缺失型血管紧张素转换酶基因与重庆地区原发性高血压的关系

目的 :为探讨重庆地区原发性高血压与血管紧张素转换酶基因 (ACE)插入 /缺失 (I/D)多态性的关系。方法 :采用多聚酶链反应直接扩增ACE基因第 16内含子 ,对 114例正常人和 75例原发性高血压患者进行分析 ,得到三种基因型 :纯合插入型 (II型 )、纯合缺失型 (DD型 )、杂合型 (ID型 )。结果 :原发性高血压患者ACE基因的DD型频率明显高于正常人 (χ2=13.75 ,P <0 .0 0 5 ) ,D等位基因频率也明显高于正常人 (χ2 =14.3 ;P <0 .0 0 5 ) ,统计学分析差异有显著性意义。结论 :ACE基因的缺失型 (DD型 )可能与重庆地区原发性高血压的发病有关系     

血管紧张素转换酶基因多态性与结直肠癌的相关性

目的:探讨血管紧张素转换酶(ACE)基因多态性在结直肠癌(CRC)发病中的作用。方法:入组120例CRC患者,采用聚合酶链反应(PCR)检测患者外周血中ACE基因多态性和等位基因分布频率,研究ACE基因缺失型(DD型)、II型和插入型(ID型)等3种基因型及I/D等位基因在CRC患者外周血中的分布频率,并与120例正常人检测结果进行对比。结果:CRC患者外周血标本中存在ACE基因插入/缺失(I/D)多态性分布,DD型、ID型和II型3种基因型的频率分别为15.00%,50.00%,35.00%,I/D等位基因分布频率分别为60.00%及40.00%;对照组的分布频率分别为16.67%,53.33%,30.00%,I/D等位基因分布频率分别为56.67%及43.33%,两组间3种基因型的分布频率无显著性差异(P>0.05)、I/D等位基因分布频率无显著差异(P>0.05)。分层分析表明,D等位基因变异与CRC低分化和远处转移相关(P<0.01及P<0.05)。结论:ACE基因I/D多态性与CRC存在一定关系,其中D等位基因异常与CRC低分化和易转移可能有关。     

2型糖尿病合并高血压与血管紧张素转化酶I基因多态性的相关性及其脂质代谢的研究

目的:探讨广西汉族2型糖尿病(DM)合并高血压与ACE基因I/D多态性的相关情况及其与血脂代谢的关系.方法:采用多聚酶链反应(PCR)技术,对81例广西地区汉族2型DM无合并高血压患者和39例2型DM合并高血压患者及100名汉族正常对照的ACE基因插入/缺失(I/D)多态性及血脂进行检测.结果:2型DM合并高血压组ACE基因各等位基因及基因型频率与正常对照组及无合并高血压组比较均无统计学意义(P＞0.05).2型DM合并高血压DD基因型组及ID基因型组甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)高于正常组,高密度脂蛋白胆固醇(HDL-C)低于正常组(P<0.05);II基因型组TG、TC及LDL-C低于DD基因型组及ID基因型组(P<0.05),与正常组对照组比较无统计学意义,HDL-C高于DD基因型组及ID基因型(P<0.05);ID基因型组TG高于正常组、DD基因型组及II基因型组(P<0.05).结论:广西地区汉族2型DM合并高血压与ACE基因I/D多态性无关联.2型DM合并高血压DD基因型及ID基因型者与正常人比较更易患高甘油三酯血症、高总胆固醇血症及高低密度脂蛋白胆固醇血症, II基因型者不易患高脂血症; ID基因型者更易患更高甘油三酯血症.     

