Incidence of fragility hip fracture across the Asia-pacific region: A systematic review.

PURPOSE: This systematic review aimed to update fragility hip fracture incidences in the Asia Pacific, and compare rates between countries/regions. METHOD: A systematic search was conducted in four electronic databases. Studies reporting data between 2010 and 2023 on the geographical incidences of hip fractures in individuals aged ≥50 were included. Exclusion criteria were studies reporting solely on high-trauma, atypical, or periprosthetic fractures. We calculated the crude incidence, age- and sex-standardised incidence, and the female-to-male ratio. The systematic review was registered with PROSPERO (CRD42020162518). RESULTS: Thirty-eight studies were included across nine countries/regions (out of 41 countries/regions). The crude hip fracture incidence ranged from 89 to 341 per 100,000 people aged ≥50, with the highest observed in Australia, Taiwan, and Japan. Age- and sex-standardised rates ranged between 90 and 318 per 100,000 population and were highest in Korea and Japan. Temporal decreases in standardised rates were observed in Korea, China, and Japan. The female-to-male ratio was highest in Japan and lowest in China. CONCLUSION: Fragility hip fracture incidence varied substantially within the Asia-Pacific region. This observation may reflect actual incidence differences or stem from varying research methods and healthcare recording systems. Future research should use consistent measurement approaches to enhance international comparisons and service planning.

Applications of Mass Spectrometry Imaging to Cancer.

Pathologists play an essential role in the diagnosis and prognosis of benign and cancerous tumors. Clinicians provide tissue samples, for example, from a biopsy, which are then processed and thin sections are placed onto glass slides, followed by staining of the tissue with visible dyes. Upon processing and microscopic examination, a pathology report is provided, which relies on the pathologist's interpretation of the phenotypical presentation of the tissue. Targeted analysis of single proteins provide further insight and together with clinical data these results influence clinical decision making. Recent developments in mass spectrometry facilitate the collection of molecular information about such tissue specimens. These relatively new techniques generate label-free mass spectra across tissue sections providing nonbiased, nontargeted molecular information. At each pixel with spatial coordinates (x/y) a mass spectrum is acquired. The acquired mass spectrums can be visualized as intensity maps displaying the distribution of single m/z values of interest. Based on the sample preparation, proteins, peptides, lipids, small molecules, or glycans can be analyzed. The generated intensity maps/images allow new insights into tumor tissues. The technique has the ability to detect and characterize tumor cells and their environment in a spatial context and combined with histological staining, can be used to aid pathologists and clinicians in the diagnosis and management of cancer. Moreover, such data may help classify patients to aid therapy decisions and predict outcomes. The novel complementary mass spectrometry-based methods described in this chapter will contribute to the transformation of pathology services around the world.

Dietary exposure to organochlorine pesticide residues of the Hong Kong adult population from a total diet study.

Dietary exposure of the Hong Kong adult population to organochlorine pesticide (OCP) residues was estimated using a total diet study (TDS) approach. OCPs listed under the Stockholm Convention as persistent organic pollutants (POPs) including, aldrin, dieldrin, chlordane, chlordecone, dichlorodiphenyltricholroethane (DDT), endosulfan, endrin, heptachlor, hexachlorobenzene (HCB), α-hexachlorocyclohexanes (HCH), ß-HCH, lindane, mirex, pentachlorobenzene and toxaphene, were studied. Out of 600 composite samples, 55% contained one or more OCP residues at detectable levels. The most commonly detected OCP was DDT (32% of all composite samples), followed by HCB (30%) and endosulfan (22%). The lower- and upper-bound mean exposure estimates of OCP residues ranged from 0% to 0.5% and were 0.1-8.4% of their respective health-based guidance values (HBGVs). The lower- and upper-bound 95th percentile exposure estimates ranged from 0% to 1.2% and were 0.1-13.6% of their respective HBGVs. This indicated that dietary exposures to the OCP residues analysed would be unlikely to pose unacceptable health risks to Hong Kong adults.

Dietary exposures to eight metallic contaminants of the Hong Kong adult population from a total diet study.

