Under the conditions of rapid highland, by establishing models of severe thoracic blast injuries in sheep, the characteristics of injuries from two different types of blast injuries were analyzed.

It was selected that 70 healthy goats from their permanent residence at 2 800 meters and transport them approximately 130 km to an altitude of 4 600 meters, using 8 kg TNT equivalent. Divide the goats into groups based on distance from the explosion source using a random number method: 30 goats at 3 meters, 12 goats at 3.5 meters, 1 goat at 8 meters, 4 goats at 12 meters, and 23 goats at 16 meters. Secure the goats in custom iron frames facing to the right, and then detonate in separate controlled explosions. Collect vital signs, arterial blood gases, imaging data, and gross lung anatomy of the goats before (2 800 m, 4 600 m) and after the explosions, and analyze the characteristics of high-altitude blast injuries using descriptive research methods.

After reaching an altitude of 4 600 meters, the goats which resided at an altitude of 2 800 meters experienced a decrease in body temperature [(39.58±0.35) vs. (38.1±0.65)]℃, a decline in arterial oxygen pressure[(47.00±5.51 )vs. (36.97±4.69)]mmHg, and a reduction in SaO₂ [(86.83±4.02)vs. (71.1±12.54)]%. Severe thoracic blast injuries resulted in a survival rate of over 15 minutes of 43 individuals(61.42%) in primary, there were 29 individuals (41.42%), and in secondary, there were 14 individuals (20.00%). And over 30 minutes of 37 individuals(52.18%), in primary, there were 24 individuals (34.28%), and in secondary, there were 13 individuals (18.57%). Primary and secondary severe thoracic blast injuries showed no statistically significant difference in survival rate (P>0.05). severe primary thoracic blast injuries mainly presented as pneumothorax and lung contusion, sometimes accompanied by burns, ear, intestinal, and cardiac contusions. Secondary severe thoracic blast injuries were characterized by chest penetration injuries and lung lacerations, sometimes accompanied by thoracoabdominal or cardiorespiratory penetrating injuries, liver lacerations, and others. Following both types of thoracic blast injuries, the average arterial pressure significantly increased (P<0.05).

At an altitude of 2 800 meters, local goats exhibit symptoms of high-altitude sickness such as hypoxia and hypothermia after reaching an altitude of 4 600 meters. There are two types of severe chest blast injuries with the same fatality rate within 30 minutes. primary blast injury manifest discreetly and are followed by increased breathing, hypoxemia, and acidosis. Secondary injuries are easily detected but pose relative difficulties in early treatment.

To establish a bleomycin-induced pulmonary fibrosis mouse model and evaluate the therapeutic effects of allicin on pulmonary fibrosis.

Twenty-four C57BL/6 mice were divided into four groups, six mice per group, as follows: normal control, normal treated, model, and model treated groups. The model and model treated mice were induced with pulmonary fibrosis by intratracheal administration of 100 μl bleomycin (5 mg·kg concentration). After seven days, both normal treated and model treated groups received daily 100 μl of allicin (5 mg·kg concentration) for treatment, while equivalent volumes of saline were administered daily to the normal control and model groups. After three weeks, the mice were euthanized, and lung tissues were harvested for analysis. Fresh lung tissue samples were embedded, sectioned, and stained with HE and Masson′s trichrome to compare the pathological changes among the different groups. Additionally, lung tissue levels of hydroxyproline (HYP), total superoxide dismutase (T-SOD) activity, and malondialdehyde (MDA) content were measured.

