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Intralesional injection is a common method among various therapeutic choices for the treatment of Infantile Hemangiomas. This article reviews the clinical application of intralesional injections for infantile hemangiomas, discusses indications for intralesional injection treatment and evaluates the safety and efficacy of different injected drugs.
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Objective: To systematically evaluate the clinical efficacy and safety of pingyangmycin and lauromacrogol in treatment of hemangioma or venous malformation. Methods: All the databases of PubMed, Cochrane Library, Embase, Web of Science, Wanfang, CBM, VIP and CNKI were searched from their inception to November 30, 2018 to seek the randomly controlled trials (RCTs) involving the efficacy and adverse reaction of lauromacrogol and pingyangmycin in treatment of hemangioma and venous malformation. According to the inclusion and exclusion criteria, two reviewers were respectively responsible for screening researches, extracting data and assessing the risk of bias of included studies. Subsequently, meta-analysis was performed with RevMan 5.3 software. Results: A total of 12 studies containing 1619 individuals with hemangioma or venous malformation were incorporated. Meta analysis showed that the cured rates of hemangioma and venous malformation were superior when treated with lauromacrogol than with pingyangmycin, the difference was statistically significant (OR=1.98, 95%CI 1.58-2.49, P<0.001). While no significant difference existed in the efficiency (OR=1.17, 95%CI 0.40-3.41, P=0.77) and inefficiency (OR=0.44, 95%CI 0.12-1.66, P=0.23) when treating hemangioma and venous malformation with lauromacrogol or pingyangmycin. The incidence of complication was distinctly lower in lauromacrogol group than in pingyangmycin group with statistical significance (OR=0.27, 95%CI 0.17-0.44, P<0.001). Conclusion: In the treatment of hemangioma and venous malformation, lauromacrogol is obviously superior to pingyangmycin in the therapeutic effect and safety, but there is no significant difference in effectively reducing the focus.
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Objective To observe the clinical effect of pingyangmycin injection combined with hypercator resection on laryngopharyngeal and laryngeal hemangioma under suspension laryngoscope. Methods Twenty-seven patients with laryngopharyngeal or laryngeal hemangioma were included. After trachea cannula via mouth and general anesthesia, the suspension laryngoscope was used to completely uncover the hemangioma, and 8 mg pingyangmycin (diluted with 6 mL saline injection) was locally injected into the tumor. And then the tumor was completely resected along its root by polypus forceps-like hypercator or was completely coagulated by electric coagulation. The intra-operative and post-operative bleeding were recorded, and the patients were given liquid diets after surgery for two weeks. The fibrolaryngoscope was reviewed to judge the curative effect at 1 month, 3 months, 1 year, 2 years, and 3 years after surgery. Results The pink or prunosus tumor turned into pinkish-white tumor after injection of pingyangmycin. When the root pedicle of the tumor was revealed by forceps holder, the polypus forceps-like hypercator could completely resect the tumor along the base of root, nearly without bleeding in the operation; when the root pedicle was big or could not be revealed, the tumor could be completely coagulated by electric coagulation. After surgery, no patients had dyspnea or wound bleeding. One month later, fibrolaryngoscope showed that the wound was repaired with pink normal mucosa. No recurrence was found in all cases after follow-up for 1 year. After 2 years of follow-up, one case had flaky purple uplift of the pharyngeal wall mucosa, and the tumor was completely resected by the above treatment. No recurrence was found after 3 years of follow-up. Conclusion Hypercator resection after local injection of pingyangmycin under suspension laryngoscope can completely resect the lesions, with less surgery trauma and quick recovery, suggesting that the treatment has affirmative efficacy and is worth popularizing.
