Objective:To construct a scientific and reliable clinical teacher competency evaluation index system, and provide a reference for strengthening the construction of clinical teachers in teaching hospitals.Methods:Based on literature research and group discussion, the initial expert consultation questionnaire was constructed. Two rounds of expert consultation were conducted using the Delphi method to form the competency evaluation index system for clinical teachers in teaching hospitals. A hierarchy analysis was conducted using Python to calculate the weights of indicators.Results:The positive coefficients of the two rounds of expert consultation were 100.00% and 95.24%, respectively, and the expert authority coefficients were 0.843 and 0.862, respectively. The Kendall's coefficients of concordance for the first-, second-, and third-level indicators in the first round of expert consultation were 0.207, 0.152, and 0.191 ( P<0.001), respectively, and these coefficients in the second round of expert consultation were 0.271, 0.176, and 0.252 ( P<0.001), respectively. The final evaluation index system included 7 first-level indicators, 15 second-level indicators, and 43 third-level indicators. The first-level indicators included professional quality, professional knowledge and skills, medical education knowledge, teaching ability, communication and cooperation, teaching motivation, and career development, and their weights were 0.147, 0.149, 0.142, 0.147, 0.146, 0.134, and 0.136, respectively. Conclusions:The evaluation index system is comprehensive, scientific, and reliable. It can provide a reference for clinical teacher selection, evaluation, and training in teaching hospitals.

Objective:To construct a scientific and reliable clinical teacher competency evaluation index system, and provide a reference for strengthening the construction of clinical teachers in teaching hospitals.Methods:Based on literature research and group discussion, the initial expert consultation questionnaire was constructed. Two rounds of expert consultation were conducted using the Delphi method to form the competency evaluation index system for clinical teachers in teaching hospitals. A hierarchy analysis was conducted using Python to calculate the weights of indicators.Results:The positive coefficients of the two rounds of expert consultation were 100.00% and 95.24%, respectively, and the expert authority coefficients were 0.843 and 0.862, respectively. The Kendall's coefficients of concordance for the first-, second-, and third-level indicators in the first round of expert consultation were 0.207, 0.152, and 0.191 ( P<0.001), respectively, and these coefficients in the second round of expert consultation were 0.271, 0.176, and 0.252 ( P<0.001), respectively. The final evaluation index system included 7 first-level indicators, 15 second-level indicators, and 43 third-level indicators. The first-level indicators included professional quality, professional knowledge and skills, medical education knowledge, teaching ability, communication and cooperation, teaching motivation, and career development, and their weights were 0.147, 0.149, 0.142, 0.147, 0.146, 0.134, and 0.136, respectively. Conclusions:The evaluation index system is comprehensive, scientific, and reliable. It can provide a reference for clinical teacher selection, evaluation, and training in teaching hospitals.

Objective: To explore the predictor of lower airway inflammation among the index of nasal inflammation by investigating the expression and association of eosinophils (EOS) in the upper-lower airways and blood of patients with chronic rhinitis. Methods: A total of 162 patients with allergic rhinitis (AR), 117 patients with non-allergic rhinitis (NAR) and 104 controls were enrolled from June 2010 to December 2013 from General Hospital of Eastern Theater Command, People′s Liberation Army. All subjects were required detailed medical history collection and nasal resistance measurement. Skin prick test (SPT), blood total immunoglobin E (tIgE) and blood EOS, nasal lavage and induced sputum EOS, nasal provocation and bronchial provocation test (NPT, BPT), nasal and forced exhaled nitric oxide (NNO, FeNO) were performed in all patients. One-way analysis of variance was used for comparison between groups. LSD t test or Mann-Whitney U test was used for comparison between the two groups. Pearson or Spearman related parameter test was used for correlation analysis. Results: The nasal lavage EOS, NNO, induced sputum EOS, FeNO, blood EOS and tIgE were higher in the AR group than that in the NAR group (3.70[1.20, 14.23]/200 HP vs 1.40[0.20, 3.40]/200 HP, 673.50[466.80, 936.00] ppb vs 455.80[248.10, 705.60] ppb, 2.97[0.00, 10.63]% vs 1.00[0.23, 2.00]%, (49.28±26.37)ppb vs (34.07±19.11)ppb, 4.00[2.00, 7.00]% vs 2.00[1.00, 5.00]%, 208.01[61.70, 387.50] IU/ml vs 43.30[19.00, 122.00] IU/ml, F or χ² value was 11.442, 19.440, 70.727, 69.449, 47.453, 46.525, respectively, all P<0.05). But there was no significant difference in nasal resistance, NPT and BPT between the two groups. Nasal lavage EOS in AR group and NAR group was correlated with induced sputum EOS, FeNO, tIgE and blood EOS (r value of AR group was 0.448, 0.202, 0.159, 0.321, r value of NAR group was 0.442, 0.268, 0.268, 0.334, respectively, all P<0.05), but not with BPT. After adjustment for gender, age, height and weight, nasal EOS was positively correlated with sputum EOS. Multiple linear regression analysis showed that nasal EOS, blood EOS and SPT were factors affecting sputum EOS levels. The optimal threshold for nasal EOS to determine induced sputum EOS was 3.30/200 HP by (receiver operating characteristic,ROC) analysis. Conclusion The nasal EOS is correlated with multiple lower airway and systemic inflammatory markers, and is a risk factor for the induced sputum EOS, which can be used as an inflammation biomarker to predict the lower air inflammation.

