ApoE基因多态性与2型糖尿病患者的相关性初步分析

目的：研究2型糖尿病患者的ApoE多态性分布频率；ApoE对2型糖尿病患者的血糖和胰岛素水平的影响。方法：通过基因位点引物测定方法测定2型糖尿病组和对照组的ApoE基因型和等位基因频率并进行分析；测定不同基因型糖尿病患者空腹及口服葡萄糖后血糖、胰岛素水平及服糖后血糖面积和胰岛素面积并进行分析。结果：与对照组比较，ApoE基因频率显示，糖尿病组ε4基因频率明显增高，糖尿病组ApoE基因型频率提示ε3／3明显降低，不同ApoE基因型患者空腹及口服葡萄糖后水平无差异，ε4基因型糖尿病患者的空腹胰岛素水平和服糖后胰岛素曲线下面积明显增高。结论：ε4基因型对2型糖尿病患者的发病有重要影响，且对2型糖尿病患者高胰岛素血症及胰岛素抵抗有影响。     

2型糖尿病患者脂蛋白脂酶基因S447X和载脂蛋白E基因多态性与冠心病的关系

目的探讨2型糖尿病患者脂蛋白酯酶(LpL)及载脂蛋白E基因(ApoE)与冠心病的关系。方法采用聚合酶链反应-限制性片段长度多态性(PCR-PFLP)技术分别检测2型糖尿病并冠心病组(110例)及对照组(116例)LpL、ApoE基因型。结果2型糖尿病并冠心病组LpL/S447XX突变频率低于对照组(P<0.05);2型糖尿病并冠心病组ε3/3和ε4/3频率分别为41.2%和37.3%,分别明显低于对照组ε3/3(频率70.7%)和高于对照组ε4/3(频率21.6%),P均<0.01。ε4等位基因频率为28.2%,明显高于对照组(13.4%,P<0.01)。结论LpL/S447XX突变降低2型糖尿病并发冠心病患者的遗传易感性,而ApoE/ε4等位基因增高2型糖尿病并发冠心病患者的遗传易感性。     

冠心病患者载脂蛋白E、血管紧张素转换酶联合基因型研究

目的 :研究中国人载脂蛋白E(ApoE)基因多态性及血管紧张素转换酶 (ACE)基因插入 /缺失 (I/D)多态性与冠心病的关联。方法 :分别用PCR -RFLP及PCR技术检测了 12 9例冠心病患者及 90例健康人ApoE ,ACE基因型。结果 :冠心病组ε3 / 4基因型及ε4等位基因频率显著高于对照组 ,ε3 / 3 基因型及ε3 等位基因频率则显著低于对照组 ;ACE各基因型及等位基因频率两组间无显著差异 ;在ε4携带情况下 ,不同ACE基因型冠心病危险度不同 ,DD型 >ID型 ,而Ⅱ型似有一定的保护作用。结论 :ε4等位基因是冠心病的遗传易患因子 ;ACE基因与冠心病发病无显著关联 ,但对ε4等位基因有一定的“修饰”作用。     

