Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Iron homeostasis is essential for normal physiological metabolism in the human body, and disorders of iron metabolism are associated with the development of several diseases. Ferroptosis is mainly manifested by the accumulation of intracellular iron and lipid peroxides, with the antioxidant system as its main defense mechanism. Current studies have demonstrated that ferroptosis is closely related to oxidative stress and male infertility, and inhibiting the accumulation of iron and lipid peroxides may be a potential strategy for the treatment of ferroptosis-associated male reproductive diseases. Recently, the study of ferroptosis, a novel cell death mode, and male reproductive disorders has attracted extensive attention and continuous exploration by scholars. Therefore, this article combines the latest research progress, mainly elaborates on the effect of ferroptosis on testicular spermatogenesis, from the mechanism of iron death, the role of ferroptosis in testicular function, the relationship with male infertility, and the potential therapeutic strategies for related male reproductive diseases, to expand the ideas for the prevention and treatment of male reproductive diseases.

Objective:To compare the efficacy of Kirschner wire fixation combined with Suture-Bridge technique and simple Kirschner wire fixation in the treatment of old lateral malleolar avulsion fractures under all-inside arthroscopy.Methods:A retrospective cohort study was conducted to analyze the clinical data of 56 patients with old lateral malleolar avulsion fractures, admitted at Xuzhou Central Hospital from January 2018 to June 2022, including 32 males (32 feet) and 24 females (24 feet), aged 19-57 years [(35.2±11.1)years]. Twenty-five patients were treated with Kirschner wire fixation under all-inside arthroscopy (K-wire group), while the other 31 patients were treated with Kirschner wire fixation combined with Suture-Bridge technique under all-inside arthroscopy (K-wire combined with suture group). The surgical time, incision healing at 2 weeks after surgery, and fracture healing rate at 6 months after surgery of the two groups were detected. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores, and foot and ankle ability measure (FAAM) scores [including activities of daily living (ADL) scores and sports function (S) scores] of the two groups were assessed before surgery, at 3, 6 months after surgery, and at the last follow-up. The anterior drawer test was performed at 3, 6 months after surgery and at the last follow-up. The time of return to sports after surgery and complication rates were also recorded.Results:All the patients were followed up for 12-18 months [(14.2±2.2)months]. The surgical time in the K-wire combined with suture group was (56.3±12.5)minutes, longer than (41.1±8.2)minutes in the K-wire group ( P<0.01). The incisions in both groups were healed by first intention at 2 weeks after surgery. In the K-wire combined with suture group, all the fractures were healed at 6 months after surgery (100%), while in the K-wire group 22 patients (88%) obtained fracture healing ( P<0.05). There were no statistically significant differences in the AOFAS ankle-hindfoot scores, FAAM-ADL scores, or FAAM-S scores between the two groups preoperatively ( P>0.05). At 3, 6 months after surgery, and at the last follow-up, the AOFAS ankle-hindfoot scores in the K-wire combined with suture group were (89.7±3.4)points, (92.8±2.8)points, and (94.9±3.3)points respectively, higher than (87.4±4.4)points, (90.4±4.1)points, and (92.5±4.6)points in the K-wire group ( P<0.05); the FAAM-ADL scores and the FAAM-S scores in the K-wire combined with suture group were (90.1±3.5)points, (91.5±2.9)points, (92.8±3.0)points and (91.4±5.4)points, (92.8±5.0)points, (94.4±4.8)points respectively, higher than (86.8±5.0)points, (88.7±3.8)points, (90.3±3.7)points and (88.0±5.3)points, (89.5±4.8)points, (91.5±5.2)points ( P<0.05 or 0.01). The AOFAS ankle-hindfoot scores, FAAM-ADL scores, and FAAM-S scores at all postoperative time points were higher than those preoperatively and increased with the passage of the follow-up time ( P<0.01). The results of the anterior drawer test at all postoperative time points in the two groups were negative. The time of return to sports after surgery in the K-wire combined with suture group was (9.2±1.3)weeks, shorter than (10.3±1.5)weeks in the K-wire group ( P<0.01). One patient (3.2%) in the K-wire combined with suture group and 3 patients (12.0%) in the K-wire group had Kirschner wire loosening and withdrawal ( P>0.05). Neither of the two groups developed complications such as nerve or tendon injuries. Conclusion:Compared with simple Kirschner wire fixation under all-inside arthroscopy, Kirschner wire fixation combined with Suture-Bridge technique under all-inside arthroscopy achieves higher fracture healing rate, more obvious improvement in life quality and ankle function, as well as earlier return to sports in the treatment of old lateral malleolar avulsion fractures.

