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变应性鼻炎的特异性免疫治疗

变应性鼻炎的主要治疗方式是：避免接触变应原、药物治疗、免疫治疗。该病的治疗方法多种多样，但大多数是对症治疗，难以达到临床治愈的目的。随着免疫学的不断发展，变应性鼻炎标准化特异性免疫治疗作为阻断变应性疾病发展进程的治疗，在临床应用中取得了良好效果。现就如何规范免疫治疗过程及方法，重视不良反应的观察和处理，提高患者的依从性等进行介绍。

Research on Screening Peptides Specifically Targeting Laryngeal Squamous Cell Carcinoma by Phage Display Technique

【摘要】　目的　筛选人源喉癌Hep-2细胞株特异结合的短肽，作为喉癌靶向治疗的载体。　方法　体外培养Hep-2细胞株作为靶细胞，人正常喉黏膜上皮细胞为吸附细胞；用噬菌体展示十二肽库进行3轮差减筛选，随机挑取10个噬菌体克隆进行测序；采用酶联免疫吸附（enzyme linked immunosorbent assay，ELISA）法鉴定噬菌体与Hep-2细胞的结合活性；通过免疫荧光鉴定喉癌细胞特异性结合肽（F2）噬菌体阳性克隆与喉癌细胞结合的特异性。　结果　经过3轮筛选后，噬菌体在靶细胞Hep-2上出现明显富集；ELISA分析鉴定显示5个阳性克隆能与Hep-2细胞特异结合，其中F2噬菌体克隆对喉癌细胞的结合靶向性明显高于对照细胞（Plt;0.05）； 免疫荧光显色显示，F2能特异性地与喉癌细胞结合。　结论　利用噬菌体展示肽库技术，可以成功筛选到F2，其可能成为喉癌靶向治疗的载体。【Abstract】　Objective　To obtain the polypeptides specifically bound to laryngeal squamous cell carcinoma line (Hep-2) and use it as a potential therapeutic vector targeting laryngeal squamous cell carcinoma patients.　Methods　With the Hep-2 cells as the target cells and human normal laryngeal squamous epithelial cells (HNLE cells) as the absorber cells, 3 rounds of panning from a Ph.D.-12TM phage-display peptide library were carried out. Ten randomly selected phage clones were sent for sequence detection. The affinity of phage clones was detected by enzyme-linked immunosorbent assay (ELISA). The positive phage clones (F2) specifically bound to Hep-2 were identified by immunofluorescence detection.　Results　After 3 rounds of screening, 5 positive phage clones showed specific binding to Hep-2 cells and the affinity of positive phage clones (F2) was significantly higher than that of the control groups (Plt;0.05). The results of immunofluorescence detection indicated that F2 could be specifically bound to Hep-2.　Conclusions　Phage display peptide libraries technique can successfully screen the peptide specifically bound to Hep-2 cell line. Thus, it provides a potential vector for targeting therapy of laryngeal squamous cell carcinoma patients.

