广东汉族人群HLA-ABDR基因频率分析

目的　检测广东汉族人群HLA -A ,B ,DRB1基因频率 ,分析该人群HLA等位基因多态性及其特点。方法　肾移植、骨髓移植供者 4 0 4例 ,抗凝血提取DNA ,半量全自动PCR -RSSO分型检测HLA -A ,B ,DRB1基因型。结果　在中分辨水平检出HLA -A等位基因 15个 ,HLA -B等位基因 31个 ,HLA -DRB1等位基因 13个。广东汉族人群HLA -A 11(0 .3342 ) ,A 0 2 (0 . 30 87) ,A 2 4 (0 . 2 2 16 ) ;HLA -B 6 0 (0 16 81) ,B 4 6 (0 . 16 81) ;HLA-DRB1 0 9(0. 175 5 ) , DRB1 15 (0 .14 90 ) ,DRB1 12 (0 . 1192 ) ,DRB1 14 (0 1192 ) ,DRB1 0 4 (0 .10 6 7)具有较高的基因频率分布 (>0. 10 )。Hardy -Weinberg平衡检验 :HLA -A(χ2 =6 0 .35 ,υ =5 4 ,P >0 1) ,B(χ2 =173. 6 7,υ =4 6 5 ,P >0 . 1) ,DRB1(χ2 =78. 4 6 ,υ =78,P >0 . 5 ) ,期望值和观察值吻合良好。结论　广东汉族群体HLA基因具有较为丰富的多态性 ,该人群HLA -A、B、DRB1等位基因处于遗传平衡状态 ,其基因频率分布具有地区性遗传特征。     

慢性乙型肝炎与HLA-DRB1等位基因的相关性研究

目的　探讨慢性乙型肝炎与HLA -DRB1等位基因多态性的相关性 ,寻找慢性乙型肝炎的易感基因或抗性基因 ,为临床诊断和预后评估提供线索。方法　采用聚合酶链反应 -序列特异性引物 ( polymerasechainreaction -sequencespecificprimers ,PCR -SSP)技术 ,检测 5 1例慢性乙型肝炎患者和 5 1例健康对照组的HLA -DRB1等位基因多态性。结果　本地区一般健康人群中以HLA -DRB1 15等位基因最常见 ,频率为 16.67%。慢性乙型肝炎组的HLA -DRB1 0 3等位基因频率为 12 .75 % ,显著高于健康对照人群 3 .92 % ( χ2 =5 .2 0 ,P <0 .0 5 ) ,相对危险度为 3 .5 8。其他等位基因频率在两组间的差异无显著性。结论　HLA -DRB1 0 3等位基因与慢性乙型肝炎的易感性呈相关性 ,可能为本地区慢性乙型肝炎的易感基因。     

广东汉族人群HLA单倍型遗传中基因重组的研究

目的 分析广东汉族人群人类白细胞抗原(HLA)Ⅰ、Ⅱ经典5位点A、Cw、B、DRB1及DQB1的连锁单倍型及单倍型遗传中基因重组事件.方法 采用聚合酶链反应-序列特异性寡核苷酸探针(PCR-SSO)法及聚合酶链反应-序列特异性引物(PCR-SSP)法,分别对2000年8月至2009年12月深圳市血液中心进行HLA配型的198个广东汉族家系共939名个体的外周血样本进行HLA-A、B、DRB1位点及HLA-Cw、DQB1位点的低分辨基因分型,再通过遗传家系分析确定HLA基因重组相关位点;对其中发生基因交换重组的52名家系成员的样本进一步采用基因测序分型(SBT)技术进行序列分析,以判断重组交换是否发生在某基因座位上.结果 198个广东汉族家系543名子一代个体中,发现有9名个体HLA单倍型基因座位发生了交换重组,频率为1.657%.3例为A/Cw座位间的交换,6例为B/DRB1座位间的交换.其中4例重组事件发生在广东汉族人群最常见的单倍型A*3303-Cw*0302-B*5801-DRB1*0301-DQB1*0201上.在9例重组事件中有5例来自母系染色体交换,4例来自父系染色体交换;3例表现为A/Cw座位间交换的个体均为女性,6例表现为B/DRB1座位间交换的个体中5例为男性、1例为女性.结论 HLA连锁单倍型遗传过程中的基因重组主要见于A/Cw座位间及B/DRB1座位间,且基因重组的发生具有单倍型特异性及性别特异性.     

