分泌性中耳炎患者鼻咽部表面活性物质的检测

目的　通过定量测定健康人及分泌性中耳炎 (secretoryotitismedia,SOM)患者鼻咽部灌洗液中代表表面活性物质的卵磷脂含量 ,进一步证实鼻咽部表面活性物质的存在 ,以探讨SOM的发病机理。方法　采集健康人和SOM患者鼻咽部灌洗液 ,用分光光度计法测定卵磷脂含量并进行对照。结果　SOM患者鼻咽部灌洗液中卵磷脂含量为 (8 637± 2 730 )mg/L( x±s,下同 ) ,明显低于健康对照组的 (39 2 12± 2 4 37)mg/L ,儿童SOM患者其鼻咽部灌洗液中卵磷脂含量 (8 0 62± 2 92 5)mg/L较健康同龄对照组 (39 787± 2 557)mg/L显著减少 ,表面活性物质含量与SOM病程无明显相关。结论局部表面活性物质减少可能是SOM发病机理之一 ,外源性表面活性物质的应用和促进内源性表面活性物质的分泌可能是预防和治疗SOM的途径之一。     

乌苯美司对放射治疗鼻咽癌的辅助治疗

目的：评价乌苯美司对放射治疗鼻咽癌患者的辅助治疗作用。方法：将接受放射治疗的85例病例以3：2的比例随机分为两组。试验组放疗加口服乌苯美司胶囊，对照组单纯放疗。观察两组的长期生存率，肿瘤的远地转移率和免疫机能变化情况。结果：两组的5年生存率统计学差异无显著意义；两组的肿瘤远地转移率统计学差异有显著意义；治疗前后的免疫机能改善，试验组有显著意义，对照组无显著意义。结论：乌苯美司对放射治疗的鼻咽癌患者有辅助治疗作用，但仍须扩大观察数量。     

鼻咽癌放射治疗后复发因素Cox模型评价

目的 探讨鼻咽癌放射治疗后复发有关因素，为提高鼻咽癌的疗效，减少复发提供参考，方法 收集鼻咽癌复发病例６０例，对造成复发的可能因素进行Ｃｏｘ模型单因素分析，结果 年龄ＴＮ分期放射剂量及照射野与复发有关，Ｔ分期，鼻咽剂量，照射野是复主要因素，结论 对分期晚的患者应保证照射范围和放射剂量达到根治要求。     

Olfactory bulb volume and olfactory function after radiotherapy in patients with nasopharyngeal cancer

Objective

Radiotherapy is the primary method of treatment for nasopharyngeal cancer (NPC) and many side effects were reported in patients receiving radiation to this area. This study was conducted to evaluate the long-term effects of radiotherapy following NPC on olfactory bulb (OB) volume and olfactory function.

Methods

Twenty-four patients with NPC who received radiotherapy at least 12 months ago were recruited. Fourteen healthy subjects with similar demographical characteristics were recruited as the healthy control group. All volunteers were subjected to a nasoendoscopical examination, and abnormalities that could potentially cause olfactory dysfunction were the exclusion criteria from the study. An experienced radiologist segmented the MRI coronal, axial and sagittal slices manually for three-dimensional OB volume measurement in a blinded manner. Olfactory function was assessed using the Connecticut Chemosensory Clinical Research Center (CCCRC) test, and average score (0: worst, 7: best) was calculated as the total CCCRC olfactory score.

Results

The mean CCCRC score was 5.5 ± 1.1 for the nasopharyngeal cancer patients, whereas the mean score of healthy control group was 6.4 ± 0.4. There was a significant difference in the olfactory scores (p = 0.003). The mean OB volume in the NPC group was 46.7 ± 12.1 mm³. Among the patients with NPC, the cisplatin receiving group had a mean OB volume of 47.2 mm³, whereas the cisplatin + docetaxel receiving group had a mean OB volume of 46.5 mm³, and they were similar. The MRI measurement of the healthy control group was 58.6 ± 13.8 mm³. The OB volumes of the healthy control group were significantly higher (p < 0.05).

