1.Arantius ligament approach to left hepatic vein in partial hepatectomy: experience in 43 patients
Zheng ZHOU ; Dinghua YANG ; Zihai DING
Chinese Journal of Hepatobiliary Surgery 2012;18(8):589-591
Objective To investigate the maneuver of dividing Arantius duct to expose the posterior of left hepatic vein.Methods Based on the anatomy of Arantius duct on 33 cadavers,exposure of posterior of left hepatic vein was carried out in 43 patients by dividing the Arantius ligament.Results The posterior of left hepatic vein was dissected to expose the left hepatic vein in 43 patients.The operations and the recovery of the patients were smooth and uneventful.Conclsion Cutting the Arantius ligament allows safe exposure and extrahepatic division of left hepatic vein.
2.Applied anatomy of the endoscopic endonasal approach to the ventral middle-lower part of clivus
Xiguang TIAN ; Yuke DONG ; Zihai DING
Journal of Chinese Physician 2009;11(12):1632-1635
Objective To establish the surgical landmarks of the endoscopic endonasal approach to the ventral region of middle-lower part of clivus and provide anatomic basis. Methods Twenty 10% formalin-fixed intact adult head specimens were used to dissect and observe the anatomic feature of this access in order to establish the surgical landmarks of the approach, and some relative anatomic data were measured. Five fresh and intact head specimens injected with colored latex were used, and completely analogical operation via endoscopic endonasal approach to the middle-lower part of clivus was performed in all cases. Results Anatomic landmarks of the approach included middle turbinate, choana narium, eustachian tube ostium, nasopharynx mucosa, longus capitis and longus colli, pharyngeal tubercle, and basi-on. To expose the ventral region of middle-lower part of clivus completely, the shortest distance was ( 89.60 ± 2. 52) mm. The ranges of stripping the inferior wall of sphenoid sinus and the lower clivus were bounded by pterygoid canal and foramen lacerum, and the distances from the median line were (9. 37 ± 0.59) mm and (10. 75 ± 0. 63 ) mm, respectively. Conclusions The structures of the ventral middle-lower part of clivus can be revealed sufficiently via an endoscopic endonasal approach.
3.Applied anatomical and clinical application of the lateral approach to the vertebral lamina for treating extreme lateral lumber dsic herniation
Xiaoyong XIE ; Zihai DING ; Pingsheng LI
Orthopedic Journal of China 2006;0(21):-
[Objective]To provide microsurgery anatomical data for the surgical operation in treating of extreme lateral lumbar dsic herniation through the observations of the regional anatomic structure about the post-median approach tolateral vetebral lamina(PMALVL).[Method]Thicknesses of intertransverse ligament,the distribution of anterior branches of lumbar nerve and vessel were measured at the adult cadavas specimens.Retrospectively analyzed with 12 cases of extreme lateral lumbar disc herniation from January 2004 to January 2006,including 7 cases were treated by the lateral approach to the vertebral lamina,5 cases treated by PMALVL.[Result]The thickness of intertransverse lingament is 0.6~1.3 mm.More than 90 percent of anterior branches of lumbar segmental arteries and the accompanying veins from L_3 to S_1 were located ventrally in the superior portion of the intertransverse ligament.A branch from Lumbar artery permanently locates in the hfiddle of post-lateral intertransverse ligament.The angle between the anterior branch of Lumbar nerve root and midline sagittal plane is 18.9?~39.2?.The distance from the root of the tranverse to the anterior branch of lumbar nerve root and from the lateral margin of the pars interarticul aris to the anterior branch of lumbar nerve root(5.6~8.0)mm and(1.7~3.6)mm respectively.The period of follow up in 12 cases was from 3 months to 24 months,with an average of 10 months.The resultwas excellentin 8 cases,good in 3 cases,total fine rate according the classification of Nakal was 91.67%.[Conclusion]Intertransvarse ligament is a reliable landmark for PMALVL and treating extreme lateral lumbar disc herniation through PMALVL may get microtraumatic and excellent effect.
