This is the case of a 62-year-old male with prior modified Bentall’s procedure using a 23-mm bioprosthetic valve last 2013 who came in with progressive heart failure symptoms. On physical examination, vital signs are stable. Physical exam revealed rhonchi on both lung fields and irregular rhythm with a grade 3 systolic ejection murmur at the aortic area. A 2-dimensional transthoracic echocardiogram showed an ejection fraction of 25%, aortic valve area of 1.0 cm2 and mean gradient of 21 mmHg consistent with severe low-flow, low-gradient aortic stenosis (AS). Options for re-do surgical aortic valve replacement (SAVR) were discussed. Since the patient was deemed high risk for another surgery, the option for transcatheter aortic valve in surgical aortic valve (TAV-in-SAV) was considered. The patient underwent successful TAV-in-SAV using a 26-mm self-expanding bioprosthetic valve. Post-procedure, there was significant improvement of functional capacity from class IV to class I.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; World Health Organization ; Vital Signs ; Respiratory Sounds ; Research Report ; Physical Examination ; Constriction, Pathologic ; Aortic Valve Stenosis

BACKGROUND : The incremental shuttle walk test (ISWT) and six-minute walk test (6MWT) assess cardiorespiratory endurance in sedentary populations, with the ISWT being externally paced and the 6MWT self-paced. This study aimed to evaluate whether both tests produce comparable cardiorespiratory responses. METHODS : 100 healthy sedentary adults (18–59 years) from Cipto Mangunkusumo Hospital completed both tests. Outcomes measured included distance traveled, maximal heart rate (HRmax), and Borg scale scores (rating of perceived exertion [RPE], dyspnea, and leg fatigue). RESULTS : Of 100 sedentary adults (25 men, 75 women), the ISWT resulted in significantly longer walking distances (p<0.001), higher post-test Borg dyspnea scores (median [interquartile range]: 2 [1–3]) versus 1 [0–2]; p = 0.024), and the higher HRmax (70.9 [9.2%] bpm versus 67.9 [10.9%] bpm; p = 0.004) compared to the 6MWT. No significant differences were observed in other parameters, and Bland–Altman analysis revealed no proportional bias for Borg leg fatigue scores (p = 0.561). CONCLUSIONS In healthy sedentary adults, the 6MWT and ISWT showed no agreement in distance traveled, Borg dyspnea scale scores, or HRmax, but they agreed on Borg leg fatigue scores.
exercise test ; exercise tolerance ; incremental shuttle walk test ; physical fitness ; six-minute walk test

Hemoptysis is a serious medical emergency associated with high mortality rates. Notably, it poses significant therapeutic challenges owing to the complexities in rapidly identifying the bleeding site and underlying cause. In severe cases, it can lead to death by asphyxia, thus necessitating prompt intervention. Bronchoscopy-guided endobronchial balloon occlusion (EBBO) is a vital procedure for blocking the bleeding bronchus, allowing time for subsequent embolization of the responsible vessel and definitive treatment. While traditional techniques for EBBO are intricate and demanding, recent advancements in balloon technology, along with procedural refinements, have simplified the process, reduced operation times, and enhanced medical staff proficiency. Nevertheless, a lack of standardized protocols and technical guidelines has hindered the widespread adoption of this technique in China. Accordingly, the Internal Medicine of Chinese Medical Association convened a group of experts to develop the "Expert consensus on endobronchial balloon occlusion in the treatment of hemoptysis (2025 edition)" to standardize this procedure. This consensus, grounded in evidence-based medicine and clinical practice both domestically and internationally, covers seven essential elements: treatment strategies, equipment, indications and contraindications, preoperative preparation, technical procedures and specifications, integration with other therapeutic techniques, efficacy assessment, and follow-up. By offering comprehensive guidance, the consensus aims to standardize and promote the use of EBBO for hemoptysis management in China.
Humans ; Hemoptysis/therapy* ; Balloon Occlusion/methods* ; Bronchoscopy ; Consensus ; Evidence-Based Medicine

A nodule in the right middle lobe of the lung was treated by a combination of cone-beam CT,three-dimensional registration for fusion imaging,and electromagnetic navigation bronchoscopy-guided thermal ablation.The procedure lasted for 90 min,with no significant bleeding observed under the bronchoscope.The total radiation dose during the operation was 384 mGy.The patient recovered well postoperatively,with only a small amount of blood in the sputum and no pneumothorax or other complications.A follow-up chest CT on the first day post operation showed that the ablation area completely covered the lesion,and the patient was discharged successfully.
Humans ; Bronchoscopy/methods* ; Catheter Ablation/methods* ; Cone-Beam Computed Tomography ; Electromagnetic Phenomena ; Imaging, Three-Dimensional ; Lung Neoplasms/diagnostic imaging* ; Tomography, X-Ray Computed

