Rosai-Dorfman disease(RDD)is a rare form of non-Langerhans cell histiocytosis.In August 2024,a 38-year-old man was admitted to the Department of Endocrinology,The Third Xiangya Hospital of Central South University.He initially presented with diabetes insipidus,and his condition gradually progressed over a 15-year disease course,eventually leading to panhypopituitarism.Imaging examinations revealed marked thickening of the pituitary stalk,2 meningioma-like dural nodules,multiple osteolytic lesions,mild interstitial pneumonia,and urinary system involvement.RDD was confirmed by a pituitary stalk biopsy,and a BRAF V600E mutation was identified.The patient subsequently received targeted therapy with the BRAF inhibitor dabrafenib in combination with pituitary hormone replacement therapy.Follow-up brain magnetic resonance imaging after 8 months of treatment demonstrated a reduction in pituitary stalk thickening and complete disappearance of the 2 meningioma-like dural nodules.The patient's quality of life also improved substantially.This retrospective analysis of the case may assist clinicians in determining the etiology and differential diagnosis of pituitary stalk thickening and enhance awareness of RDD as a rare disease.

OBJECTIVES:Non-alcoholic fatty liver disease (NAFLD) and hypertension are common metabolic disorders, both closely associated with insulin resistance (IR), suggesting potential shared pathological mechanisms. This study aims to investigate the mediating role of IR in the relationship between hypertension and NAFLD, and to evaluate the applicability and modeling value of various IR surrogate indices in predicting NAFLD risk. METHODS:A total of 280 976 individuals who underwent health examinations at the Health Management Center of the Third Xiangya Hospital of Central South University between August 2017 and December 2021 were included. NAFLD was diagnosed based on abdominal ultrasound findings, and hypertension was defined according to the criteria of the Chinese Guidelines for the Management of Hypertension. Demographic information, anthropometric indices, and biochemical parameters were collected, and multiple IR surrogate indices were constructed, including the triglyceride-glucose index (TyG) and its derivatives, as well as the metabolic score for insulin resistance (METS-IR). Group comparisons were performed between hypertensive and non-hypertensive participants, as well as between NAFLD and non-NAFLD participants. Pearson correlation analysis was applied to assess the associations of metabolic parameters and IR indices with NAFLD. Furthermore, mediation models were constructed to explore the mediating role of IR in the "hypertension-NAFLD" relationship. Finally, parametric models and machine learning algorithms were compared to evaluate their predictive performance and value in assessing NAFLD risk in this population. RESULTS:The prevalence of NAFLD was significantly higher in hypertensive individuals than in non-hypertensive participants (63.61% vs 33.79%, P<0.001), accompanied by elevated IR levels and adverse metabolic features. Correlation analysis and variable importance rankings across multiple models consistently identified TyG-waist circumference (TyG-WC) and METS-IR as the IR indices most strongly associated with NAFLD. In mediation analysis, the TyG-WC pathway explained 32.03% of the total effect, and the METS-IR pathway explained 17.02%. Interaction analysis showed that hypertension status may attenuate the mediating effect of IR (all interaction estimates were negative). In prediction model comparisons, the simplified model incorporating sex, age, WC, TyG-WC, and METS-IR demonstrated good performance in the test set. Logistic regression and its regularized form (LASSO regression) achieved an accuracy of 0.83, receiver operating characteristic (ROC)-area under the curve (AUC) of 0.91, and a Brier score of 0.12, comparable to ensemble models (random forest and XGBoost), with consistently stable performance across different algorithms. CONCLUSIONS:IR plays a significant mediating role in the association between hypertension and NAFLD, with TyG-WC identified as a key indicator showing strong mechanistic relevance and predictive value. Risk prediction models based on IR surrogate indices demonstrate advantages in simplicity and interpretability, providing empirical support for the early screening and individualized prevention of NAFLD in the general population.

