鼻内镜手术治疗慢性鼻窦炎鼻息肉200例临床疗效

目的探讨鼻内镜手术治疗慢性鼻窦炎鼻息肉的临床疗效及影响手术疗效的相关因素。方法随机抽选2010年1月——2012年1月间于我院行鼻内镜手术200例患者临床资料为回顾性分析依据。结果 I-Ⅲ型慢性鼻窦炎-鼻息肉治愈率分别为91.35%、84.31%.57.58%,三组患者治愈率经统计学分析显示P〈0.05（χ2=18.89）,I型1期、I型2期、II型1期、II型2期手术疗效显著,II型3期、Ⅲ型患者的手术疗效相对较差;坚持随访治愈率为86.88%,而未坚持随访组治愈率为70%,定期坚持随访组疗效优于未能定期随访组。结论鼻内镜手术为慢性鼻窦炎鼻息肉理想治疗方式,临床疗效与病症分期、手术操作技巧、术后护理有着密切关系,而术后定期随访则是保障手术远期疗效关键。     

鼻内镜手术治疗慢性鼻窦炎的临床疗效及其与临床分型的关系

目的:分析鼻内镜手术治疗慢性鼻窦炎的临床疗效及其与临床分型的关系.方法:选择我院2015年2月至2016年3月耳鼻喉科所收治的70例使用鼻内镜手术治疗慢性鼻窦炎的患者作为研究对象,将其随机分为实验组与常规组.实验组采用鼻内镜手术;常规组采用传统手术.独臂两组患者6个月时的临床疗疗效,以及不同临床分型的治疗效果.结果:在治疗6个月后,实验组患者的治疗总有效率(97.1%)明显高于常规组的治疗总有效率(85.7%),差异显著,具备统计学意义(P<0.05).I型与II型患者的治疗总有效率均显著高于III型,差异显著,具备统计学意义(P<0.05).结论:鼻内镜手术治疗慢性鼻窦炎的临床疗效显著,临床分型越高,疗效越差,应当按照临床分型的具体情况给予相应的早期干预,提高临床疗效.     

复发性慢性鼻窦炎鼻息肉的鼻内镜手术治疗的临床疗效分析

目的探讨鼻内镜手术用于复发性鼻窦鼻息肉的临床疗效。方法回顾性分析325例复发性慢性鼻窦炎鼻息肉患者采用鼻内镜手术治疗的临床效果及并发症情况,综合评价鼻内镜手术在复发性慢性鼻窦鼻息肉治疗的临床效果。结果 325例患者均实施鼻内镜手术,其中进行过1次鼻窦手术者157例,经鼻内镜手术治疗后,135例治愈,治愈率为85.99%;进行过2次鼻窦手术者93例,经鼻内镜手术治疗后,治愈69例,治愈率为73.91%,实施过3次鼻窦手术者52例,经鼻内镜手术治疗后,治愈31例,治愈率为59.61%,实施过4次鼻窦手术者23例,经鼻内镜手术治疗后,治愈11例,治愈率为47.83%。不同鼻窦手术患者经鼻内镜手术治疗的治愈率存在明显差异(P值均﹤0.05)。同时,随着鼻窦手术次数的增多,采用鼻内镜手术治疗后的并发症发生率亦增加。结论鼻内镜手术虽然能有效治愈复发性慢性鼻窦炎鼻息肉患者,但随着复发次数即鼻窦手术次数的增多,鼻内镜手术的治愈率呈下降趋势,因此应重视鼻内镜手术的术中处理及其围手术期治疗和术后规范的综合治疗,减少复发提高治愈率。     

鼻内窥镜治疗鼻窦炎鼻息肉疗效观察

目的 探讨鼻内窥镜手术治疗鼻窦炎鼻息肉的疗效.方法 对笔者所在医院2008年10月～2010年10月应用鼻内窥镜手术治疗慢性鼻窦炎、鼻息肉患者86例,其中Ⅰ型24例（27.91%）,Ⅱ型55例（63.95%）,Ⅲ型7例（8.14%）,术后随访6～12个月.结果 Ⅰ型治愈率为95.83%,Ⅱ型治愈率为85.45%,Ⅲ型治愈率为71.43%.结论 鼻内窥镜鼻窦手术是治疗慢性鼻窦炎鼻息肉的有效方法.     

