Objective:To explore the application of Bloom target teaching theory combined with PBL teaching mode in standardized residency training of respiratory.Methods:A total of 44 residents of Batch 2019 who had been in respiratory department of our hospital for 2 months on rotation were selected as the control group, and traditional teaching training was adopted in the group. In addition, 41 residents of Batch 2020 who were enrolled in the respiratory department of our hospital for a 2-month residency training rotation were selected as the research group, and Bloom target teaching theory combined with PBL teaching mode was applied in the group. After the residency training, the teaching effect of the two groups of training residents was evaluated by theoretical examination, practical skill operation examination and questionnaire survey. SPSS 22.0 was used to conduct t test. Results:The results of theoretical assessment and practical skills operation assessment of students in the study group were better than those in the control group, and the difference was statistically significant ( P<0.05). The subjective satisfaction of the training residents and the tutors were scored respectively. The results showed that the scores of residents in the study group were higher than those in the control group, the difference was statistically significant ( P<0.05). The subjective satisfaction score of residents on the assessment results of this stage showed that residents in the study group had higher scores than the control group, with statistical significance ( P<0.05). The tutor's subjective satisfaction score of the assessment results at this stage showed that the scores of the residents in the study group were higher than those in the control group, and the difference was statistically significant ( P<0.05). Conclusion:The combination of Bloom target teaching theory and PBL teaching mode can improve the theoretical and practical operation ability of students in respiratory department, improve their learning initiative, enthusiasm and teaching satisfaction, and then improve the teaching quality.

Objective To detect the expressions of interleukin-11 (IL-11) and interleukin-11 receptorα(IL-11Rα) in non-small cell lung cancer (NSCLC) cell lines, and explore their clinical significances. Methods The expressions of IL-11 and IL-11Rαin NSCLC cell lines A549, H2228, healthy lung small airway epithelial cell (SAEC) line cytoplasm, cell membrane and nucleus were detected by Western blot. Results The expressions of IL-11 and IL-11Rα were low in the cell membrance and nucleus (cell membrane: IL-110.04± 0.03, IL-11Rα0.05±0.03; nuclear: IL-110.45±0.19, IL-11Rα0.07±0.02;P<0.01); The expressions of IL-11 and IL-11Rα in A549 and H2228 cell lines were significantly increased compared with those of SAEC cell lines in the cell membrance and cytoplasm (P< 0.01); Among the A549 cell lines, the expressions of IL-11 and IL-11Rα in cell nucleus were much higher than those of the cell membrance and cytoplasm (P< 0.01). Among the H2228 cell lines, the expression of IL-11 in cytoplasm was the highest and the expression of IL-11Rα was the highest in the cell nucleus (P< 0.01). Conclusion The expressions of IL-11 and IL-11Rαare high in NSCLC cell lines, and it is good for the screening and early diagnosis of lung cancer by detecting the expressions of IL-11 and IL-11Rα.

Objective To understand the knowledge of tuberculosis in general hospital patients with respiratory diseases.Methods Face to face questionnaire survey 821 respiratory patients, the main contents include: the tuberculosis awareness, common symptoms of tuberculosis, tuberculosis with or without contagious, persistent cough expectorant willing to go to where the treatment of tuberculosis, national policy, treatment of the course of treatment, tuberculosis prevention measures, and whether the knowledge of tuberculosis drug resistance.Results 92.1% of patients were aware of TB and 98.7% of patients knew TB was contagious, and 99% knew that TB was transmitted by the respiratory tract.Only 4.5% of patients with symptoms appear willing to go to tuberculosis treatment of patients.94.9% of the patients were aware of a specific TB control facility, 85% knew that the basic TB treatment was free, 99% thought to be good treatment of tuberculosis patients, 55% of patients know that tuberculosis treatment for a long time, to regular medication.30% of people know that mycobacterium tuberculosis resistance.90% of patients know to isolate tuberculosis patients, 40% of patients that protect susceptible populations, and 95% believed that BCG could prevent tuberculosis.Conclusion Patients have a certain understanding of tuberculosis, the timely treatment of indifference to the treatment of treatment is probably not impressed, very little knowledge of tuberculosis resistance.

