功能性内窥镜鼻窦术对慢性鼻窦炎患者TIgE、Eos及鼻纤毛传输功能的影响

目的:探讨功能性内窥镜鼻窦术对慢性鼻窦炎患者总免疫球蛋白(TIg E)、嗜酸性粒细胞(Eos)及鼻纤毛传输功能的影响。方法:选择2015年12月-2019年12月在我院接受治疗的120例慢性鼻窦炎患者,采用抽签法将其分为观察组(n=61)和对照组(n=59)。对照组给予传统腺样体刮除术治疗,观察组给予功能性内窥镜鼻窦术治疗。比较两组患者的临床疗效、治疗前后血清TIg E、Eos、白细胞介素4(IL-4)、白细胞介素8(IL-8)、肿瘤坏死因子(TNF-α)水平、鼻黏液纤毛清除率、清除速度、传输速度的变化及并发症的发生情况。结果:治疗后,观察组的总有效率分别为95.08%,明显高于对照组(77.97%,P0.05)。治疗前,两组血清TIg E、Eos水平比较无明显差异;治疗后,两组血清TIg E、Eos水平均较治疗前显著降低,且观察组血清TIg E、Eos水平均低于对照组(P0.05)。治疗前,两组鼻黏液纤毛清除率、清除速度、传输速度水平比较均无明显差异;治疗后,两组以上指标均显著升高,且观察组上述指标均高于对照组(P0.05)。治疗前,两组血清IL-4、IL-8、TNF-α水平无明显差异;治疗后,两组血清IL-4、IL-8、TNF-α水平均较治疗前显著降低,且观察组上述指标均显著低于对照组(P0.05)。两组并发症总发生率分别为4.92%、20.34%,观察组显著低于对照组(P0.05)。结论:功能性内窥镜鼻窦术用于慢性鼻窦炎患者的临床效果显著优于传统腺样体刮除术治疗,且安全性更高,其可有效改善患者鼻纤毛传输功能,可能与其降低血清TIg E、Eos水平有关。     

鼻窦内窥镜手术联合糖皮质激素治疗慢性鼻-鼻窦炎患者疗效分析

目的探讨鼻窦内窥镜手术联合糖皮质激素治疗慢性鼻-鼻窦炎患者的临床疗效。方法将我院收治的121例慢性鼻-鼻窦炎患者随机分为两组,其中对照组60例行单纯鼻窦内窥镜手术,观察组61例联合糖皮质激素治疗,观察比较两组患者的临床疗效、鼻黏液纤毛清除功能。结果观察组的治疗总有效率为96.72%显著高于对照组的86.67%,差异有统计学意义(P0.05);治疗后,观察组的TNF-α、IL-6、IL-8、Hs-CRP水平均较对照组显著降低,差异均有统计学意义(P0.05);而且观察组患者的糖精清除时间亦显著低于对照组(P0.05),黏液纤毛清除速率、黏液纤毛清除速度均较对照组显著降低(P0.05)。结论鼻窦内窥镜手术联合糖皮质激素治疗慢性鼻-鼻窦炎的疗效显著,能显著降低各项炎性因子水平,促进鼻黏液纤毛功能恢复,预后较好,值得临床推广。     

喜炎平注射液联合阿奇霉素序贯疗法对肺炎支气管肺炎患者血清IL-33、IL-6及TNF-α水平的影响

目的:探讨喜炎平注射液联合阿奇霉素序贯疗法对肺炎支气管肺炎患者血清白介素-6(IL-6)、白介素-33(IL-33)、肿瘤坏死因子-α(TNF-α)水平的影响。方法:收集我院就诊或住院治疗的840例支气管肺炎患者,随机分为实验组和对照组,每组420例。对照组患者给予阿奇霉素治疗。实验组在对照组基础上给予喜炎平静脉滴注治疗。观察并比较两组患者血清白介素-6(IL-6)、白介素-33(IL-33)、肿瘤坏死因子-α(TNF-α)水平以及临床疗效。结果:与治疗前相比,两组患者治疗后血清IL-6、IL-33、TNF-α水平均显著下降(P0.05);与对照组相比,实验组患者的血清IL-6、IL-33、TNF-α水平较低(P0.05),临床治疗有效率较高(P0.05)。结论:喜炎平注射液联合阿奇霉素序贯疗法能够提高肺炎支气管肺炎患者的临床疗效,可能与其降低患者血清IL-33、IL-6及TNF-α水平有关。     

