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Objective: To assess the feasibility of endovascular thrombectomy (EVT) for the treatment of acute ischemic stroke (AIS) in children. Methods: Clinical data and follow-up information of 4 AIS children who received EVT in the Department of Intervention & Hemangioma at the Children's Hospital of the Capital Institute of Pediatrics from December 2020 to June 2021 were collected retrospectively. The vascular recanalization after EVT was assessed by the modified thrombolysis in cerebral infarction (mTICI) score. Efficacy outcomes were assessed with initial and postprocedural Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score, and the modified Rankin scale (mRS) score at 3 and 6 months after treatment. Safety assessments included perioperative complications and intracranial hemorrhage post-treatment. Results: A total of 5 EVT treatment were performed on 4 children with AIS, of whom 3 were male. The age of onset was 4.6, 13.8, 7.8, 8.0, 8.9 years, respectively. The time from symptom onset to initiation of EVT was 19.0, 25.0, 22.0, 4.0, 16.5 hours, respectively and all patients achieved successful recanalization of the vessel after EVT (mTICI≥2b). The PedNIHSS score was 39, 14, 25, 39, 24 before treatment and decreased to 8, 1, 12, 39, 5 at discharge. All the procedures were performed with no perioperative complications. Only 1 patient with congenital heart disease had a recurrent AIS with malignant brain oedema and brain hernia. Although the occluded vessels were successfully recanalized,the symptoms were not improved and this patient died after treatment abandonment. The other 3 patients achieved good recovery at 6 months postoperatively. The mRS score of 3 patients was 3, 1, 2 at 3 months after EVT and decreased to 2, 1, 1 at 6 months. Conclusion: EVT treatment may be feasible and safe for pediatric AIS due to large vessel occlusion even when the treatment was initiated 6 hours post stroke, but children with heart disease may have a dismal prognosis.
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Humans , Child , Male , Female , United States , Ischemic Stroke , Retrospective Studies , Thrombectomy , Brain , Stroke/therapyABSTRACT
Objective:To compare the clinical efficacy, prognosis and complications between intravenous chemotherapy (IVC) combined with intra-arterial chemotherapy (IAC) and single IAC in the treatment of children retinoblastoma (RB).Methods:A cohort study was performed.A 4-year follow-up of 300 children (352 eyes) with intraocular RB enrolled in the Children's Hospital Affiliated of Zhengzhou University from June 2015 to June 2019 was conducted.According to the different treatment methods, the children were divided into IAC group (140 cases, 160 eyes) treated with IAC combined with local laser photocoagulation/cryotherapy and IVC+ IAC group (160 cases, 192 eyes) receiving IVC combined with IAC treatment.The clinical efficacy (eye salvage rate), survival and complication incidence of the two groups were compared.The survival analysis was performed by Kaplan-Meier method.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Children's Hospital Affiliated of Zhengzhou University (No.20150503). Written informed consent was obtained from custodians of each child prior to their entering into the cohort.Results:All of the children were followed up for 2-60 months.Within the follow-up, the eye retention rate of the IAC group and IVC+ IAC group was 85.62%(137/160) and 81.21%(154/192) respectively, without statistically significant difference ( P>0.05). The recurrence rate and metastasis rate of IAC group were 18.75%(30/160) and 8.57%(12/140), which were significantly higher than 10.94%(21/192) and 3.13%(5/160) of IVC+ IAC group ( χ2=4.299, P=0.038; χ2=4.143, P=0.042). There was no significant difference in one-year survival rate between the two groups ( χ2=1.766, P=0.184), but the overall survival rate of IVC+ IAC group was 95.00%(152/160), significantly higher than 88.57%(124/140) of IAC group ( χ2=4.193, P=0.041). Kaplan-Meier analysis showed that the overall recurrence-free, metastasis-free and survival rate of IVC+ IAC group were better than those of IAC group, and the differences were statistically significant (all at P<0.05). There was no significant difference in the incidence of eyelid edema and/or ptosis, fundus hemorrhage, enophthalmos and cataract between the two groups (all at P>0.05). The incidence of myelosuppression was 32.14%(45/140) in IAC group, significantly lower than 43.75%(70/160) of IVC+ IAC group ( χ2=4.255, P=0.039). Conclusions:Compared with single IAC treatment, IVC combined with IAC can reduce the metastasis rate, recurrence rate in RB child patient and improve the survival rate, but it is with relatively high incidence of systemic complications.
