Lung cancer is the most prevalent malignant tumor worldwide. For lung cancer patients with multiple intrapulmonary metastases or impaired lung function, complete tumor resection is challenging, and the prognosis is poor. Lung transplantation demonstrates potential therapeutic value in achieving complete tumor resection, improving lung function, and enhancing quality of life. Advances in tumor detection technologies such as positron emission tomography-computed tomography and circulating tumor DNA, along with the development of comprehensive treatment strategies for lung cancer, provide powerful tools for accurately predicting tumor recurrence and treatment outcomes following lung transplantation. The feasibility of lung transplantation as a treatment for lung cancer is receiving increasing attention. This article reviews the history and clinical management of lung transplantation for lung cancer.

Objective:To explore the impact of early and late antibody-mediated rejection (AMR) on treatment options and allograft outcomes after kidney transplantation (KT).Methods:From January 2013 to December 2022, the study retrospectively enrolled 141 KT allograft recipients receiving allograft biopsy and diagnosed as AMR according to the Banff 2019 criteria. Recipients with a diagnosis of AMR within 30 days post-KT were classified into early AMR group (n=19) while the remainders assigned as late AMR group (n=122). The outcome endpoints included recipient survival rate, death-censored graft survival rate, follow-up estimated glomerular filtration rate (eGFR) and immunodominant donor-specific antibody (DSA) intensity. Wilcoxon's test was utilized for assessing the differences in eGFR and DSA intensity while Kaplan-Meier curve and Log-rank test were employed for evaluating graft survival impact. Treatment regimens for AMR were collected and categorized.Results:The median follow-up duration was 2.6(1.2, 5.2) year. No graft failure was noted in early AMR group while 44 recipients in late AMR group experienced graft failure, with 34 cases (77.2%) due to AMR progression. The 5-year death-censored graft survival rate was significantly better in early AMR group than that in late AMR group [100% vs 60.1%(50.5%, 71.6%), P=0.002]. The one-year change in eGFR for early AMR group was significantly superior to that of late AMR group [19.3(-2.6, 38.1) vs -3.3(-14.0, 5.4), P=0.001]. One-year mean fluorescent intensity (MFI) of early AMR group was 1 158(401.5, 3 126.5). It was significantly lower than that when diagnosed with early AMR [3 120.5(2 392.8, 9 340.0)] and one-year MFI of late AMR group [8 094(2 251.5, 13 560.5)] ( P=0.005, P<0.001). Early AMR group primarily received standard treatment (3/19, 15.8%) and regimens centered on rituximab and/or bortezomib (7/19, 43.8%). Late AMR group mainly received standard (16/122, 13.1%) or intensified regimens (9/122, 7.4%) and regimens focused upon rituximab and/or bortezomib (32/122, 26.2%) and MP monotherapy (21/122, 17.2%). Conclusion:The outcome for early AMR is significantly better than that for late AMR. For early AMR, early and robust immunosuppression is recommended. For late AMR, early detection and timely treatment are crucial and individualized strategies should be implemented.

Objective:To explore the morbidity features and therapeutic outcomes of rejections in pediatric kidney transplantation (KT) recipients.Methods:Between January 2013 and June 2022, 360 children undergoing KT were recruited.The relevant clinical data were collected for examining the morbidity features and therapeutic outcomes of rejections.The serum levels of creatinine were compared among groups by non-parametric rank test.And Kaplan-Meier and Log-rank methods were employed for examining the incidence of rejection and comparing mortality-censored graft survival rates among patients with different times of rejection.Results:A total of 58 recipients had 82 incidents of rejection with a cumulative incidence of 6.3%, 9.2% and 11.3% at 3/6/12 months respectively.Among 50 incidents of biopsy-proved rejections, the types were T cell-mediated rejection [TCMR, 42.0%(21/50)], antibody-mediated rejection [20.0%(10/50), ABMR] and mixed rejection [38.0%(19/50)].Among 58 incidents of initial rejection, 69% had maintained graft function (MGF) and 31% impaired graft function (IGF) after anti-rejection regimens.Among 80.8%, 85.7% and 75% of recipients with clinical rejection, ABMR or borderline rejection while 36.4% in TCMR patients had MGF.Fifteen kidney allografts lost function in 58 recipients with rejection.Five-year death-censored graft survival was significantly lower in patients with two or more incidents of rejection (30.5%, 95% CI: 12.3%-75.4%) than in those without rejection (92.9%, 95% CI: 89.3%-96.6%) ( P<0.000 1) or with only one rejection (82.9%, 95% CI: 65.9%-100%)( P<0.001). Conclusions:The rejection rate remains high in KT children and it affects graft survival.And TCMR is more likely to cause impaired graft function.Recurrent rejections have a more pronounced impact upon graft survival.

