OBJECTIVETo test the antitumor effect of a human triple-negative breast cancer cell-dendritic cell (DC) fusion vaccine.

METHODSDCs were isolated from fresh peripheral blood of healthy donors. The fusion vaccine was prepared by fusing the DCs and MDA-MB-231 cells via electrofusion. The morphology of the vaccine was identified under inverted fluorescence microscope and the phenotypes were analyzed with flow cytometry. The production of interleukin-12 (IL-12) and interferon-γ (IFN-γ) by the fusion cells was assessed using ELISA. A CCK-8 kit was used to examine the effect of the vaccine in stimulating the proliferation and cytotoxicity of autologous T lymphocytes.

RESULTSThe DCs isolated from peripheral blood mononuclear cells highly expressed CD83, CD86, CD11c and HLA-DR on the cell surface. The fusion cells were irregular in shape and coexpressed the phenotypes of DCs and MDA-MB-231 cells. The fusion cells possessed a strong ability to stimulate the proliferation of T lymphocytes in vitro. Compared with the control group, the fusion vaccine showed a stronger antitumor effect against the breast cancer cells.

CONCLUSIONThe triple-negative breast cancer-DC fusion vaccine prepared by electrofusion can stimulate the proliferation of T lymphocytes and induces strong cytotoxicity of the T cells against breast cancer cells.

Breast Neoplasms ; immunology ; Cancer Vaccines ; immunology ; Cell Fusion ; Cell Line, Tumor ; Dendritic Cells ; immunology ; Female ; Humans ; Interferon-gamma ; immunology ; Interleukin-12 ; immunology ; Lymphocyte Activation ; T-Lymphocytes, Cytotoxic ; immunology

Objective To investigate the role of SIAH2 protein in the occurrence and development of hepatocellular carcinoma (HCC). Methods Human HCC Bel-7404 cells in logarithmic growth phase were inoculated. Empty carrier small interference ribonucleic acid (siRNA) and SIAH2 siRNA were transfected in human HCC Bel-7404 cells. Then the cells were divided into 2 groups:control-siRNA group and SIAH2-siRNA group. Theβ-actin was taken as control, and the expression of SIAH2 protein in human HCC Bel-7404 cells of 2 groups was detected by Western Blot. The proliferation of cells in 2 groups was detected by methyl thiazolyl tetrazolium (MTT) assay. Cell migration in 2 groups was observed by cell scratch test. Cell invasion in 2 groups was observed by Transwell assay. The data in 2 groups were compared using t test. Results The average relative expression of SIAN2 in control-siRNA and SIAH2-siRNA group were 0.71±0.02, 0.33±0.01 respectively. The expression of SIAN2 in SIAH2-siRNA group decreased obviously compared with that in control-siRNA group (t=-4.629, P<0.05). The proliferation rate in SIAH2-siRNA group also decreased obviously. The cell migration rate in SIAH2-siRNA group[(14.3±0.4)%] was significantly lower than that in control-siRNA group [(45.3±0.4)%]( t=-3.689, P<0.05). The membrane permeating cell count in SIAH2-siRNA group (122±7) was signiifcantly less than that in control-siRNA group (563±10) (t=-3.428, P<0.05). Conclusion SIAH2 protein can promote the proliferation, migration and invasion of HCC cells and thus accelerate the occurrence and development of HCC.

