Objective To compare outcomes after single versus bilateral lung transplantation in patients with end-stage chronic obstructive pulmonary disease (COPD) with retrospective cohort study, and to provide a reference for surgical selection. Methods One hundred and two patients with end-stage COPD who received lung transplantation in Wuxi People's Hospital affiliated to Nanjing Medical University from January 2010 to May 2019 were evaluated, including 97 males and 5 females, aged from 42 to 82 years, with an average age of (59.8±8.0) years. Recipients were divided into single lung transplantation (SLT) group (31 cases) and bilateral lung transplantation (BLT) group (71 cases). Preoperative characteristics, postoperative outcomes, postoperative complications, functional improvement and survival between the two groups were analyzed retrospectively. Results The SLT group were significantly older than the BLT group [(62.6±8.8) years vs. (58.6±7.4) years, P<0.05], which was consistent with the practice mode of single lung transplantation in the elderly patients in this center. The FEV1% predicted and the six‐minute walk distance (6-MWD) in the BLT group were better than those in the SLT group (P<0.05). The cumulative survival rate in 1, 3 and 5 years after operation in the BLT group was higher than that in the SLT group (70.4%, 63.2%, 61.5%, respectively vs. 67.7%, 58.1%, 54.6%, respectively), but there was no statistical difference (P=0.388). The two groups were comparable in other preoperative clinical data (P>0.05). The cold ischemia time and total operation time were shorter in the SLT group than in the BLT group, and the intraoperative blood loss was less than that in the BLT group, but more patients required intraoperative extracorporeal membrane oxygenation support than the BLT group (P<0.05). There were no significant differences in postoperative ventilator support, reoperation, length of intensive care unit stay, postoperative hospital stay, and perioperative mortality (P>0.05). In terms of postoperative complications, the incidence of primary graft dysfunction grades 3 was higher in the SLT group than in the BLT group (35% vs. 8%, P=0.001). There were no significant differences between the two groups in chest complications, airway complications, acute rejection, infection, and bronchial occlusion syndrome (P>0.05). Nine patients (29%) developed acute native lung hyperinflation in the SLT group. ConclusionsBilateral lung transplantation is superior to single lung transplantation in the treatment of end-stage COPD. The advantage is mainly reflected in the simple perioperative management, better functional improvement after operation. Single lung transplantation as a beneficial supplement to double lung transplantation should still be considered in selected patients.
This study aims to predict expression of estrogen receptor (ER) in breast cancer by radiomics. Firstly, breast cancer images are segmented automatically by phase-based active contour (PBAC) method. Secondly, high-throughput features of ultrasound images are extracted and quantized. A total of 404 high-throughput features are divided into three categories, such as morphology, texture and wavelet. Then, the features are selected by R language and genetic algorithm combining minimum-redundancy-maximum-relevance (mRMR) criterion. Finally, support vector machine (SVM) and AdaBoost are used as classifiers, achieving the goal of predicting ER by breast ultrasound image. One hundred and four cases of breast cancer patients were conducted in the experiment and optimal indicator was obtained using AdaBoost. The prediction accuracy of molecular marker ER could achieve 75.96% and the highest area under the receiver operating characteristic curve (AUC) was 79.39%. According to the results of experiment, the feasibility of predicting expression of ER in breast cancer using radiomics was verified.