Diabetic foot is one of the most common and serious complications of diabetes. Early detection and prompt treatment is of great significance to the prevention of diabetic foot. Imaging is the most convenient and effective method for making an early diagnosis of diabetic foot, and imaging examination can directly and accurately reveal the peripheral vascular disorders, peripheral neuropathy, soft tissue complications, muscle and tendon lesions, bone complications, etc. thus the lesion’s extent can be exactly evaluated, which provides reliable basis for the selection and evaluation of the clinical therapeutic scheme. This paper aims to make a general review about the recent imaging research progress in diabetic foot.

Adult ; Bone Neoplasms ; pathology ; surgery ; Femur Neck ; pathology ; Humans ; Male ; Osteochondroma ; pathology ; surgery

Objective To establish carotid artery bifurcation aneurysm in canine, and to clarify whether specific hemodynamic insult in combination with arterial wall degeneration will lead to the occurrence and development of aneurysms. Methods New bifurcation aneurysm model of common carotid artery (CCA) was successfully established in 18 dogs, which were randomly divided into the elastase-treated bifurcation group (EBG,n=9) and the control bifurcation group (CBG,n=9). Three dogs were treated with elastase insult to both straight sections of CCA and were used as elastase-treated straight section group (ESG,n=3). Angiographic and hemodynamic analysis was conducted immediately after the operation, as well as 12 and 24 weeks after the operation. Histopathological examination was performed 12 and 24 weeks after the operation. Results Angiography showed that new aneurysm (mean diameter 3.2 ±0.4 mm) was formed at the apex of CCA bifurcation in 5 dog models of EBG group, while no new aneurysm was observed in both CBG and ESG groups. In EBG group, no rupture of the new aneurysm occurred during the follow-up period. Histological analysis revealed that in EBG group the inner elastic lamina was discontinued, the elastic fiber was disrupted, the muscle layer became thinned, the smooth muscle cells were reduced, and the inflammatory cell (macrophage) infiltration as well as the expressions of MMP-2 and MMP-9 were increased;these changes were statistically significant when compared with those in CBG group and ESG group (P<0.001). Postoperative hemodynamic analysis indicated that in EBG group the wall shear stress at the apex of CCA bifurcation was reduced, the blood flow velocity was decreased, with the relative and total pressure being the highest;all the above changes returned to normal after arterial wall remodeling. Conclusion The results of this study indicate that the arterial wall degeneration and the hemodynamic effect at the apex of CCA bifurcation can lead to new aneurysm formation in canine model.

Objective To investigate the endotoxemia initiated systemic and pulmonary inflammation and acute lung injury in endotoxin tolerant rats MethodsEndotoxi n tolerance (ET) models of SD rats were induced by four daily intraperitoneal in jections of 0 6 mg?kg -1 ?d -1 Escherichia coli LPS (serotype 055:B5).Normal control (NC) rats received intraperitoneal injections of the sa me volume saline On the fifth day,rats were injected with high dose of LPS (6 mg/kg) to induce endotoxemia and lung inflammation Blood,left bronchoalveolar lavage fluid (BALF) and right lung tissue were collected before and 2,6,24,48 ,72 hours after the high dose injection of LPS (six rats for each time point) Cytological examination of blood and BALF and histopathological examination wer e performed Bromine methylphenol green was adopted for measurement of serum alb umin BALF albumin was measured by en z yme-linked immunosorbent assay (ELISA) and adjusted by the ratio to serum album in to evaluate the permeability of pulmonary microvascular Results The symptomes such as less activity,accelerated respiratory rate and weight loss in NC rats was not found in ET rats after the high dose injectio n of LPS BALF albumin as well as the ratio of BALF albumin to serum albumin in c reasedt 2 hours after injection of 6 mg/kg LPS and reached their zenith at 6 hou rs in NC rats,while no increase in ET rats In NC rats the blood white cell dif f erentiating shifted from lymphocyte to PMN,and PMN percentage of BALF also incr eased from (0 443?0 345)% to (8 000?2 896)% with its peak at 24 hours a fter the injection (P

Objective To evaluate the effects of spinal segmental stabilization exercises (SSE)at home on the quality of life for community dwelling elderly patients with lower back pain.Methods Eighty elderly patients with lower back pain were divided into two groups according to the random number method:the experimental group,which received intervention for three months,and the control group,which received no intervention.Evaluation was conducted using the Oswestry Disability Index (ODI) and the WHO Quality of Life-BREF (WHOQOL BREF).Results The ODI and WHOQOL-BREF scores for the control group were (0.32 ± 0.09) and (87.65 ± 8.63),respectively,before treatment,and (0.32± 0.07) and (87.98 ±8.15),respectively,three months after treatment; the scores for the experimental group were (0.32 ± 0.09) and (87.97 ± 8.71),respectively,before treatment,and (0.27 ± 0.09) and (92.30 ± 9.64),respectively,three months after treatment.No statistically significant difference was found in ODI and WHOQOL-BREF scores in the control group before and three months after treatment (t=0.311 and-0.672,respectively; P ＞0.05 for both),while statistically significant differences were detected before and three months after treatment (t =0.311 and-0.672,respectively; P＜ 0.05 for both).Differences in ODI and WHOQOL-BREF scores were also found between the experimental group and the control group three months after treatment (t=8.500 and-4.526,respectively; P＜0.05 for both).Conclusions Spinal segmental stabilization exercises can effectively relieve symptoms,improve body functions and uplift the quality of life for community-dwelling elderly patients with lower back pain.As a beneficial physical therapy option,SSE can be promoted in residential communities.