Type 1 Diabetes (T1D) is characterized by hyperglycemia, and caused by a lack of insulin secretion. At present there is no cure for T1D and patients are dependent on exogenous insulin for lifelong, which seriously affects their lives. Mesenchymal stem cells (MSCs) can be differentiated to β cell-like cells to rescue the secretion of insulin and reconstruct immunotolerance to preserve the function of islet β cells. Due to the higher proportion of children and adolescents in T1D patients, the efficacy and safety issue of the application of MSC's transplant in T1D was primarily demonstrated and identified by human clinical trials in this review. Then we clarified the mechanism of MSCs to relieve the symptom of T1D and found out that UC-MSCs have no obvious advantage over the other types of MSCs, the autologous MSCs from BM or menstrual blood with less expanded ex vivo could be the better choice for clinical application to treat with T1D through documentary analysis. Finally, we summarized the advances of MSCs with different interventions such as genetic engineering in the treatment of T1D, and demonstrated the advantages and shortage of MSCs intervened by different treatments in the transplantation, which may enhance the clinical efficacy and overcome the shortcomings in the application of MSCs to T1D in future.

IgG4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory disorder that can affect multiple organs throughout the body, predominantly in middle-aged and elderly males, with a male-to-female ratio of 2꞉1 to 3꞉1. IgG4-related retroperitoneal fibrosis (IgG4-RPF), a rare subtype of IgG4-RD, has an unclear etiology, and its comorbidity with type 2 diabetes mellitus is also uncommon. A lack of awareness of this condition in clinical practice can easily lead to misdiagnosis. On July 14, 2016, the Third Xiangya Hospital of Central South University admitted a patient with type 2 diabetes mellitus complicated by IgG4-RPF. Following comprehensive treatment, including blood glucose and blood pressure control, kidney protection, circulation improvement, and the use of prednisone, the patient's condition significantly improved. The retroperitoneal fibrotic mass decreased in size, renal function improved, and serum IgG4 levels decreased. After 8 years of follow-up, the condition did not recur. Analyzing this case in conjunction with a literature review suggests that the development of IgG4-RPF in diabetic patients may be related to chronic inflammation from metabolic syndrome and atherosclerotic plaques associated with long-standing diabetes. This provides valuable clinical ideas for clinicians in diagnosing and treating this rare comorbidity.

无痛性甲状腺炎(painlessthyroiditis,PT),又称静息型甲状腺炎(silent thyroiditis)、亚急性淋巴细胞性甲状腺炎(subacute lymphocytic thyroiditis)、淋巴细胞性甲状腺炎伴自发缓解性甲亢、亢进性甲状腺炎(hyperthyroiditis)或非典型甲状腺炎(nonclassical thyroiditis).其发病病因和机制尚未明确,可能与自身免疫、病毒感染、妊娠、碘过量及环境和遗传等因素有关[1].糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)是由于胰岛素不足和升糖激素不适当升高引起的糖、脂肪、蛋白质和水盐与酸碱代谢严重紊乱综合征,是糖尿病的严重急性并发症.以往的文献研究结果显示,DKA与甲状腺激素水平有紧密关联,DKA患者的甲状腺功能出现明显异常,主要表现为甲状腺激素FT3和FT4明显降低,低T3综合征的发生率明显升高,但继发PT、一过性甲亢的病例国内外尚未见报道.研究者在2020年12月至2021年6月共观察到2例DKA继发PT的病例,予以报道如下,旨在提高临床医生对这一疾病现象的认识,避免误诊及过度医疗.

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome in which tumor-induced osteochondrosis is a metabolic bone disease caused by increased renal excretion of phosphorus due to excessive secretion of fibroblast growth factor 23 (FGF23) by tumor tissue. We report here a rare case of TIO in which the tumor was found in the hyoid body and the patient had tertiary hyperparathyroidism. The patient's symptoms did not improve after removal of the tumor from the hyoid body, and the patient's hypophosphatemia was gradually improved after subsequent removal of the left parathyroid gland. TIO derived from the tongue tumor is very rare, and also subsequent tertiary hyperparathyroidism is even rarer. This report helps to improve the understanding of TIO and provides reference in the diagnosis and treatment of TIO.

临床思维是医生在诊治疾病时所遵循和使用的思维方法,是临床决策的基础,也是住院医师规范化培训的重要内容.内分泌疾病临床表现多样,诊疗过程复杂,能很好地训练住院医师的临床思维.思维导图,基于病例的学习(Case-based learning,CBL)和基于问题的学习(Problem-based learning,PBL)是培养内分泌住院科医师临床思维的有利手段.基于APP的考核与反馈,既能及时评估住院医师临床思维能力,检验住院医师规范化培训的教学质量,也能督促住院医师不断学习,提高带教老师水平,具有良好的应用前景.

