简介：AbstractChronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The incidence of COPD is growing annually in China, and it is a significant and growing public health burden. Multivariate analysis showed that COPD was one of the independent risk factors for the occurrence of pulmonary embolism (PE), and the incidence of PE was significantly higher in COPD patients than in normal subjects. However, PE is often overlooked in patients with acute exacerbation of COPD (AECOPD) because there are many similarities in clinical symptoms between PE and AECOPD, which are difficult to distinguish, resulting in the failure of timely treatment and poor prognosis. Therefore, it is of great significance to understand the clinical manifestations, diagnosis, and treatment of COPD combined with PE for making a more accurate diagnosis, providing timely and effective treatment, and improving the prognosis of such patients.

简介：Pulmonaryhypertensionisnotasingleentityandnotallformshavethesameprognosis.Thepurposeofthiseditorialistoprovideinformationtothegeneralcardiologistrelatingtowhichtypeofpulmonaryhypertensionthepatientisexperiencing.Inordertodothisproperly,onemustdeterminethecause,theseverity,theprognosis,anddeveloptreatmentplansforthedifferentformsofpulmonaryhypertension.Pulmonaryarterialhypertension(PAH)isthemostmalignantofthedifferenttypesofpulmonaryhypertension.Whiletypicallybeingdiagnosedinayoungerpopulationthantheothertypes,PAHmaybeshowingatrendtowardsdiagnosislaterinthelifethanwhatwasthoughtfromolderregistrydata[1].TheusualcausesofcardiovasculardeathinpatientswithPAHincludesrightheartfailureandsuddendeath[2].

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简介：AbstractIntroduction:Early intervention in patients with congenitally disconnected pulmonary artery improves long-term outcome.Case presentation:We present 3 cases of isolated disconnected pulmonary artery in the absence of associated structural heart disease during a period of 3 years.Conclusion:Transcatheter stenting of the feeding ductus arteriosus re-established pulmonary artery flow and growth. Successful surgical repair was achieved, and normal perfusion and complete function of the ipsilateral lung were regained.

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简介：AbstractBackground:The incidence of chronic obstructive pulmonary disease (COPD) complicated with invasive pulmonary aspergillosis (IPA) has increased in the last two decades. The mechanism underpinning susceptibility to and high mortality of COPD complicated with IPA is unclear, and the role of T helper cells 17 (Th17 cells) in the compound disease remains unknown. Therefore, this study aimed to assess the function of Th17 cells in COPD combined with IPA.Methods:COPD, IPA, and COPD+IPA mouse models were established in male wild type C57/BL6 mice. The amounts of Th17 cells and retinoic acid-related orphan receptors γt (RORγt) were tested by flow cytometry. Then, serum interleukin (IL)-17 and IL-23 levels were detected by enzyme-linked immunosorbent assay (ELISA) in the control, COPD, IPA and COPD+IPA groups. In addition, COPD+IPA was induced in IL-17 knockout (KO) mice, for determining the role of Th17 cells in COPD+IPA.Results:Compared with the COPD group, the COPD+IPA group showed higher amounts of blood RORγt ([35.09 ± 16.12]% vs. [17.92 ± 4.91]%, P = 0.02) and serum IL-17 (17.96 ± 9.59 pg/mL vs. 8.05 ± 4.44 pg/mL, P = 0.02), but blood ([5.18 ± 1.09]% vs. [4.15 ± 0.87]%, P= 0.28) and lung levels of Th17 cells ([1.98 ± 0.83]% vs. [2.03 ± 0.98]%, P= 0.91), lung levels of RORγt ([9.58 ± 6.93]% vs. [9.63 ± 5.98]%, P = 0.49) and serum IL-23 (51.55 ± 27.82 pg/mL vs. 68.70 ± 15.20 pg/mL, P = 0.15) showed no significant differences. Compared with the IPA group, the COPD+IPA group displayed lower amounts of blood ([5.18 ± 1.09]% vs. [9.21 ± 3.56]%, P = 0.01) and lung Th17 cells ([1.98 ± 0.83]% vs. [6.29 ± 1.11]%, P = 0.01) and serum IL-23 (51.55 ± 27.82 pg/mL vs. 154.90 ± 64.60 pg/mL, P = 0.01) and IL-17 (17.96 ± 9.59 pg/mL vs. 39.81 ± 22.37 pg/mL, P = 0.02), while comparable blood ([35.09 ± 16.12]% vs. [29.86 ± 15.42]%, P = 0.25) and lung levels of RORγt ([9.58 ± 6.93]% vs. [15.10 ± 2.95]%, P = 0.18) were found in these two groups. Finally, Aspergillus load in IL-17 KO COPD+IPA mice was almost 2 times that of COPD+IPA mice (1,851,687.69 ± 944,480.43 vs. 892,958.10 ± 686,808.80, t= 2.32, P = 0.02).Conclusion:These findings indicate that Th17 cells might be involved in the pathogenesis of COPD combined with IPA, with IL-17 likely playing an antifungal role.

