目的:探讨同伴教学在临床微生物学检验混合式实验教学中的应用效果.方法:以本校医学检验技术专业 2016-2019 级学生共计 636 名为研究对象,其中 2016 级、2017 级为对照组(292名),2018 级、2019 级为教改组(344 名).对照组采用以面授和示教为主的传统实验教学方法,教改组的实验课程采用同伴教学模式.对比两组学生临床微生物学检验的理论、实践考核成绩;采用问卷调查教改组与对照组学生对两种教学模式的教学效果评价.结果:教改组学生的理论、实验考核成绩均优于对照组(P＜0.05),教改组学生在自主学习、学习兴趣、学习效率、分析解决问题能力、沟通表达和团队协作等方面的能力均显著提高,且所占比例明显高于对照组,差异有统计学意义(P＜0.05).结论 同伴教学模式在临床微生物学检验混合式实验教学中应用效果较好,能激发学生学习主动性,培养其多种综合能力,是一种值得推广的高效教学方法.

为保障新冠肺炎疫情时期"停课不停学",临床微生物学检验课程充分利用信息技术创新教学模式,将质量管理领域的PDCA循环引入线上教学过程中.倡导学生课前深度自学,课中积极探讨,课后拓展思维,贯彻"以学生为中心"的教学理念.在闭环完整性和循环延续性的基础上进行线上知识传递,为提高临床微生物学检验信息化教学能力提供了参考.

In order to “keep learning when class suspended” during the epidemic caused by coronavirus disease (COVID-19), the teaching team of clinical microbiology course makes full use of information technology to innovate the teaching mode and introduce the PDCA circulation in the field of quality management into online teaching. The teaching design is made from the four stages of plan, do, check and act. This method advocates that students should learn by themselves before class, actively discuss in class, expand thinking after class and show their learning achievements in various ways, so as to implement the “student-centered” concept. The teaching team can achieve online knowledge transfer on the basis of closed-loop integrity and continuity circulation, which provides a reference for improving the information technology teaching ability of the teaching team.

OBJECTIVE:To analyze the level of coagulation function indexes in patients with lymphoplasmacytic lymphoma (LPL) and its clinical significance.METHODS:The clinical data of 32 patients with initial LPL (LPL group) and physical examination data of 25 healthy persons (control group) who underwent physical examination in our hospital during the same period were collected. The differences of platelet (Plt), D-Dimer (D-D), fibrinogen (Fib), thrombin time (TT), prothrombin time (PT) and activated partial thrombin time (APTT) between the two groups were compared.RESULTS:The Plt count in LPL group [ (137.06±40.14)×109/L] was significantly lower than that in control group [ (215.07±33.25)×109/L], D-D [ (1.01±0.16) mg/L, PT [ (13.01±1.37) s] and APTT [ (40.96±7.24) s] in LPL group were significantly higher than those in control group [ (0.37±0.09) mg/L, (11.96±0.87) s, (25.07±5.13) s] (P＜0.01); there was no significant difference in TT and Fib levels between the two groups (P＞0.05). There was no significant difference in Plt, D-D, Fib, AP, TT and APTT among LPL patients secreting different types of immunoglobulin (Ig) (P＞0.05). After treatment, the coagulation function of LPL patients returned to normal, and no death cases occurred due to hemorrhage or thrombosis.CONCLUSION:LPL patients have hypercoagulable state blood and abnormal coagulation function, but which not closely relates to with the type of Ig secreted by patients.

