目的 探讨猴头菌提取物颗粒治疗反流性咽喉炎的临床疗效.方法 对符合条件的40例反流性咽喉炎患者随机分为猴头菌组、奥美拉唑组(例=20),在行为治疗的基础上,猴头菌组患者口服猴头菌提取物颗粒,奥美拉唑组患者口服奥美拉唑肠溶胶囊,比较治疗前及治疗2个疗程后反流症状指数评分表(RSI量表)及反流体征评分量表(RFS量表)评分.结果 猴头菌组治疗前后RSI、RFS评分比较差异有统计学意义(P＜0.05);说明猴头菌效果较好,猴头菌组与奥美拉唑组患者RSI、RFS评分比较差异无统计学意义(P＞0.05),说明两者疗效相近;不良反应:奥美拉唑组3例,猴头菌组0例,差异有统计学意义(P＜0.05).结论 中成药猴头菌提取物颗粒对于反流性咽喉炎具有良好疗效,疗效与质子泵抑制剂相当,且不良反应少,可用于反流性咽喉炎的药物治疗.

目的 系统评价脑白质异常患儿人工耳蜗植入术后康复效果,比较脑白质异常聋儿与脑白质正常聋儿术后听力及言语康复效果.方法 电子检索PubMed、Cochrane、CBM、CNKI维普、万方数据数据库,系统收集2020年2月之前国内外公开发表的关于脑白质异常聋儿行人工耳蜗植入术后听觉及言语康复效果相关资料,对符合纳入标准的文献收集资料进行Meta分析.结果 本研究共纳入文献9篇,包括795例患儿,术后6月脑白质异常与正常聋儿听力言语康复效果差异(以MD(95％CI,P)表示)分别为-0.88(-1.30～-0.46,P<0.01)和-0.45(-0.72～-0.71,P<0.01),差异显著;术后2年其听力言语康复效果差异分别为-0.08(-0.20～-0.03,P=0.16)和-0.04(-0.08～0.17,P=0.49),差异无统计学意义.结论 脑白质异常聋儿与脑白质正常聋儿相比行人工耳蜗植入术后听觉言语康复效果长期随访无明显差别.

目的 系统评价慢性化脓性中耳炎不同状态行I型鼓室成形术后疗效,分析术后鼓膜穿孔率及听力改善率.方法 电子检索PubMed、Cochrane、CBM、CNKI维普、万方数据数据库,系统收集2000年1月至2020年1月之间国内外公开发表的关于慢性化脓性中耳炎干耳与湿耳状态行I型鼓室成形术后患者鼓膜愈合情况及听力恢复情况相关资料,对符合纳入标准的文献收集资料进行Meta分析.结果 本研究共纳入文献12篇,包括1375例耳,干耳及湿耳术后鼓膜穿孔复发率分别为9.8％(69/704)和11.2％(64/571),差异无统计学意义(RR=0.81,95％CI为0.59-1.13,P=0.22).干耳及湿耳术后听力改善率分别为69.1％(385/557)和73.1％(301/412),差异无统计学意义(RR=0.81,95％CI为0.91-1.07,P=0.79).结论 慢性化脓性中耳炎不同时期(非急性感染期)行I型鼓室成形术后穿孔复发率及听力改善率无明显差别.

目的 系统评价不同方式局部应用糖皮质激素治疗突发性聋的有效性.方法 通过检索PubMed、Cochrane、CBM、CNKI、维普、万方数据库,系统收集2019年1月之前耳后及鼓室内注射糖皮质激素治疗突发性聋的随机对照试验相关文献,对符合纳入标准的文献数据中的疗效进行M eta分析.结果 本研究共检索文献934篇,通过筛选后共纳入符合要求的文献6篇,均为中文文献,包括551例患者,其中,耳后注射组276例(276耳),鼓室注射组275例(275耳).Meta分析结果显示:耳后注射治疗组总有效率78.99％(218/276),鼓室内注射治疗组总有效率68.45％(191/275),两组有效率比较差异有统计学意义(OR=1.70,95％,CI为1.15-2.53,P=0.008).结论 糖皮质激素作为突发性聋的一线治疗用药已得到普遍认可,耳后注射疗效优于鼓室内注射.

