[Role of immunotherapy in locally advanced non-small cell lung cancer]

Concomitant radiochemotherapy has been the standard of care for unresectable stage III non-small cell lung cancer (NSCLC), irrespective of histological sub-type or molecular characteristics. Currently, only 15-30 % of patients are alive five years after radiochemotherapy, and this figure remains largely unchanged despite multiple phase III randomised trials. In recent years, immune-checkpoint blockades with anti-PD-(L)1 have revolutionised the care of metastatic NSCLC, becoming the standard front- and second-line strategy. Several preclinical studies reported an increased tumour antigen release, improved antigen presentation, and T-cell infiltration in irradiated tumours. Immunotherapy has therefore recently been evaluated for patients with locally advanced stage III NSCLC. Following the PACIFIC trial, the anti-PD-L1 durvalumab antibody has emerged as a new standard consolidative treatment for patients with unresectable stage III NSCLC whose disease has not progressed following concomitant platinum-based chemoradiotherapy. Immunoradiotherapy therefore appears to be a promising association in patients with localised NSCLC. Many trials are currently evaluating the value of concomitant immunotherapy and chemoradiotherapy and/or consolidative chemotherapy with immunotherapy in patients with locally advanced unresectable NSCLC.

[Curative effect observation of application of the snare in epiglottic cystectomy by arc-shaped laryngoscopy]

Objective:To evaluate the effect of the epiglottic cystectomy by arc-shaped video laryngoscopy combined with snare. Method:The clinical data of 42 patients with epiglottic cysts were retrospectively analyzed. Forty-two patients with epiglottis cyst were treated by arc-shaped video laryngoscopy combined with snare. Result:All 42 cases were completely resected at one time without obvious complications and the cure rate was 100%. Moreover, the short operation time（5-20 min） and the minor hemorrhage（1-10 ml） were observe. There was no recurrence after 6 to 33 months follow-up. Conclusion:The epiglottic cystectomy by arc-shaped video laryngoscopy combined with snare has the advantages of broad vision, easy operation, minimal invasion, rapid recovery and good curative effect, it is worthy to be popularized in clinical application.

Radical addition-polar termination cascade: efficient strategy for photoredox-neutral-catalysed cyclopropanation and Giese-type reactions of alkenyl N-methyliminodiacetyl boronates

Silicate meets boronate: efficient cyclopropanation and Giese-type reactions of alkenyl N-methyliminodiacetyl boronates with alkyl silicates have been realized via a photoredox-neutral-catalysed radical-polar crossover process.

[Late-onset upper airway obstruction caused by alkali inhalation injury: a case report]

SummaryAlkalis can produce severe tissue injury through liquefaction. Since the liquefaction loosens tissue planes and allows deeper penetration of the agent, alkali burns tend to be more severe than acid burns. Alkaline substances ingestion and inhalation frequently causes damage to the upper respiratory and digestive tract. Initial presentation of airway alkali burn includes oropharyngeal pain, dysphagia, hoarseness and stridor. Patients with a clear history of caustic ingestion or inhalation could always receive proper management. In this paper, a middle aged female presented with acute upper airway obstruction was introduced. The cause of the airway compromise was finally determined to be alkali inhalation 3 weeks ago. By reviewing this special case, the clinical features and management of airway alkali burn was summarized.

Systematic analyses for candidate genes of milk production traits in water buffalo (Bubalus Bubalis)

Water buffalo (Bubalus bubalis) is of great economic importance as a provider of milk and meat in many countries. However, the milk yield of buffalo is much lower than that of Holstein cows. Selection of candidate genes related to milk production traits can be applied to improve buffalo milk performance. A systematic review of studies of these candidate genes will be greatly beneficial for researchers to timely and efficiently understand the research development of molecular markers for buffalo milk production traits. Here, we identified and classified the candidate genes associated with buffalo milk production traits. A total of 517 candidate genes have been identified as being associated with milk performance in different buffalo breeds. Nineteen candidate genes containing 47 mutation sites have been identified using the candidate gene approach. In addition, 499 candidate genes have been identified in six genome-wide association studies (GWASes) including two studies performed with the bovine SNP chip and four studies with the buffalo SNP chip. Genes CTNND2 (catenin delta 2), APOB (apolipoprotein B), FHIT (fragile histidine triad) and ESRRG (estrogen related receptor gamma) were identified in at least two GWASes. These four genes, especially APOB, deserve further study to explore regulatory roles in buffalo milk production. With growth in the number of buffalo genomic studies, more candidate genes associated with buffalo milk production traits will be identified. Therefore, future studies, such as those investigating gene location and functional analyses, are necessary to facilitate the exploitation of genetic potential and the improvement of buffalo milk performance.

