OBJECTIVE To investigate the application of metagenomic next-generation sequencing(mNGS)of bron-choalveolar lavage fluid(BALF)in the detection of pathogens of pulmonary infection.METHODS The clinical data of 98 patients with pulmonary infections admitted to NO.2 People's Hospital of Fuyang City from Jan.2023 to Jan.2024 were retrospectively analyzed,mNGS and traditional pathogenicity test were performed in BALF,and comprehensive clinical judgment(using a combination of alveolar lavage fluid,sputum,blood,etc.to assess)was used as the gold standard to evaluate the differences between mNGS and traditional pathogenicity tests in the path-ogenic diagnosis of pulmonary infections,compare the pathogen detection rates in pulmonary infections complicat-ed with underlying diseases,severe and non-severe illness and different infection types,and to analyze the impact on clinical adjustment of anti-infection regimens.RESULTS The positive detection rate of mNGS for pulmonary in-fection pathogens was 88.78％,higher than that of traditional pathogenology(P＜0.001).The time required for mNGS was(16.57±2.64)h,shorter than that of traditional pathogenology(P＜0.05).The positive detection rates of mNGS in patients with and without underlying diseases were 93.02％and 85.45％,respectively,higher than those of traditional pathogenology(P＜0.05).The positive detection rates of mNGS in severe and non-severe patients were 91.43％and 87.30％,respectively,higher than those of traditional pathogenology(P＜0.05).A total of 122 strains of pathogens were detected in 87 patients with positive mNGS tests,and EB virus was not de-tected.A total of 75 strains of pathogens were detected in 54 patients with positive traditional pathogenetic tests,and Neisseria,Rhizopus,parvovirus,and Chlamydia psittaci were not detected.The detection rate of bacteria by mNGS was 58.20％,higher than that by traditional pathogenetic tests(P=0.034).The detection rates of mNGS test for monotypic infection and mixed infection were 85.51％and 93.10％,respectively,higher than those by traditional pathogenetic test(P＜0.05).In pulmonary infections,mNGS guided adjustment of anti-infective treat-ment in 53.06％of patients,60.47％of those in the group with underlying pulmonary disease,and 47.27％of those without underlying disease(P=0.194).Among severe cases,68.57％had their anti-infective treatment plan adjusted,compared to 44.44％of non-severe patients(P=0.022).CONCLUSION The mNGS of BALF idenfies some rare pathogens,improves the detection rate of pathogens in pulmonary infections,and may guide the clinical adjustment of anti-infective strategies.

OBJECTIVE To investigate the application of metagenomic next-generation sequencing(mNGS)of bron-choalveolar lavage fluid(BALF)in the detection of pathogens of pulmonary infection.METHODS The clinical data of 98 patients with pulmonary infections admitted to NO.2 People's Hospital of Fuyang City from Jan.2023 to Jan.2024 were retrospectively analyzed,mNGS and traditional pathogenicity test were performed in BALF,and comprehensive clinical judgment(using a combination of alveolar lavage fluid,sputum,blood,etc.to assess)was used as the gold standard to evaluate the differences between mNGS and traditional pathogenicity tests in the path-ogenic diagnosis of pulmonary infections,compare the pathogen detection rates in pulmonary infections complicat-ed with underlying diseases,severe and non-severe illness and different infection types,and to analyze the impact on clinical adjustment of anti-infection regimens.RESULTS The positive detection rate of mNGS for pulmonary in-fection pathogens was 88.78％,higher than that of traditional pathogenology(P＜0.001).The time required for mNGS was(16.57±2.64)h,shorter than that of traditional pathogenology(P＜0.05).The positive detection rates of mNGS in patients with and without underlying diseases were 93.02％and 85.45％,respectively,higher than those of traditional pathogenology(P＜0.05).The positive detection rates of mNGS in severe and non-severe patients were 91.43％and 87.30％,respectively,higher than those of traditional pathogenology(P＜0.05).A total of 122 strains of pathogens were detected in 87 patients with positive mNGS tests,and EB virus was not de-tected.A total of 75 strains of pathogens were detected in 54 patients with positive traditional pathogenetic tests,and Neisseria,Rhizopus,parvovirus,and Chlamydia psittaci were not detected.The detection rate of bacteria by mNGS was 58.20％,higher than that by traditional pathogenetic tests(P=0.034).The detection rates of mNGS test for monotypic infection and mixed infection were 85.51％and 93.10％,respectively,higher than those by traditional pathogenetic test(P＜0.05).In pulmonary infections,mNGS guided adjustment of anti-infective treat-ment in 53.06％of patients,60.47％of those in the group with underlying pulmonary disease,and 47.27％of those without underlying disease(P=0.194).Among severe cases,68.57％had their anti-infective treatment plan adjusted,compared to 44.44％of non-severe patients(P=0.022).CONCLUSION The mNGS of BALF idenfies some rare pathogens,improves the detection rate of pathogens in pulmonary infections,and may guide the clinical adjustment of anti-infective strategies.

