中华结核和呼吸杂志最新文献

{"title":"[Immunomodulatory therapy in severe pneumonia: a double-edged sword in determining clinical outcomes].","authors":"J Z Weng, Y M Li","doi":"10.3760/cma.j.cn112147-20250505-00247","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250505-00247","url":null,"abstract":"<p><p>Severe pneumonia remains a major threat to human health, particularly in patients who progress to sepsis, with immune dysregulation playing a central role in its pathophysiological mechanism. Although immunomodulatory therapies have evolved alongside our improved understanding of immune imbalance, conflicting clinical evidence persists. For example, agents targeting similar pathways may produce divergent outcomes, while those with opposing mechanisms of action may yield comparable results. This heterogeneity likely stems from dynamic variations in the host's baseline status, pathogen type, disease stage, and therapeutic timing. Future breakthroughs will require a framework for precision immune profiling that integrates dynamic biomarker monitoring, metabolic modulation, and AI-assisted decision-making. The aim of such strategies is to achieve therapy that is tailored to the individual patient, optimized over time, and balances pathological suppression with host defense preservation. This will advance immunomodulatory therapies from empirical approaches to precision medicine paradigms.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"807-811"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Standardizing the diagnosis and treatment of sleep-related breathing disorders related to neuromuscular diseases].","authors":"W Y Li, W Wang","doi":"10.3760/cma.j.cn112147-20250720-00423","DOIUrl":"10.3760/cma.j.cn112147-20250720-00423","url":null,"abstract":"<p><p>Neuromuscular diseases (NMD) are frequently associated with various forms of sleep-disordered breathing, yet these conditions are often underdiagnosed or misdiagnosed in clinical practice. To address this issue and improve standardization in clinical care, the Sleep Disorder Group of Chinese Thoracic Society has assembled a multidisciplinary panel to develop the <i>Expert consensus on the diagnosis and treatment of sleep-disordered breathing related to neuromuscular diseases.</i> This article summarised the consensus, focusing on two key areas: (1) the diagnostic and therapeutic workflow, and (2) management strategies for sleep-disordered breathing in patients with NMD. The aim was to support clinicians in effectively applying the consensus to guide its diagnosis and treatment in practice.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"804-806"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Immune-related colitis after immune checkpoint inhibitor rechallenging: a case report].","authors":"M Q Wang, Y J Shi, R X Chen, Z Y Li, K Xu, C Shao, H Huang","doi":"10.3760/cma.j.cn112147-20250223-00103","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250223-00103","url":null,"abstract":"<p><p>Immune-related adverse events (irAE) are treatment-associated complications that single or multiple systems could be involved after immune checkpoint inhibitors(ICI), ranging from mild to life-threatening diseases, with significant heterogeneity. This is an important factor which might affect continuous ICI treatment. Patients who have experienced mild to moderate irAE could try ICI rechallenge after they recovered from irAE. However, patients would suffer from same or different irAE during ICI rechallenge. Our patient who was diagnosed with maxillary sinus carcinoma experienced checkpoint inhibitor pneumonitis (CIP) after anti-PD-1 therapy with combined chemotherapy and radiotherapy. Under closely follow-up, he tried same ICI rechallenge. Although he did not suffer from refractory CIP, he was diagnosed with immune-related colitis, which was recovered from ICI discontinuation and treatment of probiotics and Mesalazine.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"856-859"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rapid and accurate diagnosis of severe pneumonia: similarities and differences between severe community-acquired pneumonia and hospital-acquired pneumonia/ventilator-associated pneumonia].","authors":"X Su, B C He","doi":"10.3760/cma.j.cn112147-20250618-00340","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250618-00340","url":null,"abstract":"<p><p>Severe pneumonia, as a critical and prevalent condition of the respiratory system, poses a significant threat to patient survival and health outcomes. This article focuses on the similarities and differences between community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP). There is significant divergence in the predominant pathogens between severe community-acquired pneumonia (SCAP) and HAP/VAP. Epidemiologic data from China has identified the six most prevalent SCAP pathogens as influenza virus, <i>Streptococcus pneumoniae</i>, <i>Enterobacteriaceae</i>, <i>Legionella pneumophila</i>, <i>Mycoplasma pneumoniae</i>, and <i>Chlamydia psittaci</i> (listed in descending order of frequency). In contrast, HAP/VAP cases in China are predominantly bacterial, with Gram-negative bacilli accounting for the majority of isolates. The antimicrobial resistance profiles of SCAP and HAP/VAP pathogens are markedly distinct: HAP/VAP pathogens exhibit substantially higher resistance rates than their CAP counterparts, necessitating different therapeutic approaches. In terms of severity assessment criteria, SCAP has well-established severity stratification systems, whereas HAP/VAP currently lacks standardized diagnostic criteria for severe cases. This discrepancy may lead to reduced inter-rater reliability and diagnostic accuracy when evaluating clinical severity compared to CAP. For etiological diagnosis, SCAP and HAP/VAP require distinct diagnostic approaches. Culture combined with antimicrobial susceptibility testing (AST) plays a pivotal role in HAP/VAP diagnosis. Proper lower respiratory tract specimens are a prerequisite for accurate identification. In contrast, most SCAP pathogens are difficult to culture; therefore, rapid and sensitive molecular detection methods, such as polymerase chain reaction (PCR) and next-generation sequencing (NGS), are essential for SCAP pathogen identification. Clinicians should develop a rapid and precise diagnostic approach for pneumonia management, applying distinct strategies for SCAP versus HAP/VAP. While initiating appropriate empirical therapy, active identification of causative pathogens through advanced diagnostics should be pursued in order to achieve the goals of precision medicine and ultimately improve patient outcomes.