Chronic rejection remains the leading cause of chronic allograft dysfunction and late mortality after lung transplantation. Adaptive immune system and its cellular-based rejection has been the focus in the development of obliterative bronchiolitis. Recent research has identified that humoral immunity, autoimmunity, and innate immunity also contribute to obliterative bronchiolitis. This paper presents an updated review of the immune mechanisms for obliterative bronchiolitis following lung transplantation.

Objective To investigate the variation of serum Thymidine Kinase 1(TK1) in patients with non‐small cell lung canc‐er(NSCLC) and its clinical value .Methods Serum TK1 level of 129 patients with NSCLC and 90 healthy volunteers were measured by sensitive chemiluminescence dot‐blot assay .The serum TK1 level variation of 76 patients with NSCLC were compared before and after operation .Results Serum TK1 level of NSCLC patients were significantly higher than the level of healthy control group(P<0 .05) .Serum TK1 level in Stage Ⅲ >Stage Ⅳ >Stage Ⅰ + Ⅱ >Stage Tis ,comparison between each other was of statistical differ‐ence(P<0 .05) .The serum TK1 level of NSCLC patients at 30th day after surgery was remarkably lower than which before surger‐y(P=0 .001 ,P<0 .01) .The serum TKl level was correlated with lymphatic metastasis(P<0 .01) ,but not with other factors such as pathology types ,age ,sex and smoking .The serum TK1 measurement was high sensitivity and specificity to the diagnosis of NSCLC .Conclusion The serum TK1 level detection has important clinical significance in diagnosis and evaluation of NSCLC pa‐tients .

Objective To investigate the antireflux effect of esophagogastrostomy combined with modified Nissen fundoplication after esophageal middle cancer resection.Methods Eighty-two patients with esophageal middle cancer were divided into 2 groups by random digits table method,41 cases underwent esophagogastrostomy with a stapler only (control group),41 cases underwent esophagogastrostomy with stapler combined with modified Nissen undoplication (observation group).Three months after surgery,the patients of the 2 groups completed the research of EORTC QLQ-C30 questionnaire,and examined with esophageal manometry and gastroscopy.Results There was no statistical difference in incidence of postoperative complication between the 2 groups (P ＞ 0.05),death was not found during peroperative period.The scores of heart burn and regurgitation in observation group [(13.2 ± 6.1) and (16.9 ± 3.9) scores] were significantly lower that those in control group [(25.6 ± 7.2) and (26.6 ± 4.2) scores],there were statistical differences (P ＜ 0.05),but there was no statistical difference in score of dysphagia between the 2 groups (P ＞ 0.05).The resting pressure of anastomotic site in observation group [(3.5 ± 2.3) mmHg,1 mmHg =0.133 kPa] was significantly higher than that in the stomach [(2.7 ± 2.1) mmHg],there was statistical difference (P＜ 0.05).The DeMeester score was (54 ± 32) scores,control group was (141 t 84) scores,there was statistical difference (P ＜ 0.05).The incidence of reflux esophagitis in observation group was 48.8％(20/41),in control group was 75.6％(31/41),there was statistical difference (P ＜ 0.05).Conclusions Esophagogastrostomy combined with modified Nissen fundoplication after esophageal middle cancer resection significantly increases the pressure at the anastomotic site,thus reduces the extent of gastroesophageal reflux,which leads to the reduction of the extent of reflux esophagitis and the improvement of the quality of life.