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Objective:To investigate the expression of microRNA(miR)-206 in the peripheral serum of hemangioma children and its correlation with curative effect of propranolol treatment.Methods:The expression of miR-206 in serum of 45 hemangiomas children treated with propranolol treatment was detected.The children were divided into the high expression group( n=19) and the low expression group( n=26) according to the mean value of miR-206, and the clinical characteristics of the two groups were compared; The children were divided into the good efficacy group( n=29) and general efficacy group( n=16) according to the efficacy after 6 months of treatment.Logistic regression was used to analyze whether miR-206 was an influencing factor of efficacy, and ROC curve was used to evaluate the predictive value of miR-206. Results:The proportion of children <6 months, in hyperplasia stage and with tumor area ≥10 cm 2 in the high expression group was significantly lower than that in the low expression group( χ2=4.664, 7.207, 8.927, P=0.031, 0.007, 0.012, respectively). The miR-206 level after treatment(3.25±0.64) was significantly higher than that before treatment(2.12±0.41, t=9.973, P<0.05). After six months of propranolol treatment, the proportion of high expression of miR-206 before treatment in the good efficacy group(24.1%) was significantly lower than that in the general efficacy group(75.0%, χ2=10.934, P=0.001). High expression of miR-206 before treatment was a risk factor for poor curative effect of propranolol in hemangioma children[ CI(95% CI)=6.423(1.436~28.731), P=0.015]; ROC curve analysis showed that the area under ROC curve of miR-206 for predicting the efficacy of propranolol was 0.798, the sensitivity was 0.83, and the specificity was 0.75. Conclusion:The expression of serum miR-206 was correlated with age, proliferative stage and tumor area and may be one of the important indicators for predicting propranolol effect in children with hemangioma.
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Objective@#To study the hemodynamic changes of fetal umbilical artery (UA) and middle cerebral artery (MCA) and its influence on fetal outcome using color Doppler ultrasound.@*Methods@#Fifty pregnant women who underwent color Doppler ultrasound examination in Zhejiang Xin'an International Hospital from June to December 2018 with normal prenatal examination were selected as control group, and 80 pregnant women with oligohydramnios during the same period of pregnancy were selected as observation group. Color Doppler ultrasound examination was performed on both groups of pregnant women. The results of color Doppler ultrasound examination were compared between the two groups of pregnant women, and the fetal prognosis was followed up.@*Results@#Compared with the control group, the peak systolic velocity/end diastolic velocity (S/D), resistance index (RI) and pulsatility index (PI) values of UA in the observation group were significantly increased, while the S/D, RI and PI values of MCA were significantly decreased, and there were significant differences (P < 0.05). In addition, UA of 34 cases (42.5%) in observation group had S/D ≥ 3, which was much higher than that of 8 cases (16.0%) in control group, and there was significant difference (P < 0.05). The difference between the two groups was statistically significant (P < 0.05). The incidence of fetal distress, intrauterine growth retardation (IUGR) and Apgar < 4 points in observation group were significantly higher than those in control group [26.2%(21/80) vs. 12.0%(6/50), 15.0%(12/80) vs. 2.0%(1/50), 7.5% (6/80) vs. 0], and the difference were statistically significant (P < 0.05).@*Conclusions@#Prenatal color Doppler ultrasound can accurately detect the hemodynamic indexes of UA and MCA, predict the fetal intrauterine development, evaluate the fetal outcome, and provide scientific basis for clinical diagnosis.
