两种免疫调节剂辅助LAK细胞杀伤喉癌细胞的体外研究

为探讨如何提高白细胞介素－２（ＩＬ－２）／ＬＡＫ细胞过继免疫治疗的抗肿瘤作用，应用免疫调节剂分枝杆菌多糖或ＣＤ３单克隆抗体协同ＩＬ－２诱导的健康人外周血淋巴细胞来源的ＬＡＫ细胞在体外扩增，测定其对喉癌ＨＥＰ－２细胞杀伤活性。实验结果：（１）不同免疫调节剂对ＬＡＫ细胞扩增的影响。实验组三且细胞于体外扩增均明显高于对照组（Ｐ〈０．０１）；ＭＰＳ组或ＣＤ３组细胞的扩增倍数比单纯应用ＩＬ－２组为高（Ｐ〈０     

分枝杆菌多糖促人LAK细胞增殖及对喉癌HEP－2细胞杀伤活性的研究

为探讨分枝杆菌多糖（ｍｙｃｏｂａｃｔｅｒｉａｌｐｏｌｙｓａｃｃｈａｒｉｄｅｓ，ＭＰＳ）在体外对ＬＡＫ细胞（ｌｙｍ－ｐｈｏｋｉｎｅａｃｔｉｖａｔｅｄｋｉｌｅｒｃｅｌｋｉｎｅ）活性的影响，以提高ＬＡＫ细胞杀瘤活性、减少ＩＬ－２（白细胞介素－２）用量和毒副作用。通过ＭＴＴ法测定不同浓度ＩＬ－２、不同浓度ＭＰＳ对ＬＡＫ细胞促增殖能力的影响；以细胞计数法测定不同浓度ＩＬ－２、ＭＰＳ对ＬＡＫ细胞扩增倍数的影响；应用乳酸脱氢酶法测定不同条件刺激的ＬＡＫ细胞对喉癌ＨＥＰ－２细胞杀伤活性的作用。结果证明小剂量ＩＬ－２（２×１０５Ｕ／Ｌ）诱导ＬＡＫ细胞过程中加入ＭＰＳ０．４ｍｇ／Ｌ能显著增强ＬＡＫ细胞的增殖和杀伤喉癌ＨＥＰ－２细胞的活性。其扩增倍数及杀伤活性均显著超过单纯应用ＩＬ－２（１０６Ｕ／Ｌ）诱导的ＬＡＫ细胞。通过检测不同条件下诱导的ＬＡＫ细胞表型，显示ＭＰＳ联合ＩＬ－２诱导的ＬＡＫ细胞ＣＤ２５百分率明显增高，提示ＭＰＳ可能通过促进ＬＡＫ细胞表面ＩＬ－２膜受体表达，提高ＬＡＫ细胞增殖及杀伤活性。因此，ＭＰＳ可望作为一种新型免疫调节剂用于抗肿瘤治疗     

分枝杆菌多糖促人LAK细胞增殖及对喉癌HEP—细胞杀伤活…

为探讨分枝杆菌多糖在体外对ＬＡＫ细胞活性的影响，以提高ＬＡＫ细胞杀瘤活性，减少ＩＬ－２用量和毒副作用，通过ＭＴＴ法测定不同浓度ＩＬ－２，不同浓度ＭＰＳ对ＬＡＫ细胞促增殖能力的影响；以细胞计数法测定不同浓度ＩＬ－２，ＭＰＳ对ＬＡＫ细胞扩增倍数的影响；应用乳酸脱氢酶法测定不同条件刺激的ＬＡＫ细胞对喉癌ＨＥＰ－２细胞杀伤活性的作用。     

肿瘤过继免疫疗法新进展

ＬＡＫ／ＩＬ－２疗法是目前临床上最常应用的肿瘤过继免疫疗法，ＴＩＬ／ＩＬ－２疗法也在一定范围内得到应用。但这两种方法都尚存在一些不足。ＣＤ３ＡＫ细胞是一种集ＬＡＫ，ＴＩＬ优点于一身的新型肿瘤免疫杀伤细胞。基础试验已表明它具有细胞前体来源丰富，扩增及杀伤力强，ＩＬ－２依赖性低等诸多优点，不失为一种安全可靠，经济有效的免疫细胞。     

CD3A细胞体内,外抗喉鳞癌细胞株（Hep—2）的实验研究

为探索理理想的过继免疫治疗手段，对由健康人外周血分离、经ＣＤ３单克隆抗体与白细胞介素－２共同诱导激活的ＣＤ３Ａ细胞的体外扩增情况及其杀２务喉癌细胞Ｈｅｐ－２的活性水平进行了观察和研究，并与ＬＡＫ细胞作了比较。研究发现，ＣＤ３ＡＫ细胞除具有体外扩增能力强，存活时间长、ＩＬ－２依赖性等特点外，其体内、外抗喉癌作用亦十分显著。培养早期，ＣＤ３ＡＫ细胞的抗瘤活性与常规培养的ＬＡＫ细胞相似，延长培养时间至７     

