To analyze the clinical characteristics of pulmonary nodules (PN) in patients with primary Sjögren′s syndrome (pSS).

A retrospective analysis was conducted on the clinical data, histopathological examination results, and chest CT imaging findings of 32 pSS patients with pulmonary nodules admitted to our hospital from May 2017 to December 2024.

Among the 32 patients, 3 cases(9.38%) were male and 29 cases (90.62%) were female. Four patients (12.50%) had a history of smoking. Clinical manifestations included dry mouth 26 cases, dry eyes 12 cases, and arthralgia 7 cases. Respiratory symptoms (cough, chest tightness, chest pain, and hemoptysis) were present in 13 cases, while 17 cases had no respiratory symptoms and pulmonary nodules were discovered incidentally on physical examination CT. Immunoglobulin G (IgG) was elevated in 16 cases. Histopathological examination revealed benign lesions in 10 cases (31.25%), including pulmonary amyloidosis 2 cases, pulmonary granulomatous inflammation 2 cases, fibrocalcified nodules 1 case, and inflammatory cell infiltration 5 cases. Malignant tumors were found in 22 cases (68.88%), including lung cancer 17 cases, lymphoma 4 cases, and plasmacytoma 1 case. Respiratory symptoms (cough, chest tightness, chest pain, and hemoptysis) were significantly more common in patients with benign lesions compared to those with lung cancer or lymphoma (P<0.05). Patients with lymphoma had a significantly higher number of pulmonary nodules (P<0.05). Solitary pulmonary nodules and ground-glass opacity were associated with lung cancer. At the end of follow-up, 26 patients (81.25%) were alive, and 6 patients (18.75%) had died. Causes of death included lung cancer in 4 cases(12.50%), lymphoma in 1 case(3.12%), and benign lesions in 1 case(3.12%); one death was due to cerebral hemorrhage, and five were related to respiratory complications.

Malignant tumors are common findings in pSS patients with lung nodule biopsies. Solitary nodules and ground-glass opacity are frequently associated with lung cancer, while respiratory symptoms are more common in patients with benign lesions.

To explore the mechanism of PALM3 on vascular endothelial cell injury induced by Pseudomonas aeruginosa (PA).

Human umbilical vein endothelial cells (HUVEC) were randomly divided into the control group, the control+ PA group, the siRNA-control+ PA group, and the siRNA-PALM3+ PA group. Control group: HUVEC cells + normal saline; Control+ PA group: HUVEC cells exposed to fluorescently labeled 5×10⁸ CFU/ml PA bacterial solution .The siRNA-Control+ PA group and the siRNA-PALM3+ PA group transfected cells with siRNA-Control and siRNA-PALM3 plasmids respectively, and PA was added 48 hours after transfection. It was detected that vascular endothelial fibronectin, vascular endothelial growth factor c (VEGF-C), and angiopoietin-2 (ANGPT2) in the cell supernatant; The expressions of PALM3 and nuclear factor NF-κB in cells were detected. The cell survival rate was compared by MTT, and cell apoptosis was analyzed by flow cytometry.

Compared with the Control group, the expression of PALM3 protein in the cells of the Control+ PA group and the siRNA-Control+ PA group increased (P<0.05); Compared with the Control+ PA group and the siRNA-Control+ PA group, the expression level of PALM3 protein in the cells of the siRNA-PALM3+ PA group decreased, and the expression level of NF-κB protein decreased. The fibronectin (235.7±17.5), VEGF-C(0.72±0.05), and ANGPT2 (807.8±24.6) in the siRNA-PALM3+ PA group were higher than those in the Control+ PA group (109.9±5.8) and VEGF-C(0.49±0.06), ANGPT2 (464.16±26.27), and fibronectin (188.9±8.6), VEGF-C (0.49±0.02), ANGPT2 (510.57±27.6) in the siRNA-Control+ PA group (P<0.05); The cell survival rate of the siRNA-PALM3+ PA group (1.102±0.125) was higher than that of the Control+ PA group (0.870±0.052) and the siRNA-Control+ PA group (0.887±0.054) (P<0.05); The cell survival rates of the Control+ PA group and the siRNA-Control+ PA group after 6 hours were (2.760 ± 0.744) and (2.777 ± 0.604), respectively, which were higher than that of the Control group (1.662±0.150). Compared with the Control+ PA group and the siRNA-Control+ PA group, the cell survival rate in the siRNA-PALM3+ PA group (3.195±1.342) increased.

Down-regulation of PALM3 has a protective effect on the inflammatory response of pulmonary vascular endothelial cell injury caused by Pseudomonas aeruginosa, and is negatively correlated with vascular permeability.

To investigate the clinical characteristics and risk factors of chronic obstructive pulmonary diseases (COPD) complicated with lung cancer, providing references for its prevention, diagnosis, and treatment in clinical practice.

A total of 210 COPD patients with lung cancer (observation group) and 125 COPD patients without lung cancer (control group) admitted to our hospital from March 2022 to October 2024 were selected. Clinical data and laboratory indicators were collected. Univariate and multivariate logistic regression analyses were performed to identify the clinical features and risk factors associated with COPD complicated with lung cancer.

In the observation group, 184 patients (87.62%) were smokers, and 143 (68.09%) presented with hemoptysis, whereas in the control group, 89 patients (71.20%) were smokers, and only 5 exhibited hemoptysis. The differences between the two groups were statistically significant (P<0.01). No significant differences were observed in family history of lung cancer, occupational exposure, cough, dyspnea, or chest pain between the two groups (P>0.05). A significant difference was noted in platelet count (PLT) between the observation group and the control group: (245.29 ± 91.96)×10⁹/L vs. (213.91±79.21)×10⁹/L (P<0.01). Comparisons of lung tumor markers revealed statistically significant differences between the two groups (P<0.01): carcinoembryonic antigen (CEA) (35.73±170.51 vs. 2.86±1.71 ng/ml), neuron-specific enolase (NSE) (20.96±22.86 vs. 11.72±4.64)ng/ml, cytokeratin 19 fragment antigen (CYFRA21-1) (9.76±23.52 vs. 2.24±2.44)ng/ml, and pro-gastrin-releasing peptide (Pro-GRP) (206.02±693.48 vs. 47.35±18.14)pg/ml. Among the observation group, 169 patients exhibited emphysema on lung CT imaging. Histopathological analysis indicated that 95 cases (45.24%) were squamous cell carcinoma, 141 cases (67.62%) had central-type lung cancer, and 111 patients (52.86%) were at TNM stage Ⅲ at diagnosis. Diagnosis was confirmed via fiberoptic bronchoscopic biopsy in 155 patients (71.43%) and percutaneous lung biopsy in 34 patients (16.19%). Genetic testing was performed in 126 diagnosed patients (60%). Multivariate logistic regression analysis identified smoking history, hemoptysis, PLT ≥ 210.0×10⁹/L, NSE≥13.94 ng/ml, and CYFRA21-1≥3.3 ng/ml as risk factors for COPD complicated with lung cancer (P0.05).

Analysis of clinical characteristics and risk factors in COPD patients with lung cancer revealed that smoking history, hemoptysis, elevated PLT, NSE, and CYFRA21-1 levels are significant risk factors. These findings have clinical implications for the early identification of high-risk lung cancer populations among COPD patients.

