负压封闭引流对开放性骨折创面影响的 Ｍｅｔａ 分析 及试验序贯分析

郑惠灵 孙 柯 陈 惠 盖玉宁 郑喜灿

作者单位： ４５０００７ 河南 郑州， 中国人民解放军联勤保障部队第九八八医院外科 通信作者： 郑喜灿， Ｅｍａｉｌ： １３８０３８１８９５２＠ １６３.ｃｏｍ

【摘要】 目的 系统分析负压封闭引流对开放性骨折创面的治疗效果。 方法 计算机检索中国期刊全文数 据库 （中国知网）、 中国生物医学文献数据库 （ＣＢＭ）、 中文科技期刊数据库 （维普）、 中国学术期刊数据库 （万 方）、 Ｔｈｅ Ｃｏｃｈｒａｎｅ Ｌｉｂｒａｒｙ、 ＰｕｂＭｅｄ、 ＯＶＩＤ、 Ｗｅｂ ｏｆ Ｓｃｉｅｎｃｅ、 ＣＩＮＡＨＬ 等数据库建库至 ２０１８ 年 ８ 月公开发表的负 压封闭引流治疗开放性骨折创面的相关文献， 根据纳入与排除标准筛选符合标准的文献， 采用 Ｃｏｃｈｒａｎｅ ５. １.０ 手 册中的偏倚风险评估标准对纳入文献进行质量评价， 采用 Ｒｅｖ Ｍａｎ ５.３ 软件对纳入文献进行 Ｍｅｔａ 分析、 ＴＳＡ ０. ９ 软件对纳入文献进行试验序贯分析。 结果 共纳入符合标准的文献 １０ 篇， 包含开放性骨折患者 １０９７ 例。 Ｍｅｔａ 分 析结果显示， 创面行负压封闭引流治疗的开放性骨折患 者 创 面 感 染 率 明 显 低 于 常 规 治 疗 ［ ＲＲ ＝ ０.４３， ９５％ ＣＩ （０.３１，０. ６０）， Ｐ ＜ ０. ００１］， 治疗有效率明显高于常规治疗 ［ ＲＲ ＝ １.３３， ９５％ ＣＩ （１.１９， １. ５０）， Ｐ ＜ ０.００１］， 创面愈合时间明显短于常规治疗 ［ＳＭＤ ＝ － ４. ８７， ９５％ ＣＩ （ － ７.２１， － ２.５２）， Ｐ ＜ ０.００１］； 试验序贯分 析结果显示， 各结局指标在样本量达到期望信息量之前已获得肯定结果。 结论 与常规治疗方法相比， 负压封闭 引流能更有效降低开放性骨折创面感染率， 提高治疗有效率， 缩短创面愈合时间。

【关键词】 负压封闭引流； 开放性骨折； Ｍｅｔａ 分析； 试验序贯分析； 感染； 创面愈合时间

【标志符】 ｄｏｉ： １０.３９６９ ／ ｊ. ｉｓｓｎ.１００１⁃０７２６. ２０２２. ０１. ００９

【文章类型】 临床研究

ＭＥＢＴ ／ ＭＥＢＯ 治疗慢性难愈合创面机理研究 及联合应用现状

黄金梅 唐 婷 韦柳叶 付 军 唐乾利 ＨＵＡＮＧ Ｊｉｎｍｅｉ， ＴＡＮＧ Ｔｉｎｇ， ＷＥＩ Ｌｉｕｙｅ， ＦＵ Ｊｕｎ， ＴＡＮＧ Ｑｉａｎｌｉ

基金项目： 国家自然科学基金面上项目 （８１７７４３２７）； “广西特聘专家” 专项经费资助项目 （桂人才通字 ［２０１９］ １３ 号）； 广西 医学高层次领军人才培养 “１３９” 计划资助项目 （桂卫科教发 ［２０１８］ ２２ 号） 作者单位： ５３０００１ 广西 南宁， 广西中医药大学研究生院 ２０２０ 级中医外科专业 （黄金梅， 唐婷， 韦柳叶）； ５３００２３ 广西 南宁， 广西中医药大学第一附属医院肛肠外科 （付军）； ５３３０００ 广西 百色， 右江民族医学院／ 桂西高发病防治重 点实验室 （唐乾利） 通信作者： 唐乾利， Ｅｍａｉｌ： ｈｔｍｇｘ＠ １６３

负压封闭引流联合湿润烧伤膏治疗糖尿病足疗效 分析

作者单位： １２４０１０ 辽宁 盘锦， 盘锦市人民医院创面修复科 通信作者： 张伟， Ｅｍａｉｌ： １０１６７３３５２０＠ ｑｑ

Interleukin-25-Mediated-IL-17RB Upregulation Promotes Cutaneous Wound Healing in Diabetic Mice by Improving Endothelial Cell Functions

Fang Zhang1,2, Ye Liu2 , Shiqi Wang1 , Xin Yan1 , Yue Lin1 , Deyan Chen2*, Qian Tan1* and Zhiwei Wu2,3,4*

1 Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 2 Center for Public Health Research, Medical School, Nanjing University, Nanjing, China, 3 State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, China, 4 Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.

