Clinical comprehensive treatment protocol for managing diabetic foot ulcers:A retrospective cohort study

BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations in promoting efficient wound healing and preventing complications.A comprehensive treatment approach targeting multiple aspects of wound care may offer improved outcomes for patients with DFUs.The hypothesis of this study is that a comprehensive treatment protocol for DFUs will result in faster wound healing,reduced amputation rates,and improved overall patient outcomes compared to standard treatment protocols.AIM To compare the efficacy and safety of a comprehensive treatment protocol for DFUs with those of the standard treatment protocol.METHODS This retrospective study included 62 patients with DFUs,enrolled between January 2022 and January 2024,randomly assigned to the experimental(n=32)or control(n=30)group.The experimental group received a comprehensive treatment comprising blood circulation improvement,debridement,vacuum sealing drainage,recombinant human epidermal growth factor and anti-inflammatory dressing,and skin grafting.The control group received standard treatment,which included wound cleaning and dressing,antibiotics administration,and surgical debridement or amputation,if necessary.Time taken to reduce the white blood cell count,number of dressing changes,wound healing rate and time,and amputation rate were assessed.RESULTS The experimental group exhibited significantly better outcomes than those of the control group in terms of the wound healing rate,wound healing time,and amputation rate.Additionally,the comprehensive treatment protocol was safe and well tolerated by the patients.CONCLUSION Comprehensive treatment for DFUs is more effective than standard treatment,promoting granulation tissue growth,shortening hospitalization time,reducing pain and amputation rate,improving wound healing,and enhancing quality of life.

Effects of mechanical vibration on filling and solidification behavior, microstructure and performance of Al/Mg bimetal by lost foam compound casting

Al/Mg bimetal was prepared by lost foam solid-liquid compound casting,and the effects of mechanical vibration on the filling and solidification behavior,microstructure and performance of the bimetal were investigated.Results show that the mechanical vibration has a remarkable influence on the filling and solidification processes.It is found that after mechanical vibration,the filling rate increases and the filling rate at different times is more uniform than that without vibration.In addition,the mechanical vibration also increases the wettability between liquid AZ91D and A356 inlays.The mechanical vibration reduces the horizontal and vertical temperature gradient of the casting and makes the temperature distribution of the whole casting more uniform.Compared to the Al/Mg bimetal without vibration,the shear strength is improved by 39.76%after the mechanical vibration is applied,due to the decrease of the inclusions and Al_(12)Mg_(17) dendrites,and the refinement and uniform distribution of the Mg_(2)Si particles in the interface of the Al/Mg bimetal.

Anthropogenic activity,hydrological regime,and light level jointly influence temporal patterns in biosonar activity of the Yangtze finless porpoise at the junction of the Yangtze River and Poyang Lake,China

Under increasing anthropogenic pressure,species with a previously contiguous distribution across their ranges have been reduced to small fragmented populations.The critically endangered Yangtze finless porpoise(Neophocaena asiaeorientalis asiaeorientalis),once commonly observed in the Yangtze River-Poyang Lake junction,is now rarely seen in the river-lake corridor.In this study,static passive acoustic monitoring techniques were used to detect the biosonar activities of the Yangtze finless porpoise in this unique corridor.Generalized linear models were used to examine the correlation between these activities and anthropogenic impacts from the COVID-19 pandemic lockdown and boat navigation,as well as environmental variables,including hydrological conditions and light levels.Over approximately three consecutive years of monitoring(2020–2022),porpoise biosonar was detected during 93%of logged days,indicating the key role of the corridor for finless porpoise conservation.In addition,porpoise clicks were recorded in 3.80%of minutes,while feeding correlated buzzes were detected in 1.23%of minutes,suggesting the potential existence of localized,small-scale migration.Furthermore,both anthropogenic and environmental variables were significantly correlated with the diel,lunar,monthly,seasonal,and annual variations in porpoise biosonar activities.During the pandemic lockdown period,porpoise sonar detection showed a significant increase.Furthermore,a significant negative correlation was identified between the detection of porpoise click trains and buzzes and boat traffic intensity.In addition to water level and flux,daylight and moonlight exhibited significant correlations with porpoise biosonar activities,with markedly higher detections at night and quarter moon periods.Ensuring the spatiotemporal reduction of anthropogenic activities,implementing vessel speed restrictions(e.g.,during porpoise migration and feeding),and maintaining local natural hydrological regimes are critical factors for sustaining porpoise population viability.

Recent efficacy and long-term survival of Astragalus polysaccharide combined with gemcitabine and S-1 in pancreatic cancer

