Objective To investigate the expression and clinical significance of long non-coding RNA（lncRNA） colorectal cancer associated transcription factor 1（CCAT1） in laryngeal squamous cell carcinoma（LSCC）. Methods Thirty-two pairs cases of LSCC tissues and adjacent tissues were selected. The expression of lncRNA CCAT1 in LSCC tissues was detected by real-time quantitative PCR, and the correlations between the expression of lncRNA CCAT1 and clinical characteristics were analyzed. The clinical value of lncRNA CCAT1 in the diagnosis of LSCC were analyzed by ROC curve. Results The relative expression level of lncRNA CCAT1 in LSCC tissue was 2.677±1.672, which was significantly higher than that in adjacent tissue（1.551±1.211, P＜0.05）. The expression level of lncRNA CCAT1 was correlated to whether the patient smoked and the degree of tumor differentiation. The relative expression of lncRNA CCAT1 in smoking patients（2.966±1.646） was significantly higher than that in non-smoking patients（1.113±0.657）; and the relative expression of lncRNA CCAT1 in poorly differentiated cancer tissues（3.788±2.170） was significantly higher than that in well differentiated cancer tissues（2.365±1.405）（P＜0.05）. The area under the ROC curve of lncRNA CCAT1 for predicting the diagnosis of LSCC was 0.724, with sensitivity of 68.80% and the specificity of 62.50%. Conclusion lncRNA CCAT1 is highly expressed in LSCC tissues, and its expression may be correlated to the occurrence and development of LSCC.

目的 探讨醋酸染色联合内镜窄带成像技术(NBI)对咽部、会厌部乳头状瘤的诊断价值.方法 收集2020年1月至2022年1月在赣南医学院第一附属医院行电子鼻咽喉镜检查发现的疑似咽部、会厌部乳头状瘤患者57例,以病理诊断结果为金标准,比较普通白光内镜(WLE)、NBI内镜、醋酸染色联合NBI内镜(AA-NBI)3种模式下的诊断效能(灵敏度、特异度、Kappa一致性).结果 WLE模式诊断准确率为63.16％,NBI模式为84.21％,AA-NBI模式为91.23％,AA-NBI模式诊断准确率显著高于WLE模式、NBI模式(P＜0.05).ROC曲线分析显示,WLE模式诊断乳头状瘤的灵敏度为66.67％、特异度为50.00％、曲线下面积(AUC)为0.583,NBI模式分别为86.67％、75.00％、0.808,AA-NBI 模式分别为 93.33％、83.33％、0.883,AA-NBI 模式灵敏度显著高于 NBI 模式和WLE模式(P＜0.05),3种模式特异度比较差异无统计学意义(P＞0.05).Kappa 一致性分析结果显示,WLE模式、NBI模式、AA-NBI模式的Kappa值分别为0.131、0.565、0.744,WLE模式与病理诊断结果的一致性差,NBI模式一致性中等,AA-NBI模式一致性较好.结论 醋酸染色是一种安全、便宜的色素染料,醋酸染色联合NBI内镜可以清晰地显示乳头状瘤病变形态,与单纯NBI、WLE比较均具有较高的准确性,是一种诊断咽部、会厌部乳头状瘤安全、有效的方法.

目的:探讨中药艾、三叶青乙醇提取物对鼻咽癌细胞增殖的影响,为筛选出治疗鼻咽癌效果良好的江西省特色中药探索方向.方法:将鼻咽癌CNE-2 细胞分为空白对照组、实验组、阳性对照组.阳性对照组与实验组加不同浓度的江西特色 3 味中药提取物处理鼻咽癌CNE-2 细胞 48 h后,通过CCK8 检测各组细胞增殖活性,流式检测细胞的凋亡和周期,透射电镜观察各组细胞的超微结构形态变化.结果:低浓度的艾和三叶青提取物对CNE-2 细胞的增殖有一定促进作用,高浓度的艾和三叶青提取物会抑制CNE-2 细胞的增殖;喜树碱对CNE-2 细胞的增殖具有显著的抑制作用,且随着浓度增加抑制作用更加明显.艾、三叶青提取物和喜树碱3 种药物均促进CNE-2 细胞的凋亡,随着药物浓度增大,凋亡促进作用更加明显.透射电镜观察发现,对照组CNE-2 细胞表面有长短不一的微绒毛伸展,细胞核核膜清晰,染色质呈细颗粒状,核仁清晰,未见典型细胞凋亡超微结构改变.实验组药物处理组,超微结构发生变化,如CNE-2 细胞微绒毛逐渐消失,内质网扩张,胞质浓缩,胞核深染,核染色质固缩成块并边集,出现凋亡小体.结论:高浓度的艾和三叶青提取物能够抑制CNE-2 细胞的增殖;喜树碱抑制CNE-2 细胞的增殖,并且随着浓度增加,抑制作用增强.

