Voltage-gated sodium channels (VGSCs) are heteromeric protein complexes containing one core subunit α and one or more auxiliary subunit β. VGSCs are widely expressed in various forms of tumor cells and tissues. Importantly, subunit α can regulate the invasive capacity of tumor cells, and subunit β is related to the adhesion and migration capacities of tumor cells. The function of subunit β in different types of tumor is different. Emerging studies have revealed that VGSCs have certain effects on tumor invasion and metastasis, which indicates that VGSCs may become the target for tumor diagnosis and targeted therapy. Therefore, this paper summarizes the effects of VGSCs on tumor invasion and migration, as well as the research progress in VGSCs used as tumor therapeutic target.

Objective:To explore the preventive function for sweating gustatory syndrome and esthetic effect of restoring parotid gland area defect by using platysma flap. Methods: Nine patients who underwent parotidectomy and restored parotid gland area defect with platysma flap were analyzed retrospectively in this study. Observed whether there was an incidence of subjective sweating gustatory syndrome and introcession in the operation region. Results: There was no incidence of subjective sweating gustatory syndrome. Moreover, introcession in the operation region was not obvious. Conclusion: Restoring parotid defects with platysma flap can reduce introcession in the operation region. Application of platysma flap as an interpositional barrier between the skin flap and the parotid bed after parotidectomy can reduce the incidence of sweating gustatory syndrome.

Objective To investigate the efficacy of dronedarone combined with low dose metoprol-ol in the treatment of atrial tachycardia.Methods A total of 175 elderly patients with atrial tachy-cardia admitted in Northern Jiangsu People's Hospital during January 2020 to January 2022 were enrolled and then randomly divided into dronedarone group(n=57),metoprolol group(n=55)and combined group(dronedarone+metoprolol,n=48).The frequency,duration and symptom changes of arrhythmia were compared before and after treatment.Results After 3 and 6 months of administration,the total effective rate was significantly higher in the combination group than the dronedarone group and the metoprolol group(P＜0.05).The frequency of atrial fibrillation(AF)attacks[(2.31±1.78)/48 h vs(11.56±18.68)/48 h],AF duration[(4.86±6.73)h/48 h vs(10.92±9.61)h/48 h],atrial flutter(AFL)attacks[(2.33±1.53)/48 h vs(4.33±1.53)/48 h]and AFL duration[(5.15±4.87)h/48 h vs(21.54±20.08)h/48 h]in the combined group,and AFL duration[(2.75±1.94)h/48 h vs(10.29±8.04)h/48 h]in the dronedarone group were reduced after 6 months of treatment(P＜0.05).Conclusion In the treatment of atrial tachycardia,dronedarone combined with low dose metoprolol can not only obviously improve symptoms,but also significantly reduce the atrial premature and atrial tachycardia attacks,decrease the number and duration of AF and AFL attacks,and control heart rate effectively.

[Objective] To study the methylation status of CD40L gene regulatory regions in peripheral blood CD4+ T cells from patients with systemic sclerosis (SSc).[Methods] Peripheral blood mononuclear cells were isolated from the venous blood of 21 SSc patients and 20 healthy controls by density gradient centrifugation.CD4+ T cells were separated by using magnetic beads.Genomic DNA was isolated from the CD4+ T cells and treated with sodium bisulfite.Nested PCR was perfonned to amplify the desired regulatory sequences (including the promotor and enhancer) of CD40L,and the amplicons were transformed into the Escberichia coli DH5α.Subsequently,8 independent clones were selected and sequenced for each of the amplified fragments.[Results] In healthy female controls,half of the cloned fragments of CD40L regulatory sequences were unmethylated,and the other half were methylated.The mean methylation levels of CD40L promoter and enhancer from female SSc patients were significantly lower than those from healthy female controls (both P ＜ 0.01 ).Almost all of the cloned fragments of CD40L promoter and enhancer were unmethylated in healthy male controls and male SSc patients,with no significant difference in the methylation level between male SSc patients and healthy controls (both P ＞ 0.05,respectively).[Conclusion]s There is a low methylation level of CD40L regulatory elements on the inactive X chromosome in female SSc patients,which may contribute to the CD40L overexpression in CD4+ T cells.

Objective To investigate the expression levels of CD40L in CD4 + T cells from systemic sclerosis (SSc) patients.Methods PBMC ( peripheral blood mononuclear cells) cells were isolated from the peripheral venous blood of SSc patients (16females,10males) and healthy donors (15females,10males) by density gradient centrifugation.CD4 + T cells were isolated using magnetic beads.mRNA levels of CD40L in CD4 + T cells were measured by real-time quantitative polymerase chain reaction (RTPCR).Flow cytometric analysis was used to detect the CD40L protein on the surface of CD4 + T cells.Results Both CD40L mRNA and protein expression in CD4 +T cells was significantly elevated in female SSc patients compared with female healthy controls [5.61 ± 1.86 vs 2.80 ±0.94,P ＜0.01 ; (6.70 ±3.55)％vs (2.37 ± 1.39)％,P ＜ 0.05,respectively].No significant increase in CD40L mRNA and protein expression was observed in male SSc patients compared with male controls [2.59 ± 0.89 vs 1.92 ± 0.56,P ＞0.05; (2.06±1.09)％ vs (2.13±0.87)％,P ＞0.05,respectively].Conclusions CD40L was overexpressed in CD4 + T cell of female patients but not males,which maybe one of the important reasons for female susceptibility to SSc.