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study the hemodynamic changes of fetal umbilical artery (UA) and middle cerebral artery (MCA) and its influence on fetal outcome using color Doppler ultrasound. Methods Fifty pregnant women who underwent color Doppler ultrasound examination in Zhejiang Xin'an International Hospital from June to December 2018 with normal prenatal examination were selected as control group, and 80 pregnant women with oligohydramnios during the same period of pregnancy were selected as observation group. Color Doppler ultrasound examination was performed on both groups of pregnant women. The results of color Doppler ultrasound examination were compared between the two groups of pregnant women, and the fetal prognosis was followed up. Results Compared with the control group, the peak systolic velocity/end diastolic velocity (S/D), resistance index (RI) and pulsatility index (PI) values of UA in the observation group were significantly increased, while the S/D, RI and PI values of MCA were significantly decreased, and there were significant differences (P<0.05). In addition, UA of 34 cases (42.5%) in observation group had S/D≥3, which was much higher than that of 8 cases (16.0% ) in control group, and there was significant difference (P < 0.05). The difference between the two groups was statistically significant (P < 0.05). The incidence of fetal distress, intrauterine growth retardation (IUGR) and Apgar < 4 points in observation group were significantly higher than those in control group [26.2%(21/80) vs. 12.0%(6/50), 15.0%(12/80) vs. 2.0%(1/50), 7.5% (6/80) vs. 0], and the difference were statistically significant (P < 0.05). Conclusions Prenatal color Doppler ultrasound can accurately detect the hemodynamic indexes of UA and MCA, predict the fetal intrauterine development, evaluate the fetal outcome, and provide scientific basis for clinical diagnosis.
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The present study was designed to improve storage stability and oral bioavailability of Ganneng dropping pills (GNDP) by transforming lignans of Herpetospermum caudigerum (HL) composed of herpetrione (HPE) and herpetin (HPN) into nanosuspension (HL-NS), the main active ingredient of GNDP, HL-NS was prepared by high pressure homogenization and lyophilized to transform into solid nanoparticles (HL nanoparticles), and then the formulated HL nanoparticles were perfused into matrix to obtain NS-GNDP by melting method. For a period of 3 months, the content uniformity, storage stability and pharmacokinetics test in vivo of NS-GNDP were evaluated and compared with regular GNDP at room temperature. The results demonstrated that uniformity of dosage units of NS-GNDP was acceptable according to the criteria of Chinese Pharmacopoeia 2015J. Physical stability of NS-GNDP was investigated systemically using photon correlation spectroscopy (PCS), zeta potential measurement, and scanning electron microscopy (SEM). There was a slight increase in particles and PI of HL-NS re-dispersed from NS-GNDP after storage for 3 months, compared with new formulated NS-GNDP, which indicated a good redispersibility of the NS-GNDP containing HL-NS after storage. Besides, chemical stability of NS-GNDP was studied and the results revealed that HPE and HPN degradation was less when compared with that of GNDP, providing more than 99% of drug residue after storage for 3 months. In the dissolution test in vitro, NS-GNDP remarkably exhibited an increased dissolution velocity compared with GNDP and no distinct dissolution difference existed within 3 months. The pharmacokinetic study showed that HPE and HPN in NS-GNDP exhibited a significant increase in AUC, C and decrease in T when compared with regular GNDP. These results indicated that NS-GNDP possessed superiority with improved storage stability and increased dissolution rate and oral bioavailability.
Subject(s)
Animals , Humans , Male , Rats , Benzofurans , Chemistry , Biological Availability , Cucurbitaceae , Chemistry , Drug Carriers , Chemistry , Drug Compounding , Drug Stability , Freeze Drying , Furans , Chemistry , Lignans , Chemistry , Pharmacokinetics , Nanoparticles , Chemistry , Particle Size , Plant Extracts , Chemistry , Rats, Sprague-Dawley , SolubilityABSTRACT
Liver injury remains a significant global health problem and has a variety of causes, including oxidative stress (OS), inflammation, and apoptosis of liver cells. There is currently no curative therapy for this disorder. Sanwei Ganjiang Prescription (SWGJP), derived from traditional Chinese medicine (TCM), has shown its effectiveness in long-term liver damage therapy, although the underlying molecular mechanisms are still not fully understood. To explore the underlining mechanisms of action for SWGJP in liver injury from a holistic view, in the present study, a systems pharmacology approach was developed, which involved drug target identification and multilevel data integration analysis. Using a comprehensive systems approach, we identified 43 candidate compounds in SWGJP and 408 corresponding potential targets. We further deciphered the mechanisms of SWGJP in treating liver injury, including compound-target network analysis, target-function network analysis, and integrated pathways analysis. We deduced that SWGJP may protect hepatocytes through several functional modules involved in liver injury integrated-pathway, such as Nrf2-dependent anti-oxidative stress module. Notably, systems pharmacology provides an alternative way to investigate the complex action mode of TCM.
