Podocyte-specific Nup160 knockout mice develop nephrotic syndrome and glomerulosclerosis.

More than 60 monogenic genes mutated in steroid-resistant nephrotic syndrome (SRNS) have been identified. Our previous study found that mutations in nucleoporin 160 kD (NUP160) are implicated in SRNS. The NUP160 gene encodes a component of the nuclear pore complex. Recently, two siblings with homozygous NUP160 mutations presented with SRNS and a nervous system disorder. However, replication of nephrotic syndrome (NS)-associated phenotypes in a mammalian model following loss of Nup160 is needed to prove that NUP160 mutations cause SRNS. Here, we generated a podocyte-specific Nup160 knockout (Nup160podKO) mouse model using CRISPR/Cas9 and Cre/loxP technologies. We investigated NS-associated phenotypes in these Nup160podKO mice. We verified efficient abrogation of Nup160 in Nup160podKO mice at both the DNA and protein levels. We showed that Nup160podKO mice develop typical signs of NS. Nup160podKO mice exhibited progression of proteinuria to average albumin/creatinine ratio (ACR) levels of 15.06 ± 2.71 mg/mg at 26 weeks, and had lower serum albumin levels of 13.13 ± 1.34 g/l at 30 weeks. Littermate control mice had urinary ACR mean values of 0.03 mg/mg and serum albumin values of 22.89 ± 0.34 g/l at the corresponding ages. Further, Nup160podKO mice exhibited glomerulosclerosis compared with littermate control mice. Podocyte-specific Nup160 knockout in mice led to NS and glomerulosclerosis. Thus, our findings strongly support that mutations in NUP160 cause SRNS. The newly generated Nup160podKO mice are a reliable mammalian model for future study of the pathogenesis of NUP160-associated SRNS.

Scalp Tumor and Hydroureteronephrosis in Patients with Nephronophthisis and Homozygous NPHP1 Deletion.

Homozygous deletion of NPHP1 can lead to isolated nephronophthisis (NPHP) and syndromic disorders. However, the phenotype of scalp tumor and hydroureteronephrosis in NPHP patients with homozygous deletion of NPHP1 has not been reported. Clinical data, laboratory results, and genetic testing of 4 NPHP patients were collected. Examination of their eyes, heart, and urinary tract and of their hepatobiliary, skeletal, and central nervous systems was evaluated. Isolated NPHP was observed in 1 case, and syndromic disorders were observed in the other 3 patients. Their syndromic disorders showed NPHP combined with central nervous system defects, eye involvement, scalp tumor, arachnoid cyst, or hydroureteronephrosis. Large homozygous deletions covering the whole NPHP1 gene locus were identified in all 4 patients. We report a novel phenotype of scalp tumor and hydroureteronephrosis in NPHP patients with homozygous deletion of NPHP1, paving an avenue for further research on NPHP1-associated deformity in the skin and the urinary system.

Autofluorescence imaging-assisted medical thoracoscopy in the diagnosis of malignant pleural disease.

BACKGROUND: Medical thoracoscopy (MT) does not always provide a conclusive diagnosis of pleural diseases because the endoscopic appearance of pleural diseases can be misleading. Autofluorescence imaging (AFI) is an effective assistive diagnostic tool. However, its clinical application for pleural disease remains controversial. OBJECTIVES: This prospective study evaluated the clinical usefulness of AFI-assisted MT for diagnosis of malignant pleural diseases. METHODS: Patients with unexplained pleural effusion admitted to our clinics between December 2018 and September 2021 were enrolled. We performed white-light thoracoscopy (WLT) first, and then AFI, during MT. Images of endoscopic real-time lesions were recorded under both modes. Pleural biopsy specimens were analyzed pathologically. Between-groups differences in diagnostic sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV) were assessed using 95% confidence intervals (CI). Receiver operating characteristic curves and decision curve analyses were employed to analyze the diagnostic efficiency of these two modes. RESULTS: Of 126 eligible patients, 73 cases were diagnosed with malignant pleural disease. A total of 1292 biopsy specimens from 492 pleural sites were examined for pathological changes. The diagnostic sensitivity, PPV, and NPV of AFI were 99.7%, 58.2%, and 99.2%, respectively. AFI was significantly superior to WLT, which had a sensitivity of 79.7%, PPV of 50.7%, and NPV of 62.8%. Subgroup analysis showed that the AFI type III pattern was significantly more specific for pleural malignant disease than that of WLT. CONCLUSIONS: AFI could further improve the diagnostic efficacy of MT by providing better visualization, convenience, and safety.

