The patient was a male, 67 years old, admitted to the hospital on 2011-4-4 with the main cause of cough, coughing and tightness of breath after activity for six months, aggravated with fever for 4 days. Diagnosis: secondary pulmonary tuberculosis of the left lung, Tu (to be investigated), retreatment, secondary pulmonary infection, type II respiratory failure pulmonary encephalopathy shock, electrolyte disturbance – hyponatremia, post-appendectomy The patient developed cough and sputum with no obvious cause six months ago, the sputum was white mucous sputum, the amount was not much, accompanied by tightness of breath after activity, no special diagnosis and treatment was given. He was admitted to our intensive care unit (ICU) on April 4 after being treated with flu fluids for one day, but his symptoms were not relieved. The patient was hospitalized in our hospital for tuberculosis in April 2008 and May 2009; he underwent appendectomy in February 2009, and had a smoking history of more than 30 years and had quit smoking for 10 years. He had been a smoker for more than 30 years and had quit smoking for 10 years. His blood count and neutrophil percentage were significantly elevated. Blood gas analysis was performed for type II respiratory failure, blood biochemistry: sodium and chloride were significantly decreased, and troponin was elevated. Bedside chest radiograph showed: left-sided destruction and compensatory emphysema of the right lung. On admission: clear consciousness, slightly cyanotic lips, shortness of breath, slightly filled jugular veins, a few wet bow provisions could be heard in both lungs. On the second day of admission, the patient’s shortness of breath was obvious with increased heart rate and decreased urine output, and the airway was poorly dilated with gastridium, and non-invasive ventilator assisted ventilation was given. On the third day of hospitalization, the patient became confused at night and did not respond to the call, and the bilateral cone of resentment was 87/56 mmHg. Consider combined pulmonary encephalopathy with shock. The patient was treated with transoral tracheal intubation with invasive ventilator-assisted ventilation and dopamine and other drugs to raise the pressure. On the fifth day of admission, the patient’s vital signs were stable and blood pressure returned to normal. On the morning of day 6, the patient suddenly developed hemoptysis of about 50 ML, which was treated with additional hemostatic drugs. On the 8th day, the sputum culture result was reported as Escherichia coli and Candida albicans, and the patient was treated with Tylenol and Fluconazole according to the drug sensitivity. On the 9th day, the tracheal intubation was successfully removed and replaced by non-invasive ventilator-assisted ventilation, and venturi mask oxygenation was changed at night. On the same day, a chest X-ray was performed and the right pneumothorax was found. After closed chest drainage, the patient improved significantly and the closed chest drainage tube was removed on day 10. Now the patient’s vital signs are stable, without any discomfort, and was successfully saved.