Ankle sprains are orthopedic clinical common disease, accounting for joint ligament sprain of the first place. If treatment is not timely or appropriate, the joint pain and instability maybe develop, and even bone arthritis maybe develop. The mechanism of injury of ankle joint, anatomical basis has been fully study at present, and the diagnostic problem is very clear. Along with the development of science and technology, biological modeling and three-dimensional finite element, three-dimensional motion capture system,digital technology study, electromyographic signal study were used for the basic research of sprain of ankle. Biomechanical and kinematic study of ankle sprain has received adequate attention, combined with the mechanism research of ankle sprain,and to explore the the biomechanics and kinematics research progress of the sprain of ankle joint.
Ankle Injuries ; physiopathology ; Ankle Joint ; physiopathology ; Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Sprains and Strains ; physiopathology

Chemotherapy, molecular targeted therapy, and hormonal therapy are essential components of medical oncology. Al-though cancer patients significantly benefit from the emergence of various new anticancer drugs, none of these treatments can directly address drug resistance. Radiation therapy is one of the three conventional cancer treatment methods. Nearly two-thirds of cancer pa-tients accept radiation therapy during treatment. However, radiation resistance is a significant barrier affecting the therapeutic effect of this procedure. Epithelial–mesenchymal transition (EMT) is a biologic process that enables a polarized epithelial cell to undergo multi-ple biochemical changes. These changes enable the cell to assume the functions of a mesenchymal cell phenotype. These functions have been extensively studied and are related to embryogenesis, tumor invasiveness, and metastasis. In recent years, increasing evidence sug-gests that EMT is closely linked with tumor treatment resistance. The study of the relation between EMT and tumor treatment resistance is expected to contribute to the prevention of drug resistance and radiation resistance and thus improve treatment efficacy to provide benefit to cancer patients. This article explores this issue.

Objective To understand the incidence and related risk factors of healthcare-associated infection(HAI)in neu-rological patients with cerebrovascular diseases.Methods The occurrence and risk factors of HAI in patients with cerebro-vascular diseases in a hospital between Jan and December 2013 were investigated and analyzed.Results Of 3 573 investiga-ted patients,214 had HAI,the incidence of HAI was 5.99%;the main infection site was respiratory tract (54.67%),fol-lowed by urinary tract (25.23%).Univariate analysis revealed that age,length of hospitalization,disturbance of conscious-ness,chronic obstructive pulmonary disease,diabetes mellitus,invasive procedures,application of antacids,and antimicro-bial prophylaxis were all related to the occurrence of HAI (P<0.05).Multivariate logistic regression analysis revealed that disturbance of consciousness,old age,invasive procedures,chronic obstructive pulmonary disease,and diabetes mellitus were independent risk factors for the occurrence of HAI (all P <0.05).Conclusion The incidence of HAI is high in hospitalized patients of the neurology department,there are multiple risk factors associated with HAI,it is necessary to take corresponding interventions for reducing the incidence of HAI.

Objective To investigate the relationship of plasma homocysteine and the polymorphism of MTHFR gene with ischemic stroke in type 2 diabetes. Methods Serum Hcy ,folic acid and the polymorphism of MTHFR gene were compared among 81 T2DM patients with brain infarction (T2DM+BI) and 325 T2DM patients without brain infarction (T2DM ). Results All the genotypes of T2DM group and T2DM+BI group followed the hardy‐weinberg law. There was no significant difference in the frequency of mutant alleles (T) in site 677 of MTHFR gene and in frequency of TT genotype between the groups of T2DM and T2DM + BI (64.15% vs 60.15% and 42.5% vs 34.5% ,P > 0.05 ). The concentration of Hcy was significantly higher in patients with TT genotype than with CC genotype (14.4 ± 7.86) vs (10.58 ± 3.37)mmol/L(P<0.01). Conclusion There is no correlation between polymorphism of MTHFR gene and stroke in T2DM patients. The mutation of MTHFR C677T is associated with hyperhomocysteinemia.

