To analyse the significance of methylation test of Ras association family 1 isoform A (RASSF1A) and short stature homeobox 2 (SHOX2) in bronchoalveolar lavage fluid(BALF) combined with radial ultrasonic features in the differential diagnosis between malignant and benign pulmonary nodules.

Ninety patients with pulmonary nodules admitted to our hospital from September 2022 to March 2024 were selected, 54 cases of malignant pulmonary nodules diagnosed by histopathology were in the observation group, and 36 cases of benign pulmonary nodules were in the control group, and BALF was collected for cytological examination and methylation detection of the RASSF1A and SHOX2 genes to compare the methylation positivity rate of the two groups and analyse the sensitivity and specificity of pulmonary nodules. Logistic regression analysis was used to screen some clinical characteristics, radial ultrasonic features and methylation indexes as predictors to construct a prediction model of pulmonary nodules.

In the observation group, 22 cases (40.74%) of RASSF1A positivity were higher than 1 case (2.78%) in the control group(P<0.01); 25 cases (46.30%) of SHOX2 positivity were higher than 2 cases (5.56%) in the control group(P<0.01); 14 cases (25.93%) of both RASSF1A and SHOX2 positivity were higher than 1 case(2.78%) in the control group(P<0.05); 33 cases (61.11%) of RASSF1A or SHOX2 positivity were higher than 2 cases (5.56%) in the control group(P<0.01; The sensitivity for diagnosing malignant lung nodules was 61.11% and the specificity was 94.44% for the positivity of RASSF1A or SHOX2. 33 cases (61.11%) of RASSF1A or SHOX2 positivity were significantly higher than 17 cases(31.48%) of BALF cytology positivity(P<0.05); Radial ultrasound characteristics of the observation group in the ratio of the continuous margins of 81.40%, the ratio of the uneven internal echo of 83.72% and the ratio of hypoechogenic shadows of 72.09% were higher than that of the control group of 40.00%, 40.00%, 45.71% (P<0.05); Multifactorial logistic regression analysis showed that two-gene methylation, continuous margins and uneven internal echo were the risk factors for predicting malignant lung nodules, and the area under the curve (AUC) of the working characteristics of the subjects was 0.886.

RASSF1A combined with SHOX2 methylation detection of BALF is valuable for the diagnosis of malignant lung nodules, and RASSF1A and SHOX2 methylation combined with radial ultrasound features are clinically relevant for the differential diagnosis of the property of lung nodules.

To investigate the role and novel mechanism of Rab32 on the proliferation, migration, and invasion of non-small cell lung cancer (NSCLC) cells.

The expression of Rab32 in NSCLC was assessed using bioinformatics. The mRNA and protein expression levels of Rab32 in NSCLC cells were determined by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analysis. Stable Rab32-overexpressing A549 and H1299 cell lines were constructed using a lentivirus system, with the overexpression group serving as the observation group. The effects of Rab32 on the proliferation of NSCLC cells were evaluated by CCK-8 and colony formation assays. The impact of Rab32 on the migration and invasion capabilities of A549 and H1299 cells was examined using scratch and Transwell assays. The expression levels of epithelial-mesenchymal transition (EMT) markers (E-cadherin, N-cadherin, and Vimentin) in different groups of cells were measured by Western blot.

Bioinformatics analysis indicated that the mRNA expression of Rab32 was significantly reduced in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) compared to the control group(P<0.05). qRT-PCR and Western blot results revealed that the mRNA and protein expression levels of Rab32 in A549, H1299, and HCC827 were significantly lower than those in normal human bronchial epithelial cells (Beas-2B), with more pronounced decreases in A549 and H1299 cells. In A549 and H1299 cells, the mRNA and protein expression levels of Rab32 in the observation group were significantly higher than those in the empty vector control group (P<0.05). The CCK-8 and colony formation assay results showed that the cell proliferation and cloning capacity of the observation group were significantly reduced compared to the control group (P<0.05). The scratch and Transwell assay results suggested a marked decrease in the migration and invasion capabilities of the observation group cells (P<0.05). Western blot analysis showed that the protein expression level of the epithelial phenotype marker E-cadherin in the observation group cells was significantly higher than that in the control group, while the expression of mesenchymal phenotype markers N-cadherin and Vimentin was markedly increased compared to the control group (P<0.05).

Rab32 inhibits the proliferation, migration, and invasion of NSCLC cells and may serve as a potential new avenue for the clinical treatment of NSCLC patients.

To analyze the predictive effect of serum apurinic/apyrimidinic endonuclease 1 (Ape1)/ redox factor-1 (Ref-1) on the occurrence of radiation-induced lung injury (RILI) in patients with locally advanced non-small cell lung cancer(LA-NSCLC) treated with radiotherapy.

