Clinical Respiratory Journal最新文献_第4页

Evaluation of PD-L1 Expression in Patients With Non–Small Cell Lung Cancer Using DCE-MRI Quantitative Analysis 应用DCE-MRI定量分析评估非小细胞肺癌患者PD-L1表达

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-09-27 DOI: 10.1111/crj.70125

Chen Yang, Fandong Zhu, Qianling Li, Chenwen Sun, Hongyan Jin, Zhenhua Zhao

Purpose

The aim is to evaluate the expression of programmed death ligand 1 (PD-L1) in patients with non–small cell lung cancer (NSCLC) using quantitative perfusion parameters based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Methods

A total of 35 patients with a confirmed diagnosis of NSCLC and sufficient tissue pathology were enrolled in the study. The immunohistochemical (IHC) results were used as the gold standard to determine the thresholds for grouping the patients. The patients were divided into three categories based on their PD-L1 expression: (1) PD-L1-negative (IHC < 1%) and PD-L1-positive (IHC ≥ 1%); (2) PD-L1 weak (IHC < 50%) and strong expression (IHC ≥ 50%); and (3) PD-L1 nonexpression (IHC < 1%), low expression (IHC between 1% and 49%), and high expression (IHC ≥ 50%). DCE-MRI datasets were analyzed to acquire histogram parameters, including mean value, uniformity, skewness, kurtosis, entropy, energy, and quantity, of quantitative perfusion parameters using the extended Tofts model (ETM) and the exchange model (ECM). Subsequently, the parameters were compared between the aforementioned groups.

Results

IHC showed PD-L1 < 1% in 20 cases, PD-L1 (1%–49%) in 14 cases, and PD-L1 ≥ 50% in 14 cases. At a threshold of 50%, statistically significant differences were observed for ETM/K^trans (Q25 and Q50), ETM/K_ep (Q10), and ECM/V_e (Q75 and Q90), with values being higher in the weak PD-L1 expression group. With thresholds of 1% and 50%, the results of the pairwise comparison showed that the ECM/V_e (Q75) value in the low PD-L1 expression group was significantly higher than that in the high PD-L1 expression group.

Conclusion

DCE-MRI quantitative analysis is a valuable tool for the evaluation of PD-L1 expression in NSCLC. It provides a noninvasive method that can be employed as an adjunctive technique for the stratification of PD-L1 expression in patients with NSCLC.

目的利用基于动态对比增强磁共振成像（DCE-MRI）的定量灌注参数评估非小细胞肺癌（NSCLC）患者中程序性死亡配体1 （PD-L1）的表达。方法入选35例确诊为非小细胞肺癌且组织病理充分的患者。免疫组化（IHC）结果作为金标准来确定患者分组的阈值。根据PD-L1表达情况将患者分为三类：(1)PD-L1阴性（IHC≥1%）和PD-L1阳性（IHC≥1%）；(2) PD-L1弱表达（IHC≥50%）和强表达（IHC≥50%）；(3) PD-L1不表达（IHC≤1%）、低表达（IHC≤1% ~ 49%）、高表达（IHC≥50%）。采用扩展Tofts模型（ETM）和交换模型（ECM）对DCE-MRI数据集进行分析，获取定量灌注参数的均值、均匀性、偏度、峰度、熵、能量、数量等直方图参数。随后，对上述两组间的参数进行比较。结果IHC显示PD-L1≥1% 20例，PD-L1≥1% 49% 14例，PD-L1≥50% 14例。在阈值为50%时，ETM/Ktrans （Q25和Q50）、ETM/Kep （Q10）和ECM/Ve （Q75和Q90）的差异有统计学意义，且弱PD-L1表达组的数值更高。阈值分别为1%和50%，两两比较结果显示，PD-L1低表达组ECM/Ve （Q75）值显著高于PD-L1高表达组。结论DCE-MRI定量分析是评价非小细胞肺癌中PD-L1表达的一种有价值的工具。它提供了一种无创的方法，可以作为非小细胞肺癌患者PD-L1表达分层的辅助技术。

