Tumor-associated neutrophils in EBV-positive nasopharyngeal carcinoma suppress the activation of CD8+ T cells in tumor microenvironment / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To analyze tumor-associated neutrophils (TANs) infiltration in EBV-positive nasopharyngeal carcinoma (NPC) tumor microenvironment (TME) and its correlation with the prognosis and clinicopathological features of patients with NPC, and to preliminarily investigate the role of TANs in activating CD8+ T cells in EBV-positive NPC. Methods: Tumor tissue specimens from 118 patients with EBV-positive NPC without metastases admitted to Sun Yat-sen University Cancer Center from 2008 to 2012 were collected. Immunohistochemistry was performed to analyze CD8+ T cells infiltration and TANs infiltration in NPC and their correlation with EBV infection, and to evaluate the infiltration of TANs in 118 human EBV-positive NPC tissue samples and analyze its correlation with the prognosis and clinicopathological features of NPC patients; flow cytometry was used to detect the expression of N2 marker (CD182 and CD206) of neutrophils stimulated by HK1-EBV-conditioned medium and the expression of CD69 and PD-1 of CD8+ T cells co-cultured with TANs. Results: There were more CD8+ T cells and neutrophils infiltrating in EBV-positive NPC where they were negatively correlated（P=0.0052）; densely infiltrated TANs in EBV-positive NPC tissues were positively correlated with poor prognosis of patients (P=0.025 in OS; P=0.027 in PFS); the infiltration of TANs was proved to be an independent risk factor for overall survival (P=0.035) in patients with NPC; compared with Control group, freshly isolated neutrophils cultured in HK1-EBV-conditioned medium showed an increased expression of N2 markers (P<0.001 in CD182; P<0.01 in CD206) which could suppress the expression of CD69 and promote the expression of PD-1 of CD8+ T cells. Conclusion: More TANs infiltrate in EBV-positive NPC where they polarize into N2 neutrophils, exerting an immunosuppressive effect by suppressing the activation of CD8+ T cells and having a positive correlation with the poor prognosis of NPC patients.

Advances in genetic etiology research of congenital chest wall deformity / 中国胸心血管外科临床杂志

@#Congenital chest deformity is caused by abnormal development of spine or ribs, resulting in sternal depression or protrusion. Pectus carinatum and pectus excavatum are the most common diseases in clinic, which can either be accompanied by other syndromes or exist alone. The genetic factors of congenital thoracic deformity can be related to single gene mutation, polygene mutation and chromosome aberration. Common clinical congenital thoracic deformity with syndromes, such as Marfan syndrome and Noonan syndrome, often have relatively fixed and clear pathogenic genes. The genetic pathogenesis of non-syndromic and independent congenital thoracic malformations is usually diverse, and treatments for syndromic and non-syndromic congenital thoracic deformity are different. Therefore, it is necessary for us to differentiate syndromic and non-syndromic congenital thoracic deformities in basic research, clinical diagnosis and treatment.

The advancements in the relationship between imaging features of lung-ground glass opacity and prognosis of lung adenocarcinoma / 中国胸心血管外科临床杂志

@#With the development of technology, the detection rate of ground-glass opacity (GGO) is rapidly increasing. GGO comprises of pure GGO and mixed GGO. Many researches have studied the characteristics of GGO, and they found that different malignant probability of GGO was associated with different image characteristics. It is obvious that there is a close relationship between the image characteristics of GGO and its prognosis. However, due to the various image characteristics of GGO, it is essential to assess the prognosis of lung adenocarcinoma patients in a more comprehensive way. In this review, we summarize the correlation between the main GGO image features (solid proportion, size, mean CT value, shape characteristics) and the prognosis of lung adenocarcinoma patients, to provide clinical reference for prognosis prediction and decision-making for patients with lung adenocarcinoma.

Relationship of spread through air spaces and specific clinicopathological features or poor prognosis of lung adenocarcinoma: A systemic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective    To assess the specific clinicopathological characteristics as well as prognostic value of prognostic significance of spread through air spaces (STAS) in lung adenocarcinoma. Methods    We systematically searched the databases of PubMed, EMbase and Web of Science databases from their date of inception to March 2019. The quality of the included literature was assessed by the Newcastle-Ottawa scale (NOS). The NOS of the study higher than 6 points was considered as high quality. Software of Stata 12.0 was used for meta-analysis. Results    Twenty retrospective cohort studies involved with totally 6 225 patients were included. Quality of included studies was high with NOS score equal or higher than 6 points. STAS was associated with male sex, ever smoking history, abnormal carcino-embryonic antigen (CEA) level, air bronchogram negative, anaplasticlymphoma kinase (ALK) arrangement positive, epidermal growth factor receptor (EGFR) mutation positive, advanced pathological tumor stage and more invasive pathological adenocarcinoma subtypes. The presence of STAS indicated significantly poor recurrence free survival (RFS) (HR=1.960, 95%CI 1.718-2.237, P<0.001) as well as poor overall survival (OS) (HR=1.891, 95%CI 1.389-2.574, P<0.001). Further subgroup analyses showed that exhibiting tumor size including diameter less than 2 cm (HR=2.344, 95%CI 1.703-3.225,  P<0.001) and diameter over 2 cm (HR=2.571, 95%CI 1.559-4.238, P<0.001), resection type including lobectomy (HR=1.636, 95%CI 1.258-2.127, P<0.001) and sublobar resection (HR=3.549, 95%CI 2.092-6.021, P<0.001) in stageⅠ adenocarcinoma suggested that STAS had a bad effect on RFS. Conclusion    Presence of STAS is associated with more aggressive clinicopathological features and independently associated with worse RFS and OS in lung adenocarcinoma. STAS positive has a negative effect on RFS whatever the tumor size (including the diameter<2 cm or >2 cm) and resection types in stageⅠ adenocarcinoma.

