Randomized research on the mechanism of local oxygen therapy promoting wound healing of diabetic foot based on RNA-seq technology.

BACKGROUND: High purity oxygen therapy has good clinical efficacy in the treatment of diabetic foot (DF), but its mechanism of promoting wound healing has been unclear. METHODS: Patients with DF were randomly divided into an experimental group and a control group. The experimental group was given local oxygen therapy (LOT) by a micro-oxygen therapy instrument, which administered uninterrupted >95% pure oxygen for 24 h at a flow rate of 3 mL/h. Six skin samples from the experimental group before and after treatment underwent RNA sequencing (RNA-seq), and the differentially expressed genes (DEGs) were screened. RESULTS: The clinical results showed that the mean wound healing time of the experimental group was 26 days (P<0.05); the healing area of the experimental group was 3.1-15.3 cm3 , with a mean of 8.8 cm3 , and that of the control group was 2.4-10.4 cm3 (P<0.05). LOT promoted the healing of DF wounds mainly through the tumor necrosis factor (TNF) signaling pathway and the apoptosis pathway. CONCLUSIONS: According to our results, LOT can promote DF healing mainly by inhibiting the local oxidative stress reaction of wound skin and by inhibiting the inflammatory and apoptotic pathways. The molecular markers and pathways screened warrant further study.

[Fluoride preconditioning attenuates sensitivity induced by tooth bleaching: a scanning electron microscopy study].

OBJECTIVE: To evaluate the effects of fluorid on morphology change in enamel and dentin during tooth bleaching. METHODS: The study population consisted of twelve patients who required the extraction of first premolars for orthodontic reasons. Twelve participants were divided into three groups: bleaching with NaF-treated group, bleaching-treated group and control group. Immediately after bleaching treatment, all teeth were extracted and prepared for scanning electron microscope (SEM). Morphologic observations were carried out with SEM. RESULTS: In the bleaching-treated group, mild demineralization was observed on the surface of enamel and collapse of collagen scaffold was also observed on the longitudinal section of dentine. The diameter of dentinal tubule was not uniform due to peritubular dentine was demineralized. In the bleaching with NaF-treated group, the demineralization of enamel and dentin were reduced and some diameter of dentinal tubule were smaller than bleaching-treated group. CONCLUSION: Fluoride can reduced the demineralization of enamel and dentine obviously, which may be applied as a therapeutic tool for sensitivity induced by tooth bleaching.

[Effects of different methods of anesthesia and analgesia on early postoperative cognitive dysfunction after non-cardiac surgery in the elderly].

OBJECTIVE: To determine if different methods of anesthesia and analgesia will influence the incidence of early postoperative cognitive dysfunction (POCD) after non-cardiac surgery in the elderly. METHODS: One hundred and three elderly patients undergoing elective abdominal surgery were randomly allocated to receive either general anesthesia followed with postoperative intravenous analgesia (general anesthesia group, 53 cases) or combined general-epidural anesthesia followed with postoperative epidural analgesia (combined general-epidural anesthesia group, 50 cases). Cognitive function was assessed preoperatively and 7 days postoperatively using a battery of nine neuropsychological tests. A postoperative deficit in any test was defined when decline by more than or equal to 20% of the preoperative value of that test occurred. Any patient showing deficit in 2 or more tests was defined as having postoperative cognitive dysfunction. RESULTS: Ninety-two patients completed both preoperative and postoperative neuropsychological tests. On day 7, POCD occurred in 20/45 patients (44.4%) in the general anesthesia group and in 23/47 patients (48.9%) in the combined general-epidural anesthesia group. No significant difference was found between the two groups. Logistic regression analysis showed that short duration of education and operation of general surgery were independent risk factors of the occurrence of early POCD. CONCLUSION: Early POCD occurred in 46.7% of the elderly patients undergoing abdominal surgery. However, there was no significant difference between the effects of two different methods of anesthesia and postoperative analgesia on the incidence of POCD. Short duration of education and operation of general surgery were risk factors of early POCD.