A total of 76 patients with LA-NSCLC were selected who underwent concurrent chemoradiotherapy (CCRT) in otherapy in our hospital from January 2019 to January 2022. Chest CT scan showed RILI in 17 cases as observation group, no RILI in 59 cases as control group. Serum samples were collected before and after radiotherapy, serum Ape1/Ref-1 was determined by double-antibody sandwich ELISA, and its predictive value in RILI were analyzed.

The tumor diameter in the observation group was 21.0 (20.0, 27.0) mm, the tumor was located in the upper lobe in 14 cases (82.35%), and the total dose of radiotherapy 64.0 (60.0, 65.0) Gy was higher than that in the control group 19.0 (16.0, 23.0)mm 26 cases (44.07%) with tumor located in upper lobe, total dose of radiotherapy was 60.0 (59.0, 61.0) Gy (P<0.05). After radiotherapy, serum Ape1/Ref-1 was increased in observation group and control group, serum Ape1/Ref-15.90 (3.17, 9.60)ng/ml in observation group was higher than that in control group 2.18 (1.17, 3.95) ng/ml(P<0.05). Multivariate Logistic analysis showed that serum Ape1/Ref-1≥2.42 ng/ml was the risk factor for RILI after treatment (P<0.05). After treatment, serum Ape1/Ref-1 had a strong ability to predict RILI (AUC: 0.823, 95%CI: 0.723-0.922)(P<0.001). Tumor diameter ≥20 mm serum Ape1/Ref-1 level was higher at baseline, total radiotherapy dose was positively correlated with serum Ape1/Ref-1 level (P<0.05). After CCRT treatment, the disease recurred in 20 cases, the disease was controlled in 56 cases. After radiotherapy, the serum Ape1/Ref-1 in patients with disease recurrence and disease control increased, the serum Ape1/Ref-14.76 (2.45, 7.11) ng/ml in patients with disease recurrence was higher than that in patients with disease control 2.22 (1.18, 3.79) ng/ml (P<0.05).

Serum Ape1/Ref-1 after radiotherapy in LA-NSCLC can predict RILI, and high levels of serum Ape1/Ref-1 after radiotherapy are associated with increased risk of RILI and poor prognosis.

To evaluate the diagnostic value of virtual bronchoscopic navigation (VBN) combined with radial endobronchial ultrasound (R-EBUS) in peripheral lung cancer.

A total of 96 patients who underwent VBN+ R-EBUS guided lung biopsy in our hospital from January 2022 to January 2024 were selected. Chi-square test was used to compare the correlation between homogeneous/heterogeneous nodule echo, boundary characteristics, CT diagnosis and pathological diagnosis. Logistic regression analysis and receiver operating characteristic curvecurve (ROC) curve were used. To investigate the diagnostic value of R-EBUS imaging features in peripheral lung cancer.

Sixty-six cases (68.75%) showed homogeneous solid echogenicity, 30 cases (43.48%) showed heterogeneous solid echogenicity, 57 cases (59.38%) showed clear border, and 39 cases (40.62%) showed unclear border. 67 cases (69.79%) of lung cancer and 29 cases (30.21%) of other non-neoplastic diseases were diagnosed by spiral CT before operation. 58 cases (60.42%) of lung tumors were diagnosed by histopathology, including 39 cases (40.63%) of adenocarcinoma, 9 cases(9.38%) of squamous cell carcinoma and 10 cases (10.42%) of other tumors. There were 38 cases (39.58%) of non-tumor diseases diagnosed by histopathology, including 24 cases (25.00%) of inflammation, 6 cases(6.25%) of focal granulomatous inflammation or tuberculosis, and 8 cases (8.33%) of other non-tumor diseases. There were 51 cases of lung cancer (53.13%) and 15 cases of non-lung cancer (15.63%) with homogeneous echo and histopathologic diagnosis, 7 cases of lung cancer (7.29%) and 23 cases of non-lung cancer (23.96%) with heterogeneous echo.Homogeneous echo was correlated with pathological diagnosis of lung cancer (P<0.001). The sensitivity and specificity of echo diagnosis of lung cancer were 87.93% and 60.53%, respectively. Borderless and histopathologically diagnosed were lung cancer in 24 cases (25.00%) and non-lung cancer in 34 cases (35.41%). Borderless and histopathologically diagnosed were lung cancer in 15 cases(15.63%) and non-lung cancer in 23 cases (23.96%).There was no correlation between boundary features and pathological diagnosis of lung cancer (P>0.05). Logistic regression analysis showed that echo, CT and echo combined with CT detection were consistent with pathological diagnosis of lung cancer (P<0.001). ROC curve analysis showed that echo AUC: 0.7423, CTAUC: 0.7945, and echo combined with CTAUC: 0.8827.

The solid homogeneous echo in R-EBUS image is significantly correlated with the pathological diagnosis of lung cancer. R-EBUS combined with CT can improve the diagnostic accuracy of lung cancer.

