Table of Content

25 July 2023 Volume 41 Issue 4

  

Localization of the nerve entry point of the suboccipital muscles 

Xiong Wei, Wang Jie, Shu Hongyan, Yang Shengbo

Chinese Journal of Clinical Anatomy. 2023, 41(4):  377-381.  doi:10.13418/j.issn.1001-165x.2023.4.01

Abstract ( 132 )   PDF (2988KB) ( 50 )  

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Objective     To accurately localise the nerve entry points (NEPs) of the suboccipital muscles, in order to provide anatomical basis for extramuscular nerve blocks in diseases caused by hypertonia  of the suboccipital muscles.    Methods    Twenty-four adult cadavers were used. The NEPs of the suboccipital muscles (rectus capitis posterior minor muscle, rectus capitis posterior major muscle, obliquus capitis superior muscle and obliquus capitis inferior muscle) were dissected, exposed and labeled with barium sulfate, and then, dissections were sutured back in situ. Spiral CT scan and 3D reconstruction were performed. The curved line connecting the external occipital protuberance and the spinous process of 7th cervical vertebra was designed as the longitudinal reference line (L), and the curved line connecting the mastoid process and the spinous process of 7th cervical vertebra was designed as the horizontal reference line (H). The projection points of NEP on the napex and the opposite side skin were recorded as P point and P' point, respectively. Drawing vertical lines from point P to line H and line L respectively, created intersection points on lines H and L, and they were marked as points PH and PL, respectively. The percentage position of PH and PL on H line and L line respectively and the depth of NEP were determined by Syngo system.   Results   Each of the four suboccipital muscles (rectus capitis posterior minor muscle, rectus capitis posterior major muscle, obliquus capitis superior muscle and obliquus capitis inferior muscle) usually had only one NEP. The PH position of the NEPs were located at 46.29%, 35.85%, 28.88% and 32.29%, respectively on the H line. The PL were located at 27.39%, 39.06%, 35.06% and 40.42%, respectively on the L line. The depth of NEPs on PP' line were at 21.21%, 24.02%, 14.59% and 21.44%, respectively. The above percentage values were all mean values. There was no statistical difference between left and right side and between male and female (P>0.05).    Conclusions The accurate definition of the body surface percentage position and depth of these NEPs is conducive to improve the localization efficiency and efficacy for extramuscular nerve blocks when treating the diseases caused by hypertonia of suboccipital muscle.

Anatomical relationship between the accessory nerve and the cervical fascia and its clinical significance

Nie Zheng, Jiang Heng, Chen Mengmeng, Shan Jianlin

Chinese Journal of Clinical Anatomy. 2023, 41(4):  382-384.  doi:10.13418/j.issn.1001-165x.2023.4.02

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Objective    To explore the anatomical relationship between the accessory nerve and the investing fascia of the posterior border of the sternocleidomastoid, so as to provide a safe and reliable method for avoiding injury of accessory nerve in the posterior cervical triangle surgery.    Methods    Twenty-one formalin-fixed adult cadavers were dissected to expose the sternocleidomastoid and the posterior cervical triangle. The investing fascia of the posterior edge of sternocleidomastoid was cut and observed to identify its integrity and compactness. The anatomical relationship between the investing fascia and the accessory nerve was observed to identify whether the accessory nerve could be easily identified and separated from the tissue structure.    Results    The posterior investing fascia covering sternocleidomastoid muscle was intact and dense. There was no direct contact, fiber connection or other tissues between the accessory nerve and the investing fascia. After the investing fascia was cut and opened at the posterior edge, the accessory nerve could not be observed directly on both sides in the 18 specimens. The accessory nerve was separated from the investing fascia by adipose tissue. In other 3 specimens, the accessory nerve could be seen directly after cutting open investing fascia. There was no direct contact or fibrous connection between the accessory nerve and the investing fascia in all specimens. All accessory nerves were located above the great auricular nerve with a distance of (12.6±5.2) mm.   Conclusions    The investing fascia of the posterior edge of the sternocleidomastoid is intact and dense without significant connection with the accessory nerve. It is easy to identify accessory nerve after sharp dissection with clear surgical field in the posterior cervical triangle surgery.

Application of digital optimization design in coracoclavicular ligament reconstruction for precise positioning of the bone tunnel

Zhang Lei, Wang Rui-han, Tang Zi-hui, Yi Gang, Zhou Xin

Chinese Journal of Clinical Anatomy. 2023, 41(4):  385-389.  doi:10.13418/j.issn.1001-165x.2023.4.03

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Objective    To compare the differences between the virtual model of the digital optimization design navigation template and the real model of 3D printing.    Methods    Shoulder CT images were collected from 80 patients (37 women and 43 men) from January 2018 to October 2022. The patient’s CT images were imported into Mimics software to create virtual and real navigation bone tunnels. The 10 parameters were measured for virtual and real navigator bone tunnels.    Results    We designed and printed 80 shoulder joints including collarbones and shoulder blades. There was no statistically significant difference in 9 parameters (P>0.05) between the two bone tunnels, but there was a statistically significant difference in OQ (the length of the coracoid needlepoint to the coracoid tine)(P<0.05). All measurements were lower in female patients than in male patients (P<0.01).   Conclusions   The virtual model of digital optimization design has similar accuracy to the real model of 3D printing. In clinical practice, patients with acromioclavicular dislocation requiring coracoclavicular ligament reconstruction can try to locate bone tunnels using a virtual model of the digitally optimized design navigation template.

