儿童腺样体肥大影像学诊断价值探讨

目的 探讨X线影像学对儿童腺样体肥大的诊断价值.方法 22例怀疑腺样体肥大患儿均摄鼻咽侧位片,计算腺样体指数A/N值及增殖体前方的气道宽度(以下简称PAS).结果 A/N≤0.60的4例,0.60< A/N≤0.71的15例,A/N≥0.71的3例.PAS≥12mm的3例,6-12mm为16例,小于或等于5mm为3例.CT表现为鼻咽顶后壁软组织肿块,密度均匀,边缘清晰.X线影像学检查能很好的评估腺样体大小与鼻咽腔阻塞情况.结论 X线鼻咽侧位片及CT检查是诊断腺样体肥大的重要检查方法.     

腺样体肥大学龄期儿童的行为问题

目的:探讨学龄期儿童腺样体肥大与其心理行为问题的相关性。方法:学龄期腺样体肥大患儿103例和学龄期健康儿童105例,采用自制一般情况问卷、腺样体肥大相关情况调查表、Conners父母用症状问卷(PSQ)、儿童社交焦虑量表(SASC)分析被试儿童心理行为问题的严重程度。结果:腺样体肥大组PSQ总分及品行障碍、学习问题、冲动-多动、多动指数因子得分均高于正常对照组,儿童SASC总分及害怕否定评价、社交回避苦恼因子分均高于正常对照组(均P<0.05)。多元线性分析显示,腺样体肥大病程、有无腺样体肥大并发症、腺样体肥大内镜下分度与学龄期儿童PSQ得分正向关联(β=0.57、0.17、0.28,P<0.05);腺样体肥大发病年龄、腺样体肥大病程与学龄期儿童SASC得分正向关联(β=0.38、0.49,P<0.05)。结论:学龄期儿童腺样体肥大与心理行为问题的严重程度相关。     

腺样体肥大儿童焦虑抑郁情绪调查

目的：探讨腺样体肥大（AH）患儿的焦虑和抑郁心理状况及经鼻内镜腺样体切除手术和心理干预对其的影响。方法：对40例AH患儿的心理状况进行分析，并与中国常模和治疗后三个月的心理状况进行对比。结果：AH患儿儿童抑郁障碍白评量表（DSRSC）、儿童焦虑性情绪障碍筛查表（SCARED）因子分较中国常模明显增高。术后三个月各项目评分趋于正常。结论：AH患儿存在显著的心理卫生障碍，经鼻内镜腺样体切除术和心理治疗有助于患儿的身心康复。     

儿童腺样体扁桃体肥大180例的诊疗

目的 探讨儿童腺样体扁桃体肥大与相关疾病的诊疗.方法 180例腺样体扁桃体肥大患儿A组合并鼾症者106例,在全麻下行扁桃体、腺样体摘除.B组合并分泌性中耳炎患者,或流脓涕慢性鼻窦炎者74例行腺样体、扁桃体切除术的同时,鼓膜切开置管.结果 A组治愈90例,显效:11例.B组:治愈55例,好转17例.结论 对无免疫缺陷儿童,行扁桃体及腺样体切除或鼓膜切开置管术对治疗儿童鼾症具有较满意疗效.     

鼻用糖皮质激素联合白三烯受体拮抗剂对有合并症小儿腺样体肥大疗效及炎症因子的影响

目的 探讨鼻用糖皮质激素联合白三烯受体拮抗剂对伴合并症的腺样体肥大（AH）患儿的疗效并探讨作用机制。方法 纳入2020年1月至2022年1月就诊于河北省儿童医院耳鼻喉科门诊的AH患儿共135例。根据是否合并过敏性鼻炎或分泌性中耳炎分为有合并症组（46例）和无合并症组（89例）。给予所有患儿糠酸莫米松鼻喷雾剂联合孟鲁司特钠治疗3个月。主要观察指标为用药后的症状改善和不良反应发生情况,次要观察指标为血清炎症因子水平。获取治疗前后血清样本,通过酶联免疫吸附实验（ELISA）检测血清半胱氨酰白三烯（CysLTs）、白细胞介素2(IL-2)、白细胞介素6(IL-6)水平。通过对比用药前后症状改善率和不良反应发生率分析药物治疗的有效性与安全性。通过对比用药前后细胞因子差异分析药物作用机制。结果 有合并症组患儿用药后的A/N值、打鼾、睡眠不安或多动、张口呼吸改善率显著高于无合并症组（均P<0.05）;两组不良反应发生率无统计学差异（P=0.635）;有合并症组用药前CysLTs、IL-2、IL-6水平均显著高于无合并症组（均P<0.05）;有合并症组CysLTs、IL-2、IL-6改善程...     

