飞行时间质谱与TaqMan探针技术在结核病易感性相关基因单核苷酸多态性筛选中的应用

目的 对比分析飞行时间质谱技术（MALDI-TOF）和TaqMan探针筛选与结核病易感性相关单核苷酸多态性（SNP）位点的结果,以及联合应用的方法学和效果评价.方法 选取2010年10月至2011年4月在深圳市第三人民医院收治并确诊的结核病患者400例为结核病组,对照组为同时期收集的健康体检者300名,利用MALDI-TOF对选取的7个SNP位点（rs2227476、rs1800795、rs56077270、rs1800797、rs2227484、rs2227472和rs2227473）同时进行基因分型,初步筛选易感SNP位点;与结核病易感相关的单个SNP位点,采用基于TaqMan探针技术的实时荧光定量PCR对同样的标本再进行基因分型,比较两种方法的准确性与敏感度;以rs2227473位点为实例对分型结果的基因频率进行分析,确定肺结核的易感SNP.结果 MALDI-TOF分型成功率为99.7％（698/700）,TaqMan探针技术为98.4％（689/700）;在基因分型过程中,MALDI-TOF与TaqMan探针方法对1例标本的分型结果不一致,经过对此分型结果进行了测序验证,MALDI-TOF的分型结果正确,MALDI-TOF在准确性和敏感度比TaqMan法稍高.位点rs2227473基因频率分析中,结核病组G等位基因频率（90.3％,722/800）明显高于对照组（82.5％,495/600）（x2=6.911,P=0.009）.结论 上述肺结核易感基因的筛选方法是可行的;实例分析中,将两种方法联合应用,发现了IL-22基因rs2227473位点等位基因G可能与肺结核发病相关,两位点中等位基因A可能为保护性基因.     

尾加压素Ⅱ基因多态性与多囊卵巢综合征相关性的研究

目的 探讨尾加压素Ⅱ(UTS2)基因多态性与多囊卵巢综合征(PCOS)发病的关系.方法 用熔解温度不同的基因分型法.检测PCOS患者101例(PCOS组)及其父母202名和105名健康妇女(对照组)UTS2基因rs228648、rs2890565位点单核苷酸多态性(SNP),并检测基础状态下FSH、LH、睾酮、空腹血糖、空腹胰岛素水平.结果 PCOS组的UTS2基因rs228648 A/G多态性位点与对照组比较,基因型与等位基因频率均无明显差异,两组的SNP rs2890565基因型频率差异有统计学意义(P<0.05),PCOS组A等位基因频率明显高于对照组(P<0.05).传递不平衡检验(TDT)显示,SNP rs228648A/G在杂合子父母的2个不同等位基因无优势传递(P>0.05),而rs2890565 A/G在杂合子父母A等位基因优势传递(P<0.05).PCOS组UTS2基因SNP rs228648 GG基因型较携带A等位基因的PCOS患者稳态模型评估的胰岛素抵抗指数(HOMA-IR)明显增高(P<0.05).SNP rs2890565从和AG基因型空腹血糖、空腹胰岛素较GG基因型明显增高,从基因型HOMA-IR较GG基因型明显增高(P<0.05).结论 UTS2基因SNP rs228648 A/G多态性与PCOS无相关性,但与胰岛素抵抗存在关联.UTS2基因SNP rs2890565可能在PCOS的遗传易感性中起一定作用,A等位基因可能与PCOS的发生有关.     

广西壮族人ABCA1基因rs2066715多态性与血脂水平及脑梗死的关系

目的探讨广西壮族人三磷酸腺苷结合盒转运体A1(ABCA1)基因rs2066715单核苷酸多态性(SNP)位点与血脂水平及脑梗死(CI)的关系。方法采用聚合酶链反应—限制性片段长度多态性技术检测252例壮族CI患者(CI组)和249例健康壮族人(对照组)的ABCA1基因rs2066715位点基因型,分析不同基因型与血脂、CI的关系。结果壮族人ABCA1基因rs2066715位点G、A等位基因频率在CI组为53.2%、46.8%,对照组为57.8%、42.2%;GG、GA和AA基因型分布在CI组为29.4%、47.6%、23.0%,对照组为33.7%、48.2%、18.1%。两组等位基因频率和基因型分布比较均无统计学意义。对照组AA型的HDL-C、载脂蛋白A1(ApoA1)和载脂蛋白B水平比GG和GA型显著降低(P<0.05);但基因型与CI的发病无关。结论壮族人ABCA1基因rs2066715位点A等位基因携带者HDL-C及ApoA1水平较低,但A等位基因突变与CI易感性无关。     

