetamine induced conditioned place preference in mice

Hang Zhaofang, Liu Min, Mu Shouhong, Han Weikai, Zhang Jing, Yue Qingwei, Sun Jinhao

Chinese Journal of Clinical Anatomy. 2023, 41(1):  45-50.  doi:10.13418/j.issn.1001-165x.2023.1.09

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Objective    To investigate the role of prelimbic cortex (Prl) in methamphetamine (METH) induced conditioned place preference (CPP) in mice, and further identify the regulatory mechanism of Kv7.3 in Prl cortex.     Methods    In this study, C57BJ/6J mice were intraperitoneally injected with METH (2mg/kg) to establish animal model of CPP. Through chemical genetic manipulation, hM4di-mcherry virus was injected into Prl, by Clozapine N-oxide (CNO),s activation of small G protein signaling, to analyze the role of Prl in METH induced CPP. Then, qPCR and Western blot were used to detect the expression of Kv7.3 in METH addiction mice. Finally, cannulas were implanted stereotactically into Prl to observe the resulting effect of Kv7 channel agonist retigabine on CPP score.   Results   METH activated neurons in Prl and decreased the expression level of Kv7.3 significantly. CPP score was obviously reduced after specific inhibition of Prl neurons by chemical genetics. Also, Kv7.3 channel agonist retigabine decreased CPP score evidently.  Conclusions     Prl takes part in the regulation of METH induced CPP and Kv7.3 channel plays a crucial role in it.

Effects of miR-133-3p on the biological behavior of thyroid cancer SW579 cells and the growth of transplanted tumors

Duan Fangfang, Hou Xiaoxia, Zhou Hanli, Chen Lu, Wang Liuyan, Zhao Xiaoli, Zhang Yujie, Kong Tiandong

Chinese Journal of Clinical Anatomy. 2023, 41(1):  51-57.  doi:10.13418/j.issn.1001-165x.2023.1.10

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Objective     To explore the effect of miR-133-3p on the growth of thyroid cancer SW579 cells and transplanted tumors in vivo.     Methods     Thyroid cancer SW579 cells were divided into a control group, a miR-NC group, a miR-133-3p mimic group, and transfected with miR-NC and miR-133-3p mimic according to groups. qRT-PCR was used to detect the expression of miR-133-3p in thyroid cancer tissues and adjacent tissues and transfected cells, and clone formation. EDU staining were employed to detect cell proliferation, flow cytometry was performed to detect cell apoptosis and mitochondrial membrane potential changes. The protein expression of Survivin and caspase-3 were detected by Western blot. The kits were commended to detect the content of SOD and MDA in the cell supernatant. SW579 cells transfected with miR-133-3p mimic or miR-NC were subcutaneously injected into nude mice, and the expression of miR-133-3p was detected by qRT-PCR, the volume of tumor tissue was observed and recorded. TUNEL was employed to detected tumor tissue apoptosis, and immunohistochemistry was used to detect the expression of Survivin and caspase-3 in tumor tissue.    Results    The expression of miR-133-3p in thyroid cancer tissues was decreased. Compared with the control group, the expression of miR-133-3p in the miR-133-3p group was significantly increased (P<0.05). The rate of cell colony formation, the rate of EDU positive cells and the expression of Survivin protein were significantly reduced (P<0.05). The apoptosis rate and the expression of caspase-3 were significantly increased (P<0.05). The mitochondrial membrane potential and the SOD content were significantly decreased, and the MDA content was increased (P<0.05) in the cell supernatant. Compared with the control group, the size of transplanted tumors in the miR-133-3p group was significantly reduced (P<0.05), the expression of miR-133-3p, the rate of TUNEL positive cells and the rate of caspae3 positive cells were significantly increased in tumor tissues (P<0.05), and the rate of Survivin-positive cells was significantly reduced (P<0.05).    Conclusions    miR-133-3p can inhibit the proliferation of thyroid cancer SW579 cells, induce apoptosis and mitochondrial oxidative damage, thereby inhibiting the growth of subcutaneous transplanted tumors in nude mice, which is expected to become a target for gene therapy of thyroid cancer.

