经鼻给药对鼻粘膜结构的影响

目的 研究药物经鼻吸收对鼻粘膜结构的影响。方法 使用硫酸庆大霉素及胰岛素给家兔滴鼻，在用药后３、５、７ｄ和２周及停药后的１周及２周取鼻粘膜进行光不显微镜和透射显微镜观察。结果 用药后３￣７ｄ出现渐进性鼻粘膜损伤的改变，１周后部分区域上皮脱落，但基底膜完整。停药后１￣２周内上皮细胞及纤毛迅速修复。结论 鼻内给药是一种可行的有前途的给药途径。     

鼻腔粘膜吸收庆大霉素功能的研究

用静脉内、肌肉内及鼻腔内三种给药途径给１０只狗按５ｍｇ／ｋｇ用４０ｍｇ／ｍｌ的庆大霉素，并使用双波长色谱扫描法测定０～１８０分钟血清庆大霉素的浓度，比较其生物利用度。发现鼻内给药的生物利用度为静脉注射的８０．５％，肌肉注时为４２％。鼻腔用药后１０～３０分钟血清浓度达到高峰，范围在３．７～６．６μｇ／ｍｌ，半衰期长达３小时左右，表明鼻粘膜对庆大霉素有良好的通透性，可使其迅速吸收入血，并能在血中长时间维持有效浓度。     

Sch 10649对过敏性鼻炎的疗效

著者用Sch 10649给12岁以上主要对尘埃过敏的典型过敏性鼻炎患者170人进行治疗,用药方法一日三次,每次1毫克,连服一周。由患者自行记录每天的喷嚏数、擤鼻次数,鼻堵程度及服药情况。给药前及停药后的次日观察鼻粘膜颜色、肿胀度、鼻涕性质及量,瓦氏位摄片,并进行鼻分泌物嗜酸细胞、皮内抗原反应、诱发反应等项检查。试验期停止使用可以影响疗效的药物如类固醇、抗组织胺制剂及点鼻药等。     

鼻腔术后粘连52例分析

鼻腔手术后诸多并发症中,鼻粘膜粘连时有发生。１９９４～１９９８年,我们发现５２例,现分析如下,以提请临床重视。１　资料与方法５２例中,男３５例,女１７例;年龄１３～７１岁。单侧鼻粘膜粘连４５例,双侧７例。鼻腔手术后至发现粘连的时间１４ｄ～７年。粘连原因分类：鼻Ｌｉｔｔｌｅ区粘膜划痕术后９例,鼻中隔粘膜下矫正术后６例,上颌窦柯－陆手术后７例;鼻内窥镜下中鼻道上颌窦造口术后３例,鼻息肉摘除术后４例,内窥镜下鼻息肉摘除加筛窦开放术后７例,下鼻甲骨粘膜下部分切除术后７例,鼻出血鼻腔凡士林纱条填塞后５例,…     

鼻腔铁质异物长期存留误诊1例

患儿男，８岁。以间歇性发热反复发作１年余，左侧鼻前庭溃烂及流血性脓涕半年就诊。患儿自１９９７年７月出现鼻臭、发热，诊断为“感冒”并给予治疗，１周后体温恢复正常，但鼻腔恶臭味加重，流血性脓涕。２周后再次出现发热，体温在３８℃～４０℃之间，体温高时出现寒战，治疗后体温降至正常，但停药后体温再次上升。因反复发热，曾先后住院治疗达７次之多，１９９９年３月左侧鼻腔、鼻前庭出现严重溃烂，流血脓涕，多家医院门诊均以“鼻前庭溃疡”、“湿疹”给予治疗，效果不佳，且上述症状逐渐加重。体格检查：患儿全身情况好，心肺（…     

脑脊液鼻漏7例报告

原发性脑脊液鼻漏发病率较低，我院自１９９５年以来诊治７例，现报道如下。１　资料与方法１．１　一般资料７例患者，男１例，女６例；年龄２８～６０岁，平均４３．４岁。病程３ｄ～２个月。表现为单侧流清涕（量为０．１～１．８ｍｌ／ｍｉｎ）、头低位或闭气用力后流涕增多，左∶右为５∶２，发病前有咳嗽、打喷嚏、擤鼻者２例，原因不明者５例。均无外伤史，嗅觉障碍３例，脑膜炎刺激症状２例，弥漫性脑水肿并气颅１例，并发高血压病４例，糖尿病１例。鼻腔分泌物实验室检查：葡萄糖定量分析为２．７２～６．３２ｍｍｏｌ／Ｌ。７例均…     

