| Venous malformation(VM) results from an error in vascular morphogenesis; veins are dilated with thin walls and abnormal smooth muscle. Consequently, lesions expand, flow stagnates, and clotting occurs. Lesions are blue, soft, and compressible; hard calcified phleboliths may be palpable. VMs may range from small localized skin lesions to diffuse malformations involving multiple tissue planes and vital structures. A VM is especially problematic because it is progressive; it enlarges over time, particularly during adolescence; and often reexpands after treatment.Consequently, most patients who present with congenital lesions will ultimately require intervention.The first-line treatment of problematic VMs is sclerotherapy, which is generally safer and more effective than resection. Sclerotherapy involves the injection of a sclerosant into the malformation, which then cause cellular destruction, thrombosis, and intense inflammation. Scarring leads to shrinkage of the lesion. Good to excellent results are obtained in75%to90%of patients, including reduction in the size of the malformation and alleviation of the symptoms. Often, multiple treatments are required.In our country, Pingyangmycin sclerotherapy as a conventional treatment method for the treatment of venous malformation is observed to have exact curative effect. In order to guide application, therapeutic method of venous malformation with Pingyangmycin and lidocaine was proposed by committee of Oral and Maxillofacial Surgery, Branch Association of stomatology, China medical Association in2011.On one hand, Lidocaine as amide local anaesthetics can be used at different sites to block sensory nerve and lead to anesthesia, with strong penetrability and diffusivity. During the treatment of venous malformation, it can help to alleviate reflective vasospasm caused by the pain due to embolisation with Pingyangmycin and promote the medicine to fill up the nidus more completely. On the other hand, Lidocaine as calmodulin inhibitor has sensitivity-increasing effect for antineoplastic drug.This subject adopts the spleen of Kunming mouse as the animal model for human cavernous venous malformation to observe toxic effects of Lidocaine of different concentrations and Pingyangmycin of different concentrations to splenic vascular endothelial cells at different time, and toxic effects of combined medicine of Pingyangmycin and Lidocaine of different concentrations to vascular endothelial cells at different time, and to explore whether Lidocaine has synergic action to Pingyangmycin for the treatment of cavernous venous malformation by means of paraffin section optical microscopic observation, ultrathin section electron microscopic observation, labeling apoptotic cells in terminal transferase mediated nick end labeling method (TUNEL method), comparing apoptosis rate according to Image-Pro Plus6.0pathologic cells’image analysis system, and detecting expression of cysteinyl aspartate specific protease-3(Caspase-3) of apoptosis factor by real-time quantitative PCR technology. Retrospectively analyze treating cavernous venous malformation with Pingyangmycin and Lidocaine of different concentrations to explore the influence of Lidocaine for curative effect in aspect of clinic medication proportion; retrospectively analyze treating superficial cavernous venous malformation with Pingyangmycin of different concentrations to explore the influence of Pingyangmycin concentration for therapeutic effect and guide clinic medication; retrospectively analyze treating superficial venous malformation with Pingyangmycin of low concentration to conclude therapeutic effect.Part I Experimental Study on Influence of Lidocaine for the Treatment of Venous Malformation by PingyangmycinExperiment1Influence of Lidocaine of Different Concentrations for Mouse Splenic Vascular Endothelial CellsObjective:To explore cytotoxicity of lidocaine to vascular endothelial cells.Method:Separate88female Kunming mice into4groups at random according to randomized block design principle, in which16mice in group A are physiological saline control group;72mice in experimental group are divided into three groups B, C and D,24in each group, which are separately0.1%Lidocaine group,0.2%Lidocaine group, and0.4%Lidocaine group. Every group is divided into4subgroups according to schedule (2,5,8and14d group). The control group has4in every schedule subgroup, and the experimental group has6in every schedule subgroup. Mice was narcotized with10%chloral hydrate (3ml/kg) by intraperitoneal injection and disinfected. Surgical incision into the abdominal wall, turn up the stomach to reveal