Background Patients with infection- or injury-related benign airway stenosis often require repeated bronchoscopic interventions, but evidence is limited on how early treatment patterns can guide follow-up and risk reassessment. Objectives To derive phase-adapted surveillance windows after bronchoscopic intervention and determine whether the 24-week treatment trajectory identifies patients at increased risk of subsequent recurrence or progression. Design Two-center retrospective longitudinal cohort study. Methods Patients treated between January 2019 and December 2024 were included if they had infection- or injury-related benign airway stenosis and did not receive stent or T-tube placement during follow-up. Adjacent bronchoscopic records separated by ≤1 week were merged into one treatment episode. Valid intervals were defined as adjacent records separated by >1 week with assessable recurrence/progression status. Risk strata were constructed using treatment episodes within 24 weeks and window-end airway control: low risk, 1–3 episodes with adequate control; intermediate risk, 4–5 episodes or 1–3 episodes with inadequate control; and high risk, ≥6 episodes. A 24-week landmark analysis evaluated subsequent composite events. Results Overall, 213 patients contributed 879 valid intervals. Data-informed surveillance windows were approximately 1 week in the early phase, 2–3 weeks in the mid and consolidation phases, and 4–5 weeks in the maintenance phase. Among 93 patients included in landmark analysis, post-landmark composite event proportions were 31.3%, 60.9%, and 80.6% in the low-, intermediate-, and high-risk groups, respectively (log-rank P<0.001). In multivariable Cox regression, the high-risk group had a significantly increased risk of composite events (HR=5.849, 95% CI 2.031–16.845, P=0.001), whereas the intermediate-risk group showed a non-significant trend (HR=2.514, 95% CI 0.920–6.871, P=0.072). Conclusion Early treatment burden provides clinically meaningful risk stratification after bronchoscopic intervention for benign airway stenosis. Six or more treatment episodes within 24 weeks may identify a treatment-dependent high-risk phenotype requiring intensified surveillance and comprehensive reassessment.

Significance Pulmonary mucoepidermoid carcinoma (PMEC) is a rare salivary gland-type tumor with no standard treatment. While photodynamic therapy (PDT) shows promise in early-stage central lung cancers, its role in PMEC remains underexplored. Approach We report a case of a 46-year-old male with low-grade PMEC of the left main bronchus. After initial bronchoscopic electrosnare resection, recurrence occurred 2 years later. The patient was treated with PDT, consisting of three consecutive daily sessions over three days using a 630 nm light source (0.9 W). Each treatment included two light exposures, with a total irradiation time of 600 seconds (540 J) for the first two sessions and 300 seconds (270 J) for the final session. Results PDT resulted in complete tumor response, with no residual tumor cells on histology. Follow-up over 38 months confirmed no recurrence. Conclusions This case demonstrates PDT as a minimally invasive therapy for early-stage PMEC, warranting further investigation.

BACKGROUND:Central bronchopleural fistula (cBPF) is one of the most severe complications after pulmonary resection, with high morbidity and mortality. Bronchoscopic occlusion has emerged as a minimally invasive treatment for cBPF, but systematic evidence to guide optimal material selection and to predict treatment efficacy is lacking. OBJECTIVES:To evaluate how anatomical characteristics of cBPF influence the choice of bronchoscopic occlusion materials, and to develop a risk model for individualized prediction of long-term occlusion outcomes. DESIGN:Single-center retrospective observational study. METHODS:We analyzed clinical data of 56 patients with postoperative cBPF. Fistula anatomical features and their matching with various occlusion materials were evaluated. Occlusion strategies were categorized as pure pharmacologic therapy, stent-only, or combined approaches, according to the actual combinations of materials used during bronchoscopic occlusion. An outcome prediction model was constructed using the least absolute shrinkage and selection operator (LASSO) for feature selection and a Bayesian cumulative logit mixed-effects model for longitudinal outcomes at multiple time points, and key risk factors for long-term outcomes were identified during follow-up. RESULTS:Fistula size and type largely determined the choice of occlusion strategy. Occlusion outcomes evolved dynamically over time, with the 3-month postocclusion mark representing a key inflection point in outcome stability. The model showed that the 1-3-month period after bronchoscopic occlusion was a high-risk window for unfavorable occlusion grades. Patients with occult fistulas and those treated with pure pharmacologic therapy were more likely to maintain or regain better occlusion status. A visual risk-scoring nomogram was constructed based on this model to support risk stratification and individualized outcome prediction. CONCLUSION:This study provides new evidence to guide material selection for bronchoscopic cBPF occlusion and to predict therapeutic outcomes and long-term prognosis. The findings support an individualized treatment strategy and dynamic management approach for patients with bronchial stump fistula.

