CO2激光处理喉垂直部分切除术后拔管困难

为解除部分切除术后门狭窄，提高拔管率，对１６例喉垂直部分切除术后拔管困难的患者应用支撑喉镜暴露，ＣＯ２激光治疗，取得了良好的治疗效果，再拔管率８７．５％。随诊１－３年，疗效稳定。结果表明ＣＯ２激光手术是治疗喉垂直部分切除术后拔管困难的新的有效的方法。     

梨状窝粘膜修复喉部分切除术后的粘膜缺损

目的 :探讨应用梨状窝粘膜修复喉部分切除术后粘膜缺损及恢复喉功能的效果。方法 :对 198例患者施行此术式 ,其中喉水平部分切除术 87例、喉垂直部分或扩大喉垂直部分切除术 6 5例、喉水平加垂直部分切除术 4 6例。同时进行随访观察。结果 :喉水平部分切除术者拔管率为 10 0 % ;术后发音、呼吸、吞咽功能恢复好 ;5年生存率为 84 .7%。喉垂直部分或扩大喉垂直部分切除术拔管率为 87.7% ;5年生存率 86 .2 % ;术后吞咽、呼吸功能恢复好 ,但有声音嘶哑。喉水平加垂直部分切除术后初期进食呛咳较重 ,训练适应时间较长 ,拔管率为82 .6 % ;5年生存率为 78.3% ;术后声音嘶哑 ,部分患者喉狭窄导致拔管困难。结论 :本方法操作简单 ,取材方便 ,手术时间较短 ,成活率高 ,术后喉功能保留好 ,患者的 5年生存率高。     

垂直部分喉切除术的远期疗效观察

报告经随访３年以上垂直部分喉切除样１２６例。不同术式者５年生存率各异，额前部分喉切除术最高，为１００％；其次喉裂开声带切除术为９１．４％；垂直半喉切除术为７３．１％；额侧部分喉切除术为７２．２％；合计５年生存率为８０．０％。术后喉功能保存良好，拔管率为７５．４％。１２６例术后局部复发为１３例，复发率为１０．３％。颈部淋巴结转移６例，肺转移１例，多发生在手术后１年以内，大多数是行垂直半喉切除术及额侧     

喉部分切除术后功能障碍的CO_2激光治疗

本文报道８例喉部分切除术后功能（呼吸、发音和保护）障碍的病人在支撑喉镜下采用ＣＯ２激光手术治疗，功能障碍均得以纠正，随诊一年半疗效稳定。讨论了喉部分切除术后功能障碍的原因和Ｃ０２激光手术治疗的优点。     

声门型喉癌垂直部分喉切除、重建方法与效果评价

本文就声门型喉癌１０２例施行垂直部分喉切除的适应症选择、重建方法、术后喉功能恢复及生存率分析。本组拔管率９８．０％（１００／１０２），有良好的发音功能、吞咽功能。３、５、１０年生存率分别为９０．２％、８５．６％、６９．８％。其生存率不亚于全喉切除术。证实垂直部分喉切除术是根治声门型喉癌Ｔ２、Ｔ３期的合理有效的术式。     

声门型喉癌垂直部分喉切除,重建方法与效果评价

本文就声门型喉癌１０２例施行垂直部分喉切除的适应症选择、重建方法、术后喉功能恢复及生存率分析。本组拔管率９８．０％（１００／１０２），有良好的发音功能、吞咽功能。３、５、１０年生存率分别为９０．２％、８５．６％、６９．８％。其生存率不亚于全喉切除术。证实垂直部分喉切除术是根治声门型喉癌Ｔ２、Ｔ３期的合理有效的术式。     

