实验性分泌性中耳炎中耳黏膜能量代谢酶的酶细胞化学研究

目的:探讨分泌性中耳炎(OME)的病因和发病机制.方法:采用机械性阻塞右侧咽鼓管的方法建立OME动物模型,左耳作为对照,对中耳上皮黏膜中琥珀酸脱氢酶(SDH,一种重要的与能量代谢有关的酶)进行光镜和电镜酶细胞化学研究.结果:实验组中3 d组和7 d组的SDH酶活性均较正常对照组减弱,且差异有显著性.结论:发生OME时,SDH酶活性受抑制,导致能量代谢的障碍,不能产生足够的ATP以维持强烈而有效的纤毛摆动,引起中耳积液的持续存在.     

不典型分泌性中耳炎1例分析

对不典型分泌性中耳炎1例分析如下。 1病历摘要 男,49岁,农民,因“左耳痛、头痛4个月,面瘫2个月”为主诉入院。患者入院前4个月无明显诱因出现左耳疼痛,感轻微听力下降,伴左侧头部疼痛不适,可耐受,无耳呜,无眩晕、恶心、呕吐等不适,经抗炎治疗症状稍改善,2个月后患者无明显诱因出现左侧面瘫,在当地县医院就诊,给予抗感染、扩血管、     

超短波治疗小儿分泌性中耳炎疗效观察

目的 探讨超短波治疗对儿童分泌性中耳炎的临床疗效.方法 将2010-06- 2011-06收治的220例分泌性中耳炎患儿分治疗组120例154耳,对照组100例130耳.对照组采用药物治疗,1％呋麻滴鼻剂,3次/d;口服抗生素5～7d;治疗组在对照组治疗的基础上辅以超短波治疗.另对超短波组患者病程与疗效进行分析.对两组治疗结果进行分析.结果 试验组有效率为79.1％,对照组有效率为54％,两组比较差异有统计学意义(P＜0.05).结论 超短波治疗对分泌性中耳炎有效.但随着病程的延长,效果将逐渐甚至明显下降.因此,超短波治疗对急性分泌性中耳炎的疗效优于慢性分泌性中耳炎.     

分泌性中耳炎59例治疗分析

目的探讨分泌性中耳炎的有效治疗方法。方法采用药物保守治疗联合鼓膜置管术的综合疗法对59例(67耳)分泌性中耳炎患者进行治疗观察。结果治疗后30 d内作纯音测听复查,所有患者治疗前后各频率纯音听阈比较差异均有统计学意义(P<0.05或P<0.01)。经1~12个月随访,本组痊愈56耳,显效8耳,无效3耳,总有效率95.5%。结论药物保守治疗联合鼓膜置管术的综合疗法疗效确切,是分泌性中耳炎的有效治疗方法。     

儿童分泌性中耳炎病因分析及治疗效果探讨

分泌性中耳炎 (SOM)是儿童的一种常见病、多发病 ,并且是儿童致聋的疾病之一 ,发病早期易造成误诊漏诊 [1 ]。假如能在疾病早期发现 ,并予以适当地处理 ,可以收到良好的效果 ,否则 ,若延误治疗 ,则可发生中耳粘连 ,鼓室硬化或胆固醇肉芽肿等病变 ,严重影响患者的听力。因此 ,正确的诊断和恰当地治疗甚为重要。我们从 1998- 0 3～ 2 0 0 1- 0 3收治此类疾病儿童 72例 ,术前应用纯音听阈测定 ,声导抗测试 ,鼻内窥镜或纤维鼻咽镜检查等明确诊断 ,手术采用气管插管麻醉 ,在鼻内窥镜引导下 ,1次行腺样体刮除术 ,扁桃体切除术和鼓膜置管术 ,术前…     

