2011年 · 第34卷第03期

In 2010, due to the discovery of metallobeta-lactamase-1 (NDM-1) in New Delhi, a new wave of hot discussions about superbugs has been set off all over the world, and there is a trend of "a storm is coming, and the wind is full of buildings, and the dark clouds are about to destroy the city"^[1]。 In fact, super bacteria or super bugs are no longer a new concept, so there is no need to panic excessively about them. Catching up with the trend and creating momentum is the expertise and interest of the media. As medical workers and decision-makers, we should not go with the trend, but always keep a clear head and respond objectively and scientifically. We should not just follow the media as soon as it is hyped, seemingly attaching importance to it, but doing some meaningless and wasteful things, ignoring them completely after the calm, as if it never happened in the first place... The following author may as well "catch up with the trend" and talk about my personal understanding of NDM-1 and related bacterial resistance for readers' criticism and reference.

Professor Qiu Zuyuan (1904-1988) was a native of Cixi, Zhejiang Province, and was born in Beijing. He studied at the Faculty of Medicine of Yenching University and Peking Union Medical College, obtaining Bachelor of Science and Doctor of Medicine degrees. During his four years working in the Department of Internal Medicine of Peking Union Medical College Hospital and the Department of Internal Medicine of Shanxi Datong Shoushan Hospital, Professor Qiu received many tuberculosis patients every day, and most of them were patients who were difficult to cure in the advanced stage. In addition, his mother and uncle died of tuberculosis one after another, which prompted him to develop the idea of devoting himself to the cause of tuberculosis prevention, and in 1937, he went to Minnesota State Medical College in the United States to specialize in tuberculosis epidemiology.

The level of hypoxia responsiveness in respiratory center is regulated by genetics. Although several candidate genes have been found in animal experiments, there are no reports of related genes in human body. narcolepsy is a rare sleep disease, with uncontrollable drowsiness, paroxysmal cataplexy, sleep paralysis, hallucinations of falling asleep and nocturnal sleep disorders as the main clinical features. More than 95% of typical patients have human leukocyte antigen (HLA) DQB1*0602 gene positive, decreased or disappeared cerebrospinal fluid hypothalamic secretin and other manifestations. Patients are often complicated with sleep apnea. Animal experiments show that hypothalamic secretin deficiency can lead to high CO in the respiratory center in awake state₂The responsiveness was reduced, suggesting a deficiency in respiratory regulation function in narcolepsy.

As a common disease in the internal medicine system, the diagnosis of pulmonary hypertension has been a clinical difficulty. Although the right heart floating catheter is the gold standard for the diagnosis of pulmonary hypertension, it is invasive and prone to complications, which limits its widespread clinical use. Transthoracic Doppler ultrasound is the most commonly used noninvasive method for the diagnosis of pulmonary hypertension, but its value in the diagnosis of pulmonary hypertension is controversial. Therefore, we retrieved the literature of PubMed, Web of Science and Ovid databases on the use of transthoracic Doppler cardiac ultrasound in the diagnosis of pulmonary hypertension, evaluated the quality of the relevant literature by meta-analysis of diagnostic trials, extracted and included diagnostic data, and quantitatively analyzed the diagnostic value of transthoracic Doppler cardiac ultrasound in patients with pulmonary hypertension by meta-analysis.

