中华结核和呼吸杂志最新文献

{"title":"[Annual progress in critical care of pulmonary medicine 2025].","authors":"K F Wang, X L Wang, X Shi, S F Li, L X Xie","doi":"10.3760/cma.j.cn112147-20251227-00829","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20251227-00829","url":null,"abstract":"<p><p>This review systematically summarizes the annual research advances in the field of critical care of pulmonary, with a focus on pulmonary and critical care medicine (PCCM) worldwide from October 2024 to September 2025. This review focuses on severe pulmonary infections and their associated complications, such as sepsis and acute respiratory distress syndrome (ARDS), with an emphasis on early screening, diagnosis, and precision treatment. Key areas covered include rapid diagnosis of severe infections, early warning systems, dynamic assessment, personalized management of respiratory critical illnesses, and the clinical application of big data and artificial intelligence. The aim of this review is to provide valuable insights and practical guidance for healthcare professionals and researchers engaged in clinical practice and scientific research in PCCM.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"345-350"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445142","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":"[From evidence-based to precision medicine: advancing a new paradigm for the diagnosis and treatment of obstructive sleep apnea].","authors":"Y Xiao","doi":"10.3760/cma.j.cn112147-20251114-00711","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20251114-00711","url":null,"abstract":"<p><p>The 2025 edition of the <i>Guidelines for the Diagnosis and Treatment of Adults with Obstructive Sleep Apnea in adults</i> represents a major milestone in the sleep medicine field in China, marking a transition in obstructive sleep apnea management from an \"experience-based\" to an \"evidence-based\" approach, and heralding a new era of \"evidence-driven, phenotype-oriented, and whole-course management\". The new guideline systematically addresses 18 key clinical questions, employing the structured PICOS framework and adheres strictly to international AGREE Ⅱ and RIGHT standards to ensure scientific rigor and transparency in its recommendations. Several important advances distinguish the updated version: it introduces composite indices such as hypoxic burden (HB) and sleep breathing impairment index (SBII <i>Obstructive Sleep Apnea</i> I), shifting assessment from \"event frequency\" to \"pathophysiological load\"; it adopts precise classification based on clinical phenotypes (<i>e.g.</i>, excessive daytime sleepiness or asymptomatic types) and endotypes (PALM model), facilitating personalized therapy. Pharmacological treatment has advanced from a state of \"no effective drugs\" to \"targeted precision therapy\" with clear indications for wake-promoting agents and GIP/GLP-1 agonists; and it integrates telemedicine and home monitoring technologies to establish a structured follow-up system. Compared with the 2011 edition, which was largely consensus-based, the 2025 guideline is fully grounded in high-quality domestic and international evidence, incorporating the data from Chinese populations. It promotes the standardization, systematization, and individualization of obstructive sleep apnea diagnosis and treatment, providing an authoritative practical framework for achieving the goal of \"optimal therapy for every patient\".</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"257-260"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446040","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":"[Clinical, imaging, and pathological features of diffuse alveolar filling diseases].","authors":"X D Mu","doi":"10.3760/cma.j.cn112147-20250827-00521","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250827-00521","url":null,"abstract":"<p><p>Diffuse alveolar filling disease (DAFD) is characterized by diffuse lesions in both lungs caused by the abnormal filling of bilateral alveolar spaces (and sometimes the terminal bronchioles) with substances such as water, blood, lipids, inflammatory cells, pathogens, or tumor cells. Clinically, it is characterized mainly by dyspnea and hypoxemia, while imaging examinations reveal diffuse ground-glass opacities or consolidation shadows in both lungs. In the early stage, lung volume generally remains unchanged, but pulmonary interstitial fibrosis may occur in the advanced stage. Typical diseases included in this category are pulmonary alveolar proteinosis (PAP), diffuse alveolar hemorrhage (DAH), idiopathic pulmonary hemosiderosis (IPH), and pneumocystis pneumonia (PCP). While these diseases share certain similarities in clinical symptoms, imaging features, and pathological manifestations, each has its own distinct characteristics. Bronchoalveolar lavage fluid (BALF) detection and lung biopsy are the main confirmatory diagnostic methods. As a newly proposed concept, DAFD and diffuse interstitial lung diseases (DILD) both belong to diffuse parenchymal lung diseases (DPLD). The formal proposal of this new concept is of great significance for the diagnosis and differential diagnosis of DPLD.