微型切削器获取鼻息肉组织在呼吸上皮细胞培养中的意义

目的 介绍一种用微型切削器收集鼻息肉组织并进行鼻息肉上皮细胞培养的方法.方法 A组自制鼻息肉组织收集瓶,通过微型切削器于手术时收集切除的鼻息肉组织,采用气-液界面(ALI)的原代细胞培养技术,对鼻息肉上皮细胞进行培养.并与B组手术时常规钳取鼻息肉组织进行上皮细胞培养的方法的对照.结果 A组细胞培养后第5天观察见沉入底部滤膜上的上皮细胞贴壁并形成单层,形态良好,边缘清晰,折光性能强,呈鹅卵石状,纤毛细胞纤毛摆动活跃,随着培养时间的延长,至第14天时,细胞生长良好,纤毛细胞数有所增加.两组间各观察阶段细胞形态基本一致,各时点上皮细胞电阻及电位值也无明显差异(均P＞0．05).结论 在鼻息肉上皮细胞培养实验中,利用微型切削器收集鼻息肉组织,可以扩大鼻息肉标本的来源,是一种可行而且有效的方法,值得应用.     

Surgical treatment of hepatic hydatic disease during pregnancy: report of two cases

Current treatment options for hepatic hydatid disease include surgery, medical treatment, and percutaneous drainage. However, the choice between these treatment modalities for pregnant women is still controversial. We reported in this article two pregnant patients with hepatic hydatid cysts who underwent surgical treatment.     

阴式附件手术与腹腔镜附件手术临床对照分析

目的:比较阴式附件手术与腹腔镜附件手术的临床指标、并发症发生情况及卫生经济学指标。方法:回顾分析阴式附件手术92例的临床资料并与同期腹腔镜手术102例的手术时间、失血量、术后病率、并发症发生率及住院费用比较。结果:92例阴式附件手术均获成功。术中出血量、并发症、术后病率等与腹腔镜相比无统计学差异(P>0.05),手术时间、住院费用少于腹腔镜手术(P<0.05),术后白细胞计数低于腹腔镜手术(P<0.05)。结论:与腹腔镜比较,附件良性囊肿阴式手术是可行的,手术时间短,对患者全身状况、腹腔脏器干扰小,并发症发生率低且能节省手术费用。     

鼻NK/T细胞淋巴瘤的临床及病理学特征分析

目的探讨鼻NK/T细胞淋巴瘤的临床及组织病理学特征。方法对经治的21例鼻腔NK/T细胞淋巴瘤患者临床资料进行回顾性分析，总结其临床特点及组织病理学特征。结果患者主要临床症状表现为单侧鼻塞及脓血涕；经鼻内镜检查，证实肿瘤位于鼻腔外侧壁者17例，位于鼻中隔者4例；肿瘤形状类似于息肉样病变者9例，肿瘤表面糜烂且质脆者12例；CT显示肿瘤居于鼻腔前部者17例，发于鼻中隔者4例；病变累及上颌窦者12例，累及筛窦3例，同时累及上颌窦与筛窦者6例。病理学检查显示鼻型NK/T细胞淋巴瘤15例，外周T细胞淋巴瘤6例。结论本病临床表现缺乏特异性，CT检查有利于确定病变范围及临床分期，多部位活检及免疫组织化学检查是确诊鼻NK/T细胞淋巴瘤的主要依据。     

The effects of spirulina on allergic rhinitis

The prevalence of allergic rhinitis is increasing globally due to various causes. It affects the quality life of a large group of people in all around the world. Allergic rhinitis still remains inadequately controlled with present medical means. The need of continuous medical therapy makes individuals anxious about the side effects of the drugs. So there is a need for an alternative strategy. Effects of spirulina, tinospora cordifolia and butterbur were investigated recently on allergic rhinitis in just very few investigations. Spirulina represents a blue-green alga that is produced and commercialized as a dietary supplement for modulating immune functions, as well as ameliorating a variety of diseases. This double blind, placebo controlled study, evaluated the effectiveness and tolerability of spirulina for treating patients with allergic rhinitis. Spirulina consumption significantly improved the symptoms and physical findings compared with placebo (P < 0.001***) including nasal discharge, sneezing, nasal congestion and itching. Spirulina is clinically effective on allergic rhinitis when compared with placebo. Further studies should be performed in order to clarify the mechanism of this effect.     

