In the available reports on clinical medicine, the infection sites of Mycobacterium porcinum include wounds, bone marrow, respiratory tract, and catheters. A 61-year-old woman was admitted to our hospital; her hilar and mediastinal lymph nodes were found to be enlarged during health examination, but there was no specific discomfort. Initially, she had undergone a mediastinal lymph node biopsy and pathology, but the diagnosis was not confirmed. However, 16S rRNA gene sequencing revealed M. porcinum infection of hilar and mediastinal lymph nodes. Subsequently, she was treated with clarithromycin, amikacin, imipenem, and tigecycline. After 2 months, chest computed tomography showed a significant reduction in lymph nodes. M. porcinum infection was considered to be the cause of disease.

Objective To observe the role of Eps15 homology domain containing protein 2 (EHD2) in the inhibitive effects of unsaturated fatty acid of Actinidia chinesis planch seed oil (kiwi fruit essence) on the growth and metastasis of transplanted tumor in lung adenocarcinoma mice. Methods 32 C57BL/6J mice bearing Lewis lung adenocarcinoma cells were randomly divided into the control group, 60, 120 and 240 mg/kg kiwi fruit essence treatment groups. Each group included 8 animals. From the fourth day after innoculation, the mice in the control group were intragastrically treated with normal saline, and the mice were intragastrically treated with 60, 120 or 240 mg/kg kiwi fruit essence in the corresponding kiwi fruit essence treatment groups. After measuring the volume of transplanted tumors, all mice were sacrificed on day 24, and their pulmonary tissues were then removed to observe tumor metastasis. The transplanted tumors were exfoliated and weighed to calculate the metastasis inhibition rate and tumor inhibition rate. The protein expression level of EHD2 in the transplanted tumors was detected by immunohistochemistry and Western blotting. The mRNA expression level of EHD2 in the transplanted tumors was measured using real-time quantitative PCR. Results Compared with the control group, the growth, volume, quality and number of lung metastasis nodules of the subcutaneous transplanted tumors significantly decreased, and tumor inhibition rates and metastasis inhibition rates increased in 60, 120, 240 mg/kg kiwi fruit essence treatment groups. The protein and mRNA level of EHD2 in the subcutaneous transplanted tumors went up. Compared with the 60 mg/kg kiwi fruit essence treatment group, the above indicators were significantly improved in 120 and 240 mg/kg kiwi fruit essence treatment groups in a dose-dependent manner. Conclusion Kiwi fruit essence can up-regulate EHD2 expression, thereby inhibiting the growth and metastasis of lung adenocarcinoma transplantation tumor in mice.

Objective To explore the clinical value of transbronchial frozen lung biopsy in the diagnosis of diffuse lung lesions of unknown origin. Methods Fourteen patients with diffuse pulmonary lesions admitted to our hospital from June 2018 to June 2019 were enrolled. The patients underwent retrospective analysis using transbronchial biopsy data as observation group and concurrent application of clamps. Fifteen patients with diffuse lung lesions under biopsy served as a control group. The histopathological diagnosis data of the two groups were observed and compared. Results Pathological reports showed that 2 patients were diagnosed with mucinous adenocarcinoma, 3 with non-specific interstitial pneumonia (NSIP), 3 with immune-related interstitial pneumonia, and 1 with alveolar cell carcinoma. One patient was tuberculosis. The diagnostic coincidence rate of the observation group was 71.43％ (10/14); in the control group, 2 cases were diagnosed as mucinous adenocarcinoma, 2 cases were NSIP, and 3 cases were immune-related interstitial pneumonia. The diagnostic coincidence rate of the control group was 46.67％ (7/15). There was a statistically significant difference in the diagnostic coincidence rate between the two groups (P<0.05). In addition, the diameter of the tissue samples of the observation group was significantly larger than that of the control group, and the difference was statistically significant (P<0.05). However, there was no significant difference in the bleeding between the observation group and the control group (P>0.05). Conclusion The application of transbronchial frozen lung biopsy can accurately diagnose diffuse lung lesions. It has a high diagnostic coincidence rate and low bleeding volume. It is a safe and effective biopsy method.

