To identify key ferroptosis-related hub genes associated with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), explore their relationship with immune response and inflammation, and validate their diagnostic efficacy, providing new targets for early diagnosis and treatment.

Gene expression datasets GSE216943, GSE263867, and GSE236215 were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were analyzed using R software, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. Ferroptosis-related genes were integrated to identify ALI/ARDS-associated hub genes, followed by LASSO regression and random forest algorithm analysis. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of the genes, and immune infiltration was analyzed using CIBERSORT.

In dataset GSE216943, 281 DEGs were identified (39 downregulated, 242 upregulated), while GSE263867 revealed 969 DEGs (449 downregulated, 520 upregulated). There were 220 intersecting DEGs between the two datasets, comprising 32 downregulated and 188 upregulated genes. GO analysis indicated involvement in immune and inflammatory processes such as lipopolysaccharide response, cytokine signaling, and leukocyte migration. LASSO regression identified 5 key genes: Cybb, Hmox1, Cp, Ⅱ1b, and Fth1. Random forest analysis highlighted 6 key genes: Cybb, Lcn2, Ⅱ1b, Cxcl2, Hmox1, and Timp1. Venn diagram illustrated Cybb, Hmox1, and Ⅱ1b as central hub genes in ALI/ARDS. ROC curve analysis showed AUCs of 1 for Ⅱ1b, Hmox1, and Cybb in both GSE216943 and GSE263867. Validation set GSE236215 demonstrated AUCs of 1 for Ⅱ1b and Hmox1, and 0.969 for Cybb. Beanplot depicted elevated expression of Ⅱ1b, Hmox1, and Cybb in the ALI/ARDS group. The CIBERSORT algorithm revealed significant differences in immune cell composition between 11 ALI/ARDS and 11 control samples. Immune correlation analysis indicated negative correlations of memory B cells, M2 macrophages, resting dendritic cells, and resting mast cells with hub genes Ⅱ1b, Hmox1, and Cybb, while positive correlations were observed with naive B cells, M0 macrophages, M1 macrophages, activated mast cells, and neutrophils. Activated NK cells and monocytes showed negative correlations with Ⅱ1b and Hmox1, while follicular helper T cells positively correlated with Cybb.

This study identifies Cybb, Hmox1, and Ⅱ1b as pivotal ferroptosis-related hub genes in ALI/ARDS. These genes are closely associated with macrophage polarization and T cell responses, may serve as promising biomarkers and therapeutic targets for the molecular diagnosis and treatment of ALI/ARDS.

To analyze the effect of anti-angiogenic drugs combined with programmed death 1 (PD-1) blockade on the treatment of non-small cell lung cancer (NSCLC) and T lymphocyte subsets.

A total of 64 patients with advanced stage (confirmed by pathology or cytology as stage ⅢB/ⅢC/Ⅳ) NSCLC admitted to Xinjiang Production and Construction Corps Hospital (The Second Affiliated Hospital, School of Medicine, Shihezi University) from January 2019 to June 2023 were retrospectively selected as the subjects, including 33 patients in the observation group and 31 patients in the control group. Bevacizumab injection was administered intravenously or anrotinib hydrochloride capsules were administered orally. The proportion of peripheral plasma CD3⁺ T cells, CD4⁺ T cells, CD8⁺ T cells, CD4⁺ /CD8⁺ T cells, CD4⁺ /CD25⁺ regulatory T cells before and 6 weeks after treatment were analyzed by flow cytometry. The primary endpoint is to evaluate treatment response and survival based on the clinical efficacy evaluation criteria for solid tumors version 1.1, and calculate disease control rate and objective efficacy rate; Statistics on progression free survival and overall survival. The secondary endpoints are the occurrence and severity of adverse events, as well as abnormal changes in vital signs and laboratory parameters, according to the National Cancer Institute′s Common Terminology for Adverse Events 4.0. The follow-up deadline is December 2024.

There was no statistically significant difference in objective efficacy between the control group and the observation group (25.81% vs. 42.42%, P=0.162). However, the disease control rate of the control group patients was significantly lower than that of the observation group (61.29% vs. 90.91%, P=0.007). After treatment, the proportions of CD4⁺ and CD4⁺ /CD8⁺ in both groups increased compared to before treatment, and the observation group was higher than the control group (CD4⁺ : 40.48±9.86% vs. 34.03±7.48%, P=0.005; CD4⁺ /CD8⁺ : 1.68±0.59% vs. 1.33±0.49%, P=0.013). In addition, the proportions of CD8⁺ cells (25.92±6.45% vs. 33.62±9.55%) and CD4⁺ CD25⁺ (4.47±1.80% vs. 5.53±2.13%) in the observation group decreased compared to before treatment, while the percentage of CD3⁺ cells (71.66±9.90% vs. 66.18±11.25%) increased compared to before treatment (P<0.05). The incidence of adverse immune reactions was 56.25%, and more than 10% of adverse immune reactions include thyroid dysfunction, blood/lung/gastrointestinal/liver toxicity. Kaplan-Meier survival curve analysis showed that the median progression free survival in the observation group was 7.8 months, which was longer than the control group′s 6.9 months (Log Rank χ²=5.943, P=0.015).

The combination therapy of PD-1 monoclonal antibody and anti angiogenic drugs can improve the immune suppression status of the body, effectively improve the disease control rate and prolong the progression free survival of advanced NSCLC patients, and will not increase immune related adverse reactions during the treatment process.

To analyze the risk factors for secondary pulmonary infection in patients with chronic obstructive pulmonary disease (COPD) complicated by heart failure (HF).

All of 76 COPD patients with HF admitted to our hospital from January 2023 to December 2024 were selected as subjects. They were divided into groups based on the occurrence of pulmonary infection: 31 patients with secondary pulmonary infection were assigned to the observation group, and 45 patients without secondary infection were assigned to the control group. Clinical data were collected, and the occurrence of pulmonary infection was analyzed. Multivariate Logistic regression analysis was used to identify the influencing factors for secondary pulmonary infection in COPD patients with HF. A nomogram was constructed, and its predictive value was analyzed.

In the observation group 26 cases (83.87%) had a higher prevalence of diabetes history and 25 cases (80.65%)long-term use of glucocorticoids or antibiotics compared to the control group diabetes history 10 cases(22.23%); long-term glucocorticoid/antibiotic use 15 cases( 33.33%). Serum albumin levels were lower in the observation group (34.70±4.55) g/L than in the control group (39.58±4.60) g/L (P<0.05). Logistic regression analysis identified diabetes history (OR=1.050, 95%CI: 1.024~1.077), long-term use of glucocorticoids or antibiotics (OR=1.104, 95%CI: 1.043~1.169), and serum albumin level (OR=0.850, 95%CI: 0.792~0.912) as risk factors for secondary pulmonary infection in COPD patients with HF (P<0.05). The dataset was split into a training set (53 cases) and a validation set (23 cases) in a 7︰3 ratio. The area under the curve (AUC) (95% CI) of receiver operating characteristic (ROC) curve for predicting secondary pulmonary infection was 0.88 (0.77~0.98) in the training set and 0.90 (0.77~1.00) in the validation set. The calibration curve of the nomogram for predicting secondary pulmonary infection approximated the ideal curve (P=0.449, 0.188). Decision curve analysis (DCA) showed a positive net benefit within the nomogram probability threshold range of 20% to 85%. Among the 76 COPD patients with HF, 70 survived and 6 died, with 2 deaths due to pulmonary infection, 2 due to acute respiratory failure, and 2 due to malignant arrhythmia.

