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Chongqing Medical University established respiratory system course group and implemented "organ-systems-based curriculum" (OSBC) integration teaching reform.OSBC teaching of respiratory system broke the traditional disciplinary-centred teaching pattern,adopted the disease-centred and clinicaloriented teaching curriculum.The course group carried on the comprehensive reorganization to the curriculum contents and the teaching personnel,compiled integrated teaching materials,optimized teaching methods and evaluation system.OSBC teaching of respiratory system has so far made some achievements,but the integration of different disciplines,the teaching ability of teachers and the students' coordination with OSBC courses still need to be further improved.
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Objective To research the effects of different titers of bacteriophage D29 on growth and function of airway epithelial cell 9HTE.Methods Cell viability rates was analyzed after applying high(109 PFU/mL)and low(107 PFU/mL)titers of bacteriophage D29 and phage buffer respectively by MTT colorimetry.Additionally,the secretion levels of IL-6,IL-8 in cell culture supernatant were detected by ELISA.RT-PCR was performed to detect the expression of ICAM-1 mRNA.Cell apoptosis rate was analyzed by flow cytometry.Results There was no difference in cell growth,secretion levels of IL-6,IL-8,ICAM-1 mRNA and cell apoptosis rate between cells treated with high and low titers of D29 and phage buffer(P>0.05).Conclusion Neither high nor low titer of bacteriophage D29 exerts effect on growth and function of airway epithelial cell 9HTE in vitro.
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Objective·To investigate and compare the clinical characteristic of non-organic dyspnea and asthma both with complaint of dyspnea.Methods·Seventy-four consecutive patients with non-organic dyspnea,and 74 age-,height-,weight and sex-matched patients with asthma were recruited for investigation in the study.The self-assessment surveys were conducted for the two groups by means of Hospital Anxiety and Depression Scale,Nijmegen Questionnaire and Athens Insomnia Scale.The words for describing dyspnea,clinical symptoms,effective sleep hours and items of pulmonary function test were collected and analyzed Results·Non-organic dyspnea patients tended to describe psychogenic aspects.Asthma patients tended to describe airflow limitation.Non-organic dyspnea group mainly performed psychogenic symptoms.The sleeping time in non-organic dyspnea group was significantly lower than that in asthma group(P<0.05).The score of anxiety,depression,Nijmegen Questionnaire,Athens Insomnia Scale,FEV1,FEV1%Pred,FVC%Pred,FEV1/FVC in non-organic dyspnea group were significantly higher than those in asthma group (P<0.05).There was no significant difference in FVC between two groups(P>0.05).Conclusion·The non-organic group feel more anxiety,depressed and insomnic than the asthma group.Lung function test of asthma group is often abnormal.To discriminate non-organic dyspnea with asthma,clinicians should pay more attention to emotion,sleep,somatoform symptoms,medical history and so on,and do pulmonary function test,improve the understanding of the characteristics of the two diseases,decrease misdiagnosis and wrong diagnosis.
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Objective·To construct recombinant mycobacteriophage TM4-RpfE to lay a foundation for experimental research about how to eradicate Mycobacterium tuberculosis in combination with anti-tuberculosis drugs,and how to shorten treatment for tuberculosis ultimately.Methods·Electrotransformation was used to introduce pJV53 plasmid into Mycobacterium smegmatis to prepare recombinant engineering bacteria.After amplification of hsp60-RpfE fusion gene by overlap PCR,a long gene fragment (homologous +hsp60-RpfE+homologous,HHRH) was amplified by multi-step overlap PCR.The DNA of mycobaeteriophage TM4 and HHRH fragment were cotransfected into the recombinant engineering bacteria by electrotransformation,then the recombinant phage from the single primary plaques were confirmed by PCR and sequencing.SDS-PAGE was used to analyze the protein expression in recombinant phage.Results·The hsp60-RpfE fusion gene at the length of 901 bp and HHRH fragment at the length of 1 873 bp were identified by overlap PCR.The PCR product produced 955 bp and 301 bp DNA bands in the first generation plaques colony.SDS-PAGE analysis showed a specific protein band at 21 000 in the recombinant phages.Conclusion·The recombinant mycobacterium phage TM4-RpfE was successfully constructed and the expression of target gene RpfE was initially verified.