COX-2 /sEH dual inhibitor PTUPB alleviates liver fibrosis in mice by inhibiting activation of hepatic astrocytes

Ma Ling, Hong Jieru, Jin Ling, Liu Yubiao, Yang Jintong, Zhou Yong, Zhang Chenyu

Chinese Journal of Clinical Anatomy. 2023, 41(1):  58-63.  doi:10.13418/j.issn.1001-165x.2023.1.11

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Objective    To investigate the role of arachidonic acid (ARA) in liver fibrosis associated with non-alcoholic fatty liver disease (NAFLD) through cytochrome P450 (CYPs) and cyclooxygenase-2 (COX-2) metabolic pathways, and to explore the mechanism from the perspective of activation of hepatic astrocytes (HSC).      Methods    Male C57BL/6J mice were used as research subjects, and the mice model of NAFLD-related liver fibrosis was induced by high sugar and high-fat feeding (HFD). Mice were given a daily subcutaneous injection of COX-2/soluble epoxide hydrolase (sEH) dual inhibitor PTUPB (5 mg/kg). After 12 weeks, the effect of COX-2/sEH double inhibition on NAFLD-related liver fibrosis in mice was observed. The bodyweight of mice was recorded. Glucose tolerance of mice was detected. HE staining was used to observe pathological damage of liver tissue, and oil red O staining was used to observe lipid accumulation in liver tissue of mice. Masson staining and Western blot were used to detect collagen content in liver tissue. The expression of matrix metalloproteinase-inhibitor-related genes in mouse liver tissue was detected by   Real- time PCR. Western blot was used to detect the effect of PTUPB on the activation of JS1 induced by palmitic acid (PA).    Results   PTUPB could significantly reduce the bodyweight of HFD mice, improve the glucose tolerance of mice, reduce the pathological damage of liver tissue, lipid accumulation, and collagen deposition. PTUPB could also decrease the expression of matrix metalloproteinase inhibitors Timp1 mRNA and Timp2 mRNA in liver tissues of HFD mice. PTUPB was observed to reduce PA-induced activation of JS1 cells at the cellular level.    Conclusions   Inhibition of ARA COX-2 /sEH metabolism can reduce HFD-induced NAFLD-related liver fibrosis in mice, and the mechanism is related to inhibition of HSC activation.

The protective effects of emodin on myocardial energy metabolism in rats with heart failure after myocardial infarction

Huang Hui, Xiong Yan, Tang Yijia, Chen Fuli, Li Qiyong, Zhou Yongmei

Chinese Journal of Clinical Anatomy. 2023, 41(1):  64-71.  doi:10.13418/j.issn.1001-165x.2023.1.12

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Objective   To investigate the effects of emodin on the energy metabolism of cardiomyocytes in rats with heart failure after myocardial infarction and its regulation mechanism on extra-cellular signal regulated kinase (ERK) signaling pathway.    Methods    The left anterior descending branch was ligated to construct a rat model of myocardial infarction. Successfully modeled animals were randomly divided into a model group, a low-dose group, a middle-dose group, a high-dose group and a control group according to the random number table method, each with 10 animals; at the same time, another 10 rats were taken as a sham operation group. Animals in the sham operation group were only threaded, but not ligated; rats in the low-dose group, middle-dose group, and high-dose group were treated with 20 mg/kg, 40 mg/kg, 60 mg/kg emodin by gavage every day. The rats in the control group were treated with captopril at 10 mg/kg. After 14 days of continuous administration, the left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and ventricular septal thickness(IVS) of each group of rats were statistically analyzed. TUNEL staining was used to detect the apoptosis rate of rat cardiomyocytes. JC-1 staining was used to detect the mitochondrial membrane potential of rat cardiomyocytes. Western blot was used to detect the expressions of mitochondrial respiratory chain complex Ⅰ(complex Ⅰ) protein and p-ERK in myocardial tissue.    Results    Compared with the sham operation group, the LVEDD, LVESD, myocardial cell apoptosis rate, and the expression of complex I and p-ERK in myocardial tissue were significantly increased in the model group, low, medium, high dose group and the control group. LVEF, IVS and the mitochondrial membrane potential of cardiomyocytes were significantly reduced, and the differences were statistically significant (all P<0.05). Compared with  the modern group, the LVEDD, LVESD, myocardial cell apoptosis rate, and the expression of complex I and p-ERK in myocardial tissue were significantly reduced in the low, medium, high dose group and the control group. LVEF, IVS and the mitochondrial membrane potential of cardiomyocytes were increased significantly, and the differences were statistically significant (all P<0.05).    Conclusions    Emodin can significantly improve the mitochondrial damage and energy metabolism in heart failure rats after myocardial infarction, reduce the apoptosis rate of myocardial tissue, and improve the cardiac function of experimental animals.

