Objective To study the MRI features of diabetic foot osteomyelitis(DFO)and its correlation with the atherogenic index of plasma(AIP).Methods The clinical data of 96 DF patients who were treated in the our hospital from January 2016 to December 2022 were collected.According to whether DFO occurs,the patients were divided into two groups:DF group(n=52)and DFO group(n=44).The differences of age,sex,course of diabetes,AIP and other clinical indicators between the two groups were compared.Logistic regression was used to analyze the influencing factors of DFO,and receiver operating characteristic(ROC)curve was used to analyze the efficacy of AIP and common clinical indicators in predicting DFO.Results The main manifestations of DFO on MRI were soft tissue cellulitis,abscess(50/96),osteomyelitis(48/96),sinus(45/96),and Charcot's joint(12/96).Among 48 cases of osteomyelitis,4 cases were confirmed as false positive by bone puncture biopsy,13(13/44)cases had exposed bone tissue,14(14/44)cases were confirmed by bone puncture biopsyand17(17/44)cases were positive for bone pathogen culturewhichincluding 9 cases of Gram-positive bacteria(5 cases of Staphylococcus aureus,3 cases of Staphylococcus epidermidis,and 1 case of Staphylococcus hemolysis);5 cases of Gram-negative bacteria(3 cases of Pseudomonas aeruginosa,1 case of Proteus mirabilis,and 1 case of Klebsiella pneumoniae)and 3 cases were mixed bacterial infections.Compared with the DF group,the BMI,AIP,High sensitivity C reactive protein,and smoking rate of patients in the DFO group increased(P<0.05).Binary logistic regression analysis showed that AIP and smoking were the influencing factors of DFO.The ROC curve analysis showed that the area under the ROC curve of AIP predicting DFO in DM patients was 0.738,with a sensitivity of 72.7%,a specificity of 73.1%,and an optimal cutoff value of 0.19.The Delong test showed that AIP has an advantage in predicting DFO(P<0.05).Conclusions MRI can better display the involvement of soft tissue and bone joints in DFO feet.AIP and smoking are influencing factors of DFO.AIP is a monitoring indicator for the prevention and treatment of DFO.

Objective To study the MRI features of diabetic foot osteomyelitis(DFO)and its correlation with the atherogenic index of plasma(AIP).Methods The clinical data of 96 DF patients who were treated in the our hospital from January 2016 to December 2022 were collected.According to whether DFO occurs,the patients were divided into two groups:DF group(n=52)and DFO group(n=44).The differences of age,sex,course of diabetes,AIP and other clinical indicators between the two groups were compared.Logistic regression was used to analyze the influencing factors of DFO,and receiver operating characteristic(ROC)curve was used to analyze the efficacy of AIP and common clinical indicators in predicting DFO.Results The main manifestations of DFO on MRI were soft tissue cellulitis,abscess(50/96),osteomyelitis(48/96),sinus(45/96),and Charcot's joint(12/96).Among 48 cases of osteomyelitis,4 cases were confirmed as false positive by bone puncture biopsy,13(13/44)cases had exposed bone tissue,14(14/44)cases were confirmed by bone puncture biopsyand17(17/44)cases were positive for bone pathogen culturewhichincluding 9 cases of Gram-positive bacteria(5 cases of Staphylococcus aureus,3 cases of Staphylococcus epidermidis,and 1 case of Staphylococcus hemolysis);5 cases of Gram-negative bacteria(3 cases of Pseudomonas aeruginosa,1 case of Proteus mirabilis,and 1 case of Klebsiella pneumoniae)and 3 cases were mixed bacterial infections.Compared with the DF group,the BMI,AIP,High sensitivity C reactive protein,and smoking rate of patients in the DFO group increased(P<0.05).Binary logistic regression analysis showed that AIP and smoking were the influencing factors of DFO.The ROC curve analysis showed that the area under the ROC curve of AIP predicting DFO in DM patients was 0.738,with a sensitivity of 72.7%,a specificity of 73.1%,and an optimal cutoff value of 0.19.The Delong test showed that AIP has an advantage in predicting DFO(P<0.05).Conclusions MRI can better display the involvement of soft tissue and bone joints in DFO feet.AIP and smoking are influencing factors of DFO.AIP is a monitoring indicator for the prevention and treatment of DFO.

