Abstract Objective: To compare microbiome in the lower respiratory tract of patients with bronchiectasis in North and South China. Methods: Demographic and Sequencing data were collected from patients who underwent bronchoalveolar lavage fluid macro-genomic sequencing testing between September 2021 and September 2022 at Hainan Hospital of the General Hospital of the People's Liberation Army (Sanya, Hainan, South) and the Eighth Medical Center of the General Hospital of the People's Liberation Army (Haidian, Beijing, North). Sequencing data were analyzed, and patients were divided into subgroups according to their test results to compare microecological difference. Results: We enrolled 75 patients, 42 in the North and 33 in the South. The number of smokers in the Northern group was higher than that in the Southern group and the FEV1/FVC(%) value was lower than that in the Southern group; otherwise, the groups had no significant differences. The most abundance bacteria in the lower respiratory tract of the Northern group were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Nocardia wilsonii, while the Southern group had H. influenzae, P. aeruginosa, and Nocardia Gelsenkirchen. There were differences in the abundance of lower respiratory tract microbiome between patients with bronchiectasis in the Northern and Southern regions, depending on the severity of bronchiectasis. Conclusion: The lower respiratory tract microbiome of our patients with stable bronchiectasis differed significantly between the North and South. The bacterial flora of the Southern group was closer to that reported in the international literature, while the core taxa of the Northern group was significantly different. P. aeruginosa and Klebsiella pneumoniae were most abundant in the Northern group, while H. influenzae and P. aeruginosa were most abundant in the Southern group, These findings can guide antibiotic treatment of exacerbations.

Abstract Objective: To compare microbiome in the lower respiratory tract of patients with stable bronchiectasis in North and South China. Methods: Demographic and Sequencing data were collected from patients who underwent bronchoalveolar lavage fluid macro-genomic sequencing testing between September 2021 to September 2022 at Hainan Hospital of the General Hospital of the People's Liberation Army (Sanya, Hainan, South) and the Eighth Medical Center of the General Hospital of the People's Liberation Army (Haidian, Beijing, North). The patients were grouped according to the clinical test results, and the sequencing data were analyzed twice to compare the microbiome differences among different groups. Results We enrolled 75 patients, 42 in the North and 33 in the South. The number of smokers in the Northern group was higher than that in the Southern group and the FEV1/FVC (%) value was lower than that in the Southern group; otherwise, the groups had no significant differences. The most abundance bacteria in the lower respiratory tract of the Northern group were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Nocardia wilsonii, while the Southern group were H. influenzae, P. aeruginosa, and Prevotella intermedia. According to the severity of the patients with bronchiectasis (BSI), there was also a difference in the abundance of microbiome in the lower respiratory tract in patients with stable bronchiectasis from the North and South. Conclusion The lower respiratory tract microbiome of patients with stable bronchiectasis differed significantly between the North and South in China. The microbiome of the Southern group was more similar to that reported in the international literature, while the Northern group was significantly different from the results of other studies. P. aeruginosa and Klebsiella pneumoniae were most abundant in the Northern group, while H. influenzae and P. aeruginosa were most abundant in the Southern group, These findings can guide antibiotic treatment of exacerbations.

Objective To investigate the difference in clinical indexes between SARS and SARS-CoV-2 and explore immune mechanisms. Methods We recorded age, sex, clinical symptoms, immunoglobulin index, arterial blood gas analysis, and other indicators of SARS patients hospitalized at the Eighth Medical Center of the People’s Liberation Army. From June 2022 to April 2023, we recorded data from patients with SARS-CoV-2 hospitalized at the Tropical Medicine Department of Hainan Hospital of the PLA General Hospital. Results There were 116 patients with SARS pneumonia and 114 with SARS-CoV-2 pneumonia. The ratio of males to females was 64/52, with an average age of 35.36 ± 15.19 years. The ratio of males to females in the SARS-CoV-2 group was 69/45, with an average age of 66.89 ± 15.00 years. There were no significant differences in PCO2, peripheral blood white blood cell count, platelet count, neutrophil ratio, serotonin ratio, blood pressure, serum creatinine, urea nitrogen, C-reactive protein, immunoglobulin IgA, and IgG indexes in blood gas analysis. There were significant differences in heart rate, blood gas analysis partial pressure, lymphocyte percentage, immunoglobulin IgM, and myocardial injury markers. Conclusions Young and middle-aged patients with SARS pneumonia were more common, while elderly patients with SARS-CoV-2 were more common. There were differences in clinical indicators between patients infected with the two viruses, and there may be differences in virulence and interaction mechanisms.

