Clinical analysis of endobronchial aspergilloma / 中国内镜杂志

Objective To discuss the clinical feature of endobronchial aspergilloma approach strategy for diagnosis and therapy. Methods 2 cases of endobronchial aspergilloma were diagnosed and literature review were made in this study. The clinical manifestation, bronchoscopic characters, imaging performances were retrospectively studied. Results The most common complaint was bloody sputum or mild hemoptysis, and chest CT usually revealed a soft tissue mass shadow with the increasing popularity of flexible bronchoscopy, it is being recognized as a necrotic mass causing bronchial obstruction, with or without a parenchymal lesion in cavity. Conclusions Bronchoscopy maybe is the key approach to detect endobronchial aspergilloma. It should be alert to lung cancer when antifungal therapy is not effective and the lesions have no reduction or even increasing.

Administration of Pigment Epithelium-Derived Factor Inhibits Airway Inflammation and Remodeling in Chronic OVA-Induced Mice via VEGF Suppression

PURPOSE: Pigment epithelium-derived factor (PEDF) is a recently discovered antiangiogenesis protein. PEDF possesses powerful anti-inflammatory, antioxidative, antiangiogenic, and antifibrosis properties. It has been reported that PEDF can regulate vascular endothelial growth factor (VEGF) expression. This study aimed to evaluate whether recombinant PEDF protein could attenuate allergic airway inflammation and airway remodeling via the negative regulation of VEGF using a murine model of chronic ovalbumin (OVA)-induced asthma and BEAS-2B human bronchial epithelial cells. METHODS: In an in vivo experiment, mice sensitized with OVA were chronically airway challenged with aerosolized 1% OVA solution for 8 weeks. Treated mice were given injections of recombinant PEDF protein (50 or 100 microg/kg body weight) via the tail vein. In an in vitro experiment, we investigated the effects of recombinant PEDF protein on VEGF release levels in BEAS-2B cells stimulated with IL-1beta. RESULTS: Recombinant PEDF protein significantly inhibited eosinophilic airway inflammation, airway hyperresponsiveness, and airway remodeling, including goblet cell hyperplasia, subepithelial collagen deposition, and airway smooth muscle hypertrophy. In addition, recombinant PEDF protein suppressed the enhanced expression of VEGF protein in lung tissue and bronchoalveolar lavage fluid (BALF) in OVA-challenged chronically allergic mice. In the in vitro experiment, VEGF expression was increased after IL-1beta stimulation. Pretreatment with 50 and 100 ng/mL of recombinant PEDF protein significantly attenuated the increase in VEGF release levels in a concentration-dependent manner in BEAS-2B cells stimulated by IL-1beta. CONCLUSIONS: These results suggest that recombinant PEDF protein may abolish the development of characteristic features of chronic allergic asthma via VEGF suppression, providing a potential treatment option for chronic airway inflammation diseases such as asthma.

Intervention with flexible bronchoscopy in patiens with respiratory failure caused by tracheal stenosis / 中华急诊医学杂志

Objective To investigate the efficiency and safety of intervention with flexible bronchoscope under general anesthesia by using laryngeal mask in patients with severe tracheal stenosis induced respiratory failure.Methods A total of 16 in-patients with respiratory failure caused by severe tracheal stenosis admitted from September 2009 to March 2012 were retrospectively reviewed.A comprehensive bronchoscopic intervention for the complete patency of airway was successfully performed with various techniques such as cryotherapy,electrocautery,balloon dilatation,and implantation of selfexpanding metal stents under genersl anesthesia by using laryngeal mask.The efficiency of comprehensive bronchoscopic intervention and dyspnea score were evaluated by chest CT scan and bronchoscopic examination before and after the treatment.Data were expressed as ((x-)± s).Paired t test was used for statistical analysis of the data.Results The degrees of tracheal stenosis and dyspnea score before and after intervention were (85.0±8.4)％ vs.(20.9±7.6)％ (P＜0.01) and (3.9±0.3vs.2.4±0.5,P＜ 0.01),respectively.There were no life-threatening complications occurred including massive haemorrhage.Conclusions It is an effective and safe technique to resolve the tracheal stenosis-induced respiratory failure with intervention by using flexible bronchoscope under general anesthesia with laryngeal mask,and it is a promising interventional treatment for clinic application.