Serosurvey for SARS-CoV-2 among blood donors in Wuhan, China from September to December 2019

The emerging of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused COVID-19 pandemic. The first case of COVID-19 was reported at early December in 2019 in Wuhan City, China. To examine specific antibodies against SARS-CoV-2 in biological samples before December 2019 would give clues when the epidemic of SARS-CoV-2 might start to circulate in populations. We obtained all 88,517 plasmas from 76,844 blood donors in Wuhan between 1 September and 31 December 2019. We first evaluated the pan-immunoglobin (pan-Ig) against SARS-CoV-2 in 43,850 samples from 32,484 blood donors with suitable sample quality and enough volume. Two hundred and sixty-four samples from 213 donors were pan-Ig reactive, then further tested IgG and IgM, and validated by neutralizing antibodies against SARS-CoV-2. Two hundred and thirteen samples (from 175 donors) were only pan-Ig reactive, 8 (from 4 donors) were pan-Ig and IgG reactive, and 43 (from 34 donors) were pan-Ig and IgM reactive. Microneutralization assay showed all negative results. In addition, 213 screened reactive donors were analyzed and did not show obviously temporal or regional tendency, but the distribution of age showed a difference compared with all tested donors. Then we reviewed SARS-CoV-2 antibody results from these donors who donated several times from September 2019 to June 2020, partly tested in a previous published study, no one was found a significant increase in S/CO of antibodies against SARS-CoV-2. Our findings showed no SARS-CoV-2-specific antibodies existing among blood donors in Wuhan, China before 2020, indicating no evidence of transmission of COVID-19 before December 2019 in Wuhan, China.

Health economics evaluation of the cost and effectiveness of gray zone setting in blood ELISA screening / 中国输血杂志

【Objective】 To analyze the cost-effectiveness of ELISA grey area strategy through establishing the health economics model. 【Methods】 The serological grey area strategy evaluation model was composed of screening strategy subdecision tree, pathogen infection subdecision tree and pathogen detection subdecision tree. The key parameters in the model were obtained from literatures and research data. The cost-effectiveness of setting ELISA grey area strategy was compared by software, and multifactor sensitivity analysis was conducted. 【Results】 After setting the ELISA grey area, extra samples(5.86 cases/100 000) with serological false negativity could be detected, including HBV samples at 4.93/100 000, HCV samples at 0.27/100 000, HIV samples at 0/100 000, syphilis samples at 0.66/100 000. To yield an additional seropositive sample out of every 100 000 blood donors, blood center will afford extra 1 million yuan about. 【Conclusion】 Through this study, a cost-effectiveness evaluation model of serological detection strategy was established. Although the ELISA grey area setting can yield a small number of seropositive samples, the cost is much higher than the current affordability.

Analysis on testing ability of blood testing laboratories in domestic blood establishments across China / 中国输血杂志

【Objective】 To analyze testing ability of blood testing laboratories in domestic blood establishments, and to comprehensively understand the resource allocation, workload and unqualified blood samples. 【Methods】 All blood testing laboratories reported the quarterly quality indicator data via their EQA system on the website of National Center for Clinical Laboratories (https: //srv.clinet.cn/qblood/report/add1.aspx). We collected related quality indicators throughout 2020, including resource indicators, number of sample detection, and number (rate) of unqualified samples. All the data were integrated by EQA system. 【Results】 1) Throughout 2020, 324 blood testing laboratories reported that 13 529 778 donations were tested by immunoassays and 13 892 927 donations were tested by nucleic acid testing(NAT). Among them, 253 laboratories reported the data correctly throughout four quarters, and they tested 12 015 407 donations. 2) The number of equipment varied greatly among different laboratories, and a certain equipment was often overloaded in some laboratories. 3) The proportion of domestic ELISA reagents was 100% (322/322), while the proportion of imported NAT reagents was 75.33% (220/300). 4) The positive rate of HBsAg was closely related to geographical locations, as Sichuan (0.86%, 5 895/689 445), Guangdong (0.57%, 5 147/895 929), and Guangxi (0.53%, 3 021/573 216) provinces demonstrated higher positive rates than that of other provincial regions. 【Conclusions】 There are many blood stations across China, with great differences in scale and equipment. There are obvious differences in the positive rates of infectious indicators in different regions. Therefore, the laboratory should make horizontal comparison with the laboratories in the same region, to improve the detection quality of the laboratory in time and effectively.

