Treatment of severe subglottic laryngotracheal stenosis using hyoid graft with sternohyoid muscle flap]

OBJECTIVE: To evaluate the possibility and reliability of the hyoid-sternohyoid graft transfer in the correction of server subglottic laryngotracheal stenosis, and delineate the operation skills and clinical results. METHODS: Seven patients with severe subglottic stenosis underwent laryngotracheal reconstruction using the hyoid grafts with sternohyoid muscle flaps (HG-SHMF). Five of these patients had traumatic subglottic stenosis, one with scar tissue of unknown etiology arising in the subglottic region, another with tracheal narrowing caused by inhalation of hydrochloric acid. RESULTS: All seven patients were successfully decannulated with moderate good voice. The average time from reconstruction to decannulation was 15.4 months. The stent was endoscopically removed with a range of 3 to 22 months; the mean time required for stenting was 9.6 months. Two patients who received additional salvage reconstruction procedures because of graft or stent displacement were extubated with improved voices and satisfactory airway. CONCLUSIONS: The HG-SHMF transfer was a single-stage reconstruction, relatively simple procedure that can restore an adequate airway and a good voice. Patients undergoing laryngotracheal reconstruction with HG-SHMF must have regular, long-term follow-up since graft displacement and recurrent granulation tissue or scar reformation can cause restenosis after an initially successful surgery. This procedure should be used in a large number of patients to further test its reliability.     

Genetic changes in JC virus possibly associated with progressive multifocal leukoencephalopathy]

Progressive multifocal leukoencephalopathy (PML) is a fetal demyelinating disease in the central nervous system. PML was once a rare disease, but it is now relatively common among AIDS (acquired immunodeficiency syndrome) patients. The immunological state of patients mainly contributes to the pathogenesis of PML. Genetic changes of the etiological agent, however, may also be involved in the development and progression of the disease. The major genetic changes possibly associated with PML include the regulatory region rearrangement and the VP1 loop mutation. Both changes have been identified as genetic changes usually occurring in JCV (JCvirus) DNAs from the brain and cerebrospinal fluid of PML patients. Although it remained to be clarified how these changes are involved in the pathogenesis of PML, accumulating evidence suggests that the VP1 loop mutation is associated with the progression of PML. Here we overview studies (mainly those performed by ourselves) on these genetic changes.     

大鼠胼胝体神经元化学性质研究:Ⅰ.谷氨酸的免疫细胞化学研究

采用辣根过氧化物酶(HRP)逆行示踪与谷氨酸免疫细胞化学结合法对大鼠额叶和枕叶皮质内胼胝体神经元的化学性质进行了研究.结果发现含谷氨酸的胼胝体神经元为大中型锥体细胞,主要分布于皮质Ⅱ/Ⅲ、Ⅴ和Ⅵ层,并有成群分布的倾向.含谷氨酸的胼胝体神经元的数目约占 HRP 标记的胼胝体神经元的17%(额叶)和29%(枕叶).这一结果从形态学上证实,大鼠大脑皮质内相当一部分胼胝体神经元使用谷氨酸作为兴奋性递质。     

微波快速过氧化物酶染色法与灌注法用于微循环形态学研究之比较

以健康Ｗｉｓｔａｒ大白鼠为材料，对微波快速内源性过氧化物酶染色与灌注法显示微血管的方法进行了对比研究。结果，过氧化物酶组织化学法具有不用灌注，操作简单，所用时间短，对血管无扩张、破裂等人为改变的特点，保持了微血管真实的自然形态和管径大小，可以定量或半定量地判定组织器官活体时的血液循环状况。可以用于人及动物的大脑、脊髓、皮肤、耳及食管等组织内微血管形态学研究和定量分析。并对过氧化物酶显示微血管的原理和微波辐射促进染色的原理及特点进行了分析、讨论。     