目的:分析多重逆转录-聚合酶链反应(RT-PCR)对初发急性淋巴细胞白血病(ALL)患儿检测不同融合基因的诊断价值.方法:回顾性分析西安医学院第二附属医院2012年9月至2017年9月收治的80例ALL患儿的临床资料,对患儿进行免疫表型、染色体核型及融合基因分析.结果:免疫表型结果显示,髓系+B系混合表达2例,早期B表达2例,前B表达58例,CD13合并前B表达11例,CD5合并前B表达4例,CD2合并前B表达3例.染色体核型分析结果显示,72例行染色体核型分析的患者,其中无法分析5例,染色体核型正常27例,异常11例,无分裂相29例.80例ALL患儿中,共有30例(37.50％)存在6种融合基因表达,分别为MLL/AF9、CBF/MYH 11、BCR/ABL、TLS/ERG、MLL/ENL及TEL/AML1. 3例MLL/AF9融合基因表达[t(9;11)]患儿中2例早期治疗反应不良而经过加强化疗后获得完全缓解,1例行骨髓移植;1例CBF/MYH 11融合基因表达患儿家属放弃治疗;4例BCR/ABL融合基因表达[t(9;22) (q34;q11)]患儿均为早期治疗反应不良,经加强化疗后获得完全缓解,缓解期间复查该融合基因均为阳性,其中行骨髓移植2例;1例TLS/ERG融合基因表达[t(16;21)]患儿为早期治疗反应不良,经加强化疗后获得完全缓解;2例MLL/ENL融合基因表达[t(11;19)]患儿化疗过程中均复发;19例TEL/AML1融合基因表达[t(12;21)]患儿中获得完全缓解15例,部分缓解4例.结论:基因分型可弥补白血病常规分型-MICM分型的不足,通过多重RT-PCR方法可迅速测定ALL患儿染色体畸变所引起的融合基因.

OBJECTIVE:To analyze the diagnostic value of multiple reverse transcription-polymerase chain reaction (RT-PCR) for detecting different fusion genes in children with primary acute lymphoblastic leukemia (ALL).METHODS:The clinical data of 80 children with ALL treated in the 2nd affiliated hospital of Xi'an Medical College from September 2012 to September 2017 were collected and retrospectively analyzed. Immunophenotype, chromosome karyotype and fusion gene were analyzed.RESULTS:Immunophenotyping showed that there were 2 cases of mixed expression of myeloid + B system, 2 cases with pre- B expression, 58 cases with former B expression, 11 cases with CD13 combined with pre- B expression, 4 cases with CD5 combined with pre- B expression, and 3 cases with CD2 combined with pre- B expression. The results of chromosome karyotype analysis showed that among 72 cases of karyotype analysts 5 cases could not be analyzed, 27 cases were determined to be normal karyotype, 11 cases with abnormal karyotype and 29 cases without mitotic phase. Six fusion genes were expressed in 30 cases (37.50%) of 80 ALL children, including MLL/AF9, CBF/MYH 11, BCR/ABL, TLS/ERG, MLL/ENL and TEL/AML1. Among the 3 cases with MLL/AF9 fusion gene expression [t(9;11)], 2 cases showed a poor response to early treatment, but achieved complete remission after intensive chemotherapy, and 1 case accepted bone marrow transplantation; in 1 case with CBF/MYH 11 fusion gene expression, treatment was abandoned by family members, and 4 cases with BCR/ABL fusion gene expression [t (9;22) (q34; q11)] were all showed poor response to early treatment, and achieved complete remission after intensive chemotherapy. All the fusion genes were positive during remission, including 2 cases of bone marrow transplantation; 1 case with TLS/ERG fusion gene expression [t (16;21)] displayed poor response to early treatment, and completely remitted after intensive chemotherapy; 2 cases with MLL/ENL fusion gene expression [t (11;19)] recurred during chemotherapy; 19 cases with TEL/AML1 fusion gene expression [t (12;21)] also achieved complete remission. 4 cases achieved a partial remission.CONCLUSION:Genotyping can make up for the insufficiency of MICM typing, and multiplex RT-PCR can be used to rapidly detect the fusion genes caused by chromosomal aberration in children with ALL.

临床微生物学检验是医学检验技术专业的主干课程,其所涉及的微生物种类繁多、形态特点各异、逻辑性不强、容易混淆且临床常会遇到不典型菌种的鉴定,因此对于医学检验专业的学生来说学习临床微生物学检验这门课程常常会感到困惑,难以理解掌握,而课堂创新模式的改革可以提高学生学习主动性和积极性,并加以多种现代化教学方式帮助学生理解记忆,取得良好的教学效果.因此对于医学检验技术专业的学生来说掌握扎实的理论知识、具备能够设计完整详细的检验流程以及熟练的操作手法等技能是能够胜任临床微生物检验科室工作的基本要求.

临床微生物学检验是一门技术性较强、涉及范围广泛的课程,学好这门课程能够为学生的长远发展建立良好的基础.因此,为了促进临床微生物学检验专业教学水平的不断提高,就要将思政教育有效地融入平时的教学过程中.对临床微生物学检验专业课程思政教育原则进行了比较深入的论述,在此基础上,提出了具有一定针对性的临床微生物学检验专业课程思政教育路径,对从事相关工作的教育工作者具有一定的借鉴意义.

