Diabetic foot infection may hamper wound healing and lead to non-traumatic amputation in diabetes patients and early diagnosis and proper treatment can improve prognosis.In this review,the progress in classification,influencing factors,diagnostic methods and local treatment of diabetic foot infection is introduced.

Objective To compare the analgesic efficacy and safety of the sole local anesthetic ropivacaine with the combination of both local anesthetic ropivacaine and opioidergic analgesic sufen-tanil given epidurally on the labor pain control.Methods After institutional review board approval and patient consent,a total of 481 nulliparas requesting epidural labor analgesia were randomized into two groups:a sole local anesthetic group (0.125% ropivacaine,group R)and a combination of local anesthetic and opioidergic analgesic group (0.125% ropivacaine+0.3 μg/ml sufentanil,group RS). Analgesic efficacy was measured using numerical rating scale (NRS)of pain and maternal visual ana-logue scale (VAS)analgesia satisfaction with regard to the first and the second stage of labor.Anal-gesic safety was measured with the Bromage scale of maternal safety and epidural labor analgesia re-lated side effects,as well as fetal safety including Apgar scoring and umbilical cord artery blood gas a-nalysis.Results A total of 346 participants completed the study,with 1 64 and 182 women in each group R and RS,respectively.The median NRS pain score during the first stage of labor was signifi-cantly lower in the combination group (2.2,IQR:1.8-2.7 )comparing to the sole local analgesic group (2.4,IQR:2-2.8)(P <0.001).No significant difference was observed in NRS pain score dur-ing the second stage of labor.Patients in both groups were rated the same VAS satisfaction of analge-sia.Patients in the sole local analgesic group experienced fewer side effects than those in the combina-tion group (37.7% versus 47.2%,P =0.082).The incidence of 1-min Apgar≤7 was lower in the sole local analgesic group 2 (1.2%) than the combination group 10 (5.5%) (P < 0.05 ). Conclusion The sole local anesthetic ropivacaine produces a comparable labor analgesic effect as the combination of both local anesthetic ropivacaine and opioidergic analgesic sufentanil but the former has less maternal side effects,and less incidence of lower 1-min Apgar scoring.

Objective To study the expression ot secreted proteins in aggregated dermal papilla cells (DPCs).Methods DPCs were isolated from human scalp tissue and subjected to primary culture and subculture.Aggregated and non-aggregated DPCs served as the subject of this study.Secreted proteins were prepared from these cells and subjected to two-dimensional polyacrylamide gel electrophoresis.Differentially expressed proteins were screened by the PDQuest image analysis software.Protein spots were digested and identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry,and finally analyzed using the National Center for Biotechnology Information (NCBI) non-redundant (Nr) protein database.Results Two-dimensional electrophoresis maps with good repeatability and high resolution were established.Image analysis of 2-D gels revealed that the average number of detected protein spots was 1 134 ± 52 and 1 078 ± 36 in aggregated and nonaggregated DPCs respectively,and the majority of these protein spots were matched between aggregated and nonaggregated DPCs.Twenty-eight protein spots showed more than 5-fold difference between the two groups of cells,and 10 proteins were preliminarily identified as differentially expressed proteins by peptide-mass fingerprinting.Of these differentially expressed proteins,8 proteins including Rhogdi 1,filamin A,cystatin C,fibronectin,cyclophilin A,procollagen C proteinase enhancer 1,tissue inhibitor of metalloproteinase and tissue inhibitor of metalloproteinase-2 were up-regulated,and 2 proteins including neuropolypeptide h3 and matrix metalloproteinase-3/tissue inhibitor of metalloproteinase-1 complex were down-regulated in aggregated DPCs compared with non-aggregated DPCs.Conclusions Differentially expressed proteins between aggregated and non-aggregated DPCs are mainly implicated in cell signaling pathway,cellular proliferation and differentiation,extracellular matrix synthesis and degradation,and so on.

Objective To analyze the expression characteristics of annexin A2 in dermal papilla cells (DPCs) with aggregative behavior.Methods Reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot were performed to measure the mRNA and protein expressions of annexin A2 respectively in DPCs with or without aggregative behavior.Results The mRNA expression level of annexin A2 was significantly higher in DPCs with aggregative behavior than in those without aggregative behavior (0.50 ± 0.15 vs.0.35 ± 0.19, t =8.26, P ＜ 0.05).Western blot showed that annexin A2 had two isoforms, including one isoform with a relative molecular mass of 40 000 and the other one with a relative molecular mass of 36 000.The annexin A2 isoform with a relative molecular mass of 40 000 was highly expressed in both DPCs with aggregative behavior and those without aggregative behavior, while the other isoform was only expressed in DPCs with aggregative behavior.Conclusion Annexin A2 may be closely related to the aggregative growth of DPCs.

