Chinese Journal of Clinical Anatomy

Application of three-dimensional visualization technology in the anatomical variations of hilar bile ducts in Chinese population

Jiang Jianhong, Duan Renpeng, Li Xiaofeng

Chinese Journal of Clinical Anatomy. 2024, 42(1): 1-4. doi:10.13418/j.issn.1001-165x.2024.1.01

Abstract ( 84 )

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Objective This study is aimed to explore the walking of biliary system and the characteristics of anatomic variation, by reconstructing the three-dimensional model of biliary system in Chinese people. Methods According to the abdominal CT data of 100 patients who suffer from obstructive disease of biliary tract, three-dimensional models were reconstructed by using the Hisense computer-aided surgery (CAS) system，and were used to analyze the movement of intrahepatic biliary system. The biliary tract was classified according to Huang’s classification, that is the confluent mode of right posterior bile duct, right anterior bile duct and left hepatic duct, and the presence or absence of accessory hepatic duct. Results The three-dimensional models of bile ducts were successfully reconstructed in 100 Chinese patients. Seven types of biliary ducts can be observed. 54 cases (54%) had typical biliary tract anatomy (type I). 46 cases (46%) had anatomical variations, of which 10 cases (10%) were type II variants, 14 cases (14%) were type III variants, 10 cases (10%) were type IV variants, 2 cases (2%) were type V variants, and 2 cases (2%) were type VI variants. In addition, 8 cases (8%) had accessory hepatic ducts, of which 6 cases were accompanied by other variants. Conclusions The path and variation characteristics of biliary system can be identified clearly, by reconstructed Chinese biliary system in three dimensions. To discover news types of biliary tract variation can guide clinical diagnosis and treatment.

Evaluation of placental vascular structure in preeclampsia by vascular casting combined with CT three-dimensional model

Guo Hongzhi, Wang Yu, Zhang Jiaqi, Liang Haibin, Ma Ziwei, Feng Wei, Wu You, Si Ziyi

Chinese Journal of Clinical Anatomy. 2024, 42(1): 5-10. doi:10.13418/j.issn.1001-165x.2024.1.02

Abstract ( 46 )

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Objective To study the vascular casting and CT digital three-dimensional structure model of placental vessels in preeclampsia, and statistically analyze the anatomical characteristics of placental vessels in preeclampsia, so as to provide technical data for clinical prediction of preeclampsia. Methods Totally 134 cases of placentas with gestational weeks ≥ 34 weeks (68 normal placenta, among 66 preeclampsia, 36 were mild and 30 were severe ) were randomly collected from November 2018 to June 2020. The placental vascular cast models were constructed by adding barium sulfate as a contrast agent to the self-coagulating denture powder. Then, the placental vascular cast models were scanned by CT and digital three-dimensional structure models were obtained. The number of placental arteriovenous grades, the diameters of various branches and the volume of placental arteriovenous vessels in the cast models were measured and compared. Results The placental vascular volume and placental vein volume of late-onset severe preeclampsia were smaller than those of normal group and mild preeclampsia group (P<0.05). Compared with the placentas of normal group and mild preeclampsia in the same period, the placentas of late-onset severe preeclampsia had fewer grades of placental veins and narrower branches (P<0.05), the number of placental artery grades in late-onset severe preeclampsia group decreased and the diameter of the third and fourth branches of the artery became smaller (P<0.05). Conclusions Vascular casting combined with CT 3D model is helpful to understand the vascular structure of placenta in preeclampsia intuitively and comprehensively.

X-ray measurement of proximal femur anatomical parameters in Mongolian population

Li Jiawei, Zhang Jing, Li Canran, Lan Wenjie, Ji Qingyu, Guo Zhiyong, Zhang Yunfeng, Liu Qi, Chen Qingwei, Li Xiaohe

Chinese Journal of Clinical Anatomy. 2024, 42(1): 11-16. doi:10.13418/j.issn.1001-165x.2024.1.03

Abstract ( 38 )

