BACKGROUND:Management of wound infection and inflammation in diabetic foot is crucial for its treatment. Jiangjunsan has demonstrated potential anti-inflammatory properties and the ability to promote wound healing. This work aimed to investigate the effects of Jiangjunsan wrapping therapy (JJWT) on microbial colonies, levels of inflammatory factors, and regulation of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway (SPW) in diabetic foot wounds. METHODS:Sixty diabetic foot patients were enrolled into a control group (CG) and a treatment group (TG), with 30 patients in each group. CG received topical magnesium sulfate in addition to standard treatment, while TG received JJWT for two weeks. The quantity of wound microbial colonies and levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 were measured before and after treatment, and Western blot analysis was utilized to assess expression levels of PI3K and AKT in wound tissues. RESULTS:After treatment, TG exhibited a significantly lower microbial colony count than CG (P < 0.05). Both groups showed a great decrease in TNF-α and IL-6 levels post-treatment (P < 0.05), with TG demonstrating lower levels of TNF-α, IL-6, PI3K, and AKT proteins relative to CG (P < 0.05). CONCLUSION:JJWT effectively reduced microbial colony counts in diabetic foot patients, markedly suppressed the expression of TNF-α and IL-6, and enhanced wound healing by modulating PI3K/Akt SPW, indicating strong antibacterial and anti-inflammatory properties of Jiangjunsan.

OBJECTIVE:To explore the correlation between serum 25-hydroxyvitamin D (25(OH)D) levels and diabetic foot ulcers (DFU) in elderly type 2 diabetes mellitus (T2DM) patients. METHODS:Data of 198 T2DM patients treated at Shanghai Traditional Chinese Medicine-Integrated Hospital from June 2021 to June 2023 were retrospectively analysed. Totally 80 patients with DFU were classified into the study group, while the other 118 were the control group. Outcome measures included serum 25(OH)D levels and nutritional status, the relationship between the severity of DFU and serum 25(OH)D levels, lipid-related and glucose-related indicators, and independent influencing factors for the severity of DFU in elderly T2DM patients. RESULTS:The control group demonstrated significantly higher serum 25(OH)D levels compared to the study group (P<0.001), and a lower prevalence of 25(OH)D deficiency (65.25% vs. 86.25%, P=0.001). A strong inverse correlation was observed between Wagner grade and 25(OH)D levels (r=-0.746, P<0.001). The control group presented notably lower total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) levels than the study group (P<0.001), but a notably higher high-density lipoprotein cholesterol (HDL-C) (P<0.001). Multivariate logistic regression analysis identified diabetes duration (OR: 1.15-9.23, P=0.026) and serum 25(OH)D levels (OR: 0.40-0.85, P=0.005) as independent predictors of DFU severity. CONCLUSION:25(OH)D deficiency is strongly associated with the risk of DFU. Diabetes duration and serum 25(OH)D levels are independent risk factors for DFU severity in elderly patients with T2DM.

Background/objective: As a debilitating complication of diabetes mellitus, the incidence of diabetic foot ulcer is about 5.65 % and five-year mortality rates exceeding 50 %. This study aimed to evaluate the therapeutic effects of Compound Phellodendron Liquid (CP) combined with infrared irradiation on inflammatory markers and lower extremity vasculature in patients with diabetic foot. Methods: From March 2022 to August 2023, 84 diabetic foot patients (Wagner 2-3) were admitted in this single-center retrospective study. The control group received CP while the observation group got infrared irradiation and CP. Various parameters including inflammatory indexes, serum growth factors, wound area, vascular parameters, foot blood flow, and patient prognosis were measured and compared between the two groups. Results: Compared to CP therapy alone, the combined treatment significantly reduced serum inflammatory markers (CRP, IL-6, TNF-alpha; P < 0.001), increased angiogenesis factors (VEGF, bFGF, EGF; P < 0.001), accelerated wound healing (smaller wound area; P < 0.001), improved dorsalis pedis artery hemodynamics (increased diameter & flow, lower intima-media thickness; P < 0.001), and enhanced peripheral circulation (ankle-brachial index (ABI), transcutaneous oxygen partial pressure (TcPO2), and toe-brachial index (TBI); P < 0.05). Critically, the observation group had significantly lower complication rates (4.8 % vs. 28.6 %; chi(2) = 8.883, P = 0.031) during the 1-year follow-up. Conclusion: Combined infrared irradiation with CP therapy performed positive effects on various physiological parameters. The anti-inflammatory action of CP complements the vasodilatory effects of infrared irradiation, potentially achieving synergistic healing. leading to reduced recurrence of infections and complication rates from 28.6 % to 4.8 % over one year.

