瘦素受体基因3057G/A多态性与抗精神病药所致肥胖及高血压的关系

目的 了解长期服用抗精神病药(APS)患者的瘦素受体基因3057G/A多态性,并探讨其与长期应用抗精神病药物治疗相关的肥胖、糖代谢及高血压的关系.方法 入组84例长期应用APS的精神分裂症患者,采用常规酚/氯仿方法 ,提取基因组DNA,采用聚合酶链式反应-限制性片段长度多态性技术,检测瘦素受体基因3057G/A多态性和等位基因分布频率.采用放射免疫法测定血清胰岛素及瘦素水平.结果 (1)长期使用抗精神病药患者的瘦素受体基因3057G/A位G→A变异频率为92.26%.(2)肥胖与非肥胖患者之间瘦素受体基因型分布及等位基因频率均差异无显著性(x2值为5.23和1.04,均P＞0.05).(3)携带GA和AA型基因的患者之间的主要临床变量、发生糖耐量降低及2型糖尿病均差异无显著性(P＞0.05),但携带AA型患者的血胆固醇水平趋向高于携带GA型患者[(4.74±1.01)mmol/L vs(4.18±0.71)mmol/L](P值=0.08),且携带AA型患者收缩压显著高于携带GA型患者[(16.4±1.98)kPa vs(15.5±0.60)kPa](P＜0.05).(4)多元线形回归分析示瘦素受体基因3057G/A多态性与空腹血糖水平并不相关.结论 瘦素受体基因3057G/A多态性与抗精神病药物治疗相关的肥胖、糖耐量降低和2型糖尿病无明显相关,不是影响分裂症患者肥胖和血糖代谢障碍的基因危险因子.携带AA型基因的精神分裂症患者更易于发生收缩压升高及脂质代谢障碍.     

瘦素基因启动子区-2548G/A功能多态性与抗精神病药源性肥胖的核心家系关联研究

目的:探讨瘦素(leptin)基因启动子区-2548G/A功能多态性是否与首次抗精神病药物(antipsyehotie agents,APS)治疗精神分裂症(schizophrenia,SCH)惠者急性期体质量增加相关.方法:APS(利培酮或氯丙嗪)单药治疗10周,治疗前后测量体质量并计算体质量指数(body mass index,BMI).采用PCR-RFLP技术分析84例首次治疗精神分裂症患者(包含完整核心家系70个)瘦素基因-2548G/A基因型和等位基因分布频率,APS治疗所致体质量增加与瘦素-2548G/A多态性的关联分析及核心家系关联分析,采用传递不平衡检验(TDT)和数量性状传递不平衡检验(QTDT).结果:治疗后患者体质量增加是基础体质量的(8.00±6.13)%.体质量增加≥7%和<7%患者组间瘦素基因-2548G/A多态性的等位基因在两组的分布差异有统计学意义(X2=4.031,P=0.045).核心家系分析采用TDT发现,在体质量增加≥7%组患者组存在传递不平衡,等位基因A更多的由杂合子父母传递给体质量增加≥7%的患者.结论:瘦素基因启动子区-2548G/A功能多态性与APS急性期治疗致精神分裂症患者体质量增加相关,-2548A等位基因可能是APS治疗所致肥胖的危险因素.     

瘦素受体3057位基因多态性与2型糖尿病及血脂的关系

目的 探讨瘦素受体(leptin receptor,LR)基因第20外显子基因多态性与2型糖尿病(diabetes mellitus,DM)及血脂的关系. 方法 采用PCR-RF-SSCP法,检测130名(其中糖尿病患者68例,正常对照62例)山西省吕梁地区汉族人的LR基因第20外显子的基因多态性,分析其与2型糖尿病及血脂之间的关系. 结果 被检测对象LR第20外显子存在明显的多态性,在所有检测对象中,+3057位核苷酸G→A变异频率为79.27%,其中DM组和正常对照组+3057位基因变异频率比较差异有统计学意义(86.76% vs 71.77%,P<0.05).DM患者中AA型频率显著高于对照组,而GA型频率低于对照组,病例组中GG型频率只有2.94%;AA基因型组的甘油三酯含量高于GA型组,高于GG型组,而高密度脂蛋白低于GA型组,低于GG型组(P<0.05). 结论吕梁地区存在LR第20外显子+3057位核苷酸基因变异,其变异可能通过影响机体脂质代谢等参与2型糖尿病的发生.     

