Objective To investigate the distribution and infiltration characteristics of tissue-resident memory(TRM)cells in esophageal squamous cell carcinoma(ESCC),and further analyze relationship between TRM cell infiltration and ESCC immunotherapy and prognosis.Methods From January 2017 to December 2019,30 ESCC patients who did not receive preoperative neoadjuvant therapy in Xi'an Central Hospital were selected as focal tissue and para cancer tissue samples and peripheral venous blood samples.Immunofluorescence staining and flow cytometry were used to detect the distribution,expression infiltration of CD103+CD8+TRM cells and the expression of immune checkpoint molecules[Programmed death-1(PD-1)and T cell immunoglobulin and mucin domain 3(Tim-3)]in all samples.Another 86 ESCC patients who received neoadjuvant immune checkpoint PD-1 inhibitor treatment before surgery were selected during the same period,and the postoperative tissue samples were taken to detect the level of CD103+CD8+TRM cell infiltration,and the relationship between it and immunotherapy efficacy and prognosis was analyzed.Results The results of 30 ESCC patients who did not receive neoadjuvant therapy before surgery showed that:① CD103 was mainly localized in the cell membrane of tumor-infiltrating CD8+T lymphocytes.Most of the CD103+cells in ESCC cancer focus tissue co-express CD8+cells,while most of the CD103+cells in paracancer tissue did not co-express CD8+cells.②The proportion of CD103+CD8+TRM cells to CD8+T cells in ESCC cancer focus tissues was 76.9%±4.4%,which was significantly higher than that in adjacent normal tissues 65.8%±3.6%,and the difference was statistically significant(t=18.107,P＜0.001).③The proportion of CD103+CD8+TRM cells in ESCC tumor-infiltrating lymphocytes was 64.8%±4.3%,which was significantly higher than that in para-carcinoma infiltrating lymphocytes 34.6%±3.4%,the difference was statistically significant(t=30.175,P＜0.001),and peripheral blood lymphocytes were almost not expressed(1.1%±0.2%).④The immune checkpoint molecules PD-1 and Tim-3 were highly expressed in CD103+CD8+TRM cells of ESCC cancer foci.A sample of 86 ESCC patients treated with neoadjuvant immune checkpoint PD-1 inhibitors before surgery found that:① The proportion of CD103+CD8+TRM cell infiltration in the immunotherapy effective group was 76.5%±7.3%,which was significantly higher than that in immunotherapy ineffective group 58.7%±5.8%,the difference was statistically significant(t=12.126,P＜0.001).②The high infiltration group of CD103+CD8+TRM cells had higher OS survival than the low infiltration group,and the difference was statistically significant(Log-Rank χ2=2.635,P<0.05).Conclusion The expression and infiltration of CD103+CD8+TRM cells in ESCC tissues were higher than those in adjacent tissues,and the patients with high infiltration had better immunotherapy efficacy and survival prognosis,which could be used as a new biological indicator to provide a new reference for clinical prediction of the efficacy and prognosis of ESCC immunotherapy.

