To investigate the regulatory role and molecular mechanism of Rab26 in airway epithelial cell senescence induced by cigarette smoke exposure in chronic obstructive pulmonary disease (COPD). Impaired autophagy is a key feature of cellular senescence, characterized by the dysregulation of vesicle transport processes dependent on the Rab GTPase family.

An in vitro senescence model was established by treating human bronchial epithelial cells BEAS-2B with cigarette smoke extract (CSE), COPD mouse models were generated by chronic cigarette smoke exposure. Ten male C57BL/6 mice aged 6~8 weeks were selected and divided into an exposure group (n=5) and a room air control group (n=5). Techniques such as Western blotting, quantitative polymerase chain reaction, and immunohistochemistry were employed to detect the expression of Rab26, ubiquitin-specific protease 13 (USP13), and the senescence marker p21. Gain-of-function (overexpression) and loss-of-function (gene knockdown) experiments were conducted to evaluate the role of Rab26, and transcriptome sequencing was used to screen its downstream targets.

Cigarette smoke exposure successfully induced airway epithelial cell senescence. In mouse lung tissues and BEAS-2B cells, the protein expression of the senescence marker p21 was significantly increased. Specifically, treatment of BEAS-2B cells with 2% CSE for 9 days increased p21 protein levels (1.06 vs. 1.56 )(P<0.01), accompanied by an increase in the proportion of SA-β-gal-positive cells. Compared with control groups, Rab26 expression was decreased at both the mRNA and protein levels in lung tissues from smoke-exposed mice and in BEAS-2B cells treated with 2% CSE for 9 days, with Rab26 protein levels reduced (0.79 vs. 0.33)(P<0.05). In gain-of-function experiments, overexpression of Rab26 under CSE exposure significantly attenuated the upregulation of p21 protein expression (2.27 vs. 1.36) (P<0.01) and reduced the proportion of SA-β-gal-positive cells (P<0.01). Further mechanistic analyses demonstrated that USP13 is an important downstream-associated molecule involved in Rab26-mediated regulation of airway epithelial cell senescence. USP13 protein expression was decreased(0.94 vs. 0.57) in lung tissues of smoke-exposed mice (P<0.01) and (0.90 vs. 0.64)in Rab26-/- mouse lung tissues (P<0.01). Moreover, in vitro overexpression of USP13 significantly suppressed CSE-induced p21 upregulation (P<0.01), thereby alleviating the senescent phenotype.

Rab26 regulates cigarette smoke-induced airway epithelial cell senescence through the USP13 signaling pathway.

To analyze the predictive value of the lung injury prediction score (LIPS) and angiopoietin-2 (Ang-2) for the development of acute respiratory distress syndrome (ARDS) in patients with pulmonary infection.

A total of 90 patients with pulmonary infection who were admitted to the Respiratory Intensive Care Unit (RICU) and Emergency Intensive Care Unit (EICU) of the Second, First, and Third Affiliated Hospitals of Army Medical University between March 2013 and May 2022 were enrolled. Thirty-one patients who developed ARDS within one week were assigned to the observation group, and fifty-nine patients who did not develop ARDS were assigned to the control group. Clinical data were collected from both groups, including age, sex, smoking and drinking history, comorbidities (hypertension, diabetes, coronary heart disease), underlying respiratory diseases(chronic obstructive pulmonary disease and bronchiectasis), oxygenation index, APACHE Ⅱ score, LIPS score, ARDS incidence, and the expression levels of four biomarkers. Receiver operating characteristic (ROC) curves were plotted to evaluate and compare the predictive value of LIPS, Ang-2, and their combination for ARDS in patients with pulmonary infection.

The oxygenation index in the observation group was lower than that in the control group [(167.88±74.99)mmHg vs. (265.94±96.91) mmHg, P<0.05]. Fourteen patients (45.16%) died in the observation group compared with eight patients (13.56%) in the control group, with a significantly higher mortality in the observation group (P<0.05). The observation group also had higher APACHE Ⅱ scores (19.68±7.69 vs. 15.81 ±6.25), higher LIPS scores [6.50(5.50~7.50) vs. 3.50(2.50~5.50)], higher Ang-2 levels [6.01(2.50~12.32) vs. 1.64(0.75~3.29)ng/ml], and higher IL-8 levels [54.43(3.9~118.11) vs. 3.91(3.91~44.78)pg/ml], with statistically significant differences (P<0.05). Multivariate logistic regression analysis showed that LIPS and Ang-2 were independent risk factors for ARDS in patients with pulmonary infection (P<0.05). Both LIPS and Ang-2 had predictive value for ARDS, with no significant difference between the two (AUROC: 0.82 vs. 0.77, P=0.518). The combined use of LIPS and Ang-2 achieved a higher area under the curve (AUC=0.90, 95%CI: 0.82~0.96, P=0.000), which was significantly greater than that of either LIPS or Ang-2 alone (Z=2.65, P=0.008; Z=2.44, P=0.015, respectively). The combined model yielded a positive predictive value of 76.46%.

LIPS and Ang-2 can serve as predictive indicators for ARDS in patients with pulmonary infection. The combined application of LIPS and Ang-2 provides a identification of high-risk patients for developing ARDS.

To explore the impact of mechanical injury on the growth of airway epithelial cells by simulating mechanical damage through mechanical scratches, and to investigate the role of the miR-766-3p/PNCK/m-TOR pathway in this process.

The airway epithelial cells were transfected with has-miR-766-3p mimics, inhibitors, and corresponding negative control(NC), and the airway epithelial cells were mechanically scratched to create a damage model; cell counting kit-8(CCK8) method was used to detect cell viability; hematoxylin-eosin staining(HE) staining analysis of cell morphology; Transwell method for detecting cell migration ability; Western blot(WB) was used to detect protein expression levels; Quantitative reverse transcription polymerase chain reaction(RT qPCR)was used to detect RNA expression levels.

After modeling, the hsa-miR-766-3p RNA expression of cells decreased (1.01 vs. 0.31), the invasion ability decreased (180 vs. 123), and the cell activity decreased (0.97 vs. 0.72). The differences were statistically significant (P<0.05). After cell modeling, overexpression of miR-766-3p decreased cell invasion ability (127 vs. 94.5) and cell activity (0.7 vs. 0.52). After inhibitory expression of miR-766-3p, cell invasion ability (118 vs. 217) and activity (0.69 vs. 0.87) increased. The differences were statistically significant (P<0.05). After inhibitory expression of miR-766-3p, the expression of Pregnancy-upregulated nonubiquitous calmodulin kinase(PNCK)(0.34 vs. 0.84) and mammalian Target of rapamycin(mTOR)(0.45 vs. 1.05) increased, and the difference was statistically significant (P<0.05).

Through in vitro cell studies, it is believed that mechanical injury can affect the expression of miR-766-3p, and miR-766-3p further influences the activity and migration ability of airway epithelial cells by affecting the expression of PNCK and mTOR.

To analyze the relevant clinical factors associated with atelectasis following ultrasound-guided percutaneous catheter drainage (PCD) in lung cancer patients complicated with malignant pleural effusion (MPE), and to evaluate the impact of atelectasis on patient prognosis.

