This article reviews repair methods and results of flexor tendon injuries in the hand. Current problems associated with the tendon injuries include rupture of repaired tendon, adhesion formation, and stiffness of finger joints. We advocate multi-strand-repair techniques, release of part of critical pulleys, and modification of postoperative motion regimes to improve clinical outcomes. Future efforts to improve the function of the hand are outlined.

Objective Through the statistical analysis of the student assessment on curriculum quality,through the observation of the current curriculum teaching situation and its cheracteristics to promote the curriculum construction effectively and improve the medical teaching quality.Methods The current study is carried out among 2 841 undergraduates who study in varied majors and different grades in a medical university.A table of Student Evaluation of Course Teaching Quality developed by the researcher is applied to the questionnaire survey and statistical analysis including comparation means test and correlation tests are adopted in the present study to analyze the course teaching quality.Results Initially.the National Selected Model Courses show no significant difference from the common courses;secondly,three variables including teaching content adopting the course syllabus,good professional qualification and teaching capability of teachers and advanced teaching methods and techniques ale highly scored among ten variables;thirdly,the correlation coefficient of the variable of improving self-learning ability and total score is statistically significant and it can be observed higher than that of other variables and total score.Conclusion Establishing student-centered curriculum evaluation and construction of long-effect mechanism,and developing the students'ability of autonomous learning ale important to improve the quality ofthe course.

Objective To investigate the effect of nuclear factor-?B (NF-?B), NF-?B-inducing kinase (NIK) and I-?B in basic fibroblast growth factor (bFGF) promoting gene expression and signal transduction of tenocyte NF-?B. Methods Tenocytes isolated from rabbits were divided into 3 groups with 8 dishes: no bFGF (Group A), 2 ng/ml bFGF (Group B) and 10 ng/ml bFGF (Group C). Cells in all dishes were cultured for 5 days. The effect of bFGF on tenocytes proliferation was examined by means of growth curve analysis. The mRNA was isolated after 5 days and the gene expressions of NIK,IKK? and IKK? induced by NF-?B investigated by reverse transcription-polymerase chain reaction (RT-PCR). Results The growth curve moved forward with the dosage increase of bFGF. Gene expressions of NF-?B,NIK, I?B kinase (IKK)? and IKK? were 0.4? 0.2 , 0.4 ? 0.1 , 0.3 ?0.1 and 0.2?0.1 respectively in the Group B and 1.8?0.5,1.0?0.3, 0.8 ? 0.2 and 1.5 ? 0.4 in the Group C. Gene expressions were all up-regulated in the Groups B and C posterior to adding of bFGF. Conclusions bFGF stimulates tenocyte proliferation and up-regulates gene expression of NF-?B,NIK,IKK? and IKK?, as indicates that the signal transduction of promoting tenocyte proliferation by bFGF may be through NF-?B pathway.

The indexes of teaching quality evaluation,such as attitude,teaching and evaluation,contents and methods,and evaluation standards,such as "excellent,good,medium,bad,worse",show the characteristics of inaccuracy.While traditional evaluation methods focus on accurate figures,the paper proposes a new method which is based on fuzzy mathematics to evaluate teaching quality.The theory,computing procedure and examples of the method are introduced.

Objective This study was designed to evaluate the biomechanical properties in tendons across the joints when Palmar or dorsal stitches were used. Methods Twenty porcine tendons were transected and then repaired in zone Ⅱand divided into two groups,using modified Kessler by placing the stitches in volar or dorsal part of tendons.The repaired tendons were placed on a joint model with flexion of 60?. An instron tensile testing machine was used to investigate 2 mm gap formation force and ultimate tensile strength. Results 2 mm gap formation force and ultimate tensile strength were both higher when dorsal placement of stitches was used. Conclusions Dorsal placement of stitches was recommended for repairing the tendons across the joints because it can offer greater tensile strength.

Objective To investigate changes of ligament lengths with the wrist at the neutral and hyperextended positions in vivo. Methods Six volunteers were enrolled in this study.Their wrists were held in 3 controlled positions:the neutral position of the carpus,hyperextension with radial deviation of 0° and hyperextension with radial deviation of 10°.We obtained computed tomography scans of the wrists at the 3 positions for each subject for 3-dimensional reconstruction of the carpal and distal radioulnar joint with customized softvare (Mimics 10.0).A total of 9 palmar and dorsal wrist ligaments were measured for the length changes. Results Lengths of the radioscaphocapitate (RSC),long radiolunate (LRL),radioscapholunate (RSL),ulnocapitate (UC),ulnolunate (UL),ulnotriquetral (UT) ligaments,and the dorsal intercarpal (DIC) inserting on the scaphoid ligament at the position of hyperextension with radial deviation of 0° were significantly longer than those at the neutral position ( P ＜ 0.05) while lengths of the dorsal-radiocarpal (DRC) ligament and the DIG ligament inserting on the trapezoid decreased significantly ( P ＜0.05).From 0°to 10° of wrist radial deviation in hyperextension,the UL,RSC,LRL,DIG inserting on the scaphoid and the trapezoid ligaments decreased significantly in length ( P ＜ 0.05),while UT,UC,RSL and DRC ligaments lengthened significantly (P ＜0.05). Conclusions The RSL,UC and UT ligaments are subjected to higher strain at the position of hyperextension with wrist radial deviation of 10°; the RSC,LRL,UL ligaments and dorsal DIC ligament inserting on the scaphoid are subjected to higher strains at the position of hyperextension; the DRC ligament at the neutral position and the DIC ligament inserting on the trapezoid when the wrist is extended are subjected to less tension.Thses findings will help understand the mechanism and range of the injury to the wrist ligaments.