PEAR1、ApoE基因多态性与AMI患者易感性及临床特征的相关性分析

目的:探讨血小板内皮聚集受体-1（PEAR1）、载脂蛋白E （ApoE）基因多态性与急性心肌梗死（AMI）患者易感性及临床特征的相关性。方法:选取2019年1月—2021年2月心内科收治的AMI患者183例（病例组）,选取无AMI病史的中老年志愿者92名（对照组）。采用实时荧光PCR法检测PEAR1和ApoE基因多态性。收集患者性别、年龄、肥胖、吸烟史、高血压、糖尿病、高脂血症、高同型半胱氨酸（Hcy）血症、冠心病家族史等临床资料。比较两组的临床资料以及PEAR1和ApoE基因型的频率分布,分析PEAR1和ApoE基因型分布与性别、年龄、肥胖、吸烟史、高血压、糖尿病、高脂血症、高同型半胱氨酸（Hcy）血症、冠心病家族史的相关性。结果:与对照组相比,病例组肥胖、吸烟史、高血压、糖尿病、高脂血症、高Hcy血症的比例升高（?字2=7.857,P=0.005;?字2=4.787,P=0.029;?字2=34.790,P＜0.001;?字2=12.089,P=0.001;?字2=13.355,P＜0.001;?字2=11.911,P=0.001）。与对照组相比,病例组GG基因型频率降低,AA基因型频率升高（?字2=13.673,P=0.001）。与对照组相比,病例组G等位基因频率降低,A等位基因频率升高（?字2=13.560,P＜0.001）。与对照组相比,病例组ε3/ε3基因型频率降低,ε2/ε2、ε2/ε3、ε3/ε4、ε4/ε4基因型频率升高（?字2=33.003,P＜0.001）。与对照组相比,病例组ε3等位基因频率降低,ε2、ε4等位基因频率升高（?字2=36.673,P＜0.001）。PEAR1和ApoE基因型与性别、年龄、肥胖、吸烟史、高血压、糖尿病、高Hcy血症、冠心病家族史均无关联（均P>0.05）。ApoE基因型与高脂血症有关联,ε3/ε3基因型患者中高脂血症的比例低于ε2/ε4、ε2/ε2、ε2/ε3、ε3/ε4、ε4/ε4基因型患者（?字2=24.571,P＜0.001）。结论:PEAR1、ApoE基因多态性与AMI易感性有一定关联。     

早发冠心病家族史同胞的血脂水平及ApoE基因多态性分析

目的探讨血脂异常及ApoE基因多态性与早发冠心病的关系及疾病的遗传易感性.方法检测63例具有早发冠心病家族史的同胞和49例年龄、性别相匹配的健康对照者的血脂水平,聚合酶链式反应(PCR)和HhaI酶切法测定ApoE基因多态性.结果整体血脂水平上同胞组与对照组比较差异显著(P<0.01).本研究只发现3种常见ApoE基因型ε3/3、ε2/3和ε4/3,两组在基因型频率和等位基因频率分布上无统计学差异(P>0.05);两组中不同基因型亚组间血脂水平无显著差异,ε3/3基因型亚组中同胞组与对照组比较,血脂水平有显著差异(P<0.01).结论具有早发冠心病家族史的同胞具有明显的血脂代谢紊乱,但 ApoE基因多态性不是早发冠心病独立的危险因素.     

ApoE基因多态性与血脂、氧化低密度脂蛋白、糖尿病足的相关性分析

目的:评价载脂蛋白E(ApoE)基因多态性与血脂、氧化低密度脂蛋白(oxLDL)及2型糖尿病(T2DM)患者发生糖尿病足(DF)的相关性,为DF的早期基因诊断提供循证医学的证据。方法应用聚合酶链反应-限制性片段长度多态性检测70例T2DM患者(40例DF患者,30例无慢性并发症患者)和48例健康对照者的ApoE基因多态性,比较T2DM患者中并发DF(DF组)与无慢性并发症DM(DM对照组)患者及健康组的Apo E基因型分布和等位基因频率,并利用Logisitic回归分析ApoE基因多态性与DF之间的相关性。结果:DF组ε3/4基因型和ε4等位基因均高于其他两组;ε2/4、ε3/4两组TCH、LDL、oxLDL、HbA1C均明显高于ε2/3、ε3/3两组,HDL则低于上述两组;各等位基因之间比较:ε4组TCH、LDL、oxLDL、HbA1C均显著高于ε2、ε3两组,ε2组TG明显高于ε3、ε4两组;ε3/4基因型和ε4等位基因与发生DF明显相关。结论 ApoE基因多态性与T2DM患者DF的发生相关,基因型ε3/4和等位基因ε4可能是T2DM患者并发DF的危险因子,其机制可能通过血脂代谢紊乱及促进脂质氧化而影响DF的发生。     

