To investigate the association between five-time chair stand test (CST) performance and the risk of incident chronic lung disease (CLD) in middle-aged and older adults, and to explore its clinical significance for early risk identification in community populations.

Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). A total of 10, 371 participants aged ≥45 years at baseline (2011) who were free of CLD and had complete data on key variables were included, with follow-up waves in 2013, 2015, 2018, and 2020. Participants were categorized into an abnormal CST group (n=4 668, male CST>7.5 s, female CST>9.5 s) and a normal CST group (n=5 703, male CST ≤7.5 s, female CST ≤9.5 s). Kaplan-Meier curves and log-rank tests were used to compare cumulative CLD incidence between groups, and Cox proportional hazards models were employed to estimate hazard ratios (HR) and 95% confidence intervals (CI).

During follow-up, 1, 601 out of 10, 371 participants developed incident CLD, including 870 cases (18.64%) in the abnormal CST group and 731 cases (12.82%) in the normal CST group. Compared with the normal group, the abnormal group was older and had higher proportions of females, rural residents, unmarried individuals, those with lower educational levels, and those with hypertension, diabetes, heart disease, stroke, and related medication use (all P<0.05). Receiver operating characteristic (ROC) analysis showed that for males, the area under the curve (AUC) of CST for predicting incident CLD was 0.588 (95%CI: 0.567~0.610), with an optimal cut-off value of 7.5 s, sensitivity of 68.35%, and specificity of 44.96%; for females, the AUC was 0.583 (95%CI: 0.561~0.604), with an optimal cut-off value of 9.5 s, sensitivity of 41.33%, and specificity of 71.50%. Kaplan-Meier curves demonstrated that the abnormal CST group had a significantly lower event-free survival rate than the normal group (log-rank P<0.001). Cox regression showed that in the unadjusted model, abnormal CST was associated with an increased risk of incident CLD (HR=1.509, 95%CI: 1.368~1.665, P<0.001); after adjusting for demographic factors, lifestyle, comorbidities, and medication use, the association remained robust (HR=1.559, 95%CI: 1.402~1.733, P<0.001).

Baseline CST abnormality is a predictor of increased risk of incident CLD in middle-aged and older adults. It holds clinical significance for population-level risk stratification and early community-based identification.

To investigate the risk of acute exacerbations and all-cause readmission in patients with pre-chronic obstructive pulmonary disease (COPD).

A total of 127 patients with chronic airway diseases admitted to our hospital from October 2021 to October 2023 were selected. Among them, 49 patients with chronic respiratory symptoms and post-bronchodilator forced expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC) ≥ 0.7 were assigned to the observation group, and 78 patients with post-bronchodilator FEV₁/FVC<0.7 were assigned to the control group. Clinical data, chest imaging findings, laboratory results, and treatment details were collected. Acute exacerbation events and all-cause readmissions were recorded during follow-up. A Cox proportional hazards model was used to analyze the association between lung function classification and acute exacerbations as well as all-cause readmission within 12 months after discharge.

Compared with the control group, the observation group had lower COPD assessment test (CAT) scores [(17.28±5.67) vs. (19.75±6.03), P=0.021], higher arterial partial pressure of oxygen (PaO₂) [(84.16±14.88) mmHg vs. (77.85±16.24) mmHg, P=0.025], and lower arterial partial pressure of carbon dioxide (PaCO₂) [(41.08±9.45) mmHg vs. (44.92±11.53) mmHg, P=0.044]. The observation group also had lower usage rates of glucocorticoids [30(61.22%) vs. 62(79.49%), P=0.022], inhaled bronchodilators [28(57.14%) vs. 59(75.64%), P=0.025], methylxanthines [26(53.06%) vs. 59(75.64%), P=0.007], and antibiotics [36(73.47%) vs. 70(89.74%), P=0.012]. No significant differences were found in chest imaging or laboratory indicators between the two groups (P>0.05). During follow-up, the observation group had 6 cases of acute exacerbation (12.24%, 95%CI: 8.55~18.65) and the control group had 15 cases (19.25%, 95%CI: 14.70~23.48) (P<0.05); the observation group had 5 cases of all-cause readmission (10.20%, 95%CI: 9.80~13.89) and the control group had 12 cases (15.38%, 95%CI: 14.12~16.75) (P<0.05). Multivariate Cox regression analysis showed that FEV₁/FVC<0.7 was a risk factor for acute exacerbation (HR=1.925, 95%CI: 1.138~3.102, P<0.001) and all-cause readmission (HR=2.488, 95%CI: 1.685~3.615, P<0.001) within 12 months after discharge.

Patients with pre-COPD have a risk of acute exacerbations and readmission. Patients with confirmed COPD have definite airflow limitation, and their medium-term risks of acute exacerbation and readmission are higher than those of pre-COPD patients. Clinical attention should be paid to standardized follow-up, risk factor control, and dynamic monitoring of lung function in pre-COPD patients to reduce the risk of adverse outcomes.

To screen for biomarkers of chronic obstructive pulmonary disease (COPD) and myocardial infarction (MI) and explore potential common therapeutic targets.

Common differentially expressed genes (DEGs) of COPD and MI were identified based on GEO datasets and R language. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed on the DEGs. A protein-protein interaction (PPI) network was constructed using the STRING database, and key genes were screened in combination with weighted correlation network analysis (WGCNA). Expression of key genes was validated using external datasets. Immune infiltration analysis of MI datasets was conducted using the CIBERSORT algorithm to assess the correlation between key genes and immune cell infiltration levels. A transcription factor (TF)-miRNA coregulatory network was constructed. Candidate drug molecules with potential therapeutic effects on COPD-MI comorbidity were predicted.

