BACKGROUND Complications of vascular closure devices mainly include bleeding,vascular injury,and trapped device that cannot be removed percutaneously.However,arterial stenosis or occlusion induced by vascular injury i...BACKGROUND Complications of vascular closure devices mainly include bleeding,vascular injury,and trapped device that cannot be removed percutaneously.However,arterial stenosis or occlusion induced by vascular injury is rare.This article introduces a rare case with severe acute limb ischemia after using the vascular closure device(StarClose).CASE SUMMARY A 54-year-old man was admitted because of necrosis of the second toe of the left foot for 2 mo.Ultrasound showed left femoral artery stenosis,and occlusion of the left popliteal,posterior tibial,peroneal,anterior tibial and dorsalis pedis arteries,suggesting arteriosclerosis obliterans of low extremities,gangrene and type 2 diabetes.He underwent an interventional procedure of drug-eluting balloon in the left lower limb via antegrade puncture of the left common femoral artery.He developed acute limb ischemia after 1 h,and severe pain,numbness,pale skin,low skin temperature and weakened sensation in the left foot.Injury of the common femoral artery intima was considered.Exploratory surgery showed occlusion at the puncture point accompanied with bulged vascular lumen and flipped vascular intima caused by StarClose.The flipped intima was removed.The limb blood supply was restored and the limb was saved post-surgery.He recovered well at final follow-up.CONCLUSION Incorrect use of the vascular closure device was the main cause of severe acute limb ischemia in this case.展开更多
Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization.We report a case of accidental subclavian artery catheter...Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization.We report a case of accidental subclavian artery catheterization close to the vertebral artery during internal jugular venous cannulation,which was successfully managed in the interventional suite with catheter removal and use of a vascular closure device.展开更多
In the contemporary medical landscape,the burgeoning interest in natural therapies,particularly for managing gastrointestinal disorders,has brought traditional Chinese medicine(TCM)to the forefront.This article explai...In the contemporary medical landscape,the burgeoning interest in natural therapies,particularly for managing gastrointestinal disorders,has brought traditional Chinese medicine(TCM)to the forefront.This article explains the core principles and clinical applications of TCM in treating these conditions,furthering the discourse through an examination of integrated TCM strategies,as demonstrated in the study by Zhou et al.While TCM has shown promising clinical outcomes,it encounters significant hurdles in standardization,mechanistic research,and clinical validation.Future investigations should aim to solidify the scientific underpinnings of TCM and expand its use in gastrointestinal disease management,striving for a seamless fusion of traditional and contemporary medical practices.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are a significant contributor to disability and mortality in diabetic patients.Macrophage polarization and functional regulation are promising areas of research and show therapeuti...BACKGROUND Diabetic foot ulcers(DFUs)are a significant contributor to disability and mortality in diabetic patients.Macrophage polarization and functional regulation are promising areas of research and show therapeutic potential in the field of DFU healing.However,the complex mechanism,the difficulty in clinical translation,and the large heterogeneity present significant challenges.Hence,this study was to comprehensively analyze the publication status and trends of studies on macrophage polarization and DFU healing.AIM To examine the relevant literature on macrophage polarization in DFU healing.METHODS A bibliometric analysis was conducted using the Web of Science database.Relevant literature was retrieved from the Web of Science Core Collection database between 2013 to 2023 using literature visualization and analysis software(VOSviewer and CiteSpace)and bibliometric online platforms.The obtained literature was then subjected to visualization and analysis of different countries/regions,institutions,journals,authors,and keywords to reveal the research’s major trends and focus.RESULTS The number of publications on the role of macrophage polarization in DFU healing increased rapidly from 2013 to 2023,especially in the latter period.Chinese researchers were the most prolific in this field,with 217 publications,while American researchers had been engaged in this field for a longer period.Qian Tan of Nanjing Drum Tower Hospital and Qian Ding of Nanjing University were the first to publish in this field.Shanghai Jiao Tong University was the institution with the most publications(27).The keywords“bone marrow”,“adjustment,replacement,response,tissue repair”,and“activation,repair,differentiation”appeared more frequently.The study of macrophage polarization in DFU healing focused on the regulatory mechanism,gene expression,and other aspects.CONCLUSION This study through the bibliometric method reveals the research trends and development trends in this field of macrophage polarization in DFU healing from 2013 to 2023 in the Web of Science Core Collection database.The key hotspots in this field mainly include the regulation of macrophage activation,gene expression,wound tissue repair,and new wound materials.This study provides references for future research directions.展开更多
Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.D...Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.Depressive symptoms,frequently observed in breast cancer patients,significantly influence treatment outcomes and quality of life.Recent years have seen a growing focus on these symptoms,emphasizing early identification and intervention.This editorial comments on the recent study by Mao et al on a risk prediction model for de-pression in young and middle-aged breast cancer patients.Research suggests that factors such as tumor grade,monthly income,pain perception,family support,and physical activity critically influence the onset of depressive symptoms.By developing personalized risk prediction models,it becomes possible to identify high-risk patients early,allowing healthcare professionals to implement pre-ventive strategies proactively.The editorial advocates for increased attention and resources dedicated to psychological health interventions for breast cancer pa-tients,aiming to foster comprehensive care strategies that mitigate the impacts of depression and enhance overall quality of life.展开更多
BACKGROUND The high mortality rate and recurrence/metastasis remain major challenges in the clinical management of gastric cancer(GC)patients.To optimize treatment stratification and management,there is an urgent need...BACKGROUND The high mortality rate and recurrence/metastasis remain major challenges in the clinical management of gastric cancer(GC)patients.To optimize treatment stratification and management,there is an urgent need for efficient and non-invasive biomarkers.A meta-analysis on the prognostic role of circulating tumor cells(CTCs)in GC revealed a strong association between CTCs and patient prognosis.Among CTC subtypes,Interstitial CTCs(I-CTCs)exhibited the strongest invasiveness.This study innovatively investigated the expression profile of I-CTCs in advanced GC patients to evaluate their clinical utility.AIM To evaluate the clinical utility of I-CTCs as a non-invasive prognostic biomarker in advanced GC.To investigate the correlation between I-CTC count thresholds and chemotherapy efficacy in advanced GC patients.To establish the potential of preoperative I-CTC profiling for optimizing treatment stratification and postoperative surveillance.METHODS This study retrospectively analyzed 59 patients with advanced GC treated at the General Surgery Clinical Medical Center of Gansu Provincial Hospital between October 2019 and October 2020.The expression levels of I-CTCs were measured,and patient survival was monitored.The receiver operating characteristic curve was plotted to determine the optimal cut-off value for I-CTCs expression levels.Based on this cut-off value,59 GC patients were grouped into positive and negative groups.The differences in clinicopathological characteristics between the two groups were analyzed.Patient survival was follow-up and recorded until October 2022.Plotting survival curves and performing univariate and multifactorial analyses of patient prognostic factors.The Kaplan-Meier method and Cox regression model were used,respectively.RESULTS A total of 59 patients were included in this study,and receiver operating characteristic curve analysis showed that the best cut-off value for I-CTCs was 5,with an area under the curve of 0.8356(95%CI:0.7122-0.9590).The I-CTC count of≥5 defines the positive group,while counts<5 are classified as the negative group.Positive I-CTCs correlated with the degree of tumor differentiation and disease progression(P<0.05).16 of 59 patients received neoadjuvant chemotherapy.There were divided into progressive disease and disease control groups based on response to neoadjuvant chemotherapy.Patients in the I-CTCs-negative group had longer overall survival and disease-free survival than those in the positive group(P<0.05).Multifactorial analysis revealed that I-CTCs positivity(HR=13.323,95%CI:1.675-105.962,P=0.014)was an independent risk factor for survival in patients with advanced GC.CONCLUSION In patients with advanced GC,an I-CTC count of≥5 is associated with both poor prognosis and reduced chemotherapy efficacy.I-CTCs may serve as a valuable preoperative biomarker for predicting the prognosis of advanced GC.展开更多
Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient preferences.In the recent decade,the recommendations for managing symptomatic varicose ...Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient preferences.In the recent decade,the recommendations for managing symptomatic varicose veins have changed dramatically due to the rise of minimally invasive endovascular techniques.The literature was systematically searched on Medline without language restrictions.All papers on the treatment of varicose veins and venous insufficiency with different procedures were included and reviewed.Endovenous laser ablation(EVLA)and radiofrequency ablation(RFA)both are same safe and effective in terms of occlusion rate,and time to return to normal activity.In comparison with RFA or EVLT,Cure conservatrice et Hemodynamique de l’Insufficience Veineuse en Ambulatoire(CHIVA)may cause more bruising and make little or no difference to rates of limb infection,superficial vein thrombosis,nerve injury,or hematoma.In terms of recurrence of varicose veins,there is little or no difference between CHIVA and stripping,RFA,or EVLT.Great saphenous vein recanalization is highest in the ultrasound-guided foam sclerotherapy(FS)group(51%)during 1 year of follow-up.The 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and sclerotherapy.Although the mechanochemical endovenous ablation(MOCA)is a non-thermal,non-tumescent option and appears to be of similar efficacy to stab avulsion with no potential risk of nerve damage,the overall success rate of MOCA is lower than those of other procedures such as EVLA,RFA,or high ligation and stripping.EVLA is the most cost-effective therapeutic option,with RFA being a close second for the treatment of patients with varicose veins.Endovenous thermal ablation(EVLA or RFA)is recommended as a first-line treatment for varicose veins and has substituted the high ligation of saphenofemoral junctional reflux and stripping of varicose veins.Ultrasound-guided FS is associated with a high recurrence rate and can be used in conjunction with other procedures.MOCA and cyanoacrylate embolization appear promising,but evidence of their effectiveness is required.展开更多
BACKGROUND Pulmonary embolism(PE)is a fatal clinical syndrome that is generally caused by an embolus from unstable deep venous thrombosis(DVT).However,clinical and biochemical factors that are related to the stability...BACKGROUND Pulmonary embolism(PE)is a fatal clinical syndrome that is generally caused by an embolus from unstable deep venous thrombosis(DVT).However,clinical and biochemical factors that are related to the stability of DVT are not fully understood.AIM To evaluate the relationships between plasma antigen levels of factor XII(FXII:Ag)and factor XI(FXI:Ag)with the stability of DVT.METHODS Patients with DVT and no PE,DVT and PE,and controls with no DVT or PE that matched for age,gender,and comorbidities were included in this study.FXII:Ag and FXI:Ag in peripheral venous blood were measured using enzyme-linked immunosorbent assays.RESULTS Using the 95th percentile of FXI:Ag in patients with DVT and PE as the cut-off,a higher FXI:Ag was associated with a higher risk of unstable DVT(odds ratio:3.15,95%confidence interval:1.18-8.43,P=0.019).Stratified analyses showed consistent results in patients≤60 years(P=0.020),but not in those>60 years(P=0.346).CONCLUSION Higher plasma FXI:Ag might be a marker for unstable DVT,which might be associated with PE in these patients.展开更多
Objective:This study explored the timing of interventional treatment for acute intramural aortic hematoma(IMH)and the corresponding high-risk factors for its development into local aortic dissection(AD).Method:This re...Objective:This study explored the timing of interventional treatment for acute intramural aortic hematoma(IMH)and the corresponding high-risk factors for its development into local aortic dissection(AD).Method:This retrospective case study method examined clinical follow-up data of 42 patients with acute IMH between April 2013 and October 2016 from the First Affiliated Hospital of Xi?an Jiaotong University.SPSS 17.0 and PPMS1.5 were used to analyze follow-up data spanning 3–12 months(mean,7.5?3.7 months).Results:Patients were divided into the conversion group and the hematoma group according to whether they developed AD.Among them,16 patients(38.1%)developed AD and were treated with thoracic endovascular aortic repair(TEVAR).The remaining patients(61.89%)were treated conservatively.After 1 week,the mean aortic diameter of the conversion versus hematoma group was significantly widened.Hemodynamically unstable patients and those with hematoma to the abdominal aorta extension were more likely to develop AD.Patient outcomes after TEVAR were similar between groups.Conclusion:Our findings suggest that aortic isthmus diameter!3.0 cm,hematoma extending to the abdominal aorta,and hemodynamic instability are associated with AD development in acute IMH patents.TEVAR should be considered if hematoma thickening,calcification ingression,ulcer progression,or contrast enhancement within the intramural hematoma is noted beyond 2 weeks after IMH onset.展开更多
Objective:To explore the mechanism of Simiao Yong'an Decoction in treating deep venous thrombosis based on the method of network pharmacology.Methods:Through TCMSP database,the effective components of each traditi...Objective:To explore the mechanism of Simiao Yong'an Decoction in treating deep venous thrombosis based on the method of network pharmacology.Methods:Through TCMSP database,the effective components of each traditional Chinese medicine in Simiao Yong'an Decoction were obtained and their targets were predicted.The targets of deep venous thrombosis were collected by CTD database,and the key targets were obtained by intersection of the component targets and the disease targets;Protein-Protein Interaction(PPI)network was constructed by String database.The drugs-components-targets-disease network map was constructed by using the software of Cytoscape 3.7.2.GO function and KEGG pathway enrichment of Simiao Yong'an Decoction in the treatment of deep venous thrombosis were analyzed by using the plug-in of ClueGo.Results:121 effective components and 137 potential targets of Simiao Yong'an Decoction were obtained.There were 1172 targets of deep venous thrombosis.There were 214 biological processes analyzed by GO Biological Process and 72 pathways analyzed by KEGG analysis.Conclusion:Simiao Yong'an Decoction may act on ESR1,AR,PTGS2 and other key targets,as well as AGE-RAGE signaling pathway,PI3K-Akt signaling pathway,MAPK signaling pathway,IL-17 signaling pathway,TNF signaling pathway,RLX signaling pathway and other pathways to treat deep venous thrombosis.展开更多
In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin famil...In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin family member 14(KIF14),a critical kinesin,is pivotal in the proliferation,migration,and invasion of tumor cells.It has emerged as a focal point in recent studies of malignant tumors in the digestive tract.This article reviews the current research on KIF14 within these tumors and details its significant role in tumor cell behaviors,including proliferation,apo-ptosis,migration,invasion,and angiogenesis,alongside the regulatory mechanisms of the associated intracellular signaling pathways.Additionally,it explores the clinical value of KIF14 as a potential biomarker for early diagnosis,disease monitoring,and prognostic evaluation in malignant tumors of the digestive tract.The article concludes by introducing the potential regulatory role of traditional Chinese medicine,aiming to combine the strengths of both modern and traditional medical approaches to enhance treatment outcomes and prognosis for patients with these tumors.展开更多