经鼻内镜治疗小儿腺样体肥大的体会

目的探讨鼻内镜在腺样体切除术中的作用。方法采用经鼻内镜下切除腺样体肥大110例,治疗由腺样体肥大引起的睡眠呼吸障碍、鼻阻塞和咽鼓管功能障碍等。结果全部病例术后腺样体切除干净,无出血及咽鼓管损伤等并发症。随访3-6个月,临床症状消失,无并发症。结论经鼻内镜下腺样体肥大切除手术能在直视下进行,且术野清晰,增加了手术的安全性、准确性,手术切除彻底,疗效满意,并发症少。     

中西医结合治疗儿童腺样体肥大96例分析

腺样体肥大是引起儿童鼻阻塞、鼻窦炎、儿童睡眠呼吸暂停低通气综合症,卡他性中耳炎的常见病因之一,儿童时期易患急性鼻炎,急性扁桃体炎、流行性感冒等。易反复发作,腺样体可迅速增生肥大,导致加重鼻阻塞,妨碍鼻窦引流,鼻及鼻窦分泌物又刺激腺样体迅速增生,形成互为因果的恶性循环,多见于儿童,常与慢性扁桃体炎合并存在。     

鼻内镜下射频消融治疗青年人腺样体肥大

目的探讨在鼻内镜下青年人腺样体肥大的射频治疗。方法7例青年病人，年龄为16～27岁，其中男性4例，女性3例。在鼻内镜下应用射频消融进行治疗，观察疗效。结果在鼻内镜下应用射频治疗后，6例一次性治愈，仅1例术后1个月复查有肥大的腺样体残留并仍导致鼻塞，再次射频治疗后治愈，术后6～12个月复查未见有复发的患者。结论对长期鼻腔通气困难而无显著鼻腔疾病影响鼻通气的青年患者，应用鼻内镜和／或影像学检查以确定有无腺样体肥大。应用鼻内镜在直视下射频治疗青年人腺样体肥大，可以收到良好的治疗效果。     

腺样体肥大儿童血清微量元素含量的分析

目的 检测腺样体肥大儿童血清中钙(ca)、铁(Fe)、锌(Zn)、铜(Cu)、镁(Mg)五种微量元素的含量,为腺样体肥大以及相应并发症的治疗提供理论依据.方法 用火焰原子吸收分光光度法检测50例腺样体肥大儿童和32例健康儿童血清中Ca、Fe、Zn、Cu、Mg的含量.结果 腺样体肥大组儿童血清中Zn的含量低于对照组(P＜0.01),Cu和Ca的含量高于对照组(P＜0.05),而Fe和Mg的水平在两组间无统计学差异(P＞0.05).结论 儿童腺样体肥大可能与血清中铜、钙元素水平升高及锌元素的缺乏有关,避免血钙、血铜过高及适量补锌可作为对腺样体肥大儿童早期干预的一种方法.     

