The Efficacy and Safety of Shashen-Maidong Decoction Combined with Western Medicine in the Treatment of Omicron Infected Individuals Over 85 Years Old: A Retrospective Study.

Background: During the Omicron variant outbreak of COVID-19 (2022-2023), Chinese healthcare institutions combined traditional Chinese medicine (TCM) with Western medical practices to treat COVID-19 patients, especially the elderly. The efficacy and safety of this approach, especially for individuals aged over 85, need further investigation. Methods: In this retrospective study, a cohort of 62 patients aged over 85 years, diagnosed with COVID-19 infection, was examined. Among them, 34 patients were administered Shashen-Maidong decoction in conjunction with Western medicine (SMD+WM group), while the remaining 28 patients received only Western medicine (WM group). Comparative analysis was conducted between the two groups, encompassing parameters such as the duration for the nucleic acid test to turn negative, length of intensive care unit (ICU) stay, mortality rate, utilization of high-flow nasal cannula oxygen (HFNC), occurrence of endo-tracheal intubation, frequency of recurrent respiratory infections within three months, and various laboratory indicators. Results: There were no significant differences observed between the two groups in terms of the duration for the nucleic acid test to turn negative, the length of ICU stay, mortality rate, utilization of HFNC, performance of endo-tracheal intubation, or the frequency of recurrent respiratory infections within three months (P > 0.05). However, in comparison to the WM group, the SMD+WM group exhibited notably lower growth rates in white blood cell (WBC) and neutrophil (NEUT) values. Additionally, the SMD+WM group demonstrated superior improvement in cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP) values. Conclusion: In contrast to the administration of Western medicine alone, the combined use of Shashen-Maidong decoction with Western medicine significantly suppresses the increase in WBC count, particularly in NEUT levels, in elderly patients diagnosed with COVID-19. Moreover, this combined treatment exhibits a protective effect on cardiac function and demonstrates a relatively safe profile.

The Role of Histone H3 Methylation in Acute Kidney Injury.

Acute kidney injury (AKI) is a clinical syndrome in which kidney function declines sharply due to various reasons. Although the morbidity and mortality of AKI are high, the mechanism of occurrence and development of AKI has not been fully elucidated, and precise prevention and treatment measures are lacking. Epigenetics is a branch of genetics that provides a new perspective to explore the pathophysiology of AKI and renal repair. A large amount of literature shows that the methylation mechanism of H3 in histones is closely related to the development of kidney diseases. The sorting out of histone H3 methylation mechanism in AKI and kidney repair can help understand the pathophysiological process of the disease more deeply. It may also provide new ideas for diagnosing and treating of the disease.

Metabolic Profiling Revealed Prediction Biomarkers for Infantile Hemangioma in Umbilical Cord Blood Sera: A Prospective Study.

Infantile hemangioma (IH), the most common benign tumor in infancy, mostly arises and has rapid growth before 3 months of age. Because irreversible skin changes occur in the early proliferative stage, early medical treatment is essential to reduce the permanent sequelae caused by IH. Yet there are still no early screening biomarkers for IH before its visible emergence. This study aimed to explore prediction biomarkers using noninvasive umbilical cord blood (UCB). A prospective study of the metabolic profiling approach was performed on UCB sera from 28 infants with IH and 132 matched healthy controls from a UCB population comprising over 1500 infants (PeptideAtlas: PASS01675) using liquid chromatography-mass spectrometry. The metabolic profiling results exhibited the characteristic metabolic aberrance of IH. Machine learning suggested a panel of biomarkers to predict the occurrence of IH, with the area under curve (AUC) values in the receiver operating characteristic analysis all >0.943. Phenylacetic acid had potential to predict infants with large IH (diameter >2 cm) from those with small IH (diameter <2 cm), with an AUC of 0.756. The novel biomarkers in noninvasive UCB sera for predicting IH before its emergence might lead to a revolutionary clinical utility.

Intense pulsed light treatment for Becker's nevus.

