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Airway stenting is an important clinical intervention applied in patients with airway disorders, but it may change the microbial composition of the airways. Before the placement of stents for benign and malignant airway stenosis, the predominant microbiota in the airway is Staphylococcus aureus, while after stent placement, the microbial spectrum change to gram-negative bacteria. Additionally, there is a close relationship between stent-related infection and granulation tissue growth with Staphylococcus aureus and Pseudomonas aeruginosa.

Ethylene is one of the important endogenous gaseous plant hormones that regulates various metabolic and developmental processes in plants. In this study, we found that ethylene could promote bud break and improve the antioxidant system in buds, whereas ethylene increased the chlorophyll and carotenoid degradation that led to the leaves senescence. RNA-seq was also used to analyse the grape leaves and buds treated with ethylene. A total of 7457 differentially expressed genes were identified in the two comparison samples. The annotation results showed that differential genes in GO and KEGG were mainly involved in plant hormone biosynthesis, signal transduction, photosynthesis, and secondary metabolism. We developed a possible model for ethylene controlling and senescence of the leaf and the bud dormancy based on the data produced in RNA-seq. It is evident that exogenous ethylene promoted leaf senescence by regulating various hormone signals, particularly ABA, and inhibiting photosynthesis. Compared with leaves, exogenous ethylene tended to promote photosynthesis in buds and secondary metabolism to regulate buds dormancy. This study will be helpful to clarify the possible action mechanism of ethylene regulating the development of leaves and buds. [ABSTRACT FROM AUTHOR]

There is a paucity of previous related studies exploring hexagonal MgZn2 in high-pressure environments. This study systematically analyzes the mechanical behavior of MgZn2 hexagonal alloys under high-pressure conditions using first principle calculations, bridging the gap in research in this area in the field. The results reveal that, with increasing pressure, the crystallite spacing ( a / a 0 , c / c 0 ) and ratio of volumes ( V / V 0 ) decrease significantly, indicating the structural condensation of the material under high pressure. Elastic constant analysis showed a notable enhancement in all constants, except for C 13 . Among them, C 11 increased from 87.399 GPa to 311.45 GPa, and C 33 increased from 135.279 GPa to 341.739 GPa, showing a faster growth rate, suggesting improved tensile strength in the material along the tensile direction. Mechanical stability assessments confirmed that the alloy remains stable over the 0 to 30 GPa pressure range. Further material characterization indicated that Poisson's ratio remained above 0.26 at pressures from 0 to 30 GPa, suggesting excellent ductility and agreeing with the ratio of the shear modulus to the bulk modulus. As the pressure increases, both the hardness and sound velocity of MgZn2 increase, while the degree of anisotropy decreases. The present work gives important insights on the mechanical behavior of MgZn2 under high pressure, contributing to its application and property optimization. [ABSTRACT FROM AUTHOR]

Objective: With advancements in respiratory interventional techniques, bronchoscopic intervention technology has emerged as a viable approach for managing postintubation tracheal stenosis (PITS). However, there was a paucity of research investigating the potential impact of stenosis characteristics and morphology (such as stenosis degree, length, type, and morphology) on bronchoscopic intervention treatment prognosis for PITS patients. This study was to assess the impact of various preoperative stenosis characteristic factors on the bronchoscopic cure rate among patients. Methods: This is a retrospective study analyzing the medical records of patients with PITS who received bronchoscopic intervention at the tertiary interventional pulmonology center. Results: Among the cases, 115 individuals achieved a in a success rate of 79.86% for bronchoscopic intervention therapy and were assigned to Group S. On the other hand, 29 cases required surgical intervention, accounting for a surgical treatment rate of 20.14% and were assigned to Group F. The stenosis in the Group F predominantly exhibited irregular shapes with scar granulation accompanied by tracheal chondromalacia collapse. Patients in group S experienced fewer total procedures, rigid bronchoscopy treatment, intraoperative hypoxemia, needed emergency re‐bronchoscopy in 24 h and transferred to ICU postoperatively. Patients with pure scar and granuloma, the rate of bronchoscopic success cure was higher than patients with scar granulation accompanied by tracheal chondromalacia (odds ratio: 8.208; 95% confidence interval: 2.755–24.459), and regular stenosis morphology was associated with a higher bronchoscopic success cure rate (odds ratio: 9.463; 95% confidence interval: 3.128–28.623). Conclusion: Irregular airway stenosis, chondromalacia or airway collapse are key factors affecting the success rate of bronchoscopic treatment for post‐intubation tracheal stenosis. Level of evidence: 4 (historically controlled studies). [ABSTRACT FROM AUTHOR]

