【家庭护理】严防足部皮肤破损！糖尿病患者护脚指南

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

中德骨科伤口管理学校校长

广东省骨科研究院运动医学研究所所长

广东省内运动医学专业唯一的博士研究生导师

美国哈弗大学医学院骨科访问学者

专业特长处于省内领先、国内或国际先进水平以上

2018年获得“国之名医卓越建树”荣誉称号

2017年被评为全国卫生计生系统先进工作者、广东省医学领军人才

中国医师协会运动医师分会副会长

STCOT中国部运动医学分会副主任委员

广东省医学会关节外科分会主任委员

广东省医学会运动医学会分会名誉主任委员

独立承担过国家“863”课题，主持过10余项省、部级科研项目

多份专业杂志编委
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The UBR5 protein facilitates mesangial cell hypertrophy and glycolysis induced by high glucose by increasing the phosphorylation levels of AKT 2026-06-12 00:00

Lin Liao1 · Qiming Xu2 · Jie Xu3 · Jie Chen1 · Wenrui Liu1 · Wenhao Chen1 · Yunqing Tang1 · Lianxiang Duan1 · Yue Guo1 · Ziyang Liu1 · Pengyu Tao2 · Yu Cao2 · Jianrao Lu1 · Jing Hu1,4

Received: 14 June 2024 / Accepted: 31 January 2025 / Published online: 13 February 2025 © The Author(s) 2025

Abstract

Aims One of the primary pathological features in the early stages of diabetic nephropathy is mesangial cell (MC) hypertro-phy in the glomerulus. Considering the role of E3 ubiquitin ligases in regulating MC hypertrophy, the aim of this study was to identify the functional ubiquitin protein ligase E3 component N-recognin 5 (UBR5) during MC hypertrophy under high glucose conditions.

Methods Human MCs (HMCs) transduced with UBR5 silencing or overexpression vector were treated with high glucose, AKT inhibitor, or glycolysis inhibitor. Cell proliferation, cell cycle, hypertrophy and glycolysis were evaluated in the HMCs after indicated treatment. m6A methylated RNA immunoprecipitation, luciferase reporter assay, and RNA immunoprecipi-tation were performed to determine the regulation of UBR5 by Wilms tumor 1-associating protein (WTAP)/insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) induced m6A modification. Western blot was performed to determine the protein expression levels.

Results UBR5 expression was upregulated in db/db mice and in high glucose-induced HMCs. UBR5 silencing inhibited high glucose-induced HMC cell cycle arrest, cell hypertrophy, and glycolysis. UBR5 facilitated HMC hypertrophy and gly colysis by promoting the phosphorylation levels of AKT. Additionally, the promoting effect of glycolysis on cell hypertrophy were also elucidated. Further investigation into upstream regulators revealed that WTAP promoted m6A modification of UBR5 through the m6A reader IGF2BP1.

Conclusions Our study unveils a novel mechanism involved in high glucose-induced cell hypertrophy, offering new insights into the understanding and treatment of early pathological mechanisms in diabetic nephropathy.

Keywords High glucose · Hypertrophy · Glycolysis · UBR5, AKT phosphorylation

HbA1c variability as an independent risk factor for diabetic retinopathy: results from a screening program 2026-06-11 00:00

Maria Ida Maiorino1,2 · Carlo Gesualdo3,4 · Silvia Angelino5 · Settimio Rossi3 · Nicole Di Martino2 · Clemente Iodice3,5 · Miriam Longo1,4 · Lorenzo Scappaticcio1,2 · Giuseppe Bellastella1,2 · Francesca Simonelli3 · Katherine Esposito1,2,5

Received: 4 January 2026 / Accepted: 6 May 2026 © The Author(s) 2026

Abstract

Aims To investigate the independent association between long-term glycemic variability, measured as the coefficient of variation (CV) of HbA1c, and the presence of diabetic retinopathy (DR) in a cohort of adults with diabetes within a system-atic eye screening program.

Methods This study screened 379 adults with type 1 and type 2 diabetes. Long-term glycemic variability was calculated as the CV of serial HbA1c measurements. DR was assessed via dilated fundus photography. The association between HbA1c CV and DR was analyzed using multivariable logistic regression adjusting for confounders.

Results DR incidence of 12.4%, mostly mild non-proliferative. The median HbA1c CV was 7.0% (53 mmol/mol). In unad-justed bivariate analysis, the incidence of mild DR was higher in the low- glycemic variability group (CV<5%) compared to the high- glycemic variability group. However, the multivariable logistic regression analysis revealed that higher HbA1c CV was independently associated with the presence of DR (β=0.643, P=0.042), alongside diabetes duration (P<0.001) and age (P<0.001).

