福建漳州地区门诊变应性鼻炎患者变应原谱分析

目的了解福建漳州地区变应性鼻炎(AR)的常见变应原分布情况。方法采用10种标准化变应原对漳州地区917例拟诊AR患者进行皮肤点刺试验(skin pricktest,SPT)。并分析不同年龄组、不同性别和病情轻重程度不同的患者在变应原阳性率分布上的差异。结果 SPT阳性率前4位的变应原分别为屋尘螨(67.0%)、粉尘螨(64.9%)、蟑螂(32.6%)、艾蒿(20.9%)。未成年组中尘螨和艾蒿的SPT阳性率明显高于成人组(P<0.05),不同性别之间变应原分布无差异。结论尘螨、蟑螂和艾蒿是福建漳州地区AR的主要变应原,不同年龄阶段的患者致敏变应原有所不同。     

四川绵阳地区变应原皮肤点刺试验308例临床分析

目的调查绵阳地区变应性鼻炎(AR)患者主要吸入性变应原的分布。方法采用20种标准化变应原混悬液对308例AR患者(男165例,女143例,年龄5～70岁)进行变应原皮肤点刺试验,分析各种变应原的阳性率。结果变应原皮肤点刺试验阳性率前5位分别是蟑螂(42.20%,130例)、粉尘螨(38.64%,119例)、屋尘螨(35.06%,108例)、藜(9.09%,28例)和大豚草(7.46%,23例)。其中蟑螂、粉尘螨和屋尘螨的阳性率远高于其他变应原(χ2=424.28,P<0.01)。结论蟑螂、粉尘螨、屋尘螨是绵阳地区最重要的变应原,为本地区AR的防治提供了流行病学资料和临床依据。     

变应性鼻炎患者10030例吸人性变应原谱分析

目的 调查不同年龄和性别的10 030例变应性鼻炎(allergic rhinitis,AR)患者的吸入性变应原谱分布情况.方法 采用21组共43种标准化变应原对54 813例慢性鼻炎患者进行皮肤点刺试验,诊断AR 10 030例,男性和女性均按年龄(以周岁记)分为4组,分别是:3～17岁、18～39岁、40 ～59岁以及≥60岁组(共8组),分析各组患者变应原分布状况.结果 ①不同年龄组患者对不同变应原反应呈阳性的例数分析显示,男性占前4位的变应原依次为粉尘螨、屋尘螨、艾蒿、德国小蠊,女性依次为粉尘螨、屋尘螨、艾蒿和藜.②患者阳性变应原个数的分布显示,不同年龄男性和女性患者,双重变应原阳性均位列首位,其次是三重变应原阳性或单一变应原阳性.③单一阳性变应原分析显示,男性3 ～17岁患者前4位是粉尘螨、屋尘螨、交链孢霉菌、艾蒿,其余年龄组男性患者阳性变应原前4位均是粉尘螨、屋尘螨、艾蒿和德国小蠊;女性3～17岁患者阳性变应原前4位是粉尘螨、屋尘螨、艾蒿和交链孢霉菌,18 ～39岁组是粉尘螨、屋尘螨、艾蒿和蒲公英,40～59岁组是粉尘螨、屋尘螨、艾蒿和混合树1,≥60岁患者前4位变应原是粉尘螨、屋尘螨、混合动物毛和艾蒿.④不同年龄和性别患者双重阳性变应原占首位的均是粉尘螨+屋尘螨.在3 ～17岁的患者中,对交链孢霉菌的双重阳性患者例数排在粉尘螨+屋尘螨之后,高于其他变应原组合.18岁以上的患者,交链孢霉菌双重阳性患者比例下降,而花粉类变应原、德国小蠊、粉尘螨或屋尘螨的双重阳性率上升.⑤不同性别患者三重阳性变应原居首位的是粉尘螨+屋尘螨+德国小蠊,其次是粉尘螨+屋尘螨+混合动物毛和粉尘螨+屋尘螨+艾蒿,其余组合少见.结论 尘螨、夏秋花粉及杂草花粉、交链孢霉菌和德国小蠊是导致我国北方地区AR的主要变应原,不同性别和年龄阶段的患者,致病变应原有所不同.     

