Therapy-induced senescent tumor cells in cancer relapse.

Cellular senescence is characterized by a generally irreversible cell cycle arrest and the secretion of bioactive factors known as the senescence-associated secretory phenotype (SASP). In an oncogenic context, senescence is considered a tumor suppressive mechanism as it prevents cell proliferation and inhibits the progression from pre-malignant to malignant disease. However, recent studies have demonstrated that senescent tumor cells, which could spontaneously exist within cancer tissues or arise in response to various cancer interventions (the so-called therapy-induced senescence, TIS), can acquire pro-tumorigenic properties and are capable of driving local and metastatic relapse. This highlights the complex and multifaceted nature of cellular senescence in cancer biology. Here, we summarize the current knowledge of the pathological function of therapy-induced senescent tumor cells and discuss possible mechanisms by which tumor cell senescence contributes to cancer relapse. We also discuss implications for future studies toward targeting these less appreciated cells.

Hyperbaric oxygen treatment on keloid tumor immune gene expression.

BACKGROUND: Hyperbaric oxygen treatment (HBOT) has been demonstrated to influence the keloid recurrence rate after surgery and to relieve keloid symptoms and other pathological processes in keloids. To explore the mechanism of the effect of HBOT on keloids, tumor immune gene expression and immune cell infiltration were studied in this work. METHODS: From February 2021 to April 2021, HBOT was carried out on keloid patients four times before surgery. Keloid tissue samples were collected and divided into an HBOT group (keloid with HBOT before surgery [HK] group, n = 6) and a non-HBOT group (K group, n = 6). Tumor gene expression was analyzed with an Oncomine Immune Response Research Assay kit. Data were mined with R package. The differentially expressed genes between the groups were compared. Hub genes between the groups were determined and verified with Quantitative Real-time PCR. Immune cell infiltration was analyzed based on CIBERSORT deconvolution algorithm analysis of gene expression and verified with immunohistochemistry (IHC). RESULTS: Inflammatory cell infiltration was reduced in the HK group. There were 178 upregulated genes and 217 downregulated genes. Ten hub genes were identified, including Integrin Subunit Alpha M (ITGAM), interleukin (IL)-4, IL-6, IL-2, Protein Tyrosine Phosphatase Receptor Type C (PTPRC), CD86, transforming growth factor (TGF), CD80, CTLA4, and IL-10. CD80, ITGAM, IL-4, and PTPRC with significantly downregulated expression were identified. IL-10 and IL-2 were upregulated in the HK group but without a significant difference. Infiltration differences of CD8 lymphocyte T cells, CD4 lymphocyte T-activated memory cells, and dendritic resting cells were identified with gene CIBERSORT deconvolution algorithm analysis. Infiltration levels of CD4 lymphocyte T cell in the HK group were significantly higher than those of the K group in IHC verification. CONCLUSION: HBOT affected tumor gene expression and immune cell infiltration in keloids. CD4 lymphocyte T cell, especially activated memory CD4+T, might be the key regulatory immune cell, and its related gene expression needs further study.

A parasternal intercostal perforator flap for esthetic reconstruction after complete chest keloid resection: A retrospective observational cohort study.

OBJECTIVE: To report on the outcome of 35 patients with chest keloids who were treated with intercostal perforator flap surgery plus local radiotherapy at our hospital. METHODS: We retrospectively analyzed the data of patients with chest keloid who under surgical resection at the Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China between March 2014 and July 2017. We retrieved patient demographic data, donor site position, the perforator pedicle, flap size, angle of flap rotation, complications, and recurrences from the medical records. All patients underwent perforator flap surgery for complete keloid resection followed by radiation at postoperative day 1 and 8 for a total dose 16-18 Gy. RESULTS: Thirty-five patients were included in the retrospective analysis. Their mean age was 45.3 years (range 24-67 years). The mean keloid area was 5-7 cm × 6-10 cm. Surgeries were successful in all cases. There were no perioperative complications. Good outcome with no apparent scar growth was achieved in 88.6% of the cases, and 11.4% of the cases achieved satisfactory outcome with partial scar growth in the incision, but no keloid was observed. Twenty-four months after surgery, none of the resected keloids recurred and none of the donor sites developed new keloids. CONCLUSION: Intercostal perforator flap surgery is an effective and safe approach for repair of wound formed as a result of excision of relatively large chest keloids which cannot be directly appositioned.