Objective: To gain a better understanding of the emotional and behavioral problems associated determinants of primary and middle school students from Guangdong Province during the COVID-19 pandemic, so as to provide a basis for developing targeted intervention strategies. Methods: Using the method of convenience sampling, an online questionnaire survey was carried out among primary and middle school students from Guangzhou, Zhanjiang and Zhongshan from March to April 2020. The emotional and behavioral problems of primary and middle school students were assessed using the Conners Parental Symptoms Questionnaire(PSQ), and a self compiled questionnaire was used to collect basic information related to the primary and middle school students and the influencing factors of emotional and behavioral problems. A total of 7 755 valid questionnaires were retrieved and statistically analyzed using the chi square test and multivariate Logistic regression. Results: The detection rate of emotional and behavioral problems among children and adolescents aged 6 to 17-years-old in Guangdong Province was 14.8%; that was 21.0%, 14.4%, 7.3 %, and 10.1% in lower primary school students, upper primary school students, junior high school students, and high school students, respectively. The detection rate of the psychosomatic and hyperactivity index in boys was higher than that observed in girls, and the detection rate of anxiety in boys was lower than that observed in girls( P <0.05). There were statistically significant differences in emotional and behavioral problems in children in different grades( P <0.05). The results of the regression analysis showed that male students were at risk of psychosomatic ( OR= 1.37 , 95%CI =1.04-1.82) and hyperactivity disorders( OR=1.58, 95%CI =1.21-2.06), whereas the male gender was a protective factor for anxiety( OR=0.50, 95%CI =0.39-0.64). Grades were identified as the influencing factors of all of the factors related to emotional and behavioral problems. Students who reported excessive screen time and insufficient sleep were more likely to experience emotional and behavioral problems. Conclusion The detection rate of emotional and behavioral problems among primary and middle school students in Guangdong Province during the COVID-19 epidemic was high, which was associated with sex, grade, screen time and sleep. It is necessary to develop and implement targeted intervention measures.

: To investigate the current status of online classes, screen time and its influencing factors among primary school students in Guangdong during the 2019 novel coronavirus pandemic. Methods: Using the convenience sampling method, a total of 5 266 pupils aged 6-12-years-old from Guangzhou, Zhanjiang, and Zhongshan participated in the online questionnaire. ANOVA or chi square tests were performed to compare differences in online classes and screen time between grades, and multinomial Logistic regression was performed to analyze the correlates of recreational screen time. Results: The prevalence of prolonged recreational screen time was 42.2% and 55.2% on weekdays and weekends, respectively. Recreational screen time increased by 40.31 min/d on weekdays and 33.07 min/d on weekends, compared to usual school semesters. The average duration of an online class was (26.07±9.62) min, which totaled (110.41±51.98)min per day. Sex, grade, being the only child, and parents education levels were identified as the influencing factors of prolonged recreational screen time. Children who practiced moderate levels (weekdays: OR =1.27; weekends: OR =1.40; P <0.05) or lower levels of physical activity (weekdays: OR =1.86; weekend: OR =1.84; P < 0.05 ) were at a higher risk of prolonged recreational screen time than those who practiced more vigorous physical activity. Children whose parents limited their screen time to a moderate (weekdays: OR=1.61, P <0.05) or lower level (weekdays: OR=1.32, P < 0.05 ) had a higher risk of prolonged recreational screen time than those with a higher frequency. Children with parents recreational screen time ≥ 2 h/d had a higher risk of prolonged recreational screen time than the reference group; children who exhibited moderate to vigorous levels of physical activity <1 h/d (weekdays: OR=1.31, P <0.05), and those used electronic devices for learning 1-2 h/d (weekdays: OR =2.65; weekend: OR =2.65; P <0.05) or for ≥2 h/d (weekdays: OR =4.05, weekend: OR=5.24, P < 0.05 ) were at a higher risk of prolonged recreational screen time than the reference group. Conclusion During the COVID-19 pandemic, the level of screen time among children in Guangdong was high. Behavioral monitoring and targeted interventions are needed to promote children s health.

