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The Tibet Plateau is a key region to understand the evolution of the Tethys Oceans. The finding of Permian–Triassic eclogites and Carboniferous–Triassic ophiolites indicated the existence of a Paleo–Tethys Ocean in the Lhasa terrane, although the mechanism of subduction and exhumation mechanism of the high–pressure rocks remains equivocal. Here we focus on deformation, metamorphism, and geochronology of key rocks in the Sumdo area with a view to constrain the tectonic evolution of the Tethys Ocean and the geodynamic mechanism of eclogite exhumation. Structural analysis indicates two main stages of deformation (D1 and D2) in the study area. The D1 deformation (264–235 Ma) is dominated by penetrative Sn+1 foliation and solid rheological folds, resulted from the first type eclogites (~260 Ma), with exhumation at ~240 Ma along the subduction channel. The D2 deformation (213–180 Ma) is characterized by the tight and isoclinal overturned folds and thrust faults, related with the collisional exhumation (~200 Ma) of the second type eclogite (~230 Ma). Spreading of the Bangong–Nujiang and Indus–Yarlung Zangbo Tethys Oceans triggered the closure of Sumdo Tethys Ocean, as well as their initial subduction.

Bronchial asthma is a common chronic airway disease, and long-term management of asthma is the focus and difficulty of clinical treatment. Glucocorticoids are often used as the first choice for the treatment of asthma. However, the occurrence of hormone dependence, hormone resistance, local and systemic adverse reactions caused by hormone application also brings problems for the treatment of asthma. Finding safe and effective new therapeutic drugs is an important research direction at present. Icariin is the effective ingredient of traditional Chinese medicine Epimedium. It has various biological activities such as anti-inflammatory, anti-oxidative stress, and immune regulation. It has high safety and has a wide range of clinical applications. Icariin has the characteristics of multi-target intervention in the treatment of asthma. This article reviews recent studies in order to provide new research directions for further therapeutic drug development.

In this retrospective study we assessed the efficacy and safety of tocilizumab in patients with critical or severe coronavirus disease 2019 (COVID-19). We enrolled 181 patients admitted to Huoshenshan Hospital (Wuhan, China) with confirmed COVID-19 between January 2020 and February 2020. Ninety-two patients were treated with tocilizumab, and 89 patients were treated conventionally. We analyzed the clinical manifestations, changes in CT scan images, and laboratory tests before and after tocilizumab treatment, and compared these results with the conventionally treated group. A significant reduction in the level of C-reactive protein was observed 1 week after tocilizumab administration. In some cases this meant the end of the IL-6-related cytokine storm. In addition, tocilizumab relieved fever, cough, and shortness of breath with no reported adverse drug reactions. These findings suggest tocilizumab improves clinical outcomes and is effective for treatment of patients with critical or severe COVID-19. However, future clinical trials are needed to better understand the impact of tocilizumab interference with IL-6 and provide a therapeutic strategy for treatment of COVID-19.

The palaeogeographic locations of ancient continental blocks in the Tibetan Plateau, especially of micro-continental blocks during the Neoproterozoic supercontinent cycle, remain enigmatic. To clar...

Late Cretaceous igneous rocks in the southern Lhasa subterrane, Tibet, include primitive high-Mg andesites and adakites, which provide important constraints on the tectonic evolution of the Neo-Tethys Ocean. Here, we present detailed zircon U Pb and Hf isotopic and whole-rock geochemical data for granodioritic and dioritic porphyry samples from the Songdo area in the southern Lhasa subterrane. Zircon U Pb dating indicates that the granodiorite crystallized at 88 Ma, whereas the diorite yields ages of 68 and 66 Ma. The granodiorite has adakite-like geochemical characteristics, including high Sr (801–1005 ppm) and low Y (6.8–15.2 ppm) and Yb (0.6–1.3 ppm) concentrations, and high Sr/Y (62–145) and La/Yb (39–93) ratios. We infer that the adakitic granodiorites formed through partial melting of subducted oceanic crust. The dioritic porphyry has intermediate moderate SiO2 (53–58 wt%) and high MgO (5.6–8.2 wt%) contents, and high Mg# (66.4–69.5) values, and is therefore classified as a primitive high-Mg andesite that was derived from interaction between subducted sediment and mantle. The presence of coeval adakite and charnockite, as well as high-temperature granulite-facies metamorphism, indicates that mid-ocean ridge subduction occurred at 100–80 Ma, followed by a 10 Myr hiatus in magmatism and subsequent rollback of the Neo-Tethys slab at 68 Ma. These processes resulted in significant crustal growth within the Lhasa terrane.

