喉癌下咽癌患者一级亲属染色体对致突变物的敏感性研究

Several investigations revealed that lymphocytes from patients with head and neck cancers showed a high sensitivity to mutagens. However, whether lymphocytes from healthy blood relatives of the patients were sensitive to mutagen or not had not been reported. This study was aimed to investigate the unknown problem. Mutagen sensitivity was investigated in 116 laryngeal and 38 hypopharyngeal cancer patients, 107 healthy controls, and 30 blood relatives of laryngeal or hypopharyngeal cancer patients. Chromosome damage was measured by enumerating mutagen-induced chromatid breaks, the average number of chromatid breaks per cell (b/c value) was used as marker which reflects variable host susceptibility to the action of environmental carcinogens. The b/c values were 0.61 +/- 0.27, 0.66 +/- 0.31, 0.28 +/- 0.12, and 0.45 +/- 0.26 for patients with laryngeal cancer, hypopharyngeal cancer, healthy controls, and blood relatives respectively. A significant difference of b/c value was found between patients and controls (P < 0.01), but not between patients and their blood relatives (P > 0.05). Our findings suggest that genetic predisposition plays an important role in the eitiology of laryngeal and hypopharyngeal cancers. Both patients with laryngeal or hypopharyngeal cancers and their blood relatives should be considered as in high cancer risk.     

鼻咽分泌物中β2微球蛋白测定的临床意义

To study its clinical significance, beta 2-microglobulin (beta 2-MG) in nasopharyngeal secretion was examined using radioimmunoassasy methods in 73 patients with nasopharyngeal carcinoma (NPC), 30 with chronic nasopharyngitis and 30 normal control subjects. In 31 NPC patients, the examination was repeated before and after radiotherapy. The average concentrations of beta 2-MG were 4.87 +/- 2.51 mg/L in NPC group, 1.05 +/- 0.64 mg/L in chronic nasopharygitis group, and 0.85 +/- 0.32 mg/L in the control. The beta 2-MG concentration was higher in the NPC patients than in both chronic pharyngitis patients and normal subjects (P < 0.01). The concentration was lowered down in NPC patients after radiotherapy, and remained high when the treatment failed to control the condition. It seems that beta 2-MG level in nasopharyngeal secretion is closely related to the prognosis and recurrence of nasopharyngeal carcinoma.     

慢性鼻窦炎内窥镜手术上颌窦粘膜扫描电镜观察

为了对行内窥镜鼻窦手术的慢性鼻窦炎患者上颌窦粘膜的术后超微结构变化进行评价，利用扫描电镜及图像分析技术对１６例（２０侧）术中和术后上颌窦粘膜及自然孔粘膜的纤毛面积进行定量测定。发现术前上颌窦及其自然孔粘膜纤毛细胞明显减少，杯状细胞，微绒毛细胞增多，部分病例有鳞状上皮化生。术后６个月￣１年，大部分病例受损的纤毛细胞明显恢复，纤毛细胞覆盖面积增加，有统计学意义，通过内窥镜手术，改善上颌窦的通气、引流、     

听神经瘤引起突发性听力减退

为了避免听神经瘤的误诊误治，对１９８６￣１９９５年收治听神经瘤１０４例中２３例（２４耳）首发症状表现为突发性听力减退者（占２３％）的病例进行分析。听力学检测：纯音听阈〉７１ｄＢ ＨＬ者１３耳，占５４．２％，听性脑干反应（ＡＢＲ）检测均有异常；耳蜗电图－ＳＰ／ＡＰ检测９耳中７耳〉０．４，占７７．８％，声反射检测１１耳均消失。眼震电图检测１８例，１７例异常（占９４．４％），影像学检查ＣＴ阳性率８８．８     

白细胞介素6和肿瘤坏死因子—α在分泌性中耳炎渗出液中表达及…

Using enzyme-linked immunosorbant assay (ELISA), we measured levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) in middle ear effusions (MEE) from patients with secretory otitis media (SOM) undergoing auripuncture to study the role of cytokines in the pathogenesis of the disease. Significant levels of IL-6 (> 62.5 ng/L) were found in 19 (86.36%) of 22 MEEs and those of TNF-alpha (> 37.5 ng/L) in 19 (70.37%) of 27 MEEs. The mean (+/- s) levels of IL-6 and TNF-alpha were 507.68 +/- 813.11 ng/L and 186.86 +/- 166.93 ng/L, respectively. It revealed that the shorter the course, the higher the concentration of IL-6 in MEE: the longer the course, the higher the concentration of TNF-alpha in MEE. These findings suggested that during the early stages of SOM, IL-6 might participate in the defensive reaction of organism, while TNF-alpha might be closely related to the persistence of SOM, resulting in an excessive inflammatory reaction with a potential for pathological changes. It is concluded that the immunological mechanisms probably play a significant role in the pathogenesis of SOM.     

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￣     

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。     

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。     

扁桃体周脓肿感染途径的探讨

为探讨扁桃体周脓肿的真正发病机理、感染途径，对连续诊治的１３１例扁周脓肿患者进行研究。其中８３例患侧的扁桃体被切除，切除之扁桃体外侧面均平整。通过８３例组织学观察，扁桃体上极表面既无扁桃溃破亦无脓瘘，邻接扁桃体上方之软腭粘膜下发现有感染及／或纤维化的小唾液腺（Ｗｅｂｅｒ腺），这些与扁桃体相邻的腺体在其他非扁周脓肿患者则显示正常形态与结构。从而认为扁桃体周围的化脓性感染可能与Ｗｅｂｅｒ腺有关，而非急性扁桃体炎。主张早期扁桃体切除术治疗扁周脓肿，目的在于获得充分引流。