Objective: To explore the longitudinal association of the levels of plasma irisin among children with changes in obesity related parameters and newly onset obesity, and to explore whether physical activity (PA) and sedentary behavior(SB) have regulatory effects, to provide a scientific basis for the prevention and control of childhood obesity work. Methods: Cluster random sampling method was used to select 521 children from five schools in Guangzhou in 2017 at baseline and were followed up in 2019. A based on baseline PA and SB, children who meet the following criterion were selected:moderate vigorous intensity PA≥60 min/d or <150 min/week; and gender , age specific SB≥ P 75 or SB < P 25 . Plasma irisin concentration was measured in all the selected children. Multiple linear regression and Logistic regression were conducted to analyze the association. Results: The two year cumulative incidence of obesity, overweight and obesity, and central obesity was 2.82%, 6.57%, and 6.81%, respectively. There was no statistically significant association between plasma irisin levels and changes in obesity related parameters, newly onset overweight obesity or central obesity among children ( P >0.05). After stratified by PA, the irisin concentration in the low PA group was positively associated with weight change ( B=0.229, P =0.03). After stratified by SB, the irisin concentration in the low SB group was positively associated with the height change ( B=0.210, P <0.05). In addition, PA level and SB level both had a moderating effect on the association between plasma irisin levels and the weight change ( P PA=0.01, P SB =0.05). Conclusion PA and SB show moderating effect on plasma irisin concentration and weight gain. No association of irisin concentration with newly onset overweight or obesity among children has been found.

Objective: to investigate the risk factors of postoperative local infection in patients with polytetrafluoroethylene implant in rhinoplasty, and to provide evidence for reducing the risk of postoperative infection. Methods: Retrospective analysis of 923 cases of rhinoplasty implanting ePTFE prosthesis were conducted, those related factors included were as follows: gender, age, operation, history of nasal surgery, nasal pore bulky excessive sebum secretion, cartilage cap on the tip-defining points, columella support, nasal septum cartilage harvest, extend the septum cartilage transplantation, interdomal fat pad resection, adjust the alar cartilage, reduce the ala nasi, severe postoperative swelling, prevention of postoperative infection duration, postoperative folliculitis, nasal vestibular mucosa was damaged postoperative, whether the surgical incision has abnormal healing and so on are being investigated and recorded, all of which were established as multivariate logistic regression model analysis of the risk factors for independent prognosis of postoperative infection. Results: The excessive sebum of the nasal pores, adjustment of the alar cartilage and the postoperative nasal collision are the independent risk factors for postoperative infection(P<0.05). Conclusions Patients with large nasal pores and sebum secretion are more likely to render infection after operation. Partial separation and partial nasal resection of nasal alar cartilage and postoperative nasal impact will increase postoperative risk of infection.

Objective To analyze the willingness and influencing factors for usage of pre-exposure prophylaxis(PrEP) among male students who have sex with men (MSM) in universities of Guangxi. Meth-ods 295 MSM students in universities were recruited by Snow-balling methods. Questionnaires were self-administered to collect social demographic information,AIDS related risky sexual behaviors and willingness for usage of PrEP. Logistic regression was employed for univariate and multivariate analysis. Results Of the 295 MSM,58(19.7%)had ever heard PrEP,265(89.8%) said that they would like to use PrEP. Multivari-ate logistic regression analysis showed that those who had found partners through friends ( OR=11.419,95%CI:1.363~95.641), those who would advise his friend to use PrEP ( OR=87.946,95%CI:13.660-566. 222),those who concerned the convenience to gain the medicine ( OR=119.652,95%CI:3.765-3802.184) and those who said that they could take medicine every day ( OR=88.245,95%CI:10.237-760.696) were more likely to accept PrEP. The subjects whose partners would be angry if they stick to use condoms( OR=0.106,95%CI:0.019-0.606),and those who suspected the effectiveness of drugs( OR=0.010,95%CI:0. 001-0.112) were less likely to accept PrEP. Conclusion The acceptability of PrEP is high in university students'MSM. The safety of drugs and the convenience to gain the medicine are the main influencing factors for usage of PrEP.Using of PrEP should be strengthened to the MSM.

