高亲和度IgE受体β链基因多态性与过敏性哮喘相关性的研究

目的：检测Fcepsilon RI-beta三个突变位点H81L，V183L和E237G在中国南方汉族人群中的存在和频率分布；判断这些突变与哮喘及特应症的相关性。方法：利用扩增阻滞突变系统聚合酶使技术(ARMS—PCR)对60例哮喘患者Fc epsilon RI-beta基因编码181，183和237的三个氨基酸位点进行分析和检测，并与65例正常人进行对照。结果：在哮喘组中检测到1例1181L杂合子，被检人群中没有发现V183L突变。Glu237／C1y237在哮喘人群中的频率是18．3％，E237G突变基因频率为9．2％；Glu237／C1y237在特应性哮喘人群中的频率是22．6％E237G突变的基因频率为11．3％，G1u237／G1y237在正常对照人群中的频率是6．2％E237G突变的基因频率为3．1％。结论：在中国南方汉族人群中存在E237G突变。不存在V183L突变或突变率很低。E237G突变与哮喘有相关性(P＜0．05 OR＝3．18)；E237G突变与特应症有相关性(P＜0．025 OR＝4．00)，I181L突变的存在不确定。     

哮喘患者IgE高亲和力受体β链基因E237G突变的研究

目的:探讨哮喘患者IgE高亲和力受体β链基因(FcεRI-β)E237G位点多态性与支气管哮喘的相关性.方法:采用扩增阻滞突变体系聚合酶链反应(ARMS-PCR)结合琼脂糖凝胶电泳的方法,对69例支气管哮喘患者FcεRI-β链基因E237G位点突变检测,并与28名正常者进行对照.结果:在69名哮喘患者中共检测到8例E237G位点变异,概率为11.6%,其中EG型5例,占7.25%,GG型3例占4.35%.而28例正常对照组中检出1例EG型E237G位点变异,概率为3.57%.将哮喘人群E237G变异率与健康对照组比较,差别无显著性(P＞0.05).IgE升高人群与IgE正常人群间E237G突变率亦无显著差异.结论:本研究未能证实FcεRI-β链基因E237G位点变异与支气管哮喘或血清IgE升高相关联.     

河南省汉族儿童哮喘易感基因多态性分布特征分析

目的研究河南地区汉族儿童哮喘易感基因多态性的频率分布特点,为本地区哮喘的个体化治疗提供新的理论基础。方法选择2018年10月至2019年4月于郑州大学第一附属医院门诊确诊的506例哮喘患儿,并收集其颊黏膜脱落细胞。对IL-13 A2044G、IL-4 C590T、ADRB2 R16G、FcεRIβ E237G这4种哮喘相关基因位点进行检测,统计分析河南地区汉族儿童哮喘基因多态性的频率分布特点,并检索中外文数据,对河南省ADRB2 R16G基因型频率与其他地区数据比较,作进一步分析。结果河南省汉族儿童的IL-13 A2044G位点AA、AG和GG基因型频率分别为12.6%、44.7%和42.7%,IL-4 C590T位点TT、CT和CC的基因型频率分别为63.1%、31.4%和5.5%,ADRB2 R16G位点AA、AG和GG基因型频率分别为30.4%、50.4%和19.2%,FcεRIβ E237G位点AA、AG和GG基因型频率分别为72.1%、24.7%和3.2%。河南地区与南京、贵州、保山地区ADRB2 R16G基因型频率分别比较,差异无统计学意义(均P>0.05);河南省ADRB2 R16G基因型频率与毛里求斯印第安相比,差异有统计学意义(P<0.05)。结论河南省汉族儿童IL-13、IL-4、ADRB2、FcεRIβ基因多态性频率有其自身一定特点,IL-4 C590T位点的风险基因型(TT)在河南省比例最高;ADRB2基因型的分布在不同地域、种族中可能存在差异。     

