ABSTRACT
@#Objective To investigate the diagnostic value and safety of electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound in peripheral pulmonary nodules. Methods The clinical imaging, surgical and pathological data of 60 patients with 76 peripheral pulmonary nodules who underwent electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound guided biopsy in the Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from June 2020 to June 2021 were retrospectively analyzed. The diagnosis rate and complications were analyzed and summarized. The 76 pulmonary nodules were divided into a small pulmonary nodules group (10 nodules, diameter≤1 cm) and a pulmonary nodules group (1 cm<diameter≤3 cm, 66 nodules) according to diameter. The two groups were compared in terms of operation and diagnosis rate. Results Pulmonary nodules diameter was 1.8±0.6 cm, operation time 29.8±8.6 min, navigation 2.9±0.9 times, biopsy 9.5±1.9 pieces. In the 76 pulmonary nodules, 55 were confirmed by pathology, with a total diagnosis rate of 72.4%, including 32 of malignant lesions and 23 of benign lesions. In the 76 pulmonary nodules, 59 had grade 0 hemorrhage, 17 had grade 1 hemorrhage, and none had grade 2 or more serious hemorrhage. Eight patients developed pneumothorax after surgery, and the degree of lung compression was less than 30%, which was improved after symptomatic treatment with oxygen inhalation. The operation time in the small pulmonary nodules group was significantly longer than that in the pulmonary nodules group, and there was no significant difference in diagnosis rate or complications between the two groups. Conclusion Electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound is a safe and effective method for the diagnosis of periphery pulmonary nodules, and it also has a high diagnostic rate for small pulmonary nodules (≤1 cm), which is worthy of clinical promotion and application.
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<p><b>BACKGROUND</b>Giant cell interstitial pneumonia (GIP) was a rare form of pneumoconiosis, associated with exposure to hard metals, which had been reported mostly as isolated case reports. We described eight cases of GIP diagnosed in our hospital during the past seven years, with particular reference to new findings.</p><p><b>METHODS</b>Eight patients with GIP confirmed by biopsy in the Nanjing Drum Tower Hospital affiliated to Medical School of Nanjing University from 2005 to 2011 were retrospectively analyzed. For each patient, the occupy histories and medical records were thoroughly reviewed and clinic data were extracted. Two radiologists, without knowledge of any of the clinical and functional findings, independently reviewed the HRCT scans of all patients. Follow-up data were collected.</p><p><b>RESULTS</b>Among the eight patients, seven had a history of exposure to hard metal dusts, one denied an exposure history. The most common manifestations were cough and dyspnea. One patient initiated with pneumothorax and another pleural effusion, both of which were uncommon to GIP. The main pathologic appearances were the presence of macrophages and multinucleated giant cells in the alveolar space. The clinical symptoms and radiographic abnormalities were obviously improved after cessation of exposure and receiving corticosteroid treatments, recurrences were observed in two patients when they resumed work. In spite of exposure cessation and corticosteroid treatment, one patient developed pulmonary fibrosis at seven years follow-up.</p><p><b>CONCLUSIONS</b>Awareness of the patients' occupational history often provided clues to the diagnosis of GIP. Histopathologic examinations were necessary to establish the right diagnosis. Exposure cessation was of benefit to most patients; however, pulmonary fibrosis was possible in spite of exposure cessation and corticosteroid treatment. Better ways should be found out to improve the outcome and quality of life.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Alloys , Toxicity , Cobalt , Toxicity , Lung , Pathology , Lung Diseases, Interstitial , Diagnosis , Pulmonary Fibrosis , Diagnosis , Retrospective Studies , Tungsten , ToxicityABSTRACT
Objective To investigate the association among daytime sleepiness,serum tumor necrosis factor(TNF)-α levels and microarousal in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Forty male patients with OSAHS conformed by apnea hypopnea index(AHI)during sleep monitoring of polysomnography were selected as OSAHS group,15 healthy subjects were selected as control group.The level of serum TNF-α was measured by ELISA.The Epworth sleepiness(EP)scale was used in two groups.Results The level of serum TNF-α in OSAHS group[(18.42±6.23)ng/L]was significantly higher than that in control group[(9.75±3.12)ng/L],P＜0.01.The EP scale and micmarousal index were signifieand yhigher in OSAHS group than those in control group[(16.9±4.7)acores vs(4.5±2.3)dcores,(33.6±16.9)times/h vs(11.3±7.3)times/h,P＜0.01].The EP scale in OSAHS group was positively correlated with the levels of serum TNF-α(r=0.461,P＜0.01),AHI(r=0.443,P＜0.01)and microarousal index(r=0.751,P＜0.01)respectively.The levels of serum'INF-α in patients with OSAHS were also positively correlated with microarousal index(r=0.373,P＜0.01).Conclusions The levels of serum TNF-α and mieroarousal index are increased in patients with 0SAHS.The microarousal related to OSAHS plays an important role on the daytime sleepiness,the unusual levels of serum TNF-α maybe lead to interferen of sleepiness.