Conclusions In conclusion, in a cohort of individuals with both type 1 and type 2 diabetes and a low incidence of DR, long-term glycemic variability, estimated as HbA1c CV, was independently associated with an increased risk of this complication.

Keywords Diabetic retinopathy · Glucose variability · Type 1 diabetes · Type 2 diabetes · Retinopathy screening · HbA1c coefficient of variation
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【家庭护理】严防足部皮肤破损！糖尿病患者护脚指南

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06 9月 2019

Author : 伤口世界

中诺医疗文章转载公众号上海第九人民医院作者谢挺

糖尿病患者大约有1.5%会发生足部溃疡，足部溃疡经久不愈，继发感染，发生坏疽。糖尿病足的截肢率很高，有报道称截肢率可高达85%，给患者造成极大痛苦，而通过积极的预防措施，可以降低40%~80%的截肢发生率。

　　在糖尿病足的预防和综合治疗中，足部护理占有特别突出的地位，通过家庭中实施的足部护理，可有效地防止或延缓糖尿病足的发生发展。足部护理的主要内容包括以下方面：

　　注意局部皮肤变化，观察皮肤的色、温度及感觉。如皮肤干燥无汗、弹性差、毛发脱落、皮温下降、皮色变暗、足背动脉搏动减弱或消失，提示动脉供血不足；如皮肤感觉缺失提示有神经营养障碍。

　　注意足部的保护，鞋袜要合适，最好选用软底布鞋及棉线袜，穿着以舒适不挤脚为宜，以保证足部血液循环的供应。由于糖尿病患者末梢神经感觉障碍，对冷热等物理刺激反应迟钝，因此冬天注意足部保暖，避免冻伤，用热水袋取暖时，热水袋内水温不超过60℃，热水袋外面用毛巾套包裹，不可直接触及皮肤，以防烫伤。

　　注意足部卫生，每晚用40~42℃的温水浸泡双脚15~30分钟，洗后用柔软吸水性强的毛巾擦干。消除过厚角质层防止干裂，可涂上植物油按摩，以保持皮肤柔软。

　　按摩足部以改善微循环。足部按摩每日早、中、晚各一次，每次10分钟，动作轻柔，应从趾尖开始向上按摩，有利于循环流畅。

　　修剪趾甲不应太靠近皮肤以免损伤甲沟皮肤导致感染，应沿着足趾甲平行修剪，不要剪向趾甲边角的深部。有胼胝的患者不要自行处理，应请专业人员帮助处理，避免不适当地应用鸡眼膏或脚癣浸泡液，以免造成足部感染。

　　减轻病变部位的负重。为了减轻病变局部的压迫，患者应注意卧床休息，不可长时间站立，行走时使用拐杖。患肢水肿者，把患肢抬高18~30°以利于静脉回流，减轻水肿。

　　日常多进行腿部运动，每日适当步行，做到定时、定量、量力而行、持之以恒。对较轻的患者可在护士的指导下，手扶椅子做单腿站立或甩腿运动，不能行走的患者在床上取坐姿位做提足运动，每日1~2次，每次至少20下。

　　糖尿病患者足部皮肤常易发生水疱，皮肤水疱易诱发感染和坏疽，一旦出现要积极处理。保持水疱清洁，避免受压，微循环改善后可自行吸收；对严重的水疱，可在无菌操作下抽出渗液。医生建议，出现了类似水疱等糖尿病皮肤早期皮肤损害，应当前往医院，在专业医护人员的指导下进行处理。

文章作者创面修复科谢挺副主任医师

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The UBR5 protein facilitates mesangial cell hypertrophy and glycolysis induced by high glucose by increasing the phosphorylation levels of AKT 2026-06-12 00:00

Lin Liao1 · Qiming Xu2 · Jie Xu3 · Jie Chen1 · Wenrui Liu1 · Wenhao Chen1 · Yunqing Tang1 · Lianxiang Duan1 · Yue Guo1 · Ziyang Liu1 · Pengyu Tao2 · Yu Cao2 · Jianrao Lu1 · Jing Hu1,4

Received: 14 June 2024 / Accepted: 31 January 2025 / Published online: 13 February 2025 © The Author(s) 2025

Abstract

Aims One of the primary pathological features in the early stages of diabetic nephropathy is mesangial cell (MC) hypertro-phy in the glomerulus. Considering the role of E3 ubiquitin ligases in regulating MC hypertrophy, the aim of this study was to identify the functional ubiquitin protein ligase E3 component N-recognin 5 (UBR5) during MC hypertrophy under high glucose conditions.

Methods Human MCs (HMCs) transduced with UBR5 silencing or overexpression vector were treated with high glucose, AKT inhibitor, or glycolysis inhibitor. Cell proliferation, cell cycle, hypertrophy and glycolysis were evaluated in the HMCs after indicated treatment. m6A methylated RNA immunoprecipitation, luciferase reporter assay, and RNA immunoprecipi-tation were performed to determine the regulation of UBR5 by Wilms tumor 1-associating protein (WTAP)/insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1) induced m6A modification. Western blot was performed to determine the protein expression levels.