Effects of Sophora flavescens gel on histopathology, IL-6 and PAR-2 levels in psoriatic rats

Xiong Yang, Chen Yan, Wei Dong, Zhang Qin, Cheng Maojie, Song Qi

Chinese Journal of Clinical Anatomy. 2023, 41(1):  72-76.  doi:10.13418/j.issn.1001-165x.2023.1.13

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Objective   To study the effects of Kushen gel on histopathology, interleukin -6 (IL-6) and protease activated receptor -2 (PAR-2) levels in psoriatic rats.    Methods    Sixty Wistar rats were divided into a control group, a model group, a vitamin A acid group, Kushen gelatin high, medium and low dose groups, 10 rats in each group. The general condition, pathological changes of skin lesions, inflammatory cell infiltration score, Baker score and levels of IL-6 and PAR-2 in serum and skin lesions were observed in each group. Results    The scales and erythema on the back of rats in each group treated with vitamin A acid and Sophora flavescens gel were alleviated than those in model group. The symptom relief degree of Kushen gel group was better than that of vitamin A acid group. The pathological changes of the skin lesions of rats in different doses of vitamin A acid group and Sophora flavescens gel group were improved to a certain extent than those in model group. The improvement of Kushen gel medium and high dose group was better than that of vitamin A acid group. The inflammatory cell infiltration score, Baker score, IL-6 and PAR-2 levels in the model group were significantly higher than those in the control group (P<0.05). The inflammatory cell infiltration score, Baker score, IL-6 and PAR-2 levels in each treatment group were significantly lower than those in the model group (P<0.05). The inflammatory cell infiltration score, Baker score, IL-6 and PAR-2 levels in the middle and high dose group were significantly lower than those in the A acid group (P<0.05).     Conclusions    Kushen gel can improve histopathology and IL-6 and PAR-2 levels in psoriatic rats.

Triptolide prevents bone loss by inhibiting osteoclastogenesis 

Chen Junze, Yu Hui, Xiao Jin

Chinese Journal of Clinical Anatomy. 2023, 41(1):  77-80.  doi:10.13418/j.issn.1001-165x.2023.1.14

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Objective    To investigate the antiosteoporotic effect and mechanism of triptolide. Methods    A rat model of senile osteoporosis was established. Forty 22-month-old male SD rats were randomly divided into a treatment group of triptolide (15 μg/kg per day intraperitoneally) and a control group of saline (15 μg/kg per day intraperitoneally) for 8 weeks treatment. Bone mineral density (BMD) and bone microstructure of the proximal tibial cancellous were analyzed by micro-CT. Western blot was used to detect the expression level of osteogenic-related proteins. The number of osteoclasts was measured by TRACP-5b staining, and the expression levels of bone resorption markers were also detected.    Results    Micro-CT results showed that BMD, bone volume/total volume ratio (Bv/Tv), bone trabecular thickness (Tb.Th), bone trabecular number (Tb.N), and bone trabecular spacing (Tb.Sp) in the rats treated with ryanodine were significantly higher than those in the control group (P<0.05). There was no significant difference in osteogenesis-related protein expression between the two groups, and TRACP staining result showed that triptolide reduced the number of osteoclasts in vivo (P<0.05), while blood bone resorption marker levels were also significantly lower (P<0.05).    Conclusions    Triptolide has a protective effect on age-related osteoporosis by inhibiting osteoclastogenesis. Which may be a feasible option for the treatment of senile osteoporosis.

