目的 观察基于症状管理理论(SMT)的全程优质干预在突发性耳聋(SSHL)合并耳鸣患者中的应用效果.方法 选取2020 年2 月至2022 年6 月深圳市龙华区人民医院收治的80 例SSHL合并耳鸣患者为研究对象,将其按抽签法随机分为观察组(40 例)和对照组(40 例).对照组给予常规护理干预,观察组在对照组护理方法的基础上给予基于SMT的全程优质干预.比较2 组患者的纯音气导听阈均值、症状消失时间,以及匹兹堡睡眠质量指数量表(PSQI)、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分.结果 干预1 周、1 个月及2 个月后,2 组的纯音气导听阈均值均低于干预前(P均<0.05),且观察组均比同期对照组低(P均<0.05).相比于对照组,观察组的耳鸣和耳闷、头晕、恶心和呕吐消失时间均更早(P均<0.05).2 组在干预2 个月后的PSQI各项评分均低于干预前,在干预2 个月后的SAS、SDS评分均低于干预前;相比于对照组,观察组的上述评分均更低,差异均有统计学意义(P均<0.05).结论 基于SMT的全程优质干预能有效改善SSHL合并耳鸣患者的睡眠质量和不良情绪,提高其听力水平,加快症状消失.

In order to explore the application of nano-medication system of the multiple antibacterial nanometer in the treatment of otitis media, the tanshinone IIA/nano-silver composite gel was used as an example for researches in this study. The tanshinone IIA/silver nanocomposite gel was prepared using the formation principle of polymer precipitation of the in situ gel, and the obtained product was characterized and detected by ultraviolet spectrophotometry, high-performance liquid chromatography, and infrared spectroscopy. A model of guinea pig with otitis media was prepared, and all objects were treated with ofloxacin ear drops, tanshinone IIA, nano-silver, and the composite gel of tanshinone IIA and nano-silver for treatment, respectively, to observe the changes in bacterial culture, inflammatory factors, and tissue structure. The results of three methods showed that the composite gel was prepared successfully. The number of bacterial colonies in tanshinone IIA, nano-silver, and composite gel of tanshinone IIA and nano-silver was significantly lower than that in the model group (P ≤ 0.05), and the levels of TNF-α and IL-8 in the group treated with the composite gel of tanshinone IIA and nano-silver decreased significantly. In addition, the number of otitis cells in the group treated with the composite gel of tanshinone IIA and nano-silver was significantly reduced. The composite of tanshinone IIA and nano-silver had a significant effect on the treatment of otitis media, and the therapeutic effect was obviously better than that of tanshinone IIA or nano-silver alone. This experiment provided a new idea for the organic combination of more active ingredients of traditional Chinese medicine and inorganic nano-materials, and also defined a new direction for the treatment of otitis media.

目的 探讨破骨细胞核因子кB受体活化因子配体(Receptor activator of nuclear factor-kap-pa B ligand,RANKL,又称破骨细胞分化因子)和其配体核因子-κB受体活化因子(Receptor acti-vator of nuclear factor-kappa B,RANK)及骨保护素(Osteoprotegerin,OPG)在慢性化脓性中耳炎肉芽组织中的表达情况.方法 选择2015年2月至2018年4月在本院接受治疗的慢性化脓性中耳炎患者37例(慢性化脓性中耳炎组)、中耳胆脂瘤患者44例(中耳胆脂瘤组)、外伤性鼓膜穿孔患者20例(对照组)作为研究对象.采用免疫组织化学法检测慢性化脓性中耳炎组和中耳胆脂瘤组患者的肉芽组织以及对照组患者外耳道皮肤中RANKL、RANK、OPG的表达情况.结果 3组患者均可见RANKL、RANK、OPG的表达;慢性化脓性中耳炎组、中耳胆脂瘤组RANKL、RANK表达水平高于对照组,OPG/RANKL低于对照组,差异均有统计学意义(P<0.05);中耳胆脂瘤组RANKL、RANK表达水平高于慢性化脓性中耳炎组,OPG/RANKL低于慢性化脓性中耳炎组,差异均有统计学意义(P<0.05),3组患者OPG表达水平比较差异无统计学意义(P>0.05).OPG/RANKL与慢性化脓性中耳炎组和中耳胆脂瘤组的骨质破坏程度呈显著负相关(r=-0.582,-0.621,P=0.025,0.011).结论 RANKL、RANK、OPG在正常外耳道皮肤及慢性化脓性中耳炎和中耳胆脂瘤患者肉芽组织中均有表达,表达水平与骨质破坏程度有关,RANKL、RANK表达水平的升高和OPG表达水平的降低在慢性化脓性中耳炎和中耳胆脂瘤的骨质破坏机制中发挥了重要作用,OPG与RANKL的比值则可作为一个可靠的评价骨质破坏的指标.