The lungs are the most common sites of metastases from non-pulmonarymalignancies. Endobronchial metastases are rare and have no specificity in clinical manifestations,thus being prone to misdiagnosis and delayed treatment.The common tumors associated with endobronchial metastasis are renal,breast,and colorectal cancers.This article reported one case of postoperative rectal cancer with endobronchial and lung metastases,which was relieved by high-frequency electrocautery ablation via bronchoscope,chemotherapy,and targeted drugs,aiming to provide a reference for clinical diagnosis and treatment.
Humans ; Rectal Neoplasms/pathology* ; Electrocoagulation/methods* ; Bronchial Neoplasms/drug therapy* ; Bronchoscopy ; Lung Neoplasms/secondary* ; Bronchoscopes

Objective To evaluate the value of pre-ascent 6-minute walking test performed at a high altitude in predicting the incidence of acute mountain sickness(AMS)induced by rapid ascent to a very high altitude.Methods After baseline information was collected,participants completed the 6-minute walking test at a high altitude of 2 900 m.Then,they rapidly ascended to a very high altitude of 5 000 m.The Lake Louise score was recorded to assess AMS.Results The AMS group showed a shorter pre-ascent 6-minute walking distance(6MWD)at the high altitude than the non-AMS group[480.00(450.00,521.75)m vs.546.00(516.50,568.50)m,P=0.006].No difference was observed regarding the pre-ascent heart rate or peripheral oxygen saturation(both P>0.05).The pre-ascent 6MWD at the high altitude was negatively correlated with the Lake Louise score assessed after rapid ascent to the very high altitude(r=-0.497,P=0.012).Logistic regression analysis confirmed that the pre-ascent 6MWD at the high altitude was associated with the risk of AMS induced by rapid ascent to the very high altitude(OR=0.971,95% CI=0.947-0.996,P=0.022).The results indicated that the pre-ascent 6MWD demonstrated ideal prediction performance(area under receiver operating characteristic curve=0.846,P=0.006).Conclusion The pre-ascent 6MWD recorded at the high altitude is a convenient and reliable predictor of the AMS induced by rapid ascent to the very high altitude.
Humans ; Altitude Sickness/diagnosis* ; Male ; Adult ; Female ; Young Adult ; Middle Aged ; Acute Disease ; Walk Test ; Walking ; Altitude ; Exercise Test

OBJECTIVES: To investigate the risk factors for plastic bronchitis (PB) in children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) and to establish a nomogram prediction model. METHODS: A retrospective analysis was conducted on 178 children with MUMPP who underwent bronchoscopy from January to December 2023. According to the presence or absence of PB, the children were divided into a PB group (49 children) and a non-PB group (129 children). The predictive factors for the development of PB in children with MUMPP were analyzed, and a nomogram prediction model was established. The model was assessed in terms of discriminatory ability, accuracy, and clinical effectiveness. RESULTS: The multivariate logistic regression analysis showed that older age and higher levels of lactate dehydrogenase and fibrinogen were closely associated with the development of PB in children with MUMPP (P<0.05). A nomogram model established based on these factors had an area under the receiver operating characteristic curve of 0.733 (95%CI: 0.651-0.816, P<0.001) and showed a good discriminatory ability. The Hosmer-Lemeshow goodness-of-fit test indicated that the predictive model had a good degree of fit (P>0.05), and the decision curve analysis showed that the model had a good clinical application value. CONCLUSIONS The risk nomogram model established based on age and lactate dehydrogenase and fibrinogen levels has good discriminatory ability, accuracy, and predictive efficacy for predicting the development of PB in children with MUMPP.
Retrospective Studies ; Risk Factors ; Nomograms ; Mycoplasma pneumoniae/isolation & purification* ; Pneumonia, Mycoplasma/microbiology* ; Bronchitis/microbiology* ; Macrolides/therapeutic use* ; Drug Resistance, Bacterial ; Bronchoscopy ; Area Under Curve ; ROC Curve ; Fibrinogen/analysis* ; Age Factors ; Humans ; Male ; Female ; Infant ; Child, Preschool ; Child ; Adolescent ; L-Lactate Dehydrogenase/blood*

