Abstract Purpose A risk prediction model was developed to predict the risk of major amputation in patients with diabetic foot ulcer (DFU) on admission, and instruct patients to prevent and control early, and guide doctors to make clinical decisions. Patients and methods We used data from the Electronic Medical Record (EMR) database of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from February 2014 to July 2020. DFU patients were divided into major amputation group and non-major amputation group, and nested case-control study method was used to identify case group and control group. The results of the first laboratory tests, imaging examinations, complications and other information of DFU patients at admission were collected, and initial predictive variables were selected. Logistic regression and LASSO regression in R software were used to develop a clinical prediction model for DFU patients with major amputation, which was displayed in the form of nomographs, and the model was evaluated by internal validation. Results A total of 3654 patients were diagnosed as DFU, 695 patients were included in the study on the development of risk prediction model of DFU major amputation, 139 patients in the case group and 556 patients in the control group. 9 variables (WBC, Hb, ALB, Wagner grade, amputation history, smoking, ABI < 0.4, ulcer duration > 1 month, HbA1c) screened by logistic regression and LASSO regression were used as predictors of major amputation in DFU patients. The internal validation showed that the C index adjusted by Bootstrap method was 0.91 (95% CI, 0.894–0.943), the average absolute error of the prediction model for drawing the calibration curve was 0.01, and the brier score was 0.08. Conclusions The clinical risk prediction model of major amputation in DFU patients developed in this study has good discrimination and calibration, can accurately predict the outcome events, can be used as an effective tool to guide doctors to make clinical decisions, and enrich and improve the content of DFU prevention and control work, but the promotion and use of the model still needs further verification of external data. Clinical trial number Not applicable.

Background Risk factors for bloodstream infection in patients with COVID-19 in the intensive care unit (ICU) remain unclear. The purpose of this systematic review was to study the risk factors for BSI in patients admitted to ICUs for COVID-19. Methods A systematic search was performed on PubMed, EMBASE, Cochrane Library, and Web of Science up to July 2024. Data were reported as combined odds ratio (OR) for categorical variables and weighted mean difference (WMD) for continuous variables. Results 6914 studies were retrieved, of which 55 were included in the meta-analysis. Men (OR = 1.28, 95% CI: 1.10-1.50, P = 0.006), high SAPS II score (WMD = 6.43, 95% CI: 0.23-12.63, P = 0.042), diabetes (OR = 1.34, 95% CI: 1.04-1.73, P = 0.022), tracheal intubation (OR = 8.68, 95% CI: 4.68-16.08, P < 0.001), mechanical ventilation (OR = 22.00, 95% CI: 3.77-128.328, P < 0.001), ECMO (OR = 2.70, 95% CI: 1.17-6.26, P = 0.020), central venous cannulation (OR = 9.33, 95% CI: 3.06-28.43, P < 0.001), prolonged ICU stay (WMD = 10.37, 95% CI: 9.29-11.44, P < 0.001), methylprednisolone use (OR = 2.24, 95% CI: 1.24-4.04, P = 0.008), and the combination of methylprednisolone and Tocilizumab (OR = 4.54, 95% CI: 1.09-18.88, P = 0.037) were risk factors for ICU-BSI in COVID-19 patients. Conclusion We identified 10 risk factors for ICU-BSI in COVID-19 patients. In future studies, these factors can be combined to establish a more comprehensive and accurate prediction model for ICU-BSI in COVID-19 patients. Targeted measures can be taken earlier to control BSI.

In this editorial, we discuss the article by Wen et al published. Diabetic foot ulcers are prevalent and serious complications of diabetes, significantly impacting patients’ quality of life and often leading to disability or death, thereby placing a heavy burden on society. Effective diabetic wound healing is hindered by an imbalance in macrophage polarization; many macrophages fail to transition from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype, which is crucial for tissue remodelling and repair. The wound healing process is both dynamic and complex. Healthy M1 macrophages, which have strong phagocytic abilities, are vital during the inflammatory phase of diabetic wound healing. However, the failure to transition to M2 macrophages during the proliferative phase hinders wound healing. We anticipate the development of new therapies that can repair damaged M1 macrophages during the inflammatory phase and promote M2 macrophage polarization during the proliferative phase, thereby enhancing the overall healing process.

