大鼠变应性鼻炎模型鼻粘膜三种肽能神经末梢免疫组化研究

为研究变应性鼻炎（ＡＲ）时鼻粘膜速激肽类神经纤维末梢的密度变化，用二异氰酸甲苯酯（ＴＤＩ）滴鼻建立ＷＳ系列大鼠的ＡＲ实验模型，取鼻粘膜作免疫组化染色并测定三种束激肽类即Ｐ物质（ＳＰ），神经激肽Ａ（ＮＫＡ）及神经激肽Ｂ（ＮＫＢ）神经纤维的密度。结果证实实验组动物鼻粘膜ＳＰ，ＮＫＡ及ＮＫＢ神经纤维的密度显著高对照组（Ｐ〈０．０１）；实验组鼻粘膜三种肽能神经纤维染色加重，纤维变粗，曲张体增大，由于大鼠Ａ     

P物质对变应性鼻炎动物模型鼻粘膜上皮短路电流的影响

目的观察Ｐ物质（ＳＰ）作用于变应性鼻炎动物模型鼻粘膜引起的离子分泌改变导致的上皮表面短路电流（Ｓｈｏｒｔ－ｃｉｒｃｕｉｔｃｕｒｒｅｎｔ，Ｉｓｃ）的变化。方法以鸡蛋清蛋白致敏大鼠后，用Ｕｓｓ－ｉｎｇ室技术测定鼻粘膜上皮表面短路电流。并观察神经激肽受体（ＮＫ１）拮抗剂ＣＰ９６３４５、组胺Ｈ１受体拮抗剂吡拉明、Ｈ２受体拮抗剂雷尼替丁和河豚毒素对ＳＰ的阻断作用。结果经ＳＰ刺激，致敏大鼠鼻粘膜表面Ｉｓｃ显著增高。经四种物质预处理均能显著阻断ＳＰ引起的Ｉｓｃ变化。结论ＳＰ经感觉神经末梢释放后，可引起上皮表面离子电位变化、上皮通透性增高等一系列鼻粘膜病理变化。     

P物质对变应性鼻炎动物模型鼻粘膜上皮短路电流的影响

目的 观察Ｐ物质（ＳＰ）作用于变应性鼻炎动物模型鼻粘膜引起的离子分泌改变导致的上皮表面短路电流的变化。方法 以鸡蛋清蛋白致敏大鼠后，用Ｕｓｓｉｎｇ室技术测定鼻粘膜上皮表面短路电流。并观察神经激肽受体（ＮＫ１）拮抗剂ＣＰ９６３４５、组胺Ｈ１受体拮抗剂吡拉明、Ｈ２受体拮抗剂雷尼替丁和河豚毒素对ＳＰ的阻断作用。结果 经ＳＰ刺激，致敏大鼠鼻粘膜表面Ｉｓｃ显著增高。经四种物质预处理均能显著阻断ＳＰ引起的Ｉｓ     

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。     

变应性鼻炎鼻粘膜P物质受体的研究

目的探讨Ｐ物质受体（ｓｕｂｓｔａｎｃｅＰｒｅｃｅｐｔｏｒ，ＳＰＲ）在变应性鼻炎发病中的作用。方法选健康大鼠２０只，雌雄不拘，随机分为实验组和对照组各１０只。实验组用卵清蛋白腹腔注射免疫，继之鼻局部免疫建立大鼠变应性鼻炎模型，取该模型和健康对照组动物的鼻粘膜行常规ＨＥ染色及免疫组化染色，以观察ＳＰＲ在鼻粘膜中的分布、密度及其在该模型中的动态变化。结果ＳＰＲ广泛分布于健康鼻粘膜上皮细胞、血管内皮细胞、腺细胞及导管、肥大细胞、嗜酸粒细胞、浆细胞和其它单核细胞。变应性鼻炎鼻粘膜中上述部位ＳＰＲ染色加深，阳性颗粒增多，密度增强，同时ＳＰＲ阳性细胞数量增多。结论变应性鼻炎鼻粘膜中ＳＰＲ表达增多，提示ＳＰＲ在变应性鼻炎发病中发挥关键作用     