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"811-814"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research status of diagnosis, treatment and prognosis of primary Sjögren's syndrome-associated interstitial lung disease].","authors":"W Y Meng, H P Dai","doi":"10.3760/cma.j.cn112147-20241019-00622","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20241019-00622","url":null,"abstract":"<p><p>Interstitial lung disease (ILD) is a group of heterogeneous non-tumor and non-infectious lung diseases with basic lesions of alveolar unit inflammation and interstitial fibrosis. There are hundreds of kinds of ILD. The study of ILD subtypes in China found that the most common disease was idiopathic pulmonary fibrosis (IPF, 26.5%), followed by CTD-ILD (24.1%). Among CTD-ILD, primary Sjögren's syndrome-associated interstitial lung disease (pSS-ILD) accounted for the largest proportion. Compared with other CTD-ILD, pSS-ILD has insidious onset and is easy to be misdiagnosed and misdiagnosed. Therefore, more extensive and in-depth studies on pSS-ILD are needed. This article reviews the research status of this disease at home and abroad, hoping to assist clinicians in diagnosing and treating this disease.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"888-895"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert consensus on the diagnosis and treatment of sleep-disordered breathing related to neuromuscular diseases].","authors":"","doi":"10.3760/cma.j.cn112147-20250614-00332","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250614-00332","url":null,"abstract":"<p><p>Neuromuscular diseases are often accompanied by various types of sleep-related breathing disorders, which can exacerbate the underlying condition and are associated with a poor prognosis. Early identification is essential, and interventions such as non-invasive ventilation, oxygen therapy, and respiratory rehabilitation should be initiated promptly to mitigate disease progression and improve outcomes. Nevertheless, the rates of missed and misdiagnosed cases remain common in clinical practice. Currently, there are no standardized guidelines for the diagnosis and treatment of sleep-disordered breathing related to neuromuscular diseases in China. Therefore, based on the latest domestic and international research progress, and combined with domestic clinical diagnosis and treatment experience, the Sleep Disorder Group of Chinese Thoracic Society has brought together multidisciplinary experts to develop this expert consensus. This consensus provides a comprehensive overview of the epidemiology, clinical manifestations, diagnostic approaches, assessment strategies, and treatment of sleep-disordered breathing related to neuromuscular diseases. It formulates evidence-based recommendations to guide clinical practice, with the aim of providing standardized recommendations for their diagnosis and management.<b>Statement 1:</b> The neuromuscular disorders that are most frequently associated with sleep-disordered breathing include: myasthenia gravis (1A), amyotrophic lateral sclerosis (2B), post-polio syndrome (2B), myotonic dystrophy (2B), peripheral neuropathies (2C), and metabolic myopathies, among other neuromuscular conditions.<b>Statement 2:</b> Patients with neuromuscular disorders frequently develop multiple types of sleep-disordered breathing concurrently or sequentially, with obstructive sleep apnea (OSA) being the most prevalent manifestation. Distinct clinical manifestations of OSA are observed across different neuromuscular disease subtypes (1A).<b>Statement 3:</b> Neuromuscular disorders predispose to central sleep apnea (CSA), with clinical manifestations varying significantly across disease subtypes, stages of progression, and severity levels (1A).<b>Recommendation 1:</b> In patients with neuromuscular disorders exhibiting progressive hypercapnia or worsening hypoxemia, clinicians should investigate potential comorbid nocturnal alveolar hypoventilation and/or sleep-associated hypoxemia (1A).<b>Recommendation 2:</b> When sleep-disordered breathing is suspected, patients with neuromuscular disorders should be evaluated for symptoms of sleep-disordered breathing. Meanwhile, sleep monitoring, non-invasive CO₂ monitoring, and related examinations should be actively performed according to the actual situation (1A). A polysomnography should be performed when there is a high clinical suspicion of sleep-disordered breathing but a negative result on a portable sleep monitor (1A).