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目的探讨认知重构干预对急性心肌梗死(AMI)介入手术患者不良情绪及疾病感知的影响。方法72例AMI介入手术患者随机分为两组各36例,对照组给予常规护理干预,研究组在对照组基础上给予认知重构干预,比较两组的不良情绪、疾病感知以及治疗依从性。结果干预后,研究组的HAMA、HAMD评分均低于对照组,疾病感知各项评分均高于对照组(P<0.05)。研究组的治疗依从性为94.44%,高于对照组的75.00%(P<0.05)。结论认知重构干预对急性心肌梗死介入手术患者的不良情绪及疾病感知均有积极的影响,可提升患者的治疗依从性。 相似文献
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Chrystalle Katte Carreon Annachiara Benini Christopher Baird David Hoganson Michele Borisuk Sitaram Emani Sophie Hofferberth Robert F. Padera Stephen P. Sanders 《The Journal of thoracic and cardiovascular surgery》2019,157(1):342-350.e3
Objectives
Although valved venous homografts (VVHs) are used for establishing right ventricle-to-pulmonary artery continuity in some complex heart defects, the tissue changes that occur in situ have not been described. We review the gross and microscopic changes observed in explanted VVH conduits and their effects on functionality.Methods
In total, 20 explanted VVH conduits were evaluated for valve integrity, presence of thrombus, and stenosis. Hematoxylin and eosin– and trichrome-stained sections were reviewed for neointima formation, wall remodeling, inflammation, and calcification. Regurgitation and narrowing were assessed on pre-explant echocardiogram, and angiographic video clips were correlated with tissue findings. The source of the proliferating cells within the conduits was investigated by fluorescent in situ hybridization.Results
Thirteen male and 7 female infants underwent VVH implantation either as part of a composite Sano shunt (65%) or to establish right ventricle-to-pulmonary artery continuity in biventricular hearts (35%). The median duration of conduits in situ was 140 days (range: 98-340 days). Conduits were predominantly explanted for staged conversion to bidirectional Glenn (60%) and conduit upsizing (20%). The valves remained intact and functional in 75% of cases. Occlusive thrombosis was absent in all. Wall thickening due to neointima formation and wall remodeling was uniformly present and appeared to be driven by smooth muscle actin–expressing cells, which by fluorescent in situ hybridization are predominantly of recipient origin. Minimal calcification and mild adventitial chronic inflammation were present.Conclusions
Vein wall thickening is a uniform finding and can cause stenosis. The valves remain functional in most, and vein walls undergo remodeling with only minimal inflammation and calcification. 相似文献7.
Silent sinus syndrome (SSS) is a rare disorder involving bony remodeling of the maxillary sinuses, including collapse of the orbital floor. It is typically unilateral and seen in the setting of chronic maxillary sinusitis. Patients present with enophthalmos and hypoglobus occasionally accompanied by diplopia. The condition is generally diagnosed with CT imaging and treated surgically. While SSS is most often reported as very slowly progressive, we report a patient with evidence of significant remodeling of the maxillary sinus over a period of 5.5 months. 相似文献
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Paolo Fontana Francesco Fioravanti Passaretti Marianna Maioli Giuseppina Cantalupo Francesca Scarano Fortunato Lonardo 《World Journal of Medical Genetics》2020,9(1):1-11
Wiedemann-Steiner syndrome (OMIM #605130) is a rare congenital malformation syndrome characterized by hypertrichosis cubiti associated with short stature; consistent facial features, including long eyelashes, thick or arched eyebrows with a lateral flare, wide nasal bridge, and downslanting and vertically narrow palpebral fissures; mild to moderate intellectual disability; behavioral difficulties; and hypertrichosis on the back. It is caused by heterozygous pathogenic variants in KMT2A. This gene has an established role in histone methylation, which explains the overlap of Wiedemann-Steiner syndrome with other chromatinopathies, a heterogeneous group of syndromic conditions that share a common trigger: The disruption of one of the genes involved in chromatin modification, leading to dysfunction of the epigenetic machinery. 相似文献
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目的探讨特发性扩张型心肌病患者左心室逆重构(LVRR)的发生率、预测因素及预后。方法回顾性分析2014年1月至2017年5月于焦作市第二人民医院住院的51例特发性扩张型心肌病患者的一般临床资料和超声心动图数据,以复查时左心室射血分数(LVEF)绝对值增加10%以上的患者为LVRR组,LVEF绝对值增加低于10%的为NLVRR组。计算LVRR的发生率,采用logistic回归分析LVRR的预测因素,比较两组心力衰竭恶化再住院率,并采用Kaplan-Meier生存曲线法分析两组死亡率。结果特发性扩张型心肌病患者LVRR的发生率为51.0%(26/51)。LVRR的预测因素为心力衰竭病史<1年(OR=0.065,95%CI:0.007~0.562,P=0.013)和首次LVEF≥35%(OR=23.457,95%CI:2.687~204.770,P=0.004)。LVRR组的住院次数为2.8±2.9,NLVRR组为3.4±2.3,两组比较差异有统计学意义(P=0.003)。Kaplan-Meier生存曲线法分析显示,LVRR组患者的预后优于NLVRR组(95%CI:96.442~120.323和95%CI:69.909~98.364,P=0.017)。结论特发性扩张型心肌病患者的LVRR发生率为51.0%,心力衰竭病史小于1年和首次LVEF≥35%为其预测因素,此类患者预后改善。 相似文献