鼾症-颌下腺下垂与阻塞性睡眠呼吸暂停综合症

目的:研究阻塞性睡眠呼吸暂停综合症(OSAS)患者的颌下腺及其与阻塞性睡眠呼吸暂停综合症的关系;研究摘除颌下腺治疗OSAS.方法:随机对确诊为OSAS的患者20例,对颌下腺进行CT扫描和MR检查,术前行多导睡眠监测(PSG),以及颌下腺摘除术中对颌下腺形态和走向进行观察,并总结其症候群;其中8例自愿行术后PSG,对患者及家属进行调查和随访,以确定治疗效果.结果:20例OSAS患者均有颌下腺移位肿大,即向下移位和肿大;术后监测8例AHI均在14.90以下;12例患者阻塞性睡眠呼吸暂停(OSA)消失,8例呼吸暂停明显缓解;8例鼾声消除,12例减弱;全部患者白天疲劳消除,高血压患者舒张压降至90mmHg以下;随访12例患者12～24个月,无1例OSA复发.结论:鼾症可能引起颌下腺移位肿大,使舌根后坠和舌体高拱,同时压迫咽腔通道,最终导致OSAS;颌下腺移位肿大是OSAS的主要成因之一,摘除移位肿大的颌下腺是治愈OSAS的主要方法之一.     

乳腺肿瘤内分泌激素动态变化及治疗相关性研究

目的寻找乳腺癌、乳腺增生患者内分泌激素变化共同规律。方法1252例乳腺肿瘤分5组统计：加权法统计分析433和111例乳腺肿瘤的激素平均值与正常人群标准值比较;53例（滤泡期）和15例（绝经期）乳腺肿瘤治疗前、后,两组统计（x±s）对照下丘脑-垂体激素;乳腺癌和乳腺增生病各50例,在治疗前绝经前期和绝经期,用秩和检验,正态近似法（Wilcox-on两样比较法）统计分析;按百分率统计分析440例乳腺肿瘤激素轴系相关性;按百分率统计分析1252例乳腺肿瘤伴随多种腺体疾病。结果乳腺肿瘤433和111例比正常人群滤泡期和绝经期HPO轴系的正常值增高;53例（滤泡期）和15例（绝经期）乳腺肿瘤治疗前、后,两组统计对照下丘脑-垂体激素,呈亢进的激素水平明显下调;100例乳腺良、恶性绝经前期FSH和绝经期ACTH高于乳腺异常增生病患者;分析乳腺肿瘤440例的HPO激素轴系、GH轴系、PRL激素轴系和免疫激素轴（ACTH轴系、TSH轴系）的相关性;总数滤泡期973例乳腺肿瘤中,40%伴随多种腺体疾病。结论乳腺增生病、乳腺癌患者,雌激素轴系（FSH、E2）长期处于绝对过高,刺激乳腺导管上皮增生、导管扩张及刺激靶受体（ER）增多,ER活性随着乳腺癌分化程度的降低而降低,其激素变化与病理改变过程相一致;乳腺癌患者绝经前期血浆中FSH和绝经期ACTH浓度高于乳腺增生病患者;乳腺肿瘤患者往往并发多种腺体疾病;其治疗前、后的亢进激素水平明显下调。     

Salivation: A Review and Experimental Investigation of Major Techniques

Techniques for assessing salivation were reviewed and several problem areas highlighted including measurement and reliability problems, and questions relating to sex and gland differences. Ten mate and 10 female undergraduate students took part in an experiment to examine critical issues and assess the comparability of the most frequently used techniques (whole mouth, parotid capsule, and cotton swabs). Results showed that methods were significantly intercorrelated, sex differences were minimal, and laterality effects small and inconsistent.     

