家兔实验性急性化脓性鼻窦炎模型的建立

目的探讨应用金黄色葡萄球菌建立家兔急性化脓性鼻窦炎模型的方法. 方法家兔40只,其中空白组10只,单纯手术组10只,余为模型组,在全麻下行上颌窦造口术,塞入棉绒,注入金黄色葡萄球菌0.3ml.造模后7天时观察其炎症反应和鼻黏液纤毛输送功能的变化. 结果实验性急性化脓性鼻窦炎家兔7天病程时白细胞(WBC)计数及中性粒细胞(N)百分比增加,血清C-反应蛋白浓度显著升高,窦腔分泌物细菌分离培养阳性,鼻黏液纤毛传输时间延长,光镜、电镜下窦腔及窦口黏膜充血、水肿、纤毛脱落等. 结论应用金黄色葡萄球菌,采取上颌窦造口术可以建立稳定的家兔急性化脓性鼻窦炎模型.     

慢性鼻窦炎的细菌学研究进展

细菌感染是慢性鼻窦炎的发病因素之一,但患者的细菌分布与病程无明显关系,那些病程长、病情顽固者的感染并不比病程短者严重。近年认为细菌感染在慢性鼻窦炎的发病中可能不占关键地位。慢性鼻窦炎的细菌学研究不但有助于了解其本质,而且对慢性鼻窦炎治疗方法的选择也具有重要的指导意义。由于研究的结果受采样、送检和标本处理等许多因素的影响,因此,来自不同研究的结果在细菌种类、细菌的阳性培养率等方面也存在很大差异。     

家兔实验性上颌窦炎的细菌学变化

目的：探讨实验性上颌窦炎动物模型的制备方法，并在此基础上分析实验性上颌窦炎的细菌学变化。方法：将40只新西兰大白兔制成动物模型，分成6组：空白对照组、假手术对照组、窦口堵塞组、单纯细菌组、窦口堵塞加金黄色葡萄球菌组和窦口阻塞加肺炎链球菌组，检查术后不同时间窦腔脓性分泌物细菌学变化。结果：空白对照组细菌培养阳性率为0％(0／5)，假手术对照组为20％(2／10)，窦口阻塞组为84．6％(11／13)，单纯细菌组为10％(1／10)，窦口阻塞加细菌组100％(42／42)。术后2周内，培养的细菌以种植茵为主；3周以后，培养的细菌以机会致病菌为主。结论：窦口阻塞加注入细菌的方法可成功地制造实验性上颌窦炎动物模型，随着鼻窦炎时间的延长，培养出机会致病菌的阳性率升高。     

慢性鼻窦炎细菌学普通培养结果分析

鼻窦炎是常见病、多发病,临床上有急性、亚急性、慢性、急性复发性、慢性急性发作性等类型,各型发病机制并非完全相同,尤其是对于慢性鼻窦炎,2002年美国SAHP（the sinus and allergy health partnership）定义“慢性鼻窦炎是以鼻腔和鼻窦黏膜炎症为特征,时间上至少持续12周以上的一类疾病”,诸多学者认为并非单纯细菌迁延感染所致。     

学龄儿童慢性鼻窦炎36例细菌学分析

目的：探讨学龄儿童慢性窦炎的细胞学特征,为临床治疗提供依据。方法：采用鼻道脓液进行细菌培养及药敏试验。结果：细菌培养阳性率为８３．３％,复合感染率为３６．１％;需氧菌株占７６．７％,厌氧菌株占５５．６％。抗生素药敏试验较分散。结论：学龄儿童慢性鼻窦炎厌氧菌感染甚高,应尽可能在细菌培养和药敏试验下指导治疗。     