Dietary exposures to eight metallic contaminants, aluminium (Al), antimony (Sb), cadmium (Cd), lead (Pb), methylmercury (MeHg), nickel (Ni), tin (Sn) and vanadium (V), of the Hong Kong adult population were estimated using the total diet study (TDS) approach. The estimated mean exposures of Al (0.60 mg kg(-1) bw week(-1)), Sb (0.016-0.039 µg kg(-1) bw day(-1)), Cd (8.3 µg kg(-1) bw month(-1)), Pb (0.21 µg kg(-1) bw day(-1)), MeHg (0.74 µg kg(-1) bw week(-1)), Ni (3.1 µg kg(-1) bw day(-1)), Sn (0.029-0.031 mg kg(-1) bw week(-1)) and V (0.13 µg kg(-1) bw day(-1)) were well below the relevant health-based guidance values (HBGVs) where available. However, dietary exposures to MeHg of women aged 20-49 years (child-bearing age) accounted for 150% of the provisional tolerable weekly intake (PTWI) and to Al and Cd of some high consumers were found exceeding or approaching the HBGVs. The major food contributors of MeHg were fish and seafood (90%), of Al were non-alcoholic beverages including tea (33%), and of Cd were vegetables (36%). MeHg exposure during pregnancy was a public health concern in Hong Kong due to potential health risks to the foetus. Results suggest that there is a need to continue monitoring the exposures to metallic contaminants, especially Al, Cd and MeHg, of the Hong Kong population.

Dietary exposure of Hong Kong adults to pesticide residues: results of the first Hong Kong Total Diet Study.

The use of pesticides and other chemicals has become a common practice in modern agriculture to enhance and stabilise crop yield, protect the nutritional integrity of food, facilitate food storage to assure year-round supplies, and provide attractive and appealing food products. With the adoption of strict good agricultural practice (GAP), only minimal amounts of pesticide residues should remain on the crops or in connected foods of animal origin up the food chain. To assess their associated health risk to local people, the dietary exposure of Hong Kong adults to residues of four groups of pesticides or their metabolites - organophosphorus pesticides (OPPs), carbamates, pyrethrins and pyrethroids, and dithiocarbamate (DTC) metabolites - is estimated in the first Hong Kong Total Diet Study (TDS). A total of 150 commonly consumed food items were collected and prepared "as consumed". A total of 600 composite food samples were analysed for 85 pesticides or their metabolites by liquid chromatography-tandem mass spectrometry (LC-MS/MS). These pesticides were primarily found at low levels (highest mean = 350 µg kg⁻¹) in food samples of plant origin such as vegetables and fruits. Dietary exposures to pesticide residues were estimated based on the analytical results and the food consumption data of the local residents. The estimated dietary exposures of Hong Kong adults to all individual pesticides were well below their respective acceptable daily intakes (ADIs). The percentage contributions of the estimated mean and 95th percentile dietary exposures to the ADIs of individual pesticides were <6% and <24% for the OPPs, <1% for the carbamates and pyrethrins and pyrethroids, and <1% and <4% for the DTC metabolites, respectively. The findings indicate that dietary exposures to all the pesticide residues analysed in this study were unlikely to pose unacceptable health risks to the Hong Kong population.

Dietary exposure of Hong Kong adults to acrylamide: results of the first Hong Kong Total Diet Study.

Acrylamide is a processing contaminant in food formed during cooking at high temperature, such as frying and baking. To assess the associated health risk of the Hong Kong population, the dietary exposure of Hong Kong adults to acrylamide was estimated in the first Hong Kong Total Diet Study (TDS), where food samples were collected and prepared "as consumed". A total of 532 composite food samples were analysed for acrylamide using LC-MS/MS. Dietary exposures were estimated by combining the analytical results with the food consumption data of the Hong Kong adults. The mean and 95th percentile exposures to acrylamide of the Hong Kong population were 0.213 and 0.538 µg kg⁻¹ body weight (bw) day⁻¹, respectively, and their margins of exposure (MOEs) were all below 10,000. The main dietary source of acrylamide was "Vegetables and their products" (52.4% of the total exposure), particularly stir-fried vegetables (44.9%), followed by "Cereals and their products" (14.7%) and "Mixed dishes" (9.43%). The study findings suggest that the relatively low figures for MOE for a genotoxic carcinogen may indicate human health concern of the Hong Kong population. Efforts should continue to be made in the interest of reducing acrylamide levels in food locally.

Quantitative risk-benefit analysis of fish consumption for women of child-bearing age in Hong Kong.

