Chronic lung allograft dysfunction (CLAD) is a common complication after lung transplantation, which severely impairs the long-term survival of patients. At present, effective therapeutic approaches remain lacking. Dysregulation of the lung microbiome acts as a pathogenic factor for a variety of pulmonary diseases. Accumulating studies have demonstrated that the compositional characteristics of the lung microbiome after lung transplantation are closely associated with CLAD. Therefore, this article reviews the definition of CLAD, characteristics of the lung microbiome, the influence of the lung microbiome on the occurrence and progression of CLAD, the potential mechanisms underlying the lung microbiome in the pathogenesis of CLAD, and microbiome-based intervention strategies for CLAD. It aims to provide novel insights for the prevention and treatment of CLAD following lung transplantation and further improve the prognosis of lung transplant recipients.

10.3969/j.issn.2095-4344.2013.26.015

Objective To improve the traditional percutaneous cholecystolithotripsy in order to elevate the success rate and to discuss its indications. Methods With selfmade apparatus, we modified the open procedure which is otherwise impossible in removing the stones. We have followed 120 patients for 3 to 36 months to look into the recurrence of cholelithiasis. Results We have succeeded in 287 operations in a total of 291 (98 6%) cases. Among which 99 cases (34 5%) received modified open procedures, and the postoperative course was all uneventful. 120 patients were followed up postoperatively from 3 to 36 months and the stone recurrence rate was 13 3% (16 cases). Statistical analysis showed that the stone recurrence rate in patients with 3 stones and up, or poor gallbladder function was significantly higher than those with less than 3 stones and or good gallbladder function.Conclusions The percutaneous cholecystolithotripsy with improved procedures can effectively increase the success rate of operation. According to our result the indications should be restricted to those with less than 3 stones and or with good gallbladder functions.