辽宁地区汉族人群HLA-DRB1位点的测序分型研究

[目的 ]调查辽宁地区人群人类白细胞抗原 (humanleukocyteantigen ,HLA)DRB1位点等位基因多态性 ,获得完整准确的遗传学数据。 [方法 ]应用聚合酶链反应 -直接测序方法 (PCR -SBT)对 1 0 8名健康个体进行HLA -DRB1基因型检测。 [结果 ]检出DRB1等位基因亚型 33个 ,其中等位基因DRB1 0 70 1 1 , 1 5 0 1 1 , 0 90 1 2 , 1 1 0 1 1 , 1 2 0 2 1的频率较高。 [结论 ]提供了辽宁汉族人群HLA -DRB1位点等位基因频率 ,证实了PCR -SBT分型方法快速准确的优点     

山东临沂地区汉族人群HLA-A、B、DRB1位点基因多态性研究

[目的]了解山东临沂汉族人群HLA-A、B、DRB1等位基因分布特征.[方法]采用聚合酶链反应-序列特异性寡核酸探针方法(PCR-SSOP)对4035份山东临沂地区汉族人进行HLA分型.计算HLA等位基因频率,并与辽宁省、山东省、重庆市、海南省汉族人群HLA等位基因频率进行比较.[结果]共检出HLA-A、B、DRB1位点等位基因63种,其中基因频率高于10%的分别是:A*02(27.3978%)、A*24(14.6240%)、A*11(14.2131%)、A*30(11.5861%)、A*33(11.5613%)、B*13(15.8736%)、B*15(12.9864%)、B*40(11.5118%)、DRB1*15(18.3271%)、DRB1*07(15.3160%)、DRB1*04(10.7683%),其中A*02、A*11、A*24、A*30、A*33、B*07、B*13、B*15、B*40、B*44、B*46、DRB1*07、DRB1*09、DRB1*12、DRB1*13、DRB1*14等位基因频率与中国其他地区汉族人群比较差异有显著性意义(P<0.005).[结论]山东汉族临沂地区汉族人群HLA-A、B、DRB1等位基因分布具有高度多态性并且具有自身的分布特点.     

湖南汉族群体HLA-DR2等位基因多态性与系统性红斑狼疮的相关性研究

以HLA DRB基因类扩增为参照 ,通过HLA DR2组特异性扩增确定HLA DR2携带者 ,PCR/SSP作亚型分型 ,并用银染PCR/SSCP分析HLA DR2等位基因第二外显子单链构像 ,调查湖南地区汉族群体SLE(系统性红斑狼疮 )患者 5 8例和健康对照 5 9例HLA DR2等位基因分布。结果示 ,HLA DR2与SLE相关 (RR =2 .71,P <0 .0 1) ,HLA DRB1 15 0 1为疾病相关等位基因 (RR =3 .10 ,Pc <0 .0 5 ) ,该群体中检出的另外两种亚型DRB1 15 0 2 ,160 2在两组间频率分布差异无显著性。此外 ,PCR/SSCP分析表明湖南汉族HLA DR2等位基因在第二外显子内不存在其他序列变异。     