FESS手术治疗青少年慢性鼻窦炎临床疗效探讨

[目的]探讨慢性鼻窦炎行鼻内镜手术的疗效。[方法]对350例慢性鼻窦炎患者进行鼻窦CT扫描检查,确定手术方案,行鼻内镜手术(FESS)。[结果]按ESS疗效评定海口标准,治愈275例,治愈率78.6%,好转75例,有效率21.4%,总有效率100%。[结论]对慢性鼻窦炎保守治疗无效者,行鼻内镜手术(FESS),并发症少,治愈率高,疗效满意,有临床推广价值.     

鼻内镜手术结合术后氟康唑冲洗治疗非侵袭性真菌性鼻窦炎疗效观察

目的探讨鼻内镜手术结合术后氟康唑冲洗治疗非侵袭性真菌性鼻窦炎的疗效。方法总结1997-2006年本科采用鼻内镜手术（ESS）治疗非侵袭性真菌性鼻窦炎87例,术后分别进行0.2%氟康唑溶液和0.5%甲哨唑溶液冲洗,观察分析其临床疗效。结果治疗组（鼻内镜手术＋术后0.2%氟康唑溶液冲洗）的治愈率77.3%,对照组（鼻内镜手术＋术后0.5%甲哨唑溶液冲洗）的治愈率44.2%,有差异有统计学意义（P〈0.01）。结论鼻内镜手术结合术后氟康唑冲洗是治疗非侵袭性真菌性鼻窦炎比较理想的方法。     

鼻内窥镜手术治疗慢性鼻窦炎鼻息肉的疗效观察

目的 探讨鼻内窥镜鼻窦手术治疗慢性鼻窦炎鼻息肉的疗效及手术并发症.方法 对2004年2月～2006年8月完成随访的50例鼻内窥镜鼻窦手术进行临床分析.50例中Ⅰ型14例(28.0%),Ⅱ型32例(64.0%),Ⅲ型4例(8.0%).其中30例全麻,20例局麻.术后随访6～12月.结果 Ⅰ型治愈率为85.8%,Ⅱ型治愈率为75.0%.Ⅲ型治愈率为0.手术并发症的发生率为12.0%.结论 鼻内窥镜鼻窦手术是治疗慢性鼻窦炎鼻息肉的有效方法 .     

鼻内镜手术治疗鼻窦炎及鼻息肉61例分析

目的?探讨鼻内镜手术治疗鼻窦炎、鼻息肉的临床疗效.方法?采用回顾分析的方法,对我科2009年9月—2011年9月间经鼻内镜手术治疗的61例鼻窦炎、鼻息肉患者临床资料及术后随访治疗效果的情况进行研究.结果?治愈54例(88.5%),好转5例(8.2%),无效2例(3.3%),总有效率为91.3%.手术无严重的并发症发生.结论?鼻内窥手术治疗鼻窦炎、鼻息肉能彻底清除鼻道窦口复合体的病变组织,开放鼻窦窦口,保证窦口和鼻窦保持永久通气,治疗效果良好,能有效降低慢性鼻窦炎及鼻息肉的复发率.充分的术前准备,合理选择麻醉方式,术后合理地定期鼻内镜复查可提高临床治愈率.     

鼻内镜手术治疗老年非侵袭型真菌性鼻窦炎

目的探讨鼻内镜手术治疗老年非侵袭型真菌性鼻窦炎的疗效。方法对20例老年非侵袭型真菌性鼻窦炎患者行鼻内镜手术治疗,充分开放鼻窦,彻底清除病变组织,术后冲洗术腔并定期行鼻内镜检查。结果 20例患者中,18例一次手术治愈,2例复发,再次行鼻内镜手术后痊愈,随访6个月～3年。结论鼻内镜手术治疗老年非侵袭型真菌性鼻窦炎,损伤小,全身并发症少,治愈率高,是一种安全有效的治疗方法。     

鼻内镜治疗非侵袭性真菌性鼻窦炎32例的体会

目的 探讨鼻内镜治疗非侵袭性真菌性鼻窦炎的疗效.方法 对笔者所在医院2009年6月～2011年6月32例非侵袭性真菌性鼻窦炎行鼻内镜治疗,对治疗过程进行分析总结.结果 32例患者全部治愈,治愈率为100%,其中一次性治愈29例,一次治愈率为90.62%,1例上颌窦炎和2例蝶窦炎术后复发,给予再次手术后治愈.结论 根据病情选择鼻内镜手术治疗非侵袭性真菌性鼻窦炎可获得满意疗效.     

