脱敏疗法治疗常年性变应性鼻炎的疗效观察

本文对76例常年性变应性鼻炎患者,分二组进行脱敏治疗,甲组用粉尘螨注射液,乙组用吸入物抗原。甲、乙两组在治疗前及治疗半年后记分别测定血清IgG、IgE。结果表明,甲、乙两组治疗前后记分比较均有非常显著性差异(P均<0.01)。两组间有效率无显著性差异(P>0.05)。两组在治疗前后血清IgG均有非常显著差异(P<0.01)。血清IgE也有显著差异(P<0.05)。血清IgG上升与IgE下降与临床症状好转相一致。甲组具有治疗方便,疗程短等优点。     

光动力疗法发展近况

光动力疗法发展近况李峻亨（解放军总医院激光科北京１００８５３）ＡｂｓｔｒａｃｔＴｈｅｂａｓｉｃｐｒｉｎｃｉｐｌｅｓ，ｐｈｏｔｏｓｅｎｓｉｔｉｚｅｒｓｉｎｃｌｕｄｉｎｇａｐｐｒｏｖｅｄａｎｄｎｅｗｏｎｅｓｉｎｃｌｉｎｉｃａｌｔｒｉａｌｓｔａｇｅｓ．ｌｉ...     

光动力疗法在膀胱癌治疗中的研究进展

光动力疗法(photodynamic therapy,PDT)是一种新兴的肿瘤治疗方法。1975年Kelly等首先将PDT用于浅表膀胱癌的治疗,此后经过大量研究,证实PDT是治疗膀胱癌的一种有效的方法,1993年以来,PDT逐渐成为治疗膀胱肿瘤重要的手段,现就PDT治疗浅表膀胱癌的研究现状作一介绍。1光动力疗法     

鼻炎清颗粒治疗变应性鼻炎的免疫机制研究

目的:观察鼻炎清颗粒治疗大鼠变应性鼻炎(AR)后,细胞因子、血清特异性IgE和嗜酸粒细胞阳离子蛋白(ECP)的水平,了解该药治疗AR的部分免疫学机制.方法:用卵清蛋白(OVA)、氢氧化铝、百白破疫苗联合致敏大鼠建立变应性鼻炎动物模型,鼻炎清颗粒灌胃给药2周后,观察鼻黏膜组织学变化,ELISA法检测血清细胞因子IL-4、 IFN-γ、 IgE 和ECP的水平.结果:光镜观察发现,模型组鼻黏膜上皮细胞脱落、水肿、血管扩张、腺体增生,固有层内可见大量嗜酸性粒细胞、肥大细胞浸润,治疗组大剂量和中剂量组及阴性对照组则无上述改变.治疗组大、中剂量组血清IL-4水平分别为(10.30±4.41) ng/L 和(12.42±6.55) ng/L,明显低于模型组(17.62±6.10) ng/L,有统计学差异(P＜0.01或P＜0.05);而IFN-γ水平分别为(34.19±6.16) ng/L和(27.92±6.47) ng/L,明显高于模型组(19.33±5.63) ng/L(P＜0.01);3种剂量组的血清IgE水平分别为(26.46±6.12) μg/L、 (49.11±4.48) μg/L和(70.68±7.59) μg/L,与阳性模型组(81.03±7.54) μg/L,相比较有统计学差异(P＜0.01或P＜0.05);血清ECP水平分别为(1.48±0.25) μg/L,(2.30±0.56) μg/L和(3.05±1.27) μg/L,与阳性模型组(4.23±1.20) μg/L比较,大、中剂量组有统计学意义(P＜0.01或P＜0.05),小剂量组无统计学意义.结论:鼻炎清颗粒通过调节Th1和Th2细胞因子的表达,纠正失衡的Th1/Th2的细胞因子网络,降低血清特异性IgE和ECP水平和抑制炎症细胞在鼻黏膜的聚集,防止其脱颗粒,对变应性鼻炎产生治疗作用.     

CCL趋化因子与变应性鼻炎

CCL趋化因子在嗜酸性细胞的募集中起着重要的作用,而嗜酸性细胞的募集是变应性鼻炎发生发展的关键.本文综述了CCL趋化因子中Eotaxin、RANTES和MCPs在变应性鼻炎发生中的作用.     

内镜光动力微创疗法在胆管癌治疗中的作用

目的 探讨内镜光动力微创疗法(PDT)在胆管癌治疗中的作用.方法 对本院于2005年10月至2007年4月在常规综合治疗的基础上,开展内镜下的光动力微创治疗的15例胆管癌患者的相关临床资料进行回顾性总结分析.结果 15例患者在PDT治疗后均取得良好效果,治愈3例,好转12例,除1例出现光敏性皮炎、3例出现术后胆道感染外,均未出现严重并发症.至目前为止,仍存活10例,中位生存期达243 d(163～575 d).在随访期患者保持稳定的生活质量.结论 内镜光动力联合微创治疗在胆管癌综合治疗中,具有创伤少、疗效好、并发症少的特点,对于提高胆管癌综合治疗的效果,提高生活质量及延长患者的生存期有重要的临床意义.     