A Novel Use of Coblation in the Treatment of Tracheal Tumors.

Radiofrequency coblation is a new method of electrosurgical intervention. Most recently, its use has been reported in the treatment of laryngotracheal pathology. However, studies on coblation for tracheal tumors have not been reported. In this article, we described a novel use of coblation technology, in which a new type of airway-specific wand was used to ablate tracheal benign or malignant tumors in 3 cases. The results suggest the possibility of usage of coablation in the treatment of tracheal tumors. More studies that are larger and have longer follow-up are needed to further evaluate the use of this technique in the treatment of tracheal tumors.

Entanglement improvement via a single-side squeezing-based quantum scissors.

The entanglement improvement is theoretically investigated when applying a single-side quantum scissors (SSQS) with a local squeezing operation and two-asymmetrical beam splitters (BSs) to one mode of an input two-mode squeezed vacuum state (TMSV). It is found that the gain factor can be significantly enhanced with the increasing of local squeezing parameter at the expense of the success probability. The entanglement can also be further improved adjusting the local-squeezing or the transmissivity of BSs in a small initial squeezing region. In addition, our scheme is robust against the photon loss in TMSV. The improved effect becomes more obvious due to the presence of local squeezing. However, the case is not true for a more realistic SSQS. In both cases, the asymmetric BSs play a positive role for the entanglement improvement. These results suggest that the squeezing-based SSQS at single-photon level is beneficial to effectively improve the entanglement, which may have potential applications in quantum communication.

Synthesis and Photocatalytic Activity of Pt-Deposited TiO2 Nanotubes (TNT) for Rhodamine B Degradation.

Dye wastewater has attracted more and more attention because of its high environmental risk. In this study, a novel TiO2 nanotube (TNT) catalyst was prepared and its morphology and structure were characterized. The synthetic catalyst was used to degrade Rhodamine B (RhB) under UV light and evaluated for the application performance. According to the characterization results and degradation properties, the optimum synthetic conditions were selected as 400°C calcination temperature and 10 wt% Pt deposition. As a result, the degradation efficacies were sequenced as TNT-400-Pt > TNT-500-Pt > TNT-400 > TNT-300-Pt. In addition, the effect of pH and initial concentration of RhB were explored, and their values were both increased with the decreased degradation efficacy. While the moderate volume of 11 mm of H2O2 addition owned better performance than that of 0, 6, and 15 mm. Scavengers such as tertbutanol (t-BuOH), disodium ethylenediaminetetraacetate (EDTA-Na2), and nitroblue tetrazolium (NBT) were added during the catalytic process and it proved that superoxide radical anions ( O 2 - • ) , photogenerated hole (h+) and hydroxyl radical (OH•) were the main active species contributing for RhB removal. For the application, TNT-Pt could deal with almost 100% RhB, Orange G (OG), Methylene blue (MB), and Congo red (CR) within 70 min and still kept more than 50% RhB removal in the fifth recycling use. Therefore, TNT-Pt synthesized in this study is potential to be applied to the dye wastewater treatment.

LncRNA PITPNA-AS1/miR-223-3p/PTN axis regulates malignant progression and stemness in lung squamous cell carcinoma.

BACKGROUND: Long noncoding RNAs (lncRNAs) are a kind of molecule that cannot code proteins, and their expression is dysregulated in diversified cancers. LncRNA PITPNA-AS1 has been shown to act as a tumor promoter in a variety of malignancies, but its function and regulatory mechanisms in lung squamous cell carcinoma (LUSC) are yet unknown. METHODS: The mRNA and protein expression of genes were examined by RT-qPCR, western blot, and IHC assay. The cell proliferation, migration, invasion, and stemness were detected through CCK-8, colony formation, Transwell and spheroid formation assays. The CD44+ and CD166+ -positive cells were detected through flow cytometry. The binding ability among genes through luciferase reporter and RNA pull-down assays. The tumor growth was detected through in vivo nude mice assay. RESULTS: The lncRNA PITPNA-AS1 had increased expression in LUSC and was linked to a poor prognosis. In LUSC, PITPNA-AS1 also enhanced cell proliferation, migration, invasion, and stemness. This mechanistic investigation showed that PITPNA-AS1 absorbed miR-223-3p and that miR-223-3p targeted PTN. MiR-223-3p inhibition or PTN overexpression might reverse the inhibitory effects of PITPNA-AS1 suppression on LUSC progression, as demonstrated by rescue experiments. In addition, the PITPNA-AS1/miR-223-3p/PTN axis accelerated tumor development in vivo. CONCLUSIONS: It is the first time we investigated the potential role and ceRNA regulatory mechanism of PITPNA-AS1 in LUSC. The data disclosed that PITPNA-AS1 upregulated PTN through sponging miR-223-3p to enhance the onset and progression of LUSC. These findings suggested the ceRNA axis may serve as a promising therapeutic biomarker for LUSC patients.