History of diabetes, long-term use of glucocorticoids or antibiotics, and low serum albumin levels are risk factors for secondary pulmonary infection in COPD patients with HF.

To identify the differentially expressed miRNAs between elderly patients with bacterial pneumonia and healthy elderly individuals through transcriptomic analysis, and to conduct functional enrichment and pathway enrichment analyses on these miRNAs.

A total of 40 elderly patients (the observation group) diagnosed with bacterial pneumonia and admitted to the respiratory department of our hospital from October 2023 to June 2024, and 20 healthy elderly individuals (the control group) who underwent physical examinations at the same period were selected. Transcriptome sequencing was performed on these samples to obtain the analysis data. The transcriptome data of the bacterial infection group and the healthy group were extracted for differential miRNAs expression analysis. The screening criteria for differential miRNAs were P<0.05 and |Log2FC|>1. High-confidence differential miRNAs were further selected based on the criteria of P<1×10^-8 and |Log2FC|>1. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) were used to perform enrichment analysis on the differential miRNAs.

Through transcriptomic sequencing, a total of 577 differential miRNAs(P<0.05) were identified, including 405 up-regulated miRNAs and 172 down-regulated miRNAs. According to the statistical significance(P<1×10^-8 and |Log2FC|>1), 12 high-confidence differential miRNAs were selected, including ggo-miR-142_R-1、hsa-miR-140-3p_R+ 1、hsa-miR-424-3p、hsa-miR-3909、mmu-miR-25-5p_R-1、hsa-miR-548am-3p_R-1、ptr-miR-548p_L-3R+ 2、hsa-miR-548av-3p_L+ 2R-1_1、hsa-miR-548av-3p_L+ 2R-1_2、hsa-miR-503-5p_R-2_1ss21CA 、hsa-miR-143-3p_R-1、ptr-miR-142_R-1, which was down-regulated, the others were all up-regulated. GO functional enrichment showed that differential miRNAs may affect the function of immune cells by regulating the expression of transcription factors. KEGG enrichment analysis suggested that the differential miRNAs were related to metabolic pathways.

The high-confidence differential miRNAs identified in elderly patients with bacterial pneumonia may serve as diagnostic markers or therapeutic targets for infection. Enrichment analysis indicated that these differential miRNAs were associated with metabolic pathways and others.

To analyze the protective effects and mechanisms of ophiopogonin D (OP-D) on acute lung injury (ALI) and intestinal mucosal barrier injury.

Forty-eight specific pathogen-free C57BL/6 mice were randomly divided into a shame operation group, a model group, a low-dose OP-D group, and a high-dose OP-D group, with 12 mice in each group. An ALI model was induced by intratracheal injection of 5 mg/kg lipopolysaccharide. After modeling, the dead mice were excluded. There were 12, 10, 9, and 11 mice in the shame operation group, the model group, the low-dose OP-D group, and the high-dose OP-D group respectively, which were included in the statistical analysis. The wet /dry (W/D) ratio of the lungs was detected to determine the degree of pulmonary tissue edema; the activity of myeloperoxidase (MPO) in the lung tissue was detected using a kit; The blood cell analyzers counted white blood cells and neutrophils; Hematoxylin-eosin staining was used to observe the pathological morphology of the lung and colon tissues; Western Blot and immunohistochemistry experiments were used to detect the expressions of proteins related to inflammation and barrier injury in the lung and colon.

The W/D ratio, MPO activity, and the numbers of white blood cells and neutrophils in the model group [(9.26±1.43), (1.06±0.15) U/g, (5.49±0.91)×10⁹/ml, and (40.83±6.75)%] were higher than those in the shame operation group [(4.92±0.68), (0.72±0.11)U/g, (2.35±0.54)×10⁹/ml, and (14.76±2.08)%] (P<0.05). Compared with the shame operation group, the alveolar walls of the lung tissue in the model group were thickened, with infiltration of inflammatory cells, and a large number of inflammatory cells infiltrated the mucosa of the colon tissue, and the crypts were damaged. The protein levels of inducible nitric oxide synthase (iNOS), tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), toll-like receptor 4 (TLR4), phosphorylated c-Jun N-terminal kinase (p-JNK)/JNK, phosphorylated p38 mitogen-activated protein kinase (p-P38)/P38, phosphorylated nuclear factor-κB p65 subunit (p-P65)/P65, phosphorylated myosin light chain kinase (p-MLCK)/MLCK, and phosphorylated myosin light chain 2 (p-MLC2)/MLC2 in the model group were higher than those in the shame operation group, and the protein expressions of zonula occludens-1 (ZO-1) and claudin-1 were lower than those in the shame operation group (P<0.05). The W/D ratio, MPO activity, and the numbers of white blood cells and neutrophils in the high-dose OP-D group [(6.08±0.95), (0.81±0.13) U/g, (4.13±0.92)×10⁹/ml, and (26.47±3.84)%] were lower than those in the model group (P<0.05). Compared with the model group, the pathological damage of the lung and colon tissues in the high-dose OP-D group was significantly improved. The protein levels of iNOS, TNF-α, IL-1β, IL-6, TLR4, p-JNK/JNK, p-P38/P38, p-P65/P65, p-MLCK/MLCK, and p-MLC2/MLC2 in the lung and colon tissues of the high-dose OP-D group were lower than those in the model group (P<0.05). The protein expressions of ZO-1 and Claudin-1 in the lung tissue of the high-dose OP-D group [(0.95±0.16) and (0.98±0.15)] were higher than those in the model group [(0.42±0.07) and (0.39±0.06)] (P<0.05).

OP-D inhibits the inflammatory response and mucosal barrier injury in the lung and colon of ALI mice by regulating the TLR4/mitogen-activated protein kinase (MAPK)/NF-κB and MLCK/MLC2 signaling pathways.

Currently, there is a lack of clinically applicable diagnostic biomarkers for pulmonary fibrosis (PF) associated with acute respiratory distress syndrome (ARDS). This study aimed to identify PF-related genes in ARDS through transcriptomic analysis and explore potential diagnostic biomarkers for ARDS-associated pulmonary fibrosis (ARDS-PF).

Transcriptomic datasets GSE190496 (ARDS-PF) and GSE10667 (idiopathic pulmonary fibrosis) were jointly analyzed from the GEO database to identify common differentially expressed genes (DEGs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to investigate the functions of DEGs. A protein-protein interaction (PPI) network was constructed using the STRING database, and key hub genes were identified with the cytoHubba plugin in Cytoscape. The identified hub genes were validated in the ARDS-PF transcriptomic dataset GSE206788. Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC) was calculated to evaluate the diagnostic performance of the hub genes.

A total of 234 common DEGs were identified, including 132 upregulated and 102 downregulated genes. GO and KEGG enrichment analyses revealed that these genes were mainly involved in biological processes and pathways such as collagen formation, extracellular matrix (ECM) collagen deposition, ECM-receptor interaction, focal adhesion, and the PI3K-Akt signaling pathway. The PPI network constructed via STRING and analyzed with Cytoscape identified 10 hub genes: COL1A1, COL1A2, COL3A1, COL5A2, CXCL12, IGF1, MMP2, SPP1, PTGS2, and THBS2. Among them, 9 hub genes were significantly differentially expressed in GSE206788 (P<0.05). ROC curve analysis showed that COL1A1, COL1A2, COL3A1, CXCL12, IGF1, SPP1, and PTGS2 had AUC≥0.9 (P<0.01).