目的 研究复方茶油涂鼻膏对小鼠鼻腔致敏的治疗作用及其作用机制.方法 选取雄性BALB/c小鼠48只作为研究对象,随机分为空白对照组、阴性对照组、阳性对照组、低剂量药物组、中剂量药物组和高剂量药物组,每组8只.建立卵清蛋白鼻腔致敏小鼠模型,观察给药后对小鼠行为学表现和鼻黏膜组织形态学表现的影响.采用酶联免疫吸附试验(ELISA)检测鼻腔灌洗液中Ⅰ型辅助性T细胞(Th1)因子[白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)]和Ⅱ型辅助性T细胞(Th2)因子(IL-4、IL-5)水平.结果 与阴性对照组比较,中剂量药物组和高剂量药物组治疗后的行为学评分更低,鼻黏膜的组织形态学表现明显改善,差异均有统计学意义(P<0.05).与阴性对照组比较,中剂量药物组和高剂量药物组治疗后,鼻腔灌洗液中IL-2、IFN-γ水平明显升高,IL-4、IL-5水平明显下降,差异均有统计学意义(P<0.05).结论 中、高剂量复方茶油涂鼻膏治疗小鼠变应性鼻炎有效.

声带白斑在临床上又被称之为喉白斑,主要是由于辛辣饮食、过度用嗓等刺激因素长期作用于喉部黏膜导致患者黏膜上皮细胞增生以及过度角化进而引发的患者声嘶、咳嗽等不适.随着气候变化以及人们生活习惯的改变,声带白斑发病率逐渐增高.如果不及时进行治疗,声带白斑会发生恶变,将会对患者的身体健康和生命安全产生严重威胁.声带白斑的治疗方法多种多样,大致分为保守治疗、手术治疗和其他治疗.本文将从不同的形态学分型和病理学表现列举几种典型的治疗方式进行讨论,以初步了解各种治疗方法的可取和不足之处.

喉癌是头颈部常见的恶性肿瘤之一,目前其发病机制尚不清楚.随着生物科学技术的发展和基因测序技术的进步,已经可以从分子水平研究喉癌的发生发展机制,许多研究表明长链非编码RNA在喉癌的发生发展过程中发挥重要作用,这有助于喉癌的早期诊断和治疗,提高喉癌患者的术后生存质量.

支撑喉镜下喉显微外科手术是处理声带病变的常见手术方法,但在手术过程中,常面临着声带及病变暴露困难,无法暴露良好的手术视野,将导致手术无法顺利进行,即使有些患者在改变体位,加压喉体勉强完成手术,但可能造成口咽软组织的损伤、牙齿松动、颈椎损伤、声带损伤等严重后果.本文就目前临床上处理声带暴露困难的术式作以总结.

Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy, is a kind of very rare idiopathic disease. The most common feature is the excessive accumulation of Langerhans cells in lymph nodes, but it may also occur in other areas and lead to related organ damage. We report a case of a 60-year-old man with Rosai-Dorfman disease, which led to dyspnea. Surgery is the best treatment to relieve the patient's dyspnea in a short time. Rosai-Dorfman disease has trend to self-healing, but in the case of special location, surgery should be selected. Some similar mass recurred in the operative area and bilateral nasal cavity in half a year after operation. Now we reviewed the relevant literatures and summarized the experience of diagnosis and treatment in Rosai-Dorfman disease.

