嗜酸性粒细胞与鼻息肉术后复发和预后的初步探讨

目的研究嗜酸性粒细胞与鼻息肉术后复发和预后的关系。方法对51例鼻息肉病人术前鼻息肉组织和复发鼻息肉组织行嗜酸性粒细胞定量测定，并进行比较。结果嗜酸性粒细胞浸润程度越深，鼻息肉越易复发。结论嗜酸性粒细胞浸润程度与鼻息肉复发直接相关，可做为术后鼻息肉是否治愈的判断指标之一。     

水通道蛋白1在鼻息肉组织中的表达

目的明确水通道蛋白1(Aquaporin1,AQP1)在鼻息肉组织的表达及分布并探讨其与鼻息肉组织水肿的关系.方法取正常下鼻甲组织14例和鼻息肉组织26例,4%多聚甲醛固定,石蜡包埋,连续切片,应用免疫组织化学技术检测AQP1蛋白在鼻息肉组织的表达及分布.结果鼻息肉组AQP1在血管内皮,浆液性腺中的阳性细胞表达率显著高于正常下鼻甲(P＜0.01);而下鼻甲组AQP1在上皮细胞层和纤毛细胞层的阳性细胞表达率显著高于鼻息肉组.结论提示AQP1在鼻息肉中的高表达与鼻息肉组织水肿的发生密切相关,具体调控机制有待进一步明确.     

Expression and distribution of Aquaporin 1 in the nasal polyps]

OBJECTIVE: To confirm the expression and distribution of Aquaporin 1 (AQP1) in the nasal polyps and to investigate the relation between AQP1 and the nasal polyp edema. METHODS: fourteen cases of normal inferior turbinates and 26 cases of nasal polyps were used. The expression and distribution of AQP1 in nasal polyps were examined by immunohistochemical technique. RESULTS: The level of AQP1 in the epithelial cells and serous cells from nasal polyps was higher than that in inferior turbinates, and the level of AQP1 in the epithelial cells and cilium cells from inferior turbinate was higher than that in nasal polyps. CONCLUSION: There is close relationship between AQP1 and nasal polyp edema.     

金嗓散结丸和金嗓开音丸对声带息肉及声带小结的疗效观察

目的：观察金嗓散结丸和金嗓开音丸对声带息肉、声带小结的疗效。方法：对250例声带息肉、声带小结患者应用金嗓散结丸、金嗓开音丸治疗,其中88例早期声带息肉患者和115例声带小结患者单用金嗓散结丸和金嗓开音丸治疗;另47例声带息肉患者于术后配合金嗓散结丸、金嗓开音丸治疗。结果：88例早期声带息肉患者的有效率为88．6％,115例声带小结患者的有效率为98.3％;47例声带息肉患者的总有效率为100．0％。结论：金嗓散结丸、金嗓开音丸治疗声带息肉及声带小结有较好的临床疗效,值得推广。     

Fibromatous polyp of the hypopharynx

We treated a patient with hypopharyngeal fibromatous polyp and speculated the mechanism of this disease. Fibromatous polyp, consisting of fibrous tissue hyperplasia with small vessels, fatty cells and inflammatory cells, is a clinically diagnostic name. Most of pharyngeal fibromatous polyps are arising from the palatine tonsil, and those from the pharyngeal epithelium are rare. The greater part of hypopharyngeal tumors is squamous cell carcinomas, and benign tumors are really uncommon. Fibromatous polyp is not thought to be a true tumor, but the symptoms are almost the same as tumorous diseases, e.g., discomfort in the throat, swallowing difficulty and respiratory distress. Complete resection is used as the treatment method. We operated on this patient under a laryngoscope and successfully resected the polyp. Five months after the operation, there is no sign of recurrence and the patient has no symptoms. This type of polyp is considered to enlarge gradually and it can cause asphyxia and/or dysphagia, so complete ablation should be performed as soon as possible.     