Nd-YAG激光汽化结合光动力学治疗对鼻咽癌患者SIL-2R、IL-2水平及NK活性的影响

应用双抗体夹心ＥＬＩＳＡ法、３Ｈ－ＴｄＲ掺入法和１２５Ｉ－ＵｄＲ释放法对２４例鼻咽癌（ＮＰＣ）患者ＹＡＧ激光汽化结合光动力学治疗前后外周血可溶性ＩＬ－２受体（ＳＩＬ－２Ｒ）、白细胞介素２（ＩＬ－２）水平和自然杀伤细胞（ＮＫ）活性分别进行测定。结果表明鼻咽癌患者在接受激光光动力学治疗后ＳＩＬ－２Ｒ水平呈明显下降（Ｐ＜０．０００５），而ＩＬ－２水平和ＮＫ活性显著上升（Ｐ＜０．０００５）。结果提示激光光动力学治疗对恢复鼻咽癌患者免疫功能起促进作用。     

人LAK细胞在体外和裸鼠体内抗头颈部肿瘤细胞的研究

报道人ＬＡＫ细胞对头颈疗肿瘤细胞的影响。结果发现：①ＬＡＫ细胞，在体外对人喉鳞癌细胞系ＨＥＰ－２、人鼻鳞癌细胞系ＣＮＥ－２和人口腔鳞癌细胞系ＫＢ均表现出明显的杀伤活性，与对照组比较差异有显著性（Ｐ＜０．０５）。②ＬＡＫ细胞在移植瘤裸鼠体内同样具有很强的抑瘤作用。本实验结果提示临床上运用ＬＡＫ细胞治疗头颈部肿瘤可能是一种较新的有效方法。     

分泌性中耳炎患儿腺样体免疫状态的探讨

本文通过体外细胞培养的方法，研究了１０例分泌性中耳炎（ＯＭＥ）患儿腺样体的免疫状态，测定体外腺样体淋巴细胞自发性ＤＮＡ合成（ＳＤＳ）及在植物血凝素（ＰＨＡ）刺激下可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ）释放，并以阻塞性睡眠性呼吸暂停综合征患儿作对照。结果，ＯＭＥ患儿腺样体淋巴细胞ＳＤＳ（１７３３５±７０１２ｃｐｍ）较对照组（９３８２±４５５４ｃｐｍ）明显增高（Ｐ＜０．０５），ｓＩＬ－２Ｒ的释放（８６４±２４１ｕ／ｍｌ）也较对照组（４３８±１４５ｕ／ｍｌ）增高（Ｐ＜０．０５），说明ＯＭＥ患儿腺样体淋巴细胞活性较高，可能导致局部免疫异常而引起ＯＭＥ。     

喉癌患者不同来源淋巴细胞毒性的对比研究

应用细胞生物学方法，从１２例喉癌患者分离的外周血淋巴细胞（ＰＢＬ）、肿瘤引流淋巴结淋巴细胞（ＴｄＬＮＬ）和肿瘤浸润淋巴细胞（ＴＩＬ）在体外经重组务细胞介素２（ｒＩＬ－２）诱导５－７天后，成为具有杀瘤活性的淋巴因子激活的杀伤细胞（ＬＡＫ细胞）或激活的ＴＩＬ。采用＾３Ｈ－ＴｄＲ掺入法，检查它们对Ｋ５６２靶细胞的杀伤能力。实验结果显示：加入ｒＩＬ－２栖外培养的ＰＢＬ、ＴＤＬＮＬ和ＴＩＬ细胞体积增大，呈不     

RA和VD诱导喉癌患者LAK细胞TNF－α的表达

本文应用全反式维甲酸（ＲＡ）和１，２５－二羟维生素Ｄ３（ＶＤ）诱导培养喉癌患者ＬＡＫ细胞，采用Ｎｏｒｔｈｅｒｎ杂交技术和ＥＬＩＳＡ检测ＴＮＦ－α基因ｍＲＮＡ及其蛋白的表达。结果显示，ＶＤ或ＲＡ加ＶＤ诱导的ＬＡＫ细胞ＴＮＦ－αｍＲＮＡ及其蛋白的表达显著增高。提示ＶＤ或ＲＡ加ＶＤ能够促进ＬＡＫ细胞合成和释放ＴＮＦ－α，有可能因此增强了ＬＡＫ细胞的抗肿瘤作用。这为提高头颈部恶性肿瘤过继免疫治疗的疗效开避了一条新的途径。     

