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An increasing number of patients are being diagnosed with multiple ground glass opacities (GGOs), but a consensus on the treatment of these patients is still lacking. The aim of this study was to investigate the safety and feasibility of a novel technique, electromagnetic navigation bronchoscopy (ENB)-guided microwave ablation combined with uniportal video-assisted thoracoscopic surgery in patients with multiple GGOs. The clinical, radiographic, surgical, and pathologic data of patients with multiple GGOs who underwent ENB-guided microwave ablation combined with uniportal video-assisted thoracoscopic surgery from October 2018 to December 2019 were reviewed. Eleven patients with multiple GGOs underwent ENB-guided microwave ablation combined with uniportal video-assisted thoracoscopic surgery; they included 6 men and 5 women with a mean age of 61.3 ± 5.1 years (range, 53 to 68). Thirty-seven lesions were observed in the 11 patients, 21 of which were microwave ablated and 16 of which were surgically resected. Only 1 patient had postoperative pneumothorax and subcutaneous emphysema and was successfully discharged from the hospital after symptomatic treatment. The success rate and the efficiency of microwave ablation under ENB guidance were both 100%, with no other serious complications or procedure-related deaths occurring. No local metastasis or recurrence occurred in any patients during the follow-up period. Electromagnetic navigation bronchoscopy-guided microwave ablation combined with uniportal video-assisted thoracoscopic surgery is safe and feasible in patients with multiple GGOs suspected of having multiple primary lung cancers, and may represent an alternative approach for more patients, particularly patients who cannot tolerate the simultaneous resection of multiple tumors. [Display omitted] [ABSTRACT FROM AUTHOR]

• Membrane PD-L1 expression was rarely observed in the presence of ALK rearrangements. • Tumor bed infiltration CD8 + T cell more frequent in tumors with ALK mutations. • CD8+ T cells infiltrating ALK+ tumors were unable to express IFNG. Several lines of evidence have demonstrated that programmed cell death 1 (PD-1) inhibitors as monotherapies for anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer have little clinical activity. The underlying mechanisms remain not understood. In this study, using immunohistochemistry and in situ RT-PCR assays, we examined the expression of programmed cell death ligand 1 (PD-L1), PD-1, CD8, and interferon gamma (IFN-γ) in tumors. Both epidermal growth factor receptor (EGFR)-mutant and anaplastic lymphoma kinase (ALK)-positive tumors were associated with low or absent membrane PD-L1 expression. Interestingly, unlike EGFR-mutant tumors with few tumor-infiltrating CD8+ T cells, a significant number of PD-1-positive CD8+ T cells infiltrated the ALK-positive tumor bed; however, these cells did not express IFNG mRNA. These results demonstrate that the ALK-positive tumor microenvironment suppresses the immune function of tumor-infiltrating CD8+ T cells through a PD-1/PD-L1-independent mechanism, which might lead to the inability of ALK-positive tumors to respond to PD-1/PD-L1-based immunotherapy. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Combined cellulose, chitosan and filler to create the efficient adsorbents. • The CCM-AC displayed high adsorption efficiency and capacity of tylosin from water. • The adsorption rate of tylosin on CCM-AC was affected by the size-exclusion effect. • The adsorption effect was best under neutral conditions. • Three possible mechanisms were suggested to describe tylosin adsorption. Abstract Antibiotic pollution in tap water, surface water, and effluent needs to be controlled in China. Adsorption is an economical and eco-friendly way to solve the antibiotic contamination problem, such as tylosin. In this study, the chitosan/cellulose nanocomposite adsorbents entrapped with activated carbon are prepared by a sol-gel phase inversion method. Structures and properties of the adsorbents are characterized by SEM, EDXS, BET, XRD, FTIR XPS and Zeta potentials. The adsorption behavior of CCM-AC on tylosin is determined by batch and fixed-bed adsorption experiments, while their adsorption mechanism is also studied. The maximum adsorption capacity is 59.26 mg g−1, while the adsorption behavior is in accordance with the Langmuir equation and pseudo-second-order kinetics. These results confirm that the tylosin adsorption process is affected by chemical and physical interactions, and the adsorbent can be captured by tylosin with H-bond, electrostatic and π-π electron-donor-acceptor interaction. Adsorption experiments are significantly affected by pH. [ABSTRACT FROM AUTHOR]