Digital measurement and analysis of acetabular morphology in Mongolian population of Inner Mongolia

Li Jiawei, Gao Mingjie, Tong Ling, Liu Qinghua, Kang Zhijie, Zhang Kai, Wang Haiyan, Li Xiaohe

Chinese Journal of Clinical Anatomy. 2023, 41(4):  390-394.  doi:10.13418/j.issn.1001-165x.2023.4.04

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Objective   To measure and analyze the morphological parameters of the acetabulum in Mongolian population of Inner Mongolia, so as to provide reference for acetabular prosthesis design and clinical surgery.    Methods     A total of 105 patients were randomly selected for pelvic CT examination at the Affiliated Hospital of Inner Mongolia Medical University and the Second People's Hospital of Ulanqab. Mimics 21.0 was used to reconstruct the acetabulum and measure the abduction angle, anteversion angle, suprainferior diameter, anteroposterior diameter and depth, and the results were statistically analyzed by using SPSS 25.0.    Results    The acetabular abduction angle, anteversion angle, suprainferior diameter, anteroposterior diameter and depth were (53.54±6.74) °, (16.16±4.93) °, (62.35±3.89) mm, (57.61±3.83) mm and (29.19±3.69) mm in males and (51.81±5.14) °, (17.45±4.59) °, (57.98±3.24) mm, (55.18±5.45) mm, (26.94±3.94) mm in females, respectively. There was no statistical difference in the acetabulum parameters between the same sex and different sides. There were statistical differences in the suprainferior diameter, anteroposterior diameter and depth between the different sexes. and these three parameters were larger in men, while there was no statistical difference in the acetabular abduction angle and anteversion angle between the different sexes There were differences in the acetabular morphology parameters between Mongolian population and other areas.    Conclusions    There are differences in acetabular parameters between Mongolian population in Inner Mongolia and other regions. The acetabular abduction angle, suprainferior diameter, anteroposterior diameter and depth are larger than other populations in southern China, and the acetabular anteversion angle is smaller. The differences of acetabulum morphology in different regions should be taken into account when designing prosthesis and placing prosthesis during surgery, the preoperative planning of the acetabular prosthesis should be done well in order to avoid blindness and randomness during surgery.

X-ray measurement and clinical significance of height and anterior-posterior diameter of lower cervical vertebral body in elderly patients with Kashin-Beck disease

Wu Xueyuan, Yi Zhi, Ling Ming, Liu Shizhang, Sun Zhengming, Xie Limin

Chinese Journal of Clinical Anatomy. 2023, 41(4):  395-400.  doi:10.13418/j.issn.1001-165x.2023.4.05

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Objective    To measure the X-ray related parameters of lower cervical vertebral body in elderly patients with Kashin-beck disease (KBD), so as to clarify the influence of KBD on the development of lower cervical vertebral body.   Methods   Sixty-two patients with KBD (KBD group) and sixty-seven healthy people (control group) were treated with lateral cervical radiographs to observe the imaging manifestations of the lower cervical vertebral body. The anterior, middle and posterior heights of the vertebral body and anterior-posterior diameters from C3 to C7 in neutral position were measured and statistical analysis was performed. Results    The results of this study showed that the superior and inferior margins  of the vertebral endplate were uneven, depressed and sclerosis in some KBD patients. The heights of anterior and posterior margins of vertebral body were higher than that of the middle margin, and there was no significant difference between the height of anterior and posterior margins (P>0.05). In the KBD group, the median heights of C4-6 in males and C4-7 in females were smaller than that of anterior and posterior margin, and the difference was statistically significant (P<0.05). The median heights of C4-7 in males and C3-7 in females in the control group were higher than that in the KBD group, with statistically significant difference(P<0.05). There were significant differences in anterior-posterior diameters between male and female groups in the KBD patients (P<0.05). The anterior -posterior diameters of males and females in the control group were larger than those in the KBD group, but there was no statistical difference (P>0.05).   Conclusions    KBD can cause the depression, uneven and sclerosis of endplate cartilage, lead to the reduction of the middle height of cervical vertebral body, but do not affect the development of anterior -posterior diameters of the vertebral body.