To analyze the clinical efficacy of CalliSpheres^® drug-eluting beads bronchial arterial chemoembolization (DEB-BACE) in the treatment of stage Ⅲ~Ⅳ non-small cell lung cancer (NSCLC).

A retrospective analysis was conducted on 23 stage Ⅲ~Ⅳ NSCLC patients treated with DEB-BACE (observation group) and 23 patients treated with conventional BACE (C-BACE, control group) at our hospital from May 2019 to October 2024. Clinical efficacy and quality of life were compared between the two groups before and after treatment.

After BACE treatment, partial response (PR) was observed in 18 cases and stable disease (SD) in 23 cases. The objective response rate (ORR) in the observation group 56.52% was higher than that in the control group 21.74% (P=0.016). No grade 3 or higher adverse reactions occurred during BACE treatment, while 23 cases (50.00%) experienced grade 1-2 adverse reactions. The adverse reactions of 7 cases(30.43%) in the observation group was lower than 16 cases(69.57%) in the control group (P<0.05). In the observation group, significant improvements were observed in physical function (F_time=14.497), role function (F_time=6.696), cognitive function (F_time=4.839), and constipation symptoms (F_time=22.000) after treatment (P<0.05). Additionally, quality of life (F_group=10.863), dyspnea (F_group=19.101), loss of appetite (F_group=9.134), and diarrhea (F_group=22.000) showed greater improvement in the observation group compared to the control group (P<0.05), with hemoptysis symptoms effectively controlled. During a median follow-up of 6.22 months (0.47~20.80 months), 31 patients (67.39%) survived and 15 (32.61%) died, including 5 deaths (21.75%) in the observation group and 10 deaths (43.48%) in the control group. Kaplan-Meier curves indicated no statistically significant difference in median overall survival between the two groups (P=0.181).

CalliSpheres^® DEB-BACE demonstrates favorable safety and efficacy in treating stage Ⅲ~Ⅳ NSCLC, contributes to improved quality of life, and serves as a valuable alternative option for patients with stage Ⅲ~Ⅳ NSCLC.

To analyze the value of heat shock protein 90α (HSP90α), tumor-associated peptides (TAP), and interleukin-6 (IL-6) in the diagnosis and prognosis of malignant pleural effusion in non-small cell lung cancer (NSCLC).

A total of 65 patients with pleural effusion admitted to our hospital from January 2020 to December 2024 were selected. Based on the type of pleural effusion, they were divided into two groups: 31 cases with benign pleural effusion as the control group and 34 cases with malignant pleural effusion as the observation group. Serum levels of carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA 21-1), neuron-specific enolase (NSE), HSP90α, TAP, and IL-6 were measured using enzyme-linked immunosorbent assay. The diagnostic value of tumor markers, HSP90α, TAP, and IL-6 for NSCLC malignant pleural effusion was assessed using receiver operating characteristic (ROC) curves, and survival curves were plotted for patients with NSCLC malignant pleural effusion.

The serum levels of CEA (4.12±1.14) ng/ml, CYFRA 21-1 (12.82±3.75) ng/ml, and NSE (3.05±1.33) ng/ml in the control group were lower than those in the observation group CEA (6.64±1.88) ng/ml, CYFRA 21-1 (15.85±4.15) ng/ml, NSE (5.91±2.05) ng/ml (P<0.05). The levels of serum HSP90α(16.20±7.90) ng/ml, TAP (133.00±17.86) μm², thymidine kinase 1 (TK1) (4.80±2.08) pmol/L, squamous cell carcinoma antigen (SCC) (5.58±1.98) mg/L, lactate dehydrogenase (LDH) (137.33±27.84) U/L, and IL-6 (6.52±1.30) pg/L in the control group were lower than those in the observation group HSP90α(176.10±86.54) ng/ml, TAP (173.16±19.51) μm², TK1 (9.26±2.93) pmol/L, SCC (7.13±2.23) mg/L, LDH (195.74±26.78) U/L, IL-6 (8.51±1.31) pg/L (P<0.05). ROC curve analysis showed that HSP90α had higher diagnostic value for malignant pleural effusion compared to TAP, IL-6, TK1, SCC, LDH, and the combined diagnosis of CEA + CYFRA 21-1 + NSE, with a sensitivity of 97.1%, specificity of 96.8%, and an area under the curve (AUC) of 0.963 (95%CI: 0.906~1.000). K-M curves showed that higher levels of HSP90α, TAP, and IL-6 were associated with shorter survival in patients with malignant pleural effusion. Log-Rank analysis revealed chi-square and statistical values for HSP90α, TAP, and IL-6 as 66.639, 35.201, and 25.048, respectively, with P-values of 0.000, 0.000, and 0.000.

HSP90α, TAP, and IL-6 can serve as indicators for predicting the prognosis of NSCLC patients with malignant pleural effusion and hold clinical significance.

To investigate the predictive value of the neutrophil percentage to albumin ratio (NPAR) for short-term 28 day and long-term 365 day all-cause mortality in critically ill patients with chronic obstructive pulmonary disease (COPD).

Using a retrospective cohort design based on the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ) database, we enrolled 539 COPD patients admitted to the intensive care unit (ICU). Patients were stratified into quartiles (Q1~Q4) according to NPAR levels. The primary endpoints were 28 day and 365 day all-cause mortality. Kaplan-Meier survival curves were constructed, and differences were assessed using the log-rank test. Univariate and multivariate Cox proportional hazards regression models were employed to evaluate the association between NPAR and mortality. Restricted cubic spline (RCS) analysis was used to examine the dose-response relationship; if a nonlinear association was detected, a two-piecewise linear regression model was applied to identify the inflection point. Subgroup analyses were performed to assess the robustness of the findings.

The median age of the study population was 71 (63-79) years, with 281 (52.1%) male patients. Kaplan-Meier analysis revealed that the Q4 group had significantly lower cumulative survival rates at both 28 and 365 days compared to other groups (log-rank test, allP<0.001). After multivariate adjustment, the Q4 group exhibited significantly higher risks of 28-day mortality [adjusted hazard ratio (aHR)=1.61, 95%CI: 1.06~2.43, P=0.024] and 365-day mortality (aHR=1.87, 95%CI: 1.32~2.65, P<0.001) compared to the Q1 group. RCS analysis demonstrated a nonlinear U-shaped association between NPAR and mortality (nonlinearity P<0.001), with inflection points at 22.88 28 day and 22.29 365 day. Beyond these thresholds, each 1-unit increase in NPAR was associated with a 4.4% increase in 28 day mortality risk (HR=1.044, 95%CI: 1.027~1.062, P<0.001) and a 3.8% increase in 365 day mortality risk (HR=1.038, 95%CI: 1.022~1.054, P<0.001). Subgroup analyses showed no significant interaction effects (all interaction P>0.05).

NPAR is an independent predictor of short-and long-term all-cause mortality in critically ill COPD patients. The U-shaped dose-response relationship provides a novel quantitative basis for clinical risk stratification and prognostic assessment.

To analyze the clinical significance of bronchoalveolar lavage fluid (BALF) and serum interleukin-18 binding protein (IL-18BP) in predicting the prognosis of idiopathic pulmonary fibrosis (IPF).