瘦素受体基因Gln223Arg多态性与西南地区汉族人群阻塞性睡眠呼吸暂停低通气综合征的关系

目的探讨西南地区汉族人群瘦素受体基因Gln223Arg多态性与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)之间的关系。方法选取西南地区汉族人群215例(其中OSAHS组116例,健康对照组99例);用聚合酶链反应(PCR)分析研究对象瘦素受体基因Gln223Arg多态性;双抗体酶联免疫吸附试验(ELISA)法测定瘦素(LEP)、真胰岛素(TI),同时测定体重指数(BMI)、颈围(NC)、腰围(WC)。结果 OSAHS组116例中,瘦素受体基因Gln223Arg多态性的GG、AA、GA的基因型频率表达分别为0.854、0.017、0.129,G等位基因频率为0.918;A等位基因频率为0.082。对照组中,瘦素受体基因Gln223Arg多态性的GG、AA、GA的基因型频率表达分别为0.840、0.020、0.14;G等位基因频率为0.90;A等位基因频率为0.10。两组基因型频率比较差异无统计学意义(X~2=0.784,P0.05)。Gln223Arg基因多态性的GG基因型OSAHS患者与(GA+AA)基因型OSAHS患者BMI、WC、NC比较差异有统计学意义(均P0.05)。对照组及轻、中、重度OSAHS组血清LEP、TI水平逐渐升高,各组间比较差异均有统计学意义(均P0.05)。结论瘦素受体基因型Gln223Arg多态性可能参与肥胖的发生,但与西南地区汉族人群OSAHS的发病无关;OSAHS患者Gln223Arg多态性与LEP、TI无关。OSAHS患者存在高瘦素血症、高胰岛素血症。     

瘦素基因启动子区-2548G/A功能多态性与抗精神病药源性肥胖的相关分析

目的　探讨瘦素基因启动子区 - 2 5 4 8G/A功能多态性是否与首次治疗精神分裂症患者的抗精神病药物 (APS)急性期治疗导致的体重增加相关。方法　采用聚合酶链反应 限制片段长度多态性 (PCR RFLP)技术分析 12 8例患者 (男 6 1例 ,女 6 7例 ) - 2 5 4 8G/A等位基因和基因型分布频率 ,APS(利培酮或氯丙嗪 )单药治疗 10周 ,治疗前后每周测体重和体重指数 (BMI) ,采用MRI测治疗前后腹部脂肪分布 (30例 ) ,分析等位基因和基因型与基础体重指标和其变化值的相关性 ;同时分析 38名性别、年龄和BMI相匹配的健康对照者 ,其中 2 2例进行MRI扫描。结果　治疗后患者体重增加是基础体重的 (6 .2± 5 .7) % ,腹部脂肪增加是基础腹部皮下脂肪 (SUB)的 (38.5± 4 2 ) %、腹内脂肪的 (4 0 .0± 4 1.2 ) % ;- 2 5 4 8G/A等位基因和基因型在患者组和对照组分布频率差异无显著意义 ;在体重增加≤ 7%和 >7%患者组等位基因和基因型分布频率差异有非常显著意义 (χ2 =7 5 2 9,df =1,P =0 .0 0 6 ;OR =1.94 1;95 %CI:1.175～ 3.2 0 7) ;基因型对患者组或对照组的基础体重指标无显著影响 ;与携带G等位基因患者相比 ,AA基因型携带者治疗后BMI(P =0 .0 0 3)和SUB(P =0 .0 0 9)明显增加。结论　瘦素基因启动子区 - 2 5 4 8G/A功能多态     

瘦素基因启动子区G-2548A多态性与脑梗死和腹型肥胖关系

目的探讨中国青岛地区汉族人群瘦素基因启动子区G-2548A多态性与腹型肥胖和脑梗死的关系。方法采用聚合酶链反应和限制性片段长度多态性（PCR-RFLP）的方法,对216例脑梗死病人和182例健康者（对照组）的瘦素基因启动子区G-2548A位点进行多态性分析;根据腹围将两组均分为腹型肥胖组和非腹型肥胖组。结果所有受检者的基因型频率分布符合Hardy-Weinberg平衡。脑梗死组GG基因型频率显著高于对照组（χ2=62.574,P〈0.001）,G等位基因频率显著高于对照组（χ2=29.173,P〈0.001）。GG基因型人群患脑梗死的风险是GA＋AA基因型的2.494倍（OR=2.494,95%CI=1.344-4.631）,GG基因型人群空腹血浆瘦素水平高于GA＋AA基因型（t=6.924,P〈0.001）。腹型肥胖者的基因型分布和等位基因频率与非腹型肥胖者相比差异无显著性（P〉0.05）。结论瘦素基因启动子区G-2548A多态性可能与脑梗死的易感性有关,G等位基因可能是脑梗死的遗传易感因素,瘦素基因启动子区G-2548A的多态性与腹型肥胖无相关性。     