抑癌基因PML在宫颈病变组织中的表达

目的 探讨抑癌基因早幼粒细胞性白血病基因(promyelocytie leukemia,PML)在宫颈病变组织中表达量的变化.方法 选取以下宫颈病变新鲜组织标本,包括宫颈上皮内瘤样病变Ⅰ级(Cervical Intraepithelial Neoplasia,CIN I)28例、CIN Ⅱ 20例、CIN Ⅲ26例、宫颈原位癌18例、宫颈浸润鳞癌Ⅰ期21例、Ⅱ期21例、Ⅲ期6例、Ⅳ期2例、复发性宫颈癌2例(包括宫颈癌腹腔转移组织1例)以及因其他疾病切除子宫病理证实为慢性宫颈炎者30例.用免疫组化的方法检测PML在各种宫颈病变组织中的表达量.结果 PML的表达量随着宫颈病变严重程度的增加而增加(x2=113.02,P＜0.00、r=0.26,P＜0.00).结论 PML的表达与宫颈病变的严重程度呈正相关.     

空气细颗粒物与慢性鼻窦炎组织形态学相关关系的初探

目的 探讨空气颗粒物与慢性鼻窦炎(CS)组织形态学改变的关系。方法 收集CS Ⅰ、Ⅱ、Ⅲ型筛窦病变黏膜组织共60例、正常筛窦黏膜对照组织16例、成人及胎儿尸检肺组织各5例。对上述标本分别行HE染色及Warthin-Starry(W-S)空气颗粒物特殊染色,另对CSⅠ、Ⅱ、Ⅲ型病变黏膜行VG染色显示并测量基底膜的厚度。结果W-S染色发现,在各型CS病变黏膜上皮表层及损伤脱落处细胞内均有黑色空气颗粒物沉积。颗粒沉积的程度在CSⅠ、Ⅱ、Ⅲ型间逐渐加重,轻、中、重度沉积的例数:Ⅰ型分别为11/20、7/20、2/20例;Ⅱ型分别为5/20、9/20、6/20例;Ⅲ型分别为3/20、6/20、11/20例。颗粒沉积程度越重,其基底膜越厚,Ⅰ、Ⅱ、Ⅲ型基底膜厚度分别为(12.15±4.73)、(16.67±2.22)、(23.75±3.48)μm,3型之间的差异有统计学意义(P<0.01)。没有损伤的黏膜上皮细胞及对照组正常筛窦黏膜上皮层内极少见到此空气颗粒物。结论 在CS病变黏膜上皮表层及细胞内存在空气颗粒物,此颗粒物的存在与CS病变的发生可能有关。     

Molecular analysis of the SMN1 and NAIP genes in 60 Tunisian spinal muscular atrophy patients

In this study we examined the deletion of SMN and NAIP genes in 60 Tunisian families. There were 35 patients with type I SMA. 18 with type II SMA. 6 with type III SMA and I with type IV SMA. The age of onset was before 6 months for type I, between 6 months and 2 years for type II, between 2 years and 17 years for type III and 30 years for type IV. Exon 7 of SMNI gene was homozygously deleted in 95% (57/60) of SMA patients. There was a higher frequency of homozygous absence of SMN1 in type I and type II (100% and 94% respectively) than in type III (66,7%). SMN1 exon 8 was undetectable in 88% (53/60) of patients. The case type II patient with homozygous deletion of SMNI exon 7 and not exon 8 was tested for the presence of a hybrid SMN gene. This patient showed in the second PCR a SMN1 exon 8 product by restriction site assay indicating that a gene conversion event had occurred. All parents' individuals retained one copy of their SMN1 gene. Exon 5 of NAIP gene was homozygously deleted in 58% (35/60) of patients (77% in type I (27/35), 27,7% in type II (5/18), 50% (3/6) in type III. No patient had a deletion in NAIP gene without a deletion in the SMN1 gene. Homozygous deletion of NAIP exon 5 was detected in 1 parent. Our results show that the incidence of NAIP deletion is higher in the more severe SMA cases.     