Objective:To investigate the mid- to long-term outcomes of endovascular treatment with Supera interwoven nitinol stents in patients with chronic limb-threatening ischemia (CLTI).Methods:From April 2017 to December 2020, clinical data from 303 CLTI patients aged over 50 years and treated with Supera stent were collected and analyzed retrospectively at three centers including Department of Vascular Surgery of Zhongshan Hospital of Fudan University, Department of Vascular Diseases of Shanghai TCM-Integrated Hospital, and Department of Vascular Surgery of Wenling Hospital of Traditional Chinese Medicine of Zhejiang Province. Among them, there were 205 males and 98 females, with an age of (74.0±10.1) years. Telephone follow-up and collected the overall survival, clinically driven target lesion revascularization (CD-TLR), major amputation, and wound healing. The Kaplan-Meier method was used to draw survival curves and the Log rank test was used to compare the survival differences between the two groups of patients.Results:Follow-up was obtained in 296 patients, with a follow-up duration of (23.6± 2.9) months. Kaplan-Meier survival curves showed that the overall survival rates at 6, 12, 24, and 36 months were 99.0%, 96.2%, 86.1%, and 77.4%, respectively. The proportions of patients without CD-TLR at 12, 24, and 36 months were 94.2%, 91.1%, and 89.6%, respectively. During the follow-up period, 15 patients underwent major amputations, with a total limb salvage rate of 92.7% (281/303) and an effective limb salvage rate of 94.9% (281/296). Among 268 patients with preoperative wounds, 203 healed, with a wound healing rate of 75.7%. The Kaplan-Meier survival curve indicated that patients with wounds healed had a higher survival rate compared to those whose wounds did not heal, with a statistically significant difference (Log-rank χ2=32.894, P<0.01). Meanwhile, in terms of diabetes, Meggitt Wagner classification, Rutherford classification, the number of lesions and the number of preoperative outflow tracts, there were statistically significant differences between the wound healing group and the non-healing group ( P values were 0.025, 0.007, 0.005, 0.049 and 0.004, respectively). Conclusions:The utilization of Supera interwoven nitinol stents in CLTI patients demonstrates clinical benefits in improving wound healing rates and limb preservation.

Abstract By matching 333 Sedum sarmentosum targets with 2072 atheromatosis targets, 175 overlapping targets were screened, and MMP-2 was determined as one of the core targets. Gene functions are mainly involved in lipid metabolism, energy pathways, signal transduction, and so on. PI3K-Akt signaling pathway, Ras signaling pathway, Arachidonic acid metabolism, Rap1 signaling pathway, etc. may be the key pathways for Sedum sarmentosum treatment of atheromatosis. Sedum sarmentosum has great potential to be developed as a drug and targets various genes and pathways to play a role in the treatment of atheromatosis.

