Clinical Respiratory Journal最新文献_第3页

Follicular Dendritic Cell Sarcoma in Mediastinum: A Case Study and Literature Review 纵隔滤泡树突状细胞肉瘤一例及文献回顾。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-21 DOI: 10.1111/crj.70140

Qingxia Xu, Chong Zhang, Yang Ma, Longquan Xiang

Follicular dendritic cell sarcoma (FDCS) is an uncommon malignant neoplasm that arises from follicular dendritic cells (FDCs). The mediastinum is a more unusual site of FDCS. In this document, we detail a case involving the complete surgical removal of FDCS located in the mediastinum. A 28-year-old woman presented with symptoms of right chest pain. Accompanying symptoms include chest tightness, shortness of breath, and faintness. Chest computed tomography was performed and revealed abnormal enhancement in the mediastinal region. An excisional biopsy was carried out, and through the aid of immunohistochemistry (IHC), a diagnosis of FDCS was confirmed. Following surgery, the patient underwent radiotherapy for 27 sessions. The patient was followed up by the oncology service for 6 years and was still alive at the time of drafting this report. This exceedingly uncommon case underscores the challenges in making a differential diagnosis and emphasizes the significance of diagnostic indicators, including histopathology and IHC, in establishing a diagnosis. Clinicians should be alert to the possibility of encountering this disease and take into consideration various characteristics to avoid misdiagnosis.

滤泡树突状细胞肉瘤（FDCS）是一种罕见的恶性肿瘤，起源于滤泡树突状细胞（FDCS）。纵隔是FDCS较为少见的部位。在本文中，我们详细介绍了一例纵隔FDCS的完全手术切除。一名28岁女性，表现为右胸痛。伴随症状包括胸闷、呼吸短促和昏厥。胸部电脑断层扫描显示纵膈区异常强化。行切除活检，免疫组化（IHC）诊断为FDCS。手术后，患者接受了27次放疗。该患者在肿瘤服务部门随访了6年，在撰写本报告时仍然活着。这个极其罕见的病例强调了鉴别诊断的挑战，并强调了诊断指标的重要性，包括组织病理学和免疫组化，在建立诊断。临床医生应警惕本病的可能，综合考虑各种特点，避免误诊。

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引用次数: 0

EIT Outperforms Quantitative CT in Stratifying ARDS Severity After Lung Transplantation: A Retrospective Study EIT优于定量CT对肺移植后ARDS严重程度的分级：一项回顾性研究。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-13 DOI: 10.1111/crj.70135

Hui Jiang, Hu Zhao, Wei Cui, Xinxin Zhu, Ruoruo Yang, Yuqiang Wang, Xia Zheng

<div> <section> <h3> Background</h3> <p>Respiratory mechanics and gas exchange parameters are readily accessible indicators for evaluating ventilation in patients with acute respiratory distress syndrome (ARDS). Computed tomography (CT) is a widely used radiological imaging technique, while electrical impedance tomography (EIT) is a novel technique for pulmonary function monitoring developed in recent years. Studies suggest that EIT combined with quantitative CT holds unique value in assessing ventilation/perfusion (V/Q) function. Unlike classic ARDS, the pathophysiologic alterations in ARDS following lung transplantation are complex, and the specific mechanisms remain unclear. This study aims to explore the use of respiratory mechanics, gas exchange parameters, EIT, and quantitative CT for the multimodal assessment of V/Q function in post-lung transplantation ARDS. We further aim to integrate visualizing dynamic imaging and regional quantitative lung analysis into this multimodal assessment system.</p> </section> <section> <h3> Method</h3> <p>We retrospectively enrolled lung transplant recipients admitted to the intensive care unit who met the Berlin criteria for ARDS. Inclusion required an arterial partial pressure of oxygen to fraction of inspired oxygen ratio (P/F) ≤ 300 mmHg, with both EIT monitoring of V/Q and high-resolution CT performed within 24 h of documented P/F ≤ 300 mmHg. Patient baseline characteristics, respiratory mechanics parameters, gas exchange parameters, EIT data, and CT images were collected. Subjects were stratified into two groups according to P/F values: a low P/F group (P/F < 200 mmHg) and a high P/F group (200 mmHg ≤ P/F ≤ 300 mmHg). Ventilation parameters derived from EIT included global inhomogeneity index (GI), center of ventilation (COV), and regional ventilation delay index (RVDI). Using hypertonic saline contrast-enhanced EIT, we acquired V/Q parameters and calculated both global and regional EIT-based dead space fraction (EIT-Dead Space), intrapulmonary shunt fraction (EIT-Shunt), and V/Q matching (EIT-V/Q Match). Chest CT images were processed through a multitask learning U-net-based computer-aided diagnostic model. This enabled semiautomated lung segmentation, identification of high-density lesions, quantitative analysis, and three-dimensional visualization. Pulmonary volumes, lesion volumes, and percentage lesion volumes (calculated as lung lesion volume divided by lung volume) were, respectively, quantified for the left and right lungs.</p> </section> <section> <h3> Result</h3> <p>The study ultimately enrolled 21 lung transplant recipients with ARDS, comprising five patients in the low P/F group and 16 in