SMARCA4-deficient undifferentiated tumors (SMARCA4-UT) present a class of rare malignant tumors with high aggressiveness and poor prognosis, which have poor response to traditional chemotherapy. Currently, there are no specific treatment guidelines for SMARCA4-UT, but some patients have been shown to benefit from immunotherapy. This study intends to retrospectively analyze the clinical features and prognostic factors of SMARCA4-UT in the real world.

The clinical data of 48 patients with SMARCA4-UT treated in the First Affiliated Hospital of Army Military Medical University from March 2021 to June 2023 were retrospectively analyzed, including 40 patients with advanced stage and 8 patients with early and middle stage. 5 cases were treated with surgery, 22 cases with chemotherapy alone, 5 cases with chemotherapy combined with immunization, 7 cases with chemotherapy combined with anti-tumor angiogenesis, 2 cases with chemotherapy combined with anti-tumor angiogenesis and immunotherapy, and 7 cases were untreated. Immunohistochemistry and second-generation sequencing were used to analyze the clinicopathological and genetic characteristics of patients, observe the efficacy of different treatment methods, and analyze the relationship between clinical characteristics and prognosis.

PFS and OS of chemotherapy combined with immunotherapy were superior to chemotherapy alone and chemotherapy combined with anti-tumor angiogenesis therapy, among which EP chemotherapy combined with Tislelizumab could be the preferred treatment for SMARCA4-UT patients. Liver metastasis and ≥3 metastatic sites are both influential factors for PFS and OS. Patients with STK11 and KEAP1 mutations have poor overall prognosis, but immunotherapy can still prolong OS in these patients. End of follow-up date, 3 cases (60.00%) death in surgery group, 16 cases(72.73%) death in chemotherapy group, 3 cases (60.00%)death in chemotherapy combined with immunization, 5 cases (71.43%)death in chemotherapy combined with anti-tumor angiogenesis group, no case (0.00%)death in chemotherapy combined with anti-tumor angiogenesis and immunotherapy group, 7 cases(100.00%) deaths in untreated group.

The efficacy of first-line immunocheckpoint inhibitor combined with chemotherapy in advanced SMARCA4-UT patients may be better than that of chemotherapy alone, among which EP regimen may be a potential better chemotherapy choice. STK11 and KEAP1 gene mutations may be markers of poor prognosis in SMARCA4-UT patients.

This study aims to explore differentially expressed genes (DEGs) and prognostic genes in lung squamous cell carcinoma (LUSC) by integrating single-cell RNA sequencing (scRNA-seq) and data from The Cancer Genome Atlas (TCGA), and to construct a prognostic model based on these genes. To further understand the immune microenvironment (TME) in LUSC, we analyzed immune cell infiltration characteristics and revealed their potential association with patient prognosis.

Single-cell RNA-seq data for LUSC were obtained from the Gene Expression Omnibus (GEO) database (GSE118245). After quality control and data normalization, distinct cell populations were identified. Principal component analysis (PCA) and uniform manifold approximation and projection (UMAP) were performed using the Seurat package to cluster the data. Bulk RNA sequencing data from LUSC patient samples in the TCGA database were obtained using the TCGAbiolinks package, and DEGs between tumor and normal samples were identified. Weighted gene co-expression network analysis (WGCNA) was employed to construct a gene co-expression network. Cox regression and least absolute shrinkage and selection operator (LASSO) regression were applied to develop a prognostic model based on DEGs, and Kaplan-Meier survival curves were used to evaluate overall survival (OS). Additionally, the CIBERSORT algorithm was used to assess immune cell infiltration proportions in different risk groups, and the infiltration levels of 22 immune cell types were compared between the high-risk and low-risk groups.

After quality control, 5, 360 cells were identified from the LUSC single-cell data and annotated into 13 distinct cell clusters, which were further categorized into 8 cell types using SingleR. Compared with the control group, the proportions of neutrophils, CD4⁺ T cells, and skeletal muscle cells were significantly elevated in the LUSC group. DEG analysis identified 3, 396 DEGs, of which 1, 851 were upregulated and 1, 545 were downregulated. Gene Ontology (GO) and KEGG enrichment analyses revealed that these DEGs were mainly involved in biological processes such as the cell cycle, infection, and complement cascade reactions. In the TCGA-LUSC data, WGCNA identified the blue module as significantly associated with LUSC progression, from which 61 intersecting genes were selected for further analysis. Univariate Cox regression and LASSO regression identified four independent prognostic genes (ITIH3, MME, PLAAT1, and ATP13A5), and a risk score model was constructed based on these genes. Kaplan-Meier survival curves showed that patients in the high-risk group had significantly shorter OS than those in the low-risk group. The prognostic model performed well in both GEO validation cohorts (GSE192870 and GSE180712). Immune infiltration analysis indicated significant differences in the proportions of CD8⁺ T cells, activated memory CD4⁺ T cells, and follicular helper T cells between the high-risk and low-risk groups, supporting the crucial role of TME in LUSC progression.

