全耳蜗毛细胞定量分析系统

目的 介绍一种计算机辅助下的全耳蜗毛细胞定量分析系统。方法 选取氨基糖甙类药物损伤、噪声性损伤以及老年性聋动物模型的耳蜗制备全耳蜗基底膜铺片，从蜗尖向蜗底逐个视野依次进行内外毛细胞计数，将采集的数据输入到计算机并用毛细胞定量分析系统制备成耳蜗图。结果 氨基糖甙类药物耳蜗损害模型的耳蜗图显示毛细胞缺损自底回向顶回发展，外毛细胞的损伤比内毛细胞严重；强噪声引起的毛细胞破坏局限在与刺激声频率相对应的基底膜区域；6月龄C57BL／6J小鼠的耳蜗图显示老年性聋的早期损害起始于耳蜗底回的起始端，其中外毛细胞的破坏比内毛细胞严重。结论 耳蜗毛细胞定量分析系统可清晰显示全耳蜗毛细胞在基底膜上不同部位的损失程度和破坏范围，并可对应到基底膜上各个频率敏感部位。将传统的耳蜗铺片与计算机技术相结合制备的耳蜗图，具有全面可靠、简便精确、规范等优点。     

中药健耳Ⅱ号胶囊对抗C57BL/6J小鼠老年性耳蜗损害的实验研究

目的 观察中药健耳Ⅱ号胶囊是否对C57小鼠老年性耳蜗损害具有保护作用。方法 选择刚出生的C57BL／6J小鼠40只，随机平均分为对照组、中药组各20只，其中对照组小鼠为常规饲料喂养，分别在出生后2．4和7个月终止实验；中药组小鼠常规饲料喂养至出生后2个月时开始饮用健耳Ⅱ号胶囊溶液以代替日常饮水，至7月龄时终止实验。取出小鼠耳蜗分别制成耳蜗铺片和耳蜗切片，在光学显微镜下定量观察并比较两组小鼠耳蜗毛细胞的密度和疆孔内的神经纤维数量以及螺旋神经节密度。结果 对照组C57BL／6J小鼠随着月龄的递增出现耳蜗毛细胞损伤加重的趋势，且这种随着年龄增长而发生的耳蜗损害遵循着从底回逐渐向顶回发展的规律，外毛细胞的损害比同区域的内毛细胞严重。7月龄对照组动物的耳蜗毛细胞损害范围比较广泛，底回螺旋神经节细胞数量明显减少，存活神经元细胞亦呈现异常的形态学改变，同时疆孔内的神经纤维数量也有所减少。但在中药组小鼠，无论是耳蜗毛细胞的数量还是疆孔内的神经纤维数量，以及蜗轴螺旋管内的螺旋神经节细胞密度均比对照组动物的损害轻。经统计学分析，两组动物耳蜗底回的螺旋神经节细胞密度和底回疆孔内的神经纤维数量差异均有统计学意义（P〈0．001，P〈0．05）。结论 ①C57BL／6J小鼠在出生后4个月即开始发生耳蜗进行性损害，可作为研究老年性聋的理想动物模型；②鉴于在老年性耳蜗损害的早期可见毛细胞和螺旋神经节均有损害，提示老年性耳蜗损害可能是同时发生在听觉神经元；③中药健耳Ⅱ号胶囊不但可以延缓C57BL／6J小鼠随着年龄增长而发生的耳蜗毛细胞损坏，而且对于听觉神经元和听神经纤维也具有一定的保护作用。     

C57BL/6小鼠内耳形态学和年龄相关性听力损失的研究

目的探讨不同周龄C57BL/6小鼠内耳形态学及其ABR阈值变化。方法取C57BL/6小鼠3周、4周、12周、26周各10只,听性脑干反应(ABR)测试双侧2、4、8、16、20 kHz ABR阈值。采用基底膜铺片MyosinⅥ、Neurofilament免疫组化染色,观察耳蜗毛细胞和神经丝的变化。扫描电镜观察耳蜗毛细胞及其静纤毛随年龄的变化。结果随着年龄增长,C57BL/6小鼠各频率ABR阈值明显提高,顶转和底转内毛细胞缺失逐渐增多,神经丝染色渐淡,毛细胞静纤毛逐渐发生数量减少、增粗融合、倒伏等变化。到26周龄时已达到重度聋,各频率较3周组有显著统计学差异。顶转和底转内毛细胞有连续缺失,外毛细胞完全缺失,内毛细胞只有残存的少量静纤毛,粗细不均,倒伏明显。结论本研究对国产C57BL/6小鼠的内耳形态进行观察,明确了其ABR阈值和内耳毛细胞的变化规律,为用国产C57BL/6小鼠进行老年性聋研究提供了依据。     