A retrospective selection was made of 114 lung cancer patients with malignant pleural effusion (MPE) who underwent ultrasound-guided percutaneous catheter drainage (PCD) in our hospital from June 2021 to March 2024 as the subjects. They were grouped according to the lung expansion status after PCD: 18 cases with atelectasis were included in the observation group, and 96 cases without atelectasis were included in the control group. The clinical data, imaging results, and overall survival of the two groups were compared, and the risk factors for atelectasis were analyzed by regression analysis.

In the observation group, the lactate dehydrogenase( LDH) level [828.30(694.24, 909.56)], pleural fluid-to-serum LDH ratio [1.88 (1.38, 4.00)], endobronchial lesions [9 cases(50.00%)], time from diagnosis of MPE to PCD [7.00 (5.00, 11.00)] days, and drainage volume [850.00 (600.00, 1 000.00)]ml showed statistically significant differences compared with the control group, which had LDH [547.30(460.20, 669.50)], pleural fluid-to-serum LDH ratio [1.18 (0.47, 2.21)], endobronchial lesions 20 cases(20.83%), time from MPE diagnosis to PCD [4.00 (2.00, 7.00) ]days, and drainage volume [1 215.00 (950.00, 1 535.00)]ml (P<0.05). Logistic regression analysis revealed that the pleural fluid-to-serum LDH ratio (OR=2.228, 95%CI: 1.359~3.652), endobronchial lesions (OR=5.076, 95%CI: 1.488~17.317), and time from MPE diagnosis to PCD (OR=1.108, 95%CI: 1.010~1.215) were risk factors for atelectasis in lung cancer patients with MPE (P<0.05). The receiver operating characteristic AUC for predicting post-PCD atelectasis in lung cancer patients with MPE was 0.833 (95%CI: 0.716~0.949), with a Hosmer-Lemeshow test P-value of 0.564. By the end of follow-up, 27 patients (23.68%) were alive and 87 patients (76.32%) had died. The overall survival in the observation group was 79.0 days (IQR: 56.4~103.8 days), which was shorter than that in the control group (99.2 days, IQR: 73.1~142.7 days) (log rank=5.491, P=0.019). COX regression analysis indicated that ECOG-PS ≥ 2, distant metastasis, serum CRP, pleural fluid-to-serum LDH ratio, and atelectasis were risk factors for death in lung cancer patients with MPE (P<0.05).

The pleural effusion-serum LDH ratio, endobronchial lesions, and the time from MPE diagnosis to PCD can predict the occurrence of atelectasis. Atelectasis affects the overall survival of lung cancer patients with MPE after PCD treatment.

To construct a prognostic risk model based on multi-omics features and systematically analyze the prognostic value of goblet cell-related adhesion molecules in lung adenocarcinoma (LUAD), providing biomarker references for precision diagnosis and treatment.

This study integrated TCGA-LUAD (n=598), GTEx normal lung tissue (n=110), and three GEO cohorts (GSE31210, etc., n=189) for differential expression analysis. A prognostic model was constructed using LASSO-Cox regression, and the expression of target genes was validated through real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot (WB) experiments in the NCI-H1975 cell line.

1 583 differentially expressed genes (|log2FC|>1, FDR<0.05) were identified in LUAD samples, including 883 upregulated and 700 downregulated genes. GO/KEGG analysis revealed that these genes were significantly enriched in cell cycle regulation (GO: 0045786, P=1.4e-07) and the extracellular matrix-receptor(ECM) interaction pathway (hsa 04512, P=1.8e-09). Additionally, multivariate Cox regression confirmed TFF1 as an independent prognostic factor (HR=1.22, 95%CI: 0.082~0.109, P<0.001). The 5-gene model constructed with TFF1 achieved a C-index of 0.71 in the test set. Single-cell transcriptome analysis (n=17) showed that TFF family genes were specifically highly expressed in goblet cells within the tumor microenvironment (log2FC>2, P<0.001) and positively correlated with clinical stage (Spearman ρ=0.68, P=1.3×10⁷). RT-qPCR and WB experiments demonstrated significant differences in the expression of five key adhesion biomarkers (TFF1, TFF2, TFF3, REG4, and SPINK4) in LUAD cell lines (P<0.05).

The 5-gene prognostic model (TFF1/2/3, REG4, SPINK4) constructed through multi-omics data analysis was validated in an independent cohort (AUC=0.77). TFF1 drives tumor progression via goblet cells, offering a novel combination biomarker for liquid biopsy and targeted therapy in LUAD.

To explore the role of the relationship between pulmonary nodules and pleura in the prediction of pneumothorax risk after computed tomography-guided lung needle biopsy (CT-LNB).

A retrospective selection was conducted on 111 patients with pulmonary nodules who underwent CT-LNB treatment in our hospital from January 2021 to December 2024. The patients were divided into groups based on whether pneumothorax occurred after CT-LNB surgery. 27 cases with pneumothorax were classified as the observation group, and 84 cases without pneumothorax were classified as the control group. Least absolute shrinkage and selection operator (LASSO) regression and multivariate Logistic regression were used to analyze the risk factors for pneumothorax after CT-LNB and to construct a nomogram.

Among the 111 cases, 32 cases had nodules in contact with the pleura, 29 cases had nodules not in contact with the pleura (with a median distance of 3.40 cm), and 50 cases had nodules with the pleural tail sign (PTS). In the observation group, 2 cases (7.41%) had nodules in contact with the pleura, which was lower than 30 cases (35.71%) in the control group (P=0.005); 14 cases (51.85%) in the observation group had PTS in the puncture path, which was higher than 17 cases (20.24%) in the control group (P=0.001). LASSO and Logistic regression analysis showed that the presence of PTS in the puncture path (OR=6.450, P=0.005), nodule diameter <2 cm (OR=4.151, P=0.020), repeated puncture (OR=3.479, P=0.034), intrapulmonary puncture depth >2 cm (OR=8.079, P=0.011), and PTS in the puncture path were risk factors for pneumothorax after CT-LNB. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC)for predicting pneumothorax by the nomogram was 0.88 (95%CI: 0.81~0.94). Clinical decision curve analysis showed that when the high-risk threshold was 0.05~0.78, the nomogram had better net clinical benefit for predicting pneumothorax.

The presence of PTS in the puncture path, emphysema, nodule diameter <2 cm, repeated puncture, and intrapulmonary puncture depth >2 cm are risk factors for pneumothorax after CT-LNB surgery. The pneumothorax risk prediction model may be used clinically for individualized risk decision-making for pneumothorax, and when performing biopsy on pulmonary nodules with PTS, avoid puncturing through the PTS puncture trajectory to reduce the risk of pneumothorax.

To analyze the effects of recombinant tissue plasminogen activator (rt-PA) dosage on pulmonary artery pressure and bleeding risk during ultrasound-assisted catheter-directed thrombolysis (UACDT) in patients with intermediate- to high-risk acute pulmonary embolism (PE).

This retrospective study included 42 patients with intermediate-to-high-risk acute pulmonary embolism (PE) treated with UACDT at our hospital from February 2020 to December 2024. Patients were divided into two groups based on their cumulative rt-PA dose: 21 patients with rt-PA ≤ 24 mg were in the control group, and 21 patients with rt-PA > 24 mg were in the observation group. The cumulative rt-PA dose, changes in systolic pulmonary artery pressure (sPAP), and postoperative complications were recorded during treatment. Right ventricular pressure load and hemodynamic parameters, including sPAP, mean pulmonary artery pressure (mPAP), and diastolic pulmonary artery pressure (dPAP), were compared between the two groups. The relationship between cumulative rt-PA dose and postoperative bleeding risk was analyzed.

