细胞毒性T淋巴细胞相关抗原4基因型与中国南方人群Graves’病的关系

【目的】探讨细胞毒性T淋巴细胞相关抗原-4（cytotoxic T lymphocyte associated antigen4）5因第一外显子A／G（49）多态性与中国南方汉族人群Graves’病的关系。【方法】用PCR—RFLP确定CTLA-4基因第1外显子49位点基因型，分析广东地区汉族人Graves’病患者（GD组）120例及123名正常人（对照组）CTLA-4基因多态性。并把GD患者按性别、家族史、TRAb、突眼等分别分两亚组后分析CTLA-4基因第1外显子A49G位点基因型及等位基因的频率。【结果】CTLA-4基因第1外显子49位点G等位基因频率在GD组为0．704，对照组为0．679，A等位基因频率在GD组为0．296，对照组为0．321，基因型频率GG在GD组为0．483，对照组为0．447，AA在GD组为0．089，对照组为0．075，二组间均无统计学差异，P值均〉0．05。在GD组，按性别、家族史、TRAb及突眼进行分亚组后分析，CTLA-4基因A49G位点的基因型、等位基因频率也没有表现出差异俨值均〉0．05）。【结论】CTLA-4基因第一外显子A/G（49）多态性可能不是中国南方汉族人Graves’病的主要易感因素。     

细胞毒性T淋巴细胞相关抗原-4基因多态性与Graves病复发的相关性研究

目的:探讨细胞毒性T淋巴细胞相关抗原(CTLA)-4基因多态性与Graves病(GD)复发的相关性.方法:选择102例GD复发患者(A组60例为停药3年内复发60例,B组为3年后复发42例)、40例GD初发患者和80名健康人群(正常对照组),应用聚合酶链反应-限制性内切酶片段长度多态技术进行CTLA-4基因外显子1第17密码子49位点A/G多态性检测.结果:CTLA-4基因第一外显子49位点基因型及等位基因的频率分布显示,GD初发组患者GG基因型频率及G等位基因频率均高于正常对照组(P<0.01).GD复发A组GG基因型频率均高于B组和初发组(P<0.01),B组GG基因型频率高于GD初发组(P<0.01).结论:CTLA-4基因外显子1第17密码子49位点A/G多态性与GD的发生存在相关性,该位点GG基因型可能是GD患者对抗甲状腺药物疗效差及早期复发的原因.     

CTLA-4基因的多态性与自身免疫性甲状腺病的相关性研究

目的 探讨细胞毒性T淋巴细胞相关抗原-4(cytotoxic T lymphocyte associated antigen4,CTLA-4)基因第一外显子49位点A/G多态性与自身免疫性甲状腺病(AITDs)的关系.方法 采用聚合酶链反应-限制性片段多态性(PCR-PFLP)技术分析60例自身免疫性甲状腺病患者,其中Graves病(GD)36例,桥本甲状腺炎(HT)24例,87例健康对照的CTLA-4基因第一外显子的49位点基因型.结果 GD组患者CTLA-4基因49位点A/G基因型及等位基因频率与对照组比较,差异有统计学意义(P＜0.05);HT组与对照组比较,差异无统计学意义(P＞0.05);GD、HT组按性别分层分析后发现CTLA-4基因49等位基因在不同性别的分布差异均无统计学意义.结论 CTLA-4基因49位点等位基因与GD显著相关;GD、HT患者49位点A/G等位基因的分布与性别无关.     

CTLA-4基因多态性与弥漫性毒性甲状腺肿的相关性

目的探讨细胞毒性T淋巴细胞相关抗原4（Cytotoxic Tlymphocyteassociated Antigen4,CTLA一4）基因外显子1的A／G多态性与汉族人群弥漫性毒性甲状腺肿（Gravesdisease,GD）的关系。方法采用多聚酶链反应-限制性片断长度多态性分析（PCR—RFLP）法,检测90名GD患者和90名健康人外周血CTLA-4基因外显子1的基因型并行分析。结果GD患者的CTLA-4外显子1的A／G49位点GG基因型频率及G等位基因频率较正常对照组显著增高（P〈0．001）。结论CTLA-4基因可能是汉族人群中GD的易感候选基因。     

CTLA-4、PTPN22基因多态性与温州地区汉族人桥本甲状腺炎的相关性

目的:探讨CTLA-4外显子1+49A＞G位点(rs231775)、PTPN22启动子-1123G＞C位点(rs2488457)基因多态性与温州地区汉族人群桥本甲状腺炎(HT)的相关性.方法:采用病例-对照的方法,用聚合酶链反应-限制性片段长度多态性( PCR-RFLP)及单一等位基因特异性引物-聚合酶链式反应技术(PCR-SASP)比较150例桥本甲状腺炎组与120例正常人对照组之间基因型、等位基因频率的差异.结果:HT组和对照组CTLA-4外显子1+49位点和PTPN22基因启动子-1123位点的基因型和等位基因频率的差异均有统计学意义.经等位基因频率的相对风险分析发现,CTLA-4外显子1+49位点G等位基因携带者患HT的风险是A等位基因的1.616倍(OR=1.616,95％CI:1.142～2.285),PTPN22启动子-1123位点C等位基因携带者患HT的风险是G等位基因的1.459倍(0R=1.459,95％CI:1.034 - 2.059).结论:CTLA-4外显子1+49A＞G、PTPN基因启动子-1123G＞C SNP与温州地区汉族人群HT的发生有相关性,CTLA-4外显子1+49G、PTPN22启动子-1123 C基因是HT的易感基因.     

