This study implemented a novel virtual simulation operation (VSO) teaching platform to enhance offline teaching in clinical microbiology laboratory courses, specifically addressing biosafety level-3 (BSL-3) for SARS-CoV-2 isolation and culture. The study focused on the practical teaching component, comparing the effectiveness of VSO against traditional online video teaching. The study divided undergraduate medical laboratory technology students into experimental and control groups. The experimental group received teaching combining offline courses with online VSO exercises, while the control group participated in offline courses supplemented with standard teaching video reviews. Assessment criteria included comprehensive practical performance, operational skills, laboratory biosafety awareness, and aseptic awareness. An anonymous questionnaire evaluated teaching effectiveness. The integration of VSO with offline practical teaching demonstrated significant improvements in student performance, particularly in comprehensive practical skills, experimental operations, and laboratory biosafety awareness. These findings validate the effectiveness of this virtual simulation teaching platform as an innovative educational tool, offering valuable insights for curricular reform across other disciplines.

为探讨考试与学业评价改革新路径,医学院校以问题为导向,通过重构考试管理体系、强化过程性考核、从严课程成绩评定等改革,有力提升了学生核心竞争力、学生课程学习成绩和学校考试管理水平,全面提高了教学质量.

由全国高等院校医学检验专业校际协作理事会主办的华东六省一市高等院校医学检验技术专业技能大赛,杭州医学院连续获得好成绩,2021年获得团队特等奖.能在覆盖华东六省一市28所高校的医学检验技术大赛上拔得头筹,是本学院连续十年开展基于应用能力评价的检验技能竞赛成效体现.

全基因组测序技术已经广泛应用于结核分枝杆菌的研究中,包括谱系鉴定、微进化、耐药预测、传播监测、混合感染诊断等多方面.生物信息学在基因组学研究中贯穿了从数据处理、分析到可视化的各个阶段,对全基因组测序技术的应用起到了至关重要的作用.笔者主要介绍和归纳了目前在结核分枝杆菌全基因组测序中常用的主流生物信息学分析软件和平台,并对近年来新开发的生物信息学分析方法从可用性、软件选择及应用等方面进行概述,为同领域研究者更方便、更灵活地开展数据分析和快速选择研究分析工具提供参考.

Objective:To investigate the distribution and drug resistance of pathogenic bacteria on wound infections in burn patients, and provide reference for clinical application of antibiotics.Methods:The distribution and drug resistance of the bacteria isolated from the primary wound culture of patients in the Burn Department of Shaoxing Second Hospital from 2015 to 2020 were statistically analyzed.Results:A total of 2 437 strains of bacteria were detected, including 1 570 (64.42%) strains of gram-positive bacteria, mainly including 709 S. aureus, 434 S. epidermis, 174 S. haemolyticus and 112 Enterococcus. A total of 867(35.58%) strains of gram-negative bacteria were detected, mainly including 131 K. pneumoniae, 111 E. coli, 153 E. cloacae, 156 P. aeruginosa and 101 A.baumannii. The proportion of gram-negative bacteria increased significantly during 6 years ( χ2trend=78.74, P<0.001). The main gram-positive bacteria( S. aureus, S. epidermidis and S. haemolyticus) were all sensitive to tigecycline, teicoranin and vancomycin, and were highly resistant to methicillin(30.75%, 77.19% and 90.23%) and penicillin(96.90%, 97.93% and 95.98%). The resistance rates of five major gram-negative bacteria( K. pneumoniae, E. coli, E. cloacae, P. aeruginosa and A. baumannii) to meropenem, imipenem, amikacin, cefepime, ceftazidime, tobramycin, ciprofloxacin and levofloxacin were lower than 30%. The drug resistance rates of S. aureus to azithromycin, compound minophen, erythromycin, ciprofloxacin, clindamycin, moxifloxacin, gentamicin and levofloxacin showed significant downward trend during 2015 and 2020 ( χ2trend=4.75, 15.97, 5.70, 12.77, 7.16, 8.60, 11.27 and 10.71, P=0.029, <0.001, 0.016, <0.001, 0.007, 0.003, 0.001 and 0.001). Conclusions:S. aureus is the common pathogenic bacteria isolated from the wound surface of the burn patients in this hospital. The drug resistance of gram-negative bacteria is relatively low.

