Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen...Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.展开更多
BACKGROUND Ulcerative colitis(UC)is a chronic and treatment-resistant disorder requiring potent therapeutics that are effective and safe.Cedrol(CE)is a bioactive natural product present in many traditional Chinese med...BACKGROUND Ulcerative colitis(UC)is a chronic and treatment-resistant disorder requiring potent therapeutics that are effective and safe.Cedrol(CE)is a bioactive natural product present in many traditional Chinese medicines.It is known for its suppression of inflammation and mitigation of oxidative stress.Its therapeutic efficacy and mechanistic underpinnings in UC remain uncharacterized.AIM To investigate the therapeutic potential and mechanisms of CE in UC.METHODS The anti-inflammatory activity and intestinal barrier-repairing effects of CE were assessed in a dextran sulfate sodium-induced murine colitis model.Network pharmacology was employed to predict potential targets and pathways.Then molecular docking and dynamics simulations were utilized to confirm a stable interaction between CE and the toll-like receptor 4(TLR4)/myeloid differentiation factor 2(MD2)complex.The anti-inflammatory mechanisms were further verified using in vitro assays.Additionally,the gut microbiota composition was analyzed via 16S rRNA gene sequencing.RESULTS CE significantly alleviated colitis symptoms,mitigated histopathological damage,and suppressed inflammation.Moreover,CE restored intestinal barrier integrity by enhancing mucus secretion and upregulating tight junction proteins(zonula occludens 1,occludin,claudin-1).Mechanistically,CE stably bound to MD2,inhibiting lipopolysaccharide-induced TLR4 signaling in RAW264.7 cells.This led to suppression of the downstream mitogen-activated protein kinase and nuclear factor kappa B signaling pathways,downregulating the expression of tumor necrosis factor-alpha,interleukin-1β,and interleukin-6.Gut microbiota analysis revealed that CE reversed dextran sulfate sodium-induced dysbiosis with significant enrichment of butyrogenic Christensenella minuta.CONCLUSION CE acted on MD2 to suppress proinflammatory cascades,promoting mucosal barrier reconstitution and microbiota remodeling and supporting its therapeutic use in UC.展开更多
The gastroprotective activity of water extracts from Citrus reticulata'Chachi'leaves(JY)was investigated,and its potential action mechanisms were revealed using network pharmacology.First,the main chemical com...The gastroprotective activity of water extracts from Citrus reticulata'Chachi'leaves(JY)was investigated,and its potential action mechanisms were revealed using network pharmacology.First,the main chemical components of JY were identified using high performance liquid chromatography coupled to quadrupole time-of-flight tandem mass spectrometry,14 compounds were preliminarily identified,with flavonoids being the primary components.Next,the protective effect of JY on ethanol-induced damage was investigated in vitro.An MTT assay showed that JY could significantly promote the proliferation of GES-1 cells and reduce the damage caused by ethanol.A gastric ulcer model was induced in mice using ethanol,and JY(1,2,and 4 mg/kg)was orally administered to the mice to counteract ethanol-induced gastric ulcers.Pretreatment with JY reduced the severity of ethanol-induced gastric injury.Histopathological results showed that JY enhanced the cell structure of gastric tissue,increased the secretion of gastric mucosal mucus,and reduced gastric edema caused by ethanol injury.JY significantly decreased the levels of pro-inflammatory factors,including interleukin(IL)-1β,IL-6,and tumor necrosis factorα,in the serum.Additionally,JY increased the levels of prostaglandin E2 and the activity of total superoxide dismutase,while significantly reducing the levels of the lipid peroxidation product malondialdehyde in gastric tissue.In parallel,JY significantly upregulated the mRNA expressions of copper/zinc superoxide dismutase(Cu/Zn-SOD),manganese superoxide dismutase(Mn-SOD),and glutathione peroxidase(GPx)to alleviate oxidative stress.JY also promoted the healing of gastric ulcers by upregulating the mRNA expressions of vascular endothelial growth factor(VEGF)and epidermal growth factor receptor(EGFR).Finally,network pharmacology was used to analyze the potential bioactive substances in JY and their mechanisms.The results indicated that the protective effect of JY might be related to flavonoids and that JY exerts its gastroprotective effects by participating in the PI3K-Akt and VEGF signaling pathways.These findings suggest that JY could be a valuable natural resource for preventing ethanol-induced gastric injury.展开更多
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of U...Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.展开更多
The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by ...The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.展开更多
BACKGROUND Ulcerative colitis(UC)is a chronic and debilitating inflammatory bowel disease.Cumulative evidence indicates that excess hydrogen peroxide,a potent neutrophilic chemotactic agent,produced by colonic epithel...BACKGROUND Ulcerative colitis(UC)is a chronic and debilitating inflammatory bowel disease.Cumulative evidence indicates that excess hydrogen peroxide,a potent neutrophilic chemotactic agent,produced by colonic epithelial cells has a causal role leading to infiltration of neutrophils into the colonic mucosa and subsequent development of UC.This evidence-based mechanism identifies hydrogen peroxide as a therapeutic target for reducing agents in the treatment of UC.CASE SUMMARY Presented is a 41-year-old female with a 26-year history of refractory UC.Having developed steroid dependence and never achieving complete remission on treatment by conventional and advanced therapies,she began treatment with oral R-dihydrolipoic acid(RDLA),a lipid-soluble reducing agent with intracellular site of action.Within a week,rectal bleeding ceased.She was asymptomatic for three years until a highly stressful experience,when she noticed blood in her stool.RDLA was discontinued,and she began treatment with oral sodium thiosulfate pentahydrate(STS),a reducing agent with extracellular site of action.After a week,rectal bleeding ceased,and she resumed oral RDLA and discontinued STS.To date,she remains asymptomatic with normal stool calprotectin while on RDLA.CONCLUSION STS and RDLA are reducing agents that serve as highly effective and safe therapy for the induction and maintenance of remission in UC,even in patients refractory or poorly controlled by conventional and advanced therapies.Should preliminary findings be validated by subsequent clinical trials,the use of reducing agents could potentially prevent thousands of colectomies and represent a paradigm shift in the treatment of UC.展开更多