IL-10基因多态性与乙肝肝硬化易感性的相关性研究

探讨白细胞介素10(IL-10)基因多态性与乙型肝炎肝硬化易感性的关系.采用聚合酶链反应-限制性片段长度多态性(PCR-PFLP)分析方法,检测100例乙肝肝硬化患者及124例健康对照组IL-10基因启动子-1082G/A、-592A/C位点的基因多态性,并确定了其基因型和等位基因频率的分布.肝硬化组与对照组IL-10基因启动子-592A/C位点基因型分布频率和等位基因频率差异无显著性(P＞0.1),肝硬化组-1082G/A位点AA基因型频率及A等位基因频率高于对照组(P＜0.05),G等位基因相对于A等位基因患肝硬化的机会比为0.373(95%CI:0.166～0.838).IL-10基因多态性与肝硬化易感性相关,基因启动子-1082G/A位点AA基因型携带者肝硬化易感性高.     

CDKAL1基因多态性与妊娠期糖尿病及其临床特点的相关性研究

目的 探讨我国南方人群中CDKAL1基因两个SNP位点rs7754840和rs10448033的多态性与GDM易感性的关系. 方法 采用病例对照研究,分别选取GDM患者(GDM组)153例和正常糖耐量的孕妇(GNGT组)180名.采用聚合酶链反应-限制性片断长度多态性分析法(PCR-RFLP)测定两个SNP位点多态性分布,并进行统计学分析. 结果 GDM组孕前BMI、FPG、TG均高于GNGT组,TC、HDL-C及LDL-C均低于GNGT组(P＜0.05).SNP位点rs7754840基因型(CC,GC,GG)频率和等位基因频率与GNGT组比较,差异均无统计学意义(P=0.937、0.933);而SNP位点rs10440833基因型(AA,AT,TT)与GNGT组比较,差异有统计学意义(P=0.024),且风险基因型TT的频率高于GNGT组(TTvs TC+CC,P=0.032);GDM组A等位基因频率高于GNGT组[OR(95％CI):1.519(1.114～2.071),P=0.008];AA基因型患者的FPG高于其他基因型(P=0.011),TG高于TT基因型(P=0.007),HDL C低于TT基因型(P=0.001). 结论 CDKAL1基因SNP位点rs7754840与GDM无相关性;SNP位点rs10440833与GDM的易感性相关,且该位点多态性可能与血糖、TG及LDL-C的水平有关.     

白细胞介素-1F7基因单核苷酸多态性对强直性脊柱炎易感性与病情的影响

目的 探讨白细胞介素(IL)-1F7基因rs3811047位点单核苷酸多态性(SNP)对强直性脊柱炎(AS)易感性和临床表现型的影响.方法 收集AS患者158例和同期健康献血人群181名,采用连接酶检测反应(LDR-PCR)方法检测IL-1F7基因rs3811047位点SNP,分析其等位基因频率及基因型频率在AS和对照组中的分布,并比较不同基因型AS患者间临床表现型的差别.结果 AS患者和对照人群中rs3811047位点A等位基因频率(12.03%,17.68%)和G等位基因频率(87.97%,82.32%)的分布差异有统计学意义(x2=4.2204,P=0.0399);AA,AG,GG基因型频率在AS中分别为0,24.05%,75.95%,与对照组分布(2.76%,29.83%,67.41%)相比,差异亦有统计学意义(x2=6.2675,P=0.043).AG基因型的AS患者中人类白细胞抗原(HLA)-B27阳性率为70.27%(26/37),明显低于GG基因型AS中HLA-B27的阳性率94.23%(98/104),差异有统计学意义(x2=2.168,P=0.030);其红细胞沉降率和C反应蛋白水平明显亦低于GG基因型组(t=2.971,P=0.013;t=3.300,P=0.001).结论 安徽籍汉族人群AS易感性与IL-1F7基因rs3811047位点SNP有关,其基因型对AS的临床表现型有影响,携带A等位基因患者的炎症表现轻于不携带A等位基因的患者.     

