Objective To explore the diagnostic value of virtual bronchoscopic navigation (VBN) for peripheral pulmonary lesions. Methods 200 cases with peripheral pulmonary lesions (0.8 cm < diameter < 4.0 cm) were divided into VBN and control group from June 2014 to June 2015. VBN group: VBN guided ultrafine bronchoscope to the target bronchus, control group: ultrafine bronchoscopy with chest CT as a reference guided to the target bronchus. Results There were no significant differences in the diagnosis rates between VBN group and control group in 200 patients (χ2 = 3.31, P = 0.069); But, the diagnosis rates with diameter more than 2.0 cm and less than or equal to 2.0 cm had statistically significant differences of VBN group and control group (χ2 = 13.45, 5.31, P = 0.000, 0.021, respectively); We also found that the mean time of biopsy tool reach to the lesions had significant differences between the two groups (P = 0.047). There were no significant differences in total checking time and complications (P = 0.230, 0.960, respectively). Conclusions Virtual bronchoscopic navigation did not improve the diagnosis rate of pulmonary peripheral lesions, but shortened the time to locate the lesions.

Objective To explore the diagnostic efficacy of bronchoscopy combined with T-SPOT in tuber-culosis. Methods Totally 248 highly suspected tuberculosis patients were included from February 2015 to April 2016 in our department. According to the different sources of sputum specimens ,they were divided into control group,atomization group and bronchoscope group;Depending on the mode of examination,they were divided into bronchoscopy group,T-SPOT group,bronchoscopy+T-SPOT group.To compare anti-acid smear positive rate,tuber-culosis diagnosis and diagnostic efficacy in each group and safety of bronchoscopy. Results The rate of sputum specimens smear-positive was the highest(37.173%) in bronchoscopy.There were statistically significant of the three groups(P=0.001);The highest diagnostic rate of pulmonary tuberculosis was(92.670%)in Bronchoscopy+T-SPOT group,three groups were statistically significant(P=0.000). The specificity,sensitivity,positive predic-tive value,negative predictive value,positive likelihood ratio and Jorden index were highest in diagnosing tuberculo-sis of bronchoscopy+T-SPOT group ,negative likelihood ratio was lowest. There were Complications of three cases of bleeding,one case of pneumothorax,one case of arrhythmia in bronchoscopy group. Conclusion Bronchoscopy combined with T-SPOT can improve the diagnostic efficacy of tuberculosis ,safe and reliable.

Objective To explore the diagnostic value of radial ultrasound (EBUS) combined with virtual navigation (VBN) in peripheral pulmonary nodules.Methods Two hundreds and forty cases of peripheral pulmonary nodules(0.8 cm≤diameter≤3 cm) in the respiratory department of our hospital from July 2014 to July 2015 were included and according to the different guide de vices,which were divided into the radial ultrasound combined with virtual navigation group (EBUS+ VBN group),radial ultrasound group (EBUS group),virtual navigation group (VBN group) and control group.The diagnostic rates were compared among the four groups and among different sizes of lesion.The time of lesion location and operating time were also compared between the EBUS+ VBN group and EBUS group.Results Among 240 cases,the diagnostic rate in the EBUS+VBN group was highest(81.67％),and the diagnostic rates had statistically significant difference among the four groups (x2=19.344,P=0.00);the diagnostic rates of lesions less than 2 cm in diameter were lower than that of lesions ＞2 cm in the EBUS+-VBN group and EBUS group,but without statistically significant difference (x2 =2.04,3.40,P =0.15,0.07);the locating lesions time and operating times in the EBUS+ VBN group were shorter than those in the EBUS group,but the difference between them was not statistically significant (P=0.03,0.04).Conclusion EBUS combined with VBN could improve the diagnostic rate of peripheral pulmonary nodules and shorten the time of lesion location and operating time.

Objective To explore the security and its influencing factors on benign airway stenosis treated with interventional of high pressure balloon expansion catheter.Methods Clinial data of 39 cases of inpatients suffered from benign airway stenosis were chosen.17 cases were male,and 22 cases were female.The ages of them ranged from 15 to 83 years old.According to the clinical symptoms,HRCT 3D reconstruction,and the results of bron-choscope,all patients were treated with balloon expansion catheter at different criterions.The balloon catheter with size that slightly smaller than the targeted normal bronchial tube was chosen,expansion for average 1 -4 times,single balloon expansion time ranged from 0.5 to 4 min,the pressures were kept at 3 -6 atmosphere,and the highest pres-sure did not exceed 8 atmospheric pressure.The efficacy and complications were retrospectively analyzed.Results 19 cases were completely effective,14 cases were basically effective,6 cases were completely ineffective,and the total effective rate was 84.6% (33 /39 ),the incidence of complications was 35.8% (14 /39 ),moreover,no deaths occurred.Conclusion High pressure balloon catheter expansion is one of commonly used technology in breathing interventional treatment;it has the characteristics of easy operation,and immediate curative effect,and so on.But if the improper operation,incorrect selection of the case,or inaccurate evaluation of the stenosis during operation,serious complications and unnecessary iatrogenic injury can be occurred.Therefore,it is worthy of attention and further summarizing by breathing interventional physicians.

