Publications by authors named "Ke-Lei Li"

18 Publications

  • Page 1 of 1

Venous malformations with severe localized intravascular coagulopathy treated with microwave ablation.

Vascular 2021 Jun 18:17085381211026829. Epub 2021 Jun 18.

Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Objectives: To evaluate the safety and feasibility of microwave ablation for treating venous malformations (VMs) with severe localized intravascular coagulopathy (LIC).

Patients And Methods: Data for patients with the diagnosis of VMs coupled with severe LIC who underwent color Doppler-guided microwave dynamic ablation between January 2017 and June 2019 were retrospectively reviewed and analyzed. All patients had previously received sclerotherapy or other treatments with poor outcomes and gradual aggravation of coagulation abnormalities. Microwave treatment with "dynamic ablation" was performed with real-time color Doppler monitoring and was repeated if necessary after 3 months. Low-molecular-weight heparin (LMWH) was used to control consumptive coagulopathy. The therapeutic efficacy including coagulation function and lesion size was evaluated using the four-level scale developed by Achauer.

Results: Among 15 patients with extensive diffuse or multiple VMs, 10 patients presented with lesions in a single lower extremity, one in both lower extremities and the perineum, one in both upper extremities and the trunk, and three with multiple lesions. The patients underwent a total of 74 microwave ablation sessions, with an average of 4.9 sessions per person. Coagulation abnormalities were temporarily aggravated in 59 sessions within the first seven days post-ablation but improved to grade II (fair) a week later. From six months to three years after the ablation, the lesions improved to grade IV (excellent) in one patient, grade III (good) in six patients, and grade II (fair) in eight patients. Moreover, the coagulation function improved to grade IV in four patients, grade III in eight patients, and grade II in three patients, resulting in an efficiency rate of 80% (12/15). Post-ablation complications included fever, hemoglobinuria, and elevations in aspartate aminotransferase, lactate dehydrogenase, and alanine aminotransferase. The patients with fever and hemoglobinuria recovered after specific therapeutic measures, but elevations in aspartate aminotransferase, lactate dehydrogenase, and alanine aminotransferase recovered spontaneously without further interventions.

Conclusions: Ablation coupled with anticoagulation can effectively treat VMs in patients with severe LIC and improve the long-term coagulation function.
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http://dx.doi.org/10.1177/17085381211026829DOI Listing
June 2021

Vitamin D and non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials.

Food Funct 2020 Sep;11(9):7389-7399

Institute of Nutrition & Health, Qingdao University, Qingdao, China. and Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China.

The results of randomized controlled trials (RCTs) investigating supplemental vitamin D on aminotransferases and cardio-metabolic risk factors in subjects with non-alcoholic fatty liver disease (NAFLD) have been inconsistent. The present study aimed to quantitatively evaluate whether supplementation with vitamin D has beneficial effects in treatment of NAFLD. A systematical literature search was performed with Cochrane Library, PubMed, Scopus databases and Web of Science up to June 2020. The mean changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and triglyceride (TAG) were calculated as standard mean difference (SMD) using a random-effects model. Pre-specified subgroup and univariate meta-regression analyses were performed to identify the sources of heterogeneity. Ten trials with a total of 544 NAFLD subjects were included for data synthesis. The summary estimates indicated that supplemental vitamin D significantly reduced the levels of serum/plasma fasting glucose (-0.22; 95%CI: -0.39, -0.04), insulin (-0.68; 95%CI: -1.22, -0.14) and HOMA-IR (-1.32; 95%CI: -2.30, -0.34), and marginally reduced the ALT (-0.18; 95%CI: -0.39, 0.04) and TAG (-10.38; 95%CI: -21.09, 0.34) levels. However, the pooled effect did not support that supplemental vitamin D was beneficial for concentrations of AST, TC, HDL-C and LDL-C. The present study provides substantial evidence that supplemental vitamin D has favorable effects on glycemic control and insulin sensitivity in NAFLD patients. Vitamin D could be as an adjuvant pharmacotherapy of NAFLD.
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http://dx.doi.org/10.1039/d0fo01095bDOI Listing
September 2020

Standards of care for Kasabach-Merritt phenomenon in China.