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"380-382"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445983","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":"[Angiomatoid fibrous histiocytoma in the pulmonary artery: case report and review of literature].","authors":"L Bao, Y Y Shen, S X Wang, P Wang, X X Li","doi":"10.3760/cma.j.cn112147-20250813-00488","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250813-00488","url":null,"abstract":"<p><p><b>Objective:</b> To explore the clinical features, diagnosis, and treatment progress of angiomatoid fibrous histiocytoma (AFH) primary to the pulmonary artery. <b>Methods:</b> A retrospective analysis was conducted on one case of AFH primary to the pulmonary artery in a middle-aged female. Databases including SinoMed, the Wanfang Data Knowledge Service Platform, and the China National Knowledge Infrastructure (CNKI) were searched using the keywords (angiomatoid fibrous histiocytoma) and (pulmonary artery). Meanwhile, PubMed, Embase, the Cochrane Library, and Web of Science were searched using the keywords \"angiomatoid fibrous histiocytoma\" and \"pulmonary artery.\" The search was updated to April 2025. <b>Results:</b> The patient was admitted to our hospital in February 2025 due to symptoms such as chest tightness and dizziness, and a space-occupying lesion of the pulmonary artery was detected. Postoperative histopathological examination confirmed the diagnosis of pulmonary artery AFH. Only one relevant article was retrieved from domestic databases and five from foreign databases. A total of seven patients were included (including the current case), with four males and three females, aged 20-76 years (mean, 54.57±18.18 years). The lesions were located in the left main pulmonary artery (three cases), right main pulmonary artery (two cases), right upper pulmonary artery (three cases), and right interlobar pulmonary artery (one case). D-dimer levels were elevated in two cases, normal in three cases, and unknown in two cases. PET-CT showed significantly increased SUVmax in four cases and was unknown in three cases. EWSR1 gene translocation was detected in five cases, absent in one case, and unknown in one case. Surgical procedures included extended local resection of the pulmonary artery (three cases) and partial or total pneumonectomy (four cases). No recurrence or metastasis was observed in five patients, and the outcomes of two patients were unknown. <b>Conclusion:</b> AFH primary to the pulmonary artery is extremely rare. Clinically, it needs to be mainly differentiated from pulmonary thromboembolism and pulmonary artery intimal sarcoma, and clinicians in respiratory medicine and vascular intervention departments should raise awareness of this disease. In the differential diagnosis from pulmonary thromboembolism, clinical manifestations and laboratory tests (e.g., D-dimer) lack specificity, while imaging examinations such as CTPA and PET-CT are effective auxiliary methods. Definitive diagnosis still relies on histopathological examination, and EWSR1 molecular detection is an important basis for pathological confirmation. Pulmonary artery resection combined with artificial vascular replacement is an effective treatment, and long-term follow-up is necessary.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"329-333"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445077","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":"[Comparative bronchoscopic manifestations in pulmonary mucormycosis and invasive pulmonary aspergillosis].","authors":"X S Li, J Xu, P Zeng, H X Wu, W Q Dong, Y N Wang, X D Mu","doi":"10.3760/cma.j.cn112147-20250723-00436","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250723-00436","url":null,"abstract":"<p><p>Pulmonary mucormycosis (PM) and invasive pulmonary aspergillosis (IPA) are life-threatening, opportunistic infections that are commonly seen in immunocompromised patients. Both are characterized by their tendency to invade the airways. This study retrospectively analyzed 46 PM patients and 41 IPA patients diagnosed at Beijing Tsinghua Changgung Hospital between January 2018 and February 2025, systematically evaluating their bronchoscopic features and proposing the morphological concepts of \"mucormycelium\", \"aspermycelium\", and \"bronchial pulmonary cavity fistula\". The results showed that mucormycelium was more frequently observed bronchoscopically than aspermycelium. PM patients more commonly presented with bronchial pulmonary cavity fistula, granulation tissue, lumen stenosis, lumen obstruction, and purulent secretions, whereas fungal spots were more frequently identified in IPA patients. No significant differences were found between PM and IPA in terms of bronchial mucosal congestion and airway bleeding. These findings suggest that bronchoscopic features are valuable for differentiating between PM and IPA.