“补肾活血”法对骨性关节炎大鼠关节液中炎性因子的影响

目的探讨"补肾活血"法对骨性关节炎大鼠关节液中炎性因子的影响。方法 2016年5月,采用72只雄性10周龄SD大鼠,分别设为正常组、对照组和实验组,每组各24例。实验组给予牛膝煎煮液灌胃给药,正常和对照组给予同等量清水灌胃。6周后观察三组大鼠关节液中白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)和转化生长因子β1(TGF-β1)水平,同时分析膝关节软骨组织中MMP-13、ADAMTS-5 mRNA相对表达量和Makin评分。结果干预前实验组和对照组IL-1β、TNF-α、MMP-13、ADAMTS-5 mRNA相对表达量和Makin评分水平均显著高于正常组,而TGF-β1均显著低于正常组(P0.05);实验组和对照组IL-1β、TNF-α、MMP-13、ADAMTS-5 mRNA相对表达量、Makin评分和TGF-β1均无统计学差异(P0.05)。与干预前比较,干预后实验组IL-1β、TNF-α、MMP-13、ADAMTS-5 mRNA相对表达量和Makin评分显著降低,而TGF-β1显著升高(P0.05)。干预后6w,实验组IL-1β显著低于对照组[(15.38±3.28)ng/L vs.(23.57±4.17)ng/L,P0.05];TNF-α显著低于对照组[(15.43±6.37)ng/L vs.(36.48±9.25)ng/L,P0.05];但TGF-β1显著高于对照组[(87.47±14.3)ng/L vs.(41.38±11.58)ng/L,P0.05];MMP-13 mRNA相对表达量显著低于对照组(0.54±0.21 vs.(0.92±0.28,P0.05);ADAMTS-5 mRNA相对表达量也显著低于对照组(0.61±0.21 vs.0.98±0.32,P0.05];Makin评分显著低于对照组(3.76±1.37 vs.8.54±4.12,P0.05)。结论 "补肾活血"法有助于降低骨性关节炎大鼠关节液中炎性因子水平和MMP-13等蛋白酶mRNA的表达。     

同种异体富血小板对糖尿病足创面的愈合再生情况分析

目的探讨同种异体富血小板对糖尿病足创面的愈合再生情况的影响。方法选择2019年1月～2020年6月在本院接受治疗的糖尿病足溃疡患者86例进行研究。以随机数字表法将患者分为2组,每组各43例。对照组参照《中国糖尿病足诊治指南》均给予常规治疗,观察组在此基础上加以同种异体血库浓缩血小板富血小板凝胶(APG)治疗。比较2组患者临床疗效、一般情况、创面情况、炎症因子、血清中转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)、透明质酸(HA)水平。结果观察组患者总有效率为93.02%,高于对照组的76.73%(P0.05)。观察组患者创面愈合时间(15.08±3.19 vs 17.38±4.02)d及住院时间(16.12±4.03 vs 18.27±5.11)d均较对照组更短(P0.05)。治疗前两组hs-CRP(4.25±0.39 vs 4.10±0.41)mg/L、TNF-α(5.70±1.29 vs 5.81±1.33)μg/L、IL-6(96.38±24.02 vs 99.64±25.17)mg/L差异均无统计学意义(P0.05),治疗后观察组hs-CRP(2.35±0.50 vs 2.83±0.44)mg/L、TNF-α(3.15±0.82 vs 4.02±1.07)μg/L、IL-6(50.82±18.54 vs 72.93±20.25)mg/L均低于对照组(P0.05)。治疗前两组患者TGF-β1(5.66±1.25 vs 5.81±1.31)ng/L、VEGF(11.03±3.62 vs 10.83±3.72)μg/L及HA(71.19±20.84 vs 70.82±21.03)mg/L差异均无统计学意义(P0.05)。治疗后观察组患者TGF-β1(17.29±4.09 vs 14.03±3.72)ng/L、VEGF(43.03±14.17 vs 37.04±11.05)及HA(177.96±39.08 vs 151.94±36.17)水平均高于对照组(P0.05)。结论常规治疗基础上以同种异体血库浓缩血小板APG较单独使用常规治疗可有效提高糖尿病足创面疗效,缩短创面愈合时间及住院时间,其机制可能与降低炎症因子水平并提高TGF-β1、VEGF及HA有关。     

