Effectiveness of Participatory Teaching Methods in the Standardized Training of Respiratory Medicine Residents

Objective:To explore and analyze the application effect of participatory teaching method in the standardized training of respiratory medicine residents.Methods:The study period was from May 2022 to May 2023.20 doctors in the standardized training of respiratory medicine residency in our hospital were taken as research subjects and grouped into the participatory group(n=10)and the routine group(n=10)by using the random number lottery method.The participatory group practised participatory teaching methods,and the routine group practised routine teaching methods.The results of discharge assessment,teaching evaluation,and mini-Clinical Evaluation Exercise(mini-CEX)assessment were compared between the groups.Results:The theoretical assessment,operational assessment,and total scores of the participatory group were significantly higher than those of the routine group,and the difference was statistically significant(P<0.05).The teaching evaluation of independent learning,theoretical mastery,teamwork,clinical thinking,communication,and learning interest of the participatory group was significantly higher than that of the routine group,and the difference was statistically significant(P<0.05).The mini-CEX assessments of history inquiry,organizational effectiveness,professionalism,physical examination,clinical diagnosis,communication skills,and overall clinical competence of the participatory group were significantly better than those of the routine group,and the difference was statistically significant(P<0.05).The teaching satisfaction of the participatory group was significantly higher than that of the routine group,the difference was statistically significant(P<0.05).Conclusion:Participatory teaching methods can improve the overall level of doctors in the respiratory medicine residency standardized training,and the teaching satisfaction is improved.

Application of PDCA Cycle in Clinical Teaching of Respiratory Medicine During the Outbreak of COVID-19

The study was to analyze the application of PDCA cycle in the clinical teaching of respiratory department during the outbreak of COVID-19.The teaching content focused on the prevention,control,diagnosis and treatment of COVID-19.Methods:Thirty clinical interns who entered the Department of Respiratory Medicine in our hospital from June 2020 to December 2020 were selected as the research objects and were randomly divided into two groups.The control group adopted traditional teaching methods and the experimental group adopted PDCA cycle.The teaching effect of the two group was compared.Results:The experimental group that used the PDCA cycle method had significantly higher theoretical knowledge,treatment skills,and comprehensive quality evaluation of COVID-19 than the traditional teaching method of the control group.Conclusion:The application of the PDCA cycle method in clinical teaching activities can improve the teaching process during the outbreak of COVID-19 and help improve the overall quality of clinical interns.

Exploring the Role of Narrative Medicine in the Cultivation of Humanistic Spirit among Respiratory Medicine Interns

Objective:To explore the role of narrative medicine in cultivating the humanistic spirit of respiratory medicine interns.Methods:Thirty interns were selected,all of whom were received by the respiratory department of our hospital from September 2023 to June 2024 and underwent narrative medicine teaching.Scores on narrative medicine knowledge,empathy ability,humanistic care ability,and teaching recognition were compared before and after the internship.Results:Compared to before the internship,the interns’scores on narrative medicine knowledge were significantly higher after the internship,as were their empathy and humanistic care scores(P<0.05).Among the 30 interns,25 expressed interest in narrative medicine,and 29 were willing to continue with the narrative medicine teaching model.Conclusion:The application of narrative medicine in respiratory medicine internship teaching is highly effective.It cultivates the humanistic spirit of interns,improves their empathy and humanistic care abilities,and is worthy of wider implementation.

Monogenic diseases in respiratory medicine:Clinical perspectives

With the increasing awareness of genetics in respiratory medicine and improvements in molecular diagnostic techniques,many complicated and rare diseases in respiratory medicine can be diagnosed.Most respiratory diseases have no specific phenotype.However,the clinical spectrum of monogenic diseases in respiratory medicine varies,from pulmonary disease to other inherited disorders that involve the lung.The genes that mediate some of these diseases have been identified.Certain monogenic diseases remain poorly characterized clinically.Because of the specificity of the phenotype of respiratory disease,a future challenge will be to correlate the phenotype and genotype and understand its phenotypic variability.With the development of precision medicine,research on monogenic disorders has been intensive and vigorous.In this article,we provide a brief clinical introduction to monogenic diseases in pediatrics.

Give Full Play the Role of Traditional Chinese Medicine to Prevent and Treat Severe Acute Respiratory Syndrome with Integrative Chinese and Western Medicine Approach

Member of Political Bureau of Central Committee of CPC, Vice Premier of State Council concurrently Minister of Health, General Command of National Protecting and Treating Severe Acute Respiratory Syndrome ( SARS) Headquarters Vice premier WU Yi cordially met the well-known TCM specialists, and held a symposium with them. Sixteen specialists including WANG Yong-yan, CHEN Ke-ji, LI Fu-ren, JIAO Shu-de, HE Pu-ren, LIU

Clinical characteristics of pulmonary cryptococcosis coexisting with lung adenocarcinoma:Three case reports

BACKGROUND Pulmonary cryptococcosis (PC) is an invasive fungal disease caused mainly byCryptococcus (C.) neoformans or C. gattii. It may be present in immunocompetent orimmunocompromised patients. The radiographic features of PC vary, and themost common computed tomography manifestation is the presence of solitary ormultiple pulmonary nodules or masses distributed in the outer zone of the lungfield. The appearance of nodular or mass-like PC on computed tomography scansresembles that of primary or metastatic lung cancers, and differential diagnosis issometimes difficult. The coexistence of PC and malignant tumors is rarelyobserved.CASE SUMMARY This paper reports three cases of PC combined with lung adenocarcinomadiagnosed by video-assisted thoracic surgery lung biopsy, which weresuccessfully managed by early diagnosis and treatment.CONCLUSION The present case report might serve as a reminder not to neglect PC coexistingwith adenocarcinoma. Early diagnosis and treatment lead to a better prognosis.

