HLA-Ⅱ类基因多态性与霍奇金淋巴瘤相关性的Meta分析

目的探索人类白细胞抗原(human leukocyte antigen,HLA)Ⅱ类基因多态性与霍奇金淋巴瘤(Hodgkin's lymphoma,HL)的相关性。方法在OVID、Cochrane图书馆、Pub Med、中国生物医学文献数据库、万方数据库、维普数据库、中国知网中检索关于HLA-Ⅱ类基因与HL相关的病例对照研究文献,采用Rev Man 5.3软件进行Meta分析。结果共纳入7篇相关文献,经综合分析:HL患者与健康对照者比较,两者在DRB1*07、DPB1*0201、DPB1*0301、DRB1*15基因型分布上差异均有统计学意义(OR=0.53,95%CI:0.45-0.63,P<0.01;OR=0.61,95%CI:0.50-0.73,P<0.01;OR=1.71,95%CI:1.25-2.33,P<0.01;OR=1.34,95%CI:1.16-1.55,P<0.01),具有DRB1*07、DPB1*0201基因型的人群发病风险降低,而具有DPB1*0301、DRB1*15基因型的人群发病风险增加。结论现有的证据表明DRB1*07、DPB1*0201等位基因的表达降低人群HL的易感性,DPB1*0301、DRB1*15增加人群HL的易感性。     

HLA-A*0201的基因克隆及逆转录病毒载体构建

CTL对肿瘤的特异性杀伤作用受到HLA的限制.在中国人群中,HLA-A2的频率最高,所以,克隆HLA-A*0201基因,构建逆转录病毒载体可以用于研究肿瘤抗原排斥基因及HLA-A*0201限制性的肿瘤抗原肽.为了克隆HLA-A*0201全长基因,我们首先抽提B淋巴母细胞(HLA-A*0201,A19)的总RNA,在HLA-A座位cDNA特异性引物两端分别加上HindⅢ,SalⅠ的酶切序列,作RT-PCR.用HindⅢ,SalⅠ同时酶切PCR产物及测序载体pBlueScript SK( /-),低熔点琼脂糖凝胶分离,切胶、纯化、连接,用TSS转化法转入XL1-Blue细菌中.接种至涂布X-gal,IPTG的含氯苄青霉素的LB平板上,挑选白色菌落,摇菌,抽     

人类白细胞抗原Ⅰ、Ⅱ类等位基因及单倍体多态性与中国南方汉族白血病的相关性

目的探讨人类白细胞抗原(HLA)Ⅰ类(A、B、C)、Ⅱ类(DRB1、DQB1、DPB1)等位基因和单倍体多态性与中国南方汉族急性淋巴细胞白血病(ALL)、急性髓系白血病(AML)以及慢性粒细胞白血病(CML)的相关性。方法收集深圳市血液中心845例中国南方汉族白血病患者(323例ALL、350例AML及172例CML)和745名中国南方汉族健康献血者的外周血样本。应用聚合酶链反应反向序列特异性寡核苷酸探针杂交(PCR-rSSO)及测序分型(PCR-SBT)方法对HLA-A、-B、-C、-DRB1、-DQB1和-DPB1进行基因分型,鉴定HLA等位基因前4位数。采用Arlequin 3.5软件分析HLA单倍体;从HLA低分辨水平(等位基因前2位数)及高分辨水平(等位基因前4位数)分别统计分析HLA等位基因和单倍体多态性与3种白血病的相关性。结果经Bonferroni校正,ALL组A*02(36.22%比28.26%,χ²=13.41,PC<0.01)及其单倍体A*02-B*46-C*01(15.35%比10.23%,χ²=10.90,PC=0.02)、DRB1*12(15.79%比11.10%,χ²=9.02,PC=0.03)、A*02:03(9.75%比5.32%,χ²=14.25,PC=0.002)及其单倍体A*02:03-B*38:02-C*07:02(3.80%比1.51%,χ²=10.41,PC=0.02)的频率均高于对照组,是ALL易感因素;AML组A*11-B*15-C*08-DRB1*15-DQB1*06-DPB1*02的频率高于对照组(1.34%比0.07%,χ²=12.54,PC=0.003),是AML易感单倍体;CML组A*02(36.63%比28.26%,χ²=9.33,PC=0.02)及其单倍体A*02-B*15-C*04(2.17%比0.29%,χ²=11.74,PC=0.02)、DRB1*03:01-DQB1*02:01-DPB1*02:01(1.86%比0.14%,χ²=13.10,PC=0.01)的频率均高于对照组,是CML易感因素;CML组DRB1*13的频率低于对照组(1.45%比5.25%,χ²=9.29,PC=0.03),是CML拮抗基因。结论在HLA低分辨及高分辨水平发现了白血病易感或拮抗HLA等位基因和单倍体,可为探究中国南方汉族白血病发病机制并制订有效治疗策略提供参考。     