the spleen, puncture in long axis direction of the spleen with lml injector. Inject0.3ml physiological saline to contrast group and inject0.3ml Lidocaine Hydrochloride of different concentrations to experimental group. Withdraw injector at uniform speed while injecting, slightly press the pinhole of injector to stop bleeding, sew by layers, and continue to feed. Process4mice in control group on the2nd,5th,8th, and14th day after surgery, and6mice in experimental group B, C, and D. Open the peritoneal cavity along original cut after anesthesia, dissociate and cut off blood vessel and ligate mesentery around spleen, fetch the spleen, remove its head and tail, divided the middle section of the spleen into two parts., put into10%neutral formalin or2.5%glutaraldehyde solution respectively. Observe specimen changes at different concentrations and different times after HE staining; detect the apoptosis in TUNEL method by the following steps:prepare2sections for each specimen and analyze TUNEL labeling section of every group by Image-Pro Plus6.0pathologic cells’ image analysis system. Randomly select6images under optical microscope at400times in every section.count TUNEL positive cell ratio (=6positive cell counts at high magnification/total cell counts×100%) in each section and calculate its mean value. Observe the changes of vascular endothelial cells under electron microscope.Statistical Method:Normal distributed measurement data is described by mean±standard deviation (χ±s).Factor analysis was used to test the effect of interaction between group and time. If the effect of interaction was statistically significant then analyzed the effect alone. If the data are normal distribution and equal variance, then analyze by one-way ANOVA; if the data are abnormal distribution and (or) heterogeneity of variance, then adopt Kruskal-Wallis H Rank sum test; and if there is statistical significance, further make multiple comparison in SNK method, in which, if P﹤0.05, the disparity has statistical significance. The data were analyzed by SPSS software16.0.Result:The appearances of physiological saline group have no significant changes on the2nd,5th,8th, and14th day, through general observation, manifesting that the capsulae is smooth and complete, the edge is tidy and without swelling. There is no obvious difference between every experimental group and control group.Under microscope, physiological saline group shows normal spleen performances at every time point:the spleen surface is with a thin layer of fibrous tissue, the outer layer are monolayer mesothelial cells; under which the red and white pulps are clear, blood sinus is not dilated, the splenic sinus is lined with monolayer endothelial cells which are complete, the blood sinus is filled with appropriate amount of erythrocyte, there are no inflammatory cells infiltrated in mesenchyme, and the histiocyte has no hyperplasia; the splenic corpuscle has clear structure and the germinal center is not dilated.0.1%Lidocaine group:there is no obvious difference compared with contraol group at every time point.0.2%Lidocaine group:in2d day group, it shows a normal spleen performance; in5th day group, the splenic sinus bleeds occasionally; in8th day group, there are occasionally inflammatory cells infiltrated in mesenchyme and there appears local mononuclear or polynuclear macrophage occasionally; in14th day group, the infiltrated inflammatory cells are more than that in8th day group, there are fibrous protein exuding occasionally, and there appears polynuclear macrophages that swallow cell debris occasionally.0.4%Lidocaine group:in2nd day group, the splenic sinus is occasionally dilated and hyperemic, the red and white pulps are clear, and there are occasionally inflammatory cells infiltrated in mesenchyme; in5th day group, splenic sinus is dilated and obviously hyperemic, and inflammatory cells infiltrated in mesenchyme is increased; in8th day group, there exists interstitial cell infiltration, there is a small quantity of fibrous protein exuding, partial spleen trabecular structure is slightly obscure, and there appears polynuclear macrophages that swallow cell debris; in14th day group, the interstitial cell infiltration and fibrous protein exudation are increased, there appears fewer polynuclear macrophages that swallow cell debris locally, and the structures of partial red and white pulps are obscure.Transmission Electron Microscope Observation:It was revealed that three groups (A, B and C group)showed the similar represent at the different time:red pulp in large quantities,integrate structure of blood sinus, good cell junction, many red blood cell in blood sinus, lymphocytes dispersed well and integrate organelles. No apoptotic bodies was observed under electronic microscope. In the D group, there was no obvious histology change of spleen at the2nd and5th day,but failure of blood sinus and apoptotic bodies can be observed at8th and14th day.Factor analysis was used to test the endothelial cell apoptosis rate, the comparisons of four groups have statistical significance (F组间=107.676, P组间=0.000),the comparisons at the four time points have statistical significance (F时间=4.725, P时间=0.005) and the effect of interaction between group and time was statistically significant.