p21、p73及PTEN在头颈部多原发癌中的表达及意义

目的:探讨p21、p73与PTEN在头颈部多原发癌组织中的表达与意义。方法:采用 免疫组织化学方法对30例头颈部多原发癌患者的42份标本、42例头颈部单发癌及30例来源于头颈部的正常上皮组织标本中p21、p73与PTEN蛋白表达进行检测,并将检测结果作统计学分析。结果:p21、p73与PTEN蛋白在头颈部多原发癌组织中阳性表达率分别为69.05％、57.14％和71.43％;在单原发癌组阳性表达率分别为76.19％、40.48％和76.19％;在正常上皮组织中阳性表达率分别为96.66％、13.33％和100.00％。在多原发癌及单发癌组织中p21与PTEN蛋白失表达率以及p73蛋白过表达率均显著高于正常上皮组织（P＜0.05）;三个指标在多原发癌与单发癌组织中的表达差异均无统计学意义。结论:p21与PTEN蛋白失表达以及p73蛋白表达上调,参与头颈部多原发癌和单发癌的形成机制,但还不能认为其在头颈部多原发癌与单发癌形成中的作用有差别。     

Leitlinien: Antibiotikatherapie der Infektionen an Kopf und Hals

In 1999 the following guidelines were elaborated by a consensus conference of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery with delegates of 10 further societies and complemented by a Delphi procedure. In 2002 and 2008 up-dates were performed by the members of the consensus conference, the chair of the study group of ENT infectiology of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the presidency of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The guidelines concern the antibiotic treatment of bacterial infections of the ears, nose and throat, taking the expected spectrum of pathogens, the microbiological and clinical efficacy and the containment of costs into consideration. After specification of the basic principles, the various infections with their causative pathogens and the antibiotics coming into question for therapy are tabulated and a differentiation is made between the antibiotic or the antibiotics of first choice and alternatives. The different dosages of oral and parenteral antibiotics for adults and children are indicated. In the appendix the different groups of antibiotics are characterized concerning their antibacterial spectrum and pharmacokinetics and in particular the differences between the older and newer representatives of the groups are pointed out.     

头颈部淋巴水肿的诊治进展

头颈部淋巴水肿(HNL)多继发于头颈肿瘤治疗后，症状、体征缺乏特异性，相较于乳腺癌、宫颈癌治疗后继发性淋巴水肿的肿胀程度稍轻。然而，由于头颈部解剖位置的特殊性，其对患者外观、感觉、运动，乃至心理的长期影响较为严重。目前，临床医生对HNL关注较少，缺乏足够的认识，诊治手段及流程尚不规范，且没有完善的诊疗指南用于指导医疗工作，有待学界进一步探究。本文就近年国内外对HNL的诊治进展进行综述，旨在进一步明确HNL的诊治方式。     

Respiratory and metabolic disturbances in patients with laryngeal and tracheal stenosis of different etiology

Development of hypoxic hypoxia in stenosis of the larynx and cervical trachea of different etiology leads to respiratory insufficiency and bioenergetic impairment. Investigation of blood gas composition and acid-base balance in patients with laryngeal and tracheal stenosis determines severity of respiratory insufficiency and metabolic disturbances. Parameters of gas composition and acid-base balance of arterial and venous blood are not similar in different etiological groups. The studies revealed pathognomonic signs of laryngeal and cervical trachea stenosis of different etiology.     

突发性聋患者血清AT-Ⅲ、PAI-1的检测及其临床意义

目的探讨抗凝血酶Ⅲ(AT-Ⅲ)和纤溶酶原激活剂抑制物-1(PAI-1)活性水平变化与突发性聋发病的关系。方法应用发色底物法测定不同病程的突发性聋患者44例和30例健康者血清AT-Ⅲ和PAI-1活性水平,并进行统计学比较。结果AT-Ⅲ、PAI-1活性水平的改变与突发性聋病程有关。发病3天内与发病一周以上患者比较,前者的血清AT-Ⅲ水平低于后者、而血清PAI-1活性水平高于后者,两者有显著差异(P<0.05);病程一周以上患者与对照组相比血清AT-Ⅲ、PAT-1活性水平无显著性差异。结论突发性聋患者三天内血清AT-Ⅲ、PAI-1活性水平的改变提示血凝与纤溶障碍与其发病有关。     

