Asociación del complejo ring-sling con pig bronchus: a propósito de un caso pediátrico / Ring-sling complex association with pig bronchus: a pediatric case report

El complejo ring-sling es una asociación entre el sling de la arteria pulmonar y la estenosis traqueal congénita por anillos traqueales completos. El sling de la arteria pulmonar es una forma rara de anillo vascular dentro de las cardiopatías congénitas. Se presenta el caso clínico de un niño con estridor laríngeo asociado a dificultad respiratoria evaluado en otro centro, donde se realizó endoscopia respiratoria y se observó compresión traqueal extrínseca. Ante la sospecha clínica de anillo vascular, se solicitó angiotomografía computada (angioTC) y se confirmó diagnóstico de sling de arteria pulmonar. Fue derivado a nuestro hospital y durante la intervención quirúrgica se realizó nueva endoscopia respiratoria y traqueobroncografía. Se llegó al diagnóstico de estenosis traqueal congénita con bronquio derecho accesorio (pig bronchus) y anillos vasculares completos, ambos reparados en el mismo acto quirúrgico.

The ring-sling complex is an association between pulmonary artery sling and congenital tracheal stenosis. Pulmonary artery sling is a rare form of vascular ring in congenital heart disease. The clinical case of a child with inspiratory laryngeal stridor associated with respiratory distress is presented, evaluated in another center where respiratory endoscopy was performed, observing extrinsic tracheal compression. Given the clinical suspicion of a vascular ring, CT angiography was requested, confirming the diagnosis of pulmonary artery sling. He was referred to our hospital and during the surgical intervention a new respiratory endoscopy and tracheobronchography were performed, reaching the diagnosis of congenital tracheal stenosis, right accessory bronchus (pig bronchus) and complete vascular rings, both repaired in the same surgical act.

Clinical efficacy of Bacille Calmette-Guerin polysaccharide nucleic acid combined with montelukast in the treatment of bronchial asthma and its effect on lung function and serum inflammatory factor level / 中国基层医药

Objective:To investigate the clinical efficacy of Bacille Calmette-Guerin polysaccharide nucleic acid combined with montelukast in the treatment of bronchial asthma and its effect on lung function and serum inflammatory factor level.Methods:Eighty patients with bronchial asthma who met inclusion criteria and received treatment in The First People's Hospital of Huzhou from January 2019 to December 2020 were included in this study. They were randomly assigned to undergo either routine systematic treatment and oral montelukast (control group, n = 40) or routine systematic treatment, oral montelukast, and intramuscular injection of Bacille Calmette-Guerin polysaccharide nucleic acid in combination (combined group, n = 40). The changes in serum inflammatory factors and pulmonary function after treatment relative to before treatment, clinical efficacy and adverse reactions were compared between the two groups. Results:Total response rate in the control and combined groups was 80.00% (32/40) and 95.00% (38/40) respectively. Total response rate in the combined group was significantly higher than that in the control group ( χ2 = 4.11, P = 0.043). There were no significant differences in peak expiratory flow rate, forced expiratory volume in 1 second, maximum voluntary ventilation, forced vital capacity, airway resistance and forced expiratory volume in 1 second/forced vital capacity between the two groups before treatment (all P > 0.05). In the combined group, peak expiratory flow rate, forced expiratory volume in 1 second,forced expiratory volume in 1 second/forced vital capacity, maximum voluntary ventilation and forced vital capacity were significantly increased, and airway resistance was significantly decreased after treatment compared with before treatment ( t = -4.81, -5.09, -7.39, -4.12, -7.14, 5.17, all P < 0.001). After treatment, clinical efficacy in the combined group was superior to that in the control group. Before treatment, there were no significant differences in the St George's Respiratory Questionnaire score and Asthma Control Test score between the two groups (both P > 0.05). After treatment, St George's Respiratory Questionnaire score in the combined group was significantly decreased, while Asthma Control Test score was significantly increased compared with before treatment ( t = 9.19, -3.44, both P < 0.001). Before treatment, there were no significant differences in serum interleukin-4, interleukin-5, and interferon-γ levels between the two groups (all P > 0.05). After treatment, serum levels of interleukin-4, interleukin-5, and interferon-γ in the combined group were significantly lower than those in the control group ( t = 6.95, 4.72, -11.24, all P < 0.001). No drugs-related adverse reactions were found in each group during the treatment period. Conclusion:Bacille Calmette-Guerin polysaccharide nucleic acid combined with montelukast is highly effective on bronchial asthma. The combined therapy can improve quality of life and lung function, decrease serum inflammatory factor levels, and is safe.