新疆维吾尔族霍奇金淋巴瘤HLA—A高分辨基因多态性分析

目的：研究人类白细胞抗原（humanleukocyteantigen,HLA—A）高分辨等位基因型与新疆地区维吾尔族霍奇金淋巴瘤（hodgkin’Slymphoma,HL）易感性的关系,以揭示遗传因素在HL发病中的作用。方法：采用病例一对照的研究设计和DNA测序分型（SBT）法,对45例维吾尔族HL患者和110名健康者进行HLA—A基因座位的精确分型,计算HLA_A基因座位等位基因的相对频率（RF）及基因频率（AF）。结果：1）病例组共检出33个高分辨等位基因型,对照组中共检出44个高分辨等位基因型,HLA-A基因座位上等位基因频率分布均满足Hardy-Weninberg遗传平衡检验,P=0．61。2）与新疆地区维吾尔族人群比较,维吾尔族HL患者中等位基因HLA-A＊01：01：01：01（45．48％＂US16．04％）、A＊03：01（39．68％VS18．35％）、A＊01：01（33．91％vs18．35％）、A＊02：07（28．18％VS13．73％）高分辨等位基因分布频率较高,差异有统计学意义,P〈0．01。HLA—A＊02：01（69．05％vs85．47％）和A＊1l：01（16．81％VS32．34％）则相对较低,差异有统计意义,P〈0．01。3）新疆地区维吾尔族HL患者与维吾尔族健康人抗原型均以A2最为多见,各型在病例组与对照组之间分布差异无统计学意义,P〉0．05。结论：HLA-A＊01：01：01：01、A＊03：01、A＊01：01和A＊02：07基因型与维吾尔族HL存在阳性关联,可能为维吾尔族HL发病的易感基因,而HLA-A＊02：01、A＊ll：01可能为维吾尔族HL发病的拮抗基因。     

转化生长因子βⅠ型受体Int7G24A和*6A多态性与贲门腺癌发病风险的相关性研究

目的:探讨转化生长因子β受体Ⅰ型(transforming growth factor-beta receptor type 1 gene,TGFBR1)Int7G24A和*6A单核苷酸多态性(single nucleotide polymorphisms,SNPs)与中国北方人群贲门腺癌(gastric cardia adenocarcinoma,GCA)遗传易感性的关系。方法:分别采用PCR-RFLP和PCR的方法检测468例GCA患者和584例健康对照人群中TGFBR1基因第7内含子Int7G24A和第1外显子*6ASNPs分布情况,同时对110例GCA患者术后切除肿瘤组织采用免疫组织化学方法检测TGFBR1蛋白的表达情况,并与其基因型进行相关性分析。结果:TGFBR1基因Int7G24A SNPs位点的基因型和等位基因型频率在GCA组和对照组间的分布差异有统计学意义(P<0.05),A等位基因携带者患GCA的风险是G等位基因的1.34倍[经性别、年龄和上消化管肿瘤家族史校正后的比值比(odds ratio,OR)=1.34,95%可信区间(confidence interval,CI)=1.03～1.87],与GG基因型相比,携带AA基因型可显著增加GCA的发病风险(校正后的OR=2.17,95%CI=1.15～3.72)。当按肿瘤分期进行分层分析时发现,与GG基因型相比,携带GA和AA基因型可显著增加Ⅲ期和Ⅳ期GCA的发病风险(校正后的OR=1.41,95%CI=1.05～1.98)。TGFBR1基因*6ASNPs位点的基因型及等位基因型频率在GCA患者组和对照组之间,其分布差异均无统计学意义(P>0.05)。GCA组织中TGFBR1蛋白的阳性表达率为27.3%,显著低于癌旁正常组织的100%(P<0.01),TGFBR1蛋白在GCA中的表达与TGFBR1基因Int7G24A和*6A位点的基因型之间无明显相关性(P>0.05)。结论:TGFBR1基因Int7G24A位点A等位基因可能是我国北方人群GCA的遗传易感基因,携带A等位基因的个体可增加GCA的发病风险。     