Objective To investigate the influence of S100A6 gene RNA interference on the biological behaviors of A549 lung adenocarcinoma cells.Methods The S100A6 gene RNA interference vector was transfected in A549 lung adenocarcinoma by lentivirus.The experiment was divided into three groups:pLenR-GPH group (the vector without S100A6 RNAi gene was transfected),negative control group (no vectors was transfected),and RNAi group (the vector with S100A6 RNAi gene was transfected).S100A6 mRNA and protein were detected using real-time PCR and Western blotting.The biological behavior including cell proliferation,invasion,cell cycle and cell apoptosis were detected by 3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2H-tetrazolium bromide,transwell,and flow cytometer,respectively.Results The expression of S100A6 mRNA of A549 lung adenocarcinoma cell line in RNAi group (0.009 ± 0.001) was significantly decreased than those in negative control group (0.049 ± 0.005) and pLenR-GPH group (0.030 ± 0.006),with statistically significant differences (t =57.56,P =0.000;t =48.21,P =0.000).The expression of S100A6 protein of A549 lung adenocarcinoma cell line in RNAi group (0.107 ± 0.002) was significantly decreased than those in negative control group (0.341 ± 0.005) and pLenR-GPH group (0.311 ± 0.006),with statistically significant differences (t =37.34,P =0.000;t =27.51,P =0.001).The ability of cell proliferation at 48 hours in RNAi group (0.230 ± 0.008) was significantly declined than those in negative control group (0.292 ± 0.038) and pLenR-GPH group (0.307 ± 0.013),with statistically significant differences (t =25.31,P =0.003;t =29.42,P =0.001).The number of transmembrane cells in RNAi group (11.40 ± 1.36) was significantly declined than those in negative control group (26.80 ± 1.83) and pLenR-GPH group (25.80 ± 1.93),with statistically significant differences (t =29.44,P =0.001;t =23.17,P =0.005).The cell proportion of S phase in RNAi group (28.26％ ± 0.38％) was significantly lower than those in pLenR-GPH group (44.73％±0.66％) and negative control group (45.15％ ± 1.69％),with statistically significant (t =63.69,P=0.000;t =71.55,P =0.000).Cell propotion of G2-M phase in RNAi group (26.99％ ± 0.29％) was signi-ficantly higher than those in negative control group (13.26％ ±0.49％) and pLenR-GPH group (12.41％ ± 0.46％),with statistically significant (t =56.31,P =0.000;t =51.39,P =0.000).The cell apoptosis proportion in RNAi group (8.90％ ±0.48％) was significantly higher than those in negative control group (5.84％ ±0.21％) and pLenR-GPH group (5.99％ ±0.37％),with statistically significant (t=51.34,P =0.000;t =47.27,P =0.000).Conclusion S100A6 gene involves the proliferation,invasion,cell cycle and apoptosis of tumor cells,which has close correlation with occurrence,development and metastasis of lung adenocarcinoma.S100A6 gene is hopeful to become a molecular target for the diagnosis and treatment of lung adenocarcinoma.

Objective To retrospectively analyze of clinical application of BF-XP60 micro-bronchoscopy.Methods 135 clinical data of patients who adopted ultrafine micro-bronchoscopy and intervention were collected and analyzed for the complications.Results The frequency of local rhinomusoca damaging and errhysis was in 3 cases,the mucous of the glottis damaging and errhysis was in 2 cases,local mucous of the tracheal bronchus errhysis was in 3 cases.After intervention,the frequency of fever was in 13 cases,massive haemorrhage was in 1 case,pneumothorax was in 1 case,chest pain was in 2 cases,part fiber of inner untrafine micro-bronchoscopy broken was in 2 cases,check failure due to ultrafine micro-bronchoscopy broken in trachea was in 4 cases,and arrhythmia,asphyxia,and death were in 0 case.The overall incidence of side effects was 22.9％ (31/135).Conclusion Application of ultrafine micro-bronchoscopy was contributed to find the lesions within the bronchioles and around the lungs,moreover,it could evaluate the distal bronchus of airway obstruction which was planned to adopt intervention.The topic that how to reduce the incidence of the side effects of the micro-brohchoscopy and improve the success rate and safety of inspection and intervention was worth to be concerned.

