Subcutaneous Veins Research Articles

Competitive Real-Time Near Infrared (NIR) Vein Finder Imaging Device to Improve Peripheral Subcutaneous Vein Selection in Venipuncture for Clinical Laboratory Testing.

In this study, near-infrared (NIR) technology was utilized to develop a low-cost real-time near infrared (NIR) guiding device for cannulation. A portable device that can be used by medical practitioners and also by students for their skills development training in performing cannulation. Methods. First, is the development of a reflectance type optical vein finder using three (3) light emitting diode (LED) lights with 960 nm wavelength, complementary metal-oxide-semiconductor-infrared (CMOS-IR) sensor camera with 1920 × 1080 UXGA (1080P), IR filter set for the given wavelength, and an open-source image processing software. Second, is the actual in-vitro human testing in two sites: the arm and dorsal hand of 242 subjects. The following parameters were included, such as gender, age, mass index (BMI), and skin tone. In order to maximize the assessment process towards the device, the researchers included the arm circumference. This augmented subcutaneous vein imaging study using the develop vein finder device compared the difference in the captured vein images through visual and digital imaging approaches. The human testing was performed in accordance with the ethical standards of the Trinity University of Asia—Institutional Ethics Review Committee (TUA—IERC). Results. The NIR imaging system of the developed vein finder in this study showed its capability as an efficient guiding device through real-time vein pattern recognition, for both sites. Improved captured vein images were observed, having 100% visibility of vein patterns on the dorsal hand site. Fourteen (5.79%) out of 242 subjects reported non-visible peripheral subcutaneous veins in the arm sites. Conclusions. The developed vein finder device with the NIR technology and reflected light principle with low-energy consumption was efficient for real-time peripheral subcutaneous vein imaging without the application of a tourniquet. This might be utilized as a guiding device in locating the vein for the purpose of cannulation, at a very low cost as compared to the commercially available vein finders. Moreover, it may be used as an instructional device for student training in performing cannulation.

QUANTITATIVE EVALUATION OF SYMPTOMS OF CHRONIC VENOUS INSUFFICIENCY AFTER SURGICAL TREATMENT OF ACUTE VARICO-THROMBOPHLEBITISIN THE GREAT SAPHENOUS VEIN BASIN

Summary. Objective. Toquantify the symptoms of chronic venous insufficiency after surgical treatment of AVTF in the basin of the great saphenous vein.
 Materials and methods. The results of treatment of 355 patients with AVTF in the basin of the great saphenous vein were quantified. Of these, 234 (65.9 %) patients underwent surgical treatment of AVTF. Depending on the location and method of treatment, patients were divided into seven groups.
 Results. The overall clinical score before surgery ranged from (11.71±1.87) to (19.78±5.74) points, and 12 months after surgery it was highest in patients of group VII and amounted to (9.75 ± 2.89)points. Restriction of physical activity before surgery in patients with AVTF ranged from (1.13±0.21) to (2.82±0.38) points, and after 12 months — from (0.43±0.19) to (1.05±0.22) points . Assessing the severity of the disease on three components, the following results were obtained: in patients before surgery, the clinical score ranged from (10.21±2.55) to (20.51±6.43,6) months after it — from (5.27±0.78) to (13.44 ± 3.21), and after 12 months — from (2.59±0.76) to (8.24±2.17) points.
 Conclusions. The obtained quantitative results of the assessment of symptoms of chronic venous insufficiency convincingly demonstrate the high efficiency and expediency of surgical treatment of AVTF in large subcutaneous vein pools in comparison with isolated conservative treatment, which allows to obtain good early and long-term results in most patients.

Anatomical Study of the Medialis Pedis Flap and its clinical applications in Asian Singaporean Patients

PurposeThe purpose of this study was to revisit the medial plantar artery's anatomy and study its distribution for raising the medialis pedis flap. Several investigators have reported their clinical experience with the use of this flap for reconstruction of soft tissue defects of the hand. However, many have reported difficulty raising the flap due to variations in its arterial anatomy and the confusion that exists with respect to the nomenclature in our literature. MethodsThis study was divided into 2 parts: an anatomic study and clinical application. In the anatomic study, 12 cadaveric feet specimens from 6 patients were injected with latex and barium-gelatin injections and the medial branch of the deep division of the medial plantar artery distribution was studied. We then described the use of a medialis pedis flap in four clinical cases to cover defects of the digits. ResultsThe anatomic study revealed that the average pedicle length of the deep division of the medial plantar artery was 1.94cm. In the four illustrative clinical cases where the flap was used, the average flap size was 4.5 × 3.75cm. Donor sites were either closed primarily or with skin grafts. The vessels used for this flap were the medial branch of the deep division of the medial plantar artery and venae commitantes, or subcutaneous veins which provided the superficial drainage. All flaps were successful without any significant complications. The study is novel in that it describes the anatomic variability of length of the medial branch of the deep division of the medial plantar artery that exits in nature. ConclusionsThis paper describes the medial branch of the deep division of the medial plantar artery and the anatomic variations that exist in the raising of the medialis pedis flap. We have shown how a medialis pedis flap is an ideal option for reconstructing soft tissue defects of the hand because of its texture, bulkiness and pliability in the context of like for like reconstruction.

