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.

Objective To examine the distribution and antibiotic resistance proifle of the bacterial isolates from lower respiratory tract of hospitalized patients for better empirical therapy.Methods A total of 3 155 lower respiratory tract specimens were collected from Respiratory Department of the First Afifliated Hospital of Chongqing Medical University in 2013 to identify bacterial pathogens for susceptibility testing. The results were compared with the data of 2011 and 2012.Results The top three bacterial species from lower respiratory tract in the period from 2011 to 2013 wereA. baumannii,P. aeruginosa, andK. pneumoniae. The prevalence ofS. aureusincreased, while the prevalence ofS. maltophilia andS. pneumoniae was still low.A. baumannii isolates were highly resistant to antibiotics. Not more than 40% of these strains were susceptible to the antimicrobial agents except minocycline, which was active against more than 60% of the ICU and non-ICU strains. More than 70% of theP. aeruginosa strains from non-ICU were susceptible to cefepime, meropenem, imipenem, levofloxacin, and ciprofloxacin in the three years, 50%-70% of the strains from ICU were susceptible to the antimicrobial agents tested. Carbapenem-resistantA. baumannii andP. aeruginosa strains were identiifed.S. maltophilia strains were relatively susceptible to minocycline and levolfoxacin. All the S. aureus isolates were susceptible to vancomycin, linezolid, and tigecycline. The prevalence of MRSA increased year by
year. More than 80% of theK. pneumoniae andE. coli strains were susceptible to imipenem, piperacillin-tazobactam, and cefepime. ESBLs-producingK. pneumoniae was identified. More than 85% of theH. influenzae strains were susceptible to meropenem, ceftazidime, cefuroxime, ciprolfoxacin, levolfoxacin, and amoxicillin-clavulanate potassium. All theS. pneumoniae isolates were susceptible to vancomycin, and 80%-96% of these strains were susceptible to levofloxacin and penicillin.ConclusionsA. baumannii,P. aeruginosa, andK. pneumoniae are the top three bacterial species isolated from lower respiratory tract. Carbapenem-resistantA. baumannii,P. aeruginosa and ESBLs-producingK. pneumoniaeare emerging. The prevalence of MRSA is increasing year by year, which poses a challenge to antimicrobial therapy. It is urgent to contain and control the growing antibiotic resistance.

Objective To compare the ultrafine chest drainage tube with traditional thick hose as lower tube after uniport thoracoscope pulmonary nodules resection(segmentectomy,lobectomy) and evaluate its efficacy and safety.Methods Ultrafine chest drainage tube was applied in 55 patients underwent uniport thoracoscopy pulmonary resection,and traditional thick closed drainage hose was applied in another 55 patients in the same period as the control group.Postoperative drainage quantity,drainage time,pain score and incision healing between two group were compared.Results No statistically difference was found in two groups at thoracic drainage quantity on 1 day,2 days postoperative and total drainage time.But statistically difference was found in thoracic drainage quantity on 3 days postoperative,pain score and incision healing(P ＜0.05).Conclusion Ultrafine chest drainage tube has little trauma,definite clinical effect and can be easily accepted by patients.