86例HIV感染阳性患者咽喉部临床表现

目的：识别人类免疫缺陷病毒(HIV)感染阳性患者在咽喉部的临床表现。方法：回顾性总结了86例HIV阳性患者的临床资料,86例患者根据实验室等检查结果给予抗生素、抗真菌药物和对症支持治疗。结果：随访观察4～20个月,好转59例,无效24例,死亡3例。结论：HIV感染阳性患者局部感染易反复发作、迁延不愈。应熟知其临床表现,早发现、早治疗,提高患者生存质量。     

A critical analysis of human immunodeficiency virus transmission using human cartilage allografts

Summary Allogeneic cartilage represents an important source of tissue for reconstructive surgery in the head and neck. The use of allografts is now being discussed because of the possible transmission of the human immunodeficiency virus (HIV). The receptor for HIV in most cell types is the CD-4 molecule. Since cartilage is a popular homograft source, the purpose of this study was to investigate the presence of CD-4 molecules on cartilage tissue as detected with an immunoperoxidase staining and immunofluorescence flow cytometric analysis using a monoclonal antibody. Our results indicate clearly the absence of the HIV receptor on human cartilage tissue. We have concluded therefore that normal cartilage tissue cannot be infected by HIV, at least not through a CD-4-dependent mechanism.     

Management of benign lymphoepithelial lesions of the parotid gland in human immunodeficiency virus-positive patients

The diagnosis and radiotherapeutic treatment of these HIV-associated benign lympepithelilial lesions in the parotid gland are discussed. As an example of these lesions, a case is presented involving a 43-year-old HIV-infected man with a 2-year history of enlargements in both parotid glands. After evaluation by computer tomography and cytology, the diagnosis of benign lymphoepithelial lesions was made. Treatment by low-dose radiotherapy (15 Gy) caused regression of both lesions. The lesion on the left regressed completely, but the one on the right side responded only partially . A second course of high-dose radiotherapy (24 Gy) to the right lesion caused regression to a cosmetically acceptable size. Received: 20 March 1998 / Accepted: 1 April 1998     

艾滋病的耳鼻咽喉—头颈部临床表现

目的：识别艾滋病在耳鼻咽喉－头颈部的临床表现,探讨其治疗方法。方法：回顾性总结赞比亚６８例ＨＩＶ阳性患者的临床资料。结果：６８例发病年龄３个月－４６岁。其中急,慢性化脓性中耳炎１７例,萎缩性鼻为４例,鼻出血５例,慢性扁桃体炎１０例,口腔,咽喉部溃疡９例,颌下蜂窝织炎２例,腮区肿块９例,颈部及耳后肿块１２例。１８例合并肺结核,贫血,腹泻。     

Rising incidence of oropharyngeal cancer and the role of oncogenic human papilloma virus

OBJECTIVES/HYPOTHESIS: To document the increasing incidence of oropharyngeal (OP) cancer and to provide evidence that this increase is caused by oncogenic human papilloma virus (HPV). STUDY DESIGN: Epidemiologic review and retrospective case series analysis. METHODS: We collected data from Colorado and the United States comparing the average annual age-adjusted incidence rates of OP and non-OP head and neck cancer between the periods 1980 to 1990 and 1991 to 2001. We obtained data on 72 patients with OP cancer from a single county in Colorado, from 1980 through 2004. HPV status was determined by DNA-polymerase chain reaction. We assessed disease-specific survival. RESULTS: The average annual age-adjusted incidence of OP cancer in males in Colorado increased from 2.54 per 100,000 to 3.47 (P < .05) or 36.6%, whereas the U.S. rate increased from 4.34 to 4.81 (P < .05) or 10.8%. The rates in females and the rates of non-OP head and neck cancer decreased. Of the 72 cases, 50 (69%) were positive for HPV subtype 16. The ratio of HPV-positive to HPV-negative cases prior to 1995 was 0.72 (8:11) but was 3.81 (42:11) afterward. Survival was positively affected by HPV status (hazard ratio of 0.15, confidence intervals 0.07-0.36, P < .001). Disease-specific survival was 83% in the HPV-positive patients and 15% in the HPV-negative group. CONCLUSIONS: OP cancer incidence is increasing in Colorado males and to a lesser extent in U.S. males. The HPV-positive OP cancer cases were more frequent in the later years of the study. Disease-specific survival was much better in the HPV-positive patients, confirming that HPV testing defines a unique subset of patients. These findings suggest that HPV oncogenesis accounts for the increase in average annual age-adjusted incidence of OP cancer.     