Although Montgomery T-tube implantation has become an effective method for treating tracheal stenosis, the T-tube needs to be removed as a temporary treatment. At present, there is still a lack of research on the relevant factors affecting T-tube extraction. Therefore, we aimed to explore the clinical characteristics of post-tracheotomy tracheal stenosis (PTTS) disease and the risk factors affecting Montgomery T-tube extraction. Retrospective analysis of patients who underwent Montgomery T-tube implantation in the Respiratory and Critical Care Medicine of Emergency General Hospital and the Department of Respiratory Medicine at Dongzhimen Hospital from June 2014 to September 2024. They were followed up for at least 6 months. T-tube extraction was used as the main outcome measure. A logarithmic rank test was used to analyze the association between clinical characteristics and T-tube extraction. Kaplan-Meier analysis was performed to analyze the rate of T-tube extraction. Multivariate stepwise Cox regression analysis was used to explore the variables that may affect the association of T-tube extraction. A total of 49 patients were included, and 18 (36.7

Significance Photodynamic therapy (PDT) has been proven to be an effective treatment that maximizes the preservation of glottic function. Our objective is to evaluate the effectiveness of PDT in the treatment of recurrent respiratory papillomatosis (RRP). Approach We conducted a retrospective evaluation of patients from January 2020 to October 2024, recording detailed information on their disease, treatment, and follow-up. Results 4 patients underwent PDT with irradiation focused on the glottis, pharynx, and zones I-III of the airway. The average energy used was 3567.6J. 1 month after PDT, the therapeutic effects were evaluated: 1 achieved complete response (CR) and 3 achieved partial response (PR). Progression-free survival (PFS) ranged from 2 to 38 months, and complications were rare. Conclusions PDT may be a safe and effective technique for the treatment of RRP.

BACKGROUND:Ultrathin bronchoscopy (UTB) is commonly used to diagnose peripheral pulmonary lesions due to its small diameter. However, there is no consensus on its comparison with conventional bronchoscopy (CB) combined with various guiding modalities. METHODS:A comprehensive literature search was performed to identify studies comparing UTB and CB, extracting data on diagnostic yield, operating time, complications, pathological diagnoses, and lesion size. Protocol registration: identifier CRD42024554649. PRISMA guidelines were followed. RESULTS:This meta-analysis included 11 studies with 2,640 patients. UTB demonstrated a significantly higher diagnostic yield (70.5% vs. 57.6%, p = 0.005), particularly with rEBUS and fluoroscopy (p = 0.02). UTB had a higher complication rate, but the difference was not significant (p = 0.37). It also had a shorter operative time than CB-GS (p = 0.007). UTB showed a significant advantage in diagnosing malignant tumors, especially adenocarcinoma and metastatic cancer (p = 0.02, p = 0.03). Both techniques were comparable in diagnosing benign conditions, but UTB outperformed CB in all lesion size categories (p < 0.01). CONCLUSIONS:UTB's smaller diameter likely provides a diagnostic advantage over CB and CB-GS by enabling deeper and more accurate access to peripheral lung regions.

Significance Lung carcinoid tumors are rare neuroendocrine tumors. Traditional treatments like surgery, radiotherapy, and chemotherapy have limited efficacy for some patients (e.g., inoperable or recurrent cases). Photodynamic therapy (PDT), a minimally - invasive and highly - targeted treatment, shows potential in treating lung carcinoid tumors. Approach This article details a pathologically - confirmed case of an atypical lung carcinoid tumor. After surgical resection, the recurrence and metastasis were successfully treated with PDT using intravenous hematoporphyrin. Results Eleven months post-treatment, bronchoscopy revealed smooth mucosa at the lesion site. The patient showed no signs of recurrence during the 11-month follow-up period, hemoptysis symptoms disappeared, and the patient recovered well with a KPS of 100 and a score of 0 for shortness of breath. Conclusions This case report indicates that PDT has significant local control and a good safety profile in lung carcinoid tumors.