How to properly examine the veins of the lower limbs: lying, sitting or standing?

The article is a discussion of the advantages of a patient’s position during an ultrasound examination of the lower-limb venous system. The presented material is intended to objectively assess the advantages of this or that position of an examined patient in order to obtain necessary information about the state of the veins of the lower limbs from the position of doctors who have years of experience in diagnostics and treatment of acute and chronic diseases of the lower-limb venous system. The material of the article is primarily designed for doctors who, in addition to the ability to use an ultrasound scanner to some extent, know about venous hemodynamics and can afford to think outside the generally accepted concepts and clinical recommendations.The characteristics of the state of the lower-limb venous system at vertical and horizontal position of the patient are given. Schemes of venous pressure distribution in the system of the inferior vena cava in the horizontal and vertical position of the patient are presented. Methods of manual compression of the muscular mass and straining at different patient positions are described.The vertical position of the patient (or sitting position) is the most reliable way to identify the peculiarities of anatomical structure and pathological changes of the subcutaneous vein walls, which may be of great importance for planning and carrying out subsequent invasive manipulations, but there is a question about the expediency of making linear measurements in this position, if the invasive intervention is carried out while lying down. Carrying out compression ultrasound, assessment of hemodynamic parameters of venous blood flow, including the use of samples with straining and manual compression of muscle masses of the limb, it is much more convenient to perform in the lying position.

Lymphaticovenous anastomosis for advanced-stage lower limb lymphedema.

Early-stage lymphedema patients are said to be candidates for lymphaticovenous anastomosis (LVA). The progressions in the preoperative examinations have made it possible to find the suitable lymphatic vessels even in advanced-stage lymphedema. The aim of this study was to elucidate the surgical effect of LVA in cases of advanced-stage lymphedema. We evaluated 42 limbs of 34 patients with lymphoscintigraphic type 4 or 5. A mean disease duration was 7.5 ± 6.5 years. We performed multi-lymphosome indocyanine green (ICG) lymphography preoperatively to detect the saphenous lymphatics, the lateral calf lymphatics, and the lateral thigh lymphatics. We also performed ultrasound to detect the subcutaneous veins and the dilated lymphatic vessels. The pre- and postoperative evaluation was made by the sum of circumference measurements at 6 points per limb. The mean number of anastomosis per limb was 2.8 (range, 1-5). Of the 41 limbs for which we performed ICG lymphography, we found the saphenous lymphatics in 29 limbs (70.7%), lateral calf lymphatics in 28 limbs (68.3%), and lateral thigh lymphatics in 21 limbs (51.2%). We found at least 1 linear pattern in ICG lymphography for 39 limbs (95.1%). The mean pre- and postoperative circumference (sum of 6 points) were 221.7 ± 4.9 cm and 215.9 ± 4.9 cm, which was significantly reduced (p < .01). LVA was effective for advanced-stage lymphedema patients. An adequate preoperative examination with plural imaging methods seems helpful for achieving a successful surgical result.

COLLATERAL BLOOD FLOW IN THROMBOSIS IN THE ANKLE-POPLITEAL AND POPLITEAL-FEMORAL SEGMENTS OF THE VENOUS SYSTEM OF THE LOWER LIMBS WITH INVOLVEMENT POPLITEAL VENOUS COLLECTOR

