BACKGROUND:Chronic ankle instability affects normal life severely. Therefore, chronic ankle instability causes more and more attention of experts, and choice of reasonable and effective diagnosis and targeted treatment method for chronic ankle instability in early stage has become an important issue in the clinic.
OBJECTIVE:To review literature research on the diagnosis and treatment of chronic ankle instability in recent years, and to provide reference and evaluation criteria for the diagnosis and reasonable and effective treatment of chronic ankle instability in clinical practice.
METHODS:We searched PubMed database, China National Knowledge Infrastructure, Wanfang database and VIP database for clinical and basic experimental research on chronic ankle instability. Keywords were“chronic ankle, instability, diagnosis, rehabilitation exercises, surgery methods, research progress”in Chinese and“chronic ankle, instability, diagnosis, rehabilitation exercises, surgical methods, research”in English. Total y 40 literatures were analyzed.
RESULTS AND CONCLUSION:Because of the special anatomical features and biomechanical advantages of the ankle, we should first consider the early diagnosis and effective treatment in chronic ankle instability patients. The treatment should focus on the anatomic characteristics, biomechanic characteristics, etiology of chronic ankle and diagnostic methods of the ankle joint. Conservative treatment and rehabilitation exercises after surgery play a major role in the recovery of chronic ankle instability. The use of balance board, tilting board, and climbing machines is an effective rehabilitation exercises for chronic ankle instability. The application of AOFOS-hind foot and ankle fibula reaction time is important for the assessment of functional recovery of the ankle joint. The emergence of arthroscope is an important clinical research direction of ankle surgery. This plays a significant effect on the treatment of chronic ankle instability.

Objective:To investigate risk factors for early mortality (EM) in patients with newly diagnosed multiple myeloma (NDMM) and to build an EM-predictive model.Methods:In a cohort of 275 patients with NDMM, risk factors for EM at 6, 12, and 24 months after diagnosis (EM6, EM12, and EM24, respectively) were determined to establish a model to predict EM.Results:The rates of EM6, EM12, and EM24 were 5.5% , 12.7% , and 30.2% , respectively. The most common cause for EM was disease progression/relapse, accounting for 60.0% , 77.1% , and 84.3% of EM6, EM12, and EM24, respectively. EM6 was associated with corrected serum calcium >2.75 mmol/L and platelet count <100×10 9/L, whereas risk factors for EM12 included age >75 years, ISS Ⅲ, R-ISS Ⅲ, corrected serum calcium >2.75 mmol/L, serum creatinine >177 μmol/L, platelet count <100×10 9/L, and bone marrow plasma cell ratio ≥ 60% . In addition to the risk factors for EM12, EM24 was also associated with male sex and 1q21 gain. By multivariate analysis, age >75 years, platelet count <100×10 9/L, and 1q21 gain were independent risk factors for EM24 but there were no independent risk factors significantly associated with EM6 and EM12. Using a scoring system including these three risk factors, a Cox model for EM24 was generated to distinguish patients with low (score<3) and high (score ≥ 3) risk. The sensitivity and specificity of the model were 20.7% and 99.2% , respectively. Further, an internal validation performed in a cohort of 183 patients with NDMM revealed that the probability of EM24 in high-risk patients was 26 times higher than that in low-risk patients. Moreover, this model was also able to predict overall survival. The median overall survival of patients with scores of 0, 1, 2, 3, 4, and 5 were 59, 41, 22, 17.5, and 16 months, respectively. Conclusion:In the study cohort, the EM6, EM12, and EM24 rates were 5.5% , 12.7% , and 30.2% , respectively, and disease progression or relapse were main causes of EM. An EM24-predictive model built on three independent risk factors for EM24 (age>75 years, platelet count<100×10 9/L, and 1q21 gain) might predict EM risk and overall survival.