长链非编码RNA H19基因多态性与早发冠心病患者易感性研究

目的:探讨编码一段长链非编码RNA的 H19基因多态性与早发冠心病(pCAD)患者易感性的相关关系?方法:采用TaqMan技术分析 213 例早发冠心病患者和 776 例对照的H19基因 4个多态位点(rs2067051?rs2251375?rs217727?rs4929984)的基因型,用 SPSS 软件进行统计学分析?结果:早发冠心病组H19基因rs217727位点的CT基因型?TT基因型及T等位基因分布频率均高于对照组?多元Logistic回归分析显示:rs217727多态性与早发冠心病发病独立相关(P < 0.01)?T等位基因携带者?TT纯合基因患早发冠心病的风险分别是CC纯合基因型的2.42倍(OR=2.42,95%CI=1.55~3.71)和3.01倍(OR=3.01,95%CI=1.87~4.85)?结论:H19 rs217727多态性与早发冠心病易感性有关,T等位基因可能是早发冠心病的遗传易感因素?     

Toll样受体2亚家族基因单核苷酸多态性与哮喘的关系研究

目的:探讨Toll样受体(Toll-like receptor,TLR)2亚家族基因单核苷酸多态性(single nucleotide polymorphisms,SNP)与中国东南方成人哮喘以及其临床表型之间的关系。方法:共招募哮喘患者318例,正常对照352例,TLR2亚家族中共8个SNP使用SNPstream方法进行了基因分型。对各SNP和单倍型与哮喘及其表型进行了分析。结果:运用Logistic回归分析后,发现rs7656411/TLR2突变基因型TT与野生型rs7656411 GG比较能明显降低37%哮喘的发生(校正OR=0.63,95%CI:0.41~0.98,P=0.41),rs7656411 TT+GT与哮喘无明显关系(校正OR=0.77,95%CI:0.54~1.09,P>0.05)。携有rs2381289/TLR6 T等位基因的哮喘患者患过敏性鼻炎的危险度为不携带此等位基因哮喘患者的1.79倍(95%CI:1.10~2.91,P=0.025),然而携有rs11466651/TLR10 A等位基因的哮喘患者患过敏性鼻炎的危险度较不携带此等位基因的哮喘患者下降了51%(95%CI:0.26~0.95,P=0.046)。结论 :TLR2亚家族基因的突变可能在哮喘易感性中起着重要作用。     

IL-13基因多态性与喉癌遗传易感性的关联研究

目的:探讨白细胞介素-13(interleukin-13,IL-13)基因单核苷酸多态性(single-nucleotide polymorphism,SNP)与喉癌遗传易感性的关系?方法:通过病例-对照研究设计,以111例经病理确诊的喉癌患者和340例健康对照者为研究对象,选取IL-13基因3’-UTR的SNP位点rs1295685,采用TaqMan探针方法进行多态性检测,应用Logistic回归计算OR值及其95%CI,比较不同基因型与喉癌发病风险的关联?结果:病例组与对照组中rs1295685(IL-13C870T)位点基因型分布存在统计学差异,在调整年龄?吸烟?饮酒及肿瘤家族史因素后发现,与CC基因型相比,携带TT/CT基因型者喉癌发病风险显著增高(调整OR值为2.00,95%CI为1.23~3.27,P值为0.005)?与CC基因型相比,携带TT/CT基因型在年龄≤62岁?吸烟?饮酒?无肿瘤家族史各亚组中表现出更高的喉癌患病风险(OR = 2.72,95%CI:1.40~5.28; OR = 2.07,95%CI:1.19~3.58;OR = 1.96,95%CI:1.03~3.73;OR = 2.01,95%CI:1.18~3.41)?吸烟?饮酒均与TT/CT基因型存在协同作用(OR = 6.48,95%CI:2.77~15.14和OR = 7.35,95%CI:3.15~17.12)?而基因型分布在肿瘤分期?分级中未见显著差异?结论:IL-13基因rs1295685位点的单核苷酸多态性与喉癌遗传易感性有关联?     

