中华结核和呼吸杂志最新文献

{"title":"[Expert consensus on operational procedures for bronchial artery embolization in the treatment of hemoptysis].","authors":"","doi":"10.3760/cma.j.cn112147-20250104-00009","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20250104-00009","url":null,"abstract":"<p><p>Hemoptysis is a severe clinical symptom of the respiratory system, which can lead to asphyxiation and endanger life in severe cases. Treatment options include medical therapy, bronchoscopy, vascular interventions, and surgical procedures. Among these, bronchial artery embolization (BAE) has emerged as a pivotal interventional technique for managing hemoptysis due to its minimally invasive nature and robust hemostatic efficacy. BAE is now widely utilized in clinical settings, particularly in the urgent management of massive hemoptysis. However, the complexity of the procedure and the absence of standardized protocols and technical guidelines in China have limited its widespread adoption. To enhance the quality and consistency of BAE, particularly in the diagnosis and management of massive hemoptysis, the Pulmonary Embolism and Pulmonary Vascular Diseases Group of the Chinese Thoracic Society, the Pulmonary Embolism and Pulmonary Vascular Disease Working Group of the Chinese Medical Doctor Association, and the National Working Group for the Prevention and Treatment of Pulmonary Embolism and Pulmonary Vascular Diseases have collaboratively developed the \"Expert Consensus on Procedural Standards for Bronchial Artery Embolization in the Treatment of Hemoptysis.\" This consensus provides a comprehensive overview of bronchial artery anatomy, indications and contraindications for BAE, procedural guidelines, complication prevention and management, as well as postoperative care, with the objective of further standardizing the clinical application of BAE.<b>Recommendations</b>1.Given the complexity of bronchial artery anatomy, various projection angles should be utilized intraoperatively to fully visualize the morphology of the affected vessels.2.The primary culprit vessels in hemoptysis are typically the bronchial arteries, ectopic bronchial arteries, and non-bronchial systemic arteries. However, vigilance is still required for hemoptysis originating from pulmonary arteries and veins.3.It is recommended to establish a multidisciplinary team for hemoptysis management to collaboratively develop tailored treatment plans.4.In cases where the patient exhibits signs of asphyxiation, a prompt assessment of the need for tracheal intubation is crucial to maintain airway patency. If necessary, perioperative management should include endoscopic intervention.5. Preoperative bronchial artery CT angiography is recommended to thoroughly identify and assess the responsible vessels before BAE.6. Prior to embolization, comprehensive angiography of all implicated vessels should be performed. The use of coaxial microcatheter techniques and appropriate embolization materials is recommended for super-selective embolization to avoid non-target embolization.7. Long-term management and follow-up of patients post-BAE is advised, including health education and a focus on treating the underlying condition to reduce the risk of hemoptysis recurrence.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"408-417"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043171","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":"[Intraluminal intervention therapy for pulmonary vascular stenosis caused by fibrous mediastinitis:report of two cases].","authors":"J L Lin, W J Lin, X F Wu, H L Ye, X Yang, J Qu, J Y Cui, H Q Huang, C Hong","doi":"10.3760/cma.j.cn112147-20241015-00613","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20241015-00613","url":null,"abstract":"<p><p>Fibrosing mediastinitis (FM) is a pathological condition characterized by tissue proliferation and calcification within the mediastinum, leading to the compression of critical structures such as blood vessels and airways. Endovascular intervention is the preferred therapeutic strategy for FM-induced pulmonary vascular stenosis. However, when the disease involves the bifurcation of the pulmonary artery, resulting in stenosis at the origins of both branches, a single-stent implantation cannot simultaneously preserve both vessels. Double-stent implantation is technically more complex than single-stent procedures, but has the advantage of preserving both affected vessels. This article presents two cases of FM-associated pulmonary artery bifurcation stenosis treated with double-stent implantation, with an emphasis on evaluating the therapeutic efficacy and safety of this approach.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"456-460"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063427","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":"[Transformations and optimizations: updates in the global and domestic guidelines for chronic obstructive pulmonary disease over 25 years].","authors":"X W Sun, Q Y Li","doi":"10.3760/cma.j.cn112147-20241222-00749","DOIUrl":"10.3760/cma.j.cn112147-20241222-00749","url":null,"abstract":"<p><p>Over the past 25 years, both inter national and Chinese guidelines for chronic obstructive pulmonary disease (COPD) have undergone numerous updates and revisions that have continuously focused and optimized therapeutic targets, evaluation systems, and treatment strategies. We have reviewed and summarized the changes in the relevant contents of COPD guidelines, with a focus on their relevance to clinical practice. In recent years, COPD treatment has focused on two therapeutic targets: symptom relief and reduction of acute exacerbation risk. There is an increasing emphasis on individualized care, incorporating the concept of closed-loop management in upgrading/downgrading and initial/subsequent treatment to ensure dynamic adjustment of follow-up care. In addition, the emergence of new treatment options based on different pathogenesis mechanisms has provided new breakthroughs in COPD management. Chinese guidelines for COPD are also being continuously updated to provide more guidance for patients, such as early screening and diagnosis, comprehensive and self-management, and the prevention and treatment of acute exacerbations, thereby continuously improving the precision of decision-making and scientific management in the clinical practice of COPD diagnosis and treatment.