胃癌高发与低发区人群HLA—DPB1等位基因多态性的研究

目的:探讨中国北方胃癌高、低发区人群HLA-DPB1等位基因多态性分布与胃疾病及幽门螺杆菌(Helicobacter pylori,Hp)感染的关系.方法:采用聚合酶链反应-限制性片段长度多态(PCR-RFLP)技术分析863例研究对象的HLA-DPB1等位基因多态性;酶联免疫吸附方法(ELISA)检测血清Hp-IgG.结果:1)中国北方地区人群中检出4种DPB1等位基因多态:DPB1*1401(65%)最高,其次依次为*1701(5.4%)、*0901(4.0%)和*0301(0.9%).2)胃癌高、低发人群DPB1*0901和*1701等位基因频率分布差异有统计学意义(*0901x2=36.145,P<0.01;*1701:x2=35.526,P<0.01).3)胃癌与非癌对照组问DPB1*0901、*1401、*1701等位基因频率分布差异无统计学意义;HP是否感染组问DPB1*0901、*1401、*1701等位基因频率分布差异无统计学意叉.结论:HLA-DPB1*0901、*1701等位基因多态存在胃癌高、低发区人群分布差异,未发现HLA-DPB1等位基因多态与胃癌易感性及Hp感染有关.     

基因多态性与宫颈癌易感性研究进展

目的：总结基因多态性与宫颈癌易感性的研究现状。方法：应用PubMed及CHKD期刊全文数据库检索系统,以“基因多态性、宫颈癌、易感性”等为关键词。检索1999-2013的相关文献80篇,纳入标准：1）宫颈癌易感性研究进展;2）基因多态性与宫颈癌癌易感性的关系。根据纳入标准,最后纳入分析29篇文献。结果：1）DRB1＊15等位基因/DRB1＊15-DQB1＊06单体型与HPV感染或宫颈癌前病变有关,巴西妇女中HLA-DQB1＊05与HPV16阳性宫颈鳞癌呈正相关;2）中国人群中,Pro/Pro基因型在宫颈癌和对照人群中表达有明显差异,葡萄牙北部人群中ASCUS、LSIL、HSIL、ICC患者及正常人宫颈细胞进行检测,未发现p53Arg72Pro在不同人群中的分布有差异;3）TNF-α基因启动子区-238A等位基因可明显降低宫颈癌风险,TNF-α-308G/A多态性与浸润型宫颈癌的发展相关;4）中国妇女人群中,XRCC1 399Gln/Gln基因型与宫颈癌相关性是XRCC1 399Arg/Gln基因型的2.32倍;然而在阿根廷妇女中,XRCC1399Arg/Gln基因型会降低患宫颈癌的风险。结论：1）HLA多态性与宫颈癌易感性和HPV感染相关;2）P53基因多态性与不同地域宫颈癌易感性不同;3）TNF不同位点基因多态性与宫颈癌易感性相关性不同;4）DNA修复基因多态性与宫颈癌易感性关系报道不同。     