Effects of one-lung ventilation with a laryngeal mask airway combined with a bronchial blocker on respiratory function in older adult patients undergoing thoracoscopic surgery / 中国基层医药

Objective:To investigate the effects of one-lung ventilation with a laryngeal mask airway combined with a bronchial blocker on respiratory function in older adult patients undergoing thoracoscopic surgery.Methods:Sixty older adult patients who underwent thoracoscopic surgery in Zhejiang Veteran Hospital from January 2019 to December 2020 were included in this study. They were randomly divided into a single group (a simple bronchial blocker) and a combined group (a bronchial blocker combined with a laryngeal mask airway), with 30 patients in each group. Awakening (time to extubation, spontaneous respiration and eye opening), respiratory function [peripheral oxygen saturation, vital capacity, maximum voluntary ventilation measured before and 3 days after surgery], hemodynamics [heart rate and mean arterial pressure were recorded before (T 1) and immediately after placement of a bronchial blocker or a laryngeal mask (T 2) and at the time of removal of a bronchial block or a laryngeal mask (T 3)], and adverse events (hoarseness, throat pain, dysphagia and choking) were recorded. Results:Time to extubation, time to spontaneous respiration, and time to eye opening in the combined group were (5.62 ± 1.23) minutes, (6.85 ± 1.34) minutes, and (7.34 ± 1.52) minutes, respectively, which were significantly shorter than (8.62 ± 1.55) minutes, (10.25 ± 1.78) minutes, (11.38 ± 1.85) minutes in the single group ( t = 9.94, 10.00, 11.06, all P < 0.05). At 3 days after surgery, peripheral oxygen saturation, vital capacity, and maximum voluntary ventilation in the combined group were (98.23 ± 1.05)%, (2.18 ± 0.60) L, (54.23 ± 5.36) L, respectively, which were significantly higher than (96.23 ± 1.01)%, (1.82 ± 0.50) L, (48.12 ± 4.23) L in the single group ( t = 7.51, 2.52, 4.90, all P < 0.05). Mean arterial pressure measured at T 3 was significantly lower in the combined group than that in the single group [(98.25 ± 2.32) mmHg vs. (93.35 ± 2.48) mmHg, t = 7.90, P < 0.05]. The incidences of hoarseness, throat pain and choking in the combined group were 6.66% (2/30), 10.00% (3/30), 6.66% (2/30), respectively , which were significantly lower than 33.33% (10/30), 43.33% (13/30), 43.33% (13/30) in the single group (χ 2 = 6.66, 8.52, 10.75, all P < 0.05). There was no significant difference in the incidence of dysphagia between the two groups ( P > 0.05). Conclusion:Use of a laryngeal mask airway combined with a bronchial blocker during thoracoscopic surgery in older adult patients facilitates postoperative recovery, has little impact on hemodynamics, and is highly safe.

Congenital extralobar pulmonary sequestration supplied by pulmonary artery: a case report / 中华围产医学杂志

We report the clinical features of a case of congenital extralobar pulmonary sequestration in the left upper lobe supplied by the pulmonary artery. Prenatal ultrasound examination at 24 weeks of gestation revealed a high echogenic and uniform density mass in the fetal left thoracic cavity with the congenital pulmonary airway malformation volume vatio (CVR) of 1.16, which was supplied by pulmonary arterial vessels. MRI examination at 27 weeks indicated that the left lung volume increased to about 48.52 ml, while the right lung volume was about 8.56 ml giving the total lung volume of 57.08 ml. The congenital pulmonary airway malformation in the left upper lobe was suspected to be congenital bronchial atresia (CBA) or congenital lobar overinflation (CLO). The baby boy was born through vaginal delivery assisted by forceps at 38 +1 weeks without neonatal asphyxia. Postnatal CT and MRI were both indicated suspicious bronchial atresia in the left upper lobe. Bronchofibroscopy on postnatal day 2 excluded CBA or CLO and extralobar pulmonary sequestration was considered. Thoracoscopic surgery was performed due to continuous shortness of breath after birth, despite two-week conservative treatment including oxygenation, invasive and non-invasive mechanical ventilation,etc, and congenital extralobar sequestration was diagnosed. Blood supply from the left pulmonary artery was observed at the base of abnormal lung tissue. Resection of the pathogenic tissue of the left lung was performed thoracoscopically. The boy recovered and was discharged after the operation. Pulmonary sequestration was confirmed by histopathology.

