变应性鼻炎大鼠鼻黏膜Bcl-2 mRNA及其蛋白的表达

目的 :探讨变应性鼻炎 (AR)大鼠鼻黏膜凋亡相关基因Bcl 2mRNA及其蛋白的表达 ,以进一步了解变应性鼻炎的发病机制。方法 :将 2 0只大鼠随机分为实验组和对照组 ,每组 10只。实验组以卵清蛋白腹腔注射致敏 ,继之鼻局部激发建立变应性鼻炎动物模型。取实验组与对照组动物鼻呼吸区黏膜 ,行Bcl 2mRNA原位杂交染色、Bcl 2与Bax蛋白免疫组化染色 ,并行苏木精 伊红染色以资对比。结果 :实验组Bcl 2mRNA与Bcl 2蛋白主要表达于鼻黏膜腺体细胞 ,其次是上皮层 ,鼻分泌物中可见大量呈强阳性反应的嗜酸性粒细胞 ,Bcl 2mRNA与Bcl 2蛋白表达水平显著高于对照组 (P <0 .0 5 ) ,Bax蛋白与Bcl 2蛋白表达部位一致 ,两组表达水平差异无统计学意义 (P >0 .0 5 )。结论 :变应性鼻炎大鼠鼻黏膜凋亡调控基因Bcl 2mRNA及其蛋白表达上调 ,是变应性鼻炎鼻分泌物增多及鼻黏膜上皮破坏的机制之一     

Bcl-2和Bax在自发性糖尿病小鼠耳蜗中的表达研究

目的观察自发性糖尿病小鼠耳蜗组织细胞凋亡及Bcl-2和Bax基因的表达。方法非肥胖性糖尿病（non-obese,diabetes,NOD）雌鼠分为糖尿病4周组（D4组）、糖尿病12周组（D12组）和正常对照组（C组）。应用吖啶橙-碘化丙啶（AO-PI）荧光染色和DNA缺口末端原位标记法（TUNEL）检测耳蜗凋亡细胞;免疫组织化学法和Western blot技术检测Bcl-2和Bax在糖尿病耳蜗组织中的表达。结果 NOD小鼠耳蜗可见大量凋亡细胞,D12组比D4组明显增多（P〈0.05）;两组底回毛细胞较顶回凋亡率明显增高（P〈0.05）。D4组耳蜗中Bax在细胞浆内呈阳性表达,Bcl-2在细胞核及细胞浆内均呈阳性表达;D12组Bax在细胞核及细胞浆内均呈阳性表达,而Bcl-2在细胞浆内呈阳性表达;与C组比较,D4组Bax与Bcl-2表达显著增高（P〈0.05）,D12组Bax表达显著增高（P〈0.05）,但Bcl-2表达下调（P〈0.05）;D4组Bax表达较D12组显著降低（P〈0.05）,但Bcl-2表达较D12组显著增高（P〈0.05）。结论自发性糖尿病小鼠耳蜗存在明显细胞凋亡,其损伤机制与Bax表达增高及Bcl-2表达降低有关。     

凋亡相关基因Bcl-2和bax及iNOS在流感病毒感染后小鼠嗅上皮的表达

目的：研究凋亡相关基因Bcl-2、bax和诱导型一氧化氮合酶（iNOS）在流感病毒感染后小鼠嗅上皮的表达,探讨其对嗅感觉神经元凋亡的调节作用。方法：采用半定量RT—PCR法检测流感病毒感染后小鼠嗅上皮Bcl-2、bax和iNOS的mRNA表达水平。结果：流感病毒感染后：①嗅上皮表达Bcl-2mRNA相对恒定;②嗅上皮表达bax mRNA早期显著增加,恢复期逐渐回落;③嗅上皮表达iNOS mRNA在一段较短的时期内显著增加,1周后逐渐下降至不可测水平。结论：凋亡相关基因Bcl-2、bax和iNOS可能在流感病毒感染所致的嗅感觉神经元凋亡中起重要的调节作用。     