儿童鼻后孑息肉 (附2例报告)

目的提高临床医生对儿童鼻后孔息肉的诊治水平。方法回顾性研究儿童鼻后孔息肉2例的诊 治过程，对此病的临床表现和诊治要点进行讨论。结果2例均治愈出院。结论部分鼻后孔息肉发源于中 鼻甲，鼻内窥镜手术是治疗的较好方法。     

婴儿口咽部毛息肉11例

目的 探讨婴儿口咽部毛息肉的临床特点。方法 经严格确诊后的11例口咽部毛息肉患儿,采用手术将息肉进行切除。结果 术后患儿无明显并发症,随访3个月～3年,均无复发。结论 早期诊断、尽快手术治疗能提高抢救婴儿口咽部毛息肉病成功率。     

Antrochoanal polyp and obstructive sleep apnoea in children

Antrochoanal polyps were first documented in the 18th century. They represent one of the most common types of nasal polyps in children without cystic fibrosis. Only a few reports on children who had a history of snoring due to an antrochoanal polyp and only two cases where the antrochoanal polyp caused documented obstructive sleep apnoea (OSA) have been published so far. This report adds a third case of paediatric OSA induced by an antrochoanal polyp in a 12-year-old boy. After endonasal endoscopically-controlled polypectomy and a recurrence, transoral osteoplastic antrotomy in combination with endoscopic endonasal polypectomy eliminated the antrochoanal polyp and OSA was resolved. The authors have reviewed essential historical aspects about children suffering from snoring and/or OSA caused by an antrochoanal polyp.     

Immunopathological characteristics of nasal polyps

The presence of immunoglobulins in nasal polyps and surrounding mucosa was studied by direct immunofluorescence in 14 patients. Specific and total IgE were determined in polyps and in the sera of this group. Significant immunofluorescence to IgE was demonstrated in 12 polyps but in only four samples of adjacent mucosa. Eight polyps showed significant immunofluorescence to IgM. Six patients had elevated total IgE levels within polyp sac fluid in the absence of elevated serum values. In seven cases, specific IgE was found in polyp sac fluid which could not be detected on skin or serum testing. These results may suggest local production of IgE and support the concept of nasal polyps being a manifestation of a local allergic phenomenon.     

Antrochoanal polyps and allergy—A comparative study

Antrochoanal polyps, are solitary polyps arising from the maxillary autrum. Their aetiology largely remains unknown; allergy has been implicated. The study attempts to define the relation between antrochoanal polyps and allergy and the need for such an investigation by studying 24 cases with antrochoanal polyps and comparing them with 20 cases of sinonasal polyps. Nasal smear cytology, serum total IgE and polyp fluid IgE was evaluated. 52.38% of cases turned out to be allergic. In their presentation, antrochoanal polyps do not significantly differ from other polyps.     

Protein kinase C in eosinophil proliferation and infiltration in nasal polyp tissue]

OBJECTIVE: To explore the significance of protein kinase C (PKC) in eosinophil (EOS) proliferation and infiltration in nasal polyp tissues. METHODS: With the methods of in situ hybridization and immunohistochemistry staining, PKC and apoptosis gene (Bcl-2, Bax) expression were measured between nasal polyps from 26 patients and inferior turbinate mucous membrane tissue (ITMMT) from 20 normal persons. EOS was identified with May-Grünwald-Giemsa (MGG) staining. RESULTS: In EOS, the positive cell expressive rate of Bcl-2 mRNA and its protein were significantly higher in group of nasal polyps than that in group of ITMMT (P < 0.01). Although the positive cell expressive rate of Bax mRNA and its protein were slightly higher in group of nasal polyp tissue than that in group of ITMMT, the difference was not significant (P > 0.05). PKC was expressed in EOS of all 26 cases from nasal polyp tissues, but in 20 cases from ITMMT, only 7 cases showed occasional PKC expression. In both groups, PKC positive cell expression was significantly different, and the expression of PKC and Bcl-2 mRNA as well as their protein in EOS of nasal polyps showed remarkably positive relation (r1 = 0.0875, r2 = 0.0823, P < 0.01). CONCLUSION: PKC expression increasing in EOS of nasal polyp tissues was closely associated with apoptosis inhibiting. So we presumed that EOS inhibiting in nasal polyp tissues was obtained by activating PKC signal transduction pathway.     

