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Evolution of the newest diagnostic methods for COVID-19:a Chinese perspective

Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2023年第6期24卷 463-484页

作者： Mingtao LIU Jiali LYU Xianhui ZHENG Zhiman LIANG Baoying LEI Huihuang CHEN Yiyin MAI Huimin HUANG Baoqing SUN department of Clinical Laboratory National Center for Respiratory MedicineNational Clinical Research Center for Respiratory DiseaseState Key Laboratory of Respiratory DiseaseGuangzhou Institute of Respiratory Healththe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou510140China National Center for respiratory Medicine National Clinical Research Center of Respiratory DiseaseState Key Laboratory of Respiratory DiseaseGuangzhou Institute of Respiratory Healththe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510140China Guangzhou Medical University Guangzhou 511495China

Coronavirus disease 2019(COVID-19)has continued to spread globally since late 2019,representing a formidable challenge to the world's healthcare systems,wreaking havoc,and spreading rapidly through human contact.With fever,fatigue,and a persistent dry cough being the hallmark symptoms,this disease threatened to destabilize the delicate balance of our global community.Rapid and accurate diagnosis of COVID-19 is a prerequisite for understanding the number of confirmed cases in the world or a region,and an important factor in epidemic assessment and the development of control measures.It also plays a crucial role in ensuring that patients receive the appropriate medical treatment,leading to optimal patient care.Reverse transcription-polymerase chain reaction(RT-PCR)technology is currently the most mature method for detecting viral nucleic acids,but it has many drawbacks.Meanwhile,a variety of COVID-19 detection methods,including molecular biological diagnostic,immunodiagnostic,imaging,and artificial intelligence methods have been developed and applied in clinical practice to meet diverse scenarios and needs.These methods can help clinicians diagnose and treat COVID-19 patients.This review describes the variety of such methods used in China,providing an important reference in the field of the clinical diagnosis of COVID-19.

关键词： Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Coronavirus disease 2019(COVID-19) Diagnosis Polymerase chain reaction(PCR) Immunoassay Radiography

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Learning curve of a robotic-assisted bronchoscopy system in sampling peripheral pulmonary nodules

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Chinese Medical Journal 2022年第22期135卷 2753-2755页

作者： Fangfang Xie Qin Zhang Shuaiyang Liu Lijun Yan Yongzheng Zhou Jiayuan Sun department of respiratory Endoscopy Department of Respiratory and Critical Care MedicineShanghai Chest HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200030China Shanghai Engineering Research Center of respiratory Endoscopy Shanghai 200030China

To the Editor:Computed tomography(CT)has been used for the screening of lung cancer in high-risk populations,with a subsequent reduction in lung cancer-related mortality.[1]However,it has also resulted in a considerab... 详细信息

关键词： lung mortality cancer

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Potential biomarkers for diagnosis and disease evaluation of idiopathic pulmonary fibrosis

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Chinese Medical Journal 2023年第11期136卷 1278-1290页

作者： Qing Wang Zhaoliang Xie Nansheng Wan Lei Yang Zhixian Jin Fang Jin Zhaoming Huang Min Chen Huiming Wang Jing Feng department of respiratory and Critical Care Medicine Tianjin Medical University General HospitalTianjin 300052China department of respiratory and Critical Care Medicine of Kunming Municipal First People’s Hospital KunmingYunnan 650000China Respiratory Department of Sanming Yong’an General Hospital SanmingFujian 366000China