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

OBJECTIVE: To study the significance of aquaporin-1 (AQP-1) expression in the eosinophils of nasal polyps. The expression and location of AQP-1 mRNA and apoptosis associated gene Bcl-2 mRNA in nasal polyps were explored. METHODS: Sixteen nasal polyp samples were collected from 11 women and 5 men aged 20-65 years during routine endonasal surgery. Nasal mucosa specimens from the inferior turbinates of 10 patients with allergic rhinitis (7 women and 3 men, aged 16-58 years), collected during septoplasty, were used as controls. The expression of AQP-1 mRNA and Bcl-2 mRNA was detected in serial adjacent sections by in situ hybridization and eosinophils were examined by stain MGG. RESULTS: AQP-1 mRNA expression was found in all 16 nasal polyps and in 4 of 10 inferior turbinate tissues, the mean expression rates were (93.16 +/- 13.25)% and (19.54 +/- 4.98)%, respectively. All 16 nasal polyps and 10 control nasal tissues expressed Bcl-2 mRNA, by the average rates of (84.74 +/- 12.10)% and (16.45 +/- 3.12)%, respectively. The expression of AQP-1 mRNA was positively correlated with Bcl-2 mRNA expression in nasal polyps (r = 0.875, P < 0.01). CONCLUSIONS: AQP-1 contributes to the survival of eosinophils in nasal polyps by keeping the permeation balance of eosinophils.     

鼻腔鼻窦内翻性乳头状瘤中Survivin及Bcl-2的表达

目的：探讨细胞凋亡抑制蛋白Survivin在鼻腔鼻窦内翻性乳头状瘤中的表达及其与Bcl-2表达的相关性。方法：采用免疫组织化学Envision二步法检测30例鼻腔鼻窦内翻性乳头状瘤,10例鼻腔鳞状细胞癌及10例正常下鼻甲黏膜标本中Survivin和Bcl-2的表达。结果：鼻腔鼻窦内翻性乳头状瘤和鼻腔鳞状细胞癌组织中Survivin的表达分别为73.3%和80.0%,均显著高于正常下鼻甲黏膜组织（均P〈0.01）。鼻腔鳞状细胞癌组织中Bcl-2的表达率为90.0%,显著高于正常下鼻甲黏膜组织的表达率（20.0%）（P〈0.01）。鼻腔鼻窦内翻性乳头状瘤组织中Bcl-2的表达率为46.7%,高于正常下鼻甲黏膜,但两者之间的差异无统计学意义（P〉0.05）。Survivin表达与Bcl-2表达呈正相关（P〈0.01）。结论：Survivin在鼻腔鼻窦内翻性乳头状瘤和鼻腔鳞状细胞癌的发生、发展中起重要作用,可能成为鼻腔鼻窦内翻性乳头状瘤和鼻腔鳞状细胞癌基因治疗的靶点。Survivin可能与Bcl-2在鼻腔内翻性乳头状瘤的发展中起协同作用。     

中耳胆脂瘤研究进展及其与凋亡抑制蛋白survivin和Bcl-2的关系

国内外学者对中耳胆脂瘤的发病机制做了大量研究，主要集中在上皮过度增殖、骨质破坏吸收和细胞凋亡机制三方面。随着科技的发展，分子生物学技术在研究工作中大量应用，学者们开始从分子生物学角度研究胆脂瘤上皮的特征和演变、骨质破坏、免疫细胞浸润、细胞因子表达与相互作用，把中耳胆脂瘤的病因及发病机制的研究带到了一个新的领域。但是，胆脂瘤的发生、发展有很多复杂的因素，它既是一种炎性疾病，同时又具有肿瘤的某些特性（如上皮细胞过度增殖，侵袭性生长），在其发生、发展中，炎症递质及上皮增生因子（如IL-1、IL-6、IL-8、TNF、TGF、EGF、EGFR等）参与其中，也和某些抑癌基因（如p53、p16、p27等）关系密切。     

喉鳞癌蛋白激酶C与Bcl-2基因表达的相关性

目的 探讨蛋白激酶C(protein kinase C,PKC)及Bcl-2基因在喉鳞癌组织表达及细胞凋亡中的意义。方法 采用免疫组化SP法检测28例喉癌手术切除的组织标本中PKC 、Bcl - 2 基因的表达情况,25例声带息肉作为对照。结果 喉鳞癌组织中Bcl - 2基因的阳性细胞表达率显著高于对照组(P < 0.01), PKC蛋白的阳性细胞表达率显著高于对照组(P < 0.01), 且PKC与Bcl - 2基因的表达呈明显正相关(r = 0.0875)。结论 喉癌组织细胞中PKC表达增多与凋亡抑制密切相关,推测喉癌组织细胞凋亡抑制可能是通过PKC这一信号转导途径实现的。     

