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(Vit E)、复方丹参注射液对它的干预作用。方法 健康Wistar大鼠30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 Vit E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Vit E、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；Vit E、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。     

鼻内镜下鼻中隔矫正术后血肿的预防

目的探讨预防鼻内镜下鼻中隔矫正术后鼻中隔血肿的有效方法。方法回顾性分析安徽医科大学第一附属医院2016年1月—2019年4月收治的行鼻内镜下鼻中隔矫正术的220例患者的临床资料。其中90例患者鼻中隔矫正术后鼻中隔两侧黏膜完整为甲组;90例患者术后黏膜完整,行一侧近鼻底处鼻中隔黏膜水平贯穿切开,长约1 cm,本研究称之为黏膜辅助切口为乙组;40例患者术后一侧或两侧鼻中隔黏膜有不对称破损为丙组。术后3组均予膨胀海绵填塞。结果甲组患者出现鼻中隔血肿5例,乙组和丙组患者皆未出现鼻中隔血肿,所有患者均无鼻中隔穿孔。3组之间的鼻中隔血肿发生率差异具有统计学意义(χ2=9.107,P<0.05)。结论对于术后两侧鼻中隔黏膜完整的患者,鼻中隔矫正后行一侧鼻中隔黏膜切开能有效预防鼻中隔术后鼻中隔血肿的发生。     

鼻渊舒口服液加盐酸氨溴索治疗慢性鼻窦炎的临床观察

目的 评价联用鼻渊舒口服液和盐酸氨溴索治疗慢性鼻窦炎的疗效及安全性.方法 219例慢性鼻窦炎受试病例,随机分为甲、乙、丙三组.甲组联合应用鼻渊舒口服液和盐酸氨溴索,乙组单独服用鼻渊舒口服液,丙组单独服用盐酸氨溴索,均连续服用21天.分别对治疗前后的症状和体征进行记分量化评估,考核其疗效和安全性.结果 甲组显效率明显高于乙组和丙组,P均＜0.05.主要不良反应表现为胃胀、反酸、恶心,甲组出现8例（8/70,11.43%）,乙组出现6例（6/66,9.09%）,丙组出现7例（7/65,10.77%）.结论 对Ⅰ型慢性鼻窦炎患者可首选鼻渊舒口服液联用盐酸氨溴索进行治疗,其疗效优于单用其中任一种药物,而且药物的安全性也好.     

并发呼吸道梗阻的小儿脉管畸形的综合治疗

目的 总结并发呼吸道梗阻的小儿脉管畸形的临床特点,探讨该类疾病的治疗方法.方法 回顾性分析1985年6月至2007年12月间收治的47例并发不同程度呼吸道梗阻的小儿脉管畸形资料,其中男25例,女22例;年龄3个月～14岁,中位年龄2.3岁.静脉畸形27例,大囊型淋巴管畸形17例,微囊型淋巴管畸形3例.20例静脉畸形行无水乙醇病变内注射;7例广泛性静脉畸形中行无水乙醇注射+手术切除;17例大囊型淋巴管畸形行单纯平阳霉素病变内注射,3例微囊型淋巴管畸形行手术切除+平阳霉素注射.根据患者呼吸道梗阻程度和治疗需要,27例采用气管插管手术,3例术前紧急气管切开,2例术中预防性气管切开,1例拔管后气管切开.结果 30例治疗后留置气管插管24～48 h,除1例拔管后出现呼吸困难行气管切开,其余均顺利拔管;6例气管切开患儿分别于术后3周～4个月拔除气管套管.病变内注射治疗1次9例,重复注射2～5次38例.2例无水乙醇注射后出现局部黏膜坏死和1例轻度-过性血尿,5例平阳霉素注射后出现轻中度发热反应,经对症处理1 h～3周后恢复正常.全组随访1～23年,治愈38例,有效9例,没有无效患儿.结论 对合并呼吸道梗阻的小儿咽喉、纵隔部位的脉管畸形,推荐硬化疗法为主的治疗.静脉畸形可采用无水乙醇,淋巴管畸形可先用平阳霉素治疗,对多部位广泛性病变采用手术+硬化疗法的综合治疗可能缩短疗程和提高疗效.     

