1.Preliminary exploration of the pharmacological effects and mechanisms of icaritin in regulating macrophage polarization for the treatment of intrahepatic cholangiocarcinoma
Jing-wen WANG ; Zhen LI ; Xiu-qin HUANG ; Zi-jing XU ; Jia-hao GENG ; Yan-yu XU ; Tian-yi LIANG ; Xiao-yan ZHAN ; Li-ping KANG ; Jia-bo WANG ; Xin-hua SONG
Acta Pharmaceutica Sinica 2024;59(8):2227-2236
		                        		
		                        			
		                        			 The incidence of intrahepatic cholangiocarcinoma (ICC) continues to rise, and there are no effective drugs to treat it. The immune microenvironment plays an important role in the development of ICC and is currently a research hotspot. Icaritin (ICA) is an innovative traditional Chinese medicine for the treatment of advanced hepatocellular carcinoma. It is considered to have potential immunoregulatory and anti-tumor effects, which is potentially consistent with the understanding of "Fuzheng" in the treatment of tumor in traditional Chinese medicine. However, whether ICA can be used to treat ICC has not been reported. Therefore, in this study, sgp19/kRas, an 
		                        		
		                        	
2.Research progress of potassium ion channel Eag1 in tumor
Xu-Zhao WANG ; Bo-Chang WANG ; Ya-Fei CHEN ; Yong ZHAN ; Wen-Xin LIU ; Hai-Long AN
Chinese Pharmacological Bulletin 2024;40(5):823-828
		                        		
		                        			
		                        			Eag1(ether-à-go-go-1,also known as Kv10.1,KC-NH1)is a member of the KCNH gene family of voltage-gated potassiumion(K+)channels,which is mainly expressed in the central nervous system as well as in a variety of malignancies and plays an important role in tumor development.The study of the distribution and mechanism of action of Eag1 is of great impor-tance to reveal its physiological function and its association with pathological mechanisms.This paper reviews the current re-search progress on the physiological and pathological properties of Eag1,the relationship between Eag1 and tumor development and the anti-tumor application of Eag1 modulators.
		                        		
		                        		
		                        		
		                        	
3.Similarities and differences of myocardial metabolic characteristics between HFpEF and HFrEF mice based on LC-MS/MS metabolomics.
Zhan Yi ZHANG ; Xue Ying FENG ; Zi Hao WANG ; Yu Zhi HUANG ; Wen Bo YANG ; Wen Jiao ZHANG ; Juan ZHOU ; Zu Yi YUAN
Chinese Journal of Cardiology 2023;51(7):722-730
		                        		
		                        			
		                        			Objective: To reveal the similarities and differences in myocardial metabolic characteristics between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) mice using metabolomics. Methods: The experimental mice were divided into 4 groups, including control, HFpEF, sham and HFrEF groups (10 mice in each group). High fat diet and Nω-nitroarginine methyl ester hydrochloride (L-NAME) were applied to construct a"two-hit"HFpEF mouse model. Transverse aortic constriction (TAC) surgery was used to construct the HFrEF mouse model. The differential expression of metabolites in the myocardium of HFpEF and HFrEF mice was detected by untargeted metabolomics (UHPLC-QE-MS). Variable importance in projection>1 and P<0.05 were used as criteria to screen and classify the differentially expressed metabolites between the mice models. KEGG functional enrichment and pathway impact analysis demonstrated significantly altered metabolic pathways in both HFpEF and HFrEF mice. Results: One hundred and nine differentially expressed metabolites were detected in HFpEF mice, and 270 differentially expressed metabolites were detected in HFrEF mice. Compared with the control group, the most significantly changed metabolite in HFpEF mice was glycerophospholipids, while HFrEF mice presented with the largest proportion of carboxylic acids and their derivatives. KEGG enrichment and pathway impact analysis showed that the differentially expressed metabolites in HFpEF mice were mainly enriched in pathways such as biosynthesis of unsaturated fatty acids, ether lipid metabolism, amino sugar and nucleotide sugar metabolism, glycerophospholipid metabolism, arachidonic acid metabolism and arginine and proline metabolism. The differentially expressed metabolites in HFrEF mice were mainly enriched in arginine and proline metabolism, glycine, serine and threonine metabolism, pantothenate and CoA biosynthesis, glycerophospholipid metabolism, nicotinate and nicotinamide metabolism and arachidonic acid metabolism, etc. Conclusions: HFpEF mice have a significantly different myocardial metabolite expression profile compared with HFrEF mice. In addition, biosynthesis of unsaturated fatty acids, arachidonic acid metabolism, glycerophospholipid metabolism and arginine and proline metabolism are significantly altered in both HFpEF and HFrEF mice, suggesting that these metabolic pathways may play an important role in disease progression in both types of heart failure.
		                        		
