自体富血小板凝胶在糖尿病足溃疡的应用

对糖尿病足溃疡患者开展自体富血小板凝胶治疗,分析效果。方法 收集2023.1-2023.12来我院治疗的40例患者进行研究,分组方式:随机平衡,组别对照、实验组,每组20例,对照组:基础治疗,实验组在对照组患者治疗基础上 开展自体富血小板凝胶治疗,明确治疗效果;创口的愈合、患者生活质量、临床指标。结果 实验组患者治疗效果显佳,临床指标显优,创口愈合时间更短,生活质量显佳 (P < 0.05);结论 在针对于糖尿病足溃疡的治疗上,开展自体富血小板凝胶的治疗方式,在促进患者伤口愈合的效果上较佳,患者治疗的费用得到减少,提升其生活质量,值得提倡。

糖足方为主治疗糖尿病足及其对足背动脉血流动力学的影响

目的观察以糖足方为主综合治疗糖尿病足(DF)的临床疗效及其对足背动脉血流动力学变化的影响。方法将108例DF患者随机分为糖足方组和西药组各54例,糖足方组给予糖足方治疗,西药组给予654-2治疗,观察两组临床疗效及治疗后足背动脉血流动力学变化。并设35名健康体检者为健康对照组。结果糖足方组溃疡肉芽组织出现时间(GT)、溃疡愈合时间(HT)均短于西药组,愈合率明显高于西药组,截趾(肢)率明显低于西药组,两组间相应指标比较,差异具有显著性意义(P<0.05或P<0.01)。与健康对照组比较,DF患者足背动脉血管内径变小,峰值流速加快,血流量减少,谱宽度增加;治疗后,两组足背动脉血流动力学指标均明显改善(P<0.01),糖足方组改善更显著(P<0.05)。结论以糖足方为主综合治疗DF效果优于以654-2为主的综合疗法。

紫草油纱布治疗糖尿病足的疗效观察

目的探讨紫草油纱布局部治疗糖尿病足的临床疗效。方法将120例糖尿病足患者随机分成对照组(60例)和治疗组(60例)。对照组常规换药以局部彻底清创,创面及周围皮肤用0.5%的碘伏消毒,然后用生理盐水+胰岛素充分冲洗创面,再用无菌敷料包扎,每日换药一次。治疗组在常规换药的基础上用自制紫草油纱布覆盖创面,再用无菌敷料包扎。两组均每日换药一次,14 d为一疗程。结果总有效率治疗组(93.33%)明显高于对照组(78.33%);治疗组治愈时间(10.3±3.5)d明显短于对照组(13.8±2.7)d,两组差异有显著性(P<0.05);治疗组显效时间(6.3±3.1)d明显短于对照组(8.2±4.6)d,两组差异有显著性(P<0.05)。结论紫草油纱布局部湿敷治疗糖尿病足,疗效显著,无明显副作用,值得临床推广应用。

中医外治糖尿病足溃疡的研究进展

糖尿病足是糖尿病常见的严重并发症之一,其高发病率与致残率已成为一个重要的公共卫生问题。中医在治疗糖尿病足溃疡时,采用辨证论治及分期论治的原则,采取活血化瘀、益气养阴、清热解毒等治疗方法 ,并配合局部外用药物治疗,取得了较好的疗效,在极大程度上降低了致残率。本文综述了糖尿病足病因病机、外治法等中医药治疗研究的进展。

血管内介入治疗糖尿病足的护理

【目的】探讨糖尿病足血管内介入治疗围术期的护理措施。【方法】回顾性总结分析15例糖尿病足血管内介入治疗围术期的护理经验。【结果】15例糖尿病足患者介入治疗后恢复顺利，溃疡愈合时间缩短，术后未发生严重并发症。【结论】血管内介入治疗是治疗糖尿病足的有效方法，系统的护理对患者顺利渡过围术期有重要作用。

护理干预在糖尿病足患者护理中的应用

【目的】探讨护理干预对糖尿病足患者的影响。【方法】将100例糖尿病足患者随机分为观察组（50例）、对照组（50例）。观察组患者予以一系列护理干预措施，对照组患者采取传统护理。比较两组患者皮肤皴裂，肢端麻木感，灼痛情况，足背动脉搏动消失与否及感染率。【结果】观察组患者治疗效果明显好于对照组（P〈0．05）。【结论】将护理干预运用到糖尿病足的护理工作中比一般护理能更有效地促进患者的康复，减轻患者的焦虑情绪，提高患者的自我防护意识和自我护理能力，减少了感染几率。

