BackgroundType A insulin resistance syndrome, one type of the hereditary insulin resistance syndromes, is a rare disorder. Patients with type A insulin resistance syndrome are nonobese and demonstrate severe hyperinsulinemia, hyperandrogenism, and acanthosis nigricans. The clinical features are more severe in affected females than in males, and they mostly become apparent at the age of puberty. In many cases, when severe insulin resistance is covered up by other signs or symptoms of type A insulin resistance syndrome, patients are often easily misdiagnosed with other diseases, such as polycystic ovary syndrome.Case presentationOur patient was a 27-year-old Han Chinese woman who sought treatment because of a menstrual disorder and hirsutism. Tests showed that her levels of insulin and testosterone were elevated, and gynecological color Doppler ultrasound suggested multiple cystic changes in the bilateral ovaries. After a diagnosis of polycystic ovary syndrome was made, pulsatile gonadotropin-releasing hormone therapy and metformin were administered, but the patient’s symptoms did not improve in 1 year of follow-up. Considering that the previous diagnosis might have been incorrect, venous blood samples were collected from the patient and her relatives for genetic analysis. Subsequently, using Illumina sequencing, it was found that the proband, her father, and two brothers all had the c.3601C>T heterozygous missense mutation in exon 20 of the insulin receptor gene. The diagnosis was corrected to type A insulin resistance syndrome, and the patient’s treatment was modified.ConclusionWe report a case of a young woman with type A insulin resistance syndrome that was misdiagnosed as polycystic ovary syndrome. We discuss the causes, clinical features, diagnosis, and treatment of type A insulin resistance syndrome to improve the recognition of the disease and reduce its misdiagnosis. Female patients with high androgen levels and severe hyperinsulinemia should be considered for the possibility of hereditary insulin resistance syndromes (such as type A insulin resistance syndrome). Gene sequencing helps in making an early diagnosis and developing a targeted treatment strategy.

Objective. Discuss the effectiveness and value of micropower vacuum dressing (MVD) in promoting the healing of I-II grades diabetic foot wounds. Methods. Sixty patients diagnosed with diabetic foot ulcers and Wagner grades I-II were selected and randomly divided into the control group and experimental group, with 30 cases in each group. The control group was covered with conventional treatments and petrolatum gauze dressings, and the experimental group was treated with MVD on the basis of conventional reatments. The therapeutic effects of the two groups were observed, including healing rate, ulcer area reduction rate, ulcer healing time, dressing change times, ulcer recurrence rate, adverse events, and so on. Results. The healing rate (100%) of the experimental group was higher than that of the control group (56.7%); the wound reduction rate was higher than that of the control group ( P < 0.05 ); the healing time, the number of dressing changes, and the 1-month recurrence rate were all low in the control group ( P < 0.05 ). The incidence of adverse reactions in the experimental group (6.7%) was lower than that in the control group (46.7%) ( P < 0.05 ). Conclusion. MVD has significant effects in the treatment of I-II grades diabetic foot wounds and has few adverse reactions. It is an effective new method that can promote the growth of granulation tissue and epithelium and promote wound healing.

Background: The comparative efficacy of bariatric surgical procedures for type 2 diabetes mellitus (T2DM) has not been completely elucidated. To investigate this question, we conduct a systematic review and network meta-analysis. Methods: The protocol followed preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) checklist. Two review authors will independently search the PubMed, Embase (Ovid), and the Cochrane Central Register of Controlled Trials databases. The primary outcome is T2DM remission. The secondary outcomes include BMI, HbA1c (%), and percentage excess weight loss (% EWL). Results from the network meta-analysis will be presented as summary relative effect sizes (WMD or RR) and relative 95% CIs for each possible pair of treatments. Outcomes will be combined based on different periods of follow-up (12 months, 36 months, and 60 months). Results: The results will provide useful information about the efficacy of bariatric surgical procedures in patients with T2DM. Conclusion: The findings of the study will be disseminated through peer-reviewed journal. INPLASY registration number: INPLASY202050053.