Mouse weights at 1, 7, 14, and 28 days were: normal control group (20.49±0.55), (22.09±0.51), (23.76±0.57), (25.08±0.64)g; normal treated group (20.55±0.65), (21.79±0.70), (23.12±0.57), (24.64±0.49)g; model group (20.56±0.74), (19.78±0.77), (18.70±0.86), (17.67±1.11)g; model treated group (20.78±0.77), (21.49±0.81), (22.45±0.86), (23.81±0.72)g. Post-treatment with allicin, there was a reduction in alveolitis and significant improvement in pulmonary fibrosis. The pulmonary tissue HYP concentration values were: normal control group (0.87±0.09) μg/ml, normal treated group (0.86±0.03) μg/ml, model group (1.54±0.24) μg/ml, and model treated group (0.90±0.09) μg/ml. T-SOD activity levels: normal control group (24.20±0.11) U/mg, normal treated (24.29±0.14) U/mg, model group (14.75±0.64) U/mg, model treated group (19.25±0.69) U/mg. MDA contents: normal control group (1.21±0.08) nmol/mg, normal treated group (1.18±0.13) nmol/mg, model group (3.23±0.07) nmol/mg, model treated group (2.42±0.05) nmol/mg.

Allicin mitigates pulmonary fibrosis in the bleomycin-induced mouse model by reducing HYP and MDA levels and increasing T-SOD activity in lung tissue.

To analyze the role of E3 ubiquitin ligase constitutive photomorphogenetic protein 1(COP-1) in lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice and preliminarily explore its mechanism of action.

All of 48 male C57 mice were randomly divided into 4 groups: COP-1 knockout: COP-1^{+ /-}-PBS (KOPBS group), COP-1^{+ /-}-LPS (KOLPL group); Non-knockout COP-1: WT-PBS (WTPBS group), WT-LPS (WTLPS group), 12 in each group. Among them, the LPS group was given LPS 10 mg/kg intratracheally to model acute lung injury, while the PBS group was treated with an equal volume of PBS for the same time. 24 hours after modeling, lung tissue was taken, HE stained to observe morphological changes in lung tissue, wet/dry weight ratio (W/D) was measured, ELISA was used to measure tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), myeloperoxidase (MPO) activity in lung tissue and bronchoalveolar lavage fluid (BALF).

Morphological observations showed that infiltration of inflammatory cells, congestion, and edema in the KOLPS group lung tissue were more significant compared to the WT-LPS group, KOPBS group lung tissue, and the WTPBS group. Compared to the WTPBS group and KOPBS group, WTLPS group and KOLPS group, the level of inflammatory factors, MPO activity in lung tissue, and lung W/D ratio were significantly increased (P<0.05).

The knockout of E3 ubiquitin ligase COP-1 can aggravate LPS-induced acute lung injury in mice, the therapeutic effect of COP-1 in pneumonia needs further exploration.

The T cells spot test of tuberculosis infection(TSPOT.TB) and Genechip assays are new methods for the diagnosis and detection of tuberculosis (TB) infection. There is limited research on these methods in China. Since January 2021, the TSPOT.TB and Genechip assays have been routinely used at Tangdu Hospital. Therefore, the aim of this study was to investigate the efficacy of TSPOT.TB and Genechip assays and explore the feasibility of their combined diagnosis, providing reference and guidance for TB detection and diagnosis in non-TB comprehensive hospitals.

A retrospective study was conducted on 256 hospitalized patients admitted to Tangdu Hospital from January, 2021, to April, 2023. All patients underwent TSPOT.TB, Genechip, and acid-fast bacilli smear microscopy (AFB) tests. Active TB cases were considered based on a composite reference standard (CRS). The three diagnostic methods were compared and evaluated.

A total of 256 patients underwent TSPOT.TB, Genechip, and AFB testing simultaneously. Among them, 105(41.02%) were diagnosed with active TB. with 141(55.08%) being over 60 years old and 105(44.92%) being under 60 years old. For patients over 60 years old, the sensitivity, specificity, and AUC of T-SPOT.TB, AFB, and Genechip assays for TB detection were as follows: 47.45%, 82.93%, 0.652; 16.94%, 98.78%, 0.579; 74.57%, 98.78%, 0.867. For patients under 60 years old, the sensitivity, specificity, and AUC of T-SPOT.TB, AFB, and Genechip assays for TB detection were as follows: 44.65%, 85.50%, 0.656; 10.86%, 100.00%, 0.554; 73.91%, 98.55%, 0.862. In combined testing, for patients over 60 years old, the AFB+ Genechip assay showed the highest diagnostic efficacy with sensitivity, specificity, and AUC of 84.74%, 97.56%, and 0.912, respectively. For patients under 60 years old, the T-SPOT.TB+ AFB+ Genechip combination had the highest diagnostic efficacy with sensitivity, specificity, and AUC of 100.00%, 84.05%, and 0.920, respectively.

