目的 为提高免疫学课程的教学质量,加深学生对课程的理解,研究创新教学模式在免疫学教学中的应用效果.方法 2019年2-6月,选取该校2017级临床专业学生227名,分别为1班115名,2班112名开展该次创新教学模式研究.1班学生进行创新教学模式上课,包括以问题为导向的(PBL)翻转教学模式、渗透愉悦教学模式以及科研促进教学模式等,2班学生进行以授课为导向(LBL)的传统教学模式.对比不同教学模式后两组学生的期末成绩、对课程的满意度、学习动力评分、记忆学习态度评分.结果 1班学生期末成绩(83.78±5.36)分,2班学生期末成绩(78.69±5.23)分,1班学生期末成绩得分显著高于2班学生,差异有统计学意义(P<0.05);1班学生课程满意度、学习动力评分显著高于2班学生,差异有统计学意义(P<0.05);学习态度评分中,1班学生在课堂表现、作业完成度、课外自学三项评分均显著高于2班学生,差异有统计学意义(P<0.05).结论 在免疫学教学中,使用创新教学法可提高学生学习成绩,增加学生的学习动力,提高学习态度评分,使学生掌握免疫学基本理论及发展规律,创新教学模式在免疫学教学中应用效果较佳.

军团菌病( Legionella disease)是由军团菌( Legionella)引起的以非典型肺炎为主要表现的多系统损害的急性细菌性传染病。此菌及其代谢产物可损害人体的多个脏器,严重影响肺、脾、肾、消化道和中枢神经系统功能。在迄今为止的40年间,此病发病率逐年上升,对人类健康的威胁日趋严重。在军团菌病的临床治疗过程中,早期治疗使用喹诺酮类或大环内酯类药物,疗效非常显著,但如若未能及时治疗,则死亡率可高达50%[1]。目前已确认的军团菌就有近60个种,70多个血清型[2],其中能引起人类致病的约30种[3]。在早期诊断时,通常采用生化和血清学检验方法,但由于只能检测军团菌中的嗜肺军团菌( Legionella pneumophila, Lp),极易出现漏诊,延误治疗时间。因此,研究探索军团菌病的广谱抗原并实现其基因的克隆及原核表达,是实现军团菌病早期快速、有效诊断的关键。

Objective To study the laboratory features of primary biliary cirrhosis (PBC) in Chinese so as to provide the reference for PBC laboratory diagnoisis.Methods Three hundred and sisty-one stored AMA M2 autoantibodies positive serum samples which have been kept for 10 years were used to analyze the autoantibodies,biochemical abnormalities and immunoglobulins retrospectively.Results The most frequently biochemical abnormalities were alkaline phosphatase (ALP) (84.5%) and gamma glutamyl transpeptidase (GGT) (78.9%).The levels of IgM increased abnormally in 259 patients (71.7%).Biochemical indicators were normal in 53 AMA-M2 positive patients.Positive rates of AMA and ANA were 84.5% and 76.7% respectively.The main fluorescent patterns of ANA were nuclear membrane and centromere patterns.The positive rate of antibodies to the major autoantigens PDC-E2,BCOADC-E2 and OGDC-E2 were 85.3%,69.5% and 24.4% respectively in Chinese patients.Conclusion Together with a positive AMA-M2,elevated serum IgM,ALP,GGT levels and AMA positive were most freguently found in PBC patients.14.7% patients had normal biochemical indicators including ALT,ALP and GGT at the time of first diagnosis.Distributions of three major AMA-M2 autoantigens in Chinese patients were different from those in caucasian.