目的 探讨肿瘤相关因子双肾上腺样激酶1(DCLK1)和肿瘤坏死因子α诱导蛋白3(A20)在非小细胞肺癌(NSCLC)组织中的表达情况及临床意义.方法 用免疫组织化学方法检测DCLK1和A20在61例肺癌和22例癌旁肺组织中的表达.结果 (1)非小细胞肺癌原发灶组织和癌旁肺组织中A20的表达阳性率分别为59.0％(36/61)和18.2％(4/22),两组之间差异有统计学意义(P<0.05);非小细胞肺癌原发灶组织和癌旁肺组织中DCLK1表达阳性率分别为21.3％(13/61)和27.3％(6/22),两组间差异无统计学意义(P>0.05);(2)A20蛋白阳性水平与淋巴结转移显著相关(P<0.05),与NSCLC病理组织类型、肿瘤组织分化程度无相关性(P>0.05).DCLK1蛋白阳性水平与肿瘤组织分化程度、临床分期及淋巴结转移均无相关性(P>0.05).结论 A20在非小细胞肺癌组织中的表达明显高于癌旁组织,其表达情况与淋巴结转移相关,可能参与了非小细胞肺癌的发生和发展,DCLK1与非小细胞肺癌的进展无明显关系.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:探讨基于微博平台的混合式教学法在诊断学教学中的实施效果。方法:按数字表法随机选取我校2015级临床医学专业两个教学班学生为研究对象,将其随机分为对照组（123人）和实验组（119人）,对照组采用传统教学法,实验组实施基于微博平台的混合式教学法,教学结束后根据诊断学成绩、期末主题演讲、问卷调查和教学满意度进行教学效果的评价。结果:实验组诊断学期末理论考试成绩及实践操作考核成绩显著高于对照组（P&lt;0.01）。同时,实验组在期末主题演讲、问卷调查和教学满意度上对诊断学教学效果的评价优于对照组（P&lt;0.01）。结论:基于微博平台的混合式教学法可提高诊断学教学效果,是一种行之有效的教学方法。</span>

滑膜肉瘤( synovial sarcoma , SS )是一种高度恶性的软组织肉瘤,其发生率占软组织肉瘤的5％-10％,多发生于青少年及成年人中,无明显性别差异,其主要见于四肢,亦可发生于其他无滑膜的部位,并不一定都是滑膜来源[1]. 滑膜肉瘤不仅发生率较低,且无典型临床表现及影征象,极易误诊. 现就我院收治的转移性肺滑膜肉瘤并肺曲霉菌感染1例报道如下,并进行相关文献复习.

目的：探讨基于微博平台的多元互动式教学法在提高诊断学实践教学质量中的作用。方法随机选择我院临床医学专业医学生作为研究对象，将其分为对照组和实验组，对照组应用传统的示教式实践教学法，实验组采用基于微博平台的多元互动式教学法进行实践教学。教学结束后，比较两组学生诊断学实践技能考核成绩、期末理论考试成绩和及格率、优秀率，并通过问卷调查学生对诊断学实践教学效果的评价。结果实验组学生诊断学实践技能考核成绩及期末理论考试成绩和及格率均明显高于对照组（P<0.05或P<0.01），并且对诊断学实践教学效果的评价明显优于对照组（P<0.01）。然而，两组学生诊断学实践技能考核成绩优秀率和理论考试成绩优秀率比较，无显著性差异（P>0.05）。结论基于微博平台的多元互动式教学法不仅能提高诊断学的实践教学质量，还可提升医学生的综合能力，是一种值得推广应用的教学模式。

诊断学是医学课程中的核心课程，是连接基础医学与临床医学的桥梁，而诊断学实践教学是诊断学教学的重要组成部分，是医学生获取临床操作技能的关键。多元互动式教学法通过教与学的多元和互动，实现学生主动式个性化学习，师生间和生生间共同参与课堂教学。微博是一个具有信息共享性、及时性和使用灵活性、自由性特点的网络开放平台。我们将多元互动式教学法与微博平台有机的结合，探讨其在诊断学实践教学中的应用及其优势与不足，从而提高诊断学实践教学质量，促进医学生临床技能的全面提升。

目的 本文主要是观察持续正压通气呼吸机(CPAP)治疗阻塞性睡眠呼吸暂停综合征(OSAS)的疗效.方法 收集2012年1月-2013年1月本医院收治的80例OSAS患者临床资料,采取持续正压通气呼吸机对患者进行积极治疗,最后监测血气分析情况.结果 治疗后患者的血氧分压、血氧饱和度明显高于治疗前,血二氧化碳分压明显低于治疗前,对比差异显著,具有统计学意义(P＜0.01).治疗前后不良症状对比差异显著,具有统计学意义(P＜0.01).结论 持续正压通气呼吸机治疗OSAS,疗效显著,值得临床推广.

