BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical t...BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical treatment method.AIM To investigate whether Huangma Ding or autologous platelet-rich gel(APG)treatment would benefit diabetic lower extremity arterial disease(LEAD)patients with foot ulcers.METHODS A total of 155 diabetic LEAD patients with foot ulcers were enrolled and divided into three groups:Group A(62 patients;basal treatment),Group B(38 patients;basal treatment and APG),and Group C(55 patients;basal treatment and Huangma Ding).All patients underwent routine follow-up visits for six months.After follow-up,we calculated the changes in all variables from baseline and determined the differences between groups and the relationships between parameters.RESULTS The infection status of the three groups before treatment was the same.Procalcitonin(PCT)improved after APG and Huangma Ding treatment more than after traditional treatment and was significantly greater in Group C than in Group B.Logistic regression analysis revealed that PCT was positively correlated with total amputation,primary amputation,and minor amputation rates.The ankle-brachial pressure and the transcutaneous oxygen pressure in Groups B and C were greater than those in Group A.The major amputation rate,minor amputation rate,and total amputation times in Groups B and C were lower than those in Group A.CONCLUSION Our research indicated that diabetic foot ulcers(DFUs)lead to major amputation,minor amputation,and total amputation through local infection and poor microcirculation and macrocirculation.Huangma Ding and APG were effective attreating DFUs.The clinical efficacy of Huangma Ding was better than that of autologous platelet gel,which may be related to the better control of local infection by Huangma Ding.This finding suggested that in patients with DFUs combined with coinfection,controlling infection is as important as improving circulation.展开更多
Background:Hypoxia is a significant risk factor of hypertension.However,no studies have used transcutaneous tissue partial pressure of oxygen(TcPO_(2))and partial pressure of carbon dioxide(TcPCO_(2))monitors to measu...Background:Hypoxia is a significant risk factor of hypertension.However,no studies have used transcutaneous tissue partial pressure of oxygen(TcPO_(2))and partial pressure of carbon dioxide(TcPCO_(2))monitors to measure the respective partial pressures in healthy individuals.Oxygen saturation(SpO_(2))is often used for traditional monitoring of vital signs.This study investigated the changes in TcPO_(2)and SpO_(2)values during rapid changes in altitude.The trial was registered at ClinicalTrials.gov(registration no.NCT06076057).Methods:Healthy adult volunteers were instructed to sit vertically in a hypobaric oxygen chamber,which ascended from 0 m to 2500 m at a uniform speed within 10 min.The Danish Radiometer TCM4 was used to measure TcPO_(2)and TcPCO_(2)with the ventral side of the upper arm as the measurement site.The Shenzhen Kerokan P0D-1 W pulse oximeter was used to measure heart rate and SpO_(2),with values recorded once every 500 m.Results:Altogether,49 healthy volunteers were recruited between March 2023 and August 2023.With increasing altitude,TcPO_(2)and SpO_(2)decreased significantly(P<0.01).During the ascent from 0 m,TcPO_(2)began to change statistically at 500 m(P<0.05),whereas SpO_(2)began to change statistically at 1000 m(P<0.05).At the same altitude,the difference in TcPO_(2)was greater than the difference in SpO_(2).At 1000 m,there were statistically significant changes in TcPO_(2)and SpO_(2)(P<0.001).At altitudes>500 m,statistical significance was identified between TcPO_(2)in both sexes(P<0.05).Statistical significance in TcPCO_(2)and heart rate was observed at the different elevations(P<0.05).Conclusion:In acutely changing low-pressure hypoxic environments,TcPO_(2)changed more dramatically than SpO_(2).展开更多
BACKGROUND:This study aimed to observe the effect of early goal directed therapy(EGDT)on tissue perfusion,microcirculation and tissue oxygenation in patients with septic shock.METHODS:Patients with early septic shock(...BACKGROUND:This study aimed to observe the effect of early goal directed therapy(EGDT)on tissue perfusion,microcirculation and tissue oxygenation in patients with septic shock.METHODS:Patients with early septic shock(<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled(research time:12 months),and they didn't meet the criteria of EGDT.Patients who had one of the following were excluded:stroke,brain injury,other types of shock,severe heart failure,acute myocardial infarction,age below 18 years,pregnancy,end-stage disease,cardiac arrest,extensive burns,oral bleeding,difficulty in opening the mouth,and the onset of septic shock beyond 24 hours.Patients treated with the standard protocol of EGDT were included.Transcutaneous pressure of oxygen and carbon dioxide(PtcO_2,PtcCO_2) were monitored and hemodynamic measurements were obtained.Side-stream dark field(SDF) imaging device was applied to obtain sublingual microcirculation.Hemodynamics,tissue oxygen,and sublingual microcirculation were compared before and after EGDT.If the variable meets the normal distribution,Student's t test was applied.Otherwise,Wilcoxon's rank-sum test was used.Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method.RESULTS:Twenty patients were involved,but one patient wasn't analyzed because he didn't meet the EGDT criteria.PtcO_2 and PtcCO_2 were monitored in 19 patients,of whom sublingual microcirculation was obtained.After EGDT,PtcO_2 increased from 62.7+24.0 mmHg to 78.0±30.9mmHg(P<0.05) and tissue oxygenation index(PtcO_2/FiO_2) was 110.7+60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT(P<0.05).The difference between PtcCO_2 and PCO_2 decreased significantly after EGDT(P<0.05).The density of perfused small vessels(PPV) and microcirculatory flow index of small vessels(MFI) tended to increase,but there were no significant differences between them(P>0.05).PtcO_2,PtcO_2/FiO_2,and PtcCO_2 were not linearly related to central venous saturation,lactate,oxygen delivery,and oxygen consumption(P>0.05).CONCLUSION:Peripheral perfusion was improved after EGDT in patients with septic shock,and it was not exactly reflected by the index of systemic perfusion.展开更多
Objective To explore the effects of sliding-cup with different parameters on energy metabolism in the body by observing the effect of sliding-cup along the governor vessel on transcutaneous partial pressures of oxygen...Objective To explore the effects of sliding-cup with different parameters on energy metabolism in the body by observing the effect of sliding-cup along the governor vessel on transcutaneous partial pressures of oxygen and carbon dioxide in Mìngmén（命门 GV 4） in sub-healthy people. Methods A total of 10 sub-healthy adults at rest were observed and sliding-cup along the governor vessel were conducted with three different parameters, jar-pressure of –0.01~ –0.02 MPa with sliding-cup for 5 min, jar-pressure of –0.02~ –0.03 MPa with sliding-cup for 5 min and jar-pressure of –0.02~ –0.03 MPa with slidingcup for 3 min. Peri Flux System5000 PF5040 module was employed to monitor the changes of transcutaneous partial pressures of oxygen（tcp O2） and carbon dioxide（tcp CO2） in GV 4 at 0 min, 5 min, 10 min, 15 min, 20 min, 25 min and 30 min after sliding-cup with above different interventions in sub-healthy subjects. Results After sliding-cup, tcp O2 increased at first and then decreased over time; there was no difference in tcp O2 after sliding-cupping with different parameters（all P0.05）. After sliding-cup, tcp CO2 decreased; there was no difference in tcp CO2 after sliding-cup with different parameters（all P0.05）. Conclusion Sliding-cup has a sustained effect on the body and can speed up the energy metabolism in the body.展开更多
In recent years,as living standards have continued to improve,the number of diabetes patients in China,along with the incidence of complications associated with the disease,has been increasing.Among these complication...In recent years,as living standards have continued to improve,the number of diabetes patients in China,along with the incidence of complications associated with the disease,has been increasing.Among these complications,diabetic foot disease is one of the main causes of disability and death in diabetic patients.Due to the differences in economy,culture,religion and level of medical care available across different regions,preventive and treatment methods and curative results for diabetic foot vary greatly.In multidisciplinary models built around diabetic foot,the timely assessment and diagnosis of wounds and appropriate methods of prevention and treatment with internal and external surgery are key to clinical practice for this pathology.In 2019,under the leadership of the Jiangsu Medical Association and Chinese Diabetes Society,the writing group for the Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease(2020 edition)was established with the participation of scholars from the specialist areas of endocrinology,burn injury,vascular surgery,orthopedics,foot and ankle surgery and cardiology.Drawing lessons from diabetic foot guidelines from other countries,this guide analyses clinical practices for diabetic foot,queries the theoretical basis and grades and gives recommendations based on the characteristics of the pathology in China.This paper begins with assessments and diagnoses of diabetic foot,then describes treatments for diabetic foot in detail,and ends with protections for high-risk feet and the prevention of ulcers.This manuscript covers the disciplines of internal medicine,surgical,nursing and rehabilitation and describes a total of 50 recommendations that we hope will provide procedures and protocols for clinicians dealing with diabetic foot.展开更多
基金Supported by the Chongqing Science and Technology Bureau and Health Commission of Chinese Medicine Technology Innovation and Application Development Project,No.2020ZY013540General Project of Chongqing Natural Science Foundation,No.CSTB2023NSCQMSX0246 and No.CSTB2022NSCQ-MSX1271Science and Health Joint Project of Dazu District Science and Technology Bureau,No.DZKJ2022JSYJ1001.
