白细胞介素10—1082基因多态性与胃癌遗传易感性的Meta分析

目的系统分析中国人群白细胞介素10—1052（IL-10—1082）基因多态性与胃癌遗传易感性的关系。方法采用Cochrane系统评价方法,检索1966年至2012年Medline、Embase、Cochrane Library、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CJFD）和中国科技期刊全文数据库（CSJD）等数据库,收集IL-10—1052基因多态性与中国人群胃癌易感性的病例对照研究。将纳入研究的胃癌患者作为胃癌组,健康人群作为健康对照组。由2名研究者独立提取数据和进行文献质量评价,综合评价IL-10—1082位点基因型GG与AA、AG与AA及等位基因G与A在中国人胃癌组与健康对照组中是否有差异。采用Q检验和,2对异质性进行定量分析。采用固定或随机效应模型合并数据。计数资料采用优势比（OR）及95％可信区间（95％CI）表示。结果共纳入13篇文献,累计样本量5252例,其中胃癌组患者2077例,健康对照组人群3175例。Meta分析结果显示：携带IL．10—1082基因型GG与AG患者,其胃癌发生风险率高于与携带IL-10—1082基因型AA患者（OR=1．76,95％CI1．33～2．33;OR=2．05,95％CI1．62～2．66,P〈0．05）;IL-10—1082基因型具有等位基因G的患者其胃癌发生风险率高于含等位基因A的患者（OR=1．67,95％CI1．31～2．13,P〈0．05）。结论中国人群IL-10—1082基因型GG、AG及等位基因G与胃癌发生有关。     

IL-1基因多态性与胃腺癌发生的关系

目的:探讨白介素-1B(IL-1B)和白细胞介素-1RN(IL-1RN)基因多态性与胃腺癌及幽门螺杆菌(Hp)感染胃腺癌发生发展的相关性。方法:采用基因芯片技术检测130例胃腺癌患者和142例健康对照人群中IL-1B-31C/T、-511C/T位点单核苷酸多态性(SNP);以琼脂糖凝胶电泳检测IL-1RN基因多态性(VNTR),同时应用酶联免疫吸附试验(ELISA)测定了其血清中HP-IgG/IgM/IgA型抗体浓度。结果:感染Hp阳性率胃腺癌明显高于对照组(P=0.007,OR=2.53)。IL-1B-31TT频率,胃腺癌组明显高于对照组(P<0.05,OR=2.16),在低分化胃腺癌组明显高于高分化胃腺癌组(P<0.05,OR=6.55)。IL-1B-511TT基因型频率在胃腺癌组明显高于对照组(P<0.05,OR=1.81);在Hp阳性胃腺癌组-511TT基因型及T等位基因频率明显高于Hp阴性胃腺癌(P<0.05,OR=2.25及P<0.05,OR=1.78)。胃腺癌组T-T单体型频率显著高于对照组(χ2=4.56,P<0.05)。未见IL-1RN基因及IL-1B其他位点的SNP与胃腺癌组或Hp阳性胃腺癌组有显著相关性。结论:IL-1B-31TT基因型与胃腺癌特别是低分化胃腺癌易感性相关,IL-1B-511TT基因型与胃腺癌或感染Hp的胃腺癌易感性相关。T-T单体型可能是胃腺癌的遗传易感因素。     

白介素-1β基因多态性与晚期膝骨关节炎易感性的关联性研究

目的探讨IL-1β基因的单核苷酸多态性和单体型与中国汉族人晚期膝骨关节炎（KOA）的易感性相关。方法采用病例对照研究,纳入120例中国汉族膝OA患者和130例年龄、性别匹配的健康对照者,用酶联免疫吸附测定法（ELISA）测定血清中IL-1β的水平,用聚合酶链反应和限制性片段长度多态性（PCR—RFLP）方法对IL-1β基因的-511C／T（rs16944）、＋3954C／T（rs114363）和-31C／T（rs1143627）位点进行单核苷酸多态性进行分析,并测序验证酶切结果。结果膝骨性关节炎患者组血清中白细胞介素1β水平明显高于健康对照组（t=-8．26,P〈0．01）,单核苷酸多态性分析显示：在膝OA患者组和健康对照组之间IL-1β-31C／T位点基因型分布和等位基因频率没有明显差异,该研究中没有发现IL-1β＋3954Tr基因型。膝OA患中的IL-1β-511TC、IL-1β＋3954CT基因型频率较健康对照组增加（P〈0．05,P〈0．05）,通过Logistic回归分析,IL-1β-511TC、IL-1β＋3954CT基因型与膝OA高风险发病率具有相关性（IL-1β-511TC,OR=1．842,95％CI=1．021—3．327,P〈0．05;IL-1β＋3954CT,OR=2．372,95％CI=1．022—5．509,P〈0．05）。此外,单体型分析显示与单体型TCC相比,单体型TCT和CCC与膝OA高风险发病率具有更强的相关性（TCT．OR=3．24,95％CI：1．50—7．00,P〈0．01;CCC．OR=6．07,95％CI：2．20—16．07,P〈0．01）。结论白细胞介素-1β基因的-511C／T（rs16944）和＋3954C／T（rs114363）位点多态性与中国汉族人膝OA的易感性相关。     