鼻咽癌(nasopharyngeal carcinoma,NPC)是中国常见的恶性肿瘤之一,其发病机制通常与环境因素、EB病毒感染等有关.最近越来越多的研究发现,一些异常表达的长链非编码RNA(long non-cod-ing RNA,lncRNA)在鼻咽癌的发生发展起重要作用.LncRNAs是一类长度>200个核苷酸,缺乏蛋白质编码能力,可以调控很多基因的表达.尽管很多证据表明LncRNAs在鼻咽癌中的重要性,但目前还没有系统性地阐明这些lncRNAs与鼻咽癌的关系.这篇文章总结LncRNAs在鼻咽癌中的作用机制,并介绍LncRNAs可能作为鼻咽癌诊断、预后生物标志物以及潜在的治疗靶标.

慢性鼻窦炎(chronic rhinosinusitis,CRS)是耳鼻喉科常见的慢性炎症性疾病,全球患病率约4.6％～12％,发病多与感染、黏膜纤毛功能障碍、解剖结构异常、免疫反应等有关,主要临床表现为鼻塞、黏性或黏脓性鼻涕,通常被广泛地分为伴有鼻息肉的CRS(CRSwNP)和不伴鼻息肉的CRS(CRSsNP).两者在临床表型、免疫病理学特征、治疗、预后等方面有诸多差异.通常不伴鼻息肉的慢性鼻窦炎更为常见,且预后往往较CRSwNP更好,本文就CRSsNP病因及发病机制、诊断与治疗的研究进展进行综述.

目的:探讨基质金属蛋白酶11(matrix metalloproteinas-11,MMP-11)在甲状腺乳头状癌手术前后表达水平及其临床意义.方法:采用ELISA方法检测甲状腺乳头状癌患者手术前后以及甲状腺良性结节患者术前、健康人血清中MMP-11的浓度.结果:甲状腺乳头状癌患者术前MMP-11水平明显高于健康组、良性病变组(P＜0.05).甲状腺乳头状癌术前MMP-11水平明显高于术后1月和术后3月(P＜0.05).结论:基质金属蛋白酶11在甲状腺乳头状癌中表达升高,手术后降低,基质金属蛋白酶11有望成为协助诊断甲状腺乳头状癌的一种新方法.

Objective To compare the effect diffence of a self-made nasal multi-functional cystic duct and conventional surgery on the amount of bleeding, operative time, and patient comfort in functional endoscopic sinus surgery (FESS). Methods A total of 58 patients with chronic sinusitis and nasal polyps who were admitted to our hospital from February 2014 to February 2018 were enrolled. Patients were divided into group A (30 cases) and group B (28 cases) by the random number table method. Group A was given continuous low-pressure suction with a self-made nasal multi-functional cycstic duct, and group B was given intermittent aspiration with a conventional aspirator. The amount of bleeding and the time of surgery were recorded. The comfort scores were investigated using the visual scale method, including postoperative nasal symptoms, pharyngeal symptoms, nausea and vomiting. Results There was no significant difference in the amount of surgical bleeding between the two groups (P>0.05). The operation time of group A was (93.0±8.1) min, which was shorter than (101.0±14.8) min of group B, and the difference was statistically significant (P<0.05). The visual analogue score of nasal discomfort in group A was (6.9±1.0) points, which was lower than (8.2±1.0) points in group B, and the difference was statistically significant (P<0.05). The pharyngeal discomfort score in group A was (3.4±0.9) points, which was lower than (4.9±1.2) points in group B, and the difference was statistically significant (P<0.05). The nausea and vomiting discomfort score in group A was (2.5±1.0) points, which was lower than (3.1±0.9) points in group B, and the difference was statistically significant (P<0.05). Conclusion The self-made nasal multi-functional cystic duct with low negative pressure suction in FESS does not increase the amount of surgical bleeding when compared with intermittent suction by conventional device, but it can shorten the operation time and improve the comfort of patients.