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Objective To measure the morphological parameters of the proximal femur in Mongolian population and to provide reference for prosthesis design, improvement and preoperative prosthesis selection. Methods A total of 331 mongolian patients who received femur radiographs in the three tertiary hospitals were randomly selected, including 152 males, and 179 females. Huahai PACS system was used to measure femoral head diameter (FHD), femoral offset (FO), femoral neck shaft Angle (FNSA), medullary transverse diameter at the lesser trochanter (T0), Medullary transverse diameter at the 20 mm above lesser trochanter (T+20), medullary transverse diameter at the 20 mm below lesser trochanter (T-20), medullary transverse diameter of isthmus, canal flare index (CFI) and metaphyseal canal flare index (MCFI). SPSS25.0 was used to analyze the gender differences of these parameters and their correlation with age, and the differences between the femoral parameters of the Mongolian population and domestic and foreign regions were mainly compared. Results (1) The MCFI was larger in females, and there were no significant differences in FNSA and CFI between genders, while the other result of parameters were larger in males. (2) The inner diameter of the medullary cavity at T-20 level and isthmus level was positively correlated with age, CFI and MCFI were negatively correlated with age, and the other parameters were not correlated with age. (3) The anatomical parameters of proximal femur in Mongolian population were different from those in different regions at home and abroad. Compared with the southern population in China, the FHD, FO, the inner diameter of the medullary cavity at T0 level, T+20 level, T-20 level and isthmus level were larger in Mongolian population, while the FNSA, CFI and MCFI were smaller. Conclusions Compared with the southern population, the Mongolian population had larger FHD, FO, wider inner diameter of the proximal femoral medulla cavity, smaller FNSA, CFI and MCFI. Preoperative selection and design of prostheses should take into account the differences between different regions and nationalities.

Digital measurement and clinical significance of occipitocervical Angle and posterior occipitocervical Angle in children and adolescents

Chinese Journal of Clinical Anatomy. 2024, 42(1): 17-20. doi:10.13418/j.issn.1001-165x.2024.1.04

Abstract ( 39 )

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Objective To study the changes of occipitocervical Angle (OC2A) and posterior occipitocervical Angle (POCA) in children and adolescents with age and gender, so as to provide theoretical basis for the clinical treatment of occipitocervical fusion. Methods The imaging data of 321 cases (213 males and 108 females) were retrospectively studied and divided into 6 groups according to sex and age, including 1~3 year-old group, 4~6 year-old group, 7~9 year-old group, 10~12 year-old group, 13~15 year-old group and 16~18 year-old group. The original cervical tomography data were stored in DICOM format and imported into Mimics 16.0 to analyze the OC2A and POCA. Results By analyzing OC2A and POCA in different age groups, it was found that the peak values of OC2A and POCA were (18.15±5.63) ° and (124.94±14.63) °, respectively in the 10-12 year-old group, and then showed a wavy downward trend. There were significant differences in OC2A between 10-12 year-old and 1-3 year-old and between 13-15 year-old and 10-12 year-old (P<0.05). There were significant differences in POCA between the 7-9 year-old group and the 10-12 year old group, the 13-15 year old group and the 16~18 year old group (P<0.05). There was no gender difference in OC2A and POCA between males and females (P>0.05). In correlation analysis, there was a negative correlation between OC2A and POCA (r =-0.28, P=0.000). Conclusions In the clinical treatment of occipitocervical fusion, only age differences can be considered, without considering gender differences. This study, through the systematic study of occipitocervical Angle and posterior occipitocervical Angle in children and adolescents, also provides theoretical basis for the Angle selection of OC2A and POCA in posterior occipitocervical fusion.

Morphological characteristics and clinical significance of Lisfranc ligament based on MRI

Li Wen, Yang Siyi, Huang Lei, Qing Jiwen, Jiang Songtao, Zhang Lei

Chinese Journal of Clinical Anatomy. 2024, 42(1): 21-25. doi:10.13418/j.issn.1001-165x.2024.1.05

Abstract ( 38 )

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Objective To explore the morphological characteristics of Lisfranc ligament and its anatomical relationship with adjacent bones based on MRI, so as to provide imaging reference for the diagnosis and treatment of Lisfranc ligament injury. Methods The MRI imaging data of 232 outpatients and inpatients in the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University were retrospectively analyzed, and the morphological data of Lisfranc ligament was measured, including the width and length, distance from the ending point of Lisfranc ligament to lateral margin of the second metatarsal bone, distance from origin of Lisfranc ligament to the medial margin of cuneiform bone, angles between the ligament and the central axis of the first metatarsal bone, the central axis of medial cuneiform bone, and the central axis of the second metatarsal bone. Results The average width and length of Lisfranc ligament were (5.67±1.47) mm and (9.61±2.81) mm, respectively. The distance from the ending ponit of ligament to the lateral margin of the second metatarsal bone was (11.69±2.63)mm. The distance from the origin of ligament to the medial margin of cuneiform bone was (18.83±3.39) mm. The average angles between ligament and the central axis of the first metatarsal, central axis of the medial cuneiform bone, central axis of the second metatarsal bone were (51.75±11.01 )°, (38.93 ±11.40)°, (33.93 ±10.17) °, respectively. Conclusions In this study, the detailed MRI anatomical data of Lisfranc ligament and its anatomical relationship with adjacent bones were obtained, which can provide certain reference for MRI diagnosis, clinical diagnosis and surgical repair of ligament injury, and avoid Lisfranc ligament injury caused by blind internal fixation.

