Background Ischemic diabetic foot ulcer is one of the terminal complications of diabetes. The high amputation rate, recurrence rate, and treatment cost have caused a huge burden on patients and society. This study designed the modified tibial transverse transport (mTTT) technology to treat diabetic ischemic diabetic foot ulcers in patients with type 2 diabetes and investigated the effectiveness and safety of this technique. Methods This was a retrospective analysis of patients with type 2 diabetes and ischemic diabetic foot ulcers at two hospitals during January 2016–October 2019. These patients underwent mTTT surgery combined with wound debridement and vacuum sealing drainage negative pressure drainage treatment. In-hospital follow-up was performed at 1 month after the operation, while outpatient follow-up was performed at 3, 6, and 12 months after the operation. The ulcer healing time, recurrence rate, major amputation rate, and complications were analysed. Results A total of 201 patients were enrolled in this study, including 107 males and 94 females (mean age: 68.3 ​± ​7.1 years). The wounds of all patients healed completely (mean healing time: 4.6 ​± ​1.6 months). There was no occurrence of major amputation, recurrence, and treatment-related complications in the patients. Conclusion mTTT can effectively and safely treat ischemic diabetic foot ulcers in patients with type 2 diabetes. This technology is an important part of the ischemic diabetic foot ulcer treatment system and warrants further research. The Translational Potential of this Article This study introduced a new method to treat the ischemic diabetic foot ulcer which was called modified tibial transverse transport. The promising outcomes of patients indicated that this surgical method had great potential for clinical application and was worthy of further clinical research with high evidence level.

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Wireless devices consume large amount of energy during wireless communication. Since the energy storage of battery is limited, improving energy efficiency has become an important approach to prolong the lifetime of device. IEEE 802.11 protocol supports power save mode (PSM) in wireless local area networks (WLANs). But the standard PSM cannot adapt to the changes of traffic load or channel conditions. Therefore, this paper proposes an adaptive PSM mechanism (APSM) which improves energy efficiency of wireless devices in a WLAN with access point (AP). According to the current channel condition and traffic load, the AP gives devices with different priorities when they fetch buffered packets. The devices can adaptively adjust listening intervals according to network traffic and adopt different congestion windows when the network topology changes. APSM has been implemented and evaluated in NS-2. The simulation results have shown that the device using APSM can save 58% energy at most compared with the one using the standard PSM.

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