A multi-centre prospective random control study of superimposed high-frequency jet ventilation and conventional jet ventilation for interventional bronchoscopy.

Introduction: Superimposed high-frequency jet ventilation (SHFJV) is a new type of jet ventilation that simultaneously uses high- and low-frequency types of jet ventilation. We compared SHFJV with the conventional high-frequency jet ventilation (CHFJV) in interventional bronchoscopy in terms of safety and effectiveness. Methods: A multi-centre prospective random single-blind clinical trial was conducted by three interventional bronchoscopy centres. Patients who underwent diagnostic or therapeutic bronchoscopy under general anaesthesia were admitted and divided into two groups: SHFJV group (trial group) and CHFJV group (control group). PaO2 and PaCO2 were recorded before anaesthesia and during and after the procedure. SpO2 and etCO2 were recorded every 10 min throughout the procedure. Patients were observed until 24 h post-bronchoscopy. Results: Sixty patients were included in the study. Twenty-nine were in the trial group, and 31 were in the control group. Both groups had no significant differences in demographic data. In the control group, the PaO2 measured in the operation was higher than that in the trial group (p = 0.023). The values of etCO2 in the control group were more dispersed than those of the trial group. When the procedure time was over 90 minutes, the etCO2 in the control group significantly increased (p = 0.01), while the etCO2 in trial group remained stable (p = 0.594). There were more patients with PaCO2 ≥ 50 mmHg during the procedure in the control group than in the trial group (p = 0.042). Conclusion: SHFJV is effective and safe in interventional bronchoscopy. It may provide more effective and stabilised ventilation than CHFJV in cases with long procedure times.

Paclitaxel-Loaded PLGA Coating Stents in the Treatment of Benign Cicatrical Airway Stenosis.

BACKGROUND: Airway stent implantation used in the treatment of benign cicatricial airway stenosis (BCAS) can lead to local granulation and scar formation, resulting in restenosis and treatment failure. METHODS: We systematically investigated a paclitaxel-loaded PLGA-coating stent (PLPCS) and analyzed the safety and efficacy of the PLPCS in patients with BCAS. Patients were enrolled from four hospitals in China and observed for six months after implantation, by bronchoscopy performed weekly in the first month and monthly thereafter. The stent was removed immediately upon detection of granulation tissue proliferation, leading to immobility of the stent. RESULTS: Granulation tissue was formed one week after stent implantation, most of which was located at the upper edge of the stent and the narrowest airway in the stent. All stents were removed in three months (mean: 6.51 + 4.67 weeks), with a curative outcome in one case and ineffective results in two. The remaining seven patients developed complications within three months, necessitating early stent removal. The main complication was granulation formation, resulting in difficulty in stent removal. CONCLUSION: Although PLPCS showed beneficial effects in basic and animal experiments, it cannot prevent airway restenosis in actual practice, mainly due to granulation formation.

The Effects of Rapamycin on the Proliferation, Migration, and Apoptosis of Human Tracheal Fibroblasts (HTrF) and Human Tracheal Epithelial Cells (HTEpiC).

BACKGROUND: Restenosis after airway stenting needs to be addressed urgently. Rapamycin has been proven to inhibit restenosis elsewhere. This study aimed at observing its effects on the respiratory tract. METHODS: CCK-8, wound healing, Transwell and apoptosis assays were performed to detect the effects of rapamycin on the survival, migration, and apoptosis, respectively, of human tracheal fibroblasts (HTrF) and human tracheal epithelial cells (HTEpiC). RESULTS: The effective concentrations of paclitaxel, mitomycin C and rapamycin on HTrF were 10-7-10-4 mol/L, 10-6-10-4 mol/L, and 10-5-10-4 mol/L, respectively. At the effective concentrations, the inhibition rates of paclitaxel on HTEpiC were (43.03 ± 1.12)%, (49.49 ± 0.86)%, (55.22 ± 1.43)%, and (93.19 ± 0.45)%; the inhibition rates of mitomycin C on HTEpiC were (88.11 ± 0.69)%, (93.82 ± 0.96)%, and (94.94 ± 0.54)%; the inhibition rates of rapamycin on HTEpiC were (10.19 ± 0.35)% and (94.55 ± 0.71)%. At the concentration of (1-4) × 10-5 mol/L, the inhibition rate of rapamycin on HTrF was more than 50%, and that on HTEpiC was less than 20% (p < 0.05). CONCLUSIONS: Compared to paclitaxel and mitomycin C, rapamycin had the least effect on HTEpiC while effectively inhibiting HTrF. The optimum concentration range was (1-4) × 10-5 mol/L.

