Objective To investigate the clinical value of neutrophil-lymphocyte ratio (NLR) in postmenopausal patients with type 2 diabetes mellitus (T2DM). Methods A total of 128 newly diagnosed T2DM female patients were randomly recruited from the Zhujiang Hospital of Southern Medical University from March to September 2015. According to the physiological state, the patients were divided into menopausal group (n=66) and non-menopausal group (n=62). Fifty-six healthy females were chosen as the control group. The values of blood pressure, blood lipid, fasting plasma glucose (FPG), fasting insulin (FINS) and white blood count (WBC), neutrophil count, percentage of neutrophils,lymphocytes count, and percentage of lymphocytes were detected and compared between three groups. The NLR and the HOMA insulin resistance index (HOMA-IR) were calculated. Results Age, systolic blood pressure (SBP), triglyceride (TG), FINS, percentage of neutrophil, NLR, HOMA-IR were significantly higher in menopause group than those of control group and non-menopause group (P<0.05). There were no significant differences in diastolic blood pressure (DBP) and FPG between menopause group and non-menopause group, but both were significantly higher than those of control group (P < 0.05). There were no significant differences in total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), WBC and HbA1c between three groups (P>0.05). There was no linear correlation between NLR and HOMA-IR (rs=0.015, P > 0.05), HbA1c (r=0.030, P > 0.05). Conclusion NLR is of a certain significance in the assessment of inflammatory status and IR levels in postmenopausal women with T2DM, which may be related to the changes of autonomic nervous system.

Objective:To investigate the effect of lateral tibial periosteum distraction on diabetic foot and vasculitis foot.Methods:A retrospective analysis of 13 patients (16 feet) who received lateral tibial periosteal distraction between June 2019 and May 2020 were included in the study. 9 males and 4 females; aged 39-77 years (average 66 years); left foot 7 cases, right foot 9 cases. 5 cases were patients with diabetic foot, 1 case was diabetic foot with arteriosclerosis obliterans, 2 cases were thromboembolic vasculitis, and 5 cases were arteriosclerosis obliterans. The tibial periosteum was dissected and a distraction device was placed. In the 3 patients with foot ulcers, tibial periosteum distraction devices were placed on the severer side. The periosteal distraction began on the third day after surgery, about 0.75 mm/d, the adjustment was done usually in two weeks. Two weeks later, the stretch plate was removed surgically. The followings were evaluated: visual analogue scale (VAS) pain score, foot peripheral oxygen saturation, foot capillary filling test, lower extremity arterial CT angiography (CTA), etc.Results:All 13 patients were followed up for 2-12 weeks, with an average of 3.85 weeks. VAS pain score: the average pain score of 13 patients with preoperative foot pain was 5.31±1.84 (range, 2-9) points, and 2 weeks after surgery, the average value was 2.46±1.39 (range, 1-6) points with statistical significance ( t=6.124, P<0.001) ; peripheral foot oxygen saturation: the average preoperative blood oxygen saturation of 12 patients was 87.83%±14.83% (range, 50%-98%), 1 patient was not detected before surgery, and 2 weeks after operation, the average blood oxygen saturation was 92.33%±7.91% (range, 75%-99%). There was no significant difference between them ( t=1.124, P=0.285). The foot skin temperature of 10 patients was 35.68±0.85 ℃ (range, 34.00-36.60 ℃) before surgery and 36.23±0.46 ℃ (range, 35.50-36.90 ℃) after surgery, and the difference was statistically significant ( t=3.197, P=0.008) . Capillary filling test: 2 weeks after operation, the capillary filling response was significantly improved. All 13 patients had improved CTA of both lower extremity arteries before operation, and 11 patients had CTA taken back after two weeks of operation. Compared with preoperative CTA, new vascular network was found in the operation limb. In addition to 1 patient with thromboangiitis obliterans (mainly suffering from foot pain, no wound symptoms), 2 of 12 patients with heart failure, renal failure and other basic diseases did not heal, and the wounds of the other 10 patients had improved significantly 1 month later. Conclusion:Lateral tibia periosteum distraction can be used to treat chronic ischemic diseases of lower extremities with satisfactory postoperative results.