Endovenous Microwave Ablation Versus Laser Ablation for Small Saphenous Vein Varicosis.

INTRODUCTION: Laser and radiofrequency ablation are two thermal ablation methods currently widely used to treat lower limb venous insufficiency. However, very few studies have been conducted on the use of microwaves, a form of thermal ablation, for the treatment of small saphenous vein (SSV) insufficiency. This study aimed to examine the efficacy and safety of endovenous microwave ablation (EMA) for the treatment of SSV insufficiency. METHODS: The clinical data of 126 patients (126 lower limbs) with SSV insufficiency (SSV trunk reflux time ≥ 500 ms on lower limb color Doppler ultrasound) treated at the Surgery Department of The Sixth People's Hospital of Zhuji from January 2020 to June 2022 were analyzed retrospectively; 64 patients underwent EMA and 62 underwent endovenous laser ablation (EVLA). The perioperative marker data [duration of surgery, duration of hospitalization, length of thermal ablation, duration of thermal ablation, number of incisions, and numerical pain rating scale (NPRS)], complication data [skin ecchymosis, skin burns, surgical site infection, paresthesia, deep vein thrombosis (DVT), and heat-induced thrombosis (EHIT)], venous clinical severity score (VCSS), chronic venous disease quality of life questionnaire (CIVIQ-20) before and 1, 3, 12 months after surgery, and SSV trunk occlusion rate at 12 months after surgery were compared between the two groups. RESULTS: No significant differences in the surgery or hospitalization durations were observed between the two groups. There were no significant differences in the length of the SSV that required thermal ablation between the two groups; however, the thermal ablation time was shorter in the EMA group than that in the EVLA group (6.14 ± 1.47 min vs 7.05 ± 1.16 min, P < 0.001). There were no statistical differences in the number of incisions, volume of tumescent solution used, or quantity of sclerosing foam used. The NPRS scores of the EMA group at 24 h and 72 h after surgery were significantly greater than those of the EVLA group (4.03 ± 0.98 vs 3.52 ± 1.28, P = 0.013; 3.78 ± 1.06 vs 3.15 ± 1.03, P = 0.001). Moreover, the two groups showed no significant difference in the NPRS score at 1 month (1.14 ± 0.84 vs 1.07 ± 0.75, P = 0.623). The EMA and EVLA group patients experienced similar postoperative complications. The VCSS and CIVIQ-20 score significantly improved at 1, 3, and 12 months after surgery. The VCSS and CIVIQ-20 scores were compared between the two groups at 12 months after surgery, and there were no significant differences (1.44 ± 0.63 vs 1.56 ± 0.56, P = 0.261; 24.24 ± 4.96 vs 25.19 ± 5.36, P = 0.304). There was no significant difference in the incidence of SSV trunk occlusion at 12 months after surgery between the two groups (95.31% vs 96.77%, OR 1.475; 95% CI 0.238-9.146, P = 1.000). CONCLUSION: EMA and EVLA are equally effective treatment methods for SSV insufficiency. EMA is associated with higher NPRS scores in the early postoperative period.

Metabolic profiling of patients with different idiopathic inflammatory myopathy subtypes reveals potential biomarkers in plasma.

Idiopathic inflammatory myopathy (IIM) are heterogeneous autoimmune diseases that primarily affect the proximal muscles. IIM subtypes include dermatomyositis (DM), polymyositis (PM), and anti-synthetase syndrome (ASS). Metabolic disturbances may cause irreversible structural damage to muscle fibers in patients with IIM. However, the metabolite profile of patients with different IIM subtypes remains elusive. To investigate metabolic alterations and identify patients with different IIM subtypes, we comprehensively profiled plasma metabolomics of 46 DM, 13 PM, 12 ASS patients, and 30 healthy controls (HCs) using UHPLC-Q Exactive HF mass spectrometer. Multiple statistical analyses and random forest were used to discover differential metabolites and potential biomarkers. We found that tryptophan metabolism, phenylalanine and tyrosine metabolism, fatty acid biosynthesis, beta-oxidation of very long chain fatty acids, alpha-linolenic acid and linoleic acid metabolism, steroidogenesis, bile acid biosynthesis, purine metabolism, and caffeine metabolism are all enriched in the DM, PM, and ASS groups. We also found that different subtypes of IIM have their unique metabolic pathways. We constructed three models (five metabolites) to identify DM, PM, ASS from HC in the discovery and validation sets. Five to seven metabolites can distinguish DM from PM, DM from ASS, and PM from ASS. A panel of seven metabolites can identify anti-melanoma differentiation-associated gene 5 positive (MDA5 +) DM with high accuracy in the discovery and validation sets. Our results provide potential biomarkers for diagnosing different subtypes of IIM and a better understanding of the underlying mechanisms of IIM.

