Diabetic foot (DF) is one of the most serious chronic complications of diabetes. The incidence rate among global diabetes patients is as high as 15% to 25%, and about 50% of patients will develop contralateral foot ulcers within 5 years after the first unilateral ulcer. As a non-invasive prevention and control solution, the application progress of functional insoles is mainly reflected in the following aspects:(1) Material innovation. The application of new composite materials and smart materials has significantly enhanced the pressure reduction effect and comfort. (2) Structural optimization. The development of multi-layer design and local pressure reduction structure has achieved more precise pressure distribution regulation. (3) Manufacturing process. 3D printing and parametric design have enabled the personalized customization of functional insoles. (4) Intelligent monitoring. It integrates functions such as pressure sensing and temperature monitoring, achieving real-time monitoring and early warning of foot conditions. Clinical research has confirmed that personalized functional insoles could reduce the incidence of foot ulcers and shorten the healing time of ulcers. At present, the research hotspots mainly focus on the development of smart materials, the construction of multi-functional integration and remote monitoring systems. However, in-depth research is still needed in the aspects of biomechanical mechanisms, standardized evaluation systems and long-term efficacy assessment. The development of future functional insoles should focus on the coordinated advancement of "personalization-intelligence-standardization", with the aim of providing more effective solutions for the prevention and treatment of DF.
Humans ; Diabetic Foot/therapy* ; Foot Orthoses

Objective To investigate the clinical efficacy of self-made Bushen Huoxue Lishui Prescription for the treatment of patients with infertility due to hydrosalpinx.Methods Seventy patients with infertility due to hydrosalpinx differentiated as spleen deficiency and phlegm blended with blood stasis type were randomly divided into the control group and the observation group,with 35 patients in each group.Patients in both groups were given minimally invasive surgery by using a combined hysteroscopy-laparoscopy approach,and additionally,the control group was given the postoperative routine treatment(including the use of antibiotics to prevent infections,regular monitoring of the basal body temperature,and the review of the uterine adnexa ultrasound),and the observation group was treated with Bushen Huoxue Lishui Prescription based on the treatment for the control group.The medication was performed for 21 days during a menstrual cycle,and the treatment lasted for three continuous menstrual cycle.Before and after treatment,the changes in the scores of the fallopian tube obstruction and scores of traditional Chinese medicine(TCM)syndrome in the two groups were observed.Three months after the operation,the pregnancy outcomes,the recurrence of hydrosalpinx in the non-pregnant patients,and the safety of the medication in the two groups were evaluated.Results(1)Three months after the operation,the total pregnancy rate of the observation group was 51.43%(18/35),and the intrauterine pregnancy rate was 48.57%(17/35);in the control group,the total pregnancy rate was 25.71%(9/35)and the intrauterine pregnancy rate was 20.00%(7/35).The intergroup comparison(by chi-square test)showed that the total pregnancy rate and intrauterine pregnancy rate of the observation group were significantly superior to those of the control group,and the differences were statistically significant(P＜0.05).(2)After treatment,the scores of the fallopian tube obstruction in the two groups were significantly improved when compared with those before treatment(P＜0.05),and the improvement of tubal obstruction scores in the observation group was significantly superior to that in the control group,with statistically significant differences in the post-treatment scores and in the pre-and post-treatment score difference between the two groups(P＜0.05).(3)After treatment,the TCM syndrome scores in the two groups were significantly improved when compared with those before treatment(P＜0.05),and the improvement of TCM syndrome score in the observation group was significantly superior to that in the control group,with statistically significant differences in the post-treatment scores and in the pre-and post-treatment score difference between the two groups(P＜0.01).(4)Three months after the operation,the recurrence rate of hydrosalpinx in the observation group was 5.88%(1/17),and lower than that in the control group(38.46%,10/26),with statistically significant differences(P＜0.05).(5)During the treatment,no obvious adverse reactions occurred in the two groups,and the safety was high.Conclusion Bushen Huoxue Lishui Prescription has markedly efficacy in the treatment of patients with infertility due to hydrosalpinx differentiated as spleen deficiency and phlegm blended with blood stasis type,and the prescription is effective on increasing the pregnancy rate of the patients,decreasing the recurrence of hydrosalpinx,and improving the clinical symptoms,with fewer adverse reactions and high safety.