BACKGROUND Shifting from the inflammatory to the proliferative phase represents a pivotal step during managing diabetic foot ulcers(DFUs);however,existing medical interventions remain insufficient.MicroRNAs(miRs)highl...BACKGROUND Shifting from the inflammatory to the proliferative phase represents a pivotal step during managing diabetic foot ulcers(DFUs);however,existing medical interventions remain insufficient.MicroRNAs(miRs)highlight notable capacity for accelerating the repair process of DFUs.Previous research has demonstrated which miR-122-5p regulates matrix metalloproteinases under diabetic conditions,thereby influencing extracellular matrix dynamics.AIM To investigate the impact of miR-122-5p on the transition from the inflammatory to the proliferative stage in DFU.METHODS Analysis for miR-122-5p expression in skin tissues from diabetic ulcer patients and mice was analyzed using quantitative real-time polymerase chain reaction(qRT-PCR).A diabetic wound healing model induced by streptozotocin was used,with mice receiving intradermal injections of adeno-associated virus-DJ encoding empty vector or miR-122.Skin tissues were retrieved at 3,7,and 14 days after injury for gene expression analysis,histology,immunohistochemistry,and network studies.The study explored miR-122-5p’s role in macrophage-fibroblast interactions and its effect on transitioning from inflammation to proliferation in DFU healing.RESULTS High-throughput sequencing revealed miR-122-5p as crucial for DFU healing.qRT-PCR showed significant upregulation of miR-122-5p within diabetic skin among DFU individuals and mice.Western blot,along with immunohistochemical and enzyme-linked immunosorbent assay,demonstrating the upregulation of inflammatory mediators(hypoxia inducible factor-1α,matrix metalloproteinase 9,tumor necrosis factor-α)and reduced fibrosis markers(fibronectin 1,α-smooth muscle actin)by targeting vascular endothelial growth factor.Fluorescence in situ hybridization indicated its expression localized to epidermal keratinocytes and fibroblasts in diabetic mice.Immunofluorescence revealed enhanced increased presence of M1 macrophages and reduced M2 polarization,highlighting its role in inflammation.MiR-122-5p elevated inflammatory cytokine levels while suppressing fibrotic activity from fibroblasts exposed to macrophage-derived media,highlighting its pivotal role in regulating DFU healing.CONCLUSION MiR-122-5p impedes cutaneous healing of diabetic mice via enhancing inflammation and inhibiting fibrosis,offering insights into miR roles in human skin wound repair.展开更多
BACKGROUND Stem cell therapy has shown great potential for treating diabetic foot(DF).AIM To conduct a bibliometric analysis of studies on the use of stem cell therapy for DF over the past two decades,with the aim of ...BACKGROUND Stem cell therapy has shown great potential for treating diabetic foot(DF).AIM To conduct a bibliometric analysis of studies on the use of stem cell therapy for DF over the past two decades,with the aim of depicting the current global research landscape,identifying the most influential research hotspots,and providing insights for future research directions.METHODS We searched the Web of Science Core Collection database for all relevant studies on the use of stem cell therapy in DF.Bibliometric analysis was carried out using CiteSpace,VOSviewer,and R(4.3.1)to identify the most notable studies.RESULTS A search was conducted to identify publications related to the use of stem cells for DF treatment.A total of 542 articles published from 2000 to 2023 were identified.The United States had published the most papers on this subject.In this field,Iran’s Shahid Beheshti University Medical Sciences demonstrated the highest productivity.Furthermore,Dr.Bayat from the same university has been an outstanding researcher in this field.Stem Cell Research&Therapy is the journal with the highest number of publications in this field.The main keywords were“diabetic foot ulcers,”“wound healing,”and“angiogenesis.”CONCLUSION This study systematically illustrated the advances in the use of stem cell therapy to treat DF over the past 23 years.Current research findings suggested that the hotspots in this field include stem cell dressings,exosomes,wound healing,and adipose-derived stem cells.Future research should also focus on the clinical translation of stem cell therapies for DF.展开更多
Objective To investigate the clinical effects of thread-dragging therapy on gangrene of non-ischemic diabetic foot ulcers(NIDFU).Methods A total of 136 patients with NIDFU were recruited from the Department of Periphe...Objective To investigate the clinical effects of thread-dragging therapy on gangrene of non-ischemic diabetic foot ulcers(NIDFU).Methods A total of 136 patients with NIDFU were recruited from the Department of Peripheral Vascular Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between June 21,2021 and February 1,2023,and randomized into an intervention group and a control group,with 68 cases in each group.Both groups received basic treatment.The intervention group was treated with thread-dragging therapy,while the control group was treated with debridement combined with routine dressing changes after surgery.Both groups were treated continuously for 2 months.The amputation rates and changes in the ulcer area were compared between the groups.The inflammatory response index including peripheral white blood cells(WBCs),neutrophil percentage(NEUT%),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),and interleukin 6(IL-6)were compared between the two groups.Results After treatment,the ulcer areas in the intervention group were significantly smaller than that of the control group(8.50±3.88 cm^(2) vs.10.11±4.61 cm^(2),P<0.05).The amputation rates of the two groups were not statistically significant(4.4%vs.5.9%,P>0.05).Differences of WBCs count,CRP,and ESR before and after therapy in the intervention group were better than the control group(P<0.05).However,there were no significant differences in changes of NEUT%,PCT,and IL-6 between the two groups(P>0.05).Conclusion Thread-dragging therapy may be effective in the treatment of NIDFU,with the additional advantages of less tissue damage after healing.(Registration No.ChiCTR2100047496)展开更多
Background： Estrogen is one of the most important reproductive steroidal hormones and plays a critical role in the maintenance of pregnancy, and its function is mediated by estrogen receptor 1 （ESR 1）. The polymorp...Background： Estrogen is one of the most important reproductive steroidal hormones and plays a critical role in the maintenance of pregnancy, and its function is mediated by estrogen receptor 1 （ESR 1）. The polymorphisms ofESR 1 were involved in recurrent spontaneous abortion （RSA）; however, the association between ESRI polymorphisms and RSA remains controversial. The present meta-analysis was aimed to clarify the association between ESRI Pvull （-397C/T, rs2234693） and Xbal （-351 A/G, rs9340799） polymorphisms and the risk of RSA. Methods： All the included articles were retrieved from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Med Online Database up to January 3,2018. Data were processed in the Stata 12.0 software. The odds ratios （ORs） and 95% confidence intervals （95% Cls） were calculated using fixed-effects models （FEM）/random-effects models （REM）. Results： Seven case-control studies with 836 cases and 1164 controls were included in the study. Generally, the ESR 1 polymorphisms were not associated with RSA in any of the genetic analysis models. However, it was found that as rs9340799 polymorphism was related to increased risk of RSA in non-Asian group in the homozygous genetic model （OR = 2.40, 95% CI = 1.05-5.50, P = 0.039）. Moreover, in Asian group, rs9340799 polymorphism was found to be related to decreased RSA risk in both the heterozygous model （OR = 0.53, 95% CI = 0.33-0.85, P = 0.009） and the dominant genetic model （OR=0.55, 95% CI = 0.30 0.98, P = 0.042）. Conclusions： Generally. there was no significant association between the polymorphisms of ESRI and the risk of RSA. However, subgroup analysis indicated that ESR1 rs9340799 polymorphism was related to increased RSA risk in the non-Asian group while associated with decreased RSA risk in Asian group.展开更多