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Standardized training of resident doctors is the golden stage for clinicians to establish good clinical thinking. Although respiratory disease is common, there are serious and critical diseases, which need to develop clinical thinking and improve the analytical ability. The resident physicians' instructor should help residents to establish the correct diagnostic thinking through the following means: clinical demonstration teaching show, guidance of reading the relevant literature and books, strengthening the basic skills of collecting patients' history and physical examination, and guidance of appropriate use of auxiliary examination and analysis of the results. For the treatment thinking, solid theoretical knowledge and life-long learning ideas and habits can improve the successful rate of initial treatment. Furthermore, being familiar with the efficacy evaluation system and analyzing the reasons for the success and failure of the treatment will help the residents to develop a good therapeutic thinking. The good clinical thinking established by the residents in the department of respiration will be conducive to their own follow-up specialist training and career development.
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Objective To identify the cross-reactive antigens shared by Mycobacteria smegmatis(MS) and Mycobacteria tuberculosis(MTB) and to analyze their antigenicity.Methods Bacterial antigens were extracted from strains of MS and MTB by ultrasonication.Western blot assay was performed to analyze common antigens that reacted with both of the antiserum samples against MS and MTB.The extracted bacterial antigens were mixed with incomplete Freund′s adjuvant and then were injected into muscles of mice.Cytokines secreted by murine spleen lymphocytes following stimulation with various antigens of MS and MTB were determined by ELISPOT and flow cytometry on the 7th day.IgG levels in serum samples were detected by ELISA 7 days after injection.Results There were cross-reactive antigens shared by MS and MTB.Potent humoral immune responses and cellular immunity against both MS and MTB could be induced by those cross-reactive antigens after sensitization the mice by either MS or MTB antigens.Cytokines of IL-2 and IFN-γ in CD4+ and CD8+T cells of mice stimulated with MS or MTB antigens were significantly increased as compared with those of non-sensitization group and those of Brucella antigens stimulation group.ConclusionCross-reactive antigens shared by MS and MTS can effectively promote specific immune reactions to the infection of MTB, which provides a scientific basis for the development of tuberculosis vaccines.
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Objective To examine the distribution and antibiotic resistance proifle of the bacterial isolates from lower respiratory tract of hospitalized patients for better empirical therapy.Methods A total of 3 155 lower respiratory tract specimens were collected from Respiratory Department of the First Afifliated Hospital of Chongqing Medical University in 2013 to identify bacterial pathogens for susceptibility testing. The results were compared with the data of 2011 and 2012.Results The top three bacterial species from lower respiratory tract in the period from 2011 to 2013 wereA. baumannii,P. aeruginosa, andK. pneumoniae. The prevalence ofS. aureusincreased, while the prevalence ofS. maltophilia andS. pneumoniae was still low.A. baumannii isolates were highly resistant to antibiotics. Not more than 40% of these strains were susceptible to the antimicrobial agents except minocycline, which was active against more than 60% of the ICU and non-ICU strains. More than 70% of theP. aeruginosa strains from non-ICU were susceptible to cefepime, meropenem, imipenem, levofloxacin, and ciprofloxacin in the three years, 50%-70% of the strains from ICU were susceptible to the antimicrobial agents tested. Carbapenem-resistantA. baumannii andP. aeruginosa strains were identiifed.S. maltophilia strains were relatively susceptible to minocycline and levolfoxacin. All the S. aureus isolates were susceptible to vancomycin, linezolid, and tigecycline. The prevalence of MRSA increased year by year. More than 80% of theK. pneumoniae andE. coli strains were susceptible to imipenem, piperacillin-tazobactam, and cefepime. ESBLs-producingK. pneumoniae was identified. More than 85% of theH. influenzae strains were susceptible to meropenem, ceftazidime, cefuroxime, ciprolfoxacin, levolfoxacin, and amoxicillin-clavulanate potassium. All theS. pneumoniae isolates were susceptible to vancomycin, and 80%-96% of these strains were susceptible to levofloxacin and penicillin.ConclusionsA. baumannii,P. aeruginosa, andK. pneumoniae are the top three bacterial species isolated from lower respiratory tract. Carbapenem-resistantA. baumannii,P. aeruginosa and ESBLs-producingK. pneumoniaeare emerging. The prevalence of MRSA is increasing year by year, which poses a challenge to antimicrobial therapy. It is urgent to contain and control the growing antibiotic resistance.