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。     

100例成人慢性鼻窦炎鼻内镜手术临床分析

目的分析鼻内镜术中两种不同的处理方法对成人慢性鼻窦炎手术疗效的影响。方法对100例成人慢性鼻窦炎进行手术,随机分成两组。甲组55例,术中保留鼻窦黏膜及中鼻甲,不扩大鼻窦自然开口;乙组45例,术中不保留鼻窦黏膜,切除部分中鼻甲,扩大鼻窦自然开口,随诊6-12个月,按海口标准进行疗效综合评定。结果甲组治愈率85.5%,乙组治愈率57.8%,两者比较有统计学意义（P〈0.05）。甲组总有效率94.5%,乙组总有效率80%,两组比较有统计学意义（P〈0.05）。结论术中保留鼻窦黏膜及中鼻甲,不扩大鼻窦自然开口能提高成人慢性鼻窦炎鼻内镜手术疗效。     

平阳霉素联合地塞米松注射治疗咽喉部静脉畸形15例分析

目的观察平阳霉素联合地塞米松注射治疗咽喉部静脉畸形的临床效果。方法回顾分析2006年5月～2016年9月应用平阳霉素联合地塞米松瘤内注射治疗的咽喉部静脉畸形患者15例临床资料,每次注射平阳霉素8mg+地塞米松注射液5mg。每次注射后三周检查若病变未完全消失则再次注射,每4次为一疗程,平阳霉素注射总量不超过40mg。结果 15例患者中治愈14例,显效1例,没有出现肺纤维化及大出血等严重并发症,治愈率为93.33%,有效率为100%。结论平阳霉素联合地塞米松注射治疗咽喉部静脉畸形是安全、简便易行、有效的治疗方法。     

婴幼儿先天性声门下血管瘤的诊断和治疗

目的：探讨婴幼儿先天性声门下血管瘤的诊断和治疗。方法：9例患儿,反复喉喘鸣、喂哺困难及喉梗阻发作,电子支气管镜检查确诊为先天性声门下血管瘤。7例为声门下单侧病变,2例为双侧病变。其中8例采用气管切开后血管瘤内平阳霉素注射法进行治疗,术后患儿带金属气管套管出院,2周后门诊随访电子支气管镜复查,如果肿瘤未消失,再次行平阳霉素注射,直至肿瘤完全消失后进行堵管及拔管;1例单侧声门下血管瘤行瘤体吸割术,未行气管切开。结果：平阳霉素治疗的6例声门下单侧病变患者经过1次治疗后血管瘤完全消失,2例双侧病变患者经过2次治疗后血管瘤完全消失,8例均顺利堵管及拔管。1例行声门下血管瘤吸割术患者,术后2周复查黏膜光滑,完全修复。结论：对于体积较大,阻塞声门下腔范围较广的血管瘤,采用气管切开后血管瘤内平阳霉素注射法,能迅速解除气道梗阻,缩短自然病程,且戴管时间短,无术后声门下狭窄,是一种安全有效的治疗措施。对于体积较小的声门下血管瘤,在麻醉配合良好的情况下,行吸割术并给予良好止血,可避免气管切开,起到微创效果。     

