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Objective:To explore the effect of introducing mixed reality technology into traditional atlas teaching to teach airway anatomy under bronchoscopy.Methods:A total of 30 Batch 2017 fifth-year clinical medicine students from Shanghai Jiao Tong University School of Medicine were randomly divided into control group and test group by RAND function in Excel, with 15 students in each group. The control group was taught with the traditional bronchoscopic atlas teaching, and the test group was combined with mixed reality technology. The two groups had the same class time. After teaching, the teaching effect was evaluated by examination and evaluation questionnaire. SPSS 25.0 software was conducted for t test and Mann-Whitney U test. Results:The average score after teaching of test group was (61.67±20.15), and that of control group was (36.67±13.32), with statistically significant differences ( t=4.01, P<0.001). According to the questionnaire results, the scores of the test group on course understanding, course concentration, participation, mastery and satisfaction were better than those of the control group, and the differences were statistically significant ( P<0.05). Conclusion:Using mixed reality technology to assist the clinical teaching of airway anatomy under bronchoscopy can improve the quality of students' study and enhance their understanding of the teaching content and students' participation passion, achieving better teaching effect.
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SUMMARY: Obesity is a worldwide epidemic that has become a risk factor for the development of respiratory problems, meaning it is necessary to generate models that assess lung function in obese patients for proper treatment. The objective of this study was to evaluate a model for analyzing respiratory function according to body composition, by analyzing the structure and function of the airways by computed tomography (CT). Lung function and body fat percentage (BF%) were measured in three male subjects (25 ± 6 years), with different body mass index (BMI; normal, overweight, obese). A third-dimensional (3D) reconstruction of the airways was performed using CT. Trachea, right and left main bronchi and anterior segmental bronchus of the right and left lung were measured. Three measurement points were established for each structure, and the average value of these three points was used for the analysis. An increase in the thickness of the airways wall of the left and right main bronchi and right segmental bronchus was observed as BMI and BF% increased. The same was observed for the percentage of airway wall area (%AWA) and airway resistance in the main and segmental bronchi. The proposed 3D reconstruction model and the three-point analysis simplified image assessment and allowed to observe the problems caused by obesity in lung function.
RESUMEN: La obesidad es una epidemia mundial, la que se ha transformado en un factor de riesgo en el desarrollo problemas respiratorios. Al respecto, generar modelos de evaluación de la función pulmonar en pacientes obesos es relevante para su adecuado tratamiento. El objetivo de este trabajo fue evaluar un modelo de la estructura y función de las vías aéreas (VA) con tomografía computarizada (TC) que permita analizar su compor- tamiento de acuerdo a la composición corporal. A tres sujetos de sexo masculino (25±6 años), de distinto índice de masa corporal (IMC; normal, sobrepeso, obeso), se les midió función pulmonar y porcentaje de grasa corporal (% GC). A través de TC se realizó una reconstrucción en tercera dimensión (3D) de las VA. Se realizaron mediciones de las VA de la tráquea, bronquios principales derecho e izquierdo y bronquio segmentario anterior del pulmón derecho e izquierdo. Para cada estructura se establecieron tres puntos de medición, el valor utilizado para los análisis fue el promedio de estos tres puntos. En los tres participantes se observó un aumento del grosor de la pared de las vías aéreas de los bronquios principal derecho e izquierdo y bronquio segmentario derecho a medida que aumenta el IMC y el % GC. Por otra parte, el porcentaje de área de la pared de las vías aéreas (% APVA) se comportó de la misma manera para ambos bronquios principales y segmentarios. La resistencia de las vías aéreas (RVA), tanto general como específica, aumentó en paralelo con el % APVA en los bronquios principales y segmentarios. A través de un modelo de reconstrucción 3D de la estructura de la VA por TC, evaluando tres puntos, se pudo observar los problemas que trae la obesidad a la función pulmonar simplificando el análisis de imagen.
Subject(s)
Humans , Male , Adult , Young Adult , Respiratory Function Tests/methods , Respiratory System/diagnostic imaging , Tomography, X-Ray Computed/methods , Airway Resistance/physiology , Imaging, Three-Dimensional , Respiratory System/anatomy & histology , Respiratory Physiological Phenomena , Body Composition , Body Mass Index , Pilot Projects , Anthropometry , Overweight , Lung/physiology , ObesityABSTRACT
OBJECTIVE:To investigate the effects of leukotriene receptor antagonist montelukast on inflammatory factor,air-way anatomy and lung function of children with cough variant asthma. METHODS:A total of 86 children with cough variant asth-ma selected from our hospital during Apr. 2010 to Aug. 2015 were divided into control group and observation group according to random number table,with 43 cases in each group. Control group was given Budesonide aerosol 0.4 mg,bid;observation group was given Montelukast sodium chewable tablets with different dose according to age(4 mg for 2-6 year-old,tid;5 mg for 7-12 year-old,tid).A treatment course of 2 groups lasted for 4 weeks,and both groups received 2 courses of treatment. The levels of inflammatory factor,airway anatomy and lung function indexes were detected in 2 groups before and after treatment,and the oc-currence of ADR was also observed. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). Compared to before treatment,the levels of IL-4,IL-6,IL-8,TNF-α and hs-CRP in 2 groups were de-creased significantly after treatment;airway wall thickness,basement membrane thickness,airway wall thickness/outside diameter ratio,total area of airway wall,total area of airway wall/total area of airway were decreased significantly,while FVC,FEV1, FEV1/FVC,PEF were increased significantly;the indexes in observation group were significantly better than control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:For pediatric cough variant asthma,montelukast can significantly improve inflammatory reaction,airway status and lung function with good safety.
