Background and objective Neoantigen reactive T cell(NRT)has the ability to inhibit the growth of tumors expressing specific neoantigens.However,due to the difficult immune infiltration and the inhibition of tumor micro en-vironment,the therapeutic effect of NRT in solid tumors is limited.In this study,we designed NRT cells(7×19 NRT)that can express both interleukin-7(IL-7)and chemokine C-C motif ligand 19(CCL19)in mouse lung cancer cells,and evaluated the difference in anti-tumor effect between 7×19 NRT cells and conventional NRT cells.Methods We performed next-generation sequencing and neoantigen prediction for mouse Lewis lung carcinoma(LLC),prepared RNA vaccine,cultured NRT cells,constructed retroviral vectors encoding IL-7 and CCL19,transduced NRT cells and IL-7 and CCL19 were successfully ex-pressed,and 7×19 NRT was successfully obtained.The anti-tumor effect was evaluated in vivo and in vitro in mice.Results The 7×19 NRT cells significantly enhanced the proliferation and invasion ability of T cells by secreting IL-7 and CCL19,achieved significant tumor inhibition in the mouse lung cancer and extended the survival period of mice.The T cell infiltration into tumor tissue and the necrosis of tumor tissue increased significantly after 7×19 NRT treatment.In addition,both 7×19 NRT treatment and conventional NRT treatment were safe.Conclusion The anti-solid tumor ability of NRT cells is significantly enhanced by the arming of IL-7 and CCL19,which is a safe and effective genetic modification of NRT.

This study intends to establish a colorectal cancer(CRC)organoid model,expand and isolate CRC-reactive tumor-infiltrating lymphocytes(TILs),screen tumor-specific T cell receptors(TCRs)and perform functional verification,in order to provide a technological platform and research foundation for the clinical transformation of individualized adoptive T-cell immunotherapy for colorectal cancer.An organoid model derived from colon cancer patient tissues was constructed using in vitro 3D culture techniques,which then subjected to HE staining and immunohistochemistry for detecting morphological characteristics and representative molecular expression.Subsequently,CRC organoids were co-cultured with TILs for sorting reactive TILs using flow cytometry,and the characteristics of reactive TCR clones was analyzed through single T cell receptor gene cloning technology.Furthermore,the function of TCRs was verified through cytotoxicity experiments.Morphological analysis and representative molecules(CK20 and CDX2)expression indicated that there is high similarity between colorectal cancer organoids and patient tumors.In the in vitro expanded and cultured TILs,colorectal cancer-reactive T cells with upregulated CD137 expression and increased IFN-γ secretion were screened out successfully,among which TCR2-T cells demonstrated superior tumor reactivity and in vitro tumor killing function.In conclusion,a platform for screening and function validation of reactive TCRs based on CRC-Org has been established,providing a technological platform for the translational application of individualized T-cell therapy for colorectal cancer.

Humans ; Consensus ; Liver Neoplasms/therapy* ; China

Objective To examine short-term outcomes and long-term survival of elderly patients (aged over 80 years) with colorectal cancer who received laparoscopic versus open surgery. Methods A total of 313 patients over 80 years old with colorectal cancer who underwent radical surgery were included.According to the surgical method, all patients were divided into open-surgery group (n=143) and laparoscopic surgery group (n=170).Baseline data were balanced between the two groups by using propensity score matching.Kaplan-Meier was used to draw the survival curve, and survival was compared by Log rank tests.Cox proportional risk model was used to analyze the effects of all factors on overall survival (OS) and disease-free survival (DFS). Results After matching, 93 patients were included in each group.The mean intraoperative blood loss, the incidence of overall postoperative complications and gradeⅠ-Ⅱ complications in the laparoscopic surgery group were significantly lower than those in the open surgery group (all P < 0.05).The time to first flatus, the time to oral feeding, and postoperative hospital stays in the laparoscopic surgery group were significantly shorter than those in the open surgery group (all P < 0.05).The mean number of lymph-node dissection was also significantly higher in the laparoscopic surgery group than in the open surgery group (P=0.030).Patients in both groups had similar 5-year OS (P=0.594) and DFS (P=0.295).Multivariate Cox prognostic analysis showed that CEA level > 5 ng/ml, pathological TNM stage Ⅲ, and perineural invasion were independent risk factors for poor OS and DFS. Conclusion Compared with open surgery, laparoscopic surgery can provide better short-term advantages and similar long-term outcomes for colorectal cancer patients over 80 years of age.