背景：呼吸力学和气体交换参数是评价急性呼吸窘迫综合征（ARDS）患者通气情况的容易获得的指标。计算机断层扫描（CT）是一种应用广泛的放射成像技术，而电阻抗断层扫描（EIT）是近年来发展起来的一种新的肺功能监测技术。研究表明，EIT结合定量CT在评估通气/灌注（V/Q）功能方面具有独特的价值。与典型的ARDS不同，肺移植后ARDS的病理生理改变是复杂的，具体机制尚不清楚。本研究旨在探讨利用呼吸力学、气体交换参数、EIT和定量CT对肺移植后ARDS的V/Q功能进行多模态评估。我们进一步的目标是将可视化动态成像和区域定量肺分析整合到这个多模式评估系统中。方法：我们回顾性地纳入符合ARDS柏林标准的重症监护病房肺移植受者。纳入要求动脉血氧分压与吸入氧比(P/F)≤300 mmHg，并在记录的P/F≤300 mmHg的24小时内进行EIT监测V/Q和高分辨率CT。收集患者基线特征、呼吸力学参数、气体交换参数、EIT数据和CT图像。根据P/F值将受试者分为两组：低P/F组（P/F）结果：该研究最终招募了21例急性呼吸窘迫综合征（ARDS）肺移植受者，其中低P/F组5例，高P/F组16例。在21例患者中，与高P/F组相比，低P/F组通气比（VR）、RVDI、EIT-Dead Space显著高于高P/F组，EIT-V/Q匹配水平显著低于高P/F组，而两组之间EIT-Shunt无显著差异。eit -死空间与呼吸机测量的死空间分数基本一致，VR与eit -死空间呈显著正相关。在两组中，定量ct衍生的肺指标——包括肺体积、病变体积和病变体积百分比——在低P/F组和高P/F组之间没有显着差异。结论：与高P/F组相比，低P/F组肺移植患者的VR、RVDI和eit -死亡空间升高，EIT-V/Q匹配水平降低。值得注意的是，两组之间在定量ct衍生病变体积参数上没有发现显著差异。

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引用次数: 0

Distant Metastatic Pattern and Its Prognostic Significance in Malignant Pleural Mesothelioma: A Population-Based Study Based on a Machine Learning Model 恶性胸膜间皮瘤的远处转移模式及其预后意义：基于机器学习模型的人群研究

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-11 DOI: 10.1111/crj.70133

Jian Yu, Chi Peng, Qianwen Ye, Cong Huo, Binrui Gao, Qing Wei, Yibo Li, Kaidi Yang

Background

Malignant pleural mesothelioma (MPM) is an insidious and aggressive tumor, often hindering timely clinical interventions. Despite its clinical relevance, epidemiological research focusing on MPM metastases remains limited.

Methods

We conducted a retrospective review of MPM cases with site-specific metastasis records from the Surveillance, Epidemiology, and End Results (SEER) between 2010 and 2019. Propensity Score Matching was employed to minimize bias between distant metastasis and non-distant metastasis groups. A prognostic model for predicting overall survival was established using clinical variables derived from Lasso regression. Variable importance for survival outcomes was estimated using the Random Survival Forests algorithm. The performance of the nomogram was evaluated using the receiver operating characteristic (ROC) curves and calibration plots.

Results

The presence of distant metastasis significantly reduced median overall survival from 10.5 to 7 months, with further detriment observed in cases with sarcomatoid histology and without chemotherapy intervention. Multivariable analysis identified sarcomatoid subtype, T4 stage, N1+ nodal involvement, and bilateral disease as significant predictors of increased metastatic potential. Histology, surgery, and metastasis status emerged as the top three clinical variables influencing survival. The nomogram demonstrated strong discrimination and calibration for predicting the 1-year and 3-year overall survival in both training and validation cohorts. The contralateral lung was the most frequent site of distant metastasis, with lymph node metastasis presenting a significantly better prognosis than that observed in patients with metastases to other organs.