Iron homeostasis is essential for normal physiological metabolism in the human body, and disorders of iron metabolism are associated with the development of several diseases. Ferroptosis is mainly manifested by the accumulation of intracellular iron and lipid peroxides, with the antioxidant system as its main defense mechanism. Current studies have demonstrated that ferroptosis is closely related to oxidative stress and male infertility, and inhibiting the accumulation of iron and lipid peroxides may be a potential strategy for the treatment of ferroptosis-associated male reproductive diseases. Recently, the study of ferroptosis, a novel cell death mode, and male reproductive disorders has attracted extensive attention and continuous exploration by scholars. Therefore, this article combines the latest research progress, mainly elaborates on the effect of ferroptosis on testicular spermatogenesis, from the mechanism of iron death, the role of ferroptosis in testicular function, the relationship with male infertility, and the potential therapeutic strategies for related male reproductive diseases, to expand the ideas for the prevention and treatment of male reproductive diseases.

Objective:To compare the clinical outcomes of internal fixation of McCrory-Bladin type III fracture of the lateral process of the talus (FLPT) with Kirschner wire Double-pully technique under subtalar arthroscopy and open reduction with Kirschner wire fixation.Methods:A retrospective cohort study was conducted to analyze the clinical data of 42 patients (42 feet) with McCrory-Bladin type III FLPT admitted to Xuzhou Central Hospital from May 2017 to May 2022, including 15 males (15 feet) and 27 females (27 feet); aged 18-55 years [(33.3±9.8)years]. Among them, 24 patients were treated with Kirschner wire Double-pully technique under subtalar arthroscopy (arthroscopy+Kirschner group), and 18 with open reduction and Kirschner wire fixation (open reduction+Kirschner group). The surgical duration, wound healing status, and assessment outcomes at 12 weeks, 12 months and the last follow-up, including American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) score, and Foot and Ankle Ability Measure (FAAM) [Activities of Daily Living (ADL) and Sports (S) subscores], were compared between the two groups, respectively. Complication rates were also compared at the last follow-up.Results:All the patients were followed up for 12-27 months [(17.6±4.9)months]. The surgical duration in the arthroscopy+Kirschner group [(53.7±11.8)minutes] was longer than that in the open reduction+Kirschner group [(43.9±7.2)minutes] ( P<0.05). Bone grafting was not required in either group and all incision healing was achieved by primary intention. At 12 weeks, 12 months and the last follow-up, the arthroscopy+Kirschner group had higher AOFAS ankle-hindfoot score [(91.3±4.4)points, (94.0±4.2)points, (94.7±4.5)points] compared with the open reduction+Kirschner group [(74.7±11.2)points, (77.9±12.0)points, (79.2±12.0)points] (all P<0.01); the arthroscopy+Kirschner group had higher PROMIS-PF score [(69.5±3.7)points, (71.6±3.3)points, (72.5±3.2)points] compared with the open reduction+Kirschner group [(61.7±6.7)points, (62.9±6.8)points, (63.3±7.0)points] (all P<0.01); the arthroscopy+Kirschner group had higher FAAM-ADL score [(89.8±3.8)points, (92.5±3.3)points, (93.2±3.4)points] compared with the open reduction+Kirschner group [(70.3±15.2)points, (72.1±15.2)points, (73.1±16.0)points] (all P<0.01); and the arthroscopy+ Kirschner group had higher FAAM-S score [(91.5±3.6)points, (94.4±3.6)points, (94.9±3.5)points] compared with the open reduction+Kirschner group [(76.9±15.0)points, (78.6±16.2)points, (79.0±16.0)points] (all P<0.01). Subtalar joint arthritis developed in 2 patients [8.3% (2/24)] in the arthroscopy+Kirschner group at the last follow-up, but in 6 [33.3% (6/18)] in the open reduction+Kirschner group ( P<0.05). No nerve injury was found in either group. Conclusion:For McCrory-Bladin type III FLPT, the Kirschner wire Double-pully technique under subtalar arthroscopy, despite longer surgical duration, results in better physical function, improved activities of daily living, enhanced ankle function, and a lower rate of subtalar joint arthritis compared with open reduction with Kirschner wire fixation.

Endometrial receptivity is key to clinical pregnancy by in vitro fertilization-embryo transfer(IVF-ET)technique.Endometrial thickness(EMT)is a major index for pregnancy monitoring,but the optimal time indicating endometrial receptivity is controversially uncertain.Multiple studies have demonstrated the correlation between EMT and IVF pregnancy outcomes and EMT of a moderate range is essential for good pregnancy outcomes and a thin endometrium produces negative pregnancy outcomes.In this paper,we reviewed the research on the im-pact of EMT on IVF-ET pregnancy outcomes in terms of timing of EMT measurement,clinical pregnancy rate,live birth rate,ectopic pregnancy rate,placenta praevia,and low birth weight,investigating the mechanism of occur-rence and treatment of thin endometrium so as to provide clinical references for improving IVF pregnancy outcomes.