The mean treatment time for UACDT was (61.89±28.76) h, and the cumulative rt-PA was (43.28±30.03) mg. sPAP showed a decreasing trend with increasing cumulative rt-PA (F=12.451, P<0.001). In the control group, after treatment, 10 cases (47.62%) had normal right ventricular load, 9 cases (42.86%) had mild right ventricular load, 1 case (4.76%) had moderate right ventricular load, and 1 case (4.76%) had severe right ventricular load (P<0.001). In the observation group, after treatment, 14 cases (66.67%) had normal right ventricular load, 7 cases (33.33%) had mild right ventricular load, and there were no moderate or severe cases (P<0.001). After treatment, sPAP, mPAP, and dPAP in both groups decreased compared to before treatment (P<0.05). After treatment, the sPAP (43.10±4.90)mmHg, mPAP (23.10±3.20)mmHg, and dPAP (17.60±2.70)mmHg in the observation group were lower than those in the control group (sPAP (49.80±5.40)mmHg, mPAP (26.70±3.80)mmHg, and dPAP (20.70±3.10)mmHg (P<0.05). After treatment, the pulmonary vascular resistance (201.20±28.80)dyn·s·cm^-5 in the observation group was lower than that in the control group PVR (265.40±35.10)dyn·s·cm^-5 (P<0.001). The average postoperative intensive care unit (ICU) stay was (4.89±3.14) days, and the total hospital stay was (8.01±5.38) days. Complete thrombolysis was achieved in 18 cases (85.71%) in the observation group, higher than in 10 cases (48.00%) in the control group (χ²=6.886, P=0.032); the average thrombus burden score was (2.41±0.68) points, higher than in the control group (1.85±0.72) points (t=3.66, P<0.001). Complete effectiveness was achieved in 18 cases (85.71%) in the observation group, higher than in 11 cases (52.38%) in the control group (P=0.048). At the end of follow-up, 37 patients (88.09%) survived, 5 patients (11.90) died, 8 patients (19.05%) experienced mild bleeding, and 1 patient (2.39%) experienced moderate bleeding.

UACDT treatment of intermediate-to high-risk PE patients with low-dose-rate rt-PA to prolong thrombolysis time helps improve pulmonary circulatory dynamic parameters, does not increase bleeding risk, and is well tolerated.

To investigate the latent profile characteristics and influencing factors of cancer-related fatigue in lung cancer patients undergoing concurrent chemoradiotherapy.

A total of 117 lung cancer patients who received concurrent chemoradiotherapy in our hospital from January 2020 to December 2024 were selected and divided into three groups based on the degree of cancer-related fatigue: mild group 34 cases, moderate group 56 cases, and severe group 27 cases. Surveys were conducted using the Cancer Fatigue Scale (CFS), Pittsburgh Sleep Quality Index (PSQI), Social Support Rating Scale (SSRS), Hospital Anxiety and Depression Scale (HADS), and Nutritional Risk Screening 2002 (NRS-2002). Latent Profile Analysis (LPA) was employed to identify potential categories of cancer-related fatigue, and logistic regression was used to analyze the influencing factors.

There were statistically significant differences among the mild, moderate, and severe groups in terms of CFS physical fatigue, emotional fatigue, cognitive fatigue, and total scores (P<0.001). Statistically significant differences were also observed among the three groups in age, disease duration, nutritional risk, sleep quality, social support, anxiety, depression, and Karnofsky Performance Status (KPS) scores (P<0.05). Logistic regression analysis showed that age (OR=1.10, 95%CI: 1.03~1.16), disease duration (OR=1.15, 95%CI: 1.05~1.26), nutritional risk (OR=1.83, 95%CI: 1.28~2.62), sleep quality (OR=1.17, 95%CI: 1.06~1.30), anxiety (OR=1.19, 95%CI: 1.05~1.36), C-reactive protein (CRP) (OR=1.07, 95%CI: 1.03~1.12), interleukin-6 (IL-6) (OR=1.12, 95%CI: 1.03~1.22), and cytokeratin 19 fragment (CYFRA21-1) (OR=1.13, 95%CI: 1.04~1.23) were risk factors for cancer-related fatigue in lung cancer patients undergoing concurrent chemoradiotherapy. KPS score (OR=0.94, 95%CI: 0.89~0.98), hemoglobin level (OR=0.96, 95%CI: 0.93~0.99), and albumin level (OR=0.93, 95%CI: 0.87~0.99) were protective factors.

Cancer-related fatigue in lung cancer patients undergoing concurrent chemoradiotherapy exhibits hierarchical characteristics. Increased age, longer disease duration, higher nutritional risk, poor sleep quality, significant anxiety symptoms, and elevated levels of CRP, IL-6, and CYFRA21-1 are associated with more severe fatigue.

To explore the clinical significance of computed tomography (CT) radiomics and clinical features in predicting the growth of solitary pulmonary nodules.

A total of 165 patients with solitary pulmonary nodules shown by chest high-resolution computed tomography (HRCT) admitted to our hospital from May 2021 to May 2023 were selected as subjects. They were randomly divided into a training set (115 cases) and a validation set (50 cases) at a ratio of 7: 3. Radiomics feature variables based on CT images were extracted using the open-source Python package Pyradiomics. The growth of pulmonary nodules was observed during a 2-year follow-up. The maximum relevance minimum redundancy method and LASSO analysis were used to screen imaging feature variables, and a model was constructed. The receiver operating characteristic (ROC) curve was used to compare the predictive value of the model.

Among 165 cases, there were 99 growing pulmonary nodules (60.00%) and 66 stable pulmonary nodules (40.00%). LASSO analysis identified 5 features (original_shape_MajorAxisLength, log.sigma.1.0.mm.3D_glrlm_ShortRunLowGrayLevelEmphasis, log.sigma.5.0.mm.3D_firstorder_90Percentile, wavelet.LHH_gldm_LargeDependenceHighGrayLevelEmphasis, wavelet.LLL_glcm_JointEntropy) as the radiomics signature for predicting pulmonary nodule growth, and a radiomics score was established (Rad-score=0.4535973-0.3413027×original_shape_MajorAxisLength-0.113593×log.sigma.1.0.mm.3D_glrlm_ShortRunLowGrayLevelEmphasis+ 0.5150988×log.sigma.5.0.mm.3D_firstorder_90Percentile-0.7143545×wavelet.LHH_gldm_LargeDependenceHighGrayLevelEmphasis+ 0.10314×wavelet.LLL_glcm_JointEntropy). Multivariate logistic regression analysis showed that older age (OR=1.066, 95%CI: 1.018~1.117), female gender (OR=0.313, 95%CI: 0.113~0.870), solid nodule type (OR=0.495, 95%CI: 0.279~0.878), and high Rad-score (OR=1.038, 95%CI: 1.020~1.057) were risk factors for pulmonary nodule growth. The combined model (age, gender, nodule type+ Rad-score) had good discriminative ability in both the training set and the validation set area under the curve(AUC) of ROC 0.871 (95%CI: 0.804~0.939) vs. 0.873 (95%CI: 0.776~0.971). The Hosmer-Lemeshow test results for the training set and validation set were P=0.664 and P=0.502, respectively, indicating no statistically significant difference between the predicted probability and the actual probability of the combined model. Decision curve analysis showed that the combined model had clinical application value within the high-risk threshold range training set 0.60~0.95, validation set 0.60~0.93.

