Circular RNA circ_0020710 drives tumor progression and immune evasion by regulating the miR-370-3p/CXCL12 axis in melanoma.

BACKGROUND: Circular RNAs (circRNAs) have been reported to have critical regulatory roles in tumor biology. However, their contribution to melanoma remains largely unknown. METHODS: CircRNAs derived from oncogene CD151 were detected and verified by analyzing a large number of melanoma samples through quantitative real-time polymerase chain reaction (qRT-PCR). Melanoma cells were stably transfected with lentiviruses using circ_0020710 interference or overexpression plasmid, and then CCK-8, colony formation, wound healing, transwell invasion assays, and mouse xenograft models were employed to assess the potential role of circ_0020710. RNA immunoprecipitation, luciferase reporter assay and fluorescence in situ hybridization were used to evaluate the underlying mechanism of circ_0020710. RESULTS: Our findings indicated that circ_0020710 was generally overexpressed in melanoma tissues, and high level of circ_0020710 was positively correlated with malignant phenotype and poor prognosis of melanoma patients. Elevated circ_0020710 promoted melanoma cell proliferation, migration and invasion in vitro as well as tumor growth in vivo. Mechanistically, we found that high level of circ_0020710 could upregulate the CXCL12 expression via sponging miR-370-3p. CXCL12 downregulation could reverse the malignant behavior of melanoma cells conferred by circ_0020710 over expression. Moreover, we also found that elevated circ_0020710 was correlated with cytotoxic lymphocyte exhaustion, and a combination of AMD3100 (the CXCL12/CXCR4 axis inhibitor) and anti-PD-1 significantly attenuated tumor growth. CONCLUSIONS: Elevated circ_0020710 drives tumor progression via the miR-370-3p/CXCL12 axis, and circ_0020710 is a potential target for melanoma treatment.

Bilateral reduction mammoplasty after heart transplantation.

We report a bilateral reduction mammoplasty in a 15 year old female who suffered increasing back and shoulder pain and chest wall discomfort associated with bilateral breast enlargement during a 17 month period following heart transplantation. Cardiologic evaluation confirmed a structurally normal heart with good systolic and diastolic function, and ejection fraction of 80%. We performed a bilateral mammoplasty using dermal suspension flap in vertical-scar reduction. The patient recovered satisfactorily without incident, and breast morphology was excellent at the 2 year 9 month follow-up, with no recurrence of her previous symptoms or further hyperplasia.

Treatment of sternal wound infections after open-heart surgery.

OBJECTIVE: The aim of this study was to investigate the proper treatment of infected median sternotomy wounds. METHODS: A retrospective study was conducted to investigate the proper treatment of infected median sternotomy wounds on patients with sternal wound infections from January 2007 to July 2009. The characteristics of the sternal infections and the treatment outcomes were analysed. RESULTS: Ninety-seven patients with sternal wound infections were treated. A total of 32 patients acquired the infection within one month after open-heart surgery, 10 patients got the infection one to two months after the surgery, and 1 patient died two days after debridement. There were 54 patients who acquired the infection beyond two months post-surgery, while 1 patient died on the day before the operation. One patient received four cycles of wound debridement, 18 patients received two cycles and 78 patients only received one cycle. A total of 14 patients received a vacuum-assisted closure treatment. There were 73 patients who had surgery for repair of muscle flaps, 1 patient for breast tissue flap, 63 patients for pectoralis major muscle flap, and 9 patients with rectus abdominis muscle flap. There were 12 patients who received a transverse plate fixation of the sternum with titanium plating. CONCLUSION: A positive prognosis can be obtained by the algorithm treatment based on the onset and depth of the sternal infection.

[Vertical reduction mammaplasty with wide superior pedicle].

OBJECTIVE: To report the reduction mammaplasty with vertical incision and superior wide pedicle. METHODS: Typical Lejour mosque-dome design was performed. The inferior part of glandular tissue and skin were excised. The nipple-and-areola complex (NAC) was elevated to normal position with superior wide pedicle. The breast morphology was modified with vertical scar left. RESULTS: 46 patients were treated. 4 patients had unilateral breast reduction. 14 breasts had wound dehiscence. 3 breasts received debridement, others were treated conservatively with dressings. No complete NAC necrosis occurred. CONCLUSIONS: The reduction mammaplasty with vertical incision and superior wide pedicle is a safe and effective method with a low risk of NAC necrosis.

[The study on donor site sequelae after autologous breast reconstruction with an extended latissimus dorsi flap].

OBJECTIVE: To study the prevention and treatment on the donor site sequelae after autologous breast reconstruction with extended latissimus dorsi flap. METHODS: 88 patients received breast reconstruction with extended latissimus dorsi flap between May 1999 and Nov 2004 were concerned. We analyzed the donor site sequelae by objective and subjective evaluation and we assessed the functional condition. Results Dorsal hematoma developed in 1 patient. There are 7 patients with dorsal seromas and 2 of them developed capsules; 5 patients with mild skin exfoliate and 1 patient with dry skin necrosis, 2 winged shoulders. No infection and no hypertrophic scars appeared in donor site. There is no significant functional limitation and no influence in daily life. CONCLUSIONS: The main complication after autologous breast reconstruction with extended latissimus dorsi flap was seromas and it can be controlled to decrease. There is no severe complication. It's a worthy method in autologous breast reconstruction in oriental people.

[Vertical reduction mammaplasty].

OBJECTIVE: The inverted "T" operation is a typical and classic method for breast hypertrophy. Although having good results, it leaves significant scar and tends to have bottom-out deformity with time. The purpose of this study is to introduce our experience in vertical mammaplasty. METHODS: The typical Lejour's design was used. The lower part of the breast was excised. The nipple-alveolar complex was elevated to a proper position with the superior dermal-glandular pedicle. Only vertical scar was left after the skin was closed. RESULTS: 24 patients were treated using this method. The results were satisfactory except unilateral nipple-alveolar complex necrosis occurred in one patient. Another patient had a minor revision for the dog-ear 6 months after breast reduction. CONCLUSIONS: Vertical reduction mammaplasty is effective with reduced scar and highly satisfactory results. It deserves recommendation.

[Flap transplantation combined with liposuction to treat upper limb lymphedema after mastectomy].

OBJECTIVE: To investigate a new surgical method to treat unilateral limb lymphedem after radical mastectomy. METHODS: 10 cases of upper limb lymphedema after radical mastectomy were treated using flap transfer (the lateral thoracic skin flap or latissimus dorsi musculocutaneous flap combined with liposuction). RESULTS: After the treatment, the upper limb perimeter reduced in varied degrees. Nuclear lymphatic radiography showed notable changes in lymphatic circulation. The effective results were steady during the follow-up of 3-18 months. CONCLUSION: Flap transplantation combined with liposuction is a useful treatment for limb lymphedema from radical mastectomy.