变应原气道激发在变应性鼻炎和哮喘研究中的作用研究进展

随着城市化进程，环境及生活方式的改变，我国变应性疾病发病率逐年升高。目前认为变应性鼻炎和哮喘的发病主要是在遗传基因、环境因素共同作用下导致，但具体发病机制复杂，尚未完全清楚。慢性气道炎症和气道高反应性是变应性鼻炎和哮喘的典型的病理生理特征。环境中变应原的暴露可诱发疾病症状发作，引起气道及全身炎症反应增加，并导致气道敏感性/反应性升高。人为给予变应性鼻炎或哮喘患者呼吸道变应原吸入刺激，可以模拟其变应原自然暴露所致疾病症状发作，研究其病理生理变化，尚可通过药物干预评估其对症状及炎症抑制程度评估药物治疗效果。同时变应性鼻炎和哮喘作为上下气道疾病，相互影响，通过一端变应原刺激研究气道另一端症状及炎症反应，探讨上下气道之间的联系。屋尘螨为我国,特别是南方地区最主要、最常见的变应原，与疾病关系密切。主要从屋尘螨变应原鼻激发和支气管激发方法学及其在鼻炎和哮喘的研究中的应用作一综述。     

Clinical and functional studies of patients with unilateral laryngeal paralysis

Unilateral laryngeal paralysis (ULP) involves all three functions (defensive, phonating, and respiratory) of the larynx. It is necessary to make comprehensive clinical studies in patients with ULP of unknown etiology to elucidate the causes of the paralysis. The study involved X-ray tomography of the larynx, lung, and mediastinum, ultrasonography of the thyroid, X-ray study of the skull and the cervical part of the vertebral column, and barium X-ray study of the esophagus. A hundred and twenty patients with ULP underwent clinical and functional studies of the vocal apparatus, with microlaryngoscopy with palpation of the arytenocricoid joint, studies of external respiratory function and the acoustic parameters of their voice. The examination has ascertained that the clinicofunctional status of the larynx in unilateral laryngoparalysis depends on the degree of approach and the quality of closure of the vocal cords (VC) and it is determined by the position of the paralyzed VC in horizontal and vertical planes, by the degree of paralyzed VC atrophy, and by the position and mobility of the arytenoid cartilage.     

External transcolumellar approach and cartilage grafting: a very complementary association

Two major facts have modified the philosophy of rhinoplasty: the desire to obtain more harmonious and balanced nose with conservative resections and a more frequent use of the open approach. This approach allows more accuracy in the diagnosis of the deformities and in the control and the preservation of the supports of the nose, namely the tip, alar and middle vault supports, and in the use of innovative techniques, specifically in the nasal tip: suture techniques and cartilage grafts. External transcolumellar approach and cartilage grafting go hand in hand and are frequently associated in the correction of under and overtip projection. Grafts can be use for improvement of aesthetic and function and the excellent exposure provided by the open approach permits a precise placement and stabilization of the grafts. Septal surgery benefits significantly from the excellent exposure for correction of all kind of deformities.     

环舌根会厌吻合术对减轻误咽提高拔管率的探讨

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抑癌基因PTEN在鼻咽癌中的表达及突变

了解抑癌基因PTEN在鼻咽癌中的表达、突变情况,探讨其与鼻咽癌发生发展的关系。方法采用免疫组化检测52例鼻咽癌中PTEN基因的表达,利用PCR-SSCP银染、DNA测序分析等方法检测PTEN基因第5、8外显子突变。结果鼻咽癌中PTEN蛋白表达率低于癌旁组织,表达与临床TNM分期、颈部淋巴结转移密切相关（P＜0.05）。52例鼻咽癌中PTEN基因第5、8外显子未见明显突变。结论抑癌基因PTEN可能参与鼻咽癌的发生发展,其第5、8外显子在鼻咽癌的发生发展中可能不起关键作用。     

