Clinical effects of combined use of carbamazepine and amitriptyline in the treatment of diabetic neuropathy with concurrent diabetic foot.

OBJECTIVE: This study aims to analyze the clinical effects of combining carbamazepine and amitriptyline in the treatment of diabetic neuropathy with concurrent diabetic foot. METHODS: A total of 120 diabetic neuropathy patients treated at our hospital from June 2022 to November 2023 were included in the study. Patients meeting the inclusion criteria were registered, and their basic data were collected. The patients were randomly divided into two groups: the control group treated with amitriptyline and the study group treated with a combination of carbamazepine and amitriptyline. RESULTS: The study group demonstrated significantly better clinical efficacy compared to the control group (p < 0.05). There were no significant differences in psychological status and pain perception before treatment between the two groups (p > 0.05). However, post-treatment, the study group showed improved psychological status, reduced pain perception, and overall better quality of life in both physiological and psychological dimensions compared to the control group (p < 0.05). CONCLUSION: The combined use of carbamazepine and amitriptyline in the treatment of diabetic neuropathy with concurrent diabetic foot yields positive clinical outcomes. It effectively alleviates symptoms, improves psychological well-being, reduces pain sensation, and enhances overall quality of life. These findings can guide physicians in adopting a more evidence-based treatment approach and provide patients with more effective individualized treatment strategies.

An Experimental Investigation on the Dynamic Response of Buried RC Pipes Induced by Falling Impact.

Unexpected ground impacts can seriously affect the stability and operational safety of buried pipelines. In this paper, a full-scale modeling test of the dynamic response of a buried concrete pipeline under falling rock impact based on dynamic sensor testing was conducted. A commercially available reinforced concrete pipeline, buried in a clayey soil site, was used, and a 50 kg concrete ball was used to investigate the impact above the pipeline. Considering the purpose of the test, the falling process of the concrete ball and the surface vibration velocity induced by the touchdown of the concrete ball were monitored using a high-speed camera and a vibration signal tester, respectively. The dynamic response signals of the pipe under surface impact were tested using strain gauges and earth pressure gauges combined with dynamic sensors such as dynamic signal tester, and the dynamic response law was analyzed. The experimental results will provide a basis for the design of the impact resistance of reinforced concrete pipes.

A Numerical Study of the Dynamic Crack Behavior of Brittle Material Induced by Blast Waves.

Blast stress waves profoundly impact engineering structures, exciting and affecting the rupture process in brittle construction materials. A novel numerical model was introduced to investigate the initiation and propagation of cracks subjected to blast stress waves within the borehole-crack configuration. Twelve models were established with different crack lengths to simulate sandstone samples. The influence of crack length on crack initiation and propagation was investigated using those models. The linear equation of state was used to express the relationship between the pressure and density of the material. The major principal stress failure criterion was used to evaluate the failure of elements. A triangular pressure curve was adopted to produce the blast stress wave. The results indicated that the pre-crack length critically influenced the crack initiation and propagation mechanism by analyzing the stress history at the crack tip, crack propagation velocity, and distance. The inducement of a P-wave and S-wave is paramount in models with a short pre-crack. For long pre-crack models, Rayleigh waves significantly contribute to crack propagation.

Colloidal 2D Covalent Organic Framework-Tailored Nanofiltration Membranes for Precise Molecular Sieving.

Covalent organic frameworks (COFs) with tunable pore sizes and ordered structures are ideal materials for engineering nanofiltration (NF) membranes. However, most of the COFs prepared by solvothermal synthesis are unprocessable powders and fail to form well-structured membranes, which seriously hinders the development of COF NF membranes. Herein, colloidal 2D-COFs with processable membrane formation ability were synthesized by oil-in-water emulsion interfacial polymerization technology. COF NF membranes with tailored thickness and surface charge were fabricated via a layer-by-layer (LBL) assembly strategy. The prepared COF NF membrane achieved precise sieving of dye molecules with high permeance (85 L·m-2·h-1·bar-1). In this work, the strategy of prepared COF NF membranes based on colloid 2D-COF LBL assembly is proposed for the first time, which provides a new idea for the on-demand design and preparation of COF membranes for precise molecular sieving.