Background: Clostridioides difficile infection (CDI) has been primarily associated with the toxin B (TcdB), which can activate the intestinal immune system and lead to pathological damage. Even though the biological functions of intestine epithelial cell- derived extracellular vesicles (I-Evs) have been well documented, the role of I-Evs in the process of CDI is still unknown. Results: We isolated I-Evs ranging from 100–200 nm in mean diameter, with a density of 1.09-1.17 g/mL. These I-Evs expressed the extracellular vesicle-associated specific surface markers, CD63 and TSG101. In vitro, 50 µg I-Evs decreased the expression of IL-6, TNF- β, IL-1β, and IL-22 in MC38 induced by 0.8 ng/mL C. difficile TcdB, and increased expression of TGF- β1. In vivo, I-Evs also promoted regulatory T cell induction, which improved inflammation of mice up to 80% relative to C. difficile TcdB infected mice, depending on the TGF- β1 signal pathway. Conclusion: Our study firstly demonstrated that I-Evs originated from intestine epithelial cells is potentially a novel treatment endogenous candidate to effectively reduce the local infection induced by C. difficile TcdB.

高校实验室是进行教学、科研、创新与实践的重要基地,其建设与管理水平直接关系到人才培养的质量问题[1].随着国家中长期发展纲要的颁布以及对高等教育的大量投入,高校实验教学与科学研究条件得到根本性改善[2].实验室在数量、规模、仪器设备等硬件条件,已基本满足教学和科研的需求.然而在实验室建设规模的不断扩大下,以人工为主的纸质化传统实验室管理方式已远远不能满足实验室发展要求[3].尽管很多高校尝试自行开发或委托第三方开发了不同的实验室信息管理系统,对实验室日常管理、维护和教学提供了一定程度的有力支持[4].但大部实验室管理系统基于PC端或独立的APP,开发周期长且需要持续更新,以满足用户不断增长的需求,而对于学生来说需要不定期对APP进行更新、重新下载或安装,手机上安装的移动应用越来越多,导致长尾现象严重,耗电量高、数据流量多等资源大量浪费、用户体验感差等现象[5-6].在手机内存有限的情况下,让学生安装一个专门用来单个课程学习的软件,是很难被推广接受的,进而限制了应用软件的使用频率及教学效果[7].

目的 探讨呼吸系统感染高黏性肺炎克雷伯菌(hmKP)的临床特征、耐药性和荚膜血清型.方法 VITEK 2 Compact分析系统对115株分离自痰液的KP进行菌株鉴定和药敏试验,拉丝试验检测菌株的高黏液表型,PCR并测序确定荚膜血清型;比较hmKP组(28例)与传统KP(cKP)(87例)检测结果.结果 28株(24.35％)为hmKP.hmKP组年龄≥60岁人数低于cKP组,hmKP组体温＞38℃人数高于cKP组,患者胸部CT表现为结节渗出阴影或脓肿hmKP组明显高于cKP组,差异均有统计学意义(P＜0.05).对氨苄西林、哌拉西林和亚胺培南除外的其余常用抗生素耐药率hmKP株明显低于cKP株(P＜0.05).血清型总检出率与K1、K2检出率hmKP株均明显高于cKP株(P＜0.05).结论 hmKP株与cKP株感染呼吸系统的临床特征有明显差异,hmKP株对大部分抗生素敏感性高于cKP株,K1、K2是hmKP菌株的主要荚膜血清型.

为了克服传统教学中存在的缺陷,在分析应用物理学专业高等数学课程教学现状的基础上,剖析教学上的难点,提出了适合应用物理学专业高等数学课程的P_MAP教学设计策略,实施以"问题、建模、算法、编程"为主要内容的应用物理学专业高等数学课程的P_MAP教学设计,培养应用物理学专业学生的理论分析能力、解决问题能力和创新能力.

