To develop a novel polyamino acid-based nanohydrogel drug delivery system for dexamethasone to enhance its delivery efficiency to the inner ear.

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.

Objective:To investigate the clinical features, imaging characteristics, surgical strategies, and therapeutic outcomes of otitis media complicated with inflammatory response of local meninges.Methods:A retrospective analysis was conducted on the clinical data of 8 patients with chronic suppurative otitis media complicated with inflammatory response of local meninges, treated by the Department of Otolaryngology, Head and Neck Surgery, PLA General Hospital from 2019 to 2023. Appropriate surgical strategies were selected based on the patient′s clinical manifestations, imaging characteristics, extent of lesions, and facial nerve function. Follow-up was performed postoperatively to assess the therapeutic outcomes.Results:Among the eight patients, there were six males and two females, with an average age of (55.9±12.6) years old. The primary clinical manifestations included otorrhea, hearing loss, facial paralysis, earache, headache, and fever. All patients had a history of chronic suppurative otitis media and tympanic membrane perforation, with varying degrees and types of hearing loss. Seven patients presented with peripheral facial palsy preoperatively, with the House-Brackmann (H-B) grading scale as follows: 4 cases (4/7) in grade Ⅳ, 1 case (1/7) in grade Ⅴ, and 2 cases (2/7) in grade Ⅵ. The mean duration of otorrhea and/or hearing loss was (24.68±12.18) years, while, the average duration of severe headache, aggravated otorrhea and facial paralysis was (2.73±3.92) months. Preoperative high-resolution CT scan of the temporal bone revealed soft tissue shadow in the middle ear and mastoid process, with partial defects in the mastoid cortex. Cranial MRI T1WI showed high signal in the meninges on the affected side, with contrast-enhanced MRI indicating localized meningeal thickening. Four patients (4/8) had diabetes mellitus, and 2 patients (2/8) had a history of middle ear/mastoid surgery. All patients underwent surgical treatment, including thorough removal of lesions, adequate drainage, and facial nerve decompression. Tympanoplasty and hearing reconstruction were performed when conditions permitted. Specifically, 5 patients underwent intact canal wall radical mastoidectomy with facial nerve decompression and tympanoplasty, 2 patients underwent canal wall down mastoidectomy with facial nerve exploration decompression, and 1 patient underwent modified radical mastoidectomy. Postoperatively, patients experienced significant relief and gradual disappearance of ear and head pain. The postoperative H-B grading scale of facial nerve function was as follows: 4 cases in grade Ⅰ (4/8, including 1 case without preoperatively facial palsy), 2 cases (2/8) in grade Ⅱ, and 2 cases (2/8) in grade Ⅲ. Postoperative cranial MRI showed a significant reduction in localized meningeal thickening on the affected side.Conclusions:Patients with long-term chronic suppurative otitis media and/or cholesteatoma who suddenly presented with headache, fever, aggravated otorrhea, and facial paralysis should be suspected of having inflammatory response of local meninges. High-resolution CT of temporal bone and cranial MRI provide crucial diagnostic information. Early surgical exploration and thorough lesion removal are effective treatment methods.