复方健耳剂对C57BL/6J小鼠AHL毛细胞的保护作用

目的探讨老年性耳蜗毛细胞损害与中药复方健耳剂两种喂药方法干预的作用。方法选择1月龄C57BL/6J小鼠22只用于本实验,其中4只小鼠每日饮用自来水直到出生后3个月作为幼龄对照组;6只小鼠每日饮用自来水直到出生后7个月作为老年性聋对照组;6只小鼠每日自动饮用中药复方健耳剂直到出生后7个月;另6只小鼠每日自动饮用同样中药至4个月后改用每日人工灌服直到出生后7个月。各组动物实验到期终止后,取耳蜗进行全耳蜗基底膜铺片,将全耳蜗内、外毛细胞计数结果输入计算机并应用耳蜗图软件进行耳蜗毛细胞密度对比分析,其中选择基底膜上重要的病变区间的毛细胞密度进行统计学分析。结果 3月龄对照组小鼠耳蜗外、内毛细胞缺损仅仅出现在耳蜗底回钩端区域;7月龄对照组外、内毛细胞缺损从底回基底膜起始端扩展到距离耳蜗顶端约40%区域;7月龄中药灌服组和自动饮用组动物的内、外毛细胞缺损范围和程度相似,均显著比7月龄对照组为轻(P<0.001)。结论中药复方健耳剂能够有效延缓C57BL/6J小鼠老年性耳蜗毛细胞损害的发生和发展,两种喂药方式所起作用相同(P>0.05),其药理机制可能与其改善微循环,清除活性氧,保护线粒体等作用相关。     

C57BL/6J小鼠随年龄增长耳蜗内毛细胞带状突触数量变化的观察

目的探讨C57BL/6J小鼠随年龄增长耳蜗内毛细胞带状突触(ribbon synapses,RS)的数量变化情况。方法分别取2、6、10、12月龄C57BL/6J小鼠耳蜗基底膜(每组5只),应用免疫组织化学染色方法对RS前、后膜进行双重标记,激光共聚焦显微镜下定位成像,并应用三维重建技术对基底膜各段RS的数量进行计数。结果与2月龄小鼠相比较,6月龄C57BL/6J小鼠耳蜗基底膜RS数量减少主要发生在底回,10月龄时各回RS数量均明显减少,12月龄时顶回、中回RS数量继续减少,底回反而有少许增多。结论RS数量减少可能发生在C57BL/6J小鼠老年性聋的早期阶段,探索阻止RS数量减少的治疗措施可能成为早期干预老年性聋的重要途径。     

γ-Synuclein在不同年龄段C57小鼠内毛细胞中的差异表达

目的 观察不同年龄段C57BL/6J小鼠内毛细胞中γ-Synuclein的表达差异性,探讨其与老年性聋听力损失的可能关系。方法 随机选取出生后1月龄、3月龄、6月龄和9月龄C57BL/6 J小鼠各12只,对其进行ABR检测,取其耳蜗基底膜顶、底回进行免疫荧光染色,观察γ-Synuclein的表达差异情况。结果 各年龄段C57小鼠ABR32kHz（高频）听力阈值分别为38.75±7.42、45.00±7.39、66.25±9.80、79.58±8.38dB SPL,从6月龄开始32kHz听阈明显升高（P<0.05）,9月龄时相比6月龄进一步升高（P<0.05）。各年龄组免疫荧光染色耳蜗顶回γ-Synuclein染色完整未见缺失,底回γ-Synuclein出现选择性表达缺失,各年龄组选择性表达缺失数分别为1.08±1.00、1.25±1.22、2.75±1.91、4.42±2.11个,从6月龄开始γ-Synuclein在底回选择性表达缺失明显增加（P<0.05）,9月龄时相比6月龄进一步增加（P<0.05）。结论 γ-Synuclein选择性表达缺失增加的变化趋势与...     