COL1A1, COL1A2, COL3A1, CXCL12, IGF1, SPP1, and PTGS2 may serve as potential diagnostic biomarkers for ARDS-PF.

To analyze the mechanism by which itaconate inhibits NLRP3 activation and BCG-induced inflammatory injury in RAW264.7 cells through Nrf2.

RAW264.7 cells were infected with BCG. 4-octyl itaconate (OI) was used as an itaconate derivative. The cells were divided into the control group, BCG group, BCG+ OI group, and BCG+ OI+ ML385 group. The BCG group was infected with 1200 μg/ml BCG for 4 hours; the BCG+ OI group was pretreated with 15, 30, and 60 μM 4-octyl itaconate (OI) for 3 hours and then infected with 1 200 μg/ml BCG for 4 hours; the BCG+ OI+ ML385 group was pretreated with OI and then treated with 10 μM Nrf2 inhibitor ML385 and 1 200 μg/ml BCG for 4 hours. Cell viability, mRNA and protein expression levels of Irg1, Nrf2, and NLRP3, as well as IL-1β and IL-18, were detected. The role of Nrf2 was verified by using the Nrf2 inhibitor ML385.

The cell viability of the control group, BCG 100 μg/ml, 200 μg/ml, 400 μg/ml, 800 μg/ml, and 1 200 μg/ml groups was (100.00±0.00), (99.25±2.61), (95.92±2.93), (87.22±3.13), (79.57±2.44), and (63.93±2.15), respectively (P<0.05). The mRNA and protein levels of Irg1 in the BCG group were (2.34±0.15) and (0.74±0.06), respectively; those of Nrf2 were (3.16±0.51) and (0.58±0.11), respectively; and those of NLRP3 were (6.54±0.82) and (1.16±0.13), respectively. In the control group, the mRNA and protein levels of Irg1 were (1.00±0.03) and (0.54±0.04), respectively; those of Nrf2 were (1.00±0.00) and (0.36±0.18), respectively; and those of NLRP3 were (1.00±0.00) and (0.52±0.15), respectively (P<0.05). The levels of IL-1β and IL-18 in the BCG group were (45.93±1.1035) and (1076.58±164.73), respectively, which were higher than those in the control group (IL-1β: 37.95±1.02; IL-18: 429.12±45.38) (P<0.05). The cell viability of the BCG group, BCG+ 15 μM OI group, BCG + 30 μM OI group, and BCG+ 60 μM OI group was (60.262±1.770), (67.722±3.265), (70.589±1.833), and (77.091±3.251), respectively (P<0.05). The mRNA levels of NLRP3 in these groups were (6.541±0.822), (4.154±0.746), (3.761±1.210), and (3.016±0.516), respectively; and the protein levels of NLRP3 were (1.162±0.133), (0.927±0.112), (1.043±0.091), and (0.839±0.136), respectively. The levels of IL-1β were (45.926±1.105), (40.102±0.669), (37.291±2.443), and (37.001±2.539), respectively, and the levels of IL-18 were (1 076.584±164.728), (839.663±19.818), (748.350±97.910), and (667.800±11.420) (P<0.05). The mRNA and protein expression levels of Nrf2 increased (P<0.05). The mRNA (3.916±0.646) and protein expression levels (0.551±0.090) of Nrf2 in the BCG+ OI+ ML385 group were lower than those in the BCG+ OI group (5.914±0.716) and (0.753±0.060) (P<0.05). The mRNA (5.164±0.512), protein expression levels (1.450±0.210), IL-1β (10.988±0.658), and IL-18 (403.585±13.142) in the BCG+ OI+ ML385 group were higher than those in the BCG+ OI group (3.561±0.810), (1.010±0.310), (6.982±0.0445), and (298.302±16.300) (P<0.05).

BCG aggravates macrophage inflammatory injury through NLRP3 inflammasome activation, while itaconate activates Nrf2 to inhibit NLRP3 and exert anti-inflammatory effects.

To explore the relationship between serum osteoprotegerin (OPG) and the diagnosis of bone loss and osteoporosis in patients with chronic obstructive pulmonary disease (COPD).

From January 2021 to March 2024, ninety-five COPD patients with stable disease were recruited from Our hospital, and were divided into the normal bone mineral density (BMD) group (n=35), the reduced BMD group (n=37), and the osteoporosis group (n=23) according to the dual-energy X-ray absorptiometry (DEXA), and enzyme-linked immunosorbent assay (ELISA) was used to determine the serum OPG levels.

Body mass index (BMI) and forceful lung capacity (FVC) were higher in the BMD normal group than in the BMD reduced and osteoporotic patients (P<0.05). Glycosylated hemoglobin (HbA1c) was lower in osteoporotic patients than in the BMD normal and reduced BMD groups, in addition to lower force expiratory volume in 1 second (FEV₁) than in the BMD normal group (P<0.05). As BMD decreased, lumbar spine BMD and T scores as well as hip BMD and T scores gradually decreased (P<0.001); while serum OPG levels gradually increased (F=23.257, P<0.001). Serum OPG levels were significantly lower in patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification 1-2 than in patients with GOLD classification 3-4 (t=-3.332, P=0.001). Spearman′s correlation showed a weak negative correlation between serum OPG levels and FEV₁(Rho=-0.205, P=0.046), FEV₁/FVC (Rho=-0.236, P=0.022), and FEV_{25_75} (Rho=-0.226, P=0.028). The above BMI, HbA1c, FVC, FEV₁, and OPG were included as independent variables in the multiple linear regression equation, and the results showed that BMI, HbA1c, and serum OPG were independently correlated with lumbar spine T-scores (P<0.05); whereas, BMI and serum OPG were also independently correlated with hip T-scores (P<0.05). The BMD normal group was used as a control, and serum OPG diagnosed decreased BMD with an AUC was 0.737(95%CI: 0.617~0.857), and the cutoff value was 187.01 pg/ml; with the patients with normal BMD and reduced BMD as the control, the AUC of serum OPG for diagnosing osteoporosis was 0.825 (95%CI: 0.741~0.909), and the cutoff value was 206.39 pg/ml; with the reduced BMD group as a control, the AUC of serum OPG for diagnosis of BMD reduction was 0.683 (95%CI: 0.550~0.815), and the cutoff value was 187.01 pg/ml; all P<0.05.

High serum OPG levels are associated with the risk of osteoporosis in COPD patients, therefore OPG may be a biomarker for this COPD related comorbidity.

This study aims to investigate the mechanism by which astragalus polysaccharides (APS) regulate carcinoembryonic antigen-related cell adhesion molecule 7 (CEACAM7) and via the epithelial-mesenchymal transition (EMT) pathway to inhibit the malignant biological behavior of lung cancer A549 cells.

The effects of APS on A549 cell proliferation were assessed using the CCK-8 assay. The induction of apoptosis by APS was evaluated using flow cytometry. The impact of APS on cell invasion and migration was assessed using Transwell assays and wound healing assays. Western blot analysis was performed to detect the expression levels of CEACAM7 and EMT-related markers.

