一例脊肌萎缩症患者及其家系的SMN基因突变分析

目的 对1例脊肌萎缩症(spinal muscular atrophy,SMA)患者及其家系成员的SMN基因行突变分析.方法 采用多重连接依赖性探针扩增(multiplex ligation-dependent probe amplification,MLPA)技术、逆转录聚合酶链反应及T克隆-测序技术对患者SMN基因进行拷贝数分析和点突变的鉴定,应用MLPA和针对点突变区域的SMN基因第5外显子PCR-直接测序法对患者父母SMN基因进行拷贝数分析和点突变的证实,同时用200名正常人外周血进行相关位点对照研究.结果 患者具有1个拷贝的SMNl基因和1个拷贝的SMN2基因,在这个SMNl基因第230位密码子上存在1个未见报道的错义突变S230L(TCA→TTA);父亲具有两个SMN1和两个SMN2拷贝,其中1个SMNl基因存在S230L突变;母亲具有1个SMN1拷贝,而SMN2基因是纯合缺失的.200名对照中未发现该位点突变.结论 在1个SMA家系中发现了1个新的SMNI基因点突变,即S230L,并准确分析了此家系各成员的SMN基因型.     

PCR-RFLP法在脊髓性肌萎缩症基因检测中的局限性

目的 探讨聚合酶链反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)技术在脊髓性肌萎缩症(spinal muscular atrophy,SMA)基因诊断中的应用.方法 用PCR-RFLP分析935例临床疑似SMA患儿的运动神经元存活基因1(survival motor neuron,SMN1)第7和第8外显子的缺失,同时用多重连接探针扩增技术(multiplex ligationdependent probe amplification,MLPA)分析其中339例疑似病例的SMN1基因拷贝数改变.用Pearson卡方检验分析两种方法检测SMN1纯合和杂合性缺失的一致性.结果 共发现SMN1基因第7外显子纯合缺失590例,疑似患者的SMA基因诊断率为63.1％(590/935).用PCR-RFLP和MLPA技术联合分析疑似病例339例,PCR-RFLP共发现SMN1纯合缺失194例,MLPA发现196例,二者的一致性为98.9％,差异无统计学意义(x2=0.2,P=0.88).PCR-RFLP仅发现SMN1疑似杂合性缺失4例,而MLPA证实有17例,二者的一致性为23.5％,差异有统计学意义(x2=8.29,P＜0.01).结论 PCR-RFLP尽管简便、特异、实用,但对于5％～10％ SMN1杂合缺失合并点突变的病例则存在明显的局限性.     

五个脊肌萎缩症高风险胎儿的产前诊断

目的对5名生育过脊肌萎缩症(spinal muscular atrophy,SMA)患儿的妇女当前所怀胎儿进行产前诊断。方法超声监视下行羊膜腔穿刺术抽取羊水。离心后直接从沉渣中提取胎儿基因组DNA。采用短串联重复序列位点检测法排除母体基因组DNA污染。常规PCR扩增胎儿SMN基因第7外显子。PCR产物经DraⅠ酶切后,行琼脂糖凝胶电泳。通过位点特异性PCR扩增SMN1和SMN2的第7外显子。结果比较各胎儿与父母的16个短串联重复序列位点,未见羊水DNA受母体DNA污染迹象。常规PCR中,胎儿A、C、D的PCR产物(189bp)仅有部分可被DraⅠ切割,而胎儿B、E的PCR产物全部被DraⅠ切割。在位点特异性PCR中,胎儿A、C、D既有SMN1、也有SMN2的第7外显子扩增产物,而胎儿B、E只有SMN2的第7外显子扩增。结论胎儿A、C、D未见SMN1纯合性缺失,出生后患SMA的风险极小;胎儿B、E为SMN1纯合性缺失,出生后患SMA的风险极大。     