Nd:YAG激光治疗喉部分切除术后拔管困难

喉部分切除术后的一些患者 ,尤其是少数扩大垂直半喉切除术的患者 ,术后出现拔管困难。我们通过自行设计改制器械 ,将Ｎｄ :ＹＡＧ激光导入 ,只需在间接喉镜下手术 ,方法简便 ,易于推广使用。一、临床资料我科 1992年 9月～ 1996年 5月间收治行喉部分切除术后拔管困难的喉癌患者 13例 ,年龄 5 3～ 71岁 ,平均 6 7岁 ;全部为男性。其中垂直半喉切除术 2例 ,扩大垂直半喉切除术 9例 ,次全喉切除术 2例。残喉用双蒂带状肌带甲状软骨膜修复 8例 ,用甲状软骨膜直接修复 2例 ,用胸骨舌骨肌膜翻转修复 3例。治疗前患者均经ＣＴ检查并结合临床检查 ,…     

扩大垂直部分喉切除术治疗T_3声门癌

为探讨部分喉切除术治疗Ｔ３声门癌的可能性，自１９８１年６月至１９９２年１２月，为３２例Ｔ３声门癌施行了扩大垂直部分喉切除术即垂直部分喉切除加杓状软骨及部分环状软骨板切除。喉缺损用舌骨肌瓣修复。３及５年生存率分别为７８．１％及７３．９％。拔管率为８１．３％，发声满意者占８４．３％。所有患者均恢复经口进食。对Ｔ３声门癌有选择地施行扩大垂直部分喉切除术是可行的，可使患者保存喉功能，提高生存质量     

改良环状软骨上喉部分切除术治疗中晚期喉癌的疗效及生存质量评估

目的　评价改良环状软骨上喉部分切除对中晚期喉癌的生存率及生存质量的效果。方法　回顾性统计分析2002～2015年本院经治中晚期喉癌行改良环状软骨上喉部分切除手术患者共65例,其中男62例,女3例;年龄35～80岁;T2级患者26例,T3级32例,T4a级7例。并与同期120例行喉垂直部分切除手术患者的术后功能效果进行对 比。结果　T2～T4级喉癌患者行改良环状软骨上喉部分切除术后的5年累积生存率是82.3%,拔管率为98.3%,喉垂直部分切除手术患者的拔管率为86.1%,改良环状软骨上喉部分切除术后拔管率明显优于喉垂直部分切除手术组（P <0.05）。两组患者术后发音质量,误咽情况比较无明显差别（P >0.05）。结论　改良环状软骨上喉部分切除是治疗中晚期喉癌可行的手术方式。     

喉部分切除喉功能重建术

目的探讨喉部分切除术治疗声门型、声门上型喉癌的疗效和功能恢复。方法对我院1992年7月--2003年8月间喉癌行喉部分切除喉功能重建术的32例（占同期喉癌手术59．2％）临床资料进行总结和随访。其中声门型喉癌23例，声门上型喉癌9例；行喉裂开声带切除术室带下移修复术5例，垂直喉部分切除带状肌修复14例。垂直喉部分切除会厌修复3例，扩大垂直喉部分切除环舌根会厌吻合术1例，声门上水平部分喉切除术7例，扩大声门上水平部分喉切除术舌根修复2例。结果1、3、5年生存率分别为96．9％（31／32）、87．0％（20／23）、72．2（13118）。总拔管率为90．6（29／32）。全部病例恢复经口进食，一经拔管均能发音。术后复发率为12．5％。结论喉部分切除术不仅是喉癌根治的有效术式，而且同时可以较好地保留喉的生理功能，提高患者术后的生活质量。     

细菌脂多糖对人鼻黏膜上皮细胞环氧合酶-2表达和前列腺素E2释放的影响

目的:检测不同浓度和时间梯度的细菌脂多糖(LPS)诱导人鼻黏膜上皮细胞(HNE)环氧合酶-2(COX-2)表达和前列腺素E2(PGE2)释放状况,探讨其在鼻黏膜炎症发病机制中的作用.方法:应用Western印迹和荧光实时定量PCR技术检测LPS诱导下和COX-2特异性抑制剂阻断后,HNE中COX-2表达变化.以酶标免疫测定检测在此过程中PGE2的释放水平.结果:COX-2和PGE2在正常HNE中呈微弱的表达.LPS呈时间和浓度依赖性诱导HNE COX-2表达及PGE2释放;PGE2释放较COX-2晚;NS-398呈浓度依赖性减弱LPS对COX-2表达及PGE2释放的诱导.结论;LPS可有效诱导HNE COX-2表达和PGE2释放,PGE2由COX-2催化合成,COX-2和PGE2表达增加参与了LPS诱导HNE的体外炎症过程.     

