目的 通过对血液学形态的综合教学改革,提高学生对血细胞形态的掌握和认识.方法 针对血细胞形态传统教学方法的种种缺陷和限制,造成教学效率低下,学生学习掌握困难的特点,对此内容的教学进行改革和调整.大班制改为小班制,增加师资增加师生的双向交流;引入数码互动显微技术,建立网络数码显微互动形态实验室,并且建立师生用于细胞形态交流的网络平台,加强学生学习的主动性和自觉性,增强师生全方位的互动交流;增加临床知识临床诊断的分析训练,加强综合能力的培养;改革形态考核制度,充分调动学生的主观能动性.结果 极大地增加了血细胞形态教学的效率,使学生顺利而扎实地掌握血细胞形态的学习,为以后的临床实习和工作打下坚实基础.结论 对血细胞形态学的教学改革取得了良好的效果,经验值得推广和应用.

The rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the coronavirus disease 2019 (COVID-19) worldwide pandemic. This unprecedented situation has garnered worldwide attention. An effective strategy for controlling the COVID-19 pandemic is to develop highly accurate methods for the rapid identification and isolation of SARS-CoV-2 infected patients. Many companies and institutes are therefore striving to develop effective methods for the rapid detection of SARS-CoV-2 ribonucleic acid (RNA), antibodies, antigens, and the virus. In this review, we summarize the structure of the SARS-CoV-2 virus, its genome and gene expression characteristics, and the current progression of SARS-CoV-2 RNA, antibodies, antigens, and virus detection. Further, we discuss the reasons for the observed false-negative and false-positive RNA and antibody detection results in practical clinical applications. Finally, we provide a review of the biosensors which hold promising potential for point-of-care detection of COVID-19 patients. This review thereby provides general guidelines for both scientists in the biosensing research community and for those in the biosensor industry to develop a highly sensitive and accurate point-of-care COVID-19 detection system, which would be of enormous benefit for controlling the current COVID-19 pandemic.

在医学检验本科实习生的临床实习中开展PBL教学的研究,探讨其教学效果.对2016-2018年的42名医学检验本科实习生在临床传统的实习教学基础上,引入PBL教学模式,探讨PBL教学核心的“以学生为中心,以问题为中心”的教学方法在临床实习应用实施.发现其能提高学生的学习积极性,增强学生对专业知识的掌握,提高学生的临床思维能力,以及扩展学生的临床知识等方面有着积极的意义,对在医学检验的临床实习中加强理论联系实践,提高学生的综合分析能力是行之有效的方法,值得推广.

Background: Nasopharyngeal carcinoma (NPC) is common in Southern China. The molecular mechanism underlying NPC genesis and progression has been comprehensively investigated, but the key gene (s) or pathway (s) pertaining to NPC are unidentified. Methods: We explored some key genes and pathways involved in NPC through using meta-analysis of deposited expression of microarray data of NPC. The expression of proliferating cell nuclear antigen clamp associated factor (PCLAF) was determined by real-time PCR and western blots. CCK-8 assay, colony formation assay, transwell migration assay, cell wound healing assay, cell cycle analysis and cell apoptosis were carried out to assess biological behaviors caused by downregulation and overexpression of PCLAF in vitro. CHIP was utilized to determine the direct upstream regulatory transcription factors of PCLAF. Results: PCLAF was the key gene of NPC, which was significantly up-regulated in NPC cell line compared to the normal nasopharyngeal cell line. Additionally, in vitro assay has demonstrated the down-regulation and overexpression of PCLAF, resulted in significantly suppressed and enhanced NPC proliferation, metastasis and invasion respectively. Furthermore, the up-regulation of PCLAF in NPC is induced by direct binding of dysregulated NF-κB p50/RelB complex to the promoter of PCLAF. Conclusion: Our results offer a strategy for re-using the deposited data to find the key genes and pathways involved in pathogenesis of cancer. Our study has provided evidence of supporting the role of PCLAF in NPC genesis and progression.