Objective To compare the treatment effects of catheter directed thrombolysis and thrombetomy for acute ar?terial ischemia of the lower extremity. Methods Patients who visited Tianjin Medical University General Hospital from 2011 to 2013 and were attacked by acute ischemic disease of lower extremities within 3 days (n=66) were investigated. Thrombetomy and thrombolysis treatment had been performed to 32 cases and 34 cases respectively according to patients’ own willingness. Postoperative symptom remission rate, limb salvage rate, fatality rate, reperfusion injury rate (including re?nal inadequacy, heart failure, muscle fascia compartment syndrome), bleeding rate and limb dysfunction rate were compared between these two groups. Results There was no statistical difference on the rate of symptom remission (93.8% vs 94.1%), limb salvage(96.9%vs 100%), case fatality rate(3.1%vs 0), bleeding rate(0 vs 8.8%)and limb dysfunction rate (0 vs 5.9%)between these two groups. However, the incidence of reperfusion injury was higher in the group of thrombectomy (37.5%vs 2.9%, P<0.05)compared to that of the other group. Conclusion Similar effect of treatment and less reperfusion injury, especially renal injury, had been achieved by CDT compared with thrombetomy.

Objective To investigate the etiology of the nosocomial infection and immune function changes anus and anal after operation.Methods 130 patients who needed anus and anal canal surgery were recruited in the study.The clinical data were recor-ded and postoperative nosocomial infection data were observed,including infection type,distribution,pathogenic analysis and im-mune function.Results A total of 67 cases of nosocomial infection occured,the infection rate was 51.5% (67/130),the main types of infection were perineal wound infection,abdominal infections and pelvic infections,urinary tract and vaginal infections were rare. 93 isolates were collected,of which gram-negative bacilli accounted for 67.7% (63/93 ),including bacteroides fragilis (21.5%), Escherichia coli (18.3%),Pseudomonas aeruginosa (10.8%);Gram-positive bacteria accounted for 23.7% (30/93 ),including Staphylococcus aureus(17.2%),Staphylococcus epidermidis(6.5%);5 fungi were isolated accounting for 5.4%,other strains ac-counted for 3.2%.All the immune parameters detected in patients with postoperative nosocomial infection were statistically differ-ent from those before infection(P <0.05)except for IgM(P >0.05).Conclusion The incidence of nosocomial infection was rela-tively high in patients who had anus and anal canal surgery,which could serious affect the patients'outcomes,preventive and control measures should be taken in clinical practice.

ObjectiveTo explore the content of isorhynchophylline in different medicinal parts of Ramulus Uncariae Cum Uncis.MethodsHPLC was adopted to determine 8 batches of different Ramulus Uncariae Cum Uncis of different origin and different medicinal parts. The Waters Symmetry C18 color(4.6 mm×250 mm, 5μm) was used with mobile phase of methanol -0.01 mol/L ammonium acetate buffer(pH 8.0)(60∶40), column temperature of 25℃ , 20μl sample volume, velocity of 1.0 ml/min, and detection wavelength of 246 nm. ResultsIsorhynchophylline can be detected in all 8 batchs of Ramulus Uncariae Cum Uncis in different regions, and different content were found among different origins. The content of isorhynchophylline in different parts of the same origin showed a decreasing sequence of the rhabd, stem with hook, stem without hook, and twig without hook and leaves.ConclusionMost of medicinal part of Ramulus Uncariae Cum Uncis contains isorhynchophylline, which provide a lab basis for exploring medicinal parts of this herbal medicine.

Objective To investigate the effect of different doses of dexmedetomidine on myocardial injury (in perioperative peri‐od) on cardiopulmonary bypass (CPB) in patients with rheumatic heart valve replacement surgery .Methods Patients undertook rheumatic heart valve replacement surgery with mitral stenosis were divided into three groups (n=20) in randomized and double‐blind method :control group (group C) ,dexmedetomidine 0 .3 μg/kg group (DEX1 group) ,dexmedetomidine 0 .6 μg/kg group (DEX2 group) .Central venous blood was drawn respectively before anesthesia induction (T0 ) ,2h after CPB (T1 ) ,24 h after CPB (T2 ) ,48 h after CPB (T3 ) ,72 h after CPB (T4 ) .Plasma muscle calcium protein I (cTnI) and creatine kinase (CreatineKinase MB , CK‐MB) were measured and mean arterial pressure and heart rate were recorded at each time point .Furthermore ,extubation time , ICU stay ,postoperative inotropic score 24 h after operation ,drainage 24 h after operation ,cardio auto‐resuscitation rates and ad‐verse cardiovascular events were recorded .Results Compared with T0 ,HR was significantly lower in the T1 time point in DEX2 group .Compared with group C ,HR ,plasma CK‐MB ,inotropic score 24 h after operation and cardiovascular adverse events was sig‐nificantly reduced in the T1 time points in DEX1 group (P<0 .05) ,but the heart auto‐resuscitation rate did not significantly im‐proved .HR at T1 ,plasma CK‐MB values at T1 and T2 ,and plasma cTnI values at T2 -T4 were significantly reduced ;the heart re‐suscitation significantly increased ,myocardial contraction power ratings 24 h after operation and the incidence of cardiovascular e‐vents was significantly lower in DEX2 group (P<0 .05) .The extubation time ,ICU stay time and drainage 24 h after operation did not change significantly in both groups .Conclusion Dexmedetomidine has a protective effect on perioperative myocardial injury in patients with rheumatic heart valve replacement surgery ,and the effect would be better when the dexmedetomidine was infused at 0 .6 μg · kg -1 · h-1 after a loading dose of 0 .6 μg/Kg continuously .

