Clinical data of 4 patients with chronic obstructive pulmonary disease who underwent allogenic single-lung transplantation were retrospectively analyzed. All cases received corpse donor lungs. One case with diffuse emphysema underwent right lung transplantation. and 3 received left lung transplantation. including one underwent fight lung volume reduction during surgery and 2 cases underwent right lung volume reduction post-transplantation. The inductive treatment with daclizumab or antithymocyte globulin was done and the rejection was prevented with Tacrolimus. mycophenolate and prednisone. The surgery was successfulin 4 cases. One case developed acute rejection on the fifth day post-transplantation. and controlled using methylprednisolone. Two cases discharged successfully, of whom one lived more than 2 years. Two cases died 74 days and 77 days after lung transplantation. respectively.

Objective To report the experience of lung transplantation with size reduced graft lung.Methods Four cases receiving lung transplantation with size reduced graft lung were analyzed retrospectively.In case 1,left lung transplantation combined with contra-hteral lung volume mduction.In case 2,right lung transplantation Wag individually performed with partially msecfion of upper lobe of graft lung.In case 3.bilateral sequential lung transplantation wag performed using graft lung with partially resection of bilateral upper lobes.In the remained ease,bilateral sequential lung tansplantation was performed using graft lung with resection of right lower lobe.Results All the size reduced graft lungs had good functions during the peri-operation period.Case 1 and case 2 still survived without obvious complication.Case 3 experienced temporary air leak on the 5th day postoperation and cured by water seal drainage but died of abrupt bronchorrhea due to aspergillus infection on the 32th day postoperation.The last cage experienced smoothly recovery excepted fatal virus pneumonia 2 months postopemtion.Conclusion Size reduced graft lungs can be successfully used for transplantation.

OBJECTIVETo investigate the expression of secretory leucocyte protease inhibitor (SLPI) in colon cancer and their clinical significance.

METHODSImmunohistochemistry was performed to detect the SLPI expression in colon cancer tissue microarray. The expression of SLPI was scored by two pathologists and was analyzed using Χ(2) test to explore its influence on the pathologic characteristics of colon carcinoma.

RESULTSSLPI was up-regulated in colon cancer tissue compared to normal mucosa. Overexpression of SLPI protein was correlated with differentiation grade (low differentiation: 42.1% vs 57.9%; moderate/well differentiation: 2.3% vs 97.7%, TNM stages(III-IV:29.4% vs 70.6%;I-II:3.1% vs 96.9%), lymph node metastasis (28.6% vs 71.4%) and distant metastasis (84.6% vs 15.4%), but not with patient age or sex.

CONCLUSIONSLPI overexpression correlates with aggressive pathologic characteristics of colon cancer and it may server as prognostic factor of colon cancer patients. Further research will be carried out to verify whether SLPI can become a new target for colon cancer treatment.

Adult ; Aged ; Aged, 80 and over ; Colonic Neoplasms ; metabolism ; pathology ; Electrophoresis, Microchip ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasm Staging ; Secretory Leukocyte Peptidase Inhibitor ; metabolism

Objective:To evaluate the value of Sonazoid contrast enhanced ultrasound (CEUS) in preoperative prediction of proliferating cell nuclear antigen 67 (Ki-67) level of hepatocellular carcinoma (HCC) by establishing predictive model based on radiomics features of Kupffer phase.Methods:From October 2020 to August 2021, patients with histologically confirmed HCC lesion and who underwent Sonazoid CEUS examination 1 week before surgery were prospectively enrolled. The radiomics signatures were extracted from the whole tumor region on gray scale images and Kupffer phase images. Two predictive radiomics models were constructed using radiomic method. The predictive performance of 2 models was compared.Results:A total of 50 patients with histologically confirmed single HCC lesions were prospectively enrolled in this study. Among them, histological results revealed 24 HCC lesions with high level representation of Ki-67 (>20%) and 26 HCC lesions with low level representation of Ki-67 (≤20%). Two radiomics predictive models were established based on gray scale images and Kupffer phase images respectively. While compared with model based on B-mode ultrasound images, model based on Kupffer phase images showed significantly higher area under receiver operating characteristic curve (0.753 vs 0.535, P=0.017), accuracy (0.720 vs 0.580, P=0.023) and sensitivity (0.458 vs 0.250, P=0.043). Calibration plot indicated that Kupffer phase model showed better consistency with the actual Ki-67 level than gray scale model. Conclusions:The radiomics model based on Kupffer phase features of Sonazoid CEUS is a preoperative and noninvasive prediction the presentation level of Ki-67 in HCC lesions.

Objective:To study the effect of internal drainage tube and T tube in laparoscopic common bile duct exploration.Methods:The data of 103 patients who underwent laparoscopic common bile duct exploration for the treatment of choledocholithiasis from January 2016 to April 2021 in Dongguan Kanghua Hospital were analyzed, including 50 males and 53 females, aged (50.3±17.2) years old, the age range was 15 to 90 years old. A total of 103 patients were randomly divided into T tube group ( n=60), who received laparoscopic cholecystectomy + choledocholithotomy and stone removal+ T tube drainage, and self-dropping stent group ( n=43), who received laparoscopic cholecystectomy + choledocholithotomy and stone removal + placed with self-dropping stent. The operation time, intraoperative blood loss, postoperative drainage, postoperative hospital stay and incidence of postoperative complications were compared between the two groups. Results:The operation time of self-dropping stent group was (107.2±26.1) min, intraoperative blood loss 10(5, 10) ml, and postoperative hospital stay (6.5±3.5) d, which were better than those of T tube group (143.5±52.7) min, 10(10, 20) ml, (8.8±3.8) d, the differences were statistically significant (both P<0.05). There were no significant difference in postoperative drainage volume and postoperative complications between the two groups (both P>0.05). Conclusion:The internal drainage tube in laparoscopic common bile duct exploration is a safe and reliable surgical method for the treatment of choledocholithiasis, which can significantly shorten the hospitalization time of patients.