目的 观察一边黄洗剂塌渍疗法联合负压封闭引流技术治疗臁疮病(湿热瘀阻证)的疗效.方法 60例患者按随机数字表法分为对照组与治疗组各30例.治疗组采用中药一边黄洗剂塌渍疗法联合创面负压封闭引流技术治疗.对照组采用汇涵术泰湿敷联合创面负压封闭引流技术治疗.比较两组疗效及症状评分情况、两组第1、14日的白细胞计数(WBC)、肌酐(Cr)、血糖(GLU)、C反应蛋白(CRP)水平变化及两组第1、14、21日的血清基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶抑制剂-1(TIMP-1)水平.结果 治疗组总有效率为96.67％,高于对照组的73.33％(P＜0.05).两组治疗1 d创面肿胀、创面肉芽组织、创面渗出量评分、WBC、Cr、GLU、CRP、MMMP-3、和TIMP-1水平比较,差别均不大(均P＞0.05).两组治疗14、21d的创面肿胀程度、创面肉芽组织、创面渗出量评分均低于治疗第1日(均P＜0.05);且治疗组同期创面肿胀程度、创面肉芽组织、创面渗出量评分均分别低于对照组(均P＜0.05).两组治疗14 d WBC、Cr、GLU、CRP水平均低于治疗第1日(均P＜0.05),且治疗组同期WBC、Cr、GLU、CRP水平均低于对照组(均P＜0.05).两组治疗14、21 d的MMP-3、TIMP-1水平均分别低于治疗第1日(均P＜0.05),且治疗组同期MMP-3、TIMP-1水平均分别低于对照组(均P＜0.05).两组治疗期间均未发生严重不良反应.结论 一边黄洗剂塌渍疗法联合负压封闭引流治疗臁疮可有效减轻创面肿胀和创面渗出液等症状,促进创面愈合,副作用小,安全有效.

目的 探讨中药软坚清脉颗粒预防糖尿病性闭塞性动脉硬化患者动脉支架置入术后血管再狭窄的临床疗效.方法 收集2019年1月至2020年1月上海中医药大学附属上海市中西医结合医院收治的95例患有糖尿病性闭塞性动脉硬化患者的临床资料.按照随机数字表法将患者随机分为软坚清脉组(n=48)和对照组(n=47).对照组行基础治疗,软坚清脉组在对照组的基础上同时口服软坚清脉颗粒.比较治疗前后两组患者的动脉通畅率、足溃疡愈合率、足溃疡复发率、踝肱指数(ABI)、白细胞介素-6(IL-6)、血管细胞黏附分子-1(VCAM-1)、国际标准化比值(INR)、纤维蛋白原(Fib)、血小板计数(PLT)及不良反应发生情况.结果 治疗后12个月,软坚清脉组患者的动脉通畅率、ABI、足溃疡愈合率均高于对照组患者,足溃疡复发率低于对照组患者,差异有统计学意义(P<0.05).治疗后6个月,软坚清脉组患者的IL-6水平、VCAM-1水平、Fib水平、PLT均低于对照组患者PLT(P<0.05).治疗期间,两组患者均未出现胃肠道不良反应.结论 软坚清脉颗粒能够有效预防糖尿病性闭塞性动脉硬化患者支架置入术后血管再狭窄的发生,提高足溃疡愈合率,促进创面愈合,提高血管通畅率,降低足溃疡复发率.

目的 观察四逆汤联合西药治疗下肢动脉硬化闭塞症的临床疗效.方法 将100例下肢动脉硬化闭塞症患者随机分为对照组和治疗组,每组50例.对照组予常规西药基础治疗,治疗组在对照组治疗措施基础上加服四逆汤治疗.两组疗程均为28 d,观察临床疗效,比较症状、体征量化评分及踝肱指数(ABI)的变化情况.结果 ①最终完成试验者95例,治疗组48例,对照组47例.②治疗组、对照组总有效率分别为79.2％、57.4％;组间临床疗效比较,治疗组明显优于对照组(P＜0.05).③治疗前后组内比较,两组皮肤温度感、皮肤色泽、疼痛、ABI、间歇性跛行距离及间歇性跛行缓解时间模块评分差异有统计学意义(P＜0.05);组间治疗后比较,皮肤温度感、皮肤色泽、疼痛和ABI模块评分差异有统计学意义(P＜0.05),间歇性跛行距离和间歇性跛行缓解时间模块评分差异无统计学意义(P＞0.05).④治疗前后组内比较,两组ABI水平差异有统计学意义(P＜0.05);组间治疗后比较,ABI水平差异无统计学意义(P＞0.05).结论 四逆汤联合西药治疗下肢动脉硬化闭塞症的临床疗效优于单纯西药治疗,可更好地改善患者的临床症状、体征.