Objective To investigate the distribution and infiltration characteristics of tissue-resident memory(TRM)cells in esophageal squamous cell carcinoma(ESCC),and further analyze relationship between TRM cell infiltration and ESCC immunotherapy and prognosis.Methods From January 2017 to December 2019,30 ESCC patients who did not receive preoperative neoadjuvant therapy in Xi'an Central Hospital were selected as focal tissue and para cancer tissue samples and peripheral venous blood samples.Immunofluorescence staining and flow cytometry were used to detect the distribution,expression infiltration of CD103+CD8+TRM cells and the expression of immune checkpoint molecules[Programmed death-1(PD-1)and T cell immunoglobulin and mucin domain 3(Tim-3)]in all samples.Another 86 ESCC patients who received neoadjuvant immune checkpoint PD-1 inhibitor treatment before surgery were selected during the same period,and the postoperative tissue samples were taken to detect the level of CD103+CD8+TRM cell infiltration,and the relationship between it and immunotherapy efficacy and prognosis was analyzed.Results The results of 30 ESCC patients who did not receive neoadjuvant therapy before surgery showed that:① CD103 was mainly localized in the cell membrane of tumor-infiltrating CD8+T lymphocytes.Most of the CD103+cells in ESCC cancer focus tissue co-express CD8+cells,while most of the CD103+cells in paracancer tissue did not co-express CD8+cells.②The proportion of CD103+CD8+TRM cells to CD8+T cells in ESCC cancer focus tissues was 76.9%±4.4%,which was significantly higher than that in adjacent normal tissues 65.8%±3.6%,and the difference was statistically significant(t=18.107,P＜0.001).③The proportion of CD103+CD8+TRM cells in ESCC tumor-infiltrating lymphocytes was 64.8%±4.3%,which was significantly higher than that in para-carcinoma infiltrating lymphocytes 34.6%±3.4%,the difference was statistically significant(t=30.175,P＜0.001),and peripheral blood lymphocytes were almost not expressed(1.1%±0.2%).④The immune checkpoint molecules PD-1 and Tim-3 were highly expressed in CD103+CD8+TRM cells of ESCC cancer foci.A sample of 86 ESCC patients treated with neoadjuvant immune checkpoint PD-1 inhibitors before surgery found that:① The proportion of CD103+CD8+TRM cell infiltration in the immunotherapy effective group was 76.5%±7.3%,which was significantly higher than that in immunotherapy ineffective group 58.7%±5.8%,the difference was statistically significant(t=12.126,P＜0.001).②The high infiltration group of CD103+CD8+TRM cells had higher OS survival than the low infiltration group,and the difference was statistically significant(Log-Rank χ2=2.635,P<0.05).Conclusion The expression and infiltration of CD103+CD8+TRM cells in ESCC tissues were higher than those in adjacent tissues,and the patients with high infiltration had better immunotherapy efficacy and survival prognosis,which could be used as a new biological indicator to provide a new reference for clinical prediction of the efficacy and prognosis of ESCC immunotherapy.

Objective To explore the application of bundle management in enhanced recovery after surgery (ERAS) on liver transplantation.Methods The multidisciplinary team of West China Hospital of Sichuan University discussed the program of ERAS on liver transplantation in 2016,and implemented this program in July 2016.A retrospective analysis was made on 220 liver transplant patients who were admitted to West China Hospital of Sichuan University in the period from Jan.2015 to Mar.2017.According to the inclusion and exclusion criteria,there were 104 patients in traditional group and 92 patients in ERAS group.The clinical indicators during and after surgery were compared between the two groups,and the applied value of ERAS on liver transplantation was analyzed.Results As compared with the traditional group,the patients in ERAS group had advantages in operative time,blood loss,postoperative stay in intensive care unit (ICU),transfusion volume in ICU,endotracheal intubation time and total hospitalization time,with significant difference between the two groups (P＜0.05).Meanwhile readmission and mortality rate after one month in ERAS group was not increased.Conclusion The bundle management in ERAS on liver transplantation of West China Hospital of Sichuan University can improve the prognosis of liver transplant patients.

Objective To investigate the effect of glutamine (Gln) on the content of reduced glutathione hormone (GSH) and aminoglutaminic acid (Glu) of spinal cord following ischemia-reperfusion injury. Methods Totally 40 healthy adult male rabbits were randomly divided into five groups: sham-operation group (S group), ischemia-reperfusion injury group (I/R group), low-dose glutamine group (L Gln group), median-dose glutamine group (M Gln group) and high-dose glutamine group (H Gln group). After glutamine preconditioning, the model of spinal cord ischemia-reporfasion injury was established according to Zivin's method. The general status of animals was observed and the changes of Jacobs scoring were recorded in each group. Malondialdehydes (MDA), GSH, Glu and superoxide dismutase (SOD) activity in lumbar spinal cord tissues were determined using chemical colorimetry. The neuron number and deviation rate in spinal cord anterior horn were observed histopathologically. Results There was no significant difference between L Gin group and I/R group in behavior scoring, SOD activity, content of MDA and Glu, neuron number and deviation rate of spinal cord (P>0.05); however, there was a significant difference in GSH content of spinal cord (P<0.05). M Gln group and I/R group differed significantly (P<0.05) in behavior scoring, SOD activity, content of MDA, Glu, GSH, neuron number and deviation rate of spinal cord. Between H Gln group and M Gln group, there was no significant difference in behavior scoring, content of MDA and Glu, SOD activity, neuron number and aberration rate in spinal cord (P>0.05), whereas there was a significant difference in SOD activity and Giu content (P<0.05). Conclusion Pretreatment with medium-dose glutamine has a protective effect on spinal cord ischemia-reporfasion injury in rabbits, which may be related to the maintenance of GSH content, increase of SOD activity and reduction of MDA.