MEG3 rs7158663 genetic polymorphism is associated with the risk of hepatocellular carcinoma.

Recently, a meta-analysis has shown that a potentially functional genetic polymorphism (rs7158663 A > G) on the cancer-associated lncRNA MEG3 is associated with the risk of many types of cancer. Given the important role of MEG3 in the development of hepatocellular carcinoma (HCC), the current study evaluated the association of the rs7158663 genetic polymorphism with HCC risk. A total of 271 HCC patients and 267 healthy individuals were included in the current case-control study. Direct sequencing was used to detect the rs7158663 locus genotype of the included individuals. The case-control study showed that the MEG3 rs7158663 genetic polymorphism was associated with the increased risk of developing HCC [GA vs. GG: OR = 1.63, 95% CI = 1.14-2.34, p = 0.009; AA vs. GG: OR = 2.10, 95% CI = 1.10-4.08, p = 0.03; (GA + AA) vs. GG: OR = 1.70, 95% CI = 1.21-2.40, p = 0.003; A vs. G: OR = 1.53, 95% CI = 1.17-2.00, p = 0.002]. In addition, the genotype-tissue expression showed that the rs7158663 AA or GA genotype was associated with reduced MEG3 expression. Bioinformatic analysis showed that the rs7158663 genetic polymorphism not only affects the binding of transcription factors but also interacts with multiple genes through chromatin loops. In summary, the current findings suggest that the rs7158663 genetic polymorphism affecting MEG3 expression is associated with HCC risk and may serve as a marker of genetic susceptibility to HCC. However, the specific molecular mechanisms of the rs7158663 genetic polymorphism in the development of HCC need to be further revealed.

Reconstruction of Nasal Tip Using "Seagull-shaped" Cavum Concha Cartilage Composite Scaffold.

BACKGROUND: The nasal tip plays a crucial role both esthetically and functionally. The application of nasal tip grafts is an effective method for improving nasal tip form. Ear cartilage is a common choice for nasal tip grafts, but it still presents several challenges in clinical application that need to be addressed. This study aims to address the issues associated with the use of ear cartilage in clinical rhinoplasty applications through the development of a novel septal extension graft using ear cartilage for nasal tip reconstruction. METHODS: From May 2018 to April 2022, a total of 132 cases of nasal tip reconstruction surgeries were performed using a seagull-shaped nasal septum extension graft, constructed with bilateral cavum concha cartilage. Among these cases, 25 patients had previously undergone rhinoplasty using silicone implant, 7 patients had undergone augmentation rhinoplasty using expanded polytetrafluoroethylene, whereas the rest were primary rhinoplasty cases. All patients were followed up for a period ranging from 3 months to 4 years postoperatively, with photographs taken to assess the nasal tip morphology. RESULTS: In this study, all patients exhibited good healing of the incisions made at the posterior aspect of the auricular concha, with no occurrences of hematoma and inconspicuous scarring. In 116 cases, significant improvement in nasal appearance and a realistic nasal tip form were achieved postoperatively, yielding satisfactory outcomes. Only 16 patients experienced minor issues with nasal tip morphology, which were subsequently improved through further surgical procedures. CONCLUSION: This study reports a surgical technique for nasal tip refinement using bilaterally harvested cavum concha cartilage to construct a seagull-shaped nasal septal extension graft. The procedure has achieved satisfactory outcomes, and its application is worth extending to clinical practice.

The efficacy and safety of 125I seeds combined with biliary stent placement versus stent placement alone for malignant biliary obstruction: a systematic review and meta-analysis.