Tracheobronchopathia osteochondroplastica (TO) is an uncommon non‐malignant tracheal ailment characterized by the existence of numerous bone and/or cartilage nodules in the submucosa of the trachea and bronchi. At present, there is a lack of standardized treatment recommendations for TO. This article presents two instances of severe tracheal stenosis caused by TO, which were effectively managed through the implementation of bronchoscopic stent placement and rigid bronchoscopy curettage, respectively. Both cases exhibited favorable outcomes, providing novel insights and references for the treatment of TO. Laryngoscope, 134:3093–3095, 2024 [ABSTRACT FROM AUTHOR]

High‐throughput gene sequencing has identified various genetic variants as the culprits for some common hereditary cancers. However, the heritability of a substantial proportion of cancers remains unexplained, which may result from rare deleterious mutations hidden in a myriad of nonsense genetic variations. This poses a great challenge to the understanding of the pathology and thus the rational design of effective treatments for affected patients. Here, whole genome sequencing is employed in a representative case in which one monozygotic twin is discordant for lung inflammatory myofibroblastoma to disclose rare tumor‐related mutations. A missense single nucleotide variation rs61955126 T>C in the lysine methyltransferase SETD8 (accession: NM_020382, SETD8C302R) is exposed. It is shown that SETD8 is vital for genomic integrity by promoting faithful DNA replication, and its C302R mutation downregulates the p53/p21 pathway. Importantly, the SETD8C302R mutation significantly increases the sensitivity of cancer cells to WEE1 inhibition. Given that WEE1 inhibitors have shown great promise for clinical approval, these results impart a potential therapeutic approach using WEE1 inhibitor for cancer patients carrying the same mutation, and indicate that genome sequencing and genetic functional studies can be integrated into individualized therapies. [ABSTRACT FROM AUTHOR]

Background: Bronchial adenoid cystic carcinoma (ACC) is a rare disease with low malignancy and indolent progression. Airway obstruction caused by ACC can be resolved by endoscopic procedures. The efficacy of different techniques of bronchoscopic interventions for ACC has not been determined. Material and Methods: From November 2004 to March 2012, ACC patients, mainly treated with different techniques of bronchoscopic interventions in our hospital, were reviewed. Results: The study included 37 ACC patients. Five patients (13.5%) with intra-luminal type underwent bronchoscopic therapies for a median of three times (range 1-6 times). Thirty-two patients (86.5%) with mixed type underwent bronchoscopic interventions for a median of 14 times (range 4-20 times). The dyspnea index was significantly improved after the first endoscopic procedure. The overall five- and ten-year survival rate was 85.9% and 45.9%, respectively, similar to surgery-dominant treatments. Conclusions: The present study demonstrates that different procedures of bronchoscopic interventions, as main treatments for ACC, are as effective as surgery-dominant treatment. More prospective and multicentric studies are required to confirm these favorable results, which may influence the therapeutic strategy for ACC in the future. [ABSTRACT FROM AUTHOR]

