Objective To evaluate the feasibility of catheter ablation of Para-Hisian Atrial Tachycardia guide by CARTO. Method Catheter ablation guided by CARTO was performed after activation map in three patients with Para-Hisian Atrial Tachycardia. Result Successful ablation was got at right atrial in two patients and at non-coronary in one patient. Conclusion Catheter ablation guided by CARTO is safe and efficient for Para-Hisian Atrial Tachycardia.

Objective To examine the expression of CD9 protein in pancreatic cancer tissues and adjacent tissues,and to analyze its relation with the progress and prognosis of pancreatic cancer.Methods From September 2005 to December 2009,surgical resected cancer tissues and adjacent tissues of 90 patients with pancreatic cancer and their clinical data were collected.The expression of CD9 protein in pancreatic cancer tissues and adjacent tissues was detected by immunohistochemistry,and its relationship with clinicopathological features was analyzed.Chi-square test was performed for comparison of ratios between groups.Overall survival (OS) analysis of 90 patients after surgery was performed.Results The high expression rate of CD9 protein (64.4％,58/90) in cancer tissue was significantly higher than that in cancer adjacent tissue (45.6％,41/90),the difference has statistically significant (χ2 =6.847,P＜0.05).CD9 protein was highly expressed in most of pancreatic cancer tissue which was well differentiated or without lymph node metastasis (74.6％ (50/67) vs 39.1％ (9/23),χz =9.554,P＜0.01; 50.0％(17/34) vs 73.2％(41/56),χ2 =5.856,P＜0.05 respectively).However,the expression of CD9 was not correlated with gender and age (both P＞0.05).OS and progression-free survival (PFS) of the patients with CD9 highly expressed were significantly longer than those with low expression of CD9 (median OS:33.0 months vs 7.0 months,χ2 =15.400 P＜0.01.Median PFS:30.5 months vs 5.0 months,χ2 =13.750,P＜0.01).Conclusion CD9 protein is a kind of protein related with the invasive ability of pancreatic cancer,which may play a role in progression and metastasis of pancreatic cancer and can help to determine the prognosis to a certain extent.

Bacterial antitumor therapy has great application potential given its unique characteristics, including genetic manipulation, tumor targeting specificity and immune system modulation. However, the nonnegligible side effects and limited efficacy of clinical treatment limit their biomedical applications. Engineered bacteria for therapeutic applications ideally need to avoid their accumulation in normal organs and possess potent antitumor activity. Here, we show that macrophage-mediated tumor-targeted delivery of Salmonella typhimurium VNP20009 can effectively reduce the toxicity caused by administrating VNP20009 alone in a melanoma mouse model. This benefits from tumor-induced chemotaxis for macrophages combined with their slow release of loaded strains. Inspired by changes in the tumor microenvironment, including a decrease in intratumoral dysfunctional CD8⁺ T cells and an increase in PDL1 on the tumor cell surface, macrophages were loaded with the engineered strain VNP-PD1nb, which can express and secrete anti-PD1 nanoantibodies after they are released from macrophages. This novel triple-combined immunotherapy significantly inhibited melanoma tumors by reactivating the tumor microenvironment by increasing immune cell infiltration, inhibiting tumor cell proliferation, remodeling TAMs to an M1-like phenotype and prominently activating CD8⁺ T cells. These data suggest that novel combination immunotherapy is expected to be a breakthrough relative to single immunotherapy.