1型糖尿病与HLA-DRB1?DQB1基因相关性研究

目的: 研究中国江苏地区汉族人群1型糖尿病(T1DM)与人类白细胞抗原(HLA)-DRB1?DQB1基因及单倍型频率的相关性?方法:选取江苏地区汉族人群T1DM患者(112例)与对照组(69例),运用聚合酶链反应-寡核苷酸探针序列特异性引物(PCR-SSO)技术,进行HLA-DRB1?DQB1基因分型,两组间等位基因频率比较采用χ2检验,通过Arlequin软件进行单倍型频率的分析?结果:112名T1DM患者中检测到DRB1位点等位基因17个(对照组19个),DQB1位点等位基因7个(对照组7个)?与对照组相比,T1DM组DRB1*0901?DRB1*0405和DRB1*0301频率明显增高,DQB1位点的DQB1*0201与DQB1*0303频率明显高于对照组;与对照组相比,T1DM患者明显升高的单倍型频率为:DRB1*0901-DQB1*0303?DRB1*0301-DQB1*0201?DRB1*0405-DQB1*0401和DRB1*0405-DQB1*0302?结论:中国江苏地区汉族T1DM患者HLA基因DR位点的DRB1*0901?DRB1*0405?DRB1*0301及DQ位点的DQB1*0201?DQB1*0303对T1DM易感?发现了4个新的具有易感作用的单倍型:DRB1*0901-DQB1*0303?DRB1*0301-DQB1*0201?DRB1*0405-DQB1*0401和DRB1*0405 -DQB1*0302?     

中国人群胰岛素依赖性糖尿病HLA-DR基因多态性的Meta分析

目的综合评价中国人群HLA-DR基因多态性与胰岛素依赖性糖尿病(IDDM)的关联性.方法以IDDM组和健康对照组的各HLA-DR等位基因频数(基因型频数、单倍型频数)分布的OR值为统计量.全面检索相关文献,应用Meta分析对血清学分型和基因分型研究的结果进行一致性检验和数据合并,并评估发表偏倚.结果①血清学分型水平上,HLA-DR3和DR9等位基因,DR3/DR4和DR3/DR9杂合子是中国人群IDDM的危险基因(或基因型)(P＜0.05),合并OR值分别为5.08,1.59,26.74和10.74.而HLA-DR2,DR5,DR7,DR12是中国人群IDDM的保护基因(P＜0.05),合并OR值分别为0.65、0.57、0.52和0.40;②基因分型水平上,HLA-DRB1*0301,DRB1*04,DRB1*0404和DRB1*0405等位基因是中国人群IDDM的危险基因(P＜0.05),合并OR值分别为5.53,2.12,2.40和2.33;单倍型DRB1*0301/DQA1*0301/DQB1*0201和DRB1*0405/DQB18*0302,基因型DRB1*0405/DRB1*0405和DRB1*0405/DRB1*04是中国人群IDDM的危险单倍型(或基因型)(P＜0.05),合并OR值分别为6.57,14.85,8.08和1.90;而HLA-DRB1*0406,DRB1*0408,DRB1*06,DRB1*07,DRB1*08,DRB1*1301,DRB1*14和DRB1*16是中国人群IDDM的保护基因(P＜0.05),合并OR值分别为0.39,0.11,0.17,0.56,0.33,0.14,0.28和0.39.结论中国人群IDDM与HLA-DR的某些基因型及单倍型有关联性,而且与其他非中国人群有区别.     

HLA-DQB1/DRB1等位基因及夫妻抗原共享率与复发性流产的关系

目的 探讨原发性复发性流产与人类白细胞抗原DRB1/DQB1(HLA-DQB1/DRB1)等位基因及夫妻抗原共享率的关系.方法 采用顺序特异性引物聚合酶链反应(sequence-specific primers po1ymerase chain reaction,SSP-PCR)和放射免疫法,检测55例原发性复发性流产患者夫妇(研究组)HLA-DQB1/DRB1等位基因频率和HLA抗原频率,其中早期流产20例,晚期流产22例,早晚期流产(2次以上流产分别发生在早期或晚期)13例,并以50例正常孕妇女夫妇作对照组.结果 研究组中早期流产者DQB1*0303、DQB1*0403等位基因频率分别为24.3%,21.6%,显著高于对照组(9.4%,4.7%),两组比较,差异有统计学意义(P＜0.05);晚期流产者DRB1*0407等位基因频率为34.3%,显著高于对照组(5.7%),且明显高于早期流产者(13.3%),两组比较,差异有统计学意义(P＜0.05);早晚期流产者DQB1*0303、DQB1*0403、DRB1*0407等位基因频率(25.4%,20.4%,34.6%)均显著高于对照组(9.4%,4.7%,5.7%),两组比较,差异有统计学意义(P＜0.05).其余等位基因频率有差异,但差异无显著性(P＞0.05),研究组夫妇共享DQB1*0303等位基因的频率显著高于对照组,两组比较,差异有统计学意义(P＜0.05);研究组夫妇HLA-DR3、HLA-DR4抗原共享率显著高于对照组,两组比较,差异有统计学意义(P＜0.05).结论 HLA-DQB1*0303/DQB1*0403等位基因可能与早期流产有关,DRB1*0407等位基因可能与晚期流产有关.夫妇HLA抗原共享率增加是原发性复发性流产的易感因素.     