目的 系统评价我国以汉语普通话为基础的听障儿童人工耳蜗植入术后言语识别康复情况,比较双耳双模式较单耳模式于安静及噪音环境下是否存在优势.方法 检索PubMed、Cochrane、CBM、CNKI维普、万方数据库,收集2020年3月前国内外公开发表的关于人工耳蜗植入术后双耳双模式与单耳模式言语识别康复效果比较的相关资料,对符合纳入标准的文献资料进行Meta分析.结果 本研究共纳入文献7篇,包括248例患者.术后6月言语识别效果差异分别为韵母-5.80(-10.73～-0.87)、声母-5.49(-10.05～-0.94)、声调-8.17(-12.80～-3.53)、单音节词-5.83(-11.14～-0.53)、短句-11.59(-17.48～-5.70),差异显著(P<0.05);术后1年以上言语识别效果差异为双音节词-3.67(-6.32～-1.01)、短句-4.94(-8.92～-0.95),差异显著(P<0.05);噪音环境下短句识别差异为-14.12(-20.68～-7.56),差异显著(P<0.05).结论 以汉语普通话为基础的人工耳蜗植入术后听障儿童双耳双模式较单耳模式言语识别在安静及噪音条件下均具有明显优势.

目的 探讨威海市听力复筛未通过婴儿的听力学诊断及特点.方法 回顾威海市2015年1月～2016年12月新生儿听力筛查中复筛未通过转诊到威海市听力诊断中心进行听力学诊断的586例婴儿资料,对其听力学、颞骨高分辨率CT扫描及基因检查结果进行整理分析.结果 3月龄确诊听力障碍124例,占转诊婴儿的21.16％(124/586),6月龄复诊仍然存在听力障碍有83例,占转诊例数的14.16％(83/586),单侧听力损失34例,占40.96％(34/83),双侧听力损失49例,占59.04％(49/83);感音神经性听力损失70例,占84.34％(70/83),传导性及混合性听力损失13例,占15.66％(13/83);6月龄复查有48例行颞骨CT检测,大前庭水管综合征14例,先天性小耳畸形8例,耳蜗畸形1例,中耳炎5例;20例听力学相关基因检测中有3例GJB2基因235delC纯合突变,5例GJB2基因235delC杂合突变杂合突变,2例SLC26A4基因IVS7-2A>G纯合突变,2例SLC26A4基因IVS7-2A>G杂合突变.结论 婴儿听力诊断要结合ABR,ASSR,DPOAE,声导抗等客观检查并辅以影像学评估及基因检测来综合诊断,两次确诊可提高先天性听力障碍确诊率及干预率,对转诊婴儿要做好追踪随访.

目的 探讨腺样囊性癌的临床病理特征、诊断和治疗，以避免误诊误治。 方法 回顾性分析青岛大学附属威海市立第二医院收治的1例翼腭窝腺样囊性癌误诊为颞下颌关节炎患者的临床资料，并复习相关文献。 结果 该患者行鼻内窥镜下右侧翼腭窝间隙探查后病理确诊为腺样囊性癌，在内窥镜辅助下切除肿瘤，术后随访1年，无复发。 结论 腺样囊性癌为多见于小涎腺的恶性肿瘤，少数可发生于腺体外，早期症状不典型，易漏诊、误诊。其确诊主要依靠组织病理学检查，治疗首选手术及术后放疗。

Small nucleolar RNA host gene 20 (SNHG20) has been reported to serve roles in several types of malignancies, while its role in nasopharyngeal carcinoma remains unknown. In the present study, tumor tissues and adjacent healthy tissues of patient with nasopharyngeal carcinoma, as well as blood samples from patients with nasopharyngeal carcinoma and heathy controls were collected, and expression levels of SNHG20 were detected by reverse transcription-quantitative polymerase chain reaction. Receiver operating characteristic curve and survival curve analyses were performed to evaluate the diagnostic and prognostic values of SNHG20 expression for nasopharyngeal carcinoma, respectively. Associations between serum expression levels of SNHG20 and clinical data of patients with nasopharyngeal carcinoma were analyzed using χ2 test. A SNHG20 expression vector was constructed and transfected into nasopharyngeal carcinoma cells, and cell migration and invasion were detected by Transwell assays. Expression of transforming growth factor-β1 (TGF-β1) was detected by western blotting. Results indicated that the expression level of SNHG20 increased in cancer tissues compared with healthy tissues of patients with nasopharyngeal carcinoma. Serum level of SNHG20 increased in patients with nasopharyngeal carcinoma compared with healthy controls. Significant association was identified between serum levels of SNHG20 and distant tumor metastasis. Serum SNHG20 could serve as a potential diagnostic and prognostic marker for nasopharyngeal carcinoma. Overexpression of SNHG20 promoted nasopharyngeal carcinoma cell migration and invasion, and promoted the expression of TGF-β1. TGF-β1 inhibitor reduced the effects of SNHG20 overexpression on nasopharyngeal carcinoma cell migration and invasion, and exhibited no significant effect on SNHG20 expression. Therefore, the results of the present study indicated that lncRNA SNHG20 could promote the migration and invasion of nasopharyngeal carcinoma cells by upregulating TGF-β1.