Idiopathic pulmonary fibrosis(IPF)is a chronic progressive lung disease characterized by progressive lung fibrogenesis and histological features of usual interstitial pneumonia.IPF has a poor prognosis and presents a spectrum of disease courses ranging from slow evolving disease to rapid deterioration;thus,a differential diagnosis remains challenging.Several biomarkers have been identified to achieve a differential diagnosis;however,comprehensive reviews are lacking.This review summarizes over 100 biomarkers which can be divided into six categories according to their functions:differentially expressed biomarkers in the IPF compared to healthy controls;biomarkers distinguishing IPF from other types of interstitial lung disease;biomarkers differentiating acute exacerbation of IPF from stable disease;biomarkers predicting disease progression;biomarkers related to disease severity;and biomarkers related to treatment.Specimen used for the diagnosis of IPF included serum,bronchoalveolar lavage fluid,lung tissue,and sputum.IPF-specific biomarkers are of great clinical value for the differential diagnosis of IPF.Currently,the physiological measurements used to evaluate the occurrence of acute exacerbation,disease progression,and disease severity have limitations.Combining physiological measurements with biomarkers may increase the accuracy and sensitivity of diagnosis and disease evaluation of IPF.Most biomarkers described in this review are not routinely used in clinical practice.Future large-scale multicenter studies are required to design and validate suitable biomarker panels that have diagnostic utility for IPF.

关键词： Alveolar epithelial cell dysfunction Biomarker Diagnosis Fibrogenesis Extracellular matrix remodeling Idiopathic pulmonary fibrosis Immune dysfunction

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Eligibility of C-BIOPRED severe asthma cohort for type-2 biologic therapies

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Chinese Medical Journal 2023年第2期136卷 230-232页

作者： Zhenan Deng Meiling Jin Changxing Ou Wei Jiang Jianping Zhao Xiaoxia Liu Shenghua Sun Huaping Tang Bei He Shaoxi Cai Ping Chen Penghui Wu Yujing Liu Jian Kang Yunhui Zhang Mao Huang Jinfu Xu Kewu Huang Qiang Li Xiangyan Zhang Xiuhua Fu Changzheng Wang Huahao Shen Lei Zhu Guochao Shi Zhongmin Qiu Zhongguang Wen Xiaoyang Wei Wei Gu Chunhua Wei Guangfa Wang Ping Chen Lixin Xie Jiangtao Lin Yuling Tang Zhihai Han Kian Fan Chung Qingling Zhang Nanshan Zhong C-BIOPRED Consortium Pulmonary and Critical Care Medicine Guangzhou Institute of Respiratory HealthNational Clinical Research Center for Respiratory DiseaseNational Center for Respiratory MedicineState Key Laboratory of Respiratory DiseasesThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdong 510120China department of respiratory Medicine Zhongshan HospitalShanghai 200433China Guangzhou Medical University GuangzhouGuangdong 510180China AstraZeneca Shanghai 200085China department of respiratory Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China department of respiratory Medicine Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China department of respiratory Medicine The Third Xiangya Hospital of Central South UniversityChangshaHunan 410013China department of respiratory Medicine Qingdao Municipal HospitalQingdaoShandong 266001China department of respiratory Medicine Peking University Third HospitalBeijing 100191China department of respiratory Medicine Nanfang Hospital of Southern Medical UniversityGuangzhouGuangdong 510515China department of respiratory Medicine General Hospital of Northern Theater CommandShenyangLiaoning 110016China department of respiratory Medicine The First Hospital of China Medical UniversityShenyangLiaoning 110001China department of respiratory Medicine The First people’s Hospital of Yunnan ProvinceKunmingYunnan 363880China department of respiratory Medicine The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China department of respiratory Medicine Shanghai Pulmonary HospitalShanghai 200433China department of respiratory Medicine Beijing Chao-Yang HospitalBeijing 100020China department of respiratory Medicine Shanghai General HospitalShanghai 200080China department of respiratory Medicine Guizhou Province People’s HospitalGuiyangGuizhou 550002China department of respiratory Medicine The Affiliated Hospital of Inner Mongolia Me

To the Editor:Patients with severe persistent asthma experience greater morbidity with more impairment in quality of life despite higher use of health care resources and being treated with existing asthma treatments such as inhaled corticosteroids and b-agonists,and sometimes oral corticosteroid(OCS)therapy.Type-2(T2)high asthma has been identified as a phenotype that responds to targeted T2 biologic therapies such as anti-IgE,anti-interleukin(IL)5,or anti-IL5Ra and anti-IL4Ra monoclonal antibodies,which are currently available in Europe and North America,and are currently introduced in the rest of the world.[1]