Objective:To investigate the clinical features, imaging characteristics, surgical strategies, and therapeutic outcomes of otitis media complicated with inflammatory response of local meninges.Methods:A retrospective analysis was conducted on the clinical data of 8 patients with chronic suppurative otitis media complicated with inflammatory response of local meninges, treated by the Department of Otolaryngology, Head and Neck Surgery, PLA General Hospital from 2019 to 2023. Appropriate surgical strategies were selected based on the patient′s clinical manifestations, imaging characteristics, extent of lesions, and facial nerve function. Follow-up was performed postoperatively to assess the therapeutic outcomes.Results:Among the eight patients, there were six males and two females, with an average age of (55.9±12.6) years old. The primary clinical manifestations included otorrhea, hearing loss, facial paralysis, earache, headache, and fever. All patients had a history of chronic suppurative otitis media and tympanic membrane perforation, with varying degrees and types of hearing loss. Seven patients presented with peripheral facial palsy preoperatively, with the House-Brackmann (H-B) grading scale as follows: 4 cases (4/7) in grade Ⅳ, 1 case (1/7) in grade Ⅴ, and 2 cases (2/7) in grade Ⅵ. The mean duration of otorrhea and/or hearing loss was (24.68±12.18) years, while, the average duration of severe headache, aggravated otorrhea and facial paralysis was (2.73±3.92) months. Preoperative high-resolution CT scan of the temporal bone revealed soft tissue shadow in the middle ear and mastoid process, with partial defects in the mastoid cortex. Cranial MRI T1WI showed high signal in the meninges on the affected side, with contrast-enhanced MRI indicating localized meningeal thickening. Four patients (4/8) had diabetes mellitus, and 2 patients (2/8) had a history of middle ear/mastoid surgery. All patients underwent surgical treatment, including thorough removal of lesions, adequate drainage, and facial nerve decompression. Tympanoplasty and hearing reconstruction were performed when conditions permitted. Specifically, 5 patients underwent intact canal wall radical mastoidectomy with facial nerve decompression and tympanoplasty, 2 patients underwent canal wall down mastoidectomy with facial nerve exploration decompression, and 1 patient underwent modified radical mastoidectomy. Postoperatively, patients experienced significant relief and gradual disappearance of ear and head pain. The postoperative H-B grading scale of facial nerve function was as follows: 4 cases in grade Ⅰ (4/8, including 1 case without preoperatively facial palsy), 2 cases (2/8) in grade Ⅱ, and 2 cases (2/8) in grade Ⅲ. Postoperative cranial MRI showed a significant reduction in localized meningeal thickening on the affected side.Conclusions:Patients with long-term chronic suppurative otitis media and/or cholesteatoma who suddenly presented with headache, fever, aggravated otorrhea, and facial paralysis should be suspected of having inflammatory response of local meninges. High-resolution CT of temporal bone and cranial MRI provide crucial diagnostic information. Early surgical exploration and thorough lesion removal are effective treatment methods.

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.

Humans ; Urinary Bladder Neoplasms/pathology* ; Carcinoma, Transitional Cell/pathology* ; Genetic Markers ; Biomarkers, Tumor/genetics* ; Urothelium/pathology*

Objective:To compare the efficacy of different suture techniques under arthroscopy in rotator cuff injury.Methods:A retrospective analysis was performed on clinical data of 117 patients who received arthroscopic rotator cuff surgery from August 2020 to February 2023 in Department of Bone and Joint Surgery, Xuzhou Central Hospital, Jiangsu Province. According to different suture techniques, they were divided into single-row group (56 cases, single-row suture method) and double-row group (61 cases, double-row suture method). The perioperative indicators, surgical complications, shoulder range of motion, pain score (visual analogue scale, VAS), shoulder joint score (Constant-Murley score, CMS) and re-tear rate were compared between the two groups. Chi-square test was used for between-group comparison of enumeration data. Quantitative data that conforms to a normal distribution were represented as xˉ±s, and t-test or one-way ANOVA were used. LSD-t test was used for pairwise comparisons.Repeated measures analysis of variance was used to compare the range of motion, pain score, and CMS score of the shoulder joint before and after treatment. Results:The surgical time in single-row group (78.58±17.25) min was shorter than that in double-row group (88.14±18.51)min, and the difference was statistically significant ( t=2.88, P=0.005). After surgery, the ranges of motions of flexion, abduction and inward rotation of the body side of the two groups were increased gradually, and the ranges of motions in double-row group (anterior flexion: (89.67±6.93)° at 6 months postoperatively; (135.18±12.52)° at 12 months postoperatively), (abduction: (122.52±7.32)° at 6 months postoperatively; (160.87±8.31)° at 12 months postoperatively), (lateral internal rotation:(73.35±4.45)° at 6 months postoperatively; (80.82±6.27)° at 12 months postoperatively) were higher than those in single-row group (anterior flexion: (82.01±6.35)° at 6 months postoperatively; (125.21±10.41)° at 12 months postoperatively), (abduction: (115.23±6.84)° at 6 months postoperatively; (151.41±7.54)° at 12 months postoperatively), (lateral internal rotation: (68.32±4.21)° at 6 months postoperatively; (75.32±5.12)° at 12 months postoperatively), the differences were statistically significant (flexion: 6 months after surgery, t=6.37, 12 months after surgery, t=4.66; abduction: 6 months after surgery, t=5.68, 12 months after surgery, t=6.43; inward rotation: 6 months after surgery, t=6.41, 12 months after surgery, t=5.17; all P<0.001). The VAS score in the two groups was decreased significantly after surgery while the CMS was increased significantly, and there were statistically significant differences in double-row group (VAS: (3.53±0.74) points at 3 months postoperatively; (2.76±0.54) points at 6 months postoperatively; (1.87±0.38) points at 12 months postoperatively), (CMS: (66.06±5.52) points at 3 months postoperatively; (74.17±4.44) points at 6 months postoperatively; (83.87±4.38) points at 12 months postoperatively) at different time points after surgery compared to single-row group (VAS: (4.02±0.80) points at 3 months postoperatively; (2.99±0.58) points at 6 months postoperatively; (2.25±0.41) points at 12 months postoperatively), (CMS: (63.21±5.95) points at 3 months postoperatively; (71.69±4.63) points at 6 months postoperatively; (80.25±3.25) points at 12 months postoperatively), the differences were statistically significant (VAS: 3 months after surgery, t=3.44, 6 months after surgery, t=2.22, 12 months after surgery, t=5.20 ; CMS: 3 months after surgery, t=2.69, 6 months after surgery, t=2.96, 12 months after surgery, t=5.04; P values were <0.001, 0.028, <0.001,0.008, 0.004, and <0.001, respectively). The re-tear rate was significantly lower in double-row group (3.28%，2/61) than that in single-row group (14.29%，8/56), but there was no statistically significant difference between the two groups (adjusted χ2=3.23, P=0.070). Conclusion:Rotator cuff surgery can effectively restore shoulder function in patients with rotator cuff injury. Single-row suture method has simpler operation and shorter surgical time, but double-row suture method has a better fixation effect and is more conducive to prognosis.