Thrombosis of the veins of the lower extremities plays a significant role in vascular pathology. Lifestyle, concomitant pathologies and provoking factors disrupt the stability of the Virchow's Triad and lead to thrombosis, severe complications and adverse long-term consequences.&#x0D; The aim of research: to evaluate the compensatory possibilities of the collateral blood flow in the popliteal venous collector in the acute venous thrombosis.&#x0D; Rationale for the research. Normally, 90% of blood flows through the main veins. At their thrombosis there is a redistribution of outflow and the most part of blood is taken away by collateral vessels. Knowledge of the functional capabilities of collateral blood flow is an additional criterion for predicting possible complications and severity of the disease.&#x0D; Methods. The analysis is made of results examination and operative treatment of 790 patients with the acute thrombosis in the vena cava inferior system and being treated at the Transcarpathian Regional Clinical Hospital A. Novak and the Transcarpathian Regional Clinical Oncology Center during 2006 – 2016. Laboratory examination methods were used to examine patients, including instrumental ones: ultrasound duplex scanning, X-ray phlebography, СТ, radionuclide phleboscintigraphy and ultrasound scanning of heart. During the radionuclide phleboscintigraphy of patients at rest and during physical activity, the function of the muscle-venous pump of the tibial was evaluated: the average transport time, the linear speed of blood flow and the loading index.&#x0D; In patients with thrombosis of the tibia-popliteal venous segment, a significant slowing of the passage of radiopharmaceutical on the deep venous system was observed, which is reflected in the increase of the average time of transport through the veins of the tibia and femoral to 59.4 ± 4.02 s, reducing the linear speed of blood flow to 2.1 0.61 cm / s and load index up to 1.6 ± 0.49 units, in this case, deep veins are contrasted unevenly, the phleboscintigrams showing the image of collateral, mainly muscular, and subcutaneous veins, through which the main blood flow from the extremity can take place. In this case, the correlation of volume blood flow of the main and collateral veins averaged 40% and 60%, respectively.&#x0D; Conclusions. The absence of valves in the muscular venous sinuses of the tibial, their larger diameter relative to the other veins of the tibial, and prolonged hypodynamia, adversely affect the work of the muscle-venous pump, which is one of the preconditions for thrombus formation in this area. In this case, the formation of thrombotic masses in the deep veins of the lower extremity in 89.2% of patients begins in the small muscular branches of the tibia, and their spread to the popliteal vein creates optimal conditions for fragmentation and thromboembolism.

COLATERAL BLOOD FLOW AT THROMBOSIS IN THE FEMORAL VENOUS COLLECTOR

Anatomical features of collateral circulation of a hip influence on the severity of a clinical picture at deep thromboses and play a role in the prevention of complications. This necessitates the assessment of collateral blood flow.&#x0D; The aim of research: to evaluate the compensatory possibilities of the collateral blood flow in the femoral venous collector in the acute venous thrombosis.&#x0D; Methods. The analysisis made of results examination and treatment of 790 patients with the acute thrombosis in the vena cava inferior system and being treated at the Transcarpathian Regional Clinical Hospital named after A. Novak and the Transcarpathian Regional Clinical Oncology Center during 2006–2016. The laboratory methods and the instrumental ones (ultrasound duplex scanning, X-ray phlebography, computed tomography, radionuclide flebo scintigraphy and ultrasound scanning of heart) were used for investigation of patients,&#x0D; Results of research. Deep vein thrombosis in the popliteal-femoral segments was observed in 322 (40.8%) of 790 patients. At the occlusion of the popliteal-femoral segments in the collateral blood flow take part the next vessels: superficial (large subcutaneous vein, small subcutaneous vein, posterior cutaneous femoral vein) and deep (deep femoral vein, vein-satellites of the main arteries, popliteal-femoral-sciaticpath, v. articularis genusuprema, vv. comitans n. ischiadici and abnormal femoral collateral), which quickly off set violations.&#x0D; At the spread of thrombosis to general femoral vein, the clinical picture of the disease becomes more pronounced, due to the exclusion from the blood flow of deep femoral vein and most superficial venous collaterals (posterior cutaneous femoral vein and large subcutaneous vein), which leads to a sharp decompensation of venous outflow.&#x0D; Conclusions. At the deep vein thrombosis in the popliteal-femoral segment the venouscollaterals, whichin 98.4% of cases occur secondarily, quickly compensate for hemodynamicdisorders, but at progression of thrombosis and exclusion of deep femoral and large subcutaneous veins in popliteal-femoral segments the decompensation of venous blood flow rapidly.&#x0D; Thrombosis of deep veins in the popliteal-femoral segment occurs secondarily, due to the spread of thrombotic masses from the tibial veins. The jugular vein share the source of thrombosis in only 1.6% of patients.&#x0D; At occlusion of a popliteal-femoral venous segment in collateral blood flow the following vessels participate: superficial (LSV, SSV, a back cutaneousvein of a hip) and deep (DFV, veins-satellites of the main arteries, popliteal-femoral-sciatic way, v. Articularis us vv. comitans n. Ischiadici and abnormal femoral collaterals), which quickly eliminate hemodynamic disturbancesin the popliteal-wall segment.&#x0D; The most pronounced clinical symptoms of deep vein thrombosis in the popliteal-femoral segment are observed when excluding from the collateral blood flow of the deep femoral and great saphenous veins.

Prevalence of Varicose Veins Among Nurses at Different Departments in a Single Tertiary Care Center in Riyadh.

