下鼻甲移位联合泪道置管治疗复发性鼻泪管阻塞临床分析

目的 :探讨逆行置管联合下鼻甲局部压榨移位术治疗复发性鼻泪管阻塞的临床效果。方法 :用 Y型硅胶管由下鼻道逆行置入鼻泪管 ,先用带线探针按常规方法自泪点插至下鼻道 ,以弯血管钳抵探针末端并稍向鼻中隔方向移动 ,令鼻甲局部骨折移位 ,鼻泪管开口下方引流道通畅 ,引线带硅胶管由此下鼻道入鼻泪管及泪囊 ,硅胶管留置 1个月～ 2个月。结果 :采用此方法治疗各种复发性鼻泪管阻塞 10例 11眼 ,其中 9例 10眼治愈 ,1例 1眼无效 ,治愈率 90 .9%。结论 :下鼻甲压榨移位联合鼻泪管逆行置管是治疗复发性鼻泪管阻塞有效方法     

湿润烧伤膏用于微波治疗下鼻甲肥大后长期不愈的临床观察

目的观察湿润烧伤膏用于微波治疗下鼻甲肥大后长期不愈的临床效果。方法将80例行微波治疗下鼻甲肥大后长期不愈的患者随机分为治疗组和对照组各40例。对照组仅予以清洁鼻腔处理;治疗组在对照组治疗基础上予以湿润烧伤膏涂擦创面治疗。观察并比较2组临床疗效及创面愈合时间。结果治疗组总有效率为95.0%,高于对照组的65.0%;平均创面愈合时间为(15±5)d,低于对照组的(25±7)d,差异均有统计学意义(P<0.01)。结论湿润烧伤膏用于微波治疗下鼻甲肥大后长期不愈的患者,具有促进创面正常愈合、纤维组织少、疤痕小、疗效好等优点,值得临床推广使用。     

电针刺激对2型糖尿病大鼠皮肤屏障及色泽的影响

目的:探讨电针刺激对2型糖尿病大鼠皮肤状态的影响,并比较体穴电针与耳甲区电针作用的差异。方法:50只雄性SD大鼠随机分为空白对照组(n=10)、模型组(n=13)、耳甲区电针刺激组(简称耳甲区组,n=13)和体穴电针刺激组(简称体针组,n=14)。一次性腹腔注射链脲佐菌素,并以高脂饲料喂养30d复制2型糖尿病模型。体针组(取"足三里"三阴交"穴)及耳甲区组大鼠连续接受电针刺激14d。应用皮肤测量系统MPA 9测量造模前、造模后及治疗结束后各组大鼠腹部及背部皮肤的含水量指数(SCH)、水分散失指数(TEWL)、红斑指数(EI)、黑色素指数(MI)、色差值(L.值、a.值、b.值)。结果:造模后,与空白对照组相比,模型组、体针组、耳甲区组背部皮肤SCH、TEWL、EI、MI、L.值、a.值均下降(P<0.05),b.值升高(P<0.05);腹部皮肤的TEWL、EI、a.值、b.值均升高(P<0.05),SCH、L.值均下降(P<0.05),MI没有显著变化(P>0.05)。电针治疗结束后,体针组除腹部TEWL和背部EI变化不明显外(P>0.05),其余指标均较模型组有明显改善(P<0.05);耳甲区组大鼠背部皮肤TEWL、L.值、b.值及腹部皮肤SCH、L.值、b.值较模型组有明显改善(P<0.05),其它指标变化不明显(P>0.05)。结论:电针刺激"足三里"三阴交"或耳甲区后,2型糖尿病大鼠皮肤屏障受损及皮色改变的情况得以改善,体穴电针比耳甲区电针改善作用更明显。     

基于COI条形码序列的珍珠母及其混伪品的DNA分子鉴定

目的：探讨应用COI条形码序列对珍珠母及其混伪品进行物种鉴定的可行性。方法：用MEGA4．0等软件计算珍珠母及其混伪品种内及种问变异,构建珍珠母及其混伪品的NJ树。结果：珍珠母种内COI序列变异小,种问存在较多的变异位点,种问的遗传距离显著大于种内的遗传距离。通过构建的系统聚类树图可以看出,珍珠母不同来源个体均聚在一起,能够与其混伪品区分开。结论：基于COI序列的DNA条形码技术可以很好的鉴定珍珠母的正品来源及其混伪品。     

电针耳甲区不同介入时间对抑郁大鼠行为学的影响

目的:观察耳甲部迷走神经区电针刺激对抑郁模型大鼠行为学的干预作用,及不同介入时间的效果差异。方法:80只雄性Wistar大鼠应用开野实验进行筛选,分为模型组(6只)、耳甲电针组(12只)、耳甲预电针组(11只)、非耳甲电针组(12只)。各组大鼠均采用慢性轻度不可预见性复合刺激(CUMS)结合孤养方式造模,并对3个治疗组进行耳甲部电针治疗及非耳甲部电针对照治疗。各组造模前及每个周期结束进行开野实验、糖水摄入实验,评估大鼠行为活动状态。结果:耳甲电针治疗及非耳甲电针治疗对大鼠糖水偏好无影响。耳甲电针组开野实验得分始终高于正常水平;耳甲预电针组造模结束2周后得分下降幅度较大,与造模结束期相比差异有统计学意义(P<0.05);非耳甲电针组造模后及治疗后得分下降极显著(P<0.01)。结论:在持续孤养的条件下,耳甲部迷走神经区电针刺激对CUMS结合孤养模型大鼠行为抑郁状态的发展有一定的抑制作用,耳甲电针组对改善慢性应激模型大鼠在开野实验中活动度的效果好于耳甲预电针组。     

