Application of "dredging meridians and dispersing lung exercises" based on meridian theory of traditional Chinese medicine in patients with stable chronic obstructive pulmonary disease

Objective:To investigate the effects of Tongjing xuanfei exercise on clinical symptoms,pulmonary function and exercise endurance of patients with Chronic obstructive pulmonary disease at stable stage.Methods:A total of 130 patients with Chronic obstructive pulmonary disease at stable stage from the Department of Pulmonary Diseases,Qingdao Haici Medical Group during September 2018 to September 2020 were collected and randomly divided into a observation group and a control group,with 65 patients in each group.The control group was given routine pulmonary rehabilitation nursing,and the observation group was given Tongjing Xuanfei exercise treatment combined with routine pulmonary rehabilitation nursing,12 months for treatment.The changes of symptoms and pulmonary function index were observed before and after treatment.Results:FEV1,FVC,FEV1%pred,FEV1/FVC,exercise endurance and CAT score,mMRC dyspnea index score and TCM clinical symptom score in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Tongjing Xuanfei exercise is helpful to improve the clinical symptoms,pulmonary function and exercise endurance of patients with Chronic obstructive pulmonary disease at stable stage.

Pulmonary involvement in inflammatory bowel disease

AIM:To determine the relationship of pulmonary abnormalities and bowel disease activity in inflammatory bowel disease(IBD).METHODS:Thirty ulcerative colitis(UC)and nine Crohn's disease patients,and 20 control subjects were enrolled in this prospective study.Detailed clinical information was obtained.Extent and activity of the bowel disease were established endoscopically.Each patient underwent pulmonary function tests and high-resolution computed tomography(HRCT).Blood samples for measurement of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),angiotensin converting enzyme and total IgE were delivered by the patients.RESULTS:Ten(25.6%)patients had respiratory symptoms.A pulmonary function abnormality was present in 22 of 39 patients.Among all patients,the most prevalent abnormalities in lung functions were a decrease in forced expiratory volume in 1 s(FEV1),FEV1/forced vital capacity(FVC),forced expiratory flow(FEF)25%-75%,transfer coefficient for carbon monoxide(DLCO),DLCO/alveolar volume.Increased respiratory symptoms score was associated with high endoscopic activity index in UC patients.Endoscopic and clinical activities in UC patients were correlated with FEV1,FEV1/FVC,and FEF 25%-75%.Smoking status,duration of disease and medication were not correlated with pulmonary physiological test results,HRCT abnormalities,clinical/endoscopic disease activity,CRP,ESR or total IgE level or body mass index.CONCLUSION:It is important that respiratory manifestations are recognized and treated early in IBD.Otherwise,they can lead to destructive and irreversible changes in the airway wall.

High attenuation mucoid impaction in allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis(ABPA) is a complex hypersensitivity syndrome triggered against antigens of Aspergillus fumigatus,a fungus that most commonly colonizes the airways of patients with bronchial asthma and cystic fibrosis.It presents clinically with refractory asthma,hemoptysis and systemic manifestations including fever,malaise and weight loss.Radiologically,it presents with central bronchiectasis and recurrent episodes of mucus plugging.The mucus plugs in ABPA are generally hypodense but in up to 20% of patients the mucus can be hyperdense on computed tomography.This paper reviews the literature on the clinical significance of hyperattenuated mucus in patients with ABPA.

Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis

AIM: To investigate the chest radiographic and high resolution computed tomography (HRCT) chest manifestations in glucocorticoid-na?ve allergic bronchopulmonary aspergillosis (ABPA) patients. METHODS: This is a prospective observational study and includes 60 consecutive glucocorticoid-na?ve patients with ABPA who underwent chest radiography and HRCT of the chest (1.25 mm every 10 mm) in the routine diagnostic workup for ABPA. RESULTS: Chest radiographs were normal in 50% of cases. Of the remainder, most patients demonstrated permanent findings in the form of parallel line and ring shadows suggesting bronchiectasis. Consolidation was detected in 17 cases but in the majority, the corresponding HRCT chest scan showed mucus-filled bronchiectatic cavities. Chest HRCT was normal in 22 patients, while central bronchiectasis (CB) was demonstrated in the remaining 38 patients. Bronchiectasis extended to the periphery in 33%-43% depending on the criteria used for defining CB. The other findings observed on HRCT were mucoid impaction, centrilobular nodules and high-attenuation mucus in decreasing order of frequency. CONCLUSION: Patients with ABPA can present with normal HRCT chest scans. Central bronchiectasis cannot be considered a characteristic feature of ABPA as peripheral bronchiectasis is commonly observed. Consolidation is an uncommon finding in ABPA.

