Objective: To examine the use of maggot debridement therapy (MDT) for individuals with diabetic foot ulcers (DFU) after a change in prescribing policy.

Method: A self completion survey/structured questionnaire to assess healthcare professionals' existing knowledge of MDT was given to those specialist services providing wound care treatments for DFUs.

Results: The results showed that those responding had a basic understanding of MDT and its use. However, further education is required for the type of wounds that maggots can be applied to, and what enzymes are produced. Enablers and barriers to MDT use also included policy and procedures, time constraints and the 'yuck factor'.

Conclusion: While there is good clinical evidence to support the use of MDT, there is a lack of evidence examining the factors that influence healthcare professionals’ decisions to recommend this treatment.

KEY WORDS  Maggot debridement therap  Lucillia sericata   Diabetic foot ulcer  Attitudes/knowledge  Service evaluation

CRAIG FAIREY Tissue Viability Podiatrist, Sound Primary Care Network, Oakside Surgery, Honicknowle Green Medical Centre, UK SAMANTHA HOLLOWAY Reader, Centre for Medical Education, School of Medicine, Cardiff University, Wales, UK

侯显玥，杜柯锐，杨小娟*

延安大学附属医院肾内科，陕西 延安

收稿日期：2022年6月1日；录用日期：2022年6月24日；发布日期：2022年7月4日

摘 要

随着对糖尿病肾病(DKD)研究的不断深入，慢性炎症状态的地位越来越凸显。近年来，一种与天冬氨酸半胱氨酸蛋白水解酶(Caspase)-1相关的程序性细胞死亡机制，通过足细胞与肾小管上皮细胞的焦亡引起一系列炎症反应，最终导致肾功能恶化。肠道菌群异常在慢性肾脏病患者中致病证据越来越充分，其机制表现为菌群比例的失调(有害细菌增多、有益菌减少甚至缺如)，产生炎症因子及氧化应激产物。另外，内脂素(Visfatin)在DKD发生发展中均发挥作用，参与胰岛素抵抗、调控糖脂代谢、增强炎症反应等过程。同样，适应性免疫系统及相关细胞因子同样有重要作用，通过T细胞、B细胞及白细胞介素(interleukin,IL)-17A、白细胞介素(interleukin, IL)-2、肿瘤坏死因子(TNF)和肿瘤坏死因子(TNF)受体等细胞因子共同导致蛋白尿的产生、肾功能的恶化。因此，了解诱导慢性炎症的各类分子机制在糖尿病肾病发生以及发展中的作用，对糖尿病肾病的早期识别及治疗有重要意义。

关键词

糖尿病肾病，炎症，细胞焦亡，肠道菌群，内脂素，适应性免疫

Progress in the Study of Chronic Inflammatory Mechanism of Diabetic Nephropathy Xianyue Hou, Kerui Du, Xiaojuan Yang*

Department of Nephrology, Affiliated Hospital of Yan’an University, Yan’an Shaanxi Received: Jun. 1st, 2022; accepted: Jun. 24th, 2022; published: Jul. 4th, 2022

Abstract

With the continuous deepening of the study of Diabetic Kidney Disease (DKD), the status of chron-ic inflammation is becoming more and more prominent. In recent years, a programming cell death mechanism related to cyspase-1 is caused by the scorching of foot cells and renal tubular epithelial cells, which causes a series of inflammatory reactions and eventually leads to kidney function worsen. The inferior of the intestinal flora is increasingly sufficient in patients with chronic kidney disease, and its mechanism is manifested as the disorders of the flora ratio (increasing harmful bacteria, reduced beneficial bacteria, or even lack of), producing inflammatory factor and oxidation stimulating products. In addition, Visfatin played a role in the development of DKD to participate in the process of participating in insulin resistance, regulating sugar fat metabolism, and enhancing inflammatory response. Similarly, the adaptive immune system and related cytokine also have an important role, T cells, B cells and cytokines such as interleukin (IL)-17A, interleukin (IL)-2, tumor necrosis factor (TNF) and tumor necrosis factor (TNF) receptor jointly lead to the production of proteinuria and the deterioration of renal function. Therefore, understanding the role of various types of molecular mechanisms that induce chronic inflammation in the occurrence and development of diabetic nephropathy is of great significance for the early identification and treatment of diabetic nephropathy.

Keywords

Diabetic Kidney Disease, Inflammation, Pyroptosis, Gut Microbiota, Visfatin, Adaptive Immunity

Copyright © 2022 by author(s) and Hans Publishers Inc.