World J Pediatr 2021 Apr 26;17(2):123-130. Epub 2020 Aug 26.

Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.

Kasabach-Merritt phenomenon (KMP) is a rare disease that is characterized by severe thrombocytopenia and consumptive coagulation dysfunction caused by kaposiform hemangioendothelioma or tufted hemangioma. This condition primarily occurs in infants and young children, usually with acute onset and rapid progression. This review article introduced standardized recommendations for the pathogenesis, clinical manifestation, diagnostic methods and treatment process of KMP in China, which can be used as a reference for clinical practice.
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http://dx.doi.org/10.1007/s12519-020-00379-9DOI Listing
April 2021

Fruit and vegetable intake and liver cancer risk: a meta-analysis of prospective cohort studies.

Food Funct 2019 Aug 31;10(8):4478-4485. Epub 2019 Jul 31.

Institute of Nutrition and Health, Qingdao University, Qingdao, China.

The associations of vegetable and fruit intake with liver cancer risk have been inconsistent based on epidemiological studies. The present study aimed to quantitatively evaluate these associations with prospective cohort studies. A systematic literature search was performed with PubMed and Scopus databases up to June 2019. Multivariate-adjusted relative risks (RRs) with a corresponding 95% confidence interval (CI) for the highest versus lowest category were pooled by using a random-effects model. Pre-specified subgroup and univariate meta-regression analyses were performed to identify the sources of heterogeneity. Dose-response analysis was conducted by using the variance weighted least squares regression model. Nine independent prospective cohort studies with 1703 liver cancer events and 1 326 176 participants were included for data synthesis. The summary estimates showed that higher vegetable intake was associated with a 39% (95%CI: 0.50, 0.75) reduction in liver cancer risk, with no significant between-study heterogeneity (P = 0.057). Dose-response analysis indicated that the risk of liver cancer was reduced by 4% (95%CI: 0.97, 0.95; P for trend <0.001) with a 100 gram per day increment of vegetable intake. Subgroup analysis showed that higher intakes of vegetables were associated with a 50% (95%CI: 0.35, 0.72) reduction of liver cancer risk in males, but not in females. However, a non-significant association was found between fruit intake and liver cancer risk. The present study provides strong evidence that higher intakes of vegetables would have beneficial effects on the prevention of liver cancer, especially for males.
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http://dx.doi.org/10.1039/c9fo00804gDOI Listing
August 2019

Effects of EPA and DHA on blood pressure and inflammatory factors: a meta-analysis of randomized controlled trials.

Crit Rev Food Sci Nutr 2019 4;59(20):3380-3393. Epub 2019 Feb 4.

Institute of Nutrition and Health, Qingdao University, Qingdao, China.

The present study aimed to clarify whether eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have differential effects on blood pressure and inflammatory mediators. A systematic literature search was conducted in PubMed and Scopus updated to Apr. 2018. The mean changes in risk factors of chronic diseases were calculated as weighted mean difference (WMD) by using a random-effects model. Twenty randomized controlled trials (RCTs) were included. The summary estimate showed that EPA intervention significantly reduced systolic blood pressure (SBP) (-2.6 mmHg; 95%confident interval (CI): -4.6, -0.5 mmHg), especially in subjects with dyslipidemia (-3.8 mmHg; 95%CI: -6.7, -0.8 mmHg). The pooled effect indicated that supplemental DHA exerted a significant reduction in diastolic blood pressure (DBP) in subjects with dyslipidemia (-3.1 mmHg; 95%CI: -5.9, -0.2 mmHg). Both EPA (-0.56 mg/L; 95%CI: -1.13, 0.00) and DHA (-0.5 mg/L; 95%CI: -1.0, -0.03) significantly reduced the concentrations of C-reactive protein (CRP), respectively, especially in subjects with dyslipidemia and higher baseline CRP concentrations. Given that limited trials have focused on EPA or DHA intervention on concentrations of interleukin (IL)-6 and tumor necrosis factor (TNF)-α, further RCTs should be explored on these inflammatory factors. The present meta-analysis provides substantial evidence that EPA and DHA have independent (blood pressure) and shared (CRP concentration) effects on risk factors of chronic diseases, and high-quality RCTs with multi-center and large simple-size should be performed to confirm the present findings.
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http://dx.doi.org/10.1080/10408398.2018.1492901DOI Listing
February 2020