关键词： asthma therapies impairment

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Epidemiological characteristics of pulmonary tuberculosis in patients with pneumoconiosis based on its social determinants and risk factors in China:a cross-sectional study from 27 provinces

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Chinese Medical Journal 2022年第24期135卷 2984-2997页

作者： Huanqiang Wang Huaping Dai Jiayu He Xiangpei Lyu Xinran Zhang Tao Li department of Occupational respiratory Disease National Institute for Occupational Health and Poison ControlChinese Center for Disease Control and PreventionBeijing 100050China National Center for respiratory Medicine National Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100029China department of Pulmonary and Critical Care Medicine Center of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China department of Clinical Research and Data Management Center of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China

Background:Patients with pneumoconiosis have an elevated risk of contracting pulmonary tuberculosis(PTB)and need particular attention.However,extensive population-based studies on the prevalence of PTB in patients with pneumoconiosis have not been reported in China since 1992.This study aimed to investigate the epidemiological characteristics of PTB in patients with pneumoconiosis based on its social determinants and risk factors in China.Methods:Based on the Commission on Social Determinants of Health(CSDH)framework,data were obtained from a questionnaire survey of patients with pneumoconiosis from China’s 27 provinces(autonomous regions,municipalities)from December 2017 to June 2021.By chi-square and multivariate logistic regression analyses,the epidemiological characteristics of PTB in the patients were identified based on its prevalence and odds ratio(OR)and associated social determinants and risk factors.The population attributable fractions(PAFs)of significant risk factors were also calculated.Results:The prevalence of PTB in patients with pneumoconiosis(n=10,137)was 7.5%(95%confidence interval[CI]:7.0-8.0%).Multivariate logistic regression analysis showed that risk factors included in-hospital exposure to patients with PTB(OR=3.30,95%CI:2.77-3.93),clinically diagnosed cases(OR=3.25,95%CI:2.42-4.34),and northeastern regions(OR=2.41,95%CI:1.76-3.31).In addition,lack of work-related injury insurance(WRII),being born in a rural area,being unemployed,living in western regions,household exposure to patients with PTB,smoking,being underweight,complications of pulmonary bullae or pneumothorax,hospitalization history,and former drinkers among the rural patients were also statistically significant risk factors.Being born in a rural area,lack of WRII and in-hospital exposure to patients with PTB had higher PAFs,which were 13.2%(95%CI:7.9-18.5%),12.5%(95%CI:8.3-16.7%),and 11.6%(95%CI:8.8-14.3%),respectively.Conclusion:The prevalence of PTB in pneumoconiosis remains high in China;it is basically in line with the CSDH m

关键词： Pulmonary tuberculosis Pneumoconiosis Social determinants Risk factors

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Clinical characteristics of hypersensitivity pneumonitis:non-fibrotic and fibrotic subtypes

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Chinese Medical Journal 2023年第23期136卷 2839-2846页

作者： Xueying Chen Xiaoyan Yang Yanhong Ren Bingbing Xie Sheng Xie Ling Zhao Shiyao Wang Jing Geng Dingyuan Jiang Sa Luo Jiarui He Shi Shu Yinan Hu Lili Zhu Zhen Li Xinran Zhang Min Liu Huaping Dai department of Pulmonary and Critical Care Medicine Center of Respiratory MedicineChina-Japan Friendship HospitalNational Center for Respiratory MedicineNational Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100029China department of Pulmonary and Critical Care Medicine Center of Respiratory MedicineChina-Japan Friendship HospitalCapital Medical UniversityBeijing 100029China department of Radiology China-Japan Friendship HospitalBeijing 100029China department of Pathology China-Japan Friendship HospitalBeijing 100029China Institute of Clinical Medical Sciences Center of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China