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Objective@#To investigate the safety and efficacy of pingyangmycin (bleomycin A5) sclerotherapy for early peripheral arteriovenous malformations (AVM).@*Methods@#Thirteen cases of early-stage [Schobinger clinical stage (Ⅰ/Ⅱ)] peripheral AVM patients (11 stage Ⅰ and 2 stage Ⅱ patients) aged between 3 months and 51 years were selected between January 2012 and May 2015. Pingyangmycin sclerotherapy injections were administered with B-scan ultrasonography or digital subtraction angiography positioning. All patients underwent relevant supplementary examinations before and after the procedure, and clinical evaluation was performed based on the improvement of the clinical symptoms of the patient and re-examination of lesion by imaging.@*Results@#A total of 88 injections were administered to the 13 patients with an average of 6.7 injections per patient, 3-6 years of follow-up. Based on clinical evaluation, 7 patients were generally cured, 3 patients had significant improvement, 2 patients had partial improvement, and 1 patient had no improvement. Seven patients had different levels of postoperative swelling that resolved on its own. No serious complications occurred.@*Conclusions@#Pingyangmycin sclerotherapy for treatment of early peripheral AVM was effective and had few complications. It can control further progression of pathological changes.
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15 cases of large venous malformations in oral and maxillofacial region involving in multiple anatomical sites were treated by suture ligation and injection of pingyangmycin oleum iodisatum emulsion(PLE) for 2-5 times.Treatment effect of grade Ⅳ was observed in 12 cases,grade Ⅲ in 3 cases.No severe systemic adverse reaction and no local adverse reation were obseved in all cases.Suture ligation and PLE injection can enhance the therapeutic effect and reduce the adverse reactions in the treatment of large venous malformations of the oral and maxillofacial region.
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Objective To evaluate the clinical application value of three-dimensional medical image guided ultrasound in the chemotherapy of huge hepatic hemangioma.Methods Seventy-six cases were enrolled in a randomized control study.All cases were randomly divided into two groups (group A and group B).In group A,all cases underwent treatment based on the traditional two-dimensional medical images.Under the assistance of three-dimensional medical image information,preoperative treatment planning was performed in group B.After puncture treatment,therapeutic efficacy was evaluated by color ultrasound during follow-up.Results For treating huge hepatic hemangioma (tumor diameter ≥ 10.0 cm),the insertion number and pingyangmycin dosage in the group B were less than those in the group A [(6.2± 0.5)times vs (9.3±0.6) times,t=24.467,P=0.035;(99.2±8.0) mg vs (148.8±9.6) mg,t=34.613,P=0.029].The success rate of first treatment in the group B was higher than that in group A [73.6%(28/38) vs 100%(38/38),x2=131.91,P=0.032].Conclusion For huge hepatic hemangioma,the three-dimensional medical image information can be applied to reduce the insertion number and anesthetics dosage,improving the success rate of first treatment and therapeutic effect.
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Objective To observe the curative effect and safety of interventional therapy of uterine fibroids using Embosphere and Pingyangmycin lipiodol emulsion.Methods The clinical data of 120 cases with uterine fibroids treated in our hospital were reviewed,and the patients were according to the different treatments given,divided into two groups (each with 60 cases).Patients in control group were treated with interventional therapy of Pingyangmycin lipiodol emulsion,while patients in the study group were given interventional therapy of Embosphere.The clinical efficacy and safety in the two groups were compared.Results The total efficiency in the study group was 93.33%,which was significantly higher than that in the control group (75.00%),and the difference was statistically significant (P<0.05).The comprehensive indexes after the treatment were improved in both groups compared with those before the treatment,and the improvement in the study group was significantly better than the control group (P<0.05,P<0.01).Besides,the total incidence of adverse effects in the study group was 11.67%,which was significantly lower than that in the control group (26.67%)(P<0.05). Conclusion The interventional therapy using Embosphere has better effect on uterine fibroid compared with the therapy using Pingyangmycin lipiodol emulsion,which is worthwhile to be brought into clinical application.