The Genechip assay has high sensitivity and specificity and is highly valuable in TB diagnosis. However, the combined use of TSPOT.TB, AFB, and Genechip assays for TB diagnosis shows higher efficacy and can more effectively diagnose TB.

To analyze the pathological types and clinical characteristics of idiopathic pulmonary fibrosis-lung cancer (IPF-LC) patients, the protection and risk factors of IPF-LC.

From November 2014 to October 2022, 190 IPF patients admitted to our hospital were divided into simple IPF group (n=144) and IPF-LC group (n=46) according to whether the patients were complicated with lung cancer. The clinical data, blood gas analysis, imaging examination, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) levels of the two groups were collected.

Among the 144 cases in the simple IPF group, there were 95 males (65.97%) and 49 females (34.03), with an average age of (58.10±11.57) years; among the 46 cases in the IPF-LC group, there were 41 males (89.13%) and 5 females (10.87%), with an average age of (63.91±10.12) years, with a statistically significant difference in gender and age between the two groups (P<0.05). The average smoking index of the simple IPF group was 250 years, and the average smoking index of the IPF-LC group was 700 years, with a statistically significant difference (P<0.05); there were statistically significant differences in hemoptysis, chest pain, weight loss and clubbing between the simple IPF group and the IPF-LC group (P<0.05); in the IPF-LC group, there were 13 cases (28.26%) of nodular mass shadows in the upper lobe, 24 cases (52.17%) in the lower lobe, and 37 cases (80.43%) in the periphery. There were statistically significant differences in arterial oxygen partial pressure (PaO₂), CRP and ESR levels between the two groups (P<0.05); decreased PaO₂ was a risk factor for IPF patients with LC (P<0.05).

Male IPF patients over 65 years old with high smoking index are more likely to be complicated with LC; The IPF-LC group is more likely to have clubbing, hemoptysis, chest pain, and weight loss than the IPF group alone; the levels of CRP and ESR in the IPF-LC group are higher than those in the IPF group alone, suggesting that chronic inflammatory mediators play a role in the pathogenesis of IPF-LC; the imaging examination of IPF-LC shows that the masses often occur in the area of obvious fibrosis, peripheral lung and lower lobe; PaO₂ is a protective factor for IPF-LC.

To analyze the CT imaging characteristics, clinicopathological features, diagnosis and differential diagnosis of minute pulmonary meningothelial-like nodules (MPMNs).

A total of 42 patients with MPMN diagnosed in our hospital from December 2020 to January 2023 were selected. Retrospective analysis of the CT imaging features, histomorphological manifestations. Expression of SSTR2, PR, Vimentin, EMA, CD56, CK (AE1/AE3), TTF-1, CgA, Syn, SMA, Ki-67 was detected by immunohistochemical EnVision method and the relevant literature was reviewed.

In 42 cases, 23 cases were associated with pulmonary precursor adenopathy and malignancy, 8 cases with benign pulmonary lesions and 11 cases without concomitant lesions. High-resolution CT showed scattered to multiple microscopic nodules in both lungs in addition to the main lesion in 42 patients, and post-operatively multiple MPMN were found in 10 cases and single in 32 cases, with lesion sizes <1.0 cm. Both intraoperative frozen sections and paraffin sections showed widened alveolar septa with mild epithelioid and spindle cells proliferating in clusters along the interstitium with indistinct cell borders forming a syncytial pattern, round or ovoid nuclei, inconspicuous nucleoli, moderate cytoplasm, lightly stained, rare nuclear schizophrenia, and intra-nuclear pseudo-inclusion bodies. Immunohistochemical results were positive for SSTR2 (21/21) and vimentin (29/29), positive for PR (28/29), positive for EMA (28/32), positive for CD56 (18/21), and negative for ER, CK (AE1/AE3), TTF-1, CgA, Syn, and SMA were all negative, Ki-67 positivity index was<1%.