[Subsequent therapy for infantile hemangiomas after discontinuation of oral propranolol].

Shanghai Kou Qiang Yi Xue 2015 Dec;24(6):716-20

Department of Hemangiomas, Linyi Tumor Hospital. Linyi 276001,China.

Purpose: To summarize the subsequent therapy experiences for infantile hemangiomas after discontinuation of oral propranolol treatment, and explore the relationships between clinical interventions and types of infantile hemangioma.

Methods: In this retrospective study from January 2010 to May 2014, a total of 137 infants with hemangiomas undergoing sequential therapy after oral propranolol treatment. There were 41 males and 96 females. The median age was 16 months, ranging from 14 to 25 months. After oral propranolol treatment, the outcomes were evaluated to be grade III in 74 cases, grade IIin 62 cases and grade Ⅰ in 1 case. The types were papula (n=31), telangiectasis (n=11), plump (n=74), deep (n=12) and compound (n=9). The primary sites were 3 cases in scalp, forty-nine in face, thirty-three in trunk, thirty-eight in extremities. Cutis laxa presented in 45 cases, and parenchyma hypertrophy presented in 80 cases. Sequential therapy were performed including laser therapy for 38 cases, intralesional Pingyangmycin injection for 63 cases, and plastic surgery for 16 cases. The efficacy was re-evaluated on a 4-level scale, combined with evaluations of scar, cutis laxa or pigment alteration. SPSS18.0 software package was used for statistical analysis.

Results: Chi-square test showed significant differences between 5 types in occurrence of cutis laxa and parenchyma hypertrophy (x(2)=28.458,68.276, P<0.01). After a follow-up of 6 months to 4 years, the outcomes were evaluated to be grade IV in 122 cases, grade III in 15 cases, without grade IIor gradeⅠ case. There were significant differences in 5 types of infantile hemangiomas before and after sequential therapy( H=53.445, 9.941, 120.324, 17.000, 18.899, P<0.01). Postoperative scar was presented in 2 cases around to joints, and mild pigment alteration was noticed in 2 cases after intralesional Pingyangmycin injection.

Conclusions: Cutis laxa and parenchyma hypertrophy may be more likely present in infantile hemangiomas after oral propranolol treatment. Laser therapy is recommended for patients with papula or telangiectasis, when necessary, intralesional Pingyangmycin injection should be combined. Intralesional Pingyangmycin injection should be the first choice for plump or compound type,whereas surgery should be executed in patients with deep type or other plump type complicated by severe hyperplasia, after which combined intralesional Pingyangmycin injection may be required for postoperative superficial residues.
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December 2015

Propranolol inhibits angiogenesis via down-regulating the expression of vascular endothelial growth factor in hemangioma derived stem cell.

Int J Clin Exp Pathol 2014 15;7(1):48-55. Epub 2013 Dec 15.

Special Department of Vascular Anomalies, Linyi Tumor Hospital Linyi 276000, Shandong Province, China.

Background: Oral propranolol (PRN) has recently been shown to be highly effective for infantile hemangiomas (IHs), and is currently recommended as the first-line treatment of complicated IHs. However, the therapeutic mechanism(s) still remain unclear.