内镜光动力微创疗法在胆管癌治疗中的作用

目的探讨内镜光动力微创疗法(PDT)在胆管癌治疗中的作用。方法对本院于2005年10月至2007年4月在常规综合治疗的基础上,开展内镜下的光动力微创治疗的15例胆管癌患者的相关临床资料进行回顾性总结分析。结果15例患者在PDT治疗后均取得良好效果,治愈3例,好转12例,除1例出现光敏性皮炎、3例出现术后胆道感染外,均未出现严重并发症。至目前为止,仍存活10例,中位生存期达243d(163~575d)。在随访期患者保持稳定的生活质量。结论内镜光动力联合微创治疗在胆管癌综合治疗中,具有创伤少、疗效好、并发症少的特点,对于提高胆管癌综合治疗的效果,提高生活质量及延长患者的生存期有重要的临床意义。     

变应性鼻炎免疫治疗的研究进展

变应性鼻炎是一种由变应原激发并通过Ig E介导的鼻黏膜炎性疾病,因其反复发作的鼻部症状和并发症,给临床治疗带来很大挑战。免疫治疗是目前唯一能够改变变应性鼻炎自然病程、针对病因的治疗方法。近来,包括新的给药途径、变应原改造在内的各种新型免疫治疗方法大量涌现,给变应性鼻炎治疗提供更多有效和安全的选择。本文针对变应性鼻炎免疫治疗的最新研究进展进行综述,并对未来的方向进行展望。     

光动力疗法在肿瘤治疗中的应用

对于体积较小,特别是表浅的癌瘤及临床上的隐性癌,光动力疗法（Ｐｈｏｔｏｄｙ－ｎａｍｉｃ Ｔｈｅｒａｐｙ,ＰＤＴ）是一种较为行之有效的治疗方法,近２０年来激光医学工程者们对这一疗法进行了大量的研究。本文试对ＰＤＴ治疗肿瘤所涉及到的激光器、光敏剂及临床应用作一综述。     

An eosinophil-Sos1-RAS axis licenses corticosteroid resistance in patients with allergic rhinitis

BackgroundCorticosteroid resistance (CR) is a serious disadvantage in treating many chronic inflammatory conditions. Eosinophils are the main inflammation cells in allergic reactions. Environmental pollution, such as PM2.5, is associated with the pathogenesis of allergic disorders. The objective of this study is to elucidate the mechanism by which the exposure to PM2.5 confers eosinophil CR status.MethodsPatients with allergic rhinitis were recruited and assigned to corticosteroid sensitive (CS) and CR groups. Eosinophils were purified from nasal lavage fluids collected from patients with allergic rhinitis. A murine AR mouse model was developed with dust mite allergens and PM2.5 as the sensitization reagents.ResultsCR status was detected in about 60% eosinophil collected in patients with AR. Upon exposure to eosinophil activators, CS eosinophils released a large quantity of mediators, which was suppressed by the presence of steroids in the culture. CR eosinophils demonstrated resistance to steroidal therapy. RAS activation levels in eosinophils were higher in CR eosinophils than in CS eosinophils. Higher expression of the Son of sevenless-1 (Sos1) was detected in CR eosinophils, which formed a complex with RAS and glucocorticoid receptor-α in CR eosinophils to prevent the binding between steroids and glucocorticoid receptor-α. The presence of an Sos1 inhibitor dissociated glucocorticoid receptor-α from RAS/Sos1 complex, that restored the sensitivity to steroids in eosinophils. Administering the Sos1 inhibitor effectively attenuated the experimental allergic rhinitis.ConclusionsCR status was detected in approximately 1/3 eosinophils sampled from patients with allergic rhinitis. Sos1 was instrumental in the development and perseverance of CR in eosinophils. Sos1 inhibition restored sensitivity to steroids in CR eosinophils, which effectively reduced experimental allergic rhinitis.     