Conclusions

The large population-based analysis provides a comprehensive characterization of site-specific metastases in MPM. The identified risk factors can help stratify patients at higher risk for metastatic progression and support early, targeted clinical decision-making.

背景：恶性胸膜间皮瘤（Malignant pleural mesothelioma， MPM）是一种隐匿且侵袭性的肿瘤，常常妨碍及时的临床干预。尽管其临床相关性，但关注MPM转移的流行病学研究仍然有限。方法：我们对2010年至2019年监测、流行病学和最终结果（SEER）中具有部位特异性转移记录的MPM病例进行了回顾性研究。倾向评分匹配用于减少远处转移组和非远处转移组之间的偏差。利用Lasso回归得出的临床变量建立了预测总生存期的预后模型。使用随机生存森林算法估计生存结果的可变重要性。采用受试者工作特征（ROC）曲线和标定图评价nomogram的性能。结果：远处转移的存在显著降低了中位总生存期，从10.5个月降至7个月，在具有肉瘤样组织学且未进行化疗干预的病例中观察到进一步的损害。多变量分析确定了肉瘤样亚型、T4分期、N1+淋巴结受累和双侧疾病是转移潜力增加的重要预测因素。组织学、手术和转移状态是影响生存的三大临床变量。在训练和验证队列中，nomogram在预测1年和3年总生存率方面表现出了很强的判别性和校准性。对侧肺是最常见的远处转移部位，淋巴结转移的预后明显好于其他器官转移的患者。结论：基于大量人群的分析提供了MPM部位特异性转移的全面特征。确定的危险因素可以帮助对转移进展风险较高的患者进行分层，并支持早期、有针对性的临床决策。

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引用次数: 0

Is Chest Wall Resection Safe in Geriatric Non-Small Cell Lung Cancer? 胸壁切除术治疗老年非小细胞肺癌安全吗？

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-10 DOI: 10.1111/crj.70137

Ozkan Saydam, Celal Bugra Sezen, Melike Ülker, Umut Kilimci, Oguzhan Bayraktar, Mustafa Vedat Doğru, Cemal Aker, Muzaffer Metin

Purpose

Our aim in this study is to evaluate the safety and efficacy of surgery in patients undergoing chest wall resection due to non-small cell lung cancer (NSCLC) based on age groups.

Methods

The study was conducted retrospectively on 160 patients with NSCLC who underwent chest wall resection between 2009 and 2019. Patients were classified into Group A (under 70 years) and Group B (70 years and older).

Results

The study found a complication rate of 28.1%, but no negative impact of the geriatric age group on complications was determined. The risk of complications varied depending on the number of ribs removed (p = 0.035). The survival rate for Group A was 72%, while for Group B it was 93% (p = 0.189). No significant differences were found in terms of gender, Charlson Comorbidity Index (CCI), and histopathological results. In patients who underwent lobectomy, survival was 85%, while a significant difference was observed in those who underwent pneumonectomy, with a survival rate of 41% (p < 0.001).

Conclusion

It was determined that advanced age is not a prognostic factor in surgical resection regarding complications and survival, with the most important prognostic factors being the type of resection and the stage of the disease.

目的：本研究的目的是评估基于年龄组的非小细胞肺癌（NSCLC）胸壁切除术患者手术的安全性和有效性。方法：对2009年至2019年接受胸壁切除术的160例非小细胞肺癌患者进行回顾性研究。患者分为A组（70岁以下）和B组（70岁及以上）。结果：研究发现并发症发生率为28.1%，但未确定老年年龄组对并发症的负面影响。并发症的风险因切除肋骨的数量而异（p = 0.035）。A组生存率为72%，B组为93% （p = 0.189）。在性别、Charlson合并症指数（CCI）和组织病理学结果方面没有发现显著差异。接受肺叶切除术的患者生存率为85%，而接受全肺切除术的患者生存率为41% (p)。结论：确定高龄不是手术切除并发症和生存率的预后因素，最重要的预后因素是切除类型和疾病分期。

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引用次数: 0

Real-Time Predictive Analysis of ICU Ventilator Weaning Failure: A Prospective Validation Study ICU呼吸机脱机失败的实时预测分析：一项前瞻性验证研究

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-04 DOI: 10.1111/crj.70136

Lili Zhou, Peng Zhou, Changling Gao, Taozi Li, Qiaoyun Zhou

Objective

To construct and validate a nomogram model for predicting the risk of ICU ventilator weaning failure (reintubation or death within 48 h after extubation) based on multidimensional clinical indicators.

