Background The Global Cancer Observatory(GLOBOCAN)2022 and the Global Burden of Disease(GBD)2021 are two primary databases for assessing the global cancer burden.This study aimed to compare the incidence and mortality...Background The Global Cancer Observatory(GLOBOCAN)2022 and the Global Burden of Disease(GBD)2021 are two primary databases for assessing the global cancer burden.This study aimed to compare the incidence and mortality rates of tracheal,bronchus,and lung(TBL)cancer reported in these databases and to analyze the observed discrepancies.Methods Age-standardized rates(ASRs),including age-standardized incidence rates and age-standardized mortality rates for TBL cancer,were obtained from GLOBOCAN 2022 and GBD 2021 for the most recent available year.Differences in ASRs at the national level between the two databases were quantified using pairwise differences,calculated as the absolute difference in ASRs divided by the mean of the ASRs from both sources.Correlations between macroeconomic factors and pairwise differences in ASRs were evaluated,and country features correlated with high pairwise differences were assessed.The data sources and methods used in the two databases were also compared.Results Strong correlations were identified between ASRs reported by GLOBOCAN 2022 and GBD 2021;however,significant differences were observed between estimates from the two data sources.African countries commonly exhibited larger pairwise differences in ASRs,whereas European countries demonstrated smaller pairwise differences in ASRs.Additionally,some populous developing countries,including China,South Africa,Brazil and India,showed smaller differences in ASRs.Countries lacking vital registration systems or high-quality population-based cancer registries displayed larger differences in ASRs.Furthermore,differences in ASRs were negatively correlated with macroeconomic factors.The data sources and estimation methods used by the two databases were inconsistent.Conclusions Discrepancies in TBL cancer incidence and mortality were observed between GLOBOCAN 2022 and GBD 2021.While differences in sources and methods partially explain these discrepancies,a country's cancer surveillance maturity and economic status also correlate with the accuracy of the estimates.Estimating the cancer burden in less wealthy countries remains a substantial challenge,necessitating long-term assistance and investment.展开更多
Background: Right upper lobectomy(RUL) for lung cancer with di erent dissecting orders involves the most vari?able anatomical structures, but no studies have analyzed its e ects on postoperative recovery. This study c...Background: Right upper lobectomy(RUL) for lung cancer with di erent dissecting orders involves the most vari?able anatomical structures, but no studies have analyzed its e ects on postoperative recovery. This study compared the conventional surgical approach, VAB(dissecting pulmonary vessels first, followed by the bronchus), and the alter?native surgical approach, a BVA(dissecting the posterior ascending arterial branch first, followed by the bronchus and vessels) on improving surgical feasibility and postoperative recovery for lung cancer patients.Methods: According to the surgical approach, consecutive lung cancer patients undergoing RUL were grouped into a BVA and VAB cohorts. Their clinical, pathologic, and perioperative characteristics were collected to compare periop?erative outcomes.Results: Three hundred one patients were selected(109 in the a BVA cohort and 192 in the VAB cohort). The mean operation time was shorter in the a BVA cohort than in the VAB cohort(164 vs. 221 min, P < 0.001), and less blood loss occurred in the a BVA cohort(92 vs. 141 m L, P < 0.001). The rate of conversion to thoracotomy was lower in the a BVA cohort than in the VAB cohort(0% vs. 11.5%, P < 0.001). The mean duration of postoperative chest drainage was shorter in the a BVA cohort than in the VAB cohort(3.6 vs. 4.5 days, P rvival was n= 0.001). The rates of postoperative complica?tions were comparable(P = 0.629). The median overall suot arrived in both cohorts(P > 0.05). The median disease?free survival was comparable for all patients in the two cohorts(not arrived vs. 41.97 months) and for patients with disease recurrences(13.25 vs. 9.44 months)(both P > 0.05). The recurrence models in two cohorts were also comparable for patients with local recurrences(6.4% vs. 7.8%), distant metastases(10.1% vs. 8.3%), and both(1.8% vs. 1.6%)(all P > 0.05).Conclusions: Dissecting the right upper bronchus before turning over the lobe repeatedly and dissecting veins via the a BVA approach during RUL would promote surgical feasibility and achieve comparable postoperative recovery for lung cancer patients.展开更多
<strong>Objective:</strong> To investigate the rescue and nursing process of a trauma patient with multiple injuries and rupture of the right main bronchus.<strong> Methods:</strong> A patient ...<strong>Objective:</strong> To investigate the rescue and nursing process of a trauma patient with multiple injuries and rupture of the right main bronchus.<strong> Methods:</strong> A patient with multiple injuries and rupture of the right main bronchus admitted to the emergency department of the Shenzhen Hospital of the University of Hong Kong was selected as the research object on December 11, 2019. <strong>Results:</strong> In this case, the medical team treated the patient under the guidance of ATLS (Advanced Traumatic Life Support), and for the first time in our department, we used bronchoscopy to replace the double-lumen endotracheal tube for left lung single-lung ventilation, finally the patient was successfully treated. <strong>Conclusion:</strong> Through a literature search, it is found that the main bronchus rupture is less common in clinical practice. In the trauma group, the use of fiberoptic bronchoscopy and the replacement of a double-lumen tracheal tube for left lung single-lung ventilation can improve the treatment rate of such patients and is worthy of clinical application.展开更多
Increasing epidemiological evidence supports the view, that quercetin has protective roles in a multitude of disease states in human who have a high intake of polyphenols. To investigate the ability of quercetin and i...Increasing epidemiological evidence supports the view, that quercetin has protective roles in a multitude of disease states in human who have a high intake of polyphenols. To investigate the ability of quercetin and its rutinoside, rutin, to modulate the relaxation of human airways smooth muscle and to determine the mechanism (s) of such relaxation, isolated human bronchus rings were suspended in individual organ baths, precontracted with acetylcholine or with histamine and the relaxing effects of quercetin and rutin were determined by measurement of isometric tension. Quercetin induced concentration-dependent relaxant responses on acetylcholine or histamine precontracted human bronchial rings and with almost equal effectiveness. In terms of potency (pD2) and efficacy (Emax), quercetin is more potent than rutin on relaxant responses of human bronchus. K+ and Ca2+ concentration-dependent contraction curves were inhibited after incubation with increasing concentrations of quercetin. Quercetin potentiated in a concentration-dependent manner the relaxant effects of isoprenaline or sodium nitroprusside. Rutin had no effect on K+-induced contraction and on relaxant activity of isoprenaline or sodium nitroprusside. Our results suggest that the bronchodilator effects of quercetin are modulated by an increase in cyclic nucleotide levels as well as an alteration in availability of Ca2+ to the contractile machinery.展开更多