Previous studies of the Southern Qiangtang (SQ) Terrane in Tibet have shown significant growth of continental crust during the late Mesozoic (ca. 170–120 Ma) through underplating of mantle-derived ...

This paper reports newly discovered mafic rocks, including cumulate gabbros, meta-gabbro, and meta-basalt, from the Sumdo area of the southern Lhasa terrane. Fifteen samples of cumulate gabbros, meta-gabbro, and meta-basalt collected near Wenmulang in the Sumdo area have similar geochemical characteristics, including relatively low SiO2 and MgO contents and high TiO2, P2O5, and total alkali contents. The samples are strongly enriched in light rare-earth elements (LREE), particularly in Nb (vs. Th) and Ta (vs. U), and are depleted in heavy rare-earth elements (HREE). Zircon U Pb ages obtained from cumulate gabbros and meta-gabbro are 260.6 ± 3.1 Ma and 268.5 ± 1.9 Ma, respectively. The eHf(t) values of the meta-gabbro vary between −1.9 and + 1.6. We conclude that a combination of metasomatism and variable degrees of partial melting of a mantle plume explain the geochemical characteristics and origin of the Wenmulang oceanic island basalt (OIB)-type mafic rocks. There was no incorporation of continental crust or subcontinental lithospheric mantle (SCLM) during their formation. The geochemical characteristics of the Wenmulang OIB-type mafic rocks are similar to those of Hawaiian alkali basalt, suggesting that they formed in an oceanic island environment, most likely at the base of an oceanic island. We suggest that the Paleo-Tethys Ocean in the Sumdo area was a mature ocean basin during the Middle Permian. An upwelling mantle plume caused volcanism in the ocean basin and led to the formation of the Wenmulang OIB-type mafic rocks.

The COVID-19 epidemic has caused increasing public panic and mental health stress. In this study, we explore the prevalence and factors linked to anxiety and depression in hospitalized patients with COVID-19. A total of 144 patients diagnosed with COVID-19 underwent depression and anxiety assessment by using the Hospital Anxiety and Depression Scale (HADS). Social support level was also evaluated by the Perceived Social Support Scale (PSSS) at admission. Results showed that gender, age, oxygen saturation, and social support were associated with anxiety for COVID-19 patients. In addition, age, family infection with SARS-CoV-2, and social support were the risk factors associated with depression. Moreover, we designed a psychological–behavioral intervention (PBI) program that included psychological support and breathing exercises, and explored its effects on patients with COVID-19. Of the 144 participants, 26 patients with both anxiety and depression symptoms (cutoff score of ≥8 on HADS-A and HADS-D) were randomly assigned to the intervention group and the control group at a 1:1 ratio. After 10-day treatment, the HADS scores of depression and anxiety were significantly reduced in the intervention group, and PSSS scores were also significantly improved. However, no significant differences in HADS and PSSS scores between pre- and post-treatment were found in the control group. Our findings indicate that mental concern and appropriate intervention are essential parts of clinical care for COVID-19 patients.