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"470-475"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051139","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":"[Immunodeficiency and related infections caused by anti-cytokine autoantibody].","authors":"S Q Liang, B Cao, Z Y He","doi":"10.3760/cma.j.cn112147-20241014-00605","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20241014-00605","url":null,"abstract":"<p><p>Anti-cytokine autoantibody (AAb) is produced by plasma cells and interfere with the signaling pathways of their respective cytokines, thereby blocking the biological functions of these target cytokines. This disruption increases the susceptibility of patients to pathogens, leading to recurrent and complex infections. Known anti-cytokine autoantibodies include those against interferon, granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-6, IL-17, and IL-12/23. These antibodies are associated with immune deficiency-related infections. This review summarizes the clinical manifestations and underlying mechanisms of these diseases.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"487-492"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055704","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 progress of complement system activation involved in idiopathic pulmonary fibrosis].","authors":"Y M Liu, Y Y Liang, J Y Zou, N Z Zang, L Yang, L J Pang, X D Lyu","doi":"10.3760/cma.j.cn112147-20241018-00621","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20241018-00621","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) is a severe interstitial lung disease, and its pathogenesis remains unclear. In recent years, studies have shown that complement system activation plays an important role in the process of IPF. The inhibition of complement system activation provides a new approach for IPF treatment strategies. This article reviews the recent advances of complement system activation in the molecular mechanisms in the progress of IPF, and the potential therapeutic target in drug development, providing new perspectives for the prevention and treatment of IPF.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"481-486"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054513","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 characteristics and CT angiography manifestations of central pulmonary artery pseudoaneurysm].","authors":"W J Zhang, S R Xue, B Wang, S X Li, F Z Wang, D J Su, F Q Li","doi":"10.3760/cma.j.cn112147-20241118-00680","DOIUrl":"https://doi.org/10.3760/cma.j.cn112147-20241118-00680","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the clinical characteristics and pulmonary artery CT angiography (CTA) manifestations of central pulmonary artery pseudoaneurysms (PAPA), aiming to improve diagnostic accuracy. <b>Methods:</b> Twenty-three patients with complete clinical data of hemoptysis due to central PAPA admitted to Liangzhou Hospital of Wuwei City and the First Hospital of Lanzhou University from April 2019 to August 2024 were retrospectively included. There were 10 males and 13 females, with a mean age of 68 years (49-78 years). The patients were analyzed for underlying disease, CTA manifestations of the pulmonary artery of PAPA, single maximum hemoptysis and outcomes. <b>Results:</b> Pulmonary tuberculosis was identified as the primary etiology in 95.7% (22/23) of cases. PAPAs were located in the left inferior pulmonary artery (PA) trunk (9 cases), right inferior PA trunk (6 cases), left lower lobe basal segment PA trunk (2 cases), right lower lobe basal segment PA trunk (4 cases), left upper lobe PA trunk (1 case), and left lingular segment PA trunk (1 case). All PAPAs were solitary lesions with morphological variations: finger-like (9 cases, 39.1%, 9/23), sac-like (6 cases, 26.1%, 6/23), nodular (4 cases, 17.4%, 4/23), beak-like (2 cases, 8.7%, 2/23), and umbrella-like (2 cases, 8.7%, 2/23). Adjacent lung tissues exhibited patchy opacities, nodules, flocculent shadows, or consolidation, with 56.5% (13/23) of PAPAs originating from cavitary walls. The mean maximum single-episode hemoptysis volume was 570 ml (range: 150-2000 ml). Thirteen patients without endovascular treatment survived for a mean of 68.5 days, whereas 10 patients with endovascular intervention survived for 709.4 days on average. Thirteen patients died of asphyxia due to massive hemoptysis and 3 died of non-hemoptysis-related causes. <b>Conclusions:</b> Pulmonary tuberculosis is the most common cause of central PAPAs, especially in patients with hilar-adjacent cavities. After rupture of central pulmonary artery pseudoaneurysms (PAPAs), patients experience significantly larger single-episode hemoptysis volumes, leading to high risk of asphyxia-related death. Early pulmonary artery endovascular treatment can improve prognosis and prolong survival time. Pseudoaneurysms are easily missed on axial CT images when: (1) the lesion and its parent artery are not in the same imaging plane, or (2) the lesion has a nodular or beak-like morphology.