Methods: In this study, we tested hemangioma-derived stem cells for expression of vascular endothelial growth factor (VEGF) in vitro and studied the inhibition of VEGF expression. We used PCR, Elisa, Western blotting and immunohistochemistry in vivo and in vitro trial.

Results: The study demonstrated that application of PRN at a "normal" concentration equivalent to plasma concentration did not inhibit proliferation or promote apoptosis of hemangioma derived stem cells (HemSCs) isolated from IH patients. PRN suppressed expression of vascular endothelial growth factor (VEGF) and basic Fibroblast Growth Factor (bFGF) in HemSCs in vitro. Morphological, histological and immunohistological improvement were observed in vivo using murine IH model in which HemSCs pre-treated with PRN were implanted into BALB/c-nu mice. In the pre-treated HemSC grafts, mean micro-vessel density (MVD) significantly decreased and protein levels of VEGF markedly decreased, while bFGF was still detectable.

Conclusions: The results suggested PRN inhibited angiogenesis via down-regulating the expression of vascular endothelial growth factor in hemangioma derived stem cell. These findings provide critical insight into the potential mechanisms of PRN action on IH.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3885459PMC
September 2014

Preliminary study on plasma RPN concentration of patients with infantile hemangioma treated with propranolol.

Int J Clin Exp Med 2013 22;6(5):342-5. Epub 2013 May 22.

Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology Shanghai 200011, PR China.

Propranolol (PRN) has recently been recommended as the first-line medicine for complicated infantile hemangiomas (IHs), because of the significant effect. However, no pharmacokinetic parameters have ever been reported for infants who receive PRN treatment for IH. In this study, we show that plasma PRN concentration is affected by the frequency of administration of PRN. A single daily administration of PRN (1 mg/kg/d) resulted in an early elevation of plasma PRN compared to a twice a day administration of the same dose. In contrast, the twice a day application resulted in a more prolonged expression at a later time-point. Our findings provide pharmacokinetic parameters of PRN action in IH for clinic.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664000PMC
June 2013

CD133 selected stem cells from proliferating infantile hemangioma and establishment of an in vivo mice model of hemangioma.

Chin Med J (Engl) 2013 Jan;126(1):88-94

Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.

Background: Infantile hemangioma (IH) is the most common benign tumor in children with prevalence in the face and neck. Various treatment options including oral propranolol have been described for IH, but the mechanism of drugs remains enigmatic. The aim of this study was to investigate the pathogenesis and establish a reliable in vivo model of IH which can provide platform for drug exploration.

Methods: Stem cells from the proliferating hemangiomas (HemSCs) were isolated by CD133-tagged immunomagnetic beads. Their phenotype and angiogenic property were investigated by flow cytometry, culturing on Matrigel, real-time polymerase chain reaction (PCR), immunofluorescent staining and injection into BALB/c-nu mice.

Results: HemSCs had robust ability of proliferating and cloning. The time of cells doubling in proliferative phase was 16 hours. Flow cytometry showed that HemSCs expressed mesenchymal markers CD29, CD44, but not endothelial/hematopoietic marker of CD34 and hematopoietic marker CD45. The expression of CD105 was much lower than that of the reported hemangioma derived or normal mesenchymal stem cell (MSC). Real-time PCR showed that the mRNA levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and matrix metalloproteinase-1 (MMP-1) of HemSCs were higher than that of neonatal human dermal fibroblasts (NHDFs) and human umbilical vein endothelial cells (HUVECs). After HemSCs were cultured on Matrigel in vitro, they formed tube-like structure in a short time (16 hours) and differentiated into endothelial cells in 7 days. After 1 - 2 weeks of implantation into immunodeficient mice, HemSCs generated glucose transporter 1 positive blood vessels. When co-injected with HUVECs, the vascularization of HemSCs was greatly enhanced. However, the single implantation of HUVECs hardly formed blood vessels in BALB/c-nu mice (P < 0.05).