(F组间×时间=13.682, P组间×时间=0.000)The results of analysis show that the difference of apoptosis rate had no statistics significance at four time points in the group A (F=0.296, P=0.828). Both B (χ2=3.687, P=0.297)and C (χ2=4.167, P=0.244)group showed the same result as A in the tests. The results of analysis show that the difference of apoptosis rate had statistics significance at four time points in the group D (x2=19.747, P=0.000).14th day group>8th day group>5th day group, and14th day group>2nd day group.Apoptosis rate comparison between all groups at different time points:in2nd day group, the comparison differences between every group have no statistical significance (F=1.386, P=0.279); in5th day group,8th group, and14group, the apoptosis rates of0.4%Lidocaine group are rising compared with other groups, D group> A group (P<0.05), D group>B group (P<0.05) and D group>C group (P <0.05).Conclusion:When Lidocaine is of the concentrations of0.1%and0.2%, mice splenic vascular endothelial cells has no histological changes and all physiological functions work well, which cannot lead cell apoptosis. But as the intervention concentration of Lidocaine is increased and the action time is prolonged, the Lidocaine will have cytotoxicity and lead to cell apoptosis. Lidocaine inducing mice splenic vascular endothelial cells apoptosis has a time and concentration dependence.Experiment2Influence of Pingyangmycin of Different Concentrations for Mouse Splenic Vascular Endothelial CellsObjective:Explore Cytotoxicity of Pingyangmycin to Vascular Endothelial Cells.Method:Separate88female Kunming mice into4groups at random according to randomized block design principle, in which16mice in group A are physiological saline control group;72mice in experimental group are divided into three groups B, C and D,24in each group, which are separately0.5mg/ml Pingyangmycin group,1mg/ml Pingyangmycin group, and2mg/ml Pingyangmycin group. Every group is divided into4subgroups according to schedule (2,5,8and14d group). The control group has4in every schedule subgroup, and the experimental group has6in every schedule subgroup. Find mouse spleen according to the method of experiment1, puncture in long axis direction of the spleen with lml injector. Inject0.3ml physiological saline to control group and inject0.3ml Pingyangmycin of different concentrations to experimental group. Treatment after surgery is the same as experiment1and the statistical method is the same as experiment1.Result:The appearances of physiological saline group have no significant changes.0.5mg/ml Pingyangmycin group:in2nd day group, the splenic tissue is dull-red and bright, without obvious change; in5th day group, individual specimen has slightly dark color, and the capsulae is a little strained, in8th day group, the margin of partial specimen is slightly blunt and with mild swelling; in14th day group, most specimens become dark, slightly sunk, and the turgidity of splenic capsula disappears; lmg/ml Pingyangmycin group:in2nd day group, partial capsula serosa lienis is slightly strained and slightly swelling; in5th day group, capsula serosa lienis become dark, the margin is slightly blunt and with mild swelling; in8th day group, the turgidity of capsula serosa lienis disappears, and a slight irregularity in the surface of the partial area.; in14th day group, part of specimen atrophy, the margin is uneven and has incisure, there is white stripe cicatrix on surface, and adheres to the surrounding tissues.2mg/ml Pingyangmycin:in2nd day group, the capsula serosa lienis is strained, the margin is slightly blunt and with swelling of different degrees; in5th day group, the turgidity of capsula serosa lienis disappears, the color becomes dark, and a slight irregularity in the surface of the partial area; in8th day group, the spleen atrophy at different degrees, partial specimen has margin incisure, the capsula has concave-convex, there is white stripe cicatrix on surface, and adheres to the