Chronic atrophic gastritis (CAG) and gastric intestinal metaplasia (GIM) significantly increase the risk of gastric cancer. Blocking the development of CAG and GIM would help to decrease the incidence of gastric cancer. It was revealed that eradication of Helicobacter pylori could reverse gastric mucosa atrophy. Recent studies reported that GIM could be reversed to a certain extent. Clinical studies demonstrated that Lamb′s tripe extract and vitamin B12 capsule exhibited significant reversal effects on GIM. The present study systemically reviewed the diagnosis and treatment of CAG and clinical application of Lamb′s tripe extract and vitamin B12 capsule, and established the specialist instruction that would guide the reversal treatment of CAG and GIM.

Objective:To study the genotyping and regional distribution characteristics of Yersinia pestis by single nucleotide polymorphism (SNP) in Gansu Province. Methods:A total of 52 strains of Yersinia pestis isolated from Himalaya Marmot plague foci and Spermophilus alaschanicus plague foci in Gansu Province from 1962 to 2017 were selected for culture and extraction of DNA. The genomic DNA of Yersinia pestis was sequenced by the second generation of Illumina PE150 to identify the SNP sites. The species characteristics of Yersinia pestis in Gansu Province was determined by the Kimura-2-parameter model of neighbor joining of Mega 10.0 software based on the SNP sites. The molecular evolutionary tree of the groups was determined by Hasegawa-Kishino-Yano model of maximum likelihood method according to the SNP sites. Results:A total of 103 SNP sites were identified in 52 strains of Yersinia pestis in Gansu Province, including 28 intergenic loci, 43 non-synonymous mutations, 31 synonymous mutations and 1 nonsense mutation. The 52 strains of Yersinia pestis were divided into 2 biotypes and 3 groups, which were ancient type (1.IN2, 3.ANT) and medieval type (2.MED). Among them, 35 strains belonged to 1.IN2 group, 13 strains belonged to 3.ANT group, and 4 strains belonged to 2.MED group. The 1.IN2 group was further divided into 5 subgroups: the groups of Yuerhong Town and Dangchengwan Town in Subei County, the groups of Mati Town and Dahe Town in Sunan County, and the group of Xiahe County. The 3.ANT group was further divided into 2 subgroups: the groups of Hongliuwan Town in Aksay County and Machang in Dangchengwan Town of Subei County. Conclusion:The SNP method can be used to genotype Yersinia pestis from different plague foci in Gansu Province, which has certain regional characteristics.

Chronic atrophic gastritis (CAG) and gastric intestinal metaplasia (GIM) significantly increase the risk of gastric cancer. Blocking the development of CAG and GIM would help to decrease the incidence of gastric cancer. It was revealed that eradication of Helicobacter pylori could reverse gastric mucosa atrophy. Recent studies reported that GIM could also be reversed to a certain extent. Clinical studies demonstrated that Lamb’s tripe extract and vitamin B12 capsule exhibited significant reversal effect on GIM. The present study systemically reviewed the diagnosis and treatment of CAG and clinical application of Lamb’s tripe extract and vitamin B12 capsule, and established the specialist instruction that would guide the reversal treatment of CAG and GIM.