Epithelial tissues covering the external and internal surface of a body are constantly under physical, chemical or biological assaults. To protect the epithelial tissues and maintain their homeostasis, multiple layers of immune defense mechanisms are required. Besides the epithelial tissue-resident immune cells that provide the first line of defense, circulating immune cells are also recruited into the local tissues in response to challenges. Chemokines and chemokine receptors regulate tissue-specific migration, maintenance and functions of immune cells. Among them, chemokine receptor CCR10 and its ligands chemokines CCL27 and CCL28 are uniquely involved in the epithelial immunity. CCL27 is expressed predominantly in the skin by keratinocytes while CCL28 is expressed by epithelial cells of various mucosal tissues. CCR10 is expressed by various subsets of innate-like T cells that are programmed to localize to the skin during their developmental processes in the thymus. Circulating T cells might be imprinted by skin-associated antigen- presenting cells to express CCR10 for their recruitment to the skin during the local immune response. On the other hand, IgA antibody-producing B cells generated in mucosa-associated lymphoid tissues express CCR10 for their migration and maintenance at mucosal sites. Increasing evidence also found that CCR10/ligands are involved in regulation of other immune cells in epithelial immunity and are frequently exploited by epithelium-localizing or -originated cancer cells for their survival, proliferation and evasion from immune surveillance. Herein, we review current knowledge on roles of CCR10/ligands in regulation of epithelial immunity and diseases and speculate on related important questions worth further investigation.
B-Lymphocytes ; cytology ; immunology ; Cell Lineage ; Cell Movement ; genetics ; immunology ; Chemokine CCL27 ; genetics ; immunology ; Chemokines, CC ; genetics ; immunology ; Epithelial Cells ; cytology ; immunology ; Epithelium ; immunology ; Gene Expression Regulation ; immunology ; Humans ; Immunity, Mucosal ; Immunoglobulin A ; biosynthesis ; immunology ; Mucous Membrane ; cytology ; immunology ; Receptors, CCR10 ; genetics ; immunology ; Signal Transduction ; genetics ; immunology ; T-Lymphocytes ; cytology ; immunology

Objective:To investigate the CT features and surgical treatment of mixed epithelial and stromal tumor of the kidney (MESTK).Methods:From April 2015 to August 2018, 13 patients with MESTK confirmed by pathology at the First Affiliated Hospital, College of Medicine, Zhejiang University, were enrolled in this study and their clinical data were analyzed retrospectively. These patients included 3 males and 10 females, with age ranging from 22 to 80 years old and the median age of 37 years old. Two patients complained of lumbar discomfort with urinary urgency and another 2 patients presented with hematuria. Nine patients were asymptomatic and their renal lesions were detected by abdominal ultrasonography for physical examination or other reasons. There were 2 cases had a history of polycystic kidney disease, 1 patient took contraceptive for 2 years, and 3 cases took antihypertensive agents for 5-10 years. The other patients denied any administration of hormone or other medicine for long time. The urine routine test was normal for these patients except for 2 patients did not take this test before operation. The creatinine value ranged from 45 to 486 μmol/L, with the median value of 67 μmol/L. The scope of glomerular filtration rate (GFR) was 6.98 to 132.28 ml/min, with the median value of 109.28 ml/min. The preoperative computer tomography (CT) showed single neoplasm in 11 patients and no obvious neoplasm was found in 2 patients who had polycystic kidney disease. Moreover, these lesions presented cystic neoplasm for 8 cases, cystic-solid neoplasm for 2 cases and solid neoplasm for 3 cases. Long diameter was measured about 2.5 to 7.5 cm, with the median of 5 cm, and calcification was found in 4 cases. These tumors manifested mild to moderate enhancement and delayed-enhancement for tumor parenchyma and intracapsular septum. The CT attenuation value was from 20 to 55 Hounsfield unit (HU). Base on the R. E.N.A.L. score system, these renal lesions got 4 to 10 points, with the median value of 7 points. Before operation, just 1 case was diagnosed as angiomyolipoma and 2 cases were diagnosed as polycystic kidney disease. No definitive diagnosis was made for the other 10 cases by CT imaging. In addition, the tumor staging based on preoperative imaging was made at T1a for 8 cases and T1b for 3 cases. Among these cases, 2 patients with polycystic kidney disease underwent open radical nephrectomy due to recurrent hematuria and uremia. One patient underwent laparoscopic radical nephrectomy due to perirenal fat adhesion. Partial nephrectomy was performed in remaining 10 patients by open surgery for 6 patients, robotic surgery for 3 patients and laparoscopic surgery for 1 patient. These renal tumors and 0.5-1.0 cm surrounding normal renal parenchyma were removed during operation.Results:In this study, 8 patients had blood loss of 30 to 100 ml during open operation, and 5 patients had blood loss of 20 to 100 ml during laparoscopic or robotic surgery. The warm ischemic time during partial nephrectomy was around 17 to 40 min, with the median value of 20 min. All of 13 cases were diagnosed as MESTK by postoperative pathology and the surgical margin was negative. There were no serious complications or special treatment after operation. The follow-up time ranged from 12 to 41 months, with the median time of 21 months. Obvious signs of tumor recurrence or metastasis were not detected in 13 cases during follow-up.Conclusions:CT images of MESTK mostly presented cystic or cystic-solid lesions, and solid lesions were relatively rare. This disease always showed mild to moderate enhancement and delayed enhancement of septal or tumor parenchyma. If there is coarse calcification in the lesions, it is more likely to be diagnosed as MESTK. Partial nephrectomy is preferred and radical nephrectomy should be considered when perirenal fat adhesion is suggested by the preoperative CT images.

