Objective To explore the most suitable surgical modes for children with obstructive sleep apnea hypopnea syndrome (OSAHS) by comparing the preoperative and postoperative immune function of OSAHS children treated by different surgical methods in order to maximize to improve their life quality without affecting their immunity.Methods A total of 120 children aged 3-6 years old were selected.OSAHS was diagnosed by polysomnography (PSG) .They were randomly divided into the velopharyngeal angioplasty group and partial tonsillectomy group.Serum immunoglobulin IgA, IgG, IgM, complement C3, C4 levels and T lymphocyte subsets CD3+, CD4+, CD8+, CD4+/CD8+ ratio and NK value were measured before operation and at postoperative one and three months.Meanwhile the blank control group was established.The same indexes were monitored.The data before operation and at postoperative one and three months in the two experimental groups were statistically analyzed.Results At postoperative one month, the levels of IgA, IgG, IgM, complement C3 and C4 in the two experimental groups were decreased compared with those on preoperative one d, but the difference was not statistically significant (P>0.05) , which at postoperative three months were closed to the preoperative levels.In the comparison between the partial tonsillectomy group and velopharyngeal angioplasty group, the percentages of CD3+T lymphocytes and CD4+T lymphocytes and NK cells, and ratio of CD4+/CD8+ in the velopharyngeal formation group were significantly lower than those in the partial tonsillectomy group, and the difference was statistically significant (P<0.05) ;postoperative 3 months, the percentages of CD3+T lymphocytes, CD4+T lymphocytes, NK cells and CD4+/CD8+ratio in the velopharyngeal formation group were lower than those in the partial tonsillectomy group, but the difference was not statistically significant (P>0.05) .Conclusion In OSAHS children patients treated by velopharyngeal angioplasty and partial tonsillectomy, the postoperative humoral immunity and cellular immune function are slightly decreased compared with those before surgery, but which basically returns to normal within 3 months.The effects of velopharyngeal angioplasty and partial tonsillectomy on their immune function in the corresponding period have no significant difference.

目的 评价国产耳廓矫正器治疗小儿先天性耳廓畸形的疗效.方法 以先天性耳廓畸形患儿29例(35耳,男16耳,女19耳)为研究对象,其中环缩耳7耳、垂耳4耳、隐耳7耳、杯状耳4耳、招风耳5耳、耳轮畸形2耳、复合畸形3耳和Ⅰ度小耳畸形(Max分型)3耳,均佩戴国产耳廓矫正器治疗,按照初始矫正年龄分为1组(≤30天)13耳、2组(31～90天)16耳和3组(>90天)6耳,治疗3个月后比较不同年龄、不同性别、不同类型畸形患儿的矫治效果、治疗时间、并发症发生率.结果 29例(35耳)中28例(34耳)(97.14％)矫正效果为优或良,除4例(5耳)出现皮损外,无严重并发症.1、2、3组矫正效果为优者分别为12耳(92.30％)、12耳(75％)、3耳(50％),1组效果优者比例较3组高,差异有统计学意义(P<0.05);平均矫正时间分别为15.77±2.20、28.81±0.92、33.67±2.27天,1组<2组<3组,差异均有统计学意义(P<0.05).不同性别患儿间矫正效果和平均佩戴时间无显著差异;Ⅰ度小耳畸形患儿的矫正效果较其他7种畸型者差.结论 国产耳廓矫正器能有效矫正小儿先天性耳廓畸形,矫正效果与初始矫正年龄、耳廓畸形严重程度有关.

目的:探讨以情景教学为基础的教学模式在儿童耳鼻喉科临床见习中的应用效果,以提高医学生的综合救治能力.方法:选取进入我院耳鼻喉科临床见习的本科实习生60人,随机分为对照组和实验组,对照组采用传统教学法,实验组采用情景模拟教学模式进行培训.对两组实习生临床病例分析能力进行评价.结果:两组实习生在病例分析考核成绩方面,差异有统计学意义(P<0.05),实验组明显优于对照组.结论:情景模拟实训教学方法,可以进一步提高医学生实际临床操作的现场思维能力和反应能力,缩短与临床的距离,提高教学质量.