IL-12B基因多态性及单倍型与克罗恩病的关系研究

目的探讨IL-12B基因多态性及单倍型与克罗恩病(CD)的关系。方法选取94例CD患者（CD组）和106例健康体检者（对照组）,采用改良多重高温连接酶检测反应技术检测IL-12B基因2个功能性单核苷酸多态性（SNP）位点rs3212227和rs6887695的等位基因及基因型,用Haploview4.2软件进行连锁不平衡和单倍型分析,并分析IL-12B基因多态性及单倍型与CD的关系。结果CD组与对照组比较,该2个IL-12B基因SNP位点的突变等位基因和基因型频率均无统计学差异（均P＞0.05）。进一步亚组分析发现回肠型CD组患者rs6887695位点的突变C等位基因和GC+CC基因型频率均明显低于与对照组（28.75%vs44.34%,P＜0.05,OR=0.507,95%CI：0.291~0.882;50.00%vs71.70%,P＜0.05,OR=0.395,95%CI：0.186~0.836）;而上述2个位点的等位基因及基因型频率分布在结肠病变（结肠型+回结肠型）CD组患者与对照组间比较均无统计学差异（均P＞0.05）。此外,CD患者组内分层比较发现,与结肠病变CD组比较,回肠型CD组患者rs6887695位点的突变C等位基因、GC+CC基因型以及CC基因型频率亦均明显降低（28.75%vs50.00%,P＜0.05,OR=0.404,95%CI：0.218~0.745;50.00%vs72.22%,P＜0.05,OR=0.385,95%CI：0.163~0.908;7.50%vs27.78%,P＜0.05,OR=0.150,95%CI：0.037~0.613）。经Haploview4.2软件分析发现rs3212227和rs68876952个SNP位点之间存在中等强度连锁不平衡关系（D忆=0.545,r2=0.235）,但CD组与对照组比较,各单倍型的频率均无统计学差异（均P＞0.05）。结论IL-12B基因rs6887695位点多态性与CD的临床表型相关,该位点基因突变后可能降低回肠型CD的发病风险。     

XPC､XPD､XPG 基因多态与膀胱癌及其病理参数的相关性研究

目的:探讨 XPC(rs2228000?rs2228001?rs2470352)?XPD(rs13181)?XPG(rs17655)3个基因的5个多态性位点的基因型与膀胱癌及其病理参数的相关性?方法:采用病例对照研究,采用Massarray SNP检测技术对287 例膀胱癌患者和 282例正常人XPC?XPD?XPG基因的5个基因多态性位点的基因型分布进行分析?采用Logistic回归模型分析各基因型与膀胱癌发病的关系并比较不同基因型与膀胱癌及其病理参数的关系?结果:XPC rs2228000位点在病例及对照组中分布有显著性差异(χ2 = 21.949,P < 0.001),其中CT及TT基因型在病例组中的频率显著高于对照组,差异有统计学意义(CT vs CC:OR = 2.01,95% CI 1.41~2.88;TT vs CC:OR=3.06,95%CI 1.70~5.49);T等位基因携带者在病例组中的分布频率亦高于对照组,差异有统计学意义(CT/TT vs CC:OR=2.16,95%CI 1.58~3.11)?rs17655?rs2228000及rs2228001位点的基因型分布频率在不同分化程度的肿瘤中差异有统计学意义(rs17655:χ2 = 10.013,P = 0.040;rs2228000:χ2 = 13.836,P = 0.008;rs2228001:χ2 = 14.315,P = 0.006),rs2228000位点的基因型分布频率与远端转移差异有统计学意义(rs2228000:χ2 = 12.204,P = 0.002)?结论:XPC rs2228000位点与膀胱癌的发病相关,含T等位基因个体膀胱癌的相对风险高,且与膀胱癌的肿瘤分化程度及淋巴结远端转移相关?rs2228001及XPG rs17655位点的基因多态性与肿瘤的分化程度相关?     

