变应性鼻炎鼻粘膜嗜酸粒细胞脱颗粒透射电镜观察

为研究变应性鼻炎鼻粘膜嗜酸粒细胞（ＥＯＳ）超微结构，从临床确诊为常年性变应性鼻炎（ＰＡＲ，ｎ＝１３）、花粉症（ＰＳ，ｎ＝９）和健康对照（ｎ＝３）鼻粘膜取活组织检查标本，除常规组织病理学检查外，重点观察ＥＯＳ脱颗粒的超微结构改变。ＰＡＲ和ＰＳ患者的鼻粘膜除不同程度的炎性反应外，均有明显的ＥＯＳ浸润。缓解期鼻粘膜ＥＯＳ胞膜完整、无突起，胞浆颗粒密度一致、中心键（ｃｒｙｓｔａｌｏｉｄ）清晰，胞浆无空泡化，为静息期ＥＯＳ。发作期鼻粘膜ＥＯＳ胞膜多不完整，伸出较多伪足，伪足中含有颗粒，胞浆空泡化明显，颗粒密度不一，中心键常脱失，为活化期ＥＯＳ。此外，尚可见大量的肥大细胞（ＭＣ）及Ｔ淋巴细胞浸润。ＥＯＳ与ＭＣ及Ｔ淋巴细胞的相互作用在变应性鼻炎的发生、发展中起重要作用。     

常年性变应性鼻炎鼻粘膜的透射电镜观察

透射电镜下观察PAP20例。其发作期鼻粘膜的病理学特征是：上皮纤毛损害，上皮间隙扩大，上皮胞浆线粒体、粗面内质网和吞饮小泡增多；上皮下和固有层组织水肿，小血管和毛细血管扩张，腔内血浆和血细胞成分淤带，毛细血管内皮和周细胞饮小泡增多，内皮连接间隙扩大；多量嗜酸粒细胞浸润和肥大细胞脱颗粒，浆细胞增多；浆液腺体增生和分泌亢进。结合病理学所见对PAR的发病机理和病理生理学作简要讨论。     

变应性鼻炎鼻粘膜表面嗜碱性细胞的观察

对198例变应性鼻炎行鼻粘膜表面嗜碱性细胞检查,阳性者84例(42.4％),与160例非变应性鼻炎中的阳性者16例(10.0％)对比,P<0.005。提示临床上检查鼻粘膜表面的嗜碱性细胞,有助于变应性鼻炎的确诊。     

变应性鼻炎鼻分泌物中嗜酸细胞形态学观察

用电镜对７例花粉症患者和另７例常年性变应性鼻炎患者鼻分泌物中嗜酸细胞（ｅｏｓｉｎｏｐｈｉｌ，ＥＣ）在花粉期和非花粉期的形态进行了观察，并用图象分析仪对ＥＣ的形态学进行了分析。结果表明，花粉症患者鼻分泌物中ＥＣ的截面积在非花粉季节显著小于花粉季节ＥＣ的截面积，细胞表面微绒毛样突起增多。表面在非花粉季节中鼻粘膜中的ＥＣ表面皱缩，功能上处于相对不状态。     

根据变应性鼻炎患者鼻分泌物嗜酸粒细胞计数调整类固醇治疗的临床意义

目的:探讨根据常年性持续性变应性鼻炎(AR)患者鼻分泌物嗜酸粒细胞(EOS)相对计数调整类固醇治疗的临床意义。方法:选择近3个月内未接受类固醇治疗的常年性持续性AR患者42例,采用酶联免疫荧光法测定鼻分泌物EOS阳离子蛋白浓度,根据鼻分泌物EOS计数将患者分为EOS组23例(EOS≥3%)与非EOS组19例(EOS<3%),均进行AR症状、体征评分、鼻分泌物细胞分类计数。治疗2、4、6个月时进行随访和疗效评价。结果:EOS组鼻分泌物中EOS比值[中位数M(25分位数;75分位数),下同]、EOS阳离子蛋白水平(x珋±s,下同)基线值分别为0.086(0.065;0.176)、(326±145)μg/L,非EOS组分别为0.016(0.005;0.022)、(154±58)μg/L,2组比较差异有统计学意义(t值分别为4.40、3.32,均P<0.01)。治疗2、6个月后,EOS组的EOS比值、EOS阳离子蛋白水平分别为0.038(0.006;0.070)、0.019(0.010;0.060);(175±122)μg/L、(175±153)μg/L,与基线值比较差异均有统计学意义(F值分别为6.73、7.38,均P<0.05);非EOS组分别为0.014(0.004;0.032)、0.015(0.010;0.026);(118±60)μg/L、(112±60)μg/L,与基线值比较,EOS比值差异无统计学意义(F=0.82,P>0.05),而EOS阳离子蛋白水平差异有统计学意义(F=3.78,P<0.05)。平均症状、体征评分EOS组和非EOS组在基线及2、4、6个月时不同时间点比较,差异均无统计学意义。2组鼻用类固醇用量各时间点比较差异均无统计学意义(均P>0.05)。结论:对于鼻分泌物EOS增高的AR患者,采用类固醇治疗能够抑制EOS炎症,改善AR患者的症状和体征。非EOS增高的AR患者对类固醇治疗反应性差,症状、体征无改善。临床上可以根据EOS的相对计数决定是否采用类固醇治疗。     