高强度聚焦超声对恶性肿瘤患者外周血免疫抑制因子的影响

目的:探讨以物理方法变化的高强度聚焦超声(highintensityfocusedul-trasound,HIFU)对恶性肿瘤患者外周血免疫抑制因子的影响。方法:重庆医科大学附属第二医院肿瘤中心2002-09/2003-0215例恶性肿瘤患者接受了1次HIFU治疗。应用双抗体夹心酶联免疫吸附ELISA法,检测了治疗前后患者外周血血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)、转化生长因子-β2(TGF-β2)、白细胞介素6(IL-6)和白细胞介素10(IL-10)的变化。自身配对t检验分析检测结果。结果:与治疗前比较,HIFU治疗1周后外周血免疫抑制因子水平下降,其中VEGF,TGF-β1和TGF-β2的下降差异有显著性意义(t=2.555～3.648,P<0.05)。结论:HIFU治疗恶性肿瘤后患者外周血免疫抑制因子VEGF,TGF-β1和TGF-β2水平明显下降,可能有助于治疗后宿主抗肿瘤免疫平衡的恢复及改善患者的预后。     

环氧化酶-2抑制剂塞莱昔布对急性白血病细胞VEGF、b-FGF和TGF-β mRNA表达的影响

本研究旨在探讨环氧化酶-2(COX-2)特异性抑制剂塞莱昔布(celecoxib)对急性白血病细胞血管新生因子血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(b-FGF)和转化生长因子-β(TGF-β)mRNA表达的影响及其意义。采用半定量逆转录多聚酶链反应(RT-PCR)法检测30例急性白血病细胞经塞莱昔布干预前、后VEGF、b-FGF和TGF-βmRNA表达及变化。结果表明,急性白血病细胞存在VEGF、b-FGF和TGF-βmRNA的表达。VEGFmRNA与b-FGF mRNA表达存在正相关(r=0.559,P=0.001),VEGF mRNA与TGF-βmRNA表达存在负相关(r=-0.4,P=0.029)。经塞莱昔布(80μmol/L,48 h)处理后急性白血病细胞的VEGF、b-FGF和TGF-βmRNA表达较对照组明显下降,差异有统计学意义(P<0.01)。结论:塞莱昔布通过下调血管新生因子的表达而抑制血管增生,对急性白血病治疗具有辅助作用。     

针灸联合放化疗治疗鼻咽癌效果及对患者VEGF、TGF-β1和免疫功能的影响

目的探讨针灸联合放化疗治疗气血亏虚型鼻咽癌的效果及对其血清中血管内皮生长因子(VEGF)、转化生长因子β1(TGF-β1)和免疫功能的影响。方法选择中医证型属于气血亏虚型的89例鼻咽癌患者,按照随机数字表法分成两组。对照组45例单纯采用放化疗,观察组44例则联合针灸治疗,治疗7周后比较临床疗效,以及治疗前后的VEGF、TGF-β1和免疫功能的变化。结果观察组治疗后CD^4+、CD^3+、CD^4+/CD^8+均高于对照组,基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)水平均低于对照组(t分别=9.16、11.24、7.31、11.36、8.21,P均<0.05);观察组治疗后TGF-β1水平低于对照组,Karnofsky功能状态评分(KPS)高于对照组(t分别=13.81、10.38,P均<0.05);观察组总有效率93.18%高于对照组73.33%,差异有统计学意义(χ^2=6.25,P<0.05);观察组治疗后1年、2年及3年生存率均高于对照组(χ^2分别=4.89、4.05、4.45,P均<0.05);观察组口腔黏膜反应、食少纳呆、骨髓抑制、肝功能损伤、周围神经损伤等不良反应发生率均低于对照组,差异均有统计学意义(χ^2分别=9.08、21.21、6.25、4.78、5.64,P均<0.05)。结论针灸联合放化疗治疗气血亏虚型鼻咽癌效果明显,可抑制新生血管再生,提高免疫力,预防放化疗不良反应。     

