肿瘤坏死因子—β基因多态与系统性红斑狼疮关节研究

目的：探讨肿瘤坏死因子（TNF）－β的基因多态与华东地区汉族人系统性红斑狼疮（SLE）易感性的关系及其在SLE家系中的传递规律。方法：运用聚合酶链式反应－限制性片段长度多态（PCR－RFLP）对99例SLE患者，116名正常人及12个SLE家系的48名成员进行了TNF－β基因分型。结果：SLE患者的TNF－β＊2等位基因频率高于对照组（62．2％／47．0，OR＝1．89，P＝0．0012），但可能样本量过小，在SLE家系研究中未发现TNF－β基因多态存在关联的证据以及传递／连锁不平衡的证据，结论：TNF－β＊2等位基因可能是SLE的易感等位基因。     

江苏省海门市1993-2006年肝癌死亡率时间趋势分析

Objective To predict the trend of hepatocellular carcinoma (HCC) mortality and investigate the features of its mortality including age, period, and birth cohort in males living in Haimen city of Jiangsu province, China. Methods Grey model (GM) was modeled using standardized mortality rate (SMR) of HCC from 1993 to 2006, and was applied to predicting SMR until 2012. Based on the mortality density (MD) for a four-year period, the goodness-of-fit of models and comparisons between models were evaluated so as to obtain the best one among these models including the effects of intercept, age-period-cohort (APC) , age-period (AP), age-cohort (AC),period-cohort(PC), and APC. Both APC full model and the best model were used to estimate effects of age, period, and cohort on HCC mortality. In addition, MD from 2005 to 2012 was predicted by the best model. Results Predictions based on GM (1,1 )showed that SMR was 48.578 per 100 000 population (relative error=-1.267% ) in 2007 year, which declined between 2008 and 2012. The lowest value was 45.578 per 100 000 people (in the 2012 year). The results of fitted models and comparisons between models showed that AP model was the best one (△G2=9.065,AIC=202.544). The curvatures of the effects of the three factors from APC model suggested that significances existed in changes of curvatures of 36.5-40.5 years old- (-0.368) and 64.5-68.5 years old-(-0.489) as well as in the change of 1956-1959 birth cohort (C21949.5. 1967.5=-0.492). The estimation of relative risks for AP model showed that the age effects were upward to 64.5-68.5 years old-, then downward; and that the period effects were found to be declined between 1993 and 2004. Predictions based on AP model suggested the decrease of HCC mortality. Conclusion The slightly decreasing trend of HCC mortality for males might be explained by age, period and a minor birth cohort effects in Haimen of China.     

谷胱甘肽-S-转移酶M1和T1空白基因型与肝癌遗传易感性的研究

目的谷胱甘肽－Ｓ－转移酶Ｍ１和Ｔ１（ＧＳＴＭ１和ＧＳＴＴ１）空白基因型与肝癌遗传易感性的关系。方法应用多重ＰＣＲ技术检测６３例肝癌患者和８８例健康对照的ＧＳＴＭ１和ＧＳＴＴ１空白基因型。结果病例组ＧＳＴＭ１空白基因型的频率为５７．１％，对照组则为４２．０％，二者差异无显著性（χ２＝３．３５，Ｐ＝０．０６７），处于临界水平。ＯＲ值为１．８４（９５％ＣＩ＝０．９１～３．７３）。病例组ＧＳＴＴ１非空白基因型的频率为８７．３％，对照组则为６２．５％，二者差异有非常显著性（χ２＝１１．４２，Ｐ＝０．０００７２７４），ＯＲ值为４．１３（９５％ＣＩ＝１．６４～１０．７０）。叉生分析表明，ＧＳＴＴ１非空白基因型与肝癌的关联大于ＧＳＴＭ１空白基因型，两因素在肝癌发生中存在协同作用。结论具有ＧＳＴＭ１空白基因型和ＧＳＴＴ１非空白基因型的个体，患肝癌的危险性增加。     