Background and objective The aim of this study is to investigate the clinical characteristics of patients with primary bronchopulmonary carcinoma complicated with chronic obstructive pulmonary disease (COPD), and to opti-mize the early diagnoses in the coexistence of COPD and primary bronchopulmonary carcinoma.Methods The clinical data of 118 patients with COPD complicated with primary bronchopulmonary carcinoma were analyzed retrospectively, including age, sex, smoking history, smoking index, clinical symptoms and signs, pathological type, staging, metastasis site and lung func-tion index. 120 patients with simple COPD were selected as control.Results The smoking rate (55.1%) and smoking index ≥400 branch /year (90.8%) of the patients with COPD complicated with primary bronchopulmonary carcinoma were higher than the simple COPD group (20.8%, 48.0%). The difference between the two groups was statistically significant (P<0.01). There were no significant differences in the incidence of common symptoms such as cough, sputum, fever, fatigue and dyspnea in COPD complicated with primary bronchopulmonary carcinoma patients with simple COPD group (P>0.05), while the in-cidence of hemoptysis, weight loss, chest pain, hoarseness, pleural effusion and atelectasis were significantly higher than those in simple COPD group (P<0.01). When the patients were first diagnosed as COPD with primary bronchopulmonary carcino-ma, 63.6% of the group were advanced or located late, and the distant metastases are common for pleural metastasis and bone metastases. There was no significant difference in forced expiratory volume in one second/forced vital capacity (FEV1/FVC),FEV1% pre, total lung capacity (TLC) and residual volume (RV)/TLC between the two groups (P>0.05), but the diffusing capacity of carbon monoxide (DLCO) of COPD patients complicated with primary bronchopulmonary carcinoma was lower than that of simple COPD patients (P<0.05) . In the COPD patients with primary bronchopulmonary carcinoma, squamous cell carcinoma was the most common pathological type (51.7%). Male patients were mainly squamous cell carcinoma (60.7%), while female patients with adenocarcinoma (69.0%).Conclusion COPD combined with primary bronchopulmonary carci-noma occurs in male smokers more. There is higher incidence of squamous cell carcinoma. When they are first diagnosed, most of them are advanced or located late, due to no specific clinical symptoms at the early stages. Periodic chest CT examination for COPD patients can help early diagnoses of primary bronchopulmonary carcinoma.

Objective To evaluate the safety and efficacy of indacaterol in treatment of stable chronic obstructive pulmonary disease (COPD).Methods The related databases were electronically searched for the randomized controlled trials (RCT) on the treatment of stable COPD with indacaterol published before November 1st, 2016.The quality of the reports enrolled into the Meta-analysis was evaluated by Jadad scoring system.The Meta-analysis was conducted using Review Manager 5.3 software.The results were presented as relative risk (RR) and 95% confidence intervals (CI).Results A total of 10 RCTs involving 7 315 patients were enrolled, including 4 439 in the indacaterol group and 2 876 in the placebo group.The Jadad score of all literatures was 3 to 5.They were all high quality documents.The results of Meta-analysis showed that the incidence of COPD acute exacerbation in the indacaterol group was lower than that in the placebo group, the difference was statistically significant[20.6% (914/4 439) vs.22.4% (643/2 876), RR=0.85, 95%CI: 0.77-0.92, P<0.01].The results of subgroup analysis showed that the incidence of COPD acute exacerbation in doses of 150 μg/d and 600 μg/d in the indacaterol group were lower than those in the placebo group, the differences were statistically significant[(20.4% (384/1 878) vs.22.2% (359/1 617), RR=0.84, 95%CI: 0.74-0.95, P<0.01;27.5% (117/425) vs.34.7% (150/432), RR=0.79, 95%CI: 0.65-0.97, P=0.02)].The incidence of severe COPD acute exacerbation in the indacaterol group was lower than that in the placebo group, the difference was statistically significant[2.3% (103/4 439) vs.2.9% (84/2 876),RR=0.72, 95%CI: 0.54-0.96, P=0.03].The results of subgroup analysis showed that the incidence of severe COPD acute exacerbation at dose of 600 μg/d in the indacaterol group was lower than that in the placebo group, the difference was statistically significant[0.9% (4/425) vs.3.9% (17/432), RR=0.24, 95%CI: 0.08-0.7, P<0.01].The overall fatality rate in the indacaterol group was lower than that in the placebo group, but the difference was no statistically significant [0.25% (8/3 164) vs.0.58% (11/1 906), RR=0.48, 95%CI: 0.20-1.14, P=0.10].The fatality rate due to cardiovascular events in the indacaterol group was lower than that in the placebo group, but the difference was not statistically significant [0.22% (7/3 164) vs.0.42% (8/1 906), RR=0.56, 95%CI: 0.22-1.42, P=0.22].The fatality rate due to respiratory diseases in the indacaterol group was lower than that in the placebo group, but the difference was no statistically significant [0.12% (2/1 668) vs.0.20% (2/999), RR=0.65, 95%CI: 0.13-3.31, P=0.61].The result of sensitivity analysis showed that the outcome of the study was stable and not influenced by simplex trial.Conclusion Indacaterol is effective and relatively safe of treatment in patients with stable COPD.

