Introduction This study explores the presence and clinical significance of Epstein-Barr Virus (EBV) and Human Papillomavirus (HPV) in papillary thyroid carcinoma (PTC). EBV and HPV are known to contribute to various cancers, but their roles in thyroid cancer development are debated. Methods Paraffin-embedded tissue blocks from PTC patients (n=255) who underwent thyroid surgery between 2020 and 2021 were analyzed for EBV and HPV DNA using PCR-based methods. Results Results showed EBV positivity in 45.1% of PTC cases, significantly higher than in benign thyroid tumors (35.2%), while HPV positivity was low (0.7%). EBV positivity was not associated with age, gender, lesion type, lymph node metastasis, or extrathyroidal extension but was significantly higher in PTC cases with concurrent Hashimoto's thyroiditis. The study suggests a notable presence of EBV in PTC, especially in cases with Hashimoto's thyroiditis, but indicates a limited role for HPV in thyroid cancer. Conclusion Further research is warranted to understand the specific pathogenic mechanisms and potential therapeutic implications of EBV and HPV in thyroid cancer.

目的 探索智能手机应用程序(application,APP)应用软件在医学生耳鼻咽喉科手术操作中的应用.方法 选择全日制临床专业2016级本科生40人,分为对照组和试验组,每组20人.对照组采用以病例为基础的教学(case-based learning,CBL),试验组采用手机Touch Surgery APP结合CBL教学.两组学生的基础课程学习内容一致,在耳鼻咽喉科培训时间均为4个月,结束后进行出科考试,将成绩用统计软件进行分析,比较对照组和试验组理论考试与操作考试成绩.结果 试验组学生手术操作时间明显短于对照组,其操作的熟练程度优于对照组(P＜0.05),试验组的操作成绩明显高于对照组(P＜0.05).结论 Touch Surgery APP结合CBL教学方法可以提高学生自信心和耳鼻咽喉科手术动手能力、缩短培训学习时间、提高耳鼻咽喉科手术培训效果.

目的 探讨窄带成像技术(NBI)联合苯胺蓝染色在鼻咽癌内镜筛查及诊断中的价值.方法 选择2017年10月至2021年10月在海军军医大学(第二军医大学)附属公利医院和银川市第一人民医院就诊且怀疑有鼻咽部占位性病变的68例患者,使用具有NBI模式的电子鼻咽镜进行鼻咽部检查,取疑似病变表面的渗液进行苯胺蓝染色,并对疑似病变进行病理活检.以病理检查结果 作为诊断金标准,分别计算白光模式、NBI模式、苯胺蓝染色及NBI联合苯胺蓝染色4种检查手段的灵敏度、特异度、阳性预测值、阴性预测值和准确度及Kappa系数,并使用χ2 检验比较各检查方法 的诊断阳性率.结果 NBI与苯胺蓝染色联合诊断鼻咽癌的阳性率高于白光内镜、NBI、苯胺蓝染色单独诊断[97.83％(45/46)vs 56.52％(26/46)、84.78％(39/46)、80.43％(37/46)],差异均有统计学意义(P均＜0.001).NBI联合苯胺蓝染色诊断鼻咽癌的灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为97.83％、86.36％、93.75％、95.00％和94.12％.NBI联合苯胺蓝染色对鼻咽癌的诊断结果 与病理检查结果 有较好的一致性(Kappa系数为0.862).结论 相较于白光模式及单一NBI模式和苯胺蓝染色,NBI联合苯胺蓝染色对鼻咽癌有较高的灵敏度和特异度.