Clinical research progress of primary pulmonary lymphoepithelioma-like carcinoma / 中国胸心血管外科临床杂志

@#Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is a rare type of lung cancer with special characteristics of epidemiology, clinical diagnosis, treatment and prognosis. It has close relationship with Epstein-Barr virus (EBV) infection and has prominent regional feature. Most patients are young and non-smoking. There is no specificity of clinical manifestation. Most patients are asymptomatic at the time of diagnosis. As for treatment, the standard treatment for early stage disease is complete resection. Platinum-based doublet chemotherapy has been applied in locally advanced disease as the first line therapy. Due to its rarity, the treatment of advanced PPLELC is still lack of evidence of large sample randomized controlled trial. Whether target therapy or immunotherapy is effective is worth further study. This article reviews the research progress of PPLELC, to give a particular sight for clinicians and provides a better understanding of this rare tumor for researchers.

Mechanistic effect of the human GJB6 gene and its mutations in HaCaT cell proliferation and apoptosis

We constructed lentiviral vectors containing the human wild-type GJB6 gene and the mutant variants A88V and G11R. The three proteins were stably expressed by the Tet-on system in the HaCaT cell line and used to study the functional effect of the variants. The CCK-8 assay and flow cytometric analyses were used to determine the levels of cell proliferation and apoptosis. Western blot analyses were performed to analyze the relevant clinical indicators of hidrotic ectodermal dysplasia and markers of apoptosis in transfected HaCaT cells. The CCK8 assay and the flow cytometry results showed a significant increase (P<0.05) in the apoptosis of HaCaT cells expressing the A88V and G11R mutants. In addition, we demonstrated that the A88V and G11R mutants induced the apoptosis of transfected HaCaT cells via the activation of caspase-3, -8, -9, and PARA. No change was observed in the activity of BAX compared with the control. This study provides further clarification on the mechanisms underlying the effect of the mutant variants A88V and G11R of the GJB6 gene on the induction of HaCaT cell apoptosis.

Advances in the application of 3D printing technology in chest wall disease surgery / 中国胸心血管外科临床杂志

@#Because of the characteristics such as accurate, efficient and individuation, 3D printing is being widely applied to manufacturing industry, and being gradually expanded into the medical field. Diseases of chest wall is a common type in thoracic surgery, and surgery is a proper treatment to this kind of disease. For the past few years, 3D printing is being gradually applied in surgery of chest wall diseases. The article mainly makes a statement of two parts that including the possibility to apply 3D printing including chest wall reconstruction and chest wall orthopedic, and to analyze the possibility and application prospect of applying 3D printing to the chest wall disease.

Um novo dispositivo percutâneo minimamente invasivo de aumento facetário para o tratamento da radiculopatia lombar e dor axial lombar: descrição técnica, técnica cirúrgica e apresentação de casos / Un nuevo dispositivo percutáneo mínimamente invasivo de aumento facetáreo para el tratamiento de radiculopatía lumbar y dolor axial lumbar: descripción técnica, técnica quirúrgica y presentación de casos / A novel minimally invasive percutaneous facet augmentation device for the treatment of lumbar radiculopathy and axial back pain: technical description, surgical technique and case presentations