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Objective To evaluate the efficacy and safety of laryngeal mask in flexible bronchoscopy diagnosis and treatment by meta-analysis. Methods Domestic and international literatures about clinical researches on flexible bron-choscopy diagnosis and treatment by laryngeal mask and other methods in Pub Med, Cochranelibrary, CBM, CNKI, Wanfang Data online knowledge service platform from January 2000 to January 2014 were collected and screened in accordance with inclusion and exclusion criteria strictly, and Rev Man 5.0 software was used for Meta-analysis. Results 11 RCTs were included with a total of 684 cases of patients, including 292 cases in laryngeal mask group and 392 cases in non-laryngeal mask group. Firstly, the operative time in laryngeal mask group was shorter than that in the non-laryn-geal mask group (P<0.05). Secondly, the increases of intraoperative cardiac rate and mean arterial pressure in laryngeal mask group were smaller than those in the non-laryngeal mask group (P<0.05).Thirdly, the incidences of intraoperative operation interruption, hypoxemia, cough and limb movements in laryngeal mask group were lower than those in the non-laryngeal mask(P<0.05). Conclusion It is effective and safe to use laryngeal mask for flexible bronchoscopy treat-ment and laryngeal mask is able to shorten the operation time, reduce the instability of intraoperative vital signs, and increase operation fluency.
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To investigate the biological characteristics of mycobacteriophage Leo and its bactericidal effect on Mycobacterium tuberculosis for cocktail therapy ,we observed mycobacteriophage plaques after amplifying phage by double‐layer agar plate method .The morphological characteristics were observed by electron microscopy .Mycobacteriophage Leo DNA was extracted and then digested by restriction enzyme to identify the nucleic acid type .Leo was amplified in different multiplicity of infection (MOI) to find the optimal MOI and the minimum MOI .One step growth experiment was carried out to find the latent period and burst size of Leo .The frequency of Mycobacterium smegmatis mutation treated with mycobacteriophage Leo was inspected by the endpoint titration test .The effect of temperature and alcohol on Leo survival was surveyed .The ability of Leo to crack host bacteria at different pH values was examined .The effect of Leo on Mycobacterium tuberculosis was determined by bacteri‐cidal assay .Results showed that the Leo plaque was round and transparent with a diameter of 1 .5 nm .Leo has an isometric head (70 ± 3 .0 nm in diameter) and a flexible tail (211 ± 31 .7 nm in length) .Its genome could be digested by restriction en‐zyme of Hind Ⅲ and Bgl Ⅰ .The optimal MOI and the minimum MOI of Leo were 0 .000 01 and 0 .000 1 ,respectively .The mutation frequency was 10-7 .The latent period was 150 min ,and the burst size was 74 .Leo could not only crack host bacteria in solid medium at pH 7 .4 but also at pH 5 .0 .After 72 hours ,the amount of Mycobacterium tuberculosis in Leo group was less than that in control group (P<0 .05) .In conclusion ,Leo has a bactericidal effect on Mycobacterium tuberculosis and could be a candidate of phage cocktails .
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Objective To investigate the clinical feature on pulmonary complications after renal transplantation,in order to provide the evidence of prevention and treatment of pulmonary complications.Methods The clinical data of 125 renal transplant re-cipients in the First Affiliated Hospital of Chongqing Medical University from December 2006 to December 2011 were studied retro-spectively.To analyze and summarize the clinical characteristics of postoperative pulmonary complications including the incidence, the time of onset,etiology or risk factors,treatment,outcome,et al.Results Twenty-three patients(18.4%)developed pulmonary complications after renal transplantation.The most frequent complication was pulmonary infection(n = 22,17.6%),followed by pleural effusion(n=12,9.6%),pulmonary edema(n= 7,5.6%),respiratory tract bleeding(n=4,3.2%),acute lung graft versus host reaction(n=1,0.8%)and atelectasis(n= 1,0.8%).Conclusion Pulmonary infection,pleural effusion and pulmonary edema are common pulmonary complications after renal transplantation.Patients who develop pulmonary infection and pulmonary edema have a poor prognosis.