在我国人民生活水平不断改善、物质条件不断提高的同时,糖尿病患者数量也呈现逐步增加的趋势,形成了糖尿病足溃疡(diabetic foot ulcer,DFU)庞大的患者群体储备.糖尿病足作为糖尿病致残、致死的严重并发症之一,溃疡创面经久不愈是其主要特点,这也导致了糖尿病足溃疡患者住院时间动辄数月,而患者每次治疗的费用则以万计 [1].因此,一些能够切实有效防治糖尿病足溃疡的临床策略也逐步成为目前中外医学领域的关注热点.糖尿病足溃疡可归属于中医学"脱疽"范畴,祖国医学对此病的认识由来已久.《外科理例》载:"足大指赤肿焮痛,此脾经积毒下注而然,名曰脱疽."中医外科医家认为,脱疽乃是饮食不节,嗜食膏粱厚味,日久蕴热生毒,下注血脉而致,病机无外乎本虚标实两端.

目的:观察复方黄柏液塌渍外敷控制糖尿病足多重耐药菌感染的临床疗效.方法:选取2021年1月—2022年1月我院收治的糖尿病足感染患者64例,脱落3例,采用随机数字表法将61例患者随机分为治疗组31例、对照组30例.治疗组采用基础治疗+复方黄柏液塌渍外敷,对照组采用基础治疗+藻酸钙银纤维敷料常规换药.观察2周,分别于治疗(0±2)d、(7±2)d、(14±2)d时记录数据.比较两组患者总有效率、糖尿病足中医证候量化评分、感染控制率、感染控制时间、细菌培养转阴率.结果:治疗(7±2)d、(14±2)d时,治疗组中医证候量化评分分别为(36.68±8.99)分、(33.45±8.12)分,对照组分别为(38.43±10.13)分、(35.37±9.88)分,治疗组中医证候量化评分较治疗前均降低,差异有统计学意义(P<0.05),对照组治疗(14±2)d时中医证候量化评分较治疗前降低,差异有统计学意义(P<0.05);治疗(14±2)d时,治疗组感染控制率为58.06％,高于对照组的23.33％,差异有统计学意义(P<0.05).两组患者其余各项指标差异无统计学意义(P＞0.05).结论:随着用药时间增加,复方黄柏液塌渍外敷控制糖尿病足多重耐药菌感染的综合疗效优于藻酸钙银纤维敷料,且对改善糖尿病足中医证候量化评分更有效.

目前,促进糖尿病足(DF)创面愈合的研究成为热点.趋化因子家族多个成员可能参与DF创面愈合过程,尤其是CC类趋化因子配体(CCL)家族可能是介导DF创面愈合的重要环节之一.本文对CCL参与DF创面愈合的研究进展进行综述.

Ethnopharmacological relevance: The diabetic wound is one of the common chronic complications of diabetes, which seriously affects patients' quality of life and even causes disability and death. Traditional Chinese medicine (TCM) is a unique and precious resource in China, which has a good curative effect and safety. At present, it has been found that Chinese herbal compounds and effective active ingredients can effectively promote diabetic wound healing, and its mechanism needs to be further studied. Signaling pathways are involved in the pathogenesis and progression of diabetic wounds, which is one of the main targets for the pathologic mechanism of diabetic wounds and the pharmacological research of therapeutic drugs. Aim of the review: This study has been carried out to reveal the classical signaling pathways and potential targets by the action of TCM on diabetic wound healing and provides evidence for its clinical efficacy. Materials and methods: "diabetic wound", "diabetic foot ulcer", "traditional Chinese medicine", "natural plant" and "medicinal plant", were selected as the main keywords, and various online search engines, such as PubMed, Web of Science, CNKI and other publication resources, were used for searching literature. Results: The results showed that TCM could regulate the signaling pathways to promote diabetic wound healing, such as Wnt, Nrf2/ARE, MAPK, PI3K/Akt, NF-Kappa B, Notch, TGF-beta/Smad, HIF-1 alpha/VEGF, which maintaining inflammatory interaction balance, inhibiting oxidative stress and regulating abnormal glucose metabolism. Conclusion: The effect of TCM on diabetic wound healing was reflected in multiple levels and multiple pathways. It is envisaged to carry out further research from precision-targeted therapy, provide ideas for screening the core target of TCM in treating diabetic wounds and create modern innovative drugs based on this target.

