Expansion of human nasal chondrocytes on macroporous microcarriers enhances redifferentiation

Articular cartilage has a limited capacity for self-repair. To overcome this problem, it is expected that functional cartilage replacements can be created from expanded chondrocytes seeded in biodegradable scaffolds. Expansion of chondrocytes in two-dimensional culture systems often results in dedifferentiation. This investigation focuses on the post-expansion phenotype of human nasal chondrocytes expanded on macroporous gelatin CultiSpher G microcarriers. Redifferentiation was evaluated in vitro via pellet cultures in three different culture media. Furthermore, the chondrogenic potential of expanded cells seeded in polyethylene glycol terephthalate/ polybuthylene terephthalate (PEGT/PBT) scaffolds, cultured for 14 days in vitro, and subsequently implanted subcutaneously in nude mice, was assessed.

Chondrocytes remained viable during microcarrier culture and yielded doubling times (1.07±0.14 days) comparable to T-flask expansion (1.20±0.36 days). Safranin-O staining from pellet culture in different media demonstrated that production of GAG per cell was enhanced by microcarrier expansion. Chondrocyte–polymer constructs with cells expanded on microcarriers contained significantly more proteoglycans after subcutaneous implantation (288.5±29.2 μg) than those with T-flask-expanded cells (164.0±28.7 μg). Total collagen content was similar between the two groups.

This study suggests that macroporous gelatin microcarriers are effective matrices for nasal chondrocyte expansion, while maintaining the ability of chondrocyte differentiation. Although the exact mechanism by which chondrocyte redifferentiation is induced through microcarrier expansion has not yet been elucidated, this technique shows promise for cartilage tissue engineering approaches.     

Mechanism of slowing of mucociliary transport induced by SO2 exposure

Responses of nasal mucociliary transport mechanisms to exposure to 6 ppm SO₂ were studied in chickens in vivo. This model takes advantage of the natural cleft palate which exposes the mucociliated base of the nasal septum. Exposure to 6 ppm SO₂ decreased the mucociliary transport rate along the base of the nasal septum. The minimum force required to move an iron particle along this area of mucous membrane by use of a magnetic field in vivo increased significantly after SO₂ exposure, while the minimum force required to move an iron particle on a pool of mucus collected from the same chicken and tested in vitro showed no change after SO₂ exposure. The elastic recoil distance of mucus was measured both in vivo and in vitro. The in vivo recoil distance decreased significantly after SO₂ exposure, while SO₂ exposure did not change recoil distance in vitro. It is proposed that exposure of chickens to SO₂ results in the formation of multiple points of adhesion of strands of mucus between the acinar gland cells and the emergent extracellular mucus or adhesion of a mucous blanket to the cilia, causing mucociliary transport to be retarded or static.     

过敏性哮喘患者鼻分泌液中分泌性IgA含量的测定

本文对２６例过敏恶性性支气管哮喘患者鼻分泌液中ＳＩｇＡ含量等进行了超速离心检测，结果表明：患者鼻分泌液中ＳＩｇＡ，ＩｇＡ，总ＩｇＡ含量均较正常人明显增加（Ｐ＜０．０５，＜０．０１，＜０．０５）。ＩｇＡ对白蛋白的相对分泌系数与正常人无明显差异（Ｐ＜０．０５）。结合其它研究认为过敏性哮喘患者呈粘膜ＳＩｇＡ免疫高反应状态。     

丁字形泪囊鼻腔吻合术(附8眼手术报告)

本文报告8眼丁字形泪囊鼻腔吻合术,其中6眼追踪观察廿年获得完全治愈;1眼观察6个月效果良好 1眼愈后不详。同时对主要手术步骤做了介绍,鼻粘膜瓣环钻法改用十字切开法更易于吻合。     

呼吸机持续气道正压通气联合枸橼酸咖啡因治疗早产儿呼吸暂停给药时间与临床疗效的关系

目的:观察呼吸机持续气道正压通气支持下的不同枸橼酸咖啡因给药时间对早产儿呼吸暂停(AOP)疗效的影响。方法:选取91例出生胎龄<32周的原发性呼吸暂停患儿,按照枸橼酸咖啡因给药时间的不同将患儿分为早期组(51例,出生24 h内在呼吸机持续气道正压通气下完成枸橼酸咖啡因给药)和常规组(40例,72 h内在呼吸机持续气道正压通气下给予枸橼酸咖啡因治疗)。比较两组患儿的呼吸机应用时间、给药时间、吸氧天数以及呼吸暂停改善情况,记录呼吸指标变化和不良反应发生情况。结果:早期组呼吸机使用时间、给药时间、吸氧天数、3 d后呼吸暂停次数及住院时间均明显低于常规组,差异有统计学意义(t=5.561,t=2.901,t=2.821,t=3.180,t=2.987;P<0.05)。经枸橼酸咖啡因治疗3 d后,两组患儿β-内啡肽水平及二氧化碳分压较治疗前均有显著降低,且早期组较常规组下降更为明显(t=0.408,t=3.294;P<0.05);氧分压及血氧饱和度均较治疗前有显著回升,早期组较常规组升高更显著(t=6.4758,t=2.121,t=2.409;P<0.05)。早期组的治疗有效率为86.2%(44/51),常规组为72.5%(29/40),两组比较差异具有统计学意义(Z=-2.149,P<0.05)。早期组不良反应事件发生率为13.7%(7/51),常规组为15.0%(6/40),两组比较差异无统计学意义。结论:呼吸机持续气道正压通气可以改善患儿呼吸功能,有助于患儿更好的渡过呼吸暂停危险期,早期给予枸橼酸咖啡因可促进患儿更快的恢复,显著缩短治疗时间,但不会增加不良事件的发生。     

