Objective To investigate the effects of autologous platelet-rich gel (APG) combined with intelligent trauma negative-pressure comprehensive therapeutic instrument on patients with refractory diabetic foot ulcer (DFU). Methods A total of 80 patients with refractory DFU treated in the hospital from January 2015 to January 2017 were divided into the trial group (n=40) and the control group (n=40) by the random number table method. The patients in the two groups were given routine treatment, and on the basis, the patients in the control group were treated with the intelligent trauma negative-pressure comprehensive therapeutic instrument while the ones in the trial group were treated with APG combined with intelligent trauma negative-pressure therapeutic instrument alternately. All patients were observed for 12 weeks. The cure rates, healing time and changes of wound volumes in the two groups before treatment and at 2, 4, 8, and 12 weeks after treatment were recorded. Results The total effective rate of treatment in the trial group was higher than that in the control group (87.5% vs. 67.5%, P<0.05). The wound volumes in the two groups at 4, 8 and 12 weeks after treatment were smaller than those before treatment and at 2 weeks after treatment (P<0.05). The wound volumes in the trial group at 4, 8 and 12 weeks after treatment were significantly smaller than those in the control group (P<0.05). The healing times of Wagner Ⅱ and Ⅲ DFU in the trial group were significantly shorter than those in the control group [(24.71±4.29)vs. (33.84±6.09) days, P<0.05; (33.04±5.97)vs. (45.29±7.05) days, P<0.05]. Conclusion Alternate treatment with APG combined with intelligent trauma negative-pressure comprehensive therapeutic instrument for refractory DFU can promote wound healing, shorten wound healing time, and improve the clinical efficacy.
Telomeres play an important role in maintaining genomic stability and cell life. Accumulating studies show that telomeres are closely related to human aging, cardiovascular diseases and cerebrovascular diseases. There are a series of researches about telomeres and atherosclerosis across the world, including studies on the relationship between atherosclerosis, cardiovascular diseases, cerebrovascular diseases and telomere length, and on telomere-targeted treatments for cardiovascular and cerebrovascular diseases. Telomeres may be a risk predictor or a new therapeutic target for atherosclerosis and cardiovascular diseases. This article reviews the relationship between telomeres and cardiovascular and cerebrovascular diseases, introduces the research progress of telomere length and cardiovascular diseases, cerebrovascular diseases, and the possible mechanisms of their association, aiming to provide a theoretical basis for exploring new therapeutic targets for atherosclerosis.
ObjectiveTo evaluate the efficacy and safety of perioperative dual antiplatelet treatment (DAPT) or single antiplatelet treatment (SAPT) for patients undergoing carotid endarterectomy (CEA).MethodsWe searched English and Chinese databases, including PubMed, Embase, Cochrane, Web of Science, Chinese National Knowledge Infrastructure, Wanfang database, Chongqing VIP, and relevant clinical trial registry platforms (searched from database establishment to January 2020). Cohort studies or randomized controlled trials (RCTs) were included to evaluated the use of DAPT and SAPT for patients undergoing CEA. Stroke, myocardial infarction, artery restenosis, and composite endpoint (stroke or myocardial infarction or artery restenosis) were used as effectiveness outcomes. Death and any bleeding event were used as safety outcomes. Meta-analysis was performed with Review Manager 5.3 and STATA 15.1 softwares.ResultsA total of 11 studies with 123 748 patients were included. The results of meta-analysis showed that there was no significant decrease in the risk of stroke [relative risk (RR)=0.82, 95% confidence interval (CI) (0.66, 1.01), P=0.06], myocardial infarction [RR=1.31, 95%CI (0.92, 1.87), P=0.13], artery restenosis [RR=0.55, 95%CI (0.18, 1.68), P=0.29], or composite endpoint event [RR=0.90, 95%CI (0.59, 1.37), P=0.62] for CEA patients with DAPT during the perioperative period compared with SAPT. The difference in mortality rate was not statistically significant between DAPT and SAPT for CEA patients during the perioperative period [RR=0.99, 95%CI (0.44, 2.22), P=0.97]. CEA patients with DAPT had a higher risk of any bleeding event [RR=1.64, 95%CI (1.08, 2.50), P=0.02].ConclusionsPerioperative CEA patients with DAPT are not associated with a lower risk of vascular events recurrence, but the risk of any bleeding event may increase. Therefore, SAPT during the perioperative period of patients undergoing CEA may be better than DAPT.