糖尿病创面久不愈合已成为严重的医学问题，可导致感染、截肢，甚至危及生命，同时造成了巨大社会经济负担。炎症状态的慢性化是糖尿病创面愈合过程延长的重要原因。NOD样受体蛋白3（NLRP3）炎症小体是一种细胞内蛋白复合物，包括NOD样受体蛋白3（Nod - like receptor protein 3，NLRP3）、凋亡相关颗粒样蛋白（apoptosis associated speck-like protein，ASC）、半胱氨酸蛋白水解酶前体（cysteinyl aspartate specific proteinase precursor，pro-Caspase-1），激活后可释放促炎因子白介素1-I β（L-1β）和白介素-18（IL-18），参与炎症反应。NLRP3炎症小体的激活与痛风性关节炎、阿尔茨海默病、炎症性肠病、糖尿病、胰岛素抵抗等多种炎症性疾病的进展相关。而糖尿病创面微循环障碍、晚期糖基化终产物累积、氧化应激损伤、巨噬细胞长期浸润等多种因素能对NLRP3炎症小体产生影响，从而导致创面持续的炎症状态。因此，靶向NLRP3炎症小体，减少其过度激活，抑制其过度表达，成为治疗糖尿病创面的新策略。以下从糖尿病创面病理改变与NLRP3炎症小体相关联的角度，总结了调控糖尿病创面氧化应激、平衡中性粒细胞胞外诱捕网/NLRP3炎症小体轴、诱导巨噬细胞由促炎表型M1型向抑炎表型M2型极化、减少晚期糖基化终产物的过量产生、促进自噬等方面，降低NLRP3炎症小体过度表达以促进创面修复的相关研究，并分析了目前中药有效成分及复方抑制NLRP3炎症小体激活的可能作用机制，以期为促进糖尿病创面愈合提供新的靶点，为中医药抗炎、促愈的机制研究提供方向参考。

目的 探究丹黄消炎液对糖尿病性溃疡愈合过程中上皮-间质转化(epithelial-mesenchymal transition,EMT)过程的影响及可能的调控机制.方法 复制糖尿病性溃疡大鼠模型.随机分成空白组(普通创面组)、模型组(糖尿病性创面组)、对照组(碘伏组)、实验组(丹黄消炎液组),观察各组创面愈合情况并计算愈合率;采用及蛋白免疫印迹法Western Blot)和实时荧光定量聚合酶链式反应法(RT-qPCR)检测干预第7天、14天时各组创面组织内转化生长因子-β1(TGF-β1)、人Twist相关蛋白1(Twist1)、聚集蛋白(Clusterin)、E-钙黏蛋白(E-cadherin)、纤连蛋白(Fibronectin)的蛋白和mRNA表达情况.结果 干预第7天,空白组和实验组的创面愈合率显著高于对模型和组照组(P＜0.05);与模型组,空白组和实验组E-cadherin表达显著降低,Fibronectin表达显著升高,TGF-β1、Twist1、Clusterin蛋白和mRNA表达显著升高,以上差异均具有统计学意义(P＜0.05);与对照组相比,实验组E-cadherin表达显著降低,Fibronectin、Twist1蛋白表达显著升高(P＜0.05).干预14天,模型组的创面愈合率显著低于其他三组(P＜0.05);与模型组比较,空白组和实验组E-cadherin表达显著降低,Fibronectin表达显著升高,差异具有统计学意义(P＜0.05);与模型组比较,其他三组Twist1、Clusterin蛋白和mRNA表达显著升高,空白组和实验组TGF-β1蛋白和mRNA表达显著升高,差异具有统计学意义(P＜0.05).结论 糖尿病性溃疡的愈合与EMT过程有关,丹黄消炎液能够促进EMT过程,加快愈合速度,其途径可能是通过促进TGF-β1表达,介导Twist1调控Clusterin实现的.

