{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:10:39Z","timestamp":1778217039405,"version":"3.51.4"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic foot ulcers (DFUs) are among the most severe complications of diabetes, often resulting in prolonged healing, recurrent infections, and a high risk of amputation. Despite comprehensive standard treatments, many patients develop chronic non-healing ulcers due to poor tissue perfusion and immune dysregulation. Traditional Chinese medicine, such as Huafu Shengji ointment (HFSJO), offers a novel topical approach that may promote tissue repair and accelerate healing in refractory cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>This report describes four patients with persistent DFUs that responded poorly to conventional therapies and faced either prior amputation or an imminent risk of amputation. Ulcer sizes ranged from 3.0\u00a0cm \u00d7 3.0\u00a0cm to 7.0\u00a0cm \u00d7 5.0\u00a0cm, with comorbidities including hypertension and cardiovascular disease. In addition to routine wound care, patients received topical HFSJO treatment every other day. Within 30\u2013180 days, all wounds showed substantial granulation, epithelialization, and eventual closure. No clinically significant abnormalities in the liver or renal function tests or routine hematological parameters were observed during treatment or follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Topical application of HFSJO appears to be a safe and effective conservative strategy for the management of complex DFUs, particularly in patients unsuitable for surgery or unresponsive to standard care. Through its dual mechanism, i.e., targeted debridement and regenerative stimulation, it may help overcome healing stagnation. These cases offer a promising direction for integrative wound care and warrant further validation in controlled clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1736055","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:35:52Z","timestamp":1778214952000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Curative outcomes with metal-containing TCM in diabetic foot ulcers unresponsive to standard therapy: a case series"],"prefix":"10.3389","volume":"17","author":[{"given":"Yifan","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Traditional Chinese Medicine, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cai","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Carbuncle and Ulcers, Beijing Daxing District Hospital of Integrated Chinese and Western Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohan","family":"Qu","sequence":"additional","affiliation":[{"name":"School of Traditional Chinese Medicine, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiannan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Outpatient, Beijing Daxing District Hospital of Integrated Chinese and Western Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangyu","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Carbuncle and Ulcers, Beijing Daxing District Hospital of Integrated Chinese and Western Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanying","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Carbuncle and Ulcers, Beijing Daxing District Hospital of Integrated Chinese and Western Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Kong","sequence":"additional","affiliation":[{"name":"School of Traditional Chinese Medicine, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huihua","family":"Qu","sequence":"additional","affiliation":[{"name":"Center of Scientific Experiment, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuying","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Ulcerative Vascular Surgery, Beijing Hospital of Traditional Chinese Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Life Sciences, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Traditional Chinese Medicine, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2314","DOI":"10.1001\/jama.2023.17291","article-title":"What are diabetic foot ulcers","volume":"330","author":"Voelker","year":"2023","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0043","article-title":"Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers","volume":"46","author":"McDermott","year":"2023","journal-title":"Diabetes 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