The CCK-8 results showed that compared with the control group (2.1±0.17), the OD450 values of 100 mg/L, 200 mg/L and 400 mg/L in the APS treatment group were (1.63±0.12), (1.38±0.11) and (1.09±0.09) respectively on the fourth day. CCK-8 showed that APS inhibited the proliferation and promoted apoptosis of A549 cells in a dose-dependent manner. The high dose group (400 mg/L) showed the most significant inhibition. Flow cytometry showed APS treatment group significantly promoted the apoptosis of A549 cells, and the apoptotic effect was dose-dependent. Compared with the control group, the APS treatment groups (100 mg/L, 200 mg/L, and 400 mg/L) significantly enhanced A549 cell apoptosis with a dose-dependent effect, compared with the control group (16.21±1.32%), the apoptosis rates in 100 mg/L, 200 mg/L and 400 mg/L treatment groups were (26.5±2.32%), (33.7±3.11%) and (39.4±3.6%), respectively. The apoptosis rate in the high dose group was higher than that in the control group (P<0.05). Compared with the cell number of the control group (76.32±6.32), the cell number of APS treatment group at 100 mg/L, 200 mg/L and 400 mg/L was (57.32±4.16), (38.13±2.67) and (25.30±1.96) respectively. Compared with the scratch healing rate of the control group (69.81±5.16)%, the healing rate of 100 mg/L, 200 mg/L and 400 mg/L in APS treatment group was(57.95±4.66)%, (49.72±4.24)% and (41.56±3.38)% respectively.

Astragalus polysaccharides inhibit the proliferation, invasion, and migration of lung cancer A549 cells by regulating CEACAM7 via the EMT pathway. This study provides a theoretical basis for the development of new lung cancer treatment strategies based on natural drugs.

To analyze the correlation between plasma cytokine profiles, immune checkpoint inhibitors (ICIs), clinical benefits, and immune-related adverse events (irAEs) in patients with non-small cell lung cancer (NSCLC).

A total of 56 patients with unresectable stage Ⅲ~Ⅳ advanced NSCLC treated at our hospital from January 2020 to October 2024 were enrolled. Among them, 33 received ICIs monotherapy and 23 received combination ICIs therapy. 33 patients with durable clinical benefit (DCB) were assigned to the observation group, while 23 cases with non-durable clinical benefit (NDB) served as the control group. Clinical characteristics, plasma inflammatory cytokines, and complete blood counts were analyzed to identify biomarkers associated with clinical benefits and irAEs.

The median progression-free survival (PFS) for all 56 patients was 9.0 months (95%CI: 4.41~13.6). Immune partial response (iPR) was observed in 21 patients (37.50%), immune stable disease (iSD) in 14 (25.0%), immune unconfirmed progressive disease (iUPD) in 13 (23.21%), and immune confirmed progressive disease (iCPD) in 8 (14.29%). Pretreatment levels of IL-6 (P=0.024), IL-10 (P=0.035), and neutrophil-to-lymphocyte ratio (NLR, P=0.005) were higher in the control group compared to the observation group. Post-treatment changes in IL-6+ 2.14 pg/ml and IL-10 + 1.88 pg/ml in the control group exceeded those in the observation group (IL-6: 1.95 pg/ml, Z=3.123, P=0.002; IL-10: 0.27 pg/ml, Z=2.773, P=0.006). ROC curve analysis revealed that changes in IL-6 and IL-10 differentiated DCB from NDB with areas under the curve (AUC) of 0.747 (95%CI: 0.613~0.854) and 0.701 (95%CI: 0.583~0.831), respectively. Cox regression indicated that pretreatment NLR (HR=1.103, 95%CI=1.001~1.153, P=0.041) and elevated IL-6 (HR=2.027, 95%CI: 1.001~4.258, P=0.019) and IL-10 (HR=2.053, 95%CI: 1.018~4.089, P=0.002) during ICIs treatment were risk factors for reduced PFS. Among the 56 patients, 33 (58.93%) experienced at least one irAE. Pretreatment IL-6 (HR=4.458, 95%CI: 1.329~14.953, P=0.015) and increased IL-10 during ICIs therapy (HR=5.712, 95%CI: 1.088~29.993, P=0.039) were predictive of irAEs, with AUCs of 0.754 and 0.706, respectively. Patients with immune-related pneumonia exhibited higher plasma IL-6 levels, while IL-10 decreased during ICIs treatment (P<0.05).

Plasma cytokine profiling is a minimally invasive, accessible, and reproducible approach. IL-6 and IL-10 may serve as biomarkers for predicting clinical outcomes and irAEs in advanced NSCLC patients undergoing ICIs therapy.

To analyze the relationship between the level of miR-125a-5p in bronchoalveolar lavage fluid (BALF) and the severity of disease and lung function in silicosis patients.

A total of 109 patients with silicosis who underwent bronchoalveolar lavage and were admitted to our hospital from March 2019 to April 2024 were selected as the subjects. They were grouped according to the severity of the disease. 53 cases in stage 0 were the control group, and 56 cases in stages Ⅰ to Ⅲ were the observation group. The level of miR-125a-5p in BALF was analyzed by real-time fluorescence quantitative polymerase chain amplification, and the lung functions and BALF cytokines of the two groups were compared.

The level of BALF miR-125a-5p in the observation group was significantly higher than that in the control group [3.26 (2.25, 3.82) vs. 1.06 (0.62, 1.32), Z=-8.052, P<0.001]. Multivariate Logistics regression analysis showed that combined smoking history and BALF miR-125a-5p level were independent risk factors for silicosis in workers, and the variation of BALF miR-125a-5p level between the observation group and the silicosis group was clustered (effect estimate=22.670, P=0.029), and the fixed effect of smoking history [HR: 4.395, 95%CI: 1.671~11.559, P=0.003] on BALF miR-125a-5p level[HR: 47.848, 95%CI: 4.396~520.783, P<0.001] was statistically significant (F=158.993, P<0.001). The area under the working characteristic curve of BALF miR-125a-5p level for the diagnosis of silicosis was 0.947 (95%CI: 0.887~0.981), and the sensitivity and specificity of BALF miR-125a-5p level for the diagnosis of silicosis were 89.29% and 90.57%, respectively. In the silicosis group, 31 cases (55.36%) were stage Ⅰ, 16 cases (28.57%) were stage Ⅱ, and 9 cases (16.07%) were stage Ⅲ. The levels of BALF miR-125a-5p in patients with stage Ⅰ2.36(1.84, 3.26), stage Ⅱ3.50 (3.26, 4.10), and stage Ⅲ4.25 (3.50, 4.42) silicosis were significantly higher than those in the control group 1.06 (0.62, 1.32) (H=70.774, P<0.001), and the levels of BALF miR-125a-5p in stage Ⅰ to Ⅲ silicosis patients increased stage by stage. The median value of BALF miR-125a-5p in patients with silicosis was 3.26. In patients with BALF miR-125a-5p≥3.26, VC[(69.71±5.33)% vs. (75.50±2.44)%, t=5.161, P<0.001], FEV₁[ (78.24±12.20)% vs. (85.39±13.10)%, t=2.115, P=0.039], FVC[(71.39±11.25)% vs. (80.64±12.39)%, t=2.928, P=0.005] and DL_CO[ (61.22±11.12)% vs. (72.19±14.82)%, t=3.147, P=0.003] were lower than those in patients with BALF miR-125a-5p<3.26. Patients with BALF miR-125a-5p≥3.26 had a high probability of developing restrictive ventilator dysfunction [26(89.66%) vs. 11(40.74%), P<0.001]. Spearman rank correlation analysis showed that the expression level of BALF miR-125a-5p was positively correlated with the levels of interleukin (IL) -5, IL-6, IL-17A, interferon-induced protein 10(IP-10) and tumor necrosis factor α(TNF-α) in silicosis patients (r_s=0.299~0.671, P<0.05).

