Bilateral subacromial bursitis with macroscopic rice bodies: Ultrasound,CT and MR appearance

The radiological findings of ultrasound, CT and MR of a case of bilateral subacromial bursitis with macroscopic rice bodies is described. The previous literature is also reviewed.     

Pneumocystis carinii pneumonia: Pitfalls of prophylaxis

Pneumocystis carinii pneumonia (PCP) occurs commonly in immunocompromised patients. Sulfamethoxazole-trimethoprim (SMX-TMP) is effective prophylaxis, although PCP may still occur despite apparently adequate use. We report three cases of PCP which highlight some of the pitfalls of prophylaxis.     

SPECTRUM OF ACUTE RENAL FAILURE IN A SERVICE HOSPITAL

A prospective study of 82 patients with acute renal failure was carried out over the last 2 years. Mean age of the patients was 35.6 years (8-82 years). Male to female ratio was 3.5:1. The etiological factors were septicaemia in 18 patients (21.95%), aminoglycoside toxicity in 16 patients (19.51%), open heart surgery in 8 patients (9.76%), volume depletion and blood loss in 12 patients (14.63%), glomerulonephritis in 4 patients (4.88%), renal allograft dysfunction in 4 patients (4.88%), and miscellaneous causes in 20 patients (24.39%). Non-oliguric renal failure was observed in 39.02 per cent cases. Dialysis support was required in 65.8 per cent of the cases; with average 5.6 (4 to 11) dialysis sessions. Four patients of acute renal failure following open heart surgery were given continuous arterio-venous haemofiltration. Overall mortality was 32.5 per cent, septicaemia accounting for 60 per cent of the deaths.KEYWORDS: Antibiotics, Aminoglycoside, Renal failure acute, Septicemia     

Feasibility and pilot efficacy of a brief smoking cessation intervention delivered by vascular surgeons in the Vascular Physician Offer and Report (VAPOR) Trial

Background

This study determined the feasibility and potential efficacy of an evidence-based standardized smoking cessation intervention delivered by vascular surgeons to smokers with peripheral arterial disease.

明胶改性壳聚糖纤维表征及其体内降解特点

目的：采用明胶处理壳聚糖纤维,考察其表征及在大鼠肌袋内的生物相容性.方法：实验于2006-09/2007-01在解放军第八十九医院全军创伤骨科研究所实验室完成.①实验分组：分别以磷酸盐缓冲液、50,100 g/L明胶处理壳聚糖纤维.②实验评估：测定壳聚糖纤维膨胀率、拉伸强度;扫描电镜、红外光谱观察壳聚糖纤维的形态及结构;分离大鼠脊柱两侧椎旁肌肉形成3个肌袋,分别植入经γ射线灭菌的3种纤维20 mg.术后1周,1,3个月将纤维连同包膜完整取出,计算体内降解率.另取标本连同周围肌肉行苏木精-伊红染色. 结果：①壳聚糖纤维的膨胀率及拉伸强度：磷酸盐缓冲液组纤维膨胀率最高,拉伸强度最小;100 g/L明胶组膨胀率最低,拉伸强度最大.100 g/L明胶组拉伸强度与磷酸盐缓冲液组和50 g/L明胶组间差异有显著性意义（P＜0.05）,3组壳聚糖纤维膨胀率差异无显著性意义.②壳聚糖纤维的形态和结构：扫描电镜下磷酸盐缓冲液组纤维束交织,结构略显松散,50、100 g/L明胶改性后纤维结构更为致密.红外光谱分析显示明胶和壳聚糖间有相互作用.③体内降解率：磷酸盐缓冲液组体内平均降解率65%,50,100 g/L明胶组平均降解率分别为78%和81%,3组间差异无显著性意义.④壳聚糖纤维植入肌袋后的组织相容性：改性后壳聚糖纤维植入后与大鼠周围肌肉连接紧密,表面包膜薄,细胞主要为淋巴细胞,植入12周后3组纤维大部分吸收. 结论：明胶改性可进一步提高壳聚糖纤维的强度和生物相容性.     

外源性一氧化氮对创伤愈合过程中一氧化氮合酶表达及瘢痕形成的影响

目的:应用组织化学、免疫组织化学及计算机辅助图像分析方法,观察外源性一氧化氮在创伤愈合过程不同时间,对一氧化氮合酶表达和胶原形成的影响,探讨其在促进创伤愈合和抑制病理性瘢痕形成中的机制。方法:实验于2004-09/2006-03在河北省人民医院整形烧伤外科及河北省人民医院临床医学研究中心完成。以硝普钠为一氧化氮供体,将60只大鼠随机分为对照组及硝普钠0.5,1,2,4mmol/L组,每组12只,通过建立大鼠创伤模型,并分别在创面局部应用50g/L葡萄糖溶液、0.5,1,2,4mmol/L硝普钠,观察及测量创伤后3,7,10,14d的肉芽组织生长情况、一氧化氮合酶的表达情况和肉芽组织中羟脯氨酸含量。结果:60只大鼠全部进入结果分析。①形态学观察:对照组于创伤后14d可完全愈合;硝普钠0.5mmoL/L组及1mmoL/L组肉芽组织生长良好,且愈合时间较对照组提前三四天;硝普钠2mmoL/L组及4mmoL/L组愈合情况不良,完全愈合时间延迟,皮肤张力较低,炎症反应明显。②一氧化氮合酶蛋白表达:大鼠皮肤创伤后角质形成细胞、汗腺、毛囊和骨骼肌细胞以及创伤后肉芽组织的炎症细胞、成纤维细胞、血管内皮细胞均不同程度的表达一氧化氮合酶蛋白。对照组在第3天和第14天分别呈现一氧化氮合酶阳性颗粒表达高峰,而硝普钠各组仅在第7～10天出现表达一氧化氮合酶阳性高峰,呈先增加后减少的趋势。③羟脯氨酸含量:对照组从创伤后第3,7,10,14天羟脯氨酸含量进行性增加[依次为(1.637±0.127),(2.250±0.169),(2.420±0.201),(2.908±0.241)mg/g];硝普钠0.5mmol/L组在创伤后第3,7天羟脯氨酸含量低于对照组[(1.435±0.147),(1.766±0.211)mg/g,P<0.05或P<0.01],而在第10天和第14天羟脯氨酸含量均高于对照组[(3.128±0.240),(3.437±0.239)mg/g,P<0.01];硝普钠1mmol/L组和2mmol/L组在第10天和第14天的羟脯氨酸含量明显高于对照组[(1mmol/L组:(3.244±0.245)(3.582±0.282)mg/g,P<0.01;硝普钠2mmol/L组:(3.666±0.263),(4.301±0.268)mg/g,P<0.01);硝普钠4mmol/L组仅在创伤后第3天表现比对照组多[(1.912±0.139)mg/g,P<0.01),其余均与对照组水平相近。结论:局部应用外源性一氧化氮具有显著的促修复作用,主要体现在伤后第7～10天,小剂量的一氧化氮促进创面愈合的作用远远大于大剂量一氧化氮。