Background: Currently, it is unknown whether iodine-125 (125I) stent implantation has the same therapeutic effect on patients with malignant biliary obstruction (MBO) caused by different cancers. This meta-analysis aimed to investigate whether 125I implantation in patients with MBO is superior to biliary stent placement in efficacy and safety, and to further explore the difference in efficacy and safety of seed implantation in different patients through subgroup analysis. Methods: A systematic search of the PubMed, Wiley Online Library, Cochrane library, Google Scholar, the Web of Science, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang databases was conducted to screen all relevant studies up to October 30, 2022. Articles were not subjected to language or geographical limitations, but were required to meet the inclusion and exclusion criteria for this study. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of articles. The primary endpoint was survival, which was defined as the interval between initial treatment and death or the end of study. Meta analysis was performed using Stata/SE15.0. Results: A total of 12 eligible studies were enrolled including 679 patients. All the included studies were single-center studies carried out in China. The results showed that the death risk and stent occlusion risk in the 125I group was 0.441 times [95% confidence interval (CI): 0.315 to 0.619, P<0.001; I2=0%, fixed, IV] and 0.534 times (95% CI: 0.433 to 0.658, P=0.003; I2=45.4%, fixed, IV) lower than the control group, respectively. There was no significant statistical difference in the risk of complications between the 2 groups [risk ratio (RR) =1.024, 95% CI: 0.963 to 1.090, P=0.450; PQ=0.640; I2=0%]. The reduction level of total bilirubin [TBIL; weighted mean differences (WMDs) =-14.969, 95% CI: -28.670 to -1.267, P=0.032; PQ=0.409, I2=2.1%) and aspartate transaminase (AST; WMD =-14.653, 95% CI: -23.246 to -6.060, P=0.001; PQ=0.900, I2=0%) in the 125I group was higher than that in the control group 1 week after surgery. The efficacy and safety of 125I for MBO patients were found to be independent of the type of tumor causing MBO (P for meta regression >0.05). Conclusions: For patients with MBO caused by hilar tumor or other tumors, 125I seed implantation can reduce the death risk and stent occlusion risk, prolong the time of survival and stent patency, and does not increase the complication risk. Due to the limitations of the study population, these findings should be further validated in other populations and regions.

Optimization of pleural multisite anesthetic technique during CT-guide microwave ablation of peripheral lung malignancy for improving treatment tolerance.

OBJECTIVE: To assess the effect and safety of subpleural multisite anesthesia based on the area of thermal radiation during CT-guided lung malignancy microwave ablation (MWA) on the incidence of moderate or severe pain and the analgesic drug usage. MATERIALS AND METHODS: Consecutive patients with lung malignancies were retrospectively evaluated between January 2016 and December 2019. Patients undergoing CT-guided lung malignancy MWA were either given in the method of (a) standard subpleural puncture point anesthesia between January 2016 and June 2018 and (b) subpleural multisite anesthesia based on the area of thermal radiation between July 2018 and December 2019. The relationship between local anesthesia mode and moderate or severe pain, and pain medications usage was assessed by using multivariable logistic regression models. RESULTS: A total of 243 consecutive patients were included in the study. Moderate or severe pain occurred in 84 of 124 (67.7%) patients with subpleural puncture point anesthesia and in 20 of 119 (16.8%) patients with subpleural anesthesia in the area of thermal radiation (p=.001). The intravenous pain medication was required in 56 of 124 (45.2%) patients with subpleural puncture point anesthesia and in 9 of 119 (7.6%) patients with subpleural multisite anesthesia based on the area of thermal radiation (p=.001). Local anesthesia methods (p = 0.001), pleura-to-lesion distance (p=.02) and tumor size (p=.015) were independent risk factors for developing moderate or severe pain. There were no differences in adverse events and local tumor progression rate. CONCLUSIONS: Subpleural multisite anesthesia based on the area of thermal radiation for peripheral lung malignancy MWA can result in lower intraprocedural pain compared with the subpleural puncture point anesthesia. Thus, a subpleural multisite anesthesia technique may be most helpful when performing MWA of peripheral malignancy in patients who are not sedated with general or intravenous anesthesia.

I-125 seeds brachytherapy with transcatheter arterial chemoembolization for subcapsular hepatocellular carcinoma.

BACKGROUND: I-125 seeds brachytherapy (ISB) has been used to improve the clinical effectiveness of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). We aim to appraise the safety and clinical efficacy of combined ISB and TACE for the treatment of subcapsular HCC. MATERIALS AND METHODS: A retrospective investigative study extending from January 2017 to December 2020, involved individuals suffering from subcapsular HCC, who were subjected to TACE treatment with or without ISB in our center. The clinical effectiveness was compared between 2 groups. RESULTS: Sixty-four patients, in total, with subcapsular HCC had to undergo TACE with (n = 32) or without (n = 32) ISB in our center. After CT-guided ISB, only 2 (6.3%) patients experienced a self-limited pneumothorax. Combined treatment resulted in a significantly higher complete response (56.3% vs. 18.8%, P = 0.002) and total response (90.7% vs. 59.4%, P = 0.004) rates than that of TACE alone. In comparison to the TACE alone group, the median progression-free survival was substantially longer in the combined treatment group (11 months vs. 5 months, P = 0.016). Further, 15 and 28 patients in combined and TACE alone groups respectively died within the follow-up. The median OS was comparable between combined and TACE alone groups (22 months vs. 18 months, P = 0.529). CONCLUSIONS: Combined TACE and ISB therapy is a safe treatment method for individuals suffering from subcapsular HCC. When compared, combined treatment had significantly enhanced clinical efficacy as a subcapsular HCC therapy, in comparison to TACE alone.