We read with great interest the study by Zhang et al on Yiyi Fuzi Baijiang powder(YFB),which exemplifies the power of modern methods to validate traditional Chinese medicine(TCM).The key insight is that YFB doesn’t m...We read with great interest the study by Zhang et al on Yiyi Fuzi Baijiang powder(YFB),which exemplifies the power of modern methods to validate traditional Chinese medicine(TCM).The key insight is that YFB doesn’t merely alter“good”or“bad”bacteria but restores the gut microbiota’s holistic equilibrium.This is powerfully shown by its paradoxical reduction of anaerobic probiotics like Bifidobacterium,rectifying the diseased,hypoxic environment,causing their aberrant overgrowth.This challenges the conventional probiotic paradigm and underscores a core TCM principle:Herbal formulas treat disease by restoring the body’s overall functional balance.Future research should focus on the interplay between herbal components,intestinal oxygen,and microbial metabolites to further unravel this sophisticated dialogue.展开更多
Background:This study focused on developing and optimizing a self-microemulsifying drug delivery system(SMEDDS)to improve Lafutidine’s solubility and bioavailability,thereby enhancing its effectiveness in treating ga...Background:This study focused on developing and optimizing a self-microemulsifying drug delivery system(SMEDDS)to improve Lafutidine’s solubility and bioavailability,thereby enhancing its effectiveness in treating gastric ulcers.Traditional formulations are less effective due to their limited water solubility and bioavailability.Methods:The study used solubility tests,pseudo-ternary phase diagrams,and central composite design(CCD)to optimize.The formulation was optimized by varying the oil concentration(10–40%)and surfactant/cosurfactant ratio(0.33–3.00),and then tested for droplet size,drug content,emulsification,phase stability,and in vitro dissolution.Results:The study found that the optimized formulation contained 14%Capmul PG 8NF oil,62%Labrasol surfactant,and 24%Tween 80 cosurfactant.This combination generated an average droplet size of 111.02 nm and improved drug release properties.Furthermore,the formulation was stable without phase separation,with a drug content of 88.2–99.8%.Conclusion:SMEDDS significantly improves lafutidine delivery by increasing solubility and absorption,thereby overcoming oral administration challenges.The system quickly formed small droplets in water and released the drug in 15 min.Enhancing lafutidine’s bioavailability may improve its efficacy in treating gastric ulcers,resulting in better patient outcomes and potentially lower dosing frequency.展开更多
Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mu...Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mucosal samples from patients with ulcers and healthy controls,revealing significant changes in microbial diversity and composition.This article reviews their findings,emphasizing H.pylori’s role in gastric ulcers and the need for further research on its impact on duodenal ulcers.We evaluate the study’s strengths and limitations,suggesting future research directions to enhance our understanding of H.pylori’s contribution to ulcerative diseases.展开更多
Several issues should be considered before the surgical treatment of gastric ulcer perforations,including morbidity,mortality,and recurrence.However,an oftenoverlooked issue is determining the cause of the perforation...Several issues should be considered before the surgical treatment of gastric ulcer perforations,including morbidity,mortality,and recurrence.However,an oftenoverlooked issue is determining the cause of the perforation.When the perforation is secondary to an underlying and undiagnosed malignancy,stomach resection inadequately treats the oncological disease and may increase postoperative morbidity and require re-surgery.展开更多
Gastric ulcer(GU)is a common digestive system disease.Acupuncture,as one of the external treatments of traditional Chinese medicine(TCM),has the characteristics of multi-target,multi-pathway and multi-level action in ...Gastric ulcer(GU)is a common digestive system disease.Acupuncture,as one of the external treatments of traditional Chinese medicine(TCM),has the characteristics of multi-target,multi-pathway and multi-level action in the treatment of GU.The relationship between meridian points and Zang-fu is an important part of the theory of TCM,which is crucial for the diagnosis and treatment of diseases.There is an external and internal link between acupoints and Zang-fu.The pathological reaction of Zang-fu can manifest as acupoint sensitization,while stimulation of acupoints can play a therapeutic role in the internal Zang-fu.Therefore,the acupoint has the functions of reflecting and treating diseases.This review explores the tender points on the body surface of patients with GU and the rules of acupoint selection.In addition,Zusanli(ST36),as one of the most used acupoints of the stomach meridian,was selected to show the mechanisms behind acupoint stimulation in the treatment of GU in greater detail,specifically in the well-studied model of the stress GU(SGU).Hence,the mechanisms of acupuncture at ST36 and points commonly used in combination with ST36 to treat SGU are discussed further.Treatment effects can be achieved through anti-inflammatory and antioxidant activities,gastric mucosal injury repair,and interaction with the brain-gut axis.In summary,this review provides evidence for a comprehensive understanding of the phenomena and mechanism of acupoint functions for GU.展开更多
BACKGROUND Peptic ulcer disease(PUD)during pregnancy is extremely rare.Perforated peptic ulcer(PPU)during pregnancy has high maternal and fetal mortality.Symptoms attributed to pregnancy and other diagnoses make the d...BACKGROUND Peptic ulcer disease(PUD)during pregnancy is extremely rare.Perforated peptic ulcer(PPU)during pregnancy has high maternal and fetal mortality.Symptoms attributed to pregnancy and other diagnoses make the diagnosis of preoperative PPU during pregnancy and puerperium challenging.AIM To identify predictive factors for early diagnosis and treatment,and the association between the diagnosis and maternal/neonatal outcomes.METHODS We searched PubMed,PubMed Central,and Google Scholar.Articles were analyzed following preferred reporting items for systematic reviews and metaanalysis.The search items included:‘ulcer’,‘PUD’,‘pregnancy’,‘puerperium’,‘postpartum’,‘gravid’,‘labor’,‘perforated ulcer’,‘stomach ulcer’,‘duodenal ulcer’,‘peptic ulcer’.Additional studies were extracted by reviewing reference lists of retrieved studies.We included all available full-text cases and case