BACKGROUND AND OBJECTIVE: bronchial thermoplasty (BT) is a new bronchoscopic interventional treatment for bronchial asthma (asthma), which reduces the number of airway smooth muscles in asthmatic patients by controlling the application of warm heat energy on the airway wall. The aim of this study was to evaluate the effects of BT on those patients who were subjected to high doses of inhaled glucocorticoids (ICS) and long-acting beta₂-the efficacy and safety of receptor agonist (LABA) therapy in patients with severe asthma who remain symptomatic. Methods: 288 patients with severe asthma were randomly assigned to BT treatment group (BT group) and pseudo-mock group. Both groups received 3 bronchoscopy treatments. The differences in total scores of asthma quality of life questionnaire (AQLQ) between the two groups at baseline, 6 months, 9 months and 12 months were compared. Safety was assessed by collecting adverse events and visits. Bayesian statistical analysis was used to evaluate the main research indicators, assuming that the posterior probability of superiority (PPS) of BT group over the pseudo-simulation group was 95%, and the primary study endpoint PPS was 96.4%. Results: Compared with the total AQLQ score at baseline, the BT group (1.35 ± 1.10) was better than the false mock group (1.16 ± 1.23), with an overall PPS of 96.0% and a PPS of 97.9% per follow-up; The change of AQLQ score was above 0.5 in 97% of patients in BT group (PPS was 99.6%) and 64% in pseudo-simulation group; 6% of patients were hospitalized between BT treatment and 6 weeks after treatment; Within 6 to 52 weeks after BT treatment, the rate of acute severe exacerbation of asthma, the rate of emergency department and the number of missed days from work/school were less in BT group than in pseudo-simulation group (PPS: 99.5%, 99.9% and 99.3%, respectively). The duration of adverse reactions to BT treatment was shorter. Within 6 to 52 weeks after BT treatment, compared with the pseudo-mock group, the BT-treated group had a lower rate of respiratory adverse events (70% in the BT-treated group and 80% in the pseudo-mock group), a lower rate of patients' self-reported asthma syndrome (27.3% in the BT-treated group and 42.9% in the pseudo-mock group; 99.7% in the PPS), and an 84% reduction in the risk of emergency department visits (99.9% in the PPS). Conclusion: BT treatment can reduce the severe exacerbation of asthma and the rate of visits, thus improving the quality of life of patients with severe asthma. The adverse reactions of BT treatment are of shorter duration and the benefits of treatment outweigh the risks.

BACKGROUND AND OBJECTIVE: For adult patients with bronchial asthma (asthma) who are not well controlled by inhaled corticosteroids alone, the addition of long-acting beta-agonist (LABA) can effectively improve the symptoms and lung function of patients. However, recently, the safety of long-term treatment of LABA has been questioned by the US Food and Drug Administration (FDA) and some asthma experts. In addition, given that each asthma patient responds differently to treatment, it is necessary to seek alternative treatments for patients with uncontrolled asthma. Methods: 210 asthmatic patients were enrolled in a double-blind, triple-dummy, triple-crossover trial to evaluate the addition of tiotropium bromide (a long-acting anticholinergic drug approved for chronic obstructive pulmonary disease but not for asthma) to inhaled glucocorticoids, compared with inhaled double doses of glucocorticoids and salmeterol (a LABA), respectively. Results: Compared with the group with double dose of inhaled corticosteroid, the group with tiotropium bromide was able to improve the symptoms and lung function better: the morning peak expiratory flow rate (PEF) increased by an average of 25.8 L per minute (P<0.01)； Night time PEF increased by an average of 35.3 L per minute (P<0.01), the number of days of asthma control increased by 7.9% (P=0.010), FEV before bronchodilator application₁Improvement of 0.1 L (P=0.004), and the daily symptom score was reduced by 0.11 points (P<0.01)。 The efficacy of the tiotropium-added group was no lower than that of the salmeterol-added group in all evaluation indicators, and the improvement in some indicators, such as FEV before bronchodilators, was even better₁The tiotropium-added group increased by 0.11 L compared with the salmeterol-added group (P＝0.003)。 CONCLUSIONS: When tiotropium bromide is added to inhaled glucocorticoids, it improves symptoms and lung function in patients with uncontrolled asthma, and its efficacy appears to be equivalent to the addition of salmeterol.

Anticholinergic drugs relax airway smooth muscle by blocking muscarinic receptors (M receptors) in the airway. Inhaled anticholinergic drugs can improve lung function and reduce the number of acute exacerbations in COPD patients, and have become the most widely used bronchodilators in COPD patients^[1]。 However, airway obstruction in bronchial asthma (asthma for short) is multifactorial, and the efficacy and safety of anticholinergic drugs in the treatment of asthma are inconclusive. However, recent research results show that the long-acting anticholinergic drug tiotropium bromide can further improve the lung function and asthma symptoms of asthma patients on the basis of inhaled glucocorticoid (hormone for short) treatment, and it is expected to become a new choice to improve asthma treatment. The clinical value of anticholinergic drugs in the treatment of asthma is summarized as follows.

Bronchial asthma (asthma for short) is a common chronic respiratory diseases, and chronic airway inflammation is a hallmark feature of asthma^[1]In clinical practice, there is an urgent need for detection technology that can objectively reflect airway inflammation to guide the diagnosis and treatment of asthma. The determination of fractional exhaled nitric oxide (FENO) concentration is one of the most promising markers of airway inflammation in asthma. The results of the present study confirm that FENO levels in asthma patients have a good correlation with eosinophil airway inflammation^[2]。 Global Asthma Initiative (GINA)^[1]Guidelines for prevention and treatment of bronchial asthma in China^[3]FENO has also been included as a non-invasive marker of airway inflammation in asthma along with sputum inflammatory cell detection. FENO assay has the advantages of non-invasive, rapid, simple and reproducible, so it has unique advantages as an inflammatory marker of asthma. The following is a review of the progress in the application of FENO assay in the diagnosis and treatment of asthma.

