ABSTRACT
Abstract Introduction Eosinophilic otitis media is an intractable otitis media and a fairly common middle ear disease. However, the pathogenesis of eosinophilic otitis media is obscure. Objective To observe the pathological and ultrastructural changes of the Eustachian tube mucosal epithelium in rats with eosinophilic otitis media and further explore the pathogenesis of eosinophilic otitis media. Methods Animals were intraperitoneally injected with 2000 mg ovalbumin and 100 mg aluminum hydroxide (alum) on day 0, followed by 100 mg ovalbumin and 100 mg alum injection on days 7 and 14. Next they were topically boosted by daily application of 100 mg ovalbumin solution via nasal drip and intratympanic injection of 0.1 mL ovalbumin (1000 mg/mL) in the right ear (group A, n = 80) and 0.1 mL saline in the left ear as control (group B, n = 80) starting on day 21 and continuing for 14 days. The temporal bones were dissected on the 35th, 38th, 41st and 43rd day separately under anesthesia. Scanning electron microscopy, hematoxylin-eosin and toluidine blue staining were used to observe the pathological and morphological changes of Eustachian tube mucosa stained samples. Moreover, inflammatory cells and cilia were counted. Results The epithelium of the Eustachian tube in group A was swollen and thickened. The cilia were arranged in a disorderly manner and partially detached. Eosinophils infiltrated the submucosal layer of the Eustachian tube, and their number increased significantly compared with that in group B (p< 0.05). Simultaneously, mast cell degranulation was observed in group A. Scanning electron microscopy revealed that the cilia were lodged and gathered along the whole length of Eustachian tube in group A. Ciliated cell density was significantly lower than that in Group B (p< 0.01). Conclusion In the eosinophilic otitis media model, allergy caused significant changes in pathology and morphology of the Eustachian tube mucosa, affecting the normal function of the Eustachian tube which played an important role in the occurrence and development of eosinophilic otitis media.
Resumo Introdução A otite média eosinofílica é uma doença relativamente comum de orelha média; entretanto, sua patogênese é ainda obscura, assim como o tratamento. Objetivo Observar as alterações histopatológicas e ultraestruturais do epitélio da mucosa da tuba auditiva em ratos com otite média eosinofílica e investigar a sua patogênese. Método Os animais foram injetados intraperitonealmente com 2.000 mg de ovalbumina e 100 mg de hidróxido de alumínio (alúmen) no dia 0, seguido por 100 mg de ovalbumina e 100 mg de injeção de alúmen nos dias 7 e 14. Em seguida, receberam um reforço tópico através de uma aplicação diária de 100 mg da solução por gotejamento nasal e injeção intratimpânica de 0,1 mL de ovalbumina (1000 mg/mL) na orelha direita (grupo A, n = 80) e 0,1 mL de solução salina na orelha esquerda como controle (grupo B, n = 80), começou no dia 21 e continuou por 14 dias. Os ossos temporais foram dissecados nos dias 35, 38, 41 e 43 separadamente sob anestesia. Foram usadas microscopia eletrônica de varredura e coloração com hematoxilina-eosina e azul de toluidina para observar as alterações histopatológicas e morfológicas das amostras coradas de mucosa da tuba auditiva. Além disso, células inflamatórias e cílios foram contados. Resultados O epitélio da tuba auditiva no grupo A estava edematoso e espessado. Os cílios estavam dispostos de forma desordenada e parcialmente destacados. Os eosinófilos infiltraram a camada submucosa da tuba auditiva e seu número aumentou significantemente em comparação ao grupo B (p < 0,05). Simultaneamente, degranulação dos mastócitos foi observado no grupo A. A microscopia eletrônica de varredura mostrou que os cílios estavam depositados e reunidos ao longo de todo o comprimento da tuba auditiva no grupo A. A densidade das células ciliadas foi significantemente menor do que no grupo B (p < 0,01). Conclusão No modelo de otite média eosinofílica, a alergia causou alterações significativas à histopatologia e na morfologia da mucosa da tuba auditiva, afetou a função normal dela, o que desempenhou um papel importante na ocorrência e no desenvolvimento da otite média eosinofílica.
