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 efficacy of lapatinib combined with microwave hyperthermia in the treatment of human epidermal growth factor receptor 2(HER2)positive advanced breast cancer.Methods A total of 134 patients with HER2-positive advanced breast cancer treated in Huzhou Central Hospital from January 2019 to January 2020 were selected and divided into control group and observation group according to the lottery method,with 67 cases in each group.Both groups were treated with lapatinib,and the patients of observation group was treated with microwave hyperthermia on this basis.Tumor markers[carbohydrate antigen 153(CA153),carcinoembryonic antigen(CEA),tissue peptide antigen(TPA)],the number of circulating tumor cells(CTC),vimentin expression and quality of life were compared between two groups before and after treatment.The clinical efficacy and survival status of two groups were analyzed.Results After treatment,CA153,CEA,TPA,the number of CTC and vimentin expression in two groups were significantly lower than before treatment,and the quality of life score was significantly higher than before treatment(P<0.05).CA153,CEA,TPA,the number of CTC and vimentin expression in observation group were significantly lower than those in control group,and the quality of life score was significantly higher than that in control group(P<0.05).The total effective rate of observation group was significantly higher than that of control group(χ2=5.350,P=0.021).There was no significant difference in adverse reactions between two groups(P>0.05).After 24 months of follow-up,the overall survival and progression-free survival of observation group were significantly longer than those of control group,and the 24-month cumulative survival rate was higher than that of control group(P<0.05).Conclusion Lapatinib combined with microwave hyperthermia has a good effect in the treatment of HER2-positive advanced breast cancer,which can change vimentin expression,inhibit disease progression and prolong the survival of patients.

Mycoplasma capricolum subsp. capripneumoniae (Mccp) is the cause of contagious caprine pleuropneumonia (CCPP) in goats. Inactivated vaccines and capsular polysaccharide (CPS) indirect hemagglutination reagents are available for prevention and serological detection, but high culture costs and complex antigen quantification have been plagued by production staff. In order to solve these problems in production practice, a sugar fermentation medium with an initial pH value of 7.8, which could improve the production of two antigens simultaneously, was screened out by changing the initial pH value based on previous Mccp metabolomics analysis. Since phenol red can be identified by UV absorption spectrum and cetyltrimethylammonium bromide (CTAB) can bind to anionic capsular polysaccharide, a UV spectrum measurement method for analyzing the culture stage reached by Mccp and a CTAB precipitation test for relative quantification of capsular polysaccharide antigen content in the fermentation broth were established. The UV spectrum observation method can guide the production of Mccp according to the growth curve of Mccp, which greatly reduces the monitoring time of the traditional CCU method and improves the accuracy of the original eye-observation method. The established CTAB precipitation test can complete the monitoring of CPS content within 5 hours, which greatly reduces the time required compared with the traditional differential technique, and its accuracy was verified by the phenol-sulfuric acid method. The optimized culture medium and the two correlation comparison methods established in this study can effectively reduce the production cost of Mccp and improve the production efficiency. The two assays have been used in the research at our laboratory, which provides experimental data for further improvement of the production process of CCPP inactivated vaccine and capsular polysaccharide as well as rapid quantification.
Humans ; Animals ; Goats ; Cetrimonium ; Mycoplasma ; Polysaccharides

Objective: To investigate the classification of atrophic glossitis and to study the correlation between the classification and changes of VitB12, folic acid (FOL) and blood cell parameters Methods: A total of 70 patients with atrophic glossitis (AG) were divided into complex type and simple type according to whether they had ulcer or erosion on the tongue mucosa or not. Another 65 healthy subjects during the same period were collected as the control group. The levels of vitamin B12, FOL and blood cell parameters were statistically analyzed using SPSS 25.0 software package. Results: The levels of vitamin B12, red blood cell count (RBC) (3.52 ± 0.69) × 1012·L-1, hemoglobin (HGB)(11.97 ± 1.70) g·dL-1, white blood cell count (WBC) (4.85 ± 1.16) × 109·L-1, neutrophil count (NEUT) (2.76 ± 0.99) × 109·L-1, lymphocyte count (LYMPH) (1.48 ± 0.44) × 109·L-1 in complex type AG group were lower than those in simple type AG group (P<0.05). The levels of mean red blood cell volume (MCV) (104.90 ± 11.13) fL, mean corpuscular hemoglobin (MCH) (34.83 ± 4.56) pg, mean corpuscular hemoglobin concentration (MCHC) (331.09 ± 13.60) g·L-1 were higher than those in the simple type AG group (P<0.05). There was no significant difference in FOL content between these two groups (P>0.05). The levels of VitB12, MCV, MCH, MCHC, WBC, lymph and neut were correlated with the classification of atrophic glossitis (P < 0.05). Conclusion VitB12 deficiency was more apparent in complex AG, especially in large cell anemia, which correlated with the levels of WBC, NEUT, and LYMPH.

Objective:To study the association between histopathological features and HER2 overexpression/amplification in breast cancers using deep learning algorithms.Methods:A total of 345 HE-stained slides of breast cancer from 2012 to 2018 were collected at the China-Japan Friendship Hospital, Beijing, China. All samples had accurate diagnosis results of HER2 which were classified into one of the 4 HER2 expression levels (0, 1+, 2+, 3+). After digitalization, 204 slides were used for weakly supervised model training, and 141 used for model testing. In the training process, the regions of interest were extracted through cancer detected model and then input to the weakly supervised classification model to tune the model parameters. In the testing phase, we compared performance of the single- and double-threshold strategies to assess the role of the double-threshold strategy in clinical practice.Results:Under the single-threshold strategy, the deep learning model had a sensitivity of 81.6% and a specificity of 42.1%, with the AUC of 0.67 [95% confidence intervals (0.560,0.778)]. Using the double-threshold strategy, the model achieved a sensitivity of 96.3% and a specificity of 89.5%.Conclusions:Using HE-stained histopathological slides alone, the deep learning technology could predict the HER2 status using breast cancer slides, with a satisfactory accuracy. Based on the double-threshold strategy, a large number of samples could be screened with high sensitivity and specificity.