Objective:To explore the changes in activity of indoleamine 2, 3-dioxygenase(IDO)before and after stereotactic body radiation therapy (SBRT) in early stage non-small cell lung cancer(NSCLC) and its relationship with survival.Methods:The retrospective study was to assess IDO activity by serum kynurenine (Kyn) and Kyn to tryptophan (Trp) ratio before and after SBRT of early stage NSCLC.Thirty early stage NSCLC patients who received SBRT in the Cancer Hospital of the University of Chinese Academy of Sciences were enrolled, from December 2014 to July 2017. High-performance liquid chromatography and mass spectrometry were used to detect serum Kyn and Trp before and after SBRT. The ratios of Kyn after SBRT to Kyn before SBRT were divided into high and low group according to the median value. Similarly, the ratios of Kyn to Trp after SBRT were divided into high and low group.The correlation between overall survival (OS), progression-free survival (PFS) and IDO activity was evaluated. The factors influencing prognosis were analyzed.Results:In all patients, lower ratio of Kyn after SBRT to Kyn before SBRT significantly was correlated with better PFS (median PFS: not reached vs. 26.8 months, HR=0.31, 95% CI =0.11-0.90, P<0.05). The lower Kyn∶Trp ratio after SBRT had longer OS (median OS: not reached vs. 36.5 months, HR=0.27, 95% CI =0.079-0.95, P<0.05). In multivariate analysis, smoking <30 packs/year, higher BED, and lower ratio of Kyn after SBRT to Kyn before SBRT were associated with longer PFS. Lower Kyn∶Trp ratio after SBRT and higher BED were associated with longer OS. Conclusions:SBRT could alter IDO-mediated antitumor immune activity. IDO is a potentially valuable biomarker for monitoring immune status and predicting survival in early NSCLC patients after SBRT.

【Objective】 To investigate and analyze the current situation of the human resources as well as blood collection and supply of blood banks of Zhejiang Province, so as to understand the problems existing in the development of human resources and put forward suggestions. 【Methods】 Questionnaires were issued to Blood Center of Zhejiang Province, municipal central blood stations, and county-level central blood banks to investigate the relevant data in 2015 and 2019. Meanwhile, some data were obtained through the Zhejiang Blood Management Information System (BIS3.0), symposiums, and querying medical service data. Statistical analysis was carried out. 【Results】 Among the 28 blood banks, filled the questionnaires, 927 personnel were in accordance with the authorized strength, accounting for 62.26% (927/1 489), and 1069 health technicians, accounting for 71.519% (1 060/1 489). From 2015 to 2019, the annual growth rate of human resources in blood banks was 2.02%, lower than the annual growth rate of whole blood collection volume 4.83% and the annual growth rate of clinical blood supply (red blood cell) 4.82%, lagging behind the annual growth rate of 6.55%, 8.71% and 12.36% in the number of diagnoses, inpatients and surgeries in the hospitals across the province. The average annual growth rate of doctors and nurses in blood banks was 0.17% and 1.67%, lower than that of licebsed doctors and registered nurses of the province, which was 6.78% and 8.27%, respectively. 【Conclusion】 With the development trend of blood collection and supply, the personnel allocation and the proportion of health technicians of blood banks across Zhejiang Province is insufficient. It is suggested to establish a manpower allocation standard suitable to the business volume, give priority to properly solvement of the current employment, strengthen training, and improve the efficiency of physical examination consultation, testing and phlebotomy positions.