PurposeTo analyze the clinical features of foreign-body aspiration into the lower airway in geriatric patients.Patients and methodsThe clinical data of 17 geriatric patients with foreign-body aspiration were retrospectively analyzed and compared with 26 nongeriatric adult patients. The data were collected from Peking University First Hospital and Anhui Chest Hospital between January 2000 and June 2014.Results(1) In the geriatric group, the most common symptoms were cough and sputum (15 cases, 88%), dyspnea (six cases, 35%), and hemoptysis (four cases, 24%). Five patients (29%) in the geriatric group could supply the history of aspiration on their first visit to doctor, a smaller percentage than in the nongeriatric group (13 cases, 50%). Only three cases in the geriatric group were diagnosed definitely without delay. Another 14 cases were misdiagnosed as pneumonia or lung cancer, and the time of delayed diagnosis ranged from 1 month to 3 years. Complications due to delay in diagnosis included obstructive pneumonitis, atelectasis, lung abscess, and pleural effusion. (2) Chest computed tomography demonstrated the foreign body in three cases (21%) in the geriatric group, which was lower than the positive proportion of detection in the nongeriatric group (nine cases, 35%). The most common type of foreign body in the geriatric group was food, such as bone fragments (seven cases, 41%) and plants (seven cases, 41%), and the foreign body was most often lodged in the right bronchus tree (eleven cases, 65%), especially the right lower bronchus (seven cases, 41%). Flexible bronchoscopy removed the foreign body successfully in all patients.ConclusionThe clinical features of foreign-body aspiration in geriatric patients are usually more obscure than in nongeriatric adults, which may lead to long delay in diagnosis. Flexible bronchoscopy is safe and useful for early diagnosis and effective management in geriatric patients. We suggest flexible bronchoscopy as the first-line approach to similar patients, especially those with aspiration history and unexplained pneumonia.

PurposeCayenne aspiration is an unusual type of foreign-body aspiration that is usually misdiagnosed. This article analyzes the clinical features of cayenne aspiration in the lower airway.Patients and methodsClinical data on eight adult patients with cayenne aspiration were retrospectively analyzed. Six were elderly patients. The data were collected from Peking University First Hospital and Anhui Chest Hospital between January 2010 and August 2014.ResultsThe most common symptoms of cayenne aspiration were cough (eight cases, 100%) and sputum (five cases, 62.5%). Only one patient (12.5%) could supply the history of aspiration on his first visit to doctor and was diagnosed definitely without delay. The other seven cases were misdiagnosed as pneumonia and the time to accurate diagnosis was from 1 month to 6 months. The history of aspiration could be recalled after confirmed diagnosis for the other seven cases. The most common presentation shown by chest computed tomography (CT) was pneumonic opacity (eight cases, 100%). The existence of cayenne could not be detected by chest CT in any of the patients. All the patients were diagnosed definitively and managed successfully with flexible bronchoscopy. Cayenne was more often lodged in the right bronchus tree (seven cases, 87.5%), especially the right lower bronchus (four cases, 50%). The segment of cayenne was complete in five cases (62.5%) and scattered in three cases (37.5%).ConclusionThe clinical features of cayenne aspiration are usually obscure and nonspecific which may lead to delay in diagnosis. Flexible bronchoscopy is safe and useful for early diagnosis and effective management.

Background: The nutritional status affects gene expression in peripheral T lymphocytes; nevertheless, the link between nutritional status and immunity of cancer patients is unclear. The aim of the research was to evaluate the connection with nutritional parameters and the frequencies of T cells subsets on peripheral blood in non-small cell lung cancer (NSCLC) patients. Methods: We enrolled 170 NSCLC patients and 53 healthy volunteers who were age- and gender-matched. The frequencies of circulating CD3+, CD4+, CD8+, naïve CD4+, memory CD4+, naïve CD8+, memory CD8+, and regulatory T lymphocytes were assessed by the way of flow cytometry. Nutritional parameters including albumin, globulin, albumin-to-globulin ratio (AGR), total protein (TP), pre-albumin (PA), body mass index (BMI), and prognostic nutritional index (PNI), were also evaluated.Results: Low globulin levels and high AGR were associated with high frequencies of naïve CD8+ T lymphocytes (P = 0.039 and P = 0.018). Obese (BMI ≥ 25) Compare with the non-obese (BMI < 25) patients, the percentages of CD8+ T lymphocytes in NSCLC patients had decreased (P = 0.026). Between in other nutritional parameters and the frequency of circulating lymphocyte subsets had no significant correlation.Conclusions: Our findings show that nutritional status should influence the frequencies of peripheral T cell subsets in NSCLC patients.