To summarize the diagnosis and management of a highly sensitized renal transplant recipient who developed Legionella pneumophila infection during the perioperative period. A 48-year-old male recipient presented early after transplantation with both acute allograft rejection and pulmonary infection. The acute rejection episode was successfully reversed with appropriate treatment, whereas the pulmonary infection continued to progress. Initial microbiological tests were negative, and empirical antimicrobial therapy was ineffective. Legionella pneumophila was subsequently detected by metagenomic next-generation sequencing of bronchoalveolar lavage fluid obtained via bronchoscopy. Following combined therapy with moxifloxacin and tigecycline, along with withdrawal of immunosuppressive agents, the pulmonary lesions completely resolved.

To summarize the diagnosis and management of a highly sensitized renal transplant recipient who developed Legionella pneumophila infection during the perioperative period. A 48-year-old male recipient presented early after transplantation with both acute allograft rejection and pulmonary infection. The acute rejection episode was successfully reversed with appropriate treatment, whereas the pulmonary infection continued to progress. Initial microbiological tests were negative, and empirical antimicrobial therapy was ineffective. Legionella pneumophila was subsequently detected by metagenomic next-generation sequencing of bronchoalveolar lavage fluid obtained via bronchoscopy. Following combined therapy with moxifloxacin and tigecycline, along with withdrawal of immunosuppressive agents, the pulmonary lesions completely resolved.

Humans ; Nerve Tissue Proteins ; Epithelial-Mesenchymal Transition/genetics* ; Constriction, Pathologic ; Receptors, Immunologic ; Epithelial Cells/metabolism* ; Smad3 Protein/metabolism* ; Transforming Growth Factor beta1/metabolism*

Chongqing Medical University established respiratory system course group and implemented "organ-systems-based curriculum" (OSBC) integration teaching reform.OSBC teaching of respiratory system broke the traditional disciplinary-centred teaching pattern,adopted the disease-centred and clinicaloriented teaching curriculum.The course group carried on the comprehensive reorganization to the curriculum contents and the teaching personnel,compiled integrated teaching materials,optimized teaching methods and evaluation system.OSBC teaching of respiratory system has so far made some achievements,but the integration of different disciplines,the teaching ability of teachers and the students' coordination with OSBC courses still need to be further improved.

Objective To research the effects of different titers of bacteriophage D29 on growth and function of airway epithelial cell 9HTE.Methods Cell viability rates was analyzed after applying high(109 PFU/mL)and low(107 PFU/mL)titers of bacteriophage D29 and phage buffer respectively by MTT colorimetry.Additionally,the secretion levels of IL-6,IL-8 in cell culture supernatant were detected by ELISA.RT-PCR was performed to detect the expression of ICAM-1 mRNA.Cell apoptosis rate was analyzed by flow cytometry.Results There was no difference in cell growth,secretion levels of IL-6,IL-8,ICAM-1 mRNA and cell apoptosis rate between cells treated with high and low titers of D29 and phage buffer(P>0.05).Conclusion Neither high nor low titer of bacteriophage D29 exerts effect on growth and function of airway epithelial cell 9HTE in vitro.

Objective·To investigate and compare the clinical characteristic of non-organic dyspnea and asthma both with complaint of dyspnea.Methods·Seventy-four consecutive patients with non-organic dyspnea,and 74 age-,height-,weight and sex-matched patients with asthma were recruited for investigation in the study.The self-assessment surveys were conducted for the two groups by means of Hospital Anxiety and Depression Scale,Nijmegen Questionnaire and Athens Insomnia Scale.The words for describing dyspnea,clinical symptoms,effective sleep hours and items of pulmonary function test were collected and analyzed Results·Non-organic dyspnea patients tended to describe psychogenic aspects.Asthma patients tended to describe airflow limitation.Non-organic dyspnea group mainly performed psychogenic symptoms.The sleeping time in non-organic dyspnea group was significantly lower than that in asthma group(P＜0.05).The score of anxiety,depression,Nijmegen Questionnaire,Athens Insomnia Scale,FEV1,FEV1％Pred,FVC％Pred,FEV1/FVC in non-organic dyspnea group were significantly higher than those in asthma group (P＜0.05).There was no significant difference in FVC between two groups(P＞0.05).Conclusion·The non-organic group feel more anxiety,depressed and insomnic than the asthma group.Lung function test of asthma group is often abnormal.To discriminate non-organic dyspnea with asthma,clinicians should pay more attention to emotion,sleep,somatoform symptoms,medical history and so on,and do pulmonary function test,improve the understanding of the characteristics of the two diseases,decrease misdiagnosis and wrong diagnosis.