Objective To discuss the clinical features of trachea and bronchial tuberculosis and estimate the efficacy of the diagnosis of trachea and bronchial tuberculosis by fiberoptic bronchoscopy. Methods Clinical presentations and examination of fiberoptic bronchoscopy findings of 216 patients diagnosed by Olympus electric or fiberoptic bronchoscopy were retrospectively investigated. Results Male of the 216 patients were 95, female were 121, with 1.27 times higher incidence noted in female than in male subjects. An activator dry cough was the most complain in 72.7% , intermittent hemoptysis was in 34.7% , absenting of typical clinical poisoning symptoms of tuberculosis. Atelectasis and shape in lung were the most common chest roentgenographic presentations respectively in 31.0 % and 24.1 %. Chest roentgenographic presentations of 16.7% were normal. Bronchoscopic findings showed that main pathologic changes included 36.1% granulation, 31.0% mucosa inflammation, 24.1% ulceration (or necrosis) and 8. 8% cicatricial stenosis, left lung (56. 2%) was more often affected than right lung (37.6%), left bronchi (26.9% ) was in the first. The pathologic changes affected all of leaf, segment bronchi. One hundred and seventy-eight cases (82.4%) were diagnosed by bronchoscopic biopsy, 68 cases (31.5%) were diagnosed by bronchoscopic brushing examination for acid - fast bacillus. Conclusion The clinical features of trachea and bronchial tuberculosis are non - specific and easy to be misdiag-nosed. It is the main reason to be misdiagnosed that bronchial biopsy is neglected by clinical doctors. Bronchial biopsy should be the most reliable and accurate step to get the definite diagnosis.

Aim To investigate the changes of plasticity and distribution in the lungs of asthmatic guinea pigs.Methods Guinea pigs were divided into asthma group and control group.Immunohistochemistry was used in this study to observe the changes of ERK1/2 and Elk phosphoryiation in the lungs of guinea pigs.Results There were significant changes in distribution of EPK1/2 and Elk in the lungs of asthma group.The positive cells were detected on the walls of respiratory bronchioles and alveolar ducts,especially on the smooth muscle layer and basement membrane.In addition,the numbers of positive cell were clearly increased in asthma group(P< 0.01). Conclusion There is close relationship between the EPK1/2 and Elk phosphoryiation and attack of asthma.It may be a reason for persistence and progress of asthma.

Objective To evaluate the significance of fibreoptic bronchoscopy combined with percutaneous pneumocentesis in the diagnosis of peripheral pulmonary lesions.Methods 269 patients with peripheral pulmonary diseases were diagnosed with fibreoptic bronchoscopy biopsy combined with bronchial brush biopsy.In 89 out of the 269 patients no positive findings were obtained,because the lesions were located in the lung hilum,medial sphere or mesosphere,when X-ray guided fibreoptic bronchoscopy biopsy combined with bronchial brush biopsy were employed.In 77 out of the 89 patients positive fingings were still lacking,as their lesions were located in the mesosphere or peripheralzone,when X-ray guided percutaneous pneumocentesis biopsy was used.In 70 out of the 77 patients,positive fingings were lacking,as their lesions were just beneath the chest wall,when B-ultrasonography guided percutaneous automatic elastic biopsy was employed.Results 276 times of fibreoptic bronchoscopy biopsy combined with bronchial brush biopsy were performed in 269 patients,final diagnosis was obtained in 82 of them,with a diagnostic rate of 30.5%;94 times of X-ray guided fibreoptic bronchoscopy biopsy combined with bronchial brush biopsy were performed in 89 patients,and final diagnosis was obtained in 66 patients,with a diagnostic rate of 74.2%;85 times of X-ray guided percutaneous pneumocentesis biopsy were performed in 77 patients,final diagnosis was obtained in 52,with a diagnostic rate of 67.5%;79 times of B-ultrasonography guided percutaneous automatic elastic biopsy were performed in 70 patients,final diagnosis was obtained in 49,with a diagnostic rate of 70.0%.A final diagnosis was made in a total of 249 patients,with a diagnostic rate of 92.6% when 4 methods were used in combination.Conclusion Combined use of fibreoptic bronchoscopy with percutaneous pneumocentesis biopsy may remarkably raise the diagnostic rate in the patients with peripheral pulmonary diseases,and is worth to be recommended for general use in clinical work.

Objective To investigate the efficacy and safety of interventional therapy for central airway stenosing pulmonary disease. Methods In 389 petients diagnosed as central airway stenosis, their primary diseases were handled timely and correctly. On the basis of handling the primary disease, cetral airway stenosis was treated by interventional techniques, including electrosurgical unit (ESU), laser, argon plasma coagulation, freezing, high-pressure balloon expansion, stent implantation, local injection and toilet with lavage. Following the American College of Chest Physicians (ACCP) guidelines, the therapeutic effects were evaluated based on correction of stenosis after interventional treatment and the dyspnea scores. Results Of the 389 patients, 154 were treated with electrosurgical unit under bronchoscopy, 18 with laser, 76 with freezing, 69 with argon plasma coagulation, 35 with high-pressure balloon expansion, 21 with tracheobronchial stent implantation, and 16 with local injection and laving clearance. Evaluation of the therapeutic effects was made one month after the interventional treatment. As a result of the interventional treatment, a complete relieve was observed in 152 cases (39.1%), partial relieve in 138 cases (35.5%), mild response in 67 cases (17.2%), no response in 32 cases (8.2%), and with 17 deaths (4.4%). The total effective rate was 91.8%. The dyspnea scores were 1.8?0.5 before the treatment, and 0.7?0.4 after the treatment, with statistically significant difference (P