Objective To analyze the surgical treatment of hemangioma of limbs complicated by Kasabach-Mcrritt phenomenon in children.Methods A retrospective study was carried out on 31 children with hemangioma of limbs complicated by Kasabach-Merritt phenomenon.Lower limbs were affected in 19 patients,and upper limbs in 12 patients.Twenty-six patients showed decreased platelet count ((2.6-60) × 109/L) and fibrinogen level (＜ 1 g/L),and 21 prolonged partial prothrombin time (＞ 50 seconds).All the patients who had responded poorly to medications including glucocorticoids received surgical treatment.Results Of these patients,30 were cured,and one died of massive blood loss.After surgical treatment,the platelet count returned to normal in 1-3 days in 25 patients,3-7 days in 4 patients,and more than 10 days in one patient.Conclusions For pediatric hemangiomas of limbs complicated by Kasabach-Merritt phenomenon,surgical treatment should be given as early as possible so as to reduce mortality in patients.

Chronic hepatitis C virus ( HCV) infection has been reported in association with several extrahepatic complications, among which mixed cryoglobulinemia is the most documented. Clinical manifestations of HCV related cryoglobulinemia include skin lesions, glomerulonephritis, peripheral neuropathy, and widespread vasculitis.The therapy may be directed to eradicate HCV infections, suppress B-cell clonal expansion and cryoglobulin production, and ameliorate symptoms.This paper reviews the research progress on pathogenesis, clinical manifestations, diagnosis and treatment of HCV related cryoglobulinemia.

Objective To observe the effect of levocarnitine and trimetazidine on left ventricular mass index in patients with maintenance hemodialysis (MHD),and to explore the safety and efficacy of the two drugs when used in combination.Methods 48 cases of MHD were randomly divided into control group and treatment group,24 cases in each group.On the basis of routine treatment,treatment group was treated with L -carnitine 1.0g by intravenous, 3 times per week,and trimetazidine tablets 20mg,3 times daily at the end of each dialysis.The control group was only treated with L -carnitine.The course of treatment was 12 months.The left atrial diameter (LAD),left ventricular end diastolic diameter (LVDD),left ventricular end diameter (LVDS),interventricular septal thickness (IvST),left ventricular posterior wall thickness (LVPWt),left ventricular ejection fraction (LVEF),stroke volume (SV),left ventricular mass index calculation were detected and compared before and after treatment in the two groups.Results After treatment,the LAD,LVDd,LVDs,IvST,LVPWt in the control group were (40.25 ±1.73)mm,(51.16 ± 3.17)mm,(32.52 ±2.86)mm,(11.16 ±1.23)mm,(10.23 ±1.19)mm,which were decreased compared with before treatment [(42.63 ±1.82)mm,(53.71 ±3.26)mm,(35.83 ±3.12)mm,(12.51 ±1.39)mm,(11.76 ± 1.37)mm],and the LAD,LVDd,LVDs,IvST,LVPWt in the treatment group were (37.61 ±1.86)mm,(47.53 ± 3.18)mm,(29.71 ±2.93)mm,(10.46 ±1.32)mm,(9.14 ±1.32)mm,which were decreased compared with beforetreatment [(42.89 ±1.91 )mm,(54.18 ±3.29)mm,(35.76 ±3.27)mm,(12.49 ±1.35 )mm,(11.73 ± 1.41)mm](t control group =4.643,2.747,3.831,3.563,4.130,t treatment group =9.702,7.120,6.750,5.209, 6.569,all P <0.05 ),and each index of the treatment group was significantly lower than the control group (t =5.091,3.961,3.362,2.901,3.005,all P <0.05 ).The LVMI of the control group and treatment group was (121.63 ±7.16)g/m2 ,(115.49 ±7.91)g/m2 after treatment,which were decreased compared with before treatment [(127.32 ±7.51)g/m2,(126.87 ±7.28)g/m2 ](t =2.686,5.186,all P <0.05).The EF and SV of the control group were (58.16 ±4.35)%,(43.61 ±4.72)mL after treatment,which were increased compared with before treat-ment[(55.32 ±4.17)%,(40.52 ±4.13)mL](t =2.686,5.186,all P <0.05).The EF and SV of the treatment group were (61.26 ±4.13)%,(46.25 ±4.17)mL after treatment,which were increased compared with before treat-ment[(55.28 ±4.51)%,(40.81 ±4.96)mL](t =4.791,4.113,all P <0.05).After treatment,LVMI in the treat-ment group was lower than that in the control group,SV and EF were higher than those in the control group (t =2.819,2.532,2.053,all P <0.05).Conclusion Compared with single levocarnitine,the therapy of levocarnitine and trimetazidine can better reduce left ventricular mass index in MHD patients and improve the cardiac structure and function,which is safe and effective.

