声门癌术后会厌喉成形术改良的经验

为客观评价声门癌的会厌喉成形（Ｋ－Ｓ－Ｔ）术的远期根治性及功能性效果，总结１００例会厌喉成形术的十年改良经验。改良要点为：①会厌瓣侧缘与环状软骨杓区缝合，形成代杓状软骨，以缩小过大的声门。②另侧会厌上缘和杓会厌襞与声室带断缘缝合，而不与甲状软骨断缘缝合，这样，两侧会厌的游离缘和杓会厌襞尽可能下移达声门水平，以形成代声带。③纵行切开会厌舌面软骨，但保留会厌喉面粘骨膜完整，以形成一锐角的代前连合。３、     

听神经瘤的再手术（附11例分析）

为进一步提高听神经瘤手术的临床疗效，对１５８例听神经手术后１１例再次手术患者进行临床分析，发现肿瘤大小，切除方式以及手术进路与临床症状复发密切相关，肿瘤越大，复发机会越多；大部切除；次全切除及全切除的复发再手术率分别是１９．４％、１３．２％和０，迷路后进路手术复发再手术率最高，达３３．３％，防止临床复发最根本的措施是术中尽量减少肿瘤残留，力争全切。为达此目的要求早期诊断，选择适当的手术进路，对不能     

肿瘤合并颈动脉切除术的探讨

肿瘤固着于颈动脉在临床实践中并非少见，如能将肿瘤与受累动脉一并切除，仍不无救治机会。通过体外或体内对患侧颈动脉压迫训练，促使大脑侧枝循环的建立，并采用脑血管造影或／和经颅多普勒血流检测仪（ＴＣＤ）检测证实合格后，可将肿瘤及受累段颈动脉作整块切除。本文报告１９８７～１９９５年间，我们按上述方法给７位患者施行本术，取得较好的效果，无手术死亡及脑血管并发症。     

Detection of Serum Transforming Growth Factor-α in Patients of Primary Epithelial Ovarian Cancers by Enzyme Immunoassay

Transforming growth factor-α (TGF-α) is a potent mitogenic polypeptide. It is secreted by a variety of transformed cells and tumors, modifying tumor growth through autocrine or paracrine mechanism. In the present study, serum levels of TGF-α were determined by enzyme-linked immunosorbent assay (ELISA) in 27 normal females, 116 patients with benign ovarian tumors, and 42 patients with epithelial ovarian cancers (10 with stage I, 7 with stage II, 19 with stage III, and 6 with stage IV). The ELISA assay could detect a minimum level of serum TGF-α concentration at 10 pg/ml. Serum samples were obtained from normal females and from patients with benign or malignant ovarian tumors before initial surgery. The detectable rates were 11% (3/27) in normal females, 28% (32/116) in benign ovarian tumors, and 62% (26/42) in ovarian cancers. The detectable rates in serous and endometrioid ovarian cancers were 71 and 70%, respectively, which were higher than the rate of 33% in mucinous type. However, there was no obvious relationship between the detectability of serum TGF-α and the stages of ovarian cancers. The mean concentration of TGF-α in ovarian cancer was 159.8 pg/ml, which was significantly higher than 27.7 pg/ml in benign ovarian tumors (P< 0.001) as well as 15 pg/ml in normal females (P< 0.001). The mean concentrations of serum TGF-α in stages I to IV ovarian cancers were 133.5, 96.2, 194.8, and 178.3 pg/ml, respectively. The mean concentration of serum TGF-α in any two stages of ovarian cancers was not statistically different. In conclusion, measurement of serum TGF-α can be used as a supplementary tumor marker to differentiate a malignant ovarian tumor from a benign one. However, the concentration of serum TGF-α has no special relation with the stage of ovarian cancer itself. Because of the small number of stage I ovarian cancers with detectable TGF-α in the present investigation, it would probably not be feasible to differentiate a stage I ovarian cancer from a benign ovarian tumor based only on the level of TGF-α in serum.     

Hepatitis B vaccination in preterm infants

AIM—To investigate the immunogenicity and safety of existing recommendations for hepatitis B vaccination in preterm infants.METHODS—Recombinant hepatitis B vaccine (H-B-VAX II, 5 µg per dose) was given to 85 preterm infants divided into two groups, using two different schedules. Forty four group A infants with birthweights of < 2000 g received three doses at 1, 2, and 7 months of age. Forty one group B infants with birthweights of ?2000 g received three doses at 0, 1, and 6 months of age.RESULTS—After vaccination, 42 infants from group A (95%) and 37 infants from group B (90%) developed protective levels of antibody. The final seropositive rate and the geometric mean concentration of hepatitis B surface antibody between the two groups were not significantly different. The immune response of preterm infants to hepatitis B vaccines was similar to that of term infants in a previous study.CONCLUSIONS—Preterm infants can be given hepatitis B vaccines using one of the above two different schedules, at a cutoff birthweight of 2000 g.     