Electrolyte concentrations in primary and final saliva of the rat sublingual gland studied by micropuncture and catheterization techniques

Summary The salivary electrolyte concentrations at various secretory rates have been studied in the rat sublingual gland and compared with the concentrations found in acinar-intercalated duct (primary) fluid obtained by micropuncture. The primary fluid had the following composition: [Na]=126±1.6 (S.E.M.,n=39) mEq/l; [K]=11.9±1.2 mEq/l (n=39); [Cl]=99.3±2.3 mEq/l (n=33). The Na and K concentrations differed significantly from those of plasma and from those observed previously in the primary fluid of rat parotid and submaxillary glands. The composition of primary fluid was not altered by carbachol stimulation.After carbachol stimulation, the final saliva, like that of the human but unlike that of the cat and dog sublingual gland, was hypotonic and the electrolyte concentrations showed flow-rate dependence. At the lowest flow rate the Na concentrations averaged 24.6±3.9 mEq/l (n=25) which fell first to a minimum and then rose to a plateau of about 60 mEq/l as flow rate increased to a maximum. The excretory curve showed no tendency to approach the concentrations seen in primary saliva. The K excretory curve was typical of that seen in most other salivary glands, having high concentrations at low flow rates which fell towards a plateau above primary fluid levels as flow rate increased. The salivary bicarbonate concentration was always above that in plasma; it tended to rise to a plateau of about 48 mEq/l at the highest flow rates. This concentration is probably greater than that present in primary fluid although the primary levels have not been measured directly.The results are best interpreted in terms of a modified two-stage hypothesis. First a primary, Na-rich, K-poor secretion is formed in the acinar-intercalated duct region whose composition, although decidedly not plasma-like, is constant irrespective of the degree of gland stimulation. Then, secondarily, this fluid is modified during passage along the striated and excretory ducts by processes of Na reabsorption and K and HCO₃ secretion. These secondary transport processes are not transport-maximum-limited but appear to increase with increasing degree of stimulation resulting in a phenomenon which could be termed acinar-tubular balance.Although it has not proven possible to micropuncture striated ducts in the rat submaxillary or parotid glands, in the sublingual gland we were able to do so in a few cases. For the first time we are able to offer direct proof that these ducts do contain hypotonic fluid.A preliminary report of this work was presented at a meeting of the Australian Physiological and Pharmacological Society held in Hobart in August 1970 [20].     

产前诊断肾上腺肿块26例诊疗分析

目的：回顾近10年间我们诊治的产前B超发现的26例肾上腺肿块患儿临床资料,探讨B超检查发现胎儿肾上腺肿块的诊断和治疗。方法2003年6月至2012年12月本院收治经产前B超发现的新生儿肾上腺肿块26例,均进行了手术治疗,对该组病例进行回顾性分析和随访。结果肾上腺肿块患儿26例;男16例,女10例;所有病例均进行了肿瘤肉眼完整切除＋后腹膜肿大淋巴结清扫手术（其中1例因肿瘤浸润同侧肾脏而行肿瘤及受累肾脏一并切除术）。术后病理证实为肾上腺神经母细胞瘤17例,肾上腺血肿5例,海绵状血管瘤2例,成熟畸胎瘤和嗜铬细胞瘤各1例。神经母细胞瘤组与非神经母细胞瘤组在肿块大小（P＝0.04,P＜0.05）,B 超肿块内有血流信号（P＝0.03,P＜0.05）、增强CT肿块内有强化（P＝0.01,P＜0.05）上比较,差异有统计学意义。在巨大儿所占该组比例（体重＞4 kg）（P＝0.363）、随机尿VMA/Crea 检查（P＝0.389）两个方面比较,差异无统计学意义。结论通过评估肿块大小、肿块内血流信号（B超）和肿块内有强化（增强CT）等即可对神经母细胞瘤做出较为准确的诊断。而出生体重和随机尿VMA/Crea在鉴别诊断中意义不大。较大的新生儿肾上腺实质性肿块多数为肿瘤,如神经母细胞瘤等,建议出生后尽早手术,如果手术切除彻底则术后可不必化疗;较小的囊性肿块可能为肾上腺血肿,出生后血肿可变小或者消失。4s期神经母细胞瘤建议进行术后化疗,通常新生儿时期化疗耐受性较差,通常预后不佳。     

Pharmacological melioration by Selenium on the toxicity of tellurium in neuroendocrine centre (Pituitary Gland) in male wistar rats: A mechanistic approach