Linggui Zhugan Decoction Improves High Glucose-Induced Autophagy in Podocytes

Objective To explore the influence of Linggui Zhugan Decoction(LGZGD) on high glucose induced podocyte autophagy.Methods LGZGD containing serum was prepared by intragastric administation of 4.2 g/kg(low dose), 8.4 g/kg(medium dose), and 12.6 g/kg(high dose) LGZGD into SD rats respectively. MPC5 and AB8/13 podocyte cells were treated with 60 mmol/L glucose to establish diabetic nephropathy podocyte model in vitro. Both podocytes were divided into control group, high glucose group, low dose LGZGD group, medium dose LGZGD group, and high dose LGZGD group, respectively. For the three LGZGD groups, before LGZGD intervention, podocytes were treated with 60 mmol/L glucose for 3 days. After treated with LGZGD containing serum, cells were collected to analyze cell migration using Transwell assay, proliferation using CCK8, apoptosis and cell cycle using flow cytometry, autophagosome formation using transmission electron microscopy, and expression levels of Beclin-1, Atg5, LC3II/I, and P62 proteins using Western blot.Results Compared with the control group, the proliferation and migration of MPC5 and AB8/13 cells in the high glucose group slightly decreased, whereas these parameters restored after intervention with low and medium concentrations of LGZGD, with the medium dose LGZGD having the better effect(P < 0.05). Flow cytometry showed that the medium dose LGZGD group had a significantly lower apoptosis rate(P < 0.05) and higher survival rate(P > 0.05) compared to the high dose LGZGD group. High glucose arrested podocytes in G1 phase, whereas LGZGD shifted podocytes from being predominant in G1 phase to G2 phase. High dose LGZGD significanly reduced high glucose-increased autophagosome formation in both podocytes(P < 0.05). Western blot analysis showed that Beclin-1, Atg5, LC3II/I, and P62 expressions were increased in MPC5 cells treated with high glucose and reversed after adminstration of low and medium doses of LGZGD(P < 0.05).Conclusion LGZGD reduced apoptosis and enhanced autophagy in high glucose treated podocytes via regulating Beclin-1/LC3II/I/Atg5 expression.

Jinhuang powder for the treatment of diabetic foot ulcers:an updated metaanalysis with power analysis and trial sequential analysis

Background:Traditional Chinese Medicines(TCM)had been indicated to benefit for the chronic non-infectious diseases,such as cancers,hypertension,primary dysmenorrheal,etc.Although randomized controlled trials(RCTs)had been conducted,there was still the controversy on the efficacy of Jinhuang powder for diabetic foot ulcers(DFUs).Objective:This systematic review aimed to objectively evaluate the potential of Jinhuang powder for DFUs.Methods:Seven databases(CNKI,Chongqing VIP,Wanfang database,CBM,the Cochrane Library,PubMed and Web of Science)were searched to retrieve RCTs up to December,2016;and the relevant references of the eligible studies were screened.According to the eligible criteria,the literature was screened;data were extracted;and then the methodological quality was assessed.The meta-analysis,power analysis and trial sequential analysis(TSA)were performed by using Meta analyst software(version beta 3.13),Stata 12.0,Power and Precision statistical software package(Biostat)and TSA software(version0.9),respectively.Results:Finally,three RCTs with 198 participants were included.The results of meta-analysis showed that there were statistically significant differences between groups in(1)the cure rate(RR,1.25;95%CI.1.10to1.41;P=0.00)and(2)the wound healing time(SMD,-3.404;95%CI,-5.821 to -0.987;P=0.00).Three trials presented more than 80% power with 0.05α-errors in both outcomes and the power of two meta-analyses to pool different outcomes presented more than 95%.The TSA showed that the summary results were certain.Conclusion:The external application with Jinhuang powder was an effective and cost-effective therapy for DFUs.The power analysis and TSA showed that the efficacy of Jinhuang powder dressing for the treatment of DFUs is conclusive.

Nursing students’knowledge and attitude toward diabetic ulcer care and their contributing factors in Indonesia