C57BL/6J小鼠听力及耳蜗毛细胞活性的年龄相关性研究

目的 建立年龄相关性听力损失(age-related hearing loss,AHL)的小鼠动物模型,探讨C57BL/6J小鼠发生AHL与毛细胞活性变化的关系,并初步对C57BL/6J小鼠AHL模型进行AHL的病理分类.方法 按3、8、9、10、17、18月龄段分6组培育C57BL/6J小鼠,各组分别进行听性脑干反应(ABR)测试,对耳蜗毛细胞行琥珀酸脱氢酶染色并作基底膜硬铺片,观察各年龄段小鼠内外毛细胞线粒体琥珀酸脱氢酶的活性.结果 C57BL/6J小鼠随年龄增大,ABR阈值明显增高,在3月龄到9月龄期间ABR平均反应阈值增大比较缓慢,差异无统计学意义;在10月龄时,出现明显的听力下降,平均阈值比3月龄时约高18～23 dB,差异有统计学意义(click:t=5.78,P＜0.01;6 kHz:t =3.93,P＜0.01;8 kHz:t=3.01,P＜0.05).10月龄后小鼠听力继续下降,21月龄时平均阈值比3月龄时增高约60～68 dB,差异有显著统计学意义(click:t=31.23,P＜0.01;6 kHz:t=30.44,P＜0.01;8 kHz:t=33.83,P＜0.01).琥珀酸脱氰酶染色显示,随年龄增大,毛细胞线粒体活性丧失逐渐加重:先是底回外毛细胞活性下降,接着发生活性消失,并逐渐向顶回发展,最后累及内毛细胞.结论 C57BL/6J小鼠具有典型的年龄相关性听力损失特点,其听力下降的原因早期可能主要足外毛细胞及内毛细胞活性的丧失,晚期可能是由于基底膜结构混乱,导致电生理屏障消失,致耳蜗内电位(EP)不能维持而引起.C57BL/6J小鼠可作为感音型老年性听力损失动物模型.     

不同种属实验动物耳蜗毛细胞年龄相关性缺失的不同模式

目的 展示自然衰老和耳聋相关基因遗传缺陷之间耳蜗毛细胞缺失的不同模式。方法 用不同龄的长尾猴、南美栗鼠、豚鼠、Sprague-Dawley 大鼠、CBA/CaJ 小鼠、C57BL/6J 小鼠、A/J小鼠、DBA/2J 小鼠和侏儒灰色突变纯合子 (dwg/dwg) 小鼠作为受试对象。所有测试动物的耳蜗基底膜都被制作成平坦的耳蜗基底膜铺片。沿着耳蜗基底膜的全长,基底膜上所有的内外毛细胞都被完整计数,毛细胞的计数结果被输入到耳蜗图软件并自动生成每组实验条件的平均耳蜗图。结果 在天然衰老的动物中,耳蜗毛细胞的缺失总是发生在老年阶段。与此不同的是,在耳聋相关基因缺陷的动物中,耳蜗毛细胞的缺失却是发生在青年阶段甚至幼年阶段。发生在天然老化动物的耳蜗毛细胞缺失总是呈均匀分布或从耳蜗的顶回向底回扩展。 但是,发生在具有耳聋相关基因遗传缺陷动物的耳蜗毛细胞缺失却通常表现为从耳蜗的底回向顶回扩展。结论 本实验观察结果表明,发生在天然衰老的不具备耳聋相关基因缺陷动物身上的年龄相关性耳蜗毛细胞缺失反映的是真正由衰老引起的耳蜗退化性病变,而发生在伴有耳聋相关基因遗传缺陷的年幼动物身上的年龄相关性耳蜗毛细胞缺失可能与耳聋相关基因的遗传缺陷有关。     

Smad5 基因在小鼠耳蜗胚胎发育中的作用

目的检测Smad5基因在小鼠耳蜗胚胎发育中的作用。方法选用耳廓反应灵敏、健康的C57BL／6小鼠作为种鼠交配．用观察阴栓方法获得胚胎9天到20天的胎鼠，≤17天取胚胎头，≥18天在显微镜下取耳蜗，胚胎头水平冰冻切片，耳蜗平行于蜗轴冰冻切片，HE染色方法观察小鼠内耳发育形态演变过程，免疫组织化学方法检测Smad5蛋白在小鼠胚胎10～20天的表达情况。结果胚胎10天，听泡发育，胚胎12天听泡下部有蜗管始基形成并开始发育。胚胎18天，蜗管发育了2圈，形成了可以辨认的内、外毛细胞，血管纹开始分化。Smad5在小鼠内耳胚胎发育全程均有阳性表达，且表达比较广泛，尤其早期在整个听囊均有表达。在胚胎15～17天．主要集中在即将发育成基底膜听觉感受器的部分。在胚胎发育中后期在内外毛细胞、螺旋神经节细胞、支持细胞、血管纹、基底膜、前庭膜等也有表达。结论Smad5参与小鼠耳蜗胚胎发育全过程，它可能为听觉的发生所必需的基因。     