Werner syndrome（WS）is an autosomal recessive disease. It is an adult onset early aging syndrome with a total incidence rate of 1:1 million to 1:10 million. In this report,we described the clinical features,laboratory and imaging examinations of 3 cases of WS complicated with diabetes mellitus,foot ulcer and hypogonadism,and also the relevant gene testing.

Pseudohypoparayhyroidism (PHP) is a rare autosomal dominant or recessive genetic disorder characterized by low calcium, high phosphorus, and target organ resistance to parathyroid. The clinical characteristics and genetic features in 4 patients with Type Ib PHP in the Third Xiangya Hospital, Central South University, have been reviewed. All 4 patients had low calcium, high phosphorus, and parathyroid resistance. Among them, 2 patients had slightly elevated thyroid stimulating hormone and mild features of Albright's hereditary osteodystrophy, and one patient had hypokalemia. No guanine nucleotide-binding protein alpha-stimulating activity polypeptide 1 (GNAS) and gene variant associated with hypokalemia were identified using the whole exome sequencing. The results of the methylation-specific multiple ligation-dependent probe amplification showed that there were abnormal methylation of the upstream differentially methylated regions of GNAS in the 4 patients. There were phenotype overlap among the various subtypes of PHP. Detection of GNAS gene methylation in patients with clinical suspicion of Type Ib PHP is helpful for the diagnosis and treatment of PHP.

Objective:Kallmann syndrome(KS) is a complex genetic disease characterized by congenital hypogonadotropic hypogonadism and anosmia. More than 20 genes have been reported to be associated with KS. Herein, we explore potential genetic aberration in 3 KS patients using the whole-exome sequencing. The potentially pathogenic variants filtered were validated by Sanger sequencing.Methods:Genomic DNA was extracted from the peripheral blood of 3 patients with KS and their family members. Sanger sequencing and pedigree verification were performed on the pathogenic variants identified using whole-exome sequencing. The function of the mutation sites were analyzed with bioinformatics software.Results:The proband 1 was a 25 years old male, characterized by lower gonadotropin gonad hypofunction, early grey hair and bilateral sensorineural hearing loss. A heterozygous mutation c. 475C>T(p.R159W) of SOX10 gene was detected in the proband 1. His mother, sister and cousin who had KS phenotype were also found carrying this mutation, showing an autosomal dominant inheritance. The proband 2 was a 15-year-old male with hypogonadotropic hypogonadism and unilateral renal agenesis. The proband was hemizygous for c. 844delC(p.R282Vfs*28) of ANOS1 gene, his mother was heterozygous for the mutation, which was consistent with the X-linked recessive inheritance. The proband 3 was a 21 years old female, characterized by hypogonadotropic hypogonadism and anosmia. A heterozygous missense mutation c. 149G>A(p.R50Q) was detected in FGF17 gene. The mutation p. R50Q was predicted to be pathogenic by the SIFT and PolyPhen2 programs, and has not been reported in HGDM database yet, which considered to be a novel mutation.Conclusion:KS is a clinically and genetically heterogeneous disease. In this study, ANOS1 c. 844delC, SOX10 c. 475C>T and FGF17 c. 149G>A mutations were found in 3 patients with KS by whole exome sequencing, which would expand the genotypic and phenotype spectrum of KS.

Kallmann syndrome (KS) is a rare developmental disorder that manifests as congenital hypogonadotropic hypogonadism with anosmia. More than 19 genes have been found to be associated with KS. However, approximately 70% of the causes of KS remain unclear. Here, we studied seven KS patients, from three families, who had delayed puberty and olfactory bulb dysplasia. However, the families of these patients showed a range of other unique clinical features, including hearing loss, anosmia (to varying degrees) and unilateral renal agenesis. We performed whole exome sequencing and copy number variation (CNV) sequencing on samples acquired from these patients. We identified two novel mutations (c.844delC in ANOS1, c.475C>T in SOX10) and a novel trigenic pattern, PROKR2/CHD7/FEZF1 (c.337T>C in PROKR2, c.748C>G in FEZF1, c.8773G>A in CHD7). The c.844delC mutation in the ANOS1 gene was predicted to generate a truncated form of the anosmin-1 protein. SIFT and PolyPhen-2 predicted that the c.475C>T mutation in SOX10 had a damaging effect. The PROKR2 mutation (c.337T>C) was previously reported as harmful. No pathogenic copy number alterations were detected. Our study expands the genotypic and phenotypic spectrum of KS, a disease that shows considerable clinical and genetic heterogeneity. The application of whole exome sequencing could facilitate our understanding of the pathogenesis of KS.

