Bcl-x_l和Bcl-2在鼻息肉组织嗜酸粒细胞中的表达

目的　探讨B细胞淋巴瘤 白血病 2 (B celllymphoma leukemia 2 ,Bcl 2 )基因及B细胞淋巴瘤 白血病 x基因长片段 (B celllymphoma leukemia xlong ,Bcl xl)在鼻息肉组织嗜酸性粒细胞中的蛋白表达及鼻腔应用二丙酸倍氯米松 (biclomethasonedipropionate,Bdp)对其表达的影响。方法　采用May Gr櫣ｎｗａｌｄ Giemsa(MGG)染色和免疫组织化学染色 ,观察比较经Bdp治疗 10～ 12周鼻息肉组织 (2 5例 )和未治疗鼻息肉组织 (2 7例 )中嗜酸粒细胞的浸润状态和对Bcl xl,Bcl 2蛋白的表达。结果　①治疗组鼻息肉组织中嗜酸粒细胞的浸润程度弱于未治组 ,两者间差异有显著性意义 (P <0 .0 1) ;② 5 2例鼻息肉组织均无Bcl 2蛋白的表达 ;③治疗组Bcl xl 表达率为 2 0 .0 % ,未治组表达率为 48.1% ,2组的表达率差异有显著性意义 (P <0 .0 5 )。结论　Bcl xl 可能在鼻息肉组织嗜酸粒细胞凋亡中发挥抗凋亡作用 ,糖皮质激素可能通过抑制Bcl xl的表达而发挥其凋亡诱导作用     

蛋白激酶C导致鼻息肉组织中嗜酸粒细胞浸润增多

目的　探讨蛋白激酶C (proteinkinaseC ,PKC)在鼻息肉组织中嗜酸粒细胞 (eosinophlis,EOS)浸润增多的意义。方法　采用原位杂交和免疫组化法 ,对 2 6例鼻息肉组织和 2 0例下鼻甲黏膜进行PKC和促细胞凋亡基因Bax、抑凋亡基因B细胞淋巴瘤、白血病 2 (B celllymphoma leukemia 2 ,Bcl 2 )进行检测 ;用May Gr櫣ｎｗａｌｄ Giemsa(MGG)常规染色鉴别EOS。结果　①EOS中Bcl 2mRNA及其蛋白的阳性细胞表达率鼻息肉组均高于下鼻甲组 (P <0 0 1) ,而鼻息肉组EOS中BaxmRNA及其蛋白的阳性细胞的表达率均略高于下鼻甲组 ,但差异不显著 (P >0 0 5 ) ;②鼻息肉组 2 6例EOS中均有PKC表达 ,而下鼻甲组EOS只有 7例偶有PKC表达。 2组标本EOS中PKC的表达率差异有显著性。且鼻息肉组嗜酸细胞中PKC与Bcl 2mRNA及其蛋白的表达分别呈明显的正相关 (r1 =0 0 875 ,r2 =0 0 82 3,P <0 0 1)。结论　鼻息肉EOS中PKC表达增多与凋亡抑制密切相关 ,推测激活PKC传导途径是鼻息肉组织EOS凋亡抑制之一     