Significance Nasopharyngeal carcinoma (NPC) is a challenging malignancy with limited treatment options. Photodynamic therapy (PDT) has emerged as a promising local treatment modality due to its targeted approach and minimal systemic toxicity. This study evaluates the safety of PDT in treating advanced NPC. Approach A case analysis was conducted on two nasopharyngeal carcinoma patients who underwent PDT treatment at Dongzhimen Hospital. The PDT procedure involved intravenous injection of hematoporphyrin, local anesthesia, percutaneous insertion of optical fibers, and irradiation with a 630nm laser for 300-900 seconds. Results After undergoing 3-4 sessions of PDT treatment, both patients commonly experienced adverse reactions including localized pain, redness, swelling, and infection, which were alleviated following symptomatic treatment. No severe complications such as active bleeding were observed. Conclusions PDT demonstrates favorable safety in treating nasopharyngeal carcinoma.

Significance As a palliative care tool, PDT is an effective way to improve symptoms in patients with advanced airway malignancies with few complications. Approach Clinical data of 126 patients diagnosed with primary tracheobronchial squamous cell carcinoma in Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2018 to December 2024 were retrospectively collected. Results After 1 month of photodynamic therapy, the degree of airway stenosis was improved (P<0.05). The patients' symptoms were greatly improved and their survival benefited. Conclusions Photodynamic is expected to be a promising palliative therapy for the treatment of airway malignancies, especially in middle and advanced patients, which is worthy of further clinical and basic research.

Take-home message:This Chinese expert consensus focuses on the hematoporphyrin derivative(HpD)photodynamic therapy(PDT)in cervical high-grade squamous intraepithelial lesion(HSIL).It aims to provide systematic guidance for gynaecolo-gists,oncologists,nursing professionals and PDT practitioners at all levels in the clinical application of HpD-PDT for the treatment of cervical HSIL.

Ethnopharmacological Relevance:Chronic obstructive pulmonary disease (COPD) is one of the crucial chronic diseases that seriously endangers the health of residents in China. There is a complex mechanism of the pathogenesis of COPD, and no specific drugs are currently available to reverse the progressive decline in lung function during the natural course of COPD. Traditional Chinese Medicine (TCM) not only alleviates clinical symptoms, but also leads to fewer adverse reactions. However, the mechanism of action of TCM in COPD treatment remains unclear. Aim:To summarize the mechanisms of action of Chinese herbal compounds and natural drugs in the treatment of COPD and identify potential signaling pathways and targets that can provide preclinical evidence for the treatment of COPD. Methods:Literature was retrieved from the scientific databases PubMed, Web of Science, and CNKI, Wanfang Data Knowledge Service Platform, and VIP Chinese Science and Technology Journal from July 2007 to December 2023. Results:This study introduced the specific pathways, targets and mechanisms of TCM in treating COPD from the perspectives of inhibiting inflammation, reducing oxidative stress, and regulating autophagy. Conclusion:This study provides a comprehensive summary of the theories of Chinese medicine in treating COPD, which utilize multiple targets and pathways to display the advantages of Chinese medicine. This lays the foundation for further exploration of pathways related to Chinese medicine for the treatment of COPD.