Differential expression analysis of COPD and MI datasets based on the GEO database identified 49 DEGs. GO analysis showed that upregulated genes were mainly enriched in positive regulation of cytokines and pattern recognition receptor activity, while downregulated genes were enriched in leukocytemediated cytotoxicity. KEGG analysis revealed that upregulated genes were significantly enriched in the NF-κB signaling pathway, whereas no significant enrichment pathway was found for downregulated genes. Through PPI network and WGCNA analyses, six DEGs were selected. After validation with external datasets, three DEGs (TLR8, IL1B, and S100A12) were ultimately identified. Receiver operating characteristic (ROC) curves indicated that TLR8 and IL1B were associated with cigarette smoke exposure and recurrence of COPD complicated with MI. CIBERSORT analysis showed significant differences in the infiltration of 13 immune cell types between MI samples and controls. Singlesample Gene Set Enrichment Analysis (ssGSEA) revealed that key genes were negatively correlated with resting memory CD4⁺ T cells and positively correlated with monocytes, activated mast cells, and neutrophils. The TFmiRNA network suggested that the E2F1miR9TLR8 axis may be a common pathogenic pathway for the two diseases. Drug molecule prediction for the three key DEGs indicated that miglitol, TPEN and cycloheximide may have potential as common therapeutic agents for both diseases.

TLR8, IL1B and S100A12 may be therapeutic targets for COPD and MI. TLR8, IL1B serve as potential biomarkers and therapeutic targets for COPD-MI comorbidity. Cigarette smoke exposure may increase MI recurrence risk by affecting the TLR8/IL1B pathway. Neutrophil-mediated immune responses represent a crucial pathological feature shared by both diseases. Candidate drugs provide new research directions for comorbidity treatment. Miglitol, TPEN and cycloheximide may have potential therapeutic effects on both diseases.

To investigate the clinical significance of the eosinophil-to-neutrophil ratio (ENR) in predicting the efficacy of noninvasive positive pressure ventilation (NIPPV) in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

A total of 146 elderly AECOPD patients who received NIPPV treatment in our hospital from January 2022 to January 2025 were enrolled. Twenty-six patients with NIPPV failure were assigned to the observation group and 120 with successful treatment to the control group. The changes in ENR, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, Charlson comorbidity index (CCI), and ROX index were compared between the two groups before NIPPV initiation (T₀), and at 2 hours (T₂), 6 hours (T₆), and 12 hours (T₁₂) after initiation. Spearman correlation analysis was used to assess the relationship between ENR and arterial blood gas parameters. Receiver operating characteristic (ROC) curves were employed to evaluate the predictive value of ENR for NIPPV efficacy. Multivariate logistic regression analysis was performed to identify influencing factors of NIPPV failure, and restricted cubic spline (RCS) analysis was applied to explore the dose-response relationship between ENR and NIPPV failure risk.

At T₀, eosinophil percentage [0.10% (0.00%, 0.62%) vs. 0.40% (0.00%, 1.50%)] and ENR [0.12×10^-2(0.00×10^-2, 0.79×10^-2) vs. 0.52×10^-2(0.00×10^-2, 2.33×10^-2)] in the observation group were lower than those in the control group (P<0.01). At T₂, eosinophil percentage [0.17% (0.00%, 0.68%) vs. 0.50% (0.10%, 1.50%)] and ENR [0.23×10^-2 (0.00×10^-2, 0.92×10^-2) vs. 0.58×10^-2 (0.11×10^-2, 2.33×10^-2)] remained lower in the observation group (P<0.01). No significant difference in ENR was observed between the two groups at T₆ and T₁₂ (P>0.05). At T₀, ENR was significantly positively correlated with PaO₂ (r=0.651, P<0.001), but not significantly correlated with pH, PaCO₂, or HCO₂^-. The area under the ROC curve (AUC) for T₀ ENR to predict NIPPV failure was 0.781 (95% CI: 0.705~0.845), with an optimal cutoff value of <0.350×10^-2, yielding a sensitivity of 84.62% and specificity of 88.33%. The AUC for T₂ ENR was 0.731 (95%CI: 0.651~0.801), with a cutoff value of <0.391×10^-2. Multivariate logistic regression showed that APACHE Ⅱ score ≥15(OR=1.148, P=0.003) and CCI ≥4 (OR=1.236, P=0.013) were risk factors for NIPPV failure, whereas T₀ ENR (OR=0.591, P=0.004) and ROX index (OR=0.783, P=0.002) were protective factors. RCS analysis indicated a nonlinear relationship between ENR and NIPPV failure risk (P for nonlinearity=0.0586). The combined model incorporating APACHE Ⅱ, CCI, ROX index, and T₀ ENR predicted NIPPV failure with an AUC of 0.907 (95%CI: 0.845~0.947, P<0.001), sensitivity of 84.62%, and specificity of 88.33%. During hospitalization, NIPPV failure occurred in 26 patients (17.81%); 10 patients (38.46%) in the observation group died in-hospital, while no deaths occurred in the control group.

ENR can predict the risk of NIPPV failure in AECOPD patients. A T₀ ENR<0.350×10^-2 before NIPPV initiation warrants cautious management.

To investigate the effect of integrated stepwise respiratory rehabilitation training based on the cardiopulmonary interaction mechanism on postoperative cardiopulmonary function and prognosis in patients with aortic dissection (AD) complicated with chronic obstructive pulmonary disease (COPD).

A total of 57 patients with Stanford type B AD complicated with COPD who underwent thoracic endovascular aortic repair in our hospital from January 2022 to June 2025 were enrolled and randomly divided into an observation group (28 cases) and a control group (29 cases). The control group received oxygen therapy, basic respiratory exercise training, and aerosol inhalation therapy, while the observation group additionally received integrated stepwise respiratory rehabilitation training based on the cardiopulmonary interaction mechanism. Cardiac function indices, pulmonary function indices, exercise tolerance, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, and prognosis were compared between the two groups.