Objective To explore the relationship between resistin rs1862513 with type 2 diabetes mellitus (T2DM ) in Guangdong area .Methods 182 cases of newly diagnosed T2DM in the Second Affiliated Hospital of Guangzhou Medical College from October 2010 to October 2011 were collected as the treatment group and contempo-raneous 191 subjects with healthy physical examination as the control group .The distribution frequency of rs1862513 locus C/G genotype and the logistic regression analysis results were compared .Results The genotype frequency of rs1862513 locus reached the genetic equilibrium with the group representative .Among them ,χ2 = 4 .645 ,P= 0 .098 , the difference of distribution frequency of rs1862513 locus C/G genotype had no statistical significance (P > 0 .05) ;the morbidity rate of GG homozygote was 1 .375 times of the mobidity rate of CC homozygote (OR = 1 .375 ,95% CI :0 .575 - 3 .285) .The difference of the risk degrees among genotypes had no statistical significance (P> 0 .05) .Conclu-sion rs1862513 genotype has no correlation with T 2DM in Guangdong area .

Objective: to investigate the correlation between insulin resistance in type II diabetes mellitus(IR) of the lipid and the control group and the non-insulin-resistance in Type 2 diabetes mellitus.Methods:The levels of fasting blood glucose, fasting insulin, HOMA-IR, TG, HDL-CH, LDL-CH, and CHOL were measure in 159 type 2 diabetes and the control group by 132 common health examination persons.Results:(1) There were statistical differences of FBG ,FIN, IRI, TG, HDL and LDL between the insulin resistance in T2DM patients and the control group(P<0.05).(2) There were statistical differences of FBG,CHOL and HDL between the non-insulin-resistance in T2DM patients and the control group(P<0.05).(3) There were statistical differences of FBG ,FIN, IRI, TG and CHOL between the insulin resistance in T2DM and the non-insulin-resistance in T2DM patients.(4) It had significant correlativity between IR with FBG, FIN, TG and HDL.Conclusions:A positive correlation between IR and Lipid metabolism in T2DM. It is conjectured that there is easy for the patients with T2DM of non-insulin-resistance to have Lipid metabolism.

Objective:(1) To explore the difference of three kinds of adiponectin rs +16861194 (A / G ) genotype distribution in the type 2 diabetes patients and healthy people ; (2) To investigate the relationship of adiponectin rs+16861194 gene polymorphism with some biochemical indicators from T2DM and control.Methods:Selected 158 cases of type 2 diabetes patients as the experimental group, 132 cases of healthy people as the control group. The genotypes of adiponectin rs-16861194 in experimental group and the control group were detected; At the same time, fasting plasma glucose, triglyceride (TG), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL) were measured seperately. Fasting insulin was measured by chemiluminescence and insulin resistance index was calculated.Results:①T2DM group and CON group adiponectin rs +16861194 genotype distribution were: AA (70.00%), AG (24.37%), G (5.63%) and AA (74.24%), AG (24.24%), GG (1.52%), the distribution showed no statistically significant difference (P> 0.05); ②Grouped by the genotype of adiponectin rs +16861194, the level of FBG, FIN, IRI, TG, CHOL, HDL-CH, LDL-CH showed no statistically significant difference (P> 0.05) between the genotypes in T2DM and CON group. ③ Compraring between T2DM group and CON group,.the level of FBG, FIN, IRI, TG, HDL in the AA type of T2DM group and CON group had significant difference (P<0.05), while the level of CHOL and LDL showed no statistically significant difference (P> 0.05) ; The level of FBG,IRI,TG,HDL in the AG+GG type of T2DM group and CON group had significant difference (P<0.05), while the level of FIN,CHOL,LOL showed no statistically significant difference (P> 0.05).Conclusions:(1) Three kinds of locus genotype distribution of rs +16861194 (A / G) had no significant difference in Type 2 diabetes patients and healthy people.(2) The genotype of adiponectin rs+16861194 had no effect on the level of FBG、FIN、IRI、TG、CHOL、HDL-CH、LDL-CH in type 2 diabetes patients and healthy people.

