Severe inflammatory response and functional impairment of endothelial progenitor cells (EPCs) often lead to the implantation failure of EPC-captured tissue-engineered blood vessels (TEBVs) in diabetes. Regulatory T cells (Treg cells) are the most important inhibitory immune cells, but their effects in angiogenesis remain undefined, and the differences in the microenvironment may be an important reason. Here, we constructed a TEBV coated with an anti-CD34 antibody-functionalized heparin-collagen multilayer (anti-CD34 antibody-modified TEBV) using layer-by-layer self-assembly. Then, TEBVs were implanted into diabetic pigs. All TEBVs remained unobstructed 60 days after implantation, although varying degrees of intimal hyperplasia were detectable. Severe intimal hyperplasia was observed in the control group and peripheral injection of Treg cells group. Intravenous injection of Treg cells significantly inhibited intimal hyperplasia, inflammation, and cell apoptosis. Moreover, intravenous injection increased the proportion of circulating EPCs, while peripheral injection did not have these effects and reduced microvessel density around the TEBV. Interestingly, many Nestin⁺ cells could be detected in TEBVs, most of which were fusiform, showing the characteristics of smooth-muscle cells. Treg cell intravenous transplantation markedly reduced the number of Nestin⁺ cells in the TEBV. In conclusion, Treg cells inhibited the intimal hyperplasia of TEBVs in diabetic pigs by promoting EPC mobilization, anti-inflammatory action, and cellular protection.

肺磨玻璃样微小结节（ground glass opacity, GGO）病灶的定位是微创手术切除的技术难点。各种定位方法均有报道，但每一种方法均有其不足。本研究拟通过评价术中CT引导下Hook-wire定位对GGO微创切除的价值，初步探索肺部 < 10 mm的GGO积极手术治疗的必要性和可行性。 2009年10月-2013年10月共32例GGO患者，41个GGO，行胸腔镜微创切除术，麻醉插管后皆在手术体位下行计算机断层扫描（computed tomography, CT）CT引导Hook-wire定位。记录术中CT引导下Hook-wire定位技术的失败率、并发症、胸腔镜手术转为开胸手术的几率、住院时间等，计算病灶组织学分型中的恶性几率，讨论肺部 < 10 mm的GGO积极手术治疗的必要性。 共32例患者（男性15例，女性17例）行41个GGO胸腔镜微创切除术，其中2个病灶、3个病灶和5个病灶同时微创切除患者数量分别是3例、1例、1例。病灶直径2 mm-10 mm（平均5 mm），病灶距离胸膜垂直距离5 mm-24 mm（平均12.5 mm）。术中CT引导下Hook-wire定位成功率100%，严重并发症发生率0，转化为开胸手术比率为0，CT定位时间平均8.4 min（4 min-18 min），微创切除病灶所需时间平均32 min（14 min-98 min），中位住院时间为8 d（5 d-14 d）。GGOs术后组织学诊断结果为：原位腺癌（肺泡癌）19例，约46.3%，腺癌8例，约19.5%，大细胞癌1例，约2.4%，不典型腺瘤样增生9例，约22%，炎性病灶4例，约9.8%。 肺部GGO是恶性病灶的几率很大，对典型GGO患者积极微创手术治疗是非常必要的；术中CT引导下Hook-wire定位技术极大提高GGO微创切除可行性、并发症发生率低，对于GGO的鉴别诊断及治疗具有很好的临床价值。

Malignant pleural effusion is one of the most common complications of advanced lung cancer and there is no effective clinical treatment at present. Here, we constructed an aptamer-siRNA chimeras/PEI/PEG/gold nanoparticle (AuNP)/collagen membrane that can progressively activate T cells by layer by layer assembly. Electron microscope showed this collagen membrane could be divided into 10 layers with a total thickness of 50–80μm, and AuNPs could be observed. Aptamer-siRNA chimeras could bind specifically to OX40⁺ cells and silencing programmed death receptor-1 (PD-1) gene. In vitro experiments demonstrated that chimeras/PEI/PEG/AuNPs gradually activated T cells to continuously kill lung adenocarcinoma cells in malignant pleural effusion. Animal experiments showed that chimeras/PEI/PEG/AuNP/collagen membrane effectively treated malignant pleural effusion. Compared with PD-1 inhibitor group, the number of cancer cells, ki-67 proliferation index and CD44 expression in the pleural effusion was significantly decreased and the lymphocyte/cancer cell ratio was significantly increased in the chimeras/AuNP-CM group. Flow cytometry showed that compared with PD-1 inhibitor group, T cell number in the chimeras/AuNP-CM group was significantly increased, while the proportion of PD-1⁺ T cells was markedly decreased. In conclusion, we constructed an chimeras/PEI/PEG/AuNP/collagen membrane, which was more effective in the treatment of malignant pleural effusion, and had less side effects than PD-1 inhibitors.

The tumor microenvironment (TME) has a profound influence on the progression of lung adenocarcinoma (LUAD) and its response to therapy. We identified a tum