BACKGROUND: Since December 2019, many cases of pneumonia caused by novel coronavirus have been discovered in Wuhan, China, and such cases have spread nationwide quickly. At present, coronavirus disease 2019 (COVID-19) is a worldwide pandemic. What are the clinical features of this disease? What is the clinical diagnosis and how should such patients be treated? As a clinician, mastery of the clinical characteristics, basic diagnosis, and treatment methods of COVID-19 are required to provide help to patients. CASE SUMMARY: A 42-year-old male patient with a cough lasting 6 d without obvious cause, as well as fever and fatigue for 1 d, was admitted to Hankou Hospital on January 22, 2020 and transferred to Huoshenshan Hospital on February 4. The main clinical symptoms were dry cough, fatigue, and fever. He was diagnosed with COVID-19. From the 4(th) d of admission, the patient’s condition gradually worsened, with increased respiratory rate and body temperature. Peripheral blood lymphocytes decreased progressively. On the 8(th) d of admission, the patient’s highest temperature was 40.7 °C, and oxygen saturation was 83% despite high-flow oxygen inhalation. Chest computed tomography results showed that the virus progressed rapidly. The number of lesions significantly increased with expanded scope and increased density. The distribution of lesions advanced from peripheral to central. In addition to nasal catheter oxygen inhalation and symptomatic support, antiviral drugs were used throughout the treatment. On January 22, oseltamivir phosphate capsules were given orally (75 mg, twice daily) for 6 d. On January 24, three tablets of lopinavir and ritonavir were added orally (twice daily). After 6 d, this was changed to 0.2 g (two tablets) arbidol, taken orally (three times daily) for 5 d. During the severe stage, methylprednisolone was given (40 mg) once every 12 h, immunoglobulin (20 g) was administered by intravenous drip infusion once daily, and thymosin (1.6 mg) was injected subcutaneously once daily combined with immunotherapy. On February 2, symptoms decreased, various indicators improved, and pulmonary inflammation was obviously reduced. Throat swabs on February 4 and 9 were negative for novel coronavirus nucleic acid. After 19 d in the hospital, the patient was successfully treated and discharged. CONCLUSION: COVID-19 in young adults can be successfully treated with active treatment. We report a typical case of COVID-19, analyze its clinical characteristics, summarize its clinical diagnosis and treatment experience, and provide a reference for clinical colleagues.

The Gangdese magmatic belt is oriented E–W and located between the Indus–Yarlung Tsangpo and Bangong–Nujiang suture zones in Tibet. It records the subduction of the Neo-Tethyan oceanic crust, Indian–Eurasian collision, and uplift of the Tibetan Plateau. Here we present new zircon U–Pb geochronology, Hf isotopic compositions, and whole-rock geochemistry of the granodiorites in the Sumdo area of the Gangdese Belt. Our aim was to identify the petrogenesis of granitoid rcoks and to clarify the early-stage evolution of the Neo-Tethyan Ocean during the Late Triassic to Early Jurassic. The granodiorites yield zircon U–Pb ages of 193–201 Ma, indicating an Early Jurassic magmatic event. They are metaluminous, with medium- to high-K calc-alkaline geochemistry, and show characteristics of I-type granitoids. They show enrichment in light rare earth elements (LREEs) and depletion in high-field-strength elements (HFSEs) in primitive-mantle-normalized spider diagrams, indicating that their initial magma was generated in a subduction-related active continental margin. They have negative eHf(t) values (−11.3 to −4.1) and crustal model ages (TC DM) of 1.50–1.95 Ga. Hf isotopes and whole-rock geochemistry indicate that the granodiorites were derived from partial melting of ancient lower-crust material mixed with mantle material. Our data, in combination with published geochronological and geochemical data, show that the Late Triassic–Early Jurassic arc magmatism in the Gangdese magmatic belt was formed by the northward subduction of the Neo-Tethyan oceanic crust beneath the Lhasa Terrane.

The results of zircon U–Pb age dating and whole-rock geochemistry for the Late Cretaceous Nize granodiorite porphyries, combined with analysis of near-coeval structural deformation of the L...

We report new zircon U–Pb age, Hf isotopic, and major and trace element data for rhyolites from the Duolong Ore Concentration Area of the Southern Qiangtang Terrane. Building on previous studies, w...