Background:The presence of fibrosis is a criterion for subtype classification in the newly updated hypersensitivity pneumonitis(HP)guidelines.The present study aimed to summarize differences in clinical characteristics and prognosis of non-fibrotic hypersensitivity pneumonitis(NFHP)and fibrotic hypersensitivity pneumonitis(FHP)and explore factors associated with the presence of fibrosis.Methods:In this prospective cohort study,patients diagnosed with HP through a multidisciplinary discussion were enrolled.Collected data included demographic and clinical characteristics,laboratory findings,and radiologic and histopathological features.Logistic regression analyses were performed to explore factors related to the presence of fibrosis.Results:A total of 202 patients with HP were enrolled,including 87(43.1%)NFHP patients and 115(56.9%)FHP patients.Patients with FHP were older and more frequently presented with dyspnea,crackles,and digital clubbing than patients with NFHP.Serum levels of carcinoembryonic antigen,carbohydrate antigen 125,carbohydrate antigen 153,gastrin-releasing peptide precursor,squamous cell carcinoma antigen,and antigen cytokeratin 21-1,and count of bronchoalveolar lavage(BAL)eosinophils were higher in the FHP group than in the NFHP group.BAL lymphocytosis was present in both groups,but less pronounced in the FHP group.Multivariable regression analyses revealed that older age,<20%of lymphocyte in BAL,and≥1.75%of eosinophil in BAL were risk factors for the development of FHP.Twelve patients developed adverse outcomes,with a median survival time of 12.5 months,all of whom had FHP.Conclusions:Older age,<20%of lymphocyte in BAL,and≥1.75%of eosinophil in BAL were risk factors associated with the development of FHP.Prognosis of patients with NFHP was better than that of patients with FHP.These results may provide insights into the mechanisms of fibrosis in HP.

关键词： Interstitial lung disease Hypersensitivity pneumonitis Clinical characteristics Fibrosis Prognosis

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Effect of Bufei granule on stable chronic obstructive pulmonary disease: a randomized, double blinded, placebo-controlled, and multicenter clinical study

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Journal of Traditional Chinese Medicine 2014年第4期34卷 437-444页

作者： Sijia Guo Zengtao Sun Enshun Liu Jihong Feng Min Fu Yuechuan Li Qi Wu department of respiratory Medicine the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine department of respiratory Medicine Tianjin Chest Hospital department of respiratory Medicine Tianjin Haihe Hospital

OBJECTIVE: To study the therapeutic effect Bufei granule, which is a traditional Chinese drug that can enhance the immune function of the lung, on patients with stable chronic obstructive pulmonary disease(COPD).METHODS: This is a randomized, double blinded,placebo-controlled, and multicenter clinical study.Three medical centers in Tianjin, China, participated in the trial. A total of 140 patients with stable COPD were enrolled and randomized into two groups, with 70 patients in each. The treatment group was treated with Bufei granule, while the control group received Bufei placebo. The pharmacological treatment lasted for 12 weeks from the date of enrollment. Then, the indexes of patients were observed. Data were analyzed to study the effect of Bufei granule, with the frequency of acute exacerbation as the primary outcome. Traditional Chinese Medicine syndromes,Modified British Medical Research Council dyspnea scale score, St.George's respiratory questionnaire scores, pulmonary function, and serum inflammatory marker levels [including interleukin-6(IL-6), interleukin-8, tumor necrosis factor-α, and transformation growth factor-β1]were the secondary outcomes.RESULTS: During the 12-week treatment, treatment and control groups had no adverse reactions.The analysis of the indexes obtained from all patients showed that the therapeutic effect in the treatment group was significantly better than that in the control group because most of the similar probabilities of primary and secondary outcomes were less than 0.05,except for the level of IL-6.CONCLUSION: Bufei granule can treat patients with stable COPD by lowering the frequency of acute exacerbation, improving the quality of life,and alleviating the severity of inflammation.