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引用次数: 0

Relationship Between Systemic Immune-Inflammation Index and In-Hospital Mortality in Sepsis Combined With Chronic Obstructive Pulmonary Disease Modified by Mechanical Ventilation 机械通气改良的脓毒症合并慢性阻塞性肺疾病患者全身免疫炎症指数与住院死亡率的关系

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-09-24 DOI: 10.1111/crj.70122

Ren-wei Zhang, Meng-jiao Ye

Introduction

This retrospective cross-sectional study examined the correlation between Systemic Immune-Inflammation Index (SII) and in-hospital mortality in patients with sepsis combined with chronic obstructive pulmonary disease (COPD) and explored the modifying effect of mechanical ventilation on this relationship.

Methods

Logistic regression models were employed to explore the correlation between log SII and in-hospital mortality. The receiver operating characteristic curve and decision curve analysis were used to examine the predictive value of log SII for in-hospital mortality. Generalized linear regression analysis, logistic regression analysis, and restricted cubic spline were used to explore the associations among log SII, in-hospital mortality, and mechanical ventilation states.

Results

A total of 1058 patients were enrolled. Log SII was an independent risk factor for in-hospital mortality in patients with sepsis combined with COPD (odds ratios for Model 1, Model 2, Model 3, and Model 4 were 3.116, 2.847, 2.244, and 3.495, respectively; p < 0.005; log SII as an optimal-threshold categorical variable). Additionally, mechanical ventilation was closely related to log SII (p < 0.05). There was a stronger correlation between log SII and in-hospital mortality of patients who received mechanical ventilation, especially those with invasive mechanical ventilation (p < 0.05).

Conclusion

An elevated SII independently predicts elevated in-hospital mortality risk in sepsis–COPD patients. This association is strongly intensified by mechanical ventilation, particularly the invasive mode. SII serves as a valuable biomarker for risk stratification in this vulnerable population.

摘要：本回顾性横断面研究探讨了脓毒症合并慢性阻塞性肺疾病（COPD）患者全身免疫炎症指数（SII）与住院死亡率的相关性，并探讨机械通气对这一关系的调节作用。方法：采用Logistic回归模型探讨log SII与住院死亡率的相关性。采用受试者工作特征曲线和决策曲线分析检验log SII对住院死亡率的预测价值。采用广义线性回归分析、logistic回归分析和受限三次样条分析探讨log SII、住院死亡率和机械通气状态之间的关系。结果：共纳入1058例患者。logsii是脓毒症合并COPD患者住院死亡率的独立危险因素(模型1、模型2、模型3和模型4的比值比分别为3.116、2.847、2.244和3.495；p结论：SII升高独立预测脓毒症合并COPD患者住院死亡率风险升高。机械通气，尤其是有创通气，更强化了这种关联。SII可作为易感人群风险分层的有价值的生物标志物。

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引用次数: 0

Combination of Photodynamic and Bronchoscopic Intervention With Radiation Therapy in Treating Pulmonary Pleomorphic Sarcoma: A Case Report 光动力与支气管镜联合放射治疗肺多形性肉瘤1例。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-09-18 DOI: 10.1111/crj.70129

Ran An, Shishou Wang, Lijian Tang, Tao Feng, Chen Lin, Chongqing Lv

Primary pulmonary synovial sarcoma (PPSS) is a rare and challenging malignancy in terms of diagnosis and treatment. We narrated a case of PPSS treated innovatively by integrating photodynamic therapy (PDT) and localized radiation, overcoming diagnostic and treatment challenges associated with PPSS. The combination significantly improved clinical symptoms and patient survival. The case sheds light on a promising therapeutic strategy, augmenting the treatment discourse for PPSS and potentially guiding future clinical practices in managing this rare malignancy.

