咽拭子、肺泡灌洗液肺炎支原体-DNA 水平与社区获得性肺炎支原体肺炎炎性反应及免疫功能的关系

目的探究咽拭子、肺泡灌洗液肺炎支原体-DNA(MP-DNA)水平与社区获得性肺炎支原体肺炎(CA-MPP)病儿病情、炎性反应及免疫功能指标的关系。方法选取2018年1月至2019年5月南阳市中心医院收治的92例CA-MPP病儿作为研究对象,对比重症组(n=30)与轻症组(n=62)病儿咽拭子、肺泡灌洗液MP-DNA水平。根据咽拭子、肺泡灌洗液MP-DNA水平分为低菌量组、中菌量组、高菌量组,比较三组血清炎性反应因子［C反应蛋白(CRP)、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)］水平、免疫功能指标［免疫球蛋白A(IgA)、IgM、IgG］水平,分析咽拭子、肺泡灌洗液MP-DNA与炎性反应、免疫功能指标的相关性。结果重症病儿咽拭子［(5.68±0.73)比(5.14±0.51)］、肺泡灌洗液MP-DNA水平［(6.87±0.85)比(5.70±0.63)］高于轻症病儿(P<0.05);咽拭子、肺泡灌洗液MP-DNA高菌量组血清CRP、TNF-α、IL-18水平高于中菌量组、低菌量组(P<0.05);咽拭子、肺泡灌洗液MP-DNA表达量与CA-MPP病儿血清CRP、TNF-α、IL-18水平存在显著正相关关系(P<0.05);咽拭子、肺泡灌洗液MP-DNA高菌量组血清IgA低于中菌量组、低菌量组,IgM、IgG高于中菌量组、低菌量组(P<0.05);咽拭子、肺泡灌洗液MP-DNA表达量与CA-MPP病儿血清IgA水平存在显著负相关关系,与血清IgM、IgG水平存在显著正相关关系(P<0.05)。结论咽拭子、肺泡灌洗液MP-DNA水平随着CA-MPP病儿病情加重而升高,且与病儿炎性反应、免疫功能存在密切相关性,监测其水平有助于临床明确病儿病情,指导合理治疗方案的制定。     

成人喉乳头状瘤低温等离子射频切除21例

目的 探讨使用等离子射频切除治疗成人喉乳头状瘤的疗效。方法 回顾性分析经等离子射频切治疗的21例喉乳头状瘤患者的临床资料。结果 所有患者均经内镜支撑喉镜下使用Arthrocare Reflex7070#刀头一次性完整切除乳头状瘤。均无气管切开。手术时间约2～11min,平均4min。术中出血量约1～13mL,平均3mL。术后进食及发音正常,无术后出血等并发症。手术部位局部伪膜术后4～6周完全脱落。局部无明显的瘢痕。局部随访1年～3年9个月,4例次复发,平均复发时间间隔为7个月。结论 内镜支撑喉镜下应用等离子射频治疗喉乳头状瘤是一种微创且有效的手术方法。     

解脲支原体感染与胎膜早破的关系

用ＰＣＲ技术同时检测３０例胎膜早破（ＰＲＯＭ）和２２例非胎膜早破（ＮＰＲＯＭ）的新生儿咽吸出物、胎盘组织及脐静脉血清中解脲支原体（Ｕｎ）感染率，发现ＰＲＯＭ组咽吸出物Ｕｕ阳性率为３６．６７％，ＮＰＲＯＭ组咽吸出物Ｕｎ阳性率为９．０９％，差异显著（Ｐ＜０．０５）。胎盘，脐血中Ｕｕ阳性率于两组间无显著差异，ＰＲＯＭ产妇中，新生儿咽吸出物Ｕｕ＋的平均ＩＭＲＤ为４５．０８小时，Ｕｕ－的平均ＩＭＲＤ为２８．３４小时，差异显著（Ｐ＜０．０５）；而孕妇胎盘组织、脐血Ｕｕ＋组与Ｕｕ－组平均ＩＭＲＤ显著差异。结果表明羊水解脲支原体感染能导致胎膜早破。     

Life events and difficulties in relation to the onset of globus pharyngis

Fifty patients with a diagnosis of globus pharyngis and 33 control patients attending the same ENT clinic were interviewed using the (Royal Holloway &) Bedford College Life Events and Difficulties Schedule (LEDS). Information was elicited concerning life events and difficulties over the 12 months before globus onset, and this was compared with the experiences of the control patients for the year before symptom onset or, where appropriate, before the interview. Globus patients had significantly more severe events than the control patients throughout the year. Moreover, globus patients had significantly fewer close confiding relationships with their partners than did controls. There is evidence, therefore, for both psychological diathesis and social stress factors in the etiology of globus pharyngis.     

