Diabetic foot is one of the serious complications of diabetic patients. It is caused by diabetes combined with different degrees of lower extremity vascular lesions and neuropathy, and the wound can not heal for a long time. The serious results can cause bone marrow infection, bone destruction, and have high disability and death rate. At present, there are various treatment methods for diabetic foot chronic wound. On the basis of internal medicine controlling blood sugar, anti infection, lowering blood lipid, improving microcirculation and nourishment nerve, the surgical method is adopted, including the debridement of the necrosis in a short time to prevent the infection from spreading; maggot biological debridement and ozone chemical debridement will promote the growth of granulation tissue while controlling infection. Skin grafting, skin flap transplantation, skin distraction closure can be used to repair soft tissue defects, or fat transplantation, platelet-rich plasma, and rich blood are used for the refractory wound after infection control. In patients with diabetic foot, the reconstruction of lower limb blood supply is beneficial to the recovery of chronic ischemic wounds. It is feasible to improve the blood supply of the lower extremities, improve the blood supply of the lower extremity artery bypass grafting, and improve the microcirculation of the peripheral vessels around the lower extremities. Lower extremity vascular bypass pressure perfusion therapy for vascular network expansion, tibia lateral moving technique for lower limb microcirculation reconstruction. For diabetic foot ulcer caused by peripheral neuropathy, such as Charcot foot, while the application of external fixator, total contact cast technology of affected foot for reducing treatment to promote wound healing; the preparation of orthopedic shoes can play a maximum protective effect on the healing of diabetic foot wound healing.
ObjectiveTo evaluate the clinical value of skin stretching device in repair of diabetic foot wound.MethodsA retrospective analysis was made on the clinical data of 48 cases with diabetic foot wound who were treated with skin stretching device (trial group, n=24) and with the vacuum sealing drainage combined with skin graft (control group, n=24) respectively between October 2015 and July 2016. There was no significant difference in gender, age, side, course of disease, TEXAS stage between 2 groups (P>0.05). Both patients in 2 groups were treated with sensitive antibiotics according to the results of bacterial culture.ResultsOne case in control group was infected and the skin graft failed, and 1 case in trial group was infected after the treatment, and the two wounds healed after symptomatic treatment. The wounds of the other patients healed successfully, and the healing time of the trial group was significantly shorter than that of the control group [(12.8±11.6) days vs. (22.3±10.4) days; t=2.987, P=0.005). All patients were followed up 3-12 months after operation, and no wound dehiscence or recurrence occurred during follow-up.ConclusionCompared with the vacuum sealing drainage combined with skin graft, the application of skin stretching device in the repair of diabetic foot wound has advantages, such as easy to operate, shorten the wound healing time, and the appearance of wound was similar with the adjacent skin.
The 8th World International Symposium on the Diabetic Foot (ISDF) Conference which was sponsored by the International Working Group on Diabetic Foot (IWGDF) was held in the Hague between May 22nd and May 25th, 2019. The conference issued the 2019 IWGDF guidelines on the prevention and management of diabetic foot disease. The update to the 2015 edition of the guidelines involves the following 6 chapters: prevention of foot ulcers in patients with diabetes; offloading foot ulcers in patients with diabetes; diagnosis, prognosis, and management of peripheral arterial disease in patients with a foot ulcer and diabetes; diagnosis and treatment of foot infection in patients with diabetes; interventions to enhance healing of foot ulcers in patients with diabetes; classification of diabetic foot ulcers. This guideline has been changed more than the previous edition. In this paper, the guidelines will be interpreted to provide cutting-edge information for domestic diabetic foot researchers.
Objective To summarize the research progress of microRNA in acute pancreatitis. Methods By reading the domestic and international literatures published in recent years, to summarize the research progress of microRNA in acute pancreatitis. Results In recent years, researches had found that microRNA could be used as a biomarker for acute pancreatitis to predict and determine the occurrence, development, and complications of acute pancreatitis. MicroRNA could regulate the programmed cell death of acute pancreatitis, and played an important role in the development of inflammation and complications, it also could be used as a therapeutic target for acute pancreatitis. Conclusions MicroRNA plays an important role in the development of acute pancreatitis. Researching the mechanism of microRNA in acute pancreatitis is helpful for the treatment and prevention of acute pancreatitis.