Allergic bronchopulmonary aspergillosis:Lessons for the busy radiologist

The probability of a radiologist interpreting a disease correctly is not only influenced by their training and experience but also on the knowledge of a particular entity.This editorial reviews certain myths and realities associated with radiological manifestations of allergic bronchopulmonary aspergillosis(ABPA).ABPA is a hypersensitivity disorder against the antigens of Aspergillus fumigatus.Although commonly manifesting with central bronchiectasis(CB),the disorder can present without any abnormalities on high-resolution computed tomography(HRCT) of the chest,so-called serologic ABPA(ABPA-S).HRCT of the chest should not be used in screening or in the initial diagnostic work up of asthmatics,as asthma without ABPA can manifest with findings of CB.High-attenuation mucus(HAM) is the pathognomonic sign of ABPA and is very helpful in the diagnosis of ABPA complicating asthma and cystic fibrosis.Instead of classifying ABPA based on the presence and absence of CB into ABPA-CB and ABPA-S respectively,ABPA should be classif ied as ABPA-S,ABPACB and ABPA-CB-HAM.The classif ication scheme based on HAM not only identifies an immunologically severe disease but also predicts a patient with increased risk of recurrent relapses.

The Role of Endogenous Carbon Monoxide in the Hypoxic Vascular Remodeling of Rat Model of Hypoxic Pulmonary Hypertension

We investigated the expression of heme oxygenase 1 (HO 1) gene and production of endogenous carbon monoxide (CO) in the rat lung tissue at different time points of chronic hypoxic pulmonary hypertension and the effect of hemin on the expression of HO 1 gene and pulmonary hypertension. A rat model of hypoxic pulmonary hypertension was recreated by exposure to intermittent normobaric hypoxic environment (10 % O 2). Reverse transcriptase polymerase chain reaction (RT PCR) was performed to determine the level of HO 1 mRNA in the rat lung tissue and double wave length spectrophotometry was used to evaluate the quantity of COHb in arterial blood. Cardiac catheterization was employed to measure the right ventricular systolic pressure (RVSP) and HE staining was performed in dissected lung tissue to observe the pathological changes of the intra acinar pulmonary arteries (IAPA). It was found that (1) There was a low level of HO 1 mRNA in normal rat lung tissue, but the level of HO 1 mRNA increased by 2-4 times in the lung tissue of hypoxic rats ( P <0.01). The quantity of COHb was 2-3 times those of control group ( P <0.01 or P <0.05). These were accompanied by the increased of RVSP and the thickened IAPA; (2) Hemin could keep the HO 1 mRNA and COHb in the hypoxic rat lung tissue at a high level, and partially suppressed the increase of rat RVSP, thereby ameliorating the pathological changes of IAPA. In conclusion, the upregulation of the expression of HO 1 gene and production of CO in the rat lung of hypoxic pulmonary hypertension plays a role of inhibition in the development of hypoxic pulmonary hypertension. Hemin has a therapeutic effect on hypoxic pulmonary hypertension.