Objective·To construct recombinant mycobacteriophage TM4-RpfE to lay a foundation for experimental research about how to eradicate Mycobacterium tuberculosis in combination with anti-tuberculosis drugs,and how to shorten treatment for tuberculosis ultimately.Methods·Electrotransformation was used to introduce pJV53 plasmid into Mycobacterium smegmatis to prepare recombinant engineering bacteria.After amplification of hsp60-RpfE fusion gene by overlap PCR,a long gene fragment (homologous +hsp60-RpfE+homologous,HHRH) was amplified by multi-step overlap PCR.The DNA of mycobaeteriophage TM4 and HHRH fragment were cotransfected into the recombinant engineering bacteria by electrotransformation,then the recombinant phage from the single primary plaques were confirmed by PCR and sequencing.SDS-PAGE was used to analyze the protein expression in recombinant phage.Results·The hsp60-RpfE fusion gene at the length of 901 bp and HHRH fragment at the length of 1 873 bp were identified by overlap PCR.The PCR product produced 955 bp and 301 bp DNA bands in the first generation plaques colony.SDS-PAGE analysis showed a specific protein band at 21 000 in the recombinant phages.Conclusion·The recombinant mycobacterium phage TM4-RpfE was successfully constructed and the expression of target gene RpfE was initially verified.

Standardized training of resident doctors is the golden stage for clinicians to establish good clinical thinking. Although respiratory disease is common, there are serious and critical diseases, which need to develop clinical thinking and improve the analytical ability. The resident physicians' instructor should help residents to establish the correct diagnostic thinking through the following means: clinical demonstration teaching show, guidance of reading the relevant literature and books, strengthening the basic skills of collecting patients' history and physical examination, and guidance of appropriate use of auxiliary examination and analysis of the results. For the treatment thinking, solid theoretical knowledge and life-long learning ideas and habits can improve the successful rate of initial treatment. Furthermore, being familiar with the efficacy evaluation system and analyzing the reasons for the success and failure of the treatment will help the residents to develop a good therapeutic thinking. The good clinical thinking established by the residents in the department of respiration will be conducive to their own follow-up specialist training and career development.

Objective To summarize the clinical characteristics, follow-up and prognosis of Kawasaki disease (KD) in infants under 3 months. Method The clinical data of infants under 3 months diagnosed with KD during January 2009 to December 2013 were analyzed retrospectively. Results In a total of 1504 cases diagnosed with KD during during the study period, there were 40 (2.66%) infants under 3 months (30 males and 10 females). Except for fever, the frequencies of the other 5 main clinical manifestations were less than 50%. Laboratory tests suggested inflammatory reactions, thrombocytosis, anemia, and so on. Coronary artery disease was found in 32 cases (80%), including 24 cases of coronary artery dilatation, 8 cases of coronary artery aneurysm and 3 cases of coronary giant aneurysm. By the end of the follow-up period, there were no myocardial ischemia, myocardial infarction and death in all the patients; coronary artery diameter was normal in 37 cases (92.5%); 3 cases of giant coronary artery aneurysm still had coronary artery aneurysm and thrombosis. Conclusion The clinical manifestations of KD in little infants were atypical, the incidence of coronary artery disease is high, and color doppler echocardiography should be performed in time.

Objective To identify the cross-reactive antigens shared by Mycobacteria smegmatis(MS) and Mycobacteria tuberculosis(MTB) and to analyze their antigenicity.Methods Bacterial antigens were extracted from strains of MS and MTB by ultrasonication.Western blot assay was performed to analyze common antigens that reacted with both of the antiserum samples against MS and MTB.The extracted bacterial antigens were mixed with incomplete Freund′s adjuvant and then were injected into muscles of mice.Cytokines secreted by murine spleen lymphocytes following stimulation with various antigens of MS and MTB were determined by ELISPOT and flow cytometry on the 7th day.IgG levels in serum samples were detected by ELISA 7 days after injection.Results There were cross-reactive antigens shared by MS and MTB.Potent humoral immune responses and cellular immunity against both MS and MTB could be induced by those cross-reactive antigens after sensitization the mice by either MS or MTB antigens.Cytokines of IL-2 and IFN-γ in CD4+ and CD8+T cells of mice stimulated with MS or MTB antigens were significantly increased as compared with those of non-sensitization group and those of Brucella antigens stimulation group.ConclusionCross-reactive antigens shared by MS and MTS can effectively promote specific immune reactions to the infection of MTB, which provides a scientific basis for the development of tuberculosis vaccines.