标准桃金娘油胶囊联合莫米松鼻喷剂治疗分泌性中耳炎

【目的】探讨口服标准桃金娘油胶囊联合莫米松鼻喷剂治疗分泌性中耳炎的疗效。【方法】回顾性分析2010年1月至2012年6月确诊为分泌性中耳炎56例（68耳）患者（观察组）,另设对照组56例（68耳）确诊为分泌性中耳炎患者。观察组予以莫米松鼻喷剂喷鼻2次／日,口服克拉霉素片250mg,2次／日,标准桃金娘油胶囊300mg,3次／日,对照组则予以聪耳汤1号方,水煎服,每次1剂,每日1次,两组均7d一个疗程。【结果】观察组有效率95．6％（65／68）明显高于对照组73．5％（50／68）,总并发症发生率10．3％（7／68）显著低于对照组19．1％（13／68）,其差异均有统计学意义（P〈0．05）。【结论】口服标准桃金娘油胶囊联合莫米松鼻喷剂治疗分泌性中耳炎疗效优于传统中药治疗法。     

声导抗诊断分泌性中耳炎的临床观察

目的:探讨声导抗鼓室图和鼓室压值在分泌性中耳炎的临床意义.方法:分析我院对,临床疑为分泌性中耳炎患者进行纯音测听和声导抗检查及给予鼓膜穿刺的结果.结果:临床疑为分泌性中耳炎223例,声导抗检查B型图192例(202耳),鼓膜穿刺阳性(抽出积液)187耳,占92.57%.C型图23例(36耳),其中8耳鼓室负压＞200 daPa给予鼓膜穿刺,5耳阳性,占62.50%.B型图与C型图比较差异有显著性(P＜0.05).As型图8例(8耳),鼓膜穿刺阴性8耳.结论:声导抗检查对早期发现、诊断分泌性中耳炎及中耳积液具有重要价值.鼓室图形和鼓室压值与鼓膜穿刺阳性率有密切关系.     

64例儿童分泌性中耳炎临床治疗分析

目的 探讨儿童分泌性中耳炎的临床治疗效果.方法 对2008年1月至2009年12月收治的64例分泌性中耳炎患儿采用常规治疗加仙璐贝滴剂进行治疗.结果 64例患儿中,显效22例,好转31例,无效11例,总有效率为82.8%.结论仙璐贝滴剂治疗儿童分泌性中耳炎安全、有效,值得临床推广应用.     

小儿复发性分泌性中耳炎60例分析

对我院2000-2004-03小儿复发性分泌性中耳炎60例分析如下。     

儿童分泌性中耳炎误诊23例分析

对2001—10～2005—06经我科筛选发现误诊和漏诊的儿童分泌性中耳炎23例（28耳）分析如下。     

Matrix metalloproteinase-8/collagenase-2 in childhood otitis media with effusion

Abstract

Background. Matrix metalloproteinases (MMPs), gelatinases, have been associated with otitis media with effusion (OME), but the role of collagenase-2/matrix metalloproteinase-8 (MMP-8) in OME has not been studied previously. We studied the levels, isoenzyme distribution, and activation of MMP-8 in childhood OME, and also the levels of pro- and active forms of MMP-2 and -9 as well as 120 kDa gelatinase complexes were assessed.

Methods. Seventy middle ear fluid (MEF) samples were collected from 54 children with OME and classified to mucoid (n = 39) or serous (n = 31). MMPs were studied from MEF samples by time-resolved immunofluorometric assay, Western immunoblotting, and gelatin-zymography.

Results. MMP-8 was found in its active form in MEF of children with OME. MMP-8 levels were significantly higher in mucous relative to serous OME. The pro- or active MMP-2 and -9 were found in MEF, but no MEF type-specific differences were found.

Conclusion. Our results suggest that MMP-8 may play a role in the pathogenesis of childhood OME. New therapeutic strategies with MMP inhibitors targeting MMP-8, but allowing MMP-8 to carry out the protective action, may play a role in the future treatment of otitis media and OME. However, further studies of this topic are needed.     

