急性肺损伤幼鼠肺泡Ⅱ型上皮细胞和SP-A变化相关性的研究

目的：该实验旨在研究急性肺损伤（ALI）时肺泡Ⅱ型上皮细胞（AEC-Ⅱ）超微结构变化和肺组织表面活性蛋白SP-A含量的变化关系，从而探讨ALI的发病机制。方法：48只Sprague-Dawley幼鼠被随机分为正常对照组和ALI组。 腹腔注射脂多糖（LPS，4 mg/kg）建立ALI模型，正常对照组注射等量生理盐水。 LPS注射后24，48，72 h每亚组各处死8只大鼠。 取左肺下肺组织待透射电镜检查。 用Western blot方法测定肺组织SP-A的相对含量。结果：ALI 24 h时，AEC-Ⅱ微绒毛消失。24 h及48 h时板层小体（lamellar body, Lb）数量增加，体积增大，密度减低，排空明显增强，呈指环状绕核排列，细胞增生活跃，代谢旺盛。48 h时Lb呈巨大空泡样变性。肺组织SP-A含量明显高于对照组（24 h时ALI组为6.52±0.62，对照组为5.02±0.35， P< 0.01；48 h时ALI组为6.65±0.62，对照组为5.01±0.36，P< 0.01）。72 h时Lb破溃，数目明显减少，细胞核形态不规则，部分核边界不清，肺组织SP-A含量下降(ALI组为3.87±0.50，对照组为5.22±0.36，P<0.01)。结论： LPS致幼鼠ALI时AEC-Ⅱ和肺组织SP-A的变化为时间依赖性，随AEC-Ⅱ损伤程度的加重肺组织SP-A由代偿转为失代偿，可能是发生ARDS的重要机制之一。     

细化药品采购环节，全方位保障药品供应

通过探讨细化药品采购环节：包括建立和完善采购制度，优选药品配送企业，制定合理的采购时间、合理采购价格和合理的库存结构及库存水平。以便及时、准确地为临床用药提供安全、有效、经济的药品以及全方位保障药品供应。     

Digital beam attenuator technique for compensated chest radiography

The feasibility of producing patient-specific beam attenuators for chest radiography has been investigated using an anthropomorphic phantom and a human volunteer. A low-dose test exposure is digitized, processed, and used to print a small cerium filter, which is placed in the x-ray beam near the collimator. The final radiograph is recorded on film. The technique results in relatively uniform film exposure, so that structures in all regions of the chest are simultaneously displayed with optimal film contrast. The equalized exposure improves image quality in the normally underpenetrated regions and reduces the role of cross-scatter from the lungs. The image is analogous to optical or computer-processed unsharp masking techniques, but the processing is accomplished in the x-ray beam and results in an improved exposure distribution, giving advantages that cannot be achieved with image processing techniques alone.     

Familial aggregation in seronegative spondyloarthritis of enterogenic origin. A family study

A family study of 2 probands, suffering from seronegative spondyloarthritis with ileocolonoscopic evidence of chronic inflammation of the ileum, is presented. On the father's side 2 brothers carry the HLA-Bw62 antigen. One developed typical Crohn's disease, the other showed chronic inflammatory signs of the ileum on biopsy. These lesions have frequently been demonstrated in reactive arthritis and ankylosing spondylitis (AS) with peripheral arthritis, in the absence of gastrointestinal symptoms. On the mother's side there were no clinical or histological signs of ileum inflammation, or spondyloarthritic features, although the mother carries the HLA-B27 antigen. The 4 children are all HLA-Bw62 and B27 positive, but only 2 of them have developed seronegative spondyloarthritis associated with histological evidence of chronic ileum inflammation. The familial aggregation of the seronegative spondyloarthritides is demonstrated. The lesions found on ileal biopsy in reactive synovitis and AS with peripheral arthritis may be related to Crohn's disease.     

Foraminal spurs: a normal variant in the lumbar spine

A normal variant, the foraminal spur, is described in five patients. It was seen on computed tomographic studies as a bony process extending from either the pars or the pedicle into the neuroforamen dorsal to the nerve root. In four of the cases it was seen bilaterally. None of the patients had any symptoms related to these spurs. No associated disease of the neuroforamen or facet was present. These spurs most likely represent ossification of the ligamentum flavum at its point of insertion and should not be mistaken for osteophytes, free disk fragments that have calcified, or fracture fragments. Sagittal reformations are helpful in visualizing the extent of the foraminal spurs.     

A Mycobacterium tuberculosis cluster demonstrating the use of genotyping in urban tuberculosis control

Background  

DNA fingerprinting of Mycobacterium tuberculosis isolates offers better opportunities to study links between tuberculosis (TB) cases and can highlight relevant issues in urban TB control in low-endemic countries.