云南地区3049名育龄人群脊髓性肌萎缩症携带者筛查结果分析

目的对云南地区3049名育龄人群进行脊髓性肌萎缩症(spinal muscular atrophy,SMA)的携带者筛查,探讨本地区人群运动神经元存活基因(survival motor neuron,SMN)的拷贝数情况及携带频率。方法应用多重连接探针扩增技术(multiplex ligation-dependent probe amplification,MLPA)对SMN1及SMN2基因第7外显子的拷贝数进行检测,筛查出SMN1基因第7外显子拷贝数为1的SMA携带者。对双方均为携带者的夫妇提供产前诊断。结果在3049名育龄人群中,共检测出SMA携带者62例,携带率为1/49(2.03%)。男性携带率为1.91%(40/2094),女性携带率为2.30%(22/955),二者的差异无统计学意义(P>0.05)。SMN1杂合缺失占1.30%(41/3049),由SMN1转换为SMN2者占0.69%(21/3049)。SMN1等位基因的平均拷贝数为1.99。检出双方均为SMA携带者的夫妇2对,通过产前诊断避免了1例患病胎儿的出生。结论云南地区SMA男女携带者的频率无显著差异,符合常染色体隐性遗传模式。阐明SMA携带者的频率和SMN基因的拷贝数情况,可为遗传咨询和产前预防提供依据。     

应用多重连接依赖性探针扩增技术进行脊髓性肌萎缩症的基因诊断及产前诊断

目的 探讨多重连接依赖性探针扩增(multiplex ligation-dependent probe amplification,MLPA)技术在脊髓性肌萎缩症(spinal muscular atrophy,SMA)基因诊断及产前诊断中的应用.方法 选择来自8个SMA家系的患者4例,父母16例,胎儿4例,应用MLPA技术进行分析,对患者同时应用聚合酶链反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)方法进行分析.结果 对患者的检测,MLPA分析结果与PCR-RFLP检测结果相符,4例患者的运动神经元存活基因(survival motor neuron gene,SMN)1的第7和第8外显子均为纯合缺失.除家系1、4母亲的SMN1基因MLPA检测结果与其他家系不同外,其余各家系14名父母均明确诊断为SMN1基因杂合缺失突变携带者.结论 MLPA技术是一种准确可靠的基因定量分析方法 ,适合于SMA患者、携带者的基因诊断及产前诊断.     

脊髓性肌萎缩症SMN基因拷贝数定量分析

目的　探讨临床诊断为脊髓性肌萎缩症 (spinal muscular atrophy,SMA)而 PCR定性无运动神经元生存 (survival motor neuron,SMN )基因 T拷贝 (SMN - T)缺失患者的遗传基础 ;并探索 SMA表型与SMN基因 C(SMN- C)拷贝数的关系及 SMA患者及其直系亲属和正常人 SMN基因拷贝数的分布。方法对临床和病理诊断为 SMA ～ 型及少见型 4 5例患者、2 5名表型正常的 SMA直系亲属进行 SMN- T和SMN- C基因拷贝数定量分析 ,并与 33名正常人进行对比 ;所有对象均已经 PCR Dra 酶切法定性检测SMN基因 ,其中 ～ 型的 7例和 型的 2例为 SMN- T纯合缺失 ,余者无缺失。建立 SMN- T和囊性纤维化跨膜调节因子 (cystic fibrosis transmembrane conductance regulator,CFTR)的内标 ,所有标本进行非放射性、非荧光标记的多重竞争性 PCR,根据产物 SMN- T/ CFTR和 SMN- C/ CFTR比值 ,计算 SMN- T和SMN - C拷贝数。结果　 7例 ～ 型 SMN - T拷贝数均为 0 ; 型 2例拷贝数为 0 ,2例为 1个拷贝数 ,系杂合缺失 ,4例为 2个拷贝 ; 型及其他型患者均为 2个拷贝 ;直系亲属中 9例为 1个拷贝 ,系杂合缺失 ,其余及正常对照组均为 2个拷贝。SMN - C拷贝数在 SMA 型为≤ 2 , ～ 型为≤ 3, 型及其它型 SMA、直系亲属和正常对照组均为 0～ 3。结     

