Objective To identify high?risk groups of Charcot foot( CN) in the people with diabetic foot neuropathic ulcerations( NU) . Methods Twenty cases patients with CN who were diagnosed in General Hospital of the Chinese People Air Force from June 2008 to June 2013 and 58 patients with diabetic neuropathic ulcer who were hospitalized from January 2010 to December 2011 and followed up until June 2014 without foot deform?ity were retrospectively analyzed. All patient's general condition, examination and laboratory results, diabetic chronic complications,complication,diabetes distribution of foot ulcers,and plain features. Results There were no statistically significant differences in terms of patients' average age, sex ratio, proportion of smokers, BMI, HbA1c,blood lipid,dorsalis pedis artery diameter and diabetic nephropathy (Ⅲ?Ⅳperiod) ,chronic kidney dis?ease stage 3 above,proliferation diabetic retinal pathological changes,the prevalence of coronary heart disease between the two groups(P>0. 05). Compared with NU group,patients with single high proportion(40. 00%(8/20) vs. 10. 34%(6/58)),Short duration of diabetes((12. 37±5. 64) years vs. (14. 27±8. 04) years),Feet long numbness(6(5,9) years vs. 4(2,20) years),low rate of hardening of the arteries narrow(ABI<0. 9)( 0 ( 0/20) vs. 39. 66%( 13/58) ) ,high recurrent diabetic foot ulcer prevalence( 70. 00%( 14/20) vs. 25. 86%( 15/58)),more patients with diabetes mellitus autonomic neuropathy(75. 00%(15/20) vs. 39. 66%(23/58)),less combined with hypertension ( 25. 00%( 5/20 ) vs. 58. 62%( 34/58 ) ) , the differences were significant ( t orχ2=6. 981,2. 259,4. 068,3. 887,12. 405,7. 436,6. 724;P<0. 05) . Diabetic foot wound distribution on mesopodi?um of CN group and NU group was 36. 84%(7/19),6. 90%(4/58) respectively,the difference was significant (χ2=11. 443,P=0. 003) . Diabetic foot amputation rate( Wanger 4,5 grade) of CN group and NU group was 44. 44%(4/9),6. 90%(2/29) respectively,the difference was significant(χ2=4. 732,P=0. 020). Conclusion The characteristics of high?risk groups of diabetics Charcot foot in the people with diabetic foot neuropathic ulcerations are middle aged,no foot of ischemia,combine the diabetic autonomic neuropathy and the feet always with recurrent ulcers.

Objective To investigate the prevalence of depression among the patients with diabetic foot and analyze the influence factors. Methods One hundred and ten patients with diabetic foot were inquired and assessed with patient health questionnaire for self-administered measurement (PHQ-9), meanwhile, the demo-graphic data, metabolic data and diabetes behaviors were also investigated. Results Prevalence of depression was 47.3%. Logistic regression analysis showed that alternation of diarrhea and astriction (OR = 6.901, P =0.017) and formication (OR = 23.401, P = 0.009) were risk factors, and medical insurance (OR = 0.217, P =0.007) was a protective factor. Conclusions Depression is a frequent mental disorder in patients with diabet-ic foot and its influence factors include alternation of diarrhea and astriction , formication and medical insur-ance .

Objective To investigate the factors related to healing of severe diabetic foot gangrene (Wagner 4 class above) infected with pan-resistant Pseudomonas aeruginosa,and to guide clinical treatment.Methods Forty-nine hospitalized patients with diabetic foot gangrene (Wagner 4 class above) from January 2009 to July 2014 were enrolled.The affected foot wound secretion culture was pan-resistant Pseudomonas aeruginosa.According to the wound healing time,they were divided into wound healing group (26 cases,healing time ≤ 3 months) and wound un-healing group (23 cases,healing time ＞ 3 months).The general information,clinical indicators and treatment between two groups were compared,and the factors related to healing was analyzed by multi-factor unconditioned Logistic regression analysis.Results Compared with those in wound un-healing group,the blood flow volume of dorsal artery of affected foot and negative pressure attraction rate in wound healing group were higher:(43.59 ± 2.71) ml/min vs.(23.14 ± 5.39) ml/min,76.9％ (20/26) vs 47.8％(11/23),and the urinary micro-albumin was lower:(67.01 ± 3.32) mg/L vs.(234.03 ± 6.71) mg/L.There were significant differences (P ＜ 0.05 or ＜ 0.01).Multi-factor unconditioned Logistic regression analysis showed that the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa were the blood flow volume of dorsal artery of affected foot (regression coefficient was-5.551,P =0.001),urinary micro-albumin (regression coefficient was 0.127,P =0.007) and negative pressure attraction (regression coefficient was-2.244,P =0.042).Conclusion The blood flow volume of dorsal artery of affected foot,urinary micro-albumin,negative pressure attraction are the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa.

