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。     

蛋白激酶C抑制剂对离体鼻息肉组织中嗜酸粒细胞凋亡的影响

目的　研究蛋白激酶C(proteinkinaseC ,PKC)抑制剂对鼻息肉组织嗜酸粒细胞凋亡的作用。方法　用细胞培养的方法 ,观察研究PKC抑制剂——— 1 (5 异喹啉硫酰氨 ) 3 甲基哌嗪 [1 (5 lsoquinolinyl sulfony) 3 methylpiperazinedihydrochloride ,Iso H7]对鼻息肉组织嗜酸粒细胞凋亡的影响 ,即将鼻息肉组织分为 2组 ,实验组在培养液中加不同浓度 (10 -6,10 -4,10 -2 mol/L)的抑制剂———Iso H7,分别在培养后的第 1、3、5天 ,各取出 1块 ,常规石蜡包埋 ,连续切片 ,用末端脱氧核苷酸转移酶介导的d UTP缺口末端标记法 (terminal deoxynucleotidyltransferased UTPnickendlabeling ,TUNEL)、凋亡原位杂交和MGG(May GrunwaldGiemsa)双染进行嗜酸粒细胞凋亡指数测定 ;对照组不加PKC抑制剂。结果　①培养第 1天各浓度下的 2组标本均偶见凋亡的嗜酸粒细胞 ,培养到第 3天 ,实验组可见大量的嗜酸粒细胞凋亡 ,对照组第 1天与实验组第 1天比较嗜酸粒细胞凋亡指数差异无显著性 (t=1 72 0 0 ,P >0 0 5 ) ;②在实验组中 ,培养第 1天凋亡的嗜酸粒细胞与第 3天比较差异有显著性 (t=7 0 2 5 6 ,P <0 0 0 1) ,实验组第 3天与第 5天比较差异无显著性 (t=0 93995 ,P >0 0 5 ) ,但可见部分凋亡的嗜酸粒细胞膜破裂。结论     

红霉素促进鼻息肉上皮细胞凋亡的实验研究

目的：观察红霉素对上皮细胞凋亡的影响,探讨上皮细胞凋亡在鼻息肉组织形成中的意义。方法：将30例鼻息肉及6例下鼻甲上皮细胞均分成2组,1组加红霉素,培养原代上皮细胞,另1组不加红霉素,1、3、5?d时用TUNUL法检测细胞凋亡。结果：红霉素组培养1、3、5?d的上皮细胞凋亡指数分别为（33.23±6.50）%、（38.21±7.22）%和（52.63±7.86）%,不加红霉素组为（31.02±5.60）%、（32.13±7.15）%和（39.64±7.48）%,培养5?d的上皮细胞凋亡指数两组间差异有统计学意义（P＜0.05）。结论：红霉素有明显的促鼻息肉上皮细胞凋亡的作用。     

红霉素干预对人鼻息肉上皮细胞凋亡的影响

目的观察红霉素对体外培养的鼻息肉上皮细胞B细胞淋巴瘤-2基因(B cell lymphomas-2,Bcl-2)和Bcl-2相关X蛋白(Bcl-2 associated X protein,Bax)表达的影响,探讨上皮细胞凋亡在鼻息肉组织形成中的意义。方法将30例鼻息肉及15例下鼻甲组织均分成两组,分别对其上皮细胞进行原代培养,其中一组加入红霉素。培养第1、3、5天应用末端脱氧核苷酰转移酶介导的脱氧尿苷三磷酸原位缺口末端标记法(the TdT-mediated dUTP nick end labeling,TUNEL)检测细胞凋亡情况,并用免疫组化法检测细胞凋亡基因Bax、抑凋亡基因Bcl-2的表达。结果①鼻息肉红霉素组培养第1、3、5天的上皮细胞凋亡指数(用x±s表示,下同)分别为(33．23±6．50)％、(36．14±3．21)％和(52．63±7．86)％,对照组(不加红霉素组)为(31．02±5．60)％、(33．88±4．02)％和(39．64±7．48)％,培养第5天的上皮细胞凋亡指数红霉素组与对照组差异有统计学意义(t=4．480, P<0．05)。②鼻息肉上皮细胞Bcl-2和Bax表达均显著强于下鼻甲组织(P<0．01);培养第5天鼻息肉上皮细胞红霉素组Bax表达显著强于对照组(t=8．734,P<0．05),Bcl-2表达虽强于对照组,但差异无统计学意义;下鼻甲上皮细胞红霉素组与对照组的Bcl-2与Bax阳性表达差异均无统计学意义(P均>0．05);红霉素干预第5天鼻息肉上皮细胞显示明显的凋亡趋势(P<0．05)。结论红霉素能显著提高Bax蛋白的表达,有显著的促鼻息肉上皮细胞凋亡的作用。     