鼻腔鼻窦内翻性乳头状瘤中增殖细胞核抗原和Bcl-2的表达及意义

目的检测、观察和对比鼻腔鼻窦内翻性乳头状瘤(sinonasal inverted papillomas,SNIP)增殖的上皮和鼻息肉(nasal polyps,NP)炎性上皮中细胞增殖和凋亡抑制的表达情况并分析其相关性,探讨细胞增殖和凋亡抑制在SNIP发生和发展中的作用及意义。方法 SNIP标本30例,均为初发病例;鼻内镜手术中所取NP标本15例,亦均为初发病例。用免疫组化法检测标本上皮中增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)和Bcl-2的表达情况。结果在30例SNIP标本和15例NP标本中PCNA和Bcl-2均有表达,在SNIP标本中两者表达均高于15例NP标本(t=5.626,P=0.0001;t=2.539,P=0.011)。在SNIP标本中,细胞增殖与细胞凋亡抑制的表达呈正相关(r=0.53,P<0.005)。结论细胞增殖及凋亡抑制可能共同参与了SNIP的发生及发展。细胞增殖在SNIP的发生和发展中起主要的作用。相关分析显示PCNA与Bcl-2分别作为细胞增殖辅助因子和细胞凋亡的调控基因在SNIP的发生发展中可能具有一定的相关性。     

内耳免疫反应中细胞凋亡及Bcl-2与Bax的表达

目的 研究内耳免疫反应时细胞凋亡以及Bcl 2和Bax的表达情况,探讨自身免疫性内耳病发病机制。方法 选用健康SD大鼠60只,随机分成实验组30只（皮下注射Ⅱ型胶原与弗式佐剂）,佐剂组15只（皮下注射弗式佐剂）,对照组15只（予等量生理盐水）,免疫后进行畸变产物耳声发射（DPOAE）检测,扫描电镜形态学观察,DNA末端转移酶介导的缺口末端标记法（TUNEL）检测细胞凋亡及免疫组化检测Bcl-2和Bax的表达。结果 实验组DPOAE幅值下降（P<0.05）,部分毛细胞纤毛排列紊乱、簇状缺失, Corti器、血管纹和螺旋神经节可见TUNEL阳性染色, 且Bax/ Bcl-2表达比值上调,而对照组和佐剂组未见明显改变。结论 内耳免疫反应可诱导细胞凋亡发生, Bcl 2和Bax蛋白在其中起了重要调节作用。     

鼻息肉中诱导型一氧化氮合酶、Bax及Bcl-2的表达及相关性研究

目的:检测鼻息肉组织中诱导型一氧化氮合酶(iNOS)和凋亡相关基因Bax、Bcl-2的表达及相关性。方法:30例鼻息肉组织,应用TUNEL方法检测其凋亡情况;免疫组织化学SABC法检测iNOS及Bax、Bcl-2的表达;western blot方法检测iNOS、Bax、Bcl-2的表达。结果:①TUNEL方法检测凋亡细胞位于鼻息肉表层上皮细胞及腺体上皮细胞,均为弱阳性。②免疫组织化学法检测iNOS、Bax、Bcl-2均表达于鼻息肉组织上皮细胞、腺上皮细胞、血管内皮细胞和浸润的炎性细胞,阳性表达定位于细胞质,其中Bax表达为弱阳性,iNOS、Bcl-2表达为强阳性。③Western blot检测3种蛋白均有表达条带,iNOS、Bal-2条带清晰,Bax条带软弱,差异有统计学意义(P<0.01);iNOS与Bcl-2的灰度值比值呈正相关(r=0.851,P<0.01);iNOS与Bax的灰度值比值呈负相关(r=-0.714,P<0.01)。结论:鼻息肉组织中存在抗凋亡和促凋亡2种蛋白,iNOS抑制细胞凋亡,可能对鼻息肉的发生、发展起重要的促进作用。     

