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Objective:To retrieve the relevant guidelines and expert consensus on self-management of patients with high-risk foot diabetes, and analyze the content of high-quality guidelines and expert consensus recommendations, so as to provide a reference for the construction of a guidance program for self-management of patients with high-risk foot diabetes.Methods:Computer-retrieved clinical practice guidelines and expert consensus for self-management of patients with high-risk foot for diabetes from databases, guideline networks, and related professional websites. The search period was from January 1, 2012 to June 5, 2022. The quality of the included literature was evaluated and the evidence was extracted and integrated by 2 researchers. Experts were invited to evaluate the summarized evidence.Results:According to the quality of literature, a total of 12 guidelines (10 at level A and 2 at level B) and 3 expert consensus (expert discussion and decision) were included, and 8 themes were defined as regular follow-up, self-assessment, foot and decompression management, exercise management, nutrition management, indicator management, psychological management, and health education, a total of 28 recommendations. Among them, there were 23 A-level recommendations and 5 B-level recommendations.Conclusions:The quality of the guidelines and expert consensus included in this study is high,the recommended level of the summarized evidence is high. This study provides the reference and basis for the clinical staff to construct and guide the clinical practice of self-management of high-risk diabetic foot patients.
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Hyperglycemia and hyperosmolar state (HHS) is an acute complication of diabetes with a higher mortality rate. Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) , among which fatal PTE is one of the main causes of sudden death in hospitalized patients. There are relatively few clinical reports about the simultaneous occurrence of HHS and VTE. This article introduces the successful treatment of an elderly patient with HHS combined with VTE and gastrointestinal bleeding to improve clinicians’ understanding of the disease.
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Objective@#To investigate the clinical efficacy of colchicine tablets in the treatment of patients with gouty arthritis, and to observe the effect of colchicine tablets on erythrocyte sedimentation rate(ESR), C-reactive protein (CRP) and uric acid (UA).@*Methods@#From March 2016 to March 2017, 70 patients with gouty arthritis in our hospital were randomly divided into control group and observation group according to the random number table method.The control group was treated with celecoxib capsules 0.2g, 2 times a day.The observation group was treated with colchicine tablets 0.5mg three times daily, celecoxib capsules 0.2g, 2 times a day.The visual analogue scale (VAS) was used to evaluate the degree of joint pain in two groups.The Likert scale was used to evaluate the swelling of the two groups before and after treatment.The pain relief time was recorded in both two groups.The ESR, CRP and UA were measured before and after treatment.The clinical effects and adverse reactions in the two groups were analyzed.@*Results@#After treatment, the VAS score of the observation group was (2.04±0.52)points, which was significantly lower than (3.53±1.22)points of the control group(t=6.64, P=0.00). The joint swelling score of observation group after treatment was (0.62±0.24) points, which was significantly lower than (1.21±0.33)points of the control group(t=8.55, P=0.00). After treatment, the VAS score and joint swelling score in the two groups were significantly lower than those before treatment (all P<0.05). The pain relief time of the observation group was significantly shorter than that of the control group [(1.36±0.47)d vs.(1.79±0.63)d, t=3.23, P=0.00]. After treatment, the ESR, CRP and UA levels of the observation group were (12.65±3.17)mm/h, (12.14±2.27)mg/L, (417.82±55.88)μmol/L, respectively, which were significantly lower than those of the control group [(14.77±4.22)mm/h, (14.69±3.16)mg/L, (458.93±62.74)μmol/L, t=2.37, 3.87, 2.37, P=0.02, 0.00, 0.00]. After treatment, the ESR, CRP and UA levels of the two groups were significantly lower than those before treatment (all P<0.05). The total effective rate of the observation group was 80.00%, which was obviously higher than 57.14% of the control group(χ2=7.55, P=0.02). The incidence rate of adverse reaction of the observation group was 8.57%, which of the control group was 5.71%, the difference was not statistically significant (χ2=0.21, P=0.64).@*Conclusion@#Colchicine tablets combined with celecoxib capsules in the treatment of patients with gouty arthritis can reduce ESR, CRP and UA levels, improve the degree of pain and joint swelling, and will not increase the adverse reactions.