非神经材料修复面神经缺损

由广种经移植修复面神经损伤康在着许多缺点，人们试图采用白体非神经组织和其它材料作为神经的替代物来桥接种经缺损。本文就近10余年来有关非神经材料修复面神经缺损的研究进展进行概述。1870年Philipeanx和Vulpran在狗的舌下神经首次成功地进行神经移植后[1]，神经移植术被广泛地应用于周围神经的修复。对于长距离的面神经缺损，临床常用的方法系采用自体非重要神经如耳大神经移植来修复。但这种方法有诸多缺点[1]，如：需供体神经，而供体神经来源常有限；需另作一切口切取供体神经；供、受体神经的直径常不一致；手术时间长；水后供体…     

经蝶窦显微手术治疗垂体侵袭性腺瘤

为总结临床经验，报告经蝶窦进路显微手术治疗垂体侵袭性腺瘤１８例，其中４例伴有胰岛素依赖型糖尿病。施肿瘤近全切除１５例，大部分切除３例，术后追加放射治疗１０例，服用溴隐亭治疗５例，术后平均随访３．８年，其中３例（１６．６％）平均１．６年复发，二次比额手术治愈，就垂体侵袭性和伴有胰岛素依赖型糖尿病患者经蝶窦显微手术治疗的可行性进行探讨。     

变应性鼻炎患者可溶性白细胞介素—2受体的测定

为探讨可溶性白细胞介素－２受体在变应性鼻炎中的作用机理，采用双抗体夹心酶联免疫吸附测定（ＥＬＩＳＡ）法测定３９例变应性鼻炎患者，１９例慢性鼻炎患者和１５例健康人血清及鼻分泌物ＳＩＬ－２Ｒ水平。结果发现变应性鼻炎患者血清ＳＩＬ－２Ｒ水平高于慢性鼻炎患者及健康人（Ｐ〈０．００１）。提示ＳＩＬ－２在变应性鼻炎的发病中起重要作用。     

喉全切除发音重建术远期疗效分析

One hundred and twenty-five patients received voice rehabilitation operations following total laryngectomy over the period from August 1977 to December 1994. Among them, 119 were male and 6 were female, the eldest was 70 years old and the youngest 30 years old, and the average age was 55.3 years. Clinical staging was as follows: stage II, 2 cases; stage III, 45 cases; stage IV, 66 cases; and recurrence, 12 cases. The voice rehabilitation operations included pharynx-trachea anastomosis 18 cases and trachea-esophagus fistulization 107 cases. One hundred and fourteen patients were followed-up for 13 months to 18 years. The 3, 5, and 10 year survival rates were 78.2%, 61.4%, and 40.5% respectively. The effective rates of voice rehabilitation according to hearing voice distance were 84.6%, 81.1%, and 67.5% 3 weeks, 1 year, and 5 years respectively after operation. The causes of failure were closure of fistula 15 cases; food aspiration 8 cases and unknown 3 cases. The clinical value, advantages and disadvantages of voice rehabilitation, and the time to evaluate the effect of voice rehabilitation were discussed.     

DNA拓扑异构酶I抑制剂诱导鼻咽癌上皮细胞凋亡的实验研究

拟从细胞凋亡角度出发，探讨能够诱导鼻咽癌上皮细胞凋亡的因素，为有效地防治该恶性肿瘤提供新的思路。方法：光镜下观察细胞的形态变化；流式细胞仪检测细胞周期变化及亚二倍体比例；ＤＮＡ凝胶电泳及二苯胺法测定ＤＮＡ片段化程度。结果：一定浓度的拓扑异构酶Ｉ抑制剂喜树碱（ＣＰＴ）体外作用于人低分化鼻咽癌上皮细胞系ＣＮＥ－２Ｚ细胞一定时间后，镜下可见细胞体积缩小，染色质凝聚，胞膜突起及凋亡小体形成等形态变化。２￣     

