Background The utilization of noninvasive positive pressure ventilation (NPPV) is becoming more and more common, especially in patients with acute or chronic respiratory failure. The purpose of our study is to analyze the factors that influence the efficacy of NPPV in the treatment of respiratory failure caused by a variety of etiology. Methods From May 2011 to April 2020, patients treated with NPPV during hospitalization in the First Affiliated Hospital of Soochow University were enrolled. According to the clinical outcome of NPPV treatment and whether converted to invasive mechanical ventilation, patients were divided into the success group and the failure group. The clinical data and the characteristics of NPPV application were compared between the two groups. Results A total of 3312 patients were enrolled, including 2025 patients in the success group and 1287 patients in the failure group. Univariate analysis suggested that there were no statistical differences in patients' age, gender, use of analgesia and/or sedation, complicated with barotrauma, inspiratory positive airway pressure and expiratory positive airway pressure between the success and failure groups (P > 0.05). However, there were statistically significant differences in serum albumin levels, Ca2+ concentration, blood glucose levels, duration of NPPV treatment and length of hospital stay between the success and failure groups (P < 0.05). Multivariate logistic regression analysis indicated that serum albumin levels and duration of NPPV treatment had statistical significance on the therapeutic effect of NPPV (P < 0.05). Conclusion Serum albumin levels and duration of NPPV treatment were independent risk factors for the efficacy of NPPV treatment in respiratory failure.

Purpose The diagnosis of pulmonary hamartoma (PH) based on computed tomography (CT) is a challenge, especially in patients with atypical imaging characteristics. This study was aimed at summarizing the imaging characteristic of 18F-Fluoro-d-glucose positron emission tomography-computed tomography (18F-FDG PET-CT) in PH and exploring the application value of PET-CT in the diagnosis of PH. Data and methods Patients diagnosed with PH who had undergone PET-CT from literature pertaining were retrospectively analyzed, which were cases of publications from the Cochrane Library, PubMed, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI) and Wanfang databases, from 2008 to June 2022. The other 20 cases of the collection were patients from our hospital from 2008 to June 2022. Patients’ symptoms, imaging characteristics of chest CT, PET-CT characteristics, the reason for PET-CT and the complications were analyzed. Results In this retrospective study, a total of 216 patients were diagnosed with PH and had been examined by PET-CT. 20 of the cases were patients of our hospital from January 2008 to June 2022. The other cases were collected from the literature. The mean diameter of most PH lesions is 1.7 ± 1.0 cm. The mean maximum standardized uptake value (SUVmax) of the PH lesions was 1.2 ± 1.1. Most of their SUVmax were lower than internationally recognized cut-off value (SUVmax = 2.5). PET-CT was superior to CT in the diagnosis of PH but there was a correlation of between CT diagnosis and PET-CT diagnosis for the PH lesions. In order to draw the Receiver operating characteristic (ROC), we selected 29 patients with a clear SUVmax value of their PH lesion, and 29 lung cancer patients with clear SUVmax value in our hospital were collected as a control group. ROC curve analysis showed that the area under curve (AUC) of SUVmax was 0.899, and the optimal diagnostic threshold was SUVmax > 2.65. PET-CT could distinguish PH from malignant lesions with a sensitivity of 89.66% by applying a SUVmax of 2.65 as a cut-off in this study. Conclusion PET-CT might be a useful tool to diagnose PH, which shows a better diagnostic sensitivity than CT. But PET-CT can not be used as a single diagnostic approach, which should be combined with other methods and the patients’ history to make the most correct diagnosis.

Purpose The preoperative diagnosis of pulmonary hamartoma (PH) is a challenge, especially in patients with atypical imaging features. This study was aimed at exploring the application value of percutaneous transthoracic needle biopsy (PTNB) in the diagnosis and treatment of PH. Data and Methods: Patients who were diagnosed with PH and had undergone PTNB from our hospital were retrospectively reviewed. Other cases were retrieved from the literature prior to December 2022 regarding the use of PTNB in patients with PH. Patients’ age, sex, imaging characteristics of chest CT, the diagnosis by PTNB, cytology features of biopsy specimen, complications and further treatment were analyzed. Results In this retrospective study, a total of 47 patients who were diagnosed as PH and had undergone PTNB were analyzed. 6 of the cases were patients from our hospital from 2008 to 2022. Others were collected from the literature. The mean diameter of PH lesions was 24.1mm (8-60mm). The diagnosis accuracy of PTNB was 70.2%. The complication rate was 19.1%, mainly pneumothorax. Fibro myxoid stroma and chondroid material accounted for 48.9% and 38.3%, respectively. 16 cases underwent surgery, and follow-up was available for all the 47 patients and no significant growth of the PH lesion or recurrent was occurred. Conclusion PTNB might be a useful tool to diagnose PH with a lower incidence of complications. The lesion could be managed conservatively and surgical procedures can be avoided.

Purpose: The diagnosis of pulmonary hamartoma (PH) based on computed tomography (CT) is a challenge, especially in patients with atypical imaging characteristics. This study was aimed at summarizing the imaging characteristic of 18F-Fluoro-D-glucose positron emission tomography-computed tomography (18F-FDG PET-CT) in PH and exploring the application value of PET in the diagnosis of PH. Data and Methods: Patients diagnosed with PH who had undergone PET-CT from our hospital were retrospectively reviewed. And other cases were publications regarding the use of PET-CT in patients with PH were retrieved from the Cochrane Library, PubMed, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI) and Wanfang databases, until June 2022. Patients’ symptoms, imaging characteristics of chest CT, tumor markers, PET-CT characteristics, the reason for PET-CT and the complications were analyzed. Results: In this retrospective study, a total of 219 patients were diagnosed with PH and had been examined by PET-CT. 23 of the cases were patients of our hospital from January 2008 to June 2022. Others were collected from the literature. the mean diameter of most lung hamartoma lesions is 1.68 cm (0.4-5.5cm). Most of their SUVmax values were lower than internationally recognized cut-off value (SUVmax=2.5). PET-CT was superior to CT in diagnosing PH but there was a consistency of diagnostic efficiency between CT and PET-CT. ROC curve analysis showed that the AUC(Area under curve) of SUVmax was 0.905, and the optimal diagnostic threshold was SUVmax>2.65. Conclusion: PET-CT might be a useful tool to diagnose PH, even though with atypical radiographic features, and show better diagnostic accuracy than CT.