BACKGROUND Primary carcinoma ex pleomorphic adenoma arising from the tracheobronchial system is rarely reported.CASE SUMMARY We present a patient with primary carcinoma ex pleomorphic adenoma of the bronchus and revie...BACKGROUND Primary carcinoma ex pleomorphic adenoma arising from the tracheobronchial system is rarely reported.CASE SUMMARY We present a patient with primary carcinoma ex pleomorphic adenoma of the bronchus and review the associated literature for further comparison,including age,clinical manifestations,and diagnostic process.This patient had no history of neoplasms of the salivary gland.CONCLUSION Positron emission tomography played an important role in the staging work-up of primary carcinoma of ex pleomorphic adenoma.Long-term follow-up was necessary for further prognosis analysis.展开更多
Objective： The aim of our study was to introduce the surgical method and evaluate the efficacy of double sleeve Iobectomy of the bronchus and the pulmonary artery in treatment for the central lung cancer. Method： Fr...Objective： The aim of our study was to introduce the surgical method and evaluate the efficacy of double sleeve Iobectomy of the bronchus and the pulmonary artery in treatment for the central lung cancer. Method： From March 1995 to October 2010, double sleeve Iobectomy of the bronchus and the pulmonary artery was performed in 45 cases with central lung cancer that involved the bronchial opening of an upper lobe of the lungs or the main bronchus and＇pulmonary artery but didn＇t involve any lower lobes. Among them, left upper Iobectomy was performed in 37 cases, right medium-upper Iobectomy was performed in 6 cases and right upper Iobectomy was performed in 2 cases. Results： Postoperative complications were found in 12 cases. Among them, 3 cases were arrhythmia, 1 case was acute heart failure, 6 cases were obstructive pneumo-nia and pulmonary atelectasis, 2 cases were bronchial anastomotic fistula. Two cases died of cerebral infarction and massive hemoptysis respectively. Thirty-one cases were squamous carcinoma, 7 cases were adenocarcinoma, 4 cases were small cell lung cancer, 1 case was adenosquamous carcinoma, 1 case was sarcomatoid carcinomas, 1 case was mucinous adeno- carcinoma. Ten cases were T3NOM0, 11 cases were T3N 1M0, 17 cases were T3N2M0, 2 cases were T4N 1M0, 5 cases were T4N2M0. The 1-year, 3-year, 5-year survival rates were 84.4% （38/45）, 51.7% （15/29）, 53.8% （7/13） respectively. Conclu-sion： The double sleeve Iobectomy of the bronchus and the pulmonary artery can maximumly reserve the normal lung tissues while removing tumors, and avoid pneumonectomy. The surgery was safe and effective, while it required a high technique.展开更多
Objective To assess the diagnostic value of the airway post-processing technique of multi-slice spiral CT(MSCT)in accessory cardiac bronchus(ACB)and to improve the understanding of this disease.Methods The original MS...Objective To assess the diagnostic value of the airway post-processing technique of multi-slice spiral CT(MSCT)in accessory cardiac bronchus(ACB)and to improve the understanding of this disease.Methods The original MSCT axial images and various post-processing reconstructed images of 9 ACB cases were retrospectively analyzed.Airway post-processing techniques,including multi-planar reformation(MPR),minimum intensity projection(MinIP),volume rendering technique(VRT),CT virtual endoscopy(CTVE)and tissue transition projection(TTP),were employed.Three-dimensional recombination images of bronchial trees were obtained and classified according to the Mangiulea classification.Results Among the 9 cases with ACB,there were 6 cases of accessory-lobed type,3 cases of long diverticular type,and no cases of short diverticular type.The lateral axial images,MPR,MinIP,VRT,CTVE,and TTP all clearly displayed ACB.Among the 6 cases of accessorylobed type,there were 5 cases with accessory lobe dysplasia and one case with pneumonia in an accessory lobe.One case was complicated with accessory lobe emphysema.Among the 3 cases with long diverticular type ACB,one had pneumonia.Among the 9 cases,there was 1 case with old tuberculous focus,1 case with pulmonary fibrous focus,1 case with pleural thickening and adhesion,and 1 case with tracheal diverticulum.Conclusion The airway post-processing technique of MSCT can not only clarify the diagnosis,origin and classification of ACB,but also measure the opening diameter,length and distance to the tracheal carina of ACB.It guides clinical treatment and tracheoscopy,etc,and can be used as the preferred examination method for ACB.展开更多
Blunt traumatic tracheobronchial injury is rare,but can be potentially life-threatening.It accounts for only 0.5%-2%of all trauma cases.Patients may present with non-specific signs and symptoms,requiring a high index ...Blunt traumatic tracheobronchial injury is rare,but can be potentially life-threatening.It accounts for only 0.5%-2%of all trauma cases.Patients may present with non-specific signs and symptoms,requiring a high index of suspicion with accurate diagnosis and prompt treatment.A 26-year-old female was brought into the emergency department after sustained a blunt trauma to the chest from a high impact motor vehicle accident.She presented with signs of respiratory distress and extensive subcutaneous emphysema from the chest up to the neck.Her airway was secured and chest drain was inserted for right sided pneumothorax.CT of the neck and thorax revealed a collapsed right middle lung lobe with a massive pneumothorax,raising the suspicion of a right middle lobe bronchus injury.Diagnosis was confirmed by bronchoscopy.In view of the difficulty in maintaining her ventilation and persistent pneumothorax with a massive air leak,immediate right thoracotomy via posterolateral approach was performed.The right middle lobar bronchus tear was repaired.There were no intra-or post-operative complications.She made an uneventful recovery.She was asymptomatic at her first month follow-up.A repeated chest X-ray showed expanded lungs.Details of the case including clinical presentation,imaging and management were discussed with an emphasis on the early uses of bronchoscopy in case of suspected blunt traumatic tracheobronchial injury.A review of the current literature of tracheobronchial injury management was presented.展开更多
Lung autotransplantation is a new procedure with pulmonary preservation for patients in the treatment of lung cancer. It was used to treat the stage III central lung cancer of the upper lobe in the patient presented h...Lung autotransplantation is a new procedure with pulmonary preservation for patients in the treatment of lung cancer. It was used to treat the stage III central lung cancer of the upper lobe in the patient presented herein when his pulmonary function could not withstand a pneumonectomy and the length of the resected bronchus or pulmonary artery was too long to perform a bronchovascular double sleeve lobectomy.1＇2 In order to preserve pulmonary tissue and improve the quality of life, we performed lung autotransplantation for a case.展开更多
The steady flow behavior in terminal bronchus of human lung for cylindrical channel of porous medium has been studied. The governing equations have been solved analytically and numerically for cylindrical channel. Fin...The steady flow behavior in terminal bronchus of human lung for cylindrical channel of porous medium has been studied. The governing equations have been solved analytically and numerically for cylindrical channel. Finite difference method is incorporated to simulate the problem. The numerical results are compared with square duct channel for different parametric effect. It is observed that the flow rate is increased in cylindrical channel compared to square duct channel for the increasing value of pressure gradient, porosity and permeability. On the contrary, the flow rate is decreased in square duct channel compared to cylindrical channel for increasing value of viscosity. Flow rate in both channels is analyzed and compared for non-porous medium also. It is observed that flow rate is increased very high in cylindrical channel compared to square duct channel for both medium.展开更多
AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion location.METHODS Distance from the incisors and radial orientation were estimated for t...AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion location.METHODS Distance from the incisors and radial orientation were estimated for the main left bronchus and the left atrium landmarks in 207 consecutive patients using white light examination.A sub-study was also performed using white light followed by endoscopic ultrasound(EUS)in 25 consecutive patients to confirm the findings.The scope orientation throughout the exam was maintained at the natural axis,where the left esophageal quadrant corresponds to the area between 6 and 9 o'clock.When an anatomical landmark was identified,it was recorded with a photograph and its quadrant orientation and distance from the incisors were determined.The reference points to obtain the distances and radial orientation were as follows:the midpoint of the left main bronchus and the most intense pulsatile zone of the left atrium.With the video processor system set to moderate insufflation,measurements were obtained at the end of the patients'air expiration.RESULTS The left main bronchus and left atrium esophageal landmarks were identified using white light in 99%and 100%of subjects at a mean distance of 25.8 cm(SD2.3),and 31.4 cm(SD 2.4)from the incisors,respectively.The left main bronchus landmark was found to be a tubular,concave,non-pulsatile,esophageal external compression,occupying approximately 1/4 of the circumference.The left atrium landmark was identified as a round,convex,pulsatile,esophageal external compression,occupying approximately 1/4 of the circumference.Both landmarks were identified using white light on the anterior esophageal quadrant.In the substudy,the left main bronchus was identified in 24(92%)patients at 25.4 cm(SD2.1)and 26.7 cm(SD 1.9)from the incisors,by white light and EUS,respectively.The left atrium was recognized in all patients at 30.5 cm(SD 1.9),and 31.6 cm(SD2.3)from the incisors,by both white light and EUS,respectively.EUS confirmed that the landmarks corresponded to these two structures,respectively,and that they were located on the anterior esophageal wall.The Bland-Altman plot demonstrated high agreement between the white light and EUS measurements.CONCLUSION This study provides an endoscopic characterization of esophageal landmarks corresponding to the left main bronchus and left atrium,to permit radial and longitudinal orientation and accurate lesion location.展开更多
BACKGROUND Glomus tumors(GTs),defined by modified smooth cells and normal glomus body cells,usually present with a small mass occurring in the soft tissue or dermis of an extremity,especially in the subungual region.H...BACKGROUND Glomus tumors(GTs),defined by modified smooth cells and normal glomus body cells,usually present with a small mass occurring in the soft tissue or dermis of an extremity,especially in the subungual region.However,other unusual sites,such as the respiratory tract,have also been reported.They are usually sporadic.Their imaging findings are usually nonspecific and likely to appear as a well-delineated round mass that usually lacks calcification.To our knowledge,we report the first case of bronchial GTs with calcification,reminding clinicians and radiologists that GT is one of the differential diagnoses when a calcified nodular mass is found.CASE SUMMARY We report a case of a 33-yr-old Chinese man with cough and sputum for 11 d and hemoptysis for 5 d.Chest computed tomography revealed a calcified nodular lesion on the compressed posterior wall of the lower left main bronchus and bronchiectasis in the lower lobe of the left lung.To confirm the characteristics of calcified nodules,we performed fiberoptic bronchoscopy.The tumor tissue from the biopsy of bronchial mucosal lesions established the diagnosis of GT.Because the patient had no life-threatening symptoms,he was not treated with surgery.Clinical follow-up for 25 mo showed that the patient survived well without any discomfort.CONCLUSION Bronchial GTs are usually not accompanied by calcification on computed tomography scans.To our knowledge,we report the first calcified bronchial GT.We recommend that clinicians consider GT as a possible differential diagnosis when a calcified mass of the bronchi is found.展开更多
Assessment of human airway humen opening is important in diagnosing and understanding the mechanisms of airway dysfunctions such as the excessive airway narrowing in asthma and chronic obstructive pulmonary disease(CO...Assessment of human airway humen opening is important in diagnosing and understanding the mechanisms of airway dysfunctions such as the excessive airway narrowing in asthma and chronic obstructive pulmonary disease(COPD).Although there are indirect methods to evaluate the airway calibre,direct in vivo measurement of the airway calibre has not been commonly available.With recent advent of the flexible fiber optical nasopharyngoscope with video recording it has become possible to directly visualize the passages of upper and lower airways.However,quan-titative analysis of the recorded video images has been technically challenging.Here,we describe an automatic image processing and analysis method that allows for batch analysis of the images recorded during the endoscopic procedure,thus facilitates image-based quantification of the airway opening.Video images of the airway lumen of volunteer subject were acquired using a fiber optical nasopharyngoscope,and subsequently processed using Gaussian smoothing filter,threshold segment ation,differentiation,and Canny image edge detection,respectively.Thus the area of the open airway lumen was identified and computed using.a predetermined converter of the image scale to true dimension of the imaged object.With this method we measured the opening/narrowing of the glottis during tidal breathing with or without making“Hee"sound or cough.We also used this met hod to measure the opening/narrowing of the primary bronchus of either healthy or asthmatic subjects in response to hist amine and/or albuterol treatment,which also provided an indicator of the airway contractility.Our results demonstrate that the image-based method accurately quantifed the area change waveform of either the glottis or the bronchus as observed by using the optical nasopharygoscope.Importantly,the opening/nar-rowing of the airway lumen generally correlated with the airAow and resistance of the airways,and could differentiate the level of airway contr actility between the healthy and asthmatic subjects.Thus,this quant itative assessment of airway opening may provide a useful tool to ssist clinical diagnosis of airway dysfunctions and understanding the mechanisms of associated pathophysiologies.展开更多
The mediastinum is where thoracic lesions most frequently occur in young patients.The histological spectrum of diseases caused by the presence of several organs in the mediastinum is broad.Congenital lesions,infection...The mediastinum is where thoracic lesions most frequently occur in young patients.The histological spectrum of diseases caused by the presence of several organs in the mediastinum is broad.Congenital lesions,infections,benign and malignant lesions,and vascular diseases are examples of lesions.Care should be taken to make the proper diagnosis at the time of diagnosis in order to initiate therapy promptly.Our task is currently made simpler by radiological imaging techniques.展开更多