Subject(s)
Humans , Drugs, Chinese Herbal , Chemistry , Gene Expression , Hepatocytes , Metabolism , Liver , Wounds and Injuries , Metabolism , Liver Diseases , Drug Therapy , Genetics , Metabolism , Oxidative Stress , PharmacologyABSTRACT
The present study was designed to improve storage stability and oral bioavailability of Ganneng dropping pills (GNDP) by transforming lignans of Herpetospermum caudigerum (HL) composed of herpetrione (HPE) and herpetin (HPN) into nanosuspension (HL-NS), the main active ingredient of GNDP, HL-NS was prepared by high pressure homogenization and lyophilized to transform into solid nanoparticles (HL nanoparticles), and then the formulated HL nanoparticles were perfused into matrix to obtain NS-GNDP by melting method. For a period of 3 months, the content uniformity, storage stability and pharmacokinetics test in vivo of NS-GNDP were evaluated and compared with regular GNDP at room temperature. The results demonstrated that uniformity of dosage units of NS-GNDP was acceptable according to the criteria of Chinese Pharmacopoeia 2015J. Physical stability of NS-GNDP was investigated systemically using photon correlation spectroscopy (PCS), zeta potential measurement, and scanning electron microscopy (SEM). There was a slight increase in particles and PI of HL-NS re-dispersed from NS-GNDP after storage for 3 months, compared with new formulated NS-GNDP, which indicated a good redispersibility of the NS-GNDP containing HL-NS after storage. Besides, chemical stability of NS-GNDP was studied and the results revealed that HPE and HPN degradation was less when compared with that of GNDP, providing more than 99% of drug residue after storage for 3 months. In the dissolution test in vitro, NS-GNDP remarkably exhibited an increased dissolution velocity compared with GNDP and no distinct dissolution difference existed within 3 months. The pharmacokinetic study showed that HPE and HPN in NS-GNDP exhibited a significant increase in AUC, C and decrease in T when compared with regular GNDP. These results indicated that NS-GNDP possessed superiority with improved storage stability and increased dissolution rate and oral bioavailability.
Subject(s)
Animals , Humans , Male , Rats , Benzofurans , Chemistry , Biological Availability , Cucurbitaceae , Chemistry , Drug Carriers , Chemistry , Drug Compounding , Drug Stability , Freeze Drying , Furans , Chemistry , Lignans , Chemistry , Pharmacokinetics , Nanoparticles , Chemistry , Particle Size , Plant Extracts , Chemistry , Rats, Sprague-Dawley , SolubilityABSTRACT
Liver injury remains a significant global health problem and has a variety of causes, including oxidative stress (OS), inflammation, and apoptosis of liver cells. There is currently no curative therapy for this disorder. Sanwei Ganjiang Prescription (SWGJP), derived from traditional Chinese medicine (TCM), has shown its effectiveness in long-term liver damage therapy, although the underlying molecular mechanisms are still not fully understood. To explore the underlining mechanisms of action for SWGJP in liver injury from a holistic view, in the present study, a systems pharmacology approach was developed, which involved drug target identification and multilevel data integration analysis. Using a comprehensive systems approach, we identified 43 candidate compounds in SWGJP and 408 corresponding potential targets. We further deciphered the mechanisms of SWGJP in treating liver injury, including compound-target network analysis, target-function network analysis, and integrated pathways analysis. We deduced that SWGJP may protect hepatocytes through several functional modules involved in liver injury integrated-pathway, such as Nrf2-dependent anti-oxidative stress module. Notably, systems pharmacology provides an alternative way to investigate the complex action mode of TCM.
Subject(s)
Humans , Drugs, Chinese Herbal , Chemistry , Gene Expression , Hepatocytes , Metabolism , Liver , Wounds and Injuries , Metabolism , Liver Diseases , Drug Therapy , Genetics , Metabolism , Oxidative Stress , PharmacologyABSTRACT
AIM To establish the HPLC fingerprints of Kangfuxin Liquid (extract of Periplaneta americana L.) and to determine the contents of six constituents.METHODS The analysis of this drug was performed on a TOSOH TSK-GEL ODS column (250 mm × 4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-water (containing 0.07％ acetic acid) flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 280 nm.RESULTS There were twenty-four common peaks in the fingerprints of ten batches of samples (Ⅰ-Ⅹ) with the similarities of 0.932-0.993 (except for sample Ⅰ).Uracil,hypoxanthine,xanthine,inosine,protocatechuic acid and Cyclo (Gly-Tyr) showed good linear relationships within the ranges of 3.460-173.0,3.960-198.0,3.596-179.8,1.338-66.9,3.672-183.6 and 3.552-177.6 μg/mL,whose average recoveries (RSDS) were99.8％ (2.65％),98.0％ (2.55％),99.7％ (1.59％),100.7％ (2.80％),102.0％ (2.09％) and 99.6％ (1.88％),respectively.CONCLUSION This accurate,stable and simple method can be used for the quality control of Kangfuxin Liquid.