This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).

http://creativecommons.org/licenses/by/4.0/

Yinfang Tu", Yuqian Bao回1,2*, and Pin Zhang 3,*

1 Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai 200233, China
2 Department of Endocrinology and Metabolism, jinshan District Central Hospital of Shanghai Sixth People's Hospital, Shanghai 201 599, China
3 Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China* Correspondence to: Yuqian Bao, E-mail: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。; Pin Zhang, E-mail: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Edited by Wei-Ping Jia
      Obesity and its related complications comprise a serious public health problem worldwide, and obesity is increasing in China.
      Metabolic surgery is a new type of treatment with unique advantages in weight loss and obesity-related metabolic complications.
      The pathogenesis of obesity is complex and not yet fully understood. Here, we review the current efficacy and safety of metabolic surgery, as well as recent progress in mechanistic studies and surgical procedures in China. The exciting and rapid advances in this field provide new opportunities for patients with obesity and strike a balance between long-term effectiveness and safety.

Keywords: metabolic surgery, type 2 diabetes mellitus, obesity, metabolic syndrome.

 Received March 14, 2021. Revised May 27, 2021. Accepted June 14, 2021.
◎The Author(s) (2021). Published by Oxford University Press on behalf of Journal of Molecular Cell Biology, CEMCS, CAS.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:/ /creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals. 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Kavit Amin1,2,3,4, Roxana Moscalu1, Angela Imere1,5, Ralph Murphy1,2, Simon Barr1,2, Youri Tan1,2, Richard Wong1,2, Parviz Sorooshian1, Fei Zhang1,5, John Stone3,4, James Fildes3,4, Adam Reid1,2 & Jason Wong*,1,2

1 Blond McIndoe Laboratories, Division of Cell Matrix Biology & Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK

2 Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK

3Manchester Collaborative Centre for Inflammation Research (MCCIR), Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK

4The Transplant Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK

5Department of Materials, School of Natural Sciences, Faculty of Science & Engineering Research Institutes, The University of Manchester, MSS Tower, Manchester, UK *Author for correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Plastic surgery encompasses a broad spectrum of reconstructive challenges and prides itself upon developing and adopting new innovations. Practice has transitioned from microsurgery to supermicrosurgery with a possible future role in even smaller surgical frontiers. Exploiting materials on a nanoscale has enabled better visualization and enhancement of biological processes toward better wound healing, tumor identification and viability of tissues, all cornerstones of plastic surgery practice. Recent advances in nanomedicine and biomimicry herald further reconstructive progress facilitating soft and hard tissue, nerve and vascular engineering. These lay the foundation for improved biocompatibility and tissue integration by the optimization of engineered implants or tissues. This review will broadly examine each of these technologies, highlighting areas of progress that reconstructive surgeons may not be familiar with, which could see adoption into our armamentarium in the not-so-distant future.

First draft submitted: 17 March 2019; Accepted for publication: 16 August 2019; Published online: 31 October 2019

Keywords: biointegration • biomimicry • engineered implants • nanomedicine • nanoparticles • nanotechnology • plastic surgery • reconstructive surgery • tissue engineering • tissue regeneration

Foot complications from diabetes mellitus are one of main causes of lower limb amputation, however, public awareness of diabetic foot care is low. A mobile app “Happy Feet” was developed,s targeting patients with diabetic foot ulcers (DFU). Patients foot awareness substantially increased after three and six months of using the application. Mean total scores between baseline and three months were significantly increased (baseline versus three months, 22.80 versus 25.54; p<0.01), and between three and six months in “examining between the toes” and “breaking in new shoes slowly” (p<0.01). Policymakers and medical professionals benefit from the mobile app by providing accurate and precise information from this group of patients.

Key words: Diabetic foot 、Mobile phone application 、   Self-care 、  Self-assessment

Francis Lovecchio1  · Grant J. Riew2  · Dino Samartzis3,4 · Philip K. Louie5  · Niccole Germscheid6  · Howard S. An3,4 ·

Jason Pui Yin Cheung7  · Norman Chutkan8  · Gary Michael Mallow3,4 · Marko H.  Neva9  · Frank M. Phillips3,4 ·

Daniel M. Sciubba10 · Mohammad El‑Sharkawi11 · Marcelo Valacco12 · Michael H.  McCarthy13 · Melvin C. Makhni2  ·

Sravisht Iyer1

1 Department of Orthopaedic Surgery, Hospital for Special Surgery,  New York, NY, USA

2 Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Harvard Medical School,  Boston, MA, USA

3 Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA

4 The International Spine Research and Innovation Initiative, Rush University Medical Center,  Chicago, IL, USA

5 Neuroscience Institute, Virginia Mason Medical Center,  Seattle, WA, USA

6 Research Department, AO Spine International, Davos, Switzerland

7 Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong SAR, China

8 Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, AZ, USA

9 Department of Orthopaedic and Trauma Surgery, Tampere University Hospital, Tampere, Finland

10 Department of Neurosurgery, Baltimore, MD, USA, John Hopkins University, Baltimore, MD, USA

11 Department of Orthopaedic and Trauma Surgery, Assiut University Medical School, Assiut, Egypt

12 Department of Orthopaedics, Churruca Hospital de Buenos Aires, Buenos Aires, Argentina

13 Indiana Spine Group,  Carmel, IN, USA

Received: 22 September 2020 / Accepted: 27 October 2020 / Published online: 22 November 2020

© The Author(s) 2020

Abstract

Purpose To utilize data from a global spine surgeon survey to elucidate (1) overall confidence in the telemedicine evaluation and (2) determinants of provider confidence.