目的 探讨四逆汤对肢体闭塞性动脉硬化(ASO)患者血管内皮细胞功能的影响.方法 收集2019年1月至2020年12月上海中医药大学附属上海市中西医结合医院收治的144例肢体ASO患者的临床资料,根据治疗方式不同分为治疗组(在西药常规治疗的基础上给予四逆汤治疗)和对照组(在西药常规治疗基础上给予血府逐瘀汤治疗),各72例.比较两组患者的临床疗效及治疗前后的血清网膜素、脂联素、瘦素、一氧化氮(NO)水平、内皮素-1(ET-1)水平、白细胞介素-6(IL-6)水平、肿瘤坏死因子-α(TNF-α)水平等指标.结果 治疗组患者的总有效率高于对照组患者(P=0.008).治疗后,治疗组患者的血清网膜素、脂联素水平均高于对照组患者,瘦素水平低于对照组患者;IL-6、TNF-α水平均低于对照组患者;NO水平高于对照组患者,ET-1水平低于对照组患者,差异均有统计学意义(P<0.05).结论 四逆汤能够改明显改善肢体ASO患者血脉瘀阻证的临床症状,升高血清脂联素、网膜素、NO水平,降低血清瘦素、IL-6、TNF-α、ET-1水平,改善血管内皮细胞功能,从而发挥保护血管的作用.

mTOR (the mammalian target of rapamycin) is a serine/threonine kinase that can regulate a variety of signaling pathways, including cell growth, proliferation, and apoptosis. mTOR can regulate the proliferation and migration of endothelial cells and smooth muscle cells during the occurrence and progression of atherosclerosis. By inhibiting or activating mTOR at different time points, atherosclerotic vulnerable plaques can be stabilized and the occurrence and progression of atherosclerosis can be impeded. The mTOR signaling pathway plays a multifaceted role in the progression of atherosclerosis. mTOR and its interactions with molecular targets in the mechanisms of atherosclerosis and cardiovascular diseases are reviewed in this article, taking into consideration their potential of opening up novel therapeutic avenues.

Objective: To observe the effects of Sanhuang Xiaoyan Formula on the level of intestinal barrier function and inflammatory factors in patients with diabetic foot infection (with systemic inflammatory response) dampness-heat toxin excessiveness on the basis of conventional western medicine treatment. Methods: The randomized controlled method was used to divide 62 cases of diabetic foot infection with dampness-heat toxin excessiveness into control group and treatment group. Both patients were given conventional treatment of diabetic foot infection. The treatment group was also treated with Sanhuang Xiaoyan Formula for 7d. Serum diamine oxidase (DAO), C-reactive protein (CRP), tumor necrosis factor (TNF-α), and intercellular adhesion molecule-1 (ICAM-1) were detected before treatment and on the 8th day after treatment. Results: After treatment, the blood levels of DAO, CRP, ICAM-1, and TNF-α in the treatment group were lower than those before treatment (P<0.05), and the DAO and CRP decreased more significantly (P<0.05) than the control group. Conclusion: Sanhuang Xiaoyan Formula may protect the intestinal barrier by inhibiting inflammatory factors, reducing inflammation, promoting intestinal motility, and excreting excessively proliferating bacteria and toxins.

目的:观察神效生肌散促进糖尿病足溃疡创面修复的临床疗效;方法:将糖尿病足溃疡患者126例按随机数字表法分为治疗组65例和对照组61例,2组均予降压、降糖等常规处理及抗感染等治疗,治疗组在此基础上外敷神效生肌散,对照组在此基础上外敷贝复剂,2个月后观察治疗前后2组患者患足创面大小、创面愈合率、创面愈合时间及安全性.结果:治疗组创面肉芽生长情况、创面愈合率、创面愈合时间均优于对照组;总有效率治疗组为96.92％;对照组为86.89％,2组比较差异有统计学意义(P<0.05).结论:神效生肌散修复糖尿病足溃疡创面疗效优于贝复剂.