After treatment, compared with the control group, the observation group showed significantly better left ventricular ejection fraction (LVEF) [(62.32±5.14)% vs. (58.20±4.83)%, t=3.21, P=0.002], E/A ratio [(1.24±0.18) vs. (0.96±0.21), t=5.02, P=0.001], right ventricular fractional area change (RVFAC) [(42.51±6.30)% vs. (36.84±5.73)%, t=3.94, P=0.001], left atrial volume index (LAVI) [(28.32±5.45) ml/m² vs. (34.22±6.13) ml/m^2, t=4.08, P=0.001], and systolic pulmonary artery pressure (sPAP) [(36.71±6.14) mmHg vs. (42.30±5.81) mmHg, t=3.57, P=0.001]. The forced expiratory volume in one second (FEV₁)% [(72.52±7.15)% vs. (65.41±6.90)%, t=4.15, P=0.001], FEV₁/FVC ratio [(62.43±6.31)% vs. (58.94±5.82)%, t=2.38, P=0.021], and peak expiratory flow (PEF) [(4.25±0.83)L/s vs. (3.50±0.72)L/s, t=3.76, P=0.001] were significantly higher in the observation group, while the modified Medical Research Council (mMRC) dyspnea score [(1.34±0.53) vs. (1.81±0.60), t=3.52, P=0.001] was significantly lower. The changes in the six-minute walk test (6MWT) distance [(105.0±38.4)m vs. (50.1±29.8)m, t=5.92, P<0.001] and NT-proBNP level [(-769.8±245.4) pg/ml vs. (-365.0±198.9)pg/ml, t=6.28, P<0.001] were also superior in the observation group. In the observation group, treatment was effective in 25 cases (89.29%) and adverse events occurred in 3 cases (10.71%), whereas in the control group, treatment was effective in 21 cases (68.97%) and adverse events occurred in 8 cases (27.58%) (P<0.05).

Integrated stepwise respiratory rehabilitation training based on the cardiopulmonary interaction mechanism can improve postoperative cardiopulmonary function, exercise tolerance, and clinical prognosis while reducing the incidence of adverse events in patients with AD complicated with COPD, demonstrating significant clinical value.

To investigate the predictive value of lung ultrasound combined with diaphragmatic ultrasound for extubation failure in patients with acute respiratory distress syndrome (ARDS).

A total of 126 ARDS patients admitted to our hospital from January 2022 to October 2025 were enrolled. Among them, 99 patients with successful extubation were assigned to the control group, and 27 patients with extubation failure were assigned to the observation group. Bedside ultrasonography was performed 4 hours after the completion of a spontaneous breathing trial. The lung ultrasound (LUS) score was calculated using the 12zone method, and diaphragmatic excursion and diaphragmatic thickening fraction were measured. Clinical data and ultrasound parameters were compared between the two groups. LASSO regression and multivariate logistic regression were used to analyze risk factors for extubation failure, and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of each indicator.

Compared with the control group, the observation group had a higher median LUS score (15.00 vs. 9.00, P<0.001), and lower values of quiet breathing diaphragmatic excursion (QDE) (P=0.027), deep breathing diaphragmatic excursion (DDE) (P=0.006), quiet breathing diaphragmatic thickening fraction (QDTF) (P<0.001), and deep breathing diaphragmatic thickening fraction (DDTF) (P<0.001). Multivariate logistic regression analysis showed that sequential organ failure assessment (SOFA) score (OR=1.713), oxygenation index (OR=0.991), duration of mechanical ventilation (OR=1.078), LUS score (OR=1.686), and DDTF (OR=0.872) were independent risk factors for extubation failure in ARDS patients (all P<0.05). The area under the curve (AUC) of the combination of LUS score and DDTF for predicting extubation outcome was 0.923 (95%CI: 0.861~0.963), which was superior to that of LUS score alone [0.817 (95%CI: 0.732~0.876), P=0.003] or DDTF alone [0.812 (95%CI: 0.732~0.876), P=0.009]. ROC curve analysis of the combined model including SOFA score, oxygenation index, duration of mechanical ventilation, LUS score, and DDTF showed that the combined clinical and bedside ultrasound model achieved an AUC of 0.969 (95%CI: 0.921~0.991), with a sensitivity of 88.89% and a specificity of 93.94%. The HosmerLemeshow goodnessoffit test indicated good calibration (χ²=2.448, P=0.964). Clinical decision curve analysis showed that when the highrisk threshold ranged from 0.03 to 0.95, the combined prediction of extubation failure provided a high net clinical benefit.

Bedside multi-organ ultrasound monitoring can serve as an important assessment tool for extubation in patients with ARDS. By combining bedside lung ultrasound with diaphragmatic ultrasound, together with the patient′s clinical symptoms and signs, this approach can effectively guide the selection of extubation timing, help improve the extubation success rate, and is of clinical significance in ensuring that ARDS patients are extubated smoothly and safely.

To investigate the clinical significance of pulmonary CT imaging morphological features combined with coagulation function indicators in predicting the prognosis of patients with chest trauma.

A total of 104 patients with closed chest trauma admitted to our hospital from June 2020 to June 2025 were selected and divided into an observation group 41 cases and a control group 63 cases based on prognosis. Clinical data, laboratory indicators, and chest CT images were collected. Pulmonary involvement extent (≥50% or <50%) and injury pattern (ground-glass opacity or consolidation) were assessed using a visual semi-quantitative method. Multivariate logistic regression was used to analyze prognostic factors, and receiver operating characteristic (ROC) curves were drawn to evaluate the predictive performance of individual and combined indicators.