天津地区主要变应原分布特点分析

目的　调查天津地区变应性鼻炎（allergic rhinitis,AR）患者主要变应原的分布情况,为临床诊断、治疗和预防提供依据。方法　采应用20种变应原对本地1164 例疑似AR患者进行血清特异性IgE检测,分析主要变应原在年龄和季节方面的分布特点。结果　天津地区居于前三位的变应原为螨虫组合（屋尘螨/粉尘螨）、艾蒿和蟑螂,其中螨虫组合（屋尘螨/粉尘螨）变应原阳性率随年龄增长逐渐下降,并且差异有统计学意义（χ 2=35.40,P <0.05）,螨虫组合变应原阳性率在春、夏季节明显低于秋、冬季节（χ 2=28.52,P <0.05）。艾蒿在秋季变应原阳性率明显高于其他3个季节,且差异有统计学意义（χ 2=33.00,P <0.05）。蟑螂在5～17岁组和≥60岁组变应原阳性率明显高于其余两组,其变应原阳性率在不同季节差异有统计学意义（χ 2=59.02,P <0.05）,秋季最高。结论　天津地区位于前 三位的变应原为螨虫组合（屋尘螨/粉尘螨）、艾蒿和蟑螂,均为吸入性变应原,并且年龄较小者变应原阳性率较高,秋季是天津地区AR的高发季节。     

北京地区1～12岁儿童变应性鼻炎变应原谱分析

目的 调查北京地区1～12岁儿童变应性鼻炎(AR)患者吸入组变应原的分布。方法 采用敏筛定量过敏原检测系统(Allergy Screen)及其专用体外变应原诊断试剂测定663例1～12岁儿童变应性鼻炎患者血清中吸入组变应原的sIgE,并比较北京地区不同年龄段吸入组变应原阳性率的变化趋势。结果 ①所有患者吸入组变应原均呈阳性反应,首要变应原为混合真菌(61.4%),其次为户尘螨(32.6%)、屋尘(28.2%)、艾蒿(23.8 %)等;各类变应原sIgE≥Ⅲ级占相应变应原阳性例数百分率前三位依次为艾蒿(70.9%,112/158)、混合真菌(63.9%,260/407)、户尘螨(56.5%,122/216);②随年龄增长,混合真菌阳性率总体呈下降趋势,户尘螨阳性率呈增高趋势;户尘螨阳性在A～D组中的分布有统计学意义(χ2=17.757,P<0.001);③艾蒿(χ2=10.636,P=0.014)、混合真菌(χ2=8.298,P=0.040)及屋尘(χ2=11.681,P=0.005)sIgE≥Ⅲ级在A～D组的相应变应原阳性病例中的分布有统计学意义;④属牧草类的葎草和矮豚草变应原sIgE≥Ⅲ级占相应阳性例数百分率的变化曲线在艾蒿的变化曲线之下,但又高于木本植物树花粉的变化曲线;⑤单一混合真菌变应原阳性最常见;其次为双重变应原阳性,最常见双重阳性组合为混合真菌+户尘螨。结论 北京地区儿童AR患儿主要吸入组变应原以混合真菌为主;随年龄增长,各类变应原阳性率有趋势性变化;秋季杂草花粉的致敏性强于牧草,牧草的致敏性则强于木本植物树花粉;单一变应原阳性最常见。     

荆门地区变应性鼻炎患者吸入变应原谱分析

目的:了解荆门地区变应性鼻炎患者吸入变应原分布情况,为荆门地区变应性鼻炎的流行病学研究和防治方案提供重要依据。方法:回顾性分析1 800例变应性鼻炎患者对10种吸入变应原进行皮肤点刺试验的临床资料,并比较不同年龄段及吸入变应原分组阳性率在分布上的差异。结果:在本地区变应性鼻炎患者中,最主要的吸入变应原是屋尘螨(76.83%)、粉尘螨(75.50%),其次分别是艾蒿(10.50%)、豚草(7.39%)、真菌Ⅱ(6.28%)、真菌Ⅰ(5.83%)、春季花粉Ⅱ(4.44%)、春季花粉Ⅰ(3.72%)、多价兽毛(3.56%)和多价羽毛(1.89%)。并且屋尘螨、粉尘螨阳性率随年龄增长有明显下降趋势。结论:屋尘螨、粉尘螨是荆门地区变应性鼻炎的最常见变应原。     

