Background: Under the Japanese Society of Pressure Ulcers Guidelines, electrical stimulation (ES) is accorded a B rating in the treatment of pressure ulcers (PrU). The optimal conditions for application of ES remain to be determined, however.

　Objective: The optimal conditions for application of ES were investigated. Expression of VEGF mRNA and release of type-I collagen in cultured normal human dermal fibroblasts (NHDF) was determined following ES.

　Methods: The NHDF were cultured using a transwell co-culture system and then subjected to ES for 40 min in step pulses (duration, 250 ms; frequency, 2 Hz) or by direct current (DC) at an intensity up to 400μA. Direct current stimulation was applied in the horizontal or vertical directions. Levels of VEGF mRNA were quantitated by qRT-PCR. The type-I collagen level in the cultured medium was measured by ELISA.

　Results: The VEGF mRNA level was higher in the 400 μA ES (DC, horizontal as well as vertical) group than in the non-ES group (p＜0.05). Expression of VEGF mRNA also showed a significant increase in a current intensity-dependent manner with horizontal stimulation in step pulses (intensity 0 vs. 400 μA: p＜ 0.05). The type-I collagen level was higher in the 400 μA DC stimulation group than in the control or 100 μA ES group (p＜0.01).

　Conclusions: Both parameters investigated showed a significant increase following ES at 400μA. The optimal condition for ES in the treatment of PrU requires further investigation.

　Background: It has been reported that plasma sodium-chloride concentration difference ([Na⁺]－[Cl^-]) decreases with a decrease in plasma total protein level ([TP]) due to an increase in [Cl^-] as a compensatory response to maintain acid-base equilibrium.

　Objectives: This study aimed to verify this compensatory response.

　Methods: Overall, 156,220 datasets of [Na⁺], [Cl^-], [TP], and albumin levels ([Alb]) were collected from biochemical blood examinations performed at Saitama Municipal Hospital for two years between 2019 and 2020. The 95％ confidence intervals for the mean of [Na⁺]－[Cl^-], [Na⁺] and [Cl^-] at each value of [TP] or [Alb] were calculated. Thereafter, the regression lines of [Na⁺]－[Cl^-], [Na⁺], and [Cl^-] with respect to [TP] or [Alb] were estimated based on these confidence intervals.

　Results: The regression lines of [Na⁺]－[Cl^-] with respect to [TP] and [Alb] showed positive slope lines. Moreover, [Na⁺] and [Cl^-] changed synchronously with changes in [TP] or [Alb].

　Conclusion: [Na⁺]－[Cl^-] decreased with a decrease in [TP] or [Alb]. In addition, not only [Cl^-], but [Na⁺] also affected [Na⁺]－[Cl^-].

　Background: Left ventricular diastolic function is impaired in early-stage type 2 diabetes patients.

　Objectives: The relationship between left ventricular diastolic function and renal function was investigated.

　Methods: Echocardiography was performed in a total of 173 type 2 diabetes patients (90 men, 83 women; mean age, 65 years) without heart failure and E/e′ measured to determine left ventricular diastolic function. Potential correlations were investigated between E/e′ and eGFR as an indicator of renal function or other clinical parameters.

　Results: The E/e′ showed a correlation with age (r ＝ 0.401, p ＜ 0.01) and eGFR (r ＝－ 0.315, p ＜ 0.01). Multiple regression analysis revealed a relationship between E/e′ and eGFR (t ＝ 2.379, p ＜ 0.05).

　Conclusion: The results of this study suggest a relationship between left ventricular diastolic function and eGFR in type 2 diabetes without heart failure.