FCGR2A基因多态性与系统性红斑狼疮相关性研究

目的 明确FCGR2A基因H131／R131多态性在中国人群中的分布，探讨该位点是否与系统性红斑狼疮(SLE)的发病有关。方法 应用Taqman MGB方法对340例SLE病人，300例患者父母和183名正常人的H131／R131多态性位点进行大规模等位基因分型，病例对照研究应用χ^2检验，家系为基础的传递不平衡检验应用ETDT22软件。结果 病例对照研究提示SLE组和正常组之间的等位基因频率无明显差异(P=0．413)，传递不平衡检验证实该位点在中国人群SLE家系中无优势传递(P=0．6049)。结论 在中国汉族人群中FCGR2A H131／R131多态性位点与SLE的发病不存在相关性。     

胃动素基因多态性与先天性肥厚性幽门狭窄传递不平衡分析

目的探讨胃动素（motilin,MLN）基因第二外显子的多态性位点rs2281820[44C〉T]与先天性肥厚性幽门狭窄（congenital hypertrophic pyloric stenosis,CHPS）发病易感性的关联。方法对广州市第一人民医院住院的22个汉族核心家系（CHPS患者及父母双亲）采用PCR及测序方法进行基因分型,应用传递不平衡检验判断基因多态性与CHPS发病的关联。结果测序结果未发现新的突变位点;患儿及父母组内这两个多态性位点的Hardy-Weinberg平衡检验均P〉0.05,TDT检验提示多态性位点rs2281820[44C〉T]与CHPS发病无关（P=0.522）。结论胃动素基因的多态性位点rs2281820[44C〉T]与中国汉族人群CHPS发病无关。     

PBX1基因3''末端基因多态性rs3185695与系统性红斑狼疮发病相关研究

目的研究前B淋巴细胞白血病转录因子(PBX1)3’端单核苷酸多态性(SNP)与中国人系统性红斑狼疮(SLE)发病的相关性。方法对PBX1基因3’端下游区域通过测序发现SNP rs3185695, 再对发现的该SNP进行等位基因分型。以Haploview软件和延伸型传递不平衡试验(ETDT)分析SNP与中国人SLE发病的相关性。结果靠近PBX1 3’末端通过测序发现的SNP rs3185695进行家系传递不平衡检验(TDT)提示等位基因G优势传递给患者,传递:不传递(T:U)=62:41,P=0．0385。结论 PBX1基因可能为SLE的候选基因。     

血管紧张素转化酶基因多态性与系统性红斑狼疮相关性研究

目的探讨位于人类17号染色体长臂2区3带(17q23)上的血管紧张素转化酶(ACE)基因多态性G261T与系统性红斑狼疮(SLE)的关系。方法采用聚合酶链反应(PCR)和限制性片段长度多态性(RFLP)方法检测人类17q23上的ACE基因多态性G261T,运用家系为基础的相关性检验(FBAT)方法,对119个中国汉族SLE患者家系(其中核心家系95个,119例患者,316名家系其他成员)ACE多态性位点(rs4303)进行等位基因和基因型分析。结果在119例SLE患者中：G、T等位基凶频率分别是44．8%和55．2%：基因型GG、GT和TT的频率分别是13．9%,62．0%,24．1%。FBAT单位点分析显示G261T多态性与SLE显著相关：附加模型(Z=2．877．P=0．004),显性模型(Z=2．557,P=0．011)以及隐性模型(Z= 2．202,P=0．028)。传递不平衡检验(TDT)和同胞传递不平衡检验(STDT)显示其中ACE-261T等位基因由杂合子父母优势传递给患病子女或者与正常同胞相比更容易传递给患者(X~2=11．66,P=0．001)。结论ACE基因是中国汉族人群SLE的易感基因；其中ACE-261T等位基因与SLE发病相关。     

磺脲受体1基因多态性与2型糖尿病相关性家系研究

依据传递不平衡法(TDT)对上海地区55个2型糖尿病家系进行磺脲受体1(SUR1)基因多态性分析及临床表型联系分析,未发现SUR1基因的多态性和突变与上海地区2型糖尿病连锁的证据,但其对胰岛素、C肽水平有一定影响。     

采用传递与不平衡检验分析相关转运体基因和1型糖尿病的关系

1型糖尿病是与遗传有关的自身免疫性疾病.近年来在主要组织相容抗原复合物Ⅱ(MHC-Ⅱ)类区域发现的抗原处理相关转运体基因(TAP)参与内源性抗原的递呈,在自身免疫性疾病中起重要作用.本文采用家系遗传学调查法--传递与不平衡检验(TDT)对1型糖尿病家系各TAP基因单倍型的传递进行分析,为该基因多态性与1型糖尿病的连锁提供进一步的依据.     

