To develop a high-performance electrochemical immunosensor for detecting the lung cancer biomarker neuron specific enolase (NSE).

Two dimensional nano material boron nitride (BN) was used as the adsorption matrix to deposit nano gold (Au), effectively increasing the specific surface area; Using molybdenum disulfide supported platinum palladium (MoS₂@PtPd) nano mimetic enzyme complex for electron transfer catalysis and catalytic amplification signal detection of NSE; Determine the optimal conditions by examining the key factors involved in constructing sensors, and conduct repeatability, stability, and specificity tests on the sensors; And conduct methodological validation on clinical specimens.

It showes that the diameter range of BN was 200~500 nm, nm, the diameter range of MoS₂ was 500~800 nm, and the MoS₂ @ PtPd complex was about 50~120 nm. The current of BN binding on the electrode surface decreased by 40 μ A, and the current increased by 15 μ A after gold deposition. The blocking current of bovine serum albumin (BSA) decreased by 9 μ A, and the capture current of NSE decreased by 15 μ A; The optimal total concentration for catalyzing H₂O₂ is 3 μ M, and the optimal binding time for the secondary antibody to bind to the antigen is after 3 hours; When detecting NSE, the standard curve is: I=-5.13-0.40 LogC_NSE, r=0.92, and the low of detection (LOD) is 0.86 pg/ml; The relative standard deviation (R.S.D.) between sensor batches was 2.91%, and after 21 days, the peak current remained at 98.14% of its initial current; Compared with other interfering proteins at a concentration of 1 ng/ml, NSE was (2.10±0.05)μA, alpha fetoprotein (AFP) was (0.12±0.03)μA, carcinoembryonic antigen (CEA) was (0.15±0.02)μA, albumin (ALB) was (0.21±0.02)μA, and ferritin (FER) was (0.19±0.03)μA (P<0.05); The relative deviation of four serum samples with severe applicability ranges from 1.70% to 4.11%, and the recovery rate ranges from 93.09% to 103.12%.

The novel immunosensor based on MoS₂ @ PtPd catalytic combined with BN/Au membrane is simple to construct and has good performance for NSE detection. It provides an alternative method for early diagnosis of lung cancer, and has clinical significance.

To investigate the effect of transpulmonary driving pressure-guided positive end-expiratory pressure (PEEP) ventilation on lung function and prognosis in patients with acute respiratory distress syndrome (ARDS).

Fifty-one ARDS patients admitted to our hospital from May 2021 to July 2024 were selected and randomly divided into a control group (n=25) and an observation group (n=26). The control group received tidal volume PEEP titration, while the observation group received transpulmonary driving pressure-guided PEEP titration. Lung function parameters and hemodynamic parameters were measured, and hospital stay, ICU stay, duration of mechanical ventilation, weaning success rate, incidence of atelectasis, and in-hospital mortality were recorded.

The PEEP in the observation group was (8.36±1.72) cmH₂O, higher than that in the control group (6.17±1.58) cmH₂O(t=4.730, P<0.05). The physiological dead space fraction (Vd/Vt) in the observation group was (31.97±8.22)%, lower than that in the control group (37.24±10.26)%(t=2.028, P<0.05). There were no statistically significant differences in respiratory mechanics and blood gas analysis between the two groups before ICU admission (P>0.05). After 48 hours of mechanical ventilation, the observation group showed higher static compliance (45.76±20.00) ml/cmH₂O, arterial partial pressure of oxygen (PaO₂) (127.73±32.27) mmHg, and oxygenation index (PaO₂/FiO₂) (380.40±106.53) compared to the control group′s static compliance (36.40±11.97) ml/cmH₂O, PaO₂(106.96±30.76)mmHg, and PaO₂/FiO₂(310.17 ± 97.29) (r=2.048, 2.351, 2.455, P<0.05). Additionally, the observation group′s dynamic compliance (29.27±8.17) ml/cmH₂O, airway resistance (9.20±5.67) cmH₂O·L^-1·s^-1, and blood oxygen saturation (SaO₂) (105.29±19.64)% were better than the control group′s dynamic compliance (25.88±5.73) ml/cmH₂O, airway resistance (11.25±7.65) cmH₂O·L^-1·s^-1, and SaO₂ (103.08±17.25)% (t=1.709, 1.090, 0.427, P>0.05). There were no statistically significant differences in hemodynamic parameters between the two groups (P>0.05). The duration of mechanical ventilation [8.00(6.00, 13.00)days], hospital stay [15.00 (9.50, 26.50) days], and incidence of atelectasis [2 cases (7.69%)] in the observation group were lower than those in the control group [20.00 (9.00, 28.00) days, 33.00 (12.50, 62.00) days, and 5 cases (20.00%), respectively]. The weaning success rate in the observation group [14 cases (53.85%)] was higher than that in the control group [5 cases(20.00%)] (P<0.05). During hospitalization, there were 20 survivors (76.92%) and 6 deaths (23.08%) in the observation group, compared to 12 survivors (48.00%) and 13 deaths (52.00%) in the control group. The median survival time in the observation group was 30 days, longer than that in the control group (23 days) (P<0.05).

Transpulmonary driving pressure-guided PEEP can improve oxygenation and lung compliance in ARDS patients, reduce the duration of mechanical ventilation, lower the risk of atelectasis and in-hospital mortality, and help improve the weaning success rate.

To investigate the correlation between the infection status of cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus 8 (HHV-8) and the disease severity and prognosis of patients with idiopathic pulmonary fibrosis (IPF).

Seventy-nine IPF patients admitted to our hospital from January 2020 to December 2024 were selected as subjects. Based on the percentage of predicted forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO), as well as clinical manifestations, they were divided into a mild group 41 cases, a moderate group 24 cases, and a severe group (14 cases). Real-time fluorescent quantitative PCR was used to detect the serum nucleic acid load of CMV, EBV, and HHV-8. Follow-up was conducted via outpatient visits to compare the differences in virus positivity rates and nucleic acid loads among patients with different disease severities and prognoses. Pearson correlation analysis was used to analyze the association between viral load and disease condition/prognosis. The predictive value of viral load for prognosis was assessed using receiver operating characteristic (ROC) curve analysis.

The FVC (% predicted) values for the mild, moderate, and severe groups were (78.86±8.15), (60.25±6.71), and (42.25±4.89), respectively; the DLCO(% predicted) values were (61.15±6.37), (45.52±4.78), and (31.15±4.18), respectively (P<0.001). The CMV positivity rates in the mild, moderate, and severe groups were 9.76%, 37.50%, and 71.43%, respectively. The nucleic acid loads of CMV, EBV, and HHV-8 were positively correlated with the severity of IPF (r=0.562, 0.625, 0.482, P<0.001). Sixty-two survivors(78.48%), while 17 deaths (21.52%). The viral loads in deceased patients [CMV (4 112.25±705.51) copies/ml, EBV (36 412.15±3 348.84) copies/ml, HHV-8(389.95±35.56) copies/ml] were higher than those in surviving patients [CMV (845.51±145.56) copies/ml, EBV (8 847.15±1 521.15) copies/ml, HHV-8 (122.25±25.56) copies/ml]. Viral load was positively correlated with poor prognosis (r=0.612, 0.665, 0.567, P<0.001). ROC curve analysis showed that the combined detection of the three viral infection statuses for predicting IPF prognosis had an area under the curve (AUC) of 0.823, with a sensitivity of 94.12% and a specificity of 87.30%.

The infection status of CMV, EBV, and HHV-8 is significant for evaluting the disease severity and prognosis of IPF patients.