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Objective To investigate the clinical efifcacy of Tiotropium Bromide inhaler on patients with stable chronic obstructive pulmonary disease(COPD). Methods 134 cases with stable COPD were equally randomized into three groups. The conventional treatment group(n=46) were 40 male and 6 femal, aged (63.20±9.3)years old and treated with sustained-release theophylline 0.1 g orally. Observation group with 18μg Tiotropium Bromide(n=45) were 40 male and 5 femal, aged (63.4±85)years old, and given inhaled Tiotropium Bromide 18μg. Observation group with 32μg Tiotropium Bromide(n=43) were 39 male and 4 femal, aged (63.2±9.0)years old, and given inhaled Tiotropium Bromide 32 μg. All patients received same routine therapy, and lasted for 4 weeks. improvement Pre-and post-treatment Lung function and quality of life were compared among those groups. Results In observation group, the results of St George respiratory questionnaire decreased signiifcantly after treatment, which was signiifcantly lower than those of the routine-treatment group (P<0.05). FEV 1/FVC, FEV 1/Pred, FEV 1 were signiifcantly higher than those before treatment (P<0.05). However, the control group showed no signiifcant difference. Conclusion Inhaled Tiotropium Bromide can improve lung function and life quality of paitents with stable COPD, the dose with 32μg per day, which was signiifcantly lower than 18μg per day.
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Objective To investigate the clinical characteristics and risk factors of pulmonary infection after allogeneic hemato-poietic stem cell transplantation(allo-HSCT) .Methods The clinical data of 37 allo-HSCT patients treated in our transplantation u-nit from 2010 to 2012 were performed the retrospective analysis .Results Among 17 cases of allo-HSCT ,33 case-times of pulmona-ry infection occurred after transplantation ,in which more than twice pulmonary infection occurred in 11 cases ,the total occurrence rate of pulmonary infection was 45 .9% (17/37) .5 cases directly died of pulmonary infection .Only 39 .4% case-times of pulmonary infection had the pathogenic evidence .Fungal infection ,especially Candida albicans ,was predominant .The univariate analysis showed that pulmonary infection was significantly associated with human leucocyte antigen (HLA) non-identical of donor and recip-ient and graft versus host disease(GVHD)(P=0 .041 ,0 .013) ,and had no obvious correlation with the other factors (P>0 .05) . The multivariate analysis showed that the HLA non-identical of donor and recipient and GVHD were significantly associated with the occurrence of pulmonary infection (P=0 .041 ,0 .021) .Conclusion Postoperative pulmonary infection is a common complication following allo-HSCT ,which has larger threat to the patients .HLA non-identical and GVHD are significantly correlated with pulmo-nary infection after allo-HSCT .