ABSTRACT
Objective To explore the application of visible standard channel combined with F4.8 visible puncture percutaneous nephrolithotomy in the treatment of multiple renal calculi. Methods The clinical data of 46 patients with multiple renal calculi from October 2015 to September 2016 were retrospectively analyzed. There were 28 male and 18 female, with a mean age of 42.6 years (aged from 25 to 65 years). Stone diameter 3.0~5.2 cm, average (4.3 ± 0.8) cm. Application of F4.8 visual puncture assisted angioplasty to establish the standard channel, nephrolithotomy combined with ultrasonic lithotripsy treatment in the field of visible stones, then apply the F4.8 visual micro puncture percutaneous nephrolithotomy combined with holmium laser treatment of other parts of the stone, summarizes the channel establishment total time, operation time, blood red protein decreased and stone clearance rate and complication index. Results All cases were successfully established single standard channel under the guidance of F4.8 visual puncture, 24 cases were combined with single ultramicro channel, 16 cases were combined with double ultramicro channels, and the other 6 cases were combined with the three ultra micro channels. Postoperative indwelling single renal fistula, micro channel indwelling fistula, postoperative indwelling F5 double J tube. F4.8 visual puncture established standard channel establishment time (6.8 ± 1.8) min, single F4.8 visible puncture ultra - channel establishment time of (4.5 ± 0.9) min, operation time of (92.0 ± 15.0) min. A stone clearance rate was 91.3% (42/46), a decrease in hemoglobin value of (12.2 ± 2.5) g/L, 8 cases of postoperative fever, given anti-inflammatory treatment improved, 4 cases with residual calyceal stones visible 0.5~0.8 cm, given extracorporeal shock wave lithotripsy combined with postural drainage, stone, 1 months after the treatment of stones were discharged, did not appear Shi Jie, delayed bleeding, adjacent organ injury, ureteral injury cases. Conclusion Visual standard channel combined with F4.8 ultra visible puncture percutaneous nephrolithotomy in treatment of multiple renal calculi has the advantages of reducing the large number of channels, high stone clearance rate, safety, less complications, F4.8 was used to establish the visual puncture channel is more safe and accurate.
ABSTRACT
Objective To explore the application of visible standard channel combined with F4.8 visible puncture percutaneous nephrolithotomy in the treatment of multiple renal calculi. Methods The clinical data of 46 patients with multiple renal calculi from October 2015 to September 2016 were retrospectively analyzed. There were 28 male and 18 female, with a mean age of 42.6 years (aged from 25 to 65 years). Stone diameter 3.0~5.2 cm, average (4.3 ± 0.8) cm. Application of F4.8 visual puncture assisted angioplasty to establish the standard channel, nephrolithotomy combined with ultrasonic lithotripsy treatment in the field of visible stones, then apply the F4.8 visual micro puncture percutaneous nephrolithotomy combined with holmium laser treatment of other parts of the stone, summarizes the channel establishment total time, operation time, blood red protein decreased and stone clearance rate and complication index. Results All cases were successfully established single standard channel under the guidance of F4.8 visual puncture, 24 cases were combined with single ultramicro channel, 16 cases were combined with double ultramicro channels, and the other 6 cases were combined with the three ultra micro channels. Postoperative indwelling single renal fistula, micro channel indwelling fistula, postoperative indwelling F5 double J tube. F4.8 visual puncture established standard channel establishment time (6.8 ± 1.8) min, single F4.8 visible puncture ultra - channel establishment time of (4.5 ± 0.9) min, operation time of (92.0 ± 15.0) min. A stone clearance rate was 91.3% (42/46), a decrease in hemoglobin value of (12.2 ± 2.5) g/L, 8 cases of postoperative fever, given anti-inflammatory treatment improved, 4 cases with residual calyceal stones visible 0.5~0.8 cm, given extracorporeal shock wave lithotripsy combined with postural drainage, stone, 1 months after the treatment of stones were discharged, did not appear Shi Jie, delayed bleeding, adjacent organ injury, ureteral injury cases. Conclusion Visual standard channel combined with F4.8 ultra visible puncture percutaneous nephrolithotomy in treatment of multiple renal calculi has the advantages of reducing the large number of channels, high stone clearance rate, safety, less complications, F4.8 was used to establish the visual puncture channel is more safe and accurate.