MPMN occurs in middle-aged and elderly women, with small lesion diameters, and most MPMN may be multiple lesions. The cell morphology and immunophenotype are similar to meningiomas, and the diagnosis is supported by positive immunohistochemical markers SSTR2, PR, CD56, and EMA.

To study the effects of platelet (PLT), fibrinogen (FIB) and albumin / fibrinogen (ALB/FIB) on the prognosis of patients with advanced non-small cell lung cancer (NSCLC) who received second-line therapy with bevacizumab.

The baseline clinical characteristics and blood parameters of 91 patients with advanced NSCLC treated with bevacizumab in Qingdao Municipal Hospital were retrospectively analyzed. PLT, FIB and ALB/FIB are based on the latest blood test results before bevacizumab treatment to determine their best cut-off values. Kaplan-Meier analysis and COX regression analysis were used to analyze the factors related to progression-free survival (PFS).

Univariate analysis indicates a significant correlation between baseline PLT, FIB, ALB/FIB, and progression-free survival (PFS). Multivariate analysis reveals that baseline PLT and FIB are not independent prognostic factors for PFS. Instead, age (HR: 1.719, 95%CI: 1.036-2.851, P=0.036), brain metastasis (HR: 0.475, 95%CI: 0.269-0.840, P=0.01), and prior surgery (HR: 0.479, 95%CI: 0.251-0.913, P=0.025) emerge as independent prognostic factors for PFS. Additionally, the analysis indicates that a high pre-treatment level of ALB/FIB ratio independently predicts longer PFS (HR: 0.118, 95%CI: 0.025-0.553, P=0.007). Utilizing X-tile software, the optimal cutoff values for baseline PLT, FIB, and ALB/FIB are determined to be 282, 4.61, and 8.8, respectively. Kaplan-Meier analysis reveals that patients in the baseline low platelet (PLT) group exhibit a more favorable prognosis compared to those in the baseline high PLT group (217 d vs. 386 d, P<0.001). Similarly, patients in the baseline low fibrinogen (FIB) group demonstrate a superior prognosis compared to the baseline high FIB group (200 d vs. 337 d, P<0.001). Furthermore, patients in the baseline high albumin/fibrinogen (ALB/FIB) group exhibit a more favorable prognosis compared to the baseline low ALB/FIB group (360 d vs. 183 d, P<0.001).

Low levels of baseline PLT, FIB and high levels of baseline ALB/FIB may indicate a better prognosis in patients with advanced non-small cell lung cancer treated with bevacizumab.

To construct a column chart prediction model for obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension and analyze its predictive value.

A total of 127 patients with obstructive sleep apnea-hypopnea syndrome admitted to our hospital from July 2021 to February 2023 were selected as the study objects, 92 patients with simple obstructive sleep apnea-hypopnea syndrome were selected as the control group, and 35 patients with obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension were selected as the observers. The risk factors of obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension were analyzed, and the linear prediction model of obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension was constructed.

Patients with obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension have a history of underlying diseases, a proportion of recent history of acute bacterial infection, NLR, PLR, CRP, RDW, ET-1 levels, and higher levels of nitrite, SpO₂, cardiac output and NO level were relatively low (P<0.05). Multivariate logistic regression analysis showed that recent acute bacterial infection history [OR(95%CI): 4.815 (3.580-6.052)], NLR [OR(95%CI): 3.284 (2.362-4.206)], PLR[OR(95%CI): 5.124 (23.942-6.306)], CRP[OR(95%CI): 3.688 (2.754-4.622)], RDW[OR(95%CI): 4.129 (3.377-4.881)], nitrite [OR(95%CI): 4.958 (3.766-6.150)], SpO₂[OR(95%CI): 5.607(4.471-6.743)], cardiac output [OR(95%CI): 4.116(3.390-4.842)]], NO[OR(95%CI): 4.968(3.832-6.104)] and ET-1[OR(95%CI): 5.228(4.108-6.348)] were the main factors affecting obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension (P<0.05). Based on recent history of acute bacterial infection, NLR, PLR, CRP, RDW, nitrite, SpO₂, cardiac output, NO, and ET 110 independent risk factors, a column-line prediction model for obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension was drawn using a column-line online website. The sensitivity, specificity, accuracy, area under the curve and 95%CI of the prediction model for obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension were 91.47%, 92.68%, 91.81% and 0.921(0.882-0.960), respectively.