鼻息肉组织嗜酸粒细胞中水通道蛋白-1和抗凋亡基因Bcl-2 mRNA的表达及意义

目的 明确水通道蛋白-1(aquaporin-1,AQP-1)mRNA、抗凋亡基因Bcl-2 mRNA在鼻息肉组织中的表达、分布及其相关性,探讨AQP-1 mRNA在鼻息肉组织嗜酸粒细胞中表达的意义。方法 16例鼻息肉组织标本来源于鼻息肉切除的患者(女11例,男5例,年龄20-65岁);10例下鼻甲黏膜组织来源于有变应性鼻炎病史的鼻整形患者(女7例,男3例,平均年龄16-58岁)。上述标本取组织相邻切片,应用原位杂交方法检测AQP-1 mRNA和Bcl-2 mRNA的表达;以麦格-姬姆萨(May-Griunwald-Giemsa,MGG)染色法鉴别嗜酸粒细胞。结果 16例鼻息肉组织嗜酸粒细胞中均有AQP-1 mRNA和Bcl-2 mRNA表达,其阳性细胞表达率分别为(93.16±13.25)％;(84.74±12.10)％;而10例下鼻甲组织嗜酸粒细胞中均有Bcl-2 mRNA表达,但仅有4例表达AQP-1 mRNA;AQP-1mRNA和Bcl-2 mRNA在下鼻甲组织嗜酸粒细胞中阳性细胞表达率分别为(19.54±4.98)％和(16.45±3.12)％。AQP-1 mRNA与Bcl-2 mRNA在鼻息肉组织嗜酸粒细胞的表达呈明显正相关(r=0.875,P<0.01)。结论 AQP-1能够平衡鼻息肉组织嗜酸粒细胞内外液体渗透压,维持其存活,在嗜酸粒细胞抗凋亡中具有重要的意义。     

局部应用糖皮质激素对鼻息肉组织中蛋白激酶C和Bcl-2及Bax蛋白表达的影响

目的:探讨局部应用糖皮质激素对鼻息肉组织中蛋白激酶C(PKC)、抑制凋亡基因Bcl-2和促进凋亡基因Bax蛋白表达的影响及意义.方法:应用免疫组织化学方法检测PKC、Bcl-2和Bax蛋白在16例鼻息肉患者(鼻息肉组)中的表达,并在鼻腔局部应用糖皮质激素治疗4周后观察其表达的变化;以同期手术的6例鼻中隔偏曲患者的下鼻甲黏膜组织作对照组.结果:糖皮质激素治疗前,鼻息肉组中PKC主要表达在嗜酸粒细胞(Eos)、血管内皮细胞及腺体细胞, Bcl-2及Bax蛋白主要表达于鼻黏膜腺体细胞、上皮层及Eos;与对照组相比,PKC、Bcl-2表达有明显差异(P<0.01),鼻息肉组PKC、Bcl-2在使用激素后,表达明显减低;Bax蛋白在使用激素后,表达明显增加.结论:鼻息肉组中PKC及细胞凋亡相关基因表达异常可能与鼻息肉的发生、发展有一定关系,糖皮质激素可能通过抑制鼻息肉组织中PKC的表达,调节相关凋亡基因的表达,减少Eos的浸润,达到治疗鼻息肉的效果.     

鼻息肉组织中抗原递呈细胞对嗜酸性粒细胞浸润的病理学意义

目的探讨鼻息肉组织中抗原递呈细胞对嗜酸性粒细胞浸润的意义及与鼻息肉发病机制的关系.方法对10例正常鼻粘膜和14例鼻息肉组织进行免疫组织化学和组织病理学染色观察.结果鼻息肉组织中嗜酸性粒细胞和CD68表达阳性的巨噬细胞与正常鼻粘膜相比均显著增加(P<0.05).结论抗原递呈细胞-巨噬细胞在鼻息肉组织中的浸润可能有重要作用,而且以嗜酸性粒细胞为主的炎性效应细胞的积聚与介质释放所导致的鼻粘膜慢性炎症损伤可能是鼻息肉形成的重要原因.     