Some patients with antisynthetase syndrome and interstitial lung disease may still develop rapidly progressive interstitial lung disease after appropriate treatment. This study investigates the clinical features and risk factors for the development of rapidly progressive interstitial lung disease in antisynthetase syndrome with interstitial lung disease, aiming to provide a basis for early clinical identification and individualized diagnosis and treatment.

122 patients with antisynthetase syndrome with interstitial lung disease who were first diagnosed in the Department of Respiratory and Critical Care Medicine of the Affiliated Hospital of Xuzhou Medical University from August 2019 to June 2024 were collected, their clinical data were collected, and according to disease progression, they were divided into a progressive group(45 cases)and a non-progressive group(77 cases); risk factors for the occurrence of RP-ILD were analyzed using logistic regression.The predictive value of risk factors was analyzed by ROC curve.

Multifactorial logistic regression analysis showed that anti-PL-7 antibody positivity and elevated CEA were independent risk factors for the development of RP-ILD in ASS-ILD, and the high predictive value of the combination of anti-PL-7 and CEA was derived from the ROC curve(AUC=0.782), with a sensitivity and specificity of 71.1% and 80.5%, respectively. During the follow-up period, 95 of the 122 patients survived and 27 died. The observation group had 20 survivors (44.44%) and 25 deaths (55.56%), while the control group had 75 survivors (97.40%) and 2 deaths (2.60%). The observation group showed a significantly lower survival rate than the control group (P<0.05).

Patients with ASS-ILD who are positive for anti-PL-7 antibodies and have elevated CEA are at a significantly increased risk of developing RP-ILD, and such patients should be closely monitored clinically and interventions should be implemented.

To compare the impact of stereotactic body radiation therapy (SBRT) and thoracoscopic sublobar resection on the long-term survival rates of patients with early-stage non-small cell lung cancer (NSCLC).

From March 2019 to February 2024, 62 early-stage non-small cell lung cancer (NSCLC) patients admitted to our hospital were randomly divided into an observation group 30 cases and a control group 32 cases. The observation group received stereotactic body radiation therapy (SBRT), while the control group underwent thoracoscopic sublobar resection. The quality of life before and after treatment was assessed using the Quality of Life Instruments for Cancer Patients-Lung (QLICP-LU), and carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), carbohydrate antigen 724 (CA724), neuron-specific enolase (NSE), squamous cell carcinoma antigen (SCC), and Alpha-fetoprotein (AFP) were compared, Treatment efficacy was evaluated, overall survival (OS) and progression-free survival (PFS) were recorded.

After treatment, the observation group showed higher scores than the control group in the QLICP-LU scale across various domains: physical function (24.07±3.11) vs. ( 22.34±3.03), psychological function (42.97±4.15) vs. (38.78±4.10), social function (21.63±3.45) vs. (23.78±3.51), common symptoms (21.57±4.07) vs. (19.50±3.94), and specific modules (26.37±4.57) vs. (23.84±4.67) (P<0.05). In the observation group, post-treatment levels of CEA (39.48±7.47)ng/ml, CYFRA21-1 (12.46±3.47)ng/ml, CA125 (85.68±4.87)U/ml, CA199 (40.28±4.05)U/ml, and CA724 (6.28±2.00)U/ml were measured. The levels of 64 ng/ml, NSE (20.85±3.87)ng/ml, SCC (2.26±0.72)ng/ml, and AFP (2.84±0.69)U/ml were lower than those in the control group, with CEA (51.52±7.59)ng/ml and CYFRA21-1 (16.83±3.87)ng/ml, CA125 (102.21±5.01) U/ml, CA199 (45.96±3.98)U/ml, CA724 (7.93±2.49)ng/ml, NSE (24.11±3.79)ng/ml, SCC (1.33±0.65)ng/ml, AFP (3. 77±0.63)U/ml (P<0.05). The objective response rate and disease control rate in the observation group were 53.33% and 66.67%, respectively, which were higher than those in the control group (28.13% and 50.00%, respectively)(P<0.05). There was no statistically significant difference in 1-year and 2-year overall survival and progression-free survival between the two groups (P>0.05). The observation group had 14 survivors(46.67%)and 16 deaths(53.33%), while the control group had 7 survivors (21.88%)and 25 deaths(78.12%). The 3-year overall survival of the observation group was 60.00%, significantly higher than the control group′s 3-year overall survival of 34.38% (P=0.043). Similarly, the 3-year progression-free survival of the observation group was 46.64%, significantly higher than the control group′s 3-year overall survival of 21.88%(P=0.039).

Stereotactic radiotherapy is superior to thoracoscopic sublobectomy in improving clinical efficacy, 3-year overall survival, progression-free survival and quality of life in early-stage NSCLC patients, and can be used as an alternative treatment for some patients, especially those at high surgical risk.

To investigate the characteristics of the serum exosomal miRNA expression profile in patients with early-stage lung adenocarcinoma (LUAD) and to screen for microRNA (miRNA) biomarkers with value for early diagnosis.

A total of 255 subjects were enrolled from January 2021 to December 2024, including 154 patients with stage Ⅰ LUAD as the LUAD group, 101 patients with benign pulmonary nodules (BPN) as the BPN group, It was randomly divided into the discovery cohort, the screening cohort and the verification cohort. miRNA sequencing was performed, and differentially expressed miRNAs were screened by comparing them with those in the GES137140 dataset. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to validate the differentially expressed miRNAs. The diagnostic performance of candidate miRNAs was evaluated using receiver operating characteristic (ROC) curves, and target genes and related signaling pathways were predicted through bioinformatics analysis.

The average particle size of serum exosomes was 70.0 nm, with a concentration of 3.66×10⁸ particles/ml. In the discovery cohort, 38 overlapping DEmiRs were identified among the two groups, including 10 upregulated and 28 downregulated DEmiRs. Cross-analysis with the GES137140 dataset screened out seven DEmiRs: hsa-miR-486-5p, hsa-miR-346, hsa-miR-130b-3p, hsa-miR-183-5p, hsa-miR-18a-3p, hsa-miR-625-5p, and hsa-miR-25-3p. In both the screening and validation cohorts, compared with the control and BPN groups, exosomal miR-486-5p and miR-346 were upregulated, and exosomal miR-130b-3p was downregulated in the LUAD group (P<0.05). The area under the curve (AUC) for diagnosing early LUAD was >0.7 for miR-486-5p, hsa-miR-346, and miR-130b-3p, with sensitivities of 76.00%, 88.0%, and 92.80%, and specificities of 82.86%, 59.43%, and 61.32%, respectively. The combined detection of miRNAs yielded an AUC of 0.956 (95%CI: 0.921~0.979), with a sensitivity and specificity of 88.0% and 90.48%. The combination of these three miRNAs with tumor markers achieved an AUC of 0.969 (95%CI: 0.949~0.989). Four tools identified 280, 650, and 26 target genes for miR-486-5p, miR-346, and miR-130b-3p, respectively. KEGG analysis showed enrichment of terms such as the JNK signaling pathway and integrins in angiogenesis and other biological processes.

The miRNA signature composed of serum exosomal miR-486-5p, miR-346, and miR-130b-3p demonstrates good diagnostic efficacy for detecting early LUAD and shows promise as a diagnostic marker for early LUAD.

To characterize electrical impedance tomography (EIT) findings in patients with acute respiratory distress syndrome (ARDS) and to evaluate its clinical predictive value.

In this cross-sectional study, 92 patients with acute lung injury admitted to the intensive care unit (ICU) between December 2023 and December 2024 were enrolled. Participants were categorized into an ARDS group 53 cases, which included 32 patients receiving mechanical ventilation, and a non-ARDS control group 39 cases, which included 16 patients receiving mechanical ventilation. Data on clinical characteristics, the PaO₂/FiO₂ ratio, EIT-derived parameters of pulmonary ventilation and perfusion, EIT imaging features, and lower lung field CT scores were collected and analyzed to determine EIT characteristics and their predictive value.