This study successfully identified key DEGs in LUSC through the integration of single-cell RNA-seq and TCGA data and developed an effective prognostic model. The model demonstrated robust prognostic prediction in multiple validation cohorts, and the immune infiltration characteristics uncovered by this study provide new insights into the TME in LUSC. The findings suggest that immune cells play a critical role in LUSC development and progression, potentially offering new therapeutic targets for immunotherapy in LUSC.

To analyze the prognostic significance of long non-coding RNA small nucleolar RNA host gene 17 (SNHG17) expression in non-small cell lung cancer (NSCLC) resection.

A total of 87 patients with NSCLC undergoing radical surgery in our hospital from January 2020 to June 2022 were selected as the subjects. After the operation, recurrence-free survival (RFS) and overall survival (OS) were recorded. The expression level of SNHG17 was detected by real-time fluorescence quantitative PCR.

The expression of SNHG17 in NSCLC tissues (1.85±0.61) was higher than that in adjacent normal tissues (1.03±0.36)(P<0.05). TNM stage Ⅰ SNHG17 expression (1.52±0.25), stage Ⅱ (1.83±0.66)(t=2.283, P<0.05), stage Ⅲ SNHG17 expression (2.28±0.58)(t=6.058, P<0.05). The expression of SNHG17 in stage Ⅲ was higher than that in stage Ⅱ(P<0.05). There were 43 cases with high SNHG17 expression (≥1.72) and 44 cases with low SNHG17 expression (<1.72). The expression of SNHG17 in NSCLC tissues was correlated with TNM stage (P<0.05). During the follow-up period, 43 cases (49.43%) relapsed and 33 cases (37.93%) died. Compared with 33 cases (75.00%) with low expression of SNHG17, 11 cases (25.58%) with high expression of SNHG17 had no recurrence, and the median RFS time of low expression of SNHG17 was 4.30 years longer than that of high expression of SNHG17 2.40 years(P<0.05). The survival rate of 35 patients (79.55%) with low expression of SNHG17 was higher than that of 19 patients(44.19%) with high expression. The median OS time of low expression of SNHG17 was 5.11 years longer than that of high expression 4.28 years)(P<0.05). COX regression analysis showed that high expression of SNHG17 was a predictor of recurrence and death after NSCLC resection (P<0.05).

SNHG17 is highly expressed in NSCLC tissues, and high expression is closely related to the risk of recurrence and death of NSCLC. SNHG17 is a promising biomarker for predicting the prognosis of surgically resected NSCLC.

To analyze the clinical value of Eph receptor A (EPHA) 5 mutation in predicting the prognosis of lung adenocarcinoma (LUAD) treated with immune checkpoint inhibitors (ICI).

The mutation genes that may be associated with ICI response in LUAD patients were analyzed by bioinformatics in the genomics of drug sensitivity in cancer (GDSC)-LUAD dataset and the cancer genome atlas (TCGA)-LUAD dataset. A clinical cohort of 96 LUAD patients treated with pembrolizumab in our hospital from January 2020 to January 2021 was retrospectively enrolled. The patients′paraffin-embedded tissue tumor specimens and matched blood samples were collected for next-generation sequencing. According to the results, the patients were divided into EPHA5-WT subgroup 66 cases and EPHA5-MT 30 cases subgroup. The objective response rate (ORR), disease control rate (DCR) and progression-free survival (PFS) were recorded.

Bioinformatics analysis showed that LUAD patients with EPHA5-MT could benefit from ICI treatment. The results of clinical cohort analysis showed that the tumor mutation burden value of LUAD patients in the EPHA5-MT subgroup was significantly higher than that in the EPHA5-WT subgroup [27.34(19.98, 53.24) mut/Mb vs. 13.70(10.77, 17.75) mut/Mb, P<0.001]. There was no significant difference in ORR between EPHA5-WT subgroup and EPHA5-MT subgroup (22.73% vs. 33.33%, P=0.272), but the DCR of EPHA5-MT subgroup was higher than that of EPHA5-WT subgroup (86.67% vs. 62.12%, P=0.029). Thirty-six patients (54.55%) in the EPHA5-WT subgroup and 8 patients (26.67%) in the EPHA5-MT subgroup experienced disease progression. Univariate and multivariate COX regression analysis showed that EPHA5-WT was an independent risk factor for LUAD disease progression compared with EPHA5-MT. Kaplan-Meier survival curve showed that the PFS of EPHA5-MT group was longer than that of EPHA5-WT group [14.53(5.71~26.23) months vs. 7.89(0.59~30.67)months, P<0.001].

EPHA5-MT is a potential biomarker for the prognosis of LUAD patients treated with ICI.

To analyze the relationship between antibiotic (ATB) pretreatment and the therapeutic response and prognosis of pembrolizumab in patients with advanced non-small cell lung cancer (NSCLC).

