Chinese Hand Research Articles

Genotype F of Echovirus 25 with multiple recombination pattern have been persistently and extensively circulating in Chinese mainland

Echovirus 25 (E25), a member of the Enterovirus B (EV-B) species, can cause aseptic meningitis (AM), viral meningitis (VM), and acute flaccid paralysis (AFP). However, systematic studies on the molecular epidemiology of E25, especially those concerning its evolution and recombination, are lacking. In this study, 18 strains of E25, isolated from seven provinces of China between 2009 and 2018, were collected based on the Chinese hand, foot, and mouth disease (HFMD) surveillance network, and 95 sequences downloaded from GenBank were also screened. Based on the phylogenetic analysis of 113 full-length VP1 sequences worldwide, globally occurring E25 strains were classified into 9 genotypes (A–I), and genotype F was the dominant genotype in the Chinese mainland. The average nucleotide substitution rate of E25 was 6.08 × 10–3 substitutions/site/year, and six important transmission routes were identified worldwide. Seventeen recombination patterns were determined, of which genotype F can be divided into 9 recombination patterns. A positive selector site was found in the capsid protein region of genotype F. Recombination analysis and pressure selection analysis for genotype F showed multiple recombination patterns and evolution characteristics, which may be responsible for it being the dominant genotype in the Chinese mainland. This study provides a theoretical basis for the subsequent prevention and control of E25.

A Tale of Two Dependencies: European Strategic Autonomy in the Field of Energy

The concept of European strategic autonomy (ESA) in the energy field gained particular traction after the Russian invasion of Ukraine showed the extent and risks of fossil energy dependency on autocratic regimes. Fossil dependency on undemocratic and unstable petrostates is a critical weakness that increase the European Union’s (EUs) vulnerability and limit its capacity to act. This liability stretches beyond the dependency on Russia since the EU imports from many other countries that are undemocratic and heavily reliant on oil and gas revenues. Increasing new sources of renewable energy helps to address this issue, but also brings new dependencies, namely on critical raw materials (CRMs) whose value chains are largely in Chinese hands. This paper argues that the EU should nevertheless continue to reduce its fossil dependencies on petrostates and consider more pro-actively how to manage the energy relationship with them. Simultaneously, in the area of CRMs it needs to expand its partnerships, recycling capacities and research and development (R&D) into diversification into alternative materials for green energy technologies. European strategic autonomy, energy, energy security, economic security, EU, fossil fuels, petrostates critical raw materials

Representing tradition: The construction of culturally-specific visual narratives in Chinese picture books and hand scroll paintings

The picture book plays a fundamental role in the intellectual and social development of young children. While the simplest of picture books offer an accessible entry-point into basic literacy through the combination of printed word and an image of its referent, picture books in narrative form constitute a significant instrument of socialisation, as a source of both overt and covert ‘ideological’ messages about the world and about social values. This study establishes a referenceable method and framework for identifying the extent to which a given picture book produced for consumption within the Chinese market utilizes pictorial and narratological strategies that are understood to be historically accurate within - and emblematic of – Chinese society’s ideologies and cultural traditions. Ten recently-published picture books for children, each produced by ethnically Chinese authors and widely distributed in the Chinese market are scrutinized using quantitative, qualitative, semiotic and mediaanalysis methodologies. Historic Chinese hand scroll paintings are presented as a useful point of comparison with these picture books, insofar as they provide an enduring example of culturally-specific pictorial conventions of composition, character depictions and interrelations, narrative context and the interplay of text and image. Drawing upon Clare Painter, Martin and Unsworth’s influential work on visual narratives and the Multimodel Discourse Analysis approach, a basic grammar of Chinese visual narratives is established, with conclusions drawn regarding how these inform contemporary picture books for Chinese children.

