[Pulmonary artery stenosis after single lung transplantation: a case report and literature review].

Objective: To summarize and analyze the clinical features, treatment, and prognosis of pulmonary artery stenosis post-lung transplantation. Methods: A 62-year-old male patient was admitted to the hospital with a cough and chest tightness of over a year's duration, which had worsened in the last two months, leading to the diagnosis of idiopathic pulmonary fibrosis. The clinical data were observed and reviewed post-left allograft single lung transplantation. Literature searches were conducted using the keywords "lung transplantation" "stenosis, pulmonary artery" and "postoperative complications" in CNKI, Wanfang Medical Network, and PubMed databases up to December 2022. Results: On January 26, 2022, a left allograft single lung transplantation was performed under general anesthesia. Postoperatively, extracorporeal membrane oxygenation and mechanical ventilation were successfully weaned off at 22 hours and 2 days, respectively, with transfer from the intensive care unit 12 days after surgery. PaO2 and PaCO2 were 50 mmHg and 40 mmHg after deoxygenation. Both pulmonary CT angiography and ventilatory-perfusion imaging indicated stenosis of the left pulmonary anastomosis. Balloon dilation and pulmonary artery stenting were performed, with PaO2 and PaCO2 improving to 87 mmHg and 42 mmHg, respectively. The patient was discharged 102 days post-surgery, and was followed up for 1 year, with a good prognosis. Additionally, 36 related articles were retrieved, encompassing 69 cases with a median age of 53 years (38.5-59.0 years). Of these, 27.54% (19/69) were diagnosed with idiopathic pulmonary fibrosis, 46.38% (32/69) underwent single lung transplantation, with the primary clinical symptom being hypoxemia in 71.01% (49/69) cases. Left pulmonary artery anastomotic stenosis was observed in 43.48% (30/69), with 65.22% (45/69) being diagnosed in the late postoperative period. Interventional therapy was performed to 44.93% (31/69), with a mortality rate of 21.74% (15/69). Conclusions: The primary clinical manifestation of post-lung transplantation pulmonary artery stenosis is hypoxemia and can be diagnosed by pulmonary artery CT angiography, transesophageal echocardiography, and pulmonary angiography. Early diagnosis can significantly reduce mortality, and interventional therapy is an effective treatment for severe pulmonary artery stenosis post-lung transplantation.

[Lung transplantation for pulmonary alveolar proteinosis: a case report and literature review].

Objective: To observe the efficacy of lung transplantation for pulmonary alveolar proteinosis (PAP) patients and to improve the understanding of the therapy. Methods: The clinical data of a patient with autoimmune PAP treated with sequential homogenous bilateral lung transplantation were described and the literatures were reviewed. Results: This 55-year-old female patient was diagnosed with autoimmune PAP and had been treated with whole lung lavage for 19 times, but only achieved short-term symptomatic relief after each operation. Inhalation of granulocyte macrophage colony stimulating factor occurred allergic reactions. Lung transplantation was performed on February 15, 2022, and a significant improvement in oxygenation and clinical symptoms were observed. The patient remained stable during follow-up. Conclusion: Treatment with lung transplantation is safe and effective for end-stage patients with PAP in the early phase, but the long-term effect remains to be observed.

[Analysis of gadolinium magnetic resonance in inner ear by tympanic membrane puncture in 1 126 cases].

