鼻咽癌放射治疗后鼻腔粘连的临床分析

目的研究鼻咽癌放射治疗后鼻腔粘连的发病情况、临床特点、诊断、治疗以及预后。方法2000年8月～2003年12月期间收集鼻咽癌放疗后鼻腔粘连60例，男45例，女15例，年龄20岁～65岁，中位年龄为37岁，其中放疗后半年内40例病例在纤维鼻咽镜窥视下行简单分离。结果在放疗后半年内发生鼻腔粘连病例通过简单分离，实现鼻腔再通，效果满意，无1例发生再粘连；超过半年病例经简单分离难以解决。结论鼻咽癌放疗后鼻腔粘连有较高的发生率，多在放疗后6个月内形成，因此鼻腔粘连应早期处理，纤维鼻咽镜下简单分离在早期是一种很有效的方法，而且操作简单，损伤小。     

复发性鼻窦炎鼻息肉的修正性鼻内镜手术治疗

目的 总结修正性鼻内镜手术治疗复发性鼻窦炎鼻息肉的手术体会。方法 采用MesserKlinger技术对84例复发性鼻窦炎鼻息肉病人行筛窦、蝶窦开放，额窦、上颌窦窦口扩大等修正性手术治疗。结果 治愈51例，好转17例，无效16例。治愈率为60．7％，有效率为80．9％，无效率为19．1％。结论 修正性鼻内镜手术是治疗复发性鼻窦炎鼻息肉的有效方法。选择具有定向定位作用的解剖参照点是手术安全的基础；选择恰当的术式、实施精细的操作是手术成功的关键。结构变异、出血、鼻息肉病等因素是手术失败的原因。     

复方左氧氟沙星滴鼻液的制备和临床应用

目的：建立复方左氧氟沙星滴鼻液的制备和质控方法，并观察临床疗效。方法：以盐酸左氧氟沙星和替硝唑为主药制成滴鼻剂，采用紫外分光光度法测定主药含量，留样考察其稳定性，并临床应用于鼻炎、鼻窦炎共239例，观察疗效。结果：本制剂中两主药平均回收率分别为98．24％和98．88％，RSD为1．2％和0．6％(n=6)，治疗鼻炎、鼻窦炎患者，总有效率为89．96％。结论：该滴鼻液制备工艺简单，性质稳定，疗效明显，含量测定方法快速准确，适于医院制备和应用。     

硅橡胶鼻假体用于唇裂继发鼻畸形术的护理

目的:探讨行硅橡胶鼻假体,矫正单侧唇裂继发鼻畸形术的护理.方法:通过延长鼻小柱,纠正鼻小柱和鼻中隔的偏斜,广泛游离患侧鼻翼软骨,分三点悬吊固定患侧鼻翼软骨,同期植入硅橡胶L型鼻假体整复单侧唇裂继发鼻畸形24例.结果:24例均一期愈合,随访3～12个月效果患者均满意.结论:采用硅橡胶L型鼻假体整复单侧唇裂继发鼻畸形,配合正确护理效果更佳.     

慢性鼻-鼻窦炎内镜手术前后OMC区分泌腺的观察研究

目的:观察慢性鼻窦炎(CS)鼻内镜鼻窦手术前后鼻黏膜黏液纤毛清除系统的分泌腺结构和功能变化。方法:对20例慢性鼻窦炎术前及术后4个月窦口鼻道复合体(OMC)区鼻黏膜进行AB-PAS染色,光镜下观察,并与健康组(对照组10例)进行对照。结果:鼻窦炎术前组黏膜怀状细胞及黏膜下腺体有显著性增加(P<0.01),型鼻窦炎患者病理性腺体的增生尤为明显。内镜术后4个月鼻黏膜杯状细胞可恢复至正常水平,与对照组比较差异无显著性(P>0.05),而黏膜下腺体未能恢复正常。结论:鼻黏膜杯状细胞及黏膜下腺体的增生是黏液纤毛清除功能障碍的原因之一,尤其是病理性腺体的增生。内镜术后4个月鼻黏膜上皮化,但黏液纤毛清除系统的恢复需要更长时间。术后随访时间应超过4个月,以防复发。     

Propylene oxide in blood and soluble nonprotein thiols in nasal mucosa and other tissues of male Fischer 344/N rats exposed to propylene oxide vapors--relevance of glutathione depletion for propylene oxide-induced rat nasal tumors.