鼻咽泡状核细胞癌和低分化鳞癌的临床生物学行为的对比研究

目的：探讨鼻咽泡状核细胞癌（ＶＮＣＣ）和低分化鳞癌（ＰＤＳＣＣ）的临床生物学行为的差异性。方法：用原位杂交和免疫组化染色（ＳＰ法）技术,检测ＶＮＣＣ和ＰＤＳＣＣ癌组织中ＣｅｒｂＢ２、表皮生长因子受体（ＥＧＦＲ）和增殖细胞核抗原（ＰＣＮＡ）表达,用原位末端标记（ＩＳＬＥ）方法检测癌细胞凋亡,并对其预后和临床特征进行对比分析。结果：①ＶＮＣＣ的ＩＳＥＬ和ＰＣＮＡ染色强度指数（ＳＩ）明显高于ＰＤＳＣＣ;②ＶＮＣＣ的ＣｅｒｂＢ２、ＥＧＦＲｍＲＮＡ和ＣｅｒｂＢ２蛋白表达与ＰＤＳＣＣ无明显差别;③ＶＮＣＣ的５年生存率比ＰＤＳＣＣ高。结论：与ＰＤＳＣＣ比较,ＶＮＣＣ是一种生长增殖活跃、分化程度更低,但有较好预后趋向的一种癌型。     

用二异氰酸甲苯酯滴鼻建立常年性变应性鼻炎模型的光镜及电镜观察

为进一步探讨鼻超敏的发病机制，用二异氰酸甲苯酯（ＴＤＩ）———一种半抗原物质滴鼻建立大鼠常年性变应性鼻炎（ＰＡＲ）模型，对该模型鼻粘膜进行光镜、扫描电镜和透射电镜观察，发现其形态学改变与ＰＡＲ临床表现大致吻合，鼻粘膜可见特征性的肥大细胞及嗜酸性粒细胞浸润。基于本文研究的结果，认为ＴＤＩ可用于建立大鼠鼻超敏模型；ＴＤＩ诱发的鼻粘膜形态学改变可进一步加剧ＰＡＲ的病理生理学改变。     

血管活性肠肽(VIP)、P物质(SP)及胃肠多肽(BFP)在鼻息肉中的表达

文献中虽已对不同物种（包括人类）正常鼻粘膜神经介质、神经激素的解剖学分布有所描述，但尚缺少有关鼻息肉兔疫组织化学的研究。该文所研究的三种神经肽中，ＳＰ和ＢＦＰ都由感觉神经所释放，它们可引起血管扩张、血浆外渗和腺体分泌，且ＢＦＰ还可能是生长因子；而ＶＩＰ定位于副交感神经元，它亦可促使血管扩张和腺体分泌，并有增强ＳＰ的血浆外渗作用。由于神经肽的病理生理作用有赖于组织中肽神经纤维的存在，故该研究旨在通过对鼻息肉和正常鼻粘膜中三种神经肽的免疫组化比较研究探讨其分布类型及与鼻息肉发生的关系。取２０例鼻息肉…     

人体前庭终器γ-氨基丁酸能神经免疫细胞化学研究

目的探讨γ氨基丁酸（ｇａｍａａｍｉｎｏｂｕｔｙｒｉｃａｃｉｄ，ＧＡＢＡ）能神经在人体前庭终器的分布。方法应用包埋前染色免疫电镜技术，以抗ＧＡＢＡ抗体为标记物，观察５例尸体ＧＡＢＡ能神经在前庭终器的超微定位。结果发现ＧＡＢＡ免疫反应定位于富含突触小泡的神经末梢及无髓鞘神经纤维。ＧＡＢＡ免疫反应阳性神经纤维与包绕Ⅰ型前庭毛细胞的传入神经盏形成突触。前庭毛细胞、传入神经盏及传入神经呈ＧＡＢＡ染色阴性。结论ＧＡＢＡ能神经属前庭传出神经系统。     

大鼠鼻粘膜SP及CGRP逆向释放的免疫细胞化学研究

为了探讨调节肽在鼻粘膜炎症中的作用，我们用４％福尔马林滴鼻（双侧），观察大鼠鼻粘膜Ｐ物质（ｓｕｂｅｔａｎｃｅＰ，ＳＰ）及降钙素基因相关肽（ｃａｌｃｉｔｏｎｉｎｇｅｎｅｒｅｌａｔｅｄｐｅｐｔｉｄｅ，ＣＧＲＰ）免疫反应纤维的动态变化。发现每日一次、连续滴鼻５天后，鼻粘膜ＳＰ及ＣＧＲＰ纤维明显增多，以小血管壁为著；三叉神经节（ＴＧ）部分神经原胞体ＳＰ及ＣＧＲＰ免疫反应减弱。以上结果提示鼻粘膜单纯非特异性刺激可致局部ＳＰ及ＣＧＲＰ逆向释放增多。讨论了鼻粘膜ＳＰ及ＣＧＲＰ增多的临床意义。     

Innate and adaptive mediators in cystic fibrosis and allergic fungal rhinosinusitis