Recent history of acute bacterial infection, NLR, PLR, CRP, RDW, nitrite, SpO₂, cardiac output, NO and ET-1 are all associated with obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension. The prediction model based on the above indexes can effectively predict obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension.

To analyze the clinical and imaging characteristics of benign solitary pulmonary nodule (SPN), misdiagnosed as malignant, and typical malignant SPN before surgery, and establish a model to predict malignant SPN.

A total of 621 patients with suspected malignant SPN admitted to our hospital from January 2019 to March 2022 who underwent surgical treatment before surgery were selected, 243 patients with benign SPN confirmed by postoperative pathology were divided into observation group, and 378 cases with typical malignant SPN were divided into control group. The clinical image data of patients were collected, the risk factors of malignant SPN were screened by multi-factor logistic regression analysis, and the prediction model of malignant SPN was established to verify the prediction efficiency of the model.

There were 129 females (53.09%) in the observation group, with an average age of (54.66±10.52)years, and 242 females (64.02%) in the control group, with an average age of (59.68±8.48) years (P<0.05). In the observation group, there were 173 solid nodules (71.19%), 155 peripheral pulmonary cleft nodules (63.79%), and 143 circular/quasi-circular nodules(58.85%), while in the control group, 184 solid nodules (48.68%), 77 peripheral pulmonary cleft nodules (20.37%), and 161 circular/quasi-circular nodules(42.59%)(P<0.05). Multivariate regression analysis showed that age, tumor markers, diameter, average CT value of volume, clear boundary, relationship with pulmonary fissure location, lobed, pleural depression sign were risk factors for malignant SPN (P<0.05). The model verified that the area under the receiver operating characteristic curve was 0.815, which was larger than the PKUPH model (0.785, P=0.776) and Mayo model (0.502, P=0.012).

The majority of benign SPN women are easily misdiagnosed as malignant before surgery. The age of onset is younger. The imaging features are round/quasi-round, and the solid components around the pulmonary fissure are dominant. The model is effective in predicting malignant SPN and has clinical significance.

To analyze the treatment situation of multi-drug resistant pulmonary tuberculosis in a certain area, and to build a prediction model for the treatment compliance of such patients.

All of 148 patients with multidrug-resistant pulmonary tuberculosis admitted to our hospital from March 2019 to December 2022 were selected as the research object, and the treatment status of the patients was followed up for 6 months. 39 patients with Morisky medication adherence scale (MMAS) <6 points were the observation group, and 109 patients with MMAS 6-8 points were the control group, the influencing factors of treatment compliance were confirmed by multivariate Logistic regression equation, which was used to construct a nomogram prediction model of poor treatment compliance of patients with drug-resistant tuberculosis.

