Cardiac angiosarcomas are highly aggressive, extremely rare malignancies with a poor prognosis. We report the case of a 39-year-old woman presenting with a right atrial angiosarcoma with perforation of the right atrium. There is almost always a diagnostic lag for cardiac angiosarcoma, leading to a poor prognosis. Cardiovascular sarcoma is one of the most invasive malignant tumors. Radical resection surgery as the core of comprehensive treatment presently is the best treatment plan.
Coronary artery bypass grafting (CABG) is the primary surgical treatment for coronary artery disease (CAD). However, long-term clinical practice has confirmed the poor long-term patency of saphenous vein grafts (SVG), prompting surgeons to investigate alternatives, such as the use of radial artery (RA) grafts. In this report, we review and discuss the current status of radial artery application during CABG and current controversies in the field. Ultimately, evidence indicates that RA-CABG is associated with good long-term patency and is suitable for patients with severe stenosis. However, the compensatory capacity of the ulnar artery should be assessed prior to RA harvesting. Given that the RA is prone to spasms, routine application of calcium channel blockers is recommended. Several studies also have indicated that sequential grafting is an effective method for maximizing radial artery application and that patency rates are similar for the radial artery and right internal mammary artery. In contrast, the use of the bilateral internal mammary arteries is technically more demanding and exhibits a significant volume-outcome relationship. The decision to use the right internal mammary artery or radial artery should be based on individual patient characteristics and the experience of the surgical team.
Purpose: The establishment of environmental courts in China provides a good opportunity to explores the economic effects of environmental justice reform. This paper investigates how the environmental justice reform can influence corporate green transformation from the perspective of green technology innovation and explores the potential mechanisms of how the environmental courts affect green technology innovation. The heterogeneous effects of environmental courts are also considered.Methodology: Using the establishment of environmental courts in China as a quasi-natural experiment, this paper adopts a difference-in-difference (DID) method to conduct empirical test based on data on Chinese listed A-shared firms from 2004 to 2019. Moreover, this paper use propensity score matching (PSM), tobit and negative binomial regression method to address possible estimation bias.Findings: The establishment of environmental courts significantly enhances green technology innovation among enterprises. The more effective judicial enforcement and better public awareness of the environment brought by the environmental courts will increase the cost of illegality and external supervision pressure for firms, which will lead firms to innovate in green technology. Furthermore, the positive and significant effect of environmental courts on green technology innovation is more pronounced in state-owned enterprises (SOEs) and enterprises located in regions where local protectionism is more serious or regions with more ideal environmental legal system.
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