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。     

平阳霉素局部注射对鼻息肉病息肉组织中嗜酸性粒细胞凋亡的影响

目的 :通过观察平阳霉素治疗前后鼻息肉病鼻息肉组织中嗜酸性粒细胞凋亡情况 ,探讨平阳霉素治疗鼻息肉病的机制。方法 :平阳霉素 4mg息肉内注射 ,每周 1次 ,5次为 1个疗程 ;应用末端脱氧核苷酸转移酶介导的脱氧三磷酸尿苷缺口末端标记法 (TUNEL法 )检测凋亡细胞 ,与相邻连续的苏木精 伊红染色片对位对照观察嗜酸性粒细胞的凋亡情况。结果 :治愈 7例 ,好转 12例 ,治愈率为 36 .8% ,好转率为 6 3.2 % ;平阳霉素治疗前鼻息肉病组嗜酸性粒细胞表达 [(35 .0 3± 19.90 )个 ]显著高于对照组 [(5 .2 1± 6 .4 3)个 ](P <0 .0 1) ;治疗后鼻息肉病组嗜酸性粒细胞表达 [(7.6 4± 1.4 2 )个 ]明显低于治疗前 (P <0 .0 1) ;治疗后鼻息肉病组嗜酸性粒细胞AI[(4 4 .4 7± 8.97) % ]高于治疗前 [(2 0 .5 3± 7.6 6 ) % ](P <0 .0 1)。结论 :嗜酸性粒细胞是鼻息肉病鼻息肉组织中主要的浸润炎性细胞 ;平阳霉素可通过促进嗜酸性粒细胞凋亡达到治疗鼻息肉病的目的。     

糖皮质激素诱导鼻息肉中嗜酸性粒细胞凋亡的体内和体外研究

目的：观察糖皮质激素在体内和鼻息肉中嗜酸性粒细胞凋亡的影响,加深对糖皮质激素治疗鼻息肉作用机制的认识。方法：采用末端脱氧核苷酸转移酶介导的dUTP末端标记法标记鼻息肉中的凋亡嗜酸性粒细胞。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,嗜酸性粒细胞的凋亡状况。同时将未经治疗的鼻息肉组织取出,体外培养2、6和10天,观察地塞米松对体外培养的鼻息肉中嗜酸性粒细胞凋亡的影响。结果：（1）随培养时间的延长,地塞米松体外培养的鼻息肉组织中的凋亡嗜酸性粒细胞明显增多,而对照培养的鼻息肉组织中,至培养10天,也仅见散在凋亡嗜酸性粒细胞。（2）培养2天和6天时,地塞米松培养组嗜酸性粒细胞凋亡比率均明显高于对照培养组（P＜0．01）,至培养10天时,二者无显著差异（P＞0．05）。（3）鼻腔布地奈德治疗后的鼻息肉组织中未见凋亡嗜酸性粒细胞。结论：体外研究证实了糖皮质激素类药物诱导嗜酸性粒细胞凋亡理论在炎性反应消散机制中的作用,但体内研究却未观察到预期的结果。     

红霉素对体外培养人鼻息肉上皮细胞凋亡的影响

目的：观察红霉素对上皮细胞凋亡的影响,进一步探讨上皮细胞凋亡在鼻息肉组织形成中的意义。方法：将30例鼻息肉及6例下鼻甲的上皮细胞均分成2组,其中1组加红霉素（红霉素组）,另一组不加红霉素（对照组）,进行原代上皮细胞的培养,1、3、5d后应用TUNUL法检测细胞凋亡。结果：红霉素组培养1、3、5d的上皮细胞凋亡指数分别为（33．23±6．50）％、（38．21±7．22）％和（52．63±7．86）％,对照组为（31．02±5．60）％、（32．13±7．15）％和（39．64±7．48）％,培养5d的上皮细胞凋亡指数差异有统计学意义（P〈0．05）。结论：红霉素有显著的促鼻息肉上皮细胞凋亡的作用。     

