Search

Objective To compare the effects of traditional open surgery and laser therapy combined with foam sclerotherapy on immune system in patients with primary saphenous varicose veins. Methods A total of 104 patients who underwent elective varicose vein surgery were divided into the laser therapy combined with foam sclerotherapy group (MIS group，n=53) and traditional open surgery group (OS group, n=51) according to the surgical method.Venous blood sample was collected before and 24 h after operation for the measurement of superoxide dismutase (SOD), interleukin (IL) -1β, IL-6 and IL-8, IL-10, tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) levels. The changes in the proportion of T cell subsets and NK cells were detected by flow cytometry. The expression levels of differentially-expressed genes (DEGs) of immune cells in peripheral blood were determined by single-cell RNA sequence (scRNA-seq) technology. Results In the MIS group, no significant differences were observed in the levels of SOD, IL-6, IL-10, TNF-α and IFN-γ before and after operation (all P > 0.05) except that IL-1β and IL-8 levels were increased after operation (both P < 0.05) . In the OS group, significant differences were noted in the above indicators before and after operation (all P < 0.05) . No significant differences were found in the proportion of T lymphocyte subsets and NK cells before and after surgery in the MIS group (both P > 0.05), while the proportion of CD8+T cells was increased at postoperative 24 h, and that of NK cells was significantly reduced in the OS group (both P < 0.05) . Functional enrichment analysis of the DEGs in peripheral blood immune cells at postoperative 24 h indicated that postoperative hypoxia response, IFN response, and NF-κB inflammatory signaling pathways in the OS group were significantly up-regulated compared with those in the MIS group. Conclusion Laser treatment combined with foam sclerotherapy exerts slight effect on the immune inflammation and hypoxic response of the body system in patients with primary saphenous varicose veins. MIS can better maintain the body’s immune balance and preserve the capability of original immune system to resist microbial invasion to a greater extent compared with traditional OS. [ABSTRACT FROM AUTHOR]

Objective: To explore and analyze the effect of ultrasound-guided radiofrequency ablation combined with foam sclerosis treatment on the lower limb varicose vein pain stress response, hemodynamics and coagulation function. Methods: From August 2021to May 2022, 60 cases of lower extremity varicose veins diagnosed and treated in our hospital were selected as the research objects, and the patients were divided into Joint group and foam sclerosis group with 30 cases in each group according to the simple allocation principle. The ultrasound-guided foam sclerosis combined with radiofrequency ablation therapy, and the foam sclerosis group gave ultrasound-guided foam sclerosis therapy, and the changes of pain stress response, hemodynamics and coagulation function were observed and recorded. The pain stress response, hemodynamics and coagulation function changes were observed and recorded. Results: The VAS scores of pain in the two groups at 1 d after operation were lower than those at 1d before operation (P＜0.05), and the Joint group were also lower than that in the foam sclerosis group (P＜0.05). The serum levels of bradykinin (BK) and Substance P (SP) in the two groups were lower than those in the preoperative day 1 (P＜0.05), and the joint group were also lower than the foam sclerosis group group (P＜0.05).Plasma fibrinogen (Fib) and plasminogen activator inhibitor (PAI-1) in both groups at 1 week after operation were lower than those at 1day before operation (P＜0.05). Compared with the foam sclerosis group group, the joint group also decreased (P＜0.05). The total effective rate 1 month after surgery in the joint group were 100.0 %, which were higher than that in the foam sclerosis group (86.7 %） (P＜0.05).Conclusion: Compared with foam sclerosis, ultrasound-guided radiofrequency ablation combined with foam sclerosis for lower limb varicose veins can improve the coagulation function, effectively relieve pain, improve the hemodynamic condition of patients, and improve the overall treatment effect. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect and safety of ultrasonic endovascular laser ablation combined with spot stripping in the treatment of great saphenous vein varicose. Methods: A total of 140 patients with saphenous varicose veins admitted to the Department of Vascular Surgery of our hospital from January 2019 to December 2021 were selected as the research objects. All patients were grouped according to the odd and even numbers of hospitalization numbers, and divided into a combination group and a control group, with 70 cases in each group. The control group was treated with conventional high ligation combined with stripping, and the combined group was treated with ultrasonic intracavitary laser ablation combined with point stripping. The surgical indicators, clinical curative effect, preoperative and postoperative changes of lower extremity deep venous valve function and the incidence of postoperative complications were compared between the two groups. Results: The operation time in the combined group was higher than that in the control group, and the amount of intraoperative blood loss, number of incisions and hospital stay were lower than those in the control group (P<0.05); there was a significant difference in the distribution of clinical efficacy between the two groups, and the combination group had a significant effect. Compared with the control group (P<0.05); 3 months after operation, the VCT of both groups was shortened, and Vmax was increased, and the VCT of the combination group was shorter than that of the control group 3 months after operation, and the Vmax was higher than that of the control group (P<0.05 ); postoperative complications in the combination group were lower than those in the control group (P<0.05). Conclusion: Ultrasonic intracavitary laser ablation combined with spot stripping for patients with varicose veins has better curative effect than conventional surgery, and can significantly improve the venous valve function of the lower extremities, with high safety. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical features and treatment method of intramuscular venous malformation (IMVM). Methods The clinical data of 66 patients with IMVM from January 2012 to December 2021 were retrospectively analyzed. There were 41 males and 25 females, aged from 4 to 61 years old. All patients underwent ultrasound, X-ray, MRI and CT examination. The clinical features, imaging and pathological diagnosis points were summarized. Results The lesions in 7 patients underwent surgical resection were basically cleared, and the effective rate was 100% (7/7). The effective rate of 47 patients underwent sclerotherapy was 82.98% (39/47). The effective rate of 12 patients underwent indwelling copper wire combined with sclerotherapy was 100% (12/12). All lesions were significantly atrophied. There were no serious complications occurred during or after treatment. Conclusion The clinical manifestations of IMVM are atypical, so the imaging examinations are the basis of diagnosis. It is difficult to clear the lesions completely so that controlling the progression and reserving the function are the therapeutic goal of most IMVM. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical efficacy of intralesional laser combined with sclerotherapy in the treatment of kaposiform hemangioendothelioma (KHE). Methods From January 2010 to December 2020, the clinical data of 51 children with KHE were retrospectively analyzed, including age, gender, lesion location, pain symptoms and platelet status (29 cases accompanied by Kasabach-Merritt phenomenon). Magnetic resonance imaging and vascular enhancement were the routine diagnostic criteria. According to different treatment schemes, all children were divided into single sclerotherapy group (18 cases) and intralesional laser combined with sclerotherapy group (33 cases). The energy of intralesional laser, prescription of sclerosing agent, puncture points, injection volume, curative effect and complications after operation were recorded. The therapeutic effect indexes were as follows: the range of lumps and erythema reduction, skin temperature change, pain relief rate and blood index (platelet recovery). Results Both intralesional laser combined with sclerotherapy and single sclerotherapy had good efficacy in the treatment of KHE. The combined group had fewer repeated treatments, faster reduction of lumps and erythema, higher pain relief rate and fewer complications than single sclerotherapy group. Conclusion Intralesional laser combined with sclerotherapy for KHE has a larger treatment range than single sclerotherapy and can rapidly increase platelet count. The repeated treatment times are less, reduction of lumps and erythema is fast, pain relief rate is high and complications are few. [ABSTRACT FROM AUTHOR]

