A study on the expression of TGF-beta 1/T beta R II in laryngeal carcinoma]

OBJECTIVE: To explore the expression of TGF-beta 1/T beta R II in laryngeal carcinoma. METHOD: Immunohistochemical study using SP kit in 53 cases. RESULT: The expression of TGF-beta 1 was decreased in carcinoma tissues when compared with peri-cancer controls (P < 0.05). There wasn't difference in T beta R II expression when compared with peri cancer controls (P > 0.05). But it was correlated with the stage, differentiation and lymph node metastasis of laryngeal carcinoma. CONCLUSION: TGF-beta 1/T beta R II may involve in the histogenesis and development of laryngeal carcinoma. The decreased expression of TGF-beta 1/T beta R II may serve as an important molecular marker of laryngeal carcinoma.     

Pneumatization of perpendicular plate of the ethmoid bone and mucocele]

OBJECTIVE: To find out the prevalence of pneumatization of perpendicular plate of the ethmoid bone, and to discuss the diagnosis and management of perpendicular plate mucocele (nasal septal mucocele). METHODS: The CT data from 32 patients with septal deviation were reviewed, and an unusual case of perpendicular plate mucocele was reported. RESULTS: Six cases (6/32, 18%) were found to have pneumatization of perpendicular plate of the ethmoid bone, with 2 located in the anterior portion (frontal-septal pneumatization), and 4 located in the posterior portion (spheno-septal pneumatization). A patient with perpendicular plate mucocele was treated by the technique of marsupialization under nasal endoscope. This patient was followed-up for 10 months without recurrence. CONCLUSION: As a kind of variation of nasal septum, the clinical significance of pneumatization of perpendicular plate should be emphasized. We reported the first case of perpendicular plate mucocele, originated possibly from the pneumatization of perpendicular plate of the ethmoid bone. Marsupialization under endoscope was considered to be the initial management for this unusual disease.     

Study of neurological mechanism of lidocaine's suppression to tinnitus via microdialysis]

OBJECTIVE: To elucidate the neurological mechanism of lidocaine's suppression to tinnitus. METHODS: Thirty-four Wistar rats weighing 300-350 grams were randomly divided into IC group (n = 17) and AC group (n = 17), according to microdialysis region. Each group was randomly subdivided into saline treatment group (n = 4), salicylate treatment group (n = 6), and salicylate + lidocaine treatment group (n = 7). Using in vivo microdialysis technique coupled with microbore HPLC-electrochemical detection, the present study first monitored the 5-HT release in IC and AC in salicylate-induced tinnitus animal models, and then, examined the effects of lidocaine on salicylate-induced 5-HT changes in IC and AC. The statistical analysis was performed using two-way ANOVA for repeated measures of raw data with time and treatment condition as main effects. Individual time-point values between no more than two groups were compared with the unpaired Student's t-test. The accepted level of significance was 0.05, two-tailed. RESULTS: The 5-HT level increased to a maximum of 268% +/- 27% (mean +/- s) basal level in IC 2 h after salicylate application and of 277% +/- 24% basal level in AC around 3 h after application. And then, the 5-HT level gradually decreased to 157% +/- 16% of baseline in IC and 180% +/- 18% of baseline in AC by the end of the sixth hour. Saline did not alter the IC and AC dialysate 5-HT level in control rats. Two-way ANOVA with repeated measures indicated a significant effect of the condition factor [F (1, 8) = 413.949, P < 0.000001 in IC group; F(1,8) = 192.184, P < 0.000001 in AC group]. The increases of 5-HT levels in salicylate treatment groups were significantly reduced to 85% +/- 8% basal level in IC and 92% +/- 26% basal level in AC after local infusion of 1% lidocaine (P < 0.05). Compared with corresponding control value at that time (unpaired student t-test). Two-way ANOVA with repeated measures showed a significant difference between the salicylate group and salicylate + lidocaine group [P < 0.000001 with F(1, 11) = 329.267 for the condition factor in IC subgroup; P < 0.000001 with F(1, 11) = 133.844 for the condition factor in AC subgroup]. CONCLUSION: The suppression of lidocaine to tinnitus may be associated with the decrease of 5-HT level in IC and AC.     