通窍鼻炎片联合克拉霉素对慢性鼻窦炎患者嗅觉功能、鼻黏液纤毛传输速度及血清炎性因子的影响

目的:探讨通窍鼻炎片联合克拉霉素对慢性鼻窦炎患者嗅觉功能、鼻黏液纤毛传输速度及血清炎性因子的影响。方法:于2017年11月~2020年6月期间,选取我院门诊收治的慢性鼻窦炎患者86例。根据入院序号奇偶性将患者分为对照组和观察组,各43例。对照组采用克拉霉素治疗,观察组采用通窍鼻炎片联合克拉霉素治疗,均治疗4周。对比两组疗效、临床症状评分、嗅觉功能、鼻黏液纤毛传输速度及血清炎性因子,记录两组不良反应发生情况。结果:观察组的临床总有效率高于对照组(P<0.05)。两组治疗4周后T&T主观嗅觉测试法分级均较治疗前改善,且观察组的改善效果优于对照组(P<0.05)。两组不良反应发生率对比无明显差异(P>0.05)。治疗4周后,两组鼻黏膜纤毛输送率(MTR)和鼻黏膜纤毛清除率(MCC)均较治疗前升高,且观察组高于对照组(P<0.05)。治疗4周后,两组血清白介素-5(IL-5)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均较治疗前降低,且观察组低于对照组(P<0.05)。治疗4周后,观察组鼻塞、头晕头痛、鼻漏、嗅觉下降、流涕、喷嚏症状评分低于对照组(P<0.05)。结论:通窍鼻炎片联合克拉霉素治疗慢性鼻窦炎患者疗效显著,可有效改善患者嗅觉功能及鼻黏液纤毛传输速度,缓解临床症状并降低机体炎性因子水平,且安全性较好。     

功能性鼻内窥镜手术治疗鼻窦炎与鼻息肉的疗效分析

目的:探讨功能性鼻内窥镜手术治疗鼻窦炎与鼻息肉的疗效。方法:选取350例鼻窦炎与鼻息肉患者,按随机数字表法分为两组,对照组(164例)给予综合疗法,观察组(186例)给予功能性鼻内窥镜手术联合综合疗法。通过观察并记录疗效,治疗前,治疗后3个月患者体内IL-1,IL-8水平,SF-36量表评分,评价功能性鼻内窥镜手术治疗鼻窦炎与鼻息肉的疗效。结果:经手术和药物治疗,观察组有效率明显高于对照组(P0.05),治疗前,两组IL-1和IL-8水平无统计学差异(P0.05),治疗后3个月,两组IL-1和IL-8水平均明显下降,且观察组IL-1和IL-8水平低于对照组(P0.05),治疗前,两组SF-36各项评分无统计学差异,治疗后3个月,两组SF-36评分均明显增加(P0.05)。观察组在躯体疼痛和总体健康2项评分明显高于对照组(P0.05),其余6项评分相比无统计学差异(P0.05)。结论:功能性鼻内窥镜手术对鼻窦炎与鼻息肉具有较好的疗效,能显著减轻炎症反应,改善患者生活质量,值得临床推广使用。     