广东省汉族1型糖尿病患者HLA-DRB1基因多态性分析

目的 探讨HLA-DRB1基因多态性在广东汉族1型糖尿病(T1DM)患者中的分布规律及相关性.方法 采用PCR-SBT技术对58例1型糖尿病患者和454例正常对照人群进行HLA-DRB1等位基因分型.结果 在HLA-DRB1基因位点上,T1DM组和正常对照组共检出38种等位基因.与正常对照组相比,T1DM组的DRB1*0301、DRB1*0405、DRB1*0701、DRB1*0901频率明显升高,而DRB1*1202、DRB1*1502、DRB1*1602频率明显下降,差异有统计学意义(P＜0.05).结论 HLA-DRB1位点上的DRB1*0301、DRB1*0405、DRB1*0701、DRB1*0901是广东汉族人群1型糖尿病的易感基因,而DRB1*1202、DRB1*1502、DRB1*1602为保护基因.     

SLE病人及其子代与SLE相关基因及抗体关系研究

目的探讨缓解期系统性红斑狼疮(SLE)病人所生子女罹患SLE的危险性。方法应用实时定量PCR技术检测14例SLE病人、病人子女及18例对照者HLA-DRB1*1501、DRB1*0301、DQA1*0102、DQB1*0602的频率,免疫印迹法检测入组者ENA抗体谱。结果 SLE病人组DQA1*0102频率显著高于对照组(RR=2.02,P<0.05),而两组间DRB1*1501、DRB1*0301、DQB1*0602频率比较差异无显著意义(P>0.05);SLE病人组DQB1*0602频率显著高于其子女组(RR=2.06,P<0.05),而两组间DRB1*1501、DRB1*0301、DQA1*0102频率比较差异无显著性(P>0.05);SLE子女组DQA1*0102频率显著高于对照组(RR=2.14,P<0.05);而两组间DRB1*1501、DRB1*0301、DQB1*0602频率比较差异无显著性(P>0.05)。SLE病人组自身抗体SSA及dsDNA出现频率明显高于对照组(P=0.019、0.015),两组间SSB及Ro-52差异无显著性(P>0.05);SLE病人子女组所测自身抗体检出率为0。结论 HLA-DQA1*0102为SLE的易感等位基因,DQA1*0102有一定的遗传倾向。经过系统治疗达到缓解期的SLE病人生育的子女罹患SLE的危险性无明显增加趋势。     

广东汉族1型糖尿病与HLA－DRB1等位基因的相关性研究

目的：探讨HLA-DRB1基因多态性在广东汉族1型糖尿病（T1DM）患者中的分布规律及相关性。方法：采用PCR-SBT技术对58例1型糖尿病患者和454名正常对照人群进行HLA-DRB1等位基因分型。结果：在HLA-DRB1基因位点上,T1DM组和正常对照组共检出38种等位基因。与正常对照组相比,T1DM组的DRB1*0301、DRB1*0405、DRB1*0701、DRB1*0901频率明显升高,而DRB1*1202、DRB1*1502、DRB1*1602频率明显下降,具有统计学差异(P<0.05)。结论：HLA-DR位点上的DRB1*0301、DRB1*0405、DRB1*0701、DRB1*0901是广东汉族人群1型糖尿病的易感基因,而DRB1*1202、DRB1*1502、DRB1*1602为保护基因。     

