Prader-Willi综合征分子分型诊断方法的初步研究

 【目的】探讨Prader—Willi综合征（PWS）的短串联重复序列（STR）连锁分析诊断方法，为遗传咨询提供相关信息。【方法】对一例临床疑似病例经甲基化特异性PCR（MS—PCR）确诊为PWS后．应用15号染色体特定区域的STR进行家系连锁分析，探讨其在PWS分子缺陷类型诊断方面的可行性。【结果】STR连锁分析结果显示该患者为父源缺失型PWS。【结论】STR连锁分析是一种可准确诊断PWS并明确其分子缺陷类型的好方法：国人相关区域的STR位点及其多态信息等有待进一步研究．以完善并最终建立该方法。     

应用复合荧光标记STR—PCR排除绒毛取材中母体细胞污染

【目的】探讨复合荧光标记STR—PCR鉴别胎儿取材中母体细胞污染的价值。【方法】复合荧光标记STR—PCR检测16个基因座，针对常见STR基因座进行多态性分析，比较52例待鉴定绒毛样品的谱带。【结果】52例标本中，有46例无母体细胞污染，5例为母体细胞污染，1例是全部为母体细胞。鉴定结果与随访结果一致。【结论】用复合扩增荧光标记STR—PCR方法可准确判断胎儿取材中有无母亲DNA的污染。     

中国海南黎族人群15个STR位点的遗传多态性

【目的】研究海南黎族族人群15个STR位点D3S1358、TH01、D21S11、D18S51、VWA、CSFlPO、D8S1179、TPOX、FGA、D5S818、D13S317、D7S820、D16S539、D19S433、D2S1338的遗传多态性。【方法】通过人类短串联重复序列（short tandem repeat，STR）复合扩增、基因扫描、基因分型调查了110名黎族无关个体15个STR位点等位基因分布情况。【结果】15个STR位点均符合Hardy—Weinberg平衡，共检出149个STR等位基因，其频率分布在0．0045-0．5045之间，杂合度（heterozygosity，H）为0．6716～0．8754，个体识别力（discrimination power，DP）为0．8770～0．9673，非父排除率（probabilities of pakmity exclusion，EPP）为0．4383～0．7396，多态信息含量（polymorphic information content，PIC）为0．6265～0．8574。【结论】选用的15个STR位点均能检出等位基因遗传多态性。并具有较丰富的信息含量，为进一步研究中华民族STR遗传结构提供了基础资料。     

B细胞淋巴瘤SHP-1基因甲基化状态及其意义

【目的】探讨JAK／STAT信号转导途径负调控子SHP-1基因启动子区域CpG岛异常甲基化在B细胞淋巴瘤中的意义。【方法】收集存档石蜡包埋组织标本61例（S2例B细胞非霍奇金淋巴瘤标本，9例良性增生淋巴结标本），健康人外周血单个核细胞DNA标本15例，用甲基化特异性PCR（methyhfion—specmc PCR，MSP）和非甲基化特异性PCR（unmethylation—specific PCR，an—MSP）检测SHP-1启动子区域CpG岛甲基化状态，MSP、un—MSP和RT—PCR方法分别检测接受或未接受去甲基化处理的Burkitt淋巴瘤细胞系Raii的甲基化状态及mRNA的表达，MTr法检测接受去甲基化干预后细胞生长受抑情况。【结果】SHP-1基因启动子区域在弥漫性大B细胞淋巴瘤和滤泡性淋巴瘤甲基化频率分别为94％及97％。对照组9例淋巴结良性增生标本和15例正常人外周血单个核细胞标本中SHP-1基因启动子区域甲基化频率为0。经去甲基化干预后，Raji细胞SHP-1基因启动子区域呈去甲基化状态，基因恢复表达，细胞生长受到抑制。【结论】SHP-1基因启动子区域启动子区域CpG岛在B细胞淋巴瘤中存在高度甲基化，由其所致的SHP-1基因沉默可能是B细胞淋巴瘤发生的一个重要因素，SHP-1基因的甲基化可作为一个良好的分子诊断标记及可能的治疗靶点。     

PCR-STR和PCR-SSCP方法对苯丙酮尿症基因诊断的意义

①目的 探讨苯丙酮尿症的基因诊断方法。②方法 采用聚合酶链反应－短串联重复序列（PCR－STR）连锁分析技术和聚合酶链反应－单链构象多态（PCR－SSCP）分析技术,对5个苯丙酮尿症家系中17个成员的苯丙氨酸羟化酶基因突变进行分析。③结果 用PCR－STR法能准确进行基因诊断的家系3个,50％能排除诊断的家系3个;用PCR－SSCP法检出3例已知突变。④结论 联合应用PCR－STR和PCR－SSCP技术可以提高苯丙酮尿症的基因诊断率。     