OBJECTIVETo explore the therapeutic effect of radiofrequency ablation for tongue venous malformation( VM).

METHODSFrom July 2013 to July 2014, 30 cases with tongue VM (local or diffuse) were retrospectively analyzed. 23 cases underwent radiofrequency ablation treatment. The radiofrequency electrode tip(0. 5 mm in diameter) was inserted into the lesion 1 mm below the bottom with 25 W in power and 15-30 s of pulse. The treatment was repeated when the electrode tip was removed back every 1 mm. Multi-point treatment was performed.

RESULTS15 cases with unilateral VM were completely healed after one-stage radiofrequency ablation. 8 cases with bilateral VM received two-stage radiofrequency ablation with a 3-6 months of interval. Among the 8 cases, completely healing was achieved in 5 cases, partial VM residue happened in 3 cases due to its diffuse lesion and reservation of tongue function. 23 cases were followed up for 3 month to 1.5 years. Good cosmetic and functional results was achieved in 20 cases with no relapse. Partial VM residue was left in 3 cases.

CONCLUSIONSRadiofrequency ablation can effectively treat tongue VM with minimal morbidity and good cosmetic appearance. It also avoids the disadvantages of surgery.

Catheter Ablation ; instrumentation ; methods ; Electrodes ; Humans ; Retrospective Studies ; Tongue ; blood supply ; Treatment Outcome ; Vascular Malformations ; surgery ; Veins ; abnormalities

Objective: To define a new subtype of vascular anomaly, named fibro-adipose vascular anomaly(FAVA)and to discuss the methods of diagnosis and treatment in order to decrease the misdiagnosis rate and improve the recovery rate. Methods: From Jan. 2011 to Dec. 2015, 34 cases with FAVA on the lower extremities received surgical treatment in our center. The clinical data were collected to summarize the imaging and pathological characteristics for diagnosis. Results: The misdiagnosis rate was 76.5%(26/34) in all these 34 patients. The cure rate was 100% after operation. The patients were followed-up for 1-3 years(average, 19 months) with normal function and no recurrence. Conclusions FAVA is usually misdiagnosed as hemangioma or vascular malformation. The disease should be well defined to help the diagnosis and treatment. Surgical excision is one of the optional treatments.

Objective: To assess the safety and effectiveness of sufficient, short-term platelet (PLT) transfusion for the surgery preparation of the infantile patients with Kasabach-Merritt phenomenon, who were insensitive to glucocorticoids. Methods: The infantile cases were retrospectively analyzed during May 2011 to December 2016, who were clinically diagnosed as KMP and insensitive to glucocorticoids, received PLT transfusion and surgical resection. PLT transfusion in patients whose PLTC was less than 30×10⁹/L, was 0.3 therapeutic dose(TD)/kg, and 0.2 TD/kg in PLTC≥30×10⁹/L group. The maximum was 1 TD.Criteria of the PLT transrusion: 1 hour after the transfusion, the PLT count (PLTC) were tested and the corrected count increment of platelet (CCI) and practical platelet recovery (PPR) was calculated. PLTC ≥100×10⁹/L, CCI>7.5×10⁹/L and PPR>30% were defined as effective; while PLTC=(50-99)×10⁹/L, CCI>7.5×10⁹/L and PPR>30% as partial effective; PLTC<50×10⁹/L, or CCI≤7.5×10⁹/L, or PPR ≤30% were defined as ineffective. By reviewing the method and response of their PLT infusions, to figure out the most effective way in rising PLT, as a part of pre-operation treatment. Results: There were 46 cases in the research. Based on the PLTC, CCI and PPR 1 hour after PLT transfusion, there were 44 effective transfusion, 2 patients with partial effectiveness, and no ineffective case. There was no allergic or heart failure happened in any cases. No critical potential complications of PLT transfusion occurred, including fluid and iron overload, alloimmunization to human leukocyte antigen and/or PLT antigen. Conclusions Pre-operative sufficient and short-term PLT infusions are more effective than low dose and long-term ones. They can create a more optimistic opportunity for surgical resections.

Systematically evaluate the implementation of Specifications of Air Sampling for Hazardous Substances Monitoring (GBZ 159-2004) , so as to provide technical basis for the future standard revision. The semi-structured interview method was used to interview the industry experts from centers for disease control and prevention, occupational disease prevention and control hospitals/institutes, employers, third-party technical service institutions and universities, and the induction method was used to refine the topics and relevant suggestions. Some technical indicators of GBZ 159 are not suitable for the current actual work of occupational health, and need to be revised and improved urgently. The revised GBZ 159 should comply with the current situation of China's industrial development and the development of occupational health testing equipment in the new era, and improve the relevant technical requirements of sampling quality control.

