目的：回顾性分析应用Pulsar-18支架治疗自发性孤立性肠系膜上动脉夹层（spontaneous isolated dissection of superior mesenteric artery,SIDSMA）的中期疗效。方法：回顾性分析了自2019年4月至2021年3月应用Pulsar-18支架治疗的SIDSM...
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目的：回顾性分析应用Pulsar-18支架治疗自发性孤立性肠系膜上动脉夹层（spontaneous isolated dissection of superior mesenteric artery,SIDSMA）的中期疗效。方法：回顾性分析了自2019年4月至2021年3月应用Pulsar-18支架治疗的SIDSMA患者的数据。收集患者的性别、年龄、基础疾病、影像学特征等基本信息，记录随访期内患者临床症状的改善情况、支架通畅率和血管重塑情况。结果：该研究纳入了45例患者，其中男性41例，女性4例。患者年龄为45～72岁，高血压患者的比例为48.89%(22/45)。手术成功率100%。45名病人共置入63枚支架，支架直径5～7 mm。围手术期无支架急性血栓等并发症。穿刺点血肿发生概率0%。支架置入3个月、6个月、1年、2年的通畅率均为100%；血管完全重塑率分别为64.4%、82.2%、82.2%和86.7%。1例患者术后第5个月因十二指肠溃疡出现血便，病因，经内镜止血后痊愈。其他患者在2年内无腹痛复发、无新发动脉瘤、无假腔增大。结论：Pulsar-18支架置入术是治疗SIDSMA的1种有效的治疗措施，能提供高血管完全重塑率，并在中期随访内有良好的通畅率。
下肢静脉曲张是血管外科常见疾病之一。手术是下肢静脉曲张的常用治疗手段,主要分为传统结扎剥脱术及微创腔内治疗技术。腔内热消融(Endovenous Thermal Ablation, EVTA)已逐步发展为一线治疗选择,但存在手术时间长、需要肿胀麻醉、热损伤相关并发症等问题。近十年以来兴起的氰基丙烯酸酯胶消融(Cyanoacrylate-glue Ablation, CAA)治疗下肢静脉曲张具有微创便捷、非热非肿胀、并发症发生率低、中远期闭合率高等优势,未来有望成为主流选择。本文就氰基丙烯酸酯胶(Cyanoacrylate Glue, CG)的发展、作用原理、疗效以及应用特点等方面进行综述。Lower extremity varicose veins are one of the common diseases in vascular surgery. Surgery is a common treatment, mainly categorized into traditional ligation-stripping and minimally invasive endovenous techniques. Endovenous thermal ablation (EVTA) has gradually developed into a first-line treatment option, but there are some problems, such as long operation time, need for tumescent anaesthesia and thermal injury related complications. In the last decade, Cyanoacrylate-glue Ablation (CAA) has emerged as a treatment choice for lower extremity varicose veins. CAA has the advantages of minimally invasive and convenient, non-thermal and non-tumescent, low incidence of complications, high medium and long-term closure rate, and is expected to become the mainstream choice in the future. This paper reviews the development, principles, curative effect and application characteristics of Cyanoacrylate Glue (CG).
目的分析Stanford B型主动脉夹层行胸主动脉腔内修复术(thoracic endovascular aortic repair,TEVAR)术后逆行性A型主动脉夹层(retrograde type A aortic dissection,RTAD)发生的相关危险因素,为防治RTAD提供参考。方法回顾性收集重庆...