<b>Recommendation 3:</b> (1) Noninvasive positive pressure","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"815-830"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Validation study of a smartwatch-based risk prediction model for respiratory tract infections].","authors":"Y B Chen, J Li, Q Y Wang, J Wu, L X Xie, L Cao","doi":"10.3760/cma.j.cn112147-20250408-00190","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250408-00190","url":null,"abstract":"<p><p><b>Objective:</b> To explore the feasibility and accuracy of predicting respiratory tract infections (RTIs) using physiological data obtained from consumer-grade smartwatches. <b>Methods:</b> The study used smartwatches and paired mobile applications to continuously collect physiological parameters while participants slept. A personalized baseline model was established using multi-day data, followed by the construction of RTIs risk prediction algorithm based on deviations from physiological parameter trends. This algorithm converted variations in physiological parameter into quantifiable risk trend scores. Using self-reported RTIs onset as the reference standard, we stratified participants by infection status and assessed the accuracy of the prediction algorithm. <b>Results:</b> A total of 472 participants were enrolled in the study, comprising 272 who developed RTIs (RTIs group) and 200 who remained healthy throughout (non-RTIs group). Key findings included: (1) Significant fluctuations in physiological parameters preceding and following RTIs onset were reliably detected by smartwatch monitoring; (2) A strong temporal correlation was observed between risk trend predictions and self-reported infection onset. The model generated no false-positive high-risk alerts for controls and correctly issued ≥1 high-risk alert within the three-day pre-onset period for 189 RTIs cases. (3) The smartwatch-based prediction model achieved sensitivity of 69.5% (95%<i>CI</i>: 63.7%-74.9%), specificity of 91.3% (95%<i>CI</i>: 86.4%-94.9%), and overall accuracy of 80.4%. <b>Conclusion:</b> Our findings validated the robust predictive capability of the algorithm utilizing consumer-grade smartwatch data for RTIs, supporting the potential utility of wearable technology in the early detection of RTIs.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"831-837"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Anti-EJ antibody positive antisynthetase syndrome with pulmonary hypertention:a case report].","authors":"H Lin, F Sun, L Wang, S G Gong, Q H Zhao","doi":"10.3760/cma.j.cn112147-20241121-00690","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20241121-00690","url":null,"abstract":"<p><p>Antisynthetase syndrome(ASS) is an entity among the immune inflammatory myopathies(IIM), which always affects lungs. Interstitial lung disease(ILD) is common in ASS, while pulmonary hypertention(PH)is rarely observed. In this paper, we reported a case of ASS with ILD and PH. Initially, we thought PH maybe associated with ILD. After we finished pulmonary function test and right heart catheterization, rheumatism immunity,and myositis antibody spectrum,we finally considered that anti EJ antibody positive ASS related ILD (EJ-ASS-FILD) had secondary type 4 PH (chronic pulmonary disease-related pulmonary arterial hypertension). This article summarizes the clinical characteristics, diagnostic methods, and treatment options of ASS related ILD combined with PH, hoping that clinical doctors can strengthen their understanding of this disease, avoid misclassification and treatment of this disease.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"853-855"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Progress on biologic therapies for severe asthma].","authors":"Z C Zhou, H T Luo, X Y Chen, R Feng, R C Chen","doi":"10.3760/cma.j.cn112147-20250512-00260","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250512-00260","url":null,"abstract":"<p><p>Biologics play a critical role in the treatment of severe bronchial asthma. Both <i>Global initiative for asthma</i> (<i>GINA</i>) and <i>Guidelines for the prevention and management of bronchial asthma</i> in our country recommend currently approved biologics as add-on therapies for patients whose symptoms remain uncontrolled despite high dose maintenance ICS-LABA treatments. The approved biologics include Omalizumab, Mepolizumab, Benralizumab, Reslizumab, Dupilumab, and Tezepelumab. These agents exert anti-inflammatory effects in asthma by targeting immunoglobulin E (IgE), interleukin-5 (IL-5) and its receptor IL-5R, IL-4Rα, and thymic stromal lymphopoietin (TSLP), respectively. This review categorized biologics based on their therapeutic targets, summarized those approved for severe asthma and briefly introduced agents currently under clinical investigation. It also discussed common challenges and future trends in biologic therapies. This review aimed to provide clinical and research insights for optimizing the application of biologics in asthma management.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"870-877"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research status and future direction of irreversible EGFR-TKI in non-small cell lung cancer].","authors":"M X Fang, W D Wu, X X Yu","doi":"10.3760/cma.j.cn112147-20250224-00105","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250224-00105","url":null,"abstract":"<p><p>Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) are important treatments for EGFR mutant non-small cell lung cancer (NSCLC). However, the first and second generation EGFR-TKI face clinical limitations due to acquired resistance, such as the T790M mutation. Irreversible EGFR-TKI can significantly prolong the survival of patients by enhancing the inhibition of drug-resistant mutations through the covalent binding mechanism. This article systematically reviews the mechanism of action, clinical research progress and future direction of irreversible EGFR-TKI, focusing on their potential to overcome drug resistance, combination treatment strategies and biomarker guided personalized treatment, in order to provide references for clinical practice.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 9","pages":"863-869"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}