Laboratory diagnosis is the main contents of diagnostics course for clinical majors,whose contents is too broad and too difficulty to understand.For this reason,the results of traditional teaching method are not satisfactory.Therefore,teaching and research section did an exploratory reform on experiment diagnosis teaching by clearly defining teaching contents,emphasizing clinical thinking way,reforming experimental teaching,adding multimedia to assist teaching and cultivating high quality teaching teams.As a result,the reform enhanced study interest of students,promoted teaching quality and effects greatly and achieved preliminary success.

Objective To investigate whether ultrasound (US)-targeted microbubble (MB) destruction (UTMD) can influence the biofilm and bacteria in morphology.Methods Twenty-hour biofilms of Staphylococcus epidermidis RP62A were treated with US or UTMD.The acoustic intensity was 0.5-1.5W/cm2,the duty cycle was 50％ and the duration was 10 minutes.After treatment,the absorbance values (A570) of biofilms stained with the crystal violet were measured to assess the biofilm density.The biofilms were observed with macroscopy and light microscopy.The biofilms were examined by confocal laserscanning microscopy (CLSM) and scanning electron microscopy (SEM).Results A thick and compact biofilm was observed in the untreated control group,and there were no obvious micropores in biofilms under macrology and light micrology.Although there were no significant changes under macroscopy in both biofilms treated with US only and UTMD with 0.5 W/cm2 acoustic intensity,interestingly,many micropores could be found under microscopy.The diameters of micropores increased with increasing acoustic intensity,and the micropores in biofilms treated with UTMD were bigger than those treated with US-only in the same condition of acoustic intensity (P ＜0.05).The largest diameters of micropores were up to 1 mm in biofilms treated with UTMD using 1.5 W/cm2 (P ＜0.05).The biofilm density (A570 value) decreased with increasing of the acoustic intensity,and the values in UTMD group of 1.5 W/cm2 were the lowest (P ＜ 0.05).Micropores also could be observed under CLSM.There were no obvious dead bacteria in biofilms treated with US and UTMD compared with untreated control group (P ＞0.05).Under SEM,the shape of bacteria in biofilms treated with US and UTMD became irregular,and many rounded projection could be observed in the surface of the bacteria treated with UTMD.Conclusions US and UTMD can produce micropores in biofilms,which might help to promote antibiotic activity against biofilms

Objective:To study the clinical characteristics,prognosis and drug resistance caused by the non fermenting bacteria in the infants,and to provide reference for the doctors to recognize the infection features and its treatment.Methods:A total of 91 cases of non-fermentative bacteria infection were selected and the clinical materials were retrospectively analyzed.The clinical data and prognosis of the pediatric patients were analyzed,as well as the distribution and drug resistance of non-fermentative bacteria.The bacterial resistance genes were detected by PCR method,and the positive results were analyzed by gene sequencing.Results:In the past 5 years,the nonfermentative bacteria strains were isolated in 91 infant patients,including 35 cases of newborn (19 cases were premature infants),29 cases aged less than 1 year old,27 cases aged from 0 year to 3 years old.Among these patients,60 were male and 31 were female.There were 41 cases with underlying diseases (45.05 ％),16 cases with organ dysfunction (17.58％),3 cases discharged automatically (3.29 ％),and 1 case dead (1.09 ％).A total of 102 strains of non-fermentative bacteria included 42 strains of Pseudomonas aeruginosa,33 strains of Acinetobacter baumannii,21 strains of Stenotrophomonas maltophilia and 6 strains of other non-fermentative bacteria.Forty-four strains were isolated from neonatal ward,33 strains (32.35％) from neonatal ICU (43.13 ％),25 strains (24.50％) were isolated from general pediatric ward.These strains were mainly from respiratory tract secretions and blood samples,nearly 84.31％.The isolation rates of MDR,XDR,PDR Acinetobacter baumannii and Pseudomonas aeruginosa were 63.63％ and 19.04％,respectively.There were 40.48％ of Pseudomonas aeruginosa isolates were resistant to imipenem,blaPER had the highest positive gene rate (28.57％).There were 36.36％ of Acinetobacter baumannii isolates were resistant to imipenem,all resistant strains carried blaOXA-51 and blaOXA-23 genes.Conclusion:The infants with underlying diseases or invasive diagnosis and treatment are easy to infect non fermentative bacteria.Most strains of them are drug-resistant and difficult to be treated with long duration and high risk.