Methods

A total of 485 patients in the ICU who needed ventilator weaning were selected and divided into a training set (n = 340) and a validation set (n = 145) at a ratio of 7:3. Baseline data and weaning-related indicators of the patients were collected. Weaning failure (reintubation or death within 48 h after weaning) was regarded as the outcome event. Independent risk factors were screened through univariate and multivariate logistic regression. A nomogram model was constructed, and the model's performance was evaluated using the C-index, AUC, calibration curve, Hosmer–Lemeshow test, and decision curve.

Results

The weaning failure rate in the training set was 28.53% (97/340), and that in the validation set was 29.66% (43/145). Multivariate regression showed that age, APACHE II score, duration of mechanical ventilation, spontaneous breathing frequency, Glasgow Coma Scale score, and the use of sedatives were independent influencing factors (p < 0.05). The C-index of the nomogram model in the training set and the validation set was 0.829 and 0.826, respectively. The AUC was 0.828 (95% CI: 0.762–0.893) and 0.823 (95% CI: 0.732–0.915), respectively. The sensitivity and specificity were 0.811, 0.751 and 0.662, 0.702, respectively. The calibration curve and Hosmer–Lemeshow test (p = 0.109, 0.402) showed that the model had a good fit.

Conclusion

The nomogram model constructed based on the above indicators can effectively predict the risk of ICU ventilator weaning failure and provide a basis for formulating individualized weaning strategies.

目的建立并验证基于多维临床指标预测ICU呼吸机脱机失败（拔管后48 h内再插或死亡）风险的nomogram模型。方法选择485例ICU需要呼吸机脱机的患者，按7:3的比例分为训练组（n = 340）和验证组（n = 145）。收集患者的基线数据和断奶相关指标。断奶失败（重新插管或断奶后48 h内死亡）被视为结局事件。通过单因素和多因素logistic回归筛选独立危险因素。构建nomogram模型，通过C-index、AUC、校准曲线、Hosmer-Lemeshow检验和决策曲线对模型性能进行评价。结果训练集脱机失败率为28.53%(97/340)，验证集脱机失败率为29.66%（43/145）。多因素回归分析显示，年龄、APACHEⅱ评分、机械通气持续时间、自主呼吸频率、格拉斯哥昏迷评分、镇静剂使用是独立影响因素（p < 0.05）。模态图模型在训练集和验证集的c指数分别为0.829和0.826。AUC分别为0.828 （95% CI: 0.762-0.893）和0.823 （95% CI: 0.732-0.915）。敏感性和特异性分别为0.811、0.751和0.662、0.702。校正曲线和Hosmer-Lemeshow检验（p = 0.109, 0.402）表明模型拟合良好。结论基于上述指标构建的nomogram模型能够有效预测ICU呼吸机脱机失败的风险，为制定个性化脱机策略提供依据。

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引用次数: 0

Comparison of Single Versus Multiple Nonpharmacological Interventions for the Management of Lung Cancer–Related Fatigue: A Systematic Review 单一与多种非药物干预治疗肺癌相关疲劳的比较：一项系统综述。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-10-24 DOI: 10.1111/crj.70132

Audrey A. Almassi, Clarice Y. Tang, Sheree Smith

Background

Lung cancer is one of the common cancers globally. One of the adverse symptoms of lung cancer and its treatment is fatigue. Pharmacological interventions have not shown efficacy on cancer-related fatigue, and investigations on nonpharmacological interventions may be useful. This systematic review aims to evaluate the efficacy of nonpharmacological interventions on managing fatigue and quality of life outcomes among people undergoing treatment for lung cancer and evaluate if treatment efficacy differed between single and multimodal interventions.

Methods

Relevant literature published in MEDLINE, Scopus, Cochrane Library, CINAHL, and ProQuest from January 2003 to January 2023 was included. Included studies must have: participants over 16 years of age receiving treatment such as chemotherapy, radiotherapy, and/or surgery, cancer-related fatigue (CRF) as an outcome, and must be randomized controlled trials. Two reviewers independently extracted data from eligible articles, and data analysis was performed using R 4.1.0 software.