IL-13、IL-4、ADRβ2、FcεRI-β单核苷酸多态性与儿童反复喘息发作疗效及临床转归的关系

目的 了解白细胞介素-13(IL-13)、白细胞介素-4(IL-4)、肾上腺素能受体β2(ADRβ2)、免疫球蛋白E高亲和力受体β链（FcεRI-β）单核苷酸多态性（SNP）与儿童反复喘息发作的疗效及临床转归的关系。方法 选取60例喘息性支气管炎反复喘息发作患儿作为研究对象,设计IL-13 rs20541、IL-4 rs2243250、ADRβ2 R16G、 FcεRI-β E237G位点的引物,检测IL-13、IL-4、ADRβ2、FcεRI-β基因多态性,分析各基因位点SNP与患儿疗效及临床转归的关系。结果 IL-13 rs20541野生型AA和杂合型GA的治疗总有效率高于纯合型GG(P<0.01);ADRβ2 R16G不同基因型之间的治疗有效率比较差异有统计学意义（P<0.01）,其中基因型GG的治疗有效率显著高于基因型AA、AG(P<0.05);FcεRI-β E237G治疗有效率比较AA>AG> GG(P<0.05)。IL-13 rs20541野生型AA和杂合型GA发生持续性哮喘的概率低于纯合型GG(P<0.05);ADRβ2 R16...     

FcεR Ⅰ受体α亚基的重组表达、单克隆抗体的制备及特异性鉴定

目的 通过基因重组的方法表达IgE高亲和力受体FeεR Ⅰα亚基,并用重组蛋白制备单克隆抗体.方法 用RT-PCR的方法从过敏性疾病病人外周血嗜碱性粒细胞调取FcεR Ⅰα蛋白基因,经T-A克隆、亚克隆至pET28a( )原核表达载体,将重组质粒转化到大肠杆菌BL-21-STAR(DE3),IPTG诱导表达FeεR Ⅰα亚基蛋白,通过Ni-NTA亲和层析纯化融合蛋白;并用其免疫BALB/c小鼠,运用杂交瘤技术制备抗FcεR Ⅰα亚基单克隆抗体,用细胞免疫荧光法对单克隆抗体的特异性进行鉴定.结果 成功调取了人IgE高亲和力受体FcεRⅠα亚基的基因,且测序正确;构建原核表达质粒FcεR Ⅰα-pET28a( );成功建立4株稳定分泌抗FcεR Ⅰα亚基的单克隆抗体杂交瘤细胞株,分别命名为G101、C22、G113、G42.通过细胞免疫荧光实验证实,4株单克隆抗体均能特异性结合人嗜碱性粒细胞表面的FcεR Ⅰα亚基.结论 成功利用基因重组技术制备了FcεR Ⅰα亚基蛋白,制备了4株效价高、特异性好的抗FcεR Ⅰα亚基单克隆抗体,为FeεR Ⅰα亚基及其抗体在过敏性疾病中的生物学功能研究奠定了基础.     

IgE高亲和力受体FcεRⅠ与过敏性疾病的治疗

IgE在一系列急慢性过敏反应如哮喘、变应性鼻炙、异位性皮炎、莩麻疹等疾病中发挥重要作用.IgE与靶细胞上高亲和力受体Fc epsilon RⅠ(FcεR Ⅰ)的结合被认为是Ⅰ型变态反应的关键步骤,FcεR Ⅰ功能主要是传递信号导致介质和细胞因子的产生及抗原呈递.通过抑制或者阻断IgE与FcεR Ⅰ的结合治疗过敏性疾病目前倍受国内外学者的关注.     

扶正治标法对青少年花粉症患者相关基因表达的影响

目的:研究中药治疗花粉症的作用机理。方法:选择50例花粉症患者,口服敏康片,治疗6个月后观察疗效及FcεRIβ,IL-4Rα,IL-5Rα,HLA-A基因表达情况,并以20例变应性皮炎和19例正常人为对照,用Northern blot检测FcεRIβ,IL-4Rα,IL-5Rα的变化。用RT-PCR法检测HLA-A,计算相对光密度值。结果:花粉症组患者症状有明显改善(P<0.05),治疗前后血清总IgE比较差异有统计学意义(P<0.01),花粉症组4个基因的表达治疗前与正常人比较,差异均具有统计学意义(P<0.01),治疗后与治疗前比较差异有统计学意义(P<0.01)。变应性皮炎组治疗前FcεRIβ,IL-4Rα与正常组比较差异有统计学意义(P<0.05),治疗前后FcεRIβ比较,差异有统计学意义(P<0.05)。鼻炎组、皮炎组HLA-A相对光密度值均较正常组高,两组治疗前后也有不同程度的改善(P<0.05)。结论:中药可以调整花粉症患者相关基因表达,改善患者过敏体质,缓解临床症状。     