Objective To investigate the curative effect of radiofrequency ablation (RFA) combined with chemotherapy for liver metastases from breast cancer. Methods Clinical data of 6 patients with liver metastases from breast cancer in the Third Affiliated Hospital of Sun Yet-sen University from January 2009 to December 2012 were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. All the patients were female with the age ranging from 35 to 65 years old and a median of 54 years old. The liver metastases were all single metastases. The tumor diameter was 1.5 to 4.5 cm with a median of 2.5 cm. The patients received modified radical mastectomy 6 to 30 months before treatments and all received chemotherapy after the operations. The liver metastases were confirmed by ultrasound, CT and MRI. RFA was performed percutaneously under the guidance of ultrasound on the patients. After 1 week of RFA treatment, individual chemotherapy was given to the patients according to their previous chemotherapy regimen and the situation of liver metastases. The focus necrosis was checked by contrast enhanced CT or MRI examination 1 month after the RFA treatment. The curative effect of RFA was observed based on the imaging examinations. According to the patients' survival and tumor recurrence, survival analysis was conducted by drawing Kaplan-Meier curves. Results After the first RFA on 6 cases, the liver metastases in 5 cases were observed with total necrosis, and 1 case with partial necrosis. The one with partial necrosis then received the second RFA. Local recurrence of the tumor was observed in 1 case during the follow-up. All the patients survived with a median tumor-free survival time of 18 months. Conclusions The combination theraphy of RFA and chemotherapy has a definite effect for liver metastases from breast cancer and is a safe, effective comprehensive therapeutic regimen.

ObjectiveTo evaluate the therapeutic effects of radiofrequency ablation and surgical resection for liver metastasis from breast cancer.MethodsClinical data of 15 patients with liver metastasis from breast cancer admitted and treated in the Third Affiliated Hospital of Sun Yat-sen University between January 2010 and May 2014 were retrospectively studied. All patients were females with the age ranging from 33 to 66 years old and the median of 49 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to the different therapeutic regimen, the patients were divided into radiofrequency ablation + chemotherapy group (ablation group,n=9) and surgery +chemotherapy group (surgery group,n=6). The conditions of two groups during the perioperative period were observed and the survival analysis was performed. The observations during perioperative period between two groups was compared usingt test, the rates was compared using Fisher's exact test and the survival analysis was conducted using Kaplan-Meier method and Log-rank test.ResultsThe mean operation time of the ablation group was (26±5) min, which was significantly shorter than (151±27) min of the surgery group (t=-18.69,P<0.05). No case in the ablation group received blood transfusion while 3 cases in the surgery group received blood transfusion during the operation. The tumor clearance rate of the surgery group was 100%,which was the same with that of the ablation group. The postoperative hospital stay of the ablation group was (6±2) d, which was signiifcantly shorter than (11±5) d of the surgery group (t=-3.70,P<0.05). The incidence of postoperative complications of the ablation group was 4/9, which was signiifcantly lower than 5/6 of the surgery group (P=0.02). The median survival time of the ablation group and the surgery group was respectively 33, 23 months. The 1-, 2- and 5-year cumulative survival rate were respectively 88.9%, 66.7% and 22.2% for the ablation group and were respectively 82.3%, 50.0% and 0 for the surgery group and no significant difference was observed between two groups (χ2=1.53,P>0.05).ConclusionsThe radiofrequency ablation for patients with liver metastasis from breast cancer can have the same therapeutic effect with surgical resection, and has advantages of short operation time, low incidence of postoperative complications and short postoperative hospital stay.

Hand hemangioma combined with aneurysm is rare and its specific clinical diagnosis and treatment method are not yet clear. In February 2021, a 49-year-old female patient with a right small finger hemangioma and aneurysm was diagnosed and treated in the Department of Hand and Foot, Northern Jiangsu People’s Hospital. The patient was admitted to the hospital due to a tumor in the right little finger for 1 year. A low-echo mass with blood flow in the subcutaneous layer of the right little finger was detected on Doppler ultrasound and considered a hemangioma. Other laboratory tests and physical examinations showed no obvious abnormalities. The preoperative diagnosis was a right little finger mass (hemangioma). After completing the preoperative examination, we performed a resection of the hemangioma of the right little finger. Postoperative pathology showed that the mass located on the volar side of the right little finger was consistent with an aneurysm, and the one on the dorsal side of the right little finger was consistent with a venous aneurysm. After 2 years of follow-up, there was no recurrence of the lesion.

