Ankle syndesmosis injury is one of the most common ankle fractures complicated with injury,but there is certain challenges with diagnosis and treatment.The treatment of lower tibia and fibula injury is the main surgical treatment,the key is anatomical reduction.Along with some new treatment methods,the treatment effect of the lower tibia and fibula screws has been questioned more and more,And there is still a controversy on whether the removal of the lower tibia and fibula screws.Now for the ankle syndesmosis injury treatment were summarized.

Objective:To evaluate the clinical application of human serum albumin in the inpatients in our hospital to promote its rational use. Methods:Totally 1 183 cases were selected from the inpatients treated with human serum albumin from January to De-cember in 2014, the clinical department, classification of diseases, age distribution and relevant concentration checks of serum albumin in the inpatients were analytically reviewed. Results: Totally 26 clinical departments were involved in the use of human serum albu-min,mainly in the digestive departments and ICU. The elderly patients aged above 65 years accounted for great proportion (47. 68%). In addition, all patients had relevant concentration checks of serum albumin. Conclusion:The patients with digestive diseases tend to have the largest consumption proportion of human serum albumin in our hospital. It is important for physicians to strictly follow the indi-cations of medication in using human serum albumin.

[Abstract ] Objective Numerous studies had shown that synaptic-associated proteins (SNAPs) were closely related to the occurrence and development of tumors .The aim of this study was to investigate the expression of synaptosomal-associated protein 47 (SNAP47) and its correlation with the clinicopathological features in non-small cell lung cancer(NSCLC). Methods The expres-sions of SNAP family (SNAP23, SNAP25, SNAP29 and SNAP47) were extracted and analyzed through the gene expression microarray and the cancer genome atlas ( TCGA) data-base.SNAP47 mRNA expression in 52 cases of lung adenocarcinoma and their correspond-ing normal tissues were detected by quantitative real-time PCR ( qRT-PCR) . Results Among 52 cases of lung adenocarcinoma , SNAP47 mRNA expression levels of 41 cases(78.9%) were significantly higher than the adjacent lung tissue (P<0.05).The mRNA level of SNAP47 was associated with lymph node invasion and advanced clinical patho-logical stage .The mRNA levels of SNAP47 of patients in II/III stage were significantly higher than those of I stage patients ( 6.558 ± 4.730 vs 2.718 ±2.370, P<0.05).The mRNA levels of N1+N2 were higher than those of N0 (6.609 ±4.942 vs 3.360 ±2.987,P<0.05). Conclusion The high specificity of SNAP47 expression in lung cancer tissues might be associated with the invasion and lymph node metastasis of NSCLC , which is the potential therapeutic target of lung cancer .

Objective To report a multi-center series of 600 consecutive cases of completely video-assisted thoracoscopic lobectomy with 3-year follow-up results. Methods Data from 600 consecutive patients who underwent attempts for thoracoscopic lobectomy between September 2006 and August 2010 in Peking University People's Hospital, Jiangsu Cancer Hospital and Beijing Haidian Hospital were collected. Of these, 315 males (52.5%) and 285 females (47.5%), the average age was ( 59.1 ± 12.6 ) years( 15 - 86 years). Perioperative variables were assessed using standard descriptive statistics and 3-year survival was estimated by Kaplan-Meier analyses. Results One hundred and nineteen cases were diagnosed as benign disease and 481 cases were malignancy. 68.9% (82/119) of the benign cases were chronic infectious disease and the majority of the malignancy was non-small cell lung cancer, especially adenocarcinomas which comprised 65.9% (317/481) of all malignancies.Fifty-four cases required conversion to thoracotomy with a conversion rate of 9%. Of the VATS accomplished group, the median operation time was 180 min(30 -40 min), median blood loss 200 ml( 10 - 1500 ml) . Benign surgery took significantly less time, had shorter drainage time and hospitalization time, and lower morbidity than that for malignancies ( P = 0.001, P ＜0.01, P = 0.004, P = 0.020, respectively). Non-small cell lung cancer patients had a 3 -year survival of 85.4%, and pathologic stage Ⅰ patients 91.2%. Conclusion This largest case series and the first report 3-year survival in China confirms that completely thoracoscopic lobectomy surgery we performed have reached short- and middle-term standards compared with that of the western country.

【Objective】 To investigate the effects of one-stage additional posterior pedicle screws （PPS） internal fixation on early Cage subsidence after oblique lateral interbody fusion （OLIF）. 【Methods】 We made a retrospective analysis of 118 patients with lumbar degenerative diseases treated with OLIF at the Department of Orthopedics， Sir Run Run Shaw Hospital， School of Medicine， Zhejiang University， from January 2016 to December 2019. We divided the patients into OLIF stand-alone group （58 ones） and OLIF with PPS fixation group （60 ones） according to the surgical procedure. All the patients had preoperative frontal and lateral radiographs of the lumbar spine， and CT and MR scans were performed. The clinical outcomes and reoperation rates of the two groups were compared at immediate postoperative follow-up and at 1， 3， 6 and 12 months. X-ray and CT examinations were performed to assess Cage subsidence in both groups at each postoperative follow-up. 【Results】 There was no statistical difference between the two groups in baseline data and surgical segmentation. Of the 118 patients with 141 discs who underwent OLIF surgery， 58 patients with 68 discs received OLIF stand-alone surgery and 60 ones with 73 discs received OLIF with PPS fixation. There were no significant differences in intraoperative bleeding， complications， or postoperative clinical outcomes between the two groups （P>0.05）， and the Cage subsidence rate was 22.4% in OLIF stand-alone group and 5% in OLIF with PPS fixation group， with significant difference between the two groups （P<0.01）. 【Conclusion】 Both OLIF stand-alone and OLIF additional PPS fixation can achieve good early clinical outcomes， and first-stage additional PPS fixation can significantly reduce the occurrence of Cage subsidence in the early postoperative period after OLIF.