小鼠耳蜗胚胎发育过程中Smad4基因的表达

目的探讨小鼠内耳胚胎发育演变过程，检测Smad4基凶在小鼠耳蜗中的表达情况。方法选用耳廓反应灵敏、健康的C57BL／6小鼠作为种鼠交配，用观察阴栓方法获得适龄胎鼠，≤17天取胚胎头，≥18天在显微镜下取耳蜗，胚胎头水平冰冻切片，耳蜗平行于蜗轴冰冻切片，HE染色方法观察小鼠耳蜗发育形态演变过程，免疫组织化学方法检测Smad4蛋白在小鼠胚胎10～20天耳蜗巾的表达情况。结果胚胎10天，听泡发育．胚胎12天听泡下部有蜗管始基形成并开始发育．胚胎18天，蜗管发育2圈，形成了可以辨认的内、外毛细胞．血管纹开始分化。Smad4从胚胎15天才开始表达，最初表达部位为耳蜗底转将发育成蜗轴以及柱状上皮分化为感觉细胞及支持细胞的区域，但在胚胎早期表达较弱，后期在耳蜗内广泛表达，在螺旋器、血管纹、前庭膜均有表达，且表达逐渐增强，而在蜗轴部位的表达逐渐减弱。结论Smad4在小鼠内耳分化期有阳性表达，且表达具有明显的阶段性和区域性，说明其参与内耳听觉器官的发育过程并且可能存耳蜗的形成过程中起着重要的作用。     

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance Angiogenesis is essential for tumour growth and invasion. Vascular endothelial growth factor (VEGF) is a prime mediator of tumour angiogenesis. VEGF‐C is a closely related protein that effects lymphatic endothelial cells and may be important in the process of lymphatic metastasis. The purpose of this study was to evaluate the expression of these cytokines in patients with T1 and T2a glottic, squamous cell carcinoma, in comparison with normal epithelial control tissue, to ascertain any association with radioresistance. Twenty‐two tumours treated by radiotherapy (13 radiosensitive, nine radioresistant) and seven normal control tissues were studied. The minimum follow‐up was 2 years after radiotherapy. Expression of VEGF and VEGF‐C was evaluated by immunohistochemistry of formalin‐fixed, paraffin‐embedded biopsy specimens. Analysis was carried out using a quantitative computer image analyser. Both VEGF and VEGF‐C were detectable in tumour and normal control specimens. There was increased expression in tumour specimens of both VEGF (P = 0.03) and VEGF‐C (P < 0.001). In addition, the expression of VEGF‐C was associated with tumours of higher histological grade (P = 0.021). There was, however, no difference in VEGF and VEGF‐C expression between radioresistant and radiosensitive tumours. The expression of VEGF and VEGF‐C is increased in early laryngeal squamous cell carcinoma (SCC). However, measuring the expression of these proteins cannot predict radioresistance in this tumour group.     

Treatment of Maxillary Sinus Carcinoma: Clinical Results Using the Kitasato Modality

The conventional therapeutic regimen for maxillary sinus carcinoma consists of dissection of the maxilla, full-dose irradiation and extensive chemotherapy. However, the results obtained with this treatment are often poor. Even when patients recover, their quality of life is significantly reduced as a result of deformity of facial structures and swallowing and articulation dysfunctions. A retrospective analysis of 68 patients with maxillary sinus carcinoma treated with the Kitasato modality between 1975 and 1999 was conducted. All patients underwent pergingival maxillary sinus surgery combined with pre- and postoperative irradiation therapy with standardized total doses of 16 Gy; the postoperative irradiation was given in combination with regional intra-arterial infusion chemotherapy administered via the superficial temporal artery. All visible tumor lesions were removed where possible in order to preserve or facilitate cellular immunity after surgery. The cumulative 5-year survival rates were 85.7% for Stage II patients, 88.1% for Stage III, 76.6% for Stage IVA and 75.0% for Stage IVB.     

Tongue Base Reduction with Temperature-controlled Radiofrequency Volumetric Tissue Reduction for Treatment of Obstructive Sleep Apnea Syndrome