鼻腔粘膜吸收庆大霉素功能的研究

用静脉内，肌肉内及鼻腔内三种给药途径给１０只狗按５ｍｇ／ｋｇ用４０ｍｇ／ｍｌ的庆大霉素，并使用双波长色谱扫描法测定０－１８０分钟血清庆大霉素的浓度，比较其生物利用度。发现鼻内给药的生物利用度为静脉注射的８０．５％，肌肉注射为４２％。鼻腔用药手１０－３０分钟血清浓度达到高峰，范围在３．７－６．６μｇ／ｍｌ，半衰期长达３小时左右，表明鼻粘膜对庆大霉素有良好的通透性，可使期迅速吸收入血，并能在血中长时间     

液氮冷冻治疗慢性肥厚性鼻炎形态学研究

目的以光镜和电镜观察液氮冷冻治疗慢性肥厚性鼻炎鼻粘膜的变化。方法对３０例病程在１０年左右慢性肥厚性鼻炎患者，于治疗前、第１次治疗后２周和第２次治疗后８～１０周行鼻粘膜活体组织检查，进行光、电镜观察。结果冷冻前鼻粘膜上皮呈不同程度的鳞状化生和增厚。第１次冷冻后２周鼻粘膜上皮退化、脱落，上皮层明显变薄。第２次冷冻后８～１０周鼻粘膜形成新的上皮层，可见较多柱状上皮细胞，并见微绒毛和短纤毛再生，较规整。结论冷冻治疗可改善鼻粘膜病变，从而改善和恢复鼻粘膜生理功能。     

鼻粘膜纤毛清除系统对鼻内给药途径的影响

本文使用硫酸庆大霉素研究鼻兔粘膜纤毛清除系统对鼻粘膜吸收药物的影响。对兔动物模型封闭鼻咽腔（无纤毛清除系统的作用）和不封闭鼻咽腔（有纤毛清除系统的作用），然后使用庆大霉素鼻内给药，测定０－１８０分钟的血清药物浓度，结果发现鼻粘膜纤毛清除系统可减少鼻粘膜对药物的吸收，使吸收率和曲线下的吸收面积（ＡＵＣ）分别降低２５．１％和１８．２％。为减少纤毛清除系统的影响，作者设计将乙酰半胱氨酸加入滴鼻剂中以拮抗纤毛系统的活动，用鼻腔喷雾药液来代替滴鼻以增加鼻粘膜非纤毛区药物的附集。结果发现两者有明显促进鼻粘膜吸收药物的功能，前者使最大吸收和ＡＵＣ分别提高１８％和１０．７％，后者使吸收增加１．５一１．６倍。     

小儿鼻颅底针形内窥镜的检查与手术

目的：探讨应用针形内窥镜对小儿鼻颅底疾病进行探查与手术的方法及疗效。方法：在外径１．９ｍｍ的进口针形内窥镜及电视同图像系统监视下,对８例小儿（７ｄ￣１２岁）鼻颅底有关疾病进行探杳与手术。结果：先天性后鼻孔闭锁３例中,１例好转,３例痊愈。外伤性脑脊液鼻漏１例,经修补痊愈先天性脑膜脑膨出２例,确诊后１例暂缓治疗。另１例行内窥镜手术痊愈。颅底神经母细胞瘤２例取材作病理检查确诊。结论：在电视图像监视下应用     

Influence of intranasal medication on the structure of the nasal mucosa]

OBJECTIVE: To study the pathological changes and reversibility of the nasal mucosa after drug administration. METHODS: Gentamicin and insulin were dropped into the nasal cavity of rabbits for 3, 5, 7 days to two weeks, after one and two weeks, the nasal mucosa was taken and observed under optical and electron microscopes. RESULTS: It was found that after 3-7 days of drugs administration, damages of the nasal mucosa gradually appeared, and became most serious after one week when the epithelia in some regions detached from basement membr theane. After stopping drug application, the ciliated epithelia restored quickly and completely, goblet cells reproduced and inflammatory reaction disappeared. CONCLUSION: The damages induced by drugs on nasal mucosa are reversible. The intranasal route of drug administration is feasible and promising.     