Lung cancer is a malignant tumor with high morbidity and mortality in the world^[1]The incidence and mortality of lung cancer in China are also showing an obvious upward trend. The World Health Organization predicts that by 2025, the number of lung cancer patients in China will reach 1 million, becoming the largest lung cancer country in the world. In recent years, targeted therapy for nonsmall-cell lung cancer (NSCLC) has obvious advantages, and individualized therapy for specific targets has become a reality. Therefore, finding new targets has become the focus of research.

I read the "Expert Consensus on Diagnosis and Management of Refractory Asthma" published in your journal^[1](hereinafter referred to as "consensus") has benefited a lot. The formulation of "consensus" provides a scientific diagnosis and treatment basis for the diagnosis and treatment of refractory asthma in China, and plays an important role in improving the diagnosis and treatment level of refractory asthma in China. However, the author puts forward the following suggestions for the "consensus" for reference.

hypersensitivity usually refers to an abnormal and excessive immune response, that is, the body interacts with antigenic substances under certain conditions to produce sensitized lymphocytes or specific antibodies. If combined with the re-entering antigen, the immune response can lead to physiological dysfunction and tissue damage, also known as allergy. In the clinical practice of diagnosis and treatment of bronchial asthma (asthma for short), we found that there is a hypersensitivity reaction in asthma patients, but it is not hypersensitivity reaction in the traditional sense, which is manifested by allergic reaction to drugs that are not allergic to ordinary people. We think that this situation seems to be more appropriate to define as "hypersensitivity state", which means that the body is in an abnormal state, and an allergic reaction may occur to drugs that can be used normally at this time, thus increasing the difficulty of treatment. Here's a case to illustrate this situation.

It is well known that if patients with bronchial asthma (asthma for short) have acute attacks, especially severe acute attacks, systemic use of hormones is very necessary and effective^[1,2]。 However, for the dosage of systemic hormones, the guidelines at home and abroad are different, which makes us doubtful in clinical work.

The editorial department forwarded a letter from Dr. Mou Xiangdong "How to determine the dosage of systemic hormones in patients with bronchial asthma during severe acute attack", which raised a relatively important clinical problem. Because acute attacks of bronchial asthma (asthma for short) are common emergencies in respiratory departments and emergency departments, the rational use of glucocorticoids (hormones for short) is crucial in the treatment plan of patients with acute attacks of asthma. Here are some simple points on the issues raised in the letter, for reference only.

antiphospholipid syndrome (APS) is a clinical syndrome caused by antiphospholipid antibodies (aPL) with arteriovenous thrombosis, repeated pregnancy failure and thrombocytopenia as the main manifestations. It is a rare non-inflammatory autoimmune disease. The lung is the main organ involved in APS, which can cause serious complications such as pulmonary embolism. The clinical data of 5 patients with APS complicated with pulmonary embolism hospitalized in Shanghai Pulmonary Hospital affiliated to Tongji University in 2009 and 2010 were retrospectively analyzed, and the literature analysis is as follows.

Airway inflammation and airway remodeling are important links in the occurrence and development of bronchial asthma (asthma for short), but their pathogenesis is not completely clear^[1]。 Toll like receptor (TLR) is the bridge between natural and acquired immunity^[2]The results indicate that TLR may play an important role in the occurrence and development of asthma^[3]。 Dexamethasone is a classic drug for the treatment of asthma, which can improve airway inflammation and airway remodeling in asthma, but its mechanism of action is unknown. Therefore, we will establish an animal model of asthma to investigate the effects of dexamethasone treatment on asthmatic airway remodeling and TLR4 expression in asthmatic airway smooth muscle at a holistic level.

Smoking can not only cause frequent attacks of bronchial asthma (asthma for short), leading to a rapid decline in lung function, but also reduce the therapeutic effect of glucocorticoids, which ultimately makes the disease difficult to control^[1,2]。 dendritic cells (DC) are the most powerful antigen presenting cells (APCs), which can produce interleukin (IL) -12, a key cytokine that regulates the balance of helper T cells 1 (Th1) /Th2, and play an important role in asthma and allergic diseases. This study aims to investigate the effects of cigarette smoke exposure on the expression of OX-62, a specific marker protein in lung DC, and IL-12 in plasma and BALF of asthmatic rats, in order to elucidate the immunoregulatory mechanism of smoking aggravating asthma.

