突发性感音神经性聋病人的血清TNFα和IL-6检测

为探讨突发性感音神经性聋发病与血清细胞因子的关系，采用夹心法ＥＬＩＳＡ检测了３２例突聋病人、１５例慢性进行性感音神经性聋病人和２０例健康对照者血清肿瘤坏死因子和白细胞介素水平。     

变应性鼻炎患者血清IL-13和Eotaxin测定及其临床意义

变应性鼻炎为工型变态反应性疾病,是以嗜酸粒细胞（EOS）浸润为主的慢性呼吸道炎症。病因复杂且有多种细胞因子、趋化因子参与发病过程。细胞因子网络失衡在变应性鼻炎发病中起重要作用。IL-13是近年来成为研究热点的Th2细胞因子,在变应性鼻炎发病机制中起着重要作用。最近几年来,趋化因子家族在变应性鼻炎发病机制中的作用引起了人们的重视。嗜酸粒细胞趋化因子（Eotaxin）对EOS有特异性趋化作用,并且对EOS的趋化作用强于其他趋化因子。本研究的目的在于初步探讨Eotaxin和IL-13在变应性鼻炎发病机制中的作用以及与疾病严重度的关系及其临床意义。     

IL-6基因多态性与慢性鼻-鼻窦炎易感性的相关性研究

目的:探讨IL-6基因启动区-174、-572、-597位点基因多态性与上海地区汉族人群慢性鼻-鼻窦炎(CRS)易感性的关系。方法:采用病例-对照研究的方法,运用聚合酶链反应-限制性片段长度多态性、基因测序等技术检测123例CRS患者(实验组)和239例健康对照者(对照组)IL-6基因启动区-174G>C、-572G>C和-597G>A位点的基因多态性,并检测各研究对象血清总IgE、嗜酸粒细胞阳离子蛋白的浓度。结果:在该研究人群中未发现-174和-597位点的基因多态性,-572位点实验组CC、CG、GG基因型频率分别为69.1%、29.3%、1.6%,C、G等位基因频率分别为83.7%、16.3%;对照组CC、CG、GG基因型频率分别为55.2%、42.3%、2.5%,C、G等位基因频率分别为76.4%、23.6%,组间均差异有统计学意义(均P<0.05),CC型携带者患CRS的危险增加1.932倍(P<0.05,OR=1.932,95%CI为1.205～3.097),各基因型间血清总IgE和嗜酸粒细胞阳离子蛋白浓度的差异无统计学意义(P>0.05)。结论:IL-6基因-572位点基因多态性与CRS的发病有关,CC基因型可能是其发病的一个独立危险因素。     

分泌性中耳炎患者耳积液HMGB1、IL-6表达及意义

目的 检测高迁移率族蛋白B1（high mobility group protein B1,HMGB1）、白细胞介素-6（interleakin-6,IL-6）在分泌性中耳炎患者血清及耳积液表达水平,探讨其在分泌性中耳炎中的致病意义。方法 选择2019年6月～2020年12月本院治疗的分泌性中耳炎患者83例,依据病情分期分为急性组（急性中耳炎,病程<3周）28例、亚急性组（亚急性中耳炎,病程3周～3个月）30例和慢性组（慢性中耳炎,病程3～6个月）25例;根据耳积液性质分为浆液性组50例、黏液性组33例,另选取同期健康体检人员（无任何耳鼻喉疾病史）抽血并留血清85例作为对照组,采用ELISA方法检测血清及耳积液HMGB1、IL-6水平,采用Pearson法分析HMGB1、IL-6水平与分泌性中耳炎患者病程的相关性。结果 对照组与观察组血清HMGB1、IL-6水平差异无统计学意义（P>0.05）;与观察组血清比较,分泌性中耳炎患者耳积液HMGB1、IL-6水平显著升高（P<0.05）;急性组、亚急性组、慢性组中耳炎患者耳积液HMGB1、IL-6表达水平依次升高,差异有统...     

