This paper expounds four demands of connotation in higher creative education,and summarizes the creative education practice of Harbin medical university in five fields,which involves establishing creative educations base,establishing scientific research item,setting up network teaching platform,promoting teaching method and enhancing professional ability of teachers.

Non-cultural laboratory diagnostic methods include fungal antigen detection, anti-fungal antibody detection and molecular methods. Fungal antigen detection aim at ( 1, 3 )-β-D-glucan, galactomannan, cryptococcal capsular polysaccharide antigen and candida mannan antigen.Different antigen is used to diagnose different fungal infection.Antifungal antibody include antibody against Histoplasma capsulatum, Coccidioides immitis/Paracoccidiodes and Blastomyces dermatitidis.Molecular methods include non-amplification nucleic acid detection, nucleic acid amplification test, direct sequencing and matrix-assisted laser desorption/ionization time of flight mass spectrometry ( MALDI-TOF MS ) technology.Even though molecular methods are limited because of no standardization, the future of its usage is promising.

Antimicrobial susceptibility testing is an important tool for guiding rational use of antimicrobial agents in clinical settings.Proper use of antimicrobial susceptibility testing results requires clinicians and clinical microbiologists to have the knowledge of antimicrobial susceptibility testing and breakpoints,and have the ability to use pharmacokinetic and pharmacodynamic (PK/PD) principles to optimize antimicrobial therapy regimen.(Chin J Lab Med,2013,36:289-291)

Objective To investigate the expression, relationship, significance of cyclooxygenase_2 (COX-2) and malonic dialdehyde (MDA) after cerebral ischemic-reperfusion injury and provide basis of treatment. Methods The focal cerebral ischemic-reperfusion model was established with thread embolish of middle cerebral artery. Western blotting, barhituric acid method and neurological evaluation were used to examine the expression of COX-2, MDA in cortex and the changes of neurological function;TTC staining was used to observe the changes of cerebral infarction volume. Results COX-2 prorein expression was correclated well with the MDA(r=0.910,P＜0.01). The content of COX-2 and MDA was very low in sham operation group, they were increased significantly at I2h/R6h model group, with the increase of reperfusion time,they remarkably reached its peak at I2h/R24h,they were slightly lower at I2h/R48h, but still maintained at a high level;Compared with model group, in tetramethylpyrazine(TMP) treatment group, the content of MDA and cerebral infarction volume were markedly decreased(P＜0.01). Conclusion The expression of COX-2 and MDA increases in cerebral ischemic-reperfusion injury.It indicates they may play an important role in the mechanisms of cerebral ischemic-reperfusion injury;TMP has neuroprotective effect.

Objective To investigate the effect of thalidomide and As_2O_3 to the secretion of VEGF of the cell of ANLL and study if there is coorperation in thalidomide and As_2O_3.Methods From October 2001 to February 2003,23 patients with ANLL were analyzed.Heparinized marrow was taken,then it was putt into Ficoll-isopaque solution to be purified for MNC,which was cultured in the RPMI 1 640 medium,placed in 5% CO_2 saturation and 37℃ to proliferation.Choosing the cells in logarithm growth phase,adding cultural solution to abstaining the cellular density of 2?10~9/L and then putting it into 24-well plates.There are 4 groups :contrast group,thalidomide(300 ?g?mL~ -1 )group,As_2O_3(25 ?mol/L)group,and thalidomide(300 ?g?mL~ -1 )andAs_2O_3(25 ?mol/L)group,cultured for 72 hours.Examine the concentration of VEGF in upper liquid with ELISA method.Results The concentration of VEGF in upper liquid of 4 groups were respectively(1 582.67?281.51)ng/L、(1 206.29?264.87)ng/L、(941.72?236.34)ng/L、(639.12?211.98)ng/L.There were statisticd difference(P

Objective The aim of this study was to evaluate the in vitro activity of Ciprofloxacin(CIP)or Amikacin(AK)combined with four clinically-used antipseudomonas ?-lactams against multidrug-resistant Pseudomonas aeruginosa strains.Methods Determining the MICs of six antibiotics to 35 clinically isolated Pseudomonas aeruginosa strains which have different resistance patterns by 2-fold broth dilution method;determining the in vitro activity of Ciprofloxacin or Amikacin combined with Ceftazidime(CAZ),Imipenem(IMP),Meropenem(MEM)and Piperacillin/Tazobactam(TZP)by broth checkerboard method.Results The combinations of Ciprofloxacin or Amikacin with four ?-lactams have mainly synergistic or additive effect,the synergistic rate of AK-group(AK+CAZ:71.43%;AK+IMP:42.86%;AK+MEM:54.29%;AK+TZP:85.71%)was higher than that of CIP-group(CIP+CAZ:20%;CIP+IMP:25.71%;CIP+MEM:14.29%;CIP+TZP:31.43%).The combination of CIP+TZP has the highest synergistic rate in CIP-group;the combination of AK+TZP has the highest synergistic rate in AK-group.None of the combinations had an antagonistic effect.Conclusion the combination of ciprofloxacin or amikacin with ?-lactams have good in vitro activity to multidrug-resistant Pseudomonas aeruginosa strains.

0.05).Conclusion The peptide growth factors can activate the Akt kinase by phosphorylation.This process depends on the production of H2O2 and the presence of PTEN.

