CYP11B2(C-344T)基因多态性与原发性高血压危险分层相关性分析

目的探讨CYP11B2(C-344T)基因多态性与原发性高血压(EH)危险分层的相关性。方法根据《中国高血压防治指南》中高血压危险分层方法,将244例EH患者分为中危组、高危组和极高危组,采用多聚酶链式反应-限制性片断长度多态性(PCR-RFLP)法检测CYP11B2(C-344T)基因多态性,相关分析采用χ2检验。结果EH组、EH危险分层各组及对照组基因型频率和等位基因频率均符合Hardy-Weinberg平衡定律。EH组CC、TT基因型频率高于对照组,TC基因型频率低于对照组,但差异无统计学意义(P>0.05)。EH组T和C等位基因频率与对照组相近(P>0.05);中危组、高危组、极高危组及对照组之间两两比较,TT、TC、CC基因型频率及T、C等位基因频率差异无统计学意义(P>0.05)。结论CYP11B2(C-344T)基因多态性与高血压危险分层无相关性。     

原发性高血压家系与血压正常家系ACE基因I/D突变及CYP11B2基因单核苷酸多态性的相关性研究

目的探讨原发性高血压家系与血压正常家系血管紧张素转换酶（ACE）基因插入/缺失位点及醛固酮合成酶（CYP11B2）基因C( 344)T位点单核苷酸多态性的关系。方法以家系为基础进行高血压家系-血压正常家系对照研究。高血压家系组：高血压家系62个,229例受试者;正常血压家系组：正常血压家系61个,221例受试者。采用PCR技术,分析ACE基因多态性;采用PCR RELP技术,分析CYP11B2基因多态性。基因型和等位基因频率用基因计数法。结果与正常家系组比较,高血压家系组第一、二代及三代受试者全体ACE基因DD基因型与D等位基因频率升高（P＜0.05）,高血压家系组各代及三代受试者全体CYP11B2基因TT基因型及T等位基因发生频率明显多于正常血压家系（P＜0.05）。与ACE基因I/D多态性协同作用中,高血压家系组的CYP11B2基因TT基因型及T等位基因发生频率明显多于正常血压家系（P＜0.05）。结论家族性原发性高血压与ACE基因I/D多态性及CYP11B2基因T（-344）C多态性之间具有相关性。D及T等位基因频率增高是原发性高血压患者家族中ACE基因I/D多态性及CYP11B2基因T（-344）C多态性的分布特点。D及T等位基因可能在家族性原发性高血压遗传中起协同作用。     

新疆维吾尔族原发性高血压与CYP11B2基因-344T/C多态性的关联性

目的:探讨维吾尔族人群原发性高血压与醛固酮合成酶基因(CYP11B2)-344T/C多态性的关联性。方法:采用聚合酶链反应、限制性片段长度多态性的方法,检测新疆和田地区维吾尔族233例原发性高血压患者(高血压组)和252例正常人群(对照组)醛固酮合成酶基因(CYP11B2)-344T/C多态性。结果:维吾尔族正常人群及高血压患者的-344T/C基因多态性CC、TT、TC基因型频率分布分别为0.167、0.401、0.433和0.155、0.386、0.459,C和T等位基因分布频率分别为0.383、0.617和0.384、0.616,符合Hardy-Weinberg平衡。高血压组与对照组CYP11B2基因-344T/C的C及T等位基因分布差异无统计学意义(χ2=0.001,P=0.97),基因型频率差异无统计学意义(χ2=0.370,P=0.831)。结论:新疆和田地区维吾尔族原发性高血压与CYP11B2基因-344T/C多态性无关联。     