BTLA基因多态性与慢性HBV感染家系的遗传易感性

目的:探讨中国汉族人群T、B淋巴细胞弱化因子(Band Tlymphocyte attenuator,BTLA)基因单核苷酸多态性(single nucleotide polymorphism,SNP)与慢性乙型肝炎病毒(hepatitis Bvirus,HBV)感染家系的遗传易感性.方法:采用SNaPshot技术检测核心家系中慢性HBV感染者及其家庭成员BTLA基因rs2633562和rs2952323 SNP位点的多态性,采用家系内关联性分析(family-based association test,FBAT)基因型、等位基因及单体型分布频率.结果:单位点S N P遗传关联性分析显示,BTLA基因rs2952323位点多态性与慢性HBV感染的遗传易感有显著的相关性,G/G基因型Z=2.731,P=0.006308,G等位基因在附加遗传模型中Z=2.689,P=0.0007174,隐性遗传模型中Z=2.731,P=0.006308.传统的传递不平衡检验(transmission/disequilibrium test,TDT)和同胞对传递不平衡检验(siblings disequilibrium test,SDT)分析显示无主要的优势等位基因A、C或G从杂合的父母传递给患病子女,P=1.000000,P=0.151590.FBAT单倍型分析结果显示rs2633562-A/rs2952323-G(70.0%)存在优势单倍型传递给患病子女或者患病同胞,在附加遗传模型Z=3.093,P=0.001979,隐性遗传模型中Z=2.825,P=0.004721.结论:BTLA基因位点多态性可能与家族聚集性慢性HBV感染的遗传易感性相关.     

系统性红斑狼疮候选基因OAZ中单核苷酸多态性的系统筛选及相关分析

目的研究OLFl／EBF相关锌指蛋白基因（OAZ）上的单核苷酸多态性（SNP）与中国人群系统性红斑狼疮（SLE）发病的相关性。方法利用243个中国SLE患者核心家系DNA．依据http：／／www．hapmap．org/数据库中的信息，选取了OAZ基因上的35个SNP位点进行等位基因分型，以Haploview、Genehunter和Fbat生物信息学软件分析其与中国人SLE发病的相关性。结果对等位基因分型结果进行家系传递不平衡检验（TDT），提示rsl420683，rs6500240显示传递不平衡，rsl420683等位基因G优势传递给患者，传递：不传递=86：50，P=0．002；rs6500240等位基因C优势传递给患者，传递：不传递=88：56，P=0．008。结论OAZ基因上的SNP位点rs1420683和rs6500240与SLE发病相关．未发现这两个位点的突变影响转录因子的结合，并且相互之间并没有存在强的连锁关系，可能与邻近的某个影响蛋白结构或表达的功能性SNP存在连锁不平衡，需要进一步研究证实。     

组织蛋白酶D基因启动子序列单核苷酸多态性与急性心肌梗死的相关性

目的]探讨组织蛋白酶D基因启动子序列单核苷酸多态性与急性心肌梗死的关系。 [方法]采用病例-对照研究方法,对357例急性心肌梗死患者和347例对照人群的组织蛋白酶D基因启动子采用聚合酶链反应扩增目的基因片段并测序,结合目的基因测序后的序列及比对,GenBank上查找相对应的单核苷酸多态性位点后进行数据统计和分析。运用Hardy-Weinberg平衡检验后,应用χ²检验和t检验进行相关分析。采用Logistic回归对多种危险因素以及2个单核苷酸多态性位点与急性心肌梗死易感性进行关联性分析。用Haploview4.2软件和SHEsis在线软件进行连锁不平衡及单倍型分析。TRANSFAC数据库用于预测可能受单核苷酸多态性影响的转录因子的结合位点。 [结果]Logistic回归分析结果显示年龄增大、吸烟史、高血压病史、甘油三酯增高是急性心肌梗死的独立危险因素(P＜0.05),可明显增加急性心肌梗死的患病风险;高密度脂蛋白、胆固醇是急性心肌梗死的保护因素(P＜0.05),可明显降低急性心肌梗死的患病风险,此结果可能与心肌梗死组服用调脂类药物有关,需进一步扩大样本进行分析。在组织蛋白酶D基因启动子序列中的2个单核苷酸多态性位点与急性心肌梗死发病无关联性。进行连锁不平衡和单倍型分析提示,该2个单核苷酸多态性位点处于同一个连锁不平衡区域(D′=1.000,R²=0.978),单倍体型均未增加急性心肌梗死易感性(P＞0.05)。 [结论]组织蛋白酶D基因启动区两个单核苷酸多态性位点为完全连锁不平衡。该2个单核苷酸多态性位点及其单倍体型与急性心肌梗死发病无相关性,但提供了组织蛋白酶D基因启动区多态性的群体遗传学资料。     