Conclusions: HemSCs may be some kinds of primitive mesoderm derived stem cells with powerful angiogenic ability, which can recapitulate human hemangioma by co-injecting into immunodeficient mice with HUVECs.
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January 2013

New treatment strategy for granulomatous epulis: intralesional injection of propranolol.

Med Hypotheses 2012 Feb 30;78(2):327-9. Epub 2011 Nov 30.

Department of Oral and Maxillofacial Surgery and Institute of Dental Medicine, Qilu Hospital of Shandong University, PR China.

Epulis is a relapsable lesion in gingiva without specific treatment for its unexplained pathogenesis. Nowadays, surgical excision is the most popular method of treatment. To prevent recurrence, it is necessary to resect diseased tissues thoroughly, and even to remove the involved teeth. However, this may cause functional and cosmetic deformities. Therefore, it is urgent to find a new therapy without severe side effects. Infantile hemangioma is a common benign pediatric tumor which shares many features with epulis, such as rich vascularity, high incidence of female patients, high hormone level and similar treatments. A recent study showed that propranolol, a beta adrenergic receptor (β-AR) antagonist, was effective as treatment for infantile hemangioma. Our preliminary work showed that mRNA and protein levels of β2-AR were higher in epulis than in adjacent tissue. Therefore, we hypothesize that intralesional injection of propranolol may be useful as epulis treatment. Further work need to be done to confirm the safety and therapeutic effect of the treatment. After that, this specific β2-AR antagonist may be the first choice for epulis treatment.
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http://dx.doi.org/10.1016/j.mehy.2011.11.013DOI Listing
February 2012

[Treatment of infantile parotid hemangioma with propranolol].

Zhonghua Kou Qiang Yi Xue Za Zhi 2010 May;45(5):292-4

Department of Hemangioma, Tumor Hospital of Linyi City, Linyi Shandong 276000, China.

Objective: To evaluate the short-term results and safety of propranolol for the treatment of infantile parotid hemangioma.

Methods: Oral propranolol was administered to 17 infants with parotid hemangioma at a dose of 1.0-1.5 mg per kilogram of body weight per day. The patients were revisited once a week. The changes of the tumor size, texture and colour were monitored and recorded at a regular interval. The adverse effects after medication were observed and managed accordingly. The short-term results were evaluated using a 4 scales system.

Results: Among the 17 patients treated, the follow-up time was 5 to 10 months. The overall response was scale I in 0 patient, scale II in 0 patients, scale III in 5 patients, and scale IV in 12 patients. No serious adverse effects were encountered.

Conclusions: Oral propranolol at a lower dose is a safe and effective method for the treatment of infantile parotid hemangioma. The short-term results were excellent and the side effects minimal.
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May 2010

[Treatment of infantile vascular malformations associated with airway obstruction].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010 Jan;45(1):32-7

Special Department of Hemangioma, Tumor Hospital of Linyi City. Linyi 276000, China.

Objective: To summarize the clinical features of vascular malformations complicated with airway obstruction and to evaluate the therapeutic methods of these disease.

Methods: Forty-seven children with airway obstruction and dyspnea (25 males, 22 females) were treated from Jun 1985 to Dec 2007, and their clinical data were retrospectively analyzed. Among 47 patients, there were 27 cases of venous malformations, 17 cases of macrocystic lymphatic malformations, and 3 cases of microcystic lymphatic malformations. Injection with absolute alcohol were performed in 20 patients with venous malformations, whereas both surgery and injection were performed in 7 patients with extensive or multiple lesions. Seventeen patients with macrocystic lymphatic malformations were treated with pingyangmycin injection. While surgery combined with pingyangmycin injection were used in other 3 patients with microcystic lymphatic malformations. According to the degree of airway obstruction and therapeutic conditions, tracheal intubation was performed in 27 patients, urgent preoperative tracheotomy was performed in 3 patients, prophylactic tracheotomy was performed in 2 patients, and postoperative tracheotomy was performed in 1 patient.