瞬时感受器电位香草酸受体1在变应性鼻炎鼻黏膜中的作用机制

瞬时感受器电位香草酸受体1（TRPV1）通道是一种非选择性阳离子通道,其可以被辣椒素、高温等多种刺激因素激活,参与多种生理及病理过程。最新研究证实,TRPV1离子通道是神经 免疫调控网络机制的核心要素,在变应性鼻炎鼻黏膜中发挥重要作用。我们通过对TRPV1经神经 免疫调控网络调节神经肽,进而影响鼻部症状的研究进展做简要综述,期望为临床治疗变应性鼻炎提供理论依据。     

The effect of medical treatment on nasal exhaled nitric oxide (NO) in patients with persistent allergic rhinitis: A randomized control study

PurposeThis study aimed to evaluate the role of nasal nitric oxide (NO) in the management of patients with persistent allergic rhinitis (PER).MethodsIt was a randomized and comparative study. The study subjects were classified as controls (healthy subjects) or patients with PER based on defined criteria. All clinical, functional and biological data were collected for analyzing. Nasal fractional exhaled nitric oxide (FENO) was measured by electroluminescence device. Patients with PER were randomized for treatment with antihistamine (ATH) combined with leukotriene receptor antagonists (LRA) or only with intranasal steroids (INS).ResultsDuring two years, 501 subjects were included: 234 control subjects and 267 patients with PER. The levels of nasal NO, total IgE, blood eosinophil counts, and apnea-hypopnea index (AHI) in patients with PER were higher than controls (P < 0.001; P < 0.05; P < 0.05; P < 0.01; respectively). There were statistically significant correlations between nasal NO, nasal peak flows, total IgE, and blood eosinophil counts in patients with PER (R = −0.687 and P = 0.0012; R = −0.643 and P = 0.0018; R = 0.432 and P = 0.0024; R = 0.445 and P = 0.002; respectively). After 6 months of treatment, patients treated with INS had greater improvement of clinical symptoms and reduction of nasal NO values than patients treated with ATH + LRA (985 ± 253 vs. 732 ± 298 ppb; P < 0.05).ConclusionNasal NO measurement is a useful tool for the follow-up of patients with PER. It also helps clinicians to estimate the level of response to treatment in patients with PER.     

Current understanding of the pathophysiology of allergic rhinitis

The immune response to an allergen depends on an initial sensitization process, with future exposures triggering a 2-part allergic response including an early and late phase. The process by which an allergen is recognized has become clearer. Similarly, the roles of the preformed mediators responsible for many of the signs and symptoms of the early-phase response have been elucidated. Recent work also has shed some light on the cells and mediators involved in the late-phase reactions. This article discusses some of this recent work and reviews the basics behind of all of the stages of the allergic response.     

Progress in the photodynamic therapy treatment of Leishmaniasis

Leishmaniasis is a serious and endemic infectious disease that has been reported in more than 90 countries and territories. The classical treatment presents a series of problems ranging from difficulty in administration, development of resistance, and a series of side effects. Photodynamic therapy (PDT) has already shown great potential for use as a treatment for leishmaniasis that is effective and non-invasive, with very minor side effects. PDT can also be inexpensive and easy to administer. In this review, we will report the most recent developments in the field, starting with the chemical diversity of photosensitizers, highlighting important mechanistic aspects, and noting information that may assist in designing and developing new and promising photosensitizer molecules.     

小青龙汤抗过敏性鼻炎的实验研究

目的探讨小青龙汤抗豚鼠过敏性鼻炎的作用机制。结论 Ovalbumin（OVA）滴鼻建立豚鼠过敏性鼻炎模型,随机分为6组,分别为空白组（A组）,模型组（B组）,氯雷他定组（C组）,小青龙汤高、中、低剂量组（D组、E组、F组）,连续给药14d,观察各组豚鼠鼻粘膜病理变化,并采用ELISA方法检测治疗前后各组豚鼠血清中OVA-sIgE的浓度。结果与模型组相比较,小青龙汤各剂量组豚鼠鼻粘膜炎性细胞浸润及水肿程度减轻,小青龙汤高、中剂量组血清中OVA-sIgE的浓度明显减轻（P〈0.05）。结论小青龙汤通过减轻炎性浸润和抗原抗体反应发挥抗过敏性鼻炎作用。     

FOXP3基因多态性与变应性鼻炎的相关性研究

目的 探讨FOXP3基因多态性与变应性鼻炎(AR)的相关性.方法 临床纳入AR患者55例以及健康者55例作为研究对象,分别为AR组和健康组.参考Hapmap网站公布的中国北京地区人群的FOXP3基因标签单核苷酸多态性(SNPs)信息以及Haploview 4.1软件运行的结果,选择rs3761547与rs3761548两个位点,通过聚合酶链反应测序法进行相关基因型的检测.结果 rs3761547与rs3761548两个位点的杂合突变与AR的发生具有相关性,但是经校正P值后发现只有rs3761548位点仍均有统计学意义(OR值为3.10,95％CI为1.19 ～8.02,P＜0.05).对不同过敏原进行分层分析,发现尘螨过敏患者中rs3761547与发病存在明显的相关性(OR值为1.98,95％CI为1.16 ～3.37,P＜0.05).结论 rs3761548的AC杂合突变与AR发病存在较为密切的关系,而rs3761547与尘螨过敏的AR存在一定的联系.