Objective:The prevalence of diabetic foot ulcer in Indonesia is far greater than the global prevalence.Nursing students are expected to have good knowledge and positive attitudes regarding diabetic ulcer care in order to deliver high-quality wound care during clinical practice.This study aimed to assess nursing students’knowledge and attitudes toward diabetic ulcer care and to investigate the factors related to them.Methods:A cross-sectional study was conducted on 396 academic and clinical phases in three nursing schools in Indonesia from September 2021 to February 2022.Participants completed a survey including a questionnaire about knowledge and attitudes regarding diabetic ulcer care.The data were analyzed using a Chi-square test and multivariate logistic regression analysis.Results:The results show that 43.2%(171/396)of nursing students had inadequate knowledge of diabetic ulcer care.However,88.9%(352/396)had a favorable attitude toward the topic.Nursing students lacked knowledge about the characteristics of diabetic ulcers,diabetic neuropathy,wound infection,and adjunctive therapy for diabetic ulcers,and many of them believe that diabetic ulcer care is too timeconsuming to carry out.Students in the clinical phase of their studies had significantly better knowledge than those in the academic phase(aOR=9.99,95%CI 4.96e20.08,P<0.001).Male nursing students were significantly less likely to have positive attitude toward the topic than female students(aOR=0.42,95%CI 0.19e0.96,P=0.048),and students accustomed to sharing with peers as a source of knowledge had better attitudes than those who were not(aOR=2.76,95%CI 1.40e5.41,P=0.003).Conclusion:Findings show that almost half of the nursing students have insufficient knowledge of diabetic ulcer care.Curriculum developers and educators need to improve the curriculum regarding diabetic wound care and provide strategic programs to improve students’knowledge and attitudes based on the factors discovered in this study.

COMPARATIVE STUDY OF FIBRONECTIN GENE EXPRESSION IN TISSUES FROM HYPERTROPHIC SCARS AND DIABETIC FOOT ULCERS

Objective.To explore the expression characteristic of fibronectin gene in hypertr ophic scars and diabetic ul-cer tissues.Methods.The biopsies from normal skins,hypertrophic scars and diabetic foot ulc ers were taken.The tech-nique of quantitative polymerase ch ain reaction(PCR)was used to evaluate the gene express ion of fibronectin in the above biopsies.Results.Fibronectin gene expression was enhanced in hypertrophic scars and decreased in diabetic foot ul-cers compared with that in normal ski ns.Quantitative comparison showed about 2-fold increase of fibronectin mR-NA level in hypertrophic scars and ab out 3-fold decrease of fibronectin mRNA level in diabetic ulcers as com-pared with that in normal skins.Conclusions.Fibronectin gene expression is influenced by the tissue environment.Di fferent expression and synthesis of fibronectin may cause d ifferent outcomes in wound healing.

Continuing episodes of pain in recurrent acute pancreatitis: Prospective follow up on a standardised protocol with drugs and pancreatic endotherapy

AIM To assess the outcomes of drug therapy(DT)followed by pancreatic endotherapy for continuing painful episodes in recurrent acute pancreatitis.METHODS DT comprised of pancreatic enzymes and antioxidants failing which,endotherapy(ET;pancreatic sphincterotomy and stent placement)was done.The frequency of pain,its visual analogue score(VAS),quality of life(Qo L),serum C peptide and faecal elastase were compared between baseline and after 1 year of follow up in all patients and in the two subgroups on DT and ET.Response was defined as at least 50%reduction in the severity of pain to below a score of 5.RESULTS Of the thirty nine patients analysed,21(53.9%)responded to DT and 18(46.1%)underwent ET.The VAS for pain(7.0±2.0 vs 1.3±2.5,P<0.001)and the number of days with pain per month decreased[1.0(1.0,2.0)vs 1.0(0.0,1.0),P<0.001],and the Qo L scores[55.0(44.0,66.0)vs 38.0(32.00,51.00),P<0.01]improved significantly during follow up.Similar significant improvements were seen in patients in the subgroups of DT and ET except for Qo L in ET.The serum C-peptide(P=0.001)and FE(P<0.001)levels improved significantly in the entire group and in the two subgroups of patients except for the C peptide levels in patients on DT.CONCLUSION A standardised protocol of DT,followed by ET decreased the intensity and frequency of pain in recurrent acute pancreatitis,enhanced Qo L and improved pancreatic function.

The effect of foot bath of Chinese medicine combined with acupoint injection for diabetic peripheral neuropathy:a meta analysis