A Matter of Moral Justice: Black Women Laundry Workers and the Fight for Justice

A Matter of Moral Justice: Black Women Laundry Workers and the Fight for Justice

The Man without a Country: British Imperial Nostalgia in <i>Ferry to Hong Kong</i> (1959)

On New Year’s Eve 1959, Ferry to Hong Kong was screened at the Lee Theatre and the Astor in Hong Kong. Produced by Rank as its first CinemaScope feature, the big-budget movie tells the real-life tale of Steven Ragan (he was also known as Michael Patrick O’Brien), a stateless drifter who was stuck for ten months on the ferry sailing between Hong Kong and Macau from September 18, 1952, to July 30, 1953. The British film was Rank’s major Anglo-American joint venture of the year. Positioned within Cold War contexts, Ferry to Hong Kong could be seen as a British cultural-diplomatic response through cinematic soft power to reestablish national assurance on Asian Cold War fronts, following the 1956 Suez Canal debacle that witnessed the death of Britain’s imperial might at the hands of the Eisenhower administration. Unlike such vaunted Hollywood pictures as Soldier of Fortune (1955), Love Is a Many-Splendored Thing (1955), and The World of Suzie Wong (1960), which imagined the incursions of American white knights into Hong Kong (as a stand-in for China), Ferry to Hong Kong conveyed imperial nostalgia and loss. The film turns the antihero into a paragon of British gallantry who saves the passengers and refugees from the hands of Chinese (Communist) pirates. The sinking ferryboat is the traumatic device used to recall British naval war stories and retell romantic and narcissistic tales of British valor and international influence. More than an adventure of a vagabond, Ferry to Hong Kong was an espionage thriller in uneasy disguise. The film preceded Gilbert’s three James Bond films, all of which affirmed the power of the individual in cracking transboundary networks of espionage and political intrigue.

Chinese team invent fast and accurate hand gesture algo

Chinese team invent fast and accurate hand gesture algo

Sinicization, cross-cultural adjustment and reliability and validity test of the Burnt Hand Outcome Tool

Objective: To introduce the Burnt Hand Outcome Tool (BHOT) into China to conduct sinicization, cross-cultural debugging, and test the reliability and validity, thus provide a reference for the evaluation of treatment effect and making of medical decisions of hand burn patients. Methods: The cross-sectional research was conducted. After obtaining the authorization of the original author, the Brislin translation mode was used to literally translate, synthesize, back-translate, and be checked by experts to form the Chinese version of BHOT (C-BHOT) 2. Ten experts in the field of burn rescue and treatment were invited by purpose sampling method to conduct cross-cultural debugging to form C-BHOT 3. A total of 21 hand burn patients who were treated in General Hospital of Ningxia Medical University from January to March 2020 and conformed to the inclusion criteria were selected by accidental sampling method for pre-testing. Then the final version of C-BHOT 4 was formed. Hospitalized patients who met the selection criteria were recruited using accidental sampling, multi-site and cross-regional survey method from May 2020 to March 2021 in General Hospital of Ningxia Medical University, the First Affiliated Hospital of Air Force Medical University, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), and the First Affiliated Hospital of Nanchang University. The survey was performed with the general information questionnaire and C-BHOT 4. Critical ratio method and correlation coefficient method were used for item analysis, Cronbach's α coefficient test tool was used to test internal consistency, test-retest reliability was used to judge the stability of the tool, content validity index analysis tool was used to analyze the content validity, and exploratory factor analysis was used to test the validity of the structure. Data were statistically analyzed with independent sample t test or Pearson correlation analysis. Results: After the sinicization, cross-cultural debugging, and pre-testing, C-BHOT 4 was formed with a total of 20 items. All items were adjusted to positive scoring, and 7 modifications were made on the basis of the original tool. A total of 353 questionnaires were issued in the formal survey, and 344 valid questionnaires were returned, with an effective response rate of 97.45%. In the 344 patients, there were more male patients (297 patients) than female patients (47 patients), with ages of 23 to 57 years. The critical ratios of each item in the item analysis ranged from 5.48 to 12.59 (P<0.05). There were statistically significant differences in the scores between patients in high-score group and low-score group (t=-10.72--2.84, P<0.05 or P<0.01). There was significant positive relationship among the scores of each two items and between scores of each item and the overall tool score (r=0.68-0.71, 0.47-0.63, P<0.05 or P<0.01). In reliability test, the Cronbach's α coefficient of the whole tool was 0.837, and the test-retest reliability was 0.702-0.793. In validity test, the content validity index of whole tool was 0.923. The exploratory factor analysis extracted 3 common factors, and the cumulative variance contribution rate was 76.162%. The comparative fit index in the confirmatory factor analysis was 0.924. Conclusions: After the BHOT tool being sinicized, cross-culturally debugged, pre-tested, and tested for reliability and validity, it was verified that C-BHOT 4 has good reliability and validity in assessing the outcome of Chinese hand burn patients, and therefore can be used as an effective tool for the evaluation.

