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 feasibility and clinical effect of arthroscopic limited excision of flexor hallucis longus(FHL) tendon sheath combined with open technique of posterior ankle joint capsule for hallucal ganglion cyst(HGC) deriving from the ankle joint.Methods:This is a retrospective case series study. From September 2021 to September 2023, the clinical data of 18 patients (18 feet) with HGC deriving from ankle joint treated by arthroscopic limited excision of FHL tendon sheath combined with posterior ankle capsule opening technique at Department of Orthopedic, Xuzhou Central Hospital were analyzed retrospectively. There were 12 males and 6 females. The age was (49.5±10.7) years (range:32 to 66 years). There were 10 cases on the right side and 8 cases on the left side; 11 cases in fibular, 3 cases in plantar, 2 cases in tibial and 2 cases in tip. There were 8 cases of primary operation and 12 cases of recurrence after resection in other hospital. There were 10 cases with complete skin and soft tissue and 8 cases with ulcer.All patients underwent arthroscopic limited excision of FHL tendon sheath combined with open technique of posterior ankle joint capsule.Clinical evaluations included the American Orthopedic Foot and Ankle Society ankle-hindfoot score(AOFAS-AH), visual analog scale (VAS). The data were compared by paired sample t test and Wilcoxon rank sum test. Results:All cases successfully completed the operation. The operation time was (46.3±8.1) minutes (range:35 to 65 minutes), and the intraoperative blood loss was (6.8±3.1)ml (range:2 to 15 ml). All patients primarily healing without any complications such as infection and skin necrosis. All 18 patients were followed up for (16.3±2.9) months (range:12 to 20 months),and no recurrence. One patient complained of numbness of tibial nerve innervation, and the symptoms disappeared after 3 months of symptomatic treatment with oral mecobalamin. At the last follow-up, the AOFAS-AH significantly improved from 78.9±7.1 (range:65 to 90) preoperatively to 95.8±3.3 (range:89 to 100) postoperatively ( t=9.62, P<0.01). The VAS ( M(IQR)) was reduced from 3(4) preoperatively to 0(1) postoperatively ( Z=-3.75, P<0.01). Conclusions:Arthroscopic limited excision of FHL tendon sheath combined with open technique of posterior ankle joint capsule is an effective and feasible surgery, which realizes accurate and minimally invasive treatment process and good short-term clinical effect.

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 feasibility and clinical effect of arthroscopic limited excision of flexor hallucis longus(FHL) tendon sheath combined with open technique of posterior ankle joint capsule for hallucal ganglion cyst(HGC) deriving from the ankle joint.Methods:This is a retrospective case series study. From September 2021 to September 2023, the clinical data of 18 patients (18 feet) with HGC deriving from ankle joint treated by arthroscopic limited excision of FHL tendon sheath combined with posterior ankle capsule opening technique at Department of Orthopedic, Xuzhou Central Hospital were analyzed retrospectively. There were 12 males and 6 females. The age was (49.5±10.7) years (range:32 to 66 years). There were 10 cases on the right side and 8 cases on the left side; 11 cases in fibular, 3 cases in plantar, 2 cases in tibial and 2 cases in tip. There were 8 cases of primary operation and 12 cases of recurrence after resection in other hospital. There were 10 cases with complete skin and soft tissue and 8 cases with ulcer.All patients underwent arthroscopic limited excision of FHL tendon sheath combined with open technique of posterior ankle joint capsule.Clinical evaluations included the American Orthopedic Foot and Ankle Society ankle-hindfoot score(AOFAS-AH), visual analog scale (VAS). The data were compared by paired sample t test and Wilcoxon rank sum test. Results:All cases successfully completed the operation. The operation time was (46.3±8.1) minutes (range:35 to 65 minutes), and the intraoperative blood loss was (6.8±3.1)ml (range:2 to 15 ml). All patients primarily healing without any complications such as infection and skin necrosis. All 18 patients were followed up for (16.3±2.9) months (range:12 to 20 months),and no recurrence. One patient complained of numbness of tibial nerve innervation, and the symptoms disappeared after 3 months of symptomatic treatment with oral mecobalamin. At the last follow-up, the AOFAS-AH significantly improved from 78.9±7.1 (range:65 to 90) preoperatively to 95.8±3.3 (range:89 to 100) postoperatively ( t=9.62, P<0.01). The VAS ( M(IQR)) was reduced from 3(4) preoperatively to 0(1) postoperatively ( Z=-3.75, P<0.01). Conclusions:Arthroscopic limited excision of FHL tendon sheath combined with open technique of posterior ankle joint capsule is an effective and feasible surgery, which realizes accurate and minimally invasive treatment process and good short-term clinical effect.