倍氯米松对变应性鼻炎鼻分泌物中嗜酸粒细胞的作用

为探讨倍氯米松对变应性鼻炎鼻分泌物中嗜酸粒细胞的作用，使用激光共聚焦显微镜扫描和荣光技术，观察变应性鼻炎患者鼻分泌物中嗜酸粒细胞经倍氯米松处理后的形态变化。扫描图像分析显示，倍氯米松处理后，嗜酸粒细胞内RNA的荧光强度明显减弱。提示倍氯米松的抗炎作用是通过调控细胞内DNA转录形成RNA，使蛋白质合成降低，细胞分泌与释放物质的作用减弱，进而使鼻部炎症缓解来实现的。     

鼻炎冲剂对变应性鼻炎鼻粘膜的影响

观察鼻炎冲剂对应性鼻炎患者鼻粘膜的影响,证实对ＡＲ的治疗,方法：选用健康豚鼠２９只,随机分成剂组,阳性对照组,阴性对照组和空白对照组,冲剂组采用鼻炎冲剂治疗。结果冲剂组鼻痒,喷嚏计分明显低于其他组。结论鼻炎冲剂可以改善ＡＲ患者鼻粘膜的炎症变状态,从组织学证明其对ＡＲ具有明显的治疗作用。     

常年性变应性鼻炎鼻粘膜肥大细胞脱颗粒的形态学变化

应用透射电镜观察常年性变应性鼻炎（ＰＡＲ）发作期的鼻粘膜肥大细胞，发现肥大细胞颗粒表现为四种形态特征：①高电子密度颗粒；②中等电子密度颗粒；③低电子密度颗粒；④空泡。依所含颗粒的不同，肥大细胞主要表现为三种形态：①脱颗粒前形态；②脱颗粒形态；③空泡形态。本文就肥大细胞及其颗粒的形态学变化与脱颗粒过程的关系进行了讨论。     

Mechanisms of lesions of nasal mucosa microcirculation in allergic rhinitis]

Morphological study of tissue of the mucous membrane of the nasal cavity in 36 patients which was removed in the process of surgical treatment showed a marked disorder of microcirculation. Immunoluminescent studies revealed fixed globulins and a complement in the vascular wall.     

Light and electron microscopic study of primary atrophic rhinitis mucosa

BACKGROUND: This study examined the light and the electron microscopic changes in the mucosa of primary atrophic rhinitis and compared them with the normal nasal mucosa to establish the changes in the surfactant system. A prospective original study was performed. METHODS: Twenty cases of primary atrophic rhinitis were randomly selected in the outpatient clinic of Sohag University Ear, Nose, and Throat Department. Ten volunteers with no history of chronic nasal disease and with normal rhinopharyngeal picture were selected as control cases. A small punch biopsy was performed with a small forceps under local anesthesia from the medial edge of the inferior turbinate. After histological laboratory preparations, semithin sections (0.5-1 microm) were prepared by using an LKB ultramicrotome. The sections were stained by toluidine blue, examined by light microscope, and photographed. Ultrathin sections (500-800) from selected areas of the trimmed blocks were made and collected on copper grids. The ultrathin sections were then contrasted in uranyl acetate for 10 minutes and examined by electron microscope Jeol JEM-1010. RESULTS: Light microscopy of primary atrophic epithelium revealed typical nonkeratinized stratified squamous epithelium to keratinized squamous epithelium with a thin layer of keratin on the surface. Well-developed desmosomes appeared between the epithelial cells. In the lamina propria, no submucosal glands could be seen. Electron microscopy of it revealed that the stratification of the epithelium increased. Sloughing of the superficial cells was observed in some regions of the proliferating epithelium. Epithelial penetration with neutrophils (mainly) and lymphocytes (some) could be seen. No numerous multilamellar bodies (MLBs) could be detected in these cases. An increased amount of collagenous fibers was observed in the basement membrane. CONCLUSION: In primary atrophic rhinitis, the epithelial cells revealed that desmosomes are characteristic of the metaplastic squamous epithelium and had no MLB in their cytoplasm, and cells in which occasional MLBs had been established showed interdigitations between them and the surrounding cells, suggesting an association between the surfactant deficiency and the development of desmosomes.     