鼻窦炎冲洗液的药效学研究

目的研究鼻窦炎冲洗液局部运用对试验性大鼠肉芽肿的动物生长的抑制作用.方法①在大鼠背部建立肉芽肿的动物模型,分组后用鼻窦炎冲洗液制成的浓缩液与醋酸肤轻松软膏分别外涂肉芽肿.比较治疗结束后肉芽肿的重量②用浓缩的冲洗液连续滴鼻,观察全身情况及鼻腔粘膜情况.结果①鼻窦炎冲洗液高剂量组有抑制慢性肉芽肿增生的作用,实验后肉芽琼脂湿重和醋酸肤轻松软膏组的肉芽琼脂湿重与空白组的肉芽琼脂湿重相比,差异有非常显著性意义(P＜0.01);②鼻窦炎冲洗液局部应用不引起鼻粘膜的水肿和充血.结论鼻窦炎冲洗液对鼻腔粘膜无局部刺激作用,能够抑制慢性肉芽肿的增生.     

慢性鼻-鼻窦炎患者细菌学检测及药敏分析

目的　探讨慢性鼻-鼻窦炎（CRS）患者细菌学分布及药敏分析。方法　63例确诊为CRS的手术患者,取中鼻道脓性分泌物行普通细菌培养,对有临床意义的细菌 行药敏试验。结果　63例患者中,43例普通细菌培养结果为阳性,阳性率为68.25%,共分离出细菌15种,排在前3位的是甲型链球菌/黄色奈瑟菌、金黄色葡萄球菌、表皮葡萄球菌。27株行药敏试验,排在前4位的抗生素是环丙沙星81.48%,复方新诺明66.67%,庆大霉素59.26%,左氧氟沙星51.85%。结论　对于CRS患者,应根据药敏结果选择抗生素,若未能行药敏试验,应首选喹诺酮类抗生素。     

单发性鼻窦炎细菌学检测及药敏试验结果分析

目的：了解单发性鼻窦炎细菌分布及对常用抗生素敏感情况。方法：对９４例上颌窦炎和４１例筛窦炎,蝶窦炎患者行功能性鼻窦内窥镜手术,将取出的窦腔分泌舶和粘膜进行细菌培养分离和常用抗生素的药敏试验。结果：１３５份标本中,有菌生长１１９份（８８．１５％）,共分离细菌１９２株,混合细菌生长６２份,厌氧菌７５株,分离菌株对青霉素的总敏感度为５３．１２％。头孢唑啉钠总敏感度为８７．５０％〉厌氧菌对甲硝唑的总敏感度     

鼻窦炎的动物模型

鼻窦炎在动物模型上可得到很好的研究.尽管有许多研究者曾经试图从人身上研究鼻窦炎的病理生理学、免疫学和生化学等情况,但这些研究受到一些因素的制约.     

变应性真菌性鼻窦炎

目的 通过总结3例变应性真菌性鼻窦炎（allergic fungal sinusitis,AFS)的诊断、治疗过程，结合复习文献中关于本病的病理、生理过程的探讨，提示本病的诊断、治疗特点。方法 通过对3例病史、鼻窦CT检查、鼻窦分泌物及鼻腔检查，对临床怀疑变应性真菌性鼻窦炎的3例患者进行鼻窦内镜手术。通过分泌物真菌涂片、培养，组织病理学检查以及放射免疫吸附试验（radioallergosorbent test,RAST)结果，明确AFS诊断。术后口服强的松，局部雷诺考特喷鼻及大扶康冲洗鼻腔。结果 通过上述系统治疗，2例术后分别随访25个月和15个月症状完全缓解，1例术后6个月症状复发，变应性黏蛋白再次出现，经术腔清理及大扶康冲洗后局部症状及分泌物完全消失，随访2个月无复发。结论 变应性真菌性鼻窦炎有其独特的临床发生、发展过程。慢性鼻窦炎、鼻息肉中存在着一定比例的AFS，应对其做出及时的诊断和进行合理、完善的综合治疗，以降低本病的并发症和复发率。     

Association of bronchopneumonia with sinusitis due to Bordetella bronchiseptica in an experimental rabbit model

An animal model for rhinogenic sinusitis was developed in rabbits naturally colonized with Bordetella bronchiseptica. It was found that ostial occlusion predisposes the sinus to invasion with this opportunistic bacterium and subsequent sinusitis as a result of reduced local host defense. In addition to the inflammatory lesions in the sinus, bronchitis and pneumonia were found in 84% of the experimental rabbits, suggesting that ostial dysfunction can also contribute to infectious disease of the lower respiratory tract. In such a model it is possible to study the significance of asymptomatic carriage of potential pathogens after ostial occlusion.     