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Objective:To study the effect of N-acetyltransferase 10(Naa10p)expression on the sensitivity of tongue squamous cell carcinoma Tca8113 cells to pingyangmycin(PYM).Methods:The lentiviral vectors of LV-shNaa10p,LV-Naa10p and control LV-NC were transfected into Tca8113 cells,the infection efficiency were identified,then the sensitivity of the infected cells to PYM was determined by MTS assay.Results:The IC50 of Tca8113-LV-shNaa10p group,Tca8113-LV-Naa10p group and Tca8113-LV-NC group were (20.772 ±0.106)μg/ml,(2.157 ±0.123)μg/ml and (6.301 ±0.069)μg/ml respectively(between groups P <0.05).Con-clusion:Knock down of Naa10p may reduce and over expression of Naa10p can increase the sensitivity of Tca8113 cells to PYM.
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Objective To investigate the effect of cell proliferation and apoptosis induced by Pingyangmycin (PYM)and dexamethasone (DEX) on human umbilical vein endothelial cells (HUVEC)in vitro, so as to provide therotical evidence for treatment of aneurysm with PYMand DEX. Methods Control, PYM, DEX and PYM group were established after HUVEC were cultured for 24 hours. Cell morphology was observed by inverted microscope.The effect of cell proliferation and apoptosis were detected with CCK-8reagents and flow Cytometry. The apoptotic protein expression of caspase-3 was testedthrough Western blot. Results Descend of adherent cell density and the ascend of floating cells could be observed after treated with PYM and DEX for 24 hours. HUVEC could be inhibited effectively with concentration-dependent on PYM and DEX. The significant statistical difference of cell apoptosis rate between the group used for PYM alone and the group combined low-concentration PYM with DEX through Flow Cytometrywas found. There was significant statistical difference of apoptotic protein expression of caspase-3 through Western blot compared with the group used for PYM alone and the group combined low-concentration PYM with DEX. Conclusion PYM and DEXcould inhibitthe proliferation of HUVEC alone. The better effects could be observed combination low-concentration PYM with DEX , the mechanism of which might beapoptosis with low-concentration PYM and necrosis with high-concentration PYM.
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Objective To study the therapeutic effect of pingyangmycin local injection under suspension microlaryngoscopy for treatment of laryngopharyngeal and laryngeal hemangioma. Methods The total of 44 cases of patients with laryngopharyngeal or laryngeal hemangioma were randomly divided into the experimental group ( n=22 ) and the control group (n=22). They were treated with bleomycin 5 mg or pingyangmycin 4-8 mg injection under suspension microlaryngoscopy in the hemangioma, respectively. If the treatments were not curative, repeated one more times in intermittent 15 d, but not more than 3 times. Therapeutic effect and adverse effect were recorded and analyzed. Results The total effective rate (95. 4%)in the experimental group was significantly better than that (59. 1%) in the control group (P<0. 05),and side reaction in two groups showed no significant variation. Conclusion Pingyangmycin local injection for treating laryngopharyngeal and laryngeal hemangioma is effective, less adverse reaction.
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Objective To evaluate the influence and significance of Pingyangmycin chemotherapy on the c-myc and Ras-P21 protein expression in penile cancer .Methods A total of 100 penile squamous cell carci-noma cases was retrospectively studied and divided into two groups .Data were obtained from 1995 to 2005 .In the chemotherapy group ,50 cases of patients were selected to perform preoperative chemotherapy before surgery .The patients were treated by Pingyangmycin .After 7 times of medication ,partial excision of penis plus improved ingui-nal lymph node dissection was performed .In the control group ,50 cases of patients were selected for partial exci-sion of penis plus improved inguinal lymph node dissection directly without any pre -operative chemotherapy .All pathology specimens were detected of c -myc and Ras-P21 protein expression by immunohistochemical staining assay.Theχ2 test was used for the statistical analysis .Results In chemotherapy group,the positive expression rates of c-myc and Ras-P21 were 30%,27%,respectively.However,in control group,the positive expression rate of c-myc,Ras-P21 were 52%,48%,respectively.By theχ2 test,the expressive differences of c -myc,Ras-P21 positive expression rate between chemotherapy group and control group were all significant (P<0.05). Conclusion The protein expressions of c -myc and Ras-P21 is significantly decreased in the tissue of Pingy-angmycin chemotherapy of penile cancer .