鼻腔局部应用激素对鼻息肉中嗜酸粒细胞浸润和活化的影响

目的　探讨鼻腔局部应用激素布地奈德 (budisonide)对鼻息肉组织中嗜酸粒细胞浸润和活化状态的影响。方法　采用免疫组化ABC法和chromotrope 2R染色 ,分别标记鼻息肉组织中的活化嗜酸粒细胞和全部嗜酸粒细胞。观察比较经布地奈德喷鼻治疗 6～ 8周和未经治疗的鼻息肉组织 (各16例 )中 ,嗜酸粒细胞浸润和活化状况。结果　①鼻息肉组织中浸润的嗜酸粒细胞多处于活化状态 ;②激素治疗组与未治组相比 ,前者鼻息肉组织中嗜酸粒细胞的活化比例显著减少 (P <0 0 1) ,而嗜酸粒细胞总数和活化嗜酸粒细胞的浸润程度虽呈下降趋势 ,组间比较差异未见显著性 (P >0 0 5 )。结论　嗜酸粒细胞的浸润和活化程度在鼻息肉的发病机制中可能起重要作用。 6～ 8周布地奈德喷鼻治疗使局部嗜酸粒细胞性炎性反应的严重程度减轻 ,其对嗜酸粒细胞活化水平的抑制作用 ,较其对嗜酸粒细胞数量的影响更为显著。     

平阳霉素局部注射治疗鼻息肉病机制探讨

目的:观察平阳霉素局部注射治疗对鼻息肉病息肉组织中嗜酸粒细胞凋亡、转化生长因子(TGF-β1))表达的影响,探讨其治疗鼻息肉病的机制。方法:对19例平阳霉素局部注射治疗前后的鼻息肉病鼻息肉组织进行免疫组织化学染色检测TGF-β1表达;应用原位杂交法(TUNEL)检测凋亡细胞。结果:嗜酸粒细胞凋亡指数治疗前为(20.53±7.66)%,治疗后为(44.47±8.97)%,治疗前后差异有统计学意义(P<0.01);治疗后嗜酸粒细胞TGF-β1阳性表达率(74.74±5.22)%低于治疗前(85.18±8.07)%,治疗后TGF-β1在鼻息肉组织基质中的表达低于治疗前,差异均有统计学意义(P<0.05)。结论:平阳霉素可通过促进嗜酸粒细胞凋亡及减少TGF-β1在嗜酸粒细胞和基质中的表达治疗鼻息肉病。     

鼻息肉组织中白细胞介素-5和粒细胞巨噬细胞集落刺激因子水平测定及其意义

目的探讨鼻息肉组织中嗜酸粒细胞浸润与白细胞介素-5(interleukin-5,IL-5),粒细胞巨噬细胞集落刺激因子(granulocyte-macrophage colony-stimulation factor,GM-CSF)水平关系及其意义.方法应用酶联免疫吸附测定(enzyme linked immunosorbent assay,ELISA)法检测38例鼻息肉组织匀浆中IL-5和GM-CSF水平,同时观测鼻息肉组织中嗜酸粒细胞的浸润程度.以行鼻中隔手术患者中鼻甲粘膜作为对照.结果鼻息肉组织中IL-5,GM-CSF水平均明显高于中鼻甲组织(P<0.05),且两者含量分别与组织中的嗜酸粒细胞数呈正相关(前者r=0.75,后者r=0.71).结论提示IL-5,GM-CSF存在于鼻息肉组织的微环境中,它们对鼻息肉中嗜酸粒细胞的聚集起重要作用.     

红霉素干预对离体人鼻息肉嗜酸粒细胞凋亡基因表达的影响

目的　本实验探讨人鼻息肉组织中嗜酸粒细胞凋亡基因的表达以及红霉素干预对其表达的影响。方法　采用免疫组化方法检测 4 0例离体人鼻息肉组织中嗜酸粒细胞凋亡基因的表达 ,及15例经红霉素干预后 (外植块培养 )的离体人鼻息肉组织中嗜酸粒细胞凋亡基因表达的变化。结果　鼻息肉组织Bcl 2表达 5 % (2 / 4 0 ) ,Bax表达 6 5 % (2 6 / 4 0 ) ,Bcl xL 表达 4 0 % (16 / 4 0 ) ,Fas表达90 % (36 / 4 0 )。与下鼻甲黏膜相比 ,Bax和Fas表达差异有显著性 (P <0 0 5 )。经红霉素干预后 ,鼻息肉组织Bax表达明显上调 (93 3% ,14 / 15 ) ,与单纯用RPMI16 4 0培养者比较差异有显著性 (P <0 0 5 ) ,但Bcl xL和Fas表达差异无显著性。结论　Bax可能是鼻息肉组织嗜酸粒细胞凋亡抑制机制中最有意义的调控基因 ,红霉素可增强Bax的表达 ,是促进嗜酸粒细胞凋亡因素之一。     

