糖尿病足的诊断（接上篇）

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Exploring metabolomic clues in diabetic retinopathy: a pilot study 2026-04-07 00:00

Matthew Simonson1 · Yanliang Li2 · J. Jason McAnany2 · Jason C. Park2 · Felix Y. Chau2 · Bharati Prasad3,4 · Silvana Pannain5 · Erin C. Hanlon5 · Eve Van Cauter5 · Kirstie K. Danielson6 · Brian T. Layden6 · Hui Chen7 · George E. Chlipala8 · Carlos Martinez8 · Stephanie J. Crowley9 · Sirimon Reutrakul6

Received: 23 August 2025 / Accepted: 23 February 2026 © The Author(s) 2026

Keywords Metabolomics · Diabetic retinopathy · Diabetes Mellitus · Retina

Communicated by Massimo Federici, M.D Matthew Simonson 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

1 College of Medicine, University of Illinois Chicago, Chicago, IL 60612, USA

2 Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, Chicago, IL, USA

3 Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA

4 Jesse Brown Department of Veterans Affairs Hospital, Chicago, IL, USA

5 Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago, Chicago, IL, USA

6 Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA

7 Mass Spectrometry Core, Research Resource Center, Office of Vice Chancellor for Research, University of Illinois at Chicago, Chicago, IL, USA

8 Research Informatics Core, Research Resources Center, University of Illinois at Chicago, Chicago, IL, USA

9 Biological Rhythms Research Laboratory, Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA

The close relationship between inflammation and insulin resistance: a comparative perspective from a new angle 2026-04-04 00:00

Xiaoyan Wang1 · Run Yang1 · Jingxiang Li1 · Yongqi Liang2 · Chenxi Jin1 · Yining Xu1 · Xianbo Wu2 · Mengchen Zou1

Received: 4 July 2025 / Accepted: 30 September 2025 / Published online: 15 October 2025 © The Author(s) 2025

Abstract

Background Excess weight is a progressive metabolic epidemic, and inflammation plays an important role in the progres-sion of disease. Insulin resistance (IR) is an important feature of obesity, but it does not reflect systemic inflammation. Cur-rently, there is a lack of effective clinical tools for early risk stratification and intervention in physically active people.

Methods This was a prospective cohort of 72,262 overweight but physically active persons in the UK Biobank. The TyG was combined with hsCRP, waist circumference (WC), or body mass index (BMI) as indices of IR. Adjusted Cox regression, interaction tests, restricted cubic splines (RCS) analysis, Kaplan-Meier analysis, and Harrell’s C-index were used to examine the relations and time-dependent predictive power.

Results During 12.7 years of follow-up, 1,477 participants developed metabolic dysfunction-associated fatty liver disease (MAFLD). RCS analysis suggested TyG-hsCRP had a nonlinear positive correlations with all-cause mortality. Compared to the lowest quartile group, the corrected hazard ratio (HR) (95% confidence interval [CI]) of new-onset MAFLD in maximum quartile groups for TyG-hsCRP was 1.94(1.62–2.32), for TyG-WC was 1.78(1.44–2.18), for TyG-BMI was 1.36(1.12–1.65), and for TyG was 1.41(1.15–1.72). The relation between C-index of TyG-hsCRP and MAFLD was higher than that of other TyG indices. Similar results were observed in all-cause mortality.

Conclusion TyG-hsCRP is superior to other indices for identifying risk of MAFLD and all-cause mortality in overweight but physically active people. Our findings suggest the importance of inflammatory metabolism and provide evidence for effectively early anti-inflammatory treatments.

