Arterial Shear Stress Reduces Eph-B4 Expression in Adult Human Veins

Vein graft adaptation to the arterial environment is characterized by loss of venous identity, with reduced Ephrin type-B receptor 4 (Eph-B4) expression but without increased Ephrin-B2 expression. We examined changes of vessel identity of human saphenous veins in a flow circuit in which shear stress could be precisely controlled. Medium circulated at arterial or venous magnitudes of laminar shear stress for 24 hours; histologic, protein, and RNA analyses of vein segments were performed. Vein endothelium remained viable and functional, with platelet endothelial cell adhesion molecule (PECAM)-expressing cells on the luminal surface. Venous Eph-B4 expression diminished (p = .002), Ephrin-B2 expression was not induced (p = .268), and expression of osteopontin (p = .002) was increased with exposure to arterial magnitudes of shear stress. Similar changes were not found in veins placed under venous flow or static conditions. These data show that human saphenous veins remain viable during ex vivo application of shear stress in a bioreactor, without loss of the venous endothelium. Arterial magnitudes of shear stress cause loss of venous identity without gain of arterial identity in human veins perfused ex vivo. Shear stress alone, without immunologic or hormonal influence, is capable of inducing changes in vessel identity and, specifically, loss of venous identity.     

Radiofrequency Catheter Ablation Of Atrioventricular Nodal Reentry Tachycardia In A Patient With Inferior Vena Cava Anomaly

Curative radiofrequency catheter modification of the slow pathway is the recommended therapy for patients suffering from recurrent symptomatic atrioventricular nodal reentry tachycardia. This is usually performed via femoral vein and the inferior vena cava (IVC). Presence of venous occlusion or complex venous anomaly involving the IVC may preclude this approach. Here, we report a case with a complex venous anomaly involving the inferior vena cava, who underwent electrophysiological study and successful radiofrequency ablation by an alternative approach.     

Enteric release of vasoactive intestinal peptide after a peptone meal in the dog

Vasoactive intestinal peptide (VIP) concentrations were measured by radioimmunoassay in plasma from portal and peripheral venous blood obtained from six alert, non-anesthetized dogs before and after gastric infusion of a 10% peptone meal. Mean basal portal and cephalic vein plasma VIP concentrations were $\text{42 ± 11.7}$ and $\text{42 ± 8.0}\text{(S.E.M.) pg/ml}$, respectively. No significant changes in peripheral venous plasma VIP concentrations were noted after the peptone meal throughout the duration of the collection period. In contrast, however, the mean VIP concentration in portal plasma increased promptly after the peptone meal with a peak of $\text{79 ± 8.2}\text{pg/ml}$ ($\text{P < 0.02}$) occurring 8 min after infusion of the meal. This was followed by a gradual decline in portal plasma VIP levels, with a return to prefeeding concentrations at 60 min ($\text{44 ± 6.3}\text{pg/ml}$). Results of these studies demonstrate that following gastric infusion of a peptone meal in the dog, portal, but not peripheral, plasma VIP concentrations increase significantly. Failure to detect augmentation of peripheral vein VIP levels after the meal is probably due to hepatic clearance of VIP.     

Analysis of finger vein variety in patients with various diseases using vein authentication technology

In finger vein authentication technology, near‐infrared rays penetrate the finger and are absorbed by the hemoglobin in blood. The veins appear as dark areas. The finger vein pattern images of patients with various diseases were acquired; a new evaluation method applying image processing technique (“E value”) was developed, and it was examined whether the patterns have any characteristics differentiating them from those of healthy volunteers. As a result, low E values appeared in systemic sclerosis, mixed connective tissue disease, Sjögren's syndrome, and polymyositis/dermatomyositis. No statistical reduction in E value was shown in patients with rheumatoid arthritis, pernio (without rheumatic diseases), arteriosclerosis obliterans, diabetes, hypertension, hypothyroidism and alopecia areata. This technology could be used for screening and evaluation of some diseases and their conditions with impaired peripheral venous circulation. E value may be useful as an indicator of venous circulation.      