原发性肺滑膜肉瘤（PPSS）是一种罕见且具有挑战性的恶性肿瘤，在诊断和治疗方面。我们叙述了一个案例，创新地结合光动力治疗（PDT）和局部放射治疗，克服了与PPSS相关的诊断和治疗挑战。联合用药可显著改善临床症状和患者生存。该病例揭示了一种有希望的治疗策略，增加了PPSS的治疗话语，并有可能指导未来治疗这种罕见恶性肿瘤的临床实践。

引用次数: 0

Body Composition Analysis in Obstructive Sleep Apnea: A Cross-Sectional Study Using Bioelectrical Impedance Analysis 阻塞性睡眠呼吸暂停的身体成分分析：使用生物电阻抗分析的横断面研究。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-09-18 DOI: 10.1111/crj.70123

Mucahit Yetim, Macit Kalçık, Lütfü Bekar, Yusuf Karavelioğlu, Yasemin Arı Yılmaz

Introduction

Obstructive sleep apnea (OSA) is a prevalent disorder characterized by recurrent upper airway collapse, resulting in intermittent hypoxia and sleep fragmentation. While obesity is a major risk factor, traditional markers such as body mass index (BMI) inadequately reflect the complex interplay of body composition in OSA pathogenesis. This study aimed to investigate the predictive value of body composition parameters assessed by bioelectrical impedance analysis (BIA) for OSA.

Methods

In this cross-sectional single-center study, 78 patients diagnosed with OSA by polysomnography (PSG) and 78 age-, gender-, and BMI-matched controls without OSA were analyzed. BIA was used to assess fat distribution, muscle mass, and body water composition. Logistic regression analyses were performed to identify independent predictors of OSA.

Results

Compared to controls, the OSA group had significantly higher lean mass, trunk fat percentage, and total body water. Multivariable logistic regression identified body fat mass (OR = 1.06), visceral fat area (OR = 0.83), and total body water (OR = 1.10) as independent predictors of OSA. Notably, total body water had the strongest association with OSA risk, independent of traditional obesity metrics.

Conclusion

BIA-derived body composition analysis provides nuanced insights beyond BMI, highlighting the roles of central fat distribution and fluid balance in OSA pathophysiology. These findings underscore the clinical utility of incorporating detailed body composition assessment into the routine evaluation of patients at risk for OSA.

梗阻性睡眠呼吸暂停（OSA）是一种常见病，其特征是反复发生上呼吸道塌陷，导致间歇性缺氧和睡眠破碎。虽然肥胖是一个主要的危险因素，但传统的身体质量指数（BMI）等指标不能充分反映身体成分在OSA发病机制中的复杂相互作用。本研究旨在探讨生物电阻抗分析（BIA）评估的体成分参数对OSA的预测价值。方法：在这项横断面单中心研究中，分析了78例经多导睡眠图（PSG）诊断为OSA的患者和78例年龄、性别和bmi匹配的未患OSA的对照组。BIA用于评估脂肪分布、肌肉质量和身体水分组成。进行Logistic回归分析以确定OSA的独立预测因素。结果：与对照组相比，OSA组的瘦质量、躯干脂肪率和全身水分明显增加。多变量logistic回归发现体脂质量（OR = 1.06）、内脏脂肪面积（OR = 0.83）和全身水分（OR = 1.10）是OSA的独立预测因子。值得注意的是，与传统的肥胖指标无关，全身水分与阻塞性睡眠呼吸暂停风险的关系最为密切。结论：bia衍生的身体成分分析提供了比BMI更细致的见解，突出了中枢脂肪分布和液体平衡在OSA病理生理中的作用。这些发现强调了将详细的身体成分评估纳入OSA风险患者的常规评估中的临床应用。

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引用次数: 0

Investigation Into the Effect of Vaccination on Pulmonary Involvements in Patients With COVID-19 Infection, Based on High-Resolution CT Imaging 基于高分辨率CT成像研究疫苗接种对COVID-19感染患者肺部受累的影响

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-09-18 DOI: 10.1111/crj.70127

Elahe Amani, Bentolhoda Otroshi, Mohsen Tabatabaie, Azam Moslemi, Shiva Shabani

Background

COVID-19 infection has been a major pandemic of this century, causing deaths, economic hardship, and poverty worldwide. At the moment, vaccination remains the most effective measure against this health challenge. This retrospective study assessed the efficacy of COVID-19 vaccination in the affected patients who had been shown positive previously by polymerase chain reaction (PCR) tests.