Monitoring and Analysis of the Collapse Process in Blasting Demolition of Tall Reinforced Concrete Chimneys.

Aiming at the problem of displacement of collapse direction caused by the impact of the high-rise reinforced concrete chimney in the process of blasting demolition, combined with the monitoring methods such as high-speed photography observation, piezoelectric ceramic sensor, and blasting vibration monitor, the impact process of the 180 m high chimney was comprehensively analyzed. The results show that the chimney will experience multiple 'weight loss' and 'overweight' effects during the sit-down process, inducing compressive stress waves in the chimney. When the sit-down displacement is large, the broken reinforced concrete at the bottom can play a significant buffering effect, and the 'overweight' effect gradually weakens until the sit-down stops. The stress of the inner and outer sides of the chimney wall is obviously different in the process of collapsing and touching the ground. The waveform of the monitoring point of the piezoelectric ceramic sensor is divided into three stages, which specifically characterizes the evolution process of the explosion load and the impact of the chimney. The vibration induced by explosive explosion is mainly high-frequency vibration above 50 Hz, the vibration induced by chimney collapse is mainly low-frequency vibration below 10 Hz, and the vibration characteristics are obviously different. In the process of blasting demolition and collapse of high-rise reinforced concrete chimney, due to the impact of sitting down, the wall of the support tube is subjected to uneven force, resulting in the deviation of the collapse direction. In practical engineering, the control measures of chimney impact, blasting vibration, and collapse touchdown vibration should be fully strengthened to ensure the safety of the protection target around the blasting demolition object.

A successful process of treatment with necrotizing fasciitis of upper extremities in patients with diabetes mellitus: a case report.

Necrotizing fasciitis (NF) represents a rapidly progressive, life-threatening infection involving the fascia and subcutaneous tissue. Early diagnosis and intervention are crucial to treat, especially in diabetic patients. Case presentation: This case report presents on a patient with diabetes mellitus rapidly developed a NF of the upper extremities following a minor trauma in the palmar of greater thenar. In the initial stages of her hospital admission, severe hand soft tissue infection, and systemic toxicity is the most prominent clinical manifestation. During her hospitalization, efficacious multidisciplinary treatment was carried out to avoid severe consequences. Clinical discussion and conclusion: The objective of this case report is to present a successful individual strategy in a complex case to standardize the treatment process. Accurate and standardized management can improve the prognosis of patients affected from upper extremities NF of diabetic avoiding and severe complications and saving lives.

Cryogel-Templated Fabrication of n-Al/PVDF Superhydrophobic Energetic Films with Exceptional Underwater Ignition Performance.

The rapid heat loss and corrosion of nano-aluminum limits the energy performance of metastable intermolecular composites (MICs) in aquatic conditions. In this work, superhydrophobic n-Al/PVDF films were fabricated by the cryogel-templated method. The underwater ignition performance of the energetic films was investigated. The preparation process of energetic materials is relatively simple, and avoids excessively high temperatures, ensuring the safety of the entire experimental process. The surface of the n-Al/PVDF energetic film exhibits super-hydrophobicity. Because the aluminum nanoparticles are uniformly encased in the hydrophobic energetic binder, the film is more waterproof and anti-aging. Laser-induced underwater ignition experiments show that the superhydrophobic modification can effectively induce the ignition of energetic films underwater. The results suggest that the cryogel-templated method provides a feasible route for underwater applications of energetic materials, especially nanoenergetics-on-a-chip in underwater micro-scale energy-demanding systems.

Grouped-sampling technique to deal with unbalance in Raman spectral data modeling.

