应用FISH和PCR技术诊断性发育异常患者临床研究

目的：为了对性发育异常患者确定诊断,指导临床。方法：性发育异常患者在常规染色体分析基础上,对于染色体难以识别的复杂易位或微小异常及染色体核型与临床矛盾的患者采用先进的FISH和SRY－PCR技术来诊断,结果：明确了诊断,指导临床。结论：本研究新技术的建立对临床患者诊断,携带者以及产前胎儿诊断有应用价值。有助于阐明性发育异常机理和预防患儿出生。     

性发育异常患者的细胞分子遗传学分析

目的: 探讨性发育异常患者的细胞分子遗传学特征。方法: 应用多重连接依赖的探针扩增(MLPA)技术对3例染色体核型为46,XX的男性性反转综合征患者及1例女性假两性畸形患者父母进行SRY、CYP21A2、DSS、DAX1、WNT4、SOX9、NR5A1等性别相关基因的拷贝数筛查,并采用细菌人工染色体(BAC)克隆制备探针,以荧光原位杂交技术(FISH)进行基因定位。结果: 3例男性性反转综合征患者经MLPA基因筛查均发现存在单拷贝SRY基因,FISH技术鉴定存在2条X染色体,SRY基因易位于其中1条X染色体的短臂上;女性假两性畸形患者的母亲染色体核型为46,XX,MLPA基因筛查发现其CYP21A2-ex03杂合性缺失,CYP21A1P-ex02杂合性重复;父亲染色体核型为46,XY,MLPA基因筛查发现CYP21A2-ex01和CYP21A2-ex03杂合性缺失,CYP21A1P-ex02和CYP21A1-ex10杂合性重复。结论: 性别决定是以SRY基因为主导、其它多个基因参与的过程,对性发育异常患者进行MLPA基因筛查有利于明确病因。     

性发育异常的细胞遗传学及分子遗传学研究

目的：对530例性发育异常患者进行细胞、分子还传学检查分析以探讨性发育不良的原因及发病机制。方法：常规外周血淋巴细胞染色体制备及显带技术。聚合酶链式反应（PCR）检测SRY基因（sex-determiningregiononY）。结果139例患者染色体核型异常,其中119例为性染色体数目异常,20例为性染色体结构异常。另有17例患者为睾丸女性化综合征。1例46,XX男性性反转综合征,1例,46．XY女性性反转综合征及正常男性对照均检测出SRY基因,结论：性染色体异常是导致性发育异常的重要原因。SRY基因的分析为研究性分化原理及性反转综合征的发病机制提供了有价值的资料。     

性发育异常患者的分子遗传学研究

目的　对 9例性发育异常患者进行分子遗传学检查分析以探讨性别异常的原因。方法　聚合酶链反应法(PCR)检测Y染色体长臂重复序列 (Y3、Y4)和SRY基因。结果　Y染色体长臂重复序列的存在与染色体核型一致 ;而 9例患者中 ,2例 46 ,XX男性患者 ,1例 46 ,XY女性患者 ,2例 46 ,XY男性性征发育不良患者和 1例 45 ,X/ 46 ,XY嵌合体患者SRY基因呈阳性 ,其余 3例SRY基因呈阴性。结论　人类的性别决定是以SRY基因为主导 ,一系列基因参与协调表达的调控串模式 ,SRY基因与性别决定有关 ,Y染色体长臂重复序列的扩增对于确认Y染色体的存在与否有重要意义     

性分化发育异常患者FISH和SRY基因检测对发病机制的探讨

性分化发育异常是一个复杂的问题 ,目前对性分化发育异常的诊断技术 ,由以往根据临床表现、染色体、性腺、内分泌检查 ,发展至分子遗传学技术 ,为真正阐明性分化发育异常发病机制提供了有力手段。本文在细胞遗传学基础上 ,应用ＦＩＳＨ和ＳＲＹ基因 -ＰＣＲ技术 ,对 2 75例性分化发育异常患者发病机制进行初步探讨研究。资料与方法一、研究对象　本组病例来源于来我院门诊及住院患者共 2 75例。根据《人类遗传学》性别的标准有 1 染色体核型性别 2 性腺性别 3 表型性别 4 心理性别 5 社会性别等5个层次 ,正常男性或女性对以上层次完全符合…     