1型糖尿病种HLA-DQA1-DQB1连锁基因的特征研究

目的：探讨HLA-DQA1-DQB1连锁基因单倍体与成人缓慢进展型1型糖尿病（SPIDDM）和速发型1型糖尿病（FPIDDM）的相关性。方法：采用PCR/SSP技术检测本组1型糖尿病中102例SPIDDM患者和130例FPIDDM患者频率。结果：①HLA-DQA1＊0301-DQB1＊0201和DQA1＊0501-DQB1＊0201连锁基因单倍体与SPIDDM（Pc〈0.001）和FPIDDM（Pc〈0.001）均呈显著正相关。②HLA-DQA1＊0301-DQB1＊0301和DQA1＊0301-DQB1＊0602连锁基因单倍体与SPIDDM呈显著正相关（Pc〈0.001）。③HLA-DQA1＊0301-DQB1＊0302、DQA1＊0301-DQB1＊0303及DRB1＊0301-DQA1＊0301-DQB1＊0201连锁基因单倍体与FPIDDM呈显著正相关（均Pc〈0.05）;DQA1＊0102等位基因中SPIDDM组16例（15.69%）;FPIDDM组10例（7.69%）（P〈0.05）;DQA1＊03基因SPIDDM组47例（46.08%）,FPIDDM组79例（60.77%）（P〈0.05）;DQB1＊0601基因SPIDDM组10例（9.8%）,FPIDDM组4例（3.08%）（P〈0.01）。结论：SPIDDM和FPIDDM虽然均为自身免疫性糖尿病,但其HLA表型并不完全相同,不同的HLA表型可能是决定患者起病方式及病情发展不同的因素之一。     

昆明汉族人群HLA-DRB1、DQB1基因多态性分析

目的研究昆明汉族HLA-DRB1、DQB1基因的多态性,探讨其在昆明汉族人群中的遗传特征.方法应用PCR-SSP基因分型技术,对云南昆明地区72名汉族健康儿童进行了HLA-DRB1、DQB1位点的基因分型.结果在昆明汉族,HLA-DRB1位点共检出了12种等位基因,其中以HLA-DRB1*12(20.14%)、DRB1*0901(19.44%)、DRB1*04(18.06%)较常见,其他基因频率大于10%的等位基因还有HLA-DRB1*08(11.11%)、DRB1*15(10.42%);在DQB1位点共检出了7种等位基因,其中以HLA-DQB1*0301(27.08%)、DQB1*06(21.53%)较常见,其他基因频率大于10%的等位基因还有HLA-DQB1*0303(15.97%)、DQB1*05(13.19%).昆明汉族分别与南方汉族、北方汉族HLA-DRB1、DQB1分布进行了比较,均有明显的差异(P<0.001).结论昆明汉族HLA基因分布特点既不同于南方汉族人群,也不同于北方汉族人群,具有独特性.可能与复杂的民族迁移历史和民族融合及云南独特的地理环境有关.     

重庆地区汉族人群HLA-A、B、DRB1、DQB1等位基因多态性的研究

目的 研究重庆地区人群HLA-A、B、DRB1和DQB1位点等位基因的多态性特点.方法 采用序列特异性引物聚合酶链反应(PCR-SSP)技术对1 664名重庆籍健康人进行HLA-A、B、DRB1、DQB1等位基因的低分辨分型,并与国内其他地区汉族人群进行比较.结果 本次研究共检出HLA-A、B、DRB1、DQB1位点等位基因62种,其中A位点14种,B位点27种,DRB1位点13种,DQB1位点8种.A位点中A*11(34.62%)、A*02(28.81%)、A*24(14.93%)、A*30(5.53%)为重庆人群的优势基因.B位点中B*46(14.92%)＞B*40(12.96%)＞B*13(12.39%)＞B*51(7.26%).DRB1位点中,频率最高的为DRB1*09(15.65%),其次为DRB1*12(14.78%)、DRB1*14(14.49%)、DRB1*04(14.49%).DQB1位点中,频率最高的为DQB1*07(26.04%),其次为DQB1*05(19.94%)、DQB1*09(15.51%).与其他地区不同人群相比,HLA-A、B、DRB1、DQB1各位点等住基因的分布均有显著的差异.结论 重庆地区人群的HLA-A、B、DRB1、DQB1位点等住基因符合南方汉族人群分布特点,具有复杂的多态性,中国各地常见的基因均有分布,白血病及其他器官移植患者在重庆不难找到合适的供者.     

宁夏回族原发性高血压人群HLA-DQB1基因多态性分析

目的：分析HLA-DQB1基因多态性在宁夏回族人群原发性高血压（EH）患者中的分布,阐明宁夏回族人群原发性高血压的易感性。方法：采用序列特异性引物聚合酶链式反应（SSP-PCR）的方法对宁夏回族66例健康个体(对照组)及84例EH患者(病例组)的HLA-DQB1位点进行基因分型,应用遗传学统计方法分析宁夏回族原发性高血压人群DQB1基因多态性。结果：病例组等位基因DQB1*0301、*0401、*0601、*0604/5/6/7、*0302频率显著高于对照组（P<0.01或P<0.05）;病例组等位基因DQB1*0501、*0602、*0603/8、*0606、*0402、*0604/5/6/8频率显著低于对照组（P<0.01或P<0.05）。结论：DQB1*0301、*0401、*0601、*0604/5/6/7、*0302与宁夏回族人群原发性高血压的易感性有关,而DQB1*0501、*0602、*0603/8、*0606、*0402、*0604/5/6/8有可能是宁夏回族人群原发性高血压的保护因子。     

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.