Objective To investigate the correlation between glycemic variability metrics and the risk of diabetic foot(DF)in patients with type 2 diabetes mellitus(T2DM)utilizing flash glucose monitoring(FGM)tech-nology.Methods A retrospective analysis was conducted on 233 hospitalized patients with T2DM,with or without DF,who were treated in the Department of Endocrinology at Lianyungang First People's Hospital from January 2021 to May 2022 and monitored using FGM.Patients were categorized into a non-DF group(n=147)and a DF group(n=86)based on the presence of DF.The study compared general clinical characteristics,biochemical parameters,and glycemic variability metrics between the two groups and performed subgroup analyses.Binary logistic regression was employed to identify factors associated with the risk of DF,while receiver operating characteristic(ROC)curves were utilized to assess the predictive value of glycemic variability metrics for DF.Results Compared with the non-DF group,patients in the DF group exhibited significantly longer disease duration,higher body mass index(BMI),glycated hemoglobin(HbA1c),urinary albumin-to-creatinine ratio(UACR),alanine aminotransferase(ALT),serum uric acid(SUA),mean amplitude of glycemic excursions(MAGE),coefficient of variation(CV),mean of daily differences(MODD),and mean blood glucose(MBG),but lower fasting C-peptide(FCP),fasting insulin(FINS),high-density lipoprotein cholesterol(HDL-C),and time in range(TIR),with statistically signifi-cant differences(P<0.05).Subgroup analysis revealed that TIR was associated with the incidence of DF and diabetic retinopathy(DR).Binary logistic regression analysis identified HbA1c,MAGE,MODD,and MBG as risk factors for DF,while TIR was a protective factor(P<0.05).ROC curve analysis demonstrated that the area under the curve(AUC)for predicting DF using HbA1c,TIR,MAGE,MODD,MBG,and their combination were 0.646,0.850,0.868,0.764,0.619,and 0.967,respectively,indicating superior performance of the combined prediction model.Conclusions HbA1c,TIR,MAGE,MODD,and MBG are critical factors associated with the development of DF in patients with T2DM.Targeted early interventions aimed at optimizing these glycemic variability indicators may effectively reduce the incidence of DF.

Objective To investigate the correlation between glycemic variability metrics and the risk of diabetic foot(DF)in patients with type 2 diabetes mellitus(T2DM)utilizing flash glucose monitoring(FGM)tech-nology.Methods A retrospective analysis was conducted on 233 hospitalized patients with T2DM,with or without DF,who were treated in the Department of Endocrinology at Lianyungang First People's Hospital from January 2021 to May 2022 and monitored using FGM.Patients were categorized into a non-DF group(n=147)and a DF group(n=86)based on the presence of DF.The study compared general clinical characteristics,biochemical parameters,and glycemic variability metrics between the two groups and performed subgroup analyses.Binary logistic regression was employed to identify factors associated with the risk of DF,while receiver operating characteristic(ROC)curves were utilized to assess the predictive value of glycemic variability metrics for DF.Results Compared with the non-DF group,patients in the DF group exhibited significantly longer disease duration,higher body mass index(BMI),glycated hemoglobin(HbA1c),urinary albumin-to-creatinine ratio(UACR),alanine aminotransferase(ALT),serum uric acid(SUA),mean amplitude of glycemic excursions(MAGE),coefficient of variation(CV),mean of daily differences(MODD),and mean blood glucose(MBG),but lower fasting C-peptide(FCP),fasting insulin(FINS),high-density lipoprotein cholesterol(HDL-C),and time in range(TIR),with statistically signifi-cant differences(P<0.05).Subgroup analysis revealed that TIR was associated with the incidence of DF and diabetic retinopathy(DR).Binary logistic regression analysis identified HbA1c,MAGE,MODD,and MBG as risk factors for DF,while TIR was a protective factor(P<0.05).ROC curve analysis demonstrated that the area under the curve(AUC)for predicting DF using HbA1c,TIR,MAGE,MODD,MBG,and their combination were 0.646,0.850,0.868,0.764,0.619,and 0.967,respectively,indicating superior performance of the combined prediction model.Conclusions HbA1c,TIR,MAGE,MODD,and MBG are critical factors associated with the development of DF in patients with T2DM.Targeted early interventions aimed at optimizing these glycemic variability indicators may effectively reduce the incidence of DF.