30例性发育异常患者的SRY基因研究

目的对30例性发育异常患者进行分子遗传学检查以探讨性别异常的原因。方法用实时荧光定量聚合酶链反应(fluorescence quantitative poiym erace chain reaction,FQ-PCR)的方法检测SRY基因。结果11例46,XY男性尿道下裂,SRY( );2例46,XY睾丸女性化综合症,SRY( );8例46,XX女性假两性畸形,SRY(-);3例46,XX两性畸形,SRY( );1例46,XY尿道下裂,SRY(-);1例46,XX阴蒂肥大,SRY( );1例46,XY阴蒂肥大,SRY( );2例45,X/46,XY男性,其中1例SRY( ),1例SRY(-);1例46,XX/46,XY男性,SRY( )。结论性分化异常患者进行SRY基因检测对诊断和治疗及探讨其发病机制具有十分重要意义。     

8例性发育异常患者SRY基因分析

目的对8例性发育异常患者进行细胞遗传学及分子遗传学检查以探讨性别发育异常与SRY基因关系.方法用PY3.4,X着丝粒,SRY特异探针进行荧光原位杂交,用于分析性发育异常病人Y染色体及SRY基因异位情况.聚合酶链反应(PCR)扩增SRY基因,直接测序检测SRY基因突变.结果 2例46,XX男性,1例46,XY女性,1例45,X/46,XY嵌合体及1例46,X,t(Y;Y)(p11;q11)男性患者SRY基因均为阳性,直接测序未发现SRY基因阳性患者该基因突变.剩余1例46,XX男性,1例46,XY男性及1例46,XY女性患者SRY基因为阴性.FISH技术证实2例46,XX且SRY基因阳性的男性患者SRY基因易位至X染色体短臂末端.结论 SRY基因是人类性别决定的主导基因,但尚有其他基因参与性别分化.     

性发育异常患者的SRY基因分析

应用PCR扩增及PCR产物直接测序对12例性发育异常患者进行SRY基因检测,12例患者中,5例患者的社会性别与染色体性别不相符。2例性反转患者SRY结果与洒色体性别不一致,其他10例SRY基因与染色体性别均一致,即存在Y染色体的患者,SRY为阳性,无Y染色体的患者,SRY为阴生。4例确诊为性反转;2例为假两性畸形,其中1例为肾上腺增生综合症,4例为要亡命民SRY基因未见异常但伴有性器官发育不良。上述,兴类的民中能是SRY基因为主导,一系列基因参与协调的调控串模式,而性别的分化则可能是由SRY决定性别后,在由其他因素参与共同完成的。SRY基因检测是诊断性另发育异常患者的重要手段。     

一例性发育异常患儿的临床及遗传学分析CSCD

目的报道一例性发育异常患儿的诊疗过程和临床特点,并对其进行病理学、影像学以及遗传学研究。方法收集患儿的临床资料,并对其进行染色体核型分析、荧光原位杂交(fluorescence in situ hybridization,FISH)、拷贝数变异分析、SRY基因检测和多重连接探针扩增检测。结果患儿社会性别为男性,因尿道下裂术后、乳房发育就诊。影像学检查显示双乳增生,变异精囊腺,幼稚子宫,右侧睾丸体积小。病理学检查表明患儿左侧性腺为卵睾,右侧为睾丸。病理结果显示乳腺纤维腺瘤样变。染色体核型为46,XX。FISH结果显示46,XX.ish(DXZ1×2,SRY×0)。基因检测提示NR0B1、PHEX、Cxorf21、GJB1、PQBP1、COL4A5基因重复,SRY基因存在,UYT基因缺失。结论对于生殖器异常、男性乳腺发育的患者应及早进行影像学、内分泌和遗传学检查,必要时进行基因检测以明确诊断。性发育异常患儿的个体化治疗需要多学科合作。     