The newly discovered Banduo Pb–Zn deposit in the Somdo area of Tibet is hosted by a Late Triassic granodiorite. A combination of zircon U–Pb dating, Hf isotopic compositions, sulfide Rb–Sr dating, and whole-rock geochemistry was used to determine the age of the mineralization and characterize the metallogenesis of the deposit. The weighted-mean U–Pb ages of zircon from the granodiorite (203.8 ± 1.7 Ma, MSWD = 0.53; 206.1 ± 0.4 Ma, MSWD = 0.098) and the weighted-mean Rb–Sr isochron age of sulfides from the Pb–Zn mineralization (202.7 ± 2.3 Ma; MSWD = 1.3) suggest that the timing of mineralization was close to that of granodiorite crystallization during the Late Triassic. The average (87Sr/86Sr)i value of 0.71026 implies that the ore-forming metals were sourced from a mixture of mantle and crustal material. The weakly altered granodiorite of the deposit is characterized by SiO2 = 66.78–67.85 wt%, K2O = 2.57–3.37 wt%, Al2O3 = 13.53–15.15 wt%, and Mg# = 45.5–51.3. It is enriched in LREEs and LILEs and depleted in HREEs and HFSEs, and it exhibits a negative Eu anomaly. The granodiorite has positive and negative eHf(t) values (−2.5 to 1.7) and crustal model ages (TC DM) of 1.14–1.40 Ga. Hf isotopic analyses and whole-rock geochemistry indicate that the Late Triassic granodiorite was likely sourced from of a mixture of mantle and ancient lower-crust material that had undergone variable degrees of fractional crystallization. Based on regional data, the Banduo deposit is the oldest Pb–Zn deposit in the Gangdese belt and likely formed as a result of the northward subduction of the Neo-Tethys Ocean. The metallogenic epoch indicates that deposits related to the northward subduction of the Neo-Tethys oceanic crust exist in this area. The Late Triassic age of granitoid-hosted mineralization provides additional prospects for exploration in the Gangdese Metallogenic Belt.

A large-scale free-flow electrophoresis (LS-FFE) is often too large for cell separation of lab scale, whereas micro-FFE (μFFE) has great difficulty in cell isolation due to easy blockage by cell accumulation in μFFE. In this study, a mid-scale FFE (MS-FFE) is developed for cell and protein separations. The volume of the separation chamber (70×40×0.1-0.8 mm) is from 280 μL to 2.24 mL, much lower than that in an LS-FFE but higher than that in a μFFE. Gravity is used for uniform flow of the background buffer only via a single pump with 16 channels and the sample is injected via an adjuster originally used for clinical intravenous injection. The experiments reveal that the hydrodynamic and electrohydrodynamic flows are much stable, and the Joule heat can be effectively dispersed without obvious positive or negative deviation as shown by the omega plots. By the device, Escherichia coli and Staphylococcus aureus, which easily accumulate to block μFFE and are separated with difficulty due to their same negative charges carried, can be well isolated under the conditions of 4.5 mM pH 8.5 Tris-boric buffer (4.5 mM Tris, 4.5 mM boric acid) with 0.10 mM ethylene diamine tetraacetic acid and 5% m/v sucrose, 200 μL/min, 800 V, and sample injection via inlet 4. The mid-scale FFE device could also be used for the separation of three model proteins of horse heart cytochrome c, myoglobin and bovine serum albumin. The device has clear significance for mid-scale separation of cells and proteins.

This paper describes a novel free-flow electrophoresis (FFE), which is joined with gratis gravity, gas cushion injector (GCI) and self-balance collector instead of multiple channel pump, for the purpose of preparative purification. The FFE was evaluated by systemic experiments. The results manifest that (i) even though one-channel peristaltic pump is used for the driving of background buffer, there is still stable flow in the FFE chamber; (ii) the stable flow is induced by the gravity-induced pressure due to the difference of buffer surfaces in the GCI and self-balance collector; (iii) the pulse flow of background buffer induced by the peristaltic pump is greatly reduced by the GCI with good compressibility of included air; (iv) the FFE can be well used for zone electrophoretic separation of amino acids; (v) up to 20 inlets simultaneous sample injection and up to five to tenfold condensation of amino acid can be achieved by combining the FFE device with the method of moving reaction boundary. To the best of authors' knowledge, FFE has not been used for such separation and condensation of amino acids. The relevant results achieved in the paper have evident significance for the development of preparative FFE.

Although massive bleeding is the most life-threatening complication caused by flexible bronchoscopy, data on flexible bronchoscopy-induced massive bleeding are scarce, and the associated clinical characteristics and prognostic factors are unknown.This was a multicentre retrospective cohort study of all patients who underwent flexible bronchoscopy in 33 tertiary hospitals from January 2001 to June 2013. The clinical characteristics and outcomes were collected and analysed.A total of 194 patients with massive bleeding were identified among 520 343 patients who underwent flexible bronchoscopy. The average blood loss reached up to 378 mL. The overall incidence and mortality were 0.037% and 0.004%, respectively, and the overall fatality was 10.8%. The risk of massive bleeding induced by therapeutic bronchoscopies was significantly higher than that induced by diagnostic bronchoscopies (incidence: 0.059% vs 0.031%, P 0.001; mortality: 0.012% vs 0.003%, P 0.001; fatality: 20% vs 8.4%, P = 0.068). Multivariate analysis showed that age ≥65 years, tracheal bleeding, blood loss ≥500 mL and occurrence of shock were independent factors predicting poor outcome, while emergency surgery was an independent protective factor. Re-bleeding occurred in six patients, resulting in three deaths within a month.Flexible bronchoscopy-induced massive bleeding is rare but life-threatening. Age, bleeding location, bleeding volume, circulation condition and emergency surgery were independent prognostic factors.