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"334-338"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446021","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 clinical application of robotic-assisted bronchoscopy].","authors":"","doi":"10.3760/cma.j.cn112147-20250908-00554","DOIUrl":"10.3760/cma.j.cn112147-20250908-00554","url":null,"abstract":"<p><p>Robotic-assisted bronchoscopy (RAB) is an emerging diagnostic and interventional technology which integrates thin-slice CT-based virtual airway reconstruction, precise navigation, and stable robotic manipulation.It has been shown to offer clear advantages in the management of peripheral pulmonary lesions. With the rapid increase in clinical adoption in China, standardized guidance is required to ensure safe and effective use. Based on multidisciplinary expert discussions and a systematic review of the literature, this consensus summarizes key principles for the clinical application of RAB, encompassing technical foundations, indications and contraindications, procedural workflow, anesthesia and perioperative management, imaging integration, complication prevention, telemedicine application, and requirements for facilities and personnel training. The consensus emphasizes the importances of selecting appropriate patient, standardizing preprocedural planning and intraoperative navigation, optimizing anesthesia and ventilation to reduce CT-to-body divergence, and using multimodal imaging in a rational way to enhance lesion confirmation and procedural accuracy. In addition, it highlights the importance of structured emergency preparedness, device contingency management, and competency-based team training, while acknowledging current limitations and future development directions of RAB. These recommendations aim to support the safe, consistent, and evidence-informed integration of RAB into clinical practice, as well as to promote its standardized development in China.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"307-316"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446000","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":"[Use of modified balloon pulmonary angioplasty in the treatment of chronic thromboembolic pulmonary hypertension: a retrospective study from a single center].","authors":"J Chen, Z L Zhang, Y Y Chen, J H Ren, L F Chen","doi":"10.3760/cma.j.cn112147-20250610-00314","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250610-00314","url":null,"abstract":"<p><p><b>Objective:</b> This study aims to evaluate the clinical effectiveness of a modified balloon pulmonary angioplasty(BPA) procedure in the treatment of chronic thromboembolic pulmonary hypertension. <b>Methods:</b> We conducted a retrospective analysis of clinical data from patients diagnosed with chronic thromboembolic pulmonary hypertension who underwent Modified BPA at the Department of Cardiovascular Medicine in Xiamen Hospital of Traditional Chinese Medicine between January 2021 and May 2024. The study comprised 21 patients, including 5 males and 16 females, who successfully underwent the scheduled six BPA surgical sessions, totaling 126 individual cases. <b>Results:</b> All surgeries were guided by pressure guidewires. Three patients exhibited mild hemoptysis during the procedure, while two experienced mild pulmonary edema in the postoperative phase. There were no fatalities. Compared to the baseline, significant improvements were observed in indicators such as mean pulmonary artery pressure, pulmonary vascular resistance, and cardiac index following the surgical treatment course for all patients. These differences were statistically significant (<i>P</i><0.001) as measured by right heart catheterization. Three months post-treatment, there was a marked improvement in cardiac function classification (WHO FC), 6-minute walking distance, and NT-proBNP levels compared to the baseline, with these differences also being statistically significant (<i>P</i><0.001). Additionally, significant enhancements were noted in the right atrial area, estimated pulmonary artery systolic pressure, and tricuspid annular plane systolic excursion (TAPSE), all of which exhibited statistically significant differences (<i>P</i><0.001). <b>Conclusions:</b> The modified BPA procedure significantly improves the structure of the right heart, cardiac function, and hemodynamics in patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH). This intervention is not only safe but also highly effective, positioning it as an exceptional therapeutic option for patients with CTEPH.