Objective:To explore the effects of hyperbaric oxygen-assisted hemoperfusion on renal function and immune inflammatory cytokines in patients with end-stage diabetic nephropathy (ESDN).Methods:A total of 92 patients with ESDN admitted to the Department of Nephrology of the Second People’s Hospital of Lianyungang from June 2016 to December 2017 were randomly divided into control group ( n=46) and observation group ( n=46). The control group was given conventional treatment and the combination of hemodialysis with hemoperfusion, while the observation group was treated with hyperbaric oxygen on the basis of the treatments of the control group. The levels of fasting blood glucose (FBG), 24-hour urinary protein (24 h Upro), blood urea nitrogen, creatinine (Cr), uric acid and albumin (ALB), and the contents of immune inflammatory cytokines such as interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-17 (IL-17), monocyte chemoattractant protein-1 (MCP-1), and hypersensitive C-reactive protein (hs-CRP) were compared between the two groups before and after treatment. Results:After treatment, the levels of FBG, renal function indicators, and the contents of immune inflammatory cytokines in the two groups were significantly improved in comparison with those before treatment ( P<0.05). The levels of Cr, 24 h Upro, and ALB in the observation group were (482.54±166.46) μmol/L, (1 095.34±154.78) mg, and (33.04±3.91) g/L, respectively, which were significantly better than those in the control group ( P<0.05). The improvements in IL-6, IL-10, IL-17, MCP-1, and hs-CRP contents in the observation group were significantly better than those in the control group ( P<0.05). The incidences of complications such as hypoglycemia, hypoxemia, hypotension, infection, and cardio-cerebrovascular events in the observation group were also significantly lower than those in the control group ( P<0.05). Conclusion:Hyperbaric oxygen-assisted hemoperfusion can effectively inhibit vascular endothelial injury due to inflammatory irritation and restore renal microvascular circulation to improve renal function by reducing the contents of IL-6, IL-17, MCP-1, and hs-CRP, and increasing IL-10 content in ESDN patients.

Objective:To explore the effects of hyperbaric oxygen-assisted hemoperfusion on renal function and immune inflammatory cytokines in patients with end-stage diabetic nephropathy (ESDN).Methods:A total of 92 patients with ESDN admitted to the Department of Nephrology of the Second People’s Hospital of Lianyungang from June 2016 to December 2017 were randomly divided into control group ( n=46) and observation group ( n=46). The control group was given conventional treatment and the combination of hemodialysis with hemoperfusion, while the observation group was treated with hyperbaric oxygen on the basis of the treatments of the control group. The levels of fasting blood glucose (FBG), 24-hour urinary protein (24 h Upro), blood urea nitrogen, creatinine (Cr), uric acid and albumin (ALB), and the contents of immune inflammatory cytokines such as interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-17 (IL-17), monocyte chemoattractant protein-1 (MCP-1), and hypersensitive C-reactive protein (hs-CRP) were compared between the two groups before and after treatment. Results:After treatment, the levels of FBG, renal function indicators, and the contents of immune inflammatory cytokines in the two groups were significantly improved in comparison with those before treatment ( P<0.05). The levels of Cr, 24 h Upro, and ALB in the observation group were (482.54±166.46) μmol/L, (1 095.34±154.78) mg, and (33.04±3.91) g/L, respectively, which were significantly better than those in the control group ( P<0.05). The improvements in IL-6, IL-10, IL-17, MCP-1, and hs-CRP contents in the observation group were significantly better than those in the control group ( P<0.05). The incidences of complications such as hypoglycemia, hypoxemia, hypotension, infection, and cardio-cerebrovascular events in the observation group were also significantly lower than those in the control group ( P<0.05). Conclusion:Hyperbaric oxygen-assisted hemoperfusion can effectively inhibit vascular endothelial injury due to inflammatory irritation and restore renal microvascular circulation to improve renal function by reducing the contents of IL-6, IL-17, MCP-1, and hs-CRP, and increasing IL-10 content in ESDN patients.

Objective: To investigate the clinical effect of reconstruction of sensory anterolateral thigh perforator flaps in repairing soft tissue defects after radical operation for Paget disease of perineum. Methods: From April 2017 to July 2017, Ningbo First Hospital treated 3 male patients with Paget′s disease of perineum, 2 patients with RayA2 stage and 1 patient with RayB stage. The range of soft tissue defect after resection of tumors is 8 cm×10 cm to 10 cm×12 cm. The anterolateral thigh perforator flaps were designed to repair skin defect, and the lateral thigh cutaneous nerve branch was contained to reconstruct protective sensation and restore autonomic nerve function. Tension-free direct suture was performed in part of the donor site, of which 3 cases were difficult to suture directly, 2 cases were treated with skin grafting and 1 case was closed with skin distractor. Results: All 3 flaps survived. The average area of the flaps was about 12 cm×14 cm. The average follow-up period was 3 months. The appearance and function of the flaps were satisfactory. The average sensory recovery of the flaps was as high as S3. The autonomic nervous function was partially restored. Some of the skin had sweating function and normal skin temperature. At the same time, there was no difference between the urination function and sexual competence before operation. The donor site wound healed well and its appearance and function recovered well. Conclusions The reconstruction of sensory anterolateral thigh perforator flaps is an good method for repairing soft tissue defect after radical resection of Paget disease of perineum. It has satisfactory results in the protection and reconstruction of donor and recipient areas.