Unqualified rate of anti-HIV detection in the laboratories from blood banks in Beijing-Tianjin-Hebei region / 中国输血杂志

【Objective】 To investigate the unqualified rate of anti-HIV detection of blood screening laboratories in Beijing-Tianjin-Hebei region, and explore the differences in anti-HIV detection ability and influencing factors in each laboratory. 【Methods】 Through filling questionnaires via e-mail, the anti-HIV ELISA unqualified rate and confirmed (WB) positive results (data) from January to December 2018 from 15 blood screening laboratories in Beijing-Tianjin-Hebei region were collected. Our laboratory was responsible for data collection and confirmation, and statistics software SPSS22.0 was used for analysis. 【Results】 1) There was a statistically significant difference among the unqualified rate of anti-HIV ELISA(6.77‱~35.71‱) and confirmed positive rate(0.60‱~3.56‱) in 15 blood screening laboratories in Beijing-Tianjin-Hebei region (P<0.05); 2) There were significant differencse among the ELISA unqualified rate and the confirmed positive rate of 8 reagents for anti-HIV detection(P<0.01), and the sensitivity of the 4th generation detection reagent and the imported reagent was higher than that of the 3rd generation reagent and the domestic reagent. The anti-HIV ELISA unqualified rate of R5 was the highest (19.08‱). 3)There were significant differences in the anti-HIV ELISA unqualified rate of R1, R2, R3, R5 and R7 reagents among different blood station laboratories(P<0.05), and there were no significant differences in the anti-HIV ELISA unqualified rate of R4, R6 and R8 reagents among different blood station laboratories(P>0.05). 4)The unqualified rate of anti-HIV ELISA of laboratories using different regents showed significant differences(P<0.05), except H, J, M. The unqualified rate of imported reagent was significantly higher than that of domestic reagents of laboratories using imported and domestic reagents combinations(P<0.05), except O. 62.5% (5/8) laboratories using domestic 3rd and 4th generation reagent combination showed significant differences in the unqualified rates among different reagents(P<0.05); 5) The positive rate of single-reagent(62.02%~95.45%)in 15 blood screening laboratories showed significant difference(P<0.001), and A was the lowest (62.02%). 【Conclusion】 The anti-HIV detection ability among 15 blood screening laboratories in Beijing-Tianjin-Hebei region is quite different. The application of different reagents is the main factor for the difference, and other factors such as personnel, instruments and test strategies also has a great impact on the detection of anti-HIV. It is still necessary to promote the process of homogenization of blood testing quality among blood screening laboratories in Beijing-Tianjin-Hebei region.

Construction of Medical Humanities Education Mode / 中国医学伦理学

There are such problems as the contents of education lag , overemphasising cognition and intellectu-alization, despising practice and system supporting in current medical humanities education practice .We think that the medical humanistic education should adhere to the concept of student -oriented, medical education and human-ities education fusion , the idea of ideological education as the leading factor , the psychological compatibility as the base ,the system strengthening as the security .The medical humanities education mode is not only the response of the main current medical education mode of social alienation and human alienation , but also the surpassing of the object of humane education mode .It fully reflects the personality characteristics of the contemporary medical students , embodies the regularities of nurturing and development of human behavior in medical students .

Exploration of Elaborate Management of Application for National Natural Science Foundation of China in Chengdu Medical College / 中华医学科研管理杂志

Over the past few years,Cheng Medical College has made great progress in the fields of discipline construction,specialty construction,talent training,and scientific research.This paper illustrates the specific methods for application for National Natural Science Foundation as well as the project management,and explores the practice and use of elaborate management.According to this management requirements,Chengdu Medical College has determined goals,defined declare focus,enhanced the application quality,standardized and specified project management so much so that it has achieved remarkable results in recent years.

Application of HTB-SiHa Cells Transfected with a Recombinant Plasmid for External Quality Assessment of Chlamydia trachomatis PCR