BACKGROUND: Surfactant-associated proteins (SP) A and D are both innate immunity mediators and produced in normal and diseased sinus mucosa. Cystic fibrosis (CF) is associated with Th1 adaptive inflammation whereas allergic fungal rhinosinusitis (AFRS) is associated with Th2 adaptive inflammation. The purpose of this study is to show and quantify the presence of SP A, SP D, tumor necrosis factor (TNF) alpha, (a Th1 marker), and eotaxin (a Th2 marker) in normal and diseased sinus mucosa. METHODS: Intraoperative sinus mucosal biopsy specimens from human volunteers were obtained during endoscopic sinus surgery for CF (n = 4), AFRS (n = 10), and normal controls (CTLs; n = 4). Specimens were evaluated for presence and quantity of SP A, SP D, and TNF-alpha using Western blot with semiquantitative immunoblot analysis. Eotaxin was quantified using ELISA immunoassay. Results were standardized and reported as picograms of mediator per microgram of total protein. RESULTS: SP A, SP D, and TNF-alpha levels in CF tissue extracts were 2-10 times higher than levels in AFRS tissue (with SP D and TNF-alpha reaching statistical significance) but CF tissue was not significantly higher than CTL tissue. SP A, SP D, and TNF-alpha were not significantly elevated in AFRS. Eotaxin showed elevated levels in CF and AFRS when compared with CTLs (p = 0.03 and 0.003, respectively). CONCLUSION: SP D and TNF-alpha are significantly increased in CF compared with AFRS, suggesting activation of both innate immunity and Th1-mediated inflammation and potential correlation between SPs and downstream adaptive immune responses.     

Diagnosis of common causes of vertigo using a structured clinical history

The structured clinical history is the most sensitive test for diagnosing vertigo. Its diagnostic effectiveness on the first visit was analyzed and key signs and symptoms with high predictive value for common causes of vertigo were identified. One hundred outpatients who complained of dizziness or loss of balance were evaluated using a structured clinical interview. Each questionnaire was examined independently by three blinded investigators, who assigned a diagnosis and identified the elements of the history that figured most prominently in the diagnosis. The gold standard was defined as independent selection of the same diagnostic category by all three investigators. A first-visit diagnosis was obtained in 40% of patients (95% confidence interval 30-50%): 38% women and 42% men. Causes included benign positional paroxysmal vertigo (BPPV, 13 patients), headache-associated vertigo (9), Meniere disease (7), cervical vertigo (3), psychiatric dizziness (2), post-traumatic vertigo (2), vertebro-basilar transient ischemic attack (1), vestibular neuritis (1), convulsive seizure (1), and presyncope (1). The best predictors of BPPV were the precipitating mechanism (specificity [SP] 100%), positional nystagmus (sensitivity [SE] 90%, SP 63%), and the Dix-Hallpike test (SE 82%, SP 71%). Elements predictive of headache-associated vertigo were duration of the attack (minutes) and a personal history of headache (both, SP 100%). Other predictors were facial hypoesthesia (SE 92%, SP 47%) and associated neurological disease (SE 82%, SP 58%).     

Effect of substance P injection into the nucleus tractus solitarius of rats on cricothyroid and thyroarytenoid motor activity and cardiovascular and respiratory systems

Identification of central neurotransmitters that mediate laryngeal adductor and/or tensor activity may prove useful in managing pathological laryngeal adduction as occurs in laryngospasm or apparent life-threatening events. The putative transmitter substance P (SP) is found in the nucleus tractus solitarius (NTS), in which laryngeal afferents terminate. Therefore, we studied the laryngeal, cardiovascular, and respiratory effects of SP injected into the NTS of rats. We completed bilateral stereotactic injections of 20 nL of SP (15 micromol) or control solution into the region of the NTS, the dorsal motor nucleus (DMN), or the nucleus gracilis (GR) in 30 anesthetized rats. Changes in diaphragm, cricothyroid (CT), and thyroarytenoid (TA) electromyography (EMG), as well as blood pressure (BP), were compared. The injection sites were verified histologically. Injection of SP into the NTS altered CT and/or TA EMG activity in all animals. The change ranged from complete inhibition, to a phasic increase, to a tonic increase. No change in laryngeal adductor EMG activity was seen in 8 of 9 animals after SP injections into the DMN (4/5) or GR (4/4), but 1 animal demonstrated brief inhibition of CT and TA EMG activity after SP injection into the DMN. Injection of SP into the NTS induced central apnea and a significant decrease in BP in all animals. The duration of apnea tended to be longer after NTS injections than after DMN or GR injections (p < .10 and p < .05, respectively). We conclude that stereotactic injections of putative neurotransmitters in rats may be accomplished to identify effects on laryngeal motor activity. Direct application of SP into the NTS consistently elicits a change in CT and/or TA EMG activity, ranging from inhibition to excitation. This model may prove useful in evaluating pharmacological targets of central reflex activity to manage life-threatening laryngeal reflex activity.     