Background. This study is aimed at investigating the effect of combined transplantation of umbilical cord mesenchymal stem cells (UCMSCs) and umbilical cord blood-derived endothelial colony-forming cells (ECFCs) on diabetic foot ulcer healing and at providing a novel therapy for chronic diabetic foot ulcer. Methods. We reported the treatment of refractory diabetic foot ulcers in twelve patients. Among them, five patients had two or more wounds; thus, one wound in the same patient was treated with cell injection, and other wounds were regarded as self-controls. The remaining seven patients had only one wound; therefore, the difference between the area of wound before and after treatment was estimated. The UCMSCs and ECFCs were injected into the wound along with topically applied hyaluronic acid (HA). Results. In this report, we compared the healing rate of multiple separate wounds in the same foot of the same patient: one treated with cell injection combined with topically applied HA-based hydrogel and was later covered by the hydrocolloid dressings, while the self-control wounds were only treated with conventional therapy and covered by the hydrocolloid dressings. The wound underwent cell injection showed accelerated healing in comparison to control wound within the first week after treatment. In other diabetic patients with only one refractory wound, the healing rate after cell transplantation was significantly faster than that before injection. Two large wounds healed without needing skin grafts after combination therapy of cell injection and HA. After four weeks of combination treatment, wound closure was reached in six patients, and the wounds of the other six patients were significantly reduced in size. Conclusions. Our study suggests that the combination of UCMSCs, ECFCs, and HA can safely synergize the accelerated healing of refractory diabetic foot ulcers.

NLRP3 inflammasome is a key contributor to obesity-related insulin resistance and type 2 diabetes (T2D). Adenosine monophosphate-activated protein kinase (AMPK) is a principle intracellular energy sensor exerting protective effect against T2D. Strikingly, compound C, an inhibitor of AMPK, considerably inhibited the secretion of IL-1β when THP-1 cells were stimulated with LPS plus palmitic acid (PA). The underlying mechanism was examined with respect to the effect of compound C on NLRP3 inflammasome, a multiprotein complex which controls the processing and production of IL-1β. Interestingly, compound C significantly attenuated the activation of NLRP3 inflammasome. This phenomenon was reproduced in AMPK siRNA-transfected THP-1 cells, indicating that compound C exerts this function despite AMPK knockdown. Also, it significantly suppresses the mitochondria-generated reactive oxygen species (ROS) required for NLRP3 inflammasome activation. In conclusion, compound C was shown to significantly attenuate the NLRP3 inflammasome despite AMPK knockdown, rendering it as the novel target of compound C. Potentially, compound C attenuates NLRP3 inflammasome through the suppression of mitochondrial ROS production. These findings offer initial evidence into compound C as a novel pharmacological agent with significant therapeutic potential in NLRP3 inflammasome-related disorders, including obesity, insulin resistance, and T2D. Thus, further studies are essential to identify the effect of compound C on these diseases in vitro.

目的 为了提高诊断学体格检查的教学质量,受基于建构主义教学策略的启发,在诊断学体格检查的见习教学中引入基于建构主义的教学模式,对诊断学体格检查教学进行探索研究.方法 设计基于建构主义的体格检查教学模式,并对教学效果进行多元化评价,从学生满意度评价、小组评价、技能及理论考核成绩三个方面来依次进行,其中技能及理论考核成绩与同期既往的传统教学模式成绩进行对比,以评估教学效果.结果 学生满意度评价结果显示95％的学生认同本教学法可激发学习兴趣,97.5％的学生认为能激发学习积极性和主观能动性,88％认为可提高临床思维能力,96.7％认为可提高团队合作和共同解决问题的能力;课程结束后的成绩比较显示,传统教学模式组基础理论成绩和临床技能考核成绩分别为(80±4)分、(82±5)分,而建构主义教学模式组分别为(86±5)分、(89±3)分,较前明显提高.结论 使用建构主义的教学模式在诊断学体格检查教学中取得了良好的教学效果.