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Objective@#To evaluate the safety and efficacy of foam sclerotherapy with polidocanol for the treatment of venous malformation in the oropharynx.@*Methods@#The clinical data of 21 children with venous malformation in the oropharynx treated by foam sclerotherapy were retrospectively analyzed. There were 10 males and 11 females, ranging in age from 1 month to 13 years, with a median age of 2.3 years. MRI was performed in all children, and the diagnosis was further confirmed by radiography. After general anesthesia, the oropharynx was exposed by opening device. Scalp acupuncture was used to pucture lesions and polidocanol foam was injected after the nidus was confirmed by digital subtraction angiography(DSA). The follow-up time ranged from 2-29 months, with a mean time of 15 months. The clinical symptoms, imaging data, therapeutic effects and postoperative complications were evaluated.@*Results@#Total numbers of treatment were 52 times, 1-6 times/case; 13 cases were cured, 7 cases was relieved and no response in one case. Postoperative swelling in 13 cases, fever in 3 cases, local mucosal ulcer in 2 cases, difficult extubation in 2 cases. No nerve injury, swallowing function damage and cardiopulmonary accidents were found in all patients.@*Conclusion@#Foam sclerotherapy with polidocanol in the treatment of venous malformation in the oropharynx is a safe and effective method.
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Hemangioma is the most common vascular tumor in infantile period, and propranolol is the first choice, but there are still a few patients with poor curative effect. Seven cases of infant parotid hemangioma with no response to oral propranolol were treated with transcatheter arterial sclerosing embolization combined with cortisol and satisfactory results achievod. The treatment and efficacy are disccused in this paper.
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<p><b>OBJECTIVE</b>To analyze the risk factor of infection for complex tibial plateau fractures after operation.</p><p><b>METHODS</b>Totally clinical data of 293 patients with complex tibial plateau fractures underwent open reduction and internal fixation were retrospectively analyzed from September 2010 to March 2015, including 199 males and 94 females, ranging in age from 17 to 80 years old with an average of 47.3 years old. The possible risk factors such as gender, age, smoking, diabetes, type of fracture(open/closed), classification of open fracture(Gustilo-Anderson classification), classification of soft tissue injury in closed fracture (Tscherne-Gotzen classification), fracture classification(Schatzker V/VI), osteofascial compartment syndrome, ASA score, anesthesia, timing of surgery, operative time(<=150 min/>150 min), surgical approach, combined approach or not, internal fixation site were studied. The multivariate Logistic regression model was used to analyze the risk factors.</p><p><b>RESULTS</b>Twelve patients were infected of all 293 patients after operation, the infection rate was 4.10%. Univariate analysis showed that fracture type(χ ² =14.496,=0.001), fracture classification(χ²=4.560,=0.033), osteofascial compartment syndrome(χ²=15.631,=0.001), operative time(χ²=11.233,=0.001) were correlated with complex tibial plateau fractures postoperative infection. Multivariate analysis showed that open fractures(χ²=9.696,=0.002) and osteofascial compartment syndrome(χ²=9.119,=0.003) were complex tibial plateau fracture risk factors for infection after operation.</p><p><b>CONCLUSIONS</b>Open fractures and osteofascial compartment syndrome are risk factor of complex tibial plateau fracture for infection after operation. While through debridement for open fracture patients, early diagnosis and promt treatment for osteofascial compartment syndrome could reduce incidence of infection.</p>