Role of peripheral eosinophilia in acute exacerbation of chronic obstructive pulmonary disease

BACKGROUND Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease(COPD).AIM To study the role of peripheral eosinophilia in hospitalized patients with acute exacerbation of COPD(AECOPD).METHODS From January 2014 to May 2017,patients with AECOPD hospitalized in Taipei Tzu Chi Hospital were retrospectively stratified into two groups according to their peripheral eosinophil count:The EOS group(eosinophil count≥2%)and the non-EOS group(eosinophil count<2%).Demographics,comorbidities,laboratory data,steroid use,length of hospital stay,and COPD-related readmissions were compared between the groups.RESULTS A total of 625 patients were recruited,with 176 patients(28.2%)in the EOS group.The EOS group showed a lower prevalence of infection,lower cumulative doses of prednisolone equivalents,shorter length of hospital stay,and higher number of COPD-related readmissions than the non-EOS group.There were significantly linear correlations between eosinophil percentage and number of readmissions and between eosinophil percentage and length of hospital stay P<0.001,and a lower percent-predicted value of forced expiratory volume in one second(FEV1)were associated with shorter time to first COPD-related readmission[adjusted hazard ratio(adj.HR)=1.488,P<0.001;adj.HR=0.985,P<0.001,respectively].CONCLUSION The study findings suggest that the EOS group had the features of a shorter length of hospital stay,and lower doses of systemic steroids,but more frequent readmissions.The EOS group and lower percent-predicted FEV1 values were risk factors for shorter time to first COPD-related readmission.

Etiology and an Integrated Management of Severe Hemoptysis Due to Pulmonary Tuberculosis

Background: It is very important to enhance the therapeutic effect and prognosis of severe tuberculous hemoptysis after the determining of its etiological cause and the source of bleeding. The etiology and integrated curative effect of severe hemoptysis due to pulmonary tuberculosis among 112 inpatients were analyzed. Materials and Methods: The cause was retrospectively analysed. The integrated management effect after the follow-up of mean three years in 112 cases with severe hemoptysis being resulted from pulmonary tuberculosis from June 2008 to July 2012 was described. Active pulmonary tuberculosis ranked the first cause of lower respiratory tract bleeding (32/112, 28.5%), followed by old pulmonary tuberculosis (28/112, 25.0%), tuberculous bronchiectasis (25/112, 22.3%), purified tuberculous cavity (12/112, 10.7%), fungal infection in old pulmonary tuberculosis cavity (9/112, 7.1%), or broncholithiasis (6/112, 5.4%). Almost all suffers with severe hemoptysis were treated by an integrated management, including psychology, anticoagulants, vasoconstrictor agents. Etiological treatment including anti-tuberculosis and anti-infection was simultaneously or subsequently involved. Sixty-four inpatients with severe hemoptysis being failed to be cured by medical treatment were then received selective bronchial artery embolization. Four patients were received surgical wedge resection, lobectomy or pneumonectomy. The total cure rate added up to 98.2% after mean three years’ follow-up. The mortality was 1.8%. Conclusions: Active pulmonary tuberculosis was still responsible for the severe hemoptysis in the southeast region of China. Severe hemoptysis of pulmonary tuberculosis was also resulted from stable tuberculosis, tuberculous bronchiectasis, tuberculosis cavity, fungal infection, or broncholithiasis. Better clinical therapeutic effect could be attained by early etiological diagnosis and comprehensive treatment strategy.

Complete withdrawal of glucocorticoids after dupilumab therapy in allergic bronchopulmonary aspergillosis:A case report

BACKGROUND Allergic bronchopulmonary aspergillosis(ABPA)is an allergic reaction to Aspergillus species that aggravates bronchial asthma.Previous studies demonstrated the glucocorticoid-sparing effect of dupilumab in patients with ABPA.There is no report of complete withdrawal of glucocorticoids after dupilumab.CASE SUMMARY The patient was a 54-year-old woman with bronchial asthma treated with inhaled corticosteroids and a long-acting beta-2 agonist.She consulted our institution for productive cough and fever in March 2017.Chest computed tomography scan revealed mucoid impaction,and the bronchial lavage fluid culture was positive for Aspergillus fumigatus.The diagnosis was ABPA.The patient was treated with oral glucocorticoids from April 2017 to November 2017.In January 2019,she had bronchial asthma exacerbation,and a chest computed tomography scan showed recurrent mucoid impaction.She was treated with oral glucocorticoids and itraconazole.In February 2020,during tapering of oral glucocorticoid,she had the third episode of bronchial asthma exacerbation and a mucoid impaction.The patient was treated with dupilumab in addition to oral glucocorticoid and itraconazole.The clinical response improved,and oral glucocorticoid was discontinued in June 2020.CONCLUSION This is the first case of ABPA in which complete withdrawal of glucocorticoid was possible after treatment with dupilumab.