Therapeutic effect of shikonin on the treatment of granuloma lobular mastitis in model rats by regulating Nrf2/HO-1 signaling pathway

Li Fanfan, Xu Yang, Wang Xiaoxu

Chinese Journal of Clinical Anatomy. 2024, 42(1): 26-32. doi:10.13418/j.issn.1001-165x.2024.1.06

Abstract ( 27 )

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Objective To explore the effect of shikonin (SHI) on the treatment of granuloma lobular mastitis in model rats by regulating nuclear factor-erythroid 2 related factor 2/heme oxygenase (Nrf2/HO-1) signaling pathway and its mechanism. Methods The rat model of granuloma lobular mastitis (GLM) was established. Rats were grouped into a control group, a model group (GLM group), a low-dose shikonin group (SHI-L group, 17.5 mg?kg-1·d-1 SHI), a medium-dose shikonin group (SHI-M group, 35 mg?kg-1·d-1 SHI), a high-dose shikonin group (SHI-H group, 70 mg?kg-1·d-1 SHI), and a high-dose shikonin+Nrf2 inhibitor ML385 group (SHI-H+ML385 group, 70 mg?kg-1·d-1 SHI+14 mg?kg-1·d-1 ML385). HE staining was applied to observe the pathological changes of breast tissue. ELISA was applied to detect the levels of IL-1β, TNF-α, IL-8, T-AOC, SOD, GSH, MPO, NAGas, and ROS in breast tissue. Immunofluorescence was applied to detect NLRP3 expression. Western blotting was used to detect the expression of Nrf2 and HO-1 proteins. Results Compared with the control group, the mammary lobule of rats in GLM group was completely destroyed, large nodular chronic granuloma inflammatory lesions were generated, the boundary of the mammary lobule tissue was unclear, vacuoles appeared in the glandular lobe, and accompanied by infiltration of a large number of lymphocytes and neutrophils. The levels of IL-8, IL-1β, TNF-α, ROS, MPO and NAGas, and the positive expression rate of NLRP3 were obviously increased (P<0.05), the levels of T-AOC, SOD, and GSH, and the expression of Nrf2 and HO-1 proteins were obviously reduced (P<0.05). Compared with the GLM group, the breast tissue lesions in the SHI-L, SHI-M, and SHI-H groups gradually decreased, the levels of IL-8, IL-1β, TNF-α, ROS, MPO and NAGas, the positive expression rate of NLRP3 were sequentially reduced (P<0.05), the levels of T-AOC, SOD, and GSH, and the expression of Nrf2 and HO-1 proteins were sequentially increased (P<0.05). Compared with the SHI-H group, the SHI-H+ML385 group had more severe breast tissue lesions, the levels of IL-8, IL-1β, TNF-α, ROS, MPO and NAGas, and the positive expression rate of NLRP3 were obviously increased (P<0.05), the levels of T-AOC, SOD, and GSH, and the expression of Nrf2 and HO-1 proteins were obviously reduced (P<0.05). Conclusions Shikonin can improve granulomatous lobular mastitis in rats by exerting anti-inflammatory and antioxidant effects, which may be related to the activation of Nrf2 signaling pathway and upregulation of HO-1 expression.

Ginsenoside Rg1 reduces the inflammatory response of microglia after oxygen glucose deprivation/resupply by inhibiting the NLRP3 inflammasome pathway

Wang Xinghang, Ding Jiayuan, Li Fang, Bao Cuifen, Yan Lijing

Chinese Journal of Clinical Anatomy. 2024, 42(1): 33-41. doi:10.13418/j.issn.1001-165x.2024.1.07

Abstract ( 35 )