A total of 92 patients with advanced NSCLC treated with pembrolizumab in our hospital from January 2019 to January 2023 were retrospectively analyzed. The clinical data of the patients were collected, and the patients were divided into ATB (-) group and ATB (+ ) group according to whether they had received any ATB treatment within 30 days before pembrolizumab treatment. Objective response rate (ORR), disease control rate(DCR), disease progression, progression-free survival (PFS) and overall survival (OS) were recorded.

There was no significant difference in ORR between the control group 27cases(36.00%) and the observation group 8 cases(11.76%)(P>0.05). The DCR in control group 65 cases(84.00%)was significantly higher than that in observation group 8 cases(47.06%)(P<0.05). Disease progression occurred in 26 patients(34.67%) in the control group and 11 patients(64.71%) in the observation group (P<0.05).Case fatality rate in control group 7 cases(9.33%) lower than observation group 11 cases(64.71%)(P<0.05). Multivariate COX regression analysis found that ATB(+ ) was the only independent risk factor associated with disease progression and death. Kaplan-Meier mapping analyzed the relationship between ATB preconditioning and PFS in patients with advanced NSCLC. The median PFS in the observation group [1.77(0.33~14.00)months vs. 5.43(0.70~14.03)months, P=0.006], the median OS [7.17(1.90~14.00)months vs. 5.43(2.10~14.47)months, P=0.016] was significantly shorter than that of the control group.

In advanced NSCLC patients treated with pembrolizumab, ATB pretreatment within 30 days before treatment is associated with reduced therapeutic response and shorter survival.

To analyze the correlation and clinical significance of serum pentraxin 3 (PTX3) expression with bone metastasis of non-small cell lung cancer (NSCLC).

A total of 184 metastatic NSCLC patients treated in Tangdu Hospital from September 2022 to July 2023 were selected. 69 cases of NSCLC bone metastasis were the observation group, and 115 cases of NSCLC non-bone metastasis were the control group. The clinical information of patients was collected, and the expression level of serum PTX3 was detected by enzyme-linked immunosorbent assay (ELISA). Compared serum PTX3 content of two groups, we analyze the correlation of PTX3 expression with NSCLC bone metastases and compared serum PTX3 expression in NSCLC bone metastases before and after treatment. Receiver operating characteristic (ROC) curve was used to determine the diagnostic value of serum PTX3 for NSCLC bone metastasis.

There were no significant differences in gender and age between the two groups (P>0.05). There were 69 cases of bone metastasis in the observation group and 40 cases of lymph node metastasis, 31 cases of lung metastasis, 21 cases of brain metastasis, 14 cases of liver metastasis and 12 cases of adrenal metastasis in the control group. The serum PTX3 in the observation group was 104.80 (175.48) ng/ml, which was higher than that in the control group 21.48 (22.02) ng/ml (P<0.05). There were no significant differences of serum PTX3 expression in NSCLC bone metastasis patients with different clinical characteristics, including gender, age, history of cancer, smoking index, BMI index, pathological type, primary tumor location, single organ metastasis, number of metastatic lesions, nature of bone metastasis, blood calcium and serum alkaline phosphatase (P>0.05). There was no significant difference in the expression of serum PTX3 in NSCLC patients with bone metastasis before and after clinical treatment(P>0.05). The area under ROC curve of serum PTX3 in the diagnosis of NSCLC with bone metastasis was 0.860(95%CI: 0.802~0.919), with the optimal diagnostic cut-off value, sensitivity and specificity of 35.385 ng/ml, 0.855 and 0.748, respectively.

The high expression of serum PTX3 is closely related to the bone metastasis of NSCLC, which has a good diagnostic value for NSCLC bone metastasis and clinical significance.s

To analyze the clinical effect of protective mechanical ventilation (PMV) in thoracoscopic segmentectomy for lung cancer.

A total of 68 patients with lung cancer who underwent thoracoscopic segmental resection in our hospital from January 2023 to January 2024 were selected as the subjects, 35 patients with conventional mechanical ventilation as the control group, and 33 patients with protective mechanical ventilation as the observation group. The intraoperative single lung ventilation platform pressure and peak airway pressure were compared between the two groups for 15 min and 60 min. It was compared that reoperative and postoperative arterial oxygen partial pressure (PaO₂), forced expiratory volume in first second (FEV₁), forced expiratory volume, FVC), maximal voluntary ventilation (MVV) per minute, compliance of dynamic (Cd) and compliance of static (Cs), malondialdehyde (MDA), superoxide dismutase (SOD) and life quality level.