The high level of BALF miR-125a-5p is significantly correlated with the increase of silicosis severity and the decrease of lung function.

To analyze the predictive significance of heparin-binding protein (HBP) and procalcitonin (PCT) on the severity of pneumonia.

A total of 87 pneumonia patients admitted to the Department of Respiratory and Critical Care Medicine at Xishui County People′s Hospital from January 2023 to December 2023 were selected. Among them, 43 non-severe pneumonia cases were classified as the control group, and 44 severe pneumonia cases as the observation group. Levels of HBP, PCT, interleukin-6 (IL-6), D-dimer (DD), white blood cell count (WBC), and neutrophil percentage (N%) were measured in both groups. The Mann-Whitney U test was used to analyze intergroup differences, while the χ² test or Fisher′s exact test was employed for categorical comparisons. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic value of HBP, PCT, IL-6, DD, WBC, and N% in predicting pneumonia severity.

No statistically significant differences were observed between the two groups in terms of gender, age, body temperature, or medical history (P>0.05). The observation group exhibited higher respiratory rates (29.11±8.44)breaths/min and pulse rates (107.09±20.98) breaths/min compared to the control group (23.09±3.22 )breaths/min and (93.77±14.00) breaths/min, respectively(P<0.05). The observation group also showed elevated levels of HBP 166.99 (135.61, 198.36) ng/ml, PCT 8.23(1.44, 15.02) ng/ml, IL-6 596.09(112.52, 1 079.66)pg/ml, DD 1 588.57 (774.15, 2 402.99)ng/ml, and WBC 14.57 (11.90, 17.25)×10⁹/L compared to the control group HBP 79.26 (66.47, 92.05)ng/ml; PCT: 8.23(1.44, 15.02)ng/ml; IL-6: 56.16(-7.06, 119.38)pg/ml; DD: 410.73(267.91, 553.55)ng/ml; WBC: 8.88(7.44, 10.31)×10⁹/L(P<0.05). ROC curve analysis revealed that HBP cutoff: 138.23 ng/ml predicted severe pneumonia with an AUC of 0.77, sensitivity of 0.591, and specificity of 0.968 (P<0.05). PCT cutoff: 0.39 ng/ml showed an AUC of 0.76, sensitivity of 0.684, and specificity of 0.80 (P<0.05). IL-6 cutoff: 54.3 pg/ml demonstrated an AUC of 0.674, sensitivity of 0.522, and specificity of 0.896 (P<0.05), while DD cutoff: 343.80 ng/ml yielded an AUC of 0.730, sensitivity of 0.773, and specificity of 0.664 (P<0.05).

Elevated blood levels of HBP and PCT in severe pneumonia patients demonstrate predictive value. Combined detection of these biomarkers aids in identifying severe pneumonia and holds clinical significance.

To analyze the effect of a voice-prompted respiratory training device on lung function and training compliance in patients with chronic obstructive pulmonary disease (COPD).

A total of 126 COPD patients admitted to our hospital from February 2022 to October 2024 were selected and randomly divided into a control group 64 cases and an observation group 62 cases. The control group received phlegm-reducing, anti-asthmatic, and anti-infective treatments, while the observation group additionally used the voice-prompted respiratory training device. Lung function parameters, including forced vital capacity (FVC), forced expiratory volume in the first second as a percentage of predicted value (FEV₁%), peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF), arterial blood oxygen partial pressure (PaO₂), arterial carbon dioxide partial pressure (PaCO₂), oxygen saturation (SaO₂), and the number of completed respiratory training sessions, were compared between the two groups before and after treatment.

There were no significant differences in FVC, FEV₁%, PEF, or MMEF between the two groups before treatment (P>0.05). After treatment, the observation group exhibited further improvements in FVC (3.05±0.31) L, FEV₁% (73.12±7.73) %, PEF (4.55±0.35) L/s, and MMEF (1.28±0.23) L/s, surpassing the control group FVC (2.36±0.32 )L, FEV₁%(68.82±7.46)%, PEF(4.39±0.33) L/s, MMEF(1.18±0.22) L/s (P<0.05). After treatment, the observation group demonstrated significantly higher PaO₂ (72.47±7.50 )mmHg and SaO₂ (92.40±2.53)% and lower PaCO₂ (53.05 ± 6.03 )mmHg than the control groupPaO₂ ( 65.70± 6.32) mmHg, SaO₂( 90.47±3.98)%, PaCO₂(61.56±6.19) mmHg (P<0.01). Compliance remained higher in the observation group 59 cases (95.16%) compared to the control group 53 cases(82.82%) after treatment(P<0.05).

The voice-prompted respiratory training device enhances compliance with pulmonary rehabilitation training in AECOPD patients and improves lung function and blood gas analysis parameters.

To analyze the clinical significance of potential genomic characteristic factors in predicting the response to immune checkpoint inhibitors (ICIs) combined with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC).

A total of 52 patients with advanced NSCLC without baseline EGFR/ALK/ROS1 mutations, who received at least two cycles of ICIs and chemotherapy were enrolled in our hospital from January 2021 to February 2023. Pre-treatment plasma samples were collected for DNA extraction and circulating tumor DNA (ctDNA)-based targeted sequencing. After the first anti-PD-L1 antibody treatment, the responders 26 cases were divided into an observation group and non responders 26 cases in a control group. Patient objective response rate (ORR) and progression-free survival (PFS) were recorded during follow-up.

The ORR for ICIs combined with chemotherapy was 50.0%, 26 cases of partial response (PR), 15 cases of stable disease (SD), 11 cases of disease progression (PD). The median PFS for all 52 patients was 6.27 months (IQR: 3.05~9.40). During the follow-up period, 33 cases survived (63.46%)and 19 cases died(36.54%). The cause of death was PD. Age (P=0.021), smoking history (P=0.013), and first-line treatment (P=0.020) were associated with treatment response. Multi-organ metastasis (HR=2.73, 95%CI: 1.30~5.76, P=0.002) and later-line ICIs treatment (HR=0.32, 95%CI=0.15~0.67, P=0.002) were factors affecting PFS. Baseline ctDNA status, tumor mutational burden (TMB), and maximum somatic allele frequency showed no correlation (P>0.05). However, univariate and multivariate analyses revealed that RB1 mutation (OR=7.15, P=0.031) was associated with a poor response to ICIs combined with chemotherapy. RB1 mutation (vs. wild-type: log-rank=4.131, P=0.042) was associated with shorter PFS. Multivariate COX analysis showed that RB1 mutation was associated with worse PFS (HR=1.95, P=0.011), independent of PD-L1 expression status, TMB, tumor size, and C-reactive protein levels. TCGA prognostic data confirmed that NSCLC patients with RB1 mutations had a worse prognosis compared to those receiving PD-L1 combination therapy (P=0.012).

ctDNA-RB1 mutation is associated with poor PFS in advanced NSCLC patients treated with ICIs combined with chemotherapy. The ctDNA-RB1 mutation status may serve as a biomarker for predicting PFS.

To analyze the safety and efficacy of transbronchoscopic superpulse Nd: YAG laser (model: Ligenesis-MY100C) ablation in the treatment of central airway stenosis.

