[Lung transplantation for phase â ¢ silicosis: a series of 32 cases].

Objective: To evaluate the effect of lung transplantation for phase Ⅲ silicosis. Methods: From September 2002 to September 2015, 32 patients with end-stage silicosis underwent lung transplantation at Department of Thoracic Surgery, Affiliated Wuxi People's Hospital, Nanjing Medical University. There were 29 male and 3 female patients aged from 24 to 63 years. Thirty-two patients were diagnosed as phase Ⅲ silicosis by the local occupational disease prevention and control center. Fifteen patients were type Ⅰ respiratory failure and 17 patients were type Ⅱ. There were 14 cases accepted bilateral sequential lung transplantation and 18 cases accepted single lung transplantation, including 13 cases with right single lung transplantation and 5 cases with left single lung transplantation. Extracorporeal membrane oxygenation was used in 13 patients. Pulmonary function monitoring was performed at 3 months, 6 months, 1 year, and 2 years after lung transplantation. Clinical characteristics were compared using t-test, χ2 test and Fisher exact test between groups, Kaplan-Meier survival curve and Log-rank test were used to find out the factors affecting survival. Results: All the patients received lung transplantation successfully. One patient died of multiple organ failure, 1 died of sepsis, and 1 succumbed to sudden cardiac death. Twenty-nine patients were discharged from hospital. During follow-up, there were 5 deaths, two patients died of sepsis 7 months postoperatively, 1 died of renal failure 5 months post-transplant, 1 died of sudden cardiac death, and the remaining 1 patient died of bronchiolitis obliterans. Twenty-four patients lived a good quality of life, with survival rates of 90.6% at 3 months, 80.8% at 1 year, 76.7% at 3 years, and 76.7% at 5 years. Significant difference was not observed between single and bilateral lung transplantation about long-term survival rate. During follow-up pulmonary function post-transplant (3 months, 6 months, 1 year, and 2 years) were improved dramatically compared with preoperative level, and patients lived a good quality of life. Conclusion: Lung transplantation is beneficial for patients with phase Ⅲ silicosis, long-term survival is probable.

[Influencing factors for postoperative survival of patients with stage III silicosis treated by lung transplantation].

Objective: To investigate the clinical effect, postoperative complications, and causes of death in the treatment of stage III silicosis with lung transplantation and the influencing factors for survival. Methods: A retrospective analysis was performed for the clinical data of 32 patients with stage III silicosis who underwent lung transplantation in our hospital from September 2002 to September 2015. The survival, causes of death, and postoperative complications were analyzed. The Kaplan-Meier method was used to plot survival curves, the log-rank test was used to compare the influence of each factor on survival rates, and the multivariate Cox proportional hazards regression model was used to evaluate the influence of each factor on survival. Results: All the patients underwent successful lung transplantation. The 3-month and 1-, 3-, and 5-year postoperative cumulative survival rates were 90.6%, 80.8%, 76.7%, and 76.7%, respectively. Eight patients died during the postoperative follow-up, among whom 1 died of multiple organ failure, 3 died of severe infection, 2 died of sudden cardiac death, 1 died of renal failure, and 1 died of bronchiolitis obliterans. The major postoperative complications included primary graft dysfunction (PGD) in 10 patients, severe infection in 7 patients, acute rejection reaction in 3 patients, bronchiolitis obliterans in 5 patients, bleeding in 5 patients, anastomotic complication in 2 patients, and renal dysfunction in 3 patients. The Kaplan-Meier survival analysis showed that sex, postoperative PGD, postoperative infection, massive intraoperative blood loss, preoperative pulmonary arterial hypertension were influencing factors for postoperative survival rates (P<0.05). The multivariate Cox regression model showed that male sex was the protective factor (P<0.05) and postoperative PGD and massive intraoperative blood loss were independent risk factors for death after transplantation (P<0.05). Conclusion: Lung transplantation is a method for the treatment of silicosis. Postoperative PGD and massive intraoperative blood loss are independent risk factors for death after transplantation. Survival rates are affected by postoperative PGD, infection, massive intraoperative blood loss, and preoperative pulmonary arterial hypertension.

Agrocybe aegerita polysaccharide combined with chemotherapy improves tumor necrosis factor-α and interferon-γ levels in rat esophageal carcinoma.

