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.

Preprocessing and Efficacy Analysis of Comprehensive Anti-Inflammatory Treatment for Lymphedema in Patients with Irritating Contact Dermatitis

Objective: To explore the pre-treatment and efficacy analysis of comprehensive anti-inflammatory treatment for lymphedema in patients with irritating contact dermatitis. Method: Convenience sampling method was used to observe the skin of 160 patients with upper limb lymphedema admitted to the lymphedema outpatient department of our hospital. They were divided into an observation group (80 cases) and a control group (80 cases), and both groups received a course of comprehensive anti-inflammatory treatment (20 treatments). The control group received routine skin care;On the basis of the control group, the observation group received pre-treatment of the affected limb skin: Laofuzi herbal ointment was applied externally to the prone areas of irritating contact dermatitis (such as the upper arm, inner forearm, and cubital fossa). Result: The incidence of irritating contact dermatitis in the observation group was significantly lower than that in the control group (P 0.05). Patients in the observation group felt significantly better in terms of comfort, skin moisture, and itching relief after being wrapped with low elasticity bandages than those in the control group (P Conclusion: Preventive treatment can effectively reduce the incidence of irritating contact dermatitis, prolong the time of stress treatment, thereby increasing efficacy and improving patient compliance.

Loose Body in the Knee Joint: A Case Report

Background: Loose bodies (LBs) within the knee joint are commonly encountered during clinical practice and are frequently observed during knee arthroscopy. The primary treatment involves the removal of loose bodies;however, their complete eradication is often challenging and may not address underlying diseases, leading to persistent symptoms and the risk of new loose body formation. Aim: This case report aims to present the findings and surgical management of a 52-year-old male with an unusually large osseous loose body in the knee joint and associated pathologies. Case Presentation: The patient, a 52-year-old male, experienced recurrent episodes of severe, sudden, and painful locking of the knee joint, leading to difficulties moving. A plain MRI study was conducted to evaluate the condition of the knee joint, which revealed various degenerative changes and the presence of a loose body. Subsequently, an arthroscopic examination was performed under general anesthesia, uncovering the presence of an abnormally large loose body, as well as other pathologies including chondropathy, meniscal degeneration, and Baker’s cyst. Conclusion: Loose bodies (LBs) in the knee joint pose significant challenges and may lead to debilitating symptoms. Timely diagnosis and appropriate surgical intervention are crucial for symptom relief and the prevention of further joint damage as arthroscopic excision. Comprehensive imaging has a vital role in guiding treatment decisions and optimizing patient outcomes. In this case, the removal of the loose body improved patient outcomes and helped prevent potential joint complications.

Treatment Analysis of Limb Fractures Combined with Traumatic Shock

Objective:To evaluate the treatment regimen and efficacy for limb fractures combined with traumatic shock(TS).Methods:A total of 88 patients with limb fractures combined with TS,admitted between January 2021 and December 2023,were selected.Patients were divided randomly using a numerical grouping method.The observation group underwent restricted fluid resuscitation combined with comprehensive treatment,while the reference group received conventional fluid resuscitation combined with comprehensive treatment.Recovery time,fracture prognosis,complications,severity of the condition,and post-fracture joint function were compared between the two groups.Results:The observation group showed shorter symptom recovery times,a higher rate of anatomical fracture reduction,and a lower complication rate compared to the reference group(P<0.05).After one week of treatment,the severity score of the condition in the observation group was lower than that of the reference group,and all joint function scores were higher in the observation group(P<0.05).Conclusion:Restricted fluid resuscitation combined with comprehensive treatment for limb fractures with TS can alleviate symptoms,improve fracture prognosis,reduce related complications,decrease the severity of trauma,and enhance joint function.The therapeutic effect is excellent.