Objective: To explore the palliative methods to patients with central airway obstruction due to advanced malignancies. Methods: Twenty-seven patients with carcinous airway obstruction and respiratory distress were eme...Objective: To explore the palliative methods to patients with central airway obstruction due to advanced malignancies. Methods: Twenty-seven patients with carcinous airway obstruction and respiratory distress were emergency remedied, including 12 cases with atelectasis and 23 with pulmonary infection. Soft cryoablated probe of CO2 and/or reticulate endobronchial stent with filmed titanium alloy were placed to the neoplasm following by bronchofibroscope. Results: Totally there were 21 patients achieved completely remission, including airway obstruction, respiratory distress and pulmonary infection remission, and 3 cases got partial remission. Meanwhile there were 3 cases died, in which one was happened during the period of endobronchial stent making, another one with heavy airway obstruction died due to asphyxia 24 h after the operation of bronchofibroscope examination, and the last one with knob invaded died because of hemoptysis and asthema secondarily 36 h after stent placed. Conclusion: The emergency remedy using soft cryoablated probe of CO2 and/or reticulate endobronchial stent with filmed titanium alloy placed to the neoplasm following by bronchofibroscope to patients with malignant central airway obstruction was a effective salvage method and could prolong patients’ lifespan for more subsequent therapeutic opportunities.展开更多
The purpose of this study was to compare among dysplasia of oral, uterine cervix and bronchus. Using a computer cytomorphometry cell measurement program, the study was based on a retrospective review of smear cases di...The purpose of this study was to compare among dysplasia of oral, uterine cervix and bronchus. Using a computer cytomorphometry cell measurement program, the study was based on a retrospective review of smear cases diagnosed with dysplasia of oral, bronchial and uterine cervix, from 2002 to 2010. For 50 - 70 cells from each lesion, nuclear (N) and cytoplasm (C) variables were assessed: area (A), diameter (D), irregularity (I), stain brightness and granularity. NA and ND were highest in OSCC and higher according to dysplastic grading. By contrast, CA and CD were lowest in severe dysplasia. The significant difference of N/C ratio was observed among OSCC to inflammation, mild and moderate dysplasias (p < 0.05). The N/C ratios of mild and moderate dysplasias were equal. Brightness and granularity values of OSCC cases were significantly higher than those of another (p < 0.05). About the difference between mild to moderate dysplasias, it was the easiest to detect of the uterine cervix. All severe dysplasias among the 3 regions were easily identified morphometrically. The deficient in the difference between inflammation to mild dysplasia and mild to moderate dysplasia were obtained in the oral mucosal lesion. The results displayed a significant variation in cytomorphometrical values among the 3 regions. N/C values for uterine cervix and bronchus were well distinguished in comparison with oral dysplasias. Screening of mild and moderate dysplasias requires experience which carries out the comprehensive judgment of the color.展开更多
Objective:To evaluate the efficacy of transbronchoscopic large volume lung lavage in the treatment of pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD).Methods:The clinical data of 80 patient...Objective:To evaluate the efficacy of transbronchoscopic large volume lung lavage in the treatment of pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD).Methods:The clinical data of 80 patients with pneumoconiosis complicated with COPD admitted to our hospital from June 2017 to January 2019 were retrospectively analyzed.40 patients in the control group were treated with conventional drugs and 40 patients in the observation group treated with conventional drugs plus transbronchoscopic large-volume lung lavage.Dyspnea score and healthy quality of life were compared between the two groups.Results:the scores of dyspnea in the observation group were significantly lower than those in the control group at 12,24 and 48 weeks after treatment,and the(SGRQ)scores of George’s respiratory problems questionnaire in the observation group were significantly lower than those in the control group at 12,24 and 48 weeks after treatment.Conclusion:Thetransbronchoscopic large volume of lung lavage has a significant effect on the treatment of pneumoconiosis patients with COPD,which can effectively reduce the degree of dyspnea and improve the quality of life.展开更多
INTRODUCTION An effective coordination of immune and non-immune cells is essential for generating optimal regional immunity to combat tumorigenesis and infection at barrier tissues such as lung.Regional immune structu...INTRODUCTION An effective coordination of immune and non-immune cells is essential for generating optimal regional immunity to combat tumorigenesis and infection at barrier tissues such as lung.Regional immune structures such as inducible bronchus-associated lymphoid tissue(iBALT)and tertiary lymphoid structure(TLS)play essential roles in modulating lung local immune responses.While the identification of iBALTs or TLS is generally dependent on conventional histology,it remains poorly understood how immune cells are spatiotemporally coordinated in the lung at single-cell resolution to effectively eliminate malignant cells and invading pathogens.Recently studies have revealed the presence of dendritic cell(DC)-T immunity hubs in human lung with close association with tumor immunotherapy response[1],antiviral immunity[2],and inflammation resolution[3].展开更多
Background:Tracheal,bronchus,and lung cancer(TBL)is a major cause of mortality and top contributor to productivity loss in large emerging economies such as the BRICS(Brazil,Russia,India,China,and South Africa).We exam...Background:Tracheal,bronchus,and lung cancer(TBL)is a major cause of mortality and top contributor to productivity loss in large emerging economies such as the BRICS(Brazil,Russia,India,China,and South Africa).We examined the time trends of TBL mortality across the BRICS to better understand the disease burden in these countries and inform public health and healthcare resource allocation.Methods:TBL mortality-related data between 1990 and 2019 were obtained from the Global Burden of Disease Study 2019 and analyzed using age–period–cohort models.Net drift(local drift)was used to describe the expected age-adjusted TBL mortality rate over time overall(each age group);the longitudinal age curve was used to reflect the age effect;the period rate ratios(RRs)were used to reflect the period effect;and the cohort RR was used to reflect the cohort effect.Results:In 2019,there were 958.3 thousand TBL deaths across the BRICS,representing 46.9%of the global TBL deaths.From 1990 to 2019,the age-standardized mortality rate(ASMR)of TBL decreased in Russia,Brazil,and South Africa while increased in China and India,with the largest reduction reported in Russia(–29.6%)and the largest increase in China(+22.4%).India showed an overall increase(+15.7%)in TBL mortality but the mortality risk decreased among individuals born after 1990(men)and 1995(women).Although South Africa and Brazil experienced an overall decline in TBL mortality,their recent birth cohorts,such as Brazilian individuals born after 1985(men)and 1980(women),and South African men born after 1995,had an increasing TBL mortality risk.China has experienced an overall increase in TBL mortality,with the mortality risk rising among individuals born after 1995 for both men and women.Russia,which had the highest TBL mortality among the BRICS countries in 1990,has demonstrated significant improvement over the past three decades.Conclusions:Over the past 30 years,the BRICS accounted for an increasing proportion of global TBL mortality.TBL mortality increased in older women in all the BRICS countries except Russia.Among the recent birth cohort,the risk of TBL mortality increased in Brazil,China,and South Africa.More effective efforts are needed in the BRICS to reduce the burden of TBL and help achieve the United Nation’s Sustainable Development Goals.展开更多
基金supported by the Major Program of Scientific and Technical Innovation 2030(grant number:2020AAA0109504)the Science and Technology Planning Project of Beijing City(grant number:Z191100006619116).