CEAmRNA在大肠癌患者微转移早期预测中的意义

目的：大肠癌是最常见的恶性肿瘤之一,血行转移是大肠癌根治性手术失败的原因之一,在根治性切除肿瘤患者中,有大部分患者死于肿瘤的复发和转移,因此早期发现大肠癌微转移,对于延长患者预后指导下一步治疗具有重要意义。本研究已检测大肠癌患者外周血和引流静脉血中CEAmRNA的表达,以探索手术操作和微转移的关系,以及引流静脉血中微转移的发生与临床病理因素的关系,探讨早期发现大肠癌血循环微转移的意义。方法：应用逆转录多聚酶链式反应（RT-PCR）法检测大肠癌患者手术前,手术后外周血及引流静脉血液中的CEAmRNA水平。结果：（1）大肠癌患者术前外周血CEAmRNA阳性率26．7％（16／60）,引流静脉血阳性率48.3％（29／60）,引流静脉血明显高于外周静脉血（P〈0．05）。（2）大肠癌引流静脉血中CEAmRNA在肿瘤大于5厘米者、DukesC期、中低分化程度、有淋巴转移者、浸及浆膜者比外周静脉血更有统计学上的意义。（3）手术前后引流静脉血CEAmRNA阳性率具有显著差异（P〈O．05）,外周血CEAmRNA阳性率无显著差异。结论：大肠癌引流静脉血微转移是大肠癌肝转移的发生的早期阶段,引流静脉血CEAmRNA的表达能更早期反映出大肠癌患者微转移的发生,引流静脉微转移发生率与肿瘤分化程度、浸润深度、TNM分期、淋巴结转移、远处转移相关,是反映大肠癌生物学行为的指标之一,手术对大肠癌血循环微转移有促进作用。     

CEA mRNA在大肠癌患者微转移早期预测中的意义

目的:大肠癌是最常见的恶性肿瘤之一,血行转移是大肠癌根治性手术失败的原因之一,在根治性切除肿瘤患者中,有大部分患者死于肿瘤的复发和转移,因此早期发现大肠癌微转移,对于延长患者预后指导下一步治疗具有重要意义。本研究已检测大肠癌患者外周血和引流静脉血中CEA mRNA的表达,以探索手术操作和微转移的关系,以及引流静脉血中微转移的发生与临床病理因素的关系,探讨早期发现大肠癌血循环微转移的意义。方法:应用逆转录多聚酶链式反应(RT-PCR)法检测大肠癌患者手术前,手术后外周血及引流静脉血液中的CEA mRNA水平。结果:(1)大肠癌患者术前外周血CEA mRNA阳性率26.7%(16/60),引流静脉血阳性率48.3%(29/60),引流静脉血明显高于外周静脉血(P0.05)。(2)大肠癌引流静脉血中CEA mRNA在肿瘤大于5厘米者、Dukes C期、中低分化程度、有淋巴转移者、浸及浆膜者比外周静脉血更有统计学上的意义。(3)手术前后引流静脉血CEAm RNA阳性率具有显著差异(P0.05),外周血CEA mRNA阳性率无显著差异。结论:大肠癌引流静脉血微转移是大肠癌肝转移的发生的早期阶段,引流静脉血CEA mRNA的表达能更早期反映出大肠癌患者微转移的发生,引流静脉微转移发生率与肿瘤分化程度、浸润深度、TNM分期、淋巴结转移、远处转移相关,是反映大肠癌生物学行为的指标之一,手术对大肠癌血循环微转移有促进作用。     

肺静脉口弧形指数与房颤消融术后复发的关系

目的:探讨肺静脉口弧形指数与心房颤动(房颤)导管消融术后复发的关系。方法:选取2008年2月至2011年3月在我院接受导管消融术的房颤患者120例,所有患者于术前3日内利用多排CT行左心房及肺静脉造影,并进行图像的三维重建。测量每条肺静脉前后径及上下径,并计算弧形指数(肺静脉前后径/肺静脉上下径)以描述肺静脉口形态。行射频消融治疗的房颤病人全部达消融终点,术后随访超过3个月,根据患者房性快速性心律失常(房颤、房扑或房速)的发生情况,将其分为治愈组和复发组,进行统计分析。结果:由弧形指数分析,四支肺静脉开口形态存在统计学差异(P0.05);房颤消融术后,53例病人复发。房颤消融术后复发患者的LIPV弧形指数与治愈者不同,差异有显著性(P0.05);两组患者的左上肺静脉(Left Superior Pulmonary Vein,LSPV),右上肺静脉(Right Superior Pulmonary Vein,RSPV),右肺下静脉(Right Inferior Pulmonary Vein,RIPV),的弧形指数比较差异不明显(P0.05)。结论:左下肺静脉形态的不一致性与房颤导管消融术复发有关。     