Background: Nasopharyngeal carcinoma (NPC) is leading form of cancer occurring in a few well-defined regions, including southern China. NPC possess a unique and intricate etiology that remains to be elucidated. Herein, we determine expression patterns of CCNB2 and NKX3-1 and identify their roles in NPC. Materials and Methods: Gene-expression profiles of NPC in the Gene Expression Omnibus (GEO) were analyzed. Cell viability, invasion, apoptosis, cell cycle entry and mitochondrial membrane potential (MMP) were evaluated in the presence of NKX3-1 or in the absence of CCNB2. Results: In all, 187 upregulated genes and 683 downregulated genes were obtained by analyzing GSE13597. NKX3-1, the downregulated gene, and CCNB2, the upregulated one, were further confirmed by in vitro studies. Overexpression of NKX3-1 was shown to inhibit NPC cell viability and invasion. Knockdown of CCNB2 was demonstrated to reduce cell cycle entry and MMP but induce apoptosis in NPC cells. Conclusions: Taken together, the key finding obtained from the study supports CCNB2 and NKX3-1 as two promising therapeutic candidates for NPC. Molecular mechanisms that control CCNB2 or NKX3-1 disturbance require further investigation and clarification.

目的:探讨甲强龙联合利多卡因对突发性耳聋(SSNL)鼓室注射疗效.方法:将本院耳鼻喉科2015年1月-2016年12月收治的96例SSNL随机分为研究组与对照组,每组各48例,对照组SSNL患者采用甲强龙鼓室注射治疗,研究组SSNL患者采用甲强龙联合利多卡因注射治疗,比较两组患者的疗效、不同听力曲线分型下的患者疗效,治疗前后的0.25～2.00 kHz的纯音听力测试阈值.结果:研究组的治疗效果显著优于对照组(P<0.05);不同分型下总有效率比较,差异有统计学意义(P<0.05),有效率由高至低分别为中低频、高频、平坦、全聋型.研究组治疗第5、10、15天的0.25～2.00 kHz纯音听力阈值均显著低于对照组同期(P<0.05).结论:中低频听力曲线分型的SSNL患者疗效显著优于平坦或全聋型,甲强龙联合利多卡因对突发性耳聋鼓室注射治疗疗效优于甲强龙鼓室治疗,可更好降低0.25～2.00 kHz的纯音听力测试阈值.

目的 阐述急性喉梗阻时行环甲膜切开或紧急气管切开术救治患者的体会.方法 对13例急性喉梗阻的患者行环甲膜切开或紧急气管切开,并进行随访.结果 13例患者12例救治成功,1例死亡,其中1例出现喉狭窄.结论 环甲膜切开术和紧急气管切开术对于抢救急性喉梗阻患者的意义重大,应将其进一步规范化并对相关医务人员进行培训.

目的:探讨布美他尼与呋塞米两类K+转运蛋白抑制剂对小鼠听觉功能的影响.方法:以30只健康小鼠为研究对象,采用随机数字表法分为健康对照组10例,布美他尼处理组10例,呋塞米处理组10例.对照组小鼠不予处理,布美他尼处理组予以布美他尼处理,呋塞米处理组予以呋塞米处理.分别对各组小鼠进行听觉脑干反应检测,对比三组小鼠听觉脑干反应阀值,以及布美他尼处理组、呋塞米处理组小鼠给药前后和恢复后听觉脑干反应阀值.结果:给药后,布美他尼处理组、呋塞米处理组平均听觉脑干反应阀值均高于健康对照组(P＜0.05),且布美他尼处理组平均听觉脑干反应阀值高于呋塞米处理组(P＜0.05).停止给药恢复后,布美他尼处理组、呋塞米处理组平均听觉脑干反应阀值均低于给药后(P＜0.05),与给药前接近.结论:布美他尼K+转运蛋白抑制剂对钠钾氯协同转运蛋白1的抑制作用高于呋塞来,对小鼠听觉功能的损伤影响高于呋塞米.

目的 研究听觉实验中NKCC1与Na+-K+-ATPase?在耳蜗K+循环中的作用.方法 选择动物中心提供的36只健康C57BL/6J小鼠为研究对象,取12只作正常对照组,检测听觉脑干反应(ABR)阀值;另取12只作NKCC1抑制剂呋塞米实验组,予以小鼠呋塞米注射,并于给药前后及停止给药恢复后分别检测ABR阀值;剩余12只作Na+-K+-ATPase抑制剂哇巴因实验组,予以小鼠哇巴因注射,并于给药前后及停止给药恢复后分别检测ABR阀值.根据检测结果,对比分析各组ABR阀值.结果 在平均ABR阀值指标值上,给药前,对照组、呋塞米实验组、哇巴因实验组比较,差异均无统计学意义(P>0.05);给药后,呋塞米实验组、哇巴因实验组平均ABR阀值均高于给药前(P<0.05),与正常对照组接近.停止给药恢复后,呋塞米实验组、哇巴因实验组平均ABR阀值均低于给药后(P<0.05),又与给药前接近.结论 NKCC1与Na+-K+-ATPase作为离子转运蛋白,其开展的离子转运体活动是建立耳蜗K+循环,产生EP及维持听觉功能的重要因子.