梅尼埃病听力损失程度和类型对短声诱发的SP/AP比值的影响

目的 :探讨耳蜗电图 (ECoch G)在梅尼埃病诊断中听力损失程度和类型 ,对交替短声诱发的负性总和电位 (SP)与动作电位 (AP)比值 (SP/ AP)的影响。方法 :采用鼓膜电极耳蜗电图描记术 ,对梅尼埃病 90耳 (梅尼埃病组 )和其他原因感音神经性聋 6 0耳 (感音神经性聋组 )及正常听力 5 0耳 (正常对照组 )记录了 AP和 SP各参数 ,对结果进行对照分析。结果 :AP潜伏期 3组差异无显著性 ,AP振幅正常对照组高于梅尼埃病组和感音神经性聋组 (P <0 .0 5 ) ,SP振幅正常对照组高于感音神经性聋组 (P <0 .0 1)而低于梅尼埃病组 (P <0 .0 1)。SP/ AP振幅比值梅尼埃病组 (48.0 9± 14 .38) % ,明显高于感音神经性聋组 (2 0 .0 2± 15 .0 0 ) %和正常对照组 (2 3.85±8.0 5 ) % ,(均 P <0 .0 1)。梅尼埃病组 SP/ AP比值与主观纯音听阈呈正相关 (r =0 .5 6 0 1,P <0 .0 1) ,其异常率为 73%。梅尼埃病不同听力损失组中 ,SP/ AP比值轻度耳聋组低于中度和中重度组 (均 P <0 .0 1) ,后两组差异无显著性意义 (P >0 .0 5 )。低频型低于平坦型 (P <0 .0 5 ) ,高频型和前两型相比差异无显著性意义。结论 :SP/ AP振幅比值异常增大有助于梅尼埃病的临床诊断 ,在一定范围内随听阈提高而增大 ,必须有足够的残余听力才能记录质量好的图形。     

Swallowing dysfunction in myasthenia gravis patients examined with high-resolution manometry

ObjectiveTo prospectively compare oropharyngeal swallowing dysfunction in myasthenia gravis (MG) patients presenting with difficulty in swallowing between the neutral and chin-down positions, based on the results of high-resolution manometry (HRM) examination.MethodsWe prospectively compared the HRM results of swallowing studies of seven MG patients showing difficulty in swallowing (neutral and chin-down positions) at the Department of Neurology of our institution during the period February–December 2018. The HRM assessment parameters were as follows: maximum swallowing pressure (SP) at the soft palate, meso‑hypopharynx, and upper esophageal sphincter (UES), and the duration of relaxation pressure at the UES. These parameters were compared between the two positions and their correlations with the results of neurological evaluations, such as the Quantitative Myasthenia Gravis (QMG) score (total and neck muscles alone), and grip strength, were also analyzed.ResultsIn comparison with the neutral position, in the chin-down position the maximum SP at the meso‑hypopharynx was significantly increased (p < 0.05), the maximum SP at the UES was significantly decreased (p < 0.05), and the duration of relaxing SP at the UES was significantly increased (p < 0.05). Interestingly, there were no correlations between the SP at any location and the results of the neurological evaluations.ConclusionsThe chin-down position appears useful for improving pharyngeal clearance in MG patients, by promoting increased SP at the meso‑hypopharynx, relaxing SP at the UES, and increasing the duration of relaxation pressure at the UES.     

Comparative outcomes of active and passive hearing devices by transcutaneous bone conduction