The nomogram model combining chest HRCT-derived radiomics features with age, gender, and nodule type has the potential to accurately predict the short-term growth risk of pulmonary nodules. This model has shown certain clinical value in helping clinical doctors develop diagnosis and treatment strategies.

To analyze the predictive significance of receptor interacting protein kinase 2 (RIPK2) and programmed death-1 (PD-1) expression in the efficacy of immunotherapy for lung cancer patients.

Seventy-nine lung cancer patients receiving immunotherapy at Cangzhou People′s Hospital from January 2020 to December 2024 were selected. Clinical data were collected; RIPK2 and PD-1 mRNA expression levels were detected by quantitative real time polymerase chain reaction; RIPK2 and PD-1 protein expression levels were measured by immunohistochemistry; therapeutic efficacy was evaluated. Based on follow-up results, 52 patients were classified as effective (significant efficacy) and 27 as ineffective (poor efficacy or death).

RIPK2 mRNA (1.62±0.37 vs. 1.00±0.24), PD-1 mRNA (1.38±0.34 vs. 1.00±0.19), RIPK2 protein high-expression rate (72.15% vs. 51.90%), and PD-1 protein high-expression rate (69.62% vs. 53.16%) in lung cancer tissues were significantly higher than those in adjacent tissues (P<0.05). Significant differences were observed between effective and ineffective groups in eastern cooperative oncology group (ECOG) score, maximum tumor diameter, epidermal growth factor receptor (EGFR) mutation, number of metastatic sites, liver metastasis, and treatment line (P<0.05). The ineffective group exhibited higher standardized uptake value max (SUVmax) (10.34±1.89 vs. 6.15±1.76), metabolic tumor volume (MTV) (22.87±4.85 vs. 16.29±4.41 cm³), total lesion glycolysis (TLG) (96.14±11.64 vs. 80.35±10.32 g/ml), and abdominal CT abnormality rate (70.37% vs. 19.23%) compared to the effective group (P<0.05). RIPK2 mRNA (1.45±0.32 vs. 1.98±0.41), PD-1 mRNA (1.18±0.34 vs. 1.83±0.49), and protein high-expression rates (RIPK2: 63.46% vs. 88.89%; PD-1: 59.62% vs. 88.89%) in the effective group were lower than those in the ineffective group (P<0.05). Receiver operating characteristic curve (ROC) analysis revealed area under curve (AUC) values of 0.888, 0.877, and 0.952 for RIPK2 mRNA, PD-1 mRNA, and their combination in predicting efficacy, respectively (P<0.05). Patients with high RIPK2 expression showed significantly lower survival rates (28.57% vs. 42.86%) and progression-free survival rates (16.67% vs. 25.00%), while those with high PD-1 expression had lower survival rates (33.33% vs. 40.00%) and progression-free survival rates (20.83% vs. 22.00%) compared to low-expression groups (P<0.05).

High expression of RIPK2 and PD-1 combined with imaging metabolic parameters can predict the efficacy and prognosis of immunotherapy in lung cancer, with patients exhibiting low expression achieving better survival benefits.

To investigate the efficacy and safety of computed tomography(CT)-guided microwave ablation versus cryoablation in the treatment of pulmonary nodules and lung cancer.

A total of 49 patients with pulmonary nodules or lung cancer admitted to our hospital from July 2018 to October 2023 were selected. Twenty-six patients treated with microwave ablation comprised the microwave group, and 23 patients treated with cryoablation comprised the cryoablation group. Post-treatment complications and progression-free survival rates were compared between the two groups.

In the cryoablation group 23 cases, the tumor location was left-sided in 5 cases (21.74%) and right-sided in 18 cases (78.26%); nodules were subsolid in 20 cases (86.96%) and solid in 3 cases (13.04%); nodule size was <5 mm in 0 cases, 5~10 mm in 5 cases (21.74%), and >10 mm in 18 cases (78.26%); pathological types were benign in 15 cases (65.22%) and malignant in 8 cases (34.78%), including 1 case of lung squamous cell carcinoma (4.35%) and 7 cases of lung adenocarcinoma (30.43%). In the microwave group 26 cases, the tumor location was left-sided in 12 cases (46.15%) and right-sided in 14 cases (53.85%); nodules were subsolid in 17 cases (65.38%) and solid in 9 cases (34.62%); nodule size was <5 mm in 1 case (3.85%), 5~10 mm in 4 cases (15.38%), and >10 mm in 21 cases (80.77%); pathological types were benign in 8 cases (30.77%) and malignant in 18 cases (69.23%), including 1 case of lung squamous cell carcinoma (3.85%), 15 cases of lung adenocarcinoma (57.69%), 1 case of sarcomatoid carcinoma (3.85%), and 1 case of metastatic breast cancer (3.85%). In the cryoablation group, complications were: pneumothorax in 1 case (4.35%), subcutaneous emphysema in 1 case (4.35%), recurrence in 3 cases (13.04%), and death in 0 cases. In the microwave group, complications were: pneumothorax in 5 cases (19.23%), pleural effusion in 1 case(3.85%), abscess in 1 case (3.85%), distant metastasis in 1 case (3.85%), recurrence in 4 cases (15.38%), and death in 3 cases (11.54%).

Both microwave ablation and cryoablation are safe and effective for the treatment of pulmonary nodules and can be considered as treatment options in addition to surgery.

To explore the effects of synchronous intensity-modulated radiotherapy (SIB-IMRT) with different segmentation modes on intracranial progression, cognitive function, immune function, and quality of life in patients with lung cancer brain metastases (BM).

A prospective study was conducted on 92 patients with brain metastases (BM) admitted to Cangzhou Central Hospital from November 2021 to December 2024. They were randomly divided into Group A 49 cases (40Gy/20Fx whole brain+ local addition of 60Gy/20Fx) and Group B 43 cases (37.5Gy/15Fx whole brain+ local addition of 52.5Gy/15Fx). The intracranial progression free survival time (iPFS) was recorded. The flow cytometry was performed to detect blood lymphocyte subsets before and after radiotherapy. Kaplan-Meier curves was used to analyze the impact of different segmentation modes on iPFS. The effects of different segmentation modes on cognitive function, quality of life, and cellular immune function (CD3⁺, CD4⁺, CD8⁺ %) were analyzed by repeated measures method of variance.

During a median follow-up of 9.93 months, there were 21 deaths and 71 survivors. In addition, 59 patients (64.13%) experienced intracranial progression/recurrence, while the duration of iPFS 4.90 months (95%CI: 3.42-6.38 months) in Group A was less than the duration of iPFS 12.60 months (95%CI: 10.28~14.92 months) in Group B, Log-Rank=12.621, P=0.000. 44 treatment-related adverse events occurred, and there was no statistically significant difference in the incidence of adverse events between the two groups (P>0.05). At 4 and 6 months after radiotherapy, the Montreal cognitive scores of Group B (23.13±1.45) and (23.09±2.00) were higher than that of Group A (20.97±2.35) and (18.35±2.41), P=0.000; the Barthel index of daily living activities in group B (8.74±2.47) was higher than that in group A (6.95±0.39) at 6 months after radiotherapy (P=0.001). After radiotherapy for 2 months, CD8⁺ % 32.50(23.90, 41.10) in group B was higher than that in group A 27.10(17.65, 36.03)(P=0.001). Repeated analysis of variance showed that CD8⁺ % (Fgroup×time=6.966, P=0.012) had inter group interactions.

