Objective To study the application of virtual reality bronchoscopy stimulation in novice trainees. Methods Four novice bronchoscopists entered the training programby using a VR bronchoscopy in the clinical skill center. After the program, the dexterity, speed, and accuracy of all the four doctors were tested using the virtual simulation models. Results were compared to four skilled physicians as control group who had performed at least 50 bronchoscopies. Before-training and after-training test scores were compared using paired t tests. For comparisons between after-training novice and skilled physician scores, unpaired twosample t tests were used. Results All of the four trainees finished the training program. The novices significantly improved their dexterity, speed and accuracy. The percentage of observed segments increased from ( 74. 0 ±5. 1) % to ( 89. 3 ±4. 0) % . The number of contacts with the bronchial wall decreased from 87. 5 ±13. 2 to 30. 5 ±9. 3, and total time spent shortened from ( 700. 8 ±56. 6) s to ( 607. 0 ±17. 8) s. There were no statistically significant differences between novice accuracy ( the percentage of observed segments) after training and skilled physician accuracy [ ( 89. 3 ±4. 0) % vs ( 91. 3 ±3. 0) % , P = 0. 456] . Conclusion Practice using a virtual bronchoscopy simulator help novice trainees to attain a level of skill at performing diagnostic bronchoscopy, and it might play an important role in the training of chest physicians.
ObjectiveTo investigate the effect of daphnetin (DAP) combined with insulin-like growth factor 1 (IGF-1) gene transfection on chondrogenic differentiation of adipose-derived mesenchymal stem cells (ADSCs) in rats.MethodsRat ADSCs were isolated and amplified by enzymatic digestion. The third generation ADSCs were treated with IGF-1 gene transfection as experimental group and normal ADSCs as control group. The cells of the two groups were treated with different concentrations of DAP (0, 30, 60, 90 μg/mL), respectively. Cell proliferation was detected by cell counting kit 8 (CCK-8) after cultured for 72 hours. After 14 days, real-time fluorescence quantitative PCR and Western blot were used to detect the mRNA and protein expressions of chondrocyte markers (collagen type Ⅱ and Aggrecan) in each group; and toluidine blue staining and collagen type Ⅱ immunohistochemical staining were performed.ResultsCCK-8 assay showed that with the increase of DAP concentration, the cell absorbance (A) value of the control group and the experimental group increased gradually (P<0.05). At the same DAP concentration, the cell A value of the experimental group was significantly higher than that of the control group (P<0.05). Real-time fluorescence quantitative PCR and Western blot showed that with the increase of DAP concentration, the relative mRNA and protein expressions of collagen type Ⅱ and Aggrecan in the control group did not change significantly, and there was no significant difference among the different concentration groups (P>0.05). But the mRNA and protein expressions of collagen type Ⅱ and Aggrecan in the experimental group increased gradually, and the 60 and 90 μg/mL DAP concentration groups were significantly higher than 0 μg/mL DAP concentration group (P<0.05). At the same DAP concentration, the relative mRNA and protein expressions of collagen type Ⅱ and Aggrecan were significantly higher in the experimental group than in the control group (P<0.05). Toluidine blue staining showed that with the increase of DAP concentration, there was no significant difference in cell staining between the control group and the experimental group. At the same DAP concentration, the cells in the experimental group were slightly darker than those in the control group. Immunohistochemical staining of collagen type Ⅱ showed that with the increase of DAP concentration, there was no significant difference in the cytoplasmic brown-yellow coloring of the cells in the control group. The cytoplasmic brown-yellow coloring of the cells in the experimental group gradually deepened, with 60 and 90 μg/mL DAP concentration groups significantly deeper than 0 μg/mL DAP concentration group. At the same DAP concentration, the color of the cells in the experimental group was significantly deeper than that in the control group.ConclusionDAP can promote the proliferation of ADSCs in rats. The differentiation of ADSCs into chondrocytes induced by DAP alone was slightly, but DAP combined with IGF-1 gene transfection has obvious synergistic effect to promote chondrogenic differentiation of ADSCs.
Objective To explore the distribution of bacteria among community acquired lower respiratory tract infection (LRTI) inpatients with underlying chronic respiratory tract diseases.Methods The clinical data，sputum culture and drug susceptibility results of 212 community acquired LRTI patients who were hospitalized during the period 2001-2005 were retrospectively analyzed.All patients had various underlying chronic respiratory tract diseases.Results A total of 229 strains of pathogens were detected，with the majority being gram negative bacteria.In pathogens of acute exacerbation of chronic obstructive pulmonary disease，gram negative bacteria occupied 73.9%.And Pseudomonas aeruginosa and Klebsiella pneumoniae were the most common pathogens，with each occupying 18.2% and 13.6% respectively.Gram positive bacteria occupied 23.8%，mainly Staphylococcus aureus (10.2%) and Streptococcus pneumoniae (9.1%).In patients with bronchiectasis exacerbated by bacterial infection，86.2% were caused by gram negative bacteria，the top three being，in descending order，Pseudomonas aeruginosa (27.5%)，Haemophilus parainfluenzae (13.7%)，and Haemophilus influenzae (11.8%).Bronchiectasis was the major risk factor of getting Pseudomonas aeruginosa infection (OR=5.590，95%CI 2.792~11.192).The risk factors of getting Acinetobacter baumanii infection were antacid usage within 1 month (OR=9.652，95%CI 2.792~11.192) and hypoalbuminemia (OR=2.679，95%CI 1.108~6.476).For enterobacters infections，including Klebsiella pneumoniae，Enterobacter cloacae and Escherichia coli，the risk factors were antibiotic usage within 1 month (OR=4.236，95%CI 1.982~9.057)，having renal diseases (OR=4.305，95%CI 1.090~17.008) and diabetes mellitus (OR=2.836，95%CI 1.339~6.009).Conclusions Gram negative bacteria were the main pathogens of community acquired LRTI in hospitalized patients with underlying chronic respiratory tract diseases.The pathogens were influenced by underlying diseases，severity of diseases and drug usage history of patients.
Objective To investigate the feasibility of diagnosis of potential chronic obstructive pulmonary disease (COPD) patients who cannot finish the pulmonary function test via biphasic CT scan. Methods Sixty-seven male individuals aged 43 to 74 (57.0±5.9) years were divided into a COPD group (n=26) and a control group (n=41). All individuals underwent biphasic quantitative CT scan for calculating the proportion of emphysema, functional small airway disease, and normal component of the whole lung and each lobe. Results Based on principle component analysis, two principal components “imaging feature function 1 and imaging feature function 2” were calculated and analyzed by logistic regression, which found that imaging feature function 1 was an independent risk factor of COPD (odds ratio=8.749, P<0.001), and imaging features function 1 could be used to assist the diagnosis of COPD (area under receiver operating characteristic curve=0.843, P<0.001). Conclusion Imaging features function 1 is an independent risk factor for COPD and can assist the diagnosis of COPD.