Objectives To evaluate the clinical effect of one-stage reconstruction of dorsal hand softtissue defects using tendon allograft and free anterolateral thigh flaps.Methods From July 2006 to July 2011,fifteen cases of complex soft-tissue defects in dorsal hands were repaired using tendon allografts and anterolateral thigh flaps,sizing from 9 cm ×5 cm to 14 cm× 11 cm,in one stage.Two to 4 digital extensor tendons were reconstructed.With a brace on,early finger exercises were started after 2 weeks postoperatively when the flaps had survived.Results All the 15 flaps survived uneventfully.Twelve of the 15 patients were available for follow-up from 12-24 months (averaged 16 months).Two cases received tendolysis due to poor finger movement 6 moths postoperatively.At the end of follow-up,the range of wrist joint active flexion is from 40 to 70degrees and extension is from 25 to 50 degrees.The motion range of the related metacarpophalangeal joints was from 60 to 85 degrees,that of the interphalangeal joints from 80 to 90 degrees.The overall effective rate was 92 percent.Conclusion Simultaneous composite repair using tendon allografts and skin flaps proved to be reliable and cost-effective for complex dorsal hand soft-tissue defects.Allograft tendon reconstruction can not only obliterates new morbidities of autografting but also facilitates timely rehabilitation,avoiding extension loss of hand joints.

AIM:To explore the effects of decorin on procollagen type I (PcI), mRNA expression,collagen type I synthesis and proliferation of synovial type B cells of stiff knee joint synovial membrane.METHODS:Type B cells of synovial membrane were isolated from the stiff knee joint synovial membrane and cultured in vitro.The cells were treated with decorin at concentrations of 0.1 mg/L, 5 mg/L and 10 mg/L.After cultured for 24 h, 48 h and 72 h, the cell proli-feration rates were measured by MTT colorimetric determination.Cell cycle distribution and apoptosis were analyzed by flow cytometry.The mRNA level of Pc I was detected by RT-PCR, while collagen type I was measured by Western blot.RE-SULTS:The proliferation of synovial type B cells was significantly inhibited, the percentage of synovial type B cells at G1 phase was significantly increased by 5 mg/L and 10 mg/L decorin (P<0.05), and PcⅠmRNA expression and collagen type I synthesis were significantly decreased.The cells with late apoptosis were not found in control group and experimental groups.CONCLUSION:Recombinant human decorin inhibits synovial type B cell proliferation and decreases PcⅠmRNA expression and collagen type I synthesis in synovial type B cells of stiff knee joint synovial membrane in vitro, suggesting that decorin potentially contributes to the therapy of human knee stiffness.