Objective To study the clinical value of color Doppler ultrasound in carotid endarterectomy ( CEA) .Methods Forty-five patients with CEA were examined and analyzed by TCD and CDFI.The position, range,character,diameter,stenosis rate were measured by CDFI and collateral flow by TCD before CEA.The intraop-erative CDFI was applied to confirm the flow and the flaps in carotid artery.TCD monitoring of middle cerebral blood flow in CEA to assess whether use shunt technique and cerebral hyper-perfusion.CDFI was applied to assess patency and intimal hyperplasia of carotid artery.Results Seventeen low echo plaques,twelve high echo plaques and sixteen hypoechogenicity echo plaques in forty-five patients with internal carotid stenosis were found by color Doppler ultra-sound.Blood flow volume increased significantly in the ispilateal internal carotid arteries and middle cerebral arteris after operation.Carotid artery restenosis was not found by color Doppler ultrasound after CEA.Conclusion Applica-tion of color Doppler in CEA is valuable in the diagnosis of internal carotid stenosis,intraoperative monitoring and in the evaluation of effect.

Acute lateral ankle sprains are the most common musculoskeletal injury of the lower limbs. Without timely intervention, the condition may progress to chronic ankle instability, leading to a series of adverse consequences. Therefore, accurate diagnosis, classification, and active intervention are essential. Currently, there are numerous diagnostic methods, classification criteria, and treatment methods for acute lateral ankle sprains in clinical practice, with some aspects still subject to debate. This article will provide an overview of the progress and controversial issue in diagnosis, classification, and treatment methods for acute lateral ankle sprains.

Objective To evaluate the clinical features and treatment of chronic granulomatous disease (CGD ) . Methods A total of 27 CGD patients diagnosed by neutrophil respiratory burst in Zhengzhou Children Hospital from January 2007 to June 2017 were selected .The clinical ,pathogenic and radiological characteristics were retrospectively analyzed ,and the treatment and prognosis were evaluated . Chi-square test was used for statistical analysis .Results Among the 27 cases ,all patients presented with pulmonary infection (27/27) and 55 .6％ had cutaneous infection (15/27) .Lymph node enlargement was presented in 48 .1％ (13/27) of patients .Eleven neonates and four infants had cutaneous infection ,which showed significant difference (χ2= 11 .408 , P < 0 .05 ) . The results of pathogenic detection revealed 66 .7％ (18/27) fungal infection ,25 .9％ (7/27) bacterial infection and 44 .4％ (12/27) mycobacterial infection .The incidence rate of fungal infection in neonates was significant higher than that of children (χ2 = 6 .075 , P < 0 .05) .Radiologic examination showed that 12 cases had calcification of subaxillary lymph nodes ,4 cases had pneumonia and thick-walled cavity ,13 cases had multiple nodules ,5 cases had massive high-density shadow and 4 cases had pulmonary abscess .The clinical pathogenic and radiologic features were similar between neonates and children .Treatment options included long-term combination therapy of bactericidal and fungicidal medicines .Conclusions Clinical manifestations of CGD are mainly pulmonary infection as well as cutaneous infection . Combination therapy with multiple medicines is effective .Hematopoietic stem cell transplatation plus retroviral vectors genetic therapy may be the trend of CGD treatment in the future .