Conclusion

Radiotherapy following nasopharyngeal cancer results in a diminished OB volume and deteriorated olfactory function. Chemosensory olfactory dysfunction might be a contributing factor to lack of appetite, cancer cachexia and consequent lowered quality of life in NPC patients.     

镉对大鼠输精管损伤及锌保护的超微结构与葡萄糖-6-磷酸酶细胞化学的研究

目的研究小剂量氯化镉对大鼠输精管近、远段的影响及锌的保护作用。方法用１％氯化镉（２ｍｇ／ｋｇ体重）腹腔注射雄性Ｗｉｓｔａｒ大鼠后４ｈ到６０ｄ及镉、锌联合注射后３ｄ、１５ｄ取材。采用电镜观察和葡萄糖－６－磷酸酶（Ｇ－６－Ｐａｓｅ）电镜细胞化学定量研究。结果镉注射４ｈ后,输精管主细胞出现超微结构改变,３～７ｄ改变最明显,１５ｄ后有所减轻,６０ｄ后基本恢复正常。主细胞的主要改变为线粒体肿胀,内质网扩张及髓样结构增多。镉注射后４ｈ,远段主细胞Ｇ－６－Ｐａｓｅ反应产物明显减少,３ｄ最少,１５ｄ反应产物增多。镉、锌联合注射后超微结构及Ｇ－６－Ｐａｓｅ活性损伤均较单纯镉组轻。结论锌对镉所致大鼠输精管主细胞超微结构损伤及远段主细胞Ｇ－６－Ｐａｓｅ活性影响有明显保护作用。     

Nasopharyngeal tuberculosis

Today, the opportunity to see tuberculosis is decreasing. Nasopharyngeal tuberculosis is a rare entity, even in endemic tuberculosis areas. A case of nasopharyngeal tuberculosis is described. A 28-year-old woman presented with a sore throat. Irregular mucosal thickening was seen in the nasopharynx. Staining for acid-fast bacilli was positive (Gaffky 1), and the PCR test was positive for Mycobacterium tuberculosis from pharyngeal mucus. Computed tomography showed mucosal thickening in the pharynx and old pulmonary tuberculosis in the right upper lobe. Multiple anti-tuberculosis drug therapy was performed for 6 months. A few days after the initiation of therapy, the pharyngeal pain subsided. The irregular mucosal thickening was quite thin after 1 month of multidrug therapy and was no longer observed after 2 months. A case of nasopharyngeal tuberculosis is reported. A good result was obtained with multiple anti-tuberculous drug therapy for 6 months. Nasopharyngeal tuberculosis should be considered in the differential diagnosis of a white nasopharyngeal coating, especially in a patient with a history of pulmonary tuberculosis.     

Tumeur neuroendocrine à grandes cellules du nasopharynx : à propos d’un cas

Neuroendocrine carcinoma of the head and neck is a rare entity. The parotid gland is the most commonly affected site. A nasopharyngeal site has not been previously described. We report a 35-year-old patient who consulted for tinnitus and nasal obstruction. The assessment found a nasopharyngeal tumour T4N0M0. The patient underwent 6 cycles of chemotherapy based on VP16 and cisplatin, followed by radiotherapy at a dose of 70 Gy to the nasopharynx and 50 Gy to the neck. The evolution was marked by clinical improvement and radiological stability. Six months after the end of treatment, the patient had a local and meningeal relapse. He received palliative care. He died 19 months after the end of treatment.     

Foreign body in the nasopharynx of a child

Introduction of foreign body into the nasal cavity of the children by themselves is very common, but lodgment of foreign body in the nasopharyux following introduction through mouth is unusual. Here a case is presented from the Otorhinolaryngology department of S.S.K.M. Hospital, Kolkata, where a child was brought by their parents with history of introduction of a metallic foreign body in the mouth of the child by himself and this foreign body was found to be lodged in the nasopharynx of the child. The foreign body was removed orally in the out patient department. The patient returned home without any complication.     

鼻内窥镜下鼻咽部局限性病变微波治疗术(附35例分析)

在鼻内窥镜下应用微波治疗仪治疗鼻咽部局限性病变３５例，其中良性病变３２例，鼻咽癌放疗后病灶残留３例，均收到良好效果。本法具有视野清晰、疗效高、病人痛苦少等优点。