Lung transplantation after paraquat poisoning in an adolescent: one case report and literature review / 器官移植

Objective To summarize the effect of the timing of lung transplantation and related treatment measures on clinical prognosis of patients with paraquat poisoning. Methods Clinical data of a patient with paraquat poisoning undergoing bilateral lung transplantation were retrospectively analyzed. Clinical manifestations, auxiliary examination, diagnosis and treatment of this patient were summarized and analyzed. Results A 17-year-old adolescent was admitted to hospital due to nausea, vomiting, cough and systemic fatigue after oral intake of 20-30 mL of 25% paraquat. After symptomatic support treatment, the oxygen saturation was not improved, and pulmonary fibrosis continued to progress. Therefore, sequential bilateral lung transplantation was performed under extracorporeal membrane oxygenation (ECMO). After postoperative rehabilitation and active prevention and treatment for postoperative complications, the patient was discharged at postoperative 50 d. Conclusions The timing of lung transplantation after paraquat poisoning may be selected when the liver and kidney function start to recover. Active and targeted prevention of potential pathogen infection in perioperative period and early rehabilitation training contribute to improving clinical prognosis of lung transplant recipients.

A new method for evaluating lung volume: AI-3D reconstruction.

Objective: This study aims to explore the clinical application of an AI-3D reconstruction system in measuring lung volume and analyze its practical value in donor-recipient size matching in lung transplantation. Methods: The study retrospectively collected data from 75 subjects who underwent a plethysmography examination and lung CT at the First Hospital of Jilin University. General data and information related to lung function, and imaging results were collected. The correlation between actual total lung volume (aTLV), predicted total lung volume (pTLV), and artificial intelligence three-dimensional reconstruction CT lung volume (AI-3DCTVol) was analyzed for the overall, male, and female groups. The correlation coefficient and the absolute error percentage with pTLV and AI-3DCTVol were obtained. Results: In the overall, male, and female groups, there were statistical differences (p <0.05) between the pTLV formula and AI-3D reconstruction compared to the plethysmography examination value. The ICC between pTLV and aTLV for all study participants was 0.788 (95% CI: 0.515-0.893), p <0.001. Additionally, the ICC value between AI-3D reconstruction and aTLV was 0.792 (95% CI: 0.681-0.866), p <0.001. For male study participants, the ICC between pTLV and aTLV was 0.330 (95% CI: 0.032-0.617), p = 0.006. Similarly, the ICC value between AI-3D reconstruction and aTLV was 0.413 (95% CI: 0.089-0.662), p = 0.007. In the case of female research subjects, the ICC between pTLV and aTLV was 0.279 (95% CI: 0.001-0.523), p = 0.012. Further, the ICC value between AI-3D reconstruction and aTLV was 0.615 (95% CI: 0.561-0.870), p <0.001. Conclusion: The AI-3D reconstruction, as a convenient method, has significant potential for application in lung transplantation.

Analysis of drug resistance in pulmonary tuberculosis patients with positive sputum tuberculosis culture in Northeast China.

Objective: The objective of this study is to determine the drug resistance status of pulmonary tuberculosis patients in Jilin Province. Methods: A retrospective survey was conducted on 395 sputum culture TB-positive patients admitted to the tuberculosis hospital in Jilin Province in 2019. Sputum samples were cultured in acidic Roche medium. Drug sensitivity testing was conducted using the proportional method. Sensitivity was reported if the percentage of drug resistance was less than 1%, and resistance was reported if the percentage was ≥1%. Statistical analysis was performed using SPSS 22.0. Results: 395 tuberculosis patients with positive sputum tuberculosis culture were included in the study, with 102 being initially treated and 293 being retreated. The study population consisted of 283 males and 112 females. Sex, age, nationality, occupation, marital status, diabetes comorbidity, initial treatment, normal health status, BCG vaccine vaccination, smoking, and alcohol consumption were considered as factors that may affect the rate of multidrug resistance. And only the history of treatment (initial treatment) was associated with multidrug resistance (p = 0.032). This indicates that retreatment is the most significant risk factor for the occurrence of multidrug resistance in tuberculosis. The multidrug resistance rate in retreated patients is 3.764 times higher than that in initially treated patients. Conclusion: The prevalence of multidrug-resistant is higher in retreated patients compared to initially treated patients in the study population. Multidrug resistance is only associated with the treatment history (initial retreatment) and not with other factors.

