Lung transplantation is the unique method to cure pulmonary tuberculosis at final stage. This paper reviewed the history, indication and contraindication, method of donor and recipient selection and donor preservation, operation methods, postoperative complications and protocol for complications to well understand issues in lung transplantation. Moreover, lacking of donors and increasing mortality of patients waiting for transplantation are urgent problems. With technique development, prognosis amendment, and improvement of survival rate and quality of life, donor source becomes important. Many studies have been conducted to explore the application of cadaveric lung, and several animal trials have been successful. In addition, scope of in vivo pulmonary lobes transplantation is increasing. Based on split liver transplantation, split double-lung transplantation is developed. This method utilizes existed donor sources, and provides options for patients waiting for transplantation.

Background The malignant degree of the diffuse large B-cell lymphoma (DLBCL) is high.Radiation therapy is sensitive,but the therapeutic schedule can not be unified,reasonable and effective therapeutic schedule is important in clinic treatment of the DLBCL.Objective This study was to access the effect of X-ray on the cell cycle and cell apoptosis of the DLBCL.Methods DLBCL cell line was cultured and the cell suspension was inoculated to 12-well cultured plate.The cells exposed to X-ray for 6,12,24,48 hours with the irradiation doses of 2,4,6,8 Gy respectively.The cell proportions of different cycles were assayed by flow cytometer,and cell apoptosis index was evaluated and calculated.Non-irradiation cells served as controls.Results The cells grew well with a good cell vitality and round-like shape,and the growth was stable in generation 2 or 3.With the increase of X-ray doses and the lapse of irradiation time,the cell proportions in G0-G1 phase gradually reduced (Fdose =45.58,P=0.00; Ftime =43.11,P=0.00).However,cell proportions in G2-M phase were gradually increased as the increase of X-ray doses and lapse of irradiation time (Fdose =40.77,P =0.00 ; Ftime =91.91,P =0.00).In addition,the apoptotic proportion of the cells was significantly elevated with the increase of X-ray dose and irradiation time (Fdose =87.36,P =0.00; Ftime =37.31,P =0.00).Conclusions X-ray irradiation retards DLBCL in the G2-M phase and causes cell apoptosis in dose-and time-dependent manner.

Objective: Signet-ring cell carcinoma is a relatively rare cancer which occurs principally in the stomach,colon-rectum,bladder and breast,but seldom in other parts.This article analyzes the clinical and pathologic features of 3 extremely rare cases of primary signet-ring cell carcinoma in the uterus.Methods: Three cases of primary signet-ring cell carcinoma in the uterus were observed by HE and immunohistochemical staining,their clinical features analyzed and the relevant literature reviewed.Results: Of the 3 cases,2 presented nodose tumors in the cervix while the other in the uterine cavity.Histologically,there was a diffuse infiltration of the tumor cells,with an appearance of signet-ring cells.Periodic acid-Sciff(PAS) staining revealed PAS-positive diastase resistant introcytoplasmic material.Immunohistochemically,the tumor cells were positive for CK and CEA.Conclusion: Primary signet-ring cell carcinoma of the uterus is extremely rare.It is always necessary to rule out a metastatic neoplasm by clinical examination and to differentiate it from other tumors/lesions with signet-ring cell features.

Objective: To investigate the possible association between globus pharyngeus and thyroid abnormalities. Methods: Forty six patients with globus pharyngeus and 50 non globus pharyngeus patients were investigated by using 7.5 MHz high resolution thyroid ultrasound. The micro abnormatities in 2 groups were compared. Results: The incidence of thyroid abnormalities in globus pharyngeus group was 58.9%(27/46),and it was significantly higher than that(18.0%,9/50)in non globus pharyngeus group( P

OBJECTIVE: To study the effect of MDR1 (P-gp) and ABCG2 on the drug resistance in Hep 2 cells. METHOD: Flow cytometry was used to detect the variations of the antitumor drugs accumulation and discharging, and activity variations when MDR1 and ABCG2 inhibitors were used in Hep-2. RESULT: The accumulation and discharging of mitoxantrone was significantly higher than the control group when ABCG2 inhibitor FTC was used in Hep-2 (P<0. 05). In contrast, P-gp did not appear similar case; To the mitoxantrone and cisplatin, there was no statistical correlation about activity of Hep-2 between P-gp or ABCG2 antagonist and the control; To the doxorubicin, combining FTC and P-gp, the activity of Hep-2 was higher than the control and difference was significant (P<. 05), In contrast, FTC and P-gp did not appear similar case when used alone; To the 5-FU, when PGP used, the activity of Hep-2 was higher than that in the control and difference was significant (P<0. 05), In con- trast, FTC and FTC+P-gp did not appear similar case; To the paclitaxel, when P-gp or FTC+P-gp used, the activity of Hep-2 was higher than that in the control and difference was significant(P<0. 05). CONCLUSION ABCG2 may lead to drug resistance mainly by changing the ability of cell in accumulating and discharging chemotherapy drugs. P-gp has other way. P-gp and ABCG2 play different roles in different drug resistance.
ATP Binding Cassette Transporter, Subfamily B ; metabolism ; ATP Binding Cassette Transporter, Subfamily G, Member 2 ; ATP-Binding Cassette Transporters ; metabolism ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Doxorubicin ; pharmacology ; Drug Resistance, Neoplasm ; Humans ; Mitoxantrone ; pharmacology ; Neoplasm Proteins ; metabolism ; Paclitaxel ; pharmacology