Background and objective Treatment of critical airway stenoses remains a formidable challenge to surgeons and anesthiologists. Suffocate is a leading cause of death if the patients with airway diseases were not treated properly. The purpose of this study is to explore the feasibility, safety and efficiency using video-assisted rigid bronchoscopes (VARB) in the treatment of central airway stenoses. Methods From August 27, 2007 to September 30, 2010, 194 patients (140 men and 54 women, mean age 57.5±1.3 years) with airway stenoses (145 with malignant and 49 with benign stenoses) were retrospectively reviewed underwent VARB treatment in our hospital. All the procedures were carried out under general anesthesia with high frequency jet ventilation. After the VARB was placed in the main trachea through the mouth, electric bronchoscope was combined to examine the lesions. Various methods for controlling the airway have been established to solve this problem, such as the electric loop, cryoprobe or argon plasma coagulation (APC) and stents. Results T325 procedures were accomplished in all the 194 cases. Every patients received 1.6 procedures of VARB. VARB occupied 21.3% (325/1,525) in all bronchoscopic procedures. Among the patients, there were 76 cases with primary airway tumor and 69 with secondary malignant tumor, 49 with benign airway stenoses. Karnofsky performance status (KPS) and short breathless index were obviously improved after the first treatment of VARB. Improvement of bronchial stenoses was superior to that of tracheal stenoses. The effect of electasis treatment is better in obstruction of main bronchus than that of segment bronchus. 26 airway stents were removed and 13 stents were successfully placed under VARB. Conclusion VARB can be applied safely and effectively for the management of tracheobronchial stenoses. Quality of life was improved after the treatment of VARB. [ABSTRACT FROM AUTHOR]

Background: The potential role of the iroquois homeobox (IRX) genes in tumorigenesis is a subject of interest, yet their specific involvement in lung adenocarcinoma (LUAD) has not been extensively examined., Objective: This research endeavored to explore the impact of the IRX genes on the onset and progression of LUAD., Methods: Utilizing data from The Cancer Genome Atlas (TCGA), samples of LUAD were selected for analysis. The influence of the IRX genes was scrutinized through various tools, including Kaplan-Meier Plotter, cBioPortal, and the R programming language (version 3.6.3), with gene expression levels being confirmed in cellular models via quantitative real-time polymerase chain reaction (qRT-PCR)., Results: It was observed that the levels of IRX1/2/3/6 were notably diminished in LUAD tissues when juxtaposed with healthy lung tissue. Conversely, the expression of IRX4 was found to be elevated in LUAD. Correlations were identified between IRX gene expression and several clinical parameters such as T stage, smoking history quantified in pack-years, lymph node involvement, patient gender, initial treatment responses, and smoking status. The diminished expression of IRX2/5 emerged as a significant indicator of an unfavorable prognosis in LUAD. The study also highlighted the potential of various IRX genes as diagnostic indicators for LUAD. These genes were implicated in the facilitation of LUAD's growth and spread through a range of biological pathways, encompassing the Ras signaling and more. Additionally, a pronounced link was discovered between the infiltration of immune cells and the expression patterns of the IRX genes. IRX genes were abnormally expressed in LUAD cell lines., Conclusion: IRX gene family could serve not only as indicators of LUAD prognosis but also as therapeutic targets for LUAD., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Malignant central airway stenosis is treated with airway stent placement, but post-placement microbial characteristics remain unclear. We studied microbial features in 60 patients post-stent placement, focusing on changes during granulation tissue proliferation. Samples were collected before stent ( N = 29), after stent on day 3 ( N = 20), and after granulation tissue formation (AS-GTF, N = 43). Metagenomic sequencing showed significant respiratory tract microbiota changes with granulation tissue. The microbiota composition, dominated by Actinobacteria , Firmicutes , and Proteobacteria , was similar among the groups. At the species level, the AS-GTF group exhibited significant differences, with Peptostreptococcus stomatis and Achromobacter xylosoxidans enriched. Analysis based on tracheoesophageal fistula presence identified Tannerella forsythia and Stenotrophomonas maltophilia as the main differential species, enriched in the fistula subgroup. Viral and fungal detection showed Human gammaherpesvirus 4 and Candida albicans as the main species, respectively. These findings highlight microbiota changes after stent placement, potentially associated with granulation tissue proliferation, informing stent placement therapy and anti-infective treatment optimization., Importance: Malignant central airway stenosis is a life-threatening condition that can be effectively treated with airway stent placement. However, despite its clinical importance, the microbial characteristics of the respiratory tract following stent insertion remain poorly understood. This study addresses this gap by investigating the microbial features in patients with malignant central airway stenosis after stent placement, with a specific focus on microbial changes during granulation tissue proliferation. The findings reveal significant alterations in the diversity and structure of the respiratory tract microbiota following the placement of malignant central airway stents. Notably, certain bacterial species, including Peptostreptococcus stomatis and Achromobacter xylosoxidans , exhibit distinct patterns in the after-stent granulation tissue formation group. Additionally, the presence of tracheoesophageal fistula further influences the microbial composition. These insights provide valuable references for optimizing stent placement therapy and enhancing clinical anti-infective strategies., Competing Interests: The authors declare no conflict of interest.

