Analysis of postoperative recurrence of varicose veins of lower extremity in 81 cases / 国际外科学杂志

Objective To discuss the cause of relapse after the first surgery of varicose veins of lower limb,and corresponding prevention and treatment methods.Methods The data of 81 cases of recurrence varicose veins of lower limb in Department of Vascular Surgery,Yanzhou First People's Hospital from September 2010 to October 2016 were analyzed retrospectively,all patients receded ascending phlebography for deep veins Postoperative follow-up of 6 to 48 months was followed by the combination of outpatient and telephone follow-up,with the symptoms,signs and blood vessels of the lower extremities as the follow-up.Results Remnant of the main trunk or tributaries of great saphenous vein in 19 cases,31 limbs of deep venous incompetent,incompetent perforator veins 25 limbs,the residual of small saphenous vein were 3 cases,crockett's syndrome 10 cases,sequelae of deep venous thrombosis belongs to the residual 5 limbs,Klippel-Trenaunay syndrome 1 limbs.There were some patients who suffered from 2 reasons or more than two reasons simultaneously.After surgery again,the cure vate was 100％ and no serious complications such as deep vein throm-bosis.During the follow-up,12 patients showed different degrees of subcutaneous stasis,oral drug observation,and later regression.Local subcutaneous hematoma was 5 cases,2 cases of pure syringe were treated with pressure after suction,3 routine local incision was removed to remove stitches,drainage change and delayed healing.Six patients showed the sensory impairment of skin numbness in the leg boot area,and oral related neurotrophic drugs improved within 1 to 6 months after surgery.The remaining patients recovered well after operation.Conclusions Various causes can lead to the varicose vein of lower limb,a varicose vein of lower limb is a common clinical symptoms of many different diseases.Preoperative comprehensive examination to clarify the cause,this will help to reduce the probability of recurrence of lower extremity varicose veins.

Subfascial endoscopic perforator surgery in treating varicose ulcer after great saphenous vein stripping / 国际外科学杂志

Objective To evaluate the feasibility and efficacy of subfascial endoscopic perforator surgery in treating varicose ulcer after great saphenous vein stripping.Methods Between July 2008 and July 2013,152 limbs of venous ulceration after great saphenous vein stripping were divided into two groups (conservative therapy and subfascial endoscopic perforator surgery therapy) and followed up at least for 2 years,respectively compared symptoms and signs improvement,ulcer healing time,ulcer healing and ulcer recurrence rate after healing for 6,12,24 months.Results No patient underwent the surgery occured pulmonary embolism or death,2 limbs appeared hematoma.Conservative and subfascial endoscopic perforator surgery group's symptoms and signs improvement rates were 81.9％ (59/72) and 86.3％ (69/80) (not significant,P =0.528),while the ulcer healing time,ulcer healing and ulcer recurrence rate respectively were 65.3％ (47/72) and 78.8％ (63/80),(73 ±15.7) d and (41 ± 12.6) d,34.0％ (16/47) and 14.3 ％ (9/63) (significantly different,P ＜ 0.05).According to the three time-points' (6,12,24 months) follow-up,the non-recurrence rate were 89.4％ (42/47) and 96.8％ (61/63),P=0.135;72.3％ (34/47) and 92.1％ (58/63),P=0.006;66.0％ (31/47) and 85.7％ (54/63),P =0.014.Conclusions Subfascial endoscopic perforator surgery is a reliable,safe and minimally invasive surgery,and has a long-term effect in treating varicose ulcer after great saphenous vein stripping.

Continuous wavelet analysis of heart rate variability during general anesthesia / 生物医学工程学杂志

The depth of anesthesia can be assessed by means of analyzing heart rate variability (HRV). Continuous wavelet transform (CWT) was used to obtain more accurate results on the changes of low frequency (LF) and high frequency (HF) components of HRV signals (RR interval sequences) before and after general anesthesia. With wavelet scale transformed into frequency, the obtained time-frequency energy distributions showed that the LF and HF components of HRV signals were suppressed after general anesthesia, while the LF/HF ratio reduced from 9.0219 to 3.5573. The time-frequency distribution showed that CWT can more accurately locate the abrupt changes in time-domain, giving more precise range of frequency changing, compared with traditional time-frequency analysis method. The results indicated that, as a new time-frequency analysis method of analyzing HRV during general anesthesia, CWT provides more accurate time-frequency location, and consequently, offers more accurate monitoring results of anesthesia depth.

Application of 5-second heart rate variability parameter based on poincare plot in real-time monitoring of the autonomic nervous system activity / 生物医学工程学杂志

This study designed one index of HRV from Poincaré plot named 5SSD1 by the present authors, which can describe the characteristics of the heart rate dynamics with 5-second data. We also investigated the feasibility of its clinical application in real-time monitoring of the activity of autonomic nervous system. We studied 20 patients scheduled for oral maxillofacial surgery. ECG recording was obtained when kept awake and anesthetic states, respectively. We calculated the correlation coefficients between the 5SSD1 and the other quantitative indicators, such as 5-minute HRV in the time domain, the frequency domain, and the Poincaré plot families. The correlation between 5SSD1 and indicators, such as rMSSD, HF and SD1 of 5-minute HRV was significantly high, with r=0.995, 0.895, 0.996, respectively, at P<0.01 for all. However, the correlation between 5SSD1 and the other indicators of 5-minute HRV was relatively poor. It was proved that 5SSD1 could be used to assess the activities of the autonomic nervous system in real-time, and the stable and reliable results might play more roles in the clinical applications.