BACKGROUND: The participation of laboratories in external quality assessment (EQA) programs is required for the quality assurance of nucleic acid amplification of Chlamydia trachomatis. This study aimed to construct a new quality control (QC) material applicated in EQA of C. trachomatis PCR. METHODS: A QC material-HTB-SiHa cells transfected with a recombinant plasmid containing the cryptic plasmid sequence-was constructed for C. trachomatis PCR detection, and four different panels, each consisting of 4 positive samples with serial dilution of the constructed QC material and 1 negative sample, were distributed by the National Center for Clinical Laboratories among four groups of 275, 268, 317, and 304 participants across China from 2011 through 2012. A total of eight commercial kits were used for C. trachomatis PCR detection in participants. RESULTS: Nine laboratories reported false-positive results (0.9%). As the series dilution increased, the correct reporting of the data sets decreased; the lowest correct rate was 96.3% in the weakest positive samples (104 copies/mL). Eight laboratories reported false-positive results, and 42 laboratories reported false-negative results in the EQA detection of C. trachomatis. No significant differences were observed in the detection of the constructed C. trachomatis positive samples (97.9%, 98.5%, 100%, 98.5%; P=0.36) and negative samples (100%, 99.0%, 100%, 99.0%; P=0.764) using four commercial kits commonly used in China. CONCLUSIONS: The results of the EQA study indicated that the constructed material provides a noninfectious, stable control material with sufficient volume for PCR detection of C. trachomatis.

External quality assessment of antinuclear antibodies titer report from clinical laboratories in 2012 in China / 中华检验医学杂志

Objective To evaluate the agreement of antinuclear antibody (ANA) titer reported in clinical laboratories and analyze possible problems in clinical laboratories.Methods Experiment survey.The panel consisting of 5 samples was distributed to 533 laboratories.Each panel contains one negative sample and 4 positive samples,which were from individuals of autoimmune disease.ANA titer system was divided into traditional titer system with two-fold dilution and titer system with 3.2 times dilution.Clinical laboratories were required to report the ANA titers and initial screening dilution according to the standard used in routine work.Results were expressed as median titers and range for acceptable performance.As to titer system with two-fold dilution,acceptable performance on proficiency testing was defined by a result equal to median titer ± two two-fold dilutions.While as to titer system with 3.2 times dilution,acceptable performance on proficiency testing was defined by a result equal to median titer ± 3.2 times dilutions.The laboratories percentages with acceptable performance were calculated to evaluate their agreements.Results 412 laboratories reported ANA titer results,of which 11.9％ (49/412)reported results with two-fold dilution titer system,88.1％ (363/412)reported results with 3.2 times dilution titer system.The median titers of sample 1211,1212,1213 and 1215 reported with two-fold titer system were 1 ∶ 640,1∶ 320,＞ 1 ∶ 1280 and1∶ 160,respectively.The agreement within the median ANA titer reported with two-fold dilution titer system ranged from 24.5％ (12/49) to 57.1％ (28/49) and the lowest percentage of the results within the acceptable limits was 87.8％ (43/49).The median titers of sample 1211,1212,1213 and 1215 reported with 3.2 times dilution titer system were 1 ∶ 1000,1∶ 1000,＞ 1 ∶ 3200 and 1 ∶ 320,respectively.The agreement within the median ANA titer reported with 3.2 times dilution titer system ranged from 63.3％ (31/49)to 83.7％ (41/49).The lowest percentage of the results within the acceptable limits was 98.0％ (48/49).Conclusions The results of ANA titer reported are unsatisfactory.Standardization for reagent,microscopy,procedure and result interpretation is necessary to improve the agreement of ANA titer report in different laboratories.

Analysis of the results of external quality assessment for hepatitis C virus RNA tests / 中华检验医学杂志

Objective To evaluate the performance of HCV RNA detection in the first EQA program in 2012 and analyze possible problems in clinical laboratories.Methods The panel consisting of 5 samples was distributed to 927 laboratories.Each panel contains one negative sample and 4 positive samples,which were virus-like particles calibrated by international standard.The pere ent agreements of all the laboratories for qualitative and quantitative results were calculated.Genomic means (GM) and standard deviations (s) of all laboratories and each reagent were calculated.The overall GM and the GM of each reagent were compared with expected results and correlation curves were calculated.Results The percent agreements of sample 1211,1212,1213,1214 for qualitative results wcrc 99.5％ (403/405),98.5％ (400/406),100.0％ (405/405),100.0％ (406/406),respectively.The percent agreement of the negative sample was 99％ (401/405).The percent agreements of sample 1211,1212 and 1213 for quantitive results were similar,which were 93.8％ (549/585),92.3 ％ (541/586) and 94.5％ (554/586).However,the agreement of sample 1214 was only 87.7％ (514/586)and the agreement of sample 1214 for reagent A was 67.2％ (92/137).The overall GM agreed with expected results,while GMs of reagent C,E and G deviated from expected results.GMs of sample 1211,1212,1213 and 1214 reported by labs using reagent C were 4.22,3.56,5.16 and 5.90,respectively.GMs of sample 1211,1212,1213 and 1214 reported by labs using reagent E were 4.52,3.78,5.55 and 6.29,respectively.GMs of sample 1211,1212,1213 and 1214 reported by labs using reagent G were 4.83,4.36,5.72 and 6.56,respectively.Conclusions The overall results of HCV RNA qualitative and quantitative detection are satisfactory.However,some problems still exist,such as deviation of GM of some reagents,the interassay variability,systematic deviation and accidental deviation,which show that the quality of reagents should be improved.