Methods

We compared the retrospective records of 547 patients with COVID-19 over the prior 18 months (Mar. 2021 to Sept. 2022). Data from the patients' hospital records were divided into two groups of vaccinated (N = 334) versus non-vaccinated (N = 213) from individuals who had a prior positive PCR test. Subsequently, the patients' chest computed tomography (CT) images were evaluated and scored for the lung involvements based on a pathologically established scoring system.

Results

Based on the CT image scores, it was evident that the vaccination significantly reduced the lung involvements in these patients. The severity of lung involvements was significantly less in the vaccinated than in the non-vaccinated group, regardless of being younger or older than 65 years old. Also, the arterial oxygen saturation was significantly greater in the vaccinated than in the non-vaccinated patients. Lastly, the vaccination had a significant effect on lowering the mortality rate and intubation in patients older than 65 years. However, there was no significant difference between the vaccinated versus the non-vaccinated groups with respect to their admission into the ICU at the local hospital.

Conclusions

Based on the results, COVID-19 vaccination reduced the severity of lung involvements in patients significantly. Hence, it can be considered a protective measure in reducing the disease burden.

背景：COVID-19感染是本世纪的一大流行病，在全世界造成死亡、经济困难和贫困。目前，疫苗接种仍然是应对这一健康挑战的最有效措施。本回顾性研究评估了先前聚合酶链反应（PCR）检测呈阳性的受影响患者接种COVID-19疫苗的效果。方法：对547例COVID-19患者过去18个月（2021年3月至2022年9月）的回顾性记录进行比较。来自患者医院记录的数据被分为两组，接种疫苗（N = 334）和未接种疫苗（N = 213），这些患者来自先前PCR检测阳性的个体。随后，对患者的胸部计算机断层扫描（CT）图像进行评估，并根据病理建立的评分系统对肺部受累进行评分。结果：基于CT图像评分，很明显，疫苗接种显著降低了这些患者的肺部受累。无论是年龄小于65岁还是大于65岁，接种疫苗组肺部受累的严重程度明显低于未接种疫苗组。此外，接种疫苗的患者动脉氧饱和度明显高于未接种疫苗的患者。最后，疫苗接种对降低65岁以上患者的死亡率和插管率有显著效果。然而，接种疫苗组与未接种疫苗组在当地医院ICU住院方面没有显著差异。结论：基于结果，COVID-19疫苗接种显着降低了患者肺部受累的严重程度。因此，它可以被认为是减轻疾病负担的一种保护性措施。

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引用次数: 0

Prevalence, Distribution, and Risk Factors of Mycobacterium Other Than Tuberculosis Among Tuberculosis Presumptive Patients in Karonga District in Malawi 马拉维Karonga地区结核病推定患者中非结核分枝杆菌的流行、分布和危险因素

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-09-18 DOI: 10.1111/crj.70126

S. Chitsulo, L. Gogoda, H. Nyirenda, S. Chirwa, T. Mwenyenkulu, H. Kanyerere, J. Mpunga, K. Mbendera, B. Mbakaya, S. Mwale, B. Nyambalo, F. Sinyiza, M. Chisale

Introduction

Besides tuberculosis (TB), there are also other nontuberculous mycobacteria (NTM) that present with similar clinical signs and symptoms as TB. If not promptly found and treated, these organisms may affect the programming of the TB control and elimination campaign. The study sought to establish the prevalence, distribution, and factors contributing to MOTT infections among presumptive TB patients in the Karonga district.

Methods

A descriptive cross-sectional study research design was employed. A total of 196 participants were included in the study using a census approach. Data were collected by administering a questionnaire to the health care worker, and a sputum specimen was collected from the participants; this specimen was used to examine the presence of mycobacterium using the microscope. Regardless of the results at the district-level laboratory, all the specimens were then sent to the Mzuzu region TB reference laboratory to isolate Mycobacterium tuberculosis and Mycobacterium Other Than Tuberculosis.

