Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes. Current treatment methods typically focus on controlling blood glucose levels, routine care, anti-infection, debridement, and other aspects. However, these approaches have not consistently yielded satisfactory results. Adipose-derived stem cells (ADSCs) are characterized by their diverse sources, ease of acquisition, and low immunogenicity, making them a prominent topic of research area in the field of stem cells. ADSCs have emerged as a new strategy for the treatment of DFUs. This review aims to describe the pathophysiological characteristics of diabetic foot ulcers, the advantages and biological functions of ADSCs, and their mechanisms for promoting wound healing in DFUs, thereby providing a theoretical basis for the clinical application of ADSCs in the treatment of DFUs.

Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes. The current treatment method usually focus on blood glucose controlling, routine care, anti-infection, debridement and other aspects, but still have not achieved good result . Adipose-derived stem cells (ADSCs) possess the characteristics of a wide range of sources, easy acquisition, and low immunogenicity, making them hot topics of research area in the field of stem cell. ADSCs has become a new strategy for the treatment of DFUs . This review aims to describe the pathophysiological characteristics of diabetic foot ulcers, the advantages and biological function of ADSCs and their mechanisms of promoting DFUs wound healing, to provide a theoretical basis for the clinical application of ADSCs in the treatment of DFUs.

Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes. The current treatment method usually focus on blood glucose controlling, routine care, anti-infection, debridement and other aspects, but still have not achieved good result . Adipose-derived stem cells (ADSCs) possess the characteristics of a wide range of sources, easy acquisition, and low immunogenicity, making them hot topics of research area in the field of stem cell. ADSCs has become a new strategy for the treatment of DFUs . This review aims to describe the pathophysiological characteristics of diabetic foot ulcers, the advantages and biological function of ADSCs and their mechanisms of promoting DFUs wound healing, to provide a theoretical basis for the clinical application of ADSCs in the treatment of DFUs.

Objective:To explore effects of different lower limb placement angles on venous drainage among patients undergoing thoracolumbar surgery in prone position.Methods:From January 2017 to January 2018, we selected patients underwent elective thoracolumbar surgery in prone position of Operating Room in Beijing Hospital as research objects. According to the need of surgery, it was divided into 51 cases in low-angle group and 54 cases in traditional-angle group. We compared effects of different lower limb placement angles on patients by taking the changes of lower limb venous blood flow under ultrasound before and after surgery as main observation indicators and taking changes of lower limb skin temperature and leg circumference as the secondary observation indicator.Results:There were statistical differences in the changes of blood flow on the left and right popliteal veins, the left and right posterior tibial veins of patients under ultrasound between two groups before and after surgery ( P<0.05) . There were no statistical differences in the changes of the leg circumference of 10 cm above the left and right ankles and the changes of the leg circumference of 15 cm above the left and right patellae of patients between two groups ( P>0.05) ; there was also no statistical difference in the change of bilateral skin temperature ( P>0.05) . Conclusions:The lower limb placement angles among patients undergoing thoracolumbar surgery in prone position may affect the venous drainage which nurses of Operating Room should pay attention to when placing positions.

Objective: To summarize our experience in the diagnosis of internal carotid artery trauma in patients with traumatic optic neuropathy, and to make recommendations for the treatment. Methods: The clinic data of 6 cases who had traumatic optic neuropathy with internal carotid artery trauma and who were admited in Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from Jan. 2013 to Dec. 2015 were analyzed retrospectively. Results: All 6 cases were monocular blindness. Four cases did not undergo nasal endoscopic optic nerve decompression because of the diagnoses of internal carotid artery trauma. One case was diagnosed after nasal endoscopic optic nerve decompression because of fatal bleeding during the operation. One case was diagnosed because of late-onset recurrent epistaxis. Among the 6 cases with internal carotid artery trauma, 3 cases were successfully treated with endovascular interventional treatment (stent embolization was used in one case, Coil embolization was used in two cases), and 3 patients refused treatment. Conclusions The patients with traumatic optic neuropathy have the possibility of severe carotid artery trauma. Endoscopic optic nerve decompression is not suitable for these cases. It should pay more attention to patients with traumatic optic neuropathy. For suspected cases, vascular-enhanced computed tomography screening and digital subtraction angiography should be recommended and patients should be treated by endovascular intervention in a timely manner.

