Despite conventional glucocorticoid and antifungal therapy, acute exacerbation and hospitalization occur frequently in patients with allergic bronchopulmonary aspergillosis (ABPA). Whether omalizumab is an effective and safe treatment for adult patients with ABPA complicating asthma. Patients with ABPA complicating asthma who were treated with omalizumab from October 2019 to May 2023 were collected from five tertiary hospitals and evaluated. The frequencies of acute exacerbation and hospitalization; the number of eosinophils; the total IgE levels; and the average monthly medical dosages after 3, 6, and 12 months of omalizumab treatment were analysed, and the data before and after treatment (up to one year) were compared. The efficacy and safety of omalizumab treatment were assessed. In total, 26 patients were enrolled. The average monthly glucocorticoid dosage significantly decreased (median 0 vs . 24 mg/m) after 6 months of omalizumab treatment compared with 3 months; 73.68% of patients discontinued glucocorticoids after ≤ 12 months of treatment. Similarly, the average monthly dosage of antifungal agents was significantly decreased (median 0 vs . 3.49 g/m) after 12 months of treatment compared with 3 months. The average monthly glucocorticoid dosage (median 213.75 vs . 65.42 mg/m, P = 0.002) and the frequency of acute exacerbation (median 0.94 vs . 0.44 events, P = 0.033) were considerably reduced after omalizumab treatment. Omalizumab is effective in reducing the frequency of acute exacerbation and the necessary dosage of glucocorticoids in adult patients with ABPA complicating asthma. Patient age and BMI may affect the efficacy of treatment.

回顾性分析2019 年11 月14 日我科收住的l例IgG4相关性肺疾病合并甲状腺受累患者的临床资料、诊治及随访经过,并检索国内外文献,总结归纳.提高临床医师对IgG4 相关性肺疾病合并甲状腺受累的认识水平.

Objective: This study was conducted to prospectively analyze the clinical features of hospitalized patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD), sputum culture and drug susceptibility results, and the use and efficacy of antimicrobial to guide the pathogens of AECOPD hospitalized patients.Learning judgment and choice of antimicrobial drugs. Materials and Methods:A total of 327 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Jingzhou Central Hospital from January 1, 2018 to December 31, 2018 were enrolled.Among them, 46 patients were positive for sputum microbial culture, and 48 positive sputum culture results were obtained.The demographic characteristics (age, gender, BMI index), smoking history, acute exacerbation/year, mMRC score were statistically analyzed.CAT score, lung function index, presence or absence of respiratory failure, sputum culture type and drug sensitivity, antibacterial drug selection.All data were tabulated and divided into 2 groups according to the presence or absence of respiratory failure.The clinical data and etiology differences of the 2 groups were counted.According to the sputum culture, G-negative bacilli or fungi were divided into two groups, and the clinical data of the two groups were counted.The measurement data were mean±standard error, and the percentage was used.The statistical analysis was performed by Fisher's exact test.The measurement data were analyzed by independent sample t test.The count data were analyzed by chi-square test.The P value was less than 0.05, which was statistically significant.Results: A total of 327 cases were involved in the study, of which 48 were positive for sputum culture (46 patients).In the positive patients, 41 males (89.10%) and 5 females (10.4%) showed that males had higher prevalence than females.The most common age group is mostly 70-79 years old, with an average age of 73.08 years.During the follow-up, 8 people died in first year (58-83 years old, average 70.1 years old), and the mortality rate was 17.39%.Among the 46 patients, the available data were analyzed, BMI: 22.68 ± 0.67 (N = 28), AE / year: 1.82 ± 0.12 (N = 46), age (years): 73.52 ± 1.22 (N = 46), mMRC: 2.82±0.20 (N=28), CAT: 23.55±1.43(N=27), FEV1:1.05±0.08 (N=28), FEV1%: 45.21%±3.29%(N=28), FVC: 2.25±0.11(N=28), FVC%: 75.07%± 3.4% (N=28).The most common microorganism in sputum culture was Candida albicans (50%), a total of 24 cases.There were 14 cases (30%) of bacterial infections and 34 cases (70%) of fungal infections.The most commonly used antibiotics for AECOPD patients are fluoroquinolones, followed by ceftazidime, followed by carbomycins, and antifungal drugs are most commonly fluconazole, followed by voriconazole.There was a statistically significant difference in the composition ratio between bacteria