目的 探讨细胞角蛋白19(CK19)、半乳糖凝集素3(Gal-3)、p53、拓扑异构酶Ⅱ(TopoⅡ)、Ki-67、细胞周期蛋白D1(CCND1)、人骨髓内皮细胞标志物1(HBME-1)、B-Raf原癌基因丝氨酸/苏氨酸蛋白激酶V600E突变型(BRAFV600E)在甲状腺乳头状癌(PTC)病理诊断中的临床应用价值.方法 选取100例PTC和40例甲状腺良性病变标本,采用免疫组织化学染色EnVision法检测CK19、Gal-3、p53、TopoⅡ、Ki-67、CCND1和HBME-1在组织中的表达情况,通过荧光PCR检测BRAFV600E在组织中的表达情况.结果 PTC组织中CK19、Gal-3、TopoⅡ、CCND1、HBME-1和BRAFV600E阳性表达率[97.0％(97/100)、98.0％(98/100)、56.0％(56/100)、95.0％(95/100)、66.0％(66/100)、75.0％(75/100)]高于甲状腺良性组织[45.0％(18/40)、20.0％(8/40)、15.0％(6/40)、55.0％(22/40)、25.0％(10/40)、12.5％(5/40)],差异均有统计学意义(P均<0.01).8种标志物单独用于PTC的诊断时,CK19、Gal-3的灵敏度最高(97.0％、98.0％),Gal-3的准确度最高(92.9％);3种标志物联合应用并以其中任意2种阳性作为阳性判断标准时,CK19、Gal-3、HBME-1组合检测PTC的准确度最高(96.4％),其次为BRAFV600E、CK19、Gal-3组合(91.4％).结论 CK19、Gal-3、TopoⅡ、CCND1、HBME-1、BRAFV600E是诊断PTC的重要标志物,这些标志物联合应用有助于对形态不典型PTC与甲状腺良性病变进行鉴别.

目的 检测上海市杨浦区变应性鼻炎患者的血清过敏原分布情况.方法 运用敏筛过敏原检测仪专用试剂盒(免疫印迹法)对2018年1-12月就诊于我科门诊的1504例临床诊断变应性鼻炎的上海市杨浦区常驻居民患者血清中过敏原特异性IgE(sIgE)和总IgE进行半定量检测.比较不同性别(男性和女性)、不同过敏原来源(单纯食入性、单纯吸入性和混合性)、不同季节[冬季(1-3月)、春季(4-6月)、夏季(7-9月)和秋季(10-12月)]变应性鼻炎患者的过敏原阳性率.结果 1504例患者的总IgE阳性率为76.93％(1157/1504),sIgE阳性率为85.97％(1293/1504),吸入性过敏原中阳性率排前3位的依次是户尘螨(55.32％,832/1504)、狗毛皮屑(18.22％,274/1504)和屋尘(13.96％,210/1504),食入性过敏原中阳性率排前3位的依次是牛奶(13.03％,196/1504)、蟹(5.52％,83/1504)、鸡蛋白(4.45％,67/1504).男性患者过敏原sIgE阳性率高于女性患者[88.24％(705/799)vs 83.40％(588/705),P<0.01].夏季和秋季过敏原sIgE阳性率高于冬季和春季[89.76％(342/381)、89.69％(435/485)vs 79.65％(227/285)、81.87％(289/353),P均<0.05].单纯吸入性过敏原sIgE阳性率高于单纯食入性和混合性过敏原[45.68％(687/1504)vs 2.46％(37/1504)、20.28％(305/1504)],混合性过敏原阳性率高于单纯食入性过敏原(P均<0.01).结论 上海市杨浦区变应性鼻炎男性发病率高于女性,发病季节以夏秋两季为主,过敏原来源以吸入性为主、混合性次之.

目的 调查某岛礁作业人员航行期间运动病的发病情况和治疗效果,为指导部队开展运动病管理与防控提供数据支持.方法 选择某岛礁驻防的相关人员中上岛时间、出海次数、乘坐舰艇、经历海况与居住条件均相同的132名作业人员为调查对象.通过问卷调查收集基本信息、晕船程度及伴随症状、治疗史、进食和睡眠情况,并分析与晕船相关的因素.结果 共发放问卷132份,收回有效问卷132份.132名调查对象中,女24人、男108人,6人(4.55％)出海前接受过防止晕船的前庭功能训练.航行期间16人(12.12％)无晕船症状,116人(87.88％)有晕船症状,91人(68.94％)伴有呕吐症状,90人(68.18％)伴有行走不稳.晕船期间101人(76.52％)接受过治疗,其中无效38人(28.79％)、部分缓解55人(41.67％)、有效8人(6.06％);31人(23.48％)未接受过治疗.乘船期间34人(25.76％)可以正常进食,98人(74.24％)食量减少或无法进食;72人(54.55％)睡眠正常,60人(45.45％)睡眠减少或失眠.不同进食情况、不同睡眠情况的被调查者之间晕船状况差异均有统计学意义(P均<0.05),食量减少或无法进食、睡眠减少或失眠的被调查者晕船症状均较多见.结论 岛礁作业人员换防航行期间晕船发生率高,航行前应加强防晕船训练,航行中应给予抗晕、护胃、助眠药物.