The whole brain 37.5Gy/15Fx+ local dose 52.5Gy/15Fx regimen can prolong iPFS in patients with multiple BM of lung cancer and help to maintain their immune function, cognitive ability, and quality of life after radiotherapy.

To investigate the clinical significance of serum inflammatory markers in predicting the prognosis of chronic obstructive pulmonary disease (COPD).

A total of 76 COPD patients admitted to our hospital from May 2022 to December 2024 were selected as subjects. According to the severity and prognosis of the disease, the patients were divided into an observation group 30 cases and a control group 46 cases. General data and levels of serum inflammatory markers were compared between the two groups. Multivariate logistic regression was used to screen prognostic factors, and receiver operating characteristic (ROC) curves were plotted to validate the predictive value of relevant factors.

In the observation group, there were 2 cases (6.67%) of mild Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, modified British Medical Research Council dyspnea questionnaire (mMRC) score (2.04±0.42), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score (16.32±2.15), procalcitonin (PCT) (1.04±0.25), neutrophil-to-lymphocyte ratio (NLR) (5.81±1.03), and blood eosinophil (EOS) count (1.45±0.44), which were significantly higher than those in the control group: 13 cases (28.26%) of mild GOLD classification, mMRC score (1.79±0.35), APACHE Ⅱ score (14.51±2.07), PCT (0.79±0.21), NLR (4.64±1.17), and EOS (1.01±0.31) (P<0.05). Multivariate logistic regression analysis showed that APACHE Ⅱ score (OR=1.991, 95%CI: 1.156~3.427), PCT (OR=4.871, 95%CI: 1.260~18.826), NLR (OR=6.032, 95%CI: 1.848~19.688), and EOS (OR=4.498, 95%CI: 1.445~13.998) were independent risk factors for poor prognosis. Pearson correlation analysis revealed that PCT, NLR, and EOS were positively correlated with APACHE Ⅱ score (r=0.838, 0.906, 0.839, 0.851, respectively) (P<0.05). ROC curve analysis showed that the combined prediction of PCT, NLR, and EOS achieved an AUC of 0.909, which was higher than that of any single marker.

The combined prediction of serum inflammatory markers such as PCT, NLR, and EOS holds clinical significance for assessing the prognosis of COPD.

To analyze the correlation between the red blood cell volume distribution width/platelet ratio (RDW/PLT) combined with the Logistic organ dysfunction score (LODS) and disease severity in patients with sepsis complicated by pneumonia.

A total of 153 patients with sepsis complicated by pneumonia admitted to our hospital from January 2018 to December 2024 were enrolled. They were divided into groups according to prognosis during hospitalization: 99 survivors served as the control group, and 54 non-survivors as the observation group. Clinical data were collected, and comparisons were made between the two groups regarding mechanical ventilation, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, LODS score, RDW, and RDW/PLT on day 1, day 3, day 5, and day 7 (D1 RDW/PLT, D3 RDW/PLT, D5 RDW/PLT, D7 RDW/PLT). Binary logistic regression was used to analyze factors influencing prognosis, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of LODS score and RDW/PLT for disease severity in sepsis with pneumonia.

Logistic regression analysis showed that invasive mechanical ventilation (OR=11.095, 95%CI: 1.923~12.816), APACHE Ⅱ score (OR=0.916, 95%CI: 0.840~0.999), high D7 RDW (OR=1.448, 95%CI: 1.149~1.825), high D7 RDW/PLT (OR=8.020, 95%CI: 1.077~59.744), and high LODS score (OR=1.293, 95%CI: 1.091~1.531) were risk factors for death in patients with sepsis complicated by pneumonia (P<0.05). ROC curve analysis showed that the area under the curve (AUC) values for invasive mechanical ventilation, APACHE Ⅱ score, D7 RDW, D7 RDW/PLT, and LODS score were 0.628, 0.606, 0.727, 0.830, and 0.719, respectively. The optimal cutoff value for D7 RDW/PLT was 0.135, with a sensitivity of 79.6% and specificity of 74.7%. The optimal cutoff value for LODS score was 9.5 points, with a sensitivity of 55.6% and specificity of 80.8%. The combined prediction had an AUC of 0.872, with a sensitivity of 83.3% and specificity of 77.8% (P<0.01).

The combination of RDW/PLT and LODS score has clinical significance in predicting disease severity in patients with sepsis complicated by pneumonia.

To investigate the incidence and related factors of cough among troops stationed in Xinjiang, analyze its triggers and accompanying symptoms, and provide a basis for formulating targeted protective measures.

A total of 3898 officers and soldiers from a unit stationed in Xinjiang were selected as survey subjects from April to June 2022. A cluster sampling method was used for questionnaire surveys, collecting information on basic demographics, cough occurrence, triggers, and accompanying symptoms. Statistical analysis was performed using SPSS 26.0 software, employing χ² tests and Logistic regression analysis to explore factors associated with cough.

A total of 3 856 valid questionnaires were collected (98.92%). Among the respondents, 3 229 (83.74%) were non-cough individuals and 627 (16.26%) were cough individuals. The types of cough were acute cough in 499 individuals (79.58%), subacute cough in 67 (10.69%), and chronic cough in 61 (9.73%). Univariate analysis showed that age, altitude, duration of residence, history of tobacco exposure, history of solid fuel contact, history of occupational exposure, and history of catkin and pollen exposure were associated with cough occurrence (P<0.05). Multivariate Logistic regression analysis indicated that age ≥30 years (OR=2.002, 95%CI: 1.480~2.708), altitude >5 000 m (OR=5.277, 95%CI: 3.944~7.061), history of tobacco exposure (OR=1.288, 95%CI: 1.046~1.586), history of occupational exposure (OR=1.543, 95%CI: 1.208~1.970), and history of catkin and pollen exposure (OR=2.137, 95%CI: 1.738~2.627) were risk factors for cough; while a duration of residence ≥3 months was a protective factor (OR=0.644~0.662). Among accompanying symptoms, foreign body sensation (56.31%~65.67%), nasal congestion, expectoration, and sore throat were common. The distribution of accompanying symptoms differed significantly among different types of cough (P<0.05).

The occurrence of cough among troops stationed in Xinjiang is related to high altitude, tobacco exposure, occupational exposure, catkin and pollen, among other factors, while a longer duration of residence has a certain protective effect. Health education should be strengthened, the living environment improved, and necessary protection provided to reduce the incidence of cough and safeguard the health of the officers and soldiers.

Nontuberculous Mycobacteria pulmonary disease (NTM-PD) is a chronic infectious lung disease caused by these bacteria, which has seen a significant rise in cases lately. This study aims to reveal the demographic characteristics, imaging findings, and pathogen distribution patterns of NTM-PD patients by looking back at clinical data.

It was selected that 205 patients diagnosed with NTM-PD at Xi′an Chest Hospital between June 2023 and May 2025. All participants met the diagnostic criteria from the Tuberculosis Branch of the Chinese Medical Association. It was extracted that data from the hospital′s electronic medical record system. This included patients′age, gender, medical history, comorbidities, clinical symptoms, imaging findings, and microbiological results.

