影响鼻窦显微手术疗效因素的分析

目的 分析影响鼻窦显微手术疗效的因素。方法 鼻内筛窦手术,经上颌窦手术,上颌窦窦口扩大,中鼻道开窗。结果 ３５９侧鼻窦显微手术,术后１～４年（平均３６．４个月）,随访２８８侧,治愈１０８例（３７．５％）,显著进步８７例（３０．２％）,好转６５侧（２２．６％）,无效２８侧（９．７％）,良好率６７．７％,鼻内筛窦手术良好率６０．６％,经上颌窦手术良好率７２％,上颌窦窦口扩大未闭良好率６０．１％,中鼻开     

地塞米松·葡聚糖的合成及其肠内容物中的转释特性

目的　探讨地塞米松·葡聚糖 (平均相对分子质量 5× 10 5 )作为结肠定位地塞米松前体药物的可能性 .方法　以琥珀酸酐为交联剂 ,合成地塞米松前体药物 .将前体药物与大鼠胃肠道不同部位内容物一起孵育 ,检测地塞米松的释放情况 .结果　经高效液相色谱 (HPL C)分析 ,10 0 mg所合成的前体药物中载有地塞米松 9.2 mg.在 16 0 min的孵育时间内 ,前体药物在大鼠结肠及盲肠内容物中释放出地塞米松的量是其在小肠近端及小肠远端内容物中释放量的 2 .7倍 ,在胃内容物中无地塞米松的释放 .结论　地塞米松前体药物能在盲肠、结肠内容物中特异地释放出地塞米松 ,因此地塞米松·葡聚糖 (平均相对分子质量 5× 10 5 )可以作为结肠定位地塞米松前体药物 ,有选择性地将地塞米松运送到结肠     

地塞米松诱导幼龄大鼠胸腺细胞凋亡模型

目的：建立一个比较实用且成型时间短的地塞米松诱导大鼠胸腺细胞凋亡模型。方法：给幼龄大鼠（４周￣５周）腹腔注射地塞米松（０．０２ｇ／ｋｇ）采用形态学（光镜和电镜）、ＤＮＡ琼脂糖凝胶电泳、流式细胞光度分析等方法研究３、６、９、１５、２４ｈ等不同注射时间胸腺细胞凋亡变化。结果：在１５ｈ内,地塞米松诱导的大鼠胸腺细胞凋亡百分率随时间延长,凋亡发生率从６．２％逐渐增至５８．５％,注射地塞米松１５ｈ,在光镜和     

Inhibition of neutrophil and monocyte recruitment by endogenous and exogenous lipocortin 1

