[Application of femoral-femoral artery bypass grafting combined with transverse tibial bone transporting for lower extremity arteriosclerosis obliterans or combined with diabetic foot]

Intelligent Algorithm-Based Analysis on Ultrasound Image Characteristics of Patients with Lower Extremity Arteriosclerosis Occlusion and Its Correlation with Diabetic Mellitus Foot

Objective

The study focused on the correlation between lower extremity arteriosclerosis and diabetic mellitus (DM) foot, and it was explored by virtue of ultrasound images processed by an intelligent algorithm.

Methods

A total of 60 DM foot patients admitted to our hospital in the past three years were selected and divided into two groups according to their condition. Patients with DM foot alone were in group B (30 cases), and patients with DM foot combined with lower extremity arteriosclerosis occlusion were in group C (30 cases). 30 healthy people were in group A as a control. Color Doppler ultrasound was used to examine the arteries of the lower extremities of all subjects. It the intramedia thickness (IMT) from the femoral artery to the dorsal foot artery was recorded, whether there was plaque in the artery or knowing the size of the plaque, its echo, and distribution, and whether the artery had stenosis. Next, the stenosis percentage was calculated. Additionally, the general information of patients was analyzed. At the same time, an intelligent algorithm was used to process ultrasound images, and its effects on image quality were evaluated.

Results

Doppler ultrasound images processed by Artificial Bee Colony (ABC) had less noise and better quality, and key information about the lesion was clearly displayed. There was no statistical difference between the general data of the three groups of patients; group B and group C had higher IMT value, plaque incidence, arterial stenosis incidence, and degree of stenosis versus group A, and there were statistically significant differences between groups B and C. In particular, the incidence of femoral artery stenosis and the degree of stenosis were significantly higher in group C than in group B. The rate of stenosis above grade I in group C was as high as 71%, while that in group B was only 19%; in Group C, the incidence of stenosis above grade II was 30%, and that in group B was 13.1%. Compared with group A, group B and group C had decreased peak arterial blood velocity (PSV), resistance index (RI), and pulse index (PI), and there were statistically significant differences between groups B and C.

Conclusion

DM foot is a risk factor for arteriosclerosis occlusion; color Doppler ultrasound demonstrates good diagnostic effects on arteriosclerosis occlusion; the algorithm proposed in this study can improve the quality of Doppler ultrasound images and has a high application value.

Humanistic care interventions in patients with lower extremity arteriosclerosis obliterans

OBJECTIVE

This study was designed to investigate the application value of humanistic care interventions in patients with lower extremity arteriosclerosis obliterans (LEASO).

METHODS

We enrolled 98 LEASO patients undergoing interventional therapy in our hospital into this study, among whom 47 cases received conventional care interventions (the regular group) while the other 51 received humanistic care interventions based on conventional care interventions (the research group). The two groups were compared in negative emotions, complications, and quality of life of patients.

RESULTS

Scores of negative emotions were lower in the research group than in the regular group after care (P < 0.05). The pain intensity decreased in both groups after care, with a sharper decrease in the research group (P < 0.05). The incidence of complications was lower in the research group than in the regular group after care (P < 0.05). The pain-free walking distance (PFWD) increased remarkably in both groups after care, with a longer PFWD in the research group than in the regular group (P < 0.05). Scores of the 36-Item Short-Form Health Survey (SF-36) increased after care in both groups (P < 0.05), with higher SF-36 scores in the research group than in the regular group (P < 0.05). SF-36 reflects the quality of life of patients from four aspects including vitality, emotional state, social function, and role-emotional. The care compliance and satisfaction level with care of patients were higher in the research group than in the regular group (P < 0.05). The care compliance rate and patient satisfaction level with care were higher in the research group than in the regular group (P < 0.05).

CONCLUSION

Humanistic care interventions can reduce postoperative pain intensity and improve the quality of life in patients with LEASO.

[Research progress of tibial transverse transport in treatment of chronic ischemic diseases of the lower extremities]

OBJECTIVE

To summarize the research progress of tibial transverse transport (TTT) in treatment of chronic ischemic diseases of the lower extremities.

METHODS

The related literature was systematically searched and the mechanisms, clinical treatment methods, clinical efficacy, indications, contraindications, and complications of TTT were discussed.

RESULTS

Based on the law of tension-stress, TTT is a new method in the treatment of chronic ischemic diseases of the lower extremities. It can relieve the ischemic symptoms, promote the wound healing, and increase the limb salvage rate. The clinical application in recent years has shown good effectiveness, and the scope of application is expanding.

CONCLUSION

Due to the current limited clinical application, the sample size of the TTT for the chronic ischemic diseases of the lower extremities is relatively small, and the follow-up time is limited. So its validity, long-term effectiveness, and bone transport standards are need further research.

[Effect of transverse tibial bone transport on expression of serum angiogenesis-related growth factors]

OBJECTIVE

To investigate the effect of transverse tibial bone transport on the expression of angiogenesis-related growth factors in the serum of diabetic foot patients.

METHODS

Between January 2018 and December 2018, 10 patients who suffered from diabetes mellitus accompanied with Wagner stage 4 diabetic foot underwent transverse tibial bone transport. There were 5 males and 5 females with an average age of 59.2 years (range, 51-70 years). The duration of diabetes was 2-60 months, with an average of 24.2 months. The duration of diabetic foot was 30-120 days, with an average of 54.1 days. Peripheral venous blood was taken at 1 day before operation and at 1, 4, 11, 18, 28, and 35 days after operation. The serum was centrifuged and subjected to ELISA test to detect the expression levels of serum vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), and platelet-derived growth factor (PDGF).

RESULTS

The levels of serum VEGF, bFGF, and EGF increased rapidly at 11 days after operation, and the expression levels of the factors at 11, 18, 28, and 35 days were significantly higher than those before operation ( P<0.05). The expression level of PDGF increased suddenly at 18 days after operation, and the expression level of PDGF at 18, 28, and 35 days was significantly higher than that before operation ( P<0.05).

CONCLUSION

Transverse tibial bone transport for the treatment of diabetic foot can significantly increase the expression of serum angiogenesis-related growth factors in early stage, which may be the mechanism of promoting the healing of diabetic foot wounds.