Influence of L-arginine on the Expression of eNOS and COX2 in Experimental Pulmonary Thromboembolism

The influence of L-arginine on endothelial nitric oxide synthase （eNOS） and cyclooxygenase 2 （COX2） was observed in experimental pulmonary thromboembolism and the action mechanism on pulmonary thromboembolism was explored. Wistar rats were randomly divided into control group, model group and treatment group. Pulmonary thromboembolism models were established by auto-blood back transfusion, and L-Arg 100 mg/kg was intraperitoneally injected after successful model preparation. The animals were sacrificed at 3 h, 1 day, 3 days and 7 days after embolism. Plasma NO, TXB2 and 6-Keto-PGF1 α were detected. The expression of eNOS and COX2 protein and mRNA in pulmonary tissues was detected by immunohistochemistry and RT-PCR respectively. The results showed that pulmonary thrombosis could be seen post pulmonary embolism and inflammatory reaction was significant. Plasma NO was decreased （P〈0.01）, and the levels of TXB2, 6-Keto-PGF1α and T/P ratio were all elevated. The expression of eNOS protein and mRNA in the pulmonary tissue was down-regulated （P〈0.05）, while that of COX2 protein and mRNA was upregulated （P〈0.01）. In treatment group, the level of NO was increased, the levels of TXB2 and T/P ratio were decreased, but the level of 6-Keto-PGF1 α was increased. The expression of eNOS protein and mRNA in pulmonary tissue was upregulated （P〈0.05）, while that of COX2 protein and mRNA was down-regulated （P〈0.05）. In conclusion, L-arginine can educe the role of pulmonary tissue protection through up-regulating the expression of intra-pulmonary NOS and down -regulating COX2 in pulmonary thromboembolism.

Extrapulmonary small cell carcinoma of lymph node: Pooled analysis of all reported cases

AIM: To study clinical outcomes and management of lymph nodes extrapulmonary small cell carcinoma(LNEPSCC). METHODS: Herein, we perform a systematic search of published literature in the PubMed and EMBASE databases for studies describing LNEPSCC. For uniformity of reporting, LNEPSCC was staged as limited if it involved either single lymph node station or if surgery with curative intent had been undertaken. The disease was staged extensive if it involved two or more lymph node regions.RESULTS: The systematic literature review yielded eight descriptions(n = 14) involving cervical, submandibular and inguinal lymph nodes. Eleven(64.7%) patients had limited disease(LD) and six(35.3%) had extensive disease(ED) at presentation. Chemotherapy(n = 6, 35.3%) or surgery(n = 4, 23.5%) were the most common form of treatment given to these patients. Complete response was achieved in 12(70.6%) of the patients. Median(interquartile range) progression free survival and overall survival was 15(7-42) mo and 22(12.75-42) mo respectively. Of the three illustrative cases, two patients each had ED at presentation and achieved complete remission with platinum based combination chemotherapy.CONCLUSION: LNEPSCC is a rare disease with less than 15 reported cases in world literature. Surgical resection with curative intent is feasible in those with LD while platinum based combination chemoradiation is associated with favorable outcomes in patients with ED. Prognosis of LNEPSCC is better than that of small cell lung cancer in general.