BackgroundVaricose veins (VV) is a chronic venous disease that affects the lower extremities. It is the dilation of subcutaneous veins, three to four millimeters in diameter. VV can be attributed to several risk factors such as age, obesity, multiple parities, heavy lifting, and long-standing hours. Direct and indirect complications can occur due to VV. Several studies were conducted to estimate the prevalence of VV.MethodsA self-administered questionnaire was used to estimate the prevalence of VV among nurses from different departments in the National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia. The questionnaire included questions on weight, height, work history, lifestyle, and multiple diseases. The chi-square test and Fisher’s exact test were used for testing the association between the various predictors and the diagnosis of VV.ResultsA total of 366 nurses participated in the study. There were 40 (39 females and one male) cases of VV accounting for 11.0%. Variables that have a statistically significant association with VV were social status and lifting heavy objects (p=0.02), a family history of VV (p-value=<0.001), and the number of childbirths (p=0.04). The observation of each department was not statistically significant with VV (p=0.35).ConclusionAmong nurses, positive family history, age, marital status, long-standing hours, and heavy object lifting were significant risk factors for the development of VV. However, the prevalence of VV in the four departments was low.

A PROSPECTIVE COMPARATIVE STUDY OF RADIOFREQUENCY ABLATION VERSUS SUBFASCIAL ENDOSCOPIC PERFORATOR SURGERY FOR THE TREATMENT OF VARICOSITIES IN VARICOSE VEINS PATIENTS.

Introduction: Dilated &amp; tortuous subcutaneous veins 3mm or more in diameter are known as varicose veins. When perforating veins become incompetent, it causes chronic venous insufficiency. Majority cases are managed conservatively. Cases with significant skin changes and ulcers, requires surgical procedures.&#x0D; Methods: A prospective comparative study of 30 patients of varicosities, divided into two groups, A and B according to CEAP classification were assessed for VCSS preoperatively. They underwent radiofrequency ablation (RFA) and subfascial endoscopic perforator surgery (SEPS) respectively and postoperative VCSS was calculated at follow up at 4 weeks. Collected data was assessed for the change in clinical severity of the disease and compared for the complications of both surgical methods.&#x0D; Results: The mean difference of pre op and post op VCSS in patient treated by RFA is 6.0 and the mean difference of pre op and post op VCSS in patient treated by SEPS is 5.4. Post RFA complications include pain (20%) and ecchymosis (13.3%). Paraesthesia and DVT was not noted. Post SEPS complications include pain (40%), ecchymosis (40%) and paresthesia (13.33%). DVT was not noted post SEPS. Only 1 case (6.66%) treated by SEPS developed recurrence post operatively. Conclusion: RFA and SEPS are two different approaches for varicosities, RFA being truncal therapy and SEPS for perforators, both are almost equally effective in context of postoperative hospital stay and improvement of VCSS; safe in terms of post op complications.&#x0D; Keywords: Radiofrequency ablation (RFA), Subfascial endoscopic perforator surgery (SEPS), venous clinical severity score (VCSS), varicose veins

Veins Depth Estimation Using Diffused Reflectance Parameter

In order to perform the standard Intravenous (IV) catheterization, subcutaneous veins must be localized. It is a difficult task, especially in the cases when veins are hard to localize. The factors which affect the veins localization process are the physiological characteristics of patients, mainly darker skin tone, scars, hair, dehydration and low blood pressure. With the help of Near Infrared imaging, subcutaneous veins can be envisioned. This is due to the higher absorption of NIR light energy by Hemoglobin (Hb) found in the veins. Besides a superficial view, the veins depth information is also important in order to avoid their rupture by piercing through the walls during IV catheterization process. Diffused reflectance, measured with a camera sensor, can be used for the depth estimation of blood vessels. In this paper, a method to measure the depth of veins using diffused reflectance parameter, is presented. The well-known Monte Carlo model of light propagation in human tissues is used for the mathematical representation. A four-layered skin model is presented with varying vessel depths to describe the diffused reflectance of light while propagating inside skin tissues. The results are validated with Monte Carlo simulations for light propagation in layered medium. A sensitivity analysis of proposed method is also performed with a 5% alteration in the optical parameters of skin due to the change in operating conditions. The results showed a marginal error of maximum value 6.23% in vessel depth estimation using the standard optical parameters, 1.6% for −5% and 10.74% for +5% change in optical parameters.

Circular RNA hsa_circ_0004872 inhibits gastric cancer progression via the miR-224/Smad4/ADAR1 successive regulatory circuit

