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 By observing the impact of allergic rhinitis control pulmonary ventilation function of clinical bronchial asthma(asthma),which can provide a reference for the clinical treatment of patients.Methods Interception of our hospital in January 2012-October 2014 period were treated with 68 cases of asthma and allergic rhinitis in asthma patients were divided into observation group and control group,in which the observation group for asthma with allergic rhinitis,38 cases;control group of patients with asthma,30 cases.Two groups were compared asthma control test (ATC) and the elimination of asthma control questionnaire (ACQ) score,while nearly a month statistics patient and the asthma frequency of use of salbutamol aerosol expiratory volume in 1s percent predicted (FEV1 %pred) and call gas percent predicted peak flow (PEF% pred).Results ①ACT score:mean observation group (1 5.7 ± 5.5) was significantly lower than the control group points (1 9.2 ± 5.1) min,P <0.05.② ACQ score:mean observation group(2.2±1.4)was significantly higher points in the control group(1.3±1.0)min, P <0.05.③ The use of salbutamol aerosol:the observation group average (4.2 ±0.3) times the control group was significantly higher(0.5±0.1)times,P <0.05.④ Pulmonary function:mean FEV1 %pred in&nbsp;the observation group(65.1±21.9)% was significantly lower than the control group (78.5 ±22.3)%,P <0.05.Mean PEF%pred in the observation group(66.1±21.9)% was significantly lower than the control group (79.9 ± 25.8)%,P < 0.05.Observation group dyspnea and wheezing and wheezing disappeared time was (3.61 ± 1.47) days,(2.68 ± 0.97) days,(4.39 ± 1.91) was shorter than the control group (6.12±2.1 9) days,(4.30 ± 1.28) days,(6.95 ±2.47) days,with statistical significance,P <0.05.⑤VAS was negatively correlated with the ACT,was positively correlated with ACQ,and pulmonary function was negatively correlated,P < 0.05.Conclusions With allergic rhinitis is not conducive to clinical control of asthma patients,while also increasing the asthma symptoms and rescue medication use frequency,so that patients pulmonary function decline.Patients with more severe symptoms of rhinitis, asthma control,the worse,and the lower the pulmonary function.

选取笔者所在医院收治的突发性耳聋患者90例，随机分为观察组和对照组，每组45例。对照组行常规西医治疗，观察组行中西医结合治疗，即在对照组的基础上予银杏叶制剂治疗。比较两组临床疗效及两组有无伴发耳鸣、眩晕与疗效的关系。结果观察组总有效率明显高于对照组，差异有统计学意义(P<0.05)。伴耳鸣或眩晕者，两组总有效率比较差异无统计学意义(P>0.05)；不伴耳鸣或眩晕者，观察组总有效率明显高于对照组，差异有统计学意义(P<0.05)。观察组中，伴耳鸣或眩晕者总有效率明显低于不伴者，差异有统计学意义(P<0.05)；对照组中，伴耳鸣或眩晕者与不伴者总有效率比较差异无统计学意义(P>0.05)。中西医结合治疗突发性耳聋疗效显著，其中以无伴发耳鸣、眩晕的患者效果更为满意。