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1.
国际癌症研究机构(International Agency for Research on Cancer,IARC)于2021年5月出版了《WHO胸部肿瘤分类(第5版)》。与2015年出版的《WHO胸部肿瘤分类(第4版)》相比,《WHO胸部肿瘤分类(第5版)》变更了主要章节的框架,新增和调整部分疾病的命名和分类,并充实了流行病学、病因学、组织病理学和分子遗传学等相关内容。现就《WHO胸部肿瘤分类(第5版)》中胸膜、心包及胸腺肿瘤分类变化较大的内容予以简要介绍。  相似文献   
2.
目的 评估牛心包补片用于人眼后巩膜加固术的安全性和生物相容性.方法 回顾性系列病例研究.分析2006年1月至2014年10月在上海和平眼科医院行后巩膜加固术的进展性轴性近视连续病例377例(670眼),其中应用牛心包生物补片组182例(330眼),年龄3~64岁,等效球镜度-6.00~-30.00 D,应用同种异体硬脑膜组195例(340眼),年龄3~61岁,等效球镜度-6.00~-33.00 D,随访时长为至少6个月.所有患者均行常规眼部检查,部分患者还行眼部高频B超检查.采用卡方检验对计数资料进行分析.结果 牛心包补片组和硬脑膜组术后6个月最佳矫正视力提高的分别有105眼(31.8%)和119眼(35.0%),不变的有209眼(63.3%)和205眼(60.3%),下降的有16眼(4.8%)和16眼(4.7%),组间差异均无统计学意义(x2=0.765,P>0.05).术后第1天2组发生球结膜水肿的分别有225眼(68.2%)和258眼(75.9%),组间差异有统计学意义(x2=4.935,P<0.05).2组病例在术后6个月内均未出现感染、视网膜脱离、眼内出血、斜视/斜视加重及复视等并发症.牛心包补片组有1例出现双眼排异反应,而硬脑膜组有1例1眼出现排异反应,差异无统计学意义(发生率分别为0.61%和0.29%,P>0.05).行眼部高频B超检查的硬脑膜组有术后至少6年患者10例19眼,均检测到加固条带,而且未见条带钙化;牛心包补片组有术后6~12个月患者15例28眼,均检测到加固条带,而且厚度正常,出现部分钙化的有3眼(P>0.05).结论 牛心包补片应用于人眼后巩膜加固术具有良好的安全性、生物相容性和耐降解性.  相似文献   
3.
ObjectiveGraft infections are rare but serious complications of vascular operations. The aim of this study was to evaluate the results of in situ reconstruction with bovine pericardium in infected aortic and peripheral vessel fields.MethodsA retrospective cohort study was conducted with a focus on the treatment of infected grafts with bovine pericardium. We retrospectively reviewed 19 consecutive patients with prosthetic graft infections and in situ repair with bovine pericardium. All operations were done between March 2015 and January 2018. No other materials were used. Excision of the infected graft, radical débridement of the infected tissue, and in situ reconstruction with bovine pericardium were applied in all patients. Short-term outcomes including primary patency, freedom of reinfection, mortality, and complication rates were analyzed.ResultsBovine pericardium was used in 19 patients (84% male) with a median age of 70 years (range, 56-84 years) to reconstruct the descending aorta (n = 1), abdominal aorta (n = 5), iliac artery (n = 4), and femoral artery (n = 9). Graft infections were observed in all patients (one thoracic endovascular aneurysm repair, three infrarenal endovascular aneurysm repairs, two open aortic repairs, four iliac-femoral reconstructions, and