Results: Tracheal intubation was remained for 24 to 48 hours in 30 patients, whose intubation was removed successfully in 29 patients except 1 patient who occurred dyspnea after removal of tracheal intubation resulting in tracheotomy. Tracheal cannula was successfully removed in all 6 patients 3 weeks to 4 months after the tracheotomy. There were 9 patients treated once, whereas injections were repeated 2 to 5 times in 38 patients. Necrosis of mucosa occurred in 2 cases after the injection with absolute alcohol, while temporary hemoglobinuria one occurred in 1. There were 5 cases of light or mediate fever after the pingyangmycin injection who recovered well after the symptomatic treatment. Follow-up lasted 1 to 23 years, 38 patients cured, 9 patients valid, and no patient invalid.

Conclusions: It is suggested that sclerotherapy should be the first choice in the treatment of vascular malformations complicated with airway obstruction, in which absolute alcohol should be used in venous malformations compared to pingyangmycin in lymphatic malformations. Combined therapy should be carried out in patients with extensive lesions in order to shorten the course of treatment and to get good therapeutic result.
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January 2010

[Treatment of infantile hemangiomas with low-dose propranolol: evaluation of short-term efficacy and safety].

Zhonghua Yi Xue Za Zhi 2009 Dec;89(44):3130-4

Specialty Department of Hemangioma and Lymphangioma, Tumor Hospital of Linyi, Shandong Province, Linyi 276001, China.

Objective: To evaluate the short-term efficacy and safety of propranolol in the treatment of infantile hemangiomas.

Methods: Between October 2008 and May 2009, oral propranolol was applied to 58 infants with hemangiomas at a dose of 1.0 - 1.5 mg per kilogram of body weight per day in Linyi, Shandong and Shanghai. There were 19 males and 39 females 1 to 12 months old with a mean age of 4 months. The primary tumor size was 1.5 cm x 1.0 cm to 18.0 cm x 5.0 cm. Twenty-seven were superficial, nine deep-seated and 22 mixed. The tumors were located in head and neck (n = 41), trunk and extremities (n = 12), labium vulvae (n = 2), perianal region (n = 1), perineum (n = 1) and scrotum (n = 1). The patients were hospitalized for 7 to 10 days, continued medication at home and revisited every 2 weeks. The changes of tumor size, texture and color were monitored and recorded at a regular interval. The adverse effects after medication were observed and managed accordingly. The short-term results were evaluated using a 4-point scale system.

Results: At 24 hours post-medication, all the tumors decreased in density, color and size. The changes became conspicuous within 5 to 7 days. Seven patients had medication for 2 months, 22 for 3 months, 21 for 4 months and 8 for 5 months. The follow-up period was 5 to 9 months. The overall response was scale I (poor) in 1 patient (1.7%), scale II (moderate) in 12 patients (20.7%), scale III (good) in 35 patients (60.4%) and scale IV (excellent) in 10 patients (17.2%). Statistical analysis showed that the treatment response for deep-seated hemangiomas was significantly better than that for superficial hemangiomas (P < 0.05), but no significant difference was found among different primary sites (P > 0.05). The main adverse effects were bradycardia (100%), diarrhea (63.8%) and sleep change (30.2%), which resolved after expectant treatment without any significant sequel. No serious adverse effect was observed.

Conclusions: Oral propranolol treatment at a low dose is a safe and effective regimen for infantile proliferating hemangiomas. And it can be used as the first-line therapeutic modality. The short-term efficacy is excellent while the side effects are minimal.
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December 2009

Photodynamic therapy of port wine stains-a report of 238 cases.

Photodiagnosis Photodyn Ther 2007 Mar 12;4(1):53-9. Epub 2007 Feb 12.