Clinical application of liquid biopsy based on circulating tumor DNA in non-small cell lung cancer.

Lung cancer is a widely occurring and deadly malignancy, with high prevalence rates in China and across the globe. Specifically, non-small cell lung cancer (NSCLC) represents about 85% of all lung cancer cases. The 5-year disease-free survival rate after surgery for stage IB-IIIB NSCLC patients (disease-free survival, DFS) has notably declined from 73% to 13%. Early detection of abnormal cancer molecules and subsequent personalized treatment plans are the most effective ways to address this problem. Liquid biopsy, surprisingly, enables safe, accurate, non-invasive, and dynamic tracking of disease progression. Among the various modalities, circulating tumor DNA (ctDNA) is the most commonly used liquid biopsy modality. ctDNA serves as a credible "liquid biopsy" diagnostic tool that, to a certain extent, overcomes tumor heterogeneity and harbors genetic mutations in malignancies, thereby providing early information on tumor genetic alterations. Despite considerable academic interest in the clinical significance of ctDNA, consensus on its utility remains lacking. In this review, we assess the role of ctDNA testing in the diagnosis and management of NSCLC as a reference for clinical intervention in this disease. Lastly, we examine future directions to optimize ctDNA for personalized therapy.

Analysis of the influencing factors in the long-term survival of esophageal cancer.

Background: To analyze the prognosis and diagnostic value of relevant hematological indexes on the survival status of patients with esophageal squamous cell carcinoma after radical surgery. Methods: This study included 206 patients with esophageal cancer who underwent surgical R0 resection. The data, including the basic information, preoperative blood routine, albumin, fibrinogen, surgery-related information, postoperative pathology, and overall survival, of the patients were compared. Results: The survival and death groups showed a significant difference in overall survival (OS), the degree of differentiation, depth of infiltration, pathological stage, vascular infiltration, nerve infiltration, fibrinogen, white blood cell, neutrophils, platelet, and platelet hematocrit (P<0.05). Tumor located in the middle thorax, larger lesion length, deeper invasion, later pathological stage, vascular infiltration, nerve infiltration, lymph node metastasis, cardiovascular disease, and higher smoking grade were risk factors for poor prognosis of esophageal squamous cell carcinoma (ESCC) (P<0.05). Cardiovascular disease, lower differentiation, tumor located in the middle thorax, and nerve infiltration were independent risk factors for the reduction of survival time of patients with ESCC (P<0.05). Conclusions: History of cardiovascular disease, tumor located in the middle chest, poorly differentiated esophageal squamous cell carcinoma, visible nerve cancer invasion, hematocrit (HCT), mean erythrocyte hemoglobin concentration (MCHC), and hemoglobin (HB) are independent risk factors for the long-term survival of patients with ESCC.

Efficacy of adjuvant therapy in 110 patients with N1 lymph node metastasis of esophageal squamous cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to evaluate the effect of postoperative adjuvant therapy on the survival in patients with N1 lymph node metastasis of esophageal squamous cell carcinoma (ESCC).</p><p><b>METHODS</b>110 patients with positive N1 lymph node metastasis of esophageal squamous carcinoma were included in this study. The surgery group included 46 cases and the postoperative adjuvant therapy group included 64 cases (24 cases in the adjuvant chemotherapy subgroup and 40 cases in the adjuvant concurrent chemoradiotherapy). The disease-free survival (DFS) and overall survival (OS) of the two groups were compared and the prognostic factors were analyzed by multivariate Cox model.</p><p><b>RESULTS</b>In the postoperative adjuvant therapy group, the DFS (16.8 months) and OS (21.3 months) were significantly prolonged compared with those in the surgery group (10.6 months, P=0.007) and (13.7 months, P=0.001), respectively. Postoperative adjuvant chemotherapy significantly extended the OS (31.1 months) of N1-positive patients compared with 13.7 months (P=0.002) in the surgery group. But there were no significant differences between the DFS in the two subgroups (16.3 and 16.8 months, P=0.346) and between the OS (23.4 and 21.3 months, P=0.491). Postoperative adjuvant therapy was an independent prognostic factor in the ESCC patients with N1 lymph node metastasis.</p><p><b>CONCLUSION</b>Postoperative adjuvant therapy can improve the prognosis and prolong the survival time in ESCC patients with positive N1 lymph node metastasis.</p>

