The underlying cause of low response rates to existing immunotherapies is that tumor cells dominate tumor immune escape through surface antigen deficiency and inducing tumor immunosuppressive microenvironment (TIME). Here, we proposed an in situ tumor cell engineering strategy to disrupt tumor immune escape at the root by restoring tumor cell MHC-I/tumor-specific antigen complex (MHC-I/TSA) expression to promote T-cell recognition and by silencing tumor cell CD55 to increase the ICOSL⁺ B-cell proportion and reverse the TIME. A doxorubicin (DOX) and dual-gene plasmid (MAC pDNA, encoding both MHC-I/ASMTNMELM and CD55-shRNA) coloaded drug delivery system (LCPN@ACD) with tumor targeting and charge/size dual-conversion properties was prepared. LCPN@ACD-induced ICD promoted DC maturation and enhanced T-cell activation and infiltration. LCPN@ACD enabled effective expression of MHC-I/TSA on tumor cells, increasing the ability of tumor cell recognition and killing. LCPN@ACD downregulated tumor cell CD55 expression, increased the proportion of ICOSL⁺ B cells and CTLs, and reversed the TIME, thus greatly improving the efficacy of αPD-1 and CAR-T therapies. The application of this in situ tumor cell engineering strategy eliminated the source of tumor immune escape, providing new ideas for solving the challenges of clinical immunotherapy.

Microglia-mediated neuroinflammation is widely perceived as a contributor to numerous neurological diseases and mental disorders including depression. Discs large homolog 1 (Dlg1), an adaptor protein, regulates cell polarization and the function of K
Animals ; Depression/chemically induced* ; Inflammation ; Lipopolysaccharides/toxicity* ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Microglia ; NF-kappa B ; Neuroinflammatory Diseases

Objective:To assess the feasibility and effects of the mobile device-based video teaching in plastic surgery education.Methods:In the study, 22 participants were assigned into two groups according to their standardized training area. The intervention group ( n=11) which was outside Beijing had an unlimited access to video-based education; the control group ( n=11) which was in Beijing received traditional teaching. After the end of the first semester of teaching, the two groups of students were tested on theory and clinical operational theory, and the evaluation results were compared. SPSS 18.0 software was applied for t test and chi-square test. Results:After the first semester, the effect of teaching method was evaluated by the scores of written examination and clinical examination. The average scores of the written test in the intervention group were (38.82±3.22) points, while that in the control group were (38.36±2.98) points, without significant differences between the two groups ( P=0.74); the average scores of the clinical examination theory test in the intervention group and the control group were (46.36±3.44) points and (41.00±5.24) points, respectively, with significant differences between the two groups ( P=0.01). In term of total scores, the average scores of the intervention group were (85.18±4.83) points, and those of the control group were (79.36±5.52) points, with statistical differences between the two groups ( P=0.016). Conclusion:Mobile device-based video teaching in plastic surgery education can not only improve students' performance but also facilitate their clinic skills, which is worth popularizing.

Objective:To investigate the method of the complex labia minora and clitoris prepuce hypertrophy and summarize the experience.Methods:From January 2016 to October 2019, a total of 432 patients with complex labia minora and clitoris prepuce hypertrophy in the 10th Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, were selected by classification. The patients were 18-46 years old (average 28 years old). The redundant prepuce of clitoris was repaired to transform the complex labia minora and clitoris prepuce hypertrophy into simple labia minora hypertrophy, and then labiaplasty was performed by edge or wedge resection.Results:A total of 346 cases were followed up for 3-12 months, 86 cases were lost. Hematoma occurred in 2 cases, bilateral asymmetry in 9 cases, irregular edge in 12 cases, and scar hyperplasia in 1 case. After respective treatment and secondary repair, the patients were satisfied. The overall satisfaction rate was 93.6%(324/346).Conclusions:Our method, through the decomposition operation, will change the complex shape into simple labia minora hyperplasia, reduce the difficulty of operation at the same time, which can achieve more satisfactory appearance.

Objective:To investigate the motivation of patients seeking labiaplasty and the external influencing factors.Methods:From January 2018 to December 2019, 268 patients who sought for operative labiaplasty at the Gynecological Plastic Surgery Center of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences were investigated for their motivation and influencing factors in the questionnaire. The motivation includes four options: aesthetic reasons, functional impairment, both aesthetic and functional reasons, and psychological factors. External influencing factors include two options: a self-requirement, was influenced by others. After collating the data, statistical analysis of the survey result was performed.Results:A total of 216 valid questionnaires were received. Motivation for pursuing operative labiaplasty: 22.2% (48/216) of the patients complained about cosmetic reasons, 38.4% (83/216) of dysfunction, and 35.2% (76/216) had both aesthetic and functional reasons. Psychological factors accounted for 4.2% (9/216). In terms of external influencing factors: all patients motivated by dysfunction were not influenced by others, while 6.3% (3/48) of patients of cosmetic reasons were affected by male partners. In the other two motivations, 7.9% (6/76) and 6/9 respectively indicated that they were affected by male spouse. In addition, there were 2.6% of patients with these 2 motivations (2/76) and 3/9 were affected by the media.Conclusions:Most patients seek labia minora reduction surgery because of functional reasons, and a small number of people are affected by sexual partners and media.

