碱性成纤维细胞生长因子对外伤性鼓膜穿孔的治疗观察

目的 观察碱性成纤维细胞生长因子（bFGF）对外伤性鼓膜穿孔的治疗效果。方法 随机将外伤性鼓膜穿孔分为两组：治疗组66例，用浸湿bFGF的压薄无菌棉片贴补，并每日两次用bFGF喷耳；对照组22例仅用贴补治疗。结果治疗4周后，治疗组鼓膜穿孔愈合率为98.3％，平均愈合时间为10．6天；对照组鼓膜穿孔愈合率为63．6％，平均愈合时间为22.2天。结论 bFGF浸湿棉片贴补加喷耳治疗外伤性鼓膜穿孔可促进穿孔愈合。缩短愈合时间。     

鼻息肉中血管内皮生长因子和碱性成纤维细胞生长因子的表达

目的探讨血管内皮生长因子 (vascular endothelial growth factor,VEGF)和碱性成纤维细胞生长因子 (basic fibroblast growth factor,bFGF)在鼻息肉发病过程中的意义。方法将鼻息肉患者分为A、B2组,A组为Ⅰ型及Ⅱ型1、2期鼻息肉患者,B组为Ⅱ型3期及Ⅲ型鼻息肉患者,采用免疫组化SP法对2组39例鼻息肉患者鼻息肉组织中VEGF、bFGF的表达进行检测。结果正常鼻粘膜中VEGF、bFGF的染色呈阴性,而在A、B组鼻息肉组织中的阳性率分别达到59%、41%和71%、80%,B组中阳性率和阳性细胞数均高于A组;VEGF和bFGF在鼻息肉组织中主要定位于基底膜周围的炎性细胞和上皮细胞以及血管周围和血管壁内皮细胞。结论 VEGF、bFGF通过在鼻息肉组织中的过度表达,促进息肉组织内的血管增殖和炎性细胞聚积,促进鼻息肉的发生发展,可能是鼻息肉病区别于鼻息肉的重要组织学特征之一。     

葛根素对慢性高眼压模型大鼠视神经的保护作用

目的 观察葛根素对慢性高眼压模型大鼠视神经的保护作用。 方法 采用随机数字表法将60只SD大鼠随机分为假手术组,模型对照组及葛根素组,每组20只,均以右眼为实验眼。模型对照组及葛根素组大鼠采用巩膜静脉烧灼法建立慢性高眼压模型,假手术组大鼠仅剪开球结膜。术前及术后每日葛根素组大鼠腹腔内注射葛根素(10 mL/kg),假手术组和模型对照组大鼠腹腔内注射0.5 mL生理盐水,共注射4周。测量术前,术后1 d、3 d、1周、2周、3周及4周的眼压。术后第4周制备大鼠眼球及视神经标本,采用苏木精-伊红染色法测定视网膜厚度,透射电子显微镜观察各组大鼠视神经轴突超微结构的变化,western blotting法检测视网膜中p-AKT/AKT蛋白的表达。 结果 模型对照组及葛根素组造模前后眼压值变化差异均有统计学意义(F葛根素=448.22,P<0.001,F模型=450.86, P<0.001),造模后第4周3组间眼压差异有统计学意义(F=520.88,P<0.001)。 造模后4周,3组大鼠视网膜厚度值比较差异有统计学意义(F=441.29,P<0.001),视神经中有髓神经纤维数量比较差异有统计学意义(F=1 344.31, P<0.001),视网膜中p-AKT及AKT比值比较差异有统计学意义(F=90.22, P<0.001)。 结论 葛根素对慢性高眼压模型大鼠视神经具有保护作用。     

碱性成纤维细胞生长因子对鼓膜修复的影响

目的探讨碱性成纤维细胞生长因子(bFGF)对鼓膜修复的影响。方法将87例(103耳)鼓膜干性穿孔患者(慢性化脓性中耳炎88耳,外伤性鼓膜穿孔15耳)随机分为bFGF组54例(62耳)和对照组33例(41耳),bFGF组术中将蘸有bFGF的明胶海绵放入鼓室内,铺入颞肌筋膜,然后把蘸有bFGF的明胶海绵置入外耳道深部外固定筋膜,氯霉素纱条填塞外耳道。对照组除术中明胶海绵未蘸bFGF外,其余手术方法同bFGF组。对两组的鼓膜愈合过程和听力恢复等情况进行观察。结果bFGF组鼓膜穿孔愈合时间平均为15天,对照组平均为20天,鼓膜愈合时间两组比较差异有显著统计学意义(P<0.01)。两组鼓室导抗图、声顺值、中耳压峰值相近,bFGF组听力平均提高19.5dB,对照组听力平均提高14.3dB。结论bFGF具有增强鼓膜愈合的作用,对听力的提高影响不大。     