乳腺癌发病风险及侵袭特性与白细胞介素-8和CXCR2基因多态性的关系

目的 探讨细胞因子白细胞介素( 1L)-8(- 251)位点及其受体CXCR2(±1208)位点多态性与乳腺癌发病风险及侵袭特性的关系.方法 采用等位基因特异-聚合酶链反应(AS-PCR)分析方法检测228名乳腺癌患者和100例健康对照者的IL-8(- 251)位点及其受体CXCR2(±1208)位点多态性分布,并进行统计学分析.结果 IL-8(- 251)位点TA型和AA型以及CXCR2(± 1208) TT型是乳腺癌的高危基因型[比值比(OR)=1.57,95％可信区间(CI)=1.08～2.32;OR =2.68,95％ CI=1.26 ～2.99;0R=2.02,95％CI=1.08～3.62],在两组间表达频率的差异有统计学意义(P＜0.05).携带1个及以上高危基因型增加患乳腺癌的风险.分层分析表明携带IL-8(-251)等位基因A和CXCR2(± 1208)等位基因T增加乳腺癌的侵袭特性,其分布频率在肿瘤的高组织学分级(OR=1.95,P＜0.01;OR=1.52,P＜0.05)和淋巴结转移阳性(OR=1.65,P＜0.05;0R=1.66,P＜0.01)中差异有统计学意义.另外,IL-8(-251)A等位基因与ER( -)乳腺癌显著相关( OR=1.65,P＜0.05).结论 IL-8和CXCR2的基因多态性可能与女性乳腺癌的发生发展关系密切,可作为乳腺癌早期基因诊断的指标.     

细胞因子基因多态性与胃腺癌发生及其临床病理特点的关系

目的 探讨肿瘤坏死因子α（TNF-α）和白细胞介素6（IL-6）基因单核苷酸多态性（SNP）与胃腺癌合并或未合并幽门螺杆菌（Hp）感染的关系.方法 采用基因芯片技术检测130例胃腺癌患者（胃癌组）和142例健康对照人群（对照组）中TNF-α-238G/A,-308G/A和IL-6-597G/A,-174G/C,-572G/C位点多态性.同时应用酶联免疫吸附试验（ELISA）测定两组血清中Hp-IgG/IgM/IgA型抗体浓度.结果 胃癌组Hp的感染阳性率明显高于对照组（P＜0.01, 相对危险度[OR]=2.59）.TNF-α-238GA基因型和A等位基因频率,胃癌组明显高于对照组（P＜0.01,OR=2.44 ;P＜0.01,OR=2.13）;Hp阳性胃癌组明显高于Hp阴性胃癌（P＜0.05,OR=4.53 ;P＜0.01,OR=3.52）;低分化胃癌组显著高于高分化胃癌组（P＜0.05,OR=4.16）.胃癌组IL-6-572CC基因型频率明显低于对照组（P＜0.01,OR=0.17）.未见TNF-α和IL-6其他位点的SNP与胃癌组或Hp阳性胃癌组有任何相关性.结论 TNF-238GA基因型及其等位基因A与胃腺癌或感染Hp的胃腺癌易感性相关,而IL-6-572CC基因型则能降低胃腺癌易感性.     