Introduction Metabolic surgery is an effective treatment for type 2 diabetes (T2D). At present, there is no authoritative standard for predicting postoperative T2D remission in clinical use. In general, East Asian patients with T2D have a lower body mass index and worse islet function than westerners. We aimed to look for clinical predictors of T2D remission after metabolic surgery in Chinese patients, which may provide insights for patient selection. Methods Patients with T2D who underwent metabolic surgery at the Third Xiangya Hospital between October 2008 and March 2017 were enrolled. T2D remission was defined as an HbA1c level below 6.5% and an FPG concentration below 7.1 mmol/L for at least one year in the absence of antidiabetic medications. Results (1) Independent predictors of short-term T2D remission (1-2 years) were age and C-peptide area under the curve (C-peptide AUC); independent predictors of long-term T2D remission (4–6 years) were C-peptide AUC and fasting plasma glucose (FPG). (2) The optimal cutoff value for C-peptide AUC in predicting T2D remission was 30.93 ng/ml, with a specificity of 67.3% and sensitivity of 75.8% in the short term and with a specificity of 61.9% and sensitivity of 81.5% in the long term, respectively. The areas under the ROC curves are 0.674 and 0.623 in the short term and long term, respectively. (3) We used three variables (age, C-peptide AUC, and FPG) to construct a remission prediction score (ACF), a multidimensional 9-point scale, along which greater scores indicate a better chance of T2D remission. We compared our scoring system with other reported models (ABCD, DiaRem, and IMS). The ACF scoring system had the best distribution of patients and prognostic significance according to the ROC curves. Conclusion Presurgery age, C-peptide AUC, and FPG are independent predictors of T2D remission after metabolic surgery. Among these, C-peptide AUC plays a decisive role in both short- and long-term remission prediction, and the optimal cutoff value for C-peptide AUC in predicting T2D remission was 30.93 ng/ml, with moderate predictive values. The ACF score is a simple reliable system that can predict T2D remission among Chinese patients.

Providing a better understanding of the risk factors for amputation in this particular region, Hunan province, in China might help patients with diabetic foot ulcers receive timely and appropriate medical care and help prevent amputation. Diabetic foot ulcer patients referred to the Third Xiangya Hospital during the period between December 2014 and September 2018 were enrolled. Participants who underwent amputations and received conservative treatments were compared using univariate and multivariate analyses to identify the independent predictors of amputation. Those who required amputation presented significantly higher levels of white blood cell counts, platelet counts, erythrocyte sedimentation rate, C-reactive protein, and glycated haemoglobin (HbA1c) levels. However, levels of haemoglobin, postprandial plasma C-peptide, triglyceride, high-density lipoprotein cholesterol, albumin, and uric acid were decreased in patients with amputations. Patients with more advanced Wagner grades had much higher rates of amputation. Multivariable-adjusted odds ratios in stepwise logistic regression model was 1.317 for HbA1c (95% CI: 1.015-1.709), 0.255 for triglyceride (95% CI: 0.067-0.975), and 20.947 for Wagner grades (95% CI: 4.216-104.080). Independent risk factors for amputation in these Chinese diabetic foot ulcer patients included an elevated HbA1c level, lower triglyceride level, and higher Wagner grades.

Objective To evaluate the effect of flipped classroom combined with case-based learning (CBL) applied in clinical practice teaching of evidence-based medicine. Methods 50 eight-year undergraduates of clinical medicine in Xiangya Medical College were randomly divided into two groups with 25 students in each group. The experimental group adopted the CBL case-based learning (CBL) teaching method. The control group adopted the traditional teaching method. After the completion of the teaching, the teaching effect is evaluated through questionnaires and theoretical examination. Results The combination of CBL and the teaching method of evidence-based medicine has been praised by most students. The satisfaction of the students in the experimental group to the teaching method was higher than that in the control group (92.0% vs. 64.0%). The difference was statistically significant (P < 0.05). Theoretical examination results showed that there was no significant difference between the two groups (P > 0.05). The results of analysis in the experimental group were higher than those in the control group (P < 0.05). Conclusion The teaching effect of the flipped classroom combined with CBL group was satisfactory. Using the flipped classroom combined with CBL can develop students evidence-based medicine thinking ability, improving their learning initiative and enthusiasm.

