Clinical study of bilateral axillo-breast approach robot in obese women with thyroid cancer / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the safety and feasibility of bilateral axillo-breast approach （BABA） robot in the operation of thyroid cancer in obese women. Methods:The clinical data of 81 obese female patients who underwent da Vinci robotic thyroid cancer surgery（robotic group） at the Department of Thyroid and Breast Surgery, PLA 960 Hospital from May 2018 to December 2021 were retrospectively analyzed and compared with the clinical data of 106 obese female thyroid cancer patients who underwent open surgery（open group） during the same period. The age, body mass index（BMI）, mean time of surgery, mean postoperative drainage, tumor diameter, postoperative tumor stage, number of lymph node dissection in the central and lateral cervical regions, number of positive lymph nodes in the central and lateral cervical regions, postoperative cosmetic outcome satisfaction score, mean postoperative hospital stay and postoperative complications of all patients were counted. The results were analyzed using SPSS 26.0 statistical software, and the count data were compared using the χ² test, and the measurement data were compared using the t test. Results:All patients completed the operation successfully, and there was no conversion in the robot group, postoperative pathological results were all composed of papillary thyroid carcinoma. The operation time in the robot group was（144.62±36.38） min, which was longer than that in the open group（117.06±18.72） min（P<0.05）. The average age of the robot group was（40.25±9.27） years, which was lower than that of the open group（49.59±8.70） years（P<0.05）. The satisfactory score of cosmetic effect in the robot group（9.44±0.65） was higher than that in the open group（5.23±1.07）（P<0.05）. There was no significant difference in tumor diameter, BMI, average postoperative drainage, temporary hypoparathyroidism and recurrent laryngeal nerve injury, number of central and lateral cervical lymph node dissection, number of positive lymph nodes in the central and lateral cervical regions, and average postoperative hospital stay between the two groups. There was no permanent hypoparathyroidism and recurrent laryngeal nerve injury in both groups. Conclusion:The application of BABA pathway robot in thyroid cancer surgery in obese women is safe and feasible, and the cosmetic effect is better after operation.

Eukaryotic expression, protein purification and biological effects research of human CS1-Fc fusion protein / 生物工程学报

Signaling lymphocyte activation family 7 (SLAMF7/CS1) is a cell surface glycoprotein that is highly expressed in multiple myeloma cells. CS1 is a sensitive and specific biomarker for multiple myeloma. CAR-T cell immunotherapy is a new method for the treatment of multiple myeloma. CS1 CAR-T cell immunotherapy has good effect on relapsed refractory multiple myeloma. To detect the expression efficiency of CS1 CAR on CS1 CAR-T cells and to find an auxiliary means to CAR-T cell immunotherapy, we prepared a CS1-Fc fusion protein. First, the extracellular domain of CS1 was amplified from the existing plasmid by PCR and ligated with human IgG1-Fc fragment by overlap extension PCR. The recombinant fragment was ligated into pMH3 eukaryotic expression vector. After restriction enzyme digestion and DNA sequencing, the pMH3-CS1-Fc-his recombinant plasmid was successfully constructed. The recombinant plasmid was transfected into Chinese hamster ovary cell (CHO-S) by liposome. The expression of the CS1-Fc fusion protein in CHO-S cells was identified by flow cytometry after G418 pressure screening. Next, the CS1-Fc fusion protein was purified by nickel column. Western-blot analysis showed that molecular weight of the fusion protein was about 70 kDa was identified by Western blotting. The CS1-Fc fusion protein couldeffectively detect the expression rate of CS1 CAR and promote the activation, proliferation andcytokines secretion of the CS1 CAR-T cells. The results will lay the experimental foundation for the in vitro detection and potentiation of CAR-T cells in multiple myeloma treated with CS1 CAR-T cell.

A comparative study of robot BABA path and traditional surgery for thyroid cancer with hyperthyroidism / 国际外科学杂志

Objective@#To evaluate the safety and feasibility of Da Vinci robot in the treatment of thyroid cancer with hyperthyroidism via bilateral axillo-breast approach (BABA).@*Methods@#The clinical data of 21 patients with thyroid cancer complicated with hyperthyroidism who received thyroidectomy + central lymph node dissection and(or)neck lymph node dissection using the Da Vinci through axillo-bilateral-breast approach in the thyroid and breast surgery of the 960th Hospital of the PLA Joint Logistics Support Force, from February 2014 to February 2019 were analyzed retrospectively. The clinical data of 21 patients were used as observation group, including 5 males and 16 females, aged (46.03±3.08) years. At the same period, 19 patients with the thyroid cancer complicated with hyperthyroidism who underwent traditional open surgery were selected as the control group, including 5 males and 14 females, aged (47.06±2.03) years. The t test, rank sum test, and χ2 test were used to compare the operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain (VAS), cosmetic outcome satisfaction, and related surgical complications between the two groups.@*Results@#All the patients of the two groups completed the operation successfully. The operation time of the observation group was longer than that of the control group [(191.12±3.17) vs (145.37±6.37) min, P<0.05]; The postoperative pain degree score of the observation group was lower than that of the control group [(3.40±1.12) points vs (5.10±1.19) points, P<0.05]. The cosmetic effect score of the observation group was better than that of the control group [(9.10±3.03) points vs (5.05±1.02) points, P<0.05]. There were no significant differences in the amount of intraoperative blood loss, mean postoperative drainage, postoperative hospital stay, central lymph node metastasis and complication rate between the two groups (P>0.05). There was no significant difference in Tg level and recurrence rate between the two groups (P>0.05).@*Conclusion@#Da Vinci robotic assisted treatment for thyroid cancer with hyperthyroidism is safe and feasible, which with good cosmetic and privacy protection effects.