series.Demographic,clinical,obstetric,diagnostic and treatment parameters,and outcomes were collected.RESULTS Forty-three cases were collected.The mean maternal age was 30.9 years;36.6%were multiparous,and 63.4%were nulliparous or primiparous,with multiparas being older than primiparas.Peptic ulcer perforated in 44.2%of postpartum and 55.8%of antepartum patients.Antepartum PPU incidence increased with advancing gestation 2.3%in the first,7%in the second,and 46.5%in the third trimester.The most common clinical findings were abdominal tenderness(72.1%),rigidity(34.9%),and distension(48.8%).Duodenal ulcer predominated(76.7%).In 79.5%,the time from delivery to surgery or vice versa was>24 hours.The maternal mortality during the third trimester and postpartum was 10%and 31.6%,respectively.The trimester of presentation did not influence maternal mortality.The fetal mortality was 34.8%,with all deaths in gestational weeks 24-32.CONCLUSION Almost all patients with PPU in pregnancy or puerperium presented during the third trimester or the first 8 days postpartum.Early intervention reduced fetal mortality but without influence on maternal mortality.Maternal mortality did not depend on the use of X-ray imaging,perforation location,delivery type,trimester of presentation,and maternal age.Explorative laparoscopy was never performed during pregnancy,only postpartum.展开更多
BACKGROUND The use of proton pump inhibitors(PPIs)with the intent of reducing gastric acidity to the desired therapeutic level for treating bleeding peptic ulcer still has several limitations.AIM To compare intravenou...BACKGROUND The use of proton pump inhibitors(PPIs)with the intent of reducing gastric acidity to the desired therapeutic level for treating bleeding peptic ulcer still has several limitations.AIM To compare intravenous PPIs and oral potassium competitive acid blockers(PCABs)administered prior to endoscopic treatment of bleeding peptic ulcers.METHODS This retrospective study involved 105 consecutive patients with non-variceal upper gastrointestinal bleeding(treated August 2023 to February 2024).Prior to emergency endoscopy,patients received either intravenous PPI(pantoprazole 80 mg bolus)or oral PCAB(tegoprazan 50 mg single-dose).Severity of bleeding was assessed using the Glasgow-Blatchford,Rockall,and AIMS65 scoring systems.Patients with severe comorbidities were excluded.Primary outcomes included need for therapeutic endoscopic intervention and occurrence of re-bleeding.Multivariate logistic regression was performed to adjust for potential confounding factors.RESULTS Total of the 105 patients,61 received intravenous PPI injection and 44 received oral PCAB prior to emergency endoscopy.To minimize selection bias,bleeding severity was assessed using the Glasgow-Blatchford,Rockall and AIMS65 scores,with no statistically significant differences observed between the two groups.During emergency endoscopy performed within 48 hours,ulcer bed status was classified according to the Forrest classification.The proportion of lesions graded IIa or higher was significantly lower in the PCAB group(P<0.001),as was the frequency of therapeutic endoscopy intervention(odds ratio=0.272,95%confidence interval:0.111-0.665,P=0.004).The frequency of re-bleeding events was statistically significantly higher in the PPI group(odds ratio=0.141,95%confidence interval:0.024-0.844,P=0.032).CONCLUSION Pre-endoscopic PCAB administration is more effective than PPI injection for upper gastrointestinal bleeding and may reduce ulcer bleeding mortality.展开更多
Background Peptic ulcer disease(PUD)is a common health problem that affects many people worldwide and contributes to morbidity and mortality.While several antiulcer medications show considerable effectiveness in treat...Background Peptic ulcer disease(PUD)is a common health problem that affects many people worldwide and contributes to morbidity and mortality.While several antiulcer medications show considerable effectiveness in treating ulcers,they often come with high costs and can lead to issues like resistance,tolerance,relapses,side effects,and adverse reactions.This highlights the necessity for optimal treatments that are economical,safe,and have a minimal risk of recurrence,especially those derived from natural sources.Objective This study aimed to document the medicinal plants used to manage PUD by the indigenous people of the Missenyi and Kyerwa districts of Kagera,Tanzania.Methods A cross-sectional survey was conducted in four villages in the Missenyi and Kyerwa districts through face-to-face interviews guided by a semi-structured questionnaire.The information obtained included the participants'awareness of PUD,its symptoms,and its management using medicinal plants.Then,the plant species were collected and authenticated,followed by a literature review and verification.Results Thirty informants were interviewed,and 20 medicinal plants from 16 taxonomic families were identified.The informants'knowledge of PUD was poor,and commonly used plant parts included seeds and whole plants,mixed with adjuvants such as water,honey,raw eggs,milk,and black tea decoctions.Decoctions represent the most utilized mode of preparation,and most informants recommend a dose equivalent to 250 mL,after every eight hours,for three months.The majority(60%)of the documented plants are edible.Literature verification supports the claimed ethnomedical use of adjuvants and 85%of plants,whereas 15%(Arachis hypogaea,Lagenaria sphaerica,and Myrica salicifolia)are being reported for the first time in this study.Conclusion The use of the majority of plants documented in this study has a literature backup,and the fact that most plant parts are edible minimizes the risk of toxicity.In addition,the use of three plants to treat PUD was reported for the first time in this study.Therefore,this study recommends that their activity,safety,and efficacy be studied and that more extensive ethnopharmacological surveys be conducted to avoid the loss of valuable information,as many plants are yet to be explored.展开更多