Maternal fish consumption is associated with both risks from methylmercury (MeHg) and beneficial effects from omega-3 fatty acids to the developing foetal brain. This paper assessed the dietary exposure to MeHg of women of child-bearing age (20-49 years) in Hong Kong, and conducted risk-benefit analysis in terms of the effects in children's intelligent quotient (IQ) based on local data and the quantitative method derived by the expert consultation of FAO/WHO. Results showed that average and high consumers consume 450 and 1500 g of fish (including seafood) per week, respectively. About 11% of women of child-bearing age had a dietary exposure to MeHg exceeding the PTWI of 1.6 µg kg(-1) bw. In pregnant women MeHg intake may pose health risks to the developing foetuses. For average consumers, eating any of the 19 types of the most commonly consumed fish and seafood during pregnancy would result in 0.79-5.7 IQ points gain by their children. For high consumers, if they only ate tuna during pregnancy, it would cause 2.3 IQ points reduction in their children. The results indicated that for pregnant women the benefit outweighed the risk associated with eating fish if they consume different varieties of fish in moderation.

Dietary exposure to dioxins and dioxin-like PCBs of Hong Kong adults: results of the first Hong Kong Total Diet Study.

Dioxins and dioxin-like polychlorinated biphenyls (PCBs) are persistent organic pollutants (POPs) covered by the Stockholm Convention on POPs. To assess the associated health risk of the Hong Kong population, the dietary exposure of the Hong Kong population and various age-gender subgroups to dioxins and dioxin-like PCBs was estimated in the first Hong Kong Total Diet Study (TDS), where food samples were collected and prepared "as consumed". A total of 142 composite food samples, mainly foods of animal origin and their products and oily food, were analysed for polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) and dioxin-like PCBs by the high-resolution gas chromatograph/high-resolution mass spectrometer (HRGC/HRMS) system. Dietary exposures were estimated by combining the analytical results with the food consumption data of Hong Kong adults. The mean and 95th percentile exposures to dioxins and dioxin-like PCBs of the Hong Kong population were 21.9 and 59.7 pg toxic equivalent (TEQ) kg⁻¹ body weight (bw) month⁻¹ respectively, which amounted to 31.3% and 85.2% of the provisional tolerable monthly intake (PTMI). The main dietary source of dioxins and dioxin-like PCBs was "Fish and seafood and their products" (61.9% of the total exposure), followed by "Meat, poultry and game and their products" (20.0%) and "Mixed dishes" (6.95%). The study findings suggest that the Hong Kong population is unlikely to experience the major undesirable health effects of dioxins and dioxin-like PCBs.

Occurrence of bound 3-monochloropropan-1,2-diol content in commonly consumed foods in Hong Kong analysed by enzymatic hydrolysis and GC-MS detection.

The aim of this study was to determine the level of bound 3-monochloropropan-1,2-diol in foodstuffs commonly consumed in Hong Kong, China, by an enzymatic hydrolysis indirect method which proved to be free from interferences. A total of 290 samples were picked up randomly from the local market and analysed. About 73% of these samples were found to contain detectable amounts of bound 3-MCPD. Amongst the 73 food items, bound 3-MCPD was not detected in 13 food items, including extra virgin olive oil, beef ball/salami, beef flank, ham/Chinese ham, nuts, seeds, soy sauce, oyster sauce, butter, yoghurt, cream, cheese and milk. For those found to contain detectable bound 3-MCPD, the content ranged up to 2500 µg kg(-1). The highest mean bound 3-MCPD content among the 14 food groups was in biscuits (440 [50-860] µg kg(-1)), followed by fats and oils (390 [n.d.-2500] µg kg(-1)), snacks (270 [9-1000] µg kg(-1)), and Chinese pastry (270 [n.d.-1200] µg kg(-1)). Among the samples, the highest bound 3-MCPD content was in a grape seed oil (2500 µg kg(-1)), followed by a walnut flaky pastry (1200 µg kg(-1)) and a grilled corn (1000 µg kg(-1)). Basically, the results of this study agreed well with other published results in peer-reviewed journals, except for cheese, cream, ham, nuts and seeds.

Dietary exposure of the Hong Kong adult population to polybrominated diphenyl ethers (PBDEs): results of the first Hong Kong Total Diet Study.