腺样体肥大患者的认知功能改变

目的探讨腺样体肥大患者的认知功能改变,进一步指导临床。方法对70名10～19岁腺样体肥大患者采用《基本认知能力测验》（2.0版）进行认知功能检查。结果除无意义图形再认以外,基本认知能力总分及各分项分均为两个高年龄组低于10～12岁组。总分13～15岁组与10～12岁组差异有显著性（P=0.039）;汉字比较13～15、16～19岁组分别与10～12岁组的差异均有显著性（P值分别为0.007、0.001）;双字词再认16～19岁组与10～12岁组的差异有显著性（P=0.029）。两个高年龄组基本认知能力的印象评定均显著差于10～12岁组。除无意义图形再认外,总分及各分项分均为男性差于女性,其中总分及汉字比较、双字词再认男女差异均具有显著性（P分别为0.028、0.000、0.028）。结论腺样体肥大是认知功能损害的重要因素,认知速度、记忆能力的损害尤为显著;12岁是一重要的分界年龄;同等基线条件下男性的认知功能损害重于女性。建议早期手术治疗,对于男性相对放松手术指征,以减少对患者认知功能的损害。     

Mometasone furoate monohydrate nasal spray for the treatment of nasal congestion in allergic rhinitis

Allergic rhinitis (AR) affects an estimated 20–40 million Americans annually. It is a multifaceted condition comprising a range of symptoms, including nasal congestion, arguably the most bothersome symptom. Of the various types of medications available for the treatment of AR, intranasal corticosteroids are considered the most effective. Mometasone furoate nasal spray is an intranasal corticosteroid with anti-inflammatory properties. It is indicated for the treatment of the nasal symptoms of seasonal AR and perennial AR in adults and children, for the prophylaxis of nasal symptoms of seasonal AR and for the treatment of nasal polyps. Numerous clinical trials have demonstrated that mometasone furoate nasal spray effectively relieves nasal congestion in adults and children with AR, while providing excellent safety and tolerability.     

负压封闭引流技术用于四肢创伤复杂创面治疗价值评价

目的：观察负压封闭引流技术对四肢创伤复杂创面治疗的临床疗效。方法选取来我院就诊的四肢创伤性骨折伴有严重皮肤损伤的患者84例,随机分为两组,观察组42例、对照组42例。对照组采用传统的方法进行治疗,观察组采用负压封闭引流技术方法进行治疗。记录治疗前后患者的创伤面积变化以及创面清洁时间,植皮后临床效果,换药次数,住院时间,并发症的情况等。结果两组患者植皮后的临床疗效相比,观察组的优良率为92.86%,对照组的优良率为64.29%,两者的差异具有统计学意义(<0.05);两组患者的创面清洁时间,换药次数,治疗前后创面面积情况以及住院时间,并发症率比较得到观察组的效果都较对照组的效果好(<0.05)。结论负压封闭引流技术在四肢创伤复杂创面的治疗效果显著,较传统的单用换药方式效果好,且并发症发生率较低。因此,在临床的工作过程中要积极的应用该方法进行四肢创伤复杂创面的治疗。     

Suppressive Effects of Mometasone Furoate on an Antigen-Specific IgE Antibody Response and Production of IL-4 in Mice

A nasal formulation of mometasone furoate (MF) is advantageous in avoiding systemic activity characteristic of glucocorticoids when it is applied topically. To confirm antiallergic effects of this glucocorticoid formulation elaborately, we investigated whether the drug can suppress the production of IgE antibodies and related cytokines. It we showed that IgE production induced in mice immunized via intranasal route was significantly reduced when the mice were administered MF intranasally. Further, MF was effective in inhibiting production of type-2 helper T cell cytokines in vivo and in vitro. These results provide a immunopharmacological basis for clinical efficacy of this drug.     

Fundamental Morphological Changes in Human Olivary Hypertrophy

Morphological features of neurons in human inferior olivary nuclei were studied in 6 autopsied patients with dentato olivary pathway lesions, who had survived for between 6 days and 15 months. Central chromatolysis like neuronal enlargements were already present in the acute cases. Electron microscopy revealed round, homogeneous and electron dense granules, varying in diameter from 0.15 μm to 2.5 μm, occuring frequently within the rough endoplasmic reticulum (ER) in the chromatolytic neurons of all 6 patients. No similar granules were observed in 6 controls. The vacuoles were due to dilatation of the rough ER, and often contained floccular materials. Neurofilamentous hyperplasia in the neurons was more frequently seen in the chronic cases. These findings suggest that the fundamental changes in the neurons in olivary hypertrophy occur within the rough ER.     