1. The role played by endogenous lipocortin 1 in the anti-migratory action exerted by dexamethasone (Dex) on monocyte recruitment in an in vivo model of acute inflammation was investigated by use of several neutralizing polyclonal antibodies raised against lipocortin 1 or a lipocortin 1-derived N-terminus peptide (peptide Ac2-26). The efficacy of peptide Ac2-26 in inhibiting monocyte and polymorphonuclear leucocyte (PMN) recruitment was also tested.
2. Intraperitoneal (i.p.) injection of zymosan A (1 mg) produced a time-dependent cell accumulation into mouse peritoneal cavities which followed a typical profile of acute inflammation: PMN influx was maximal at 4 h post-zymosan (between 15 and 20×10⁶ cells per mouse), and this was followed by an accumulation of monocytes which peaked at the 24 h time-point (between 10 and 15×10⁶ cells per mouse).
3. Dex administration to mice reduced zymosan-induced 4 h PMN infiltration and 24 h monocyte accumulation with similar efficacy: approximately 50% of inhibition of recruitment of both cell types was achieved at the dose of 30 μg per mouse (∼1 mg kg⁻¹, subcutaneously (s.c.)). Maximal inhibitions of 64% and 67% on PMN and monocyte recruitment, respectively, were measured after a dose of 100 μg per mouse (∼3 mg kg⁻¹, s.c.).
4. Dex (30 μg s.c.) inhibited monocyte (53%) and PMN (69%) accumulation in response to zymosan application in mice which had been treated with a non-immune sheep serum (50 μl s.c.). In contrast, the steroid was no longer active in reducing cell accumulation in mice which had been passively immunized against full length human recombinant lipocortin 1 (serum LCS3), or against lipocortin 1 N-terminus peptide.
5. Treatment of mice with vinblastine (1 mg kg⁻¹, intravenously (i.v.)) produced a remarkable leucopenia as assessed 24 h after administration. This was accompanied by a 60% reduction in 4 h-PMN influx, and by a 27% reduction in 24 h-monocyte accumulation, measured after zymosan administration. The inhibitory effect of Dex on monocyte recruitment was not significantly modified in vinblastine-treated mice, with 36% and 57% of inhibition calculated at the dose of 30 μg Dex, and 70% and 60% of inhibition at 100 μg Dex, in vehicle- and vinblastine-treated mice, respectively.
6. Treatment of mice with peptide Ac2-26 dose-dependently attenuated PMN influx at 4 h post-zymosan with a significant effect at 100 μg per mouse (45% of inhibition, n=9, P<0.05) and a maximal effect of 61% inhibition at the highest dose tested of 200 μg s.c. (n=14, P<0.05). No effect of peptide Ac2-26 (200 μg s.c.) was seen on zymosan-induced 24 h monocyte recruitment. In contrast, administration of 200 μg peptide Ac2-26 every 6 h was effective in reducing the number of monocytes harvested from the inflamed peritoneal cavities at 24 h post-zymosan: 9.40±0.58×10⁶ monocytes per mouse (n=13) and 5.74±0.34 monocytes per mouse (n=14) in vehicle- and peptide Ac2-26-treated mice, respectively (P<0.05).
7. Finally, peptide Ac2-26 produced a concentration-dependent inhibition of the rate of phagocytosis of mouse resident peritoneal macrophages as measured by flow cytometry, with a maximal reduction of 34% at the highest concentration tested of 100 μg ml⁻¹ (n=8 experiments performed in duplicate; P<0.05).
8. In conclusion, this study suggests that in vivo monocyte recruitment during acute inflammation is, at least in part, under the negative modulatory control of endogenous lipocortin 1 (as seen after administration of Dex by using the specific antisera) and exogenous lipocortin 1 mimetics (as observed with peptide Ac2-26). In addition to the neutrophil, we can now propose that the monocyte also can be a target for the in vivo anti-inflammatory action of lipocortin 1.

     

Confocal Laser Scanning Microscopic Visualization of the Transport of Dextrans After Nasal Administration to Rats: Effects of Absorption Enhancers

Purpose. To visualize the transport pathway(s) of high molecular weight model compounds across rat nasal epithelium in vivousing confocal laser scanning microscopy. Furthermore, the influence of nasal absorption enhancers (randomly methylated -cyclodextrin and sodium taurodihydrofusidate) on this transport was studied. Methods. Fluorescein isothiocyanate (FITC)-labelled dextrans with a molecular weight of 3,000 or 10,000 Da were administered intranasally to rats. Fifteen minutes after administration the tissue was fixed with Bouin. The nasal septum was surgically removed and stained with Evans Blue protein stain or DiIC18(5) lipid stain prior to visualization with the confocal laser scanning microscope. Results. Transport of FITC-dextran 3,000 across nasal epithelium occurred via the paracellular pathway. Endocytosis of FITC-dextran 3,000 was also shown. In the presence of randomly methylated -cyclodextrin 2% (w/v) similar transport pathways for FITC-dextran 3,000 were observed. With sodium taurodihydrofusidate 1% (w/v) the transport route was also paracellular with endocytosis, but cells were swollen and mucus was extruded into the nasal cavity. For FITC-dextran 10,000 hardly any transport was observed without enhancer, or after co-administration with randomly methylated -cyclodextrin 2% (w/v). Co-administration with sodium taurodihydrofusidate 1% (w/v) resulted in paracellular transport of FITC-dextran 10,000, but morphological changes, i.e. swelling of cells and mucus extrusion, were observed. Conclusions. Confocal laser scanning microscopy is a suitable approach to visualize the transport pathways of high molecular weight hydrophilic compounds across nasal epithelium, and to study the effects of absorption enhancers on drug transport and cell morphology.     