八例性发育异常患者的SRY基因检测

采用多聚酶链式反应（ＰＣＲ）结合核酸杂交的方法对８例性发育异常患儿进行了ＳＲＹ基因检测，３例，４６，ＸＸ男性患儿有２例显示基因组ＤＮＡ中含有ＳＲＹ基因，证实ＳＲＹ基因易位是导致患儿性发育异常的原因。４例，４６，ＸＹ女性患儿ＳＲＹ基因为阳性。探讨了ＳＲＹ基因检测对临床诊断的意义和应用的可能性。     

Comparative Genomic Hybridization: A Comparison with Molecular and Cytogenetic Analysis

Comparative genomic hybridization (CGH) is a powerful technique for detecting copy number changes throughout the genome. We describe the development of a versatile image analysis program for CGH studies. Several methods for the production of metaphases which give optimum hybridization signals have also been assessed. CGH analysis was performed on DNA samples from several different and clinically relevant specimens: amniotic fluid cells trisomic for a single chromosome, lymphoblastoid cell lines with abnormalities involving single chromosome bands, malignant cell lines and biopsy material from primary ovarian carcinomas. The results were compared with those derived from G-banding, chromosome painting, and molecular genetic techniques. Our data demonstrate that CGH was able to detect a wide range of quantitative genetic alterations including duplication or deletion of single chromosome bands. CGH analysis also indicated the presence of genetic abnormalities that were not detected by other cytogenetic or molecular approaches. Moreover, our CGH methodology allowed the ready comparison of CGH results from different tumors, a process which greatly facilitated identification of shared genetic changes.     

Molecular Analysis of Mycobacterium avium Isolates by Using Pulsed-Field Gel Electrophoresis and PCR

Genetic relationships among 46 isolates of Mycobacterium avium recovered from 37 patients in a 2,500-bed hospital from 1993 to 1998 were assessed by pulsed-field gel electrophoresis (PFGE) and PCR amplification of genomic sequences located between the repetitive elements IS1245 and IS1311. Each technique enabled the identification of 27 to 32 different patterns among the 46 isolates, confirming that the genetic heterogeneity of M. avium strains is high in a given community. Furthermore, this retrospective analysis of sporadic isolates allowed us (i) to suggest the existence of two remanent strains in our region, (ii) to raise the question of the possibility of nosocomial acquisition of M. avium strains, and (iii) to document laboratory contamination. The methods applied in the present study were found to be useful for the typing of M. avium isolates. In general, both methods yielded similar results for both related and unrelated isolates. However, the isolates in five of the six PCR clusters were distributed among two to three PFGE patterns, suggesting that this PCR-based method may have limitations for the analysis of strains with low insertion sequence copy numbers or for resolution of extended epidemiologic relationships.     

A Molecular Cytogenetic Analysis of the Tribe Bovini (Artiodactyla: Bovidae: Bovinae) with an Emphasis on Sex Shromosome Morphology and NOR Distribution

Q-band comparisons were made among representative species of the four genera of the tribe Bovini (Bos, Bison, Bubalus, Syncerus) as well as to selected outgroup taxa representing the remaining two tribes of the subfamily Bovinae (nilgai, Boselaphini; eland, Tragelphini), the Bovidae subfamily Caprinae (domestic sheep) and the family Cervidae (sika deer and white- tailed deer). Extensive autosomal arm homologies were noted, but relatively few derivative character states were shared. Focus was then made on variation of the sex chromosomes and the chromosomal distribution of nucleolar organizer regions (NORs). Bovine BAC clones were used in molecular cytogenetic analyses to decipher rearrangements of the sex chromosomes, and a pocket gopher 28s ribosomal probe was used to map the chromosomal locations of nucleolar organizing regions (NORs). Some of the more noteworthy conclusions drawn from the comparative analysis were that: 1. The Bovidae ancestral X chromosome was probably acrocentric and similar to acrocentric X chromosomes of the Bovinae; 2. The domestic sheep acrocentric X is probably a deriative character state that unites non-Bovinae subfamilies; 3. Bos and Bison are united within the tribe Bovini by the presence of shared derivative submetacentric X chromosomes; 4. Sika and white- tailed deer X chromosomes differ by inversion from X chromosomes of the Bovinae; 5. The Bovini ancestral Y chromosome was probably a small acrocentric; 6. Bos taurus, B. gaurus and B. banteng share derivative metacentric Y chromosomes; 7. Syncerus and Bubalus are united by the acquisition of X-specific repetitive DNA sequence on their Y chromosomes; 8. Bovinae and Cervidae X chromosome centromere position varies without concomitant change in locus order. Preliminary data indicate that a knowledge of the chromosomal distribution of NORs among the Bovidae will prove to be phylogenetically informative.     

