Aclinical Study On Promoting The Healing Of Diabetic Foot Through Negative-pressure Wound Therapy Combined With Local Injection Of Insulin

Objective To explore the clinical effects of negative-pressure wound therapy combined with local injection of insulin in promoting the wound healing in patients with diabetic foot and the effect of ?-catenin and cyclinD1 expression in the subcutaneous tissue of patients.Methods A total of 60 patients who required NPWT for diabetes treatment from January 2016 to December 2017 in our hospital were randomly divided into a combination treatment group and a control group,30 patients in each group.The combined treatment group was treated with NPWT and insulin.The control group was treated with NPWT alone.The wound area and wound healing time were compared between the two groups.The content of IL-6 and TNF-? in the skin samples of the patients before and 2 weeks and 4 weeks after treatment were detected by ELISA.And to collect damaged skin tissue for immunohistochemistry,qRT-PCR and Western Blot assay,to compare the expression of ?-catenin and cyclinD1 in the damage skin samples of the patients before and 2 weeks and 4 weeks after treatment.Results Before treatment,2 weeks and 4 weeks of treatment,the difference in foot area between the two groups was not statistically significant(P>0.05),but after 8weeks of treatment,the wound area of the combined treatment group was significantly smaller than that of the control group.The difference between the two groups was statistically significant(P<0.05),and the average wound healing time in the combined treatment group was significantly lower than that in the control group,and the difference between the groups was also statistically significant(P<0.05).Additionally,there was no significant difference in the levels of IL-6 and TNF-? in the skin samples before treatment between the two groups(P>0.05),but after 2 weeks of treatment,the difference of contents of IL-6 and TNF-? in damage skin samples of patients,between the combined treatment group with the control group,were statistically significant(P<0.05).And the results of immunohistochemistry,qRT-PCR,and Western Blot showed that before treatment,the expression of ?-catenin and cyclinD1 and CES score in skin samples of the two groups were not statisticallydifferent(P>0.05),but they were treated with 2 weeks and 4 weeks,respectively,compared with the control group,the expression of the cyclinD1 m RNA and protein levels and CES scores,in the combined treatment group,were significantly higher than those in the control group(P<0.05),and after 4 weeks of treatment,the expression of the ?-catenin mRNA and protein levels and CES scores,in the combined treatment group,were significantly higher than those in the control group(P<0.05).Conclusion Negative-pressure wound therapy combined with local injection of insulin can effectively promote the expression of ?-catenin and cyclinD1 in damaged skin,thereby enhancing cell proliferation and differentiation,and accelerating the healing of diabetic foot wounds.It has good clinical therapeutic effect on diabetic foot.