胸部医学杂志

论文导读一:
Non-intubated complete thoracoscopic bronchial sleeve resection for central lung cancer

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Wenlong Shao, Kevin Phan, Xiaotong Guo, Jun Liu, Qinglong Dong, Jianxing He

Abstract: Bronchial sleeve resection has emerged as an effective thoracoscopic approach for central lung cancer with reduced operation mortality rates, optimal lung function and long-term survival. Endobronchial intubation is a commonly used method of anesthesia for such thoracoscopic procedures, but is associated with increased intubation-related and lung complications. Non-intubated epidural anesthesia represents an alternative approach which may avoid such difficulties, particularly in complicated sleeve resection situations. Here we have described a case of complete endoscopic bronchial sleeve resection of right lower lung cancer under non-intubated epidural anesthesia.

Keywords: Lung cancer; bronchial sleeve resection; non-intubated epidural anesthesia

http://www.jthoracdis.com/article/view/3189/html


论文导读二:
Remodeling of rat pulmonary artery induced by chronic smoking exposure

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Lei Zhao, Jian Wang, Lu Wang, Yu-Ting Liang, Yu-Qin Chen, Wen-Jun Lu, Wen-Liang Zhou

Objective: To evaluate the dominant role in rat pulmonary artery (PA) remodeling induced by chronic smoking exposure (CSE). 

Methods: Thirty-five male Sprague-Dawley (SD) rats were exposed to 36 cigarettes per day, 6 days per week, for 1, 3, or 5 months. Another 35 SD rats were sham-exposed during the same period. Hemodynamic measurement, evaluation of the right ventricular hypertrophy index (RVHI) plus right ventricle-to-weight ratio, and hematoxylin eosin staining was performed. Wall thickness, artery radius, luminal area, and total area were measured morphometrically. Western blotting assessed expression of PPAR-γ BMP4, BMPR2, and TRPC1/4/6 in the artery and lung. Store-operated calcium entry (SOCE) and [Ca2+]i were measured using Fura-2 as dye. 

Results: Mean right ventricular pressure increased after 3 months of smoking exposure and continued to increase through 5 months. Right ventricular systolic pressure (RVSP) increased after 3 months of exposure and then stabilized. RVHI increased after 5 months; right ventricle-to-weight ratio was elevated after 3 months and further increased after 5 months. Wall thickness-to-radius ratio does-dependently increased after 3 months through 5 months, in parallel with the decreased luminal area/total area ratio after 5 months. Other changes included the development of inflammatory responses, enlargement of the alveolar spaces, and reductions in the endothelial lining of PAs, proliferative smooth muscle cells, fibroblasts, and adventitia. Moreover, BMP4 and TRPC1/4/6 expression increased to varying degrees in the arteries and lungs of smoking-exposed animals, whereas BMPR expression and SOCE increased only in the arteries, and PPAR-γ was downregulated in both the arteries and lungs. 

Conclusions: In SD rats, smoking exposure induces pulmonary vascular remodeling. The consequences of increased SOCE include increase in TRPC1/4/6, probably via augmented BMP4 expression, which also contribute to inflammatory responses in the lung. Moreover, interactions between BMP4 and PPAR-γ may play a role in preventing inflammation under normal physiological conditions.

Keywords: Pulmonary artery hypertension (PAH); smoking; remodeling

http://www.jthoracdis.com/article/view/2520/html


论文导读三:
Construction and management of ARDS/sepsis registry with REDCap

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Wenlong Shao, Kevin Phan, Xiaotong Guo, Jun Liu, Qinglong Dong, Jianxing He

Xiaoqing Pang, Natascha Kozlowski, Sulong Wu, Mei Jiang, Yongbo Huang, Pu Mao, Xiaoqing Liu, Weiqun He, Chaoyi Huang, Yimin Li, Haibo Zhang

Objective: The study aimed to construct and manage an acute respiratory distress syndrome (ARDS)/sepsis registry that can be used for data warehousing and clinical research.

Methods: The workflow methodology and software solution of research electronic data capture (REDCap) was used to construct the ARDS/sepsis registry. Clinical data from ARDS and sepsis patients registered to the intensive care unit (ICU) of our hospital formed the registry. These data were converted to the electronic case report form (eCRF) format used in REDCap by trained medical staff. Data validation, quality control, and database management were conducted to ensure data integrity.

Results: The clinical data of 67 patients registered to the ICU between June 2013 and December 2013 were analyzed. Of the 67 patients, 45 (67.2%) were classified as sepsis, 14 (20.9%) as ARDS, and eight (11.9%) as sepsis-associated ARDS. The patients’ information, comprising demographic characteristics, medical history, clinical interventions, daily assessment, clinical outcome, and follow-up data, was properly managed and safely stored in the ARDS/sepsis registry. Data efficiency was guaranteed by performing data collection and data entry twice weekly and every two weeks, respectively.

Conclusions: The ARDS/sepsis database that we constructed and manage with REDCap in the ICU can provide a solid foundation for translational research on the clinical data of interest, and a model for development of other medical registries in the future.

Keywords: Acute respiratory distress syndrome (ARDS)/sepsis registry; research electronic data capture (REDCap); data quality; data management

http://www.jthoracdis.com/article/view/3042/html


论文导读四:
Chinese National Guidelines on Diagnosis and Management of Cough: consensus and controversy

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Kefang Lai

Abstract: Cough, especially chronic cough, is a common condition in clinical practice. Chronic cough accounts for at least 30% of respiratory specialist visits and significantly interferes with patients’ daily life, and nearly 50% women patients with chronic cough suffer from urinary incontinence (1). The Asthma Workgroup of the Chinese Society of Respiratory Diseases (CSRD) issued The Chinese National Guideline on Diagnosis and Management of Cough (draft) in 2005 (2). The guideline primarily focuses on the etiological diagnosis and management of chronic cough. Since the establishment of the guideline, many clinicians, especially respiratory specialists, have significantly improved their expertise on the diagnosis of chronic cough, which has an important instructive impact on clinical practice. Therefore, the CRSD has revised the 2005 cough guideline to further improve the guideline and better present the progresses achieved both in China and abroad (3,4). The consensus and controversy on the guidelines are discussed in the present review.

http://www.jthoracdis.com/article/view/3372/html


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