Objective To investigate the effects of different temperatures on the system of in vitro physiological environment fostering limbs. Methods Twenty-four limbs were harvested from 6 adult Bama mini pigs and were randomly divided into 4 groups (n=6) according to different temperatures: limbs were placed in in vitro physiological environment foster-ing limbs at 26℃ (group A), 4℃ (group B), 10℃ (group C), and 18℃(group D). After 12 hours of perfusion, the morphology observation was done for the structure and ultrastructure changes of the skeletal muscle by light microscope and transmission electron microscope. The mRNA levels of tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) were detected by real-time fluorescent quantitative PCR (RT-qPCR). Results Histological results showed that the skeletal muscle exhibited mild edema, integrity of the sarcolemma, and occasional perivascular inflammatory cell infiltration in groups B, C, and D, meanwhile, the cells of group C had normal morphology; however, muscle fibers degenerated, muscle cells were seriously damaged, a great number of inflammatory cells infiltrated in the fractured muscle fibers in group A. Transmission electron microscope results showed as follows: the muscle fibers arranged in disorder, and many focal solubility necrosis occurred in group A; the muscle fibers arranged in order relatively and sarcolemma was still intact, with mild swelling and flocculent degenerative mitochondria in group B; a large number of muscle fibers arranged in order and regularity with clear sarcomere in group C; and the muscle fibers arranged in disorder and irregularity and partly dissolved in group D. RT-qPCR results showed that the expressions of inflammatory factor TNF-α and IL-1β mRNA in group A were significantly higher than those in groups B, C, and D (P lt; 0.05); the expressions were significantly lower in groups B and C than in group D, and in group C than in group B (P lt; 0.05). Conclusion In the system of in vitro physiological environment fostering limbs, temperature plays an important role in the preservation of amputated limbs. It is suggested that 10℃ can significantly attenuate the reperfusion-induced skeletal muscle cell injuries in this system.
ObjectiveTo understand the current progress of programmed cell death in the pathogenesis of acute pancreatitis, and to provide reference for the pathogenesis and treatment of acute pancreatitis.MethodThe research progress of acute pancreatitis and programmed cell death in recent years was reviewed by reading relevant literatures at home and abroad in recent years.ResultsProgrammed cell death was defined as controlled cell death performed by intracellular procedures, including apoptosis, autophagy, programmed necrosis, and coronation. The pattern of death of pancreatic acinar cells mainly includes apoptosis and programmed necrosis. Although the pathogenesis of acute pancreatitis had not yet been fully clarified, it was known that through the study of programmed cell death, it could help us to understand the pathogenesis and pathogenesis of acute pancreatitis and provide more effective treatment methods.ConclusionsProgrammed cell death is very important for acute pancreatitis. The mechanism of programmed cell death in acute pancreatitis is necessary for the treatment and prevention of it.
ObjectiveTo understand current research progress of microRNA (miRNA) in pathogenesis of triple-negative breast cancer (TNBC), and to provide reference for understanding pathogenesis and treatment of TNBC.MethodTheresearch progress of relationship of TNBC and miRNA was reviewed by reading relevant literatures at home and abroad in recent years.ResultsThe miRNAs were involved in a variety of biological processes, including the cell proliferation, apoptosis, autophagy, differentiation, metastasis, etc., and played an important role in the cancer initiation and metastasis. Therefore, researchers had attempted to treat and prevent the TNBC by targeting miRNAs. At present, there had been a large number of reports that the miRNAs played a key role in TNBC, which were classified as the anti-oncogene and oncogene, and was associated with metastasis and prognosis of TNBC.ConclusionmiRNA is very important in pathogenesis of TNBC. Mechanism of studying miRNA is necessary for treatment and prevention of TNBC.
Objective To investigate the current situation of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and analyze the related influencing factors. Methods A questionnaire survey was conducted among AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University from August 2022 to October 2023. The survey included basic demographic information, anxiety and depression scores, quality of life and dyspnea symptoms in the AECOPD patients. The clinical data of patients in the electronic medical record system were also collected. According to the anxiety score or depression score, the patients were divided into an anxiety group and a non-anxiety group, or a depression group and a non-depression group. The indicators between two groups were compared and the influencing factors were analyzed. Results Among the 164 patients with AECOPD, 123 patients (75.0%) were complicated with anxiety, 125 patients (76.2%) were complicated with depression, and 105 patients (64.0%) were complicated with anxiety and depression. Education level, place of residence, monthly income, smoking index, and chronic obstructive pulmonary disease assessment test (CAT) score were associated with AECOPD and anxiety (P<0.05). Higher CAT score was an independent risk factor for anxiety in the patients with AECOPD. Residence, monthly income, smoking index, CAT score, modified British Medical Research Council (mMRC) dyspnea questionnaire rating, actual bicarbonate, neutrophilic granulocyte percentage (NEU%), lymphocyte percentage (LYM%), basophile percentage (BASO%), alkaline phosphatase, total carbon dioxide concentration, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were associated with AECOPD and depression (P<0.05). Among them, higher CAT score and PLR value were independent risk factors of AECOPD and depression. Conclusion Anxiety and depression have higher prevalence in AECOPD patients, and the influencing factors include quality of life, dyspnea symptoms, education level, place of residence, monthly income, smoking index, acid base balance, NEU%, LYM%, BASO%, NLR和PLR, etc.