Compared with the control group, the observation group had significantly higher neutrophil count [7.05(6.59, 7.55) ×10⁹/L vs. 5.02(4.56, 5.46)×10⁹/L], lymphocyte count [1.01(0.87, 1.85)×10⁹/L vs. 0.80(0.77, 0.81)×10⁹/L], NLR[10.40(10.39, 10.98) vs. 7.99(7.68, 8.22)], CRP[80.94 (76.87, 85.95)mg/L vs. 49.43(44.88, 52.46)mg/L], ferritin [902.25 (791.01, 996.27) mcg/dl vs. 661.18(620.57, 700.66)mcg/dl], and D-dimer [2.17(2.09, 2.22)mg/L vs. 1.05(1.04, 1.08)mg/L], as well as a higher proportion of pulmonary involvement ≥50% (41.5% vs. 20.6%) and consolidation pattern (48.8% vs. 23.8%) (P<0.05). Multivariate logistic regression analysis revealed that NLR (OR=9.304, 95%CI: 1.328~65.186, P=0.025), D-dimer (OR=1.250, 95%CI: 1.099~1.422, P=0.001), pulmonary involvement extent ≥50% (OR=3.048, 95%CI: 1.311~7.083, P=0.010), and consolidation-type lung injury (OR=2.724, 95%CI: 1.140~6.508, P=0.024) were independent risk factors for poor prognosis. ROC curve analysis showed that the combined prediction of D-dimer, NLR, pulmonary involvement extent, and lung injury pattern yielded an area under the curve (AUC) of 0.863 (95%CI: 0.785~0.940), with a sensitivity of 85.4% and a specificity of 79.4%. Among the 104 patients, 95 survived (91.35%) and 9 died (8.65%). Causes of death included sepsis complicated by multiple organ dysfunction syndrome in 4 cases, acute respiratory distress syndrome in 3 cases, and pulmonary embolism due to venous thromboembolism in 2 cases.

Pulmonary CT imaging morphological features combined with coagulation function indicators can effectively predict the prognosis of chest trauma, facilitating early identification of high-risk patients.

To investigate the predictive value of dynamic monitoring of circulating tumor DNA (cfDNA), neutrophil-to-lymphocyte ratio (NLR), and programmed cell death ligand 1 messenger RNA (PD-L1 mRNA) for immunotherapy efficacy and prognosis in patients with non-small cell lung cancer (NSCLC).

A total of 42 patients with advanced NSCLC admitted to our hospital from January 2019 to June 2022 were selected and divided into an observation group 22 cases and a control group 20 cases based on immunotherapy efficacy. cfDNA concentration, NLR, and PD-L1 mRNA expression levels were measured before and after treatment, and the rate of change for each indicator was calculated. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of single indicators and the combined model for objective response rate (ORR). Cox proportional hazards regression was used to analyze the association between dynamic changes in the indicators and progression-free survival (PFS).

After treatment, cfDNA, NLR, and PD-L1 mRNA levels in the observation group were lower than those in the control group, and the absolute values of the rate of change were greater than those in the control group (P<0.05). Compared with the control group, the observation group showed: cfDNA rate of change [(-24.46±8.11)% vs. (-16.40±8.93)%, t=3.064, P=0.004]; NLR rate of change [(-24.51±6.86)% vs. (-15.75±10.65)%, t=3.196, P=0.003]; PD-L1 mRNA rate of change [(-20.29±5.89)% vs. (-15.83±5.10)%, t=2.607, P=0.013]. ROC curve analysis showed that the area under the curve (AUC) for predicting ORR was 0.761 (95%CI: 0.605~0.879) for cfDNA rate of change, 0.748 (95%CI: 0.590~0.869) for NLR rate of change, and 0.732 (95%CI: 0.573~0.857) for PD-L1 mRNA rate of change. The combined model of the three indicators yielded an AUC of 0.895 (95%CI: 0.762~0.968), with a sensitivity of 90.91% and a specificity of 80.00%, which was superior to any single indicator. Multivariate Cox regression analysis showed that cfDNA rate of change ≤20% (HR=6.541, 95%CI: 1.336~31.333, P=0.019), NLR rate of change ≤22% (HR=7.910, 95%CI: 1.538~40.684, P=0.013), and PD-L1 mRNA rate of change ≤20% (HR=6.501, 95%CI: 1.038~40.705, P=0.045) were risk factors for shortened PFS in NSCLC patients receiving immunotherapy.

Dynamic monitoring of cfDNA, NLR, and PD-L1 mRNA can effectively predict immunotherapy efficacy and prognosis in NSCLC patients. The combination of these three indicators provides a reference for clinical individualized treatment decisions.

To investigate the value of a nomogram based on non-contrast CT radiomics and morphological features in preoperatively differentiating lung adenocarcinoma from benign pulmonary nodules.

A total of 248 patients with pulmonary nodules admitted to our hospital from January 2018 to December 2024 were retrospectively enrolled and randomly divided into a training set 173 cases and a validation set 75 cases at a 7︰3 ratio. Radiomics features were extracted from non-contrast CT images. The radiomics score (Rads) was calculated from selected features. Morphological features of the pulmonary nodules were also evaluated. Multivariate logistic regression was applied to identify independent risk factors, and a nomogram model was constructed. Model performance was assessed using area under the curve of receiver operating characteristic curves (AUC), confidence interval (CI), calibration curves, and decision curve analysis.

Among the 248 cases, there were 142 lung adenocarcinomas and 106 benign nodules. Eleven key radiomics features and two morphological features (shallow lobulation and vascular convergence) were selected. Multivariate logistic regression revealed that shallow lobulation (OR=3.342, P=0.002), vascular convergence (OR=2.229, P=0.040), and Rads (OR=3.347, P<0.001) were independent risk factors for differentiating lung adenocarcinoma from benign nodules. The nomogram constructed based on these variables achieved an AUC of 0.831 (95%CI: 0.767~0.884) with a sensitivity of 67.0% and specificity of 84.3% in the training set, and an AUC of 0.825 (95%CI: 0.721~0.903) with a sensitivity of 74.4% and specificity of 86.1% in the validation set. Calibration curves demonstrated good model calibration (Hosmer-Lemeshow test: P=0.9434 in the training set, P=0.6345 in the validation set), and decision curve analysis indicated satisfactory clinical net benefit.

