ObjectiveTo investigate the efficacy of preoperative nebulized indocyanine green (ICG)-assisted thoracoscopic anatomical lesion resection (TALR) in treating pediatric congenital pulmonary airway malformation (CPAM). MethodsA retrospective analysis was conducted on clinical data of 45 children with CPAM who underwent thoracoscopic surgery at the Third Affiliated Hospital of Zhengzhou University between June 2023 and March 2025. The patients were divided into an ICG group (preoperative nebulized ICG 0.5 mg/kg+TALR) and a non-ICG group (TALR under white light), with perioperative and postoperative recovery parameters compared between groups. ResultsA total of 45 children [22 males, 23 females; median age 7.4 (1.1-75.0) months] were enrolled. The ICG group (n=22) and non-ICG group (n=23) both achieved uneventful recoveries. Compared to the non-ICG group, the ICG group demonstrated significantly shorter surgical duration [91.3 (38.0, 144.0) min vs. 100.0 (50.0, 175.0) min, P=0.032], reduced intraoperative blood loss [3.0 (2.0, 10.0) mL vs. 5.0 (1.0, 10.0) mL, P=0.049], shorter postoperative drainage duration [2.7 (1.9, 3.9) d vs. 3.4 (1.8, 19.9) d, P=0.003], and shortened hospital stay [4.6 (2.9, 9.8) d vs. 5.0 (3.9, 21.5) d, P=0.013]. Residual lesions occurred in 2 patients from the non-ICG group but none in the ICG group. Intragroup comparisons revealed significant improvements in peak inspiratory flow ratio, tidal volume ratio, and normalized tidal volume per kilogram after surgery in both groups (P<0.05), though intergroup differences showed no statistical significance (P>0.05). ConclusionPreoperative nebulized ICG administration facilitates lesion identification in CPAM, reduces technical difficulty of TALR, enhances therapeutic outcomes, and provides valuable assistance for performing TALR procedures.
Acute pharyngitis belongs to the category of "acute throat impediment" in traditional Chinese medicine (TCM), which has a high incidence and is easy to recur. In clinical practice of TCM, Chinese patent medicines with the effects of clearing heat and detoxifying, reducing swelling and relieving pain are widely used in the treatment of acute pharyngitis. These medicines have the advantages of definite efficacy, low side effects, and low risk of developing drug resistance. However, at present, there are no standardized clinical diagnostic and therapeutic evaluation norms for acute pharyngitis in TCM, which has hindered the application of TCM in the prevention and treatment of acute pharyngitis and the development of new TCM preparations. Therefore, the China Association of Chinese Medicine initiated this expert consensus, which was led the formulation by Xiyuan Hospital, China Academy of Chinese Medical Sciences. This expert consensus integrates the current best evidence and extensive clinical expert experience from the front line, covering seven aspects: applicable scope, diagnosis in both Chinese and Western medicine, syndrome classification and evaluation scales, basis for efficacy evaluation, and time for efficacy evaluation. It has formed 8 types of TCM syndromes for acute pharyngitis, as well as the diagnostic criteria, syndrome classification and evaluation scales, evaluation basis for efficacy, and scoring standards for syndromes and diseases. This expert consensus can be used to standardize the diagnosis of the TCM syndromes of acute pharyngitis, as well as the core indicators and evaluation methods for syndrome and disease efficacy, with the aim of providing references for clinical practice and scientific research on acute pharyngitis.
Acute pharyngitis is a common respiratory disease. The combination of traditional Chinese and Western medicine has been proven effective in alleviating pharyngeal pain and systemic symptoms, as well as reducing the use of antibiotics. However, standardized clinical practice guideline was lacking. To address this, the Ear, Nose and Throat Medicines Research Professional Committee of the China Association of Chinese Medicine, in collaboration with over 20 domestic hospitals, has formed a multidisciplinary expert team of both Chinese and Western medical practitioners. Following the principles, methods, and steps of evidence-based guideline development, we identified clinical issues (three background questions and seven clinical questions) through literature review and expert consensus. Based on existing evidence-based guidelines at domestic and overseas, and the results of systematic reviews/meta-analyses, they considered the quality of evidence, weighed the pros and cons of intervention measures, and took into account patient preferences and values. Through the Delphi expert consensus meeting, we formulated 27 recommendations covering the assessment, laboratory and imaging tests, identification of danger signals, and both Chinese and Western medical treatment and prevention measures for acute pharyngitis.