surrounding tissues; in14th day group, most specimens have hard and dull-red spleens, the capsulas are concave-convex and atrophy, there is white cicatrix on surface, spleen margins are sharp and have irregular incisures, and adhere to the surrounding tissues and are remarkable macroscopic shrink.Under microscope, physiological saline group shows normal spleen performances at every time point.0.5mg/ml Pingyangmycin:in2nd day group, individual sinus lienis is dilated and hyperemic, and there exists little inflammatory cell infiltration; in5th day group, there exists interstitial inflammatory cell infiltration, sinusoidal endothelial cells are swelling, individuals are degeneration and with little fibrous protein exudation, in8th day group, splenic sinuses are dilated and obviously hyperemic, sinusoidal endothelial cells are swelling and degeneration, part of splenic cords are obscure, and there exists more inflammatory cell infiltration, fibrous protein exudation, and histiocytosis; in14th day group, there exist fibrous protein exudation, degeneration, and fibroplastic proliferation, erythrocytes diffuse, part of splenic sinuses are sunk and destroyed, and splenic corpuscle atropies and has uneven forms, lmg/ml Pingyangmycin:in2nd day group, splenic sinus is hyperemic and dilated, there exists little inflammatory cell infiltration, and there appear polynuclear macrophages occasionally; in5th day group, splenic tissue is obviously hyperemic, and has inflammatory cell infiltration, fibrous protein deposits, endothelial cells swell and degeneration, and polynuclear macrophages increase; in8th day group, splenic cords are obscure, fibrous protein deposits with hyperplasia of fibrous tissue, and it is clear to see fresh bleeding; in14th day group, splenic sinuses are degeneration and destroyed, splenic corpuscle atrophise and has uneven forms, there exist fibrous protein exudation, degeneration, and more mononuclear or polynuclear macrophages gather.2mg/ml Pingyangmycin:in2nd day group, the splenic sinus is dilated and hyperemic, sinusoidal endothelial cells swell, individual sinusoidal endothelial cell and splenic cord fibrocyte degenerates, or cell nucleus concentrates, crushes, the splenic cord structure is obscure, and there exists little inflammatory cell infiltration and histiocyte hyperplasia; in5th day group, the splenic tissue is hyperemic obviously, more sinusoidal endothelial cells and splenic cord fibrocyte degenerate, a large number of cell nucleuses concentrate, crush, and disintegrate, much more mononuclear or polynuclear macrophages gather, the splenic cord structure is obscure, and there exists more inflammatory cell infiltration and histiocyte hyperplasia; in8th day group, splenic sinuses are destroyed, endothelial cell nuclei dissolves and shatters, and a large number of mononuclear or polynuclear macrophages gather, there exist fibrous protein exudation, degeneration, fibrous tissue proliferates, erythrocyte diffuse, part of splenic corpuscles shrink and with uneven forms, and the margin is hyperemic and bleeding; in14th day group, splenic sinus endothelial cell apoptosis increases, splenic corpuscle collapses and shrink, fibrous tissue proliferates, and the capsula is thicken.Under Electron Microscope, It was revealed that groups A showed the represent as experiment1.Failure of blood sinus, apoptotic bodies, expanded Endoplasmic Reticulum and structural change of mitochondrion can be observed in varying degrees in group B,C and D at the different times.Factor analysis was used to test the endothelial cell apoptosis rate, the comparisons of four groups have statistical significance ((F组间=9549.392, P组间=0.000),the comparisons at the four time points have statistical significance (F时间=2499.782, P时间=0.000) and the effect of interaction between group and time was statistically significant (F组间×时间=279.087, P组间×时间=0.000). The results of analysis show that the difference of apoptosis rate had no statistics significance at four time points in the group A (F=0.296, P=0.828) The results of analysis show that the difference of apoptosis rate had statistics significance at four time points in the group B (F=1144.825, P=0.000),C (F=1494.281, P=0.000)and D(F=963.028, P=0.000),14th day group>8thday group>5th day group,>2nd day group. Apoptosis rate comparison between all groups at different time points:in2nd (F=1232.831, P=0.000),5th (F=1201.614, P=0.000),8th (F=2134.600, P=0.000) and14th (F=14886.604, P=0.000) day group, the comparison differences between each group have statistical significance. D group>C group>B group> A group.Conclusion:Pingyangmycin can lead to