分拣蛋白受体1基因多态位点rs1133174与中国汉族遗忘型轻度认知损伤风险的关联研究

目的:探讨分拣蛋白受体1(sortilin-related receptor 1,SORL1)基因rs1133174多态性位点与遗忘型轻度认知损伤(amnestic mild cognitive impairment,aMCI)风险的相关性?方法:募集了63例aMCI患者和179例正常健康对照,利用连接酶检测-聚合酶链反应(LDR-PCR)方法对SORL1基因多态性位点rs1133174进行基因分型,比较等位基因和基因型与aMCI发病风险的关系?结果:aMCI组中SORL1基因rs1133174等位基因G的频率显著高于正常对照组(OR = 2.221,95%CI = 1.396~3.533,P = 0.000 6)?Logistic回归分析显示G等位基因携带者患病风险较非携带者增加(GG + GA vs. AA,OR =2.713,95%CI = 1.495~4.918,P = 0.000 5)?此外,分层分析发现多态性位点rs1133174可能是独立的风险因素?结论:SORL1基因rs1133174多态性位点与中国汉族人群aMCI风险相关?     

儿童手足口病重症病例影响因素的病例对照研究

目的:探讨儿童手足口病(hand-foot-mouth disease,HFMD)重症病例发生的影响因素?方法:采用性别?年龄?入院时间的1∶2匹配的方法对江苏省南京?镇江?扬州?常州市级医疗机构收治的手足口重症病例和轻症病例进行问卷调查,数据分析采用Cox比例风险模型进行单因素和多因素分析?手足口病原学的检测采用PCR方法进行确认?结果:单因素分析显示:发病-入院天数(OR=1.668,95%CI:1.307~2.128)?发热(OR=5.181,95%CI:1.939~13.844)?发热持续天数(OR=1.562,95%CI:1.1421~2.135)?颈项强直(OR=3.188,95%CI:1.055~9.634)?白细胞计数偏高(OR=1.038,95%CI:1.013~1.064)?中性粒细胞计数偏高(OR=1.235,95%CI:1.108~1.378)?Enterovirus 71(EV71)阳性感染(OR=5.069,95%CI:2.472~10.393)是儿童患手足口重症的危险因素,淋巴细胞计数增高(OR=0.968,95%CI:0.944~0.992)?Coxsackievirus A16(CoxA16)阳性(OR=0.191,95%CI:0.094~0.388)患手足口重症的风险比例较小;多因素分析结果显示:发病-入院天数?WBC计数偏高?中性粒细胞计数偏高是儿童患手足口重症的危险因素,其OR值分别为1.668(95%CI:1.122~2.477)?1.304(95%CI:1.080~1.575)?1.088(95%CI:1.001~1.184);CoxA16阳性的儿童患手足口重症的风险比例较小,其OR值为0.169(95%CI:0.038~0.753)?结论:加强对手足口患儿的临床监测和病原学监测,早期诊断,早期治疗,可以有效预防手足口患儿发展成重症的可能性?     

?茁2肾上腺素能受体基因Arg16Gly多态性与沙美特罗反应性的相关性研究

目的:评价使用丙酸氟替卡松的哮喘患者,其β2-肾上腺素受体基因(ADRB2)Arg16Gly的变异对沙美特罗临床反应性的影响?方法:62例哮喘患者,给予丙酸氟替卡松/沙美特罗(FSC)(100 ?滋g/50 ?滋g),2次/天吸入,治疗12周,治疗结束后有2~4天的导出期;以DNA直接测序法,确定62例ADRB2 5个位点的基因型及单倍型?结果:①哮喘在沙美特罗治疗期间,无论Arg16Gly为哪一种基因型,哮喘控制指标如峰值呼气流速(PEF)?1秒钟用力呼气容积(FEV1)?沙丁胺醇的使用量以及哮喘症状评分较其基础值都有持续地明显地改善(P < 0.001),Arg/Arg患者的PEF较其基础值增加了(114.4 ± 21.5)L/min,Gly/Gly与Arg/Gly患者分别增加了(100.3 ± 14.7)L/min和(103.3 ± 23.7)L/min,但3种基因型的哮喘控制指标的变化的比较,差异无显著性(P > 0.05);其他的3个哮喘指标也有相似的改变;②对沙美特罗的反应性不受单倍型配对的影响(P > 0.05);③在导出期,所有患者的哮喘控制指标都有相似的下降,但无基因型方面的差异(P > 0.05)?结论:在长期吸入糖皮质激素的情况下,Arg16Gly基因型或单倍型不会影响对沙美特罗的治疗反应性?然而,目前尚需要大规模的前瞻性的临床药物遗传学研究以及遗传流行病学研究来进一步阐明?     