Objective:To explore the surgical methods and effects of different types of pudendal thigh flaps in repairing rectovaginal fistula.Methods:From March 1996 to November 2019, totally 18 cases with rectovaginal fistula admitted to Plastic Surgery Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively. The ages of the patients ranged from 17 months to 39 years with an average of 20.8 years. The bilateral pudendal thigh flap based on the anterior cutaneous branches of obturator artery can be used for larger fistula, which is larger than 1 cm in diameter and covered with serious local scars. Smaller fistula with diameter less than 1 cm can be repaired by the unilateral pudendal thigh flap pedicled with lateral branches of posterior labial artery transferred through subcutaneous tunnel. If the local tissue can be closed directly without tension, pudendal thigh fascial flap is inserted between the vaginal and rectal mucosa to act as a waterproof layer.Results:All flaps used in the 18 patients of this group survived postoperatively with fistula closure and donor site healed primarily. The size of the flaps ranged from 4 cm×2 cm to 7 cm×4 cm. The recipient sites including bilateral pudendal thigh island flaps (4 cases), unilateral pudendal thigh flaps (5 cases) and unilateral facial flaps (9 cases). No recurrence was reported during the follow-up period of 6 to 36 months.Conclusions:The application of pudendal thigh flaps can be considered as a safe and reliable procedure for the management of the middle and lower rectovaginal fistula. According to the anatomical characteristics of fistula, we could design rational flaps to meet the functional, morphological and cosmetic demands from the patients.

Objective:To investigate the method of the complex labia minora and clitoris prepuce hypertrophy and summarize the experience.Methods:From January 2016 to October 2019, a total of 432 patients with complex labia minora and clitoris prepuce hypertrophy in the 10th Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, were selected by classification. The patients were 18-46 years old (average 28 years old). The redundant prepuce of clitoris was repaired to transform the complex labia minora and clitoris prepuce hypertrophy into simple labia minora hypertrophy, and then labiaplasty was performed by edge or wedge resection.Results:A total of 346 cases were followed up for 3-12 months, 86 cases were lost. Hematoma occurred in 2 cases, bilateral asymmetry in 9 cases, irregular edge in 12 cases, and scar hyperplasia in 1 case. After respective treatment and secondary repair, the patients were satisfied. The overall satisfaction rate was 93.6%(324/346).Conclusions:Our method, through the decomposition operation, will change the complex shape into simple labia minora hyperplasia, reduce the difficulty of operation at the same time, which can achieve more satisfactory appearance.

Objective:To investigate the motivation of patients seeking labiaplasty and the external influencing factors.Methods:From January 2018 to December 2019, 268 patients who sought for operative labiaplasty at the Gynecological Plastic Surgery Center of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences were investigated for their motivation and influencing factors in the questionnaire. The motivation includes four options: aesthetic reasons, functional impairment, both aesthetic and functional reasons, and psychological factors. External influencing factors include two options: a self-requirement, was influenced by others. After collating the data, statistical analysis of the survey result was performed.Results:A total of 216 valid questionnaires were received. Motivation for pursuing operative labiaplasty: 22.2% (48/216) of the patients complained about cosmetic reasons, 38.4% (83/216) of dysfunction, and 35.2% (76/216) had both aesthetic and functional reasons. Psychological factors accounted for 4.2% (9/216). In terms of external influencing factors: all patients motivated by dysfunction were not influenced by others, while 6.3% (3/48) of patients of cosmetic reasons were affected by male partners. In the other two motivations, 7.9% (6/76) and 6/9 respectively indicated that they were affected by male spouse. In addition, there were 2.6% of patients with these 2 motivations (2/76) and 3/9 were affected by the media.Conclusions:Most patients seek labia minora reduction surgery because of functional reasons, and a small number of people are affected by sexual partners and media.

Objective:To explore the surgical methods and effects of different types of pudendal thigh flaps in repairing rectovaginal fistula.Methods:From March 1996 to November 2019, totally 18 cases with rectovaginal fistula admitted to Plastic Surgery Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively. The ages of the patients ranged from 17 months to 39 years with an average of 20.8 years. The bilateral pudendal thigh flap based on the anterior cutaneous branches of obturator artery can be used for larger fistula, which is larger than 1 cm in diameter and covered with serious local scars. Smaller fistula with diameter less than 1 cm can be repaired by the unilateral pudendal thigh flap pedicled with lateral branches of posterior labial artery transferred through subcutaneous tunnel. If the local tissue can be closed directly without tension, pudendal thigh fascial flap is inserted between the vaginal and rectal mucosa to act as a waterproof layer.Results:All flaps used in the 18 patients of this group survived postoperatively with fistula closure and donor site healed primarily. The size of the flaps ranged from 4 cm×2 cm to 7 cm×4 cm. The recipient sites including bilateral pudendal thigh island flaps (4 cases), unilateral pudendal thigh flaps (5 cases) and unilateral facial flaps (9 cases). No recurrence was reported during the follow-up period of 6 to 36 months.Conclusions:The application of pudendal thigh flaps can be considered as a safe and reliable procedure for the management of the middle and lower rectovaginal fistula. According to the anatomical characteristics of fistula, we could design rational flaps to meet the functional, morphological and cosmetic demands from the patients.

Microglia-mediated neuroinflammation is widely perceived as a contributor to numerous neurological diseases and mental disorders including depression. Discs large homolog 1 (Dlg1), an adaptor protein, regulates cell polarization and the function of K