Objective To evaluate the safety and efficacy of indacaterol in treatment of stable chronic obstructive pulmonary disease (COPD).Methods The related databases were electronically searched for the randomized controlled trials (RCT) on the treatment of stable COPD with indacaterol published before November 1st, 2016.The quality of the reports enrolled into the Meta-analysis was evaluated by Jadad scoring system.The Meta-analysis was conducted using Review Manager 5.3 software.The results were presented as relative risk (RR) and 95% confidence intervals (CI).Results A total of 10 RCTs involving 7 315 patients were enrolled, including 4 439 in the indacaterol group and 2 876 in the placebo group.The Jadad score of all literatures was 3 to 5.They were all high quality documents.The results of Meta-analysis showed that the incidence of COPD acute exacerbation in the indacaterol group was lower than that in the placebo group, the difference was statistically significant[20.6% (914/4 439) vs.22.4% (643/2 876), RR=0.85, 95%CI: 0.77-0.92, P<0.01].The results of subgroup analysis showed that the incidence of COPD acute exacerbation in doses of 150 μg/d and 600 μg/d in the indacaterol group were lower than those in the placebo group, the differences were statistically significant[(20.4% (384/1 878) vs.22.2% (359/1 617), RR=0.84, 95%CI: 0.74-0.95, P<0.01;27.5% (117/425) vs.34.7% (150/432), RR=0.79, 95%CI: 0.65-0.97, P=0.02)].The incidence of severe COPD acute exacerbation in the indacaterol group was lower than that in the placebo group, the difference was statistically significant[2.3% (103/4 439) vs.2.9% (84/2 876),RR=0.72, 95%CI: 0.54-0.96, P=0.03].The results of subgroup analysis showed that the incidence of severe COPD acute exacerbation at dose of 600 μg/d in the indacaterol group was lower than that in the placebo group, the difference was statistically significant[0.9% (4/425) vs.3.9% (17/432), RR=0.24, 95%CI: 0.08-0.7, P<0.01].The overall fatality rate in the indacaterol group was lower than that in the placebo group, but the difference was no statistically significant [0.25% (8/3 164) vs.0.58% (11/1 906), RR=0.48, 95%CI: 0.20-1.14, P=0.10].The fatality rate due to cardiovascular events in the indacaterol group was lower than that in the placebo group, but the difference was not statistically significant [0.22% (7/3 164) vs.0.42% (8/1 906), RR=0.56, 95%CI: 0.22-1.42, P=0.22].The fatality rate due to respiratory diseases in the indacaterol group was lower than that in the placebo group, but the difference was no statistically significant [0.12% (2/1 668) vs.0.20% (2/999), RR=0.65, 95%CI: 0.13-3.31, P=0.61].The result of sensitivity analysis showed that the outcome of the study was stable and not influenced by simplex trial.Conclusion Indacaterol is effective and relatively safe of treatment in patients with stable COPD.

