[Retrospective Study of Bronchoscopic Intervention Therapy for Bronchopleural Fistula Induced by Pulmonary Surgery].

BACKGROUND: As a new technique developed in recent years, bronchoscopic intervention therapy has the advantages of minimal invasion, high safety and repeatability. The aim of this study is to investigate the clinical characteristics of bronchopleural fistula (BPF) induced by surgeries for lung malignancies or benign diseases and the effect of bronchoscopic intervention therapy for BPF, so as to provide support for prevention and treatment of BPF. METHODS: Data 64 patients with BPF who were treated by bronchoscopic intervention in Respiratory Disease Center of Dongzhimen Hospital, Beijing University of Chinese Medicine from June 2020 to September 2023 were collected. Patients with fistula diameter ≤5 mm were underwent submucous injection of macrogol, combined with blocking therapy with N-butyl cyanoacrylate, medical bioprotein glue or silicone prosthesis. Patients with fistula diameter >5 mm were implanted with different stents and cardiac occluders. Locations and characteristics of fistulas were summarized, meanwhile, data including Karnofsky performance status (KPS), shortbreath scale (SS), body temperature, pleural drainage volume and white blood cell count before and after operation were observed. RESULTS: For all 64 patients, 96 anatomic lung resections including pneumonectomy, lobectomy and segmentectomy were executed and 74 fistulas occurred in 65 fistula locations. The proportion of fistula in the right lung (63.5%) was significantly higher than that in the left (36.5%). Besides, the right inferior lobar bronchial fistula was the most common (40.5%). After operation, KPS was significantly increased, while SS, body temperature, pleural drainage volume and white blood cell count were significantly decreased compared to the preoperative values (P<0.05). By telephone follow-up or readmission during 1 month to 38 months after treament, median survival time was 21 months. 33 patients (51.6%) showed complete response, 7 patients (10.9%) showed complete clinical response, 18 patients (28.1%) showed partial response, and 6 patients (9.4%) showed no response. As a whole, the total effective rate of bronchoscopic intervention for BPF was 90.6%. CONCLUSIONS: BPF induced by pulmonary surgery can lead to severe symptoms and it is usually life-threating. Bronchoscopic intervention therapy is one of the fast and effective therapeutic methods for BPF.

[A Case of Multidomain Integrated Treatment Strategy 
for Complex Primary Pulmonary Sarcomatoid Carcinoma].

Pulmonary sarcomatoid carcinoma (PSC) is a rare and highly malignant tumor, which includes the following five pathologic types: pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma and pulmonary blastoma. The onset of PSC is occult with non-specific clinical symptoms and signs. The clinical manifestations include irritating cough, bloody sputum, dyspnea, chest pain and so on, which are closely related to the growth and invasion site of the tumor. PSC tends to metastasize early, so most patients are already in local advanced stage or advanced stage with a median survival of 9 months at the time of hospital visit. A patient with primary PSC which led to 90% stenosis in central airway was treated by combined method of vascular and tracheoscopic intervention in our respiratory center. This treatment prolonged the patient's survival time and got a satisfactory effect at 19-month follow-up after surgery. Herein we report the case for clinical reference.
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Resilience assessment of metro stations against rainstorm disaster based on cloud model: a case study in Chongqing, China.

Extremely heavy rainfall has posed a significant hazard to urban growth as the most common and disaster-prone natural calamity. Due to its unique geographical location, the metro system is more vulnerable to waterlogging caused by rainstorm disaster. Research on resilience to natural disasters has attracted extensive attention in recent years. However, few studies have focused on the resilience of the metro system against rainstorms. Therefore, this paper aims to develop an assessment model for evaluating metro stations' resilience levels. Twenty factors are carried out from dimensions of resistance, recovery and adaptation. The methods of ordered binary comparison, entropy weight and cloud model are proposed to build the assessment model. Then, taking Chongqing metro system in china as a case study, the resilience level of 13 metro stations is calculated. Radar charts from dimensions of resistance, recovery, and adaptation are created to propose recommendations for improving metro stations' resilience against rainstorms, providing a reference for the sustainable development of the metro system. The case study of the Chongqing metro system in china demonstrates that the assessment model can effectively evaluate the resilience level of metro stations and can be used in other infrastructures under natural disasters for resilience assessment.

Sustainable Development of Urban Metro System: Perspective of Coordination between Supply and Demand.

Metro systems are gradually becoming more and more crucial in promoting the economy and society in cities. However, various challenges such as financial resources and the efficiency of utilizing these metro plans bring difficulties for metro construction. Hence, accurately evaluating the urban metro system's development condition seems significant for the sustainable development of the urban metro system. Therefore, a comprehensive evaluation indicator system of metro development conditions containing 25 indicators from dimensions of demand and supply is established in this study, and a coupling coordination degree model combined with the entropy weight method and Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) method is proposed to analyze the level of metro development conditions and coupling coordination conditions of 35 cities in China. According to the calculation results, 35 cities are divided into six categories, and radar charts are constructed to promote the sustainable development of the metro system.