碱性成纤维细胞生长因子在鼓膜穿孔愈合中的作用

1　正常鼓膜结构及其穿孔后的修复机制鼓膜分为三层 :外为上皮层 ,系与外耳道皮肤相连续的复层鳞状上皮 ;中间是固有层 ,即纤维组织层 ,分为浅层的放射状纤维和深层的环状纤维 ,含有成纤维细胞、血管和神经。放射状纤维从锤骨柄向周围放射 ,环状纤维近鼓膜边缘较丰富 ,中央较稀少 ,松弛部纤维层不及紧张部明显 ,纤维走行无规律 ;内为粘膜层 ,与鼓室粘膜相连续。鼓膜穿孔常继发于外伤、感染、鼓室置管术后等。尽管大多数穿孔在 2～ 6周内能够自行愈合 ,但其确切机制尚不清楚 ,涉及上皮增生、移行 ,成纤维细胞增生、炎症反应、纤维合成、新血…     

鼻息肉中血管内皮生长因子和碱性成纤维细胞生长因子的表达

目的 探讨血管内皮生长因子（vascular endothelial growth factor,VEGF)和碱性成纤维细胞生长因子（basic fibroblast growth factor bFGF)在鼻息肉发病过程的意义。方法 将鼻息肉患者分为A、B2组,A组为Ⅰ型及Ⅱ型1、2期鼻息肉患者,B组为Ⅱ型 3期及Ⅲ型鼻息肉中层得,采用免疫组化SP法对2组39人列鼻息肉患者鼻息肉组织中VEGF、bFGF的表达进行检测。结果 正常鼻粘膜中VEGF、bFGF的染色呈阴性,而在A、B组鼻息肉组织中的阳性率分别达到59％、41％和71％、80％,B组中阳性率和阳性细胞数均高于A组;VEGF和bFGF在鼻息肉组织中主要定位于基底膜周围的炎性细胞和上皮细胞以及血管周围和血管壁内皮细胞。结论 VEGF、bFGF通过在鼻息肉组织中的过度表达,促进息肉组织内的血管增殖和炎性细胞聚积,促进鼻息肉的发生发民,能是鼻息肉病区别于鼻息肉的重要组织学特征之一。     

重组人表皮生长因子及碱性成纤维细胞生长因子治疗鼻中隔黏膜糜烂

鼻出血是耳鼻咽喉科常见病,鼻中隔黏膜糜烂又是鼻出血的重要原因之一,其中尤以Little区病变较多。我科使用重组人表皮生长因子(rhEGF)及重组牛碱性成纤维细胞生长因子(rb-bFGF)治疗鼻中隔黏膜糜烂出血患者214例,现报告如下。     

碱性成纤维细胞生长因子棉片鼓膜贴补治疗外伤性鼓膜穿孔效果分析

外伤是导致鼓膜穿孔的常见原因,鼓膜穿孔可增加中耳感染的概率,为患者带来很多不便。我科于2006年起开展碱性成纤维细胞生长因子（basicfibroblastgrowthfactor,bFGF）棉片贴补的方法治疗鼓膜穿孔,疗效满意,现报告如下。     

碱性成纤维细胞生长因子治疗外伤性鼓膜穿孔的临床观察

碱性成纤维细胞生长因子 (ｂＦＧＦ)有加速外伤性鼓膜穿孔愈合的作用。 2 0 0 1年 1月至 2 0 0 2年 2月用ｂＦＧＦ对外伤性鼓膜穿孔进行局部治疗 ,获得较好疗效。报道如下 :1　资料与方法1.1　临床资料　 60例四川省人民医院耳鼻咽喉科门诊和住院的外伤性鼓膜穿孔患者 ,年龄 16～ 65岁。采用Ｄｏｌｌ随机分配表进行分组 ,分为ｂＦＧＦ治疗组及非ｂＦＧＦ治疗的对照组。治疗组 3 0例 ,男 17例 ,女 13例 ,平均年龄 3 8岁 (最大 65岁 ,最小 16岁 )。对照组 3 0例 ,男 16例 ,女 14例 ,平均年龄 3 6岁(最大 5 8岁 ,最小 18岁 )。均无鼻及鼻窦疾患…     