Objective:To determine whether salvianolic acid B(Sal B)exerts protective effects on diabetic peripheral neuropathy by attenuating apoptosis and pyroptosis.Methods:RSC96 cells were primarily cultured with DMEM(5.6 mmo...Objective:To determine whether salvianolic acid B(Sal B)exerts protective effects on diabetic peripheral neuropathy by attenuating apoptosis and pyroptosis.Methods:RSC96 cells were primarily cultured with DMEM(5.6 mmol/L glucose),hyperglycemia(HG,125 mmol/L glucose)and Sal B(0.1,1,and 10μmol/L).Cells proliferation was measured by 3-(4,5-cimethylthiazol-2-yl)-2,5-dilphenyltetrazolium bromide assay.Reactive oxygen species(ROS)generation and apoptosis rate were detected by flow cytometry analysis.Western blot was performed to analyze the expressions of poly ADP-ribose polymerase(PARR),cleaved-caspase 3,cleavedcaspase 9,Bcl-2,Bax,NLRP3,ASC,and interleukin(IL)-1β.Results:Treatment with HG at a concentration of125 mmol/L attenuated cellular proliferation,while Sal B alleviated this injury(P<0.05).In addition,Sal B inhibited HG-induced ROS production and apoptosis rate(P<0.05).Furthermore,treatment with Sal B down-regulated HG-induced PARP,cleaved-caspase 3,cleaved-caspase 9,Bax,NLRP3,ASC,and IL-1βexpression,but mitigated HG-mediated down-regulation of Bcl-2 expression(P<0.05).Conclusion:Sal B may protect RSC96 cells against HG-induced cellular injury via the inhibition of apoptosis and pyroptosis activated by ROS.展开更多
Objective: To investigate the effect of Yinqi ointment on wound morphology and growth factor in treating diabetic foot ulcer(DFU).Methods: From December 2016 to December 2017, 92 cases of DFU with deficiency of both ...Objective: To investigate the effect of Yinqi ointment on wound morphology and growth factor in treating diabetic foot ulcer(DFU).Methods: From December 2016 to December 2017, 92 cases of DFU with deficiency of both Qi and Yin syndrome were randomly divided into treatment group and control group(44 cases in each group). The treatment group was treated with Yinqi ointment, while the control group was treated with mupirocin ointment. After 4 weeks of treatment, the ulcer healing effect, ulcer area, granulation tissue, epithelial tissue coverage,pain score, and dynamic analysis of vascular endothelial growth factor(VEGF), epidermis growth factor(EGF), and basic fibroblast growth factor(bFGF) in local granulation tissue were statistically analyzed before and after treatment in both groups. Results: The total effective rate was 88.37% in the treatment group and 74.42% in the control group. The wound reduction rate, epithelial tissue coverage rate, granulation tissue growth rate, and local pain relief rate in the treatment group were significantly superior to those in the control group(P < 0.05). Through the local granulation detection, the treatment group and the control group have increased VEGF, EGF, and bFGF, but the treatment group increased the role of growth factor than the control group. Conclusion: Yinqi ointment can promote the healing of DFU, and its mechanism may be related to the increase of the content of growth factor in granulation tissue.展开更多
Background Pulmonary thromboembolism （PTE） is a serious disease often leading to disability and death. Percutaneous placement of an inferior vena cava （IVC） filter is an effective method to prevent fatal PTE cause...Background Pulmonary thromboembolism （PTE） is a serious disease often leading to disability and death. Percutaneous placement of an inferior vena cava （IVC） filter is an effective method to prevent fatal PTE caused by lower extremity deep venous thrombosis （LEDVT）. We developed the ZQL-type retrievable vena cava filter. The aim of this study was to evaluate the safety and effectiveness of the ZQL-type filter for prevention of fatal PTE. Methods A total of 144 patients with indications for placement of an IVC filter received insertion of filters via a femoral （n=37） or jugular （n=107） vein approach. Abdominal X-ray and color Doppler ultrasonography of IVC were regularly performed to visualize the position and condition of the IVC filter following filter placement. If thrombi in the lower extremity deep veins were removed within 2 weeks, the filter retrieval procedure was performed after an abdominal radiograph, an inferior vena cavogram and a pulmonary angiography. Otherwise, the filter should be kept permanently in place with regular follow-up inspections. Results One hundred and forty-four filters were implanted at the target sites with a success rate of 98.61% for one-time placement and 100% for two-time placement. Of the 137 patients followed up （follow-up rate, 95.14%）, 43 patients had filters retrieved during a period of between 7 and 14 days （median, 12 days） following filter placement. The remaining 94 patients were followed for 7 days to 39 months （median follow-up period, 17 months）. No filter migration or tilt, filter fracture or IVC perforation was observed. No obstruction of IVC occurred. No symptomatic PTE developed during the follow-up period. Conclusion The ZQL-type retrievable vena cava filter is a safe and effective device to prevent PTE. This filter possesses a distinctive stent-shape, stable design, high capture efficacy, and is easy to insert and retrieve and thus is suitable for clinical application. Chin Med J 2009; 122（2）： 140-144展开更多
Because China is becoming an aging society,the incidence of diabetes and diabetic foot have been increasing.Diabetic foot has become one of the main health-related killers due to its high disability and mortality rate...Because China is becoming an aging society,the incidence of diabetes and diabetic foot have been increasing.Diabetic foot has become one of the main health-related killers due to its high disability and mortality rates.Negative pressure wound therapy(NPWT)is one of the most effective techniques for the treatment of diabetic foot wounds and great progress,both in terms of research and its clinical application,has been made in the last 20 years of its development.However,due to the complex pathogenesis and management of diabetic foot,irregular application of NPWT often leads to complications,such as infection,bleeding and necrosis,that seriously affect its treatment outcomes.In 2020,under the leadership of Burns,Trauma and Tissue Repair Committee of the Cross-Straits Medicine Exchange Association,the writing group for‘Consensus on the application of negative pressure wound therapy of diabetic foot wounds’was established with the participation of scholars from the specialized areas of burns,endocrinology,vascular surgery,orthopedics and wound repair.Drawing on evidence-based practice suggested by the latest clinical research,this consensus proposes the best clinical practice guidelines for the application and prognostic evaluation of NPWT for diabetic foot.The consensus aims to support the formation of standardized treatment schemes that clinicians can refer to when treating cases of diabetic foot.展开更多
基金Supported by the Traditional Chinese Medicine Science,No.2017-057,2017-058 and 2019-0969Technology Development Project of Shandong Province,No.2019-0971
文摘BACKGROUND Complications of vascular closure devices mainly include bleeding,vascular injury,and trapped device that cannot be removed percutaneously.However,arterial stenosis or occlusion induced by vascular injury is rare.This article introduces a rare case with severe acute limb ischemia after using the vascular closure device(StarClose).CASE SUMMARY A 54-year-old man was admitted because of necrosis of the second toe of the left foot for 2 mo.Ultrasound showed left femoral artery stenosis,and occlusion of the left popliteal,posterior tibial,peroneal,anterior tibial and dorsalis pedis arteries,suggesting arteriosclerosis obliterans of low extremities,gangrene and type 2 diabetes.He underwent an interventional procedure of drug-eluting balloon in the left lower limb via antegrade puncture of the left common femoral artery.He developed acute limb ischemia after 1 h,and severe pain,numbness,pale skin,low skin temperature and weakened sensation in the left foot.Injury of the common femoral artery intima was considered.Exploratory surgery showed occlusion at the puncture point accompanied with bulged vascular lumen and flipped vascular intima caused by StarClose.The flipped intima was removed.The limb blood supply was restored and the limb was saved post-surgery.He recovered well at final follow-up.CONCLUSION Incorrect use of the vascular closure device was the main cause of severe acute limb ischemia in this case.