CBCT study on the anatomical factors related to anterior dental implants

Song Hao, Yang Mengyuan, Lu Yiwen, Zhang Xudong, Chen Ruixue

Chinese Journal of Clinical Anatomy. 2023, 41(4):  401-408.  doi:10.13418/j.issn.1001-165x.2023.4.06

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Objective    To have a better understanding of the anatomical factors related to the anterior dental implants through measurement and analysis  of CBCT images of 400 adult anterior dental regions, , so as to provide reference for implant in aesthetic.    Methods   CBCT images of 400 patients were selected and enrolled in this study. The bone thickness at different sites of the labial and palate were measured and the positional relationship between the root of the upper anterior teeth and the alveolar bone was explored.  Results    The labial bone wall thickness was thicker at the apex of the root, thinner at 2 mm below the crest of the labial alveolar side and the thinnest at 1/2 the mid- root. The percentage of bone wall thickness > the proportion of 1mm in the in central incisor teeth to cuspid teeth  was 37%, 30%; 31%, 27%; and 56%, 34%, respectively. The thickness of palatal bone showed an increasing tend from the crest of alveolar to the root. The proportion of root bone mass > the proportion of 5 mm in the in central incisor teeth to cuspid teeth  was 94%, 82% and 97%, respectively. The position relationship of central incisor teeth, cuspid teeth and alveolar bone was classified as Type Ⅰ, Ⅱ, Ⅲ and Ⅳ. Type Ⅰ, Ⅱ, Ⅲ and Ⅳ were 79.5%, 10.5%, 1.0%, 2.0%; 72.0%, 14.5%, 3.0%, 5.0%; 83.0%, 5.5%, 0.0%, 0.5%, respectively. Subtype I: (it was difficult to distinguish the thickness of the labial bone plate in the accuracy images) the proportion of each tooth position was 7.0%, 5.5%, 11.0%, respectively.    Conclusions    The thickness of bone plate at the crest of labial alveloar and the mid-root of anterior dental area is generally thin, and the thickness of alveolar bone in most sites was less than 1mm. The labial bone wall thickness in the mid-root is the minimum. The palatal bone wall thickness showed an increasing tend from the crest of alveolar to the root. The position relationship between maxillary anterior root and alveolar bone is mostly type I, which provides a favorable anatomical position for immediate implantation in the aesthetic area, but the location of subtype I, due to the thin labial bone wall and possible defect, suggesting that more consideration should be given to the way of bone grafting before implantation. 

Study on the protective mechanism of Ginsenoside Rg1 through TNF-α/TNFR1/RIPKs pathway to regulate acute lung injury induced by acute kidney injury

Cao Yingxin, Chi Xiaochen, Bao Cuifen, Li Tingyu, Liu Xia

Chinese Journal of Clinical Anatomy. 2023, 41(4):  409-415.  doi:10.13418/j.issn.1001-165x.2023.4.07

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Objective   To investigate the protective and regulative mechanism of Ginsenoside Rg1 on acute kidney injury (AKI) induced acute lung injury.   Methods   Sixty male Kunming mice were randomly divided into 4 groups with 15 mice per group: Group A (sham operation group), Group B (model group), Group C (Ginsenoside Rg1 group), and Group D (necrostatin-1 control group).  AKI models were prepared，after 24h, the serum level of serum creatinine (Scr) and blood urea nitrogen (BUN) were detected. The wet/dry weight ratio of lung tissues were also measured. Pathological changes of lung tissues were evaluated by HE staining. Expression of tumor necrosis factor-α (TNF-α), IL-1β, IL-6 and IL-8 were detected by ELISA. Expressions of tumor necrosis factor receptor 1 (TNFR1) and receptor interacting protein kinase (RIPK) were observed by immunohistochemistry and western blotting.   Results   (1) Compared with Group A, the serum level of Scr and BUN in Group B were significantly increased, while compared with Group B, the serum level of Scr and BUN in Group C and Group D were significantly decreased (P<0.01). (2) Compared with Group A, the wet/dry ratio of lung tissues in Group B was significantly increased. Compared with Group B, the wet/dry ratio of lung tissues in Group C and Group D was significantly decreased (P<0.01). HE staining showed that the lung tissues structure of Group A was basically intact, while part of alveolar cavity was collapsed, cells were necrotic with the serious infiltration of inflammatory cells in Group B. Compared with Group B, the lung injury degree of Group C and Group D was alleviated. (3) ELISA showed that TNF-α, IL-1β, IL-6 and IL-8 in serum of Group B were significantly increased compared with Group A, while in Group C and Group D were significantly decreased compared with Group B (P<0.01). (4) Immunohistochemical and western blotting results showed that the protein content of TNFR1, RIPK1 and RIPK3 in Group B were significantly increased compared with Group A, while in Group C and Group D were significantly decreased compared with Group B (P<0.01).    Conclusions    Ginsenoside Rg1 can alleviate the acute lung injury induced by acute kidney injury, the mechanism may be related to the inhibition of TNF-α/TNFR1/RIPKs pathway.

