Dynamic changes of vestibular autorotation test in patients with unilateral vestibular dysfunction during rehabilitation / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the dynamic changes of vestibular autorotation test (VAT) before and after vestibular rehabilitation treatment in patients with unilateral vestibular hypofunction (UVH). Methods: A retrospective study was carried out,48 patients who were diagnosed with UVH and under vestibular rehabilitation in department of otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2019 to January 2021 were enrolled. Among them, there were 21 males and 27 females, with an average age of 46.9 years old, including 25 cases of Meniere's disease, 13 cases of sudden deafness with vertigo and 10 cases of vestibular neuritis. The course of disease ranged from 5 days to 10 years. Demographic characteristics, detailed case data and routine examination were collected for the patients. The horizontal gain/phase, vertical gain/phase, and asymmetry of VAT at different frequencies before and after vestibular rehabilitation were collected. The absolute value of the difference between the measured value of 2.0-5.9 Hz before and after rehabilitation and the standard value were statistically analyzed. Results: Before vestibular rehabilitation, the incidence of abnormal gain was 62.5% (30/48), the incidence of abnormal phase was 56.3% (27/48), and the incidence of asymmetry was 16.7% (8/48). After 4-6 weeks of vestibular rehabilitation, the incidence of gain abnormality was 22.9% (11/48), the incidence of phase abnormality was 31.3% (15/48), and the incidence of asymmetry was 12.5% (6/48).The horizontal gain at frequency of 2.0-3.9 Hz showed statistically significant difference compared with before vestibular rehabilitation (P<0.05), and the horizontal gain at frequency of 4.3-5.9 Hz showed that there was no significant difference (P>0.05); the horizontal phase at 5.9 Hz showed that the difference was statistically significant (P=0.043), and there was no significant difference before and after rehabilitation treatment at 2.0-5.5 Hz (P>0.05); the vertical gain at 4.3 Hz showed the difference was statistically significant (P=0.020), and the remaining frequency showed no significant difference (P>0.05); No frequency of asymmetry and vertical phase showed the difference before and after rehabilitation was statistically significant (P>0.05). Conclusion: VAT can be used to monitor the change trend of multiple frequency bands before and after vestibular rehabilitation in UVH, in order to provide reference for the formulation of personalized rehabilitation strategies.

Progressive massive fibrosis in pneumoconiosis is mimicking lung malignancy on (18)F-FDGPET-CT: two cases report / 中华劳动卫生职业病杂志

Occupational pneumoconiosis is one of the main occupational diseases in China. Progressive massive fibrosis in pneumoconiosis should be distinguished from lung cancer for their similar imaging features which is often identified by (18)F-FDG PET-CT in clinic. Here we reported two cases of pneumoconiosis. Both of them were suspected of carrying malignant tumors by preoperative PET-CT exam, however, nodules in these two patients were all proved to be benign by intraoperative pathology which suggested that there is false-positive possibility in the distinguishment of pneumoconiosis nodules by (18)F-FDG PET-CT.

Lung transplantation as therapeutic option in acute respiratory distress syndrome for coronavirus disease 2019-related pulmonary fibrosis / 中华医学杂志(英文版)

BACKGROUND@#Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients.@*METHODS@#From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores.@*RESULTS@#Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation.@*CONCLUSIONS@#LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.

Caffeoyl quinic acids in Chrysanthemum morifolium improve LPS-induced HUVEC vascular endothelial cell injury by regulating ERK/MAPK signaling pathway / 药学学报