目的 探讨“清法”联合可吸收线活扣打结减张缝合术治疗中度感染糖尿病足湿热毒盛证急性创面的疗效及其对全身和创面局部炎症反应的影响.方法 96例中度感染、清创后创面宽度在3至5cm之间而无法一期缝合的糖尿病足湿热毒盛证患者,根据清创时间随机分为清法缝合组(n=32)、单纯缝合组(n=32)、清法换药组(n=32),3组均采用相同的基础治疗.清法缝合组运用“清法”联合可吸收线活扣打结减张缝合术治疗,单纯缝合组和清法换药组分别采用西医清创术后可吸收线活扣打结减张缝合和“清法”联合保守换药治疗.3组均观察清创前、后血清C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及创面组织中TNF-α、IL-6的含量变化,记录创面愈合时间,并随访1年.结果 清法缝合组创面愈合时间最短(34.84±7.27)d,疗效优于对照组(P＜0.001);治疗组在清创前、清创术后第7天、第14天血清CRP的含量为(75.83±46.48,9.44±8.98,2.56±1.85)mg/L、IL-6的含量为(69.39±25.29,15.04±10.84,6.99±5.47)ng/mL和TNF-α的含量为(50.66土16.40,30.00±7.58,25.11±6.90)ng/mL,及清创术后第1、7、14天创面组织中的TNF-α的含量为(124.5 ±49.93,83.86±20.54,57.97±14.06,35.68±15.50)ng/mL和IL-6的含量为(57.24±20.19,48.87±17.02,39.86土16.59,29.46±13.88)ng/mL,治疗组各参数均较清创前和对照组下降;差异有统计学意义.治疗组患者创面随访1年无1例复发,但复发率较对照组无统计学差异(P＞0.05).结论 采用“清法”联合可吸收线活扣打结减张缝合术的方法可有效治疗创面皮肤缺损较大而无法一期闭合创面的糖尿病足湿热毒盛证患者,减少全身及创面局部炎症因子的含量,从而减轻全身及足部炎症反应,并能利用原位皮肤快速缩小创面面积,加速创面愈合.

Objective To investigate the correlation of NLR and CRP in treating HAP patients with Reduning injection before and after therapy.Methods One hundred HAP patients were enrolled.Peripheral blood of White blood count (WBC) and classification detection and CRP test were performed before and after therapy.Results (1) It was more common in the men aged (average age was 70.74±15.00 years old,male-female ratio was 71 to 29).(2) Peripheral blood of WBC,neutrophil count(NC),1ymphocyte count(LC),neutrophilto-lymphcyte ratio(NLR) and C-reactive Protein(CRP) in hospital-acquired pneumonia patients were significant difference before and after therapy(all P＜0.05).(3) Spearman or Pearson correlation analysis showed that NLR had positive correlation with CRP(r or rs=0.538,P＜ 0.01).Conclusion Reduning injection could treat HAP patients effectively after therapy,which reflected it could lower pulmonary inflammation of the patients,and the positive correlation of NLR and CRP could further illustrate the key to the therapy.

BACKGROUND:We evaluated the influence of different debridement methods on the prognosis of elderly patients with diabetic foot ulcers complicated with sepsis.METHODS:Retrospective study was adopted to study 65 hospitalized elderly patients with Wagner Grade-4 diabetic foot ulcer and sepsis in Vascular Disease Department of Shanghai TCM-Integrated Hospital. Thirty-two cases were included in the thorough debridement group and the other 33 were included in the minor debridement group. We compared the mortality rates on the 7th day and 14th day after debridement, and monitored changes of sepsis-related organ failure assessment (SOFA) Score as well as C-reactive protein (CRP), procalcitonin (PCT) and D-Dimer (D-D) levels. Cox regression analysis and Kaplan-Meier analysis were used to analyze the mortality rates. Binary logistic regression analysis was employed to screen relevant prognostic factors to see the prognostic value of SOFA Score, PCT and D-D.RESULTS:Fatality rates of the thorough debridement group on the 7th day and 14th day of the debridement were higher than those in the minor debridement group and such a difference has statistical significance. The CRP, PCT, and D-D of patients within seven days after thorough debridement were obviously higher than those of patients after minor debridement.CONCLUSIONS:Damage control should be provided for elderly patients with diabetic foot ulcers and sepsis when debridement is being performed. Palliative debridement methods such as small-scale incision and drainage are less likely to affect systematic inflammatory response and coagulation function, and thus can buy time for further treatment to improve clinical effect.