Efficacy of triamcinolone-soaked polyglycolic acid sheet plus fully covered metal stent for preventing stricture formation after large esophageal endoscopic submucosal dissection

Esophageal stricture is a major problem for patients with large superficial esophageal squamous cell neoplasms (SESCNs) after endoscopic submucosal dissection (ESD). Although many measures could be used as prophylaxis for post-ESD strictures, a well-accepted method has not yet been established. We propose using a triamcinolone-soaked polyglycolic acid sheet plus fully covered metal stent (TS-PGA+FCMS) as a novel method to prevent stricture formation after large esophageal ESD. From June 2016 to May 2017, nine patients with SESCNs (≥3/4 of the esophageal circumference) who underwent TS-PGA+FCMS placement immediately after ESD and did not require additional surgical resection were enrolled in this case series. All stents were removed 4-6 weeks post-ESD. The sizes of mucosal defects in 9 patients were 3/4 (n = 1), 4/5 (n = 2), 1/1 (n = 6). The average size of resection was 90.0 mm (range: 60-140 mm). The incidence of stricture was 33.3% (3/9) of patients. No stricture occurred in 3 patients with noncircumferential resection, while stricture occurred in 50% (3/6) patients with circumferential resection. The median number of EBD sessions was 4 (range: 3-4 sessions). No adverse events or recurrences were observed during the median follow-up period of 15.2 months (range: 12-22 months). The TS-PGA+FCMS method is safe and may decrease the incidence of esophageal stricture and the number of EBD sessions after large esophageal ESD.

[Clinicopathologic analysis of extranodal non-hodgkin lymphoma of the sinonasal cavities: a 15-case report]

Objective:To investigate the clinical manifestation, imaging and histological features of different histological subtypes of non-Hodgkin's lymphoma of nasal cavity and paranasal sinuses.Method:Fifteen NHL patients of the sinonasal region were collected from the Department of Otolaryngology of Peking University Third Hospital from 2010 to 2016. HE staining and immunohistochemical staining were performed. The clinical characteristics and imaging features of different subtypes were described and analyzed.Result::We analyzed a total of 6 patients with localized sinonasal diffuse large B cell lymphoma and 9 patients with localized sinonasal extranodal NK/T cell lymphoma. The age distribution for these two subtypes is very distinct. The median age of the patients with localized sinonasal extranodal NK/T cell lymphoma was 39 years. There were 5 males and 4 females. Nine sinonasal NHLs were NK/T-cell lymphoma, nasal type, all of which were infected with EBV. The median age of the patients with localized sinonasal diffuse large B cell lymphoma was 64 years. There were 3males and 3 females. Symptoms for patients with SN-DLBCL and SN-ENKTL were significantly different in epiphora, proptosis, diplopia and nasal congestion (P=0.18, 0.004, 0.18, 0.18). Imaging features for patients with SN-DLBCL and SN-ENKTL were significantly different in tumor extended to orbit and inferior turbinate (P>0.05). Positive staining for CD 56 was detected in 9 patients, for CD 3 in 9 patients, for EBER in 9 patients. The Hans algorithm identified 1 patient with the germinal center B-cell (GCB) subtype and 5 with the non-GCB subtype.Compared with the control group, the observation group was significantly better than the control group (P < 0.01).Conclusion:Early symptoms of epiphora, proptosis, diplopia, and images finding with orbital invasion should be highly suspected of diffuse large B cell lymphoma. Positive staining for CD 56 and EBER were detected in all patients with extranodal NK/T cell lymphoma, and positive staining for CD20 was detected in all patients with SN-DLBCL.