LOX基因G473A多态性研究在结直肠癌患者肿瘤风险评估中的应用

目的研究赖氨酰氧化酶(LOX)基因G473A多态性与结直肠癌易感性的关系,为结直肠癌肿瘤的风险评估提供依据。方法随机选择2010年5月~2014年8月我院收治的200例结直肠癌患者作为研究对象,并随机选择同期200例体检健康者作为对照组,分别抽取所有研究对象的肘静脉血5 mL和抽取基因组后对LOX基因G473A位点测序,检测各个体LOX基因G473A的基因型。然后采用Logistic回归分析不同LOX基因G473A基因型与结直肠癌患病风险之间的相关性。结果 (1)结肠癌组GG、GA、AA基因型患者分别占47.37%(45/95)、41.05%(39/95)、11.58%(11/95)。携带GG基因型个体患结肠癌的风险明显低于GA和AA基因突变型个体(OR=1.71,95%CI=1.01~2.65,P=0.03;OR=3.94,95%CI=1.43~8.96,P=0.00)。(2)直肠癌组GG、GA、AA基因型患者分别占51.43%(54/105)、37.4%(39/105)、11.43%(12/105)。携带GG基因型个体患直肠癌的风险明显低于AA基因突变型个体(OR=3.45,95%CI=1.61~8.03,P=0.00)。(3)结直肠癌组GG、GA、AA基因型患者分别占49.50%(99/200)、39.00%(78/200)、11.50%(23/200)。携带GG基因型个体患结直肠癌的风险明显低于GA和AA基因突变型个体(OR=1.67,95%CI=1.01~2.18,P=0.03;OR=3.68,95%CI=1.81~7.65,P=0.00)。结论 LOX基因G473A多态性与结直肠癌的发病风险有一定关系,行LOX基因G473A多态性检测在结直肠癌风险评估中具有一定的应用价值。     

瘦素受体基因多态性与胃癌易感性研究

目的:探讨瘦素受体基因多态性与胃癌易感性的关系。方法:随机选取89例胃癌患者作为研究对象,97例健康体检者作为正常对照,采用PCR-RFLP技术检测瘦素受体基因rs1137100和rs1137101位点的多态性,同时运用ELISA法测定血清瘦素水平。结果:胃癌组瘦素受体基因rs1137100位点的AA基因型和A等位基因明显降低罹患胃癌的风险(P=0.036,OR=0.259,95%CI=0.068-0.987;P=0.008,OR=0.493,95%CI=0.291-0.833)。rs1137101位点AA和GA基因型与胃癌发病风险无明显相关性。但是,位点rs1137101的A等位基因可能会降低胃癌的发病几率(P=0.006,OR=0.446,95%CI=0.248-0.802)。胃癌组血清瘦素水平明显高于正常对照组(P<0.05)。结论:瘦素受体基因多态性与胃癌易感性密切相关,瘦素受体基因rs1137100和rs1137101的A等位基因可能会降低胃癌发病风险。     

血清瘦素及受体基因Gln223Arg多态性与胃食管反流病的相关性

目的 探讨人外周血血清瘦素及瘦素受体(LEPR)基因Gln223 Arg多态性与胃食管反流病(GERD)的相关性.方法 根据GERD症状诊断问卷联合胃镜检查确诊GERD,选取具有完整临床资料的GERD患者62例,分为反流性食管炎组(RE组)、非糜烂性反流病组(NERD组),同时选取健康体检者63例为对照组.采用酶联免疫法(ELISA)定量检测血清瘦素;采用限制性片段长度多态性聚合酶链反应法检测血清瘦素受体基因Gln223Arg多态性.结果 RE组、NERD组瘦素水平均明显高于对照组(P＜0.05);RE组炎症的严重程度与瘦素水平呈正相关.RE组、NERD组瘦素受体基因Gln223 Arg的GA+ AA基因型频率和A等位基因频率均明显高于对照组(P＜0.05).GERD患者中GA+ AA基因型的瘦素水平明显高于GG基因型(P＜0.05).结论 GERD的发生与血清瘦素水平升高及瘦素受体基因Gln223Arg多态性相关.     

LR3057位基因多态性与2型DM和肥胖及血脂的关系

目的探讨瘦素受体(leptin receptor,LR)基因第20外显子基因变异与2型糖尿病(diabetes mellitus,DM)和肥胖及血脂的关系.方法采用聚合酶链反应-限制性酶切片段长度多态性(PCR-RFLP)方法,对134例血标本检测了瘦素受体基因第20外显子 3 057位核苷酸基因多态性,并分析其与2型DM及肥胖的关系.结果对75例2型DM病人和59例血糖正常者检测LR基因 3 057位核苷酸G→A的变异频率,总变异频率为82.09%,其中DM组为87.33%,正常对照组为75.42%(P＜0.05),OR=2.25.DM患者中AA型频率显著高于对照组,而GA型频率低于对照组,病例组中未见GG型频率(趋势χ2=6.77,P＜0.01),按BMI及WHR划分,未见其基因变异与肥胖的关系.AA基因型组甘油三酯、收缩压、舒张压高于GA型组,而高密度脂蛋白低于GA型组(P＜0.05).结论重庆地区存在LR基因第20外显子 3 057位核苷酸基因变异,它可能是该地区人群2型DM的遗传易感标记,A等位基因与2型DM及高血压、高血脂发病有一定的关系.     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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…     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.