Surgical management of Marjolin ulcer with the anterolateral thigh free flap: a retrospective analysis.

INTRODUCTION: MU is an aggressive entity, and extended surgical resection is the primary treatment. The defects from an MU extended resection need repair using free flaps, of which the ALT free flap is the most common. OBJECTIVE: This study described the feasibility and application value of the ALT free flap in repairing defects after MU resection. MATERIALS AND METHODS: Fifteen patients with MU had repairs with ALT free flaps and were treated by the authors' unit from June 2015 through June 2021. All defects were repaired with 1 ALT free flap except for 1 case that required 2 flaps. RESULTS: The average age of the 11 male and 4 female patients was 52 years (range, 36-71 years). Defect sizes ranged from 8 cm × 5.5 cm to 21 cm × 13.5 cm (mean size, 10.9 cm × 6.5 cm). Flap sizes ranged from 10 cm × 7.5 cm to 23 cm × 15.5 cm (mean size, 12.9 cm × 8.5 cm). All flaps survived completely except for 1 flap in which re-exploration was needed. CONCLUSIONS: The individualized ALT free flap may be selected based on the receiving area characteristics and has certain clinical application value in defect repair after MU resection.

SLC gene-modified dendritic cells mediate T cell-dependent anti-gastric cancer immune responses in vitro.

Dendritic cells (DCs) are potent professional antigen-presenting cells (APCs) with the ability to prime naïve T cells, and play an important role in the initiation and regulation of immune responses. In this study, we constructed a recombinant adenovirus carrying the SLC gene (Ad-SLC), and detected the biological effects of Ad-SLC-modified DCs as an adjuvant for the initiation of gastric cancer immune responses. Human DCs were transfected with Ad-SLC and the recombinant adenovirus carrying the ß-galactosidase gene, Ad-LacZ, respectively. Modified DCs were pulsed with the cell lysate antigen of SGC-7901 cells (a type of gastric cancer cell line) and co-cultured with autologous T cells. The T cells were harvested and incubated with SGC-7901 cells and the cytotoxic function of the T cells was detected. Based on the data, the expression of mature DC phenotypes CD83 and CCR7 was upregulated after transfection with Ad-SLC and the chemotaxis function of DCs was augmented after transfection with Ad-SLC. Moreover, the expression of RANTES in DCs was upregulated by Ad-SLC transfection, while expression levels of IL-12p70 and IL-10 were not significantly altered. When co-cultured with autologous T cells, DCs modified with the SLC gene and pulsed with SGC-7901 cell lysates significantly promoted the proliferation of autologous T cells and induced Th1 differentiation, and displayed a strong cytotoxicity to SGC-7901 cells. In conclusion, Ad-SLC promoted DC maturation, enhancing the ability of DCs for T-cell chemotaxis and T-cell stimulation, and induced specific anti-gastric cancer cellular immunity. Recombinant Ad-SLC-modified DCs may be used as an adjuvant to induce an effective anti-gastric cancer immune response.