麻黄碱对鼻黏膜的影响及三磷酸腺苷对其治疗作用的探讨

目的:观察麻黄碱对健康Sprague-Dawley大鼠鼻黏膜形态、超微结构的影响,并探讨三磷酸腺苷(ATP)对它的干预作用。方法:健康Sprague-Dawley大鼠23只采用随机数字表法分为3组:对照组(A组),麻黄碱滴鼻组(B组),麻黄碱滴鼻加ATP腹腔注射组(C组)。于1、2、3、8周取鼻黏膜进行光镜和电镜观察。结果:B组用药第1、2、3周鼻黏膜的损害逐渐加重,3周后停药,第8周取材,观察损伤鼻黏膜形态没有恢复正常。C组用药第1周鼻黏膜几乎没有损伤,第2、3周鼻黏膜稍有损伤,3周后停用麻黄碱并续用ATP至第8周见损害鼻黏膜形态基本恢复正常。结论:麻黄碱可损伤健康Sprague-Dawley大鼠鼻黏膜,并随时间推迟而损伤程度加重,且损伤达到一定程度不可恢复;ATP可减轻麻黄碱对Sprague-Dawley大鼠鼻黏膜的损害,对麻黄碱引起的鼻黏膜损伤具有保护和治疗作用。     

阿奇霉素对慢性鼻-鼻窦炎患者术腔黏膜中NF-kBp65IL-8表达的影响

目的 观察阿奇霉素对慢性鼻-鼻窦炎患者术腔黏膜中NF-kBp65、IL-8表达的影响,探讨阿奇霉素治疗术腔慢性炎症的机制。方法 将45例慢性鼻-鼻窦炎术后2周的患者随机分成阿奇霉素组、头孢菌素组和对照组进行随访治疗,所有患者均应用布地奈德喷鼻、生理盐水冲洗术腔,阿奇霉素组加用阿奇霉素500mg口服,每日1次;头孢菌素组加用头孢菌素500mg口服,每日1次;对照组继续同前治疗,连续3周后,取术腔病变黏膜作为实验标本,应用免疫组织化学PV-6000二步法检测各组治疗前后及三组间术腔黏膜上皮细胞、炎性细胞中NF-kBp65和IL-8表达的情况,计数阳性细胞数。结果 慢性鼻-鼻窦炎患者术腔黏膜呈慢性炎症表现,NF-kBp65主要表达在术腔黏膜的黏膜上皮细胞、炎性细胞的胞浆和部分胞核。IL-8主要表达在黏膜的上皮细胞、炎性细胞的胞浆。三组治疗后NF-kBp65和IL-8在上皮细胞和炎性细胞中的表达均较治疗前减少(P<0.05);阿奇霉素组治疗后术腔黏膜上皮细胞和炎性细胞中NF-kBp65、IL-8的表达均较头孢菌素组、对照组明显减少(P<0.05);头孢菌素组与对照组治疗后上皮细胞和炎性细胞中NF-kBp65、IL-8的表达无明显差别(P>0.05)。结论 阿奇霉素联合应用布地奈德抑制慢性鼻-鼻窦炎患者术腔黏膜上皮细胞、炎性细胞中NF-kBp65、IL-8的表达,较单独应用布地奈德明显,可能是阿奇霉素治疗慢性炎症的机制之一,对慢性鼻-鼻窦炎患者术腔黏膜慢性炎症的转归具有促进作用。     

Efficacy of a topical nasal decongestant in different formulations: the effect of viscosity.

Factors affecting the absorption of drugs through the nasal mucosa are increasingly being studied. Dosage form factors, i.e. the viscosity of the excipients, have been claimed to be of importance for enhanced nasal absorption due to prolongation of contact time between drug and mucosa. In the present study, a comparison was made of the effect of a local nasal sympathomimetic when administered intranasally in formulations with different viscosities. Volunteers received the test drugs as nasal sprays in a randomized cross-over design by a rhinomanometric technique, the effect of the drug being recorded for up to 5 h after administration. No significant differences in effects were observed when the test formulations were compared.     