非小细胞肺癌患者化疗前后血清VEGF/血小板数和TGF-β1检测的临床意义

目的探讨非小细胞肺癌(NSCLC)患者化疗前后血清VEGF/血小板数和TGF-β1浓度的变化,探讨两者在病情监测中的临床价值。方法 72例NSCLC患者化疗前采用酶联免疫法测定血清VEGF/血小板数和TGF-β1浓度,化疗采用GP方案,连用2周期,治疗结束后1周再次测定血清VEGF/血小板数和TGF-β1浓度,并行胸部CT检查,根据CT结果分为化疗有效组(完全缓解+部分缓解)和无效组(病情稳定+疾病进展),组间比较采用t检验,以P0.05为差异有统计学意义。结果 NSCLC患者化疗前血清VEGF/血小板数、TGF-β1浓度分别为(0.803±0.078)10~(-6)pg、45.56±4.54ng/ml,均高于对照组的(0.539±0.027)10~(-6)pg、16.02±2.32ng/ml,差异有统计学意义(t=19.57、39.56,P0.05)。不同性别、年龄、病理类型和分化程度NSCLC患者之间血清VEGF/血小板数、TGF-β1浓度接近,差异均无统计学意义(P0.05)。化疗有效组化疗前血清VEGF/血小板数为(0.810±0.121)10~(-6)pg,化疗后下降至(0.415±0.098)10~(-6)pg,差异有统计学意义(t=16.84,P0.05);化疗无效组化疗前血清VEGF/血小板数为(0.815±0.104)10~(-6)pg,化疗后浓度明显升高,差异有统计学意义(t=24.42,P0.05)。化疗有效组化疗前血清TGF-β1浓度为42.57±4.47ng/ml,化疗后浓度下降至20.75±3.43ng/ml,差异有统计学意义(t=26.72,P0.05);化疗无效组化疗前血清TGF-β1浓度为41.90±5.26ng/ml,化疗后浓度为45.51±4.48ng/ml,差异有统计学意义(t=2.38,P=0.030)。结论血清VEGF/血小板数和TGF-β1浓度与肿瘤活动度密切相关,可用于判定NSCLC化疗近期疗效。     

转化生长因子-β、碱性成纤维生长因子和血小板衍生生长因子在骨折愈合中的表达

目的:观察转化生长因子-β(TGF-β)、碱性成纤维细胞生长因子(bFGF)和血小板衍生生长因子(PDGF)在骨折愈合中的表达和分布情况,进而探讨其作用机制。方法:选用SD大鼠制作胫骨骨折愈合模型,伤后不同时期处死取材,分别进行组织学和TGF-β、bFGF和PDGF免疫组化染色观察。结果:(1)伤后3d开始形成原始骨痂。1周时肉芽组织中的间质细胞开始分化为软骨细胞,软骨形成后再进行软骨内化骨。4周时形成连接骨折端的桥接骨痂。(2)伤后早期血肿中炎性细胞表达bFGF、PDGF。伤后1周骨膜增殖细胞、肉芽组织中的成纤维细胞、内皮细胞、骨端骨细胞以及原始骨痂成骨细胞表达TGF-β、bFGF和PDGF。伤后2周软骨细胞表达TGF-β、bFGF和PDGF。结论:TGF-β、bFGF和PDGF有着各自的表达和分布特点,并共同调解骨原细胞的增殖和成骨细胞、软骨细胞的分化,最终完成骨折愈合。     