In the observation group, platform pressure single lung ventilation for 15min (16.00±3.00) cmH₂O, 60min(13.00±3.00) cmH₂O and airway peak single lung ventilation for 15 min (20.00±4.00) cmH₂O, 60 min(16.00±3.00) cmH₂O were lower than that of the control group 15 min (20.00±4.00) cmH₂O, 60min (19.00±2.00) cmH₂O, Airway peak pressure single lung ventilation for 15 min (27.00±4.00) cmH₂O and 60min (25.00±3.00)cmH₂O (P<0.05). PaO₂, FEV₁, FVC and MVV decreased in two groups after operation (P<0.05). Observation group PaO₂ (78.31±5.22)mmHg, FEV₁ (1.13±0.42)L, FVC (2.18±0.51)L and MVV (92.34±4.26)L were higher than PaO₂(61.23±6.27)mmHg, FEV₁ (0.96±0.51)L, FVC (2.02±0.32) L and MVV (90.17±3.45)L in the control group (P<0.05); The levels of Cd and Cs in the observation group were higher (41.00±5.00) and Cs (128.00±32.00) than those in the control group (38.00±5.00) and Cs (113±43) (P<0.05). SOD (74.32±6.57) U/ml in the observation group was higher than that in the control group (70.32±5.46) U/ml. The MDA (4.87±0.66) nmol/ml was lower than that of the control group (5.24±0.68) nmol/ml (P<0.05). The life quality score of the observation group was higher than that of the control group (P<0.05).

Protective mechanical ventilation in thoracoscopic segmental resection of lung cancer can effectively improve lung function, it has clinical significance.

This study aims to analyse the efficacy and safety of nebulization inhalation of ambroxol hydrochloride solution in the treatment of chronic obstructive pulmonary disease (COPD) patients with phlegm.

A total of 316 COPD patients meeting the screening criteria were enrolled in 32 hospitals from May 2021 to April 2022, conducted to administer nebulized inhalation of ambroxol hydrochloride solution 3 ml (2 ml︰15 mg) twice a day for up to seven days to adult COPD patients with symptoms of phlegm and difficulty in expectoration. Changes in respiratory sputum characteristics, difficulty of expectoration, sputum volume, cough, and quality of life of patients before and after treatment were compared, and sensitivity analysis and subgroup analysis were also performed based on whether they belong to an acute exacerbation stage in clinical practice.

A total of 316 COPD patients meeting the screening criteria were enrolled. Compared with the condition prior to treatment, the patient showed significant improvement in sputum characteristics, difficulty in coughing up sputum, sputum volume, cough symptoms, and sputum viscosity at the completion of treatment. The scores decreased by 1.64 (95%CI: -1.73, -1.56), 1.41(95%CI: -1.50, -1.33), 1.10(95%CI: -1.19, -1.01), 1.22(95%CI: -1.30, -1.13), and 1.73(95%CI: -1.83, -1.64) respectively. Additionally, the quality of life score increased by 0.06 points (95%CI: 0.05, 0.07). These differences were statistically significant (P<0.05). Furthermore, a longer treatment duration correlated with a higher overall clinical efficacy rate (P<0.05). The number of cases exhibiting overall clinical efficacy on the first, third, fifth day post-treatment, and at the completion of treatment were 125 (39.56%), 215 (68.04%), 265 (83.86%), and 285 (90.19%), respectively. The results of subgroup analysis and sensitivity analysis were consistent with the overall results. The incidence of adverse reactions was 4.75%, and there were no serious adverse reactions.

Nebulization inhalation of ambroxol hydrochloride solution can effectively improve phlegm in COPD patients and is safe and well-tolerated.

Exploring the clinical significance of Multiplanar volume rendering (MPVR) technology in diagnosising the invasiveness of pulmonary ground glass nodules.

A retrospective analysis was conducted on 325 neoplastic GGNs, 114 adenocarcinoma in situ (AIS), 104 minimally invasive adenocarcinoma (MIA), and 107 invasive adenocarcinoma (IAC) in 303 patients between January 2020 and May 2023. The internal performance of GGN were divided into Ⅰ-Ⅴ types, and the external morphology were divided into Ⅰ-Ⅲ types according to the multiplanar volume rendering (MPVR) performance. Define MIA and IAC as invasive lesions(ILs), and based on the ratio of the maximum diameter of solitary nodules in GGN on MPVR to the 3D maximum diameter of GGN, and then the cutoff value for distinguishing invasive lesions and invasive adenocarcinoma were obtained via ROC analysis.

The internal manifestation of AIS, MIA, IAC on MPVR were mainly type Ⅰ, type Ⅴ and type Ⅳ, and statistical significance (P<0.001) were found between the three groups. there also were statistically significant difference between AIS and IAC in type Ⅱ, and between AIS and MIA, IAC in type Ⅲ (each P<0.001 ). The external manifestation of AIS, MIA, IAC on MPVR were mainly type Ⅰ, type Ⅱ, and type Ⅲ, and statistical significance (P<0.001) were found between the three groups. For distinguishing invasive lesions and invasive adenocarcinoma, the cutoff value for the ratio of the maximum diameter of solitary nodules in GGN on MPVR to the 3D maximum diameter of GGN was 0.5 (AUC: 0.816, sensitivity: 71.93, specificity: 85.71, P<0.001), and 0.508 (AUC: 0.883, sensitivity: 87.5, specificity: 79.03, P<0.001).

MPVR technology has important role in evaluating the invasiveness of pulmonary ground glass nodules and has guiding significance for clinical practice.