Background This study was performed to investigate clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases at the start of the pandemic in China. Methods In this retrospective, multicenter cohort study, patients with mild to moderate SARS-CoV-2 pneumonia were included. Demographic data, symptoms, laboratory values, and clinical outcomes were collected. Data were compared between non-severe and severe patients. Results 58 patients were included in the final analysis. Compared with non-severe cases, severe patients with SARS-CoV-2 pneumonia had a longer: time to clinical recovery (12·9 ± 4·4 vs 8·3 ± 4·7; P = 0·0011), duration of viral shedding (15·7 ± 6·7 vs 11·8 ± 5·0; P = 0·0183), and hospital stay (20·7 ± 1·2 vs 14·4 ± 4·3; P = 0·0211). Multivariate logistic regression indicated that lymphocyte count was significantly associated with the rate of converting to severe cases (odds ratio 1·28, 95%CI 1·06–1·54, per 0·1 × 10 9 /L reduced; P = 0·007), while using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0·14, 95%CI 0·02–0·80; P = 0·0275). Conclusions The low peripheral blood lymphocyte count was an independent risk factor for SARS-CoV-2 pneumonia patients converting to severe cases. However, this study was carried out right after the start of the pandemic with small sample size. Further prospective studies are warranted to confirm these findings. Trial registration Chinese Clinical Trial Registry, ChiCTR2000029839 . Registered 15 February 2020 - Retrospectively registered.

Although the introduction of immune- and targeted-therapy has improved the clinical response and outcomes, lung cancer remains a therapeutic challenge. Developing new therapeutics is necessary to improve the treatment of lung cancer. Here, we show that ribavirin, a clinically available anti-viral drug, is an attractive candidate for lung cancer treatment. We show that ribavirin is active against a panel of lung cancer cell lines regardless of molecular and cellular heterogeneity. Notably, the effective concentrations of ribavirin are clinically achievable, display minimal toxicity to normal cells and synergistic effect with paclitaxel. Its potent efficacy and synergism with chemotherapy on cancer cell, and minimal toxicity on normal cells are observed in lung xenograft mouse model. Ribavirin is also an angiogenesis inhibitor as it inhibits capillary network formation, growth and survival of human lung tumor-associated endothelial cell (HLT-EC). The mechanism studies demonstrate that ribavirin acts on lung cancer cells via suppressing eIF4E and mTOR signaling, leading to the subsequent inhibition of eIF4E-mediated protein translation. Our work suggests that ribavirin has advantage than many anti-cancer agents by targeting both tumor cells and angiogenesis. Our work also highlights the therapeutic potential of ribavirin for the treatment of lung cancer.

BACKGROUND:Expression of murine calcium-activated chloride channel family member 3 (mCLCA3) has been reported to be increased in the airway epithelium of asthmatic mice challenged with ovalbumin (OVA). However, its role in asthmatic airway inflammation under no OVA exposure has not yet been clarified.METHODS:mCLCA3 plasmids were transfected into the airways of normal BALB/c mice. mCLCA3 expression and airway inflammation in mouse lung tissue were evaluated. Cell differentials and cytokines in bronchoalveolar lavage fluid (BALF) were analyzed. The expression of mCLCA3 protein and mucus protein mucin-5 subtype AC (MUC5AC) were analyzed by Western blotting. The mRNA levels of mCLCA3, MUC5AC and interleukin-13 (IL-13) were determined quantitatively.RESULTS:mCLCA3 expression was not detected in the control group while strong immunoreactivity was detected in the OVA and mCLCA3 plasmid groups, and was strictly localized to the airway epithelium. The numbers of inflammatory cells in lung tissue and BALF were increased in both mCLCA3 plasmid and OVA groups. The protein and mRNA levels of mCLCA3 and MUC5AC in the lung tissue were significantly increased in the mCLCA3 plasmid and OVA groups compared to the control group. The level of IL-13, but not IL-4, IL-5, IFN-γ, CCL2, CCL5 or CCL11, was significantly increased compared with control group in BALF in the mCLCA3 plasmid and OVA groups. The level of IL-13 in the BALF in the mCLCA3 plasmid group was much higher than that in the OVA group (P < 0.05). The level of mCLCA3 mRNA in lung tissue was positively correlated with the levels of MUC5AC mRNA in lung tissue, IL-13 mRNA in lung tissue, the number of eosinophils in BALF, and the content of IL-13 protein in BALF. The level of IL-13 mRNA in lung tissue was positively correlated with the number of eosinophils in BALF and the level of MUC5AC mRNA in lung tissue.CONCLUSION:These findings suggest that increased expression of a single-gene, mCLCA3, could simulate an asthma attack, and its mechanism may involve mCLCA3 overexpression up-regulating IL-13 expression.