Objective:To investigate the distribution of pathogens in midstream urine samples collected from patients with suspected urinary tract infection (UTI) in outpatient department, the genotype and carrying rate of extended-spectrum β-lactamase (ESBL) gene in dominant strains of E.coli, and the difference of resistance to antibiotics between producing and non-producing ESBL E.coli. Methods:Midstream urine samples were collected from patients with suspected UTI in Shaoxing Central Hospital Medical Community Qianqing Branch during 2017 and 2019. Pathogens were cultured and isolated, and then were identified by VITEK2 Compact automatic bacteria analyzer. The drug sensitivity to antibiotics and ESBL production of E.coli isolates were detected by disk diffusion method and double disk synergy test, respectively. PCR was used to detect ESBL related genes and carrying rate. Results:In 1 529 UTI patients, 392 cases were positive for pathogens in midstream urine with the positive rate of 25.6%. A total of 424 strains were isolated, among which gram-negative bacteria, gram-positive bacteria and fungi accounted for 70.3%, 22.4% and 7.3%, respectively. E.coli was the predominant bacteria (226 isolates) , of which 101 (44.7%) isolates produced ESBL. The genotypes of ESBL-producing E.coli isolates were mainly CTX-M (87.1%) and TEM (70.3%) . The resistance rates of ESBL-producing E. coli isolates to 18 antibiotics except imipenem and meropenem were significantly higher than those of non-ESBL-producing isolates. Conclusions:E. coli is the major pathogen of UTI in this region. The detection rate of ESBL-producing E.coli isolates is high. CTX-M and TEM are the main encoding genotypes of ESBL. Imipenem, meropenem, cefoperazone/sulbactam, piperacillin/tazobactam and amikacin are sensitive for E.coli.

目的 研究黄芪多糖对沙门菌诱导雄性大鼠睾丸氧化应激损伤的保护作用.方法 将40只10周龄成年♂ SD大鼠随机分为4组,分别进行黄芪多糖和/或沙门菌处理,处理期为7d.试验结束后,取睾丸称重,计算绝对和相对重量.制作组织切片并观察睾丸形态与组织结构,检测生精细胞Tunel表达.分离血清,取睾丸匀浆,并测定血清和睾丸的抗氧化酶活性.结果 与对照组比较,沙门菌暴露引起大鼠睾丸明显萎缩,重量显著下降,生精小管组织结构紊乱,生精细胞的Tunel表达显著增加;血清和睾丸组织的抗氧化酶活性显著降低.与单独沙门菌处理组比较,黄芪多糖+沙门菌处理组睾丸重量显著升高,生精小管的组织结构有明显改善,生精细胞的Tunel表达显著下降;血清和睾丸抗氧化酶活性显著升高;但与对照组比较,仍有较大差距.与对照组比较,单独黄芪多糖处理组的睾丸组织结构、Tunel表达和抗氧化酶活性均有一定程度提高,但差异不显著.结论 沙门菌暴露诱导大鼠睾丸组织氧化应激损伤7d后,黄芪多糖在一定程度上抑制氧化应激和生精细胞凋亡,缓解了沙门菌对大鼠睾丸组织的破坏作用.

Haemophilus influenzae (H. influenzae) is one of the most important pathogenic bacteria causing respiratory tract infection diseases in children. There are two main types of H. influenzae, encapsulated H. influenzae and nontypeable H. influenzae (NTHi). Serotype b of H. influenzae (Hib) used to be the main epidemic type of H. influenzae, causing the invasive infection. However, the epidemiology of invasive H. influenzae disease has changed substantially, and most invasive diseases are now caused by NTHi and other serotypes of H. influenzae. The aim of this study was to determine the main epidemic strains of H. influenzae in Zhejiang Province in China, and establish a one-step multiplex PCR assay to distinguish H. influenzae from other bacteria associated with respiratory tract infections, and distinguish encapsulated H. influenzae from NTHi.

Objective To analyze the risk factors of acute stroke with pulmonary infection and the characteristics of distribution and drug resistance of pathogens. Methods The results of bacterial culture, strain identification and drug susceptibility test in289 patients with acute stroke complicated with pulmonary infection were analyzed retrospectively. The related factors causing pulmonary infection were analyzed statistically. Results The pulmonary infection in acute stroke patients was significantly correlated with age, disease type, bed-time, dysphagia, consciousness, diabetes, smoking and invasive operation (P ＜ 0. 05).Pulmonary infection rate was 20. 1％ in patients with stroke, and the positive rate of bacteria culture was 89. 7％ in patients with pulmonary infection. 70 strains of pathogens were isolated. The major gram-negative bacteria were sensitive to imipenem, piperacillin/tazobactam and tobramycin. Mainly gram-positive bacteria Staphylococcus aurcus were completely resistant to penicillin and completely sensitive to sulfamethoxazole/methoxybenzine, tigecycline and vancomycin. Conclusion The interaction of the multiple risk factors of acute stroke patients may result in pulmonary infection. Gram-negative bacteria are the dominant pathogens in pulmonary infection pathogens. Antibiotics should be reasonably used according to drug sensitive test to reach their best curative effect, and be based on infection-related factors to take active preventive measures and to improve the prognosis of patients.

