雌激素受体基因多态性与中国南方妇女绝经后脊柱骨质疏松症的关系

目的 对中国南方绝经后妇女雌激素受体（ER）基因PvuⅡ和XbaⅠ核酸限制性内切酶多态性与脊柱骨质疏松的关系进行病例一对照调查，了解ER基因多态性与妇女绝经后脊柱骨质疏松的关系。方法 182名中国南方绝经后妇女，均用DEXA检测腰椎（L2-5）的骨密度，用PCR—RFLP鉴定雌激素受体的基因型。分析ER基因多态性与骨密度关系以及各基因型在骨质疏松组与对照组的分布。结果 骨密度呈以下分布规律：PP〈Pp〈PP、xx〈Xx〈XX。PP，PPxx，Ppxx的骨密度较其他基因型低。在分层分析中，表明PP型及复合基因型PPxx及Ppxx型在脊柱的骨质疏松组中的分布频率高于对照组，差异有显著性（P〈0．01）。结论 ER基因PvuⅡ和XbaⅠ核酸限制性内Ⅵ酶多态性与骨质疏松存在关系，可以将ER基因PvuⅡ和Xbal多态性作为在中国南方进行筛选绝经后脊柱骨质疏忪高危人群的依据之一。     

绝经后妇女骨质疏松侯选基因ER、IL-6、C0LIA1 的研究

目的 骨质疏松是一种多基因疾病，本研究目的是探讨绝经后妇女的雌激素受体（ER）、白介素－6（IL－6）和I型胶原α1（COLIA1）基因多态性与骨密度等指标的关系。方法 用DEXA检测205例绝经后妇女的腰椎和股骨颈骨密度，用PCR－RFLP方法检测ER基因PvuⅡ和XbaI多态性和I型胶原α1（COLIA1）基因多态性；PCR扩增IL－6基因3‘端非翻译区的多态性区域。结果 ER基因PP、Pp和pp基因型频率分别为13．7％、51．2％和35．1％，pp型的绝经后妇女股骨颈骨密度Z值明显高于Pp型。ER基因XX、Xx和xx基因型分别占6．8％、25．9％和67．3％。XX基因型的妇女虽然停经时间更长，但腰椎骨密度仍高于Xx和xx型。发现了D／D、D／E、C／D、C／C和E／E5种IL－6基因型，93％以上的绝经后妇女属于D／D和D／E型。在绝经10年以上的妇女中，D／E型的腰椎骨密度明显高于D／D型，且前者的体重指数更高。所有样本的COLIA1基因型检测结果都是无突变的纯合子SS。结论 ER基因型中的pp和XX型可能分别对股骨颈和腰椎有保护作用；IL－6基因多态性与停经时间较长的绝经后妇女腰椎骨密度有一定关系；COLIA1基因型可能不适于评估本地区绝经后妇女骨密度的差异。这些骨质疏松候选基因的意义尚有待在不同种族的人群进行更大样本的研究。     

内蒙古地区蒙古族男性雌激素受体基因多态性与骨密度关系的研究

目的 探讨内蒙古地区蒙古族男性雌激素受体a(estrogen receptor,ER)基因多态性与骨密度(BMD)的关系.方法采用PCR- 限制性片段长度多态性检测500名无血缘关系的蒙古族健康男性ER- a基因XbaⅠ和PvuⅡ多态性,结合双能X 线吸收仪检查腰椎(L2-L4)和股骨近端股骨颈( femoral neck)、大转子区( trochanter) 和Ward三角部位BMD.结果 本研究人群XbaⅠ和PvuⅡ等位基因频率分布符合Hardy-Weinberg 定律.PvuⅡ多态性与腰椎(L2-L4)和Ward三角部位BMD 值均有相关性( P<0.05),而XbaⅠ多态性与各部位BMD 值均无相关性; PP基因型在上述部位平均BMD值明显高于Pp和pp 基因型(P< 0.05).结论 本研究结果提示ER-a基因PvuⅡ多态性直接影响蒙古族男性松质骨的骨峰值.     

雌激素受体α和维生素D受体基因多态性与哈尔滨地区绝经后妇女骨密度的关系

目的探讨哈尔滨市绝经后妇女雌激素受体α(ER-α)基因和维生素D受体(VDR)基因多态性与骨密度的关系。方法对哈尔滨市81例无亲缘关系汉族健康妇女进行PCR-RFLP测定ER-α基因PvuⅡ、XbaⅠ多态性和VDR基因BSMⅠ多态性,用双能X线吸收法测定骨密度(BMD)。结果本研究人群PP、Pp及pp基因型频率分别为13.6%、49.4%、37.0%;XX、Xx及xx基因型频率各为4.9%、40.7%、54.4%;BB、Bb及bb基因型频率各为0%、16.0%、84.0%,t检验分析各基因型与BMD值的关系显示:绝经后妇女中,雌激素受体基因型仅与腰椎骨密度有显著差异。维生素D受体基因型在股骨颈、大转子部位有显著差异。PvuⅡ多态性和BSMⅠ多态性共同作用对骨密度影响更大。结论雌激素受体、维生素D受体基因型分布频率均符合Hardy-Weinberg定律,并且与骨密度有一定的关联,尤其是基因与基因的共同作用与骨密度的关系更为密切。     