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Objiective To prepare pingyangmycin water-soluble wax stick and to establish its content determination method. Method The formula was optimized by orthogonal experiment and the content of pingyangmycin in wax stick was determined by high performance liquid chromatography (HPLC). Results The formula of pingyangmycin wax stick matrix was optimized as 1 g of alcohol ethoxylate and 1 g of S 40. Pingyangmycin was added when the temperature of the matrix raised to 70℃and stirred for 20 min. The linear range of pingyangmycin determined by HPLC was 34.4~172μg/mL,the regression equations was y=8298.9 x-34996(r=0.9999),and the average recovery of pingyangmycin was 102.67%(n=9). Conclusion The Preparing procedure of pingyangmycin water-soluble wax sticks is simple and stable. The HPLC method for determining the content of pingyangmycin in water-soluble wax sticks is simple, fast and accurate.
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A 74-year-old man presented with a progressively worsening pain in sacrum and was diagnosed to have a sacral chordoma by biopsy in May, 2004. Percutaneous intratumoral injection with lipiodol-pingyangmycin suspension (LPS) was carried out under image guidance and repeated when the pain in sacrum recurred and the tumor increased. During a 6-year follow-up period, three sessions of this treatment were executed. CT imaging and Karnofsky Performance Score were used to evaluate the size of tumor and quality of life, respectively. The patient was free of pain after each procedure and had a high quality of life with a Karnofsky Performance Score above 80 points. The tumor lesion in sacral area was effectively controlled. No complications were observed. Percutaneous intratumoral injection with LPS under image guidance may be an effective and safe alternative for the patients with sacral chordoma.
Subject(s)
Aged , Humans , Male , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Biopsy , Bleomycin/administration & dosage , Chordoma/diagnosis , Ethiodized Oil/administration & dosage , Injections, Intralesional , Magnetic Resonance Imaging , Sacrum , Spinal Neoplasms/diagnosis , Suspensions , Tomography, X-Ray ComputedABSTRACT
Objective To investigate the clinical effect and safety of microwave thermosetting joint pingyangmycin injected within the occlusion in treatment of maxillofacial hemangioma.Methods The clinical data of 102 patients with maxillofacial hemangioma were retrospectively analyzed.According to the different period of the different choice of treatment,the patients were divided into microwave thermosetting group and surgery group.The clinical effect,treatment time and hairdressing effect of the two groups were analyzed.Results Total effective rate of microwave thermosetting group was 96.30%,surgery group was 95.83%,the difference between the two groups had no statistical significance (x2 =0.153,P > 0.05).The average surgical time of surgery group was obviously shorter than microwave thermosetting group(t =7.625,P < 0.01),but satisfaction of hairdressing effect in microwave thermosetting group was obviously higher than that of the surgery group(90.74% vs 75.00%,x2 =4.533,P <0.05),the incidence rate of adverse reaction was significantly lower than the surgery group(5.56% vs 18.75%,x2 =4.262,P < 0.05).The facial nerve injury occurred in 3 patients (6.2 5 %) after operation in the surgery group,microwave thermosetting group had no facial nerve injury after treatment.There was no recurrence after follow-up for 6 months.Conclusion The clinical effect and hairdressing effect of microwave thermosetting joint pingyangmycin injected within the occlusion in treatment of maxillofacial hemangioma are satisfied,the incidence rate of adverse reaction and complication is relatively low.It is safe and effective,which is worth expanding in clinical practice.