BACKGROUND Gastric ulcer(GU),a common gastrointestinal condition,is influenced by multiple factors,particularly inflammatory and immune responses.Complete blood count(CBC)-derived inflammatory biomarkers represent a n...BACKGROUND Gastric ulcer(GU),a common gastrointestinal condition,is influenced by multiple factors,particularly inflammatory and immune responses.Complete blood count(CBC)-derived inflammatory biomarkers represent a novel indicator of systemic inflammation and immune status;however,their association with GU remains unclear.AIM To investigate the association between CBC-derived inflammatory markers and GU.METHODS The study sample included individuals admitted to the Gastroenterology Unit of the Second Affiliated Hospital of Nanchang University from 2023 to 2024.We explored how each CBC-based inflammation indicator correlated with GU occurrence through logistic models,and assessed their predictive ability using receiver operating characteristic curve analysis.Additionally,we applied the least absolute shrinkage and selection operator method along with stepwise regression techniques to determine which inflammatory indicators were most significantly linked to GU.RESULTS Higher levels of log2 neutrophil-to-lymphocyte ratio,log2 monocyte-to-lymphocyte ratio,log2 systemic immuneinflammation index,log2 systemic inflammatory response index(SIRI),and log2 aggregate index of systemic inflammation were significantly associated with increased GU prevalence across all models,while log2 platelet-tolymphocyte ratio was significant only in the fully adjusted model.SIRI demonstrated the highest discriminative ability,with an area under the curve of 0.868.CONCLUSION Hematological indicators derived from CBC tests show a significant correlation with the prevalence of GU.Among them,SIRI demonstrated the most prominent association.These markers could act as practical tools in recognizing individuals more likely to develop GU.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therape...BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.展开更多
Diabetic foot(DF)is a major public health concern.As evident from numerous previous studies,supervision of DF ulcer(DFU)is crucial,and a specific quality check-up is needed.Patients should be educated about glycaemic ...Diabetic foot(DF)is a major public health concern.As evident from numerous previous studies,supervision of DF ulcer(DFU)is crucial,and a specific quality check-up is needed.Patients should be educated about glycaemic management,DFUs,foot lesions,proper care for injuries,diet,and surgery.Certain reasonably priced treatments,such as hyperbaric oxygen and vacuum-assisted closure therapy,are also available for DFUs,along with modern wound care products and techniques.Nonetheless,DF care(cleaning,applying antimicrobial cream when wounded,and foot reflexology),blood glucose monitoring to control diabetes,and monthly or quarterly examinations in individuals with diabetes are effective in managing DFUs.Between 50%and 80%of DF infections are preventable.Regardless of the intensity of the lesion,it needs to be treated carefully and checked daily during infection.Tissue regeneration can be aided by cleaning,dressing,and application of topical medicines.The choice of shoes is also important because it affects blood circulation and nerve impulses.In general,regular check-ups,monitoring of the patient’s condition,measuring blood glucose levels,and providing frequent guidance regarding DFU care are crucial.Finally,this important clinical problem requires involvement of multiple professionals to properly manage it.展开更多
Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affec...Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.展开更多
BACKGROUND Pain often predisposes patients with diabetic foot ulcers(DFUs)to negative emotional states,such as anxiety and depression,which can significantly impair treatment outcomes and recovery.However,very few stu...BACKGROUND Pain often predisposes patients with diabetic foot ulcers(DFUs)to negative emotional states,such as anxiety and depression,which can significantly impair treatment outcomes and recovery.However,very few studies have explored the relationship between anxiety,depression,and pain in DFUs,as well as the associated risk factors.AIM To analyze the correlation between anxiety,depression,and pain in patients with DFUs and to identify the associated risk factors.METHODS This study included 106 patients diagnosed with DFUs who were admitted to Tiantai County People’s Hospital between March 2022 and March 2024.The patients’anxiety levels were evaluated using Zung’s self-rating anxiety scale(SAS),depression status was assessed using Zung’s self-rating depression scale(SDS),and pain intensity was assessed using the visual analog scale(VAS).Subsequently,correlations between SAS,SDS,and VAS scores were analyzed.Univariate and multivariate analyses were conducted to explore the risk factors that contributed to anxiety and depression in patients with DFUs.RESULTS Among the 106 patients,39.62%exhibited anxiety and 43.40%presented with depression.Most patients experiencing anxiety or depression exhibited mild symptoms,with no severe cases observed.Compared with asymptomatic patients,those with anxiety or depression had significantly higher VAS scores.Correlation analysis indicated a significant positive relationship between both SAS and SDS scores and the VAS score.Univariate analysis identified sex,age,Wagner’s grade,presence of other complications,and smoking history as factors significantly associated with anxiety and depression.Multivariate analysis further confirmed that younger age,higher Wagner’s grade,and higher VAS scores were independent predictors of anxiety and depression.CONCLUSION This study reveals a significant positive correlation between anxiety,depression,and pain in patients with DFUs.This finding suggests that timely and effective pain intervention may be beneficial in alleviating negative emotions such as anxiety and depression.In addition,younger age(<50 years),higher Wagner’s grade,and higher VAS scores increase the risk of developing anxiety and depression in this patient population.展开更多
Ulcerative colitis has baffled researchers since the early 20th century.The pre-vailing explanation attributes the chronic recurring episodes of bloody diarrhea and abdominal pain to some form of immune abnormality,de...Ulcerative colitis has baffled researchers since the early 20th century.The pre-vailing explanation attributes the chronic recurring episodes of bloody diarrhea and abdominal pain to some form of immune abnormality,despite the lack of supporting evidence.This highlights the critical need for innovative research directions and methodologies to uncover the cause and develop a cure for this disease.By analyzing existing data from less than a dozen previously published studies,a novel,evidence-based pathogenesis was constructed,implicating colonic epithelial hydrogen peroxide as a causal factor in the development of this disease.This newly identified mechanism informed the creation of a ground-breaking class of therapeutics,known as reducing agents,which have demon-strated remarkable success in resolving colonic inflammation and restoring colonic health in patients with refractory ulcerative colitis.This paper outlines the timeline of these publications and reinterprets the findings within the context of contemporary biomedical science.展开更多
基金Supported by the National Natural Science Foundation of China,No.82170406 and No.81970238.