OBJECTIVE To observe the effect of administration intranasal corticosteroids on small airway disfunction for allergic rhinitis (AR) patients. METHODS AR patients with small airway disfunction were administrated intranasal corticosteroids for twelve weeks. Before treatment, nasal VAS, RQLQ were recorded, pulmonary function test were given. After therapy, VAS, RQLQ were obtained again at the 4th, 8th and 12th week. Pulmonary function test were performed at the 4th and 12th week. RESULTS VAS, RQLQ were all improved after therapy (P <0.01). The indices of FEV1/FVC%, MMEF pred%, MEF75pred%, MEF50pred%, MEF25pred%were also improved significantly (P<0.05), especially for MMEFpred%, MEF75pred%, MEF50pred% (P<0.01). CONCLUSION Small airway lesions can be obviously improved by the intranasal corticosteroids applied for AR. It has positive significance for preventing AR from developing into asthma.

Objective Our study was aimed to study the clinical effect of carbon dioxide laser in the treatment of adult laryn -geal papilloma . Methods Clinical data of patients with adult laryngeal papilloma received treatment at our hospital from January 2012 to June 2014 was retrospectively analyzed .Patients were divided into two groups according to the type of treatment , observation group:received carbon dioxide laser treatment;control group:received tumor forceps treatment .Participants included 61 cases of pa-tients, the observation group of 26 cases, control group 35 cases.Compare the general clinical data , short-term clinical effects(opera-tion time, length of hospital stay , complications , short-term curative effect ) , the change of immune inflammation indexes before and after operation and postoperative recurrence in 1 year of two groups patients. Results The operation time and the length of hospital stay in observation group was significantly lower than that in control group[(33.66 ±4.71)min vs (37.19 ±5.21)min,(4.07 ±1.25)d vs (4.83 ±1.38)d, P<0.05].On the 3th day, The levels of CRP、IL-6、TNF-αand IL-1βin observation group were ( 6.15 ±1.67 ) mg/L, (6.51 ±1.12)ng/L, (23.56 ±4.16)ng/L, (5.25 ±1.21) ng/L, those in control group were (12.20 ±3.41)mg/L, (15.63 ±
4.11) ng/L, (36.16 ±7.37) ng/L, (12.63 ±4.12) ng/L.The differences of these parameters between the two groups were signifi-cant (P<0.001).Observation group patients had a lower rate of recurrence 1 year after surgery than that of control group patients (12.00%vs 37.93%, P=0.029). Conclusion In the treatment of adult laryngeal papilloma , carbon dioxide laser can achieve a better minimally invasive and lower postoperative recurrence when compare to tumor forceps treatment .