腮腺炎性肌纤维母细胞瘤一例

误吞纽扣电池致食道狭窄一例

Effects of BQ123 on Carcinoma Angiogenesis of Implanted Laryngeal Carcinoma

摘要:目的: 探讨选择性内皮素A受体拮抗剂BQ123对人喉癌Hep2细胞裸鼠种植瘤的生长及血管形成的影响。 方法 :将实验动物裸鼠随机分为3组:BQ123［n =8,2mg/(kg·day)］、氟尿嘧啶组［n =8,2mg/(kg·day)］、生理盐水组(n =8),比较各组裸鼠成瘤体积、微血管密度(MVD)。 结果 :BQ123组肿瘤体积为(162±053)cm3,明显小于生理盐水组及氟尿嘧啶组,差异具有统计学意义;BQ123组的肿瘤组织中MVD高倍镜下为232,明显低于生理盐水组(586)及氟尿嘧啶组(395),差异具有统计学意义。 结论 :BQ123对人喉癌Hep2细胞在裸鼠体内有明显抑瘤作用,肿瘤的体积、肿瘤组织MVD显著低于对照组,表明BQ123可通过抑制肿瘤血管生成而显著抑制肿瘤生长。Abstract: Objective: To study the effects of endothelin A receptor blockade BQ123 on the implanted human laryngeal carcinoma angiogenesis of nude mouse. Methods : From March 2008 to July 2009, 24 Balb/c nude mice were randomly divided into three groups: BQ123 group ［〖WTBX〗n =8, BQ123 at 2mg/(kg·day)］, 5Fu group ［〖WTBX〗n =8, fluorouracil at 2mg/(kg·day)］ and the control group (〖WTBX〗n =8, normal saline). The carcinoma volume and microvascular density of each group were compared. Results : The tumor size of BQ123 group, which was (162±053)cm3 in average, was significant smaller than the tumor sizes of the other two group s. The average microvascular density score of the tumors in BQ123 group was 232 per hyper power len (HP), which was also significantly less than the average scores of control groups (586 and 395 respectively). Conclusion : Nude mouse experiments show that the carcinoma volume and microvascular density of BQ123 group are significantly lower than those of the control groups. BQ123 inhibits the growth of carcinoma by its inhibition of carcinoma angiogenesis.

Gastrodin Injection in the Treatment of Vertigo: A Multi-center Single-blind Randomized Controlled Trial

Objective　To evaluate the clinical effectiveness and safety of gastrodin injection in the treatment of vertigo. Methods　A multi-center, single-blind randomized controlled trial was designed to study 240 vertigo patients who were randomly allocated into the treatment and the control groups.Patients in the treatment group were treated with gastrodin injection 600 mg, intravenously guttae, daily for 7 days, while those in the control group were treated with betahistin 30 mg, intravenously guttae, daily for 7 days. All data were analyzed by SAS. CMH (Cochran’s and Mantel-Haenszel) method was used to compare the clinical effect between the two groups. Nonparametric statistics and t-test were used in baseline data analysis. Results　① The clinical effectivenes on vertigo: according to the intention-to-treat (ITT) analysis, the clinical control rate and effective rate in the treatment group (n=117) were 71.19% and 90.60%, respectively, while 54.17% and 77.50% were in the control group (n=120). A statistic significance difference was found between the two groups (P=0.005 and P=0.004 for control and effective rate respectively).According to the per-protocol population (PP) analysis, the clinical control rate and effective rate in the treatment group (n=116) were 72.41% and 91.38%, respectively, and were 54.70% and 77.78% in the control group (n=117). Statistic significance was found between the two groups (P=0.005 and P=0.004 respectively). ITT and PP analysis revealed similar results. ② The clinical effect on vestibular function: the clinical control rate and effective rate were 62.26% and 81.13% respectively in the treatment group (n=53), and were 42.37% and 76.27% in the control group (n=58). Statistic significance was found in the clinical control rate but was not found in the effective rates between the two groups (P=0.029 and P=0.504, respectively). ITT and PP analysis revealed the same results. ③ Adverse drug reactions (ADRs) were slight to moderate. ADRs rates were 8.33% in the treatment group (n=120) and 10.83% in the control group (n=120), respectively. No statistic significance was found between the two groups(P=0.538). Conclusions　Gastrodin injection and betahistine injection are safe and effective drugs for vertigo; gastrodin injection is better than betahistine injection in relieving vertigo symptoms.

Randomized Controlled Trial of Compound Loratadine Capsule in the Treatment of Allergic Rhinitis

