Breast cancer is a female malignant tumor with the highest incidence rate worldwide, and surgery-based comprehensive treatment is the main treatment mode. Radiotherapy after total mastectomy can improve the regional control rate and survival rate of high-risk patients with lymph node positive breast cancer. With the improvement of survival, patients have increasing demand for the quality of life and cosmetic effects. Breast reconstruction after total mastectomy improves the quality of life of patients. The utilization of immediate breast reconstruction following mastectomy in breast cancer has been steadily increasing, which poses significant challenges for adjuvant radiotherapy if indicated. Radiotherapy is known to increase the risk of complications in the reconstructed breast, and the type of reconstruction and heterogeneity of radiotherapy can impact the outcomes of the reconstructed breast. In this article, we briefly review the principal factors influencing the complication risk of reconstructed breast after radiotherapy, and the appropriate radiation target delineation, dose fractionation and techniques. Furthermore, we provide an overview of the research in preoperative radiotherapy in the setting of immediate breast reconstruction.

Antibody-mediated rejection (AMR) is a rare and serious complication after lung transplantation, with no characteristic of pathological manifestation, no systematic standard treatment, and the poor efficacy and prognosis. We reported a case of early AMR after lung transplantation and the relevant literature has been reviewed. A male patient presented with symptoms of cold 99 days after transplantation and resolved after symptomatic treatment. He admitted to the hospital 14 days later because of a sudden dyspnea and fever. Anti-bacteria, anti-fungi, anti-virus, and anti-pneumocystis carinii treatment were ineffective, and a dose of 1 000 mg methylprednisolone did not work too. The patient's condition deteriorated rapidly and tracheal intubation was done to maintain breathing. Serum panel reactive antibody and donor specific antibody showed postive in humen leukocyte antigen (HLA) II antibody. Pathological examination after transbronchial transplantation lung biopsy showed acute rejection. Clinical AMR was diagnosed combined the donor-specific antibody with the pathological result. The patient was functionally recovered after combined treatment with thymoglobuline, rituximab, plasmapheresis, and immunoglobulin. No chronic lung allograft dysfunction was found after 3 years follow up. We should alert the occurrence of AMR in lung transplantation recipient who admitted to hospital with a sudden dyspnea and fever while showed no effect after common anti-infection and anti-rejection treatment. Transbronchial transplantation lung biopsy and the presence of serum donor-specific antibody are helpful to the diagnosis. The treatment should be preemptive and a comprehensive approach should be adopted.
Graft Rejection ; Graft Survival ; HLA Antigens ; Humans ; Isoantibodies ; Lung Transplantation/adverse effects* ; Male

To analyze the components of tumor infiltrating T lymphocyte (TIL) cells in malignant pleural effusion of lung adenocarcinoma, and evaluate their killing activities to autologous tumor cells. 
 Methods: Malignant pleural effusions were collected from 17 patients with lung adenocarcinoma. Mononuclear cells were isolated by Ficoll density gradient centrifugation and flow cytometer was used to analyze TIL cell components. TIL and tumor cells were separated through adherent culture. The tumor cells were identified via intramuscular injection of adherent cells into nude mice and the killing effect of cultured lymphocytes on autologous tumor cells was studied.
 Results: Of the TIL in malignant pleural effusions, T cells accounted for 60.6%-79.3%, while T helper cells were significantly higher than T killer cells (36.63%±1.90% vs 24.64%±2.32%, P<0.001). There were also natural killer (NK) cells and NK T cells in the effusions. Tumor cells were successfully isolated and cultured. The killing activity of cultured TIL to autologous tumor cells was 39.14%±12.04%, and the killing activity of TIL with high proliferation rate to autologous tumor cells was higher than that of low proliferation group (50.51%±3.80% vs 29.04%±5.77%, P<0.001).
 Conclusion: T lymphocytes are the major components of TIL in malignant pleural effusions derived from lung adenocarcinoma, and T helper cells are more than T killer cells. The killing activity of TIL with strong proliferation ability to autologous tumor cells is higher than that of TIL with weak proliferation ability. Therefore, cells from malignant pleural effusions could be used for cellular immunotherapy against tumor.
Adenocarcinoma of Lung ; Animals ; Cytotoxicity, Immunologic ; Humans ; Interleukin-2 ; Lung Neoplasms ; Mice ; Mice, Nude ; Pleural Effusion, Malignant ; T-Lymphocytes