Objective:To analyze the clinical characteristics of hospitalized patients with bronchiectasis in Hainan Province, and to summarize the disease characteristics.Methods:This was a cross-sectional study involving 207 hospitalized bronchiectasis patients in the Hainan Hospital of Chinese PLA General Hospital from May 2012 to January 2022.Their final diagnosis recorded in the inpatient medical record information management system were bronchiectasis, bronchial dilation, bronchiectasis with infection, or bronchiectasis with hemoptysis.Chest high-resolution CT image data were available.Baseline characteristics, imaging manifestations, pulmonary function and sputum microbial culture data of the enrolled patients were collected.Clinical symptoms, signs, pulmonary function and sputum microbial detection rate of bronchiectasis patients with varying morphological manifestations (columnar, cystic columnar, cystic) were compared.The detection rate of sputum microorganisms in bronchiectasis patients with different distribution ranges (single lobe involvement and multiple lobes involvement) were compared.Lung function differences between bronchiectasis patients with or without specific bacteria were compared.The results of drug sensitivity test of Pseudomonas aeruginosa were analyzed.Results:A total of 207 cases were recruited, including 110 males (53.14%) and 97 females (46.86%).The mean age was (64.37±13.91) years.The elderly aged 65 years and above accounted for 55.07% (114/207).The mean age of onset was 50.73±19.39 years.History of tuberculosis, chronic obstructive pulmonary disease, bronchial asthma, interstitial pneumonia and immunosuppression due to long-term glucocorticoid treatment of tumors, leukemia, nephrotic syndrome and other causes was detected in 23.19% (48/207), 21.74% (45/207), 5.80% (12/207), 3.38% (7/207) and 9.66% (20/207) of cases, respectively.The cause of the disease could not be determined in most of patients, and only 15.46% (32/207) had identified causes; 59.38% (19/32) of bronchiectasis patients were caused by pulmonary tuberculosis.The main symptoms were cough (89.37%), expectoration (82.61%), shortness of breath (43.96%) and hemoptysis (30.43%).Cylindrical (47.34%, 98/207), mixed (16.43%, 34/207) and saccular lesions (36.23%, 75/207) were found in imaging examinations; 30.43% (63/207), 69.57% (144/207) and 18.84% (41/207) of patients had the involvement of a single lobe, multiple lobes and all lobes, respectively.Among the involved lung lobes, the right lower lobe accounted for 57.49% (119/207).Seventy-three patients underwent pulmonary function examination during hospitalization, of which 67.12% (49/73), 54.79% (40/73) and 39.73% (29/73) had obstructive ventilatory disorder, restrictive ventilatory disorder, and mixed ventilatory disorder, respectively.According to the imaging classification, there was significant difference in the percentage of forced expiratory volume in the first second to the predicted value (FEV 1%pred) of bronchiectasis patients with cylindrical, saccular and mixed lesions ( F=4.41, P=0.016), while no significant differences were found in the percentage of forced vital capacity in the predicted value (FVC% pred) and the percentage of forced expiratory volume in the first second to the predicted value (FEV 1/FVC)(both P>0.05).A total of 184 sputum samples were collected for microbial culture during hospitalization, and the positive rate was 57.07% (105/184).101 cases (54.89%) were positive for bacteria and 22 cases (11.96%) were positive for fungi.A total of 147 strains of 26 kinds of bacteria were cultured, including 136 strains of 19 Gram-negative bacteria and 11 strains of 7 Gram-positive bacteria.Two or more kinds of bacteria were detected in 34 (18.48%) cases.The bacteria with a high composition included the Pseudomonas aeruginosa 38.10% (56/147), Klebsiella pneumoniae 14.29% (21/147), and Acinetobacter baumannii 11.56% (17/147).The detection rate of Pseudomonas aeruginosa in bronchiectasis patients with the involvement of multiple lobes was significantly higher than that in those with single lobe involvement (39.53% [51/129] vs 9.09% [5/55], χ2=19.12, P<0.001).The pulmonary function indexes of bronchiectasis patients with Pseudomonas aeruginosa infection were significantly lower than those without Pseudomonas aeruginosa infection ( P<0.05). Conclusions:Bronchiectasis is common in the elderly in Hainan Province, and the etiology is unclear.The proportion of patients with previous tuberculosis infection is high.The clinical symptoms are various, and most of the pulmonary functions have obstructive ventilatory disorder.The imaging features mainly include cylindrical bronchiectasis and the involvement of multiple lobes.The detection rate of Gram-negative bacteria in sputum samples is high, and the detection of Pseudomonas aeruginosa is associated with lung dysfunction.

The incidence and prevalence of bronchiectasis have increased significantly in recent years.However, the pathogenesis and aggravation mechanism of bronchiectasis has not been fully elucidated.Some studies show that the composition and abundance change of pulmonary microbiome is one of the most important reasons for the aggravation of bronchiectasis.Therefore, it has attracted wide attention.There are many kinds of microbial colonization in the lung of patients with bronchiectasis.The core bacterial colonization varies from patients to patients.The colonization of core bacteria represented by Pseudomonas aeruginosa is an independent risk factor for the decline of lung function and increase of exacerbation frequency in patients with bronchiectasis.This article reviews the changes of pulmonary microbiome in stable and aggravated bronchiectasis, so as to provide guidance to the treatment of bronchiectasis.

阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)和慢性阻塞性肺疾病(chronic obstructive pul-monary disease,COPD)都是较常见的慢性呼吸系统疾病.OSA是与睡眠相关的特定呼吸障碍,其特征是睡眠期由于间歇性上气道部分或完全塌陷,反复出现呼吸停止并伴有间歇性低氧血症.COPD是一种可预防和可治疗的系统性疾病,其特征是持续的呼吸道症状和气流受限,由于气道阻塞、肺过度膨胀和呼吸肌损伤引起通气减少,进而出现低氧血症和高碳酸血症.这两种疾病的共存被称为重叠综合征(overlap syndrome,OVS),由Flenely于1985 年命名[1-3].