vascular lesions

血管病变
  • 文章类型: Journal Article
    这项研究旨在对口腔中的孤立性血管角化瘤病例进行综合审查,并报告一名39岁男性的新病例。使用PubMed使用了改进的PECOS策略,Embase,Scopus,WebofScience数据库,以及所选文章的参考列表。以英文发表的口腔孤立性血管角化瘤的病例报告,葡萄牙语,包括经组织病理学诊断但不存在系统性疾病的西班牙语语言。在确定的51篇文章中,18符合资格标准。孤立性血管角膜瘤有轻微的男性好发,发病率在生命的第四个十年达到高峰。舌头是最常见的定位(77.7%),其次是颊粘膜(11.1%),唇粘膜(5.6%),和扁桃体支柱(5.6%)。肉芽肿的外观是最常见的临床方面。94.4%的病例实施了手术切除。病灶预后良好,3~24个月无复发。总之,孤立性血管角化瘤是一种罕见的口腔病变。进行口腔诊断的专业人员应熟悉血管角化瘤的临床表现,并准备在色素性病变的鉴别诊断中考虑它,因为这些病变可能是全身性疾病的一部分。
    在线版本包含补充材料,可在10.1007/s12070-024-04631-w获得。
    This study aimed to perform an integrative review of solitary angiokeratomas cases in the oral cavity and to report a new case in a 39-year-old man. A modified PECOS strategy was used using PubMed, Embase, Scopus, Web of Science databases, and the reference lists of the selected articles. Case reports of oral solitary angiokeratoma published in English, Portuguese, and Spanish languages with histopathological diagnosis without the presence of systemic disorders were included. Of the 51 articles identified, 18 met the eligibility criteria. Solitary angiokeratomas have a slight male predilection, with a peak incidence in the fourth decade of life. The tongue was the most common localization (77.7%), followed by buccal mucosa (11.1%), labial mucosa (5.6%), and tonsillar pillar (5.6%). The granulomatous appearance was the most frequent clinical aspect. Surgical excision was implemented in 94.4% of the cases. The lesion presented a good prognosis, with no recurrence in 3 to 24 months. In summary, solitary angiokeratoma is a rare lesion in the oral cavity. The professional making the oral diagnosis should be familiar with the clinical manifestation of angiokeratoma and be prepared to consider it in the differential diagnosis of pigmented lesions since these lesions may be part of systemic disorders.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-024-04631-w.
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  • 文章类型: Journal Article
    两种最常见的儿童血管异常是婴儿血管瘤(IH)和葡萄酒色斑(PWS)。它们在出生后不久变得明显,但具有不同的病理生理学和临床表现。这项研究的目的是确定母亲的血管瘤或PWS病史是否与这些血管异常有关。我们评估了英国匿名电子病历数据库,其中包含儿童与其母亲之间的关联病历。Cox比例风险模型用于评估母亲因素与儿童IH或PWS发作时间之间的关联。在2004年至2021年之间,有639,085名儿童与母亲的医疗数据相关联,共进行了4,270,773人年的随访。与没有血管瘤的母亲相比,患有血管瘤的母亲所生的孩子患IH的可能性高60%以上(HR:1.64[1.07,2.52])。患有PWS的母亲所生的孩子与没有PWS的母亲所生的孩子相比,患有PWS的可能性高出近20倍(18.95[4.71,76.26])。患有血管瘤的母亲不太可能有PWS的孩子,而患有PWS的母亲也不太可能有IH的孩子。调整后,效果估计值变化最小。我们证明,患有血管瘤或PWS的母亲所生的孩子患IH或PWS的风险增加,分别。
    The two most prevalent childhood vascular abnormalities are infantile hemangioma (IH) and port-wine stain (PWS). They become apparent shortly after birth but have distinct pathophysiology and clinical manifestations. The goal of this study was to determine if mother\'s history of angioma or PWS is associated with these vascular abnormalities. We evaluated an UK anonymized electronic medical records database with medical records that were linked between children and their mothers. Cox proportional hazards models were used to evaluate the association between maternal factors and the time of onset of either IH or PWS in children. Between 2004 and 2021, 639,085 children were linked to their mom\'s medical data with a total of 4,270,773 person-years of follow up. Children born to mothers with an angioma as compared to a mother without an angioma were more than 60% more likely to have an IH (HR: 1.64 [1.07, 2.52]). Children born to mothers with a PWS as compared to children born to mothers without a PWS were nearly 20 times more likely to have a PWS (18.95 [4.71,76.26]). Mothers with angiomas were not more likely to have children with PWS and mothers with PWS were not more likely to have children with IH. The effect estimates were minimally changed after adjustment. We demonstrated that children born to mothers with angiomas or PWS were at increased risk of IH or PWS, respectively.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:大动脉炎(TAK)缓解和疾病活动的定义仍不清楚。血管成像是随访患者的重要工具。在这里,我们旨在比较TAK患者接受相同CT血管造影模式后,常规疾病缓解抗风湿药(cDMARDs)与生物DMARDs(bDMARDs)下血管病变(即血管壁增厚和狭窄)的演变情况.
