儿童鼻窦炎的序列治疗

目的探讨儿童慢性鼻窦炎治疗方法和疗效。方法386例接受治疗的慢性鼻窦炎儿童,给予三阶段治疗:①以上颌窦穿刺、置管冲洗、窦内吸氧“三联”治疗为基础的系统、规范保守治疗;②腺样体中重度肥大患儿予以刮除或切除腺样体同时完成保守疗法;③上述方法治疗无效时,选择鼻内窥镜手术;术后随访6个月。结果在386例病人中,经保守治疗后总有效率98.30%;腺样体刮除 保守治疗总有效率100%;鼻内窥镜手术总有效率98.30%。各组间有效率无显著性差异。结论儿童慢性鼻窦炎以规范、系统的保守治疗为首选,腺样体刮除是有效的辅助措施,鼻内窥镜手术适应证应严格掌握。     

Maxillary sinus hypoplasia masquerading as chronic sinusitis

Maxillary sinus hypoplasia is a common condition that may be misdiagnosed as chronic sinusitis. Although hypoplasia can usually be seen on conventional sinus films, computed tomography may be necessary, as in the cases described by the authors in this article.     

Therapeutic antibodies as a treatment option for dengue fever

Dengue fever is the most prevalent mosquito-borne viral disease globally with about 100 million cases of acute dengue annually. Severe dengue infection can result in a life-threatening illness. In the absence of either a licensed vaccine or antiviral drug against dengue, therapeutic antibodies that neutralize dengue virus (DENV) may serve as an effective medical countermeasure against severe dengue. However, therapeutic antibodies would need to effectively neutralize all four DENV serotypes. It must not induce antibody-dependent enhancement of DENV infection in monocytes/macrophages through Fc gamma receptor (FcγR)-mediated phagocytosis, which is hypothesized to increase the risk of severe dengue. Here, we review the strategies and technologies that can be adopted to develop antibodies for therapeutic applications. We also discuss the mechanism of antibody neutralization in the cells targeted by DENV that express Fc gamma receptor. These studies have provided significant insight toward the use of therapeutic antibodies as a potentially promising bulwark against dengue.     

聚焦超声治疗慢性宫颈炎的疗效及影响因素

目的 探讨聚焦超声治疗慢性宫颈炎的效果及其影响因素.方法 采用CZF型聚焦超声治疗仪对1 280例慢性宫颈炎患者进行聚焦超声治疗.对其中有完整记录的1 080例患者的治疗效果及影响疗效的因素进行分析.结果 本组聚焦超声治疗宫颈糜烂的总有效率为98.8%(1 065/1 080).在其他参数不变的情况下,糜烂面直径与辐照时间呈指数关系.结论 聚焦超声治疗慢性宫颈炎临床效果显著;根据糜烂面积和不同组织声能量沉积的差异决定辐照时间,可提高治疗过程的可控性及治疗的成功率.     

Therapeutic potential of adenovirus as a vaccine vector for chronic virus infections

Therapeutic vaccines for chronic infections and cancer are needed. Challenges faced by therapeutic vaccines differ from those of preventative vaccines. Whereas the latter target a naive immune system, the former have to readjust an antigen-experienced immune system that is subverted due to sustained exposure to antigen. E1-deleted adenoviral vectors have succeeded preclinically as preventative vaccines and are now in clinical trials. Their potential as therapeutic vaccines for diseases caused by chronic virus infections or virus-associated malignancies remains to be explored in more depth and may require modifications to circumvent negative immunoregulatory pathways that develop following chronic infections or during tumour progression.     

Attention management as a treatment for chronic pain

Attention management is often included in cognitive‐behavioural treatments (CBT). The aim of this study was to evaluate the effects of attention management strategies in the treatment for chronic pain. The present pilot study consisted of six weekly 90‐min treatment sessions and was based on a CBT attention management manual describing techniques such as attention diversion, imagery and mindfulness exercises. The intended outcomes were reduction in pain‐related anxiety and hypervigilance to pain and decrease in pain impact of everyday life, measured by self‐report. Information was collected at baseline, pre‐treatment, post‐treatment, and at 3 and 6 months follow‐up. The results at the end of treatment, and at 3‐month follow‐up, show significant reductions in pain‐related anxiety, hypervigilance and interference of pain (effect sizes 0.40–0.90). Reduction in pain‐related interference and anxiety remained at the 6‐month follow‐up. The results indicate that attention control skills can be a useful method to reduce anxiety in the short term. Clinical implications of the results are discussed.     