Special Clinic for Hemangioma, Cancer Hospital of Linyi City, Shandong 276001, PR China.

Objective: Retrospective analysis of clinical effects of vascular acting photodynamic therapy (PDT) for the treatment of port wine stains (PWS).

Methods: Between September 1997 and June 2003, a total of 238 PWS cases (2-56 years old) were treated with Photocarcinorin-mediated PDT using a copper vapour laser. Among them, 20 cases were pink lesions (Type I), 44 cases red lesions (Type II), 99 cases dark red lesions (Type III), 51 cases purple lesions (Type IV), and 24 cases nodular or thickened lesions (Type V), respectively. Patient received a slow intravenous injection of Photocarcinorin (4-5mg/kg b.w.) and light was delivered during the drug injection at dose levels of 160-260J/cm(2) at fluence rates of 70-100mW/cm(2). The same procedure was repeated 2-4 times for some patients. All patients were followed up for 6 months to 4 years.

Results: Sixty-eight cases (28.6%) showed excellent response, 76 cases (31.9%) good response, 87 cases (36.6%) fair response and 7 cases (2.9%) poor or no response. Secondary scar formation was reported in three cases. Highest good to excellent response rates were seen in patients of 5-20 years old. PDT-induced transitional hyperpigmentation was reported in some patients but disappeared without the need of treatment within 3-6 months.

Conclusion: Copper vapour laser PDT can selectively destroy PWS vessels without damage to the normal skin. If the technique is applied properly, it can cure superficial lesions and greatly improve thick lesions.
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http://dx.doi.org/10.1016/j.pdpdt.2007.01.001DOI Listing
March 2007

[A study on clinical differential diagnosis between hemangioma and vascular malformation in infant].

Zhonghua Kou Qiang Yi Xue Za Zhi 2005 Jul;40(4):280-3

Special Department of Hemangioma, Tumor Hospital of Linyi, Linyi Shandong 276001, China.

Objective: To explore the main points of clinical differentiation between hemangioma and vascular malformation in infant.

Methods: Based on Mulliken and Waner's classification, from March, 1997 to February, 1999, 81 baby patients with hemangioma were included in this study. Thirty-eight cases, 43 cases received medical treatment of steroids.

Results: All the patients were followed up from 5 to 7 years. Thirty-eight cases of red strawberry-like lesions limited in the skin began to involute within two years old. Of the 30 patients with strawberry-like lesions and subcutaneous mass, 20 cases involuted in varying degree; 10 cases' subcutaneous mass grew gradually and didn't involute, in 4 cases biopsy was performed, 3 cases were confirmed as hemangioma accompanied with venous malformation by pathology, 1 case was hemangioma accompanied with arteriovenous malformation. Of 13 cases with light blue or normal skin and subcutaneous mass, 7 cases involuted in varying degree; 6 cases grow gradually and didn't disappear, 2 cases were confirmed as venous malformation by biopsy.

Conclusions: Hemangioma in infant begins to involute within two years old. Vascular malformation or hemangioma with deep vascular malformation grows persistently and does not disappear. Skin temperature of lesion surface and dilative veins on the skin artery pulsation, are indexes compressibility, for differentiation between hemangioma and vascular malformation in clinical diagnosis.
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July 2005

[Clinical analysis of 13 cases of hemangioma and vascular malformation associated with thrombopenia].

Shanghai Kou Qiang Yi Xue 2005 Apr;14(2):108-12

Special Department of Hemangioma, Tumor Hospital of Linyi, Linyi 276001, Shandong Province, China.

Purpose: To explore the diagnosis and treatment of hemangioma and vascular malformation associated with thrombopenia (Kasabach-Merritt syndrome, KMS).

