BACKGROUND:The incidence rate of allergic rhinitis (AR) is on the rise, which seriously affects the quality of life, work efficiency, mental state of patients, and sleeping in AR sleep. This experiment aimed to investigate the changes in Treg/Th17 cells in the nasal mucosa of an AR mouse model and the intervention effect of an Anti-IL-17 antibody. METHODS:A mouse model of AR was induced by intraperitoneal ovalbumin (OVA) injection for sensitization and stimulation with nasal drops. The times of rubbing, sneezing, and symptomatology scores were counted and analyzed. Pathological damage to the nasal mucosa was observed by Hematoxylin-Eosin (HE) staining. Peripheral blood CD4+CD25+CD127- Treg cell levels and the content of Th17 cells were measured by flow cytometry (FCM). ELISA kits were used to detect the levels of relevant cytokines (IL-10 and TGF-β1) secreted by Treg cells. The intervention effect of Anti-IL-17 antibody was observed by giving Anti-IL-17 antibody treatment. RESULTS:The times of rubbing, sneezing, and symptomatology scores were significantly higher in mice in the OVA group than in the Control group (p < 0.001). The percentage of CD4+CD25+CD127- Treg cells in CD4+CD25+ T cells (p < 0.05) and the levels of IL-10 (p < 0.001) and TGF-β1 (p < 0.001) were significantly decreased. After OVA induction, the continuity of the nasal mucosa of mice was interrupted, the percentage of Th17 cells, IL-17, and IL-4 levels were increased, and IFN-γ levels were significantly reduced (p < 0.001). And protein expression of RORγt was significantly upregulated (p < 0.001). In addition, all of these results were reversed by Anti-IL-17 antibody treatment, significantly improving AR-related symptoms (p < 0.05). CONCLUSION:Anti-IL-17 antibodies may regulate the body's immune response by promoting CD4+CD25+CD127- Treg cell differentiation, thereby ameliorating the symptoms associated with AR.

Angioleiomyoma (ALM) is a benign neoplasm marked by the presence of blood vessels and smooth muscle cells, commonly located within the subcutaneous or deep dermal layers. Its manifestation in the pterygopalatine fossa is infrequent, thereby posing difficulties in its diagnosis and distinction from other benign tumors within the same anatomical site. In the present case study, an ALM originating in the right pterygopalatine fossa of a 44-year-old female patient was investigated. The patient underwent surgical intervention for the vascular smooth muscle tumor, and there has been no recurrence noted during the postoperative monitoring period.

Sinonasal inverted papillomas（SNIP） is a common tumour arising from the nasal epithelial mucosa. Most lesions are benign, but a subset of SNIP progress to dysplasia and squamous cell carcinoma. Although the epidemiology and clinical features of SNIP are well known, the pathogenesis is still unclear. Given the established role of human papilloma virus（HPV） in the formation of other mucosal tumours including cervical and oropharyngeal cancer, some have suggested the virus may play a role in SNIP development. However, the association between HPV and SNIP has not yet been proven.we summarize a large number of early clinical reports and synthesize recent studies about the association between HPV and SNIP,and discuss the role HPV may have in the pathogenesis of SNIP.

1临床资料 患者,女,58岁,因"咽痛3 h"就诊于苏北人民医院耳鼻咽喉科门诊.患者3 h前出现咽部疼痛,伴下颌疼痛,无意识不清,无头晕,无恶心呕吐,体温正常,无其他不适.患者既往高血压病史十年余,未进行正规治疗及定期监测血压,否认冠心病、糖尿病等慢性疾病史,否认手术史、外伤史,否认吸烟酗酒等其他不良嗜好.门诊查体:咽部色红,扁桃体Ⅰ度、不伴充血肿胀,间接喉镜下会厌正常.电子喉镜示双侧声带肥厚,黏膜慢性充血,双侧前中1/3处边缘结节样小隆起.颈内动脉超声检查发现左侧颈总动脉内见絮状回声,范围较大,大部分充填血管管腔,内血流部分充盈,提示左侧颈总动脉内急性栓子,范围较大(图1),考虑可能为导致咽痛的主要原因,遂转诊于血管外科.头颈CT血管造影(CTA)检查示左侧颈动脉夹层,予以抗凝溶栓等对症治疗,随即患者咽痛症状消失.3个月后随访,未见异常.