The Application of Digital Design Combined with 3D Printing Technology in Skin Flap Transplantation for Fingertip Defects during the COVID-19 Epidemic.

Objective We aimed to evaluate the advantages of preoperative digital design of skin flaps to repair fingertip defects during the COVID-19 pandemic. We combined digital design with a 3D-printed model of the affected finger for preoperative communication with fingertip defect patients under observation in a buffer ward. Methods From December 2019 to January 2021, we obtained data from 25 cases of 30 fingertip defects in 15 males and 10 females, aged 20-65 years old (mean 35 ± 5 years). All cases were treated by digitally designing preoperative fingertip defect flaps combined with a 3D-printed model. Preoperative 3D Systems Sense scanning was routinely performed, 3-matic 12.0 was used to measure the fingertip defect area ranging from 1.5 cm × 3.5 cm to 2.0 cm × 5.0 cm, and the skin flap was designed. The flap area was 1.6 cm × 3.6 cm to 2.1 cm × 5.1 cm. CURA 15.02.1 was used to set parameters, and the 3D model of the affected finger was printed prior to the operation. Full-thickness skin grafts were taken from donor areas for repair. Results No vascular crises occurred in any of the 25 cases, and all flaps survived. The postoperative follow-up occurred over 3-12 months. All patients were evaluated 3 months after operation according to the trial standard of hand function evaluation of the Chinese Hand Surgery Society. The results showed that 20 cases had excellent outcomes (80%), four cases had good outcomes (16%), and one case had a fair outcome (4%). The excellent and good rate was 96%. Conclusions During the COVID-19 epidemic, fingertip defects were treated with preoperative digital design of fingertip defect flaps combined with 3D printing. Precision design saves surgery time and improves the success rate of surgery and the survival rates of skin flaps. In addition, 3D model simulations improve preoperative communication efficiency, and the personalized design improves patient satisfaction.

Clinical application of the technology of supercharging and making flap in Yamano area I type II replantation of broken finger

Objective To investigate the clinical efficacy of the use of the technology of supercharging and making flap on Yamano area I type II replantation of broken finger. Methods From January, 2016 to June, 2018, 15 cases (16 fingers) of type II replantation of severed fingers in Yamano area I were treated. During the operation, 2 arteries in the severed fingers were anastomosed and supercharged outside the arteries. Bone fragments in the severed fingers were removed to make them flaps. The blood supply and long-term healing of replanted finger were observed after routine treatment including antiinfection, anticoagulation and antispasm in outpatient follow-up. Results Sixteen fingers of replantation of severed fingers survived smoothly. Followed-up for 6-12 months showed that there were no deformities in the surviving finger, good nail growth, full abdomen and recovery of pain and temperature. The static 2-PD was 7-9 mm. According to the Evaluation Criteria of Replantation Function of Severed Finger of Chinese Medical Association Hand Surgery Society, 13 fingers were excellent and 3 fingers were good. Conclusion In the replantation of Yamano area I type II amputated finger, high survival rate and good healing effect can be achieved by using the technology of supercharging and making flap. Key words: Replantation of broken finger; Yamano I area; Supercharging; Making flap