Influence of geometric parameters on partial compressive force and pushing performance of flow diverter.

Research on flow diverter (FD) has progressed over the past decades; however, the relationships between parameters such as stent diameter, porosity, and number of wires and the properties of FDs, such as partial compressive force and push resistance, are not well understood. In this study, the partial compressive force and push resistance of braided FDs with varying porosity (61%-75%), diameter (2.5-5.0 mm), and number of wires (48 or 64) were evaluated using finite element analysis (FEA) and bench tests. At a small compression ratio, the 48-wire stents exhibited a larger partial compressive force than 64-wire stents of the same diameter. But when the compression ratio was 50%, the 64-wire stents had better resistance to pressure. The partial compressive force decreased as the stent diameter increased when all other parameters were equal. However, the influence of the diameter decreased as the stent porosity increased. The push resistance decreased as the porosity and diameter increased, and increased with the number of wires. These results provide useful information for FD design. Decreasing the number of wires can reduce the push resistance, while the push resistance is mainly influenced by the porosity and number of wires, and almost has no relationship with the partial compressive force. The FEA model proved very reliable, and corresponded well to the bench test results, which indicates that this model can be utilized to guide the design of FDs.

A novel EZH2/NXPH4/CDKN2A axis is involved in regulating the proliferation and migration of non-small cell lung cancer cells.

NXPH4 is discovered to be a neuropeptide-like glycoprotein, belonging to the Neurexophilins (Nxphs) family. NXPH4 shares a similar domain structure with NXPH1, which, however, is poorly understood in terms of its function. Bioinformatics analysis and experimental verification in this study confirmed the abnormal high expression of NXPH4 in non-small cell lung cancer (NSCLC) tissues and cells. Knockdown of NXPH4 by siRNA can inhibit the proliferation and migration of cells, resulting in significant cell cycle arrest in S1 phase. Furthermore, in NSCLC cells, NXPH4 was regulated by transcriptional activation of enhancer of zeste homolog 2 (EZH2) in its upstream. While downstream, NXPH4 could interact with CDKN2A and downregulate its protein stability, thus participating in the cell cycle regulation through interacting with cyclinD-CDK4/6-pRB-E2F signaling pathway. To sum up, the present study reveals a regulatory pathway of EZH2/NXPH4/CDKN2A in NSCLC, providing possible reference for understanding the function of NXPH4 in tumors.

The Diagnostic Value of Metagenomic Next-Generation Sequencing in Lower Respiratory Tract Infection.

Lower respiratory tract infections are associated with high morbidity and mortality and significant clinical harm. Due to the limited ability of traditional pathogen detection methods, anti-infective therapy is mostly empirical. Therefore, it is difficult to adopt targeted drug therapy. In recent years, metagenomic next-generation sequencing (mNGS) technology has provided a promising means for pathogen-specific diagnosis and updated the diagnostic strategy for lower respiratory tract infections. This article reviews the diagnostic value of mNGS for lower respiratory tract infections, the impact of different sampling methods on the detection efficiency of mNGS, and current technical difficulties in the clinical application of mNGS.

Differences in Manifestations and Gut Microbiota Composition Between Patients With Different Henoch-Schonlein Purpura Phenotypes.