ACE基因和CYP基因多态性与妊娠期高血压疾病的相关性研究

目的 探讨血管紧张素转换酶(ACE)基因插入/缺失(1/D)、醛固酮合成酶(CYPllB2)基因-344T/C位点突变多态性与妊娠期高血压疾病的相关关系.方法 采用聚合酶链反应一限制性内切酶片段长度多态性技术(PCR-RFLP),分别检测87例妊娠期高血压疾病组和175例正常对照组ACE基因I/D、CYP11B2基因-344T/C突变位点的基因型.结果 妊娠期高血压疾病组中ACE基因I/D的ID和DD基因型频率明显高于正常对照组,分别为41.4%和28.7%;相对于II 基因型,携带ID和DD基因型人群患妊娠期高血压疾病的OR值分别为1.981和2.347;D等住基因频率也高于正常对照组为49.42%,差异有显著性;相对于I等位基因,D等位基因患妊娠期高血压疾病的OR值为1.737;妊娠期高血压疾病组CYP11B2基因-344T/C的TC和CC基因型频率分别为40.2%和17.2%;相对于TT基因型,携带TC和cc基因型人群患妊娠期高血压疾病的OR值分剐为1.577和6.081;c等位基因频率为37.4%,相对于T等住基因,C等位基因患妊娠期高血压疾病的OR值为2.114;ACE和CYP11B2两组联合基因分析:相对于 II-TT联合基因型,同时携带TC-DD联合基因型患妊娠期高血压疾病的OR值为6.019:CC-II、CC-ID、CC-DD联合基因型由于样本量小,不具有代表性,应加大样本量.其余联合基因型,差异均无显著性(P>0.05).结论 ACE基因中D等位基因及CYP11B2基因 -344T点突变等位基因C可能增加妊娠期高血压疾病的遗传易感性;在妊娠期高血压疾病的发生中,ACE基因及CYP11B2基因可能共同对妊娠期高血压疾病的发生起作用.     

ACE I／D和 CYP11 B2-344 C／T基因多态性与齐齐哈尔汉族人群原发性高血压的关系

目的：观察齐齐哈尔地区原发性高血压（ EH）患者ACE I/D和CYP11B2-344 C/T基因多态性及其在EH发病中的相互作用。方法 EH患者486例,血压正常者457例。取外周血提取基因组DNA,用PCR-RLFP对ACE I/D和CYP11B2-344 C/T进行基因分型。结果（1）高血压组和血压正常组ACE I/D各种基因型分别为II 0．344/0．326、ID 0．372/0．497、DD 0．284/0．177（P＜0．001）,D等位基因频率为0．470/0．404（P ＜0．05）;（2）高血压组和血压正常组 CYP11B2-344 C/T 各种基因型分别为 CC 0．136/0．166、CT 0．469/0．438、TT 0．395/0．385（P＞0．05）,T等位基因频率为0．630/0．615（P＞0．05）;（3）高血压组DD＋CT联合基因型频率高于血压正常组（P＜0．01）;而高血压组ID＋TT联合基因型频率低于血压正常组（ P ＜0．05）。结论 ACE I/D 多态性与齐齐哈尔地区人群的原发性高血压相关, CYP11B2-344 C/T基因多态性与齐齐哈尔地区人群的原发性高血压不相关;但两基因可能存在相互作用。     

血管紧张素转换酶和醛固酮合成酶基因多态性与原发性高血压病的关系研究

目的 探讨血管紧张素转换酶(ACE)基因的插入/缺失(I/D)多态性和醛固酮合成酶(CYP11B2)基因-344C/T多态性与原发性高血压病(EH)之间的关系.方法 应用聚合酶链反应(PCR)对200例汉族EH患者和192例汉族正常血压者的ACE基因I/D多态性和CYP11B2基因-344C/T多态性进行检测,测定空腹血糖、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)等指标,分析各基因型和等位基因频率与EH的关系.结果 ACE I/D各基因型在EH组和正常对照组间差异有统计学意义(P=0.022),ACE D等位基因在EH组中的频率明显高于对照组 (0.49和0.37,P=0.012).用Logistic 回归模型校正了传统危险因素的影响后,ACE DD基因型的携带者患高血压的危险性显著增加(P=0.003),OR值为3.66[95%CI(1.54,8.69)];EH组和对照组CYP11B2-344C/T各基因型与等位基因频率比较,差异均无统计学意义(P＞0.05).结论 ACE DD基因型与EH发病相关,可能是高血压发病的风险因子,CYP11B2基因-344T/C多态性不能独立预测高血压的患病风险.     