Background: The curative potential of various bronchoscopic treatments such as electric snare, carbon dioxide freezing, argon plasma coagulation (APC), Neudymium-dopted Yttrium Aluminium Garnet (Nd:YAG) laser and photodynamic therapy (PDT) for the treatment of intraluminal tumor has been administered previously, but this regimen is not common in the treatment of typical carcinoid. The aim of this study is to investigate the curative effects both in short-term and long-term of interventional bronchoscopy in the treatment of typical carcinoid., Methods: We retrospectively reviewed the clinical data of typical carcinoid patients who were treated with interventional bronchoscopy for tumor suppression and they were hospitalized in the Emergency General Hospital from December 2010 to December 2020, and Wilcoxon rank sum test and chi-square test were used for analysis., Results: A total of 32 patients were included, including 18 cases of preoperative bronchial artery embolization (embolization rate 56%, 95%CI: 31%-79%). The grade score of dyspnea decreased from before treatment to after treatment, and the difference was statistically significant [(1.44±1.03) score vs (0.25±0.58) score, P=0.003]; The degree of bronchial stenosis decreased from pre-treatment to post-treatment, and the difference was statistically significant [(87.50%±13.90%) vs (17.50%±6.83%), P<0.001]; There was significant difference in bronchial diameter before and after treatment [(0.14±0.18) cm vs (0.84±0.29) cm, P<0.001]., Conclusions: Bronchoscopic interventional therapy has significant short-term and long-term effects in the treatment of typical carcinoid.

High-throughput gene sequencing has identified various genetic variants as the culprits for some common hereditary cancers. However, the heritability of a substantial proportion of cancers remains unexplained, which may result from rare deleterious mutations hidden in a myriad of nonsense genetic variations. This poses a great challenge to the understanding of the pathology and thus the rational design of effective treatments for affected patients. Here, whole genome sequencing is employed in a representative case in which one monozygotic twin is discordant for lung inflammatory myofibroblastoma to disclose rare tumor-related mutations. A missense single nucleotide variation rs61955126 T>C in the lysine methyltransferase SETD8 (accession: NM&#95;020382, SETD8 C302R ) is exposed. It is shown that SETD8 is vital for genomic integrity by promoting faithful DNA replication, and its C302R mutation downregulates the p53/p21 pathway. Importantly, the SETD8 C302R mutation significantly increases the sensitivity of cancer cells to WEE1 inhibition. Given that WEE1 inhibitors have shown great promise for clinical approval, these results impart a potential therapeutic approach using WEE1 inhibitor for cancer patients carrying the same mutation, and indicate that genome sequencing and genetic functional studies can be integrated into individualized therapies., Competing Interests: The authors declare no conflict of interest., (© 2020 The Authors. Published by Wiley‐VCH GmbH.)

