Objective:To investigate the clinical effect of tibial periosteal lateral distraction combined with compound Ziyin ointment in the treatment of diabetic foot.Methods:A total of 62 patients with diabetic foot treated in the First People′s Hospital of Wuhu from July 2022 to September 2023 were prospectively selected and divided into routine group and combination group according to random number table method, with 31 cases in each group. The conventional group was treated with tibial periosteal lateral stretch, and the combined group was treated with tibial periosteal lateral distraction combined with compound Ziyin ointment, and the treatment lasted for 2 weeks. Traditional Chinese Medicine (TCM) syndrome scores, serum inflammatory factors, growth factors, foot temperature, toe oxygen saturation, pain and quality of life scores, clinical efficacy and complications were observed before and after treatment in the two groups.Results:After treatment, TCM syndrome score, serum inflammatory factor level and pain score were lower than before treatment, serum growth factor level, life quality score, foot temperature and toe end blood oxygen saturation were higher than before treatment (all P<0.05). After treatment, the pain score, TCM main disease score, TCM secondary disease score and inflammatory factor levels in the combined group were lower than those in the conventional group (all P<0.05), and the serum growth factor level, life quality score, foot temperature and toe end blood oxygen saturation were higher than those in the conventional group (all P<0.05). The total effective rate of combined group was higher than that of conventional group [93.55%(29/31) vs 70.97%(22/31), P<0.05]. There was no significant difference in the total incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Tibial periosteal lateral distraction combined with compound Ziyin ointment can improve the levels of serum inflammatory factors, growth factors, foot temperature and toe oxygen saturation, reduce TCM syndrome score and relieve pain degree, improve patients′ quality of life and clinical efficacy, and have high safety.

Objective:To investigate the clinical effect of tibial periosteal lateral distraction combined with compound Ziyin ointment in the treatment of diabetic foot.Methods:A total of 62 patients with diabetic foot treated in the First People′s Hospital of Wuhu from July 2022 to September 2023 were prospectively selected and divided into routine group and combination group according to random number table method, with 31 cases in each group. The conventional group was treated with tibial periosteal lateral stretch, and the combined group was treated with tibial periosteal lateral distraction combined with compound Ziyin ointment, and the treatment lasted for 2 weeks. Traditional Chinese Medicine (TCM) syndrome scores, serum inflammatory factors, growth factors, foot temperature, toe oxygen saturation, pain and quality of life scores, clinical efficacy and complications were observed before and after treatment in the two groups.Results:After treatment, TCM syndrome score, serum inflammatory factor level and pain score were lower than before treatment, serum growth factor level, life quality score, foot temperature and toe end blood oxygen saturation were higher than before treatment (all P<0.05). After treatment, the pain score, TCM main disease score, TCM secondary disease score and inflammatory factor levels in the combined group were lower than those in the conventional group (all P<0.05), and the serum growth factor level, life quality score, foot temperature and toe end blood oxygen saturation were higher than those in the conventional group (all P<0.05). The total effective rate of combined group was higher than that of conventional group [93.55%(29/31) vs 70.97%(22/31), P<0.05]. There was no significant difference in the total incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Tibial periosteal lateral distraction combined with compound Ziyin ointment can improve the levels of serum inflammatory factors, growth factors, foot temperature and toe oxygen saturation, reduce TCM syndrome score and relieve pain degree, improve patients′ quality of life and clinical efficacy, and have high safety.