Biomechanical effect of the distal Chevron osteotomy on contact characteristics of foot joints of hallux valgus

Ma Dong, Wang Yining, Xu Chujiang, Xiao Jin, Feng Zhengkuan, Xu Guangwei, Yu Wanqi, Qian Lei, Ouyang Jun

Chinese Journal of Clinical Anatomy. 2023, 41(1):  81-86.  doi:10.13418/j.issn.1001-165x.2023.1.15

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Objective   To explore the influence of the distal lateral displacement distance of Chevron osteotomy on contact characteristics of the hallux valgus, so as to provide reference for selecting suitable displacement distance in clinical practice.   Methods    The contact force, peak pressure and contact area of each joint of the forefoot, midfoot and hindfoot were measured in normal foot, hallux valgus foot, the distal Chevron osteotomy of the hallux valgus after the lateral displacement of 2.0, 4.0, 6.0 mm in the neutral position of the ankle joint, respectively.  The results were compared and analyzed.    Results   Compared with the normal foot, the contact force of the 1st tarsometatarsal joint (t=-3.33, P=0.02), the calcaneocuboid joint (t=-2.74, P=0.03) and the subtalar joint (posterior articular surface) (t=-2.89, P=0.03) of hallux valgus foot significantly increased. The peak pressure of the talonavicular joint (t=-2.73, P=0.03) and the calcaneocuboid joint (t=-2.74, P=0.03) of the hallux valgus foot increased significantly. After Chevron osteotomy was performed, with the increasing of lateral displacement distance of distal osteotomy, the contact force of the 1st tarsometatarsal joint and the calcaneocuboid joint of hallux valgus foot decreased gradually; the peak pressure of the the talonavicular joint and the calcaneocuboid joint of hallux valgus decreased gradually.    Conclusions    After Chevron osteotomy is performed on moderate hallux valgus foot, when the distal end of the first metatarsal osteotomy is displaced outward by 4mm or 6mm, it can effectively restore the distribution of some inter articular forces and alleviate the local stress concentration of some joints.

Clinical efficacy and anatomical basis of encircle method for resection of thoracic ossification of ligamentum flavum

Huang Yangliang, Zhong Yi, Liu Shaoyu

Chinese Journal of Clinical Anatomy. 2023, 41(1):  87-91.  doi:10.13418/j.issn.1001-165x.2023.1.16

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Objective    To identify the surgical indications, clinical outcomes and anatomical basis of one stage posterior approach encircle method for resection of thoracic ossification of ligamentum flavum (TOLF).    Methods    From January 2010 to June 2018, 20 TOLF cases admitted in our department were selected according to following indications: 1) the first diagnosis was TOLF; 2) fused type and tuberous type of Sato classification was excluded. 3) dural ossification signs showed on CT scans were excluded. 4) patients with the ossified mass occupation rate more than 55% was excluded. Preoperative and last follow-up modified JOA score, anatomy profiles, operative time, bleeding amount, complications were recorded and retrospectively analyzed.    Results    Twenty cases were collected, there were 9 males and 11 females, average age was 55.2 years old (43~75 years old). All cases were successful managed by one stage posterior approach for encircle method for resection of thoracic ossification of ligamentum flavum. There were 36 segments totally. Average operative time was 116 minutes per segment. Bleeding amount was 131ml on average. There was 1 case in cerebrospinal fluid leakage. After suture was preformed, the patient recovered without any complication. All cases were successfully followedup for 48 to 54 months, with an average of 50.9 months. Preoperative modified JOA score was (7.50±1.02), last follow-up score was (10.25±0.62), there was statistical difference between two groups (P<0.05). The postoperative recovery rate was 80.43% on average, 13 cases were evaluated as excellent, 7 case were evaluated as good. No symptom recurrence was observed. Conclusions    After careful patient selection according to indications, encircle method for resection of thoracic ossification of TOLF could be carried out with a satisfied clinical outcome, simplified procedure, less auxiliary means, short operative time, few complication and good prognosis.