BackgroundEmerging evidence has shown that circular RNAs (circRNAs) play a crucial regulatory role in the occurrence and development of cancer. Exploring the roles and mechanisms of circRNAs in tumorigenesis and progression may help to identify new diagnostic markers and therapeutic targets. In the present study, we investigated the role and regulatory mechanism of hsa_circ_0004872 in gastric cancer (GC).MethodsqRT-PCR was used to determine the expression of hsa_circ_0004872 in GC tissues and cells. EdU, CCK-8, transwell and scratch wound healing assays were used to assess the role of hsa_circ_0004872 in GC cell proliferation, invasion and migration, respectively. Subcutaneous and tail vein tumor injections in nude mice were used to assess the role of hsa_circ_0004872 in vivo. RIP assay, biotin-coupled probe pull-down assay, FISH and luciferase reporter assay were performed to confirm the relationship between hsa_circ_0004872 and the identified miRNA. ChIP assay, luciferase reporter assay and western blot were used to determine the direct binding of Smad4 to the promoter of the ADAR1 gene.ResultsIn this study, we found that hsa_circ_0004872 was dramatically downregulated in GC tissues compared with adjacent noncancerous tissues. The expression level of hsa_circ_0004872 was associated with tumor size and local lymph node metastasis. Enforced expression of hsa_circ_0004872 inhibited the proliferation, invasion and migration of GC cells, whereas knockdown of hsa_circ_0004872 had the opposite effects. Nude mice experiments showed that ectopic expression of hsa_circ_0004872 dramatically inhibited tumor growth and metastasis in vivo. Moreover, we demonstrated that hsa_circ_0004872 acted as a “molecular sponge” for miR-224 to upregulate the expression of the miR-224 downstream targets p21 and Smad4. Importantly, we found that the RNA-editing enzyme ADAR1 inhibited hsa_circ_0004872 expression and further led to the upregulation of miR-224. Smad4, the downstream target of miR-224, could further affect hsa_circ_0004872 levels by directly binding to the promoter region of ADAR1 to inhibit ADAR1 expression.ConclusionsOur findings showed that hsa_circ_0004872 acted as a tumor suppressor in GC by forming a negative regulatory loop consisting of hsa_circ_0004872/miR-224/Smad4/ADAR1. Thus, hsa_circ_0004872 may serve as a potential biomarker and therapeutic target for GC.

Tactics of treatment of the inflow varico-thrombophlebitis

Objective. To substantiate the indications for surgical treatment of the inflow thrombophlebitis, depending on state of venous hemodynamics in the large subcutaneous vein basin.&#x0D; Materials and methods. Analysis of the examination and treatment results was conducted in 23 patients, suffering the inflow varico-thrombophlebitis in the large subcutaneous vein basin.&#x0D; Results. Localization, length, borders, level of proximal and distal edges of thrombotic occlusion, and the thrombotic masses character were estimated in a case of the inflow thrombophlebitis diagnosis. Establishment of an acute inflow varico-thrombophlebitis diagnosis have had served the indication for performance of an urgent operation. At the same time, taking into account of the ultrasonographic investigation results obtained, it became possible to elaborate a differentiated tactics for the inflow varico-thrombophlebitis in the large subcutaneous vein basin present.&#x0D; Conclusion. Following an active surgical tactics for the inflow varico-thrombophlebitis have permitted to prevent effectively the spread of thrombtotic process on the large subcutaneous vein trunk and insufficient perforant veins, as well as to prevent the development of thrombosis in deep veins and venous thromboembolism morbidity. At the same time the operation volume reduction due to the inflow thrombophlebitis presence in the patient gave a chance to preserve the intact subcutaneous vein for possible further reconstructive interventions and to prevent the chronic venous insufficiency development as well.

Estimation of quality of life after operative treatment for venous trophic ulcers of the lower extremities

Objective. To study the patients’ quality of life after operative interventions, performed for venous trophic ulcers of the lower extremities.&#x0D; Маterials and methods. Analysis of data from 82 hospital cards of stationary patients was conducted. The patients were treated during 2010 - 2017 yrs in the Department of Vascular Surgery of Poltava Regional Clinical Hospital named after М. V. Sklifosovskyi for venous trophic ulcers of the lower extremities (Class С5 in accordance to Clinical-Etiological-Anatomical-Pathophysiological classification - СЕАР). The cause of trophic ulcers occurrence in all the patients was confirmed, using ultrasound duplex scanning of pelvic and the lower extremities arteries and veins. After conduction of certain conservative therapy the operative intervention, directed on elimination of the occurrence cause of trophic ulcers, was done. In all the patients the conduction of endovenous thermal ablations was not indicated, taking into account the anatomic peculiarities presented. Depending on the methods of operative interventions performed, the patients were distributed into two groups: Group I - 48 (58.5%) patients, surgical treatment of whom consisted of typical conventional open operative interventions, using a standard set of instruments, while Group II - 34 (41.5%) patients, to whom operative interventions were done, using elaborated own gadgets for the wounds edges opening, dissection and ligation of perforant and large subcutaneous veins, nontraumatic suturing of postoperative wounds. All operative interventions in the Group II patients were performed, using ultrasonographic support. In patients of both Groups a subjective estimation of quality of life was conducted, using questionnaire CIVIQ (Chronic Insufficiency Venous International Questions) for interviewing preoperatively and in 1, 3 and 6 mo postoperatively.&#x0D; Results. In accordance to data obtained, in patients of Group II the score in points of quality of life was higher, because in them the ulcers have healed faster, the pain sensation reduced, resulting in the psycho-emotional state improvement. Besides this, 29 (85.3%) patients of Group II have noted, that even while some symptoms persisted, their subjective signs reduced, leading to the well-being improvement. The conduction of treatment in accordance to own procedures proposed have promoted the raising of the quality of life score in patients, suffering trophic ulcers of the lower extremities.&#x0D; Conclusion. Application of gadgets of own elaboration during operative intervention on venous system of the lower extremities accelerates its performance and reduces traumaticity. This leads to reduction of the pain sensitivity intensity, raising of subjective estimation of quality of life in remote postoperative period.