From January 2022 to September 2024, transbronchoscopic hyperpulse Nd︰YAG laser was performed by the Department of Respiratory and Critical Care Medicine of our hospital. Clinical data of 45 patients treated with Ligenesis-MY100C were analyzed, including general clinical data, laser treatment and post-treatment follow-up.

Among the 45 patients with central airway stenosis, 32 cases (74.42%) were pulmonary malignant tumors, including 21 cases (65.62%) of lung squamous cell carcinoma, 7 cases (21.88%) of lung adenocarcinoma, 3 cases (9.38%) of small cell lung cancer, and 1 case of adenoid cystic carcinoma (3.12%), indicating that the rates of central airway stenosis caused by squamous cell carcinoma and adenocarcinoma were similar. There were 13 cases of benign lung lesions (25.58%), including 7 cases of endotracheal tuberculosis (53.85%), 5 cases of hamartoma (38.46%) and 1 case of tracheal ossification (7.69%). After bronchoscopic superpulse Nd︰YAG laser ablation, no burns, moderate to massive bleeding, or uncontrollable arrhythmia were found during the operation. No asphyxia, arrhythmia, frequent cough, or pain occurred after the operation. After 3 months of follow-up, no patients with benign airway stenosis had airway stenosis again, and about 10 patients with malignant airway stenosis had airway stenosis again due to tumor regrowth. Oxygen is cut off during the operation, and the smoke produced by ablation can be drawn by continuous negative pressure to clear the airway for a clear view. The KPS score of the patients after laser ablation was significantly improved, and the difference was statistically significant (P<0.05).

Transbronchoscopic superpulse Nd︰YAG laser ablation can be safely and widely used for benign and malignant central airway stenosis as long as the operation skills are mastered, and benign airway stenosis has more benefits. For patients with malignant airway stenosis, the primary lesion should be controlled with effective systemic therapy.

To investigate the application of contrast-enhanced ultrasound and ultrasound-guided percutaneous puncture in pulmonary lesions in patients with acquired immune deficiency syndrome (AIDS).

According to the examination methods, 84 patients with AIDS and pulmonary lesions were divided into ultrasound group with 39 cases and contrast-enhanced ultrasound group with45 cases. The images of the two groups were analyzed, and the ultrasound characteristics, the success rate of primary sampling, the occurrence of complications and the contrast-enhanced ultrasound characteristics of benign and malignant lesions were compared. The diagnostic value of agent arrival time (AT), mean transit time (MTT) and pathogen-to-lung time (T_at) in the diagnosis of benign and malignant lesions were analyzed.

Contrast-enhanced ultrasound and ultrasound-guided percutaneous puncture can be used for the diagnosis of pulmonary lesions in AIDS patients. There were no significant differences in ultrasound characteristics and the incidence of complications between the two groups (P>0.05). The success rate of primary sampling in contrast-enhanced ultrasound group was significantly higher than that in ultrasound group (P<0.05). Contrast-enhanced ultrasound features of benign and malignant lesions: There were significant differences in contrast enhancement types, blood flow signal grades of AT, MTT, T_at and Adler (P<0.05). The area under the curve (AUC) values of AT, MTT and T_at for the diagnosis of benign and malignant lesions alone were 0.817, 0.741 and 0.878, respectively, and the AUC value of combined diagnosis of benign and malignant lesions was 0.926. The value of AUC was significantly higher than that of AT and MTT alone (P<0.05).

Contrast-enhanced ultrasound and ultrasound-guided percutaneous puncture have clinical application value in the diagnosis of pulmonary lesions in AIDS patients, which can improve the success rate of one-time sampling, and quantitative parameters can be used to diagnose benign and malignant lesions.

Objective To analyze the disease spectrum and clinical characteristics of 1 316 patients with interstitial lung disease (ILD).

The clinical data of 1316 patients with ILD diagnosed and treated in our hospital from January 2015 to December 2021 were collected, and the disease spectrum and clinical characteristics of ILD in this population were analyzed.

In the disease spectrum of ILD cases, 602 cases (45.74%) were connective tissue disease associated interstitial lung disease (CTD-ILD), including 174 cases (13.22%) of idiopathic inflammatory myopathy associated interstitial lung disease (IIM-ILD). 339 cases (25.76%) were rare diseases. The diagnosis of 60 patients evolved during the follow-up, most of them were IIP patients who gradually developed CTD related symptoms and signs, or IPAF patients diagnosed with CTD-ILD. Among the imaging subtypes of ILD, 604 cases were non-specific interstitial pneumonia (NSIP) and 414 cases were common interstitial pneumonia (UIP); Chest imaging of CTD-ILD patients mainly showed NSIP, organized pneumonia (OP), NSIP+ OP. In terms of comorbidities, 48 cases were complicated with malignant tumors and 132 cases with pulmonary hypertension (PH). Acute exacerbation occurred in 54 cases (4.10%). Other complications include infection, pneumothorax, mediastinal emphysema, etc.

CTD-ILD accounts for a large proportion in ILD population. The diagnosis of ILD often requires dynamic follow-up, and the occurrence of acute exacerbation, lung cancer, pulmonary hypertension, infection, pneumothorax, and mediastinal emphysema should be vigilant.

To analyze the clinical significance of circulating cytokine profiling in predicting radiation-induced pulmonary fibrosis (RILF) in patients with non-small cell lung cancer (NSCLC).

A total of 86 patients with stage Ⅰ-Ⅲ NSCLC who underwent radical thoracic radiotherapy in the First Affiliated Hospital of Xi'an Jiaotong University Yulin Hospital from January 2021 to December 2024 were selected and divided into a training set of 63 cases and a validation set of 23 cases in a ratio of 7︰3. The clinical data of the patients were collected. Circulating cytokines were detected by the human cytokine/chemotactic magnetic bead panel kit and the enzyme-linked immunosorbent assay kit. The occurrence of RILF≥ grade 2 (RILF2) in the patients was recorded.

There were 11 cases (17.46%) of RILF2 in the training set and 4 cases (17.39%) of RILF2 in the validation set (χ²=0.001, P=0.994). The median onset time of RILF2 in patients was 4.90 months. Logistic and LASSO regression analyses showed that the mean lung dose(MLD) (HR: 3.674, 95%CI: 1.240~10.887), interleukin-8 (IL-8) (HR: 0.231, 95%CI: 0.060~0.887), C-C chemokine ligand 4 (CCL4) (HR: 0.204, 95%CI: 0.053~0.777), transforming growth factor-β1 (TGF-β1) (HR: 21.831, 95%CI: 1.609~296.240) are the influencing factors of RILF2 in NSCLC patients. The nomogram predicted the RILF2 of the training set and the validation set, and the area under the receiver operating characteristic curve was 0.884 (95%CI: 0.779~0.989) and 0.841 (95%CI: 0.672~0.990), respectively. The Hosmer-Lemeshow test results showed a good fit (P>0.05), and the high-risk thresholds were 0.05-0.73 and 0.09-0.68, respectively.

The nomogram of cytokines MLD, IL-8, CCL4, TGF-β1 and the dosimetric factor RILF2 has clinical significance in predicting RILF in NSCLC patients.

To analyze the correlation between serum soluble suppression of tumorigenicity-2 (sST-2) levels and pulmonary arterial hypertension (PAH) hemodynamics, and to evaluate the predictive value of sST-2 for PAH prognosis.