Among mechanically ventilated ARDS patients, the application of positive end-expiratory pressure (PEEP) was associated with a significantly increased ventilation ratio in the non-dependent lung region (R2) (28.08±9.83)% and a decreased ventilation ratio in the dependent lung region (R3) (17.61±8.20) % compared to non-ventilated patients (P<0.01). The ventral (non-gravity-dependent) lung regions demonstrated a significantly higher overall ventilation ratio (64.27±13.52) % compared to the dorsal (gravity-dependent) regions (35.73±13.52) %(P=0.008). Concerning perfusion, ARDS patients showed a reduced perfusion distribution in R2 (25.93±4.72) % compared to non-ARDS patients (28.55±4.78) %. A marked right-left lung perfusion asymmetry was observed, with ARDS patients exhibiting a higher percentage of perfusion in the right lung (53.27±5.16) % versus non-ARDS patients (50.15±5.39) %(P=0.006). Lower lung CT scores demonstrated good predictive value for ARDS. EIT findings showed a high degree of concordance with corresponding CT images. Notably, EIT was capable of detecting significant regional ventilation or perfusion abnormalities, which served as indicators for underlying pathologies such as lobar consolidation, substantial pleural effusion, cardiomegaly, or pulmonary embolism.

Electrical impedance tomography is a valuable, non-invasive, radiation-free, and cost-effective bedside monitoring tool. It facilitates the early detection of aberrant pulmonary ventilation and perfusion distributions, potentially alerting clinicians to impending pulmonary complications and specific pathologies. Furthermore, EIT guidance can optimize clinical management strategies, including PEEP titration, potentially improving patient prognosis and reducing mortality.

To explore the relationship between the level of protein tyrosine phosphatase non-receptor type 2 (PTPN2) in bronchoalveolar lavage fluid (BALF) and the severity of the disease and lung function in patients with silicosis.

By a simple sampling method, a total of 56 patients with silicosis who underwent bronchoalveolar lavage for the first time in Nanjing Chest Hospital from May 2021 to February 2025 were prospectively selected as the research subjects, including 31 cases in stage Ⅰ, 16 cases in stage Ⅱ, and 9 cases in stage Ⅲ. In addition, 51 coal miners who underwent bronchoalveolar lavage due to chest pain or cough during the same period (X-ray chest films could not determine pneumoconiosis changes) and did not reach stage Ⅰ silicosis were included as the control group. The level of PTPN2 in BALF of the subjects was detected by enzyme-linked immunosorbent assay. A correlation analysis was conducted between the levels of PTPN2 in BALF and lung function in silicosis patients.

The level of BALF PTPN2 at diagnosis in the silicosis group was significantly higher than that in the control group (P<0.05). The area under the ROC curve (AUC) of BALF PTPN2 for diagnosing silicosis was 0.869 (95%CI: 0.802-0.936). There were significant differences in PTPN2 levels among different disease severity groups. The PTPN2 level was the highest in stage Ⅲ patients, followed by that in stage Ⅱ patients, and the lowest in stage Ⅰ patients (P<0.05). The AUC of BALF PTPN2 in differentiating patients with stage Ⅱ~Ⅲ and stage Ⅰ silicosis could reach 0.897(95%CI: 0.812~0.971). Logistic regression analysis showed that the higher level of BALF PTPN2 was an independent predictor of the progression of stage Ⅱ-Ⅲ silicosis (P<0.05). Spearman′s rank correlation analysis showed that the BALF PTPN2 level in patients with silicosis was significantly negatively correlated with forced expiratory volume in 1 second percentage (FEV₁%) predicted value (r=-0.359, P=0.007), forced vital capacity percentage (FVC%) predicted value (r=-0.409, P=0.002), FEV₁/FVC (r=-0.309, P=0.021) and diffusion lung carbon monoxide (r=-0.285, P=0.033). Besides, The level of BALF PTPN2 in patients with silicosis was significantly positively correlated with inflammatory and fibrotic indicators such as interleukin (IL)-6, IL-8, tumor necrosis factor-α, monocyte chemoattractant protein 1, and interferon-induced protein 10(P<0.05).

The elevated level of BALF PTPN2 is significantly associated with the aggravation of silicosis and the deterioration of lung function. PTPN2 may be involved in the pathophysiological process of silicosis and is expected to become a potential biomarker for the diagnosis of silicosis and the assessment of the risk of disease deterioration.

Analysis of vascular cell adhesion molecule-1 (VCAM-1), heparin-binding protein (HBP), and regulatory T cells The predictive significance of Treg level detection for patients with bronchial asthma (BA) complicated with pulmonary infection.

A retrospective analysis was conducted on the case data of 67 asthma patients admitted to our hospital from June 2020 to December 2024. According to whether there was lung infection or not, they were divided into 32 infected cases as the observation group and 35 cases without lung infection as the control group. The clinical data, pulmonary function parameters, changes in blood VCAM-1, HBP protein and Treg cell levels of the two groups of patients were compared. Pearson or Spearman rank correlation analysis was used to analyze the correlations between the levels of blood VCAM-1, HBP protein and Treg cells and pulmonary function parameters, and the receiver operating characteristic was applied. The ROC curve was used to predict the levels of VCAM-1, HBP protein and Treg cells for pulmonary infection in patients with bronchial asthma.

The white blood cell count (WBC) of patients in the observation group was (7.53±2.82) ×10⁹/L, procalcitonin (PCT) was (0.24±0.12) ng/ml, and C-reactive protein (CRP) was (34.04±12.82) mg/L, erythrocyte sedimentation rate (ESR) was (19.57±2.36) mm/1 h, partial pressure of carbon dioxide in arterial blood (PaCO₂) (51.36±7.25) mmHg, VCAM-1 (532.22±68.87) ng/ml and HBP (54.68±14.88) ng/ml were higher than those in the control group [(5.84±1.61) ×10⁹/L, (0.17±0.05) ng/ml, (28.63±7.49) mg/L, (18.41±2.17) mm/1 h, (46.29±7.63) mmHg, (421.71±68.35) ng/ml, (35.84±8.92) ng/ml], partial pressure of oxygen in arterial blood (PaO₂) was (69.38±9.85) mmHg, forced expiratory volume in one second (1.53±0.27) L, ratio of forced expiratory volume in one second to forced vital capacity (FEV₁/FVC) was (55.18±7.10)%, peak expiratory flow (PEF) (316.69±31.24)L/min and Treg (3.88±0.56)% were lower than those in the control group [(72.85±8.43)mmHg, (1.71±0.29)L, (62.82±9.20)%, (343.05±41.77)L/min, (4.75±0.61)%], the difference was statistically significant (P<0.05). In patients with bronchial asthma, VCAM-1 was negatively correlated with the parameters of pulmonary function FEV₁, FEV₁/FVC, and PEF (r=-0.433, -0.532, -0.489, P<0.05). The HBP protein in patients with bronchial asthma was negatively correlated with the parameters of pulmonary function FEV₁, FEV₁/FVC, and PEF (r=-0.340, -0.465, -0.517, P<0.05). The level of Treg cells was positively correlated with the parameters of FEV₁, FEV₁/FVC and PEF in lung function (r=0.367, 0.461, 0.468, P<0.05). The ROC curve showed that the AUCs of VCAM-1, HBP protein, and Treg cell levels for predicting pulmonary infection in patients with bronchial asthma, respectively and in combination, were 0.887, 0.861, 0.870, and 0.900, respectively. There was no difference in the AUC values predicted respectively and in combination (P>0.05). There were 24 cases of bilateral lung infection and 3 cases of thoracic deposition in patients with bronchial asthma complicated with pulmonary infection.