OBJECTIVE:To study the soluble B7-H4 (sB7-H4) expression in serum and lymphoma tissues of patients with malignant lymphoma (ML) and its value for diagnosis and re-examination lymphoma.METHODS:The serum samples from 83 cases of ML were collected, among them 69 cases of newly diagnosed ML were enrolled in group A including 11 cases of Hodgkin's lymphoma (NHL group) and 58 cases of non-Hodgkin's lymphoma (NHL group), the serum samples from 14 cases of relapsed ML were enrolled in group B; at the same time the serum samples of 50 healthy persons conformed by physical examination were collected and enrolled in control group. The double antibody sandwich ELISA was used to detect the serum level of sB7-H4 in each group, and immunohistochemistry method was used to detect the expression of sB7-H4 in malignant lymphoma and reactive lymphoid hyperplasia tissues.RESULTS:The serum level of sB7-H4 in the group A was significantly increased in comparison with the group B and control group, and the level of group B was significantly higher than that in the control group (P<0.05); the serum level of sB7-H4 in the NHL group was significantly increased in comparison with HL group and control group, and the level of HL group was higher than that of control group (P<0.05). The expression of sB7-H4 in reactive lymphoid hyperplasia tissues was negative, but the positive expression rate in malignant lymphoma tissues was 47.50%, suggesting the positive rate of sB7-H4 in malignant lymphoma tissues was significantly higher than that of reactive lymphoid hyperplasia tissues (P<0.05).CONCLUSION:The high expression of sB7-H4 in serum and lymphoma tissues of patients with malignant lymphoma has a certain value for the diagnosis and re-examination of patients with malignant lymphoma.

The molecular mechanisms underlying ostcoar-thritis (OA) and Kashin-Beck disease (KBD) remain poorly understood. Hypertrophic chondrocytes serve an important role in the development of both OA and KBD, whereas oxidative stress can contribute to the pathological progression of cartilage damage. Therefore, the aim of the present study was to detect altered expression of osteogenesis-related genes in hypertrophic chondrocytes, following treatment with 3-morpholinosydnonimine (SIN-1). ATDC5 cells were induced to develop into hypertrophic chondrocytes via Insulin-Transferrin-Selenium. The appropriate concentration and time of SIN-1 treatment was determined via MTT assay. Following hype chondrocyte stimulation with SIN-1, a liquid chip was analyzed using a polymerase chain reaction (PCR) array. Reverse transcription-quantitative PCR was conducted on individual genes to validate the array-based data. Analyses of protein-protein interactions, gene ontology functions and Kyoto Encyclopedia of Genes and Genomes pathway enrichment of the differentially expressed genes were also performed. A total of 6 upregulated and 34 downregulated genes were identified, including the mothers against decapentaplegic homolog (Smad) family (Smad1-4), bone morphogenetic proteins and their receptors (Bmp2, Bmp3, Bmpr1 alpha and Bmpr1 beta), and matrix metalloproteinases (MMP2, -9 and -10). These genes are associated with collagen biology, transcriptional control, skeletal development, bone mineral metabolism, and cell adhesion. SIN-1 induced death of hypertrophic chondrocytes likely through TGF-beta/SmadorBMPiSmadpathways.Oxidative-stress-dependent induction of abnormal gene expression may be associated with chondronecrosis in the cartilage of patients with OA or KBD.