扁桃体炎血清可溶性白细胞介素2受体测定及其临床意义

目的 :观察扁桃体炎血清可溶性白细胞介素 2受体 (SIL- 2 R)水平及其临床意义。方法 :采用 EL ISA双抗夹心法检测 6 8例急慢性扁桃体炎及 6 8例正常人血清 SIL- 2 R水平。结果 :初发急性扁桃体炎及慢性扁桃体炎急性发作期患者 SIL - 2 R水平分别为 (6 42 .2± 87.2 )× 10 3u/ L ,(76 2 .3± 90 .5 )× 10 3u/ L ,均显著高于正常对照组的 (2 85 .5± 49.6 )× 10 3u/ L (P <0 .0 1) ,而且后者高于前者 (P <0 .0 1)。慢性扁桃体炎慢性期与正常对照无显著性差异 (P >0 .0 5 ) ,抗生素治疗 3～ 5 d后有效病例血清 SIL - 2 R明显下降。结论 :血清 SIL - 2 R测定对扁桃体炎诊断及疗效判定有一定意义。     

慢性鼻窦炎手术前后ECP、EGF、IL-6的水平变化及临床意义

目的 探究慢性鼻窦炎(CRS)鼻息肉患者鼻内镜手术(ESS)前后患者鼻腔分泌物中嗜酸性粒细胞阳离子蛋白(ECP)、表皮生长因子(EGF)、白细胞介素-6(IL-6)的变化,分析它们在术腔创伤愈合中的意义。 方法 选取行ESS的163例CRS鼻息肉患者作为研究对象,另选同期健康体检者50例作为对照组。所有患者术前及术后1、6、12周行鼻内镜检查并采集鼻腔分泌物,采用酶联免疫荧光分析技术检测鼻腔分泌物中ECP、EGF、IL-6的浓度。 结果 与对照组相比,术前ECP、EGF、IL-6含量显著升高(P<0.05)。术后1周ECP、EGF、IL-6含量显著低于对照组、术前(P<0.05)。术后6周ECP、EGF、IL-6含量显著高于对照组、术前、术后1周(P<0.05)。术后12周ECP、EGF、IL-6含量显著低于术前及术后6周(P<0.05),显著高于术后1周(P<0.05),与术前相比差异无统计学意义(P>0.05)。线性回归分析结果表明,术前ECP、EGF、IL-6含量影响术后6周和术后12周患者术腔创伤愈合情况(P<0.05)。 结论 CRS鼻息肉患者术前ECP、EEG、IL-6含量显著升高,且在术后创伤愈合过程中的动态变化与术后上皮修复过程可能有相关性,术前ECP、EEG、IL-6含量是影响鼻黏膜术后上皮修复的指标。     

金属硫蛋白2及白细胞介素1α和6在中耳胆脂瘤组织中的表达及意义

目的 观察金属硫蛋白2( metallothionein 2,MT-2)及白细胞介素1α(IL-1α)、白细胞介素6(IL-6)在中耳胆脂瘤组织中的表达及相关性,探讨其在中耳胆脂瘤发生发展过程中的作用.方法 采用免疫组化和反转录聚合酶链反应(RT-PCR)技术检测25例中耳胆脂瘤组织和7例正常外耳道皮肤组织中MT-2及IL-1α、IL-6蛋白和MT-2 mRNA的表达情况并分析其相关性.进一步以胆脂瘤鳞屑刺激人角质细胞系HaCaT,观察细胞MT-2 mRNA和蛋白质的表达变化.结果 MT-2、IL-1α及IL-6在中耳胆脂瘤中的表达明显高于正常外耳道皮肤,差异具有统计学意义(P值均＜0.05);MT-2mRNA在中耳胆脂瘤和正常外耳道皮肤中的表达差异具有统计学意义(t=15.38,P＜0.05).中耳胆脂瘤组织中MT-2与IL-1α的表达呈正相关关系(r=0.856,P＜0.05),与IL-6的表达亦呈正相关关系(r=0.714,P＜0.05).在胆脂瘤鳞屑刺激下,HaCaT细胞MT-2的mRNA和蛋白质表达均有明显增强,其表达变化与鳞屑组织呈浓度依赖关系.结论 MT-2和IL-1α、IL-6的异常表达可能在中耳胆脂瘤的发生、发展过程中起一定的作用.胆脂瘤鳞屑组织可能通过促进MT-2的过量表达而参与了胆脂瘤上皮的过度增殖.     