实验性变应性鼻炎鼻黏膜组织重塑的特点

目的观察变应性鼻炎动物造模状态下鼻黏膜组织重塑的特点。方法Hartley系豚鼠24只,雄性,体重250~300g,随机分为4组,即对照组、短期(1周)抗原攻击组(实验1组)、抗原攻击8周组(实验2组)和抗原攻击12周组(实验3组),每组6只豚鼠。实验组动物采用腹腔注射卵清蛋白致敏后卵清蛋白鼻腔攻击1周,制成变应性鼻炎动物模型,长期抗原攻击组给予卵清蛋白鼻腔攻击分别8周(实验2组)和12周(实验3组)。组织标本石蜡包埋,采用苏木素-伊红(hematoxylin-eosin,HE)、阿辛蓝-过碘酸-希夫(alcian blue-periodic acid-Schiff,AB-PAS)和Masson三色胶原染色(Masson′s Trichrome,MT)法染色,计数鼻中隔黏膜中嗜酸粒细胞、上皮杯状细胞数量,半定量测量上皮细胞损伤及鼻中隔黏膜和鼻甲基底膜区及上皮下胶原含量。结果①对照组鼻黏膜未见明显嗜酸粒细胞浸润,实验组鼻黏膜可见大量嗜酸粒细胞浸润;②对照组和短期抗原攻击组黏膜上皮较完整(完整上皮分别占87.7%±11.1%,77.1%±7.1%;x-±s,下同),长期抗原攻击组鼻黏膜发生上皮细胞损伤(实验2组完整上皮占36.7%±16.9%,实验3组占37.9%±12.9%);③长期抗原攻击组鼻中隔黏膜杯状细胞明显高于对照组和短期抗原攻击组;④长期抗原攻击组鼻中隔黏膜及鼻甲基底膜增厚,黏膜内细胞外基质沉积。结论黏膜上皮细胞损伤、杯状细胞化生和细胞外基质沉积是变应性鼻炎中鼻黏膜组织重塑的特点。     

颈外动脉及其分支结扎与平阳霉素注射治疗鼻唇颊部血管瘤

鼻唇颊部血管瘤采用手术治疗可致鼻面部严重畸形、面神经损伤等严重并发症,且易复发;对血流速度快者单纯采用硬化剂或平阳霉素治疗效果多不满意;而采用动脉栓塞治疗要求的设备和技术条件较高,基层医院多难满足。我科自1997～2002年采用颈外动脉和（或）其分支结扎与平阳霉素（商品名：平阳星,天津太河制药有限公司产）注射治疗鼻唇颊部血管瘤21例,取得良好效果,报告如下。     

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.     

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。     

Vitamin E reduces cisplatin ototoxicity

OBJECTIVES/HYPOTHESIS: Cisplatin ototoxicity is a major dose-limiting factor in the treatment of several neoplasms. Vitamin E, a slow-acting free radical scavenger, has been shown to ameliorate nephrotoxicity and endothelial cell damage in animals receiving cisplatin. The purpose of the study was to determine the effectiveness of vitamin E as an otoprotectant. STUDY DESIGN: Prospective, randomized controlled trial in the rat model. METHODS: Wistar rats (weight, 261-386 g) were sedated using 172.4 mg/kg intramuscular ketamine and 3.4 mg/kg xylazine. Baseline auditory brainstem response (ABR) testing was performed in response to clicks and 8-, 16-, and 32-kHz tone bursts. After auditory thresholds were determined, the animals received intraperitoneal drug administration according to one of three group classifications. Group 1 received 4 g/kg vitamin E followed after 30 minutes by 16 mg/kg cisplatin. Group 2 received 6 mL/kg soybean oil followed after 30 minutes by cisplatin. Group 3 received soybean oil followed after 30 minutes by 16 mL/kg saline. After 3 days' follow-up, ABR testing was performed and threshold changes were recorded. Cochleae were removed and processed for scanning electron microscopy after follow-up auditory testing was carried out. RESULTS: Group 2 animals showed marked hearing loss with average threshold shifts of 28.75 +/- 2.3 dB for clicks, 30.0 +/- 1.9 dB at 8 kHz, 21.25 +/- 4.0 dB at 16 kHz, and 45.0 +/- 4.2 dB at 32 kHz. No significant loss was observed in group 3 with shifts of 2 +/- 1.3 dB, 3 +/-3.0 dB, -2.2 +/- 3.1 dB, and -1.1 +/- 4.0 dB for clicks and tone bursts at 8, 16, and 32 kHz, respectively. Significant protection was seen in group 1 animals compared with group 2 animals. In the former group, threshold shifts of 12.5 +/- 3.1 dB for clicks, 7.5 +/- 2.5 dB at 8 kHz, 5.0 +/- 3.3 dB at 16 kHz, and 24.4 +/- 5.6 dB at 32 kHz were observed. These findings were supported by the scanning electron microscope observations that severe outer hair cell destruction occurred in group 2 rats, whereas outer hair cells were preserved to a much greater extent in the cochleae of rats in group 1 that were pretreated with vitamin E. CONCLUSION: Vitamin E appears to have a protective effect against cisplatin ototoxicity.     