肺间质纤维化合并肺气肿患者血清相关因子的变化

目的 探讨转化生长因子β1(TGF-β1)、血管内皮生长因子(VEGF)、胰岛素生长因子-Ⅰ(IGF-Ⅰ)在肺间质纤维化合并肺气肿(CPFE)发病机制中的作用.方法 选择2011年7月至2012年2月在我院呼吸内科住院的CPFE患者20例,特发性肺间质纤维化(IPF)患者40例,肺气肿患者40例,ABC-ELISA法测定其血清TGF-β1、VEGF、IGF-Ⅰ.结果 CPFE组和IPF组血清TGF-β1、IGF-Ⅰ水平均明显高于肺气肿组[TGF-β1:(160.73 ±40.62)、(167.35±42.82)、(128.75±35.77) ng/L,IGF-Ⅰ:(179.65±60.73)、(192.32 ±58.75)、(148.73±49.67) ng/L,P＜0.05或＜0.01],IPF组血清VEGF水平明显高于肺气肿组[(506.12±82.37)、(437.31±62.58) ng/L,P＜0.01].CPFE与肺气肿组血清中TGF-β1与IGF-Ⅰ呈正相关(r值分别为0.885和0.918,P均＜0.01).CPFE吸烟组血清VEGF明显低于非吸烟组[(406.19 ±66.94)、(482.88 ±79.91) ng/L,t=-2.287,P=0.035].结论 IPF组血清VEGF水平明显升高,推测其参与了肺间质纤维化的形成.TGF-β1与IGF-Ⅰ存在正线性回归关系,两者在致纤维化的过程中可能起协同作用.     

儿童慢性粒细胞白血病慢性期红细胞参数及血清bFGF、TGF-β1、VEGF表达变化分析

目的 探究儿童慢性粒细胞白血病(CML)慢性期红细胞参数及血清碱性成纤维细胞生长因子(bFGF)、转化生长因子β1(TGF-β1)及血管内皮生长因子(VEGF)表达变化。方法 前瞻性选取2020年1月至2023年1月在首都医科大学附属北京儿童医院进行治疗的54例CML慢性期患儿为研究组,另随机抽取46名同期在本院进行体检的健康儿童为健康对照组。研究组给予酪氨酸激酶抑制剂治疗。比较两组间红细胞参数及血清bFGF、TGF-β1、VEGF表达变化,并比较研究组治疗前后红细胞参数及血清bFGF、TGF-β1、VEGF表达水平。结果 研究组的RBC、血红蛋白、红细胞压积(HCT)及平均红细胞血红蛋白浓度(MCHC)水平分别为(3.45±0.04)×10¹²/L、(102.33±1.15) g/L、(32.03±0.61)%、322.15±2.58,均显著低于对照组[(4.98±0.03)×10¹²/L、(149.78±1.88) g/L、(44.33±0.31)%、334.12±0.77],平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)及红...     

腹腔镜下射频消融术在肝癌患者中的临床应用价值及其对血清血管内皮生长因子和基质金属蛋白酶-2的影响*

目的探讨腹腔镜下射频消融术(LRFA)在肝癌患者中的临床应用价值及其对血清血管内皮生长因子(VEGF)和基质金属蛋白酶-2(MMP-2)的影响。方法收集2012年1月-2013年12月该院收治的晚期原发性肝癌患者120例,将患者随机分为LRFA组和对照组。LRFA组患者采用LRFA治疗后,继续采用FOLFOX4方案化疗;对照组仅采用PIAF方案化疗。主要观察指标为健康相关生存质量(HRQL)、实体瘤疗效评价(RECIST)等级、无进展生存期和2年死亡率;次要观察指标为血清VEGF和MMP-2水平。结果与对照组相比,LRFA组患者病情进展率明显降低(28.33%vs 50.00%,P=0.015);无进展生存期明显延长(500 d vs 380 d,P=0.013);临床干预后6个月时HRQL明显增高[(80.33±5.84)vs(65.87±9.59),P=0.000];临床干预后7、14和28天以及6个月时VEGF明显降低(P值均为0.000);临床干预后14和28天以及6个月时MMP-2明显降低(P值分别为0.003、0.001和0.000)。结论 LRFA明显改善了肝癌患者临床预后,并显著降低患者VEGF、MMP-2水平。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.