Total contact casts versus removable offloading interventions for the treatment of diabetic foot ulcers: a systematic review and meta-analysis

ObjectiveThis study aimed to evaluate the effectiveness of total contact casts (TCCs) versus removable offloading interventions among patients with diabetic foot ulcers (DFUs).MethodsA comprehensive search was done in databases Embase, Cochrane Library, and, PubMed. The references of retrieved articles were reviewed, up until February 2023. Controlled trials comparing the effects of TCCs with removable offloading interventions (removable walking casts and footwear) in patients with DFUs were eligible for review.ResultsTwelve studies were included in the meta-analysis, involving 591 patients with DFUs. Among them, 269 patients were in the intervention group (TCC), and 322 in the control group (removable walking casts/footwear). The analysis revealed that the TCC group had higher healing rates (Risk Ratio(RR)=1.22; 95% confidence interval(CI):1.11 to 1.34, p<0.001), shorter healing time (Standard Mean Difference(SMD)=-0.57; 95%CI: -1.01 to -0.13, P=0.010), and elevated occurrence of device-related complications (RR=1.70; 95%CI:1.01 to 2.88, P=0.047), compared with the control group. Subgroup analysis illustrated patients using TCCs had higher healing rates than those using removable walking casts (RR=1.20; 95%CI:1.08 to 1.34, p=0.001) and footwear (RR=1.25; 95%CI:1.04 to 1.51, p=0.019), but they required comparable time for ulcer healing compared with those using removable walking casts (SMD=-0.60; 95%CI: -1.22 to 0.02, P=0.058) or footwear group (SMD=-0.52; 95%CI: -1.17 to 0.12, P=0.110). Although patients using TCCs had significantly higher incidence of device-related complications than those using footwear (RR=4.81; 95%CI:1.30 to 17.74, p=0.018), they had similar one compared with those using the removable walking casts (RR=1.27; 95%CI:0.70 to 2.29, p=0.438).ConclusionThe use of TCCs in patients with DFUs resulted in improved rates of ulcer healing and shorter healing time compared to removable walking casts and footwear. However, it is important to note that TCCs were found to be associated with increased prevalence of complications

Infusion of Bone Marrow Mesenchymal Stem Cells Attenuates Experimental Severe Acute Pancreatitis in Rats

Background & Aims. Severe acute pancreatitis (SAP) remains a high-mortality disease. Bone marrow (BM) mesenchymal stem cells (MSCs) have been demonstrated to have plasticity of transdifferentiation and to have immunomodulatory functions. In the present study, we assessed the roles of MSCs in SAP and the therapeutic effects of MSC on SAP after transplantation. Methods. A pancreatitis rat model was induced by the injection of taurocholic acid (TCA) into the pancreatic duct. After isolation and characterization of MSC from BM, MSC transplantation was conducted 24 hrs after SAP induction by tail vein injection. The survival rate was observed and MSCs were traced after transplantation. The expression of TNF-α and IL-1β mRNA in the transplantation group was also analyzed. Results. The survival rate of the transplantation group was significantly higher compared to the control group (p<0.05). Infused MSCs were detected in the pancreas and BM 3 days after transplantation. The expression of TNF-α and IL-1β mRNA in the transplantation group was significantly lower than in the control group in both the pancreas and the lungs (p<0.05). Conclusions. MSC transplantation could improve the prognosis of SAP rats. Engrafted MSCs have the capacity of homing, migration, and planting during the treatment of SAP

Inferring the diagnostic potential of 18F-FDG-PET/CT in post-renal transplantation from a unique case harboring multiple rare complications

Renal transplantation is undoubtedly an effective treatment for patients with end-stage renal disease, but it is certainly not a cure. Patients require lifelong immunosuppression to maintain optimal allograft function, and post-operative risk complications such as cancer in the transplant recipient cannot be ignored. Besides, infection is a silent complication that follows transplantation. Relatedly, herein, we present a report of a 40-year-old patient who underwent renal transplantation and promptly developed a diffuse large B-cell tumor in the liver and Aspergillus infection in the trachea. In addition, an inflammatory necrotizing granuloma was also observed in the muscles. Of importance, we also described the potential of 18F-FDG-PET/CT, which was instrumental in monitoring and evaluating these relevant post-operative complications in this rare case