耳廓开放性外伤的治疗方法探析

目的 探讨耳廓开放性外伤的治疗方法。方法 23耳耳廓开放性外伤经彻底清创，肝素生理盐水冲洗伤口后，对位缝合。术后用抗生素抗感染、丹参扩张血管、罂粟碱改善微循环。结果 23耳中2耳失访，18耳完全成活，1耳部分成活，2耳完全坏死。结论 耳廓撕裂伤、断伤、带有皮蒂的耳廓离断伤，由于断端双侧血管丰富，经对位缝合后容易成活。但耳廓完全离断伤由于缺乏血供，经对位缝合后不易成活，可采用去皮血管植入包埋法，带肌蒂皮瓣移植法或尝试显微外科技术施行血管吻合，以提高耳廓完全离断伤的成活率。     

诊治7例鼻腔嗅神经母细胞瘤的体会

目的：提高临床对鼻腔嗅神经母细胞瘤的认识及治疗效果。方法：７例患者按Ｋａｄｉｓｈ分期，Ｂ期２例，Ｃ期５例，单纯放疗３例，术前放疗４例，放射剂量为５０００￣７０００ｃＧｙ。均随访至１９９７年１２月，结果：存活５例，存活时间分别为２０，２２，２３，２９及７６个月；结论：放疗对该肿瘤有效；放疗与化疗结合的方法值得探讨，该瘤病理上可能存在不同的亚型。     

急性化脓性耳廓软骨膜炎手术疗效分析

目的 探讨能够缩短化脓性耳廓软骨膜炎疗程,降低耳廓畸形发生率且具个体化的局部治疗方法.方法 回顾分析1 989年4月～2010年2月我科诊治的25例化脓性耳廓软骨膜炎的临床资料.除进行抗生素治疗外,局部治疗方法包括清创术后重新行耳甲腔成行术;脓腔穿刺置静脉留置针进行持续负压引流;清创后创腔置管引流.结果 自定义疗效评定...     

Effects of time of contact and concentration of caustic agent on generation of injuries

OBJECTIVES: Solid caustic soda (CS) ingestion levels continue high in Brazil. The aggressiveness of a caustic agent depends, among other factors, on its concentration and time of contact with mucosa. However, the interdependence of these factors in the production of caustic lesion in the esophageal mucosa is not known, especially regarding CS as the strongest corrosive agent. We analyze the effects of concentration and time of contact on the aggressiveness of CS to the esophagus of live animals. STUDY DESIGN/METHODS: One milliliter of CS at concentrations between 1.83% and 73.33% was applied to rats. The solution was kept in contact with the mucosa for 10 to 120 minutes. Internal and external organ aspects were analyzed and the epithelium, submucosa, muscle layer, and adventitia were analyzed microscopically RESULTS: Epithelial necrosis was observed at all concentrations. Among the necrotic layers, the submucosa was observed starting at the 7.33% concentration, and the muscular layer and adventitia were observed at 14.66% concentration. Damage to the pulmonary parenchyma and trachea occurred at 33.66% after 10 minutes, and perforation of the esophagus was observed only after 120 minutes. After 10 minutes, important corrosive lesions installed in the esophageal layers, expanding in depth and superficial extension. The use of heparin had no effect on the production of lesions. CONCLUSIONS: Ten minutes were sufficient to provoke necrosis, and longer contact increased the area of necrosis. Solution concentration levels were more important in damage production: 1.83% was sufficient for epithelial necrosis, 7.33% caused submucosal necrosis, and 14.66% muscle and adventitia necrosis; 33.66% solutions caused lung and trachea damage after 10 minutes and esophageal perforation after 120 minutes.     

Scales of degree of facial paralysis: analysis of agreement

IntroductionIt has become common to use scales to measure the degree of involvement of facial paralysis in phonoaudiological clinics.ObjectiveTo analyze the inter- and intra-rater agreement of the scales of degree of facial paralysis and to elicit point of view of the appraisers regarding their use.MethodsCross-sectional observational clinical study of the Chevalier and House & Brackmann scales performed by five speech therapists with clinical experience, who analyzed the facial expression of 30 adult subjects with impaired facial movements two times, with a one week interval between evaluations. The kappa analysis was employed.ResultsThere was excellent inter-rater agreement for both scales (kappa > 0.80), and on the Chevalier scale a substantial intra-rater agreement in the first assessment (kappa = 0.792) and an excellent agreement in the second assessment (kappa = 0.928). The House & Brackmann scale showed excellent agreement at both assessments (kappa = 0.850 and 0.857). As for the appraisers’ point of view, one appraiser thought prior training is necessary for the Chevalier scale and, four appraisers felt that training is important for the House & Brackmann scale.ConclusionBoth scales have good inter- and intra-rater agreement and most of the appraisers agree on the ease and relevance of the application of these scales.     

