ObjectiveTo evaluate the efficacy and safety of selective large volume broncholavage by bronchonscopy in treatment of patients with acute exacerbation of bronchiectasis. MethodsA single-center randomized control,non-blind clinical trial was conducted.A total of 65 patients were randomly divided into Group A(large volume broncholavage group,n=21),Group B (mini- large volume broncholavage group,n=22) and Group C (control group,n=22).All patients received routine therapy of acute exacerbation of bronchiectasis while additional broncholavage was administered in the treatment groups for only once.Warm normal saline solution was instilled for Group A at volume of 500 to 2 000 mL and for Group B at volume of 100 to 200 mL.The baseline characteristics,Simplified Clinical Pulmonary Infection Score(CPIS) and C-reactive protein (CRP) were recorded at the first and on 7th day.The duration of antibiotic use,the length of hospital stay and total effective rate were compared among three groups. ResultsThe lavage volume was (1 250.0±403.3)mL for Group A and (141.0±41.2)mL for Group B.The length of hospital stay and duration of antibiotic use were (8.4±1.0)d and (7.9±1.1)d respectively,shorter than those in Group B[(13.5±1.6)d,(11.6±2.4)d] and Group C[(15.3±3.2)d,(13.3±2.6)d] with significant difference between three groups(all P<0.05).The total effective rates was 95.23% in Group A,higher than those in Group B (81.82%) and Group C (68.19%)(all P<0.05).The CPIS on the 7th day of Group A was 1.9±1.4,lower than that in Group B (2.7±0.8) and Group C (3.7±0.9)(P<0.05).The CRP of Group A decreased more quickly than Group B and Group C.The adverse events occurred in Group A and Group B including transient hypoxemia (23.81%,9.09%, respectively),tarchycardia(100%,68.18%, respectively),airway mucosal injury(38.09%,13.64%, respectively) and elevated blood pressure (19.05%,13.64%, respectively). ConclusionSelective large volume broncholavage through bronchonscopy is an effective and safe treatment for patients with acute exacerbation or bronchiectasis.
Objective To report our experience in using The Bethesda System for Reporting Thyroid Cytopathology(TBSRTC), and to investigate the diagnostic value of the system based on the cytologic-histologic result. Methods Pathological data of 2 257 thyroid nodules classified by TBSRTC which were obtained from the Department of Pathology of West China Hospital between Jan.2010 to Dec.2012 were collected and analyzed, to investigate the diagnostic evaluation indicators, such as the sensitivity, specificity, and diagnostic accuracy of the system based on the cytologic-histologic result. Results Of the 2 257 thyroid nodules, 442 (19.6%) were diagnosed as categoryⅠ, 1 184(52.4%) were diagnosed as categoryⅡ, 216(9.6%) were diagnosed as categoryⅢ, 38(1.7%) were diagnosed as categoryⅣ, 172(7.6%) were diagnosed as categoryⅤ, 205(9.1%) were diagnosed as categoryⅥ. Using TBSRTC categoryⅡas the boundary point of diagnosing benign and malignant diseases, the sensitivity, specificity, and diagnostic accuracy were 93.7%(236/252), 86.6%(323/373), and 89.4%(559/625)respectively, while categoryⅢwas excluded from analysis. When including categoryⅢinto analysis, the sensitivity, specificity, and diagnostic accuracy were 94.3%(267/283), 74.9%(323/431), and 82.6%(590/714)respectively. Conclusion The validity of TBSRTC was high at our institution. TBSRTC has proven to be an accurate and reliable approach for the diagnosis of thyroid nodules.