High concentrations of propylene oxide (PO) induced inflammation in the respiratory nasal mucosa (RNM) of rodents. Concentrations > or =300 ppm caused nasal tumors. In order to investigate if glutathione depletion could be relevant for these effects, we determined in PO exposed male Fischer 344/N rats PO in blood and soluble nonprotein SH-groups (NPSH) in RNM and other tissues. Rats were exposed once (6 h) to PO concentrations between 0 and 750 ppm, and repeatedly for up to 20 days (6 h, 5 days/week) to concentrations between 0 and 500 ppm. At the end of the exposures, PO in blood and NPSH in tissues were determined. PO in blood was dependent on concentration and duration of exposure. After the 1-day exposures, NPSH depletion was most distinctive (RNM > liver > lung). Compared to controls, NPSH levels were 43% at 50 ppm PO in RNM and 16% at > or =300 ppm in both RNM and liver. Lung NPSH fell linearly to 20% at 750 ppm. After repeated exposures over 3 and 20 days to 5, 25, 50, 300, and 500 ppm, NPSH losses were less pronounced. At both time points, NPSH were 90%, 70%, 50%, 30%, and 30% of the control values in RNM. Liver NPSH decreased to 80% and 50% at 300 and 500 ppm, respectively. After 20 days, lung NPSH declined to 70% (300 ppm) and 50% (500 ppm). We conclude that continuous, severe perturbation of GSH in RNM following repeated high PO exposures may lead to inflammatory lesions and cell proliferation, critical steps on the path towards tumorigenicity.     

Chronic inhalation exposure to mainstream cigarette smoke increases lung and nasal tumor incidence in rats.

An animal model of lung carcinogenicity induced by chronic inhalation of mainstream cigarette smoke would be useful for research on carcinogenic mechanisms, smoke composition-response relationships, co-carcinogenicity, and chemoprevention. A study was conducted to determine if chronic whole-body exposures of rats would significantly increase lung tumor incidence. Male and female F344 rats (n = 81 to 178/gender) were exposed whole-body 6 h/day, 5 days/week for up to 30 months to smoke from 1R3 research cigarettes diluted to 100 (LS) or 250 (HS) mg total particulate matter/m(3), or sham-exposed to clean air (C). Gross respiratory tract lesions and standard lung and nasal sections were evaluated by light microscopy. A slight reduction of survival suggested that the HS level was at the maximum tolerated dose as commonly defined. Cigarette smoke exposure significantly increased the incidences of non-neoplastic and neoplastic proliferative lung lesions in females, while nonsignificant increases were observed in males. The combined incidence of bronchioloalveolar adenomas and carcinomas in females were: HS = 14%; LS = 6%; and C = 0%. These incidences represented minima because only standard lung sections and gross lesions were evaluated. Mutations in codon 12 of the K-ras gene occurred in 4 of 23 (17%) tumors. Three mutations were G to A transitions and one was a G to T transversion. The incidence of neoplasia of the nasal cavity was significantly increased at the HS, but not the LS level in both males and females (HS = 6%, LS = 0.3%, C = 0.4% for combined genders). These results demonstrate that chronic whole-body exposure of rats to cigarette smoke can induce lung cancer.     

两种鼻黏膜切口在鼻内镜下鼻腔泪囊吻合术中的应用

目的：比较两种鼻黏膜切口在鼻内镜下鼻腔泪囊吻合术中出血情况和术后治疗效果。

方法：回顾性研究。收集2016-06/2018-05在我院眼科确诊为慢性泪囊炎并接受鼻内镜下鼻腔泪囊吻合手术治疗的患者63例66眼。根据鼻黏膜瓣基底部位的不同分组,A组以中鼻甲腋为基底的鼻腔黏膜切口行泪囊鼻腔吻合术,B组以上颌骨线为基底的鼻腔黏膜切口行泪囊鼻腔吻合术。随访至术后6mo,比较两组患者术中出血和术后疗效。

结果：两组患者术中出血情况有差异(χ²=11.803,P<0.05),术后有效率比较无差异(82% vs 73%,P>0.05)。

结论：以中鼻甲腋为基底部的鼻腔黏膜切口,术中并发出血较多; 而以上颌骨线为基底的鼻腔黏膜切口,术中出血较少。两组患者术后疗效无差异。     

鼻内镜手术治疗鼻窦炎、鼻息肉132例临床分析

目的 回顾分析鼻内镜手术治疗慢性鼻窦炎鼻息肉的疗效及影响因素.方法 总结132例(196侧)慢性鼻窦炎鼻息肉患者的临床资料.结果 全组均随访3～12个月,治愈率72.7%,好转率21.2%,总有效率93.9%.无效6.1%.结论 鼻内镜手术治疗鼻窦炎鼻息肉刨伤小、疗效好,熟练精细的手术操作和正确的术后治疗是提高治愈率的关键.     

低氧刺激鼻息肉黏膜上皮细胞炎性因子变化的初探

目的:研究低氧刺激慢性鼻窦炎伴鼻息肉（CRSwNP）与正常鼻黏膜上皮细胞炎性因子的变化与异同,探讨其在CRSwNP发病机制中的作用。方法:选择2015年6月至2018年1月在吉林大学中日联谊医院就诊的68例CRSwNP患者,其中男性36例,女性32例,年龄（45.2±12.5）岁（ xˉ±s,下同）,患者的...