Objective Small airway hypofunction is an early manifestation of asthmatic airway injury and is found in patients with non-asthma allergic rhinitis.However, no report has been seen on the changes of small airway function in patients with non-aller-gic rhinitis ( NAR) .This study was to investigate the possibility of small airway lesion in NAR patients and its relationship with airway responsiveness by observing the changes of small airway function in NAR patients without asthma and/or lower airway symptoms. Methods We recruited 324 subjects for this study, including 262 NAR patients and 62 healthy controls, and assigned them to an air-way hyperresponsiveness (AHR) and a non-airway hyperresponsiveness (nAHR) group.All the subjects underwent medical history collection, nasal examination, allergen skin prick test, blood routine test, serum total immunoglobin E assay, pulmonary function test, and bronchial challenge test. Results Compared with the healthy con-trols, the NAR patients showed remarkably lower predicted percenta-ges of maximal mid-expiratory flow ([85.6 ±17.1] vs [81.3 ± 19.9]%), mid-expiratory flow (MEF) with 75% of forced vital ca-pacity (FVC) expired ([96.1 ±16.1] vs [88.8 ±23.1]%), MEF with 50%of FVC expired ([88.4 ±17.8] vs [84.8 ±20.8]%), and MEF with 25%of FVC expired ([92.7 ±25.9] vs [82.9 ± 28.7]%) (P<0.05), but had no statistically significant differences in the predicted percentages of FVC, forced expiratory volume in 1 second (FEV1), and the ratio of FEV1 to FVC (P>0.05).The positive rate of AHR was 6.1% (16/246) in the NAR group.All the indices of small airway function were significantly lower in the AHR than in the nAHR group (P <0.01). Conclusion NAR patients are apt to undergo obvious changes in small airway function, some with AHR, which is associated with lower airway function changes.

OBJECTIVE: Observe the changes of small airway function in patients with rhinitis but without asthma and/or lower airway symptoms. METHOD: Between June 2008 and December 2012, we recruited 903 subjects, including 377 with allergic rhinitis (AR), 262 with non-allergic rhinitis (NAR) and 264 healthy subjects. All subjects underwent meticulous history taking, nasal examination, allergen skin prick test, blood routine test, serum total immunoglobin E assay, pulmonary ventilation function test and bronchial challenge test. RESULT: The indices of FEV1/FVC%, MEF25pred% and MMEFpred% were lower in AR group than in the control group (P < 0.05). The indices of FEV1/FVC, MMEFpred%, MEF25pred% and MEF50pred% were also lower in NAR group than in the control group (P < 0.05). According to the FVCpred% and FEV1pred%, there were no differences between rhinitis group and the control group (P > 0.05). The positive rate of airway hyperresponsiveness(AHR) in AR group and in NAR group was 12.2%, 6.1% respectively. Indices of small airway function were all lower in the AHR group than NAHR group in rhinitis. CONCLUSION Compared with healthy controls, small airway function in patients with rhinitis has apparent changes, part of rhinitis patients has AHR, and is associated with small airway function changes.
Asthma ; Case-Control Studies ; Humans ; Respiratory Function Tests ; Respiratory System ; physiopathology ; Rhinitis ; physiopathology ; Rhinitis, Allergic ; physiopathology ; Skin Tests

OBJECTIVE: The aim of this study was to explore the changes of the extracellular matrix in nasal mucosa by a guinea pig model of prolonged allergic-induced rhinitis. METHOD: Thirty-two male Hartley guinea pigs were randomly divided into four groups: allergen challenged groups (Group 2 w, Group 6 w and Group 12 w) and a control group. Ovalbumin-sensitized guinea pigs were repeatedly challenged with allergen twice a week from 2 weeks to 12 weeks. Matched control groups were challenged with physiological saline. Nasal mucosa were obtained from the animals killed. Hematoxylin-Eosin, Masson's trichrome, and immunohistochemical staining against transforming growth factor-beta1 (TGF-beta1), Collagen III and Collagen I were performed to nasal mucosa. RESULT: (1) Pathological examination showed obvious infiltration of eosinophils and the enlarged thickness of epithelial layer of nasal mucosa in the experiment groups. (2) The area ratios of blue stained in the extracellular matrix of nasal mucosa were increased. The area ratios of blue stained were statistically different in Group 6 w and Group 12 w compared with the control group. (3) The increasing absorbance of TGF-beta1 were statistically different in the experiment groups with the control group. The absorbance of Collagen III and Collagen I showed a rising trend along prolonged allergen challenged in the experiment groups. CONCLUSION Prolonged allergen challenge and the inflammation of nasal mucosa, can lead to the increasing of the inflammation relevant factors and the deposit of collagen in the extracellular matrix of nasal mucosa.
Allergens ; immunology ; Animals ; Collagen Type I ; metabolism ; Collagen Type III ; metabolism ; Eosinophils ; immunology ; Extracellular Matrix ; immunology ; metabolism ; pathology ; Guinea Pigs ; Inflammation ; Male ; Nasal Mucosa ; immunology ; metabolism ; pathology ; Rhinitis, Allergic, Perennial ; immunology ; metabolism ; pathology ; Transforming Growth Factor beta1 ; metabolism