文摘BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical treatment method.AIM To investigate whether Huangma Ding or autologous platelet-rich gel(APG)treatment would benefit diabetic lower extremity arterial disease(LEAD)patients with foot ulcers.METHODS A total of 155 diabetic LEAD patients with foot ulcers were enrolled and divided into three groups:Group A(62 patients;basal treatment),Group B(38 patients;basal treatment and APG),and Group C(55 patients;basal treatment and Huangma Ding).All patients underwent routine follow-up visits for six months.After follow-up,we calculated the changes in all variables from baseline and determined the differences between groups and the relationships between parameters.RESULTS The infection status of the three groups before treatment was the same.Procalcitonin(PCT)improved after APG and Huangma Ding treatment more than after traditional treatment and was significantly greater in Group C than in Group B.Logistic regression analysis revealed that PCT was positively correlated with total amputation,primary amputation,and minor amputation rates.The ankle-brachial pressure and the transcutaneous oxygen pressure in Groups B and C were greater than those in Group A.The major amputation rate,minor amputation rate,and total amputation times in Groups B and C were lower than those in Group A.CONCLUSION Our research indicated that diabetic foot ulcers(DFUs)lead to major amputation,minor amputation,and total amputation through local infection and poor microcirculation and macrocirculation.Huangma Ding and APG were effective attreating DFUs.The clinical efficacy of Huangma Ding was better than that of autologous platelet gel,which may be related to the better control of local infection by Huangma Ding.This finding suggested that in patients with DFUs combined with coinfection,controlling infection is as important as improving circulation.
基金supported by grants from Shandong Province Key R&D Program(2021CXGC011301).
文摘Background:Hypoxia is a significant risk factor of hypertension.However,no studies have used transcutaneous tissue partial pressure of oxygen(TcPO_(2))and partial pressure of carbon dioxide(TcPCO_(2))monitors to measure the respective partial pressures in healthy individuals.Oxygen saturation(SpO_(2))is often used for traditional monitoring of vital signs.This study investigated the changes in TcPO_(2)and SpO_(2)values during rapid changes in altitude.The trial was registered at ClinicalTrials.gov(registration no.NCT06076057).Methods:Healthy adult volunteers were instructed to sit vertically in a hypobaric oxygen chamber,which ascended from 0 m to 2500 m at a uniform speed within 10 min.The Danish Radiometer TCM4 was used to measure TcPO_(2)and TcPCO_(2)with the ventral side of the upper arm as the measurement site.The Shenzhen Kerokan P0D-1 W pulse oximeter was used to measure heart rate and SpO_(2),with values recorded once every 500 m.Results:Altogether,49 healthy volunteers were recruited between March 2023 and August 2023.With increasing altitude,TcPO_(2)and SpO_(2)decreased significantly(P<0.01).During the ascent from 0 m,TcPO_(2)began to change statistically at 500 m(P<0.05),whereas SpO_(2)began to change statistically at 1000 m(P<0.05).At the same altitude,the difference in TcPO_(2)was greater than the difference in SpO_(2).At 1000 m,there were statistically significant changes in TcPO_(2)and SpO_(2)(P<0.001).At altitudes>500 m,statistical significance was identified between TcPO_(2)in both sexes(P<0.05).Statistical significance in TcPCO_(2)and heart rate was observed at the different elevations(P<0.05).Conclusion:In acutely changing low-pressure hypoxic environments,TcPO_(2)changed more dramatically than SpO_(2).