		                        		
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Heart Failure/metabolism*
		                        			;
		                        		
		                        			Stroke Volume
		                        			;
		                        		
		                        			Chromatography, Liquid
		                        			;
		                        		
		                        			Tandem Mass Spectrometry
		                        			;
		                        		
		                        			Metabolomics
		                        			;
		                        		
		                        			Arachidonic Acids
		                        			;
		                        		
		                        			Proline
		                        			
		                        		
		                        	
4.Acupuncture for lumbar myofascial pain syndrome: systematic review and Meta-analysis.
Ran ZHANG ; Sheng-Yue WEN ; Hong-Sheng ZHAN ; Xun LIN ; Min ZHANG ; Jian PANG ; Yue-Long CAO ; Bo CHEN
Chinese Acupuncture & Moxibustion 2023;43(11):1324-1332
		                        		
		                        			
		                        			This study systematically reviewed the clinical efficacy of acupuncture for lumbar myofascial pain syndrome. The randomized controlled trials (RCTs) regarding acupuncture for lumbar myofascial pain syndrome were searched in PubMed, Cochrane Library, Web of Science, EMbase, Scopus, China national knowledge infrastructure (CNKI), Wanfang database, VIP database, and China biomedical literature service system (SinoMed) from database inception until August 1st, 2022. The Cochrane's risk of bias assessment tool was used to assess the risk of bias in all included studies, and Review Manager 5.3 software was used for statistical analysis of the extracted data. As a result, 12 RCTs, involving 1 087 patients with lumbar myofascial pain syndrome, were ultimately included. The Meta-analysis results showed that the visual analog scale (VAS) score of pain in the observation group was lower than those in the oral non-steroidal anti-inflammatory medication control [SMD=-1.67, 95%CI (-2.44, -0.90), Z=4.26, P<0.000 1] and other treatment control [low-frequency electrical stimulation, tuina, electromagnetic wave irradiation combined with piroxicam gel, SMD=-1.98, 95%CI (-2.48, -1.48), Z=7.74, P<0.000 01]. The pain rating index (PRI) score in the observation group was lower than those in the lidocaine injection control [MD=-2.17, 95%CI (-3.41, -0.93), Z=3.44, P=0.000 6] and other treatment control [low-frequency electrical stimulation, tuina, MD=-5.75, 95%CI (-9.97, -1.53), Z=2.67, P=0.008]. The present pain intensity (PPI) score in the observation group was lower than that in other treatment control [low-frequency electrical stimulation, tuina, MD=-1.04, 95%CI (-1.55, -0.53), Z=4.01, P<0.000 1]. In conclusion, compared with oral non-steroidal anti-inflammatory medication, low-frequency electrical stimulation, tuina, and electromagnetic wave irradiation combined with piroxicam gel, acupuncture is more effective in reducing pain in patients with lumbar myofascial pain syndrome; acupuncture also exhibites advantage over lidocaine injection in improving PRI score and showed better outcomes over tuina and low-frequency electrical stimulation in improving PRI and PPI scores.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Piroxicam
		                        			;
		                        		
		                        			Acupuncture Therapy/methods*
		                        			;
		                        		
		                        			Pain
		                        			;
		                        		
		                        			Myofascial Pain Syndromes/therapy*
		                        			;
		                        		
		                        			Anti-Inflammatory Agents, Non-Steroidal/therapeutic use*
		                        			;
		                        		
		                        			Lidocaine
		                        			
		                        		
		                        	
5.Relevant thoughts on development of traditional Chinese medicine industry in new era.
Ju HUANG ; Geng LI ; Xiao-Xiao ZHANG ; Yong MA ; Zhi-Lai ZHAN ; Wei-An YUAN ; Li-Ping QU ; Shi-Yao HUANG ; Bo LI ; Bo-Hua YAN ; Wen-Yuan LI ; Li LIU ; Zhi-Lei WANG ; Yi FENG ; Lei ZHANG ; Jian-Yuan TANG
China Journal of Chinese Materia Medica 2022;47(17):4799-4813
		                        		
