ObjectiveTo investigate the relationship between the expressions of B-cell-specific monoclonal leukemia virus insert site 1 (Bmi1) and human telomerase reverse transcriptase (hTERT) genes and the proliferative capacity of stem cells. MethodsCord blood CD34+ cells were cultured in IMDM medium containing fetal bovine serum, stem cell growth factor, thrombopoietin, and Fms-like tyrosine kinase 3 ligand during a 28-day ex vivo expansion process, while the expansion fold, specific growth rate, and the colony-forming efficiency were monitored. Then the Bmi1 and hTERT mRNA expressions in CD34+ cells were detected by fluorescence quantitative PCR, and the relations between the expressions and the cell proliferative capacity were analyzed. ResultsCD34+ cells expanded (20.1 ± 3.5) folds during the 28-day culture, while the proportion declined from 95.5% ± 2.6% before culture to 2.1% ± 0.4%. Both the specific growth rate and colony-forming efficiency of CD34+ cells declined significantly after 7 days, while the expression levels of Bmi1 and hTERT mRNA in CD34+ cells reached top at 7 days and declined gradually thereafter. ConclusionThe expressions of Bmi1 and hTERT genes may have a close relation to the proliferative capacity of CD34+ cells.
Objective To investigate the effect of hepatocyte-l ike cells induced by CD34+ cells in vitro on the repair of the injured hepatic tissues of mice in vivo. Methods Mononuclear cells were isolated from umbil ical blood by density gradient centrifugation and enriched CD34+ cells were obtained. The cells were (1 × 105 cells/mL) cultured in serumfreemedium containing stem cell factor (SCF), hepatocyte growth factor (HGF), EGF, oncostatin M (OSM), bFGF (the concentration were 50, 20, 20, 10, 10 ng/mL respectively) in vitro for 10 days. Forty-eight 6-week-old female ICR mice werechosen to prepare l iver injury model by injecting carbon tetrachloride and 2-acetylamionoflu-orene. The mice were randomly divided into two groups (n=24 per group): the experimental group, the cultured cells were injected into the mice through the tail vein; the control group, the equivalent serum-free medium was injected. Six mice from each group were killed at 7, 14, 21, and 28 days after operation to receive HE staining, PCR gel electrophoresis, immunohistochemistry staining, and hepatic function detection. Results HE staining: the morphology of injured hepatic tissues in the control group recovered to normal 28 days after operation, while in the experimental group, it recovered to normal 14 days after operation. PCR gel electrophoresis and immunohistochemistry staining: the cells expressing human serum albumin were detected in the hepatic tissue of the experimental group at each time point after operation; while in the control group, no such cells were detected within 28 days after operation. Hepatic function detection: the activity of alanine aminitransperase in the control group recovered to normal 14 days after operation; the mean activity of aspartate aminotransferase of two groups failed to recover within 28 days. Conclusion The hepatocyte-l ike cells induced by CD34+ cells in vitro can promote the morphological and functional recovery of the injured hepatic tissue in mice. Moreover, it can be transformed into human-derived hepatic cells in l iver-injured mice.
【Abstract】 Objective To observe the effect of cytokines and combinations in the inducement of human umbil icalcord blood-derived CD34+ cells into hepatocyte-l ike cells. Methods The mononuclear cells (MNCs) were derived by density gradient centrifugation and the CD34+ cells were sperated from MNCs. The human umbil ical cord blood-derived CD34+ cells were cultivated through 49 different combinations of cytokines including leukemia inhibitor factor (LIF), oncostatin M, bFGF, aFGF, hepatocyte growth factor, EGF and stem cell factor for 28 days, and the concentrations of the cytokines were 10, 10, 10, 10, 20, 20 and 50 ng/mL, respectively. The mRNAs of cytokeratin 19 (CK-19), CK-18, glutamine synthetase (GS), human albumin (ALB) and α-fetoprotein (AFP) were detected every seven days. The ALB secretion abil ity, detoxification abil ity and hepatin synthesis abil ity of the induced cells were detected by immunofluorescence assay, indocyanine green (ICG) and periodic acid-schiff assay, respectively. The fresh umbil ical cord blood-derived CD34+ cells were detected at the same time as a control. Results The mRNAs of CK-19, CK-18 and GS could be transcribed in all the induced cells, but the transcription of the mRNAs of ALB and AFP which was the special mark of mature hepatocyte and l iver stem cell, respectively, was not found. All the mRNAs could not be found in freshly isolated umbil ical cord blood-derived CD34+ cells. All the cells induced in vitro could not release ALB, and not help the detoxification of ICG which was the fundamental function of mature l iver cells. These results were the same in the control group. The hepatin synthesis abil ity of all the induced cells increased by comparison to the fresh ones. Conclusion Though some mRNAs of proteins which are transcribed in hepatocytes can be found in the induced cells, umbil ical cord blood-derived CD34+ cells could not be transdifferentiated into hepatocyte-l ike cells through cytokines in vitro.
