线粒体基因ND1／T3394C突变与糖尿病

目的：调查线粒体NADH脱氢酶亚单位1（ND1）基因的T3394C位点突变与中国人糖尿病的发病情况，方法：随机收集338例无血缘关系的糖尿病患及262例正常对照组，用聚合酶链反应扩谱，限制性内切酶Hae Ⅲ消化进行突变筛查，DNA序列分析确认。结果：糖尿病患中T3394C突变共8例（2．37％），正常对照组中只有1例（0．38％，P＜0．01），糖尿病突变患中4例有糖尿病家族史，4例病人由于胰岛素分泌功能下降和／或出现并发症，需用胰岛素治疗。结论：ND1／T3394C突变在糖尿病患中的发生率明显高于正常对组，提示这个位点突变可能是导致线粒体糖尿病的易感基因之一。     

线粒体DNA 3243、3316、3394位点突变与精神分裂症相关分析

目的分析线粒体tRNALeu(UUR)基因3243位点及ND1基因3316、3394位点突变对精神分裂症(SZ)发病的影响。方法采用PCR扩增、限制性内切酶消化、琼脂糖凝胶电泳分型检测、DNA测序等方法,对随机抽取的无亲缘关系的250例患者(SZ组)和292例对照组的外周血mtDNA进行3243、3316和3394位点的突变检测。结果在SZ组中发现8例3316G/A突变,对照组中3例,两组相比差异无统计学意义(P=0.138)。在SZ组中发现15例3394T/C突变,对照组中有4例,两组相比差异有统计学意义(P=0.007)。在精神分裂症患者组和对照组中均未发现3243A/G突变。结论 mtDNA3394T/C突变可能与SZ发生有一定关系,mtDNA 3243A/G、3316G/A突变可能与SZ发生无关。     

线粒体DNA3316、3394等4个突变位点与2型糖尿病的关系研究

目的:探讨DNA tRNA Leu(UUR)基因及ND-1基因3316 G/A、3394 T/C等4个突变位点与2型糖尿病的关系。方法:对236例海南地区2型糖尿病患者和252例健康对照者进行空腹血糖测定并采用聚合酶链式反应—限制性核酸内切酶片段长度多态性(PCR-RFLP)的分析方法进行mtDNA的3243、3316、3394、和3593共4个位点进行突变筛选,并采用DNA测序方法确证。结果:实验组空腹血糖(9.37±3.01)mmol/L与健康对照组(4.96±0.76)mmol/L差异有统计学意义(P<0.05);实验组检出3316(G→A)突变8例,3394(T→C)突变3例;健康对照组未发现上述突变;突变检测结果与测序一致。两组间3316(G→A)突变率差异有统计学意义(P<0.05)。结论:线粒体DNAtRNALeu(UUR)基因及ND-1基因3316、3394位点的基因突变,尤其是3316位点(G→A)突变可能与某些核基因或环境因素协同促进了2型糖尿病的发生。     

中国人2型糖尿病人群中线粒体基因tRNAleu~((UUR))nt324 3A→G和ND-1基因nt331 6G→A突变的发生率及其临床特点的研究(英文)

