Objective:To investigate whether deltoid ligament (DL) injury produces axial-plane rotational instability of the ankle in patients with chronic ankle instability (CAI).Methods:A retrospective study was conducted to analyze the 33 patients with CAI who had been treated at Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University between January 2023 and December 2024. The cohort consisted of 17 males and 16 females with an age of (31.5±9.9) years. The patients were assigned into 2 groups based on the presence of DL injury: a lateral chronic ankle instability (LCAI) group ( n=17) and a rotational ankle instability (RAI) group ( n=16). Barefoot natural walking trials were performed in all patients. Three-dimensional kinematic data were synchronously collected using an optical motion capture system (12 cameras) and force plates. A lower extremity model was constructed to obtain shank axial rotation (internal/external rotation) and rear-foot inversion/eversion angles. Continuous relative phase (CRP) analysis was employed to assess shank-rearfoot movement coupling. The mean absolute relative phase (MARP) and deviation phase (DP) were calculated. Results:There was no statistically significant difference in the clinical baseline data between the 2 groups, indicating comparability ( P>0.05). Throughout the gait cycle, no significant differences were found in shank rotation angles or rear-foot eversion angles between the RAI group and the LCAI group. However, CRP analysis revealed that during the early stance phase (initial contact and loading response), shank-rearfoot coupling was significantly lower in the RAI group than in the LCAI group. In the early stance phase, the CRP values in the RAI group were significantly higher than those in the LCAI group. The CRP curve changes in the RAI group were consistently higher in the standce phase of the entire gait cycle than those in the LCAI group, and the peak value of the CRP curve was larger in the RAI group. Concurrently, the RAI group exhibited significantly higher MARP and DP values than the LCAI group (27.48°±14.54° versus 15.21°±9.56°; 26.02°±11.73° versus 17.83°±9.82°) (both P<0.05). Conclusion:DL injury significantly damages the axial rotational stability of the ankle joint and significantly exacerbates the mechanical instability of the ankle joint in CAI patients.

Objective:To investigate whether deltoid ligament (DL) injury produces axial-plane rotational instability of the ankle in patients with chronic ankle instability (CAI).Methods:A retrospective study was conducted to analyze the 33 patients with CAI who had been treated at Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University between January 2023 and December 2024. The cohort consisted of 17 males and 16 females with an age of (31.5±9.9) years. The patients were assigned into 2 groups based on the presence of DL injury: a lateral chronic ankle instability (LCAI) group ( n=17) and a rotational ankle instability (RAI) group ( n=16). Barefoot natural walking trials were performed in all patients. Three-dimensional kinematic data were synchronously collected using an optical motion capture system (12 cameras) and force plates. A lower extremity model was constructed to obtain shank axial rotation (internal/external rotation) and rear-foot inversion/eversion angles. Continuous relative phase (CRP) analysis was employed to assess shank-rearfoot movement coupling. The mean absolute relative phase (MARP) and deviation phase (DP) were calculated. Results:There was no statistically significant difference in the clinical baseline data between the 2 groups, indicating comparability ( P>0.05). Throughout the gait cycle, no significant differences were found in shank rotation angles or rear-foot eversion angles between the RAI group and the LCAI group. However, CRP analysis revealed that during the early stance phase (initial contact and loading response), shank-rearfoot coupling was significantly lower in the RAI group than in the LCAI group. In the early stance phase, the CRP values in the RAI group were significantly higher than those in the LCAI group. The CRP curve changes in the RAI group were consistently higher in the standce phase of the entire gait cycle than those in the LCAI group, and the peak value of the CRP curve was larger in the RAI group. Concurrently, the RAI group exhibited significantly higher MARP and DP values than the LCAI group (27.48°±14.54° versus 15.21°±9.56°; 26.02°±11.73° versus 17.83°±9.82°) (both P<0.05). Conclusion:DL injury significantly damages the axial rotational stability of the ankle joint and significantly exacerbates the mechanical instability of the ankle joint in CAI patients.