Asymptomatic pharyngeal carriage of beta-haemolytic streptococci and streptococcal pharyngitis among patients at an urban hospital in Croatia

In a one-year study at the University Hospital of Infectious Diseases in Zagreb, Croatia the rate of asymptomatic throat carriage of beta-haemolytic streptococci was investigated. Throat carriage was investigated in 1796 patients, none of whom had a sore throat nor signs and/or symptoms of a respiratory tract infection. The carrier rate of beta-haemolytic streptococci was 8.3%, for group A streptococci 6%, group B 1.3%, group C 0.3% and group F 0.1%. The highest rate was observed in the 6 to 14 year age group: 13.8% for all streptococcal groups, 11.7% for group A alone. The proportion of non-A streptococci was higher in older age groups. Tonsillectomised individuals were less frequently carriers. No sex or season-dependent variations were observed. In a four-month study of 629 patients with pharyngitis the throat cultures yielded: group A streptococci in 44.7%, group B in 1.7%, group C in 0.8%, and group G in 0.6% of the patients. Group A streptococcal rates in carriers compared to rates in patients with pharyngitis suggest that approximately one fourth of the schoolchildren with culture-positive pharyngitis actually are not truly infected, but only carriers currently having a sore throat of non-streptococcal etiology.Antibiotics were administrated to 605 (96.2%) patients with pharyngitis; in 571 (94.4%) of the cases before culture results became available. After culture-negative results were obtained the therapy was discontinued in only 28.5% of the cases. The throat culture is the standard for laboratory testing of group A streptococcal infection and should have more influence on the management of patients with pharyngitis at our hospital.     

《重楼玉钥》三十六症喉风病名今析

清代医学家郑梅涧所作的《重楼玉钥》是一部很有价值的喉科专著。笔者通过学习,试用现代医学观点对诸症喉风进行了初步分析后认为:《重楼玉钥》中论及的喉风虽分三十六症,但实际上共提到41种病症,包括现代医学57种疾病和症状。其中耳鼻咽喉科有27种,口腔科18种,皮肤科4种,外科4种,内科1种,传染病方面有3种。有的一种喉风包括数种疾病和症状,也有的几种喉风实为一种疾病。现归纳为三个部分,分述如下:　　一、咽喉病症(14种)　　1.单鹅风　引文:“此症生在帝中之旁,如莲子样。”又“枢扶氏曰:‘……此症致生咽喉之旁,状如蚕蛾,亦有形若枣栗者,…     

清咽喉雾化液的制备及质量标准研究

目的：制备清咽喉雾化液,并建立其质量控制方法。方法：以黄芩、黄连、黄柏、金银花、鱼腥草等制备清咽雾化液;采用薄层色谱法对金银花、黄芩进行鉴别;用高效液相色谱法测定绿原酸的含量;对制剂进行稳定性试验。结果：所得制剂为黄棕色至棕褐色的液体。各项检查均符合《中国药典（2010版一部）》相关规定。绿原酸含量在1．90—13．97μg（r=0．9991）范围内与峰面积呈良好线性关系,平均回收率为98．1％,RSD为3．70％。结论：该制剂制备工艺简单可行,所建立的质量控制方法可靠,制剂质量稳定。     

清热泻下法治疗鼻咽喉炎性疾病的临床观察

目的 探讨清热泻下合剂治疗鼻咽喉炎性疾病的疗效。方法 对鼻咽喉的炎性疾病的病人应用清热泻下合剂治疗并设对照组,观察临床疗效和作用机理。结果 清热泻下合剂和对照组比较有很好的疗效,差异有显著性意义(P<0.05)。结论 清热泻下合剂治疗鼻咽喉炎性疾病有很好的临床效果,值得临床推广。     

喉外伤的急救和护理

目的:探讨喉外伤的急救和护理经验。方法:密切观察呼吸变化,保持呼吸道通畅;建立有效的静脉通道;做好术前准备、呼吸道护理、饮食护理、心理护理及特殊患者的护理。结果:32例患者均治愈出院,无窒息、死亡及护理并发症发生。结论:保持呼吸道通畅是抢救喉外伤最基础、最主要的措施;及时正确的急救和护理,是提高抢救成功率,减少并发症,促进康复的关键。