To explore the effect of total extract of Chrysanthemum morifolium on lipopolysaccharide (LPS)-induced acute lung injury in mice, we studied the effects of three caffeoyl quinic acids isolated from Chrysanthemum morifolium on vascular endothelial cell injury and their mechanisms of action. All animal experiments were carried out strictly in accordance with the National Animal Welfare Ethics and Protection Regulations. A mouse model of acute lung injury was established by intranasal instillation of LPS. After 6 days of oral administration of chrysanthemum extract, the lung wet weight/dry weight ratio, tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) were measured in mouse bronchoalveolar lavage fluid. Human umbilical vein endothelial cells (HUVEC) were serum starved for 12 h and treated with 2.5 μg·mL-1 LPS for 24 h to establish the in vitro model of vascular endothelial cell injury. After 24 h of treatment of caffeoyl quinic acids from Chrysanthemum morifolium, the levels of TNF-α, IL-6, IL-1β, vascular cell adhesion molecule-1 (VCAM-1) and endothelin-1 (ET-1) were measured by ELISA in the cell culture supernatant, the malondialdehyde (MDA) level was detected by TBA method, the superoxide dismutase (SOD) level was determined by hydroxylamine method, and the nitric oxide (NO) level was assayed by a one-step method. The levels of p-MEK1/2, MEK1/2, p-ERK1/2, ERK1/2, p-JNK, JNK, p-P38 and P38 of mitogen-activated protein kinase (MAPK) signaling pathway were detected by Western blot. The total extract of Chrysanthemum morifolium can significantly reduce the wet weight/dry weight ratio of lung in mice and the levels of TNF-α, IL-6 and IL-1β in alveolar lavage fluid. The caffeoyl quinic acids from Chrysanthemum morifolium significantly increased the levels of SOD and NO, decreased the levels of TNF-α, IL-6, IL-1β, VCAM-1, ET-1 and MDA, and significantly reduced the levels of p-MEK1/2, p-ERK1/2. In conclusion, total extracts of Chrysanthemum morifolium exhibit certain protective effect on mice with acute lung injury, and three caffeoyl quinic acids from Chrysanthemum morifolium may improve LPS-induced vascular endothelial cell injury by inhibiting inflammatory cytokines and oxidative stress, and regulating inter-cellular adhesion molecule and vasomotor factors through ERK/MAPK signaling pathway.

Lung transplantation in China between 2015 and 2018 / 中华医学杂志(英文版)

BACKGROUND@#Lung transplantation (LT) has been demonstrated as the only effective therapy for patients with end-stage lung diseases. Increasing listed lung transplant candidates and expanding volumes of lung transplant centers across China require well-organized programs and registry data collection based on the large population. This study aimed to summarize and analyze the data of LT development in China.@*METHODS@#We retrospectively collected and analyzed data from the China Lung Transplantation Registry (CLuTR). Key data were reported from the registry with transplant types, indications, donor and recipient characteristics, outcomes and survival. The survival Grade 0), renal insufficiency (estimated glomerular filtration rate <60 mL·min·1.73 m), were independently associated with a higher risk for 3-year mortality in the entire cohort.@*CONCLUSIONS@#Facing more end-stage of lung diseases and comorbidities, this study analyzed the outcomes and survival of LT recipients in China. Further prospectively stratified analyses with longer follow-up will be needed.

Paeoniflorin-6′-O-benzene sulfonate influences expression of CXCL12/CXCR4 in spleen of adjuvant-induced arthritis / 中国药理学通报

Aim To observe the expression of CXCL12 and its receptor CXCR4 in spleen of rats with adjuvant-induced arthritis (AA) and the effects of paeoniflorin-6′-O-benzene sulfonate (CP-25). Methods AA rats were induced using complete Freund's adjuvant and were randomly divided into normal group,AA group, CP-25 group (50 mg·kg-1) and methotrexate group (MTX,0.5 mg·kg-1),which were treated from d 14 to d 28. HE staining was used to assess the pathologi-cal changes of spleen. The expression of CXCL12 and CXCR4 in spleen was detected by ELISA,immunohis-tochemitry and Western blot. Results CP-25 (50 mg ·kg-1)alleviated the pathological changes of spleen and decreased the expression of CXCL12 and CXCR4 in spleen of AA rats. The pathological changes of spleen and the expression of CXCL12/CXCR4 in spleen revealed a positive correlation. Conclusions Increased expression of CXCL12 and its receptor CX-CR4 may be associated with the pathological changes of spleen in AA rats,which plays an important role in the pathogenesis of RA. CP-25 has obvious therapeutic effect on AA rats and its mechanism may be related to the inhibition of the expression of CXCL12 and CXCR4 in the spleen.

Bilateral lung transplantation for bronchiolitis obliterans after allogeneic bone marrow transplantation: a case report and literature review / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the feasibility and efficiency of lung transplantation in the treatment of bronchiolitis obliterans (BO) after allogeneic bone marrow transplantation (allo-BMT).</p><p><b>METHODS</b>We reported one case of bilateral lung transplantation for BO after allo-BMT and reviewed the related literatures.</p><p><b>RESULTS</b>A 23 year-old man diagnosed as BO after allo-BMT underwent a sequential bilateral lung transplantation through bilateral anterolateral thoracotomy without sternal division. The patient suffered from acute rejection on post-operation day (POD) 2, and cured by mechanical ventilation, large dose of methylprednisolone and gamma globulin. The patient was transferred out of the intensive care unit on POD 14 and discharged from the hospital on POD 43. Chest CT scans and pulmonary function tests showed good performance in 3 and 6 months follow-up period.</p><p><b>CONCLUSION</b>BO is one of the late common non-infectious pulmonary complication after allo-BMT. For patients who have no response to medication, lung transplantation is the only efficient treatment choice so far, which can prolong survival and improve the quality of life. However, limited by small samples, optimal surgery time and appropriate care of postoperative complications still need accumulation of experience by multicenter and large samples studies.</p>