目的 研究新霉素致损小鼠听觉上皮后线粒体转录因子B1(mitochodnrial transcription factor B1,TFB1M)与听觉上皮毛细胞凋亡的关系.方法 每次解剖出20只出生1～2d的新生ICR小鼠40个耳蜗,使用体外无血清培养法培养听觉上皮,培养后分为正常对照组和新霉素致损组(n=20),然后在新霉素致损4、12、24 h及24 h洗脱后2d检测TFB1M在听觉上皮细胞核和线粒体中的表达,以及听觉上皮线粒体膜电位的变化和毛细胞的凋亡.结果 新霉素致损4h后,听觉上皮中圈毛细胞形态完整,其线粒体膜电位开始降低;致损12 h,耳蜗听觉上皮线粒体以及细胞核内的TFB1M表达上调,听觉上皮出现毛细胞底圈、中圈大量毛细胞缺失,未缺失处毛细胞出现线粒体膜电位明显降低;致损24 h中圈、底圈毛细胞基本消失,未检测到线粒体膜电位.洗脱后2d,TFB1M表达较正常对照组降低,基底膜毛细胞未见进一步缺失.而正常对照组在新霉素致损组相对应的时间点上,离体培养的听觉上皮的毛细胞形态完整,排列整齐,线粒体膜电位无改变.新霉素致损12 h,TFB1M在线粒体和细胞核内的表达较4、24 h,洗脱后2d都明显(P＜0.01).结论 TFB1M蛋白质水平的表达上调可能导致线粒体功能异常和毛细胞凋亡.

目的:探讨并比较儿童腺样体肥大患者使用鼻喷激素或白三烯受体拮抗剂治疗的临床效果.方法:对我院2011年6月至2013年8月收治的160例腺样体肥大患儿,随机分为治疗组和对照组,治疗组分为鼻喷激素治疗组(雷诺考特)、白三烯受体拮抗剂治疗组(孟鲁司特钠)以及雷诺考特与孟鲁司特钠联用治疗组,每组患儿各40例,并观察临床症状指标评分及腺样体厚度/鼻咽腔宽度(Adenoido/Nasopharyngeal比值)的改变.结果:鼻喷激素治疗组患儿临床症状综合评分较对照组明显下降,分别为3.20±0.29、3.27±0.48及3.50±0.17,差异具有统计学意义(2组比较均P=0.000),腺样体厚度/鼻咽腔宽度比降至0.60以下;白三烯受体拮抗剂治疗组患儿临床症状综合评分较对照组明显下降,分别为3.49±0.45、3.61±0.32及3.41±0.39,差异具有统计学意义(两组比较均P=0.000),腺样体厚度/鼻咽腔宽度比降至0.71以下;联合治疗组患儿临床症状综合评分较对照组明显下降,分别为3.02±0.13、3.22±0.41及3.38±0.12,差异具有统计学意义(两组比较均P=0.000),腺样体厚度/鼻咽腔宽度比降至0.60以下;联合治疗组部分临床症状评分优于单独给药组(2组比较均P=0.000);联合治疗组改善腺样体体积疗效优于单独给药组(P分别为0.05、0.001及0.001).结论:鼻喷激素(雷诺考特)与白三烯受体拮抗剂(孟鲁司特钠)能有效改善儿童腺样体肥大患者的临床症状,且联合治疗组疗效优于单独给药组.

Objective To compare the antitumor effects of Ewing’s sarcoma protein ( EWS ) 306, EWS 289 and EWS 401 of human leukocyte antigen ( HLA )-antigen ( A ) / 0201-restricted epitope peptides against dendritic cells ( DCs ) of Ewing’s sarcoma.Methods The peptide 9 of EWS / FLI-1 protein, which was easily combined with HLA-A / 0201 of human cell antigen was screened by Operating software of BIMAS and SYFPEITHI. And then the corresponding epitope peptide was generated. The standard 4 h-51Cr release experiment was used to test the lethal effects of cytotoxic T lymphocytes ( CTLs ) against tumor cells. Enzyme linked immunospot assay ( ELISPOT ) was applied to detect the interferon-γ ( IFN-γ ) releasing of effector cells induced by DC vaccines of epitope peptides. Accordingly, the antitumor effects in vitro were compared in an animal experiment, and all these animals received immunotherapy. Results A strong binding force with HLA-A / 0201 was noticed in the screened EWS 306, EWS 289 and EWS 401, and the generated epitope peptides were QLWQFLLEL ( EWS 306 ), ILGPTSSRL ( EWS 289 ) and SMYKYPSDI ( EWS 401 ) respectively. A high lethality was noticed in EWS 306, EWS 289 and EWS 401 groups. When the effector /target cell ratio was 50 : 1, the lethalities in EWS 306, EWS 289 and EWS 401 groups were ( 20.2±1.8 ) %, ( 12.6±0.3 ) % and ( 11.9±0.2 ) % respectively. And while in the control group, the lethality was ( 6.7±0.1 ) %. When the effector / target cell ratio was 100:1, the lethalities in EWS 306, EWS 289, EWS 401 and the control groups were ( 51.2±3.7 ) %, ( 24.6±2.1 ) %, ( 17.8±0.9 ) % and ( 7.2±0.2 ) % respectively. There were statistically signiifcant differences when the lethality between the EWS 306 group and the others was compared (P<0.05 ). The number of secreted IFN-γ in EWS 306 group was 118.3±3.6, which was obviously higher than 35.1±1.0 in EWS 401 group, 34.2±0.9 in EWS 289 group and 5.0±0.1 in the control group ( P<0.05 ). The tumor volume was ( 978.9±28.2 ) mm3 in EWS 306 group, which was obviously smaller than ( 1992.9±16.1 ) mm3 in the negative control group and ( 2001.9±12.3 ) mm3 in the blank control group. At the 35 day after inoculation, the survival rate in EWS 306 group was 80%, which was higher than 0% in the blank control group and 10% in the negative control group (P<0.05 ). At 40 day after inoculation, the survival rate in the blank control group was reduced to 0%, and 80% in EWS 306 group was obviously higher than that of the other control groups (P<0.05 ).Conclusions Stronger antitumor effects against DCs are noticed in EWS 306 when compared with that of EWS 289 and EWS 401. EWS 306 can effectively activate the lethal effects of CTLs against tumor cells and provide a new direction for the immunotherapy for Ewing's sarcoma.