BACKGROUND: Becker's Nevus (BN) is a benign hamartoma with an esthetically troublesome condition secondary to hyperpigmentation and hypertrichosis. Many treatment modalities have been utilized with variable outcomes. OBJECTIVES: To evaluate the efficacy and safety of intense pulsed light (IPL) in the treatment of BN. PATIENTS AND METHODS: IPL was used at filter of 590 nm, fluence of 18-22 J/cm2, double-pulse mode (pulse width of 3-10 ms, pulse delay of 20-30 ms) at 3-month intervals. Final evaluations were performed by physician global assessment and patient satisfaction. Side effects were monitored at each treatment session and follow-up visit. RESULTS: Twenty-four patients (9 females, 15 males) with BN (16 hypertrichotic, 8 atrichotic) completed the study. The mean number of treatment sessions was 5 ± 2.17. The improvement in atrichotic BN group (4.87 ± 0.35) was significantly greater than that observed in hypertrichotic BN group (3.63 ± 0.89) (p = .001). Hair density simultaneously decreased with treatment in hypertrichotic BN. The mean satisfaction score was 5.75 ± 2.05 and 8 ± 0.93 in hypertrichotic and atrichotic BN groups respectively (p = .002). No repigmentation was noted during the follow-up period. No permanent side effects were observed. CONCLUSIONS: IPL is an effective and well-tolerated treatment option for patients with hypertrichotic and atrichotic BN.

The crystal structure of KSHV ORF57 reveals dimeric active sites important for protein stability and function.

Kaposi's sarcoma-associated herpesvirus (KSHV) is a γ-herpesvirus closely associated with Kaposi's sarcoma, primary effusion lymphoma and multicentric Castleman disease. Open reading frame 57 (ORF57), a viral early protein of KSHV promotes splicing, stability and translation of viral mRNA and is essential for viral lytic replication. Previous studies demonstrated that dimerization of ORF57 stabilizes the protein, which is critical for its function. However, the detailed structural basis of dimerization was not elucidated. In this study, we report the crystal structures of the C-terminal domain (CTD) of ORF57 (ORF57-CTD) in both dimer at 3.5 Å and monomer at 3.0 Å. Both structures reveal that ORF57-CTD binds a single zinc ion through the consensus zinc-binding motif at the bottom of each monomer. In addition, the N-terminal residues 167-222 of ORF57-CTD protrudes a long "arm" and holds the globular domains of the neighboring monomer, while the C-terminal residues 445-454 are locked into the globular domain in cis and the globular domains interact in trans. In vitro crosslinking and nuclear translocation assays showed that either deletion of the "arm" region or substitution of key residues at the globular interface led to severe dimer dissociation. Introduction of point mutation into the zinc-binding motif also led to sharp degradation of KSHV ORF57 and other herpesvirus homologues. These data indicate that the "arm" region, the residues at the globular interface and the zinc-binding motif are all equally important in ORF57 protein dimerization and stability. Consistently, KSHV recombinant virus with the disrupted zinc-binding motif by point mutation exhibited a significant reduction in the RNA level of ORF57 downstream genes ORF59 and K8.1 and infectious virus production. Taken together, this study illustrates the first structure of KSHV ORF57-CTD and provides new insights into the understanding of ORF57 protein dimerization and stability, which would shed light on the potential design of novel therapeutics against KSHV infection and related diseases.

Involvement of MrgprC in Electroacupuncture Analgesia for Attenuating CFA-Induced Thermal Hyperalgesia by Suppressing the TRPV1 Pathway.

Mas-related G-protein-coupled receptor C (MrgprC) plays an important role in modulating chronic inflammatory pain. Electroacupuncture (EA) has a satisfactory analgesic effect on chronic pain. This study aimed to investigate the involvement of MrgprC and its transient receptor potential vanilloid 1 (TRPV1) pathway in EA analgesia in chronic inflammatory pain. Chronic inflammatory pain was induced by subcutaneously injecting complete Freund's adjuvant (CFA) into the left hind paw. EA (2/100 Hz) stimulation was administered. MrgprC siRNAs were intrathecally administered to inhibit MrgprC expression, and bovine adrenal medulla 8-22 (BAM8-22) was used to activate MrgprC. The mechanical allodynia was decreased by EA significantly since day 3. The piled analgesic effect of EA was partially blocked by 6 intrathecal administrations of MrgprC siRNA. Both EA and BAM8-22 could downregulate the expression of TRPV1 and PKC in both the DRG and the SCDH. Both EA and BAM8-22 could also decrease the TRPV1 translocation and p-TRPV1 level in both the DRG and the SCDH. The effects of EA on PKCε, TRPV1 translocation, and p-TRPV1 in both the DRG and the SCDH were reversed by MrgprC siRNA. The results indicated that MrgprC played crucial roles in chronic pain modulation and was involved in EA analgesia partially through the regulation of TRPV1 function at the DRG and SCDH levels.