雌激素受体基因Pvu Ⅱ多态性对筛选绝经后骨质疏松危险因素的作用

目的 通过雌激素受体基因PvuⅡ基因分型，筛选绝经后骨质疏松的危险因素。方法 检测759例绝经后骨质疏松症者腰椎、股骨上段的骨密度和198例雌激素受体基因PvuⅡ基因型，分析不同基因型的年龄、体重指数等因素与骨密度的相关性。结果 在PP型，低体重是股骨颈、大转子骨密度的危险因素；在pp型，高龄是大转子、Ward’s区骨密度的危险因素；在Pp型，高龄是腰椎、股骨颈、Ward’s骨密度的危险因素；低体重是股骨颈、大转子骨密度的危险因素。结论 通过雌激素受体基因PvuⅡ多态性筛选危险因素对临床防治绝经后骨质疏松有重要的指导价值。     

绝经后妇女骨质疏松侯选基因ER、IL-6、COLIA1的研究

目的　骨质疏松是一种多基因疾病 ,本研究目的是探讨绝经后妇女的雌激素受体(ER)、白介素 6 (IL 6 )和Ⅰ型胶原α1(COLIA1)基因多态性与骨密度等指标的关系。方法　用DEXA检测 2 0 5例绝经后妇女的腰椎和股骨颈骨密度 ,用PCR RFLP方法检测ER基因PvuII和XbaⅠ多态性和Ⅰ型胶原α1(COLIA1)基因多态性 ;PCR扩增IL 6基因 3’端非翻译区的多态性区域。结果　ER基因PP、Pp和pp基因型频率分别为 13 7%、5 1 2 %和 35 1% ,pp型的绝经后妇女股骨颈骨密度Z值明显高于Pp型。ER基因XX、Xx和xx基因型分别占 6 8%、2 5 9%和 6 7 3%。XX基因型的妇女虽然停经时间更长 ,但腰椎骨密度仍高于Xx和xx型。发现了D/D、D/E、C/D、C/C和E/E5种IL 6基因型 ,93%以上的绝经后妇女属于D/D和D/E型。在绝经 10年以上的妇女中 ,D/E型的腰椎骨密度明显高于D/D型 ,且前者的体重指数更高。所有样本的COLIA1基因型检测结果都是无突变的纯合子SS。结论　ER基因型中的pp和XX型可能分别对股骨颈和腰椎有保护作用 ;IL 6基因多态性与停经时间较长的绝经后妇女腰椎骨密度有一定关系 ;COLIA1基因型可能不适于评估本地区绝经后妇女骨密度的差异。这些骨质疏松候选基因的意义尚有待在不同种族的人群进行更大样本的研究     

雌激素受体α基因多态性与新疆维、汉两民族妇女腰椎峰值骨密度的关系

目的探讨新疆地区维吾尔族(维族)、汉族两民族妇女雌激素受体(ER-α)基因多态性与腰椎峰值骨密度的关系。方法分别对乌鲁木齐地区无亲缘关系、年龄20～40岁的160例汉族健康妇女和135例维吾尔族健康妇女进行PCR-RFLP测定雌激素受体α基因XbaI及PvuⅡ多态性,用定量CT(QCT)骨密度仪测定腰椎骨密度(BMD)。结果维、汉族女性骨密度均值比较,差异有显著性(P<0.05)。维、汉族妇女ER-α的基因型及等位基因频率分布均符合Hardy-Weinberg平衡定律;XbaI及PvuⅡ多态性基因型频率及等位基因频率在维、汉两民族妇女中比较,差异均有显著性(P<0.05)。协方差方法分析各基因型与BMD的关系显示:仅PvuⅡ多态性与维族妇女L2-4BMD值显著相关(P<0.05),Pp/pp基因型在L2-4BMD值明显低于PP基因型,差异有显著性(P<0.05)。结论 ER-α基因XbaI多态性对新疆地区维、汉族妇女腰椎峰值骨量无潜在影响;PvuⅡ多态性对维族妇女腰椎峰值骨量的达到和维持有关,与汉族无关。     