Seventy-one PAH patients admitted to our hospital from January 2020 to December 2024 were enrolled. Blood samples were collected after right heart catheterization, and serum sST-2 levels were measured using the Presage ST2 assay. Spearman correlation and multivariate linear regression analyses were performed to assess the relationships between serum sST-2 and mean pulmonary artery pressure (mPAP), pulmonary artery wedge pressure (PAWP), pulmonary vascular resistance (PVR), right atrial pressure (RAP), partial pressure of oxygen in pulmonary artery blood (PaO₂), and partial pressure of carbon dioxide in pulmonary artery blood (PaCO₂).

The median serum sST-2 level in PAH patients was 41.12 ng/ml. By the end of follow-up, clinical worsening occurred in 21 patients (29.57%), including 5 cases of WHO functional class (WHO-FC) deterioration, 4 cases requiring escalation of PAH-specific therapy, 8 cases rehospitalized due to heart failure or PAH progression and 4 deaths related to PAH. Serum sST-2 showed positive correlations with mPAP (rho=0.328, P<0.001), PVR (rho=0.331, P<0.001), WHO-FC (rho=0.305, P<0.001), and NYHA functional class (rho=0.196, P=0.031), and negative correlations with PaO₂(rho=-0.313, P<0.001) and 6-minute walking distance (6MWD) (rho=-0.269, P=0.003). Multivariate linear regression analysis revealed that sST-2 was positively associated with WHO-FC, mPAP, and PVR, and negatively associated with 6MWD and PaO₂(P<0.05). Multivariate analysis identified sST-2 (HR=1.007, P=0.003) and PaO₂(HR=0.930, P=0.016) as predictive variables for clinical worsening in PAH patients. The combination of sST-2 and PaO₂ achieved a sensitivity of 88.89% and specificity of 61.18% for predicting the risk of clinical worsening in PAH patients.

PAH patients exhibit elevated serum sST-2 levels. Higher sST-2 is associated with poor functional status and abnormal hemodynamics. sST-2 serves as a predictor of clinical worsening in PAH patients and demonstrates predictive value when combined with PaO₂.

To construct a machine learning model based on serum biomarkers for predicting the risk of mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and analyze its predictive performance.

A total of 62 AECOPD patients treated in our hospital from January to December 2023 were enrolled. Among them, 33 patients without mechanical ventilation were assigned to the control group, and 29 patients requiring mechanical ventilation were assigned to the observation group. An XGBoost model was developed to predict the risk of mechanical ventilation in AECOPD patients based on serum biomarkers. The predictive performance was evaluated using the receiver operating characteristic (ROC) curve, and the model′s predictive value was validated by comparing it with individual serum biomarkers.

High-sensitivity C-reactive protein(hs-CRP)46.30 (16.55, 104.20) mg/L, albumin(ALB)36.90 (31.05, 41.65) g/L, direct bilirubin(DBIL) 4.00 (3.05, 5.85) μmol/L, total cholesterol(TC) 3.83 (3.12, 4.30) mmol/L, andapolipoprotein A1(APOA1) (1.17±0.32) g/L in the observation group showed statistically significant differences compared to the control group in hs-CRP 7.30 (1.05, 18.25) mg/L), ALB 40.90 (36.85, 44.20) g/L, DBIL 2.90(2.45, 3.85) μmol/L), TC 4.33 (3.72, 4.90) mmol/L and APOA1 (1.46±0.29) g/L (P<0.05). The XGBoost model achieved an area under the ROC area under curve (AUC) of 0.831, sensitivity of 71.29%, specificity of 90.00%, accuracy of 75.81%, and an F1-score of 0.933, outperforming individual biomarkers such as hs-CRP, ALB, DBIL, TC, HDL, and APOA1. The calibration curve demonstrated good model fit with a calibration score of 0.075.

The machine learning model based on serum biomarkers provides a more accurate prediction of mechanical ventilation risk in AECOPD patients, aiding clinicians in developing more effective treatment strategies.

To analyze the impact of thoracoscopic bronchial sleeve resection on postoperative complications and respiratory function in lung cancer patients.

Eighty-six lung cancer patients admitted to our hospital from February 2021 to October 2024 were selected and divided into two groups based on surgical approach, 39 patients undergoing thoracotomy served as the control group, and 47 patients undergoing thoracoscopy served as the observation group. Both groups underwent bronchial sleeve resection. Perioperative indicators, postoperative complications, prognosis, arterial partial pressure of oxygen (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), and blood oxygen saturation (SaO₂) were compared between the two groups. Factors influencing complications after thoracoscopic bronchial sleeve resection were analyzed.

There was no statistically significant difference in operative time between the two groups (P>0.05). The observation group showed significantly lower intraoperative blood loss (125.51±24.41) ml, postoperative drainage duration (4.23±0.56) days, length of hospital stay (10.02±1.52) days, and pain score at 4 hours postoperatively (3.56±0.52) points compared to the control group (192.25±28.45) ml, (6.65±0.71) days, (14.45±1.89) days, (5.02±0.66) points, respectively(P<0.05). Postoperative PaO₂ (84.25±7.35)mmHg and SaO₂ (95.15±1.25)% were significantly higher in the observation group than in the control group PaO₂(79.22±6.84)mmHg, SaO₂(92.33±1.58)%(P<0.05), while postoperative PaCO₂ (40.12±4.36) mmHg was significantly lower in the observation group than in the control group (46.88±4.78 )mmHg(P<0.05). The incidence of postoperative complications was 9 cases (19.15%) in the observation group and 11 cases (28.21%) in the control group (P>0.05). During postoperative follow-up, there were 2 deaths (4.26%) in the observation group and 4 deaths (10.26%) in the control group (P>0.05). Multivariate logistic regression analysis identified the following as risk factors for complications after thoracoscopic bronchial sleeve resection: age > 60 years (OR=1.748), high TNM stage (OR=1.665), history of smoking (OR=2.125), intraoperative blood loss>100 ml(OR=1.995), preoperative left ventricular ejection fraction (LVEF) ≤50% (OR=2.465), and operative time>3 hours (OR=2.336).

Thoracoscopic bronchial sleeve resection in lung cancer patients can reduce surgical trauma, shorten postoperative recovery time, and improve respiratory function. Age, tumor stage, smoking history, intraoperative blood loss, preoperative LVEF, and operative time are influencing factors for postoperative complications.

To analyze the safety and effectiveness of intrathoracic vagus nerve block combined with general anesthesia in thoracoscopic lobectomy for lung cancer.

A total of 95 patients with primary lung cancer who underwent thoracoscopic lobectomy at Qianjiang Central Hospital from April 2020 to March 2024 were collected. According to different anesthesia methods, they were divided into a control group with 52 cases and a observation group with 43 cases. The control group was given general anesthesia. The observation group received vagus nerve block on the right side of the lower segment of the trachea under thoracoscopy combined with general anesthesia, and was administered 2.5 ml of 0.75% ropivacaine. Compared the hemodynamics, pulmonary function indicators, pulmonary CT imaging, postoperative pain intensity, postoperative rehabilitation status, and the occurrence of adverse reactions such as postoperative nausea, vomiting, dizziness, etc, between the two groups.