Background: It is very difficult to deal with the comprehensive central airway diseases, especially the malignant airway obstruction. The aim of this study is to explore the clinical effects of multiple interventional bronchoscopies for the treatment of 112 cases with comprehensive malignant central airway diseases so as to evaluate the clinical applications of thermoablation and cryosurgery., Methods: The 112 cases with malignant airway diseases retrospectively reviewed for bronchoscopic interventions performed in more than two lesions of carina and/or bifurcation. The age was from 22 to 90 years, which including 55 cases with squamous carcinoma (SQ), 16 adenocarcinoma (AD), 15 adenocystic carcinoma (ACC), 10 metastasis tumor (MT), 8 small cell lung carcinoma (SCLC) and 8 mixed carcinoma (MC). All bronchoscopic interventions such as argon plasma coagulation (APC), cryosurgery, electronic snare and stenting were performed under rigid bronchoscopy combined with electric bronchoscopy in general anesthesia., Results: The 460 bronchoscopic procedures were successfully performed in 112 cases. Cryosurgery and APC were the most used in every group. Stent was more common in patients with MT, balloon dilation was more common in patients with ACC and AD. Electric snare and radioactive seeds implantation were frequently used in cases with SCLC. Trachea stricture is more severe in MT than that in others, while bronchus stricture is more severe than that of trachea in SQ and ACC group. Karnofsky performance score (KPS) is lower and shortness of breath score (SBS) is higher in MC, MT and SCLC group. Trachea and bronchus stricture is improved after comprehensive treatment in 5 groups except of mixed group. KPS increased and SS decreased significantly in 5 groups except of adenocarcinoma. In follow-up, the overall survival time (OS) is 15 months and median survival time is 10 months, especially OS is 28.4 months in ACC and 21.7 months in AD, 8.9 months in SCLC and 7.4 months in mixed group., Conclusions: APC combination with Cryosurgery and other bronchoscopic interventions are indicated for the treatment of complex or difficult airway diseases whether they are located in trachea or bronchus. It is a safe and rapid during procedure.

Background: Pulmonary sarcoma is a rare malignant tumor in soft tissues. Resection is the preferred option to treat this tumor. The aim of this study is to explore the effect of interventional bronchoscopies in the treatment of pulmonary sarcoma if the patient is inoperable., Methods: Sixteen cases with pulmonary sarcoma were retrospectively reviewed in our hospital from November 2008 to July 2014. The mean age was (53.1±5.4) years old. Rigid bronchoscopy was applied for the first procedure with general anesthesia, and electronic bronchoscopy was used for the second procedure or slight patients., Results: Sixteen cases, which include 10 sarcomatoid carcinoma, 2 fibrosarcoma, 2 sarcoma, 1 fibromucoid sarcoma, and 1 spindle cell synovial sarcoma, were collected in this study. Eleven cases (68.8%) were peripheral and mainly located in the right upper lobe and left lower lobe. Five cases (31.2%) were central. Of these cases, 82% (9/11) were mixed and primary tumors in pulmonary tumor. Meanwhile, 56% (9/16) were intraluminal and 69% (11/16) were metastatic in central airway. All of the four cases with whole atelectasis were completely relieved through postbronchoscopic interventions. Three of the seven cases with segment atelectasis were completely reopened; two of them were partially relieved; and the remaining two had no response. The obstructive degree, Karnofsky performance status (KPS), and shortness of breathless score improved significantly after the treatment., Conclusions: Interventional bronchoscopy could rapidly and efficiently remove endobronchial tumor, relieve airway obstruction, and improve clinical symptoms.

Objective: To analyze the relationship between the pathological features and 64-multislice spiral computed tomography (64-MSCT) findings of pulmonary nodules in autopsies from patients with coal workers' pneumoconiosis (CWP), to investigate the optimal imaging method for the distribution of pulmonary nodules, and to provide data for the establishment of CT diagnostic criteria for CWP., Methods: Cadaveric lung specimens were collected from 7 CWP patients. All of them were men, aged 42∼77 years (mean, 60.00±13.00 years), and their dust exposure time was 5∼30 years (mean, 15.4±8.01 years). The cadaveric lung specimens were treated by aeration, sectioning, and immobilization and were then examined by coronary 64-MSCT. The primitive images were reconstructed into the maximumintensity projection (MIP) images (slice thickness: 3 mm, 5 mm, and 8 mm). The sensitivities of imaging methods with different slice thickness were evaluated based on the pathology and anatomy of local pulmonary nodules, and the correlation between pathological results and radiological findings was analyzed., Results: There were significant differences between the stages determined by pathological examination and high-kV chest radiography (before death) (χ(2) = 4.667, P < 0.05; kappa value = 0.167, P < 0.05). A total of 271 nodules were found in all pathological sections, including peribronchovascular nodules (27, 9.9%), centrilobular nodules (67, 24.6%), interlobular nodules (65, 24.3%), nodules within 5 mm from the pleura (45, 16.5%), pleural plaque-like nodules on the lateral chest wall (45, 16.5%), and nodules on the interlobar pleura (22, 8.1%). The likelihood ratio was the highest (0.981) between 5-mm MIP images and pathological results according to the chi-square test., Conclusion: The stage of pulmonary nodules determined by pathological examination is significantly different from that determined by high-kV chest radiography. The 5-mm MIP images of 64-MSCT provide a good reflection of the local pathology and anatomy of pulmonary nodules in CWP patients.

