Objective To build new management model for diabetic foot disease,and to observe the therapeutic effect of diabetic foot ulcers under the new model.Methods 52 patients with newly diagnosed diabetic foot disease were recruited and randomly divided into the experimental group (n=26) and the control group (n=26).While the experimental group adopted the interdisciplinary collaboration model (nurse-doctor jointed diabetes care management model),the control group were treated by the single department pattern.The foot ulcer healing rate,average length of stay (ALOS),fasting plasma glucose (FPG),2 h postprandial blood glucose (2 h PBG),glycosylated hemoglobin (HbA1c),and the patient awareness of the knowledge about diabetes self-management were respectively compared at 3 and 6 months.Results After receiving a multidisciplinary joint diagnosis and treatment,FPG and 2 h PBG of the patients from the experimental group [(6.44±2.93)mmol/L,(8.52± 2.09)mmol/L] were significantly decreased than those of the patients from the control group [(8.17±3.19)mmol/L,(10.77±3.27)mmol/L].HbA1c at 3 and 6 months (7.2％,7.7％) and ulcer recurrence rate (3.8％) after 6 months of patients of the experimental group were significantly reduced than those of the control group(8.9％,9.1％ and 15.4％).When compared with patients of the control group,patients of varying severity in the experimental group showed significantly shortened ulcer healing time and hospital stay.Moreover,patients from the experimental group showed statistically higher knowledge level and self management ability (P＜0.05).Conclusion Through interdisciplinary collaboration,podiatric medical joint management model can significantly improve cure rate,shorten ALOS,improve blood sugar control and patient satisfaction.

OBJECTIVE:To summarizethe application of polypropylene repair material in treating inguinal hernia.METHODS:Papers regarding polypropylene repair material in treating inguinal hernia published in VIP data between January 1998 and October 2009 were researched using key words of "polypropylene,inguinal hernia,and complication".Inclusion criteria Repairing inguinal hernia using polypropylene materials.Experimental results concerning related complications.Exclusion criteria:repetitive study and relatively old literature.A total of 17 documents were included in this study.RESULTS:Organic polymeric materials were clinical utilized in repairing inguinal hernia at the end of 1950s.The polypropylene patch was knitted by slngle fiber or multi-strands fibers of polypropylene,and exhibited single layer network structures,which is preferred material for repairing abdominal-wall defect.Compared with other unabsorble materials,the polypropylene patch had following advantage:obviously stimulating fibroplasias; easy permeated by fibrous tissues and embedded into tissues; maintaining highly tensile strength following implantation; and relative low cost.Few material-related complications occurred following repairing,mainly presented with infection,serofiuid swelling,ankylenteron,intestinal leakage,material displacement,as well as material shrinkage.CONCLUSION:Polypropylene material is an ideal repair material due to good histocompatibility,few rejections,and anti-infection capability.It leads to easy operation,small trauma,fast recovery and few complications in repairing defects.

Aim To research into the effect of diltiazem on cytokines expression in mononuclearcells induced by concanavalin A.Methods Ficoll density gradient centrifugation was used to separate the mononuclearcells from rat's spleen.There were 3 groups including control, Con A, diltiazem-Con A group in the study.The cytokines expressions in supernatant were detected by ELISA.Results Compared with control, IL-10, TNF-α, IL-6 were increased significantly in Con A group with low level IL-1β and non level TGF-β_1.But in diltiazem-Con A group, IL-10, TNF-α, IL-6 were decreased significantly compared with Con A group.Conclusion Diltiazem inhibits IL-10, TNF-α, IL-6 expressions in mononuclearcells induced by Con A.

Aim To explore the cardiac cytokine expression in rat model of myocardial calcium overload, and the intervention from diltiazem.Methods The intracellular Ca~(2+) overload was induced by the isolated rat heart subjected to 5 min Ca~(2+) depletion and 30 min Ca~(2+) repletion (Ca~(2+) paradox) by the Langendorff technique.There were five groups in this study, including Ca~(2+) overload group, normal control group, Ca~(2+) depletion control group, Ca~(2+) overload-diltiazem group, and Ca~(2+) depletion-diltiazem group.The views of myocardial pathology and ultrastruction were observed by electron microscope and light microscope respectively. The cardiac intracellular [Ca~(2+)]_i was detected by atom spectrophotometer. The expression of TNF-α, IL-1β, L-6, TGF-β1, and IL-10 was detected by RT-PCR method.Results In Ca~(2+) overload group, few inflammatory cells were found in myocardium under the light microscope. And the views of electron microscope presented that cardiocyte membranes, nucleolus, and mitochondria were disorganized obviously.Compared with normal control group, the inflammatory cytokines as TNF-α, IL-1β, and IL-6 were increased significantly whereas there was nearly no difference of the expression of TGF-β1 and IL-10 in Ca~(2+) overload group.Ca~(2+) overload-diltiazem group showed that TNF-α, IL-1β, and IL-6 were decreased significantly. There were no statistical differences in the structure of myocardium, intracellular [Ca~(2+)]_i, and cardiac cytokines expressions in the three control groups, including normal control group, Ca~(2+) depletion control group and Ca~(2+) depletion-diltiazem group.Conclusions Instead of TGF-β1 and IL-10, the expression of TNF-α, IL-1β, and IL-6 is increased obviously in myocardium of calcium paradox model. Diltiazem can inhibit the cardiac expression of TNF-α, IL-1β, and IL-6 induced by myocardial calcium overload.