关键词：慢性阻塞性肺疾病稳定期多中心颗粒随机临床中国传统医学治疗效果

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Clinical Evaluation of a Vancomycin Dosage Strategy Based on a Serum Trough Concentration Model in Elderly Patients with Severe Pneumonia

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Biomedical and Environmental Sciences 2023年第5期36卷 397-405页

作者： YAN Wei SUN Xiao Yan WANG Meng ZHAO Fei Fan ZHOU Qing Tao department of respiratory and Critical Care Medicine Peking University Third HospitalBejing 100191China

Objective This study aimed to evaluate the clinical benefits of a vancomycin dosage strategy based on a serum trough concentration model in elderly patients.Methods This prospective single-center, open-label, randomized controlled trial categorized 66 elderly patients with severe pneumonia into study and control groups. The control group received vancomycin using a regimen decided by the attending physician. Meanwhile, the study group received individualized vancomycin therapy with a dosing strategy based on a serum trough concentration model. The primary endpoint was the proportion of patients with serum trough concentrations reaching the target values.The secondary endpoints were clinical response, vancomycin treatment duration, and vancomycinassociated acute kidney injury(VA-AKI) occurrence.Results All patients were at least 60 years old(median age = 81 years). The proportion of patients with target trough concentration achievement(≥ 15 mg/L) with the initial vancomycin regimen was significantly higher in the study group compared to the control group(75.8% vs. 42.4%, P = 0.006).Forty-five patients(68.2%) achieved clinical success, the median duration of vancomycin therapy was10.0 days, and VA-AKI occurred in eight patients(12.1%). However, there were no significant differences in these parameters between the two groups. The model for predicting vancomycin trough concentrations was upgraded to: serum trough concentration(mg/L) = 17.194-0.104 × creatinine clearance rate(mL/min) + 0.313 × vancomycin daily dose [mg/(kg·d)].Conclusion A vancomycin dosage strategy based on a serum trough concentration model can improve the proportion of patients achieving target trough concentrations in elderly patients with severe pneumonia.

关键词： Pneumonia Clinical trials Vancomycin Trough concentration Elderly patients

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Late onset of neutral lipid storage disease due to a rare PNPLA2 mutation in a patient with myopathy and cardiomyopathy

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Chinese Medical Journal 2022年第19期135卷 2389-2391页

作者： Ye Tian Shiyao Wang Fang Wang Li Yi Mingrui Dong Xu Huang department of Pulmonary and Critical Care Medicine Center of Respiratory MedicineChina-Japan Friendship HospitalNational Center for Respiratory MedicineInstitute of Respiratory MedicineChinese Academy of Medical SciencesNational Clinical Research Center for Respiratory DiseasesBejing 100029China department of Cardiology China-Japan Friendship HospitalBeijing 100029China department of Neurology China-Japan Friendship HospitalBeijing 100029China.

To the Editor:Neutral lipidd storage disease with myopathy(NLSDM)is a rare autosomal recessive disorder caused by mutations in the PNPLA2 gene.The gene encodes adipose triglyceride lipase(ATGL),an enzyme that catalyzes hydrolysis of triglycerides in mammalian adipose tissue and plays key roles in the function of lipid droplets(LDs).The results of many biochemical studies have revealed intracellular localization of ATGLwithLDs,but catalyticactivity iscompletely lost in the context of PNPLA2mutation.

关键词： myopathy rare cardiomyopathy

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Strategies for reopening in the forthcoming COVID-19 era in China

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National Science Review 2022年第3期9卷 5-6页

作者： Wei-jie Guan Nan-shan Zhong State Key Laboratory of respiratory Disease National Clinical Research Center for Respiratory Disease Guangzhou Institute of Respiratory Health The First Affiliated Hospital of Guangzhou Medical University Guangzhou Medical University department of Thoracic Surgery Guangzhou Institute for Respiratory Health The First Affiliated Hospital of Guangzhou Medical University Guangzhou Medical University department of respiratory and Critical Care Medicine Foshan Second People's HospitalAffiliated Foshan Hospital of Southern Medical University

The transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the culprit pathogen of coronavirus disease 2019 (COVID-19), has resulted in more than 0.43 billion cases and 6 million deaths globally. Compared with other existing variants of concern, the Omicron variant is characterized by significantly greater infectivity (Ro≈6),greater tropism of the upper respiratory tract and lower severity of human infections [1].These characteristics of the Omicron variant are the basis upon which several developed countries are considering reopening.

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