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In order to ensure the normal teaching order during the prevention and control of the COVID-19 epidemic, the second semester of the 2019-2020 academic year in Central South University was devoted to the online teaching. In response to the school's call, the diagnostics teaching team has applied the Tencent classroom software, WeChat mini programs, analog teaching software and digital curriculum platform to carry out online teaching activities. On the basis of summarizing the previous online teaching experience, we have made a preliminary discussion and reflection on the online teaching, which will provide ideas and directions for the reform of medical education.
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Congenital pulmonary cyst is a common benign disease in the lung, but intracapsular hemorrhage combined with infection is rare, which is easy to be misdiagnosed. A 14-year-old male patient presented fever for one week and companied with right chest pain and blood in sputum for 5 days. The external hospital diagnosed the disease as "the cause of pleural effusion" which the patient still had fever and intraluminal active hemorrhage after performing closed drainage of pleural cavity, draining haemorrhagic fluid, and the treatment of anti-infection, thoracic irrigation, and thoracoscope. Because of no effect after angiography and vascular embolization treatment, emergency thoracotomy was performed. Postoperative pathology proved it to be congenital pulmonary cyst with intracapsular hemorrhage and infection. Intracapsular hemorrhage in congenital pulmonary cyst with infection is easy to be confused with intrapleural hemorrhage in imaging. What's more, invasive operation will increase the difficulty in imaging differentiation. Clinicians should pay a great attention to the initial images of patients.
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Adolescente , Humanos , Masculino , Quistes , Drenaje , Hemorragia , Pulmón , Derrame PleuralRESUMEN
BACKGROUND@#To explore the expression of adiponectin and its relationship with matrix metalloproteinase (MMP)-9 and angiogenesis in non-small cell lung cancer (NSCLC) tissue. @*METHODS@#A total of 87 samples of NSCLC and 10 samples of normal lung tissue were collected for detection of adiponectin and MMP-9 expression by immunohistochemical method. Anti-CD34 monoclonal antibody against endothelial marker was used to evaluate microvessel density (MVD). @*RESULTS@#The positive rate for adiponectin in NSCLC (49.43%) was significantly lower than that in normal lung tissues (90.00%) while for MMP-9 in NSCLC (59.77%) was significantly higher than that in normal lung tissues (10.00%, P<0.05); MVD in NSCLC (14.58 ± 0.67) was higher than that in normal lung tissues [(0.80 ± 0.12), P<0.05]. In NSCLC, the positive rates of adiponectin and MMP-9 were varied in groups with different lymph node metastasis, tumor size and clinical stage (P<0.05). Meanwhile, MVD value in NSCLC with or without lymph node metastasis was significantly different. There was a negative correlation between adiponectin level and CD34 (MVD) or MMP-9 level (r=-0.22 or r=-0.55, respectively, P<0.05). On the contrary, MMP-9 was positively correlated with MVD (r=0.21, P<0.05). @*CONCLUSIONS@#The decreased expression of adiponectin might be related to the development of NSCLC through negative regulation of MMP-9 expression. .
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Humanos , Adiponectina , Metabolismo , Carcinoma de Pulmón de Células no Pequeñas , Metabolismo , Pulmón , Patología , Neoplasias Pulmonares , Metabolismo , Metástasis Linfática , Metaloproteinasa 9 de la Matriz , Metabolismo , Neovascularización PatológicaRESUMEN
Objective To study the risk factors for pulmonary fungal infection associated with chronic obstructive pulmonary disease (COPD),and evaluate the efficacy and safety of itraconazole for treatment of pulmonary fungal infection associated COPD.Methods A retrospective analysis were conducted on clinical data of 42 COPD patients who were confirmed pulmonary fungal infection in a respiratory disease department from September 1 ,2007 to May 31 ,2012,and 53 COPD patients who had no pulmonary fungal infection were as control.Results Of 42 patients with COPD and pulmonary fungal infection,8 were confirmed by histopathological examination,34 were confirmed by clinical diagnosis;6 were acute cases,36 were chronic cases;28 were positive for fungal detection,6 of whom were detected Candida albicans ,13 were detected Aspergillus ,7 were detected unclassified fungi,and 2 had mixed fungal infection.Univariate analysis showed that underlying diseases,long-term use of broad-spectrum antimicrobi-als,long-term use of glucocorticoid,hypoproteinemia,invasive procedure,invasive mechanical ventilation,diabetes mellitus,history of invasive fungal infection were major risk factors for pulmonary fungal infection associated with COPD.After patients were treated by itraconazole,the improvement rate of clinical symptoms was 66.67%,fungal eradication rate was 60.71 %,total effective rate was 64.29%.Of 28 cases with positive fungal detection,the im-provement rate of clinical symptoms,fungal eradication rate,and total effective rate was 71 .43%(n=20),60.71 %(n=17),and 67.86%(n=19)respectively.Itraconazole had good therapeutic efficacy on acute and chronic pulmo-nary fungal infection associated with COPD.Adverse drug reaction rate was 23.81 %,most were mild and reversi-ble,and had no obvious impact on the treatment.Conclusion Itraconazole has positive clinical efficacy on treating pulmonary fungal infection associated with COPD,it is highly safe.