The induction of systemic lupus erythematosus by human cytomegalovirus pp65 / 中华微生物学和免疫学杂志

Objective To investigate the potential role of human cytomegalovirus lower matrix phosphoprotein 65 (HCMV pp65) in murine systemic lupus erythematosus (SLE).Methods The prokaryotic vector pET-28b and eukaryotic vector pcDNA 3.0 were constructed to express the HCMV pp65 protein.All the C57BL/6 mice were inoculated with pp65 eukaryotic vector intramuscularly five times at 2-week intervals and then were bled via the retro-orbital vein.Subsequently,indirect ELISA was used to evaluate the concentration of anti-pp65 IgG,anti-dsDNA and ANA.At the same time,IL-1 b,IL-6,and TNF-α were determined by competitive ELISA.Results The early onset of autoantibodies and an overexpression of IL-6 were observed in immunized male C57BL/6 mice.Conclusion HCMV pp65 triggers the deregulation of humoral immunity in C57BL/6 mice,which indicates that the immune responses induced by HCMV pp65 may be involved in the development of SLE.

The potential role of miR-146a in the pathogenesis and diagnosis of autoimmune diseases / 中华检验医学杂志

MicroRNA(miR),a type of 22nt non-coding RNA,modulate gene expression at posttranscriptional level by interacting with targeting mRNA and play an important role in both inflammatory reaction and autoimmune diseases.Especially,the expression of miR-146a in autoimmune diseases has gotten more and more attention in recent studies.This review summarized the correlation between the expression of miR-146a and the pathogenesis of some common autoimmune diseases.What's more,the potential role of miR-146a in the clinical diagnosis of autoimmune diseases are also discussed.

External quality assessment of autoantibodies detection in clinical laboratories during 2006-2011 in China / 中华检验医学杂志

ObjectiveTo evaluate the performance of antinuclear antibody (ANA) detection in clinical laboratories.Methods There were 2 external quality assessments (EQA) scheme for nuclear antibody detection.The panel consisting of 5 samples was distributed.Each participant laborotory of the EQA program was required to report the ANA qualitative results,patterns,titers and anti-double strain DNA (dsDNA) antibody,anti-extractable nuclear antigen(ENA) antibody,the percent agreements of which were calculated respectively.ResultsThe number of laboratories performing ANA test with IIF increased from 77.6％ ( 149/192 )in 2006 to 82.2％ (342/416) in 2011,while the number of laboratories performing ANA test with ELISA was in the range of 14.5％ ( 53/365 ) and 16.0％ ( 52/326 ).The positive percent agreements of IIF was over 98％.The positive percent agreement of ELISA were all over 90％.IIF showed more satisfying positive percent agreements than ELISA every year.Over 90％ of the laboratories reported correct results for samples with granular ANA pattern except 0613 and 0624.Over 95％ of the laboratories reported correct results for samples with homogeneous ANA pattern.Two samples with centromere pattern were correctly detected by 88.5％ ( 161/182 ),79.0％ ( 147/186 ) of the laboratories in 2007,while the sample with centromere pattern was correctly detected by 98.4％ (299/304), which indicated an improvement in the detection of centromere pattern.In ANA positive results,the lowest percentage of the laboratories reporting the median result was 36％ (94/261),while the highest percentage was only 85.5％(224/262).The satisfied results of anti-ENA antibody were over 90％.And those of anti-dsDNA antibody was over 85％.ConclusionsIIF is the most common method for ANA screening in clinical laboratories.ELISA is also used in some laboratories.The two methods reported satisfying results in ANA test.The detection of anticentromere antibodies is improved.But the results of ANA titer reported are unsatisfactory. ANA detection in routine practice needs to be improved by standardization.