宁夏回族HLA-A，B，DRB1基因座遗传多态性和单倍型分析

目的:研究宁夏回族自治区地区回族人群HLA-A,B,DRB1基因座的等位基冈及其组成的单倍型频率分布特征.方法:采集宁夏回族122名无关健康个体静脉血,应用聚合酶链反应一序列特异性引物方法对其HLA-A,B和DRB1基因座进行基冈分型.直接计数法统计基因频率,采用最大数学预期值算法计算HLA单体型频率.结果:122名宁夏回族个体的HLA-A,B,DRB1基因座分别检出14,29,13个等位基因.高频等位基因分别为HLA-A*02;HLA-A*11:HLA-A*24;HLA-A*03,HLA-B*35;HLA-B*46;HLA-B*13;HLA-B*51,HLA-DRB1*15;HLA-DRB1*09;HLA-DRB1*07;HIA-DRB1*12.高频单倍型分别为HLA-A*02-B*46:HLA-A*11-B*60;HLA-A*02-B*51;HLA-B*46-DRB1*09;HLA-B*13-DRB1*07;HLA-B*58-DRB1*17;HLA-A*02-B*46-DRB1*09;HLA-A*02-B*58-DRB1*17;HIJA-A*02-B*13-DRB1*12.结论:宁夏回族自治区回族人群HLA基凶座的等位基因和单倍型具有较高的遗传多态性.HLA-A*01-B*37,HLA-A*30-B813,HLA-A* 02-B*50,HLA-B*31-DRB1-10在该民族具有极强的连锁不平衡.     

中国湖北汉族人群HLA-DRB1基因多态性研究

目的:调查湖北汉族人群人类白细胞抗原(HLA)-DRB1基因多态性,获得完整准确的遗传学数据。方法:应用序列特异性引物聚合酶链反应(PCR-SSP)方法对213名随机选取无亲缘关系的湖北籍汉族健康体检者或健康献血员进行HLA-PDRB1基因型检测。结果:在213名正常个体中,发现基因频率(GF)较高的有DRB1*1501-1502(GF=11.0%)、*1101-1105(GF=8.5%)、*0901(GF=6.8%)、*1301-1302(GF=6.6%)、DRB4*0101(GF=19.0%)、DRB5*0101(GF=16.9%),低频率等位基因是DRB1*04、*1001和*0101-0103。结论:从基因水平分析了HLA-DRB1基因在湖北汉族群体中的分布特征,提供了一套比较完整准确的DRB1基因频率,为人类学和疾病相关性等研究提供了重要的参考数据。     

广东汉族人群人类白细胞抗原-A,B及DRB1基因多态性和单倍型分布

目的分析广东汉族人群人类白细胞抗原(HLA)-A、B、DRB1基因和单倍型的分布特征。方法根据3 275名广东汉族无关骨髓供者的HLA基因型数据,采用最大似然性方法计算HLA-A、B、DRB1的基因频率和单倍型频率。结果广东汉族人群中共检出73个HLA基因(或抗原),其中A*02、A*11、A*24、A*33、B*46、B60、B*13、B75、B*58、DRB1*09、DRB1*15、DRB1*04、DRB1*08和DRB1*12最常见;385条A-B单倍型中,20条频率高于0.01并至少有25条单倍型为显著性正连锁不平衡;458条B-DR单倍型中,24条频率高于0.01并至少可见37条单倍型为显著性正连锁不平衡;2 836条A-B-DR单倍型中,仅487条单倍型的频率有价值(大于等于3.05×10-4),36条常见单倍型中A2-B46-DR9和A33-B58-DR17频率最高。结论广东汉族人群HLA-A、B、DRB1基因和HLA单倍型的分布有其自身特点,本研究所获得的HLA-A、B、DRB1基因和单倍型频率可作为广东汉族人群的参考标准。     

福建汉族慢性粒细胞性白血病患者HLA-DRB1基因分析

目的　探讨HLA DRB1基因多态性与慢性粒细胞性白血病 (CML)的关联。　方法　聚合酶链反应 序列特异引物 (PCR SSP)方法对 33例CML患者 (实验组 )和 10 4例健康志愿者 (对照组 )的HLA DRB1基因进行分型并分析HLA DRB1基因在二组间的分布。　结果　与对照组相比 ,CML患者的HLA DRB1 0 9的基因频率明显增高 ,RR =3 14 ,χ2 =7 82 ,P <0 0 1,其他等位基因频率在实验组与对照组间差异无显著性。　结论　福建汉族人群中HLA DRB1 0 9与慢性粒细胞性白血病有关联。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.