Objective:To observe the clinical efficacy of autologous platelet rich gel (APG) in the treatment of type 2 diabetic foot (DF) patients and the effect of APG on the expression of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in peripheral blood mononuclear cells (PBMCs).Methods:A total of 62 patients with DF admitted to the Affiliated Hospital of Kangda College of Nanjing Medical University from February 2021 to May 2022 were randomly divided into a control group (30 cases) and an observation group (32 cases) using a random number table method. The control group received ultrasound debridement and dressing change treatment, while the observation group received ultrasound debridement combined with APG treatment. After 6 weeks of treatment, the effective rate, transcutaneous oxygen partial pressure (TcPO 2), and serum tumor necrosis factor- α (TNF-α), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), hypoxia inducible factor α (HIF-1 α)and the level of MALAT1 expression in PBMCs of the two groups of patients were observed. The Pearson correlation analysis was used to investigate the relationship between the expression change of MALAT (△ MALAT1) and the total effective rate of treatment. Results:The total effective rate of the observation group was higher than that of the control group [93.75%(30/32) vs 73.33%(22/30), P<0.05]. After treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), urinary microalbumin/creatinine (UACR), uric acid (UA), white blood cells (WBC), TNF- α and IL-6 of both groups had decreased compared to before; HIF-1 α, VEGF and MALAT1 increased compared to before treatment (all P<0.05); After treatment, there was a statistically significant difference in UA, HIF-1α, VEGF, and MALAT1 between the observation group and the control group (all P<0.05). Pearson correlation analysis showed that Δ MALAT1 in DF patients was negatively correlated with TNF -α ( r=-0.61, P=0.02), IL-6 ( r=-0.52, P=0.04), WBC ( r=-0.53, P=0.03), and positively correlated with VEGF ( r=0.58, P=0.03) and HIF-1α ( r=0.54, P=0.03). The total effective rate of DF treatment was higher in the high change group of△ MALAT [88.37%(38/43) vs 73.68%(14/19), P<0.05]. There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:APG can significantly upregulate the expression of MALAT, improve wound tissue blood perfusion, wound angiogenesis, and inflammatory response, promote ulcer healing, and changes in MALAT expression can help determine the prognosis of DF.

Rotator cuff injury is one of the common injuries of the shoulder joint. The tendon-bone interface is the special organizational structure of the multi-layer structure of bone, fibrocartilage and tendon. Further, it has stress concentration point. Thus, rotator cuff injury is often difficult to heal spontaneously once injuries and it has a higher re-tear rate after surgical intervention. Platelet-rich plasma (PRP) is obtained by concentrating autologous whole blood. Its platelet concentration is higher than the baseline level of whole blood. It also contains various growth factors and other blood components. At present, it has been widely used in treating orthopedics, skin and oral disorders. In recent years, the application of PRP in rotator cuff injury has attracted attention. PRP can assist the treatment of rotator cuff injury in regulating inflammation, angiogenesis, matrix synthesis and tissue remodeling. The use of PRP after rotator cuff repair can improve the postoperative shoulder joint function score, relieve postoperative pain in the short term, and effectively reduce the rotator cuff re-tear rate. However, the efficacy of PRP in treating rotator cuff injuries is affected by many factors, such as the type of PRP, the severity of rotator cuff tear, and different using approaches. Currently, we focus on PRP in the treatment of rotator cuff injury, aiming to systematically explain the differences among different studies and reveal the differences in the efficacy of PRP with varied components and different forms of administration. Moreover, we want to provide a reference for the proper and rational use of PRP in the treatment of various rotator cuff injuries. Meanwhile, the present review could provide a basis for future researches in the application of PRP for rotator cuff injury.