Methods Members of AO Spine International were sent a survey encompassing participant’s experience with, perception of,and comparison of telemedicine to in-person visits. The survey was designed through a Delphi approach, with four rounds of

question review by the multi-disciplinary authors. Data were stratified by provider age, experience, telemedicine platform, trust in telemedicine, and specialty.

Results Four hundred and eighty-five surgeons participated in the survey. The global effort included respondents from Africa (19.9%), Asia Pacific (19.7%), Europe (24.3%), North America (9.4%), and South America (26.6%). Providers felt that physical exam-based tasks (e.g., provocative testing, assessing neurologic deficits/myelopathy, etc.) were inferior to inperson exams, while communication-based aspects (e.g., history taking, imaging review, etc.) were equivalent. Participants who performed greater than 50 visits were more likely to believe telemedicine was at least equivalent to in-person visits in the ability to make an accurate diagnosis (OR 2.37, 95% C.I. 1.03–5.43). Compared to in-person encounters, video (versus phone only) visits were associated with increased confidence in the ability of telemedicine to formulate and communicate a treatment plan (OR 3.88, 95% C.I. 1.71–8.84).

Conclusion Spine surgeons are confident in the ability of telemedicine to communicate with patients, but are concerned about its capacity to accurately make physical exam-based diagnoses. Future research should concentrate on standardizing the remote examination and the development of appropriate use criteria in order to increase provider confidence in telemedicine technology.

Keywords Telemedicine · Spine surgery · Examination · International · Survey

Cristian Lieneck 1,* , Joseph Garvey 2 , Courtney Collins 2 , Danielle Graham 2 , Corein Loving 2

and Raven Pearson 2

1 School of Health Administration, Texas State University, San Marcos, TX 78666, USA

2 School of Health Sciences, Southern Illinois University-Carbondale, Carbondale, IL 62901, USA; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (J.G.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (C.C.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (D.G.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (C.L.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (R.P.)

*Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。; Tel.: +1-512-245-6362

Received: 16 October 2020; Accepted: 26 November 2020; Published: 29 November 2020

Abstract: The implementation and continued expansion of telehealth services assists a variety of health care organizations in the delivery of care during the current COVID-19 global pandemic. However, limited research has been conducted on recent, rapid telehealth implementation and expansion initiatives regarding facilitators and barriers surrounding the provision of quality patient care. Our rapid review evaluated the literature specific to rapid telehealth implementation during the current COVID-19 pandemic from three research databases between January 2020 and May 2020 and reported using preferred reporting items for systematic reviews and meta-analyses (PRISMA). The results indicate the rapid implementation and enhanced use of telehealth during the COVID-19 pandemic in the United States surrounding the facilitators and barriers to the provision of patient care, which are categorized into three identified themes: (1) descriptive process-oriented implementations,(2) the interpretation and infusion of the CARES Act of 2020 telehealth exemptions related to the relaxation of patient privacy and security (HIPAA) protocols, and (3) the standard of care protocols and experiences addressing organizational liability and the standard of care. While the study limitation of sample size exists (n = 21), an identification of rapid telehealth implementation advancements and challenges during the current pandemic may assist health care organizations in the delivery of ongoing quality care during the COVID-19 pandemic.

Keywords: telehealth; telemedicine; COVID-19; coronavirus; implementation.

Abstract: Macrophages play a prominent role in wound healing. In the early stages, they promote inflflammation and remove pathogens, wound debris, and cells that have apoptosed. Later in the repair process, they dampen inflflammation and secrete factors that regulate the proliferation, differentiation,and migration of keratinocytes, fifibroblasts, and endothelial cells, leading to neovascularisation and wound closure. The macrophages that coordinate this repair process are complex: they originate from different sources and have distinct phenotypes with diverse functions that act at various times in the repair process. Macrophages in individuals with diabetes are altered, displaying hyperresponsiveness to inflflammatory stimulants and increased secretion of pro-inflflammatory cytokines. They also have a reduced ability to phagocytose pathogens and efferocytose cells that have undergone apoptosis. This leads to a reduced capacity to remove pathogens and, as efferocytosis is a trigger for their phenotypic switch, it reduces the number of M2 reparative macrophages in the wound. This can lead to diabetic foot ulcers (DFUs) forming and contributes to their increased risk of not healing and becoming infected, and potentially, amputation. Understanding macrophage dysregulation in DFUs and how these cells might be altered, along with the associated inflflammation, will ultimately allow for better therapies that might complement current treatment and increase DFU’s healing rates.

Keywords: macrophage; inflflammation; diabetic foot ulcer; chronic wound; efferocytosis; phenotype; infection.

Authors

Cathy L. Wogamon

Keywords

quality improvement

Authors

Beenish Nafees

Mikkel Rasmussen

Andrew Lloyd