Objective: To investigate the success rate, safety and repeatability of gadolinium (Gd)-enhanced inner ear magnetic resonance (MR) by tympanic membrane puncture. Methods: The imaging and clinical data of 1 126 cases with Gd-enhanced inner ear MR by tympanic membrane puncture from February 2010 to June 2020 were retrospectively analyzed. All cases were reexamined in the outpatient clinic after MR gadolinium contrast to check the tympanic membrane and external auditory canal. The success rate was identified by whether there was gadolinium contrast in the labyrinth. Meanwhile, the pure tone hearing threshold data of asymptomatic ears before and after gadolinium contrast was collected and compared. The consistency in the scores of the asymptomatic ears in patients who underwent twice Gd-enhanced MR was analyzed, in which the scores of vestibular, cochlea, and semicircular canals were acquired respectively. Results: Among 1 126 patients [including 506 males and 620 females, aged (54±17) years old], 45 were reviewed once, while 4 patients were reviewed twice. There were 958 cases who were examined on both sides, and 168 cases were checked only on one side. There were 166 cases of Meniere's disease (14.7%), 219 cases of sudden sensorineural hearing loss (19.5%) and 741 cases of being remained to be investigated (65.8%), respectively. A total of 2 084 ears underwent first gadolinium angiography, of which 63 ears had no contrast agent in the labyrinth, with a success rate of 97.0% (2 021/2 084). Only 1 case had tympanic membrane perforation while the rest had no complications. The hearing threshold before and after otography in 57 asymptomatic ears had no differences at any frequency (all P>0.05). Moreover, the consistency in the scores of two radiography within the 21 asymptomatic ears in vestibular and cochlea was good [both intraclass correlation coefficient (ICC) values>0.75]. Conclusion: The success rate and safety of Gd-enhanced inner ear MR is high by tympanic membrane puncture, and the results can be repeated well.

[The network investigation on knowledge, attitude and practice about COVID-19 of the residents in Anhui Province].

Objective: To analyze the current situation of the knowledge, attitudes and practice about COVID-19 of the residents in Anhui Province. Methods: Anonymous network sampling survey was carried out with an electronic questionnaire that designed by the questionnaire star, and a total of 4 016 subjects from Anhui province were investigated. The content of the survey includes that the basic information of subjects,the residents' knowledge, attitudes and practice about COVID-19, as well as their satisfaction with the prevention and control measures adopted by the government and health authorities and the suggestions on future prevention. The questionnaire doesn't involve any privacy information, and all questions were mandatory to ensure the response rate. Results: The M (P(25), P(75)) age the 4 016 subjects was 21 (19, 24) years old, and the ranging from 7 to 80 years old. The number of males was 1 431 (35.6%). Social networking tools such as WeChat and QQ were the main sources of epidemic information for residents (97.8%, 3 929 respondents). Residents had higher awareness rate of cough (99.5%,n=3 997) and fever (96.0%, n=3 857) symptoms, the transmission by droplets (99.5%, n=3 995), aerosol transmission (81.1%, n=3 258), and contact transmission (92.3%, n=3 708), but lower awareness of symptoms os muscle pain or fatigue (62.7%, n=2 518). 92.6% of the subjects (n=3 720) think that the outbreak was scary. In terms of psychological behavior scores, the results showed that female (9.38±4.81), the urban (9.37±5.02) and the medical workers (10.79±5.19) had a poorer mental health than the male (8.45±5.00), the rural (8.71±4.75) and the non-medical workers (the students: 8.85±4.83; public institude workers: 9.02±5.08; others: 8.97±5.39) (P<0.05). 71.9% of the residents (n=2 887) were satisfied with the local epidemic control measures. The residents took various of the measures to prevent and control the epidemic. The ratio of residents that could achieve "no gathering and less going out" , "wear masks when going out " and " do not go to crowded and closed places " was up to 97.4% (n=3 913), 93.6% (n=3 758) and 91.5% (n=3 673) respectively. Conclusion: The residents in Anhui province have a good KAP about COVID-19, yet it is necessary to strengthen the community publicity, the mental health maintenance of residents and students' health education.

[The network investigation on knowledge, attitude and practice about Novel coronavirus pneumonia of the residents in Anhui Province].