文摘Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.
基金Supported by the Provincial Key Cultivation Laboratory for Digestive Disease Research,No.2021SYS13Shanxi Province’s“Si Ge Yi Pi”Science and Technology Driven Medical Innovation Project,No.2021MX03Shanxi Provincial Basic Research Program,No.202403021222423.
文摘BACKGROUND Ulcerative colitis(UC)is a chronic and treatment-resistant disorder requiring potent therapeutics that are effective and safe.Cedrol(CE)is a bioactive natural product present in many traditional Chinese medicines.It is known for its suppression of inflammation and mitigation of oxidative stress.Its therapeutic efficacy and mechanistic underpinnings in UC remain uncharacterized.AIM To investigate the therapeutic potential and mechanisms of CE in UC.METHODS The anti-inflammatory activity and intestinal barrier-repairing effects of CE were assessed in a dextran sulfate sodium-induced murine colitis model.Network pharmacology was employed to predict potential targets and pathways.Then molecular docking and dynamics simulations were utilized to confirm a stable interaction between CE and the toll-like receptor 4(TLR4)/myeloid differentiation factor 2(MD2)complex.The anti-inflammatory mechanisms were further verified using in vitro assays.Additionally,the gut microbiota composition was analyzed via 16S rRNA gene sequencing.RESULTS CE significantly alleviated colitis symptoms,mitigated histopathological damage,and suppressed inflammation.Moreover,CE restored intestinal barrier integrity by enhancing mucus secretion and upregulating tight junction proteins(zonula occludens 1,occludin,claudin-1).Mechanistically,CE stably bound to MD2,inhibiting lipopolysaccharide-induced TLR4 signaling in RAW264.7 cells.This led to suppression of the downstream mitogen-activated protein kinase and nuclear factor kappa B signaling pathways,downregulating the expression of tumor necrosis factor-alpha,interleukin-1β,and interleukin-6.Gut microbiota analysis revealed that CE reversed dextran sulfate sodium-induced dysbiosis with significant enrichment of butyrogenic Christensenella minuta.CONCLUSION CE acted on MD2 to suppress proinflammatory cascades,promoting mucosal barrier reconstitution and microbiota remodeling and supporting its therapeutic use in UC.
基金supported by the National Natural Science Foundation of China(8197347182003937)。
文摘The gastroprotective activity of water extracts from Citrus reticulata'Chachi'leaves(JY)was investigated,and its potential action mechanisms were revealed using network pharmacology.First,the main chemical components of JY were identified using high performance liquid chromatography coupled to quadrupole time-of-flight tandem mass spectrometry,14 compounds were preliminarily identified,with flavonoids being the primary components.Next,the protective effect of JY on ethanol-induced damage was investigated in vitro.An MTT assay showed that JY could significantly promote the proliferation of GES-1 cells and reduce the damage caused by ethanol.A gastric ulcer model was induced in mice using ethanol,and JY(1,2,and 4 mg/kg)was orally administered to the mice to counteract ethanol-induced gastric ulcers.Pretreatment with JY reduced the severity of ethanol-induced gastric injury.Histopathological results showed that JY enhanced the cell structure of gastric tissue,increased the secretion of gastric mucosal mucus,and reduced gastric edema caused by ethanol injury.JY significantly decreased the levels of pro-inflammatory factors,including interleukin(IL)-1β,IL-6,and tumor necrosis factorα,in the serum.Additionally,JY increased the levels of prostaglandin E2 and the activity of total superoxide dismutase,while significantly reducing the levels of the lipid peroxidation product malondialdehyde in gastric tissue.In parallel,JY significantly upregulated the mRNA expressions of copper/zinc superoxide dismutase(Cu/Zn-SOD),manganese superoxide dismutase(Mn-SOD),and glutathione peroxidase(GPx)to alleviate oxidative stress.JY also promoted the healing of gastric ulcers by upregulating the mRNA expressions of vascular endothelial growth factor(VEGF)and epidermal growth factor receptor(EGFR).Finally,network pharmacology was used to analyze the potential bioactive substances in JY and their mechanisms.The results indicated that the protective effect of JY might be related to flavonoids and that JY exerts its gastroprotective effects by participating in the PI3K-Akt and VEGF signaling pathways.These findings suggest that JY could be a valuable natural resource for preventing ethanol-induced gastric injury.
基金Supported by National Natural Science Foundation of China,No.82374200Construction of Traditional Chinese Medicine Inheritance and Innovation Development Demonstration Pilot Projects in Pudong New Area-High-Level Research-Oriented Traditional Chinese Medicine Hospital Construction,No.YC-2023-0901.
文摘Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.
文摘The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.
文摘BACKGROUND Ulcerative colitis(UC)is a chronic and debilitating inflammatory bowel disease.Cumulative evidence indicates that excess hydrogen peroxide,a potent neutrophilic chemotactic agent,produced by colonic epithelial cells has a causal role leading to infiltration of neutrophils into the colonic mucosa and subsequent development of UC.This evidence-based mechanism identifies hydrogen peroxide as a therapeutic target for reducing agents in the treatment of UC.CASE SUMMARY Presented is a 41-year-old female with a 26-year history of refractory UC.Having developed steroid dependence and never achieving complete remission on treatment by conventional and advanced therapies,she began treatment with oral R-dihydrolipoic acid(RDLA),a lipid-soluble reducing agent with intracellular site of action.Within a week,rectal bleeding ceased.She was asymptomatic for three years until a highly stressful experience,when she noticed blood in her stool.RDLA was discontinued,and she began treatment with oral sodium thiosulfate pentahydrate(STS),a reducing agent with extracellular site of action.After a week,rectal bleeding ceased,and she resumed oral RDLA and discontinued STS.To date,she remains asymptomatic with normal stool calprotectin while on RDLA.CONCLUSION STS and RDLA are reducing agents that serve as highly effective and safe therapy for the induction and maintenance of remission in UC,even in patients refractory or poorly controlled by conventional and advanced therapies.Should preliminary findings be validated by subsequent clinical trials,the use of reducing agents could potentially prevent thousands of colectomies and represent a paradigm shift in the treatment of UC.