At thirty minutes and sixty minutes after the start of the operation, the heart rate (HR) and mean arterial pressure (MAP) levels of the patients in both groups were significantly lower than those before anesthesia induction, and the HR and MAP levels in the observation group were significantly lower than those in the control group (P<0.05). At forty minutes of one-lung ventilation, the peak airway pressure (Ppeak) and plateau airway pressure (Pplat) levels in the observation group [(21.02±2.87) cmH₂O, (20.74±2.79) cmH₂O] were significantly lower than those in the control group [(22.61±2.96) cmH₂O, (22.18±3.01) cmH₂O], while the dynamic lung compliance (Cdyn) level [(29.11±5.17) ml/cmH₂O] was significantly higher than that in the control group [(27.03±4.59) ml/cmH₂O] (P<0.05). The results of pulmonary CT imaging: There were 3 cases of pneumonia in the control group and 2 cases in the observation group after the operation, 1 case of atelectasis in the control group and 1 case in the observation group, 2 cases of pleural effusion in the control group and 1 case in the observation group, and the rest were normal. There was no significant difference between the two groups (P>0.05). At 6 hours, 12 hours, and 24 hours after the operation, the visual analogue pain scale scores in the observation group [(2.24±0.67) points, (3.61±0.94) points, (2.47±0.84) points] were significantly lower than those in the control group (2.63±0.81) points, (4.23±1.16) points, (3.06±0.63) points (P<0.05). At 2 days after the operation, the score of the quality of recovery-15 scale (QoR-15) in the observation group (151.34±6.25) points was higher than that in the control group (148.13±7.76) points (P<0.05). The observation group reported 13 postoperative adverse events (30.23%) lower than control group 24 cases (46.15%), there was no significant difference in the incidence of postoperative adverse reactions between the two groups (P>0.05).

Intrathoracic vagus nerve block combined with general anesthesia is feasible for thoracoscopic lobectomy. It can not only ensure the intraoperative ventilation efficiency and hemodynamic stability, but also provide good postoperative analgesia, rehabilitation effects, and safety for patients.

To analyze the influencing factors of chronic obstructive pulmonary disease (COPD) in patients with acquired immunodeficiency syndrome (AIDS).

A total of 398 AIDS patients admitted to our hospital from January 2020 to December 2023 were enrolled and divided into groups based on the degree of diffusion impairment: normal diffusion function group 48 cases, mild decline group 40 cases, moderate decline group 92 cases, and severe decline group 218 cases. Clinical data were collected, and statistical methods including t-test, analysis of variance (ANOVA), χ² test, and Logistic regression were used to analyze the factors influencing COPD in AIDS patients.

Statistically significant differences (P<0.05) were observed among the groups in terms of body weight, CD4⁺ and CD8⁺ cell counts, smoking history, cough, expectoration, IL-6 levels, right ventricular measurements, bronchiectasis, Pneumocystis pneumonia(PCP), pulmonary tuberculosis, and pulmonary fungal infections. Multivariate analysis revealed that body weight (OR=0.944, 95%CI: 0.909~0.979), smoking (OR=2.798, 95%CI: 1.452~5.392), and CD4⁺ cell count (OR=0.996, 95%CI: 0.994~0.998) were influencing factors for diffusion dysfunction in AIDS patients. Significant differences (P<0.05) were also found in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), maximal mid-expiratory flow (MMEF75/25), peak expiratory flow (PEF), total lung capacity (TLC), residual volume (RV), and maximal vital capacity (VC MAX) among the groups. At the end of the 3-year follow-up, 251 patients had not developed COPD, while 99 had, with the distribution as follows: 0 cases in normal group, 2 cases(5.00%) in mild group, 19 cases (20.65%) in moderate group, and 78 cases(35.78%) in severe group (P<0.001). Compared to non-COPD patients, AIDS patients with COPD exhibited statistically significant differences (P<0.05) in body weight, smoking, hospitalization frequency, CD4⁺ and CD8⁺ lymphocyte counts, concurrent PCP, pulmonary tuberculosis, pulmonary fungal infections, Talaromyces marneffei infection, FEV₁, FVC, and FEV₁/FVC ratio. Severe and persistent diffusion impairment was identified as a risk factor for COPD in AIDS patients (OR=2.699, 95%CI: 1.571~4.637).

Smoking is a risk factor for diffusion dysfunction in AIDS patients, while body weight and CD4⁺ cell count are predictive factors. Smoking, severe diffusion impairment, and hospitalization history are risk factors for COPD in AIDS patients, whereas CD4⁺ cell count and body weight serve as predictive factors. Maintaining normal CD4⁺ cell levels, adhering to standardized antiviral therapy, smoking cessation, improving nutrition, and controlling pulmonary infections may help enhance diffusion function and reduce COPD incidence in this population.

To analyze the predictive value of serum periostin levels for early treatment responsiveness in children with cough variant asthma (CVA).

Fifty-nine children with CVA admitted to our hospital from June 2021 to November 2024 were enrolled. All children received inhaled corticosteroids combined with long-acting β₂ agonists (ICS/LABA) for 28 days. Forty-eight children with good treatment responsiveness were assigned to the control group, and 11 children with poor treatment responsiveness were assigned to the observation group. Clinical data were compared between the two groups. Multivariate logistic regression was used to identify influencing factors, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of serum periostin levels for poor treatment responsiveness in CVA children.

The observation group showed significantly higher values than the control group in: disease duration (2.48±0.41 months vs. 2.06±0.32 months), proportion with a history of recurrent respiratory infections 9 cases (81.82%) vs. 18 cases(37.50%), serum periostin levels (82.29±2.22 ng/ml vs. 78.33±4.42 ng/ml), and fractional exhaled nitric oxide (FeNO) (21.28±3.74 ppb vs. 18.33±1.80 ppb) (P<0.05). Multivariate logistic regression analysis revealed that serum periostin level (OR=1.346, 95%CI: 1.028~1.761) and FeNO(OR=1.670, 95%CI: 1.068~2.611) were independent risk factors for poor treatment responsiveness in CVA children (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for predicting poor treatment responsiveness was 0.807 for serum periostin, 0.769 for FeNO, and 0.837 for the combination.

The level of serum periostin can predict the treatment responsiveness of children with CVA, which is of clinical significance.

This study aimed to develop and evaluate a teaching model that integrates curriculum ideology and politics into the instruction of laboratory diagnostics for respiratory system-related diseases among medical interns. Based on the established teaching syllabus, relevant literature, and clinical teaching experience, an integrated teaching approach was designed and implemented. A total of 44 medical interns from our department, enrolled between January 2017 and December 2023, were selected as participants. These interns were divided into two groups: the control group (n=20), which received traditional teaching methods, and the observation group (n=24), which was taught using the newly developed integrated model. The effectiveness of the teaching model was assessed through theoretical and practical examinations, as well as through self-assessments by the students and evaluations by instructors. The observation group demonstrated significantly higher theoretical scores (87.61±1.08) and practical skills scores (48.64±1.04) compared to the control group (79.69±1.63 and 42.06±1.77, respectively) (P<0.05). Student self-assessments indicated that the observation group showed greater improvement in the mastery of theoretical knowledge (91.7% vs. 60.0%) and communication skills (83.3% vs. 50.0%) compared to the control group. Instructor evaluations also revealed higher total scores for the observation group (40.36±0.91) than for the control group (32.78±1.36) (P<0.05). Furthermore, the observation group outperformed the control group in professional competence (8.72±0.34 vs. 7.00±0.61) and teamwork ability (7.54±0.49 vs. 6.40±0.49) (P<0.05). The integration of curriculum ideology and politics into the teaching of laboratory diagnostics for respiratory diseases has proven effective in enhancing medical students′professional competence, humanistic literacy, and overall capabilities, thereby demonstrating significant practical value for medical education.