Objective To know the distribution of antibiotic resistance genes in Qian Tang River. Methods Eighteen water samples from upper and lower reaches of Qian Tang River were collected for determining the existence of tetracycline, sulfamethazine and ampicillin resistant bacteria. The antibiotic resistance gene, tet A, sul I and ctx-1, were detected by PCR and the genes' Ct value and relative expression value were examined by fluorescent quantitative PCR. Results The positive rates of ampicillin, Sulfanilamide and tetracycline resistance bacteria in 18 water samples were 100. 00％, 88. 89％ and 61. 11％, respectively; the positive rates of target gene tet A, sul I, and ctx-1 were 70. 59％, 47. 06％ and 52. 94％ in the mixed microbial DNA. Fluorescence quantitative PCR results showed that the expressions of the three antibiotic resistance genes were increasing from upper stream to midstream, and the antibiotic resistance gene expression showed a rising trend in the samples of residential water from upstream to downstream and higher than Qian Tang River. The relative expression of sul I was the highest.Conclusion There are antibiotic resistance genes pollution of tet A, sul I and ctx-1 in the Qian Tang River basin, and the variation and degree of pollution are related to the enrichment of human activities and the geographical environment.

目的 探讨慢性化脓性中耳炎(CSOM)患者病原菌分布及对抗生素的耐药情况,以指导临床合理用药.方法 对223例CSOM患者在确诊后24h内采集鼓膜穿孔处或鼓室内分泌物进行细菌培养及鉴定,并对分离的主要病原菌进行药物敏感试验.结果 细菌培养阳性178例,阳性率为79.8％;分离到病原菌209株,革兰阳性、阴性菌和真菌分别占50.7％、35.9％和13.4％;主要为金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌、变形杆菌.金黄色葡萄球菌和表皮葡萄球菌对万古霉素、利福平和利奈唑胺完全敏感,铜绿假单胞菌、变形杆菌对亚胺培南完全敏感,上述细菌对青霉素耐药率接近90％.结论 金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌和变形杆菌是本地区引起CSOM的主要病原菌,临床用药应该根据药物敏感试验结果来选择.

Quick diagnosis of smear-negative pulmonary tuberculosis (TB) and extra-pulmonary TB are urgently needed in clinical diagnosis. Our research aims to investigate the usefulness of the interferon-γ release assay (IGRA) for the diagnosis of smear-negative pulmonary and extra-pulmonary TB.

说课可以强化课堂教学的效果,提高教师备课的质量,同时提升教师的职业素质.微生物学革兰氏染色法是药学专业学生最为常用的知识点.为了提高该课程的教学质量,本文从教学目标的确定、教学内容的处理、教学过程的设计、教学方法的运用以及教学效果的评价等5个方面对该内容进行了说课方案设计.

探讨案例立体教学法(CTTM)在医学免疫学与病原生物学课程教学中的应用及效果.在《医学免疫学与病原生物学》教学中,选择同一年级临床医学1401-04及1405-1408两个教学班级,分别为试验组和对照组,试验组采用CTTM教学法,对照组采用传统教学法.比较两组学生期末考试成绩的差异.结果表明,试验组学生期末考试成绩优于对照组,两组比较,差异具有统计学意义(p<0.05).CTTM教学法,将实际临床问题引入课堂,使教学过程更加生动有趣,学生学到了实际临床应用中所需的知识和技能,实现我校培养应用型人才的宗旨.

通过调查发现高职高专院校基础医学实验课程在教学中普遍存在的若干突出问题，如教学方法单一、教学内容更新滞后、学生缺乏主体意识、教学资源难以共建共享等。本文以微信为载体，改进基础医学实验课程的教学方法和手段，开展“讨论式”、“启发式”、“参与式”、“探究式”教学方法改革，使教学方法、教学内容、教学资源、教师、学生等相关要素形成合力，实现基础医学实验课程教学质量的提升。

实验教学是高职高专院校培养应用型人才的重要环节.医学免疫学与病原生物学实验多元学习评价体系的实施,对提高实验教学效果,培养高端技能型专门人才具有重要意义.