太原市1382例变应性鼻炎患者变应原谱分析

目的 研究太原地区变应性鼻炎(AR)患者变应原的分布特征,为该地区AR的合理防治提供参考依据。方法 回顾性分析我院2020年1月—2021年12月就诊的1 382例疑似AR且行血清特异性IgE(sIgE)检测患者的临床资料,使用SPSS 26.0软件对数据进行分析与总结。结果 943例(68.23%)患者sIgE呈阳性反应,其中艾蒿(48.26%)、豚草(21.56%)、室内尘螨组合(19.10%)为主要变应原;吸入性变应原阳性率(34.88%)显著高于食入性变应原(3.40%);随着患者年龄增加,变应原呈降低趋势,不同年龄间变应原阳性率差异具有统计学意义(P<0.05);不同病程间变应原阳性率差异具有统计学意义(P<0.05),其中2~3年最高(80.00%);不同月份间变应原阳性率差异具有统计学意义(P<0.05),其中8月最高(79.89%);不同季节间艾蒿、豚草变应原阳性率差异具有统计学意义(P均<0.05),以夏秋季高发;患者变应原阳性个数组合从1种到12种均有分布,其中2种组合最高(15.63%)。结论 太原地区的主要变应原是艾蒿、豚草、室内尘螨组合。绝大数患者为多重致敏,年龄、病程、季节也是影响变应原阳性率的因素。     

不同年龄变应性鼻炎患者AllergyScreen检测系统结果分析

目的:探究不同年龄变应性鼻炎患者对AllergyScreen变应原检测系统中各变应原的阳性率之间的差异及血清中总IgE水平与特异性IgE(sIgE)阳性率的关系.方法:利用AllergyScreen变应原检测系统对653例变应性鼻炎患者进行检测.结果:AllergyScreen检测结果的阳性率为85.5%.其中,户尘螨粉尘螨sIgE阳性率最高,为76.3%,猫毛皮屑狗毛皮屑sIgE阳性率最低,为20.3%.所有患者按≤6岁、7～12岁、13～18岁、19～45岁、46～60岁和≥61岁分组,户尘螨粉尘螨、矮豚草蒿葎草和蟑螂sIgE阳性率在不同年龄组间差异有统计学意义(P＜0.05).以年龄≤18岁和＞18岁分组,除点青霉分枝孢霉烟曲霉交链孢霉外,所有变应原的阳性率在不同年龄组间差异均有统计学意义(P＜0.05).AllergyScreen检测结果中血清总IgE水平不能完全反映sIgE的阳性率高低.结论:结合患者的临床症状,综合分析AllergyScreen检测结果中血清总IgE及sIgE水平是诊断变应性鼻炎有效可靠的方法.不同年龄的变应性鼻炎患者对同一变应原的反应程度不同.针对不同年龄组给予不同的防病治病方案,才能更好地治疗变应性鼻炎.     

甘肃庆阳地区576例变应性鼻炎患者变应原谱分析

目的：了解甘肃庆阳地区变应性鼻炎（AR）患者变应原分布情况,为该地区AR的流行病学研究和防治方案提供依据。方法：采用28种变应原对576例疑似AR患者进行皮肤点刺试验,并比较不同年龄段及不同性别在变应原阳性率方面的差异。结果：480例（83．3％）患者变应原呈阳性反应,阳性率相对较高的变应原依次为艾蒿（73．3％）、大豚草（55．7％）、树Ⅱ（51．7％）、树I（48．3％）、粉尘螨（43．3％）及屋尘螨（36．7％）,并且阳性率随年龄的增长有明显下降趋势,男女性别组问阳性率无明显差异。结论：艾蒿、大豚草、树Ⅱ是庆阳地区最主要的变应原。     