The peripheral pulmonary lesions are located far from the central airway and close to the pleura, so it is a challenge for clinical diagnosis of their nature through biopsy. Therefore, the Ion robot-assisted bronchoscopy system which has started its commercialization in China is proposed to diagnose and treat peripheral pulmonary lesions. The Ion system can be used for navigation, registration, biopsy and treatment. In this paper, the structural principle of the Ion system is expounded, and its technical advantages such as shape perception, slender catheter and flexible operation are summarized. It represents the latest development direction of the diagnosis and treatment of peripheral pulmonary lesions. Then, the clinical application and development status of the Ion system are analyzed and discussed in detail. Finally, the development trend of the robot-assisted bronchoscopy system is prospected, which provides new ideas for realizing the "integrated and one-stop" diagnosis and treatment services for peripheral pulmonary lesions based on this system.
Bronchoscopy/instrumentation* ; Humans ; Robotics ; Robotic Surgical Procedures

OBJECTIVE: To evaluate the efficacy and safety of a hospital-made resuscitation pack, a Chinese medicinal herbal compound formula designed to enhance recovery in post-bronchoscopy patients. METHODS: In this randomized, single-blind, placebo-controlled clinical trial, eligible patients were randomly assigned 1:1 to either the treatment or control groups. The patients in the treatment group applied the resuscitation pack, which contained aromatic compounded Chinese herbs. The patients in the control group applied a hospital-made, single herb placebo pack. Packs were placed on the Tiantu (CV 22) acupuncture point for 4 h as soon as the bronchoscopy finished. Efficacy indicators, such as recovery time, patients' symptoms including nausea and dizziness, and adverse events (AEs) were observed and compared. The outcome indices were evaluated at baseline, 1 and 24 h after the bronchoscopy. Subgroup analysis was further performed by patients' age and depth of sedation. RESULTS: When applying generalized estimating equations (GEE) to evaluate the intensity of post-bronchoscopy nausea and vomiting, the intensity was lower in the treatment group (163 cases) compared with the control group (162 cases; 95% CI: 0.004, 0.099, P=0.03]. Also, significantly lower intensity of nausea was observed in the 60-70 years of age subgroup (95% CI: 0.029, 0.169, P=0.006) and deep sedation subgroup (95% CI: 0.002, 0.124; P=0.04). There was no significant difference in dizziness between two groups by GEE (95% CI: -0.134, 0.297; P=0.459). In addition, no serious AEs were observed in either group. CONCLUSIONS Our study found that the resuscitation pack markedly improved patients' symptoms by reducing nausea and vomiting after bronchoscopy without AEs, compared with placebo in the perioperative period. (Trial registration No. ChiCTR2000038299).
Humans ; Male ; Middle Aged ; Female ; Bronchoscopy/adverse effects* ; Single-Blind Method ; Aged ; Drugs, Chinese Herbal/adverse effects* ; Treatment Outcome ; Resuscitation ; Adult ; Medicine, Chinese Traditional

OBJECTIVE: To investigate the effect of traditional Chinese Five-body balance exercise on patients with preserved ratio impaired spirometry (PRISm). METHODS: Fifteen patients with PRISm and 15 patients diagnosed with chronic obstructive pulmonary disease (COPD) were recruited from the Outpatient Department of Guang'anmen Hospital and Beijing Niujie Health Service Center from April to December, 2023. Participants in both groups attended supervised Five-body balance exercise training twice a week for 12 weeks. Patients with COPD continued their regular medication regimen during the intervention period. The endpoints were mean changes in the 6-min walk test (6MWT), St. George's Respiratory Questionnaire (SGRQ) score, cardiopulmonary exercise testing (CPET), pulmonary function, and scores of COPD assessment test (CAT), modified British Medical Research Council, Self-Rating Anxiety Scale, and Self-Rating Depression Scale from baseline to 12 weeks. Adverse events were monitored throughout the study. RESULTS: The PRISm group showed a significant improvement from baseline to week 12 in 6MWT, SGRQ symptom score, and forced vital capacity (FVC) compared to the COPD group (P<0.05). No significant between-group changes were observed in other outcome measurements (P>0.05). In addition, compared with baseline, both groups exhibited improvements in 6MWT, SGRQ score, and CPET at week 12 (P<0.05). The PRISm group also showed a significant increase in forced expiratory volume in 1 s and FVC, as well as a significant decrease in CAT score at week 12 (P<0.05). No adverse events were reported. CONCLUSION Patients with PRISm may benefit from Five-body balance exercise training, which can improve the exercise capacity, health-related quality of life, and lung function. (Registration No. ChiCTR2200059290).
Humans ; Spirometry ; Male ; Female ; Pulmonary Disease, Chronic Obstructive/therapy* ; Lung/physiopathology* ; Middle Aged ; Exercise Tolerance/physiology* ; Exercise Therapy ; Aged ; Medicine, Chinese Traditional ; Respiratory Function Tests ; East Asian People