[Randomized controlled study on the application effect of a new type of intravenous radiofrequency closed therapy system made in China and an imported system].

Objective: To compare the application effect of domestic and imported intravenous radiofrequency closure system in the treatment of primary varicose veins of lower extremities. Methods: This single-center prospective, non-inferiority randomized controlled trial was performed in the Department of Vascular Surgery, the Fourth Affiliated Hospital, Zhejiang University School of Medicine from January 2021 to January 2022. Patients with primary varicose veins of lower extremities who met the ataxation criteria were randomly assigned to the experimental group(domestic novel venous radiofrequency closure system) or the control group(imported venous radiofrequency closure system) in a ratio of 1∶1. The two groups of subjects were compared in terms of target vein closure rate, technical success rate, system operation performance, incidence of adverse events and incidence of serious adverse events(SAE) within 6 months after surgery. Quantitative data were compared by Mann-Whitney U test, and categorical data were compared by χ2 test and non-inferiority test. Results: A total of 80 subjects were included in the trial (41 in the experimental group and 39 in the control group), including 27 males and 53 females, aged (M(IQR)) 55(23) years (range:40 to 78 years). There were 48 cases of left lower limb and 32 cases of right lower limb. The technical success rate and system control performance between the groups were 100%.The incidence of adverse events (58.5% (24/41) vs. 61.5% (24/39), χ2=0.075, P=0.784), and the incidence of SAE (7.3% (3/41) vs. 5.1% (2/39), χ2=0.163, P=0.686) within 6 months after surgery in experimental group and control group had no statistical significance. There was one device-related adverse event in each of the two groups. In the experimental group, one patient developed endovenous heat-induced thrombosis after surgery and recovered after taking rivaroxaban tablets. One patient in the control group had pain in the upper right thigh for more than 1 day after operation, which was cured after using analgesic cream. No device-related SAE occurred. The venous closure rate of the experimental group was 100% (38/38) at 6 months after surgery, and that of the control group was 97.4% (37/38). The difference between the two groups was 2.63% (95%CI:-3.19 to 8.45, Z=4.865, P<0.01), and the 95%CI lower limit of the difference in target venous closure rate between two groups was greater than the non-inferiority threshold of -10.00%. Conclusion: The early application effect of the new domestic intravenous radiofrequency closure system in patients with primary varicose veins of lower extremities is in line with expectations, it is not inferior to the imported system.

The implication of diabetes metabolomics in the early diagnosis and pathogenesis of pancreatic cancer.

The aim of this study was to analyze metabolite differences in pancreatic cancer and diabetic patients, to better diagnose these diseases. Gas chromatography-mass spectrometry was used to evaluate the metabolomic differences in blood samples of 50 pancreatic patients, 50 diabetic patients and 50 healthy people. Metabonomic data was analyzed with primary component analysis and discriminant analysis. The results show that pancreatic cancer patients, diabetic patients and healthy people can have significantly distinct metabolite profiles. Upregulated metabolites in the serum of the diabetic group included sugars (glucose, fructose), cholesterol, tyrosine and phosphoric acid and other substances, and down-regulation was observed in lactic acid, glycine, alanine, glutamine, proline, citric acid and other substances. It is indicated that identification of the most common changes in specific markers between the two diseases, can provide a new perspective and experimental basis for a better understanding of the metabolic differences and the pathogenesis of the two diseases in future. The present study sheds new light on the diagnosis of pancreatic cancer and diabetes.

Laboratory values improve predictions of hospital mortality.

OBJECTIVE: To compare the precision of risk adjustment in the measurement of mortality rates using: (i) data in hospitals' electronic discharge abstracts, including data elements that distinguish between comorbidities and complications; (ii) these data plus laboratory values; and (iii) these data plus laboratory values and other clinical data abstracted from medical records. DESIGN: Retrospective cohort study. SETTING: Twenty-two acute care hospitals in St Louis, Missouri, USA. STUDY PARTICIPANTS: Patients hospitalized in 1995 with acute myocardial infarction, congestive heart failure, or pneumonia (n = 5966). MAIN OUTCOME MEASURES: Each patient's probability of death calculated using: administrative data that designated all secondary diagnoses present on admission (administrative models); administrative data and laboratory values (laboratory models); and administrative data, laboratory values, and abstracted clinical information (clinical models). All data were abstracted from medical records. RESULTS: Administrative models (average area under receiver operating characteristic curve=0.834) did not predict death as well as did clinical models (average area under receiver operating characteristic curve=0.875). Adding laboratory values to administrative data improved predictions of death (average area under receiver operating characteristic curve=0.860). Adding laboratory data to administrative data improved its average correlation of patient-level predicted values with those of the clinical model from r=0.86 to r=0.95 and improved the average correlation of hospital-level predicted values with those of the clinical model from r=0.94 for the administrative model to r=0.98 for the laboratory model. CONCLUSIONS: In the conditions studied, predictions of inpatient mortality improved noticeably when laboratory values (sometimes available electronically) were combined with administrative data that included only those secondary diagnoses present on admission (i.e. comorbidities). Additional clinical data contribute little more to predictive power.

[The spermicidal activity of fish oil, polyunsaturated fatty acids and their sodium salts].

PIP: The chief polyunsaturated fatty acids and unsaturated acids known to exist in fish oil are: docosahexaenoic acid, eicosapentaenoic acid, arachidonic acid, linolenic acid, linoleic acid, oleic acid, and docosenoic acid. They have been made into emulsions of pluronic F68-physiological saline and sodium salts physiological saline solutions. Following that, the action of their spermicidal activities in vitro occurred. Emulsion and sodium salt solutions of docosahexaenoic acid had the strongest spermicidal activity observed. The most efficient concentration was 0.001 mM, similar to that of propranolol. In line for most efficient after that were eicosapentaenoic acid, arachidonic acid, oleic acid, and docosenoic acid. The experimental results indicated that the spermicidal activity of fatty acid was intensified with the increase of the unsaturated bond. Besides, the most efficient concentration of either morrhuic acid or sodium morrhuate was 0.1%. Therefore, they contained more docosahexaenoic acid and eicosapentaenoic acid and were ideal spermicides in vitro. The spermicidal mechanism of fatty acids may be related to the potential action of the carboxyl group. (author's modified)^ieng