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<p><b>OBJECTIVE</b>This study aimed to review the available literatures on control of latent tuberculosis (TB) infection and propose a new control strategy to shorten the course of TB chemotherapy.</p><p><b>DATA SOURCES</b>The data used in this review were mainly obtained from articles listed in PubMed. The search terms were "therapy (treatment) of tuberculosis," "therapy (treatment) of latent TB infection," and "vaccine of TB."</p><p><b>STUDY SELECTION</b>Articles regarding treatment and vaccine of TB were selected and reviewed.</p><p><b>RESULTS</b>The most crucial reason causing the prolonged course of TB chemotherapy is the dormant state of Mycobacterium tuberculosis (M. tuberculosis). Nevertheless, there are, to date, no effective drugs that can directly kill the dormant cells of M. tuberculosis in clinical therapy. In accordance with the growth cycle of dormant M. tuberculosis in the body, the methods for controlling dormant M. tuberculosis include direct killing with drugs, prevention of dormant M. tuberculosis resuscitation with vaccines, and resuscitating dormant M. tuberculosis with preparations or drugs and then thoroughly killing these resuscitated M. tuberculosis by using anti-TB therapy.</p><p><b>CONCLUSIONS</b>The comprehensive analysis of the above three methods suggests that the drugs directly killing dormant cells are in clinical trials, TMC207 is the most beneficial for controlling TB. Because the side effect of vaccines is less and their action period is long, prevention of dormant cells resuscitation with vaccines is promising. The last control method makes it probable that when a huge number of active cells of M. tuberculosis have been killed and eradicated after 1-month short chemotherapy, only a strong short-term subsequent chemotherapy can completely kill and eradicate the remaining M. tuberculosis. This control strategy is expected to significantly shorten the course of TB chemotherapy and bring a new change and breakthrough in TB treatment.</p>
الموضوعات
Humans , Antitubercular Agents , Therapeutic Uses , Diarylquinolines , Therapeutic Uses , Latent Tuberculosis , Drug Therapy , Mycobacterium tuberculosis , Virulence , Tuberculosis , Drug Therapyالملخص
Objective To investigate smoking status,knowledge of smoking hazards,attitude of tobacco control and skill of assisting smoking cessation of the staff in a teaching hospital in Chongqing and to provide references for the further construction of‘smoking-free hospital’. Methods General investi-gation was taken on the staff in a teaching hospital in Chongqing with a self-designed questionnaire. Main contents of questionnaire include:social demographic information,smoking status,awareness of tobacco hazard,willingness and methods of tobacco control,etc. All the data were inputted with software Epidata 3.1 and were analyzed with SPSS 13.0. Results The total smoking rate was 9.65%,with 30.49%for male, 2.75%for female and 12.50%for clinician. The age distribution of smoking staff was described as follow-ing:91.97% being under 50 year-old and more than 50.00% being 20-35 year-old. 52.43% of the surveyed did not know Framework Convention of Tobacco Control of WHO . Relatively ,most of the surveyed only knew well the relationship between respiratory diseases and tobacco use and the relation-ship between fetal abnormalities and tobacco use. 84.99%of the surveyed agreed with outdoor-smoking policy;83.56%of the surveyed claimed that they had discouraged smoking behaviors in public at various extents,14.20%of the surveyed agreed that assisting the public in smoking cessation was one of the aims of constructing‘smoking-free hospital’;70.00%clinicians claimed routinely inquiring and noting smok-ing status of patients, which was better than nurses and medical technicians;almost 30.00%clinic staff did not know quitting smoking drugs at all,approximately 70.00%clinic staff claimed a lack of confidence in smoking control and approximately 70.00% clinicians and nurses did not recommend pro-fessional methods of smoking cessation in practice. Conclusions Smoking staff in the teaching hospital are almost younger people,which is an alarm of the urgent need for tobacco control education. Most staff reach a consensus on keeping smoking-free environment in hospital,but they do not sufficiently acknowledge their social responsibility for tobacco control,and also there is a distance before they can serve as a smok-ing cessation assistant. Tobacco control must be incorporated in long-term mechanism of hospital con-struction. There are three steps in the construction of smoking-free hospital:①creating a smoking-free en-vironment in hospital;②encouraging patients to quit smoking and providing professional service of smoking cessation;③making a positive effort on social tobacco control and advocating smoking cessation in public.
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Objective To assess the effect of the Asthma Healthy Breathing Center on healthy behaviour of asthma patients . Methods Asthma Healthy Breathing Center management mode including asthma specialist out-patient ,asthma health mission cen-ter and asthma patients club .Doctors ,nurses and patients participated jointly in standard treatment ,systematic education manage-ment on asthma patients .the change of treating patients and self management present situation ,the symptoms and lung ventilation function of 144 asthma patients from January 2010 to January 2011 before and after the management were studied .Results After standardization management treatment ,accept and use of inhaled steroid ,correct use of inhaled drugs method ,insisting on drug treatment ,abuse of antibiotics and composition of unknown traditional Chinese medicine(TCM)of 144 patients have been improved significantly from 41 .67% ,20 .14% ,26 .39% ,68 .75% to 93 .06% ,95 .14% ,94 .44% ,6 .25 respectively (P<0 .05) .Knowledge of asthma self-management ,adhere to the peak current meter monitoring used ,records of asthma diary ,health education activities have been improved significantly from 12 .50% ,5 .56% ,5 .56% ,13 .89% to 75 .00% ,88 .89% ,88 .89% ,95 .83% (P<0 .05) .ACT as-sessment ,FEV1 predicated value ,PEF predicated value have been improved from 15 .00 ± 3 .34 ,60 .2 ± 13 .50 ,63 .65 ± 11 .23 to 23 . 00 ± 2 .23 ,77 .6 ± 8 .30 ,80 .00 ± 6 .50(P<0 .05) .Conclusion Establishing Asthma Healthy Breathing Center can significantly im-prove the patient′s health behavior ,and it indicated that establish Prompt construction area slow disease control and prevention cen-ter is effective and necessary for the treatment of patients with asthma .
