雌激素受体单核苷酸多态性与妊娠期肝内胆汁淤积症遗传易感性研究

目的探讨雌激素受体单核苷酸的多态性与妊娠期肝内胆汁淤积症（ICP）遗传易感性的相互关系。方法应用PCR和RFLP技术,对我院2009年8月～2011年10月收治的200例ICP患者（ICP组）及200例非ICP患者（对照组）产妇的雌激素受体α（ERα）基因多态性进行分析。结果 ICP组ERαPvuⅡ酶切后基因型PP、Pp、pp的基因频率以及等位基因P与p的基因频率与对照组差异无统计学意义（P〉0.05）;ERαXbaⅠ酶切后基因型XX、Xx、xx基因频率以及等位基因X与x的基因频率与对照组差异无统计学意义（P〉0.05）。两组ERα基因的PvuⅡ和XbaⅠ的联合基因型分布差异无统计学意义（P〉0.05）。结论雌激素受体单核苷酸的多态性与ICP的发病无明显相关。     

特发性中枢性性早熟女童ERα基因Pvu Ⅱ和Xba Ⅰ多态性分析

目的 探讨雌激素受体α(Estrogen receptor,ERα)基因PvuⅡ和Xba Ⅰ多态性与特发性中枢性性早熟(Idiopathic central precocious puberty,ICPP)女童发病的关系.方法 选取特发性中枢性性早熟女童100例,同时选择体检健康女童100例为对照组,采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)方法检测两组女童ERα基因内切酶PvuⅡ和Xba Ⅰ限制性片段长度多态性,比较分析两组Pvu Ⅱ和Xba Ⅰ基因型及等位基因分布频率.结果 ①ERα基因PvuⅡ基因型PP、Pp、PP频率,XbaⅠ基因型XX、Xx、xx频率分别与对照组相比,差异均有统计学意义(x2=9.023,P=0.011;x2=11.740,P=0.003);②携带Pvu Ⅱ的P等位基因发生ICPP的相对风险是p的1.750倍(95％CI:1.152～ 2.659,P＜0.05);携带XbaⅠ的X等位基因发生ICPP的相对风险是x的2.061倍(95％CI:1.351～ 3.145,P＜0.05).结论 在ICPP人群中存在雌激素受体α基因Pvu Ⅱ和Xba Ⅰ位点基因多态性,P等位基因和X等位基因可能是特发性中枢性性早熟女童遗传易感性基因,Pp基因型或Xx基因型相对易于患病.     

雌激素受体基因多态性与子宫内膜异位症、子宫肌腺症的相关性研究

目的 探讨雌激素受体基因ERα多态性是否与子宫肌腺症、子宫内膜异位症的发病相关.方法 应用聚合酶链反应(PCR)和限制性片断长度多态性分析(RFLP)检测68例子宫肌腺症、56例子宫内膜异位症患者和78例正常健康妇女ERα基因型.结果 ERα PvuⅡ基因频率pp、Pp、PP在子宫肌腺症组和对照组分别为:38.2%vs39.7%、42.6% vs 48.7%、19.1% vs 11.5% ;XbaⅠ基因型频率xx、Xx、XX在子宫肌腺症组和对照组分别为61.7% vs 56.4%、32.4% vs 41.0%、5.4% vs 2.6%, 两组比较差异无统计学意义(P>0.05).PvuⅡ基因型频率pp、Pp、PP在子宫内膜异位症组和对照组分别为:44.6%和39.7%、37.5%和48.7%、17.9%和11.5% ;XbaⅠ基因型频率xx、Xx、XX在子宫内膜异位症组和对照组分别为64.2%和56.4%、32.1%和41.0%、3.6%和2.6% ,两组比较差异无统计学意义(P>0.05);ERα多态性与宫内膜异位症患者临床分期也无关联.结论 雌激素受体基因ERα多态性可能与上海地区子宫肌腺症、子宫内膜异位症的发病无关联.     

