蝶筛窦外侧壁应用解剖

观察５７具成人尸头标本蝶、筛窦外侧壁，以及同视神经管和颈内动脉的毗邻关系。眶板前下宽，后上窄，平均厚度为０．２ｍｍ。９３．８６％的视神经管内壁与蝶、筛窦外侧壁毗邻，且视神经管内蝶、筛窦内突出形成隆起的找率和程度同蝶、筛窦气代程度呈正相关。     

最后筛房的解剖学研究及其临床意义

目的：了解最后筛房的解剖发育情况及其解剖毗邻关系对临床开展蝶鞍区域手术的指导意义。方法：对50具成人头颅进行鼻窦冠状位及水平位薄层CT扫描,重点观测后筛窦最后筛房的影像解剖形态及其毗邻关系。结果：测得其矢状径位于5．76～21．48mm之间。其中,最后筛房大于或等于同侧蝶窦腔的有23侧(23％)。最后筛房与蝶窦、视神经管之间的解剖关系的不同形成蝶上筛房的有28侧(28％)。形成蝶旁筛房的有5侧(5％),形成Onodi窦的有24侧(24％)。结论：鼻窦冠状位及水平位CT扫描在最后筛房的影像解剖研究及临床手术中具有实际的指导作用。最后筛房与蝶窦、视神经管之间的解剖关系可形成蝶上筛房、蝶旁筛房或Onodi窦对临床开展蝶鞍区域手术具有一定的影响。     

神经生长因子基因转染联合强化铁营养防治豚鼠爆震性聋的实验研究

Objective To study the protective effects of adenovirus-mediated human beta-nerve growth factor gene (hNGFβ) transfer combined with iron fortified nutrition on blast hearing damage in guinea pigs. Methods Deafness was induced by blast (172dB SPL) in 35 healthy guinea pigs. Seven days after noise exposure, 10 guinea pigs were inoculated with adenovirus-mediated hNGFβ (Ad-hNGFβ) into the perilymphatic space (the gene group), another 10 guinea pigs were given hNGFβ combined with iron fortified nutritional diet (the combination group), still another 10 guinea pigs were inoculated with artificial perilymphatic fluid (APF), and 5 guinea pigs served as control, given neither medicine nor noise exposure. Auditory brainstem response (ABR) threshold shifts were monitored in the guinea pigs before blast exposure and after gene transfer. Changes in cochlear morphology were examined with immunohistochemical and HE staining. Results One week after successful inoculation of hNGFβ, it was noted that Ad-hNGFβ protein was expressed in each turn of the cochlea, and its intensity was almost equal. After gene transfer in the combination group and the gene group, ABR threshold shifts at week 1 and 4 were significantly smaller than those of the APF group. HE staining showed that the number of the spiral ganglion cells in the combination group and the Ad-hNGFβ group was significantly higher than that of the control group after 4 weeks (P<0.01). Conclusions Ad-hNGFβ combined with iron fortified nutritional diet was effective in the prevention and treatment of blast hearing damage of cochlear hair cells.     

神经生长因子防治爆震性聋的近期疗效观察

目的 观察神经生长因子(nerve growth factor，NGF)防治爆震性聋的临床效果。方法 参加实弹演习的炮手125例，分防治组48例(射击前2周至射击后2周肌肉注射NGF)、治疗组43例(射击后1—14d肌肉注射NGF)和对照组34例(不注射NGF)。测定射击前，射击后1，7和14d纯音听阈。结果 爆震后1d：防治组仅1例(2．1％)出现听阈提高(为轻度聋)，治疗组有3例听阈提高(7．0％，其中2例轻度聋，1例为中度聋)，对照组有6例听阈提高(17．6％，并有重度听力异常)；爆震后7d：防治组1例及治疗组中2例轻度听力异常者听力均恢复正常，治疗组中1例中度者转为轻度；14d后：治疗组听力全部恢复正常，而对照组中无听力好转者。结论 神经生长因子对防治爆震性聋有积极作用。     

钬激光剥离法切除扁桃体116例临床分析

扁桃体切除术是耳鼻咽喉科常见手术之一.采用传统的手术方式术中术后易出血,我们于1997年1月至2001年12月采用钬激光剥离法切除扁桃体,实现了剥离与止血同步,效果良好,现报告如下.     