200例鼻内镜鼻窦手术临床观察和分析

目的 研究鼻窦炎鼻息肉的不同分型、手术方式和术后处理等因素对手术疗效的影响.方法对200例慢性鼻窦炎鼻息肉患者行内窥镜鼻窦手术,分析术后疗效,术后1年内随访.结果Ⅰ型治愈率为94.38%（84/89）,Ⅱ型治愈率为78.67%（59/75）,Ⅲ型治愈率为61.11%（22/36）,三型之间治愈率的差异有统计学意义（χ2=21.54,P＜0.01）.结论术前对疾病的分型和术中对内窥镜鼻窦手术术式的选择是治愈的关键,而围手术期合理使用抗生素、脱敏药物,可促进术后伤口的愈合、有效减少术后复发,提高手术的治愈率.     

抑癌基因PML在宫颈病变组织中的表达

目的探讨抑癌基因早幼柱细胞性白血病基因（promyelocytie leukemia,PML）在宫颈病变组织中表达量的变化。方法选取以下宫颈病变新鲜组织标本,包括宫颈上皮内瘤样病变I级（cervieal Intraepithelial Neoplasia,CINI）28侧、CINII20倒、CINIII26例、宫颈原位癌18例、宫颈浸润鳞癌I期2l例、Ⅱ期21例,m期6例,IV期2例、复发性宫颈癌2例（包括宫颈癌腹腔转移组织1例）以及因其他疾病切除子宫病理证实为慢性宫颈炎者30例。用免疫组化的方法检测PML在各种宫颈病变组织中的表达量。结果PML的表达量随着宫颈病变严重程度的增加而增加（χ^2=113．022,P=〈0．00,r=O．262,P〈0．00）。结论PML的表达与宫颈病变的严重程度呈正相关。     

p27kip1蛋白在宫颈癌及癌前病变中的表达及临床意义

目的:探讨宫颈癌及癌前病变组织中p27kip1蛋白的表达情况及临床意义。方法:采用免疫组化S-P法检测32例宫颈正常鳞状上皮、70例宫颈上皮内瘤样病变(CINⅠ22,CINⅡ24,CINⅢ24)、47例宫颈浸润癌中p27kip1蛋白的表达,分析宫颈癌形成过程中p27kip1蛋白表达的变化以及p27kip1蛋白表达与宫颈癌临床病理特征的关系。结果:p27kip1蛋白在CINIII及宫颈浸润鳞癌中表达平均阳性细胞百分率分别为37.1%,14.3%,显著低于宫颈正常鳞状上皮和CINⅠ、Ⅱ(分别为58.0%,65.9%,62.1%),有统计学意义(P<0.0001)。p27kip1蛋白在不同组织类型、分化程度、临床期别、有无淋巴转移的宫颈浸润癌中的表达无统计学差异。结论:p27kip1蛋白表达下降可能在宫颈细胞的恶性转化过程中起重要作用,为宫颈癌变的早期信号。     

Determining factors in mitral valve reconstructive surgery. Report of 150 cases

150 patients had mitral valve repair for mitral valve incompetence. There were 57 males and 93 females with a mean age of 22 years. 60% of the patients were in Class II NYHA and 40% in Class III and IV. Type I was present in 18 patients, type II in 98 and type III in 34 cases. Mitral repair included correction of valve prolapse, valvular enlargement with pericardial patch and annuloplasty with semi-rigid ring in 128 cases and PTFE patch along the posterior leaflet in 12 cases. The perioperative mortality rate was 2.6%. All patients had early post-operative echocardiography. According to this, mitral regurgitation was absent or tiny in 135 patients, grade II in 10 cases and grade III in 2 cases. It was moderate or important in twelve patients. In the late post-operative period. All the others patients were reoperated upon for mitral dysfunction in a mean time of 37 months. The reason for reoperation was in the majority of the cases the recurrence of mitral regurgitation related to increase of valvular and sub valvular disease. The late mortality rate is 7%. Out of 126 reviewed survivors on the long run, 71 patients are asymptomatic in class I, 53 patients in class II and 2 patients in class III NYHA. The estimated mitral regurgitation by echography in those patients is absent or trivial in 96 cases. grade II in 29 cases and grade III in one case. Mitral valvuloplasty is the preferred procedure in mitral insufficiency surgical management. It is associated to a low early mortality and morbidity rate. Despite the need for reoperation in about 10% of the cases in the long follow-up, mitral repair offers a good quality of life without anticoagulant treatment.     