鼻咽癌患者单个核细胞mIL-2R表达和血清sIL-2R水平的检测及意义

目的：探讨ＩＬ－２Ｒ与鼻咽癌发生、发展的关系。方法：应用间接免疫荧光法和ＥＬＩＳＡ法对６２例鼻咽癌、２１例鼻咽良性病变和２６例健康对照者外周血单个核细胞（ＰＢＭＣ）经植物血凝素（ＰＨＡ）刺激后的ｍＩＬ－２Ｒ和血清ｓＩＬ－２Ｒ水平进行检测。结果：１）鼻咽癌患者ｍＩＬ－２Ｒ表达显著低于鼻咽良性病变和健康对照组（Ｐ＜０．０５）;２）鼻咽癌患者血清ｓＩＬ－２Ｒ水平显著高于鼻咽良性病变和健康对照组（Ｐ＜０．０１）;３）与无远处转移的鼻咽癌患者相比,有远处转移的鼻咽癌患者血清ｓＩＬ－２Ｒ显著升高（Ｐ＜０．０１）;４）鼻咽良性病变与健康对照组之间ｍＩＬ－２Ｒ表达和ｓＩＬ－２Ｒ水平无显著差异。结论：结果提示ｍＩＬ－２Ｒ表达低下和ｓＩＬ－２Ｒ异常升高在鼻咽癌患者机体免疫抑制中可能起重要作用。     

变应性鼻炎患者血清IL-12及IL-31水平测定及其临床意义

目的探讨变应性鼻炎患者血清IL-12及IL-31水平及其临床意义。方法变应性鼻炎患者按照体外检测血清中抗体常规加入吸入性过敏原特异性抗体Ig E(s Ig E)抗体检测结果分为阳性组和阴性组,采用酶联免疫吸附法(ELISA)检测164例变应性鼻炎患者和82例健康对照组血清中IL-12及IL-31水平。特异性Ig E测定采用德国欧盟优敏系列(EUROALLER)检测系统。结果变应性鼻炎特异性Ig E阳性组、阴性组的血清IL-12及IL-31检测结果分别为:23.8±9.1、19.1±7.9和27.9±9.4;22.8±6.7;对照组的血清IL-12及IL-31检测结果分别为:11.3±4.8、14.9±7.5;与对照组相比IL-12、IL-31均有统计学意义(P0.05)。变应性鼻炎特异性Ig E阳性组亚组中,螨虫过敏组的血清Il-12水平最高,其次为蟑螂过敏组等;与对照组相比,螨虫过敏组与蟑螂过敏组均有显著性差异(P0.05);变应性鼻炎特异性Ig E阳性组的血清IL-31水平与对照组相比均有显著性差异(P0.05)。结论免疫因子IL-12及IL-31可能参与变应性鼻炎的发病过程,环境中的螨虫与蟑螂是变应性鼻炎的主要诱因。     

Effects of glycerol on sodium and potassium concentrations in guinea pig perilymph