文摘BACKGROUND:This study aimed to observe the effect of early goal directed therapy(EGDT)on tissue perfusion,microcirculation and tissue oxygenation in patients with septic shock.METHODS:Patients with early septic shock(<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled(research time:12 months),and they didn't meet the criteria of EGDT.Patients who had one of the following were excluded:stroke,brain injury,other types of shock,severe heart failure,acute myocardial infarction,age below 18 years,pregnancy,end-stage disease,cardiac arrest,extensive burns,oral bleeding,difficulty in opening the mouth,and the onset of septic shock beyond 24 hours.Patients treated with the standard protocol of EGDT were included.Transcutaneous pressure of oxygen and carbon dioxide(PtcO_2,PtcCO_2) were monitored and hemodynamic measurements were obtained.Side-stream dark field(SDF) imaging device was applied to obtain sublingual microcirculation.Hemodynamics,tissue oxygen,and sublingual microcirculation were compared before and after EGDT.If the variable meets the normal distribution,Student's t test was applied.Otherwise,Wilcoxon's rank-sum test was used.Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method.RESULTS:Twenty patients were involved,but one patient wasn't analyzed because he didn't meet the EGDT criteria.PtcO_2 and PtcCO_2 were monitored in 19 patients,of whom sublingual microcirculation was obtained.After EGDT,PtcO_2 increased from 62.7+24.0 mmHg to 78.0±30.9mmHg(P<0.05) and tissue oxygenation index(PtcO_2/FiO_2) was 110.7+60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT(P<0.05).The difference between PtcCO_2 and PCO_2 decreased significantly after EGDT(P<0.05).The density of perfused small vessels(PPV) and microcirculatory flow index of small vessels(MFI) tended to increase,but there were no significant differences between them(P>0.05).PtcO_2,PtcO_2/FiO_2,and PtcCO_2 were not linearly related to central venous saturation,lactate,oxygen delivery,and oxygen consumption(P>0.05).CONCLUSION:Peripheral perfusion was improved after EGDT in patients with septic shock,and it was not exactly reflected by the index of systemic perfusion.
基金Suported by Tianjin Municipal Administration of Traditional Chinese Medicine:11028
文摘Objective To explore the effects of sliding-cup with different parameters on energy metabolism in the body by observing the effect of sliding-cup along the governor vessel on transcutaneous partial pressures of oxygen and carbon dioxide in Mìngmén（命门 GV 4） in sub-healthy people. Methods A total of 10 sub-healthy adults at rest were observed and sliding-cup along the governor vessel were conducted with three different parameters, jar-pressure of –0.01~ –0.02 MPa with sliding-cup for 5 min, jar-pressure of –0.02~ –0.03 MPa with sliding-cup for 5 min and jar-pressure of –0.02~ –0.03 MPa with slidingcup for 3 min. Peri Flux System5000 PF5040 module was employed to monitor the changes of transcutaneous partial pressures of oxygen（tcp O2） and carbon dioxide（tcp CO2） in GV 4 at 0 min, 5 min, 10 min, 15 min, 20 min, 25 min and 30 min after sliding-cup with above different interventions in sub-healthy subjects. Results After sliding-cup, tcp O2 increased at first and then decreased over time; there was no difference in tcp O2 after sliding-cupping with different parameters（all P0.05）. After sliding-cup, tcp CO2 decreased; there was no difference in tcp CO2 after sliding-cup with different parameters（all P0.05）. Conclusion Sliding-cup has a sustained effect on the body and can speed up the energy metabolism in the body.
基金The National Natural Science Foundation of China(grant number:81770810)。
文摘In recent years,as living standards have continued to improve,the number of diabetes patients in China,along with the incidence of complications associated with the disease,has been increasing.Among these complications,diabetic foot disease is one of the main causes of disability and death in diabetic patients.Due to the differences in economy,culture,religion and level of medical care available across different regions,preventive and treatment methods and curative results for diabetic foot vary greatly.In multidisciplinary models built around diabetic foot,the timely assessment and diagnosis of wounds and appropriate methods of prevention and treatment with internal and external surgery are key to clinical practice for this pathology.In 2019,under the leadership of the Jiangsu Medical Association and Chinese Diabetes Society,the writing group for the Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease(2020 edition)was established with the participation of scholars from the specialist areas of endocrinology,burn injury,vascular surgery,orthopedics,foot and ankle surgery and cardiology.Drawing lessons from diabetic foot guidelines from other countries,this guide analyses clinical practices for diabetic foot,queries the theoretical basis and grades and gives recommendations based on the characteristics of the pathology in China.This paper begins with assessments and diagnoses of diabetic foot,then describes treatments for diabetic foot in detail,and ends with protections for high-risk feet and the prevention of ulcers.This manuscript covers the disciplines of internal medicine,surgical,nursing and rehabilitation and describes a total of 50 recommendations that we hope will provide procedures and protocols for clinicians dealing with diabetic foot.