简介：AbstractPulmonary rehabilitation (PR) is a cornerstone management for chronic obstructive pulmonary disease (COPD). International respiratory societies defined PR is more than "just an exercise program" ; it is a comprehensive care delivered by a team of dedicated healthcare professionals with a strong emphasis on long-term health-enhancing Behaviors. However, "Uncertainty" exists with varied reasons for the political and geographical barriers of referral, uptake, attendance, and completion of PR in both primary and secondary care. Besides, COVID-19 pandemic has sparked many global controversies and challenges on pulmonary rehabilitation service delivery. Post-COVID-19 guidelines emphasize on integrated care rehabilitation for patients with COPD. Thus, this concise review intends to understand the gaps in United Kingdom healthcare policies, practices, and PR services resources. To date, there is no clear consensus on PR integrated care model pathway to address the unmet needs, measure the health and social care disparities; adds to the disease burden of COPD. Based on the culmination of evidence, this perspective offers a theoretical framework of PR integrated service model, a pathway to deliver high-value personalized care to patients with COPD.

简介：AbstractOver the last 20 years, it has become possible to use a precision medicine approach to the management of chronic obstructive pulmonary disease (COPD). Clinical and physiological features as well as a blood biomarker can be used to target treatments to patients most likely to benefit and avoid treatment in patients less likely to benefit. Future advances in a precision medicine approach to COPD will depend on more precise characterization of individual patients, possibly using quantitative imaging, new physiological techniques, novel biomarkers and genetic profiling. Precision medicine has led to significant improvements in the management of COPD and clinicians should use all available information to optimize the treatment of individual patients.

简介：Objective:Toinvestigatethecorrelationbetweentraumaandpulmonarythromboembolism.Methods:Comminutedfracturesandextensivesoft-tissuecontusionatbothhindlimbsweremadebyafallingweightfromaheightin16rabbits.Lungperfusionscanningwasperformedtoobtaintheradioactivitycountsbeforetrauma,at1h,48hand96haftertrauma.Allthedataweredividedinto4groupsbasedontheabove4timepoints.Therabbitsweresacrificedwhenpositivefindingsonthepulmonaryperfnsionscanningappeared.Theirlungswereharvestedtobeparaffin-embeddedandstainedwithhematoxylin-erosinmethodforhistologicalexaminationofthromboembolism.TherandomizedblockdesignANOVAandthemethodofleastsignificantdifference(LSD)wereusedforstatisticalanalysisoftheradioactivitycounts.Results:Thehistologicalfindingsshowedthatpulmonaryembolismdevelopedin6ofthe16rabbits(37.5%).Fiveofthe6pulmonaryembolismrabbitspresentedneitherclinicalsymptomsnorpositivepulmonaryembolismmanifestationsinthelungperfusionscanning.Asignificantdifferencewasfoundinlungperfusionradioactivitybetweenthepre-traumatic,post-traumatic1hgroupsandpost-traumatic48hand96hgroups(P<0.05).Conclusions:Fracturesofthehindlimbsaccompaniedwithextensivesoft-tissuecontusionmaycausepulmonarymicro-embolismthatisnotsensitivetolungperfusionscanningandtendstohavenoclinicalsymptoms.Pulmonaryembolismdevelopmentmaytakemorethantwodaysaftertrauma.