The vast majority of patients with hepatocellular carcinoma (HCC) in China originate from hepatitis B cirrhosis, while 90% of cirrhotic patients may develop portal hypertension, and the HCC patients with portal hypertension account for 15%-30%. Portal hypertension is a group of clinical syndromes characterized by elevated portal venous pressure and formation of portal-systemic collateral circulation, and it is one of the most important complications of liver cirrhosis. HCC and portal hypertension affect each other, and portal hypertension seriously affects the prognosis of HCC patients. The development of systemic treatment regimens for HCC provides more treatment options for patients with advanced HCC, including molecular-targeted drug therapy, immunotherapy, and chemotherapy. Different systemic therapeutic drugs for HCC have different impacts on portal hypertension, and this article reviews the effect of commonly used systemic therapeutic drugs for HCC on portal hypertension.

Objective:To systematically evaluate the qualitative research on rehabilitation experience of patients after hip and knee arthroplasty, so as to provide theoretical reference for nursing workers to scientifically and reasonably carry out nursing services.Methods:The research is a Meta-synthesis of qualitative research. Computer retrieval of PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure, VIP, WanFang and China Biology Medicine disc was conducted to collect articles on qualitative research of patients' experience in rehabilitation after artificial joint replacement. The retrieval time limit was from the establishment of the database to February 27, 2022. The quality of article was evaluated using the quality evaluation criteria for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center. The results were integrated and analyzed using the pooled integration method.Results:A total of 17 articles were included, including 8 phenomenological studies, 3 rooted theoretical studies, and 6 descriptive studies. The quality evaluation of 17 articles were all Grade B. Finally, 3 integration results were obtained, forming 8 new categories, namely, the challenge of "returning to normality" (category 1: recovery of individual physical and mental state; category 2: return to normal life; category 3: return to family and social roles) , desire for multi-dimensional support (category 1: desire for continuous medical information support; category 2: emotional social support was of great significance) , changing self-coping styles (category 1: positive behavioral coping strategies; category 2: positive psychological adjustment strategies; category 3: reliance on spirit and belief) .Conclusions:The rehabilitation experience of patients after arthroplasty mainly includes the challenge of "returning to normality", the desire for multi-dimensional support and the changing self-coping styles. Medical staff should pay attention to the physical and mental changes, information and emotional needs of patients after joint replacement, and provide targeted support and help to accelerate the progress of patients' postoperative rehabilitation, improve their quality of life, and deepen their social integration.

BACKGROUND: To determine the prevalence and prognostic impact of hepatopulmonary syndrome (HPS) in patients with unresectable hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). METHODS: Fifty-four patients with unresectable HCC undergoing TACE between December 2014 and December 2015 were prospectively screened for HPS and were followed up for a maximum of 2 years or until the end of this prospective study. RESULTS: Nineteen of the 54 (35.2%) patients were considered to have HPS, including one (5.3%) with severe HPS, nine (47.4%) with moderate HPS, and nine (47.4%) with mild HPS. The median overall survival (OS) was 10.1 (95% confidence interval [CI], 3.9-16.3) months for patients with HPS and 15.1 (95% CI, 7.3-22.9) months for patients without HPS, which is not a significant difference ( P  = 0.100). The median progression-free survival was also not significantly different between patients with and without HPS (5.2 [95% CI, 0-12.8] vs. 8.4 [95% CI, 3.6-13.1] months; P  = 0.537). In the multivariable Cox regression analyses, carbon monoxide diffusing capacity (hazard ratio [HR] = 1.033 [95% CI, 1.003-1.064]; P  = 0.028) and Child-Pugh class (HR = 1.815 [95% CI, 1.011-3.260]; P  = 0.046) were identified to be the independent prognostic factors of OS. CONCLUSION Mild or moderate HPS is common in patients with unresectable HCC undergoing TACE, but it does not seem to have a significant prognostic impact.
Humans ; Carcinoma, Hepatocellular/pathology* ; Chemoembolization, Therapeutic ; Prospective Studies ; Liver Neoplasms/pathology* ; Prognosis ; Hepatopulmonary Syndrome/therapy* ; Prevalence ; Treatment Outcome ; Retrospective Studies