		                        			
		                        			Since the 18th National Congress of the Communist Party of China(CPC), the CPC and the government have highligh-ted the development of traditional Chinese Medicine(TCM) and issued a series of policies, such as the Plan for Protection and Deve-lopment of Chinese Medicinal Materials(2015-2020) forwarded by the General Office of the State Council in 2015, the Plan for Healthy Development of Traditional Chinese Medicine(2015-2020) released by the General Office of the State Council in the same year, the Healthy China 2030 Plan published by the CPC Central Committee and the State Council in 2016, the Law of the People's Republic of China on Traditional Chinese Medicine which took effect on July 2017, On the Preservation and Innovative Development of Traditional Chinese Medicine promulgated by CPC Central Committee and the State Council in 2019, and Plan for the Development of Traditional Chinese Medicine during the 14th Five-Year Plan Period of China released by the General Office of the State Council in March 2022, to promote the development of the TCM industry, which have brought historical opportunities to the TCM industry. However, TCM industry faces various challenges in the development. In terms of drug development in TCM, the current studies mainly focused on the chemical research and technical requests, which neglected TCM characteristics and cased in conformity between new drug transformation of TCM and clinical practice. Therefore, a more considerable and profound authoritative guideline is needed, and innovative thought and research are necessary for academics and the industry. Through the investigation of the development TCM industry in recent years, this study summarized the policies on and trends of Chinese medicinal materials, new drug development in TCM, catalogue of national basic drugs, and national basic health insurance, and proposed suggestions for further development of TCM industry.
		                        		
		                        		
		                        		
		                        			China
		                        			;
		                        		
		                        			Drugs, Chinese Herbal
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Industry
		                        			;
		                        		
		                        			Medicine, Chinese Traditional
		                        			;
		                        		
		                        			Policy
		                        			
		                        		
		                        	
6.Alterations in the transmural gradient of ventricular repolarization with different pacing sites in normal and heart failure canines.
Tao WANG ; Zhan-Qi PANG ; Xue-Qi LIN ; Bo-Wen SONG ; Zhuo-Ran LI ; Shi-Jun LI ; Yun-Long XIA
Acta Physiologica Sinica 2020;72(4):419-425
		                        		
		                        			
		                        			Alterations of the transmural gradient of repolarization may contribute to the increase of transmural dispersion of repolarization and ventricular arrhythmias. The transmural gradient of repolarization may play an important role in sudden death associated with left ventricular epicardial pacing. To investigate the changes of transmural gradient dispersion of ventricular repolarization with different pacing sites in heart failure (HF) canines, 8 mongrel dogs were randomized into healthy group and HF group (n = 4). We mapped the monophasic action potential duration (MAPD) in the subendocardial, subepicardial and mid-myocardial layers of the left ventricle (LV) in canines of healthy and HF groups during right atrium (RA) pacing, right ventricular apical endocardial (RV) pacing, left ventricular lateral epicardial (LV) pacing and biventricular (Biv) pacing respectively. The results showed that in the healthy group, the MAPDs were significantly different among the three layers during RA pacing (all P < 0.05). The MAPD was longer in the mid-myocardial layer compared with those in the subepicardial and subendocardial layers during RV, LV or Biv pacing (P < 0.05). However, there was no significant difference in MAPD between the subendocardial and subepicardial layers during RV, LV or Biv pacing (P > 0.05). In the HF group, the MAPDs in all three layers were prolonged compared with those in the same locations in the healthy group (all P < 0.05). However, there were no differences in MAPD among the three layers during RA, RV, LV or Biv pacing (all P > 0.05). By MAP recording with our new mapping electrode, we found a transmural MAPD gradient among the three layers of the LV during RA pacing and the gradient between the subendocardial and subepicardial layers vanished during RV, LV or Biv pacing in healthy dogs. In contrast, there was no transmural MAPD gradient during RA, RV, LV or Biv pacing in HF dogs. These results are helpful to understand the mechanism of ventricular arrhythmias in patients with HF.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Arrhythmias, Cardiac
		                        			;
		                        		
		                        			Dogs
		                        			;
		                        		
		                        			Heart
		                        			;
		                        		
		                        			Heart Failure
		                        			;
		                        		
		                        			Heart Ventricles
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Myocardium
		                        			
		                        		
		                        	
7.Comparison of clinical and immunological features between clinically amyopathic dermatomyositis and typical dermatomyositis.
Yu Zhou GAN ; Yu Hui LI ; Li Hua ZHANG ; Lin MA ; Wen Wen HE ; Yue Bo JIN ; Yuan AN ; Zhan Guo LI ; Hua YE
Journal of Peking University(Health Sciences) 2020;52(6):1001-1008
		                        		
		                        			OBJECTIVE:
		                        			To study the differences between clinically amyopathic dermatomyositis (CADM) and typical dermatomyositis (DM) on clinical and immunological features.
		                        		