Background: Gut microbiota plays an important role in the pathogenesis of immune-mediated diseases. However, the complex pathogenesis of Henoch-Schonlein Purpura (HSP) remains elusive. This study aimed to characterize the gut microbiota in HSP patients and explore the potential association between gut microbiota composition and phenotypic changes in HSP. Methods: 16SrRNA gene sequencing and bioinformatic analyses were performed using total DNA extracted from the fecal microbiota of 34 children with HSP, including 18 primary cases, 16 recurrent cases, and 23 healthy children. Results: The diversity indexes showed significant differences in the microbial community among the primary HSP groups, the recurrent HSP group and healthy controls. The abundance of Escherichia-Shigella in the recurrent HSP group was significantly higher than that in the primary HSP group, and the constructed ROC curve had an AUC value of 0.750. According to the Spearman correlation analysis, the abundance of Bacteroides was positively associated with the serum IgG level in children with HSP, while the abundance of Lachnoclostridium was negatively correlated with the complement component 3 (C3). The diversity indexes of gut microbiota in the HSP group with abdominal symptoms were higher than those in the HSP group without GI involvement, and also higher than those in the healthy control group. In the HSP group with GI involvement, the abundance of Faecalibacterium was decreased, while the abundance of Streptococcus and Fusobacteria was increased, compared to the HSP group without GI involvement. Conclusions: The gut microbiota of children with HSP was different from that of healthy children. The genus Escherichia-Shigella has a diagnostic value for HSP recurrence. Bacteroides and Lachnoclostridium may affect IgG and complement C3 levels in children with HSP. Abdominal symptoms in HSP children were related to gut microbiota (Streptococcus and butyric acid-producing bacteria).

Interventional bronchoscopic therapy in adult patients with tracheobronchial schwannoma.

BACKGROUND: Tracheobronchial schwannomas are extremely rare tumors of neurogenic origin. Treatment includes surgery and interventional bronchoscopic therapy. Studies that have described interventional bronchoscopic therapy for tracheobronchial schwannoma have been reported in the published literature, but most of them are individual case reports, in which the long-term efficacy and recurrence are poorly understood. This study aimed to explore the feasibility, efficacy, and safety of interventional bronchoscopic therapy in adult patients with tracheobronchial schwannoma. METHODS: Patients with pathologically diagnosed tracheobronchial schwannoma between January 2007 and December 2020 who underwent interventional bronchoscopic therapy in a single center in China were retrospectively reviewed. The clinical features, interventional bronchoscopic therapy procedures, complications, and follow-up results were analyzed. RESULTS: A total of 7 patients (5 men and 2 women; median age, 56 years; age range, 26-63 years) were enrolled. Patients' symptoms were all significantly relieved after interventional bronchoscopic therapy, with mean American Thoracic Society Dyspnea Index score decreasing from 2.29±0.76 to 0.29±0.49 (t=6.481; P=0.001). No severe procedure-related complications were observed. Intraluminal tumors were found subsequently in three cases during a short-term follow-up (4 days to 1 month). One patient underwent surgery; thereafter got lost to follow-up, while the other 2 patients underwent a second endoscopic resection with good prognosis. Six patients received long-term follow-up (range, 2-12 years; median period, 6 years), with all patients being in stable conditions. CONCLUSIONS: Interventional bronchoscopic therapy is an acceptable approach in the management of tracheobronchial schwannoma, and is a useful alternative to surgical resection, especially for those who are at a high risk of surgery or unwilling to undergo surgery. However, long-range bronchoscopic surveillance is necessary because of the possibility of tumor recurrence. Due to its benign nature, repeat endoscopic resection can still be considered after recurrence.

Customized self-expanding bare metal Y stents in the treatment of malignant carinal stenosis: a retrospective analysis.

BACKGROUND: Self-expanding Y metal stent insertion is a safe and effective palliative method for malignant lesions involving the lower trachea, tracheal carina, and the main-stem bronchi. However, the length and degree of airway stenosis in different patients tend to vary, which leads to a call for a customized Y stent that could achieve a better treatment effect. METHODS: This retrospective analysis included patients who received customized self-expanding bare metallic Y stents for malignant carinal stenosis at Beijing Tiantan Hospital, Capital Medical University between January 2007 and June 2020. CT scans and initial bronchoscopy were performed to provide reliable data for stent selection and size customization. Data on technical success, clinical success, and follow-up were analyzed. RESULTS: A total of 36 patients (26 males and 10 females; median age, 61 years; age range, 30-83 years) were enrolled. Technical success was 97.2% (35/36), while clinical success was 97.2% (35/36). There was no procedure-related mortality. Out of 35 patients, 4 (11.4%) had stent-associated complications that did not affect the procedure of stent insertion. Re-stenosis of the stent due to tumor progression was the main mid- and long-term stent-related complication (65% and 57.1%, respectively), followed by stent fractures (5% and 14.3%, respectively). CONCLUSIONS: The current study described the design and insertion of customized self-expanding bare metal Y-stents and demonstrated the feasibility of their use for maintaining tracheal and main-stem bronchus patency in malignant carinal stenosis. This approach could be used as a bridging method before commencing adjuvant therapy and final palliative therapy for the relief of symptoms.