ER基因多态性与中国南方妇女绝经后骨质疏松症的病例-对照研究

目的对中国南方绝经后妇女中雌激素受体基因PvuⅡ和XbaⅠ核酸限制性内切酶多态性与骨质疏松症的关系进行了病例一对照调查。方法中国南方绝经后妇女182人，分为骨质疏松组和正常对照组，每组91人；均用DEXA检测骨密度，用PCR—RFLP的方法鉴定雌激素受体的基因型，分析雌激素受体基因多态性与骨密度的关系及各基因型在骨质疏松组与对照组的分布。结果PP、xx、Ppxx、PPxx型在骨质疏松组中的分布频率高于正常对照组，差异有统计学意义。PP、xx、Ppxx、PPxx四种基因型的携带者比正常人骨质疏松的易患程度分别高2．46、2．972、2．2、15倍。结论可以将ER基因PvuⅡ和XbaⅠ多态性作为在中国南方进行筛选绝经后骨质疏松症的高危人群的依据之一。     

ER基因多态性与中国南方妇女绝经后骨质疏松的病例对照研究

[目的]对中国南方绝经后妇女中雌激素受体基因PvuⅡ和XbaⅠ核酸限制性内切酶多态性与骨质疏松症的关系进行了病例一对照调查。[方法]研究对象总共182名中国南方绝经后妇女，研究对象均用DEXA检测骨密度，用PCR-RFLP的方法鉴定雌激素受体的基因型，分析雌激素受体基因多态性与骨密度的关系及各基因型在骨质疏松组与对照组的分布。[结果]PP、xx、Ppxx、PPxx型在骨质疏松组中的分布频率高于正常对照组，差别有统计学意义。PP、XX、Ppxx、PPxx4种基因型的携带者比正常人骨质疏松的易患程度分别高2．46、2．972、2．2、15倍。[结论]可以将ER基因PvuⅡ和XbaⅠ多态性作为在中国南方进行筛选绝经后骨质疏松症的高危人群的依据之一。     

雌激素受体基因多态性与骨密度及骨代谢关系的研究

目的研究中国健康绝经后妇女的雌激素受体estrogenreceptorER基因多态性与骨密度bonemineraldensityBMD、骨代谢的关系。方法选取246名中国健康绝经后妇女,年龄44～78岁,平均61岁。运用双能X线骨吸收法分别对其腰椎L1～4和股骨股骨颈N、Ward区W、大转子T的BMD进行测量,并用生物化学的方法测其血清中钙Ca、磷P、碱性磷酸酶ALP、甲状旁腺激素PTH和降钙素CT的含量,用分子生物学的方法分析内切酶PvuⅡ、XbaⅠ限制性片段长度多态性restrictionfragmentlengthpolymorphism,RFLP,观查ER基因多态性与BMD及骨代谢的关系。RFLP用PpPvuⅡ和Xx(XbaⅠ)来表示。结果PPxx基因型BMD明显低于其它基因型。结论ER基因RFLP与绝经后妇女BMD有关,此即为中国妇女绝经后骨质疏松症发病的原因。     

2015年乳腺癌辅助化疗进展

【摘要】〓乳腺癌是危害我国女性健康的头号杀手,尽管近年来辅助化疗的研究进展突飞猛进,但临床中仍有不少问题未能明确,如辅助化疗的合适人群、化疗的开始时间、蒽环及紫杉类的地位和用法、强化维持治疗的作用、疗效及预后的生物标志物等。本文结合乳腺癌辅助化疗在临床上的常见问题和2015年各大乳腺癌会议阐述乳腺癌辅助化疗的最新进展。     

西宁地区烧伤病人动脉血气分析观察

对高海拔地区的27例烧伤病人动脉血气变化进行了分析和观察。结果证明:无论是存活病人还是死亡病人伤后均存在有低氧血症问题。并且在死亡病人和烧伤合并吸入性损伤病人其低氧血症的发生早于单纯烧伤病人。提示:吸入性损伤病人应立即行气管切开术以保障氧气供给,单纯烧伤病人可常规吸氧以维持正常血 PaO_2,ARDS 均发生在合并吸入性损伤的病人,高频喷射通气技术对纠正低氧血症有一定效果。     

Controversies in Fistula in Ano

Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies.     

β-半乳糖苷酶在体内外成骨细胞中的表达

目的 研究β—半乳糖苷酶(β—gal)在成骨细胞中的表达状况，为阐明MorquioB综合征的发病机制提供依据。方法 裸鼠各器官和骨组织标本行X-gal染色检测。抽取羊和人骨髓行骨髓基质细胞(BMSCs)培养，分为4组：I：Adv-hBMP-2转染组；Ⅱ：Adv—β—gal转染组；Ⅲ：未转染组；Ⅳ：地塞米松诱导组。分别行X-gal染色和RT-PCR检测β—gal的表达。结果 裸鼠骺板两侧、骨膜内面及松质骨的成骨细胞和破骨细胞可见多量β—gal的表达。未转染BMSCs组有少量β—gal的表达，其他3组细胞的β—gal表达增高。结论成骨细胞和破骨细胞可表达多量β—gal，该两种细胞的β—gal缺乏可能是MorquioB综合征骨骼异常的直接原因。     

