Objective To investigate the risk factors associated with prolonged hospitalization in patients diagnosed with diabetic foot ulcers(DFU),to develop a predictive model,and to conduct internal validation of the model.Methods The clinical data of DFU patients admitted to West China Hospital,Sichuan University between January 2012 and December 2022 were retrospectively collected.The subjects were randomly assigned to a training cohort and a validation cohort at a ratio of 7 to 3.Hospital stays longer than 75th percentile were defined as prolonged length-of-stay.A thorough analysis of the risk factors was conducted using the training cohort,which enabled the development of an accurate risk prediction model.To ensure robustness,the model was internally validated using the validation cohort.Results A total of 967 inpatients with DFU were included,among whom 245 patients were identified as having an extended length-of-stay.The training cohort consisted of 622 patients,while the validation cohort comprised 291 patients.Multivariate logistic regression analysis revealed that smoking history(odds ratio[OR]=1.67,95%confidence interval[CI],1.13 to 2.48,P=0.010),Wagner grade 3 or higher(OR=7.13,95%CI,3.68 to 13.83,P＜0.001),midfoot ulcers(OR=1.99,95%CI,1.07 to 3.72,P=0.030),posterior foot ulcers(OR=3.68,95%CI,1.83 to 7.41,P＜0.001),multisite ulcers(OR=2.91,95%CI,1.80 to 4.69,P＜0.001),wound size≥3 cm2(OR=2.00,95%CI,1.28-3.11,P=0.002),and white blood cell count(OR=1.11,95%CI,1.05 to 1.18,P＜0.001)were associated with an increased risk of prolonged length of stay.Additionally,a nomogram was constructed based on the identified risk factors.The areas under the receiver operating characteristic(ROC)curves for both the training cohort and the validation cohort were 0.782(95%CI,0.745 to 0.820)and 0.756(95%CI,0.694 to 0.818),respectively,indicating robust predictive performance.Furthermore,the calibration plot demonstrated optimal concordance between the predicted probabilities and the observed outcomes in both the training and the validation cohorts.Conclusion Smoking history,Wagner grade≥3,midfoot ulcers,posterior foot ulcers,multisite ulcers,ulcer area≥3 cm2,and elevated white blood cell count are identified as independent predictors of prolonged hospitalization.Therefore,it is imperative that clinicians conduct a comprehensive patient evaluation and implement appropriate diagnostic and therapeutic strategies to effectively shorten the length of stay for DFU patients.

Objective To explore the characteristics of baseline inflammatory markers in diabetic foot patients and their relationship with the prognosis of diabetic foot ulcers.Methods The clinical data of diabetic foot patients(n=495)admitted to West China Hospital,Sichuan University since 2016 were retrospectively collected through the hospital electronic medical record system to analyze the characteristics of inflammatory markers and their relationship with the prognosis of diabetic foot ulcers.Results White blood cell count(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)levels were significantly higher in patients defined as grade 4 on the Wagner Scale than those in patients defined as grade 0-3 on the Wagner Scale.Neutrophil percentage(NE％)was higher in Wagner grade-4 patients than those in Wagner grade-0 and grade-1 patients and higher in Wagner grade-3 patients than those in Wagner grade-0 patients.NE％,CRP,PCT,and IL-6 levels were positively correlated with the severity of diabetic foot,with the respective odds ratio(OR)at 95％confidence interval(CI)being 1.038(1.019-1.056),1.019(1.012-1.026),8.225(2.015-33.576),and 1.017(1.008-1.025).Using Wagner grade-0 patients as the reference,patients with higher WBC were more likely to progress to Wagner grade 2,3,and 4,with the respective OR(95％CI)values being 1.260(1.096-1.447),1.188(1.041-1.356),and 1.301(1.137-1.490);patients with higher ESR were more likely to progress to Wagner grade 3 and 4,with the respective OR(95％CI)values being 1.030(1.006-1.054)and 1.045(1.019-1.071).Baseline ESR(P=0.008),CRP(P=0.039),and IL-6(P=0.033)levels were lower in patients who had received antibiotics prior to their admission than those in patients who had not received antibiotics before admission.The levels of WBC,NE％,ESR,PCT,and IL-6 were lower in the full recovery group than those in the group of patients who did not respond to treatment.The higher the levels of NE％and IL-6,the worse the prognosis of diabetic foot ulcers became,with the respective OR(95％CI)values being 1.030(1.010-1.051)and 1.008(1.002-1.013).Conclusion The severity of diabetic foot ulcers increased with the rise in baseline levels of inflammatory markers.Elevated baseline NE％and IL-6 levels suggest a poor prognosis.Our findings suggest that early assessment of diabetic foot infection and standardized antibiotic therapy should be implemented to improve the prognosis.

This study aimed at the molecular mechanism of Cordyceps sinensis polysaccharide-A(CPS-A) on angiotensin (Ang Ⅱ)-induced injury of L02 cells.The effect of AngⅡ and CPS-A on the proliferation of L02 cells was analyzed by MTT assay.PCR,Real-Time PCR and Western blot were also employed to determine the expression of IL-1β,AT1R,AT2R,NF-κB p65,TNFα and other inflammatory factors at mRNA and protein levels.The results showed that Ang Ⅱ and CPS-A could inhibit the proliferation of L02 cells by 1 × 10-5 mol/L and 200 μg/ mL,respectively.PCR,Real-Time PCR and Western blot showed that CPS-A could significantly down-regulate IL-1 β,TNF-α,NF-κB and AT1R.CPS-A has a good protective effect on AngⅡ-induced L02 cell injury.

Objective To understand the distribution of infectious pathogens and antibiotics resistance from children patients with dacryocystitis .Methods Lacrimal secretion specimens of the outpatients with dacryocystitis were identified for bacteria using automatic instrument VITEK2 and API systems .Antibiotics sensitivity tests were detected by using VITEK 2 instrument and K‐B method .Results There were 800 strains of pathogenic bacteria isolated from eye secretions .Gram positive bacteria were 502 strains ,accounting for 62 .75% ,mainly of which were Streptococcus pneumoniae ,Streptococcus viridans and Staphylococcus au‐reus .Gram negative bacteria were 295 strains ,accounting for 36 .88% ,mainly of which were Klebsiella pneumoniae and Pseudo‐monas aeruginosa .There were 3 strains of Candida albicans ,accounting for 0 .37% .Streptococcus pneumonia and Streptococcus viridans were highly resistant to tobramycin ,erythromycin and clindamycin .At the same time ,Staphylococcus aureus resistant rate to penicillin was 99 .3% .The resistant rate of Klebsiella pneumoniae to ampicillin was 98 .6% ,but susceptible to the third generation cephalosporins and tobramycin ,and completely susceptible to imipenem .Most of children patients with dacryocystitis were from 1 month to 1 year old .Conclusion Children patients with dacryocystitis were mainly distributed in infants .Antibiotic resistant rate of pathogenic bacteria might be high .