文摘Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization.We report a case of accidental subclavian artery catheterization close to the vertebral artery during internal jugular venous cannulation,which was successfully managed in the interventional suite with catheter removal and use of a vascular closure device.
基金Supported by the 2023 Government Funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731DNatural Science Foundation of Hebei Province,No.H202423105.
文摘In the contemporary medical landscape,the burgeoning interest in natural therapies,particularly for managing gastrointestinal disorders,has brought traditional Chinese medicine(TCM)to the forefront.This article explains the core principles and clinical applications of TCM in treating these conditions,furthering the discourse through an examination of integrated TCM strategies,as demonstrated in the study by Zhou et al.While TCM has shown promising clinical outcomes,it encounters significant hurdles in standardization,mechanistic research,and clinical validation.Future investigations should aim to solidify the scientific underpinnings of TCM and expand its use in gastrointestinal disease management,striving for a seamless fusion of traditional and contemporary medical practices.
基金Supported by the Qilu Medical School Traditional Chinese Medicine Academic School Inheritance Project,No.93 LW[2022]Construction Project of the Inheritance Studio of National Famous Traditional Chinese Medicine Experts,Traditional Chinese Medicine Teaching Letter No.75[2022]Qilu Health and Fitness Talents in 2019,No.3 LWRZ[2020].
文摘BACKGROUND Diabetic foot ulcers(DFUs)are a significant contributor to disability and mortality in diabetic patients.Macrophage polarization and functional regulation are promising areas of research and show therapeutic potential in the field of DFU healing.However,the complex mechanism,the difficulty in clinical translation,and the large heterogeneity present significant challenges.Hence,this study was to comprehensively analyze the publication status and trends of studies on macrophage polarization and DFU healing.AIM To examine the relevant literature on macrophage polarization in DFU healing.METHODS A bibliometric analysis was conducted using the Web of Science database.Relevant literature was retrieved from the Web of Science Core Collection database between 2013 to 2023 using literature visualization and analysis software(VOSviewer and CiteSpace)and bibliometric online platforms.The obtained literature was then subjected to visualization and analysis of different countries/regions,institutions,journals,authors,and keywords to reveal the research’s major trends and focus.RESULTS The number of publications on the role of macrophage polarization in DFU healing increased rapidly from 2013 to 2023,especially in the latter period.Chinese researchers were the most prolific in this field,with 217 publications,while American researchers had been engaged in this field for a longer period.Qian Tan of Nanjing Drum Tower Hospital and Qian Ding of Nanjing University were the first to publish in this field.Shanghai Jiao Tong University was the institution with the most publications(27).The keywords“bone marrow”,“adjustment,replacement,response,tissue repair”,and“activation,repair,differentiation”appeared more frequently.The study of macrophage polarization in DFU healing focused on the regulatory mechanism,gene expression,and other aspects.CONCLUSION This study through the bibliometric method reveals the research trends and development trends in this field of macrophage polarization in DFU healing from 2013 to 2023 in the Web of Science Core Collection database.The key hotspots in this field mainly include the regulation of macrophage activation,gene expression,wound tissue repair,and new wound materials.This study provides references for future research directions.
基金Supported by The 2023 Government-Funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731DNatural Science Foundation of Hebei Province,No.
文摘Breast cancer ranks among the most prevalent cancers worldwide,particularly affecting young and middle-aged women,who face higher recurrence rates,lower survival rates,and substantial psychological health challenges.Depressive symptoms,frequently observed in breast cancer patients,significantly influence treatment outcomes and quality of life.Recent years have seen a growing focus on these symptoms,emphasizing early identification and intervention.This editorial comments on the recent study by Mao et al on a risk prediction model for de-pression in young and middle-aged breast cancer patients.Research suggests that factors such as tumor grade,monthly income,pain perception,family support,and physical activity critically influence the onset of depressive symptoms.By developing personalized risk prediction models,it becomes possible to identify high-risk patients early,allowing healthcare professionals to implement pre-ventive strategies proactively.The editorial advocates for increased attention and resources dedicated to psychological health interventions for breast cancer pa-tients,aiming to foster comprehensive care strategies that mitigate the impacts of depression and enhance overall quality of life.
基金Supported by China Postdoctoral Science Foundation,No.2024M751334.
文摘BACKGROUND The high mortality rate and recurrence/metastasis remain major challenges in the clinical management of gastric cancer(GC)patients.To optimize treatment stratification and management,there is an urgent need for efficient and non-invasive biomarkers.A meta-analysis on the prognostic role of circulating tumor cells(CTCs)in GC revealed a strong association between CTCs and patient prognosis.Among CTC subtypes,Interstitial CTCs(I-CTCs)exhibited the strongest invasiveness.This study innovatively investigated the expression profile of I-CTCs in advanced GC patients to evaluate their clinical utility.AIM To evaluate the clinical utility of I-CTCs as a non-invasive prognostic biomarker in advanced GC.To investigate the correlation between I-CTC count thresholds and chemotherapy efficacy in advanced GC patients.To establish the potential of preoperative I-CTC profiling for optimizing treatment stratification and postoperative surveillance.METHODS This study retrospectively analyzed 59 patients with advanced GC treated at the General Surgery Clinical Medical Center of Gansu Provincial Hospital between October 2019 and October 2020.The expression levels of I-CTCs were measured,and patient survival was monitored.The receiver operating characteristic curve was plotted to determine the optimal cut-off value for I-CTCs expression levels.Based on this cut-off value,59 GC patients were grouped into positive and negative groups.The differences in clinicopathological characteristics between the two groups were analyzed.Patient survival was follow-up and recorded until October 2022.Plotting survival curves and performing univariate and multifactorial analyses of patient prognostic factors.The Kaplan-Meier method and Cox regression model were used,respectively.RESULTS A total of 59 patients were included in this study,and receiver operating characteristic curve analysis showed that the best cut-off value for I-CTCs was 5,with an area under the curve of 0.8356(95%CI:0.7122-0.9590).The I-CTC count of≥5 defines the positive group,while counts<5 are classified as the negative group.Positive I-CTCs correlated with the degree of tumor differentiation and disease progression(P<0.05).16 of 59 patients received neoadjuvant chemotherapy.There were divided into progressive disease and disease control groups based on response to neoadjuvant chemotherapy.Patients in the I-CTCs-negative group had longer overall survival and disease-free survival than those in the positive group(P<0.05).Multifactorial analysis revealed that I-CTCs positivity(HR=13.323,95%CI:1.675-105.962,P=0.014)was an independent risk factor for survival in patients with advanced GC.CONCLUSION In patients with advanced GC,an I-CTC count of≥5 is associated with both poor prognosis and reduced chemotherapy efficacy.I-CTCs may serve as a valuable preoperative biomarker for predicting the prognosis of advanced GC.