小青龙汤加味联合盐酸左西替利嗪胶囊治疗鼻鼽的疗效及免疫功能探究

摘要 目的：探究小青龙汤加味联合盐酸左西替利嗪胶囊治疗鼻鼽的疗效及免疫功能。方法：选择2018年12月至2020年4月陕西省中医医院诊治的鼻鼽患者102例,按照随机的数字表法分为两组,研究组60例,给予小青龙汤加味联合盐酸左西替利嗪胶囊治疗;对照组62例,给予盐酸左西替利嗪胶囊治疗,两组均持续治疗28 d,对比两组治疗的有效率、治疗前后症候积分、免疫指标免疫球蛋白E（immunoglobulin E,IgE）、白介素（interleukin,IL）IL-4、IL-12、IL-17A、IL-35 及不良反应的情况。结果：治疗前,两组的症候积分比较无差异（P>0.05）,治疗28 d后,两组的症候积分均显著降低,且观察组显著低于对照组（P<0.05）。治疗后观察组的总有效率为91.67 %,显著高于对照组（75.81 %,P<0.05）。治疗前,两组的IgE、IL-4、IL-12、IL-17A、IL-35 的水平对比无差异（P>0.05）,治疗后28 d,两组IgE、IL-4、IL-17A水平均降低,IL-12、IL-35 的水平升高,且研究组均优于对照组（P<0.05）。治疗期间观察组不良反应的发生率为8.33 %,与对照组对比无差异（11.29 %,P>0.05）。结论：小青龙汤加味联合盐酸左西替利嗪胶囊治疗鼻鼽,能够显著改善患者的症候,提高疗效,改善患者的免疫功能,同时有助于矫正体内免疫功能失衡,系可能是治疗鼻鼽的机制,同时不会增加不良反应。     

桃红四物汤对膝关节骨折患者血沉，CRP及TNF-α水平的影响及其临床疗效

目的:探讨桃红四物汤在膝关节骨折中的应用及对血沉、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)的影响。方法:112例膝关节骨折患者按抽签法分为对照组与实验组,各56例,对照组予以常规治疗,实验组基于对照组加用桃红四物汤治疗,比较两组血沉,CRP、TNF-α、白细胞介素-1(IL-1),红细胞比积、血浆黏度、全血低切黏度、全血高切黏度,中医症候积分,膝关节功能。结果:实验组血沉,CRP、TNF-α、IL-1、红细胞比积、血浆黏度、全血低切黏度、全血高切黏度低于对照组(P0.05)。实验组中医症候积分低于对照组(P0.05)。实验组膝关节功能优良率高于对照组(P0.05)。结论:桃红四物汤可促进膝关节功能的恢复,降低血沉、CRP、TNF-α水平,值得推广。     

氨溴索注射液治疗COPD合并肺结核患者的疗效及对血清IL-6、TNF-α水平的影响

目的:观察氨溴索注射液治疗慢性阻塞性肺疾病(COPD)合并肺结核(PTB)患者的临床疗效及对患者血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平的影响。方法:选取2015年1月～2018年1月我院诊治的COPD合并PTB患者181例,按照入院先后顺序分为对照组和观察组。对照组90例,给予常规对症药物治疗。观察组91例,在对症治疗的基础上加用氨溴索注射液。两组均持续治疗8周。比较两组临床有效率、病灶吸收和空洞闭合有效率、临床症状积分、肺功能及治疗前后血清IL-6和TNF-α水平的变化。结果:治疗后,观察组和对照组的总有效率分别为95.60%、74.44%,观察组显著高于对照组,两组相比具有统计学差异(P0.05);观察组治疗后病灶吸收有效率和症状积分均明显优于对照组(P0.05),空洞闭合有效率与对照组相比差异无统计学意义(P0.05);观察组治疗后用力呼气量(FVC)、一秒用力呼气容积(FEV1)和FEV1/FVC值显著高于对照组(P0.05),血清IL-6和TNF-α水平均显著低于对照组(P0.05)。结论:氨溴索注射液可显著提高COPD合并PTB患者的临床疗效,改善临床症状、病灶吸收和空洞闭合有效率和肺功能,可能与其有效降低血清IL-6和TNF-α水平有关。     