文摘Background The Global Cancer Observatory(GLOBOCAN)2022 and the Global Burden of Disease(GBD)2021 are two primary databases for assessing the global cancer burden.This study aimed to compare the incidence and mortality rates of tracheal,bronchus,and lung(TBL)cancer reported in these databases and to analyze the observed discrepancies.Methods Age-standardized rates(ASRs),including age-standardized incidence rates and age-standardized mortality rates for TBL cancer,were obtained from GLOBOCAN 2022 and GBD 2021 for the most recent available year.Differences in ASRs at the national level between the two databases were quantified using pairwise differences,calculated as the absolute difference in ASRs divided by the mean of the ASRs from both sources.Correlations between macroeconomic factors and pairwise differences in ASRs were evaluated,and country features correlated with high pairwise differences were assessed.The data sources and methods used in the two databases were also compared.Results Strong correlations were identified between ASRs reported by GLOBOCAN 2022 and GBD 2021;however,significant differences were observed between estimates from the two data sources.African countries commonly exhibited larger pairwise differences in ASRs,whereas European countries demonstrated smaller pairwise differences in ASRs.Additionally,some populous developing countries,including China,South Africa,Brazil and India,showed smaller differences in ASRs.Countries lacking vital registration systems or high-quality population-based cancer registries displayed larger differences in ASRs.Furthermore,differences in ASRs were negatively correlated with macroeconomic factors.The data sources and estimation methods used by the two databases were inconsistent.Conclusions Discrepancies in TBL cancer incidence and mortality were observed between GLOBOCAN 2022 and GBD 2021.While differences in sources and methods partially explain these discrepancies,a country's cancer surveillance maturity and economic status also correlate with the accuracy of the estimates.Estimating the cancer burden in less wealthy countries remains a substantial challenge,necessitating long-term assistance and investment.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.81673031,81001031,81372285)
文摘Background: Right upper lobectomy(RUL) for lung cancer with di erent dissecting orders involves the most vari?able anatomical structures, but no studies have analyzed its e ects on postoperative recovery. This study compared the conventional surgical approach, VAB(dissecting pulmonary vessels first, followed by the bronchus), and the alter?native surgical approach, a BVA(dissecting the posterior ascending arterial branch first, followed by the bronchus and vessels) on improving surgical feasibility and postoperative recovery for lung cancer patients.Methods: According to the surgical approach, consecutive lung cancer patients undergoing RUL were grouped into a BVA and VAB cohorts. Their clinical, pathologic, and perioperative characteristics were collected to compare periop?erative outcomes.Results: Three hundred one patients were selected(109 in the a BVA cohort and 192 in the VAB cohort). The mean operation time was shorter in the a BVA cohort than in the VAB cohort(164 vs. 221 min, P < 0.001), and less blood loss occurred in the a BVA cohort(92 vs. 141 m L, P < 0.001). The rate of conversion to thoracotomy was lower in the a BVA cohort than in the VAB cohort(0% vs. 11.5%, P < 0.001). The mean duration of postoperative chest drainage was shorter in the a BVA cohort than in the VAB cohort(3.6 vs. 4.5 days, P rvival was n= 0.001). The rates of postoperative complica?tions were comparable(P = 0.629). The median overall suot arrived in both cohorts(P > 0.05). The median disease?free survival was comparable for all patients in the two cohorts(not arrived vs. 41.97 months) and for patients with disease recurrences(13.25 vs. 9.44 months)(both P > 0.05). The recurrence models in two cohorts were also comparable for patients with local recurrences(6.4% vs. 7.8%), distant metastases(10.1% vs. 8.3%), and both(1.8% vs. 1.6%)(all P > 0.05).Conclusions: Dissecting the right upper bronchus before turning over the lobe repeatedly and dissecting veins via the a BVA approach during RUL would promote surgical feasibility and achieve comparable postoperative recovery for lung cancer patients.
文摘<strong>Objective:</strong> To investigate the rescue and nursing process of a trauma patient with multiple injuries and rupture of the right main bronchus.<strong> Methods:</strong> A patient with multiple injuries and rupture of the right main bronchus admitted to the emergency department of the Shenzhen Hospital of the University of Hong Kong was selected as the research object on December 11, 2019. <strong>Results:</strong> In this case, the medical team treated the patient under the guidance of ATLS (Advanced Traumatic Life Support), and for the first time in our department, we used bronchoscopy to replace the double-lumen endotracheal tube for left lung single-lung ventilation, finally the patient was successfully treated. <strong>Conclusion:</strong> Through a literature search, it is found that the main bronchus rupture is less common in clinical practice. In the trauma group, the use of fiberoptic bronchoscopy and the replacement of a double-lumen tracheal tube for left lung single-lung ventilation can improve the treatment rate of such patients and is worthy of clinical application.