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Objective To investigate the effect of ginsenoside Rg1 on the inflammatory response of microglia cells after oxygen-glucose deprivation/resupply injury through NLRP3 inflammasome pathway, and to further investigate its anti-inflammatory mechanism. Methods BV-2 microglia were randomly divided into six groups: No treatment group (Con), oxygen glucose deprivation/resupply group (OGD/R), ginsenoside Rg1 low, medium and high dose groups (0.1, 0.2, 0.4 mmol/L, Rg1L, Rg1M, Rg1H), MCC950 control group (0.05 mmol/L, MCC950). The cell proliferation was detected by CCK8. Immunofluorescence and western blotting were used to detect the expression of NLRP3 inflammasome-related protein in BV-2 microglia after treatment with different concentrations of ginsenoside Rg1 and MCC950 for 48 h. The expression levels of IL-1β and IL-18 in BV-2 microglia were detected by ELISA. Results Compared with Con group, Iba-1 green fluorescence was observed in the cytoplasm of BV-2 microglia cells treated with hypoxia and glucose deficiency/resupply. After OGD/R treatment of BV-2 microglia for 2h, the proliferation rate of BV-2 microglia cells showed an obvious downward trend after 48 h culture with different concentrations of ginsenoside Rg1 and MCC950. There were significant positive expressions of NLRP3, ASC, Caspase-1, IL-1β and IL-18 in the OGD/R group. The NLRP3 protein expression in Rg1L, Rg1M and Rg1H groups was significantly decreased, and the expression decreased with the increasing of drug concentration. The results showed that compared with OGD/R group, ginsenoside Rg1 and MCC950 inhibited the expression of NLRP3 in activated BV-2 microglia cells (P<0.01). Conclusions Ginsenoside Rg1 may inhibit the expression levels of IL-1β and IL-18, thus inhibiting the inflammatory response by inhibiting the expressions of NLRP3, ASC, Caspase-1 and interfering with NLRP3 inflammasome synthesis.

Activation and functional changes of astrocytes cultured in vitro under inflammatory stimulation

Cheng Yingying, Wu Jianjun, Cai Haiyan , Jiao Xunwen, Ma Jiangbo, Ding Yinxiu

Chinese Journal of Clinical Anatomy. 2024, 42(1): 42-46. doi:10.13418/j.issn.1001-165x.2024.1.08

Abstract ( 25 )

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Objective To observe the activation and functional changes of astrocytes cultured in vitro under inflammatory stimulation. Methods Astrocytes from the cortex of C57BL/6 mice were isolated and cultured in vitro, the changes of astrocyte morphology were observed by immunocytochemistry and the expression levels of proinflammatory factors (iNOS, IL-6, TNF-α) and anti-inflammatory factors (ARG1, IL-10, TGF-β1) were determined by Western blot protein analysis. Results After inflammatory stimulation, immunofluorescence cell staining showed that astrocytes in M1（LPS+IFN-γ） group were abnormally activated, cell body swelling, enlargement, distortion and other morphological changes were also obvious, and the number of GFAP positive astrocytes in M1 group were evidently increased (P<0.001 vs. control). CCK-8 test showed that compared with the control group, the absorbance values of LPS group, IFN-γ group and M1 group were increased, especially the absorbance values of M1 group was significantly increased (P<0.001 vs. control). Western blot results showed that the expression levels of iNOS, IL-6 and TNF-α in M1 group were markedly increased after LPS and IFN-γ combined stimulation (P<0.001 vs. control). The expression levels of anti- inflammatory factors (ARG1, IL-10 and TGF-β1) in each group were also significantly upregulated (P<0.01 or 0.001 vs. control). Conclusions Under inflammatory stimulation, the cultured-astrocytes in vitro can be abnormally activated, its morphological and functional changes are distinct, and the expression level of A1-like inflammatory factors in astrocytes are increased.

Edaravone regulates Sirt3 expression in lipopolysaccharide-activated microglia via MAPKs signaling pathway

Qi Zhi, Yang Li, Jia Qiuye, Chen Haolun, Duan Zhaoda, Wu Chunyun

Chinese Journal of Clinical Anatomy. 2024, 42(1): 47-53. doi:10.13418/j.issn.1001-165x.2024.1.09

Abstract ( 29 )

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Objective To investigate the effect of edaravone on Sirt3 and MAPKs pathway-related proteins in LPS-activated microglia and its regulatory mechanism. Methods Western Blot and immunofluorescence were used to detect the effect of edaravone on the protein expression of Sirt3 and MAPKs pathway-related proteins ERK1/2, P38, JNK as well as their phosphorylated forms p-ERK1/2, p-P38 and p-JNK in the activated BV2 cells. Western Blot techniques were applied to detect the effects of ERK1/2 pathway inhibitor on the expressions of p-ERK1/2 and Sirt3. Results The expressions of Sirt3, p-ERK1/2, p-P38 and p-JNK in microglia were significantly increased after BV2 cells activation. Edaravone promoted the expression of Sirt3 and p-ERK1/2 and downregulated the expression of p-JNK and p-P38. The protein expression of Sirt3 and p-ERK1/2 decreased after co-treatment with edaravone and ERK1/2 inhibitor. Edaravone promoted the overexpression of Sirt3 and p-ERK1/2 and downregulated the expression of p-JNK and p-P38. Conclusions Edaravone can regulate MAPKs signaling pathway and promote Sirt3 production in BV2 cells, possibly regulates neuroinflammatory responses via ERK/Sirt3 signaling pathway.