Objective:To introduce the therapeutic effect of forearm radial artery perforator propeller flap for repair of hand and wrist soft tissue defects.Methods:The clinical data of patients with soft tissue defects of hand and wrist who received the treatment with forearm radial artery perforator propeller flap in Northern Jiangsu People’s Hospital from January 2018 to September 2020 were collected. The radial artery of the forearm was projected on the skin surface as the axis, and the nearest perforator was selected as the rotation point according to the location of the soft tissue defect. The radial artery perforator propeller flap was designed based on the location, area and shape of soft tissue defect. The length of the large paddle of the flap is equal to the distance between the proximal side of the wound edge and the rotation point plus the length of the wound, and the length of the small paddle of the flap is equal to the distance between the proximal side of the wound edge and the rotation point. The donor site was closed directly or with full-thickness skin graft from the ipsilateral upper arm. The survival, appearance of the flap and skin graft, hand and wrist function and patients satisfactory rate were observed and recorded.Results:A total of 6 patients were included, including 4 males and 2 females; the mean age was 40.5 years (range, 25-65 years ). There were 1 case on the palm side of the hand, 1 case on the dorsal side of the hand, 3 cases on the volar side of the wrist, and 1 case on the dorsal side of the wrist. The area of soft tissue defect after debridement was 2 cm × 3 cm-7 cm × 10 cm. The forearm radial artery perforator propeller flap ranged from 3 cm × 4 cm to 8 cm × 11 cm. The donor site was closed directly in 3 cases, and with full-thickness skin graft in 3 cases. The flaps in all 6 patients survived completely with primary healing. The skin grafts for the donor site in 3 cases survived completely. The patients were followed up for 3 months to 1 year, with an average of 5 months. The function of the hand and wrist recovered well. The texture of the flap was similar to that of the surrounding tissue with good appearance, no swelling or slight swelling, no obvious color difference. The donor site healed well without scar hyperplasia. The patients were satisfied with the surgical results.Conclusion:Propeller flap pedicled with forearm radial artery perforator is a simple and effective method to repair soft tissue defects of wrist and hand with reliable recovery of appearance and function. The patients’ satisfactory rate is also high.

Objective:To investigate the clinical effect of super-thin free anterolateral thigh (ALT) flap at the junction plane of superficial and deep fat of superficial fascia to repair the soft tissue defects of the foot.Methods:The clinical data of patients with foot soft tissue defects admitted to Northern Jiangsu People’s Hospital Affiliated to Yangzhou University from June 2017 to December 2022 were retrospectively analyzed. During the operation, the super-thin free ALT flap on the affected side was harvested at the junction of superficial and deep fat of superficial fascia to repair the foot wound. The donor site wound was sutured directly or repaired with full-thickness skin graft. The flap survival and complications were observed after the operation, and the operation effect was evaluated from the following five aspects. (1) The Maryland foot function score was used to evaluate the recovery of foot function. The full score was 100 points, of which 90-100 points were excellent, 75-89 points were good, 50-74 points were fair, and < 50 points were poor. (2) The Vancouver scar scale (VSS) was used to evaluate the scar condition of the foot. The total score was 0-15 points. The higher the score, the more serious the scar. (3) The cold intolerance symptom severity (CISS) scale was used to evaluate the cold tolerance of the affected foot. The total score was 4-100 points. The higher the score, the more serious the symptoms. (4) Measuring static two-point discrimination to evaluate foot sensation, the smaller the measured value, the better the sensory recovery. (5) The satisfaction of patients with foot appearance was investigated, which was divided into five grades: very satisfied, satisfied, general, dissatisfied and very dissatisfied. Descriptive analysis of the data was performed using SPSS 26.0 software.Results:A total of 13 patients with foot soft tissue defects were enrolled, including 8 males and 5 females. The mean age was 54.7 years (range, 39-70 years). There were 10 cases of left foot and 3 cases of right foot. The wound area after thorough debridement ranged from 5.5 cm ×5.0 cm to 22.0 cm ×18.0 cm. The operation time was (145.1 ± 30.6) min. The area of the flap was 6.0 cm×5.5 cm to 23.5 cm×19.0 cm, and the thickness was (5.2 ± 1.1) mm (range, 3.0- 6.5 mm). The wound at the donor site was sutured directly in 9 cases, and coverd with the abdominal full-thickness skin graft in 4 cases. After the operation, 1 patient had partial epidermal necrosis at the distal end of the flap, 1 patient had venous crisis.The flaps survived after symptomatic treatment. The remaining 11 flaps survived smoothly. The patients were followed up for 12 to 20 months, with an average of 16 months. The foot flaps were soft and free of damage, and no secondary fat reduction or plastic surgery was required. There were no complications such as wound dehiscence, skin graft necrosis, muscle hernia, and quadriceps weakness in 13 cases of donor site except for hypoesthesia caused by scar hyperplasia in 4 cases with skin graft. At the last follow-up, the Maryland foot function score was (87.4±7.3) points, of which 7 cases were excellent, 4 cases were good, and 2 cases were fair. The excellent and good rate was 11/13. The foot scar was not obvious, the VSS score was (3.2±1.2) points. The foot was more tolerant to cold and the sensory recovery was better, the CISS score was (37.5±7.1) points and the static two-point discrimination was (13.9±1.0) mm. One month after the operation, the results of patients’ satisfaction with foot appearance were as follows: 11 cases were very satisfied and 2 cases were satisfied.Conclusion:The super-thin free ALT flap is obtained at the junction plane of superficial and deep fat of superficial fascia to repair the soft tissue defect of the foot, which can optimize the operation time. The appearance and function of the foot recover well after the operation, avoiding the secondary shaping operation, reducing the damage to the donor site, and the patients are satisfied.