目的 通过分析臭氧暴露后人鼻黏膜上皮细胞中氧化应激相关基因表达的变化,初步探索臭氧暴露引发慢性鼻窦炎的机制.方法 建立人鼻黏膜上皮细胞臭氧暴露体外培养模型,用高通量PCR芯片技术对臭氧暴露前后鼻黏膜氧化应激相关基因进行检测,并用qRT-PCR进行验证.采用qRT-PCR、蛋白质印迹法及流式细胞术检测臭氧暴露前后培养细胞中环氧化酶2(Cox2)和活性氧(ROS)的表达.结果 用PCR芯片对鼻黏膜上皮细胞中84个氧化应激相关基因进行筛查,发现高强度臭氧暴露后人鼻黏膜上皮细胞中醛酮还原酶家族1成员C2(AKR1C2)、谷氨酸半胱氨酸连接酶(GCLM)、谷胱甘肽过氧化物酶2(GPX2)、谷胱甘肽还原酶(GSR)、血红素加氧酶1(HMOX1)、NADPH氧化酶(NOX5)、前列腺素内过氧化物酶合酶2(PTGS2)、超氧化物歧化酶2(SOD2)及丝氨酸肽酶抑制剂(Kazal型)1(SPINK1)9个基因表达上调,而趋化因子配体5(CCL5)、细胞球蛋白(CYGB)、可溶性环氧化酶水解酶2(EPHX2)、谷胱甘肽S-转移酶zeta 1(GSTZ1)、角蛋白1(KRT1)、组氨酸磷酸酶(LHPP)、肌球蛋白(MB)、MPV17线粒体内膜蛋白(MPV17)、硒蛋白P(SEPP1)及转运蛋白颗粒复合物6A(TRAPPC6A)10个基因表达下调.同时,臭氧暴露导致ROS大量生成(暴露组及对照组荧光强度:184.3±6.8 vs 13.0±1.4,P<0.05),Cox2 mRNA及蛋白表达水平升高(暴露组与对照组mRNA相对表达量:6.4±1.2 vs 1.0±0.0,P<0.05;暴露组与对照组蛋白相对表达量:11.7±2.6 vs 13.8±1.5,P<0.05).结论 臭氧暴露后GSTZ1、NOX5、SOD2等相关基因参与鼻黏膜氧化应激调控,臭氧暴露引发鼻黏膜炎症反应可能与这些基因调控Cox2表达的相关信号通路有关.

目的 研究LncROR在鼻咽癌细胞增殖、抗凋亡及上皮-间质转化中的作用.方法 收集2016年6月至2017年6月上海市浦东新区公利医院及长海医院经病理确诊的初治鼻咽癌患者及慢性鼻咽炎患者的病例标本各15例,分别采用实时荧光聚合酶链(qRT-PCR)方法检测lncROR的表达水平;以鼻咽癌细胞株CNE-2为研究对象,抑制lncROR表达后,CCK-8法检测CNE-2增殖能力变化,Western blot方法检测CNE-2凋亡相关蛋白(caspase-3,caspase-9)及上皮-间质转化相关蛋白(E-钙粘蛋白、β-连环蛋白、N-钙粘蛋白、波形蛋白)的表达变化.结果 LncROR在鼻咽癌组织及鼻咽癌细胞株中均有高表达,且在鼻咽癌细胞株CNE-2中表达明显高于其他细胞株;体外实验证实,抑制lncROR表达后,与转染对照组相比,细胞增殖能力明显减弱;活化的caspase-3,caspase-9蛋白表达升高;上皮标志蛋白(E-钙粘蛋白、β-连环蛋白)表达升高,间质标志蛋白(N-钙粘蛋白、波形蛋白)表达下降.结论 LncROR在鼻咽癌组织中高表达,并可以促进鼻咽癌细胞增殖、抗凋亡及上皮-间质转化.