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OBJECTIVE:To investigate the effects of leukotriene receptor antagonist montelukast on inflammatory factor,air-way anatomy and lung function of children with cough variant asthma. METHODS:A total of 86 children with cough variant asth-ma selected from our hospital during Apr. 2010 to Aug. 2015 were divided into control group and observation group according to random number table,with 43 cases in each group. Control group was given Budesonide aerosol 0.4 mg,bid;observation group was given Montelukast sodium chewable tablets with different dose according to age(4 mg for 2-6 year-old,tid;5 mg for 7-12 year-old,tid).A treatment course of 2 groups lasted for 4 weeks,and both groups received 2 courses of treatment. The levels of inflammatory factor,airway anatomy and lung function indexes were detected in 2 groups before and after treatment,and the oc-currence of ADR was also observed. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). Compared to before treatment,the levels of IL-4,IL-6,IL-8,TNF-α and hs-CRP in 2 groups were de-creased significantly after treatment;airway wall thickness,basement membrane thickness,airway wall thickness/outside diameter ratio,total area of airway wall,total area of airway wall/total area of airway were decreased significantly,while FVC,FEV1, FEV1/FVC,PEF were increased significantly;the indexes in observation group were significantly better than control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:For pediatric cough variant asthma,montelukast can significantly improve inflammatory reaction,airway status and lung function with good safety.
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BACKGROUND: Damage to teeth has long been associated with endotracheal intubation. But, no rules designed to predict dental injuries have been formulated. In this prospective study, we undertook to identify relationships between anatomic airway measurements used customarily in bedside practice, and blade-tooth distance during laryngoscopy, to assess the usefulness of these anatomic measurements as predictors of dental injury. METHODS: Four hundred and eighty-three patients scheduled for elective surgery requiring general anesthesia with endotracheal tube placement were included. During a preoperative visit, a number of measurements and assessments of features that might predict difficult intubation were performed. When optimum visibility of the glottis was obtained during laryngoscopy, the distance between the flange of the blade and the upper incisor was measured. We determined which of the individual airway characteristics correlated with the blade-tooth distance and best predicted the potential of dental injury. RESULTS: The blade-tooth distance was found to correlate with the individual scales of the Mallampati classification (Spearman's correlation coefficient, r = - 0.356, P < 0.01), mandibular protrusion (r = - 0.390, P < 0.01), head and neck movement (r = - 0.276, P < 0.01), interincisor gap (r = - 0.648, P < 0.01), and the condition of the upper teeth (r = - 0.313, P < 0.01). The frequency of direct blade-tooth contact significantly increased as the scales of these five anatomic measurements increased (P < 0.01). CONCLUSIONS: This study shows for the first time that some airway measurements are correlated with blade-tooth distance, and that they can be considered as useful predictors of dental injury during laryngoscopy.
Subject(s)
Humans , Anesthesia, General , Classification , Glottis , Head , Incisor , Intubation , Intubation, Intratracheal , Laryngoscopy , Neck , Prospective Studies , Tooth , Weights and MeasuresABSTRACT
BACKGROUND: Unexpected failed mask ventilation can result in brain damage or death. The purpose of this study was to demonstrate that the tests for predicting difficult tracheal intubation can be used to predict difficult mask ventilation in Koreans. METHODS: One hundred ninety one patients were assessed before operation using the modified Mallampati test and by measuring the atlanto-occipital angle (AOA), thyromental distance (TM), hyomental distance (HM), sternomental distance (SM), and horizontal length of mandible (HLM). The mask ventilation grades and the laryngeal grades were determined. The sensitivities, specificities and positive predictive values of tests were calculated. RESULTS: Eleven patients (5.7%) had difficulty in mask ventilation and 8 patients (4.1%) had difficulty in intubation. AOA grade had the highest sensitivity and every tests had relatively high specificities for predicting difficult mask ventilation. CONCLUSIONS: The tests for predicting difficult tracheal intubation can be used to predict difficult mask ventilation.