Hyperbaric oxygen therapy improves the effect of keloid surgery and radiotherapy by reducing the recurrence rate.

OBJECTIVE: Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue following an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen therapy (HBOT) to reduce the keloid recurrence rate after surgical excision and radiotherapy. METHODS: (1) A total of 240 patients were randomly divided into two groups. Patients in the HBOT group (O group) received HBOT after surgical excision and radiotherapy. Patients in the other group were treated with only surgical excision and radiotherapy (K group). (2) Scar tissue from recurrent patients was collected after a second operation. Hematoxylin and eosin (H&E) staining was used to observe keloid morphology. Certain inflammatory factors (interleukin-6 (IL-6), hypoxia-inducible factor-1α (HIF-1α), tumor necrosis factor-α (TNF-α), nuclear factor κB (NF-κB), and vascular endothelial growth factor (VEGF)) were measured using immunohistochemical staining. RESULTS: (1) The recurrence rate of the O group (5.97%) was significantly lower than that of the K group (14.15%), P<0.05. Moreover, patients in the O group reported greater satisfaction than those in the K group (P<0.05). (2) Compared with the recurrent scar tissue of the K group, the expression levels of the inflammatory factors were lower in the recurrent scar tissue of the O group. CONCLUSIONS: Adjunctive HBOT effectively reduces the keloid recurrence rate after surgical excision and radiotherapy by improving the oxygen level of the tissue and alleviating the inflammatory process.

Resection and repair of large abdominal wall lesions in gynecologic patients.

BACKGROUND: The techniques of resection and repair of large lesions in the abdominal wall are very challenging in the area of gynecology. We explored the techniques of resection and plastic surgical repair of large abdominal wall lesions in gynecologic patients. METHODS: Twenty-six patients with large lesions in the abdominal wall underwent resection by the gynecologists and repair through abdominal plasty and V-Y plasty with or without fascia patch grafting by the gynecologists or plastic surgeons from March 2003 to October 2010. RESULTS: All patients had a history of cesarean section. One patient had an infected sinus tract after cesarean section, one patient had an inflammatory nodule, and the others had lesions of endometriosis, including one cancer. The average largest lesion diameter was (4.79 ± 4.18) cm according to the ultrasonography results. The lesions of all patients were completely resected with pretty abdominal contour. A polypropylene biological mesh was added to the fascia in 20 patients. One patient underwent groin flap repair, and one underwent V-Y advanced skin flap repair on the left of the incision to relieve the suture tension. CONCLUSIONS: Multi-department cooperation involving the gynecology and plastic surgery departments, and even the general surgery department, is essential for patients with large lesions in the abdominal wall. This cooperative effort enabled surgeons to completely resect large lesions. Abdominal wall plastic surgical repair can ameliorate large wounds of the abdominal wall.

Site-specific pathology in breast reduction mammoplasty.

OBJECTIVE: To investigate the feasibility and clinical value of site-specific pathology in breast reduction mammoplasty. METHODS: Totally 127 patients who underwent breast reduction mammoplasty from June 2007 to June 2010 were included. Pathologic specimens were sent for frozen pathology according to the clock-wise method. Patients with confirmed cancer were arranged for conservative breast surgery. RESULTS: Of the 127 patients, 53 patients (41.7%) had gland hyperplasia; 7 had fibroadenoma (5.5%); 1 (0.79%) had ductal carcinoma in situ, who underwent breast conserving surgery, following by chemotherapy and radiotherapy, no relapse was noted during the three-year follow-up. CONCLUSION: Clock-wise method is useful to locate the tumor and ensure the patients to receive skin-spared breast resection even cancer is detected.

[Application of melanocytes and bone marrow mesenchymal stem cells in tissue engineered skin construction].

