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With the development of interventional pulmonology, photodynamic therapy (PDT) is gradually being used in the treatment of respiratory malignant tumors because of its low level of trauma, high specificity, and compatibility with traditional or common therapies. However, at present, the data of clinical evidence‐based medicine for PDT applied in central airway tumors is very limited, and derives mainly from case reports or series of case studies which lack consensus on clinical diagnosis and treatment. In order to further disseminate China's experience, the Tumor Photodynamic Therapy Committee of China Anti‐Cancer Association and the World Endoscopy Association‐Respiratory Endoscopy Association invited experts from relevant fields to form an expert committee. After several rounds of discussion and revision by this committee, and following a vote, the consensus was formulated for reference by physicians in respiratory, oncology and other related disciplines to refer to the practice of tumor photodynamic therapy. [ABSTRACT FROM AUTHOR]

Objectives. 1,25-Dihydroxyvitamin D3 (1,25-(OH)2D3) has immune- and inflammation-modulating properties in asthma, but its possible effects on asthmatic airway remodeling remain uncertain. In this study, we investigated the effects of 1,25-(OH)2D3 on airway remodeling in a murine model of chronic asthma and investigated its role in regulating nuclear factor- κB (NF- κB) activation. Methods. BALB/c mice were sensitized to ovalbumin (OVA) and subsequently exposed to intranasal OVA challenges for 9 weeks. Some mice also received an intraperitoneal injection of 1,25-(OH)2D3 at the time of challenge. At the end of the challenge period, mice were evaluated for chronic airway inflammation and airway remodeling. Nuclear translocation of NF- κB p65 in lung tissue was examined by Western blot. Inhibitor of NF- κB alpha (I κB α) expression was determined by real-time quantitative Reverse Transcription Polymerase Chain Reaction (RT-PCR) and Western blot. Phosphorylated I κB α protein expression was also determined by Western blot. Results. 1,25-(OH)2D3 treatment reduced OVA-induced chronic inflammation in lung tissue and attenuated established structural changes of the airways, including subepithelial collagen deposition, goblet cell hyperplasia, and increased airway smooth muscle mass. 1,25-(OH)2D3 also inhibited the nuclear translocation of NF- κB p65 in lung tissue. Concurrently, 1,25-(OH)2D3 induced increased I κB α protein levels via inducing increased I κB α mRNA levels and decreased I κBα phosphorylation. Conclusion. 1,25-(OH)2D3 could attenuate asthmatic airway remodeling and its inhibition of NF- κB activation may underlie this protective effect. [ABSTRACT FROM AUTHOR]

Background: Invasive fungal disease (IFD) has become a serious threat to human health in China and around the world, with high mortality and morbidity. Currently, the misdiagnosis rate of IFD is extremely high, compounded with the low quality of prescription antifungals and the high incidence of adverse events associated with IFD treatment, resulting in lengthy hospitalization, low clinical response, and high disease burden, which have become serious challenges in clinical practice. Antifungal stewardship (AFS) can not only significantly increase the early diagnosis rate of IFD, reduce inappropriate utilization of antifungal drugs, improve patient prognosis, but can also improve therapeutic safety and reduce healthcare expenses. Thus, it is urgent to identify key AFS metrics suitable for China's current situation., Methods: Based on metrics recommended by international AFS consensuses, combined with the current situation of China and the clinical experience of authoritative experts in various fields, several metrics were selected, and experts in the fields of respiratory diseases, hematology, intensive care units (ICUs), dermatology, infectious diseases, microbiology laboratory and pharmacy were invited to assess AFS metrics by the Delphi method. Consensus was considered to be reached with an agreement level of ≥80% for the metric., Results: Consensus was reached for 24 metrics, including right patient metrics (n=4), right time metrics (n=3), and right use metrics (n=17). Right use metrics were further subdivided into drug choice (n=8), drug dosage (n=4), drug de-escalation (n=1), drug duration (n=2), and drug consumption (n=2) metrics. Forty-six authoritative experts assessed and reviewed the above metrics, and a consensus was reached with a final agreement level of ≥80% for 22 metrics., Conclusions: This consensus is the first to propose a set of AFS metrics suitable for China, which helps to establish AFS standards in China and is also the first AFS consensus in Asia, and may improve the standard of clinical diagnosis and treatment of IFD, and guide hospitals to implement AFS, ultimately promoting the rational use of antifungal drugs and improving patient prognosis., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-24-13/coif). Nanshan Zhong serves as Editor-in-Chief of Journal of Thoracic Disease. F.Y. reports that this work was supported by the National Natural Science Foundation of China (Nos. 82270007, 82202544), the Natural Science Foundation of Guangdong Province (No. 8227010505) and Horizontal Project (No. 75772451). The other authors have no conflicts of interest to declare., (2024 Journal of Thoracic Disease. All rights reserved.)