目的　为了解线粒体tRNALeu(UUR) nt32 4 3A G突变和ND 1基因nt3316GA突变在中国人 2型糖尿病人群中的精确发病率及该基因突变所导致的II型糖尿病的临床特征。方法　我们采用PCR RFLP技术对 716例随机抽取的无亲缘关系的 2型糖尿病患者进行了突变的筛查。结果　在 2型糖尿病组中发现 3例 (0 4 % )该基因突变携带者 ,并在先证者一级亲属中又发现 4例携带该突变的2型糖尿病患者。比较mt32 4 3A G突变阳性的 2型糖尿病患者与mt32 4 3A G突变阴性的 2型糖尿病患者的临床特点后发现mt32 4 3A G突变阳性的 2型糖尿病患者具有以下特征 :1) 发病早 (38 0± 10 1vs 5 3 4± 10 0岁 ,P <0 0 0 1) ;2 ) 体重减轻 (BMI,19 5± 2 0vs 2 4 9± 10 9kg/m2 ,P <0 0 0 0 1) ;3) 胰岛素分泌能力下降 (OGTT试验胰岛素曲线下面积 ,2 94 6± 16 47 2vs74 6 9± 6 6 47 7,P <0 0 1)。在 2型糖尿病组中发现ND1基因nt3316G A突变16例 (2 2 % ) ,在 181例正常对照组中发现 5例突变携带者 (2 7% ) ,突变的发生率在两组间无显著性差异。携带mt3316位点G A突变的 2型糖尿病组与无该突变的 2型糖尿病组之间的临床特点亦无显著差异。结论　线粒体tRNALeu(UUR) nt32 4 3A G突变在中国人 2型糖尿病人群中的发病率为 0 4     

基因芯片筛查糖尿病线粒体基因突变

目的建立一种快速、准确的高通量检测线粒体DNA突变的基因芯片技术,并探讨这些突变与糖尿病的关系。方法以尼龙膜为介质,通过紫外交联固定28个待测突变位点的野生型和突变型探针,并采用该基因芯片对200例2型糖尿病患者和210名健康对照的线粒体tRNA leu（UUR）基因及ND1基因进行筛查,DNA测序进一步确证突变位点,Mfold和Antheprot软件预测变异型基因及蛋白质二级结构。结果成功研制可检测28个突变位点的线粒体DNA芯片,在糖尿病组检出tRNA leu（UUR）基因13290C突变2例（1．0％）,ND1基因突变23例：G3316A突变6例（3．0％）、13394C突变5例（2．5％）、A4164G突变8例（4．0％）,T4216C突变2例（1．0％）,T3593C（0．5％）和A3606G突变各1例（0．5％）;对照组检出G3316A突变1例（0．5％）、A4164G突变5例（2．4％）。这些突变位点的测序结果与基因芯片检测结果一致。两组间仅13394C突变率差异有统计学意义（P=0．027）。G3316A突变导致丙氨酸→苏氨酸,13394C突变导致酪氨酸→组氨酸,13593C突变导致缬氨酸→丙氨酸,T4216C突变导致酪氨酸→组氨酸,A3606G和A4164G突变分别为亮氨酸和蛋氨酸的无意义突变,前4种突变型的ND1蛋白二级结构不同于野生型。结论线粒体DNA芯片是一种快速可靠的高通量基因突变检测方法,ND1基因13394C突变可能参与了线粒体基因缺陷型糖尿病的发病。     

线粒体基因16189 T/C突变性糖尿病的特点

目的：研究线粒体基因16189 T/C突变性糖尿病在中国北方人群中的特点。方法：采用聚合酶链反应（PCR）和限制性片段长度多态性（RELP）分析方法对中国北方155例2型糖尿病患者（糖尿病组）和164例正常中国北方人（对照组）进行核心家系线粒体基因筛检和分析。结果：①线粒体基因 16189 T/C 突变在糖尿病组占32.26%（50/155）,在对照组占15.24%（25/164）,二者比较差异有显著性（P<0.05）。②在糖尿病患者中线粒体基因16189 T/C 突变组（n=50）与非突变组(n=105)比较,空腹血糖（FPG）、糖化血红蛋白（GHbA₁c）、空腹C-肽及餐后2 h C-肽,差异均无显著性。③线粒体基因16189 T/C突变的糖尿病患者临床特点多为50岁左右发病,男女发病率无明显差异（1.3∶1）;发病时体重指数常较高（74%的患者BMI超过标准值）;65%患者伴血脂代谢异常;具有明显的母系遗传倾向。结论：线粒体基因16189 T/C点突变可能仅为人群中的基因多态现象,还不能确定其为糖尿病单基因致病突变。     