External quality assessment for the quantitative detection of HCV RNA in China / 中华检验医学杂志

Objective Anti-RNase virus-like particles containing HCV RNA 5'-UTR were used as positive samples in national external quality assessment ( EQA ) to evaluate the competency of clinical Laboratories for the quantification of HCV RNA and analyze the possible problems of domestic kits. Methods The quality control samples with target values in EQA panels were distributed nationally twice by National Center of Clinical Laboratory (NCCL) to participating laboratories for the quantification of HCV RNA in 2008 and 2009. Each panel consisted of 5 samples. All participants were required to carry out the detection and to return results in expected time. Positive samples were virus-like particles which had been calibrated against the WHO HCV International Standard (NIBSC96/798)and the results of positive samples from participants should be in the range of target value of logarithm ± 0. 5. The 2nd panel in 2008 contained the common HCV genotypes and the 2nd panel in 2009 contained serial diluted samples of genotype 1b. The results of positive samples detected with 3 different lots reagent (21001,21078 and 21097) from the 2nd EQA in 2009 were statistically analyzed using the analysis of variance, then Dunnett'S T3 and Tamhane'S T2 were used if heterogeneity of variance was found. Results There was 390 participating laboratories in 2008 and 428/426 in 2009. The percentages of laboratories within the range of target value of logarithm ± 0. 5 for varied genotypes were different. The percentages of laboratories for 1b were more than 91%, for 2a were 93.7% and 74. 2% ,for6 were 83.3% and 80. 3%. The CVfor the low-level sample was higher than that for the high-level sample in the same year. The numbers of laboratories reporting false-negative samples in 2008and the 2nd in 2009 were 5, 1 and 10 respectively. Statistical differences were found among the results of four quality control serum samples using 3 different reagents( F = 288.23, 324. 79, 291.98 and 261.16,P ＜0. 01 ). Conclusion The competency for detecting low concentration samples and samples with genotype 2a or 6 needs to be improved.

Human-human antibody conjugate as positive control in the immunoassays for measuring specific IgM to hepatitis A virus / 中华检验医学杂志

ed to construct a series of positive control materials that are applicable to many other immunoassays.

Construction and expression of ribonuclease-resistant virus-like particles containing long chimeric RNA sequence / 中华检验医学杂志

Objective To construct and express ribonuclease-resistant virus-like particles containing long chimeric RNA sequence by changing quantity and affinity of ms2 19mer stem-loop.Methods 1.7 kb maturase and coat protein gene of ms2 were amplified.We used a C-variant aptamer of the wild-type stem-loop where uridine-5 has been substituted by cytosine.The 1700 bp PCR-amplified DNA fragments was gel-purified and then digested with BamH Ⅰ and Hind Ⅲ and ligated to linearized pET28b vector to generate recombinant plasmid pET-MC-pac.The five target DNA sequences were spliced by overlapping extension(including 3 fragment of SARS-CoV,one fragment of HCV and one fragment of HSN1).PCR was carried out using primers contained Not Ⅰ site and then PCR were cloned into a pGEM(R) T-easy vector and then excised with the Not Ⅰ restriction enzymes from the resulting recombinant plasmid.simoutaniously the pET-MC-pac plasmid was digested with Not Ⅰ restriction enzymes,fragments were ligated into the linearized pET-MC-pac plasmid to produce a new donor plasmids pET-MC-3V.Simoutaniously,we constructed three recombinant expression vector for control,including N-P3V-pET-P、N-P3V-pET-Cand P-3V-pET-P.N-P3V-pET-P contained one wild type pacsite located behind ms2 sequence:N-P3V-pET-C contained one C-variant pacsite located behind ms2 sequence:P-3V-pET-P contained two wild type pacsites that one is located behind ms2 sequence,another is located between SARS-CoV 3 and HCV sequence.Then these four expression vector were transformed into E.coli strain BL21(DE3),respectively.The 3V Armored RNA was expressed and purified.A260 absorbance value of expression product was determined.Results Four expression plasmids were constructed successfully.The Armored RNA with 1891 bases was snccessfully expressed by the two-paesite expression system of pET-ms2-3V and P-3V-pET-P;for N-P3V-pET-P、N-P3V-pET-C,only 1 200 bp target sequence was packaged into virus-like particles.Expression efficiency of N-P3V-pET-P、N-P3V-pET-C、P-3V-pET-P and N-P3V-pET-P was 0.23,0.35,0.35,0.51 mg/ml,respectively.Armored RNA was shown to have the charaeterization of Ribonuclease-resistant and stable at 4℃,37℃ and 25℃ respectively.Conclusion The expression plasmids containing two pacsites were constructed successfully and prokaryotic expression system can be used as an expressing plasmid platform for preparation of Ribonuclease-resistant virus-like particles containing long chimeric RNA sequence.

