中鼻道及其周围结构的解剖学观测

目的　探讨临床上经上颌窦口进入上颌窦诊疗的途径。方法　在 40例成人尸体颅矢状切面上 ,对中鼻道、半月裂孔、上颌窦口及其周围结构进行解剖学观测及上颌窦口的探针插入试验。结果　中鼻道、半月裂孔的长度分别为5 6.3 6± 2 .5 8mm、2 1.46± 1.79mm ;40例中 ,2 8侧 (70 .0 0 % )的上颌窦口位于半月裂孔的中 1/3部 ;12侧 (3 0 .0 0 % )的上颌窦口位于半月裂孔的后 1/3部。上颌窦口的形态不一。上颌窦口的前后径为 3 .14± 0 .47mm。上颌窦口距鼻腔底部、鼻小柱的距离分别为 3 0 .41± 2 .85mm、49.5 2± 2 .3 7mm。鼻小柱到上颌窦口与到鼻腔基底面连线的夹角为 40 .2± 3 .7°。 3 7侧 (92 .5 0 % )的上颌窦口能用直径≤ 2 .5mm的探针穿过。结论　经上颌窦自然开口行上颌窦口穿刺是安全、简便和有效的一种诊治方法。     

复方环丙氟哌酸鼻腔膜的研制及临床疗效观察

本文以明胶海绵为衬底,用环丙氟哌酸和氢化考的松、云南白药酊、达克罗宁制备的鼻腔消炎止血药膜,制备简便,质量稳定。临床观察结果证明,具有给药方便、疗效高、疗程短、药物作用持久,无毒副作用等优点。     

Effects of fexofenadine and desloratadine on subjective and objective measures of nasal congestion in seasonal allergic rhinitis

BACKGROUND: In vitro studies have shown much higher H1-receptor antagonist potency with desloratadine (DL) compared to fexofenadine (FEX), although it is unclear whether this has any clinical relevance on disease control parameters in seasonal allergic rhinitis (SAR), especially for nasal congestion. OBJECTIVE: To compare the relative efficacy between presently recommended doses of DL and FEX on daily measurements of peak nasal inspiratory flow (PNIF) and nasal symptoms in SAR. METHODS: Forty-nine patients with SAR were randomized into a double-blind, placebo-controlled cross-over study during the grass pollen season, comparing 2 weeks of once daily treatment with (a) 180 mg FEX or (b) 5 mg DL, taken in the morning. There was a 7-10 day placebo run-in and washout prior to each randomized treatment. Measurements were made in the morning (AM) and in the evening (PM) for PNIF (the primary outcome variable), nasal and eye symptoms. The average of AM/PM values were used for analysis. RESULTS: There were significant (P < 0.05) improvements, compared to placebo, with FEX and DL, for PNIF, nasal blockage, nasal irritation, and total nasal symptoms, but not nasal discharge or eye symptoms. There were no significant differences between active treatments. Values for PNIF (L/min) for mean placebo baseline, mean difference from baseline (95% CI for difference) were 126, 10 (4-16) for FEX; and 122, 11 (4-17) for DL. The mean difference (95% CI) between FEX vs. DL was 1 L/min (-7-8). Values for total nasal symptoms (out of 12) were: 3.2, 0.7 (0.2-1.2) for FEX; and 3.4, 0.9 (0.3-1.5) for DL, and for nasal blockage (out of 3) were: 1.1, 0.2 (0.1-0.4) for FEX; and 1.2, 0.3 (0.1-0.5) for DL. The mean difference (95% CI) in total nasal symptoms and nasal blockage between FEX vs. DL was 0.1 (-0.6-0.8) and 0.1 (-0.2-0.3), respectively. CONCLUSIONS: Recommended once daily doses of fexofenadine and desloratadine were equally effective in improving nasal peak flow and nasal symptoms in SAR.     