Glomerular Hypertrophy in Offspring of Subtotally Nephrectomized Ewes

We have shown that fetuses whose mothers underwent subtotal nephrectomy (STNx) before pregnancy had high urine flow rates and sodium excretions, but lower hematocrits, plasma chloride, and plasma renin levels compared with controls. To see if these functional differences in utero persist after birth and are the result of altered renal development, we studied 8 lambs born to STNx mothers (STNxL) and 10 controls (ConL) in the second week of life. These lambs were of similar body weights, nose–rump lengths and abdominal girths. Their kidney weights were not different (ConL 36.1 ± 1.9 vs. STNxL 39.8 ± 3.3 g), nor were kidney dimensions or glomerular number (ConL 423,520 ± 22,194 vs. STNxL 429,530 ± 27,471 glomeruli). However, STNxL had 30% larger glomerular volumes (both mean and total, P < 0.01) and there was a positive relationship between total glomerular volume and urinary protein excretion (P < 0.05) in STNxL. Despite this change in glomerular morphology, glomerular filtration rate, tubular function, urine flow, and sodium excretion rates were not different between STNxL and ConL, nor were plasma electrolytes, osmolality, and plasma renin levels. Thus while many of the functional differences seen in late gestation were not present at 1–2 weeks after birth, the alteration in glomerular size and its relationship to protein excretion suggests that exposure to this altered intrauterine environment may predispose offspring of mothers with renal dysfunction to renal disease in adult life. Anat Rec, 291:318–324, 2008. © 2008 Wiley‐Liss, Inc.     

缬沙坦治疗高血压病并逆转左心室肥厚改善心功能的临床研究

目的评估缬沙坦治疗高血压病的降压效果、安全性与逆转高血压心肌肥厚和改善心功能的疗效。方法以氨氯地平为对照药物，在老年性轻、中度高血压患者中进行随机、平行对照的临床研究。结果缬沙坦组患者治疗4周总有效率为60．8％（45／74），降压幅度15．6／10．9mmHg；治疗24周后总有效率为78．4％（54／74）．降压幅度21．1／17．9mmHg。缬沙坦组治疗24周后在逆转高血压心肌肥厚中取得满意的疗效，能显著逆转左室肥厚（LVH），左室后壁厚度（PWT），室间隔厚度（IVST），降低左室重量指数（LVMI），且缬沙坦组能有效地改善心功能．经治疗后患者的心脏每分输出量（CO）、左室射血分数（LVEF）、舒张早期与舒张晚期峰值流速的比值（E／A）、E峰减速度（Ede）均不同程度得到改善；缬沙坦组患者血尿酸、C-反应蛋白较治疗前明显下降，不良反应率为8．1％．主要是面红、头昏及心悸。心率、血生化、肝肾功能无明显变化。结论缬沙坦降压疗效好，且能逆转左心室肥厚，改善心功能，不良反应少，可作为治疗老年性轻、中度高血压伴左心室肥厚的一线药物。     

Hypertrophy of mucosa and serosa in the obstructed intestine of rats

After a surgically induced partial obstruction of the small intestine (ileum) in adult rats there is an accumulation of ingesta and a progressive enlargement of the lumen accompanied by wall thickening: over a period of 2–3 wk the circumference of the hypertrophic intestine increases by a factor of 2·7 and the thickness of the musculature increases more than threefold, while the length of the ileum (measured at the mesenteric attachment) remains unchanged. The villi become markedly larger and more elongated in the circumferential direction, and have a greater separation between one another. The number of villi per unit surface is markedly reduced but the number of villi per unit length of ileum, whilst appearing to show a small increase, was not significantly altered. The component epithelial cells (absorptive cells) appear unchanged in morphology and size (height). The microvilli of the epithelial cells have the same appearance, size (height) and packing density in the control and the hypertrophic ileum. Glands of Lieberkühn, Peyer's patches and single lymphatic follicles constituting the Peyer's patches are significantly increased in size in the hypertrophic intestine. The serosal surface of the hypertrophic ileum, in spite of the great expansion, remains regularly covered by mesothelial cells; these are much larger than in the controls and have an altered distribution of their microvilli.