目的 探讨无创呼吸机在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸功能衰竭的疗效.方法 将100例COPD合并Ⅱ型呼吸功能衰竭患者随机分为对照组和实验组,每组50例.对照组采用常规治疗措施,实验组在对照组的基础上加用无创呼吸机.对两组患者临床效果以及动脉血气分析变化进行观察和比较.结果 实验组在临床效果上明显优于对照组,实验组治疗12 h后动脉氧分压(PaO2)显著升高,动脉二氧化碳分压(PaCO2)有所下降,pH值有所改善,两组比较差异有统计学意义(P＜0.05).结论 无创呼吸机在COPD合并Ⅱ型呼吸功能衰竭的临床上具有较高的应用价值,效果显著,值得临床推广应用。

Objective To observed the inhibition of Suramin on transplanted lung adenocarcinoma in mice by detecting the expression of leptin in transplanted tumor,and to understand the anti-tumor effects of Suramin.Methods Mouse model of transplanted lung adenocarcinoma was built.Twenty-four C57BL/6J mice inoculated with Lewis lung carcinoma were randomly divided into three groups using random number table: control group,cisplatin group and suramin group.After the appropriate drug intervention,mice in each group were sacrificed 24 hours after inoculation.Subcutaneous tumor was peeled off and the inhibitory rate was calculated.The leptin and vascular endothelia growth factor(VEGF) were detected by immunohistochemical methods.Results The inhibition rate of tumor in cisplatin group and Suramin group was 39.2% and 49.1%,and the tumor weight was significantly different compared with that of control group(P0.01),The grayscale values of leptin in control group,cisplatin group and the Suramin group were 135.47±5.30,127.87±5.51 and 80.44±4.69,VEGF gray values were 156.26±6.45,134.7±5.81 and 96.13±5.66.Conclusions Suramin can significantly inhibit tumor growth in transplated lung adenocarcinoma.The mechanism may be inhibition of leptin and VEGF expression.

Objective: To investigate the inhibitory effects of ginsenoside Rg3 on the growth and metastasis of lung carcinoma allografts in mice, and to explore the possible mechanism. Methods: The mice bearing a metastatic variant of Lewis lung carcinoma were established, and then they were randomized to receive 0.9% sodium chloride solution (as a control), DDP (cisplatin), and ginsenoside Rg3 from the fourth day after transplant, respectively. Until the twenty-fourth day after transplant, the mice were sacrificed. The subcutaneous tumor was dissected, and the lung was removed. The inhibitory rate of tumor growth and the number of metastatic foci on the lung surface were counted. The expressions of SSTR (somatostatin receptor), VEGF (vascular endothelial growth factor) and PCNA (proliferation cell nuclear antigen) in subcutaneous tumor were examined by immunohistochemistry. The apoptosis was detected by TUNEL (terminal transferase-mediated dUTP nick end-labeling) method. Results: The inhibitory rates of tumor growth in DDP-treated group and the ginsenoside Rg3-treated group were 39.20% and 54.86%, respectively (P < 0.01). The numbers of metastatic foci on the lung surface in DDP-treated group and the ginsenoside Rg3-treated group were decreased by 30.25% and 58.57%, respectively (P < 0.05). The expression level of SSTR and the apoptosis index in the ginsenoside Rg3-treated group were higher than those in the control group and the DDP-treated group (P < 0.01), while the expression level of VEGF and the proliferation index of PCNA in the ginsenoside Rg3-treated group were decreased as compared with the control group and the DDP-treated group (P < 0.01, P < 0.05). Conclusion: Ginsenoside Rg3 can inhibit the growth and metastasis of lung carcinoma allografts in mice. The mechanism may be associated with the overexpression of SSTR. DOI:10.3781/j.issn.1000-7431.2012.08.002