Conclusion Bonebridge (BB) and Sophono (SP) devices improved hearing; with the BB implant showing a better performance at medium and high frequencies. Furthermore, the BB, as an active implant, showed higher functional gain and increased time of use, when compared to the SP, a passive system. Objectives This study aims to compare surgical and audiological outcomes of SP and BB devices in order to assess and further differentiate the indication criteria. Methods Fourteen patients with conductive and mixed hearing loss were evaluated pre- and post-operatively (BB or SP) (period 2013–2014). Age, gender, surgical history, cause and type of hearing loss, implant use per day, levels of bone and air conduction, and functional gain were recorded. Data was analysed by Wilcoxon singed-rank and Wilcoxon rank-sum tests. Results Fourteen patients (BB; n?=?10 and SP; n?=?4) with an average age?=?25.42 years (CI95?=?12.41–38.43) were evaluated. The gender relation was equal (1:1), with pre-implantation osseous thresholds of 20.42?dB (CI95?=?11.15–29.69), and pre-implantation aerial thresholds of 70.83?dB (CI95?=?62.52–79.14). The SP wearing time was significantly lower than that of the BB (SP?=?7–10?h/day, BB?=?8–12?h/day; p?=?0.0323). The functional gain did not differ significantly between the two devices (BB?=?40.00?±?13.19?dB, SP?=?34.06?±?15.63?dB; p?=?0.3434), but a significant improvement from pre- to post-implantation was observed (p?p?=?0.0140) and 4?kHz (p?相似文献   

分泌性中耳炎中耳积液中P物质含量与临床相关性研究

目的：探讨分泌性中耳炎（SOM）中耳积液（MEE）中P物质（SP）含量与临床的相关性。方法：观察64例（79耳）SOM患者的病程、听力、MEE量、MEE性质及其与MEE中的SP含量的关系。结果：浆液性MEE中SP的浓度比黏液性者明显增高（P〈0．01）;MEE中的SP含量与MEE量呈正相关（r=0．985,P〈0．01）,与发病时间呈负相关（r=-0．6217,P〈0．01）;听力损失黏液组明显多于浆液组;浆液组MEE中SP含量与听阈呈正相关（r=0．985,P〈0．01）,黏液组MEE中SP含量与听阈无显著性相关（r=0．2415,P〉0．05）。结论：①SP在SOM的发病中影响了病程的全过程,但在早期起主要作用。②检测SOMMEE中SP含量对于判断MEE的性质,了解病情的发展,指导临床治疗有一定的意义。     

Immunohistochemical demonstration of neuroactive substances in the inner ear of rat and guinea pig

The presence and localization of different neuropeptides and other putative neurotransmitters or -modulators were examined by immunohistochemistry in the cochleovestibular end organs and in neurons innervating them in rats and guinea pigs. In the organ of Corti neural elements beneath inner hair cells showed immunoreactivity for enkephalin (ENK), calcitonin gene-related peptide (CGRP), L-glutamate decarboxylase (GAD), substance P (SP) and tyrosine hydroxylase (TH). Nerve chalices of type I vestibular hair cells contained SP and GAD, but not consistently. SP was only occasionally observed in neuronal cell bodies of the 8th cranial nerve but fine fibers with different neuroactive substances were seen in the nerve trunk in the following relative numbers: TH greater than SP greater than CGRP greater than ENK. The present data demonstrate the presence of several different neuroactive substances in the rat and guinea pig inner ear suggesting a multiplicity of neurotransmitters or -modulators in this system.     

鼻敏片对豚鼠变应性鼻炎动物模型血浆中P物质的影响

目的研究中成药鼻敏片对变应性鼻炎豚鼠血浆中P物质的影响.方法将60只豚鼠随机分为6组,即正常组、模型组、对照组、治疗组(鼻敏片分高、中、低剂量各1组)共6组,以TDI鼻内给药法建立鼻超敏反应动物模型,息斯敏为对照,血浆P物质为指标,观察鼻敏片的作用.结果模型组血浆P物质含量高于正常组,鼻敏片中、高剂量组均能有效降低血浆P物质的含量,息斯敏组及鼻敏片低剂量组血浆P物质含量改变不明显.结论鼻敏片通过降低血浆P物质的含量,对变应性鼻炎发挥治疗作用.     

Gap junctions in the stria vascularis and effects of ethacrynic acid

Two methods were used to extract frequency specific information from the gross d.c. cochlear potential, the summating potential (SP). The first approach was to derive SP tuning curves using a two-tone simultaneous masking procedure; the second to obtain SP iso-response functions. The influence of various parameter changes on the configuration of these functions was also investigated. While SP tuning curves measured using the two-tone paradigm have higher Q10 dB values than SP iso-response functions in the base of the cochlea, the latter have the advantage of avoiding contamination by various nonlinear phenomena which are inherent in the simultaneous tone-on-tone masking procedure. Since SP tuning curves are similar to those for basilar membrane motion (Sellick, P.M., Patuzzi, R. and Johnstone, B.M. (1982): J. Acoust. Soc. Am. 72, 131-141) and the whole nerve action potential (AP) (Cheatham, M.A. and Dallos, P. (1979): J. Acoust. Soc. Am. 65, S13), nearly the same degree of tuning may be reflected at these peripheral recording locations.