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Lung cancer remains the most common cancer and the leading cause of cancer death worldwide. Despite effective chemotherapy and molecular-based therapies, the median and overall survival remains poor. Immune checkpoint inhibitors have changed the treatment landscape for patients with non-small cell lung cancer (NSCLC) by inhibiting negative T cell regulators, including programmed death 1 (PD-1, CD279) and programmed death ligand 1 (PD-L1, also known as B-H1, CD274) inhibitors. Nonetheless, most patients do not respond to these inhibitors. Recently, PD-L1 expression has been demonstrated to influence the anti-tumor efficacy of immune checkpoint inhibitors. However, the mechanisms of PD-L1 regulation are not clearly understood. This review thus aims to summarize the current knowledge and recent developments in the regulatory mechanisms of PD-L1 expression levels and attempts to clarify its latent function in anti-tumor activity, with the goal of guiding better designs for future NSCLC immunotherapies. Low-grade central osteosarcoma (LG-COS) is an uncommon variant of osteosarcoma (OS) that sometimes progresses to high-grade OS post-recurrence. We herein present a case of dedifferentiated LG-COS with extensive cystic change arising in the right iliac bone of a 26-year-old man. The LG-COS was initially diagnosed and managed as a simple bone cyst. The lesion recurred thrice, and high-grade OS was diagnosed during the third recurrence. The first lesion appeared as a typical benign cystic mass on radiography. However, a huge malignant osteoblastic mass subsequently developed in the right pelvis at the third recurrence. Extended hemipelvectomy with ipsilateral hemisacral resection was performed. Histologic analysis showed tumor necrosis and irregular neoplastic tumor osteoid, while immunohistochemistry revealed that the tumor was diffusely positive for MDM2 and CDK4. The histologic diagnosis was high-grade OS dedifferentiated from a preceding cystic lesion. Our final diagnosis of the primary lesion was LG-COS with extensive cystic change. BACKGROUND Long noncoding RNAs (lncRNAs) have been identified to modulate the development and progression of prostate cancer (PCa) via the regulation of their target genes. However, the biological function underlying the effect of lncRNA TUG1 in PCa remains unclear. METHODS Reverse transcription-quantitative polymerase chain reaction (qRT-PCR) and Western blotting analysis were used to assess the mRNA expression of TUG1 and protein expression levels of Nrf2 pathway members, respectively. The migration, invasion, and proliferation abilities of cells were assessed by the wound-healing, Transwell migration/invasion, and CCK8 assays, respectively. RESULTS TUG1 was strikingly upregulated in PCa cells compared with non-tumorigenic human prostate epithelial cells. The LncTar Web Server, which is a bioinformatics tool, was used to predict the target association between TUG1 and Nrf2. Moreover, the expression of TUG1 showed a strikingly positive correlation with that of Nrf2 in TCGA PCa RNA-Seq data (r = 0.26,P = 4.63E-09). Subsequently, inhibition of TUG1 using siRNA resulted in deceased proliferation, migration, and invasion of PCa cells; however, these effects were reversed by treatment with oltipraz (an activator of Nrf2). LDC203974 purchase Finally, we evaluated the Nrf2 pathway to reveal the underlying mechanism of TUG1 in PCa cells, and found that TUG1 knockdown decreased the protein expression of Nrf2 downstream members (e.g., HO-1, FTH1, and NQO1). CONCLUSIONS LncRNA TUG1 plays an oncogenic role in human PCa cells by promoting the cell proliferation and invasion in PCa cell lines, at least partly via the Nrf2 signaling pathway. The aim of this study was to evaluate the feasibility of microvascular anastomosis using a 4K three-dimensional exoscope system (VITOM 3D) in 10 consecutive cases of free flap head and neck reconstructive surgery. This was a clinical human study of free flap microvascular anastomosis using a VITOM 3D exoscope in 10 consecutive patients undergoing reconstruction after ablative surgery for head and neck carcinoma. Microvascular anastomoses were performed successfully using the exoscope in all patients, without any need for the conventional microscope. Arterial anastomoses were all end-to-end. Venous anastomoses were end-to-end in eight cases and end-to-side with the internal jugular vein in two cases. This study demonstrates the technical feasibility of microvascular anastomosis using a 4K three-dimensional exoscope system (VITOM 3D) in a series of 10 cases. BACKGROUND Current guidelines recommend perioperative warming as one of the strategies to prevent surgical site infection, although there are gaps in the knowledge produced on this issue. AIM Assess the efficacy of active warming methods to maintain perioperative patients' body temperature and its effect on the occurrence of surgical site infection. METHODS A systematic review with meta-analysis was carried out. PubMed, CINAHL, LiLACS, CENTRAL, and EMBASE databases were searched. FINDINGS Of the 956 publications identified, 9 studies were selected for quantitative synthesis and 6 for the meta-analysis. The forced-air warming system was investigated in 8 studies. The generated evidence indicated that the use of an active warming method could maintain higher average body temperature as well as could decrease the surgical site infection incidence. Exposure of the patient to temperatures below 36°C in the perioperative period increased the chances of developing this type of infection. The meta-analysis indicated that the association between perioperative active warming methods compared with others to reduce the chances of developing surgical site infection remains unclear (odds ratio = e-3.59 = 2.718-0.59 = 0.552, 95% confidence interval (odds ratio) = (0.269-1.135), P = 0.106 I2 = 54.34%). CONCLUSIONS The employment of an active warming method is effective to maintain higher averages of body temperature. However, more randomized clinical trials are needed to assess the efficacy of that intervention to prevent surgical site infection.
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