等离子射频消融术治疗儿童腺样体肥大的疗效观察及对患儿通气功能和炎症反应的影响

目的:探讨等离子射频消融术治疗儿童腺样体肥大的临床疗效及对患儿通气功能和炎症反应的影响。方法:选取我院2016年12月至2017年8月治疗的腺样体肥大患儿100例为研究对象,其中50例手术治疗者为等离子组,同期保守药物治疗者50例为对照组。对照组给予孟鲁司特钠、糠酸莫米松鼻喷雾剂治疗,等离子组行低温等离子射频消融术。比较两组治疗前后症状积分、通气功能、炎症因子水平的变化。结果:治疗前,两组症状积分、通气功能指标呼吸紊乱指数(apnea hypopnea index,AHI)、最长呼吸暂停时间(longest apnea time,LAT)、氧减指数(oxygen reduction index,ODI)、最低夜间血氧饱和度(lowest nocturnal oxygen saturation,LSaO_2)、血氧饱和度小于90%时间所占睡眠时间百分比(percentage of time when oxygen saturation lower than 90%,SLT90%)以及血清肿瘤坏死因子-α(inflammatory mediators of tumor necrosis factor,TNF-α)、白介素-4(interleukin,IL-4)、嗜酸细胞阳离子蛋白(eosinophil cationic protein,ECP)水平比较差异均无统计学意义(P0.05)。治疗后,两组打鼾、鼻塞、张口呼吸等症状积分与治疗前相比均显著降低(P0.05),且等离子组打鼾、鼻塞、张口呼吸各项积分均显著低于对照组(P0.05)。治疗后,两组AHI、LAT、ODI、SLT90%、血清TNF-α、ECP、IL-4水平均较治疗前显著降低(P0.05),LSaO_2水平均较治疗前显著升高(P0.05),且等离子组AHI、LAT、ODI、SLT90%、血清TNF-α、ECP、IL-4水平均显著低于对照组,LSaO_2水平显著高于对照组(P0.05)。结论:低温等离子射频消融术可显著缓解儿童腺样体肥大患儿的临床症状,改善机体通气功能,减轻炎症反应。     

细菌溶解产物联合沙美特罗替卡松在支气管哮喘患儿中的应用效果

目的探讨细菌溶解产物胶囊联合沙美特罗替卡松粉吸入剂对支气管哮喘患儿血清CD4~+/CD8~+水平的影响。方法选取我院2016年2月至2017年12月收治的84例支气管哮喘患儿为研究对象,采用随机数字表将患者分为对照组(n=42)和研究组(n=42)。对照组患儿在常规治疗基础上采取沙美特罗替卡松粉吸入剂进行治疗,研究组患者采用沙美特罗替卡松气雾剂+细菌溶解产物胶囊(泛福舒)进行治疗,两组患者均治疗3个月。记录两组患者临床疗效,治疗前及治疗后血清学指标[干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)]水平,肺功能[呼气流速峰值(PEF)、第一秒用力呼气量(FEV_1)]和免疫功能(NK细胞、CD4~+/CD8~+)水平。结果研究组患者治疗总有效率(95.24%)高于对照组(78.57%)。两组患者治疗后IL-4水平低于治疗前,IFN-γ水平高于治疗前,且研究组变化情况优于对照组(均P0.05)。两组患者治疗结束后FEV_1、PEF较治疗前增高,且研究组高于对照组(均P0.05)。治疗后两组患者NK细胞、CD4~+/CD8~+水平较治疗前增高,且研究组高于对照组(均P0.05)。结论沙美特罗替卡松粉吸入剂联合细菌溶解产物胶囊可有效改善支气管哮喘患儿肺功能,降低其血清IFN-γ、IL-4水平,调节机体免疫功能,提高治疗效果。     

Effect of anatomy on human nasal air flow and odorant transport patterns: implications for olfaction

Recent studies that have compared CT or MRI images of an individual's nasal anatomy and measures of their olfactory sensitivity have found a correlation between specific anatomical areas and performance on olfactory assessments. Using computational fluid dynamics (CFD) techniques, we have developed a method to quickly (相似文献   

