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Objective:To evaluate the role of virtual bronchoscopy intelligent system in improving the theory and operation level of bronchoscopy in pulmonary and critical care medicine (PCCM) teaching for standardized training specialists.Methods:A total of 50 PCCM physicians who had participated in virtual bronchoscopy training in Xijing Hospital, Air Force Medical University from 2018 to 2021 were selected as research subjects. In this study, self-controlled method was adopted to evaluate the change of assessment indicators after 1 week and 2 weeks of training. Questionnaire survey was also used to evaluate the training effect. SPSS 23.0 software was used for paired t-test and Chi-square test. Results:All the 50 PCCM physicians successfully completed the training of virtual bronchoscopy operation. The theoretical score was significantly improved after the training [(80.0±5.2) points vs. (92.4±3.8) points]. The basic operation time [(1 050.9±103.3) s vs. (386.4±47.7) s], and the number of hitting the bronchial wall [(88.3±12.7) times vs. (27.0±5.3) times] were significantly reduced. The recovery rate of alveolar lavage fluid [(27.6±7.4)% vs. (58.0±8.2)%] and the positive rate of biopsy [(19.2±13.1)% vs. (86.8±10.8)%] were significantly increased. The learning curve of the final score indicated that the score improved more rapidly in the first week of training, and the score improved more slowly in the second week of training. Questionnaires before and after the training indicated that virtual intelligent training could significantly improve the confidence and proficiency of students in bronchoscopy.Conclusion:Through the systematic training of virtual bronchoscopy intelligent system, the PCCM physicians have significantly improved their theoretical knowledge and operational proficiency. Therefore, the virtual bronchoscopy training system has practical significance for improving the overall training effect of clinical bronchoscopy for PCCM trainees, which is worthy of promotion.
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Objective To evaluate the value and feasibility of Microsim medical simulation training system in medical students' clinical thinking training. Method 96 students of 5-year program of medicine of Grade 2009 and Grade 2010 were the research object. These students were randomly divided into two groups (group A:After 3 weeks' clinical practice in respiratory medicine, taking 1 week Microsim training. group B: Taking 4 weeks clinical practice in respiratory medicine. Each group has 48 students.). The examination and teaching satisfaction of the two groups were observed after the end of the internship. SPSS 17.0 statistical software was used to analyze the collected data (measurement data matching t test, counting data by chi-square test). Results The Microsim system score: group A was (89.37±7.18), group B was (61.95±15.34). The difference between groups was statistically signifi-cant. The following scores suggested the assessment of students' ability of clinical thinking: ability to analyze problems [group A (89.95±4.02) vs. group B (75.51±6.34)], the ability to deal with the prob-lem [group A (78.81±8.09) vs. group B (59.67±9.33)], treatment scheme [group A (86.74±6.59) vs. group B (70.39±7.05)] and the treatment effect [group A (88.61±8.16) vs. group B (63.54±11.48)]. In these aspects, the two groups had statistically significant difference, but communication [group A (82.47 ±5.23) vs. group B (84.09 ±3.72)] had no statistically significant difference between the two groups. 89.6% (43) of the participants believed that the Microsim medical simulation training system could significantly improve the clinical thinking ability, but only 58.3% (28) of the students believed that the basic theory of knowledge could be consolidated. Conclusion Microsim medical simulation training system can improve the students' ability of clinical thinking and clinical comprehensive treat-ment ability. It can be used as an effective complement to clinical practice teaching.