术前使用布地奈德对声带息肉手术疗效的影响

目的 研究术前使用布地奈德雾化吸入治疗对手术疗效的影响。方法 按病程将3个月以内和1年以上患者随机分为两组,一组术前给予布地奈德雾化治疗,一组没有,术后两周复诊。分别于初诊、手术前和复诊时使用嗓音测试仪对病人进行测试并记录参数。结果 病程3个月以内患者术前给予雾化治疗后,其术后声学参数明显改善。结论 病程3个月以内患者术前给予雾化治疗能缩短术后恢复时间。     

A national audit of sinus surgery. Results of the Royal College of Surgeons of England comparative audit of ENT surgery

The results of a national audit of sinus surgery are presented. Forty-six consultant ENT surgeons reported on over 2500 sinus procedures. There has been an exponential rise in the number of surgeons in England and Wales performing functional endoscopic sinus surgery (FESS) in recent years. Sixty-five per cent of surgeons in our study used the FESS technique and 81% had formal or other training. Outpatient sinus endoscopy and CT scans have become more routine pre-operative investigations, whilst the use of plain films has waned. There was a wide variation in the numbers of FESS procedures performed by individual surgeons in the 6-month period (between 5 and 85). The overall complication rate was 0.75% for conventional surgery and 1.41% for functional surgery but no major complications were recorded. The primary symptom of blockage was most successfully treated by both conventional and functional surgery (70% and 84% asymptomatic or improved at 6 months). Pain was relieved in 75% of functional procedures and 47% of conventional procedures and discharge relieved in 76% of FESS procedures and 47% of conventional procedures.     

磷霉素在减轻卡那霉素耳中毒过程中的作用

本文采用磷霉素笔卡那霉素联合应用，经扫描电镜、透射电镜、耳蜗铺片和组织化学反应观察，了解磷霉素减轻卡那霉素耳毒性的机制以及卡那霉素所致耳毒性的发展过程。通过实验可以看到磷霉素有保护溶酶体膜的作用，所以能减轻卡那霉素的耳毒性，但由于它不能直接对抗AmAn耳毒性作用机制，因而不能完全预防其耳毒性。     

CT对鼻腔鼻窦内翻性乳头状瘤起源的探讨

目的 探讨鼻腔鼻窦内翻性乳头状瘤起源的CT影像学特点。 方法 回顾性分析47例经鼻内镜手术及术后病理组织学确诊的鼻腔鼻窦内翻性乳头状瘤患者的CT影像学资料。对肿瘤病变在CT上的骨质变化进行分析,并与术中发现的肿瘤起源根蒂部位进行对比,分析CT影像中骨质改变与肿瘤起源之间的关系。 结果 47例患者中,39例有骨质增生影像表现,其中37例骨质增生部位与肿瘤起源的根蒂部位一致,一致性达78.7%,提示可根据骨质增生部位推测肿瘤起源位置。 结论 CT影像中的骨质增生与鼻腔鼻窦内翻性乳头状瘤的根蒂起源部位有较高的一致性,有助于术前评估肿瘤起源和指导术前制定合理的手术方案。     

慢性鼻窦炎病原学变迁的研究

目的:了解慢性鼻窦炎病原学分布的变迁。方法:术中收集2010年全年111例(实验组)上颌窦或筛窦脓性分泌物,分别进行需氧菌和真菌培养,同时以30例健康受试者作为对照组,其培养结果与2005年的各种数据比较,分析病原微生物的分布变化。结果:实验组共培养出15种病原微生物,主要为肺炎克雷伯菌、甲型链球菌、鲍曼不动杆菌、表皮葡萄球菌、铜绿假单胞菌、白色念珠菌等;需氧菌和真菌培养阳性率为81.8%,其中革兰阳性菌37.8%,革兰阴性菌54.4%,各种真菌7.8%;对照组检测出表皮葡萄球菌、流感嗜血杆菌、甲型链球菌、卡他布兰汉菌和金黄色葡萄球菌5种细菌,与实验组比较差异有统计学意义(χ2=0.009,P<0.01);与2005年数据(革兰阳性菌56.3%,革兰阴性菌43.7%,真菌阳性率1.4%)比较,其分布特征有明显差异。结论:细菌感染是慢性鼻窦炎的重要原因之一;细菌分布结构从原来的革兰阳性菌变成现在的以革兰阴性菌为主,真菌感染也不容忽视。应用抗生素治疗宜先进行细菌培养与药敏试验。