4.Anatomical study of compartment syndrome of foot after calcanealintar-articular fractures
Zhijie WANG ; Shizhen ZHONG ; Zihai DING
Orthopedic Journal of China 2006;0(04):-
Objective To study the anatomical character of compartment syndrome of foot after calcaneal intra-articaular by experimental model. MethodSix intact human cadaver lower extremities were used to produce calcaneal intra-articular fracture models, fracture patterns of the model were observed with radiographical technique, and anatomical study was proceeded to observe the fractures and their effects on soft tissues and compartments in foot.ResultAll specimens were sustained calcaneal intra-articular fractures successfully, 4 were joint depression fracture in x-ray, 2 were tongue type; 3 were Sander Ⅱ type and others were Sander Ⅲ type in CT. the primary fracture line coursed from anterolateral to posteromedial, and from anterosuperior to posteroinferior. It damaged all the soft tissue arosed from fractures medially and laterally, included adductor hallucis,quadratus plantae, flexor digitorum brevis and abductor digiti minimi as well.ConclusionFrom anatomical view, soft tissues of many compartments in foot rather than of simple compartmen are injuried when calcaneal intra-articular fractures occur, decompressive fasciotomies should be performed in all compartments involved. The present experimental protocol is useful to reproduce calcaneal intra-articular fractures.
5.Placement of percutaneous translaminar facet screw: an anatomic study
Sheng LU ; Yongqing XU ; Zihai DING
Orthopedic Journal of China 2006;0(05):-
[Objective]To provide anatomic basement for the clinic appliance of percutaneous thranslaminar facet screw.[Method]From L_1 to L_5,anatomic measurements for screw path length,superior and inferior lamina border thickness in 30 dried lumbar spines,caudal and lateral angles of laminar were measured with CT and X ray.[Result]The superior border of the lamina was relatively thinner from L_1 to L_5,The thickness of the inferior border of the lamina,the mean values of the length of the screw path and lateral angle gradually increased,and the caudal angle of screw placement relative to transverse plane gradually decreased.[Conclusion]A translaminar facet screw with 4.5 mm in diameter is safe.from L_(1~5).Screw should be inserted in inferior lamina border,not in the superior border of the lamina,caudal and lateral angles of laminar should be ajustable to fit the lumbar facet joint.
6.Transplant the big toe tip to reconstruct the finger tip
Zengtao WANG ; Zihai DING ; Jiyao ZOU
Chinese Journal of Microsurgery 1998;0(01):-
Objective To explore the method to reconstruct finger tip. Methods Transplanted the big toe tip to reconstruct the finger tip and anastomosed the artery and nerve of big toe with the artery and nerve of the finger.The venae digitales plantares of finger,toe and venae digitales volares of finger and toe were anastomosed with microsurgery. Results All the reconstituted finger tips were successful.The shape of the reconstituted finger tips were near to the normal finger tip.The shape of the big toes had only a little change. Conclusion Use the big toe tip can reconstruct a beautiful finger tip look like the normal finger.
7.Anatomical and Morphological Research for Laparoscopic Anterior Lumbar Interbody Fusion
Jinwei LIU ; Lei SONG ; Zihai DING
Chinese Journal of Minimally Invasive Surgery 2001;0(01):-
Objective To study the vascular anatomy for laparoscopic anterior lumbar interbody fusion(LALIF),and to evaluate the feasibility of the surgical approach.Methods Vascular anatomy of 36 adult human bodies were studied by infusing red latex into the arteries.They were classified according to the percentage of the exposed lumbosacral disc in the interiliac triangle.Results The mean height of the aortic bifurcation(AB)was(41.81?13.82)mm,and the height of the confluence of the common iliac vein(CCIV)was(20.22?14.20)mm.The angles of the AB and CCIV were(51.88?12.09)? and(77.08?20.98)? respectively.The width of the median sacral artery(MSA)were(1.57?0.42)mm and(1.33?0.50)mm respectively at the top and bottom of the lumbosacral disc.While the distance from the right iliac vessel(RIV)to MSA at the top and bottom of the lumbosacral disc were(20.83?7.73)mm and(27.60?7.80)mm.The average width of the exposed disc was(36.78?13.06)mm,which accounts for(72.29?25.64)% of that of the disc.According to our morphological classification,22 specimens(61.1%)belong to type Ⅰ(Standard type,being exposed by more than 65%),9(25.0%)type Ⅱ(Narrow type,being exposed by 45% to 65%),and 5(13.9%)type Ⅲ(Barrier type,being exposed by less than 45%).The height of CCIV was negatively,but not significantly,correlate to its angle(r=-0.287,P=0.089).Conclusions In 86.1% of our patients,anterior approach is a safe and effective way for laparoscopic interbody fusion.Moreover,in 61.1% of the patients,the procedure can be carried out without managing the iliac vessels arround the interiliac triangle.