Due to limitations in disease prevalence and hospital specificity, spectral data are often collected with unbalanced sample size. To solve this problem, a new sampling method - grouped-sampling was proposed in this research, which is shown to be effective for unbalanced data. It avoids over-fitting of over-sampling and overcomes under-sampling utilization of under-sampling. In this study, we applied grouped-sampling to two unbalanced datasets where the sample proportions are 199:40 and 75:225. And then verified from two classic models: PCA-SVM (Principal Component Analysis-Support Vector Machine) and the deep learning algorithm GoogLeNet. The accuracy of these two datasets were 85.11% and 96.15% in PCA-SVM and 85.10% and 84.61% on GoogLeNet. Also, the F1-score were evaluated to measure the classification balance of sampling method, and result shows that F1-score of grouped-sampling is always the highest compared to over-sampling and under-sampling. In summary, compared to traditional sampling methods, grouped-sampling performs better on prediction for classes with smaller sample size, which means grouped-sampling can improve the balance of classification results and the potential of practical application. Therefore, we develop a group sampling method that distinguishes between under- and over-sampling, which greatly improves the accuracy and balance of predictions for unbalanced samples.

[Clinical assessment of moderate-dose glucocorticoid in the treatment of recurrence of primary nephrotic syndrome in children: a prospective randomized controlled trial]. / ä¸­ç­‰å‰‚é‡ç³–çš®è´¨æ¿€ç´ æ²»ç–—æ¿€ç´ æ•æ„Ÿè‚¾ç— ç»¼åˆå¾å¤å‘æ‚£å„¿çš„å‰çž»æ€§éšæœºå¯¹ç §ç ”ç©¶.

OBJECTIVES: To study the clinical effect and adverse drug reactions of different doses of glucocorticoid (GC) in the treatment of children with recurrence of steroid-sensitive nephrotic syndrome (SSNS). METHODS: A total of 67 children who were hospitalized and diagnosed with SSNS recurrence in the Department of Nephrology, Children's Hospital, Capital Institute of Pediatrics, from November 2017 to December 2019 were enrolled. They were randomly divided into a moderate-dose GC group (32 children) and a full-dose GC group (35 children). The two groups were compared in terms of urinary protein clearance, recurrence rate within 6 months, and incidence rate of GC-associated adverse reactions. RESULTS: There was no significant difference in the urinary protein clearance rate between the moderate-dose GC and full-dose GC groups (91% vs 94%, P>0.05). There was also no significant difference in the recurrence rate within 6 months between the two groups (41% vs 36%, P>0.05). At 6 months of follow-up, compared with the full-dose GC group, the moderate-dose GC group had a significantly lower cumulative dose of prednisone [(87±18) mg/kg vs (98±16) mg/kg, P=0.039] and a significantly lower proportion of children with an abnormal increase in body weight (6% vs 33%, P=0.045). The logistic regression analysis showed that prednisone dose ≥10 mg/alternate day at enrollment was a risk factor for recurrence within 6 months in children with SSNS (P=0.018). CONCLUSIONS: For children with SSNS recurrence, moderate-dose GC has similar effects to full-dose GC in the remission induction rate and the recurrence rate within 6 months, with a lower cumulative dose and fewer GC-associated adverse reactions within 6 months than full-dose GC.

Gait analysis in the elderly patients with lumbar spinal stenosis.

PURPOSE: This study aims to analyze the gait characteristics of the elderly patients with lumbar spinal stenosis by an intelligent device for energy expenditure and activity (IDEEA) to assist clinical work. METHODS: A total of 98 subjects were included in this study from January 2017 to December 2018. A total of 49 elderly outpatients with symptomatic lumbar spinal stenosis in unilateral lower extremity were included as the experimental group, and another 49 healthy subjects matched with gender, age, and body mass index (BMI) were analyzed as the control group. The gait data of the subjects (including single support, double support, SLS/DLS, swing duration, step duration, cycle duration, pulling accel, swing power, ground impact, foot fall, foot off, push off, speed, cadence, step length, and stride length) were collected to compare between the experience group and control group, the affected leg and the healthy leg in experimental group. RESULTS: The results of this study presented that small intermittent claudication occurred in all patients. The time of single support was significantly increased (p < 0.05). Double support, step duration, and pulling accel were increased (p < 0.05), and the Push off, speed, step length, and Stride length were decreased (p < 0.05) in the experimental group compared with the control group. CONCLUSION: Small intermittent claudication was the basic gait composition of the elderly patients with lumbar spinal stenosis that can reflect the abnormal gait characteristics by IDEEA.

