1.Effect of closed negative pressure drainage combined with Ilizarov transverse tibial bone displacement on the clinical efficacy and complications of severe diabetic foot
Yuejing ZHAO ; Zelin CHEN ; Wu ZHANG
The Journal of Practical Medicine 2025;41(13):2052-2057
Objective To investigate the impact of closed negative pressure drainage in combination with Ilizarov transverse tibial bone transport on oxidative stress and inflammatory response in patients with severe diabetic foot.Methods A total of 60 patients with severe diabetic foot who were admitted to the hospital from July 2019 to March 2023 were recruited as the research subjects.These patients were randomly allocated into a control group(n=30)and an observation group(n=30).The control group received Ilizarov tibial transverse bone transport alone,whereas the observation group was treated with closed negative pressure drainage in conjunction with Ilizarov tibial transverse bone transport.The following parameters were compared between the two groups of patients:the reduction rate of wound size,the healing rate,growth factors[Epidermal Growth Factor(EGF),Transforming Growth Factor(TGF),Vascular Endothelial Growth Factor(VEGF)],oxidative stress indicators[Advanced Protein Oxidation Products(AOPP),Malondialdehyde(MDA),Superoxide Dismutase(SOD)],inflammatory factors[Procalcitonin(PCT),Interleukin-18(IL-18),C-reactive Protein(CRP)],adverse reactions,and the amputation rate.Results The shrinkage rate and healing rate of patients in the observation group were both significantly higher than those in the control group(P<0.05).Post-treatment,the improvement in growth factor levels,including EGF,TGF,and VEGF,in the observation group was more pronounced compared to that in the control group(P<0.05).Regarding serum AOPP,MDA,and SOD levels,the improvement in the observation group was superior to that in the control group(P<0.05).Moreover,the improvement in inflammatory factor levels such as serum PCT,IL-18,and CRP in the observation group was more notable than that in the control group(P<0.05).The incidence of adverse reactions such as redness,swelling,pain,and bleeding in the observation group was 6.67%.When compared with the incidence of 11.67%in the control group,no statistically significant difference was observed(P>0.05).The amputation rate of patients in the observation group was 3.33%,which was significantly lower than 23.33%in the control group(P<0.05).Conclusions Closed negative pressure drainage combined with Ilizarov tibial transverse bone transport demonstrates better efficacy in the treatment of severe diabetic foot.This treatment modality can effectively promote wound healing,enhance oxidative stress regulation,and inhibit the inflammatory response,presenting a relatively high safety profile.Therefore,the application of closed negative pressure drainage combined with Ilizarov tibial transverse bone transport in the treatment of severe diabetic foot merits clinical reference and promotion.
2.Effect of closed negative pressure drainage combined with Ilizarov transverse tibial bone displacement on the clinical efficacy and complications of severe diabetic foot
Yuejing ZHAO ; Zelin CHEN ; Wu ZHANG
The Journal of Practical Medicine 2025;41(13):2052-2057
Objective To investigate the impact of closed negative pressure drainage in combination with Ilizarov transverse tibial bone transport on oxidative stress and inflammatory response in patients with severe diabetic foot.Methods A total of 60 patients with severe diabetic foot who were admitted to the hospital from July 2019 to March 2023 were recruited as the research subjects.These patients were randomly allocated into a control group(n=30)and an observation group(n=30).The control group received Ilizarov tibial transverse bone transport alone,whereas the observation group was treated with closed negative pressure drainage in conjunction with Ilizarov tibial transverse bone transport.The following parameters were compared between the two groups of patients:the reduction rate of wound size,the healing rate,growth factors[Epidermal Growth Factor(EGF),Transforming Growth Factor(TGF),Vascular Endothelial Growth Factor(VEGF)],oxidative stress indicators[Advanced Protein Oxidation Products(AOPP),Malondialdehyde(MDA),Superoxide Dismutase(SOD)],inflammatory factors[Procalcitonin(PCT),Interleukin-18(IL-18),C-reactive Protein(CRP)],adverse reactions,and the amputation rate.Results The shrinkage rate and healing rate of patients in the observation group were both significantly higher than those in the control group(P<0.05).Post-treatment,the improvement in growth factor levels,including EGF,TGF,and VEGF,in the observation group was more pronounced compared to that in the control group(P<0.05).Regarding serum AOPP,MDA,and SOD levels,the improvement in the observation group was superior to that in the control group(P<0.05).Moreover,the improvement in inflammatory factor levels such as serum PCT,IL-18,and CRP in the observation group was more notable than that in the control group(P<0.05).The incidence of adverse reactions such as redness,swelling,pain,and bleeding in the observation group was 6.67%.When compared with the incidence of 11.67%in the control group,no statistically significant difference was observed(P>0.05).The amputation rate of patients in the observation group was 3.33%,which was significantly lower than 23.33%in the control group(P<0.05).Conclusions Closed negative pressure drainage combined with Ilizarov tibial transverse bone transport demonstrates better efficacy in the treatment of severe diabetic foot.This treatment modality can effectively promote wound healing,enhance oxidative stress regulation,and inhibit the inflammatory response,presenting a relatively high safety profile.Therefore,the application of closed negative pressure drainage combined with Ilizarov tibial transverse bone transport in the treatment of severe diabetic foot merits clinical reference and promotion.