Current status of breast reconstruction in China: an experience of 951 breast reconstructions from a single institute.

BACKGROUND: Since mastectomy remained the primary strategy for treating breast cancer in China, post-mastectomy reconstruction is of great importance in the Chinese population. The current study aimed to assess the current status of breast reconstruction in China. METHODS: We reviewed all patients who received breast reconstruction from August 2000 to July 2015 in the Department of Breast Surgery in our institute. Patients' baseline characteristics, reconstruction strategy, final pathology and loco-regional recurrence (LRR) information were collected. RESULTS: A total of 951 breast reconstructions were conducted during the past 15 years, among which 247 (27.0%) were abdominal flap reconstruction; 471 (51.5%) were latissimus dorsi myocutaneous ± implant; and 233 (25.5%) were prosthesis-based reconstruction. The majority of cases (78.1%) were invasive breast cancer and up to 894 cases (94.0%) were immediate reconstruction. Prosthesis-based reconstruction rapidly increased in recent years, and was associated with bilateral reconstruction, contralateral augmentation and higher complications. 18 patients (2.0%) developed local-regional recurrence at the median follow-up time of 26.6 months (range, 3.7-62.0 months). A total of 66 nipple-areolar complex-sparing mastectomies (NSMs) (6.9%) were performed, none of which developed recurrence. CONCLUSIONS: Breast reconstruction cases increased over the 15 years with the change of paradigm. Most strikingly, prosthesis-based reconstruction rapidly gained its prevalence and became the most common strategy. NSM was only performed for highly selected patients. Patients with breast reconstruction were able to achieve satisfactory loco-regional control in our cohort.

Open-label nonrandomized left-right comparison of imiquimod 5% ointment and timolol maleate 0.5% eye drops in the treatment of proliferating superficial infantile hemangioma.

BACKGROUND: Infantile hemangiomas (IHs) are common childhood tumors. OBJECTIVE: Our study aimed to compare the efficacy and side effects of imiquimod and timolol maleate for the treatment of proliferating superficial IHs. METHODS: A total of 54 patients with superficial IHs were enrolled in this study. Each lesion was evenly divided into two parts. One part was treated with 5% imiquimod cream once every other day, and the other part was smeared with 0.5% timolol maleate eye drops thrice daily. After 16 weeks of treatment, the thickness, color and size of each lesion were measured, and the side effects were recorded. RESULTS: The efficacy rates for imiquimod and timolol maleate were 81.4 and 88.9%, respectively, but the difference between treatments was not significant. However, timolol maleate showed better effects for color involution, onset time and side effects than imiquimod. CONCLUSION: Timolol maleate might be the first choice for the topical treatment of superficial IHs.

Serum-level changes of vascular endothelial growth factor in children with infantile hemangioma after oral propranolol therapy.

Oral propranolol is the first-line therapy for infantile hemangioma (IH), but its mechanism of action remains unclear. The aim of this study was to evaluate the change in serum vascular endothelial growth factor (VEGF) levels in patients with IH who underwent propranolol treatment. The study included 22 patients with IH receiving propranolol treatment. At three time points-before treatment and 1 and 3 months after treatment-blood samples were examined by enzyme-linked immunosorbent assay for serum VEGF expression. The mean serum VEGF concentration in children with proliferative hemangiomas was 395.0 ± 176.7 pg/mL, approximately twice as high as in patients with venous malformations (mean 170.7 pg/mL) and in healthy controls (204.8 pg/mL, p = 0.006). After 1 month of propranolol treatment, the level had fallen 21.6% (p = 0.003), although the downward trend was less obvious after 3 months of treatment (18.0%, p = 0.63). VEGF expression correlated significantly with the lesion size (correlation coefficient [R] = 0.43, p = 0.046), whereas no correlation was observed with age (R = 0.13, p = 0.56). Serum VEGF levels were higher in patients with IH and fell after 1 month of oral propranolol treatment. Similar results, although less pronounced, were found after 3 months of treatment. Lesion volume and serum level of VEGF were significantly correlated.

Maternal and perinatal risk factors for infantile hemangioma: a case-control study.