Among the 205 patients, male 121 cases (59.02%) and female 84 cases (40.98%); 153 cases were aged ≥50 years (74.63%). Among the patients, 27 cases (13.17%) had a history of tuberculosis, 36 cases (17.56%) had concurrent bronchiectasis, and 25 cases (12.20%) had chronic obstructive pulmonary disease (COPD). Other comorbidities included abnormal blood glucose (including diabetes, impaired glucose tolerance, and hyperglycemia), hepatitis, pneumoconiosis, and tumors. Among males, 22 cases (18.18%)with COPD higher than 3 cases (3.57%) in females. Females also had 20 cases (23.81%) of bronchiectasis higher than 16 cases (13.22%) in males (P<0.05). The main symptoms were cough in 169 cases (82.44%), expectoration in 151 cases (73.66%), dyspnea in 79 cases (38.54%), chest tightness in 54 cases (26.34%), fever in 39 cases (19.02%), chest pain in 22 cases (10.73%), and hemoptysis in 32 cases (15.61%). The incidence of fever was higher in males 30 cases(24.79%) than in females 9 cases(10.71%) (P<0.05). The imaging features of thorax were nodular 124 cases(60.49%) and cavity (74 cases, 36.10%), and other common features were bronchiectasis, lymphadenopathy, pleural effusion, pneumothorax, etc.The number of lung cavities was 62 cases in males (51.24%) and 12 cases in females (14.29%). The number of bronchiectasis was 31cases in females (36.90%) and 29 cases in males (23.97%)(P<0.05). The etiology was mainly intracellular mycobacteria 79 cases(38.54%), followed by Mycobacterium abscessus 38 cases(18.54%), Mycobacterium kansasii 30 cases(14.63%) and Mycobacterium avium 14 cases(6.83%).The proportions of Mycobacterium abscessus, Mycobacterium kansasii, and Mycobacterium avium were significantly different between males and females (P<0.05).

There are gender differences in the clinical characteristics and pathogen distribution of NTM-PD patients, emphasizing the need for early identification, which can help tailor treatments, and suggesting that more research is needed on its epidemiological features and treatment strategies.

Analyze the therapeutic effect of bedaquiline combined with enteral nutrition support on multi-drug-resistant pulmonary tuberculosis (MDR-PTB).

The clinical data of 57 MDR-PTB patients admitted to our hospital were collected and divided into an observation group with 26 cases and a control group with 31 cases according to the treatment methods. Patients in the control group received conventional anti-tuberculosis treatment (levofloxacin, linezolid, clofazimine, cycloserine, and pyrazinamide) combined with enteral nutrition support (oral enteral nutrition powder 500~1 000 ml/d, with appropriate supplementary homogenate meals such as milk and vegetable puree, for 24 consecutive weeks). Patients in the observation group, on the basis of the control group′s regimen, took bedaquiline fumarate tablets orally, with an initial dose of 400 mg/d for 2 consecutive weeks, then reduced to 200 mg per dose, 3 times a week, for 22 consecutive weeks. The clinical efficacy, sputum smear conversion of Mycobacterium tuberculosis, serum immune function indexes [immunoglobulin (Ig) A, IgG, IgM, the ratio of CD4⁺ /CD8⁺ T lymphocytes], pulmonary function indexes [forced expiratory volume in the first second (FEV₁), peak expiratory flow (PEF), percentage of FEV₁ to predicted value (FEV₁%)], computed tomography (CT) signs [thick-walled cavity, calcification shadow, pulmonary consolidation and pleural thickening], nutritional status [hemoglobin (Hb), total lymphocyte count (TLC), albumin (ALB) level and Short Form 36 Health Survey Questionnaire (SF-36) score] and the occurrence of adverse reactions were compared between the two groups.

The clinical efficacy of the observation group was 23 cases (88.46%), which was higher than 19 cases (61.29%) in the control group. The sputum smear negative conversion rate, sputum culture negative conversion rate, IgA, IgG, IgM, the CD4⁺ /CD8⁺ ratio, PEF, FEV₁, FEV₁%, TLC, Hb, ALB levels and SF-36 scores of the observation group were (84.62%), (80.77%), (3.91±0.82) g/L, (20.18±3.97) g/L, (2.57±0.34) g/L, (1.41±0.16), (6.91±1.23) L/s, (1.41±0.22) L, (80.83±9.58)%, (1.94±0.47)×10⁹/L, (117.52±19.68) g/L, (40.14±8.75) g/L, (78.15±12.29) points respectively, all of which were higher than those of the control group [(67.74%), (61.29%), (3.32±0.79) g/L, (17.94±2.68) g/L, (2.31±0.48) g/L, (1.29±0.14), (6.28±1.07) L/s, (1.28±0.19) L, (75.19±9.64)%, (1.68±0.42)×10⁹/L, (105.73±21.56) g/L, (35.29±7.63) g/L, (71.03±13.48) points]. The incidences of thick-walled cavity, calcification shadow, pulmonary consolidation and pleural thickening in the observation group were 23.08%, 15.38%, 11.54%, 15.38% respectively, which were lower than those in the control group 48.39%, 45.16%, 38.71%, 41.94%, (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Bedaquiline combined with enteral nutrition support therapy has an obvious efficacy in the treatment of MDR-PTB, which can improve the nutritional status of patients, regulate the immune function, promote the recovery of the pulmonary structure and function of patients, and the safety feature is of significant importance.

To investigate the factors influencing postoperative pain in patients with nonsmall cell lung cancer (NSCLC) after thoracoscopic surgery.

Eightyseven non-small cell lung cancer patients who underwent thoracoscopic lobectomy in our hospital from April 2023 to May 2025 were selected. They were followed up for 3 months after surgery and divided into groups according to the numeric rating scale (NRS) score: 40 patients with postoperative pain (NRS>3) were assigned to the observation group, and 47 patients without pain (NRS≤3) were assigned to the control group. Clinical data and perioperative indicators were compared between the two groups.

Among the 87 patients, 40 cases(45.98%) experienced pain at 3 months after surgery. The observation group had a higher proportion of preoperative chestback pain 15 cases (37.50%), higher postoperative analgesic dosage (28.58±3.88)mg, and longer hospital stay (13.18±2.48)d compared with the control group [preoperative chestback pain 5 cases (10.64%), postoperative analgesic dosage (22.75±4.02) mg, hospital stay(9.91±1.80)d (P<0.05). Logistic regression analysis showed that preoperative chestback pain (OR=6.620, 95%CI: 1.511~28.992), postoperative analgesic dosage (OR=1.269, 95%CI: 1.055~1.526), and hospital stay (OR=1.716, 95%CI: 1.222~2.409) were influencing factors for postoperative pain in non-small cell lung cancer patients after thoracoscopic surgery (P<0.05). Preoperative chest and back pain, postoperative analgesic dosage, and hospital stay predicted the area under the receiver operating characteristic (ROC) curve for postoperative pain in patients with non-small cell lung cancer undergoing thoracoscopic surgery, with values of 0.634, 0.855, and 0.853, respectively. The combined prediction of the three factors yielded an AUC of 0.918 (95%CI: 0.853~0.983), which was superior to the individual prediction of preoperative chestback pain (Z=5.926, P=0.000), postoperative analgesic dosage (Z=2.188, P=0.029), or hospital stay (Z=2.107, P=0.035).

