中药别敏对大鼠鼻黏膜血管通透性的影响

目的探讨中药别敏治疗变应性鼻炎的作用是否与鼻黏膜血管通透性改变有关。方法中药组及模型组大鼠于第1、7天腹腔注射卵蛋白和氢氧化铝凝胶混悬液,使BN大鼠致敏;中药组大鼠第8～17天灌服中药别敏混悬液;第18天进行鼻腔灌流,测定灌流液中的Evens blue的浓度,以观察中药别敏对该模型鼻黏膜血管通透性的影响。结果（1）模型组大鼠灌流液中伊文氏蓝浓度明显高于正常组,两者之间差异具有显著性（P〈0．01）。（2）中药组大鼠灌流液中伊文氏蓝浓度明显低于模型组,两者之间差异具有显著性（P〈0．01）。结论中药别敏具有明显改善致敏BN大鼠鼻黏膜血管通透性作用。表明别敏具有缓解变应性鼻炎临床症状的作用,可能与改善鼻黏膜血管通透性有关。     

Outcome of patients with nasal natural killer (NK)/T-cell lymphoma treated with radiotherapy, with or without chemotherapy

BACKGROUND: This study reviews the outcome of patients with nasal natural killer (NK)/T-cell lymphoma treated at the Therapeutic Radiology Department, National Cancer Centre, Singapore, from 1997 to 2003. METHODS: Twenty-one consecutive patients treated with radiotherapy, with or without chemotherapy, were retrospectively reviewed. RESULTS: The median age was 44 years (range, 27-86 years). Thirteen patients had stage I disease, five had stage II disease, and three had stage IV disease. Immunophenotyping was CD 56+ in 18 patients. Median follow-up for patients still alive was 23.4 months (range, 8.9-78.5 months). A median dose of 50 Gy (range, 35-56 Gy) was delivered. Sixteen patients also received chemotherapy. Two-year overall survival was 52.8%. Five patients had rapidly progressive disease, with a median survival of 89 days from diagnosis. The other 16 patients had complete remission, after which four relapsed. There were two local relapses. CONCLUSIONS: This disease often carries a poor prognosis, despite multimodality treatment. Radiotherapy may contribute to local control in some patients.     

Comparison of three ways to determine and deliver pressure during nasal CPAP therapy for obstructive sleep apnoea

BACKGROUND: The simplest method of initiating and maintaining therapeutic continuous positive airways pressure (CPAP) therapy for obstructive sleep apnoea (OSA) has not been established. METHODS: Ninety eight subjects with OSA requiring CPAP treatment (more than 10 dips in oxygen desaturation of >4% per hour of sleep study and Epworth Sleepiness Score (ESS) >9) were randomised prospectively to three different methods of CPAP delivery for 6 months: (1) autotitration pressure throughout; (2) autotitration pressure for 1 week followed by fixed pressure (95th centile) thereafter; and (3) fixed pressure determined by algorithm (based on neck size and dip rate). Patients and investigators were blind to group allocation. One week after initiation the patients were routinely reviewed by sleep nurses. Study assessments took place before starting CPAP treatment and 1 and 6 months after to assess ESS, maintenance of wakefulness test, 24 hour blood pressure, general health (SF-36), and sleep apnoea related quality of life. CPAP internal monitoring data were also collected. RESULTS: There were no significant differences in any of the outcome measures or CPAP monitoring data between the three groups. The 95th centile CPAP pressures delivered in the 6 month and 1 week autotitration groups were higher than in the algorithm group, but the median pressures were lowest in the 6 month autotitration group. CONCLUSIONS: The method of determining CPAP pressure for treatment of moderate to severe OSA makes no significant difference to clinical outcome measures. The autotitration CPAP machine used has no advantage in this setting over simpler methods of pressure determination.     