OBJECTIVE: To explore the method of constructing tissue-engineered skin using melanocytes and bone marrow mesenchymal stem cells (BMSCs) in vivo. METHODS: Melanocytes were isolated from human foreskin. BMSCs were isolated from human bone marrow. Both of them were co-cultured at a ratio of 1:10, and then were implanted into the collagen membrane to construct the tissue-engineered skin, which was applied for wound repair in nude mice. The effectiveness of wound repair and the distribution of melanocytes were evaluated by morphological observation, in vivo 4,6-diamidino-2-phenylindole, dihydrochloride (DAPI) fluorescent staining tracing, HE staining, S-100 immunohistochemistry, and transmission electron microscopy. RESULTS: The wounds were satisfactorily repaired among the nude mice. The melanocytes were distributed in the skin with normal structure, as confirmed by DAPI fluorescent staining tracing, HE staining, S-100 immunohistochemistry, and transmission electron microscopy. CONCLUSION: Melanocytes and BMSCs, after proper in vitro culture at an appropriate ratio, can construct the tissue-engineered skin with I type collagen membrane.

[Application of abdominoplasty and polypropylene to repair the abdominal defect].

OBJECTIVE: To introduce a operation method of repairing the abdominal defect with abdominoplasty and polypropylene. METHODS: 27 patients were treated with abdominoplasty and polypropylene. RESULTS: Follow up 3 - 20 months, the focus in inferior abdominal wall were removed thoroughly. The incision is cure with A level. No weakness, bulk, hernia and complication occur in the abdominal wall. CONCLUSIONS: The method of repairing the abdominal defect with abdominoplasty and polypropylene is a good method. It is a simple method. Its' result is relied.

[Analysis of Millard II technique for correcting secondary deformities of unilateral cleft lip].

OBJECTIVE: To analyze the Millard II technique for correcting secondary deformities of unilateral cleft lip. METHODS: The Millard II technique was used to correct secondary deformities of unilateral cleft lip in 42 patients from March of 2003 to September of 2004. Dissection was made between the alar cartilage and skin, and the alar cartilage was suspended. RESULTS: The postoperative follow-ups with 3 approximately 6 months revealed good results of the symmetrical nostrils and philtrums, prolonged columella nasi, good-shaped cupid's bow, and invisible scar. CONCLUSIONS: The Millard II technique could be an ideal method to correct secondary deformities of unilateral cleft lip. Releasing and suspending alar cartilage spontaneously at the same time can correct nasal deformity adequately.

[Preventive effect of chitosan on capsular contracture after implantation of silicone gel-filled mammary implants in rats].

OBJECTIVE: To study the preventive effect of chitosan on capsular contracture after implantation of silicone gel-filled mammary implants in rats. METHODS: 18 SD female rats were divided into three groups randomly. Small silicone gel-filled mammary implants were implanted under each side of latissimus dorsi muscle. Chitosan was injected into left cavities as experimental sides, and nothing was injected into right cavities as control sides. 4, 8 and 12 weeks postoperation, specimens were dissected and observed using light microscope, and area density of collagen both type I and type III were also detected. RESULTS: Fibrous capsules around implants consist of two layers: dense layer and loose layer. 4 weeks postoperation, total thickness of the experimental sides was less than that of the control sides (P < 0.01). Area density of collagen either type I or type III of the experimental sides was lower than that of the control sides (P < 0.01). Both 8 and 12 weeks postoperation, total thickness of the experimental sides was less than that of the control sides (P < 0.05). Area density of collagen type I of the experimental sides was lower than that of the control sides (P < 0.05). Area density of collagen type III was of no statistical difference between the experimental sides and the control sides (P > 0.05). CONCLUSIONS: Chitosan can remarkably prevent capsule contracture during the early period after implantation of silicone gel-filled mammary implants.

[Repairment of the large wound of endometriosis in the abdominal wall].

OBJECTIVE: To explore the plastic surgical repairment of the large wound of endometriosis in the abdominal wall. METHOD: Since March 2003 to December 2004, 6 patients were treated with abdominoplasty and V-Y plasty for the wounds of the endometriosis in the abdominal wall. RESULTS: The endometriotic foci were removed thoroughly with pretty abdominal contour. No complications were observed. CONCLUSION: Abdominoplasty and V-Y plasty are good methods to repair the wounds of the endometriosis in the abdominal wall.