目的 研究雷公藤红素在鼻咽癌细胞增殖、迁移及上皮间质转化中的作用.方法 使用终浓度为1.8μmol/L的雷公藤红素处理人鼻咽癌HNE1、CNE2细胞,并设二甲基亚砜(DMSO)对照组.用CCK-8法检测HNE1、CNE2细胞的增殖能力,细胞划痕实验检测细胞迁移能力,细胞克隆形成实验检测细胞的克隆形成数,细胞黏附与分离实验检测细胞的黏附、分离能力,蛋白质印迹法检测细胞上皮间质转化蛋白(E-钙黏蛋白、β-连环蛋白、N-钙黏蛋白、波形蛋白)的表达.结果 与DMSO对照组比较,采用1.8μmol/L雷公藤红素处理24、48、72 h后,HNE1细胞的增殖能力均降低(P均<0.05),处理48、72 h后,CNE2细胞的增殖能力均降低(P均<0.05);处理48 h后,HNE1、CNE2细胞的迁移能力均下降(P均<0.05);处理2周后,HNE1、CNE2细胞的克隆形成数均减少(P均<0.05);处理1 h后,HNE1、CNE2细胞的黏附率降低(P<0.05);处理24 h后,HNE1、CNE2细胞的分离率降低(P<0.05);处理6 h后,HNE1、CNE2细胞中E-钙黏蛋白、β-连环蛋白的表达升高(P<0.05),N-钙黏蛋白、波形蛋白的表达降低(P均<0.05).结论 雷公藤红素可抑制鼻咽癌HNE1、CNE2细胞的增殖、迁移及上皮间质转化.

Although sinonasal inverted papilloma (SNIP) is a common benign tumor which usually occurs in nose and paranasal sinus, it has a trend of attacking, recurrence and malignancy. Human papillomavirus (HPV) infection plays an important role in SNIP development. Subtypes of HPV may have close relation to SNIP malignancy has been regularly realized. An in-depth research in biological and clinical character of HPV will improve the diagnosis, treatment and prevention of SNIP. This review is about the researching progress of relationship between SNIP malignancy and HPV infection.

目的 检测患者染色体上有无变应性鼻炎相关基因单体型模块SDAD1、CXCL 10、CXCL11、EoBL的存在,有无单核苷酸多态性(SNP)的存在及遗传因素对这些SNP有无影响.方法 提取有遗传背景组和散发组的变应性鼻炎患者的血液样本DNA,通过PCR引物设计、合成、扩增后进行基因测序.结果 实验在2组中一共检测出46个位点,其中发生突变的位点有34个,总的突变率为78.3％.变应性鼻炎的基因突变在有遗传背景组(66.67％)和散发组(78.57％)之间差异无统计学意义(P=0.58).结论 变应性鼻炎患者染色体上单体型模块SDAD1,CXCL9,CSCL10及CXCL11基因连续表达,变应性鼻炎相关基因SDAD1、CXCL 10、CXCL11、EoBL上有SNP的广泛存在,但遗传因素对这些突变无明显的影响.

Certain nasal neoplasms, such as ectopic menigioma, present as nasal polyps, together with similar symptoms. The present study reports the diagnosis and treatment of ectopic meningioma in the bilateral nasal olfactory cleft in order to improve the diagnosis and treatment of ectopic meningioma in the nasal cavity. By retrospectively analyzing the clinical data and reviewing the associated literature, a detailed introduction to the clinical manifestation, diagnosis and treatment of ectopic meningioma of the nasal cavity was ascertained. The tumor was removed from the sinus by functional endoscopy surgery. Regular follow-up appointments were scheduled every three months, with no evidence of recurrence to date. The olfactory recovery and nasal ventilation were normal subsequent to surgery. Meningiomas are infrequently occurring tumors with unpredictable clinical behavior. A clear understanding of the etiology and appropriate diagnostic and management principles may aid in overcoming the challenges of treating primary extracranial meningiomas.

淋巴瘤是指发生于淋巴组织的恶性增生性肿瘤，扁桃体淋巴瘤属结外型恶性淋巴瘤，其中非霍奇金淋巴瘤（ non-Hondgkin′s lymphoma，NHL）常见，霍奇金淋巴瘤（ Hondgkin′s lymphoma，HL）罕见。扁桃体恶性淋巴瘤男性发病高于女性，平均发病年龄为42岁［1］，国外研究发现扁桃体是恶性淋巴瘤的常见发病部位，约占73%［2］。我院近期收治老年扁桃体恶性淋巴瘤1例，现报告如下。