Preoperative chestback pain, postoperative analgesic dosage, and hospital stay are influencing factors for pain at 3 months after thoracoscopic surgery in non-small cell lung cancer patients, and their combined prediction has clinical significance.

To analyze the current status and epidemiological characteristics of different pathogen infections in the respiratory tract of children, providing reference for clinical diagnosis and treatment, as well as for the prevention and control of respiratory infectious diseases in children.

A total of 39, 025 children diagnosed with respiratory tract infections in our hospital from March 2024 to February 2025 were selected. Pharyngeal swab specimens were collected from these children, and nucleic acid testing for six respiratory pathogens was performed using the Natch 48 nucleic acid extraction method. The pathogens tested were Mycoplasma pneumoniae(MP), Influenza B virus (FluB), Influenza A virus (FluA), Respiratory syncytial virus (RSV), Adenovirus (ADV), and Human rhinovirus (HRV).

Among the 39 025 children tested, pathogens were detected in 22 867 cases (58.5%). Among these, single pathogen infections were found in 19 523 cases (85.38%), and mixed pathogen infections were found in 3 344 cases (14.62%). The distribution of the six pathogens among positive cases was as follows: ADV in 6 373 cases (32.64%), HRV in 4 745 cases (24.30%), MP in 4 050 cases (20.75%), FluA in 2 293 cases (11.75%), RSV in 1 346 cases (6.89%), and FluB in 716 cases (3.67%). Among children aged one month to one year, 1 528 pharyngeal swabs were tested, with 730 positive cases (47.77%). Among children aged >1 to 3 years, 5 224 were tested, with 3 950 positive cases (75.61%). Among children aged >3 to 6 years, 17 887 were tested, with 7 372 positive cases (41.21%). Among 7-year-old children, 14 386 were tested, with 7 471 cases (51.93%). Among children living in home-based care settings, 6 752 were tested, with 4 963 positive cases (73.50%). Among children attending kindergarten, 32 273 were tested, with 14 827 positive cases (45.94%). The difference in positive detection rates among children of different age groups was statistically significant (P<0.001). By season, 8 406 tests were performed in spring, with 4 032 positive cases (47.97%); 10 756 tests in summer, with 5 818 positive cases (54.09%); 9 714 tests in autumn, with 4 934 positive cases (50.79%); and 10 149 tests in winter, with 4 739 positive cases (46.69%). The difference in positive detection rates among children across different seasons was statistically significant (P<0.001).

The most common single pathogens causing respiratory infections in children are ADV, HRV, and MP. Mixed respiratory pathogen infections frequently involve combinations of HRV and ADV, as well as HRV and MP, which should receive clinical attention. Prevention and control measures should be formulated based on epidemiological characteristics to reduce the incidence of respiratory pathogen infections in children.

To analyze the efficacy of tislelizumab following stereotactic body radiation therapy (SBRT) in patients with metastatic non-small-cell lung cancer (mNSCLC).

Retrospective data were collected from 112 mNSCLC patients treated at our hospital between January 2021 and December 2024. Patients were divided into control group 59 cases and observation group 53 cases based on treatment regimens. Chemotherapy was initiated 14 days after SBRT. The control group received carboplatin AUC 5~6 + paclitaxel 175 mg/m² or pemetrexed 500 mg/m² intravenously on day 1, repeated every 3 weeks until disease progression or intolerable toxicity. The observation group received tislelizumab 200 mg intravenously every 3 weeks. Clinical efficacy, tumor marker levels, T lymphocyte subsets and cytokine levels, pulmonary function, CT findings, adverse events, and survival outcomes were compared between the two groups.

No significant differences were observed in objective response rate (ORR), disease control rate (DCR), or incidence of adverse events between the observation and control groups (P>0.05). After treatment, the observation group showed lower levels of carcinoembryonic antigen (CEA) (14.93±3.48) ng/ml, cytokeratin 19 fragment antigen21-1 (CYFRA21-1) (8.17±3.03) ng/ml, carbohydrate antigen 50 (CA50) (10.85±2.96) U/ml, regulatory T cells (Treg) (2.39±0.68)%, interleukin-5(IL-5) (20.74±2.76) pg/ml, arterial phase normalized iodine concentrations (NICAP) 0.17±0.05, venous phase normalized iodine concentrations (NICVP) 0.44±0.11, and slope of spectral Hu curve (s-SHC) 1.48±0.33 compared to the control group (16.54±3.29) ng/ml, (9.62±3.28) ng/ml, (12.33±3.07) U/ml, (2.78±0.76)%, (22.13±3.49) pg/ml, (0.20±0.06), (0.49±0.12), and ( 1.62±0.29) (P<0.05). The observation group exhibited higher CD4⁺ T cells (CD4⁺ )/ CD8⁺ T cells (CD8⁺ ) 0.71±0.16, interferon-γ (IFN-γ) (54.26±6.51) pg/ml, forced expiratory volume in one second (FEV₁) (2.38±0.32) L, peak expiratory flow (PEF) (2.62±0.46) L/s, maximal mid-expiratory flow curve (MMEF) (2.12±0.34) L/s, median progression-free survival (PFS) 14.3 months, survival rate 47.17%, and median overall survival (OS) 24.6 months compared to the control group 0.64±0.14, (51.32±6.48) pg/ml, (2.22±0.29) L, (2.43±0.39) L/s, (1.96±0.31) L/s, 11.0 months, 28.81%, and 20.5 months (P<0.05).

Tislelizumab after SBRT reduces tumor marker levels, modulates immune function, improves pulmonary function, and enhances survival outcomes in mNSCLC patients with a favorable safety profile.

To analyze the value of mean platelet volume/platelet count ratio (MPR) and lactate/albumin ratio (LAR) combined for predicting the prognosis of patients with severe pneumonia.

A total of 119 patients with severe pneumonia admitted to our hospital from January 2020 to December 2024 were retrospectively selected as study subjects. According to the survival status of patients, they were divided into good prognosis group (survival) and poor prognosis group (death). Clinical data and MPR and LAR values of the two groups were collected and compared. Pearson correlation analysis was used to explore the correlation between MPR, LAR and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores in patients with severe pneumonia. Multivariate logistic regression analysis was used to identify the influencing factors for poor prognosis in patients with severe pneumonia. Receiver operating characteristic (ROC) curves and decision curve analysis were drawn to evaluate the value and clinical net benefit of MPR, LAR, and their combined application for predicting poor prognosis in patients with severe pneumonia.

