分泌性中耳炎中耳积液和血清中sIL－2R水平的初步研究

应用酶联免疫吸附法（ＥＬＩＳＡ）对３０例正常人血清（对照组）和６０例分泌性中耳炎患者（ＳＯＭ组）中耳积液和血清中可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）进行了检测。结果示ＳＯＭ组血清ｓＩＬ－２Ｒ水平明显高于对照组，ＭＥＦ中其含量明显高于血清；鼻咽癌组血清及ＭＥＦ中ｓＩＬ－２Ｒ水平明显高于─般ＳＯＭ组；粘液组高浆液组；慢性组高于急性组（均Ｐ＜０．０１）。提示：血清及ＭＥＦ中ｓＩＬ－２Ｒ水平的测定有助于对ＳＯＭ患者免疫状态的评估；ＭＥＦ中ｓＩＬ－２Ｒ可能主要由局部中耳粘膜产生；ＭＥＰ中高浓度的ｓＩＬ－２Ｒ存在可能是ＳＯＭ迁延不愈的─个原因。     

颞骨内面神经管的解剖测量及其临床意义

目的为避免中耳手术中对面神经的损伤。方法对50例(100侧)成人尸头颞骨内面神经管进行解剖测量。结果面神经管迷路段为4.53±1.21mm,鼓室段为9.32±1.25mm,乳突段为13.25±1.53mm,面神经管总长为29.86±0.57mm。结论熟悉颞骨内面神经管的解剖结构,可避免对面神经的损伤,减少和避免面瘫的发生。     

Ultrastructure of melanocytes in the dark cell area of human vestibular organs: Functional implications of gap junctions,isolated cilia,and annulate lamellae

Background: It is known that melanocytes exist in almost all parts of the inner ear, such as the cochlear duct, stria vascularis, Reissner's membrane, modiolus, vestibular organs in the region surrounding the cristae and maculae, semicircular canals, and pars rugosa of the endolymphatic sac. But there have been few studies using human materials, because of the difficulty of obtaining materials. We attempted to investigate the detailed ultrastructure of melanocytes in the vestibular organs of human inner ear. Methods: Eight surgical specimens obtained from patients with vestibular schwannoma were studied by light microscopy and electron microscopy. Results: Melanocytes were found in the subepithelial layer of the dark cell area. Melanocytes had round or spindle-shaped nuclei and clear cytoplasm with brown pigment granules. Besides melanocytes, there were melanophages, fibroblasts, and small blood vessels. Through electron microscopy we found melanocytes with round-shaped melanosomes in various stages of pigmentation, well-developed Golgi apparatus and endoplasmic reticulum in the cytoplasm, and many cytoplasmic processes. Gap junctions were occasionally found between the cytoplasmic processes. And there were pinocytotic vesicles just under the limiting membrane of melanocytes, and intermediate filaments were abundant in the cytoplasm. Isolated cilia of melanocytes, annulate lamellae, and fusiform banded structures in the connective tissue area around melanocytes were found. Conclusions: Melanocytes in human vestibular organs actively synthesize melanosomes. Frequent findings of isoalted cilia and fusiform banded structures and the incidental existence of annulate lamellae may be an indicator of this metabolically activated state of melanocytes. Moreover, monitoring environmental changes by isolated cilia, melanocytes in the human inner ear could act not only as one cell but also as a group to achieve their physiological functions by means of information transmission through gap junctions. © 1994 Wiley-Liss, Inc.     

Topical anti-inflammatory properties of flutrimazole,a new imidazole antifungal agent

The topical anti-inflammatory properties of flutrimazole, a new imidazole antifungal, have been evaluated. Flutrimazole inhibited mouse ear oedema induced by arachidonic acid, tetradecanoylphorbolacetate and dithranol, with IC₅₀ values of 3.32, 0.55 and 2.42 mols/ear, respectively. Ketoconazole showed similar potency in arachidonic acid and dithranol models (IC₅₀=3.76 and 2.41 mols/ear) whereas it was less active against tetradecanoylphorbol acetate (IC₅₀=1.96 mols/ear). The standard anti-inflammatory sodium diclofenac was overall slightly more potent than antifungals (IC₅₀=2.23, 0.57 and 0.57 mols/ear against arachidonic acid, tetradecanoylphorbol acetate and dithranol, respectively). Both 2% flutrimazole and 2% ketoconazole creams, applied topically, inhibited carrageenan-induced rat paw oedema by about 40%. Under the same conditions, 1% flutrimazole and diclofenac creams inhibited by 26 and 54%, respectively. Flutrimazole may work through the inhibition of 5-lipoxygenase, as it inhibited LTB₄ production by human granulocytes with an IC₅₀ value of 11 M (IC₅₀ value for ketoconazole was 17 M), whereas ram seminal vesicle cyclooxygenase was only inhibited by 16% at a concentration of 25 M. Drugs such as flutrimazole, with dual anti-inflammatory/antifungal activity, may be advantageous in the treatment of topical fungal infections with an inflammatory component.accepted by I. Ahnfelt-Rønne     