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"317-323"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445960","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":"[Annual review of community-acquired pneumonia (CAP) 2025].","authors":"F Zhou, Z P Liu, B Cao","doi":"10.3760/cma.j.cn112147-20251124-00741","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20251124-00741","url":null,"abstract":"<p><p>Community-acquired pneumonia (CAP) remains a significant global health challenge. This review summarizes the major advances in clinical research or CAP between October 1, 2024, and September 30, 2025. Given the high prevalence of macrolide<i>-</i>resistant Mycoplasma pneumoniae (MRMP) in China, PCR test for MRMP was recommended in pediatric patients to guide appropriate antibiotic selection. Increased attention is warranted for respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) due to their increasing prevalence and poor prognosis. PSI and CURB-65 scores remain the reliable tools for assessing the severity of CAP, while the SOFA-2 score may offer a promising approach for identifying patients requiring intensive care unit (ICU) admission. Although multiplex PCR (mPCR), targeted next-generation sequencing (tNGS), and metagenomic next-generation sequencing (mNGS) have been widely adopted in clinical practice, current evidence does not demonstrate sufficient benefits in improving patient survival or optimizing antibiotic stewardship. A rational, empirical antibiotic strategy should be individualized according to local pathogen epidemiology, risk of antimicrobial resistance and aspiration, and patient's clinical presentation. Short-course antibiotic therapy guided by \"clinical stability\" criteria is reliable, yet achieving stability requires more time in elderly patients and cases with comorbidities. Cefpirome and lefamulin are new antimicrobial agents on the market, but further clinical data are needed to support their use in severe cases and elderly patients. Suraxavir marboxil (GP681), a newly antiviral agent drug targeting the polymerase acidic protein of the influenza virus RNA polymerase, has recently been approved in China. Extending the administration of steroids to severe CAP without septic shock should be approached with extreme caution. High level of C-reactive protein may serve as a potential indicator for identifying cases who could benefit from steroids. In addition, RSV vaccines and monoclonal antibodies will emerge as important strategies for preventing RSV pneumonia in high-risk populations.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"339-344"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445997","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":"[Enhancing the capacity of pulmonary vascular intervention system in China: current status, opportunities, and challenges].","authors":"Q Huang, C M Xiong, J Z Wang, Z G Zhai, C Wang","doi":"10.3760/cma.j.cn112147-20251203-00763","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20251203-00763","url":null,"abstract":"<p><p>Recent advances in endovascular techniques, together with the increasing adoption of multidisciplinary team (MDT) models, have substantially transformed the management of pulmonary vascular diseases. Management strategies have evolved from a predominantly pharmacotherapy-based approach toward a more comprehensive framework that integrates multimodal diagnostic evaluation, interventional procedures, and coordinated multidisciplinary care. Owing to their precision and minimally invasive nature, pulmonary vascular interventional techniques have become an integral component of contemporary clinical practice. Nevertheless, marked heterogeneity persists across regions and medical centers in China with respect to technical expertise, resource availability, and the capacity to deliver standardized care. Moreover, these interventions require close collaboration among multiple specialties, yet uniform protocols and standardized clinical workflows remain insufficiently established. Such limitations contribute to variability in care delivery and constrain opportunities for system-wide quality improvement. Therefore, the development of a standardized, multidisciplinary pulmonary vascular interventional care system is essential to improve clinical outcomes and promote more equitable access to high-quality care nationwide.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"251-256"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446003","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":"[Annual progress of interventional pulmonology in 2025].","authors":"X Y Xu, H J Chen, S Y Li","doi":"10.3760/cma.j.cn112147-20260104-00004","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20260104-00004","url":null,"abstract":"<p><p>In 2025, interventional pulmonology continues to progress rapidly through technological innovation and multidisciplinary integration, playing an increasingly prominent role in the diagnosis and management of respiratory diseases. Significant developments are primarily reflected in the maturation of navigational and robotic bronchoscopy technologies, the emergence of transbronchial interventional ablation as a key therapeutic modality for peripheral lung cancer, the expanding repertoire of interventional techniques offering more treatment options for patients with airway diseases, and the transformative potential introduced by artificial intelligence and regenerative medicine. Together, these advances are steering interventional pulmonology toward greater efficiency, precision, intelligence, and personalization.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"49 3","pages":"351-355"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446048","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}