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

Objective: This study aimed to evaluate the effectiveness of total contact casts (TCCs) versus removable offloading interventions among patients with diabetic foot ulcers (DFUs). Methods: A 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. Results: Twelve 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). Conclusion: The 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.

Development of prediction models to estimate extubation time and midterm recovery time of ophthalmic patients undergoing general anesthesia: a cross-sectional study.

BACKGROUND: To develop prediction models for extubation time and midterm recovery time estimation in ophthalmic patients who underwent general anesthesia. METHODS: Totally 1824 ophthalmic patients who received general anesthesia at Joint Shantou International Eye Center were included. They were divided into a training dataset of 1276 samples, a validation dataset of 274 samples and a check dataset of 274 samples. Up to 85 to 87 related factors were collected for extubation time and midterm recovery time analysis, respectively, including patient factors, anesthetic factors, surgery factors and laboratory examination results. First, multiple linear regression was used for predictor selection. Second, different methods were used to develop predictive models for extubation time and midterm recovery time respectively. Finally, the models' generalization abilities were evaluated using a same check dataset with MSE, RMSE, MAE, MAPE, R-Squared and CCC. RESULTS: The fuzzy neural network achieved the highest R-Squared of 0.956 for extubation time prediction and 0.885 for midterm recovery time, and the RMSE value was 6.637 and 9.285, respectively. CONCLUSION: The fuzzy neural network developed in this study had good generalization performance in predicting both extubation time and midterm recovery time of ophthalmic patients undergoing general anesthesia. TRIAL REGISTRATION: This study is prospectively registered in the Chinese Clinical Trial Registry, registration number: CHiCRT2000036416, registration date: August 23, 2020.

Braces versus casts for post-operational immobilization of ankle fractures: A meta-analysis.

Background and aims: Both casts and braces can be used for post-operational immobilization of ankle fractures. This meta-analysis aimed to assess the complications and functional effects of the two types of immobilization. Material and methods: PubMed, Embase, Cochrane, and CNKI was searched for randomized controlled trials (published between Jan 1, 1950, and March 2022). Relative risk (RR) or standard mean difference (SMD) with a 95% confidence interval (CI) was used to present the outcomes. The pooled data were assessed by using the fixed-effects model or random-effects model. Results: A total of 5 randomized controlled studies involving 930 subjects were included according to our inclusion criteria. On the ankle score at 6w,12w and 52w, there was no statistically significant difference between the two groups. In terms of 6w, the brace group showed better ankle dorsiflexion (MD = 6.78, 95% CI 0.56-13.00, p = 0.03) and plantar flexion (MD = 6.58, 95% CI 1.60-11.55, p = 0.01) than the cast group. The wound complications (RR = 3.49, 95% CI 1.32 to 9.24, p = 0.01) and total complications (RR = 3.54, 95% CI 1.92 to 6.50, p < 0.0001) in the brace group were three times more than that in the cast group. There was no statistically significant difference between the two groups in the non-wound complications. There was no statistically significant difference between the two groups in the time of going back to work, swelling of the ankle, and atrophy of the calf muscle. Conclusion: The short-term and long-term functional outcomes after postoperative treatment of adult ankle fractures with braces are similar to those with casts. The usage of braces may cause three times more wound complications than that of casts.

Recent Synthesis Developments of Organoboron Compounds via Metal-Free Catalytic Borylation of Alkynes and Alkenes.

Diboron reagents have been traditionally regarded as "Lewis acids", which can react with simple Lewis base to create a significant nucleophilic character in one of boryl moieties. In particular, bis(pinacolato)diboron (B2pin2) reacts with simple Lewis bases, such as N-heterocyclic carbenes (NHCs), phosphines and alkoxides. This review focuses on the application of trivalent nucleophilic boryl synthon in the selective preparation of organoboron compounds, mainly through metal-free catalytic diboration and the ß-boration reactions of alkynes and alkenes.

Beclin-1 suppresses gastric cancer progression by promoting apoptosis and reducing cell migration.

To investigate Beclin-1 expression in gastric cancer and its clinical relevance, 60 samples were collected from patients with gastric carcinoma, which were subjected to immunohistochemical staining and analysis. Associations of Beclin-1 expression with the clinical parameters of the patients, including tumor size, histological differentiation and metastatic status, were examined by statistical analysis. The results demonstrated that Beclin-1 expression in gastric carcinoma tissue was significantly associated with the tumor, node, metastasis stage and tumor invasion status. Further experiments indicated that Beclin-1 overexpression promoted MKN-45 gastric cancer cell apoptosis and inhibited their migration. These data suggested that Beclin-1 was a suppressor of tumorigenesis in gastric cancer and a potential therapeutic target for patients with gastric cancer.

Selective synthesis of alkylboronates by copper(I)-catalyzed borylation of allyl or vinyl arenes.

An efficient copper-catalyzed borylation reaction of allyl or vinyl arenes with bis(pinacolato)diboron has been developed, without using ligands. Markovnikov-selectivity is observed in the borylation of allyl arenes with bis(pinacolato)diboron, while the regioselectivity is completely opposite when styrene derivatives are used as substrates. A mechanism involving Cu-B species regioselectively adding olefin double bonds to form the alkylcopper or η(3)-benzyl copper intermediate, which is followed by protonation to obtain products, is proposed.

catena-Poly[[bis-(3-methyl-benzoato-κO,O')lead(II)]-µ-4,4'-bipyridine-κN:N'].

In the title complex, [Pb(C(8)H(7)O(2))(2)(C(10)H(8)N(2))](n), the Pb(II) atom is located on a twofold rotation axis and is six-coordinated by four carboxyl-ate O atoms from two 3-methyl-benzoate ligands and two N atoms from two 4,4'-bipyridine (4,4'-bpy) ligands, displaying a hemi-directed coordination. The 4,4'-bpy ligand has an inversion center at the mid-point of the central C-C bond. The Pb(II) atoms are linked by bidentate bridging 4,4'-bpy into a chain along [101]. These chains are further connected into layers via C-H⋯O hydrogen bonds.

Cytotoxic pentacyclic triterpenoids from Combretum oliviforme.

Four pentacyclic triterpenoids were obtained from the leaves of Combretum oliviforme Chao, 3beta-hydroxyolean-12-en-28-oic acid (1), 23-O-[alpha-L-(4'-acetylrhamnopyranosyl)]-imberbic acid (2), 23-acetoxy-3beta-acetylimberbic acid-29-methyl ester (3), and 23-O-[alpha-L-rhamnopyranosyl]-1,3beta-diacetylimberbic acid (4). Hydrolysis of 2 and 4 gave 23-hydroxyimberbic acid (5). The structures were elucidated by NMR, electrospray ionization mass spectrometry (ESIMS) and comparison with literature data. Compounds 1, 2, 3 and 4 were isolated from C. oliviforme Chao leaves for the first time and 3 for the first time from any natural source. All compounds were tested in vitro for their activity against human lung cancer cell line SPC-A-1, human erythroleukaemic line K562 and human gastric cancer SGC-7901 cells. Compounds 1, 3, 4 and 5 had cytotoxic activity for the three cell lines with IC50 0.69-69.68 microM. These results suggest that the presence of acetyl group in the triterpene aglycone structure plays an essential role for cytotoxic activity.