Results

Of the 196 samples collected, 14 (7.1%) were positive at the district level. When sent for culture, 195 (99.5%) had culture results, and 23 (12%) had growth in culture. Out of the 23 (100%) culture-positive results, 12 (52%) were MOTT-positive, while 11 (48%) were MTB complex. There were more men, seven (58%) with MOTT-positive than women, five (42%), and more in the age group of 15–39 years old, with six (50%) and less in more than 60 years old two (16.7%).

Conclusion

The results show the presence of MOTT infections among presumptive TB patients who submitted samples to the study. The distribution by sex shows that more men had MOTT infections than women. However, all the risk factors listed for the study were not significant for MOTT infections. The recommendation is to improve the testing techniques to identify these microorganisms, which are neglected but very difficult to assess, especially when no clear population is at risk of getting these infections compared with TB.

简介：除了结核病（TB），还有其他非结核分枝杆菌（NTM）表现出与结核病相似的临床体征和症状。如果不及时发现和治疗，这些微生物可能会影响结核病控制和消除运动的规划。该研究试图确定Karonga地区推定结核病患者中MOTT感染的患病率、分布和因素。方法：采用描述性横断面研究设计。通过人口普查的方法，共有196名参与者参与了这项研究。通过对卫生保健工作者进行问卷调查收集数据，并收集参与者的痰标本；该标本用于显微镜检查分枝杆菌的存在。无论区级实验室的结果如何，所有标本随后都被送往Mzuzu地区结核病参比实验室，以分离结核分枝杆菌和非结核分枝杆菌。结果：196份样本中，14份（7.1%）呈区级阳性。送去培养时，195例（99.5%）有培养结果，23例（12%）培养有生长。在23例（100%）培养阳性结果中，12例（52%）为mtt阳性，11例（48%）为MTB复合物。mott阳性的男性为7人（58%），女性为5人（42%），15-39岁年龄组较多，6人（50%），60岁以上年龄组较少，2人（16.7%）。结论：结果显示，在提交样本的推定结核病患者中存在MOTT感染。按性别划分的分布表明，男性感染MOTT的人数多于女性。然而，该研究列出的所有危险因素对MOTT感染的影响并不显著。建议改进检测技术，以识别这些被忽视但很难评估的微生物，特别是当没有明确的人群与结核病相比有感染这些微生物的风险时。

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引用次数: 0

The Role of Gut Microbiota on Idiopathic Pulmonary Fibrosis Mediated by Circulating Inflammatory Proteins: A Two-Step, Two-Sample Mendelian Randomization Study 肠道菌群在循环炎性蛋白介导的特发性肺纤维化中的作用：一项两步、两样本孟德尔随机研究

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-09-09 DOI: 10.1111/crj.70120

Hongyu Zhu, Caihua Chen, Haixie Guo, Bo Zhang, Quanteng Hu

Background

Persistent inflammation is a crucial characteristic of idiopathic pulmonary fibrosis (IPF). Gut microbiota (GM) contribute to the occurrence and development of several pulmonary diseases through the “gut–lung axis.” The genetic role of GM in IPF and the mediating effect of circulating inflammatory proteins.

Methods

A single nucleotide polymorphism (SNP) was used as an instrumental variable (IV) for exposure to evaluate the causal relationship between exposure and outcome. A two-step, two-sample Mendelian randomization study mainly based on an “inverse variance weighted (IVW)” approach was performed to explore the causal relationship between GM and IPF mediated by circulating inflammatory proteins.

Results

The IVW way illustrated 12 taxa (Bacillales, Gastranaerophilales, Selenomonadales, Family XIII, Bacteroidaceae, Bacteroides, and Actinomyces, Bifidobacterium, Oscillibacter, Ruminococcus gnavus, Subdoligranulum, Veillonella) of GM and 8 circulating inflammatory proteins (CCL11, CXCL6, CXCL9, CCL8, CCL7, NRTN, STAMPB, and TGFa) had suggestive evidence of causality on IPF. The mediation MR demonstrated the causal pathway from Actinomyces to IPF was partly mediated by CCL11 (the mediation effect: 0.063, 95% CI [1.016–1.126]; p = 0.004) with a mediation proportion of 13.035%.

Conclusions

These findings may suggest a genetically predicted association between GM and IPF mediated by circulating inflammatory proteins.