Objective To investigate the effect of preemptive parecoxib on blood coagulation in patients undergoing abdominal hysterectomy. Methods This was a randomized, double-blind controlled study. Seventy ASA Ⅰ or Ⅱ patients aged 38-56 yr weighing 50-75 kg undergoing abdominal hysterectomy under combined spinal-epidural anesthesia were randomized to one of 2 groups (n=35 each): parecoxib group (group P) received intravenous parecoxib 40 mg/2 ml at 20 min before anesthesia and control group (group C) received normal saline 2 ml instead of parecoxib. Both groups received patient-controlled intravenous analgesia (PCIA) with butorphanol after surgery. The PCIA solution contained butorphanol 0.2 mg/kg and ondansetron 4 mg in normal saline 100 ml.The PCIA was set up with background infusion 2 ml/h, incremental dose 2 ml, and lockout interval 15 min. VAS score was used to assess the intensity of pain (O= no pain, 10 = worst pain). Venous blood samples were taken before and at 30 min and 2 h after parecoxib or normal saline administration for coagulation test and platelet count.The postoperative ambulation time and adverse response were recorded. Butorphanol consumption per hour during postoperative analgesia and total consumption of butorphanol within 24 h after operation were also recorded. Results Compared with those before parecoxib administration, prothrombin time and thrombin time in group C and thrombin time in group P were significantly prolonged and fibrinogen concentration was significantly lower in group C at 30 min after parecoxib administration (P＜ 0.05), but no significant difference was found in the other parameters of blood coagulation and platelet count at 30 min after parecoxib administration in group P ( P＞0.05).The fibrinogen concentration was significantly higher, the incidence of postoperative nausea and vomiting was significantly lower, the postoperative ambulation time was significantly shorter, and butorphanol consumption per hour during postoperative analgesia and total consumption of butorphanol within 24 h after operation were significantly lower in group P than in group C ( P＜0.05 ), but there was no significant difference in the other parameters of blood coagulation and platelet count between group P and group C ( P ＞ 0.05 ). Conclusion Preemptive parecoxib 40 mg can enhance blood coagulation in patients undergoing abdominal hysterectomy.

OBJECTIVE:To observe the anesthetic effect of dexmedetomidine in pelvic floor reconstructive surgery of elderly patients with pelvic organ prolapse(POP). METHODS:60 elderly patients with pelvic floor reconstructive surgery were randomly di-vided into observation group and control group. Observation group was treated with 0.5 μg/kg dexmedetomidine by pumping and control group was treated with 0.125 ml/kg 0.9% sodium chloride injection by pumping 15 min before anesthesia,and conventional intravenous induction was conducted after 15 min. MAP,HR and bispectral index(BIS)in entering the room(T0),5 min after ad-ministration(T1),immediate intubation(T2),1 min after intubation(T3),5 min after intubation(T4),surgical skin incision(T5), immediate extubation(T6)and 5 min after extubation(T7),restlessness score,sedation score,recovery time and incidence of ad-verse reactions in 2 groups were observed. RESULTS:MAP and HR in observation group in T1-7 were significantly lower than T0 and control group,MAP and HR in control group in T2-7 were significantly high than T0 except that T1 was significantly lower than T0,the differences were statistically significant(P<0.05);BIS in 2 groups T1-7 was significantly lower than T0,the differences were statistically significant(P<0.05),however,there was no significant difference between 2 groups(P>0.05). Restlessness score in observation group was significantly lower than control group,sedation score was significantly higher than control group,the differ-ence was statistically significant(P<0.05),there was no significant difference in the recovery time between 2 groups(P>0.05). There were no obvious adverse reactions in 2 groups during treatment. CONCLUSIONS:Dexmedetomidine can effectively reduce the stress response and maintain cycle stability in the treatment of elderly patients with pelvic floor reconstructive surgery,with good safety.

Objective To investigate the factors affecting platelet transfusion efficiency.Methods A total of 102 cases of leuke-mia patients were recruited in the study,whose platelet count were measured before platelet transfusion and 1,24 h after platelet transfusion,then corrected count increment(CCI)values were calculated.By using CCI combined with clinical manifestations,the ef-ficacy of platelet transfusion were evaluated.The platelet antibody were detected before platelet transfusion.Depending on whether there were platelet antibodies,complications,the number of times of platelet transfusion,the types of platelet,patients were grouped and their platelet transfusion efficiency and CCI values were compared.Results The total effective rate of platelet transfusions were 71.6%(73/102 ).Invalid transfusion group had higher platelet antibody positive rate (17.2%)than effective transfusion group (2.7%),the difference were statistically significant(P <0.05).Among the groups of different transfusion times,the tansfusion effi-ciency was statistically different(P <0.05).With the increase of the number of times of platelet transfusion,the platelet transfusion efficiency decreased.Comparison between different types of platelets showed different platelet transfusion efficiency,which was sta-tistically significant(P <0.05).1 h and 24 h CCI value,platelet antibodies and whether patients with complications were related(P<0.05).1 h and 24 h CCI values were both associated with platelet antibodies and complications(P <0.05).Conclusion Platelet antibodies,complications,times of platelet transfusion and types of platelet transfusion are affecting factors of the transfusion effica-cy in patients with leukemia.

Objective: To explore the effective application of ventilation at prone position on patients with severe acute respiratory distress syndrome(ARDS) at high altitude. Methods: A total of 19 severe ARDS patients in ICU of Qinghai Province People's Hospital were enrolled from February in 2016 to February. in 2018, all of them ventilated at the prone position, several indicators were assessed:heart rate (HR), respiratory (R), mean arterial pressure (MAP); blood gas indicators: arterial oxygen partial pressure (PaO₂), inhaled oxygen concentration (FiO₂), carbon dioxide partial pressure (PaCO₂), blood oxygen saturation (SpO₂), oxygenation index (PaO₂/FiO₂), PH, lung compliance, PEEP and so on, which assessed before and 12h, 24h, 48h, 72h after the ventilation. Results: FiO₂ and PEEP significantly declined at 12 h, 24 h, 48 h, 72 h after ventilation at the prone position. HR, MAP, R, PaO₂, PaCO₂, SPO₂, PaO₂/FiO₂, pH and lung compliance significantly improved (F=32.30,24.73, P < 0.05). Conclusions It was an effective method for ARDS patients to improve the oxygenation status and vital signs at the plateau with ventilation used at the prone position and probably nursing intervention, which have clinical application value.