继发性唇裂鼻畸形硅胶植入整复术

本文介绍一种使继发性唇裂鼻畸形获得较好外形的新手术方法。术式包括切除偏曲的鼻中隔软骨,并将一片硅胶植入于中央作为鼻小柱支柱,从而矫正歪斜的鼻小柱和抬高鼻尖,使两侧鼻孔形态对称一致,用本法为11例单侧唇裂畸形较重者进行了整复,随访4个月至4年半。绝大多数(10/11)取得满意效果,未见有严重感染和变形等并发症。     

花生凝集素受体在鼻息肉组织中的表达及意义

目的 :探讨花生凝集素受体在鼻息肉组织中的表达及意义。方法 :将 2 4例鼻息肉标本及 15例正常鼻窦黏膜标本行凝集素亲合组织化学ABC法染色。结果 :正常鼻息肉黏膜染色基本阴性 ,鼻息肉呈弱染色。N -PNA(预先经神经氨酸酶处理后再进行PNA染色 )染色均显著加深。结论 :从正常鼻窦黏膜到鼻息肉 ,花生凝集素受体的表达发生改变 ,该种改变在鼻息肉的病理机制中可能起着重要作用     

Bilateral choanal atresia and paranasal sinus hypoplasia in an adult patient with hypogammaglobulinaemia

We present an unusual case of a young female patient presenting with bilateral choanal atresia, which was probably acquired, associated with nasal and paranasal sinus hypoplasia and hypogammaglobulinaemia.     

Acoustic rhinometry in nasal provocation test in perennial allergic rhinitis

Acoustic rhinometry is one method to evaluate nasal geometry by an acoustic reflection technique. The aim of this study was to investigate the changes in acoustic rhinometry after nasal provocation in patients with exclusively perennial allergic rhinitis. In 19 patients, acoustic rhinometry and active anterior rhinomanometry were performed before and after nasal provocation test. There was a statistically significant nasal flow reduction measured by active anterior rhinomanometry after nasal provocation (p < 0.05) and a median symptom score of four points, both indicating a positive response to nasal provocation. On the other hand, there was no statistically significant change in the values of acoustic rhinometry after nasal provocation (p > 0.05). In patients with exclusively perennial allergic rhinitis, acoustic rhinometry does not seem to significantly change after nasal provocation. In contrast, active anterior rhinomanometry values decreased significantly after nasal provocation. The presented results indicate that acoustic rhinometry does not seem to be a diagnostic method superior to active anterior rhinomanometry in this context.     

完全性房室间隔缺损的外科治疗

目的回顾性总结手术治疗完全性房室间隔缺损的经验。方法112例病儿,≤6个月43例(38%,X组),>6个月69例(62%,Y组)。85例行心导管检查。Rastelli A型89例,Rastelli B型10例,Ras- telli C型13例。手术技术分单片法,双片法和简化单片法。术中经食管超声检查发现异常而即刻再次手术者7例(二尖瓣反流4例,二尖瓣狭窄2例,左室流出道梗阻1例)。术后入重症监护室,左房压8～21 mm Hg,中心静脉压7～12mm Hg。呼吸机平均应用47h,监护室平均滞留6.3d。结果室间隔缺损残余分流(直径>2mm)13例,二尖瓣中度反流12例,完全性房室传导阻滞4例。院内死亡6例(X组1例,Y组5例)。术后随访91例(81%),随访1～5年,平均2.3年。1例术后1年因肺炎心衰死亡,1例术后2年因二尖瓣中-重度反流而换瓣。结论院内死亡率提示,小于6月龄完全性房室间隔缺损病婴手术是安全的。随着年龄增大,瓣膜成形效果、肺动脉高压的预后可能会更差。双片法修补室间隔缺损较易发生残余漏(9例,18%),简化单片法出院时二尖瓣关闭不全发生率明显高于另外两种方法(6例,16%)。     