Infantile hemangioma (IH) is the most common benign tumor occurring during childhood. We hypothesized that, in addition to already known risk factors, such as female sex, prematurity, and low birthweight (LBW), antenatal vaginal bleeding and progesterone therapy would be highly associated with IH. We randomly selected 650 individuals with IH and matched them with 650 children of the same age and nationality without IH. Trained investigators used a standardized questionnaire to collect data from both groups, including demographic, prenatal, and perinatal characteristics. Prematurity (p < .001, odds ratio [OR] = 2.22, 95% confidence interval [CI] = 1.44-3.41), LBW (p < .001, OR = 3.10, 95% CI = 1.87-5.16) and female sex (p < .001, OR = 2.06, 95% CI = 1.65-2.58) were significantly associated with IH. Maternal vaginal bleeding during the first trimester was shown to be an independent risk factor according to logistic regression analyses (p < .001, OR = 1.6, 95% CI = 1.36-1.91), which was most evident in those receiving progesterone therapy to prevent miscarriage (p < .001, OR = 2.11, 95% CI = 1.77-2.51). Subgroup analyses revealed that the effect was more pronounced in female than in male infants (OR = 2.82, 95% CI = 2.39-3.34). In addition to the known relationships, the present study identified a close relationship between maternal vaginal bleeding and progesterone therapy during early pregnancy and IH. Twins appeared to have a higher incidence of IH than singletons.

[Topical timolol in the treatment of periocular superficial infantile hemangiomas: a prospective study].

OBJECTIVE: To investigate the efficacy and side effect of topical beta-blocker (Timolol Maleate) in the treatment of periocular hemangioma in a prospective study. METHODS: 432 outpatients with infantile hemangioma visited our special clinic service in Shanghai Ninth People's Hospital from July 2010 to December 2011. Among them, 12 superficial periocular lesions were selected in the study. Timolol was used topically on the lesion in every 12 hours. Two independent special doctors evaluated the results according to the pictures before and after four-week application of timolol. RESULTS: Were categorized into four levels: continuous growth (the lesion continues to grow), stable (no visible change), moderate (0-50% of regression) , perfect (more than 50% of improvement). Result of the 12 outpatients, 4 showed perfect result, 2 moderate, 4 stable and 2 continuous growth. No side effect was observed. CONCLUSIONS: Topical timolol is effective and safe in the treatment of superficial periocular infantile hemangioma. It could be considered as the first line treatment of proliferative superficial hemangioma.

Treatment of venous infraorbital dark circles using a long-pulsed 1,064-nm neodymium-doped yttrium aluminum garnet laser.

BACKGROUND: Infraorbital dark circles are a common cosmetic problem with multiple causative factors and few studies into the different treatment options. OBJECTIVE: To assess the effectiveness and safety of long-pulsed 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy for infraorbital dark circles caused by visible prominent veins. PARTICIPANTS AND METHODS: Twenty-six patients with venous infraorbital dark circles were treated with a Nd:YAG laser (fluence, 130-140 J/cm(2) ; spot size, 6 mm) in double-pulse mode (pulse width, 6-10 ms; interpulse interval, 20 ms). Patients were examined 12 months after the final treatment. Results were ranked in five categories based on percentage clearance (5 = 100%, 4 = 75-99%, 3 = 50-74%, 2 = 25-49%, 1 ≤ 25% clearance). Patient satisfaction was ranked on a scale of 1 to 3 (1 = minimal improvement; 3 = completely satisfied), and pain was ranked on a scale of 1 to 10 (1 = mild pain; 10 = severe pain). RESULTS: Twenty-six patients completed the study. Objective improvement scores were 5 in all patients, and all patient satisfaction scores were 3. All patients tolerated the moderate pain (mean score 3.6). Transient erythema was observed in all patients. CONCLUSION: Long-pulsed 1,064-nm Nd:YAG-laser treatment appears effective and safe for the treatment of venous infraorbital dark circles and selectively removes visible prominent veins.

[A prospective study of propranolol as first-line treatment for problematic infantile hemangioma in China].

