| Objective:(1)To confirm the effect of Ilizarov microcirculation reconstruction technique on the ultrastructure of granulation tissue on the healing surface of diabetic foot ulcer;(2)To determine the dynamic regulatory effect of Ilizarov microcirculation reconstruction technique on VEGF,TGF-β1 and smad3 Proteins in the granulation tissue of diabetic foot ulcer wound;(3)To Preliminarily reveal the mechanism by which Ilizarov microcirculation reconstruction technique regulates the ex Pression of Proteins related to wound healing of diabetic foot ulcer.Thus,it Provides theoretical basis and research ideas for the clinical a PPlication of this technique in the Prevention and treatment of diabetic foot ulcer.Methods :(1)From August 2020 to December 2022,60 patients with type 2 diabetic foot ulcer who received in-patient treatment with transverse tibial transposition in the Affiliated Hos Pital of Youjiang Medical College for Nationalities were collected.(2)The size of the ulcer was measured before treatment and at week 1,2,3 and 4 after treatment.(3)Ankle-brachial index and VAS score were measured before and 8 weeks after surgery,and CTA angiography of both lower limbs was performed to understand the condition of acrovascular regeneration.(4)histopathological changes and the degree of vascularization were observed by HE staining.(5)Granulation tissue from the same part of the wound surface was taken at five time points before surgery,3 days,1 week,2 weeks and 4 weeks after surgery,and Western The expression of VEGF,smad3 and TGF-β1 protein in the wound tissue was determined by Blot(6)The expression levels of TGF-β1 and smad3 protein in the wound granulation tissue were determined by immunohistochemical technology before surgery and 2 weeks after surgery(7)The peripheral blood VEGF was detected by ELISA before surgery,3 days after surgery,1 week,2 weeks and 4 weeks after surgery,TGF-beta 1,TNF-α,and the expression of IL-22.Results :(1)More fresh granulation tissue appeared on the wounds of 60 patients 2weeks after transverse tibia transfer,and the wounds were significantly reduced 4 weeks later.Finally,all foot ulcers were healed,the healing time was 9.0±1.8 weeks on average,and scar tissue was less after healing,the difference was statistically significant(P<0.05).(2)At 8weeks after surgery,angiography showed significant increase of minor arteries in the leg and foot,VAS score and ankle-brachial index were better than those before surgery(P<0.05).(3)HE staining showed that the number of positive blood vessels after surgery was higher than before surgery,the difference was statistically significant(P<0.05).(4)West blot results showed that the expression levels of VEGF,smad3 and TGF-β1 protein were increased in all phases after surgery compared with those before surgery.Meanwhile,the expression levels of Smad3 and TGF-β1 protein after surgery were increased compared with those before surgery,with statistical significance(P<0.05).(5)after 3 days,1 week,2 weeks and 4 weeks of peripheral blood serum VEGF and TGF-beta 1 compared with preoperative obviously increases,and the postoperative phase TNF-α and IL-22 are reduced than before,the difference was statistically significant(P < 0.05).Conclusions:(1)Ilizarov microcirculation reconstruction technology can improve the reconstruction of microcirculation in diabetic foot ulcers,so as to promote the repair of diabetic foot ulcer wounds.(2)the Ilizarov microcirculation reconstruction technology may through enhanced VEGF,smad3 and TGF-beta 1 protein expression level,reduce the number of TNF-α and IL-22 protein expression level,The expression of corresponding promoting angiogenic protein is enhanced to achieve the purpose of promoting the formation of vascular network and improving microcirculation,so as to promote the healing of diabetic foot ulcer,shorten the healing time of wound and reduce the formation of scar. |
PDF Full Text Request