In the field of respiratory medicine, the use of endoscopy is involved in almost all diseases, both diagnostic and therapeutic. In recent years, respiratory endoscopy technology has developed significantly, which has enabled us to make great progress in the diagnosis and treatment of respiratory diseases. Specifically, it is reflected in the following aspects: a. Lesion display technology: In the past, the diagnosis of lung cancer was made by biopsy only when there were obvious lesions under the microscope, and it was difficult to deal with the lesions if they were not visible. At present, new respiratory endoscopy techniques make many examinations that were previously impossible to be performed by ordinary bronchoscopy possible, and can play a greater role in early diagnosis of lung cancer and clinical staging of lung cancer. For example, fluorescence bronchoscopy and narrow-spectrum bronchoscopy can detect tumors earlier and define the margins of tumors and the scope of surgery more precisely. Confocal endoscopy technology, which has the advantage of magnifying the lesion many times and using its own fluorescence to observe the morphology of cells, can determine whether the patient has tumor in the first place, is currently in the development stage and has good prospects for development. Second, bronchoscopic navigation technology: this is a type of technology that has been developing rapidly in recent years, mainly for the diagnosis and treatment of lesions in the periphery of the lung or outside the lumen that cannot be seen in the lumen. One of them is the virtual bronchial technique, in which a virtual bronchial image is reconstructed by CT and indicates the path to reach the lesion. The physician can refer to these images during the operation to achieve a synchronized travel with the simulated images and guide the physician to the lesion site. Next is electromagnetic navigation technology, which uses the principle of electromagnetic induction to perform localization. The CT examination is performed first and the image information is input into the computer, just like the electronic map of the GPS positioning system. And then the location of the lesion is found on the map. The biopsy forceps or treatment instruments have an electronic navigation coil at the head end, and their position in the magnetic field can be sensed by the induction coil, and then compared with the electronic images in the computer to determine the location where the biopsy or treatment instruments arrive. Ultrasound bronchoscopy technology is also a type of navigation technology. Ultrasound allows deep access to extra-luminal lesions and needle aspiration biopsy to obtain the lesion tissue. For lesions in extra-luminal lymph nodes, ultrasound bronchoscopy can now be used to puncture lesions that cannot be seen by conventional bronchoscopy, allowing patients who previously required more invasive procedures such as open chest or mediastinoscopy to obtain a definitive diagnosis to obtain diagnostic results through less invasive methods, enabling diagnosis and precise analysis of tumors and guiding surgical procedures. Ultra-fine bronchoscopy technology. It can reach very small bronchus to observe the lesion, and the patient suffers very little pain during the examination, and it can access to the 8th level bronchus. Third, interventional techniques for airway lesions. Tumors or other lesions invade or compress the airway and cause breathing difficulties in patients. To relieve the obstruction, the lumen needs to be propped up or removed. Airway narrowing is divided into two types of techniques: those that reduce tissue volume and those that dilate or support the airway. In the first category of techniques to reduce tissue volume include: 1. Rigid bronchoscopy, which is inserted and removed directly from the tumor tissue very quickly. The safety is very high due to the good control of the airway. Our country has not done enough, in foreign countries this is a necessary technology, because it is both safe and valuable for the treatment of complex airway lesions. 2, cryo-technology, from freezing to rewarming, so that the tumor tissue necrosis, but also through the freezing probe to remove the tumor. 3, thermal ablation technology, including electrodesiccation, argon plasma coagulation, electrocoagulation laser, microwave and other means. The volume is abated by heating the tissue and causing vaporization to occur. Comparing the two techniques of hot and cold, cryotherapy is suitable for benign lesions that do not penetrate outside the lumen and is safe for dealing with lesions close to the canal wall to avoid perforation. Hot therapy cuts quickly and is suitable for cases where urgent relief of obstruction is needed, and treatment bleeds less.4. Photochemical ablation. This technique is relatively mature, but the drug is likely to cause adverse reactions in patients, photosensitivity, and expensive and other disadvantages, and also prone to some complications. 5.Radiation ablation. This technique is not yet carried out, and requires precise calculation of irradiation dose and cooperation of radiotherapists. 6.Chemical ablation. The efficacy of this method has yet to be evaluated. In the second category of airway dilatation techniques: techniques to make the lumen dilate, broadly include dilatation by three techniques: rigidoscopic dilatation, balloon and stent use. Scleroscopy is used only during surgery to allow dilatation of the narrowed area. Long-term treatment is mainly by means of balloons and stents. Balloon dilation requires the support structure to be intact, and when the support structure is incomplete, only stents can be used. At present, putting in stents in benign lesions is a big problem and needs further standardization. Fourth, the treatment methods for chronic respiratory diseases: this is an area of rapid progress in recent years. It is mainly reflected in two aspects: one is chronic obstructive pulmonary disease (COPD), and the other is asthma. In the case of COPD, emphysema is one of the main manifestations. It can be treated by two means: (a) the method of pulmonary decongestion. The current method of lung decongestion has achieved better results. By removing or collapsing the over-inflated, non-functional target lung tissue and reducing the lung volume, it is possible to restore lung compliance to the remaining better functioning lung tissue, reduce airway resistance, relieve dyspnea symptoms in patients with emphysema, and improve quality of life. 1. Bronchoscopic reduction of lung volume with a single live valve. At present, it has good effect on properly selected patients, and the improvement of FEV1 in some patients reaches more than 25%, which far exceeds the efficacy of drugs and can significantly improve the quality of life of patients. However, the key at present is to select the right patient and target site for treatment.2. Other methods of volume reduction include the use of spring wire to shrink the lung, thermal steam treatment to necrosis some lung tissues with severe emphysema), and biogel plugging of distal hyperemphysemic lungs and bronchi to collapse and reduce volume in these areas. All of these techniques have some potential, but none of them have been formally applied clinically and are still in the stage of research to evaluate the indications and contraindications of these different approaches. 2, Another type of approach to treat COPD is bypass therapy. In the case of obstruction of airflow in normal channels, an artificial channel is created by drilling holes in the bronchial wall and placing stents to form an artificial channel to be able to reduce emphysema, but there are certain surgical risks. The company that developed this technology has gone out of business and its future is worrisome. In Europe, we are currently studying the bypass method, in which an opening is made in the chest wall and a one-way valve is placed, so that gas can only go out but not in. For bronchial asthma, the current method of radiofrequency, treatment of asthma patients with poor results of drug therapy, clinical trial results have proved effective. 3, endoscopic thoracoscopy: At present, local anesthesia is not required, only a hole is needed, and a rigid mirror was used in the early days. Through thoracoscopy, pleural diseases can be treated. Especially for persistent pleural fluid (malignant or benign) or recurrent pneumothorax), the technique of spraying adhesives via endoscopic thoracoscopy to make pleural adhesions and reduce the occurrence of pleural fluid or pneumothorax is practical and effective. 4.Progress in general endoscopy: The technique of needle aspiration biopsy of bronchus is relatively mature, which can significantly improve the diagnosis rate of tumor and help staging. However, if the lesion is small, the positivity rate is low. In terms of biopsy technique, some people have come in to use frozen biopsy technique to obtain larger tissues, which can improve the positive rate of diagnosis. 5, training: At present, there are about 20,000 respiratory doctors nationwide, but there are still not many of them who master or are proficient in endoscopic techniques, which is a bottleneck in the development of respiratory discipline. 2011, the Chinese Medical Association Respiratory Branch established the Interventional Respiratory Group, which plays a good role in the development of this field. Several training programs have been carried out and training standards are being established so that respiratory endoscopy techniques can be standardized, popularized and improved.