Methods: From October 1997 to December 2003, 13 cases of KMS were treated in our hospital. Among the 13 patients, 4 were located in the maxillofacial region, 3 were located in the trunk, 6 were located in the lower limb. The size of the lesion of all patients exceeded 8 cm; 10 were hemangioma, 1 was arteriovenous malformation (AVM), 1 was venous malformation (VM), 1 was Klippel-Trenaunay Syndrome (KTS). The platelet count was all lower than 70 x 10(9)/L, the lowest was 10 x 10(9)/L, the average was 41 x 10(9)/L. The clinical characteristics and course of treatment were analyzed.

Results: 9 patients were cured, 1 improved, 1 had no response, and 2 died. The treatment of choice for KMS was steroids, but the response rate was not high (23.08% in this series). If patients had no response to steroids, they also had no response to interferon.

Conclusions: If a proper treatment was taken in early stage, most patients could get a good result, but for patients with an extensive vascular malformation that can't be removed, the prognosis was poor. For lesions in the limbs and trunk, pneumatic compression therapy has certain curative effect, fewer side effects, therefore worthy of popularization.
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April 2005

[The clinical classification and treatment of arteriovenous malformations of maxilloface].

Zhonghua Wai Ke Za Zhi 2004 Sep;42(18):1128-31

Special Department of Hemangioma, Cancer Hospital of Shandong Linyi, Linyi 276001, China.

Objective: To explore the clinical classification and ideal therapy for maxillofacial AVMs.

Methods: According to the clinical characteristics, 106 patients with maxillofacial AVMs were divided into the 4 types Of them, 38 cases were cystic dilatation lesions, 22 cases were limited thicken lesions, 42 case were diffuse thicken lesions, 4 cases were central maxillary hemangioma. 106 patients with maxillofacial AVMs were treated in our hospital, of them, 8 cases received operation (group 1); 23 cases received embolization of supplying artery alone (group 2); 37 cases received embolization of supplying artery plus hardener intra-tumorous injection (group 3); 38 cases received embolization of supplying artery plus tumor resection (group 4).

Results: Of all the patients were followed up 1 - 11 years, In group 1, 2, 3, and 4, the cure rates is 62.50%, 17.39%, 89.19%, and 97.37% respectively. one patient died of embolization of abnormal communication branches between external carotid and intra-cranical arteries.

Conclusions: (1) This new clinical classification is beneficial for selecting method of treatment. (2) It is necessary that a good digital subtraction angiography for maxillofacial AVMs. (3) The embolization of tumor supplying artery alone could cure the small AVM with single branch terminal blood supply. (4) The embolization of supplying artery plus hardener intratumorous injection or the embolization of supplying artery plus tumor resection is an effective method for maxillofacial AVMs.
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September 2004

[Interventions for nasal hemangiomas in children].

Shanghai Kou Qiang Yi Xue 2002 Sep;11(3):210-2

Special Department for Hemangiomas of Shandong Province, Tumor Hospital of Linyi City, Shandong Linyi, China.

Objective: To explore an ideal therapy for nasal hemangiomas in children.

Methods: From June 1998 to April 2001, 110 patients with nasal hemangiomas in children were treated. Of them, 76 cases received Pingyangmycin intralesional injection (group I); 11 cases received steroids injection (group II); 7 cases received intralesional injection of absolute ethanol (group III); 6 cases received cryotherapy (group IV) and 10 cases with tumor resection (group V).

Results: In group I, II, III, IV and V, the cure rates were 88.16%, 27.27%, 100%, 50% and 80%, respectively. The satisfactory rates of the nasal contour after treatment were 86.84%, 18.18%, 0,0% and 10.00%, respectively.

Conclusion: The nose is a special portion of the body with fine configuration. Once destroyed, it is difficult to restore. Therefore, it is necessary to adopt an effective therapy in the earlier stage. It is not advocated to wait for spontaneous involution. Intralesional injection of Pingyangmycin is an effective method in the treatment of nasal hemangiomas in children; Its result is exact, without significant side effects. The nasal appearance remains good after treatment.
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September 2002