Summary Serum, cerebrospinal fluid (CSF), scala vestibuli perilymph, and scala tympani perilymph were collected from 85 normal guinea pigs both before and after i.v. administration of glycerol (1 ml/kg), and the sodium and potassium concentrations were assessed using a microflame photometer. Marked increases in sodium concentrations were observed in scala tympani perilymph and CSF, while there was a slight decrease in the serum and there was no significant change in scala vestibuli perilymph. These increases in sodium concentrations are considered to occur in the dehydration process in the body fluids mentioned above. On the other hand, increase in the potassium concentrations was found only in scala vestibuli perilymph and thus cannot be explained by simple dehydration process. This potassium elevation in scala vestibuli perilymph should be understood by further experiment on endolymph. It became evident that scala vestibuli perilymph differs from scala tympani perilymph and CSF in the dynamics of electrolytes after glycerol administration. In this regard, the nature of the scala vestibuli as fluid space should be studied in future. The above findings obtained in the present study may imply the significance in elucidating the glycerol effect on hearing of endolymphatic hydrops case.This study was funded in part by a grant from the Ministry of Education, Science, and Culture, Japan     

豚鼠耳蜗结构在9.4T MRI系统中的成像特点

目的研究豚鼠耳蜗结构在9.4 T MRI系统中的成像特点。方法2015年5—10月选用5只白化豚鼠在9.4 T MRI系统中进行内耳扫描,随后右侧颈内静脉注射钆喷酸葡胺(3 ml/kg),分别于注射后10、30、60、90和120 min进行内耳扫描。使用Image J软件对耳蜗的底转、第二转、第三转和顶转四个部位的不同时间点的MRI图像灰度值进行提取,绘制静脉注射造影剂后不同时间点耳蜗各部位MRI图像灰度变化曲线图,使用GraphPad Prism 5软件对结果行one-way ANOVA分析。结果注射造影剂前,MRI仅能显示豚鼠耳蜗及前庭轮廓,不能辨别内、外淋巴液。注射造影剂后10 min(底转灰度值8203±819)耳蜗前庭在T1像上即有增强,注射后30 min(底转灰度值10489±819)和60 min(底转灰度值13965±591)后耳蜗各阶显像逐渐增强,注射后90 min(底转灰度值18050±1250)时耳蜗、前庭、半规管均充分显影,可以清晰分辨出内外淋巴液,注射后120 min(底转灰度值18952±1185)时图像显影较90 min时无明显增强。造影剂进入内耳各部位的速度和量不等,在一定时间内,内耳各部位的造影剂分布变化均呈现持续上升的过程;造影剂在内耳各个部位的分布不均匀,耳蜗底转造影剂量最多,蜗顶最少,存在浓度梯度。结论用钆喷酸葡胺增强的高分辨MRI系统可以清晰区分出豚鼠内外淋巴液,静脉注射钆造影剂后90 min为MRI内耳增强显影的最佳观察时间,使用钆造影剂的MRI成像为内淋巴积水的病理改变提供了影像学诊断依据。     

7.0T磁共振成像观察耳后给药促进药物进入内耳的可行性

目的借助磁共振成像系统,观察新给药方式耳后给药,药物在内耳的吸收过程,探讨耳后给药治疗内耳疾病的可行性。方法 12只白色红目豚鼠随机分为2组,一组耳后注射造影剂,一组静脉注射造影剂。7.0T小动物专用磁共振成像系统,在给药前、给药后0.5h、1h、2h、3h、4h、6h、8h、12h、24h、48h,分别进行磁共振T1加权像成像。测量右侧耳蜗底转鼓阶的信号强度,描绘信号-时间曲线,计算曲线下面积,对比耳后组与静脉组之间的差异。结果耳后组与静脉组信号-时间曲线下面积分别为68.14×105及36.17×105,耳后组面积更大,差异有统计学意义(P<0.05)。结论耳后给药治疗内耳疾病是可行的,局部疗效好,全身并发症少,便于在临床推广应用。     