Objective:To investigate the effect of PLTP gene on CSE-induced IL-8 production in human alveolar Type Ⅱcells ( Adenocarcinomic human alveolar epithelial cells , A549 ) .Methods: The different concentrations of CSE co-cultured with human alveolar epithelial cell line ( A549 ) for 24 hours.MTT assay was performed to study the effect of CSE on human alveolar epithelial cell line(A549) growth.Expression levels of PLTP mRNA and IL-8 mRNA were examined by RT-PCR,protein of PLTP were examined by Western blot ,and protein of IL-8 was examined by ELISA .Results: MTT assay showed that the proliferation of A 549 cell line were stimulated by the 0.125%CSE,while the proliferation of A549 cell tends to decrease at high concentrations of CSE (2.0% CSE and 4.0%CSE),and in this middle concentrations of CSE (0.25%CSE ,0.5%CSE and 1.0%CSE),the proliferation of A549 cell was not significantly affected .Our studys suggested that PLTP and IL-8 release were induced by CSE in a concentration-dependent and time-dependent manner ,and expression levels of IL-8 obviously increased after silence PLTP gene .Conclusion:PLTP siRNA can increased CSE-induced IL-8 production in human alveolar epithelial cells (A549).

Objective:To investigate the application value of interferon-γ release assay ( IGRA ) in immunocompromised patients with pulmonary tuberculosis. Methods:180 cases were chose including immunocompromised patients,pulmonary tuberculosis patients,immunocompromised patients with pulmonary tuberculosis and healthy volunteers to undergo IGRA in order to determine and compare the content of specific interferon-γ( IFN-γ) in plasma. At the same time, the result of immunocompromised patients with pulmonary tuberculosis was compared with tuberculin skin test (TST). Results:180 cases of the list were tested,included 40 immuno-compromised patients ( group A ) , 50 pulmonary tuberculosis patients ( group B ) , 40 immunocompromised patients with pulmonary tuberculosis patients(group C),and 50 cases in healthy control group(group D). The median of specific IFN-γ contents in the four groups were respectively 0. 112,7. 835,5. 726,0. 697 U/ml. The comparison of differences among the four groups was statistically significant (χ2=74. 046,P<0. 001). Pairwise comparisons among the four groups,and the differences between group B and group C were no significant,but specific IFN-γ content of the two groups was significantly higher than the other two groups,while the group D was higher than group A,the differences were statistically significant. The positive rate of IGRA was significantly higher than that of TST in group C(χ2=11. 314,P=0. 001). Conclusion: IGRA diagnosis in the application of immunocompromised patients with pulmonary tuberculosis was less affected by immune status and was more sensitive than TST,which can be used as auxiliary diagnosis.