文摘Increasing epidemiological evidence supports the view, that quercetin has protective roles in a multitude of disease states in human who have a high intake of polyphenols. To investigate the ability of quercetin and its rutinoside, rutin, to modulate the relaxation of human airways smooth muscle and to determine the mechanism (s) of such relaxation, isolated human bronchus rings were suspended in individual organ baths, precontracted with acetylcholine or with histamine and the relaxing effects of quercetin and rutin were determined by measurement of isometric tension. Quercetin induced concentration-dependent relaxant responses on acetylcholine or histamine precontracted human bronchial rings and with almost equal effectiveness. In terms of potency (pD2) and efficacy (Emax), quercetin is more potent than rutin on relaxant responses of human bronchus. K+ and Ca2+ concentration-dependent contraction curves were inhibited after incubation with increasing concentrations of quercetin. Quercetin potentiated in a concentration-dependent manner the relaxant effects of isoprenaline or sodium nitroprusside. Rutin had no effect on K+-induced contraction and on relaxant activity of isoprenaline or sodium nitroprusside. Our results suggest that the bronchodilator effects of quercetin are modulated by an increase in cyclic nucleotide levels as well as an alteration in availability of Ca2+ to the contractile machinery.
文摘BACKGROUND Primary carcinoma ex pleomorphic adenoma arising from the tracheobronchial system is rarely reported.CASE SUMMARY We present a patient with primary carcinoma ex pleomorphic adenoma of the bronchus and review the associated literature for further comparison,including age,clinical manifestations,and diagnostic process.This patient had no history of neoplasms of the salivary gland.CONCLUSION Positron emission tomography played an important role in the staging work-up of primary carcinoma of ex pleomorphic adenoma.Long-term follow-up was necessary for further prognosis analysis.
文摘Objective： The aim of our study was to introduce the surgical method and evaluate the efficacy of double sleeve Iobectomy of the bronchus and the pulmonary artery in treatment for the central lung cancer. Method： From March 1995 to October 2010, double sleeve Iobectomy of the bronchus and the pulmonary artery was performed in 45 cases with central lung cancer that involved the bronchial opening of an upper lobe of the lungs or the main bronchus and＇pulmonary artery but didn＇t involve any lower lobes. Among them, left upper Iobectomy was performed in 37 cases, right medium-upper Iobectomy was performed in 6 cases and right upper Iobectomy was performed in 2 cases. Results： Postoperative complications were found in 12 cases. Among them, 3 cases were arrhythmia, 1 case was acute heart failure, 6 cases were obstructive pneumo-nia and pulmonary atelectasis, 2 cases were bronchial anastomotic fistula. Two cases died of cerebral infarction and massive hemoptysis respectively. Thirty-one cases were squamous carcinoma, 7 cases were adenocarcinoma, 4 cases were small cell lung cancer, 1 case was adenosquamous carcinoma, 1 case was sarcomatoid carcinomas, 1 case was mucinous adeno- carcinoma. Ten cases were T3NOM0, 11 cases were T3N 1M0, 17 cases were T3N2M0, 2 cases were T4N 1M0, 5 cases were T4N2M0. The 1-year, 3-year, 5-year survival rates were 84.4% （38/45）, 51.7% （15/29）, 53.8% （7/13） respectively. Conclu-sion： The double sleeve Iobectomy of the bronchus and the pulmonary artery can maximumly reserve the normal lung tissues while removing tumors, and avoid pneumonectomy. The surgery was safe and effective, while it required a high technique.
文摘Objective To assess the diagnostic value of the airway post-processing technique of multi-slice spiral CT(MSCT)in accessory cardiac bronchus(ACB)and to improve the understanding of this disease.Methods The original MSCT axial images and various post-processing reconstructed images of 9 ACB cases were retrospectively analyzed.Airway post-processing techniques,including multi-planar reformation(MPR),minimum intensity projection(MinIP),volume rendering technique(VRT),CT virtual endoscopy(CTVE)and tissue transition projection(TTP),were employed.Three-dimensional recombination images of bronchial trees were obtained and classified according to the Mangiulea classification.Results Among the 9 cases with ACB,there were 6 cases of accessory-lobed type,3 cases of long diverticular type,and no cases of short diverticular type.The lateral axial images,MPR,MinIP,VRT,CTVE,and TTP all clearly displayed ACB.Among the 6 cases of accessorylobed type,there were 5 cases with accessory lobe dysplasia and one case with pneumonia in an accessory lobe.One case was complicated with accessory lobe emphysema.Among the 3 cases with long diverticular type ACB,one had pneumonia.Among the 9 cases,there was 1 case with old tuberculous focus,1 case with pulmonary fibrous focus,1 case with pleural thickening and adhesion,and 1 case with tracheal diverticulum.Conclusion The airway post-processing technique of MSCT can not only clarify the diagnosis,origin and classification of ACB,but also measure the opening diameter,length and distance to the tracheal carina of ACB.It guides clinical treatment and tracheoscopy,etc,and can be used as the preferred examination method for ACB.
文摘Blunt traumatic tracheobronchial injury is rare,but can be potentially life-threatening.It accounts for only 0.5%-2%of all trauma cases.Patients may present with non-specific signs and symptoms,requiring a high index of suspicion with accurate diagnosis and prompt treatment.A 26-year-old female was brought into the emergency department after sustained a blunt trauma to the chest from a high impact motor vehicle accident.She presented with signs of respiratory distress and extensive subcutaneous emphysema from the chest up to the neck.Her airway was secured and chest drain was inserted for right sided pneumothorax.CT of the neck and thorax revealed a collapsed right middle lung lobe with a massive pneumothorax,raising the suspicion of a right middle lobe bronchus injury.Diagnosis was confirmed by bronchoscopy.In view of the difficulty in maintaining her ventilation and persistent pneumothorax with a massive air leak,immediate right thoracotomy via posterolateral approach was performed.The right middle lobar bronchus tear was repaired.There were no intra-or post-operative complications.She made an uneventful recovery.She was asymptomatic at her first month follow-up.A repeated chest X-ray showed expanded lungs.Details of the case including clinical presentation,imaging and management were discussed with an emphasis on the early uses of bronchoscopy in case of suspected blunt traumatic tracheobronchial injury.A review of the current literature of tracheobronchial injury management was presented.
文摘Lung autotransplantation is a new procedure with pulmonary preservation for patients in the treatment of lung cancer. It was used to treat the stage III central lung cancer of the upper lobe in the patient presented herein when his pulmonary function could not withstand a pneumonectomy and the length of the resected bronchus or pulmonary artery was too long to perform a bronchovascular double sleeve lobectomy.1＇2 In order to preserve pulmonary tissue and improve the quality of life, we performed lung autotransplantation for a case.
文摘The steady flow behavior in terminal bronchus of human lung for cylindrical channel of porous medium has been studied. The governing equations have been solved analytically and numerically for cylindrical channel. Finite difference method is incorporated to simulate the problem. The numerical results are compared with square duct channel for different parametric effect. It is observed that the flow rate is increased in cylindrical channel compared to square duct channel for the increasing value of pressure gradient, porosity and permeability. On the contrary, the flow rate is decreased in square duct channel compared to cylindrical channel for increasing value of viscosity. Flow rate in both channels is analyzed and compared for non-porous medium also. It is observed that flow rate is increased very high in cylindrical channel compared to square duct channel for both medium.
