Weak SARS-CoV-2-specific responses of TIGIT-expressing CD8 + T cells in people living with HIV after a third dose of a SARS-CoV-2 inactivated vaccine / 中华医学杂志(英文版)

BACKGROUND@#T-cell immunoreceptor with immunoglobulin and immunoreceptor tyrosine-based inhibition motif domains (TIGIT), an inhibitory receptor expressed on T cells, plays a dysfunctional role in antiviral infection and antitumor activity. However, it is unknown whether TIGIT expression on T cells influences the immunological effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inactivated vaccines.@*METHODS@#Forty-five people living with HIV (PLWH) on antiretroviral therapy (ART) for more than two years and 31 healthy controls (HCs), all received a third dose of a SARS-CoV-2 inactivated vaccine, were enrolled in this study. The amounts, activation, proportion of cell subsets, and magnitude of the SARS-CoV-2-specific immune response of TIGIT + CD4 + and TIGIT + CD8 + T cells were investigated before the third dose but 6 months after the second vaccine dose (0W), 4 weeks (4W) and 12 weeks (12W) after the third dose.@*RESULTS@#Compared to that in HCs, the frequency of TIGIT + CD8 + T cells in the peripheral blood of PLWH increased at 12W after the third dose of the inactivated vaccine, and the immune activation of TIGIT + CD8 + T cells also increased. A decrease in the ratio of both T naïve (T N ) and central memory (T CM ) cells among TIGIT + CD8 + T cells and an increase in the ratio of the effector memory (T EM ) subpopulation were observed at 12W in PLWH. Interestingly, particularly at 12W, a higher proportion of TIGIT + CD8 + T cells expressing CD137 and CD69 simultaneously was observed in HCs than in PLWH based on the activation-induced marker assay. Compared with 0W, SARS-CoV-2-specific TIGIT + CD8 + T-cell responses in PLWH were not enhanced at 12W but were enhanced in HCs. Additionally, at all time points, the SARS-CoV-2-specific responses of TIGIT + CD8 + T cells in PLWH were significantly weaker than those of TIGIT - CD8 + T cells. However, in HCs, the difference in the SARS-CoV-2-specific responses induced between TIGIT + CD8 + T cells and TIGIT - CD8 + T cells was insignificant at 4W and 12W, except at 0W.@*CONCLUSIONS@#TIGIT expression on CD8 + T cells may hinder the T-cell immune response to a booster dose of an inactivated SARS-CoV-2 vaccine, suggesting weakened resistance to SARS-CoV-2 infection, especially in PLWH. Furthermore, TIGIT may be used as a potential target to increase the production of SARS-CoV-2-specific CD8 + T cells, thereby enhancing the effectiveness of vaccination.

Tissue wasting and perioperative treatment strategies of pancreatic cancer patients / 中华消化外科杂志

Pancreatic cancer is a highly malignancy of the digestive system, with low early diagnosis rate and poor prognosis. Cancer cachexia, muscle and adipose tissue wasting are important factors affecting surgical complications and long-term prognosis of patients with pancreatic cancer. On one hand, the occurrence and development of pancreatic cancer cachexia are associated with the decrease of food intake. On the other hand, the characteristic of tumor hypermetabolism, many inflammatory factors, fat and protein regulatory factors and many neuroendocrine pathways are also involved in pancreatic cancer cachexia. At present, the understanding of cancer cachexia and tissue wasting is not comprehensive, and the diagnostic methods are not unified. The main screening method is based on body mass index, but it is not applicable to obese patients. The detection of serum cytokines and determination of intramuscular fat content based on the abdominal computed tomography scan also play pivotal roles in the diagnosis of pancreatic cancer cachexia. Perioperative inhibition of tissue wasting can not only reduce surgical complications, but also improve the prognosis of pancreatic cancer patients. However, there is no effective method to completely reverse cancer cachexia. Multidisciplinary treatment is the routine therapy. Surgical treatment to remove the tumor is the fundamental measure to impede the development of cachexia. In addition, strengthening nutritional support, reducing inflammation and stress reaction, reducing the muscle wasting are also important in the treatment of cachexia during the perioperative period. Combined with self experience, the authors comprehensively analyze research advances, summarize the etiology, molecular mechanism, diagnosis and treatment of tissue wasting, in order to investigate tissue wasting and perioperative treatment strategies of pancreatic cancer patients.

Efficacy of oral estradiol valerate combined with microwave separation treatment of cervical carcinoma in si-tu of the cervix conization cervical adhesions / 中国基层医药

Objective To investigate the microwave separation combined oral estradiol valerate treatment of cervical carcinoma in situ of the clinical effects of postoperative adhesions cervical conization.Methods Microwave separation treatment was given to 82 patients with cervical adhesions (for cervical carcinoma in situ in line of the cer-vical cone postoperative cervical adhesion)for the control group;86 patients with select cervical adhesion (for cervi-cal carcinoma in situ in line of the cervical cone postoperative cervical adhesion)for the observation group and gyne-cology (because of cervical carcinoma in situ cervical conization of cervical adhesions),estradiol valerate give micro-wave separation combined oral treatment,compare two groups and adverse reactions.Results After treatment a month,endometrial thickness,respectively (8.56 ±2.54)mm and (7.96 ±2.64)mm,and were significantly better than before treatment (4.38 ±1.90)mm and (4.36 ±2.10)mm.Endometrial thickness of the observation group was better than that in the control group(P <0.05 );after three months of treatment,caused by intrauterine adhesions patients in the control group was 63.41%,total effective rate was 82.93%;Caused by intrauterine adhesions in the observation group cure rate was 70.93%,total effective rate was 91.86%,the total cure rate and total effective rate, the difference between the two groups had statistical significance (χ2 =5.48,P <0.05);After treatment a month,the observation group of patients with menstrual period 95.35% better than the control group 89.02%,difference was sta-tistically significant (χ2 =6.38,P <0.05).The incidences of adverse reactions in the control group and observation group were 9.76% and 3.49% respectively (χ2 =7.25,P <0.05).Conclusion Microwave separation combined oral estradiol valerate treatment of cervical carcinoma in situ cervical conization cervical adhesions had clinically effec-tive rate,side effects,which is worthy of clinical application.