血管紧张素转换酶基因I／D多态性在云南省彝族人群中的分布

目的 研究云南省晋宁县彝族人群ACE基因插入/缺失(I/D)多态性分布的情况.方法 采用聚合酶链式反应(PCR)技术,检测居住在云南省晋宁县129例彝族健康人的ACE基因I/D多态性,计算DD、ID、II基因型频率和D、I等位基因频率.结果 云南省晋宁县彝族ACE基因的DD、ID、II基因型频率分别为17.1%、42.6%和40.3%,D、I等位基因频率分别为38.4%和61.6%.和不同种族人群比较,云南彝族人群ACE基因I/D多态性分布与古巴黑人、古巴白人和美国黑人差异有统计学意义(P<0.01),而与日本人接近(P>0.05).与我国其它民族比较,除云南彝族人群的II基因型频率和I等位基因频率高于维吾尔族(P<0.05)、D等位基因频率低于维吾尔族(P<0.05)外,云南彝族人群ACE基因I/D多态性分布接近汉族、黎族、哈萨克族、蒙古族和藏族(P>0.05).结论 ACE基因型频率和基因频率存在种族差异.     

食管癌患者血管紧张素转换酶基因多态性

目的检测食管癌患者血管紧张素转换酶(ACE)基因多态性,评估ACE基因与食管癌的关系。方法选择50例食管癌患者为研究组,采用PCR检测ACE基因,观察缺失纯合子型(DD型)、缺失与插入纯合子型(ID型)和插入纯合子型(Ⅱ型)3种基因型多态性分布频率,及计算I/D等位基因比率,50例同年龄段健康人群作为对照。结果 50例食管癌患者ACE基因呈插入/缺失(I/D)多态性分布,DD型、ID型和Ⅱ型基因占比分别为44.0%,22.0%,34.0%,I/D等位基因分布频率分别为34.0%和66.0%,对照组DD型、ID型和Ⅱ型3种基因型的占比分别为18.0%、52.0%、30.00%,I/D等位基因分布频率分别为30.0%和70.0%,两组间DD型、ID型基因的分布频率差异有统计学意义(P<0.01)、I/D等位基因分布频率差异无统计学意义。结论食管癌患者存在ACE基因I/D多态性,DD型基因分布较正常对照组显著升高,ID型显著降低,提示DD基因型高表达与食管癌发病有一定联系。     

2型糖尿病合并冠心病与血管紧张素转化酶I基因多态性的相关性及脂质代谢的研究

目的:探讨2型糖尿病(DM)合并冠心病(CHD)与血管紧张素转化酶I(ACE)基因插入/缺失(I/D)多态性的相关性及其各基因型血脂代谢情况. 方法:采用多聚酶链反应(PCR)技术,对32例广西地区汉族2型DM合并CHD患者,88例2型DM无合并CHD患者及100名汉族正常对照的ACE基因I/D多态性及血脂进行检测.结果:2型DM合并CHD组ACE基因D等位基因及ID基因型发生频率高于正常对照组及无合并CHD组(P<0.05);I等位基因及II基因型频率低于正常对照组及无合并CHD(P<0.05).2型DM合并CHD组ID基因型组甘油三酯(TG)及总胆固醇(TC)高于正常对照组、DD基因型组及II基因型组,高密度脂蛋白胆固醇(HDL-C)低于正常对照组,低密度脂蛋白胆固醇(LDL-C)高于正常对照组(P<0.05);2型DM合并CHD DD基因型组TG、LDL-C及TC高于正常对照组(P<0.05).结论:①广西地区汉族2型DM合并CHD与ACE基因I/D多态性有关.②D等位基因及ID基因型可能为2型DM合并CHD的易感基因,I等位基因及II基因型可能为2型DM合并CHD的保护基因.③广西地区汉族2型DM合并CHD的 ID基因型者及DD基因型者易合并高甘油三酯血症及高胆固醇血症.     