BACKGROUND Pancreatic cancer is a highly malignant tumor with a rapid progression rate and a high susceptibility to infiltration and metastasis.Astragalus polysaccharide(APS),a pure Chinese medicine preparation primarily made from the traditional Chinese herb Astragalus,plays a positive role in the treatment of many malignant tumors.AIM To explore the recent efficacy of APS combined with gemcitabine plus tegafur gimeracil oteracil potassium capsule(S-1)(GS)regimen in the treatment of pancreatic cancer and assess its effect on the immune function and long-term survival of patients.METHODS A total of 97 patients who were diagnosed with pancreatic cancer and received GS chemotherapy at The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)from March 2021 to December 2021 were included in the retrospective analysis.Among them,41 patients received APS combined with GS chemotherapy,and 56 patients received GS chemotherapy only.The recent efficacy,immune function,adverse reactions,and long-term survival were compared among these patients.RESULTS After 4 cycles of treatment,the objective response rate of patients receiving the combined therapy of APS and GS was 51.22%,and the disease control rate(DCR)was 56.10%,higher than those of patients receiving the monotherapy with GS alone(30.36%and 35.71%,respectively).Besides,the percentages of CD3+T cells(50.18%±9.57%)and CD4+T cells(31.52%±5.33%)in the peripheral blood of patients receiving the combined therapy of APS and GS were higher compared with those treated with GS regimen alone[(44.06%±8.55%)and(26.01%±7.83%),respectively].Additionally,the incidences of leukopenia,thrombocytopenia,and fatigue in patients receiving the combined therapy of APS and GS were significantly lower than those in patients receiving the monotherapy of GS alone(17.07%,9.76%,31.71%vs 37.50%,28.57%,60.71%).Moreover,the median survival time of patients receiving the combined therapy of APS and GS was 394 days,significantly longer than that of patients receiving the mono-therapy of GS alone(339 days)(hazard ratio:0.66;95%CI:0.45-0.99;P=0.036).All these differences were statistically si-gnificant(P<0.05).CONCLUSION The combined therapy of APS and GS improved the recent efficacy and long-term survival of patients with pancreatic cancer and alleviated chemotherapy-induced immune suppression and adverse reactions.

Entrapment of the temporal horn secondary to postoperative gamma-knife radiosurgery in intraventricular meningioma: A case report

BACKGROUND Entrapment of the temporal horn (ETH) is a rare pathologic condition. It is a kind of focal hydrocephalus caused by obstruction of flow pathway of cerebrospinal fluid. It is caused by various conditions, but ETH secondary to postoperative gamma-knife radiosurgery (GKS) is extremely rare. CASE SUMMARY A 52-year old previously healthy woman underwent resection of a large intraventricular meningioma. A small fragment of residual tumor with no obvious enlargement of the temporal horn was observed 3 mo after surgery, and she was referred for GKS. Two months after GKS, she complained of headache and progressive paralysis of the left limb. Magnetic resonance imaging revealed enlargement of the temporal horn. There was a second procedure to resect the residual tumor 8 mo after GKS. After the second procedure, she recovered smoothly. As of the date of this writing, she has remained in good condition. CONCLUSION This case reminds us that ETH should be considered in the treatment of intraventricular meningiomas, especially before GKS.

The dynamical architecture and habitable zones of the quintuplet planetary system 55 Cancri

We perform numerical simulations to study the secular orbital evolution and dynamical structure of the quintuplet planetary system 55 Cancri with the self-consistent orbital solutions by Fischer and coworkers. In the simulations, we show that this system can be stable for at least 108 yr. In addition, we extensively investigate the planetary configuration of four outer companions with one terrestrial planet in the wide region of 0.790AU 〈 a 〈 5.900AU to examine the existence of potential asteroid structure and Habitable Zones （HZs）. We show that there are unstable regions for orbits about 4：1, 3：1 and 5：2 mean motion resonances （MMRs） of the outermost planet in the system, and several stable orbits can remain at 3：2 and 1：1 MMRs, which resembles the asteroid belt in the solar system. From a dynamical viewpoint, proper HZ candidates for the existence of more potential terrestrial planets reside in the wide area between 1.0 AU and 2.3 AU with relatively low eccentricities.

Isolation, chemical characterization, and immunomodulatory activity of naturally acetylated hemicelluloses from bamboo shavings

Bamboo shavings, the outer or intermediate layer of bamboo stems, are the bulk of by-products produced in bamboo processing. In this study we investigated the isolation, chemical characterization, and immunostimulatory activity in vitro of the hemicelluloses from bamboo shavings. Shavings were first pretreated by steam explosion. The optimal pretreatment was found to be steam explosion at 2.2 MPa for 1 min. Following this pretreatment, the yield of hemicelluloses reached（2.05±0.22）%（based on the dry dewaxed raw materials）, which was 5.7-fold higher than that of untreated samples. Bamboo-shavings hemicellulose（BSH） was then prepared by hot water extraction and ethanol precipitation from the steam-exploded shavings. Purification of BSH by anion-exchange chromatography of diethylaminoethanol（DEAE）-sepharose Fast Flow resulted in a neutral fraction（BSH-1, purity of 95.3%, yield of 1.06%） and an acidic fraction（BSH-2, purity of 92.5%, yield of 0.79%）. The weight-average molecular weights（Mw） of BSH-1 and BSH-2 were 12 800 and 11 300 g/mol, respectively. Chemical and structural analyses by Fourier transform infrared spectroscopy（FT-IR）, 1D（^1H and ^13C） and 2D（heteronuclear single quantum correlation（HSQC）） nuclear magnetic resonance（NMR） spectra revealed that BSH-1 was O-acetylated-arabinoxylan and BSH-2 was O-acetylated-（4-Omethylglucurono）-arabinoxylan. BSH-1 had a higher content of acetyl groups than BSH-2. For the immunomodulatory activity in vitro, BSH and BSH-2 significantly stimulated mouse splenocyte proliferation while BSH-1 had no effect; BSH, BSH-1, and BSH-2 markedly enhanced the phagocytosis activity and nitric oxide production of the murine macrophage RAW264.7 in a dose-dependent manner. Our results suggest that the water-extractable hemicelluloses from steam-exploded bamboo shavings are naturally acetylated and have immunostimulatory activity.