Objective To investigate changes of peripheral blood eosinophils(EOS),D-dimer(D-D)and neutrophil/lymphocyte ratio(NLR)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their relationship with pulmonary ventilation function.Methods Sixty-five AECOPD patients(the observation group)and 65 COPD patients(the control group)were selected respectively and included in this study.Basic data were collected in the two groups of patients,and laboratory indexes were examined.EOS and D-D levels were determined,and NLR was calculated.The lung function indexes including the first second expiratory volume with exertion(FEV1),the first second expiratory volume with exertion as a percentage of expiratory lung capacity with exertion(FEV1/FVC),and blood gas indexes of arterial blood partial pressure of oxygen[p(O2)]and arterial blood partial pressure of carbon dioxide[p(CO2)]were detected.Multifactorial Logistic regression was used to analyze the influencing factors of AECOPD.The nomogram model of AECOPD was established and verified by R4.2.3.Results Compared with the control group,levels of EOS,D-D and NLR were elevated,and FEV1 and FEV1/FVC levels were reduced in the observation group(P＜0.05).Multifactorial Logistic regression analysis showed that elevated EOS,D-D and NLR,and reduced FEV1/FVC and FEV1 were independent risk factors for patients with AECOPD(P＜0.05).The area under the receiver operating characteristic(ROC)curve of AECOPD nomogram model was 0.817(95%CI:0.784-0.904),and the Hosmer-Lemeshow test showed goodness of fit of the model(χ2=4.320,P＞0.05).EOS,D-D and NLR were positively correlated with FEV1 and FEV1/FVC(P＜0.05).Conclusion The elevated levels of EOS,D-D and NLR are risk factors that affect pulmonary ventilation in AECOPD patients,which can be used as an important indicator to evaluate pulmonary ventilation function.

Objective To investigate the characteristics of lymph node metastasis in T 1 stage of lung cancer and the curative effects of minimally invasive surgery and open surgery .Methods Totally 120 cases of T1 stage of lung cancer were divided into two groups ,68 cases in the minimally invasive surgery group and 52 cases in the open surgery group ,the number of lymph node me‐tastasis in the patients with lung cancer in T 1 stage were studied ,the perioperative related indicators for different tumor size were compared between the two different surgical methods .Results All patients were successfully completed the operation without op‐erative death case .The two groups had no significant difference in the aspects of operation time ,intraoperative bleeding volume and number of lymph node dissection .The lymph node metastasis rates in the maximum tumor diameter ≤1 .0 ,1 .0 -3 .0 cm were 1 .3% and 9 .7% respectively .N1 ,N2 squamous cancer of the maximal tumor diameter ≤1 .0 cm had no metastasis .The periopera‐tive related clinical indicators in the maximal tumor diameter ≤1 .0 cm had significant differences between the two kinds of opera‐tion method(P<0 .05) ,the perioperative related clinical indicators in the maximal tumor diameter 1 .0-3 .0 cm had no significant differences between the two kinds of operation method .Conclusion The patients with T1 stage of lung cancer and the maximal tumor diameter ≤1 .0 cm are more suitable for the minimally invasive surgery ,but the patients with T1 stage of lung cancer and the maximal tumor diameter>1 .0 cm have little difference in minimally invasive surgery and open surgery .