obvious vascular endothelial cell apoptosis at the concentration of0.5mg/ml. Its cytotoxicity to vascular endothelial cell shows obvious time and concentration dependence.Experiment3Influence of Pingyangmycin and Lidocaine of Different Concentrations for Mouse Splenic Vascular Endothelial CellsObjective:To Explore Whether Lidocaine Has synergistic effect on Pingyangmycin for Treatment of Cavernous Venous MalformationMethod:Separate88female Kunming mice into4groups at random according to randomized block design principle, in which16mice in group A are physiological saline control group;72mice in experimental group are divided into three groups B, C and D,24in each group, which are separately0.5mg/ml Pingyangmycin group,0.5mg/ml Pingyangmycin+0.1%Lidocaine group, and0.5mg/ml Pingyangmycin +0.2%Lidocaine group. Every group is divided into4subgroups according to schedule (2,5,8and14d group). The control group has4in every schedule subgroup, and the experimental group has6in every schedule subgroup. Find mouse spleen according to the method of experiment1, puncture in long axis direction of the spleen with lml injector. Inject0.3ml physiological saline to control group and inject0.5mg/ml Pingyangmycin solution or mixed solution of Pingyangmycin and Lidocaine0.3ml. Fetch mouse spleen at every time point according to the method of experiment1. Remove its head and tail, divide the middle section of the spleen into two parts in group A, then put into10%neutral formalin and2.5%glutaraldehyde solution respectively; divide the middle section of the spleen into three parts in experimental group, place one part is preserved in liquid nitrogen; put the other two parts into10%neutral formalin and2.5%glutaraldehyde solution respectively. The liquid nitrogen frozen tissue is used for real-time quantitative (RT-PCR) check of proapoptotic protein Caspase-3. The statistical method is the same as that in experiment1.Result:The appearances of group A have no significant changes on the2nd,5th,8th, and14th day. Group B:appearances at every timing point are the same as the performances of Pingyangmycin group of the same concentration in experiment2. No significant changes were observed in group C compared with the group B. group D: in2nd day group, the splenic tissue is dull-red and bright, partial capsula serosa lienis is slightly strained and slightly swelling; in5th day group, spleen become dark and the margin is slightly blunt; in8th day group, the turgidity of capsula serosa lienis disappears, the color becomes dark, and slight irregularity in the surface of the partial area.; in14th day group, part of specimen the margin is uneven and has incisure.Under microscope, group A shows normal spleen performances at every timing point. Group B, the performances at every time point are the same as the performances of Pingyangmycin group of the same concentration in experiment2. group C:The performances at every timing point have no obvious changes compared with that of group B. group D:in2nd day group, partial splenic sinus is dilated and hyperemic, there exists little inflammatory cell infiltration, and there appear polynuclear macrophages occasionally; in5th day group, splenic tissue is obviously hyperemic, splenic sinus has inflammatory cell infiltration, little fibrous protein deposits, endothelial cells swell and denaturize, and polynuclear macrophages increase; in8th day group, splenic cords are obscure, fibrous protein deposits with hyperplasia of fibrous tissue, and it is clear to see fresh bleeding; in14th day group, part of splenic sinuses are destroyed, partial splenic corpuscle shrinks and has uneven forms, there exists fibrous protein exudation, degeration, and proliferation, and more mononuclear or polynuclear macrophages gather.Under Electron Microscope, It was revealed that groups A showed the represent as experiment1.Failure of blood sinus, apoptotic bodies, expanded Endoplasmic Reticulum and structural change of mitochondrion can be observed in varying degrees in group B, C and D at the different times.Factor analysis was used to test the endothelial cell apoptosis rate, the comparisons of four groups have statistical significance (F组间=1510.583, P组间=0.000),the comparisons at the four time points have statistical significance (F时间=917.257, P时间=0.000) and the effect of interaction between group and time was statistically significant (F组间×时间=88.540, P组间×时间=0.000). The results of analysis show that the difference of apoptosis rate had no statistics significance at four time points in the group A (F=0.296, P=0.828) The results of analysis show that the difference of apoptosis