Hand hemangioma combined with aneurysm is rare and its specific clinical diagnosis and treatment method are not yet clear. In February 2021, a 49-year-old female patient with a right small finger hemangioma and aneurysm was diagnosed and treated in the Department of Hand and Foot, Northern Jiangsu People’s Hospital. The patient was admitted to the hospital due to a tumor in the right little finger for 1 year. A low-echo mass with blood flow in the subcutaneous layer of the right little finger was detected on Doppler ultrasound and considered a hemangioma. Other laboratory tests and physical examinations showed no obvious abnormalities. The preoperative diagnosis was a right little finger mass (hemangioma). After completing the preoperative examination, we performed a resection of the hemangioma of the right little finger. Postoperative pathology showed that the mass located on the volar side of the right little finger was consistent with an aneurysm, and the one on the dorsal side of the right little finger was consistent with a venous aneurysm. After 2 years of follow-up, there was no recurrence of the lesion.

Objective:To introduce the therapeutic effect of forearm radial artery perforator propeller flap for repair of hand and wrist soft tissue defects.Methods:The clinical data of patients with soft tissue defects of hand and wrist who received the treatment with forearm radial artery perforator propeller flap in Northern Jiangsu People’s Hospital from January 2018 to September 2020 were collected. The radial artery of the forearm was projected on the skin surface as the axis, and the nearest perforator was selected as the rotation point according to the location of the soft tissue defect. The radial artery perforator propeller flap was designed based on the location, area and shape of soft tissue defect. The length of the large paddle of the flap is equal to the distance between the proximal side of the wound edge and the rotation point plus the length of the wound, and the length of the small paddle of the flap is equal to the distance between the proximal side of the wound edge and the rotation point. The donor site was closed directly or with full-thickness skin graft from the ipsilateral upper arm. The survival, appearance of the flap and skin graft, hand and wrist function and patients satisfactory rate were observed and recorded.Results:A total of 6 patients were included, including 4 males and 2 females; the mean age was 40.5 years (range, 25-65 years ). There were 1 case on the palm side of the hand, 1 case on the dorsal side of the hand, 3 cases on the volar side of the wrist, and 1 case on the dorsal side of the wrist. The area of soft tissue defect after debridement was 2 cm × 3 cm-7 cm × 10 cm. The forearm radial artery perforator propeller flap ranged from 3 cm × 4 cm to 8 cm × 11 cm. The donor site was closed directly in 3 cases, and with full-thickness skin graft in 3 cases. The flaps in all 6 patients survived completely with primary healing. The skin grafts for the donor site in 3 cases survived completely. The patients were followed up for 3 months to 1 year, with an average of 5 months. The function of the hand and wrist recovered well. The texture of the flap was similar to that of the surrounding tissue with good appearance, no swelling or slight swelling, no obvious color difference. The donor site healed well without scar hyperplasia. The patients were satisfied with the surgical results.Conclusion:Propeller flap pedicled with forearm radial artery perforator is a simple and effective method to repair soft tissue defects of wrist and hand with reliable recovery of appearance and function. The patients’ satisfactory rate is also high.