Keywords Excess weight · Inflammation · Insulin resistance · Physically active

Communicated by Salvatore Corrao, M.D

Mengchen Zou

该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Xianbo Wu

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1 Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Road North, Guangzhou 510515, China

2 Department of Occupational Health and Medicine, School of Public Health, Southern Medical University, Guangzhou, China
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糖尿病足的诊断（接上篇）

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18 10月 2019

Author : 伤口世界

原创：胡海涛负压引流与创面修复

世界卫生组织(WHO)定义:糖尿病足是指糖尿病患者由于合并神经病变及各种不同程度末梢血管病变而导致下肢感染、溃疡形成和(或)深部组织的破坏。

三个必须条件，缺一不可：

糖尿病患者；
合并神经病变及不同程度末梢血管病变；
下肢感染、溃疡形成或深部组织坏死；

该患者疼痛明显、足背动脉博动好，不符合糖尿病足诊断标准2、3，所以排除糖尿病足诊断。伤口内见到痛风石、CT看到切口区域关节周围痛风结节较多，按痛风结节诊治方案处理，伤口愈合。

糖尿病足鉴别诊断：糖尿病患者合并痛风结节破溃、下肢动脉硬化闭塞、血栓闭塞性脉管炎等。

最后提醒：遇到糖尿病患者足溃疡时，第一步是诊断，第二步是鉴别诊断，尤其当治疗效果不好时，得再次思考这两个问题。

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Exploring metabolomic clues in diabetic retinopathy: a pilot study 2026-04-07 00:00

Matthew Simonson1 · Yanliang Li2 · J. Jason McAnany2 · Jason C. Park2 · Felix Y. Chau2 · Bharati Prasad3,4 · Silvana Pannain5 · Erin C. Hanlon5 · Eve Van Cauter5 · Kirstie K. Danielson6 · Brian T. Layden6 · Hui Chen7 · George E. Chlipala8 · Carlos Martinez8 · Stephanie J. Crowley9 · Sirimon Reutrakul6

Received: 23 August 2025 / Accepted: 23 February 2026 © The Author(s) 2026

Keywords Metabolomics · Diabetic retinopathy · Diabetes Mellitus · Retina

Communicated by Massimo Federici, M.D Matthew Simonson 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

1 College of Medicine, University of Illinois Chicago, Chicago, IL 60612, USA

2 Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, Chicago, IL, USA

3 Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA

4 Jesse Brown Department of Veterans Affairs Hospital, Chicago, IL, USA

5 Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago, Chicago, IL, USA

6 Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA

7 Mass Spectrometry Core, Research Resource Center, Office of Vice Chancellor for Research, University of Illinois at Chicago, Chicago, IL, USA

8 Research Informatics Core, Research Resources Center, University of Illinois at Chicago, Chicago, IL, USA

9 Biological Rhythms Research Laboratory, Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
The close relationship between inflammation and insulin resistance: a comparative perspective from a new angle 2026-04-04 00:00

Xiaoyan Wang1 · Run Yang1 · Jingxiang Li1 · Yongqi Liang2 · Chenxi Jin1 · Yining Xu1 · Xianbo Wu2 · Mengchen Zou1

Received: 4 July 2025 / Accepted: 30 September 2025 / Published online: 15 October 2025 © The Author(s) 2025

Abstract

Background Excess weight is a progressive metabolic epidemic, and inflammation plays an important role in the progres-sion of disease. Insulin resistance (IR) is an important feature of obesity, but it does not reflect systemic inflammation. Cur-rently, there is a lack of effective clinical tools for early risk stratification and intervention in physically active people.

Methods This was a prospective cohort of 72,262 overweight but physically active persons in the UK Biobank. The TyG was combined with hsCRP, waist circumference (WC), or body mass index (BMI) as indices of IR. Adjusted Cox regression, interaction tests, restricted cubic splines (RCS) analysis, Kaplan-Meier analysis, and Harrell’s C-index were used to examine the relations and time-dependent predictive power.