环氧合酶-2对细菌脂多糖诱导的鼻黏膜组织中MUC2基因表达的影响

目的探讨细菌脂多糖(lipopolysaccharide,LPS)诱导的离体鼻黏膜组织中环氧合酶-2(cyclooxygenase-2,COX-2)及前列腺素E2(prostaglandin E2,PGE2)对黏液素2(mucin2,MUC 2)表达的影响,以阐明慢性鼻-鼻窦炎中黏液过度分泌的病理学机制。方法应用荧光实时定量PCR技术检测不同浓度的LPS、PGE2和COX-2特异性抑制剂NS-398干预前后,体外培养的鼻黏膜组织中COX-2和MUC2的基因表达变化,并以酶标免疫测定检测干预前后的PGE2释放水平。结果 COX-2,MUC2和PGE2在体外培养的健康鼻黏膜组织中呈微弱的表达。LPS呈浓度依赖性诱导鼻黏膜组织中COX-2和MUC2基因表达及PGE2释放增加;以不同浓度的NS-398阻断COX-2后,观察到NS-3 9 8呈浓度依赖性减弱LPS对MUC 2的基因表达及PGE 2释放的诱导。外源性的PGE2呈浓度依赖性增加MUC2的基因表达,对COX-2表达无明显影响。结论 LPS通过诱导COX-2进而增加PGE2合成来调节MUC2的表达增高,可能是慢性鼻-鼻窦炎中黏液过度分泌的部分机制。     

P2X receptor immunoreactivity in the rat cochlea, vestibular ganglion and cochlear nucleus

P2X receptors have been reported to be involved in neurotransmission in both central and peripheral nerves. In the present study, polyclonal antibodies against P2X1, P2X2, P2X3, P2X4, P2X5, and P2X6 were used to study the distribution of P2X receptors in rat cochlea and vestibulocochlear nerve pathways. It was found that in the vestibular ganglion all six types of antibodies stained the neurons to different intensities. The strongest signal was obtained with the P2X2 antibodies, followed by P2X3 antibodies. The other four antibodies produced weak signals, of approximately the same intensity. In the spiral ganglion, the six types of antibodies also stained almost all neurons. However, the rank order of intensity was different from that in the vestibular ganglion: the strongest signal was still obtained with P2X2 antibodies, followed by P2X4, P2X1, and P2X3 antibodies. The immunolabelling was much weaker with P2X5, and P2X6 antibodies compared with the other four types of antibodies. In the cochlea, besides the spiral ganglion neurons, other tissues such as stria vascularis, the organ of Corti and the tectorial membrane were labelled intensively with P2X2 antibodies only. High density P2X2 immunoreactivity was also observed in the vestibulocochlear nerve fibres. In the cochlear nucleus, neurons and nerve fibres were stained with the P2X2 antibodies, as were the neurons in the trapezoid body. These results suggested that P2 receptors, especially the P2X2 receptors, may play important roles in the signal transduction involved in the perception of sound and balance.     