尾加压素Ⅱ基因多态性与多囊卵巢综合征相关性的研究

目的 探讨尾加压素Ⅱ(UTS2)基因多态性与多囊卵巢综合征(PCOS)发病的关系.方法 用熔解温度不同的基因分型法.检测PCOS患者101例(PCOS组)及其父母202名和105名健康妇女(对照组)UTS2基因rs228648、rs2890565位点单核苷酸多态性(SNP),并检测基础状态下FSH、LH、睾酮、空腹血糖、空腹胰岛素水平.结果 PCOS组的UTS2基因rs228648 A/G多态性位点与对照组比较,基因型与等位基因频率均无明显差异,两组的SNP rs2890565基因型频率差异有统计学意义(P<0.05),PCOS组A等位基因频率明显高于对照组(P<0.05).传递不平衡检验(TDT)显示,SNP rs228648A/G在杂合子父母的2个不同等位基因无优势传递(P>0.05),而rs2890565 A/G在杂合子父母A等位基因优势传递(P<0.05).PCOS组UTS2基因SNP rs228648 GG基因型较携带A等位基因的PCOS患者稳态模型评估的胰岛素抵抗指数(HOMA-IR)明显增高(P<0.05).SNP rs2890565从和AG基因型空腹血糖、空腹胰岛素较GG基因型明显增高,从基因型HOMA-IR较GG基因型明显增高(P<0.05).结论 UTS2基因SNP rs228648 A/G多态性与PCOS无相关性,但与胰岛素抵抗存在关联.UTS2基因SNP rs2890565可能在PCOS的遗传易感性中起一定作用,A等位基因可能与PCOS的发生有关.     

Use of fab fragments of digoxin-specific antibodies in the therapy of massive digoxin poisoning

A case of massive digoxin ingestion with multiple arrhythmias, consisting of high grade A-V block and ventricular ectopy not responsive to lidocaine, is described. The arrhythmias ceased following administration of digoxin-specific Fab fragments. The patient improved and was transferred to the psychiatric unit.     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

Comparison of intravenous and oral routes of theophylline loading in acute asthma

In a prospective, randomized clinical trial, 19 patients with an acute exacerbation of asthma were given a loading dose of aminophylline by the IV (n = 10) or oral route (n = 9) of administration following treatment with epinephrine. Plasma concentrations of theophylline were measured prior to giving the loading dose, and one, two, three, and 24 to 48 hours later. Therapeutic effectiveness was evaluated by analyzing spirometric measurements prior to giving the loading dose, and one, three, and 24 to 48 hours later. Side effects also were recorded. In the IV group, the mean peak plasma theophylline concentration was 15.1 micrograms/mL one hour after loading, and in the oral group the mean peak serum theophylline concentration was 14.2 micrograms/mL three hours after loading. There was no correlation between theophylline concentrations and normalized change in spirometric values. There was no significant difference in spirometric values between the IV and oral groups. Nausea was slightly more common in the IV group. We conclude that there is no therapeutic advantage to giving a loading dose of aminophylline by the IV route rather than orally in patients with mild-to-moderate exacerbation of asthma initially treated with epinephrine.     

Role of microRNA in regulation of myeloma-related angiogenesis and survival

Multiple myeloma (MM) is a malignant disease caused by clonal proliferation of plasma cells that result in monoclonal gammopathy and severe end organ damage. Despite the uniform clinical signs, the disease is very diverse in terms of the nature and sequence of the underlying molecular events. Multiple cellular processes are involved in helping the malignant cells to remain viable and maintain proliferative properties in the hypoxic microenvironment of the bone marrow. Specifically, the process of angiogenesis, triggered by the interactions between the malignant MM cells and the stroma cells around them, was found to be critical for MM progression. In this review we highlight the current understanding about the epigenetic regulation of the proliferation and apoptosis of MM cells and its dependency on angiogenesis in the bone marrow that is carried out by different microRNAs.     