血管紧张素Ⅱ受体2型基因及醛固酮合酶基因多态性与高血压左室肥厚相关性研究

目的观察血管紧张素Ⅱ受体2型(AT2-R)基因 1675A/G多态性及醛固酮合酶(CYP11B2)基因-344C/T多态性与高血压左室肥厚(LVH)的相关性。方法按心脏超声特点将314例原发性高血压患者分为左室肥厚〔LVH( )〕组156例(男61例,女95例),无左室肥厚〔LVH(-)〕组158例(男96例,女62例)。使用常规方法提取白细胞DNA,采用多聚酶链式反应(PCR),限制性内切酶方法测定AT2-R基因多态性及CYP11B2基因多态性。结果(1)在LVH( )组与LVH(-)组,男性和女性AT2-R基因 1675A/G多态性各基因型构成及等位基因频率间差别均无显著性意义(P>0.05);(2)CYP11B2基因-344C/T多态性显示LVH( )组TT基因型频率显著高于LVH(-)组(P<0.05),而CT基因型频率LVH( )组显著低于LVH(-)组(P<0.05);T等位基因频率LVH( )组显著高于LVH(-)组(P<0.05)。结论(1)AT2-R基因 1675A/G多态性与高血压LVH的发生无关;(2)CYP11B2基因-344TT基因型及T等位基因频率与高血压LVH的发生有关。     

醛固酮合酶基因-344T/C多态性与心房颤动的相关性研究

目的探讨原发性高血压人群醛固酮合酶(CYP11B2)基因-344T/C多态性与心房颤动(Af)的关系.方法运用病例对照法,选择402例原发性高血压患者,运用PCR-RFLP对202例伴AF者(Af组)和200例窦性心律者(Non-Af组)的CYP11B2基因-344T/C多态性进行基因分型及分析.结果2组T和C 等位基因的分布,差异无统计学意义(χ2=1.36 P=0.24);三种基因型分布比较,差异有统计学意义(χ2=10.69 P=0.005);Af组CC基因型频率明显高于Non-AF组,与携带TT+TC基因型者比较,高血压患者携带CC基因型者Af的风险增加(OR=1.91,95%CI:1.09~3.13).结论 CYP11B2基因-344T/C多态与原发性高血压患者Af的发生可能存在相关性.     

新疆不同民族原发性高血压与醛固酮合成酶基因CYP11B2—344T／C多态性的相关性研究

目的:探讨新疆维、哈、汉族人群醛固酮合成酶基因CYP11B-2-344T/C多态性与原发性高血压的关联性.方法:采用聚合酶链反应-限制性内切酶技术分别检测原发性高血压组(EH)(维族233例、哈族252例、汉族246例)和对照组(NT)(维族252例、哈族254例、汉族277例)醛固酮合成酶CYP11B-2-344T/C基因多态性.结果:醛固酮合成酶CYP11B-2-344T/C基因的C和T等位基因及CC、TT、CT基因型频率在维、哈、汉族的EH组及NT组分布差异均无统计学意义,但C和T等位基因频率在各民族间分布有显著差异.结论:CYP11B-2-344T/C多态性与新疆哈、维、汉族人群原发性高血压无相关性,但C和T等位基因频率分布在不同民族间有差异.     

北方汉族人群醛固酮合成酶基因多态性与高血压的关系

目的 探讨北方汉族人群醛固酮合成酶基因（CYP11B2）启动子区C-344T和第三外显子K173R多态性位点与原发性高血压的关系。方法在哈尔滨报社人群中分别选取182例原发性高血压患者和189例正常对照者进行病例．对照研究,采用多聚酶链式反应／限制性片段长度多态性（PCR—RFLP）及直接测序技术检测C-344T和K173R的基因型。结果各位点基因型分布在男性和女性组中均符合Hardy—Weinberg遗传平衡定律。C-344T位点的基因型和等位基因频率以及K173R的等位基因频率在整个群体和按性别分组后亚群体的分布在高血压组和对照组间差异均没有显著性（P≥0．05）。而K173R位点的基因型频率在整个群体中具有边缘统计学意义（P=0．0500）,且在女性组中更为明显（P=0．0038）,并以显性方式遗传,这种遗传方式在对混杂因素进行校正后更加明显。同时K173R与女性的收缩压显著相关。结论 在北方汉族人群中,CYP11B2K173R多态性位点与女性高血压的易感相关联。     

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.