Association of the left common ostium with clinical outcome after pulmonary vein isolation in atrial fibrillation

IntroductionElectrical pulmonary vein isolation (PVI) is used for the invasive treatment of atrial fibrillation (AF). However, despite the procedure’s technical evolution, the rate of AF recurrence due to electrical reconnection of the PVs is high. The aims of this study was to assess the influence of left common pulmonary venous ostium (LCO) on clinical outcomes following PVI.MethodsRetrospective cohort of 254 patients who underwent the first procedure of PVI from the years 2013–2018 was assessed. Patients with persistent AF of long duration and extra-pulmonary focus associated with triggers for arrhythmia were excluded. Patients were stratified into two groups according to the presence of a LCO and received follow up for atrial tachyarrhythmia-free survival. The mean follow-up period was 28 ± 1.73 months.ResultsThe majority were men (68.5%), with a mean age of 54 ± 12 years. With respect to the atrial anatomy, LCO occurred in 23.6% of cases after pulmonary venous angiotomography. The arrhythmia-free survival rate was 79.5% in the follow-up period. The Cox regression model was utilized and the adjusted hazard ratio for LCO was 0.36 (95% CI 0.15–0.87; p = 0.02) in terms of age, body mass index, left atrium diameter, bi-directional blocking of the cavotricuspid isthmus, persistent AF, left ventricular ejection fraction adjusted model.ConclusionAnatomic abnormality with the presence of the LCO is present in a quarter of patients undergoing AF ablation, which is associated with a lower rate of arrhythmia recurrence in our population.     

Anatomy of the crocodilian spinal vein

The crocodilian spinal vein is remarkably robust yet historically overlooked. Using corrosion casting, we describe the anatomy of this vessel and its connections with the caval and hepatic venous systems in representatives from four crocodilian genera. The spinal vein arises from an enlarged occipital sinus over the medulla and extends the entire length of the vertebral column. Unlike in squamate reptiles, the spinal vein is single (nonplexiform), voluminous, and situated dorsal to the spinal cord, and plexi lateral to the cord span between emerging intercostal veins. The connections with the other venous systems are otherwise similar to those in other tetrapods. The overall anatomy of this vessel and its abundant connections with the other venous systems indicate it likely plays a primary role in returning blood to the heart from all parts of the body. Preliminary studies of function suggest that this vessel could also play an adaptive role during basking and diving.     

A morphological study of the vertebral venous plexus and its connections in the Cape dune mole‐rat,Bathyergus suillus (Bathyergidae)

Bathyergus suillus are subterranean rodents found in the Western Cape of South Africa, where they inhabit sandy, humid burrows. Vertebral venous plexuses around the vertebral column have been implicated in aiding the maintenance of a constant central nervous system temperature via its connections with muscles and interscapular brown adipose tissue. The morphology of the vertebral venous plexuses and its connections in B.suillus were investigated. Frozen (n = 10) animals were defrosted; the venous system injected with latex and the vertebral venous plexuses, azygos‐ and intercostal veins dissected along the dorsal and ventral aspects of the vertebral column. Specimens (n = 4) were used for histological serial cross sections of the thoracic vertebrae. Veins drained from the interscapular brown adipose tissue to the external vertebral venous plexus, via a dorsal vein at the spinous process of T2 which might represent the “vein of Sulzer” described in rats. The intercostal veins cranial to the level of T8 drained directly into the ventral external vertebral venous plexus instead of into the azygos vein as seen in rats. The azygos vein was situated ventrally on the thoracic vertebral bodies in the median plane as opposed to most rodents that have a left sided azygos vein. The internal vertebral venous plexus consisted of two ventrolateraly placed longitudinal veins in the spinal epidural space. Veins from the forelimbs entered the internal vertebral venous plexus directly at the levels of C7 and T1 and have not been described in other rodents. Serial histological sections, revealed no regulatory valves in vessels leading toward the internal vertebral venous plexus, allowing blood to presumably move in both directions within the vertebral venous plexus. The vertebral venous plexus of B. suillus shows similarities to that of the rat but the vessels from the forelimbs draining directly into to the internal vertebral venous plexus and the position of the azygos vein and the intercostal veins draining into the external vertebral venous plexus are notable exceptions. J. Morphol., 2011. © 2010 Wiley‐Liss, Inc.     