Results

Total of 14 randomized controlled trials were included and categorized into four groups: physical activities, traditional Chinese medicine (TCM), education, and dietary counselling. Our extensive search did not find any multimodal studies related to CRF in patients with lung cancer. Pooled results of this systematic review found that TCM and education interventions have a significant positive impact on fatigue in patients with lung cancer. Physical activity and dietary counselling were not effective in managing fatigue. None of the reported nonpharmacological interventions in this review significantly impact QoL.

Conclusions

This review identified that TCM and educational programs improved CRF in patients with lung cancer. However, physical activities and dietary counselling did not show any improvements in fatigue for patients undergoing lung cancer treatment.

Registration

PROSPERO registration ID: CRD42023407326.

背景：肺癌是全球常见的癌症之一。肺癌及其治疗的不良症状之一是疲劳。药物干预尚未显示出对癌症相关疲劳的疗效，对非药物干预的研究可能是有用的。本系统综述旨在评估非药物干预在治疗肺癌患者的疲劳和生活质量方面的疗效，并评估单模式和多模式干预的治疗效果是否存在差异。方法：检索2003年1月至2023年1月在MEDLINE、Scopus、Cochrane Library、CINAHL、ProQuest等网站上发表的相关文献。纳入的研究必须有：参与者年龄超过16岁，接受化疗、放疗和/或手术等治疗，癌症相关疲劳（CRF）作为结果，并且必须是随机对照试验。两名审稿人独立从符合条件的文章中提取数据，使用R 4.1.0软件进行数据分析。结果：共纳入14项随机对照试验，并将其分为体育活动、中医药、教育和饮食咨询4组。我们的广泛搜索未发现肺癌患者中与CRF相关的任何多模式研究。本系统综述的综合结果发现，中医药和教育干预对肺癌患者的疲劳有显著的正影响。体力活动和饮食咨询对控制疲劳没有效果。本综述中没有报道的非药物干预对生活质量有显著影响。结论：本综述确定中医药和教育方案可改善肺癌患者的慢性肾功能衰竭。然而，对于接受肺癌治疗的患者来说，体育活动和饮食咨询并没有显示出任何改善疲劳的效果。注册：PROSPERO注册ID: CRD42023407326。

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引用次数: 0

Construction and Validation of an Automatic Segmentation Method for Respiratory Sound Time Labels 呼吸声音时间标签自动分割方法的构建与验证。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-10-21 DOI: 10.1111/crj.70124

Jian Fan, Haoran Ni, Xiulan Chen, Yulin Duan, Wanmin Wang, Fan Xu, Yan Shang

<div> <section> <h3> Background</h3> <p>In the field of respiratory system diseases, the utilization of respiratory sounds in auscultation plays a crucial role in the specific disease diagnosis. However, during the process of auscultation, the personal experiences and environmental factors may affect the decision making, leading to diagnostic errors. Therefore, to accurately and effectively obtain and analyze respiratory sounds can be positively contribute to the diagnosis and treatment of respiratory system diseases.</p> </section> <section> <h3> Objectives</h3> <p>Our aim was to develop an analytical method for the visualization and digitization of respiratory audio data, and to validate its capability to differentiate between various background diseases.</p> </section> <section> <h3> Methods</h3> <p>This study collected the respiratory sounds of patients admitted to the Department of General Medicine of Shanghai Changhai Hospital from June to December 2023. After strict screening according to the inclusion and exclusion criteria, a total of 84 patients were included. The research process includes using an electronic stethoscope to collect lung sounds from patients in a quiet environment. The patients expose their chests and lie flat. Sound data are collected at six landmark positions on the chest. The collected audio files are imported into an analysis tool for segmentation and feature extraction. Specific analysis methods include distinguishing heart sounds and respiratory sounds, segmenting respiratory sounds, determining the inspiratory and expiratory phases, and using a tool developed by the team for automatic segmentation encoding.</p> </section> <section> <h3> Results</h3> <p>We standardized the respiratory sounds of 84 patients and segmented multiple respiratory cycles. Following the localization and segmentation of the respiratory cycles based on label information, we calculated the average and standard deviation of the amplitude features for each segment of the respiratory cycle. The results indicated differences among various diseases.</p> </section> <section> <h3> Conclusions</h3> <p>The robust algorithm platform is capable of segmenting the respiratory sounds into inhale and exhale phases accordingly, then comparing the difference between different background diseases. This method provides objective evidence for the auscultation of respiratory sounds and visual display of breath sounds.</p> </section> </div