XRCC1?PARP1和APE1多态性与晚期非小细胞肺癌铂类药物化疗敏感性的关系

目的:探讨碱基切除修复系统(BER) 3个重要基因——X线修复互补基因(XRCC1)?多(ADP核糖)聚合酶(PARP1)及脱嘌呤/脱嘧啶核酸内切酶(APE1)的单核苷酸多态性(SNPs)与晚期非小细胞肺癌(NSCLC)患者铂类药物化疗疗效的相关性?方法:对151例接受以铂类药物为基础化疗的晚期NSCLC患者进行临床疗效评价?采用TaqMan 探针法对XRCC1 G28152A(Arg399Gln)?XRCC1 C26304T (Arg194Trp)?PARP1 T2444C (Val762Ala)及APE1 T1349G (Asp148Glu)多态性位点进行基因型分析?比较不同基因型与铂类药物化疗效果之间的关系?结果:XRCC1 G28152A多态性与铂类化疗敏感性密切相关,GA杂合型患者临床受益率明显高于野生型,其化疗有效率为GG野生型的2.85倍(调整的OR=2.85, 95%CI:1.291~6.277, P < 0.05);至少携带1个变异等位基因A的患者(GA/AA)临床受益率为GG野生型携带者的2.48倍 (调整的OR=2.48, 95%CI:1.330~6.075, P < 0.05)?XRCC1 26304位点及PARP1 2444位点的突变纯合基因型携带者,其化疗有效率都明显下降,XRCC1 26304的TT基因型有效率是CT/CC基因型的0.36倍(调整的OR=0.36, 95%CI:0.040~3.298),PARP1 2444 CC基因型有效率是CT/TT基因型的0.37倍(调整的OR=0.37, 95%CI:0.118~1.170),但均未见有统计学差异?未发现APE1 T1349G多态性与铂类化疗疗效之间存在关联?结论:BER修复通路XRCC1 G28152A多态性与晚期NSCLC 患者铂类药物化疗临床受益相关,XRCC1 28152位点基因型检测有可能作为晚期NSCLC铂类化疗敏感性的预测指标?     

宁夏回族人群eNOS基因多态性与原发性高血压关联性分析

目的探讨在宁夏地区回族人群中eNOS基因4个SNP位点与原发性高血压(EH)的关联性。方法采用PCR-RFLP方法对134例EH患者及115例健康个体eNOS基因rs2070744(T>C)、rs1799983(G>T)、rs1800780(A>G)和rs3918181(A>G)共4个SNP位点进行检测。EH组与对照组间基因型频率、等位基因频率的差异比较采用χ2检验,并采用SHEsis在线分析软件对单倍型进行分析。结果 EH组和健康对照组间,rs1800780位点和rs1799983位点基因型频率的分布差异有统计学意义(P<0.05)。rs1799983位点等位基因频率的分布差异有统计学意义(P<0.05),其等位基因G的频率在EH组低于健康对照组,且OR值为3.851(95%CI:2.236～6.631)。4个SNP位点共检出15种单倍型,其中单倍型CGAG、TTAG、TGGG、TTGG、TTGA在宁夏回族健康人群及EH患者中差异有统计学意义(P<0.05)。单倍型CGAG、TGGG的OR值为0.352、0.600,95%CI小于1;单倍型TTAG的OR为2.689,95%CI大于1。结论 rs1799983位点等位基因G为宁夏回族人群易患EH的危险因子,单倍型CGAG与TGGG可降低回族EH的患病风险,而单倍型TTAG可增加回族EH的患病风险。     

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…