Objective To explore the predictive value of combined detection of serum C-peptide(C-P),forkhead box O transcription factor-3a(FOXO3a),and metallothionein(Metrnl)for diabetic peripheral neuropathy(DPN).Methods A total of 210 patients with type 2 diabetes mellitus(T2DM)in Kailuan General Hospital were enrolled in this study from May 2021 to May 2023.All the patients were followed up for 1 year and 4 patients lost follow-up.All the 206 patients were divided into DPN group(n=52)and simple T2DM group(n=154)according to whether they had concurrent DPN.Baseline data,serum C-P,FOXO3a,and Metrnl levels were compared between the two groups.The relationship between serum C-P,FOXO3a,Metrnl levels and DPN was analyzed using point-biserial correlation and Cox regression analysis.The predictive value of serum C-P,FOXO3a,and Metrnl levels for DPN was analyzed using receiver operating characteristic(ROC)curve analysis.Results DM duration,hemoglobin A1c(HbA1c)levels and FOXO3a were higher in the DPN group than in the T2DM group(P<0.05).Serum C-P and Metrnl levels were lower in the DPN group than in the T2DM group(P<0.05).Correlation analysis showed that serum C-P and Metrnl levels were negatively correlated with DPN(P<0.01),while FOXO3a levels were positively correlated with DPN(P<0.01).Cox regression analysis revealed that serum C-P,FOXO3a,and Metrnl were independent factors for DPN,both before and after adjusting DM duration and HbA1c.The area under the curves for predicting DPN using serum C-P,FOXO3a,and Metrnl were 0.773,0.788,and 0.756,respectively.The sensitivities were 75.00%,76.92%,and 76.92%,and the specificities were 70.78%,69.48%,and 67.53%.The AUC for predicting DPN using the combination of the three markers was 0.921,with a sensitivity of 80.77%and a specificity of 90.26%.The combined predictive value was significantly higher than that of each marker alone(Z=3.520,2.969,3.531,all P<0.05).Conclusions Serum C-P,FOXO3a,and Metrnl are independent influencing factors for DPN in T2DM patients,and the combined detection has reliable predictive value.

Objective To explore the predictive value of combined detection of serum C-peptide(C-P),forkhead box O transcription factor-3a(FOXO3a),and metallothionein(Metrnl)for diabetic peripheral neuropathy(DPN).Methods A total of 210 patients with type 2 diabetes mellitus(T2DM)in Kailuan General Hospital were enrolled in this study from May 2021 to May 2023.All the patients were followed up for 1 year and 4 patients lost follow-up.All the 206 patients were divided into DPN group(n=52)and simple T2DM group(n=154)according to whether they had concurrent DPN.Baseline data,serum C-P,FOXO3a,and Metrnl levels were compared between the two groups.The relationship between serum C-P,FOXO3a,Metrnl levels and DPN was analyzed using point-biserial correlation and Cox regression analysis.The predictive value of serum C-P,FOXO3a,and Metrnl levels for DPN was analyzed using receiver operating characteristic(ROC)curve analysis.Results DM duration,hemoglobin A1c(HbA1c)levels and FOXO3a were higher in the DPN group than in the T2DM group(P<0.05).Serum C-P and Metrnl levels were lower in the DPN group than in the T2DM group(P<0.05).Correlation analysis showed that serum C-P and Metrnl levels were negatively correlated with DPN(P<0.01),while FOXO3a levels were positively correlated with DPN(P<0.01).Cox regression analysis revealed that serum C-P,FOXO3a,and Metrnl were independent factors for DPN,both before and after adjusting DM duration and HbA1c.The area under the curves for predicting DPN using serum C-P,FOXO3a,and Metrnl were 0.773,0.788,and 0.756,respectively.The sensitivities were 75.00%,76.92%,and 76.92%,and the specificities were 70.78%,69.48%,and 67.53%.The AUC for predicting DPN using the combination of the three markers was 0.921,with a sensitivity of 80.77%and a specificity of 90.26%.The combined predictive value was significantly higher than that of each marker alone(Z=3.520,2.969,3.531,all P<0.05).Conclusions Serum C-P,FOXO3a,and Metrnl are independent influencing factors for DPN in T2DM patients,and the combined detection has reliable predictive value.

Objective To analyze the effects of fat mass and obesity-associated (FTO) gene, IL-6, and HSP-60 gene polymorphism on the incidence rate and prognosis of breast cancer (BCa) for patients with type 2 diabetes mellitus (T2DM). Results A total of 1551 patients with BCa were included in the experimental group and 1605 women of the same age who participated in physical examination were included in the control group. The clinical data of the 3156 participants were collected through the baseline data questionnaire, and the genotypes of FTO, IL-6, and HSP-60 single-nucleotide polymorphism (SNP) were determined through blood sample detection. The predictive value of the three SNPs for the incidence risk of BCa for T2DM patients was evaluated. The OS of 1168 patients with BCa was obtained through follow-up, and the effects of the three SNPs and T2DM on OS of BCa patients were evaluated. Results The three loci were FTO rs3751812, IL-6 rs1800796, and HSP-60 rs2605039. The BCa incidence rate for T2DM women with wild homozygous SNP genotype was significantly higher than that for non-T2DM women (FTO: χ²=3.530, P=0.013; IL-6: χ²=6.288, P=0.029; HSP-60: χ²=4.926, P=0.005). The three wild homozygous genotypes were independent risk factors that influenced the incidence rate of BCa (all P < 0.05). Patients with HSP-60 rs2605039 (GT+TT) genotype had better OS (P=0.031). Conclusion FTO, IL-6, and HSP-60 gene polymorphisms have certain value in BCa prediction for T2DM patients. Patients with BCa and HSP-60 rs2605039 GT+TT genotype have high OS.

Objective To explore the outcome of the tibial bone-skin flap grafts in the management of severe traumatic osteomyelitis complicated with bone and skin defect in leg.Methods Twenty-seven cases of the traumatic osteomyelitis complicated with bone and skin defect in leg were treated with vascularized tibial bone-skin flap grafe from August, 2007 to November, 2013.Reconstruction of limb tibia continuity and cover the wound.Results The tibial bone-skin flaps were completely survived in 26 of the 27 cases except 1 ease which was repaired by adjacent flap because of the disorder blood circulation.The followed-up showed that all flaps had good blood circulation.The infection was controlled completely.The leg function and contour were satisfactory.Conclusion The tibial boneskin flap has the advantages of abundant blood supply, full bone-skin flap supply, shortens hospitalization and suitable for treatment of traumatic osteomyelitis complicated with bone and skin defect in leg.