支气管肺泡灌洗液、血清、尿液中CEA测定对肺癌诊断价值的研究

应用放射免疫方法联合检测支气管肺泡灌洗液(BALF)、血清、尿液中癌胚抗原(CEA)含量,结果显示:肺癌患者BALF、血清、尿液中CEA均有不同程度的升高,与结核及肺良性疾病组间有显著差异(P<0.01)。其阳性率分别为63.64％,57.38％,27.58％,以BALF阳性率为最高,这对肺癌的诊断及判断预后提供了方便可行的检测手段。     

A study of some current methods for assessment of nasal histamine reactivity

The aim of this study was to investigate the reactivity of the nasal mucosa of patients with pollen allergy compared to healthy controls, when challenged with histamine outside the pollen season. Assessments were made with symptom score, acoustic rhinometry, nasal peak expiratory and inspiratory flow (NPEF and NPIF) and rhinomanometry in order to find the most sensitive method for the purpose. Twenty-one patients with seasonal allergic rhinitis and 20 healthy controls were challenged with histamine dihydrochloride in increasing concentrations (0.01, 0.1, 1.0 mg/ml) locally in the nose. Our results show no difference in mucosal reactivity between the patients and controls regardless of the method used. When comparing the methods we find that NPIF and NPEF are more sensitive to mucosal changes than the other methods we have studied.     

Techniques of nasotracheal intubation with the fiberoptic bronchoscope

When nasotracheal intubation with a fiberoptic bronchoscope is performed, the tube may be blocked in the nasal cavity or larynx, resulting in several complications including epistaxis and hoarseness. We review the causes and complications of tube blockage and discuss optimal techniques for minimizing it.     

Nasal septum lesions caused by chromium exposure among chromium electroplating workers

A chromium electroplating worker, suffering from epistaxis during work, was found to have nasal septum perforation. To determine the etiology and prevalence of nasal septum lesions, we conducted a survey of seven chromium electroplating factories and examined 79 workers. Forty workers from three aluminum electroplating factories were also enrolled as the reference group. Subjects were thoroughly examined by an otolaryngologist and each of them provided a blood and urine sample. A questionnaire interview regarding symptoms of the upper respiratory tract, past medical history, life style, and work history was also conducted. Air chromium concentrations were measured by taking area samples for 4–6 hours. Based on field observation and chromium measurements, we divided chromium electroplating into three different exposure zones: workers directly dealing with electroplating tanks (n = 31), other process workers (n = 29), and office workers and drivers (n = 19). Among the 79 chromium electroplating workers, there were 16 cases of nasal septum perforation, and 42 with either scar formation or ulceration; 10 chromium electroplating workers developed skin ulcers after performing chrome plating. No workers from aluminum electroplating factories had any nasal septum or skin abnormalities. There was a consistent trend between the degree of chromium exposure and the signs and symptoms related to the nose, throat, and skin. Immediate improvement of occupational hygiene is warranted.     

耳廓复合组织瓣连续法修复鼻翼缺损

目的观察耳廓复合游离组织瓣连续法修复鼻翼缺损的疗效，以探讨鼻翼缺损的有效修复手段。方法耳廓复合游离组织瓣2次连续法修复鼻翼缺损7例，移植物面积0．5cm×0．7cm～0．8cm×1．2cm。结果7例耳廓复合游离组织瓣移植后全部成活。术后随访6～18个月，移植物无明显回缩，鼻外形满意。结论耳廓复合游离组织瓣连续移植修复鼻翼缺损，适合较严重鼻翼缺损，手术成功率高，术后鼻外形满意，双侧分次取材，耳廓外形双侧对称无畸形。     

CT扫描在内窥镜鼻窦手术中的应用价值

目的 探讨鼻窦CT扫描在内窥镜鼻窦手术中的应用价值。方法 回顾性对80例慢性鼻窦炎患者鼻窦CT扫描与手术中所见进行分析总结。结果 冠状位CT扫描鼻窦病变发现率高，辅以水平CT扫描，鼻窦精细结构、病变范围和程度能够清楚地显示，符合术中所见。结论 鼻窦CT扫描能精确显示鼻窦结构及病变，能正确指导鼻窦内窥镜手术。     

齿槽裂植骨整复畸形鼻

目的:探讨齿槽裂及鼻底进行天然多孔骨(Bio-OssCollagen材料)移植整复畸形鼻的可行性和临床疗效。方法:对12例齿槽裂及鼻底行Bio-OssCollagen材料植入整复手术。结果:随访9￣12月外形恢复良好,唇部和鼻底丰满,鼻翼提升,X线片示齿槽裂及鼻底植入Bio-OssCollagen材料基本被自体骨取代。结论:用Bio-OssCollagen材料代替自体骨植入齿槽裂及鼻底整复畸形鼻,均效果良好。