优选短串联重复序列应用于脊肌萎缩症产前诊断的连锁分析

目的建立完整的适合汉族人群的脊肌萎缩症（SMA）产前基因诊断体系。方法对30名正常汉族人的外周血样本进行基因多态性分析,评估位于运动神经元存活基因1（SMN1）两侧的短串联重复序列（STR）位点的多态信息含量;并通过在6个SMA产前诊断家系连锁中的应用,优选出STR位点,并结合PCR酶-切法（PCR-RFLP）进一步评价STR位点与SMN1基因的连锁紧密性。结果从7个STR位点中优选出D5S435、D5S629、D5S610和D5S351四个STR位点用于家系连锁分析,联合PCR-RFLP,在6名待检胎儿中检出2例患者和4例携带者。结论通过优选出的4个多态性强、与SMN1基因紧密连锁的STR位点,联合家系连锁和PCR-RFLP,建立起稳定可靠的适合汉族人群的SMA产前基因诊断体系。     

前列腺特异性膜抗原新型剪接变异体PSM-E在外周血的定量表达

【目的】检测分析前列腺特异性膜抗原（PSMA）及其新型剪接变异体（PSM．E）在前列腺癌（PCA）及良性前列腺增生（BPH）患者外周血中的表达,探讨其意义。【方法】通过实时荧光定量PCR方法对PSM—E、PSMA在前列腺癌（53例）和前列腺增生（79例）两组患者外周血中定量表达,分析其差异。【结果】PSM．E相对表达量在PCA组（-8．22±0．32）高于BPH组（-9．99±0．41）,P〈0．001;PSMA相对表达量在PCA组（-12．514-0．31）高于BPH组（-13．72±0．48）,差异有统计学意义,P〈0．05;PCA组和BPH组内PSMA与PSM—E相对表达量有相关性（r=0．36,P〈0．05;r=0．65,P〈0．01）,与血清PSA均不相关。【结论】外周血定量检测PSM—E表达差异可用于区分良性前列腺增生和前列腺癌;与PSMA相比PSM．E表达量更高,其检测的灵敏度更高,PSM—E诊断前列腺癌的敏感性和特异性更好。     

促性腺激素释放激素受体在EMS患者子宫内膜的表达

【目的】检测促性腺激素释放激素受体（GnRH—R）在子宫内膜异位症（EMS）患者子宫内膜组织的表达，探讨其存在的意义。【方法】应用免疫组化和巢式PCR方法，从蛋白和mRNA水平检测GnRH—R表达。【结果】GnRH—R蛋白在EMS和对照组在位子宫内膜组织及体外培养子宫内膜细胞中持续表达；在异位内膜组织中的表达率为54．2％，低于对照组（P〈0．01）。GnRH—R mRNA的表情况与蛋白相符。【结论】在EMS在位、异位内膜存在着GnRH—R的自／旁分泌调节，GnRH—R可能成为临床GnRH类似物（GnRH—α）治疗的靶点。     

不同区域晶状体上皮细胞基因表达差异分析

【目的】比较不同区域猪晶状体上皮细胞的基因表达在转录组水平上的差异。【方法】解剖显微镜下分离晶状体前囊膜，将附着于其上的上皮细胞分为中央（直径为10．56mm）和周边两部分。分别提取两个样本的总RNAs并经PCR扩增，以Cy3和Cy5分别标记扩增的中央与周边部分的cDNA。与含7548个基因的表达谱芯片杂交，经图像分析，生物信息学处理获得基因表达在转录水平差异的相关信息。【结果】中央与周边区域的猪晶状体上皮细胞在转录组水平共鉴定出952个有效表达的基因点，其中差异表达基因261个．以中央区域为参照，周边上皮细胞mRNA上调137个，下调124个。差异表达基因主要涉及的功能有：细胞周期与凋亡、细胞骨架蛋白及细胞外基质、转录、细胞信号分子等。【结论】中央与周边区域猪晶状体上皮细胞基因表达在转录组水平上差异明显。这类差异呈明显的功能聚类。     

白细胞介素-1B-511T／C多态性与不同临床病理学类型胃癌的关系

【目的】研究中国人白细胞介素（IL）-1B-511T／C多态性与不同临床病理学特征胃癌的遗传易感性的关系及其对胃癌患者预后的影响。【方法】采用聚合酶链反应-限制性长度片段多态性（PCR．RFLP）对563例胃癌及500例健康对照进行IL—1B～511位点基因分型,分析该多态性与不同临床病理学类型胃癌发病风险关系并对其预后进行生存分析。【结果】IL-1B-511T／C多态性与胃癌遗传易感性相关,携带IL-1B-511T等位基因者发生胃癌的风险较CC基因型增加（OR=1．60,95％CI=1．19—2．16,P=0．0019）,T等位基因显著增加老年病人（至65岁）胃癌发病风险（OR=2．35,95％CI：1．29．4．28,P=0．006）。T等位基因与肠型胃癌（OR=1．63,95％CI：1．18～2．24,P=0．003）及低分化胃癌（OR=1．74,95％CI=1．24～2．43,P：0．001）相关。IL-1B-511不同基因型患者胃癌的生存率无统计学差异。【结论】IL-1B-511T等位基因可能增加胃癌的发病风险,且与某些临床病理学特征有关,但并非影响胃癌患者预后的独立危险因素。     

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.     

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…     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.