背景：在呼吸系统疾病领域，听诊中呼吸音的应用在特定疾病的诊断中起着至关重要的作用。然而在听诊过程中，个人经历和环境因素可能会影响决策，导致诊断错误。因此，准确有效地获取和分析呼吸音对呼吸系统疾病的诊断和治疗具有积极的作用。目的：我们的目的是开发一种呼吸音频数据可视化和数字化的分析方法，并验证其区分各种背景疾病的能力。方法：收集上海市长海医院综合内科2023年6 - 12月住院患者的呼吸音。按照纳入和排除标准严格筛选后，共纳入84例患者。研究过程包括使用电子听诊器在安静的环境中收集患者的肺部声音。病人露出胸部，平躺。在胸部的六个标志性位置收集声音数据。将收集到的音频文件导入分析工具中进行分割和特征提取。具体的分析方法包括区分心音和呼吸音，分割呼吸音，确定吸气和呼气相，以及使用团队开发的工具进行自动分割编码。结果：对84例患者的呼吸音进行了标准化，并对多个呼吸周期进行了分割。根据标签信息对呼吸周期进行定位和分割，计算呼吸周期各段振幅特征的平均值和标准差。结果表明不同疾病之间存在差异。结论：鲁棒的算法平台能够将呼吸音分割为吸气和呼气阶段，然后比较不同背景疾病之间的差异。该方法为呼吸音听诊和呼吸音视觉显示提供了客观依据。

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引用次数: 0

Risk Factors and Outcomes of Clostridioides difficile Infection in Respiratory Intensive Care Unit Patients 重症监护室患者艰难梭菌感染的危险因素和结局。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-10-09 DOI: 10.1111/crj.70130

Tingting Hou, Yifang Huang, Jinjun Jiang, Yuanlin Song, Shujing Chen

Objective

This retrospective study aimed to investigate the risk factors and clinical outcomes of Clostridioides difficile infection (CDI) in critically ill patients admitted to the respiratory intensive care unit (RICU).

Methods

We enrolled adult patients who developed diarrhea during their stay in the RICU and underwent C. difficile toxin testing. Patients were stratified into two groups based on test results: CDI group and Clostridioides difficile-negative diarrhea (CDN) group. Risk factors for CDI and clinical outcomes were compared between the two groups.

Results

The incidence of CDI in RICU patients was 8.3%. Compared with the CDN group, the CDI group had significantly lower PaO₂/FiO₂ (P/F) ratios (median 135 vs. 189 mmHg, p = 0.012) and higher rates of parenteral nutrition (83.78% vs. 60.0%, p = 0.012), vasopressor use (62.16% vs. 40.0%, p = 0.029), and analgesic administration (72.97% vs. 47.14%, p = 0.01). Multivariate analysis indicated that male sex was a risk factor for CDI (OR, 4.07; 95% CI, 1.25–13.26; p = 0.02). The CDI group had a nonsignificantly higher 60-day mortality rate (35.14% vs. 34.29%; p = 0.976). Survivors of CDI patients exhibited better oxygenation (175.43 vs. 102.88 mmHg; p = 0.004) and lower SOFA scores (6.38 vs. 9.0; p = 0.017). No independent risk factors for mortality were identified. CDI patients had significantly longer RICU stays (median: 32 vs. 21.5 days, p = 0.02).

Conclusion

In this study, male sex was independently associated with an increased risk of CDI. Although CDI did not significantly affect 60-day mortality, it was linked to prolonged RICU hospitalization.

目的：本回顾性研究旨在探讨呼吸道重症监护病房（RICU）危重患者艰难梭菌感染（CDI）的危险因素及临床结局。方法：我们招募了在RICU住院期间出现腹泻并进行艰难梭菌毒素检测的成年患者。根据检测结果将患者分为CDI组和艰难梭菌阴性腹泻（CDN）组。比较两组CDI的危险因素和临床结果。结果：RICU患者CDI发生率为8.3%。与CDN组相比，CDI组PaO2/FiO2 （P/F）比值显著降低（中位数135比189 mmHg， P = 0.012），肠外营养（83.78%比60.0%,P = 0.012）、血管加压药（62.16%比40.0%,P = 0.029）和镇痛药（72.97%比47.14%,P = 0.01）的使用比例较高。多因素分析显示，男性是CDI的危险因素（OR, 4.07; 95% CI, 1.25-13.26; p = 0.02）。CDI组60天死亡率无显著性增高（35.14% vs. 34.29%; p = 0.976）。CDI患者的幸存者表现出更好的氧合（175.43比102.88 mmHg, p = 0.004）和更低的SOFA评分（6.38比9.0,p = 0.017）。未发现死亡的独立危险因素。CDI患者的RICU停留时间显著延长（中位数：32天vs. 21.5天，p = 0.02）。结论：在本研究中，男性与CDI风险增加独立相关。虽然CDI对60天死亡率没有显著影响，但它与RICU住院时间延长有关。