Objective:To investigate the effect of PLTP gene on CSE-induced IL-8 production in human bronchial epithelial cell line (HBECs). Methods:Wistar rats were exposed to air or cigarette smoke for 6 hours/day on 3 consecutive days,then the lungs were sectioned and examined. The number of total white blood cell and differential white blood cells in BALF were counted. The different concentrations of CSE co-cultured with HBECs for 24 hours. Cells growth was detected by MTT assay. Expression levels of PLTP mRNA and IL-8 mRNA were examined by RT-PCR,protein of PLTP was investigated by Western blot,and production of IL-8 ex-amined by ELISA. Results:The number of white blood cells in BALF was significantly increased compared with controls. Enhanced ex-pression level of PLTP and IL-8 were observed in CS-exposure group. Proliferation of HBECs tends to decrease at high concentrations of CSE(2. 0% CSE and 4. 0% CSE). The results suggested that the production of IL-8 induced by CSE in a time- and concentration-dependent manner,while the expression of PLTP induced by CSE in a dose-dependent manner. Furthermore,expression levels of IL-8 significantly increased after silence PLTP gene. Conclusion:PLTP siRNA could increase CSE-induced IL-8 production in HBECs.

Objective: To investigate the relationship between the c-Jun N-terminal kinase (JNK) pathway and lung-resistance protein (LRP). Methods:A549 cells were treated with various concentrations of CDDP for 72 h. The LRP mRNA expression was then analyzed using reverse transcription PCR (RT-PCR). LRP, JNK, and P-JNK were analyzed by Western blotting. The A549 cells were then pretreated with SP600125 (2 μg/ml to 4 μg/ml ) for 1 h. Afterward, CDDP (16 μg/ml) was added into the culture for 72 h. A Cell Counting Kit-8 was used to investigate the sensitivity of CDDP to the A549 cells. Flow cytometry was used to detect the apoptosis rate. The LRP mRNA expression was analyzed using RT-PCR. LRP, JNK, and P-JNK were analyzed by Western blotting. Results:CDDP in-duced the mRNA and protein expression of both LRP and P-JNK in a dose-dependent manner. Pretreatment with SP600125 enhanced the sensitivity of CDDP to the A549 cells and increased the apoptosis rate. However, the LRP mRNA and LRP expression in the pre-treated cells was lower than that in the presence of CDDP alone. Conclusion:In A549 cells, CDDP induces the LRP expression via the JNK pathway. This result suggests that lung cancer therapy can be improved by the addition of CDDP to inhibit the JNK signaling path-way.

Medical phylogeny contains profound philosophic thinking.The clinical teaching of respiratory internal diseases history helps to understand dynamic course of disease development and gains scientific epistemology and thinking methods.Dialectical thoughts in diseases history is to foster new medical talents with scientific thinking views,to meet the demands of the modern medical development.

Objective: To compare the difference in colony-forming units(CFU) of mycobacteria and drug susceptibility to mycobacterium tuberculosis(MTB) between weighting method and Mcfarland method.Methods: The bacterial suspensions of non-tuberculosis mycobacteria(NTM) 28 strains,MTB 42 strains were prepared by using both weighting method and Mcfarland method.0.1ml of bacterial suspensions(10-4mg/ml,10-5mg/ml,10-6mg/ml) were incubated for CFU of mycobacteria.0.1ml of bacterial suspensions(10-2mg/ml) of MTB were incubated for the drug susceptibility testing of absolute concentration method.0.1ml of bacterial suspensions(10-3mg/ml,10-5mg/ml) of MTB were incubated for the drug susceptibility testing of proportion method.Results: The CFU of NTM showed significant difference(P0.05),the CFU quantity of MTB was from 5?106CFU/ml to 5?107CFU/ml in weighting method and Mcfarland method.The accordance rate of drug susceptibility of MTB with absolute concentration method between weighting method and Mcfarland method were 95.2% and 97.6% in INH and RFP,respectively.The accordance rate of drug susceptibility of MTB were 95.2% and 92.8% in absolute concentration method and proportion method about Isonizid and Rifampicin,respectively.Conclusion: The CFU of different mycobacteria strains are significant different.The accordance rate of drug susceptibility of MTB between weighting method and Mcfarland method is high.