To analyze the correlation between systemic immune-inflammation index (SII) and severity of moderate-severe patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

A total of 174 patients with AECOPD hospitalized in respiratory wards of Shanghai Yangsi Hospital and Shanghai Pudong New District Punan Hospital from March, 2023 to March, 2024 were selected as study participants. According to severity of AECOPD, all the participants were divided into control group (n=90), and observation group (n=84). Routine blood test, serum C-reactive protein (CRP), serum procalcitonin (PCT), arterial blood gas analysis, dyspnea scores, and SII, were recorded for two groups, at admission and 10 days after admission. The abovementioned parameters were compared between two groups, before and after treatment. Correlation between the SII and other parameters was analyzed.

At the admission, control group SII (1 354.5±324.5)×10⁹/L, CRP(60.2±16.4)mg/L, PCT(3.26±0.58)ng/ml, pH(7.18±2.11), PaO₂(55.9±13.8)mmHg, PaCO₂(56.6±16.8)mmHg, oxygenation index(266.4±60.2)mmHg、dyspnea score (2.54±0.51). observation group(1 892.3±511.2)×10⁹/L, (78.3±20.1)mg/L, (7.32±2.21)ng/ml, (7.09±2.16), (46.5±11.4)mmHg, (76.5±23.4)mmHg, (222.1±45.5)mmHg, (3.44±0.66); 10 days after the admission, control group SII (667.1±156.1)×10⁹/L, CRP(25.4±5.4)mg/L, PCT(1.49±0.39)ng/ml, pH(7.34±2.32), PaO₂(76.2±18.8)mmHg, PaCO₂(45.7±14.2)mmHg, oxygenation index(362.8±88.7)mmHg, dyspnea score(1.08±0.36), observation group(987.2±261.3)×10⁹/L, (33.2±10.9)mg/L, (2.11±0.90)ng/ml, (7.32±2.21), (66.2±15.3)mmHg, (55.3±17.8)mmHg, (318.3±73.5)mmHg, (2.15±0.59). There were statistical differences between pairwise comparison among the control group and observation group, in the SII, serum CRP, serum PCT, pH, PaO₂, PaCO₂, oxygenation index and dyspnea score, at the admission and 10 days after the admission, respectively (P<0.05). The abovementioned parameters at the admission were statistically different from those 10 days after the admission, in each group (P<0.05). The SII was positively correlated with the serum CRP, PCT, PaCO₂ and dyspnea score, whereas negatively correlated with the pH, PaO₂ and oxygenation index, at the admission and 10 days after the admission, for the two groups. In the observation group, 74 cases survived(88.10%), 10 cases death (11.90%). In the control group, 88 cases survived(97.78%), 2 cases death (2.22%), the mortality rate of the observation group was statistically higher than control group (P<0.05).

There is a definite positive correlation between SII and severity of moderate-severe patients with AECOPD. The severer the AECOPD, the higher the SII.

To analyze the relationship between serum proprotein convertase subtilisin/Kexin 9 (PCSK9) and clinical features hemodynamics, and prognosis of idiopathic pulmonary hypertension(IPAH).

All of 42 patients with IPAH in our hospital from December 2019 to November 2022 were selected as subjects. Serum PCSK9 level was detected by enzyme-linked immunosorbent assay. The 1-year survival rate without clinical deterioration was recorded.

The level of PCSK9 in patients with IPAH was 135.63 (77.93, 216.69) ng/ml. Receiver operating characteristic (ROC) analysis showed that the area under the IPAH curve of serum PCSK9 level diagnosis was 0.763 (95%CI: 0.655 ~ 0.871)(P<0.05), the optimal cut-off value of serum PCSK9 was 107.48ng/ml, and the specificity was 88.2%. Serum PCSK9 level in IPAH was positively correlated with systolic blood pressure (r=0.488), diastolic blood pressure (r=0.634) and mean pulmonary artery pressure (mean pulmonary artery pressure(mPAP) (r=0.653), mean pulmonary vascular wedge pressure (r=0.315), pulmonary vascular resistance (r=0.576), World Health Organization functional classification (r=0.519) (P<0.05), and were negatively correlated with 6min walking distance (r=-0.361, P<0.05). After 1 year of follow-up, 11 IPAH patients died (26.19%) and 31 survived (73.81%). Kaplan-Meier analysis showed that 5 cases (11.90%) of IPAH patients with PCSK9>107.48 ng/ml were clinically progression-free compared with 26 cases (61.90%) of IPAH patients with PCSK9≤107.48 ng/ml (P<0.05). Multivariate COX analysis showed that BNP (HR: 1.476, 95%CI: 1.082-2.013) and PCSK9 (HR: 1.007, 95%CI: 1.001-1.014) were predictors of clinical deterioration. PCSK9 was linearly correlated with clinical deterioration HR (P<0.05) when three samples were restricted.

PCSK9 is associated with the functional status, hemodynamics and prognosis of pulmonary hypertension.