支气管肺泡灌洗液与咽拭子荧光定量PCR法检测成人肺炎支原体感染的对比研究

目的 用实时荧光定量PCR方法对肺部感染危重患者的咽拭子样本和支气管肺泡灌洗液（BALF）进行检测,探讨不同样本对检测结果的影响.方法 450例肺部感染危重患者纳入临床研究,用实时荧光定量PCR方法检测患者咽拭子样本和BALF样本,对检测结果进行比较.结果 在450例肺部感染危重患者中,肺炎支原体肺炎（MPP）患者1 15例,占25.6％.BALF样本检测的阳性率为69.56％,咽拭子样本检测的阳性率为13.04％.肺炎支原体（MP）感染的年龄段主要在20～39和50 ～59岁,以50-59岁年龄段人数最多.结论 MP是肺部感染主要病原体之一,采集BALF标本用实时荧光PCR检测MPP阳性率更高,是MPP诊断的有效手段.     

乳腺癌患者Heath-Carter法体型研究

目的：探讨乳腺癌患者的体型特征。方法：应用Heath—Carter体型测量法对106例女性乳腺癌患者（未绝经57例,已绝经49例）及同期到该医院体检的106名健康妇女进行体型评定并比较。结果：未绝经的乳腺癌组平均体型5．3-3．6—2．0、对照组平均体型5．3-3．6-2．0,两组比较差异无统计学意义（P〉0．05）;已绝经的乳腺癌组平均体型5．9-4．2-1．5、对照组平均体型5．14．0-1．6,两组比较差异有统计学意义（P〈0．01）。结论：乳腺癌组的平均体型是偏中胚层的内胚层体型;绝经以后体脂的增加可能与乳腺癌的发生有一定的相关性,而绝经前没有这种相关性。     

Development of a New Molecular Subtyping Tool for Salmonella enterica Serovar Enteritidis Based on Single Nucleotide Polymorphism Genotyping Using PCR

The lack of a sufficiently discriminatory molecular subtyping tool for Salmonella enterica serovar Enteritidis has hindered source attribution efforts and impeded regulatory actions required to disrupt its food-borne transmission. The underlying biological reason for the ineffectiveness of current molecular subtyping tools such as pulsed-field gel electrophoresis (PFGE) and phage typing appears to be related to the high degree of clonality of S. Enteritidis. By interrogating the organism''s genome, we previously identified single nucleotide polymorphisms (SNP) distributed throughout the chromosome and have designed a highly discriminatory PCR-based SNP typing test based on 60 polymorphic loci. The application of the SNP-PCR method to DNA samples from S. Enteritidis strains (n = 55) obtained from a variety of sources has led to the differentiation and clustering of the S. Enteritidis isolates into 12 clades made up of 2 to 9 isolates per clade. Significantly, the SNP-PCR assay was able to further differentiate predominant PFGE types (e.g., XAI.0003) and phage types (e.g., phage type 8) into smaller subsets. The SNP-PCR subtyping test proved to be an accurate, precise, and quantitative tool for evaluating the relationships among the S. Enteritidis isolates tested in this study and should prove useful for clustering related S. Enteritidis isolates involved in outbreaks.     