Head and neck squamous cell carcinoma (HNSCC) is a common malignant tumor that seriously threatens human health and life. With increasing studies on the mechanism of tumor immune escape, programmed death receptor 1 (PD-1) and programmed death ligand receptor 1 (PD-L1) have been proven to be involved in tumor immune escape. The primary mechanism is that PD-1 recruits protein tyrosine phosphatase (SHP-2) to dephosphorylate downstream tyrosine kinase (SyK) and phosphatidylinositol 3-kinase (PI3K), thereby inhibiting downstream protein kinase B (AKT), extracellular regulated protein kinases (ERK) and other important signaling pathways, ultimately inhibiting T cell activation. In recent years, PD-1/PD-L1 inhibitors have become popular immunotherapies. Pembrolizumab and nivolumab have been approved for HNSCC patients by the U.S. Food and Drug Administration. Both durvalumab and atezolizumab are still in clinical trials, and published data show that both have certain safety and efficacy but still need much clinical data to support them. Meanwhile, the combination of PD-1/PD-L1 inhibitors with radiotherapy, chemotherapy and immunotherapy is still controversial in terms of clinical efficacy and adverse events, and further research is needed. However, serious immune-related adverse reactions limit the clinical application of PD-1/PD-L1 inhibitors, despite promising curative effects. Therefore, developing novel inhibitors and investigating stable and effective biomarkers and upstream and downstream signaling mechanisms are urgent issues.

Objective To discuss the test efficiency of three methods for detecting Toxoplasma IgG antibody. Methods To-tally 304 specimens were detected parallelly for Toxoplasma IgG antibody by using the gold marked method,indirect hemagglutina-tion test(IHA),and enzyme-linked immunosorbent assay(ELISA),and the sensitivity,specificity and Youden index of these methods were compared. Results The detection sensitivities of gold marked method,IHA,and ELISA for Toxoplasma IgG anti-body were 85.5%,89.8%and 91.9%respectively(χ2=4.12,P>0.05);the specificities were 92.4%,96.6%and 97.5%respec-tively(χ2=4.06,P>0.05). The detection efficiency and Youden index of ELISA were 94.1%and 0.89 respectively,being high-er than those of IHA and gold marked method. Conclusion The sensitivity and specificity of the ELISA method for Toxoplasma IgG antibody are higher,and in addition,it can be automated. Therefore,it is suitable for large-scale Toxoplasma IgG antibody screening.

Objective To explore the impact of Toxoplasma gondii infection on pregnancy outcomes in early pregnancy wom-en. Methods Toxoplasma gondii IgM and IgG antibodies in the peripheral blood of 2 993 early pregnant women were detected by using enzyme-linked immunosorbent assay(ELISA). According to the test results,the infected ones were divided into an acute in-fection group,a previous infection group,and an active infection group,and 200 pregnant women without Toxoplasma infection were randomly chosen as a control group,and the pregnancy outcomes of the four groups were followed up and the results were compared. Results There were 286 women infected with Toxoplasma gondii,with the infection rate of 9.56%(286/2 993),in which 43 cases were diagnosed as acute infection,156 were previous cases,and the other 87 were active infection ones. The inci-dences of adverse pregnancy outcomes in the above 3 groups and the control group were 13.95%(6/43),1.92%(3/156),5.75%(5/87)and 1.50%(3/200),respectively. The incidences of adverse pregnancy outcomes in the acute infection group and active in-fection group were both higher than that in the control group,the differences were statistically significant(both P<0.05),while there was no significant difference between the previous infection group and control group(P>0.05). Conclusion Acute and ac-tive Toxoplasma gondii infections are closely associated with the occurrence of adverse pregnancy outcomes in early pregnant wom-en;therefore,Toxoplasma gondii IgM antibody should be included in the routine inspection items of the pre-pregnancy physical examination for child-bearing age women.