目的:采用网络药理学方法分析黄芪-当归(HQ-DG)治疗糖尿病足,促进溃疡愈合的作用机制.方法:检索中药系统药理学数据库与分析(TCMSP)数据库,查阅文献获得黄芪-当归潜在活性成分及作用靶点,通过GeneCards数据库、OMIM数据库、DDT数据库和Drugbank数据库获得糖尿病足的疾病潜在靶点;应用Metascape平台对潜在靶点进行基因本体(GO)富集分析和京都基因与基因组百科全书(KEGG)富集分析;运用String数据库和Cytoscape软件构建蛋白相互作用(PPI)网络和"药物-有效成分-靶点-通路"网络.结果:黄芪-当归治疗糖尿病足核心成分包括丁子香萜、异鼠李素、山柰酚、β-谷固醇/植物甾醇、豆甾醇等,核心靶点有基质金属酶(MMP)-9、血管内皮细胞生长因子A(VEGFA)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、CXCL8等,主要作用于AGE-RAGE糖尿病并发症信号通路、白细胞介素-17信号通路、TNF信号通路等途径,其功能主要为调节细胞增殖、迁移等.结论:本研究初步揭示了黄芪-当归治疗糖尿病足,促进溃疡愈合的多成分、多靶点、多通路的作用机制,为今后复方机制研究提供参考.

糖尿病创面愈合障碍是糖尿病常见的慢性并发症之一,严重影响患者生活质量,甚至致残、致死,给社会带来了沉重的负担.中药是我国独特且珍贵的资源,具有较好的疗效和安全性.氧化应激在糖尿病创面的发生发展中有重要作用,体内抗氧化防御机制紊乱是导致糖尿病创面迁延不愈的因素之一.核因子E2相关因子2(Nrf2)是机体内维持细胞内氧化还原稳态的重要转录因子,可调节氧化/异源性应激并减少炎症反应.Nrf2对正常伤口的愈合并不是必须的,而对糖尿病伤口的愈合却至关重要.目前发现许多中药及其有效成分能有效促进糖尿病创面愈合,其机制与激活Nrf2信号通路有关.中药靶向激活Nrf2可减轻糖尿病创面的氧化应激反应、炎症反应和细胞凋亡,从而延缓症状的进一步加重,是促进糖尿病创面愈合药物的潜在靶点.该文总结了Nrf2信号通路与糖尿病创面的关系,并分析中药及其有效成分通过调节Nrf2通路促进糖尿病创面愈合的作用方式及可能机制,以期为创制基于该通路的糖尿病创面治疗药物提供参考.

目的:探讨桃核承气汤含药血清对脂多糖(LPS)诱导的主动脉内皮细胞增殖及相关因子表达的影响.方法:将30只雄性SD大鼠随机分为2组,正常组与含药血清组各15只,含药血清组用桃核承气汤灌胃,正常组给予等剂量生理盐水灌胃,7 d后自腹主动脉取血,离心取血清,分装备用.用不同浓度梯度含药血清干预细胞,CCK-8法、流式细胞仪检测各浓度含药血清对内皮细胞增殖、凋亡的影响,确定10μmol/L为最佳干预浓度.将主动脉内皮细胞分为空白对照组(10％空白血清)、空白血清组(10％含药血清)、模型对照组(LPS+10％空白血清)、模型血清组(LPS+10％含药血清).Western-blotting检测各组干预后的主动脉内皮细胞磷脂酰肌醇-3激酶(PI3K)、蛋白激酶B(Akt)、转化生长因子(TGF-β)、假性蛋白激酶3(TRIB3)蛋白的表达.结果:与空白血清组、空白对照组相比,模型对照组的PI3K、Akt、TGF-β表达均下降,TRIB3表达含量上升,差异有统计学意义(P<0.05);经桃核承气汤含药血清培养后,与模型对照组相比,模型血清组的PI3K、Akt、TGF-β表达含量上升,TRIB3表达下降,差异有统计学意义(P<0.05).结论:桃核承气汤含药血清可以抑制TRIB3表达,促进PI3K、Akt和TGF-β表达,桃核承气汤含药血清能促进损伤内皮细胞新生,可能与PI3K/Akt信号通路有关.

下肢深静脉血栓属中医学"股肿"范畴,其病机多以"瘀""热"为主."股肿"与"蓄血证"均以瘀热互结为主要病机,治疗应以祛瘀通络、清热凉血为原则,均可运用桃核承气汤治之.通过论证将下肢深静脉血栓归纳为中医学"蓄血"范畴,并将桃核承气汤应用于该病的临床防治,有助于开拓桃核承气汤在临床中新的应用领域,为血栓性疾病提供中医药治疗新方案.