Venous and arterial endothelial proteomics: mining for markers and mechanisms of endothelial diversity

Endothelial cells (ECs) line the inside of arterial and venous blood vessels in a continuous monolayer and have the important function of responding to environmental cues to regulate vascular tone and new blood vessel formation. They also have well-defined roles in supporting tumorigenesis, and alterations in their function lead to cardiovascular disease. Consequently, ECs have been studied extensively as a cellular model of both normal and abnormal physiology. Despite their importance and the increased utility of proteomic tools in medical research, there are relatively few publications on the topic of vascular endothelial proteomics. A thorough search of the literature mined 52 publications focused exclusively on arterial and/or venous endothelial proteomics. These studies mostly relied upon examination of whole-cell lysates from cultured human umbilical vein ECs to investigate in vitro effects of various molecules, such as VEGF in the context of altering human umbilical vein EC functions related to angiogenesis. Only a few of these publications focused solely on a proteomic characterization of ECs and our analysis further revealed a lack of published studies incorporating proteomic analysis of freshly isolated ECs from tissues or in vitro conditions that mimic in vivo variables, such as oxygen tension and shear stress. It is the purpose of this article to account for the diversity of vascular EC proteomic investigations and comment on the issues that have been and should be addressed in future work.     

Distribution of the pulmonary artery and vein in the chimpanzee lung

Lungs of two chimpanzees (Pan troglodytes) were examined. The right pulmonary artery runs across the ventral side of the right upper lobe bronchiole and, then across the dorsal side of the right middle lobe bronchiole. Thereafter, it runs between the dorsal bronchiole system and the lateral bronchiole system, along the right bronchus. During its course, it gives off arterial branches which run along each bronchiole. The left pulmonary artery runs across the dorsal side of the left middle lobe bronchiole and then between the dorsal bronchiole system and the lateral bronchiole system. The branches of the pulmonary artery run mainly along the dorsal or lateral side of the bronchiole. The pulmonary veins run mainly along the ventral or medial side of the bronchioles, and between them. Finally, they enter the left atrium with four large veins, i.e. the common trunk of the right upper lobe vein and the right middle lobe vein, right lower lobe pulmonary venous trunk, left middle lobe vein, and left lower lobe pulmonary venous trunk.     

The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire

The supraclavicular fossa ultrasound view can be useful for central venous catheter (CVC) placement. Venipuncture of the internal jugular veins (IJV) or subclavian veins is performed with a micro-convex ultrasound probe, using a neonatal abdominal preset with a probe frequency of 10 Mhz at a depth of 10-12 cm. Following insertion of the guidewire into the vein, the probe is shifted to the right supraclavicular fossa to obtain a view of the superior vena cava (SVC), right pulmonary artery and ascending aorta. Under real-time ultrasound view, the guidewire and its J-tip is visualized and pushed forward to the lower SVC. Insertion depth is read from guidewire marks using central venous catheter. CVC is then inserted following skin and venous dilation. The supraclavicular fossa view is most suitable for right IJV CVC insertion. If other insertion sites are chosen the right supraclavicular fossa should be within the sterile field. Scanning of the IJVs, brachiocephalic veins and SVC can reveal significant thrombosis before venipuncture. Misplaced CVCs can be corrected with a change over guidewire technique under real-time ultrasound guidance. In conjunction with a diagnostic lung ultrasound scan, this technique has a potential to replace chest radiograph for confirmation of CVC tip position and exclusion of pneumothorax. Moreover, this view is of advantage in patients with a non-p-wave cardiac rhythm were an intra-cardiac electrocardiography (ECG) is not feasible for CVC tip position confirmation. Limitations of the method are lack of availability of a micro-convex probe and the need for training.     

