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Background and purpose:Hepatic epithelioid hemangioendothelioma (HEHE) is an extremely rare, vascularly original tumor, and would be misdiagnosed easily in the clinical and imaging characteristics. This study aimed to investigate the imaging features of HEHE and our experience in clinical diagnosis and treatment, and to provide important reference for the diagnosis and treatment of HEHE in the future.Methods:This study retrospectively analyzed clinical manifestations, imaging features, pathological characteristics and treatment effects of 5 HEHE cases confirmed by pathology at Department of Integrative Cancer, Fudan University Shanghai Cancer Center.Results:The ratio of male to female patients was 2 to 3. HEHE predominantly occurred in middle-aged female patients whose ages range from 26 to 65 (mean=45.6). Imaging features of HEHE included multifocal hepatic disease (n=2), systemic multi-center multi-tissue occurrence (n=3). The ultrasound images showed isoechoic or hypoechoic lesions with no obvious blood lfow signal in the lesions. CT plain scan showed isointensity or hypointensity, while MR unenhanced with hypointense T1 signal and hyperintense T2 signal. The density or signal was uneven. Contrast-enhanced CT and MR images showed “slow in slow out”, obvious and variable degrees of peripheral rim enhancement. High FDG uptake showed delayed imaging characteristics (PET/CT). DSA angiography showed the tumor blood vessels were slim. After transcatheter arterial chemoembolization (TACE) surgery, lipiodol deposition within the lesion was not ideal. Under the microscope, tumor cells showed epithelial differentiation; angiogenesis was also visible. Immunohistochemistry staining showed CD31 and CD34 positive in all the 5 cases. Two cases treated with TACE combined with high intensity focused ultrasound (HIFU) and/or radiofrequency ablation (RFA) had good result.Conclusion:The clinical and radio-logical characteristics of HEHE are distinctive. Currently, for patients with systemic multi-organizational multi-center lesions, TACE combined with HIFU and/or RFA might be the most effective treatment method.
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BACKGROUND: Both antioxidant and cytokine can induce the differentiation of umbilical cord blood-derived mesenchymal stem calls (UCB-MSCs) towards neuron-like cells in vitro. It remains unclear regarding how to select an inductor that has the ability of either neuro-protection like cytokines or powerful antioxidation. After wide screening, baicalin has been included in this study. OBJECTIVE: To observe the effects of baicalin on in vitro purification, amplification, and differentiation towards neuron-like cells of hUCB-MSCs.DESIGN, TIME AND SETTING: A randomized, controlled, cytological in vitro observation was performed at the laboratory of Department of Neurology, First Affiliated Hospital of Nanchang University between February and April 2005. MATERIALS: Ten portions of UCB were collected from healthy full-term normal delivery pregnant women aged 23-25 years old. Baicalin with purity > 95% was purchased from Department of Pharmaceutics, Xiangya Medical College of Central South University. Antioxidant additive J -mercaptoethanol was provided by Sino-American Biotechnology Company, China. METHODS: The collected UCB was anticoagulated with heparin to separate mononuclear cells. After concentration adjustment (1 ×109/L), UCB mononuclear cells were purified and amplified with dulbecco's modified eagle's medium containing fetal bovine serum (0.2 volume fraction), glutamine, B27, granulocyte colony-stimulating factors, and stem cell factors. According to antioxidant additive application, 4 groups were set: baicalin, blank control, β -mercaptoethanol, and baicaUn+ β -mercaptoethanol. Cells in each group were cultured for a total of 4 consecutive weeks. MAIN OUTCOME MEASURES: (1) Detection of CD 34 and CD 29 immunoreactive expression on days 7, 14, 21, and 28 after cryopreservation. (2) Cellular morphology observation. (3) Detection of surface antigen expression of MSCs by flow cytometry. (4) Detection of neuron-specific enolase (NSE), microtubule associated protein 2 (MAP-2), and glial fibrillary acidic protein (GFAP) expression after 4 weeks of culture by immunocytochemistry. RESULTS: O Compared with prior to cryopraservation, trypan blue exclusion rate of UCB-MSCs was significantly reduced on days 7, 14, 21, and 28 after cryopreservation (P < 0.05). (2) Morphological observation: UCB mononuclear cells adhered to the wall 2-3 days after culture, reached a peak level at 2 weeks, and formed a confluence of approximately 80%-90% 3 weeks after culture; at this time, all UCB-MSCs displayed a spindle shaped appearance. Four weeks later, in the baicalin group, some spindle-shaped UCB-MSCs began to present shrinkage, with slender processes on the cell edge, and some UCB-MSCs tended to be spherical-, conical-, and triangle-shaped appearance, with many slender processes on the pseudopodia. In the β-mercaptoethanol and baicalin+β -mercaptoethanol groups, an increasing number of cells defoliated and died with culture time in addition to above-mentioned appearances. (3) Four weeks after culture, cells were positive for CD45 in the blank control group, while cells in the remaining groups were positive for CD29 and CD 83, in particular in the baicalin+ β -mercaptoethanol group, followed by the baicalin group, and lastly the β -mercaptoethanol group. Significant difference in CD29 and CD 83 immunoreactivity exhibited between groups (P < 0.01). No CD34 immunoraactive calls were found in each group. (4) Four weeks after culture, NSE and MAP-2 immunoreactive expression was significantly lower in the blank control and β -mercaptoethanol groups than in the baicalin group (P < 0.01). The percentage of cells expressing GFAP was lower than 1% in each group. CONCLUSION: 100 μmol/L baicalin can promote the in vitro amplification of UCB-MSCs in a time-dependent manner and also can induce the differentiation of UCB-MSCs towards neuron-like cells in vitro to some extent.
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BACKGROUND: Present studies have verified that Baicalin has protective effects on various brain damage in the nervous system.OBJECTIVE: To study the possibility of intravenous transplantation of human umbilical blood mesenchymal stem cells (hUBMSCs) and Baicalin after hypoxic-ischemic brain damage (HIBD) in neonatal rats.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Laboratory of the Department of Neurology, First Affiliated Hospital, Nanchang University from February 2007 to January 2008.MATERIALS: Totally 10 umbilical blood samples from healthy full-term pregnant women were obtained from the Department of Obstetrics, First Affiliated Hospital, Nanchang University. A total of 85 clean Sprague Dawley neonatal rats aged 7 days were randomly assigned to a normal control group (n=15), a model group (n =20), a cell transplantation group (n =25), a cell transplantation + Baicalin group (n =25).METHODS: The umbilical blood mononuclear cells were isolated by the gelatin sedimentation + density gradient centrifugation method, and amplified in vitro. Cells at the fifth passage were used for transplantation. Cells were labeled by DAPI at 6-12 hours before use. Neonatal rats in the model, cell transplantation and cell transplantation + Baicalin groups were used to establish HIBD models. Rats in the blank control group were left intact. At 2, 3,4, 5 weeks following model induction, rats in the cell transplantation and cell transplantation + Baicalin groups were injected with DAPI-labeled hUBMSCs (5-10 μL/g) via caudal vein at the density of 1 ×10~9/L. From the first day of transplantation, rats in the cell transplantation + Baicalin group were injected with 120 mg/kg Baicalin via intraperitoneal injection, once a day, for three successive days.MAIN OUTCOME MEASURES: The following parameters were measured: brain tissue lesion, DAPI-positive cell number, location of hUBMSCs following transplantation.RESULTS: Lesion rate of brain tissue was significantly lower in the cell transplantation + Baicalin group compared with the model and cell transplantation groups at 4 weeks following transplantation (P < 0.05). Compared with the cell transplantation group,DAPI-positive cell number was significantly increased in the cell transplantation + Baicalin group at 1, 2, 4 weeks (P < 0.01). From the 3~(rd) week following model induction, abundant DAPI-labeled cells were found surrounding the lesion site, without obvious boundary integrated with the host brain. Few DAPI-positive hUBMSCs were found in non-ischemic region. At 4 and 5 weeks following model induction, DAPI-positive cells were significantly decreased in the lesion site.CONCLUSION: The third week following HIBD is an optimal time for cell transplantation. Baicalin can make a large number of hUBMSCs across the blood-brain barrier to distribute and scatter around the disease focus integrated with host brain tissue.