Clinical Observation of Spraying Mannatide and 5-fluorouracil in Anocelia during Surgery of Lung Cancer / 中国药房

OBJECTIVE:To observe the efficacy and safety of spraying mannatide and 5-fluorouracil in anocelia during sur-gery of lung cancer based on the adjuvant chemotherapy. METHODS:Totally 114 patients with lung cancer radical surgery were randomly divided into observation group(59 cases)and control group(55 cases). There were spraying mannatide(40-80 mg)and 5-fluorouracil(500 mg)in the observation group;and nothing drugs were sprayed in control group. The patients higher than phaseⅡ were treated by adjuvant chemotherapy after surgery for continuous 2 cycles,21 d as a cycle. The clinical data was compared, including amount of bleeding and drainage,hospital stay,complications,toxicity,KPS score,body weight changes,immune func-tion,survival rate and recurrence rates between 2 groups. RESULTS:There were no significant differences among the amount of bleeding and drainage,hospital stay and complications in the 2 groups (P>0.05). The nausea,vomiting,leucopenia,the KPS score,improvement of total effective rate,and improvement rate of body mass,immune function,survival rate in 1 and 2 year (s),recurrence rate and time within 2 years in observation group were significantly better than control group,with significant dif-ferences(P<0.01 or P<0.05). CONCLUSIONS:Spraying mannatide and 5-fluorouracil can reduce the toxicity in anocelia during surgery of lung cancer based on the adjuvant chemotherapy,improve the immune function and survival rate,reduce recurrence rate and prolong the recurrence time.

Expression and significance of PTEN and Ki-67 in thymoma / 中国医师进修杂志

Objective To investigate the relationship of PTEN,Ki-67,type of credits of thymoma in WHO organization and Masaoka staging,and the significance of the biology's expression in thymoma.Methods The expression of PTEN and Ki-67 in 52 pieces of thymoma specimens was detected by the method of immunohistochemical SP.Results Positive expression rate of the 52 patients with thymoma was decreased gradually after WHO classification (8/10,10/14,6/12,4/11,0,0 and 10/13,12/20,6/16,0),Masaoka staging and PTEN.The difference were significant in statistics (λ2 =11.751,P =0.038 ; x2 =8.311,P =0.040).Positive expression rate of Ki-67 was gradually increased (1/10,6/14,6/12,8/11,2/3,2/2 and 3/13,9/20,10/16,3/3),the difference was also significant in statistics (x2 =11.231,P =0.047; x2 =7.904,P =0.048).Conclusions The positive expression rate of PTEN,Ki-67 are both related to clinical classification and staging closely.The detection to the positive expression rate of PTEN and Ki-67 can contribute to judging thymoma biological characteristics,thus,it will be helpful in diagnosing the thymoma,analyzing the degree of malignancy,invading and transferring ability.And then provide objective indicators for clinical diagnosis and treatment.

Expression of tumor-associated carbohydrate antigen sTn in breast neoplasm / 吉林大学学报(医学版)

Objective To investigate the expression of tumor-associated carbohydrate antigen sTn in breast neoplasm,and analyzed the association between the expression of sTn and size of tumor,age,menopause,axillary lymph node metastasis,clinical stage,pathologic grade and the level of estrogen receptor in breast carcinoma.Methods The monoclonal antibody TKH-2 was used to detect the immunohistochemical expression of sTn in 46 cases of breast carcinoma,4 breast adenoma and 2 gynecomastia.The level of estrogen receptor was detected by S-P method in 46 breast carcinoma.Results Immunohistochemical expression of sTn was not detected in breast adenoma and gynecomastia.The expression of sTn was found in 28 of 46 breast carcinoma(60.9%).The expression of sTn was significantly associated with axillary lymph node metastasis(P0.05).In 46 breast carcinoma,the positive quantity of estrogen receptor was 25(54.3%).Conclusion STn immunostaining appears to be a poor prognostic factor in patients with breast carcinoma.It is more useful in detecting the expression of sTn together with the level of estrogen receptor in breast carcinoma to investigate the prognosis of the patients.