儿童分泌性中耳炎的疗效观察

分泌性中耳炎临床常见,儿童发病率尤高,也是常见的致聋原因之一.为提高分泌性中耳炎的治疗效果.我科对2003年5月至2006年5月在鼻内窥镜直视下施行腺样体切除术,联合激光打也治疗儿童分泌性中耳炎33例(65耳),取得了满意疗效,现报告如下:     

鼻内镜下鼓膜置管术治疗分泌性中耳炎

目的 探讨鼻内镜下行鼓膜置管术治疗分泌性中耳炎的方法和疗效.方法 对88例分泌性中耳炎患者在鼻内镜下采用鼓膜切开置入硅胶管方法治疗.结果 88例(100耳)分泌性中耳炎患者经随访3-6个月,治愈85耳(85%),好转l4耳(14%),无效1耳(1%),有效率99%.结论 鼻内镜下鼓膜置管术治疗分泌性中耳炎,视野清晰、操作简便、安全有效.     

鼻内窥镜下治疗儿童腺样体肥大和分泌性中耳炎的临床研究

目的 探讨鼻内窥镜下治疗儿童腺样体肥大及分泌性中耳炎的方法。方法采用气管插管全麻，104例腺样体肥大患儿行腺样体切割术，其中，43例合并分泌性中耳炎：22例（44耳）显微镜下行鼓膜切开＋置管术，21例（40耳）鼻内窥镜下行鼓膜穿刺抽吸造口术；58例行双扁桃体切除术。结果随访3～6个月，患儿行鼻内窥镜检查见鼻咽部黏膜红润、光滑，未见瘢痕及腺样体残留。所有分泌性中耳炎患儿鼓膜愈合、标志正常存在，鼓室压图正常、患耳听力明显提高。结论鼻内窥镜下治疗儿童腺样体肥大方法简便、切除彻底、创伤小、术后恢复快、并发症发生少。     

鼓膜微波造孔治疗顽固性分泌性中耳炎疗效观察

目的:分析耳内窥镜下微波鼓膜造孔和穿刺冲洗在儿童顽固性分泌性中耳炎治疗中的效果。方法:选取2012年1月—2014年1月期间收治的经保守治疗效果不佳的分泌性中耳炎患者92例作为研究对象,按治疗方法的不同,随机分为对照组和观察组,各46例,两组患者均给予药物治疗,对照组行鼓膜穿刺冲洗治疗,观察组行耳内窥镜下微波鼓膜造孔治疗,对两组患者的临床效果进行分析比较。结果:观察组有效率为97.83%,对照组有效率为78.26%,差异有统计学意义(P<0.05)。结论:儿童顽固性分泌性中耳炎在耳内窥镜下行微波鼓膜造孔治疗临床效果显著,具有操作方便、视野清晰、定位准确的特点。     

置换疗法治疗儿童分泌性中耳炎的临床观察

目的探讨鼻内负压置换疗法治疗儿童分泌性中耳炎的临床疗效。方法对90耳儿童分泌性中耳炎患儿随机分组,治疗组50耳,对照组40耳,对其结果进行分析,比较两组疗效,并进行统计学处理。结果治疗组有效率86%,对照组有效率60%。两组疗效经统计学χ2检验,P<0.01,具有统计学差异,治疗组优于对照组。结论鼻内负压置换疗法治疗儿童分泌性中耳炎效果明显。     

鼻内窥镜下咽鼓管吹张术治疗分泌性中耳炎

目的探讨电视监视鼻内窥镜下咽鼓管吹张治疗分泌性中耳炎的疗效。方法选择75例分泌性中耳炎病人在鼻内窥镜引导下经欧氏管吹张咽鼓管结合咽鼓管注入药液。结果电视监视鼻内窥镜下咽鼓管吹张术治疗分泌性中耳炎有效率88%。结论电视监视鼻内窥镜下经欧氏管咽鼓管吹张结合咽鼓管注药治疗分泌性中耳炎疗效显著,具有临床推广应用价值。     

耳内窥镜在诊断小儿分泌性中耳炎的应用

目的 :了解硬质耳内窥镜在诊断小儿分泌性中耳炎中的作用。方法 :用硬质耳内窥镜和声阻抗鼓室图分别检查门诊分泌性中耳炎患儿250例共500耳。结果 :硬质耳内窥镜诊断阳性398耳 ,声阻抗鼓室图诊断阳性400耳。两者对诊断小儿分泌性中耳炎差异无显著性。结论 :硬质耳内窥镜与声阻抗鼓室图在诊断小儿分泌性中耳炎中具有同等作用 ,特别是对年幼儿童 (<6岁 )尤为方便。     

鼓膜置管术治疗分泌性中耳炎

目的探讨分泌性中耳炎的治疗方法。方法应用鼻内窥镜镜对106例(116耳)患者采用鼓膜切开置入硅胶管方法治疗。结果106例患者,治愈78例,好转18例,总有效率达90.6%。结论鼓膜置管法治疗分泌性中耳炎效果良好。     

耳内窥镜在儿童分泌性中耳炎治疗中的应用

目的：探讨耳内窥镜在儿童分泌性中耳炎治疗中的应用价值。方法：对36例（48耳）儿童分泌性中耳炎经保守治疗及鼓膜穿刺无效后在耳内窥镜下行鼓膜置管术及术前、术后检查。结果：36例（48耳）患儿手术均一次完成,无明显并发症。对分泌性中耳炎鼓室黏膜及咽鼓管口黏膜充血、肿胀的转归有了更清楚的了解。结论：耳内窥镜使分泌性中耳炎鼓膜置管术更清晰,操作简便,安全易行,能更好地了解鼓室及咽鼓室的病变转变过程。     

咽鼓管置管注药治疗分泌性中耳炎

分泌性中耳炎的治疗以清除中耳积液,改善中耳通气引流为基本原则。我科自1998年4月起在鼻内窥镜下行咽鼓管插管并留置,注药治疗分泌性中耳炎72例(84耳),取得良好效果。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.