Neuromuscular electrical stimulation accelerates  spinal cord injury repair by regulating inflammatory factors 

Liang Yinhua, Song Haiwang, Jiang Guanhua, Lou Yi, Liu Guoxiang, Yang Dan

Chinese Journal of Clinical Anatomy. 2023, 41(4):  416-421.  doi:10.13418/j.issn.1001-165x.2023.4.08

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Objective    To investigate the mechanism of neuromuscular electrical stimulation (NMES) regulating the expression of inflammatory factors in repairing spinal cord injury (SCI).    Methods   Sixty healthy adult mice were randomly divided into a Sham group, a SCI group, a 1 Hz NMES group, a 20 Hz NMES group, 15 mice in each group. Basso Mouse Scale (BMS) score and footprint analysis were used to observe the recovery of hindlimb motor function of mice. Immunofluorescence was used to observe the number of anterior horn neurons of spinal cord injury. Real-time RT-PCR was used to detect the expression of inflammatory factors TNF-α, IL-6 and IL-12 mRNA. Western Blot was used to determine  the inflammatory factors TNF-α, IL-6, IL-12 and the expression of BDNF, GFAP.    Results    Compared with the SCI group, the hindlimb motor function of mice was significantly improved after the neuromuscular electrical stimulation intervention, and the number of surviving neurons at the injury site was increased, and the number of neurons in the 20 Hz NMES group was more than that in the 1 Hz NMES group. Neuromuscular electrical stimulation intervention could down-regulate the expression of TNF-α, IL-6, IL-12 and GFAP,  and promote the expression of BDNF.    Conclusions    Neuromuscular electrical stimulation can down-regulate inflammatory factors, inhibit the expression of GFAP, inhibit glial scarring, and up-regulate the expression of BDNF to protect the number of neurons, and promote the recovery of motor function in mice after spinal cord injury.

Mir-325-3p attenuates neuronal injury in rats with intracerebral hemorrhage by activating RIPK33 / TFEB signaling pathway

Ma Xiaowei, Zhou Xiyan, Li Bin, Zang Yunhua, Wang Qun, Yu Miao

Chinese Journal of Clinical Anatomy. 2023, 41(4):  422-427.  doi:10.13418/j.issn.1001-165x.2023.4.09

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Objective   To investigate the effect of mir-325-3p on neuronal injury in rats with intracerebral hemorrhage by regulating RIPK3/TFEB pathway.    Methods    SD male rats were randomly divided into a sham operation group, an intracerebral hemorrhage group, an agomir NC group, an agomir-325-3p group, a GSK872 (RIPK3 inhibitor) group, and an agomir-325-3p+GSK872 group, with 18 rats in each group. The motor function, limb coordination ability and modified neurological deficit score (MNSs) of rats were evaluated. The brain water content, pathological changes of brain tissue around hematoma, neuronal apoptosis, autophagy of rats, CO localization of LC3 and NeuN, RIPK3/TFEB signal pathway in hippocampus and the expression of autophagy related proteins were measured.    Results    Compared with the sham operation group, the neurons in CA1 area of intracerebral hemorrhage group were swollen and loosely arranged, with a large number of lysosomes and autophagy bodies, the success rate of forelimb placement, the percentage of left turn and TFEB decreased (P<0.05), and the MNSs score, brain water content, the rate of neuronal apoptosis, RIPK 3, Beclin-1, LC3-II / LC3 - Ⅰ and LC3 / NeuN strong positive numbers increased (P<0.05). Agomir-325-3p and GSK872 can reduce the damage of hippocampal neurons and enhance autophagy.    Conclusions    Mir-325-3p overexpression may promote autophagy and reduce neuronal damage in rats with intracerebral hemorrhage by regulating RIPK3 / TFEB.

Comparison of the effect of two kinds of nerve functional reconstruction operation on the recovery of lower limb motor function in rats 

Jiang Mengnan , Zhang Ziju , Zhang Qianling, Su Huan, Gao Yifan , Lu Wei, Yang Lin

Chinese Journal of Clinical Anatomy. 2023, 41(4):  428-433.  doi:10.13418/j.issn.1001-165x.2023.4.10

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Objective    To compare the clinical efficacy of "targeted muscle reinnervation (TMR)" and "targeted nerve function replacement (TNFR)" for neurological reconstruction in patients with amputation. Methods     SD rats were randomly divided into a Sham group, a simple tibial nerve dissection (TNT) group, a TMR group and a TNFR group. The two operative efficacy were evaluated by footprint blotting, electromyography (EMG), and Sihler's intramuscular nerve staining.    Results    (1) Analysis of the footprint blotting results showed that the tibial nerve index in the TMR group (-13.79±5.289) was slightly smaller than that in the TNFR group (-12.30±4.06). (2) at  the 8th week,  compared with the TNT group, the amplitude of EMG on the affected side was greater in the TMR and TNFR groups (P<0.05). The amplitude of EMG on the affected side in the TNFR group was greater than that of the TMR group.(3) Sihler's intramuscular nerve staining results showed that the degree of nerve and muscle atrophy in the TNFR and TMR groups was less severe than that in the TNT group. The medial head of the gastrocnemius muscle in the TNFR group inherited the original function of the tibial nerve, and its nerve branches were denser compared with those in the TMR group.   Conclusions   Both TNFR and TMR can delay muscle atrophy and promote motor function reconstruction, and the long-term efficacy of TNFR is better than that of TMR.