Growth Promoting Effect of Vacuum Sealing Drainage in the Healing Processes of Diabetic Foot Ulcers.

AIM: To explore the growth-promoting effect of vacuum sealing drainage (VSD) during the healing processes of diabetic foot ulcers (DFUs). METHODS: From November 2018 to December 2019, 38 patients with unilateral DFUs were enrolled in this retrospective study. All patients were divided into two groups according to the use of VSD or not: the VSD group (n=20) and the control group (n=18). The following parameters were used to evaluate the healing process: changes in the mean areas of the ulcers; healing rate (HR); epithelial hyperplasia and angiogenesis as determined by hematoxylin-eosin staining (HE staining); and expression of CD34, CD68 and VEGF as assessed through immunohistochemistry. Perioperative side effects and complications were also recorded. RESULTS: All patients received follow-up and eventually healed. The mean area of wounds was reduced in the VSD group compared to the control group (1.75±0.64 cm2 vs 0.88±0.54 cm2, P=0.031). The mean HR of the ulcers in the VSD group was significantly higher than that in the control group (35.23±2.87% vs 28.78±1.09%, P=0.017). HE staining showed that the amount of epithelial hyperplasia and angiogenesis increased significantly after VSD, and the immunohistochemistry results showed that the expression of CD34, CD68 and VEGF increased significantly in the VSD group. CONCLUSION: VSD could significantly accelerate the wound healing process, probably by enhancing the inflammatory response and promoting granulation and angiogenesis in DFUs.

Maggot excretions/secretions promote diabetic wound angiogenesis via miR18a/19a - TSP-1 axis.

AIMS: The impaired angiogenesis is one of the main factors affecting the healing of diabetic foot ulcer (DFU) wounds. Maggot debridement therapy (MDT) promotes granulation tissue growth and angiogenesis during DFU wound healing. Non-coding microRNAs can also promote local angiogenesis in DFU wounds by regulating wound repairing related gene expression. The purpose of this study was to investigate the mechanism of microRNAs in MDT promoting DFU wound angiogenesis. METHODS: In this study, we applied MDT to treat DFU wound tissue and detect the expression of the miR-17-92 cluster. In vitro experiments, human umbilical vein endothelial cells (HUVECs) were treated with maggot excretions/secretions (ES), the miR-17-92 cluster and the predicted target gene expression were measured. Tube formation assay and cell scratch assay were performed when inhibition of miR-18a/19a or overexpression of thrombospondin-1 (TSP-1) were used in this study. RESULTS: miR-18a/19a transcription significantly up-regulated and TSP-1 expression down-regulated in patients wound tissue and in HUVECs. Inhibition of miR-18a/19a or overexpression of TSP-1 partially blocked the migration and tube formation ability stimulated by ES. CONCLUSION: Targeted activation of miR-18a/19a transcription levels and subsequent regulation of TSP-1 expression may be a novel therapeutic strategy for DFU.

Maggot debridement therapy promotes diabetic foot wound healing by up-regulating endothelial cell activity.

To determine the role of maggot debridement therapy (MDT) on diabetic foot wound healing, we compared growth related factors in wounds before and after treatment. Furthermore, we utilized human umbilical vein endothelial cells (HUVECs) to explore responses to maggot excretions/secretions on markers of angiogenesis and proliferation. The results showed that there was neo-granulation and angiogenesis in diabetic foot wounds after MDT. Moreover, significant elevation in CD34 and CD68 levels was also observed in treated wounds. In vitro, ES increased HUVEC proliferation, improved tube formation, and increased expression of vascular endothelial growth factor receptor 2 in a dose dependent manner. These results demonstrate that MDT and maggot ES can promote diabetic foot wound healing by up-regulating endothelial cell activity.

Hypoxia promotes C-X-C chemokine receptor type 4 expression through microRNA-150 in pancreatic cancer cells.