目的 探讨鼻用激素联合低温等离子射频消融术治疗常年变应性鼻炎临床应用效果.方法 选取2015年10月~2016年7月间我院收治的常年变应性鼻炎患者86例作为本次研究对象,对照组给予单纯低温等离子射频消融术治疗,研究组经低温等离子射频消融术联合鼻用激素治疗.结果 研究组临床治疗总有效率(90.70%)显著高于对照组(72.09%),数据对比P<0.05.结论 应用低温等离子射频消融术联合鼻用激素治疗可获得更为理想的常年变应性鼻炎治疗效果.

目的 探讨鼻内镜下低温等离子射频消融术治疗鼻前庭囊肿临床效果.方法 40例鼻前庭囊肿患者,随机分为研究组和对照组,各20例.研究组实施鼻内镜下低温等离子射频消融术,对照组给予传统唇龈沟切口进路切除术,记录两组患者手术情况、预后情况.结果 研究组患者术中出血量少于对照组,差异有统计学意义(P<0.05);两组上皮化时间、伤口愈合时间、手术时间比较差异无统计学意义(P>0.05).研究组不良反应发生率10.00%显著低于对照组55.00%,差异有统计学意义(P<0.05);随访1年,研究组复发率0显著低于对照组25.00%,差异有统计学意义(P<0.05).结论 应用鼻内镜下低温等离子射频消融术治疗鼻前庭囊肿可显著减少患者术中出血量、术后并发症发生率及复发率,对保障患者疗效、预后均具有积极意义,值得今后推广.

目的 探讨血管平滑肌脂肪瘤的临床病理特征、诊断和治疗.方法 回顾性分析我院收治的1例颏区血管平滑肌脂肪瘤患者的临床资料,并复习相关文献.结果 该病例行左侧颏区肿物切除术后病理确诊为血管平滑肌脂肪瘤,术后随访2年,无复发.结论 血管平滑肌脂肪瘤为多见于肾、肝等脏器的良性肿瘤,少数可发生于浅表组织,检查手段以CT、B型超声为主,首选手术治疗,可通过术后病理确诊.

目的 探讨鼻窦中药冲洗对慢性鼻窦炎(ORS)鼻内镜手术效果的影响.方法 收集初次手术治疗的ORS患者80例,根据根据入院先后顺序,单号纳入观察组,双号纳入对照组,每组40例.两种均采用鼻内镜手术(FESS)治疗,对照组术后用生理盐水冲洗鼻腔及术腔,观察组术后用中药冲洗液冲洗鼻腔及术腔.比较两组患者冲洗治疗前后症状积分、鼻黏液纤毛传输速度、术腔黏膜上皮化时间、炎性细胞数变化情况.结果 冲洗治疗后,观察组的症状总积分明显低于对照组(P＜0.05);鼻黏液纤毛传输速度明显大于对照组(P＜0.05);术腔黏膜上皮化时间明显比对照组短(P＜0.05);炎症细胞数、嗜酸性细胞数明显少于对照组(P＜0.05).结论 FESS术后鼻窦中药冲洗具有较强的抗菌、减轻炎症反应,减轻黏膜水肿,改善鼻腔微循环,促进黏膜上皮化等作用,可作为FESS术后综合疗法的一个较好的选择.

Background Ebstein-Barr virus (EBV) plays a critical role in nasopharynx cancer, which can be effectively monitored by serum levels of early antigen antibody (EA-IgA) and viral capsid antigen antibody (VCA-IgA). This study explored the diagnostic value of combined assays of sialic acid (SA), EA-IgA, and VCA-IgA via the expressional assay. Material/Methods A total of 42 nasopharynx cancer patients and 42 benign rhinitis and healthy controls were recruited in this study. Serum EA-IgA and VCA-IgA were tested by enzyme-linked immunosorbent assay (ELISA) and enzymatic assay of serum SA. Specificity and sensitivity of those 3 assays were compared. The diagnostic value of each parameter was evaluated by ROC curves. Results All 3 indexes (SA, EA-IgA and VCA-IgA) showed elevated serum levels in nasopharynx cancer patients when compared to those with rhinitis, who had higher levels than healthy individuals. Concentrations of these factors were also positively correlated with the TNM staging of cancer. The sensitivity and specificity were 30.95% and 83.33% (in SA), 57.14% and 95.24% (in EA-IgA), and 76.19% and 92.86% (in VCA-IgA), respectively. VCA-IgA had the highest sensitivity among all 3 indexes. The combined assay increased the diagnostic sensitivity to 92.86% without compromising specificity. Conclusions SA, EA-IgA, and VCA-IgA levels were significantly elevated in nasopharynx patients’ serum. The combined assay may have clinical value in diagnosis and monitoring.