Objective To investigate the changes of blood lipid and glycosylated hemoglobin (HbA1c) levels in obese type 2 diabetes (T2DM) patients and their relationship with insulin resistance (Homa-IR). Methods A total of 120 cases of T2DM newly diagnosed in Motuo County, Tibet from February to October 2022 were selected as the observation group. According to BMI, the patients were divided into diabetes normal weight group (46 cases), overweight group (43 cases) and obesity group (31 cases); 145 healthy subjects were selected as the control group. The levels of HbA1c, fasting blood glucose (FPG), fasting insulin (FINS), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) were detected in the study subjects, and Homa-IR and Homa-β indices were calculated. The height, weight, and abdominal circumference were measured. The differences in the levels of the above indicators between the observation group patients and the control group, as well as among various subgroups within the observation group were compared. The influencing factors of Homa-IR in obese T2DM patients were analyzed. Results Compared with the control group, a significant increase in BMI, abdominal circumference, blood pressure, HbA1c, FBG, FINS, TC, TG, LDL-C, UA, visceral fat area, and the levels of Home-IR and Home-β was found in the observation group (all P<0.05). There were significant differences in BMI, abdominal circumference, and the levels of FINS, Homa IR, Homa-β, and HbA1c in diabetes patients with different BMI (all P<0.05). Correlation analysis showed that TG levels in obese T2DM patients in the observation group were significantly correlated with HbA1c (r=0.396, P=0.027), Homa-IR (r=0.405, P=0.024), and Home-β (r=-0.401, P=0.025); LDL-C was significantly correlated with Homa-IR (r=0.411, P=0.022) and Homa-β (r=-0.412, P=0.021); HbA1c was significantly positively correlated with BMI (r=0.371, P=0.040). Conclusion Insulin resistance is closely related to TG, LDL-C, and BMI in obese T2DM patients from the Motuo ethnic minority of Tibet, suggesting that these factors may play a role in the occurrence of T2DM.

Objective To investigate the nutritional status of elderly patients with diabetic foot ulcers and to explore its influencing factors and relationship.Methods Convenience sampling method was used to recruit 182 elderly patients with diabetic foot ulcers.The mini nutritional assessment (MNA) was adopted to assess nutritional status,and patients' clinical information,hemoglobin A1c,hemoglobin,serum albumin,C-reactive protein were also collected.Results The average score of MNA was 16.36±3.68 for 182 patients,and 121 patients suffered from malnutrition(66.48％),while 61 patients suffered from potential malnutrition(33.52％).The occurrence of malnutrition was positively correlated with age,course of diabetes,classification of foot ulcer,infection,C-reactive protein,hemoglobin A1c and food intake (P＜0.05);the incidence of malnutrition and C-reactive protein for patients with Wagner grade 3 and above were higher than those for patients with low Wagner grades,and hemoglobin A1c and hemoglobin were lower for patients with Wagner grade 3 and above(P＜0.05).Conclusion There was high incidence rate of malnutrition in elderly patients with diabetic foot ulcers,closely related to inflammatory state.Health care providers should provide targeted interventions in time,improve condition of malnutrition,and promote rehabilitation.

Objective To study the relationship between C reactive protein ( CRP) and postoperative deliri-um of elderly patients after hip fracture , and to explore the possible mechanism of delirium .Methods A total of 186 elderly patients with hip fracture who received operation were included in the study .24h after operation,according to the patients'awareness of ICU fuzzy evaluation method ,the patients were divided into the delirium group and non delirium group .The levels of CRP and procalcitonin were detected and compared .Results The CRP levels in the de-lirium group and non delirium group were (207 ±86)mg/L,(87 ±42)mg/L,there was significant difference between two groups (t =2.427,P <0.01).The procalcitonin levels in the delirium group and non delirium group were (0.32 ±0.11)μg/L,(0.27 ±0.13)μg/L,the difference between the two groups was not significant (t=0.347,P>0.05).Conclusion CRP may be related with delirium.Inflammatory response without systemic infection may be one of the mechanisms of delirium .