Objective To explore the mechanism of "Clearing Method" in treatment of the patients with di?abetic foot gangrene and dampness heat toxic syndrome in the acute phase. Methods Eighty patients with dia?betic foot gangrene and acute dampness heat toxic syndrome (Wagner 4 level) were randomly divided into"Clear?ing Method"treatment group (n=40) and western medicine control group (n=40). All patients received basic treat?ment. In addition, the patients in treatment group received Xi Jiuyi's prescriptions—Chenlanhua granules, San?huangxiaoyan granules and Qufuqingjin debridement for dispelling putridity and clearing sinew. The patients in control group experienced surgical debridement. The effectiveness of wound healing was examined 2 weeks and 4 weeks after debridement. At the same time, wound fluids were collected before debridement, and on the 1st, 7th, 14th and 28th days after debridement. The levels of tumor necrosis factor-a (TNF-a), interleukin (IL)-6 and intercellular adhesion molecule (ICAM)-1 in the acute wound fluid were assessed to evaluate the severity of the was (132551.2678±69467.8635) pg/mL,(120472.4313±85215.3433)pg/mL,(99812.8301±78081.8376)pg/mLl,(90345.3259±74386.5024)pg/mL and(74491.4063±61588.1498)pg/mL before debridement and on the 1st, 7th, 14th and 28th days after debridement, while IL-6 was (67583.2999 ± 26329.1573) pg/mL, (58222.3824 ± 25733.9665) pg/mL,(55535.6338 ± 22380.2142) pg/mL, (50220.2076 ± 19794.5744) pg/mL and (43185.8820±20904.6316)pg/mL, ICAM-1 was(6399.4579±2833.9183)pg/mL,(5811.0572±2792.3656)pg/mL, (4722.0211 ± 2200.8927) pg/mL, (4231.5074 ± 1988.8923) pg/mL, (3407.6614 ± 2031.0389) pg/mL respec?tively. The levels of three inflammatory factors in each group at each time after debridement were significantly lower than those before debridement, while the levels of TNF-α and IL-6 in treatment group at each time after debridement were lower than those in control group. Conclusion "Clearing Method" can alleviate local in?flammatory responses by reducing the level of inflammatory factors in acute wounds and promote wound healing in diabetic foot gangrene with dampness heat toxic syndrome.

Objective To observe the effect of Yanghe Tongmai Tablets on the function of vascular endothelial cells in extremity arteriosclerosis obliterans,and provide the evidence of clinical effectiveness of the tablets.Methods 240 cases of patients with limb arteriosclerosis obliterans of cold accumulation syndrome were randomly divided into an observation group of 120 cases treated with Yanghe Tongrnai Tablets,6 tablets each time,3 times a day orally,and a control group of 120 cases,with Compound Salvia Tablets,3 tablets each time,3 times a day orally,28 days for 1 course.1 courses of treatment were observed clinically.Results The total effective rate of the observation group was 62.04％,and that of the control group was 46.23％,and the difference between the two groups was statistically significant(P =0.044).After the treatment,skin temperature reduction and resting pain were improved in both two groups compared with that before the treatment,the differences were statistically significant(P ＜ 0.05,P ＜ 0.01);serum 6-keto prostaglandin F1α,thromboxane B2(TXB2),and nitric oxide (NO) were increased compared with those before the treatment,endothelin-1 (ET-1) was decreased,the difference was statistically significant (P ＜ 0.01);in the observation group,cold skin,intermittent claudication and ankle brachial index (ABI) were improved,compared with those before the treatment,the differences were also statistically significant (P ＜ 0.01,P ＜ 0.05).After the treatment,there was a statistically significant difference in cold skin,skin temperature lowering,intermittent claudication,resting pain,ABI,6-Keto-PGF1α,TXB2,NO and ET-1 between the two groups (P ＜ 0.05,P ＜ 0.01).Conclusion Yanghe Tongmai Tablets in the treatment of arteriosclerosis obliterans of cold accumulation syndrome has significant curative effect,and it can improve the clinical symptoms and signs of ischemia,dilate blood vessels,inhibit thrombosis,improve microcirculation,and protect endothelial cells.