Objective To investigate the executive function of preschoolers with attention-deficit/ hyperactivity disorder(ADHD),and comorbid of oppositional defiant disorder (ODD),and analyze the correlation between executive function and ADHD,executive function and ODD symptom.Methods The 234 ADHD preschool children enrolled in this study,aged 4y0m-5y11 m(including 191 children with ADHD and 43 with ADHD+ ODD),met both the clinical diagnosis with DSM-5 criteria and the interview diagnosis by Diagnostic Infant and Preschool Assessment.Total of 115 healthy normal children with the similar age to the ADHD children were as control.Behavior Rating Scale of Executive Function-Preschool Version (BRIEF-P) and Chinese Version of Swanson Nolan and Pelham,Version Ⅳ Scale-parent Form (SNAP-Ⅳ)were used to evaluate executive function,symptoms of ADHD and ODD respectively.Covariance and partial correlation analysis were applied to explore the relation between executive function and symptoms of ADHD and ODD.Results The comorbidity rate of ADHD with ODD among preschoolers in this research was 18.4％ (43/234),no significant difference was found between two genders (18.6％ and 17.5％ in boys and girls respectively,x2=0.03,P＞0.05).There was no significant difference in the age among the three groups.There were significant differences in gender (x2=22.33,P＜0.01)and intelligence quotient (IQ;F=15.87,P＜0.05) among the three groups.After the gender,IQ and scores of inattention and hyperactivity were controlled,domains of BRIEF-P (except for working memory and metacognition index) among ADHD+ODD children were significantly higher than those in ADHD children (all P＜0.01).Besides,partial correlation analysis showed a positive correlation between ODD symptom and executive function (except for working memory;r=0.11-0.49,all P＜0.01).The correlation was still positive between ADHD symptom and executive function when gender,IQ and ODD symptom were statistically controlled (r=0.16-0.70,all P＜0.01).Conclusions Compared with that in normal preschool children,the executive function in children with ADHD only or ADHD combined ODD are damaged.There is a significant positive correlation between executive function and ADHD,ODD symptom in preschool children.

Objective To investigate the executive function of preschoolers with attention-deficit/ hyperactivity disorder(ADHD),and comorbid of oppositional defiant disorder (ODD),and analyze the correlation between executive function and ADHD,executive function and ODD symptom.Methods The 234 ADHD preschool children enrolled in this study,aged 4y0m-5y11 m(including 191 children with ADHD and 43 with ADHD+ ODD),met both the clinical diagnosis with DSM-5 criteria and the interview diagnosis by Diagnostic Infant and Preschool Assessment.Total of 115 healthy normal children with the similar age to the ADHD children were as control.Behavior Rating Scale of Executive Function-Preschool Version (BRIEF-P) and Chinese Version of Swanson Nolan and Pelham,Version Ⅳ Scale-parent Form (SNAP-Ⅳ)were used to evaluate executive function,symptoms of ADHD and ODD respectively.Covariance and partial correlation analysis were applied to explore the relation between executive function and symptoms of ADHD and ODD.Results The comorbidity rate of ADHD with ODD among preschoolers in this research was 18.4％ (43/234),no significant difference was found between two genders (18.6％ and 17.5％ in boys and girls respectively,x2=0.03,P＞0.05).There was no significant difference in the age among the three groups.There were significant differences in gender (x2=22.33,P＜0.01)and intelligence quotient (IQ;F=15.87,P＜0.05) among the three groups.After the gender,IQ and scores of inattention and hyperactivity were controlled,domains of BRIEF-P (except for working memory and metacognition index) among ADHD+ODD children were significantly higher than those in ADHD children (all P＜0.01).Besides,partial correlation analysis showed a positive correlation between ODD symptom and executive function (except for working memory;r=0.11-0.49,all P＜0.01).The correlation was still positive between ADHD symptom and executive function when gender,IQ and ODD symptom were statistically controlled (r=0.16-0.70,all P＜0.01).Conclusions Compared with that in normal preschool children,the executive function in children with ADHD only or ADHD combined ODD are damaged.There is a significant positive correlation between executive function and ADHD,ODD symptom in preschool children.

Functional experiment plays an important role in understanding the mechanisms of diseases and principles of diagnosis and treatment. It requires students to master basic skills of func-tional operation, and complicated disciplines of functional alteration as well. Thus functional experi-ment needs to be an open course. The use of the virtual reality (VR) and real-time recording tech-niques provides potential for this exploration. By the way of real-time recording system, HD video of experiment operation is played, which helps guiding students to learn basic experiment skills; while based on the development status of VR technology, it is more applicable for learning by oneself, such as preview before the class and review for the test, and furthermore, the advantage of VR technique will be more apparent, if the key development focuses on experiment extensions to disclose more compli-cated functional alterations. This new technique helps to improve teaching effects of functional experi-ment.

Simple oxygenation respirator is mainly used for respiratory failure patients who are failed in being treated with open positive pressure.It can markedly improve the oxygenation concentration and ventilation.Most respiratory failure patients can avoid using mechanical respirator if it is used adequately.Respiratory model Ⅰ,Ⅱ,Ⅲ can be applied according to different type of respiratory failure respectively.It is also very effective to cerebral vascular diseases.The structure of respirator is fit for human physiology without interfering cardiac and pulmonary functions.It has no contraindications and side effect.It is simple,cheap and practical.