The levels of VCAM-1, HBP protein and Treg cells are closely related to pulmonary infection and have predictive significance for BA complicated with pulmonary infection, providing a reference for clinical diagnosis, treatment and disease monitoring.

To explore the predictive value of inflammatory factors in bronchoalveolar lavage fluid (BALF) for the risk of sputum plugs in patients with severe pneumonia.

Seventy-eight patients with severe pneumonia admitted to our hospital from December 2020 to December 2024 were selected as subjects. They were divided into groups based on the presence or absence of sputum plugs found during bronchoscopy: 32 cases with sputum plugs formed the observation group, and 46 cases without sputum plugs formed the control group. Levels of inflammatory factors in BALF were detected. Logistic regression analysis was used to screen characteristic variables associated with the risk of sputum plugs in severe pneumonia. An AI-based model was constructed to predict the risk of sputum plugs in severe pneumonia, and its performance was validated by receiver operating characteristic (ROC) curve analysis.

The levels of interleukin-4 (IL-4) (20.66±4.12) pg/ml, interleukin-6 (IL-6) (116.35±16.75) pg/ml, interleukin-8 (IL-8) (213.68±20.19) pg/ml, interleukin-10 (IL-10) (32.83±4.74) pg/ml, tumor necrosis factor-α (TNF-α) (64.59±8.22) pg/ml and C-reactive protein(CRP)(38.72±5.68)mg/L in the BALF of the observation group were higher than those in the control group IL-4 (18.35±3.27) pg/ml, IL-6 (105.14±15.22) pg/ml, IL-8 (213.68±20.19) pg/ml, IL-10 (29.16±4.09) pg/ml, TNF-α (58.32±7.15) pg/ml and CRP(31.56±4.84)mg/L (t=2.645, 3.017, 4.286, 3.555, 3.493, 5.812; P<0.05). Multivariate logistic regression analysis showed that pleural effusion (OR=1.439), forced expiratory volume in 1 second(FEV₁) (OR=0.844), neutrophils (OR=1.737), CRP (OR=2.015), IL-6 (OR=1.600), IL-8 (OR=1.575), IL-10(OR=1.233), and TNF-α(OR=1.131) were risk factors for sputum plugs in severe pneumonia (P<0.05). ROC curve analysis showed that the area under the curve (AUC) was 0.904, sensitivity was 75.00%, specificity was 93.48%, and the Youden index was 0.685, which was higher than that of any single BALF inflammatory factor.

The AI-based model utilizing BALF inflammatory factors can predict the risk of sputum plugs in patients with severe pneumonia, aiding in the early identification of high-risk patients and the formulation of personalized treatment plans.

To investigate the predictive significance of ventilatory efficiency [the slope of minute ventilation (VE) to carbon dioxide output (VCO₂)] for prolonged air leak (PAL) after video-assisted thoracoscopic surgery (VATS) in patients with non-small cell lung cancer (NSCLC).

A retrospective selection was made of 82 NSCLC patients who underwent video-assisted thoracoscopic anatomic lung resection in our hospital from March 2022 to August 2024. Based on the occurrence of postoperative PAL, patients were divided into two groups: 15 patients with PAL constituted the observation group, and 67 patients without PAL constituted the control group. Preoperative pulmonary function tests and cardiopulmonary exercise testing (CPET) were performed, and the VE/VCO₂ slope was recorded.

The VE/VCO₂ slope in the observation group was 32.00 (28.00, 35.00), which was higher than that in the control group [27.00 (24.00, 31.00)](P<0.05). The area under the receiver operating characteristic (ROC) curve (AUC) for the VE/VCO₂ slope predicting PAL was 0.833 (95%CI: 0.731~0.936), with a cutoff value of 31.5, a sensitivity of 80.00%, and a specificity of 79.10%. Logistic regression analysis showed that smoking history [OR(95%CI): 8.006 (1.013~63.279)], percentage of forced expiratory volume in one second in predicted value (FEV₁%) [OR(95%CI): 0.088 (0.009~0.864)], pleural adhesion [OR(95%CI): 10.366 (1.225~87.752)], and VE/VCO₂ slope [OR(95%CI): 28.889(3.851~216.729)] were risk factors for PAL(P<0.05). ROC curve analysis showed that the nomogram model for predicting the risk of postoperative PAL had an AUC of 0.914 (95%CI: 0.851~0.977), with a sensitivity and specificity of 93.30% and 74.60%, respectively. The Hosmer-Lemeshow goodness-of-fit test indicated a good fit (χ²=0.992, P=0.986). Clinical decision curve analysis showed a good net clinical benefit for predicting postoperative PAL when the high-risk threshold was between 0.03 and 0.82.

Ventilatory efficiency (VE/VCO₂ slope) is associated with an increased risk of PAL after VATS in NSCLC patients. A higher VE/VCO₂ slope indicates lower ventilatory efficiency and a higher risk of postoperative PAL.

To explore the clinical application value of morphological and radiomics feature models based on computed tomography (CT) in the differentiation of benign and malignant sub-centimeter solid pulmonary nodules (SSPNs).

A retrospective analysis was conducted on the CT image data of 203 SSPNs patients from January 2021 to March 2023. They were randomly divided into the training set 143 cases and the test set 60 cases in a ratio of 7︰3. Baseline low-dose chest CT evaluated the clinical and morphological features of SSPNs, while extracting radiological features of the entire lung. The Least Absolute Shrinkage and Selection Operator (LASSO) is used for radiological feature selection and calculating radiological feature scores, and constructing machine learning models. In the test set, the performance of the model is evaluated through the area under the curve (AUC) of receiver operating characteristic(ROC), Hosmer-Lemeshow test, and decision curve.

The detection rate of malignant nodules was 48.28% (98/203). In both the training set and the test set, there were significant differences between the benign group and the malignant group in terms of nodule diameter, vascular convergence sign, nodule-lung interface, spiculation sign, pleural indentation, vacuole sign, and air bronchogram sign (P<0.05). Multivariate Logistic regression analysis showed that nodule diameter, nodule-lung interface, spiculation sign, pleural indentation, and air bronchogram sign were significantly associated with the malignant risk of SSPNs (P<0.05). Morphological feature models were established using these five CT features. A total of 1, 783 high-throughput radiomics features were extracted. After correlation analysis, Mann-Whitney U test, and LASSO contraction, four of the most significant radiomics features were finally screened to establish the model(wavelet-HLL_gldm_DependenceNonUniformity, squareroot_ngtdm_Strength, gradient_glcm_Imc1, original_glrlm_LongRunLowGrayLeve). Based on the Delong test, the AUC of the combined model in both the training set and the test set was significantly higher than that of the morphological feature model (Z=4.618, 2.534, P<0.05) and the radiomics model (Z=2.449, 1.982, P<0.05). After the H-L goodness-of-fit test, the combined model in the training set and the test set (χ²=3.899, 2.815, P<0.05) fitted well. Decision curve analysis shows that when the high-risk threshold is between 0.02 and 0.98, the joint model offers greater net benefits than the single model.

The combined model of CT morphology and radiomics features has good diagnostic performance in differentiating benign and malignant SSPNs and is expected to become an important auxiliary tool for the clinical diagnosis of malignant SSPNs in high-risk surgical cohorts.

To investigate the clinical significance of serum tRF-Lys-CTT expression levels in predicting postoperative recurrence in patients with lung adenocarcinoma.