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目的分析Stanford B型主动脉夹层行胸主动脉腔内修复术(thoracic endovascular aortic repair,TEVAR)术后逆行性A型主动脉夹层(retrograde type A aortic dissection,RTAD)发生的相关危险因素,为防治RTAD提供参考。方法回顾性收集重庆医科大学附属第一医院2017年1月至2023年6月期间因Stanford B型主动脉夹层行TEVAR且符合纳入和排除标准的患者,采用多因素logistic回归分析影响RTAD发生的风险因素,检验水准α=0.05。结果经过严格的纳入和排除标准后最终纳入176例患者,有7例患者发生RTAD,发病率为3.98%。多因素logistic回归分析结果显示,俯视观主动脉中心线夹角τ角度越大[OR(95%CI)=1.195(1.032,1.384)]及主动脉弓弯曲程度(头臂干近端点至左锁骨下远端点的曲线距离)越小[OR(95%CI)=0.756(0.572,0.999)],TEVAR后发生RTAD的概率越大(P<0.05)。结论从本研究结果看,对Stanford B型主动脉夹层行TEVAR治疗患者,术前细致评估主动脉弓的形态学特征[特别是主动脉中心线夹角τ角和主动脉弓弯曲程度(头臂干近端点至左锁骨下远端点的曲线距离)]并据此调整手术方式对降低RTAD的发病率至关重要。
肠道菌群具有调节乳腺癌发生发展并改善治疗的作用,本综述结合了近年来国内外相关研究试验,总结了相关研究进展,分析了肠道菌群通过DNA损伤、类固醇激素、代谢产物、免疫及炎症反应等机制参与乳腺癌的发生发展;详细阐述了肠道菌群对化疗、靶向治疗等新辅助治疗药物的相互作用;简单讨论了益生菌利用其关系在未来为乳腺癌的预防、诊断及治疗提供了新的思路。The gut microbiota plays a role in regulating the occurrence and development of breast cancer and improving treatment. This review integrates relevant domestic and foreign research trials in recent years, summarizes the related research progress, and analyzes the mechanisms by which the gut microbiota is involved in the occurrence and development of breast cancer, including DNA damage, steroid hormones, metabolites, immune, and inflammatory responses. It elaborates on the interactions between the gut microbiota and neoadjuvant therapeutic drugs such as chemotherapy and targeted therapy. Additionally, it briefly discusses how probiotics, leveraging these relationships, may provide new perspectives for the prevention, diagnosis, and treatment of breast cancer in the future.
下肢静脉曲张(VV)是一种常见疾病,表现为下肢的静脉扩张和曲张,通常伴随有疼痛、肿胀和不适等症状。该疾病的发生与多种因素有关,包括遗传、性别、年龄、肥胖和久站等。在诊断静脉曲张时,临床医生通常会考虑多种因素,包括患者的病史、体格检查和影像学检查。影像学检查在VV的诊断中起着关键作用,常用的影像学检查方法包括彩色多普勒超声、数字减影血管造影(DSA)、计算机断层扫描静脉成像(CTV)和磁共振静脉成像(MRV),需根据病人具体情况选择检查方式。VV的治疗方法包括保守治疗和手术治疗。保守治疗通常采用压迫疗法和药物治疗,旨在缓解症状和改善生活质量。手术治疗包括大隐静脉高位结扎、剥脱等外科手术、内源性激光消融(EVLA)、射频消融(RFA)、泡沫硬化疗法(UGFS)、和胶粘疗法(氰基丙烯酸酯粘合)等方式,这些方法可有效切除或阻止反流的隐静脉,进而缓解静脉功能不全症状,因其各自的优势均有广泛应用。VV诊断方式及手术方式的选择仍存在一些争议,需要进一步研究达成共识。Varicose veins (VV) of the lower extremities represent a prevalent medical condition characterized by the dilation and varicosity of veins in the lower limbs, frequently accompanied by symptoms such as pain, swelling, and discomfort. The etiology of this condition is multifactorial, with contributing factors including genetic predisposition, gender, age, obesity, and prolonged periods of standing. The diagnostic process for varicose veins typically involves a comprehensive assessment by the clinician, incorporating the patient’s medical history, physical examination, and relevant imaging studies. Imaging is integral to the diagnosis of varicose veins (VV), with frequently employed modalities including color Doppler ultrasound, digital subtraction angiography (DSA), computed tomography venography (CTV), and magnetic resonance venography (MRV). The selection of these imaging techniques is tailored to the individual patient. The management of VV encompasses both conservative and surgical approaches. Conservative management typically involves the use of compression therapy and pharmacological interventions aimed at alleviating symptoms and enhancing quality of life. Surgical interventions for venous insufficiency encompass a range of procedures, including high saphenous vein ligation, stripping, endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), and cyanoacrylate adhesive closure. These techniques are efficacious in eliminating or halting reflux in saphenous veins, thereby alleviating the
股腘动脉段狭窄闭塞是下肢动脉最常见的发病部位。介入治疗凭借微创、住院周期短等优点逐步成为了患者的首选治疗方式。但由于目前在手术过程中,远期股腘动脉通畅率仍不理想,因此,未来研究仍将重点放在提高股腘动脉通畅率方面。基于此,文章将会对当前腔内治疗的最新进展进行全面的综述,并且结合国内外相关的研究成果展开进一步的分析和探讨。The stenosis and occlusion of the femoropopliteal artery segment is the most common site of onset in lower extremity arteries. Interventional therapy has gradually become the preferred treatment method for patients due to its advantages, such as minimal invasiveness and short hospital stay. However, during the current surgical procedures, the long-term patency rate of the femoropopliteal artery is still not satisfactory. Therefore, future research will still focus on improving the patency rate of the femoropopliteal artery. Based on this, this article will comprehensively review the latest progress in current endovascular treatment and further analyze and discuss it in combination with relevant research results at home and abroad.
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