文摘Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient preferences.In the recent decade,the recommendations for managing symptomatic varicose veins have changed dramatically due to the rise of minimally invasive endovascular techniques.The literature was systematically searched on Medline without language restrictions.All papers on the treatment of varicose veins and venous insufficiency with different procedures were included and reviewed.Endovenous laser ablation(EVLA)and radiofrequency ablation(RFA)both are same safe and effective in terms of occlusion rate,and time to return to normal activity.In comparison with RFA or EVLT,Cure conservatrice et Hemodynamique de l’Insufficience Veineuse en Ambulatoire(CHIVA)may cause more bruising and make little or no difference to rates of limb infection,superficial vein thrombosis,nerve injury,or hematoma.In terms of recurrence of varicose veins,there is little or no difference between CHIVA and stripping,RFA,or EVLT.Great saphenous vein recanalization is highest in the ultrasound-guided foam sclerotherapy(FS)group(51%)during 1 year of follow-up.The 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and sclerotherapy.Although the mechanochemical endovenous ablation(MOCA)is a non-thermal,non-tumescent option and appears to be of similar efficacy to stab avulsion with no potential risk of nerve damage,the overall success rate of MOCA is lower than those of other procedures such as EVLA,RFA,or high ligation and stripping.EVLA is the most cost-effective therapeutic option,with RFA being a close second for the treatment of patients with varicose veins.Endovenous thermal ablation(EVLA or RFA)is recommended as a first-line treatment for varicose veins and has substituted the high ligation of saphenofemoral junctional reflux and stripping of varicose veins.Ultrasound-guided FS is associated with a high recurrence rate and can be used in conjunction with other procedures.MOCA and cyanoacrylate embolization appear promising,but evidence of their effectiveness is required.
基金Supported by the Fund for Key Research and Development Program Project of Shannxi ProvinceNo. 2017SF-254
文摘BACKGROUND Pulmonary embolism(PE)is a fatal clinical syndrome that is generally caused by an embolus from unstable deep venous thrombosis(DVT).However,clinical and biochemical factors that are related to the stability of DVT are not fully understood.AIM To evaluate the relationships between plasma antigen levels of factor XII(FXII:Ag)and factor XI(FXI:Ag)with the stability of DVT.METHODS Patients with DVT and no PE,DVT and PE,and controls with no DVT or PE that matched for age,gender,and comorbidities were included in this study.FXII:Ag and FXI:Ag in peripheral venous blood were measured using enzyme-linked immunosorbent assays.RESULTS Using the 95th percentile of FXI:Ag in patients with DVT and PE as the cut-off,a higher FXI:Ag was associated with a higher risk of unstable DVT(odds ratio:3.15,95%confidence interval:1.18-8.43,P=0.019).Stratified analyses showed consistent results in patients≤60 years(P=0.020),but not in those>60 years(P=0.346).CONCLUSION Higher plasma FXI:Ag might be a marker for unstable DVT,which might be associated with PE in these patients.
文摘Objective:This study explored the timing of interventional treatment for acute intramural aortic hematoma(IMH)and the corresponding high-risk factors for its development into local aortic dissection(AD).Method:This retrospective case study method examined clinical follow-up data of 42 patients with acute IMH between April 2013 and October 2016 from the First Affiliated Hospital of Xi?an Jiaotong University.SPSS 17.0 and PPMS1.5 were used to analyze follow-up data spanning 3–12 months(mean,7.5?3.7 months).Results:Patients were divided into the conversion group and the hematoma group according to whether they developed AD.Among them,16 patients(38.1%)developed AD and were treated with thoracic endovascular aortic repair(TEVAR).The remaining patients(61.89%)were treated conservatively.After 1 week,the mean aortic diameter of the conversion versus hematoma group was significantly widened.Hemodynamically unstable patients and those with hematoma to the abdominal aorta extension were more likely to develop AD.Patient outcomes after TEVAR were similar between groups.Conclusion:Our findings suggest that aortic isthmus diameter!3.0 cm,hematoma extending to the abdominal aorta,and hemodynamic instability are associated with AD development in acute IMH patents.TEVAR should be considered if hematoma thickening,calcification ingression,ulcer progression,or contrast enhancement within the intramural hematoma is noted beyond 2 weeks after IMH onset.
基金General Project of the National Natural Science Foundation of China(No.81774311)Traditional Chinese Medicine Technology Development Foundation of Shandong Province,China(No.2019-0149,2019-0764)Shandong Youth Education Scientific Planning Project College Students Academic Subjects(No.20BSH086)。
文摘Objective:To explore the mechanism of Simiao Yong'an Decoction in treating deep venous thrombosis based on the method of network pharmacology.Methods:Through TCMSP database,the effective components of each traditional Chinese medicine in Simiao Yong'an Decoction were obtained and their targets were predicted.The targets of deep venous thrombosis were collected by CTD database,and the key targets were obtained by intersection of the component targets and the disease targets;Protein-Protein Interaction(PPI)network was constructed by String database.The drugs-components-targets-disease network map was constructed by using the software of Cytoscape 3.7.2.GO function and KEGG pathway enrichment of Simiao Yong'an Decoction in the treatment of deep venous thrombosis were analyzed by using the plug-in of ClueGo.Results:121 effective components and 137 potential targets of Simiao Yong'an Decoction were obtained.There were 1172 targets of deep venous thrombosis.There were 214 biological processes analyzed by GO Biological Process and 72 pathways analyzed by KEGG analysis.Conclusion:Simiao Yong'an Decoction may act on ESR1,AR,PTGS2 and other key targets,as well as AGE-RAGE signaling pathway,PI3K-Akt signaling pathway,MAPK signaling pathway,IL-17 signaling pathway,TNF signaling pathway,RLX signaling pathway and other pathways to treat deep venous thrombosis.
基金Supported by the 2023 Government-funded Project of the Outstanding Talents Training Program in Clinical Medicine,No.ZF2023165Key Research and Development Projects of Hebei Province,No.18277731D+1 种基金Natural Science Foundation of Hebei Province,No.H202423105Hebei Provincial Administration of Traditional Chinese Medicine,Scientific Research Project,No.2020014.
文摘In this editorial,we comment on the article by Qin et al,recently published in the World Journal of Gastrointestinal Oncology.Malignant tumors of the digestive tract represent a significant health threat.Kinesin family member 14(KIF14),a critical kinesin,is pivotal in the proliferation,migration,and invasion of tumor cells.It has emerged as a focal point in recent studies of malignant tumors in the digestive tract.This article reviews the current research on KIF14 within these tumors and details its significant role in tumor cell behaviors,including proliferation,apo-ptosis,migration,invasion,and angiogenesis,alongside the regulatory mechanisms of the associated intracellular signaling pathways.Additionally,it explores the clinical value of KIF14 as a potential biomarker for early diagnosis,disease monitoring,and prognostic evaluation in malignant tumors of the digestive tract.The article concludes by introducing the potential regulatory role of traditional Chinese medicine,aiming to combine the strengths of both modern and traditional medical approaches to enhance treatment outcomes and prognosis for patients with these tumors.
基金Supported by the National Natural Science Foundation of China,No.82274528.