rate had statistics significance at four time points in the group B (χ2=21.600, P=0.000),C (F=876.169, P=0.000) and D (F=21.600, P=0.000),14th day group>8thday group>5th day group,>2nd day group. Apoptosis rate comparison between all groups at different time points:in2nd (χ2=17.360, P=0.0011,5th (χ2=17.202, P=0.001),8th (χ2=17.715, P=0.001) and14th (χ2=17.146, P=0.001) day group, the comparison differences between each group have statistical significance. D group>C group>A group, D group>B group> A group.Factor analysis was used to test the caspase-3copy numbers, the comparisons of three groups have statistical significance (F组间=9549.392, P组间=0.000),the comparisons at the four time points have statistical significance (F时间=2499.782, P时间=0.000) and the effect of interaction between group and time was statistically significant (F组间×时间=279.087, P组间×时间=0.000).The results of analysis show that the difference of caspase-3copy numbers had statistics significance at four time points in the group B(χ2=21.600, P=0.000),C (χ2=21.600, P=0.000) and D (F=21.600, P=0.000),14th day group>8th day group>5th day group,>2nd day group. Caspase-3copy numbers comparison between all groups at different time points:in2nd day group, the comparison differences between all groups have statistical significance (χ2=15.158, P=0.001), group D>group C>group B. In5th day group (χ2=11.415, P=0.003),8th day group (χ2=11.474, P=0.003), and14th day group (F=127.582, P=0.000), the comparison between all groups, group D>group C; group D> group B.Conclusion:When applying0.5mg/mI Pingyangmycin and0.1%Lidocaine, the apoptosis rate of splenic endothelial cell has no obvious change compared with only applying Pingyangmycin, and Lidocaine does not have synergistic action for apoptosis induced by Pingyangmycin; when applying0.5mg/ml Pingyangmycin and0.2%Lidocaine, the apoptosis rate of splenic endothelial cell is obviously increased compared with only applying Pingyangmycin and is obviously increased compared with applying0.5mg/ml Pingyangmycin and0.1%Lidocaine, Lidocaine has synergistic action for apoptosis induced by Pingyangmycin and the action improves as time goes on. It implies that Lidocaine’s synergistic action to Pingyangmycin has time and concentration dependence.Part II The Clinical Study on Pingyangmycin Sclerotherapy of Cavernous Venous MalformationSection I Effect of Lidocaine in Defferent Concentration with Pingyangycin on Cavernous Venous MalformationObjective To investigate the clinical efficacy of Lidocaine in defferent concentration with Pingyangycin oncavernous venous malformation.Method Patients with cavernous venous malformation were treated with Lidocaine in defferent concentration with Pingyangycin in our department from June2008to June2010. Patients were divided into three groups:treated with1mg/ml Pingyangmycin (group A), treated with lmg/ml Pingyangmycin with0.5%Lidocaine (group B), treated with lmg/ml Pingyangmycin with1%Lidocaine (group C). All of the patients presented with a measurable lesion. Informed consent was given to the use of drug as injection therapy. A standardised data collection sheet recorded patient details including:age, sex, weight, location of lesion, size, clinical history, special investigations, dosage, clinical response, side effects and follow-up. Colour photographs were taken of every patient before, during, and after completion of treatment. All patients underwent direct intralesional injection of different solution.A needle connected to a syringe containing liquid medicine was inserted into the venous space, and the intraluminal position of its tip was confirmed by blood aspiration. The sclerosant was then injected slowly into the lesion. The volume of the solution varied from1.5to6.0ml per injection.They were observed0.5h and ischarged home. Treatment was performed in several stages. The applications were carried out after intervals of15days. Procedure was done by one operator.Utilizing Chi-square test, analysis of variance and rank sum texst to analyse the collected data in SPSS16.0software. If P<0.05, the difference has statistical significance.Result The ages, sexes and clinical characteristics of patients with cavernous venous malformation were not significantly different (P>0.05). There were decreasing trend of mean therapeutic times in group C, but therapeutic times in three groups had no significant difference (P=0.586). Twelve to16months followed up after termination of the therapy. All patiens had no functional lesion of liver and kidney and pulmonary fibrosis. Curative effect in three groups had no significant difference (P=0.904).All