胰岛素抵抗、胰岛β细胞分泌功能对妊娠糖尿病发生的影响

妊娠糖尿病 (ＧＤＭ)往往是妊娠中晚期伴随胰岛素抵抗(ＩＲ)的发展而发生的 ,故经典的观点认为ＧＤＭ主要与ＩＲ有关。ＩＲ是指胰岛素靶组织 (如骨胳肌、脂肪组织、肝脏等 )对胰岛素敏感性降低 ,对葡萄糖的利用降低及抑制肝葡萄糖输出的作用减弱。妊娠期的ＩＲ与胎盘分泌具有拮抗胰岛素作用的激素有关。不过 ,单一的ＩＲ尚不能引起ＧＤＭ。因为妊娠中晚期ＩＲ均增加 ,但仅约 5 %发展为ＧＤＭ。提示ＧＤＭ妇女除了有ＩＲ ,胰岛素分泌可能也存在缺陷〔1〕。本研究通过观察不同糖耐量状态〔ＧＤＭ、糖耐量低减(ＩＧＴ)、糖耐量正常 (ＮＧＴ)〕…     

AN ANALYSIS OF EFFECTS OF FETAL ORDER AND PARENTAL AGE ON RETINOBLASTOMA

Seventy-eight cases of retinoblastoma (Rb) diagnosed at the Eye ENT Hospital, Shanghai Medical University from 1953 to 1985 were studied. The results of multiple logistic regression analysis and conditional probability model showed that high fetal order had a moderate risk (OR=1.28, P<0.05) of developing unilateral Rb. Both unilateral and bilateral cases were independent of parental ages, and no interaction could be found between fetal order and paternal of maternal age; also, the effect of fetal order was not confounded by parental ages.     

上海县计划免疫进展

自1981年中美专家对上海县的计划免疫进行综合评价后,近几年上海县在巩固和发展计划免疫成果方面,作出了积极的努力,取得了较好成果。白喉已连续11年、脊髓灰质炎已连续8年没有病例,麻疹已连续8年控制在10/10万以下,1986年发病率为0.25/10万,为历史最低水平。     

上海县居民疾病谱分析

为了反映上海县居民健康状况的变化,明确今后卫生防病的重点,我们将从主要死因分析、传染病发病、医院住院病例、农村卫生服务等资料进行分析,找出近年来上海县居民疾病谱变化情况。     

NIDDM家族史与儿童肥胖及血压间的相关研究

为研究ＮＩＤＤＭ家族史与儿童肥胖度，体脂分布及血压的关系，方法我们对１６０８名７－１３岁儿童进行ＮＩＤＤＭ家族史调查及儿童形态指标，血压的测量。结果儿童ＮＩＤＤＭ家族史阳性率１７．４１％，有ＮＩＤＤＭ家族史儿童与无ＮＩＤＤＭ家族儿童相比，体块指数更大，差异有显著性意义；体重更，更为肥胖；两组儿童体脂分布类型及血压判别无显著性。结论 儿童肥胖与ＮＩＤＤＭ相关密切。     

原发性肝癌的遗传流行病学研究

目的　研究原发性肝癌的遗传模式 ,探讨本病的遗传与环境的交互作用。方法　采用Penrose法、简单分离分析和Falconer法对乙型肝炎表面抗原 (HBsAg)阳性队列中的 10 0例原发性肝癌家系资料进行遗传流行病学研究。先证者样本来自同地区 9万名 8年随访队列人群 ,分析遗传模式并将队列中家系样本发病情况分别与队列人群和一般人群的发病情况进行比较 ,计算遗传度。结果　先证者家系一级亲属肝癌发生率为 4 .0 % ,高于一般人群发生率 (0 .4 4 % ) ,也高于队列人群的肝癌发生率 (1.0 3% )。HBsAg阳性在先证者家系中存在聚集 ,且HBsAg阳性与肝癌的发生有强相关(OR =8.4 4 ,95 %CI :3.37～ 2 0 .0 6 ,P <0 .0 0 1) ;应用Penrose法计算 ,同胞肝癌发生率 一般人群肝癌发生率 (s q)接近 1 q1 2 ;简单分离分析提示不符合单因子遗传模式 ;与一般人群遗传度相比 (5 9%±7% ) ,队列人群遗传度h2 =4 2 %± 6 % ,P <0 .0 5。在控制了HBsAg后 ,一般人群遗传度下降为4 7%± 7% ,队列人群遗传度下降为 2 9%± 8%。结论　肝癌不符合单基因遗传模式 ,为一多因子疾病 ,受遗传与环境的综合影响。     

系统性红斑狼疮多因子遗传的通径分析

本文应用ATRIBUTE软件对215例先证者及其核心家系进行了通径分析,以探讨SLE可能的遗传模式。结果表明,与一般模型比较,H＝0和（H＝0,C＝0）的假设被拒绝,提示SLE不符合单基因遗传,存在多基因遗传模式。本病可能是一多因子疾病,遗传度为49．9％。