Objective To understand antimicrobial resistance and therapeutic efficacy of imipenem/cilastatin and meropenem for treatment of multidrug-resistant Pseudomonas aeruginosa (MDRPA)from patients with mechanical ventilation.Methods From January 2010 to December 2015,78 patients with mechanical ventilation and isolated MDRPA from sputum cultures were selected and divided into imipenem/cilastatin (n=44)and meropenem(n=34) treatment groups,basic condition,time of emergence of drug resistance,and therapeutic efficacy of antimicrobial agents between two groups were compared.Results The basic data of two groups were comparable,before treat-ment by imipenem/cilastatin and meropenem,resistance rates of Pseudomonas aeruginosa (P .aeruginosa )to quinolones,ceftazidime,piperacillin,and amikacin were not significantly different (all P >0.05).After patients received antimicrobial agents for 6 days,difference in antimicrobial resistance between imipenem /cilastatin and meropenem treatment groups were not significantly different (22.73% vs 8.82%,P >0.05).On the 8th,10th,and 12th day of treatment,resistance rates of imipenem treatment group were 40.91%,77.27%,and 97.73%, respectively,which were all higher than meropenem treatment group (17.65%,32.35%,44.12%,respectively,all P <0.05).After the treatment with different antimicrobial agents,the average time for the emergence of resistance in imipenem/cilastatin and meropenem treatment group were 9.0 days and 13.5 days respectively.Therapeutic efficacy between two groups was not significantly different (64.71% vs 74.19%,P =0.41).Conclusion Compared with meropenem,imipenem/cilastatin shows higher risk for the emergence of drug resistance during therapy of P . aeruginosa infection in patients with mechanical ventilation,there is no significant difference in therapeutic efficacy between two groups of patients after 7 days of treatment.

Objective To explore the prevalence and influential factors of chronic respiratory system diseases among resi-dents over 1 5 years old in Hubei province and provide evidence for disease prevention.Methods During October to November in 2013,through stratified cluster sampling,we sampled 20 cities or counties.The survey included the the general condition of family, individual,chronic diseases.Results A total of 28 563 residents answered the questionnaire and 423 of them reported chronic re-spiratory system diseases by themselves.The prevalence rate was 14.8‰.These included 229 cases with COPD(54.1%),44 cases with asthma(10.4%),35 cases with chronic pharyngolaryngitis(8.3%)and 1 1 5 cases with other chronic respiratory system disea-ses(27.2%).In urban and rural area,the prevalence rate were 13.6‰ and 1 5.7‰ respectively.Multivariate logistic analysis showed that gender,age,economic status and medical insurance are influential factors of chronic respiratory system diseases.Conclusion Prevalence rate of chronic respiratory system diseases among residents over 1 5 years old in Hubei province was slightly increased and disease control measures should be brought out.

Objective To evaluate the safety of pirfenidone in treatment of idiopathic pulmonary fibrosis( IPF). Methods PubMed,the Cochrane library,EMbase,CNKI,and WanFang database were searched using the keywords pirfenidone,idiopathic pulmonary fibrosis,and IPF from January 1999 to January 2015. Randomized controlled trials( RCTs)of pirfenidone in treatment of IPF were selected. The patients in the trial group were given pirfenidone alone while the patients in the control group were given oral placebo. The primary end point event of the outcome was the incidence of pirfenidone′s adverse events. The Meta-analysis was performed using RevMan 5. 2. Results A total of 4 articles including 5 RCTs were enrolled. There were 945 patients in the trial group and 766 patients in the control group. The incidents of many kinds of adverse events in the trial group were markedly higher than those in the control group, including gastrointestinal discomfort[12. 6%(101/804)vs. 5. 2%(40/766),RR = 2. 31,95% CI:63-3. 29,P< 0. 01],nausea[34. 6%(241/695)vs. 15. 0%(99/659),RR = 2. 373,95% CI:1. 92-2. 92,P< 0. 01]and vomiting[13. 3%(83/623)vs. 6. 3%(39/624),RR= 2. 13,95% CI:1. 48-3. 06,P< 0. 01],diarrhea[25. 8%(161/623)vs. 20. 4%(127/624),RR= 1. 27,95% CI:1. 03-1. 56,P=0. 02],anorexia[15. 2%(122/804)vs. 4. 7%(36/766),RR= 3. 10,95% CI:2. 16-4. 46,P<0. 01],abnormal liver function[6. 0%(49/804)vs. 1. 7%(13/766),RR= 2. 48,95% CI:1. 46-4. 23,P<0. 01],rash[30. 4%(189/623)vs. 10. 3%(64/624),RR= 2. 95,95% CI:2. 27-3. 83,P<0. 01],photosensitivity reaction[24. 7%(129/526)vs. 6. 1%(30/489),RR= 5. 54,95%CI:1. 78-17. 30,P<0. 01],insomnia[10. 4%(65/623)vs. 6. 6%(41/624),RR=1. 59,95% CI:1. 09-2. 31,P= 0. 02],dizziness[16. 4%(120/732)vs. 9. 8%(72/731),RR=1. 67,95% CI:1. 27-2. 19,P<0. 01],fatigue[25. 6%(178/695)vs. 16. 3%(108/659),RR = 1. 60,95% CI:1. 29-1. 98,P< 0. 01],and weight loss[10. 1%(63/623)vs. 5. 4%(34/624),RR= 1. 85,95% CI:1. 24-2. 77,P = 0. 03]. However,there was no statistically significant difference in treatment-related serious events[26. 5%(165/623)vs. 26. 4%(165/624),RR = 1. 00,95% CI:0. 83-1. 20,P = 0. 94]. Compared with the control group,there was a statistical significance in the rate of drug withdrawal in the trial group[14. 6%( 117/804 ) vs. 9. 0%( 69/766 ),RR = 1. 62,95% CI:1. 22-2. 15,P <0. 01 ). Conclusion The common adverse events of pirfenidone are gastrointestinal,skin,and neurological system damage and fatigue and loss of weight. The adverse events are mild and mostly recoverable without obvious sequelae. The pirfenidone is safe and well-tolerated.