RNAi沉默SOX2表达增强Hep-2化疗药物敏感性作用研究

目的：研究SOX2表达对人喉癌上皮细胞Hep-2化疗敏感性的影响。方法：设计合成RNAi-SOX2序列,瞬时转染Hep-2细胞,Westernblot法筛选沉默效率最好的RNAi-SOX2构建pGCsi-H1-SOX2质粒,并构建其对照质粒pGCsi-HI-NC,分别转染Hep-2细胞建立稳定沉默SOX2表达细胞株psiSOX2-Hep-2及其对照细胞株psiNC-Hep-2。CCK-8法检测SOX2表达沉默对Hep-2细胞对化疗药物敏感性的影响;Hoechst染色法检测SOX2表达沉默对化疗药物诱导Hep-2细胞凋亡的影响;Westernblot法检测SOX2表达沉默对凋亡相关基因Survivin、Bcl-2、Bax、cleaved caspase-3表达的影响。结果：成功获取SOX2表达沉默细胞株psiSOX2-Hep-2及其对照psiNC-Hep-2细胞株,与psiNC-Hep-2细胞相比,psiSOX2-Hep-2中SOX2表达下降78％。SOX2表达沉默后,psiSOX2-Hep-2细胞对5-FU和紫杉醇的敏感性均增强,psiSOX2-Hep-2细胞48h的IC50值分别下降到8．12ug／ml和5．16ug／ml;同时,psiSOX2-Hep-2细胞凋亡数增多;抗凋亡基因Survivin、Bcl-2表达下降明显,凋亡基因Bax、cleaved caspase-3表达显著上升。结论：RNAi沉默SOX2表达将显著增强人喉癌上皮细胞Hep-2对5-FU和紫杉醇的敏感性。     

Alternative distortion product otoacoustic emissions and hearing loss in a clinical population

Parameters of the alternative distortion product otoacoustic emissions (DPOAEs) 4f1-3f2, 3f1-2f2, 2f2-f1, 3f2-2f1 and 4f2-3f1 as well as the cubic distortion product 2f1-f2 were extracted from the ILO 92 binary files of patients reported on earlier (Lind, 1998). The DPOAEs were recorded at 18 stimulus levels between 19 and 70 dB SPL. The prevalence of at least one valid DPOAE data-point varied from 74% at 4f1-3f2 to 100% at 2f2-f1. The mean number of valid points was six for 2f2-f1, but generally below four for the others. The mean maximum amplitude for the alternative DPOAEs was 6-12 dB below that of the 2f1-f2. The mean maximum signal-to-noise-ratio (SNR) was between 2.5 and 3.5 dB SPL for the four most peripheral emissions and increased to 6.7 dB SPL for the 2f2-f1. As reported earlier, the 2f1-f2 distortion was fairly well correlated with hearing threshold at 2 kHz. The 2f2-f1 shows some correlation with hearing loss at frequencies above f2, but the other DPOAEs were not correlated with hearing loss at any frequency, which may suggest different generating mechanisms and/or sites. The inf1uence of age on maximum amplitude was small but significant for all DPOAEs.     

siRNA沉默C-erbB-2基因对人喉癌Hep-2细胞PI3K/Akt信号通路的影响

目的：探讨siRNA沉默人喉癌Hep-2细胞C—erbB-2基因对细胞增殖的影响,及其与P13K／Akt信号通路的关系。方法：利用siRNA技术转染Hep-2细胞C—erbB-2基因,RT—PCR3检测siRNA转染后C-erbB-2mRNA的水平变化,MTT检测细胞增殖情况改变,Western blot检测ERK1／2和AKT1蛋白磷酸化变化情况。结果：转染C—erbB-2 siRNA24h后的Hep-2细胞C—erbB-2mRNA水平出现下调,细胞增殖抑制率增加,ERK1／2和AKT1蛋白磷酸化水平也相应降低,C—erbB-2基因表达与ERK1／2和AKT1蛋白磷酸化水平之间有显著相关性。结论isiRNA沉默Hep-2细胞C-erbB-2抑制Hep-2细胞增殖,这种增殖抑制可能通过降低ERK1／2和AKT1蛋白磷酸化水平实现。     

Expression of cytosolic phospholipase A2 and cyclooxygenase 2 and their significance in human oral mucosae, dysplasias and squamous cell carcinomas