Eighty-seven IPF patients admitted to our hospital between January 2019 and December 2023 were prospectively enrolled. All received antifibrotic therapy. Serum and BALF IL-18BP levels were measured using enzyme-linked immunosorbent assay (ELISA). The patients were grouped according to their survival status. 52 surviving cases were assigned to the control group, and 35 deceased cases were assigned to the observation group.

The median serum IL-18BP level across all 87 patients was 3.40 (IQR: 0.67, 120.64) ng/ml, and the median BALF IL-18BP level was 3.12 (IQR: 0.06, 72.97) ng/ml. During a median follow-up of 36 months, 35 patients (40.23%) died. 27 cases (31.03%) experienced acute exacerbation within one year. The observation group had significantly higher serum IL-18BP levels [12.04 (5.05, 33.14)ng/ml] and significantly lower BALF IL-18BP levels [2.53 (1.15, 4.44) ng/ml] compared to the control group [serum: 2.55 (1.82, 3.40) ng/ml, BALF: 3.65 (1.66, 6.25) ng/ml] (P<0.05). Spearman rank correlation analysis revealed a positive correlation between serum and BALF IL-18BP levels (r=0.215, P=0.020). Serum IL-18BP levels were significantly higher in AE patients [56.12 (22.99, 124.37) ng/ml] compared to non-AE patients [4.92(2.39, 11.85) ng/ml] (Z=-4.787, P<0.001). Receiver operating characteristic (ROC) curve analysis showed serum IL-18BP predicted IPF-related death with an area under the curve (AUC) of 0.864, and an optimal cutoff value of 5.10 ng/ml (P<0.05). Multivariate Cox proportional hazards regression analysis identified high serum IL-18BP level as an independent risk factor for poor IPF prognosis (P<0.05). Kaplan-Meier curve analysis showed that among 54 cases with low serum IL-18BP level (<5.10 ng/ml), 47 cases (87.04%) survived, and among 33 cases with high serum IL-18bp level (≥5.10 ng/ml), 5 cases (15.15%) survived. The median OS was 34 and 26 months respectively (χ²=47.795, P<0.001). Spearman rank correlation analysis showed a negative correlation between serum IL-18BP levels and diffusing capacity of the lung for carbon monoxide (DLCO)% predicted (r=-0.193, P=0.037).

High serum IL-18BP levels are associated with a significantly increased risk of poor prognosis in IPF. Serum IL-18BP may serve as a biomarker for early risk stratification in IPF.

To analyze the efficacy of quantitative computed tomography (CT) in evaluating and predicting the clinical outcomes of patients with idiopathic pulmonary fibrosis (IPF) for pulmonary fibrosis and emphysema.

Patients diagnosed with IPF in our hospital from January 2021 to April 2024 were retrospectively included. All patients underwent high-resolution CT (HRCT), quantitative CT and pulmonary function tests. Pixels with a degree of emphysema lower than -950 HU were segmented into low attenuation areas (LAA), and the %LAA of each slice was calculated. The degree of fibrotic lesions is that all pixels greater than -700 HU are segmented into highly attenuation areas (HAA), the %HAA is calculated, and the %LAA and %HAA of each thoracic segment are added together to obtain the percentage of abnormal area (%AA). The adverse clinical outcomes were clinical events (hospitalization, acute exacerbation, and death) in patients during the follow-up observation period.

Cluster analysis was conducted based on quantitative CT, pulmonary function tests, and clinical characteristics. Patients in cluster 1 had a higher percent predicted of forced vital capacity (FVC%pred), a lower CT visual score, and lower %LAA and %AA. Among the patients in Cluster 2, the FVC%pred was the lowest and the CT visual score was high. Patients in Cluster 3 had a relatively high FVC%pred, but a high CT visual score, and the %LAA and %AA were also the highest. A total of 35 cases (38.04%) of IPF patients had clinical events. The event-free survival time of patients in cluster 1 was longer than that of patients in clusters 2 and 3 (log rank=6.257, P=0.044; Cluster 1 vs. Cluster 2: log rank=4.921, P=0.027; Cluster 1 vs. Cluster 3: log rank=4.622, P=0.032). However, there was no statistically significant difference in the clinical outcomes between cluster 2 and Cluster 3 (log rank=0.002, P=0.966). Through Spearman rank correlation analysis, %LAA, %HAA, and %AA were all negatively correlated with the percent predicted of diffusing capacity of the lung for carbon monoxide (DL_CO%pred) (rho=-0.407, -0.536, -0.737, P<0.001). The results of the time-dependent receiver operating characteristic curve analysis showed that %AA had a better predictive efficacy for adverse outcomes in IPF patients at 1 year, 2 years, and 3 years [areas under the curves were 0.729(95%CI: 0.681~0.770), 0.852(95%CI: 0.794~0.922), 0.748(95%CI: 0.693~0.796), respectively].

Quantitative CT detection is significantly correlated with the results of pulmonary function tests and the clinical outcomes of patients with IPF. CT quantitative measurement can be used as an effective method to determine the clinical course and prognosis of patients with IPF.

This study investigates the microbial composition of bronchoalveolar lavage fluid (BALF) in cases of small cell lung cancer (SCLC), large cell neuroendocrine carcinoma (LCNEC), and benign pulmonary diseases. The objective is to examine potential associations between lung cancer and alterations in the pulmonary microbiome.

From May 2021 to December 2023, patients who underwent bronchoscopy in the Department of Thoracic Surgery, Tangdu Hospital, Air Force Military Medical University were enrolled. Among them, 10 cases were pathologically diagnosed as small cell lung cancer, 4 cases were diagnosed as large cell neuroendocrine carcinoma, and 15 cases were diagnosis of benign pulmonary disease served as a control. The total DNA of the microbiome in the BALF samples of the research subjects was collected, PCR amplification was performed with primers selected according to V3-V4 sequence, high-throughput paired-end sequencing was performed using the NovaSeq6000 sequencer, and the obtained sequence data was analyzed in depth using bioinformatics methods.

The α-diversity of the microbiome, including indices such as Chao1 (294.67; 297.17), Observed OTUs (288.00; 293.25), and Shannon (5.85; 6.15), was higher in SCLC and LCNEC compared to benign pulmonary diseases (Chao1: 216.31, Observed OTUs: 211.73, Shannon: 4.90) (P<0.05). There was no statistically significant difference in the microbiome between SCLC and LCNEC (P>0.05). However, the β-diversity between SCLC and benign pulmonary diseases exhibited a statistically significant difference (P=0.046). Compared with the benign control group, at the family level, Oxalobacteriaceae, Pseudomonases, Xanthomonasceae, Enterobacteriaceae, and Moraxellaceae were significantly reduced in small cell lung cancer and large cell neuroendocrine carcinoma; veillonellaceae and actinomycetes were significantly increased. At the genus level, the genera of pseudomonas, stenotrophomonas, spirulina, and acinetobacter were significantly reduced in small cell lung cancer and large cell neuroendocrine carcinoma; Prevotellap, Veillonella genus and Actinomycetes significantly increased.

These bacteria are expected to be new potential targets for the diagnosis or treatment of small cell lung cancer and large cell neuroendocrine carcinoma.

