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.

Objective To investigate the prognostic value of serum adiponectin and fibroblast growth factor-23 (FGF23) levels in patients undergoing cardiac valve replacement. Methods A total of 98 patients undergoing heart valve replacement were selected as the study group. The patients in the study group were divided into good prognosis group (n=67) and poor prognosis group (n=31). A total of 90 healthy subjects were selected as control group. Spearman method was used to analyze the correlation of serum adiponectin and FGF23 levels with plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and Acute Physiology and Chronic Health EvaluationⅡ (APACHE Ⅱ) scores, respectively. Multivariate Logistic regression analysis was used to analyze the prognostic factors of patients with heart valve replacement. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum adiponectin and FGF23 levels in patients with heart valve replacement. Results Serum FGF23, NT-proBNP level and APACHEⅡ score in the study group were significantly higher, and serum adiponectin level was significantly lower than that in the control group (P < 0.05). The levels of serum FGF23, NT-proBNP and APACHE Ⅱ score in the poor prognosis group were significantly higher, and the serum adiponectin level was significantly lower than that in the good prognosis group (P < 0.05). Serum FGF23 level was positively correlated with NT-proBNP level and APACHE Ⅱ score (P < 0.05). Serum adiponectin level was negatively correlated with NT-proBNP level and APACHE Ⅱ score (P < 0.05). The levels of serum adiponectin, FGF23, NT-proBNP and APACHE Ⅱ score were the influencing factors for the prognosis of patients with heart valve replacement (P < 0.05). The area under the curve (AUC) of serum adiponectin and FGF23 for predicting the prognosis of patients undergoing cardiac valve replacement was 0.862 and 0.807, respectively, and the AUC of the combined prediction was 0.911. The AUC of combined prediction of adiponectin and FGF23 was higher than that of individual prediction (P < 0.05). Conclusion The combination of serum adiponectin and FGF23 has a good effect in predicting the prognosis of patients with heart valve replacement. Serum adiponectin and FGF23 are expected to be effective indicators for evaluating the prognosis of patients undergoing heart valve replacement.

Objective To observe the effect of transthoracic echocardiography (TTE) monitoring in percutaneous closure of patent foramen ovale (PFO). Methods The data of 98 patients with PFO were retrospectively analyzed. All patients underwent interventional plugging. They were divided into X-ray group (n=50) and TTE group (n=48) according to different intraoperative guidance methods. The occlusions, complications, surgical indexes, right-to-left shunt (RLS) grading and the improvement of headache in patients with migraine were compared between the two groups. Results A total of 98 cases of PFO were successfully occluded, among which 2 cases in the TTE group received transesophageal ultrasound guidance due to poor intraoperative sound window. The operation time of the TTE group was significantly longer than that of the X-ray group (P < 0.05). After operation, RLS rating and Headache Impact Test-6 (HIT-6) score of migraine patients in the two groups were significantly lower than those before operation (P < 0.05). Conclusion Simple TTE guided percutaneous PFO occlusion has a good improvement effect on RLS and migraine in PFO patients, and can avoid radiation damage caused by X-ray to doctors and patients.

Mechanical thrombectomy is a minimally invasive interventional method. Embolization device is too close to the blood vessel wall and venous valve in clinical applications, and it can cause blood vessel damage when it is sucked into the lumen. Embolization device is easy to cause hemolysis. Optimal design can reduce the damage to red blood cells, but it cannot be completely avoided; Shedding emboli can complicate the pulmonary artery. The clinical application studies of mechanical thrombectomy devices in the world was reviewed, including 74 experimental studies and 166 clinical application studies. The current status and causes of vascular injury, hemolysis and pulmonary embolism caused by mechanical thrombectomy were analyzed. This paper aims to make recommendations for the optimization of mechanical thrombectomy devices.

Objective To investigate the application of CT image and cone beam computed tomography (CBCT) image registration based on 3D Slicer software in image-guided radiotherapy for uterine cervical neoplasms. Methods Based on 3D Slicer software and Slicer RT toolkit, 10 positioning CT images and 50 CBCT images of 10 patients with uterine cervical neoplasms in Henan Provincial People's Hospital between January 2018 and October 2018 had rigid registration and b-spline deformation registration respectively. The dice similarity coefficient (DSC) and Hausdorff distance (HD) of the bladder, rectum, femoral head, spinal cord, and body of CT-CBCT images were compared by using paired t-test before and after the registration. Results Pre-registration, rigid registration and after b-spline deformation registration of CT images and CBCT images, the DSC in the bladder (0.459±0.177, 0.528±0.184, 0.542±0.187, respectively), the rectum (0.564±0.141, 0.632±0.091, 0.684±0.097, respectively), the femoral head (0.695±0.088, 0.833± 0.030, 0.865±0.027, respectively), the spinal cord (0.587±0.119, 0.746±0.085, 0.834±0.032, respectively) and the body surface (0.922±0.013, 0.948±0.011, 0.959±0.009, respectively) showed an increased trend; HD in the bladder (12.8±7.2, 12.2±7.1, 11.7±7.3, respectively), the rectum (5.0±1.8, 4.4±1.2, 3.4±1.2, respectively), the femoral head (3.6±1.2, 1.8±0.5, 1.5 ±0.5, respectively), the spinal cord (4.0 ±1.0, 2.7 ±1.3, 1.8 ±0.5, respectively) and the body surface (6.3±2.1, 5.2±2.0, 4.3±2.0, respectively) showed a decreased trend. The differences of pairwise comparison in the same parts were statistically significant (all P < 0.05). Conclusions Both rigid registration and b-spline deformation registration of CT-CBCT images based on 3D Slicer softwarecan improve the radiotherapy accuracy of uterine cervical neoplasms, and b-spline deformation registration has more significant advantages.

Objective To study the effect of thrombin on proliferation and invasion of esophageal cancer cell line Eca109, and to explore its possible mechanism. Methods The proliferation and invasion of Eca 109 cells treated with thrombin were detected by MTT and Transwell assay, respectively. The activity of matrix metalloproteinase 2 (MMP-2) and MMP-9 in the supernatant of Eca109 cells was detected by gelatin zymography. Reverse transcription polymerase chain reaction (PCR) and immunocytochemistry were used to study the mRNA expression of protease-activated receptor 1 (PAR-1), the important receptor of thrombin, and subcellular localization of PAR-1 protein in Eca109 cells, respectively. Results Thrombin could promote Eca109 cells proliferation in a dose-dependent manner. Cell proliferative rates of 0.5 U/ml and 1.0 U/ml thrombin were 34.38 % and 57.19 %, respectively (P< 0.05). Compared to that of control group, the number of Eca109 cells incubated with 1.0 U/ml thrombin invading through the basement membrane of Transwell was increased (303.33 ±6.66 vs. 116.33 ±11.51, P< 0.05). When treated with various concentrations of thrombin for 24 h, the activities of MMP-2 and MMP-9, especially MMP-9, in the supernatant of Eca109 cells were increased in a dose-dependent manner. Eca109 cells expressed PAR-1 mRNA, and PAR-1 protein was mainly located on the cellular membrane. Conclusion Thrombin increases proliferation and invasion of esophageal cancer Eca109 cells and enhances the activities of MMP-2 and MMP-9 in cells supernatant, which might be induced by activation of PAR-1 located on cellular membrane.