    方法:我们使用CT血管造影比较了接受cDMARDs(n=40行)和bDMARDs(n=35行)的TAK患者的75行治疗方法。我们建立了1-3个主要靶血管,血管壁增厚和/或狭窄。在免疫抑制治疗开始时和12个月时测量每个目标血管的厚度和管腔直径。
    结果:我们观察到73%的病例动脉壁厚度总体减少,31%的病例壁厚度相对减少>25%。使用线性混合效应模型,一线免疫抑制治疗(p=0.012)和bDMARDs相对于cDMARDs(p=0.026)与TAK血管壁厚度减少独立相关.在免疫抑制治疗下,38%的狭窄血管的管腔直径相对增加>25%。与cDMARD相比,bDMARD的管腔直径相对增加>25%,分别为56%和17%。
    结论:免疫抑制治疗可降低TAK动脉壁厚度,扩大管腔直径。bDMARDs似乎比cDMARDs更有效地改善TAK的动脉病变。
    BACKGROUND: The definition of Takayasu arteritis (TAK) remission and disease activity is still unclear. Vascular imaging is an essential tool for following-up patients. Herein, we aimed to compare the evolution of vascular lesions (ie vessel wall thickening and stenosis) under conventional disease-modifying anti-rheumatic drugs (cDMARDs) relatively to biological DMARDs (bDMARDs) in TAK patients followed with the same CT angiography modalities.
    METHODS: We compared 75 lines of therapy in TAK patients who received cDMARDs (n = 40 lines) and bDMARDs (n = 35 lines) using CT angiography. We established 1-3 main target vessels with vessel wall thickening and/or stenosis. Every targeted vessel had its thickness and its lumen diameter measured at the initiation of immunosuppressive treatment and at 12 months.
    RESULTS: We observed an overall reduction of arterial wall thickness in 73% of cases and 31% had >25% of wall thickness relative decrease. Using a linear mixed effects model, first line immunosuppressive therapy (p= 0.012) and bDMARDs relatively to cDMARDs (p= 0.026) were independently associated with vessel wall thickness reduction in TAK. Thirty-eight percent of the stenotic vessels had a > 25% relative increase in lumen diameter under immunosuppressive therapy. The relative increase >25% in lumen diameter was noted in 56% vs 17% with bDMARDs compared with cDMARDs.
    CONCLUSIONS: Immunosuppressive treatments can reduce arterial wall thickness and widen lumen diameter in TAK. bDMARDs seems to be more effective than cDMARDs to improve arterial lesions in TAK.
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  • 文章类型: Journal Article
    背景:大血管病变是糖尿病患者死亡和残疾的主要原因,胆固醇和脂质的过度积累可导致血管内皮细胞的长期和反复损伤。脐带间充质干细胞(UCMSCs)可减轻1型糖尿病小鼠血管内皮损伤,而复方血栓通胶囊(FXC)对内皮功能有保护作用;FXC联合UCMSCs能否改善T2DM大血管病变及其作用机制尚不清楚。因此,本研究的目的是揭示FXC+UCMSCs在T2DM血管病变中的作用及其治疗T2DM的潜在机制。
    方法:对照组和T2DM组胃内给予等量的生理盐水,UCMSCs组尾静脉注射UCMSCs(1×106,用0.5mLPBS重悬细胞),FXC组胃内给药0.58g/kgFXC,UCMSCs+FXC组尾静脉注射UCMSCs(1×106),其次是FXC(0.58克/千克),八个星期。
    结果:我们发现FXCUCMSCs可有效降低脂质水平(TG,TC,和LDL-C)并改善T2DM大鼠的主动脉病变。同时,Nrf2和HO-1表达上调。我们证明抑制Nrf-2的表达可阻断FXCUCMSCs-CM对细胞凋亡和氧化应激损伤的抑制作用。
    结论:我们的数据表明,FXC+UCMSCs可能通过激活Nrf-2/HO-1通路减轻T2DM的氧化应激损伤和大血管病变。
    BACKGROUND: Macrovascular lesions are the main cause of death and disability in diabetes mellitus, and excessive accumulation of cholesterol and lipids can lead to long-term and repeated damage of vascular endothelial cells. Umbilical cord mesenchymal stem cells (UCMSCs) can attenuate vascular endothelial damage in type 1 diabetic mice, while Fufang Xueshuantong capsule (FXC) has a protective effect on endothelial function; however, whether FXC in combination with UCMSCs can improve T2DM macrovascular lesions as well as its mechanism of action are not clear. Therefore, the aim of this study was to reveal the role of FXC + UCMSCs in T2DM vasculopathy and their potential mechanism in the treatment of T2DM.