Lung cancer is one of the world's highest morbidity and mortality disease in malignant tumors currently. Squamous-cell lung cancer (SQCLC) is one of the most prevalent subtypes of lung cancer worldwide, after surgery, radiotherapy, chemotherapy and other comprehensive treatment, its 5-year survival rate is still below 15%. The current molecular targeted therapy plays an important role in the treatment of SQCLC, an urgent need to be more in-depth study. SQCLC molecular targeted therapy mainly epidermal growth factor receptor (EGFR), phosphoin-3-kinase catalytic alpha polypeptide (PIK3CA), fibroblast growth factor receptor 1 (FGFR1), discoidin domain receptor 2 (DDR2), phosphatase and tensin homolog deleted on chromosome ten (PTEN), BRAF, MET, insulin-like growth factor 1 receptor (IGF-1R) and other as the target of the drug, some targeted drugs are being developed, and some targeted drugs have entered clinical trials. In recent years, with studies molecular targeted therapy in SQCLC, analysis of the development and trgeted therapy achieved substantial progress in improving the survival rate of SQCLC, and other research to improve the quality of life, make is possible to individualized targeted therapy of SQCLC.

Background: Obstructive atelectasis is frequently accompanied by pulmonary infection and hypoxia. The key to treating this condition is by directly reopening the obstructive airway. The aim of the present study is to explore the safety and efficacy of interventional bronchoscopy for the treatment of malignant obstructive atelectasis., Methods: A total of 120 cases with pathology-proved malignant obstructive atelectasis were retrospectively analyzed for the treatment of argon plasma coagulation and cryosurgery under bronchoscopy. Patients' age is between 5 and 90 years old., Results: A total of 120 cases had 187 atelectasis originating from 98 lesions with primary airway tumors and 89 with metastases. The most common location of atelectasis was in the upper lobe in the primary group and in the single lung in the metastasis group. Although there was no significant difference in tumor debulging between the two groups, the reopening rate of atelectasis was lower in the primary group than that in the metastasis group. The Karnofsky physical score significantly increased, and shortbreath scale decreased after interventional bronchoscopy. Among the patients, 3/4 had hypoxemia and 3.4% had severe bleeding, which caused the death of 1 patient during a procedure. The mean survival time was 6 months, and the survival rate of 1 year was 27.1%., Conclusions: Bronchoscopy can rapidly and effectively debulge the airway tumor and reopen the atelectasis.

Background: Treating airway fistulas, including esophagorespiratory fistulas (ERFs), bronchopleural fistulas (BPFs), and tracheomediastinal fistulas (TMFs), is difficult. The aim of this study is to evaluate the safety and clinical efficacy of metallic covered Z-type stents (CZTS) for the treatment of airway fistulas through bronchoscopy or fluroscopy., Methods: Thirty-eight patients with fistulas between the esophagus, mediastina, and airways (32 ERFs, 5 BPFs, and 1 TMF) were retrospectively reviewed after treatment with covered metallic esophageal and airway stents. The fistulas were caused by esophageal (n=26), bronchogenic (n=11), and thyroid (n=1) carcinomas., Results: Forty-six fistulas were found in 38 patients. The fistula size ranged from 0.5 cm to 7.0 cm. Forty airway covered metal stents (24 Y-type, 8 L-type, and 8 I-type) and 24 esophageal metal stents were placed. Complete responses to the sealing effects of fistulas were noted in 4.3% of all the fistulas, 60.9% showed complete clinical responses, 23.9% showed partial responses, and 10.9% showed no response. An effectivity rate of 89.1% was observed, and the median survival duration of all patients was 5 months., Conclusions: The use of CZTS appears to be safe and feasible for the palliative treatment of ERFs, BPFs, and TMFs. Airway stent placement is recommended for patients with ERF. In the event that airway stents fail, esophageal stents should be given. Airway bifurcation stents were observed to be especially suitable for the sealing of fistulas near the trachea carina.