Protective effect of Baicalin on rats with pulmonary hypertension through PDGF/P38 MAPK signaling pathway

Zhang Jingjing, Wang Hongxin

Chinese Journal of Clinical Anatomy. 2024, 42(1): 54-58. doi:10.13418/j.issn.1001-165x.2024.1.10

Abstract ( 30 )

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Objective To investigate the protective effect and mechanism of Baicalin on monocrotaline-induced pulmonary hypertension in rats. Methods Forty SD rats were randomly divided into 4 groups: a control group, a pulmonary hypertension group, a baicalin 50 mg·kg-1 group and a baicalin 100 mg·kg-1 group. A single intraperitoneal injection of monocrotaline (60mg/kg) was used to establish the pulmonary hypertension model. After injection of monocrotaline, baicalin was gavage continuously for 28 days. Right ventricular catheterization method was used to detect RVSP and mPAP. The levels of SOD, GSH-px, ICAM-1, VCAM-1, IL-8 and IL-1β in serum were detected by ELISA. The formation of reactive oxygen species (ROS) in lung tissue was observed by DHE staining. The expression of bax and bcl-2 in lung tissue were detected by immunofluorescence. Western blot was used to detect the protein expression of PDGF and P38 MAPK. Results Compared with the model group, mPAP, RVSP, RVHI and W/D were significantly decreased, and the contents of ICAM-1, VCAM-1, IL-8 and IL-1β in serum were significantly decreased, the contents of bcl-2, SOD and GSH-px were increased significantly in the Baicalin group. The contents of ROS, bax, PDGF and P38 MAPK and the level of bax/bcl-2 ratio in lung tissue were significantly decreased in the Baicalin group. Conclusions Baicalin may play a protective role in improving inflammation, oxidative stress and apoptosis of rats with pulmonary hypertension through PDGF/P38 MAPK signaling pathway.

Effect of Bletilla striata polysaccharides on the choke-area of cross-boundary flap in rats

Yue Qin, Chen Rongli, Xiong Jingxi, Wang Tingyi, Cai Zhiheng, Yi Qiushi, Zeng Xinyi

Chinese Journal of Clinical Anatomy. 2024, 42(1): 59-64. doi:10.13418/j.issn.1001-165x.2024.1.11

Abstract ( 22 )

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Objective To investigate the effect and mechanism of Bletilla striata polysaccharides on the choke-area of cross-boundary skin flap in rats. Methods Thirty-two SD rats were randomly divided into two groups: a control group, was given physiological saline; a treatment group, was given physiological saline solution of Bletilla striata polysaccharides. The thoracodorsal artery and posterior intercostal artery were ligated surgically, preserving the iliac lumbar artery. The survival rate of the flap was counted at 7 days after operation. The growth of choke artery was observed by angiography. The microvessel density and arterial intraluminal diameter of choke area were observed by HE staining microscope, and the expression level of vascular endothelial growth factor (VEGF) protein in the flap tissue of choke area was detected by Western blot. Results At day 7 after operation, the survival rate of the flap in the treatment group was higher than that in the control group[(86.1±1.4)% vs (61.3±4.0)%, P<0.0001].The diameter of the iliopsoas artery in the treatment group was thicker than that of the control group(681.60±35.48 vs 446.98±21.61μm, P<0.0001), and the blood vessels extended longer towards the distal end of the flap(6.50±0.33 vs 5.41±0.38 cm，P<0.0001). The microvessel density in choke area was higher in the treatment group [(11.8±1.5) vs (6.7±1.3), P<0.0001], with a larger arterial lumen diameter in choke area(60.14±6.99 vs 28.01±5.07μm, P<0.0001). The expression level of VEGF protein increased (P<0.0001). Conclusions Bletilla polysaccharides can promote the survival of flap, through the regulation of angiogenesis, dilation and VEGF expression in the Chokearea.