    METHODS: The control and T2DM groups were intragastrically administered with equal amounts of saline, the UCMSCs group was injected with UCMSCs (1×106, resuspended cells with 0.5 mL PBS) in the tail vein, the FXC group was intragastrically administered with 0.58 g/kg FXC, and the UCMSCs + FXC group was injected with UCMSCs (1×106) in the tail vein, followed by FXC (0.58 g/kg), for 8 weeks.
    RESULTS: We found that FXC+UCMSCs effectively reduced lipid levels (TG, TC, and LDL-C) and ameliorated aortic lesions in T2DM rats. Meanwhile, Nrf2 and HO-1 expression were upregulated. We demonstrated that inhibition of Nrf-2 expression blocked the inhibitory effect of FXC+UCMSCs-CM on apoptosis and oxidative stress injury.
    CONCLUSIONS: Our data suggest that FXC+UCMSCs may attenuate oxidative stress injury and macroangiopathy in T2DM by activating the Nrf-2/HO-1 pathway.
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  • 文章类型: Letter
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  • 文章类型: Letter
    致编辑的这封信与题为“基于深度学习模型自动检测具有不同出血风险的小肠(SB)病变”的研究有关。胶囊内窥镜检查(CE)是评估SB疾病的主要工具,但这是一个耗时的过程,错误率很高。CE中人工智能(AI)的发展可以简化医生的任务。Zhang等人的新深度学习模型似乎能够识别各种SB病变及其出血风险,它可以为下一步的前瞻性研究铺平道路,以更好地增强AI在临床实践中检测不同类型的SB病变的诊断支持。
    The present letter to the editor is related to the study with the title \"Automatic detection of small bowel (SB) lesions with different bleeding risk based on deep learning models\". Capsule endoscopy (CE) is the main tool to assess SB diseases but it is a time-consuming procedure with a significant error rate. The development of artificial intelligence (AI) in CE could simplify physicians\' tasks. The novel deep learning model by Zhang et al seems to be able to identify various SB lesions and their bleeding risk, and it could pave the way to next perspective studies to better enhance the diagnostic support of AI in the detection of different types of SB lesions in clinical practice.
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  • 文章类型: Journal Article
    阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是最常见的睡眠和呼吸障碍。这种综合征可诱发严重的心脑血管并发症,间歇性缺氧是造成这种损害的关键因素。血管病理与靶器官损伤密切相关,标志着当前研究的重点。血管病变是多器官疾病的基本病理生理基础,表明常见心脑血管疾病的共同致病机制。表明它们作为公共卫生问题的重要性。越来越多的证据表明OSAHS与血管病变之间存在很强的相关性。以前的研究主要集中在OSAHS本身的病理生理改变,例如间歇性缺氧和零散的睡眠,导致血管破裂.这篇综述旨在通过检查所涉及的微观病理生理机制来深入研究受OSAHS影响的血管病变。重点研究了OSAHS如何通过破坏内皮屏障诱导血管病变,代谢失调,细胞表型改变,神经内分泌紊乱,程序性细胞死亡,血管炎症,氧化应激和表观遗传修饰。这篇综述研究了OSAHS和血管疾病的流行病学和相关危险因素,随后描述了OSAHS在心血管疾病中引起的血管病变的现有证据。脑血管,视网膜,肾脏和生殖系统。详细介绍了当前有关介导OSAHS引起的血管病变的病理生理机制的研究,最终讨论了减轻OSAHS相关血管病变的治疗方式的研究进展以及这些治疗策略的意义。
    Obstructive sleep apnea-hypopnea syndrome (OSAHS) is the most prevalent sleep and respiratory disorder. This syndrome can induce severe cardiovascular and cerebrovascular complications, and intermittent hypoxia is a pivotal contributor to this damage. Vascular pathology is closely associated with the impairment of target organs, marking a focal point in current research. Vascular lesions are the fundamental pathophysiological basis of multiorgan ailments and indicate a shared pathogenic mechanism among common cardiovascular and cerebrovascular conditions, suggesting their importance as a public health concern. Increasing evidence shows a strong correlation between OSAHS and vascular lesions. Previous studies predominantly focused on the pathophysiological alterations in OSAHS itself, such as intermittent hypoxia and fragmented sleep, leading to vascular disruptions. This review aims to delve deeper into the vascular lesions affected by OSAHS by examining the microscopic pathophysiological mechanisms involved. Emphasis has been placed on examining how OSAHS induces vascular lesions through disruptions in the endothelial barrier, metabolic dysregulation, cellular phenotype alterations, neuroendocrine irregularities, programmed cell death, vascular inflammation, oxidative stress and epigenetic modifications. This review examines the epidemiology and associated risk factors for OSAHS and vascular diseases and subsequently describes the existing evidence on vascular lesions induced by OSAHS in the cardiovascular, cerebrovascular, retinal, renal and reproductive systems. A detailed account of the current research on the pathophysiological mechanisms mediating vascular lesions caused by OSAHS is provided, culminating in a discussion of research advancements in therapeutic modalities to mitigate OSAHS-related vascular lesions and the implications of these treatment strategies.