A simplified technique for embryo biopsy: Use of the same micropipette for zona drilling and blastomere aspiration

Purpose: Using different micropipettes for zona drilling and blastomere aspiration for embryo biopsy is prevalent at centers of preimplantation genetic diagnosis. The purpose of our study was to simplify the technique by using only one micropipette. Methods: In this animal model, ICR mouse embryos at the four-cell stage (n=446) were randomly allocated into two groups: a biopsied group (n=224) for blastomere aspiration and a control group (n=222) without micromanipulation. We used a drilling/biopsy micropipette to drill a hole in the zona by expulsion of acidified Tyrode’s solution and to aspirate the blastomere by gentle suction with the same micropipette and pull it out of the zona. One blastomere was biopsied from each embryo. Results: In all, 222 (99.1%) intact blastomeres were successfully biopsied from 224 embryos. Only two blastomeres were damaged during aspiration. The capacity for blastocyst development (92.4 vs 93.7%) was not different between the two groups, but the percentages of embryos hatching (51.8 vs 18.0%) and hatched (29.9 vs 8.1%) were significantly higher in the biopsied group than in the control group. Conclusions: This simplified technique of embryo biopsy is safe and highly efficient for obtaining blastomeres for preimplantation genetic diagnosis and may also facilitate hatching of the blastocysts.     

肿瘤转移抑制基因nm23H1产物在人鼻咽癌中表达的研究

采用ＳＰ免疫组化技术，以ＮＤＰＫ／ｎｍ２３Ｈ１特异的单克隆抗体为探针，对人鼻咽癌中ｎｍ２３Ｈ１的表达及其与颈淋巴结转移的关系进行了研究。结果：３１例鼻咽癌中ｎｍ２３Ｈ１基因产物表达的阳性率为４１．９％（１３／３１）。其中无转移组的阳性率为５２．３％（１１／２１），有转移组的阳性率为２０％（２／１０），两组间具有显著性差异（Ｐ〈０．０１），而在转移的颈淋巴结组织中ｎｍ２３Ｈ１产物表达极微或无表达，其     

氯胺酮对不完全性脑缺血的保护作用

目的：观察氯胺酮对兔不完全性脑缺血后神经损害后果的影响，并探讨其可能的作用机制。方法：１２只家兔随机分为两组。缺血对照组（组Ⅰ，只数＝６），氯胺酮组（组Ⅱ，只数＝６），组Ⅱ用氯胺酮２５ｍｇ／ｋｇ静脉注射和５０ｍｇ／ｋｇ肌肉注射作前处理。采不同时相动脉血分别测定血浆ＴＮＦ、ＮＡ、Ａ的水平。结果：缺血３０分钟组Ⅱ血浆ＴＮＦ、ＮＡ、Ａ浓度显著低于组Ⅰ（Ｐ＜０．０５），神经损害的后果及与卒中有关的死亡率，组Ⅱ也较组Ⅰ明显改善。结论：用氯胺酮前处理可以明显改善不完全性兔脑缺血的神经学损害，其机制可能与氯胺酮拮抗缺血期中枢ＮＭＤＡ受体和抑制外周儿茶酚胺释放，降低ＴＮＦ水平有关。     

Impact of pill organizers and blister packs on adherence to pill taking in two vitamin supplementation trials

The impact of pill organizers on pill taking was determined in the Trial of Antioxidant Vitamins C and E (TRACE) Study, a factorial trial of vitamin C and vitamin E supplementation in 184 individuals. Participants were recruited in 1996-1997 and randomized to one of two groups (pill organizer or no organizer) and to one of four supplement groups for 2 months. The pill count (observed/expected X 100%) distribution was similar in the organizer and no organizer group for both vitamins. Mean differences in changes in serum vitamin levels between active and placebo groups did not differ by pill organizer use. The impact of pill organizers and blister packs was compared in another trial, the Vitamins, Teachers, and Longevity (VITAL) Study, in 297 individuals randomized in 1993-1994 to receive study pills either in blister packs or in pill organizers and to take one of two supplements. Among those with lower adherence, the pill count distribution in the blister-pack group exceeded that in the organizer group. Mean differences in serum vitamin E levels between active and placebo groups did not differ by types of pill packaging. In summary, use of blister packs, but not pill organizers, improved adherence as measured by pill counts among those with lower adherence. Neither pill delivery system improved adherence as measured by serum vitamin levels.