Miliary nodules due to secondary pulmonary hemosiderosis in rheumatic heart disease

Pulmonary hemosiderosis is defined as the clinical and functional consequence of iron overload of the lungs,which usually occurs due to recurrent intra-alveolar bleeding.It can manifest as miliary mottling and should be entertained in the differential diagnosis of patients presenting with miliary nodules on chest radiography,especially those with mitral stenosis.The management of secondary pulmonary hemosiderosis secondary to valvular heart disease includes valvuloplasty and/or valve replacement.The radiological opacities may disappear with successful treatment of the underlying valvular disease in many patients.However,they may persist with no physiological impairment to the patient.Here,we present a 32-year-old man with mitral stenosis who presented with fever and miliary shadows on chest radiography,which was ultimately diagnosed as secondary pulmonary hemosiderosis.

Assessment of Respiratory lmpedance During Deep Slow Breathing with lmpulse Oscillometry in Patients with Chronic Obstructive Pulmonary Disease

Objective: To observe the relationship of deep slow respiratory pattern and respiratory impedance(RI) in patients with chronic obstructive pulmonary disease (COPD). Methods: RI under normal respiration and during deep slow respira tion was measured one after the other with impulse oscillometry for 8 patients with COPD and for 9 healthy volunteers as control. Results: When r espiration was changed from normal pattern to the deep slow pattern, the tida l volume increased and respiratory frequency significantly decreased in both gro ups , the total respiratory impedance (Z respir) showed a decreasing trend in COPD group, but with no obvious change in the control group. No chang e in the resonant frequency (fres) was found in both groups, and the respiratory viscous resistance obviously decreased in the COPD group(R5: P =0.0168 ; R20: P =0.0498; R5—R20: P =0.0388),though in the control group it was unchanged. Conclusion: IOS detection could reflect the response he terogeneity of different compartments of respiratory system during tidal breathi ng. During deep slow respiration, the viscous resistance in both central airw ay and peripheral airway was decreased in patients with COPD. RI measurement by impulse oscillometry may be a convenient pathophysiological method for studying the application of breathing exercise in patients with COPD.

Drug Resistance Trends and Patterns of Mycobacterium Tuberculosis Isolates from Pulmonary Tuberculosis Patients at a Tertiary Care Hospital in Turkey

Background: We aim to determine the proportions and patterns of resistance to first-line drugs: isoniazid (H), rifampicin (R), ethambutol (E) and streptomycin (S) among pulmonary tuberculosis patients. Methods: Strains were obtained from 1584 culture positive pulmonary tuberculosis patients. All specimens were inoculated into L?wenstein-Jensen media (LJ) and TK selective;drug susceptibility tests (DST) were performed for first-line drugs. Results: Multidrug resistant (MDR) were detected in 146 (9.2%) isolates. Three hundred (18.9%) isolates were resistant to H;220 (13.9%) to R;168 (10.6%) to S;137 (8.6%) to E. Any drug resistance was detected in 442 (27.9%) isolates. MDR rate was higher in male patients than females (P = 0.006). MDR rates were different according to the age groups (P = 0.02). The highest rate was in 35 - 44 years and the lowest rate was in 15 - 24 years. Conclusions: We found an association between middle age and male gender and MDR tuberculosis.

The Benefits of Pulmonary Rehabilitation Program on Post-Tuberculosis Bronchiectasis

Pulmonary rehabilitation has emerged as a recommended standard of care for patients with chronic lung disease. As in chronic obstructive pulmonary disease (COPD), persons with other forms of chronic respiratory disease commonly experience deconditioning and decreased quality of life. The aim of this prospective study is to determine the effect of a 4-week pulmonary rehabilitation program (PRP) on patients diagnosed with post-pulmonary tuberculosis bronchiectasis in the Philippines. The participants were above 18 years of age, diagnosed to have stable Post-Pulmonary tuberculosis bronchiectasis with chest computerized tomography (CT) scan or chest radiograph showing bronchiectatic changes, consented to attend the PRP sessions and be included in the study. The subjects underwent PRP for 4 weeks with a total of 8 sessions and determination of Forced expiratory volume at 1 second (FEV1), forced vital capacity (FVC), quality of life determination using the Saint George Respiratory Disease Questionnaire (SGRQ), and exercise endurance using the 6-minute walking test (6 MWT), before and after the PRP. A total of fourteen patients, six males and eight females, aged from 28 - 72 years old, completed the 4-week pulmonary rehabilitation program. There were four ex-smokers and ten non-smokers with concomitant asthma and COPD in some patients. There was significant improvement in the 6-minute walk test and quality of life after 4 weeks of rehabilitation program among the subjects with p value for 6 MWT at p = 0.0001 and p = 0.008 for SGRQ. Conclusion: Pulmonary rehabilitation program led to a significant improvement in exercise capacity and health related quality of life among patients with post-pulmonary tuberculosis bronchiectasis.