自体鼻中隔软骨联合膨体聚四氟乙烯与自体耳软骨移植在鼻尖整形中的对照研究

目的 评价自体鼻中隔软骨联合膨体聚四氟乙烯移植与自体耳软骨移植在鼻尖整形中的临床效果.方法 对照观察自体鼻中隔软骨联合膨体聚四氟乙烯移植(A组:70例)与自体耳软骨移植(B组:48例)在鼻尖整形中的疗效、手术操作时间及术中术后并发症.以SPSS 12.0软件进行t检验或x2检验.结果A组手术操作平均((x)±s)时间短于B组,差异有统计学意义(t=13.258,P=0.000).A组鼻尖宽度在6～8 mm的67例(95.7％),B组46例(95.8％),差异无统计学意义(x2=0.001,P=0.996);2组患者鼻尖表现点、后旋角、鼻背与鼻小柱夹角、鼻尖高度差异均无统计学意义(x2值分别为0.001、0.069、0.149、0.073,P值均＞0.05).结论 自体鼻中隔软骨联合膨体聚四氟乙烯与自体耳软骨移植术临床效果相近.     

鼻内镜下自体软骨鼻整形同期鼻中隔偏曲矫正治疗外伤性歪鼻畸形的临床分析

目的对鼻内镜下自体软骨（鼻中隔软骨、耳软骨和肋软骨）鼻整形同期行鼻中隔偏曲矫正治疗外伤性歪鼻畸形的临床分析。方法收集2017~2018年20 例陈旧外伤性歪鼻畸形患者的临床资料,所有患者均行全麻下鼻小柱倒“V”型切口暴露松解并切除偏曲的鼻中隔软骨及骨质,针对不同患者设计使用不同软骨（鼻中隔软骨、耳软骨和肋软骨）矫正鼻中隔骨性或软骨性支架,对鼻尖、鼻背及外鼻重新塑形。结果随访3~12个月,行鼻内镜下自体软骨鼻整形同期鼻中隔偏曲矫正术的患者鼻外形及通气均有明显改善,手术效果更好,无鼻腔粘连、鼻中隔血肿及穿孔。结论鼻内镜下自体软骨鼻整形同期鼻中隔偏曲矫正治疗外伤性歪鼻畸形同期解决了鼻部畸形和鼻通气功能,实现了美容和功能的统一,同时减少了手术治疗的次数和费用,可行性高。     

自制金属圆棒与双极电凝治疗鼻中隔偏曲矫正术中腭大动脉出血的疗效比较

目的 探讨自制金属圆棒与双极电凝在鼻中隔矫正术中腭大动脉出血止血的疗效。 方法 选取2013年5月至2016年8月住院行鼻中隔矫正手术的患者60例,符合入选标准的患者按照入院顺序,采用随机数字表法分为两组,A组(30例)采用圆棒砸平上颌骨棘突腭大动脉处,B组(30例)采用双极电凝止血上颌骨棘突腭大动脉处。比较两组腭大动脉出血量、止血时间及两组因腭大动脉出血形成血肿的例数。 结果 A组患者止血时间为(1.93±0.94)min;B组止血时间为(5.96±1.62)min。A组出血量为(25.5±10.5)mL, B组为(72.0±17.6)mL。 A组未出现血肿,B组血肿3例。 结论 自制金属圆棒砸平鼻中隔上颌骨鼻棘腭大动脉处止血时间较双极电凝组少,出血量少,术后腭大动脉继发性出血少,经济性高,值得在临床上推广应用。     

A schwannoma in the nasal septum

Schwannomas of the sinonasal tract are very rare neoplasms. We present the case of a schwannoma developing in the nasal septum. The patient was a 51-year-old woman with the complaint of unilateral nasal obstruction. We completely removed this tumor by an endoscopic approach. We discuss the clinical presentation, differential diagnosis, and treatment of this rarely encountered neoplasm.     

唇龈沟径路治疗鼻中隔软骨前脱位

目的 介绍经唇龈沟径路治疗鼻中隔软骨前脱位的手术方法。方法 所有鼻中隔软骨前脱位的患者均经唇龈沟径路行鼻中隔矫正。直视下于唇龈沟作一横切口,分离两侧中隔软骨膜,还纳脱位的鼻中隔。结果 患者鼻腔通畅,鼻堵、流涕等症状消失,随访半年,治愈率100%,未发生鼻尖塌陷、鼻中隔穿孔等并发症。结论 经唇龈沟径路治疗鼻中隔软骨前脱位安全有效,并发症少,是一种有效的手术方法。     