血浆D- 二聚体检测在下肢深静脉血栓诊断中的价值

目的:探讨血浆D-二聚体在下肢深静脉血栓形成(DVT)中的诊疗价值。方法:用SYS MEX CA2 1500全自动血凝分析仪检测185例可疑为DVT患者及60例健康体检者血浆中纤维蛋白降解产物D-二聚体水平,比较其D-二聚体水平与健康体检组的差别。结果:60例健康体检者及185例疑似DVT患者中18例患者血浆D-二聚体含量<临界值,经下肢彩色多普勒超声检查证实无一例患有DVT;167例患者血浆D-二聚体含量≥临界值,经下肢彩色多普勒超声检查证实DVT患者150例,D-二聚体检测DVT的敏感性、特异性、阳性预期值、阴性预期值分别为100%、51.43%、89.82%、100%。结论:血浆D-二聚体检测具有快速、经济、无创、可动态监测等优点,可以作为DVT诊断的排除试验,值得在临床检验诊断中推广应用。     

The manifestation of vortical and secondary flow in the cerebral venous outflow tract: An in vivo MR velocimetry study

Aberrations in flow in the cerebral venous outflow tract (CVOT) have been implicated as the cause of several pathologic conditions including idiopathic intracranial hypertension (IIH), multiple sclerosis (MS), and pulsatile tinnitus (PT). The advent of 4D flow magnetic resonance imaging (4D-flow MRI) has recently allowed researchers to evaluate blood flow patterns in the arterial structures with great success. We utilized similar imaging techniques and found several distinct flow characteristics in the CVOT of subjects with and without lumenal irregularities. We present the flow patterns of 8 out of 38 subjects who have varying heights of the internal jugular bulb and varying lumenal irregularities including stenosis and diverticulum. In the internal jugular vein (IJV) with an elevated jugular bulb (JB), 4Dflow MRI revealed a characteristic spiral flow that was dependent on the level of JB elevation. Vortical flow was also observed in the diverticula of the venous sinuses and IJV. The diversity of flow complexity in the CVOT illustrates the potential importance of hemodynamic investigations in elucidating venous pathologies.     

椎体静脉稀疏区注入骨水泥对PVP术中骨水泥渗漏的影响

目的:探讨椎体静脉稀疏区注入骨水泥对骨质疏松椎体压缩性骨折患者行经皮穿刺椎体成形术(percutaneous vertebroplasty,PVP)术中骨水泥渗漏的影响。方法:选择西安交通大学第二附属医院2014年1月至2018年6月收治的61例骨质疏松椎体压缩性骨折患者,根据骨水泥注入区域的不同,将所有患者分为A组(30例)及B组(31例),A组骨水泥注入区域为椎体静脉密集区(椎体中1/3平面处),B组骨水泥注入区域为椎体静脉稀疏区(椎体上1/3及下1/3平面处),对比两组的骨水泥渗漏率,术前、术后6个月时的视觉模拟评分(Visual analogue scale,VAS),治疗中的骨水泥用量、椎体高度恢复率及cobb角恢复度数。结果:B组的骨水泥渗漏率及骨水泥用量均明显低于A组(P0.05)。两组的VAS评分、椎体高度恢复率、cobb角恢复情况对比差异无统计学意义(P0.05)。结论:与椎体静脉密集区相比,在椎体静脉稀疏区注入骨水泥可显著降低骨质疏松椎体压缩性骨折患者PVP术中骨水泥渗漏率,椎体静脉稀疏区可作为PVP术中骨水泥注射的一个相对安全区域。     

Diminished hyperaemic response of the hepatic artery to portal venous occlusion (the buffer response) in Asian hybrid minipigs: a comparison of the response to that observed in dogs