Objective To investigate whether patients with locally advanced esophageal squamous cell carcinoma need further surgery after programmed cell death-1 (PD-1) inhibitor combined with chemotherapy, and its impact on survival. MethodsPatients with ⅡA-ⅢB esophageal squamous cell carcinoma who received immunotherapy combined with chemotherapy in our hospital from January 2020 to June 2022 were selected. According to whether surgery was performed after PD-1 antibody combined chemotherapy, the patients were divided into surgery group and non-surgery group. The general clinical data, side effects, clinical complete response rate (CCR), progression-free survival (PFS), and overall survival (OS) were compared between the two groups. Results Finally 58 patients were included, including 45 males and 13 females. There were no significant differences in general clinical data and adverse reactions between the surgery group and the non-surgery group. Univariate analysis showed that ORR and surgery were significantly associated with PFS (P<0.05). Binary logistic regression analysis showed that surgery was the only independent risk factor for PFS (P=0.003). K - M survival analysis showed that the PFS and OS in surgical group were significantly higher than those in the non-surgery group (HR=0.13, 95%CI 0.036 to 0.52, P＜0.01; HR=0.17, 95%CI 0.045 0.68, P＜0.01). ConclusionAfter PD-1 inhibitor combined with chemotherapy, patients with locally advanced esophageal squamous cell carcinoma still needs to be treated with surgery, so as to obtain better PFS and OS.
ObjectiveTo investigate the feasibility,safety and short-term clinical outcomes of complete videoassisted thoracoscopic surgery (VATS) lobectomy for patients with early-stage lung cancer (LC). MethodsClinical data of 138 consecutive patients with early-stage LC who underwent lobectomy in the First People's Hospital of Jining from January 2012 to May 2013 were retrospectively analyzed. There were 71 patients undergoing complete VATS lobectomy including 39 male and 32 female patients with their age of 57.9±10.6 years (VATS group) and 67 patients undergoing lobectomy via traditional thoracotomy including 36 male and 31 female patients with their age of 60.3±8.2 years (thoracotomy group). Operation time,intraoperative blood loss, groups and number of lymph node dissection,thoracic drainage duration, postoperative hospital stay,vision analogue scores (VAS) on the 1st,3rd and 30th postoperative day, and postoperative morbidity were compared between the 2 groups. ResultsAll the patients in both groups success fully received their operation. Intraoperative blood loss (147±113 ml vs. 146±91 ml) number of lymph node dissection (9.9±3.6 vs. 10.0±3.6) group of lymph node dissection (3.1±1.3 vs. 3.4±1.3) and VAS on the 1st and 3rd postoperative day of VATS group were not statistically different from those of the thoracotomy group (P>0.05). Operation time (119±27 minutes vs. 135±29 minutes) thoracic drainage duration (3.0±0.9 days vs. 3.8±1.2 days) postoperative hospital stay (8.0±2.1 days vs. 10.2±5.4 days) VAS on the 30th postoperative day (2.6±0.7 vs. 3.2±1.1) and postoperative morbidity (8.5% vs. 19.4%) of VATS group were significantly shorter or lower than those of the thoracotomy group (P<0.05). Fifty-nine patients in VATS group and 58 patients in the thoracotomy group were followed up for 2-18 months after disc harge. During follow-up,there was no death in either group. There was 1 patient with brain metastasis,1 patient with liver metastasis,and 2 patients with bone metastasis. ConclusionComplete VATS lobectomy is safe and feasible for the treatment of early LC with the advantages of minimal invasiveness,less morbidity,better postoperative recovery and less chronic incision pain. Complete VATS lobectomy can also achieve similar standardization of lymph node dissection as routine thoracotomy.