文摘BACKGROUND Shifting from the inflammatory to the proliferative phase represents a pivotal step during managing diabetic foot ulcers(DFUs);however,existing medical interventions remain insufficient.MicroRNAs(miRs)highlight notable capacity for accelerating the repair process of DFUs.Previous research has demonstrated which miR-122-5p regulates matrix metalloproteinases under diabetic conditions,thereby influencing extracellular matrix dynamics.AIM To investigate the impact of miR-122-5p on the transition from the inflammatory to the proliferative stage in DFU.METHODS Analysis for miR-122-5p expression in skin tissues from diabetic ulcer patients and mice was analyzed using quantitative real-time polymerase chain reaction(qRT-PCR).A diabetic wound healing model induced by streptozotocin was used,with mice receiving intradermal injections of adeno-associated virus-DJ encoding empty vector or miR-122.Skin tissues were retrieved at 3,7,and 14 days after injury for gene expression analysis,histology,immunohistochemistry,and network studies.The study explored miR-122-5p’s role in macrophage-fibroblast interactions and its effect on transitioning from inflammation to proliferation in DFU healing.RESULTS High-throughput sequencing revealed miR-122-5p as crucial for DFU healing.qRT-PCR showed significant upregulation of miR-122-5p within diabetic skin among DFU individuals and mice.Western blot,along with immunohistochemical and enzyme-linked immunosorbent assay,demonstrating the upregulation of inflammatory mediators(hypoxia inducible factor-1α,matrix metalloproteinase 9,tumor necrosis factor-α)and reduced fibrosis markers(fibronectin 1,α-smooth muscle actin)by targeting vascular endothelial growth factor.Fluorescence in situ hybridization indicated its expression localized to epidermal keratinocytes and fibroblasts in diabetic mice.Immunofluorescence revealed enhanced increased presence of M1 macrophages and reduced M2 polarization,highlighting its role in inflammation.MiR-122-5p elevated inflammatory cytokine levels while suppressing fibrotic activity from fibroblasts exposed to macrophage-derived media,highlighting its pivotal role in regulating DFU healing.CONCLUSION MiR-122-5p impedes cutaneous healing of diabetic mice via enhancing inflammation and inhibiting fibrosis,offering insights into miR roles in human skin wound repair.
基金Supported by:The study was funded by the National Natural Science Foundation of China(82274528)Construction Task Book for the Three-Year Action Plan for Accelerating the Inheritance and Innovative Development of Traditional Chinese Medicine in Shanghai(2021-2023)(ZY(2021-2023)-0211)+4 种基金Shanghai Municipal Health Commission Scientific Research Programme Mission Statement(202240228)Special Youth Project for Clinical Research of Shanghai Municipal Health Commission(20234Y0162)Clinical Research Talent Training Program of Shanghai University of Traditional Chinese Medicine Affiliated Hospital(2023LCRC06)Four Bright Foundations of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine(SGKJ-202301)Shanghai Pudong New Area Health and Family Planning Commission’s Pudong Famous TCM Cultivation Program project(PWRZM2020-18).
文摘BACKGROUND Stem cell therapy has shown great potential for treating diabetic foot(DF).AIM To conduct a bibliometric analysis of studies on the use of stem cell therapy for DF over the past two decades,with the aim of depicting the current global research landscape,identifying the most influential research hotspots,and providing insights for future research directions.METHODS We searched the Web of Science Core Collection database for all relevant studies on the use of stem cell therapy in DF.Bibliometric analysis was carried out using CiteSpace,VOSviewer,and R(4.3.1)to identify the most notable studies.RESULTS A search was conducted to identify publications related to the use of stem cells for DF treatment.A total of 542 articles published from 2000 to 2023 were identified.The United States had published the most papers on this subject.In this field,Iran’s Shahid Beheshti University Medical Sciences demonstrated the highest productivity.Furthermore,Dr.Bayat from the same university has been an outstanding researcher in this field.Stem Cell Research&Therapy is the journal with the highest number of publications in this field.The main keywords were“diabetic foot ulcers,”“wound healing,”and“angiogenesis.”CONCLUSION This study systematically illustrated the advances in the use of stem cell therapy to treat DF over the past 23 years.Current research findings suggested that the hotspots in this field include stem cell dressings,exosomes,wound healing,and adipose-derived stem cells.Future research should also focus on the clinical translation of stem cell therapies for DF.
基金Supported by the Health and Family Planning Research Project of Pudong New Area Health Committee,Shanghai,China(No.PW2020E-4)。
文摘Objective To investigate the clinical effects of thread-dragging therapy on gangrene of non-ischemic diabetic foot ulcers(NIDFU).Methods A total of 136 patients with NIDFU were recruited from the Department of Peripheral Vascular Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between June 21,2021 and February 1,2023,and randomized into an intervention group and a control group,with 68 cases in each group.Both groups received basic treatment.The intervention group was treated with thread-dragging therapy,while the control group was treated with debridement combined with routine dressing changes after surgery.Both groups were treated continuously for 2 months.The amputation rates and changes in the ulcer area were compared between the groups.The inflammatory response index including peripheral white blood cells(WBCs),neutrophil percentage(NEUT%),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),and interleukin 6(IL-6)were compared between the two groups.Results After treatment,the ulcer areas in the intervention group were significantly smaller than that of the control group(8.50±3.88 cm^(2) vs.10.11±4.61 cm^(2),P<0.05).The amputation rates of the two groups were not statistically significant(4.4%vs.5.9%,P>0.05).Differences of WBCs count,CRP,and ESR before and after therapy in the intervention group were better than the control group(P<0.05).However,there were no significant differences in changes of NEUT%,PCT,and IL-6 between the two groups(P>0.05).Conclusion Thread-dragging therapy may be effective in the treatment of NIDFU,with the additional advantages of less tissue damage after healing.(Registration No.ChiCTR2100047496)
基金This work was supported by the Natural Science Foundation of China （No. 81373670, No. 81673981, and No. 81601442）, the Primary Research and Development Plan of Shandong Province （No. 2016GSF202016, No. 2017GSF19118, 2017G006018, and No. 2017GSF218013）, the Project of Transformation in High-tech Achievements （No. 2013ZHZX2A0405）, the Science and Technology Development Grant of the State Administration of traditional Chinese medicine of Shandong Province （No. 2013-2016 and No. 2017-174）, the Family Planning Committee of Shandong Province （No. [2014] 14）, the Project for Shandong Medical and Health Science and Technology Plan （No. 2015WS0191）, the Project of Science and Technology of Shandong Academy of Medical Sciences （No. 2016-34, No. 2016-35, and No. 2017-15）, and the Innovation Project of Shandong Academy of Medical Sciences.
文摘Background： Estrogen is one of the most important reproductive steroidal hormones and plays a critical role in the maintenance of pregnancy, and its function is mediated by estrogen receptor 1 （ESR 1）. The polymorphisms ofESR 1 were involved in recurrent spontaneous abortion （RSA）; however, the association between ESRI polymorphisms and RSA remains controversial. The present meta-analysis was aimed to clarify the association between ESRI Pvull （-397C/T, rs2234693） and Xbal （-351 A/G, rs9340799） polymorphisms and the risk of RSA. Methods： All the included articles were retrieved from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Med Online Database up to January 3,2018. Data were processed in the Stata 12.0 software. The odds ratios （ORs） and 95% confidence intervals （95% Cls） were calculated using fixed-effects models （FEM）/random-effects models （REM）. Results： Seven case-control studies with 836 cases and 1164 controls were included in the study. Generally, the ESR 1 polymorphisms were not associated with RSA in any of the genetic analysis models. However, it was found that as rs9340799 polymorphism was related to increased risk of RSA in non-Asian group in the homozygous genetic model （OR = 2.40, 95% CI = 1.05-5.50, P = 0.039）. Moreover, in Asian group, rs9340799 polymorphism was found to be related to decreased RSA risk in both the heterozygous model （OR = 0.53, 95% CI = 0.33-0.85, P = 0.009） and the dominant genetic model （OR=0.55, 95% CI = 0.30 0.98, P = 0.042）. Conclusions： Generally. there was no significant association between the polymorphisms of ESRI and the risk of RSA. However, subgroup analysis indicated that ESR1 rs9340799 polymorphism was related to increased RSA risk in the non-Asian group while associated with decreased RSA risk in Asian group.