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Objective To explore the clinical diagnosis and treatment of multiple organ failure(MOF)in obstetrics.Methods 17 cases of MOF in obstetrics were studied retrospectively.Results Postpartum hemorrhage,severe regnancy-induced hypertension syndrome(PIH),amniotic fluid embolism,and placental abruption were the major factors leading to MOF from the 17 cases.The blood coagulation dysfunction and the renal failure were the most common organ dysfunction.8 cases died and the fatality rate was 47.06%.Conclusion The key to lowering the fatality rate of MOF is to prevent and treat the primary diseases,diagnose and treat blood coagulation dysfunction and renal failure early.
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BACKGROUND: Nowadays, the obesity has become a serious problem of public health in global sphere. The status of development of obesity in adults from different region and analysis on feature of risk population can instruct the prevention and treatment.OBJECTIVE: To analyze the status of obesity and the characteristics of the easy-attack obese people in adults from Guangxi so as to provide reference data for obese prevention and treatment in groups.DESIGN: Randomized cluster sampling, cross-sectional study.SETTING: Postgraduate School of Beijing Sport University.PARTICIPANTS: A total of 5 157 adults, aged from 20-59 years were selected from Nanning, Guilin and Yulin as observational subjects according to national physical fitness surveillance for national people and Guangxi citizens with randomized cluster sampling method in 2000.METHODS: Digital Electronic Height Meter and the RCS-160 Digital Electronic Weight Scale designated by China Center of National Physical Fitness Surveillance, were adopted to measure the height and body mass of the 5 157 participants, and then Body Mass Index (BMI) was calculated.Level of obesity of all participants was evaluated according to the evaluation criterion of obesity, made by WHO in 1997. Sex, age, profession, region, city, country and the situation of physical exercise, etc. were investigated according to the Logging Card of National Physical Fitness Surveillance in 2000. Single factor analysis of variance, t-test and contingency table chi-square test were performed on experimental data.MAIN OUTCOME MEASURES: Body Mass Index (BMI) and the rate of overweight.RESULTS: The number of people whose BMI≥25 kg/m2 was 1 028. ①The BMI of males and females were(2291±2.81) kg/m2 and (2237±2.96) kg/m2,respectively. It was higher in males than that of females(t=6.75,P ＜ 0.01),and both were lower than the weighted mean of nation, which were 23.34 kg/m2 and 22.93 kg/m2 (tm=-7.78, tl=-9.60,P ＜ 0.01), respectively. ②The rates of over-weight in males and females were 21.88% and 17.98%, respectively.The difference of gender was obvious, (Pearson Chi-Square=8.247, df=1, P ＜ 0.01). ③The mean value of BMI of people aged 20-24 years and the rate of overweight were the lowest. 20-34 years in males and 25-39 years in females were the swift growth period. Male in his 40-44 years and 55-59 years reached a maximum, respectively. Female in her 50-54 years also reached a maximum. The curve of BMI in males and females with the rate of over-weight got a first cross in the age of 40-44 years,and the BMI and the rate of females were higher than those of males. The second across occurred at the age of 55-59 years, and those of males were higher than those of females. ④The rate of overweight and mean value of BMI of samples from Guilin were higher than those of Nanning and Yulin (Pearson Chi-Square=13.579,df=2, P ＜ 0.01;F=12.328,P ＜ 0.01),and the obese severity was Guilin, Nanning and Yulin in order. ⑤The rate of overweight and mean value of BMI in farmers were much lower than those of urban citizens, and the difference was very obvious between city and countryside (Pearson Chi-Square=82.700-137.026,df=2, P ＜ 0.000;F=1 11.539,P ＜ 0.000).⑥Among people with different jobs, the rate of overweight in farmers was the lowest, both males and females(9.49% and 8.51%). For males, the order of the rate was taking service work (48.21%), in charge of an enterprise (40.91%) and clerk (36.34%). For females, the order was business woman (32.56%), worker for transportation (25.00%)and producer (24.38%), and the difference between all sorts of professions was obvious (Pearson Chi-Square=97.944-178.888,df=2, P ＜ 0.000).CONCLUSION: The level of obesity in Guangxi adults in 2000 is lower than the national average level. The distribution of obese population has relative obvious characteristics of difference on age, gender, locality, city,countryside and profession.