The usual transbronchial coagulation techniques include microwave, argon plasma coagulation (APC), electrocautery and cryotherapy. However, there are serious clinical problems in the safety of each. By analyzing the experimental data and clinical observations, we observed the variable effects of different coagulation techniques via bronchofibroscopy, to look for an optimal interventional management of luminal bronchus diseases, and evaluate the safety and the equivalent point.Four kinds of coagulation techniques under bronchoscopy were performed on the fresh bronchus of healthy sheep, and the pathologic changes in all groups were observed under the microscope. The different treatment parameters were as follows: microwave 60 W×1 second, 3 seconds, 5 seconds and 40 W×1 second, 3 seconds, 5 seconds; APC 40 W×1 second, 3 seconds, 5 seconds; electrocautery 40 W×1 second, 3 seconds, 5 seconds; cryotherapy 100 Ω×60 seconds, 120 seconds.After treatment, ovine bronchial mucosa in all groups showed pathologic changes such as local necrosis and amotio of the mucosa lining epithelium, local submucosa coagulative necrosis or tissue defects, while inflammation in the surrounding tissue was not obvious. Under the same output power and action time, different methods had different outcomes. The damage by APC was the most superficial, microwave was the second, and electrocautery caused the worst damage. The study also found that effects of electrocautery at 40 W×3 seconds, microwave at 40 W×5 seconds or 60 W×3 seconds, APC at 40 W×5 seconds and cryotherapy at 100 Ω×120 seconds were the equivalent point conditions. The appearance included mucosa absence, partial submucosa absence, and collagen fiber coagulation in treatment areas.Each coagulation technique has its own characteristic. It is very important to choose the appropriate power and action time of the suitable method according to the therapy requirement.

To observe the therapeutic efficacy of bronchoscopic interventional therapy on severe tuberculous main bronchial stenosis or atresia complicated with unilateral atelectasis.Ninety patients with severe tuberculous main bronchial stenosis or atresia complicated with unilateral atelectasis, who had received bronchoscopic interventional therapy, were divided into group A and B according to whether stents had been implanted or not. Patients in group A had been treated with electrocautery, balloon dilatation and cryotherapy. Group B had been treated with metallic stent implantation on the basis of the above interventional management. In order to observe the effectiveness, the time needed for taking effect and restenosis rate were noted. The efficacy between patients with different disease courses, radiology, bronchoscopy and dyspnea index were evaluated before treatment and after the patients' conditions were stable.Three months after treatment, the good response rate and the total effective rate of group B were higher than those of group A, 97% vs 42% (χ(2) = 29.595, P0.05), 100% vs 81% (χ(2) = 6.060, P0.05), respectively. The time needed for taking effect in group B was significantly shorter than that in group A, 0.25 month vs 1.6 month. The dyspnea indexes of both groups were significantly improved after treatment, but the improvement of group B was more significant than that of group A (u = -2.478, P0.05). The disease course of patients with different therapeutic efficacy was evaluated, and the median disease course was 2 months in good response efficacy patients, 3.5 months in improved patients, and 5 months in ineffective patients; the difference being significant between ineffective and good response efficacy patients (u = -3.079, P0.01). The restenosis rate of group B was significantly higher than that of group A, 72% vs 32% (χ(2) = 9.090, P0.01). The median restenosis time was 4 months in group A, and 6 months in group B. Bronchoscopy follow-up 12 months after the initial effective treatment showed that the good response rate and the total effective rate of group B were better than those of group A, 60% vs 29% (χ(2) = 10.559, P0.01), 88% vs 60% (χ(2) = 10.261, P0.01, respectively), and the total effective rate of main bronchial atresia patients in group B was significantly higher than that in group A, 90% vs 50% (Fisher's exact test, P0.05). There was no significant difference in effectiveness between severe stenosis and atresia patients in group A and B.Electrocautery, balloon dilatation, cryotherapy and stent implantation were effective methods to treat severe tuberculous main bronchial stenosis or atresia complicated with unilateral atelectasis. Among them, the therapeutic efficacy was better and the symptoms improved more quickly in patients with stent implantation. The efficacy of stent implantation was better than that of conventional interventional therapy, but the incidence of restenosis was also higher. Following-up should be emphasized in this group of patients. Disease courses were associated with the therapeutic efficacy; longer disease course was related to worse therapeutic efficacy, and restenosis occurred earlier. So interventional therapy should be initiated earlier for bronchial tuberculosis with dyspnea, especially for that complicated by atelectasis.