经鼻蝶窦入路垂体瘤切除术后颅内感染病原学及其影响因素

目的探讨经鼻蝶窦入路垂体瘤切除术后并发颅内感染病原菌特征及影响因素。方法回顾性分析浙江省丽水市人民医院2014年1月-2019年2月500例经鼻蝶窦入路垂体瘤切除术患者临床资料,观察颅内感染发生情况,分析感染组感染病原菌分布情况及影响因素。结果500例经鼻蝶窦入路垂体瘤切除手术患者共有42例发生颅内感染,发生率为8.40%。年龄、肿瘤直径、手术时间、术中脑脊液漏、术后留置引流管是导致经鼻蝶窦入路垂体瘤切除术后颅内感染发生的独立危险因素;从42例感染患者脑脊液标本中共分离出51株病原菌,以凝固酶阴性葡萄球菌感染占比33.33%最高,其次为金黄色葡萄球菌、肺炎克雷伯菌、鲍氏不动杆菌;根据术后28 d患者临床结局,比较生存(n=493)和病死(n=7)患者,高龄、肿瘤直径较大、肿瘤具侵袭性、术后颅内感染患者的病死比例较高(P<0.05)。结论年龄、肿瘤直径、手术时间、术中脑脊液漏、术后留置引流管均是经鼻蝶窦入路垂体瘤切除术后颅内感染发生的影响因素,感染病原菌主要为凝固酶阴性葡萄球菌、金黄色葡萄球菌、鲍氏不动杆菌、肺炎克雷伯菌,术后颅内感染不利于患者预后。     

西安市134例百日咳疑似病例不同标本百日咳鲍特菌检测阳性率比较

目的比较百日咳疑似病例鼻、咽和鼻咽拭子标本百日咳鲍特菌(Bordetella pertussis,Bp)检测阳性率。方法选择西安市两家医院2018年1-7月134例百日咳疑似病例,同时采集鼻、咽和鼻咽拭子标本,进行Bp分离培养和实时荧光定量聚合酶链反应核酸检测。结果百日咳疑似病例的Bp检测总阳性率为44.78%(60/134),其中鼻、咽、鼻咽拭子阳性率分别为36.57%、32.09%、39.55%(χ²=1.64,P=0.440);发病后0-7d、8-14d、15-21d、22-28d、29d采样的阳性率分别为23.33%、64.52%、63.89%、42.86%、23.33%(χ²=22.13,P=0.000)。鼻、咽、鼻咽拭子Bp核酸检测阳性率分别为36.57%、32.09%、39.55%(χ²=1.64,P=0.440);分离培养阳性率分别为0.00%、0.00%、4.59%(Fisher精确概率法,P=0.036)。在Bp核酸阳性病例中鼻和/或咽、鼻和/或鼻咽、咽和/或鼻咽拭子阳性分别占93.33%、91.67%、100%(Fisher精确概率法,P=0.080)。结论百日咳疑似病例鼻、咽和鼻咽拭子Bp检测总阳性率相当;核酸检测阳性率以鼻咽拭子最高,组合采样可提高Bp核酸检测阳性率;分离培养仍建议选择鼻咽拭子。     

炎症细胞与淋巴细胞在鼻息肉发病机理中的相关性研究

目的：探讨炎症细胞、淋巴细胞及浆细胞在鼻息肉发病中的作用;方法：采用免疫组化SP法及HE、甲苯胺兰染色对34例鼻息肉和30例正常中鼻甲粘膜进行研究;结果：鼻息肉中嗜酸性粒细胞阳性率显著高于对照组织（P＜0.01）;鼻息肉中肥大细胞数量显著多于对照组织（P＜0.01）,肥大细胞数量在吸入性变应原皮肤试验阳性组与阴性组间无显著性差异;鼻息肉中T淋巴细胞阳性细胞（CD43）和B淋巴细胞阳性细胞（CD20）、浆细胞数量显著多于对照组织（P＜0.01）,鼻息肉中T淋巴细胞与B淋巴细胞之间无显著性差异;结论：鼻息肉中存在活跃的细胞免疫和体液免疫,与嗜酸性粒细胞、肥大细胞及中性粒细胞共同参与鼻息肉的发病。     

综合治疗多发性鼻息肉72例疗效观察

目的：探讨综合治疗多发性鼻息肉的疗效。方法;对多发性鼻息肉72例进行综合治疗即行鼻息肉摘除术＋筛窦开放术＋术后随诊治疗3个月。随访1－6年。结果：治愈51例,复发21例,治愈率为70．8％。结论：此方法能有效地降低鼻息肉的复发率,消除鼻窦炎的症状,如多脓涕、头痛等。疗效比常规单纯鼻息肉摘除持久。     

孤立性蝶窦病变的诊断与治疗

目的;提高孤立性蝶窦病变的诊断和治疗率。方法;总结使用鼻窦内窥镜诊治孤立性蝶窦病变１２例的全过程。结果：１２例孤立性蝶窦病变的患者的均获准确诊断,使用鼻窦镜行经鼻腔蝶窦手术,有效率为８３．３％,随访６￣２４个月,１０例无复发,复发２例二次手术后治愈;结论：孤立性蝶窦病变患者可用鼻窦内窥镜诊断与治疗。