Sputum culture in 81 cases (54.73%) turned negative, MMAS score was (6.15±1.03), 67 cases (45.27%) did not turn negative, MMAS score was (5.76±1.05) points (P<0.05). The age of the observation group [(51.05±8.23) vs. (46.18±7.59)] years, the number of drug types (>6) [27 cases (69.23%) vs. 52 cases (47.71%)] and the adverse reactions after medication [12 cases (30.77%) vs. 16 cases (14.68%)] were higher than those of the control group. Years of education [(9.65±2.62) vs. (11.20±3.17)], average monthly personal income (<3 000 yuan) [19 cases (48.72%) vs. 21 cases (19.27%)], SSRS score [(35.15±4.02) vs. (40.36±6.18)] and the proportion of disease education [18 cases (46.15%) vs. 71 cases (65.14%)] were lower than those in the control group (P<0.05). Multivariate Logistic regression coefficient analysis showed that age (OR=1.158), years of education (OR=0.815), personal average monthly income (<3, 000 yuan) (OR=27.408) and SSRS score (OR=0.860) were independent influencing factors of treatment compliance of patients with multidrug-resistant pulmonary tuberculosis (P<0.05). The nomogram prediction model shows that the score of nomogram model increases by 9 points every time the patient′s age increases by 5 years; For every 2 years of education, the score of nomogram model will increase by 5 points; The nomogram score corresponding to an average monthly income of less than 3, 000 yuan is 27.5 points; For every 5 points of SSRS score reduction, the nomogram model increases by 13.5 points. The ROC curve shows that the AUC of the nomogram prediction model is 0.871 (95%CI: 0.811-0.931). The slope of calibration curve and Hosmer-Lemeshow goodness-of-fit test (χ²=7.347, P=0.500) showed that the nomogram model predicted the risk of treatment noncompliance in patients with multi-drug-resistant tuberculosis and the actual risk was in good agreement.

After 6 months of treatment, 54.73% of patients with multi-drug-resistant pulmonary tuberculosis turned negative. Age, years of education, average monthly income and low level of social support are the independent risk factors of patients′poor treatment compliance. The nomogram model of patients′poor treatment compliance formed by integrating these risk factors can be applied to predict the risk of patients′poor treatment compliance in clinic and provide value for improving the treatment effect of diseases.

To analyze the clinical characteristics of patients with interstitial lung disease (ILD) complicated with pneumothorax and mediastinal emphysema.

The clinical data of 36 ILD patients with pneumothorax and mediastinal emphysema diagnosed and treated in the respiratory department of our hospital from November, 2011 to August, 2022 were retrospectively analyzed, the clinical characteristics of this population were described, and the outcome was analyzed.

There were 20 patients with pneumothorax and 16 patients with mediastinal emphysema. IPF accounted for the highest proportion of the two types of patients, 8 cases (40.00%) and 4 cases (25.00%), respectively. Other ILD types include: idiopathic pleuroparenchymal fibroelastosis(iPPFE), idiopathic non-specific interstitial pneumonia(iNSIP), interstitial pneumonia with autoimmune features(IPAF), dermatomyositis interstitial lung disease(DM-ILD), rheumatoid interstitial lung disease(RA-ILD), microscopic polyvasculitis interstitial lung disease(MPA-ILD), pulmonary alveolar proteinosis(PAP), chemotherapy related interstitial lung disease, cryptogenic organizing pneumonia(COP). usual interstitial pneumonia(UIP) and NSIP were the main imaging types. The patients had cough symptoms. They were complicated with emphysema, pulmonary bullae, pulmonary heart disease, pleural effusion, infection, etc. Some patients also had ILD exacerbation or acute exacerbation of ILD(AE-ILD). Among the patients who died, the proportion of patients with ILD exacerbation, AE-ILD, ventilator treatment during hospitalization and glucocorticoid treatment before onset was higher (P<0.05), and the proportion of patients with pneumothorax and mediastinal emphysema who developed AE-ILD was higher (P<0.05).

Pneumothorax and mediastinal emphysema are both of the complications of ILD. They can affect the prognosis of patients with ILD, and should be actively prevented. When patients with ILD have increased dyspnea, chest pain, decreased oxygenation and other conditions, it is necessary to actively improve the relevant examination, and be alert to the occurrence of pneumothorax and mediastinal emphysema.

To analyze the effects of vitamin D₃ combined with Montelukast sodium on vascular endothelial growth factor (VEGF) and transforming growth factor (TGF-β1) and lung function in the treatment of bronchial asthma.

A total of 69 patients with bronchial asthma admitted to our hospital from January 2020 to December 2022 were selected as subjects. Vitamin D₃ combined with Montelukast sodium treated 32 cases as observation group, Montelukast sodium treated 37 cases as control group. The therapeutic effect, clinical symptoms, lung function parameters, immune function level, serum VEGF and TGF-β1 levels and adverse reactions were compared between the two groups.