Inspirational airflow patterns in deviated noses: a numerical study

This study attempts to evaluate the effects of deviation of external nose to nasal airflow patterns. Four typical subjects were chosen for model reconstruction based on computed tomography images of undeviated, S-shaped deviated, C-shaped deviated and slanted deviated noses. To study the hypothetical influence of deviation of external nasal wall on nasal airflow (without internal blockage), the collapsed region along the turbinate was artificially reopened in all the three cases with deviated noses. Computational fluid dynamics simulations were carried out in models of undeviated, original deviated and reopened nasal cavities at both flow rates of 167 and 500 ml/s. The shape of the anterior nasal roof was found to be collapsed on one side of the nasal airways in all the deviated noses. High wall shear stress region was found around the collapsed anterior nasal roof. The nasal resistances in cavities with deviated noses were considerably larger than healthy nasal cavity. Patterns of path-line distribution and wall shear stress distribution were similar between original deviated and reopened models. In conclusion, the deviation of an external nose is associated with the collapse of one anterior nasal roof. The crooked external nose induced a larger nasal resistance compared to the undeviated case, while the internal blockage of the airway along the turbinates further increased it.     

A quantitative structure activity analysis on the relative sensitivity of the olfactory and the nasal trigeminal chemosensory systems

We have applied a quantitative structure-activity relationship (QSAR) approach to analyze the chemical parameters that determine the relative sensitivity of olfaction and nasal chemesthesis to a common set of volatile organic compounds (VOCs). We used previously reported data on odor detection thresholds (ODTs) and nasal pungency thresholds (NPTs) from 64 VOCs belonging to 7 chemical series (acetate esters, carboxylic acids, alcohols, aliphatic aldehydes, alkylbenzenes, ketones, and terpenes). The analysis tested whether NPTs could be used to separate out "selective" chemosensory effects (i.e., those resting on the transfer of VOCs from the gas phase to the receptor phase) from "specific" chemosensory effects in ODTs. Previous work showed that selective effects overwhelmingly dominate chemesthetic potency whereas both selective and specific effects control olfactory potency. We conclude that it is indeed possible to use NPTs to separate out selective from specific effects in ODTs. Among the series studied, aldehydes and acids, except for formic acid, show clear specific effects in their olfactory potency. Furthermore, for VOCs whose odor potency rests mainly on selective effects, we have developed a QSAR equation that can predict their ODTs based on their NPTs.     

Comparison between effects of various partial inferior turbinectomy options on nasal airflow: a computer simulation study

Partial inferior turbinectomy is typically performed on patients suffering from chronic nasal obstruction due to hypertrophy of inferior turbinates and is refractory to other more conservative treatments. The effects of the various options of incision performed on the inferior turbinate in terms of the resulting nasal airflow pattern are examined using computational fluid mechanics. The pressure drops across the severely blocked nose and healthy nose models were found to be 32.3 and 12.3 Pa, respectively, whereas the pressure drops across the nasal cavity following one-third turbinate resection, total turbinate resection and front-end resection were obtained as 5.8, 6.1 and 30.5 Pa correspondingly. Based on the total pressure drop results, the one-third resection option seems to be better than the front-end surgery and the total turbinate resection.     

Bmp4 gene is expressed at the putative site of fusion in the midfacial region

The molecular mechanisms by which the primordia of the midface grow and fuse to form the primary palate portion of the craniofacial region are not well characterized. This is in spite of the fact that failure of growth and/or fusion of these primordia leads to the most common craniofacial birth defect in humans (i.e. clefts of the lip and/or palate). Bmp4 plays a critical role during early embryonic development and has previously been shown to play a role in epithelial-mesenchymal interactions in the craniofacial region of chicks. We analyze the expression of bmp4 in mouse as the midfacial processes undergo fusion to form the primary palate. We show that bmp4 is expressed in a very distinct manner in the three midfacial processes (lateral nasal, LNP, medial nasal, MNP, and maxillary processes, MxP) that ultimately fuse to form the midface. Prior to fusion of the midfacial processes, bmp4 is expressed in the ectoderm of the LNP, MNP, and MxP in a distinct spatial and temporal manner near and at the site of fusion of the midface. Bmp4 appears to demarcate the cells in the LNP and MNP that will eventually contact and fuse with each other. As fusion of the three prominences proceeds, some bmp4 expressing cells are trapped in the fusion line. Later, the expression of bmp4 switches to the mesenchyme of the midface underlying its initial expression in the ectoderm. The switch occurs soon after fusion of the three processes. The pattern of expression in the midfacial region implicates the important role of bmp4 in mediating the fusion process, possibly through apoptosis of cells in the putative site of fusion, during midfacial morphogenesis.     