Objective To investigate the clinical feature,diagnosis,treatment and prognosis of endometriosis of the bladder.Methods A retrospective study was conducted to review the clinical data of 10 patients with bladder endometriosis.Patient's age ranged from 30 to 48 years (with mean age of 38 years).Eight cases were admitted to hospital with urinary tract irritating symptoms during the menstrual period and 6 cases with hematuria; 2 patients without any symptoms were found through examination.The course of disease was 1-36 months (with mean of18 months).Ultrasound shows with low echo,single,wide base and no significant blood flow mass whose boundaries are less clear within the bladder wall.CT reveals soft-mass protruding into the bladder.Results Eight of the 10 patients were undergone partial cystectomy.And 2 cases was treated with transurethral resection.All cases were pathologically confirmed to be bladder endometriosis.Recurrence and ectopic lesion had not be found during follow-up period from 10 to 72 months (with mean of 30 ± 5.6 mon).Conclusions Endometriosis is a common disease in females in their reproductive years,but thebladder endometriosis is rare.The initial diagnosis needs to be made combining with imaging studies.It is confirmed by cystoscopy and pathological biopsy.Surgery is the option for the treatment of bladder endometriosis.

Objective To summarize the diagnosis and treatment strategy of the retroperitoneal fibrosis(RPF)associated with hydronephrosis.Methods The clinical data of 26 RPF cases treated from Jan.2005 to Mar.2012 were analyzed retrospectively.Early symptoms mainly included lumbar,flank,abdominal pain,nausea and vomit.Retroperitoneal mass was found in 12(46.2％)cases by ultrasonography,while in 23(88.5％)cases by CT.Results Ureterolysis with intra-peritoneal transposition was underwent in 10 cases who were followed up for 6-25 months,and no relapse was found.Ureterocystostomy was underwent in 1 cases for difficulty in ureterolysis who was followed up for 45 months,and no relapse was found.D-J stent inter-ureter drainage was performed in 15 cases,all of whom had replaced the D-J stent discontinuously except that 2 cases had ceased replacement successfully,and all of the obstruction were relieved during the follow-up period for 16-84 months post-operatively.Conclusions Retroperitoneal mass can be found by CT of abdomen effectively.The therapeutics should depend on the pathological condition of the retroperitoneal mass.Obstruction can be relieved effectively by both ureterolysis with intraperitoneal transposition and D-J stent inter-ureter drainage and replacement.The complication occurred in the replacement of D-J can be relieved or eliminated by all kinds of measures.The unimpaired kidney drainage should be paid attention in the follow-up.

To evaluate the effect of dexmedetomidine on prognosis after cardiac surgery with cardiopulmonary bypass (CPB) in the patients.For this retrospective study,753 patients of both sexes,aged 18-84 yr,who underwent cardiac surgery with CPB from September 2013 to May 2015,were divided into 2 groups depending on whether or not dexmedetomidine was used during surgical procedures:control group (group C,n=548) and dexmedetomidine group (group D,n =205).Propensity score matching analysis with preset caliper width was used.A total of 197 matched pairs were selected from the patients.The development of postoperative arrhythmia,in-hospital mortality,pulmonary infection after operation,and acute renal injury,length of intensive care unit stay,length of hospital stay and 30-day readmission to the hospital were collected.Compared with group C,the incidence of postoperative tachyarrhythmia and inhospital mortality rate were significantly decreased (P＜0.05),and no significant changes were found in the incidence of postoperative bradyarrhythmia,pulmonary infection after operation and postoperative acute renal injury,length of intensive care unit stay,length of hospital stay and rate of 30-day readmission to the hospital in group D (P＞0.05).Dexmedetomidine can effectively improve prognosis after cardiac surgery with CPB in the patients.

Objective To investigate the risk factors of acute kidney injury (AKI) in patients undergoing cardiac valve surgery with cardiopulmonary bypass (CPB).Methods A retrospective cohort database study was conducted, involving 1 349 patients undergoing heart valve surgery with CPB technique.Logistic regression was used to screen out the risk factors of AKI after the surgery.Results Of the 1 349 patients, the incidence of AKI in valve surgery was 28.4%.One year older (OR=1.05, 95%CI 1.03-1.06, P<0.001), diabetes (OR=2.11, 95%CI 1.22-3.68, P=0.008), anemia (OR=1.50, 95%CI 1.05-2.21, P=0.026), each additional basic serum creatinine of 1 mg/dl (OR=1.01, 95%CI 1.01-1.02, P=0.001), each additional operation time of 1 hour (OR=1.28, 95%CI 1.15-1.41, P<0.001), plasma transfusion during surgery (OR=1.50, 95%CI 1.14-1.97, P=0.004) were the independent risk factors for AKI in multivariate logistic regression model.Conclusion AKI is a common and serious complication following cardiac valve surgery.More attention should be paid to the patients with elder age, anemia, prolonged operation time, diabetes, increased basic serum creatinine and requirement of plasma transfusion during surgery.

In adult orbital diseases, thyroid associated ophthalmopathy (TAO) is of very high incidence rate, and it can seriously affect patients' appearance, eyesight and binocular visual function and so on, and significantly reduce the patients' quality of life.In addition to the common manifestations such as eyelid retraction, exophthalmos and strabismus, some TAO patients may suffer from obviously increased ocular pressure and even visual field damage, which are often ignored or missed in diagnosis and should be paid more attention to.The pathogenesis of elevated intraocular pressure in TAO is mainly related to the elevated episcleral venous pressure and the extraocular muscles.Because the elevated intraocular pressure resulted from TAO is secondary and its pathogenesis is complex, personalized treatment different from primary glaucoma therapy is needed.In this article, the epidemiology, pathogenesis and therapy of elevated intraocular pressure in TAO including medication, surgery, and radiotherapy were reviewed to provide reference for the clinical diagnosis and treatment for TAO.