Effect of human papilloma virus expression on clinical course of laryngeal papilloma

Conclusion. Our observations suggest that human papilloma virus (HPV) 6/11 is the main causative agent of laryngeal papilloma and that detection of active HPV DNA expression may be helpful in identifying patients with aggressive recurrent laryngeal papilloma. Objectives. HPV is assumed to be the main causative agent of this disease. We investigated the expression of the entire genotype of HPV in cases of laryngeal papilloma and correlated their expression with the clinical course of the disease. Subjects and methods. Seventy cases of laryngeal papilloma were evaluated for the presence of the HPV genome by in situ hybridization (ISH) using wide-spectrum HPV DNA probe. Specific types of HPV infection were determined by DNA ISH using type-specific HPV DNA probes (HPV 6, 11, 16, 18, 31, 33). Separate analyses were conducted comparing viral types, frequency of recurrences and duration of disease-free periods. Results. We detected HPV DNA in 40 of the 70 laryngeal papilloma cases (57%). In particular, HPV DNA was detected in 75% of the juvenile types. There were significant associations between HPV and laryngeal papilloma (p<0.01). Among the HPV-positive cases, major specific types were HPV 6/11 (97%). Significant associations were also noted between viral expression and clinical course.     

Audiologic and vestibular findings in a sample of human immunodeficiency virus type-1-infected Mexican children under highly active antiretroviral therapy

OBJECTIVE: There is little information about audiologic and vestibular disorders in pediatric patients infected with the Human Immunodeficiency Virus type-1 (HIV-1). The aim of this study was to evaluate audiologic and vestibular disorders in a sample of HIV-1-infected children receiving Highly Active Antiretroviral Therapy. METHODS: Patients underwent pure tone audiometry, speech discrimination testing, auditory brainstem responses, electronystagmography, and rotatory testing. HIV-1 viral load and absolute CD4+ cell counts were registered. RESULTS: Twenty-three patients were included, aged 4.5 years (median, range 5 months to 16 years). Pure tone audiometry was carried out in 12 children over 4 years of age: 4 (33%) showed hearing loss, 2 were conductive. Auditory brainstem responses were measured in all 23 patients, suggesting conductive hearing loss in 6 and sensorineural hearing loss in 2. Most patients with conductive hearing loss had the antecedent of acute or chronic suppurative otitis media but with dry ears at the time of evaluation (p=0.003). Abnormal prolongations of interwave intervals in auditory brainstem responses were observed in 3 children (13%, 4 ears), an abnormal morphology in different components of auditory brainstem responses in 4 (17.4%, 7 ears), and abnormal amplitude patterns in 11 patients (48%, 17 ears). Vestibular tests were abnormal in all six patients tested, with asymmetries in caloric and rotatory tests. Although differences were not significant, in general, audiologic abnormalities were more frequent in patients with more prolonged HIV-1 infections, higher viral loads, or lower absolute CD4+ cell counts. CONCLUSIONS: Conductive hearing loss associated with previous otitis media events, abnormalities in auditory brainstem responses suggesting disorders at different levels of the auditory pathways, and unilateral vestibular hyporeflexia were frequent findings in our sample of HIV-1-infected children under Highly Active Antiretroviral Therapy. These findings suggest that HIV-1-infected children should be submitted to audiologic and vestibular evaluation as early as possible in order to reduce their impact on the psychosocial development of these patients.     

表达凋亡素基因的重组禽痘病毒对人喉癌细胞Hep-2的抑制效应研究

目的：探讨含鸡贫血病病毒（CAV）凋亡素（Apoptin）基因的重组禽痘病毒vFVApoptin诱导人喉癌细胞Hep-2凋亡的作用及其作用方式。方法：用vFVApoptin感染体外培养的人喉癌细胞Hep-2,运用MTT染色法检测重组质粒对肿瘤细胞的抑制作用;并运用流式细胞仪检测肿瘤细胞线粒体跨膜电位（△ψm）和细胞内活性氧（ROS）水平变化情况;通过免疫印迹检测细胞色素c（Cyto c）释放;应用底物显色法检测Caspase-3／9活性。结果：vFVApoptin感染可明显抑制Hep-2肿瘤细胞,并具有下调肿瘤细胞△ψm,上调其ROS水平,促进Cyto c释放和激活Caspase3／9的功能。结论：vFVApoptin通过上调Hep-2肿瘤细胞内线粒体ROS产生,造成Cyto c的释放,激活Caspase-9,进而激活Caspase-3等下游凋亡因子,最终通过线粒体途径诱导细胞凋亡抑制Hep-2肿瘤细胞。     

The epidemiology of human immunodeficiency virus infection and acquired immunodeficiency syndrome in the United States

As of October 1989, there were more than 112,000 documented cases of AIDS and more than 1 million Americans were thought to be infected with HIV. Three primary routes of HIV transmission have been defined: sexual contact, parenteral exposure, and perinatal transmission. Epidemiologic surveillance studies provide important information about trends in HIV infection and AIDS among groups recognized to be at increased risk, various demographic subgroups, and the general population. As of this writing, the majority of reported cases have occurred among homosexual or bisexual men. However, a growing risk category involves intravenous drug users, as well as their sexual partners and their children.     