Bronchial asthma (asthma for short) is a chronic inflammatory disease of airway involved by a variety of cells, including airway inflammatory cells, structural cells and cellular components. Its pathogenesis is still not fully understood. Various factors in macrophage activating factor family are involved in airway inflammatory response and asthma attack^[1]。 Macrophage-derived chemokine (MDC) is a new type of CC chemokine discovered in recent years^[2]It is possible to participate in the occurrence of asthma. To investigate the role of MDC in asthma, we measured the level of MDC in induced sputum in 40 asthmatic patients from July to December 2009 and analyzed its correlation with FEV₁In order to further explore the involvement factors in the pathogenesis of asthma, the percentage of induced sputum eosinophils (EOS%) and the percentage of induced sputum eosinophils were studied.

MTB secreted protein 64 (MPT64) is one of the immunoprotective antigens in the early secretion protein of MTB. This study investigated the immune response of mice immunized with recombinant MPT64 subunit vaccine using adenovirus as vector and its protective ability against MTB infection, aiming to provide theoretical basis for the research of new tuberculosis vaccine.

A 37-year-old female was admitted to the hospital on 15 July 2009 due to "hemoptysis for 8 years, cough and shortness of breath for 1 year and aggravation for 1 week". Eight years ago, the patient underwent lung CT examination in the local hospital due to "massive hemoptysis", which revealed multiple nodules in both lungs, and then developed eyelid swelling, hearing loss, nasal congestion and loss of smell. Cranial magnetic resonance examination revealed multiple soft tissue masses in the orbit and nasal cavity, and underwent "intraorbital mass and nasal cavity mass biopsy" for 8 times, all of which revealed "granulomatous inflammation". Seven years ago, I developed multiple purpura-like rash on my limbs with skin ulceration on the extension surface of the joint. The pathology of skin biopsy was consistent with Wegener's granuloma. I was given "methylprednisolone + cyclophosphamide" treatment. During this period, I was given methylprednisolone 500 mg pulse treatment twice, cyclophosphamide 1.0 g pulse treatment several times, and then "prednisone 10 mg/d" was given for maintenance. Admission physical examination: vital signs stable, right eyelid swelling, palpable induration the size of a silkworm bean, hard texture, no tenderness, saddle nose, loss of smell. The breathing sounds of both lungs were thick, and dry rales could be heard. Multiple painless nodules on the extension surface of the joints of the limbs, surface keratinization and pigmentation remaining. Auxiliary examination: CRP was 4.6 mg/L, ESR was 17 mm/1 h, perinuclear anti-neutrophil cytoplasmic antibody (P-ANCA) was negative, and cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA) was positive. Chest CT examination showed multiple patchy nodules in both lungs, stenosis of the lower main trachea and left main bronchus (Figure 1，Figure 2)。 Admission diagnosis: Wegener's granuloma. After 1 week of treatment with "methylprednisolone 40 mg/d", the patient still had unstoppable cough and obvious shortness of breath. After consultation with respiratory medicine and thoracic surgery, it was considered that laser cauterization and stent placement under bronchoscope were not suitable, so infliximab 200 mg was given. After 4 treatments at 0, 2, 6 and 14 weeks, the patient's symptoms of chest tightness and shortness of breath were significantly improved, the right eyelid mass was smaller than before, and the dry rales in both lungs disappeared. After 4 months of treatment, reexamination of chest CT showed that the lumen of the lower main trachea was dilated compared with the previous one, and the original stenotic left bronchial lumen was patent (Figure 3，Figure 4)。 After 11 months of outpatient follow-up, the patient's right eyelid mass was not enlarged, the breathing sounds of both lungs were clear, and no dry rales were heard.

