Objective: To observe the effects of different concentrations and doses of urea on the proliferation and apoptosis of human hemangioma endothelial cells, in order to provide evidence for the further mechanism study of urea in the treatment of hemangioma. Methods: Human hemangioma endothelial cells (HemECs) and normal endothelial cells (VE) were cultured in vitro. Cell viability was detected by CCK-8 after invention with different concentrations(40%, 50%, 60%, 70%) and doses(3, 6, 9 μl/ml) of urea. The apoptosis of HemECs was detected by flow cytometry dual-dye and propidium lodide single dye. Results: The viability of HemECs was significantly lower than that of VE under different concentrations and doses of urea (P<0.05). The inhibition rate of 40% urea on HemECs increased with the increase of urea dose (P<0.05), and the inhibition effect was most obvious at 4 h and 12 h. The apoptosis of HemECs increased in a time and dosage dependent manner with the treatment of 40% urea. High dose(9 μl/ml)of 40% urea significantly promoted the apoptosis of HemECs(P<0.05). Conclusions Low dose of 40% urea significantly inhibited the proliferation of HemECs, and had no significant effect on VE. However, high doses of urea promoted apoptosis of HemECs.

Objective: To compare the curative effect of non-surgical treatment, early operation and advanced operation on the Kaposiform hemagioendothelioma (KHE). To explore the optimal treatment for KHE. Methods: The 106 cases of KHE patients admitted by our hospital from January 2004 to December 2016 were selected as the study subjects. The age is the minimum 1d and the maximum 43 years, median age 94.5 d. According to different treatment methods, they were divided into non-surgical treatment and surgical treatment: according to the onset of the disease and the day of the operation, the early operation was performed less than three months since the onset of the disease, and the advanced operation more than 3 months. Efficacy evaluation criteria: The recovery meant that the tumor disappeared or mostly disappeared, the platelets returned to normal, and there was no recurrence more than half a year after treatment. " Effective" indicated that tumors were shrunken significantly and the platelet counting rose significantly. " Ineffective" indicated that the tumor was not shrunken or continued to increase and platelet counting did not rise or continued to decrease.The three groups of patients were followed up, and the efficacy of the three groups after treatment and the changes of platelet counting before and after treatment on day 1, 7 and 14 were compared. The two groups of early and late treatment were compared for operative and postoperative conditions. Results: All patients were followed up for 6-23 months, 24 cases were effective, 12 cases were ineffective, and 5 cases died. After 7 days of treatment, the platelet counting of the three groups were 68 (31, 157)×10⁹/L in the non-surgical treatment group, (294.75±150.59)×10⁹/L in the early operation group, (221.48±148.71)×10⁹/L in the late operation group, with statistical significance (P < 0.05). After 14 days of treatment, the platelet counting of the three groups were 78 (25.51, 54.5) in the non-surgical treatment group, 281 (234, 356)×10⁹/L in the early operation group, and in the late operation group (219.67±140.95)×10⁹/L, with statistical significance (P < 0.05). After at least half a year of follow-up, the total effective rate of clinical efficacy in the three groups was the non-surgical treatment group 62.07%, the early operation group 96.34% and the late operation group 81.82%; the difference was statistically significant between two groups (P < 0.05); There was significant difference between the early operation group and the late operation group in the amount of bleeding and operation time, the time of platelet counting and the total hospitalization time (P< 0.05). Conclusions Early surgical treatment of Kaposiform hemangioendothelioma is superior to late-operative and non-surgical treatment.Surgical treatment will be the preferred option for treatment of Kaposiform hemangioendothelioma, and examinations should be operated to potential patients for early diagnosis.

The patient, a 19-year-old female, found that the blue and purple mass was in her left forearm 3 years ago, and the mass gradually increased without obvious pain. It disappeared when pressing. The first diagnosis was "left forearm venous malformation" . During the operation, the boundary of the tumor body was clear and the capsule was complete. The blood supply of the tumor body was very rich. There were many micro capillary networks in the tumor body. It looked like "venous malformation" by general observation. But it was diagnosed as subcutaneous hamartoma by pathological examination. It was very similar to venous malformations by preoperative and intraoperative clinical manifestations, which will lead to misdiagnosis. Therefore, we should carefully handle and broaden the thinking of disease analysis in the similar cases.

The patient, a 19-year-old female, found that the blue and purple mass was in her left forearm 3 years ago, and the mass gradually increased without obvious pain. It disappeared when pressing. The first diagnosis was "left forearm venous malformation" . During the operation, the boundary of the tumor body was clear and the capsule was complete. The blood supply of the tumor body was very rich. There were many micro capillary networks in the tumor body. It looked like "venous malformation" by general observation. But it was diagnosed as subcutaneous hamartoma by pathological examination. It was very similar to venous malformations by preoperative and intraoperative clinical manifestations, which will lead to misdiagnosis. Therefore, we should carefully handle and broaden the thinking of disease analysis in the similar cases.