鼻阻力测压与鼻声反射测量的相关性研究

目的探讨主动后鼻阻力测压仪的参数——鼻阻力(nasal resistance,NR)与鼻声反射测量仪的参数——鼻腔容积(nasal cavity volume,NV)、鼻腔最小横截面积(minimal cross sectional area,MCSA)间是否具有相关性。方法应用主动后鼻阻力测压法和鼻声反射测量法对316例有鼻阻塞的患者进行前瞻性研究。根据减充血前双侧鼻阻力(bilateral NR,BNR)将患者分为2组,组1:BNR减充血前≤0.25 Pa/cm~3·s,组2:BNR减充血前>0.25 Pa/cm~3·s。Spearman等级相关分析研究上述两种客观测量法的参数在全体研究对象及各组中的相关性。结果在使用减充血剂前、后,316例患者单侧鼻阻力(unilateral NR,UNR)与单侧鼻腔容积(unilateral NV,UNV)、单侧鼻腔最小横截面积(unilateral MCSA,UMCSA)间均存在显著性负相关(P值均=0.000);组1(104例)和组2(212例)在减充血前、后的UNR与UNV、UMCSA间均存在显著性负相关(P值均=0.000)。鼻阻力与鼻腔最小横截面积的相关系数均大于鼻阻力与鼻气道容积的相关系数。结论在有鼻阻塞的患者中,NR、NV及MCSA存在负相关,MCSA是影响NR的主要因素。     

人鼻黏膜上皮细胞中白细胞介素12和细胞间黏附分子1及单核细胞趋化因子3的表达研究

目的:利用RT-PCR检测原代培养的人鼻黏膜上皮细胞中IL-12、细胞间黏附分子1(ICAM-1)以及单核细胞趋化因子3(MCP-3)mRNA的表达。方法:获取人鼻黏膜组织,原代培养人鼻黏膜上皮细胞。设计IL-12 p35亚基、IL-12 p40亚基I、CAM-1以及MCP-3的引物,参照物采用3-磷酸甘油醛脱氢酶(GAPDH),目标扩增片段938 bp。半定量RT-PCR检测其mRNA在鼻黏膜上皮细胞的表达。结果:×400光镜下观察结果显示原代培养的鼻黏膜上皮细胞形状呈圆形或不规则形,饱满贴壁。RT-PCR结果通过1%琼脂糖凝胶电泳显示,鼻黏膜上皮细胞有IL-12 p35I、CAM-1以及MCP-3 mRNA的表达,但无IL-12 p40亚基的表达。结论:人鼻黏膜上皮细胞中有IL-12 p35、ICAM-1以及MCP-3的mRNA表达,但无IL-12p40亚基的表达。人鼻黏膜上皮细胞不能合成完整有活性的IL-12。     

鼻内镜修正手术治疗80例复发性鼻窦炎鼻息肉的病例分析

目的探讨鼻内镜手术治疗鼻窦炎、鼻息肉复发的原因，提高修正手术的疗效。方法复习我院2004年以来对复发性鼻窦炎、鼻息肉Ⅲ期80例修正手术病例的治疗体会，术前术后的综合治疗，术后随访6个月～1年半。结果80例复发病例经鼻内镜修正手术治疗后，随访一年以上，治愈42例，好转20例，无效18例，修正手术的有效率为77．5％，无严重的并发症发生。结论熟悉鼻内镜手术的应用解剖，熟练的手术操作技巧，特别是对几个容易引起复发的部位的处理得当，以及术后定期合理的鼻内镜随访是预防和减少复发的重要因素。     

Bilateral nasal vestibular stenosis: a case of rhinoscleroma and review of surgical techniques

Vestibular stenosis is an uncommon but debilitating cause of nasal obstruction. It is caused by disruption of the nasal vestibular lining with secondary proliferation of granulation and fibrous tissue. A number of techniques have been described for repair of the stenotic segment. Correction can be difficult because of the tendency of wound contracture and recurrence. We present a surgical technique that employs the concept of excision of the stenotic segment, enlargement of the vestibule and placement of a full thickness skin flap. Its ability to resist contracture obviates the need for post-operative stenting and gives good result.     

Long-term effects of postoperative measures after sinus surgery

To compare the long-term effects of different postoperative treatment regimes after functional endoscopic sinus surgery (FESS), we performed a randomized controlled trial. Inclusion criteria were chronic rhinosinusitis with (CRSwNP) or without (CRS-NP) bilateral nasal polyps and acute recurrent rhinosinusitis (ARR). All patients (male/female = 56/65; mean age = 42.8 years; age range 18–73 years) underwent sinus surgery for the first time. The patients included in 2004 were allocated to a packing in middle meatus for 5 days or saline irrigation only postoperatively. The patients included in 2005 were randomized to debridement 6 and 12 days postoperatively or saline irrigation. At baseline and 56 weeks (32–77) postoperatively, the patients reported symptoms such as nasal congestion, facial pain, headache, and change in sense of smell, nasal discharge, sneezing and reduced general condition on visual analogue scale (VAS). We used ANCOVA to compare symptom improvement. Among patients with CRSwNP, nasal congestion and sneezing improved, respectively, 20 mm (P value = 0.041) and 18 mm (P value = 0.011) more in the debridement group than in the saline irrigation group. Although a packing had positive effects on the symptom improvement they were not significant. Patients with CRSwNP, who had undergone debridement after FESS, had significantly larger symptom improvement 56 weeks after surgery than patients who had only done saline irrigation.