The 83-year-old female was admitted to the respiratory department of Zunhua People's Hospital on November 8, 2005 due to "intermittent cough and expectoration for more than 30 years, aggravation for 1 week and confusion for 1 day". For more than 30 years, more patients have coughed and sputum after catching cold in winter, without wheezing, lasting for more than 3 months every year, and attacks have occurred year after year, which can be relieved by anti-inflammatory symptomatic treatment. After catching a cold 1 week ago, the symptoms worsened again, coughing up white sticky sputum, which was not easy to cough up, and there was no fever. The patient experienced confusion 1 d ago. He has a history of smoking for 42 years, a smoking index of 30 packages per year, and has quit smoking for 13 years. Has a history of type 2 diabetes for 10 years. There was no history of hypertension and heart, liver and kidney diseases. Admission diagnosis: acute exacerbation of COPD, bilateral pneumonia, type II respiratory failure, pulmonary encephalopathy, type 2 diabetes. Anti-infection and expectorant treatment were given, but the effect was not good. Then invasive mechanical ventilation was applied, and the condition gradually improved. And insulin aspart injection was given regularly postprandial subcutaneous injection (18 U in the morning, 16 U in the middle, and 16 U in the evening), and the fasting blood glucose was controlled at 6.5-8.0 mmol/L. After admission, two withdrawals failed, and then tracheotomy was performed, and the condition was stable with synchronous intermittent command ventilation mode. The patient had no fever, cough with yellow phlegm and asthma. On 23 January 2008, the patient felt chest tightness, and the symptoms gradually worsened. After 1 d, obvious dyspnea, face and whole body were bruised, accompanied by convulsions. Extremely weak respiratory sounds in both lungs, heart rate 130 beats/min, low blunt heart sounds, blood pressure 160/110 mm Hg (1 mm Hg =0.133 kPa), SaO₂75%. Ventilator monitoring showed: peak airway pressure 80 cm H₂O (1 cm H₂O =0.098 kPa), exhaled tidal volume of 110 to 230 ml, minute ventilation of 3 L, and respiratory rate of 35 beats/min. Chest X-ray showed hyperinflation of both lungs and a flat diaphragm. Arterial blood gas analysis: pH 7.25, PaO₂is 45 mm Hg, PaCO₂88 mm Hg. Electrocardiogram showed sinus tachycardia. Blood routine: white blood cells 8.9×10⁹/L, neutrophils 0.70, eosinophils 0.01, hemoglobin 115 g/L, platelets 101×10⁹/L. Clinical diagnosis: severe bronchospasm. After administration of bronchodilators (ipratropium bromide solution 500 μ g plus physiological saline 4 ml aerosol inhalation), the convulsions stopped about 10 min, and the respiratory sounds in the lungs gradually recovered. After 1 h, the respiratory sounds in both lungs were clear, and SaO₂It rose to 97%, the heart rate dropped to 100 beats/min, and the blood pressure was 130/70 mm Hg. After about 6 h, the patient experienced chest tightness and wheezing again, and the peak airway pressure rose to 80 cm h₂O, apply the above drugs again for aerosol inhalation, and the symptoms are relieved. This treatment is carried out 3 to 4 times a day until the 5th day. The peak airway pressure decreased when the patient was patted on the back in the lateral position, but it rose again after the recumbent position. At this time, we carefully analyzed the reason, which may be due to the displacement of the tracheotomy tube, the nozzle against the tracheal wall, causing ventilation obstruction, and directly stimulating the tracheal wall, resulting in bronchospasm. Therefore, the patient's pillow was removed, the head position was adjusted, and the tracheotomy tube was ventilated smoothly. At the same time, the patient was aerosolized and inhaled once a day. After 2 days, the airway spasm was completely relieved, and the aerosolized drug treatment was discontinued. The patient has not experienced the aforementioned symptoms since January 2008.

Ewing's sarcoma, also known as Ewing's tumor, is a primary malignant small round cell tumor of bone, with the long bones of the limbs as the prevalent site. Ewing's sarcoma originating from the ribs is relatively rare. A case of Ewing's sarcoma of the rib admitted to our hospital is reported and related literature is reviewed.

bronchopleural fistula (BPF) refers to the communication between the pleural cavity and the bronchus, which is one of the serious complications after pneumonectomy^[1]。 With the continuous improvement of surgical technique and perioperative management level, the incidence of BPF after pulmonary surgery has decreased significantly in recent years. At present, the incidence rate is 1% ~4%, but the mortality rate of this disease is high (16% ~72%)^[2]The main causes of death were respiratory failure, hypoxia and carbon dioxide retention due to severe thoracic infection^[3]。 The clinical treatment of BPF is difficult, and early diagnosis and timely and effective treatment are the key factors affecting its prognosis. The diagnosis and treatment of 27 patients with BPF after pneumonectomy in Zhongshan Hospital affiliated to Fudan University is summarized as follows.

