Esophageal hiatal hernia involves abnormal abdominal entry into thoracic cavity. It is classified based on orientation between esophageal junction and diaphragm. Sliding hiatal hernia (Type-I) comprises the most frequent category, emanating from right crus of diaphragm. Type-II esophageal hernia engages both left and right muscular crura. Type-III and IV additionally include the left crus. Age and increased body mass index are key risk factors, and congenital skeletal aberrations trigger pathogenesis through intestinal malrotations. Familiar manifestations include gastric reflux, nausea, bloating, chest and epigastric discomfort, pharyngeal and esophageal expulsion and dysphagia. Weight loss and colorectal bleeding are severe symptoms. Areas covered: This review summarizes updated evidence of pathophysiology, risk factors, diagnosis and management of hiatal hernias. Laparoscopy and oesophagectomy procedures have been discussed as surgical procedures. Expert commentary: Endoscopy identifies untreatable gastric reflux; radiology is better for pre-operative assessments; manometry measures esophageal peristalsis, and CT scanning detects gastric volvulus and associated organ ruptures. Gastric reflux disease is mitigated using antacids and proton pump and histamine-2-receptor blockers. Severe abdominal penetration into chest cavity demands surgical approaches. Hence, esophagectomy has chances of post-operative morbidity, while minimally invasive laparoscopy entails fewer postoperative difficulties and better visualization of hernia and related vascular damages.

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Myeloid derived suppressor cells (MDSC) play a pivotal role in tumor immune evasion and MDSC levels increased in patients with cancer. Studies confirmed the associations between MDSC and various cytokines in the peripheral blood. However, little is known about the association between parenchymal MDSC subsets and cytokines, or the mechanism drawing MDSC into tumor parenchyma. This study was to analyze the correlation between MDSC subsets and CCL2 level in lung cancer model. G-MDSC and M-MDSC from the blood and parenchyma were analyzed by flow cytometry and western blot in the lung tumor model. CCL2 was detected by ELISA assay, real-time PCR, western blot and flow cytometry. Furthermore, the therapeutic effects of combination treatment combining CCL2 antagonist and anti-PD1 antibody were assessed. Results showed that MDSC subsets had a positive correlation with CCL2, suggesting CCL2 may attract MDSC into the parenchyma. Gene and protein expression of CCL2, as well as the CCL2 surface expression significantly increased in blood and tumor of tumor-bearing mice. Anti-CCL2 treatment decreased G-MDSC and M-MDSC in the periphery and tumor through inhibiting the protein expression of arginase 1 and iNOS. In addition, combination therapy enhanced CD4+ and CD8+ T cell infiltration, as well as the production of interferon gamma (IFNγ), and increased the survival time of tumor-bearing mice. Our study provided potential new target to enhance the efficacy of immunotherapy in patients with lung cancer, in addition to elucidate a possible association between MDSC subsets and the cytokine drawing MDSC migration into the tumor tissue.

Owing to the development of nanotechnology and noninvasive treatment, thermal therapy in combination with external stimuli has been applied for tissue engineering and regenerative medicine (TERM), which has attracted more and more attention in recent years. In this review, the recent progress of applying a variety of non‐invasive thermal therapeutic modalities for TERM, including photothermal therapy, magnetic thermotherapy, and ultrasound thermotherapy, as well as other thermal therapeutics are discussed. The parameters and conditions that need to be considered and regulated to realize a well‐controlled thermal therapy for tissue regeneration are also discussed. Afterwards, the current concerns and challenges of putting thermal therapy into clinical applications are pointed out. At last, perspectives are provided for the future development directions, aiming to providing opportunities and a novel pathway for TERM.

Anticancer modalities based on oxygen free radicals, including photodynamic therapya nd radiotherapy, have emerged as promising treatments in the clinic. However,t he hypoxic environment in tumor tissue prevents the formation of oxygen free radicals.H ere we introduce an ovel strategy that employs oxygen-independent free radicals generated from ap olymerization initiator for eradicating cancer cells.T he initiator is mixed with aphase-changematerial and loaded into the cavities of gold nanocages.U pon irradiation by an earinfrared laser,t he phase-change material is melted due to the photothermal effect of gold nanocages,l eading to the release and decomposition of the loaded initiator to generate free radicals.T he free radicals produced in this waya re highly effective in inducing apoptosis in hypoxic cancer cells.

BackgroundOur case describe a rare recurrence case of Unicentric Castleman’s disease (UCD) with hyaline vascular type 14 years after surgery.Case presentationA 35-year-old Chinese female was admitted to hospital with one and half months history chest distress and chest pain. Patient reports a history of thoracic operation for mediastinal mass 14 years ago, and it was diagnosed UCD with hyaline vascular type after postoperative pathological examination. At this time, the imaging examination showed a mediastinal mass once again. Combining the medical history, postoperative microscopically examination and immunoperoxidase staining, patient was again diagnosed UCD with hyaline vascular type again. The hyaline vascular type is the most common type and usually presents as a UCD. Most patients with UCD have no clinical symptoms. The diagnosis of UCD is generally achieved with histological and immunohidtochemical findings postoperatively. Currently, the standard treatment of UCD is the complete surgical resection, with almost no relapse postoperative. The recurrence in UCD with hyaline vascular type postoperative have not previously been reported. Therefore, herein we describe a recurrence case of UCD with hyaline vascular type 14 years after surgery.ConclusionOur case is the first case which reports the relapse of UCD with hyaline vascular type after completely surgery. It indicates that long term follow-up is necessary for patient who is diagnosed UCD after surgery.

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Skin wound healing often contains a series of dynamic and complex physiological healing processes. It is a great clinical challenge to effectively treat the cutaneous wound and regenerate the damaged skin. Hydrogels have shown great promise for skin wound healing through the rational design and preparation to endow with specific functionalities. In the mini review, we firstly introduce the design and construction of various types of hydrogels based on their bonding chemistry during cross-linking. Then, we summarize the recent research progress on the functionalization of bioactive hydrogel dressings for skin wound healing, including anti-bacteria, anti-inflammatory, tissue proliferation and remodeling. In addition, we highlight the design strategies of responsive hydrogels to external physical stimuli. Ultimately, we provide perspectives on future directions and challenges of functional hydrogels for skin wound healing.