To analyze the correlation between neutrophil elastase activity and disease severity and exacerbation in patients with bronchiectasis.

A total of 103 patients with non-cystic fibrosis (CF) bronchiectasis admitted to our hospital from January, 2020, to December, 2023, were selected as subjects. Their HRCT scores, bronchiectasis severity index (BSI), and lung function were compared. Serum neutrophil elastase activity was measured using an activity-based immunoassay, and patients were followed for one year to observe bronchiectasis exacerbations. Multiple linear regression and COX proportional hazards analysis were used to analyze the relationship between serum neutrophil elastase and disease severity and exacerbation.

Among the 103 patients, 41 had mild bronchiectasis, 39 had moderate bronchiectasis, and 23 had severe bronchiectasis. The serum neutrophil elastase activities in patients with mild, moderate, and severe bronchiectasis were 2.51(1.29, 3.29)μg/ml, 3.22(1.80, 4.55)μg/ml, and 5.77(4.42, 9.95)μg/ml, respectively (H=35.618, P<0.001). Gender (β=2.791, 95%CI: 1.182~4.401, P=0.001), body mass index (BMI) (β=-0.261, 95%CI: -0.443~-0.079, P=0.006), number of acute exacerbations in the past year (β=0.001, 95%CI: 0.616, P=0.245~0.987), forced vital capacity (FVC) (β=-5.744, 95%CI: -10.933~-0.555, P=0.030), and serum neutrophil elastase activity (β=0.248, 95%CI: 0.093~0.402, P=0.002) were associated with BSI (P<0.05). High serum neutrophil elastase activity (HR=1.312, 95%CI: 1.202~1.431, P<0.001) was associated with exacerbation in bronchiectasis patients during the one-year follow-up period. During the one-year follow-up, 50 patients experienced ≥1 exacerbation event; 94 cases(91.26%)survived, 9 patients died (8.74%), with causes of death including bronchiectasis exacerbation (6 cases), chronic obstructive pulmonary disease (2 cases), and respiratory infection (1 case). Kaplan-Meier curves showed that compared to patients with low serum neutrophil elastase activity (<3.22 μg/ml), those with high serum neutrophil elastase activity (≥3.22 μg/ml) had a shorter time to exacerbation-free survival (Log-Rank=40.557, P<0.001).

Serum neutrophil elastase activity is associated with disease severity and the risk of exacerbation in non-CF bronchiectasis patients.

To analyze the risk factors of moderate to severe acute pain after thoracoscopic segmental resection of the lung in patients with bronchogenic lung cancer.

Seventy-two patients with acute pain after thoracoscopic segmental resection of bronchogenic lung cancer and a pain duration of more than 20 minutes who were admitted to our hospital from August 2022 to August 2024 were selected as the subjects. The severity of acute pain was determined by the visual analogue scale (VAS). Eighteen cases with a score of 4 to 10 were classified as the moderate to severe group, and 54 cases with a score of 1 to 3 were classified as the mild group. The age, gender, smoking history, drinking history, educational level, diabetes, hypertension, preoperative anxiety, preoperative depression, preoperative fear score (Fear of Pain Questionnaire-Ⅲ-FPQ-Ⅲ), history of chest and back pain, and TNM stage (Ⅰ, Ⅱ, Ⅲ) were compared between the two groups Stage A), surgery and postoperative conditions (American Society of Anesthesiologists classification, operation time, surgical site, days of postoperative analgesia, number of closed thoracic drainage tubes, days of closed thoracic drainage tubes, postoperative hospital stay, anesthesia time, consumption of analgesic drugs within 7 days after surgery, presence or absence of complications), Logistic regression was used to analyze the factors of moderate to severe acute pain after surgery.

The results of multivariate analysis indicated that the history of alcohol consumption (OR=2.038, 95%CI: 1.345~3.088), preoperative anxiety (OR=2.375, 95%CI: 1.314~4.293), and preoperative fear score (OR=1.923, 95%CI: 1.414~2.616), diameter (OR=2.625, 95%CI: 1.595~4.318), operation time (OR=2.421, 95%CI: 1.184~4.950), postoperative hospital stay (OR=2.237, 95%CI: 1.660~3.013), anesthesia time (OR=2.136, 95%CI: 1.139~4.007), postoperative analgesia method (intercostal nerve resistance) (OR=0.521, 95%CI: 0.312~0.871), incision intercostal space width (≥1.5 cm) (OR=0.470, 95%CI: 0.285~0.772) is an influencing factor for moderate to severe acute pain in patients after bronchogenic lung cancer surgery (P<0.05).

Factors such as drinking history, preoperative anxiety, preoperative fear score, diameter, and operation time are risk factors for moderate to severe acute pain after thoracoscopic segmental resection of bronchogenic lung cancer. Early identification and treatment are helpful to reduce the incidence of moderate to severe acute pain after surgery and improve the quality of life after surgery.

To compare the clinical effects of high-flow nasal cannula oxygen therapy (HFNC) and non-invasive ventilation (NIV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with hypoxemia.

A total of 67 patients with AECOPD and hypoxemia admitted in our hospital from May 2021 to June 2024 were selected. Among them, 32 patients who received HFNC were assigned to the observation group, and 35 patients who received NIV were assigned to the control group. Vital signs, blood gas parameters, lung function, and inflammatory markers were compared between the two groups.

After treatment, the respiratory rate (18.19±2.28) breaths/min and heart rate (81.05±7.20) beats/min in the observation group were lower than those in the control group (22.53±3.27) breaths/min, (85.36±8.04)beats/min (P<0.05). The arterial carbon dioxide partial pressure (PaCO₂) in the observation group was lower than before treatment (P<0.05), while the arterial oxygen partial pressure (PaO₂) and oxygenation index in both groups were higher than before treatment (P<0.05). After treatment, the forced vital capacity (FVC) (2.05±0.41)L, maximal voluntary ventilation (MVV) (50.86 ± 5.72)%, and forced expiratory volume in one second (FEV₁) (1.81±0.38)L in the observation group were higher than those in the control group FVC(1.73±0.35 L), MVV (42.54±4.65%), FEV₁ (1.42±0.33)L (P<0.05). The levels of serum surfactant protein-D (SP-D) (121.04±16.18) μg/L and pulmonary activation-regulated chemokine/CC type chemotactic factor 18 (PARC/CCL18) (80.06±9.23) μg/L in the observation group were lower than those in the control group SP-D(156.38±20.24)μg/L, PARC/CCL18 (95.19±12.05)μg/L (P<0.05). The rate of nasal and facial skin damage in the observation group (3.13%) was lower than that in the control group (20.00%) (P<0.05), and the comfort score in the observation group (8.72±0.30) was higher than that in the control group (5.80±0.64) (P<0.05). In the observation group, 30 patients survived (93.75%), and 2 died (6.25%), with the cause of death being respiratory failure. In the control group, 32 patients survived (91.43%), and 3 died (8.57%), with the causes of death being respiratory failure in 1 case and combined infection in 2 cases.

Both NIV and HFNC can regulate blood gas parameters in patients with AECOPD and hypoxemia, with favorable prognoses. However, compared to NIV, HFNC more effectively improves vital signs and lung function, reduces inflammatory responses, enhances comfort, and lowers the risk of nasal and facial skin damage.