Study on Anisotropy Properties of in vitro Pig Trachea and Numerical Simulation / 医用生物力学

Objective To study mechanical properties of the anisotropy for pig trachea and main bronchi, and determine the constitutive model of trachea deformation by finite element numerical simulation. Methods The pig tracheas were collected and cut through in their axial directions and expanded into two-dimensional planes. Then, by setting the length direction of the trachea aortas as 0°, each planar trachea was anticlockwisely cut into 6 samples with orientation of 30°,60°,90°,120°,150° and 180°, respectively. Uniaxial tensile tests were applied on the specimen in 6 angular directions by using the electronic universal test machine, to obtain stress and strain of the specimen in different directions. Nonlinear fitting to the experimental data was performed by using the Mooney-Rivilin hyperelastic model, in order to obtain the material characteristic parameters. Finite element models of the trachea and the main bronchi were established, and tensile numerical simulation was carried out.Results Samples at different angles showed different stress-strain curves. In the trachea, the stresses of samples with angle of 30°, 120° and 150° were in the range of 1.0-1.5 MPa, the stresses of samples with angle of 60° and 90° were in the range of 0.5-1.0 MPa, and the stresses of samples with angle of 180° were in the range of 2.5-3.0 MPa. In the main bronchi, the stresses of samples with angle of 30°, 120° and 150° were in the range of 0.8-1.0 MPa, the stresses of samples with angle of 90° and 180° were in the range of 1.4-1.8 MPa, and the stresses of samples with angle of 120° were in the range of 0.4-0.6 MPa. There was an obvious difference between the trachea and the main bronchi. The finite element simulation verified that the Mooney-Rivilin constitutive model was suitable for describing small deformation behavior of the trachea. Conclusions The pig trachea exhibits strong anisotropy. Meanwhile, the Mooney-Rivilin model can characterize small tracheal deformations. The results provide theoretical references for tracheal resection and reconstruction in clinical treatment and intervention with surgical instruments such as bronchoscopy.

Tomographic findings in bronchial atresia / Achados tomográficos na atresia brônquica

Abstract Objective: To evaluate computed tomography (CT) findings in 23 patients with bronchial atresia. Materials and Methods: The CT images were reviewed by two radiologists who reached decisions by consensus. We included only patients who presented with abnormalities on CT and in whom the diagnosis had been confirmed by pathological examination of the surgical specimen (if the lesion was resected). The CT scans were assessed in order to identify the main findings and to map the distribution of the lesions (i.e., to determine whether the pulmonary involvement was unilateral or bilateral). Results: The main CT finding was the combination of bronchocele and hyperinflation of the distal lung. That combination was observed in all of the patients. The lesions were unilateral in all 23 cases, being seen predominantly in the left upper lobe, followed by the right lower lobe, right upper lobe, middle lobe, and left lower lobe. Conclusion: The diagnosis of bronchial atresia can be reliably made on the basis of a finding of bronchocele accompanied by hyperinflation of the adjacent lung parenchyma.

Resumo Objetivo: Analisar os achados na tomografia computadorizada (TC) de tórax de 23 pacientes com atresia brônquica. Materiais e Métodos: As imagens de TC foram avaliadas por dois observadores e os casos discordantes foram resolvidos por consenso. Os critérios de inclusão foram a presença de anormalidades na TC compatíveis com atresia brônquica e/ou diagnóstico confirmado por exame anatomopatológico das peças cirúrgicas para os pacientes submetidos a ressecção cirúrgica. As TCs foram avaliadas quanto aos principais achados de imagem, à distribuição das lesões, ao envolvimento pulmonar unilateral ou bilateral. Resultados: Os principais achados na TC foram a presença de broncocele, hiperinsuflação do parênquima pulmonar ou ambos. A combinação desses achados foi encontrada em todos os pacientes. Em relação à distribuição, o envolvimento foi unilateral nos 23 casos. Quando se consideraram os lobos mais acometidos, o lobo superior esquerdo foi o mais acometido, seguido do lobo inferior direito, lobo superior direito, lobo médio e lobo inferior esquerdo. Conclusão: O diagnóstico de atresia brônquica pode ser feito em presença de broncocele associada com hiperinsuflação do parênquima pulmonar adjacente.