简介：AbstractThere is considerable epidemiological evidence indicating that air pollution has adverse effects on human health and is closely related to respiratory diseases, including chronic obstructive pulmonary disease (COPD). These effects, which can be divided into short- and long-term effects, can manifest as an exacerbation of existing symptoms, impaired lung function, and increased hospitalization and mortality rates. Long-term exposure to air with a high concentration of pollutants may also increase the incidence of COPD. The combined effects of different pollutants may become more complex in the future; hence, there is a need for more intensive research on specific at-risk populations, and formulating corresponding protective strategies is crucial. We aimed to review the epidemiological evidence on the effect of air pollution on COPD, the possible pathophysiological mechanisms underlying this effect, as well as protective measures against the effects of air pollutants in patients with COPD.

简介：Thephenomenonofparticleinteractioninvolvedinpulmonarydrugdeliverybelongstoawidevarietyofdisciplinesofparticletechnology,inparticular,fluidization.Thispaperreviewsthebasicconceptsofpulmonarydrugdeliverywithreferencestofluidizationresearch,inparticular,studiesonGeldartgroupCpowders.Drypowderinhalerdevice-formulationcombinationhasbeenshowntobeaneffectivemethodfordeliveringdrugstothelungfortreatmentofasthma,chronicobstructivepulmonarydiseaseandcysticfibrosis.Evenwithadvanceddesigns,however,deliveryefficiencyisstillpoormainlyduetopowderdispersionproblemswhichcausepoorlungdepositionandhighdosevariability.Drugparticlesusedincurrentinhalersmustbe1-5mindiameterforeffectivedepositioninsmall-diameterairwaysandalveoli.Thesepowdersareverycohesive,havepoorflowability,andaredifficulttodisperseintoaerosolduetocohesionarisingfromvanderWaalsattraction.Theseproblemsarewellknowninfluidizationresearch,muchofwhichishighlyrelevanttopulmonarydrugdelivery.

简介：AbstractIn the United States, pulmonary embolism (PE) accounts for approximately 10% of all pregnancy related deaths. The standard treatment for a patient with high-risk PE is systemic thrombolysis. Systemic thrombolysis in pregnancy is associated with the risk of maternal hemorrhage and fetal complications, including spontaneous abortion, preterm delivery, and fetal bleeding. Currently, there is limited evidence for a standardized approach for the treatment and management of intermediate-and high-risk PEs in pregnancy. A 36-year-old gravida 3 para 2002 woman at 31+1 weeks of gestation with a history of deep vein thrombosis in her prior pregnancy presented with shortness of breath. A computed tomography angiogram revealed a large pulmonary embolus with a saddle component that extended into the bilateral upper and lower lobes and into the secondary and tertiary pulmonary branches. A subsequent bedside echocardiogram demonstrated a dilated right ventricle with severely reduced right ventricular systolic function. The patient was successfully treated with bilateral ultrasound-assisted catheter-directed thrombolysis. She subsequently delivered a healthy male infant at term. Reported cases of ultrasound-assisted catheter-directed thrombolysis in pregnant patients is limited. Our case demonstrates that localized thrombolysis is a viable treatment option for life-threatening PE in pregnancy. Catheter-directed thrombolysis can be efficacious in treating intermediate-and high-risk PEs in pregnancy while simultaneously reducing the risk of bleeding complications.

简介：AbstractChronic obstructive pulmonary disease (COPD), characterized by persistent and not fully reversible airflow restrictions, is currently one of the most widespread chronic lung diseases in the world. The most common symptoms of COPD are cough, expectoration, and exertional dyspnea. Although various strategies have been developed during the last few decades, current medical treatment for COPD only focuses on the relief of symptoms, and the reversal of lung function deterioration and improvement in patient’s quality of life are very limited. Consequently, development of novel effective therapeutic strategies for COPD is urgently needed. Stem cells were known to differentiate into a variety of cell types and used to regenerate lung parenchyma and airway structures. Stem cell therapy is a promising therapeutic strategy that has the potential to restore the lung function and improve the quality of life in patients with COPD. This review summarizes the current state of knowledge regarding the clinical research on the treatment of COPD with mesenchymal stem cells (MSCs) and aims to update the understanding of the role of MSCs in COPD treatment, which may be helpful for developing effective therapeutic strategies in clinical settings.

简介：AbstractChronic obstructive pulmonary disease (COPD) is a respiratory disease with a high incidence, mortality, and disability rate. Because there are few symptoms in the early stages of COPD, diagnosis and treatment are seriously insufficient. It is necessary to find effective clues for early COPD diagnosis and provide appropriate interventions. Several studies suggest that small airway disease is the earliest stage of COPD because it is correlated with subsequent development of airflow obstruction. However, there are currently no globally accepted criteria for defining early COPD. This study mainly introduced risk factors, definition, diagnosis, and treatment of early COPD from a new perspective.