중국식 숫자 손 제스처 인식을 위해 개선된 다단 형판 정합

한 손으로 10가지 제스처를 표현하는 중국식 한 손 숫자 제스처는 중국에서 자주 사용되는 의사소통 수단이다. 한 손만 사용하기 때문에 5, 6가지 제스처 인식을 위해 제안된 기존 방법들은 제약이 있어 문헌상 보고된 인식률도 91.15%로 저조하다. 이를 위해 제시된 다단 형판 정합 방법에서 제기된 문제점을 개선하기 위해, 손 영역 검출과 손바닥 영역 검출을 수정하고 Major/Minor 그룹 분류 기준에 손바닥 넓이를 추가한다. 끝으로 Minor 그룹 내에서 클래스 7과 10을 분류하기 위해 HoG 정합을 대안으로 제시한다. 크기, 방향, 조명이 다양한 2000개 손 제스처 영상에 대해 성능 검증을 실시한 결과 제안하는 방법은 최종적으로 93.65%의 인식률을 기록한다.

Some Research Notes on Sutra of the Twelve [-year] Travel [of the Buddha] (十二遊經)

There are over a dozen translations of biographies of the Buddha in the Chinese Buddhist canon, the Shi’er you jing being one of them. Scholarly attention to some aspects of this text started over a hundred years ago, but basic issues such as its provenance and the connection between its contents and other early Chinese Buddhist translations need serious critical review. As a preliminary attempt, this paper first combs through all the information regarding this text in the traditional Chinese bibliographies and finds that the text had always been considered by traditional Chinese Buddhist bibliographers to be an authentic translation, although the information presented by Fei Zhangfang’s catalogue is confusing, if not mistaken. By analyzing other Chinese-written works which either quoted from or referred to this text the same conclusion is arrived, which means that various Chinese masters had too taken the text as a genuine translation. The paper next highlights some of the obvious issues surrounding this text and makes some research notes on the main points of the major episodes of the early life of Śākyamuni Buddha. It specially focuses on the Origin Story of the Śākya clan, the Bodhisattva’s descending from heaven, Siddhartha’s wives, early ministry career of the Buddha and the ending part of the text of which a missing part was identified in the Jingü yixiang. Finally the paper selectively identifies a couple of writing issues that might betray its mixed identity as a translated text. The tentative conclusion the paper reached is that this text might have been a hybrid apocrypha, containing something genuinely foreign and organized probably by a Chinese hand. It is hoped that this paper will serve to pave the way for future, more detailed studies, since such problem as how much the Buddha’s early preaching overlapping with the Buddhist texts available in China by the time this text appeared needs more efforts and bigger scale than this short paper could offer.

The (Unequal) Relationship between Hong Kong’s Waters and China’s Baselines

This article aims to clarify the legal relationship between Hong Kong’s maritime areas and China’s baseline system by conducting an historical inquiry into how the current status quo was reached and considering the implications for Hong Kong’s future development. China’s well-known position is that the treaties granting authority to the British in Hong Kong, including the ninety-nine year lease of the New Territories, were ‘unequal’ and therefore invalid so that sovereignty over the land and waters of Hong Kong never left Chinese hands and this position would be recognized and remedied at the appropriate time. As the Hong Kong experience illustrates, when territory is surrendered or leased, rights and claims are altered and sometimes extended. The historical evolution of those rights and claims therefore impacts on current territorial relationships. The example of Hong Kong may additionally serve as a reference point for modern day lease arrangements concerning coastal territory made outside the colonial context.