Results UBR5 expression was upregulated in db/db mice and in high glucose-induced HMCs. UBR5 silencing inhibited high glucose-induced HMC cell cycle arrest, cell hypertrophy, and glycolysis. UBR5 facilitated HMC hypertrophy and gly colysis by promoting the phosphorylation levels of AKT. Additionally, the promoting effect of glycolysis on cell hypertrophy were also elucidated. Further investigation into upstream regulators revealed that WTAP promoted m6A modification of UBR5 through the m6A reader IGF2BP1.

Conclusions Our study unveils a novel mechanism involved in high glucose-induced cell hypertrophy, offering new insights into the understanding and treatment of early pathological mechanisms in diabetic nephropathy.

Keywords High glucose · Hypertrophy · Glycolysis · UBR5, AKT phosphorylation
HbA1c variability as an independent risk factor for diabetic retinopathy: results from a screening program 2026-06-11 00:00

Maria Ida Maiorino1,2 · Carlo Gesualdo3,4 · Silvia Angelino5 · Settimio Rossi3 · Nicole Di Martino2 · Clemente Iodice3,5 · Miriam Longo1,4 · Lorenzo Scappaticcio1,2 · Giuseppe Bellastella1,2 · Francesca Simonelli3 · Katherine Esposito1,2,5

Received: 4 January 2026 / Accepted: 6 May 2026 © The Author(s) 2026

Abstract

Aims To investigate the independent association between long-term glycemic variability, measured as the coefficient of variation (CV) of HbA1c, and the presence of diabetic retinopathy (DR) in a cohort of adults with diabetes within a system-atic eye screening program.

Methods This study screened 379 adults with type 1 and type 2 diabetes. Long-term glycemic variability was calculated as the CV of serial HbA1c measurements. DR was assessed via dilated fundus photography. The association between HbA1c CV and DR was analyzed using multivariable logistic regression adjusting for confounders.

Results DR incidence of 12.4%, mostly mild non-proliferative. The median HbA1c CV was 7.0% (53 mmol/mol). In unad-justed bivariate analysis, the incidence of mild DR was higher in the low- glycemic variability group (CV<5%) compared to the high- glycemic variability group. However, the multivariable logistic regression analysis revealed that higher HbA1c CV was independently associated with the presence of DR (β=0.643, P=0.042), alongside diabetes duration (P<0.001) and age (P<0.001).

Conclusions In conclusion, in a cohort of individuals with both type 1 and type 2 diabetes and a low incidence of DR, long-term glycemic variability, estimated as HbA1c CV, was independently associated with an increased risk of this complication.

Keywords Diabetic retinopathy · Glucose variability · Type 1 diabetes · Type 2 diabetes · Retinopathy screening · HbA1c coefficient of variation
中国人群中面部年轻化治疗专家共识 2026-06-10 00:00

中国整形美容协会面部年轻化分会中国整形美容协会抗衰老分会

中国整形美容协会医美线技术分会

通信作者:李勤,Email: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。

【摘要】随着年龄的增长,中面部深层脂肪逐渐萎缩,浅层脂肪逐渐移位,眶区、上颌骨逐渐老化,中面部是面部老化最早出现的部位之一,也是实现年轻化外观的重要部位。由中国整形美容协会面部年轻化分会、抗衰老分会、医美线技术分会组织部分专家对中国人群中面部年轻化治疗的诸多问题进行了研讨,并形成共识。主要内容包括,中国人群中面部定义、中面部老化特征及评估方法、常见治疗方式(微创注射技术、光电技术、美塑疗法、埋线技术、脂肪填充、手术治疗)等,并针对中面部不同老化特点采用的联合治疗方案进行了推荐。

【关键词】中面部; 年轻化; 治疗; 专家共识; 中国 DOI:10.3760/cma.j.issn.1671-0290.2020.01.001

中面部是面部老化最早出现的部位之一,是实现年轻化外观的重要部位。近年来,随着大众审美需求的提高,中国美容就医者对中面部年轻化的诉求增多,亟须规范中面部年轻化治疗。为此,由中国整形美容协会面部年轻化分会、抗衰老分会、医美线技术分会组织部分专家,参考中面部年轻化文章,结合现状和专家的经验,制定针对中国人中面部年轻化治疗的专家共识。希望通过共识为优化中国人中面部年轻化治疗提供指导意见,以期推进中面部年轻化治疗的规范管理。

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2019广东省医疗行业协会伤口管理分会年会

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2019年6月15日中国广州
主办单位：广东省医疗行业协会伤口管理分会

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长