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     

白细胞介素-5及嗜酸性粒细胞在鼻息肉中的相关性研究

目的探讨白细胞介素-5(IL-5)在鼻息肉中的表达及其在鼻息肉形成与发展中的作用。方法采用双抗体夹心酶联免疫吸附测定法检测31例鼻息肉患者、11例慢性鼻窦炎患者及6例正常人组织匀浆中IL-5含量;对15例鼻息肉、11例慢性鼻窦炎及6例正常人进行HE切片染色,以观察组织中嗜酸性粒细胞的数量。结果①鼻息肉、慢性鼻窦炎及正常对照组IL-5含量(pg／mg)分别为23．44±6．68,16．41±3．09,12．86±4．17,鼻息肉组织IL-5含量高于慢性鼻窦炎及正常对照组(P<0．01)。②鼻息肉、慢性鼻窦炎及正常对照组的苏木精伊红染色嗜酸性粒细胞数分别为7．42±2．33,1.30±0．59,1．07±0．70,鼻息肉组嗜酸性粒细胞数高于慢性鼻窦炎和正常对照组(P<0．05)。结论鼻息肉是以嗜酸性粒细胞浸润为特征的疾病过程,对嗜酸性粒细胞有活化作用的IL-5对鼻息肉的形成起着一定的作用。     

Efficacy of Curcumin in the healing of paracentesis in rats

Objectives

The present study was designed to investigate the possible beneficial effect of Curcumin (CMN) in healing of paracentesis in terms of wound thickness, sclerosis and closure by histological evaluation. To evaluate the efficacy of CMN, paracentesis was performed experimentally in the rats; and the results were presented histologically.

Methods

Sixteen, each 270–310 g weighted, healthy Sprague-Dawley female rats were included into the study. In both groups, paracentesis was performed into the eardrum bilaterally. In Group 1 (Paracentesis + Saline Group), saline drop was applied; and in Group 2 (Paracentesis + Curcumin group), Curcumin drop treatment was applied. Paracentesis area did not healed bilaterally in two rats (one in Group 1 and one in Group 2). Therefore, these two rats were excluded from the study. Histological examination performed in 14 rats and 28 temporal bones on the 15th day after the completion of drop treatment and closure of the paracentesis-area and wound healing were evaluated according to the histological examination criteria: Thickening of the tympanic membrane (ThicTM); and sclerosis.

Results

Both tympanic membrane thickening and sclerosis values of Paracentesis + Curcumin Group (Group 2) were significantly lower than those of the Paracentesis + Saline Group's (median: 2.0) (p = 0.001). Histological examination by light microscopy showed that in Paracentesis + Curcumin Group (Group 2), the structure of the tympanic membrane is near to the normal and decreased sclerosis was observed in connective tissue. Whereas in Paracentesis + Saline Group (Group 1), tympanic membrane thickening and connective tissue sclerosis were observed.

Conclusions

Curcumin improves wound healing process in paracentesis of TM. By using Curcumin drops, the closured paracentesis area was observed near to the normal eardrum; and thickness of the TM and sclerosis were less than the control, showing the improved healing at 15th day. The possible mechanisms may be anti-inflammatory effect, improving collagen deposition, and increasing fibroblast and vascular density in wounds thereby enhancing impaired wound healing.     

电子鼻咽喉镜在小儿腺样体肥大诊治中的应用

目的 探讨电子鼻咽喉镜在小儿腺样体肥大诊治中的应用。方法 对578例具有上气道阻塞症状的患儿（病例组）采用电子鼻咽喉镜检查，分析腺样体增大程度与上气道阻塞的关系及其可行性。结果 ①本组病例中，411例能主动配合，119例稍有哭闹，仅48例是在协助固定体位下进行。②14例因鼻中隔偏曲导致一侧后鼻孔和鼻咽部无法检查，5例因双侧鼻腔狭窄无法检查，其余559例均可检查。③559例均有不同程度的腺样体增大。④29例在检查中出现鼻黏膜少量出血，未引发其他并发症。结论 电子鼻咽喉镜检查适合于小儿，该法直观、准确、安全，是判断小儿腺样体肥大最有效、最直观的检查方法。Ⅳ°腺样体是小儿上气道阻塞的主要病因，是手术治疗的适应证。     

我国汉族女性鼻整形手术的研究进展

随着鼻整形手术技术的发展,对填充材料的使用有了更多、更深刻的理解。近年来,我国整形外科的专家们,针对汉族女性鼻部的美学特征,以及不同填充材料的应用特点,设计了一系列更精确的手术方式,使鼻整形手术更趋完善。结合汉族女性的鼻部特点,对鼻背部整形、鼻尖部整形、鼻整形术后并发症及鼻整形材料的使用情况进行总结分析。     

食管异物摘取术的麻醉选择

为探讨食管异物摘取术的麻醉方法，提高手术效果，对７２例食管异物患者采用强化表面麻醉法和气管内插管麻醉法进行了手术和对比观察。７２例异物均取出顺利，无严重并发症发生。资料显示：两种麻醉各具优越性，前者适用于年龄较大的儿童和成人，后者适用于食管异物并呼吸困难的小儿。     