Objective To study the expression of β-catenin(β-cat) and P65 in laryngeal carcinoma and its correlation with pathological classification and clinical stages.Methods S-P immunochemical method was performed to detect the expression of β-cat and P65 in 42 specimens of laryngeal carcinoma and 20 of para-carcinoma tissue.The correlation between expression and pathological classification and clinical stages was analyzed.Results ① The abnormal expression rates of β-cat and P65 in laryngeal carcinoma tissue were66.7% and71.4% respectively.The differences of expression rates between laryngeal carcinoma and para-carcinoma tissue were statistically significant(P0.01).② Abnormal expression of β-cat was closely related with pathological differentiation,clinical stages,lymph node metastasis and 5-year survival rate;its abnormal expression rate increased with the rise of pathological classification and clinical stages(P0.05).Abnormal expression of P65 was closely related with clinical stages,lymph node metastasis(P0.05),but not with pathological classification and 5-year survival rate(P0.05).③ P65 and β-cat were simultaneously expressed in 22 specimens of laryngeal carcinoma and the expression of P65 was significantly correlated with that of β-cat(r=0.392,P0.05).Conclusion The expression of P65 is closely correlated with that of β-cat in laryngeal carcinoma.The abnormal expression of P65 and β-cat is closely related with differentiation,clinical stage,metastases in this tumor.

Objective To evaluate the clinical curative effect observation of vinpocetine and citicoline sodium to sudden deafness.Methods 64 cases of sudden deafness were divided into two groups in random(32 cases 36 ears in vinpocetine treatment group,32 cases 40 ears in controlled group).Results The vinpocitine group effectiveness was 86.11%;the effectiveness of controlled treatment group was 70%,χ~2=4.0674,P<0.05,the difference between them was significant.The side effect of vinpocetine group was rare and light.Conclusion Vinpocetine and citicoline sodium to sudden deafness had good clinical effect and the side effect was rare and light.

Objective:To evaluate the significance of ultrasonic scores in distinguish benign and malignant thyroid knot,to increase the diagnosis rate.Methods:To analyse the ultrasonography of 41 cases of malignant and 187 cases of benign thyroid knots which were statistic by pathology,and examine the ultrasonic scores of each knots,compare the differentials between the benign and malignant thyroid knot.Results:There were significance differentials in ultrasonography between the benign and malignant thyroid knot,ultrasonic scores of malignant thyroid knot were higher than benign thyroid knot.The critical point is 5.5,the sensitivity is 93.9%,and the specificity is 94.7%.Conclusion:The Ultrasonic scores has significance value in distinguish the benign and malignant thyroid knot.

患者男性,49岁,因右耳闷、听力下降8月,反复血性耳液溢3月,于1999年9月18日收入我院.患者于8月前无诱因出现右侧耳闷,伴听力下降,不伴耳鸣、耳痛及耳脓溢.自服阿莫西林及头孢类抗生素.症状未见好转.于3月前出现右耳流脓.间歇性带有鲜血,并逐渐出现阵发性同侧颞部疼痛.耳鸣,听力下降明显.在当地医院怀疑"中耳结核",取耳部病变组织活检排除结核,疑似恶性黑色素瘤.

Objective To evaluate the effect of endoscopy after traditional adenoidectomy. Method 107 cases of adenoid hypotrophy including 43 cases of degree Ⅲ and 64 cases of degree Ⅱ were first treated by traditional adenoidectomy, then the remains were removed by endoscopy. Results Remains were found in all cases. In 57 cases, 41(95.3%)cases of degree Ⅲ and 16(25.0%)cases of degree Ⅱ, the remains were longer than 1 cm. The remains of 35 (61.4%) cases were located in the upper part of the adenoid, of 16 (28.1%) cases were located in the lower part of the adenoid, of 28 (49.1%) cases were located near the pharyngeal ostium of the eustachian tube. Conclusion Traditional adenoidectomy is poor in that remaining tissues are mainly found in the upper part of the adenoid, the lower part of the adenoid and near the pharyngeal ostium of the eustachian tube.

Objective: To investigate the etiological factors of chronic cough and the effect of endoscopic examination of the upper respiratory tract.Method: Endoscopic examination of the upper respiratory tract and the assistance inspection were performed on 120 cases of chronic cough to explore the etiology.Results: In the 120 cases,posterior nasal drip syndrome was found in 47 cases,acidophile bronchitis and cough variability asthma in 32 cases,gastroesophageal reflux diseases in 35 cases,hysteria in 2 cases and unknown cause in 4 cases.After treatment,98 cases were greatly improved in 3-7days,106 patients felt obviously improved in 2 weeks,and 106 cases stopped taking medicine 1 week after the symptoms vanished.The other 14 cases were transferred to departments of paediatrics or psychology.Conclusion: Chronic cough is caused by many factors.Endoscopic examination is helpful in observing the slight pathological changes of the upper respiratory tract.