Effect of morroniside on high glucose-induced human retinal vascular endothelial cells oxidative stress and apoptosis by regulating miR-483-5p expression

Chen Ping, Wei Xuemei, Tan Lili

Chinese Journal of Clinical Anatomy. 2023, 41(4):  434-439.  doi:10.13418/j.issn.1001-165x.2023.4.11

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Objective     To investigate the effect and molecular mechanism of Morroniside (Mor) on high glucose-induced human retinal microvascular endothelial cells (HRECs) oxidative stress and apoptosis. Methods    HRECs were divided into a control (Con) group, a high glucose (HG) group, a HG+Mor-low dose (L) group, a HG+Mor-medium dose (M) group, a HG+Mor-high dose (H) Group, a HG+anti-miR-NC group, a HG+anti-miR-483-5p group, a HG+Mor+miR-NC group, a HG+Mor+miR-483-5p group. The apoptosis rate and ROS level of HRECs were detected by using flow cytometry. MDA level and SOD activity were assessed by using enzyme-linked immunosorbent assay. miR-483-5p expression was detected by using Real-time quantitative PCR.    Results   Compared with the Con group, the apoptosis rate, ROS and MDA levels of HRECs in the HG group were significantly increased (P<0.05), SOD activity was significantly decreased (P<0.05), and miR-483-5p expression was significantly increased (P<0.05). Compared with the HG group, the apoptosis rate, ROS and MDA levels of HRECs in the HG+Mor-L group, HG+Mor-M group, and HG+Mor-H group were significantly reduced (P<0.05), and SOD activity was significantly increased (P<0.05), miR-483-5p expression was significantly reduced (P<0.05). Compared with the HG+anti-miR-NC group, the apoptosis rate, ROS and MDA levels of HRECs in the HG+anti-miR-483-5p group were significantly reduced (P<0.05), and SOD activity was significantly increased (P<0.05). Compared with the HG+Mor+miR-NC group, the apoptosis rate, ROS and MDA levels of HRECs in the HG+Mor+miR-483-5p group were significantly increased (P<0.05), and SOD activity was significantly decreased (P<0.05).    Conclusions    Morroniside inhibits high glucose-induced HRECs oxidative stress and apoptosis by down-regulating miR-483-5p expression.

MicroRNA-125a-targeted sortilin suppresses macrophage lipid accumulation and aortic atherogenesis

Lv Yuncheng, Ming Xinyue, Liu Fang, Chen Shirui, Peng Tianhong, Ouyang Shuhui

Chinese Journal of Clinical Anatomy. 2023, 41(4):  440-446.  doi:10.13418/j.issn.1001-165x.2023.4.12

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Objective    To investigate the effect and mechanism of miR-125a on the lipid metabolism of macrophages and the development of aortic atherosclerosis (AS) in LDLR?/? mice.   Methods  The lipid accumulation in macrophages was evaluated by Oil red O staining and colorimetry. The bioinformatics was used to predict the target gene of miR-125a. Double luciferase reporter gene analyzed the targeted binding between miR-125a and SORT1. The expressions of miR-125a and sortilin were detected in lipid-laden THP-1 macrophages and low-density lipoprotein receptor knockout (LDLR?/?) mice by qPCR、Western blot and immunohistochemistry. The blood lipid level was measured with automatic biochemical analyzer. The aortic AS plaque and lipid accumulation were showed by histological staining.   Results   Overexpression of miR-125a reduced lipid accumulation in THP-1 macrophages. Bioinformatics analysis and luciferase reporter gene showed that sortilin mRNA was a potential target of miR-125a. Overexpression of miR-125a suppressed sortilin expression and lipid accumulation in macrophages. miR-125a also ameliorated the blood lipid profile and reduced the plaque area of aortic AS in LDLR?/? mice.    Conclusions   miR-125a inhibits macrophage lipid accumulation and the progression of aortic AS by down-regulating sortilin expression.

Investigation of Fasudil in its efficacy at improving flap innervation in mice

Xu Yidan, Wang yanting, Chen shaoFeng, Jing Xing, Xu Dan, Fangfang, Wang Hai, Xie Yun, Zhuang Yuehong

Chinese Journal of Clinical Anatomy. 2023, 41(4):  447-452.  doi:10.13418/j.issn.1001-165x.2023.4.13