碱性成纤维细胞生长因子鼓室给药治疗感音神经性聋的研究

目的:探讨碱性成纤维细胞生长因子治疗感音神经性聋的临床应用价值及鼓室局部给药的可行性。方法:随机选择本院1998～1999年收治的感音神经性聋患者40例(50耳),碱性成纤维细胞生长因子(bFGF)作鼓膜穿刺鼓室内给药。治疗前后进行纯音测听,定期随访,追踪观察bFGF的疗效。结果:经bFGF治疗后,患者语频、高频及0.25～4 kHz各频率的听阈平均值均有明显提高,分别与治疗前比较,差异有极显著性意义(P<0.01)。总有效率为96％,其中治愈率8％,显效率38％,好转率50％。除有轻度胀痛外,无其他不良反应。结论:鼓室局部应用bFGF治疗感音神经性聋疗效明显,方法可行。     

Restoring vocal fold movement after transection and immediate suturing of the recurrent laryngeal nerve with local application of basic fibroblast growth factor: an experimental study in the rat

OBJECTIVE: To evaluate the effects of basic fibro-blast growth factor (bFGF) on the recovery of vocal fold movement and the attenuation of laryngeal muscle atrophy after transection of the recurrent laryngeal nerve (RLN). STUDY DESIGN: Quantitative assessment of vocal fold movement using the video cassette recorder (VCR) image-analysis method and histologic examination of the laryngeal muscle. METHODS: Fifty-eight Wistar rats underwent RLN transection and one of the following three procedures: 1) transection of the RLN alone (transection group, n = 18), 2) suture of the nerve stumps followed by local administration of phosphate-buffered saline (PBS) solution using an osmotic pump (PBS group, n =20), or 3) suture of the nerve stumps followed by local administration of bFGF (FGF group, n = 20). Vocal fold movements were recorded with VCR by way of a rigid endoscope, and the VCR images were analyzed on a computer. Histologic changes in the thyroarytenoid (TA) muscle were evaluated by measuring the cross-sectional area of the muscle and average size of muscle fibers. RESULTS: In the transection group, vocal fold movement did not recover, and atrophy of the TA muscle gradually progressed after sectioning the nerve. In contrast, vocal fold movement as assessed by VCR image-analysis recovered in some cases in the immediate suturing groups, more markedly in the FGF group (34.1 +/- 29.1%) than in the PBS group (5.5 +/- 7.9%) (P <.05). Histologically, atrophy of the laryngeal muscle was significantly attenuated by the local administration of bFGF. CONCLUSION: bFGF facilitates regeneration of the transected RLN and attenuation of intrinsic laryngeal muscle atrophy, thereby restoring laryngeal function.     

碱性成纤维细胞生长因子对豚鼠椭圆囊毛细胞再生的影响

目的 利用豚鼠椭圆囊培养的方法观察碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)对毛细胞再生的影响。方法 应用新霉素破坏豚鼠离体椭圆囊毛细胞,实验组培养液含有bFGF,对照组培养液则不含有bFGF。培养18d后两组均行扫描电镜检查,并行新生毛细胞计数,比较两组新生毛细胞数目的差异,观察bFGF对椭圆囊毛细胞再生的影响。结果 实验组新生毛细胞数目明显多于对照组(P<0.05)。结论bFGF对椭圆囊毛细胞的再生有促进作用。     