小儿耳蜗植入后电诱发复合动作电位的阈值及其临床应用

目的：研究应用神经反应遥测（neural response telemetry,NRT)技术，测试电诱发复合动作电位（electrically-evoked compound action potential,ECAP)阈值以指导小儿人工耳蜗映射调图的策略与时机。方法：应用NRT3．0软件对辐值增长函数进行线性拟合，确定ECAP阈值。比较6例儿童植入者在术后1、2、3个月ECAP阈值的变化，同时比较了7例儿童术中、术后ECAP阈值的差异。结果：ECAP幅值增长函数在接近阈值或进入饱和时不再呈线性。术后ECAP阈值保持稳定。各导电极的术中ECAP阈值比术后阈值平均高约15CL，二者有显著性相关（R2＝0．9154）。结论：应选取幅值增长函数的直线段部分进行拟合以确定ECAP阈值。术后应用ECAP阈值指导小儿映射调图时，测试一次ECAP阈值即可。术中ECAP阈值可用作开机时映射图的C值。     

少年儿童鼻内镜手术远期疗效及相关临床因素探讨

目的 探讨接受内镜鼻窦手术少年儿童鼻窦炎患者的疗效及影响疗效的相关因素。方法 接受内镜鼻窦手术的少年儿童鼻窦炎性疾病患者268例(432侧)，年龄3～17岁，平均14．3岁，男186例，女82例。全身麻醉176例，局部麻醉12例。188例(305侧)术后随访超过1年，占病例总数70．1％。随访在鼻内镜下进行，以黏膜表面麻醉为主。术后综合治疗包括：清理术腔、鼻腔冲洗、抗生素、激素、黏液促排剂及免疫调节剂等。结果 慢性鼻窦炎89例(147侧)，慢性鼻窦炎、鼻息肉86例(142侧)，鼻窦黏液囊肿13例(16侧)。治愈132例(70．2％)，好转43例(22．9％)，无效13例(6．9％)。术后头痛缓解率93．1％(175／188)，其次为鼻堵为85．1％(160／188)，脓涕60．1％(113／188)。11例手术前后无变化，2例症状较术前加重。术前56例失嗅者，术后34例(60．7％)改善或恢复。术后症状完全缓解123／188例(65．4％)，部分缓解52／188例(27．7％)，总有效率为93．1％。8例(4．3％)接受再手术。结论 少儿慢性鼻窦炎、鼻息肉内镜鼻窦手术远期疗效满意，应重视术中黏膜合理取舍和积极处理中鼻甲；随访质量为影响手术远期疗效重要因素。患者就医和手术前是否进行了规范药物治疗为手术适应证重要前提。     

女性睡眠呼吸暂停低通气综合征临床特点

OBJECTIVE: To realize the characteristics of symptoms and polysomnography in women with sleep apnea-hypopnea syndrome (SAHS) compared with that of male patients. METHODS: The symptoms and polysomnography were compared between men and women with SAHS and among mild (5 to 19 events/h), moderate (20 to 39 events/h), severe (> or = 40 events/h) of female patients. RESULTS: Female patients were older than that of male(51.1 +/- 11.2 yr versus 43.9 +/- 10.1 yr). The mean body mass index(BMI) for women was (27.8 +/- 3.9) kg/m2 and (28.1 +/- 3.8) kg/m2 for men. Women with higher AHI snored more severely, and female had a lower apnea hypopnea index (AHI) and apnea index (AI) but higher hypopnea index (HI) than did male. In addition, the respiratory events during non-rapid eye movement for men were significantly higher than that for women. CONCLUSION: Female patients are older than male but not more adipose. SAHS and respiratory events during NREM sleep are less severe in women.     

喉鳞癌瘤内微血管及微淋巴管形态计量研究及临床意义

目的:研究喉鳞癌瘤内微血管和微淋巴管形态、分布、密度,以及相关临床意义。方法:采用5’-Nase-AlPase双重酶组织化学法和HE染色对40侧喉鳞癌标本冰冻切片进行研究。结果:光镜下微血管呈蓝色,微淋巴管呈棕色。除转移组微血管密度显著高于未转移组外,与其余临床指标均未见相关性。结论:瘤内微血管密度与淋巴转移有明显相关,而微淋巴管密度未发现明显临床意义,其机制待深入研究。     

妊娠合并肺动脉高压23例分析

目的 探讨合并肺动脉高压(PH)妇女能否妊娠及妊娠的适宜时间。方法 回顾性分析1997～2002年在我院诊治的23例合并有PH的孕妇，分析PH的分类，妊娠结局。结果 3例合并原发性肺动脉高压(PPH)孕妇，2例在剖宫产术中死亡，1例在孕早期终止妊娠后存活。14例因合并风湿性心脏病(风心病)致PH的孕妇，妊娠至足月行剖宫产者10例，1例早产，3例引产，无一例孕妇死亡。6例因合并先天性心脏病(先心痛)致PH的孕妇，轻度PH孕妇3例，均妊娠至足月；重度PH孕妇3例，2例死亡，1例存活。结论 PPH患者应避免妊娠。风心病致PH的孕妇，依心功能、PH高低及血氧饱和度决定是否终止妊娠。对先心病致PH者，最好在手术或药物治疗后妊娠；患Eisenrnenger’s综合征妇女禁止妊娠。     

从新药审评看我国第一类创新中药的研究与开发

通过对近两年申报的有关创新中药新药资料审评的回顾与分析,对目前我国一类中药创新药物研究与开发的现状、优势、特点及存在问题等进行探讨。