BACKGROUND:Adiponectin and periodontal disease are closely related with type 2 diabetes. OBJECTIVE:To detect the expression of adiponectin in periodontal tissue of Kunming mice of diabetes periodontitis, and explore the effects on periodontal tissue pathology and prognosis. METHODS:Sixty 3-week-old Kunming mice were divided into three groups according to the different modeling methods:control group (normal feeding), diabetes group (diabetic model was established by injection of al oxan), diabetes and periodontitis group (periodontitis model was established by local ligation and bacteria developed). Each group contained 20 rats. RESULTS AND CONCLUSION:At 20 days after modeling, the blood glucose, fasting insulin and insulin resistance index of mice in the diabetes group were higher than that in the control group (P<0.05). ELISA, RT-PCR and western blot analysis results showed that, adiponectin gene and protein expression levels in periodontal tissues were the highest in the control group, then in the diabetes group, and the lowest in the diabetes and periodontitis group, at 1, 3, 6, months postoperatively, respectively (P<0.05). The periodontal gum tissue inflammation and histopathological changes were observed at 1, 3, 6, months postoperatively. The results showed that, the inflammation in periodontal tissues was the most obvious in the diabetes and periodontitis group, and was visible in the diabetes group, but the inflammation was not present in the control group. Experimental findings indicate that, the down-regulation of adiponectin expression in the periodontal tissue is one of the important factors that trigger and aggravate the onset of periodontitis.

Objective To compare the clinical effects and influence on CA125,endometrial antibody of trip-torelin the treatment of endometriosis surgery endometriosis surgery,to provide reference for clinical treatment. Methods 60 patients with endometriosis surgery were randomly divided into 30 cases of I group and 30 cases of II group,I group was treated with mifepristone on the first days after menstruation 12.5mg/d,qd,II group was given triptorelin 3.75mg,every 28 days for 1 times,treated for 3 months,the symptoms and signs before and after treatment were observed,then menstruation and dysmenorrhea score were evaluated,Elbow vein blood was taken out for calculat-ing CA125 and serum antiendometrial antibody,the clinical efficacy were evaluated and the adverse reactions were observed,all patients were followed up for 1 years,then 1 years cumulative pregnancy rate were recorded.Results The CA125,EMab,menstrual score,dysmenorrhea score of I group and II group after the treatment were (18.2 ±2.8)U /mL and (8.8 ±3.2)U /mL,(405.2 ±141.1)pg/mL and (202.1 ±79.8)pg/mL,(18.85 ±6.32)score and (7.68 ± 4.19)score,(1.91 ±0.35)score and (0.95 ±0.63)score,all index of both group after treatment were significantly lower than those before treatment(t =8.433 and 14.824,7.659 and 14.578,20.772 and 26.286,15.853 and 19.513,P <0.01),all index of II group after treatment were significantly lower than those of I group(t =5.711, 6.632,6.675,5.624,all P <0.01).The total effective rate,pregnancy rate,recurrence rate of I group and II group were 96.67% and 93.33%,53.33% and 50%,3.33% and 6.67%,the difference were not statistically significant (P >0.05);the irregular vaginal bleeding rate of I group was 23.33%,the II group were 3.33%,χ2 =5.192,P <0.05.Conclusion Triptorelin and mifepristone has same clinical effect in endometriosis postoperative,but triptorelin can reduce more effectively the CA125 and anti endometrium antibody,abnormal vaginal bleeding and reduce dysmen-orrhea postoperative,postoperative recurrence rate and pregnancy rate is good,can be used as a recommended drugs in the treatment patients with endometriosis surgery.