黄芪对顺铂耳毒性保护作用的实验研究

目的探讨黄芪是否对顺铂的耳毒性具有保护作用。方法健康SD大鼠40只随机分成4组,每组10只。对照组：生理盐水2ml／d腹腔注射6天;黄芪组：黄芪注射液5g&#183;kg^-1&#183;d。腹腔注射6天;顺铂组：顺铂4mg&#183;kg^-1&#183;d^-1腹腔注射6天;顺铂加黄芪组：腹腔注射黄芪5g&#183;kg^-1&#183;d^-1加顺铂4mg&#183;kg^-1&#183;d^-16天。用药前及用药后第7天行畸变产物耳声发射（DPOAE）检测,然后处死大鼠。每组半数动物冰冻连续切片,DNA末端转移酶介导的缺口末端标记法（TUNEL）检测毛细胞凋亡;半数动物扫描电镜观察毛细胞形态。结果顺铂组用药后DPOAE幅值下降,毛细胞受损,并可观察到凋亡细胞,与对照组及黄芪组比较差异具有显著统计学意义（P〈0．01）。顺铂加黄芪组用药后DPOAE幅值上升,毛细胞受损减轻,凋亡细胞数量减少,与顺铂组比较,差异有统计学意义（P〈0.05）.结论黄芪能有效保护耳蜗免受顺铂的耳毒性损伤。     

吸入糖皮质激素对变应性鼻炎大鼠鼻黏膜病理改变影响的实验研究

目的 探讨吸人性糖皮质激素对变应性鼻炎大鼠鼻黏膜病理改变的影响.方法 选健康SD大鼠180只,应用随机数字表法完全随机分成正常对照组(A组,60只)和实验组(120只).首先对实验组大鼠予以卵清蛋白(ovalbumin,OVA)进行基础致敏、致敏加强、局部激发建立变应性鼻炎动物模型,然后再将实验组动物完全随机分为B、C二组,每组60只.B组继续予以等浓度OVA双侧鼻腔滴鼻,每周2次;C组在予以等浓度OVA双侧鼻腔滴鼻每周2次的同时,每天予以丙酸氟替卡松每侧鼻腔50μl/,次,喷鼻1次,A组则以等量生理盐水代替进行腹腔注射及滴鼻.分别于治疗后第1、2、4、8、12、及16周末从各组中随机挑选10只进行处死,其中1只行鼻黏膜微血管铸型,其余9只立即取鼻黏膜送病理检查,以观察鼻黏膜形态学改变、微血管铸型情况.结果 大鼠接受变应原激发后,鼻黏膜出现柱状上皮杯状细胞化生,部分细胞剥脱,固有层腺体增生肥大、嗜酸粒细胞为主的炎症细胞浸润及血管增多;电镜下见上皮层纤毛不同程度脱落,排列欠整齐,基底膜板层网状结构增厚,胶原沉积及纤维增生,微血管密度增加,血管迂曲,粗细不一,并交织成网状.B组由于持续变应原接触,鼻黏膜病变进一步加重;C组吸入糖皮质激素后可有效控制临床症状,但鼻黏膜仍有纤毛脱落,上皮细胞杯状细胞化生,腺体增生及炎性细胞浸润,基底膜增厚,胶原沉积及纤维增生,微血管密度增加.结论 变应性鼻炎可导致鼻黏膜发生病理改变,接触时间越长,病变越明显.糖皮质激素可较好地控制变应性鼻炎的症状,在一定程度上可减轻鼻黏膜的病理改变,但对已经发生不可逆性改变的黏膜结构无逆转或明显的修复作用.     