Finite element study on the treatment of Sanders type II calcaneal fracture with three-step reduction method

Li Xiaoyu , Zhang Lei , Fu Lei , Li Dongbo , Wang Guoyou

Chinese Journal of Clinical Anatomy. 2024, 42(1): 65-70. doi:10.13418/j.issn.1001-165x.2024.1.12

Abstract ( 30 )

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Objective To explore the feasibility and scientificity of the three-step reduction method for treating Sanders type II calcaneal fracture, and to promote the optimization of the treatment plan for calcaneal fracture. Methods Using the CT data of healthy adult male ankle joints, normal ankle model and Sanders type II calcaneal fracture model were constructed, and mechanical loading of the three-step reduction method was performed on the fracture model, simulating techniques such as traction, lifting and pressing, and pinching and joining ends. The reduction of the calcaneus before and after reduction was evaluated and the mechanical changes under different techniques were solved. Results Normal foot model and Sanders type II A/B/C calcaneal fracture model were established. The calcaneal length, height, width, Gissane’s angle, and Bohler’s angle were significantly corrected after manual loading and reduction. By solving the mechanical trends of different techniques, it was found that traction effectively corrected overlapping displacement, pressing and pushing focused on correcting anterior-posterior displacement, and squeezing the bone ends aimed at correcting medial-lateral displacement. Conclusions The three-step reduction method can effectively treat Sanders type II calcaneal fracture by correcting the fracture displacement and restoring the anatomical structure of the calcaneus in sequence, confirming the effectiveness and scientificity of this technique.

Study on the correlation between the reconstruction of grayscale values using CT post-processing technology and the compressive strength of the endplate

Wu Yanfei, Ma Jianxiong, Lu Bin, Wang Ying, Bai Haohao, Jin Hongzhen, Ma Xinlong

Chinese Journal of Clinical Anatomy. 2024, 42(1): 71-76. doi:10.13418/j.issn.1001-165x.2024.1.13

Abstract ( 30 )

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Objective To explore the correlation between CT reconstruction values and endplate compression strength by using CT post-processing techniques. Methods After conventional CT scanning of five calf lumbar vertebrae, endplates were reconstructed by using CT post-processing techniques and the average CT value of five standardized test points was measured. The lumbar vertebrae were then dissected into 30 free vertebrae, and a 5 mm diameter flat-bottomed pressure head was used to perform uniaxial compression tests at a rate of 12 mm/min on standardized test points of bony endplates. The failure load values of each test point were determined based on the load-displacement curve to calculate the compressive strength. The intraclass correlation coefficient was used to verify the consistency of the measurement results, and correlation analysis was applied to analyze the correlation between CT reconstruction values and endplate compression strength. Results The intra- and inter-observer intraclass correlation coefficients of the reconstructed CT values and the compression strength of the calf vertebral test points were both greater than 0.9, and the reconstructed CT values and compression strength of the corresponding test points had a strong correlation (r>0.8, P<0.01). Conclusions There is a significant correlation between CT reconstruction values of endplates and their compression strength, which can be used as a reference index to assess endplate strength before surgery.

An early and mid-term retrospective study of the effects of arthroscopy combined with high tibial osteotomy on patellar position and patellofemoral joint function

Zhuang Wanqiang, Tang Yi, Luo Yonggang, Zhang Hui

Chinese Journal of Clinical Anatomy. 2024, 42(1): 77-82. doi:10.13418/j.issn.1001-165x.2024.1.14

Abstract ( 31 )

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Objective To investigate whether the changes in patellar position affect patellofemoral joint function and functional outcomes or not. Methods Patients who underwent arthroscopy combined with high tibial osteotomy (ACHTO) from March 2018 to March 2021 were enrolled in a retrospective study. Arthroscopic diagnosis was performed during primary surgery and internal fixation removal, and the status of articular cartilage and clinical outcomes were compared. Imaging measurements were also taken to evaluate changes in patellar position. At the same time to explore the relationship between articular cartilage status and function. Results A total of 60 patients who received arthroscopy combined with high tibial osteotomy were included in this study, including 18 male patients and 42 female patients, with an average age of (58.6±7.2) years and an average follow-up time of (26.8±8.5) months. After underwent ACHTO surgery, there was no statistical difference in the patellar height index ISI, and the BPI index changed from the preoperative (0.90±0.11) to (0.81±0.13). By secondary arthroscopy, the cartilage condition of the medial femoral condyle improved from 3.81 to 3.35 (P=0.005) and that of the medial tibial plateau from 3.75 to 3.48 (P=0.005) as assessed by the ICRS scoring system. The mean ICRS score of the lateral femoral condyle decreased from 0.15 to 0.43 (P=0.004), and the mean ICRS score of the lateral tibial condyle decreased from 0.38 to 0.96 (P<0.001). The average ICRS grading of the patellar side was 2.29-2.31 and the average ICRS grading of the femoral trochlea was 2.18-2.25. Knee functional scores were significantly improved compared with those before operation. Conclusions After arthroscopy combined with high tibial osteotomy, no obvious damage or degeneration of patellofemoral cartilage is observed. Moreover, the knee function, especially the patellofemoral joint function, was not affected by the change of patellar position.