OBJECTIVE: To prospectively assess the efficacy and safety or propranolol as a first-line treatment for problematic infantile haemangioma in China. METHODS: From Mar. 2009 to Feb. 2010, 78 patients with problematic infantile hemangioma were included in the prospective study. The characteristics of the tumor, including sex, age, site, complications, were recorded. The response to treatment at 1 week, at 1 month and at the end of treatment was evaluated. The efficacy of treatment was graded as no response, stabilization, or accelerated regression. The indications for treatment, side effects and relapse after treatment were documented. The mean follow-up period was 16.7 months (range, 12.1-23.6 months). RESULTS: Oral therapy was initiated at mean age of 3.7 months (range, 1.1-9.2 months) as first-line therapy. The mean age at the end of treatment was 11.2 months (range, 5.2-22.3 months). The treatment was lasted for 7.6 months (range, 2. 1-18.3 months). One week after treatment beginning, the hemangioma growth was controlled in all the patients. The accelerated regression was achieved in 88.5% (69/78) of patients after one week of treatment, and 98.7% (77/78) of patients after 1 month of treatment and at the end of treatment. Ulceration was occurred in 14 cases before treatment, which was healed after treatment for 2 months. Minor side effects were happened in 15.4% (12/78) of patients. Rebound growth of lesion was noticed in 35.9% (28/78) of patients. CONCLUSIONS: Propranolol is effective in the treatment of infantile hemangioma with minor side effect. We suggest it should be used as the first-line treatment.

Nodules arising within port-wine stains: a clinicopathologic study of 31 cases.

Nodules are seen in approximately 10%-30% patients within port-wine stains (PWS) and usually regarded as vascular "tumor." However, nodules arising within PWS have not been systematically examined and the precise pathologic characteristics of them are unknown. The aim of this study is to evaluate the clinicopathologic and immunohistochemical features of blood vessels of nodules in 31 cases. A total of 31 biopsy specimens (excision) were obtained from the representative areas of lesion of each patient with nodules. Clinical features of all patients were recorded. Hematoxylin and eosin staining, immunohistochemical staining, and Weigert elastic stain were performed to investigate the histopathologic features of nodules. In a total of 31 subjects, there are 16 patients whose nodules occurred in the area innervated by the second branch of the trigeminal nerve (51.6%), 4 in the first branch (12.9%), 6 in the third branch (19.4%), 2 in both the first, and the second branch (6.5%). Based upon specular microscopic findings, 14 biopsy specimens were designated as pyogenic granuloma (PG) (45.1%), 10 as arteriovenous malformation (AVM) (32.3%), 5 as both (16.1%), and 2 cases as cavernous-like vascular ectasia (6.5%). Moreover, both AVM and PG were prone to occurring in the area innervated by the second branch of the trigeminal nerve. In summary, we believed that both AVM and PG are not rare histologic changes in PWS. Moreover, histologic findings suggest that the major portion of nodules arising within PWS can be categorized into AVM, PG, and AVH associated with PG.

[Clinical application of imiquimod for the treatment of infantile hemangiomas].

OBJECTIVE: To explore the clinical application of imiquimod for the treatment of infantile hemangiomas (IH). METHODS: 320 children with IH, including 250 superficial cases, 20 deep cases, and 50 mixed cases, were treated with 5% imiquimod cream every other day for 16 weeks. The clinical efficacy and side effects were evaluated at one year of age. RESULTS: The total effective rates of the superficial, deep, and mixed IH were 61.2% (153/250), 10.0% (2/20) and 60.0% (30/50) respectively, showing no statistical difference between superficial and deep type (P = 0.874), but significant difference between superficial and mixed (P < 0.01), deep and mixed type (P < 0.01). 56.0% (28/50) of mixed IH showed proliferation of its deep lesions. Slight skin erythema and crusting were the most common side effects. CONCLUSIONS: 5% imiquimod cream is effective and safe in superficial IH and superficial lesions of mixed IH with minimal skin reactions. The dysplasia of local tissue and systemic growth retardation are not found. It should be avoided to apply the cream to IH located around the cavities and skin fold. Imiquimod cream is a simple and convenient home-nursing medication. It can reduce care burden of family. Thus topical use of imiquimod can be considered as a good clinical indication for the treatment of superficial lesions of IH.

[Pathological characteristics and clinical significance of macrochilia secondary to venular malformation].