目的:探讨高血压合并阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)患者血清胱抑素(CysC)的危险因素. 方法:83例高血压患者行血生化和多导睡眠仪检测,根据多导睡眠仪的监测结果,符合OSA诊断的41例患者作为高血压合并OSA组,42例单纯高血压患者作为高血压组. 结果:(1)高血压合并OSA组的体质量、体质量指数、颈围、腰围、腰臀比、收缩压、夜间缺氧事件总数、夜间缺氧事件总时间、睡眠呼吸暂停低通气指数(AHI)、空腹血糖、餐后2h血糖、CysC、总胆固醇、三酰甘油和低密度脂蛋白胆固醇均高于高血压组(P均＜0.05);(2)Pearson相关或Spearman相关分析显示,血清CysC与体质量、颈围、腰围、腰臀比、夜间缺氧事件总数、夜间缺氧事件总时间和AHI呈正相关(P均＜005);(3)多元线性逐步回归分析示仅夜间缺氧事件总数(β=0.484,P＜0.05)和AHI(β=0.481,P＜0.05)与血清CysC的相关性有统计学意义.结论:夜间缺氧事件总数和AHI是高血压合并OSA患者血清CysC的独立危险因素.

目的 探讨中药清法治疗糖尿病足患者微量白蛋白尿对微循环障碍疗效.方法 200例糖尿病足患者随机分为中西医治疗组和西医对照组,各100例.两组均采用相同的基础治疗.中西医治疗组予中药清法,药物组成:穿心莲、蚤休、垂盆草、川乌、三七、冰片,100 ml/袋,每次1袋,2次/d;西医对照组予西洛他唑100 mg,1次/d,口服,且均行血生化、微量白蛋白尿及血液流变学的检测,比较治疗前后二组的变化.结果 用药前,两组患者的年龄、体质量、身高、BMI、收缩压、舒张压、TC、HDL-C、LDL-C、TG、BUN、Cr、UA、FPG、2hPG、MA、全血黏度低切、全血黏度中切、全血黏度高切、血浆黏度、血细胞比容、红细胞聚集指数和纤维蛋白原差异均无统计学意义(P＞0.05).治疗后,两组患者的TC、TG、UA、FPG、MA、全血黏度低切、全血黏度中切、全血黏度高切、血浆黏度、血细胞比容、红细胞聚集指数和纤维蛋白原差异有统计学意义(P＜0.05),HDL-C、LDL-C、BUN、Cr、2hPG差异无统计学意义(P＞0.05).此外,依据“脱疽”诊治疗效标准和糖尿病足坏疽疗效判定标准比较中西医治疗组与西医对照组的治疗结果,疗效差异有统计学意义(P＜0.01).结论 中药清法通过治疗糖尿病足患者微量白蛋白尿和血液流变学,进而改善患者微循环障碍,促进伤口愈合,是值得推广的一种方法.

Objective. To evaluate the effectiveness of external application of traditional Chinese medicine (EA-TCM) on venous ulcers. Methods. Seven databases were searched until April 2015 for randomized controlled trials (RCTs) of EA-TCM for venous ulcers. Risk of bias was assessed using Cochrane Handbook guidelines. Study outcomes were presented as risk ratios (RRs) for dichotomous data or mean differences (MDs) for continuous data. Results. Sixteen of 193 potentially relevant trials met the inclusion criteria; however, their methodological qualities were low. Comparison of the same intervention strategies revealed significant differences in total effectiveness rates between EA-TCM and conventional therapy groups (RR = 1.22, 95% confidence interval [CI] = 1.16-1.29, and P < 0.00001). Compared to conventional therapy, EA-TCM combined with conventional therapy had a superior total effectiveness rate (RR - 1.11, 95% CI - 1.04-1.19, and P - 0.003). There were no significant differences in recurrence rates during followup and final pain measurements between the experimental and those in the control groups (RR = 0.86, 95% CI = 0.31-2.39, and P = 0.85; MD -0.75, 95% CI = -2.15-0.65, and P = 0.29). Conclusion. The evidence that EA-TCM is an effective treatment for venous ulcers is encouraging, but not conclusive due to the low methodological quality of the RCTs. Therefore, more high-quality RCTs with larger sample sizes are required.