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Objective    To explore whether Fasudil can promote the regeneration of the sensory nerve after flap surgery and its underlying mechanism.    Methods    92 ICR mice were selected and randomly divided into the control, Fasudil , LY294002, and Fasudil+LY294002 groups, and the corresponding drugs were injected intraperitoneally daily from 3d before surgery. At 0 d, 5 d, 7 d, 15 d and 30 d after operation, immunofluorescence staining was used to observe the axon outgrowth in the flap. The flap tissue at 5d after surgery was collected, and Western blotting was used to detect the expressions of RhoA, ROCK1+2, p-CPI-17, p-MYPT, p-PTEN, p-PI3K, and p-Akt in the flap. Secondly, rats 15d in pregnancy were adopted, the DRGs on both sides of the spinal cord were harvested and divided into 6 groups: the control, Fasudil, Fasudil+LY294002, CSPG, CSPG+Fasudil and CSPG+Fasudil+LY294002 groups. After 5d of culture, the axon lengths of the DRGss in the 6 groups were measured.    Results    Abundant nerve fibers could be observed in each group at 0d after operation; at 7d after operation, all nerve fibers underwent complete degeneration; at 15d and 30d after operation, only the Fasudil group had nerve fibers again. p-CPI-17 and p-MYPT in Fasudil group were down-regulated, and p-PI3K and p-Akt were up-regulated 5 days after operation (P<0.001). The average axon lengths of DRGs in the control, Fasudil, Fasudil+LY294002, CSPG, CSPG+Fasudil, and CSPG+Fasudil+LY294002 groups after 5d of culture were (1.96±0.24) mm, (2.73±0.30)mm, (2.07±0.13)mm, (1.62±0.20)mm, (2.35±0.13)mm, and (1.84±0.31)mm, respectively. The differences among the groups were statistically significant (P<0.001).    Conclusions    Fasudil promotes nerve regeneration in flap after surgery by inhibiting the RhoA/ROCK pathway and activating the PI3K/Akt pathway.

Relationship between calcified tissue of coronary atherosclerosis and c-kit⁺ and sca-1⁺ cells in rats 

Sun Panwen, Guo Yonglong, Jia Yangyang, Sun Changye, Guo Zhikun

Chinese Journal of Clinical Anatomy. 2023, 41(4):  453-458.  doi:10.13418/j.issn.1001-165x.2023.4.14

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Objective    To investigate the expression change of sca-1 and c-kit in the calcified area of coronary atherosclerosis in rats, so as to provide clinical reference for further study of the mechanism of coronary atherosclerosis.   Methods   Thirty-two healthy adult SD rats were randomly divided into a normal control group (n=8) and an atherosclerotic calcification model group (n=24). The model was prepared by gavage of propylthiouracil, feeding with high fat and cholesterol diet and intraperitoneal injection of vitamin D3. After the model was successfully prepared, the expression changes of sca-1 and c-kit in the coronary artery tissues of the model group and the normal group were observed by immunohistochemistry and immunofluorescence techniques. Immunofluorescence technique was used to detect the co-expression of sca-1 and α-SMA. Western blotting was used to detect the differences of c-kit and sca-1 protein expression between model group and normal group.    Results    At the 12th week of modeling, the coronary artery wall of rats was significantly thickened, the intima was significant hyperplasia, the smooth muscle cells were arranged in a significant disorder, and there were necrotic substance deposition, lipid deposition and calcium nodule precipitation. Immunohistochemical and immunofluorescence results showed that sca-1+cells and c-kit+ cells were significantly higher in the intima, media and adventitia of coronary artery in atherosclerotic and calcified areas than those in the normal control group. Some cells have co-expression of sca-1 and α-SMA in the location of lesion. Western blotting result showed that the expressions of c-kit and sca-1 protein in atherosclerotic and calcified areas were higher than those in normal control group.    Conclusions   Sca-1+ cells and c-kit+ cells have the tendency to migrate to the calcification area of coronary atherosclerosis, and the mechanism needs to be further  investigated.

Finite element analysis of different forms of intravesical prostatic protrusion

Hong Liting , Meng Qingguo, Wu Jianhui, Xu Lingyan, Gao Runze, Zhai Lidong

Chinese Journal of Clinical Anatomy. 2023, 41(4):  459-464.  doi:10.13418/j.issn.1001-165x.2023.4.15

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Objective     To explore the effect of intravesical prostatic protrusion with different forms on urination by the finite element analysis method.    Methods    The finite element models for male lower urinary tract was reconstructed based on MRI images of a patient with middle lobe and bilateral lateral lobes protrusion into the bladder model 3. Other models with only the bilateral lateral protrusion and only the middle lobe protrusion were created by adjusting the shape of the protruded part. The two-way fluid-structure interaction of the lower urinary tract was simulated by the finite element analysis software. The deformation of prostatic urethra and flow dynamics parameters were compared between models with different IPP shapes. Results     The largest reduction of prostatic urethra angle was found in model 3 during  urination, followed by model 2 and model 1. The liquid pressure loss was most severe in model 3. The velocity in majority part of model 1 was higher than that of other two models. The maximum flow rate of model 3 was lower than that of other two models. Under the same bladder outlet cross-sectional area, the maximum flow rate of model 3 was lower than that of other models, and increasing bladder outlet cross-sectional area would further widen this gap.    Conclusions    This study reveals that patients with middle lobe and bilateral lateral lobes protrusion have greater urethral resistance and smaller maximum flow rate than those having comparable-length IPP with only middle lobe protrusion or only bilateral lateral lobes protrusion. When evaluating IPP, we should measure its length, as well pay attention to its form.

