The efficacy and safety of modified transbronchial cryobiopsy in the diagnosis of interstitial lung disease.

The objective of this study is to investigate the efficacy and safety of flexible transbronchial cryobiopsy (TBCB) in the diagnosis of diffuse parenchymal lung disease (DPLD) in a routine bronchoscopy examination room under analgesia and sedation, using neither endotracheal intubation or rigid bronchoscope nor fluoroscopy or general anesthesia. The data from 50 DPLD patients with unknown etiology who were treated in the Affiliated Hospital of Guilin Medical College from May 2018 to September 2020 were collected, and 43 were eventually included. The specimens obtained from these 43 patients were subjected to pathological examination, pathogenic microorganism culture, etc, and were analyzed in the clinical-radiological-pathological diagnosis mode to confirm the efficacy of TBCB in diagnosing the cause of DPLD. Subsequently, the intraoperative and postoperative complications of TBCB and their severity were closely observed and recorded to comprehensively evaluate the safety of TBCB. For the 43 patients included, a total of 85 TBCB biopsies were performed (1.98 [1, 4] times/case), and 82 valid tissue specimens were obtained (1.91 [1, 4] pieces/case), accounting for 96.5% (82/85) of the total sample. The average specimen size was 12.41 (1, 30) mm2. Eventually, 38 cases were diagnosed, including 11 cases of idiopathic pulmonary fibrosis, 5 cases of connective tissue-related interstitial lung disease, 5 cases of nonspecific interstitial pneumonia, 4 cases of tuberculosis, 4 cases of occupational lung injury, 3 cases of interstitial pneumonia with autoimmune characteristics, 1 case of lung cancer, 2 cases of interstitial lung disease (unclassified interstitial lung disease), 1 case of hypersensitivity pneumonitis, 1 case of pulmonary alveolar proteinosis, and 1 case of fungal infection. The remaining 5 cases were unclarified. For infectious diseases, the overall etiological diagnosis rate was 88.4% (38/43). With respect to complications, pneumothorax occurred in 4 cases (9.3%, 4/43, including 1 mild case and 3 moderate cases), of which 3 cases (75%) were closed by thoracic drainage and 1 case (25%) was absorbed without treatment. In addition, 22 cases experienced no bleeding (51.2%) and 21 cases suffered bleeding to varying degrees based on different severity assessment methods. TBCB is a minimally invasive, rapid, economical, effective, and safe diagnostic technique.

Peripheral blood oxidative stress markers for obstructive sleep apnea-a meta-analysis.

OBJECTIVES: The purpose of this study was to clarify the relationship between obstructive sleep apnea (OSA) and oxidative stress markers in blood. METHODS: We conducted a systematic literature search on databases including Pubmed and Embase for studies reporting circulating oxidative stress markers in patients with OSA and controls that were published between 1988 and June 2019. Standardized mean differences (SMDs) and 95% confidence intervals (95%CI) were calculated. RESULTS: Of the 2226 articles initially retrieved, 52 were included in our meta-analysis, covering a total of 12 oxidative stress markers. The concentrations of malondialdehyde (SMD = 1.18; 95%CI: 0.87, 1.49; p < 0.001), thiobarbituric acid reactive substances (SMD = 1.82; 95%CI: 0.79, 2.86; p = 0.001), advance oxidative protein products (SMD = 0.68; 95%CI: 0.14, 1.23; p = 0.014), total oxidant capacity (SMD = 1.32; 95%CI: 0.33, 2.31; p = 0.009), and asymmetric dimethylarginine (SMD = 0.32; 95%CI: 0.16, 0.47; p < 0.001) in the blood of patients with OSA were higher than those of the control group, whereas the concentrations of thiols (SMD = - 0.37; 95%CI: - 0.60, - 0.15; p = 0.001) and nitric oxide (SMD = - 2.61; 95%CI: - 4.02, - 1.21; p < 0.001) were lower than those of the control group. CONCLUSIONS: The oxidative stress markers in the blood of patients with OSA were aberrant, indicating an imbalanced state of oxidation and antioxidation in OSA.

A meta-analysis on the relationship of exosomes and the prognosis of lung cancer.

BACKGROUND: A lot of research evidence shows that exosomes play an indelible role in the prognosis of lung cancer, but there are many disputes. Therefore, we conduct a meta-analysis to further demonstrate. METHODS: A literature retrieval was performed through a search of PubMed, Embase, Web of Science, Cochrane, CKNI, Wanfang, and other databases to locate documents from the literature that satisfied the inclusion criteria. There were four outcome indicators: overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), and progression-free survival (PFS). Subgroup analysis was conducted according to sample size, country, detection method, analysis method, and pathological type. Stata 14.0 software was used to evaluate the prognostic value of exosomes in lung cancer. RESULTS: A total of 2456 patients with lung cancer from 29 studies in 16 articles were included. The expression level of exosomes was closely associated with the OS and DFS of patients, although no statistical difference was observed between exosomes and DSS or PFS. Eighteen studies with 2,110 patients were evaluated to examine the prognostic value of exosomes in lung cancer by exploring the association between exosomes and OS. The results showed that exosomes were strongly associated with worse OS, and the combined hazard ratio (HR) was 2.01 (95% confidence interval [CI]: 1.70-2.39, P = .000). Six studies investigated the association between exosomes and DFS, and showed a pooled HR of 2.48 (95% CI: 1.75-3.53, P = .000). CONCLUSION: Our analysis indicated that the expression level of exosomes was closely associated with the OS and DFS of patients with lung cancer, suggesting that exosomes are associated with poor prognosis of lung cancer. Exosomes may be a new biomarker for the prognosis of lung cancer, although a large number of prospective studies are still needed to support this.