本文介绍中西医结合防治糖尿病下肢动脉闭塞症的临床和基础研究.内容包括糖尿病下肢动脉硬化闭塞症的西医治疗措施,中西医结合药物降糖、抗凝血、抗血小板聚集、降脂等方面作用预防糖尿病下肢动脉闭塞症发生,中西医结合药物延缓糖尿病下肢动脉闭塞症进展,中西医结合药物预防糖尿病下肢动脉闭塞症患者血运重建术后再狭窄发生等.中西医结合治疗糖尿病下肢动脉闭塞症具有一定的临床疗效,值得临床推广.

目的:应用高通量蛋白芯片技术筛查糖尿病小鼠创面与正常小鼠创面组织的差异蛋白,探讨糖尿病性创面难愈的可能机制.方法:选取雄性健康BALB/c小鼠20只,随机选取10只予常规饲喂作为正常组,余10只为糖尿病组,高脂高糖联合注射链脲佐菌素(STZ)法制备糖尿病模型,皮肤全层切除法制备创面模型,在创面模型复制成功第3天取材.GSM-CAA-4000芯片定量检测两组小鼠创面组织中200种蛋白因子的含量.结果:高脂高糖饲喂联合腹腔注射STZ法成功制备糖尿病小鼠模型,糖尿病组小鼠成模后体重明显下降(P<0.05),血糖高于正常组(P<0.01).GSM-CAA-4000芯片定量检测两组小鼠创面200种蛋白水平,共筛选出29种差异蛋白.与正常组对比,糖尿病组创面组织中含量降低的蛋白因子包括:ACE、Gas 1、IL-33、P-Cadherin、E-selectin、6 Ckine、IL-1 ra、Periostin、VEGF-D、Dtk、MCSF、SDF-1a、VEGF、TARC、Pro-MMP-9、gp130、VCAM-1、TNF RI(P<0.05);含量升高的蛋白因子包括:MBL-2、CD36、SHH-N、Renin 1、Fetuin A、Limitin、IL-10、VEGF-B、Persephin、TRANCE(P<0.05).结论:通过蛋白芯片技术共筛选出29个差异蛋白,主要涉及生长因子、趋化因子、黏附分子、肿瘤坏死因子及受体家族,提示糖尿病性创面存在细胞增殖、趋化,迁移黏附以及基质降解等方面异常.

糖尿病足溃疡(DFUs)是糖尿病严重的并发症之一,发病率和截肢率高,目前具体发病机制仍未完全明确.相关研究表明,炎症、感染和营养障碍等多种因素共同影响DFUs的转归及预后.抑制相关炎症通路和细胞因子表达,可促使坏死组织脱落促进愈合.此外,细胞因子信号传导抑制因子家族蛋白(SOCS)可通过激活蛋白酪氨酸激酶(JAK)/信号转导和转录活化因子(STAT)信号通路参与细胞因子信号转导,参与DFUs创面炎症反应以及愈合过程.近年来,大量研究发现具有"去腐生新"功效的单味中药及其活性成分、中药复方对DFUs具有很好的疗效,研究中药治疗DFUs的具体机制已成为近些年来研究的热点之一.文章查阅近年文献,就SOCS通路与DFUs的关系及中医药治疗DFUs作用机制进行综述.

糖尿病创面是糖尿病严重的并发症之一,发病率高,创面愈合困难,目前具体发病机制仍未完全明确.相关研究表明,感染和炎症等因素共同影响糖尿病创面的进展,抗感染、抑制相关炎症通路和细胞因子表达,可以促进愈合.Toll样受体(toll-like receptors,TLRs)可通过激活相应信号通路参与机体抗感染及抗炎细胞因子信号转导,调控糖尿病创面愈合过程.近年来,大量研究发现中医中药对糖尿病创面具有很好的促愈疗效,研究中药治疗糖尿病创面的具体机制已成为近些年来研究的热点之一.通过查阅近年文献,文章就TLRs通路与糖尿病创面的关系及中医药治疗糖尿病创面作用机制进行如下综述.

随着社会经济不断发展,人们的生活节奏明显加快,饮食结构和生活习惯有了明显的改变,糖尿病患者人数逐年增加,根据国际糖尿病联盟相关统计数据,预计在2025年全球将有接近4亿的糖尿病患者.糖尿病大血管病变是一种常见的慢性并发症,且近几该病的发病率呈上升趋势,约有60.0％ ～ 70.0％的糖尿病患者由于血管病变伤残或死亡.目前,糖尿病大血管病变已经成为危害性最大的一类糖尿病慢性并发症.作者即围绕糖尿病大血管病变,就活血化瘀重要的干预机制,以及糖尿病大血管纤维化的研究进展,发表几点看法.