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ObjectiveTo investigate an optimal treatment of localized low flow type venous malformation located in the oral and maxillofacial region.MethodsFifty seven patients with localized low-flow venous malformation were treated by intralesional injection of PYM.The injections was repeated at an interval of 10 to 14 days,but not more than 3-5 sessions within a therapeutic period.If necessary,the secondary therapeutic period was performed 1 month later.The general and local adverse responses and the appearance improvement were recorded.The clinical outcomes and aesthetic effects were assessed with a follow-up of 1 to 3 years.ResultsAfter 3-8 injections,complete clinical resolutions were achieved in 52 patients.The deformity disappeared thoroughly.The surface skin and the appearance of lesions showed normal.4 patients received completed lesion control and showed nor mal skin or muco but a little hypertrophy tissue.One venous malformation reduced 2/3 volume after 8injections but improved slowly.The therapeutic time seemed to be related with the size of lesion.Diameter less than 3 cm could be usually cured within 1 treatment period.No ulcerations or scars were presented in injection regions.The function of nerves in oral and maxillofacial region remained normality in all patients.The systematic complication included transient pyrexia and poor appetite appeared in several cases.No allergy was found.No clinical recurrence was observed during the follow-up.ConclusionsTreatment of localized low-flow venous malformations in oral and maxillofacial region with PYM sclerotherapy reveals a high rate of complete clinical resolution,a fair cosmetic and function result,and does not damage facial nerves or form local scars.And it might be regard as an optimal therapeutic method to localized low-flow venous malformations.
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Objective To evaluate the clinical efficacy of pingyangmycin (PYM) injection on infantile hemangioma located in the parotid gland region. Methods Twelve patients were treated by intralesional injection of PYM. When necessary, the injections were repeated at an interval of one week, but not more than 3-4 sessions within a therapeutic period. Normally, the secondary therapeutic period was performed 1 month later. The general and local adverse responses were recorded and the clinical outcomes were assessed with a follow-up of 1 to 3 years. Results Complete clinical resolutions were achieved in 10 patients. 2 patients received one injection, 3 patients received 2 injections, 3 patients received 3 injections, and 2 patients received 4 injections. The remaining 2 patients with partial resolution received 6 and 7 injections respectively. No clinical recurrence was observed during the follow-up of 1 to 3 years. No ulcerations or postoperative sears in injection regions were presented. The function of facial nerve was remained normality in all patients. The systematic side effects included transient pyrexia and poor appetite appeared in partial patients. No allergy cases were found. Conclusion Treatment of infantile hemangioma located in parotid gland region with PYM injection reveals a high rate of complete clinical resolution, with fair cosmetic results and short treatment time, and it does not damage the facial nerve or form local scar.The treatment time of PYM injection seems to be positively related to size of the lesions.
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Objective To observe the change of vascular endothelial cells and structure of the auricular posterior vein caused by freezing or pingyangmycin injection alone and freezing in combination with pingyangmycin injection,to investigate the effect of these treatments on the vein. Methods Eighteen rabbits were divided into 3 groups of 6 each, and another rabbit was used as a control. (Pingyangmycin) was injected into the auricular posterior vein in the first group, spray freezing within 20 seconds on the auricular posterior vein was performed in the second group,and freezing in combination with pingyangmycin injection was performed in the third group. Light microscope and transmission electron microscope were used to observe the change of auricular posterior vein in the rabbits.Results Proliferation of endothelial cells,and thickening of vessel wall were induced by pingyangmycin. Thrombus formation, tissue oedema and inflammatory infiltration induced by spray freezing within 20 seconds were reversible. Thrombus formation, proliferation of endothelial cells and thickening of the vessel wall was induced by freezing in combination with pingyangmycin injection.Conclusion Freezing and pingyangmycin injection have the synergistic effect, resulting in the proliferation of endothelial cells, thrombus formation, thickening of vessel wall, and even occlusion of vessels.