Effects of EPCs transplantation on chronic deep vein thrombosis in rats / 中华普通外科杂志

Objective To study the effect of endothelial progenitor cells(EPCs) transplantation on chronic deep venous thrombosis.Methods Bone marrow-derived mouonuclear cells (BMMNCs) were isolated from rat bone marrow by ficoll and cultured with EGM-2MV medium.A rat model of chronic deep vein thrombosis was established by partial ligation of the inferior vena cava and intravenous injection of thrombosin.Model rats were randomly divided into three groups:A(n =25),EPCs group,1 ml 10~6 EPCs transplantation;B(n = 25),EGM-2MV medium group,1 ml EGM-2MV medium transplantation;C (n =25),control group,without any treatment.After transplantation,HE staining and immunohistochemical staining was conducted to detect recanalization of the inferior vena cava.Western blotting of inferior vena cava thrombosis was used to detect VEGF,bFGF protein expression changes.SPSS13.0 software was used for analysis.Results Compared with group B and C,VEGF,bFGF protein significantly increased in group A.The recanalization capillary density was significantly higher in group A than that in group B,and C (P ＜0.05).The neovascularization was identified by immunohistochemical staining using vWF antibody,as endothelial cells.Conclusions EPCs were the precursor of endothelial cells,when transplanted into the deep vein thrombos,initiating angiogenesis and accelerating organization and recanalization of vein thrombus.

The effect of endothelial progenitor cells transplantation on microenvironments in a murine model of chronic vein thrombosis / 中华普通外科杂志

Objective To investigate the effect of bone marrow derived endothelial progenitor cells (EPC)transplantation on microenvironments in a murine model of chronic vein thrombosis.EPCs transplantation was evaluated whether it can up-regulate thrombus organization and recanalization associated cytokines(VEGF,ANG-1 and MCP-1). Method EPCs from immature Wister rats' bone marrow were isolated using a Ficoll density gradient centrifugation,and cultured in fibronectin-coated plate in EGM-2M Vmedium.EPCs were harvested on the 10th day,then were transplanted into chronic inferior vens cava thrombus of adult Wister rat through the femoral vein.Rats were divided into three groups:blank control group(group A,sham operation),the control group(group B,the medium injected)and the experimental group(group C,EPCs injected).The rats were sacrificed after 28 days.VEGF,ANG-1 and MCP-1 mRNA was measured by real-time quantitative PCR and protein expression change by Western blotting from IVC and thrombus tissue. Results EPCs were identificated successfullv by immunohistochemistry,immunofluorescence and function,then were transplanted into chronic inferior vena cava thrombus of adult rats.After EPCs transplantation,the VEGF,ANG-1 and MCP-1 mRNA expression in group C expression was significantly up-regulated with statistical significance(P＜0.01)compared with group A and group B in IVC and thrombus tissue by real-time PCR.There was no significant difference between group A and group B (P＞0.05).VEGF,ANG-1 and MCP-1 protein expression were similar to mRNA expression.There was significant increase in group C compared to group A and group B(P＜0.01)and no statistical significance between group A and group B(P＞0.05).Conclusion EPCs deriving from bone marrow may change the microenvimnment of chronic vein thrombus through up-regulating thrombus organization and recanalization associated cytokines(VEGF,ANG-1 and MCP-1).

Respiratory effects on heart rate variability / 国际生物医学工程杂志

Respiration is one of the most important modulators of heart rate variability(HRV). The modulation mechanism of respiration on HRV were introduced. The effects of respiratory rate, respiratory volume and respiratory patterns on HRV were discussed, and these effects on HRV in patients were also referred. These respiratory effects should be taken into account when HRV is used to predict cardiac vulnerability.

Beat to beat analysis of morphological difference of ECG waveforms / 生物医学工程学杂志

Three different kinds of ECG data including the healthy, angina and myocardial infarction from the ECG database were analyzed to obtain the morphological difference sequence of their P-waves, QRS-wave and T-wave, and their RR interval sequences. Then the variability of these four sequences was analyzed by detrended fluctuation analysis (DFA) method. The results indicate that, the changing pattern in the DFA index of RR interval sequence from the healthy to the morbidity is different from those of the P-wave, QRS-wave and T-wave. The DFA indices of the RR interval sequence are about 1 in all three states, while the DFA indices of the other three sequences are about 0.5 in the healthy and all decrease from the healthy to morbidity.

Determination of optimal complexity for long ECG sequence / 生物医学工程学杂志

In this article is reported a study on the optimal complexity of the long electrocardiogram (ECG) signal. At first, the original signal sequence was symbolized, then its complexity was calculated by Lempel-Ziv algorithm, and different factors of the complexity were discussed, and three different kinds of ECG signals, i.e., normalcy, angina and myocardial infarction, were studied. The results indicate that the optimal threshold-value to symbolize the original signal and the optimal signal length are two main factors that affect the complexity value, and the optimal complexity value can effectively distinguish normal ECG and patients' ECG.

ECG real time monitoring system based on LabVIEW / 医疗卫生装备

This paper introduces an ECG real time monitoring system based on LabVIEW.With Wavelet transformation,the original ECG signals are processed to increase the accuracy of R peak detection.The feature of real time in this system is ensured by the application of simplified algorithm.The result panel offers various types of HRV information in time domain,including numerical and graphical displays which make the data more intuitional and more convenient to obtain.The system runs well in lab and the result is acceptable.