应用遗传连锁分析法对伴传导功能障碍的扩张型心肌病家系致病基因的定位

目的: 对一个常染色体显性遗传扩张型心肌病(familial dilated cardiomyopathy,FDCM)家系进行基因定位。方法: 收集FDCM 家系, 对该家系成员进行详细心血管内科检查确诊为扩张型心肌病,且伴发有传导功能障碍;采集外周血3～5 mL,并抽提基因组DNA;选取与该表型相关的已定位区间CMD1A(1q21.2-q21.3),CMD1H(2q14-q22), CMD1E(3p22-p25)和CMD1F(6q22-23)内的共计18个微卫星DNA标记,在该家系中进行排除性定位分析;最后,进行全基因组扫描及连锁分析。结果：①已定位区间的18个微卫星DNA标记位点的LOD值均<-2,证实该家系与已知DCM位点不连锁;②全基因组扫描及两点连锁分析结果显示,该家系致病基因位点与遗传标记D3S1614(3q26)连锁, 在θ= 0时得到最大LOD值2.68。结论: 该家系与已知的4个DCM位点均不连锁,其致病基因位于D3S1614（3q26）附近的一个新位点。     

广东地区视网膜色素变性两大家系RHO基因突变分析

目的 分析广东地区两个常染色体显性遗传视网膜色素变性(autosomal dominant retinitis pigmentosa，ADRP)家系视紫红质（rhodopsin, RHO）基因突变，探讨基因突变与临床表型的关系。 方法 收集广东地区两个常染色体显性遗传视网膜色素变性家系的临床资料，对家系成员进行视力、视野、眼底镜检查；应用聚合酶链反应（PCR）和直接测序技术，对两个家系所有现存成员进行RHO基因检测。 结果 发现一家系患者为P347S杂合性突变，另一家系患者存在P171L杂合性突变，两家系的临床表现为发病早，病情进展快，表型较严重，该两家系正常成员均未发现RHO基因突变。 结论 RHO基因的P347S与P171L突变分别为该两家系视网膜色素变性的病因。该两种突变均导致较严重的临床表型，与分子基础一致。     

一个疑似X连锁型视网膜色素变性家系的遗传连锁分析的研究

目的对一个疑似X连锁型视网膜色素变性(X-linked retinitis pigmentosa,XLRP)家系进行分析,确定其致病基因的所在位点。方法选取已知XLRP候选基因附近的微卫星位标,用多点参数分析方法计算其最大优势对数值(LOD score),并通过对家系成员单倍型分析,确定该家系致病基因所在的染色体位置。结果位于X染色体长臂的微卫星标记DXS8043与该例遗传家系间最大LOD值小于-2,其他位于X染色体短臂的11个微卫星标记与该例遗传家系LOD值保持在0.5上下,无明显的高值。单倍型结果表明该家系中2例患者兄弟(Ⅲ1、Ⅲ6)和他们的携带者母亲(Ⅱ2)在DXS8051与DXS1214之间拥有在正常成员中不存在的基因型,表明该基因型与疾病共分离,进一步确定了他们X性连锁遗传模式,并且可将致病基因初步定位于DXS8051与DXS1214之间的RP23和RP6基因。结论可以排除该例家系的致病位点与X染色体长臂上的RP24基因的连锁,高度怀疑连锁位点存在于X染色体的短臂的RP23和RP6基因,需另增加位标的信息量,以进一步缩小致病基因所在的具体范围。     

甘肃地区一遗传痉挛性截瘫家系致病基因的定位

目的：对中国甘肃地区一个常染色体显性遗传痉挛性截瘫家系致病基因的初步定位研究．方法：用常见的常染色体显性遗传痉挛性截瘫的3个基因区域内的10个微卫星位点D14S264、D14S75、D14S69、D14S266、D14S66、D2S2347、D2S2255、D2S2351，D15S128、GABRB3对该家系致病基因进行等位基因共享分析及连锁分析．结果：该家系致病基因在SPG4基因区域的D2S2351位点连锁(θ=0，最大LOD值为2．71)．结论：该家系致病基因在SPG4基因座，疾病基因是spastin．     

应用微卫星多态位点对X连锁型视网膜色素变性疾病进行遗传连锁分析的研究

目的应用遗传连锁分析方法对X连锁型视网膜色素变性家系进行分析，确定其致病基因的所在位点。方法在2个目前常见的X-连锁遗传位点——RP2和RP3处分别选取具有高信息量的微卫星位标，对2例疑似X连锁型视网膜色素变性家系进行遗传连锁分析。通过对家系成员的单倍型分析，并使用两点法计算其最大优势时数（LOD Score）值，确定致病基因所在的染色体位置。结果微卫星标记DXS993与2例遗传家系表型间最大LOD值分别为：〈-2和0．8；DXS 1068在2例遗传家系LOD值分别为0．4和0．8。结论RP2基因可能不是XY家系的致病性基因；在ZLK家系，怀疑疾病位点与RP2或RP3基因连锁。用遗传连锁分析方法确定致病基因所在染色体的范围起到重要的作用。     