Background and Objective: Treatment of critical airway stenoses remains a formidable challenge to surgeons and anesthesiologists. Suffocate is a leading cause of death if the patients with airway diseases were not treated properly. The purpose of this study is to explore the feasibility, safety and efficiency using video-assisted rigid bronchoscopes (VARB) in the treatment of central airway stenoses., Methods: From August 27, 2007 to September 30, 2010, 194 patients (140 men and 54 women, mean age 57.5±1.3 years) with airway stenoses (145 with malignant and 49 with benign stenoses) were retrospectively reviewed underwent VARB treatment in our hospital. All the procedures were carried out under general anesthesia with high frequency jet ventilation. After the VARB was placed in the main trachea through the mouth, electric bronchoscope was combined to examine the lesions. Various methods for controlling the airway have been established to solve this problem, such as the electric loop, cryoprobe or argon plasma coagulation (APC) and stents., Results: T325 procedures were accomplished in all the 194 cases. Every patients received 1.6 procedures of VARB. VARB occupied 21.3% (325/1,525) in all bronchoscopic procedures. Among the patients, there were 76 cases with primary airway tumor and 69 with secondary malignant tumor, 49 with benign airway stenoses. Karnofsky performance status (KPS) and short breathless index were obviously improved after the first treatment of VARB. Improvement of bronchial stenoses was superior to that of tracheal stenoses. The effect of electasis treatment is better in obstruction of main bronchus than that of segment bronchus. 26 airway stents were removed and 13 stents were successfully placed under VARB., Conclusions: VARB can be applied safely and effectively for the management of tracheobronchial stenoses. Quality of life was improved after the treatment of VARB.

Background and Objective: It is a complex problem and difficult treatment for tracheobronchial stenoses/occlusions involving in carina. The aim of this study is to investigate the feasibility and efficiency of argon plasma coagulation (APC) and bifurcated covered Z-type stents (CZTS) placement for the treatment of tracheobronchus stenoses and esophagorespiratory fistula (ERF)., Methods: Thirty-two cases with airway disorders were retrospectively reviewed for the treatment of APC and CZTS placement. Under the bronchoscopic guidance, APC was first given in patients with airway stenoses, then CZTS was placed under the fluoroscopic and flexible bronchoscopic guidance either with airway stenoses or ERF., Results: APC was first given in 19 patients with airway stenoses. Airway structures were significantly improved after APC procedure (57.4%-72.1% before APC vs 12.8%-25.8% after APC). Thirty-two CZTS were technically successfully placed in 30 out of 32 cases involving in carinal bifurcation. After APC and stent placement, short breath index was significantly reduced and karnofsky physical score (KPS) increased obviously. The endobronchial defects were successfully palliated with bifurcated CZTS placed under fluoroscopy and flexible bronchoscopy in 12 out of 13 patients with ERFs. There is no bleeding introprocedure. Mucous retention was very common in all types of the stents less than 2 weeks after stenting, which required debridement by bronchoscopy and could be prevented by normal saline solution nebulizations. Granuloma developed at the ends of stents after 1 month of stenting which all of them were treated successfully with APC and CO2 cryosurgery., Conclusions: Utilization of APC and retrieval bifurcated CZTS placement is a simple and safe protocol for the management of airway complex stenoses involving the tracheal carina and ERF.