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<p><b>OBJECTIVE</b>To investigate the serological and genetic characteristics of an individual with B(A) phenotype of the ABO subtype and his family members.</p><p><b>METHODS</b>Serological assaying was carried out to characterize the erythrocyte phenotype of the discrepant samples. Exons 6 and 7 of the ABO gene were amplified with PCR and subjected to direct sequencing. Exon 7 of the ABO gene was also subjected to single strand sequencing.</p><p><b>RESULTS</b>The serological results of two samples from the family were prelimilarily typed as AwB and genotyped as B(A)04/O1 by sequence-specific primer PCR (PCR-SSP). Direct and single strand sequencing confirmed that the three samples all carried a B(A)04 allele and had a nt640A>G mutation in exon 7 of the ABO gene.</p><p><b>CONCLUSION</b>The nt640A>G mutation of the B allele has resulted in an amino acid substitution (Met214Val), which probably underlies the B(A)04 subtype. Blood samples with serological typing difficulty may be resolved by pedigree analysis using molecular methods such as PCR-SSP and DNA sequencing.</p>
Subject(s)
Adult , Humans , Male , ABO Blood-Group System , Genetics , Alleles , Base Sequence , Exons , Genotype , Molecular Sequence Data , Mutation , Pedigree , PhenotypeABSTRACT
Objective Isolation , purification and structure identification of phthalides from A pium graveolens L . Methods Silica gel column and preparative TLC chromatography were used to isolate and purify the phthalide compounds .The structures of those compounds were determined through spectral analysis .Results Three pure compounds were identified as 3-n-butylphthalide ,sedanenolide and sedanolide .Conclusion Three pure phthalide compounds can be used as analytical reference standard for quantitative analysis of A .graveolens .
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Objective To evaluate the safety and efficacy of percutaneous ethanol embolization (PEE) in treating arteriovenous malformation (AVM) of foot in children.Methods The clinical data of 11 sick children with arteriovenous malformation of foot,who were treated with PEE in authors' department during the period from January 2007 to January 2016,were retrospectively analyzed.The clinical symptoms,the type of tumor nidus,the therapeutic effect and the postoperative complications were analyzed.Results The 11 sick children included 6 boys and 5 girls,with a mean age of 9 years.Foot mass was seen in 8 children,pain in 8 children,claudication in 3 children and ischemic skin ulcer in one child.Cho Ⅲ b type was observed in 10 children and Cho Ⅱ type in one child;Yakes Ⅳ type was found in 10 children and Ⅱa type in one child.A total of 30 PEE procedures were performed,with an average of 2.7 times per case.The children were followed up for 6-48 months,with a mean of 24 months.Evaluation of curative effect showed that complete cure was achieved in 7 children and partial remission in 3 children,the effective rate was 90.9％.Treatment failure (showing no remission) was seen in one child,and no deterioration of disease was observed.Complications included transient blood oxygen decrease in operation (n=1),toe ischemia (n=1),postoperativeblister (n=1) and local skin ulcer (n=l),no severe complications were observed.Conclusion PEE is a safe and effective treatment for arteriovenous malformation of foot in children.
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Objective To compare the clinical effect of single-port laparoscopic appendectomy and traditional mult-port laparoscopic appendectomy in children with appendicitis. Methods The clinical data of 96 appendicitis children who had underwent laparoscopic appendectomy were retrospectively analyzed. Among the children, 48 children received single- port laparoscopic appendectomy (observation group), and 48 children received mult-port laparoscopic appendectomy (control group). The operation time, blood loss, postoperative exhaust time, postoperative hospital stay, incision length and surgery-related complications between 2 groups were compared. Results All children were operated successfully. There were no statistical differences in blood loss and postoperative hospital stay between 2 groups (P>0.05). The operation time, postoperative exhaust time and incision lengths in observation group were significantly lower than those in control group: (19.8 ± 5.3) min vs. (30.2 ± 8.1) min, (15.6 ± 4.7) h vs. (22.7 ± 6.5) h and (1.1 ± 0.2) cm vs. (2.3 ± 0.4) cm, and there were statistical differences (P<0.01). There was 1 case with incision infection in observation group, and the child was cured after symptomatic treatment. There was no other surgery-related complication in 2 groups, and all children recovered smoothly. Conclusions The single-port laparoscopic appendectomy is safe and feasible in children with appendicitis. It has short operation time, fast recovery of gastrointestinal function, and better cosmetic effect.