Objective: To explore the effects of human erythropoietin (hEPO) on healing related transforming growth factor β₁ (TGF-β₁)/Smad3 signal transduction pathway in acute wounds of rats. Methods: Seventy-two healthy Sprague Dawley rats were divided into normal saline control group, low dose group, middle dose group, and high dose group according to the random number table, with 18 rats in each group, after round acute wounds with diameter of 2.5 cm were inflicted on the back of rats. Rats in the 4 groups had debridement routinely. Wounds of rats in normal saline control group were covered by gauzes infiltrated with 1 mL normal saline, while wounds of rats in low dose group, middle dose group, and high dose group were respectively covered by gauze infiltrated with 1 mL hEPO in doses of 50, 100, and 150 U every day, and then the wounds were bandaged with 6 layers of dry gauze. Dressing change was performed once every day. On treatment day (TD) 3, 7, and 14, 6 rats from each group were taken for general observation and calculation of wound healing rate. Then the wound tissue samples were harvested after the rats were sacrificed for observation of expressions of CD31 and transforming growth factor β₁ (TGF-β₁) with immunohistochemical method. Protein expression of phosphorylated Smad3 of the wound tissue of 3 rats were detected by Western blotting. Data were processed with analysis of variance of factorial design, one-way analysis of variance, least-significant difference test, and Bonferroni correction. Results: (1) On TD 3, obvious exudation and scab were observed in the wounds of rats in the 4 groups. On TD 7, the wounds of rats in low dose group, middle dose group, and high dose group were reduced compared with those in normal saline control group. On TD 14, all wounds of rats in the 4 groups were healed. On TD 7, the wound healing rates of rats in middle dose group and high dose group were significantly higher than the rate in normal saline control group (P<0.01). At the other time points, the wound healing rates of rats in the 4 groups were close (P>0.05). (2) CD31 mainly expressed in blood vessels. Except for those in low dose group on TD 3 and 7 (P>0.05), the expressions of CD31 in wound tissue of rats in low dose group on TD 14 and in middle dose group and high dose group on TD 3, 7, and 14 were significantly higher than those in normal saline control group (P<0.01). Except for those on TD 3 (P>0.05), the expressions of CD31 in wound tissue of rats in middle dose group and high dose group on TD 7 and 14 were significantly higher than those in low dose group (P<0.01). Except for that on TD 3 (P>0.05), the expressions of CD31 in wound tissue of rats in high dose group on TD 7 and 14 were significantly higher than those in middle dose group (P<0.01). (3) Except for that in low dose group on TD 3 (1.9±0.7, P>0.05), the expressions of TGF-β₁ in wound tissue of rats in low dose group on TD 7 and 14 (3.3±1.0, 3.7±0.7), and in middle dose group and high dose group on TD 3, 7, and 14 (3.3±1.0, 3.6±1.0, 3.9±0.9, 3.4±0.7, 3.8±0.8, 4.2±0.4) were significantly higher than those in normal saline control group (1.7±0.5, 2.7±1.0, 3.0±0.9, P<0.01). Except for those on TD 7 (P>0.05), the expressions of TGF-β₁ in wound tissue of rats in middle dose group and high dose group on TD 3 and 14 were significantly higher than those in low dose group (P<0.01). Except for that on TD 14 (P<0.01), the expressions of TGF-β₁ in wound tissue of rats in high dose group on TD 3 and 7 were close to those in middle dose group (P>0.05). (4) Except for those in low dose group on TD 3 and 14 and in middle dose group and high dose group on TD 14 (P>0.05), the protein expressions of phosphorylated Smad3 in wound tissue of rats in the 3 groups at the other time points were significantly higher than those in normal saline control group (P<0.01). Except for those on TD 14 (P>0.05), the protein expressions of phosphorylated Smad3 in wound tissue of rats in middle dose group and high dose group on TD 3 and 7 were significantly higher than those in low dose group (P<0.01). Except for that on TD 14 (P>0.05), the protein expressions of phosphorylated Smad3 in wound tissue of rats in high dose group on TD 3 and 7 were significantly lower than those in middle dose group (P<0.01). Conclusions Exogenous hEPO can increase the expressions of CD31, TGF-β₁, and phosphorylated Smad3 in acute wounds of rats, promote angiogenesis of wounds, and activate TGF-β₁/Smad3 signal transduction pathway to promote wound healing.