[Application of endoscope assisted curved laryngoscope in laryngeal microsurgery of patients with difficulty laryngeal exposure]

Objective:To investigate the feasibility and clinical value of endoscope assisted curved laryngoscopy in laryngeal microsurgery of patients with difficulty laryngeal exposure. Method:The data of 28 patients with difficulty laryngeal exposure underwent microlaryngosurgery with endoscope assisted curved laryngoscopy technique were collected. Result:Surgeries with endoscope assisted curved laryngoscopy technique were completed successfully one-time in all patients. The fully exposure of glottis was 100%. All cases were followed up for 2 to 18 months. No residual disease or recurrence occurred and no obvious complication occurred. Conclusion:Endoscope assisted curved laryngoscopy technique is a useful solution to difficulty laryngeal exposure. It has satisfactory glottis exposure, clear surgical field and fewer complications which is worthy of promotion.

Molecular characterization and expression patterns of ghrelin in the reindeer (Rangifer tarandus)

Ghrelin is a novel growth hormone (GH)-releasing peptide, which has been identified as an endogenous ligand for the GH-sretagogue receptor. The sequence and expression of ghrelin has been determined in many species. In this study, to reveal the molecular characterization and expression patterns of ghrelin in the reindeer (Rangifer tarandus), the full-length DNA and cDNA encoding ghrelin were cloned from reindeer stomach using genome walking and rapid amplification of complementary deoxyribonucleic acid ends (RACE). The expression of ghrelin in almost all tissues was examined by real-time quantitative PCR (RT-qPCR). The 4076 bp amplicon of the ghrelin gene consisting of 4 exons and 3 introns was cloned from reindeer. Results of cDNA cloning and sequence analysis revealed that the full-length ghrelin cDNA was composed of 539 bp that included a 5'-untranslated region (46 bp), an open reading frame (ORF) (351 bp), and a 3'-untranslated region (142 bp). In addition, ghrelin was expressed in the all tissues examined, with the expression in the abomasum significantly higher than that in other tissues (p<0.05), followed by the pancreas, duodenum, testis and oesophagus. The results show that the expression of ghrelin in the reindeer gastrointestinal tract is extensive, suggesting its may have a role in regulating the digestive function.

[Application of endoscope assisted curved laryngoscopy technique in transoral laryngopharyngeal minimally invasive surgery]

Objective: To explore the possibility of endoscope assisted curved laryngoscopy technique applied in transoral laryngopharyngeal minimally invasive surgery and evaluate the advantages of this technique. Methods: Eight patients with huge benign lesions in larynx and pharynx undergoing transoral microsurgery at Peking University Third Hospital between February 2016 and February 2017 were enrolled in this study.The diagnosis included cyst at the base of tongue in two patients, cysts in the epiglottis in two patients, hemangioma in two patients, multiple masses of the hypopharynx and amyloidosis in supraglottic area in one patient each.The time and exposure during surgery, occurrence rate of complication and conditions of following-up were recorded. Results: The mean time of surgery was 20 min, the exposure was satisfying.There was no obvious complication after surgery.No residual or recurrent lesion was observed after 1 to 12 months follow-up(mean time 4.5 months). Conclusion: The endoscope assisted curved laryngoscopy technique has advantages in shortening the time of surgery, improving exposure and reducing the rate of complication and recurrence.

Synthetic Poly(Vinylalcohol)-Based Membranes for Cartilage Surgery and Repair

Cell-based therapies for cartilage repair are continually being developed to treat osteoarthritis. The cells are either introduced directly by intra-articular injection or via a cell-seeded matrix scaffold. Here, poly(vinylalcohol)-based membranes are developed to be used for mesenchymal stem cell implantation in cartilage repair procedures, having controllable physicochemical properties such as porosity, mechanical strength, and permeability, and a unique self-sealing property. The membranes possess a bilayer structure with a less porous layer providing mechanical strength and selective permeability, exhibit an elastic modulus of between 0.3 and 0.9 MPa, and are permeable to molecules <40 kDa, which is in the range of cartilage permeability. Three different peptide ligands with the sequences Ac-GCGYGRGDSPG, Ac-GCG(OPG)4REGOFG(OPG)4, and Ac-GCG(OPG)7, respectively, are conjugated to the membranes and subject to in vitro cell adhesion and differentiation assays. Col I/Col II gene expression ratios indicated that the collagen-mimetic peptide, Ac-GCG(OPG)7, best supported mesenchymal stem cell differentiation into the chondrogenic lineage. Although low retention of the membrane is observed in vivo in a rabbit knee model, results suggest that the membrane was able to facilitate mesenchymal stem cell implantation and differentiation to chondrocytes. These PVA-based membranes provide a feasible, synthetic, off-the-shelf material for the delivery of stem cells, and can be modified for other surgical applications.

