OBJECTIVE To investigate the clinical characteristic and antimicrobial resistance of pathogenic bacteria causing lower respiratory tract infection,in order to provide reference for the clinical application of drugs.METHODS The strains of pathogenic bacteria were detected and their sensitivity to antibiotics was determined by Walkway 40 automatic bacterium identifying and drug sensitivity analyzing systems,then the specimens in which bacteria was detected and the result of sensitivity to antibiotics were analyzed,and the extended spectrum β-lactamase(ESBLs) were identified by means of disc agar diffusion method.RESULTS All 684 pathogenic bacteria strain were detected,among which Gram-positive cocci accounted for 27.6%,Gram-negative bacteria accounted for 62.1%,and fungus accounted for 10.2%.Among the isolated 37 strains ESBLs producing Escherichia coli(53.6%) and Klebsiella pneumoniae(34.3%).Gram-positive cocci were all sensitive to vancomycin.The resistant rate of Gram-negative bacteria to IMP and complex antibiotics containing β-lactamases inhibitor were relatively low,while the resistant rate to other antimicrobial drugs was higher.CONCLUSION The drug resistance of ESBLs-producing E.coli is increasing with the consecutive application of antibiotics.It is very important to rationally use drugs for clinical treatment of the infections according to the results of antibiotics susceptibility tests.

检测我院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的耐药性和基因型.表型确定临床分离产ESBLs的大肠埃希菌和肺炎克雷伯菌56株,应用PCR基因扩增技术及双脱氧DNA测序方法,分别对TEM、SHV、CTX-M-1、CTX-M-2和CTX-M-9编码基因进行分析.产酶菌株对亚胺培南、美洛培南、阿米卡星、头孢吡肟耐药性较低,对其他16种抗生素耐药性较高.在56株菌株中有50株为CTX-M型,占89%,34株为TEM型(60.7%),20株SHV型(35.7%);其中CTX-M-9型共计39株占78%,CTX-M-1型19株占38%,CTX-M-2型16株占32%.产ESBLs大肠埃希菌和肺炎克雷伯菌的耐药性值得关注,主要临床流行基因型是CTX-M型.

Objective To investigate the expression of BALP and free/total prostate-specific antigen(f/t-PSA) in patients of prostatic carcinoma(Pca),and evaluate the importance on detecting the BALP and f-PSA/t-PSA in prostatic carcinoma complicating osseous metastasis patients.Methods Osseous metastasis was diagnosed by the bone imaging adding CT after 3 monthes as glod standard,35 patients having multiple osseous metastasiswere recruited into experiment group,other 21 prostatic carcinoma patients without osseous metastasis were control group,extecting the PSA,BALP by ELISA methods,calculate the ensitivity and specificity of different diagnosis methods.Results The level of t-PSA and BALP in peripherial blood in osseous group show significant higher than control group(P0.05),while the f-PSA/t-PSA show significant lower than control group with none osseous metastasis.The sensitivity of f-PSA/t-PSA0.15 is highest(85.7%),but specificity lower(47.6%);The sensitivity combining f-PSA/t-PSA and BALP was lowest(62.9%),but the specificity was highest(76.2%).Conclusion Combining the BALP with f-PSA/t-PSA can increase specificity of BALP on diagnosising the osseous metastasis of prostatic carcinoma.Detection of BALP combined with f-PSA/t-PSA is a valuable scheme for early diagnosis of skeletal metastasis of prostate cancer.

随着我国医疗卫生事业的发展,医学检验专业迅速发展起来了,但是检验人才的培养滞后于临床发展的需要。针对检验教学的现状,文章进行一些分析并从检验学生理论课的设置、教学、理论课与实践的联系、临床实习等几个方面提出几点建议,供参考。

实验教学在医学检验专业人才培养过程中有着举足轻重的作用.目前,按照医学检验教学大纲要求,理论教学与实验教学的衔接过程中,实验教学的课程评分方法设置,有着不十分恰当的地方.因此,在具体的教学实践中调整考核办法,增加具有创新研究的开放设计性、综合性试验考核显得尤为重要.

社会需求是人才培养的方向,医学检验专业也因此不断的调整.专业教学应针对学生毕业后的工作实际,注重培养学生解决实际问题的能力,重视思想方法及实验技术的培养.

目的:通过改进实验诊断学课程的教学方法,增强实验诊断学课程的趣味性、临床有用性、理论指导性,使理论与实践有机的结合起来,提高学生学习积极性.方法:通过学生的考试成绩分析教学方法的得与失.结果:采用结合检验报告单讲解实验诊断学课程确实提高了学生的考试成绩.结论:结合检验报告单讲解实验诊断学课程这种教学方法增强了实验诊断学课程的趣味性、临床有用性、理论指导性,使理论与实践有机的结合起来,提高学生学习的积极性.

室间质量评价可以客观地评价各实验室的试验结果,了解各实验室之间结果的差异,帮助其校正,使其结果具有可比性[1].卫生部临床检验中心于1988年开始了全国乙肝标志物检验的室间质评工作.现将1994～1997年我室抗HBe和抗HBc室间质评的错误结果及其产生的原因分析如下.