Prevalence and epidemiology of hepatitis C virus in patients with squamous cell carcinoma of the head and neck

OBJECTIVE: Recently, we have noticed that a large number of patients with squamous cell carcinoma of the head and neck (SCCHN) are also infected with the hepatitis C virus (HCV). A review of the literature has revealed no published studies examining this association. The objective of this study was to determine the incidence and epidemiology of HCV infection in patients with SCCHN. STUDY DESIGN: A retrospective chart review. METHODS: Patients diagnosed with SCCHN were analyzed to determine whether they were screened for HCV. Patients were then stratified into two groups (HCV positive and HCV negative). The patient's age at onset, site and stage of the tumor at presentation were determined, and statistical analysis was performed. RESULTS: Ninety-nine (26%) patients were screened, and 21 (21.2%) were HCV positive. This incidence was increased when compared with previously published data (9.9%) (P < .0038). HCV-positive patients presented at an earlier age (51 years) versus the HCV-negative group (60 years) (P < .0002). There were no significant differences in the site or stage at presentation. CONCLUSIONS: In this study, 21% of patients diagnosed with SCCHN were found to be infected with HCV. These patients presented at an earlier age but had similar presentation with respect to site and stage. More research is needed to determine the significance of HCV infection in this patient population.     

EB病毒BHRF1基因表达对鼻咽癌细胞增殖能力的影响

为了解ＥＢ病毒编码基因ＢＨＲＦ１的表达对鼻咽癌细胞增殖能力的影响，通过构建携有ＢＨＲＦ１的高表达载体，并转染低分化鼻咽癌细胞株ＣＮＥ２细胞，观察转染后的癌细胞在缺乏营养条件下增殖能力的改变。结果发现：ＢＨＲＦ１的表达能抑制增殖核抗原的表达，并促进其在缺乏营养条件下生存能力。提示ＥＢ病毒编码的ＢＨＲＦ１基因可能与鼻咽癌的发生和发展过程有关。     

喉乳头状瘤患儿血清人乳头状瘤病毒11b病毒样颗粒抗体检测及意义

目的　制备人乳头状瘤病毒 (humanpapillomavirus,HPV) 11b型病毒样颗粒 (viruslikeparticles ,VLP)检测儿童喉乳头状瘤 (juvenilelarynxpapilloma ,JLP)患者血清抗HPV11bVLP抗体 ,探讨与疾病发生、发展的关系。方法　采用重组杆状病毒昆虫细胞系统制备HPV11bVLP。通过酶联免疫吸附试验 (enzymelinkedimmunosorbentassay,ELISA)方法检测 4 6份复发性儿童喉乳头状瘤患儿不同发病时期的血清和 2 0份健康对照组的血清抗体。将标本分 5组 :A组 :健康对照 (2 0份 ) ;B组 :发病 1年(15份 ) ;C组 :发病 2年 (15份 ) ;D组 :未复发 1年 (8份 ) ;E组 :未复发 2年 (8份 )。结果A、B、C、D、E各组血清抗体吸光度 (A)值平均 ( x±s)分别为 0 0 73± 0 0 35 ;0 12 0± 0 0 4 9;0 137± 0 0 5 7;0 5 18±0 12 2 ;0 5 5 7± 0 14 4 ,B、C、D、E各组与A组比较差异均有显著性意义 (P <0 0 5 )。未复发组 (D +F组 )和复发组 (B +C组 )间A均值比较差异有高度显著性意义 (t=14 90 ,P <0 0 0 0 1)。两组年龄比较差异有显著性意义 (6 2 5 0± 1 6 93和 3 2 2 7± 1 4 5 3;t=6 76 7,P <0 0 0 0 1)。结论　HPV感染的JLP患者血清能产生抗HPV抗体 ,疾病发展和预后与血清抗病毒中和抗体水平密切相关。HPV11bVLP及血     

鼻咽癌治疗前后EB病毒DNA载量的动态观察及其临床意义

目的：通过研究鼻咽癌患者血浆EBVDNA载量预测复发及远处转移的发生,为个体化治疗提供分子学指标。方法：对54例初治鼻咽癌患者分别在治疗前和治疗结束时采用荧光定量PCR方法检测血浆EBVDNA载量,并对所有患者进行随访复查,评价其远期疗效,计算无进展生存率及总生存率。结果：所有患者治疗前血浆EBVDNA载量能较好地反映患者的临床特征;远处转移者治疗前血浆EBVDNA载量及治疗后EBVDNA检出率均高于持续缓解者（均P〈0．05）;以治疗前20000copies／ml为界限,EBVDNA低载量患者的无进展生存率、总生存率均高于高载量患者（P〈0．01和P〈0．05）。结论：鼻咽癌患者治疗前血浆EBVDNA载量能一定程度地预测远处转移的发生。     

