Application of hyperbaric oxygen therapy in diabetic foot ulcers: A meta-analysis.

Hyperbaric oxygen therapy (HBOT) has been used in patients with diabetic foot ulcers (DFU) for many years, but its clinical efficacy is still controversial. Therefore, this study explored the efficacy of HBOT applied to DFU by means of meta-analysis. PubMed, Cochrane Library, Embase, CNKI and Wanfang databases were searched, from database inception to October 2023, and published randomised controlled trials (RCTs) of HBOT in DFU were collected. Two investigators independently screened the collected literature, extracted relevant data and assessed the quality of the literature. Review Manager 5.4 software was applied for data analysis. Twenty-nine RCTs with 1764 patients were included. According to the combined results, when compared with conventional treatment, HBOT significantly increased the complete healing rate of DFUs (46.76% vs. 24.46%, odds ratio [OR]: 2.83, 95% CI: 2.29-3.51, p < 0.00001) and decreased the amputation rate (26.03% vs. 45.00%, OR: 0.41, 95% CI: 0.18-0.95, p = 0.04), but the incidence of adverse events was significantly higher in patients (17.37% vs. 8.27%, OR: 2.49, 95% CI: 1.35-4.57, p = 0.003), whereas there was no significant difference in the mortality (6.96% vs. 12.71%, OR: 0.52, 95% CI: 0.21-1.28, p = 0.16). Our results suggest that HBOT is effective in increasing the complete healing rate and decreasing the amputation rate in patients with DFUs, but increases the incidence of adverse events, while it has no significant effect on mortality.

[Pregnant outcomes and neonatal anthropometry in women with abnormal glucose challenge test and normal oral glucose tolerance test during pregnancy.].

OBJECTIVE: To evaluate the influences of abnormal glucose challenge test(GCT) on pregnancy outcomes and neonatal anthropometric data in women with normal oral glucose tolerance test(OGTT). METHODS: Totally 214 women who delivered in the First Affiliated Hospital of Sun Yat-sen University from November 2006 to December 2007 were enrolled. 50 g GCT was performed at 24-28 weeks of gestation and 75 g OGTT would be followed if GCT >/= 7.8 mmol/L. Those patients, whose OGTT results below the following criteria (5.3 mmol/L, 10.0 mmol/L, 8.6 mmol/L, 7.8 mmol/L), were classified as normal OGTT. Altogether, 116 of the 214 women with abnormal GCT and normal OGTT were collected as the study group and the rest 98 women with normal GCT as the control group. The pregnant outcomes of the two groups were analyzed. The neonatal anthropometry, including birth weight, body length, head circumference and shoulder circumference, were recorded. Other neonatal anthropometric data, such as upper arm circumference, tricep skinfold thickness and hypodermic fat thickness of abdomen were measured by a tape measure within 24 hours after birth. RESULTS: (1) Pregnant outcomes: No significant difference was found in the rate of assisted vaginal delivery, polyhydramnios, premature rupture of membranes and fetal distress between the study and control group [10.3% (12/116) vs 4% (4/98), 5.2% (6/116) vs 10% (10/98), 13.8% (16/116) vs 17% (17/98), 20.7% (24/116) vs 13% (13/98), P > 0.05, respectively], but the rate of cesarean section, spontaneous vaginal delivery and large for gestational age babies in the study group were different from those of the control [72.4% (84/116) vs 51% (51/98), 17.2% (20/116) vs 45% (44/98), 25.9% (30/116) vs 6% (6/98), P < 0.05, respectively]. (2) Neonatal anthropometry: The birth weight of the study group was significantly higher than that of the control group [(3.4 +/- 0.4) kg vs (3.3 +/- 0.4) kg, P < 0.05], but no significant difference was shown in any other neonatal anthropometric results between the study and control group, including body length [(49.9 +/- 1.3) cm vs (49.7 +/- 1.4) cm], head circumference [(33.4 +/- 1.5) cm vs (33.8 +/- 1.7) cm], shoulder circumference [(35.4 +/- 2.3) cm vs (35.0 +/- 2.3) cm], upper arm circumference [(11.0 +/- 0.7) cm vs (10.9 +/- 0.8) cm], tricep skinfold thickness [(9.7 +/- 1.0) mm vs (9.9 +/- 1.4) mm] and hypodermic fat thickness of abdomen [(7.2 +/- 1.2) mm vs (7.2 +/- 1.0) mm; all P > 0.05]. CONCLUSION: Women with abnormal GCT alone may have no significant influences on neonatal anthropometric data, but might have more cesarean section, large for gestational age babies, and neonatal birth weight than those women with normal GCT.