Surgery is the preferred treatment for resectable esophageal cancer, but in locally advanced esophageal cancer, the effect of surgery alone is not ideal, so surgery-based comprehensive treatment is the best option. Neoadjuvant therapy has become a standard treatment in the treatment of locally advanced resectable esophageal cancer. Neoadjuvant therapy includes neoadjuvant chemotherapy, radiochemotherapy, immunotherapy, targeted therapy, etc. With the significant efficacy and acceptable toxicity of immunotherapy in the first-line and second-line treatment of advanced esophageal cancer, neoadjuvant immunotherapy has become a research hotspot of locally advanced resectable esophageal cancer. This article reviews the latest research progress and some limitations of neoadjuvant immunotherapy in locally advanced resectable esophageal cancer.
Objective To observe the short-term efficacy and safety of neoadjuvant sintilimab combined with chemotherapy in the treatment of patients with locally advanced resectable esophageal squamous cell carcinoma (ESCC). MethodsClinical data were collected from patients with locally advanced resectable ESCC who received neoadjuvant immunotherapy combined with chemotherapy followed by surgical treatment at the Thoracic Surgery Department of Jining First People's Hospital from April 2020 to April 2022. The endpoints included major pathological response (MPR), pathological complete response (pCR), R0 resection rate, safety, and postoperative survival. Results A total of 43 patients with ESCC who received at least one cycle of neoadjuvant immunotherapy before surgery were included. Among them, there were 31 males and 12 females, aged from 46 to 77 years, with a median age of 65 years. All patients successfully completed the surgery without any surgical delays. The pCR rate was 14.0% (6/43), the MPR rate was 58.1% (25/43), and the R0 resection rate was 97.7% (42/43). Patients exhibited reliable safety during neoadjuvant therapy and postoperatively. The 2-year overall survival (OS) and disease-free survival (DFS) rates were 90.7% and 81.4%, respectively. Kaplan-Meier survival analysis and log-rank test revealed lower recurrence rates and better survival in the MPR group compared to the non-MPR group. Conclusion The combination of neoadjuvant sintilimab and chemotherapy in the treatment of patients with locally advanced resectable ESCC has demonstrated significant clinical efficacy, while also being safe and reliable.
Objective To evaluate the efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy in patients with locally advanced resectable non-small-cell lung carcinoma. Methods The clinical data of patients with non-small cell lung cancer (NSCLC) who received neoadjuvant immunotherapy combined with chemotherapy and surgery after chemotherapy alone from April 2021 to January 2021 in the first People's Hospital, Jining, were retrospectively analyzed. According to the preoperative neoadjuvant regimen, the patients were divided into a combination group and a chemotherapy group, and the clinical data of the two groups were compared. ResultsA total of 66 patients were enrolled, including 61 males and 5 females. There were 53 patients in the combination group with an average age of 63.40±6.80 years, and 13 patients in the chemotherapy group with an average age of 58.62±8.30 years. There was statistical difference in age between the two groups (P=0.02), but no statistical difference in other baseline data (P＞0.05). MPR was 54.7% in the combination group and 23.1% in the chemotherapy group (P=0.042), and PCR was 39.6% in the combination group and 0.0% in the chemotherapy group (P=0.006). The combined group had a shorter operative time (P=0.039). There were no statistical differences in intraoperative bleeding, postoperative tube-carrying time, postoperative complications, OS or EFS between the two groups. Conclusion Surgery after neoadjuvant immunotherapy is safe and feasible, and long-term efficacy should be confirmed by further follow-up.