Lung transplantation(LT)is currently a surgical therapy option for end-stage lung disease.Venous thromboembolism(VTE),which can occur after LT,is associated with significant morbidity and mortality.Because of improved out-comes,increasing numbers of patients are receiving LT as treatment.Patients on the waitlist for LT tend to be older with weakness and frailty in addition to pulmonary symptoms.These factors contribute to a heightened risk of post-operative VTE.Furthermore,patients who clinically deteriorate while on the waitlist may require extra corporeal membrane oxygenation as a bridge to LT.Bleeding and thromboembolism are common in these patients.Pulmonary embolism(PE)in a freshly transplanted lung can have significant effects leading to morbidity and mortality.PE typically leads to impairment of gas exchange and right ventricular strain.In LT,PE can affect healing of bronchial anastomosis and may even contribute to the development of chronic allograft lung dysfunction.This article discussed the incidence,clinical features and diagnosis of VTE after LT.Furthermore,the treatment modalities,complications,and outcomes of VTE were reviewed.
Lung cancer is among the most prevalent cancers and has the highest mortality rate globally.The diagnosis,pathohistological classification,and molecular testing of lung cancer primarily rely on tissue biopsy or surgical resection.These methods are invasive and associated with limitations,including sample quantity and quality,as well as patient tolerance.Radiomics,an emerging technology,enables the extraction of high-throughput quantitative information from medical images,providing radiomic features applicable to clinical diagnosis and treatment.Significant advancements have been made in the application of radiomics to the diagnosis,molecular detection,efficacy prediction,and prognosis of lung cancer.This review examines the progress in radiomics for individualized and precise diagnosis and treatment of lung cancer in recent years.
Tongtong LiuFang WangShuai QieXuefeng WangKuan LiuYang LiHongyun Shi
背景与目的铁死亡相关基因在调控细胞内铁稳态和脂质过氧化中发挥关键作用,并且参与调控肿瘤的生长与耐药。铁死亡相关基因在肿瘤组织中的表达可用来预测患者未来的生存时间,帮助医生和患者预测疾病未来的进展。基于癌症基因组图谱(e Cancer Genome Atlas,TCGA)数据库中肺腺癌(lung adenocarcinoma,LUAD)患者的测序数据,本研究筛选出参与铁死亡调控的基因,构建了预后模型,并评估了该模型的预测效果。方法由GeneCards数据库提供1467个铁死亡相关基因。TCGA数据库提供了541个LUAD患者的mRNA表达矩阵以及临床数据,提取所有影响铁死亡的基因的表达数据,并利用R软件筛选出癌组织与癌旁组织差异表达的影响铁死亡的基因。对这些基因进行生存分析,以筛选出与预后相关的基因。接着,采用LASSO回归模型构建由影响铁死亡的基因组成的预后模型。对所有LUAD患者样本进行评分,并根据中位数分为高风险组和低风险组。随后,绘制受试者操作特征(receiver operating characteristic,ROC)曲线并计算曲线下面积(area under the curve,AUC),由Kaplan-Meier生存曲线检验模型的性能,以及在外部数据集中验证。最后,利用单因素Cox分析确定模型是否有意义,多因素Cox分析探讨模型的独立预后价值以及临床相关性。结果通过生存分析,初步筛选出121个与预后相关的铁死亡基因。在此基础上,利用LASSO回归构建了一个由12个影响铁死亡的基因(ALG3、C1QTNF6、CCT6A、GLS2、KRT6A、LDHA、NUPR1、OGFRP1、PCSK9、TRIM6、IGF2BP1和MIR31HG)组成的预后模型用以预测LUAD患者的生存时间。结果表明,高风险组患者的生存时间明显少于低风险组(P<0.001),并且在训练集(1年AUC=0.721)和外部验证集(1年AUC=0.768)中均展现出不错的预测结果。患者的风险得分在单因素Cox分析和多因素Cox分析中与LUAD患者的预后显著相关(P<0.001),提示该评分是LUAD�
Lung transplantation (LT)has emerged as a crucial life-saving option for critically ill patients with severe coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS) or irreversible lung injury.[1]Intensive care unit-acquired weakness (ICU-AW)is a prevalent complication in critically ill patients.[2] The recovery of recipients undergoing LT for COVID-19-related respiratory failure may face impediments due to ICU-AW,which negatively affects early mobilization and functional improvement. This study describes two cases of successful bilateral LT for severe COVID-19-related ARDS with the occurrence of ICU-AW and subsequent successful discharge.
Patients with non-small cell lung cancer(NSCLC)harboring epidermal growth factor receptor(EGFR)mutations show a notable response to tyrosine kinase inhibitor(TKI)treatment.However,almost all patients eventually develop resistance[1].Given the limited post-resistance treatment options,identifying effective solutions for this sizable group has become a pressing clinical concern.The emergence of immunotherapy has marked a significant breakthrough for patients with NSCLC without driver gene mutations.However,its efficacy remains a subject of debate on the carriers of EGFR mutation.While preclinical studies have hinted at the potential benefits of immunotherapy for patients with EGFR mutations,early clinical investigations have painted a less optimistic picture[2,3].