Objective:The aim of this systematic review was to assess the effect of foot bath of Chinese medicine combined with acupoint injection(FBCMCAI)on patients with diabetic peripheral neuropathy(DPN).Methods:Databases such as Cochrane Library,Pubmed,Web Of Science,China Biology Medicine(CBM),CNKI,VIP and WANFANG DATA were electronically searched to collect the randomized controlled trials(RCTs)(up to October 2016).According to the inclusion and exclusion criteria,literature about effects of FBCMCAI in the treatment of DPN were screened and data were extracted.Literature quality evaluation was appliced by Cochrane Reviewer Handbook 5.1.0.A random or a fixed effects model was used to analyze outcomes by RevMan 5.3 software.Subgroup analysis,sensitivity analysis,and orientation description were performed if necessary.Results:11 randomized controlled trials with a total of 927 patients were included.Meta analysis results revealed that the efficacy of FBCMCAI for DPN was significantly superior to the control treatment(OR=5.07,95%CI:3.23-7.94,Z=7.08,P<0.00001).Besides,there was an increase in motor conduction velocity of peroneal nerve(SMD=1.08,95%CI:0.66-1.48,Z=5.30,P<0.00001),motor conduction velocity of tibial nerve(SMD=1.08,95%CI:0.58-1.58,Z=4.22,P<0.0001)and motor conduction velocity of median nerve(SMD=0.46,95%CI:0.23-0.68,Z=3.96,P<0.0001)in FBCMCAI groups.For another,there was also an increase in sensory motor conduction velocity of the motor nerve(SMD=0.80,95%CI:0.54-1.05,Z=6.06,P<0.00001)and sensory motor conduction velocity of median nerve(SMD=0.66,95%CI:0.38-0.93,Z=4.73,P<0.00001)in the FBCMCAI groups.Symptoms score was significantly reduced after FBCMCAI treatment(WMD=-4.21,95%CI[-4.95,-3.48],Z=11.25,P<0.00001).Conclusion:FBCMCAI may have significant therapeutic efficacy for the treatment of DPN.Diabetic neurologic symptoms and nerve conduction velocities can be improved under FBCMCAI treatment.In-depth research and high quality randomized controlled trials on the efficacy of FBCMCAI are necessary.

Clinical observation on tuina plus foot bath with Chinese medicine for diabetic foot in early stage

Objective:To observe the clinical effect of tuina plus foot bath with Chinese medicine for patients with diabetic foot (DF) in early stage.Methods:A total of 70 patients with early-stage DF were randomly allocated by the random number table into two groups,with 35 cases in each group.Patients in the control group received conventional medication,while patients in the observation group received tuina plus foot bath with Chinese medicine on the basis of conventional medication.The clinical efficacy was compared after 2 courses of treatment.Results:After treatment,intra-group comparisons of ankle-brachial index (ABI) showed statistical significance in both groups (both P<0.05).The curative rate was 83.3% in the observation group,with the total effective rate of 96.7%,versus 29.4% and 76.5% in the control group,respectively,and the between-group comparisons showed statistical significance (both P<0.05),indicating a better effect in the observation group.Conclusion:Tuina plus foot bath with Chinese medicine has a good therapeutic effect for DF patients in early stage.

Elevated skin autofluorescence is strongly associated with foot ulcers in patients with diabetes: a cross-sectional, observational study of Chinese subjects

Objective: This study was designed to evaluate the association between skin autofluorescence (AF), an indicator of advanced glycation end-products (AGEs), and foot ulcers in subjects with diabetes. Methods: In this study, 195 Chinese diabetic subjects were examined. Their feet were examined regardless of whether an ulcer was present or not. Skin AF was measured with an AGE reader. Demographic characteristics and blood data were recorded. Results: The mean values of skin AF were 2.29±0.47 for subjects without foot ulcers, and 2.80±0.69 for those with foot ulcers, a significant difference (P<0.05). Skin AF was strongly correlated with age and duration of diabetes. After adjusting for these factors, multivariate logistic regression showed that skin AF was independently associated with foot ulcerations. Conclusions: Skin AF is independently associated with diabetic foot ulcerations. It might be a useful screening method for foot ulceration risk of diabetic patients.

Efficacy observation on acupuncture for diabetic gastroparesis

Objective： To observe the effect of acupuncture on gastric motility, plasma motilin and serum gastrin in patients with diabetic gastroparesis （DGP） and evaluate its clinical efficacy. Methods： A total of 100 eligible cases were randomly allocated into an acupuncture group （n=50） and a control group （n=50）. Patients in the acupuncture group were treated by needling Zhongwan （CV 12）, Zusanli （ST 36） and Neiguan （PC 6）, whereas patients in the control group were treated with oral administration of Domperidone. The clinical efficacies of the two groups were compared; and changes in gastric motility, plasma motilin and serum gastrin in both groups were observed before and after treatment. Results： After treatment, the symptom scores, gastric motility and contents of plasma motilin and serum gastrin were significantly improved in both groups （P〈0.05）. There were between-group statistically significant differences in symptom scores, gastric motility and levels of plasma motilin and serum gastrin after treatment （all P〈0.05）. The total effective rate was 96% in the treatment group, versus 78% in the control group, showing a statistically significant difference （P〈0.05）. Conclusion： Acupuncture is effective for DGP and can reduce the levels of plasma motilin and serum gastrin.