Construction and application of quality control materials for Chlamydia trachomatis polymerase chain reaction detection / 中华检验医学杂志

Objective To construct quality control materials for chlamydia trachomatis (CT) polymerase chain reaction detection and evaluate the stability of the material.Methods The reference regarding the target sequence for CT PCR detection has been reviewed.The ovedap extension technique and molecular cloning techniques were used to construct a recombinant lasmid.Then the recombinant plasmid pTARGETTM-CT was transfected into a HTB-SiHa cells.The cuhured epithelia cells,vere collected as quality control material.Then we evaluated the stability of this material with domestic kits for CT PCR detection.The stability in different conditions were summarized and evaluated.The EQA samples for CT test survey ere prepared from the above prepared cells and distributed to the EQA participants nationwidely.Results Five fragments from CT(178-610),(1219-1993),(2471-3260),(5239-5864),(6722-7499) were cloned into pTARGET TM.The recombinant plasmid was transfected into mammalian cells as a final form for the quality control materials.Real-time PCR analysis howed the original material was positive with domestic chlamydia trachomatis kit(3.21×108 copies/ml).A Series of dilution resulted in the decreased result .The stability testing indicated the quality control materials were stable at least for one month when stored at 4℃,room temperate or 37℃.Conclusions We used several kinds of molecular iology methods such as ovedap PCR and enzyrnatie digest to construct a recombinant plasmid which contained several fragments.The quality control materials for chlamydia trachomatis PCR detection was developed successfully.

External quality assessment on TORCH immunoassay in China / 中华检验医学杂志

Objective To evaluate performance of the clinical laboratories for detection of TORCH immunoassay. Methods There were 2 times external quality assessment (EQA) for nuclear antibody detection. Each panel consisting of 5 liquid serum samples were distributed. Each participants of the EQA program had to reply the results, the methodological procedure and the kits. All data were analyzed and then provided to all laboratory in our EQA program. Results In 2007, the rate of good response were more than 80% for HSV immunoglobulin-M, Rubella immunoglobulin-M and CMV immunoglobulin-M. Response for Toxo immunoglobulin-M was poor (53.1%). The sensitivities of the commercial kits were quite low (<80%). Some clinical laboratories using the same kits gave quite different S/CO value. Conclusions A lot of clinical laboratories get good score in TORCH detection external quality program. False negative is the major problem.

Sectional anatomy characteristics versus image anatomy of bone nasolacrimal duct / 中国组织工程研究

BACKGROUND: Researches are recently focus on topography and image dissection of nasolacrimal duct, but it is lack of systemically contrast researches between sectional anatomy and image anatomy on bone nasolacrimal duct by using dry cranium samples.OBJ ECTIVE: To investigate the characteristics of sectional anatomy and image anatomy on bone nasolacrimal duct and provide evidences for related operations of nasolacrimal duct.DESrGN: Self controlled study.SETTING: Office of Teaching Supplies, Chengdu Medical College.MATERIALS: The experiment was carried out in the Topography Laboratory, Department of Human Anatomy, Chengdu Medical College from September 2005 to September 2006. Non-injured dry cranium was randomly selected from 34 adults (68 sides), including 34 sides on males and 34 sides on females.METHODS: ① Based on OM line, a routine scanning base line, which was regarded as the axial scanning baseline,samples were scanned at flat level with SHIMADZU CT device. Bone nasolacrimal duct was factitiously divided into three parts, including 1/3 superior segment, 1/3 middle segment and 1/3 inferior segment. The means at each related layer were determined as the final results. ② Cranium samples were signed based on image scanning baseline, and then they were cut into sections at cross section fault along scanning baseline at flat level with section razor. In addition, related indexes of bone nasolacrimal duct were measured and compared with image results.MAIN OUTCOME MEASURES: ① Anterior, posterior, left and right diameters of superior aperture, 1/3 superior segment,1/3 middle segment, 1/3 inferior segment and inferior aperture of bone nasolacrimal duct; ② depth of internal bone wall and posterior bone wall in superior aperture, 1/3 superior segment, 1/3 middle segment, 1/3 inferior segment and inferior aperture if bone nasolacrimal duct; ③ position and form of inferior aperture of bone nasolacrimal duct; ④ comparisons of bone nasolacrimal duct between image anatomy and sectional anatomy.RESULTS: ① Anterior, posterior, left and right diameters of cross section of bone nasolacrimal duct: Superior aperture of bone nasolacrimal duct was narrow, but inferior aperture was changed obviously. Diameter was increased from top to bottom. In addition, anterior and posterior diameters were more than left and right ones. There was significant difference in internal diameter of superior aperture and 1/3 inferior segment of bone nasolacrimal duct between male and females (t =2.458, 2.227, P ＜ 0.05). However, there was no significant difference in internal diameter of 1/3 superior segment, 1/3 middle segment and inferior aperture of bone nasolacrimal duct between male and female (P ＞ 0.05). ② Depth of internal bone wall and posterior bone wall of bone nasolacrimal duct at cross section: Depths of internal bone wall and posterior bone wall of bone nasolacrimal duct were (0.87±0.23) mm and (0.21±0.19) mm, respectively. In addition, there was significant difference between them (t =2.547, P ＜ 0.05). However, there was no significant difference in depth of internal bone wall and related posterior bone wall of superior aperture, 1/3 superior segment, 1/3 middle segment, 1/3 inferior segment and inferior aperture of bone nasolacrimal duct between male and female (P ＞ 0.05). ③ Position and form of inferior aperture of bone nasolacrimal duct changed remarkably. Results of image anatomy of bone nasolacrimal duct were as the same as those of sectional anatomy.CONCLUSION: Perfection of normal sectional anatomy and image anatomy of bone nasolacrimal duct is beneficial for successfully performing related operations of nasolacrimal duct and reducing complications.