Alterations in T-Cell Subset Frequency in Peripheral Blood in Obesity

Background: Obesity affects the regulation of immune and inflammatory responses. This study characterizes differences in peripheral blood lymphocyte phenotype in obese humans. Methods: Frequencies of lymphocyte subsets among peripheral blood mononuclear cells were compared between 10 obese (BMI ≥35) and 10 lean subjects, as determined by antibodies directed against cluster differentiation (CD) markers. Results: Obese patients demonstrated an increased frequency of CD3+CD4+ T-cells (mean difference 12%, P=0.004), a decreased frequency of CD3+CD8+ T-cells (mean difference 9.4%, P=0.016) and an increased frequency of CD3+CD8+CD95+ T-cells (mean difference 13.3%, P=0.032). No other differences among T-cell or monocyte subsets were noted. Conclusions: Obesity is associated with alterations in frequencies of peripheral CD4+ and CD8+ T-cells and aberrations in the expression of CD95 among CD8+ T-cells. These data suggest both CD4+ and CD8+ T-cell compartments, as well as the regulation of CD95 expression on CD8+ T-cells, as targets for further study into obesity's effects on the immune system.     

Fluid-phase transcytosis in the primate epididymis in vitro and in vivo

Ligated tubules from the corpus epididymidis of men and monkeys were incubated in medium containing horseradish peroxidase (HRP) as a marker for fluid-phase endocytosis. HRP was localized by light and electron microscopy after 0, 15, 30 and 60 min of incubation. Movement between the cells was prevented by tight junctions, but bypass of this barrier was apparently achieved by an intracellular vesicular mechanism leading to a time-dependent appearance of HRP in the lumen. Uptake of HRP into basal cells and capture by the lysosomal apparatus of principal cells were also observed. HRP-filled vesicles also appeared in the basal, mid and apical cytoplasm of epithelial cells in the caput 1 h after injection of the tracer into the epididymal circulation of the monkey, suggesting that this pathway also operates in vivo.     

Surgical management of ductal carcinoma in situ in Australia in 1995

Background: In the present paper we describe the presentation and management of ductal carcinoma in situ (DCIS) of the breast in women in Australia in 1995. This representative, national data set provides a historical comparator for studies examining DCIS management that follow. Methods: Surgeons identified by population‐based cancer registries as having treated a new diagnosis of DCIS between 1 April and 30 September 1995 completed a questionnaire on the presentation and management of each case. Results: Two hundred and five surgeons supplied treatment details on 418 DCIS tumours in 415 women . Half of all tumours were detected at BreastScreen clinics and a further 25% were detected at other mammography centres. Twenty‐six percent of tumours were palpable at presentation, 33% were multifocal and 55% were high grade (including comedocarcinoma). Breast conserving therapy (BCT) rather than mastectomy was utilized in 260 (62%) of cases. Tumours that were of low grade, small in size and not multifocal were more likely to be treated by BCT. Surgeons seeing six or more DCIS cases in the 6‐month period were more likely to utilize BCT. Of the conservatively treated cases, 22% were referred for a radiation oncology consultation. The most common reasons for treating DCIS with mastectomy were that the tumour was too extensive or multifocal (63%), it extended to margins of the specimen (42%), or patient concerns about recurrence (34%). Conclusions: In 1995 the majority of DCIS was treated with breast conserving surgery alone. Surgeons treating more DCIS cases were more likely to perform conservative surgery than surgeons treating only one DCIS case in the study period.     

Single center experience in single-incision laparoscopic surgery in children in Turkey

Purpose

Minimally invasive surgery has evolved into single-incision laparoscopic surgery (SILS) in the recent years. Few reports have addressed the practicality of SILS in children. Our current experience with regard to feasibility and effectiveness of SILS in children is presented.

Methods

A retrospective review of the operative database for patients operated on using SILS in our department from March 2009 to July 2010 was performed. Data regarding the type of the procedure, age, sex, operative performance, hospital stay, and complications were collected.

Main Results

Among 43 patients, cholecystectomy was performed in 11; appendectomy, in 10; unroofing for ovarian cysts, in 5; unroofing for splenic cysts, in 4; oophorectomy, in 6 (ovarian torsion, 2; teratoma, 4); ovary-preserving teratoma excision, in 1; splenectomy, in 1; gonadectomy, in 3; and varicocelectomy, in 2. There were no conversions to standard laparoscopic or open techniques. The only postoperative complication was a wound infection that occurred after an appendectomy.

Conclusion

Although currently more expensive, SILS can be performed in children in almost every pediatric surgical procedure that can be accomplished with conventional laparoscopic techniques. The most significant contribution of SILS procedure is cosmesis. Postoperative pain and length of hospital stay were not improved.