基金(in part)a grant in aid from the Emura Foundation for the Promotion of Cancer Research,No.01221
文摘AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion location.METHODS Distance from the incisors and radial orientation were estimated for the main left bronchus and the left atrium landmarks in 207 consecutive patients using white light examination.A sub-study was also performed using white light followed by endoscopic ultrasound(EUS)in 25 consecutive patients to confirm the findings.The scope orientation throughout the exam was maintained at the natural axis,where the left esophageal quadrant corresponds to the area between 6 and 9 o'clock.When an anatomical landmark was identified,it was recorded with a photograph and its quadrant orientation and distance from the incisors were determined.The reference points to obtain the distances and radial orientation were as follows:the midpoint of the left main bronchus and the most intense pulsatile zone of the left atrium.With the video processor system set to moderate insufflation,measurements were obtained at the end of the patients'air expiration.RESULTS The left main bronchus and left atrium esophageal landmarks were identified using white light in 99%and 100%of subjects at a mean distance of 25.8 cm(SD2.3),and 31.4 cm(SD 2.4)from the incisors,respectively.The left main bronchus landmark was found to be a tubular,concave,non-pulsatile,esophageal external compression,occupying approximately 1/4 of the circumference.The left atrium landmark was identified as a round,convex,pulsatile,esophageal external compression,occupying approximately 1/4 of the circumference.Both landmarks were identified using white light on the anterior esophageal quadrant.In the substudy,the left main bronchus was identified in 24(92%)patients at 25.4 cm(SD2.1)and 26.7 cm(SD 1.9)from the incisors,by white light and EUS,respectively.The left atrium was recognized in all patients at 30.5 cm(SD 1.9),and 31.6 cm(SD2.3)from the incisors,by both white light and EUS,respectively.EUS confirmed that the landmarks corresponded to these two structures,respectively,and that they were located on the anterior esophageal wall.The Bland-Altman plot demonstrated high agreement between the white light and EUS measurements.CONCLUSION This study provides an endoscopic characterization of esophageal landmarks corresponding to the left main bronchus and left atrium,to permit radial and longitudinal orientation and accurate lesion location.
基金Supported by The Study on the Diagnosis and Treatment of COPD Complications Complicated With Diseases,China,No.2016YFC1304500.
文摘BACKGROUND Glomus tumors(GTs),defined by modified smooth cells and normal glomus body cells,usually present with a small mass occurring in the soft tissue or dermis of an extremity,especially in the subungual region.However,other unusual sites,such as the respiratory tract,have also been reported.They are usually sporadic.Their imaging findings are usually nonspecific and likely to appear as a well-delineated round mass that usually lacks calcification.To our knowledge,we report the first case of bronchial GTs with calcification,reminding clinicians and radiologists that GT is one of the differential diagnoses when a calcified nodular mass is found.CASE SUMMARY We report a case of a 33-yr-old Chinese man with cough and sputum for 11 d and hemoptysis for 5 d.Chest computed tomography revealed a calcified nodular lesion on the compressed posterior wall of the lower left main bronchus and bronchiectasis in the lower lobe of the left lung.To confirm the characteristics of calcified nodules,we performed fiberoptic bronchoscopy.The tumor tissue from the biopsy of bronchial mucosal lesions established the diagnosis of GT.Because the patient had no life-threatening symptoms,he was not treated with surgery.Clinical follow-up for 25 mo showed that the patient survived well without any discomfort.CONCLUSION Bronchial GTs are usually not accompanied by calcification on computed tomography scans.To our knowledge,we report the first calcified bronchial GT.We recommend that clinicians consider GT as a possible differential diagnosis when a calcified mass of the bronchi is found.
基金supported by grants from Natural Science Foundation of China(Grant No.11172340)Training Program for Hundreds of Distinguished Leading Scientists of Chongqing,Chongqing Natural Science Foundation(Project No.CSTC,2010BA5001)Sharing Fund of Chongqing University Large-Scale Equipment(Nos.2010063057,2011063048,and 2011063049).
文摘Assessment of human airway humen opening is important in diagnosing and understanding the mechanisms of airway dysfunctions such as the excessive airway narrowing in asthma and chronic obstructive pulmonary disease(COPD).Although there are indirect methods to evaluate the airway calibre,direct in vivo measurement of the airway calibre has not been commonly available.With recent advent of the flexible fiber optical nasopharyngoscope with video recording it has become possible to directly visualize the passages of upper and lower airways.However,quan-titative analysis of the recorded video images has been technically challenging.Here,we describe an automatic image processing and analysis method that allows for batch analysis of the images recorded during the endoscopic procedure,thus facilitates image-based quantification of the airway opening.Video images of the airway lumen of volunteer subject were acquired using a fiber optical nasopharyngoscope,and subsequently processed using Gaussian smoothing filter,threshold segment ation,differentiation,and Canny image edge detection,respectively.Thus the area of the open airway lumen was identified and computed using.a predetermined converter of the image scale to true dimension of the imaged object.With this method we measured the opening/narrowing of the glottis during tidal breathing with or without making“Hee"sound or cough.We also used this met hod to measure the opening/narrowing of the primary bronchus of either healthy or asthmatic subjects in response to hist amine and/or albuterol treatment,which also provided an indicator of the airway contractility.Our results demonstrate that the image-based method accurately quantifed the area change waveform of either the glottis or the bronchus as observed by using the optical nasopharygoscope.Importantly,the opening/nar-rowing of the airway lumen generally correlated with the airAow and resistance of the airways,and could differentiate the level of airway contr actility between the healthy and asthmatic subjects.Thus,this quant itative assessment of airway opening may provide a useful tool to ssist clinical diagnosis of airway dysfunctions and understanding the mechanisms of associated pathophysiologies.
文摘The mediastinum is where thoracic lesions most frequently occur in young patients.The histological spectrum of diseases caused by the presence of several organs in the mediastinum is broad.Congenital lesions,infections,benign and malignant lesions,and vascular diseases are examples of lesions.Care should be taken to make the proper diagnosis at the time of diagnosis in order to initiate therapy promptly.Our task is currently made simpler by radiological imaging techniques.