Objective: To analyze the current situation of the knowledge, attitudes and practice about Novelcoronavirus pneumonia (NCP) of the residents in Anhui Province. Methods: Anonymous network sampling survey was carried out with an electronic questionnaire that designed by the questionnaire star, and a total of 4016 subjects from Anhui province were investigated. The content of the survey includes that the basic information of subjects,the residents' knowledge, attitudes and practice about NCP, as well as their satisfaction with the prevention and control measures adopted by the government and health authorities and the suggestions on future prevention. The questionnaire doesn't involve any privacy information, and all questions were mandatory to ensure the response rate. Results: The M (P(25), P(75)) age the 4016 subjects was 21 (19, 24), and the ranging from 7 to 80 years old. The number of males was1431(35.6%). Social networking tools such as WeChat and QQ were the main sources of epidemic information for residents (97.8%, 3 929 respondents). Residents have a high awareness rate of the main symptoms, transmission routes, using of masks, hand washing and treatment information of NCP, while a low awareness rate of the atypical symptoms. 92.6% of the subjects (n=3 720) think that the outbreak was scary. In terms of psychological behavior scores, the results showed that female (9.38±4.81), the urban (9.37±5.02) and the medical workers (10.79±5.19) had a poorer mental health than the male (8.45±5.00) , the rural (8.71±4.75) and the non-medical workers (the students: 8.85±4.83; public institude workers: 9.02±5.08; others: 8.97±5.39) (P < 0.05). 71.9% of the residents (n=2 887)were satisfied with the local epidemic control measures. The residents took various of the measures to prevent and control the epidemic. The ratio of residents that could achieve "no gathering and less going out" , "wear masks when going out" and "do not go to crowded and closed places" was up to 97.4% (n=3 913), 93.6% (n=3758) and 91.5% (n=3 673) respectively. Conclusion: The residents in Anhui province have a good KAP about NCP, yet it is necessary to strengthen the community publicity, the mental health maintenance of residents and students' health education.

[Sleep quality analysis in patients with unilateral idiopathic sudden sensorineural hearing loss].

Objective:To analyze the characteristics of sleep quality and its correlation with the clinical features and hearing curative effects in patients with unilateral idiopathic sudden sensorineural hearing loss (ISSHL). Method:Pittsburgh sleep quality index (PSQI) was applied to evaluate the sleep quality of unilateral ISSHL patients in our department. Patient group is divided into poor sleep quality subgroup (total PSQI score>7 points) and normal sleep subgroup (total PSQI score≤7 points). The differences of Patient group and two subgroups between hearing curative effect in the 30 days after treatment and sleep quality scores were compared and analyzed. Questionnaire survey was applied to control group, which contained 70 healthy people with normal hearing level and age matched. Result:A total of 75 cases were collected. To compare with control group, there were statistical difference in the scores of subjective sleep quality, habitual sleep efficiency, sleep disturbance and PSQI before treatment and in the score of habitual sleep efficiency after the treatment for 30 d (P<0.05). The sleep quality between poor sleep quality subgroup and normal sleep subgroup, total therapeutic effect after treatment for 30 d was no significant difference (P>0.05). The proportion for poor sleep quality were no statistically significant differences in the different efficacy of two subgroups (P>0.05). Two subgroups before treatment, in addition to sleep duration, there were statistically significant in all the sleep quality dimensions (P<0.05); after treatment for 30 d, in addition to subjective sleep quality, sleep duration, all have statistical difference (P<0.05). The poor sleep quality subgroup in the case group compared before and after treatment for 30 d, there was statistically significant in subjective sleep quality (P<0.05). The sleep disturbance before treatment, the sleep duration and PSQI scores after treatment for 30 d were associated with clinical features in patients with unilateral ISSHL (P<0.05). Conclusion:The sleep quality of patients with Unilateral SSNHL was significantly lower than that of normal hearing patients, the sleep quality had no significant effect on the general efficacy of unilateral SSNHL, but some sleep quality dimensions are associated with the clinical features before and after treatment.

Diagnostic value of three-dimensional magnetic resonance imaging of inner ear after intratympanic gadolinium injection, and clinical application of magnetic resonance imaging scoring system in patients with delayed endolymphatic hydrops.

