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Diabetic lower extremity ulcers (DLEUs) are a severe complication of diabetes mellitus (DM) and are difficult to heal. This study aimed to explore the efficacy of autologous point columnar full-thickness skin graft taken from the ulcer wound margin combined with negative pressure wound therapy (NPWT) in refractory DLEUs. This is a prospective cohort study. A total of 40 inpatients with refractory DLEUs were recruited in the Diabetes Foot Center of Guangxi Zhuang Autonomous Region People's Hospital from October 2019 to November 2021. According to the doctors' professional suggestions and the patients' personal wishes, these enrolled patients were divided into two groups based on different topical wound management: the graft group (n = 18) and the conventional wound therapeutic (CWT) group (n = 22). The efficacy evaluations included the time to complete re-epithelialization of the wound and healing speed within 14 days of graft treatment or after 14 days of graft treatment in the two groups. Before the treatment, the graft group had a significantly larger ulcer area than the CWT group [27.22 (15.28, 46.59) versus 10.92 (7.00, 24.93) cm

Realizing green development in agriculture is fundamental to sustained economic development. As a measure to facilitate the transfer of rural population, urbanization is considered to be strategic in promoting agricultural green development. This paper employs a SBM-DDF–Luenberger method to measure agricultural green total factor productivity (AGTFP) and the agricultural labor surplus in China, and empirically tests the heterogeneous effects of household registration urbanization, permanent residence urbanization, and employment urbanization on the efficiency of agricultural green development. The results reveal that: (1) the average annual growth rate of China’s AGFTP is 4.4374%, which is achieved mainly through improvements in green scale efficiency. (2) The agricultural sector in China is suffering a large surplus of labor force, with an estimation of 20.64 million in 2020. (3) Both household registration urbanization and permanent residence urbanization have a significant promoting effect on agricultural green development efficiency, though the former promotes less. (4) Employment urbanization improves agricultural green development efficiency by providing employment guidance for migrant workers, and employment urbanization of the tertiary industry has a more pronounced improvement effect. The findings suggest that governments remove restrictions on the household registration system and actively guide surplus agricultural laborers to engage in urban service industries to provide an impetus for promoting green agricultural development.

This study aimed to explore the risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis (DFO) and diabetic nephropathy (DN). This is a prospective cohort study. Between May 2018 and May 2021, we selected 120 inpatients with comorbid severe diabetic foot infection (PEDIS Grade 3 or above) and DN for inclusion in our study. All cases were followed up for 36 months. The study outcomes were whether foot ulcer recurred and the time to recurrence. The risk factors of ulcer recurrence were analysed by comparing the data of the three groups. According to the recurrence of foot ulcer, the participants were divided into three groups: Group A (no foot ulcer recurrence, n = 89), Group B (foot ulcer recurrence within 12-36 months, n = 19) and Group C (foot ulcer recurrence within 6-12 months, n = 12). The multivariate Cox regression analysis showed that urine albumin-creatinine ratio (UACR) (HR: 1.008, 95% CI: 1.005-1.011, P .001) and vibration perception threshold (VPT) (HR: 1.064, 95% CI: 1.032-1.096, P .001) were identified as independent risk factors. Kaplan-Meier curves showed a significant positive association between UACR or VPT and the risk of foot ulcer recurrence (log rank, all P .05). Areas under the ROC curves for UACR, VPT and the combination of UACR and VPT were 0.802, 0.799 and 0.842, respectively. The best cut-off values of UACR and VPT were 281.51 mg/g and 25.12 V, respectively. In summary, elevated UACR and VPT were independent risk factors. The best clinical cut-off values of UACR and VPT for prediction of foot ulcer recurrence were 281.51 mg/g and 25.12 V, respectively. Besides, our results suggested that microcirculation disorders rather than macrovascular complications play a major role in the recurrence of foot ulcer in patients with comorbid DFO and DN.