线粒体DNA3160-3755区域基因突变与2型糖尿病的关系

目的研究线粒体DNA3160-3755区域基因在延边地区2型糖尿病（T2DM）患者中的突变情况,探讨该区域线粒体基因突变与2型糖尿病的关系。方法应用聚合酶链反应-限制性片段长度多态性（polymorphismchainreaction-restrictionfragmentlengthpolymorphism,PCR-RFLP）技术和直接测序法对延边地区人群108例正常健康体检者、328例T2DM患者（其中2例合并耳聋）,进行线粒体DNA3160-3755区域基因突变筛查。结果线粒体DNA3316G-A在糖尿病组和正常对照组中的突变率分别为3．7％和3．8％。两组间差异无统计学意义（P〉0．05）;3394T→C在糖尿病组和正常对照组中的突变率分别为7．3％和1．9％,两组间差异有统计学意义（P〈0．05）;在糖尿病组及正常对照组中均未检测到线粒体DNA3243A→G、3593T→C和3714A→G突变。结论线粒体DNA3316G→A突变与延边地区T2DM的发生无关;线粒体DNA3,394T→C突变与延边地区T2DM的发生有关;线粒体DNA3423A→G,3593T→C,3714A→G突变在延边地区T2DM中的发生率为0,提示上述位点基因突变率极低。     

线粒体DNA ND1基因G3316A突变与2型糖尿病相关性研究

目的 研究浙江台州地区汉族人群线粒体DNA ND1基因中G3316A突变的发生率与2型糖尿病的相关性.方法 应用聚合酶链反应技术对无血缘关系的270例2型糖尿病患者和185例健康对照者的外周血DNA进行检测.结果 发现10例T2DM患者存在G3316A突变(3.70%),对照组中有1例突变(0.54%),G3316A在两组间比较有显著性差异(P＜0.05).结论 线粒体DNA ND1 G3316A突变可能与浙江台州地区汉族人群2型糖尿病的发生与发展有关.     

线粒体12SrRNA、ND1基因突变与糖尿病

目的探讨线粒体基因(mtDNA)12SrRNA1382、1442位点及NDI3394、3423位点突变与中国上海地区非肥胖2型糖尿病的关系。方法采用PCR-SSCP及PCR产物直接测序等技术检测mtDNA12SrRNA、NDI片段的突变情况。结果286例非肥胖2型糖尿病患者在12SrRNA1382位点有6例存在A→C的点突变，1442位点8例存在G→A的点突变；242例非糖尿病对照组中，2例存在1382位点A→C，1例存在1442位点G→A的点突变。286例非肥胖2型糖尿病和242例非糖尿病对照组中，未发现NDI3394位点突变，而3423位点的突变率为100％。结论12SrRNA1382、1442位点突变可能增加糖尿病的易感性。mtDNANDI3423位点突变率为100％，可能与人种有关；3394位点不存在突变说明糖尿病的发生在线粒体遗传上存在一定的异质性。     

线粒体DNA ND4基因12026（A→G）点突变与2型糖尿病相关性研究

目的 研究中国云南2型糖尿病人群线粒体ND4基因ntl2026A→G点突变的发生频率及其与2型糖尿病的相关性.寻求准确、快速、简易的临床糖尿病基因诊断方法.方法 随机选取350例中国云南2型糖尿病患者和225例无糖尿病家族史的健康对照者作为研究对象.通过聚合酶链式反应及限制性片段长度多态性分析(PCR-RFLP)检测线粒体12026A→G点突变.结果 经DNA直接测序确证.结果 350例2型糖尿病患者中12026A→G点突变者11例(3.14%),225例对照者中携带该突变者6例(2.67%),突变发生率在两组间差异尤统计学意义(x2=0.0059,P=0.8064).结论 线粒体ND4基因12026A→G突变可能仪为人群中线粒体基因组的正常多态,不是中国(特别是云南)人群中2型糖尿病的常见致病因.     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.