Comprehensive treatment for primary liver cancer

IntroductionPrimary liver cancer (PLC) is one of the mostcommon malignancies in China. Since the1990s, it has been the first leading cause of cancerdeath in the rural areas versus the 2nd in the urbanareas in this country. 45% of all the newly en-countered cases in the world each year are from themainland of China, and the situation is extremelyworsened in its high risk southeast coastal area.Liver resection is chosen as an optimal treatmentfor liver cancer, yet the low resectability and highpostoperative recurrence prevent the long-term sur-vival of patients. Therefore, proper comprehensivetreatment of PLC for the improvement of the overalltherapeutic efficacy has been the focus of clinicalpractice and research. In comparison with single treatment, compre-

Guidelines and standards for comprehensive clinical diagnosis and interventional treatment for diabetic foot in China(Issue 7.0)

Diabetic foot(DF)is one of the most common complications of diabetes and is associated with high morbidity,disability,lethality and low cure-rate.The clinical diagnosis and treatment of DF need to be standardized.The Chinese Diabetic Foot Cell and Interventional Therapy Technology Alliance has released six editions of guidelines and standards for clinical diagnosis and interventional treatment of DF,which filled the gap in the domestic DF treatment standard and played an important role in improving the level of diagnosis and treatment in China.In line with the latest developments in diagnosis and treatment,the Alliance,along with other 89 institutions,developed and issued the new edition based on the sixth edition to help standardize the clinical diagnosis and treatment of DF in China.

The application of Meta-analysis in the latest comprehensive treatment of breast cancer

Meta-analysis is a kind of systematic review,which uses quantitative method to summarize the results.It is a comprehensive evaluation to the findings of previous studies with higher credibility.Recently,it is applied to all areas of scientific research,particularly in the integrated treatment of breast cancer.Currently,breast cancer is known one of the most common malignant tumors,and its incidence is increasing year by year.Therefore,more and more clinical doctors pay attention to the effect of comprehensive treatment for patients with breast cancer.This article mainly collects the results of comprehensive treatment of breast cancer,in which the method of Meta-analysis is applied.In addition,we discuss the latest progress in order to guide the clinical treatment.

Comprehensive Strategy for Keloid Treatment:Experience at Shanghai Ninth People's Hospital

Keloids are a notorious fibroproliferative disorder that may cause cosmetic concerns and life inconvenience.Various methods such as surgery,injection,and laser have been used;however,single treatments are at risk of recurrence;therefore,comprehensive therapy is the better solution.Here,we focused on the management of different medical interventions according to subjective and objective conditions of keloid patients and summarized several clinical comprehensive strategies based on our clinical experience.One original concept of laser combined with radiotherapy was also introduced as a promising method,especially for wide-based pathological scars.

Comprehensive treatment for primary right renal diffuse large B-cell lymphoma with a renal vein tumor thrombus:A case report

BACKGROUND Renal involvement in lymphoma is commonly associated with widespread nodal or extranodal lymphoma.Primary renal diffuse large B-cell lymphoma is an extremely rare extranodal lymphoma,accounting for fewer than 1%of all renal masses.Interestingly,the patient in this study had a renal vein tumor thrombus that was observed after laparoscopic radical nephrectomy.CASE SUMMARY We report the case of a 56-year-old female patient with primary renal lymphoma and a renal vein tumor thrombus whose first symptom was right pain in the back and gross hematuria.Histopathology revealed primary renal diffuse large B-cell lymphoma.The patient received 8 standard cycles of rituximab with cyclophosphamide,doxorubicin,vincristine,and prednisone chemotherapy after surgery,and no obvious signs of recurrence were observed during the one-year follow-up.CONCLUSION We evaluated comprehensive treatment of primary renal diffuse large B-cell lymphoma and multidisciplinary management of this malignancy.

INTERVENTION CHEMOTHERAPY IN COMPREHENSIVE TREATMENT OF ADVANCED NASOPHARYNGEAL CARCINOMA

Objective: To study the use of interventional chemotherapy in comprehensive treatment for advanced nasopharyngeal carcinoma. Methods: Interventional chemotherapy with multi-drugs including cisplatin (DDP) 100 mg, 5-fluorouracil (5-FU) 1000 mg and bleomycin (BLM) 16 mg was used to treat 30 cases with advanced nasopharyngeal carcinoma before radiotherapy. 50 cases that received radiotherapy alone were used as a control group. The methods, time and dose schedule of radiotherapy were similar in the two groups. Results: The primary lesions in 16 cases and the cervical lymph nodes in 12 cases were reduced hi size after interventional chemotherapy. Radiation doses of those in complete response in their primary lesion and cervical lymph nodes were lower than that of the control group (P<0.05). The complete response rate of study group was 83.3% and that of control group was 72.0% (P<0.05). Conclusion: Interventional chemotherapy plus radiotherapy is a valuable treatment method in advanced nasopharyngeal carcinoma.

