To make up a portable, economic drainage device to prevent the development of pocket hematoma and avoid the additional therapies of pocket hematoma. Between 2003 and 2006, a total of 265 devices were implanted at our institution. The 89 high-risk patients were determined by the predictors of hematoma occurrence (marasmatic elder, inevitable oral antiplatelet/anticoagulation therapy, venous pressure increased by other comorbidity, the deficiency of the clotting mechanism for hepatic diseases, or incognizable severe intraoperative bleeding), and other 186 patients were included in non-high-risk group. The 89 high-risk patients were randomized into treatment and control subgroups by sortition. Surgical procedures differed only by the application of the portable, economic drainage device prior to wound closure in treatment subgroup. The incidence of pocket hematoma was 4.3% in treatment subgroup, 18.6% in control subgroup and 2.7% in non-high-risk group, leading to 2, 6 and 3 patients' prolonged hospitalization, respectively. The additional cost due to pocket hematoma was lower (1.5 times) in the treatment group compared to the control group. There wasn't antidromic infection and delayed cure of the skin incision with the use of our drainage device within 6 months. Our portable drainage device was made up easily and quickly. It could decrease the total cost of hospitalization, did not increase the other adverse events and seemed to be suitable for such patients with a tendency to develop pocket hematoma undergoing the implantation of pectoral pacemakers, implantable cardioverter defibrillator, or cardiac resynchronization therapy.
Abstract Treatment of non–small cell lung cancer (NSCLC) has drastically changed in recent years owing to the robust anticancer effects of immune checkpoint inhibitors (ICI). However, only 20% of the patients with NSCLC benefit from ICIs, highlighting the need to uncover the mechanisms mediating resistance. By analyzing the overall survival (OS) and mutational profiles of 424 patients with NSCLC who received ICI treatments between 2015 and 2021, we determined that patients carrying a loss-of-function mutation in neurotrophic tyrosine kinase receptor 1 (NTRK1) had a prolonged OS when compared with patients with wild-type NTRK1. Notably, suppression of the NTRK1 pathway by knockdown or entrectinib treatment significantly enhanced ICI efficacy in mouse NSCLC models. Comprehensive T-cell population analyses demonstrated that stem-like CD4+ T cells and effector CD4+ and CD8+ T cells were highly enriched in anti–PD-1–treated mice bearing tumors with decreased NTRK1 signaling. RNA sequencing revealed that suppression of NTRK1 signaling in tumor cells increased complement C3 expression, which enhanced the recruitment of T cells and myeloid cells and stimulated M1-like macrophage polarization in the tumor. Together, this study demonstrates a role for NTRK1 signaling in regulating cross-talk between tumor cells and immune cells in the tumor microenvironment and provides a potential therapeutic approach to overcome immunotherapy resistance in patients with NSCLC with NTRK1 wild-type. Significance: Inhibition of NTRK1 signaling confers sensitivity to immunotherapy by enhancing complement C3-mediated T-cell and macrophage functions, leading to improved responses to immune checkpoint inhibitors in patients with lung cancer with NTRK1 mutations.
Objective To evaluate the clinical effects of the guided bone regeneration(Bio-oss) and collagen membrane in the treatment of larger radicular cyst.Methods 63 patients suffering radicular cyst were enrolled.All these cases were randomly divided into 3 groups.21 cases were treated with Bio-Gide and Bio-oss,and 21 were treated with collagen membrane in fossa only.The last 21 cases who received cyst extraction were the control group.Clinical parameters evaluated included changes in tooth mobility and the bone loss of the alveolar process according to radiograms preoperatively and at the 3rd,6th and 12th months after operation.Results At the 3rd,6th and 12th months postoperatively,two observation groups showed significantly more bone density increased according to the radiographs than the control group(P0.05).The 1st group with Bio-oss and collagen membrane had the best efficacy.The teeth with radicular cyst remained well.Conclusions Bio-oss and absorbable collagen membranes show excellent bio-compatibility,which can accelerate the bone repair progress and can be successfully used for reconstruction of alveolar bone to obtain satisfactory clinical effects.
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