Analysis of clinical characteristics of 17 patients with inhalation dimethyl sulfate poisoning / 中华劳动卫生职业病杂志

This paper analyzed the clinical data of 17 patients with inhalation dimethyl sulfate poisoning in Changzhou Third People's Hospital, in order to understand the clinical characteristics, treatment and prognosis of patients with inhalation dimethyl sulfate poisoning, and guide clinicians to make effective measures in time. Dimethyl sulfate poisoning progresses rapidly and dangerously. The prognosis is usually better if the patients are separated from the toxic environment as soon as possible, given glucocorticoids in early and short-term, closely observed respiratory tract injury, and treated with endotracheal intubation and invasive mechanical ventilation when necessary.

Estudio morfométrico de los bronquios principales y del bronquio intermedio en una muestra cadavérica colombiana / Morphometric study of the main bronchi and the intermediate bronchus in a Colombian cadaveric sample

Conocer la morfometría en longitud, circunferencia y angulación de los bronquios principales y del bronquio intermedio pueden ser datos relevantes en procedimientos radiológicos, quirúrgicos e inclusive en eventos que amenazan la vida como la broncoaspiración. Existe poca evidencia acerca de la morfometría de los bronquios principales y del bronquio intermedio, es por ello que el presente estudio tuvo como objetivo describir la morfometría de los bronquios principales y del bronquio intermedio en una muestra de población cadavérica colombiana. Se realizó un estudio descriptivo donde se seleccionaron 29 especímenes de Cali, Colombia; 11 correspondieron a cadáveres y 18 a órganos aislados del tracto respiratorio inferior; se incluyeron los cadáveres con las estructuras debidamente disecadas y se excluyeron las muestras con estructuras anatómicas ausentes o dañadas y que afectaran la realización de las mediciones. La media de longitud del bronquio principal derecho fue de 1,69 cm IC 95 % (1,51 - 1,87) la media de la longitud del bronquio intermedio fue de IC 95 % 2,89 cm (2,66 - 3,12), la media de longitud del bronquio principal izquierdo fue de 3,34 cm IC 95 % (3,01 - 3,68); el ángulo interbronquial tiene una media de 80,17º IC 95 % (72,87 - 87,48). Las mediciones del bronquio principal derecho concuerdan con las reportadas en la literatura, lo contrario ocurre con el bronquio principal izquierdo; la medición del ángulo interbronquial muestra diferencias a la reportada por la literatura. Este estudio muestra que a pesar de que existen nomenclaturas y consensos internacionales, estos no han sido implementados correctamente por los profesionales de la salud y el término de bronquio intermedio es utilizado en la práctica diaria, por lo que se hace necesario que las Sociedades de Anatomía y Morfología vuelvan a discutir su importancia y reconocimiento en la nomenclatura.

Knowing morphometry in length, circumference and angulation of the main bronchi and the intermediate bronchus can be relevant data in radiological, surgical procedures and even in life-threatening events such as bronchoaspiration. Evidence is scarce about the morphometry of the main bronchi and the intermediate bronchus, that is why the present study aimed to describe the morphometry of the main bronchi and the intermediate bronchus in a Colombian cadaveric population sample. A descriptive study was carried out where 29 specimens were selected from Cali, Colombia; 11 corresponded to cadavers and 18 to organs isolated from the lower respiratory tract; cadavers with duly dissected structures were included and samples with anatomical structures that were absent or damaged, and that affected the performance of the measurements were excluded. Descriptive statistics was used to analyze the data. The mean length of the right main bronchus was 1.69 cm 95 % CI (1.51-1.87), the mean length of the intermediate bronchus was 2.89 cm 95 % CI (2,663,12), the mean length of the left main bronchus was 3.34 cm 95 % CI (3-3.68); the interbronchial angle had an average of 80.17º 95 % CI (72.87-87.48). The measurements of the right main bronchus agree with those reported in the literature, the opposite occurs with the left main bronchus; interbronchial angle measurement showed differences to that reported by the literature. This study shows that although there are international nomenclatures and consensus, these have not been implemented correctly by health professionals and the term intermediate bronchus is used in daily practice, it is therefore necessary that the Societies of Anatomy and Morphology again discuss their importance and recognition in the nomenclature.