鼻息肉中IgE及GM-CSF与嗜酸粒细胞浸润的相关性研究

目的:探讨鼻息肉组织中IgE和粒细胞巨噬细胞集落刺激因子(GM-CSF)的表达对嗜酸粒细胞浸润聚集的作用及二者的关系及意义。方法:采用免疫组织化学SP法检测30例鼻息肉标本(鼻息肉组)和11例下鼻甲部分切除术患者下鼻甲黏膜标本(对照组)组织中IgE阳性细胞分布情况;酶联免疫吸附法检测上述标本中GM-CSF含量,同时观测2组组织中嗜酸粒细胞的浸润程度。结果:鼻息肉组中IgE、GM-CSF水平及嗜酸粒细胞数均明显高于对照组(均P<0.01),且IgE与GM-CSF的水平分别与鼻息肉组织中嗜酸粒细胞浸润数呈正相关(r=0.65、0.62,均P<0.01),鼻息肉组中IgE与GM-CSF水平呈正相关(r=0.52,P<0.01)。结论:鼻息肉是以嗜酸粒细胞浸润为特征的疾病过程,IgE及GM-CSF则对鼻息肉中嗜酸粒细胞浸润发挥重要作用,IgE介导的Ⅰ型变态反应在鼻息肉的形成和发展中占有重要地位。     

颞下窝咽侧区肿瘤的诊断与手术治疗

目的 寻求颞下窝咽侧区肿瘤的早期诊断及有效的手术途径。方法1978～2002年我院手术治疗颞下窝咽侧区肿瘤75例。手术采用4种进路：①颌下进路。②截断下颌骨颌下联合进路。③耳前颌下进路。④经上颌窦前外进路。绝大多数采用第1种手术入路。恶性肿瘤术后行放疗或化疗；继发性肿瘤在切除原发性肿瘤的同时予以切除。结果手术效果良好，无并发症。良性肿瘤38例术后6个月～18年(其中26例超过5年以上)，1例复发。恶性肿瘤37例中，12例死亡，5例失访，余20例观察3～5年无复发及转移。结论①颞下窝咽侧区肿瘤CT扫描及针吸细胞病理检查是有效的诊断手段。②颌下进路是该区肿瘤较好的手术途径。③术中彻底止血、尽可能消灭死腔及负压引流对预防切口感染和预防呼吸道阻塞都相当重要。     

Neurotransmitters in the cochlea and the cochlear nucleus

The inhibitory efferent transmitter in the cochlear is most likely acetylcholine. The afferent transmitter (between hair cells and primary afferent fibres) is not known. There is some evidence for glutamate (or aspartate) but the high concentrations necessary to activate the afferents when these amino-acids are applied intracochlearly may indicate that their effects is unspecific. A number of other transmitter candidates can be safely ruled out at these synapses. In the cochlear nucleus of transmitter between primary afferents and secondary cells is probably glutamate (or aspartate).     

Herpes and the head and neck: the difficulties in diagnosis

A case of primary herpes of the head and neck is presented. The exact source of infection and the precise diagnosis proved difficult to establish, but evidence tended to support a diagnosis of varicella zoster infection as opposed to a herpes simplex infection, though a dual infection was not ruled out. Herpes simplex has specific clinical features which usually make its distinction from varicella zoster clear cut. In this case we relied heavily on laboratory investigations to improve the accuracy of our diagnosis since the clinical characteristics were blurred. Unlike varicella zoster there has been little written about herpes simplex infections specifically affecting the ear, face and neck.     