Risk factors of postoperative complications of calcaneal fractures treated with hippocampal plate internal fixation through minimally invasive method

Luo Ying, Dou Weiyu, Wu Xiaohang, Chen Jingkun, Peng Changgui, Pan Jianying

Chinese Journal of Clinical Anatomy. 2024, 42(1): 83-88. doi:10.13418/j.issn.1001-165x.2024.1.15

Abstract ( 34 )

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Objective To investigate the factors influencing the postoperative complications of internal fixation of the tarsal sinus incision hippocampal plate for Sanders type II and III calcaneal fracture. Methods A retrospective analysis of 85 patients with Sanders type II and III calcaneal fracture treated with tarsal sinus incision hippocampal plate internal fixation from January 2021 to April 2022 was performed. According to the postoperative complications, they were divided into a complication group and non-complication group. The non-complication group was defined as recovery to baseline function within 6 months after operation, doing normal work and daily activities, and no continuous need for analgesics. The complication group was defined as fracture complication requiring re-hospitalization, the use of a walking aid, and continuous analgesics. The risk factors for complications of Sanders II and III bone fractures were analyzed by univariate and multifactorial methods. Results Multi-factorial logistic regression analysis result showed that time from fracture to surgery, Sander type III, postoperative B?hler angle, and DVBA were as independent risk factors for complications. Age was not associated with the development of postoperative complications. Conclusions Clinicians should be alert for postoperative complications in patients with Sander type III, poor postoperative B?hler angle recovery, and long fracture-to-operation time for calcaneal fracture.

Comparison of the efficacy of aspiration thrombectomy and thrombectomy with combined aspiration and stent retriever in the treatment of anterior circulation cerebral embolism

Chen Junchen, Cao Wenying, Luo Yanjun, He Wanyi, Zhu Zhenzhen, Peng Zhiqiang

Chinese Journal of Clinical Anatomy. 2024, 42(1): 89-93. doi:10.13418/j.issn.1001-165x.2024.1.16

Abstract ( 23 )

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Objective To compare the efficacy and safety of aspiration thrombectomy and thrombectomy combined with aspiration and stent retriever for the treatment of anterior circulation cerebral embolism. Methods Patients with anterior circulation cerebral embolism and treated with emergency thrombectomy surgery at Guangzhou Panyu Central Hospital from January 2020 to June 2022 were enrolled in this study. They were divided into two groups based on the thrombectomy method received: an aspiration thrombectomy group (40 cases) and a thrombectomy combined with aspiration and stent retriever group (64 cases). The NIHSS score, good prognosis rate (mRS score ≤ 2), post-thrombectomy vessel recanalization rate (mTICI score ≥ 2b), and perioperative complication rate were compared between the two groups. Results The change of NIHSS score from preoperative to postoperative, the good prognosis rate at the time of discharge and at 90 days after discharge, the thrombectomy group were significantly better than those in the thrombectomy with combined aspiration and stent retriever group. There were no significant differences in the rates of successful vessel recanalization and adverse events between the two groups. Conclusions Compared with the thrombectomy combined with aspiration and stent retriever, aspiration thrombectomy may lead to better improvement in neurological function deficits and good prognosis rates for patients with anterior circulation cerebral embolism. There is no significant difference in the rates of successful vessel recanalization and perioperative complications between the two approaches.

Prospective clinical study on the effect of implant abutment materials on the soft and hard tissues around the implant

Hu Shuohong, Zheng Xuebin, Li Fujie, Wang Hong

Chinese Journal of Clinical Anatomy. 2024, 42(1): 94-98. doi:10.13418/j.issn.1001-165x.2024.1.17

Abstract ( 22 )