Local changes in the oral cavity in patients after operation of malignant tumours of the tongue and bottom of the oral cavity

This study is aimed an objective and subjective evaluation of local changes after operations of malignant tumours of the tongue and the bottom of the oral cavity. THE MATERIAL AND METHODS: we have examined 74 patients (70 men and 4 women) treated in Department of Otolaryngology of the University School of Medical Sciences in Poznań with recognized of malignant tumour of the tongue and floor of the mouth. On the base of subjective and objective ultrasound and x-ray examination with use of contrast and stereognostic test it was evaluated movability, alteration of articulation zones, regularity of swallowing acts, sense of taste and efficiency of stereognosion. In all of the patients we found orders in swallowing, speech and taste dependen on the kind of the operation.     

头颈部骨化性纤维瘤与纤维结构不良的鉴别诊断

目的探讨骨化性纤维瘤(ossifying fibroma,OF)与纤维结构不良(fibrousdys plasia,FD)的临床病理特征和免疫组化染色在鉴别诊断中的意义。方法对40例OF和26例FD进行临床及病理资料的回顾性研究,并应用免疫组化染色方法标记PCNA、Ki-67、Laminin、CK19。结果40例OF,包括青少年沙瘤样骨化性纤维瘤(juvenile psammomatoid ossifying fibroma,JPOF)8例与26例FD(单骨型14例,多骨型12例),两者平均年龄相近,OF男性常见,FD多骨型女性好发,平均年龄较小。OF好发于筛窦(75%),FD好发于蝶骨(58%)。26例OF(6例JPOF)及10例FD的免疫组织化学染色结果,经四格表x2检验PCNA染色结果有显著性差异,P<0.01。Ki-67、laminin及CK19无显著意义。结论OF与FD发病年龄、性别比例、好发部位、及临床症状不同,OF与FD免疫组化PCNA染色有助于两者的鉴别诊断。     

Three-dimensional analysis of the physiological foramen geometry of maxillary and mandibular molars by means of micro-CT

The aim of this study was to investigate the physiological foramen diameter, shape and distance between physiological and anatomical apex of maxillary and mandibular first and second molars. Accurate knowledge of the physiological foramina morphology; thus, inherent mechanical shaping technical hindrances, is decisive when taking the corresponding root canal final preparation decision. The morphological dimensions of a total of 1 727 physiological foramina were investigated by means of micro-computed tomography. Mean narrow and wide (to a high number, oval) diameters of the physiological foramen were 0.24, 0.22 and 0.33 mm and 0.33, 0.31 and 0.42 mm in mesiobuccal (MB), distobuccal (DB) and palatal (P) roots in maxillary first molars; 0.24, 0.22 and 0.33 mm and 0.41, 0.33 and 0.44 in MB, DB, and P roots in maxillary second molars. Mandibular first molars showed mean narrow and wide diameters of 0.24 and 0.30 mm and of 0.39 and 0.46 mm in mesial (M) and distal (D) roots; second mandibular molars showed 0.25 and 0.31 mm and 0.47 mm in M and D roots. The mean distance between the physiological foramina and anatomical apex was 0.82, 0.81 and 1.02 mm and 0.54, 0.43 and 0.63 mm in MB, DB and P roots of the maxillary first and second molars, respectively. A mean distance of 0.95 mm (M) and 1.05 mm (D) in the first and 0.78 mm (M) and 0.81 mm (D) in the second mandibular molars was observed. Based on the results obtained, assumable recommendations for final preparation size of the physiological foramen were calculated. However, when taking into consideration, the resulting standard deviations of marginal errors must be cautiously considered when taking a final decision in clinical endodontic treatment.     