Polybrominated diphenyl ethers (PBDEs) are a group of industrial chemicals that are persistent and can bioaccumulate. In the first Hong Kong Total Diet Study, the dietary exposure of Hong Kong adults to PBDEs was estimated to assess the associated health risks. Food samples, which represented the Hong Kong people's diet, were collected and prepared in table-ready form for analysis. Concentrations of PBDEs were determined in 142 composite samples. The dietary exposures were estimated by combining the analytical results with the local food consumption data of the adults. The mean and 95th percentile of dietary PBDEs exposures of the Hong Kong people were 1.34 and 2.90 ng kg(-1) body weight day(-1), respectively. The main dietary source of PBDEs was "fish and seafood and their products", which contributed 27.3% of the total exposure, followed by "meat, poultry and game and their products" (20.7%), "cereals and their products" (15.9%), and "fats and oils" (15.9%). The large margins of exposure (MOE) (>2.5) calculated following the European Food Safety Authority (EFSA) approach for four important congeners, BDE-47, BDE-99, BDE-153 and BDE-209, indicate that the estimated dietary exposures are unlikely to be a significant health concern.

Dietary exposure to inorganic arsenic of the Hong Kong population: results of the first Hong Kong total diet study.

Inorganic arsenic, a human carcinogen, can be found in the environment and food. In the first Hong Kong Total Diet Study, the dietary exposure of the Hong Kong people, including various age-gender subgroups, to inorganic arsenic was estimated for assessing the associated health risk. Food samples, which represented the Hong Kong people's diet, were collected and prepared "as consumed" for analysis. Concentrations of inorganic arsenic, as sum of arsenite (As(III)) and arsenate (As(V)) were determined in 600 composite samples by using inductively coupled plasma mass spectrometry. The dietary exposures were estimated by combining the analytical results with the local food consumption data of the adult population. The mean and 95th percentile of inorganic arsenic exposures of the Hong Kong people were 0.22 and 0.38µg/kg body weight (bw)/day, respectively. Among the 12 age-gender subgroups, the respective exposures ranged from 0.19 to 0.26µg/kg bw/day and from 0.33 to 0.46µg/kg bw/day. The main food category that contributed inorganic arsenic was "cereals and their products" (53.5% of the total exposure), particularly rice. Having considered the carcinogenic risk of inorganic arsenic to humans, it is suggested that efforts should be made to reduce the inorganic arsenic exposure of the Hong Kong population.

Iodine content in commonly consumed food in Hong Kong and its changes due to cooking.

Levels of iodine of foods found in Hong Kong were analysed in 271 samples from 11 groups, including (i) cereals and grain products, (ii) legumes and vegetables, (iii) meat and poultry, (iv) egg and egg products, (v) milk and milk products, (vi) fish, (vii) crustaceans and mollusks, (viii) non-alcoholic beverages, (ix) condiments and sauces, (x) sashimi and (xi) seaweeds. All food samples were analysed individually as purchased. The iodine in all samples ranged from undetectable to 2.9 g kg(-1). Seaweeds, iodised salt, seafood, milk and milk products as well as egg and egg products were rich sources of iodine. To estimate the influence of cooking on iodine levels in foods, a total of 15 individual samples were analysed as raw and respective cooked food. The influence of cooking on the iodine level was minimal, except for boiling, as iodine dissolved into the soup.

Nephrotoxicity, including acquired Fanconi's syndrome, caused by adefovir dipivoxil - is there a safe dose?

WHAT IS KNOWN AND OBJECTIVE: Adefovir dipivoxil (ADV) is an oral bioavailable prodrug of adefovir that possesses potent in vitro activity against hepadnaviruses, retroviruses and herpes viruses. ADV is excreted unchanged in the urine through glomerular filtration and tubular secretion and is known to be nephrotoxic at doses of 60mg daily and above. Thus, the long-term safety of ADV, particularly nephrotoxicity, is a major concern. Our objective is to comment on the nephrotoxcicity of low-dose (10mg daily) ADV through a case report. COMMENT: The clinical features of nephrotoxicity because of ADV are described. A case report of acquired Fanconi's syndrome in a chronic hepatitis B patient treated with ADV 10mg daily is used to illustrate several key aspects. WHAT IS NEW AND CONCLUSION: Adefovir dipivoxil can be nephrotoxic at conventional dosage and therefore, patients treated with long-term ADV should have regular monitoring of renal function, and calcium and phosphate levels.

Nitrate and nitrite levels in commonly consumed vegetables in Hong Kong.

