醛固酮合酶基因多态性与原发性高血压相关性研究

目的探讨醛固酮合酶基因（CYP11B2）-344T/C多态性与原发性高血压的相关性。方法采用关联分析,收集湖南地区汉族男性原发性高血压患者100例,正常对照100名。应用聚合酶链反应-限制性片段长度多态性分析（PCR-RFLP）对2组对象的CYP11B2-344T/C多态进行分析。结果2组对象CYP11B2基因型（TT型、CT型和CC型）的频率差异无统计学意义（χ^2=0.34,P〉0.05）,等位基因的频率差异也无统计学意义（χ^2=0.28,P〉0.05）,但各组内等位基因T的频率（原发性高血压组：67.67%）高于等位基因C（32.33%）;对照组T69.67%高于C 30.33%。结论多基因联合分析显示,在男性患者中,CYP11B2-344T/C多态性与原发性高血压无明显相关,但CYP11B2-344各组内等位基因T的频率高于等位基因C。     

醛固酮合酶基因多态性与原发性高血压相关性研究

目的探讨醛固酮合酶基因(CYP11B2)-344T/C多态性与原发性高血压的相关性。方法采用关联分析,收集湖南地区汉族男性原发性高血压患者100例,正常对照100名。应用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)对2组对象的CYP11B2-344T/C多态进行分析。结果2组对象CYP11B2基因型(TT型、CT型和CC型)的频率差异无统计学意义(χ2=0.34,P>0.05),等位基因的频率差异也无统计学意义(χ2=0.28,P>0.05),但各组内等位基因T的频率(原发性高血压组:67.67%)高于等位基因C(32.33%);对照组T69.67%高于C 30.33%。结论多基因联合分析显示,在男性患者中,CYP11B2-344T/C多态性与原发性高血压无明显相关,但CYP11B2-344各组内等位基因T的频率高于等位基因C。     

EMILIN1 CYP11B2基因多态性与原发性高血压相关性研究

目的 研究 EMILIN1、CYP11B2基因多态性与原发性高血压的相关性。方法 回顾性分析该院2010年3月至2012年3月期间收治的100例原发性高血压患者,将其作为临床研究对象（患者组）,另选取血压正常的健康自愿者100例作为健康对照组,进行基因多态性的对比研究。采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法 分别检测两组EMILIN1基因SNP位点和CYP11B2基因SNP位点的等位基因及基因型分布情况。结果 患者组患者EMILIN1基因rs2304682位点上的基因型与等位基因频率与健康对照组比较,差异有统计学意义（P＜0．05）,患者组CG基因型、G等位基因频率明显高于健康对照组,而CC基因型、C等位基因频率则比健康对照组低;CYP11B2基因多态性基因型及等位基因频率发现,患者组（CYP11B2）-344 T/C基因多态性中TT基因型、T基因频率明显高于健康对照组,而CT 基因型、C基因频率则低于健康对照组,差异均有统计学意义（P＜0．05）。结论 EMILIN1基因多态性可能与原发性高血压有一定的相关性,（CYP11B2）-344T/C位点上等位基因T的频率较高。     

AT1R 1166A/C和CYP11B2-344C/T基因多态性与湖南汉族原发性高血压的相关性

摘要：目的：探讨血管紧张素Ⅱ-1型受体（AT1R）1166A/C和醛固酮合酶（CYP11B2）-344T/C基因多态性与原发性高血压(EH)的相关性。 方法：用限制性片段长度多态性聚合酶链反应（PCR-RFLP）对100例EH患者和100例体检健康者AT1R 1166A/C和CYP11B2-344T/C基因多态性进行检测。 结果：EH组AT1R 1166A/C AC型和C等位基因的频率高于健康对照组;AC基因型的血压值、TG,TC,LDL-C均明显高于AA基因型。HDL-C低于AA型CYP11B2各基因型频率和等位基因频率无显著性差异（P＞0.05）。各组内等位基因T的频率高于等位基因C（P＜0.05）。两基因联合分析显示,相对于AA-TT联合基因型,同时携带AC-CT联合基因型的人群患高血压的危险性增加了2.25倍。 结论：AT1R 1166A/C多态性与EH易感性相关,CYP11B2-344T/C基因多态性与EH无关,携带T1R 1166A C型基因以及AC-CT联合基因型的人群患高血压的危险性大。     