Objective: The effects and enhancement of catalpol (CP) on specific immune therapy (SIT) were investigated with an established animal model associated with bronchial asthma. Materials and methods: A total of 50 adults BALB/c mice were randomly divided into five groups with 10 mice in each group. These groups are control group, model group, CP group, SIT group and CP/SIT joint group. The mice were sensitized and challenged with OVA and Bronchoalveolar lavage fluid (BALF) and peripheral blood were obtained, the cell counts and the levels of cytokines (IL-1, IL-4, IFN-γ) in BALF were detected using ELISA methods. Results: The total number of cells in BALF of the group treated with CP/SIT joint group was significantly lower than the other experimental groups. Furthermore the eosinophils of the mice were dramatically reduced comparing the other experimental groups, the cytokines IL-1 and IL-4 display the similar tendency, but the IFN-γ concentration for the experimental groups was higher than the model group. After the therapy using CP, SIT and a combination of CP and SIT, asthma-associated inflammation was inhibited, IL-4 level was decreased and IFN-γ level was increased. In addition, the expression of TLR-4 protein in peripheral blood was detected by Western Blot method. Conclusions: In summary, CP can enhance the treating effect of SIT and the joint treatment by CP/SIT might be a potential method for clinical treatment of asthma, the mechanism is related to the inhibition of TLR-4 signaling pathway., Competing Interests: None.

Objective: To compare the effectiveness and safety of moxifloxacin and cefoperazone-sulbactam therapy in acute exacerbation of chronic obstructive pulmonary disease (COPD)., Methods: This was a prospective, randomized, multicentre study conducted between December 2011 and December 2012 involving 21 hospitals in Fujian. A total of 202 patients with AECOPD requiring antibiotic therapy were enrolled. Of these patients randomized to either treatments, 102 patients [male 60, female 42, (69.8 ± 6.5) y] received moxifloxacin (400 mg qd) and 100 [male 56, female 44, (69.6 ± 6.7) y] received cefoperazone-sulbactam (3.0 q 8 h). Clinical effectiveness, bacterial eradication and drug safety were evaluated., Results: The clinical effectiveness rate was 90.2% (92/102) in the moxifloxacin group and 88.0% (88/100) in the cefoperazone-sulbactam group. The bacterial eradication rate was 51.9% (14/27) and 48.3% (14/29) in the 2 groups respectively. The differences between groups were not statistically significant in terms of clinical and microbiological effectiveness (χ² = 0.251, χ² = 0.072, both P > 0.05). The length of hospital stay and antibiotic-days were shorter in the moxifloxacin group [(8.7 ± 2.4) vs (11.7 ± 3.0) d; (6.7 ± 2.2) vs (8.7 ± 2.3) d], the differences being significant between the 2 arms. (t = 6.360, t = 7.732, P < 0.05). Both drugs were well tolerated with no significant differences in numbers of drug-related adverse events (P > 0.05)., Conclusions: Moxifloxacin was equivalent to cefoperazone-sulbactam therapy for clinical success, bacteriologic eradication and showed superiority over the control group in shortening the length of hospital stay and antibiotic-days. Additionally, the drug safety of moxifloxacin was good.

Objective: To improve the understanding of pulmonary mucormycosis by analyzing the clinical manifestations, imaging features, diagnosis, treatment and prognosis of this disease., Methods: The clinical data of eight patients diagnosed as pulmonary mucormycosis by histopathologic examination were retrospectively analyzed., Results: Eight patients included six males and two females with age from 36 days to 66 years. Underlying conditions covered diabetes (n = 4), renal transplantation (n = 3), premature (n = 1) and long-term corticosteroid treatment in two cases. Imaging manifestations revealed multiple irregular lumps or nodules in three cases, multiple cavities with thick wall in three cases, diffuse lung infiltrate in one case and lung opacities in one case. The diagnoses of seven patients were confirmed by percutaneous needle lung biopsy and the remaining one was diagnosed with fiberoptic bronchoscopy biopsy. Surgery combined with amphotericin B liposome (60 mg/d for three weeks) was applied to one patient who was cured with no recurrence after a 22 month follow-up. Three cases were given amphotericin B liposome (a newborn with 7mg/d for 62 days, the other two 60 mg/d for 31 days and 70 mg/d for 71 days respectively). All had achieved marked response with follow up from 8 to 29 months, but one patient relapsed and died of recurrent lung mucormycosis. The other three patients were treated with itraconazole 400-200 mg/d from 21 days to 1 year with duration of follow up from 1 month to 20 months. One patient was not evaluable due to missing. Two patients relapsed and one died., Conclusion: Pulmonary mucormycosis is difficult to diagnose and treat with a high mortality. Percutaneous transthoracic lung biopsy is a useful diagnostic method. Amphotericin B liposome or itraconazole may be active against mucus. Early control of causes is essential to improve the prognosis and reduce the recurrence in patients with pulmonary mucormycosis.