Objective To investigate the expression of vascular cell adhesion molecule-1 (VC.AM-1) in oxidative stress induced hypertrophic chondrocytes,in Kaschin-Beck disease (KBD) patients and in rat fed with T-2 toxin under selenium deficient conditions in order to analyze the relationship between VCAM-1 biological function and the dysregulation of chondrocyte differentiation in KBD.Methods The ATDC5 was cultured in 1％ ITS solution (10 mg/L insulin,5.5 mg/L transferrin,and 6.7 μg/L sodium selenite) for 21 days,and stimulated with 3-morpholino-sydnonimine (SIN-1,a nitric oxide [NO] donor) to obtain the oxidative stress induced hypertrophic chondrocytes.Real-time PCR was used to detect VCAM-1 mRNA in hypertrophic chondrocytes induced by different concentrations of SIN-1.The expressions of VCAM-I in articular cartilage of child and adult KBD patients and KBD animal model were determined via the immunohistochemical method,and KBD cartilage samples were obtained in KBD areas from KBD child who had died or from adults who had had surgery.Results After treatment of hypertrophic chondrocytes (ATCD5 cells) with SIN-1 (0,1,3,5 mmol/L),VCAM-1 mRNA levels (1.00 + 0.00,1.22 ± 0.20,0.71 ± 0.22,0.37 ± 0.16) were decreased in a dose-dependent manner when compared with the control group (F =27.788,P ＜ 0.05).The densities of VCAM-1 positive cells in superficial and middle zones of the articular cartilage of children KBD patients [(16.08 ± 5.20)％,(19.20 ± 9.71)％] were higher than those of control group [(0.00 ± 0.00)％,(0.00 ± 0.00)％],while that in the deep zone [(7.00 ± 4.40)％] in children KBD patients was significantly lower than that of control [(51.60 ± 20.58)％,tS/M/D=-10.972,-6.249,6.564,P ＜ 0.05].The positive cell density of VCAM-1 in the adult patients was significantly increased in the superficial zone [(7.92 ± 4.29)％ vs (3.12 ± 1.12)％] but significantly decreased in the middle zone [(17.54 ± 8.27)％ vs (31.75 ± 13.30)％] of articular cartilage when compared with that of control group (tS/D =-3.824,3.037,P ＜ 0.05).In articular cartilage of the four groups of KBD rats,the density of VCAM-1 positive cells in the superficial zone was significantly higher in low selenium diet group,T-2 toxin diet group and selenium deficient plus T-2 toxin diet group [(4.11 ± 1.90)％,(5.00 ±2.02)％,(2.78 ± 1.48)％ vs (1.89 ± 1.76)％,P ＜ 0.05].But the density of VCAM-1 positive cells in the deep zone was significantly lower in rat feed with selenium diet and selenium deficient plus T-2 toxin diet [(13.67 ± 2.45)％,(20.56 ± 7.42)％] than that of control group [(33.00 ± 12.57)％,P ＜ 0.05] in the epiphyseal cartilage of KBD rats.Conclusions The level of VCAM-1 is decreased both in the SIN-1 induced hypertrophic chondrocytes and in the deep zone of articular cartilage in KBD patients and in rat fed with T-2 toxin and selenium-deficient diets.VCAM-1 may be associated with the death of deep zone chondrocytes and differentiation disorder in cartilage.

The threat of tuberculosis to human health is becoming more and more serious, and its characteristics of strong infectious and difficult detection in the early stage make it impossible to guard against. The research on the pathogen isolation of mycobacterium tuberculosis and identification of infectious disease mechanism in mice help people to further understand the relationship between mycobacterium tuberculosis and biological organism, and diagnose tuberculosis earlier. The method of sputum separation culture was used in this paper, with convenient and low cost, and reliable results can be obtained. The positive rate of bacterial growth could be improved by the re culture of the growing colonies, and the colony growth could be seen in 2-4 weeks, and the results were confirmed by microscopic examination. Through the determination of PDD in mice injected with mycobacterium H37Rv, the nylon wool column separation method was selected, which improved the purity of T cells, the ratio of living cells and the recovery rate. Through experiments, the recovery rate of T cells was 30%, and the ratio of living cells was 93%. The results show that the ratio of living cells is high. In the experiment of the proliferation and transformation of T lymphocytes in mice, it can be seen that the stimulation value of the immune group is higher than that of the normal group, which shows that the cell immunity of anti-tuberculosis has occurred in mice with the maximum stimulation value of 3.04.

目的：了解吉林省白城市某高校学生氟斑牙患者的情绪及心理变化情况。方法：对507名学生中的63名患者和64名正常对照用自评量表(SCL-90)进行问卷调查，评价其心理健康状况。结果：对照组9个因子得分与常模比较，p>0.05，无统计学意义；氟斑牙组9个因子得分与对照组比较，人际关系、抑郁、焦虑、敌对因子得分高于对照组，p<0.05，差异有统计学意义，躯体化、强迫、恐怖、偏执、精神病性因子得分高于对照组，p>0.05，无统计学差异。结论：氟斑牙严重影响着患者的身心健康，教学过程中应及时发现，给予必要的引导。