RNA-Seq在老年神经退行性疾病研究中的应用

阿尔茨海默病及帕金森病是老年人最常见的两种神经退行性疾病,但其发病机制及治疗是研究的热点。随着高通量测序技术的进步及成本的下降,RNA-Seq也成为神经退行性疾病机制研究及生物标志物发现的有力手段。RNA-Seq相对于microarray具有高灵敏度、高准确性、高重复性以及噪声低等优势,在阿尔茨海默病及帕金森病研究中有较为广泛的应用,包括检测差异表达基因,可变剪接、新长链非编码RNA预测分析和miRNAs调控等,但是容易受病理复杂性及样本等因素影响。目前阿尔茨海默病及帕金森病转录组研究相比于癌症等还不够深入,在临床诊断及治疗应用还面临较大挑战。但是随着新技术及新方法的发展,RNA-Seq将进一步推动神经退行性相关疾病的研究和临床转化。     

岳阳市城区小学生血吸虫病防治健康教育现状调查

目的 调查湖南省岳阳市城区小学生血吸虫病防治知识、行为现状及健康教育需求情况,为制定科学有效的小学生血吸虫病健康教育方案提供参考依据。方法 采用分层整群抽样方法,抽取岳阳市城区洞庭湖湖畔学校和中心城区学校各2所,每所再从五、六年级分别抽取2个班的学生,通过调查问卷了解小学生血吸虫病相关知识、预防行为及健康教育需求,并进行统计分析。结果 共调查湖畔小学353人、中心城区小学363人,两组学校小学生年龄、性别、年级构成差异无统计学意义（t=-0.494,χ²_性别=1.615,χ²_年级=2.152;P均>0.05）。学生血吸虫病防治知识总知晓率为42.60%（305/716）,其中,湖畔学校小学生血防知识知晓率（52.97%）高于中心城区（32.51%）,差异有统计学意义（χ²=30.661,P<0.05）;学生行为正确率为76.68%（549/716）,血防知识知晓组行为正确率（81.31%）高于不知晓组（71.24%）,差异有统计学意义（χ²=6.384,P<0.05）。学生血防知识主要来源于老师（47.49%）;91.90%的学生愿意了解更多的血防知识,最喜欢的血防知识学习方式是参加课外活动（50.42%）。结论 岳阳市城区小学生的血防知识知晓率及行为正确率偏低,对血吸虫病防治健康教育需求较高。建议针对学生开展形式多样的血防健康教育,以增强学生的血吸虫病防护意识,提高自我防护能力。     

欧洲儿童肝豆状核变性诊疗推荐意见简介

正肝豆状核变性(Wilson’s disease,WD)是常染色隐性遗传相关的铜代谢障碍性疾病,估计患病率为1:30000。该病是由于编码P型ATP酶的ATP7B基因突变,影响铜的分泌及排泄所致铜沉积。儿童肝豆状核变性的临床表现可以从无症状肝脏疾病到肝硬化或者肝衰竭,但是神经精神症状却非常少见。常规的检测方法包括血清铜蓝蛋白、24 h尿铜。最终的诊断需要基于症状、评估铜代谢的生化学检     

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation

The role of the external and internal anal sphincters in the mechanism of anal continence is presented. The external sphincter induces continence by 1) preventing internal sphincter relaxation, what I have called the “voluntary inhibition action,” and 2) mechanical compression of the rectal neck and anal canal proper. The mechanism of both actions is described. The internal sphincter plays a significant role not only in involuntary, but also in voluntary, continence. The importance of this role in the correction of anal incontinence is clarified. “Stress defecation,” a condition which follows internal sphincter damage, is discussed. A “single loop continence” theory is presented, based on the fact that each of the three loops of the external sphincter has its own innervation, attachment, and direction of muscle bundles; each loop thus acts as a separate sphincter. The clinical application of this theory is presented.     

Predicting, treating and preventing postoperative recurrence of Crohn's disease: the state of the field

The majority of patients diagnosed with Crohn's disease eventually require surgical intervention. Unfortunately, postsurgical remission tends to be short lived; a significant number of patients experience clinical relapse and many require additional operations. The pathogenesis of this postoperative recurrence is poorly understood and, currently, there are no reliable tools to predict when and in whom the disease will recur. Furthermore, the postoperative prophylaxis profiles of available Crohn's disease therapeutic agents such as 5-aminosalicylates, immunomodulators, steroids and probiotics have been disappointing. Recently, the combination of antibiotics and azathioprine in selected high-risk patients has demonstrated some potential for benefit. The goal of the present article is to provide a coherent summary of previous and new research to guide clinicians in managing the challenging and complex problem of postoperative Crohn's disease recurrence.