变应性鼻炎鼻黏膜组织重塑的研究

目的:探讨变应性鼻炎(AR)鼻黏膜组织是否存在重塑,检测与组织重塑密切相关的转化生长因子β1(TGF-β1)、基质金属蛋白酶9(MMP-9)及其组织抑制物1(TIMP-1)在AR患者鼻黏膜组织中的表达情况。方法:15例单纯性鼻中隔偏曲患者为对照组,16例鼻中隔偏曲伴轻度间歇性AR的患者为轻度AR组,12例鼻中隔偏曲伴重度持续性AR的患者为重度AR组。均取中鼻甲黏膜组织,苏木精-伊红染色观察嗜酸粒细胞浸润情况并测定上皮损伤情况;AB-PAS法计数杯状细胞数,MT法测定细胞外基质沉积面积百分比,ELISA测定组织中TGF-β1、MMP-9及TIMP-1的表达。结果:①对照组无明显嗜酸粒细胞浸润,轻度、重度AR组嗜酸粒细胞浸润均较对照组明显增多(均P<0.05);②轻度AR组中仅上皮细胞损伤1级比对照组明显(P<0.05),重度AR组上皮损伤1、2、3级均比对照组明显(均P<0.05);③轻度、重度AR组杯状细胞数明显多于对照组(均P<0.05);④与对照组相比,轻度AR组胶原沉积面积增多,但差异无统计学意义(P>0.05);重度AR组胶原沉积面积比对照组明显增多(P<0.05);⑤TGF-β1、MMP-9及TIMP-1在轻度、重度AR组黏膜中的表达均较对照组增高(均P<0.05);重度AR组TGF-β1和TIMP-1的表达均比轻度AR组增高(均P<0.05)。结论:AR的鼻黏膜组织发生了重塑,表现为上皮细胞损伤、杯状细胞化生、细胞外基质沉积,重度AR患者的鼻黏膜重塑更强、更广泛,TGF-β1、MMP-9、TIMP-1积极参与了AR鼻黏膜组织的重塑。     

Distribution of substance P receptors in rat nasal mucosa of allergic rhinitis]

OBJECTIVE: To explore the potential role of substance P receptor (SPR) in the initiation and development of allergic rhinitis (AR). METHODS: Twenty healthy rats were randomly divided into two groups. A model of allergic rhinitis in rat was established by using ovalbumin intraperitoneal immunization and nasal antigen challenge. The nasal mucosa obtained from seven out of ten AR models as well as ten normal controls were studied routinely by HE and immunohistochemical staining to observe the distribution and changes of SPR. RESULTS: The study showed that immunoreactivity to SPR was present both on the surface and in the cytoplasm of epithelial cells, eosinophils, glandular cells and its ducts, mast cells, plasmocyte and other monocytes. During nasal hypersensitiveness, the staining density and the positive staining cells increased significantly as compared with those in normal controls. CONCLUSION: The increase of SPR in nasal mucosa in rat AR model indicates that SPR might play a critical role in the development of AR.     

实验性应变性鼻炎鼻粘膜神经生长因子的测定

OBJECTIVE: To investigate the role of nerve growth factor in the development of allergic rhinitis. METHODS: Animal model of allergic rhinitis was established in rat, the content of nerve growth factor in the nasal mucosa was measured using enzyme-linked immunosorbent assay (ELISA) technique. RESULTS: The content of nerve growth factor significantly (P < 0.001) increased in the nasal mucosa of experimental allergic rhinitis (6.65 +/- 0.42) ng/g wet weight, compared with that in control animals (3.51 +/- 0.29) ng/g wet weight. CONCLUSION: Nerve growth factor may play an important role in the development of allergic rhinitis by regulating expression and release of neuropeptides and/or by activating immune cells such as mast cells.     

Leukotriene receptor antagonist pranlukast suppresses eosinophil infiltration and cytokine production in human nasal mucosa of perennial allergic rhinitis

The purpose of this study was to investigate the influence of pranlukast on eosinophilic inflammation and cytokine production in human nasal mucosa. Twelve patients were treated with pranlukast, and samples were obtained from the nasal mucosa of the inferior turbinate. With respect to cell infiltration, a significant decrease was observed in the percentage of inflammatory cells (secreted eosinophil cationic protein [EG2] and neutrophil elastase) after treatment. The levels of cytokines and chemical mediators (interleukin [IL]-4, IL-5, RANTES [regulated on activation, normal T cell expressed and secreted], cysteinyl leukotrienes, IL-1beta, tumor necrosis factor-alpha, and IL-8) assessed by enzyme-linked immunosorbent assay and enzyme immunoassay were significantly decreased. These results indicate that pranlukast decreased the levels of a majority of the cytokines in nasal mucosa, leading to improvement in subjective nasal symptoms. Furthermore, these results support the hypothesis that pranlukast exerts its therapeutic action primarily by blocking the leukotriene receptors on eosinophils.     

Scanning electron microscopic study on newborn middle ear mucosa]

Scanning electron microscopic studies were made on the mucosa of newborn middle ear. The results were: 1. The epithelial surface was found to contain four types of cell: the ciliated cell, the nonciliated cell without secretory granules (SG), the nonciliated cell with secretory granules (SG) and the flat cell. 2. The ciliated cell population appeared in the following order (from dense to sparse): eustachian tube, hypotympanum, antetympanum, epitympanum, promontory and post-tympanum. 3. The density of nonciliated cell without SG population was gradually increasing from anterior to posterior part of middle ear. 4. The population of nonciliated cell with SG was fewer and they were always found near the ciliated cells. 5. The flat cells were only seen on the flaccid part of tympanic membrane. This paper suggests that the ciliary system is basically mature and the development of mucus secreting members still is not perfect in newborn middle ear mucosa.