The Tai Chi Flap: A Novel Design for the Radial Forearm Flap.

OBJECTIVE: Tai Chi is an ancient philosophy used to explain the universe. The Tai Chi symbol is represented by Yin/Yang fishes. The authors describe a novel radial forearm flap (RFF) design for the reconstruction of circular defects based on the Tai Chi symbol. METHODS: Eleven consecutive patients with craniofacial skin or mucus defects underwent reconstruction with a Tai Chi RFF. Patient perioperative and follow-up information was collected. RESULTS: The diameter of the Tai Chi RFF was 5 to 6 cm. All flaps healed uneventfully without ischemic problems, and all donor site defects were closed primarily without skin grafts. Remarkably, 2 patients received a tattoo to mark the Tai Chi symbol and greatly appreciate the shape of the flap. CONCLUSIONS: The Tai Chi flap is an economically friendly flap design that can be used to prevent skin grafts while providing psychological comfort to patients.

A Pan-Histone Deacetylase Inhibitor Enhances the Antitumor Activity of B7-H3-Specific CAR T Cells in Solid Tumors.

PURPOSE: The limited efficacy of chimeric antigen receptor (CAR) T-cell therapies with solid malignancies prompted us to test whether epigenetic therapy could enhance the antitumor activity of B7-H3.CAR T cells with several solid cancer types. EXPERIMENTAL DESIGN: We evaluated B7-H3 expression in many human solid cancer and normal tissue samples. The efficacy of the combinatorial therapy with B7-H3.CAR T cells and the deacetylase inhibitor SAHA with several solid cancer types and the potential underlying mechanisms were characterized with in vitro and ex vivo experiments. RESULTS: B7-H3 is expressed in most of the human solid tumor samples tested, but exhibits a restricted expression in normal tissues. B7-H3.CAR T cells selectively killed B7-H3 expressing human cancer cell lines in vitro. A low dose of SAHA upregulated B7-H3 expression in several types of solid cancer cells at the transcriptional level and B7-H3.CAR expression on human transgenic T-cell membrane. In contrast, the expression of immunosuppressive molecules, such as CTLA-4 and TET2, by T cells was downregulated upon SAHA treatment. A low dose of SAHA significantly enhanced the antitumor activity of B7-H3.CAR T cells with solid cancers in vitro and ex vivo, including orthotopic patient-derived xenograft and metastatic models treated with autologous CAR T-cell infusions. CONCLUSIONS: Our results show that our novel strategy which combines SAHA and B7-H3.CAR T cells enhances their therapeutic efficacy with solid cancers and justify its translation to a clinical setting.

Comparison of postoperative cytokine and hormone between endoscopically assisted and open parotid tumor resection.

OBJECTIVE: Endoscopically assisted extracapsular dissection through a single incision along the cephaloauricular furrow has been adapted as a method of access for operating on benign parotid gland tumors. However, no study has compared the immune and stress responses after surgery between the endoscopic procedure and conventional open surgery. METHODS: Through a randomized method, 50 patients with benign parotid gland tumors were assigned to undergo either endoscopically assisted extracapsular dissection or open parotidectomy. The postoperative inflammatory changes and hormonal response in the patients were analyzed at serum level during the preoperative period and at 12, 24, and 72 hr after either surgery. RESULTS: Twenty-three patients received an endoscopic procedure, while 27 underwent open surgery. The size of the incision, amount of intraoperative bleeding, volume of drainage, postoperative pain score, and satisfaction with appearance were all improved in the endoscopic procedure group. Additionally, the serum levels of C-reactive protein, interleukin (IL)-6, IL-10, and cortisol were significantly lower in the endoscopy group in comparison with those in the open surgery group. CONCLUSION: Endoscopically assisted extracapsular dissection on patients with benign parotid gland tumors is associated with lower inflammatory changes and hormone responses than open surgery, thereby reducing perioperative pathophysiological disturbance and enhancing recovery after surgery.

Clinical and pathological analysis of 2 456 cases of salivary gland tumor / 口腔疾病防治

Objective@# To investigate the clinical characteristics of salivary gland tumors and their pathological types.@*Methods@#Data from 2 456 patients with salivary gland tumors diagnosed between January 1973 and December 2018 at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were collected, and their gender, age and tumor pathological type, location, and benign and malignant composition ratios were retrospectively analyzed.@*Results@#Over the 46-year study period, 2 456 patients with salivary gland tumors were treated; 41.9% were female, and 58.1% were male. The peak incidence was found among the 40 to 60 years of age group, in which 593 (24.1%) patients had malignant tumors and 1 863 (75.9%) had benign tumors. The ratio of benign and malignant tumors was 3.1∶1. The top two most common benign tumors were pleomorphic adenoma (58.7%) and Warthin tumors (33.6%). The top two most common malignant tumors were mucoepidermoid carcinoma (27.7%) and adenoid cystic carcinoma (26.1%). The most common sites of benign pleomorphic adenomas were the parotid glands, palate, and submandibular glands. Mucinous epidermoid carcinomas in malignant tumors were common in the parotid glands and small salivary glands. The incidence of salivary gland tumors in this group has increased each year, and this group accounted for 53.3% of the total cases over the past 10 years.@*Conclusion@#The number of patients with salivary gland tumors is increasing each year. The total incidence of salivary gland tumors is higher in men than in women. Large salivary gland tumors are mainly benign tumors, and small salivary gland tumors are more common. Polymorphic adenomas, Warthin tumors, and mucoepidermoid carcinomas are the most common tumor types; patients 40~60 years old are most likely to have benign salivary glands and have a high incidence of malignant tumors.