A combination of lenalidomide, bortezomib, and dexamethasone (RVD) provides deep-er responses in patients with newly diagnosed multiple myeloma / 中国肿瘤临床

Objective: This study investigated the efficacy and safety of a combination of lenalidomide, bortezomib, and dexametha-sone (RVD) in patients with newly diagnosed multiple myeloma (NDMM). Methods: The clinical features and responses of 48 patients with NDMM who were treated with RVD from January 2015 to May 2019 in Beijing Chaoyang Hospital were retrospectively analyzed. Results: The median age of the 48 patients was 59 years (range: 34-79). Among these, 44 patients were Durie-Salmon stageⅢ, 15 were ISS stageⅡ, 19 were ISS stageⅢ, and 12 had plasmacytoma; 32.5% of all patients were cytogenetic high-risk. All patients re-ceived a median of four cycles (range: 1-9) of the RVD regimen as induction treatment. The overall response rate was 97.9%, with 35.4% of patients achieving complete response (CR) or better. The rate of very good partial remission (VGPR) or better was increased from 64.1% (after two cycles) to 84.6% (after four cycles). The mean collection of CD34+cells was 4.2 (± 2.6)×106/kg. Negative minimal residual disease (MRD), as indicated by next-generation flow (NGF), was achieved in 20.6% of patients after induction. Two patients with positive MRD after induction became MRD negative after transplantation. Two patients developed grade 3 or 4 hematologic toxic-ity. No nonhematologic toxicity of grade 3 or 4 was observed. Conclusions: In patients with NDMM, RVD treatment resulted in signifi-cantly improved response rates and exhibited an acceptable risk-benefit profile, with no adverse impact on stem cell collection. RVD combined with transplantation significantly improved the negative rate of MRD, as indicated by NGF.

A comparative study of robot BABA path and traditional surgery for thyroid cancer with hyperthyroidism / 国际外科学杂志

Objective To evaluate the safety and feasibility of Da Vinci robot in the treatment of thyroid cancer with hyperthyroidism via bilateral axillo-breast approach (BABA).Methods The clinical data of 21 patients with thyroid cancer complicated with hyperthyroidism who received thyroidectomy + central lymph node dissection and(or)neck lymph node dissection using the Da Vinci through axillo-bilateral-breast approach in the thyroid and breast surgery of the 960th Hospital of the PLA Joint Logistics Support Force,from February 2014 to February 2019 were analyzed retrospectively.The clinical data of 21 patients were used as observation group,including 5 males and 16 females,aged (46.03 ± 3.08) years.At the same period,19 patients with the thyroid cancer complicated with hyperthyroidism who underwent traditional open surgery were selected as the control group,including 5 males and 14 females,aged (47.06 ± 2.03) years.The t test,rank sum test,andx2 test were used to compare the operation time,postoperative hospital stay,postoperative drainage volume,postoperative pain (VAS),cosmetic outcome satisfaction,and related surgical complications between the two groups.Results All the patients of the two groups completed the operation successfully.The operation time of the observation group was longer than that of the control group [(191.12 ± 3.17) vs (145.37 ± 6.37) min,P ＜ 0.05];The postoperative pain degree score of the observation group was lower than that of the control group [(3.40 ± 1.12) points vs (5.10 ± 1.19) points,P ＜ 0.05].The cosmetic effect score of the observation group was better than that of the control group [(9.10 ± 3.03) points vs (5.05 ± 1.02) points,P ＜ 0.05].There were no significant differences in the amount of intraoperative blood loss,mean postoperative drainage,postoperative hospital stay,central lymph node metastasis and complication rate between the two groups (P ＞ 0.05).There was no significant difference in Tg level and recurrence rate between the two groups (P ＞ 0.05).Conclusion Da Vinci robotic assisted treatment for thyroid cancer with hyperthyroidism is safe and feasible,which with good cosmetic and privacy protection effects.