patients showed different degree hypertrophy and pain and the postoperative pain degrees of group A is more than group B and group C by clinical observation. Adverse reatction and complication in patients of the three groups:fever, gastrointestinal reatction, local blister, skin ulcer and local necrosis. The rate of complications and drug adverse reactions were similar in two groups (P=0.875)Conclusion Lidocaine has no synergistic effect with Pingyangmycin in the process of treating cavernous venous malformation.Section II Comparison among treatment of cavernous venous malformation with Pingyangmycin of different concentrationObjective To compare the clinical efficacy of cavernous venous malformation treated with Pingyangmycin of different concentrationMethod Patients with cavernous venous malformation were treated with Pingyangycin of defferent concentration in our department from February2008to February2010. Patients were divided into two groups:treated with0.5mg/ml Pingyangmycin (group A), treated with2mg/ml Pingyangmycin (group B),32patients in each group. All of the patients presented with a measurable lesion. Informed consent was given to the use of drug as injection therapy. A standardised data collection sheet recorded patient details including:age, sex, weight, location of lesion, size, clinical history, special investigations, dosage, clinical response, side effects and follow-up. Colour photographs were taken of every patient before, during, and after completion of treatment. All patients underwent direct intralesional injection of different solution. A needle connected to a syringe containing liquid medicine was inserted into the venous space, and the intraluminal position of its tip was confirmed by blood aspiration. The sclerosant was then injected slowly into the lesion. The volume of the solution varied from0.7to6.0ml per injection. They were observed0.5h and is charged home. Treatment was performed in several stages. The applications were carried out after intervals of15days. Procedure was done by one operator.Utilizing Chi-square test, t-test, rank sum test to analyse the collected data in SPSS16.0software. If P<0.05, the difference has statistical significance.Result The ages, sexes and clinical characteristics of patients with cavernous venous malformation were not significantly different(P>0.05). Cases had treated for1to6times and12to16months followed up after termination of the therapy. All patiens had no functional lesion of liver and kidney and pulmonary fibrosis. All patients showed different degree hypertrophy and pain and that of groupB is more than group A by clinical observation. Curative effect in two groups had no significant difference (P=0.306). The rate of complications and drug adverse reactions were similar in two groups (P=0.198)Conclusion Sclerotherapy with low concentration Pingyangmycin is proved to be a safe, effective therapy for superficial sporadic, solitary venous malformations of critical organs.Section III Percutaneous sclerotherapy for superficial venous malformations of the lips with low concentration Pingyangmycin and dexamethasonumObjective To evaluate the clinical effect of using low concentration Pingyangmycin and dexamethasonum to treat superficial vascular malformation of the lips.Methods Sixty eight patients with superficial venous malformation of the lips(29males and39females, age range:13-69years)were treated in our department from January2007to January2011.The lesions ranged in size from0.5×0.8cm to3×2.1cm. Pingyangmycin(about0.5mg/ml) and dexamethasonum (about1mg/ml) was injected into the center and periphery of the superficial venous malformation, the injection was repeated every15days when necessary.Results All patients required multiple therapeutic sessions. At a mean follow-up of21months (range12to32),66patients were cured and2had marked improvement. No patients presented with signs of recurrence.Conclusion Percutaneous Sclerotherapy with low concentration Pingyangmycin and dexamethasonum is proved to be a safe, effective therapy for superficial venous malformations of the lips.Section IV Treatment for venous malformations of the glans penis with low concentration PingyangmycinObjective To study the therapeutic methods of venous malformations of the glans penis.Methods From January2002to October2010,29patients, aged16～33years old, were treated with low concentration Pingyangmycin (0.5mg/ml) and the volume of the solution varied from1to3ml per injection.. Physical examination showed light-to-dark-blue, elevated and irregular lesions over the d... |
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