Objective To explore the curative effect of combination therapy of low-temperature plasma radiofrequency ablation and nasal endoscopy for chronic nasal sinusitis. Methods From January 2010 to January 2012,98 patients with chronic nasal sinusitis in our hospital were ramdomly divided into observation group and control group. The observation group (49 cases) received plasma radiofrequency ablation at low temperature combined nasal endoscopic treatment. The control group (49 cases) were performed only nasal endoscopic treatment. The curative effect of the 2 groups were compared. Results After 1 month and 1 year, the total effective rate of the observation group were 91. 84% and 89. 80%, the total effective rate of the control group were 77. 55% and 73. 47% respectively. To compare the total effective rate of 2 groups were compared,there were statistically significant differences(P<0. 05). Conclusion Curative effect of plasma radiofrequency ablation at low temperature and nasal endoscopy is distinct,it is worthy of being widely applied in clinic.

Objective To explore the expression and significance of transcription factor SOX 11 in nasopharyngeal carci-noma .Methods By the prospective study method ,26 cases of nasopharyngeal carcinoma organization specimens and 20 cases of nasopharyngitis organization specimens were selected .Expression of SOX11mRNA of the 2 groups were detected by polymerase chain reaction (PCR).Results SOX11mRNA level of nasopharyngeal carcinoma group and nasopharyngitis group were com -pared,the difference had statistical significance (P<0.05);SOX11mRNA level was related to T stage ,clinical stage,lymph node metastasis,pathology differentiation,and was not related to age,sex and course.Conclusion Transcription factor SOX11 may play a direct or indirect role in tumorigenesis ,tumor cell differentiation and cell proliferation process .

目的:探讨鼻内镜治疗鼻窦真菌病的临床效果。方法:本院治疗的鼻窦真菌病患者62例,均给予鼻内镜手术治疗,观察患者的治疗效果。结果:62例患者中,41例治愈,占66.13%;17例有效,占27.42%;4例无效,占6.45%。临床总有效率为93.55%。患者治疗后症状明显好转(P<0.05)。结论:鼻内镜治疗鼻窦真菌病具有十分良好的治疗效果,值得临床推广。

Objective To explore the quality of life (QOL) status and psychology characteristics of patients with Sudden Deafness. Methods One hundred and thirty-five patients with sudden deafness were enrolled by random,their QOL scores were assessed by using Chinese version of the SF-36,their psychological scores were assessed by filling out SAS,SDS. The demographic characteristics of sudden deafness group and health group were compared. Results Compared with health group,there was a significant impairment in all QOL dimensions in patients with allergic rhinitis(P < 0.05).Especially in mental health,role limitations due to emotional problems,vitality,general health perceptions,role limitations due to physical health dimensions. SAS and SDS scores of a sudden deafness patients had significant increase compared with norm(P<0.001).Conclusion Sudden deafness patients experience significant impairment in QOL and they have evident anxiety and depression.

目的探讨内镜鼻窦开放术后使用纳吸绵鼻腔填塞止血材料的临床疗效观察。方法将98例鼻腔鼻窦手术患者随机分为两组，一组采用纳吸绵止血材料填塞止血；另一组采用Merocel高膨胀材料填塞止血，比较两组患者在术后48h内、抽取填塞物时的临床症状及取出填塞物后鼻腔的局部表现。结果使用纳吸绵组术后48h内头痛、鼻痛及鼻渗/出血发生率低于Merocel高膨胀材料组（P＜0.05），抽取鼻腔填塞物时疼痛率及出血率明显低于Merocel高膨胀材料组（P＜0.01），术后鼻腔恢复通气天数、术腔上皮化时间较短，发生鼻腔粘连数、术腔肉芽、囊泡数均比Merocel高膨胀材料组少（P＜0.05）。结论纳吸绵疗效确切，不良反应少，病人痛苦少，是理想的鼻腔填塞材料。