Dynamic Sign Language Recognition Based on Video Sequence With BLSTM-3D Residual Networks

Sign language recognition aims to recognize meaningful movements of hand gestures and is a significant solution in intelligent communication between the deaf community and hearing societies. However, until now, the current dynamic sign language recognition methods still have some drawbacks with difficulties of recognizing complex hand gestures, low recognition accuracy for most dynamic sign language recognition, and potential problems in larger video sequence data training. In order to solve these issues, this paper presents a multimodal dynamic sign language recognition method based on a deep 3-dimensional residual ConvNet and bi-directional LSTM networks, which is named as BLSTM-3D residual network (B3D ResNet). This method consists of three main parts. First, the hand object is localized in the video frames in order to reduce the time and space complexity of network calculation. Then, the B3D ResNet automatically extracts the spatiotemporal features from the video sequences and establishes an intermediate score corresponding to each action in the video sequence after feature analysis. Finally, by classifying the video sequences, the dynamic sign language is accurately identified. The experiment is conducted on test datasets, including DEVISIGN_D dataset and SLR_Dataset. The results show that the proposed method can obtain state-of-the-art recognition accuracy (89.8% on the DEVISIGN_D dataset and 86.9% on SLR_Dataset). In addition, the B3D ResNet can effectively recognize complex hand gestures through larger video sequence data, and obtain high recognition accuracy for 500 vocabularies from Chinese hand sign language.

Находки раннего ручного огнестрельного оружия из Южной Сибири

Purpose. This article is aimed at identifying early samples of hand firearms at different Siberian territories (Buriatia, the Upper Ob region). Such facts open new perspectives for studying and reconstructing the process of development and distribution of hand firearms in Northern Asia and helps identify regional peculiarities of this historic phenomenon. Results. One of the earliest firearms found on the territory of Southern Siberia is a bronze barrel of a Chinese hand firearms discovered in the valley of the Dzhida River in Buriatia, which refers to the Ming Epoch (the Yongle period). Judging by a serial number of the gun (50138), it was manufactured at the early period of mass production of hand firearms in China, i. e. in the first quarter of the 15th century. Currently, it is one of the earliest foreign samples of oriental firearms known in Siberia. In the Upper Ob region (in the surroundings of the Biysk Fortress (Ostrog), there was another tube of an early hand firearms found. It is of Russian origin and dates the second half of the 16th – beginning of the 17th century. These samples of Siberian firearms are archaic, which demonstrates a trend of using archaic weapons up to the beginning of the 18th century in the absence or lack of modern firearms. It is quite vividly demonstrated by the materials of the artillery treasure of the Umrevinsky Ostrog (1703). Conclusion. The buffer location of Southern Siberia between the growing territories of the Tsardom of Muscovy and Ming China starting from the 1500s A.D. determined the presence of foreign hand firearms of different origin. As evidenced by written sources, they were numerous on the territories where armed conflicts took place and defensive fortifications (Ostrogs) were subsequently constructed.

Microsurgical repair of ring avulsion injuries

Objective To investigate the clinical effect of microsurgical repair after ring avulsion injuries. Methods From March, 2009 to December, 2014, 6 cases (6 fingers) of ring avulsion injury were repaired. There were 4 males and 2 females with an age range of 18-30(mean, 22) years, which were 4 cases of ring finger and 2 cases of middle finger. The plane of injury was metacarpophalangeal band. Fracture and dislocation was reduced and fixed if damage fingers following with fracture and dislocation of interphalangeae. The damage ligament and volar plate and extensor tendon was repaired. The digital arteries and veins were repaired, and the digital nerves were sutured. System rehabilitation exercise carried out postoperatively. Results All fingers survived, and were followed-up for 8 to 30 months. The appearance of the fingers was excellent. The avarege range of motion of the proximal interphalangeal was 80°(ranged from 70° to 100°). The distal interphalangeal was 50° (ranged from 40° to 60°). The sensory recovery of finger pulp ranged from S3 to S3+. The two-point discrimination was 5 mm to 12 mm. According to the Evaluation Criteria for Finger Replantation and Reconstruction Issued by Chinese Hand Surgery of Chinese Mdical Association, 4 fingers had excellent while 2 had fairly good function. Conclusion Microsurgical repair of ring avulsion injury can achieve satisfactory clinical results by rehabilitation exercises postoperatively. Key words: Fingers; Ring avulsion injury; Repair; Microsurgical technique

Hallux-nail flap with distal phalanx combined with iliac bone for reconstruction of thumb with III degree defect

