胶质肉瘤(gliosarcoma, GS)是指包含胶质母细胞瘤和肉瘤两种混合成分的原发中枢神经系统恶性肿瘤。在中枢神经系统肿瘤的广泛分类体系中,GS明确归属于胶质母细胞瘤的一个特殊亚型,具有胶质和间叶组织双向分化的恶性肿瘤,单克隆起源。这...胶质肉瘤(gliosarcoma, GS)是指包含胶质母细胞瘤和肉瘤两种混合成分的原发中枢神经系统恶性肿瘤。在中枢神经系统肿瘤的广泛分类体系中,GS明确归属于胶质母细胞瘤的一个特殊亚型,具有胶质和间叶组织双向分化的恶性肿瘤,单克隆起源。这一归类强调了其独特的病理特征和恶性程度,即该肿瘤具有显著的恶性肿瘤特性。在临床上,GS是一种罕见的高度恶性中枢神经系统肿瘤,被世界卫生组织(WHO)分类为IV级,其发病率在多形性胶质母细胞瘤中约占1.8%至8%。GS作为一种罕见的中枢神经系统恶性肿瘤,其影像学特征对于临床诊断和治疗规划至关重要。本文通过对一例GS患者的前后两次的影像学特征表现进行分析,并结合文献复习,探讨了GS的影像学特点及其在诊断和鉴别诊断中的价值。旨在提高本疾病的影像成像诊断水平及经验。Gliosarcoma (GS) is a primary central nervous system malignant tumor that contains both glioblastoma and sarcoma components. Within the extensive classification system of central nervous system tumors, GS is distinctly categorized as a special subtype of glioblastoma, a malignant tumor with bidirectional differentiation of glial and mesenchymal tissues, and monoclonal origin. This classification emphasizes its unique pathological characteristics and degree of malignancy, that is, the tumor has significant malignant tumor characteristics. Clinically, GS is a rare and highly malignant central nervous system tumor, classified by the World Health Organization (WHO) as grade IV, with an incidence rate of about 1.8% to 8% in glioblastoma multiforme. GS, as a rare malignant tumor of the central nervous system, its imaging characteristics are crucial for clinical diagnosis and treatment planning. This article analyzes the imaging features of a GS patient in two instances and reviews the literature to explore the imaging features of GS and their value in diagnosis and differential diagnosis. The aim is to improve the level of imaging diagnosis and experience of this disease.展开更多
目的:观察沙库巴曲缬沙坦治疗持续性房颤的临床效果以及对心脏结构的影响。方法:随机选择2023年1月至2023年12月至我院进行治疗的持续性房颤患者110例,使用随机数字法将患者分为观察组和对照组各55例,分别予以沙库巴曲缬沙坦 + 胺碘酮...目的:观察沙库巴曲缬沙坦治疗持续性房颤的临床效果以及对心脏结构的影响。方法:随机选择2023年1月至2023年12月至我院进行治疗的持续性房颤患者110例,使用随机数字法将患者分为观察组和对照组各55例,分别予以沙库巴曲缬沙坦 + 胺碘酮治疗和单独应用胺碘酮治疗。比较两组患者治疗后14 d电复律比例和随访1年复发率、超声检查治疗前后左心室和左心房结构变化,以及血流动力学变化。结果:观察组患者14 d电复律治疗率、6个月和1年房颤复发率分别为20.00%、10.91%和27.27%,均低于对照组的49.49%、25.45%和58.18% (χ2 = 10.292, P = 0.001;χ2 = 3.911, P = 0.048;χ2 = 10.736, P = 0.001)。两组患者治疗前左心房内径(left anterior descending, LAD)、左心房容积(left atrial volume, LAV)、左心房容积指数(left atrial volume index, LAVI)、左心房存储应变(left atrial strain during reservoir phase, LASr)、左心室射血分数(left ventricular ejection fraction, LVEF)、舒张末期内径(left ventricular end diastolic diameter, LVEDD)、收缩末期内径(left ventricular end systolic diameter, LVESD)水平均无明显差异(P > 0.05),治疗1年后,两组患者上述指标与治疗前相比均有组内差异(P P P > 0.05),治疗后两组患者心率与治疗前相比均降低(P t = 8.651;P Objective: To observe the clinical effect of sackubactril valsartan in the treatment of persistent atrial fibrillation and its effect on cardiac structure. Methods: A total of 110 patients with persistent atrial fibrillation who were treated in our hospital from January 2023 to December 2023 were randomly selected and divided into observation group and control group by random number method, 55 patients in each group were treated with sacubactril valsartan + amiodarone or amiodarone alone. The proportion of electro cardioversion at 14 days after treatment, the recurrence rate at 1 year follow-up, the structural changes of left ventricle and left atrium before and after ultrasound, and the hemodynamic changes were compared between the two groups. Results: The 14 d electro cardioversion rate, 6-month and 1-year atrial fibrillation recurrence rates in the observation group were 20.00%, 10.91% and 27.27%, respectively, which were lower than those in the control group (49.49%, 25.45% and 58.18%, χ2 = 10.292, P = 0.001;χ2 = 3.911, P = 0.048;χ2 = 10.736, P = 0.001). left anterior descending (LAD), left atrial volume (LAV), left atrial volume index (left atrial volume index), left anterior descending (LAD), left atrial volume index (LAV) LAVI), left atrial strain during reservoir phase (LASr), left ventricular ejection fraction (left ventricular ejection fraction, LASr) LVEF), left ventricular end diastolic diameter (left ventricular end diastolic diameter, There were no significant differences in LVEDD and left ventricular end systolic diameter (LVESD) levels (P > 0.05). After 1 year of treatment, there were intra-group differences in the above indicators between the two groups compared with before treatment (P P P > 0.05), and the heart rate of the two groups after treatment was lower than that before treatment (P P < 0.001). Conclusion: Sakubactril valsartan is beneficial to the recovery of sinus rhythm in patients with persistent atrial fibrillation, and long-term use can help the recovery of heart structure and reduce heart rate, but does not affect the blood pressure of patients, which has good clinical application value.展开更多