Results During 12.7 years of follow-up, 1,477 participants developed metabolic dysfunction-associated fatty liver disease (MAFLD). RCS analysis suggested TyG-hsCRP had a nonlinear positive correlations with all-cause mortality. Compared to the lowest quartile group, the corrected hazard ratio (HR) (95% confidence interval [CI]) of new-onset MAFLD in maximum quartile groups for TyG-hsCRP was 1.94(1.62–2.32), for TyG-WC was 1.78(1.44–2.18), for TyG-BMI was 1.36(1.12–1.65), and for TyG was 1.41(1.15–1.72). The relation between C-index of TyG-hsCRP and MAFLD was higher than that of other TyG indices. Similar results were observed in all-cause mortality.

Conclusion TyG-hsCRP is superior to other indices for identifying risk of MAFLD and all-cause mortality in overweight but physically active people. Our findings suggest the importance of inflammatory metabolism and provide evidence for effectively early anti-inflammatory treatments.

Keywords Excess weight · Inflammation · Insulin resistance · Physically active

Communicated by Salvatore Corrao, M.D

Mengchen Zou

该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Xianbo Wu

该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

1 Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Road North, Guangzhou 510515, China

2 Department of Occupational Health and Medicine, School of Public Health, Southern Medical University, Guangzhou, China
How to promote the hierarchical diagnosis and treatment system: A tripartite evolutionary game theory perspective 2026-04-03 00:00

Chunhai Tao1 , Xi Chen2*, Wenji Zheng1*, Zehao Zhang1 , Ruoyan Tao3 , Rui Deng1 and Qizhe Xiong1

1School of Statistics, Jiangxi University of Finance and Economics, Nanchang, China, 2School of Economics and Management, Nanchang University, Nanchang, China, 3School of Liberal Arts, Macau University of Science and Technology, Taipa, Macau SAR, China

OPEN ACCESS

EDITED BY

Kui Yi, East China Jiaotong University, China

REVIEWED BY

Yong Wang, Dongbei University of Finance and Economics, China Gang Peng, Southwestern University of Finance and Economics, China

*CORRESPONDENCE

Xi Chen 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 Wenji Zheng 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

SPECIALTY SECTION

This article was submitted to Organizational Psychology, a section of the journal Frontiers in Psychology

RECEIVED 27 October 2022 ACCEPTED 05 December 2022 PUBLISHED 05 January 2023

CITATION

Tao C, Chen X, Zheng W, Zhang Z, Tao R, Deng R and Xiong Q (2023) How to promote the hierarchical diagnosis and treatment system: A tripartite evolutionary game theory perspective Frint Psychol. 13:1081562.

doi: 10.3389/fpsyg.2022.1081562

COPYRIGHT

© 2023 Tao, Chen, Zheng, Zhang, Tao, Deng and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the origina publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Due to the disorderly access to medical care and inefficient use of health resources, the advancement of the hierarchical diagnosis and treatment is more valued in promoting health system reform. Hence, this article integrates prospect theory into an evolutionary game model of the local government health departments, the medical institutions, and the patients in the system promotion of the hierarchical diagnosis and treatment. The simulation shows the specific influencing mechanism of the psychological perceived value of game subjects. Then by introducing the stochastic evolutionary game model, the system promotion under different medical cultures is also discussed in detail. The results indicate that for local government health departments, the amount and duration of financial subsidies are the key factors influencing the game system’s evolution. For medical institutions, participating in the hierarchical diagnosis and treatment system is relatively beneficial. For patients, the recovery rate in primary hospitals matters more than the cost of treatment. Changes in the risk sensitivity coefficient will cause the equilibrium of the game system to change. However, changes in the loss avoidance factor do not change the equilibrium and only have an impact on the speed of convergence. With the health departments’ intervention, patients in rural medical culture are more inclined to support the hierarchical diagnosis and treatment system than those in urban or town medical culture. Therefore, in order to promote the hierarchical diagnosis and treatment system, this article recommends that more attention should be paid to the regulatory role of health departments and the participation improvement of medical institutions and patients.

KEYWORDS

hierarchical diagnosis and treatment, evolutionary game theory, prospect theory, stochastic disturbance, medical cultures

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