云南汉族人群CTLA-4基因多态性与自身免疫性甲状腺疾病的关系

目的:探讨云南地区汉族人群自身免疫性甲状腺疾病(AITD)与细胞毒性T淋巴细胞相关抗原4(CTLA-4)第1外显子第17密码子49位点A/G基因多态性的相关性。方法:应用多聚酶链反应—限制性片断长度多态性分析(PCR-RFLP)的实验方法,检测82例Graves病(GD)患者,51例桥本氏甲状腺炎(HT)患者和80例健康人外周血CTLA-4基因第1外显子的第17密码子49位点的基因型并行分析。结果:GD组GG基因型的频率及等位基因G的频率明显高于健康对照组(X2=9.353,P=0.009;X2=7.548,P=0.006);而HT组GG基因型及G等位基因的分布频率与健康对照组比较差异无统计学意义(X2=0.062,P=0.969;X2=0.046,P=0.830)。结论:CTLA-4基因第1外显子的第17密码子49位点可能是云南汉族GD的易感候选基因。     

甲状腺眼病与CTLA-4基因外显子1第17密码子49位点A/G多态性的关系

目的:对Graves病伴眼病与不伴眼病患者CTLA-4基因外显子1第17密码子49位点A/G多态性进行研究,以期探讨Graves病患者伴发眼病的原因.方法:应用PCR技术并采用限制性内切酶BbvI来测定107例Graves病患者(其中伴突眼的50例,不伴眼病的57例)及57例健康对照者外周血单个核细胞CTLA-4基因外显子1第17密码子49位点A/G多态性.分析其基因表型、基因频率与眼病的关系.结果:无眼病GD组GG基因型的频率及等位基因G的频率与健康对照组相比差异均无显著性.而伴眼病GD组其GG基因型的频率及等位基因G的频率明显高于无眼病GD组及健康对照组.结论:CTLA-4外显子1第17密码子49位点A/G二态性GG基因表型可能是GD患者伴发突眼的重要因素.     

CTLA-4基因多态性与Graves病预后关系的研究

目的:对Graves病(GD)患者CTLA-4基因外显子1第17密码子49位点A/G多态性与GD患者的临床特点及其对抗甲状腺药物的疗效关系进行研究,为临床治疗的决策提供依据.方法:根据Graves病患者服用抗甲状腺药物的效果及其停药后是否复发分为A组(治疗效果较好、预后好组)与B组(难治性或易复发组).应用PCR技术并采用限制性内切酶BbvI来测定其外周血单个核细胞CTLA-4基因外显子1第17密码子49位点A/G多态性.分析其基因表型、基因频率与临床表现及预后的关系.结果:难治性或易复发的GD患者GG基因型及等位基因G频率明显高于治疗效果较好、预后好的GD患者,而AG基因型及等位基因A频率则明显低于治疗效果较好、预后好的GD患者.结论:CTLA-4基因外显子1第17密码子49位点表现为GG基因型可能是Graves病患者对抗甲状腺药疗效差及甲亢易复发的重要原因.     

CTLA-4基因微卫星多态性与广西地区汉族Graves病的相关性研究

目的研究CTLA-4基因微卫星多态性与广西地区汉族Graves病(Graves' Disease,GD)的相关性。方法64例广西地区汉族GD患者和50例正常对照组,应用聚合酶链反应技术,检测CTLA-4基因外显子4的3,非翻译区包含(AT)n[CTLA-4(AT)n]重复序列的特异性等位基因。结果广西地区汉族人CTLA-4(AT)n有18种等位基因;汉族GD组与正常对照组比较,106bp等位基因在GD组中显著增高(P<0.05),汉族正常对照组104bp等位基因频率较GD组高(P=0.01),差异有统计学意义。结论CTLA-4基因与广西汉族GD患者明显相关,CTLA-4(AT)n106bp等位基因可能是广西汉族GD的易感基因,104bp等位基因可能是广西汉族GD的保护基因。     

Association between CTLA-4 gene polymorphism and type 1 diabetes mellitus in Han population in the south of Henan province

目的 探讨细胞毒性T淋巴细胞相关抗原4(CTLA-4)基因第一外显子+49 A/G的多态性与豫南地区汉族人群1型糖尿病(T1DM )的相关性.方法 采用PCR-RFLP技术分析108 T1DM患者及100例正常对照组的CTLA-4基因第一外显子+49 A/G多态性.结果 T1DM 组等位基因+49G 频率明显高于正常对照组(P＝0.001),基因型GG明显高于正常对照组(P=0.005).结论 CTLA-4基因第一外显子+49 A/G多态性与豫南地区T1DM 易感性相关.     

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.     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.