Reason and strategies of intraoperative complications of minimally invasive hip arthroplasty using SuperPATH approach in the treatment of elderly patients with femoral neck fracture 

Liu Yu, Gu Sanjun, Xu Yaozeng, Li Haifeng, Wei Changbao, Yin Qin

Chinese Journal of Clinical Anatomy. 2023, 41(4):  465-469.  doi:10.13418/j.issn.1001-165x.2023.4.16

Abstract ( 117 )   PDF (4026KB) ( 31 )  

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Objective   To investigate the reason and strategies of intraoperative complications of minimally invasive hip arthroplasty through SuperPATH approach in the treatment of elderly patients with femoral neck fracture.     Methods    From June 2015 to December 2018, total of 120 patients with femoral neck fracture treated by SuperPATH approach were retrospectively analyzed. There were 74 males and 56 females, with an average age of 74.5 years (range 65-98). All the cases underwent SuperPATH approach hip arthroplasty, including 63 cases of total hip arthroplasty (THA) and 57 cases of hemiarthroplasty (HA). Results     All of the patients were followed up for at least 24 months, among them, intraoperative complications occurred in 12 cases, including acetabular abrasion and fracture, femoral lateral fissure fractures, too small anterior angle of the femoral components or placed internally and externally. Normal hip function was restored after corresponding treatment. There were no complications such as infection and dislocation, and no secondary operation.    Conclusions    SuperPATH minimally invasive hip arthroplasty in the treatment of elderly patients with femoral neck fracture adopts intermuscular interspace approach, which has the characteristics of less trauma, less bleeding, quick functional recovery and good patient satisfaction. At the same time, due to the small visual field of operation and the non-standard operation, it is easy to make surgical mistakes, so we must pass through strict formal training and standardized operation to effectively avoid the occurrence of surgical complication.

Effect of repairing of  annular ligament  on the pediatric chronic Monteggia fracture 

Yang Xi, Xu Yongqing, Liu Wuhua, Xu Yujian, Shi Yan, Fang Xiang, He Xiaoqing

Chinese Journal of Clinical Anatomy. 2023, 41(4):  470-474.  doi:10.13418/j.issn.1001-165x.2023.4.17

Abstract ( 74 )   PDF (4776KB) ( 16 )  

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Objective    To evaluate the effect of repairing of annular ligament in the treatment of pediatric chronic Monteggia fracture based on ulnar osteotomy.    Methods    Between March 2013 to January 2022, a retrospective case series study was conducted to analyze 30 children with chronic Monteggia fracture-dislocations. In all cases were treated with open reduction of the radial head and lengthening-angulation osteotomy of ulnar, in of which 17 cases underwent only lengthening-angulation osteotomy of ulna (Group A), 13 combined annular ligament repairing (Group B). Following up was performed for mean 18 (range, 12 to 96) months postoperatively. The outcome was evaluated by the Kim score and range of motion, and radiography.    Results    There was no statistical difference in the excellent-and-good rate between group A and group B (P>0.05), according to Kim score. There was no statistical difference in the total elbow range of motion between group A and group B (P>0.05). There were no complications of nonunion in follow-up radiographs. Relocation of radiocapitellar joint were observed in 28 cases, radial head subluxation recurred in 2 cases.    Conclusions   Lengthening-angulation osteotomy of ulna is the key in the treatment of chronic Monteggia fractures, on the basis of which the repairing of annular ligament is not a major determinant for prognosis.

Effect of non-whole time tourniquet application on perioperative outcomes of arthroscopic combined high tibial osteotomy

Li Ming, Jia Bingshen, Jiao Tuo, Zhang Ying, Fu Kun

Chinese Journal of Clinical Anatomy. 2023, 41(4):  475-480.  doi:10.13418/j.issn.1001-165x.2023.4.18

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Objective   To investigate the effect of non-whole-time application of tourniquet in arthroscopy combined with high tibial osteotomy on clinical outcomes.    Methods    Clinical data of patients who underwent arthroscopic combined tibial high osteotomy in our hospital from June 2018 to January 2022 were retrospectively analyzed, and a total of 72 patients were included in this study according to the inclusion and exclusion criteria, which were divided into 38 cases in the whole time tourniquet application group and 34 cases in the tourniquet application group only in the arthroscopic exploration stage, and the perioperative indicators were recorded and compared between the two groups.   Results   （1）There was no statistical difference in terms of operative time and hospitalization days (P>0.05). （2）There was no statistical difference in terms of postoperative hemoglobin,  hematokrit, drainage volume, blood loss and transfusion rate between the two groups (P>0.05). （3）The non-whole-time tourniquet group had lower pain scores in the early postoperative period and could achieve better range of motion on the third postoperative day (P<0.05). （4）There was less incidence of thigh pain in the non-whole-time tourniquet group (P<0.05), but there was no statistical difference in other complications between the two groups (P>0.05).   Conclusions   The results suggest that the use of tourniquet only in the stage of arthroscopic exploration will not increase the postoperative blood loss, operation time and hospital stay after high tibial osteotomy. However, it can reduce the pain of knee and tourniquet site in the early postoperative period, which is conducive to the early postoperative functional recovery, and will not increase the incidence of complications.