HLA-KIR-MICA基因及其NK受体免疫应答与子宫颈癌的相关性

目的探讨广州市汉族人群HLA-KIR-MICA基因及其NK受体免疫应答与子宫颈癌的相关性。方法收集500例子宫颈上皮细胞癌(鳞状细胞癌和腺癌)的初诊患者(宫颈癌组)和100例与宫颈癌组在区域、年龄、种族、婚姻生育史、个人史等方面差异无统计学意义的健康人群(对照组)。采用PCR-SBT法,对所有样本进行HLA等位基因检测、KIR基因和MICA基因检测;采用realtime PCR法进行HPV-E1、HPV-E2、HPV-E4、HPV-E5、HPV-E6、HPV-E7、HPV-L1、HPV-L2的转录水平监控,以及对HPV蛋白表达差异样本进行MICA表达量检测。结果宫颈癌组患者HLA-KIR*1003、HLA-KIR*14、HLA-KIR*17、HLA-KIR*02、HLA-KIR*12等位基因的分布与对照组比较,差异均有统计学意义(P<0.05);宫颈癌组患者MICA*13、MICA*20、MICA*04、MICA*15等位基因的分布与对照组比较,差异均有统计学意义(P<0.05)。结论广州市汉族人群HLA-KIR*02、HLA-KIR*12、HLA-KIR*0801和MICA*04、MICA*15、MICA*17、MICA*0601等位基因可能与宫颈癌的发生相关。     

人乳头状瘤病毒感染及人白细胞抗原-DQB1等位基因多态性与南疆维吾尔族女性宫颈癌的关系

目的 探讨人类乳头状瘤病毒(HPV)感染及人类白细胞抗原(HLA)-DQB1等位基因多态性与南疆维吾尔族女性官颈癌的关系.方法 采用导流杂交基因芯片技术,检测190例南疆维吾尔族女性宫颈癌组织和190例正常维吾尔族女性宫颈组织21种HPV亚型的感染情况.采用聚合酶链反应序列特异性寡核苷酸探针(PCR-SSO)检测其5个HLA-DQB1等位基因的基因频率.结果 (1)在对照组中,HPV感染17例,感染率为8.9%.190例宫颈癌中,HPV感染133例,感染率为70.0%,高于对照组(P<0.05).其中HPV16的感染率最高,为64.7%,也明显高于对照组(3.7%,P<0.05).其他亚型的感染率均远低于HPV16,依次为HPV18(2.6%)、HPV68(2.1%)、HPV45(1.6%)、HPV58(1.6%)、HPV39(1.6%)、HPV31(1.1%)、HPV56(1.1%)及HPV59(0.5%),中国汉族人常见类型HPV53和低危型HPV6的感染率均为0.5%.(2)宫颈癌组和对照组的HLA-DQBI*03基因分布差异有统计学意义(P=0.014),携带HLA-DQB1*03基因者罹患宫颈癌的风险降低31.7%(OR=0.683),其他等位基因与维吾尔族女性宫颈癌的发生无关.(3)携带HLA-DQB1*06基因的宫颈癌患者HPV和HPV16的感染率高于非HLA-DQB1*06携带者(P值分别为0.046和0.025),携带HLA-DQB1*06等位基因的维吾尔族女性更容易被HPV和HPV16感染(OR分别为1.808和1.879).其他等位基因与HPV及HPV16感染无关.结论 南疆维吾尔族女性宫颈癌患者的HPV感染率高于非宫颈癌女性,均以HPV16感染为主.HLA-DQB1*03可能为南疆维吾尔族女性罹患宫颈癌的保护基因.HLA-DQB1*06为HPV和HPV16感染的易感基因.     

髓过氧化物酶基因多态性与肺癌遗传易感性的研究

背景与目的:髓过氧化物酶(myeloperoxidase,MPO)基因启动子区域-463bp处存在G/A多态位点,国外研究表明此位点与肺癌遗传易感性有关,但中国人MPO基因型与肺癌易感性关系尚未见报道,本研究拟对此问题作一探讨。方法:采用病例-对照分子流行病学方法,以PCR-RFLP技术检测98例原发性肺癌和112名健康对照MPO基因型,通过比较不同基因型者的比值比(oddsratio,OR)及其95%可信区间(confidenceinterval,CI)分析基因多态性与中国人肺癌易感性的关系。结果:正常人群G/G、G/A、A/A基因型频率分别为47.3%、42.9%和9.8%,肺癌病例组分别为63.3%、33.7%和3.0%,杂合子G/A在两组人群中分布无显著性差异(P>0.05),但病例组A/A基因型频率显著低于对照组(P<0.025)。携带至少一个等位基因A者患肺癌的风险是基因型为G/G者的52.0%(95%CI0.29～0.93)。在吸烟人群中,等位基因A对肺癌易感性的保护作用有显著性意义(OR=0.41,P<0.025),而在非吸烟人群,这种保护作用无显著性意义(P>0.25)。结论:本研究人群MPO基因多态与肺癌遗传易感性相关,等位基因A对吸烟人群的肺癌易感性有保护作用。     

