气管颗粒细胞瘤1例报告及文献复习

颗粒细胞瘤（ＧｒａｎｕｌａｒＣｅｌＴｕｍｏｒ，ＧＣＴ）是一种罕见的肿瘤。常发生于舌、皮肤及皮下组织、乳腺等部位。呼吸道ＧＣＴ发生率低，若累及呼吸道则以喉和支气管较多见。原发部位位于气管的ＧＣＴ极少，截止到１９８６年英文文献仅有１０例气管ＧＣＴ报道，国内近１３年未有气管颗粒细胞瘤报道，。本文报道１例３０岁女性气管ＧＣＴ患者，结合文献对气管ＧＣＴ的组织发生、临床表现、病理特点、诊断与鉴别诊断以及治疗方法等问题进行讨论。     

脉冲角加速度刺激诱发豚鼠短潜伏期前庭诱发电位

以脉冲角加速度刺激在豚鼠记录出短潜伏期诱发反应，反应由发生于刺激开始后10ms以内的5～7个波组成，高强度刺激时反应振幅数微伏，I波潜伏期约2．5ms，不同动物及同一动物不同时间测试反应非常稳定。系列实验结果表明脉冲角加速度刺激诱发的豚鼠短潜伏期诱发反应系前庭诱发电位。     

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。     

糖尿病合并妊娠伴视网膜病变孕妇的临床观察

目的：研究糖尿病合并妊娠伴视网膜病变孕妇的妊娠结局及孕期视网膜病变。方法：回顾性分析１９８１～１９９５年间４９例糖尿病孕妇妊娠情况。伴视网膜病变的１６例分为第Ⅰ组；无视网膜病变的３３例分为第Ⅱ组。第Ⅰ组糖尿病病程平均为８．９２±４．３５年；第Ⅱ组为３．１１±１．７４年。结果：第Ⅰ组孕妇并发症及围产儿发病率较高，但两组比较，差异无显著性（Ｐ＞０．０５）。３１．１％孕妇视网膜病变在孕期加重，但仍属单纯型（背景期）。结论：糖尿病合并妊娠伴眼底病变时，仍可以继续妊娠，但孕期应密切观察眼底变化和严格控制血糖。     

长期应用小剂量米非司酮对子宫内膜形态和雌、孕激素受体的影响

本文利用HE染色和免疫组化方法结合计算机辅助图象分析技术观察了长期服用小剂量米非司酮对子宫内膜形态和雌、孕激素受体（ER、PR）的影响，15例子宫肌瘤患者于早卵泡期服用来非司酮（10例，10mg／日；5例，20mg／日）治疗，1～3个月后取内膜，另10例肌瘤患者取内膜作对照。结果：用药后所有的患者均闭经，内膜变薄，发育不良，无周期性改变，大部分基质致密，基质与腺体发育不同步，同时相间存在增殖与分泌期样改变，以增殖期样改变为主，腺体以分泌期样改变为主，腺体大小形态不一，但分泌不良。免疫组化显示内膜ER、PR明显分布不均，图象分析结果表明用药后内膜ER、PR相当于对照组增殖早中期水平。结果表明每日10mg米非司酮可明显抑制排卵并影响内膜成熟，在无孕激素存在的情况下，米非司酮有微弱的孕激素样作用。     

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.     

不同方法肺活检的评价

总结肺活检１００例，其中经皮穿刺肺活检５８例，分别在Ｘ线，ＣＴ，Ｂ超引下进行，经纤维支气管镜肺活检４２例，总诊断准确率为７８％，其中肺癌诊断准确度为７８．２％，良性病变为７７．８％，全组并发症总发生率为２６％，并对各种方法肺活检的临床价值进行了分析。     

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     

活性碳纤维对NO2气体动态吸附研究

为探讨粘胶基活性碳纤维（ＡＣＦ）对ＮＯ２气体的动态吸附，考察了ＮＯ２浓度、流速、湿度、温度及ＡＣＦ再生次数对吸附效率的影响。结果表明：ＮＯ２在低浓度下，ＡＣＦ能长时间高效工作；流速增加，穿透时间缩短，但穿透吸附量变化不明显；湿度增加，穿透时间缩短，穿透吸附量降低；温度升高、ＡＣＦ再生次数增加，穿透时间缩短，穿透吸附量及饱和吸附量均降低。证明ＡＣＦ对ＮＯ２的吸附以物理吸附为主，但存在一定程度的化学吸     

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.