OBJECTIVETo assess the methodological quality and reporting quality on Meta-analysis being published in the Chinese Journal of Gastrointestinal Surgery.

METHODSComputerized literature searching was carried out in Wanfang Medical Online to collect articles that Meta-analysis was used in the Chinese Journal of Gastrointestinal Surgery since it was founded till July, 2014. Manual retrieval was also conducted. Two researchers independently screened for literature and extracted data. Qualities on methodologies or on the processes of reporting and reviewing were evaluated by both AMSTAR and PRISMA scales.

RESULTSForty-two papers on meta-analyses were included in this study. Results on the quality of methodology evaluation showed that the lowest and highest scores were 6 and 9 respectively, the median score was 7. Two articles (4.8%) were rated as high, 40 articles (95.2%) as moderate and 0 articles (0%) as low. Although the quality of methodology was above the average, however, there were still some problems seen in some papers as the conflict of interest was not stated, the list of studies (included and excluded) was not provided, a comprehensive literature search was not performed, the likelihood of publication bias was not assessed, etc. Results on the quality of reporting evaluation showed that the lowest and highest scores were 14 and 22 respectively, the average score was 18.43 ± 2.03, 3 articles (7.1%) scored less than 15 points, 35 articles (83.3%) scored 15.5-21 points, and 4 articles (9.6%) scored 21.5-27 points. The included reviews had high quality on the titles of the report, inclusion criteria, rationale of introduction, synthesis of results, results of individual. However, the abstract, objectives of introduction, scheme and registered, inclusion criteria, research screening, additional analysis, conclusion limitations, funding support etc. were lack of comprehensive reports.

CONCLUSIONSArticles on Meta-analysis published in the Chinese Journal of Gastrointestinal Surgery are of high quality. The Chinese Journal of Gastrointestinal Surgery can provide better evidence for clinical decision to gastrointestinal surgeons. However, both of qualities on methodology and reports sill call for continuous improvement.

Objective To assess the methodological quality and reporting quality on Meta-analysis being published in the Chinese Journal of Gastrointestinal Surgery. Methods Computerized literature searching was carried out in Wanfang Medical Online to collect articles that Meta-analysis was used in the Chinese Journal of Gastrointestinal Surgery since it was founded till July , 2014. Manual retrieval was also conducted. Two researchers independently screened for literature and extracted data. Qualities on methodologies or on the processes of reporting and reviewing were evaluated by both AMSTAR and PRISMA scales. Results Forty-two papers on meta-analyses were included in this study. Results on the quality of methodology evaluation showed that the lowest and highest scores were 6 and 9 respectively, the median score was 7. Two articles (4.8%) were rated as high, 40 articles (95.2%) as moderate and 0 articles (0%) as low. Although the quality of methodology was above the average , however, there were still some problems seen in some papers as the conflict of interest was not stated , the list of studies (included and excluded) was not provided, a comprehensive literature search was not performed, the likelihood of publication bias was not assessed, etc. Results on the quality of reporting evaluation showed that the lowest and highest scores were 14 and 22 respectively , the average score was 18.43±2.03, 3 articles (7.1%) scored less than 15 points, 35 articles (83.3%) scored 15.5-21 points, and 4 articles (9.6%) scored 21.5-27 points. The included reviews had high quality on the titles of the report, inclusion criteria, rationale of introduction, synthesis of results, results of individual. However, the abstract, objectives of introduction, scheme and registered, inclusion criteria, research screening, additional analysis, conclusion limitations, funding support etc. were lack of comprehensive reports. Conclusions Articles on Meta-analysis published in the Chinese Journal of Gastrointestinal Surgery are of high quality. The Chinese Journal of Gastrointestinal Surgery can provide better evidence for clinical decision to gastrointestinal surgeons. However, both of qualities on methodology and reports sill call for continuous improvement.