Objective To investigate the CT imaging features of pancreatic fatty replacement and its clinical significance. Methods Three patients with pancreatic fatty replacement detected by CT were retrospectively analyzed. CT examination included plain scan and contrast-enhanced scanning at the arterial and portal venous phases. The shape, size, density, pancreatic lobulation and interlobular spaces, course of the pancreatic duct were carefully observed. The clinic and laboratory data were also analyzed to determine the clinical significance of pancreatic fatty replacement. Results ①Imaging features: Two patients had complete fatty replacement involving the entire pancreas, another one had most fatty replacement sparing the posterior aspect of head and tail. Two patients had regular configuration of pancreas. The size of pancreas was slightly enlarged in 2 patients. Lobular atrophy and widening of interlobular spaces were present in all 3 patients. The pancreatic duct was normal in 3 patients. ②Clinic findings: Chronic diarrhea was present in 3 patients. Two patiens had diabetes (one had chronic cholangitis with choledochal lithiasis), another one had small stone in the common bile duct. Serum lipase was low in 3 patients, of which one had low serum amylase. Conclusion Pancreatic fatty replacement demonstrates certain characteristic CT appearances, and is usually associated with disturbances of both the endocrine and exocrine functions of the pancreas.

Objective To evaluate the capabilities of disc diffusion and Vitek2-compact GN13 methods for testing antimicrobial susceptibility of screening ESBLs ( extended-spectrumβ-lactamase) in En-terobacteriaceae clinical isolates.Methods A total of 93 Enterobacteriaceae strains were isolated from pa-tients with intra-abdominal infections in 21 hospitals during 2011 to 2012.The in vitro minimum inhibition concentration ( MIC ) values of ampicillin-sulbactam, piperacillin-tazobactam, ertapenem, ceftazidime, ceftriaxone, cefepime, imipenem, amikacin, ciprofloxacin and levofloxacin were determined by disc diffu-sion, Vitek2-compact GN13 and broth microdilution methods, respectively.Categorical agreement ( CA ) rates of disc diffusion and Vitek2-compact GN13 methods were determined by using broth microdilution meth-od as the reference method.The genes encoding ESBLs were screened in Escherichia coli (E.coli), Kleb-siella pneumoniae (K.pneumonia), Klebsiella oxytoca (K.oxytoca) and Proteus mirabilis (P.mirabilis) strains by using PCR analysis and gene sequencing.Disc diffusion and Vitek2-compact GN13 methods were used for the phenotypic confirmatory test of ESBLs and the sensitivity, specificity, positive predictive value and negative predictive value of the two tests were evaluated.Results The CA values of disc diffusion and Vitek2-compact GN13 methods for the 10 antibiotics were all >90% as compared with broth microdilution method.The major error (ME) rate for ertapenem was 3.2%and the very major error (VME) rates for am- picillin-sulbactam, ceftazidime and cefepime tests were all 2.2% by using Vitek2-compact GN13 method. The sensitivity, specificity, positive predictive value and negative predictive value of disc diffusion and Vitek2-compact GN13 methods in the phenotypic confirmatory test of ESBLs were 96.7%(29/30), 100%(20/20), 100%(30/30) and 95%(19/20), respectively.Conclusion Both disc diffusion and Vitek2-compact GN13 methods could be used for testing the antimicrobial susceptibility and the detection of ESBLs in Enterobacteriaceae clinical isolates with the advantage of accuarcy.Attention should be paid to the posibil-lity of oaurance of ME and VME when testing ertapenem, ampicillin-sulbactam, ceftazidime and cefepime by using Vitek2-compact GN13 method.

Objective To understand the occurrence of catheter-associated urinary tract infection(CAUTI)in pa-tients with catheterization,and provide evidence for reducing the incidence of CAUTI.Methods Based on monito-ring requirement for CAUTI in competency building project of healthcare-associated infection(HAI)prevention and control established by Hospital Infection Management Committee of Chinese Hospital Association,CAUTI among patients who hospitalized and received urinary catheterization ≥2 days in a hospital from January to December 2014 were analyzed prospectively,incidences of CAUTI in different patients were compared.Results A total of 6 046 patients with urinary catheterization were monitored,166 of whom developed CAUTI,incidence of CAUTI was 2.75%,the total urinary catheter days were 31 833 days,incidence of CAUTI was 5.21 per 1 000 urinary catheter days.There was no significant difference in the incidence of CAUTI among patients of different genders (χ2 =1 .23, P =0.54);incidence of CAUTI in patients > 60 years old was higher than those ≤60 years (4.72% vs 2.07%,χ2=30.38,P <0.01);incidence of CAUTI in patients with different duration of catheterization was significantly dif-ferent(χ2 = 251 .14,P <0.01 );with the prolongation of duration of catheterization,incidence of CAUTI also in-creased(trendχ2 =211 .82,P <0.001 ).Patients in department of neurology had the longest average catheterization time(14.84 days)and highest incidence of CAUTI(15.00%,10.11 ‰);patients in the other departments of surgery had the shortest average catheterization time(3.56 days)and lowest incidence of CAUTI(0.97%,2.74‰);inci-dences of CAUTI in patients with urinary catheterization in different departments were significantly different(χ2 =302.24,P <0.001).166 CAUTI patients were isolated 66 isolates of pathogenic strains,86.36% were gram-nega-tive bacilli,33.33% of which were Escherichia coli .Conclusion CAUTI is related to the age of patients and dura-tion of indwelling urinary catheter.Daily assessment on the necessity of indwelling catheter and timely removal of catheter is helpful for reducing the occurrence of CAUTI.