After treatment, 28 cases (87.50%) were effective in observation group and 25 cases (67.56%) in control group (P<0.05). The clinical symptoms of the two groups were relieved, the relief of wheezing (3.45±0.55) d, cough (5.87±1.32) d, chest tightness (4.55±1.07) d, dyspnea (1.38±0.25) d and wheezing (4.44±1.32) d in the observation group were lower than those in the control group (P<0.05). The levels of FVC, FEV₁ and PEF in the two groups were higher than those before treatment, and FVC (4.56±1.23) L, FEV₁ (2.98±0.53) L and PEF (3.97±1.98) L/min in the observation group were higher than those in the control group (P<0.05). The level of immune function in both groups was improved compared with that before treatment (P<0.05). CD3⁺ (69.75±4.87) %, CD4⁺ (45.13±3.56) % and CD4⁺ /CD8⁺ (1.78±0.56) in observation group were higher than those in control group, and CD8⁺ (25.32±2.58) % were lower than those in control group (P<0.05). The levels of VEGF and TGF-β1 in the two groups were lower than those before treatment, and the levels of VEGF (223.62±63.35) ng/L and TGF-β1 (364±66.65) ng/L in the observation group were lower than those in the control group (P<0.05).

Vitamin D₃ combined with Montelukast sodium is effective in the treatment of bronchial asthma, which can shorten the clinical symptoms of patients with bronchial asthma, improve lung function, enhance immunity, and reduce the levels of VEGF and TGF-β1.

To analyze the clinical prevalence distribution characteristics of patients with rare diseases.

The medical records of 1 820 cases of Rare disease hospitalized in our hospital from 2019 to 2021 were selected for descriptive epidemiological research.

The 1 820 rare disease inpatients accounted for 0.51% of the total 360 348 inpatients admitted to our hospital during the same period. Among 1 820 patients with rare diseases, 1 136 were males and 684 were females. The sex ratio of hospitalized patients with rare diseases was 1.41︰1; The distribution of cases in different age groups was as follows: young adults > middle-aged and elderly > adolescents > children; Ten of the 21 disease system classifications were involved, among which the largest number of patients with neurological diseases was 1 149 (63.13%); a total of 1 202 cases (66.04%) were covered by the 10 types of rare cases, in the following order: homocysteinemia, 598 (49.75%); optic neuromyelitis optica, 139 (11.56%); autoimmune encephalitis, 117 (9.73%); and multiple system atrophy, 84 cases (9.73%), multiple system atrophy in 84 cases (6.99%), Castleman′s disease in 79 cases (6.57%), dark spot polyp syndrome in 44 cases (3.66%), ventricular myocardial densification insufficiency in 43 cases (3.58%), spinal cerebellar ataxia in 38 cases (3.16%), systemic sclerosis in 31 cases (2.58%), and Marfan syndrome in 29 cases (2.41%); Follow-up and prognostic results, overall follow-up of rare diseases was 1 405 cases (77.20%), of which 524 cases (87.63%) were followed up for homocysteinemia, with an effective rate of 475 cases (90.64%).

Rare diseases are characterized by a wide age range of prevalence, diverse types of disease, and wide variation in efficacy and prognosis.

To analyze the efficacy of different doses of imipenem/cilastatin sodium in the treatment of severe pneumonia.

A total of 58 patients with severe pneumonia admitted to the hospital from July 2021 to August 2023 were selected and divided into a control group (27 cases) and an observation group (31 cases) according to different treatment methods. Both groups received basic treatment. The control group received low dose (1.0 g) of imipenem and cilastatin sodium, while the observation group received high dose (2.0 g) of imipenem and cilastatin sodium. Both groups were treated for 7 days. Lung function, blood gas indexes, clinical efficacy, serological indexes, pathogenic bacteria clearance and adverse reactions were compared in two groups.