		                        			METHODS:
		                        			By collecting clinical data of 106 CADM patients and 158 DM patients from January 2010 to June 2019 in the department of Rheumatology and Immunology, Peking University People's Hospital, the clinical characteristics and immunological features in the two groups were compared, and the distribution characters and the clinical meanings of myositis autoantibodies were discussed in the two groups respectively. Myositis autoantibodies were measured by immunoblotting according to the manufacturers' instructions.
		                        		
		                        			RESULTS:
		                        			In the aspects of clinical manifestations, CADM presented more with onset of interstial lung diseases (ILD) compared with DM (20.7% vs. 7.6%, P=0.002), and CADM-ILD was more likely to be acute ILD (58.3% vs. 26%, P < 0.001), and there were no differences between CADM and DM in cutaneous manifestations, accompanied with connective tissue disease (CTD) and malignancy. In CADM, the positive rate of rheumatoid factors and antinuclear antibodies was lower in DM. The most common myositis specific autoantibodies (MSAs) in CADM were anti-MDA5 (36%), anti-PL-7 (11.2%) and anti-TIF-1γ (10.1%). The most common MSAs in DM were anti-Jo-1 (19.2%), anti-TIF-1γ (11.5%) and anti-MDA5 (11.5%). Anti-MDA5 was correlated with acute ILD and skin ulceration both in CADM and DM; in CADM, skin ulceration was not associated with the titer of anti-MDA5; while in DM, skin ulceration was associated with high titer of anti-MDA5. In DM, anti-TIF-1γ was correlated with heliotrope eruption, V/shawl neck sign, perionychia erythma and malignancy, and higher rate of malignancy was seen in all titers of the anti-TIF-1γ positive patients. In CADM, anti-TIF1-γ showed no correlation with clinical manifestations. The most common myositis associated autoantibody was anti-Ro-52 both in CADM and DM. In CADM, anti-Ro-52 was associated with Raynaud's phenomenon and chronic ILD, while in DM, anti-Ro-52 was associated with mechanic's hands, noninfectious fever and accompanied CTD.
		                        		
		                        			CONCLUSION
		                        			Compared with DM, ILD is more likely to be acute in CADM. It is different between CADM and DM about the distribution of myositis autoantibodies and the clinical significance of the same myositis antibody, and the clinical significance of some myositis antibodies is related to titers.
		                        		
		                        		
		                        		
		                        			Autoantibodies
		                        			;
		                        		
		                        			Dermatomyositis/complications*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lung Diseases, Interstitial
		                        			;
		                        		
		                        			Neoplasms
		                        			
		                        		
		                        	
8.Antioxidant and Anti-inflammatory Capacity of Ferulic Acid Released from Wheat Bran by Solid-state Fermentation of Aspergillus niger.
Zhi Na YIN ; Wen Jia WU ; Chong Zhen SUN ; Hui Fan LIU ; Wen Bo CHEN ; Qi Ping ZHAN ; Zhuo Gui LEI ; Xuan XIN ; Juan Juan MA ; Kun YAO ; Tian MIN ; Meng Meng ZHANG ; Hui WU
Biomedical and Environmental Sciences 2019;32(1):11-21
		                        		
		                        			OBJECTIVE:
		                        			A strain of Aspergillus niger (A. niger), capable of releasing bound phenolic acids from wheat bran, was isolated. This strain was identified by gene sequence identification. The antioxidant and anti-inflammatory capacity of ferulic acid released from wheat bran by this A. niger strain (FA-WB) were evaluated.
		                        		
		                        			METHODS:
		                        			Molecular identification techniques based on PCR analysis of specific genomic sequences were conducted; antioxidant ability was examined using oxygen radical absorbance capacity (ORAC), cellular antioxidant activity (CAA) assays, and erythrocyte hemolysis assays. RAW264.7 cells were used as a model to detect anti-inflammatory activity.
		                        		