Tide breathing, also known as Cheyne-Stokes breathing, is an abnormal breathing pattern that was first described by John Cheyne and William Stokes in the 19th century, hence the name. This breathing mode is characterized by a gradual change in breathing from shallow to deep and fast, then from deep and fast to shallow and slow, followed by a period of apnea, and then the above periodic changes are repeated. It is a breathing pattern that switches back and forth between apnea and hypopnea, and is accompanied by changes in arterial partial pressure of oxygen and partial pressure of carbon dioxide.

A 28-year-old male was admitted for 3 months with cough and left chest pain. During the course of the disease, the patient occasionally felt dyspnea, and had no symptoms such as fever, night sweats and hemoptysis. X-ray chest radiography was performed in another hospital and diagnosed as "left encapsulated effusion" without further treatment. He was in good health, once joined the army and retired a year ago, and had no hobbies such as smoking and keeping pets. Physical examination showed no fever, superficial lymph nodes were not palpable and swollen, left lung buckling showed solid sound, breathing sound was weakened, no abnormalities were found, and laboratory examination showed no obvious abnormalities. X-ray chest radiograph showed a huge mass in the left upper lung (Figure 1), chest CT showed a huge mass of left lung with clear boundaries, uniform density, no burrs, and several punctate calcifications (Figure 2)； Enhanced CT showed mild homogeneous enhancement of the tumor. Percutaneous lung biopsy was performed under the guidance of chest CT. Pathological examination showed that the tumor tissue was loose reticular structure with few tumor cells and was round. The nucleus was spindle-shaped, wavy-shaped or comma-shaped, without mitotic image, and a small number of cell dense areas were also seen. The tumor cells in the dense areas were long spindle-shaped, palisade-shaped or vortex-shaped (Figure 3), diagnosed as pulmonary schwannoma. Left lung tumor resection was performed in surgery. Because of the huge tumor, the necrotic tissue was aspirated after surface incision and the tumor was removed. Postoperative pathology confirmed that it was a giant schwannoma originating from intercostal nerve. The patient was followed up for half a year without recurrence.

In recent years, with the development of rigid bronchoscope technology assisted by television, the application range of rigid bronchoscope has been widened. Rigid bronchoscope can keep the airway unobstructed, and there is a side hole at the operating end connected to the ventilator, so it is also called "ventilation bronchoscope"^[1]。 Modern rigid bronchoscopes also have interventional channels that allow flexible bronchoscopes and other devices to enter the airway, greatly broadening their application range, allowing for stent release, laser ablation, argon plasma coagulation (APC) and freezing operations under direct vision^[2,3,4,5]。 In recent years, the author adopted video-assisted rigid bronchoscope combined with electronic bronchoscope, and applied cryo combined with APC to treat central airway tumors, and achieved very good curative effect.

The 2nd National Academic Forum on Lung Cancer and Interventional Pulmonology, jointly sponsored by the Editorial Committee of Chinese Journal of Tuberculosis and Respiratory Medicine of Chinese Medical Association and the Respiratory Department of the First Affiliated Hospital of Wenzhou Medical College, and co-organized by Wenzhou Medical Association, was held in Wenzhou from October 29 to 31, 2010. More than 200 experts and scholars in respiratory medicine and oncology from all over the country attended the meeting. The conference invited more than 20 experts in the fields of lung cancer and interventional diseases at home and abroad to give special reports on the diagnosis, targeted therapy and chemotherapy of lung cancer, and the application of interventional pulmonology in various benign and malignant airway lesions. The conference also conducted face-to-face academic exchanges with experts, which fully demonstrated the scientific research and clinical level of Chinese scholars in this field in recent years.

The 9th event of Beijing Young Respiratory Scholars Salon in 2010 was held in Chinese Medical Association on November 25th, 2010. This event was hosted by Dr. Huang Hui, Department of Respiratory Medicine, Peking Union Medical College Hospital, and mainly discussed the theme of "How to improve the diagnosis rate of chest diseases" in the form of case analysis.

In 2010, due to the discovery of metallo-beta-lactamase-1 (NDM-1) in New Delhi, a new wave of superbugs started all over the world. Major media "jumped on the trend and created momentum", and all kinds of news and comments poured in. As an expert in the professional field, Professor Liu Youning, the editor-in-chief of this journal, also came to "catch up with the trend". In the column of "Editor-in-Chief Essay", Professor Liu talked about some personal views on the similarities and differences between NDM-1 and other superbacteria and the different drug resistance characteristics of common pathogens in China and abroad.