埋没导引缝合法矫治鹰钩鼻鼻尖畸形

目的介绍一种较新的矫治鹰钩鼻鼻尖畸形的手术方法。方法自1995年2月至2005年5月,采用埋没导引缝合技术对18例鹰钩鼻鼻尖畸形患者进行手术矫治,术后结合鼻管支撑的鼻孔悬吊法外固定7~10d。结果术后经14个月至3年的随访,18例患者的鼻尖外形良好,形态满意。其中1例患者因鼻腔内悬吊线穿透引起轻度炎症,术后3周剪除缝线,5d自愈。结论采用埋没导引缝合的手术方法对鹰钩鼻鼻尖畸形患者进行矫治,并结合缝合、悬吊和固定,获得了良好的术后效果。此方法是一种较理想的手术方法,值得推广应用。     

上颌扩弓治疗纠正早期功能性下颌偏斜

目的:通过头颅定位后前位片(P-A)测量,探讨上颌扩弓纠正单侧后牙反牙合,改善早期功能性下颌偏斜. 方法:混合牙列或早期恒牙列,单侧后牙反牙合伴有或不伴有前牙反牙合, 下颌功能性偏斜患者16名,采用上颌Quad-Helix扩弓的方法,矫治前后头颅定位后前位片P-A测量分析,用统计软件处理数据. 结果:单侧后牙反牙合矫正后,下颌骨两侧结构不对称性有明显改善. 下颌骨两侧综合长度差亦减小(P<0.01),两侧下颌体长度差明显减小(P<0.01). 结论:混合牙列或早期恒牙列,由于单侧后牙反牙合导致的功能性下颌偏斜,采用扩大上颌牙弓,可以使下颌骨的不对称得到一定的改善,是早期纠正下颌功能性偏斜的有效手段.     

Oral administration of an edible-mushroom-derived protein inhibits the development of food-allergic reactions in mice

BACKGROUND: Food allergy is a common disease without effective treatment. Since strict elimination of food allergens may be difficult, strategies for effective intervention are urgently needed. OBJECTIVE: The aim was to investigate the prophylactic use of orally administrated FIP-fve, an immunomodulatory protein isolated from the edible mushroom Flammulina velutipes, in a murine model of food allergy. METHODS: BALB/c mice were immunized twice intraperitoneally with ovalbumin (OVA), at an interval of 2 weeks. Before and during each period of immunization, FIP-fve (200 microg per mouse) or phosphate-buffered saline was given orally every other day with a total of five doses. Then OVA-specific antibodies and cytokine profiles were determined. Subsequently, the mice were orally challenged with OVA. Symptoms of anaphylaxis, levels of plasma histamine, and histology of intestines were examined. RESULTS: Mice receiving oral FIP-fve treatment during sensitization to OVA had an impaired OVA-specific IgE response with a Th1-predominant cytokine profile. These mice were protected from systemic anaphylaxis-like symptoms induced by subsequent oral challenge with OVA. CONCLUSION: Oral administration of FIP-fve has a Th1-skewing effect on the development of the allergen-specific immune response, and may serve the purpose of immunoprophylaxis for food allergy and other allergic diseases.     

鼻腔粘膜吸收庆大霉素功能的研究

用静脉内、肌肉内及鼻腔内三种给药途径给１０只狗按５ｍｇ／ｋｇ用４０ｍｇ／ｍｌ的庆大霉素，并使用双波长色谱扫描法测定０～１８０分钟血清庆大霉素的浓度，比较其生物利用度。发现鼻内给药的生物利用度为静脉注射的８０．５％，肌肉注时为４２％。鼻腔用药后１０～３０分钟血清浓度达到高峰，范围在３．７～６．６μｇ／ｍｌ，半衰期长达３小时左右，表明鼻粘膜对庆大霉素有良好的通透性，可使其迅速吸收入血，并能在血中长时间维持有效浓度。     

Bilateral reverse U incisions and separately placed columella relaxation incision for correction of bilateral cleft lip nose deformity

The reverse U incision method has been employed for the correction of the unilateral cleft lip nose deformity for more than twenty years with satisfactory results. It has some columella lengthening effect and thus has proved to be useful for the correction of nasal deformities of bilateral cleft lip. To augment its columella lengthening effect a columella relaxation incision is added to the bilateral reverse U incision for the correction of the bilateral cleft lip nose deformity. This results in a reconstructed columella of satisfactory length and width.