自然流产夫妇染色体异常的三例报告

本文报道在80例2次或2次以上自然流产夫妇的细胞遗传学研究中发现的3例染色体异常,其发生率为3.75％。异常染色体核型分别为:46,XX,del(19)(pter→p12)146,XY,t(15;Y)(15qter→15p11::Yq11→Tqter);46,XX,t(3;14)(14qter→14q24::3p27→3qter;14pter→14q24)。结合复习文献,对自然流产夫妇的染色体异常发生率及其临床意义进行了讨论。     

习惯性流产夫妇中的3;18平衡易位核型

本文观察了1对习惯性流产夫妇的染色体,其丈夫有46,XY,t(3;18)(3qter→3p22::18q23→18qter;18pter→18q23::3p22→3qter)平衡易位核型,并有一个1qh~+的标记染色体。他们曾不明原因地连续流产3次,大产1胎无脑儿。这个平衡易位携带者为产前检查提供了新的易位核型。     

1例罕见的染色体易位t(6;9)(q23;p24)及其遗传咨询

本文报告1例因染色体平衡易位导致不良孕产史的患者。其表型正常,该染色体核型为46,XX,t(6;9)(6pter→6q23::9p24→9pter;9qter→9p24::6q23→6qter),国内外尚未见报道,并对其进行了遗传咨询。     

世界首报7例染色体异常核型

本文首报7例世界人类染色体异常核型如下: 46,XX,t(1;7)(p32;p22);46,XY,t(5;11)(q31;q23); 46,XY,t(3;6)(q21;q25);47,XY, 21,t(5;11)(q31;q23); 46,XX,t(X;14)(q13;q11);47,XY, 21,inv(6)(p21;q21); 46,XY,t(3;4)(q12;p11); 并就染色体平衡易位患者的表型效应及平衡易位染色体对染色体复合畸变的影响做了初步探讨。     

45,X,der(Y)t(Y;13)不育男性患者的临床细胞和分子遗传学研究

目的:了解核型为45, X, der (Y) t (Y; 13)(q11.1; q12), -13伴无精子症、双侧乳腺轻微发育和多发性皮下结节男性患者的分子遗传学特点. 方法:进行常规染色体核型分析,用荧光原位杂交(FISH)进一步确定患者核型.用PCR-STSs以确定Yq上的断裂点.用DNA多态性方法检测位于13q12 上的BRCA 2基因拷贝数.对患者的睾丸和皮下结节进行活检. 结果:细胞遗传学和FISH证实患者SRY基因和Y染色体着丝粒位于13号染色体上.因此,患者核型为45,X,der(Y)t(Y;13)(q11.1;q12),-13.ish der(Y)(SRY , DYZ3 , wcp13 ).Y染色体长臂上的AZFa,b,和C区域全部丢失,断裂点位于sY82以下.BRCA 2基因的多态性检测无拷贝数的丢失.睾丸活检结果为唯支持细胞综合征.皮下结节病理检查为血管脂肪瘤. 结论:患者的男性表型是由于基因组中存在SRY基因.无精子症、睾丸体积小与病理结果一致,是由于Y染色体Yq11.1 → Yqter 片段丢失所致.但血管脂肪瘤的分子机制仍然不清楚.     

急性早幼粒细胞白血病染色体易位联合R显带和间期荧光原位杂交技术分析

目的探讨荧光原位杂交(FISH)及常规细胞遗传学染色体核型分析技术对急性早幼粒细胞白血病(APL)患者PML/RARa融合基因检测的灵敏度和特异度及其在临床中应用价值。方法选取51例APL患者,应用常规细胞遗传学染色体核型分析方法及FISH技术检测患者PML/RARa融合基因的表达情况。结果在进行常规染色体核型分析的51例患者中41例(80.4%)为t(15;17)(q22;q21)易位的核型异常,其中38例(74.5%)为单纯t(15;17)(q22;q21)易位的核型异常,3例(5.9%)为伴t(15;17)(q22;q21)易位的复杂核型异常;10例(19.6%)无t(15;17)(q22;q21)易位的核型异常中1例(2.0%)为不伴t(15;17)(q22;q21)易位的复杂核型异常,1例(2.0%)为t(11;17)(q13;q21)易位的核型异常,3例(5.9%)为正常核型,5例(9.8%)未见分裂相。在进行FISH检测的51例患者标本中48例(94.1%)有PML/RARa融合基因异常,同时进行常规染色体核型分析和FISH检测的41例患者同时存在t(15;17)(q22;q21)易位的核型异常和PML/RARa融合基因异常,两者符合率为100%;在15例正常骨髓标本的FISH检测中15例标本结果均未发现有PML/RARa融合基因,提示FISH检测技术具有较高的敏感度和特异性。结论对于初发的APL患者,常规染色体核型分析和间期荧光杂交技术结合分析APL患者细胞遗传学特征是诊断该病的有力工具,FISH技术操作更为简单,省时直观。     

人体小细胞肺癌细胞系LTEP—sm的细胞遗传学研究

应用G显带技术对我国第一个小细胞肺癌细胞系(SCLC)LTEP-sm进行细胞遗传学研究,共分析分散及显带良好的55代和99代中期相细胞各30个,并对55代及99代各50个中期相细胞进行染色体计数。结果表明,该细胞系55代细胞染色体众数为51～53条,99代为51～54条,基本是一亚三倍体。恒定出现的标记染色体有6个,其中3号染色体短臂缺失即del3p14-23在30个中期相中高达26(55代)及28(99代)个;另5个标记染色体是t(1;15)(1qter→1p22∷15p12→15qter),del(1)(qter→p31:),del(7)(pter→q31:),t(6;9)(6pter→6q14∷9q21→9qter),del(12)(qter→p12.3:)。99代细胞的染色体众数与55代基本一致,且标记染色体完全相同,表明该细胞系遗传结构稳定。     

一例具t(3;11)相互易位合并11q部分缺失综合征的报告

本文对一例具有先天性智力低下,通贯掌,弱视及精神运动障碍等症状的女孩,进行了外周血培养,G-显带分析,发现其核型为46,xx,t(3;11)(3qter→3P21∶11P14→11Pter;11P14→11q24:3P21→3Pter),del(11q24→11qter).经一年多的追踪观察,发现该女孩具11q部分单体综合征相类似的临床症状,故认为染色体的不平衡易位是引起先天性畸形的主要原因之一。     

世界首报四例染色体异常核型

(1)本文报告4例,世界上尚未报导的染色体异常核型,分别为:46,xx,t(6;9)(q21;p22) 46,xy,t(1;18)(q21;q21)46,xx,t(4;9)(p14;q34) 46,x,t(x;13)(q28;q14)(2)阐述了广泛开展细胞遗传学检查的重要性。     

用Y特异DNA探针对染色体核型46,X,t(X;Y)(p22.3;q12.1)患者的分析

本文报道一女性的第一、二性征均正常,但GTG显带的核型中可见到下条异常X染色体短臂增长,断裂点为Xp22.3,CBG显带核型中异常X染色体均连接1个额外浅染片段。用凝胶原位杂交法以Y特异DNA探针进行DNA分析,分子杂交图谱与正常男性相一致,证实患者基因组DNA含有DYZ_1重复顺序。故该女性染色体核型为46,X,t(X; Y) (qter→p22.3::q12.1→qter).此外,对患者的临床特征、女性性腺激素、染色体异常产生原因及有关问题作了讨论。     

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.