The nomogram model incorporating the CT radiomics score, shallow lobulation, and vascular convergence demonstrates stable and robust diagnostic performance in preoperatively differentiating lung adenocarcinoma from benign nodules. It may serve as a non-invasive auxiliary tool to support individualized preoperative decision-making for patients with pulmonary nodules.

Programmed death-1(PD-1) is a T-cell inhibitory molecule, while CD28 serves as a T-cell co-stimulatory molecule. This study aimed to comprehensively analyze the expression patterns and differences of PD-1 and CD28 on T cells in patients with benign pulmonary nodules and lung cancer.

A total of 55 patients with benign pulmonary nodules and 586 patients with lung cancer from the Second Affiliated Hospital of Air Force Medical University were enrolled. Flow cytometry was utilized to assess the surface expression of PD-1 and CD28 on peripheral blood T cells, while electrochemiluminescence was employed to measure serum tumor markers.

Compared with the control group at 15.22% (10.75%, 18.63%), the ratio of CD3⁺ PD-1⁺ T cells was significantly increased in the benign group at 19.16% (14.66%, 26.09%) and the lung cancer group at 21.01% (16.00%, 26.70%), but there was no statistical significance between the lung cancer group and the benign group (P>0.05). The ratio and count of CD3⁺ CD4⁺ PD-1⁺ T cells in the benign group at 22.76% (16.87%, 28.38%) and 125 (93, 161) cells/μl, and in the lung cancer group at 24.8% (19.17%, 32.02%) and 114 (77, 160) cells/μl were significantly higher than those in the control group at 17.46% (11.62%, 22.31%) and 92 (68, 134) cells/μl (P<0.05). Compared with the benign group at 475 (345, 612) cells/μl; 378 (270, 490) cells/μl; 84 (60, 132) cells/μl, the absolute counts of CD3⁺ CD28⁺ , CD3⁺ CD4⁺ CD28⁺ , and CD3⁺ CD8⁺ CD28⁺ T cells in the lung cancer group at 390 (277, 539) cells/μl; 303 (212, 425) cells/μl; 72 (44, 109) cells/μl were significantly decreased (P<0.05). The levels of serum tumor markers in the lung cancer group, including CEA 3.24 (1.88, 7.83) ng/ml, FER 238.5 (129.3, 416.8) μg/ml, NSE 16.3 (13.15, 21.65) ng/ml, CA125 17.4 (11.7, 33.95) U/ml, CYFRA21-1 2.71 (1.86, 4.44) ng/ml, and CA50 9.05 (6.25, 12.72) U/ml, were significantly higher than those in the benign group at 2.06 (1.3, 3.05) ng/ml; 139 (88, 214) μg/ml; 13.6 (11, 16.6) ng/ml; 9.61 (7.53, 14.6) U/ml; 2.03 (1.6, 2.87) ng/ml and 6.39 (5.24, 8.49) U/ml (P<0.05). There was no significant correlation between the ratio of PD-1 or CD28 positive T cells and the levels of tumor markers (P>0.05).

Compared with the healthy and benign pulmonary nodule groups, the proportion of PD-1⁺ T cells was markedly increased in lung cancer patients, whereas the number of CD28⁺ T cells was significantly decreased. These findings suggest an immune-inhibitory state of T cells in lung cancer patients, and the continuous alterations in PD-1 and CD28-positive T cells may be closely associated with the progression of lung cancer.

To analyze the effects of ciprofol versus propofol on hemodynamics during anesthesia induction and maintenance and on postoperative recovery in video-assisted thoracoscopic surgery (VATS) lobectomy.

A total of 173 patients who underwent VATS segmentectomy or lobectomy in our hospital from January 2024 to December 2025 were selected. 95 patients were assigned to the propofol group and 78 to the ciprofol group. In the propofol group, anesthesia was induced with target-controlled infusion (TCI) of propofol 1.5~2.5 mg/kg and maintained with 4~12 mg/(kg·h) under bispectral index (BIS) monitoring. In the ciprofol group, anesthesia was induced with TCI of ciprofol 0.4~0.5 mg/kg and maintained with 0.4~2.4 mg/(kg·h). Intraoperative vital signs, postoperative recovery, and safety were evaluated.

The success rate of anesthesia induction was 100% in both groups. At T₃-T₄ during induction, BIS values reached their nadir in both groups; during the maintenance phase, BIS in the ciprofol group was lower than that in the propofol group at T₇-T₁₀ (P<0.05). The proportion of time with bispectral index (BIS) ranging from 40 to 60 was 44.21% vs 24.36% (P=0.007), and the relative time proportion was (79.67±24.81)% vs (72.62±23.59)% (P=0.059); no statistically significant difference was observed between the two groups. Compared with the propofol group, the reductions in systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were milder in the ciprofol group (P=0.028, 0.044, <0.001). The QoR-15 score was higher in the ciprofol group than in the propofol group [137.00 (134.00, 140.00) vs 135.00 (132.75, 137.00), Z=-2.359, P=0.040]. There were no significant differences between the two groups in postoperative RASS score [4.00(3.00, 4.00) vs 4.00(3.00, 4.00), P=0.981], T_ROC [(5.60±1.87) min vs (6.07±2.01) min, t=1.579, P=0.116], extubation time [(4.15±2.05)d vs (4.67±2.16)d, t=1.620, P=0.107], Numerical Rating Scale (NRS) score [2.41(1.81, 2.24) vs 2.93(1.87, 2.70), P=0.601], and incidence of postoperative nausea and vomiting (14.00% vs 18.00%, P=0.585). The incidence of grade 2-3 injection site pain was lower in the ciprofol group (11.54% vs 33.68%, χ²=11.621, P=0.001), as was the incidence of drug-related hypotension during anesthesia maintenance (7.69% vs 24.21%, χ²=8.376, P=0.004). No significant between-group differences were found in the incidences of bradycardia (10.26% vs 13.68%), tachycardia (6.41% vs 13.68%), hypertension (7.69% vs 11.58%) and intubation response (2.56% vs 6.32%) (P>0.05).