		                        			RESULTS:
		                        			The filamentous fungal isolate was identified to be A. niger. ORAC and CAA assay showed that FA-WB had better antioxidant activity than that of the ferulic acid standard. The erythrocyte hemolysis assay results suggested that FA-WB could attenuate AAPH-induced oxidative stress through inhibition of reactive oxy gen species (ROS) generation. FA-WB could significantly restore the AAPH-induced increase in intracellular antioxidant enzyme activities to normal levels as well as inhibit the intracellular malondialdehyde formation. TNF-a, IL-6, and NO levels indicated that FA-WB can inhibit the inflammation induced by lipopolysaccharide (LPS).
		                        		
		                        			CONCLUSION
		                        			Ferulic acid released from wheat bran by a new strain of A. niger had good anti-inflammatory activity and better antioxidant ability than standard ferulic acid.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Anti-Inflammatory Agents
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			pharmacology
		                        			;
		                        		
		                        			Antioxidants
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			pharmacology
		                        			;
		                        		
		                        			Aspergillus niger
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			isolation & purification
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Coumaric Acids
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			pharmacology
		                        			;
		                        		
		                        			DNA, Fungal
		                        			;
		                        		
		                        			analysis
		                        			;
		                        		
		                        			Dietary Fiber
		                        			;
		                        		
		                        			microbiology
		                        			;
		                        		
		                        			Erythrocytes
		                        			;
		                        		
		                        			drug effects
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Fermentation
		                        			;
		                        		
		                        			Hep G2 Cells
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Interleukin-6
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Lipopolysaccharides
		                        			;
		                        		
		                        			pharmacology
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			RAW 264.7 Cells
		                        			;
		                        		
		                        			Sheep
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha
		                        			;
		                        		
		                        			metabolism
		                        			
		                        		
		                        	
9.Influence of cow's milk protein allergy on the diagnosis of functional gastrointestinal diseases based on the Rome IV standard in infants and young children.
Bo-Wen FENG ; Si-Mao FU ; Quan-Shan ZHANG ; Xiao-Ling LONG ; Xiao-Ling XIE ; Wei REN ; Zhan-Tu LIANG ; Zhu-Ling YANG ; Ang CHEN
Chinese Journal of Contemporary Pediatrics 2018;20(1):56-59
OBJECTIVETo study the influence of cow's milk protein allergy (CMPA) on the diagnosis of functional gastrointestinal diseases (FGID) based on the Rome IV standard in infants and young children.
METHODSA total of 84 children aged 1 month to 3 years who were diagnosed with CMPA were enrolled as the case group, and 84 infants and young children who underwent physical examination and had no CMPA were enrolled as the control group. The pediatricians specializing in gastroenterology asked parents using a questionnaire for the diagnosis of FGID based on the Rome IV standard to assess clinical symptoms and to diagnose FGID.
RESULTSThe case group had a significantly higher incidence rate of a family history of allergies than the control group (P<0.05). In the case group, 38 (45%) met the Rome IV standard for the diagnosis of FGID, while in the control group, 13 (15%) met this standard (P<0.05). According to the Rome IV standard for FGID, the case group had significantly higher diagnostic rates of reflex, functional diarrhea, difficult defecation, and functional constipation than the control group (P<0.05). The children who were diagnosed with FIGD in the control group were given conventional treatment, and those in the case group were asked to avoid the intake of cow's milk protein in addition to the conventional treatment. After 3 months of treatment, the case group had a significantly higher response rate to the treatment than the control group (P<0.05).
CONCLUSIONSIn infants and young children, CMPA has great influence on the diagnosis of FGID based on the Rome IV standard. The possibility of CMPA should be considered during the diagnosis of FGID.
10.Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture.
Rong-Jie BAI ; Hui-Bo ZHANG ; Hui-Li ZHAN ; Zhan-Hua QIAN ; Nai-Li WANG ; Yue LIU ; Wen-Ting LI ; Yu-Ming YIN
Chinese Medical Journal 2018;131(9):1051-1058
BackgroundHand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities.
MethodsSixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed.
ResultsThe normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons.
ConclusionsSports injury-related fingers and thumb deformity are relatively common. MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the fingers and thumb. It is a useful tool for accurate diagnosis of the sports-related ligaments and tendons injuries in hand.
Adult ; Athletic Injuries ; diagnosis ; surgery ; Female ; Hand Deformities ; diagnosis ; surgery ; Humans ; Ligaments ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Male ; Metacarpophalangeal Joint ; diagnostic imaging ; surgery ; Middle Aged ; Soft Tissue Injuries ; diagnostic imaging ; surgery ; Tendon Injuries ; diagnostic imaging ; surgery ; Thumb ; abnormalities ; surgery
            
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