In recent years a considerable effort has been made to establish the use of different surgical techniques for the treatment of obstructive sleep apnea syndrome (OSAS). Nevertheless, treatment of hypopharyngeal obstruction due to tongue base hypertrophy remains in many ways an unsolved problem. The aim of this study was to evaluate the safety and efficacy of tongue base reduction with temperature-controlled radiofrequency volumetric tissue reduction in the treatment of OSAS. Twenty patients with OSAS and tongue base hypertrophy were treated with radiofrequency tissue ablation. An intensified treatment protocol was used, delivering 2,800 J per treatment session under local anesthesia. Two nights of polysomnography testing were performed before and after treatment. Daytime sleepiness, snoring and postoperative morbidity were assessed using questionnaires. Mean respiratory disturbance index (RDI) was reduced from 32.1 to 24.9/h after a mean of 3.4 treatment sessions. Six patients (33%) were cured after the procedure (reduction in RDI of &#83 50% and a postoperative RDI of <15/h) and ten (55%) showed an improvement of >20% in their RDI. Daytime sleepiness and snoring improved significantly. Peri- and postoperative morbidity was low; one severe complication occurred (tongue base abscess). We were able to achieve similar cure and responder rates to those reported in a recently published pilot study but with a reduced number of treatment sessions. We believe that this technique may improve patient acceptance and have beneficial cost implications.     

Cervical Reflex Induced by Click Stimuli in Cats

We studied click-evoked potentials in the anterior horn of the spinal cord in 17 cats. A concentric needle electrode was inserted into the anterior horn of the spinal cord at levels C3-C6. Potentials evoked with 105 dB SPL clicks were recorded with a peak latency of 4.89-5.10 ms only at the C3 level. These responses were observed 45-60 dB SPL above the auditory brainstem response (ABR) threshold, and no potentials were evoked by stimulation of the contralateral ear. Average was performed 100 times with changes in stimulation frequency of 1-20 Hz. The amplitude of the potentials decreased with increasing stimulus frequency, but there were no changes in ABRs. The responses disappeared after destruction of the medial vestibulospinal tract at the obex level, but ABRs were still recorded. The spinal nucleus of the accessory nerves was located in the anterior horn of the spinal cord at levels C1-C6, and the sternocleidomastoid muscle motoneurons were found at levels C1-C3. The click-evoked potentials recorded in this study reflect responses of the spinal nucleus of accessory nerves through the vestibulospinal tract to click stimulation. The responses have the same characteristics as vestibular-evoked myogenic potentials that can be recorded using surface electrodes over the sternocleidomastoid muscles of humans.     

Lack of significant estrogen and progesterone receptor expression in nasal telangiectasias in hereditary hemorrhagic telangiectasia: an immunohistochemical analysis

Obstructive sleep apnea syndrome (OSAS) is characterized by snoring and apnea during sleep leading to decreased oxygen saturation and disturbed sleep, excessive daytime sleepiness and neuropsychological disturbances. This study investigates cognitive neuropsychological abilities in a group of 53 OSAS patients before and after treatment with uvulopalatopharyngoplasty. General intellectual ability, verbal learning and memory as well as executive functioning were measured at baseline and 6 months postoperatively. After surgery there were significant improvements in verbal learning and memory (mean change - 39, SD 57.3, p <0.001), recall (mean change - 24.3, SD 39.3, p <0.001) and executive functioning (as assessed by percentage of errors on the Wisconsin Card Sorting Test; mean change-9.1, SD 15.7, p <0.001). These improvements were in accordance with improvements in the degree of sleep apnea, the oxygen desaturation index (mean change -9.7, SD 15.9, p <0.001) and arterial minimum oxygen saturation (mean change 4.5%, SD 10.2%, p <0.01). Surgical treatment seems to improve verbal learning, memory and recall and executive functions in parallel with better oxygenation in OSAS.     

Measurement of chemosensory function

Although hundreds of thousands of patients seek medical help annually for disorders of taste and smell, relatively few medical practitioners quantitatively test their patients' chemosensory function, taking their complaints at face value. This is clearly not the approach paid to patients complaining of visual, hearing, or balance problems. Accurate chemosensory testing is essential to establish the nature, degree, and veracity of a patient's complaint, as well as to aid in counseling and in monitoring the effectiveness of treatment strategies and decisions. In many cases, patients perseverate on chemosensory loss that objective assessment demonstrates has resolved. In other cases, patients are malingering. Olfactory testing is critical for not only establishing the validity and degree of the chemosensory dysfunction, but for helping patients place their dysfunction into perspective relative to the function of their peer group. It is well established, for example, that olfactory dysfunction is the rule, rather than the exception, in members of the older population. Moreover, it is now apparent that such dysfunction can be an early sign of neurodegenerative diseases such as Alzheimer's and Parkinson's. Importantly, older anosmics are three times more likely to die over the course of an ensuring five-year period than their normosmic peers, a situation that may be averted in some cases by appropriate nutritional and safety counseling. This review provides the clinician, as well as the academic and industrial researcher, with an overview of the available means for accurately assessing smell and taste function, including up-to-date information and normative data for advances in this field.