2015年河南省新确证HIV-1感染者耐药传播状况研究

目的调查2015年河南省新确证人类免疫缺陷病毒1型(HIV-1)感染者中HIV耐药株的流行情况。方法对河南省4个地区2015年1—6月新确证HIV-1感染者确证时的信息资料进行整理,随后进行血样采集,基因型耐药检测和数据的分析。结果共收集到117例患者的样本和信息,得到63例患者的基因型耐药检测结果。63例患者中有11例被检测到携带耐药株,耐药传播率为17.46%。男性的耐药传播率高于女性(P<0.05),20~39岁病例的耐药传播率高于其他年龄段(P<0.05),B亚型的耐药传播率高于其他亚型(P<0.05),郑州地区病例的耐药传播率高于其他地区(P<0.05)。非核苷类逆转录酶抑制剂(NNRTI)和核苷类逆转录酶抑制剂(NRTI)耐药突变的发生率分别为15.87%(10/63)、4.76%(3/63)。NRTI耐药突变有M184V、K65R和F227FL,NNRTI耐药突变有V106I/V/M、V179D/V/E、G190E、V108I、Y181C和H221Y。2例病例同时携带NNRTI和NRTI耐药突变。CRF07-BC亚型占比最高,为36.51%(23/63),其次为B亚型[34.92%(22/63)]和CRF01-AE[26.98%(17/63)]。结论河南省新确证HIV-1感染者中已经出现了一定程度的耐药传播,CRF07-BC和CRF01-AE已经成为主流毒株亚型。     

IgE低亲和力受体基因mRNA表达水平与哮喘的关系

目的 探讨IgE低亲和力受c体(FcεRⅡ,CD23)基因表达水平在哮喘组与正常组间有无差异及基因表达与TlgE水平有无相关.方法 逆转录-聚合酶链反应(RT-Pc)检测FcεRⅡ基因表达水平,并用t检验作组间比较;直线相关分析基因表达与TlgE水平的相关性.结果 哮喘组TIgE水平与正常对照组之间差异有显著性(t=5.15,P＜0.01);FcεRⅡ基因表达水平在哮喘组与正常组之间差异有显著性(t=4.20,P＜0.01);在哮喘组与正常对照组中,FcεRⅡ基因表达水平均与TIgE水平间呈正的直线相关.结论 FcεRⅡ基因对血浆TIgE水平有调节作用,其功能变化在哮喘发病中可能有重要作用.     

FcεRⅠβ基因多态性与湖北地区儿童变应性哮喘的关系

目的　探讨IgE高亲和力受体 β链基因 (FcεRⅠβ)启动子 - 10 9位和编码区Glu2 37Gly基因多态性与湖北儿童变应性哮喘及血浆总IgE的关系。方法　采用聚合酶链反应 限制性片段长度多态性技术检测 110例儿童变应性哮喘患者和 92例相匹配对照者FcεRⅠ β基因启动子区 - 10 9位和编码区Glu2 37Gly两位点多态性。结果　①儿童变应性哮喘患者FcεRⅠ β基因启动子区 - 10 9位T/T、T/C和C/C基因型频率是 0 391、 0 4 91和 0 118;与对照相比差异无显著性意义 (χ2 =0 0 2 34,P >0 0 5 ) ,但儿童变应性哮喘组T/T基因型患者血浆总IgE对数值为 2 4 78± 0 94 4 ,与T/C基因型的 2 2 87± 1 114和C/C基因型的 2 315± 0 86 6相比差异具有显著性意义 (F =4 336 ,P <0 0 1)。②FcεRⅠ βGlu2 37Gly位点Glu/Glu、Glu/Gly和Gly/Gly型频率为 0 5 91、 0 36 4和 0 0 4 5 ,与正常对照相比差异具有显著性意义 (χ2=6 5 86 ,P <0 0 5 ) ,Gly/Gly型血浆总IgE对数值为 2 6 2 3± 0 96 2 ,与Glu/Glu的 2 30 6± 0 915和Glu/Gly的 2 4 18±0 894相比差异具有显著性意义 (F =6 6 5 4 ,P <0 0 1)。结论　IgE高亲和力受体 β链启动区 - 10 9位T/T型与血浆总IgE相关 ,编码区 2 37位Gly/Gly型与儿童变应性     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.