Levels of nitrate and nitrite in 73 different vegetables, a total of 708 individual samples grouped into leafy, legumes, root and tuber, and fruiting vegetables, which are traded mainly in Hong Kong, were measured. Where available, five samples of each vegetable type were purchased from different commercial outlets during the winter of 2008 and summer of 2009. Levels of nitrate and nitrite were determined by ion chromatography and flow injection analysis, respectively. Nitrate and nitrite levels of all samples ranged <4-6300 and <0.8-9.0 mg kg⁻¹, respectively. Nitrate concentrations for the different groups, in descending order, were leafy > root and tuber > fruiting and legume vegetables. More than 80% of vegetables had mean nitrate concentrations less than 2000 mg kg⁻¹, but mean nitrate concentrations of three types of leafy vegetables, namely Chinese spinach, Shanghai cabbage and Chinese white cabbage, were >3500 mg kg⁻¹. On the other hand, nitrite concentrations were generally low - <1 mg kg⁻¹ on average. Nitrate in vegetables (i.e. Chinese flowering cabbage, Chinese spinach and celery) can be reduced significantly (12-31%) after blanching for 1-3 min, but not after soaking.

Ethyl carbamate in fermented foods and beverages: dietary exposure of the Hong Kong population in 2007-2008.

To evaluate the potential public health risk of ethyl carbamate (EC), EC exposure from fermented foods and beverages for Hong Kong population was estimated. In 276 samples analysed, EC was detected (limit of detection (LOD) at 0.4 µg kg(-1)) in 202 samples (73%), with higher levels in fermented red bean curd (150-650 µg kg(-1)) and yellow wine (140-390 µg kg(-1)), while low or non-detected (ND) in preserved vegetables (ND-10 µg kg(-1)) and fermented tea (ND-15 µg kg(-1)). The estimated dietary exposure from all fermented foods and beverages was 8.27 ng kg(-1) bw day(-1), while exposure excluding alcoholic beverages was 5.42 ng kg(-1) bw day(-1), with calculated margins of exposure (MOEs) at 3.6 × 10(4) and 5.5 × 10(4) respectively. The risk of adverse health effects was low for the average population but higher (MOE of 10(3)) for high consumers of alcoholic beverages especially habitual drinkers of alcoholic types with high EC contents.

Treatment of pesticide rinsate towards reuse by photosensitized Fenton-like process.

A Fenton-like process with combination of dye has been used to enhance the treatment of carbofuran (2,3-dihydro-2,2-dimethylbenzofuran -7-yl methylcarbamate) pesticide rinsate. Results showed that as compared to Fenton-like process, this photosensitization Fenton-like process improved the degradation efficiency of carbofuran rinsate significantly. Among the conditions studied, the optimum dosage for the complete destruction of carbofuran molecular structure was found under a [H2O2]0/[Fe3+]0 ratio of 30-35 and a [Dye]0/[Fe3+]0 ratio of 2%, respectively, after an irradiance of 500 W/m2 for 20 min. As a result, the COD degradation efficiency of rinsate could be promoted from 37.1 to 61.2% and 66.0% by an addition of methylene blue (MB) and alizarin red S (ARS), respectively. Nevertheless, ARS showed a much more effective acceleration effect on the mineralization and microtoxicity reduction of carbofuran than MB. A mineralization efficiency of 57.2% and a microtoxicity reduction of 90% could be achieved with the addition of ARS. Because of its quinone structure unit, the dye ARS could play a role like hydroquinone to recycle Fe2+ from Fe3+, resulting in one more catalytic effect on the reduction of Fe3+ and thus the mineralization and microtoxicity reduction of carbofuran was greatly promoted in the presence of ARS. In addition, it was found that carbofuran molecules could be decomposed quickly to lower-molecular-weight intermediates and even mineralized by attacking of hydroxyl radicals. Carbofuran was found to be decomposed to carbofuran phenol, 3-oxo carbofuran phenol, and 3-hydroxyl carbofuran phenol initially, and then further be degraded to smaller molecules, such as NO3-, CH3COOH, (COOH)2 and CO2. Accordingly, it was believed that the Fenton-like process along with the aid of a photosensitizer, such as ARS, under an appropriate ratio could be a feasible and potential technology for the treatment of pesticide rinsate.

Pasireotide (SOM230) demonstrates efficacy and safety in patients with acromegaly: a randomized, multicenter, phase II trial.