Natural compounds have generated great interest as alternative treatments of diseases like cancer. Here, we investigated the anti-tumor mechanism of one such compound, Agrocybe aegerita polysaccharide, by assessing expression of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in rat esophageal carcinoma (EC). EC was induced in healthy Wistar rats by methyl-n-amyl nitrosamine. Subsequently, rats were administered cancer treatment daily for 4 weeks, as follows: the normal control group (the only group not treated with methyl-n-amyl nitrosamine) and model group received only distilled water; the chemotherapy group received tegafur treatment; and the combination group received tegafur combined with A. aegerita polysaccharide. In normal and combination groups, body weight increased gradually after each week of treatment (P < 0.05), while body weights did not change in model and chemotherapy groups. Using enzyme linked immunosorbent assay, we found serum TNF-α was lower in the combination group (31.56 ± 7.20 pg/L) than either the model (46.24 ± 8.52 pg/L) or chemotherapy (52.39 ± 9.16 pg/L) group, and, while higher, was more similar to the normal controls (25.08 ± 2.93 pg/L; P < 0.05), a finding that was confirmed by the immunohistochemistry of esophageal samples. In contrast, serum IFN-γ was higher in the combination group (97.20 ± 10.92 pg/L) than in either the model (76.11 ± 11.92 pg/L) or chemotherapy (76.04 ± 9.85 pg/L) group, but lower than in the normal group (117.56 ± 10.88; P < 0.05), also confirmed by immunohistochemistry. Therefore, Agrocybe aegerita polysaccharide, when combined with chemotherapy, can regulate immune function in EC, potentially by modulating cytokine activity, specifically downregulation of TNF-α and upregulation of IFN-γ.

Case report: a left donor lung implanted in the recipient's right thorax for the therapy of pulmonary fibrosis.

A 68-year patient suffering from pulmonary fibrosis underwent single lung transplantation on April 4, 2005. Because the ipsilateral donor lung was severely damaged, we had to implant the contralateral lung--the left lung--to the right thorax, and finally this patient recovered.

[Eustachian tube and its dysfunction related diseases' occurence and treatments].

Summary Eustachian tube is the bone-muscular pipeline of connecting nasopharynx with the middle ear,which plays the role of middle ear pressure regulation,the clearance of foreign bodies and protection.However,Eustachian tube dysfunction is closely related with occurence,development and prognosis of middle ear disease.Since the Eustachian tube is deep in hiding,narrow complex anatomical structures and lack of understanding to its physiological function and so on.For centuries,scientists have tried to use various methods to solve the problem of Eustachian tube dysfunction,but the results were often less than expected.Recently,with the wide application of high resolution CT,endoscopy and other technology,the knowledge of anatomy and physical function on Eustachian tube are becoming increasingly comprehensive.Additionally,some new techniques to treat dysfunction, mainly including laser eustachian tuboplasty and balloon dilation Eustachian tuboplasty,are also rapidly appeared.Now,these are summarized below.

In vitro application of RNA interference to silence livin gene expression to induce apoptosis in leukemia cells.

OBJECTIVE: To search for new targets and novel methods of anti-leukemia treatment and to discuss the mechanism of silencing the livin gene using small RNA interference technology to induce apoptosis in the K562 leukemia cell line. METHODS: We designed and synthesized livin-specific small interference RNA (siRNA). Transfected K562 cells were cultured. Reverse-transcription polymer chain reaction (RT-PCR) was used to detect livin mRNA expression. Protein expression for livin was detected using Western blotting. A non-transfected group was used as a control. Meanwhile, vectors carrying enhanced green fluorescent protein (EGFP) were transfected as a positive control and flow cytometry was used to determine the transfection efficiency by detecting green fluorescence. The rate of apoptosis was determined using the annexin V and propidium iodide double-staining method. ELISA was used to determine the activity of Caspase-3. RESULTS: The transfection efficiency of electroporation was as high as 50%. The siRNA sequences could knockdown livin gene expression at both the mRNA and protein levels. Apoptosis rate of the cells was 27.41 ± 2.30% 48 h after transfection with specific siRNA. This was significantly higher than that of the control group (9.63 ± 0.89%, p < 0.05). The 48-h apoptosis rate of the combined effect group VP-16 (5 µmol/L) and transfection rate was 45.1 ± 4.40%, which was significantly elevated (p < 0.05) compared with the groups treated with only VP-16 or by transfection. CONCLUSIONS: Caspase-3 activity in cells transfected with siRNA was significantly elevated compared to the cells in the non-transfected groups (p < 0.05).