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.

Sequencing is becoming increasingly important in the early detection, companion diagnostics, molecular subtyping, and prognosis assessment of malignant tumors. In this special column of'tumors and sequencing′, renowned experts in the field of laboratory medicine elaborate on cutting-edge concepts, technologies, and applications related to drug target gene and polymorphism analysis, novel techniques of liquid biopsy, and the clinical cases of mutated genes in solid tumors and hematoma. Notably, liquid biopsy techniques based on circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) are advancing rapidly, offering the potential to serve as non-invasive diagnostic tools that facilitate precision medicine in oncology. To address the limitations of current ctDNA next-generation sequencing (NGS), future developments may focus on NGS targeting CTC-DNA for more precise tumor-targeted therapy. Despite the progress, challenges remain in integrating oncogene sequencing into clinical laboratories and advancing laboratory medicine. Addressing these challenges is crucial to improving public health.

BACKGROUND: Anterior subtotal vertebrectomy and fusion using titanium mesh cage (TMC) is an effective surgical treatment for cervical spondylosis, while TMC subsidence usually occurs. The risk factors for TMC subsidence and its effect on the treatment outcomes remain controversial. OBJECTIVE: To investigate the TMC subsidence after anterior subtotal vertebrectomy and TMC fusion and its effect on the treatment outcomes, thereby understanding the underlying mechanism and related risk factors. METHODS: Clinical data of 34 patients undergoing anterior subtotal vertebrectomy and TMC fusion in the Second Department of Spine, Shanghai Changzheng Hospital Affiliated to the Second Military Medical University from March to September 2015 were analyzed retrospectively. After 12-month follow-up, the height of the fused segments was measured, and the neurologic outcomes were evaluated using the Japanese Orthopedic Association scores. The loss of the fused segments subsided more than 3 mm compared with that at 1 day postoperatively was considered as TMC subsidence, and all patients were allotted to TMC subsidence and control (without TMC subsidence) groups.RESULTS AND CONCLUSION: (1) Totally 19 patients (56%) experienced TMC subsidence that occurred in postoperative (6.00±3.73) months averagely. (2) No significant differences were found in the age, sex or the level of fused segments between two groups (P=0.731, 0.672, 0.053). (3) The Japanese Orthopedic Association recovery ratio in the control group was significantly higher than that in the TMC subsidence group (P=0.01), suggesting that TMC subsidence might be correlated with the poor improvement of neurologic function after surgery. (4) To conclude, TMC subsidence is a common complication after anterior subtotal vertebrectomy, which does harm to the treatment outcomes.Moreover, age, sex or the level of fused segments are not independent risk factors for TMC subsidence.