2015年 · 第95卷第17期

The successful holding of the 2008 Beijing Olympic Games and the 2013 Nanjing Youth Olympic Games indicates that China is gradually moving from a big sports country to a strong sports country. Undertaking large-scale international comprehensive sports events is a symbol of a country's strong comprehensive national strength and noble national civilization, and it has an infinite promoting role in many fields such as economy, society, culture and environmental sanitation of the host country. However, during the extremely competitive event, facing tens of thousands of athletes, coaches, staff, etc., and facing more professional, specialized and systematic medical needs, how to safeguard athletes' health, prevent the occurrence of sports injury and other diseases, quickly and accurately diagnose and evaluate the degree of sports injury, and provide detailed information for the choice of treatment plan and rehabilitation evaluation is an important topic and huge challenge to the development of sports medicine imaging in China. Therefore, it is necessary to improve the research level of sports medicine imaging in China^[1]It is of great value to give full play to its important role in medical security in large-scale sports games and establish a sports injury imaging diagnosis platform that meets international standards.

A 21-year-old male, Han nationality, was seen for "weakness of both upper limbs for 3 years". Three years ago, the patient accidentally found weakness in both upper limbs, with weakness in proximal lifting, but he could still lift it, and there was no obvious obstacle in eating and brushing his teeth. After 1 to 2 months, it was relieved, and no diagnosis and treatment were given. Two months later, lumbar compression fracture was caused by trauma, and the proximal weakness of both upper limbs was aggravated again, and the distal ends of both upper limbs were gradually involved, resulting in a loss of fine touch in both hands. In the past year and a half, the patient's symptoms have obviously aggravated, and he can no longer take care of himself in daily life. Since the onset of the disease, there is occasional fleshy sensation in the upper limbs and chest, but there is no numbness and pain in the limbs, no dysarthria, choking and coughing after drinking water, dysphagia, no vision loss and diplopia.

The patient was an 18-year-old male with muscle soreness and weakness in his limbs for 2 d. He was admitted to hospital on July 8, 2014. The patient and three family members all experienced nausea and vomiting after eating self-collected wild fungi for 6~18 h, and self-induced vomiting and catharsis. The patient experienced shoulder and upper arm soreness 48 h after taking mushroom, and lower limb soreness and pain, which progressively aggravated to the point that he could not walk, relieving "soy sauce-colored" urination. The patient had no fever, excessive exercise, no trauma, and no history of drinking alcohol or drugs before illness. Physical examination at admission: body temperature: 36.5 ℃, heart rate: 105 beats/min, respiratory rate: 26 beats/min, blood pressure: 139/84 mmHg (1 mmHg =0.133 kPa), uniform heart rhythm, no pathological murmur, coarse respiratory sound in both lungs, no dry and wet rales, soft abdomen, insufficient liver and spleen. Main positive signs of nervous system: proximal muscle strength of both upper limbs grade 4, distal muscle strength of both upper limbs grade 5-, proximal muscle strength of both lower limbs grade 3, distal muscle strength of both lower limbs grade 4, and decreased muscle tone. The tendon reflexes of the extremities were weakened, and bilateral gastrocnemius tenderness was evident. Blood routine on the day of admission: white blood cells: 11.46×10⁹/L, neutrophils: 0.894, red blood cells 6.13×10¹²/L, hemoglobin 179 g/L, platelets 165×10⁹/L. Urine routine: urine "soy sauce color", pH: 5.0, white blood cells 0~1/HP, red blood cells 0~1/HP, Pro (+ + +), occult blood (-). Creatine kinase (CK) 75 785 IU/L, ECG: sinus tachycardia. HIV antibody negative, TORCH antibody negative. Blood immunology negative. Electromyography of the extremities: myogenic lesions. Symptomatic treatment such as hormones and alkalized urine was given, and the patient's symptoms were aggravated, with dyspnea, weak cough and dysphagia. On July 9, CK continued to rise, and there was myocardial injury (Table 1)。 Electrolytes: serum potassium 5.53 mmol/L, serum sodium Na 134.8 mmol/L, calcium and phosphorus normal. Liver function aspartate aminotransferase, alanine aminotransferase high, bilirubin normal. Kidney function is normal. HA330 blood perfusion was continued three times (once daily) after plasma exchange once on July 9 (60 h after eating mushroom). The symptoms began to improve on the next day of blood purification treatment, and the muscle enzymology review was shown inTable 1After 12 days of treatment, the patient's symptoms disappeared, CK was normal, and the patient was discharged.