Objective To evalvate the influence of elbow joint stability following ulna coronoid process fractures. Methods Three cadaveric upper extremities were used. The height, width, thickness, diameter and opening angle of ulna coronoid process were measured in six arms, while the coronoid process fragments at the level of 2 mm, quarter, half, three quarter and whole height were resected consecutively, the changes of the range of the elbow joint movement were recorded. Another sixteen specimens were divided into two groups: the anterior bundle of the ulnar collateral ligaments (UCL) in one group was unrepaired; While the other repaired, then the angle of cubitus valgus between two groups was compared. Results If the osteotomy bone was within quarter of ulna coronoid process, the elbow joint function was good. However, in cases of osteotomy on half of coronoid process, the elbow extension function was limited and the elbow became unstable. After reduction with internal fixation, the angle of cubitus valgus was greater in the second group, and the difference of elbow joint in flexion 0?, 30?, 60?, 90? and 120? had statistical significance(P

Objective To investigate the length changes of scapholunate interossous ligament (SLIL) at wrist full extension and forearm rotation and the related significance.Methods Eighteen healthy volunteers (12 males and 6 females) aged at 20-38 years (mean,28 years) were divided into forearm rotation group,wrist hyperextension group and wrist hyperextension-rotation group according to the random number table,with 6 cases per group.CT images of the wrist were analyzed and reconstructed in three-dimensions.Length of SLIL in dorsal,proximal and palmar segments was measured in different settings and compared.Results Conpared with the neutral position,lengths of palmar SLIL in distal,middle and proximal parts increased by (1.4 ±0.5)mm,(1.4 ±0.4)mm and (1.3 ±0.4)mm respectively in wrist hyperextension and increased by (0.3 ± 0.1) mm,(0.2 ± 0.1)mm and (0.3 ± 0.1)mm respectively in forearm maximal pronation.At the positions of wrist full extension,hyperextension with radial deviation or forearm maximal rotation,the palmar and part of proximal SLIL were elongated significantly (P ＜ 0.05).At forearm maximal pronation,palmar and part of proximal SLIL were elongated (P ＜ 0.05).Conclusions At wrist full extension,strain is greater in the palmar and proximal components of the SLIL.SLIL is inclined to injury at wrist hyperextension and forearm rotation.

Objective To observe the expression changes of heme oxygenase-1(HO-1) and its mRNA after spinal cord injury (SCI). Methods SD rats were randomly divided into normal (n=5), control (n=5) and experimental group (n=10). The rats were given no operation in the normal group, laminectomy only in the control and both laminectomy and traumatic injury in the experimental group. The SCI animal models were made by using a modified Allen's weight-drop device (50 g.cm) on T 12 . Rats were sacrificed at 1 and 3 days after injury. The distribution and content changes of HO-1 and its mRNA in spinal cord segments were observed by means of immunohistochemistry and in situ hybridization. Results Expression of HO-1 was mainly in neurons in the normal spinal cord. After injury, HO-1 expressed primarily in astrocytes and microglia and the distribution of positive cells closely correlated with intraparenchymal hemorrhage. Protein began to increase at the first day after injury. The expression intensity and the area of positive cells were (148.26?11.39) and (90.50?8.70)?10 3 ?m 2 respectively. At the third day, protein expressed more significantly with expression intensity of (128.03? 12.59) and area of (112.99?10.01)?10 3 ?m 2. The expression intensity and area of positive cells expressed by mRNA were (106.02?9.10) and (70.05?9.26)?10 3 ?m 2 respectively at the first day after injury, (85.82?9.07) and (87.37?10.95)?10 3 ?m 2 respectively at the third day after injury. There was significant difference between experimental and control groups ( P

Objective To evaluate the effects of 4 different epitendinous sutures on the tensile strength of the repaired tendons. Methods 40 plantar flexion deep tendons from pigs were divided into 4 groups randomly, with 10 in each group. After the core suture of Modifier Kessler was applied, 4 epitendinous sutures at different distances from suture sites to broken ends (4mm, 7mm, 10mm, 12mm) were used respectively in each group to repair the transected tendons. MTS Instron 4411 was used to test the repaired tendons. Tensile strengths at 2mm gap formation and at the peak were collected for statistical analyses by ANOVA. Results In this test, the tensile strength was found to increase with the distance from suture sites to broken ends. The tensile strength in the 4mm group was significantly lower than that in the others. There was little statistical difference between the other 3 groups. Conclusion Tensile strength of the repaired tendon tends to increase with the distance from suture sites to broken ends in epitendinous suture.