文摘胶质肉瘤(gliosarcoma, GS)是指包含胶质母细胞瘤和肉瘤两种混合成分的原发中枢神经系统恶性肿瘤。在中枢神经系统肿瘤的广泛分类体系中,GS明确归属于胶质母细胞瘤的一个特殊亚型,具有胶质和间叶组织双向分化的恶性肿瘤,单克隆起源。这一归类强调了其独特的病理特征和恶性程度,即该肿瘤具有显著的恶性肿瘤特性。在临床上,GS是一种罕见的高度恶性中枢神经系统肿瘤,被世界卫生组织(WHO)分类为IV级,其发病率在多形性胶质母细胞瘤中约占1.8%至8%。GS作为一种罕见的中枢神经系统恶性肿瘤,其影像学特征对于临床诊断和治疗规划至关重要。本文通过对一例GS患者的前后两次的影像学特征表现进行分析,并结合文献复习,探讨了GS的影像学特点及其在诊断和鉴别诊断中的价值。旨在提高本疾病的影像成像诊断水平及经验。Gliosarcoma (GS) is a primary central nervous system malignant tumor that contains both glioblastoma and sarcoma components. Within the extensive classification system of central nervous system tumors, GS is distinctly categorized as a special subtype of glioblastoma, a malignant tumor with bidirectional differentiation of glial and mesenchymal tissues, and monoclonal origin. This classification emphasizes its unique pathological characteristics and degree of malignancy, that is, the tumor has significant malignant tumor characteristics. Clinically, GS is a rare and highly malignant central nervous system tumor, classified by the World Health Organization (WHO) as grade IV, with an incidence rate of about 1.8% to 8% in glioblastoma multiforme. GS, as a rare malignant tumor of the central nervous system, its imaging characteristics are crucial for clinical diagnosis and treatment planning. This article analyzes the imaging features of a GS patient in two instances and reviews the literature to explore the imaging features of GS and their value in diagnosis and differential diagnosis. The aim is to improve the level of imaging diagnosis and experience of this disease.
文摘目的:观察沙库巴曲缬沙坦治疗持续性房颤的临床效果以及对心脏结构的影响。方法:随机选择2023年1月至2023年12月至我院进行治疗的持续性房颤患者110例,使用随机数字法将患者分为观察组和对照组各55例,分别予以沙库巴曲缬沙坦 + 胺碘酮治疗和单独应用胺碘酮治疗。比较两组患者治疗后14 d电复律比例和随访1年复发率、超声检查治疗前后左心室和左心房结构变化,以及血流动力学变化。结果:观察组患者14 d电复律治疗率、6个月和1年房颤复发率分别为20.00%、10.91%和27.27%,均低于对照组的49.49%、25.45%和58.18% (χ2 = 10.292, P = 0.001;χ2 = 3.911, P = 0.048;χ2 = 10.736, P = 0.001)。两组患者治疗前左心房内径(left anterior descending, LAD)、左心房容积(left atrial volume, LAV)、左心房容积指数(left atrial volume index, LAVI)、左心房存储应变(left atrial strain during reservoir phase, LASr)、左心室射血分数(left ventricular ejection fraction, LVEF)、舒张末期内径(left ventricular end diastolic diameter, LVEDD)、收缩末期内径(left ventricular end systolic diameter, LVESD)水平均无明显差异(P > 0.05),治疗1年后,两组患者上述指标与治疗前相比均有组内差异(P P P > 0.05),治疗后两组患者心率与治疗前相比均降低(P t = 8.651;P Objective: To observe the clinical effect of sackubactril valsartan in the treatment of persistent atrial fibrillation and its effect on cardiac structure. Methods: A total of 110 patients with persistent atrial fibrillation who were treated in our hospital from January 2023 to December 2023 were randomly selected and divided into observation group and control group by random number method, 55 patients in each group were treated with sacubactril valsartan + amiodarone or amiodarone alone. The proportion of electro cardioversion at 14 days after treatment, the recurrence rate at 1 year follow-up, the structural changes of left ventricle and left atrium before and after ultrasound, and the hemodynamic changes were compared between the two groups. Results: The 14 d electro cardioversion rate, 6-month and 1-year atrial fibrillation recurrence rates in the observation group were 20.00%, 10.91% and 27.27%, respectively, which were lower than those in the control group (49.49%, 25.45% and 58.18%, χ2 = 10.292, P = 0.001;χ2 = 3.911, P = 0.048;χ2 = 10.736, P = 0.001). left anterior descending (LAD), left atrial volume (LAV), left atrial volume index (left atrial volume index), left anterior descending (LAD), left atrial volume index (LAV) LAVI), left atrial strain during reservoir phase (LASr), left ventricular ejection fraction (left ventricular ejection fraction, LASr) LVEF), left ventricular end diastolic diameter (left ventricular end diastolic diameter, There were no significant differences in LVEDD and left ventricular end systolic diameter (LVESD) levels (P > 0.05). After 1 year of treatment, there were intra-group differences in the above indicators between the two groups compared with before treatment (P P P > 0.05), and the heart rate of the two groups after treatment was lower than that before treatment (P P < 0.001). Conclusion: Sakubactril valsartan is beneficial to the recovery of sinus rhythm in patients with persistent atrial fibrillation, and long-term use can help the recovery of heart structure and reduce heart rate, but does not affect the blood pressure of patients, which has good clinical application value.