Bacterial examination of sinusitis using antral puncture and irrigation

Aerobic bacterial examination for sinusitis was conducted using specimens from maxillary sinuses collected by antral puncture in 540 patients--284 men and 256 women aged 6-89 years--between May 1999 and April 2000. We obtained 528 strains of bacteria. Our results were as follows: 1. We obtained 303 pathogens from 540 patients. In acute sinusitis, the most frequently found was Streptococcus pneumoniae (30.4%), followed by Hemophilus influenzae (27.7%). In chronic cases, the most frequently found was Streptococcus pneumoniae (16.0%), followed by Hemophilus influenzae (15.1%) and Staphylococcus epidermidis (12.6%). 2. We found an increase in bacteria resistant to multiple drugs, with 11.1% of the Staphylococcus aureus isolates methicillin-resistant in acute sinusitis and 40% methicillin-resistant in chronic sinusitis, and that 30.6% of Streptococcus pneumoniae isolates were penicillin-resistant. 3. Ciclacillin was effective against 64.7% of all pathogens isolated in this study, cefpodoxime proxetil effective against 6.5%, and cefixime effective against 2.4%. 4. In considering pathogens, we therefore choose antibiotics and make a maxillary aspiration puncture.     

Osteitis and mucosal inflammation in a rabbit model of sinusitis

IntroductionSeveral experimental studies have shown osteitis after the onset of sinusitis, supporting the idea that bone involvement could participate in the dissemination and perpetuation of this inflammatory disease. However, procedures commonly performed for the induction of sinusitis, such as antrostomies, can trigger sinusitis by themselves.ObjectiveTo evaluate osteitis in an animal model of sinusitis that does not violate the sinus directly and verify whether this is limited to the induction side, or if it affects the contralateral side.MethodsExperimental study in which sinusitis was produced by inserting an obstructing sponge into the nasal cavity of 20 rabbits. After defined intervals, the animals were euthanized and maxillary sinus samples were removed for semi-quantitative histological analysis of mucosa and bone.ResultsSigns of bone and mucosal inflammation were observed, affecting both the induction and contralateral sides. Statistical analysis showed correlation between the intensity of osteitis on both sides, but not between mucosal and bone inflammation on the same side, supporting the theory that inflammation can spread through bone structures, regardless of mucosal inflammation.ConclusionThis study demonstrated that in an animal model of sinusitis that does not disturb the sinus directly osteitis occurs in the affected sinus and that it also affects the contralateral side.     

Autoradiographic findings in experimental sinusitis in rabbits

In order to study the effect of a purulent infection in the sinus cavity on the uptake of radionuclide in the surrounding bone, two series of experiments were performed; one using 45Ca-chloride (T1/2 = 153 d), that was given intravenously in a dose of 50 MBq to the previously infected animal, and in the other 99Tcm-DP was used in a dose of 530-1600 MBq. The animals were killed 4-6 hours later and analyzed using an autoradiographic technique and histological examination. Chronic unilateral infection of the maxillary sinus was induced experimentally according to the technique described by Kumlien and Schiratzki (1985). An acute unilateral maxillary sinusitis was induced experimentally according to Johansson et al. (1988). An increased uptake of 99Tcm-DP in the bone surrounding the sinus cavity with an infected mucosa could be seen. This uptake could be seen four days after induction of an acute, purulent, pneumococcal sinusitis, and five months after the induction of an purulent, chronic sinusitis. No increase in uptake could be seen in the mucosa of the sinus with purulent infection. The beta-emitting nuclide gave better resolution in autoradiography than did the gamma-emitting nuclide, and would give better possibilities in identifying structures; however, the specificity to bone of 45Ca was not high enough to be suitable.     