Cross-sectional observation of pterygopalatine fossa from adult cranial bone / 中国组织工程研究

BACKGROUND: Foreign and domestic scholars have made some studies on local anatomy and imageology of osseous pterygopalatine fossa, but studies on anatomy of section of osseous pterygopalatine fossa are few.OBJECTIVE: To measure hole-hole distance and aperture of pterygopalatine fossa from adult cranial bone at coronary and horizontal planes, and to observe the morphology of pterygopalatine fossa at corresponding sections.DESIGN: Repeated measurement design.SETTING: Scientific Research Office, Chengdu Medical College.MATERIALS: This experiment was carried out in the Laboratory for Local Anatomy, Department of Human Anatomy,Chengdu Medical College from March to November 2006. Sixty sides of complete dry cranial bone samples from 30 Chinese adult cases, who were of either gender and regardless of age, were involved in this study.METHODS: Bilateral pterygopalatine fossa of 30 dry cranial bone samples (60 sides) were sliced, 15 for slicing at coronary plane, and 15 for slicing at horizontal plane. Morphology of pterygopalatine fossa at the corresponding layers was observed, and related hole-hole distance and aperture were measured. Outcome was performed statistical analysis.MAIN OUTCOME MEASURES: Measurement at coronary plane: [1]orbit-rotundum distance (distance from the lowest point of inferior orbotal fissure to the center of rotundum); ② rotundum- pterygoid canal distance Ⅰ (vertical distance from the center of rotundum to the center of pterygoid canal); ③ rotundum- pterygoid canal distance Ⅱ (Distance from the area where rotundum appeared to the area where pterygoid canal appeared). Measurement at horizontal plane: [1]anterior-posterior dimension ( the largest distance between anterior and posterior walls which paralleled to perpendicular plate of palatine bone in each layer); ② lateral dimension (distance from midpoint of perpendicular plate of palatine bone to midpoint of line, which was between outermost sphenoidal process in the anterior wall of pterygopalatine fossa and foremost evagination in the posterior wall of pterygopalatine fossa). Morphology of pterygopalatine fossa in each layer was observed at coronary and horizontal planes, separately.RESULTS: ①At the coronary plane, the 1st to 6th layers of bilateral pterygopalatine fossa presented with inclined inverted trapezoid (70%, 21 sides), and inclined quadrilateral (30%, 9 sides), and the 7th to 10th layers of bilateral pterygopalatine fossa presented with canal-shape (100%). Themean value of right orbit-rotundum distance was (5.0±2.7) mm, andthat of left orbit-rotundum distance was (5.3±2.1) mm; The mean value of right rotundum- pterygoid canal distance Ⅰ was (6.4±3.9) mm, and that of left rotundum- pterygoid canal distance Ⅰ was (6.1±4.3) mm; The mean value of right rotundum- pterygoid canal distance Ⅱ was (7.3±2.6) mm, and that of left rotundum- pterygoid canal distance Ⅱ was (7.5±2.1) mm. ② At horizontal plane: The anterior and posterior walls of the 1st and 2nd layers of bilateral pterygopalatine fossa mainly presented with double curves with palinal convex surfaces (80%, 24 sides); the 3rd and 4th layers mainly presented with opposing convex surfaces (66.7%, 20 sides); The 5th to 6th layers mainly presented with canal shape (60%, 18 sides);And the 7th to 10th layers presented with canal shape (100%). At horizontal plane, for the pterygopalatine fossa in the 1st to 6th layers, its lateral dimension was larger than its anteroposterior dimension, and for the pterygopalatine fossa in the 7th to 10th layers, its lateral dimension was equal to its anteroposterior dimension. There were no significant differences of aperture in each layer of pterygopalatine fossa between bilateral samples (P＞ 0.05).CONCLUSION: Anatomical studies on the section of osseous pterygopalatine fossa retrieve the limitation in local anatomy,and provide reliable anatomical evidence for imageology of pterygopalatine fossa and related surgical operation.