雌激素α受体PvuⅡ和XbaⅠ基因多态性与产后抑郁障碍的相关性

目的探讨雌激素α受体(ERα)基因多态性与产后抑郁障碍发生的关联性,为产后抑郁障碍发生的病因机制提供遗传学证据,进而为疾病基因诊断与治疗提供理论基础。方法选取产后抑郁障碍产妇(产后抑郁组)与健康产妇(正常对照组)各45例,运用限制性片段长度多态性聚合酶链式反应分析法、基因记数法统计两组ERα基因的基因型和等位基因频率,分析ERαPvuⅡ和XbaⅠ多态性与产后抑郁的关联性。结果产后抑郁组与正常对照组ERαPvuⅡ基因型及等位基因(P与p)频率分布差异有统计学意义(P<0.05),产后抑郁组与正常对照组ERαXbaⅠ基因型及等位基因(X与x)频率分布差异无统计学意义(P>0.05),ERαPvuⅡ与XbaⅠ联合基因型分布差异无统计学意义(P>0.05)。结论 ERαPvuⅡ基因多态性与产后抑郁障碍发病有相关性,XbaⅠ基因型突变对于产后抑郁障碍发病无相关性,联合基因分析,产后抑郁产妇与健康产妇整体基因型分布相似。     

雌激素受体基因多态性与复发性流产的相关性研究

目的探讨雌激素受体(ER)基因多态性与复发性流产的相关性.方法取实验组与对照组妇女外周血,采用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)方法研究ER基因的XbaⅠ和PvuⅡ酶切多态性,通过统计学分析探讨ER基因的多态性分布与复发性流产的关系.结果 ER基因PvuⅡ酶切多态性分布与复发性流产存在显著相关性(P<0.01),而ER基因XbaⅠ酶切多态性分布与复发性流产无显著相关性(P>0.1).结论 ER基因PvuⅡ酶切多态性分布与复发性流产显著相关(P<0.01).本研究为探讨复发性流产在分子生物学范畴的发病机制及预防与预后提供了有益的依据.     

中国北京地区绝经后汉族妇女雌激素受体基因多态性与骨密度的相关性研究

目的 :研究雌激素受体 (estrogenreceptor,ER)基因多态性在中国北京地区绝经后的汉族妇女中的分布及其与骨密度的相关性。方法 :采用聚合酶链式反应 限制性片段长度多态性 (PCR restrictionfragmentlengthpoly morphisms ,PCR RFLP)方法研究ER基因的XbaⅠ和PvuⅡ酶切多态性 ,检测骨密度 ,通过方差分析探讨ER基因的多态性分布与骨密度的关系。结果 :ER基因PvuⅡ酶切多态性分布与桡骨松质骨以及桡骨密质骨的骨密度之间不存在相关性 ,而ER基因XbaⅠ酶切多态性分布与桡骨松质骨以及桡骨密质骨的骨密度之间存在相关性 ,XX基因型骨密度值最低 ,xx基因型骨密度值最高。结论 :ER基因XbaⅠ酶切多态性分布与桡骨松质骨以及桡骨密质骨的骨密度之间显著相关 (P <0 .0 5 )。本研究为探讨骨质疏松症在分子生物学范畴的发病机制及预防与预后提供了有益的依据     

雌激素受体基因多态性与脑梗死的相关性研究

目的　探讨中国汉族人群雌激素受体 (ER)基因PvuⅡ和XbaⅠ酶切多态性与脑梗死的相关性。方法　采用病例 对照研究方法和PCR RFLP方法 ,检测 2 34例脑梗死和 2 59例非脑血管病患者的ER基因PvuⅡ及XbaⅠ多态性 ,用多元Logistic回归模型分析与脑梗死的相关性。结果　经年龄、性别、吸烟、饮酒、文化程度、高血压、糖尿病、冠心病、高脂血症调整后可见 :(1 )ER基因PvuⅡ酶切多态性的Pp基因型致脑梗死发病危险性显著增加 (OR =1 97,95 %CI:1 2 1～ 3 2 1 ) ;(2 )ER基因XbaⅠ酶切多态性与脑梗死无显著相关性 ;(3)ER基因PPXx Ppxx基因型经高血压、高脂血症分层前后均致脑梗死发病危险性显著增加 (OR值分别为 1 67,2 52及 2 1 8,P <0 0 5) ;(4)ER基因PvuⅡ酶切多态性与高血压、糖尿病、高脂血症对脑梗死的发生具有明显的协同作用。结论　ER基因可能是中国人群脑梗死的遗传易感基因     