目的 探讨锁骨上皮瓣在头颈肿瘤缺损修复中的应用.方法 回顾性分析2017年1月～2020年12月于扬州大学附属苏北人民医院收治的应用锁骨上皮瓣修复头颈缺损的9例患者临床资料,通过研究其头颈肿瘤缺损的原因、术前放疗史、手术方式、皮瓣尺寸及术后愈合情况等因素,探讨锁骨上皮瓣的制备技巧、应用指征及术后并发症的处理.结果 9例患者均为男性,年龄51～79岁.3例一期修复包括1例下咽癌,1例舌根恶性肿瘤,1例鼻咽癌继发颈部淋巴结转移癌;6例二期修复包括1例下咽癌术后继发颈部淋巴结转移癌,1例喉癌术后继发气管造瘘口癌,1例喉及食管癌术后吻合口瘘,3例下咽癌术后咽瘘.2例咽瘘患者采用锁骨上皮瓣联合胸大肌皮瓣修复缺损,7例患者单独采用锁骨上皮瓣修复.术中所取锁骨上皮瓣宽度为4～8 cm,长度为6～15 cm.8例术后随访皮瓣存活,1例术后皮瓣坏死,清创换药后愈合.1例下咽癌术后患者皮瓣存活,但食管入口肿瘤复发予以放射性粒子植入,局部未控,术后第11个月死亡.结论 锁骨上皮瓣是喉咽及颈部皮肤术后缺损较为理想的修复组织瓣,技术比较成熟,术中应注意皮瓣血管的保护,治疗效果比较可靠.

目的 探讨手术后复发的慢性鼻窦炎伴鼻息肉患者中嗜酸粒细胞性鼻息肉患者与嗜酸粒细胞性鼻息肉患者的其复发时间长短、打喷嚏、鼻塞、流涕、头痛、嗅觉减退等临床症状与CT表现的差异.方法 收集2019.02～2020.02的患者在我院耳鼻咽喉科就诊的54名具有明确鼻息肉手术史的手术患者,依据嗜酸性粒细胞占白细胞总数分为嗜酸性粒细胞性慢性鼻窦炎伴鼻息肉组(n=32)与非嗜酸性粒细胞性慢性鼻窦炎伴鼻息肉组(n=22),依据患者的病史资料,制作两组患者的临床表现的VAS评分(0～10分)、Lund-Kennedy评分(0～24分),依据量化评分对两组患者进行评价.结果 嗜酸性粒细胞性慢性鼻窦炎伴鼻息肉患者其病程、鼻塞、流涕等临床症状较非嗜酸性粒细胞性慢性鼻窦炎伴鼻息肉患者更重(P<0.05),且影像学表现更为严重(P<0.05),但是患者其他比如头痛、嗅觉减退等临床表现在二组间未见明显差异(P>0.05).结论 嗜酸性粒细胞性慢性鼻窦炎伴鼻息肉患者其易复发,鼻塞、流涕等临床表现更重,且影像学表现更为明显,嗜酸性粒细胞性慢性鼻窦炎伴鼻息肉更为顽固.

目的 进一步验证BCAP通过激活PI3K引起炎性反应症状,高水平BCAP可能会促进变应性鼻炎的发生.方法 采集21例变应性鼻炎患者和6名健康志愿者的外周血样本,对血浆中BCAP水平进行ELISA测定.结果 变应性鼻炎患者血浆中BCAP含量显著高于健康对照,与先前转录组分析结果一致.结论 变应性鼻炎患者中BCAP基因表达显著增强,在变应性鼻炎的发病过程中起着重要作用.