Trace elements in nasal polyps

The reason why nasal polyps occur has not been explained yet. In the literature, the role of immunological factors are considered and broadly discussed, but there is no information on the role of microelements in the pathogenesis of nasal sinusal polyposis. In this study concentrations of Cu, Se, Zn, and Pb in tissue of nasal polyps were determined. The tissue samples were taken from 41 patients during polypectomia procedures, whereas healthy tissue from nasal mucosa was sampled from 10 patients during endonasal surgery. The concentrations of the elments were determined by atomic absorption spectrometry. It was found that the concentrations of all the elements were significantlylower in polyp tissues than in healthy nasal mucosa. The reasons for this are unclear in the present study     

Changes of Gap and Tight Junctions during Differentiation of Human Nasal Epithelial Cells Using Primary Human Nasal Epithelial Cells and Primary Human Nasal Fibroblast Cells in a Noncontact Coculture System

The epithelium of upper respiratory tissues such as nasal mucosa forms a continuous barrier to a wide variety of exogenous antigens. The epithelial barrier function is regulated in large part by the intercellular junctions, referred to as gap and tight junctions. However, changes of gap and tight junctions during differentiation of human nasal epithelial (HNE) cells are still unclear. In the present study, to investigate changes of gap and tight junctions during differentiation of HNE cells in vitro, we used primary human HNE cells cocultured with primary human nasal fibroblast (HNF) cells in a noncontact system. In HNE cells cocultured with HNF cells for 2 weeks, numerous elongated cilia-like structures were observed compared to those without HNF cells. In the coculture, downregulation of Cx26 and upregulation of Cx30.3 and Cx31 were observed together with extensive gap junctional intercellular communication. Furthermore, expression of the tight junction proteins claudin-1, claudin-4, occludin and ZO-2 was increased. These results suggest that switching in expression of connexins and induction of tight junction proteins may be closely associated with differentiation of HNE cells in vitro and that differentiation of HNE cells requires unknown soluble factors secreted from HNF cells.     

Numerical modeling of turbulent and laminar airflow and odorant transport during sniffing in the human and rat nose

Human sniffing behavior usually involves bouts of short, high flow rate inhalation (>300 ml/s through each nostril) with mostly turbulent airflow. This has often been characterized as a factor enabling higher amounts of odorant to deposit onto olfactory mucosa than for laminar airflow and thereby aid in olfactory detection. Using computational fluid dynamics human nasal cavity models, however, we found essentially no difference in predicted olfactory odorant flux (g/cm2 s) for turbulent versus laminar flow for total nasal flow rates between 300 and 1000 ml/s and for odorants of quite different mucosal solubility. This lack of difference was shown to be due to the much higher resistance to lateral odorant mass transport in the mucosal nasal airway wall than in the air phase. The simulation also revealed that the increase in airflow rate during sniffing can increase odorant uptake flux to the nasal/olfactory mucosa but lower the cumulative total uptake in the olfactory region when the inspired air/odorant volume was held fixed, which is consistent with the observation that sniff duration may be more important than sniff strength for optimizing olfactory detection. In contrast, in rats, sniffing involves high-frequency bouts of both inhalation and exhalation with laminar airflow. In rat nose odorant uptake simulations, it was observed that odorant deposition was highly dependent on solubility and correlated with the locations of different types of receptors.