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Objective To analyze the angiographic characteristics of Kasabach-Merritt syndrome (KMS) and study the value of transcatheter arterial embolization (TAE) in KMS therapy. Methods The clinical data of 36 infants with KMS treated between June 2010 and June 2016 in our hospital were reviewed retrospectively. All infants performed angiography and TAE therapy. These angiographic characteristics were analyzed by comparing with infantile hemangioma(IH).The times of TAE and the level of platelet after TAE therapy were observed. Results The angiographic characteristics of KMS were as follows: The capillary blush of KMS were ill defined with no-uniform distribution. There were a lot of very fine feeding arteries. The diameter of feeding artery was disproportionate to the volume of tumor blush because the feeding arteries were too small or fine. Normal artery was usually embedded in tumor blush. However, the angiographic characteristics of IH were different as follows:the capillary blush of IH were well defined with uniform distribution.There were about 1-4 feeding arteries.The diameter of feeding artery was proportional to the volume of tumor blush. Normal artery was not embedded in tumor blush. Tumor blush was usually located beside the normal artery. In 36 patients, 107 embolization treatments were performed. The platelet declined for 11 times and increased for 96 times after TAE therapy. The platelet count for these 96 cases increased to ≥100×109/L at(7.1 ± 2.4)days following therapy. However, the platelet level fluctuated thereafter and the average relapse time was(45.9 ± 21.8)days. All cases were followed-up ranging from 6 months to 2 years and finally received other therapies.Eight cases were cured and the other 28 cases were improved. Conclusions The angiographic characteristics of KMS are different from common infantile hemangioma. It is difficult to embolize the feeding arteries of KMS because there are a lot of very fine feeding arteries.TAE may rapidly improve the level of platelets while the long term effect was poor.It might be better to combine TAE with other medical therapies to treat KMS.
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A method of capillary electrophoresis fingerprint was developed for evaluation of the quality of Arnebia euchroma ( Royle) Johnst. The samples were separated on a 50 μm × 40 cm uncoated capillary separation column at separation voltage of 25 kV with 100 mmol/ L borate buffer ( pH 8. 0) containing 25 mmol/ L SDS and 20% (V/ V) dehydrated alcohol as running buffer. The injection volume of sample was 0. 5 psi ×5 s and the detection wavelength was 214 nm. The results indicated that the samples of Arnebia euchroma (Royle) Johnst were well separated and detected in 35 min. With Shikonin peak as reference peak, 6 characteristic peaks of standard Arnebia euchroma (Royle) Johnst were determined. The quality discriminant analyses were accomplished for different kinds of samples named Arnebia euchroma ( Royle) Johnst that purchased from eight sources by means of characteristic fingerprint peak analysis, similarity evaluation and cluster analysis. This method had good reproducibility, and could be used for the quality control of Arnebia euchroma (Royle) Johnst.
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Objective To investigate the safety and efficiency of laparoscopic gallbladder - preserving chole-lithotomy in the treatment of cholecystolithiasis in children. Methods The clinical data obtained from 18 children with gallstones undergoing laparoscopic gallbladder - preserving cholelithotomy at Dalian Children′s Hospital of Dalian Medi-cal University during July 2010 and December 2016 were retrospectively analyzed. Eight boys and 10 girls of 5 - 14 years old [mean (9. 2 ± 3. 1)years old]were included in the study,of whom 11 cases had a single stone,7 cases with multiple stones. All patients were followed up for 3 - 72 months. Results All of 18 patients without pancreaticobiliary maljunction were diagnosed by Color Doppler ultrasound and magnetic resonance cholangiopancreatography(MRCP). Gallbladder functions were assessed preoperatively and they were all in good condition. Laparoscopic gallbladder - pre-serving cholelithotomy was successfully performed in all patients without conversion to cholecystectomy. Operation time was 28 - 66 min,with mean value of (40. 2 ± 14. 3)min;intraoperative blood loss was 4 - 12 mL,with mean value of (8. 3 ± 2. 8)mL;postoperative hospital stay lasted 3 - 5 d,with mean value of (3. 8 ± 1. 2)d. There were no complica-tions such as bile leakage,postoperative bleeding,biliary duct damage,biliary pancreatitis during therapy. The patients were followed up for 3 - 72 months,and the Color Doppler ultrasound showed no gallstone recurrence after surgery. Conclusions For children with good gallbladder function,laparoscopic gallbladder - preserving cholelithotomy can preserve gallbladder function and the integrity of biliary tract. The operation is easy and reliable,with minimal invasion, quick recovery,and low recurrence rate. It is a feasible method for the treatment of gallstones in children.