Objective:To explore the quantitative analysis value of diffusion tensor imaging (DTI) for early changes of calf muscle in type 2 diabetes mellitus (T2DM) patients without peripheral ischemia.Methods:From September 2018 to March 2019, 20 male T2DM patients (age: 45-64 years) without peripheral ischemia and 20 matched male healthy controls (age: 46-62 years) who performed lower limb DTI in Wuxi Second Hospital Affiliated to Nanjing Medical University were prospectively analyzed. Fractional anisotropy (FA), apparent diffusion coefficient (ADC) and λ 1, λ 2, λ 3 values of medial head of gastrocnemius (GM), lateral head of gastrocnemius (GL), tibialis anterior(TA) and soleus muscles(SOL) were measured respectively. The differences of DTI diffusion characteristics between 2 groups were compared by using independent-sample t test, and the correlation between FA, ADC and body mass index (BMI), fasting blood glucose (FBG), hemoglobin A 1c (HbA1c), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglyceride (TG) were analyzed by Pearson correlation analysis. Results:The ADC of TA and SOL in T2DM group ((1.77±0.15) and (1.83±0.10)×10 -3 mm 2/s) was higher than that in control group ((1.66±0.11) and (1.75±0.16)×10 -3 mm 2/s); λ 1, λ 2, and λ 3 of TA in the T2DM group ((2.30±0.21), (1.63±0.17) and (1.38±0.13)×10 -3 mm 2/s) were higher than those in control group ((2.17±0.12), (1.51±0.13) and (1.31±0.12)×10 -3 mm 2/s); λ 2 and λ 3 of SOL were also higher than those in control group ((1.74±0.11) vs (1.64±0.18)×10 -3 mm 2/s and (1.53±0.12) vs (1.44±0.15)×10 -3 mm 2/s; t values: 2.65-3.91, all P<0.05). There were no significant correlations between FA, ADC and BMI, FBG, HbA1c, HDL, LDL and TG ( r values: from -0.15 to 0.08, all P>0.05). Conclusions:Quantitative parameters of DTI, especially ADC, can sensitively detect the microstructural changes of calf muscle in T2DM patients without peripheral ischemia. TA and SOL have high sensitivity to the diffusion of T2DM-related microstructural changes.

Objective To investigate the clinicopathological features of central nervous system hemangioblastoma in von Hippel-Lindau syndrome.Methods The data of 10 patients with central nervous system hemangioblastoma in our hospital since 2013 were analyzed retro-spectively,and the clinicopathological features of central nervous system hemangioblastoma in von Hippel-Lindau syndrome were summarized. Results The macroexamination result showed that most tumor lesions were found in the cerebellum and medulla oblongata,with cystic chan-ges,size from 1 cm to 5 cm,the average size was (3.1 ±0.2)cm,clear boundary,intracapsular yellow cyst fluid.The microscopy result showed tumor foci with a rich blood supply,endothelial cell proliferation and hypertrophy in vascular,which arranged in nests or lobulated mesenchymal cells,the cytoplasm of stromal cells was abundant and lightly stained,a rich lipid was seen,with vesicular or foam.Conclusion The von Hippel-Lindau syndrome is usually cystic lesion,the microscopic examination shows tumor foci with rich blood supply,endothelial cell proliferation,hypertrophy and other changes in vascular.

Objective To analyze the 2015 IAAF World Athletics Championships victim of disease type and composition,investigate medical emergency services for major international sporting events.Methods The 2015 IAAF World Athletics Championships in Medical Encounter Forms records in 737 cases during the game (2015-8-21 to 2015-8-30) were retrospectively reviewed and analyzed.Results Total of 737 patients during the match,trauma 259 cases (35.1％),respiratory diseases 196 cases (26.6％),digestive diseases 77 cases (10.4％),heat-related illnesses 41 cases (5.6％).Athletes 170 cases (23.1％),174 cases of staff (23.6％),139 cases of the IAAF family members (18.9％),136 cases of spectators (18.4％),members of the media 56 cases (7.6％).Conclusions 2015 IAAF World Athletics Championships type of disease the treatment of patients with the most common sports injury,followed by respiratory diseases and common diseases in summer heat-related illnesses.Clinic staff personnel structure the most common,followed by extended family members as well as the IAAF athletes and spectators.Major sports events should develop reasonable security programs for priority diseases and key customer base,and to ensure a smooth operation.