非皮质类固醇联合妥布霉素地塞米松滴眼液治疗季节性过敏性结膜炎的临床研究

目的探讨非皮质类固醇联合妥布霉素地塞米松滴眼液治疗季节性过敏性结膜炎的临床效果。方法 100例季节性过敏性结膜炎患者随机分为两组各50例,对照组采用妥布霉素地塞米松滴眼液治疗,研究组采用非皮质类固醇联合妥布霉素地塞米松滴眼液治疗,比较两组的治疗效果。结果治疗后,研究组的症状评分、体征评分、总评分、眼压均显著低于对照组(P <0.05);两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论非皮质类固醇联合妥布霉素地塞米松滴眼液治疗季节性过敏性结膜炎能有效改善患者的临床症状,安全性高。     

中耳占位性病变的CT诊断

目的：探讨中耳不同占位性病变的CT诊断及鉴别诊断问题。方法：对手术病理证实的25例中耳良性及恶性占位性病变患者的CT图像资料进行分析,分别总结其CT诊断及鉴别诊断要点。结果：（1）胆脂瘤：肿物多为单发,中心多位于上鼓室或鼓窦入口区,常破坏鼓室盾板,骨破坏区边缘多清晰硬化,常见听小骨受压移位表现。（2）炎性肉芽肿：肿物呈多发结节状或斑片状,病灶常相连并紧贴鼓室或鼓窦壁附壁分布伴边缘清楚的骨破坏。（3）中耳癌：肿物及骨破坏区形态极不规则,边缘模糊不清,可累及中耳结构以外的骨结构;骨破坏区达乳突或岩骨边缘者,CT横断层面示乳突或岩骨边缘骨壁呈“多点中断”表现。结论：听小骨移位及鼓室盾板骨破坏为诊断胆脂瘤最可靠和重要的依据;骨破坏区边缘模糊,乳突或岩骨边缘骨壁呈“多点中断”表现为中耳癌的特征性CT征象。     

复方洗必泰滴眼液治疗真菌性角膜炎的临床研究

目的　探讨复方洗必泰滴眼液对真菌性角膜炎的治疗作用。方法　将真菌性角膜炎患者 65例68眼分为两组 ,每组 34眼 ,实验组用复方洗必泰滴眼液点眼。对照组用 0 .3%二性霉素B溶液滴眼治疗 ,并且回顾研究以前接治的未采用以上两法治疗的 30例病人的情况。疗效观察比较 ,所获数据经 χ2 检验。结果　实验组有效率 82 .35% ,阳性对照组有效率 67.65% ,卡方检验 ,P <0 .0 5,有统计学差异 ;回顾以前病人有效率 4 0 % ,与实验组比较 ,P <0 .0 0 5,差异显著。结论　复方洗必泰滴眼液可以作为临床抗真菌性角膜炎的一线局部用药 ,其疗效明显高于二性霉素B及其它传统药物治疗效果。     

幼兔近视模型及大光明护眼液的疗效

目的 :探讨学生近视眼的发病机制和有效治疗药物。方法 :选用 2 0只新西兰纯种幼兔建立近视模型 ,然后分别采用2种药物和生理盐水治疗。结果 :大光明护眼液治疗组的平均屈光度 (D)值为 (+ 2 5 0± 0 6 8)、平均裸眼觅食距离 (cm)值为(2 80 0 0± 2 7 30 )、平均体重 (g)增长值为 (72 6 0 0± 31 30 ) ;而珍视明滴眼液治疗组和生理盐水治疗组近视屈光度 (D)值分别为(+ 1 6 6± 0 2 9)和 (+ 0 85± 0 42 ) ,平均裸眼觅食距离 (cm)分别为 (2 5 6 0 0± 5 4 48)和 (196 0 0± 76 48) ,平均体重 (g)增长分别为 (6 2 2 0 0± 31 94)和 (5 6 0 0 0± 6 2 85 )。结论 :(1)长期限制视距、微弱光线照射和经常习惯性近距离视物是造成近视眼的直接因素 ;(2 )采用大光明护眼液治疗近视眼的疗效明显 ,优于珍视明滴眼液和生理盐水治疗组 (P <0 0 1)。     

耳针分娩镇痛效果及对母儿的影响

目的 :探讨耳针镇痛的临床效果。方法 :对 6 8例正常足月初产妇临产后取耳穴、子宫穴、神门穴、交感穴、内分泌穴针刺镇痛 ,同时以 6 0例足月妊娠的正常产妇为对照组 ,不采取任何方法进行镇痛。记录 2组镇痛效果及产程、分娩方式、产后出血及新生儿评分的数值。结果 :耳针能协调子宫收缩、减轻疼痛、缩短产程 ,对分娩方式、产后出血量及新生儿阿氏评分均无影响。结论 :耳针用于分娩镇痛安全、简便、有效、便于推广     

先天性外耳道闭锁中耳畸形临床分析

采用外耳道及鼓室再造术治疗先天性外耳道完全闭锁29例。统计各种外、中耳畸形情况,比较耳廓发育程度、颞骨相当于外耳道口处有无骨性小凹、术前听力损失程度与中耳畸形的关系,将术前的常规横断位CT检查结果与术中所见进行对照。结果显示,术前可通过耳廓发育程度、相当于外耳道口处有无骨性小凹、听力损失程度和颞骨CT扫描来综合估计中耳畸形情况,为术前了解手术难度和确定手术进路及方式提供一定的参考依据。