A prospective study was conducted on 75 patients who underwent surgery for lung adenocarcinoma at our hospital between January 2022 and December 2023. Based on recurrence within one year post-surgery, patients were divided into an observation group with recurrence 31 cases and a control group without recurrence 44 cases. Clinical data, laboratory indicators, and chest CT imaging features were collected. Serum tRF-Lys-CTT expression levels were detected using real-time quantitative(PCR). Univariate and multivariate logistic regression analyses were performed to identify factors influencing postoperative recurrence, and receiver operating characteristic polymerase chain reaction(ROC) curves were plotted to evaluate the predictive value of individual indicators and their combination for recurrence.

The observation group had higher age, larger tumor diameter (3.53±0.48)cm, and higher proportions of stage Ⅱ18 cases(58.06%) and stage Ⅲa 4 cases(12.91%) disease compared to the control group age, tumor diameter(3.32±0.33) cm, stage Ⅱ 14 cases(31.82%), stage Ⅲa 3 cases(6.82%). The tRF-Lys-CTT expression level (1.68±0.43) in the observation group was significantly lower than that in the control group (2.37±0.71), (P<0.001). Multivariate analysis identified age (OR=1.170, 95%CI: 1.027~1.331) and tumor stage (OR=6.233, 95%CI: 1.694~22.934) as independent risk factors for postoperative recurrence, while tRF-Lys-CTT (OR=0.028, 95%CI: 0.004~0.202) was a protective factor. ROC curve analysis showed that the area under the curve (AUC) for tRF-Lys-CTT in predicting recurrence was 0.815, with a sensitivity of 74.19% and specificity of 82.82%. The combination of age, tumor stage, and tRF-Lys-CTT improved the AUC to 0.908, with a sensitivity of 77.42% and specificity of 90.91%, which was superior to any single indicator (P<0.05). After treatment, 75 patients were followed up in the outpatient department. Among them, 67 cases (89.33%) survived and 8 (10.67%) died.

Low serum expression of tRF-Lys-CTT is closely associated with postoperative recurrence in lung adenocarcinoma and serves as a protective factor. The combination of age, tumor stage, and tRF-Lys-CTT detection improves the prediction of postoperative recurrence in lung adenocarcinoma, facilitating early identification of high-risk patients and guiding individualized intervention.

To investigate the expression and functional significance of phosphoribosylaminoimidazole succinocarboxamide synthetase (PAICS) in human lung adenocarcinoma and its mechanisms.

The GEO, GEPIA, and HPA databases were used to investigate the difference in expression of PAICS in lung adenocarcinoma compared with paracancerous tissues. The prognosis value of PAICS in patients with lung adenocarcinoma was evaluated by the GEPIA database and Kaplan-Meier Plotter platform. PAICS-associated co-expressed genes were obtained from the LinkedOmics database and used to perform gene ontology (GO) enrichment and KEGG enrichment analysis. The TIMER database was used to evaluate the relationship between PAICS and immune infiltration level of lung adenocarcinoma. Cultured A549 and H1299 cell lines were transfected with PAICS siRNA to investigate the effects of PAICS downregulation on the proliferation and migration of lung adenocarcinoma cell lines and the mRNA expression of CCNA2, CCNB1, CCNB2, and immune checkpoint gene PD-L1 in A549 and H1299.

Multiple databases analysis revealed that PAICS expression was upregulated in patients with lung adenocarcinoma (P<0.001). High PAICS expression was negatively correlated with overall survival(P<0.001). The TIMER database revealed that the expression of PAICS in patients with lung adenocarcinoma were significantly and positively correlated with tumor cell purity (r= 0.13, P<0.01) but negatively correlated with B cells (r=-0.236, P<0.01), CD4⁺ T cells (r=-0.173, P<0.01), macrophages (r=-0.156, P<0.01), and dendritic cells (r=-0.131, P<0.01) in tumor microenvironment. GO enrichment and KEGG enrichment analyses indicated that PAICS-associated co-expressed genes were involved in the pathogenesis of lung adenocarcinoma through the regulation of cell cycle and cell mitosis. In cultured A549 and H1299 cell lines, PAICS siRNA transfection markedly attenuated the proliferation (P<0.01) and migration (P<0.01) of both cell lines and downregulated the expression of the genes encoding cyclin CCNA2 (P<0.05), CCNB1 (P<0.05), CCNB2 (P<0.05), and PD-L1 (P<0.05). In a xenograft mouse model transplanted with A549 cells, PAICS siRNA transfection markedly decreased the tumor size (P<0.05) and tumor weight (P<0.05).

PAICS plays a key role in the pathogenesis of lung adenocarcinoma. PAICS may serve as a prognostic indicator and potential target of lung adenocarcinoma, it with prospective clinical significance.

To analyze the clinical efficacy of pulmonary rehabilitation training management in patients with postoperative pulmonary infection after laparoscopic esophagectomy for esophageal cancer.

A total of 49 patients who underwent thoracoscopic esophagectomy at the Second Medical Center of the General Hospital of the People′s Liberation Army from June 2023 to February 2025 were selected as the subjects. 25 patients received perioperative clinical nursing management as the control group, and 24 patients received pulmonary rehabilitation training management on the basis of the control group as the observation group. between two groups Forced Expiratory Volume in One Second and percentage of forced vital capacity(FEV₁/FVC%), peak expiratory flow(PEF), partial pressure of oxygen(PaO₂), partial pressure of carbon dioxide(PaCO₂), oxygen saturation(SaO₂), step count(SC), Respiration(R)and Heart Rate(HR); Record two groups of pulmonary complications.

Before surgery, the FEV₁/FVC% (59.17±3.86)% and PEF (4.36±0.34) L/s in the observation group were higher than those in the control group (56.64±3.70)% and PEF (4.11±0.38) L/s (P<0.05); The FEV₁/FVC% (64.08±4.42)% and PEF(4.52±0.37) L/s in the observation group were higher than those in the control group after surgery (59.32±4.02)% and (4.19±0.37)L/s, respectively (P<0.01). Before surgery, the PaO₂ (74.28±17.21) mmHg and PaCO₂ (55.69±8.17) mmHg in the observation group were better than those in the control group (71.59±15.39) mmHg and PaCO₂ (57.79±6.59) mmHg (P>0.05), and the SaO₂ (92.34±15.62)% was higher than that in the control group (91.87±13.75)% (P<0.05); The PaO₂ (78.24±16.87) mmHg and PaCO₂ (48.41±9.25) mmHg of the observation group were better than those of the control group after surgery (74.38±14.62) mmHg and (52.83±7.15) mmHg, respectively (P>0.05); SaO₂ (94.84±18.35)% was higher than the control group (91.65±14.68)% (P>0.05). Before surgery, the SC (1 120.96±95.82), R (31.21±6.40) min, and HR (102.71±20.39) min of the observation group were better than those of the control group SC(1 052.00±85.85), R (35.64±5.99) min, and HR (116.96±21.83) min (P<0.05); After surgery, the SC(1 443.96±85.74), R (26.46±6.35) min, and HR (89.83±18.06) min in the observation group were better than those in the control group SC(1 260.24±81.13), R (32.16±6.97) min, and HR (108.64±25.30) min (P<0.01). During hospitalization, there were 3 cases (12.50%) of pulmonary complications in the observation group, including 2 cases of pleural effusion and 1 case of pulmonary infection; There were 7 cases (28.00%) of pulmonary complications in the control group, including 4 cases of pleural effusion, 2 cases of pulmonary infection, and 1 case of atelectasis. After surgery, the observation group showed relief of pulmonary complications, while the control group had 2 cases of pleural effusion and 1 case of pulmonary infection.

Pulmonary rehabilitation training management can improve lung function, improve blood gas indicators, accelerate recovery speed, and reduce pulmonary complications in patients undergoing thoracoscopic esophagectomy.