Background and Objective: Transcatheter arterial chemotherapy and embolization is the main method in the treatment of lung cancer, but most of the reports do not study individually to small cell lung cancer (SCLC), non-small cell lung cancer (NSCLC), hypovascular and hypervascular lung cancer. The pre-embolization perfusion of hemotherapeutics is still being used routinely and seldom report to iodized oil embolization. The article summarized the quality of life after the treatment, clinical efficiency, survival time and complications to evaluate the clinical effect of primary hypervascular NSCLC treated with embolization of emulsion of chemotherapeutics and iodized oil., Methods: The study totally analyzed 41 cases which confirmed by pathology and follow up study from January, 2008 to January 2009. The CT scan with IV contrast demonstrates over moderate enhanced lesion which indicate hypervascular. Within the 41 cases, 23 cases of central, 18 cases of peripheral. Suqamous carcinoma 21 cases, adenocarcinoma 15 cases and squamoadenocarcinoma 5 cases. Stage IIIb 34 cases, stage IV 7 cases. Superselective incubation with microcatheter under DSA, to embolize the capillary bed with liquefied iodized oil and the emulsion of pharmorubicin, to embolize the supply artery of the tumor with gelatin foam microparticle. The liquefied iodized oil 5 mL-10 mL, pharmorubicin 10 mg-30 mg. The longest follow up is 12 months and to compare with the references of 2007-2009., Results: The KPS is widely acclaimed after the treatment (P < 0.05), no complete response (CR), 31 cases of partial response (PR), 7 cases of no change (NC) and 3 cases of progressive disease (PD), the total efficiency (CR+PR) is 75.6%. The clinical efficiency (CR+PR+NC) is 92.68%. 33 cases of total survival tome over 12 months (80.48%), IIIb stage 29/34 (85.29%), IV stage 4/7 (57.14%). 1 case with severe complication-spinal injury., Conclusion: To treat primary hypervascular NSCLC with simple embolization of emulsion of chemotherapeutics and iodized oil is very useful and can avoid the side effect of chemotherapeutics. The key point to avoid spinal injury and other severe complications is to distinguish the spinal aretery and intratumor AV fistula by using superselective incubation with microcatheter under DSA.

Background and Objective: TACE, Ar-He target cryosurgery and radioactive seeds implantation are the mainly micro-invasive methods in the treatment of lung cancer. This article summarizes the survival quality after treatment, the clinical efficiency and survival period, and analyzes the advantages and shortcomings of each methods so as to evaluate the clinical effect of non-small cell lung cancer with multiple minimally invasive treatment., Methods: All the 139 cases were non-small cell lung cancer patients confirmed by pathology and with follow up from July 2006 to July 2009 retrospectively, and all of them lost operative chance by comprehensive evaluation. Different combination of multiple minimally invasive treatments were selected according to the blood supply, size and location of the lesion. Among the 139 cases, 102 cases of primary and 37 cases of metastasis to mediastinum, lung and chest wall, 71 cases of abundant blood supply used the combination of superselective target artery chemotherapy, Ar-He target cryoablation and radiochemotherapy with seeds implantation; 48 cases of poor blood supply use single Ar-He target cryoablation; 20 cases of poor blood supply use the combination of Ar-He target cryoablation and radiochemotheraoy with seeds implantation. And then the pre- and post-treatment KPS score, imaging data and the result of follow up were analyzed., Results: The KPS score increased 20.01 meanly after the treatment. Follow up 3 years, 44 cases of CR, 87 cases of PR, 3 cases of NC and 5 cases of PD, and the efficiencywas 94.2%. Ninety-nine cases of 1 year survival (71.2%), 43 cases of 2 years survival (30.2%), 4 cases with over 3 years survival and the median survival was 19 months. Average survival was (16 +/- 1.5) months. There was no severe complications, such as spinal cord injury, vessel and pericardial aspiration., Conclusion: Minimally invasive technique is a highly successful, micro-invasive and effective method with mild complications. To non-small cell lung cancer, we can improve the middle and long term clinical effect by using the different combination of multiple minimally invasive treatments according to the patient's condition.