The Efficacy of Diabetic Foot Treatment in a "TOSF" Pattern: A Five-Year Retrospective Study.

Aim: To evaluate the advantages and problems in the diagnosis and treatment of diabetic foot (DF) patients by analyzing the results of a 5-year follow-up of the organ system based (TOSF) treatment model. Methods: A retrospective study was conducted in 229 patients with diabetic foot. Chi-square test and rank-sum test were used to analyze the effects of patients' general condition, behavioral and nutritional status, degree of infection (inflammatory markers), comorbidity, diabetic foot grade/classification, and revascularization on readmission rate, amputation rate, all-cause mortality, incidence of other complications, and wound healing time. Logistic regression was used to analyze the risk factors affecting the prognosis of diabetic foot. Kaplan-Meier survival curve was used to analyze the differences in amputation rate and mortality rate at each time point. Results: This study showed that nutritional status, degree of infection, and revascularization influenced readmission rates. General condition, behavior and nutritional status, degree of infection, Wagner grade and revascularization affect the amputation rate. General conditions, behavioral and nutritional status, degree of infection, comorbidities, classification and revascularization affect the mortality of patients. Age and white blood cell(WBC) count affected the incidence of other complications. Influence of infection degree and Wagner grade and revascularization in patients with wound healing time. Revascularization was an independent protective factor for readmission, amputation, and mortality.Elevated serum inflammatory markers are an independent risk factor for amputation. Hypoproteinemia is an independent risk factor for mortality. Conclusion: In the "TOSF" diagnosis and treatment pattern, diabetic foot patients have a good prognosis. Special attention should be paid to the screening and revascularization of lower extremity vascular disease in patients with diabetic foot.

Catalytic pyrolysis of waste printed circuit boards to organic bromine: reaction mechanism and comprehensive recovery.

The production of waste printed circuit boards (WPCBs) is increasing, and its complex composition makes recycling difficult. In addition, the presence of heavy metals and brominated flame retardants makes it a hazardous waste. Therefore, its recycling is a necessary way for resource recycling and green sustainable development. The purpose of this study is to propose a green, efficient, and pollution-free recycling process as an alternative to recycle WPCBs. In this work, an alkaline metal oxide catalytic pyrolysis process was used to recover WPCBs. In the presence of alkali metal oxides (such as Ca(OH)2) and coexisting copper, Ca(OH)2 and coexisting copper are transformed into CaBr2 and Cu Br by reacting with organic bromine in WPCBs and remaining in the solid phase product. The bromine content and the proportion of inorganic bromine in the solid phase products were 87.68% and 87.56%, respectively. In addition, the content of organic bromine in the pyrolysis oil obtained by co-pyrolysis was significantly reduced. This study demonstrated the feasibility of Ca(OH)2 catalytic pyrolysis for WPCB recovery.

[Predictive factors of intestinal necrosis in acute mesenteric vascular occlusive diseases].

OBJECTIVE: To explore the predictive factors of intestinal necrosis in acute mesenteric vascular occlusive diseases and its significance for the timing of exploratory laparotomy. METHODS: This retrospective study enrolled 63 patients diagnosed as acute mesenteric vascular occlusive diseases at Peking University People's Hospital between July 1995 and June 2015. Univariate analysis and multivariate logistic regression analysis were used to identify predictive factors for intestinal necrosis. RESULTS: Of 63 patients, 39 were male and 24 were female, with a mean age of (58.8±12.7)(31 to 82) years. The overall rate of intestinal necrosis was 46.0%(29/63). Patients with intestinal necrosis had a poorer prognosis than those who did not develop intestinal necrosis (χ2=5.908, P=0.015). In univariate analysis, the predictive factors of intestinal necrosis were systemic inflammatory reactive syndrome (SIRS) (χ2=18.535, P=0.000), shock (χ2=7.775, P=0.007), peritoneal irritation sign (χ2=11.533, P=0.001), changes of intestinal wall and blood signals on ultrasound or CT scans (χ2=14.344, P=0.000), international normalized ratio(INR) (prothrombin time) ≥1.2 (χ2=4.498, P=0.034), D-dimer ≥1 000 g/L(χ2=6.680, P=0.010), low-density lipoprotein ≥270 U/L (χ2=6.513, P=0.011), serum albumin <35 g/L (χ2=3.914, P=0.048), blood urea nitrogen ≥6.2 mmol/L (χ2=11.377, P=0.000), pH values <7.35 (χ2=15.887, P=0.000), blood lactate ≥2 mmol/L(χ2=17.134, P=0.000), base excess <-1.0 mmol/L (χ2=6.674, P=0.010). According to multivariate logistic regression analysis, SIRS(OR=28.945, 95%CI:2.294 to 365.199, P=0.009), pH values <7.35(OR=13.174, 95%CI:1.157 to 150.027, P=0.038), changes of intestinal wall and blood signals on ultrasound or CT scans(OR=4.857, 95%CI:1.110 to 21.253, P=0.036) were independent predictive factors of intestinal necrosis in patients with acute mesenteric vascular occlusive diseases. CONCLUSIONS: Intestinal necrosis in acute mesenteric vascular occlusive diseases prompts a poor prognosis. When patients with acute mesenteric vascular occlusive diseases are found to have acidosis, SIRS and changes of intestinal wall and blood signals on ultrasound or CT scans, surgeons should be alert to the occurrence of intestinal necrosis and should perform laparotomy promptly in order to take suitable management.