脑白质疏松症临床相关因素和脂质代谢障碍的研究

目的:探讨脑白质疏松症发病的相关因素和脂质代谢异常及载脂蛋白E基因多态性与脑白质疏松症的关系。方法:将脑白质疏松症、脑梗死和脑萎缩的277例病人进行CT与临床出院诊断的回顾性对比分析;采用聚合酶链反应———限制片段长度多态性技术对50例脑白质疏松症患者和108例正常对照者的载脂蛋白E基因型进行分析并进行血脂水平测定。结果:脑白质疏松症、脑梗死和脑萎缩三者的伴随疾病谱相似,但脑白质疏松症高血压、动脉粥样硬化和心脏病的伴随率分别为58.3%～75%,66.7%和41.7%～60%,均明显高于脑梗死和脑萎缩组(P<0.05)。脑白质疏松症、脑梗死和脑萎缩三者之间的伴发率极高。脑白质疏松症患者ApoE2等位基因频率为0.15,明显高于对照组的0.074(P<0.05);在脑白质疏松症患者中检测出携带有Apoε2/2纯合子基因者4例,高于对照组。携带ApoE2等位基因患者的甘油三酯,低密度脂蛋白;载脂蛋白B的含量均高于ApoE3等位基因患者。结论:脑白质疏松症、脑梗死与脑萎缩三者存在着共同相似的病因。载脂蛋白E2等位基因,尤其是ε2/2纯合子基因可能是脑白质疏松症的一种遗传易感因子。脑白质疏松症可能是通过以甘油三酯含量增高为主的高脂血症的途径而发病的。     

载脂蛋白E基因多态性与脑白质疏松症的关系

目的探讨载脂蛋白E基因多态性与脑白质疏松症的关系.方法采用聚合酶链反应-限制片段长度多态性对50例脑白质疏松症患者和108例正常对照者载脂蛋白E基因型进行分析.结果脑白质疏松症患者ApoE2等位基因频率为0.15,明显高于对照组的0.074(P＜0.05);在脑白质疏松症患者中检测出携带有Apoε2/2纯合子基因者4例,携带有Apoε4/4纯合子基因者2例,高于对照组.结论载脂蛋白E2等位基因,尤其是ε2/2纯合子基因可能是脑白质疏松症的一种遗传易感因子.     

载脂蛋白E基因多态性与脑白质疏松症的关系

目的:探讨载脂蛋白E基因多态性与脑白质疏松症的关系。方法:采用聚合酶链反应———限制片段长度多态性对50例脑白质疏松症患者和108例正常对照者载脂蛋白E基因型进行分析。结果:脑白质疏松症患者ApoE2等位基因频率为0.15,明显高于对照组的0.074(P<0.05);在脑白质疏松症患者中检测出携带有Apoε2/2纯合子基因者4例,携带有Apoε4/4纯合子基因者2例,高于对照组。结论:载脂蛋白E2等位基因,尤其是ε2/2纯合子基因可能是脑白质疏松症的一种遗传易感因子。     

脑白质疏松症患者载脂蛋白E基因多态性与血脂水平的关系

目的:探讨脑白质疏松症患者载脂蛋白E基因多态性与血脂水平的关系。方法:采用聚合酶链反应———限制片段长度多态性对50例脑白质疏松症患者和108例正常对照者载脂蛋白E基因型进行分析并进行血脂水平测定。结果:脑白质疏松症患者ApoE2等位基因频率为0.15,明显高于对照组的0.074(P<0.05);含ApoE2等位基因患者的甘油三酯、低密度脂蛋白;载脂蛋白B的含量均高于ApoE3等位基因患者。结论:载脂蛋白E2等位基因可能是脑白质疏松症的一种遗传易感因子,ApoE基因多态性可能通过影响血脂水平而影响脑白质疏松症的发生。     

应用基因芯片技术探讨载脂蛋白E基因多态性与脑白质疏松的关系

目的探讨用基因芯片技术检测载脂蛋白E基因的可行性,研究载脂蛋白E基因多态性与脑白质疏松症的关系。方法分别对204例脑CT或MRI检查确诊的脑白质疏松症患者（LA组）和180例脑CT或MRI正常者（对照组）。应用基因芯片技术进行载脂蛋白E基因多态性检测。结果LA组ApoEE2、E3和ε4等位基因频率分别为0．078、0．745、0．186,对照组等位基因频率分别为0．088、0844、0．066,LA组ApoEE4基因频率显著高于对照组,差异有统计学意义（P〈0．05）,而ApoE￡3及ApoEE2基因频率两组与对照组比较差异无统计学意义。结论ApoEE4等位基因与脑白质疏松有关,ApoE4等位基因可能是脑白质遗传易患标志之一。     