ObjectiveTo determine the incidence and characteristics of adverse events following immunization （AEFI） in 2016‒2020 in Dazu District of Chongqing， and evaluate the AEFI surveillance information system and provide scientific evidence for vaccine safety. MethodsDescriptive epidemiological analysis was performed on the cases collected by the AEFI surveillance system. Incidence and coverage of AEFI were then presented. ResultsA total of 319 AEFI cases were reported in 2016‒2020. Reported incidence of AEFI was determined to be 24.64/10⁵ doses. The proportion of timely reporting AEFI within 48 hours was 94.04% and that of timely investigation within 48 hours was 98.41%. The proportion of completing the AEFI survey was 100.00% and that of AEFI classification was 99.69%. The male to female ratio was 1.28∶1. Majority of the AEFI cases were less than 1 year old （64.26%， 205/319）， from April to September （68.97%， 220/319）， and reported at 0‒1 day post-immunization （89.34%， 285/319）. Moreover， the reported incidence differed significantly between time periods （χ²=32.481，P<0.05） and time intervals from vaccination to occurrence of AEFI （χ²=961.408， P<0.05）. Coverage of reporting AEFI at county level reached 100％. In addition， non-severe AEFI cases accounted for 98.43% （314/319） and no death case was reported. General events， such as fever， redness， and scleroma， accounted for 80.56% （257/319）， whereas rare adverse events accounted for 15.99% （51/319）. The reported incidence of NIP vaccines was highest in the diphtheria tetanus acellular pertussis combined vaccine， followed by measles and rubella combined attenuated vaccine and diphtheria tetanus combined vaccine. Clinical diagnosis of rare adverse events was mainly allergic rashes. ConclusionThe AEFI surveillance information system in Dazu District of Chongqing achieves efficient monitoring of AEFI. It has proven that the vaccines are generally safe and immunization strategies may be continuously implemented. Furthermore， the sensitivity of AEFI surveillance should be improved through multiple approaches.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective:To evaluate the diagnostic and therapeutic effect of percutaneous intranodal lymphography in patient with chylous leakage.Methods:The clinical data of percutaneous intranodal lymphography in patients with chylous leakage from January 2019 to November 2019 in Cancer Hospital Chinese Academy of Medical Sciences were retrospectively analyzed. A total of 8 patients (5 males and 3 females, median age 64 years old) were enrolled. Four patients were iatrogenic chylothorax, 3 patients iatrogenic chyloperitoneum, and 1 patient chyloperitoneum with unknown cause. All 8 patients were received inguinal lymph nodes puncture under ultrasound guidance, and contrast agent iodinated oil was injected for lymphography. The procedure complications were recorded and the follow-up data were collected for efficacy assessment.Results:The percutaneous intranodal lymphography was successfully performed in all patients (8/8). The median amount of iodinated oil used was 17.5 ml; the median operation time was 88 min, without complications found during the procedure. The results of percutaneous intranodal lymphography was positive in 5/8 cases, of which chylothorax and chyloperitoneum was 4/4 and 1/4, respectively. Four cases with chylothorax showed contrast extravasation at different level of thoracic duct, and 1 case after pancreatic cancer resection showed contrast extravasation at L3-4 level. The chylous leakage was treated in 5 patients (5/8) during and resolved after percutaneous intranodal lymphography, with 3 chylothorax and 2 chyloperitoneum cases, respectively.Conclusion:Percutaneous intranodal lymphography is a safe and effective lymphography method for the diagnosis of chylous leakage, and also has application values in the treatment of chylous leakage.