背景持续炎症是特发性肺纤维化（IPF）的一个重要特征。肠道微生物群（GM）通过“肠-肺轴”促进几种肺部疾病的发生和发展。转基因在IPF中的遗传作用及循环炎症蛋白的介导作用。方法采用单核苷酸多态性（SNP）作为暴露的工具变量（IV），评价暴露与预后的因果关系。一项主要基于“逆方差加权（IVW）”方法的两步、两样本孟德尔随机化研究，旨在探讨GM与循环炎症蛋白介导的IPF之间的因果关系。结果IVW方法显示12个类群（芽胞杆菌、嗜气胃杆菌、单胞硒门、13科、拟杆菌科、拟杆菌科、放线菌科、双歧杆菌、Oscillibacter、瘤胃球菌、小肠子菌、小肠子菌）的GM和8个循环炎性蛋白（CCL11、CXCL6、CXCL9、CCL8、CCL7、NRTN、STAMPB、TGFa）与IPF存在因果关系。中介MR表明CCL11部分介导了放线菌与IPF的因果通路（中介效应：0.063,95% CI [1.016-1.126]; p = 0.004），中介比例为13.035%。结论：这些发现可能表明GM和循环炎症蛋白介导的IPF之间存在遗传预测关联。

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引用次数: 0

Comparative Evaluation of Pleural Fluid Cholesterol and Total Protein Versus Light's Criteria in Differentiation of Exudates and Transudates: A Cross-Sectional Analysis at Tribhuvan University Teaching Hospital Tribhuvan大学教学医院胸膜液胆固醇和总蛋白与Light标准鉴别渗出液和渗出液的比较评价

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-08-27 DOI: 10.1111/crj.70121

Amrit Raj Subedi, Tritha Man Shrestha, Yagya laxmi Shakya, Bishal Budha

<div> <section> <h3> Introduction</h3> <p>Pleural effusions are very common clinical findings in clinical practice. Their proper diagnosis based on different parameters like pleural fluid protein, LDH, ADA, and cholesterol is very important. Light's criteria, though used as a standard method in differentiating pleural effusions as exudates and transudates, usually misidentifies 15%–20% of transudates as exudates. Hence, the role of other criteria like combined pleural fluid cholesterol and total protein in the differentiation of pleural fluid is studied in this study. The objectives of our study are to determine the role of combined pleural fluid cholesterol and total protein in the differentiation of exudates and transudates in cases presenting in Tribhuvan University Teaching Hospital.</p> </section> <section> <h3> Methods</h3> <p>This is a single-centered, analytical, cross-sectional, observational study. This is carried out among patients who are diagnosed as a case of pleural effusions from the emergency ward and respiratory ward of Tribhuvan University Teaching Hospital. Data collection was started after ethical approval was taken from IRB. The data were analyzed through SPSS version 22 for data analysis.</p> </section> <section> <h3> Results</h3> <p>Total of 90 patients with pleural effusion were enrolled in this study. Out of 90 patients, 49 patients were male, and 41 patients were female. The mean age of patients was 52.86 (±17.90) years. Tuberculosis was the most common disease associated with effusions, followed by pneumonia and malignancy. Based on Light's criteria, 65 (72.2%), pleural effusions were found to be exudates, and 25 were found to be transudates, with sensitivity and specificity of 98.4% and 85.7%, respectively. According to pleural fluid total protein, it classified 62.2% [<i>n</i> = 56] of cases as exudates and 37.8% [<i>n</i> = 34] of cases as transudates. Sensitivity and specificity were 88.7% and 96.4%, respectively. Based on pleural fluid cholesterol, 64.4% [<i>n</i> = 58] of cases were shown as exudates and 35.6% [<i>n</i> = 32] of cases as transudates, with sensitivity and specificity of 93.5% and 100%, respectively. Combined pleural total protein and cholesterol, however, classified 57.8% [<i>n</i> = 52] of cases as exudates and 42.2% [<i>n</i> = 38] of cases as transudates, with sensitivity and specificity of 83.9% and 100%, respectively.</p> </section> <section> <h3> Conclusion</h3> <p>Though Light's criteria remain the gold standard for distinguishing transudates from exudates, combined pleural fluid cholesterol

