Objective To investigate the clinical value of endoscopic transnasal dacryocystorhinostomy ( ET-DCR) by suture techniques.Methods 85 patients of 98 eyes with chronic dacryocystifis were randomly divided into the two groups:control group ( without suture) and observation group ( by suture) .All cases were followed up for more than 12 months.The cure rates and occurrence of granulation tissue were compared between the two groups. Results The cure rate of the observation group ( 96.00%, 48/50 ) was higher than that in the control group (81.25%,39/48) (χ2 =5.35,P<0.05). During process of following up,the occurrence of granulation tissue at the ostium margins accounted for 14.00%(7/50) in the observation group and 31.25%(15/48) in the control group (χ2 =4.19,P<0.05).Conclusion ET-DCR by suture techniques reduces the formation of granulation tissue and improves the cure rate.Especially, ET-DCR by suture techniques for the small lacrimal sac of patients may have special advantages.

Objective To explore the effect of endoscopic transnasal dacryocystorhinostomy(ET-DCR) by suture in the treatment of acute dacryocystitis(AD) as early as possible.Methods The clinical data of 32 patients with unilateral AD who underwent ET-DCR by suture as early as possible were retrospectively analyzed.Results All patients presented clear anatomic structure,intraoperative hemorrhage increased in 3 cases,swelling and pain was rapidly relieving in all patients in the first day of postoperation,the mean resolution time of congestion and swelling in the middle canthus was average 3 days(range 1-6 days),no spread of infection occurred,no facial scar appeared in all patients except one case of abscess rupture.Complete complaint relief in 26 cases,slight epiphora presented in 6 patients who confirmed for lacrimalduct obstruction and cured by intubation,and all ostial patency with no AD recurrences at the mean follow-up of 2 years (range 12 months-5 years).Conclusion ET-DCR by suture as early as possible can be used to cure acute dacryocystitis and it is effective safe and economy.

Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

Chimeric antigen receptor (CAR) T cells have been indicated effective in treating B cell acute lymphoblastic leukemia and non-Hodgkin lymphoma and have shown encouraging results in preclinical and clinical studies. However, CAR T cells have achieved minimal success against solid malignancies because of the additional obstacles of their insufficient migration into tumors and poor amplification and persistence, in addition to antigen-negative relapse and an immunosuppressive microenvironment. Various preclinical studies are exploring strategies to overcome the above challenges. Mobilization of endogenous immune cells is also necessary for CAR T cells to obtain their optimal therapeutic effect given the importance of the innate immune responses in the elimination of malignant tumors. In this review, we focus on the recent advances in the engineering of CAR T cell therapies to restore the immune response in solid malignancies, especially with CAR T cells acting as cellular carriers to deliver immunomodulators to tumors to mobilize the endogenous immune response. We also explored the sensitizing effects of conventional treatment approaches, such as chemotherapy and radiotherapy, on CAR T cell therapy. Finally, we discuss the combination of CAR T cells with biomaterials or oncolytic viruses to enhance the anti-tumor outcomes of CAR T cell therapies in solid tumors.
Humans ; Immunotherapy, Adoptive ; Neoplasms/therapy* ; T-Lymphocytes ; Tumor Microenvironment