A pilot double-blind, randomized, placebo-controlled trial of curcumin/bioperine for lung cancer chemoprevention in patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease is an inflammatory condition with increased risk of lung cancer. We hypothesized that curcumin/ bioperine (CB), which has anti-inflammatory effects, may reduce cytological abnormalities in the sputum of patients with COPD. We conducted a 3-month, three-to-one randomized, doubleblind, pilot trial of escalating doses of CB in patients with moderate or worse COPD who were capable of producing sputum. The primary efficacy endpoint was changed in sputum cytology. We also explored changes in fluorescence in situ hybridization (FISH). We obtained sputum samples for cytology and chromosome abnormalities at baseline and each monthly follow-up visit. We enrolled 57 participants, with 35 completing the study. The participants’ mean age (standard deviation [SD]) was 66.6 (8.2) years, and they were mainly male (91.2%), with an average of 63.8 pack-years of smoking history. Also, 42.1% of participants were active smokers and the mean (SD) FEV1 was 37% (13%). At baseline, 13 subjects had moderate or worse dysplasia (22.8%). Subjects with moderate to severe sputum dysplasia had more chromosome abnormalities in epithelial cells and neutrophils, as measured by deletion and aneuploidy in 10q22.3. The changes in sputum cytology and chromosome abnormalities did not differ between the active and placebo arms. CB was well tolerated at the bid doses of 1, 1.5, and 2 gm of curcumin and 5 mg of bioperine, with minor side effects related to the gastrointestinal tract. In this short pilot trial, CB compared to placebo did not alter cytological and chromosomal abnormalities seen in sputum of patients with COPD.

GENETIC POLYMORPHISM IN HUMAN β-DEFENSIN-1 AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN HAN POPULATION IN SOUTH OF CHINA

Objective To investigate the correlation between human β-defensin-1 (HBD-1) exon 2 variations and chronic obstructive pulmonary disease susceptibility in Han population in south of China. Methods The frequency of polymorphic genotypes of HBD-1 exon 2 (1654G/A) was examined in 120 COPD patients (COPD group) and 108 smokers without COPD (control group) by restriction fragment length polymorphism. Results The frequencies of polymorphic genotypes in HBD-1 exon 2 in COPD group were G/G 82.50%, G/A 10.83%, and A/A 6.67%. The frequencies of polymorphic genotypes in control group were G/G 95.37%, G/A 3.70%, and A/A 0.93%. It showed significant difference between two groups(P<0.01). The differences in allele frequencies were also significant between two groups (G allele frequency: 87.92% vs 97.22%; A allele frequency: 12.08% vs 2.78%; P<0.01). The G→A mutation rised along with the severity of the COPD. Conclusion The genetic polymorphism in HBD-1 exon 2 gene might be associated with the susceptibility to COPD in Han population of South China.

Delayed inflammatory pulmonary syndrome: A distinct clinical entity in the spectrum of inflammatory syndromes in COVID-19 infection?