目的研究非器质性咽异感症患者的心理健康状况,并探讨心理认知疗法的疗效。方法采用症状自评量表(SCL-90)和认知偏差问卷(CBQ)从158例门诊非器质性咽异感症患者中筛选出抑郁倾向较为明显的患者60例,将患者分为两组,每组30例,对照组使用健民咽喉片和维生素B1治疗,观察组除应用上述药物外,还应用心理认知疗法,治疗时间为1个月左右,然后进行疗效评估。结果观察组治疗后SCL-90总分和CBQ结果与治疗前比较差异有统计学意义(P<0.01),而对照组治疗前后SCL-90总分和CBQ结果较治疗前差异无统计学意义(P>0.05),观察组治疗有效率为83.3%,而对照组为40.0%(P<0.01)。结论非器质性咽异感症患者存在明显的心理健康问题,心理认知疗法可使患者抑郁程度明显减轻,一定的心理疏导可以明显提高疗效。

目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者行改良悬雍垂腭咽成形(H-UPPP)手术前后血中儿茶酚胺水平及与瘦素的相关性。方法检测OSAHS患者行H-UPPP手术前和手术后3、6个月及一年时血中儿茶酚胺及瘦素水平。结果术后3、6、12个月,患者儿茶酚胺水平呈下降趋势,且与对照组比较差异有统计学意义(p<0.05);OSAHS组患者血清瘦素水平下降,且与对照组比较差异有统计学意义,p<0.05。结论 OSAHS患者儿茶酚胺水平与血清瘦素水平存在直接相关性,可为临床治疗提供理论依据。

<正>由深圳市第六人民医院(南山医院)、《中国医学文摘耳鼻咽喉科学》杂志社及香港中文大学联合主办"激光与喉微创外科学习班"2011年12月23～26日在深圳市第六人民医院(南山医院)举行。此次会议由深圳市医学会耳鼻咽喉专业委员会主任委员刘明致辞,应邀出席会议的有首都医科大学附属北京同仁医院副院长、中华医学会耳鼻咽喉头颈

<正>上下呼吸道疾病的相关性问题早在公元2世纪就已被提出,当时著名医学家Galen就提出肺部疾病可能是由鼻部疾病通过直接的解剖途径导致〔1〕。随着对疾病发病机制认识的深入,有学者建议将传统意义上的鼻炎和鼻窦炎重新定义为鼻-鼻

<正>过敏性哮喘是IgE依赖的一类特殊的炎症疾病,具有反复发作性、气流受限和气道反应性增高的特点。除了遗传因素外,过敏原、呼吸道刺激物、呼吸道病毒感染和职业性暴露,都会通过不同的途径导致相同的结果:多细胞性的炎症、强烈的支气管反应和气道阻塞等。在过去的25 a里,哮喘的病理含义一直在随着复杂技术的使用和临床实践而完善,本文对哮喘发病过程中的病理生理机制予综述如下。

OBJECTIVE:To study the inhibitory effects of short hairpin RNA (pshLMP1) combined with DNAzyme or alone on latent membrane protein-1 (LMP1)expression in HNE1 cell lines.METHOD:The pshLMP1 and DNAzymes were co-transfected with pEGFP-N1-1158 (a expression vector encoding LMP1 and EGFP fusion protein) into HNE1 cells, divided into 4 groups as positive control, RNA interference, combining and DNAzyme groups. The green fluorescence were analyzed and then the mRNA and protein of LMP1 gene were detected.RESULT:The HNE1 cells expressing green fluorescence in combining group were significantly less than that in RNA interference group (P < 0.01); The inhibition efficiency of green fluorescence in combining group were 86. 31% Wp 88.88% ,which were higher than that in RNA interference group with 75.15%. The detection of LMP1 mRNA and proteins showed that combining group had a higher inhibition ability.CONCLUSION:Combining gene therapy with pshLMP1 and DNAzyme is superior to pshLMP1 alone to inhibit LMP1 gene expression.

Objective:To investigate the effect of culture filtrate proteins(culture filtrate proteins,CFP)of Mycobacterium tuberculosis in vitro culture on IL-4,IFN-γ,GM-CSF in patients with nasal polyp.Methods:5 ml peripheral venous bloods was obtained from the enrolled thirty patients with nasal polyp,and peripheral blood mononuclear cells(PBMCs)were isolated.The optimal CFP concentration that stimulated lympholeukoeyte proliferation was measured by MTT.method.IL-4,IFN-γ,GM-CSF levels in culture supematant of the PBMCswere determined by ELISA before and after CFP treatment.Results:Supematant IL-4,GM-CSF levels were all significantly increased,while IFN-γlevel was significantly decreased in these nasal polyp as compared with these normal of contro1.Aftert treatment of CFP,supematant IL-4,GM-CSF levels were significantly reduced,while IFN-γlevel was significantly increased.Conclusion:CFP may inhibit Th2 cell activation and modulate the imbalance state of the Thl and Th2 cytokines.It proves that CFP could be useful in the treatment of nasal polyp.