To investigate the relationship between eosinophil (EOS) count and alveolar damage in patients with chronic obstructive pulmonary disease (COPD) complicated with emphysema.

A total of 186 patients with COPD and emphysema admitted to our hospital from January 2021 to June 2025 were selected. EOS counts were measured, and patients underwent chest computerized tomography (CT) scans, pulmonary function tests, and cardiopulmonary exercise testing (CPET). Spearman analysis was used to analyze the correlations between EOS count and CT parameters, pulmonary function, and CPET parameters. Multiple linear regression was employed to adjust for confounding factors.

Among the 186 patients, 82 were identified as the EOS phenotype (EOS ≥300/μl) and 104 as the non-EOS phenotype (EOS<300/μl). The use of bronchodilators was higher in the EOS phenotype group 63 cases( 76.83%) compared to the non-EOS phenotype group 56 cases(53.85%) (P=0.001), and the neutrophil count was lower in the EOS phenotype group (P=0.027). Spearman correlation analysis showed that in the EOS phenotype group, EOS count was positively correlated with the expiratory to inspiratory ratio of mean lung density (E/I) (r_s=0.484, P=0.000), the wall area percentage of the 5th generation apical segment bronchus (B¹ 5th WA%) (r_s=0.396, P=0.000), and the wall thickness of the 5th generation apical segment airway (B¹ 5th WT) (r_s=0.245, P=0.041). It was negatively correlated with the peak of minute ventilation (VE_peak) (r_s=-0.239, P=0.030), maximum voluntary ventilation (MVV) (r_s=-0.442, P=0.000), peak heart rate (HR_peak) (r_s=-0.336, P=0.002), oxygen saturation (SpO₂) (r_s=-0.230, P=0.037), Z score of forced expiratory volume in one second (FEV_{1 Z-score}) (r_s=-0.484, P=0.000), Z score of FEV₁ to forced vital capacity ratio (FEV₁/FVC_Z-score) (r_s=-0.488, P=0.000), Z score of diffusion capacity for carbon monoxide of the lung (DL_{CO Z-score}) (r_s=-0.230, P=0.038), and Z score of alveolar ventilation (VA_Z-score) (r_s=-0.231, P=0.037). In the non-EOS phenotype group, EOS count was negatively correlated with diffusion capacity for carbon monoxide per liter of alveolar volume (K_CO) (r_s=-0.200, P=0.042). Multiple linear regression showed that in the EOS phenotype group, EOS count was associated with E/I (P=0.000), B¹ 5th WA% (P=0.000), B₁ 5th WT (P=0.041), VE_peak (P=0.008), MVV (P=0.000), VR (P=0.004), FEV_{1 Z-score} (P=0.000), FEV₁/FVC_Z-score (P=0.000), and VA_Z-score(P=0.029). No such associations were found in non-EOS patients.

Alveolar damage in patients with COPD and emphysema is associated with airway eosinophilic inflammation. The EOS phenotype is associated with more severe emphysema and alveolar damage.

To analyze the clinical efficacy of combined therapy with inhaled corticosteroids (ICS), long-acting muscarinic antagonists (LAMA), and long-acting β₂ agonists (LABA) in treating chronic obstructive pulmonary disease(COPD) -asthma overlap syndrome (ACOS).

A total of 67 ACOS patients admitted to our hospital from December 2021 to June 2024 were selected as subjects and divided into a control group (32 cases) and an observation group (35 cases) based on treatment regimens. The control group received ICS and LABA, while the observation group received ICS, LAMA, and LABA. Changes of CT signs of lung, Clinical efficacy, lung function, endothelial function, immune function, oxidative stress response, and adverse reactions were compared between the two groups.

The chest CT signs of the observation group were lower than those of the control group (P<0.05). The treatment effectiveness rate in the observation group was 31 cases (88.57%), higher than 22 cases (68.85%) in the control group (P<0.05). After treatment, the observation group showed higher forced vital capacity (FVC) (2.45±0.37) L, forced expiratory volume in the first second (FEV₁) (1.43±0.24) L, FEV₁/FVC ratio(60.67±3.89) %, and peak expiratory flow rate (PEF)(4.15±0.74) L/s compared to the control group FVC (2.23±0.28)L, FEV₁(1.25±0.31)L, FEV₁/FVC (55.99±2.49)%, PEF(3.70±0.15)L/s (P<0.05). Post-treatment levels of endothelin-1 (ET-1)(2.75±0.21)ng/L and soluble intercellular adhesion molecule-1(sICAM-1) (570.23±34.46) mg/ml were lower in the observation group than in the control group ET-1(3.05±0.55)ng/L, sICAM-1(597.82±44.83) mg/ml(P<0.05). Post-treatment levels of T helper 1 cell (Th1) (29.71±3.66)% and Th1/Th2 ratio (8.54±1.63) were higher in the observation group than in the control group Th1 (20.16±0.94) %, Th1/Th2 (7.38±0.96) (P<0.05). Post-treatment malondialdehyde (MDA) levels (6.13±0.99)nmol/L were lower in the observation group than in the control group (6.91±0.54)nmol/L, while superoxide dismutase (SOD) levels (51.05±4.73)U/ml were higher than in the control group (43.35±4.68)U/ml (P<0.05). The incidence of adverse reactions was 2 cases (5.71%) in the observation group, lower than 6 cases (18.75%) in the control group.

Triple therapy with ICS, LAMA, and LABA in ACOS patients improves treatment efficacy, enhances lung function, immune function, endothelial function, reduces oxidative stress response, and demonstrates high safety.

To analyze the clinical efficacy of electrical impedance tomography (EIT)-guided titration of positive end-expiratory pressure (PEEP) in the treatment of patients with acute respiratory distress syndrome (ARDS).

A total of 69 ARDS patients admitted to our hospital from March 2023 to April 2025 were selected and divided into a control group 36 cases and an observation group 33 cases using a random number table. The control group received PEEP selection based on the PEEP-fraction of inspired oxygen (FiO₂) strategy, while the observation group received EIT-guided PEEP titration. The two groups were compared in terms of pulmonary function indicators [pulmonary vascular resistance index (PVRI), extravascular lung water index (EVLWI), pulmonary vascular permeability index (PVPI)], respiratory mechanics parameters [peak airway pressure (Ppeak), compliance of the respiratory system (Crs), plateau airway pressure (Pplat), oxygenation index (PaO₂/FiO₂)], disease-related scores [acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), lung ultrasound (LUS), sequential organ failure assessment (SOFA)], gas distribution, and treatment efficacy.

After treatment, the observation group had significantly lower EVLWI[(5.85±0.91) ml/kg], PVRI[(2.61±0.44) WU], and PVPI[(1.54±0.21)] than the control group[(6.48±1.13) ml/kg, (2.85±0.46) WU, (1.72±0.28), respectively] (P<0.05). In terms of respiratory mechanics parameters, the observation group had lower Ppeak[(25.93±4.27) cmH₂O] and Pplat[(22.17±3.53) cmH₂O] than the control group [(28.49±4.16) cmH₂O, (24.58±3.94) cmH₂O, respectively], while higher Crs[(36.78±5.14) ml/cmH₂O] and PaO₂/FiO₂[(203.25±31.58) mmHg] than the control group[(34.27±5.08) ml/cmH₂O, (185.63±27.82) mmHg, respectively] (P<0.05). The observation group also had lower APACHE Ⅱ score [(14.43±2.68) points], LUS score[(14.35±2.57) points], and SOFA score [(6.29±1.35) points] compared with the control group [(16.28±2.75) points, (15.92±2.78) points, (7.12±1.57) points, respectively] (P<0.05). At 24 hours after treatment, the observation group showed significantly higher percentages of region of interest (ROI) 1 [(12.07±1.63)%], ROI 3[(34.63±3.76)%], and ROI 4[(11.31±1.63)%] than the control group[(11.28±1.57)%, (32.62±4.31)%, (10.52±1.58)%, respectively], and a lower percentage of ROI 2[(42.18±4.85)%] than the control group[(45.59±5.69)%] (P<0.05). The duration of mechanical ventilation[(5.17±0.94) days] and length of stay in the intensive care unit (ICU)[(8.28±1.42) days] in the observation group were significantly shorter than those in the control group[(5.69±0.78) days, (9.03±1.56) days, respectively] (P<0.05). However, there were no significant differences in in-hospital mortality(12.12% vs. 25.00%) between the two groups (P>0.05).