摘要胸腔积液是临床上非常常见的临床表现。根据胸水蛋白、LDH、ADA和胆固醇等不同参数对其进行正确诊断是非常重要的。Light的标准虽然被用作区分胸腔积液为渗出液和渗出液的标准方法，但通常会将15%-20%的渗出液误诊为渗出液。因此，本研究探讨了其他标准如胸水胆固醇和总蛋白在胸水鉴别中的作用。我们研究的目的是确定联合胸膜液胆固醇和总蛋白在特里布万大学教学医院出现的病例中渗出物和渗出物的鉴别中的作用。方法本研究为单中心、分析性、横断面观察性研究。这是在特里布万大学教学医院急诊病房和呼吸病房诊断为胸腔积液的病人中进行的。数据收集在获得IRB的伦理批准后开始。采用SPSS 22对数据进行分析。结果本研究共纳入90例胸腔积液患者。90例患者中，男性49例，女性41例。患者平均年龄为52.86（±17.90）岁。肺结核是与积液相关的最常见疾病，其次是肺炎和恶性肿瘤。根据Light的诊断标准，65例（72.2%）胸腔积液为渗出物，25例为渗出物，敏感性为98.4%，特异性为85.7%。根据胸膜液总蛋白，62.2% [n = 56]例为渗出物，37.8% [n = 34]例为渗出物。敏感性和特异性分别为88.7%和96.4%。基于胸膜液胆固醇，64.4% [n = 58]的病例为渗出物，35.6% [n = 32]的病例为渗出物，敏感性为93.5%，特异性为100%。而胸膜总蛋白和胆固醇联合检测将57.8% [n = 52]的病例归为渗出物，42.2% [n = 38]的病例归为渗出物，敏感性为83.9%，特异性为100%。结论虽然Light的标准仍然是区分渗出物和渗出物的金标准，但在排出物的诊断与Light标准结果不同的情况下，联合胸膜液胆固醇和总蛋白检查提高了诊断的准确性。

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引用次数: 0

Establishment and Evaluation of Cell Models for Bronchopulmonary Dysplasia: Challenges and Prospects 支气管肺发育不良细胞模型的建立与评价：挑战与展望

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-08-27 DOI: 10.1111/crj.70118

Zhenzhuang Zou, Li Fu, Jiaying Liu, Bo Huang

Bronchopulmonary dysplasia (BPD) is a chronic lung condition primarily affecting premature infants. It significantly impacts their growth, development, and health. Recently, in vitro models have been created, offering new insights into the causes and potential treatments for BPD. This review summarizes the current methods for creating in vitro models of BPD. It also discusses their evaluation criteria and applications in drug testing and biological research. This paper evaluates the advantages and disadvantages of different models.

支气管肺发育不良（BPD）是一种主要影响早产儿的慢性肺部疾病。这对他们的成长、发育和健康有很大的影响。最近，体外模型已经建立，为BPD的病因和潜在治疗提供了新的见解。本文综述了目前制备BPD体外模型的方法。并讨论了它们的评价标准及其在药物试验和生物学研究中的应用。本文评价了不同模型的优缺点。

引用次数: 0

IL-15 Superagonist SHR-1501 Enhances Immune Responses in Lung Cancer by Modulating Tumor Microenvironment IL-15超级激动剂SHR-1501通过调节肿瘤微环境增强肺癌的免疫应答

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-08-13 DOI: 10.1111/crj.70117

Qian Zhang, Congli Hu, Minlin Jiang, Yuanyuan Wang, Heng Luo, Xuefei Li

Background

Interleukin-15 (IL-15) is a pleiotropic cytokine recognized as a promising therapeutic agent in cancer immunotherapy. IL-15 superagonists have shown efficacy across various cancers, yet their effects in lung cancer immunotherapy remain underexplored.