显微支撑喉镜下CO2激光治疗声门型喉癌的疗效分析

[目的]探讨显微支撑喉镜下CO2激光治疗声门型喉癌的临床应用.[方法]回顾性分析2007年至2009年61例采用显微支撑喉镜下CO2激光治疗的喉癌患者的临床资料.其中T1N0M0期37例,T2N0M0期24例.[结果]61例患者手术顺利,无并发症发生.患者随访2.5～4.5年.4例患者因复发行再次手术,1例患者死于心脑血管意外,2例失访.其余54例患者均健在,无肿瘤复发,生活质量良好.3年生存率为95.0％,局部复发率为6.6％.[结论]显微支撑喉镜下CO2激光是治疗T1、T2期声门型喉癌的有效手术方式,喉功能保全好,创伤小,疗效可靠.     

耳鼻咽喉科双语教学的相关探索

针对医学院校中进行耳鼻咽喉科双语教学的现状、存在问题、开展双语教学的重要性进行分析讨论,并提出提高耳鼻咽喉科双语教学效果的一些建议,为在医学院 校中更好的开展耳鼻咽喉科双语教学提供经验,培养优秀的全方位医学人才。     

江浙沪地区人群中修复基因XRCC1多态性与鼻咽癌易感性的关系

目的 探讨我国江浙沪地区人群中DNA损伤修复基因XRCC1多态性与鼻咽癌易感性的关系。方法 选取87例江浙沪地区汉族鼻咽癌患者,并随机选取同地区同种族的94例健康者作为对照,两组年龄、性别差异无统计学意义。采用限制性片段长度多态性聚合酶链反应（PCR-RFLP）方法分析研究对象的XRCC1基因Arg194Trp及Arg399Gln两个位点的基因多态性,并比较不同基因型与鼻咽癌发病之间的关系。结果 XRCC1 Arg194Trp及Arg399Gln各基因型在鼻咽癌组和对照组间的分布频率基本相同。与携带Arg/Arg基因型者相比携带194位点Trp/Trp基因型者鼻咽癌的发生风险有所降低,但差异无统计学意义（OR=0.41,95% CI：0.08～1.65,P=0.21）。194位点其他基因型以及399位点各基因型对鼻咽癌的发病无明显影响。结论 XRCC1基因194和399位点的单核苷酸多态性可能与鼻咽癌的易感性无关,但194位点的Trp等位基因可能会降低鼻咽癌发病风险。     

Effect of Noise on the Function of Auditory Brainstem Center

The amplitudes and latencies of auditory brainstem evoked response(ABR)were recorded at both high(50/s)and low(10/s)click rates as sound stimuli before andafter the guinea pigs were exposed to variant intensity noise.The maximum amplitude ofwave V increased significantly,but those of wave Ⅰ,Ⅲ,and Ⅳ decreased significantly afterexposure to 110 dB noise for 20 or 30 min.The wave Ⅴ latency recorded at 50/s clickrate was shorter in every group after exposure.The changes of wave V latency recordedat 10/s click rate were complex,it was shorter after exposure to 95 dB or 105 dB for 10min;no change was found after exposure to 110 dB for 10 min,but it was longer initiallyand then became shorter after exposure to 110 dB noise for 30 min.The difference valueof wave V latency from 10/s to 50/s was negatively correlated with the noise intensityand exposure time.The more intense noise stimuli and the longer time,the less the differ-ence value became.The results indicate that the auditory bralnstem center was affectedby intense noise,and it is helpful to use difference value of wave V latency to analysis thefunction of brainstem center after exposure to noise.     

强化铁营养防治爆震性聋临床初步观察

目的 观察强化铁营养防治爆震性聋的临床初步疗效。方法 将参加实弹演习的193例炮手分为防治组62例(射击前14d至射击后14d口服临床常规用药剂量1倍的硫酸亚铁片剂)、治疗组58例(于射击后1～14d用药，药物剂量同防治组)和空白对照组73例(不服用任何药物)，分别行射击前、后纯音测听检查。结果 射击后1d：防治组仅2例(3．2％)出现轻度听力损伤；治疗组有4例(6．8％)出现听力损伤，其中3例为轻度，1例为中度；而空白对照组有13例(17．8％)出现听力损伤，并有2例重度听力异常。射击后3d：防治组及治疗组中轻度听力损伤者均恢复正常；治疗组中1例中度损伤者转为轻度，于治疗14d后恢复正常；空白对照组中听力损伤者无明显变化。结论 口服临床常规用药剂量1倍的硫酸亚铁片剂进行强化铁营养对防治爆震性聋具有一定的临床价值。