Upregulation of COX-1 and COX-2 in nasal polyps in cystic fibrosis

BACKGROUND: Since abnormalities in prostanoid metabolism occur in the lower airway of patients with cystic fibrosis (CF), it is likely that they could also be detected in the nose. METHODS: The degree of mRNA and protein expression of cyclo-oxygenase (COX) enzymes 1 (COX-1) and 2 (COX-2) was examined using quantitative reverse competitive polymerase chain reaction (RT-PCR) and Western blot analysis in the nasal polyps from 10 patients with CF, nasal polyps from 10 non-CF patients and 11 nasal mucosa specimens. The results are presented as 10(6) cDNA molecules/mug total RNA and the densitometric ratio between protein and beta-actin. RESULTS: COX-1 mRNA levels were significantly higher in CF nasal polyps (median 2.34, 25-75th percentiles 1.6-3.2) than in the nasal mucosa (0.78, 0.11-1.21), while there was no difference with non-CF nasal polyps (1.11, 0.80-3.15). COX-1 protein levels were significantly higher in CF nasal polyps (3.63, 2.71-4.27) than in nasal mucosa (1.55, 0.66-2.33) and non-CF nasal polyps (2.19, 1.72-3.68). COX-2 mRNA was significantly higher in CF nasal polyps (3.34, 2.42-7.05) than in nasal mucosa (1.69, 0.19-3.50). No differences were found in COX-2 mRNA expression between CF and non-CF polyps (1.38, 0.12-6.07). COX-2 protein levels were also significantly higher in CF nasal polyps (0.23, 0.04-0.34) than in non-CF nasal polyps (0.011, 0.009-0.016) or nasal mucosa (0.014, 0.014-0.016). CONCLUSIONS: Upregulation in the expression of COX-1 and COX-2 could explain the high production of prostanoids reported in CF. These findings raise questions regarding the potential use of selective or non-selective COX-2 non-steroidal anti-inflammatory treatment in CF.     

Mirror image duplication of the hands and feet: Report of a sporadic case with multiple congenital anomalies

Mirror image duplication of the hands and feet is a rare entity. Based on 3 previous reports, findings include nasal abnormalities, dimelia of ulna and fibula, tibial hypoplasia and mirror image duplication of hands and feet. We report on a sporadic case in which mirror image duplication was associated with multiple congenital anomalies. Although these cases may represent variable expression of the same dominantly transmitted complex polysyndactyly syndrome, it is possible that mirror image duplication of the hands and feet is a manifestation common to a number of distinct clinical entities. During limb bud development, duplication and aberrant positioning of the zone of polarizing activity in relation to the apical ectodermal ridge may account for the anatomic abnormalities of the hands and feet in these patients. © 1995 Wiley-Liss, Inc.     

小儿上颌窦的年龄解剖学观测

解剖观测了180具(男97、女83)新生儿、身长51cm～、71cm～、91cm～、111cm～及131～150cm 6组(每组30例,60侧)小儿尸的上颌窦。在Ⅰ～Ⅴ组中,上颌窦以卵圆形为多见;在Ⅵ组中,锥体形占半数。测得了6组上颌窦的大小、容积及开口至鼻孔的距离。观测了窦底与鼻腔底的关系。通过对观测结果的分析、比较,提示小儿上颌窦的形态、大小等均随身长增长而发生变化。     

Reconstruction of distal nasal deficiency using the bilobed flap

Summary Many techniques have been described to repair defects of the distal nose. The author has found the bilobed flap to be a useful technique in the repair of partial thickness and full thickness defects. Good cosmetic results can be achieved. Several examples are described.     

鼻腔和副鼻窦恶性肿瘤的单纯放射治疗

本文对40例鼻腔和副鼻窦恶性肿瘤的单纯放射治疗作了疗效观察。其临床症状和体征相似于文献描述。其1、2和5年总生存率分别为67.50％、57.50％和39.28％。未分化癌的预后比其它类型癌瘤稍好些。未分化癌和鳞状细胞癌的放射剂量建议分别为小于5000和大于7000cGy为好。