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引用次数: 0

Correction to “Epidemiological Characteristics of Upper Respiratory Tract Pathogens in Children in Guangdong, China” 对“广东省儿童上呼吸道病原体流行病学特征”的修正。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-09-30 DOI: 10.1111/crj.70131

Q. Zhao, P. Ke, L. Hu, et al., “ Epidemiological Characteristics of Upper Respiratory Tract Pathogens in Children in Guangdong, China,” Clinical Respiratory Journal 18, no. 10 (2024), https://doi.org/10.1111/crj.70011.

In the paragraph under “2.2.2|Multiplex Probe Amplification (MPA) PCR Testing” heading, the original description of the PCR kit and its detected pathogens was incorrect. Specifically, the kit name, the list of pathogens, and the inclusion of SARS-CoV-2 (COVID-19) genes were not accurate.

The corrected text should read as follows:

Nucleic acids stored at −80°C were subjected to testing for multiple viral pathogens using commercial kits, following the manufacturer's instructions. The PCR detection kit was purchased from Guangzhou Biotron Technology Co. Ltd. (Guangzhou, China), and the product name is Respiratory 11 Pathogens Nucleic Acid Test Kit (fluorescent PCR melting curve method). This kit is designed to simultaneously detect 11 common respiratory pathogens, including Influenza A virus (IFA), Influenza B virus (IFB), Respiratory syncytial virus (RSV), Human rhinovirus (HRV), Human parainfluenza virus (HPIV), Human adenoviruses (HAdV), Human coronavirus (HCoV), Human bocavirus (HBoV), Human metapneumovirus (HMPV), Mycoplasma pneumoniae (MP), and Chlamydia pneumoniae (CP). Primer sequences are proprietary and cannot be disclosed.

In the paragraph under “3.3|Seasonal Features” heading, the text stating “The results indicated that, except for HBoV, all other viruses had p values less than 0.01” is incorrect. It should be corrected to

“The results indicated that, except for HBoV, all other viruses had p values less than 0.001.”

Table 2 needs revision. The text ‘in bold’ should be deleted from the table footnote. Below is the corrected table:

We apologize for these errors.

赵琪，柯平，胡丽，等，“广东省儿童上呼吸道病原体流行病学特征”，《临床呼吸杂志》，第18期。10 (2024), https://doi.org/10.1111/crj.70011。在“2.2.2|多重探针扩增（MPA） PCR检测”标题下的段落中，对PCR试剂盒及其检测到的病原体的原始描述不正确。具体来说，试剂盒名称、病原体列表和包含的SARS-CoV-2 （COVID-19）基因不准确。更正后的文字应如下：按照制造商的说明，使用商用试剂盒对储存在- 80°C的核酸进行多种病毒病原体的检测。PCR检测试剂盒购自广州百创科技有限公司（中国广州），产品名称为呼吸道11型病原体核酸检测试剂盒（荧光PCR熔融曲线法）。本试剂盒可同时检测甲型流感病毒（IFA）、乙型流感病毒（IFB）、呼吸道合胞病毒（RSV）、人鼻病毒（HRV）、人副流感病毒（HPIV）、人腺病毒（hav）、人冠状病毒（HCoV）、人博卡病毒（HBoV）、人超肺病毒（HMPV）、肺炎支原体（MP）、肺炎衣原体（CP）等11种常见呼吸道病原体。引物序列是专有的，不能公开。在“3.3|季节性特征”标题下的段落中，文本“结果表明，除HBoV外，所有其他病毒的p值都小于0.01”是不正确的。应更正为“结果表明，除HBoV外，其他所有病毒的p值均小于0.001。”表2需要修改。应从表脚注中删除“粗体”文本。更正后的表格如下：我们为这些错误道歉。

