鼻前庭三角瓣法唇裂修复术

目的　介绍鼻前庭三角瓣法修复Ⅱ度唇裂的手术方法及其优点。方法　鼻前庭三角瓣法唇裂修复术按直线法定点 ,根据鼻底部三角形大小设计鼻前庭三角瓣修复Ⅱ度唇裂 ,并充分考虑Ⅱ度唇裂特点 ,在延长患唇时只延长裂隙内侧而不延长外侧 ,保留和合理利用了上方 (鼻孔底部 )本该切除的等边三角形皮瓣 ,使手术效果更令人满意。结果　 1993年 3月至 2 0 0 0年 12月行鼻前庭三角瓣法手术修复 2 0 8例唇裂患者 ,随访 136例 ,随访时间为 3个月至 6年零 5个月 ,优良率为 92 .6 %。结论　鼻前庭三角瓣法唇裂修复术既保留了直线法与上三角瓣法的优点 ,又克服了其他方法的不足 ,适用于Ⅱ度唇裂的修复     

基质金属蛋白酶在鼻内翻性乳头状瘤及鼻息肉组织中的表达

目的:探讨基质金属蛋白酶 (MMP)家族成员中的 MMP- 2和 MMP- 9在鼻内翻性乳头状瘤和鼻息肉组织中的表达。方法:采用免疫组织化学方法检测 30例鼻内翻性乳头状瘤和 15例鼻息肉组织中 MMP- 2和 MMP- 9的表达。结果 :MMP- 2和 MMP- 9在细胞浆染色最强。鼻内翻性乳头状瘤组织和鼻息肉组织中 MMP- 2阳性表达率分别为 5 6 .6 7%和 4 6 .6 7% (χ2 =0 .4 0 2 ,P >0 .0 5 ) ,MMP- 9阳性表达均为 80 .0 0 %。结论:MMP家族所致的蛋白水解酶活性增高可能在鼻内翻性乳头状瘤对骨的破坏力上起主要作用。     

Virtual dissection and automated polyp detection of the colon based on spiral CT — Techniques and preliminary experience on a cadaveric phantom

Summary   Background: CT colonography was found to be sensitive and specific for detection of colonic polyps and colorectal cancer (CRC). Depending on the software used, CT colonography requires a certain amount of operator interaction, which limits it’s widespread usage. The goal of this papers is to present two novel automated techniques for displaying CT colonography: virtual dissection and automated colonic polyp detection. Methods: Virtual dissection refers to a technique where the entire colon is virtually stretched and flattened thus simulating the view on the pathologist’s table. Colonic folds show a ‘global outward bulging of the contour’, whereas colonic polyps exhibit the inverse (‘local inward bulging’). This feature is used to map areas of ‘local inward bulging’ with colours on 3D reconstructions. A cadaveric phantom with 13 artificially inserted polyps was used for validation of both techniques. Results: On virtual dissection all 13 inserted polyps could be identified. They appeared either as bumps or as local broadening of colonic folds. In addition, the automated colonic polyp detection algorithm was able to tag all polyps. Only 10 min of operator interaction were necessary for both techniques. Conclusions: Virtual dissection overcomes the shortcomings of CT colonography, and automated colonic polyp detection establishes a roadmap of the polyps.      

鼻中隔动脉的形态学观测

经两侧颈总动脉灌注墨汁混合液，显示鼻部动脉，借助体视显微镜对鼻中隔动脉各主干的数量，外径，长度，行程，分布范围及鼻中隔各区动脉主要来源，分支密度，吻合弓级数及弓数作了观测。     