Objective: To investigate death and attrition in HIV-infected children under initial antiretroviral therapy (ART) and associated factors in Guangxi Zhuang autonomous region. Methods: This retrospective cohort study was conducted in HIV-infected children under initial ART in Guangxi from 2004 to 2019, data from ART information system of National comprehensive AIDS prevention and treatment information system. Cox proportional hazards models were used to assess factors associated with the death and attrition. Results: In 943 HIV-infected children, the overall mortality and attrition rates were 1.00/100 person-years and 0.77/100 person-years, respectively. The mortality and attrition rates within the first year of ART were 3.90/100 person-years and 1.67/100 person-years, respectively. The cumulative survival rate during the first, second, fifth and tenth year after ART was 96.14%, 95.80%, 93.68% and 91.54%, respectively. Multivariate Cox proportional hazards models results showed that being female (aHR=2.00, 95%CI: 1.17-3.40), CD4⁺T lymphocytes (CD4) counts before ART <200 cells/μl (aHR=2.79, 95%CI: 1.54-5.06), weight-for-age Z score before ART <-2 (aHR=2.38, 95%CI: 1.32-4.26), hemoglobin before ART <80 g/L (aHR=2.47, 95%CI: 1.24-4.92), initial ART with LPV/r (aHR=5.05, 95%CI: 1.15-22.12) were significantly associated with death; being female (aHR=2.23, 95%CI: 1.22-4.07) and initial ART with LPV/r (aHR=2.02, 95%CI: 1.07-3.79) were significantly associated with attrition. Conclusions: The effect of ART in HIV-infected children in Guangxi was better, but the mortality and attrition rates were high within the first year of treatment. It is necessary to strengthen the training in medical staff and health education in HIV-infected children and their parents in order to improve the treatment effect.
Anti-HIV Agents/therapeutic use* ; Child ; China/epidemiology* ; Female ; HIV Infections/drug therapy* ; Humans ; Male ; Proportional Hazards Models ; Retrospective Studies

Objective To deduce carotid elasticity transmission index (CETI) and explore the correlation between CETI and intima-media thickness (IMT) of the carotid artery to investigate the clinical value of CETI. Methods Seventy-seven patients with essential hypertension (EH) and 24 healthy controls were collected. Their blood flow rate of cerebral arteries was detected by transcranial Doppler (TCD) and the pulsatility index (PI) was calculated. Their IMT and blood flow rate of common carotid artery (CCA) were detected by difunctional color Doppler; and then, their PI was calculated to analyze the correlation between CETI and IMT by curve fitting. The formulas were determined as: CETI1=PIMCA/PICCA, CETI2=PHCA/PICCA and CETB=PIBA/PICCA. Multiple stepwise regression analysis was employed to reflect the sensitive factors of IMT and CETI. Results Curvilinear correlation (curve of quadratic equation) was noted between CETI, including CETI1, CETI2 and CETI3, and IMT; each of the determination coefficient was r2=0.665, 0.601 and 0.573, respectively. Quadratic equations were y1=0.504+0.049x+0.203x2, r=0.815, P=0.000; y2= 1.009-1.141x+0.891x2, r=0.775, P= 0.000; y3=0.775-0.687x+0.641x2, 7=0.756, P=0.000. Among them, the correlation between CETI1 and IMT was the most significant. Linear regression was noted between IMT and LDL-C, daily dosage of smoking, SBP and gender. Linear regression was noted between CETT1 and both SBP and daily dosage of smoking. Linear regression was noted between CETI1 and both SBP and daily dosage of smoking. Linear regression was noted between CETI3 and SBP, CHOL and daily dosage of smoking. Conclusions CETI increases with the increase of IMT, suggesting that the rate of cerebral atherosclerosis is faster than the one of carotid in hypertensive patients when the elastic reserve of intracranial carotid artery and cerebral arteries decreases and the thickness of IMT increases to a certain extent. The risk factors of CETI are similar to IMT.

OBJECTIVEConstruction of a small interfering RNA (siRNA) eukaryotic expression vector specific to mouse myocardin gene and study on the role of myocardin-siRNA on differentiation of mouse bone mesenchymal stem cells (MSCs) into smooth muscle-like cells induced by PDGF-BB in vitro.

METHODSMouse MSCs were isolated from bone marrow and cultured with 50 mg/L PDGF-BB and fetal bovine serum (20%). Specific myocardin-siRNA sequence was cloned into a plasmid pGenesil-1.0 vector, which contained U6 promoter. The recombinant plasmid and control plasmid were transfected into MSCs which had been cultured with PDGF-BB for 6 days beforehand. The expression of myocardin mRNA was detected by RT-PCR 48 hours after the transfection. Immunohistochemistry was used to detect the SM-MHC and to identify the smooth muscle-like cells.

RESULTSThe recombinant plasmids carrying myocardin-siRNA sequences were constructed successfully and the myocardin mRNA was reduced 42.86% by pGen-myo-shRNA in comparing with that of the controls (P<0.01); and the expression of SM-MHC protein was down-regulated (P<0.01).

CONCLUSIONSubset of mouse MSCs have the potential to differentiate into smooth muscle-like cells, a possible cell source responsible for atherosclerotic plaque formation, and myocardin expression may play an important role during this process.

Animals ; Bone Marrow Cells ; cytology ; metabolism ; Cell Differentiation ; Cells, Cultured ; Down-Regulation ; Gene Silencing ; Genetic Vectors ; Male ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Mice ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; cytology ; metabolism ; Myosin Heavy Chains ; metabolism ; Nuclear Proteins ; biosynthesis ; genetics ; physiology ; Plaque, Atherosclerotic ; pathology ; Plasmids ; Platelet-Derived Growth Factor ; pharmacology ; Proto-Oncogene Proteins c-sis ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; Trans-Activators ; biosynthesis ; genetics ; physiology ; Transfection