In situ self-assembled macroporous interconnected nanosheet arrays of Ni-1,3,5-benzenetricarboxylate metal - organic framework on Ti mesh as high-performance oxygen evolution electrodes.

Highly efficient metal-organic framework (MOF)-based oxygen evolution reaction (OER) catalysts are desirable for water splitting, but their development remains challenging due to poor accessibility of coordinatively unsaturated metal (cum) sites and low intrinsic activity. A large-area three-dimensional (3-D) macroporous interconnected nanosheet array of Ni-1,3,5-benzenetricarboxylate has been in situ self-assembled on Ti mesh (TM) by using ethanol as the solvent and high-affinity oxide layer on TM to promote in situ nucleation. The obtained nanoarchitecture exhibits much superior catalytic activity compared to most reported catalysts including MOF-based catalysts, other precious-metal-free ones, and Ir/Ru-based ones. Additionally, this electrode undergoes no current decay after 300 cyclic voltammetry (CV) cycles and can maintain at 250 mA cm-2 for over 266 h. The excellent catalytic performance is mainly due to the 3-D macroporous and interconnected nanosheet array structure improving cum site exposure and charge transport and in situ activated cum cations enhancing OH- adsorption. This work not only develops a facile and economical approach to synthesize 3-D macroporous interconnected MOF nanosheet arrays to simultaneously increase the number, exposure, and intrinsic activity of active sites and facilitate charge transport for high-performance eletrocatalysis, but provides scientific insights into the mechanisms for self-assembly of this unique nanoarchitecture and for the high OER performance.

The efficacy and safety of low-molecular-weight heparin calcium combined with Xueshuantong injections in the treatment of elderly acute deep venous thrombosis patients.

OBJECTIVE: To explore the therapeutic effect of low-molecular-weight heparin calcium (LMWH-Ca) combined with Xueshuantong injections in treating elderly acute deep venous thrombosis (ADVT) patients, and to analyze the effect of this combination on the coagulation function, hemorheology, and safety. METHODS: A total of 122 elderly patients with ADVT who were treated in our hospital were recruited as the study cohort. The patients were randomly divided into a control group (n=61) and an observation group (n=61). The patients in the control group were given abdominal subcutaneous injections of low-molecular-weight heparin calcium (LMWH-Ca). The patients in the observation group were given intravenous drips of LMWH-Ca (low-molecular-weight heparin calcium) and Xueshuantong injections. After the treatment, comparisons of the detumescence times of the affected limb, the differences in the circumferences of the lower limbs, the coagulation parameters, the overall response rates, the incidences of complications, and the hemorheological parameters were conducted between both groups. RESULTS: After the treatment, the detumescence times and the average differences in the circumferences of the lower limbs were significantly reduced (P<0.001; all P<0.001), the prothrombin times (PT) and the activated partial thromboplastin times (APTT) were significantly extended (all P<0.01), the overall response rate was higher (all P<0.05), and the three hemorheological parameters (high shear viscosity, low shear viscosity, and plasma viscosity) were lower in the observation group than they were in the control group (all P<0.001), there were no statistical differences in the fibrinogen (FIB) levels, the incidences of complications, or the incidences of adverse drug reactions between the two groups (P>0.05; P=0.343; P=0.298). CONCLUSION: To sum up, low-molecular-weight heparin combined with Xueshuantong injections can effectively treat elderly ADVT patients, reduce the differences in the circumferences of the lower limbs, regulate the coagulation function, and improve the blood viscosity, so it is worthy of clinical promotion.