Stent with radioactive seeds strand insertion for malignant hilar biliary obstruction.

PURPOSE: This study aimed to assess clinical efficacy and long-term patient outcomes in individuals with malignant hilar biliary obstruction (MHBO) that had been treated via insertion of a stent with a radioactive seed strand (RSS). MATERIAL AND METHODS: A total of 84 MHBO patients were treated via either normal stent insertion (n = 48) or stent with RSS insertion (n = 36) from January 2015 to December 2018. RESULTS: The technical success rates of normal stent insertion and stent with RSS insertion were 93.8% (45/48) and 97.2% (35/36), respectively (p = .632), with clinical success rates of 93.3% (42/45) and 100% (35/35), respectively (p = .252). In these two patient groups, 11 and seven patients, respectively, suffered from stent dysfunction (p = .637). In the normal and RSS groups, median stent patency was 165 and 225 days, respectively (p < .001). All patients in the present study died due to tumor progression, with median survival times of 188 and 250 days in the normal and RSS stent groups, respectively (p < .001). CONCLUSION: Relative to normal stent insertion, combined stent with RSS insertion can effectively prolong both stent patency and patient survival in patients with MHBO.

MMP-3-1612 polymorphism - a risk factor for deep venous thrombosis formation.

BACKGROUND: We investigated the association of the 5A/6A polymorphism in the promoter region at -1612 of the matrix metalloproteinase-3 gene (MMP-3-1612) and deep venous thrombosis (DVT). PATIENTS, MATERIALS AND METHODS: The distribution of the MMP-3 (-1612 5A/6A) polymorphism in the case and control groups was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Serum MMP-3 level of two groups was detected using enzyme-linked immunosorbent assay (ELISA). HepG2 cells containing MMP-3-1612 recombinant plasmid were cultured in vitro and the MMP-3 level was defined by luminescence intensity of luciferase. A DVT rat model was built. Serum MMP-3 level in the rats' wounded vein at different time points was detected by ELISA and recorded for investigation of the association between MMP-3 and DVT. Statistical data analysis was conducted with SPSS18.0. RESULTS: On the basis of the observation of MMP-3-1612 genotype frequency and allele frequency in the case and control groups, we identified significantly higher MMP-3-1612 5A allele frequency and higher serum MMP-3 level in the case group than in the control group (both P < 0.05). According to in vitro luciferase measurements, the 5A allele had higher transcriptional activity than the 6A allele. As observed in the rat model, serum MMP-3 level increased with time passing and thrombosis formation after modelling. CONCLUSIONS: The MMP-3-1612 5A/6A polymorphism may effect serum MMP-3 level and over-expression of serum MMP-3 level may be a risk factor for DVT formation.

Male circumcision performed with 8-figure non-absorbable suture technique.

INTRODUCTION: We analyze the outcome of circumcisions performed with 8-figure non-absorbable suture (8FNS) and assess the feasibility of using the technique in male circumcision. METHODS: We randomly divided 317 patients who would undergo circumcision between February 2009 and January 2012 into 2 groups. Each group was subdivided into children (age range: 7 to 15 years) and adult (range: 16 to 85 years). In the experiment group (n =166), we used 8FNS and in control group (n = 151), commonly absorbable suture (CAS) were used for the circumcised wound closure. The results of 2 groups were compared. We also performed a cost analysis and a mean 6-month follow-up (range: 1-12). Chi-square and Student's t-test were used in statistical analysis. Differences were considered significant (p < 0.05). RESULTS: No patients were required to remove their sutures postoperatively. Among them, the sutures of the 8FNS for circumcision fell off spontaneously within 9 days (6.2 ± 1.57). There was no statistically significant difference between the 2 groups in surgical duration (16.2 ± 1.73 vs. 15.8 ± 2.01) and follow-up time (6.4 ± 3.82 vs. 6.2 ± 2.39). The overall complication rate of the 2 groups was 6.63% and 10.53% (p = 0.15), respectively. In addition, the complication rate among the adults was significantly lower in the 8FNS group compared to children (2.53% vs. 10.34%, p = 0.04). Also, the average cost (in US dollars) of 8FNS for circumcision was $20.7 ± $3.83 less than $35.8 ± $5.02 of CAS, which is a very significant difference (p < 0.0001). CONCLUSIONS: 8FNS for circumcision is feasible, easy, safe and cost-effective, especially for adult males.