IL-33基因多态性及其血清水平与云南宣威肺癌的相关性研究

目的探究IL-33基因多态性及其血清水平与云南宣威肺癌的相关性。方法选取2018年5月至2019年12月在我院治疗的100例肺癌患者作为肺癌组,另收取健康人群100例作为对照组。对两组的IL-33基因rs10975521位点基因及血清IL-33表达水平进行测定;分析其与云南宣威肺癌发生风险的相关性。结果rs10975521位点符合HWE定律(P>0.05)。云南宣威人IL-33基因rs10975521位点分别为AA、GA、GG三种,频率分别为19.00%、48.00%、33.00%。肺癌组携带AA基因型频率高于对照组(P<0.05);肺癌组与对照组的AA、GA、GG各基因频率分布的比较(χ^2=6.066,P=0.048)。携带AA基因型与增加肺癌风险具有相关性(OR=1.59,CI:1.18~3.53,P=0.016)。肺癌组A等位基因占比高于对照组,肺癌组与对照组的A、G等位基因比较(χ^2=6.193,P=0.013)。A等位基因型发生肺癌风险是G等位基因型的1.35倍(OR=135,CI:1.25~3.97,P=0.022)。肺癌组的血清IL-33表达水平(27.89±6.85)pg/mL明显高于对照组的(20.13±5.97)pg/mL,(t=8.540,P<0.001)。肺癌组的AA、GA、GG三种不同基因型之间血清IL-33表达水平比较(P<0.05)。肺癌组AA、GA基因型的IL-33表达水平明显高于对照组(P<0.05)。结论IL-33基因rs10975521位点多态性与云南宣威肺癌易感性具有相关性,其中rs10975521位点表现为AA时可促进血清IL-33的高表达,与云南宣威肺癌发生风险相关。     

Lp-PLA2基因多态性与急性心肌梗死患者的易感性和临床特征的相关性研究

目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)基因多态性与急性心肌梗死(AMI)易感性之间的关系。方法选取2017年1月～2018年2月于西安交通大学医学院第一附属医院住院的AMI患者176例(AMI组)以及健康体检志愿者191例(对照组),采集受试者血清标本,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测Lp-PLA2基因rs1805017、rs16874954、rs1051931位点单核苷酸多态性(SNP);采用Logistic回归分析Lp-PLA2基因突变与AMI易感性的相关性。结果 rs1805017位点检测到GG、GA、AA三种基因型;rs16874954位点检测到CC、AC两种基因型;rs1051931位点检测到AA、AC、CC三种基因型;AMI组rs1805017位点AA基因型以及rs16874954位点CC基因分布频率相对对照组更高(P0.05)。rs1805017位点GA+AA基因型患者三酰甘油(TG)水平高于GG基因型患者,而高密度脂蛋白胆固醇(HDL-C)水平明显低于GG基因型患者(P0.05);rs16874954位点AC基因型患者TG水平明显高于CC基因型患者(P0.05);其余血脂水平在不同基因型患者之间并无统计学差异(P0.05)。经单因素二元Logisitic回归分析,rs1805017(OR=0.788,95%CI:0.713～0.923,P0.05)、rs16874954(OR=0.923,95%CI:0.859～0.983,P0.05)位点SNP与AMI密切相关。多因素回归分析结果表明rs1805017位点多态性与AMI发病独立相关(OR=0.839,95%CI:0.804～0.975,P0.05)。结论本研究人群Lp-PLA2基因rs1805017、rs16874954多态性位点与急性心肌梗死的发生有关,而rs1051931位点SNP与AMI的发生可能无直接相关性。     

磷酸二酯酶4D基因rs966221位点单核苷酸多态性与缺血性脑卒中发病的关系

目的探讨广西壮族人群磷酸二酯酶4D(PDE4D)基因rs966221位点单核苷酸多态性与缺血性脑卒中(IS)发病的关系。方法采用病例-对照研究设计,运用SNaPshot技术对101例广西壮族IS患者(IS组)及同期104例健康体检者(对照组)的PDE4D基因rs966221位点单核苷酸多态性进行检测,比较2组各基因型及等位基因频率,并进行相关性分析。结果 IS组与对照组PDE4D基因rs966221位点GG、GA、AA基因型(0.99%vs 3.85%,29.70%vs 21.15%,69.31%vs 75.00%)及G、A等位基因频率(15.84%vs 14.42%,84.16%vs 85.58%)比较,差异无统计学意义(P0.05)。单因素及多因素logistic回归分析显示,在显性(AAvs GG+GA)、隐性(GGvs AA+GA)和加性(GGvs AA)3种遗传模型下,PDE4D基因rs966221位点单核苷酸多态性与IS患病风险均无关联(P0.05)。结论广西壮族人群PDE4D基因rs966221位点单核苷酸多态性与IS发病不相关。     