简介：Objective:Toinvestigatetheclinicalfeaturesandthereasonofmisdiagnosisofconsolidativeprimarypulmonarylymphoma.Methods:Retrospectivestudywasconductedforthreecaseswithconsolidativeprimarypulmonarylymphoma(PPL).Therelevantliteraturesofprimarypulmonarylymphomainrecentyearswerealsoreviewed.Results:Allpatientshadbeenmisdiagnosedforalongtimeduetothenon-specificclinicalfeatures.Conclusion:ConsolidativePPLisdifficulttodiagnoseandismisdiagnosedfrequentlyinclinic.DefinitivediagnosisofPPLrequiresanadequatebiopsyspecimen.Themostimportantprognosticfactoristhehistology.

简介：Duringthepastdecade,roboticsurgicalsystemshavebeenincreasinglyutilizedtoperformhighlycomplexsurgicalprocedures.Infact,therobotic-assistedapproachtothetreatmentofmanygynecologicalandurologicalsurgicalprocedureshasbecomethestandard-of-care.Theuseofroboticsurgicalsysteminthoracicsurgeryisinitsearlydevelopment.Video-assistedthoracoscopicsurgery(VATS)

简介：Rightventricularfailure(RVF)remainstheprimarycauseofdeathinpatientswithpulmonaryarterialhypertension.WereviewthepathophysiologyofRVF,includingtheremodelingandventriculoarterialuncouplingthatoccurswhenthefailingrightsideoftheheartisunabletocompensateforarisingafterload.Secondly,thenoninvasiveimagingtechniquesusedintheassessmentofRVFareexplored,includingechocardiography,cardiacmagneticresonanceimaging,computedtomography,andpositronemissiontomography.Third,wedescribehowtheseimagingtechniquesandapatient’sclinicalcharacteristicsmaybeusedtodetermineprognosis.Lastly,weexplorethemedicalandsurgical/interventionaltreatmentoptionsforRVF.Despitethesetreatmentoptions,morbidityandmortalityremainhighinthispatientpopulation.Thediscoveryofnewprognosticindicators,useofhybridimagingforearlydetectionofRVF,andstrategiestopreventthedevelopmentofRVFwillbeimportantifoutcomesinthispatientpopulationaretoimprove.

简介：ObjectivesToinvestigatetheclinicalfeatureofacutepulmonaryembolism.MethodsRetrospectiveclinicalanalysiswasperformedaccordingtothedataof38casesofpulmonaryembolism.ResultsThereweregrounddiseasesandpredisposingfactorsin36casesofpulmonaryembolismamong38cases,theratiowas94.7%,amongthetotalpredisposingfactors,tumor,cardiovasculardisease,venousthrombosisoflowerextremity,smokingandlong-termbedwerecommon.Therewasnospecificityinclinicalfeature,physicalsignandroutchestXray,electrocardiography,andtheirappearanceswerediversified.Therewerespecificityandsensitivityinechocardiogram(UCG)andD-dimertosomeextent.But,thefinaldiagnosismustdependonsomespecialexaminations,suchasselectivepulmonaryarteriography,CTPA,MRAandsoon.ConclusionsThespecialexaminationsmustbedonetomakeadefinitediagnosistoconfirmpulmonaryembolismwhenthehighriskfactorsandgrounddiseasesareexisting.Itisnecessarytosomecaseswhentheclinicalfeaturecannotbeexplainedbyotherdiseases.

简介：AbstractTrauma-induced pulmonary thromboembolism is the second leading cause of death in severe trauma patients. Primary fibrinolytic hyperactivity combined with hemorrhage and consequential hypercoagulability in severe trauma patients create a huge challenge for clinicians. It is crucial to ensure a safe anticoagulant therapy for trauma patients, but a series of clinical issues need to be answered first, for example, what are the risk factors for traumatic venous thromboembolism? How to assess and determine the status of coagulation dysfunction of patients? When is the optimal timing to initiate pharmacologic prophylaxis for venous thromboembolism? What types of prophylactic agents should be used? How to manage the anticoagulation-related hemorrhage and to determine the optimal timing of restarting chemoprophylaxis? The present review attempts to answer the above questions.