The hyperaemic response of the hepatic artery to portal vein occlusion (the buffer response) and the action of exogenous adenosine upon hepatic artery blood flow was studied in Asian hybrid minipigs as a potential alternative experimental model to that previously developed in dogs. Adenosine produced a dose-dependent hepatic artery vasodilatation, but of lesser extent than that observed in dogs. A greatly diminished buffer response was observed in the pigs compared to that seen in dogs, and could not be replicated consistently. The adenosine uptake inhibitor dipyridamole did not potentiate responses to adenosine or the buffer response. It is concluded that the minipig is an unsuitable alternative model for the study of the hepatic artery buffer response.Abbreviations bw body weight - DPD dipyridamole - GDV gastroduodenal vein - HA hepatic artery - PV portal vein - PVO portal venous occlusion - PVP portal venous pressure - SE standard error     

对比分析四维容积超声及彩色多普勒超声在胎儿肺静脉异位引流诊断中的应用

摘要 目的：对比分析四维容积超声及彩色多普勒超声在胎儿肺静脉异位引流（APVC）诊断中的应用价值。方法：采用回顾性分析方法,2019年1月到2022年1月选择在本院进行诊治的胎儿肺静脉异位引流孕妇60例作为研究对象,都给予四维容积超声及彩色多普勒超声,记录影像学特征并判断诊断价值。结果：在60例孕妇中,彩色多普勒超声检查判断为胎儿肺静脉异位引流51例,诊断敏感性为85.0 %;四维容积超声检查判断为胎儿肺静脉异位引流59例,诊断敏感性为98.3 %,四维容积超声检查对胎儿肺静脉异位引流的诊断敏感性明显高于彩色多普勒超声检查（P<0.05）。彩色多普勒超声检查与四维容积超声检查诊断的特异性都为100.0%。在60例孕妇中,判断为胎儿肺静脉异位引流心上型32例,心下型28例;心上型的肺静脉引流途径为肺静脉-垂直静脉-右上腔静脉22例、肺静脉-垂直静脉-左上腔静脉10例,心下型的肺静脉引流途径为肺静脉-垂直静脉-左头臂静脉-右上腔静脉6例、肺静脉-垂直静脉-门静脉22例。合并心脏畸形32例,合并畸形率为53.3 %;有51例孕妇终止妊娠,9例孕妇继续妊娠,其中8例未经治疗者新生儿期死亡,1例在3月龄死亡。结论：相对于彩色多普勒超声,四维容积超声在胎儿肺静脉异位引流诊断中的应用可提高诊断敏感性,可有效反映肺静脉回流情况,可指导临床进行早期干预。     

Computational Phlebology: The Simulation of a Vein Valve

We present a three-dimensional computer simulation of the dynamics of a vein valve. In particular, we couple the solid mechanics of the vein wall and valve leaflets with the fluid dynamics of the blood flow in the valve. Our model captures the unidirectional nature of blood flow in vein valves; blood is allowed to flow proximally back to the heart, while retrograde blood flow is prohibited through the occlusion of the vein by the valve cusps. Furthermore, we investigate the dynamics of the valve opening area and the blood flow rate through the valve, gaining new insights into the physics of vein valve operation. It is anticipated that through computer simulations we can help raise our understanding of venous hemodynamics and various forms of venous dysfunction.     

Distribution of the pulmonary artery and vein in the lung of the white handed gibbon

The lungs of four white handed gibbons (Hylobates agilis) were examined. The right pulmonary artery runs across the ventral side of the right upper lobe bronchiole, and then traverses the dorsal side of the right middle lobe bronchiole. Thereafter, it runs along the dorso-lateral side of the right bronchus, between the dorsal bronchiole system and the lateral bronchiole system, and gradually follows the dorsal side of the right bronchus. During its course, it gives off arterial branches which run along each bronchiole. The left pulmonary artery runs across the dorsal side of the left middle lobe bronchiole and then along the left bronchus as in the right lung. The branches of the pulmonary artery run mainly along the dorsal or lateral side of the bronchiole, while the pulmonary veins run mainly the medial side of the bronchioles or between them. However, in a few portions, the pulmonary veins run the lateral side of the bronchioles. Finally, they enter the left atrium with four large veins i.e. the common trunk of the right upper lobe vein and right middle lobe vein, right lower lobe pulmonary venous trunk, left middle lobe vein, and left lower lobe pulmonary venous trunk.