Objective　To evaluate the clinical effectiveness and safety of compound loratadine capsule in the treatment of allergic rhinitis. Methods　A multi-center randomized single blind controlled trial (by using a random number table generated random sequence and the sequence was concealed by sealed envelopes) was designed. Two hundred and forty outpatients with allergic rhinitis who met the inclusion and exclusion criteria were randomized to the treatment group (n=120 with compound loratadine capsule, 1 capsule q 24 h) or the control group (n=120 with loratadine tablet, 1 tablet q 12 h). All patients were given standard therapy. Results　① At the end of the treatment, in the compound loratadine group, 101 patients completed the study, and 19 patients withdrew. In the loratadine group, 103 patients completed the study, 17 patients withdrew. According to intention-to-treat analysis (ITT), the improvement rates of the treatment and control groups were 89.17% (107/120) and 88.33% (106/120) respectively. No significant difference was seen between the two groups (rank sum test, u=-1.8348, P＞0.05). According to per-protocol analysis (PP), the improvement rates of the treatment and control groups were 96.04% (97/101) and 91.26% (94/103) respectively. No significant difference was seen between the two groups (rank sum test, u=-1.625 7, P＞0.05). ② Adverse events were slight to moderate.The adverse event rates were 22.5% (27/120) and 21.67% (26/120) in the treatment and control groups respectively. No significant difference was seen between the two groups ( χ2 test, P＞0.05). Conclusion　Compound loratadine capsule is effective and safe for allergic rhinitis.

Clinical Pathologic Analysis of Tonsil Tumor

ObjectiveTo summarize the clinical pathologic features of primary tonsil tumor, in order to provide reference for its diagnosis and treatment. MethodsWe retrospectively analyzed the clinical data from January 2002 to April 2012, and found 810 cases of malignant tumor and 113 cases of benign tumor. The pathologic patterns and clinical manifestations of these cases were recorded for analysis. ResultsMost tonsil tumors were unilateral, and the malignant types were much more than the benign. The most common malignant tonsil tumors were lymphoma (610 cases), followed by squamous cell carcinoma (172 cases); inverted papilloma was the most common benign tumor (87 cases). Paresthesia in the pharynx was the most common clinical manifestation that existed in almost all cases. ConclusionTonsil tumor pathological type is very important for its diagnosis, treatment and prognosis. Laying emphasis on pathological diagnosis and differential diagnosis could avoid missed diagnosis, misdiagnosis and improper treatment, which is particularly important for clinical physicians of the otolaryngology, head and neck surgery.

CLINICAL STUDY ON SUBMENTAL ISLAND FLAPS IN REPAIRING PHARYNGEAL FISTULA

Objective To explore the appl ication of submental island flaps in repairing pharyngeal fistula after total laryngectomy. Methods From July 2002 to February 2006, 9 cases of concomitant pharyngeal fistula (including 7 cases of laryngeal carcinoma and 2 cases of hypopharyngeal neoplasms) were repaired with submental island flaps after total laryngectomy. All patients were male and their ages were 52-71 years (mean 61.8 years). Pharyngeal fistula occurred 5-62 days (mean 14.7 days) after total laryngectomy. The diameter of medial pharyngeal fistula ranged from 1.9 cm to 4.1 cm. All patients failed to respond to conservative therapy for 25-46 days. The size of submental island flap was 2.5 cm × 2.4 cm to 4.6 cm × 4.0 cm. After the pharyngeal fistula were repaired with submental flap, the donor site were sutured directly. Results All of the nine submental flaps were survived and no local necrosis or wound infection occurred. Incision at donor site healed by first intention and no obvious scar formed. Fistula occurred 10 days after operation and was cured after symptomatic treatment in one patient who received radiotherapy before operation; other patients achieved the satisfactory results of one-stage repair. The gastric tube was pulled out 14 to 22 days after operation, all of the patients have no sense of swallow obstruction. Nine patients were followed up for 10-38 months (mean 27 months). The ppearance of neck was satisfactory. Conclusion Because of its short distance, abundant blood supply, convenient operation and minimal donor-site morbidity, the submental island flap is a good alternative mthod in repairing pharyngeal fistula.

The Status and Development of Otorhinolaryngology-Head and Neck Surgery Informatics

This article carries out a comprehensive review on otorhinolaryngologic-head and neck informatics, focusing on the definition, content and characteristics of otorhinolaryngologic informatics as well as the application of computer, communication and information technology in otorhinolaryngology-head and neck surgery. Otorhinolaryngologic informatics is the future development direction of otorhinolaryngology-head and neck surgery.