Golli-MBP Copy Number Analysis by FISH, QMPSF and MAPH in 195 Patients with Hypomyelinating Leukodystrophies

The inherited disorders of CNS myelin formation represent a heterogeneous group of leukodystrophies. The proteolipoprotein (PLP1) gene has been implicated in two X‐linked forms, Pelizaeus‐Merzbacher disease (PMD) and spastic paraplegia type 2, and the gap junction protein α12 (GJA12) gene in a recessive form of PMD. The myelin basic protein (MBP) gene, which encodes the second most abundant CNS myelin protein after PLP1, presents rearrangements in hypomyelinating murine mutants and is always included in the minimal region deleted in 18q‐ patients with an abnormal hypomyelination pattern on cerebral MRI. In this study, we looked at the genomic copy number at the Golli‐MBP locus in 195 patients with cerebral MRI suggesting a myelin defect, who do not have PLP1 mutation. Although preliminary results obtained by FISH suggested the duplication of Golli‐MBP in 3 out of 10 patients, no abnormal gene quantification was found using Quantitative Multiplex PCR of Short Fluorescent fragments (QMPSF), Multiplex Amplifiable Probe Hybridization (MAPH), or another FISH protocol using directly‐labelled probes. Pitfalls and interest in these different techniques to detect duplication events are emphasised. Finally, the study of this large cohort of patients suggests that Golli‐MBP deletion or duplication is rarely involved in inherited defects of myelin formation.     

性腺激素在绝经和继发性闭经中水平的对比研究

目的:探讨性腺激素在绝经与继发性闭经中的不同变化特点,评价卵巢功能,为二者的鉴别诊断和临床治疗提供依据.方法:采用放射免疫分析对40例正常月经者(1组)、40例绝经者(2组)及40例继发性闭经者(3组)的血清性腺激素进行测定,并相互对比各组检测结果.结果:2组FSH和LH值高于1组和3组,其中3组高于1组,E2反之;1组和2组PRL值水平接近,但二者明显低于3组;2组P值低于1组和3组,1组和3组水平接近;1组和3组t值相近,二者均高于2组.结论:绝经期卵巢萎缩伴卵巢功能衰竭,继发性闭经多为HPOU(下丘脑-垂体-卵巢-子宫)轴、肾上腺轴和甲状腺轴功能失调所致,卵巢功能尚存.     

Molecular Genetic Analysis of SLC3A1 and SLC7A9 Genes in Czech and Slovak Cystinuric Patients

Cystinuria is a frequently inherited metabolic disorder in the Czech population (frequency 1/5,600) caused by a defect in the renal transport of cystine and dibasic amino acids (arginine, lysine and ornithine). The disease is characterized by increased urinary excretion of the amino acids and often leads to recurrent nephrolithiasis. Cystinuria is classified into two subtypes (type I and type non‐I). Type I is caused predominantly by mutations in the SLC3A1 gene (2p16.3), encoding heavy subunit (rBAT) of the heterodimeric transporter. Cystinuria non‐I type is caused by mutations in the SLC7A9 gene (19q13.1). In this study, we present results of molecular genetic analysis of the SLC3A1 and the SLC7A9 genes in 24 unrelated cystinuria families. Individual exons of the SLC3A1 and SLC7A9 genes were analyzed by direct sequencing. We found ten different mutations in the SLC3A1 gene including six novel ones: three missense mutations (G140R), D179Y and R365P), one splice site mutation (1137‐2A>G), one deletion (1515_1516delAA), and one nonsense mutation (Q119X). The most frequent mutation, M467T; was detected in 36% of all type I classified alleles. In the SLC7A9 gene we found six mutations including three new ones: one missense mutation (G319R), one insertion (611_612insA) and one deletion (205_206delTG). One patient was compound heterozygote for one SLC3A1 and one SLC7A9 mutation. Our results confirm that cystinuria is a heterogeneous disorder at the molecular level, and contribute to the understanding of the distribution and frequency of mutations causing cystinuria in the Caucasian population.     

运用KJ法对护士护患沟通影响因素的研究

目的 探讨影响护患沟通相关因素,寻求提升沟通的有效方法。方法 选择不同专科疾病的患者及不同层级的执业护士各10名,进行深度访谈,收集资料,应用KJ法进行分析、归类。结果 在影响护患沟通的诸多因素中,护士的人文关怀理念、专业水平、沟通能力及患者的文化背景、病情和情绪状况是影响沟通的主要因素。结论 提升护士的人文意识及沟通交流能力,选择适宜的沟通时机及方式,实施个性化沟通,是提升护患沟通效果、维护和谐医患关系的有效举措。