电针耳甲区对2型糖尿病大鼠胃肠动力的影响

ObjectiveTo observe the impacts of electroacupuncture (EA) at auricular concha on gastrointestinal motility in the rats with type 2 diabetes (T2D).MethodsA total of 30 SD male rats were collected. 8 rats of them were in a control group and the rest 22 rats were prepared as the model of T2D by intraperitoneal injection with streptozotocin (STZ) and high-fat forage. Blood glucose ≥ 16.7 mmol/L for 3 times was considered as modeling success in rats, thus the rats were collected in a T2D group (n = 16). These 16 T2D rats were divided into a model group (n = 8) and an intradermal auricular electroacupuncture stimulation (iaES) group (n = 8) according to random number table. In the iaES group, intervention with EA was applied at auricular concha unilaterally each time, once daily, on both sides alternatively, 5-day treatment as 1 course, at the interval of 2 days between courses, totally for 4 weeks. No any intervention was given in the model group and the control group. At the end of 4 weeks of intervention, the gastric emptying and intestinal propulsion were determined, ELISA method was adopted to determine gastrin (GAS) and motilin (MTL), and random blood glucose value and food intake were recorded in the iaES group, the model group and the control group successively.ResultsAfter modeling, as compared with the control group, the food intake and random blood glucose were increased significantly (both P < 0.001) and body weight was reduced obviously (P < 0.01) in the T2D group. After intervention for 4 weeks, compared with the model group, the food intake and gastric content weight were obviously reduced (both P < 0.05), the serum GAS content, gastric emptying and intestinal transit rate, as well as random blood glucose reduction were all higher (all P < 0.05) in the rats of the iaES group, but the difference was not significant in MTL between the iaES groups and the model group (P > 0.05).ConclusionElectroacupuncture at auricular concha improves gastrointestinal motility in T2D model rats.     

鼻丘及下鼻甲划痕法治疗变应性鼻炎的机制研究

目的 探讨鼻丘、下鼻甲划痕术治疗变应性鼻炎(allergic rhinitis,AR)的机制.方法 对24例持续性AR患者行鼻丘、下鼻甲划痕手术治疗,并于手术前、手术后4周取其下鼻甲鼻黏膜组织各1块,行HE染色、甲苯胺蓝染色及P物质(substance P,SP)免疫组织化学染色.观察鼻黏膜组织的组织形态及以嗜酸性粒细胞浸润为主的炎症病变情况;肥大细胞(MCs)浸润及脱颗粒情况,并计算MCs活化分数;SP免疫组化积分光密度值(IOD )的测定情况.结果 HE染色:手术后以嗜酸性粒细胞浸润为主的炎症病变程度较手术前有一定改善;SP免疫组化积分光密度值测定:手术前后相比,差异具有统计学意义(P<0.05);MCs情况:手术前后MCs浸润数量、脱颗粒情况及活化百分数经两两比较,差异均具有统计学意义(P<0.05).手术前后SP积分光密度值变化与MCs活化分数变化经相关性检验,存在相关关系(R=0.594).结论 鼻丘、下鼻甲划痕通过阻断鼻腔黏膜表面C类阳性感觉神经纤维,进而抑制SP的表达水平,降低其对MCs脱颗粒反应的协同作用,减少炎性介质的释放,进而缓解鼻腔黏膜变应性炎症,改善患者的鼻部症状,且SP含量的变化可在一定程度影响MCs的活化比例.     

自体耳软骨联合膨体聚四氟乙烯矫正短鼻畸形

目的：介绍一种矫正先天性短鼻畸形的手术方法一自体耳软骨联合膨体聚四氟乙烯（expanded polytetrafluethlene,ePTFE）,对先天性短鼻畸形患者行鼻部延长及鼻尖成形术。方法：采用闭合式切口,钝性分离鼻背筋膜后间隙至合适范围,充分松解鼻翼软骨处连接韧带,根据患者自身要求雕好鼻假体,耳屏软骨固定于假体小柱端成“L”形,耳甲腔软骨置于鼻尖处,缝合固定双侧鼻翼软骨肉侧角于“L”形植入体短臂上。结论：对145例患者随访1～2年,鼻延长长度为5～11mm,平均为9mm,伴有鼻尖低平者,鼻尖突出度增加3～7mm,平均5mm,均获得满意效果。结论：采用自体耳甲腔软骨及耳屏软骨联合ePTFE可以有效延长鼻长度,疗效可靠,可作为矫正先天性短鼻畸形的方法之一。     

Referred Headache of Rhinogenic Origin in the Absence of Sinusitis

SYNOPSIS
Nasal signs and symptoms commonly accompany cephalgia in some headache syndromes. Head pain associated with sinusitis is also fairly well-recognized. However, referred cephalgia of rhinogenic origin, in the absence of sinonasal symptoms or disease, is poorly understood. We report a case of a patient with chronic and severe headache for whom neurological and neurosurgical evaluation failed to reveal an etiology, but who possessed an intranasal anatomical variant (without sinusitis). Her headache resolved after endoscopic nasal surgery. We discuss the mechanisms of such referred pain, and the recent technological advances that made the diagnosis and treatment of this disorder possible.