Background: Unplanned early rehospitalization (UER) is common among lung transplant recipients, but its incidence varies among lung transplant centers. This study aimed to analyze the incidence, causes and predictors of UER in a lung transplant center in China and to explore the impact of preoperative nutritional risk status, postoperative duration of mechanical ventilation (MV) and extracorporeal membrane oxygenation support in the intensive care unit on unplanned readmission in lung transplant patients.

Methods: This study was conducted in one of the largest lung transplant centers in China. We collected demographic and clinical data from lung transplant recipients who underwent transplantation and were discharged in 2022. Predictors of UER within 30 days after discharge were analyzed through a retrospective cohort study.

Results: A total of 99 patients were included in this study. The incidence of UER was 29.3%. The three most common reasons were chest distress with shortness of breath (38%), cough with expectoration (21%), and fever (21%). Multivariate analysis revealed that the postoperative MV duration [odds ratio (OR) =1.027; 95% confidence interval (CI): 1.008–1.046; P=0.004] and preoperative Nutrition Risk Screening 2002 (NRS-2002) score (OR =1.615; 95% CI: 1.189–2.194; P=0.002) were significant risk factors for UER.

Conclusions: Patients with higher preoperative NRS-2002 scores and longer postoperative MV duration had a greater risk of UER within 30 days after initial discharge. More research is needed to determine whether improving preoperative nutritional risk status and shortening the duration of MV can reduce UER in patients.

Keywords: Lung transplantation; rehospitalization; unplanned early rehospitalization (UER)

Background: Single-use flexible bronchoscopes (SUFBs) offer various advantages over reusable bronchoscopes (RBs) including portability and cost-effectiveness, and potentially reduced infection transmission. Our study aimed to review the performance of the Ambu^® aScope™ 5 Broncho suite in Cork University Hospital.

Methods: Following ethical approval, data was collected prospectively on procedures performed with the Ambu^® aScope™ 5 in Cork University Hospital. Data included patient demographics, procedure details (location, indication, SUFB size, procedures, complications), and user satisfaction and demographics.

Results: There were 98 procedures performed with the Ambu^® aScope™ 5, all in the endoscopy suite. There were 42 female patients (42.9%) and 56 male (57.1%). Various sized models were used—2.7/1.2 (n=3), 4.2/2.2 (n=4), 5/2.2 (n=60), 5.6/2.8 (n=31). Infection was the most common indication while others included malignancy, haemoptysis, sarcoidosis, and asthma. The most commonly performed procedure was airway inspection (n=98), while bronchoalveolar lavage (BAL) (n=84), brushings (n=3), endobronchial biopsies (n=5), transbronchial needle aspiration (TBNA) (n=1), and argon plasma coagulation (APC) (n=1) were among others. The average user satisfaction rating (from one to five in ascending order of satisfaction) was 4.8 [5 (n=85), 4 (n=9), 3 (n=1), 2 (n=3), 1 (n=0)]. The most common reason for user dissatisfaction was related to suction (n=3). Conversion from single-use to RB was not required in any case. There were no bronchoscope-related patient complications.

Conclusions: Within this cohort of patients, the Ambu^® aScope™ 5 was both safe and versatile with a high level of user satisfaction.

Keywords: Single-use flexible bronchoscope (SUFB); bronchoscopy; interventional pulmonology

Professor JIANXING HE, a leading scientist is recruiting postdoctoral candidates. His team pioneered on (1) tubeless minimally invasive techniques, including autonomous ventilation lung transplantation and tracheal reconstruction; (2) An intelligent screening, diagnosis, treatment, and rehabilitation system for lung cancer; (3) Heterotopic heart-lung combined transplantation. Prof. HE’s team has published a large number of internationally influential research achievements, encompassing significant innovations in lung cancer surgery, personalized treatment, and application of cutting-edge technologies. Their work has been featured in top-tier international scholarly journals such as NEJM and The Lancet, with a total of 678 SCI papers published. Among these, 36 papers’ IF＞30, and 72 papers’ IF＞10.

Multiple functional groups of potassium benzyl(trifluoro)borate (BnBF₃K) are employed as a bifacial linker to improve adhesion and stability in flexible perovskite solar modules. BnBF₃K enhances efficiency to 21.82% (certified at 21.39%) at an area of 12.80 cm² with excellent mechanical flexibility, maintaining 96.56% of initial efficiency after 6000 bending cycles.

Background: Alterations in the vascular microenvironment of cancer have gradually gained widespread attention in oncology research, and early qualitative diagnosis using noninvasive examination techniques is crucial in clinical practice. This study aimed to explore the value of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the assessment of vascular architecture of solid solitary pulmonary nodules (SSPNs).

Methods: DCE-MRI scan images of a total of 79 patients with SSPNs from November 2021 to December 2023 were prospectively analyzed. Quantitative permeability parameters K^trans, K_ep, and V_e values of the lesions were measured, labeled immunohistochemically with CD31 microvessel density (CD31-MVD), smooth muscle actin microvessel density (SMA-MVD), and vascular endothelial growth factor (VEGF), and quantitative values of vascular architectural parameters were obtained using the image analysis software Image-J. The diagnostic efficacy of quantitative permeability parameters for the diagnosis of malignant SSPNs was analyzed by receiver operating characteristic (ROC) curves using surgical pathology findings as the gold standard for the diagnosis of malignant SSPNs. Spearman’s correlation analysis was used to evaluate the relationship between quantitative permeability parameters and vascular construct parameters.

Results: The study included 51 female patients (64.6%) with a mean age of 50.5±11.5 years. Only 21 patients (26.6%) had a smoking history, and 30 patients (38.0%) had a normal weight. Statistically significant differences were found between benign and malignant SSPNs subgroups in K^trans and V_e values in quantitative permeability parameters, and in SMA-MVD and microvascular perfusion index (MPI) in vascular conformation parameters (P<0.05). K^trans and V_e values showed high diagnostic value for malignant SSPNs [area under the curve (AUC), 0.813 and 0.759]. K^trans, K_ep, and V_e were significantly positively correlated with CD31-MVD, with r-values of 0.857, 0.830, and 0.798 (P<0.05); they were also significantly positively correlated with VEGF, with r-values of 0.851, 0.859, and 0.764 (P<0.05); and K_trans and K_ep were significantly negatively correlated with MPI, with r-values were −0.779 and −0.864 (P<0.05).

Conclusions: The quantitative permeability parameters of DCE-MRI correlate with some of the vascular architectural parameters, and magnetic resonance image-based quantification of pulmonary nodal vascular architecture provides a noninvasive method for the differential diagnosis of SSPNs.

Keywords: Solid solitary pulmonary nodules (SSPNs); dynamic contrast enhanced magnetic resonance imaging (DCE-MRI); vascular architecture; quantitative permeability parameters; immunohistochemistry