Correlation between the angle of fixation and the curvature of the lower cervical spine with posterior atlantoaxial fixation fusion

Li Jianyang, Li Bo, Ouyang Bingping, Luo Chunshan, Ma Xiangyang, Zou Xiaobao, Lu Tingsheng

Chinese Journal of Clinical Anatomy. 2023, 41(1):  92-96.  doi:10.13418/j.issn.1001-165x.2023.1.17

Abstract ( 111 )   PDF (2864KB) ( 26 )  

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Objective   To evaluate the correlation between different occipitocervical angle (C0~C2), C1~C2 angle and postoperative lower cervical curvature (C2~C7 angle) after posterior atlantoaxial fixation fusion, and to explore the best angle of atlantoaxial fixation and assess the reliability of the influence of these two indexes on the lower cervical curvature, so as to provide theoretical basis for clinical treatment.    Methods From January 2016 to June 2018, 78 patients with disorders of the upper cervical spine who underwent posterior atlantoaxial fixation fusion were followed up. C0~C2, C1~C2 and C2~C7 angles on lateral radiographs of cervical spine were measured respectively. Lordosis was "+" value, kyphosis was "-" value, and the correlation between the included angles was observed.   Results   All patients were followed up for 12 to 18 months, with an average of 16 months. The mean C0~C2 angles during preoperative and postoperative follow-up were (11.87±1.36)°and (20.14±5.20)°, respectively, with statistically significant differences (t=-14.635, P<0.001). The mean C1~C2 angles during preoperative and postoperative follow-up were (15.55±1.70)° and (26.67±7.70)°, respectively, the difference was statistically significant (t=-12.748, P<0.001). The mean C2~C7 angle during preoperative and postoperative follow-up were (18.16±2.81)° and (13.05±6.27)°, respectively, with statistical significance (t=7.500, P<0.001). The postoperative follow-up included 37 cases with the fixed angle of C0~C2 <20° (10°~20°) and 41 cases with the fixed angle ≥20°(20°~28°). There were 37 cases of C1~C2 fixation angle <25°(10°~25°), and 41 cases of C1~C2 fixation angle ≥25°(25°~42°). During follow-up, there was no clear correlation between C1~C2 angle <25°, C0~C2 angle <20° and C2~C7 angle (P=0.635 and 0.510, r=0.081 and 0.112). C1~C2 angle ≥25° and C0~C2 angle ≥20° were negatively correlated with C2~C7 angle (P=0.002 and 0.000, r=-0.466 and -0.872, respectively). C0~C2 angle fixing angle ≥20° is strongly correlated with C2~C7 angle (r=-0.872, absolute value > 0.8), while C1~C2 angle fixing angle ≥25° is not closely correlated with C2~C7 angle (r=-0.466, absolute value<0.5).  Conclusion  With posterior atlantoaxial fixation fusion, the fixation angle of C0~C2 ≥20° or the fixation angle of C1~C2 ≥25° may lead to the decrease of the postoperative curvature of the lower cervical spine, while the fixation angle of C1~C210°~25° and the fixation angle of C0~C2 10°~20° may better maintain the physiological curvature of the lower cervical spine. The fixed angle of C0~C2 is more reliable.

Sequential application of etanercept and csDMARDs in treating ankylosing spondylitis: A prospectively mid-term follow-up study

Jiang Weizhou, Hu Yong, Song Minkai, Liu Huan, Huang Wenhua, Xiao Jun

Chinese Journal of Clinical Anatomy. 2023, 41(1):  97-104.  doi:10.13418/j.issn.1001-165x.2023.1.18