基金Supported by the National Natural Science Foundation of China(Nos.81673785 and 81874447)Natural Science Basic Research Program of Shaanxi(Nos.2020JQ-515 and 2020JZ-34)+1 种基金Shaanxi Province Administration of Traditional Chinese Medicine(No.2019-ZZ-JC048)Hospital Topic of the First Affiliated Hospital of Xi'an Jiaotong University(No.2018MS-32)。
文摘Objective:To determine whether salvianolic acid B(Sal B)exerts protective effects on diabetic peripheral neuropathy by attenuating apoptosis and pyroptosis.Methods:RSC96 cells were primarily cultured with DMEM(5.6 mmol/L glucose),hyperglycemia(HG,125 mmol/L glucose)and Sal B(0.1,1,and 10μmol/L).Cells proliferation was measured by 3-(4,5-cimethylthiazol-2-yl)-2,5-dilphenyltetrazolium bromide assay.Reactive oxygen species(ROS)generation and apoptosis rate were detected by flow cytometry analysis.Western blot was performed to analyze the expressions of poly ADP-ribose polymerase(PARR),cleaved-caspase 3,cleavedcaspase 9,Bcl-2,Bax,NLRP3,ASC,and interleukin(IL)-1β.Results:Treatment with HG at a concentration of125 mmol/L attenuated cellular proliferation,while Sal B alleviated this injury(P<0.05).In addition,Sal B inhibited HG-induced ROS production and apoptosis rate(P<0.05).Furthermore,treatment with Sal B down-regulated HG-induced PARP,cleaved-caspase 3,cleaved-caspase 9,Bax,NLRP3,ASC,and IL-1βexpression,but mitigated HG-mediated down-regulation of Bcl-2 expression(P<0.05).Conclusion:Sal B may protect RSC96 cells against HG-induced cellular injury via the inhibition of apoptosis and pyroptosis activated by ROS.
文摘Objective: To investigate the effect of Yinqi ointment on wound morphology and growth factor in treating diabetic foot ulcer(DFU).Methods: From December 2016 to December 2017, 92 cases of DFU with deficiency of both Qi and Yin syndrome were randomly divided into treatment group and control group(44 cases in each group). The treatment group was treated with Yinqi ointment, while the control group was treated with mupirocin ointment. After 4 weeks of treatment, the ulcer healing effect, ulcer area, granulation tissue, epithelial tissue coverage,pain score, and dynamic analysis of vascular endothelial growth factor(VEGF), epidermis growth factor(EGF), and basic fibroblast growth factor(bFGF) in local granulation tissue were statistically analyzed before and after treatment in both groups. Results: The total effective rate was 88.37% in the treatment group and 74.42% in the control group. The wound reduction rate, epithelial tissue coverage rate, granulation tissue growth rate, and local pain relief rate in the treatment group were significantly superior to those in the control group(P < 0.05). Through the local granulation detection, the treatment group and the control group have increased VEGF, EGF, and bFGF, but the treatment group increased the role of growth factor than the control group. Conclusion: Yinqi ointment can promote the healing of DFU, and its mechanism may be related to the increase of the content of growth factor in granulation tissue.
文摘Background Pulmonary thromboembolism （PTE） is a serious disease often leading to disability and death. Percutaneous placement of an inferior vena cava （IVC） filter is an effective method to prevent fatal PTE caused by lower extremity deep venous thrombosis （LEDVT）. We developed the ZQL-type retrievable vena cava filter. The aim of this study was to evaluate the safety and effectiveness of the ZQL-type filter for prevention of fatal PTE. Methods A total of 144 patients with indications for placement of an IVC filter received insertion of filters via a femoral （n=37） or jugular （n=107） vein approach. Abdominal X-ray and color Doppler ultrasonography of IVC were regularly performed to visualize the position and condition of the IVC filter following filter placement. If thrombi in the lower extremity deep veins were removed within 2 weeks, the filter retrieval procedure was performed after an abdominal radiograph, an inferior vena cavogram and a pulmonary angiography. Otherwise, the filter should be kept permanently in place with regular follow-up inspections. Results One hundred and forty-four filters were implanted at the target sites with a success rate of 98.61% for one-time placement and 100% for two-time placement. Of the 137 patients followed up （follow-up rate, 95.14%）, 43 patients had filters retrieved during a period of between 7 and 14 days （median, 12 days） following filter placement. The remaining 94 patients were followed for 7 days to 39 months （median follow-up period, 17 months）. No filter migration or tilt, filter fracture or IVC perforation was observed. No obstruction of IVC occurred. No symptomatic PTE developed during the follow-up period. Conclusion The ZQL-type retrievable vena cava filter is a safe and effective device to prevent PTE. This filter possesses a distinctive stent-shape, stable design, high capture efficacy, and is easy to insert and retrieve and thus is suitable for clinical application. Chin Med J 2009; 122（2）： 140-144
基金Research on in situ skin repair and regeneration based on micro-tissue engineering technology and 3D printing.(The National Key R&D Program of China,Grant Number 2019YFA0110503).The study on natural living micro-amniotic scaffolds to dynamic regulate immune inflammation and reconstruct wound repairing.(National Natural Science Foundation of China,Grant Number 81971836).The systemic study of miR-23b_24-1 cluster in the prevention and treatment of MODS caused by sepsis after burns.(National Natural Science Foundation of China,Grant Number 81930057).The experimental study on regulating the immune inflammatory microenvironment of burn wounds and promoting repair and regeneration based on micro-tissue engineering technology.(National Natural Science Foundation of China,Grant Number 81871559).
文摘Because China is becoming an aging society,the incidence of diabetes and diabetic foot have been increasing.Diabetic foot has become one of the main health-related killers due to its high disability and mortality rates.Negative pressure wound therapy(NPWT)is one of the most effective techniques for the treatment of diabetic foot wounds and great progress,both in terms of research and its clinical application,has been made in the last 20 years of its development.However,due to the complex pathogenesis and management of diabetic foot,irregular application of NPWT often leads to complications,such as infection,bleeding and necrosis,that seriously affect its treatment outcomes.In 2020,under the leadership of Burns,Trauma and Tissue Repair Committee of the Cross-Straits Medicine Exchange Association,the writing group for‘Consensus on the application of negative pressure wound therapy of diabetic foot wounds’was established with the participation of scholars from the specialized areas of burns,endocrinology,vascular surgery,orthopedics and wound repair.Drawing on evidence-based practice suggested by the latest clinical research,this consensus proposes the best clinical practice guidelines for the application and prognostic evaluation of NPWT for diabetic foot.The consensus aims to support the formation of standardized treatment schemes that clinicians can refer to when treating cases of diabetic foot.