Methods

This study evaluated the antitumor effects of SHR-1501 through intratumoral injection in two murine lung cancer models: Lewis lung carcinoma (LLC) and Kras G12D/p53−/− (KP). We employed flow cytometry to assess immune cell populations in the tumor microenvironment (TME) and systemic circulation. Immunohistochemistry (IHC) was used to analyze TME changes in tumor tissues, while single-cell RNA sequencing provided insights into TME modulation following SHR-1501 treatment. Additionally, we assessed the synergistic potential of combining SHR-1501 with PD-1 monoclonal antibody (mAb) therapy and explored the abscopal effect of SHR-1501.

Results

SHR-1501 significantly inhibited tumor growth in both KP and LLC models at 5 μg and 15 μg doses (p = 0.0022 and p = 0.0002, respectively, for KP; p = 0.0508 and p = 0.0131, respectively, for LLC). Flow cytometry revealed increased infiltration of CD8+ T cells, effector memory CD8+ T cells (TEM), and natural killer (NK) cells in the TME. SHR-1501 also enhanced systemic immune responses, increasing CD8+ T cells and TEM populations in peripheral blood and spleen, with an early NK cell elevation on day 7 post-treatment. Single-cell analysis indicated that SHR-1501 promoted the activity of macrophages, increasing M1 macrophage proportions. Moreover, SHR-1501 enhanced the antitumor immune response by promoting pro-inflammatory changes across multiple cell types within the TME, including neutrophils, fibroblasts, and endothelial cells. When combined with PD-1mAb, SHR-1501 exhibited potent synergistic antitumor effects. The combination therapy significantly prolonged overall survival with no significant toxicity observed. Furthermore, SHR-1501 may have the ability to induce an abscopal effect.

Conclusion

SHR-1501 demonstrated potent antitumor activity, especially when combined with PD-1 mAb. Its mechanism likely involves promoting CD8+ T cell and NK cell infiltration and enhancing M1 macrophage activity. These findings provide evidence for further clinical trials exploring SHR-1501 in nonsmall cell lung cancer (NSCLC) therapy.

白细胞介素-15 （IL-15）是一种多效性细胞因子，在肿瘤免疫治疗中具有广阔的应用前景。IL-15超级激动剂已显示出对多种癌症的疗效，但其在肺癌免疫治疗中的作用仍未得到充分探讨。方法通过瘤内注射SHR-1501对Lewis肺癌（LLC）和Kras G12D/p53−/−(KP)两种小鼠肺癌模型的抗肿瘤作用进行研究。我们采用流式细胞术评估肿瘤微环境（TME）和体循环中的免疫细胞群。免疫组织化学（IHC）用于分析肿瘤组织中TME的变化，而单细胞RNA测序提供了shr1 -1501治疗后TME调节的见解。此外，我们评估了SHR-1501与PD-1单克隆抗体（mAb）联合治疗的协同潜力，并探索了SHR-1501的体外效应。结果SHR-1501在5 μg和15 μg剂量下显著抑制KP和LLC模型的肿瘤生长（p = 0.0022和p = 0.0002）；p = 0.0508和p = 0.0131，分别为LLC)。流式细胞术显示TME中CD8+ T细胞、效应记忆CD8+ T细胞（TEM）和自然杀伤细胞（NK）的浸润增加。SHR-1501还能增强全身免疫反应，增加外周血和脾脏中的CD8+ T细胞和TEM数量，并在治疗后第7天早期NK细胞升高。单细胞分析表明，shr1 -1501促进巨噬细胞活性，增加M1巨噬细胞比例。此外，SHR-1501通过促进TME内多种细胞类型（包括中性粒细胞、成纤维细胞和内皮细胞）的促炎变化来增强抗肿瘤免疫反应。当与PD-1mAb联合使用时，shr1 -1501表现出强大的协同抗肿瘤作用。联合治疗显着延长了总生存期，无明显毒性观察。此外，SHR-1501可能具有诱导超视距效应的能力。结论SHR-1501具有较强的抗肿瘤活性，特别是与PD-1单抗联合使用时。其机制可能与促进CD8+ T细胞和NK细胞浸润，增强M1巨噬细胞活性有关。这些发现为进一步临床试验探索SHR-1501在非小细胞肺癌（NSCLC）治疗中的作用提供了证据。

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引用次数: 0