OBJECTIVE: To analyze the histologic characteristics of macrochilia secondary to port-wine stain and to elucidate the possible mechanism. METHODS: Twenty-one cases of macrochilia secondary to venular malformation were included and the histology of the lesions was observed by light microscope. RESULTS: Histological examination revealed vascular abnormalities and a number of widely distributed hamartomatous changes in macrochilia secondary to venular malformation. The average vessel diameter is (39.8 +/- 15.7) microm. The degree of hamartomatous change: mild (1 case), moderate (7 cases) and severe (13 cases). CONCLUSIONS: The complex hamartomatous changes suggest a genetically determined, multilineage developmental field defect in the pathogenesis of venular malformation.

[The pathological characteristics and clinical significances of maturational change of port-wine stain].

OBJECTIVE: In this study histologic observations were presented to elucidate the possible mechanism of maturational change of port-wine stain(PWS). METHODS: Normal PWS(3 cases) , thicken PWS (11 cases) and nodular PWS (9 cases) were included to present histologic observations. RESULTS: Normal PWS, only shows mild dilated, thin-walled vessels within superficial dermis. Thicken PWS, shows further dilated vessels and sebaceous gland throughout dermis and superficial subcutaneous fat. Nodular PWS can be divided into three groups. I Similar to thicken PWS, shows further dilated vessels and sebaceous gland throughout dermis and superficial subcutaneous fat. II Shows Large number of dilated vessels, honeycombing and less vascular mesenchymal. III Tenacious texture shows mild dilated vessels, diffused collagen, mesenchymal rarefaction, lymphocyte infiltration and lymphedema change. CONCLUSIONS: Histologic examination revealed not only the expected vascular abnormalities, but also a number of widely distributed hamartomatous changes in thicken and nodular PWS. The complex hamartomatous changes suggest a genetically determined, multilineage developmental field defect in the pathogenesis of PWS.

[Non-involuting congenital hemangioma: a study for diagnosis and treatment].

OBJECTIVE: To study the history, clinical symptoms, imaging and histology of a rare distinct infantile hemangioma. METHODS: 12 patients (5 female, 7 male; aged 18 months - 26 years) diagnosed as non-involuting congenital hemangioma were retrospectively analyzed. The history, imaging, histologic examination and the treatment were collected. RESULTS: Most of the patients had only one lesion which was round or ovoid, flat or plaque-like. The average size was about 5 cm x 6 cm. The overlying skin was usually had coarse telangiectasia with central or peripheral pallor. The skin has a high skin temperature. Magnetic resonance imaging, computed tomography angiography and digital subtraction angiography findings were similar to those of common infantile hemangioma. Histologic examination revealed lobular collections of small, thin-walled vessels with a large, often stellate, central vessel. "Hobnailed" endothelial cells lined along the intralobular vessels. Small arteries were observed "shunting" directly into lobular vessels or into abnormal extralobular veins. All lesions were easily excised without recurrence. CONCLUSIONS: Non-involuting congenital hemangioma is a distinct infantile vascular tumor. It should be diagnose early and treated appropriately.

[Superselective ethanol endovascular therapy under digital subtraction angiography for craniofacial arteriovenous malformations].

OBJECTIVE: To introduce superselective endovascular therapy under digital subtraction angiography for craniofacial arteriovenous malformations using absolute ethanol, and to assess the efficacy and complications of the method. METHODS: A retrospective review of patient medical and imaging records was performed. 8 patients (7 male, 1 female, 11-50 years) with craniofacial arteriovenous malformations underwent staged selective ethanol endovascular therapy (1-4 times, median 2 times). Clinical follow-up (8-24 months, mean 12.1 months) was performed in all patients, and results from imaging follow-up (2-6 months, mean 4.3 months) were available in 4 patients. Therapeutic outcomes were established by evaluating the clinical outcome of symptoms, as well as the degree of devascularization at follow-up angiography. RESULTS: 16 sessions of selective ethanol endovascular therapy were performed in 8 patients. 5 of 8 patients were cured, 2 had improvement, 1 had no change. Selective ethanol endovascular therapy was considered effective in 7 patients (87.5%). 4 patients will need further treatment sessions for residual arteriovenous malformations. Blistering, superficial skin necrosis and transient hemolysis occurred in 4 of 8 patients. All the complications were healed with observation. No major complications occurred. CONCLUSION: Superselective ethanol endovascular therapy under digital subtraction angiography has the potential for cure of craniofacial arteriovenous malformations and is able to obtain excellent cosmetic results, and with acceptable risk of complications.