Among 119 patients with severe pneumonia, 88 cases survived and 31 cases died after treatment. The APACHE Ⅱscore[(19.76±4.01)vs.(25.59±3.38)], D-D[(3.89±1.06)μg/ml vs.(4.35±1.19)μg/ml], CRP[(102.75±26.15)mg/L vs.(114.56±30.12)mg/L], PCT[(7.23±1.56)ng/ml vs.(8.91±2.64)ng/ml], MPR[(4.58±0.90)vs.(5.73±1.15)], LAR[(0.05±0.01)vs.(0.09±0.03)] of survivors and the dead, with statistically significant differences were found in comparison(P<0.05). Pearson correlation analysis showed that MPR and LAR were both positively correlated with APACHE Ⅱ scores in patients with severe pneumonia (P<0.05). Logistic regression analysis showed that after adjusting for other confounding factors, MPR (OR=2.962, 95%CI: 1.674~5.242) and LAR (OR=13.045, 95%CI: 3.899~43.649) were still independent risk factors for poor prognosis in patients with severe pneumonia (P<0.05). ROC curves showed that MPR and LAR had clinical significance in predicting the prognosis of patients with severe pneumonia, and the AUC of combined prediction was higher than that of single indicator prediction (P<0.05). Decision curve analysis results showed that MPR combined with LAR prediction could obtain maximum clinical benefit when the threshold probability was 0.30~0.65.

MPR and LAR are closely related to the condition and prognosis of patients with severe pneumonia, and their combined detection has higher efficacy in predicting poor prognosis of patients.

To investigate the clinical application value of rigid bronchoscopy combined with flexible bronchoscopy in the removal of bronchial foreign bodies.

A retrospective analysis was conducted on 59 patients with bronchial foreign bodies admitted to our hospital from January 2010 to June 2024. Foreign bodies were removed using rigid bronchoscopy combined with flexible bronchoscopy. Clinical data were collected to compare the types, locations, endoscopic findings, removal methods, and prognosis of the bronchial foreign bodies.

Among the 59 patients, there were 41 males and 18 females, aged 2 to 87 years. The longest duration of a foreign body was 27 years, and the shortest was 1 day. Clinical presentations included recurrent pneumonia in 16 cases (27.12%), hemoptysis in 6 cases (10.17%) and asymptomatic discovery via imaging in 8 cases (13.56%). Endoscopy revealed varying degrees of airway stenosis accompanying the foreign body in 58 cases (98.31%), with no stenosis in 1 case (1.69%). Types of foreign bodies included bony objects in 18 cases, plant-based objects in 17 cases (chili pepper, peanut, melon seed, soybean), metal objects in 5 cases (suona mouthpiece, long steel nail), plastic objects in 5 cases (whistle, ballpoint pen cap), teeth or dentures in 4 cases, pills/drug capsules in 2 cases, and medical glue, earplug, and activated charcoal in 1 case each. Five cases involved foreign bodies of unknown nature. The longest foreign body was a fish bone, measuring 6.0 cm. Diagnosis was confirmed by chest CT and flexible bronchoscopy. Successful removal was achieved in 58 cases (98.31%), with 1 case not removed. Among the 58 successful cases, a single interventional technique was used in 41 cases: biopsy forceps 21 cases, cryoextraction with CO₂ 4 cases, snare 8 cases, foreign body forceps 4 cases, foreign body basket 3 cases, rigid forceps 2 cases. Two interventional techniques were used in 14 cases, and three or more techniques were used in 4 cases.

The application of rigid bronchoscopy combined with flexible bronchoscopy for the treatment of bronchial foreign bodies allows for rapid removal, alleviation of airway stenosis, and improvement of clinical symptoms. It is efficient, safe, has a high success rate, and holds promising clinical application prospects.

To investigate the clinical manifestations and diagnosis of Epstein-Barr virus (EBV)-associated pulmonary lymphomatoid granulomatosis (PLG) complicated with hemophagocytic syndrome (HPS).

We retrospectively analyzed the clinical features, laboratory findings, and treatment course of a patient with EBV-associated PLG and HPS, along with a literature review.

A 66-year-old female presented with fever, cough, and cutaneous nodular ecchymosis. The comprehensive examination revealed multiple nodules in both lungs, mediastinal lymphadenopathy, and splenomegaly; blood routine test: white blood cell count 2.15×10⁹/L, hemoglobin 77 g/L, platelet count 67×10⁹/L; C-reactive protein (CRP) 24.98 mg/L, erythrocyte sedimentation rate 35mm/1 h, ferritin>2 000.00μg/L, interleukin-2 receptor 7 500.00 U/ml, Epstein-Barr virus quantification positive, hepatitis B surface antigen, hepatitis B e antibody, and hepatitis B core antibody positive; bronchoalveolar lavage fluid next-generation sequencing(NGS) indicated Epstein-Barr virus positivity; bone marrow aspiration showed decreased platelet count and a bone marrow picture. Lung tissue biopsy immunohistochemistry (IHC) shows CD20(+ ) and Ki-67(+ ). Special stains: PAS (-) and PASM (-). In situ hybridization: EBER (+ ). The final pathological diagnosis suggests lymphomatoid granulomatosis cannot be excluded. The final diagnosis included HPS, PLG, EBV infection, chronic hepatitis B, and pulmonary infection. Initial treatment with anti-infectives, anti-inflammatory agents, and antivirals led to symptomatic improvement. However, the patient experienced recurrent pulmonary infections post-discharge. Ten months after onset, she was readmitted for fever and cough, and repeat lung biopsy confirmed B-cell lymphoma, prompting referral to hematology.

This report describes a rare case of EBV-associated PLG progressing to B-cell lymphoma with concurrent HPS. The findings aim to enhance clinicians′awareness of this disease entity.

To analyze the clinical manifestations, diagnostic strategies, and treatment options for eosinophilic granulomatosis with polyangiitis (EGPA), and to improve the early recognition and diagnostic capability of eosinophilic granulomatosis with polyangiitis. Additionally, to explore the efficacy of Mepolizumab monotherapy in patients with antineutrophil cytoplasmic antibody (ANCA)-negative eosinophilic granulomatosis with polyangiitis.

A case of antineutrophil cytoplasmic antibody-negative eosinophilic granulomatosis with polyangiitis admitted to our department on July 26, 2024, was selected. The symptoms, signs, laboratory tests, imaging findings, and treatment process were analyzed, and a literature review was conducted.

The patient was a 43-year-old female admitted due to recurrent wheezing and shortness of breath for over 30 years, along with the discovery of a pulmonary shadow for more than one month. She had a medical history of bronchial asthma, chronic sinusitis, and nasal polyps. Auxiliary examinations showed a peripheral white blood cell count of 8.74×10⁹/L, an absolute eosinophil count of 0.90×10⁹/L, an erythrocyte sedimentation rate of 31 mm/1h, and an elevated eosinophil proportion in bronchoalveolar lavage fluid to 76%. Total cholesterol 6.70 mmol/L, LDL cholesterol 3.98 mmol/L, Lipoprotein (a) 344.0 mg/L, Triglycerides 2.64 mmol/L. IgM positive (1.00 COI), IgG significantly elevated (>300.00 AU/ml). Antineutrophil cytoplasmic antibody testing was negative. Pathological biopsy of the right middle lung lobe revealed eosinophil infiltration in the lung tissue. A diagnosis of antineutrophil cytoplasmic antibody-negative eosinophilic granulomatosis with polyangiitis was considered. The patient was treated with Mepolizumab monotherapy for maintenance. Follow-up outpatient examinations showed a decrease in eosinophil count, and chest CT revealed significant absorption of the pulmonary lesions.

Patients with a long-term history of asthma and persistently elevated peripheral blood eosinophil levels should be alert to the possibility of eosinophilic granulomatosis with polyangiitis. Mepolizumab can serve as an effective maintenance treatment for antineutrophil cytoplasmic antibody-negative eosinophilic granulomatosis with polyangiitis.