Objective To analyze the clinical characteristics and gene mutations of 56 patients with congenital hyperinsulinism(CHI)and to provide a theoretical basis for clinical diagnosis and treatment of CHI.Methods Fifty-six children who were diagnosed as CHI between February 2002 and January 2016 in Beijing Children's Hospital Affiliated to Capital Medical University were selected as research subjects.A retrospective study was done about the clinical data and the treatment procedures of the 56 patients,such as perinatal conditions,clinical manifestations,laboratory data,treatments,prognosis and so on.Polymerase chain reaction(PCR)-DNA technology or next-generation sequencing technology was used to analyze the CHI relevant genes of the 56 patients.Results Thirty of the 56 patients carried CHI gene mutation.(1)Twenty-three of 56 patients(41.0％)carried ABCC8/KCNJ11 gene mutations:4 of 23 patients carried complex heterozygous mutation,1 of 23 patients carried both ABCC8 and KCNJ11 gene mutation,1 of 23 patients carried maternally inherited ABCC8 gene mutation,12 of 23 patients carried paternally inherited ABCC8 gene mutation,1 of 23 patients carried paternally inherited KCNJ11 gene mutation,3 of 23 patients carried de novo ABCC8 gene mutation,1 of 23 patients had unknown genetic way,19 of 23 patients were treated with Diazoxide,2 of 19 patients were responsive to Diazoxide,7 of 19 patients were unresponsive to Diazoxide and 10 of 19 patients were uncertain to Diazoxide.(2)Five of 56 patients(8.9％)carried GLUD1 gene mutation,4 of 5 patients were treated with Diazoxide and they were all responsive to Diazoxide.(3)One of 56 patients(1.7％)carried de novo GCK gene mutation,responsive to Diazoxide treatment.(4)One of 56 patients(1.7％)carried maternally inherited SLC16A1 gene mutation,responsive to Diazo-xide treatment.Conclusions The ABCC8 gene and GLUD1 gene mutation are the main causative genes of CHI.The GCK gene and SLC16A1 gene mutation are in the minority.Most ABCC8 gene and KCNJ11 gene mutation are unresponsive to Diazoxide treatment.

Objective To investigate the prevalence of feeding intolerance (FI),and to explore the FI within 7 days of ICU admission in association with clinical outcome in critically ill patients.Methods The adult patients from 14 general ICUs in Zhejiang Province with an expected admission to ICU for at least 24h were recruited from March 2014 to August 2014,and all clinical,laboratory,and survival data were prospectively collected.The AGI (acute gastrointestinal injury) grade was daily assessed based on gastrointestinal (GI) symptoms,feeding details and organ dysfunction within the first week of ICU stay.The intra-abdominal pressures (IAP) was measured using AbViser device.Results Of 550 patients enrolled,418 were assessed in GI symptoms and feeding details within 7 days of ICU stay.The mean age and SOFA score were (65.1 ± 18.3) years and (8.96 ±4.10),respectively.Of them,355 patients (84.9％) were under mechanical ventilation support,and 37 (8.85％) received renal replacement therapy.The mean length of time for enteral feeding was (30.8 ±26.2) h,and the prevalence of FI on the 3rd and 7th day of ICU stay accounted for 39.2％ and 25.4％,respectively.Compared to those with FI within 7 days of ICU stay,the patients without FI had higher rate of successively weaning from mechanical ventilation (21.3％ vs.5.7％,P =0.003) and higher rate of withdrawal of vasoactive medication (45.5％ vs.20.0％,P =0.037),as well as lower mortality rate of 28-day (24.4％ vs.38.7％,P =0.004) and 60-day (29.6％ vs.44.3％,P =0.005).In multivariate Cox regression model with adjustment for age,sex,participant center,serum creatinine and lactate,AGI grade on the first day of ICU stay,and comorbidities,the FI within 7 days of ICU stay (x2 ≥ 7.24,P ＜ 0.01) remained to be independent predictors for 60-day mortality.After further adjusted for SOFA score,the FI within 7 days of ICU stay (HR =1.71,95％ CI:1.18-2.49;P =0.006) and AGI grade on the first day of ICU stay (HR =1.33,95 ％ CI:1.07-1.65;P =0.009) could provide independent prognostic values of 60-day mortality.Conclusions There is high rate of FI occurred within 7 days of ICU stay,and is significantly associated with worse outcome.In addition,this study also provides evidence to further support that measurement of gastrointestinal dysfunction could increase value of SOFA score in outcome prediction for the risk of 60-day mortality.