文摘Objective: To explore the palliative methods to patients with central airway obstruction due to advanced malignancies. Methods: Twenty-seven patients with carcinous airway obstruction and respiratory distress were emergency remedied, including 12 cases with atelectasis and 23 with pulmonary infection. Soft cryoablated probe of CO2 and/or reticulate endobronchial stent with filmed titanium alloy were placed to the neoplasm following by bronchofibroscope. Results: Totally there were 21 patients achieved completely remission, including airway obstruction, respiratory distress and pulmonary infection remission, and 3 cases got partial remission. Meanwhile there were 3 cases died, in which one was happened during the period of endobronchial stent making, another one with heavy airway obstruction died due to asphyxia 24 h after the operation of bronchofibroscope examination, and the last one with knob invaded died because of hemoptysis and asthema secondarily 36 h after stent placed. Conclusion: The emergency remedy using soft cryoablated probe of CO2 and/or reticulate endobronchial stent with filmed titanium alloy placed to the neoplasm following by bronchofibroscope to patients with malignant central airway obstruction was a effective salvage method and could prolong patients’ lifespan for more subsequent therapeutic opportunities.
文摘The purpose of this study was to compare among dysplasia of oral, uterine cervix and bronchus. Using a computer cytomorphometry cell measurement program, the study was based on a retrospective review of smear cases diagnosed with dysplasia of oral, bronchial and uterine cervix, from 2002 to 2010. For 50 - 70 cells from each lesion, nuclear (N) and cytoplasm (C) variables were assessed: area (A), diameter (D), irregularity (I), stain brightness and granularity. NA and ND were highest in OSCC and higher according to dysplastic grading. By contrast, CA and CD were lowest in severe dysplasia. The significant difference of N/C ratio was observed among OSCC to inflammation, mild and moderate dysplasias (p < 0.05). The N/C ratios of mild and moderate dysplasias were equal. Brightness and granularity values of OSCC cases were significantly higher than those of another (p < 0.05). About the difference between mild to moderate dysplasias, it was the easiest to detect of the uterine cervix. All severe dysplasias among the 3 regions were easily identified morphometrically. The deficient in the difference between inflammation to mild dysplasia and mild to moderate dysplasia were obtained in the oral mucosal lesion. The results displayed a significant variation in cytomorphometrical values among the 3 regions. N/C values for uterine cervix and bronchus were well distinguished in comparison with oral dysplasias. Screening of mild and moderate dysplasias requires experience which carries out the comprehensive judgment of the color.
基金Social Benefiting Project by Science and Technology for Ningxia Hui Autonomous Region:Comprehensive Demonstration of Integrated Prevention and Control Technology of Pneumoconiosis in Ningdong Coal Mine(Project No.:KJHM201503)。
文摘Objective:To evaluate the efficacy of transbronchoscopic large volume lung lavage in the treatment of pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD).Methods:The clinical data of 80 patients with pneumoconiosis complicated with COPD admitted to our hospital from June 2017 to January 2019 were retrospectively analyzed.40 patients in the control group were treated with conventional drugs and 40 patients in the observation group treated with conventional drugs plus transbronchoscopic large-volume lung lavage.Dyspnea score and healthy quality of life were compared between the two groups.Results:the scores of dyspnea in the observation group were significantly lower than those in the control group at 12,24 and 48 weeks after treatment,and the(SGRQ)scores of George’s respiratory problems questionnaire in the observation group were significantly lower than those in the control group at 12,24 and 48 weeks after treatment.Conclusion:Thetransbronchoscopic large volume of lung lavage has a significant effect on the treatment of pneumoconiosis patients with COPD,which can effectively reduce the degree of dyspnea and improve the quality of life.
基金supported by Grants from the National Key R&D Program of China(2023YFA1801400)National Natural Science Foundation of China(92374115 and 82388201).
文摘INTRODUCTION An effective coordination of immune and non-immune cells is essential for generating optimal regional immunity to combat tumorigenesis and infection at barrier tissues such as lung.Regional immune structures such as inducible bronchus-associated lymphoid tissue(iBALT)and tertiary lymphoid structure(TLS)play essential roles in modulating lung local immune responses.While the identification of iBALTs or TLS is generally dependent on conventional histology,it remains poorly understood how immune cells are spatiotemporally coordinated in the lung at single-cell resolution to effectively eliminate malignant cells and invading pathogens.Recently studies have revealed the presence of dendritic cell(DC)-T immunity hubs in human lung with close association with tumor immunotherapy response[1],antiviral immunity[2],and inflammation resolution[3].
基金supported by the China National Natural Science Foundation(Nos.72104113,72293585,and 72204112)the Fundamental Research Funds for the Central Universities(No.30923011101)the Social Science Fund of Jiangsu Province(No.21GLD008).
文摘Background:Tracheal,bronchus,and lung cancer(TBL)is a major cause of mortality and top contributor to productivity loss in large emerging economies such as the BRICS(Brazil,Russia,India,China,and South Africa).We examined the time trends of TBL mortality across the BRICS to better understand the disease burden in these countries and inform public health and healthcare resource allocation.Methods:TBL mortality-related data between 1990 and 2019 were obtained from the Global Burden of Disease Study 2019 and analyzed using age–period–cohort models.Net drift(local drift)was used to describe the expected age-adjusted TBL mortality rate over time overall(each age group);the longitudinal age curve was used to reflect the age effect;the period rate ratios(RRs)were used to reflect the period effect;and the cohort RR was used to reflect the cohort effect.Results:In 2019,there were 958.3 thousand TBL deaths across the BRICS,representing 46.9%of the global TBL deaths.From 1990 to 2019,the age-standardized mortality rate(ASMR)of TBL decreased in Russia,Brazil,and South Africa while increased in China and India,with the largest reduction reported in Russia(–29.6%)and the largest increase in China(+22.4%).India showed an overall increase(+15.7%)in TBL mortality but the mortality risk decreased among individuals born after 1990(men)and 1995(women).Although South Africa and Brazil experienced an overall decline in TBL mortality,their recent birth cohorts,such as Brazilian individuals born after 1985(men)and 1980(women),and South African men born after 1995,had an increasing TBL mortality risk.China has experienced an overall increase in TBL mortality,with the mortality risk rising among individuals born after 1995 for both men and women.Russia,which had the highest TBL mortality among the BRICS countries in 1990,has demonstrated significant improvement over the past three decades.Conclusions:Over the past 30 years,the BRICS accounted for an increasing proportion of global TBL mortality.TBL mortality increased in older women in all the BRICS countries except Russia.Among the recent birth cohort,the risk of TBL mortality increased in Brazil,China,and South Africa.More effective efforts are needed in the BRICS to reduce the burden of TBL and help achieve the United Nation’s Sustainable Development Goals.