Synergistic effect of ibrutinib and CD19 CAR-T cells on Raji cells in vivo and in vitro.

Ibrutinib might improve the efficacy of anti‐CD19 chimeric antigen receptor (CD19 CAR) T‐cell therapy in chronic lymphocytic leukemia (CLL). We studied the possibility and mechanism of the synergistic effect of ibrutinib and CAR‐T cells in other types of lymphoma. In this study, we selected the CD19 CAR‐T cells of a patient with lymphoma who failed in his CD19 CAR‐T‐cell therapy and a dose of 8 mg/kg/d ibrutinib. Subcutaneous and tail vein tumorigenic mice were established with Raji cells. The differences in the synergistic effect between these 2 models were compared by bioluminescence imaging (BLI) monitoring and flow cytometry (FCM). The expression of the STAT‐3 signaling pathway was assessed by western blot analysis. There was no synergistic effect of ibrutinib and CD19 CAR‐T cells in vitro. Programmed cell death‐ligand 1 (PD‐L1) was expressed in 0.23 ± 0.06% of Raji cells. In the subcutaneous tumorigenic model, the luciferase signal was reduced significantly in the group receiving ibrutinib combined with CD19 CAR‐T cells. Moreover, the proportion of CD19 CAR‐T cells was higher in the polytherapy group than in the CAR‐T‐cell monotherapy group. However, we did not get an analogous synergistic effect in the tail vein tumorigenic model. STAT‐3 signaling pathway expression in the residual tumor cells did not differ between those with and those without ibrutinib, suggesting that the IL‐10/STAT‐3/PD‐L1 pathway was not involved in the synergistic effect. Therefore, some other mechanism might be a target for ibrutinib. Our results provide evidence for the use of ibrutinib in polytherapy for other types of B‐cell lymphoma.

Label-free quantitative proteomic analysis identifies the oncogenic role of FOXA1 in BaP-transformed 16HBE cells

Lung cancer has been the leading cause of cancer incidence and mortality in China for years. Benzo[a]pyrene (BaP) is a well-known carcinogen for lung cancer. To understand alternation of key proteins and their role in BaP-induced lung cancer, we compared proteome profiles between BaP-transformed 16HBE cell line T-16HBE-C1 (THBEc1) cells and control using label-free quantitative proteomic analysis. Forkhead box protein A1 (FOXA1) was selected and evaluated for its potential role in BaP-induced carcinogenesis in vitro and in vivo. Relationship between FOXA1 expression and survival of lung cancer patients were examined via The Cancer Genome Atlas (TCGA) database. A total of 183 differentially expressed proteins were identified, with 67 proteins including FOXA1 up-regulated and 116 proteins down-regulated in THBEc1 cells. Differentially expressed proteins mainly functioned in basic cellular metabolism, tumor related pathways and regulation of transcription factors. FOXA1 knockout inhibited colony formation and migration of THBEc1 cells in vitro. FOXA1 knockout inhibited tumor growth and metastasis in BALB/c-nude mice after subcutaneous and tail vein injection of FOXA1 knockout THBEc1 cells, respectively. FOXA1 mRNA expression was higher in tumor tissues for patients with lung squamous cell carcinoma, but not associated with survival of lung cancer patients. Our findings revealed oncogenic role of FOXA1 in BaP-induced lung cancer and improved understanding of mechanism in BaP-induced carcinogenesis.

RETRACTED ARTICLE: KRLODPLSMR-GCV3DC—improving contrast-based photoacoustic imaging based on model reconstruction

Contrast-based photoacoustic imaging is an emerging imaging technology that gold nanoparticles (a kind of photoacoustic contrast agent with a size of 100 nm) are injected into blood vessels for photoacoustic imaging. Image reconstruction is a critical step in photoacoustic imaging, due to the fact that limitations and incompleteness of photoacoustic imaging data of image reconstruction are equivalent to the linear inverse problems. The photoacoustic data is transferred to IOT based on the platform of MATLAB and is quickly processed through the regularization method of Krylov space (the widely used method is LSQR). In order to solve the problem of Krylov space uncertainty, Krylov space dimension selection, and the minimum mismatch of the LSQR objective function (the limitation of LSQR algorithm) of LSQR algorithm, a KRLODPLSMR-GCV3DC algorithm is proposed to solve the above problems in this paper.In this study, the raw photoacoustic data was obtained by injecting gold nanoparticles into capillaries and subcutaneous veins of the palm, and the KRLODPLSMR-GCV3DC algorithm was verified to solve the limitations of LSQR algorithm through four groups of experiments.