Aim To research the effect of diltiazem on cytokine expression and inflammatory cell activity in rat heart with ischemia/reperfusion.Methods The rats, underwent ischemia reperfusion, were divided into three groups:diltiazem group(D group),ischemia/reperfusion group (I/R group),and sham group (Sgroup).Echocardiogram was detected at 1,2,4 weeks after operation. RT-PCR was used to detect the inflammatory cytokines as IL-1β,TNF-α, IL-6 and anti-inflammatory cytokines as IL-10,TGF-β.Results Compared with I/R group,EF were increased and LVM, IL-β,TNF-α,IL-6 reduced significantly in D group.There was no significant/difference for IL-10 and TGF-β in three groups .Conclusion Diltiazem inhibits IL-1β,TNF-α, IL-6 expressions and inflammatory cell infiltration in rat heart with ischemia reperfusion.

Objective:To explore the effects of diltiazem on ventricular remodeling and inflammation in rat heart following acute myocardial infarction(AMI).Methods:The model of AMI rats was randomly divided into diltiazem group(D group)and control group(AMI group),besides another group of sham operation(S group).The data of ejection fraction(EF) and the left ventricular mass(LVM)were examined with echocardiography,and leukocyte infiltration in situ was analyzed on the HE staining slices,with the expression of proinflammatory cytokines(IL-I?,IL-6,TNF-?)detected by RT-PCR at 1d,3d,1w,2w and 4w intervals after AMI.Results:The results from echocardiography showed that EF increased(73.7?3.1% vs 61.0?2.6%)and LVM decreased(0.81?0.12g vs 0.92?0.12g),both significantly in D group at 4w,compared with those of the AMI group(P

Ca2+ activity has been found to associate with the immunity and inflammation within cardiovascular diseases in recent years. Researchers have begun to focus on the effect of calcium channel blockers, which could modify the immunity and inflammation. This review presented the mechanism underlying the concentration and activation of Ca2+ influenced the response of immunity and inflammation and how calcium channel blockers interfered with it, which may have potential in treatment of cardiovascular diseases.

Objective To evaluate the regulatory effect of OX40 co-stimulatory signal on the expression of Foxp3 in inductive regulatory T cells (iTreg) in vitro.Method CD4+ CD25+ naive T cells were isolated from C57BL/6 mouse lymphocyte suspension by MASC CD4+ CD25+ regulatory T cell isolation kit.Inductive Tregs were generated by stimulation of naive T cells in the presence of transforming growth factor beta (TGFβ1),anti-CD3,anti-CD28 and IL-2.The regulatory effect on iTregs was shown by use of OX40 stimulation monoclonal antibody (OX86) or control antibody.Using flow cytometric analysis (FACS),we examined the antibody-based identification of Tregs surface markers CD4 and CD25,along with the intracellular activation marker FoxP3.Results The ratio of CD4+ CD25+ nTregs isolated from mouse lymphatic node was (5.0 ± 0.4)％ vs.(71.8 ± 13.4)％ of TGFβ1-driven iTregs.The ratio of CD4+ CD25+ Tregs was (80.0 ± 1.6) ％ in OX40 stimulation McAb group vs.(86.0 ± 1.4)％ in control antibody group.Furthermore,the expression of Foxp3 was (59.2 ± 0.7) ％ in OX40 stimulation McAb group vs.(70.0 ± 0.8) ％ in control antibody group (P＜0.05).Conclusion TGFβ1-dependent protocol may induce the conversion of naive CD4+ T cells into CD25+ Foxp3+ iTregs.OX40 stimulation can down-regulate the expression of Foxp3 in CD4+ CD25 + iTreg significantly.Thus OX40 molecular may become an attractive target in Tregs-induced transplant tolerance.Further study should be performed to increase the suppressive activity of iTregs through blockade of OX40 signal.

Objective To investigate the awareness of non-respiratory physicians to the diagnosis and medical treatment of chronic obstructive pulmonary disease.Methods A cross-sectional study was conducted in 370 non-respiratory physicians from 9 hospitals of Beijing.All the subjects were required to complete a self-administrated questionnaire.Chi-square test and analysis of variance were used for data analysis.Results The physicians in the first-grade hospitals had lower awareness of COPD than those in the second-or third-grade hospitals (57.5 ± 17.1,67.1 ± 15.0 and 68.9± 13.6,respectively; F=18.75,P＜0.05).Moreover,the residency and attending physicians were found to have lower awareness of COPD than chief physicians (61.4± 12.9,61.4± 15.0 and 79.3± 13.2,respectively; F=34.82,P＜0.05).Conclusion The medical knowledge on the management of COPD might be poor among non-respiratory physicians in Beijing.Primary healthcare workers and non-respiratory physicians should pursue intensive COPD training in the furture.

Asthma ; physiopathology ; Child ; Female ; Humans ; Male ; Maximal Expiratory Flow-Volume Curves ; Oscillometry ; methods ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; Respiratory Function Tests