白细胞介素1B和1RN基因多态性与骨关节炎易感性的关系

目的在中国青岛地区膝骨性关节炎患者中,探讨白细胞介素-1B(-31C/T、-511C/T、＋3954C/T)及其拮抗基因IL-1RN基因多态性与骨关节炎易感性的关系。 方法采用病例对照研究,对就诊青岛市胶州中心医院经临床诊断为膝关节骨关节炎的216例患者和233例年龄、性别匹配的健康对照者,排除既往有膝关节外伤史、类风湿性关节炎及合并其他内科疾病的患者,以聚合酶链反应和限制性片段长度多态性(PCR-RFLP)方法检测IL-1B的－31C/T、－511C/T、＋3954 C/T位点及IL-1RN的多态性,采用logistic回归分析方法比较不同基因型与骨关节炎发病风险的关系。 结果骨关节炎组中IL-1B-511CT、IL-1B＋3954CT基因型频率明显高于对照组,与对照组差异有统计学意义(IL-1B-511CT χ²＝2.034,P＝0.026;IL-1B＋3954CT χ²＝5.526,P＝0.017),IL-1B＋3954C/T位点未发现TT基因型,通过logistic回归分析,结果显示与野生型的纯合子相比,杂合子-511CT、＋3954CT基因型与骨性关节炎高风险发病率具有相关性[IL-1B-511CT,OR＝1.89,95%CI(0.56,1.39),P＝0.026;IL-1B＋3954CT,OR＝2.51,95%CI(1.18,5.35),P＝0.017]。骨关节炎组和对照组在IL-1B-31C/T位点及IL-1RN基因型分布未见明显差异。 结论IL-1B-511TC、＋3954CT基因型人群可能增加对膝骨关节炎的易感性,而IL-1B-31C/T, IL-1RN*2基因多态性可能与膝骨关节炎遗传易感性不具相关性。     

TERT基因多态性及HP感染与胃癌遗传易感性的研究

目的：探讨端粒酶逆转录酶（TERT）基因rs2075786单核苷酸多态性（SNP）、幽门螺杆菌（HP）与胃癌遗传易感性的关系。方法：采用聚合酶链反瘦一限制性片段长度多态性（PCR—RFLP）法分析297例胃癌患者、105例萎缩性胃炎患者及402例非萎缩性胃炎患者的基因多态性,采用病理学诊断和13C尿素酶呼气试验（13C—UBT）检测幽门螺杆菌（Hp）感染。结果：rs2075786位点CC、TC、TT基因型频率在对照组与萎缩性胃炎组分布差异无统计学意义,胃癌组TT基因型频率显著高于对照组（25．6％VS125％）,TT基因型携带者患胃癌风险增加2．23倍（95％CI：1．46～3．40）,对照组、萎缩性胃炎组、胃癌组HP感染率分别为40．3％、64．8％、56．9％,差异有统计学意义（P〈0．01）,OR值分别为2．73（95％CI：1．74～426）、196（95％CI：1．44～2．67）。经Logistic回归分析,发现Hp感染与基因突变无明显交互作用。结论：TERT基因rs2075786基因多态性与胃癌遗传易感性有关。     

HLA—DRB1基因与IgA肾病关联性的研究

目的：探讨HLA—DRB1等位基因与山西汉族IgA肾病的关联性。方法：用聚合酶链反应序列特异性探针（PCR—SSO）法，对30例IgA肾病患者和45例正常对照者进行了HLA—DRB1等位基因分型。结果：IgA肾病组的HLA—DRB1＊15基因频率明显较正常对照低（5.00％ vs 17.78％，P=0．021，OR=0．243，95％CI：0．068，0.876），IgA肾病组的HLA—DRB1＊04基因频率明显较正常对照高（30．00％ vs 15．56％，P=0．034，OR=2．327，95％CI：1.052，5．145）。结论：HLA—DRB1＊15可能与山西IgA肾病的抵抗性有关，HLA—DRB1＊04可能与山西IgA肾病的易感性有关。     