应用多重连接探针扩增技术行脊髓性肌萎缩症产前诊断的结果分析与遗传咨询指导

目的对脊髓性肌萎缩症(spinal muscular atrophy,SMA)家系进行产前诊断,为SMA产前分子诊断提供遗传咨询指导意见。方法纳入2016年至2019年在本院产前诊断中心就诊的21个家系开展研究,应用多重连接探针扩增(multiplex ligation-dependent probe amplification,MLPA)技术检测SMN基因的拷贝数。应用短串联重复序列(short tandem repeat,STR)技术排除母源污染。结果21个家系共23次妊娠的产前诊断结果显示14例胎儿为SMA携带者,1例为患儿,8例为正常人。44例携带者父母样本中共发现3例"2+0"携带者(SMN1基因为2拷贝,但2个拷贝均位于同一条染色体,另一条染色体SMN1等位基因缺失)。结论MLPA技术可准确评估当前胎儿患SMA疾病风险。遗传咨询时应高度重视"2+0"携带者家庭生育SMA患儿潜在风险,提供具有针对性的遗传咨询和再生育指导意见,降低SMA患儿的出生率。     

脊髓性肌萎缩症SMN1基因定量研究及基因携带者的筛查

目的进行脊髓性肌萎缩症（spinal muscular atrophy，SMA）基因携带者的筛查，为遗传咨询提供理论依据。方法应用实时荧光定量PCR特异性扩增264名健康人、88例经基因诊断确诊SMA患者的双亲、32名SMA家系其它成员的SMN1基因第7外显子及其邻近区域，以已确定只有2拷贝SMN1的样品作为标准对照。结果88例确诊SMA患者双亲除4名SMN1拷贝数为2外，其余均只有1拷贝SMN1。264名正常人中5人仅有1拷贝SMN1，为基因携带者，该组中含2、3、4拷贝SMN1的人数分别为232、25、2。32名SMA家系成员中有2名SMN1拷贝数为1，为基因携带者，25名SMN1拷贝数为2，另5名拷贝数为3。结论实时荧光定量PCR技术可进行单拷贝差异SMN1基因的定量检测，结果准确、重复性好，基因携带者的筛查为本病遗传咨询提供了重要依据。     

一例貌似强直性肌营养不良的脊肌萎缩症的临床、病理及基因诊断

目的 明确1例表型复杂的神经肌病患者的诊断.方法 对该患者进行电生理、病理和致病基因突变分析,并结合国内外文献进行总结.结果 该患者临床病理表现貌似强直性肌营养不良( myotonic dystrophy,DM).基因诊断未发现假肥大型肌营养不良(Duchenne/Becker muscular dystrophy,DMD/BMD)致病基因Dystrophin 21个外显子的缺失突变以及DM1型致病基因DMPK的(CTG)n和DM2型致病基因ZNF9的(CCTG)n的重复扩增突变,但发现脊肌萎缩症(spinal muscular atrophy,SMA)致病基因SMN第7和8外显子的纯合缺失突变.结论 报告1例极为罕见的临床病理表现特殊而经基因诊断确诊的SMA.SMA有明显的临床异质性,临床电生理和病理诊断有其局限性,确诊必须结合基因诊断.     

应用变性高效液相色谱技术快速诊断儿童型脊髓性肌萎缩症

目的 介绍变性高效液相色谱(denaturing high-performance liquid chromatography，DHPLC)技术在儿童型脊髓性肌萎缩症(spinal muscular atrophy，SMA)基因诊断中的应用。方法 PCR扩增25名正常人、1份标准样品及25例SMA患者运动神经元生存基因(survival，motor rleuron，SMN)第7外显子及其侧翼区域，PCR产物变性、复性后直接上样于DHPLC系统。通过改变A、B缓冲液的比例来分离各种DNA成份。结果 各种不同DNA成份以色谱峰的形式表现出来。23名正常标本呈现3个峰，依次为SMN1／SMN2异源双链峰、SMN2同源双链峰、SMN1同源双链峰。2名正常标本及1份标准品只有SMN1峰，表明缺失了SMN2。22例SMA患者只有SMN2峰，表明缺失了SMN1。另3例SMA患者呈现3个峰，表明无SMN1或SMN2缺失。结论 DHPLC诊断SMA具有敏感、准确、快速、简便等优点。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.