Efficacy and mechanism of fire needling bloodletting for lower extremity varicose veins / 中国针灸

OBJECTIVE@#To compare the clinical effect of lower extremity varicose veins between fire needling bloodletting and operation, and to explore the possible mechanism.@*METHODS@#A total of 60 patients were randomized into an observation group and a control group, 30 cases in each one. In the control group，the operation was adopted. The fire needling bloodletting was applied in the observation group, twice a week for 4 weeks. Before and after treatment, the venous clinical severity score (VCSS) and venous disability score (VDS) were recorded, the hemorheological indexes [blood viscosity, plasma viscosity, hematocrit, fibrinogen and erythrocyte sedimentation rate (ESR)], immune inflammatory response indexes[serum C-reactive protein (CRP), tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6)], vascular endothelial cell function indexes [the number of circulatingendothelial cell (CEC), plasma endothelin (ET-1) and NO)] and apoptosis indexes (Bcl-2, Bax and Caspase-3) were detected in the two groups.@*RESULTS@#Compared before treatment, the scores of VCSS and VDS, hemorheological indexes, immune inflammatory response indexes and levels of plasma NO after treatment were reduced in the two groups (<0.05). The level of serum Bax after treatment was reduced in the observation group (<0.05). The number of CEC and levels of plasma ET-1 after treatment were increased in the two groups (<0.05). The levels of serum Bcl-2 and Caspase-3 after treatment were increased in the observation group (<0.05). In the observation group, the scores of VCSS and VDS, hemorheological indexes，immune inflammatory response indexes, vascular endothelial cell function indexes and level of serum Bax after treatment were lower than the control group (<0.05), and the levels of Bcl-2 and Caspase-3 were higher than the control group (<0.05).@*CONCLUSION@#Fire needling bloodletting could effectively treat lower extremity varicose veins, and the mechanism may be related to the improvement of hemorheology, downregulation of immune inflammatory response, improvement of vascular endothelial cell function and inhibition of apoptosis.

Clinical significance of antegrade lower limb venography in varicose veins of lower limbs / 中国医师杂志

Objective@#To investigate the clinical significance of antegrade lower limb venography in varicose veins of lower limbs.@*Methods@#The data of 230 cases of varicose veins of lower limb in Department of Vascular Surgery, Xiangyang Central Hospital from June 2018 to August 2019 were examined by antegrade lower limb venography. All patients were divided into simple varicose veins group (group A, 67 cases) and secondary varicose veins group (group B, 63 cases) according to the patency of deep veins. The data of sex, limb side, swelling and ulcer were analyzed respectively.@*Results@#There was no significant difference in the results of sex between the two groups (57.5% vs 63.5%, P>0.05). The incidence of left side in group A was lower than that in group B (59.3% vs 76.2%, P<0.05). And the incidence of swelling of lower extremities and ulcer in boot area in group A was lower than that in group B (31.1% vs 49.2%, P<0.05; 18.6% vs 31.7%, P<0.05 respectively).@*Conclusions@#Combined with swelling of lower extremities, ulcer in boot area or the varicose veins in left side had a higher incidence of secondary varicose veins. Anterograde venography of lower extremities can accurately distinguish the classification of varicose veins of lower extremities and improve the diagnostic coincidence rate, which has significant clinical significance.

Clinical significance of antegrade lower limb venography in varicose veins of lower limbs / 中国医师杂志

Objective To investigate the clinical significance of antegrade lower limb venography in varicose veins of lower limbs.Methods The data of 230 cases of varicose veins of lower limb in Department of Vascular Surgery,Xiangyang Central Hospital from June 2018 to August 2019 were examined by antegrade lower limb venography.All patients were divided into simple varicose veins group (group A,67 cases) and secondary varicose veins group (group B,63 cases) according to the patency of deep veins.The data of sex,limb side,swelling and ulcer were analyzed respectively.Results There was no significant difference in the results of sex between the two groups (57.5％ vs 63.5％,P ＞ 0.05).The incidence of left side in group A was lower than that in group B (59.3％ vs 76.2％,P ＜ 0.05).And the incidence of swelling of lower extremities and ulcer in boot area in group A was lower than that in group B (31.1％ vs 49.2％,P＜0.05;18.6％ vs31.7％,P＜0.05 respectively).Conclusions Combined with swelling of lower extremities,ulcer in boot area or the varicose veins in left side had a higher incidence of secondary varicose veins.Anterogrede venography of lower extremities can accurately distinguish the classification of varicose veins of lower extremities and improve the diagnostic coincidence rate,which has significant clinical significance.

Analysis of short to medium-term efficiency of 1470 nm laser with foam sclerotherapy to treat varicose veins of lower extremity / 上海交通大学学报（医学版）

Objective · To compare the short and medium-term efficiency and safety of 1470 nm laser with foam sclerotherapy with ligation of great saphenous vein and 808 nm laser with foam sclerotherapy to treat varicose veins of lower extremity. Methods · Seventy-seven hospitalized patients patients and twenty-one day-surgery patients were retrospectively analyzed. Results · There was no obvious difference in the closure of great saphenous vein for short to medium-term efficiency between the day-surgery group and hospitalized group. The postoperative complications and recurrence rate of day-surgery group was not higher than that of the hospitalized group, but the degree of perioperative comfort, economic cost and the time returning to normal life of day-surgery group were superior to that of the hospitalized group. Conclusion · 1470 nm laser with foam sclerotherapy with ligation of great saphenous vein and 808 nm laser with foam sclerotherapy to treat varicose veins of lower extremity had similar clinical effect, but the degree of safety and comfort was higher and trauma was less. The day surgery with 1470 nm laser to treat varicose vein of lower extremity could also simplify the procedure of hospitalization and reduce the cost of health care, which could be a new option for patients.

Clinical research on encircling constriction of superficial femoral vein with electrocoagulation in the varicose veins of lower extremity / 中国综合临床

Objective To observe the effect of the operation and application value of encircling constriction of superficial femoral vein with electrocoagulation in the varicose veins of lower extremity.Methods 271 cases were divided into the research group(n=166)with encircling constriction of superficial femoral vein with electro-coagulation and the control group(n=105)with traditional encircling constriction of superficial femoral vein with electrocoagulation.The degrees of the venous reflux,velocities of blood flow,CEAP classification and clinical scoring of the two groups were compared.Results The research group was better than the control group on decrease in de- grees of the venous reflux.increase in velocities of blood flow and decrease in clinical scores(P<0.01).Conclu- sions The encircling constriction of superficial femoral vein with electrocoagulation is the desirable method in the treatment of varicose veins of the lower extremity.