Prostaglandin E(2) (PGE(2)) plays an important role in promoting carcinogenesis. Cytosolic phospholipase A(2) (cPLA(2)) and cyclooxygenase 2 (COX-2) are both key enzymes for PGE(2) biosynthesis. Recent evidence suggests that the coordinated function of cPLA(2) and COX-2 in the arachidonic acid pathway may contribute to the process of carcinogenesis in various tissue types. However, the concomitant effect of these enzymes on oral carcinogenesis remains unclear. In this study,we evaluated the expression of cPLA(2) and COX-2 in normal oral mucosa, dysplastic oral mucosa and squamous carcinoma (SCC) using immunohistochemistry. In an in vitro assay, Tca8113 and KB oral cancer cells were treated with NS-398 (a selective inhibitor of COX-2) for varying time intervals: 6, 12, 24, 48 and 72 h. The levels of cPLA(2) and COX-2 expression were evaluated by Western blot, and PGE(2) production was analyzed by radioimmunoassay. We found that cPLA(2) and COX-2 were expressed at higher levels in oral dysplasia and SCC than in normal oral mucosa. cPLA(2) expression was also found to correlate closely with COX-2 expression. Moreover, the enzymatic activities of cPLA(2) and COX-2 were gradually downregulated with longer durations of treatment with NS-398, as demonstrated by a reduction in the amount of PGE(2) production over time. Our data suggest that the coordinated activity of cPLA(2) and COX-2 contribute to the process of oral carcinogenesis, thus identifying cPLA(2) as a potential target for the prevention and treatment of oral cancers.     

Detection of hearing loss using 2f2-f1 and 2f1-f2 distortion-product otoacoustic emissions.

Although many distortion-product otoacoustic emissions (DPOAEs) may be measured in the ear canal in response to 2 pure tone stimuli, the majority of clinical studies have focused exclusively on the DPOAE at the frequency 2f1-f2. This study investigated another DPOAE, 2f2-f1, in an attempt to determine the following: (a) the optimal stimulus parameters for its clinical measurement and (b) its utility in differentiating between normal-hearing and hearing-impaired ears at low-to-mid frequencies (相似文献   

Lipofectamine^TM2000介导pIRES2-DsRed2-Hath1、pIRES2-EGFP-NT3质粒对HEK293T细胞共转染的实验研究

目的检测真核表达质粒载体pIRES2-EGFP—NT3、pIRES2-DsRed2-Hath 1在阳离子脂质体介导下对HEK293T细胞的共转染情况。方法分别提取含有目的基因NT3的真核表达质粒载体pIRES2-EGFP—NT3和含有目的基因Hath 1的真核表达质粒载体pIRES2-DsRed2-Hath 1，在阳离子脂质体Lipofectamine^TM2000介导下将其共转染HEK293T细胞，转染后24h，通过Confocal显微镜观察HEK293T细胞的转染情况和转染效率。结果pIRES2-EGFP-NT3和pIRES2-DsRed2．Hath 1能有效转染并共转染HEK293T细胞，其转染率pIPES2-EGFP-NT3为23．79％（157／660）；pIRES2-DsRed2-Hath 1为8．03％（53／660）；共转染率为3．64％（24／660）。结论pIRES2-EGFP—NT3和pIRES2-DsRed2-Hath 1在阳离子脂质体介导下对HEK293T细胞的共转染成功为NT3和Hath 1基因共转染耳蜗的实验奠定基础。     

Development of 2f1-f2 otoacoustic emissions in the rat

2f1-f2 otoacoustic emissions have been recorded from the rat cochlea during its development. Acoustic responses were recorded at 3, 5 and 7 kHz using a fixed value of the f2/f1 ratio (= 1.17). The first 2f1-f2 acoustic responses were obtained at 12 days after birth for 2f1-f2 = 7 and 5 kHz, and 2 days later for 2f1-f2 = 3 kHz. Adult-like patterns of the acoustic responses were achieved by day 18 for 2f1-f2 = 3 kHz, by day 20 for 2f1-f2 = 5 kHz and by day 28 for 2f1-f2 = 7 kHz. These results are discussed in relation to the available anatomical and functional data on the cochlear development of the rat. The delayed appearance of the 3 kHz acoustic responses might be related to the basal-to-apical gradient of morphological cochlear maturation. The fact that the 2f1-f2 otoacoustic emissions reached adult characteristics from the low to high frequencies is consistent with the development of the tuning properties of the basilar membrane. The long development of the 2f1-f2 acoustic responses at 7 kHz suggests that the organ of Corti undergoes subtle changes well after the end of its apparent maturation.