Huperzine A recently serves as the first-line drug for treating Alzheimer's disease. This paper re-views the latest progress in source and development of Huperzine A from the comprehensive angles of drug needs and pharmaceutical industry. The development of transformation methods in future is prospected. Extraction from natural herbs, as the most convenient way for obtaining huperzine A, has a long history and still has great vitality. However, the method has been faced with a bottleneck of limited plant resources. Chemical synthesis is still one of the important ways for development of huperzine A, but it has the disadvantages of trivial steps, high cost and difficulty in obtaining composites with pure optical activity. Now, adopting biological techniques to obtain huperzine A from endophytic fun-gi and fermentation of H. serrata has been making great progress. It is recognized that utilizing biological techniques for transformation would become one of the important directions in industrial production of huperzine A.

建立科学合理的实验室评估指标有利于实验室的规范化管理，本文对西安医学院医学检验实验中心参与校级实验室评估做了总结和分析。

家兔经绵羊红细胞（SRBC）免疫后血清中可出现抗SRBC的抗体，采集免疫动物血液分离血清，即可获得抗SRBC 的抗血清。用 SRBC与相应抗血清混合，当有补体存在时，在一定条件下， SRBC被溶解破坏，故抗 SRBC 抗体又称为溶血素。动物免疫血清是医学教学、科研及临床实验工作中经常要用到的试剂。但目前市场上购买到的溶血素价格昂贵，效价也不高，因此为了节约经费，使用方便，提高实验课的教学质量，本实验室选取S RBC作为颗粒性抗原，在短时间内获得了高效价的免疫血清（溶血素），并取得了较好效果，现报告如下。

《临床微生物学检验》是检验学生一门重要的专业课程，因课程内容知识点多且连续性差，学生极易产生厌学情绪。从学生感兴趣的角度出发，根据不同的教学内容，设计病案教学法、故事教学法、讨论式教学法、亲验式教学法、人文科学教学法、立体式教学法等多种教学方式，充分调动学生的积极性和主动性，收到了良好的教学效果。

<正>临床微生物学检验是医学检验专业的主干课程之一,具有很强的实践性和技术性[1]。临床微生物检验的主要任务是感染性疾病病原体的诊断、指导临床合理使用抗菌药物及对院内感染进行监控[2]。近年来随着新的病原体的不断出现、现有病原体的变异及耐药性逐渐增加、条件致病菌感染率不断上升等都给临床微生物检验带来极大挑战[3],因此对微生物检验工作者的要求也更加严格,而实验教学则是提升操作者能力的重要组成部分[4]。为了使学生在进入实习过程中能够更快的适应

目的 了解少数民族地区中小学生乙型肝炎病毒感染与性别、民族、城乡、乙肝疫苗接种、年龄以及出生地等因素的关系,为预防乙型肝炎提供科学依据.方法 整理分析2006-2007年甘肃省玛曲县疾控中心提供的乙肝表面抗原检测结果及相关基本资料.结果 玛曲县3 167名在校中小学生中HBsAg阳性197人,阳性率为6.2％,不同性别学生、三个民族(藏、汉、回)学生、城乡学生之间的HBsAg感染差异均有统计学意义(P＜0.05),接种乙肝疫苗与未接种乙肝疫苗的学生、不同年龄组间以及在家出生与在医院出生的学生之间的HBsAg感染差异亦均有统计学意义(P＜0.05).结论 少数民族地区中小学生HBV感染与性别、民族、城乡、乙肝疫苗接种、年龄以及出生地等因素有关.

目的 探讨幽门螺杆菌(Hp)感染与咸阳地区上消化道疾病的关系.方法 应用W-S银染和革兰染色法检测上消化道疾病患者病理组织切片中Hp的感染状况,并分析Hp感染与上消化道疾病及人群分布的关系.结果 咸阳地区上消化道疾病患者Hp感染率为64.61％(115/178),其中浅表性胃炎、消化性溃疡、癌前病变及胃癌组织中Hp感染率分别为49.12％、60.71％、70.37％、77.27％.胃癌组与浅表性胃炎组比较Hp感染率比较差异有统计学意义(P＜0.05);农村居民与城镇居民Hp感染率有差异(P＜0.05).不同性别上消化疾病患者Hp感染率无差异.结论 咸阳地区上消化道疾病患者Hp感染与上消化道疾病病变程度有关,农村居民Hp感染率高于城镇居民.