IntroductionMore than half of patients with tracheal carcinoma (TC) do not receive radical treatment, but the clinical characteristics, palliative treatment options, and prognosis of this group remain unclear.MethodsThis retrospective study analyzed 94 single primary TC patients (42 with tracheal squamous cell carcinoma [TSCC] and 52 with tracheal adenoid cystic carcinoma [TACC]) admitted to the Emergency General Hospital and Dongzhimen Hospital, Beijing University of Chinese Medicine. Kaplan-Meier survival curves, Log-rank tests, univariate and multivariate Cox and AFT models were used to assess overall survival (OS).ResultsAmong 89 patients without radical treatment, the median survival was 57 months, with 5-year and 10-year survival rates of 46.33% and 13.43%, respectively. Univariate analysis identified pathological type, smoking history, initial tumor extension (ITE), and targeted therapy as significant prognostic factors. The AFT model revealed that the median OS for TSCC patients was significantly shorter than for TACC patients, with a time ratio (TR) of 0.243 (95% CI: 0.153-0.386; P < 0.01), while targeted therapy was associated with a 1.790-fold increase in OS (TR: 1.790, 95% CI: 1.061-3.020; P = 0.029). Patients with extensive ITE had worse outcomes, with a TR of 0.628 (95% CI: 0.406-0.971; P = 0.037). Smokers had a TR of 0.601 (95% CI: 0.397-0.912; P = 0.017) compared with non-smokers. Subgroup analysis showed that smoking history was strongly associated with shorter OS in TSCC but not in TACC.ConclusionsPathological type, ITE, targeted therapy and smoking history are important factors for evaluating the prognosis of TC patients receiving palliative treatment.

ABSTRACT Background Tracheal adenoid cystic carcinoma (TACC) is a rare salivary gland malignant tumor. Previous studies mainly focused on surgery, radiation, and chemotherapy. The purpose of this study is to describe more clinical characteristics, treatments, and overall survival (OS) of TACC. Methods Retrospectively analyzed TACC patients from two medical institutions and the SEER database from January 2010 to December 2021. Survival curves were drawn using the Kaplan–Meier method, and the effects of prognosis were analyzed by multivariate COX regression and AFT. The endpoint of the study was overall survival (OS). Results One hundred fifty TACC patients were enrolled (DZM 11, EG 64, SEER 75), and the 5‐ and 10‐year survival rate was 70.62% and 35.80%, with a median survival time of 98 months. Lymph node status (yes) is an independent risk factor for TACC (HR = 3.020, 95% CI = 1.419–6.426, p = 0.004), and surgery is an independent protective factor (HR = 0.293, 95% CI = 0.146–0.587, p = 0.001). The AFT yielded similar results. In subgroup analysis of 63 non‐surgical patients, lymph node status (Yes) (HR = 3.511, 95% CI = 1.498–8.229, p = 0.004), and tumor longitudinal diameter range (TLDR) > 1 (HR = 2.975, 95% CI = 1.360–6.506, p = 0.006) are independent risk factors, while Targeted Therapy (HR = 0.248, 95% CI = 0.096–0.637, p = 0.004) is an independent protective factor. Conclusion Lymph node status and TLDR are prognostic factors of TACC. Surgery is associated with prolonged survival of TACC. Targeted therapy may be associated with improved survival among non‐surgical TACC patients. Trial Registration: ChiCTR2400083551

Background:With the rapid development of critical care medicine, tracheal intubation and tracheotomy are increasingly used. Meanwhile, the number of tracheal stenosis cases, as one of the complications, is gradually rising. Bronchoscopic interventional treatment is quite effective for tracheal stenosis. However, the differences in treatment effects between post-intubation tracheal stenosis (PITS) and post-tracheostomy tracheal stenosis (PTTS) remain unclear. Also, there is a lack of in-depth and systematic exploration on the distinctions between these two types of tracheal stenosis with different causes. Thus, this article will describe and compare PITS and PTTS in detail, explore their differences and differences in treatment effects, aiming to provide a basis and guidance with certain reference value for clinical medical practice. Methods:In this cross-sectional observational study, the data of PITS and PTTS patients undergoing bronchoscopic interventional therapy in the Department of Respiratory and Critical Care Medicine II, and Oncology Department of Emergency General Hospital and the Department of Respiratory Medicine in Dongzhimen Hospital of Beijing University of Chinese Medicine were retrospectively analyzed. Results:The PTTS group had a higher prevalence of neurological diseases and burns, with more common dynamic stenosis; the PITS group was more commonly associated with drug poisoning respiratory, digestive, and circulatory system diseases, with scar tissue being more prevalent (P<0.05). Stenosis length was significantly longer in the PTTS than in the PITS. In terms of treatment modalities balloon dilatation and scleroscopic laser were more frequently used in the PITS group than in the PTTS group (P<0.05). After treatment, both groups showed significant reductions in the degree of stenosis and modified Medical Research Council (mMRC) scores, with a significant increase in Karnofsky Performance Status (KPS) scores (P<0.05), and a significant improvement in the degree of endoscopic stenosis (P<0.05). The PTTS group had fewer average hospitalizations and longer intervals between the two hospitalizations (P<0.05). Conclusions:The clinical characteristics of the two patient groups are different. Bronchoscopic intervention showed significant efficacy on PITS and PTTS, with a more pronounced improvement in KPS scores in PTTS patients.