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BACKGROUND: Recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) could stimulate the proliferation of fibroblasts, keratinocyte and skin mucosae cells to different degrees.OBJECTIVE: To observe the effect of rhGM-CSF on the healing of drug exosmose induced skin ulcers.DESIGN: A randomized and controlled animal experiment.SETTING: Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University of Chinese PLA.MATERIALS: This experiment was carried out at the Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University of Chinese PLA from June to November 2004. Totally 20 male Kunming white mice, with body mass of 18 to 24 g, were chosen.METHODS: Prepared skin ulcers animal models were randomly divided into control group and treated group with 10 white mice in each group.Mice in the control group were given 1mg phentolamine ,20 mg lidocaine and 1mg dexamethasone diluted by normal saline to 0.5 mL ,then sealed up , once a day for 7 days; 25 μg rhGM-CSF was diluted by normal saline to 0.5 mL , then the solution was injected into the periphery of ulcers of mice in treated group , once every other day, for 7 days. Healing time and histological change of skin tissue at ulcer were observed.MAIN OUTCOME MEASURES: To observe the effect of rhGM-CSF on the healing time of drug exosmose induced skin ulcer and anabrosis and histological changeRESULTS: Totally 20 mice entered the stage of result analysis. ①Healing time: the healing time of ulcer and erosion was significantly longer in control group than in treated group [(20-24,8-12)d,t=2.264,P=0.01];②Histological observation: hyperplasia of granulation tissue was not obviously on 7 days after treatment in control group; Hyperplasia of granulation tissue appeared and the newly born blood vessel was abundant on 7 days after treatment in the treated group.CONCLUSION: rhGM-CSF can promote the wound healing of drug induced anabrosis and ulcer.
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Objective To investigate the expressions and effects of interleukin-4(IL-4) and its alternative spliced variant(IL-4?2) in patients with atopic asthma.Methods The expressions of IL-4 and IL-4?2 were detected in 10 cases of patients with atopic asthma using a quantitative nested reverse-transcription polymerase chain reaction(RT-PCR) protocol.Result The expression level of IL-4 was higher in the patients with atopic asthma than that of the healthy controls.The median ratio of IL-4 to IL-4?2 was much higher in the patients with atopic asthma compared with that of the healthy controls.Conclusion The relative expression of IL-4 and IL-4?2 may play an important role in the mechanism of the pulmonary pathology in patients with atopic asthma,and may be one of the reason for the functional diversity of Th2 cells in different clinical conditions.
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AIM: To obtain a vaccine with sLAG-3 as immunoadjuvant and investigate its biologic activity in order to establish the safe and effective way for asthma as one of the specific immunotherapy.METHODS: The coding sequence of LAG-3 was amplified by polymerase chain reaction,the expression vector pcDNA-sLAG-3-Ig was constructed by inserting the PCR products of sLAG-3 and Fc sequence of IgG.With electroporation transfection,pcDNA-sLAG-3-Ig was transfected into COS-7 cells and its biologic activity was investigated by Western blotting analysis.RESULTS: By temperature induction,the LAG-3-Ig was highly expressed in E.coli DH5?.LAG-3-Ig fusion protein was observed by SDS-PAGE and Western blotting,the results showed that the LAG-3-Ig protein was an antagonist of the IL-4-induced synthesis of IgE in B cells.CONCLUSION: A new vaccine with sLAG-3 as immunoadjuvant was obtained.It could inhibit synthesis of IgE in B cells.Thus,LAG-3-Ig would be hopeful to establish the safe and effective way for asthma as one of the specific immunotherapy.
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Objective To study the changes in expression of osteoglycin (OGN) in the lung tissue in a rat acute pulmonary embolism (PE) model and its effects on the metabolism of collagen. Methods A rat acute PE model was reproduced by injecting 3-4 emboli into the left jugular vein. The lung tissue samples were collected at different time points as following: 1h, 8h, 24h and 48h, then the total RNA and total proteins of the lung tissue were extracted. Normal rats were used as control. The changes in mRNA level in OGN were assayed by semi-quantitative RT-PCR, and the changes in protein level were determined by Western blot method. The immunohistochemical method was employed to study the distribution and expression changes in OGN in the lung tissue after PE. Masson staining was employed to observe the deposition of collagen in the lung tissue 4 weeks after acute PE. Results t different time points, the mRNA levels and the protein levels of OGN were lowered gradually in the lung tissue in rat acute PE models. The immunohistochemical study indicated that OGN was distributed beneath the bronchial epithelium, and in the periphery of cartilaginous tissue and the lung alveoli. It also could be observed beneath the arterial endothelium and in the adventitia of pulmonary arteries. In pulmonary veins, OGN accumulated in the adventitia, media, and intima. The deposition of collagen in the lung tissue increased obviously 4 weeks after acute PE. Conclusion The expression of OGN is down-regulated after acute PE. It facilitates the deposition of collagen in the lung tissue.