Ciprofol can be used for anesthesia induction and maintenance in VATS, with efficacy and safety non-inferior to propofol. It provides more stable hemodynamics and is associated with lower incidences of grade 2~3 injection site pain and hypotension.

To explore the value of Revolution CT energy spectrum imaging technology combined with serum tumor suppressor gene 53 (p53) and tumor autoantibody 7 (GAGE7) antibodies in the diagnosis of non-small cell lung cancer (NSCLC).

72 suspected NSCLC patients admitted to the hospital from June 2021 to April 2022 were selected and divided into two groups based on pathological results: NSCLC group (20 cases diagnosed with NSCLC) and control Group (52 cases with benign lung diseases). The basic data of the two groups were compared, and the diagnostic efficacy of NSCLC was analyzed by analyzing the multiple logistic and ROC curves that affect the occurrence of NSCLC.

The blood flow, capillary permeability, spectral CT parameters k1, GAGE7, and p53 levels in were all higher than those in control group(P<0.05). Through multiple logistic regression analysis, it was found that blood flow [OR=7.374(95%CI: 1.202, 13.546)], capillary permeability [OR=6.966(95%CI: 1.371, 12.621)], spectral CT parameter k1 level [OR=7.996(95%CI: 1.410, 14.582)], GAGE7 level [OR=9.152(95%CI: 1.414, 16.890)], and p53 level [OR=8.474(95%CI: 1.632, 15.316)] can be the main factors for evaluating the occurrence of NSCLC (P<0.05). According to ROC curve analysis, the sensitivity of blood flow, capillary permeability, energy spectrum CT parameter k1, GAGE7, and p53 in diagnosing NSCLC is 75.00%, 75.00%, 80.00%, 80.00%, and 90.00%, respectively; The specificity was 75.00%, 76.92%, 76.92%, 78.85%, and 88.46%, respectively. The value of combined detection in diagnosing NSCLC is relatively high (AUC=0.934).

The combination of Revolution CT energy spectrum imaging technology and serum p53 and GAGE7 antibodies has high diagnostic value for NSCLC, providing more diagnostic information for clinical practice and improving the diagnostic accuracy of NSCLC.

To investigate the effect of apneic oxygen insufflation(AOI) applied to the non-ventilated lung on the risk of hypoxemia during one-lung ventilation(OLV) in patients undergoing thoracoscopic lobectomy.

A total of 79 patients who underwent thoracoscopic lobectomy in our hospital from September 2019 to March 2024 were enrolled and randomly divided into an observation group 40 cases and a control group 39 cases. During one-lung ventilation, the observation group received apneic oxygen insufflation to the non-ventilated lung at an oxygen flow rate of 5 L/min for 30 minutes, while the control group did not receive apneic oxygen insufflation. The incidence of hypoxemia (SpO₂<90%), intraoperative changes in SpO₂ and PaO₂/FiO₂, and in-hospital adverse events were compared between the two groups.

There were no statistically significant differences between the two groups in age, sex, ASA classification, pulmonary function, surgical procedure, anesthetic drug dosage, or one-lung ventilation duration (P>0.05). The incidence of hypoxemia in the observation group was 3 cases (7.50%), which was significantly lower than the 10 cases (25.64%) in the control group (P=0.037). As the operation time progressed, SpO₂ showed a downward trend in both groups (F_time=13.524, P<0.001), but the decrease in the observation group was smaller than that in the control group (F_{treatment×time}=3.042, P=0.004; F_treatment=8.038, P=0.008). At OLV 20 min(OLV 20), OLV 25 min (OLV 25), OLV 40 min (OLV 40) and OLV 45 min(OLV 45), SpO₂ in the control group was significantly lower than that in the observation group (P<0.05). PaO₂/FiO₂ in both groups reached the lowest value at OLV 30 and rebounded at OLV 45 (F_time=101.016, P<0.001). At OLV 30 and OLV 45, PaO₂/FiO₂ in the control group was significantly lower than that in the observation group [OLV 30: (28.05±8.42)kPa vs (35.38±10.84)kPa, t=3.351, P=0.001; OLV 45: (37.07±10.99)kPa vs (43.14±10.99)kPa, t=2.454, P=0.016]. During hospitalization, adverse events occurred in 7 cases (17.50%) in the observation group and 9 cases (23.08%) in the control group, with no statistically significant difference (P=0.481).

In patients undergoing thoracoscopic lobectomy, applying apneic oxygen insufflation to the non-ventilated lung during one-lung ventilation can reduce the incidence of hypoxemia, improve intraoperative oxygenation, and does not increase the risk of adverse events.

To analyze the potential clinical risk factors and imaging characteristics of severe Chlamydia psittaci pneumonia.

A retrospective analysis was conducted on the clinical data of 54 patients with Chlamydia psittaci pneumonia admitted to the First Affiliated Hospital of Anhui Medical University from June 2020 to May 2025. All patients were diagnosed via metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid. Patients meeting the inclusion criteria were divided into a severe group (requiring intensive care unit treatment) and a non-severe group. Clinical data were compared between the two groups. Multivariate logistic regression was used to identify risk factors associated with severe Chlamydia psittaci pneumonia.

