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 precautions and clinical effects of minimally invasive lateral bone transfer of tibia in the treatment of diabetic foot.Methods:A retrospective analysis was performed on 82 patients with diabetic foot admitted to the Trauma Department of Changzhou First People's Hospital from January 2019 to December 2022. According to the Wagner grade of diabetic foot, there were 12 cases of grade 2, 50 cases of grade 3, and 20 cases of grade 4. According to the surgical method, 45 patients were divided into bone transfer group. There were 29 males and 16 females, with an average age of 65.27±10.74 years (ranging from 44-87 years), who underwent minimally invasive bone transfer of tibia combined with local debridement treatment. In the non-bone transfer group, there were 37 cases (26 males and 11 females) with an average age of 66.05±11.08 years (ranging from 44 to 86 years), who were treated with local debridement. Gender, age, Wagner grade, surface temperature difference of the affected limb, visual analogue scale (VAS) score of the affected limb before and 1 month after surgery, wound healing rate 1 month after surgery, and recurrence rate of the affected foot 1 year after surgery were compared between the two groups. Outcomes of the cases of different Wagner grades were compared.Result:All 82 patients were followed up for 14.23±1.20 months. There was no significant difference in gender, age, Wagner grade and preoperative VAS between the two groups ( P>0.05). The skin temperature of the affected limb before and after surgery in the bone transfer group was significantly higher than that in the non-bone transfer group 1.93±0.31 ℃ ( P<0.05), and the VAS of the bone transfer group was 2.18±0.58 points 1 month after surgery, which was lower than that in the non-bone transfer group of 5.41±0.93. The VAS difference before and after surgery in the bone transfer group was 4.80±1.24 points, which was greater than that in the non-bone transfer group of 1.62±1.48 points with significant difference ( P<0.05). The wound healing rate was over 98.78%±2.17% in the bone transfer group and 52.57%±6.41% in the non-bone transfer group one month after surgery. No recurrence or recurrence was found in the bone transfer group one year after surgery, and the recurrence rate was 86% (32/37) in the non-bone transfer group with significant difference ( P<0.05). There was no difference in preoperative VAS for different grades of diabetic foot (grades 2, 3, and 4). There were significant differences in VAS, VAS decrease, postoperative limb surface temperature increase, local wound healing rate at 1 month, and lower limb ulcer recurrence or recurrence rate at 12 months in the bone transfer groups of Wagner grade 2, 3, and 4 ( P<0.05). Conclusion:Minimally invasive lateral bone transfer of tibia combined with local precision debridement could significantly increase the healing rate of diabetic foot ulcer, improve the peripheral microcirculation of the affected limb, reduce the pain of the affected limb, and decrease the recurrence rate of diabetic foot ulcer.

Objective:To explore the effect of hanging electronic baking lamp on the quality and progress of flap recovery in patients with hand injury flap repair.Methods:A total of 180 patients undergoing hand injury flap repair in Yantaishan Hospital in Yantai City from January 2019 to May 2022 were selected as the research objects by the convenient sampling method. They were divided into the control group and the observation group, with 90 cases in each group. The control group was treated with routine nursing combined with ordinary baking lamp nursing, while the observation group was treated with routine nursing combined with hanging electronic baking lamp nursing. The postoperative flap recovery quality (survival rate, healing grade) and recovery process (exudation drying time, the regression time of swelling , the healing time of flap wound) were compared between the two groups.Results:In the control group, 85 flaps survived, with a survival rate of 94.44% (85/90) ; in the observation group, 87 flaps survived, with a survival rate of 96.67% (87/90) ; there was no statistically significant difference in the results between the two groups ( P>0.05) . In the control group, there were 43 cases of grade A skin flap healing, 26 cases of grade B skin flap healing and 21 cases of grade C skin flap healing; in the observation group, 63 cases had grade A healing, 16 cases had grade B healing and 11 cases had grade C healing; there was statistically significant difference in the level of skin flap healing between the two groups of patients ( P<0.05) . The exudation drying time were (3.79±1.22) d in the observation group and (3.21±1.38) d in the control group; the regression time of swelling were (5.23±1.06) d in the observation group and (3.89±1.19) d in the control group; the healing time of the flap wound in the observation group was (12.36±2.58) d, while in the control group it was (8.98±1.47) d; the differences were all statistically significant ( P<0.05) . Conclusions:The use of a hanging electronic baking lamp after surgery can improve the quality of skin flap recovery for patients undergoing hand injury flap repair and accelerate their recovery progress.

Sixty ASA Ⅰ-Ⅱ male patients aged 45-65 yrs undergoing general anesthesia in Chenzhou First People′s Hospital from May to September 2019 were randomly divided into two groups with 30 cases in each. Before the recover from anesthesia, patients in group L were irrigated with 100 mg lidocaine and 20 ml normal saline through the urinary catheter, while those in group C were irrigated with 20 ml normal saline in the same way. After irrigation, the catheter was clamped for 5 min and then released. The of urination intention when patient is conscious was observed and urethral irritation score was assessed. The cases of unconscious catheter grasping behavior, catheter-related restlessness and the need for rescued medication were compared between two groups. Compared to group C, group L had lower urinary intention rate (3.3%), lower urethral irritation score (1.94±0.15), lower rate of unconscious catheter grasping (6%), lower incidence of catheter agitation (0) and remedial medication (0). It is suggested that bladder irrigation with lidocaine before anesthesia recovery can reduce the symptoms of catheter-related irritation.