OBJECTIVE To study the distribution of HPV subtypes in the nasal polyps, and to evaluate the relationship between HPV and nasal polyps. METHODS Thirty seven HPV subtypes were detected in paraffinembedded tissues of 204 cases of nasal polyps by f low through hybridization and gene chip(HybriMax) and normal nasal mucosa of 36 cases were used as control. RESULTS HPV infection was prevalent in patients with nasal polyps. HPV infection in the nasal polyp tissues was significant higher than that in control group(40.2% vs 0%, P 0.05). Genotyping analysis showed that LR-HPV-11 was the most prevalent type(45.28%). However, patients' gender, age, and number of operations, disease course were not correlated with HPV infection or HPV subtypes. CONCLUSION Our present results indicated that the occurrence and development of nasal polyps is closely related with HPV infection. Both high risk-HPV(HR-HPV) and low risk-HPV(LR-HPV) genotypes were identified in nasal polyps tissues, and HPV-11 was the most prevalent type. Patients' gender, age, and number of operations are not correlated with HPV infection or HPV subtypes.

Human papillomavirus (HPV) infection has been shown to be associated with human tumorigenesis. The aim of the present study was to demonstrate the association between HPV infection and parotid gland tumors. Paraffin-embedded tissue sections from 59 cases of parotid gland tumors and 20 normal oral mucosa were subjected to DNA extraction and flow-through hybridization and gene chip technology to detect infection of 37 HPV types. The HPV-positive rate was 57.6% in parotid gland tumor paraffin-embedded tissue specimens, whereas, the normal control group was negative for HPV. The HPV-positive rate was 59.6% in parotid gland benign tumor tissues and 42.9% in parotid malignant tissues. HPV infection in parotid gland tumors was dominated by the high-risk subtypes (80.7%), which mainly consisted of HPV 16, 18 and 52 (61.4%). In addition, parotid gland tumor tissues were found to be infected by multiple or single types of HPV, but were predominantly infected by mixed HPV types. In this study, we found that the occurrence of parotid gland tumor is correlated with HPV infection.

儿童慢性扁桃体炎和腺样体肥大在临床上十分常见,主要与细菌和病毒感染有关.因为EB病毒具有嗜B淋巴细胞的特性,当我们在体外进行B细胞培养时加入EB病毒可以促进其增生,而同样EB病毒感染患儿的扁桃体炎和腺样体肥大的术后病理也显示B淋巴细胞大量增生.近年来EB病毒在疾病发病机制中的作用成为研究的热点,本文结合国内外最新文献对EB病毒相关疾病,尤其是儿童慢性扁桃体炎和腺样体肥大与EB病毒感染的相关性研究进展做一综述.

Objective To explore distribution of EB virus in children with chronic tonsillitis and adenoid hypertrophy,to investigate the relationship between the EBV and the pathogenesis of chronic tonsillitis and adenoid hypertrophy.Methods This study included 42 children with chronic tonsillitis and 104 children with adenoid hypertrophy,and all the patients received surgical therapy.The specimens that obtained in operation had been detected the quantity of the EBV by using real-time fluorescent quantitative PCR(RT-PCR).Results The positive rate of EBV detected in tonsillar tissue was 45.24%(19/42),and the adenoid tissue was 67.31 %(70/104).The difference of the EBV quantity between the tonsillar tissue and the adenoid tissue was statistically significant(P0.05).The quantity of EBV had no relationship with the gender,months of age,disease duration and nationality.Conclusion The EBV relates with the pathogenesis of chronic tonsillitis and adenoid hypertrophy.

吞咽障碍是脑卒中后常见并发症,多数伴有构音障碍和摄食困难,严重影响预后,及时准确的评估是成功治疗的关键。本文通过回顾文献了解目前脑卒中吞咽障碍的发病机制及诊断评估的方法,以此指导制定合理有效的治疗方案,尽早干预以降低致残率和死亡率。本文就目前脑卒中患者吞咽障碍的发病机制、功能检查及诊断评估进行综述,旨在科学的指导康复治疗,改善预后。

儿童扁桃体和腺样体肥大在临床上十分常见,主要与细菌和病毒的感染有关.目前引起扁桃体和腺样体肥大较为公认的病因是细菌感染,但近年来随着病毒分子生物学和免疫组化、基因测序等科技的发展,病毒致病的因素逐步引起人们的关注,其中人乳头状瘤病毒成为研究的热点.本文对儿童扁桃体和腺样体肥大与人乳头状瘤病毒的相关性研究进展做一综述.