p16与C—myc在喉鳞状细胞癌中的表达意义

目的：研究p16和C－myc在喉鳞状细胞癌中的表达意义。方法：应从p16和C－myc单克隆抗体，通过免疫组织化学法检测6例正常喉粘膜和47例喉鳞癌中p16和C－myc的表达。结果：6例正常喉粘膜组织中未发现p16和C－myc蛋白阳性表达，47例喉鳞癌中p16和C－myc阳性表达率分别为48．9％（23／47）和57.4％（27／47），与性别、年龄和肿瘤发生的部位无相关性（P＞0．05），与临床分期和病理分级相关（P＜0．05）；C－myc还与颈淋巴结转移相关（P＜0．05）。结论：p16和C-myc蛋白阳性表达在喉鳞癌的发生和发展中起重要作用，可作为评价喉鳞癌预后的新指标。     

Interleukin-8 Concentration Predicts the Neutrophil Count in Middle Ear Effusion

Interleukin-8 (IL-8), a potent neutrophilic chemoattractant and inflammatory cytokine, is present in middle ear effusions (MEEs) of children with otitis media and is thought to be responsible for the accumulation of neutrophils in MEEs. We hypothesized that IL-8 concentration predicts the total number and proportion of neutrophils in MEEs. IL-8 concentration and total and differential cell counts were measured in MEEs of children undergoing tympanostomy tube placement for otitis media. IL-8 was present in 80 (98%) of 82 effusions. The mean ± SEM value for IL-8 was 7342 ± 847 pg/mL. The mean ± SEM count and percentage of neutrophils were 1.34 × 10⁶ ± 3.44 × 10⁵ and 70.6 ± 3.1%, respectively. IL-8 concentrations correlated positively with the total number(r = +0.30; P = 0.02) and percentage of neutrophils(r= +0.32; P = 0.01) in the effusion. Additionally, purulent effusions had greater IL-8 concentrations (P = 0.003) and greater neutrophil count (P = 0.03) than mucoid or serous effusions. We conclude that IL-8 is consistently present in MEEs of children and IL-8 concentration predicts the total number and proportion of neutrophils. Furthermore, IL-8 concentration and the total number of neutrophils correlate positively with the type of effusion. These results support the hypothesis that IL-8 recruits neutrophils to the middle ear in MEEs.     

鼻咽结核22例报告

报告鼻咽结核22例，5例合并肺结核，16例合并颈淋巴结核。临床诊断注意与鼻咽癌鉴别。颈淋巴结FNA细胞学检查与PCR检测有助于诊断，确诊需病理学检查。全身抗痨治疗，同时应用5％链霉素局部灌洗，可显著提高疗效，缩短病程。对合并巨大的或全身用药不敏感的结核性颈淋巴结炎采取手术切除效果良好。     

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     

5,10-Methylenetetrahydrofolate reductase gene variants and congenital anomalies: a HuGE review

The enzyme 5,10-methylenetetrahydrofolate reductase (MTHFR) is involved in folate metabolism. The MTHFR gene is located on chromosome 1 (1p36.3), and two common alleles, the C677T (thermolabile) allele and the A1298C allele, have been described. The population frequency of C677T homozygosity ranges from 1% or less among Blacks from Africa and the United States to 20% or more among Italians and US Hispanics. C677T homozygosity in infants is associated with a moderately increased risk for spina bifida (pooled odds ratio = 1.8; 95% confidence interval: 1.4, 2.2). Maternal C677T homozygosity also appears to be a moderate risk factor (pooled odds ratio = 2.0; 95% confidence interval: 1.5, 2.8). The A 1298C allele combined with the C677T allele also could be associated with an increased risk for spina bifida. Some data suggest that the risk for spina bifida associated with C677T homozygosity may depend on nutritional status (e.g., blood folate levels, intake of vitamins) or on the genotype of other folate-related genes (e.g., cystathionine-beta-synthase and methionine synthase reductase). Studies of the C677T allele in relation to oral clefts, Down syndrome, and fetal anticonvulsant syndrome either have yielded conflicting results or have not been yet replicated.