Objective: To explore the relationship between psychological factors and recurrent aphthous ulcer (RAU), oral lichen planus (OLP), and burning mouth syndrome (BMS) and to provide a reference for clinical diagnosis and treatment of the disease. Methods: From July to October 2018, 50 patients with common RAU, refractory RAU, OLP and BMS were selected as the observation group, and 50 healthy participants without major systemic diseases and oral mucosal diseases matched for age and sex served as the control group. The psychological status of the subjects in each group was investigated by questionnaires, including the generalized anxiety disorder 7-item scale(GAD-7) and the patient health questionnaire-9 (PHQ-9). Results: Compared with the control group, the PHQ-9 scores in the refractory RAU, common RAU, OLP and BMS groups were higher than those in the control group (P < 0.05), and the GAD-7 scores in the refractory RAU, OLP and BMS groups were higher than those in the control group (P < 0.05). In the RAU group, the GAD-7 score of intractable RAU was higher than that of common RAU (P < 0.05), and there was no significant difference in the PHQ-9 score (P > 0.05). Conclusion RAU, OLP and BMS are common psychosomatic diseases presented by patients in the Department of Oral Mucosal Diseases. Their occurrence and development are related to the psychological status of patients. A tendency toward anxiety is significantly more common among refractory RAU patients than common RAU patients.

Objective To investigate the clinical curative effect of Qingrehuatan method in the treatment of insomnia elderly patients with benzodiazepines dependence.Methods From April 2016 to April 2017,49 insomnia elderly patients with benzodiazepines dependence in the Second People's Hospital of Zhoushan were divided into the observation group(20 cases)and control group (29 cases)according to the different treatment methods.In the gradual reduction at the same time,the control group was treated with trazodone,the observation group was treated with Qingrehuatan method.Before treatment and after treatment for 1course,the revised Pittsburgh sleep quality scale (PSQI),index of insomnia symptom score,TCM symptom score,Zung Anxiety Rating Scale score,Wechsler Adult Intelligence Scale(WAIS－RC)and Wechsler Memory Scale(WMS－RC)score were observed in the two groups. Results After treatment,the rate of withdrawal and discontinuation of the observation group was significantly higher than that of the control group (90.0% vs.68.9%),the difference was statistically significant (χ2＝6.918,P＜0.05).After treatment,the PSQI scores and symptom scores of the two groups were significantly decreased,and the PSQI scores and TCM symptom scores of the observation group improved significantly better than those of the control group[(8.8 ±1.1)points vs.(10.6 ±1.3)points,(2.9 ±0.8)points vs.(4.6 ±1.2)points],the differences were statistically significant(t＝5.063,5.535,all P＜0.05).After treatment,the Zung Anxiety Scale scores of the two groups were significantly lower,and the improvement of the observation group was significantly better than that of the control group[(42.90 ±5.65)points vs.(48.21±5.27)points],the difference was statistically significant(t ＝ 3.366,P＜0.05 ).After treatment,the long －term memory,short －term memory and memory quotient of the two groups were significantly increased,and short－term memory and memory quotient of the observation group improved significantly better than those of the control group[(23.30 ±5.31)points vs.(20.55 ±6.58)points,(76.67 ± 12.70)points vs.(67.36 ±19.13)points],the differences were statistically significant (t＝2.274,2.047,all P＜0.05 ).Conclusion Qingrehuatan method in the treatment of insomnia elderly patients with benzodiazepines depend-ence can improve the possible reduction in the process of stopping drug withdrawal symptoms and memory function, and can improve the symptoms of patients at the same time,and it is worthy of clinical application.

With the establishment of the singapore college of traditional Chinese medicine (TCM) and the landing of the TCM Practitioners Act in 2000, TCM is booming in Singapore. At present, TCM service trade consumes less outside Singapore, but cross-border consumption, commercial existence and natural person flow have greater advantages. At the same time, the treatment of damp-heat disease, geriatric diseases and tourism of TCM in Singapore made the trade of TCM services show broad prospects for its development. This paper suggests that we should attach importance to the location of service agencies, integrate resources to treat special diseases, increase peer exchanges, take mobile payment as an entry point, and adopt a culture-first approach to develop trade in TCM services.

Objective: To compare the short-term effects of triamcinolone acetonide paste(TAP) with prednisone acetate paste(PAP) for the treatment of minor aphthous ulcer (miRAU). Methods: 65 patients with miRAU were divided into 2 groups randomly. TAP(n = 32) and PAP(n = 33) were topically applied for the patients in the 2 groups respectively 3 times per day for a week. Ulcer size and pain index(VAS) on day 3 and day 5 were recorded. Re-examination was conducted 1 week after treatment. The effects were compared between the 2 groups. Results: The ulcer size and VAS decreased in the 2 groups after treatment(P＜ 0. 05). In TAP group ulcer size and VAS both decreased more than those in PAP group(P＜ 0. 05). The ulcer duration(d) of TAP and PAP group was 4. 65 ± 1. 91 and 6. 45 ± 1. 09(P＜ 0. 05), the effective rate was 80. 6％ and 34. 5％ (P＜ 0. 05), respectively. Conclusion: Triamcinolone acetonide paste has an advantage in short-term effects over prednisone acetate paste, and it improves the efficiency of treating miRAU.