BACKGROUND During the second wave of the coronavirus disease 2019(COVID-19)pandemic,a subset of critically ill patients developed delayed respiratory deterioration in the absence of new infection,fluid overload or extra-pulmonary organ dysfunction.AIM To describe the clinical and laboratory characteristics,outcomes,and management of these patients,and to contrast this entity with other post COVID-19 immune dysregulation related inflammatory disorders.METHODS This was a retrospective observational study of adult patients admitted to the medical intensive care unit of a 2200-bed university affiliated teaching hospital,between May and August 2021,who fulfilled clearly defined inclusion and exclusion criteria.Outcome was assessed by a change in PaO_(2)/FiO_(2) ratio and levels of inflammatory markers before and after immunomodulation,duration of mechanical ventilation after starting treatment,and survival to discharge.RESULTS Five patients developed delayed respiratory deterioration in the absence of new infection,fluid overload or extrapulmonary organ dysfunction at a median interquartile range(IQR)duration of 32(23-35)d after the onset of symptoms.These patients had elevated inflammatory markers,required mechanical ventilation for 13(IQR 10-23)d,and responded to glucocorticoids and/or intravenous immunoglobulin.One patient died(20%).CONCLUSION This delayed respiratory worsening with elevated inflammatory markers and clinical response to immunomodulation appears to contrast the well described Multisystem Inflammatory Syndrome–Adults by the paucity of extrapulmonary organ involvement.The diagnosis can be considered in patients presenting with delayed respiratory worsening,that is not attributable to cardiac dysfunction,fluid overload or ongoing infections,and associated with an increase in systemic inflammatory markers like C-reactive protein,inteleukin-6 and ferritin.A good response to immunomodulation can be expected.This delayed inflammatory pulmonary syndrome may represent a distinct clinical entity in the spectrum of inflammatory syndromes in COVID-19 infection.

Applications of artificial intelligence in common pulmonary diseases

Artificial intelligence(AI)is a branch of computer science where machines are trained to imitate human-level intelligence and perform well-defined tasks.AI can provide accurate results as well as analyze vast amounts of data that cannot be analyzed via conventional statistical methods.AI has been utilized in pulmonary medicine for almost two decades and its utilization continues to expand.AI can help in making diagnoses and predicting outcomes in pulmonary diseases based on clinical data,chest imaging,lung pathology,and pulmonary function testing.AI-based applications enable physicians to use enormous amounts of data and improve their precision in the treatment of pulmonary diseases.Given the growing role of AI in pulmonary medicine,it is important for practitioners caring for patients with pulmonary diseases to understand how AI can work in order to implement it into clinical practices and improve patient care.The goal of this mini-review is to discuss the use of AI in pulmonary medicine and imaging in cases of obstructive lung disease,interstitial lung disease,infections,nodules,and lung cancer.

Application of acupoint massage combined with acupoint application in stable stage of chronic obstructive pulmonary disease

Objective:To investigate the application of acupoint massage combined with acupoint application in pulmonary rehabilitation of chronic obstructive pulmonary disease.Methods:Inhaled drugs,oral expectorant,such as conventional treatment,select our hospital on June 6,2019-March 2021 in lung disease clinics,a total of 130 patients with COPD,with digital method of random divided into control group and observation group,65 cases in each group,control group given observation group in the control group on the basis of joint acupoint sticking therapy combined with acupuncture point massage,two groups of treatment for 15 days,respectively,The total effective rate,TCM syndrome score,lung function index and dyspnea degree score(mMRC)were compared between the two groups after treatment.Results:After treatment,the total effective rate was 81.54%in the control group and 93.85%in the observation group.After treatment,the symptoms of cough,expectoration,wheezing,shortness of breath,fatigue,chills and tenderness of waist and knee were significantly improved in the two groups compared with the control group.After treatment,the symptoms of cough,expectoration,wheezing,shortness of breath,fatigue,chills and tenderness of waist and knee were significantly improved in the observation group compared with the control group.Compared with before treatment,FEV1 and FEV1/FVC values in 2 groups were increased(P<0.05),and the two indexes in observation group were better than control group(P<0.05),the differences were statistically significant.MMRC score in 2 groups was significantly lower than before treatment(P<0.05),and the improvement of mMRC score in observation group was significantly better than that in control group(P<0.05),the difference was statistically significant.Conclusion:Acupoint massage combined with acupoint application can effectively improve the lung function of patients with chronic obstructive pulmonary disease,relieve patients with dyspnea,achieve the purpose of promoting pulmonary rehabilitation,clinical efficacy is positive,worthy of promotion.