嗅神经上皮瘤的临床病理分析

分析嗅神经上皮瘤（嗅神经母细胞瘤）的临床、病理特点,探讨免疫组化技术和电镜在嗅神经上皮瘤诊断中的应用价值。方法对１９例嗅神经上皮瘤进行了临床分析,光镜复查,免疫组化检测,４例做了透射电镜观察。结果嗅神经上皮瘤主要发生于中青年,起病缓慢,首发症状以单侧鼻塞和鼻出血为多见,病理形态为小圆细胞和短梭形细胞呈巢状及弥散分布,菊形团结构少见或缺如;免疫组化检测ＮＳＥ、Ｓｙｎ阳性,ＣＫ、Ｓ－１００等部分阳性,ＧＦＡＰ阴性;电镜超微结构２例在胞质内找到神经分泌颗粒,３例在胞质内发现中间丝、微丝和基膜,１例有细胞连接和神经突起。结论嗅神经上皮瘤这个名称较嗅神经母细胞瘤更确切,诊断除常规病理外,尚需借助于免疫组化检测,分化差的病例只能通过电镜或其他先进的手段来解决。     

Dexamethasone effects on cerebral protein synthesis prior to and following hypoxia-ischemia in immature rat

We hypothesized that the neuroprotection against cerebral hypoxic-ischemic damage observed with dexamethasone treatment in immature rats is related to a change in cerebral protein synthesis. Six-day-old Wistar rats were injected with either vehicle (10 ml/kg) or dexamethasone (0.1 mg/kg) 24 h prior to cerebral hypoxia-ischemia. Local cerebral protein synthesis (incorporation of 14C-leucine into proteins) was measured in 7-day-old rats during normoxia, during hypoxia-ischemia, and after hypoxia-ischemia which was produced with right carotid artery ligation and 2-h exposure to 8% O2. In normoxic controls, cerebral protein synthesis was similar in dexamethasone and vehicle-treated animals. During hypoxia-ischemia, local cerebral protein synthesis decreased markedly (p < 0.0001) in ischemic regions ipsilateral to the occlusion, irrespective of treatment. After hypoxia-ischemia, protein synthesis declined even further in vehicle-treated animals. Reductions in protein synthesis were substantially more severe in vehicle- than dexamethasone-treated animals, particularly after hypoxia-ischemia (p < 0.0001). Thus, neuroprotection with dexamethasone is not related to a reduction in basal levels of cerebral protein synthesis, but is associated with an improved protein synthesis during and following hypoxia-ischemia.     

Acceptance and effects of nasal lavage in volunteer woodworkers

Wood dust is an irritant and is carcinogenic to the nasal mucosa. It inhibits its own clearance from the nose. It therefore makes sense to lavage retained wood dust from the nose following exposure. To our knowledge this is the second study conducted to determine whether the procedure of nasal lavage reduces nasal symptoms in woodworkers. Forty-six woodworkers from 150 approached volunteered to trial nasal lavage using gravity fed, home-made unbuffered isotonic saline for 2 months in a crossover trial and then be followed-up a year later. The group reported significantly decreased nasal symptoms and over half continued to use nasal lavage voluntarily after 1 year. Results support the findings of the previous study that nasal lavage improves nasal symptoms and supplements those findings with data indicating patterns of voluntary usage following the study's conclusion. It is concluded that nasal lavage is an acceptable, effective and inexpensive option with minimal side effects for woodworkers who experience nasal symptoms and who wish to try the procedure.     

平阳霉素联合地塞米松治疗颌面部大面积海绵状血管瘤

目的：观察平阳霉素（ＰＹＭ）联合地塞米松（ＤＸＭ）治疗颌面部大面积海绵状血管瘤的临床疗效和不良反应。方法：对９例临床确诊的颌面部范围６ｃｍ×７ｃｍ～１０ｃｍ×１２ｃｍ之间的大面积海绵状血管瘤,采用每周１次多点多方向瘤腔内注射药物,比较治疗前后患者的反应和肿瘤的形成变化。结果：全部病例肿瘤消失,无明显不良反应,经８个月～４６个月观察,临床治愈率为１００％。结论：ＰＹＭ联合ＤＸＭ能够治愈颌面部大面积海绵状血管瘤,具有完整保存组织正常形态和功能的特点,克服了单独使用ＰＹＭ带来的不良反应,提示两药在治疗上有协同作用。     

Effects of cocaine on human nasal mucosa

Summary The effects of cocaine on the contractile response of isolated human nasal mucosal blood vessels to field stimulation and methoxamine were investigated. Results showed that cocaine antagonized methoxamine and inhibited field stimulation. The drug increased resting tension in human nasal mucosa in vitro through direct actions and potentiated mucosal contractions by norepinephrine and epinephrine. The study indicated that high concentrations of cocaine may actually antagonize -adrenoceptors, but these concentrations are not necessary in eliciting desired degrees of vasoconstriction in nasal blood vessels while being applied as a local anesthetic.