Synchronous Dynamic Research on Respiratory and Intestinal Microflora of Chronic Bronchitis Rat Model

Objective： To investigate the mechanism of the Chinese medicine theory that Fei（Lung） and Dachang（Large Intestine） are exteriorly and interiorly related via synchronous observation on the dynamic changes of the respiratory and intestinal microflora. Methods： Forty specific pathogen free Sprague-Dawley rats were selected and randomly divided into blank（10 rats） and chronic bronchitis model groups（30 rats）. The blank group rats were put into the smoke-free environment and the model group rats were put into the smoke environment in order to establish pulmonary disease（chronic bronchitis） model. Then the corresponding changes of the respiratory and intestinal microflora of the model on 20th, 50th and 70th days were synchronously observed. Results： The respiratory tract microflora showed an increase in the total aerobic and Staphylococcus aureus and reduced anaerobic amount significantly on 20th day in the respiratory tract microflora（P〈0.05 or 0.01）. On 50th day, total aerobic, total anaerobic amount and bifidobacterium significantly increased（P〈0.05）. On 70th day, Staphylococcus aureus reduced and lactobacillus increased significantly（P〈0.01）. The intestinal microflora showed an increase in the total aerobic, Clostridium perfringens, enterobacter and enterococcus significantly increased on 20th day（P〈0.05 or 0.01）. Staphylococcus aureus on 50th day increased significantly（P〈0.05）. Total aerobic and enterococcus increased, total anaerobic and Clostridium perfringens reduced significantly on 70th day（P〈0.05 or 0.01）. Conclusions： The microecosystem of respiratory tract and intestine of rat model during the pathological process showed a dynamic disorder, indicating an interaction between the lung and large intestine which may be one of the connotations as they exteriorly and interiorly related.

Effect of a Traditional Chinese Medicine combined therapy on adolescent idiopathic scoliosis:a randomized controlled trial

OBJECTIVE:To evaluate the effectiveness of a combined Traditional Chinese Medicine(TCM) therapy versus conventional treatment on adolescent idiopathic scoliosis.METHODS:One hundred twenty outpatients with mild and moderate adolescent idiopathic scoliosis were randomly divided into a TCM group(TCMG)and a brace group(CG).TCMG patients underwent Daoyin,Tuina,and acupotomology therapies.CG patients were treated with a Milwaukee brace.Each patient's Cobb angle was measured after 12 and 24 months of treatment,and pulmonary function was determined after 12 months of treatment.Average electromyogram(AEMG) ratio of the surface electromyogram was measured after 6 and 12 months of treatment and followed-up after 18 and 24 months.RESULTS:The Cobb angle significantly decreased in both groups after 12 months of treatment compared with before treatment(P< 0.05).The percentages of original Cobb angle in TCMG and CG were51.4%and 47.8%(P > 0.05) after 12 months and62.5%and 34.7%(P < 0.05) after 24 months,respectively.Pulmonary function significantly improved after 12 months in TCMG(P < 0.05) but significantly decreased in CG(P < 0.05).The AEMG ratio was significantly lower(P < 0.01) and tended to remain at1 after stopping treatment in TCMG,but increased in CG(P<0.05).CONCLUSION:TCM combined therapy can prevent the progression of scoliosis.The AEMG ratio is a promising index that could replace radiography in the evaluation of treatment effect and progression in scoliosis.

Neuroprotective Effect of Shenfu Injection (参附注射液) Following Cardiac Arrest in Pig Correlates with Improved Mitochondrial Function and Cerebral Glucose Uptake

Objective：To test whether Shenfu Injection（参附注射液,SFI）might attenuate the impact of cerebral energy dysfunction after resuscitation in a pig model of cardiac arrest（CA）.Methods：Thirty-four Wuzhishan miniature inbred pigs were randomly divided into three groups：the SFI group（n=12）,the saline group（SA group,n=12）,and the sham-operated group（sham group,n=10）.Following successful return of spontaneous circulation（ROSC）from 8-min untreated ventricular fibrillation,animals received a continuous infusion of either SFI（0.2 mL/min）or saline for 6 h.Cerebral performance category score was evaluated at 24and 48 h after ROSC,followed by positron emission tomography and computed tomography scans of cerebral glucose uptake.Surviving pigs were euthanized 48 h after ROSC,and the brains were removed for detecting mitochondrial function.Results：Compared with the SA group,SFI treatment produced a better neurologic outcome48 h after ROSC（P〈0.05）.However,there was no significant difference of survival rate between the SA and SFI groups（83.3%vs.81.8%,P〉0.05）.After ROSC,the SA group showed a decrease in the maximum standardized uptake value of different regions in the brain tissue,where SFI treatment can ameliorate these decreases（P〈0.01or P〈0.05）.Improved mitochondrial respiratory properties and higher mitochondrial membrane potential were also found following SFI treatment compared with the SA group at 48 h after ROSC（P〈0.05 or P〈0.01）.Conclusion：SFI treatment after resuscitation has significant neuroprotective effects against disruption of cerebral energy metabolism from CA by improving glucose uptake and by normalizing mitochondrial function.