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Objective To evaluate the inhibitory effect on the VX2 tumor of rabbit with CT-guided percutaneous high-temperature pingyangmycin lipiodol injecting. Methods New Zealand white rabbits were performed to plant rabbit VX2 tumor in the left liver leaf. After two weeks, all the rabbits were scanned with CT and divided into 5 groups randomly, and every group was injected different temperature pingyangmycin combined with lipiodol, then the effect was evaluated after 2 weeks. Results Compared with control group, the volume of VX2 tumor in every group injected high-temperature lipiodol reduced obviously (P<0.05), and the necrosis rate of hepatic transplant tumor increased significantly (P<0.05) as the temperature increased. MVD value of the tumor and VEGF expression obviously reduced (P<0.05), there was a positive relationship between MVD value and VEGF expression with the temperature. Conclusion CT-guided percutaneous high-temperature pingyangmycin lipiodol injecting can inhibit the VX2 tumor growth and tumor angiogenesis formation obviously, and the higher temperature, the better the therapeutic effect.
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Objeetive To investigate the optimized concentration,effectiveness and histological change of Pingyangmycin by local injection of keloids for two weeks.Methods The appropriate concentration was analyzed,based on the Vancouver scar scale.48 eases of keloids were randomly divided into 4 groups with different concentrations of Pingyangmycin (1,0.5,0.25,and 0.125 mg/ml).Each case was iniected for five times at two weeks intervals,and then the statistical results (pair t test) and the histological changes were evaluated.Results Statistically,0.5 mg/ml group was more effective (P=0.0026),and this group had significant differences from the others (SNK test).The rate of the recurrence for one year was 12.00% in the whole effective cases.The keloid tissue after treatments,histologically,showed the thicker epidermis and larger papillary layer of the dermis,more inflammatory cells.Conclusions 0.5 mg/ml Pingyangmycin is the most appropriate concentration in this study and 0.25 mg/ml is the effective one.This treatment for keloid is convenient,safe,effective,low recrudescence and few side effects.
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Objective To analyze the factors that might affect the therapeutic results of pingyangmycin-lipiodol emulsion intra-arterial sclerosing embolization (PLE-IASE) in treating symptomatic cavernous hemangioma of liver (SCHL). Methods PLE-IASE was performed in 89 patients with SCHL (32 males and 57 females). Before treatment the mean diameter of the hemangioma was (8.3±3.8) cm. Of 89 patients, 53 experienced anxiety, 35 suffered from right upper abdominal pain and the remaining one developed Kasabach-Merrit syndrome. Before PLE-IASE, the arteriographic classification was conducted based on hepatic arteriographic findings. Then pingyangmycin-lipiodol emulsion (PLE) was injected through the feeding artery. The dosage of pingyangmycin (PYM) was (9.8±4.4) mg and the dosage of lipiodol (LP) was (5.9±2.9) ml. The lipiodol deposition status was judged by the follow-up spot film taken immediately after PLE-IASE. The observations of the occurrence of complications, the relief of symptoms and the minification of SCHL were followed for 6-72 months after PLE-IASE. The linear regression analysis statistics was conducted by taking the minification as dependent variable and taking the arteriographic classification, lipiodol deposition status, the dosage of PYM, the dosage of lipiodol and the preoperative SCHL diameter as independent variable. Results Of all 89 cases of SCHL, hypervascular type was seen in 51, hypovascular type in 26 and arteriovenous shunt (AVS) type in 12. Good lipiodol deposition status was found in 64 patients and poor deposition in 25 patients after PLE-IASE. After PLE-IASE, the symptom of anxiety in 53 patients was relieved and the right upper abdominal pain was reduced in 33 cases although intermittent pain still remained in 2 patients. The blood platelet count of the patient with Kasabach-Merrit syndrome returned to normal after the treatment. The symptomatic relieve rate was 98.7%. No serious complications occurred in the follow-up period. The linear regression analysis showed that arteriographic classification, lipiodol deposition status and PYM dosage used in treatment had statistically significant impact on tumor minification, while the preoperative diameter of SCHL and lipiodol dosage used in treatment had no statistically significant impact on it. Conclusion PLE-IASE is an effective and safe interventional treatment for SCHL. Arteriographic classification, lipiodol deposition status and PYM dosage used in treatment have a significant correlation with the minification of SCHL, while the preoperative diameter of SCHL and lipiodol dosage used in treatment bear no relationship to the minification of SCHL.