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In order to improve the Interns’ synthetic medical quality of respiratory medicine, based on the teaching practice of respiratory medicine in our hospital, the analysis of admission introduction and requests for high quality medical ability are reviewed in the present article.
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Objective:To evaluate the value and safety of intrathoracic blood transfusion in the treatment of obstinate pneumothorax.Methods:A dose of 400ml matched blood was poured into the pleural cavity of twelve patients with obstinate pneumothorax.Results:After the transfusion of blood ten patients were cured in l h to 2.5d.The total cure rate was 83.3% and the recurrent rate was 10% with chest pain as only side-effect occurred in 8.3% of the sufferers.Comparatively,the parameters observed in the control group of erythromycin injection were 2~13d,61.5%,25% and 46.2%,respectively.Conclusion:This study shows that transfusion of blood into pleural cavity have a potential role in treating obstinate pneumothorax.
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Objective To investigate the inhibitive effects of biosynthesized short hairpin RNA(shRNA)on the duplication of Influenza A virus(IAV)in human bronchial epithelium(HBE)cells.Methods NP-shRNA and PA-shRNA targeting to the highly conservative sequences of IAV nucleoprotein(NP)and acidic RNA polymerase(PA)were designed and biosynthesized by in vitro transcription,and then were inserted into the plasmid pGenSil-1.After sequencing analysis,the recombinant plasmids NP-shRNA and/or PA-shRNA were transduced into HBE cells followed by infected with IAV A/PR/8/34 H1N1(A/PR8)virus.The cytopathogenic effect(CPE)of the HBE cells,hemagglutination assay(HA)and 50% tissue culture infective dose(TCID50)titer of A/PR8 in the culture supernatants were determined respectively.The mRNA and protein expressions of NP and PA were detected by RT-PCR and Western blotting respectively,and the results were compared in order to evaluate the inhibitive efficiency of NP-shRNA and/or PA-shRNA to A/PR8 duplication in HBE cells.Results The content of NP-shRNA and PA-shRNA biosynthesized by in vitro transcription were respectively 59.4 nmol and 50.6 nmol in each 100 ?l.The purity was more than 2.0 and the sequences were verified to be correct after sequencing analysis.The CPE of HBE cells and the virus titer in the culture supernatants of cells transfected with NP-shRNA,PA-shRNA or NP-shRNA+PA-shRNA were markedly lower than those of the control groups.In 3 h after 1 TCID50 A/PR8 infection,the mRNA level of NP in NP-shRNA group,the mRNA level of PA in PA-shRNA group and those in NP-shRNA+PA-shRNA group were 41.7%,43.4%,68.5% and 73.7% respectively,lower than those of the control group.At 48 h after 1 TCID50 A/PR8 infection,NP synthesis were 92.3%,84.0% and 91.7% respectively of those of the control group.Conclusion Anti-IAV NP-shRNA and PA-shRNA are successfully prepared by in vitro transcription.Both of those markedly inhibit the reproduction of IAV A/PR8 and produce a favorable protective effect on HBE cells.
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0.05), but for the DCs with low DC-SIGN expression, the ability was much lower than those of the other group did (P
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0.05). Conclusion Lentivirus-mediated RNAi of DC-SIGN gene suppresses the gene expression on the surface of DCs effectively,but had no effect on the maturity and functions of DCs.