Two patients with primary hypertrophic osteoarthropathy (PHO) and their available healthy family members were studied. All exons of the SLCO2A1 and HPGD gene and adjacent exon-intron sequences were amplified by PCR and subsequently sequenced. To assess the damaging effects of missense mutations in silico, the online database, PolyPhen-2 and SIFT were used. We identified two homozygous mutations in SLCO2A1 gene: one was c.1106G>A (p.G369D) in exon 9, the other was c.611C>T (p.S204L) in exon 4. No HPGD mutation was found in the affected individuals. The two mutation were predicted in silico by the bioinformatic tools. Our study further supports the role of mutations in the SLCO2A1 gene in the pathogenesis of PHO. Identification of the genotype in PHO may not only help the clinical diagnosis of PHO but also help the interpretation of genetic information for prenatal diagnosis and genetic counseling.

Purpose: The balance between T helper (Th) cells Th1- and Th2-related cytokines plays a key role in the clinical process of acute coronary syndrome (ACS) and type 2 diabetes mellitus (T2DM) or impaired glucose tolerance (IGT). The objective of this study was to assess the status of Th1/Th2 cytokines in patients with ACS and T2D or IGT. Methods: A total of 201 ACS patients were enrolled in the study. All ACS patients were divided into three groups: Group I-patients with normal glucose tolerance (NGT), Group II-patients with IGT and Group III-patients with T2D. We measured circulating Th1/Th2-type cytokines (interleukin [IL] -4, IL-13, interferon-gamma [IFN-gamma], and tumor-necrosis factor-alpha [TNF-alpha]) using enzyme-linked immunosorbent assay and calculated the ratio of Th1/Th2. Results: Significant elevations in serum levels of IL-4, IL-13, IFN-gamma, and TNF-alpha were found in ACS-T2D and ACS-IGT groups compared to that in both ACS-NGT group and healthy individuals. Higher serum levels of IL-4, IL-13, and TNF-alpha were found in ACS-NGT group than that in the control group. Furthermore, IL-4 and IFN-gamma concentrations were significantly higher in ACS-T2D patients than in ACS-IGT patients. IFN-gamma/IL-4, IFN-gamma/IL-13, and TNF-alpha/IL-4 ratios as markers of Th1/Th2 ratio were significantly higher for the ACS-T2D group and ACS-IGT group as compared to that in the ACS-NGT group and control group (P < 0.05). Conclusion: Shifts in the balance of Th1/Th2 toward a predominance of Th1 may represent more severe inflammatory status in ACS patients with type T2D or IGT.

Infected diabetic foot ulcer (DFU) is an important problem because it is a limb or even life threatening, and burdens a great financial load to the community. It’s shown that circulating inflammatory proteins are reputed to be of poor value for diagnosing DFU as lack of specificity. Therefore it's necessary to investigate newer discussed inflammatory parameters. NLRP3 inflammasome, a multiprotein complex consists of NLRP3, ASC and pro-caspase-1 and controls the production of IL-1β and IL-18, is an important contributor to the development of type 2 diabetes. The RNA-specific adenosine deaminase (ADAR1) is interferon-inducible double stranded (ds) RNA-binding protein, which is demonstrated to inhibit the production of type I interferons and various proinflammatory cytokines such as TNF-a and IL-6. But little is known about the ex vivo profile of NLRP3 inflammasome and ADAR1 in DFU. On this basis the aim of our study was to evaluate the role of NLRP3 inflammasome and ADAR1 in subjects with DFU in comparison with subjects without DFU. We completed a study including 20 healthy volunteers, 20 newly diagnosed type 2 diabetic (T2D) patients and 30 DFU patients (wagner2-4). Then peripheral blood mononuclear cells were collected from all subjects and NLRP3, ASC, Caspase-1, ADAR1 contents were detected by real-time PCR. The results showed that mRNA of NLRP3, ASC, Caspase-1 in T2D patients were significantly higher than those of healthy persons, while 2-fold lower than DFU patients (both P < 0.05); ADAR1 mRNA in T2D patients were significantly higher than those of healthy persons (P < 0.05). Interestingly, however, ADAR1 mRNA in DFU patients were decreased by 3-fold compared with T2D (P < 0.05), indicating that ADAR1 is increased in low-grade inflammation state but decreased in severe infectious state. This study suggests that NLRP3 inflammasome and ADAR1 may be useful markers to diagnose and follow the DFU. Further investigation is needed and it will be interesting to investigate the connection between them. Disclosure F. Wang: None. L. Zhao: None. W. Yang: None. H. He: None. Z. Mo: None.