Prevalence of hepatitis C virus genotypes in southern Italy

HCV is ubiquitous. In 50% of all cases it causes chronic hepatitis that often evolves into liver cirrhosis and hepatocellular carcinoma. Recently HCV has been classified in 5 genotypes by Okamoto. The purpose of this study is to evaluate the prevalence of 5 genotypes in Campania, a region of Southern Italy, where the prevalence of anti-HCV antibodies ranges from 0.87 to 4%, and to evaluate the correlation between the HCV genotypes and the severity of histological damage. One hundred and thirty-five anti-HCV positive patients were enrolled and tested by PCR to identify HCV-RNA. One hundred and twenty-four patients resulted HCV-RNA positive. Genotyping was performed as described by Okamoto et al. with minor modifications of the specific primer to type III proposed by Silini et al. Eight patients were negative for all genotypes. Eight patients were positive for type I(1a), 61 for type II(1b), 39 for type III(2a), 11 for type IV(2b) and 1 for type V(3a). In 4 cases two different genotypes were present in the same sample [II(1b)-IV(2b), III(2a)-II(1b) twice, III(2a)-IV(2b)]. Histological evaluation of liver damage showed: CPH (22 cases), minimal CAH (56), severe CAH (31) and liver cirrhosis (15). There was no statistically significant correlation between the 5 genotypes and the severity of histological damage. Data on the prevalence of genotype II(1b) in Italy are similar to those reported for other European countries. The prevalence of genotypes in Southern Italy is similar to that reported in the population of Northern Italy.     

Relevant factors in mitral valve reconstructive surgery. Report of 150 cases

150 patients had mitral valve repair for mitral valve incompetence. There were 57 males and 93 females with a mean age of 22 years, 39% were less than 15 years of age. 60% of the patients were in Class II NYHA and 40% in Class III and IV. According to Carpentier's classification, isolated type I was present in 18 patients (12%), type II in 98 patients (64%) and type III in 34 cases (24%). Mitral repair included correction of valve prolapse, valvular enlargement with pericardial patch and annuloplasty with semi-rigid ring in 128 cases and PTFE patch along the posterior leaflet in 12 cases. The perioperative mortality rate was 2.6% (4 patients). All patients had early post-operative echocardiography. According to this, mitral regurgitation was absent or tiny in 135 patients (92%), grade II in 10 cases and grade III in 2 cases. It was moderate or important in twelve patients (8%). In the late post-operative period, three patients were lost to follow-up. All the others patients were reoperated upon for mitral dysfunction in a mean time of 37 months. The reason for reoperation was in the majority of the cases the recurrence of mitral regurgitation related to increase of valvular and sub valvular disease. The late mortality rate is 7% (10 patients). Out of 126 reviewed survivors on the long run, 71 patients (56%) are asymptomatic in class I, 53 patients (42%) in class II and 2 patients in class III NYHA. Mitral valvuloplasty is the preferred procedure in mitral insufficiency surgical management. It is associated to a low early mortality and morbidity rate. Despite the need for reoperation in about 10% of the cases in the long follow-up, mitral repair offers a good quality of life without anticoagulant treatment.     

Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major abdominal surgery

BACKGROUND & AIMS: It is hypothesized that provision of pre- and/or postoperative omega-3 fatty acids to surgical patients in clinical routine improves clinical outcome. METHODS: Retrospective evaluation of a 2-year-longitudinal data base of ICU patients (n=249) elected for major abdominal surgery. Group I (n=110): postoperative standard parenteral nutrition (1.2 g amino acids, 0.3 g glutamine dipeptide, 0.6 g lipids, 4 g/kg glucose; energy ratio glucose to lipid 2:1); group II (n=86): part of postoperative lipid emulsion replaced by fish oil; group III (n=53): in addition 2-3 days preoperative fish oil supplementation (max. 100 ml/d). RESULTS: A decrease in mortality was observed in group III compared to group I (P=0.02). The number of patients requiring mechanical ventilation was lower with perioperative fish oil (n=34 in groups I and II. 10 in III, P<0.05). The number of days in ICU was not different (group I: 7.6 days, group II: 7.0, group III: 7.3), the length of hospital stay was shorter in group I (group I: 29.2 days, group II: 24.9, group III: 22.2, P<0.05 vs I). CONCLUSIONS: In a retrospective evaluation, perioperative provision of parenteral fish oil (ca. 10 g/day) beneficially influences patient outcome probably by modulating the immune response.