ApoE基因多态性与冠心病的相关性研究

目的 研究ApoE基因多态性与冠心病(CHD)的相关性.方法 随机选择潍坊地区汉族人88例CHD患者与75例健康对照者,抽取空腹静脉血测定CHD患者及健康对照者的TC、TG、HDL-C、LDL-C、ApoA1、ApoB-100等6项血脂代谢指标,应用改良的聚合酶链反应-限制性片段长度多态性分析及聚丙烯酰胺凝胶电泳法检测ApoE基因型.结果 ①共发现5种ApoE基因型,分别为E2/3,E3/3,E3/4,E2/4,E4/4,未发现E2/2,两组中均以E3/3分布最高.②CHD组ApoE2/4,E4/4基因型频率明显高于对照组,而ApoE3/3基因型频率低于对照组,而ε2,ε4等位基因频率CHD组高于对照组,ε3等位基因频率低于对照组.结论 ApoE基因多态性与血脂代谢及与CHD的发生密切相关.ε4等位基因是CHD发病的遗传易感因子,ε2等位基因是预防CHD发生的保护因子.ApoE基因多态性可能通过影响ApoE水平而实现CHD致病作用.     

江苏汉族人群心脑血管病患者载脂蛋白E基因研究

目的:探讨用基因测序法检测载脂蛋白E(ApoE)基因多态性及其与心脑血管疾病之间的关系。方法:应用基因测序方法检测了193例心脑血管疾病患者和100例无血缘关系的健康汉族人群ApoE基因型。结果:ε3/3基因型高血压组频率为64.3%,高血压 冠心病组为57.7%,高血压 脑血管病组为62.2%均明显低于对照组的86%(P<0.05);而ε3/4基因型频率,高血压组为21.4%,高血压 冠心病组为19.2%,高血压 脑血管病组为24.4%,均显著高于对照组的6%(P<0.05);ε4/4基因型高血压 冠心病组频率为5.1%明显高于对照组0%(P<0.05)。分析等位基因频率,高血压组和高血压 冠心病组、高血压 脑血管病组ε3等位基因频率分别为80.7%,74.4%和78.9%,明显低于对照组92.5%(P<0.05),ε4等位基因频率分别为12.1%,16.7%和14.5%,明显高于对照组的3.5%(P<0.05),差异有明显统计学意义。两组间其它各基因型无统计学差异。结论:应用基因测序方法进行ApoE基因分型是最全面、最直接、可靠的方法;ε4等位基因是心脑血管疾病共同的遗传易患因子,而ε3等位基因具有保护作用。     

血管紧张素原及载脂蛋白E基因多态性与冠心病关系的研究

目的：研究血管紧张素原(AGT)基因M235T多态性及载脂蛋白E(ApoE)基因多态性与中国人群冠心病的关联。方法:分别用PCR—RFLP技术检测了129例冠心病患者及90例健康人AGT及ApoE基因型。结果：(1)冠心病组ε3/4基因型及ε4等位基因频率显著高于健康对照组，ε3/3基因型及ε3等位基因频率则显著低于对照组;(2)AGT各基因型及等位基因频率在两组间无显著差异;(3)携带ε4等位基因的不同AGT基因型在两组间也无显著差异。结论:(1)ε4等位基因是冠心病的遗传易患因子；(2)AGT基因与冠心病发病无显著关联，与ApoE基因间也无协同作用。     

老年人冠心病与缺血性脑卒中载脂蛋白E基因多态性对比研究

目的探讨老年人冠心病与缺血性脑卒中载脂蛋白E(ApoE)基因分布及其与临床类型的关系。方法 >60岁的冠心病患者68例(急性心肌梗死38例、不稳定型心绞痛30例)和>60岁的缺血性脑卒中患者61例(脑梗死30例、短暂性脑缺血发作31例),健康人156例为对照组,采用PCR进行ApoE基因分型。结果 3组ApoE基因型分布及等位基因频率比较,差异有统计学意义(P<0.05);冠心病组及缺血性脑卒中组各基因型及等位基因频率比较,差异无统计学意义(P>0.05);正常对照组ApoEε3为优势基因,冠心病组及缺血性脑卒中组ApoEε4基因频率及等位基因频率均较对照组高(P<0.05);急性心肌梗死、不稳定型心绞痛、脑梗死、短暂性脑缺血发作4组ApoEε4基因阳性率比较,差异无统计学意义(P>0.05)。结论 ApoEε4(+)是老年人冠心病与缺血性脑卒中共同危险因素,其机理可能与ApoEε4阳性促进动脉粥样硬化有关。     

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.     

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.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.