To analyze the efficacy of α-interferon in the treatment of acute respiratory virus infection and its effects on T helper cell 1 (Th1)/T helper cell 2 (Th2) and lung function.

A total of 79 patients with acute respiratory virus infection admitted to North Hospital of Ankang Central Hospital from December 2020 to December 2022 were divided into observation group 35 cases and control group 44 cases using random number table method. Both groups were given routine symptomatic treatment, the control group received nebulized inhalation of ribavirin injection, and the observation group received recombinant human interferon α-2b injection nebulized inhalation. Compare the clinical efficacy and time of symptom disappearance after treatment between the two groups; The pulmonary function indexes [forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), peak expiratory flow (PEF)] before and after treatment were detected, the proportion of Th1 and Th2 cells was detected, and the Th1/Th2 value was calculated. Serum C-reactive protein (CRP), interleukin (IL-6), and tumor necrosis factor were detected-α (TNF-α) Horizontal.

The total effective rate of the observation group was 31 cases(88.57%), significantly higher than that of the control group 30 cases(68.18%)(P<0.05); After treatment, the disappearance time of throat pain, cough, runny nose, and fever in the observation group was (80.43±11.35)h, (65.28±15.63)h, (35.52±11.24)h, and (34.32±8.64)h, respectively, which were significantly shorter than those in the control group [92.64±15.49)h, (80.47±11.28)h, (57.26±13.44)h, and (51.37±10.12)h, respectively, P<0.05]; After treatment, the FVC, FEV₁, and PEF in the observation group were (1.35±0.24)L, (2.47±0.42)L, and (195.32±30.12)L/min, respectively, which were significantly higher than those in the control group [1.22±0.18)L, (2.06±0.39)L, and (177.58±28.42)L/min, respectively, P<0.05]; After treatment, the Th1 and Th1/Th2 values in the observation group were (11.24±2.08)% and (1.77±0.53)%, respectively, significantly higher than those in the control group (9.36±1.55)% and (1.35±0.42)%, respectively). The Th2 values in the observation group were (6.33±0.87)%, lower than those in the control group (6.92±1.13)%(P<0.05); Post treatment observation group CRP, IL-6, TNF- α The levels were (8.63±1.95) mg/L, (34.26±6.51) pg/ml, and (118.62±9.17) pg/ml, respectively, which were significantly lower than those in the control group [(14.25±3.76) mg/L, (51.22±9.06) pg/ml, (146.02±11.64) pg/ml, P<0.05].

α- Interferon has a good therapeutic effect on acute respiratory virus infection, which is beneficial for promoting Th1/Th2 cell balance and reducing CRP, IL-6, and TNF- α Level, can promote the recovery of lung function in patients, with high safety.

To analyze the clinical characteristics, diagnostic and therapeutic methods, and prognosis of patients with broncholithiasis.

It was reviewed that 26 patients diagnosed with broncholithiasis and treated at the Department of Pulmonary and Critical Care Medicine, Tangdu Hospital, Air Force Medical University from January 2010 to December 2021, and collected their clinical data, treatment procedures, and outcomes.

The main clinical features of the 26 patients included cough in 24 cases (92.31%), sputum production in 19 cases (73.08%), and dyspnea in 9 cases (34.62%). Radiological findings showed intrabronchial high-density shadows in 17 cases (65.38%), associated with lung collapse in 8 cases (30.77%), bronchial stenosis in 5 cases (19.23%), consolidation in 4 cases (15.38%), cavity formation in 1 case (3.85%), and pleural effusion in 1 case (3.85%). Locations of bronchial stones included 15 cases in the right bronchus (57.69%) and 10 cases in the left bronchus (38.46%), specifically 6 cases in the left upper lobe (23.08%), 6 cases in the right upper lobe (23.08%), 5 cases in the right middle lobe (19.23%), 4 cases in the left main bronchus (15.38%), 3 cases in the right lower lobe (11.54%), 1 case in the right middle segment (3.85%), and 1 case of multifocal airway stones (3.85%). Treatment modalities included single intervention in 15 cases (57.69%), dual interventions in 9 cases (34.62%), three or more interventions in 2 cases (7.69%), and surgery in 1 case (3.85%). Use of single-forceps biopsy was noted in 10 cases (38.46%), and combined with other therapies in another 10 cases (38.46%). After treatment, complete clearance of bronchial stones was achieved in 14 cases (53.85%), partial clearance in 10 cases (38.46%), and no clearance in 2 cases (7.69%). There were no major complications such as hemorrhage, heart failure, or malignant arrhythmias. There was a statistically significant improvement in airway narrowing scores and dyspnea indices after treatment (P<0.05).

Broncholithiasis is a rare pulmonary disease with nonspecific symptoms and a generally favorable prognosis, which can be effectively managed with bronchoscopic interventions, with a low recurrence rate. Surgical resection should be considered for cases where stones invade vessels or when endoscopic removal fails.