Schwannomas of Head and Neck and Review of Literature

Benign nerve cell tumours have been given various names like schwannoma, neurilemmoma, neurinoma, neurofibroma, spindle cell tumours etc. Extra cranial head and neck schwannomas usually present as solitary and well-demarcated lesions. The lesion can cause secondary symptoms, such as nasal obstruction, dysphasia, and hoarseness, depending upon the location of the lesion. Fine needle aspiration cytology, CT scans, and MRI may be of limited help in the diagnosis of schwannomas. The treatment is complete surgical excision of the benign tumour and postoperative histopathological examination establishes the final diagnosis.     

A comparative study of knowledge and awareness of colorectal and breast cancerA comparative study of knowledge and awareness of colorectal and breast cancer

Aims: To assess and compare knowledge and awareness of colorectal cancer and breast cancer in a sample of the general population. Methods: Eleven hundred visitors to six different outpatient clinics, in a University Hospital, were given a study-specific questionnaire, based on educational material from the British Association of Cancer United Patients (CancerBACUP). The questionnaire consisted of 12 statements on the incidence, presentation, detection, treatment and prognosis of colorectal and breast cancer. Results: One thousand and sixty-eight individuals returned the questionnaire. One thousand and four completed questionnaires were analysed. The mean age (SD) of respondents was 50.1 (17.2) years, and the male to female ratio was 2:3. Respondents had read more about breast than about colorectal cancer (60.3%vs 32.4%,P <0.0001, McNemar's test). The proportion of correct answers for each statement on breast cancer was higher than for answers to corresponding items on colorectal cancer. Mean overall scores (95% CI) for breast and colorectal cancer were 88.1 (86.9, 89.2) and 64.4 (62.5, 66.3) respectively, the mean difference (95% CI) being 23.7 (22.0, 25.5). Scores were higher for breast cancer irrespective of age or gender. Conclusion: There is a low level of understanding of colorectal cancer in the general population when compared to breast cancer. This highlights the importance of public education in this common cancer.     

miRNA与肿瘤侵袭转移

目前,microRNA (miRNA)已成为肿瘤研究中最基本的参与者,主要通过与靶标基因3 'UTR(非翻译区)的完全或不完全配对,降解靶标基因mRNA或抑制其翻译,从而参与调控个体发育、细胞凋亡、增殖及分化等生命活动.miRNA作为调控基因表达的重要分子在肿瘤侵袭转移中的作用越来越受到重视,表明miRNA在肿瘤侵袭和转移中的作用机制具有重要的理论意义,同时也可为肿瘤的诊断和治疗提供新方法.本文就miRNA通过调控上皮间质转化及肿瘤干细胞导致肿瘤侵袭转移的最新研究进展作一综述.     

Quality of life and care in leukemia,myeloma and non-malignant disease. Opinions of patients and relatives,and effects of geography and time

In a questionnaire study 140 subjects answered 4200 questions in 1980 and 1986. They consisted of patients with myeloma, acute leukemia, lung carcinoma, and non-malignant disease and their relatives. In 22 additional cases the questionnaire was not answered. The results show that myeloma patients are less content with the general care than leukemia patients (P < 0.05). Similarly, relatives of deceased myeloma patients are less satisfied with the information given to them than relatives of deceased leukemia patients (P < 0.001). The information has improved with time, however, since the patients were more satisfied in 1986 than in 1980 (P < 0.001) and relatives of myeloma patients still alive were more satisfied than relatives of patients who had died earlier (P < 0.001).     