COMPREHENSIVE TREATMENT FOR SARCOMA BOTRYOIDES OF UTERINE CERVIX

Seven cases of sarcoma botryoides of the uterine cervix are reviewed. The age of the patients ranged from 19 to 40 years, with a median age of 23 years. Four patients were diagnosed as stage Ia, two as Ib and one as Ⅱ a, 6 cases were treated with surgery, chemotherapy and/or radiotherapy, and 1 with surgery only, 5 cases in this group survived more than 5 years with a mean 7.9 years of follow-up. The prognosis for cervical sarcoma botryoides is similar to that of other female genital tract embryonal rhabdomyosarcomas. Primary therapy should consist of vincristine and dactinomycin based chemotherapy. Surgery should be guided by the response to initial chemotherapy and should attempt to conserve the function of the bladder, rectum, vagina, and ovaries. Radiotherapy was used for involved surgical margins or positive nodes. The effect of radiotherapy is unclear for stage Ia cases.

Comprehensive Treatment Technology of Pesticidecontaminated Soil

Access approach of pesticide into soil and its migration and transformation process in soil are analyzed in the paper. Furthermore, it is put forward that soil pollution can be prevented by enhancing farmers＇ consciousness of safe and reasonable application of pesticide, strengthening production and management of pesticide, adopting comprehensive prevention and control measures, and developing treatment technology of pesticide-contaminated soil.

Long-term survival of patients with hepatocellular carcinoma with hepatic,pulmonary,peritoneal and rare colon metastasis:A case report

BACKGROUND Hepatocellular carcinoma(HCC)is a highly malignant cancer that often metastasizes and has a poor prognosis.Gastrointestinal tract metastases are rare,and colon metastases are even rarer.The long-term survival of patients with multiple intrahepatic and extrahepatic metastases,especially to the colon,has not been previously reported.CASE SUMMARY We present an atypical clinical case of a patient with liver,right lung,peritoneal,and colon metastases diagnosed successively following hepatic resection for primary HCC.Comprehensive treatment,including partial liver,lung and colon resection,palliative management such as systemic chemotherapy,trans-arterial chemoembolization,targeted therapy with sorafenib,and cryotherapy were attempted.Despite his early metastases,the patient remained relatively healthy for 8 years after diagnosis.CONCLUSION This case indicates that comprehensive treatment is beneficial for certain patients with metastatic HCC.Clinicians should be alert as to the possibility of rare site metastatic tumors that may be easily misdiagnosed as primary tumors.

Malignant melanoma resection and reconstruction with the first manifestation of lumbar metastasis:A case report

BACKGROUND Malignant melanoma(MM)has shown an increasing incidence worldwide,and a potential to metastasize to almost any part of the body.Clinically,MM with bone metastasis as the initial manifestation is extremely rare.Spinal metastatic MM can cause spinal cord or nerve root compression,resulting in severe pain and paralysis.Currently,the primary clinical treatments for MM are surgical resection in conjunction with chemotherapy,radiotherapy,and immunotherapy.CASE SUMMARY Here,we report the case of a 52-year-old male who presented to the clinic with progressive low back pain and limited nerve function.No primary lesion or spinal cord compression was detected from computed tomography and magnetic resonance imaging of the lumbar vertebrae and positron emission tomography scan.A lumbar puncture biopsy confirmed the diagnosis of lumbar spine metastatic MM.Following surgical resection,the patient’s quality of life improved,symptoms were relieved,and comprehensive treatment was initiated,which prevented recurrence.CONCLUSION Spinal metastatic MM is clinically rare,and may cause neurological symptoms,including paraplegia.Currently,the clinical treatment plan consists of surgical resection in combination with chemotherapy,radiotherapy,and immunotherapy.