A retrospective analysis of autologous peripheral blood hematopoietic stem cell mobilizations and collections in 149 multiple myeloma patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyze the results and influential factors of mobilization and harvesting of autologous peripheral blood stem cell in patients with multiple myeloma (MM).</p><p><b>METHODS</b>Retrospective analysis of peripheral blood stem cell collection data [CD34⁺ cells collected, successful mobilization rate (CD34⁺ cells≥2×10⁶/kg body weight), good mobilization rate (CD34⁺ cells≥5×10⁶/kg body weight)] of 149 multiple myeloma patients who were treated with cyclophosphamide (CTX) or E-CHOP (etoposide+ CTX+epirubicin+vindesine+prednisone) chemotherapy combined with G-CSF mobilization from January 1998 to March 2014. The relevance between gender, age, subtype, DS staging, ISS staging, treatment before mobilization, disease status at mobilization, regiment of mobilizationand the collection results was analyzed.</p><p><b>RESULTS</b>A total of 177 stem cell mobilizations were performed in 149 MM patients, the median CD34⁺ cells harvested were 3.20 (0.13-22.34)×10⁶/kg body weight (BW), successful mobilization rate and good mobilization rate were 74.5% and 27.5%, respectively. The single logistic regression analysis showed that gender, age （>60 ys vs ≤60 ys）, subtype, DS staging (III vs II+I), ISS staging (III vs II+I) and regiment of mobilization (E-CHOP+G-CSF vs ID-CTX+G-CSF) were not correlated with the cell collection or successful mobilization rate (P>0.05). However, successful collection rate of single harvest in old patients (age>60 ys) was lower (P<0.05), andthe good mobilization rate in patients at ISS stage III was lower (P<0.05). The collection results of patients with fewer cycles of treatment (treatment before mobilization ≤6 cycles) and optimal disease status (disease status at mobilization ≥partial remission) were much better. Analysis of logistic factors revealed that treatment efficacy before mobilization affected success rate of collection (P=0.006). Risk of collection failure in patients who received more than 6 cycles of treatment before mobilization was high (OR 3.57, 95% CI 1.45-8.78).</p><p><b>CONCLUSION</b>Gender, age, subtype, DS staging, ISS staging and mobilization regimen did not influence MM patients peripheral blood stem cell collection; but old patients may need twice mobilizations to collect sufficiently. Few cycles of treatment and stable disease status before mobilization is favorable to the mobilization and collection of peripheral blood stem cells.</p>

Recombinant interlukin-2 plus chemotherapy in treatment of multiple myeloma / 白血病·淋巴瘤

Objective To study the effect of recombinant interlukin-2 plus chemotherapy in treatment of multiple myeloma. Methods We divided into two groups: chemotherapy plus rIL-2 group and simple chemotherapy group. The patients were given at dose of rIL-2 1×l06 IU/d, iH, qd, for 4 weeks and 4cycles. After 4 cycles the changes of T-cell subsets of their peripheral blood were determined. Response was evaluated according to Blad criteria. Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0. Results The positive percentages of CD_3, CD_4 NK, CD_(69) and CD_4/CD_8ratio after chemotherapy in chemotherapy plus rIL-2 group were significantly higher than those before chemotherapy in the same group and those after chemotherapy in the other group. The overall response rate and complete response rate were 66.7 % and 25.0 % vs 50.0 % and 8.3 % respectively. The side effects of rIL-2 were predictable and manageable. Conclusion Recombinant interlukin-2 plus chemotherapy could increase immune function of patients with multiple myeloma and has a higher response rate as compared with simple chemotherapy.

Combination therapy with thalidomide plus dexamethasone for patients with reaped or refractory multiple myeloma and for patients on stable phase multiple myeloma / 白血病·淋巴瘤

Objective To evaluate the effects of thalidomide in combination with dexamethasone (ID) in patients with relapsed or refractory multiple myeloma and in patients on stable phase. Methods Sixty-two patients with multiple myeloma were studied, include 25 with relapsed or refractory multiple myeloma, and 37 in stable phase. For the relapsed or refractory patients, thalidomide and dexamethasone was given at first three cycles, and then other regiments were given to no-response patients. For the all response patients, the second three cycles TD were enforced. On stable phase patients, thalidomide and dexamethasone were given as the second three cycles of relapsed or refractory patients. Then, thalidomide was given persistently until the disease relapse. Results All of the 25 relapsed or refractory patients were accepted the first 3 cycle TD treatment. The total response rate (VGPR+PR+MR) was 80 %. No complete remission (CR) and near CR(nCR) was gained. For the all response patients, the second three cycles TD were enforced. One patient achieved nCR. Thalidomide was given to all response patients. The median remission time was 6.8 (4～12) months. TD regimen was used to the 37 stable phase patients. The median remission time was 17.5 (8～26) months. The remission time of stable remission patients is longer then that of relapsed or refractory patients (P <0.001). Conclusion The combination of thalidomide and dexamethasone is a feasible and active regimen in the treatment of relapsed or refractory, and stable phase myeloma patients.