血管紧张素转换酶基因插入 /缺失多态性与 PAI-1活性的相关性

[目的]研究血管紧张素转换酶( ACE)基因插入 /缺失( ID)多态性与血浆 PAI-1活性的关系.[方法]用 PCR方法扩增 93例心肌梗死患者及 87例健康体检者 ACE基因特异性片段,同时应用发色底物法测定 PAI-1活性.[结果] ①心肌梗死组 ACE DD基因型频率 32.3%和 D等位基因频率 54.3% ,高于对照组 12.6%和 37.4%, P均 < 0.01; ACE基因型分布与年龄、性别、体重指数、血压、胆固醇、甘油三脂、血糖等无关.②心肌梗死组血浆 PAI-1活性( 0.85± 0.19) AU/mL,高于对照组( 0.66± 0.20) AU/mL, P< 0.01.③心肌梗死组 DD基因型血浆 PAI-1活性高于 ID基因型及Ⅱ基因型 P均 < 0.01; ID型血浆 PAI-1活性亦高于Ⅱ型 P< 0.05.对照组 DD基因型血浆 PAI-1活性高于Ⅱ基因型 P< 0.05;而 DD型血浆 PAI-1活性虽高于 ID型, ID型亦高于Ⅱ型,但差异无统计学意义.[结论] ① ACE DD基因型可能是心肌梗死发生的独立危险因素性;② PAI-1水平可能受 ACE基因 ID多态性的影响, ACE基因型可能通过影响纤溶平衡而引起心肌梗死.     

上海地区老年人ACE基因多态性频率的分布

目的研究血管紧张素转换酶(ACE)基因插入(I)/缺失(D)多态性在上海地区正常老年人群中的分布. 方法利用PCR三条引物法对478例上海地区正常人进行ACE I/D基因型的分析比较,其中老年人(＞60岁)344例. 结果上海地区正常人的ACE I/D基因型分布是:II型47.70%、ID型43.51%、DD型8.79%.在老年人群中的分布频率分别为47.09%、43.61%和9.30%,各基因型频率与新加坡人、日本人、台湾地区、香港的华人接近,但与白种人和非洲裔人群差异显著. 结论ACE基因多态性的分布与年龄无关,但有明显的种族和地区差异.     

哮喘患儿血管紧张素转换酶基因多态性的初步研究

目的探讨哮喘患儿血管紧张素转换酶（angiotensin converting enzyme,ACE）的基因型及其分布。方法提取87例哮喘患儿（实验组）和58例正常儿童（对照组）外周血基因组DNA,用PCR方法检测其ACE的基因型。结果实验组基因型为缺失型纯合子DD型38例、缺失型杂合子ID型19例、插入型纯合子II型30例,对照组基因型为缺失型纯合子DD型9例、杂合子ID型18例、插入型纯合子II型31例,两组基因型构成差异有统计学意义（P〈0.05）。实验组等位基因D的频率为54.59%、I为45.41%,对照组的等位基因D的频率为31.03%、I为68.97%,两组等位基因频率差异有统计学意义（P〈0.05）。结论哮喘患儿ACE的基因型以DD型为多见,ACE的基因多态性和儿童哮喘的易感性有关,可能是儿童哮喘发生的危险性因素。     

血管紧张素转换酶基因多态性与原发性高血压左心室肥厚的关系

①目的　探讨血管紧张素转换酶 (ACE)基因插入 /缺失 (I/D)多态性与原发性高血压左心室肥厚的关系。②方法　应用PCR技术测定 146例高血压病人的ACE基因型 ,同时测量身高、体质量、血压、血脂 ,记录高血压病程 ,并行心脏彩超检查 ,计算左室质量指数。③结果　 75例高血压伴左室肥厚病人中 ,DD基因型频率为2 9% ,ID型为 3 9% ,II型为 3 2 % ;而 71例高血压不伴左室肥厚病人中 ,DD型为 13 % ,ID型为 46% ,II型为 41% ,高血压伴左室肥厚病人DD基因型频率高于高血压不伴左室肥厚病人 ( χ2 =6.0 2 ,P <0 .0 5 )。④结论　高血压左心室肥厚的发生与ACE基因型有关 ,DD基因型高血压病人易出现左心室肥厚     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.