In this paper, the controllable band width, resolution and sample loading were investigated by the injection system of free-flow electrophoresis (FFE) with gratis gravity. Two general injection methods were described herein. The first method was the one in which sample injection fluxes were variable with constant background flux, while the second was the one in which the background fluxes were flexible with stable sample flux. With methyl green and crystal violet as two viewable model compounds, a series of experiments were performed, and the experimental results revealed that (1) the sample band width could be under desiring control through the regulation of ratios between sample and background fluxes, (2) the separative resolution could be also adjusted elaborately via the regulation of flux ratios during the separation of methyl green and crystal violet with only one charge disparity, and (3) the sample loading could be conveniently controlled via the flux ratios and an approximate maximum sample loading could be selected under the condition of just completed separation of two adjoining solutes. In addition, it was observed that the flux ratio had soft influence on the separative resolution of two solutes. These results were of significance to the designs on band width, resolution and sample loading in the newly developed FFE device with gratis gravity.

The epidemic data of Wenchuan area earthquake trauma of ear, nose and throat were investigated.Affected families and sufferers of part of disaster area in Sichuan province in 2008 were investigated with emphasis on severity, cause and treatment of otorhinolaryngologic trauma.Two hundred and twenty-seven cases of otorhinolaryngologic trauma in survival crowd 3 days after earthquake were included in this study. Most of them were minor trauma or complex lesion. There were 185 cases of soft tissue wound in head and face, 13 cases of fracture of the nose, 18 cases of hemorrhage of the nose, 7 cases of fracture of the skull base, 4 cases of lacerated wound of the auricle. Diagnosis and management were carried out by medical aid post and field ambulance on different condition. The methods of treatment included debridement and suture of soft tissue wound and positioning of fracture. If there was serious injury and accompanied complex lesion, the patients should be sent to hospital after emergent treatment. Forty-six cases were treated in medical aid post, except 3 cases of complex lesion by transportation, 43 cases recovered in 5 to 10 days after treatment. One hundred and eighty-one cases were treated in field ambulance, except 3 cases with fracture of skull base by transportation. Among 31 hospitalized patients, 26 recovered and were discharged before 26th of may, 5 were still in ward because of complex lesion. Among 147 cases treated out of wards with soft tissue wound, 146 cases recovered and bone fracture in rehabilitation. 1 case of lacerated wound of auricle was infected with delayed healing. There were no complication in all cases.For earthquake trauma of the ear, nose and throat, emergent management are debridement, suture and positioning of fracture. For seriously injured patient, transportation to hospital in time can decrease complications and death rate.