Ⅰ期非小细胞肺癌淋巴结微转移规律的研究

目的探讨几个问题：（1）Ⅰ期非小细胞肺癌淋巴结微转移比率；（2）淋巴结微转移与肿瘤大小、病理类型、细胞分化程度、部位、分型、分期进行Logstic回归分析，确定影响微转移的主要因素；（3）探讨微转移的方式、顺序。方法对91例非小细胞肺癌清扫的肺门和隆突下淋巴结进行MCK（AEI／AE3）免疫组化标志检测微转移的存在。另外收集45例肺部良性病变手术时切除的肺门淋巴结45枚和Ⅱ期、Ⅲ期肺癌常规病理检查阳性的肺门淋巴结45枚进行MCK（AEI／AE3）免疫组化（SP法）标志，分别作为阴性和阳性对照。结果45例肺部良性病变手术时切除的肺门淋巴结45枚进行MCK（AEI／AE3）免疫组化标志均为阴性；Ⅱ期和Ⅲ期常规病理检查阳性的肺门淋巴结45枚进行MCK（AEI／AE3）免疫组化标志均为阳性。91例Ⅰ期非小细胞肺癌总的微转移率为49％（45／91）。结论Ⅰ期非小细胞肺癌淋巴结中存在微转移；Ⅰb期非小细胞肺癌微转移率明显高于Ⅰa期；有必要对Ⅰb期非小细胞肺癌进行术后化疗；肿瘤分期和分化程度是影响淋巴结微转移的主要因素；淋巴结微转移遵循肺门到纵隔的途径；腺癌存在跳跃式微转移。     

胰RNA对离体瘤细胞的杀伤作用及其机制的探讨

在体外培养瘤细胞的实验中,胰RNA提取物对艾氏腹水瘤细胞及其他瘤细胞(S_(180),P_(88),H_(22))有杀伤作用。在胰RNA提取物中,对瘤细胞具有杀伤作用的活性物质不是性凝集素样多糖类物质或能透过半透膜的小分子化合物,而是具有二级结构的低分子RNA。     

Mitogenic effect of polyclonal anti-porcine lymphocyte E-receptor antiserum IgG

In the present paper we report the mitogenic effect of the sheep anti-porcine lymphocyte E-receptor antiserum IgG(APERIgG) on porcine peripheral T-lymphocytes in vitro. The effect was apparently dose-dependent and not seen in the B-lymphocyte cultures. Kinetic study showed that the maximal 3H-thymidine incorporation, similar to that induced by Con A, occurred on the third day of incubation. Neither F(ab')2 nor Fab fragment of APERIgG was able to induce cell proliferation, indicating that the integrity of IgG molecule was essential for cell response. It was very interesting to note that though there is cross antigenicity between porcine and human E-receptors, no similar effect could be produced by APERIgG in human peripheral lymphocyte cultures under the same experimental conditions, suggesting the existence of minor difference in structure between the porcine and human E-receptors.     

Lung cancer and prior tuberculosis infection in Shanghai

In a population-based case-control study of lung cancer in Shanghai involving interviews during 1984-86 with 1,405 cancer patients and 1,495 controls, a significant 50% elevation in the risk of lung cancer, adjusted for cigarette smoking, was observed among persons who had a history of tuberculosis. Among those diagnosed with tuberculosis within the past 20 years, the risk exceeded 2.5-fold. In males the lung cancers tended to occur on the same side as the previous tuberculosis infection. For both sexes, the effect of recent tuberculosis was most apparent for adenocarcinoma and peripheral tumours. No relationship was found between lung cancer risk and the type of tuberculosis therapy, including use of isoniazid. The findings suggest that tuberculosis may predispose to lung cancer, with the association most apparent among recent survivors of the infection.     

有抑郁症史者想象力的研究

实验组为45名缓解的内源性抑郁症患(男25例,女20例)。对照组为15名缓解的双相障碍患者(男8例,女7例),71名正常人(男41例,女30例)。利用作者建立的想象结局法发现:实验组想象力总分显著低于正常人组,特别是当涉及不愉快事件的测题时,单项分亦显著低于正常人。双相障碍组总分亦显著低于正常人。实验组有关性内容的比率得分显著低于正常人。