Objective To study the curative effect and the prognostic factors of endoscopic traumatic optic neuropathy (TON). Methods The clinical data of 53 patients with TON from 2010 to 2015 years was retrospectively analyzed. Divided the patients into the surgery group and the non-surgery group, according to whether or not accept the treatment of endoscopic optic decompression. And evaluating the potential prognostic factors in chi-square test, group t-test and multiple regression analysis. Results In 53 patients (55 eyes ), 31 eyes have no visual acuity before treated: 8 eyes’ visual acuity was improved in 16 eyes (8/16) that accepted operation; 3 eyes’ visual acuity was improved in 15 eyes (3/15) that with non-operation;24 eyes have visual acuity before treated:11 eyes’ visual acuity was improved in 14 eyes (11/14) that accepted operation;3 eyes’ visual acuity was improved in 10 eyes (3/10) that with non-operation;19 eyes’ visual acuity was improved in 30 eyes (19/30) that accepted operation, the total effective rate was 63.3%, and there was no complications happened in the patients who accepted operation. The age, eye-side, sex, visual acuity, optic canal fracture , orbit fracture , all these factors have no correlation to the prognosis (P>0.05), but the interval time between injury and operation (less than 3 days) and the way of the treatment are benefit to improve vision (P<0.05). Conclusions The endoscopic optic decompression is an effective treatment in TON, and it’s better to improve vision in 3-day after TON.

Objective To study the effect and postoperative reaction of nasal endoscopic low temperature plasma radiofrequency ablation on children with snoring. Methods 104 cases with snoring received surgical treatment from May 2013 to May 2015 were divided into experimental group and control group. The experimental group patients re-ceived nasal endoscopic low temperature plasma radiofrequency ablation, the control group received adenoidectomy curettage combined with tonsillectomy. Then the surgery condition, postoperative pain, stress response and ventila-tion function were compared between the two groups. Results Operation indicator: the experimental group operation time, postoperative pain time, symptoms remission time, intraoperative blood loss were significantly lower than the control group ( < 0.05); Pain degree: 6 h, 24 h, 48 h, 72 h after surgery, the experimental group VAS score were significantly lower than that in control group ( < 0.05); Stress reaction: 24 h after surgery, the experimental group patients serum MDA, 8-isoPG, 3-NT content were significantly lower than that in control group, SOD, GSH content were significantly higher than that in control group ( < 0.05); Ventilation function: 6 months after surgery, the ex-perimental group AHI, ODI, SLT90%, LAT were significantly lower than that in control group, LSaO2 were signifi-cantly higher than that in control group ( <0.05). Conclusion Nasal endoscopic low temperature plasma radiofre-quency ablation can reduce surgical trauma and relieve postoperative pain and stress reaction, improve ventilation function, it's an ideal operative method for the treatment of children with snoring.

Objective To investigate application feasibility of the heterogeneous de protein cancellous bone in the treatment of lumber intertransverse process spinal fusion.Methods Thirty 6 ～ 8 month healthy male goats were selected to make intertransverse bone bed,and were randomly divided into groups Ⅰ and Ⅱ,with 15 in each group.Group Ⅰ was the left side implanted the tissue engineering bone (A group),and the right side implanted recombinant human bone morphogenetic protein-2 (rhBMP-2) composite bone (B group);Group Ⅱ was the left implanted autologous bone (C group),and the right side implanted simple heterogeneous de protein cancellous bone (D group).Each group was observed with the Xray,histological morphology,and maximum bending load.Results (1) In groups B and D,postoperative 4-,8-and 12-week X-ray scores were lower than that of group C (P ＜0.05);In group A,postoperative 4-,8-and 12-week X-ray score were (5.30 ± 0.41) points,(8.54 ± 0.89) points,and (11.25 ± 0.91)points,compared to group C,without statistically significant difference (P ＞ 0.05);(2) For groups A,B and D,postoperative 4-and 8-week histological scores were significantly lower than those in group C (P ＜0.05).For group A,postoperative 4-and 8-week histological scores were significantly higher than those of groups B and D (P ＜0.05).The histological scores of groups B and D postoperative 12 weeks were lower than those of group C (P ＜0.05).The histological score of group A postoperative 12 weeks was (11.04 ± 1.52) points,compared to group C without statistically significant difference (P ＞ 0.05);(3) The maximum bending load of groups B and D was lower than that of group C (P ＜ 0.05).The maximum bending load of group A was (60.32 ± 10.10) N,compared to group C without statistically significant difference (P ＞ 0.05).Conclusions The construction of tissue engineered bone by the heterogeneous de protein cancellous bone,its osteogenesis is close to autogenous bone,but simple heterogeneous de protein cancellous bone osteogenesis is poor.