To describe a new posterior minimally invasive method of facet stabilization for treatment of the degenerating lumbar motion segment. The biomechanics of this Percudyn (Interventional Spine; Irvine, CA) system are distinct from that of other interspinous dynamic stabilization systems as it acts bilaterally directly within the middle column of the spine. Based on biomechanical evalution, the paired prosthesis supports, cushions, and reinforces the facet complexes by limiting both extension and lateral bending thereby maintaining central and foraminal volumes. METHODS: the Percudyn device consists of a pedicle anchor upon which sits a cushioning polycarbonate-urethane stabilizer that serves as a mechanically reinforcing stop between the inferior and superior articular facets. A 1.5 cm skin incision is made bilaterally over the lower pedicle of the treated segment through which a Jamshidi needle is percutaneously targeted under biplanar fluoroscopic guidance into the caudal aspect of the superior articular process directly underneath the lip of the inferior facet from the level above. Progressive onestep tubular dilation is then performed to secure a small disposable working portal. Through this access, the Percudyn stabilizers are then placed over the wire and anchored bilaterally into the inferior pedicles of the degenerated motion segment. RESULTS: three patients (ages 26-41, male) with significant low back pain as well as radiculopathy with lateral recess stenosis from a large disc herniation/ ligamentum and facet hypertrophy (L4-5 and/or L5-S1) underwent a minimally invasive decompression/ discectomy and bilateral Percudyn placement at each disease level. Each patient had significant relief of both his radiculopathy and axial back pain post-operatively and was discharged home within 18 hours without sequelae. CONCLUSION: this novel technique of percutaneous posterior facet augmentation allows for safe placement of bilateral...

Descrever um método de estabilização facetária posterior minimamente invasivo para tratamento de segmento móvel degenerativo. A biomecânica do sistema Percudyn (Interventional Spine, Irvine, Califórnia) é distinta de outros sistemas de estabilização dinâmica inter-espinhosa, pois este atua direta e bilateralmente dentro da coluna média da coluna vertebral. Baseada em avaliações biomecânicas, a prótese dupla dá suporte, atua como amortecedor e reforça os complexos facetários limitando a extensão e a inclinação lateral, mantendo assim os volumes centrais e foraminais. MÉTODOS: o sistema Percudyn consiste de uma ancora pedicular sobre a qual está apoiado um estabilizador de plicarbonato-uretano que atua como um bloqueio mecanicamente reforçado entre as facetas inferiores e superiores. Uma incisão na pele de 1,5cm é feita bilateralmente sobre o pedículo inferior do segmento a ser tratado, por meio da qual é introduzida percutaneamente uma agulha de Jamshidi com auxílio de fluoroscopia biplanar em direção da porção caudal do processo articular superior, diretamente abaixo da borda da faceta inferior do nível superior. É feita uma dilatação tubular progressiva para assegurar um pequeno e temporário portal de trabalho. Por meio desse acesso, os estabilizadores Percudyn são colocados sobre o fio e ancorados bilateralmente nos pedículos inferiores de cada segmento móvel degenerativo. RESULTADOS: três pacientes (idade de 26 a 41 anos, sexo masculino) com lombalgia significativa, assim como radiculopatia e estenose do recesso lateral em consequência de um grande fragmento de disco herniado, ou hipertrofia ligamentar e facetária (L4-5 e/ou L5-S1) foram submetidos a uma descompressão/discectomia minimamente invasiva e implantação do Percudyn bilateralmente em cada segmento afetado. Todos os pacientes tiveram um alivio pós-operatório significante, tanto da radiculopatia como da dor axial lombar, e alta hospitalar até 18 horas sem sequelas...

Describir un método de estabilización facetárea posterior mínimamente invasiva para tratamiento del segmento móvil degenerativo. La biomecánica del sitema Percudyn (Interventional Spine, Irvine, California) es distinta de otros sistemas de estabilización dinámica interespinosa, pues ésta actúa directamente y bilateralmente dentro de la columna media de la columna vertebral. Con base en evaluaciones biomecánicas, la prótesis dupla da soporte, actúa como amortiguador y refuerza los complejos facetáreos limitando la extensión y la inclinación lateral, manteniendo así los volúmenes centrales y foraminales. MÉTODOS: el sistema Percudyn consiste de un áncora pedicular sobre la cual está apoyado un estabilizador de policarbonato-uretano, que actúa como un bloqueo mecánicamente reforzado entre las facetas inferiores y superiores. Una incisión en la piel de 1.5 cm es hecha bilateralmente sobre el pedículo inferior del segmento a ser tratado, a través del cual es introducida percutáneamente una aguja de Jamshidi con auxilio de fluoroscopia biplanar en dirección a la porción caudal del proceso articular superior, directamente abajo del borde de la faceta inferior del nivel superior. Es hecha una dilatación tubular progresiva para sujetar un pequeño y temporal portal de trabajo. A través de este acceso, los estabilizadores Percudyn son puestos sobre el hilo o alambre y ancorados bilateralmente en los pedículos inferiores de cada segmento móvil degenerativo. RESULTADOS: tres pacientes (edad de 26 a 41 años, sexo masculino) con lumbalgia significativa, así como radiculopatía y estenosis del receso lateral en consecuencia de un fragmento grande del disco herniado, o hipertrofia ligamentar y facetárea (L4-5 y/o L5-S1) fueron sometidos a una descompresión/ disectomía mínimamente invasiva e implantación del Percudyn bilateralmente en cada segmento afectado. Todos los pacientes tuvieron un alivio postoperatorio significativo tanto de la radiculopatía...