Objectives: 1,25-Dihydroxyvitamin D(3) (1,25-(OH)(2)D(3)) has immune- and inflammation-modulating properties in asthma, but its possible effects on asthmatic airway remodeling remain uncertain. In this study, we investigated the effects of 1,25-(OH)(2)D(3) on airway remodeling in a murine model of chronic asthma and investigated its role in regulating nuclear factor-κB (NF-κB) activation., Methods: BALB/c mice were sensitized to ovalbumin (OVA) and subsequently exposed to intranasal OVA challenges for 9 weeks. Some mice also received an intraperitoneal injection of 1,25-(OH)(2)D(3) at the time of challenge. At the end of the challenge period, mice were evaluated for chronic airway inflammation and airway remodeling. Nuclear translocation of NF-κB p65 in lung tissue was examined by Western blot. Inhibitor of NF-κB alpha (IκBα) expression was determined by real-time quantitative Reverse Transcription Polymerase Chain Reaction (RT-PCR) and Western blot. Phosphorylated IκBα protein expression was also determined by Western blot., Results: 1,25-(OH)(2)D(3) treatment reduced OVA-induced chronic inflammation in lung tissue and attenuated established structural changes of the airways, including subepithelial collagen deposition, goblet cell hyperplasia, and increased airway smooth muscle mass. 1,25-(OH)(2)D(3) also inhibited the nuclear translocation of NF-κB p65 in lung tissue. Concurrently, 1,25-(OH)(2)D(3) induced increased IκBα protein levels via inducing increased IκBα mRNA levels and decreased IκBα phosphorylation., Conclusion: 1,25-(OH)(2)D(3) could attenuate asthmatic airway remodeling and its inhibition of NF-κB activation may underlie this protective effect.

Background: Pathology is the "gold standard" of the diagnosis of lung cancer, but at present there are few articles about evaluating the value of cytopathological check. The aim of this study is to evaluate the value of cytopathological check in the diagnosis of primary bronchogenic carcinoma of the lung., Methods: A total of 552 samples' cytopathological results of 248 patients from January 2003 to May 2005 in this hospital were retrospectively analyzed. The samples included pleural fluids (110 for 68 patients), materials from lung puncture (33 for 31 patients), smears of transcatheter bronchial brushing (152 for 138 patients), bronchoalveolar lavage fluids (30 for 26 patients) and sputa (227 for 118 patients)., Results: The positive results of different specimens were as follow: the pleural fluids was 69.12%, the materials from lung puncture 67.74%, the smears of transcatheter bronchial brushing 65.22%, the bronchoalveolar lavage fluids 23.08% and sputa 21.19% respectively. The positive rates of the pleural fluids, the materials from lung puncture and the smears of transcatheter bronchial brushing were higher than that of the bronchoalveolar lavage fluids and sputa (P < 0.01). There was no significant difference among the positive rates of the pleural fluids, the materials from lung puncture and the smears of transcatheter bronchial brushing, and between the positive rates of the bronchoalveolar lavage fluids and sputa (P > 0.05)., Conclusions: The cytopathological examination is helpful for the diagnosis of primary bronchogenic carcinoma of the lung, and is one of the important ways to the diagnosis of primary bronchogenic carcinoma of the lung.

Objective: To study the status of oral pharyngeal carriage and characteristics of Haemophilus influenzae (Hi) in healthy preschool children in Fuzhou., Methods: Six hundred and three healthy children in two representative kindergartens in Fuzhou were studied as research subjects, and the rates of oral pharyngeal carriage of Hi were studied in four seasons. All Hi strains were serotyped and biotyped., Results: The oral pharyngeal carriage of Hi in day care nursery healthy children were 36.7% in winter, 18.0% in autumn, 12.4% in summer and 10.9% in spring respectively. Serotype Hib was preponderant in autumn (6.9%). In winter, the carriage rates of NTHi and Hib were 17.1%, 5.4% respectively. The carriage rates of other serotypes were low. Biotype VII and VIII were preponderant in autumn, spring and summer but biotype VII and VIII were decreasing evidently in winter., Conclusion: There was evident seasonal difference in the rates of oral pharyngeal carriage and type of Hi in healthy preschool children. The carriage rate of Hi strains was high in autumn and winter. Results suggested that while the inoculation of Hib-binding bacterial vaccine was expanded the study on new bacterial vaccine of Hi still needs to be augmented.