文摘We read with great interest the study by Zhang et al on Yiyi Fuzi Baijiang powder(YFB),which exemplifies the power of modern methods to validate traditional Chinese medicine(TCM).The key insight is that YFB doesn’t merely alter“good”or“bad”bacteria but restores the gut microbiota’s holistic equilibrium.This is powerfully shown by its paradoxical reduction of anaerobic probiotics like Bifidobacterium,rectifying the diseased,hypoxic environment,causing their aberrant overgrowth.This challenges the conventional probiotic paradigm and underscores a core TCM principle:Herbal formulas treat disease by restoring the body’s overall functional balance.Future research should focus on the interplay between herbal components,intestinal oxygen,and microbial metabolites to further unravel this sophisticated dialogue.
文摘Background:This study focused on developing and optimizing a self-microemulsifying drug delivery system(SMEDDS)to improve Lafutidine’s solubility and bioavailability,thereby enhancing its effectiveness in treating gastric ulcers.Traditional formulations are less effective due to their limited water solubility and bioavailability.Methods:The study used solubility tests,pseudo-ternary phase diagrams,and central composite design(CCD)to optimize.The formulation was optimized by varying the oil concentration(10–40%)and surfactant/cosurfactant ratio(0.33–3.00),and then tested for droplet size,drug content,emulsification,phase stability,and in vitro dissolution.Results:The study found that the optimized formulation contained 14%Capmul PG 8NF oil,62%Labrasol surfactant,and 24%Tween 80 cosurfactant.This combination generated an average droplet size of 111.02 nm and improved drug release properties.Furthermore,the formulation was stable without phase separation,with a drug content of 88.2–99.8%.Conclusion:SMEDDS significantly improves lafutidine delivery by increasing solubility and absorption,thereby overcoming oral administration challenges.The system quickly formed small droplets in water and released the drug in 15 min.Enhancing lafutidine’s bioavailability may improve its efficacy in treating gastric ulcers,resulting in better patient outcomes and potentially lower dosing frequency.
文摘Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mucosal samples from patients with ulcers and healthy controls,revealing significant changes in microbial diversity and composition.This article reviews their findings,emphasizing H.pylori’s role in gastric ulcers and the need for further research on its impact on duodenal ulcers.We evaluate the study’s strengths and limitations,suggesting future research directions to enhance our understanding of H.pylori’s contribution to ulcerative diseases.
文摘Several issues should be considered before the surgical treatment of gastric ulcer perforations,including morbidity,mortality,and recurrence.However,an oftenoverlooked issue is determining the cause of the perforation.When the perforation is secondary to an underlying and undiagnosed malignancy,stomach resection inadequately treats the oncological disease and may increase postoperative morbidity and require re-surgery.
基金funded by National Key Research and Development Program of China(No.2022YFC3501705)National Natural Science Foundation of China general projects(No.82274066)Shanghai Science and Technology Innovation Project(No.22S21901200).
文摘Gastric ulcer(GU)is a common digestive system disease.Acupuncture,as one of the external treatments of traditional Chinese medicine(TCM),has the characteristics of multi-target,multi-pathway and multi-level action in the treatment of GU.The relationship between meridian points and Zang-fu is an important part of the theory of TCM,which is crucial for the diagnosis and treatment of diseases.There is an external and internal link between acupoints and Zang-fu.The pathological reaction of Zang-fu can manifest as acupoint sensitization,while stimulation of acupoints can play a therapeutic role in the internal Zang-fu.Therefore,the acupoint has the functions of reflecting and treating diseases.This review explores the tender points on the body surface of patients with GU and the rules of acupoint selection.In addition,Zusanli(ST36),as one of the most used acupoints of the stomach meridian,was selected to show the mechanisms behind acupoint stimulation in the treatment of GU in greater detail,specifically in the well-studied model of the stress GU(SGU).Hence,the mechanisms of acupuncture at ST36 and points commonly used in combination with ST36 to treat SGU are discussed further.Treatment effects can be achieved through anti-inflammatory and antioxidant activities,gastric mucosal injury repair,and interaction with the brain-gut axis.In summary,this review provides evidence for a comprehensive understanding of the phenomena and mechanism of acupoint functions for GU.
