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Objective To analyze the changes in the anterior talofibular ligament(ATFL)after injury in patients with ankle sprains.Methods A total of 97 ATFL injury patients with ankle sprains exceeding 3 months and clinical symptoms were selected as injury group from the outpatient department of Huzhou Central Hospital from January 2019 to December 2021.During the same period,A total of 112 healthy individuals were recruited as control group.The echo changes of ATFL on both sides of the enrolled patients were explored under the natural and stress states of the ankle joint,the length,width,and thickness of ATFL were measured.The ATFL data changes of the two groups of enrolled patients were statistically analyzed.Results The ATFL boundaries of patients in injury group were mostly unclear,and the ligament echoes were disordered;The ATFL boundaries of control group participants were clear,with uniform echoes.There were no statistically significant differences in the length,width,and thickness of ATFL on both sides(P>0.05).The comparison of ATFL on both sides of injury group patients showed an increase in the length and thickness of ATFL on the injured side,with statistical significance(P<0.05),while the difference in width was no statistically significant(P>0.05).The length and width of ATFL increased in injury group of patients with natural injury than those in control group,and the differences were statistically significant(P<0.01),while the difference in thickness was not statistically significant(P>0.05);The length and width of ATFL in injury group of patients increased under stress than those in control group,and the differences were statistically significant(P<0.01),while the difference in thickness was no statistically significant(P>0.05).The comparison of the difference in length,width,and thickness of ATFL between the two groups of participants under non stress and stress states showed that the differences in length and thickness of ATFL in injury group were statistically significant(P<0.01),while the difference in width change was no statistically significant(P>0.05).Conclusion The length of ATFL in patients with ankle sprains significantly increases under stress and natural conditions,and the difference in ATFL length changes was also more pronounced.
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Objective To investigate the ability of locking plate construct plus fibular autograft that varies in way of augmentation to withstand varus stresses in a model of proximal humeral fracture.Methods Wedge osteotomy was conducted in the humeral surgical necks of 12 shoulders from 6 cadaveric specimens to create models of proximal humeral fracture.There were 3 males and 3 females;their average age at death was 83 years (from 75 to 87 years).The 12 left and right cadaveric humeri were randomly divided into equal groups A and B (n =6) for autogenous iliac bone graft.All the fibular autografts were harvested without distinction from the thinnest and even part of the fibular shaft.A fibular autograft of 8 cm was placed vertically in group A while a fibular autograft of 6 cm was placed slantly in group B.After the fractures were fixated with the proximal humerus internal fixation locking system (PHILOS),varus stress was repeatedly applied to the proximal humerus until the internal fixation failed in the fracture model.The 2 groups were compared in terms of number of compression,number of compression leading to 1 mm deformation,and average shape variable after each press.Results Cut-out of the lateral cortex of the humeral head by the humeral screw and plate loosening to different extents were observed in both groups.The number of compression leading to internal fixation failure was 31,338 ± 5,994 for group A and 30,608 ± 8,015 for group B;the number of compression leading to 1 mm deformation was 2,808 ± 1,501 for group A and 3,153 ±2,024 for group B;the average shape variable after each press was 0.52 ±0.39 μm/time for group A and 0.53 ±0.47 μm/time for group B.All the above comparisons between the 2 groups showed no significant differences (P ＞ 0.05).Conclusion As locking plate construct plus slant fibular autograft augmentation provides no more strength to withstand repetitive varus stresses than locking plate construct plus vertical fibular autograft augmentation,it is not necessary to adopt the former way of augmentation in clinic practice for proximal humeral fracture.
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Objective To detect C-met protein expression and gene amplification in lung adenocarcinoma, and to analyze their relationship with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) resistance and prognosis. Methods A total of 120 cases of lung adenocarcinoma diagnosed in Shanxi Provincial Cancer Hospital from January 2011 to May 2013 were selected. The expressions of C-met protein and C-met gene amplification were conducted by immunohistochemistry (IHC) method and fluorescence in situ hybridization (FISH), and all patients were followed up. The relationship between the expression of C-met protein and gene amplification with clinicopathological features and EGFR-TKI resistance and prognosis were analyzed. Results The high expression of C-met protein and gene amplification in 120 tissues were 17.5 ％ (21/120), 10.83 ％ (13/120). Of the 80 patients treated with EGFR-TKI, the incidence of C-met protein high expression was 30.43 ％ (14/46) in patients with drug resistance, which was significantly higher than that in patients without drug resistance (11.76 ％, 4/34), the difference was statistically significant (χ2= 3.908, P= 0.048). The rate of C-met gene amplification was 19.57 ％ (9/46) in patients with drug resistance,which was significantly higher than that in patients without drug resistance (2.94 ％, 1/34) the difference was statistically significant (P= 0.038). The expression of C-met protein in 46 patients with drug resistance was positively correlated with gene amplification (r= 0.388, P= 0.008), but in 40 patients without TKI, the expression of C-met protein was not correlated with gene amplification (r=0.279, P=0.081). The high expression of C-met protein was correlated with age, pathological grade and clinical stage (all P<0.05), while C-met gene amplification was related to clinical stage (P=0.036). Cox regression analysis suggested that C-met gene amplification was an independent prognostic factor (P= 0.034). Conclusions C-met protein expression and gene amplification are risk factors for EGFR-TKI resistance. C-met gene amplification suggests poor prognosis, and can be used as an independent factor for prognostic evaluation.