PurposeThe present research was designed to evaluate the toxicity of tellurium and its prevention by selenium on the pituitary gland in male Wistar rats.Methods30 rats were used weighing 200–250 gm, and randomly divided them into five groups. Each group contained an equal number of animals. Group-1 was nominated as control group. Group-2 received an intraperitoneal dose of selenium 0.3  mg per kg body wt. Group-3 was administered with tellurium 4.15 mg per kg body wt. Group-4 was given low-dose (L) of both selenium 0.15 and tellurium 2.075, Group-5 was given High-dose (H) of both selenium 0.3 and tellurium 4.15 mg/kg body wt. orally once in a day. After 15 days of dosing, the behavioral activities- motor co-ordination rotarod and grip strength test were measured. On 16th-day animals were sacrificed and activity of LPO, GSH, caspase-3, caspase-9, GPx, GR, SOD, catalase, and AChE were performed on the pituitary gland as per standard method reported.ResultsSe when given together with Te, significantly protects the motor coordination up to 32.5%, and also protects the grip strength up to 75% in group 4 and 5 respectively as compared to group- 3. Se + Te treatment protects the activity of TBARS up to 48.68% and GSH is 58%. As compared to control, it protects caspase-3 up to 118% and caspase-9 up to 83%. The level of AChE was also observed to be modulated by the administration of Se in Group- 4 and 5. Se + Te protected AChE up to 28.6%. Similar findings were observed for the biochemical activities of GPx (140% protection), SOD (458%), GR (159%), and catalase (95%) activities that were protected significantly Se + Te in Group- 4 and 5.ConclusionSelenium dose-dependently protects behavioral activities. It also protects apoptosis, oxidative stress, and AChE activities in the pituitary gland.     

不同方法治疗儿童不同程度分泌性中耳炎的疗效观察

目的分析采用不同方法治疗儿童不同程度分泌性中耳炎的临床疗效,为临床治疗儿童不同程度的分泌性中耳炎提供参考依据。方法不伴腺样体肥大儿童患者20例为A组,伴腺样体肥大且单纯声导抗测试异常40例为B组,伴腺样体肥大且声导抗测试异常且伴有听力损失患儿20例为C组。A组患儿采用鼓膜置管术治疗,B组采用腺样体切除术治疗,C组患儿采用腺样体切除术和鼓膜置管术联合治疗。术后3个月内所有患者服用抗生素预防感染,6个月后观察治疗效果。结果 3组患儿经手术后症状均好转,与术前比较各频率气导听阈明显下降（P〈0.05）;C组患儿术后并发症高于A、B两组。结论采用不同方法治疗儿童不同程度的分泌性中耳炎有助于提高治疗效果,医生要注意使用不同手术方法,减少术后并发症。     

FZD2基因与涎腺腺样囊性癌增殖及侵袭转移能力的关系

目的 探讨FZD2基因表达与涎腺腺样囊性癌转移的相互关系及其对癌细胞增殖和侵袭能力的影响.方法 采用免疫组织化学方法分析FZD2基因在转移和非转移的涎腺腺样囊性癌组织样本中的表达,并采用siRNA干扰技术下调FZD2基因的表达,观察FZD2基因表达对涎腺腺样囊性癌细胞增殖能力、侵袭能力的影响.结果 FZD2基因在涎腺腺...     

腮腺Warthin瘤的MSCT诊断价值和临床分析

目的探讨腮腺腺淋巴瘤(Warthin瘤)的MSCT表现与临床分析,以提高对该瘤的诊断水平。方法回顾性分析经手术病理证实的29例腮腺Warthin瘤的MSCT表现,并与行细针吸取细胞学检查的14例进行比较,分析MSCT的诊断价值。结果 29例患者中男25例;单侧单发22例,双侧单发2例,单侧多发4例,双侧多发1例,共45个病灶,其中75.6%(34/45)病灶位于腮腺浅叶后下极。MSCT平扫4例,25例行增强扫描动脉期,6个病灶轻度强化,12个中度强化,23个明显强化,其中22例诊断为Warthin瘤。14例细针吸取细胞学检查中诊断Warthin瘤的有10例,1例诊断为炎症,2例诊断为囊性病变,1例诊断为恶性可能性大。结论 MSCT增强扫描对腮腺Warthin瘤的诊断价值与细针吸取细胞学检查相当,临床考虑Warthin瘤的患者可依据MSCT表现进行手术方案的选择。