Therapeutic ultrasound

Currently the most widely applied use of therapeutic ultrasound in ophthalmology is for the treatment of refractory glaucoma. This new technique is described, histologic changes in experimental animals discussed, and mode of action postulated. The intraocular pressure (IOP) results obtained after treatment of 187 patient eyes are presented, with a review of complications and visual acuity changes. This study demonstrates that 70% of patients treated had an IOP reduction to 25 mm Hg or less one year after ultrasound therapy.     

综合疗法对儿童慢性鼻窦炎的疗效及护理

目的探讨综合治疗儿童慢性鼻窦炎的效果及护理方法。方法将232例儿童慢性鼻窦炎的患儿随机分为治疗组和对照组各116例,对照组给予常规治疗,治疗组在此基础上给予鼻腔冲洗、雾化、弱激光理疗进行综合治疗。结果治疗组有效率93．97％,对照组有效率79．30％,两组总有效率比较差异有统计学意义（x^2=10．76,P〈0．05）。结论综合疗法是治疗儿童慢性鼻窦炎一种效果显著、安全、无痛苦的辅助疗法,值得推广。     

鼻用激素联合克拉霉素治疗慢性鼻-鼻窦炎疗效观察

目的探讨鼻用激素和克拉霉素联合用药对慢性鼻-鼻窦炎(CRS)的治疗效果。方法将130例CRS患者随机分成3组,即布地奈德鼻喷雾剂组(42例)、克拉霉素组(45例)和布地奈德鼻喷雾剂联合克拉霉素组(43例),疗程均为12周,治疗前后采用主观症状自评治疗效果及Lund-Mackey鼻窦CT评分。结果布地奈德鼻喷雾剂联合克拉霉素组自评得分[(2.39±0.58)分]显著低于布地奈德鼻喷雾剂组[(3.98±1.57)分]和克拉霉素组[(4.12±1.35)分],差异有统计学意义(P<0.05),Lund-Mackey鼻窦CT评分布地奈德鼻喷雾剂联合克拉霉素组[(2.61±0.91)分]显著低于布地奈德鼻喷雾剂组[(4.33±1.05)分]和克拉霉素组[(4.37±0.92)分],差异有统计学意义(P<0.05)。结论布地奈德鼻喷雾剂和克拉霉素联合用药治疗CRS临床疗效较好。     

Cephalexin in the treatment of acute and chronic maxillary sinusitis

We evaluated the efficacy of cephalexin therapy in 104 patients with infectious maxillary sinusitis. Confirmation of diagnosis was made by x-ray film, antral puncture, and culture. Sixty-nine patients met all criteria for evaluation. The majority of patients received cephalexin, 1 gm/day in four divided doses for ten days, including the 48-hour period after the patient had become asymptomatic. Patients returned for observation one week and two weeks after initiating therapy. Satisfactory clinical results were obtained in 57 (83%). Results showed that cephalexin was effective in treating sinusitis and that adverse reactions were rare. Bacteriology results showed that many of the pathogens usually involved in infectious maxillary sinusitis were resistant to the recommended or frequently prescribed antibiotics. These same pathogens, however, did not show resistance to cephalexin.     