Objective:To analyze the metabolism of blood glucose and lipid in breast cancer patients after the first chemotherapy.Methods:Breast cancer patients who received chemotherapy for the first time from December 2016 to January 2020 were collected in our hospital, and their blood glucose and lipid levels were monitored. Patients were grouped according to different treatment plans. Non-parametric rank sum test was used for statistical analysis on SPSS software.Results:There were 1 356 female breast cancer patients were enrolled, blood glucose and lipid levels were compared before and after chemotherapy. Our results showed that baseline medium blood glucose was 5.2 mmol/L, lower than 5.3 mmol/L after chemotherapy ( P<0.05). The baseline triglyceride (TG) was 1.2 mmol/L, lower than 1.6 mmol/L after chemotherapy ( P<0.05). The baseline small dense low-density lipoprotein (sdLDL) was 0.7 mmol/L, lower than 0.8 mmol/L after chemotherapy ( P<0.05). The baseline high density lipoprotein (HDL) was 1.3 mmol/L, higher than 1.2 mmol/L after chemotherapy ( P<0.05). Patients′ menstrual status and body mass index were related with blood glucose, TG, LDL and sdLDL (all P< 0.05). Conclusions:Abnormal metabolism of blood glucose and lipid are observed in breast cancer patients after the first chemotherapy. More awareness of cardiovascular disease in breast cancer patients might ensure their overall clinical benefits.

Objective:To investigate the clinicopathological features, classification, and genetic characteristics of common lymphatic malformation (CLM) in superficial soft tissue.Methods:A retrospective study of 110 patients with the diagnosis of CLM at the Henan Province People′s Hospital, China from August 2019 to August 2022 was performed. The clinicopathological features, relevant immunohistochemical (IHC) staining results, and fluorescence quantitative PCR of PIK3CA mutation were analyzed, and patients were followed up.Results:Among the 110 CLM patients, there were 53 males and 57 females; 65 cases (65/110, 59.1%) were first detected when the patients were≤2 years old. The most common location was the head and neck in 41 cases (41/110, 37.3%). Clinically, 102 cases (102/110, 92.7%) were solitary, 83 cases (83/110, 75.5%) were skin-colored, 69 cases (69/110, 62.7%) had indistinct borders, and 10 cases (10/110, 9.1%) had diffuse and severe macroscopic manifestations. There were 52 macrocystic type (52/110, 47.3%), 23 microcystic type (23/110, 20.9%), and 35 combined type (35/110, 31.8%). The macrocystic CLM presented as soft, translucent masses with large cystic cavities on the cut surface, and histologically they were composed of large, irregularly dilated channels that were thicker with irregular smooth muscle and lymphocytic infiltration. Microcystic CLM showed wartlike projections or translucent blisters on the skin, with small honeycomb structures on the cut surface, and histologically consisted of round or angular dilated small lymphatic vessels with little or no smooth muscle. The combined CLM had both macrocystic and microcystic morphologies. IHC staining showed that the lymphatic endothelial cells were positive for LYVE-1, D2-40, PROX1, CD31, and VEGFR3 but negative for CD34; in the macrocystic and combined CLM vessel walls were positive for SMA. Eight of 13 CLM had PIK3CA mutation. All patients were followed up, and 24 (24/110, 21.8%) had relapses, which more frequently occurred in combined type, followed by microcystic type.Conclusions:CLM is a congenital vascular malformation composed of dilated, abnormal lymphatic channels, with PIK3CA mutation. There are significant differences in clinicopathological characteristics among the different types. Since microcystic and combined CLM are prone to recurrence, accurate pathological subtyping is necessary to guide treatment and to predict prognosis.

Objective　To investigate the difference and significance in the expression of miR-134 in peripheral blood of patients with epilepsy.Methods　Trizol was used to extract serum RNAs of patients with epilepsy,NCode TM VILO TM micrornas cDNA short Kit and Express Sybr those TM micrornas qRTPCR Kits was used to reverse transcriptions and real-time fluorescent quantitative PCR to detect the expression of miR-134.All cases were grouped according to the course of disease,seizure frequency,onset time limit,brain electrical activity and special epilepsy syndrome.Results　Compared with control group,the expression of miR-134 in peripheral blood of epilepsy group is significantly increased,it is obviously higher in long course group and acute group.The expression of miR-134 in different seizure frequency group and special epilepsy syndrome group has no difference.Conclusion　The expression of miR-134 in peripheral blood of patients with epilepsy was significantly increased while it was affected by the length of disease and the duration of seizure.In addition,the expression of miR-134 in peripheral blood of patients with epilepsy was positively correlated with the degree of discharge and severity of damage,indicating that miR-134 could be a biomarker for epilepsy.