鼻咽癌中VEGF、bFGF的表达及其与颈淋巴结转移的关系

目的 探讨鼻咽癌中血管生长因子VEGF、bFGF的表达及其与颈淋巴结转移的关系。方法 采用免疫组化S－P法对35例鼻咽癌（其中15例同时取颈部转移癌组织）,20例鼻咽粘膜不典型增生组织和10例慢性炎症组织中VEGF、bFGF的表达进行了检测。结果（1）35例鼻咽癌中17例（48．6％）VEGF表达阳性,明显高于非癌对照组（6．7％,P＝0．000）,有颈淋巴结转移鼻咽癌中VEGF的表达（73．3％）明显高于无颈淋巴结转移者（30％,P＝0．018）;晚期（Ⅲ、Ⅳ期,70．6％）明显高于早期（Ⅰ、Ⅱ期,27．8％,P＝0．018）：但咽癌原发灶中VEGF的表达与颈部转移灶中的表达无相关性（P＞0．05）;（2）35例鼻咽癌中有8例（22．9％）bFGF表达阳性,明显高于非癌对照组（3．3％,P＝0．031）。但鼻咽癌中bFGF的表达与患者的年龄、性别、肿瘤的组织学类型和分期无关,也与肿瘤的N分期无关（P＞0．05）。结论 （1）VEGF与鼻咽癌的生长及颈淋巴结转移有关,它可能可以作为预测鼻咽癌颈淋巴结转移的的指标;（2）bFGF可能与鼻咽癌的生长有关系,但与肿瘤的颈淋巴结转移可能无关。     

Injection of basic fibroblast growth factor for unilateral vocal cord paralysis*

Objective: Unilateral vocal cord paralysis (UVCP) not only induces severe dysphonia, but aspiration as well. Although laryngeal framework surgery is usually performed to treat this condition, the procedure is not tolerated by some patients. In the previous study, basic fibroblast growth factor (bFGF) injections for vocal cord scarring and sulcus have been reported to provide favorable outcomes while being minimally invasive. In this study, the authors retrospectively investigated phonological outcomes after bFGF injection in patients with UVCP.

Methods: This study was registered in University hospital Medical Information Network – Clinical Trials Registry (UMIN000019347). Nineteen patients with unilateral cord paralysis were treated with bFGF injection. The treatment regimen involved a single injection of 50?μg of bFGF into the muscle layer. More than six months after the injection, aerodynamic and acoustic outcomes were examined.

Results: The voice handicap index, maximum phonation time, mean airflow rate, and pitch range improved significantly after injection of bFGF. No sex-related differences were observed in any phonological parameter.

Conclusion: bFGF injection, an easy method and suitable as an office procedure, significantly improved the hoarseness caused by UVCP. It is expected to be widely adopted and effective adjunctive drugs, and procedures are anticipated to be developed.     

Safety and short-term outcomes of basic fibroblast growth factor injection for sulcus vocalis

Abstract

Background: Sulcus vocalis (SV) is characterized by the appearance of a groove and fibrotic changes in the vocal fold mucosa and an often irrevocable loss of tissue viscoelasticity and vibratory potential. Although several surgical approaches have been proposed, none are ideal treatments. Basic fibroblast growth factor (bFGF) may stimulate fibroblasts in the superficial layer of the lamina propria (SLP) and increase the vibration of vocal fold mucosa.

Aims/objectives: The aim of this study was to evaluate the safety and short-term outcomes of bFGF injection for SV.

Materials and methods: This study was registered with the University Hospital Medical Information Network-Clinical Trials Registry (UMIN000019347). Twelve cases of pathological SV were treated using a method involving bFGF injection. The treatment regimen involved the injection of 50 µg of bFGF into the SLP. More than 3 months after the injection, aerodynamic and acoustic outcomes were examined.

Results: No adverse events were recorded. Significant improvements were observed in the maximum phonation time (MPT) and Voice Handicap Index (VHI) after treatment. Multiple injections achieved additional effects.

Conclusions and significance: bFGF injection may be a safe and suitable office-based surgery for the alleviation of hoarseness caused by SV based on this preliminary short-term study.     

丙酸氟替卡松对变应性鼻炎大鼠鼻黏膜中碱性成纤维细胞生长因子蛋白和mRNA表达的影响

目的：观察碱性成纤维细胞生长因子（bFGF）在变应性鼻炎（AR）大鼠鼻黏膜组织中的表达情况及丙酸氟替卡松（FP）干预的影响。方法：90只SD大鼠随机分为正常对照组、AR组和FP治疗组,以卵清白蛋白激发法制备AR模型,采用免疫组织化学和RT—PCR法测定鼻黏膜组织中bFGF蛋白和mRNA的表达情况。结果：AR组bFGF蛋白和mRNA的表达水平显著高于正常对照组（P％0．01）,FP治疗组显著低于AR组（P〈0．01）,但与正常对照组相比仍较高（P〈0．01）,上皮细胞为主要表达细胞。结论：bFGF参与了AR的发病机制,FP可抑制bFGF蛋白和mRNA的表达增加效应,这可能是FP抑制AR鼻黏膜重塑的重要机制之一。