Cation transport in the ampulla of the semicircular canal and in the endolymphatic sac

We examined the effects of anoxia and ethacrynic acid on the endolymphatic potential and cation activity in the superior ampulla of the guinea pig, using double-barrelled ion-exchanger microelectrodes. In normal guinea pigs the ampullar endolymphatic potential was + 3.9 +/- 1.2 mV (n = 32), the Cl- activity 130 +/- 4.6 mM (n = 9), and the Na+ activity 18.4 +/- 4.4 mM (n = 20). After anoxia, the ampullar DC potential decreased rapidly and reversed its polarity within 5 min. It then decreased gradually for 60 min and increased afterwards to approximately zero. K+ activity decreased gradually after a latency of 10 min, whereas Na+ activity increased. During the gradual decrease of a negative ampullar endolymphatic potential, an increase in Na+ activity was observed. Thirty minutes after the intravenous injection of ethacrynic acid (100 mg/kg), the potential began to decrease, changed to a negative polarity, and approached a maximum negative level 100 min after the injection. The decrease in K+ activity corresponded to the reduction of potential whereas Na+ activity remained unchanged. The DC potential of the endolymphatic sac in normal guinea pigs was + 14.7 +/- 5.1 mV (n = 17). The Na+ concentration was 103.3 +/- 14.7 mM (n = 14) and the K+ concentration was 11.6 +/- 0.8 mM (n = 4). After anoxia, the DC potential decreased rapidly and approached 0 mV within 8 min. No negative potential could be observed. The Na+ concentration began to increase 2 min after anoxia and reached the extracellular Na+ concentration about 30 min later.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cation transport in the ampulla of the semicircular canal and in the endolymphatic sac

Summary We examined the effects of anoxia and ethacrynic acid on the endolymphatic potential and cation activity in the superior ampulla of the guinea pig, using double-barrelled ion-exchanger microelectrodes. In normal guinea pigs the ampullar endolymphatic potential was +3.9±1.2 mV (n=32), the Cl^– activity 130±4.6 mM (n=9), and the Na⁺ activity 18.4±4.4 mM (n=20). After anoxia, the ampullar DC potential decreased rapidly and reversed its polarity within 5 min. It then decreased gradually for 60 min and increased afterwards to approximately zero. K⁺ activity decreased gradually after a latency of 10 min, whereas Na⁺ activity increased. During the gradual decrease of a negative ampullar endolymphatic potential, an increase in Na⁺ activity was observed. Thirty minutes after the intravenous injection of ethacrynic acid (100 mg/kg), the potential began to decrease, changed to a negative polarity, and approached a maximum negative level 100 min after the injection. The decrease in K⁺ activity corresponded to the reduction of potential whereas Na⁺ activity remained unchanged. The DC potential of the endolymphatic sac in normal guinea pigs was + 14.7±5.1 mV (n=17). The Na⁺ concentration was 103.3±14.7 mM (n=14) and the K⁺ concentration was 11.6 ±0.8 mM (n=4). After anoxia, the DC potential decreased rapidly and approached 0 mV within 8 min. No negative potential could be observed. The Na⁺ concentration began to increase 2 min after anoxia and reached the extracellular Na⁺ concentration about 30 min later. No significant effect of intravenous administration of ethacrynic acid (100 mg/kg) on DC potential and Na + concentration could be observed. The results suggest the presence of a different ion transport system in the endolymphatic sac from that of the cochlea and the ampullae of the semicircular canals.     

Contact between the tectorial membrane and the cochlear sensory hairs in the human and the monkey

European Archives of Oto-Rhino-Laryngology - The surface structure of the organ of Corti and the overlying tectorial membrane were studied in human and monkey cochleas under a scanning electron...