耳鼻咽喉头颈外科医疗纠纷现状分析及防御对策研究

目的 通过分析耳鼻咽喉头颈外科诊疗特点以及医疗纠纷现状,提出针对耳鼻咽喉头颈外科医疗纠纷的防御对策及干预措施.方法 对医务人员和患者医疗纠纷的认识等情况以及既往医疗纠纷病例进行调查分析,提出减少或避免耳鼻咽喉头颈外科医疗纠纷的防御对策,并运用于临床.以2016年全年医疗纠纷数量及患者对医疗满意度等指标为对照组,2017...     

The masquerade of vasculitis: head and neck diagnosis and management.

Wegener's granulomatosis and forms of giant cell arteritis result from vasculitis and masquerade with symptoms of common head and neck disease entities. Recognition of the manifestations of vasculitis can be made early in the disease course and confirmed pathologically, allowing effective therapy. Current therapy of Wegener's granulomatosis with Cytoxin and Imuran and steroids for giant cell arteritis frequently results in reversal of head and neck involvement, prevention of systemic disease, and prolonged survival.     

Glycobiology of head and neck squamous epithelia and carcinomas

An impressive variety of regulatory processes including cell adhesion and migration, proliferation, apoptosis and differentiation folding and routing of glycoproteins have been found to be mediated by specific lectin-carbohydrate interactions. This article summarizes the data on glycobiological aspects of differentiation of squamous epithelia in the head and neck region under physiological conditions and in cancer. The possible function of lectins in tumor development and invasiveness is debated. Introduction of labeled endogenous lectins as a tool for the study of functional glycomics at the cellular level in head and neck squamous epithelia and carcinomas enables a complex interpretation of studied data because these lectins are normally occurring in these tissues. The lectinology of Langerhans cells in head and neck squamous epithelia and carcinoma is also mentioned. Finally, the use of the described data in the diagnosis and prospectively in the treatment of head and neck squamous cell carcinoma is shown.     

The role of acoustic rhinometry in the evaluation of the volume of nasopharynx before and after adenoidectomy]

OBJECTIVE: To determine the type of acoustic rhinometry curve in different kinds of nasal and nasopharyngeal diseases and the role of acoustic rhinometry in the evaluation of the changes of the volume of nasopharynx before and after adenoidectomy. METHODS: One hundred and fifty-one patients with nasal and nasopharyngeal diseases, including rhinitis, nasal polyps, obstructive sleep apnea syndrome, palatoschisis, atrophic rhinitis, adenoid vegetation, perforation of nasal septum, carcinoma of nasopharynx, and stricture of nasal limen, were measured with acoustic rhinometry. Meanwhile, 15 patients with adenoid vegetation were measured before and after adenoidectomy, the changes in volume recorded by acoustic rhinometry were compared with the adenoid volume obtained by the method of displacement. RESULTS: Acoustic rhinometry curve can be divided into normal and abnormal curves and the abnormal curves can be divided into four types according to the site of changes. Acoustic rhinometry curve altered with the changes in character, degree and site of nasal and nasopharyngeal diseases and could return to normal after surgery or medical treatment. The volume of nasopharynx of adenoid vegetation patients was significantly smaller than that of the normal control and it rose significantly and became closed to normal after adenoidectomy. The volume of adenoid and the calculated changes in volume of the nasopharynx was found to be interrelated and highly significant(r = 0.87, P < 0.001). CONCLUSION: The results indicate that acoustic rhinometry curve is a useful method in the assistant diagnosis and judgment of therapeutic effectiveness of many kinds of nasal and nasopharyngeal diseases and can provide reference for the evaluation of the volume of adenoids.     

The biophysics of nasal airflow

The biophysics of nasal airflow involve the measurement, analysis, and understanding of bulk airflow or momentum transport through the nasal cavity and of the exchange of mass and heat laterally between the air stream and the walls. In both of these areas, optimal progress depends on judicious, combined, and continuous use of physical models, mathematical calculations, and measurements made on human subjects. The progress that has been made to date is both fascinating and encouraging and suggests that great improvement in understanding, diagnosis, and treatment of nasal and upper airway disease will be possible in the future through closer contact and cooperation between clinicians and physical and biological scientists.