CONTEXT: Pasireotide (SOM230) is a novel multireceptor ligand somatostatin analog with affinity for somatostatin receptor subtypes sst(1-3) and sst(5). Because most GH-secreting pituitary adenomas express sst(2) and sst(5), pasireotide has the potential to be more effective than the sst(2)-preferential somatostatin analogs octreotide and lanreotide. OBJECTIVE: Our objective was to evaluate the efficacy and safety of three different doses of pasireotide in patients with acromegaly. DESIGN: We conducted a phase II, randomized, multicenter, open-label, three-way, crossover study. PATIENTS: Sixty patients with acromegaly, defined by a 2-h five-point mean GH level higher than 5 microg/liter, lack of suppression of GH to less than 1 microg/liter after oral glucose tolerance test, and elevated IGF-I for age- and sex-matched controls. Patients could have had previous surgery, radiotherapy, and/or medical therapy or no previous treatment. INTERVENTION: After treatment with octreotide 100 microg s.c. three times daily for 28 d, each patient received pasireotide 200, 400, and 600 microg s.c. twice daily in random order for 28 d. MAIN OUTCOME MEASURE: A biochemical response was defined as a reduction in GH to no more than 2.5 microg/liter and normalization of IGF-I to age- and sex-matched controls. RESULTS: After 4 wk of octreotide, 9% of patients achieved a biochemical response. After 4 wk of pasireotide 200-600 microg s.c. bid, 19% of patients achieved a biochemical response, which increased to 27% after 3 months of pasireotide; 39% of patients had a more than 20% reduction in pituitary tumor volume. Pasireotide was generally well tolerated. CONCLUSIONS: Pasireotide is a promising treatment for acromegaly. Larger studies of longer duration evaluating the efficacy and safety of pasireotide in patients with acromegaly are ongoing.

Dietary exposure of secondary school students in Hong Kong to polybrominated diphenyl ethers from foods of animal origin.

This paper reports levels of polybrominated diphenyl ethers (PBDEs) in a wide range of foods of animal origin and estimates their dietary exposure for secondary school students in Hong Kong, China. Dietary exposure to PBDEs was estimated using local food consumption data obtained from secondary school students in 2000 and the concentrations of PBDEs in food samples taken from local market in 2008. The PBDE levels on a fresh weight basis for fish ranged from 13 to 6600 pg g(-1), for seafood and seafood products ranged from 15 to 1200 pg g(-1), for meat and meat products ranged from 23 to 3500 pg g(-1), for poultry ranged from 68 to 670 pg g(-1), for eggs ranged from 280 to 800 pg g(-1), and for dairy products ranged from 12 to 480 pg g(-1). The dietary exposures of secondary school students for the average and high consumers were estimated to be 2.6 and 6.4 ng kg(-1) body weight day(-1), respectively. According to the Joint FAO/WHO Expert Committee on Food Additives (JECFA), for the more toxic PBDE congeners, adverse effects would be unlikely to occur in laboratory animals at doses of less than approximately 100 microg kg(-1) body weight day(-1). The resulting margins of exposures (38,000 for average consumers and 16,000 for high consumers) showed that the estimated dietary exposures of secondary school students were far below any adverse effect dose observed in laboratory animals and were therefore of low concern for human health.

Pharmacological investigation on the wound healing effects of Radix Rehmanniae in an animal model of diabetic foot ulcer.

ETHNOPHARMACOLOGICAL RELEVANCE: Radix Rehmanniae (RR) has a very long history of usage in traditional Chinese medicine and is usually one of the principal herb found in many herbal formulae used in diabetic foot ulcer. AIM OF THE STUDY: RR aqueous extract was investigated for its wound healing effects in a diabetic foot ulcer rat model and its detailed mechanism of actions. MATERIALS AND METHODS: A previously established diabetic foot ulcer rat model was used to assess the effect of RR extract on wound area reduction, tissue regeneration and angiogenesis. Carrageenan-induced inflammation rat model was used for inflammation study; and diabetic control was evaluated using a neonatal streptozotocin-induced diabetic rat model. RESULTS: In the RR treated group, a trend of reduction of the wound area was observed from days 8 to 18 and a significant difference (as compared with control group) was found on day 8. The ulcer healing effect of RR extract was further supported by better developed scars and epithelialization as well as good formation of capillaries with enhanced VEGF expression. Carrageenan-induced inflammation was also significantly alleviated with RR extract. CONCLUSIONS: Our results demonstrated for the first time that Radix Rehmanniae was effective in promoting diabetic foot ulcer healing in rats through the processes of tissue regeneration, angiogenesis and inflammation control, but not glycemia control. The present study provided scientific basis to support the traditional use of Radix Rehmanniae in diabetic foot ulcer.