武汉地区2707例变应性鼻炎患者变应原皮肤点刺试验结果分析

目的 了解武汉地区变应性鼻炎(allergic rhinitis,AR)患者各变应原阳性率变化情况,从而为AR的防治提供参考.方法 同顾性分析2006-2010年5年间武汉地区2707例确诊为AR患者的皮肤点刺试验结果,比较各变应原阳性率在这5年间里分布上的差异及变化趋势.以SPSS17.0软件对数据进行统计学分析.结果 屋尘螨与粉尘螨5年间阳性率呈增加趋势,且差异有统计学意义(x2值分别为12.11、11.11,P值均＜0.05),其中屋尘螨由2006年的84.5％增加到2010年的90.5％,差异有统计学意义(x2=6.88,P＜0.05);粉尘螨由2006年的81.5％增加到2010年的89.0％,差异有统计学意义(x2=9.68,P＜0.05);艾蒿、豚草、真菌Ⅰ和真菌Ⅱ5年间阳性率比较差异均有统计学意义(x2值分别为194.10、67.06、18.95、36.62,P值均＜0.05),且艾蒿、豚草变应原致敏呈下降趋势,真菌Ⅰ和真菌Ⅱ呈现增长趋势.结论 尘螨依然是武汉地区近5年来AR患者最常见的变应原,并有增长的趋势;真菌过敏在AR患者中呈逐年上升的趋势;豚草和艾蒿过敏在AR患者中呈下降趋势.     

Efficacy of Curcumin in the healing of paracentesis in rats

Objectives

The present study was designed to investigate the possible beneficial effect of Curcumin (CMN) in healing of paracentesis in terms of wound thickness, sclerosis and closure by histological evaluation. To evaluate the efficacy of CMN, paracentesis was performed experimentally in the rats; and the results were presented histologically.

Methods

Sixteen, each 270–310 g weighted, healthy Sprague-Dawley female rats were included into the study. In both groups, paracentesis was performed into the eardrum bilaterally. In Group 1 (Paracentesis + Saline Group), saline drop was applied; and in Group 2 (Paracentesis + Curcumin group), Curcumin drop treatment was applied. Paracentesis area did not healed bilaterally in two rats (one in Group 1 and one in Group 2). Therefore, these two rats were excluded from the study. Histological examination performed in 14 rats and 28 temporal bones on the 15th day after the completion of drop treatment and closure of the paracentesis-area and wound healing were evaluated according to the histological examination criteria: Thickening of the tympanic membrane (ThicTM); and sclerosis.

Results

Both tympanic membrane thickening and sclerosis values of Paracentesis + Curcumin Group (Group 2) were significantly lower than those of the Paracentesis + Saline Group's (median: 2.0) (p = 0.001). Histological examination by light microscopy showed that in Paracentesis + Curcumin Group (Group 2), the structure of the tympanic membrane is near to the normal and decreased sclerosis was observed in connective tissue. Whereas in Paracentesis + Saline Group (Group 1), tympanic membrane thickening and connective tissue sclerosis were observed.

Conclusions

Curcumin improves wound healing process in paracentesis of TM. By using Curcumin drops, the closured paracentesis area was observed near to the normal eardrum; and thickness of the TM and sclerosis were less than the control, showing the improved healing at 15th day. The possible mechanisms may be anti-inflammatory effect, improving collagen deposition, and increasing fibroblast and vascular density in wounds thereby enhancing impaired wound healing.     

电子鼻咽喉镜在小儿腺样体肥大诊治中的应用

目的 探讨电子鼻咽喉镜在小儿腺样体肥大诊治中的应用。方法 对578例具有上气道阻塞症状的患儿（病例组）采用电子鼻咽喉镜检查，分析腺样体增大程度与上气道阻塞的关系及其可行性。结果 ①本组病例中，411例能主动配合，119例稍有哭闹，仅48例是在协助固定体位下进行。②14例因鼻中隔偏曲导致一侧后鼻孔和鼻咽部无法检查，5例因双侧鼻腔狭窄无法检查，其余559例均可检查。③559例均有不同程度的腺样体增大。④29例在检查中出现鼻黏膜少量出血，未引发其他并发症。结论 电子鼻咽喉镜检查适合于小儿，该法直观、准确、安全，是判断小儿腺样体肥大最有效、最直观的检查方法。Ⅳ°腺样体是小儿上气道阻塞的主要病因，是手术治疗的适应证。     