Effects of pingyangmycin on mucous membrane of respiratory tract and its prevention]

OBJECTIVE: To observe the effects of pingyangmycin(PYM) on the histomorphology and ultrastructure of airway mucosa from the healthy Wistar rats and explore the intervenient role of Vitamin E and Composite Salvia Miltiorrhiza (CSM) on these effects. METHODS: Thirty Wistar rats were divided randomly into four groups: Group A as control group (injection of N. S into peritoneal cavity); Group B received intracavitary injection of PYM; Group C received both intracavitary injection of PYM and tube feeding of Vitamin E; Group D received intracavitary injection of PYM and CSM. The nasal and tracheal mucosa were taken for light microscopy(LM), transmission electron microscopy(TEM) and scanning electron microscopy(SEM) at the 1st, 2nd, 4th and 6th week of the experiment. RESULTS: Edema and degeneration of epithelial cells manifested as expansion of endoplasmic reticula, swelling of mitochondria, disarrangement of mitochondrial crista, vesicula formation of mitochondria, reduction of mitochondria in part cells, mild expansion of perinuclear space and slight peripheral accumulation of nuclear chromatin could be seen in Group B at the end of the 1st week without necrosis or detachment of the cells. At the 2nd week, there were necrosis and exfoliation of epithelial cells, rupture of cell membrane, phenomena of outflow of mitochondria and endoplasmic reticula. The degree of cell damage became more seriously at the 4th week and was not recovered to normal condition even 2 weeks after stopping administration of PYM. The cell damages in Group C and D were significantly lighter than that in Group B and its occurrence were significantly postponed. The injured cells recovered definitely after stopping PYM administration and continuous application of Vitamin and CSM for another 2 weeks. CONCLUSIONS: (1) The nasal and tracheal mucosa of Wistar rats can be damaged by injection of PYM and the degree of damage which become more serious with the increase of dose. (2) Vitamin E and CSM can alleviate the damages of the respiratory mucosa from Wistar rats caused by PYM. Both drugs could be used to prevent respiratory tract mucosa from the damages induced by PYM in clinical.     

放射性鼻黏膜损伤后组织纤维化重塑的特点

目的 探讨鼻黏膜纤维化在放射性鼻黏膜损伤中的作用.方法 清洁级SD大鼠72只,雄性,随机分为两组,空白对照组36只,予以假照射;辐射损伤组36只,予以X射线局部照射,总辐射剂量40 Gy.损伤组分别于辐射完成后1周、2周、4周、8周、3个月和6个月(每个时间点各6只大鼠)配对处死大鼠,取出中鼻甲子以扫描和透射电镜观察,苏木素-伊红(hematoxylin-eosin,HE)染色;阿辛蓝-过碘酸-希夫(alcian blue-periodic acid-SclIif,AB-PAS)染色,Masson三色胶原染色(Masson trichrome,MT)法染色,观察鼻黏膜组织病理变化;化学比色法测定鼻黏膜羟脯氨酸(Hyp)的含量.结果 辐射损伤后,早期(4周内)主要以急性炎性反应为特点,4周后修复开始,6个月时修复基本结束.受照后1周,大鼠鼻黏膜中出现胶原沉积,胶原沉积量随着时间的推移而进行性增多.结论 照射能引起鼻黏膜组织一系列的病理改变,鼻黏膜纤维化可能是放射性鼻黏膜损伤迁延不愈的重要原因之一.     

Effects of topical chlorhexidine applied to the rabbit nasal mucosa

OBJECTIVE: To search the effects of administration of various concentrations of a wide-spectrum antimicrobial agent, chlorhexidine, to the nasal mucosa. MATERIAL AND METHODS: About 0.20, 0.12, 0.06 and 0.03% concentrations of chlorhexidine gluconate were applied to the rabbit nasal mucosa as one puff twice a day throughout 5 days. Another group, treated with serum saline to the nose, behaved as the control group. On the fifth day following drug administration, specimens were taken from nasal mucosa of the rabbits and examined under light microscope. RESULTS: As a result of comparison between drug treated group and control group, with increasing drug concentrations progressively increased neutrophil infiltration in mucosa, ciliary loss in cells, and occasional metaplasia were observed. CONCLUSION: There is a linear, positive and strong association between concentrations of chlorhexidine and its irritative effects on rabbit nasal mucosa. While 0.20 and 0.12% concentrations of chlorhexidine cause excess irritation on the nasal cavity, 0.06 and 0.03% concentrations of chlorhexidine gluconate causes lower irritation and effects on the animals which have experimentally induced rhinosinusitis must be evaluated.     