Objective To investigate the curative effect of modified endoscopic sinus surgery operation to treat Killian ′s polyp of children.Methods 65 children with Killian ′s polyp were divided into 2 groups:the A group(35 of them only received functional nasal endoscopic sinus surgery,)and the B group(30 of them received functional nasal endoscopic sinus surgery and Caldwell-Luc surgery).The 65 patients with Killian ′s polyp were followed up for 2 years after operation.Results The recurrence rate of the A group was 11.43%.there wasn′t recurrence in the B group.Conclusion The modified endoscopic sinus surgery operation offers a better curative effect in recurrence than only nasal endoscopic sinus surgery.

Objective To investigate the expression of phosphoinositide 3-kinase (PI3K) and protein kinase B (Akt) and their role in pathogenesis in laryngeal squamous cell carcinoma. Methods Immunohistochemical S-P method was used to detect the expression of PI3K and p-Akt in 40 paraffin-embedded human laryngeal squamous cell carcinoma, 20 cases of polyp of vocal cords and 20 cases of laryngeal papilloma. All the samples were stained by HE method to confirm their pathologic characteristics. Positive rates of PI3K and p-Akt were evaluated by microscopy. Results PI3K and p-Akt showed low expression in the polyp tissues of vocal cords, while they were of significantly higher expression in laryngeal squamous cell carcinoma (P0.01). Papilloma cells revealed a high expression of PI3K, but low expression of p-Akt. The poor differentiation of cancer cells correlated well with the low expression of PI3K and p-Akt (P0.01).There was a positive relationship between PI3K and p-Akt in the same sample(r=0.687, P0.01). Conclusion PI3K and p-Akt express highly in laryngeal squamous cell carcinomas, which is related to the pathological differentiation and pathogenesis of the tumor.

软骨肉瘤是起源于软骨细胞或间胚叶组织的一种少见的恶性肿瘤,好发于四肢长骨、骨盆、肋骨及上肢腕骨等处.头颈部少见,约占全身软骨肉瘤的10%,多发生于鼻腔及上颌窦,其他鼻窦少见.

Objective To identify the effect of C-Met transfection on cell proliferation of cancer of larynx cell line Hep2.Methods Recombinant adenovirus vector encoding C-Met(Ad-C-Met)and mockadenovirus vector were transfected into Hep2 cell,and named C-Met-Hep2 and mock Hep2,respectively.The two kind of cells were cultured with TGF-β1 for 1d,3d,5d,7d,and the survival ceils were counted,the clone-formation rate on 12d and cell cycle on 7d were detected.Results Compared with mock- Hep2 ,speed of C-Met-Hep2 proliferation was faster(P0.05),clone-formation rate and propotion of S phase cell were higher(P0.05) ,and propotion of G_0/G_1 phase ceil were lower.Conclusion C-Met participates in the signal pathway of TGF-βin larynx cancer cell.C-Met may block the inhibition of TGF-βto proliferation.

现就间隙连接蛋白(Cx)在恶性肿瘤发生、发展中的作用以及在头颈部肿瘤中的表达及意义综述如下.