目的 分析近5年来我院鲍曼不动杆菌感染的耐药性变迁及其在医院中的流行状况,指导临床合理选用抗菌药物,采取有效的预防感染措施,控制耐药菌的产生及传播.方法 采用WHONET 5.4和SPSS 17.0统计软件对2007年1月至2011年12月我院临床送检的各类标本中分离的鲍曼不动杆菌进行回顾性统计分析.结果 鲍曼不动杆菌与5年间同期分离出的革兰阴性菌株相比,检出率排名从第4位逐年上升至第2位,对多种抗菌药物耐药率明显上升,差异有统计学意义(P＜0.05).2010年和2011年对多种抗菌药物耐药率达60％以上的占76.9％(20/26)和88.5％(23/26).结论 鲍曼不动杆菌已成为院内感染的主要非发酵菌,多重耐药情况十分严重,应引起临床医师的高度重视.临床医师应结合本院耐药监测情况合理选用抗菌药物,以减少多重耐药株的出现。

Objective To investigate the clinical distribution,the prevalence of ESBLs and antibiotic resistance of Proteus mirabilis isolated during the year of 2011-2013, and provide some clues for clinical therapy of Proteus mirabilis(P.mirabilis). Methods The antibiotic susceptibility results of P. mirabilis which isolated from our hospital during January 2011 to December 2013 were collected and analyzed by using WHONET 5.4 statistical software. Results Most of the clinical isolatescame from urine and sputum specimens(39.90% and 11.40%); followed by pus(5.18%),blood(1.5%),and other types of specimen. In 2011-2013, the ESBLs test positive rates of P.mirabilis were 9.30%,22.97% and 28.95%,respectively. This shows a rising trend of ESBLs positive P.mirabilis year by year. P.mirabilis was more sensitive to the following antibiotics:Meropenem(0.0%),Imipenem(0.0%), Ticarcillin / Clavulanic acid(0.0%), Cefoperazone / Sulbactam(2.5%), Piperacillin / Tazobactam(5.0%), Cefoxitin(7.5%), Amikacin(15.0%). Conclusions The ESBLs positive rate is high in P.mirabilis clinical isolates. The antibiotic resistance situation is also serious for this bacterial strain. It is important to strengthen the separation,identification and antibiotic resistance testing of P.mirabilis, which would provide helpful information for P. mirabilis infection therapy.

目的:了解重症监护室深部真菌感染情况及耐药性变化,控制院内感染,为指导临床合理用药提供依据。方法:对2005-2009年临床标本分离出的174株真菌进行统计分析。结果:分离的174株真菌中,以白色念珠菌(53.4%)为主要菌种,其次是热带念珠菌(19.0%);分布主要在痰标本(37.9%)、尿标本(31.0%)和血标本(17.2%)中。对抗真菌药物的敏感性分别为两性霉素B99.4%、5-氟胞嘧啶94.2%、氟康唑87.4%、伊曲康唑56.0%。结论:临床医师应重视对真菌的培养鉴定和药敏试验,密切关注真菌的耐药变迁,合理选择抗菌药物,是防止和延缓耐药株进一步扩大的必要措施。

目的:探讨IQ200流式尿沉渣定量分析仪对尿路感染的筛选价值。方法:收集256例怀疑尿路感染的门诊及住院患者的尿液标本,在进行细菌培养后,立即用IQ200流式尿沉渣定量分析仪检测细菌(BACT)、芽殖酵母样真菌(BYST)和小颗粒(ASP),以细菌培养结果作为标准,比较其对尿路感染病原菌检出的敏感性、特异性,并计算其假阴性假阳性率。结果:IQ200检测BACT、BYST和ASP的敏感性分别为80.9%、85.7%和83.3%,修饰后分别为85.1%、92.9%和87.5%。特异性分别为94.7%、89.4%和56.2%,修饰后分别为96.7%、95.6%和59.0%。假阳性分别为22.4%、50.0%和83.6%,修饰后分别为14.9%、27.8%和81.9%。假阴性分别为4.3%、1.9%和3.0%,修饰后分别为3.3%、1.0%和2.1%。结论:IQ200流式尿沉渣定量分析仪对尿路感染具有一定的筛选作用,尤其是在专业技术人员对结果进行修饰后,并能快速提供结果。但其不能完全代替细菌培养,为确保临床的准确诊断,对筛选出的阳性患者应及早进行尿液细菌培养。