nine femoral reconstructions including two closure device infections after coronary angiography). Ten patients (53%) had a complication perioperatively and postoperatively. The 30-day mortality was 10.5%; the total mortality rate after 1 year was 32%. There was no reinfection after bovine reconstruction observed in our cohort. Graft occlusions were detected in two cases during follow-up (median, 6 months; range, 1-47 months).ConclusionsBovine pericardium reconstruction shows a good short-term outcome after aortic or peripheral graft infections. It is associated with good patency, low reinfection rate, and acceptably low early mortality rate. It can be a good therapeutic option in prosthetic graft infections when in situ repair with a prosthetic (even soaked) or autologous vein or homograft is not recommended or is not possible.  相似文献   
4.
目的探讨心外膜脂肪厚度、CT值及心脏外科与介入治疗狭窄冠脉研究(Syntax)评分与冠心病的关系。 方法选取2017年2月至2018年10月就诊于临沂市兰陵县人民医院心血管内科,经冠状动脉造影检查确诊的冠心病患者,共69例作为研究组,另选同期正常健康体检者60例作为对照组。两组均行冠状动脉CT血管成像(CTA)检查,比较心外膜脂肪厚度及CT值。分析冠心病患者造影结果,计算Syntax评分,比较不同水平Syntax评分冠心病患者心外膜脂肪厚度及CT值差异。 结果研究组患者甘油三酯[(1.62±0.68)mmol/L]、总胆固醇[(5.12±1.83)mmol/L]水平明显高于对照组[(1.50±0.53)mmol/L,(4.90±1.20)mmol/L](t=4.60,3.82;均P<0.05);研究组高密度脂蛋白胆固醇[(1.49±0.43)mmol/L]和低密度脂蛋白胆固醇[(2.45±0.63)mmol/L]水平与对照组[(1.50±0.55)mmol/L,(2.50±0.55)mmol/L]比较,均差异无统计学意义(t=0.55,0.34;均P>0.05)。研究组心外膜脂肪厚度[(12.30±2.66)mm]高于对照组[(9.50±1.85)mm](t=8.60,P<0.01);研究组心外膜脂肪CT值[(-98.60±15.66)HU]高于对照组[(-70.55±9.82)HU](t=19.36,P<0.01);低积分组冠心病患者心外膜脂肪厚度[(11.30 ± 2.20)mm]、心外膜脂肪CT值[(-90.60±9.55)HU]、平均Syntax评分[(-17.32±8.42)分]低于高积分组冠心病患者[(14.50±2.76)mm、(-115.30±13.36)HU、(-30.44±9.19)分],均差异有统计学意义(t=6.42,9.58,21.15;均P<0.01)。 结论心外膜脂肪厚度、CT值可能影响冠心病患者Syntax评分结果,可作为患者病情评估的参考指标,有推广价值。  相似文献   
5.
目的探讨不同组织来源的生物补片体内组织重塑的差异,并提供信息供临床选择生物补片时参考。 方法选取健康SD大鼠,随机分组,每组10处缺损,建腹壁肌部分层次缺损模型并以基底膜(basement membrane,BM)/小肠黏膜下层(small intestine submucosa,SIS)复合细胞外基质补片、SIS补片、真皮补片和心包补片修补,设立未修补组为空白对照。术后2、4、8、16周评价修复区血清肿发生、皱缩率、植入降解比例,取修复区组织做组织学切片分析补片内组织长入、新生血管化、周围组织包裹情况。 结果实验期内,BM/SIS复合细胞外基质补片未发生血清肿,基本维持植入面积,术后4周再生高度有序的新生胶原替代缺损区域,术后8周补片降解。术后2周,SIS补片的血清肿发生率为65%,修复区早期大量炎性细胞浸润,再生胶原组织有序性较差,术后8周补片降解,术后16周皱缩率为-52.0%±9.8%。50%的真皮补片细胞浸润补片中央,完全降解。其余真皮补片出现纤维囊包裹,细胞仅浸润交界区,修复区显著扩张,实验期内无降解。心包补片仅少量细胞浸润交界区,无组织长入,术后16周皱缩率为-29.5%±14.0%,出现致密纤维囊包裹,实验期内无降解。 结论与SIS补片、心包补片和真皮补片相比,BM/SIS复合细胞外基质补片具备优异的组织修补和再生疗效。  相似文献   
6.
7.