OBJECTIVE: The aim of this study was to use a guinea pig model of prolonged allergic-induced rhinitis to characterize the feature of nasal mucosa remodeling. METHOD: Forty-eight male Hartley guinea pigs were randomly divided into six groups: allergen challenged groups (Group OVA(2w) , Group OVA(6w) and Group OVA(12w)) and control groups respectively (Group Sal(2w), Group Sal(6w) and Group Sal(12w)). Each group had 8 guinea pigs. To develop a guinea pig model of nasal mucosa remodeling, ovalbumin-sensitized guinea pigs were repeatedly challenged with allergen twice a week from two weeks to 12 weeks. Matched control groups were challenged with physiological saline. Nasal lavage was performed 24 hours after the last intranasal challenge. Then nasal mucosa were obtained. HE, AB-PAS, MT, and immunohistochemical staining against transforming growth factor-beta1 (TGF-beta1) were performed. Eosinophil cationic protein (ECP) and OVA-special IgE (OVA-sIgE) were detected by ELISA in nasal lavage fluid. RESULT: (1) The levels of OVA-sIgE in nasal lavage fluid in Group OVA(6w) and Group OVA(12w) were significantly different from Group OVA(2w), while the levels of ECP had no significant difference among the experiment groups. The levels of OVA-sIgE and ECP in experiment groups were significantly different from control groups respectively (P < 0.01). (2) Grade 0 and Grade 1 of epithelial damage were significantly different in Group OVA(6w) and Group OVA(12w) when compared with from Group OVA(2w) (P < 0.01). At the same time, Grade 0 and Grade 1 of epithelial damage were statistically different in the experiment groups when compared with the respectively control groups (P < 0.05). (3) Goblet gland hyperplasia and collagen deposit within the extracellular matrix (ECM) were easily found in Group OVA(6w) and Group OVA(12w) compared with Group OVA(2w) (P < 0.01). The number of goblet gland and the ratio of collagen deposit were statistically more in Group OVA(6w) and Group OVA(12w) than in Group Sal(6w) and Group Sal(12w) (P < 0.05). That feature of the ratio of collagen deposit did not show in Group OVA(2w) versus Group Sal(2w). (4) Increased TGF-beta1 expressions were observed in Group OVA(6w) and Group OVA(12w) compared with Group OVA(2w) (P < 0.01). Those increasing expressions were also observed in experiment groups rather than in the respectively control groups (P < 0.01). CONCLUSION Epithelial damage, goblet cells hyperplasia and collagen deposition in ECM were observed as the features of remodeling in this guinea pig model of allergic rhinitis under prolonged allergen challenge. Epithelial damage, excessive expression of related cytokines and enhancement activity of enzymes were observed in early time after challenge of allergen. The features of goblet cells hyperplasia and collagen deposition in ECM were observed at a later stage.
Airway Remodeling ; Allergens ; immunology ; Animals ; Disease Models, Animal ; Guinea Pigs ; Male ; Nasal Mucosa ; immunology ; pathology ; Rhinitis, Allergic, Perennial ; immunology ; pathology

Objective: To intensively investigate sporadic CMT patients, we have analyzed the LMNA gene in this study in a series of 32 unrelated CMT patients. Methods: Twelve exons of the LMNA gene were amplified from genetomic DNA. PCR products of each exon were analyzed by single strand conformational polymorphism (SSCP). Results: No abnormal SSCP pattern, suggesting no mutation in our CMT patients, was detected. Conclusion: The CMT diseases resulted from the mutations of LMNA gene were rare.