文摘BACKGROUND Peptic ulcer disease(PUD)during pregnancy is extremely rare.Perforated peptic ulcer(PPU)during pregnancy has high maternal and fetal mortality.Symptoms attributed to pregnancy and other diagnoses make the diagnosis of preoperative PPU during pregnancy and puerperium challenging.AIM To identify predictive factors for early diagnosis and treatment,and the association between the diagnosis and maternal/neonatal outcomes.METHODS We searched PubMed,PubMed Central,and Google Scholar.Articles were analyzed following preferred reporting items for systematic reviews and metaanalysis.The search items included:‘ulcer’,‘PUD’,‘pregnancy’,‘puerperium’,‘postpartum’,‘gravid’,‘labor’,‘perforated ulcer’,‘stomach ulcer’,‘duodenal ulcer’,‘peptic ulcer’.Additional studies were extracted by reviewing reference lists of retrieved studies.We included all available full-text cases and case series.Demographic,clinical,obstetric,diagnostic and treatment parameters,and outcomes were collected.RESULTS Forty-three cases were collected.The mean maternal age was 30.9 years;36.6%were multiparous,and 63.4%were nulliparous or primiparous,with multiparas being older than primiparas.Peptic ulcer perforated in 44.2%of postpartum and 55.8%of antepartum patients.Antepartum PPU incidence increased with advancing gestation 2.3%in the first,7%in the second,and 46.5%in the third trimester.The most common clinical findings were abdominal tenderness(72.1%),rigidity(34.9%),and distension(48.8%).Duodenal ulcer predominated(76.7%).In 79.5%,the time from delivery to surgery or vice versa was>24 hours.The maternal mortality during the third trimester and postpartum was 10%and 31.6%,respectively.The trimester of presentation did not influence maternal mortality.The fetal mortality was 34.8%,with all deaths in gestational weeks 24-32.CONCLUSION Almost all patients with PPU in pregnancy or puerperium presented during the third trimester or the first 8 days postpartum.Early intervention reduced fetal mortality but without influence on maternal mortality.Maternal mortality did not depend on the use of X-ray imaging,perforation location,delivery type,trimester of presentation,and maternal age.Explorative laparoscopy was never performed during pregnancy,only postpartum.
文摘BACKGROUND The use of proton pump inhibitors(PPIs)with the intent of reducing gastric acidity to the desired therapeutic level for treating bleeding peptic ulcer still has several limitations.AIM To compare intravenous PPIs and oral potassium competitive acid blockers(PCABs)administered prior to endoscopic treatment of bleeding peptic ulcers.METHODS This retrospective study involved 105 consecutive patients with non-variceal upper gastrointestinal bleeding(treated August 2023 to February 2024).Prior to emergency endoscopy,patients received either intravenous PPI(pantoprazole 80 mg bolus)or oral PCAB(tegoprazan 50 mg single-dose).Severity of bleeding was assessed using the Glasgow-Blatchford,Rockall,and AIMS65 scoring systems.Patients with severe comorbidities were excluded.Primary outcomes included need for therapeutic endoscopic intervention and occurrence of re-bleeding.Multivariate logistic regression was performed to adjust for potential confounding factors.RESULTS Total of the 105 patients,61 received intravenous PPI injection and 44 received oral PCAB prior to emergency endoscopy.To minimize selection bias,bleeding severity was assessed using the Glasgow-Blatchford,Rockall and AIMS65 scores,with no statistically significant differences observed between the two groups.During emergency endoscopy performed within 48 hours,ulcer bed status was classified according to the Forrest classification.The proportion of lesions graded IIa or higher was significantly lower in the PCAB group(P<0.001),as was the frequency of therapeutic endoscopy intervention(odds ratio=0.272,95%confidence interval:0.111-0.665,P=0.004).The frequency of re-bleeding events was statistically significantly higher in the PPI group(odds ratio=0.141,95%confidence interval:0.024-0.844,P=0.032).CONCLUSION Pre-endoscopic PCAB administration is more effective than PPI injection for upper gastrointestinal bleeding and may reduce ulcer bleeding mortality.
文摘Background Peptic ulcer disease(PUD)is a common health problem that affects many people worldwide and contributes to morbidity and mortality.While several antiulcer medications show considerable effectiveness in treating ulcers,they often come with high costs and can lead to issues like resistance,tolerance,relapses,side effects,and adverse reactions.This highlights the necessity for optimal treatments that are economical,safe,and have a minimal risk of recurrence,especially those derived from natural sources.Objective This study aimed to document the medicinal plants used to manage PUD by the indigenous people of the Missenyi and Kyerwa districts of Kagera,Tanzania.Methods A cross-sectional survey was conducted in four villages in the Missenyi and Kyerwa districts through face-to-face interviews guided by a semi-structured questionnaire.The information obtained included the participants'awareness of PUD,its symptoms,and its management using medicinal plants.Then,the plant species were collected and authenticated,followed by a literature review and verification.Results Thirty informants were interviewed,and 20 medicinal plants from 16 taxonomic families were identified.The informants'knowledge of PUD was poor,and commonly used plant parts included seeds and whole plants,mixed with adjuvants such as water,honey,raw eggs,milk,and black tea decoctions.Decoctions represent the most utilized mode of preparation,and most informants recommend a dose equivalent to 250 mL,after every eight hours,for three months.The majority(60%)of the documented plants are edible.Literature verification supports the claimed ethnomedical use of adjuvants and 85%of plants,whereas 15%(Arachis hypogaea,Lagenaria sphaerica,and Myrica salicifolia)are being reported for the first time in this study.Conclusion The use of the majority of plants documented in this study has a literature backup,and the fact that most plant parts are edible minimizes the risk of toxicity.In addition,the use of three plants to treat PUD was reported for the first time in this study.Therefore,this study recommends that their activity,safety,and efficacy be studied and that more extensive ethnopharmacological surveys be conducted to avoid the loss of valuable information,as many plants are yet to be explored.
文摘BACKGROUND Gastric ulcer(GU),a common gastrointestinal condition,is influenced by multiple factors,particularly inflammatory and immune responses.Complete blood count(CBC)-derived inflammatory biomarkers represent a novel indicator of systemic inflammation and immune status;however,their association with GU remains unclear.AIM To investigate the association between CBC-derived inflammatory markers and GU.METHODS The study sample included individuals admitted to the Gastroenterology Unit of the Second Affiliated Hospital of Nanchang University from 2023 to 2024.We explored how each CBC-based inflammation indicator correlated with GU occurrence through logistic models,and assessed their predictive ability using receiver operating characteristic curve analysis.Additionally,we applied the least absolute shrinkage and selection operator method along with stepwise regression techniques to determine which inflammatory indicators were most significantly linked to GU.RESULTS Higher levels of log2 neutrophil-to-lymphocyte ratio,log2 monocyte-to-lymphocyte ratio,log2 systemic immuneinflammation index,log2 systemic inflammatory response index(SIRI),and log2 aggregate index of systemic inflammation were significantly associated with increased GU prevalence across all models,while log2 platelet-tolymphocyte ratio was significant only in the fully adjusted model.SIRI demonstrated the highest discriminative ability,with an area under the curve of 0.868.CONCLUSION Hematological indicators derived from CBC tests show a significant correlation with the prevalence of GU.Among them,SIRI demonstrated the most prominent association.These markers could act as practical tools in recognizing individuals more likely to develop GU.