Objective: To establish a standard operation procedure (SOP) for ribosome genotyping (ribotyping) on Clostridioides (C.) difficile, supplement and verify ribotyping typing library, so as to improve the comparability of data between different laboratories and to develop surveillance network of C. difficil in China. Methods: Molecular typing of 54 reference strains from the United States and Europe of C. difficile were performed by using the SOP referencing correspondence from abroad and from our laboratory with a BioNumerics 7.6 software to estimate the reference library of types of C. difficile. Identification of 374 clinical and animal isolates of C. difficile from 13 cities in China between 2010 and 2018, to supplement the library information. Kappa test was used to evaluate the consistency. Results: Results of capillary electrophoresis of reference strains appeared clear and stable, which guaranteed the clustering results being fast and accurate. Results from the supplementary typing showed that there were 84 types of isolates, of which 25 RT types were consistent with reference strains from abroad, while 58 RT types were different from referenced types. In the 40 referenced types, 15 RT types were not found in this study. In the consistency evaluation, the Kappa value was 0.891 and (P<0.01), showing the two Molecular typing as consistent and with close resemblance. Conclusions The result of capillary electrophoresis by applying SOP for ribotyping on C. difficile base on QIAxcel capillary electrophoresis system, appeared clear and stable. The standardized library seemed more easily used for comparability and data sharing between the laboratories.

Objective The action mechanisms of Qingfei Oral Liquid ( QFOL) in the treatment of respiratory syncytial virus ( RSV) infection need to be studied more deeply.The aim of this study is to examine the expressions of interleukin ( IL)-10 and IL-17 in the lung tissue and those of Treg and Th17 in the spleen tissue of RSV-infected mice before and after treated with QFOL, and to explore the action mechanisms of QFOL from the perspective of the Treg/Th17 cy-tokines balance. Methods Fifty BABL/c mice were equally ran-domized to five groups: blank control, RSV model, Ribavirin, low-dose QFOL, and high-dose QFOL.Models of RSV ( long strain) infec-tion were made in the latter four groups.At 48 hours after viral activa-tion, the mice of the control and RSV model groups were treated intragastrically with 0.9%normal saline and those in the Ribavirin and QFOL groups with Ribavirin at 0.0025 g/mL and QFOL at 1.33 g/mL and 4 g/mL, respectively, all for 72 hours.Then all the mice were killed and the lung tissue harvested from 5 animals in each group for pathological analysis, while the levels of IL-10 and IL-17 in the bronchoalveolar lavage fluid of the other 5 detected by ELISA.The expressions of the cytokines Treg and Th17′in the spleen from 4 mice in each group were determined by flow cytometry. Results Compared with the RSV models, pathologic changes were significantly re-duced in the mice of the QFOL, Ribavirin and control groups (P<0.01), the expression of IL-10 remarkably up-regulated in the low-dose QFOL, high-dose QFOL, Ribavirin, and control groups ([39.21 ±1.57] vs [43.54 ±1.03], [46.64 ±0.48], [47.83 ±0.87], and [50.44 ±1.04] ng/L, all P<0.01), while the level of IL-17 markedly down-regulated ([70.96 ±0.53] vs [55.92 ±0.83], [33.66 ±0.70], [21.92 ±1.38], and [9.42 ±0.59] pg/mL, all P<0.01).The expressions of Treg/Th17′were significantly in-creased in the low-dose QFOL, high-dose QFOL, Ribavirin, and control groups (2.89 ±0.52, 6.38 ±0.36, 3.95 ±0.26, and 3.54 ± 0.85) as compared with that in the RSV models (0.96 ±0.16) (all P<0.01).Both low-and high-dose QFOL groups showed statisti-cally significant differences from the Ribavirin group in the levels of Treg, Th17, and Treg/Th17 (P<0.05). Conclusion QFOL can regulate the balance of Treg/Th17, increase the expression of IL-10 and decrease that of IL-17 in the lung tissue of RSV-infected mice, which further proves the efficacy of QFOL in the treatment of RSV-induced pneumonia.

Objective To determine the in vitro production of virulence factors for Candida (C.) tropicalis,including aspartyl proteinases,phospholipases and hemolytic activities,describe the regulation of virulence factors varying with time in C.tropicalis,and analyze the differences in aspartyl proteinases and hemolytic activities of C.tropicalis isolated from anatomically distinct sites.Methods A total of 64 C.tropicalis strains were spot-inoculated onto bovine albumin agar,egg yolk agar and sheep blood agar plates,respectively.Then the plates were incubated for 24,48 and 72 hour at 37 ℃,respectively.The aspartyl proteinases,phospholipase and hemolytic activities were determined at each time point,respectively.Results All the C.tropiclais isolates showed positive aspartyl proteinases and hemolytic activities at each time point,but no phospholipases activity was detected in C.tropicalis.On comparison of aspartyl proteinases and hemolytic activities at different time points,aspartyl proteinases activity at 48 and 72 hour was higher than that at 24 hour.During 72 hour,hemolytic activity of C.tropicalis increased.No statistical significant differences in aspartyl proteinases and hemolytic activities of C.tropicalis were observed among different infection sites (P=0.368 and 0.985).Conclusion The C.tropicalis clinical isolates in China have aspartyl proteinases activity,hemolytic activity,but have no phospholipase activity.

Objective: To study the optimum extraction conditions of alkaloid of Rhizoma pinelliae processecd with ginger.Methods:The alkaloid content was used as a marker.The percolation process of Rhizoma Pinellia(processed with ginger) was studied by orthogonal design with 3 factors and 3 levels(L 9(3 4)) .Results:The alcohol concentration was remarkable factor in the test.Conclusion:Considering the demand of manufacture,the best extraction condition is A 3B 1C 1。