In order to obtain liposomes with properties of heptocyte-specificity and pH-sensitivity,four galactosylated derivatives were synthesized. A series of liposomes were prepared by mixing the galactosylated derivatives with DC-chol/DOPE respectively. The liposome 18-gal was proven to have favorable gene transfer efficiency to human hepatoma HepG2 cells, which was significantly inhibited in the presence of galactose solution, indicating that the liposomal transfection activity was mediated by asialoglycoprotein receptors. The liposome showed prominent pH-sensitivity and low cytotoxicity. Its optimum gene transfer conditions were also determined. The results showed that the liposome may be developed as a potential hepatocyte targeting pH sensitive delivery system for nucleic acid drugs.

Objective To establish a diagnostic scoring system for coronary artery disease(CAD)in patients with diabetic foot(DF)and evaluate its application efficiency. Methods The clinical data of 445 DF inpatients were analyzed retrospectively in this case?control study. These patients were divided into the CAD group(n=372,DF with CAD)and the control group(n=73,DF without CAD)according to the presence or absence of CAD. Risk factors were screened from related clinical factors examined through multiple logistic regression analysis for CAD in patients with DF and were assigned according to odds ratio(OR)to establish the scoring system for diagnosis of CAD in patients with DF. Application efficiency of the di?agnostic scoring system was tested by calculating area under the receiver operating characteristic(ROC)curve. Results The multiple logistic re?gression analysis showed that risk factors for CAD in patients with DF were age,male sex,the duration of diabetes≥10 years,the ankle?brachial in?dex(ABI)≤0.9,body mass index(BMI)≥25 kg/m2 and chronic renal insufficiency. According to ORassigned age(<50 years=0,50?64 years=1,≥65 years=2),sex(female=0,male=2),the duration of diabetes(<10 years=0,≥10 years=3),ABI(>0.9=0,≤0.9=2),BMI(<25 kg/m2=0,≥25 kg/m2=3)and chronic renal insufficiency(absent=0,present=3)scores. Area under the ROC curve of the diagnostic score scheme was 0.758(0.682?0.835),the standard error was 0.039,and the point of the diagnosis of CAD was 7. Conclusion The scoring system established in the study is efficacious,simple and practical,which provides an important reference for CAD in patients with DF.

Objective To make a cross-sectional assessment of the morbidity of lower extremity arterial disease (LEAD) in inpatients with type 2 diabetes mellitus (T2DM) and to analyze its risk factors,thus providing evidence for its clinical prevention.Methods We enrolled 664 inpatients with T2DM from June 2012 to June 2013 and collected clinical data,including age,gender,duration of diabetes,body mass index,smoking,fasting & postprandial blood glucose levels,glycosylated hemoglobin,serum lipids,renal function,fibrinogen,neck ultrasonography,lower extremity vascular ultrasound,ankle brachial index and treatment records.Logistic multiple regression analysis was conducted to identify risk factors for LEAD.Results A total of 247 cases met the diagnostic criteria for LEAD,with morbidity reaching to 37.2％.The percentages of morbidity in patients with different durations of diabetes were:23.12％ (≤ 5 years),27.95％ [(5 10) years],38.71％ [(1015) years],51.16％ [(15-20) years],62.34％ (≥ 20 years).The differences were statistically significant (P＜0.05).Of the patients in the LEAD group,73.2 ％ were treated with antihypertensive medications and 54.6％ were treated with statins.The goal attainment rates for total cholesterol,lowdensity lipoprotein cholesterol,high-density lipoprotein cholesterol and triglycerides were 56.3％,39.3％,47.4％ and 61.5％,respectively,in the LEAD group and 45.1％,34.5％,35％,and 49.4％,respectively,in the non-LEAD group.With the exception of the rates for low density lipoprotein cholesterol,the rates between the two groups are statistically significant (P＜0.05).Significant differences in age,BMI,blood pressure,coronary heart disease,cerebrovascular disease,carotid intima-media thickness,carotid artery plaque,and carotid artery stenosis were also observed between the two groups (P＜0.05 for all parameters).Logistic multiple regression analysis revealed that age,history of diabetes,cerebrovascular disease,carotid artery plaque,and carotid artery stenosis were risk factors for LEAD.Conclusions The morbidity of LEAD is 37.2％ in type 2 diabetic patients.Age,history of diabetes,cerebrovascular disease,carotid artery plaque,and carotid artery stenosis are risk factors for LEAD,while traditional risk factors for atherosclerosis,including hypertension,levels of cholesterol and low-density lipoprotein cholesterol,smoking,and non-drug intervention,are risk factors for LEAD in type 2 diabetic patients.

