BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical t...BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical treatment method.AIM To investigate whether Huangma Ding or autologous platelet-rich gel(APG)treatment would benefit diabetic lower extremity arterial disease(LEAD)patients with foot ulcers.METHODS A total of 155 diabetic LEAD patients with foot ulcers were enrolled and divided into three groups:Group A(62 patients;basal treatment),Group B(38 patients;basal treatment and APG),and Group C(55 patients;basal treatment and Huangma Ding).All patients underwent routine follow-up visits for six months.After follow-up,we calculated the changes in all variables from baseline and determined the differences between groups and the relationships between parameters.RESULTS The infection status of the three groups before treatment was the same.Procalcitonin(PCT)improved after APG and Huangma Ding treatment more than after traditional treatment and was significantly greater in Group C than in Group B.Logistic regression analysis revealed that PCT was positively correlated with total amputation,primary amputation,and minor amputation rates.The ankle-brachial pressure and the transcutaneous oxygen pressure in Groups B and C were greater than those in Group A.The major amputation rate,minor amputation rate,and total amputation times in Groups B and C were lower than those in Group A.CONCLUSION Our research indicated that diabetic foot ulcers(DFUs)lead to major amputation,minor amputation,and total amputation through local infection and poor microcirculation and macrocirculation.Huangma Ding and APG were effective attreating DFUs.The clinical efficacy of Huangma Ding was better than that of autologous platelet gel,which may be related to the better control of local infection by Huangma Ding.This finding suggested that in patients with DFUs combined with coinfection,controlling infection is as important as improving circulation.展开更多
目的系统评价中国社区老年居民衰弱的发生率及其影响因素。方法计算机检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library相关文献,检索时限为建库至2023年2月,采用Stata 12.0和RevM...目的系统评价中国社区老年居民衰弱的发生率及其影响因素。方法计算机检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library相关文献,检索时限为建库至2023年2月,采用Stata 12.0和RevMan 5.3软件对中国社区老年居民衰弱的发生率及影响因素进行Meta分析。结果共纳入17篇文献,合计11928例老年人。Meta分析结果显示,中国社区居民衰弱发生率为16%[95%CI(12%,20%)]。其危险因素包括营养不良[OR=6.68,95%CI(3.35,13.32)]、合并慢性病[OR=6.22,95%CI(5.24,7.38)]、多重用药[OR=2.71,95%CI(2.03,3.63)]、睡眠质量差[OR=2.54,95%CI(1.66,3.89)]、抑郁情绪[OR=3.42,95%CI(1.78,6.58)]、使用步行辅助工具[OR=5.42,95%CI(1.98,14.86)]、日常生活活动能力受损[OR=8.07,95%CI(5.21,15.21)]、年龄≥80岁[OR=2.68,95%CI(1.95,3.69)];小学以上文化程度[OR=0.53,95%CI(0.42,0.66)]是其保护性因素。结论中国社区老年居民衰弱发生率高,危险因素较多。应对社区老年人进行早期衰弱筛查并开展针对性的干预,预防老年人衰弱的发生,促进健康老龄化。展开更多
基金Supported by the Chongqing Science and Technology Bureau and Health Commission of Chinese Medicine Technology Innovation and Application Development Project,No.2020ZY013540General Project of Chongqing Natural Science Foundation,No.CSTB2023NSCQMSX0246 and No.CSTB2022NSCQ-MSX1271Science and Health Joint Project of Dazu District Science and Technology Bureau,No.DZKJ2022JSYJ1001.
文摘BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical treatment method.AIM To investigate whether Huangma Ding or autologous platelet-rich gel(APG)treatment would benefit diabetic lower extremity arterial disease(LEAD)patients with foot ulcers.METHODS A total of 155 diabetic LEAD patients with foot ulcers were enrolled and divided into three groups:Group A(62 patients;basal treatment),Group B(38 patients;basal treatment and APG),and Group C(55 patients;basal treatment and Huangma Ding).All patients underwent routine follow-up visits for six months.After follow-up,we calculated the changes in all variables from baseline and determined the differences between groups and the relationships between parameters.RESULTS The infection status of the three groups before treatment was the same.Procalcitonin(PCT)improved after APG and Huangma Ding treatment more than after traditional treatment and was significantly greater in Group C than in Group B.Logistic regression analysis revealed that PCT was positively correlated with total amputation,primary amputation,and minor amputation rates.The ankle-brachial pressure and the transcutaneous oxygen pressure in Groups B and C were greater than those in Group A.The major amputation rate,minor amputation rate,and total amputation times in Groups B and C were lower than those in Group A.CONCLUSION Our research indicated that diabetic foot ulcers(DFUs)lead to major amputation,minor amputation,and total amputation through local infection and poor microcirculation and macrocirculation.Huangma Ding and APG were effective attreating DFUs.The clinical efficacy of Huangma Ding was better than that of autologous platelet gel,which may be related to the better control of local infection by Huangma Ding.This finding suggested that in patients with DFUs combined with coinfection,controlling infection is as important as improving circulation.