目的 分析鼓膜穿孔患者的性别、年龄、病因、诊断及治疗时机.方法 回顾性分析906例门诊鼓膜穿孔患者的临床资料.结果 906例鼓膜穿孔患者中,男682例,女224例;平均年龄(32.64±10.81)岁;168例(18.5％)患者受伤与饮酒有关.致伤原因为耳外伤319例(35.2％),中耳炎282例(31.1％),外耳道清理不当173例(19.1％),外耳道异物84例(9.3％),交通事故35例(3.9％),鼓膜通气管拔出后未愈合8例(0.8％),其他5例(0.6％).季节分布为春季248例(27.4％),夏季203例(22.4％),秋季265例(29.2％),冬季190例(20.9％).硬管耳内镜检查判断患者鼓膜穿孔的阳性率为100％,高于电耳镜检查的80.8％,差异有统计学意义(P＜0.05).536例创伤性鼓膜穿孔患者在4周后复查时完全愈合.结论 耳外伤和中耳炎是鼓膜穿孔发生的主要原因,男性占绝大多数,高发年龄为19～ 29岁,创伤性鼓膜穿孔大部分在4周左右可愈合.应用耳内窥镜检查在鼓膜穿孔诊断中具有重要意义.

Objective:The aim of this study is to compare the night sleep hypoxia degree and sleep structure of young and middle-aged and elderly patients with OSA, so that PSG has more important application value.Method:A total of 438 patients diagnosed with OSA from February 2017 to January 2019 were selected,including 119 patients in the youth group with an average age of (28.5±5.1）years,and 319 patients in the middle and elderly group with an average age of (45.8±2.7)years.The results recorded by PSG in the two groups were retrospectively analyzed. Result:①The AHI, ODI, OAI, MAI and ASaO₂of OSA patients in the junior group were significantly higher than those in the middle-aged and elderly group, while CAI was not statistically significant between the two groups (P=0.419).②The NREM stage Ⅰ (61.1±4.3)% in the junior group was significantly higher than that in the junior group (53.3±3.4)%.NREM stage Ⅱ (33.2±2.3)% and NREM stage Ⅲ+Ⅳ (4.3±1.3)% in the junior group were higher than those in the middle-aged group (29.2±3.9)% and stage Ⅲ+Ⅳ (2.6±0.9)%, while the percentage of REM stage and microarousal index were not statistically significant between the two groups.③Young OSA patients were associated with hypertension and 47.0% middle-aged and elderly patients were associated with hypertension.There was no statistical difference between the two groups in whether hypertension was associated with hypertension or not.Conclusion:The NREM phase is particularly susceptible to age, and age affects slow wave sleep. The sleep structure of middle-aged and older people demonstrates their sleep characteristics: reduced total sleep time,slow wave sleep,low sleep efficiency,and delayed sleep. The young people's nighttime hypoxia is more serious. AHI,ODI,OAI,MAI,ASaO₂ and other indicators are significantly higher than the middle-aged and elderly people, but the sleep structure 2 groups are similar, indicating that young people have strong sleep physiological compensation and Adjustment ability.

Objective: The purpose of this study was to demonstrate the prognostic role of inflammatory biomarkers in patients with laryngeal squamous cell carcinoma. Methods: For this study, we enrolled 151 patients who had undergone surgery for laryngeal squamous cell carcinoma. We assessed the preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), mean platelet volume, red cell distribution width, and alkaline phosphatase. The chi-square test, Kaplan-Meier survival analysis, and Cox proportional hazards model were conducted on overall survival, progression-free survival, locoregional recurrence-free survival, and distant metastasis-free survival of patients with laryngeal squamous cell carcinoma. Results: Both Kaplan-Meier analysis and univariate analysis showed significant prognostic differences with age, laryngectomy methods, Tumor Node Metastasis (TNM) staging, tumor location, NLR, PLR, MLR, and mean platelet volume. Multivariate analysis indicated that NLR (overall survival: hazard ratio [HR] = 3.02, 95% confidence interval [CI]: 1.28-7.10,P= .011), PLR (overall survival: HR = 0.33, 95% CI: 0.14-0.78,P= .011; progression-free survival: HR = 0.016,95% CI: 0.10-0.79,P= .016), and MLR (overall survival: HR = 0.29, 95% CI: 0.11-0.76,P= .012) were independent prognostic factors for 5-year survival. However, red cell distribution width and alkaline phosphatase had no significant difference in overall survival and progression-free survival. Conclusions: Preoperative high NLR, PLR, and MLR were associated with poor prognosis. They were found to be effective and reliable inflammatory biomarkers for patients with laryngeal squamous cell carcinoma.