Introduction

Pericarditis is an inflammation of the pericardium. It may be infectious or secondary to a systemic disease. The aim of this study was to analyze the clinical findings, course, treatment and follow‐up of children diagnosed with pericarditis at our center.

Methods

We performed a retrospective analysis of all children admitted to our pediatric cardiology unit with pericarditis between 2003 and 2015. Patient characteristics were summarized using frequencies and percentages for categorical variables and medians with percentiles for continuous variables.

Results

Fifty patients were analyzed (40 male, 10 female) with a median age of 14 years. The most common diagnosis was acute pericarditis (80%). Thirty‐five patients (70%) presented with chest pain and 26% reported fever. Cardiomegaly was identified on chest X‐ray in 11 patients (22%), 30 patients (60%) had an abnormal ECG and 44 patients (80%) had alterations on the transthoracic echocardiogram. In 17 cases (34%) there was myocardial involvement. Forty‐eight percent of patients presented with infectious pericarditis and the pathologic agent was identified in half of them. Postpericardiotomy syndrome was diagnosed in five cases. The first‐line therapy was aspirin in 50% of cases. Pericardiocentesis was performed in 12 patients. The median length of stay was nine days. There was symptom recurrence in seven children.

Conclusions

In this study, acute infectious pericarditis was the most common presentation and about one third of patients also had myocarditis. The symptom recurrence rate was not negligible and is probably related to the type of therapy employed.  相似文献   
8.
Introduction and importancePericardial involvement due to gastric cancer is uncommon, especially when it is secondary to direct tumor infiltration. Its manifestation as cardiac tamponade is an exceptional situation that represents a challenge for the treating medical team.Case presentationa case of a patient with advanced gastric cancer with cardiopericardial infiltration, complicated with cardiac tamponade is reported. A narrative review of the diagnostic and therapeutic management was performed.Clinical discussionThere are no well-established diagnostic and therapeutic algorithms.ConclusionsIt is such an exceptional entity that most of the available bibliography is based on case reports or expert opinions. It is a situation with a very bad prognosis.  相似文献   
9.
We have developed a prototype, in?vitro anthropomorphic model for simulating pressure-guided, subxiphoid access procedures done to enable minimally invasive epicardial cardiac procedures including treatments for ventricular tachycardia. Life-size replicas of the heart and lungs were modelled using anatomically accurate surrogates. The dynamic pressure–frequency profiles of simulated pericardial fluid surrounding the water-pumped replica heart were measured and validated against previously acquired human intrapericardial pressure observations (Pearson's r?=?0.88, p?<?0.001). In replicating access procedures for approaching and entering the pericardial space, the system produced physiologically appropriate pressure measurements at each intermediate point along the needle's insertion pathway. Details of construction and performance are presented and discussed.  相似文献   
10.
目的探讨应用自体心包的改良二尖瓣成形术治疗小儿二尖瓣关闭不全的手术经验及临床效果。方法回顾性分析2005年1月至2012年1月我们收治的32例二尖瓣关闭不全患儿临床资料,年龄1~17岁,平均年龄(8.12±7.05)岁;单纯二尖瓣关闭不全14例,合并其他心血管畸形18例。其中中度二尖瓣关闭不全15例,重度17例。二尖瓣脱垂2例,瓣叶裂24例,二尖瓣环扩大32例。患儿均在全麻中低温体外循环下采用自体心包行改良二尖瓣成形术,同时矫正合并心血管畸形;术中均采用经左心室注水试验、心脏复跳后再次检查及停体外循环后测左房压等一系列方法评价成形效果。结果全组无一例手术死亡;术后早期死亡1例,于术后第2天死于低心排出量综合征。31例痊愈出院,完整随访28例,时间6~72个月,平均(42.10±9.50)个月。术后6个月超声心动图复查提示二尖瓣中度反流2例,心功能Ⅱ级,于术后1年再次行二尖瓣成形术。随访期间无死亡病例。除2例再次手术患儿外,其余获访患儿NYHA心功能评级均保持在I级,5年生存率96.8%,再手术率6.25%。结论应用自体心包的改良二尖瓣成形术治疗小儿尖瓣关闭不全具有预防后瓣环扩张和保留前瓣叶及其瓣环部分生长潜力的优点,同时能够保证二尖瓣开口的柔软性,再手术率相对较低,可获得良好疗效。  相似文献   
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