鼻部皮肤肿瘤切除后的创面修复

目的 介绍鼻部皮肤肿瘤切除后创面的即刻修复经验。方法 1996年4月～2006年4月，在遵循鼻亚单位组成的美学原则基础上，根据创面大小、形状、部位及周围皮肤情况，选择相应局部皮瓣修复鼻部肿瘤切除后致鼻缺损428例。其中男273例，女155例；年龄12～78岁，中位年龄52岁。基底细胞癌146例，鳞状细胞癌83例，表皮囊肿54例，色素痣145例；恶性肿瘤临床分期0～Ⅰ期，病程1周～3个月。鼻尖51例，鼻翼102例，鼻背138例，鼻侧壁137例；其中跨鼻亚单位缺损83例。肿瘤切除后致鼻缺损0．6cm×0．6cm～3．0cm×4．0cm。皮瓣来源于额鼻皮瓣58例，双叶皮瓣67例，改良菱形皮瓣152例，鼻唇沟皮瓣118例，额正中皮瓣33例。供区创面直接拉拢缝合。结果 患者创面Ⅰ期愈合423例；3例皮瓣远端部分表皮坏死，经局部换药后创面愈合；2例患者切口轻度感染，经局部换药处理后创面Ⅰ期愈合。供区均未形成继发性缺损，创面Ⅰ期愈合。术后385例获随访1～60个月。鼻外形轮廓较好，修复组织色泽、质地与周围皮肤匹配良好，恶性肿瘤无复发。结论 遵循鼻亚单位美学原则，应用局部皮瓣能修复鼻部肿瘤切除后中等以上创面，且色泽、质地、轮廓等均能达到较好匹配和协调，可获得满意功能和稳定的美学效果。     

上颌窦霉菌病的鼻内镜手术治疗

目的探讨鼻内镜下单纯上颌窦口扩大术治疗非侵袭性霉菌球型上颌窦炎的疗效. 方法回顾分析16例非侵袭性霉菌球型上颌窦炎的临床资料. 结果手术时间30～120 min,平均60 min.无手术并发症发生.住院5 ～7 d,平均6 d.16例术后病理找到菌丝和孢子,9例霉菌培养为曲霉菌.16例术后随访3～24个月,平均18个月,14例无症状,内镜示窦口通畅,窦腔粘膜正常;2例复发,再次扩大窦口,分别随访6、13个月无复发. 结论非侵袭性霉菌球型上颌窦炎鼻内镜下单纯上颌窦口扩大术可达到根治和微创的临床效果,但应特别注意窦口处理.     

胎儿鼻粘膜毛细血管的超微结构研究

本文在透射电镜下观察了五例足月胎儿下鼻甲粘膜毛细血管的超微结构。在上皮下和腺泡周围的固有膜中观察到有孔毛细血管。我们对 Kanan 所提出的有孔毛细血管是出生后冷空气激发所致的观点提出疑议。     

The role of TNF alpha polymorphism and expression in susceptibility to nasal polyposis

Objective: In this study, we first performed a meta-analysis to assess the role of single-nucleotide polymorphism (SNP) within tumor necrosis factor alpha (TNF alpha) gene and TNF alpha expression in the risk of nasal polyposis.

Methods: STATA 12.0 software was utilized to conduct the Mantel–Haenszel statistics, Cohen statistics, Begg’s test, Egger’s tests and sensitivity analysis.

Results: We systemically carried out the database retrieval and initially identified 486 articles. After screening, 15 articles were included in our meta-analysis. For TNF alpha rs1800629 G/A SNP, compared with control group, an increased risk of nasal polyposis of case group was observed in the models of A vs. G [p (P value of association) = 0.009, OR (odds ratio) = 1.35], GA vs. GG (p = 0.001, OR = 1.69), GA+AA vs. GG (p = 0.010, OR = 1.47). The similar results were observed in Caucasian subgroup (p < 0.05, OR > 1). For TNF alpha rs361525 G/A SNP, no significant difference between control and case group was detected (all p > 0.05). In addition, a significant difference exists between case and control groups in the meta-analyses of TNF alpha expression in nasal mucosal cells, secreted TNF alpha (p < 0.05, OR > 1), but not serum TNF alpha (p = 0.090).

Conclusion: The present meta-analysis revealed that TNF alpha rs1800629, increased TNF alpha expression and secretion of nasal mucosal cells were associated with an increased risk of nasal polyposis.