A Novel Method for Interferometric Phase Estimation in Dual-Channel Cancellation

Multichannel SAR systems have grown rapidly over the past decade due to their powerful high-resolution and wide-swath (HRWS) capabilities. Because spatially separated channels also have the potential to suppress jamming, dual-channel cancellation is a general method that is effective regardless of the type of jamming signal. In this paper, the principle of dual-channel cancellation (DCC) is introduced, and several practical problems using DCC are also discussed. Moreover, this paper emphasizes interferometric phase estimation, which is the key to DCC. If the jamming-to-signal ratio (JSR) is high, the interferometric phase can be estimated accurately from the interferometry of two channel signals, but estimation becomes rather difficult when the JSR decreases. To solve the problem of interferometric phase estimation under a low JSR, a novel interferometric phase estimation method using cosine similarity is proposed in this paper. L-band airborne dual-channel SAR is performed to investigate the applicability of the method. The results not only prove that cosine similarity is an effective method for interferometric phase estimation, but also demonstrate the potential of DCC in the SAR anti-jamming processing

Linezolid Inhibited Synthesis of ATP in Mitochondria: Based on GC-MS Metabolomics and HPLC Method

Linezolid has been widely used in serious infections for its effective inhibiting effect against multidrug-resistant gram-positive pathogens. However, linezolid caused severe adverse reactions, such as thrombocytopenia, anaemia, optic neuropathy, and near-fatal serotonin syndrome. In order to investigate the toxicity of linezolid, twenty-four Sprague-Dawley rats were randomly divided into: control group (n=7), low-group (n=8), and high-group (n=9). The rats of low-group and high-group were given by gavage with linezolid 60 and 120 mg/kg/day for 7 days, respectively. The serum concentration of linezolid was determined by high performance liquid chromatography (HPLC); blood metabolic change was analyzed by gas chromatography-mass spectrometer (GC-MS). Adenosine triphosphate (ATP) concentration in HepG2-C3A after being cultured with linezolid was determined by HPLC. The results showed that there were six metabolites and nine metabolites had statistical differences in low-group and high-group (P<0.05). The trimethyl phosphate was the most significant indicator in those changed metabolites. Except for d-glucose which was slightly increased in low-group, octadecanoic acid, cholest-5-ene, hexadecanoic acid, α-linolenic acid, eicosapentaenoic acid, 9,12-Octadecadienoic acid, and docosahexaenoic acid were all decreased in low-group and high-group. ATP concentration was decreased in HepG2-C3A after cultured with linezolid. In conclusion, the toxicity of linezolid is related to its serum concentration. Linezolid may inhibit the synthesis of ATP and fatty acid

Characterization of the development of Haemonchus contortus ZJ strain from gerbils

Abstract Background Haemonchus contortus is a serious parasitic nematode in domestic ruminants around the world, including China. Haemonchus contortus has developed extensive resistance to commercial anthelmintics, which has produced a demand for new control methods, such as more effective drugs. Gerbils infected with H. contortus have previously been used as a model for anthelmintics selections, and the growth of H. contortus had been briefly examined. To enhance the model, this study provides an additional description of the development of H. contortus ZJ strain in gerbils. Results Gerbils were infected with H. contortus ZJ strain at a dose of 2000 exsheathed infective larvae (xL3s) and sacrificed at 4, 7 and 18 days post-infection (dpi). Only fourth-stage larvae were found in the stomachs. About 2% of the inoculums were obtained at each of the three sampling time points. Larvae grew more slowly in gerbils than in sheep, but presented almost the same morphology. Rod-like crystalline inclusions were present in the intestinal cells of larvae, indicating that the metabolic rate of larvae was probably greatly reduced. Histological examination of stomach sections showed that larvae are located in the lumens or at the mucosal surfaces, with few inflammatory changes evident. Conclusions The development and features of H. contortus ZJ strain in gerbils were described. Our results provide supplementary information of H. contortus growth in gerbils, especially the presence of rod-like crystalline inclusions, and may contribute to improve the anthelmintic selection system