Objective:To observe the effect on renal function and hemodynamics of pancreatic kininogenase in patients with clinical diabetic nephropathy(DN,Ⅳ Period).Methods: 145 patients with clinical diabetic nephropathy(DN,Ⅳ Period) were divided into the observation group (75 cases) and the control group (70 cases) as random method. The control group was given conventional treatment, and the observation group was given pancreatic kininogenase based on the conventional treatment. After 8 weeks, to observe and analyze the changes of renal function indexes and hemodynamics indexes of the two groups.Results:After treatment, the serum creatinine(SCr), blood urea nitrogen(BUN), Serum Cys C(CysC) and urinary albumin excretion rate(UAER) of observation group were obviously decreased compared with that before treatment; the Cys C, UAER of control group also were obviously decreased, but SCr, BUN of control group had no significant changes compared with that before treatment; and all indexes of the observation group were lower than those of the control group, with significant differences (t=4.2744, t=3.0832,t=6.8261,t=8.0936;P<0.05). After treatment, the systolic pressure(SBP), diastolic blood pressure(DBP) and resistance index(RI) of two groups were decreased; both of peak systolic blood flow(PSV) and end-diastolic blood flow velocity(EVD) were increased, and the change ranges of every index of the observation group were improved more than those in the control group, with significant difference (t=5.6270,t=6.2009,t=5.0926,t=4.764,t=3.1844;P<0.05). Conclusion: Pancreatic kininogenase has the clear effect on protecting renal function in the treatment of clinical diabetic nephropathy(Ⅳ Period), and it can reduce urinary albumin excretion and improve hemodynamics.

Objective To investigate the expression of intercellular adhesion molecule 1(ICAM-1)in patients with diabetic foot ulcer(DFU)and its correlation with inflammatory cytokines.Methods A total of 152 patients with DFU(DFU group)and 133 patients with type 2 diabetes mellitus(T2DM group)admitted to our hospital from January 2021 to December 2022 were selected as the study group.120 healthy people matched in age and sex were set as the control group(NC group).Pearson correlation analysis was applied to analyze the correlation between serum ICAM-1 and wagner grade in DFU patients.Results HbA1c,TG,ICAM-1,C-RP,TNF-α,IL-6,IL-18,IL-1β in NC,T2DM and DFU groups gradually increased,but HDL-C gradually decreased(P＜0.05).Pearson correlation analysis showed that serum ICAM-1 was positively associated with C-RP and TNF-α,IL-6,IL-18,IL-1β and wagner grading in DFU patients(P＜0.01).Logistic regression analysis showed that ICAM-1,C-RP,HbA1c and IL-18 were the influencing factors of DFU.Conclusion High levels of serum ICAM-1 in DFU patients are closely related to inflammatory factors and Wagner grading,which helps to identify the severity of the condition.