我国汉族女性鼻整形手术的研究进展

随着鼻整形手术技术的发展,对填充材料的使用有了更多、更深刻的理解。近年来,我国整形外科的专家们,针对汉族女性鼻部的美学特征,以及不同填充材料的应用特点,设计了一系列更精确的手术方式,使鼻整形手术更趋完善。结合汉族女性的鼻部特点,对鼻背部整形、鼻尖部整形、鼻整形术后并发症及鼻整形材料的使用情况进行总结分析。     

食管异物摘取术的麻醉选择

为探讨食管异物摘取术的麻醉方法，提高手术效果，对７２例食管异物患者采用强化表面麻醉法和气管内插管麻醉法进行了手术和对比观察。７２例异物均取出顺利，无严重并发症发生。资料显示：两种麻醉各具优越性，前者适用于年龄较大的儿童和成人，后者适用于食管异物并呼吸困难的小儿。     

Apoptosis in the pathogenesis of cholesteatoma in adults

The aim of this study was to determine the distribution and apoptotic capacity in the various layers of cholesteatoma epithelium compared to the normal skin. Cholesteatomas were collected during surgical procedures of the ear. Normal skin specimens taken from the retroauricular area served as controls. Apoptosis was detected by using highly specific antibodies against APO2.7 antigen. The Membstain Apoptosis kit Direct based on in situ labeling of nuclear DNA fragmentation (Tolt-mediated dUTP nick and labeling TUNEL staining) was used. The distribution of apoptotic cells in the layer of the cholesteatoma epithelium and the epidermis was determined. The percentage of apoptotic cells was then counted per 100 cells of cholesteatoma epithelium and the normal epidermis in three different areas of each section and expressed in terms of mean ± SD. An automatic analyzing system was used for counting. In normal epidermis, the apoptotic cells were observed in the granular layer of the epidermis. The percentage of these cells was 28.5±8.1%. A significantly greater number of apoptotic cells was observed in the suprabasal layers of the cholesteatoma epithelium (47.39±6.2%). A statistically significant difference was obtained for APO2.7-positive cells in the cholesteatoma epithelium as compared to the skin (P<0.05) as determined by Students t-test and the Mann-Whitney U test. Apoptotic activity is mainly observed in the suprabasal layer of cholesteatoma epithelium. It is not seen in the basal layer. Apoptosis plays an important role in the pathogenesis of cholesteatoma. It seems to be part of the differentiation and accumulation of keratin debris within the middle ear and expansion of cholesteatoma.     

Use of tympanometry in general practice in Denmark

Objectives

Otitis media has been a serious disease and can be that even today. The diagnosis of otitis media is often difficult. Pneumatic otoscopy, otomicroscopy, and tympanometry can improve the diagnostic quality by indication of fluid in the middle ear and thereby improve the quality of treatment. The aim of this ongoing study is to analyze the use of tympanometry in Denmark after reimbursement for doing tympanometry (November 2006) when clinically indicated. Our research questions were: How many clinics were using tympanometry? How frequent was it used? Is the use increasing? Has the number of GPs in the clinic any relation to the use of tympanometry?

Method

We used information in The Danish National Health Service in three Regions to analyze the use of tympanometry in general practice during the years 2007–2009. The coverage of the GPs is 100% in the regions.

Results

The three regions counted about half of Danish population. In 2009 the material was 902 different clinics with more than 1700 GPs. In 2007 55% of the clinics did tympanometry, in 2009 the figure was 60%. In the clinics doing tympanometry the median value was 28 tympanometries per year (inter-quartile range 13–53) per GP. The variation in the use of tympanometry was surprisingly high, from none or a few per GP per year to a maximum of more than 500 tympanometric examinations per GP a year. This huge variation has to be discussed.

Discussion

Many answers can be given. Some of the explanation was problems in doing correct tympanometry, and problems understand the clinical implications of curves and the figures.     

立体放射治疗技术在听神经瘤治疗中的应用进展

听神经瘤(Vestibular Schwannomas,VS)是最常见的桥小脑角肿瘤,目前发病率正逐年提升。立体放射治疗(Stereotactic Radiosurgery,SRS)技术作为手术的替代疗法近年来在VS的治疗中体现出了巨大的潜力和优势。本文将针对近年来SRS技术在VS治疗效果、适应证选择和治疗策略制定方面的进展加以综述。