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 5","pages":"440-447"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000458","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 excessive daytime sleepiness in obstructive sleep apnea patients].","authors":"Y X Wang, Y Xiao","doi":"10.3760/cma.j.cn112147-20241209-00730","DOIUrl":"10.3760/cma.j.cn112147-20241209-00730","url":null,"abstract":"<p><p>Excessive daytime sleepiness (EDS) and residual EDS are common clinical symptoms of obstructive sleep apnea (OSA). To better guide clinicians in the diagnosis and treatment of EDS in patients with OSA, the Sleep Disorder Group of Chinese Thoracic Society has developed the \"<i>Expert consensus on the diagnosis and treatment of excessive daytime sleepiness in obstructive sleep apnea</i>\". This commentary discusses the key points of the consensus guidelines by focusing on two aspects: recommendations for the diagnostic and treatment protocols for OSA-induced EDS, and pharmacotherapy recommendations, with the aim of helping clinicians to better understand and apply the consensus.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 4","pages":"301-303"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756280","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":"[Multiple pulmonary nodules in an electric welder with recurrent fever].","authors":"S T Wang, R E Feng, M Chen, X L Tian, J H Shi, L Song, Y L Yang","doi":"10.3760/cma.j.cn112147-20240830-00518","DOIUrl":"10.3760/cma.j.cn112147-20240830-00518","url":null,"abstract":"<p><p>This article reported a 33-year-old male electric welder with myelodysplastic syndrome (MDS) who presented with recurrent fever. Laboratory tests revealed anemia, thrombocytopenia, elevated inflammatory markers, and positive blood cultures. Chest imaging examinations showed diffuse miliary nodules in both lungs, enlarged mediastinal lymph nodes, and recurrent new patchy shadows in the lungs. Antibacterial treatment was ineffective. Through video-assisted thoracoscopic surgery and pathology, the patient was diagnosed with pulmonary iron dust deposition, lipoid pneumonia, pulmonary alveolar proteinosis (PAP) and secondary aspergillus infection. After antifungal and short-term antibacterial treatment, the patient's body temperature returned to normal. Considering the patient's overall condition, it is likely that MDS led to secondary PAP and lipoid pneumonia, and the decreased white blood cell function caused by MDS triggered subsequent pulmonary aspergillosis and bloodstream infections. This case highlighted the importance of considering potential hematological diseases in patients with complex pulmonary manifestations. At the same time, this case added to the limited real-world data on the relationship between MDS and PAP, particularly in patients with occupational exposures and concurrent infections.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 4","pages":"373-377"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756223","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":"[A case of heterogeneous emphysema treated with bronchoscopic thermal vapour ablation(BTVA)].","authors":"X W Song, Y C Li, X Sun, K S Zhang","doi":"10.3760/cma.j.cn112147-20241014-00603","DOIUrl":"10.3760/cma.j.cn112147-20241014-00603","url":null,"abstract":"<p><p>Bronchoscopic thermal vapour ablation (BTVA), recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as a respiratory intervention technique, has not been widely implemented in China for the treatment of severe chronic obstructive pulmonary disease (COPD) patients. Here, we reported a case of a 78-year-old man with upper lobe heterogeneous emphysema who was treated with BTVA. This therapy resulted in clinically significant improvements in pulmonary function, quality of life, and exercise tolerance. No serious adverse events were observed.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 4","pages":"382-385"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756139","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 airway complications after lung transplantation].","authors":"","doi":"10.3760/cma.j.cn112147-20240814-00485","DOIUrl":"10.3760/cma.j.cn112147-20240814-00485","url":null,"abstract":"<p><p>Lung transplantation is the only effective treatment for end-stage pulmonary disease. As surgical techniques and post-operative management protocols have been optimised, the number of lung transplantations has steadily increased worldwide. Airway complications (AC), which include airway stenosis, tracheobronchomalacia, ischemic necrosis, and anastomotic leaks, are one of the most common complications following lung transplantation, with an overall incidence ranging from 15% to 20%. These complications have a significant impact on the quality of life and survival rate of transplant recipients, with airway stenosis being the most common. In lung transplant recipients, AC can affect both large and small airways, with the majority of large airway complications occurring within the first year after surgery. This consensus focuses specifically on AC of large airways. It is widely recognized that impaired bronchial blood supply is a common underlying cause of AC due to a variety of factors. The post-transplant management of AC, particularly the technical requirements for specialized interventional procedures, remains a major challenge. Currently, there is no standardized diagnostic and therapeutic approach within the country. This consensus aims to unify and propose guidelines on the diagnosis, treatment options, interventional strategies, methodologies, and key considerations for the management of AC after lung transplantation, with the hope of improving patient outcomes and serving as a reference for practitioners in the field.</p>","PeriodicalId":61512,"journal":{"name":"中华结核和呼吸杂志","volume":"48 4","pages":"318-328"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756218","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}