       Diabetic foot ulcer (DFU) frequently leads to non-traumatic amputation and finally even death. However, the mechanism of DFU is not fully understood. Interleukin 25 (IL-25), an alarmin cytokine that responds to tissue injury, has been reported to participate in tissue regeneration and maintaining glucose homeostasis. However, the role of IL-25 in diabetic wound healing remains unknown. Here, we showed that interleukin 17 receptor B (IL- 17RB), the functional receptor of IL-25, was significantly inhibited in the wound skin of both diabetic patients with DFU and streptozotocin (STZ)-induced diabetic mice. Topical administration of recombinant IL-25 protein improved angiogenesis and collagen deposition in the wound bed and thus ameliorated delayed diabetic wound healing. IL- 25 increased endothelial-specific CD31 expression in diabetic wounds and exogenous IL- 25 protected endothelial cells from high glucose-impaired cell migration and tube formation in vitro. We further revealed that IL-25-mediated-IL-17RB signaling rescued the downregulation of Wnt/b-catenin pathway both in vivo in diabetic mice and in vitro in HUVECs and induced the phosphorylation of AKT and ERK 1/2 in HUVECs under high glucose conditions. This study defines a positive regulatory role of IL-25-mediated-IL- 17RB signaling in diabetic wound healing and suggests that induction of IL-25-mediated  IL-17RB signaling may be a novel therapeutic strategy for treating poor healing diabetic wounds.

Keywords: IL-25, IL-17RB, diabetes mellitus, wound healing, endothelial cell functions.

The role of rehabilitation in the management of diabetic foot wounds

Elif Aydın1, Mustafa Bülent Ertuğrul2

1 Department of Physical Medicine and Rehabilitation, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey

2 Department of Infectious Diseases and Clinical Microbiology, Reyap Hospital, Istanbul, Turkey

Received: March 19, 2021 Accepted: August 17, 2021 Published online: December 01, 2021

ABSTRACT

        Diabetes is one of the most common health problems worldwide. Diabetic foot wounds (DFWs) are hazardous complications of the disease. Patients are often referred to rehabilitation facilities at later stages of the diabetic complications, particularly after amputation surgery. There are potential benefits of rehabilitation practices in preventing and managing DFWs. Therefore, rehabilitation needs to be more involved in the management of DFWs and should be in all stages of diabetic care. In this review, we discuss literature data to bring rehabilitation perspective to the multidisciplinary management of DFWs.

Keywords: Diabetic foot, exercise, foot ulceration, plantar pressure, rehabilitation.

Worldwide Research Trends on Diabetic Foot Ulcers (2004–2020): Suggestions for Researchers

Pin Deng,1 Hongshuo Shi ,2 Xuyue Pan ,1 Huan Liang ,1 Shulong Wang ,1Junde Wu,1 Wei Zhang ,3 Fasen Huang ,1 Xiaojie Sun ,1 Hanjie Zhu ,1and Zhaojun Chen1

1 Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China

2 College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250000, China

3 Orthopaedic Center, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China

Correspondence should be addressed to Zhaojun Chen; 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。

Received 9 August 2021; Revised 18 December 2021; Accepted 5 January 2022; Published 27 January 2022

Academic Editor: Ferdinando Carlo Sasso

Copyright © 2022 Pin Deng et al. This is an open access article distributed under the Creative Commons Attribution License,

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

       Objectives. Diabetic foot ulcer (DFU) is one of the devastating complications of diabetes. It has high mortality and disability rates. The number of research articles on DFUs has increased. This study was designed to explore the global trends and research hotspots of DFUs to benefit researchers in shaping future research directions. Methods. Literatures relating to DFU from 2004 to 2020 were retrieved from the Science Citation Index Expanded (SCI-expanded) of Web of Science Core Collection (WoSCC). The current status of DFU research (including publications, journals, the performances of relevant countries, institutions, and authors and the research trends and hotspots of DFU) was analyzed with the WoSCC. VOSviewer v1.6.10.0 was utilised for cocitation, coauthorship, cooccurrence analyses, and bibliographic coupling. Results. A total of 5869 publications on DFUs were retrieved. We performed a longitudinal review of publications over 17 years: 4500 articles and 865 review articles on DFUs published from 2004 to 2020 were analyzed. The total citation was 107,296. The USA (n = 1866), England (n = 606), and China (n = 599) were the three largest contributors. The University of Washington had the greatest number of publications within this time period (n = 103), and it had the most cooperative units and was in the core position in all research institutions, followed by the University of Manchester (n = 94) and the University of Miami (n = 92). Armstrong DG (91/1.69%) and Lavery LA (55/1.19%) should be regarded as scholars who have made outstanding contributions. The top journal with the greatest total link strength was Diabetes Care. Analysis showed that the global research hotspots of DFU focused on lower limb amputation, diabetic foot infection, and treatment and management of DFU. Studies on osteomyelitis, wound therapy and management, multidisciplinary integration and mechanism of DFUs, and its related diseases are the research fronts that should be closely watched in the future. Conclusions. This study revealed the current research status and hotspots in the domain of DFU over the past 17 years, which can help researchers to further pinpoint potential perspectives on hot topics and research frontiers.