Inductive tissue interactions during inner ear development

Summary Inductive tissue interactions were studied in the otocyst of the CBA/CBA mouse. Otocysts with surrounding mesenchyme explanted at the 12.5–13th gestational day and cultured in vitro for 4 days underwent morphogenesis with formation of semicircular canals, vestibular organs, and some cochlear coiling. Without their surrounding mesenchyme only little, if any, development was seen. However, otocysts without mesenchyme but grown in a medium precultured with mesenchyme did develop normally. A soluble and diffusible induction factor is apparently produced by mesenchyme and also by other fetal organs. Cell-cell contact may not be needed for induction.Supported by grants from the Swedish Medical Research Council (Project 12X-720) and the Foundation Tysta Skolan, and by NIH Program Project Grant NS-05785     

Melanin in the inner ear

Summary Following several studies on the effects of kanamycin toxicity on the inner ears of guinea pigs, we have studied the importance of melanin in this phenomenon. Transmission electron microscopy showed that, under the influence of kanamycin, the intermediate strial cells developed a secretory aspect similar to that seen in skin melanocytes. This aspect as yet has never been described for the inner ear cells. A planimetric, morphometric method was also used to determine the strial cell melanin status in control animals. Additional findings in the study confirmed an increase in the number of melanosomes during kanamycin poisoning. Statistical data are discussed.Presented at the First European Congress of Oto-Rhino-Laryngology and Cervico-Facial Surgery, Paris, 26–29 September 1988     

Otosyphilis mimics immune disorders of the inner ear

Abstract

Syphilis is a well established cause of hearing loss. Sensorineural hearing loss may develop in the congenital or acquired form. The clinical course of the early acquired and late congenital forms are similar: sudden or rapidly progressive bilateral sensorineural hearing loss with mild vestibular symptoms. Cochleovestibular involvement in early acquired syphilis has been related to a basilar meningitis with lymphocytic infiltration of the labyrinth and VIIIth nerve. However, neurosyphilis and inner ear syphilis are not the same disease. Prompt diagnosis and treatment with corticosteroids and penicillin are mandatory to reduce the immune response and fibrosis of the labyrinth and the endolymphatic sac. Unfortunately, early acquired syphilis is frequently overlooked in the differential diagnosis of other forms of sensorineural hearing loss, particularly autoimmune inner ear disease. Given the increasing number of luetic infection cases, especially in immunocompromised patients, this condition should be considered in any sexually active patients affected by sudden hearing loss. Cases of inner ear syphilis are presented. Immunopathology of luetic inner ear infection is discussed and compared with immune disorders of the inner ear.     

Wideband tympanometry findings in inner ear malformations

ObjectiveThe deficits in the cochlea which is at the one end of the ear sound transfer system, may effect middle ear functions. Wideband typanometry (WBT) is frequently used to evaluate these transfer functions which play a crucial role in setting the impedance matching between the external ear and the cochlea. To this end, the aim of this study was to investigate the ear transfer functions in inner ear malformations via WBT, and to question whether these functions change depending on the types of inner ear malformation.MethodsThis prospective case-control study was conducted in a university hospital. One hundered-fifty-seven ears (aged 3–37 years) under the groups of cochlear hypoplasia, incomplete partition I, incomplete partition II, cochlear aplasia and complete labyrinthine aplasia were evaluated. In the control group, 30 ears with normal hearing were enrolled and WBT was carried out. Tympanometric peak pressure, equivalent middle ear volume, static admittance, tympanogram width, resonance frequency, average wideband tympanometry and absorbance measurements were analyzed.ResultsThe inner ear malformation groups demonstrated statistically significant differences than the control group and from each other in terms of traditional tympanometric parameters and WBT test parameters (p < 0.05). The most remarkable difference was between the group of complete labyrinthine aplasia and the control group, most probably because of complete labyrinthine aplasia’s structural effects. However, on some parameters, incomplete partition II and the control group showed similarities. In absorbance measurements, there was significant difference between all patient groups and the control group, especially at high frequencies (p < 0.05). The largest difference was between the control group and the group of complete labyrinthine aplasia which has revealed the lowest absorbance values (p < 0.05). In averaged-wideband tympanogram analysis, all patient groups obtained a lower amplitude peak than the control group; complete labyrinthine aplasia group had the flattest peaked amplitude, while the incomplete partition II group had a near-normal curve.ConclusionThe results of the study revealed the distinctive effects of inner ear malformations in middle ear transfer functions. It is concluded that the absence of inner ear structures causes negative effects on energy absorbance and the other transfer functions of the middle ear. WBT may provide additional information on diagnosis of patients with inner ear malformations.     