Histogenesis Of Human Lung - Retrospective Fetal Autopsy Study

Histogenesis of human fetal lung was studied in 40 human fetuses under light microscope after sectioning andstaining with hematoxylin & eosin stain, in fetuses with gestational age ranging from 10 weeks to fetuses above30 weeks. Appearance of various levels of bronchi were identified with the changes in the epithelium at differentlevels of bronchi. The appearance of alveolar ducts and few alveoli were recognized after 25 weeks of gestation.Vascularisation of the fetal lung was observed as early as 10 weeks of gestation. Appearance of various levels ofbronchi were identified with the changes in the epithelium at different ages of gestation

Overview and outlook of CT quantification technology for chronic obstructive pulmonary disease / 西安交通大学学报(医学版)

Chronic obstructive pulmonary disease (COPD) is a type of disease with diverse clinical manifestations and strong heterogeneity; thus early diagnosis is difficult. Patients at stable period often suffer from poor life quality. Frequent hospitalization induced by acute exacerbations has high social and economic burdens. COPD is predicted to be the third leading cause of death in the world by 2020 and the fifth leading cause of disability. At present, there is a lack of accurate quantitative technology. Our research team, in bearing of the Public Welfare Special Industry of National Health Commission "Diagnostic and Evaluation System of Respiratory Diseases Based on Digital Lung" and on the basis of CT quantitative technology, investigated the morphological changes of pulmonary parenchyma, bronchi and pulmonary vessels as well as their correlations. We provide an individualized, standardized and comprehensive evaluation for COPD patients. In this paper we also discuss the hot issues of COPD and point out the future research direction.

Feasibility of quantitative measurement of fetal trachea and bilateral bronchial angles by ultrasound to diagnose heterotaxy syndrome in middle and late pregnancy / 中华围产医学杂志

Objective To analyze the feasibility of prenatal ultrasound quantitative measurement of the angles between trachea and bilateral bronchi as a new diagnostic tool for fetuses with heterotaxy syndrome.Methods The angles between trachea and bilateral bronchi were measured at 18-34+6 gestational weeks for 200 fetuses with normal ultrasound findings (normal group) and 41 fetuses with heterotaxy syndrome [35 right atrial isomerisms (right group) and six left atrial isomerisms (left group)] diagnosed by ultrasound and confirmed after abortion or induction (case group) in Chongqing Health Center for Women and Children from October 2015 to December 2018.Scatter plots of left/right bronchus angle (α / β) ratios were drawn.Differences in bilateral bronchus angles between the three groups were statistically analyzed using one-way analysis of variance and paired t-test.Results In the normal group,scatter plots showed the α/β ratios were relatively constant at 0.8-1.0 with larger β than α (t=-33.14,P＜0.05),indicating that the right bronchus always went more steeply than the left one.In the case group,the α/β ratios were around 1.0.In the right group,the α value increased and was close to the β value [(153.90±5.43) ° vs (156.02±5.59) °,t=-2.56,P＞0.05] and presented as bilateral right bronchial angle;in the left group,the β value decreased and was close to the α value [(147.38±3.16)° vs (148.82±5.56) °,t=-1.18,P＞0.05] and presented as bilateral left bronchial angle.There were significant differences in the α and β values among the normal group,the right and left groups (all P＜0.05),and the bronchial angles of the right group were both greater than those of the left group (all P＜0.05).Conclusions Prenatal ultrasound measurement of the angles between trachea and bilateral bronchi can be used as an indirect indicator for the diagnosis of heterotaxy syndrome.

