简介:ObjectivesToinvestigatetheexpressionofhistamineH1receptors(H1R)inthevestibularnucleusofbrainsteminratsandtheroleofH1Rinmotionsickness(MS).MethodsAtotalof24healthySprague-Dawleyratsweredividedrandomlyintofourgroups(n=6each)whichdeterminediftheanimalswouldreceiveinductionofMSordrug(promethazine)treatment:MS(-)/Drug(-);MS(+)/Drug(-);MS(-)/Drug(+at0.25mg);andMS(+)/Drug(+).MSwasinducedbycomplexmotionstimulationandtheconditionedtasteaversionwasusedasabehavioralindicatorofMS.Thevolumeof0.15%sodiumsaccharinsolution(SS)intakewithin45minutesaftermotionstimulationwasmeasured.H1Rinthevestibularnucleuswasexaminedbyimmunofluorescencestaining.TheexpressionofH1Rproteininbrainstemtissueatvestibularnucleuslevelwasdetectedbywesternblot.ResultsThemeanSSintakevolumeintheMS(+)/Drug(-)group(8.8ml)wassignificantlylessthanthatoftheMS(-)/Drug(-)group(15.1ml)(P<0.01).ThemeanSSintakevolumeoftheMS(-)/Drug(+)group(14.8ml)wassimilartothatoftheMS(-)/Drug(-)group.ThemeanSSintakevolume(9.6ml)oftheMS(+)/Drug(+)groupwasmorethanthatoftheMS(+)/Drug(-)group(P<0.01),butlessthanthatoftheMS(-)/Drug(-)grouporMS(-)/Drug(+)group(P<0.01).ImmunofluorescencestainingshowedpositiveexpressionofH1Rinthevestibularnucleusofbrainstemandtheexpressionwasenhancedbymotionstimulation.WesternblotanalysisshowedthatH1Rproteinexpressedinthebrainstemtissueatvestibularnucleuslevelandtheexpressionalsoincreasedsignificantlyaftermotionstimulation.TheMS-inducedincreaseofH1Rwasnotaffectedsignificantlybypromethazine.ConclusionsH1RsexistinthevestibularnucleusinratsandH1Rexpressionisup-regulatedbymotionstimulation,butnotaffectedbypromethazine.ThefindingsindicatethatthehistaminergicsystemisinvolvedinMS.Promethazine,asanH1Rblocker,mayplayitsanti-MSrolebycompetingthebindingsiteon
简介:目的分析外伤所致传导性耳聋的症状体征、听力学表现及影像学特点,总结诊断要点和手术治疗效果。方法回顾性分析解放军总医院2008年1月~2011年3月收治的具有明确外伤史、鼓膜完整的传导性听力下降患者20例。每位患者均进行详细病史询问、临床检查、听力测试和影像检查。行鼓室探查术,根据患者听骨链损伤的不同类型,行听骨链重建术。术后1~3个月复查纯音听力,比较术前和术后的纯音听阈,总结分析手术治疗效果。结果本组20例患者,手术探查听骨链发现砧骨移位14例,包括砧镫关节脱位、锤砧关节分离以及二者兼具的听骨链损伤,锤骨移位且粘连固定2例,镫骨足弓骨折2例,砧骨长脚骨折1例,镫骨底板自前庭窗脱出1例;其中3例砧骨移位患者术中可见面神经明显水肿。根据鼓室探查情况行相应的听骨链重建术,15例行自体听骨雕凿后的听骨链重建术,1例行砧镫关节复位术,4例行人工听骨植入术,3例合并面瘫患者行听骨链重建术的同时行面神经减压术。术后1~3个月随访,患者自觉听力提高,纯音测听示言语频率内气导平均听阈恢复至30±11dB,平均气骨导差为18±10dB。伴有面瘫患者的面神经功能恢复至HBI级。结论有外伤史的患者如有听力下降,应行全面细致的耳科检查、听力学检查和高分辨颞骨CT扫描,如纯音测听气导听阈下降且存在明显的气骨导差,或颞骨CT显示听骨链形态异常,应考虑系听骨链中断引起的传导性耳聋。应根据听骨链损伤的不同类型,重建听骨链,恢复患者听力,合并面瘫者,同时行面神经探查减压手术。