The application of EIT technology to guide PEEP therapy helps shorten the duration of mechanical ventilation and ICU stay, and improves respiratory mechanics parameters and pulmonary gas distribution.

To explore the relationship between hemoperfusion (HP) combined with continuous veno-venous hemofiltration (CVVH) and pulmonary fibrosis and prognosis in patients with acute severe organophosphorus pesticide poisoning (ASOPP).

Seventy-five ASOPP patients admitted to our emergency department from July 2022 to March 2025 were selected as subjects and divided into a control group (38 cases) and an observation group (37 cases) based on the treatment method. The control group received HP treatment, while the observation group received HP combined with CVVH treatment. Levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), Procollagen Ⅲ amino terminal propeptide (PⅢNP), Collagen Type Ⅳ (CIV), and transforming growth factor-beta 1 (TGF-β1) were compared between the two groups. Clinical efficacy and mortality were recorded during follow-up.

There were no statistically significant differences in CRP, IL-6, and TNF-α levels between the two groups before treatment (P>0.05). After treatment, the levels of CRP, IL-6, and TNF-α in the observation group were lower than those in the control group (P<0.05). There were no statistically significant differences in PⅢNP, CIV, and TGF-β1 levels between the two groups before treatment (P>0.05). After treatment, the levels of PⅢNP, CIV, and TGF-β1 in the observation group were lower than those in the control group (P<0.05). One case (2.70%) of pulmonary fibrosis occurred in the observation group, which was lower than the 8 cases (21.05%) in the control group (χ²= 8.656, P=0.003). Multivariate logistic regression analysis showed that HP+ CVVH treatment was a protective factor for reducing the risk of pulmonary fibrosis (OR=0.057, 95%CI: 0.004~0.754, P=0.030), and the pre-treatment SOFA score was a risk factor for pulmonary fibrosis (OR=1.628, 95%CI: 1.072~2.474, P=0.022). The CHE activity recovery time in the observation group was 4.00 (3.00, 7.00) days, shorter than 6.00 (4.00, 9.00) days in the control group (P=0.035). After 28 days of outpatient follow-up, there were 26 survivors (68.42%) and 12 deaths (31.58%) in the control group; there were 33 survivors (89.19%) and 4 deaths (10.81%) in the observation group (P=0.028). The incidence of intermediate syndrome after hemoperfusion in the observation group was 2 cases (5.41%), lower than 8 cases (21.05%) in the control group (χ²=3.972, P=0.046). The incidence of organ injury in the observation group was 8 cases (21.62%), which was lower than that in the control group (14 cases, 36.84%) (χ²=2.095, P=0.148).

HP combined with CVVH treatment helps reduce the incidence of pulmonary fibrosis and mortality in ASOPP patients, improving prognosis.

To investigate the impact of a multidimensional management model based on prehabilitation and Enhanced Recovery After Surgery (ERAS) protocols on perioperative rehabilitation and prognosis in elderly patients undergoing lung cancer surgery.

Seventy elderly patients who underwent lung cancer resection in our Hospital from January 2022 to December 2024 were enrolled. According to different perioperative management interventions, they were divided into a control group (32 cases) and an observation group (38 cases). Patients in the control group received a prehabilitation program tailored to their comorbidities, including smoking cessation, aerobic exercise, anemia correction, resistance training, inspiratory muscle training, and enhanced psychological support. The observation group received additional interventions aimed at improving functional residual capacity (FRC) and forced expiratory volume in the first second (FEV₁) based on the control group′s protocol. The following parameters were compared between the two groups: time to first ambulation, time to first flatus, postoperative hospital stay, pain visual analogue scale (VAS) scores at different postoperative time points (6 h, 12 h, 24 h, 48 h), incidence of postoperative complications, and survival status during a 3-10 month follow-up.

There was no significant difference in preoperative pulmonary function test results between the two groups (P>0.05). The postoperative recovery process was significantly accelerated in the observation group. The time to first ambulation (28.55±8.33 hours vs. 44.82±12.72 hours), time to first flatus (21.74±4.24 hours vs. 32.91±5.64 hours), and postoperative hospital stay (6.21±1.10 days vs. 9.03±1.93 days) were all significantly shorter in the observation group (P<0.01). VAS pain scores at all measured postoperative time points were significantly lower in the observation group (P<0.05). However, there were no statistically significant differences between the two groups in the incidence of postoperative complications or in survival/mortality rates during the 3-10 month follow-up (P>0.05).

In the perioperative management of elderly lung cancer patients, integrating prehabilitation and ERAS concepts through a multidimensional intervention model can effectively accelerate postoperative recovery, shorten hospital stays, and improve acute postoperative pain control, demonstrating significant clinical value.

To investigate the relationship between the frailty index (FI) and acute exacerbations in elderly patients with chronic obstructive pulmonary disease (COPD).

A total of 87 elderly patients with acute exacerbation of COPD (AECOPD) admitted to our hospital between January 2020 and January 2025 were selected. Patients were divided into an observation group (frail, FI ≥ 0.25, n=46) and a control group (non-frail, FI<0.25, n=41). General data of the two groups were compared. Multivariate logistic regression was used to analyze influencing factors for frailty in AECOPD patients. Pearson correlation analysis was used to examine the relationship between FI and lung function indicators. The receiver operating characteristic (ROC) curve was used to analyze the value of indicators in predicting the severity of AECOPD in elderly patients. The prognosis of the two groups was compared after a 1-year follow-up.

The observation group had significantly higher COPD duration, (neutrophil+ monocyte)/lymphocyte ratio(NMLR), number of hospitalizations, C-reactive protein(CRP) levels, and FI than the control group (P<0.05). Multivariate logistic regression analysis showed that the annual number of hospitalizations and NMLR were risk factors for frailty in AECOPD patients (P<0.05). Levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and FEV₁/FVC in the observation group were lower than those in the control group (P<0.05). Pearson correlation analysis showed that FI was negatively correlated with FEV₁, FVC, and FEV₁/FVC (r=-0.577, -0.582, -0.539, respectively, P<0.001). The number of hospitalizations (r=-0.414, -0.481, -0.510) and NMLR (r=-0.451, -0.504, -0.504) were negatively correlated with lung function indicators (P<0.05). FI demonstrated high sensitivity and specificity for predicting AECOPD severity, with an AUC of 0.935, which was higher than the AUC for the number of hospitalizations (AUC=0.621) and NMLR (AUC=0.708) (Z hospitalization-FI=5.389, Z NMLR-FI=3.983, P<0.05). During the follow-up of elderly AECOPD patients, 61 survivors (70.11%) and 26 deaths (29.89%) were recorded. In the observation group, there were 28 survivors (60.87%) and 18 deaths (39.17%); in the control group, there were 33 survivors (80.49%) and 8 deaths (19.51%). The mortality rate in the observation group was significantly higher than that in the control group (P<0.05).