兔鼻窦炎模型骨质重塑的组织学观察

目的 评估兔鼻窦炎模型造模不同时段骨质变化的病理学表现及其与时间的相关趋势,探讨骨质重塑在鼻窦炎发病机制中的作用.方法 应用慢性鼻一鼻窦炎患者上颌窦穿刺液进行细菌培养,分离出金黄色葡萄球菌制造兔鼻窦炎模型,根据造模时间将实验组分为A(2～4周)、B(6～8周)、C(12周)3组,每组8只,健康对照组4只.在特定造模时间收集鼻窦标本,石蜡包埋、进行HE、Magson和AB-PAS以及碱性磷酸酶和抗酒石酸酸性磷酸酶染色.首先对接种侧和未接种侧上颌窦骨质进行重塑评分;然后以黏膜厚度、黏骨膜厚度、成骨细胞密度和破骨细胞数量为指标对接种侧上颌窦骨质进行定量和半定量评估.结果 3组动物接种侧上颌窦骨质重塑评分分别为2.250、2.875、2.875分,未接种侧分别为1.625、2.250、2.500分.A组黏膜厚度、黏骨膜厚度、成骨细胞密度(x±s,下同)分别为(143.75 ±8.76)tun、(15.00 ±1.31)μm、(42.50±8.45)个/500μm,与对照组的(60.00±2.94)μm、(5.75±0.58)tun、(5.00 4±0.82)+/500μm相比,差异均有统计学意义(P值均<0.05);B组黏膜厚度、成骨细胞密度分别为(268.75 ±11.26)μm、(135.00±23.90)个/500 μm,与A组相比差异具有统计学意义(P值均<0.05);C组和B组相比,黏膜厚度、黏骨膜厚度、成骨细胞密度3项指标差异均无统计学意义.结论细菌性鼻窦炎可以引起鼻窦骨质重塑,早期以破坏为主,随时间延长增生逐渐占主要地位,提示骨质重塑为鼻窦炎的基本病理特征之一,且为病变迁延或慢性化的原因.     

兔鼻窦炎模型骨质重塑的组织学观察

目的 评估兔鼻窦炎模型造模不同时段骨质变化的病理学表现及其与时间的相关趋势,探讨骨质重塑在鼻窦炎发病机制中的作用.方法 应用慢性鼻一鼻窦炎患者上颌窦穿刺液进行细菌培养,分离出金黄色葡萄球菌制造兔鼻窦炎模型,根据造模时间将实验组分为A(2～4周)、B(6～8周)、C(12周)3组,每组8只,健康对照组4只.在特定造模时间收集鼻窦标本,石蜡包埋、进行HE、Magson和AB-PAS以及碱性磷酸酶和抗酒石酸酸性磷酸酶染色.首先对接种侧和未接种侧上颌窦骨质进行重塑评分;然后以黏膜厚度、黏骨膜厚度、成骨细胞密度和破骨细胞数量为指标对接种侧上颌窦骨质进行定量和半定量评估.结果 3组动物接种侧上颌窦骨质重塑评分分别为2.250、2.875、2.875分,未接种侧分别为1.625、2.250、2.500分.A组黏膜厚度、黏骨膜厚度、成骨细胞密度(x±s,下同)分别为(143.75 ±8.76)tun、(15.00 ±1.31)μm、(42.50±8.45)个/500μm,与对照组的(60.00±2.94)μm、(5.75±0.58)tun、(5.00 4±0.82)+/500μm相比,差异均有统计学意义(P值均<0.05);B组黏膜厚度、成骨细胞密度分别为(268.75 ±11.26)μm、(135.00±23.90)个/500 μm,与A组相比差异具有统计学意义(P值均<0.05);C组和B组相比,黏膜厚度、黏骨膜厚度、成骨细胞密度3项指标差异均无统计学意义.结论细菌性鼻窦炎可以引起鼻窦骨质重塑,早期以破坏为主,随时间延长增生逐渐占主要地位,提示骨质重塑为鼻窦炎的基本病理特征之一,且为病变迁延或慢性化的原因.