新疆哈萨克族、维吾尔族、汉族代谢综合征与CYP11B2基因-344T/C多态性相关性研究

目的:探讨新疆哈萨克、维吾尔、汉族不同人群醛固酮合成酶基因CYP11B2基因(-344)T/C多态性与代谢综合征(metabolic syndrome,MS)的关联性.方法:选取新疆哈萨克、维吾尔、汉族居民共1 220例,均用常规方法提取白细胞DNA.用PCR结合限制性内切酶(HaeⅢ)检测CYP11B2基因(-344)T/C多态性.根据有无MS分为MS组(汉族130例,哈萨克族115例,维吾尔族130例)和对照组(汉族206例,哈萨克族285例.维吾尔族354例).结果:(1)3个民族标化后MS的患病率明显不同(P<0.05).(2)3个民族CYP11B2-344T/C基因多态性CC、CT、TT基因型频率及等位基因分布频率相比较,差异有统计学意义(P<0.05).(3)维吾尔、哈萨克、汉3个民族CYP11B2-344T/C基因多态性CC、CT、TT基因型频率及等位基因分布频率分别与对照组比较,差异无统计学意义(P>0.05).结论:新疆地区维吾尔、哈萨克、汉族CYPllB2基因-344T/C多态性存在差异性,各民族内代谢综合征与CYP11B2基因-344T/C多态性无相关性.     

醛固酮合成酶基因多态性与心血管疾病关系的研究进展

醛固酮是人体内最重要的盐皮质激素,除了调节体内水盐代谢,醛固酮可直接影响心血管系统。我们以前认为醛固酮合成酶(CYP11B2)基因-344C/T的多态性只影响CYP11B2基因的表达。而近几年研究发现,这一多态性不仅会影响各级醛固酮分泌和血压水平,而且在基因-344C/T等位基因与左心室扩大和可能增加个体患心肌梗死的危险都有紧密联系。     

CYP11B2-344T/C基因多态性与2型糖尿病肾病的关系

目的:研究2型糖尿病(T2DM)患者CYP11B2-344T/C基因多态性与糖尿病肾病(DN)的相关性以及与DN不同分期的关系。方法:将145例T2DM患者分为DN组73例和糖尿病非肾病组(NDN组)72例,另选择52例门诊体验健康人为正常对照组(NC组)。应用聚合酶链反应-限制性内切酶片段长度多态性(PCR-RFLP)对以上197例观察对象进行基因型分析。结果:(1)DN患者存在CYP11B2-344T/C多态性,本研究197例观察对象中CYP11B2-344T/C多态性存在CC、CT、TT3种基因型,频率分别为12.7%、50.3%、37.1%;C、T等位基因频率分别为31.2%、68.8%。(2)DN组CYP11B2-344T/CT等位基因频率明显高于NC组(P<0.05)。(3)DN组CYP11B2-344T/C多态性CC、CT、TT3种基因型各临床指标均数比较差异无显著性(均P>0.05)。(4)DN组内微量白蛋白尿期、临床白蛋白尿期和肾功能不全期CC、TT、CT基因型频率和C、T等位基因频率差异均无显著性(均P>0.05)。(5)CYP11B2-344T/C基因型与DN无相关性(P>0.05)。(...     