OBJECTIVE: Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging of the inner ear after intratympanic injection of gadolinium, together with magnetic resonance imaging scoring of the perilymphatic space, were used to investigate the positive identification rate of hydrops and determine the technique's diagnostic value for delayed endolymphatic hydrops. METHODS: Twenty-five patients with delayed endolymphatic hydrops underwent pure tone audiometry, bithermal caloric testing, vestibular-evoked myogenic potential testing and three-dimensional magnetic resonance imaging of the inner ear after bilateral intratympanic injection of gadolinium. The perilymphatic space of the scanned images was analysed to investigate the positive identification rate of endolymphatic hydrops. RESULTS: According to the magnetic resonance imaging scoring of the perilymphatic space and the diagnostic standard, 84 per cent of the patients examined had endolymphatic hydrops. In comparison, the positive identification rates for vestibular-evoked myogenic potential and bithermal caloric testing were 52 per cent and 72 per cent respectively. CONCLUSION: Three-dimensional magnetic resonance imaging after intratympanic injection of gadolinium is valuable in the diagnosis of delayed endolymphatic hydrops and its classification. The perilymphatic space scoring system improved the diagnostic accuracy of magnetic resonance imaging.

Invasive and prognostic significance of pRB in esophageal squamous cell carcinoma: a meta-analysis.

This paper investigates the association between protein retinoblastoma (pRB) loss and the T,N stage and prognosis in esophageal squamous cell carcinomas (ESCCs) using meta-analysis. We conducted a meta-analysis of 16 studies, comprising 1,117 patients to clarify this issue. All the studies searched by the electronic literature PubMed and http://www.KJEBM.com, which had been published during the period from January 1996 to January 2012 according to the inclusion criteria. Summary odds ratios (OR) were calculated using fixed or random-effects models. The summary odds ratios (ORs) for pRB inactive were 0.64 (95% confidence interval [CI]:0.45-0.91, P = 0.01) for T1/T2 versus T3/T4 tumors; summary OR = 0.69 (95% CI:0.51-0.94, P = 0.02) for N0 versus N1 tumors. The association between pRB loss and prognosis was examined in nine studies, and the summary hazard ratio was 1.39 (95% CI:1.11-1.74, P = 0.004). pRB inactive was significant associated with T3/T4 tumors and N1 stage as well as adverse prognosis for ESCCs. It appears warranted to prospectively validate that pRB loss may be used for subdividing the T,N stage evaluation of patients with ESCCs, and these patients may be the preponderant people for individualized treatment or target therapy.

A new magnetic resonance imaging scoring system for perilymphatic space appearance after intratympanic gadolinium injection, and its clinical application.

OBJECTIVE: To establish a new magnetic resonance imaging scoring system for diagnosing endolymphatic hydrops. PATIENTS AND METHODS: A total of 214 ears of 107 patients were categorised into five groups: no symptoms, Ménière's disease, sudden deafness, delayed endolymphatic hydrops and other ear disorders. Gadolinium distribution within the labyrinth was scored separately and quantitatively by two radiologists. Multiple independent-sample non-parametric tests, Bayesian discriminant analysis, multivariate logistic regression and receiver operating characteristic curve analyses were performed. RESULTS: The derived scoring model was highly accurate for diagnosing Ménière's disease and delayed endolymphatic hydrops. Two magnetic resonance imaging scoring methods for the perilymphatic space were proposed for the diagnosis of endolymphatic hydrops: a pre-1 value (a new variable that predicts individual probability) of more than 0.3982299, or a sum of all labyrinth component scores of less than 14.5. CONCLUSION: A convenient method is proposed which offers reliable radiological diagnostic criteria for Ménière's disease and delayed endolymphatic hydrops.

Radioresistant malignant myoepithelioma of the breast with high level of ataxia telangiectasia mutated protein.

Malignant myoepithelioma of the breast (MMB) is a rare and often aggressive disease with poor prognosis. Little is known regarding its optimal treatment and progression. We describe the clinical history of a woman following excision of a benign adenomyoepithelioma which recurred years later as a radioresistant malignant myoepithelioma with high levels of ataxia telangiectasia mutated protein and mutant p53 (Cys135Phe). MMB requires close follow-up and aggressive treatment. If adjuvant radiotherapy is adopted to improve local control, minimal postoperative delay and higher doses than for standard post-mastectomy radiation are recommended.

Rapid radiation-induction of ATM protein levels in situ.