目的:分析大肠埃希菌在尿路感染中的分布特点、产酶情况和耐药性。方法:采用法国生物梅里埃鉴定系统,对本院2006年1月至2008年12月临床细菌性尿路感染的住院患者标本中分离出的254例大肠埃希菌采用琼脂纸片扩散法进行药敏试验,并进行β-内酰胺酶(ESBL)检测及分析。结果:尿路感染大肠埃希菌以老年人多见。分离出的254例大肠埃希菌中,有144例产超广谱ESBL,阳性率达56.7%。药敏显示:碳青霉烯类(亚胺培南)仍是最敏感的抗菌药物,其次为阿米卡星、呋喃妥因,敏感率均达85%以上。青霉素类、头孢菌素类、氨基糖苷类以及喹诺酮类对产ESBL大肠埃希菌耐药率较高,多重耐药性ESBL菌株显著高于非产ESBL菌株。结论:检测产超广谱ESBL菌株,有助于临床治疗由大肠埃希菌引起的尿路感染,防止医院交叉感染和耐药菌扩散,控制病原菌的暴发性流行。

Objective Reseach on the distribution of common pathogens and their resistance of the clinical urinary tract infection to guide clinical use of antimicrobial agents.Methods 795 pathogens were isolated from the urine culture of the out-patients and hospitalized patients with urinary tract infection from Jan.2006 to Nov.2008,and the pathogens were identified and put into vitro drug resistance testing,and Escherichia coli,Klebsiella pneumoniae was under the defection of super-extended-spectrum β-lactamase(ESBL).Results Totally,795 pathogens were isolated from the specimens of the patients with urinary tract infection,with 398 strains of gram negative bacilli,counted for 50.1%,230 strains ofGram positive bacteria(28.9%),167 strains of fungi counted for 21.0%.The main pathogens were escherichia coli 254(31.9%),167 fungus(21.0%),enterococcus faecalis 77(9.7%),enterococcus faecium 74(9.3%),klebsiella pneumoniae and 41 of the pseudomonas aeruginosa(5.2%).ESBL confirmatory test: Of 254 escherichia coli,152 were deteced out,with the enzyme production rate of 59.8%;Of 41 Klebsiella pneumoniae,32 were detected out,with the enzyme production rate of 78.1%.Pathogen isolation rate and the upward trend of drug resistance were increasing.Conclusion Escherichia coli,enterococci,fungus are the main pathogens of urinary tract infection,and drug resistance isolated from the clinic is in a very serious situation.Therefor,the proper use of antimicrobial agents should be strengthened,and attention should be paied to dynamic monitoring of bacterial resistance in guiding clinical rational use of antimicrobial drugs.It is of great importance in controling control the spread of drug resistance strains,and proventing the occurrence of infection in the hospital.

目的 研究全身炎症反应与凝血系统的关系,为临床治疗提供理论基础.方法 以急诊监护室和ICU危重病人为研究对象,按照SIRS的诊断标准将患者分为SIRS组70例,非SIRS组50例,另外健康的正常人50例作为对照,分别检测血小板数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶(TT)、纤维蛋白原(Fg)、抗凝血酶(AT)、蛋白C(PC)及D-二聚体(DD).观察在SIRS中,患者的凝血系统指标的变化.结果 对PLT、Fg、AT和PC的检测在SIRS组中比非SIRS组和健康对照组出现下降(P＜0.05),对PT、APTT、TT和DD的检测在SIRS组中比非SIRS组和健康组出现升高(P＜0.05).结论 在全身炎症综合征时,有促凝物质增加,抗凝物质减少,纤溶系统被抑制,形成复杂的全身炎症/凝血反应,炎症越重,凝血系统的激活越明显,预后越差.因此,观察凝血系统的指标,对全身炎症综合征的诊断、疗效及预后都有重要价值.

细菌感染是引起泌尿系感染的重要原因,这些细菌常具有较高的耐药性.我院1998-2000年对从临床收集的泌尿系感染标本进行培养及耐药性分析,以期对临床用药提供依据,现将结果分析报告如下.