To analyze the causes of benign central airway stenoses and to evaluate the efficacy of interventional treatments through flexible bronchoscopy.Three hundred and eighty-six outpatients and inpatients with benign central airway stenoses in our hospital from January 1999 to December 2006 were retrospectively analyzed. Interventional treatments through flexible bronchoscopy were used to treat the benign central airway stenoses. The endoscopic interventional treatments included laser, electrocautery, argon plasma coagulation, cryotherapy, balloon dilation and stent insertion. Airway diameters, FEV1 and dyspnea index of patients were evaluated before and immediately after the last treatment procedure.The main causes of benign central airway stenoses were as follows: tuberculosis in 64.25% (248/386), secondary to prolonged orotracheal intubation or tracheotomy in 15.03% (58/386), injury in 3.63% (14/ 386) and inhalation burns in 3.11% (12/386), others were 54 cases. All the 386 patients received endoscopic interventional treatments. 89.89% (347/386) of the patients experienced improvement in dyspnea and cough. The average airway diameter increased from (2.49 +/- 1.57) mm to (6.41 +/- 1.70) mm (t = 47.427, P0.01). Dyspnea index decreased from 2.40 +/- 0.79 to 0.64 +/- 0.50 (t = 44.226, P0.01). The average value of FEV1 evaluated in 115 inpatients increased from (2.11 +/- 0.60) L to (3.46 +/- 0.75) L (t = 20.128, P0.01). Most patients needed multiple interventional treatments except 26 patients who received a single endoscopic treatment. Stable control of the diseases was achieved in 65.54% (253/ 386) patients 3 months after the last operation.Tuberculosis is the most common cause of benign central airway stenoses in this series. Utilization of interventional methods through flexible bronchoscopy is effective in treating benign central airway stenoses.

To report the diagnostic experience for broncholithiasis, and to evaluate the value of flexible bronchoscopic management for the disease.The clinical data, radiological features, bronchoscopy findings, the effect and complications of bronchoscopic management in 31 patients with broncholithiasis admitted to changhai hospital of second military medical university and zhejiang Taizhou Hospital between 2000 and 2007 were retrospectively reviewed.There were 19 men and 12 women, the mean age was 58.6 +/- 12.6. There were 26 cases missed diagnosis, and 19 cases were misdiagnosis. The diagnosis was confirmed by chest CT combined with bronchoscopy in all the patients. Thirty-six broncholiths were revealed, of which 26 were intraluminal, 9 eroding in the bronchial wall, and 1 peribronchial. In 26 patients, 31 broncholiths were managed by flexible bronchoscope, and 25 broncholiths were successfully removed. The success rate for intraluminal free broncholiths was higher (23/25). One patient experienced hemoptysis of 300 ml after therapy, but no significant complications occurred in other patients.The diagnosis of broncholithiasis can be easily missed or misdiagnosed. Chest CT combined with bronchoscopy were useful methods for the diagnosis of the disease. Extraction of broncholiths with flexible bronchoscope is a safe and effective management, especially for intraluminal broncholiths.

To describe the clinical features and treatment of relapsing polychondritis with involvement of the respiratory tract.Thirteen cases (admitted from Aug 2000 to Oct 2006) of relapsing polychondritis with involvement of the respiratory tract treated in our hospital were retrospectively analyzed.There were 9 males and 4 females, with ages ranging from 30 to 61 years (mean 50 years). At early stage of the disease, clinical manifestations included cough, throat pain and hoarseness. Patients in later stage usually complained of chest distress, shortness of breath and dyspnea. Severe complications were repeated lower respiratory tract infections and/or respiratory failure. Bronchoscopic examination revealed an edematous larynx, narrowing of the glottis, tracheobronchial edema, turgescence of bronchial cartilage rings and airway stenosis at early stage. At later stage of the disease, malacia of trachea and bronchi due to disappearance of bronchial cartilage rings, and partly obliteration of the both trachea and main bronchus on expiration were demonstrated. Thoracic CT scan, with three-dimensional reconstruction of the airways, demonstrated a diffusely thickened tracheobronchial wall with tracheobronchial stenosis in earlier period of the disease and showed severe narrowing of both trachea and main bronchi in later period. Lung function measurements showed a moderate obstructive ventilatory disorder in 5 patients. Medical treatment with corticosteroids and immunosuppressive drugs was given in 12 patients. Symptoms were improved in 6 patients in earlier period of the disease, however, 6 patients in later period were not relieved. Twelve self-expanding metallic stents were placed in the airways (trachea and/or main bronchi), and obstruction of the respiratory tract was relieved in 5 patients, but there was no improvement in 1 patient who later was treated with positive airway pressure support. The 13 patients were followed for 1 to 48 months, and 12 patients survived, but one patient died 2 years after diagnosis.Corticosteroid therapy is effective in improving the symptoms and delaying the progression of relapsing polychondritis with involvement of the respiratory tract at early stage. At later stage of the disease, airway interventional therapy, such as metallic stent placement, tracheostomy or positive airway pressure support, can be used to treat airway obstruction and to improve the survival.