江苏地区汉族人群白细胞介素28B基因多态性与丙型肝炎易感性的关系

目的探讨江苏地区汉族人群白细胞介素(IL)28B基因多态性分布及其与丙型肝炎易感性的关系。方法选取2011年南京市第二医院就诊的丙型肝炎患者88名,体检中心健康体检的健康人群100例。应用聚合酶链式反应(PCR)和直接测序法检测丙型肝炎患者和健康人群IL-28B rs8099917、rs12979860、rs12980275、rs8113007和rs12972991位点的单核苷酸多态性(SNP),并统计分析这些位点的基因型和等位基因在两种不同人群中分布的差异。采用Pearsonχ2检验进行分析,计算Hardy-Weinberg遗传平衡以判断样本的代表性。结果两者间性别和年龄差异均无统计学意义(P=0.92、0.28),在检测人群中IL-28B基因5个位点的主要基因型分别是TT、CC、AA、AA、AA;丙型肝炎患者IL-28B基因SNP位点与健康人群在基因型(χ2=0.31、0.50、0.60、0.15、0.07,P均0.05)和等位基因(χ2=0.29、0.48、0.56、0.14、0.07,P均0.05)分布上差异均无统计学意义。结论 IL-28B的SNPs位点(rs8099917、rs12979860、rs12980275、rs8113007、rs12972991)可能与江苏省汉族人群丙型肝炎易感性无关。     

A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

Interplay between interferon-mediated innate immunity and porcine reproductive and respiratory syndrome virus

Innate immunity is the first line of defense against viral infection, and in turn, viruses have evolved to evade host immune surveillance. As a result, viruses may persist in host and develop chronic infections. Type I interferons (IFN-α/β) are among the most potent antiviral cytokines triggered by viral infections. Porcine reproductive and respiratory syndrome (PRRS) is a disease of pigs that is characterized by negligible induction of type I IFNs and viral persistence for an extended period. For IFN production, RIG-I/MDA5 and JAK-STAT pathways are two major signaling pathways, and recent studies indicate that PRRS virus is armed to modulate type I IFN responses during infection. This review describes the viral strategies for modulation of type I IFN responses. At least three non-structural proteins (Nsp1, Nsp2, and Nsp11) and a structural protein (N nucleocapsid protein) have been identified and characterized to play roles in the IFN suppression and NF-κB pathways. Nsp's are early proteins while N is a late protein, suggesting that additional signaling pathways may be involved in addition to the IFN pathway. The understanding of molecular bases for virus-mediated modulation of host innate immune signaling will help us design new generation vaccines and control PRRS.     

Disease Pandemics and Major Epidemics Arising From New Encounters between Indigenous Viruses and Introduced Crops

Virus disease pandemics and epidemics that occur in the world’s staple food crops pose a major threat to global food security, especially in developing countries with tropical or subtropical climates. Moreover, this threat is escalating rapidly due to increasing difficulties in controlling virus diseases as climate change accelerates and the need to feed the burgeoning global population escalates. One of the main causes of these pandemics and epidemics is the introduction to a new continent of food crops domesticated elsewhere, and their subsequent invasion by damaging virus diseases they never encountered before. This review focusses on providing historical and up-to-date information about pandemics and major epidemics initiated by spillover of indigenous viruses from infected alternative hosts into introduced crops. This spillover requires new encounters at the managed and natural vegetation interface. The principal virus disease pandemic examples described are two (cassava mosaic, cassava brown streak) that threaten food security in sub-Saharan Africa (SSA), and one (tomato yellow leaf curl) doing so globally. A further example describes a virus disease pandemic threatening a major plantation crop producing a vital food export for West Africa (cacao swollen shoot). Also described are two examples of major virus disease epidemics that threaten SSA’s food security (rice yellow mottle, groundnut rosette). In addition, brief accounts are provided of two major maize virus disease epidemics (maize streak in SSA, maize rough dwarf in Mediterranean and Middle Eastern regions), a major rice disease epidemic (rice hoja blanca in the Americas), and damaging tomato tospovirus and begomovirus disease epidemics of tomato that impair food security in different world regions. For each pandemic or major epidemic, the factors involved in driving its initial emergence, and its subsequent increase in importance and geographical distribution, are explained. Finally, clarification is provided over what needs to be done globally to achieve effective management of severe virus disease pandemics and epidemics initiated by spillover events.     