Objective To explore the clinical effect of using hallux-nail flap with the distal part of phalanx combined with iliac bone for reconstruction of thumb with III degree defect. Methods From June, 2011 to June, 2016, 7 patients with thumb III degree defect were treated with the hallux-nail flaps with distal phalanx combined with iliac bone to reconstruct thumbs. According to the thumb defect indexing method reported by Cheng Guoliang, the type 1 of thumb III degree defect was 4 cases, and the type 2 of III degree defect was 3 cases. The donor site was covered with skin grafting in 1 case, free superficial iliac artery graft in 5 cases and free peroneal artery perforator flap in 1 case. All patients kept the number and length of donor toes. Regular follow-up was performed after operation to observe the function, shape, feeling of finger reconstruction, the survival condition of flaps or skin graft in donor site, etc. It was also observed if the pain by walking actually exists in the long-term effect. Results All of the reconstructed thumbs survived. One patient suffered the necrotic in the donor site repaired by superficial iliac artery flap, which was successfully covered with the skin graft. All patients were followed-up from 3 months to 18 months (mean, 8 months). The reconstructed thumb with smooth nail had fine textile and good elasticity, good flexion and extension function of the palm, fingers and the metacarpophalangeal joint. The donor sites recovered with fine texture, and there were no difficulties in walking and running and no complaint about the pain and discomfort. According to the Trial Criteria of Upper Limb Functional Evaluation of Chinese Medical Association Hand Surgery Society, 5 cases resulted in excellent, and 2 cases resulted in good. Conclusion The hallux-nail flap with the distal phalanx combined with iliac bone is an excellent option to reconstruct thumb with III degree defect with the outcome of good function and appearance. The trauma of the donor site is small and the number and length of the toes are remained. The clinical effect is good. Key words: Thumb defect; Hallux-nail flap; Reconstruction; Microsurgery

Effectiveness of Chinese Hand Massage on Anxiety Among Patients Awaiting Coronary Angiography: A Randomized Controlled Trial.

Anxiety is the most common negative emotion among the patients awaiting coronary angiography. The increased anxiety may exacerbate coronary heart disease symptoms and possibly contribute to complications during the procedure. Chinese hand massage is a nonpharmaceutical intervention that has been used in several clinical situations in China and might have beneficial effects on reducing anxiety before coronary angiography. The aim of this study was to evaluate the effectiveness and safety of Chinese hand massage care on anxiety among patients awaiting coronary angiography. One hundred eighty-five subjects awaiting coronary angiography in a single hospital in Fuzhou, China, between May 2012 and September 2012 were screened. One hundred eligible participants were recruited and randomly assigned into the control or Chinese hand massage group. The control group received the conventional therapies and care according to the guidelines, and those in the Chinese hand massage group received additional Chinese hand massage care in conjunction with the same conventional therapies and care as the control group. The anxiety scores (evaluated by using the Hamilton Anxiety Rating Scale), heart rate, blood pressure, quality of life (Short-Form Health Survey), and the adverse events were recorded at the baseline and after coronary angiography, respectively. The scores of Hamilton Anxiety Rating Scale in the Chinese hand massage group (11.78 [SD, 2.9]) had a statistically significant decrease compared with those in the control group (15.96 [SD, 3.4]) at post-procedure (P < .01). There was no statistically significant difference on blood pressure, heart rate, and Short-Form Health Survey at postangiography between the Chinese hand massage group and the control group. No adverse event was reported during the intervention period. Chinese hand massage effectively alleviated anxiety without any adverse effects among patients awaiting coronary angiography. Therefore, it might be recommended as a nonpharmacological nursing intervention. However, future study with a larger sample size is needed to further confirm the efficacy of Chinese hand massage intervention.