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  • 文章类型: Case Reports
    血管瘤是先天性的良性软组织肿瘤,由于血管的异常增殖而发生。血管瘤最常见的位置是皮下脂肪组织,但骨骼肌血管瘤非常罕见,占所有血管瘤的0.8%。通常,肌肉内病变常见于大腿区和小腿肌肉,在面部肌肉中相对罕见。长期的病变会导致静脉血栓,这可能会引起一些症状。这些孤立病变的常规治疗可能无法获得令人满意的结果。因此,手术切除病灶可获得美观的结果,复发几率低。在这篇文章中,我们报告了一例19岁患者的左咬肌肌内血管瘤,该病例通过完全手术切除成功治疗。
    Hemangiomas are benign soft tissue tumors which are congenital and occur due to abnormal proliferations of blood vessels. Most common location of hemangiomas is subcutaneous adipose tissue, but skeletal muscle hemangiomas are very rare which make up to 0.8% of all hemangiomas. Usually, the intramuscular lesions are common in thigh region and calf muscles and are relatively rare in the facial muscles. Long-standing lesions results in phleboliths, and this may cause some symptoms. Conventional treatment of these isolated lesions may not yield satisfactory results. Hence, surgical excision of the lesion in toto results in aesthetically pleasing results with low chances of recurrence. In this article, we report a case of a left masseter intramuscular hemangioma in 19-year-old patient which was successfully managed by complete surgical excision.
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  • 文章类型: Journal Article
    背景:海绵状瘤是具有遗传遗传的血管病变,可以在中枢神经系统上发现。每当这些病变位于雄辩的区域时,不建议手术切除。在这种情况下,伽玛刀立体定向放射外科(GKRS)可能是治疗患者的可行选择。因此,我们旨在探讨与该手术相关的结局.
    方法:我们基于Kaplan-Meier曲线对重建的事件发生时间数据进行了系统回顾和荟萃分析。在PubMed上进行了彻底的搜索,科克伦,WebofScience和Embase数据库针对通过Kaplan-Meier曲线提供与GKRS相关的出血结果信息的论文。
    结果:在特定数据库中进行系统搜索后,本综述纳入了7项研究.值得注意的是,共有1071例患者有1104例接受GKRS治疗的海绵体瘤.对手术后的短期和长期结果进行评估,估计2年的总体无事件率为89.8%(95%CI87.7-91.5),while,十年后,估计的总体无事件率为71.3%(95%CI67.2~75.1).
    结论:在早期和长期随访中,GKRS似乎是控制症状事件的良好选择。尽管未来的研究需要进一步的调查。
    BACKGROUND: Cavernomas are vascular lesions with a genetic heritage that can be spotted on the central nervous system. Whenever these lesions are localized in eloquent regions, surgical resection is not recommended. In this type of situation, Gamma Knife stereotactic radiosurgery (GKSRS) could be a feasible option for treating patients. Thus, we aimed to explore the outcomes associated with this procedure.
    METHODS: We performed a systematic review and meta-analysis of reconstructed time-to-event data based on Kaplan-Meier curves. A thorough search was conducted on PubMed, Cochrane, Web of Science, and Embase databases targeting papers that provided information regarding hemorrhagic outcomes associated with GKSRS through Kaplan-Meier curves.
    RESULTS: After a systematic search in the specific databases, seven studies were included in this review. Notably, a total of 1,071 patients had 1,104 cavernomas treated by GKSRS. Assessment of short-term and long-term post-procedure outcomes was performed, with the estimated overall events-free rate at 2 years being 89.8% (95% CI: 87.7-91.5), while, at 10 years, the estimated overall events-free rate was 71.3% (95% CI: 67.2-75.1).
    CONCLUSIONS: GKSRS seems to be a good alternative for the control of symptomatic events in early and long-term follow-up, despite the need for further investigation provided by future studies.
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