Early cardiovascular complications post lung transplantation / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the early cardiovascular complications of patients underwent lung transplantation.</p><p><b>METHODS</b>The clinical records of 73 patients who underwent lung transplantation in Wuxi People's Hospital from September 2002 to September of 2010 were retrospectively analyzed. All patients were transferred to intensive care unit (ICU) after lung transplantation, received invasive monitoring (PICCO), mechanical ventilation, immunosuppressive therapy and measures to prevent ischemic reperfusion injury. The early cardiovascular complications after lung transplantation up to discharge from hospital were observed.</p><p><b>RESULTS</b>The postoperative mortality was 20.5% (15/73) within 30 days after surgery. Five patients died of cardiovascular reasons including 2 cases of pulmonary embolism and 3 cases of ventricular fibrillation. Cardiovascular complications during the early post-operation period included: paroxysmal atrial fibrillation (19 cases, 26.0%) and persist atrial fibrillation (1 case, 1.4%); atrial fibrillation and atrial flutter in 3 cases and persistent atrial flutter in 1 patient; ventricular fibrillation (3 cases, 4.1%); paroxysmal supraventricular tachycardia (3 cases, 4.1%); ventricular tachycardia (2 cases, 2.7%); bundle branch block (8 cases, 11.0%); intraventricular block(4 cases, 5.5%); left ventricular heart failure(4 cases, 5.5%), right heart failure(6 cases, 8.2%); pulmonary embolism (2 cases, 2.7%), deep venous thrombosis (1 case, 1.4%).</p><p><b>CONCLUSIONS</b>Atrial fibrillation is the most common cardiovascular complication post lung transplantation. Pulmonary embolism and ventricular fibrillation are not common but related with high mortality rate post lung transplantation.</p>

Lung transplantation for silicosis: a report of 5 cases / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the selection of recipients, operative technique, and perioperative management of lung transplantation for silicosis.</p><p><b>METHODS</b>Lung transplantations (LTx) were performed for five end-stage silicosis in our hospital who were diagnosed in accordance with recommendations of the local Prophylactic Therapeutic Institution for Occupational Diseases. The chest roentgenogram and high resolution CT showed somewhat pulmonary interstitial fibrosis, pulmonary emphysema and massive opacities. The mean pulmonary artery pressure (mPAP) was > 30mmHg, NYHA III or IV. Two patients received thoracic surgery prior to LTx, one patient was ventilator-dependent. One patient received bilateral sequence lung transplantation (BSLT) under extracorporeal membrane oxygenation (ECMO) support. Four patients received single lung transplantation (SLT), 3 under ECMO support.</p><p><b>RESULTS</b>Patient five died of multiple organ failure on postoperative day 8, the remaining four patients were discharged from hospital. During follow up, patient three died of severe infection 7 month postoperatively, the remaining three patients were alive for 5 years, 3 years and 2 years respectively, and lived good quality of life, especially with lower mPAP and improved lung function. Although our patients suffered low-grade chronic rejection with the manifestation of bronchiolitis obliterative syndrome (BOS).</p><p><b>CONCLUSION</b>Lung transplantation is a viable option for patients with end-stage silicosis, providing acceptable quality of life and survival. Both SLT and BSLT are satisfactory approach for end-stage silicosis,and long-term survival requires further investigations.</p>