3.Successful treatment of a patient with catatonia and sever pneumonia using modified electroconvulsive therapy performed with tracheotomy
Yuejing WU ; Qian HE ; Li ZHANG ; Zhong XU ; Qiaoqiao LU ; Fugang LUO
Chinese Journal of Psychiatry 2024;57(6):367-370
Catatonia is a group of severe psychomotor syndromes that affect patients' motor function, speech, and complex behaviors. Patients with catatonia typically display rigidity accompanied by decreased mobility, speech, sputum production, defecation, and eating. Both catatonia-related risks, such as increased muscle tension, reduced swallowing, and coughing reflexes, and risks attributed to therapeutic methods, such as prolonged bed rest and sedative drugs, can increase the risk of aspiration pneumonia, severe pneumonia, and acute respiratory failure. These conditions and complications can seriously affect the treatment of catatonia, lead to poor prognosis, and threaten the patient's safety. This paper reports a patient with catatonia combined with severe pneumonia and respiratory distress syndrome recovered after modified electroconvulsive therapy (MECT) under tracheotomy. This case report can offer valuable insights for psychiatrists when facing similar cases and assist in making rational therapeutic plans to improve the condition as soon as possible.
4.Successful treatment of a patient with catatonia and sever pneumonia using modified electroconvulsive therapy performed with tracheotomy
Yuejing WU ; Qian HE ; Li ZHANG ; Zhong XU ; Qiaoqiao LU ; Fugang LUO
Chinese Journal of Psychiatry 2024;57(6):367-370
Catatonia is a group of severe psychomotor syndromes that affect patients' motor function, speech, and complex behaviors. Patients with catatonia typically display rigidity accompanied by decreased mobility, speech, sputum production, defecation, and eating. Both catatonia-related risks, such as increased muscle tension, reduced swallowing, and coughing reflexes, and risks attributed to therapeutic methods, such as prolonged bed rest and sedative drugs, can increase the risk of aspiration pneumonia, severe pneumonia, and acute respiratory failure. These conditions and complications can seriously affect the treatment of catatonia, lead to poor prognosis, and threaten the patient's safety. This paper reports a patient with catatonia combined with severe pneumonia and respiratory distress syndrome recovered after modified electroconvulsive therapy (MECT) under tracheotomy. This case report can offer valuable insights for psychiatrists when facing similar cases and assist in making rational therapeutic plans to improve the condition as soon as possible.
5.Application of combined detection of PCT ,hs-CRP ,IL-6 and WBC in diagnosing type 2 diabetes mellitus bloodstream infection
Xueqin FENG ; Runjie WU ; Lanfen LU ; Juan WANG ; Lishao MIAO ; Haizhong YAN ; Xihua LUO ; Yuejing MU ; Yang LI
International Journal of Laboratory Medicine 2018;39(2):169-172,175
Objective To investigate the application value of single detection and combined detection of 4 kinds of inflammatory indicators of procalcitonin (PCT ) ,high sensitivity C-reactive protein(hs-CRP) ,interleu-kin-6(IL-6) and white blood cell(WBC) in diagnosing type 2 diabetes mellitus(T2DM) bloodstream by analy-zing the levels of peripheral blood PCT ,hs-CRP ,IL-6 and WBC in the T2DM bloodstream infection group and T2DM non-bloodstream infection group .Methods The clinical data in 85 patients with T2DM bloodstream in-fection (T2DM bloodstream infection group ) and contemporaneous 80 cases of T2DM non-bloodstream infec-tion(T2DM non-bloodstream infection group) in this hospital from January 2013 to July 2016 were retrospec-tively analyzed .The levels of various inflammatory indicators in peripheral blood were analyzed .The receiver operating characteristic(ROC) curve of various inflammatory indicators was drawn ,the area under the curve (AUC) and the best cut-off value were calculated .The detection schemes included 24 kinds of schemes such as the single indicator ,2-indicator ,3-indicator and 4-indicator .Results The levels of PCT ,hs-CRP ,IL-6 and WBC in the T2DM bloodstream infection group were significantly higher than those in the T 2DM non-blood-stream infection group ,the difference was statistically significant (P<0 .05) .AUC of PCT ,hs-CRP ,IL-6 and WBC were 0 .909 ,0 .818 ,0 .838 and 0 .760 respectively ,with best cut-off values of 0 .493 ng/mL ,11 .19 ng/mL ,40 .95 pg/mL and 11 .87 × 109/L respectively .The Youden index of PCT was highest (0 .65) and the ac-curacy of IL-6 was highest (83 .33% ) in the single indicator detection scheme .The Youden index and accuracy of the scheme of PCT/hs-CRP and PCT+hs-CRP+IL-6 were highest in the combined detection scheme .Con-clusion PCT detection has the prominent value in the assisted diagnosis of T 2DM bloodstream infection .Inthe combined detection scheme ,PCT/hs-CRP and PCT+hs-CRP+IL-6 have the highest value in the assisted diagnosis in T2DM bloodstream infection .

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