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引用次数: 0

The Correlation Between NLR, RDW, and Pulmonary Hypertension in Patients With Bronchiectasis and Chronic Obstructive Pulmonary Disease Overlap Syndrome 支气管扩张合并慢性阻塞性肺疾病重叠综合征患者NLR、RDW和肺动脉高压的相关性

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-09-29 DOI: 10.1111/crj.70128

Lingling Hu, Zhenxin Liu, Jiangtao Yu, Zhongfei Yang, Daxi Feng

<div> <section> <h3> Introduction</h3> <p>Based on the analysis of the relationship between neutrophil to lymphocyte ratio (NLR) and red blood cell distribution width (RDW) and pulmonary hypertension (PH) in patients with bronchiectasis and chronic obstructive pulmonary disease overlap syndrome (BCOS), this paper aims to explore the indexes that not only represent the severity of patients with BCOS overlapping PH but also are highly related to BCOS overlapping PH.</p> </section> <section> <h3> Methods</h3> <p>The clinical data of 159 patients with BCOS admitted to Qilu Hospital of Shandong University Dezhou Hospital from January 2019 to November 2024 were collected and analyzed. All the patients had complete color Doppler echocardiography at this hospital and were separated into experimental group (106 cases, BCOS with PH) and control group (53 cases, BCOS not combined with PH group), according to whether they were complicated with pulmonary hypertension or not. And then the experimental group was divided into mild, moderate and severe subgroups. The correlation of NLR, RDW with pulmonary artery systolic blood pressure (PASP) in BCOS patients was analyzed. And whether there were differences or not between NLR and RDW among experimental group, control group as well as subgroups was compared. Furthermore, receiver operating characteristic (ROC) curves were constructed to evaluate the efficacy of NLR and RDW in distinguishing between “PH-complicated” and “non-PH-complicated” statuses among BCOS patients at the cross-sectional level.</p> </section> <section> <h3> Results</h3> <p>First, the level of NLR and RDW in experimental group was higher than those in control group, in addition the difference was statistically significant (<i>p</i> < 0.05). Second, significant intergroup differences in NLR and RDW levels were observed among the three subgroups of the experimental group (NLR: <i>p</i> < 0.001; RDW: <i>p</i> = 0.011). Specifically, both NLR and RDW levels in the severe PH subgroup were significantly higher than those in the mild PH subgroup (NLR: adjusted <i>p</i> < 0.001; RDW: adjusted <i>p</i> = 0.009). Additionally, NLR levels in the severe PH subgroup were higher than those in the moderate PH subgroup (adjusted <i>p</i> = 0.011), whereas no statistically significant difference in RDW levels was noted between the severe and moderate PH subgroups (adjusted <i>p</i> = 0.148). Furthermore, there were no significant differences in NLR or RDW levels between the mild and moderate PH subgroups (NLR: adjusted <i>p</i> = 0.196; RDW: adjusted <i>p</i> = 0.607). Third, the level of NLR and RDW was positively correlated with PASP (<i>r</i> = 0.294,

本文通过分析支气管扩张合并慢性阻塞性肺疾病重叠综合征（BCOS）患者中性粒细胞/淋巴细胞比值（NLR）、红细胞分布宽度（RDW）与肺动脉高压（PH）的关系，探讨既能反映BCOS重叠PH严重程度又与BCOS重叠PH高度相关的指标。收集分析2019年1月至2024年11月山东大学德州医院齐鲁医院收治的159例BCOS患者的临床资料。所有患者均在该院行全彩色多普勒超声心动图检查，根据是否合并肺动脉高压分为实验组（106例，BCOS合并PH）和对照组（53例，BCOS未合并PH）。然后将实验组分为轻度、中度和重度亚组。分析BCOS患者NLR、RDW与肺动脉收缩压（PASP）的相关性。并比较实验组、对照组、亚组间NLR、RDW是否有差异。此外，构建受试者工作特征（ROC）曲线，在横断面水平上评价NLR和RDW在BCOS患者中区分“ph复杂”和“非ph复杂”状态的功效。结果：首先，实验组NLR和RDW水平高于对照组，且差异有统计学意义（p < 0.05）， NLR和RDW是BCOS患者PH发展的独立危险因素（p < 0.05）。结论：NLR和RDW水平与BCOS患者肺动脉压严重程度相关。这两项指标可作为肺动脉高压合并BCOS的重要相关因素。

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引用次数: 0