Comparing the therapeutic effect of lung transplantation with the therapeutic effect of whole lung lavage for the patients with end-stage pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the therapeutic effects of lung transplantation (LTx) and whole lung lavage (WLL) for patients with end-stage pneumoconiosis.</p><p><b>METHODS</b>From June 2002 to February 2011, 5 cases with end-stage pneumoconiosis were treated with LTx and 12 cases with end-stage pneumoconiosis were treated with WLL. The clinical symptoms, pulmonary functions, pulmonary artery pressures, blood gas analysis, imagings of chest and survival status were retrospectively analyzed.</p><p><b>RESULTS</b>In LTx group, the clinical symptoms (cough, sense of suppression in the chest), pulmonary functions and blood gas indicators were improved, pulmonary artery pressures decreased to normal levels, the imaging of chest showed that the implanted lung inflated well and was with clear lung markings. But the contralateral lungs without treatment appeared the progression of disease in the imaging of chest. In WLL group, the clinical symptoms in a half year after treatment were improved but the symptomatic relief rate declined with time, the pulmonary functions in half year after treatment were improved but decreased after 2 years, the pulmonary artery hypertension enhanced generally, as compared with that prior to WLL. The disease progression in the chest imaging examination was not found in a half year after WLL, but appeared in 1 ∼ 2 years after WLL. During following-up. the mean survival times in LTx and WLL groups were 40.5 and 21.4 months, respectively. In LTx group, one patient died of multiple organ dysfunctions (MODS) caused by primary graft dysfunction (PGD), one case died of severe infection in seven months after LTx. Up to now, other 3 cases have survived for 65, 41 and 29 months, respectively. In WLL group, 3 cases died of pulmonary infection, 2 cases died of respiratory failure, one case died of heart failure and one case died of encephalon vascular accident, the mean survival time of these 7 patients was (19.0 ± 8.7) months. So far other 5 cases have survived for 7, 9, 13, 18 and 26 months, respectively.</p><p><b>CONCLUSION</b>LTx has greater risk of death during preoperative period, but patients after LTx may have long survival times with good quality of life. The clinical symptoms and pulmonary functions of patients can be improved temporarily after WLL, but the survival time of WLL is inferior to that of LTx.</p>

The cryosurgery of central lung cancer by rigid bronchoscopy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the method and effectiveness of rigid-bronchoscopic cryosurgery for advanced central lung cancer.</p><p><b>METHODS</b>Forty-eight patients were enrolled in this study from June 2002 to December 2008, including 33 male and 15 female. The average age was 70 years (ranged from 45 to 83 years old). For the 48 patients, 38 cases were patients with advanced central lung cancer who were not suitable for surgery, and the remaining 10 cases were patients with local recurrence in trachea or main bronchus postoperatively. Cryosurgery was performed 120 times for all patients, 2.5 times per patient on average. The trachea or bronchus station, symptom such as dyspnea, hemoptysis, respiratory function and quality of life were observed.</p><p><b>RESULTS</b>The unblocked ratio of trachea and bronchi was 97%. All patients got satisfied improvement ratio of symptoms, 87.5% for dyspnea, 72.9% for cough, 93.8% for hemoptysis and 62.5% for chest pain. Respiratory function tests showed that both the mean forced expiratory volume in first second and forced vital capacity got an improvement from (1.03+/-0.05) L to (1.85+/-0.13) L and from (1.69+/-0.18) L to (2.96+/-0.14) L respectively (P<0.01). Karnofsky score also got no less than 20 scores improvement. The Follow-up time was 6 to 62 months. The longest survival was 62 months. The median survival time was 20 months. There was no severe perioperative complications and mortality except for 3 cases of moderate exeduation.</p><p><b>CONCLUSIONS</b>Cryosurgery is easy to perform with minimal complications. Not only could it provide an effective and rapid control of symptoms caused by central lung cancer, it could also unobstructed bronchus promptly and improve patients' quality of life.</p>

Cross-talk between MEK1/2-ERK1/2 signaling and G protein-couple signaling in synoviocytes of collagen-induced arthritis rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Signaling pathways that regulate the production of cytokines and destructive enzymes have been implicated in rheumatoid arthritis (RA) pathogenesis. There are co-relations between signaling pathways. The aim of this study was to investigate interactions and cross-talks between MEK1/2-extracellular signal-related kinase (ERK1/2) signaling and G protein-couple signaling in synoviocytes of collagen-induced arthritis (CIA) rats by the stimulation of interleukin-1 (IL-1), U0126, isoprenaline hydrochloride and aminophylline respectively.</p><p><b>METHODS</b>Twenty Sprague-Dawley (SD) rats were induced by chicken type II collagen. Synoviocytes of CIA rats were isolated and cultured. The expressions of Gi, phosphorylated MEK1/2 (p-MEK1/2) and phosphorylated ERK1/2 (p-ERK1/2) were detected by Western blotting. cAMP level and protein kinase A (PKA) activity were measured by radioimmunoassay and kinase-glo luminescent kinase assay respectively.</p><p><b>RESULTS</b>There was remarkable inflammation in CIA rats accompanied by swelling paws, hyperplastic synovium, pannus and cartilage erosion. cAMP level and PKA activity of synoviocytes decreased. Gi, p-ERK1/2 and p-MEK1/2 increased. rIL-1alpha improved the expression of Gi, p-ERK1/2 and p-MEK1/2. cAMP and PKA increased with stimulation of rIL-1alpha. U0126 inhibited Gi, cAMP and PKA of synoviocytes stimulated by rIL-1alpha. Isoprenaline hydrochloride enhanced Gi, cAMP and PKA, but had no effects on p-MEK1/2 and p-ERK1/2. Aminophylline increased cAMP and PKA, but inhibited p-MEK1/2 and p-ERK1/2.</p><p><b>CONCLUSIONS</b>Mitogen-activated protein kinases (MAPKs) and G protein-couple signaling are associated with synovitis. There are cross talks between MAPKs and G protein-couple signaling. The two signaling pathways represent potential therapeutic targets for RA.</p>