FI is an important factor influencing the severity of AECOPD in elderly patients, closely related to lung function. Frailty is associated with an increased risk of death in AECOPD patients. FI may serve as a potential indicator for assisting in predicting the severity and prognosis of AECOPD, providing a reference for clinical practice.

To analyze the relationship between chronic disease resource utilization, disease perception and respiratory muscle group exercise compliance in elderly patients with chronic obstructive pulmonary disease (COPD).

A total of 219 COPD patients who were treated in our hospital from January 2020 to April 2025 were included in the study. The general information questionnaire, the chronic disease resource utilization questionnaire (CIRS), the simple disease perception questionnaire (BIPQ), and the breathlessness beliefs questionnaire(BBQ) were used for the investigation.Pearson correlation analysis of the three correlation, using SPSS macro program Model-4 to analyze whether the intermediary role of chronic disease resource utilization is established, and carry out Bootstrap test.

Among the 219 patients, the dyspnea fear score (14.23±4.67), CIRS score (49.74±6.41) and BIPQ score (50.32±8.56) were scored. CIRS score was negatively correlated with BIPQ score (r=-0.337) and dyspnea fear score (r=-0.256), while BIPQ score was positively correlated with dyspnea fear score (r=0.257) (P<0.05). The results of the mediating effect show that the direct effect of disease perception on the fear of dyspnea is 0.105, and the mediating effect of chronic disease resource utilization between disease perception and the fear of dyspnea is 0.035, accounting for 25.00% of the total effect.

The fear level of dyspnea in elderly COPD patients is generally at a high level, and the utilization of chronic disease resources has a partial mediating effect on disease perception and dyspnea fear level.

To investigate the correlation of the Children′s Asthma Control Test (C-ACT) score, serum periostin, thymic stromal lymphopoietin (TSLP), eosinophil cationic protein (ECP) levels and the severity of illness in children with allergic asthma.

A total of 105 children with allergic asthma admitted to our hospital from March 2023 to April 2025 were selected as subjects. They were divided into a control group (70 cases, FEV₁% ≥ 60%) and an observation group (35 cases, FEV₁%<60%) based on the percentage of forced expiratory volume in the first second (FEV₁%) of predicted value. The basic clinical characteristics, disease and respiratory function characteristics, C-ACT scores, and serological indicators were compared between the two groups. Correlation was analyzed using Pearson correlation and multivariate logistic regression.

The observation group had higher proportions of combined allergy history (82.9% vs. 34.3%), respiratory rate (29.74±1.39) breaths/min vs. (29.33±1.31) breaths/min, serum periostin (19.49±6.46) ng/ml vs. (16.81±4.84) ng/ml, TSLP(42.59±9.48) pg/ml vs. (37.53±10.04) pg/ml, and ECP (19.08±6.08) μg/L vs. (16.80±4.11) μg/L compared to the control group (P<0.05). The observation group had lower FEV₁% (50.49±2.91) vs. (76.99±4.75) and C-ACT scores (18.79±2.19) vs. (19.98±2.36) than the control group (P<0.05). Pearson analysis showed that FEV₁% was positively correlated with C-ACT score (r=0.634, 0.586, 0.721, P<0.001) and negatively correlated with serum periostin (r=-0.578, -0.509, -0.614), TSLP (r=-0.592, -0.531, -0.663), and ECP (r=-0.601, -0.527, -0.756) in both groups (P<0.001). Multivariate logistic regression showed that lower C-ACT score (OR=0.755, 95%CI: 0.653~0.873) and higher serum periostin (OR=1.083, 95%CI: 1.016~1.153), TSLP (OR=1.065, 95%CI: 1.029~1.102), and ECP (OR=1.091, 95%CI: 1.016~1.171) levels were closely associated with disease severity (P<0.05).

In children with allergic asthma, the C-ACT score is negatively correlated with disease severity, while serum periostin, TSLP, and ECP levels are positively correlated with disease severity.

To improve diagnosis and treatment level of furazolidone-induced interstitial lung disease by analyzing the clinical data of patients.

Retrospective analysis of three patients diagnosed with furazolidone-induced interstitial lung disease in South China Hospital Affiliated to Shenzhen University.

The study included one male and two female patients, aged 40, 23, and 39 years old respectively. All patients experienced fever and exertional chest tightness on the 10th day of furazolidone treatment, two cases with intermittent dry cough, while one case with fatigue and myalgia, as well as one case with nausea and headache. Laboratory examination results revealed the leukocyte count (10.9~13.9) ×10⁹/L, neutrophil count (8.98~12.44) ×10⁹/L and C-reactive protein (19.14~287.52) mg/L were significantly increased, while eosinophils counts were normal. Chest CT scans indicated that smooth interlobular septal thickening in both lungs of all patients, while two of them were accompanied by ground-glass opacities localized in upper lungs near central pulmonary regions. The Nord′s score of all three patients was 7. By analyzing medication history and imaging characteristics, furazolidone-induced interstitial lung disease was diagnosed after excluding cardiogenic pulmonary edema, or interstitial lung disease caused by other drugs and exposures. Discontinuation of furazolidone along with intravenous infusion of methylprednisolone succinate for anti-inflammatory treatment resulted in symptom improvement, while repeat chest CT scan showed absorption of lesions further supporting the diagnosis.

In cases of fever and chest tightness during furazolidone treatment, furazolidone-induced interstitial lung disease should be considered if chest CT scan reveals smooth interlobular septal thickening in both lungs, with or without ground-glass opacities. Discontinuation of furazolidone and initiation of anti-inflammatory therapy could typically lead to favorable outcomes.

To analyze the clinical data of one case with pulmonary cavitary nodule caused by Tropheryma whipplei(T.whipplei) infection and review the literature, aiming to improve the clinical understanding of pulmonary infection caused by T. whipplei.

A case of T. whipplei lung infection was reviewed and summarized, including the patient′s medical history, laboratory test results, CT imaging findings, metagenomic next generation sequencing (mNGS) results, treatment process, and therapeutic outcomes. The case was also compared with relevant literature on T. whipplei lung infections.

The study enrolled a female 39-year-old urban residents with a history of feline feline contact.Laboratory and auxiliary examinations revealed the following: white blood cell count 6.35×10⁹/L, absolute neutrophil count 3.5×10⁹/L, absolute lymphocyte count 2.02×10⁹/L, absolute monocyte count 0.58×10⁹/L, absolute eosinophil count 0.21×10⁹/L, hemoglobin 118 g/L, C-reactive protein (CRP) 0.4 mg/L. Coagulation panel: prothrombin time (PT) 11.0 sec, activated partial thromboplastin time (APTT) 28.7 sec, thrombin time (TT) 14.7 sec, fibrinogen (FBG) 2.45 g/L. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) indicated: Gram-positive bacteria: Tropheryma whipplei, sequence count 1179, relative abundance 14.60%; Fungus: Candida parapsilosis, sequence count 18, relative abundance 0.16%; DNA virus: Human betaherpesvirus 7, sequence count 3, relative abundance 2.12%. Chest CT showed a solitary cavitary nodule in the left lower lung as the initial presentation. The patient was diagnosed with Tropheryma whipplei pulmonary infection via mNGS and received a standardized 3-month course of oral cotrimoxazole (trimethoprim-sulfamethoxazole) anti-infective therapy. Following treatment, the cavitary nodule diameter decreased from 18 mm×13 mm to 11 mm×6 mm, indicating effective treatment response.

Bronchoalveolar lavage fluid mNGS is an effective diagnostic method for pulmonary infections caused by T. whipplei. Patients without immunosuppression who present solely with lung cavities or nodules should be vigilant for T. whipplei infection in clinical. Oral treatment with compound sulfamethoxazole has shown significant therapeutic effects.