Objective To observe the clinical efficacy and its mechanism of Tongluoyuzufang Ⅰ in patients with diabetic foot (DF).Methods A total of 60 cases with DF was randomly divided into experimental group and control group,30 cases in each group.All patients were given insulin and/or hypoglycemic drugs and other Western medicine comprehensive treatment to control blood sugar steadily.The control group received methylcobalamin treatment,and the experimental group received Tongluoyuzufang Ⅰ therapy treatment based on the methylcobalamin treatment.Both groups were treated for 4 weeks for a course of treatment.The clinical efficacy,ankle-brachial index,nerve conduction velocity,hemorheology,blood lipid,serum cytokines and adverse reactions before and after treatment were compared after 3 courses of treatment.Results After treatment,the total effective rate was 90.0 ％ in the observation group,higher than that in the control group(x2 =5.963,P＜0.05).After treatment,the ankle-brachial index,nerve conduction velocity,hemorheology and blood lipid level in both groups were significantly improved(P＜0.05).After treatment,serum levels of tumor necrosis factor-α(TNF-α) and vascular endothelial growth factor(VEGF) in both groups were significantly decreased,while the levels of anti-thrombin Ⅲ (AT-Ⅲ) has increased(P＜0.05).The improvement of the indexes in the observation group was better than that in the control group(P＜0.05).There were no serious adverse events during treatment.Conclusion Tongluoyuzufang Ⅰ can significantly improve limb ischemia and nerve conduction function in patient with DF.

Objective:To investigate the status of caring burden, psychological resilience and psychological distress among spouses of dyskinesia stroke survivors and to explore the path relationship among three aspects.Methods:A total of 200 spouses of dyskinesia patients for 4 hospitals were investigated with Zarit Caregiver Burden Interview, Connor-Davidson Resilience Scale and Distress Thermometer from Jan 2017 to Dec 2017.Results:The overall caring burden was middle level, and 26.2%(49/187) was high, the score of Connor-Davidson Resilience Scale was 57.31±12.37, 70.6%(132/187) of all spouses with psychological distress. There was a significant difference in three aspects with different education level ( P<0.01). Whether there was a minor only child has an influence on the psychological resilience of the spouses( P<0.05). The score of Zarit Caregiver Burden Interview and Connor-Davidson Resilience Scale was negatively correlated( r value was -0.832, P<0.01). The score of Connor-Davidson Resilience Scale and Distress Thermometer was was positively correlated( r value was 0.867, P<0.01). The score of Zarit Caregiver Burden Interview and Distress Thermometer was negatively correlated( r value was -0.975, P<0.01). Furthermore,psychological resilience effected as a mediator in caring burden and psychological distress. Conclusions:The detection rate of care burden and psychological distress in the stroke patients with limb movement disorder are high, and the psychological resilience plays a mediating factor between them. The nursing staff should raise the awareness of the patient′s psychological nursing care while paying attention to the patients themselves. It can improve the physical and mental health and care ability of the spouse, improve the quality of life of the family.

The study aims to explore the effect of mesenchymal stem cells-derived exosomes (MSCs-Exo) on staurosporine (STS)-induced chondrocyte apoptosis before and after exposure to pulsed electromagnetic field (PEMF) at different frequencies. The AMSCs were extracted from the epididymal fat of healthy rats before and after exposure to the PEMF at 1 mT amplitude and a frequency of 15, 45, and 75 Hz, respectively, in an incubator. MSCs-Exo was extracted and identified. Exosomes were labeled with DiO fluorescent dye, and then co-cultured with STS-induced chondrocytes for 24 h. Cellular uptake of MSC-Exo, apoptosis, and the protein and mRNA expression of aggrecan, caspase-3 and collagenⅡA in chondrocytes were observed. The study demonstrated that the exposure of 75 Hz PEMF was superior to 15 and 45 Hz PEMF in enhancing the effect of exosomes in alleviating chondrocyte apoptosis and promoting cell matrix synthesis. This study lays a foundation for the regulatory mechanism of PEMF stimulation on MSCs-Exo in inhibiting chondrocyte apoptosis, and opens up a new direction for the prevention and treatment of osteoarthritis.
Animals ; Rats ; Apoptosis ; Chondrocytes ; Electromagnetic Fields ; Exosomes/physiology* ; Mesenchymal Stem Cells/metabolism*