Tracheobronchial adenoid cystic carcinoma (TACC) is an uncommon gland-type tumor. While prior studies have addressed its clinical features and prognosis, evidence from larger cohorts remains scarce. TACC patients treated at Dongzhimen Hospital (DZM) and Emergency General Hospital (EG) between 2010 and 2023 were enrolled. Survival curves were plotted using the Kaplan–Meier method before and after propensity score matching (PSM). The key variables were screened by LASSO regression, and predictive and interaction analysis was done by multifactor Cox regression and accelerated failure time (AFT) models. Overall survival (OS) was the study endpoint. The median age of 169 TACC patients (EG 144, DZM 25) was 47.8 ± 13.2 years, 50.9

Trachea squamous cell carcinoma (TSCC) is a subtype of lung cancer. A thorough investigation of the tumor microenvironment of TSCC is crucial for the development of cancer therapeutics and predicting clinical responses. In this study, we utilized single-cell RNA sequencing to analyze seven TSCC samples (including five malignant and two non-malignant samples) and obtained 70,682 high-quality cells. Based on the expression levels of marker genes, we identified 7 major cell types within the samples. By comparing malignant samples that received chemotherapy with those that did not, we identified critical transcriptional regulators responsible for T cell state transition in response to chemotherapy. Additionally, we found specific transcriptional regulators and differentially expressed genes between malignant and non-malignant groups. We identified more particularly abundant specifical intercellular communication in the malignant sample group and that may significantly influence the progression and spread of cancerous cells. Overall, our study provides the first single-cell atlas that comprehensively explains TSCC development and chemotherapy effects, thereby laying a new molecular foundation for therapeutic research in TSCC.

Significance Photodynamic therapy (PDT) has gained attention in laryngeal cancer treatment due to its minimally invasive nature and precision, offering an alternative to surgery for early-stage patients and a novel adjunct for advanced cases. Approach Evaluate the clinical efficacy and safety of photodynamic therapy in the treatment of laryngeal squamous cell carcinoma. Results Five months after photodynamic therapy, the patient's symptoms had significantly improved without serious complications. Conclusions Photodynamic therapy effectively controls the growth of the mass and improves the survival quality of tumor patients to a certain extent, and it can also be used as a new adjuvant treatment for patients with tumor recurrence after surgical resection. Future studies should focus on improving the precision and effectiveness of treatment and exploring combined treatment strategies.

Objective To explore the efficacy of thermal ablation combined with percutaneous injection of amphotericin B in the treatment of chronic pulmonary aspergillosis.Case reports Case 1 was a 66-year-old female, whose computed tomography (CT) showed a space-occupying lesion in the upper lobe of the right lung. Case 2 was a 48-year-old female, and her CT scan revealed an eccentric cavity in the upper right lung accompanied by the formation of an aspergilloma. Case 3 was a 40-year-old male, and his CT indicated the formation of an aspergilloma within the cavity in the upper lobe of the left lung. All three patients had a history of pulmonary tuberculosis and were diagnosed with pulmonary aspergillosis in other hospitals. Due to the unsatisfactory effect of oral triazole drugs, they finally came to our hospital to receive the treatment of thermal ablation combined with percutaneous injection of amphotericin B. They recovered well after the operation without significant complications.Results During the follow-up period ranging from 1 month to 2 years after discharge, the patients reported no discomfort symptoms such as hemoptysis or chest pain. CT scans showed that the lesions were stable and even absorbed compared with those before treatment. The patients recovered well.Conclusion The combination of thermal ablation and percutaneous injection of amphotericin B in the treatment of chronic pulmonary aspergillosis can significantly improve the clinical symptoms of patients and enhance their quality of life. It may become a treatment method for chronic pulmonary aspergillosis.