Th1/Th2 imbalance in HCV-related liver cirrhosis

The mechanism by which Hepatitis C virus(HCV) infection promotes the development of hepatocellular carcinoma(HCC) is not known exactly. HCV related HCC occurs frequency in the patients with cirrhosis. There have been reports indicating that Th2-type cytokines down-regulated antitumor immunity, and the activation of type 1 T cell responses produced antitumor immunity. We thought Th1/Th2 imbalance in HCV-related liver cirrhosis might be closely related to the development of HCC. In this study, therefore, we investigated the Th1/Th2 balance at the single lymphocyte level of the patients with HCV-related liver cirrhosis and compared with normal controls by using flow cytometry. Th1-type cytokines(IFN-gamma, IL-2) production was significantly decreased in patients with cirrhosis, whereas Th2-type cytokine production(IL-10) was increased. These suggest Th1/Th2 imbalance in HCV-related cirrhosis would decrease the antitumor immunity and its improvement might present the protective effect from HCC.     

Mucolytic agents and otitis media with effusion

Middle ear effusion was obtained from children with otitis media with effusion and separated into thick (mucoid) and thin (serous) pools. Both effusion types contained similar amounts of non-dialysable solids. However, the thick effusions contained more mucus glycoprotein than the thin effusions, 25% and 8.2% respectively. Amino acid and carbohydrate analysis of the CsCl purified mucus glycoproteins demonstrated that the glycoprotein from the thick and thin effusions differed in their protein core, those from the thick effusions possessing a higher percentage of serine and threonine, the amino acids to which the sugar side-chains attach. They are also more glycosylated. N-acetyl cysteine and mercaptoethanol caused a fall in the viscosity of solutions of purified middle ear glycoprotein and effusion homogenate. However, longer term incubation caused a rise above the starting viscosity. This effect was concentration-dependent, and was mediated by low molecular weight components in the effusion and not the mucus glycoprotein. S-carboxymethyl cysteine had no effect on the viscosity of either the purified mucus glycoprotein or the effusion homogenate. Therefore, to produce a decrease in effusion viscosity in vivo, the concentration of mucolytic reaching the middle ear and the time it remains there are critical factors.     

Office-based CO2 laser-assisted tympanic membrane fenestration addressing otitis media with effusion

OBJECTIVE: To use the CO2 laser-assisted tympanic membrane fenestration in office settings, under local anesthesia, as the sole treatment for patients with chronic otitis media with effusion (OME). BACKGROUND DATA: This new treatment ensures artificial ventilation of the middle ear for several weeks, and provides an intermediate solution between ordinary lancet-made tympanocentesis and transtympanic ventilation tube insertion. The operative technique is already well codified, and preliminary studies have demonstrated that tympanic membrane fenestration does not expose patients to any major hazard. METHODS: We treated 30 ears in 21 children and 29 ears in 24 adults. All patients had presented with OME persistent for more than 3 months. The laser tympanostomy was performed under local anesthesia, as an outpatient procedure, using a CO2 flash-scanning laser in conjunction with a handpiece (OTOLAM). Using a power of 12 W to 17 W, a single laser pulse usually sufficed to create a 2-mm-diameter circular perforation in the anteroinferior quadrant of the eardrum. RESULTS: The tympanic membrane fenestration allows avoiding ventilation tube insertion in 63% of children and 75% of adults. CONCLUSIONS: The CO2 laser-assisted tympanic membrane fenestration seems a valid therapeutic option addressing OME. This study should be pursued on a larger scale to define more precisely the indications of the laser tympanostomy.     

急性冠状动脉综合征患者IL-18／IL-10比值与Th1／Th2失衡

目的研究免疫炎性因子在急性冠状动脉综合征（ACS）中的作用机制。方法入选经冠状动脉造影确诊的ACS患者189例，26名正常人作对照。入院时即采血，并随防观察有无心脏病死亡、心绞痛再发、再梗死、心律不齐等发生。采用流式细胞术检测辅助性T细胞（Th）1与Th2，酶联免疫吸附试验（ELISA）检测白细胞介素（IL）-18和IL-10表达。结果ACS患者Th1、IL-18较正常人明显增加（P〈0．01，P〈0．05），而Th2和IL-10明显减少（P均〈0．05），Th1／Th2与IL-18／IL-10呈正相关（r=0．532，P〈0．01）。结论ACS患者Th1／Th2和IL-18／IL-10比值升高，提示ACS患者动脉斑块形成与Th1细胞及其分泌的前炎性因子IL-18升高有关。