A randomized controlled study of special traction splint vs cast immobilization in the treatment of displaced distal radius fractures

Li Xin, Yin Qudong, Wei Xuming, Yang Haoxia, Lu Yao, Liu Jun, Rui Yongjun

Chinese Journal of Clinical Anatomy. 2023, 41(4):  481-486.  doi:10.13418/j.issn.1001-165x.2023.4.19

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Objective    To investigate the effect of special traction splint vs plaster immobolization in the treatment of distal radius fractures and clarify the mechanism of traction splint.   Methods   Total of 70 patients with displaced distal radius fractures treated conservatively were randomly divided into an experimental group ( traction splint immobolization, 35 cases) and a control group (plaster immobolization , 35 cases). There was no significant difference in age, gender, fracture type and fixation timing, and visual analog scale (VAS) for pain between the two groups (P>0.05). The fracture healing and fixation time, re-displacement, unacceptable displacement, operation rate, radius height, radial inclination angle, palmar inclination, range of motion (ROM) of radial-ulnar inclination，flection- extension and rotation, VAS for pain, hand grip strength, patient-rated wrist evaluation (PRWE) and wrist functional recovery (Gartland- Werley’s method) were compared between the two groups.   Results   The re-displacement, unacceptable displacement and operation rate of the experimental group were less than those of the control group, and the differences were statistically significant (P<0.05). There was no significant difference in fracture healing time and fixation time between the two groups (P>0.05). All the patients were followed-up for 10 to 18 months, with an average follow-up of 12.2 months. At the last follow-up, the radius height and radius inclination angle of the experimental group were better than those of the control group, and the differences were statistically significant (P<0.05). However, there was no significant difference in the palmar inclination, ROMs of radius-ulnar inclination, flection-extension and rotation, VAS, hand grip strength, patient-rated wrist evaluation (PRWE), and excellent to good rate of wrist function between the two groups (P>0.05).  Conclusions Comparing with plaster, traction splint immobolization can better maintain the position of distal radius fracture and the height of radius, reduce the re-displacement and operation rate, and the overall effect is better.

Treatment strategies for the Altemeier procedure in incarcerated rectal prolapse from a laparoscopic anatomical perspective

Hua Wei, Li Yanzhu, Lei Tin, Zhou Furong, Liu Yonggan

Chinese Journal of Clinical Anatomy. 2023, 41(4):  487-489.  doi:10.13418/j.issn.1001-165x.2023.4.20

Abstract ( 85 )   PDF (2352KB) ( 8 )  

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Research on the fabrication technique of vessels casting specimens of internal porcine femoral head

Geng Kailong, Deng Wei, Zhang Xiangnan, Wang Dingsong, Wang Hongyu, Liu Hongdong, Li Lei, Ju Wen, Zhou Zhenghu, Tang Linfeng, Ju Jihui, Hou Ruixing

Chinese Journal of Clinical Anatomy. 2023, 41(4):  490-492.  doi:10.13418/j.issn.1001-165x.2023.4.21

Abstract ( 48 )   PDF (3340KB) ( 5 )  

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Review of the application of internal fixation devices for scapular fractures

Shi Huiming, Lv Haixia, Zheng Yu, Zhang Lipeng, Liu Ning, Qu Fufeng, Wang Yang

Chinese Journal of Clinical Anatomy. 2023, 41(4):  493-495.  doi:10.13418/j.issn.1001-165x.2023.4.22

Abstract ( 76 )   PDF (488KB) ( 11 )  

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Progress on the localization of nerve block target for anterior forearm muscles spasticity

Zhou Jiayu, Yang Shengbo

Chinese Journal of Clinical Anatomy. 2023, 41(4):  496-498.  doi:10.13418/j.issn.1001-165x.2023.4.23

Abstract ( 42 )   PDF (499KB) ( 8 )  

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Research progress of miRNA regulation of pyrolysis in type 2 diabetes and related cardiovascular diseases

Yang Yingya, Zhou Wenjing, Wang Haiying

Chinese Journal of Clinical Anatomy. 2023, 41(4):  499-502.  doi:10.13418/j.issn.1001-165x.2023.4.24

Abstract ( 47 )   PDF (1084KB) ( 21 )  

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Angiofibroma of abdominal wall: a case report

Hu Fangang, Liu Jinfeng, Liu Debin

Chinese Journal of Clinical Anatomy. 2023, 41(4):  503.  doi:10.13418/j.issn.1001-165x.2023.4.25

Abstract ( 90 )   PDF (1789KB) ( 30 )  

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