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Objective    To evaluate etanercept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) in treating ankylosing spondylitis (AS) and its mid-term therapeutic effect among mild-to-moderate AS patients.   Methods   Sixty-four patients diagnosed with mild-to-moderate AS treating in our department from 2017 to 2018 were enrolled. Etanercept was used in the short term during the active stage of the disease, and csDMARDs combination was used for oral administration during the remission stage. Clinical remission rate was assessed before treatment, 3, 6 and 12 months after treatment. Tthe therapeutic effect was evaluated by BASFI, BASDAI and SQOL-AS scales.    Results   Patients Global, BASFI, BASDAI and ASDAS-CRP scores, CRP and ESR values decreased (P<0.05), while SQOL-AS scores increased (P<0.05) at 3, 6 and 12 months of follow-up. At the end of the follow-up, 85.9% and 79.7% of all enrolled patients achieved ASAS 20, ASAS 40 remission criteria, respectively. No tuberculosis, opportunistic infection or tumor occurred during the treatment.   Conclusions   For mild to moderate AS, the sequential combination of etanercept and csDMARDs shows satisfied mid-term therapeutic efficacy and expects to  be an alternative treatment for those low-income AS patients.

Image-based epidemiological study on left common iliac vein compression in unselected population in Guangdong province

Zhu Qiaohua, Zhu Huiyan, Chen Minming, Kong Wei, Feng Ruizhi, Luo Jun, Chen Dehua

Chinese Journal of Clinical Anatomy. 2023, 41(1):  104-109.  doi: 10.13418/j.issn.1001-165x.2023.1.19

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Objective    To investigate the epidemiology of left common iliac vein (LCIV) compression in unselected population in Guangdong province of China.    Methods   Nonprobability sampling method was used in this multiple center study. CT parameters, such as LCIV minimum diameter, right common iliac vein minimum diameter, inferior vena cava bifurcation angle (IVC-BA), abdominal aorta bifurcation angle (AA-BA) and lower lumbar lordosis angle (LLLA) were measured, and presence of lumbar vertebral hyperostosis(LVH) and iliac arterial calcification(IAC) near the compression site were recorded. The compression percentage of LCIV (LCIV-CP) was calculated. Compression severity (CS) was classified as mild (CP≤50%), moderate (50% 70%).    Results    One thousand and seventy-eight subjects were enrolled, including 584 males and 494 females, with a median age of 56.0. The median LCIV-CP was 44.21% and the range was 0-89.9%. 61.41%, 29.31%, and 9.28% of subjects were graded with mild-, moderate-, and severe CS, respectively. The median LCIV-CPs of females and males were 46.61% and 42.12%, with a significant difference. The median LCIV-CPs of the young, middle-aged, and elderly groups were 52.0%, 45.2%, and 38.1%, respectively. Age differences were observed. Middle-aged females comprised the highest percentage of subjects with moderate or severe CS. The factors affecting the LCIV-CP and CS distribution were gender and age.    Conclusions    LCIV compression is common, and gender and age affect the LCIV-CP and CS distribution. Middle-aged females are the high-risk population with moderate-severe compression.

Misdiagnosis of thoracic pyogenic spondylitis in children (an analysis of 1 case)

Lin Jiezhao, Lin Yucong, Luo Jinzhou, Wang Tao, Chen Qifang, Zhou Chusong

Chinese Journal of Clinical Anatomy. 2023, 41(1):  110-111.  doi:10.13418/j.issn.1001-165x.2023.1.20

Abstract ( 148 )   PDF (1653KB) ( 10 )  

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Research progress of the "cross-talk" between microglia and astrocytes after cerebral ischemia

Jia Qiuye, Wu Chunyun

Chinese Journal of Clinical Anatomy. 2023, 41(1):  112-114.  doi:10.13418/j.issn.1001-165x.2023.1.21

Abstract ( 93 )   PDF (456KB) ( 26 )  

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Research status of molecular markers of Telocytes in different tissues

Wang Tianwei, Wang Jia, Wei Hangzhi, Wu Fahong, Ma Hanwei, Zhang Youcheng

Chinese Journal of Clinical Anatomy. 2023, 41(1):  115-117.  doi:10.13418/j.issn.1001-165x.2023.1.22

Abstract ( 131 )   PDF (503KB) ( 35 )  

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