载脂蛋白E基因多态性与2型糖尿病合并冠心病的关系

【目的】探讨载脂蛋白E(ApoE)基因多态性与2型糖尿病合并冠心病的关系。【方法】采用以医院为基础的配对病例对照研究方法,对100对研究对象进行了研究。应用聚合酶链式反应-限制性片断长度多态性(PCR-RFLP)技术进行ApoE基因多态性分析。【结果】ApoE基因多态性与2型糖尿病合并冠心病之间存在统计学关联,携带ApoEε4等位基因的2型糖尿病患者合并冠心病的危险性高于不携带ApoEε4等位基因的患者,OR及其95%可信区间为2.800(1.360~5.764),经糖尿病病程调整后此种关联仍然存在。未发现ApoEε2和ε3等位基因与2型糖尿病合并冠心病之间有统计学关联。【结论】携带ApoE基因ε4等位基因增加2型糖尿病合并冠心病的危险性。     

2型糖尿病肾病的载脂蛋白E基因多态性研究

目的研究载脂蛋白E(ApoE)基因多态性与2型糖尿病肾病的关系.方法采用聚合酶反应(PCR)和限制性片段、长度多态性分析(RFLP)技术,研究58例2型糖尿病肾病患者、56例2型糖尿病未合并肾病患者和76例正常对照者载脂蛋白(ApoE)的基因多态性.结果①2型糖尿病肾病患者ε2等位基因频率(14.6%)高于2型糖尿病非肾病患者(3.6%)(P<0.01,χ2=8.37)和正常对照者(5.7%)(P<0.05,χ2=4.28),3组中ε3和ε4等位基因频率差异无显著性(P>0.05).②携带ε2等位基因的2型糖尿病患者TG水平较携带ε3和ε4等位基因的2型DM患者增高(P<0.01 vs P<0.05),而LDL-C水平降低(P<0.05),携带ε4等位基因的2型DM患者,其TC和LDL-C水平较携带ε2和ε3等位基因的个体增高(P<0.01).③ApoE基因多态性在男女性别上差异无显著性(P>0.05).结论 ApoE基因多态性与2型糖尿病肾病的发生有关,提示ε2等位基因频率越高,发生2型糖尿病肾病的可能性越大.     

载脂蛋白E基因多态性与脑梗死的相关性

目的探讨载脂蛋白E（apoE）基因多态性与脑梗死的相关性。方法采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）技术,检测40例脑梗死患者以及50例健康人的apoE基因型,同时检测不同基因型患者总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、载脂蛋白A（apoA）、载脂蛋白B（apoB）水平。结果ε3/ε3为常见基因型。ε4等位基因频率脑梗死组（20%）明显高于正常对照组（6%）（P〈0.01）。apoEε4等位基因携带者总胆固醇、低密度脂蛋白、apoB水平比apoEε2、ε3携带者高（P〈0.05）。结论apoE基因多态性与脑梗死的发病有关,ε4基因可能为该病的危险因子,其发病机制可能是通过调控载脂蛋白E导致脂代谢紊乱。     

动脉粥样硬化性脑梗死患者载脂蛋白E基因多态性研究

目的 :探讨载脂蛋白E(ApoE)基因多态性与动脉粥样硬化性脑梗死的关系。方法 :以聚合酶链反应 -限制性片段长度多态性 (PCR -RFLP)技术结合银染色方法检测了 40例动脉粥样硬化性脑梗死 (ACI)患者和 90例无血缘关系的健康汉族人群载脂蛋白E基因型。结果 :ACI组ε4 等位基因频率明显高于对照组 (P <0 .0 1) ,ε3等位基因频率明显低于对照组 (P <0 .0 1)。结论 :ε4 等位基因是动脉粥样硬化性脑梗死的遗传易患因子之一 ,ε3等位基因是动脉粥样硬化性脑梗死的保护因子。     

载脂蛋白E基因多态性与脑梗死的相关性

目的 探讨载脂蛋白E(apoE)基因多态性与脑梗死的相关性.方法 采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术,检测40例脑梗死患者以及50例健康人的apoE基因型,同时检测不同基因型患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、载脂蛋白A(apoA)、载脂蛋白B(apoB)水平.结果 ε3/ε3为常见基因型.ε4等位基因频率脑梗死组 (20%)明显高于正常对照组 (6%)(P ＜0.01).apoEε4等位基因携带者总胆固醇、低密度脂蛋白、apoB水平比apoEε2、ε3携带者高 (P ＜0.05).结论 apoE基因多态性与脑梗死的发病有关,ε4基因可能为该病的危险因子,其发病机制可能是通过调控载脂蛋白E导致脂代谢紊乱.     

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.