妊娠高血压综合征和雌激素受体基因血管紧张素转化酶基因相关性研究

目的 探讨雌激素受体(estrogen receptor ER)基因和血管紧张素转化酶(anglotensin lconverting enzyme.ACE)基因基因多态性与妊娠高血压综合征发生的相关性。方法:采用聚合酶链反应(PCR)和限制性内切酶长度多态性方法 分别对近5年之内的妊高征病人117例及同期正常怀孕妇女110例的ER基因和ACE基因的基因型进行分析,并统计分析。结果 1ER PVU Ⅱ基因类型包括突变型(PP)、杂合型(Pp)、野生型(pp)ER X bal基因类型包括突变型(XX)、杂台型(Xx)、野生型(xx),ACE基因类型包括缺失型(DD)、杂合型(DI)、插入型(ⅠⅠ)。2.妊高征病人PP,XX和DD基因型频率均明显高于正常妊娠妇女 P X和D等位基因频率也都明显高于正常妊娠妇女。结论:ER的Pvu Ⅱ基因多态性、Xba Ⅰ基因多态性以及ACE基因多态性都与妊高征的发病有关。     

雌激素受体基因多态性与急性心肌梗死关系的研究

目的 了解雌激素受体（ER）基因多态性在中国汉族人群中的分布及其与急性心肌梗死（AMI）是否相关。方法 应用聚合酶链反应（PCR）和限制性片段长度多态性（RFLP）分析方法,检测75例AMI患者和118例正常对照者ER基因型,结合血脂水平、选择性冠状动脉造影（SCA）结果探讨两者间的关系。结果 ER等位基因X、x和P、p频率在AMI组和对照组分别为0.207、0.793,0．169、0.831;0.287,0.713,0.339,0.661。基因型频率分布符合Hardyweinberg平衡定律。XbaI酶切多态性基因型频率,等位基因频率及结合XbaI和PvuⅡ两个酶切多态性分析在组内、组间比较差异均无显著意义（P＞0．05）,且ER基因型间血脂水平、SCA结果在组内比较差异均无显著意义（P＞0．05）。但是,PvuⅡ酶切多态性在正常对照组与AMI组比较差异有显著意义（P＜0．05）,而Pvu Ⅱ酶切多态性与AMI有相关性（P＜0．05）,Pvu Ⅱ基因多态性可能是AMI发病的危险因素之一。     

雌激素受体基因多态性与女孩性早熟关系的研究

目的 探讨雌激素受体α(ERα)、雌激素受体β(ERβ)基因多态性与女孩性早熟的相关性.方法 应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析技术,分别检测90例性早熟女孩(病例组)和70例健康体检者(对照组)ERα基因PvuⅡ和XbaⅠ酶切位点基因多态性及ERβ基因RsaⅠ和AluⅠ酶切位点基因多态性,并观察基因型对血清雌二醇(E2)的影响.结果 病例组ERα基因XbaⅠ、ERβ基因RsaⅠ基因型和等位基因频率分布与对照组相比差异均有统计学意义(均P＜0.05).等位基因X使女孩性早熟发病风险提高了2.26倍(95%CI:1.35~3.78);纯合子突变(XX)基因型、杂合子突变(Xx)基因型与野生型(xx)基因型相比,患性早熟的危险度分别为1.32倍(95%CI:0.46~3.81)和2.51倍(95%CI:1.27~4.97).等位基因R使女孩性早熟发病风险提高了3.12倍(95%CI:1.90~4.79);纯合子突变(RR)基因型、杂合子突变(Rr)基因型与野生型(rr)基因型相比,患性早熟的危险度分别为7.05倍(95%CI:2.78~7.88)和2.64倍(95%CI:1.09~6.42).E2增高组ERα基因XbaⅠ和ERβ基因AluⅠ基因型分布与E2正常组相比,差异均有统计学意义(均P＜0.05);ERα基因RsaⅠ及ERβ基因 Pvu Ⅱ基因型和等位基因频率分布在病例组与对照组、E2增高组与E2正常组相比,差异均无统计学意义(均P＞0.05).结论 ERα基因XbaⅠ位点和ERβ基因RsaⅠ多态性与女孩性早熟有关,突变基因增加了女孩性早熟的发病风险,Xx和RR基因型最易患病.     

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.     

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.     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.