IL-20亚家族成员包括IL-19、IL-20、IL-22、IL-24和IL-26,它们之间有着相同的受体亚单位、下游信号转导途径以及相似的靶细胞和生物学功能.目前越来越多的研究发现,它们对多个T细胞亚群具有调节作用,影响它们的分化方向,而Th1、Th2、Th17等亚群的变化在变应性气道炎性疾病中起着关键作用.因此,IL-20亚家族可能与变应性气道炎性疾病的发生密切相关.本文将对IL-20亚家族细胞因子的特点以及各成员在变应性鼻炎和哮喘中的研究现状进行简要述评.

目的:建立不同严重程度的变应性鼻炎小鼠模型.方法:用含有氢氧化铝佐剂的卵清蛋白腹腔注射致敏BALB/c小鼠,然后于激发阶段分别予以卵清蛋白连续鼻部激发7天,14天和21天建立模型.通过行为学、鼻粘膜组织形态学和血清sIgE含量三个方面来评价模型的建立情况.结果:鼻部激发时间不同的三组模型小鼠与对照组比较,行为学评分、血清sIgE的含量均升高(P＜0.05).三组模型小鼠间比较,随着激发时间的延长,行为学评分、血清sIgE的含量增加(P＜0.05).结论:通过延长鼻部激发时间,可以建立不同严重程度的变应性鼻炎小鼠模型.

Objective:To study the clinical features of common allergens in patients with allergic rhinitis in Gannan area and provide reference for the prevention，diagnosis and treatment of allergic rhinitis with regional character.MethodThe clinical data of 363 patients who were newly diagnosed with allergic rhinitis and given allergen skin prick test（skin prick test，SPT）at our department from August 2012 to May 2016 were analyzed retrospectively.SPSS 180 was used to ananlyze the data.Result:Two hundred and fifty-two cases of allergen skin prick test were positive.The positive rates of allergens were 86.90% of house dust mites，86.11% of dust mites，51.19% of cockroach，14.29% of hair fungus，4.76% of crab meat and 3.17% of shrimp.The positive rate of various allergens in the children group was 93.24% for dust mites，91.89% for house dust mites，44.59% for cockroach，8.11% for crab meat，6.76% for shrimp，and 1.35% for hair fungus.The difference in positive rate of allergens among different age groups was statistically significant（P<0.01），among which the highest was 2 to 14 years old，which was 90.24%；the lowest was ＞44 to 74 years old，which was 31.70%.The difference in positive rates of allergens among different occupations was statistically significant（P<0.01），among which the highest was 86.45% for students，and the lowest was 45.24% for those without employment.There was no significant difference in the positive rate of allergens between different seasons.ConclusionThe most common allergens in Gangnan area are house dust mites，dust mites cockroache and scrab meat.Patients with allergic rhinitis are more common with multiple allergens.Age and occupation are also factors affecting the positive rate of allergens.

目的:观察应用糜蛋白酶溶液浸泡鼻咽部加鼻腔0.9％氯化钠溶液冲洗对鼻咽癌放射治疗后鼻咽部结痂及黏膜炎症反应的治疗效果.方法:选取2016年5月-2017年8月本院因鼻咽癌根治性放疗后鼻咽部重度结痂的患者64例,将其分为试验组和对照组,每组各32例.试验组采用400 U/mL浓度糜蛋白酶溶液10 mL经滴鼻浸泡鼻咽部20 min,然后再用0.9％氯化钠溶液行鼻腔冲洗;对照组采用0.9％氯化钠溶液10 mL经滴鼻浸泡鼻咽部20 min,然后再用0.9％氯化钠溶液行鼻腔冲洗,两组治疗频率均为2次/d.治疗2周后在电子鼻咽喉镜下观察鼻咽部结痂及黏膜炎症反应治疗效果.结果:试验组鼻咽部黏膜炎症反应治疗有效率为62.5％,高于对照组的25.0％(P<0.05);试验组鼻咽部结痂清除治疗有效率为78.1％,高于对照组的31.3％(P<0.05).结论:鼻咽癌放疗后鼻咽结痂严重者采用经鼻滴入糜蛋白酶溶液浸泡鼻咽部后再0.9％氯化钠溶液冲洗,能增强对鼻咽癌放疗后鼻咽黏膜炎症的恢复,增强鼻咽部结痂冲洗的治疗效果.

