Objective To investigate the relationship between MTHFR C677T gene polymorphism and peripheral edema after intracerebral hemorrhage.Methods Two hundred and sixteen patients with hypertensive intracerebral hemorrhage were divided into edema enlargement group and edema non-enlargement group according to whether cerebral edema enlargement occurred.Clinical data of the patients were collected,and the MTHFR C677T genotype was detected.Results The level of homocysteine(Hey),vascular endothelial growth factor(VEGF)level at 72 h after admission,blood loss and incidence of venous thrombosis of lower extremity in edema enlargement group were significantly increased than those in edema non-enlargement group(P＜0.05-0.01).The frequency of TT genotype of MTHFR C677T in edema enlargement group was significantly higher than that of CT genotype,and the frequency of CT genotype was significantly higher than that of the frequency of CC genotype(all P＜0.05).There were significant differences in MTHFR C677T genotype and allele frequency between edema enlargement group and edema non-enlargement group(X2=70.668,P＜0.001;x2=84.139,P＜0.001).Multivariate Logistic regression analysis showed that VEGF level at 72 h after admission,MTHFR C677T CT genotype and TT genotype were independent risk factors for cerebral hemorrhage edema enlargement(OR=1.013,95％CI:1.007-1.019,P＜0.001;OR=5.534,95％CI:2.426-12.625,P＜0.001;OR=33.088,95％CI:9.012-121.479,P＜0.001).After adjusting for other factors,the OR of MTHFR C677CT to MTHFR C677CC was 5.53(95％CI:2.426-12.625,P＜0.05),and the OR of MTHFR C677TT to MTHFR C677CC was 33.09(95％CI:9.012-121.479,P＜0.05).The edema growth rate of TT genotype,CT genotype and CC genotype at MTHFR C677T site was significantly different(F=3.204,P=0.044).There was no significant difference in VEGF level among TT genotype,CT genotype and CC genotype of MTHFR C677T site at admission(F=0.978,P=0.379),but there was significant difference in VEGF level at 72 h after admission(F=5.819,P=0.007).Conclusion MTHFR C677T gene polymorphism is associated with secondary edema enlargement after intracerebral hemorrhage.

Objective To investigate the relationship between MTHFR C677T gene polymorphism and peripheral edema after intracerebral hemorrhage.Methods Two hundred and sixteen patients with hypertensive intracerebral hemorrhage were divided into edema enlargement group and edema non-enlargement group according to whether cerebral edema enlargement occurred.Clinical data of the patients were collected,and the MTHFR C677T genotype was detected.Results The level of homocysteine(Hey),vascular endothelial growth factor(VEGF)level at 72 h after admission,blood loss and incidence of venous thrombosis of lower extremity in edema enlargement group were significantly increased than those in edema non-enlargement group(P＜0.05-0.01).The frequency of TT genotype of MTHFR C677T in edema enlargement group was significantly higher than that of CT genotype,and the frequency of CT genotype was significantly higher than that of the frequency of CC genotype(all P＜0.05).There were significant differences in MTHFR C677T genotype and allele frequency between edema enlargement group and edema non-enlargement group(X2=70.668,P＜0.001;x2=84.139,P＜0.001).Multivariate Logistic regression analysis showed that VEGF level at 72 h after admission,MTHFR C677T CT genotype and TT genotype were independent risk factors for cerebral hemorrhage edema enlargement(OR=1.013,95％CI:1.007-1.019,P＜0.001;OR=5.534,95％CI:2.426-12.625,P＜0.001;OR=33.088,95％CI:9.012-121.479,P＜0.001).After adjusting for other factors,the OR of MTHFR C677CT to MTHFR C677CC was 5.53(95％CI:2.426-12.625,P＜0.05),and the OR of MTHFR C677TT to MTHFR C677CC was 33.09(95％CI:9.012-121.479,P＜0.05).The edema growth rate of TT genotype,CT genotype and CC genotype at MTHFR C677T site was significantly different(F=3.204,P=0.044).There was no significant difference in VEGF level among TT genotype,CT genotype and CC genotype of MTHFR C677T site at admission(F=0.978,P=0.379),but there was significant difference in VEGF level at 72 h after admission(F=5.819,P=0.007).Conclusion MTHFR C677T gene polymorphism is associated with secondary edema enlargement after intracerebral hemorrhage.

BACKGROUND: Platelet-rich plasma has been used in the treatment of wounds in orthopedics, burn and plastic surgery, and has achieved good results. But its therapeutic effect in diabetic foot ulcers is still controversial. OBJECTIVE: To systematically evaluate the efficacy and safety of platelet-rich plasma in diabetic foot ulcer. METHODS: PubMed, EMbase, The Cochrane Library, CBM, CNKI, and VIP databases were searched for a randomized controlled trial of platelet-rich plasma for treating diabetic foot ulcers published before September 2018. Meta-analysis was performed using RevMan 5.3 software after two investigators independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. RESULTS AND CONCLUSION: (1) Sixteen randomized controlled trials were included, including 925 patients. The trial group was treated with platelet-rich plasma alone or platelet-rich plasma combined with conventional therapy (debridement, vacuum sealing drainage, or dressing coverage) . The control group received routine treatment, blank control or placebo treatment. (2) Meta-analysis showed that the healing rate in the trial group was higher than that in the control group [OR=3.05, 95％CI (2.25, 4.13) , P < 0.000 01]; effective rate was higher than that in the control group [OR=3.84, 95％CI (2.44, 6.06) , P < 0.000 01]; the ulcer healing time was shorter than that in the control group [MD=-11.39, 95％CI (-13.45, -9.34) , P < 0.000 01]; the cost of treatment was lower than that in the control group [MD=-5 927.76, 95％CI (-10 413.04, -1 442.49) , P=0.010]; and the hospitalization time was less than that in the control group [MD=-14.77, 95％CI (-18.82, -10.73) , P < 0.000 01]. (3) Four studies reported adverse reactions, but adverse reactions were not associated with platelet-rich plasma. (4) These results suggest that platelet-rich plasma has a good clinical effect in promoting the healing of diabetic foot ulcers, and no adverse reactions occur. Due to limitations in the quantity and quality of the studies, the above conclusions are yet to be verified by more high-quality studies.

Objective:To analyze the clinical efficacy of Seretide combined with noninvasive positive pressure ventilation (NIPPV) in the treatment of chronic obstructive pulmonary disease (COPD) complicated with type 2 respiratory failure (RF).Methods:120 patients of COPD complicated with type 2 RF were randomly divided into the observation group and the control group.All patients were treated with routine,symptomatic and supportive treatment,based on that NIPPV was used in the control group,and the observation group was treated with Seretide on the basis of NIPPV.The levels of arterial blood gas,inflammatory factors,pulmonary function and CAPS score before and after treatment were compared and analyzed.Results:After treatment,the pH,PaO2 and SaO2 of both groups were significantly increased,PaCO2 levels weresignificantly decreased,serum IL-33,TNF-oα and sICAM-1 levels were significantly decreased,FVC,PEFR,FEV1％ and FEV1/FVC were significantly decreased,and the CAPS scores were significantly decreased;the changes of all the index mentioned above in the observation group were more statistically significant (P＜0.05).Conclusion:Seretide com bined with NIPPV could more effectively decrease the levels of inflammatory factors and improve the blood gas and lung function in the patients of COPD with type 2 respiratory failure.