Rationale for the use of osteopathic correction in the treatment of patients with chronic lower limb vein disease

Introduction. Despite the constant improvement of treatment methods, chronic lower limb vein disease (CLLVD) remains an urgent and not completely solved problem. Therefore the search for new methods of this disease treatment is actual. The effectiveness of osteopathic treatment of patients with CLLVD has been shown in recent years. But despite this the use of osteopathic treatment in this area has not been widely used today because further research, generalization of results and creation of an evidence base are required.The goal of research— is to substantiate the possibility of osteopathic treatment for patients with CLLVD C1–C3 (according to the international classification system CEAP).Materials and methods. The study involved 20 patients suffering from C1–C3 CLLVD. The main group (10 people) receiving osteopathic treatment and the control group (10 people) receiving standard treatment were formed by simple randomization. At the beginning and the end of the study there were evaluated osteopathic status of study participants, changes in pain intensity by visual analogue scale (VAS), changes in quality of life according to the questionnaire CIVIQ (Chronic Venous Insufficiency Quality of Life Questionnaire), and changes in the diameter of the saphenous veins of the lower extremities.Results. Osteopathic examination of patients with CLLVD C1–C3 (according to the CEAP classification system) prior to the treatment allowed to establish the presence of somatic dysfunctions of the regional (lumbar and pelvic regions, structural and visceral), and local (diaphragm, sigmoid and caecum) level. The use of osteopathic correction in the main group compared with medical treatment in the control group leads to a statistically significant (p&lt;0,05) decrease in the number of regional biomechanical dysfunctions of the lumbar and pelvic region, visceral components, and local somatic dysfunction of the diaphragm. The use of osteopathic correction in the main group leads to a statistically significant (p&lt;0,01) more expressed reduction in pain intensity and improved quality of life compared to the control group receiving medication. Both osteopathic correction and standard medical treatment are accompanied by a significant (p&lt;0,05) decrease in the diameter of the small saphenous vein of the affected limb, as well as the diameter of the large saphenous vein (only in the group that received osteopathic correction). There were no cases of adverse treatment outcome.Conclusion. The infl uence of the somatic dysfunctions osteopathic correction on the development of chronic lower limb venous disease (classes C1–C3 according to the CEAP classification system) was studied. It was shown that this infl uence is not inferior to the standard medical method of treatment. The patients′ life quality improves, the experienced pain level decreases, and the subcutaneous veins diameter decreases. In comparison with the control group using the drug method of treatment, there is a statistically significant more expressed decrease in the number of somatic dysfunctions. The obtained results suggest the possibility of osteopathic correction using for C1–C3 class CLLVD according to the international classification system CEAP.

Оцінка результатів планових відкритих хірургічних втручань при первинному хронічному захворюванні вен у вагітних