Electrospun polystyrene scaffolds as a synthetic substrate for xeno-free expansion and differentiation of human induced pluripotent stem cells

The use of human induced pluripotent stem cells (hiPSCs) for clinical tissue engineering applications requires expansion and differentiation of the cells using defined, xeno-free substrates. The screening and selection of suitable synthetic substrates however, is tedious, as their performance relies on the inherent material properties. In the present work, we demonstrate an alternative concept for xeno-free expansion and differentiation of hiPSCs using synthetic substrates, which hinges on the structure-function relationship between electrospun polystyrene scaffolds (ESPS) and pluripotent stem cell growth. ESPS of differential porosity was obtained by fusing the fibers at different temperatures. The more porous, loosely fused scaffolds were found to efficiently trap the cells, leading to a large number of three-dimensional (3D) aggregates which were shown to be pluripotent colonies. Immunostaining, PCR analyses, in vitro differentiation and in vivo teratoma formation studies demonstrated that these hiPSC aggregates could be cultured for up to 10 consecutive passages (P10) with maintenance of pluripotency. Flow cytometry showed that more than 80% of the cell population stained positive for the pluripotent marker OCT4 at P1, P5 and P10. P10 cells could be differentiated to neuronal-like cells and cultured within the ESPS for up to 18months. Our results suggest the usefulness of a generic class of synthetic substrates, exemplified by ESPS, for 'trapped aggregate culture' of hiPSCs.

STATEMENT OF SIGNIFICANCE

To realize the potential of human induced pluripotent stem cells (hiPSCs) in clinical medicine, robust, xeno-free substrates for expansion and differentiation of iPSCs are required. In the existing literature, synthetic materials have been reported that meet the requirement for non-xenogeneic substrates. However, the self-renewal and differentiation characteristics of hiPSCs are affected differently by the biocompatibility and physico-chemical properties of individual substrates. Although some rules based on chemical structure and substrate rigidity have been developed, most of these efforts are still empirical, and most synthetic substrates must still be rigorously screened for suitability. In this paper, we demonstrate an alternative concept for xeno-free expansion and differentiation of hiPSCs using synthetic substrates, which hinges on the structure-function relationship between electrospun polystyrene scaffolds (ESPS) and pluripotent stem cell growth. ESPS of differential porosity was obtained by fusing the fibers at different temperatures. The more porous, loosely fused scaffold was found to efficiently trap the cells, leading to a large number of three-dimensional (3D) aggregates. In the form of these trapped aggregates, we showed that hiPSCs could be cultured for up to 10 consecutive passages (P10) with maintenance of pluripotency, following which they could be differentiated to a chosen lineage. We believe that this novel, generic class of synthetic substrates that employs 'trapped aggregate culture' for expansion and differentiation of hiPSCs is an important conceptual advance, and would be of high interest to the readership of Acta Biomaterialia.

Functional Kidney Bioengineering with Pluripotent Stem-Cell-Derived Renal Progenitor Cells and Decellularized Kidney Scaffolds

Recent advances in developmental biology and stem cell technology have led to the engineering of functional organs in a dish. However, the limited size of these organoids and absence of a large circulatory system poses limits to its clinical translation. To overcome these issues, decellularized whole kidney scaffolds with native microstructure and extracellular matrix (ECM) are employed for kidney bioengineering, using human-induced pluripotent-stem-cell-derived renal progenitor cells and endothelial cells. To demonstrate ECM-guided cellular assembly, the present work is focused on generating the functional unit of the kidney, the glomerulus. In the repopulated organ, the presence of endothelial cells broadly upregulates the expression level of genes related to renal development. When the cellularized native scaffolds are implanted in SCID mice, glomeruli assembly can be achieved by co-culture of the renal progenitors and endothelial cells. These individual glomerular units are shown to be functional in the context of the whole organ using a simulated bio-reactor set-up with urea and creatinine excretion and albumin reabsorption. Our results indicate that the repopulation of decellularized native kidney using clinically relevant, expandable patient-specific renal progenitors and endothelial cells may be a viable approach for the generation of a functional whole kidney.