Objective:To investigate the clinical effect of super-thin free anterolateral thigh (ALT) flap at the junction plane of superficial and deep fat of superficial fascia to repair the soft tissue defects of the foot.Methods:The clinical data of patients with foot soft tissue defects admitted to Northern Jiangsu People’s Hospital Affiliated to Yangzhou University from June 2017 to December 2022 were retrospectively analyzed. During the operation, the super-thin free ALT flap on the affected side was harvested at the junction of superficial and deep fat of superficial fascia to repair the foot wound. The donor site wound was sutured directly or repaired with full-thickness skin graft. The flap survival and complications were observed after the operation, and the operation effect was evaluated from the following five aspects. (1) The Maryland foot function score was used to evaluate the recovery of foot function. The full score was 100 points, of which 90-100 points were excellent, 75-89 points were good, 50-74 points were fair, and < 50 points were poor. (2) The Vancouver scar scale (VSS) was used to evaluate the scar condition of the foot. The total score was 0-15 points. The higher the score, the more serious the scar. (3) The cold intolerance symptom severity (CISS) scale was used to evaluate the cold tolerance of the affected foot. The total score was 4-100 points. The higher the score, the more serious the symptoms. (4) Measuring static two-point discrimination to evaluate foot sensation, the smaller the measured value, the better the sensory recovery. (5) The satisfaction of patients with foot appearance was investigated, which was divided into five grades: very satisfied, satisfied, general, dissatisfied and very dissatisfied. Descriptive analysis of the data was performed using SPSS 26.0 software.Results:A total of 13 patients with foot soft tissue defects were enrolled, including 8 males and 5 females. The mean age was 54.7 years (range, 39-70 years). There were 10 cases of left foot and 3 cases of right foot. The wound area after thorough debridement ranged from 5.5 cm ×5.0 cm to 22.0 cm ×18.0 cm. The operation time was (145.1 ± 30.6) min. The area of the flap was 6.0 cm×5.5 cm to 23.5 cm×19.0 cm, and the thickness was (5.2 ± 1.1) mm (range, 3.0- 6.5 mm). The wound at the donor site was sutured directly in 9 cases, and coverd with the abdominal full-thickness skin graft in 4 cases. After the operation, 1 patient had partial epidermal necrosis at the distal end of the flap, 1 patient had venous crisis.The flaps survived after symptomatic treatment. The remaining 11 flaps survived smoothly. The patients were followed up for 12 to 20 months, with an average of 16 months. The foot flaps were soft and free of damage, and no secondary fat reduction or plastic surgery was required. There were no complications such as wound dehiscence, skin graft necrosis, muscle hernia, and quadriceps weakness in 13 cases of donor site except for hypoesthesia caused by scar hyperplasia in 4 cases with skin graft. At the last follow-up, the Maryland foot function score was (87.4±7.3) points, of which 7 cases were excellent, 4 cases were good, and 2 cases were fair. The excellent and good rate was 11/13. The foot scar was not obvious, the VSS score was (3.2±1.2) points. The foot was more tolerant to cold and the sensory recovery was better, the CISS score was (37.5±7.1) points and the static two-point discrimination was (13.9±1.0) mm. One month after the operation, the results of patients’ satisfaction with foot appearance were as follows: 11 cases were very satisfied and 2 cases were satisfied.Conclusion:The super-thin free ALT flap is obtained at the junction plane of superficial and deep fat of superficial fascia to repair the soft tissue defect of the foot, which can optimize the operation time. The appearance and function of the foot recover well after the operation, avoiding the secondary shaping operation, reducing the damage to the donor site, and the patients are satisfied.