OBJECTIVETo investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty.

METHODSFrom October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula.

RESULTSThe mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups.

CONCLUSIONRivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

Arthroplasty, Replacement, Hip ; adverse effects ; Case-Control Studies ; Female ; Hemorrhage ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Morpholines ; pharmacology ; Postoperative Complications ; prevention & control ; Risk ; Rivaroxaban ; Thiophenes ; pharmacology ; Time Factors

Objective To investigate the effects of adenosine preconditioning on the expression of myocardial tumor necrosis factor-alpha (TNF-α) mRNA and intercellular adhesion molecule-1 (ICAM-1) mRNA in patients undergoing off-pump coronary artery bypass graft (OPCABG).Methods Forty patients, aged 44-68 yr, with more than three coronary artery obstructions and the ejection fraction≥40%,undergoing elective OPCABG, were randomly divided into 2 groups (n=20 each): control group and adenosine group. Adenosine group received adenosine preconditioning, with the initial infusion rate of 50 μg. kg-1.min-1, then increasing to 100μg.kg-1.min-1after 1 min, finally increasing to 150 μg. kg-1 . min-1 after 2 min and maintaining for 7 min. Vascular anastomosis was started at 5 min after preconditioning. While the control group received normal saline instead of adenosine. Tissue samples of the right auricle were taken before preconditioning (baseline) and at 15 min after blood current retum to measure the expression of myocardial TNF-α mRNA and ICAM-1 mRNA. The myocardial ultrastructure was observed and hemodynamic parameters were monitored.Results The myocardial damage was milder in the adenosine group than in the control group. The expression of myocardial TNF-α mRNA and ICAM-1 mRNA was significantly lower in the adenosine group than in the control group ( P＜0.05).Conclusion Adenosine preconditioning can attenuate myocardial ischemia-reperfusion injury in patients undergoing OPCABG through down-regulating the expression of myocardial TNF- mRNA and ICAM-1 mRNA.

Objective To investigate the variation of myocardial glycometabolism and the release of cardiac creatine kinase and cardiac troponin I on isolated rat heart after stimulated with hyperinsulinism.Methods Thirty Sprague-Dawley rats were random divided into five groups,and their hearts were taken out to be mounted onto a Langendorff perfusion apprartus to perfuse with krebs-Henseleit buffer contained diversity concentration of insulin as 0,10,20,30,50 U/L.The coronary effluent was collected on time,and the concentration of glum was determined to evaluate the glycometabolism of the rat heart,meanwhile the release of cardiac creutine kinase(CK)and cardiac troponin I were detected to evaluate the state of myocardial damage.Results Compared with control group,the rat hearts of the hyperinsulinism group had a significantly depression of glucose uptake and oxidation,and the level of CK and cTn-I in the coronary effluent was increased.Conclusion After the isolated rat hearts were stimulated with hyperinsulinism,the glucose uptake of cadiocyte were suppressed,myocardial insulin resistance appeared,and the rat myocardial got damaged.

Objective To investigate the feasibility of establishing aneurysm model at the carotid artery bifurcation in experimental dogs. Methods New aneurysm model at the common carotid artery (CCA) bifurcation was established in 18 experimental dogs, which were randomly and equally divided into study group (n =9) and control group (n=9). In the dogs of the study group, the bifurcation top was treated with elastase, while in the dogs of the control group the bifurcation top was treated with saline. Angiography was separately performed immediately after, and at 12 and 24 weeks after the operation to observe the changes of the aneurysm top. Pathological examination was separately carried out at 12 and 24 weeks after the operation. Results Angiography showed that nascent aneurysm formation (mean diameter of 3.2 ± 0.4 mm) was demonstrated at the arterial bifurcation top in 5 dogs of the study group; while no nascent aneurysm at the arterial bifurcation top was observed in the control group. During the follow-up period, no rupture of the nascent aneurysm occurred in the study group. Pathological examination revealed that discontinued internal elastic membrane, elastic fiber fracture, thinning muscle layer and reduction of smooth muscle cells were detected in the aneurysm at bifurcation top in the study group; when compared with those in the control group, the difference was statistically significant (P< 0.001). Conclusion The elastase-induced digestive degeneration of artery wall can cause new aneurysm formation in the newly-established aneurysm located at carotid artery bifurcation in experimental dogs.

Complex clinical situation requires healthcare providers to be able to perceive, un-derstand and predict the situation changes correctly, namely they need situation awareness. Good clin-ical situational awareness can help clinical decision-making and cooperation, which is critical to im-proving the quality of healthcare. Therefore this review aims to summarize the meaning, applications, status and influence factors, measurements and training of clinical situation awareness, to provide evidence for training and improving clinical situation awareness.