To analyze the clinical characteristics and influencing factors of in-hospital pulmonary infections in lung cancer patients during chemotherapy.

74 lung cancer patients admitted to our hospital from March 2022 to March 2024 were selected as the research subjects. The grouping was based on whether hospital acquired lung infections occurred during chemotherapy. The hospital acquired lung infections were the observation group 19 cases and the control group 55 cases. Analyze the distribution and drug resistance of pathogenic bacteria, compare two sets of general data, and perform multivariate analysis using logistic regression.

During chemotherapy, 19 out of 74 patients developed hospital acquired pulmonary infections, with an incidence rate of 25.67%. A total of 27 pathogenic bacteria were isolated, including 17 strains (62.96%) of gram-negative bacteria, 6 strains (22.22%) of gram-positive bacteria, and 4 strains (14.82%) of fungi; The resistance rates of various Gram negative bacteria to ampicillin, ampicillin sulbactam, and compound sulfamethoxazole are all ≥50.00%; Staphylococcus aureus has high resistance to commonly used antibiotics and is most sensitive to penicillin; The age of the observation group, KPS score<80 points before chemotherapy, underlying diseases, ≥2 types of chemotherapy drugs, TNM stage Ⅲ~Ⅳ, invasive procedures, chemotherapy time ≥2 cycles, Alb<35 g/L, Hb<110 g/L, and neutropenia were higher in the control group compared to the control group (P<0.05); Alb<35 g/L、Combining underlying diseases, KPS score<80, invasive procedures Hb<110 g/L, ≥ 2 types of chemotherapy drugs, neutropenia, TNM stages Ⅲ~Ⅳ, and ≥2 cycles of chemotherapy are risk factors for pulmonary infection (P<0.05).

The incidence of pulmonary infection during chemotherapy in lung cancer patients is relatively high, and there are many risk factors. Active prevention and treatment should be taken to reduce the risk of pulmonary infection in patients.

To analyze the clinical application effect of a self-regulation illness perception intervention in patients with interstitial lung disease (ILD).

A total of 87 ILD patients admitted to our hospital from May 2023 to May 2024 were selected and randomly divided into a control group 43 cases and an intervention group 44 cases. The control group received normal health education, while the observation group adopted self-regulating illness perception intervention on the basis of the control group. Clinical data were compared between the two groups, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and diffusing capacity of the lungs for carbon monoxide (DLCO), as well as scores from the brief illness perception questionnaire (B-IPQ), acceptance and action questionnaire-Ⅱ (AAQ-Ⅱ), modified british medical research council dyspnea scale, world health organization quality of life brief scale (WHOQOL-BREF), and herth hope index (HHI), assessed before and after the intervention.

After the intervention, the observation group showed FVC (2.74±0.58) L, FEV₁(2.27±0.45)L, and DLCO (17.78±2.11)ml/(mmHg·min), while the control group had FVC (2.70±0.56) L, FEV₁(2.20±0.43) L, and DLCO (17.84±2.56) ml/(mmHg·min). The B-IPQ (43.44±2.93) and AAQ-Ⅱ (23.20±1.95) scores in the observation group were significantly lower than those in the control group B-IPQ(47.31±2.25), AAQ-Ⅱ(25.98±2.43)(P<0.05). Meanwhile, the WHOQOL-BREF physical domain (58.02±4.33), psychological domain (63.01±3.33), and HHI (33.10±2.84) scores in the observation group were significantly higher than those in the control group physical (54.30±3.45), psychological (59.72±3.25), HHI (31.29±3.24)(P<0.05).

Self-regulating perception intervention can improve the illness perception level of patients with ILD and has clinical significance.

To analyze the efficacy of computed tomography(CT) guided percutaneous lung biopsy for pulmonary tumors.

A total of 152 patients with pulmonary tumors who underwent CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) at our hospital from January 2022 to June 2024 were selected as subjects. Using surgical histopathological results as the reference standard, the puncture success rate, diagnostic efficacy, complications, and influencing factors were analyzed.

Among the 152 cases, surgical histopathological results were positive in 103 cases (67.76%) and negative in 49 cases (32.24%). One-time puncture success was achieved in 148 cases (97.37%), while puncture failure occurred in 4 cases (2.63%). Complications occurred in 51 cases, including simple pneumothorax in 27 cases (52.94%). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT-PTNB for diagnosing pulmonary tumors were 96.71%, 97.09%, 95.92%, 98.04%, and 94.00%, respectively, showing good consistency with surgical histopathological results (Kappa=0.757, P<0.05). The lesion diameter in patients with complications was (3.28±1.01) cm, which was smaller than that in patients without complications (4.33±1.12) cm, while the distance from the lesion to the chest wall was (4.32±1.07) cm, which was greater than that in patients without complications (3.72±0.97) cm (P<0.05). Logistic regression analysis showed that an increase in lesion diameter (OR=0.542, 95%CI: 0.419~0.665) was a protective factor against complications in CT-PTNB, while an increase in the distance from the lesion to the chest wall (OR=3.284, 95%CI: 1.587~4.981) was a risk factor for complications in CT-PTNB (P<0.05).

CT-PTNB demonstrates high accuracy, sensitivity, and specificity in the diagnosis of pulmonary tumors, with a one-time puncture success rate of 97.37%. The complication rate is slightly high, with simple pneumothorax being the main complication. Timely optimization and improvement of preventive measures can help enhance the safety of CT-PTNB.

To analyze the clinical efficacy of a novel prone positioning assistive device in patients with acute respiratory distress syndrome (ARDS), aiming to reduce the number of healthcare workers required for traditional manual positioning, decrease complication risks, and address clinical workforce shortages.

Twenty-nine ARDS patients (severe cases 10.34%) admitted between April 2021 and July 2022 and meeting the Berlin Definition criteria were enrolled. A total of 58 prone positioning sessions were performed, using a self-controlled design, 29 manual turns, 29 device-assisted turns. The assistive device comprised a body-turning blanket and a lifting mechanism to secure and mechanically reposition patients. Manual turns required 4~5 staff members. Operation times (preparation time T₁, turning time T₂), complications, and workload index (staff number×time) were recorded.

Device-assisted turns required(3.34±0.48) staff members, significantly fewer than manual turns (5.10±0.49)(P<0.05).Workload index was lower in the device-assisted group (1 397.00±341.67) s versus the manual group (1 932.00±365.76) s(P<0.05). Total operation time (TT=T₁+ T₂) was longer for device-assisted turns (P<0.05), primarily due to increased T₁(blanket placement). No difference was observed in T₂. Complication rates 6.90% were identical, Manual group: 1 hypoxemia + 1 gastric tube dislodgement. Device-assisted group: 1 pressure ulcer + 1 gastric tube dislodgement (P>0.05). Vital signs, blood gas parameters and ventilator settings showed no significant differences between groups.

The novel prone positioning assistive device significantly reduces healthcare worker requirements and overall workload without increasing complication risks. It offers a safe and efficient solution for promoting prone ventilation therapy in ICU settings facing workforce shortages.