Effects of paeoniflorin on the level of antibodies and cAMP produced by splenocytes in rats with adjuvant arthritis / 药学学报

This study is to investigate the effects of paeoniflorin (Pae) on the levels of related serum antibodies and cAMP of splenocytes in rats with adjuvant arthritis. Complete Freund's adjuvant was used to induce AA in rats. The level of circulating immune complexes in serum was determined by PEG6000 assay, and the levels of anti-C II antibody and anti-TB antibody in serum were measured by enzyme-linked immunosorbent assay (ELISA), the level of cAMP in splenocytes was measured by radioimmunoassay, separately. Pae (25, 50, and 100 mg x kg(-1)) and GTW (40 mg x kg(-1)) were given by intragastric administration for 7 days from the 17th day after immunization. Pae (50 and 100 mg x kg(-1)) reduced the levels of circulating immune complexes, anti-C II antibody and anti-TB antibody in serum in rats with adjuvant arthritis. The inhibition ratios of Pae groups to AA model group were dosage-dependent; Pae (12.5, 62.5, and 312.5 mg x L(-1)) decreased the elevated levels of cAMP in splenocytes in vitro. Pae (ig) decreased the levels of related serum antibodies and elevated the level of cAMP in rats with adjuvant arthritis.

Single lung transplantation with concomitant contralateral lung volume reduction for end- stage emphysema / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of single lung transplantation with concomitant contralateral lung volume reduction surgery (LVRS) for the management of end-stage emphysema.</p><p><b>METHODS</b>A 46 year-old patient with end-stage emphysema received right lung transplantation and LVRS through the bilateral anterior-lateral intercostal incisions simultaneously.</p><p><b>RESULTS</b>Hyperinflation of the native lung or mediastinal shift did not occur after the operation, and the transplanted right lung dilated well without suppression. Acute rejection was not observed and the patient weaned from tracheal intubation 60 h after operation and from ventilator 108 h postoperatively. Persistent air leak occurred after LVRS but closed after instillation of hyperosmotic glucose. The patient was discharged 45 days after operation with significantly improved pulmonary function and normal life.</p><p><b>CONCLUSION</b>Single lung transplantation with concomitant contralateral lung volume reduction for emphysema eliminates such complications of single lung transplantation as native lung hyperinflation, mediastinal shift, excessive suppression of the transplanted lung and hemodynamics instability, and can improve the success rate of the operation.</p>

Heart and lung transplantation from the same donor to different recipients at the same time:report of 6 cases / 中华器官移植杂志

Objective To improve the efficiency of donated organs and to investigate the possi- bility and operation protocol of heart and lung transplantation from the same donor to different reci- pients.Methods The organs of heart and lung were obtained from three donors through the method of orthotopic lavage and whole cutting,and transplanted to end-stage patients with heart diseases or lung diseases.First,the donor was subjected to mechanical ventilation,thoracotomy and lavage of heart and lung.The heart and lung were cut in whole and separated.The recipients were subjected the re- trograde lavage of heart and lung.In the patients receiving unilateral lung transcription,the left and right lungs were isolated.Among 3 recipients of lung transcription,one underwent left unilateral lung transplantation and 2 bilateral lung transplantation.Three cases received orthotopic cardiac transplan- tation by using bicaval orthotopic heart transplantation (BOHT) anastomosis method.Results One recipient of left unilateral lung transplantation recovered well after operation.In one recipient under- going bilateral lung transplantation,right upper lung embolism occurred.After re-operation of cutting the right upper lung on the 9th day of the first one,he recovered from the illness.In another recipient receiving bilateral lung transplantation,anastomotic stenosis of trathea and pulmonary infection occurred after operation.After expectant treatment,he recovered from the illness,but died from serious infection 7 months after operation.One of the heart recipients was found having renal failure of first stage,and recovered from disease after hemodialysis treatment.Quality of life was good in all 3 heart recipients after operation and their heart function achieved the restoration of 0-Ⅰstage.Conclusion The treatment protocol of transplantation from the same donor to different recipients at the same time, which can make full use of the organs from donors,is feasible and has good effect.