Objective To evaluate the safety of pirfenidone in treatment of idiopathic pulmonary fibrosis( IPF). Methods PubMed,the Cochrane library,EMbase,CNKI,and WanFang database were searched using the keywords pirfenidone,idiopathic pulmonary fibrosis,and IPF from January 1999 to January 2015. Randomized controlled trials( RCTs)of pirfenidone in treatment of IPF were selected. The patients in the trial group were given pirfenidone alone while the patients in the control group were given oral placebo. The primary end point event of the outcome was the incidence of pirfenidone′s adverse events. The Meta-analysis was performed using RevMan 5. 2. Results A total of 4 articles including 5 RCTs were enrolled. There were 945 patients in the trial group and 766 patients in the control group. The incidents of many kinds of adverse events in the trial group were markedly higher than those in the control group, including gastrointestinal discomfort[12. 6%(101/804)vs. 5. 2%(40/766),RR = 2. 31,95% CI:63-3. 29,P< 0. 01],nausea[34. 6%(241/695)vs. 15. 0%(99/659),RR = 2. 373,95% CI:1. 92-2. 92,P< 0. 01]and vomiting[13. 3%(83/623)vs. 6. 3%(39/624),RR= 2. 13,95% CI:1. 48-3. 06,P< 0. 01],diarrhea[25. 8%(161/623)vs. 20. 4%(127/624),RR= 1. 27,95% CI:1. 03-1. 56,P=0. 02],anorexia[15. 2%(122/804)vs. 4. 7%(36/766),RR= 3. 10,95% CI:2. 16-4. 46,P<0. 01],abnormal liver function[6. 0%(49/804)vs. 1. 7%(13/766),RR= 2. 48,95% CI:1. 46-4. 23,P<0. 01],rash[30. 4%(189/623)vs. 10. 3%(64/624),RR= 2. 95,95% CI:2. 27-3. 83,P<0. 01],photosensitivity reaction[24. 7%(129/526)vs. 6. 1%(30/489),RR= 5. 54,95%CI:1. 78-17. 30,P<0. 01],insomnia[10. 4%(65/623)vs. 6. 6%(41/624),RR=1. 59,95% CI:1. 09-2. 31,P= 0. 02],dizziness[16. 4%(120/732)vs. 9. 8%(72/731),RR=1. 67,95% CI:1. 27-2. 19,P<0. 01],fatigue[25. 6%(178/695)vs. 16. 3%(108/659),RR = 1. 60,95% CI:1. 29-1. 98,P< 0. 01],and weight loss[10. 1%(63/623)vs. 5. 4%(34/624),RR= 1. 85,95% CI:1. 24-2. 77,P = 0. 03]. However,there was no statistically significant difference in treatment-related serious events[26. 5%(165/623)vs. 26. 4%(165/624),RR = 1. 00,95% CI:0. 83-1. 20,P = 0. 94]. Compared with the control group,there was a statistical significance in the rate of drug withdrawal in the trial group[14. 6%( 117/804 ) vs. 9. 0%( 69/766 ),RR = 1. 62,95% CI:1. 22-2. 15,P <0. 01 ). Conclusion The common adverse events of pirfenidone are gastrointestinal,skin,and neurological system damage and fatigue and loss of weight. The adverse events are mild and mostly recoverable without obvious sequelae. The pirfenidone is safe and well-tolerated.