克拉霉素治疗慢性鼻-鼻窦炎疗效观察

目的 观察长期低剂量克拉霉素治疗慢性鼻窦炎的疗效.方法 将56例慢性鼻-鼻窦炎患者,随机分为两组,治疗组28例,对照组28例,分别口服克拉霉素、阿莫西林克拉维酸钾治疗12周和4周,根据患者症状、体征的改善情况进行疗效评估.结果 治疗组患者症状评价为治愈19例(67.8%),有效7例(25%),无效2例(12%);对照组治愈15例(53.3%),有效4例(14.2%),无效9例(32.3%),两组患者整体症状评分、鼻塞、嗅觉障碍、流涕和头痛等观察指标治疗前比较差异无统计学意义,治疗后,整体症状评分治疗组较对照组明显改善(P<0.01),鼻塞、嗅觉障碍、流涕治疗有效(P<0.05)但头痛无明显改善.结论 长期低剂量应用克拉霉素对慢性鼻窦炎患者有良好疗效,不良反应更小.     

慢性鼻窦炎、鼻息肉综合治疗的临床应用与体会

目的 为提高慢性鼻寞炎、鼻息肉的疗效。方法 应用Stryker鼻内窥镜对72例慢性鼻窦炎、鼻息肉患者进行术前干预、手术及术后镜下随访等综合治疗。结果 按照FESS-97海口疗效评定标准，72例中失随访5例，治愈46例（638％），好转17例（23．6％），无效（息肉复发）4例。有效率87．4％，无严重手术并发症。结论 鼻内窥镜手术治疗慢性鼻窦炎、鼻息肉疗效显著，术前术后综合治疗及术后长期随访对提高鼻窦炎、鼻息肉的治愈率具有重要意义。     

慢性鼻窦炎鼻息肉内镜手术整体治疗

目的探讨提高慢性鼻窦炎鼻息肉临床治愈的措施。方法 120例慢性鼻窦炎、鼻息肉患者均采用表面麻醉加局麻手术,鼻内镜下Messerkinger术式,围手术期和术后定期复查。结果 120例中治愈93例,其中Ⅰ型治愈50例（41.67%）,Ⅱ型治愈30例（25.00）%,Ⅲ型治愈13例（10.83）%。结论手术、合理的术前准备、术后综合处理和术后随访构成了内镜手术治疗慢性鼻窦炎、鼻息肉的整体,术后综合处理、术后随访和成功的手术具有同等重要的地位。     

Therapeutic ultrasound.

Therapeutic ultrasound has been in use for many years. Early applications were those for which tissue heating was the goal, and so it was used for soft tissue injuries such as may be incurred during sport. More recently, attention has been drawn both to high intensity focused beams that may be used for thermal ablation of selected regions, and also to low intensity fields that appear to be able to stimulate physiological processes, such as tissue repair, without biologically significant temperature rises. Ultrasonic tools are used for therapeutic effect in dentistry and are being investigated for use in thrombolysis. This paper reviews the various therapeutic applications of ultrasound.     

慢性鼻窦炎疾病患儿生活质量的研究

目的 探讨SF-36量表应用于慢性鼻窦炎患儿生活质量研究的可行性.方法 选择慢性鼻窦炎患儿136例,用SF-36量表对患儿术前、术后的一般情况和生活质量进行自评量表式调查.结果 患儿在接受鼻内镜手术治疗后,PF、RP、BP、SF和VT维度得分均显著提高,GH、RE、和MH维度得分无明显变化.结论 鼻内镜手术对患儿的生存质量有明显的改善.     

儿童鼻窦炎的鼻内窥镜手术治疗

目的：探讨儿童慢性鼻窦炎的特点，提高对本病的诊断及治疗水平。方法：采用鼻内窥镜鼻窦手术治疗儿童慢性鼻窦炎82例(139侧)，慢性上颌窦炎24例(42侧)，慢性筛-上颌窦炎伴中鼻甲水肿或息肉样变23例(41侧)，慢性筛一堞窦炎lO例(18侧)，慢性全鼻窦炎19例(30侧)，慢性筛窦炎4例(6侧)，慢性堞窦炎2例(2侧)。结果：总治愈率为(121／139)87．1％，好转(12／139)8．6％，无效(6／139)4．3％。3例术中出现筛骨纸样板损伤，术后出现眼睑瘀血，10例(12侧)术后出现鼻腔粘连，无大量出血及其它严重并发症。结论：鼻内窥镜鼻窦手术治疗儿童慢性鼻窦炎是行之有效的方法，且具有创伤小、操作精确、病变清除彻底等优点。