白细胞介素10-819C/T多态性和幽门螺杆菌感染在胃癌中交互作用研究

目的探讨恩施人群IL-10-819C/T多态性与胃癌关联性及其与幽门螺杆菌感染交互作用。方法采用多聚酶链反应-限制性片段长度多态性(PCR-RFLP)方法分析142例胃癌患者和136名正常对照IL-10-819C/T基因型。纯合突变型(TT)为170bp、25bp,杂合基因型(CT)为195 bp、170 bp,野生基因型(CC)为195 bp。分析各基因型与发病中易感性关系以及与幽门螺杆菌感染的交互作用。采用SPSS19.0进行分析。基因型和等位基因频率比较采用非条件Logistic回归分析,基因型Hardy-Weinberg平衡法χ~2检验。计量资料符合正态分布则采用(x珋±s)表示,用t检验;以P0.05为差异具有统计学意义。结果非条件Logistic分析表明认携带CC/CT基因型幽门螺杆菌感染个体胃癌罹患风险是携带TT基因非幽门螺杆菌感染个体的3.33倍(OR=3.33,95%CI:2.34,5.01,P=0.000)(RERI=1.66,95%CI:1.27,2.19;API=0.49,95%CI:0.36,0.79;S=1.27,95%CI:1.11,1.94)。结论 IL-10-819C/T多态性增加恩施地区胃癌罹患风险,且与幽门螺杆菌感染存在胃癌发病中存在协同效应。     

荆门地区CD14-159C/T多态性和幽门螺杆菌在胃癌中交联作用研究

目的探讨荆门地区人群CD14-159C/T多态性与胃癌关联性及其与幽门螺杆菌交互作用。 方法采用多聚酶链反应-限制性片段长度多态性（PCR-RFLP）方法,分析127例胃癌患者和127名健康者的CD14-159C/T基因型。非条件Logistic分析各基因型与发病中易感性关系以及与幽门螺杆菌的交互作用。 结果携带C（CC/CT）基因个体患病风险较非C基因携带者（TT）风险明显增加（OR=1.35,95% CI=1.22~2.56,P=0.000;校正OR=1.61,95% CI=1.21~3.01,P=0.000）。条件Logistic分析表明,携带CC/CT基因型幽门螺杆菌个体胃癌罹患风险是携带TT基因非幽门螺杆菌个体的3.39倍（OR=3.39,95% CI=2.66~5.36,P=0.000）（RERI=1.94,95% CI=1.41~2.77;API=0.59,95% CI=0.33~0.84;S=1.46,95% CI=1.37~2.66）。 结论CD14-159C/T多态性增加荆门地区个体胃癌的罹患风险,且与幽门螺杆菌在胃癌发病中存在协同效应。     

2015年乳腺癌辅助化疗进展

【摘要】〓乳腺癌是危害我国女性健康的头号杀手,尽管近年来辅助化疗的研究进展突飞猛进,但临床中仍有不少问题未能明确,如辅助化疗的合适人群、化疗的开始时间、蒽环及紫杉类的地位和用法、强化维持治疗的作用、疗效及预后的生物标志物等。本文结合乳腺癌辅助化疗在临床上的常见问题和2015年各大乳腺癌会议阐述乳腺癌辅助化疗的最新进展。     

Alterations in T-Cell Subset Frequency in Peripheral Blood in Obesity

Background: Obesity affects the regulation of immune and inflammatory responses. This study characterizes differences in peripheral blood lymphocyte phenotype in obese humans. Methods: Frequencies of lymphocyte subsets among peripheral blood mononuclear cells were compared between 10 obese (BMI ≥35) and 10 lean subjects, as determined by antibodies directed against cluster differentiation (CD) markers. Results: Obese patients demonstrated an increased frequency of CD3+CD4+ T-cells (mean difference 12%, P=0.004), a decreased frequency of CD3+CD8+ T-cells (mean difference 9.4%, P=0.016) and an increased frequency of CD3+CD8+CD95+ T-cells (mean difference 13.3%, P=0.032). No other differences among T-cell or monocyte subsets were noted. Conclusions: Obesity is associated with alterations in frequencies of peripheral CD4+ and CD8+ T-cells and aberrations in the expression of CD95 among CD8+ T-cells. These data suggest both CD4+ and CD8+ T-cell compartments, as well as the regulation of CD95 expression on CD8+ T-cells, as targets for further study into obesity's effects on the immune system.     

西宁地区烧伤病人动脉血气分析观察

对高海拔地区的27例烧伤病人动脉血气变化进行了分析和观察。结果证明:无论是存活病人还是死亡病人伤后均存在有低氧血症问题。并且在死亡病人和烧伤合并吸入性损伤病人其低氧血症的发生早于单纯烧伤病人。提示:吸入性损伤病人应立即行气管切开术以保障氧气供给,单纯烧伤病人可常规吸氧以维持正常血 PaO_2,ARDS 均发生在合并吸入性损伤的病人,高频喷射通气技术对纠正低氧血症有一定效果。     

Controversies in Fistula in Ano

Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies.     

