Objective To evaluate the effect of azitromycin upon the bronchiolitis obliterans and T helper (Th)17/regulatory T cell (Treg) balance after lung transplantation. Methods Twenty-four specific pathogen free(SPF) C57BL/6 mice were used as the donors and 48 Balb/c mice were utilized as the recipients. The Balb/c mice were randomly divided into the control (C group), azitromycin control (Cazm group), transplantation (T group) and transplantation + azitromycin groups (Tazm group), 12 mice in each group. In the T and Tazm groups, heterotopic tracheal transplantation models were established to simulate bronchiolitis obliterans after lung transplantation. From 1 d post-transplantation, intragastric administration of azitromycin was given at a dose of 30 mg/kg three times per week in the Cazm and Tazm groups. At 14 and 28 d after transplantation, the transplanted trachea was removed and peripheral blood was collected. The tracheal sample was prepared for hematoxylin-eosin (HE) staining for pathological observation. The expression levels of ROR-γt and Foxp3 messenger ribonucleic acid (mRNA) in the peripheral blood were quantitatively measured by reverse transcription polymerase chain reaction (RT-PCR). The variation in the related cytokines levels of Th17 cells and Treg in the plasma was detected by enzyme linked immunosorbent assay (ELISA). Results After heterotopic tracheal transplantation, compared with the C group, thetracheal occlusion accompanied with inflammatory infiltration was observed in the T and Tazm groups. The severity of relevant symptoms in the Tazm group was slighter than that in the T group. Compared with the T group, the expression level of ROR-γt mRNA in the Tazm group was significantly down-regulated (P<0.05). No statistical significance was identified in the expression of Foxp3 mRNA between two groups (P>0.05). Compared with the T group, the levels of interleukin (IL)-6 and IL-17 cytokines in the Tazm group were significantly down-regulated (all P<0.05). Conclusions Persistent therapy of azitromycin can delay the progression of bronchiolitis obliterans after transplantation, which is probably associated with inhibiting Th17 cell differentiation and inflammation.

Objective To explore the levels of serum adiponectin (ADPN) and retinol-binding protein 4 (RBP4) in patients with type 2 diabetes mellitus (T2DM) and obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods A total of 155 patients with T2DM and OSAHS were selected and divided into mild group (n=62),moderate group (n=53) and severe group (n=40) according to apnea-hypopnea index (AHI),35 OSAHS patients were designed as OSAHS group,42 T2DM patients were selected as T2DM group,and 38 healthy controls were selected as control group.Serum ADPN and RBP4 levels were detected by ELISA.Results Compared with healthy controls,the serum level of RBP4 significantly increased and the ADPN level significantly decreased in the other three groups (P<0.01).In subgroups of OSAHS and T2DM group,the level of RBP4 increased with increasing of AHI level,ADPN level is on the contrary (P<0.01).Conclusion The serum levels of ADPN and RBP4 are closely related with the severity of T2DM patients with OSAHS.

Objective To explore the levels of serum adiponectin (ADPN) and retinol-binding protein 4 (RBP4) in patients with type 2 diabetes mellitus (T2DM) and obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods A total of 155 patients with T2DM and OSAHS were selected and divided into mild group (n=62),moderate group (n=53) and severe group (n=40) according to apnea-hypopnea index (AHI),35 OSAHS patients were designed as OSAHS group,42 T2DM patients were selected as T2DM group,and 38 healthy controls were selected as control group.Serum ADPN and RBP4 levels were detected by ELISA.Results Compared with healthy controls,the serum level of RBP4 significantly increased and the ADPN level significantly decreased in the other three groups (P<0.01).In subgroups of OSAHS and T2DM group,the level of RBP4 increased with increasing of AHI level,ADPN level is on the contrary (P<0.01).Conclusion The serum levels of ADPN and RBP4 are closely related with the severity of T2DM patients with OSAHS.

Objective To explore the efficacy and prognosis of lung transplantation from donors combined with pulmonary contusion on the treatment of patients with end-stage lung disease. Methods Clinical data of 73 cases of donors and recipients were collected. The donors and recipients were divided into contusion group (23 cases of donors and recipients, with a maximum diameter of contusion in 5-8 cm) and standard group (50 cases of donors and recipients) depending on combined pulmonary contusion. Major clinical indicators [postoperative oxygenation index, duration of mechanical ventilation and chest tube drainage and incidence of primary graft dysfunction (PGD)] and prognosis of the recipients in both groups were compared. Results The recipients in both groups presented no significant difference in postoperative oxygenation index, duration of mechanical ventilation and chest tube drainage and incidence of PGD (all P>0.05). The postoperative 1-year survival of the recipients in standard group and contusion group was 74％ and 83％, which presented no statistically significant difference (P>0.05). Conclusions The efficacy and prognosis of lung transplantation from donors combined with pulmonary contusion (with a maximum diameter of 5-8 cm) are comparable to those of lung transplantation from standard donors.