CYP1182-344T/C基因多态性与2型糖尿病肾病的关系

目的:研究2型糖尿病(T2DM)患者CYPlIB2.344T/C基因多态性与糖尿病肾病(DN)的相关性以及与DN不同分期的关系.方法:将145例12DM患者分为DN组73例和糖尿病非肾病组(NDN组)72例,另选择52例门诊体验健康人为正常对照组(NC组).应用聚合酶链反应一限制性内切酶片段长度多态性(PCR-RFLP)对以上197例观察对象进行基因型分析.结果:(1)DN患者存在CYPllB2-344T/C多态性.本研究197例观察对象中CYP11B2-344T/C多态性存在CC、CT、TT3种基因型,频率分别为12.7%、50.3%、37.1%;C、T等位基因频率分别为31.2%、68.8%.(2)DN组CYPllB2.344T/C T等位基因频率明显高于NC组(P<0.05).(3)DN组CYP11B2-344T/C多态性CC、CT、TT3种基因型各临床指标均数比较差异无显著性(均P0.05).(4)DN组内微量白蛋白尿期、临床白蛋白尿期和肾功能不全期CC、TT、CT基因型频率和C、T等位基因频率差异均无显著性(均P0.05).(5)CYP11B2-344T/C基因型与DN无相关性(P0.05).(6)DN患者TT基因型血浆醛固酮水平最高.结论:CYP1182-344T/C多态性与2型糖尿病肾病无显著相关性.     

新疆哈萨克族人群内皮型一氧化氮合酶基因与醛固酮合成酶基因协同作用与原发性高血压的关联性

目的：分析新疆哈萨克族人群内皮型一氧化氮合酶（eNOS）基因与醛固酮合成酶CYP11B2T（-344）C基因协同作用与原发性高血压的关联性。 方法：选择2001-01／2004-03在新疆巴里坤县普查的年龄≤60岁的哈萨克族牧民。原发性高血压组174例[收缩压≥160mmHg（1mmHg=0．133kPa）和（或）舒张压≥95mmHg]，正常血压组157例[收缩压〈140mmHg和（或）舒张压〈90mmHg]。所有受试者均测定血压，身高，体质量，总胆固醇，三酰甘油，空腹血糖。应用聚合酶链反应、限制性内切酶方法检测了CYP11B2基因C-344T及eNOS基因G894T多态性。 结果：331例受试者均进入结果分析。①将CYP11B2T（-344）C基因型CC,CT,TT和eNOSG894T基因型GG，GT＋TT联合分为6组，结果显示：CYP11B2-344CC＋eNOS894GG基因型组合与CYP11B2-344CT＋eNOS894GG及CYP11B2-344TT＋eNOS 894GT-TT比较，收缩压、舒张压较高（P〈0.05），其他组合之间差异无显著性。②原发性高血压组CYP11B2-344CC＋eNOS894GG组合收缩压较CYP11B2-344TT＋eNOS 894GG组合高（P〈0．05），与其他组合之间差异无显著性，但收缩压及舒张压有高于其他基因型组合趋势。③正常血压组CYP11B2-344CC＋eNOS 894GG组合与其他基因型组合之间比较，收缩压和舒张压无显著差异，但年龄较其他基因型组合大。 结论：提示CYP11B2-344CC和eNOS 894GG纯合子具有协同作用，可能与新疆哈萨克族高血压具有关联作用。     

中国人醛固酮合成酶CYP11B2基因多态性与原发性高血压左室肥厚相关性的Meta分析

目的通过Meta分析评估醛固酮合成酶CYP11B2（-344C／T）基因多态性与原发性高血压左室肥厚之间的相关性。方法查阅1980年1月-2012年12月发表的有关CYP11B2基因多态性与中国汉族人群原发性高血压左室肥厚关系的病例对照研究文献,选择的数据库有中国期刊全文数据库、中国生物医学文献数据库、维普中文期刊数据、万方数据库及Pubmed。以左室肥厚组[LVH（＋）]和无左室肥厚组[LVH（-）]基因分布的OR值为统计量,应用RevMan 5．1软件对各研究结果进行异质性检验和数据合并。结果最终入选6篇病例对照研究文献。共人选原发性高血压患者1791例。LVH（＋）组与LVH（-）组CC／（TT＋TC）OR=1．21,95％CI（0．80,1．81）,P=-0．36;（TC＋CC）／TTOR=1．16,95％CI（0．68,1．98）,P=0．59;LVH（＋）组与LVH（-）组C等位基因／T等位基因频率OR=1．09,95％CI（0．78,1．54）,P=0．61。结论中国人的CYP11B2基因多态性与原发性高血压左室肥厚无关。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.