To compare the effects of budesonide, glycopyrronium bromide and formoterol fumarate inhalation aerosol combined with high-flow nasal cannula oxygen therapy (HFNC) and non-invasive positive pressure ventilation (NIPPV) respectively in the treatment of patients with chronic obstructive pulmonary diseases (COPD) complicated with type Ⅱ respiratory failure.

A total of 96 patients with COPD complicated with type Ⅱ respiratory failure admitted to our hospital were collected as the research objects. They were divided into a control group with 45 cases and an observation group with 51 cases. The control group was treated with budesonide, glycopyrronium bromide and formoterol fumarate inhalation aerosol combined with NIPPV, and the observation group was treated with budesonide, glycopyrronium bromide and formoterol fumarate inhalation aerosol combined with HFNC. Both groups were continuously treated for 7 to 10 days. The clinical efficacy, arterial blood gas analysis [respiratory rate (RR), heart rate (HR), oxygenation index (PaO₂/FiO₂), arterial partial pressure of carbon dioxide (PaCO₂), partial pressure of arterial oxygen (PaO₂), potential of hydrogen (pH)], computed tomography (CT) of the lungs and pulmonary function indexes [peak expiratory flow (PEF), forced expiratory volume in one second/forced vital capacity (FEV₁/FVC), maximal inspiratory volume (MIV), maximal expiratory volume (MEV)], oxidative stress and inflammatory indexes [β₂-microglobulin (β₂-MG), cholinesterase (CHE), soluble intercellular adhesion molecule-1 (sICAM-1), lipid peroxidation (LPO)], respiratory status, treatment comfort level and adverse reactions [COPD assessment test (CAT), Kolcaba general comfort questionnaire (GCQ) score, modified medical research council (mMRC) score] were compared between the two groups.

In the observation group, 32 cases were effective and 15 cases were improved, and the improvement rate of pulmonary function was 45 cases(88.24%), which was higher than that in the control group (24 cases were effective and 11 cases were improved, and the improvement rate of pulmonary function was 34 cases(75.56%). The levels of RR, HR, PaCO₂, LPO, sICAM-1, β₂-MG, MIV, MEV, CAT and mMRC scores in the observation group were (18.43±1.85) times/min, (82.89±3.24) times/min, (49.83±3.14) mmHg, (4.56±1.31) nmol/L, (185.45±19.77) ng/ml, (2.19±0.48) mg/L, (4287.51±314.27), (2123.06±274.33), (13.74±2.18) points and (1.57±0.33) points respectively, which were lower than those in the control group [(19.54±2.02) times/min, (84.57±3.36) times/min, (51.35±3.43) mmHg, (5.35±1.47) nmol/L, (196.52±22.37) ng/ml, (2.19±0.48) mg/L, (4 431.24±329.45), (2 269.62±285.47), (15.13±2.32) points and (1.76±0.38) points] (P<0.05). The levels of PaO₂/FiO₂, PaO₂, PEF, pH, FEV₁/FVC value, CHE level and GCQ score in the observation group were (304.54±22.71) mmHg, (66.11±3.56) mmHg, (356.42±25.68) L/min, (7.37±0.08), (70.07±5.22)%, (3 876.29±455.38) U/L and (85.07±4.12) points respectively, which were higher than those in the control group (292.36±24.42) mmHg, (64.25±3.43) mmHg, (343.26±24.73) L/min, (7.33±0.09), (67.76±4.84)%, (3 658.17±423.35) U/L and (82.75±4.34) points (P<0.05).

Budesonide, glycopyrronium bromide and formoterol fumarate combined with HFNC has an obvious curative effect on COPD patients with type Ⅱ respiratory failure, which can reduce the oxidative stress and inflammatory reaction in patients, and improve their physiological function, respiratory function, ventilation status and comfort level.

To analyze the correlation between peripheral blood heart-type fatty acid binding protein (H-FABP) and myocardial injury and prognosis in patients with severe pneumonia.

Sixty-four patients with severe pneumonia treated in our hospital from April 2020 to April 2024 were selected as the subjects. They were grouped according to the prognosis. 21 cases died as the observation group and 43 cases survived as the control group. The H-FABP and troponin Ⅰ in the peripheral blood of the patients were detected, and the correlation between H-FABP and troponin Ⅰ in the peripheral blood was analyzed by Spearman correlation. The general data of the two groups of patients were compared, and Logisic regression was used to analyze the influencing factors of the prognosis of severe pneumonia. The receiver operating characteristic(ROC) curve was applied to analyze the prediction of peripheral blood H-FABP level for the prognosis of patients with severe pneumonia.

The H-FABP in the peripheral blood of 64 patients was (6.88±1.41)ng/ml; Troponin Ⅰ was 0.28 (0.14, 0.45) μg/L. The Spearman results showed that H-FABP in peripheral blood was positively correlated with troponin Ⅰ (r=0.647, P<0.05); Age of the observation group, Acute Physiology and Chronic Health Evaluation Ⅱ score is Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ) (19.33±1.80)points, peripheral blood H-FABP (8.03±0.74)ng/ml, troponin Ⅰ 0.47(0.44, 0.53)were higher than the age, APACHEⅡ (17.77±2.29) points, peripheral blood H-FABP (6.33±1.32)ng/ml, and troponin Ⅰ 0.21 (0.10, 0.28) μg/L of the control group (P<0.05). The results of multivariate Logistic regression showed that age (OR=1.780, 95%CI: 1.166~2.717), APACHE Ⅱ(OR=1.779, 95%CI: 1.104~2.866), and peripheral blood H-FABP (OR=5.476, 95%CI: 1.769~16.948) were risk factors for the prognosis of patients with severe pneumonia (P<0.05); ROC analysis showed that age, APACHE Ⅱ, and the area under the curve of peripheral blood H-FABP predicted the prognosis of patients with severe pneumonia. The area under the curve (AUC) values were 0.847, 0.712, and 0.873 respectively (P<0.05).

Age, APACHE Ⅱ, and peripheral blood H-FABP level are the influencing factors for the prognosis of patients with severe pneumonia. There is a correlation between peripheral blood H-FABP level and myocardial injury, which can predict the prognosis of patients with severe pneumonia.

To analyze the perioperative therapeutic effectiveness of an ultrasound-guided serratus anterior plane block integrated within a multimodal anesthetic regimen in lung cancer patients undergoing thoracoscopic lobectomy.

A total of 87 lung cancer patients who underwent thoracoscopic lobectomy in our hospital from January 2020 to December 2024 were selected as the subjects. Based on anesthesia protocols, patients were systematically allocated into two distinct study cohorts: an observation group comprising 41 patients and a control group containing 46 patients. The control group received ultrasound-guided thoracic paravertebral nerve block, while the observation group underwent ultrasound-guided serratus anterior plane blockade targeting the surgical side as part of their anesthetic management. Respiratory parameters, postoperative analgesia, pulmonary function, perioperative medication use and anesthesia-related adverse effects were compared between the two groups.