Ataxia-telangiectasia (A-T) is characterised by hypersensitivity to ionising radiation (IR), immunodeficiency, neurodegeneration and predisposition to malignancy. Mutations in the A-T gene (ATM) often result in reduced levels of ATM protein and/or compromise ATM function. IR induced DNA damage is known to rapidly upregulate ATM kinase activity/phosphorylation events in the control of cell cycle progression and other processes. Variable expression of ATM levels in different tissues and its upregulation during cellular proliferation indicate that the level of ATM is also regulated by mechanisms other than gene mutation. Here, we report on the IR induction of ATM protein levels within a number of different cell types and tissues. Induction had begun within 5 min and peaked within 2 h of exposure to 2 Gy of IR, suggesting a rapid post-translational mechanism. Low basal levels of ATM protein were more responsive to IR induction compared to high ATM levels in the same cell type. Irradiation of fresh skin biopsies led to an average three-fold increase in ATM levels while immunohistochemical analyses indicated "low expressing" cells within the basal layer with ten-fold increases in ATM levels following IR. ATM "high expressing" lymphoblastoid cell lines (LCLs) which were initially resistant to the radiation-induction of ATM levels also became responsive to IR after ATM antisense expression was used to reduce the basal levels of the protein. These results demonstrate that ATM is present in variable amounts in different tissue/cell types and where basal levels are low ATM levels can be rapidly induced by IR to saturable levels specific for different cell types. ATM radiation-induction is a sensitive and rapid radioprotective response that complements the IR mediated activation of ATM.

Clinical radiohypersensitivity screening using radiation-induced chromosomal aberrations.

Severe acute toxicity to radiotherapy (radiohypersensitivity) can limit the effective use of radiotherapy and it is not usually possible to identify such individuals before treatment commences. Five patients with acute radiohypersensitivity (RH) were detected over a 3-year period. All five RH subjects demonstrated a significantly higher degree of radiation-induced chromosomal aberrations (ICA) in fresh blood lymphocytes when compared to normal controls. Results indicate the feasibility of using the ICA assay in conjunction with other tests to screen for radiosensitivity.

Absence of ATM truncations in patients with severe acute radiation reactions.

PURPOSE: Severe acute toxicity limits the effective use of radiotherapy in patients who are radiosensitive, and it is not usually possible to identify these radiohypersensitive (R-H) individuals before treatment commences. Five such R-H patients were detected over a 3-year period. We undertook this study to determine whether the severe acute radiohypersensitivity of these five individuals showed any correlation with cellular and molecular parameters known to be abnormal in radiosensitivity-related syndromes such as ataxia-telangiectasia (A-T). METHODS AND MATERIALS: Lymphoblastoid cells were isolated from fresh blood from the 5 R-H individuals who had previously demonstrated clinical R-H at least 9 months prior to sampling. Lymphoblastoid cell lines (LCLs) were established to determine the extent of postradiation chromosomal aberrations, cell cycle delay, cell proliferation, and tumor suppressor p53 protein stabilization. The polymerase chain reaction (PCR) and protein truncation (PTT) assays were used to test for the possibility of mutations in the gene mutated in A-T, termed ATM. RESULTS: LCLs derived from R-H subjects retained a significantly higher degree of radiation-induced chromosomal aberrations when compared to normal control LCLs. p53 stabilization by ionizing radiation appeared normal in all but one R-H subject. There was no evidence of A-T gene truncation mutations in any of the R-H subjects tested. CONCLUSIONS: All R-H subjects in this study had their cellular radiosensitivity confirmed by the chromosomal aberration assay. Delayed p53 stabilization at 4 hours postirradiation in one R-H subject suggested that different etiologies may apply in the radiohypersensitivity investigated in this study.

Production and verification of an anti-ovine IgE monoclonal antibody.

Recombinant mouse/sheep IgE was used in the production of an anti-IgE monoclonal using conventional hybridoma techniques. The specificity of hybridomas secreting anti sheep IgE monoclonal antibodies was verified using a number of assays including competitive ELISAs, ability to induce mediator release from mast cells, and IgE binding using western blotting. Immunohistochemical staining demonstrated the binding of putative anti-IgE monoclonals to the sheep mast cell surface. The isotype of the antibody was IgG1:K.