Sensate M-shaped digital artery flap for repairing fingertip defect caused by degloving injury in children

Objective To investigate the clinical outcomes of M-shaped digital artery flap with nerve coaptation for treatment of fingertip degloving injury in children. Methods From March 2013 to March 2014, 9 pediatric cases of fingertip degloving injury were treated with M-shaped digital artery flap. The size of the flaps ranged from 3.0 cm×1.0 cm to 3.5 cm×1.2 cm. The dorsal cutaneous nerve inside the flap was coapted to the digital nerve on one side to restore sensation of the fingertip. Results All 9 flaps survived completely. The patients were follow-up for 6 to 14 months. The color, texture and contour of the flaps were good. Two-point discrimination was 6.0 to 9.0 mm on the flap. Joint movement of the fingers was normal. According to the upper limb functional assessment criteria issued by the Chinese Hand Surgery Society, the results were rated as excellent in 7 fingers and good in 2 fingers. No contracture complication occurred at the donor site. Conclusion The surgical procedure of M-shaped digital artery flap transfer is simple. The nerve coaptation makes it a sensate flap. It is an ideal method to treat fingertip degloving injuries. Key words: Finger injuries; Surgical flaps; Child

Application of regulating pre- and post-load of the blood vessel in small joint transplantation

Objective To explore the clinical application of regulating the pre- and post-load of the blood vessel in small joint transplantation. Methods Four cases of metacarpophalangeal joint defects and 2 cases of proximal interphalangeal joint defects were treated with free transplantation of the second toe metatarsophalangeal joint and proximal interphalangeal joint, respectively. The conventional end-to-end anastomosis of perforators was modified to collateral anastomosis, end-to-side anastomosis, and inset anastomosis. The pressure within the free tissue was balanced by the regulation of the arterial perfusion volume and venous return flow. Results All 6 transplants of small joint free transplantation survived. Tenolysis was done in 3 cases 3 months postoperatively. All the cases were follow-up for 3 to 16 months, the average being 6 months. Range of motion of the metacarpophalangeal joint was 75° to 85°of flexion and -10° to 0° of dorsiflexion: 4.5 points based on the upper limb functional assessment criteria issued by the Chinese Hand Surgery Society. Range of motion of the interphalangeal joint was 65° to 75°of flexion and -15°to 0° of dorsiflexion: 3.1 points. The appearance of the fingers was satisfactory, while the thumb opposition function was good. Conclusion Regulating the pre- and post-load of the blood vessel can improve the survival rate of small joint free transplantation. Key words: Finger joint; Treatment outcome; Pre- and post-load of blood vessels; Toe joint transplantation

Finger pulp reconstruction with innervated reverse digital artery flap through bilateral neurorrhaphy

Objective To investigate the clinical outcomes of finger pulp reconstruction with innervated reverse digital artery flap with the sensory nerve branches through bilateral neurorrhaphy. Methods From April 2014 to March 2015, innervated reverse digital artery flaps with the sensory branches of proper digital nerves were transferred to repair pulp defects of 17 fingers in 15 patients. The flap was designed at the lateral aspect of the proximal phalanx. Two branches of the proper digital nerve that projected towards the flap were included in the flap. After flap inset, these two branches were coapted with the stumps of the bilateral proper digital nerves. Results All the flaps and skin grafts survived uneventfully. These cases were follow-up for 7 to 11 months. The reconstructed pulps had good appearance and supple texture. There was no flap bulkiness or pigmentation. The involved fingers recovered normal active motion. The pain and temperature sensation were recovered in all the flaps. Static two-point discrimination value was 5 to 8 mm, while the average Semmes-Weinstein monofilament score was 3.22 to 3.84. The average Cold Intolerance Severity Score(CISS) was 23 (range, 11 to 44), with 15 patients corresponded to mild cold intolerance and 2 patients corresponded to moderate cold intolerance. According to the upper limb functional assessment criteria issued by the Chinese Hand Surgery Society, the results were rated as excellent in 14 fingers, good in 2 fingers, and fair in 1 finger. Conclusion Satisfactory appearance and sensation of finger pulp can be restored by transferring innervated reverse digital artery island flap with bilateral neurorrhaphy to the branches of the proper digital nerves. Key words: Surgical flaps; Finger injuries; Treatment outcome; Neurorrhaphy