毛囊闭锁三联征一家系致病基因精细定位研究

目的 对1例毛囊闭锁三联征家系进行连锁分析精细定位研究,确定其致病基因位点.方法 应用覆盖1号染色体1p21.1～1q25.3区域的17个微卫星标记对该家系进行基因分型、连锁分析和单倍型分析.结果 在1号染色体上的微卫星标记DIS2 707处获得最大LOD值为2.11(重组率θ=0.00).通过单倍型分析将该家系致病基因定位在微卫星标记D1S2 715和D1S484之间的染色体1q21.3～1q23.2区域.结论 该研究提示1p21.1～1q25.3(61.8cM)是毛囊闭锁三联征致病基因连锁区域,并将致病基因支持连锁范围缩小至1q21.3～1q23.2(9.8 cM)区域.     

视网膜色素变性致病基因研究概况

视网膜色素变性(retinitis pigmentosa,RP)是视网膜光感受器细胞和色素上皮细胞变性导致夜盲和进行性视野缺损的一组具有临床亚型的基因遗传性致盲眼疾病.RP在世界范围内的发病率约为1/3 500~([1]),国内统计发病率为1/3 784,主要临床表现:早期出现夜盲、进行性视野缩小、视网膜骨细胞状色素沉着、视盘呈蜡黄色萎缩和视网膜电图(ERG)呈熄灭型等.其遗传方式为常染色体显性遗传(autosomal dominant retinitis pigmentosa,ADRP)、常染色体隐性遗传(autosomal recessive retinitis pigmentosa,ARRP)、X染色体连锁遗传(X-linked retinitis igmentosa,XLRP)、双基因突变遗传(digenic RP)及线粒体遗传(mitochondrial RP)~([2]),在各类遗传类型中,约15%～25%的患者表现为ADRP,5%～25%的患者表现为ARRP,5%～15%的患者表现为XLRP,40%～50%的患者表现为散发型,双基因突变RP和线粒体RP只占极少数.     

两例疑为X连锁型视网膜色素变性家系的单倍型分析研究

目的应用遗传连锁分析方法对X连锁型视网膜色素变性家系进行分析,定位其致病基因的所在位点.方法选取已知X连锁视网膜色素变性候选基因附近的短串联重复序列多态性标记(short tandem repeat polymorphism, STRP),即在RP2、RP3、RP6、RP23和RP24处分别选取具有高信息量的微卫星位标,对2例疑似为X连锁型视网膜色素变性家系进行遗传连锁分析;通过对家系成员的单倍型分析,并进行两点法连锁分析,确定其致病基因所在染色体的大致位置.结果 2例家系在DXS 993处得到的最大LOD值分别为:1.18和1.03;在DXS 1068处得到的最大 LOD值分别为:0.58和-2.69;在DXS 1214处得到的最大LOD值分别为:-2.33和-2.45;在DXS 8051处得到的最大LOD值分别为:-2.34和-2.51;在DXS 8043处得到的最大LOD值分别为:-2.23和-2.62.结论 ZCF家系的致病基因,可能不在RP3、RP6、RP23或RP24位点;而对于FYJ家系,我们则怀疑致病基因位于RP2位点,但也不排除与RP3连锁;用遗传连锁分析方法对确定致病基因所在染色体的范围起到重要的作用.     

全基因组扫描定位毛囊闭锁三联征致病基因

目的在1例4代毛囊闭锁三联征大家系中定位其致病基因所在区域。方法用覆盖全基因组的微卫星标记对1例毛囊闭锁三联征大家系进行致病基因定位研究,用AB I3730测序仪进行微卫星标记的基因分型,利用L inkage软件(5.10version)和Cyrillic软件(2.01 version)进行连锁和单倍型分析。结果该家系符合常染色体显性遗传模式,当外显率为99.9%时,在1号染色体上的微卫星标记D1S2624处获得最大LOD值为3.26(重组率θ=0.00)。单倍型分析将该家系致病基因定位在微卫星标记D1S248和D1S2711之间的染色体1p21.1 1q25.3区域,遗传距离61.8 cM。结论染色体1p21.1 1q25.3区域存在毛囊闭锁三联征的致病基因。     

遗传性乳光牙本质家系致病基因的染色体定位

目的 研究一个在天津塘沽地区发现的遗传性乳光牙本质回族家系致病基因是否与染色体4q21连锁。方法 提取该家系13名成员的外周血DNA，选择染色体4q21上的8个短串联重复序列多态性标记(short tandem repeat polymorphisms，STRPs)做荧光标记PCR等位片段分析，用lod连锁分析法分析该家系致病基因位点与上述8个STRPs的连锁关系。结果 得到13名个体8个位点的基因型和单体型，连锁分析结果显示：8个STRPs的最大lod值均大于0，其中5个STRPs的M值大于1。结论 该家系致病基因定位在染色体4q21上，表明中国回族人和报道的欧美人的DGⅠ-Ⅱ的基因座位是一致的。     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.