Objective To explore the application of ROADMAP function in endovascular sclerotherapy of venous malformations guided by digital subtraction angiography (DSA). Methods From May 2019 to July 2020, 11 patients underwent endovascular sclerotherapy of venous malformations guided by DSA. The ROADMAP function was used to monitor the administration of sclerosant in real time during the operation. Postoperative follow-up and efficacy evaluation were performed. Results Eleven patients received sclerotherapy of 25 times for 13 lesions, with an average of (2.1±0.9) times. The average treatment period was (18.5±3.4) min, and the average use period of the ROADMAP function was (52.5±10.3) s. All patients were followed up for 24 months. Seven cases had complete response, 2 cases had significant response and 2 cases had partial response. No recurrence or progression was found. No serious complications such as bleeding, ulceration, infection or dysfunction occurred in all patients. Conclusion The ROADMAP function can improve the safety of treatment, grasp the structure of lesion, make the drug dose more accurate and does not significantly increase the operative duration. It should be considerable for clinical application. [ABSTRACT FROM AUTHOR]

Objective. To compare and analyze the therapeutic effect of 980 nm laser endovascular thermal ablation (EVTA) combined with foam sclerotherapy on day surgery (local anesthesia) and high ligation of great saphenous vein+810 nm laser EVTA combined with foam sclerotherapy on inpatient surgery (general anesthesia) for patients with lower extremity varicose vein. Methods. Data of the patients who underwent the above different surgical procedures respectively in the Department of General Surgery, The First Hospital of Xuzhou Mining Group from March 2019 to March 2020 were retrospectively analyzed, including 111 day surgery patients (980 nm group) and 107 inpatient surgery patients (810 nm group). The baseline data, postoperative data and follow-up data were collected, and the differences between the two groups were compared. Results. There was no significant difference between the two groups in baseline data and follow-up data. After operation, the 980 nm group was better than the 810 nm group in pain score, duration of pain, the proportion of using painkillers, the time required to resume daily life and economic cost (all P<0.05). Conclusion. Endovascular thermal ablation (980 nm laser) combined with foam sclerotherapy in the day surgery for lower extremity varicose vein has certain advantages in postoperative comfort, hospitalization time and cost, which will provide a new option for patients who are not suitable for general anesthesia. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical efficacy of Digital subtraction angiography (DSA) in the treatment of varicose veins of lower extremities with polyvinyl alcohol foam sclerotherapy. Methods: 120 patients with varicose veins of lower limbs in our hospital from October 2015 to October 2020 were selected and randomly divided into observation group and control group, with 60 cases in each group. Patients in the control group were treated with DSA-guided sclerotherapy, and patients in the observation group were treated with ultrasound-guided sclerotherapy. The treatment effect, MCS, PCs and VCSs scores, treatment cost and hospitalization time of the two groups were compared And operation time, adverse reactions. Results: The total effective rate of treatment in the observation group was96.67 %, which was higher than the total effective rate of 86.67 % in the control group. There was a statistical difference between the groups (P<0.05). There was no significant difference in the scores of MCS, PCs and VCSs between the two groups before treatment (P>0.05). After treatment, the MCS score of the observation group was higher than that of the control group, and the VCSs score was lower than that of the control group. The hospitalization time and operation time of the observation group were higher than those of the control group, and the difference was statistically significant (P<0.05). The total incidence of adverse reactions in the observation group was 5.00 %,lower than 20.00 % in the control group, and the difference was statistically significant (P<0.05). The difference was statistically significant (P<0.05). Conclusion: Ultrasound-guided treatment of varicose veins of the lower extremities has a significant effect, which can improve the mental health, physical health and clinical severity of venous diseases of patients with varicose veins, and promote the patient’s speedy recovery. [ABSTRACT FROM AUTHOR]

Objective To analyze the effect of endoscopic ligation and sclerotherapy on internal hemorrhoids bleeding and the effect of technical cooperation with endoscopic technicians. Methods The clinical data of 80 patients with internal hemorrhoids bleeding admitted to the gastroenterology endoscopy center of our hospital from July 2019 to January 2020 were retrospectively analyzed. The patients were divided into two groups: Ligation Group and Sclerotherapy Group,with 40 cases in each group.The differences in the success rate of endoscopic hemostasis,the incidence of postoperative complications,the treatment time of internal hemorrhoids, the elimination rate of internal hemorrhoids,and the relationship between the two groups and the coordination of endoscopic technologists were analyzed. Results The success rate of hemostasis in the ligation group [87.5% (35/40)] was significantly higher than that in the sclerotherapy group [65.0% (26/40)].The endoscopic treatment time [(6.6±1.5)min] was significantly shorter than that of the sclerotherapy group [(9.4±1.2)min]. the hemostatic effect of endoscopic ligation 1 and 6 months after operation was significantly better than that of sclerotherapy group. There was no bleeding of internal hemorrhoids after endoscopic ligation.The elimination rate of internal hemorrhoids [100.0% (40/40)] was significantly higher than that of sclerosis treatment group [85.0% (34/40)]. Only 2 patients had mild scar stricture of rectum,the incidence of postoperative complications[5.0%(2/40)] was much lower than that of the sclerotherapy group (1 case of Anorectal Stenosis,2 cases of postoperative infection,6 cases of secondary bleeding,the incidence of complications was 22.5%(9/40)). The technical cooperation degree of senior technician was better than that of the competent technician,and the technical cooperation degree of the competent technician was better than that of the junior technician. The better the technical cooperation of the technician,the better the curative effect and the less the complications. Conclusion In patients with internal hemorrhoids bleeding,endoscopic ligation is shorter than Sclerotherapy,with higher success rate and fewer long-term complications. Skilled cooperation of technical personnel is closely related to clinical curative effect. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical efficacy of Digital subtraction angiography (DSA) in the treatment of varicose veins of lower extremities with polyvinyl alcohol foam sclerotherapy. Methods: 120 patients with varicose veins of lower limbs in our hospital from October 2015 to October 2020 were selected and randomly divided into observation group and control group, with 60 cases in each group. Patients in the control group were treated with DSA-guided sclerotherapy, and patients in the observation group were treated with ultrasound-guided sclerotherapy. The treatment effect, MCS, PCs and VCSs scores, treatment cost and hospitalization time of the two groups were compared And operation time, adverse reactions. Results: The total effective rate of treatment in the observation group was 96.67 %, which was higher than the total effective rate of 86.67 % in the control group. There was a statistical difference between the groups (P<0.05). There was no significant difference in the scores of MCS, PCs and VCSs between the two groups before treatment (P>0.05). After treatment, the MCS score of the observation group was higher than that of the control group, and the VCSs score was lower than that of the control group. The hospitalization time and operation time of the observation group were higher than those of the control group, and the difference was statistically significant(P<0.05). The total incidence of adverse reactions in the observation group was 5.00 %, lower than 20.00 % in the control group, and the difference was statistically significant(P<0.05). The difference was statistically significant(P<0.05). Conclusion: Ultrasound-guided treatment of varicose veins of the lower extremities has a significant effect, which can improve the mental health, physical health and clinical severity of venous diseases of patients with varicose veins, and promote the patient's speedy recovery. [ABSTRACT FROM AUTHOR]