In the observation group, T₁ oxygenation index (PaO₂/FiO₂) (149.32±28.95) mmHg, T₂ PaO₂/FiO₂(318.72±41.25) mmHg, T₃ PaO₂/FiO₂(354.83±48.76) mmHg, forced vital capacity (FVC) (2.14±0.46) L, forced expiratory volume in one second (FEV₁) (1.84±0.36)L, and maximal mid-expiratory flow curve (MMF) (1.43±0.31) L/s were higher than those in the control group (134.53±20.16)mmHg, (298.26±37.45) mmHg, (328.21±41.29) mmHg, (1.85±0.41) L, (1.68±0.31) L, (1.25±0.33) L/s, respectively. The observation group showed lower T₁ alveolar-arterial oxygen tension difference (A-aDO₂) (369.83±45.34) mmHg, T₂ A-aDO₂ (314.53±36.35) mmHg, T₃ A-aDO₂ (284.25±34.39)mmHg, 12-hour resting visual analogue scale (VAS) score (2.32±0.43) points, 24-hour resting VAS score (3.19±0.51) points, 12-hour coughing VAS score (2.97±0.61) points, 24-hour coughing VAS score (3.63±0.85) points, and total sufentanil consumption (104.34±16.32) μg compared to the control group (397.54±52.29) mmHg, (335.69±39.87) mmHg, (305.62±41.23) mmHg, (2.52±0.45) points, (3.56±0.58) points, (3.31±0.62) points, (4.15±0.89) points, (112.56±18.19) μg, respectively. The first patient controlled analgesia (PCIA) demand time in the observation group (7.62±1.12) h was later than that in the control group (7.09±1.08)h. The number of effective PCIA compressions in the observation group at 48 h (2.67±0.82) times was significantly lower than that in the control group (3.26±0.95) times (P<0.05).

The analgesic effect of ultrasound-guided serratus anterior plane block combined with general anesthesia is good. It is helpful to improve the lung function of patients, reduce the use of perioperative drugs, which is of clinical significance.

To investigate the effect of budesonide inhalation aerosol and non-invasive positive pressure ventilation (NPPV) on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with type Ⅱ respiratory failure.

A total of 102 patients with AECOPD complicated with type Ⅱ respiratory failure admitted to our hospital from January 2021 to January 2024 were enrolled. They were randomly divided into two groups, 42 cases in the control group and 60 cases in the observation group. The control group received NPPV treatment, while the observation group received additional budesonide inhalation aerosol treatment. After two weeks of treatment, the respiratory condition(SGRQ), arterial blood gas parameters, inflammatory markers and the airway wall thickness (WT), WT to airway diameter ratio (TDR) of the bronchial apical segment of the upper lobe of right lung were compared between the two groups.

Compared with before treatment, after treatment, the SGRQ scores in the two groups decreased, the observation group was better than the control group (P<0.05); The blood gas analysis was improved, the observation group PaO₂(80.56±9.47) mmHg and PaCO₂(45.47±4.89)mmHg were better than the control group (73.11±8.52)mmHg and (51.34±5.63)mmHg (P<0.05); The inflammation indicators of the two groups were also improved. The CRP (8.24±1.11)ng/ml and PCT (2.08±0.45)ng/ml were lower than the control group (12.60±2.63)ng/ml and (3.92±0.64) ng/ml (P<0.05); The WT and TDR of the upper lobe apical segment of the right lung decreased compared with before treatment. The WT (1.42±0.03) mm in the observation group and the TDR (0.20±0.03) was lower than that of the WT (1.48±0.02) in the control group and the TDR (0.24±0.02) (P<0.05); There were 4 patients of adverse reactions in the observation group (6.67%) and 2 patients in the control group (4.76%), There was no significant difference between the two groups (P>0.05).

The combined treatment of budesonide and NPPV can improve respiratory condition, lung function, arterial blood gas parameters, and inflammatory response in patients with AECOPD complicated with type Ⅱ respiratory failure.

This study seks to improve the clinical understanding of lung absceses that originate from the oral cavity. It emphasizes the pathogenesis, diagnostic aproaches, and treatment methods of Treponema denticola (T. denticola)-induced lung absceses. Moreover, the significance of oral-lung axis infection in respiratory infectious diseases is highlighted.

We present a case of T. denticola lung absces in a 58-year-old female patient with type 2 diabetes and por oral hygiene, and analyze its clinical characteristics while reviewing literature. The patient had chronic dry cough as the primary symptom, and imaging showed multiple consolidations in both lungs. We conducted a comprehensive etiological diagnosis by employing bronchoscopic biopsy, traditional microbial culture, and metagenomic next-generation sequencing (mNGS). The treatment regimen involved a sequential aproach with the use of piperacilin-tazobactam, penicilin G, and local oral care using povidone-iodine gargle, along with blod glucose management. A literature search included pathogenesis, diagnostic chalenges, and treatment strategies.

Erythrocyte sedimentation rate(ESR)64.00 mm/1 h, glucose(GLU)11.10 mmol/L, C-reactive protein(CRP)8.3 mg/L, The patient was definitively diagnosed by mNGS (T. denticola sequence count: 9, 165), while traditional culture failed to detect the pathogen. Symptoms improved after 10 days of initial piperacillin sodium-tazobactam sodium treatment, and follow-up CT after 6 weeks of sequential penicillin G therapy showed significant lesion resolution. Literature indicates that aspiration of oral flora is the core pathogenic mechanism, with diabetes and immunodeficiency as high-risk factors. Moreover, mNGS can overcome the limitations of traditional culture and accurately identify anaerobic bacteria. Effective treatments include β-lactam antibiotics combined with oral hygiene, typically requiring a 4-6 week course.

T. denticola lung abscess is rare but prone to misdiagnosis, particularly in individuals with poor oral hygiene and underlying diseases. mNGS technology significantly improves pathogen detection rates, guiding clinicians in precise anti-infective therapy. Penicillin-based treatment combined with oral intervention and management of underlying conditions is key to cure, and a multidisciplinary collaborative model is crucial for optimizing diagnosis and treatment.

To analyze the impact of silverestana combined with methylprednisolone sodium succinate and airway pressure release ventilation (APRV) on lung function in patients with acute respiratory distress syndrome (ARDS) caused by sepsis.

A total of 54 patients with ARDS due to sepsis admitted to our hospital from January 2020 to December 2024 were selected. They were divided into a control group of 31 patients and an observation group of 23 patients based on the treatment method. Both groups received conventional treatment and respiratory management. The control group was treated with APRV and intravenous infusion of 40 mg of methylprednisolone sodium succinate daily. The observation group received an additional 4.8 mg/kg of silverestana intravenously via a pump on top of the control group′s treatment regimen. The medications were administered continuously for 7 days. Hematological indicators, lung function, lung CT imaging results, acute physiology and chronic health evaluation Ⅱ (APACHE-Ⅱ) scores, murray lung injury scores (MLIS), sequential organ failure assessment (SOFA) scores, prognosis, and adverse reactions were compared between the two groups.

After treatment, the observation group exhibited lower levels of interleukin-6 (IL-6) (0.47±0.06) ng/L, procalcitonin (PCT) (0.43±0.07) ng/ml, C-reactive protein (CRP) (12.38±3.17) mg/L, and extravascular lung water index (ELWI) (8.34±1.39) ml/kg, APACHE-Ⅱ (13.19±2.12) points, MLIS (2.26±0.34) points, and SOFA (6.32±1.17) points compared to the control group, which had values of (0.52±0.09) ng/L, (0.48±0.09) ng/ml, (14.35±3.62) mg/L, (9.23±1.75) ml/kg, (14.65±2.68) points, (2.54±0.35) points, and (7.14±1.48) points, respectively. The observation group showed higher dynamic lung compliance (Cdyn) values (18.28±3.45) ml/cm and a higher survival rate of 18 cases compared to the control group, which had values of (16.47±3.06) ml/cm and 16 cases, respectively (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).