Total laryngectomy is a common method for the treatment of malignant tumors of the pharynx and larynx in China, but pharyngocutaneous fistula often happens after surgery, which burdens patients and affects postoperative recovery. At present, there are many measures to prevent pharyngocutaneous fistula, including strengthening nutrition pre-operative and post-operative, testing related indicators, controlling comorbidities, rational use of drugs, regular oral care, optimal selection of incision closure, and using of flaps and special materials during operation, etc. However, the choice of specific program needs to take care of the patient's condition, surgeon's skills and hospital conditions, and often requires multiple programs to be used together throughout the perioperative period. This article will provide a brief review of some strategies for preventing pharyngocutaneous fistula after total laryngectomy.

Chronic suppurative otitis media (CSOM) is one of the common diseases in the Department of Oto-laryngology Head and Neck Surgery. It is the irreversible chronic inflammation in the middle ear and the mastoid. Up to now, the etiology of the disease and the mechanism is not completely clear. Its etiology is complex, and its occurrence is related to a variety of factors, including infection, dysfunction of eustachian tube and immunologic inadequacy. Bacterial infection is one of the most important and direct exogenous pathogenic factors of CSOM. At present, with the wide use of antibiotics, the sensitivity of CSOM pathogenic bacteria to antibiotics is gradually decreased, and the composition of the pathogen is also changing. Therefore, detecting the pathogenic bacteria in CSOM and identifying its drug sensitivity as soon as possible is of great significance for clinical treatment of CSOM. This review summarizes the distribution and drug resistance of pathogenic bacteria of CSOM, pathogenic bacteria detection and rational use of antimicrobial agents, based on the relevant literatures at home and abroad in recent years.

目的 探讨鼻咽癌放疗后放射性中耳炎新的治疗手段.方法 回顾性分析2013年7月至2016年1月因鼻咽癌放疗后被确诊为放射性中耳炎,在赣南医学院第一附属医院分别采用两种不同方法治疗的116例(132耳)患者的临床资料.其中采取鼓膜穿刺治疗54例(65耳),经电子鼻咽喉镜下咽鼓管置管治疗62例(67耳).穿刺组为自确诊放射性中耳炎后经鼓膜穿刺抽液并注入地塞米松+桉柠蒎溶解液者,置管组为自确诊放射性中耳炎后在电子鼻咽喉镜下经咽鼓管抽液并注入地塞米松+桉柠蒎溶解液者.两组患者治疗后观察3个月、6个月并记录患者的耳闷感、语频气骨导听阈值、中耳压力峰压值改变情况.结果 穿刺组患者经治疗3个月和6个月后的耳闷感改善有效率分别为81.54％和82.00％,均低于咽鼓管置管组的94.03％和88.06％,差异均有统计学意义(P<0.05);穿刺组患者语频气骨导听阈均值经治疗3个月、6个月后分别为(30.76±4.82)dBHL和(33.72±3.97)dBHL,均高于咽鼓管置管组的(27.79±5.58)dBHL和(29.32±5.76)dBHL,差异均有统计学意义(P<0.05);穿刺组患者经治疗3个月和6个月后的鼓室导抗图峰压值均值分别为(-160±15.0)daPa和(-175±20.0)daPa,均低于置管组的(-150±15.0)daPa、(-140±15.0)daPa,差异均有统计学意义(P<0.05).结论 电子鼻咽喉镜下经咽鼓管置管注射桉柠蒎溶液对治疗放射性中耳炎有较好的临床疗效.

目的:在喉癌患者喉部分切除后喉功能的重建中,探讨应用钛网作为喉支架进行喉功能重建的可行性.方法:对于合适的喉癌患者,先行喉垂直额侧部分切除,在术中根据喉部缺损的需要应用钛网制作恰当的喉支架,保留胸骨舌骨肌及其筋膜,作为喉支架的衬里,肩胛舌骨肌覆盖钛网喉支架的外侧,进行三明治式的喉腔重建.术后观察患者术后吞咽、呼吸、发音等功能.结果:所有患者术后无感染,无呼吸困难,术后吞咽、呼吸、发音功能恢复良好.结论:对于合适的声门型喉癌患者,可以应用钛网作为喉支架进行喉腔重建.