Cost of Diabetic Foot Ulcer Management in China: A 7-Year Single-Center Retrospective Review.

BACKGROUND: The cost of care for diabetic foot ulcers has became a global economic burden. The study aimed to analyze diabetic foot ulcer cost changes over time and to identify factors associated with these variables, so as to strengthen and improve the management of diabetic foot ulcers. METHODS: We retrospectively analyzed the data in the electronic medical record system of our wound treatment center. The homepage of the system was queried using the national clinical version 2.0 disease diagnosis code (ICD-10), the data of patient's basic information were exported. Through the statistics and analysis of these data, the socioeconomic changes and possible risk factors of diabetic foot ulcers management in recent years were obtained. RESULTS: There were 3654 patients included in the study, an average of 522 per year. The total cost per patient increased from ¥15,535.58 in 2014 to ¥42,040.60 in 2020, with an average of ¥21,826.91. The average length of stay between 14.29 days and 31.4 days from 2014 to 2020, with an average of 18.10 days. Besides, the average incidence of peripheral arterial disease in diabetic foot ulcers patients admitted was as high as 81.9%, and the average amputation rate was 9.9%. The study reflected the total cost and length of stay of diabetic foot patients increased significantly from 2014 to 2020, which were related to age (>85 years), gender (male), peripheral arterial disease, amputation (P < 0.05). CONCLUSION: A heavy cost from diabetic foot ulcers and its complications was significantly increased yearly, which was related to older age, co-morbidity, amputation and duration of hospitalization. The prevention and treatment of diabetic foot ulcers have a long way to go, early comprehensive prevention and multi-disciplinary cooperation may still be an effective way.

Extensive serum biomarker analysis before and after treatment in healing of diabetic foot ulcers using a cytokine antibody array.

Diabetic foot ulcers (DFU) remain a serious public health problem. However, the current evaluation and confirmation of the efficacy of DFU is unclear. The present study aimed to measure the alterations of circulating proteins in patients after DFU healing for the exploration of the prognostic biomarkers. The serum cytokine profiles of DFU patients before and after treatment were analyzed by a human antibody microarray technology using diabetic patients and healthy population as control groups. The results showed that ten differential cytokines were associated with DFU healing. Among these ten cytokines, comparing to DFU group, nine ones (Jagged-1, CD14, Cathepsin S, Syndecan 4, MDC, TARC, Angiopoietin-4, Clusterin and HGFR) were significantly up-regulated in DFU-treated group and Follistatin-like 1 was significantly down-regulated, while their levels in DFU-treated group showed no significant differences from those in control groups. Furthermore, ELISA validation also showed that compares to DFU group four of ten (MDC, TARC, Clusterin, and Syndecan 4) were increased in DFU-treated group equal to the levels in control groups, consistent with the array results. Our finding shows that these four cytokines may have great potential for prognostic evaluation of DFU healing.

Circular RNA circ_0124644 exacerbates the ox-LDL-induced endothelial injury in human vascular endothelial cells through regulating PAPP-A by acting as a sponge of miR-149-5p.

The modulatory roles of numerous circular RNAs (circRNAs) have been exposited in atherosclerosis (AS). Our study paid attention to the function of circRNA_ 0124644 (circ_0124644) in AS development, as well as its functional mechanism. The AS cell model was established by the treatment of oxidized low-density lipoprotein (ox-LDL) to human vascular endothelial cells (HUVECs). Cell proliferation and cycle were severally measured by Cell Counting Kit-8 (CCK-8) and cell cycle detection kit. The examination of apoptosis rate was executed through flow cytometry. Western blot was exploited for detecting the associated proteins. The expression levels of circ_0124644 and microRNA-149-5p (miR-149-5p) and pregnancy-associated plasma protein-A (PAPP-A) were assayed using quantitative real-time polymerase chain reaction. The combination of targets was validated via the dual-luciferase reporter assay, RNA immunoprecipitation (RIP), and RNA pull-down assay. Clonal capacity was analyzed using colony formation assay. Ox-LDL restrained HUVECs proliferation and cycle, but facilitated apoptosis. Circ_0124644 expression was increased, while miR-149-5p was downregulated in ox-LDL-treated HUVECs. Besides, circ_0124644 served as a molecular sponge of miR-149-5p and intensified the ox-LDL-induced HUVECs injury by sponging miR-149-5p. PAPP-A was a target of miR-149-5p and miR-149-5p could mitigate the HUVECs injury caused by ox-LDL through inhibiting PAPP-A. Moreover, PAPP-A was positively regulated by circ_0124644 via the miR-149-5p. In this report, we concluded the promoted role of circ_0124644 in the ox-LDL-induced endothelial injury of HUVECs via the miR-149-5p/PAPP-A axis with an emphasis on its diagnostic and therapeutic values in AS.

The genetic association between LMP2 and LMP7 polymorphisms and susceptibility of insulin dependent diabetes mellitus: A meta-analysis.

BACKGROUND: Insulin dependent diabetes mellitus (IDDM) is a kind of heterogeneous disease caused by the interaction of polygene inheritance and environmental factors. The LMP2 and LMP7 are 2 loci in LMP gene, and although genetic association between LMP2 and LMP7 polymorphisms were reported, the results are inconclusive. The aim of this study was to investigate the association between LMP2 and LMP7 polymorphisms and IDDM risk. METHODS: An exhaustive search was performed out through the electronic databases including PubMed, Embase, and Chinese National Knowledge Infrastructure (CNKI). The pooled odds ratio (OR) and 95% confidence interval (CI) were used to assess the strength association between LMP2 CfoI and LMP7 G37360T polymorphisms and IDDM risk. RESULTS: A total of 7 studies with 707 cases and 821 controls were included in the present study. The results indicated that the dominant model of LMP2 CfoI was significantly associated with IDDM in Asian population (OR = 1.96, 95% CI: 1.24-3.10, P = .004). In addition, the allelic and dominant models of LMP7 G37360T were associated with IDDM in Caucasian population (allelic model: OR = 0.69, 95% CI: 0.56-0.85, P = .0005; dominant model: OR = 0.67, 95% CI: 0.50-0.89, P = .007). CONCLUSIONS: The dominant model of LMP2 CfoI might be a risk factor for IDDM in Asian population. Whereas, the allelic and dominant models of LMP7 G37360T might be protective factors for IDDM in Caucasian population.