Bronchus perforation by EZ-Blocker™ endobronchial blocker during esophageal resection after neoadjuvant chemoradiation: a case report / 대한마취과학회지

BACKGROUND: Double-lumen tubes (DLT) and endobronchial blockers (EB) are used for one-lung ventilation in thoracic surgery. More complications are seen when using DLT when compared to EB, while major complications are rarely seen. CASE: This case report describes a perforation of the right mainstem bronchus by an EZ-Blocker EB in a patient undergoing a minimally invasive esophagectomy after neoadjuvant chemoradiation. CONCLUSIONS: We advise to insert an EZ-Blocker™ EB with caution and only under direct bronchoscopic visualization, especially in previous irradiated patients.

Correlation analysis of antibody titer and immune balance after infection of mycoplasma pneumoniae in children with bronchial asthma / 中国基层医药

Objective@#To study the correlation of antibody titer and immune balance after infection of mycoplasma pneumoniae in children with bronchial asthma.@*Methods@#From October 2010 to August 2015, 108 children with bronchial asthma infected with mycoplasma pneumoniae were selected.There were 71 patients in the observation group, children with mycoplasma pneumoniae antibody titers >1∶160, and 37 cases were selected as control group, mycoplasma pneumonia antibody titer≤1∶160.The titer of mycoplasma antibody, serum interferon gamma(IFN-γ), interleukin-4(IL-4) and interleukin-17(IL-17) were measured.@*Results@#The serum IFN-γ, IL-4 and IL-17 levels in the control group were (41.04±3.13)μg/L, (17.04±3.16)μg/L and (30.81±4.23)μg/L, respectively, which in the observation group were (33.26±3.17)μg/L, (24.15±5.09)μg/L and (41.29±5.09)μg/L, respectively.The serum IL-4 and IL-17 levels of the observation group were significantly higher than those of the control group(t=5.126, 3.429, all P<0.05). After infection of mycoplasma pneumoniae, the serum IFN-γ in the observation group decreased significantly(t=4.168, P<0.05).@*Conclusion@#The titer of antibody after mycoplasma pneumoniae infection in children with bronchial asthma is closely related to the immune balance.The higher the antibody titer, the more serious the immune imbalance.

Feasibility of quantitative measurement of fetal trachea and bilateral bronchial angles by ultrasound to diagnose heterotaxy syndrome in middle and late pregnancy / 中华围产医学杂志

Objective@#To analyze the feasibility of prenatal ultrasound quantitative measurement of the angles between trachea and bilateral bronchi as a new diagnostic tool for fetuses with heterotaxy syndrome.@*Methods@#The angles between trachea and bilateral bronchi were measured at 18-34+6 gestational weeks for 200 fetuses with normal ultrasound findings (normal group) and 41 fetuses with heterotaxy syndrome [35 right atrial isomerisms (right group) and six left atrial isomerisms (left group)] diagnosed by ultrasound and confirmed after abortion or induction (case group) in Chongqing Health Center for Women and Children from October 2015 to December 2018. Scatter plots of left/right bronchus angle (α/β) ratios were drawn. Differences in bilateral bronchus angles between the three groups were statistically analyzed using one-way analysis of variance and paired t-test.@*Results@#In the normal group, scatter plots showed the α/β ratios were relatively constant at 0.8-1.0 with larger β than α (t=-33.14, P<0.05), indicating that the right bronchus always went more steeply than the left one. In the case group, the α/β ratios were around 1.0. In the right group, the α value increased and was close to the β value [(153.90±5.43)° vs (156.02±5.59)°, t=-2.56, P>0.05] and presented as bilateral right bronchial angle; in the left group, the β value decreased and was close to the α value [(147.38±3.16)° vs (148.82±5.56)°, t=-1.18, P>0.05] and presented as bilateral left bronchial angle. There were significant differences in the α and β values among the normal group, the right and left groups (all P<0.05), and the bronchial angles of the right group were both greater than those of the left group (all P<0.05).@*Conclusions@#Prenatal ultrasound measurement of the angles between trachea and bilateral bronchi can be used as an indirect indicator for the diagnosis of heterotaxy syndrome.