Tumors in posterior cranial fossa are closely related to the surrounding cranial nerves, blood vessels and brain stem. The most common complication of surgery is the damage of cranial nerves, which seriously affects the quality of life of patients. At present, precision is the development direction and concept of neurosurgery in the high-tech era^[1]。 Intraoperative neuroelectrophysiological monitoring can monitor the corresponding nerve function while the surgeon removes the tumor tissue in the brain, and protect the nerve function to the maximum extent. From March 2012 to February 2014, the Department of Neurosurgery of Huanhu Hospital performed intraoperative neuroelectrophysiological monitoring of cranial nerves in 50 patients with tumors in the posterior cranial fossa area, and followed up to evaluate the functional preservation of patients' nerves after surgery. The results are reported below.

Ankle injury is a common lower limb injury in athletes, and the incidence rate can reach 21% ~40%. Some studies have shown that if athletes fail to make accurate diagnosis and timely and effective treatment in the early stage after ankle injury, and enter training and competition before the symptoms and signs have completely recovered, it will lead to further serious injury of ankle joint, cause joint dysfunction, and even affect athletes' career^[1,2]。 Therefore, early and accurate diagnosis, effective treatment and rehabilitation after ankle injury are very important for athletes to maintain a good competitive state and prolong their athletic life. Imaging examination methods and diagnostic skills are important links for early detection of lesions in time and accurate diagnosis. This article reviews the problems related to imaging diagnosis of ankle injury.

osteoarthritis (OA) is a chronic progressive joint disease characterized by degeneration of articular cartilage and secondary bone hyperplasia. It is the result of the imbalance of normal synthesis and degradation of articular chondrocytes, extracellular matrix and subchondral bone due to the interaction of mechanical and biological factors. The pathological changes of OA were mainly: focal changes, destruction and defect of articular cartilage, reactive bone hyperplasia and osteophyte formation around the lesion^[1]。 The results of the Global Burden of Disease 2010 (GBD2010) survey show that the global prevalence of knee arthritis is 3.8% and hip arthritis is 0.85%, and the loss of healthy life due to osteoarthritis of the hip and knee increased from 10.5 million people/year in 1990 to 17.1 million people/year in 2010^[2]。 The data show that by 2050, the population over 60 years old will exceed 20% of the global total population, and the prevalence of OA will further increase. The associated medical costs, loss of social productivity and additional economic burden will also increase^[3,4]。 Therefore, it is urgent to find an effective treatment for osteoarthritis. After cartilage injury, it can be partially repaired by itself, but the cartilage tissue produced by it is fibrocartilage instead of normal hyaline cartilage, which lacks the durability and special function of normal cartilage tissue^[5]。 Therefore, once the articular cartilage is destroyed, it is difficult to achieve complete repair. At present, the treatment of OA is mainly a combination of drug and non-drug treatment, and surgery is performed if necessary. The results of the former two can not meet the expectations, surgical treatment increases the financial and psychological burden of patients, and there is still a lack of ideal and effective methods for repairing articular cartilage defects. In recent years, the use of stem cells in the treatment of OA has become a research hotspot, and bone marrow mesenchymal stem cells (BMSCs) as an ideal seed cell for the treatment of OA have made some progress. Although BMSCs avoid the immunogenicity, ethics, law, religion and other problems of embryonic stem cells, there are still many shortcomings, such as limited source, invasive materials, and limited ability to differentiate into chondrocytes. With the intensive research of induced pluripotent stem cells (iPSCs), it may replace BMSCs as the most desirable seed cells in osteoarthritis treatment research.

bile acid sequestrants (BASs) are basic anion exchange resins, which are difficult to dissolve in water and are not easily destroyed by digestive enzymes. They can combine with bile acids to prevent the hepatic and intestinal circulation of bile acids, so that cholesterol in liver cells is continuously converted into bile acids, and a large amount of cholesterol in liver is consumed. It has been proved by clinical trials to be a safe and effective drug to reduce plasma total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C). As a second-generation bile acid chelator, colesevelam hydrochloride continues the advantages of the first-generation bile acid chelator in reducing plasma TC and LDL-C, and its tolerability and safety have also been greatly improved. In 2000, it was approved by the US FDA as a lipid-lowering drug for clinical use^[1,2]。