Insertion of I-125 seed-loaded stent for inoperable hilar cholangiocarcinoma.

INTRODUCTION: Stent insertion is the most frequently used option to treat malignant biliary obstruction (MBO) patients. Hilar cholangiocarcinoma (HCCA) is the most common disease that causes hilar MBO. AIM: To assess the clinical efficacy and long-term outcomes of I-125 seed-loaded stent (ISS) insertion for HCCA patients. MATERIAL AND METHODS: Consecutive patients with HCCA underwent either normal stent (NS) or ISS insertion between January 2017 and December 2019. The baseline and treatment data of these two groups were compared. RESULTS: During the period, a total of 93 patients with inoperable HCCA were divided into either NS (n = 48) or ISS (n = 45) insertion groups at our centre. Technical success rates of the NS and ISS insertion were 91.7% and 95.6%, respectively (p = 0.733). Clinical success rates were 93.2% and 100% in the NS and ISS groups, respectively (p = 0.24). Stent dysfunction was observed in 11 and 8 patients in the NS and ISS groups, respectively (p = 0.47). The median stent patency was 143 days and 208 days in the NS and ISS groups, respectively (p < 0.001). All patients died in the follow-up period, with median survival duration of 178 days and 220 days in the NS and ISS groups, respectively (p < 0.001). ISS insertion was the only predictor of longer patency (p = 0.002) and survival (p = 0.01). CONCLUSIONS: ISS insertion might achieve longer patency and overall survival in patients with inoperable HCCA as compared with NS insertion.

Results Obtained with the Protege EverFlex Self-expanding Bare Stent in Interventional Treatment of Spontaneous Isolated Visceral Artery Dissection.

OBJECTIVE: We evaluated the early and midterm results of the endovascular approach with a certain type of bare stent to treat spontaneous isolated visceral artery dissection (SIVAD). METHODS: 28 patients with symptomatic SIVAD were selected from two hospitals from July 2014 to September 2020. All patients had symptoms of acute persistent abdominal pain accompanied by varying degrees of nausea and vomiting. The diagnosis of SIVAD was made according to the multidetector CT angiography (CTA) findings. We retrospectively analyzed the patients' medical records. According to our previous clinical experience, the Protege EverFlex self-expanding bare stent was used in these patients, and we subsequently followed up the patients to record and analyze their outcomes after surgery. The imaging results before and after the operations were compared. RESULTS: All 28 patients were successfully implanted with Protege EverFlex stents. The true lumen blood flow of the SIVAD recovered during the operation. The residual stenosis rate was less than 30%, and the technical success rate was 100%. There were no complications, such as bleeding, intestinal necrosis, digestive tract perforation, liver failure or spleen infarction. The abdominal pain was relieved or eliminated in all patients. CONCLUSION: The Protege EverFlex self-expanding bare stent and the endovascular approach could be a minimally invasive, safe and effective treatment method for SIVAD with a high success rate and a relatively low price.

Synthesis and Properties of 3-Azido-2,2-bis(azidomethyl)propyl 2-Azidoacetate: A Potential Azido Ester Plasticizer.

This study reports the synthesis and characterization of a novel azido ester plasticizer, 3-azido-2,2-bis(azidomethyl)propyl 2-azidoacetate (ABAMPA), with good yield and high purity. The density, impact sensitivity, friction sensitivity, thermal decomposition temperature and glass transition temperature were determined to be 1.326 g ⋅ cm-3 , 16 J, 324 N, 235.9 °C and -50.4 °C, respectively. The plasticizing effect of ABAMPA on glycidyl azide polymer (GAP) was calculated by molecular dynamics, the solubility parameter difference value was 1.7(J ⋅ cm-3 )0.5 , and the glass transition temperature of GAP was reduced from -35 °C to -43 °C when the weight ratio of ABAMPA and GAP was 50 : 50. The new azido ester exhibits high energy, remarkable thermostability and good compatibility with GAP, which indicates that it would have potential application in explosive and propellant formulations.

The contribution of melanocytes to pathological scar formation during wound healing.

Both hypertrophic scars and keloid scars are caused by abnormal wound healing, the key feature of which is excess collagen fiber secretion by fibroblasts. Many different factors could affect the process of hypertrophic scar and keloid formation, but most have not been identified to date. We assume that, during wound healing, melanocytes from the stratum basale contact or interact with fibroblasts from the dermal layers after the basal membrane is damaged, which in turn facilitates fibroblast proliferation and the secretion and deposition of collagen. This plays a significant role in the generation of hypertrophic scars and keloids.