Serum indicators, IL-8 of observation and control groups before treatment(0.47±0.06) vs. (0.46±0.05), after treatment (0.21±0.03) vs. (0.28±0.04)ng/ml(P<0.05); sICAM-1 before treatment(33.57±4.96) vs. (32.48±4.32), after treatment(8.25±2.08) vs. (14.19±3.27)ng/L(P<0.05). Arterial blood gas parameters, PaCO₂ of observation and control groups, before treatment(83.57±7.22) vs. (82.43±7.68)mmHg, after treatment(56.38±5.07) vs. (67.23±6.15)mmHg(P<0.05); PaO₂ before treatment(54.83±6.79) vs. (53.40±6.51)mmHg, after treatment (91.35±9.81) vs. (77.36±8.42)mmHg(P<0.05); SaO₂ before treatment(85.26±6.64) vs. (86.77±6.24)%, after treatment(95.63±8.97) vs. (90.82±7.39)%(P<0.05). After treatment, maximum mid-expiratory flow (MMF), forced expiratory volume in the first second (FEV₁) and forced vital capacity (FVC) levels in 2 groups were increased (P<0.05), and those in observation group were higher [FVC(2.99±0.48)L, FEV₁(2.18±0.35)%, MMF(1.59±0.31)L/s (P<0.05)].

Compared with low dose imipenem cilastatin sodium, high dose imipenem cilastatin sodium is effective in the treatment of severe pneumonia, can improve lung function and blood gas indexes, reduce inflammatory response, regulate serum sICAM-1 and CD40L levels, and increase the clearance rate of pathogenic bacteria, and is safe and reliable.

To analyze the clinical characteristics of acquired immunodeficiency syndrome(AIDS) complicated with chronic obstructive pulmonary disease (COPD).

The clinical data of 98 COPD patients who were admitted to Chongqing Public Health Medical Center during the period from June 2021 to October 2022 were reviewed retrospectively. According to pulmonary function tests, 35 COPD+ AIDS patients were divided into observation group, 63 COPD patients were divided into control group, and analyzed the differences of clinical characteristics between the two groups.

Patient sex, smoking history, body weight, hypertension, diabetes, coronary heart disease, partial pressure of carbon dioxide in arterial blood, right atrium and right ventricle measurements, pulmonary artery pressure, bronchiectasis, lung infection did not show significant differences between the two groups (P>0.05). In observation group, patients had younger age[(58.72±16.86)vs. (68.92±7.87)](P<0.05), lower CD4⁺ T cell count[(137.55±88.32)vs. (319.82±119.78)]and higher CD8⁺ T cell count[(408.79± 209.66)vs. (269.74±412.06)](P<0.05), lower oxygenation index[(320.48±86.27)vs. (345.78±68.16)](P<0.05), more obviously emphysema(77.14% vs.15.87%)than patients in control group(P<0.05). In observation group, patients had significantly lower Vcmax[(2.02±0.68)vs.(2.56±0.75)], TLC[(68.99±17.29)vs. (97.10±22.57)], RV%[(110.46±38.61)vs. (137.13±40.18)], FVC[(1.92±0.67)vs. (2.58±0.83)], FEV₁[(1.05±0.49)vs. (1.32±0.57)], FEV₁%[(41.42±14.58)vs. (54.79±19.63)], PEF%[(22.69±9.83)vs. (42.78±17.64)], DLCO[(3.26±1.98)vs. (5.65±1.38)], VA[(0.87±0.46)vs. (1.02±0.26)]and worse dispersion function(88.57% vs. 12.70%) than control group (P<0.05). In observation group, had significantly higher FEV₁/FVC[(62.65±3.67)vs. (50.23±11.97)], MVV[(108.24±17.63) vs. (36.79±21.37)], MMEF75/25%[(20.12±14.83)vs. (18.98±7.26)]than controlgroup(P<0.05).

AIDS+ COPD patients who are younger have lower oxygenation index, the increased CD8⁺ cell count accelerated the develop of COPD. AIDS lead to more severe lung function impairment especially in diffusion disorder and restrictive ventilation disorder. Diffusion disorder is not completely reversible while ventilation dysfunction might be improved by antiretroviral therapy(ART) or treatment of opportunistic infections. Considering of the treatment of AIDS complicated with COPD, early regular ART, prevention and treatment of various lung opportunistic infections are expected to reverse the sustained impairment of lung function in patients to a certain extent.