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To explore the clinical manifestations, diagnosis and treatment of pulmonary thromboembolism associated with protein C (PC)/protein S (PS) deifciency. Two male patients 29 and 26 years old diagnosed with PC deifciency and/or PS deifciency were retrospectively analyzed and related literatures were reviewed. The most common symptoms were pain in the lower limbs with chest pain or decreased vision. Color dopper lfow imaging (CDFI) showed lower deep venous phlebothrombosis. Multislice CT angiography (CTA) revealed pulmonary embolism. The level of serum homocysteine (HCY) increased and the level of plasma PC/PS content decreased to PC 57.4%, and PS 28.9%in patient 1, while PS 33.4%in patient 2. Poor routine anticoagulant response was observed. After the diagnosis of PC/PS deficiency, vitiamin B6 and B12 anticoagulant therapy was added, and the symptoms in the patients improved significantly. Congenital thrombophilia should be taken into consideration for young patients with lower deep venous thrombosis and pulmonary embolism which occur recurrently without obvious predisposing causes before 40. Plasma PC/PS concentrations or activity help a lot in the diagnosis and treatment.
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Objective To study the clinical features of invasive pulmonary aspergillosis (IPA) with chronic obstructive pulmonary diseases (COPD),so as to provide evidence for early diagnosis and treatment.Methods A retrospective analysis was made upon clinical data,diagnosis,treatment and prognosis of 53 patients with IPA and COPD admitted between January 2005 and February 2011 collected in a respiratory unit of the Second Xiangya Hospital Affiliated Central South University.Results There were 53 cases of diagnosed as IPA with COPD,with history of using broad-spectrum antibiotics.And there were 43 cases using steroids more than 2 weeks,51 with obvious breathlessness,and 20 with fever.Early stage didn't present characteristical changes on CT scan.However,after disease progression,32 cases had maculas shadows and nonspecific consolidations in bilateral lung,14 with solitary or multiple nodules,4 with solitary or multiple air crescent sign,and 2 with halo sign.Four patients of COPD with IPA underwent bronchoscopy examination.In fungi pathogeny,sputum positive rate and galactomannan positive rate were 56.6％ and 52.8％,respectively.A total of 53 cases received antifungal treatment.Among 37 cases which underwent mechanical ventilation,24 received noninvasive ventilation and 13 received invasive ventilation.There were 33 cases which were improved and cured,and 20 cases which had no relief after half-a-month treatment or withdrew treatment.Among them,13 cases died because of multiple-organ failure (5/15) or acute renal failure (8/15).Conclusions Early suspected diagnosis,timely examination in allusion to IPA,actively searching for etiological and imaging evidences,early established diagnosis and antifungal treatment would improve prognosis of patients with COPD combined IPA who have history of high doses of cortieosteroids,obvious breathlessness and non-response to antibiotics.