The duration of fever after admission was significantly longer in the severe group compared to the non-severe group (P<0.05). The severe group had a higher prevalence of wheezing as a chief complaint and chills as an initial symptom (P<0.05). Compared to the non-severe group, the severe group had significantly lower levels of lymphocytes, partial pressure of oxygen, monocytes, albumin, and platelets (P<0.05). Conversely, the severe group exhibited significantly higher levels of white blood cells, neutrophils, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, aspartate aminotransferase, direct bilirubin, indirect bilirubin, brain natriuretic peptide, procalcitonin, prothrombin time, fibrin degradation products, D-dimer, and a longer recovery time for C-reactive protein (CRP) (P<0.05). CT imaging revealed that the severe group had significantly more consolidations, air bronchograms, pleural effusions, and multilobar lesions compared to the non-severe group (P<0.05). During treatment, the severe group required respiratory support at a higher rate (P<0.05). Multivariate logistic regression analysis identified the following independent risk factors for severe Chlamydia psittaci pneumonia: duration of fever after admission (OR=1.460, 95%CI: 1.151~1.852, P<0.05), chills as an initial symptom (OR=5.473, 95%CI: 1.401~21.109, P<0.05), neutrophil count ≥9.5×10⁹/L (OR=10.500, 95%CI: 2.555~43.143, P<0.05), white blood cell count ≤1.1×10⁹/L (OR=4.952, 95%CI: 1.489~16.466, P<0.05), direct bilirubin ≥19 μmol/L (OR=4.667, 95%CI: 1.410~15.448, P<0.05), lactate dehydrogenase ≥100 U/L (OR=7.286, 95%CI: 1.775~29.907, P<0.05), procalcitonin ≥13 ng/ml (OR=4.062, 95%CI: 1.115~6.131, P<0.05), prothrombin time ≥4 s (OR=4.250, 95%CI: 1.169~15.454, P<0.05), air bronchogram on CT imaging (OR=6.538, 95%CI: 1.793~23.843, P<0.05), and pleural effusion (OR=2.854, 95%CI: 1.329~21.109, P<0.05).

The clinical manifestations of Chlamydia psittaci pneumonia are atypical. Early bronchoscopy with mNGS of bronchoalveolar lavage fluid can aid in early diagnosis. Specific clinical indicators, laboratory parameters, and CT imaging features serve as independent risk factors for severe Chlamydia psittaci pneumonia.

To evaluate the applicability of Nutritional Risk Screening 2002 (NRS2002), Mini Nutritional Assessment (MNA), and Malnutrition Universal Screening Tool (MUST) in hospitalized patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB), using the Global Leadership Initiative on Malnutrition (GLIM) criteria as the reference standard.

A descriptive study was conducted, consecutively enrolling 350 patients diagnosed with MDR-PTB at Xi′an Chest Hospital between June 2019 and December 2021. Nutritional risk screening was performed using the 3 toolsSensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and agreement were calculated for each tool. Receiver operating characteristic (ROC) curves were constructed, and the area under the curve (AUC) was computed. Univariate and multivariate logistic regression analyses were conducted to assess the association between nutritional status and clinical outcomes, with sputum culture conversion at 2 months and the occurrence of adverse events as primary endpoints.

Among the 350 MDR-PTB patients, 204 cases (58.29%) were diagnosed with malnutrition according to the GLIM criteria, and 146 cases (41.71%) were well-nourished. The nutritional risk detection rates of various screening tools were as follows: MNA in 294 cases (84.00%), NRS2002 in 228 cases (65.14%), and MUST in 240 cases (68.57%). The screening time required for MNA [(3.40 ± 2.07) minutes] was significantly longer than that for NRS2002 [(2.23±0.76)minutes] and MUST [(1.54±0.33) minutes], with a statistically significant difference (F=0.578, P<0.001). According to GLIM criteria, 58.29% of patients were diagnosed with malnutrition. Performance analysis revealed that MNA had the highest sensitivity (99.51%) but the lowest specificity (37.67%). NRS2002 and MUST demonstrated higher specificity (66.44% vs. 63.70%) and greater AUC values (0.771 vs. 0.777). Multivariate binary logistic regression indicated that, compared with well-nourished patients, those identified as malnourished by GLIM criteria (OR=20.511, 95%CI: 4.509~93.308) and those at high risk by NRS2002 (OR=3.492, 95%CI: 1.147~10.627) had a significantly higher risk of non-conversion in sputum culture at 2 months. Similarly, the GLIM malnutrition group (OR=2.951, 95%CI: 1.023~8.509) and the MNA high-risk group (OR=17.213, 95%CI: 1.794~165.179) were associated with a higher risk of adverse treatment outcomes.

Among the three nutritional screening tools, MNA showed the highest sensitivity, while NRS2002 exhibited the highest specificity, MUST demonstrated better overall screening performance. For focusing on short-term clinical outcomes, NRS2002 and MUST have higher screening efficacy, while MNA is superior for early identification of nutritional risk and assessment of long-term clinical outcomes, and may be more suitable for the clinical nutritional management strategy of MDR-PTB patients.

To evaluate the effect of omalizumab on the balance of helper T cell 1 (Th1)/Th2 cytokines and its clinical efficacy in elderly patients with bronchial asthma.

A total of 105 elderly patients with bronchial asthma treated at The First People′s Hospital of Xianyang from September 2021 to October 2024 were enrolled and assigned to an observation group 48 cases, receiving conventional inhalation therapy plus subcutaneous injection of omalizumab or a control group 57 cases, receiving conventional inhalation therapy alone based on treatment preference (non-randomized design). The treatment duration was 12 weeks. Clinical efficacy, peripheral blood Th1-type cytokines [interferon-gamma (IFN-γ), interleukin-2 (IL-2)], Th2-type cytokines (IL-4, IL-13), inflammatory markers [high-sensitivity C-reactive protein (hs-CRP), IL-6, tumor necrosis factor-alpha (TNF-α)], total immunoglobulin E (IgE), lung function parameters [forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), maximum mid-expiratory flow (MMEF), FEV₁/FVC ratio], and adverse events were compared between the two groups.