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Objective To investigate the influence of different abutment materials on soft and hard tissues around implants. Methods A prospective study was conducted on 75 patients with a single anterior tooth defect requiring implant repair who were admitted to our hospital from January 2019 to December 2020. The patients were randomly divided into three groups by using a random number table method, with 25 patients in each group. Different materials were used to implant and complete single crown repair, and they were divided into a pure titanium group, a zirconia group, and an alumina group. The implant retention rate, clinical periodontal indicators, implant marginal bone resorption, pink aesthetic index (PES), white aesthetic index (WES), oral health related quality of life, satisfaction, and incidence of complications among the three groups at 12 months after restoration were observed and compared. Results After 12 months of repair, the retention rates of implants in both the pure titanium group and the zirconia group were 100%, with no mechanical complications such as implant loosening or detachment. In the alumina group, there was one abutment fracture, with a retention rate of 96.0%. There was no significant difference in PD, SBI, and PFI among the three groups (P>0.05), while the PLI of the zirconia group was significantly lower than that of the pure titanium and alumina groups (P<0.05). The bone resorption at the implant edge in the zirconia and alumina groups was lower than that in the pure titanium group (P<0.05). There was significant differences in the pink aesthetic index among the three groups (P<0.05), with zirconia group>alumina group>pure titanium group. There was no significant difference in the white aesthetic index and the quality of life related to oral health among the three groups of patients (P>0.05). Among the three groups of patients, the satisfaction of the zirconia group was higher than that of the other two groups. There was no significant difference in the total incidence of biological complications among the three patients (P>0.05). Conclusions For anterior dental implant restoration, the short-term retention rate, clinical biological effects, and overall patient satisfaction of using three types of material abutments are comparable. Compared with pure titanium abutments, using zirconia and alumina abutments for implant restoration reduces bone resorption at the edges. The use of zirconia abutments has the best aesthetic effect, and patients are more satisfied with the aesthetic effect.

Feasibility of abdominal CT angiography with high concentration and low velocity contrast agent combined with low tube voltage

Zhou Wei, Shi Qianqian, Li Gai, Chen Weibin

Chinese Journal of Clinical Anatomy. 2024, 42(1): 99-103. doi:10.13418/j.issn.1001-165x.2024.1.18

Abstract ( 17 )

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Objective To explore the feasibility of using high concentration and low flow rate contrast agents combined with low tube voltage injection in abdominal aortic CTA. Methods Four hundred and thirty patients with abdominal aortic CT angiography were retrospectively collected and divided into group A (215 cases) and group B (215 cases). Group A was treated with iopamidol (370 mgI/ml) and administered at 400 mgI/kg, with a flow rate of 5 ml/s and a tube voltage of 120 kV. Group B was treated with lomeprol (400 mgI/ml) and administered at 300 mgI/kg, with a flow rate of 4 ml/s and a tube voltage of 100 kV. The image quality score, CT values of abdominal aorta and branches, effective radiation dose, and other indicators between the two groups were compared. Results Compared with Group A, the renal artery vascular display grading and image quality score in group B were better, the CT values of the abdominal aorta, abdominal trunk, superior and inferior mesenteric arteries, and left and right renal arteries were higher, the radiation dose significantly decreased from (3.94±0.62) to (12.25±1.19) mSv (P<0.05), the total amount of iodine injected was less and the incidence of contrast agent extravasation was lower, all P<0.05. There was no statistical difference in signal-to-noise ratio and contrast-to-noise ratio between the two groups (P>0.05) Conclusions The combination of high concentration, low flow rate contrast agent and low tube voltage scheme can effectively reduce the risk of radiation dose, total injected iodine and contrast agent extravasation.

Clinical characteristics and progress in diagnosis and treatment of cervical rheumatoid arthritis

Yu Xincheng, Zha Dingsheng, He Shaojie , Zhao Zhenyu , Cai Xingda

Chinese Journal of Clinical Anatomy. 2024, 42(1): 104-108. doi:10.13418/j.issn.1001-165x.2024.1.19

Abstract ( 37 )

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Research Progress of Relationship Between Gut Microbiome and Osteoporosis

Lin Jie, Jin Yong, Pang Qingjiang

Chinese Journal of Clinical Anatomy. 2024, 42(1): 109-111. doi:10.13418/j.issn.1001-165x.2024.1.20

Abstract ( 41 )

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A review of biomechanical studies of wrist after total wrist arthroplasty

Zhang Yue, Cai Xingbo, Zhang Bihuan, Wang Bin, Xu Yongqing

Chinese Journal of Clinical Anatomy. 2024, 42(1): 112-114. doi:10.13418/j.issn.1001-165x.2024.1.21

Abstract ( 33 )

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Research progress on the anatomy and clinical application of masseter muscle

Chen Ren, Yang Shengbo

Chinese Journal of Clinical Anatomy. 2024, 42(1): 115-117. doi:10.13418/j.issn.1001-165x.2024.1.22

Abstract ( 41 )

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