Proteomic profiling of biomarkers by MALDI-TOF mass spectrometry for the diagnosis of tracheobronchial stenosis after tracheobronchial tuberculosis.

Tracheobronchial tuberculosis (TB) leads to airway stenosis, irreversible airway damage and even death. The present study aimed to identify biomarkers for the diagnosis of tracheobronchial stenosis (TBS) secondary to tracheobronchial TB. A cohort was recruited, including patients with TBS after tracheobronchial TB, TBS after tracheal intubation or tracheotomy (TIT) and no stenosis of early-stage lung cancer,. Proteomic profiling was performed to gain insight into the mechanisms of the pathological processes. Differentially expressed proteins in the serum and bronchial alveolar lavage fluid (BALF) from patients were detected by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Subsequently, ELISA was performed to validate the changes of protein levels in an additional cohort. MALDI-TOF MS revealed that 8 peptides in the serum, including myeloid-associated differentiation marker, keratin type I cytoskeletal 18, fibrinogen α-chain, angiotensinogen (AGT), apolipoprotein A-I (APOAI), clusterin and two uncharacterized peptides, and nine peptides in BALF, including argininosuccinate lyase, APOAI, AGT and five uncharacterized peptides, were differentially expressed (molecular-weight range, 1,000-10,000 Da) in the TB group compared with the TIT group. The ELISA results indicated that the changes in the protein levels had a similar trend as those identified by proteomic profiling. In conclusion, the present study identified proteins that may serve as potential biomarkers and provide novel insight into the molecular mechanisms underlying TBS after tracheobronchial TB.

Choice of bronchoscopic intervention working channel for benign central airway stenosis.

The purpose of this study is to report our experiences over 12 years with bronchoscopic interventions in patients with benign central airway stenosis using three types of working channels (rigid bronchoscope, laryngeal mask, and endotracheal intubation), with a focus on their related advantages, disadvantages, and postoperative complications. We analyzed the clinical data from 273 patients with benign central airway stenosis who underwent a bronchoscopic intervention. The Wilcoxon rank-sum test was used to analyze the immediate results after the first bronchoscopic intervention, and the Chi-square test was used to analyze the correlation between glottic edema and operation time. The 273 patients underwent a total of 479 bronchoscopic interventions, with satisfactory results. The immediate effective rates of the first bronchoscopic intervention by rigid bronchoscope, laryngeal mask, and endotracheal intubation were 91.4%, 91.3%, and 85.2%, respectively. Postoperative complications related to the working channels included hoarseness, glottic edema, pharyngalgia, paresthesia pharynges, cough, and tooth loss. Glottic edema was the most serious complication, and it occurred in 37.7% (23/61) of the rigid bronchoscope group and 9.8% (32/326) in the laryngeal mask group. And the incidence rate was significantly correlated with the operation time (P < 0.01). Therefore, for patients with benign central airway stenosis, the best choice of working channel during an operation should be made by the operation procedure, lesion location, and pathology of the patients. Shortening the operation time was an important factor in preventing glottic edema.

Extraction of airway foreign bodies with bronchoscopy under general anesthesia in adults: an analysis of 38 cases.

BACKGROUND: To explore the efficacy and safety of extracting airway foreign bodies with bronchoscopy under general anesthesia in adults. METHODS: Altogether, 38 adult patients who underwent airway foreign body extraction with bronchoscopy under general anesthesia in the Pneumology Department of Beijing Tiantan Hospital, Capital Medical University, from January 2005 to December 2014 were included in the study and retrospectively analyzed concerning the extraction methods and complications. The indications and experience and lessons were summarized. RESULTS: In 38 patients with general anesthesia who had foreign bodies removed by bronchoscopy, 1 case failed to be removed, and 37 cases were successfully removed, with a success rate of 97.4%. One of the patients failed to remove the foreign body due to massive hemorrhage during the resection of the right middle bronchial stone, and the operation was interrupted. Blood loss was analyzed in all patients, 4 patients (10.5%) lost blood greater than 10 mL, and 1 patient (2.63%) lost blood greater than 300 mL. To analyze the status of airway injury, 3 patients (7.9%) had local airway mucosal tearing, and 1 patient had mild glottis edema. All the patients in this group had silent portal injury, severe hypoxemia or asphyxia, and no complications such as pneumothorax, mediastinal emphysema or pulmonary edema occurred. CONCLUSIONS: Extraction of airway foreign bodies with bronchoscopy under general anesthesia in adults is safe and effective and can avoid surgical treatment in some patients.