The operative technique selection of lung transplantation for end-stage emphysema / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the operation of lung transplantation for end-stage emphysema.</p><p><b>METHODS</b>From September 2002 to February 2005, 9 patients with chronic obstructive pulmonary disease (COPD) underwent lung transplantation. The types of surgery included single lung transplantation in 2 patients, lung transplantation with asynchronous contralateral lung volume reduction (one week later) in 1, single lung transplantation with synchronized contralateral lung volume reduction in 4, and bilateral sequential lung transplantation without cardiopulmonary bypass in 2.</p><p><b>RESULTS</b>The volume of chest drainage was more than 2000 ml at the first postoperative day in 2 patients, one was reoperated for hemostasis and another was successfully responded to conservative therapy. The ventilation time was ranged from 3 to 22 days postoperatively. Two patients were received tracheotomy. Seven patients achieved good results, two of them had returned to work, and 1 patient had lived for 30 months. One patient was died of severe acute rejection (4A) at 15th postoperative day and 1 succumbed to multisystem organ failure due to severe bacterial infection combine fungal infection.</p><p><b>CONCLUSION</b>End-stage emphysema is an indication for single lung transplantation. Single lung transplantation with contralateral lung volume reduction is a good way to utilize donor. If patient suffered from infection, double-lung transplantation should be considered first.</p>

Single-lung transplantation for end-stage emphysema / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate operative technique, patient selection and perioperative management of single-lung transplantation for a patients with end-stage emphysema.</p><p><b>METHODS</b>A 56-year-old patient with end-stage emphysema underwent left-lung transplantation on September 28, 2002. The surgical technique used was similar to that mentioned in the literature. The donor lung was perfused by LPD solution with a cold ischemic time of 260 minutes. Cardiopulmonary bypass was not performed.</p><p><b>RESULTS</b>The patient weaned from a ventilator at the 93th hour after operation. Immunosuppressants included cyclosporine, mycophenolate mofetil and corticosteroid. Acute rejection occurred on the ninth day after operation and was cured by bolus methylprednisolone given intravenously. Lung function was improved significantly and the patient was discharged from the hospital on the 47th day after operation.</p><p><b>CONCLUSION</b>Single-lung transplantation for patients with end-stage emphysema is effective for long-term improvement of pulmonary function.</p>

The early etiological diagnosis and endovascular embolization therapy of Hunt-Hess Ⅳ—Ⅴ grade subarachnoid hemorrhage / 中华放射学杂志

Objective To explore the methods of early etiological diagnosis and principles of endovascular embolization in Hunt-Hess Ⅳ—Ⅴ grade subarachnoid hemorrhage(SAH),and to evaluate the therapeutic efficacy.Methods Thirty-one patients underwent imaging examinations such as CT and DSA to make the early diagnosis of SAH.Meanwhile,Guglielmi detachable microcoil(GDC)was used to applying aneurysmal intracapsular embolization in the ruptured aneurysms,and efficient symptomatic treatment was adopted early postoperatively.The results were tested by ?~2 test.Results All 31 cases were diagnosed early and operated successfully.Among them,the aneurysm lumen was 100% occluded in 26 cases,95% occluded in 3 cases;90% occluded in 2 cases.There were 5 cases complicating with cerebral vasospasm.One case recurrent was cured with secondary complementary GDC embolization.Nine cases(29.0%)had permanent sequelae associated with SAH.According to the Glasgow prognosis score, the therapeutic efficacy was as following:6 patients were in grade Ⅰ,9 in grade Ⅱ,4 in grade m,2 in grade Ⅳ,and 10 in grade Ⅴ;10 patients died,and the morality rate was 32.3%.None of them exhibited re-bleeding with follow-up period of 3 to 68 months postoperatively.Morality rates were significantly different between the group with aneurysmal diameter of 11—25 mm and the group of 5—10 mm(?~2=6.60,P