S-100蛋白和HLA-DR在鼻息肉组织中的表达

目的 研究糖皮质激素治疗前后S-100蛋白和HLA-DR在鼻息肉组织中的表达, 探讨二者介导的免疫反应在糖皮质激素治疗鼻息肉的作用机制。方法 收集2010年11月至2012年6月在滨州医学院烟台附属医院耳鼻喉科行鼻内镜手术治疗的鼻息肉标本74例, 其中激素治疗组37例, 未用激素治疗组37例;另取同期收治的单纯鼻中隔偏曲患者行鼻内镜下鼻中隔偏曲矫正术中切除的下鼻甲组织21例为正常对照组。采用免疫组织化学染色法检测S-100蛋白、HLA-DR在三组的表达水平。结果 S-100蛋白、HLA-DR在有鼻息肉组织中的表达明显高于正常对照组, 差异有统计学意义(P<0.05)。S-100蛋白、HLA-DR在未经治疗的鼻息肉组中的表达明显高于经激素治疗5 d的鼻息肉组, 差异亦有统计学意义(P<0.05)。结论 S-100蛋白、HLA-DR在鼻息肉组织中的高表达提示, 由二者介导的免疫反应在鼻息肉的发病中起重要作用。激素治疗5 d后鼻息肉组织中S-100蛋白、HLA-DR的表达降低, 表明激素的抗免疫机制发挥了作用。     

A new variant of choanal polyps

Seven cases of ethmochoanal polyps, a form of nasal polyps, originating from mucosa of the back ethmoidal labyrinth and lowering into the nasopharynx are described. Such polyps are diagnosed primarily by computed tomography and endoscopy of the nasal cavity. Histologically, ethmochoanal polyps are similar to other polyps from paranasal sinuses. Surgical treatment of ethmochoanal polyps is made under the control of endoscope via approach through the superior nasal passage. The polyp part situated in posterior compartment of the ethmoidal labyrinth was removed with a microdebrider. 1 to 3 year follow-up registered no cases of recurrence.     

Histological analysis of nasal polyps in children

During 1991-1999, in the Children's ENT Department of Warsaw Medical University, 39 polypectomies were performed. We analysed the histological structure of all polyps. The most common type of nasal polyp tissue in children was the inflammatory polyp (95% of cases).     

嗓音训练在单侧声带息肉术后嗓音恢复中的应用

目的 探讨单侧大、小声带息肉术后发声功能恢复规律和嗓音训练最佳时机.方法 选取68例武汉市第三医院耳鼻咽喉科行单侧声带息肉手术患者,根据与声带平行的息肉最大直径占同侧声带膜部1/3以下称为小声带息肉,1/3及以上为大声带息肉,分成大声带息肉组30例,小声带息肉组38例,每组随机分成嗓音训练组和禁声组;分别于术前1d,术...     

还氧合酶-2与鼻息肉发病的关系

目的探讨还氧合酶-2(COX-2)在鼻息肉组织中的表达,分析它在鼻息肉发病过程中的作用,为鼻息肉发病机制的研究提供理论依据,并为鼻息肉的药物治疗寻找新的特异性靶点。方法选取34例未应用任何药物的鼻息肉手术组织标本,根据1997年海口会议标准,分为鼻息肉A组（Ⅱ型1、2期鼻窦炎鼻息肉）和鼻息肉B组（Ⅱ型3期及Ⅲ型鼻窦炎鼻息肉）。同时取10例手术患者的下鼻甲游离缘作为正常对照。采用免疫组织化学SP法对鼻息肉和正常下鼻甲黏膜组织中的COX-2进行观测并拍照。采用JD901图像分析软件分析阳性染色面积和染色密度。结果 COX2在正常下鼻甲黏膜组织中无或极少量表达,在鼻息肉组织中均显示高表达（P<0.01）;Ⅲ型鼻息肉组织中的阳性表达面积和密度均高于Ⅱ型鼻息肉组(P<0.05)。结论COX-2在鼻息肉组织中高表达,且与鼻息肉的分型有关,表明其催化产物PGE2参与了鼻息肉的发生发展。     