The observation group had higher total effective rate [87.50%(42/48) vs. (70.18%, 40/57)] (P<0.05). After treatment , the observation group had higher IFN-γ and IL-2 [(29.63±6.78) pg/ml and (15.66±4 .42)pg/ml vs. (21.22±5.19)pg/ml and (11.57±3.09)pg/ml], while lower levels of IL-4 and IL-13 [(18.57±4.13) pg/ml and (19.48±4.87)pg/ml vs. (23.99±5.64)pg/ml and (25.22±5.38)pg/ml] (P<0.05); the observation group showed a decreasing trend of hs-CRP(12.27±2.65) mg/L, IL-6 (41.31±8.18) pg/ml, TNF-α(28.44±7.76) pg/ml, and total IgE (181.57±43.82)IU/ml, and those in the observation group were lower [(16.22±3.82) mg/L, (50.46±9.49)pg/ml, (37.68±8.93) pg/ml, (225.46±59.23)IU/ml] (P<0.05); the observation group had higher FEV₁(1.47±0.35)L, FVC(2.36±0.46)L, MMEF (1.31±0.36) L/s, FEV₁/FVC (66.39±5.42)% vs. (1.34±0.36)L, (2.15±0.47)L, (1.08±0.31)L/s, (62.46±5.65)% (P<0.05). The observation group had higher incidence of adverse reactions (14.58% vs. 8.77%), without statistically significant difference (P>0.05).

In elderly patients with bronchial asthma, addition of omalizumab to conventional therapy can restore the Th1/Th2 cytokine balance, reduce systemic inflammation and IgE levels, and improve lung function, with an acceptable safety profile.

Sample analysis NOD heat receptor protein structure domain related protein 3 (NLRP3) signaling pathways and related cell factors to predict the value of the death of elderly patients with severe pneumonia was.

The clinical data of 100 elderly patients with severe pneumonia treated in our hospital from June 2021 to June 2024 were prospectively analyzed, and the patients were divided into survival group and death group according to whether they survived for 28 days. The baseline data, NLRP3 signaling pathway and related cytokine levels of the two groups were compared.Multiariable Logistic regression analysis of the risk factors of death of elderly patients with severe pneumonia was taken ROC analysis was used to analyze the value of pneumonia severity index (PSI) score, NLRP3 signaling pathway and related cytokines in predicting the death of elderly patients with severe pneumonia.

37 of 100 elderly patients with severe pneumonia died, the mortality rate was 37%. 63 patients were discharged successfully after treatment, and the survival rate was 63%. The mechanical ventilation time, ICU stay days, PSI score, NLRP3, Caspase-1 and IL-1β levels in death group were higher than those in survival group (P<0.05); Multiple Logistic regression analysis confirmed that longer mechanical ventilation time, PSI score, NLRP3, Caspase-1, IL-1β levels were risk factors for death in elderly patients with severe pneumonia was both (P<0.05); Confirmed by ROC analysis PSI score, NLRP3, Caspase 1, the level of IL-1 beta can be used to predict mortality risk of elderly patients with severe pneumonia was, the area under the curve were 0.678, 0.825, 0.744, 0.749, And the above factors combined prediction can be obtained under higher curve area is 0.966, both(P<0.05).

NLRP3 signaling pathways and related cytokine levels and risk of death of elderly patients with severe pneumonia was closely related to, joint PSI grading test can further improve the predictive value.

To investigate the effect of sputum induction (SI) combined with the active cycle of breathing technique (ACBT) on pulmonary function and rehabilitation compliance in patients with chronic obstructive pulmonary disease (COPD).

A total of 96 COPD patients admitted to our hospital from August 2023 to July 2025 were selected and randomly divided into an observation group (48 cases) and a control group (48 cases) using a random number table. The control group received a conventional pulmonary rehabilitation nursing program, while the observation group received SI combined with ACBT in addition to the treatment given to the control group. The two groups were compared in terms of pulmonary function indices [forced expiratory volume in 1 second (FEV₁), FEV₁% predicted, forced vital capacity (FVC), FEV₁/FVC], total sputum volume and viscosity, 6-minute walk distance (6MWD), General Self-Efficacy Scale (GSES) score, COPD Assessment Test (CAT) score, pulmonary rehabilitation compliance, and adverse reactions.

After treatment, the observation group had significantly better pulmonary function than the control group: FEV₁[(1.49±0.37) L vs (1.23±0.23) L, P<0.001]; FEV₁% pred [(62.62±14.08)% vs (53.18±11.82)%, P<0.001]; FVC[(2.79±0.46) L vs (2.48±0.41) L, P=0.001]; FEV₁/FVC [(53.27±7.40)% vs (49.85±5.66)%, P=0.012]. After treatment, the observation group showed a lower total sputum volume than the control group [(20.99±3.57) ml vs (23.29±5.11) ml, P<0.05], and a significantly greater improvement in sputum viscosity [(grade Ⅰ: 20.83% vs 10.42%, grade Ⅱ: 75.00% vs 56.25%, grade Ⅲ: 4.17% vs 33.33%), Z=-2.561, P=0.001]. The observation group was also superior in 6MWD [(376.85±31.54) m vs (318.29±14.20) m, P<0.001], GSES score [(25.75±3.48) vs (21.77±1.61), P<0.001], and CAT score [(13.58±2.34) vs (20.71±4.59), P<0.001]. The complete compliance rate for pulmonary rehabilitation was 45.83% in the observation group, higher than 25.00% in the control group (χ²=-2.198, P=0.012). The incidence of adverse reactions in the observation group was 9 cases (18.75%), lower than the 19 cases (39.58%) in the control group (χ²=4.084, P=0.043).

SI combined with ACBT can effectively improve pulmonary function, reduce total sputum volume and viscosity, enhance exercise tolerance, self-efficacy, quality of life, and rehabilitation compliance, and reduce adverse reactions in COPD patients, demonstrating clinical significance.