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Objective:To explore the risk factors of perioperative outcomes of lung transplantation and establish a predictive model for delayed extubation after lung transplantation.Methods:From January 1, 2020 to December 31, 2022, 104 lung transplantation recipients were retrospectively collected to identify the risk factors of early post-operative outcome.According to the timing of extubation post-lung transplantation, they were assigned into two groups of normal(77 cases)and delayed(27 cases). Baseline profiles, type of primary diagnosis, cold ischemic duration and lung transplantation approach were compared between two groups.The factors with significant difference were examined by univariate and multivariate Logistic regression.Furthermore, multivariate logistic model was visualized by a nomogram.Receiver operating characteristic(ROC)curve and decision curve analysis(DCA) were performed for evaluating the model's predictive performance and its value for clinical utilization.Results:The postoperative mortality rate was 9.6%.Delayed extubation was a strong predictor for postoperative mortality.Cold ischemic time outperformed others variates in terms of delayed extubation prediction.AUC of cold ischemic time and multivariate logistic model was 0.75(95% CI: 0.69-0.81)and 0.87(95% CI: 0.82-0.91). Conclusions:Delayed postoperative extubation is a key predictor of early post-lung transplantation mortality.The established predictive model may effectively identify high-risk patients for preventive intervention and survival improvement post-lung transplantation.
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@#Lung cancer is the most common cancer and the leading cause of cancer-related death in China. Early screening of lung cancer proves to be effective in improving its prognosis. The National Comprehensive Cancer Network (NCCN) has updated and released version 2, 2022 NCCN clinical practice guidelines for lung cancer screening in July, 2022. Based on high-quality clinical evidence and the latest research progress, the guidelines have developed and updated criteria for lung cancer screening which have been widely recognized by clinicians around the world. Compared with Chinese lung cancer screening guidelines, this article will interpret the updated content of the brand new 2022 NCCN screening guidelines, providing some reference for the current lung cancer screening practice in our country.
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Lung adenocarcinoma is the most common histology type of lung cancer clinically in many countries.A new international multidisciplinary classification was proposed by International Association for the Study of Lung Cancer/American Thoracic Society/ European Respiratory Society(ISALC/ATS/ERS) in 2011,renewing the classification of lung adenocarcinoma in detail,in which invasive adenocarcinoma were further classified as lepidic-predominant,acinar predominant,papillary predominant,micropapillary predominant and solid predominant according to growth patterns.In 2015,World Health Organization introduced the concept of "air space invasion".As an important constituent part of air space invasion,spreading through air spaces(STAS) often occurs in lung cancer,especially early-stage lung adenocarcinoma.STAS is defined as the "spread of lung cancer cells into air spaces in the lung parenchyma beyond the edge of the main tumor".STAS is not only an independent prognostic factor besides growth patterns,but also an independent risk factor of local and distant relapse after limited resection of stageⅠlung adenocarcinoma.Therefore,it is of great guiding significance to judge the existence of STAS either preoperatively or intraoperatively in order to choose a suitable operation method and postoperative treatment of lung adenocarcinoma.This review mainly focuses on the latest research progress on the pathological appearance,related factors,mechanisms and clinical significance of STAS.
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The article explores the relationship of the hepatitis C virus infection with interferon treatment and thyroid diseases and reviews the subtypes of the thyroid diseases.Autoimmune and nonautoimmune cases of thyroiditis are often seen in patients with chronic hepatitis C while undergoing interferon treatment,especially in females with positive thyroid autoantibodies.Graves' disease is very rare.The thyroid function may be as a transient thyrotoxicosis,then followed by hypothyroidism.The thyroid function in patients with nonautoimmune thyroiditis is usually easy to recover.