Interferon-alpha therapy for refractory kaposiform hemangioendothelioma: a single-center experience.

Kaposiform hemangioendothelioma (KHE) is a relatively rare vascular tumor with an aggressive and infiltrating nature. Previous studies have revealed an exclusive relationship between KHE and Kasabach-Merritt Phenomenon (KMP), which is associated with high morbidity and mortality. No universally accepted treatment modality exists for refractory KHE with or without KMP. The aim of this study was to evaluate the safety and efficacy of interferon-alpha (IFN-α) therapy for treatment of refractory KHE. Twelve consecutive patients with KHE were treated with subcutaneous injections of IFN-α after other treatments had failed. Eleven patients exhibited a reduction in tumor size of more than 50%, and the platelet count for all five patients with KMP returned to normal level after IFN-α therapy. The duration of IFN-α treatment ranged from 3 months to 9 months (mean: 6.3 months). The response time for IFN-α treatment ranged from 10 days to 5 weeks (mean: 3.6 weeks). Additionally, no severe complications, such as neurological damage or spastic diplegia, were observed in these patients. In conclusion, our study suggested that IFN-α therapy is effective and safe for refractory KHE, and IFN-α may be used as an alternative after other treatments have failed.

Treatment of deep-seated facial microcystic lymphatic malformations with intralesional injection of pingyangmycin.

Treatment of microcystic lymphatic malformations (LMs) is still a great challenge to physicians in the field of managing vascular anomalies. Several kinds of treatment have been proposed for microcystic LMs, but the responses to these treatment modalities vary considerably among individuals. The aim of the study was to investigate the safety and efficacy of intralesional injection of pingyangmycin for microcystic LMs located in the deep facial region.Twenty-one consecutive patients with deep-seated facial microcystic LMs were treated with intralesional injection of pingyangmycin between March 2010 and April 2015. The patients received 2 to 8 injections, and the average session was 3.7. The therapeutic efficacy was accessed on the basis of the imaging findings and clinical measurements.Among the 21 patients, the clinical responses were excellent in 7 patients (33.33%), good in 9 patients (42.86%), fair in 3 patients (14.29%), and poor in 2 patients (9.52%). No severe side effects were encountered. Furthermore, therapeutic outcomes were significantly associated with lesion location (P = 0.006) and number of injections (P = 0.003).Our study supports that sclerotherapy with pingyangmycin is safe and effective for the treatment of deep-seated facial microcystic LMs.

GSK3ß negatively regulates HIF1α mRNA stability via nucleolin in the MG63 osteosarcoma cell line.

Hypoxia-inducible factor 1α (HIF1α) is a transcription factor involved in the growth, invasion and metastasis of malignant tumors. Glycogen synthase kinase 3 beta (GSK3ß) is a protein kinase involved in a variety of signaling pathways, such as the Wnt and NF-κB pathways; this kinase can affect tumor progress through the regulation of transcription factor expression and apoptosis. Recent studies showed that GSK3ß was involved in the expression of HIF1α. However, the effect of GSK3ß on HIF1α expression in osteosarcoma cells remains unknown. To understand the relationship between GSK3ß and HIF1α comprehensively, small RNA interference techniques, Western blot analyses, quantitative real-time PCR analyses and luciferase assays were used in our study. Experimental data revealed that inhibition of GSK3ß could increase HIF1α protein levels and expression of its target genes by increasing the stability of the HIF1α mRNA, not by affecting the HIF1α protein stability, and that this process could be mediated by nucleolin.

[Phosphorus threshold for the shift between grass- and algae-stable states in Dahong Harbor of Gehu Lake].

Taking the macrophytes remaining area in Dahong Harbor of Gehu Lake as test object, this paper studied the phosphorus threshold for the shift between grass- and algae-stable states under natural conditions. The correlation analysis on the environmental factors showed that the total phosphorous in water body had better liner relationships with phytoplankton chlorophyll a and Secchi depth, and principal component analysis indicated that total phosphorous and nitrogen in the water body were the two main components affecting the water quality, among which, total phosphorous was the maximum weight source and played a determinant role in the shift between grass- and algae-stable states. The Harbor was in grass-stable state in winter, shifted to grass-algae intermediate state in spring, and kept the intermediate state in summer and autumn. The total phosphorous threshold for grass-stable state shifting to grass-algae intermediate state was 61 microg x L(-1), and that for grass-algae intermediate state shifting to algae-stable state was 115 microg x L(-1). In order to make the ecosystem shift from algae-stable state to grass-stable state, some measures such as cutting and controlling the Lake's nutrient sources, removing the sediment rich in organic matter, and constructing submerged macrophytes areas should be adopted to make the total phosphorous threshold in the water body dropped to below 61 microg x L(-1).

[Proteomics analysis of distinct proteins in human atherosclerosis obliterans: identification and verification].