目的:观察桃核承气汤对脂多糖(LPS)致体外培养血管内皮细胞炎症因子及TLR4、TRIB3表达的影响.方法:SD大鼠桃核承气汤灌胃制备含药血清.LPS诱导主动脉血管内皮细胞损伤制备损伤模型,分为正常组(生理盐水灌胃血清)、正常加药组(桃核承气汤含药血清)、模型组(LPS+生理盐水灌胃血清)、模型加药组(LPS+桃核承气汤含药血清),ELISA检测比较各组IL-1β、IL-6、TGF-β蛋白表达水平,qPCR检测各组IL-1β、IL-6、TGF-β、TLR4、TRIB3的mRNA相对表达量.结果:与正常组比较,模型加药组IL-1β表达显著升高、IL-6、TGF-β表达升高,与模型组比较,其余三组IL-1β、IL-6蛋白明显抑制,模型加药组TGF-β蛋白表达显著上升,差异均有统计学意义(P<0.05).与模型组比较,模型加药组IL-1βmRNA表达抑制,其余三组IL-6、TLR4的mRNA表达下降,而TGF-βmRNA表达升高,正常组和正常加药组TGF-βmRNA的降低,差异均有统计学意义(P<0.05).结论:桃核承气汤可抑制炎症因子IL-1β、IL-6表达,促进抗炎因子TGF-β表达,发挥对血管内皮细胞的保护作用,TLR4信号通路可能参与其中.

目的:应用糖尿病小鼠模型,探讨丹黄消炎液外敷对糖尿病创面的治疗作用及相关机制.方法:通过多次小剂量腹腔注射链脲佐菌素(STZ)制作I型糖尿病小鼠模型,并切除小鼠15 mm×15 mm背部全层皮肤制作创面;将造模成功的小鼠随机分为模型组、阳性药组、中药组,每组10只;从普通小鼠创面模型中随机挑选10只作为正常组.从造模后第3天起,正常组和模型组用生理盐水1 mL/只外敷,阳性药组用碘伏1 mL/只外敷,中药组用丹黄消炎液1 mL/只外敷,医用自粘绷带包扎1次/d,连续外敷7 d.给药后观察并计算各组小鼠愈合面积,同时收集各组小鼠创面组织进行HE染色及Masson染色,检测各组小鼠创面中病理学变化及纤维组织分布,评价丹黄消炎液外敷对糖尿病小鼠创面的治疗作用;荧光定量PCR法检测各组小鼠创面组织中低氧诱导因子1-α(HIF1-α)及血管内皮生长因子(VEGF)mRNA表达水平,免疫组化法检测各组小鼠创面组织中HIF1-α、VEGF及CD31蛋白表达水平.结果:正常组、阳性药组、中药组创面愈合面积分别为(117.40±8.04)mm2、(115.76±14.34)mm2、(147.82±6.31)mm2,显著高于模型组(P<0.05);中药组愈合面积显著高于阳性药组(P<0.05);与模型组相比,正常组、阳性药组、中药组HIF1-αmRNA和VEGF mRNA表达水平显著上调(P<0.05),中药组HIF1-αmRNA表达水平与阳性药组相比显著上调(P<0.05);免疫组化结果显示,与模型组相比,正常组、阳性药组、中药组小鼠创面组织中CD31显著增加,且中药组高于阳性药组,差异有统计学意义(P<0.05).HIF1-α及VEGF主要表达于纤维组织与血管内皮细胞的细胞质中.与模型组相比,正常组、阳性药组及中药组创面组织中HIF1-α及VEGF阳性表达水平显著增加(P<0.05).中药组的HIF1-α与阳性药组相比无统计学差异,但两组HIF1-α蛋白阳性表达水平均低于正常组(P<0.05);中药组创面的VEGF蛋白表达水平显著高于阳性药组,差异有统计学意义(P<0.05).结论:丹黄消炎液可通过上调HIF1-α和VEGF的表达促进创面肉芽组织血管生成,从而促进糖尿病创面的愈合.