经鼻给药对鼻粘膜结构的影响

目的研究药物经鼻吸收时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周取鼻粘膜进行光学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。     

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.     

丹参对庆大霉素耳毒性的减毒作用

目的　为探讨丹参对庆大霉素耳毒性的减毒作用。方法　将 2 4只沙鼠分为 4组 ,每组 6只 ,①生理盐水对照组。②丹参组 (SA)。③庆大霉素加丹参组 (GM SA)。④庆大霉素组 (GM)。所有药物均经肌肉注射 ,GM组和GM SA组每天注射庆大霉素 15 0mg/kg ,共 10d ;GM SA组和SA组同时注射丹参 2 g/kg ,共 10d ;生理盐水组每天注射生理盐水 2ml/kg ,共 10d。在注射前和注射后 4周和 8周进行CAP检测 ,第 8周听力测定后处死动物行扫描电镜检查。结果　 4周和 8周GM组高频CAP阈明显上升 ,而GM SA组听阈明显低 ,统计学处理有显著差异 (P <0 .0 1,t检验 ) ;GM组毛细胞损伤率底圈和第二圈分别为 35 %和 30 % ,GM SA组分别为 9%和 7% ,差异非常显著 (P <0 .0 1,χ2 检验 )。结论　丹参能明显降低庆大霉素对沙鼠的耳毒性作用 ,且不降低血液中庆大霉素的浓度。电生理检测结果与形态学变化一致。     

缺血对大鼠嗅球影响的实验研究

目的：观察成年大鼠嗅球缺血性损伤后的病理改变,探讨缺血对嗅觉的影响。方法：选取40只成年SD大鼠（体重250-300g）,分成对照组、实验组（1周组、1月组、2月组）,每组10只。将实验组大鼠双侧颈总动脉结扎造成缺血,分别在1周、1个月、2个月时处死,光镜下观察嗅球病理改变,透射电镜下观察嗅球内细胞超微结构的变化。结果：光镜下可见实验组大鼠嗅球僧帽细胞胞核深染、颗粒细胞数目减少。透射电镜下1周组大鼠嗅球内僧帽细胞线粒体破坏,细胞变性、坏死;1月组僧帽细胞退行性变,神经纤维髓鞘断裂、板层脱落。结论：缺血可损伤神经细胞和神经纤维,可能造成或加重嗅觉障碍。     

A comparison of the efficacy of 5-fluorouracil/triamcinolone, carnitine and dexamethasone therapy on wound healing in tracheal injury: potential for preventing tracheal stenosis?

The aim of the study was to investigate the efficacy of 5-flourouracil/triamcinolone acetonide (5-FU/TA), carnitine and dexamethasone on wound healing in an animal model of tracheal injury. Twenty-eight rats underwent surgical injury of the tracheal mucosa and perichondrium under general anesthesia, and were randomized into four groups. Group I (the control group) received nothing after tracheal trauma. Group II received intratracheal 5 mg 5–FU/TA combined with 0.2 ml sodium hyaluronic acid once. Group III received intraperitoneal carnitine 100 mg/kg/day for 20 days. Group IV received intramuscular dexamethasone 0.1 mg/day for 20 days. After 1 month, the levels of superoxide dismutase enzyme activity (SOD) and levels of malondialdehide (MDA) and nitric oxide (NO) in serum were measured and the tracheal specimens were harvested for histopathologic examination. SOD was significantly lower in the carnitine group compared to the control group. A statistically significant decrease in MDA levels were observed in the 5-FU/TA and carnitine groups compared to the control group. NO levels were significantly lower in the 5-FU/TA group, but significantly higher in the dexamethasone group, compared to the control group. The fibrotic tissue volumes of tracheal specimens were significantly lower in both the 5-FU/TA and carnitine groups than those of the control group, but trended toward higher volumes in the dexamethasone group when compared to controls. We concluded that 5-FU/TA and carnitine diminish the occurrence of tracheal stenosis (TS) secondary to experimentally induced tracheal trauma.