Correlation analysis of antibody titer and immune balance after infection of mycoplasma pneumoniae in children with bronchial asthma / 中国基层医药

To study the correlation of antibody titer and immune balance after infection of myco-plasma pneumoniae in children with bronchial asthma.Methods From October 2010 to August 2015,108 children with bronchial asthma infected with mycoplasma pneumoniae were selected.There were 71 patients in the observation group,children with mycoplasma pneumoniae antibody titers ＞1:160,and 37 cases were selected as control group , mycoplasma pneumonia antibody titer ≤1 : 160.The titer of mycoplasma antibody , serum interferon gamma (IFN-γ),interleukin-4(IL-4) and interleukin -17( IL-17) were measured.Results The serum IFN -γ, IL-4 and IL-17 levels in the control group were (41.04 ±3.13) μg／L,(17.04 ±3.16) μg／L and (30.81 ± 4.23)μg／L,respectively,which in the observation group were (33.26 ±3.17) μg／L,(24.15 ±5.09) μg／L and (41.29 ±5.09) μg／L,respectively.The serum IL-4 and IL-17 levels of the observation group were significantly higher than those of the control group (t＝5.126,3.429,all P＜0.05).After infection of mycoplasma pneumoniae ,the serum IFN-γin the observation group decreased significantly ( t ＝4.168,P＜0.05).Conclusion The titer of antibody after mycoplasma pneumoniae infection in children with bronchial asthma is closely related to the immune balance.The higher the antibody titer ,the more serious the immune imbalance.

Carcinoma mucoepidermoide bronquial: a propósito de dos casos clínicos / Bronchopulmonary mucoepidermoid carcinoma: apropos of two clinical cases

Resumen El carcinoma mucoepidermoide bronquial es una neoplasia infrecuente, representando el 0,1 a 0,2% de los tumores malignos primarios del pulmón. En general tiene un buen pronóstico, sin embargo, existe un subtipo de alto grado de pronóstico más ominoso. En este artículo se presentan dos casos clínicos de carcinoma mucoepidermoide bronquial de bajo grado, enfocado en su diagnóstico y manejo quirúrgico.

ABSTRACT Bronchopulmonary mucoepidermoid carcinoma is an uncommon neoplasm, accounting for 0.1 to 0.2% of primary malignant tumors of the lung. In general it has a good prognosis, however there is a subtype of high grade of more ominous prognosis. In this paper we present two clinical cases of low grade pulmonary mucoepidermoid carcinoma, focused on their diagnosis and surgical management.

Heparin-free extracorporeal membrane oxygenation in a patient with severe pulmonary contusions and bronchial disruption

Pulmonary contusion complicated with endobronchial hemorrhage is potentially life-threatening, particularly in patients with tracheobronchial tree disruption and severe airway bleeding after blunt trauma, and pose a high mortality risk. In such cases, extracorporeal membrane oxygenation (ECMO) can be used as a salvage treatment modality. However, the use of ECMO for moribund trauma patients with respiratory failure may be limited for several reasons, such as intractable bleeding. In this case report, we describe a patient with severe bilateral pulmonary contusions with tracheobronchial tree disruption that was successfully treated using heparin-free venovenous ECMO.

Effects of acupoint application combined with modified Xiaoqinglong decoction on airway remodeling and inflammatory factors levels in patients with bronchial asthma / 国际中医中药杂志

Objective To explore the effects of acupoint application combined with modified Xiaoqinglong decoction on airway remodeling and serum C-reactive protein (CRP), interleukin-8 (IL-8) and eosinophil chemotactic factor (eotaxin) levels in patients with bronchial asthma. Methods A total of 78 patients with bronchial asthma were randomly divided into two groups, 39 cases each group. The control group was treated with conventional western medicine therapy, and the study group was treated with acupoints plus Xiaoqinglong decoction on the basis of the control group.The treatment effect,adverse reaction were observed, and airway remodeling associated indicators like Transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and serum CRP, IL-8, Eotaxin levels were detected as well. Results After treatment, the clinical asthma control rate was 87.18% (34/39) in the study group and 58.97% (23/39) in the control group, and the difference was statistically significant (χ2=7.885,P<0.05).After treatment,the TGF-β1(6.74 ± 2.21 μmol/L vs.10.90 ± 2.24 μmol/L,t=8.256),VEGF(27.63 ± 5.14 ng/ml vs.35.76 ± 5.82 ng/ml,t=6.539),bFGF(7.15 ± 1.54 μmol/L vs.12.62 ± 2.23μmol/L,t=12.605)in the study group were significantly lower than those of the control group (P<0.05). After treatment, the CRP (9.16 ± 1.85 mg/L vs.16.74 ± 2.20 mg/L,t=16.468),IL-8(51.26 ± 17.25 pg/L vs.114.32 ± 20.15 pg/L,t=14.847),IL-8 (98.59 ± 34.12 pg/ml vs.159.62 ± 52.74 pg/ml,t=6.068)in the study group were significantly lower than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reaction between the study group 20.5%(8/39) and the control group12.8%(5/39) during treatment (χ2=0.831, P>0.05). Conclusions The acupoint application combined with modified Xiaoqinglong decoction can significantly improve the clinical effect, inhibit airway remodeling, decrease the level of serum CRP, IL-8 and Eotaxin in patients with bronchial asthma, and its safety is high.