Valve repair after infective endocarditis secondary to perforation caused by Streptococcus gordonii:A case report

BACKGROUND We report a case of infective endocarditis(IE)in a patient with congenital heart valve lesions accompanied by IE,which was diagnosed based on blood culture analysis that revealed the presence of a gram-negative bacterium,Streptococcus gordonii.CASE SUMMARY The patient had a history of precordial valve disease diagnosed by cardiac ultrasound,as well as a 4-mo history of fever.He was subjected to comprehensive anti-infection and anti-heart failure treatment in the internal medicine department.Further examination revealed sudden dislodgement from and perforation through the aortic valve by the superfluous organisms,as well as occurrence of bacterial emboli dislodgement,which caused bacteremia and infectious shock.He recovered and was discharged from the hospital after surgical and postoperative anti-infection treatments.CONCLUSION We review the treatment process and highlight inspirations and reflections from this case;suggest possible future changes in treatment modalities.

Generalized periodontitis treated with periodontal,orthodontic,and prosthodontic therapy:A case report

BACKGROUND Generalized periodontitis is a severe periodontal disease characterized by rapid periodontal destruction in healthy persons.This case report describes the treatment of a severe crowding,large overjet,and occlusal collapse due to the loss of anterior guidance with generalized periodontitis.CASE SUMMARY A 35-year-old female patient with a chief complaint of crowding and maxillary protrusion was diagnosed with generalized periodontitis by clinical and radiographic examinations.To improve crowding and overjet,orthodontic treatment was performed after basic periodontal therapy.Severely damaged upper right lateral incisor and left canine were extracted,and lower right first premolar and left second premolar were also removed to treat severe crowding.After orthodontic treatment,periodontal flap surgery for upper left molars and guided tissue regeneration for the lower left second molar was performed.Then,a dental implant was inserted in the upper left canine legion.The esthetics of the maxillary anterior tooth was improved by prosthetic restorations.The treatment result showed a well-improved occlusion with proper anterior guidance and healthy periodontal tissue after a retention period of 10 years.CONCLUSION Periodontal,orthodontic,and prosthodontic treatments are extremely useful to improve function and stable periodontal tissue for generalized periodontitis.

A self-guidance biological hybrid drug delivery system driven by anaerobes to inhibit the proliferation and metastasis of colon cancer

Colorectal cancer is often accompanied by multiple organ metastasis.Anaerobic Bifidobacterium Infantis(BI)bacterial can selectively grow in hypoxic colorectal tumor microenvironment(TME),to own the natural advantage of preferentially colorectal tumor targeting.Herein,a self-guidance biological hybrid drug delivery system(BI-ES-Fe Alg/DOX)based on BI was constructed to inhibit the proliferation and metastasis of colon cancer.Results demonstrated that BI-ES-Fe Alg/DOX could overcome physical barriers to target and accumulate in colon tumor tissues.Then DOX was released to kill tumor cells along with the phase transition(solid to liquid)of Fe Alg hydrogel,due to Fe3+was reduced to Fe^(2+)by intracellular GSH.Meanwhile,BI-ES selectively colonized into tumors and expressed endostatin(ES)protein to down-regulate VEGF and b FGF expression,exerting anti-angiogenic effect.Moreover,Fe Alg catalyzed H_(2)O_(2)in the local tumor to generate cytotoxic·OH,further enhancing the antitumor effect.The pharmacodynamic result in AOM/DSS model proved that BI-ES-Fe Alg/DOX had the best therapeutic effect,with the final V/V0of 2.19±0.57,which was significantly lower than the other groups.Meanwhile,on CT-26tumor-bearing model,it also showed an outstanding anti-tumor effect with inhibition rate of 82.12%±3.08%.In addition,lung metastases decreased significantly in tumor metastasis model after BI-ES-Fe Alg/DOX treatment.