平阳霉素对呼吸道黏膜的影响及其预防探讨

目的　观察平阳霉素对健康Wistar大鼠鼻和气管黏膜组织形态、超微结构的影响并探讨维生素E(VitE)、复方丹参注射液对它的干预作用。方法　健康Wistar大鼠 3 0只采用随机数字表法分为 4组 ,甲组 :对照组 (腹腔注射 0 9%氯化钠溶液 ) ;乙组 :平阳霉素腹腔注射组 ,每次 1 0mg/kg体重每周 2次 ,共 4周 ;丙组 :平阳霉素腹腔注射 +VitE灌胃组 ;丁组 :平阳霉素腹腔注射 +复方丹参注射液腹腔注射组。于 1、2、4、6周取鼻和气管黏膜行光镜和电镜观察。结果　乙组在第 1周见细胞水肿、变性 ,表现为内质网扩张 ,线粒体肿胀 ,嵴排列紊乱 ,线粒体空泡化 ,部分细胞线粒体减少 ,核周间隙轻度扩大 ,染色质轻度边集等。第 2周见上皮细胞坏死、脱落 ,细胞膜破裂 ,线粒体、内质网等细胞器外溢。第 4周细胞受损伤程度更加重 ,停药 2周后仍呈较重损伤。丙、丁 2组均可见细胞受损伤程度明显减轻 ,且出现时间推迟 ,停用平阳霉素并续用VitE、复方丹参注射液 2周可见细胞无明显改变 ,与甲组相似。结论　平阳霉素可损伤健康Wistar大鼠鼻和气管黏膜 ,并随剂量增加而损伤程度加重 ;VitE、复方丹参注射液均可减轻平阳霉素对Wistar大鼠鼻和气管黏膜的损害 ,对平阳霉素的呼吸道黏膜损伤具有保护作用     

辐射对豚鼠鼻黏膜结构的损伤及中药保护作用实验研究

目的动态观察辐射对豚鼠鼻黏膜的损伤及中药的保护作用及其机理。方法90只健康豚鼠。随机分为空白对照（Ⅰ）组、单纯照射（Ⅱ）组和中药保护（Ⅲ）组。Ⅱ组和Ⅲ组豚鼠予直线加速器射线照射。Ⅲ组豚鼠在受照射前1周直至处死当日予服加减百合固金汤口服液。分期分批处死动物。取中鼻甲前端黏膜进行光镜、电镜观察和显微图像分析，并检测丙二醛（MDA）含量及超氧化物歧化酶（SOD）活性。结果Ⅱ组豚鼠鼻黏膜辐射后早期表现为急性炎症反应．2周时仅少部分黏膜表面被覆正常的纤毛结构，4周时开始修复．半年时基本结束．但修复不完善．有鳞状上皮化生。Ⅲ组豚鼠鼻腔黏膜病理改变较轻。炎症反应减退早．修复的黏膜大多保持了正常的纤毛柱状上皮结构。Ⅱ、Ⅲ组豚鼠均同时伴有SOD活性降低，MDA含量升高。但Ⅱ组恢复时间较长，而Ⅲ组在4周时就基本回到正常水平。结论加减百合固金汤能加速清除氧自由基，增加SOD活性．从而减轻辐射所致早期炎症反应、促进鼻黏膜向正常黏膜上皮方向修复。     

变应性鼻炎动物模型鼻黏膜感觉神经肽研究

目的：探讨感觉神经肽在变应性鼻炎发病机制和疾病发展中的作用。方法：①将12只致敏兔随机分成2组：实验组8只进行致敏,对照组4只作为对照。实验组致敏后1、4周各处死4只,同时对照组各处死2只,取出鼻黏膜,制片后行免疫组织化学检查,测定P物质（SP）、降钙素基因相关肽（CGRP）的阳性率。②将24只致敏兔分成2组：蝶腭神经切断组和交感神经切除组。2组兔分别在术后1、2、4周各处死4只,取出鼻黏膜,制片后行免疫组织化学检查。结果：①实验组鼻黏膜中SP和CGRP的阳性率明显高于对照组（均P〈0．01）。②蝶腭神经切断组术后1周与2周鼻黏膜中SP和CGRP阳性率差异均有统计学意义（均P〈0．01）,4周后二者阳性率与第1周无明显差异。交感神经切除组鼻黏膜中SP和CGRP阳性率术后1、2、4周无明显差异。结论：SP和CGRP与变应性鼻炎发病和发展有相关性。