甲状腺手术的技巧及副损伤的预防和处置

鉴于甲状腺手术是普外科的常见手术，为求其日渐完美，以有益于病人，现根据作者的体会，并结合阅读相关文献，就其手术操作、喉返神经处理、甲状旁腺处理进行扼要阐述。     

芦荟大黄素及芦荟提取物的诱变性和抗诱变性

目的:用L5178Y小鼠淋巴瘤细胞体外微核试验评价芦荟大黄素和芦荟提取物的诱变和抗诱变作用,为其安全性评价提供依据。方法:设溶剂对照、阳性对照和抗诱变对照,芦荟大黄素和芦荟提取物诱变和抗诱变试验各设4个剂量组,处理L5178Y细胞12 h后按常规方法进行体外微核试验分析。结果:较高浓度(6.67μg/ml)的芦荟大黄素可致微核细胞率增加,与对照组比较,差异有统计学意义(P0.05);而芦荟提取物未见此效应。在一定剂量范围内,芦荟大黄素(0.22～6μg/ml)和芦荟提取物(20～180μg/ml)对甲磺酸甲酯(MMS)所致微核细胞率均有一定程度的拮抗作用,与对照组比较,差异有统计学意义(P0.01)。结论:芦荟大黄素具有一定的诱变作用,而在本实验剂量范围内的芦荟提取物未见遗传毒性。两种受试物在一定范围内均能较好地拮抗MMS所致的染色体损伤。     

Comparison of the Efficacy and Safety of Ceftibuten and Cefaclor in the Treatment of Pneumonia and Bronchiectasis

Summary

In a multicentre, international study of 187 adult patients with bacterial pneumonia or bronchiectasis, the safety and efficacy of a regimen of 200 mg ceftibuten administered twice-daily was compared with cefaclor given in a dosage of 500 mg three times a day. Of the 94 evaluable patients, 66 received ceftibuten and 28 received cefaclor. The overall bacteriological response was similar in the two treatment groups with elimination of the original pathogen in 91% and 89% of the patients receiving ceftibuten and cefaclor, respectively. The overall clinical response mirrored the bacteriological results with a successful clinical outcome in 92% of ceftibuten-treated patients compared with 93% in patients receiving cefaclor. Adverse experiences were, in general, few and mild, being reported in 8% and 17% of patients receiving ceftibuten and cefaclor, respectively.     

Erythrocyte levels of cadmium and lead and risk of B-cell non-Hodgkin lymphoma and multiple myeloma

Cadmium and lead are persistent environmental toxins that are known or probable carcinogens, based on evidence for causality for nonhematologic cancers. Associations of these metals with risk of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) are unknown but biologically plausible. To examine the associations of circulating levels of lead and cadmium exposure with risk of B-cell NHL (B-NHL) and multiple myeloma, we conducted a nested case-control study among 299 incident B-cell NHLs and 76 MM cases within the Cancer Prevention Study-II Nutrition Cohort (CPS-II NC). Each case was incidence-density matched to two eligible controls on age, race, sex and blood draw date. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (CI) for lymphoid malignancies overall and stratified by subtype. We observed a significant positive association between high erythrocyte lead concentration and risk of lymphoid malignancies overall (RR = 1.16, 95% CI: 1.02-1.33 per 17.6 μg/L (1 standard deviation [SD])) and follicular lymphoma in particular (RR = 1.80, 95% CI: 1.15-2.80 per SD). In contrast, there was no association between erythrocyte cadmium and risk of B-NHL (RR = 0.89, 95% CI: 0.75-1.06 per 0.37 μg/L [1 SD]), or any B-NHL subtypes; but a strong inverse association with MM risk (RR = 0.59, 95% CI: 0.38-0.89, per SD). Results from our study suggest a positive association between erythrocyte lead level and risk of lymphoid malignancies and a possible inverse association between cadmium and myeloma. Additional research is needed to confirm and further explore these findings.     

甲胎蛋白与自噬在肝癌发生发展中的作用及其相互关系

甲胎蛋白（AFP）作为临床诊断肝癌最常用的肿瘤标志物,有抑制免疫、促进细胞生长、抑制癌细胞凋亡的作用。自噬是一种维持细胞生存的重要途径之一,其与肝癌的发生发展及治疗有着密切联系,对肝癌既有抑制又有促进作用。PI3K/AKT作为两者共有的信号通路,它们是否有着相互关系来促进肝癌的发展尚需进一步研究。