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Objective To investigate the regulation effect of interleukin-1? (IL-1?) on the expression of VEGF in A549 cells. Methods A549 cells were incubated with IL-1? in the presence or absence of Celecoxib. After incubation, cells were harvested to detect VEGF mRNA by reverse transcription-polymerase chain reaction (RT-PCR), and the supernatant was collected to determine the concentration of VEGF protein by enzyme-linked immunosorbent assay (ELISA). Results After treatment with IL-1?, the expression of VEGF mRNA and protein in A549 cells were significantly higher than that in the control group(P
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Objective To investigate the distribution,the drug-sensitivity tests and drug-resistance of bacteria in patients with lower respiratory tract infections diseases in respiratory intensive care units(RICU).Methods Retrospective study of the clinical data,the distribution and the drug-sensitivity of bacteria of 178 cases with mechanical ventilation in RICU.The drug-sensitivity were examined by Kribry-Bauer(KB)paper method and minimal-inhibitory-concentration(MIC)by agar double dilute method.Results A total of 326 strains bacteria were obtained in 178 patients.Among 326 strains G-bacteria were the most common kinds of bacteria(78.2%);main kinds of the G-bacteria were pseudomonas areuginosa(30.4%)and baumanii(23.0%);fungus was the second commonest kind of bacteria(16.6%).Most of the G+ bacteria were staphycoccus aureus.In 107 cases more than two kinds of bacteria were obtained.The drug sensitivity test in vitro showed that these strains were multiresistant to commonly used antibiotics,and drugs whose sensitive rate was over 70% included meropenem,impienem,cefoperazone/sulbactam,amikacin and piperacillin/tazabactam,the sensibility of vancomycin to G+ bacteria being 100%.Conclusion Pseudomonas areuginosa,baumanii and fungus are the main pathogens of the patients in RICU;meropenem,impienem,cefoperazone/sulbactam,amikacin and vancomycin are effctive antibiotics for treating lower respiratory tract infection in RICU.There is mixed infection by various bacteria,and some strains are multiresistant.We should monitor drug-sensitivity to bacteria dynamic and use antibiotics reasonably.
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Objective To investigate the effect of the selective cyclooxygenase-2 inhibitor celecoxib on the expression of PGE2 and VEGF induced by IL-1? in A549 cell lines.Methods A549 cells were incubated with IL-1? in the presence or absence of celecoxib.After indicated incubation time,cells were harvested to detect VEGFmRNA by reverse transcription-polymerase chain rection(RT-PCR),the medium was collected to determine the concentration of PGE2 and VEGF by enzyme-linked immunosorbent assay(ELISA).Results After Celecoxib intervention,the formation of PGE2 and VEGF expression decreased more than control group(IL-1? induced),the difference being significance(P
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Objective The aim of this paper was to investigate the reliability and validity of the Chronic respiratory disease questionnaire (CRQ) in China. Method Sixty-eight patients with chronic respiratory disease who were in hospital from January to November, 1999 were surveyed with CRQ. Eighteen patients were investigated repeatly with CRQ in one week to test the reliability; before and the 10th day after treatment, 50 patients were surveyed twice with CRQ and the peakflow of these patients were also detected. The same doctor explained questionnaires and tested peakflow. Results The correlated analysis of reliability was positive (r=0.732, P<0.01). The correlatied analysis between the difference of twice-questionnaire scores and the difference of twice-peakflow value was also positive (r=0.565, P<0.01).Conclusion CRQ can be used by the clinical doctors of China.
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Objective To investigate the relationship between the HIF-1? expression and tumor biological characteristics in non small cell lung cancer(NSCLC). Methods The expression of HIF-1? in NSCLC tissues was evaluated by immunohistochemical method. Results The positive rate of HIF-1? expression in NSCLC was 71.11%, and significantly higher than that in normal lung tissues(P
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Objective To investigate the expressions of Cycloxygenase-2(COX-2),vascular endothelial growth factor(VEGF) in non-small cell lung cancer(NSCLC) to explore the relationships between them and the tumor biological characteristics,tumor angiogenesis in NSCLC.Methods The expressions of COX-2,VEGF and the microvessel density(MVD) were detected by immunohistochemical staining.Results The positive rates of COX-2 and VEGF expression in NSCLC tissue were 55.5% and 66.7% respectively,with significantly higher than those of normal lung tissue(all P