OBJECTIVE: To identify distinct proteins involved in human atherosclerosis obliterans (ASO) by a differential proteomic approach. METHODS: Eight atherosclerotic femoral arteries with a mean age of 68.6 years (6 male and 2 female) and 5 normal femoral arteries with a mean age of 44.2 years (3 male and 2 female) were obtained from high amputation patients. Then the first 2-dimensional maps of the proteome of human femoral arteries was plotted to compare ASO and control specimens. Proteomic profiling was to differentiate and identify histological proteins that were associated with ASO. The differentially expressed proteins were sequenced by matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF-MS). The result was verified by immunohistochemistry (IHC) and Western blot. RESULTS: ASO was associated with distinct patterns of protein expression in the femoral arteries. A total of 25 distinct spots corresponding to 13 different proteins were identified by MALDI-TOF-MS using the NCBI and IPI databases. These proteins were mainly involved in the pathogenetic mechanisms such as inflammation, oxidative stress, proliferation and transformation of SMCs. The low level of heat shock protein 27 (HSP27) in ASO was verified by IHC and western-blot in accord with the result of MS. CONCLUSION: Proteomic analysis can be used to investigate differentially expressed proteins, which may provide new insights into ASO pathogenesis, such as HSP27.

[Endovascular angioplasty for the treatment of long iliac artery chronic total occlusions].

OBJECTIVE: To evaluate the effectiveness, safety and feasibility of endovascular angioplasty in treating long iliac artery chronic total occlusions (CTO). METHODS: The clinical data from a consecutive series of patients with long (> 5 cm) iliac artery CTO who treated by endovascular angioplasty from January 2006 to December 2010 was retrospectively analyzed. There were 139 patients (157 limbs) with long iliac artery CTO treated by endovascular angioplasty in this study [male 93 and female 46, mean age (77 ± 10) years]. According to TASC II classification, there were 18 patients in type B, 89 patients in type C and 32 patients in type D. Recanalization of the occluded lesions was attempted with the left brachial and/or femoral access. RESULTS: The ankle brachial index increased from 0.42 ± 0.19 before treatment to 0.81 ± 0.26 after treatment. The rate of technical success was 96.2% (151/157) and the patency rate of iliac artery was 94.1% (111/118) during the follow-up. Significant restenosis or reocclusion was found in 7 iliac lesions and there were no major interventional complications, such as iliac artery rupture, stent displacement, pseudoaneurysms, and arteriovenous fistula. CONCLUSIONS: Endovascular angioplasty is an effective, safe and feasible method in treating long iliac CTO with high patency rate. Combined left brachial and femoral access can increase the technical success rate significantly.

[Surgical treatment of visceral artery aneurysms].

OBJECTIVE: To analyze the experience with diagnosis and surgical treatment of visceral artery aneurysms (VAAs). METHODS: From June 2003 to December 2008, 8 patients (2 male and 6 female) with 9 VAAs underwent surgical treatment. Mean age was 49 years (ranged from 30 to 72 years). The site of aneurysmal disease was splenic artery in 4 cases, superior mesenteric artery in 2 cases, renal artery in 2 cases (3 aneurysms). In 1 patient of splenic artery aneurysm, portal vein hypertension coexisted. All the VAAs of preoperative diagnostic workup consisted of a ultrasound, computed tomography (CT) scan, and digital subtraction angiography. Six patients were operated on and two patients was treated with endovascular procedures. Only one small VAAs was treated with follow-up. RESULTS: No deaths or major complications occurred in the perioperative period. All the patients remained symptom free during a follow-up of 26.5 months (ranged from 2 to 60 months). Follow-up consisted of clinical and ultrasound scan examinations or CT scan at 1 and 6 months, and yearly thereafter. CONCLUSIONS: Aggressive approach to the treatment of VAAs is essential. Elective open surgical treatment and an endovascular procedure of visceral artery aneurysms are both safe and effective, and offers satisfactory early and long term results. There is some evidence that small (< 2 cm) and asymptomatic VAAs may be safely observed.

[Gene expression difference analysis between abdominal aorta aneurysm and normal abdominal artery].

OBJECTIVE: To identify gene expression differences between abdominal aorta aneurysm (AAA) and normal abdominal artery. METHODS: Five AAA specimens and five normal abdominal artery specimens were collected. Total RNA was extracted and purified from the samples independently. Then isolated RNA was labeled and hybridized onto the Affymetrix Genechip. RESULTS: One thousand nine hundreds and sixty-two differently expressed genes were identified in AAA compared with normal abdominal artery, of which 554 genes were up-regulated and 1408 genes were down-regulated. Functional analysis revealed that genes involved in immune response, inflammatory response and chemokines were significantly up-regulated in AAA. CONCLUSION: The differently expressed genes may be useful in providing new insights and foster a better understanding of the mechanism of AAA.

[The clinical values of subintimal angioplasty for treatment lower extremity arterial occlusions].

OBJECTIVE: The purpose of this study was to assess the technical feasibility and early outcomes of subintimal angioplasty to treat lower extremity arterial occlusions. METHODS: During a 2-year period (from December 2003 to December 2005), 36 lower extremities with arterial occlusions (median length, 11.5 cm; range, 4.5 to 28.0 cm) were treated on an intention-to-treat basis with SIA. Thirteen lower extremities had disabling claudication and twenty-three had limb-threatening ischemia. MAIN OUTCOME MEASURES: technical success, cumulative patency, clinical results and complications. RESULTS: The technical success rate was 80% and four out of seven failures were treated by conventional surgery. After 13.2 months follow-up, recanalization vessel patency rate was 70%, and clinical effectiveness rate was 81%, no serious complications occurred. CONCLUSION: In a selected group of patients, SIA is feasible with a high initial technical success rate and the short-term results are satisfied, SIA is a good treatment alternative in patients who are lower extremity arterial occlusions. The durability of this method of therapy is unknown, and our length of follow-up is not sufficient to answer this question.