Hypoxia promotes pancreatic cancer progression by triggering cancer cell invasion. However, the mechanism underlying this process remains unclear, hindering the development of effective therapies. The present study aimed to delineate the molecular mechanisms underlying the prometastatic effect of hypoxia in pancreatic cancer cells. The expression of microRNA-150 (miRNA-150) was detected using reverse transcription-quantitative polymerase chain reaction in pancreatic cancer samples and in the hypoxia-induced CaPan2 human pancreatic cancer cell line. The target gene was identified using bioinformatics and a luciferase reporter assay. Inhibition of the expression of C-X-C chemokine receptor type 4 (CXCR4) by miRNA-150 was confirmed using transfection with miRNA-150 mimics. The prometastatic effect of hypoxia was detected using migration assays. The expression of miRNA-150 was shown to be downregulated in pancreatic cancer samples compared with that in normal pancreatic tissue samples. Furthermore, its expression was reduced in hypoxia-induced CaPan2 cells, compared with that in control cells. Bioinformatics and the results of the luciferase reporter assay, demonstrated that miRNA-150 inhibited the expression of CXCR4 by directly targeting the 3' untranslated region of CXCR4 mRNA. The results of the migration assay showed that hypoxia promotes cell migration and invasion. However, this prometastatic effect was reversed by transfection with miRNA-150 mimics. The present results suggest that hypoxia promotes pancreatic cancer migration by downregulating miRNA-150.

Minocycline attenuates pain by inhibiting spinal microglia activation in diabetic rats.

The mechanisms associated with diabetes-induced neuropathic pain are complex and poorly understood. In order to understand the involvement of spinal microglia activity in diabetic pain, the present study investigated whether minocycline treatment is able to attenuate diabetic pain using a rat model. Diabetes was induced using a single intraperitoneal injection of streptozotocin (STZ). Minocycline was then intrathecally administered to the rats. Paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were tested weekly. The expression of OX-42, Iba-1, phospho-p38 mitogen-activated protein kinase (MAPK), tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß) and inducible nitric oxide synthase (iNOS), were examined in the spinal cord in order to evaluate the activation of microglia. The present study demonstrated that rats with STZ-induced diabetes exhibited increased mean plasma glucose concentration, decreased mean body weight and significant pain hypersensitivity compared with control rats. PWT and PWL values of rats with STZ-induced diabetes increased following treatment with minocycline. No differences were observed in expression levels of the microglial activity markers (OX-42, Iba-1 and phospho-p38 MAPK) between rats with STZ-induced diabetes and control rats. However, TNF-α, IL-1ß and iNOS expression levels were higher in rats with STZ-induced diabetes compared with control rats. Following treatment with minocycline markers of microglial activation, including cytokines and iNOS, were downregulated in rats with STZ-induced diabetes. The results of the present study indicated that minocycline treatment may inhibit spinal microglial activation and attenuate diabetic pain in rats with STZ-induced diabetes.

Negative methylation status of vimentin predicts improved prognosis in pancreatic carcinoma.

AIM: To determine the existence of a potential relationship between the methylation state of the Vimentin gene and its prognostic value in pancreatic cancer. METHODS: Sixty-four primary tumor specimens and normal tissues were collected consecutively from pancreatic cancer patients during surgery at Hangzhou First People's Hospital and Affiliated Hospital of the Logistics University of the Chinese People's Armed Police Force. DNA was extracted from the samples and subsequently quantitative methylation-specific polymerase chain reaction was used to detect the Vimentin methylation status of the samples. All of the patients were followed up to December 2012. χ(2) test, Kaplan-Meier survival and Cox regression statistical models were used. RESULTS: Out of 64 pancreatic cancer tissues, 21 were marked as Vimentin methylation-positive, and 43 were marked as Vimentin methylation-negative. The location of pancreatic carcinoma was related to the Vimentin methylation state. The pathological T staging (P < 0.001), adjuvant chemotherapy (P = 0.003) and the Vimentin methylation state (P = 0.037) were independent prognostic factors. CONCLUSION: In our study, Vimentin methylation status can predict the prognosis of pancreatic cancer patients. However, additional experiments and clinical trials are needed to accurately validate this observation.