Apoptosis in the pathogenesis of cholesteatoma in adults

The aim of this study was to determine the distribution and apoptotic capacity in the various layers of cholesteatoma epithelium compared to the normal skin. Cholesteatomas were collected during surgical procedures of the ear. Normal skin specimens taken from the retroauricular area served as controls. Apoptosis was detected by using highly specific antibodies against APO2.7 antigen. The Membstain Apoptosis kit Direct based on in situ labeling of nuclear DNA fragmentation (Tolt-mediated dUTP nick and labeling TUNEL staining) was used. The distribution of apoptotic cells in the layer of the cholesteatoma epithelium and the epidermis was determined. The percentage of apoptotic cells was then counted per 100 cells of cholesteatoma epithelium and the normal epidermis in three different areas of each section and expressed in terms of mean ± SD. An automatic analyzing system was used for counting. In normal epidermis, the apoptotic cells were observed in the granular layer of the epidermis. The percentage of these cells was 28.5±8.1%. A significantly greater number of apoptotic cells was observed in the suprabasal layers of the cholesteatoma epithelium (47.39±6.2%). A statistically significant difference was obtained for APO2.7-positive cells in the cholesteatoma epithelium as compared to the skin (P<0.05) as determined by Students t-test and the Mann-Whitney U test. Apoptotic activity is mainly observed in the suprabasal layer of cholesteatoma epithelium. It is not seen in the basal layer. Apoptosis plays an important role in the pathogenesis of cholesteatoma. It seems to be part of the differentiation and accumulation of keratin debris within the middle ear and expansion of cholesteatoma.     

Use of tympanometry in general practice in Denmark

Objectives

Otitis media has been a serious disease and can be that even today. The diagnosis of otitis media is often difficult. Pneumatic otoscopy, otomicroscopy, and tympanometry can improve the diagnostic quality by indication of fluid in the middle ear and thereby improve the quality of treatment. The aim of this ongoing study is to analyze the use of tympanometry in Denmark after reimbursement for doing tympanometry (November 2006) when clinically indicated. Our research questions were: How many clinics were using tympanometry? How frequent was it used? Is the use increasing? Has the number of GPs in the clinic any relation to the use of tympanometry?

Method

We used information in The Danish National Health Service in three Regions to analyze the use of tympanometry in general practice during the years 2007–2009. The coverage of the GPs is 100% in the regions.

Results

The three regions counted about half of Danish population. In 2009 the material was 902 different clinics with more than 1700 GPs. In 2007 55% of the clinics did tympanometry, in 2009 the figure was 60%. In the clinics doing tympanometry the median value was 28 tympanometries per year (inter-quartile range 13–53) per GP. The variation in the use of tympanometry was surprisingly high, from none or a few per GP per year to a maximum of more than 500 tympanometric examinations per GP a year. This huge variation has to be discussed.

Discussion

Many answers can be given. Some of the explanation was problems in doing correct tympanometry, and problems understand the clinical implications of curves and the figures.     

Results of an evaluation of clinical practice in orthognathic surgery in France in 2002

BACKGROUND: Over the years, orthognathic surgery has become a mainstay of maxillofacial surgery and is the object of many publications and oral communications. However, in spite of well-established methodology, disparities still exist in France basically concerning the way orthognathic surgery is performed. MATERIALS AND METHODS: In relation with the XXXIXth congress of Stomatology and Maxillofacial surgery, a questionnaire was mailed to 100 French maxillofacial surgeons. Questions dealing with some practical points of orthognathic surgery (condylar positioning, osteosynthesis technique, rate of condylar resorption.) were asked. RESULTS: Overall reply rate was 37%. Condylar positioning was performed empirically in 73% of the cases. Mandibular osteosynthesis was achieved by titanium miniplates alone in 70%. Post-operative condylar resorption rate was about 2%. This survey produced numerous astute comments. DISCUSSION: This survey highlighted the interest of maxillofacial surgeons for practical aspects of orthognathic surgery including the questions of condylar positioning or osteosynthesis technique. These points are instrumental in achieving high-quality surgical result.     

立体放射治疗技术在听神经瘤治疗中的应用进展

听神经瘤(Vestibular Schwannomas,VS)是最常见的桥小脑角肿瘤,目前发病率正逐年提升。立体放射治疗(Stereotactic Radiosurgery,SRS)技术作为手术的替代疗法近年来在VS的治疗中体现出了巨大的潜力和优势。本文将针对近年来SRS技术在VS治疗效果、适应证选择和治疗策略制定方面的进展加以综述。