岳阳市城区小学生血吸虫病防治健康教育现状调查

目的 调查湖南省岳阳市城区小学生血吸虫病防治知识、行为现状及健康教育需求情况,为制定科学有效的小学生血吸虫病健康教育方案提供参考依据。方法 采用分层整群抽样方法,抽取岳阳市城区洞庭湖湖畔学校和中心城区学校各2所,每所再从五、六年级分别抽取2个班的学生,通过调查问卷了解小学生血吸虫病相关知识、预防行为及健康教育需求,并进行统计分析。结果 共调查湖畔小学353人、中心城区小学363人,两组学校小学生年龄、性别、年级构成差异无统计学意义（t=-0.494,χ²_性别=1.615,χ²_年级=2.152;P均>0.05）。学生血吸虫病防治知识总知晓率为42.60%（305/716）,其中,湖畔学校小学生血防知识知晓率（52.97%）高于中心城区（32.51%）,差异有统计学意义（χ²=30.661,P<0.05）;学生行为正确率为76.68%（549/716）,血防知识知晓组行为正确率（81.31%）高于不知晓组（71.24%）,差异有统计学意义（χ²=6.384,P<0.05）。学生血防知识主要来源于老师（47.49%）;91.90%的学生愿意了解更多的血防知识,最喜欢的血防知识学习方式是参加课外活动（50.42%）。结论 岳阳市城区小学生的血防知识知晓率及行为正确率偏低,对血吸虫病防治健康教育需求较高。建议针对学生开展形式多样的血防健康教育,以增强学生的血吸虫病防护意识,提高自我防护能力。     

Barrett's Esophagus: Where Do We Stand?

Barrett''s esophagus (BE) is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.     

Routine diagnosis of intestinal tuberculosis and Crohn’s disease in Southern India

AIM:To investigate whether routinely measured clinical variables could aid in differentiating intestinal tuberculosis(ITB)from Crohn’s disease(CD).METHODS:ITB and CD patients were prospectively included at four South Indian medical centres from October 2009 to July 2012.Routine investigations included case history,physical examination,blood biochemistry,ileocolonoscopy and histopathological examination of biopsies.Patients were followed-up after 2 and 6 mo of treatment.The diagnosis of ITB or CD was re-evaluated after 2 mo of antituberculous chemotherapy or immune suppressive therapy respectively,based on improvement in signs,symptoms and laboratory variables.This study was considered to be an exploratory analysis.Clinical,endoscopic and histopathological features recorded at the time of inclusion were subject to univariate analyses.Disease variables with sufficient number of recordings and P<0.05 were entered into logistic regression models,adjusted for known confounders.Finally,we calculated the odds ratios with respective confidence intervals for variables associated with either ITB or CD.RESULTS:This study included 38 ITB and 37 CD patients.Overall,ITB patients had the lowest body mass index(19.6 vs 22.7,P=0.01)and more commonly reported weight loss(73%vs 38%,P<0.01),watery diarrhoea(64%vs 33%,P=0.01)and rural domicile(58%vs 35%,P<0.05).Endoscopy typically showed mucosal nodularity(17/31 vs 2/37,P<0.01)and histopathology more frequently showed granulomas(10/30vs 2/35,P<0.01).The CD patients more frequently reported malaise(87%vs 64%,P=0.03),nausea(84%vs 56%,P=0.01),pain in the right lower abdominal quadrant on examination(90%vs 54%,P<0.01)and urban domicile(65%vs 42%,P<0.05).In CD,endoscopy typically showed involvement of multiple intestinal segments(27/37 vs 9/31,P<0.01).Using logistic regression analysis we found weight loss and nodularity of the mucosa were independently associated with ITB,with adjusted odds ratios of 8.6(95%CI:2.1-35.6)and 18.9(95%CI:3.5-102.8)respectively.Right lower abdominal quadrant pain on examination and involvement of≥3 intestinal segments were independently associated with CD with adjusted odds ratios of 10.1(95%CI:2.0-51.3)and 5.9(95%CI:1.7-20.6),respectively.CONCLUSION:Weight loss and mucosal nodularity were associated with ITB.Abdominal pain and excessive intestinal involvement were associated with CD.ITB and CD were equally common.