基金Hubei Province Top Medical Youth Talent Program,Wuhan Knowledge Innovation Special Basic Research Project,No.2023020201020558Clinical Research Project of Affiliated Hospital of Guangdong Medical University,No.LCYJ2021B004 and No.LCYJ2019B010Science and Technology Plan Project of Zhanjiang,No.2022A01191.
文摘BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.
基金Supported by the King Salman Center for Disability Research,No.KSRG-2023-407.
文摘Diabetic foot(DF)is a major public health concern.As evident from numerous previous studies,supervision of DF ulcer(DFU)is crucial,and a specific quality check-up is needed.Patients should be educated about glycaemic management,DFUs,foot lesions,proper care for injuries,diet,and surgery.Certain reasonably priced treatments,such as hyperbaric oxygen and vacuum-assisted closure therapy,are also available for DFUs,along with modern wound care products and techniques.Nonetheless,DF care(cleaning,applying antimicrobial cream when wounded,and foot reflexology),blood glucose monitoring to control diabetes,and monthly or quarterly examinations in individuals with diabetes are effective in managing DFUs.Between 50%and 80%of DF infections are preventable.Regardless of the intensity of the lesion,it needs to be treated carefully and checked daily during infection.Tissue regeneration can be aided by cleaning,dressing,and application of topical medicines.The choice of shoes is also important because it affects blood circulation and nerve impulses.In general,regular check-ups,monitoring of the patient’s condition,measuring blood glucose levels,and providing frequent guidance regarding DFU care are crucial.Finally,this important clinical problem requires involvement of multiple professionals to properly manage it.
基金Supported by National Science and Technology Major Project,No.2024ZD0521002The Innovation Team Project of Traditional Chinese Medicine of Liaoning Province,No.LNZYYCXTD-CCCX-003+1 种基金General Program of the National Natural Science Foundation of China,No.82074296Construction Project of Inheritance Studios of Famous Chinese Medicine Experts in China,No.[2022]No.75.
文摘Peptic ulcer(PU)is characterized by inflammation,necrosis,and erosion of the gastrointestinal mucosa caused by various pathogenic factors,leading to ulcer formation.The stomach and duodenum are the most commonly affected sites.Bletilla striata,a traditional Chinese medicinal herb,contains diverse chemical constituents and exhibits multiple pharmacological effects.As a key component in various traditional Chinese medicine compound formulations,it has demonstrated notable clinical efficacy.Moreover,it has a solid research foundation and broad application prospects in the treatment of gastrointestinal diseases.This paper systematically elaborates on the clinical efficacy and mechanisms of action of Bletilla striata in the treatment of PUs,drawing from ancient medical literature and traditional formula applications to provide support for clinical use.
文摘BACKGROUND Pain often predisposes patients with diabetic foot ulcers(DFUs)to negative emotional states,such as anxiety and depression,which can significantly impair treatment outcomes and recovery.However,very few studies have explored the relationship between anxiety,depression,and pain in DFUs,as well as the associated risk factors.AIM To analyze the correlation between anxiety,depression,and pain in patients with DFUs and to identify the associated risk factors.METHODS This study included 106 patients diagnosed with DFUs who were admitted to Tiantai County People’s Hospital between March 2022 and March 2024.The patients’anxiety levels were evaluated using Zung’s self-rating anxiety scale(SAS),depression status was assessed using Zung’s self-rating depression scale(SDS),and pain intensity was assessed using the visual analog scale(VAS).Subsequently,correlations between SAS,SDS,and VAS scores were analyzed.Univariate and multivariate analyses were conducted to explore the risk factors that contributed to anxiety and depression in patients with DFUs.RESULTS Among the 106 patients,39.62%exhibited anxiety and 43.40%presented with depression.Most patients experiencing anxiety or depression exhibited mild symptoms,with no severe cases observed.Compared with asymptomatic patients,those with anxiety or depression had significantly higher VAS scores.Correlation analysis indicated a significant positive relationship between both SAS and SDS scores and the VAS score.Univariate analysis identified sex,age,Wagner’s grade,presence of other complications,and smoking history as factors significantly associated with anxiety and depression.Multivariate analysis further confirmed that younger age,higher Wagner’s grade,and higher VAS scores were independent predictors of anxiety and depression.CONCLUSION This study reveals a significant positive correlation between anxiety,depression,and pain in patients with DFUs.This finding suggests that timely and effective pain intervention may be beneficial in alleviating negative emotions such as anxiety and depression.In addition,younger age(<50 years),higher Wagner’s grade,and higher VAS scores increase the risk of developing anxiety and depression in this patient population.
文摘Ulcerative colitis has baffled researchers since the early 20th century.The pre-vailing explanation attributes the chronic recurring episodes of bloody diarrhea and abdominal pain to some form of immune abnormality,despite the lack of supporting evidence.This highlights the critical need for innovative research directions and methodologies to uncover the cause and develop a cure for this disease.By analyzing existing data from less than a dozen previously published studies,a novel,evidence-based pathogenesis was constructed,implicating colonic epithelial hydrogen peroxide as a causal factor in the development of this disease.This newly identified mechanism informed the creation of a ground-breaking class of therapeutics,known as reducing agents,which have demon-strated remarkable success in resolving colonic inflammation and restoring colonic health in patients with refractory ulcerative colitis.This paper outlines the timeline of these publications and reinterprets the findings within the context of contemporary biomedical science.
