Objective To explore the prognostic significance of baseline clinical and pulmonary physiological variables on idiopathic pulmonary fibrosis ( IPF) . Methods Patients diagnosed with IPF according to 2011 ATS/ERS/JRS/ALAT statementwere selected from Nanjing DrumTower Hospital between January 1, 2002 and July 31, 2010. The baseline characteristics were abstracted, including age, gender, smoking history, corticosteroid, delay before diagnosis, body mass index, finger clubbing, oxygenation index ( PaO2 /FiO2 ) , C-reaction protein, erythrocyte sedimentation rate ( ESR) , serum lactate dehydrogenase ( LDH) , albumin, vital capacity ( VC) , forced vital capacity ( FVC) , total lung capacity ( TLC) , and singlebreath diffusing capacity of the lung for carbon monoxide ( DLCO) . The relationships between all factors and survival were examined with a univariate Cox proportional-hazard model. Kaplan-Meier method was used to assess the survival probabilities between groups with different baseline characteristics. Results Eighty-four patients were included in this study, with the median survival time of 34. 7 months. PaO2 /FiO2 , FVC% pred, VC% pred, TLC% pred, and DLCO% pred showed significant associations with the mortality of IPF ( hazard ratios 0. 940-0. 994, P lt; 0. 01) . The Kaplan-Meier analyses for above variables also showed significant differences ( P lt;0. 05) . Besides, the statistical difference of survival probability could be found between the patients with elevated serumLDH and those with normal LDH ( 27. 0 months vs. 43. 1 months, P =0. 014) . Conclusions Baseline oxygenation and pulmonary function parameters may indicate the prognosis of IPF patients. Serum LDH may provide clinicians with additional prognostic information.
Objective To explore the prognostic value of preoperative pulmonary ventilation function for postoperative survival of patients with non-small cell lung cancer ( NSCLC) . Methods 146 NSCLC patients who underwent cured lung surgical resection between January 1, 2003 and December 31,2008 in Nanjing Drum Tower Hospital were recruited in the study. Pulmonary ventilation function was obtained preoperatively for each patient, including vital capacity ( VC) , forced vital capacity ( FVC) , forcedexpiratory volume in 1 second ( FEV1 ) , FEV1 /FVC, and peak expiratory flow ( PEF) . The effects of the above lung function variables on postoperative survival were evaluated by both univariate and multivariate Cox proportional hazard models. Kaplan-Meier method was used to assess the survival probabilities betweendifferent groups.Results The median survival time after surgery was 31. 0 months ( 95% CI 22. 55-39. 45) . VC% pred, FVC% pred and FEV1% pred showed significant associations with the risk of mortality in the NSCLC patients after surgery ( hazard ratios 0. 979-0. 981, P lt; 0. 05) . The survival time after surgery was significantly shorter in the patients with VC ≤ 80% predicted compared to those with VC gt; 80% predicted ( median survival time: 31. 0 months vs. 34. 0 months) . The same difference could be found between the patients with FVC≤80% predicted and those with FVC gt; 80% predicted ( median survival time: 27. 0 months vs. 43. 0 months) . There was also significant difference in median survival between the patients with FEV1 ≤80% predicted and those with FEV1 gt; 80% predicted ( median survival time: 17. 0 months vs. 44. 0 months) . Conclusion Preoperative pulmonary ventilation function parameters may be used to informclinical decisions and indicate the prognosis of NSCLC patients after surgery.
ObjectiveTo analyze the clinical radiographic features and treatment of interstitial lung disease (ILD) inpatients infected with influenza virus. MethodsThe clinical data of ILD patients with influenza in Nanjing Drum Tower Hospital from October 2023 to January 2024 were collected. According to each patient results of influenza nucleic acid detection, they were divided into an influenza infection group and a non-infection group. ResultsA total of 73 patients received influenza nucleic acid detection were enrolled, 23 cases including 5 males and 18 females were positive. Twenty-one cases were infected with influenza A virus, 2 cases were infected with influenza B virus. The median age of influenza positive patients was 64.7±7.8 years. Cough (23 cases, 100.0%), sputum (23 cases, 100.0%), wheezing (20 cases, 87.0%) and fever (17 cases, 73.9%) were the most common symptoms of the patients infected with influenza. Compared with the non-infection patients, fever was more common in the influenza infection group (P<0.05). Laboratory examination indicated that lymphocytopenia were detected in the influenza infection patients. There was no statistical difference in the level of white blood cell count, neutrophil count, lactate dehydrogenase, creatine kinase, erythrocyte sedimentation rate, C-reactive protein, calcitonin, interleukin-6 and oxygenation index. Ground glass opacity in the influenza virus infection group was more common than that in the non-infection group (P<0.05). Ten ILD patients infected with influenza virus (43.5%) were co-infected with Aspergillus. The chest CT type of ILD patients with Aspergillus infection was usual interstitial pneumonia (UIP). Honeycombing was more common than those without Aspergillus infection group (P<0.05). Twenty-two patients (95.7%) received antiviral treatment, of which 20 patients (87.0%) were treated with oseltamivir, 5 patients (21.7%) were treated with mabaloxavir, and 4 patients (17.4%) were treated combined with paramivir. Seventeen patients (73.9%) were previously treated with glucocorticoids, and 16 patients did not adjust the glucocorticoids dosage; 9 patients (39.1%) were previously treated with immunosuppressants, and 2 patients stopped immunosuppressants. Four patients (17.4%) infected with influenza virus developed acute exacerbation of ILD. There was no statistically significant difference in acute exacerbation between the two groups (P>0.05). ConclusionsCompared with ILD patients not infected with influenza, fever, lymphocytopenia and ground-glass opacity are the common clinical and chest CT features of ILD patients infected with influenza. Patients with UIP type combined with honeycomb were prone to be co-infected with Aspergillus infection.