Anatomical basis of adult meniscal sports injury / 中国组织工程研究

BACKGROUND: There have been some foreign studies on the general anatomy of meniscus, while domestic materials about adult normal meniscus are few.OBJECTIVE: To measure the various data of adult meniscus, so as to provide anatomical basis for clinical meniscal sport injury.DESIGN: Repetitive measurement design.SETTING: Department of Scientific Research, Chengdu Medical College.MATERIALS: This experiment was carried out in the Laboratory of Local Anatomy, Department of Human Anatomy, Chengdu Medical College during September 2003 to September 2005. Totally 94 adult knee joint samples, without any diseases were harvested from 94 patients, including 48 male and 46 female.METHODS: Skin of knee joint, subcutaneous tissue and muscle were removed. Tendon of musculus quadriceps fexoris was cut above the whirbone. Articular capsule was open, and incisions were made and prolonged to the posterior wall of articular capsule. Anterior and posterior cruciate ligaments were exposed and cut near the starting point of anterior cruciate ligaments. Fat pad of articular capsule was carefully cleaned. Various data of adult medial and lateral meniscus before and after ex vivo were measured up and down.MAIN OUTCOME MEASURES: Measurement before ex vivo: ① The largest sagittal diameter, the length of outer arc, the width of anterior angle, caudomedial part and posterior angel of medial meniscus. ②The largest sagittal diameter, the length of outer arc, the largest transverse diameter, aperture length ( distance between anterior and posterior angel border of lateral meniscus), the width of anterior angle, caudomedial part and posterior angle of the lateral meniscus. Measurement after exvivo: ①The largest sagittal diameter, the length of outer arc, the width of anterior angle, caudomedial part and posterior angel as well as the thickness of lateral border, center and free edge of anterior angle, caudomedial part and posterior angel of medial meniscus. ② The largest sagittal diameter, the length of outer arc, the largest transverse diameter,aperture length, the width of anterior angle, caudomedial part and posterior angel as well as the thickness of lateral border, center and free edge of anterior angle, caudomedial part and posterior angel of lateral meniscus. RESULTS: ①The measuring data of medial and lateral meniscus of female samples were a little smaller than those of male samples. The measuring results of medial and lateral meniscus of male samples were basically consistent with the observed results. ②The anterior angle, caudomedial part and posterior angle of medial and lateral meniscus were gradually thinned from lateral border to interior free edge, and they were filled in the plateau between medial or lateral condyles and tibia in wedge shape. ③ Medial meniscus presented "C" or crescent shape. An terior angle adhered to the anterior intercondylar fossa of tibia which located in the front of the attachment point of anterior cruciate ligament, and posterior angle adhered to posterior intercondylar fossa of tibia which located in the rear of posterior angle of lateral meniscus and in the anteriomedialis of the attachment point of posterior cruciate ligament; There was no obvious changes in the length of outer arc of medial meniscus be- fore ex vivo (t=1.98,P ＞ 0.05). ④The lateral meniscus presented "0" shape a little , and anterior angle adhered to the front part of nodus among condyles of tibia and the rear of anterior cruciate ligament, and the posterior angle adhered to the rear of lateral intercondylar tubercle which located in the front of attachment point of posterior angle of medial menisus; There were no obvious changes in the length of outer arc of lateral meniscus before and after ex vivo (t=0.61,P ＞ 0.05), but ob vious changes existed in the width of anterior angle, caudomedial part and posterior angel of medial meniscus (t=2.49,P ＜ 0.05). CONCLUSION: The obtained measuring data of meniscus provide referencing basis for clinical meniscal sport injury.