Prospective evaluation of the effect of early nasal layer closure on definitive repair in cleft palate patients

IntroductionThe cleft palate is one of the most common congenital anomalies treated by plastic surgeons. The cleft width increases the tension of repair and necessitates excessive dissection that might affect maxillary growth. Decreasing the width of cleft minimize tension, dissection and may limit the impact on maxillary growth.ObjectivesThe purpose of the study was to evaluate the effect of nasal layer closure of the hard palate at the time of cleft lip repair in patients with complete cleft lip and palate, to demonstrate the efficacy of narrowing the gap and to reduce the incidence of fistulae or other complications.MethodsThirty patients less than 1 year of age were included in this prospective observational study. A superiorly based vomer flap was used to repair the nasal layer of the cleft hard palate at the time of primary cleft lip repair. 12–14 weeks after the vomer flap, the cleft soft and hard palate was definitively repaired. Alveolar and palatal gaps were recorded during the 1st and 2nd operations to demonstrate the reduction of the gap defect.ResultsThe mean reduction of the alveolar cleft width in patients who had a vomer flap in the first stage was 4.067 mm and the mean reduction of the palatal gap was 4.517 mm. Only 3 patients developed small fistula on the repaired nasal layer that was discovered and corrected during definitive palatoplasty.ConclusionNasal layer closure is a simple surgical technique that can be used to close the hard palate at the time of cleft lip repair. It is a valuable addition to cleft lip and palate repair that may prevent some cleft palate surgical complications.     

鼻中隔一期重建硬腭部分缺损的研究

目的探讨利用鼻中隔对硬腭部分缺损进行术后修补的可行性。方法回顾性分析11例上颌窦癌患者的临床资料,上颌骨截除术后均采用一期鼻中隔修补硬腭部分缺损。结果 11例患者中8例肿瘤切除后硬腭重建一期愈合,2例出现小裂隙,1例发生鼻中隔坏死。结论上颌骨切除术后,可利用鼻中隔一期修补硬腭缺损。     

耳屏软骨联合带蒂鼻腔黏骨膜瓣在修补鼻中隔大穿孔中的应用

目的 探讨耳屏软骨联合带蒂鼻腔黏骨膜瓣修补鼻中隔大穿孔的方法及疗效.方法 选取联勤保障部队第九四○医院18例鼻中隔大穿孔(直径≥15 mm)患者,鼻内镜下采用耳屏软骨联合带蒂鼻腔黏骨膜瓣行鼻中隔穿孔修补术,间断缝合,明胶海绵贴敷固定,术后观察修补物的存活情况.结果 18例患者术后全部随诊6个月至1年,17例完全修补成功...     

Tragal cartilage augmentation in repair of cleft palate, a new technique and its clinical implications

Background

Cleft palate is one of the most common congenital anomalies of the head and neck worldwide. In addition to the evident feeding and growth problems, patients are involved with and suffer from speech, hearing and dental problems. Many surgical techniques and modifications have been advocated to improve functional outcome and aesthetic results, aiming at normal speech, minimizing growth disturbances, and establishing a competent velopharyngeal sphincter. Despite the variety of techniques described for repair of the clefts, there is still a relatively high incidence of postoperative fistula reaching up to 35%. This is mainly related to type and degree of the defect, and type of surgical repair.

Objectives

To evaluate the efficacy of placement of tragal cartilage free graft between the oral and nasal mucosal layers of the neo-palate in improving success rates, and anatomical and functional outcomes in repair of cleft palate with reduction of the extent of dissection.

Patients and methods

Fourteen patients were managed by our technique, only in large cases minimal von Langenbeck lateral release incisions were made. In all cases a tragal cartilage graft was interpositioned and fixed to the muscle layer of the neo-palate, 2-3 extramucosal trans-muscle sutures were placed for 3-4 weeks if needed, and the patients were followed up for a minimum of 12 months during which functional and anatomical assessments were done.

Results

Results, including both anatomical and functional outcomes, were favorable with no gross failures, permanent significant fistula formations (one case with minor non-significant fistula), nor donor site co morbidities.

Conclusion

The use of tragal cartilage free graft to augment the area at the junction between the hard and soft palate appears to be a safe and effective method in repair of cleft palate that reduces the incidence of postoperative palatal fistulae, without donor site comorbidities.