一个早期起病的遗传性痉挛性截瘫非裔美国家族中SPG3A基因的新突变

背景:GTP酶基因SPG3A新突变导致常染色体显性遗传性痉挛性截瘫,该病与14q染色体(SPG3)连锁有关,后者约占所有常染色体显性遗传性痉挛性截瘫病例的10%～15%。SPG3A基因的突变谱及其表型/基因型相关性尚未确定。目的:描述1个因SPG3A基因新突变而致婴儿期起病的遗传性痉挛性截瘫家族。方法:对1个较小非裔美国家族中6例罹患者进行全面的神经系统检查和遗传学分析。对染色体2p和14q上常染色体显性遗传性痉挛性截瘫位点附近的遗传标记物进行连锁分析。分析SPG3A基因的编码序列。通过对来自正常对照者的200条染色体进行序列分析,检测序列…     

遗传连锁分析法对一常染色体显性遗传性视网膜色素变性家系的基因定位研究

目的：对一个常染色显性遗传性视网膜色素变性（autosomal dominant retinitis pigmentosa,ADRP)大家系进行基因定位。方法：收集ADRP家系，对该家系成员进行详细眼科检查确诊为视网膜色素变性（retinitis pigmentosa,RP），采集外周血3－5ml并抽提DNA；采用多个已知遗传标记与该家系致病基因位点进行连锁分析。结果：两点连锁结果显示该家系致病基因位点与遗传标记1D3S1292连锁，在θ=0.1时得到最大LOD分数2．73。结论：由于D3S1292位于3号染色体长臂21区（3q21)，从而将该家系致病基因位点大致定位于3q21附近。     

一个先天性甲状腺功能亢进症家系的排除性定位分析

目的 对一个常染色体显性遗传的先天性甲状腺功能亢进症家系,进行与已知致病基因TSHR和THRB的连锁分析以确定此家系致病基因是否为这2个已知基因.方法 选择3个与TSHR和THRB紧密连锁的微卫星标记物D14S74、D3S2338和D3S1266,进行微卫星标记的基因连锁分析,采用Genemapper 3.5软件分析数据. 结果 3个微卫星标记物的LOD值均小于1,显示该家系致病基因与这3个位点均不连锁,提示该家系可能存在新致病基因. 结论 常染色体显性遗传类型的先天性甲状腺功能亢进症可能有新致病基因.     

一种连锁SPG27的新表型及其在10号染色体上的精确编码区域定位

遗传性痉挛性截瘫具有遗传和临床上的异质性。迄今为止,已经确认26个基因位点与之有关。最近在一个常染色体隐性遗传性痉挛性截瘫(A R-H SP)单一家族的10号染色体中发现了SPG27位点,属于单纯表型。报道1个连锁SPG27的复杂型A R-H SP突尼斯家庭,父母是第一代表兄妹,4个孩子中有3     

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。     

常染色体显性遗传性先天性白内障一家系致病基因的初步定位

目的 初步定位常染色体显性遗传性先天性白内障(ADCC)一家系的致病基因。方法 收集ADCC一家系资料，在已知先天性白内障致病基因和位点附近，选择合适的短串联重复序列多态性标记(STRP)，对ADCC一家系进行连锁分析，使用Mlink软件采用对数优势记分法(LOD)计算LOD值。结果 在STRP中，D17S805、D17S1294及D17S1293与致病基因位点连锁的最大IDD值分别为2．03、2．49及2．22(重组率θ=0)。结论 该ADCC家系的致病基因初步定位在第17对染色体上；CRYBA1基因为候选基因。     

遗传痉挛性截瘫的新基因位点位于染色体1p31.1～1p21.1

补充1个苏格兰大家系的临床表现资料,该家族患者因罹患常染色体显性遗传性食管裂孔疝而导致痉挛性截瘫合并听力障碍和持续性呕吐。利用全基因组定位技术,确定该型遗传痉挛性截瘫位于染色体1p31.1～21.1上的1个新位点(SPG29),并将其限定在标记物D1S2889和D1S248之间22.3cM的区域     

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。     

一常染色体显性遗传寻常型鱼鳞病家系致病基因的定位

目的 研究一常染色体显性遗传寻常型鱼鳞病家系的致病基因。方法 采用基因组扫描方法,利用1号染色体上的微卫星标记对该家系进行连锁分析,然后对候选基因FLG的部分编码区及外显子与内含子交界处进行突变检测。结果 在D1S2696得到最大两点连锁LOD值3．46（0=0）,单体型分析将疾病基因定位在D1S2726-D1S305之间约15cM范围内;在FLG基因的外显子非重复序列及部分重复序列未发现与疾病相关的突变。结论 该寻常型鱼鳞病家系的致病基因位于D1S2696附近,其致病基因可能是除FLG以外的其他基因。     

良性家族性婴儿惊厥基因定位

目的：对5个中国良性家族性婴儿惊厥(benign familial infantile convulsion，BFIC)家系进行基因定位研究。方法：选择D19S245、D19S250、D16S3131、D16S3133、D2S399、D2S2330等6个STR作为DNA标记，应用聚合酶链反应(PCR)，变性聚丙烯酰胺凝胶电泳(PAGE)和银染技术，采用LINKAGE软件包中的MLINK程序进行连锁分析。结果：在常染色体显性(AD)模式下，在标记位点D19S250处，家系2、3、5在重组率为0．000，外显率为90％时，获得最大两点对数优势计分值(log odds score，LOD)总和为2．151；在标记位点D16S3131处，家系2、5在重组率为0．085，外显率为70％、60％时，获得最大两点LOD值总和分别为1．056、1．155；在重组率为0．080，外显率为50％时，获得最大两点LOD值总和为1．227。提示这2个位点与BFIC疾病基因可能存在连锁关系。在其他位点处未获得提示连锁关系的信息。结论：部分BFIC家系的致病基因可能与D19S250或D16S3131存在连锁关系。     

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.     

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.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…