8.The anatomic relationship between the thoracic transverse process and adjacent bony structures
Xingang CUI ; Zihai DING ; Jinfang CAI
Chinese Journal of Orthopaedic Trauma 2014;16(6):518-520
Objective To study the anatomic relationship between the thoracic transverse process and adjacent bony structures and its clinical significance for thoracic screw fixation.Methods The present anatomic measurement used 45 dry cadaveric specimens of the normal adult thoracic vertebrae.We measured the distances from the horizontal midline of the transverse process to the superior,middle and inferior margius of the pedicle,the height of the anterolateral transverse process sheltered by ribs,and the position at the horizontal midline of the transverse process corresponding to the vertebral body.Results The horizontal midlines margius of the transverse processes of T1 to T10 are localized in the plane ranging from the superior to the inferior margins of the pedicle.The midlines of the transverse process are closer at T6 and T7 while more apart at T9 and T10.From T1 to T8,the anterolateral transverse process is totally or mostly sheltered by ribs,but the shelter is much less at T9 and T10.The horizontal midline of the transverse process corresponds to the upper 1/3 or middle 1/3 of the vertebral body.Conclusion Thoracic screw fixation across the transverse process to the vertebral body is safe,reliable and feasible in clinic.
9.Selenium-enriched Spirulina platensis promotes proliferation of hepatocytes in rat partial hepatectomy
Feng HUANG ; Zhi HUANG ; Wenjie ZHENG ; Fang YANG ; Zihai DING
Chinese Journal of Pathophysiology 1989;0(05):-
AIM: To explore the effects of selenium-enriched Spirulina platensis (Se-SP) on proliferation of hepatocytes in rat hepatectomy. METHODS: Rat hepaectomy model was conducted using male Wistar rats. The rats were randomized into five groups: operation groups with 150 (H), 50 (M) and 15 (L) mg?kg-1?d-1 of Se-SP, placebo-control (P) and sham operation group (F). Activities of glutathione peroxidase (GPx) and thioredoxin reductases (TR) in hepatocytes were determined by chemical colorimetry. The expression index of proliferating cell nuclear antigen (PCNA) in hepatocytes was detected by immunohistochemistry, and the level of [3H]-TDR incorporation in regenerative hepatocytes was analyzed by radio-immunity. RESULTS: Activity of GPx and TR, PCNA expression index as well as [3H]-TDR insertion in hepatocytes (in vitro) were obviously higher (P
10.Microsurgical anatomy of the arterial network of submental flap
Xian HUA ; Ran DING ; Junyi KE ; Zihai DING ; Peng LIU ; Xuefeng ZHENG
Chinese Journal of Microsurgery 2021;44(1):56-59
Objective:To provide microsurgical anatomy data in the course, branch, distribution, arterial network profile of the submental artery and the range of the flap excision in submental flap transplantation.Methods:From March, 2015 to March, 2020, a total of 36 head and neck cast specimens were studied. Acrylic-butadience-styrene plastic (ABS) filler were perfused into the external carotid artery to make cast specimens. The course, branching, distribution and the arterial framework of the submental artery under a surgical microscope were investigated.Results:The submental artery originated from the facial artery before reaching the lower edge of the mandible (1.50±0.50) cm, with a diameter of (1.50±0.85) (0.6-2.3) mm. The main trunk of submental artery was (5.5±0.5) cm in length, which ran forward along the lower edge of the mandible and branched out (9.0±3.0) (7-13) branches with diameters between 0.1-0.5 mm, and mainly distributed to skin and superficial fascia of the submental area. The main trunk of submental artery divided into ascending, horizontal and descending branches about 3.0 cm of the midline of the mandible. The ascending branch went upwards over the lower edge of the mandible and joined up with the lower labial arch or participated in the formation of the lower labial arch; the horizontal branch divided into several branches and joined up with the branches from the opposite side; the descending branch branched posteriorly and inferiorly, joined up with branches of lingual artery and superior thyroid artery. The branches of the submental artery and the branches of the peripheral arteries were joined up in the submental area to form the submental artery network. The diameter of the vessels in the network ranged 0.1-0.2 mm. The arterial network was built in the form of 1 to 3 layers, and the area of main network was about 7.0 cm×5.0 cm.Conclusion:The submental artery has a long trunk, many branches and abundant anastomoses between the branches, forming a dense submental artery network, which provides sufficient pedicle length, rich blood supply and cutting area for submental flap. The flap can be transplanted free or transposed. The best location of submental flap is near the midline of arterial network, and the appropriate area is 7.0 cm×5.0 cm.