The combination of silverestana with methylprednisolone sodium succinate and APRV has clinical significance in improving blood gas indicators and lung function, reducing inflammation levels, and improving the prognosis of ARDS patients.

To analyze the predictive significance of combined serum biomarker testing for biological targeted therapy in children with bronchial asthma (BA).

A total of 64 children with BA admitted to our hospital from March 2022 to April 2025 were selected. Based on the efficacy after 16 weeks of omalizumab treatment, they were divided into two groups: 48 effective cases as the observation group and 16 ineffective cases as the control group. Clinical data, forced expiratory volume in one second (FEV₁), forced expiratory volume in one second/forced vital capacity ratio (FEV₁/FVC), peak expiratory flow (PEF), and serum biomarkers including immunoglobulin E (IgE), interleukin (IL)-4, IL-6, IL-17A, and IL-2R were compared between the two groups. Logistic regression analysis was used to identify factors influencing the responsiveness of BA children to biological targeted therapy, and receiver operating characteristic (ROC) curves were plotted to evaluate predictive value.

In the observation group, 23 cases (47.92%) had mild disease, and FEV₁ (94.42±8.54)% was higher than that in the control group [3 cases (18.75%), FEV₁ (81.53±5.65)%]. Total IgE (1 102.9±292.5)IU/ml, IL-4 (8.86±2.02)pg/ml, IL-6(8.95±2.37)pg/ml, IL-17A(8.62±2.31)pg/ml, and IL-2R(164.64±54.16)U/ml in the observation group were lower than those in the control group total IgE (1 677.7±527.9)IU/ml, IL-4 (12.78±3.54)pg/ml, IL-6 (10.64±3.15)pg/ml, IL-17A (13.39 ± 4.45)pg/ml, IL-2R (248.54±75.39)U/ml (P<0.05). Logistic regression analysis showed that disease severity (OR=0.358, 95%CI=0.127~1.006), FEV₁(OR=1.238, 95%CI=1.102~1.392), serum total IgE (OR=0.980, 95%CI: 1.102~1.392), IL-2R(OR=0.974, 95%CI: 0.954~0.994), and IL-4(OR=0.617, 95%CI: 0.402~0.947) were influencing factors for biological targeted therapy in children with BA. ROC curve analysis revealed that the area under the curve (AUC) for the combined prediction of serum total IgE, IL-4, and IL-2R for biological targeted therapy in children with BA was 0.896 (95%CI=0.906~0.999), which was higher than the AUCs for individual predictions of serum total IgE (0.683, 95%CI=0.703~0.904), IL-4 (0.654, 95%CI: 0.722~0.917), and IL-2R (0.642, 95%CI: 0.676~0.886).

Serum levels of IgE, IL-4, and IL-2R are negatively correlated with the efficacy of biological targeted therapy in children with BA. The combined prediction of serum IgE, IL-4, and IL-2R holds clinical significance for biological targeted therapy in children with BA.

To analyze the clinical efficacy of high-frequency chest wall oscillation expectoration (HFCWOE) versus traditional airway clearance techniques (TACT) in the treatment of severe pneumonia.

A retrospective analysis was conducted on 71 elderly patients with severe pneumonia, divided into control group 39 cases and observation group 32 cases according to the distinct treatment methods they received. Control group received fiberoptic bronchoscopic alveolar lavage combined with TACT. Observation group received fiberoptic bronchoscopic alveolar lavage combined with HFCWO. Clinical efficacy, symptom relief time, lung function, blood gas parameters, inflammatory mediator levels, and immune function were compared between the two groups.

After treatment, The total response rate of observation group was 87.50%, peak expiratory flow (PEF) (2.93±0.38)L/s, forced vital capacity (FVC) (2.61±0.33)L, forced expiratory volume in 1 second (FEV₁) (2.28±0.26)L, partial pressure of O₂ (PaO₂) (83.27±7.24)mmHg, PaO₂/fraction of inspiration O₂ (FiO₂) (341.86±37.54)mmHg, CD3⁺ T cell (CD3⁺ ) (62.53±11.28) % and natural killer cell (NK) (15.76±3.51)% were higher than those in control group 66.67%, (2.74±0.29)L/s, (2.42±0.28)L, (2.13±0.17)L, (78.92±6.86)mmHg, (320.63±42.79)mmHg, (55.78±10.36)%, (13.92±2.98)% (P<0.05). The disappearance time of lung wet rale (5.30±1.16)d, sputum relief time (4.89±1.07)d in observation group were shorter than those in control group (5.96±1.28)d, (5.46±1.19) d (P<0.05). partial pressure of CO₂(PaCO₂) (41.63±5.19) mmHg, neutrophil elastas (NE) (10.34±2.36)ng/L, soluble form of triggering receptors expressed on myeloid cell-1 (sTREM-1) (24.31±3.27)ng/L, interleukin-10(IL-10) (19.54±3.22)ng/L, CD8⁺ T cell (CD8⁺ ) (24.63±3.58)% in observation group were lower than those in control group (44.52±4.71) mmHg, (11.94±2.75)ng/L, (26.82±4.19) ng/L, (21.73±4.16)ng/L, (27.09±4.45) % (P<0.05).

HFCWOE has good clinical effect on patients with severe pneumonia. Compared with the use of TACT, it can shorten the time of relieving clinical symptoms, improve lung function and immune function of patients, regulate blood gas level of patients, and reduce inflammatory response.

To explore whether the doctor-nurse collaboration management can improve the tolerance, compliance and therapeutic effect of patients with malignant central airway stenosis treated by bronchoscopy under general anesthesia.

According to the characteristics of patients with malignant central airway stenosis treated by bronchoscopy under general anesthesia and the environment of respiratory endoscopy room, the doctor-nurse collaboration management was established. The object of study were patients diagnosed as malignant central airway stenosis from January 2022 to December 2023 and treated by intervention by bronchoscope under general anesthesia. 68 patients were divided into two groups. There were 35 patients in the doctor-nurse collaboration management group (observation group) and 33 patients in the conventional management group (control group). The observation indicators included preoperative negative emotions, postoperative comfort, operation time, total hospitalization time, complications, satisfaction and referral rate.

The total operation time of the observation group was (57.03±15.37) min, which was significantly lower than that of the control group (70.58±16.65) min, and the hospitalization time was significantly shortened. Postoperative comfort score of the observation group was (8.03±1.42) points, satisfaction rate was 88.58%, subsequent visit rate was 74.29%, which were significantly higher than control group (6.46±1.22)points, 67.74%, 48.39%. There was no significant difference in the incidence of intraoperative and postoperative complications between the two groups, and there were no serious complications such as cardiac arrest, malignant arrhythmia and massive hemorrhage.

Doctor-nurse collaboration management can obviously improve patients with malignant airway stenosis under general anesthesia via bronchoscope treatment of tolerance, satisfaction, compliance, reduce the operation time, is worthy of clinical application.