The Prognostic Significance of Notch1 and Fatty Acid Binding Protein 7 (FABP7) Expression in Resected Tracheobronchial Adenoid Cystic Carcinoma: A Multicenter Retrospective Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Adenoid cystic carcinoma (ACC) of the trachea and bronchus is a rare tumor. Although MYB-NFIB oncogene fusion and Notch1 mutation have been identified in ACC, little is known about the expression and clinical significance of Notch1 and its target gene fatty acid binding protein 7 (FABP7) in tracheobronchial ACC. MATERIALS AND METHODS: Primary tracheobronchial ACC that were resected between 1998 and 2014 were identified through the pathology and oncology database from five thoracic oncology centers in China. A tissue array was constructed from the patients’ samples and the expressions of Notch1 and FABP7 were evaluated by immunohistochemistry. The association between the expression of both markers and survival was determined. RESULTS: Overexpression of Notch1 and FABP7, detected in 37.8% and 38.3% of 368 patients with tracheobronchial ACC, respectively, was an independent prognostic indicator for recurrencefree survival (RFS) by multivariable Cox proportional hazard model (p=0.032 and p=0.048, respectively). Overexpression of Notch1, but not of FABP7, predicted overall survival (OS) (p=0.018). When categorized into four groups according to coexpression of Notch1 and FABP7, patients with overexpression of both Notch1 and FABP7 belonged to the group with the shortest RFS and OS (p=0.01 and p=0.048, respectively). CONCLUSION: Expression of Notch1 and FABP7, and coexpression of Notch1 and FABP7, is strongly associated with poor survival in resected tracheobronchial ACC. These data are consistent with the hypothesis that poor differentiation of tracheobronchial ACC correlates with the activation of Notch signaling.

Comparison of the effects of aminophylline and doxofylline in the treatment of bronchial asthma / 中国基层医药

Objective To compare the clinical effects of aminophylline and doxofylline in the treatment of bronchial asthma , thus to provide guidance for clinical practice .Methods 130 patients with bronchial asthma admitted in Zhejiang Rongjun Hospital from January 2015 to January 2017 were selected as the objects of observation , and they were randomly divided into two groups according to the digital table ,with 65 cases in each group .The control group was given aminophylline treatment ,the observation group was given doxofylline treatment .The clinical curative effect,pulmonary function index[forced vital capacity (FVC),forced expiratory volume in one second(FEV1),FEV1/FVC],quality of life scores and the incidence rate of adverse reactions were observed in the two groups .Results The total effective rate of observation group was 92.31％,which was higher than 70.77％of the control group ,the difference was statistically significant(χ2 =10.015,P<0.05).After treatment,the FEV1 [(2.72 ±0.64)L],FVC[(2.96 ± 0.67)L],FEV1/FVC[(89.35 ±7.77)％] in the observation group were significantly better than those in the control group[(2.05 ±0.35)L,(2.41 ±0.52)L,(80.58 ±7.69)％] (t=7.405,5.228,6.467,all P<0.05).The quality of life score in the observation group was (87.87 ±5.31) points,which was significantly higher than (75.35 ± 5.40)points in the control group (t=13.328,P<0.05).The incidence rate of adverse reactions in the observation group was 9.23％,which was lower than 27.69％ in the control group,there was statistically significant difference between the two groups (χ2 =7.358,P <0.05).Conclusion Aminophylline and doxofylline in the treatment of bronchial asthma can obtain certain curative effect ,but the effect of doxofylline is better ,and with less adverse reactions .