The objective: to evaluate the results of planned open surgical interventions (POSI) in pregnant women with primary symptomatic chronic vein disease (PSCVD). Materials and methods. The study included 457 pregnant women operated on a routine basis with PSCVD. The patients underwent ultrasound duplex angioscanning (USDA) of the veins of the lower extremities, inguinal canals, and iliac veins. The severity of the clinical manifestations of PSCVD was evaluated on a VCSS scale. With the help of the circadian visual-analog scale, the dynamics after the operative pain were studied. The effect of POSI on uterine tone and cardiac function of the fetus was investigated using cardiotocography. When forming the results for POSI, data from USDA, the severity of clinical and cosmetic manifestations of PCVD, the need for active prevention of thrombophlebetic, thromboembolic and hemorrhagic complications, minimization of surgical childbirth were taken into account. The results of treatment were studied in 2 groups of patients. Patients of the first group were treated with conservative therapy, the second group – POSI. Parametric indicators, which were presented as mean and standard error M(SD), were used for statistical data processing of the study, and their reliability was estimated using Student’s t-test. The species was determined to be significant at p&lt;0.05. Results. 495 POSI were performed at 28-38 weeks gestation in an obstetric hospital (perinatal center), by a vascular surgeon from the staff of the center, who was familiarized with the peculiarities of working with this contingent of patients. Surgery was performed under local anesthesia in 346 (75.49%) pregnant women at one extremity, in 111 (24.51%) – at two in one session. According to the results of the study, it was noted that in the first group 33.7% of patients had a positive clinical result due to the reduction of pain syndrome, while 67.5% of patients had an increase and spread of varicose transformation in the area of saphenous and/or non-saphenous veins with spread of pathological venous reflux in the distal direction. 78% of patients had the need to administer prophylactic doses of low molecular weight heparins, both during pregnancy and in postpartum period. Out of 126 pregnant women with pronounced varicose veins of the external genital organs and perineum in 36 (28.6%) deliveries were performed by caesarean section. In 9 (3%) patients there was an acute thrombophlebitis of the subcutaneous veins of the lower extremities, which required 5 pregnant women to undergo urgent surgery when the inflammatory process had spread to the middle and above along the femoral vein of the large subcutaneous vein. Pregnant women of the second group with PSCVD on the basis of obstetric hospital (perinatal center) POSI were performed in the organization, which laid the ideology of the FTS program, strictly individual indications for intervention in the optimal terms of pregnancy, multidisciplinary management of patients, due to this in 93% of operated patients regression of clinical manifestations of the disease was noted, whch contributed to the correct and safe delivery of pregnancy with 100% absence of preterm birth, abnormalities in fetal development, pregnancy course, negative impact on obstetric and somatic condition of the pregnant woman. No hemorrhagic, thrombophlebic, thromboembolic complications were noted. Patients in the postoperative period did not require medical support, as during the period of pregnancy, during delivery and in the postpartum period. There were no indications for surgical delivery. 2.4% of patients experienced complications of post-operative wounds in the form of cheese, which had no effect on pregnancy and was eliminated before delivery. In the postoperative period, if necessary, it was recommended to use elastic compression class garments 1–2. Conclusion. POSI made at PSCVD in optimal terms of pregnancy in a specialized obstetric hospital by a vascular surgeon in strictly individual indications is safe, both for the fetus and the pregnant woman. It is promising to further study the results of POSI in pregnant women with PSCVD to introduce it into the arsenal of treatment of this pathology. Key words: FTS ideology, planned open surgical interventions in pregnant women.

THE USE OF ENDOTHERMICTRE AT MENT OF THE MOUTH OF THE LARGE SUBCUTANEOUS VEIN IN PATIENTS IN THE ACUTE PERIOD OF VARICOTROMBOPHLEBITIS

Summary. One of the most common complications of varicose veins is lower varicotrombophlebitis, which occurs in 30-59 % of cases and is an em bolo genic risk.&#x0D; Aim. The aim of our study is to evaluate the effectiveness of using the method of endothermic treatment of the mouth of a large subcutaneous vein in patients in the acute period of varicotrombophlebitis.&#x0D; Materials and methods of research. The data of 58 patients treated for acute varicotrombophlebitis in State Institution “Institute of Generaland Emergency Surgery”. V. T. Zaitseva NAMS of Ukraine”, Kharkov in 2018-2020.&#x0D; Research results. With ultra sound control in the main group on the 1st post operative day in 100 % of cases, obliteration of the proximal segment of the large subcutaneous veins with the saphenofemoral mouth. After 1 month on ultrasound in the comparison group complete recanalization o VPV trunk, and in the comparison group obliteration of the proximal segment of the VPV in the p/3 thighs, distally was noted recanalization of the VPV.&#x0D; Conclusions. We consider endothermic treatment of a large saphenous vein in patients with acute varicotrombophlebitis to avoid complications such as deep vein thrombosis or pulmonary.

A clinical study on varicose veins of lower limb, surgical management and functional outcome at a tertiary care hospital of South India

Background: Varicose veins defined as dilated, tortuous, subcutaneous veins ≥3 mm in diameter, measured in the upright position with demonstrable reflux. Though the history of varicose veins dates prehistorically, the advances in diagnosis and new management modalities gained attention recently. The aim of the present study was to study the clinical profile, risk factors and their association, different types of surgical procedures employed and complications associated with varicose veins.Methods: A one year observational after ethical committee approval was conducted by department of general surgery at ACSR Medical College. Cases fulfilling the inclusion criteria were clinically examined and duplex ultrasound colour Doppler was performed for diagnosing the varicose veins and findings of site of incompetence was noted. All the cases were operated and followed up for six months period. The results were tabulated and analyzed in Microsoft Excel for any corrections.Results: Eighty cases with 66.25% males and 33.75% females with mean age of 40.24 years and majority (40%) were in 41 to 50 years group. 60% of cases had varices in right limb and long saphenous vein was involved in 52.5% of cases.85% had dilated veins, perforator incompetence was noted below the knee in 30% of cases. 41.25% of cases saphenofemoral flush ligation with stripping of long saphenous vein. Wound infection was the common postoperative complication.Conclusions: Operative line of management should be the first line of treatment even though conservative management relieves the symptoms but always requires a definitive management.