布地奈德对鼻息肉组织中水通道蛋白-3表达的影响

目的探讨鼻腔局部应用布地奈德喷雾剂（BUD）对鼻息肉组织中水通道蛋白-3表达的影响及糖皮质激素治疗鼻息肉的作用机制。方法46例慢性鼻窦炎鼻息肉Ⅱ型患者治疗前后取鼻息肉组织,采用免疫组化技术检测组织标本Aquaporin-3（AQP-3）的表达情况,比较分析组间差异。结果布地奈德治疗后鼻息肉组织（治疗组）中AQP-3的表达数在上皮下间质的腺体细胞及血管内皮细胞中较未治疗组（对照组）显著下降（P〈0．01）,而黏膜上皮细胞表达数较未治疗组中提高（P〈0．01）。结论在布地奈德作用下鼻息肉组织水肿减轻,体积缩小与组织中水通道蛋白-3在上皮下间质的腺体细胞及血管内皮细胞中表达减少有关。     

Choanal and angiomatous polyps of the sinonasal tract.

Choanal and angiomatous polyps can be distinguished from ordinary sinonasal polyps by either a distinctive clinical presentation (choanal) or the histopathologic appearance (angiomatous). Nearly all choanal polyps arise within paranasal sinuses, with the antrochoanal polyp the most common. The angiomatous polyp is most often a secondary change in a choanal polyp and can be mistaken for vascular neoplasms, eg, angiofibroma.     

鼻息肉中白介素-8的检测和意义

目的　探讨鼻息肉中白介素 8(interleukin 8,IL 8)的表达及作用。方法　应用免疫组化和酶联免疫吸附测定法 ,对 2 2例鼻息肉和 10例对照组 (鼻中隔偏曲者 )下鼻甲组织内IL 8的分布及含量进行测定。结果　IL 8免疫阳性染色物呈棕黄色颗粒 ,主要位于鼻息肉上皮细胞浆及炎性细胞浆 ,鼻息肉组织中IL 8的含量较对照组明显增高 ,鼻息肉组的吸收值范围在 32 2 0 6～ 2 0 91 41pg/ml之间 ,对照组的吸收值范围在 2 9 31～ 332 19pg/ml之间 ,2组之间差异有显著性 (P <0 0 0 1)。结论　IL 8可能是鼻息肉发病机理中诸多因素之一 ,深入了解这一作用对寻找鼻息肉有效的治疗方法可能有重要意义。     

The early stages of polyp formation.

The purpose of this study is to describe polyp formation in the mucosa of the middle ear as a possible model for the pathogenesis of nasal polyps. In 65 Wistar rats, the eustachian tube was occluded on the left side for up to 20 months; 60 right-sided, nonoccluded ears served as controls. Following occlusion, the middle ear mucosa was examined for signs of polyps. Signs of polyp formation or fully developed polyps were seen in 14 (22%) of the middle ears, and were only seen in middle ears with signs of actual or previous infection. It was established that the first stages of polyp formation include epithelial rupture, proliferation of fibrous tissue through the epithelial defect, and epithelialization of the prolapsed fibrous tissue by proliferation and migration of epithelial cells from the surrounding epithelium until there is full epithelial covering of the polyp. This report discusses whether the described middle ear model may form basis for the explanation of the pathogenesis of nasal polyps.