Occurrence of NaK-ATPase isoforms during rat inner ear development and functional implications

This study examined the presence of NaK-ATPase isoforms in the developing inner ear of the rat and studied the importance of functional subunit combinations in endolymph homeostasis. The findings were: (a) the combination α₁β₁ is found in epithelial, mesenchymal, and neural inner ear cells with an early starting expression 14 days postconception (dpc) in some endolymphatic sac cells; (b) from 1 day after birth (dab) expression of α₁β₂ is observed in marginal cells, vestibular dark cells, and certain vestibular nonsensory cells; (c) a transient expression of α₂β₁ is found in suprastrial fibrocytes and spiral ligament fibrocytes type II between 10 and 15 dab; (d) starting at 16 dpc the combination α₃β₁ is uniquely expressed in inner ear neural cells (as in other neural tissues). In conclusion, during development a switch from α₂β₁ towards α₁β₁ is observed in suprastrial fibrocytes and in spiral ligament fibrocytes type II. Thus, according to the biochemical characteristics of these combinations, a switch towards a NaK-ATPase with higher capacity takes place. In addition, prominent expression of the α₁β₂ combination in predominantly K⁺ ion transporting marginal and dark cells is in accordance with the characteristic of this combination and thus with the presumed function of these cells as important K⁺ suppliers for the endolymph. We believe this combination in certain vestibular nonsensory cells to be involved in K⁺ sensing. Early expression of the α₁β₁ combination in the endolymphatic sac, prior to that in the other parts of the inner ear, suggests that this structure may be involved to some extent in the development of the vestibulum and cochlea. Received: 1 August 2000 / Accepted: 30 October 2000     

先天性内耳畸形并中耳畸形患者多通道人工耳蜗植入术3例报告

目的：探讨先天性内耳畸形并中耳畸形患者行多通道人工耳蜗植入术的方法及效果。方法：1995年5月-2002年5月我院为3例罕见的先天性内耳畸形并中耳畸形患者经乳突进路行人工耳蜗植入术,分别植入27、28、32个电极,植入后3个月行声场测听。结果：3例患者均成功地行人工耳蜗植入,术中、术后无严重并发症发生,术后声场测听听阈达35-40dBHL。结论：罕见的先天性内耳畸形并中耳畸形患者也可行人工耳蜗植入术,术后效果满意。     

内耳免疫反应中的细胞凋亡活性及其与FasL表达的相关性

目的 观察内耳免疫反应过程中是否存在细胞凋亡以及细胞凋亡活性与FasL表达相关性。方法16只雌性白色豚鼠。随机分为实验组与对照组，每组各8只。所有动物均先以钥孔虫戚血蓝蛋白全身免疫。然后，实验组再以相同抗原进行单侧内耳局部免疫，对照组则于单侧内耳注射等量磷酸盐缓冲生理盐水。3天后处死动物，取内耳免疫侧（或对照注射侧）耳蜗制备石蜡切片，脱氧核糖核苷酸末端转移酶介导的缺口末端标记技术检测内耳细胞凋亡活性，免疫组化法检测内耳FasL表达水平。结果实验组动物内耳Cord器毛细胞、血管纹的缘细胞和螺旋神经节细胞中存在阳性着色的凋亡细胞，对照组豚鼠内耳则否。实验组动物内耳Corti、蜗管侧壁、螺旋神经节细胞FasL表达阳性。对照组则为阴性。结论 内耳免疫反应可诱导局部细胞凋亡活性增高，FasL在此过程中可能发挥重要作用。