HPV11对小儿喉乳头状瘤预后的影响

目的 :研究人乳头状瘤病毒 (HPV)型别对小儿喉乳头状瘤 (JLP)预后的影响。方法 :应用聚合酶链反应结合斑点杂交技术对 2 5例JLP的石蜡标本进行HPV定型分析 ,并统计HPV11、HPV6 感染组的气管切开率和术后复发率。结果 :HPV总检出率为 96.0 % ,其中HPV11为 5 6.0 % ,HPV6 为 4 0 .0 % ,HPV16、18、33无一例阳性。HPV11感染组的气管切开率为 71.4 % ,术后复发率为 85 .7% ;HPV6 感染组的气管切开率为 3 0 .0 % ,术后复发率为4 0 .0 %。两组分别比较 ,其差异均有显著性意义 (P <0 .0 5 )。结论 :HPV6、11与JLP发生密切相关 ,HPV11感染与JLP的喉梗阻和术后复发率相关 ,HPV11感染可作为JLP预后评判的重要依据。     

The seroprevalence of hepatitis B,hepatitis C,and human immunodeficiency virus in patients undergoing septoplasty

Introduction

Worldwide, hepatitis B virus, hepatitis C virus, and human immunodeficiency virus are major health problems. Healthcare workers are at risk of transmitting blood–borne viruses, and surgeons have a higher risk of exposure to blood and higher rates of percutaneous injury than other healthcare workers. Septoplasty is among the 3 most commonly performed otolaryngological surgeries worldwide.

新城疫病毒抗人喉癌的实验研究

目的探索喉癌生物治疗新方法。方法用新城疫病毒（Newcastle disease virus,NDV）在体外培养人喉癌细胞进行抗人喉癌细胞实验。建立人喉癌裸鼠模型,瘤内注射NDV,在裸鼠体内进行抗人喉癌实验,对实验后的裸鼠多种组织进行病理学检查、病毒分离实验、血清酶联免疫吸附测定（enzyme-linked immunosorbent assay,ELISA）实验。结果 NDV可在Hep-2细胞内复制、增殖,并引起细胞死亡,NDV可明显降低Hep-2细胞的独立生存与增殖能力。动物实验,在实验组与对照组之间经校正t检验,裸鼠质量t′=2.397（P<0.05）,肿瘤质量t′=2.852（P<0.05）,瘤体积t′=6.058（P<0.01）,裸鼠质量、肿瘤质量、瘤体积的差异都有显著性,抑瘤率达84.856％;病毒分离实验只有肿瘤组织中分离到病毒;ELISA实验组呈阳性;光镜和电镜下可见肿瘤细胞的坏死与凋亡及炎性细胞浸润。结论新城疫病毒能够杀伤体外培养人喉癌细胞,能够抑制裸鼠体内肿瘤的生长和转移,且不侵犯正常组织。     

新疆部分地区儿童复发性喉乳头状瘤HPV6和HPV11病毒感染在维吾尔族及汉族患者之间的差异

目的：研究新疆部分地区喉乳头状瘤病毒HPV6,HPV11在汉族及维吾尔族儿童复发性喉乳头状瘤（JRRP）患儿中的表达差异。方法：采用聚合酶链反应（PCR）技术对喉乳头状瘤组织中HPV11和HPV6 DNA进行定型分析,结合回顾性分析1996—01—2008—03期间在新疆医科大学第一附属医院耳鼻咽喉科连续收治的42例JRRP患者。结果：HPV6／11阳性检出率97．61％（41／42）,HPV6阳性36．58％（41／15）,HPV11阳性63．41％（41／26）,HPV6阳性组中维族HPV6阳性53．33％（8／15）,汉族HPV6阳性46．67％（7／15）,HPV11阳性组中维族HPVll阳性65．38％（17／26）,汉族HPV11阳性34．61％（9／26）。结论：新疆部分地区JRRP以HPV11,6感染为主,HPV11感染者占多数,HPV病毒类型与维汉间的发病率之间差异无统计学意义。     

重组人表皮生长因子在外伤性鼓膜穿孔治疗中的临床应用

外伤性鼓膜穿孔是耳鼻咽喉科的常见病、多发病,近年来有上升趋势。鼓膜穿孔破坏了鼓膜的正常结构并影响鼓膜的正常生理功能,穿孔后鼓室与外耳道直接相通,为病原微生物侵入中耳打开了门户,且鼓膜穿孔患者常有不同程度的耳闷、耳鸣及听力下降等症状,对患者的生理及心理造成一定影