Objective To determine the efficacy of individual cognitive training (CT) in the treatment of cognitive and neuropsychiatric symptoms in patients with mild to moderate Alzheimer disease ( AD). Methods A randomized, controlled, rater-blind clinical trial recruited 32 AD patients. AH patients were assigned to a CT group (n = 16) or a control group (a time and attention control, n = 16) for 10 weeks. All outcome measures were administered at baseline and follow-up. The cognitive status was evaluated using the Mini Mental State examination (MMSE) , a clock-drawing test (CDT) , Fuld's object memory evaluation (FOME) , a rapid verbal retrieval (RVR) , digit span assessments (DS) , block designing (BD), and the A version of the trail making test (TMTA). The patients' functional status was evaluated using an activities of daily living (ADL) scale. Any psychological and behavioural disorders were evaluated with the Neuropsychiatry Inventory ( NPI). Results Patients receiving CT showed greater average improvements in NPI total score, TMT-A score and MMSE total score than the controis at week 10. There was no statistically significant benefit for CT-treated patients in terms of ADL score. Conclusions Cognitive training can raise the NPI total scores and MMSE total scores of patients with mild to moderate AD.

Objective To enhance the protective immunity effects against Schistosoma japonicum infection by priming with cocktail DNA vaccines and boosting with cocktail protein vaccines in infected BALB/c mice.Methods Plasmids and proteins for immunization were prepared and diluted in no bacterial saline solution to final concentration of 1.5 mg/ml,and mixed with pcDNA3.1-SjC23,pcDNA3.1-SjCTPI,pcDNA3.1-(CDR3)6 plasmid DNAs by equal volume to form the cocktail DNA vaccine,and also mixed with recombinant proteins SjC23-HD,SjCTPI,and NP30 by equal volume to form the cocktail protein vaccine.Seventy female BALB/c mice of 4-5 weeks old were randomly divided into 5 groups(A,B,C,D,E).In Group A(control group),each mouse was immunized with 100 ?l saline solution by intramuscular(i.m.);in Group B(pcDNA3.1 control group),each mouse was immunized(i.m.)with 100 ?l pcDNA3.1 for three times at week 0,3,6;in Group C(pcDNA3.1 and cocktail protein group),each mouse was immunized(i.m.)with 100 ?l pcDNA3.1 for three times at week 0,3,6 and immunized with 100 ?l mixed protein vaccines plus 100 ?l FCA by subcutaneous at week 9;in Group D(cocktail DNA vaccines group),each mouse was immunized(i.m.)with 100 ?l mixed DNA vaccines for three times at week 0,3,6;in Group E(cocktail DNA vaccines plus cocktail proteins),each mouse was immunized(i.m.)with 100 ?l mixed DNA vaccines for three times at week 0,3,6 and immunized with 100 ?l mixed protein vaccines plus 100 ?l FCA by subcutaneous at week 9.Four weeks after the last DNA immunization or two weeks after protein boosting,all the mice were challenged with(40?1)cercariae of Schistosoma japonicum by abdominal skin penetration at the same time.Forty-two days post-challenge,the mice were sacrificed and perfused,and the numbers of recovered worms and eggs in liver were counted.The blood was collected from the tail veins of all the mice two days before the first immunization and challenge,respectively,the serum was prepared for detection of IgG,IgG1 and IgG2a.Two days before the challenge,the spleen cells of two mice from each group were cultured and stimulated with ConA and soluble egg antigen(SEA),and the supernatant was collected for detection of IL-2,IL-4 and IFN-?.Results The worm reduction rates in Group C,D and E were 17.70%,32.88% and 45.35%,respectively,compared with the control group.The worm reduction rates in Group D and E were significantly higher than that in Group C(P

Objective To construct, express and purify human scFv antibody (S1) against the recombinant SAG1 of Toxoplasma fused to magainin, and observe its protective effect against Toxoplasma in infected mice. Methods The S1 scFv antibody gene amplified from phagmid S1/pIT-2 fused to magainin was cloned into procaryotic expression vector pET-32c. The recombinant plasmid S1M/pET-32c proved by DNA sequencing was transformed into E.coli BL21, and induced for fusion expression of S1M with IPTG. The expressed S1M was purified with Ni 2+ chelating HiTrap HP column and detected with SDS-PAGE. The effect of reduction of infection of Toxoplasma was observed through in vivo and in vitro experiments in mice. Results The fused gene of S1 and magainin was successfully cloned into procaryotic expression vector pET-32c proved by DNA sequencing. The recombinant S1M protein about 43 kDa was expressed in E.coli as inclusion body, and prepared with Ni 2+ column purification. Tachyzoite of Toxoplasma preincubated with S1M showed decreased infectivity in mice, the result of in vivo experiments showed that mice treated with S1M hadlonger survival time than the mice untreated. Conclusion The purified targeting antimicrobial peptide S1M could reduce the infectivity of tachyzoites of Toxoplasma in a certain extent and has a potential value for biological therapy of toxoplasmosis; otherwise, the constructed targeting antimic robial peptide S1M also provides a new model for biological therapy of toxoplasmosis.