β-半乳糖苷酶在体内外成骨细胞中的表达

目的 研究β—半乳糖苷酶(β—gal)在成骨细胞中的表达状况，为阐明MorquioB综合征的发病机制提供依据。方法 裸鼠各器官和骨组织标本行X-gal染色检测。抽取羊和人骨髓行骨髓基质细胞(BMSCs)培养，分为4组：I：Adv-hBMP-2转染组；Ⅱ：Adv—β—gal转染组；Ⅲ：未转染组；Ⅳ：地塞米松诱导组。分别行X-gal染色和RT-PCR检测β—gal的表达。结果 裸鼠骺板两侧、骨膜内面及松质骨的成骨细胞和破骨细胞可见多量β—gal的表达。未转染BMSCs组有少量β—gal的表达，其他3组细胞的β—gal表达增高。结论成骨细胞和破骨细胞可表达多量β—gal，该两种细胞的β—gal缺乏可能是MorquioB综合征骨骼异常的直接原因。     

Smoking-Attributable mortality in Spain in 2016

IntroductionSmoking-attributable mortality (SAM) is a valuable indicator that can be used to characterize the course and health burden of the smoking epidemic. The aim of this paper was to estimate SAM in Spain in 2016 in the population aged 35 and over, using the best available evidence.MethodsA smoking prevalence-dependent analysis based on the estimation of population-attributable fractions was performed. Smoking prevalence (never, former, and current smokers) was calculated from a combination of the Spanish Health Survey (2016) and the European Health Survey (2014); the relative risk of death among current and former smokers was taken from the follow-up of various cohorts; and mortality rates were obtained from National Center for Statistics data. SAM estimates are presented globally, and by sex, age groups, and major disease categories: cancer, cardiometabolic diseases and respiratory diseases.ResultsIn 2016, 56,124 deaths were attributed to tobacco consumption, 84% in men (47,000), and 50% in the population aged over 74 (27,795). Overall, 50% of SAM was due to cancer (28,281), 65% of which was lung cancer. One in 4 attributable deaths (13,849) occurred before the age of 65.ConclusionsOne in 7 deaths in Spain in 2016 were attributable to smoking. This estimation of SAM clearly highlights the great impact of smoking on mortality in Spain, mainly due to lung cancer and chronic obstructive pulmonary disease.     

MicroRNAs in hepatic pathophysiology in diabetes

MicroRNAs(miRNAs or miRs) are small approximately 22 nucleotide RNA species that are believed to regulate diverse metabolic and physiological processes.In the recent past,several reports have surfaced that demonstrate the role of miRNAs in various biological processes and numerous disease states.For a disease as complex as diabetes,the emergence of miRNAs as key regulators leading to the disease phenotype has added a novel dimension to the area of diabetes research.On the other hand,the liver,a metabolic hub,contributes in a major way towards maintaining normal glucose levels in the body as it can both stimulate and inhibit hepatic glucose output.This equilibrium is frequently disturbed in diabetes and hence,the liver assumes special significance considering the correlation between altered hepatic physiology and diabetes.While the understanding of the mechanisms behind this altered hepatic behavior is not yet completely understood,recent reports on the status and role of miRNAs in the diabetic liver have further added to the complexities of the knowledge of hepatic pathophysiology in diabetes.Here,we bring together the various miRNAs that play a role in the altered hepatic behavior during diabetes.     

Fluid-phase transcytosis in the primate epididymis in vitro and in vivo

Ligated tubules from the corpus epididymidis of men and monkeys were incubated in medium containing horseradish peroxidase (HRP) as a marker for fluid-phase endocytosis. HRP was localized by light and electron microscopy after 0, 15, 30 and 60 min of incubation. Movement between the cells was prevented by tight junctions, but bypass of this barrier was apparently achieved by an intracellular vesicular mechanism leading to a time-dependent appearance of HRP in the lumen. Uptake of HRP into basal cells and capture by the lysosomal apparatus of principal cells were also observed. HRP-filled vesicles also appeared in the basal, mid and apical cytoplasm of epithelial cells in the caput 1 h after injection of the tracer into the epididymal circulation of the monkey, suggesting that this pathway also operates in vivo.