Necrotizing soft tissue infection (NSTI) is a kind of disease characterized by skin and subcutaneous soft tissue necrosis caused by bacterial infection.Firstly,the epidemiology,etiology and pathogenesis of NSTI are discussed in this paper and its major pathogenic microorganisms and classification are also summarized.Knowing the characteristics of rapid progress and serious local tissue destruction of NSTI,then we mainly describe the clinical manifestations and analyze the key points of diagnosis of NSTI in order to improve the alertness of clinicians to this kind of disease.Finally,this paper summarizes the current strategies for NSTI treatment,including thorough debridement and drainage,adequate resuscitation and the use of sensitive antibiotics.

目的 翻转课堂作为一种新型教学模式正逐步在医学教育领域开展.本文拟探讨辅以微信公众平台的翻转课堂在外科手术学基础教学中的应用.方法 以外科手术学基础中的缝合章节教学为试点,以微信公众平台辅助,选取海军军医大学140名学员,随机分为两组,实验组实行翻转课堂教学法,对照组则采用传统教学法.结果 实验组学员在基础知识掌握、缝合步骤熟练度以及组员之间配合默契度中得分更高,操作更加规范和准确.翻转课堂教学法在激发自主学习兴趣,提高自主动手能力,加强师生互动等方面有明显优势.结论 采用翻转课堂教学模式能够有效提高学员对专业知识和操作技能学习的兴趣,提高自主学习时效性并且加深对知识的理解记忆.

Objective: To examine the responsivenss of newborn rat mesencephalic progenitors to different chemicals, looking for a way to efficiently enhance their neurogenesis in vitro. Methods: Newborn rat midbrain-derived neural progenitors were used to examine the effects of different chemicals. Eight different chemicals, glial cell line-derived neurotrophic factor (GDNF),ciliary neurotrophic factor (CNTF),interleukin-1 alpha(IL-1α),puerarin, arctiin ginsenoside Rg1,gastrodin or 17 beta-estradiol,were screened for their ability to induce the mesencephalic progenitors toward neuronal phenotype. Using immunocytochemistry,the percentage of microtubule-associated protein-2ab (a specific neuron marker)-positive cells was calculated. Results: In contrast to spontaneous differentiation,only IL-1α was found to promote neuron-oriented differentiation on mesencephalic progenitors while GDNF,CNTF and gastrodin showed an inhibitory effect, and the rest chemicals had no effect on neuronal differentiation. Conclusion: Fate of newborn rat mesencephalic progenitors can be manipulated by environmental signal in a neuronal phenotype before cell transplantation.Further investigation may contribute to find gene targets to control linage specification of neural progenitors.

Objective To examine wether cytokine dose and extremely low\|frequency electromagnetic field(ELF\|EMF) would influence the effects of ciliary neurotrophic factor (CNTF) and interleukin\|1 alpha(IL\|1α) on the differentiation of neural stem cells(NSCs) from midbrains of new\|born rats. Methods Differentiation of NSCs,exposed or unexposed to ELF\|EMF,was induced by CNTF or IL\|1α at different concentration for 5 days.Cells then were fixed and processed for immunofluorescent staining to detect the neuron\|specific marker,microtubule\|associated protein 2ab(MAP2ab),thus the percentage of MAP2ab\++ cells was calculated. Results In contrast with the control,low\|dosed CNTF and IL\|1α increased the percentage of neuron\|fated cells while high\|dosed CNTF significantly decreased the percentage of MAP2ab\|positive cells( P 0\^01).ELF\|EMF exposure enhanced the stimulating effect of low\|dosed CNTF;The most exciting finding was that the EMF converted the inhibitory effect of high\|dosed CNTF on neurogenesis to the stimulative effect.The EMF diminished the promoting effects of low\|dosed IL\|1α as well as failed to influence the high\|dosed IL\|1α effect.Conclusion Inductive effects of cytokines on NSCs differentiation are dose\|related.Coeffects of ELF\|EMF and cytokines would not be simply added up or subtracted,implying that the role of organism EMF during CNS development should not be ignored.EMF may be a promising strategy for manipulating NSCs differentiation.\;[

应用荧光影像系统检测了原代培养海马神经元内钙离子的变化情况,并分析了皮质酮、肿瘤坏死因子(TNF-α)对谷氨酸引起的海马神经元内钙升高的调节作用及其皮质酮对TNF-α作用的调节.结果显示:(1)使用不同浓度的皮质酮处理海马神经元48 h后,观察到10-6 mol/L和10-7 mol/L的皮质酮可诱导海马神经元静息钙浓度升高,但10-8 mol/L和10-9 mol/L的皮质酮对海马神经元内钙无影响.(2)10-6 mol/L皮质酮处理海马神经元48 h后,对谷氨酸诱导的海马神经元内钙升高无调节作用.(3)使用100 ngTNF-α处理海马神经元48 h后,既可诱导海马神经元静息钙升高,也可抑制谷氨酸引起的海马神经元内钙升高.(4)皮质酮可逆转TNF-α对海马神经元静息钙浓度的调节作用,但对TNF-α抑制谷氨酸升钙效应无影响.

采用细胞共培养方式和免疫化学染色方法,研究骨髓基质细胞对神经干细胞分化为神经元、星形胶质细胞和寡突胶质细胞的影响.实验发现,体外培养的中脑神经干细胞在与成年大鼠骨髓基质细胞共培养7 d后,在神经干细胞后代中神经元比例可达38.6%±10.8%,明显高于自然分化组20%,提示骨髓基质细胞提供的微环境可明显提高神经干细胞后代中神经元的比例.

目的:观察成年大鼠骨髓基质细胞诱导新生大鼠中脑神经干细胞分化为神经元的机制.方法;采用骨髓基质细胞和神经干细胞共培养方法,通过显微镜观察神经干细胞的分化状态;使用免疫组织化学技术,分析神经元在神经干细胞后代中所占的比例.结果:(1)骨髓基质细胞可诱导神经干细胞分化为高比例神经元;(2)骨髓基质细胞可促进神经元的存活.结论:骨髓基质细胞可提供神经干细胞分化为神经元和促进神经元存活的信号物质.

神经干细胞(neural stem cells,NSCs)的发现,改变了以往认为成年哺乳动物中枢神经系统神经元不能再生的认识,成为神经系统疾病的一种新治疗策略而备受关注.干细胞治疗包括了干细胞取材、体外扩增、调控分化、植入等基本过程.本文拟在啮齿类NSCs研究结果比较基础上,循着干细胞治疗的流程,对人NSCs取材、扩增、分化及应用研究概况等方面加以综述,以阐示神经系统疾病干细胞治疗的前景.

Neural stem cells have broader differenti at ive repertoire than expected. Before the full potential of neural stem cells can be realized, the mechanism of their differentiating into the specific lineage need to be elucidated. Recent studies demonstrate that both cytokines and enviro nmental signals play roles in regulating cell fate. The more the mechanism is e lucidated, the faster neural stem cells will be clinically applied.