Objective To study the expression of S1RT1 in breast cancer with diabetes mellitus,and analyze the correlation between SIRT1 and p53,and analyze blood lipid differences in breast cancer tissue without diabetes mellitus and breast cancer tissue with diabetes mellitus,and to research its relation with type 2 diabetes mellitus and assesse the clinical value.Methods Immunohistochemistry was used to examine the expressions of SIRT1 and p53 in 30 breast cancer patients with diabetes mellitus and 30 breast cancer patients without diabetic mellitus,and their correlation was analyzed.Results The positive rate of SIRT1 in breast cancer tissue with diabetes mellitus was significantly lower than that in breast cancer tissue without diabetic mellitus(P ＜0.05).In SIRT1 positive tissue,the expression level of p53 was significantly higher than that in SIRT1 negative tissue(P ＜ 0.05 ).The expression of SIRT1 was significantly positively related with p53 expression in breast cancer tissue with diabetes( P ＜ 0.05).BMI and TG in breast cancer group with diabetes mellitus were significantly higher than those in breast cancer group without diabetic mellitus( P ＜ 0.05 ),but HDL was lower( P =0.05 ).However,CHO and LDL had no significant differences in both groups( P ＞0.05 ).Conclusions SIRT1 is up-regulated in breast cancer,but the posltive rate of SIRT1 in breast cancer tissue with diabetes mellitus is significantly lower than that in breast cancer tissue without diabetic,and is associated with the progression of diabetes mellitus.SIRT1 protein is significantly positively correlated to p53 expression and it may be involved in the adjustment process of blood lipids,SIRT1 might be a new biological target in diabetes and breast cancer.

Serum matrix metalloproteinase-9 (MMP-9)and advanced glycation end products (AGE)levels were measured in the diabetic patients with or without foot problems as well as in healthy retired people. In diabetic patients serum MMP-9 and AGE levels were significantly higher than those in healthy subjects. Median MMP-9 level in patients with diabetic foot was higher than that in diabetic patients without foot ulcers. Increased serum MMP-9 in diabetes might predict occurance of diabetic foot and poor wound healing of the foot ulcers.

Objective:To investigate the clinical effect of primary debridement combined with external fixation and secondary sequential internal fixation in the treatment of Rüedi-Allg?wer Ⅱ Pilon fracture.Methods:The clinical data of 36 patients with Rüedi-Allg?wer Ⅱ Pilon fracture from January 2017 to December 2019 in the People′s Hospital of Quzhou City, Zhejiang Province were retrospectively analyzed. Among them, 16 patients were treated with primary debridement with calcaneal traction and secondary internal fixation (internal fixation group), and 20 patients were treated with primary debridement combined with external fixation and secondary sequential internal fixation (combined fixation group). The operative time, intraoperative blood loss, postoperative drainage volume, time of full weight bearing, fracture healing time, American Society of Foot and Ankle Surgery (AOFAS) posterior ankle foot function score, visual analogue score (VAS), reduction quality (Burwell-Charnley score) and incidence of complication were compared between 2 groups.Results:The patients were followed up for 6 to 18 (10.7 ± 2.8) months. The time of full weight bearing and fracture healing time in combined fixation group were significantly shorter than those in internal fixation group: (7.2 ± 1.9) weeks vs. (9.4 ± 2.1) weeks and (3.4 ± 0.8) months vs. (4.1 ± 1.2) months, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in operative time, intraoperative blood loss and postoperative drainage volume between 2 groups ( P>0.05). There was no statistical difference in AOFAS posterior ankle foot function score 1 month after surgery between 2 groups ( P>0.05); the AOFAS posterior ankle foot function score 3 and 6 month after surgery in combined fixation group was significantly higher than that in internal fixation group: (86.4 ± 1.7) scores vs. (75.7 ± 1.2) scores and (93.6 ± 2.2) scores vs. (82.1 ± 1.9) scores, and there was statistical difference ( P<0.05). There was no statistical difference in VAS between 2 groups ( P>0.05). There were no statistical differences in rate of reduction satisfaction and incidence of complication between 2 groups ( P>0.05). Conclusions:The primary debridement combined with external fixation and secondary sequential internal fixation for the treatment of Rüedi-Allg?wer Ⅱ Pilon fracture is conducive to the rapid recovery, which is worthy of extensive clinical promotion.