家族性糖尿病人群中线粒体ND-1基因点突变的分析研究

目的了解线粒体ND-1基因mt3316G→A、mt3394T→C变异在中国家族性糖尿病人群中的发生率及其临床特点。方法应用PCR-RFLP结合直接测序方法对随机抽取的无亲缘关系的770个糖尿病家系的先证者及309例非糖尿病对照者进行线粒体基因mt3316G→A、mt3394T→C变异的筛查。结果在糖尿病先证者组中发现17例（2.21%）mt3316G→A变异,18例（2.34%）mt3394T→C变异;在正常对照组中分别发现5例（1.62%）和6例（1.94%）变异携带者,变异的发生率在两组间差异无统计学意义。在糖尿病先证者组见到2例同时携带上述两种变异者。伴mt3316G→A或mt3394T→C突变的糖尿病组与无该变异的糖尿病组之间的临床特点（年龄、体质指数、胰岛素抵抗指数）比较差异无统计学意义。结论线粒体ND-1基因mt3316G→A,mt3394T→C变异可能不是中国人线粒体糖尿病发病的致病原因,而是中国人线粒体的基因多态。     

糖尿病与线粒体ND1点突变的关系

目的探讨湖北省线粒体基因的热点突变区域ND1点突变(3243,3316,3394,3593)与老年2型糖尿病的关系。方法采用聚合酶链反应-限制性片段长度多态性法对无血缘关系的134例老年糖尿病患者及152例正常对照个体的血细胞线粒体DNA进行突变分析。结果病例组中3316G→A点突变率为3·7%,3394T→C点突变发生率为3·0%,而对照组3316和3394的突变率分别为0·66%和0,3394组间差异比较均有显著性(P<0·05)。病例组中3593点突变发生率为0·75%,对照组未见该突变,两组间差异无显著性。未发现3243的突变。结论线粒体DNA3394T→C突变与老年线粒体糖尿病的发生与发展有关,并起着重要作用。     

线粒体DNA变异与老年2型糖尿病患者易感性的相关性

目的 研究湖北地区老年2型糖尿病(T2DM)患者中线粒体基因突变的发生率及其相关性.方法 采用PCR-RFLP、基因测序技术,对175例老年T2DM患者和200例糖耐量正常的健康老年对照组进行检测.结果 MIND1 3316(G→A)、MTTL1 3243(A→G)、MIND13394( T→C)、MIND14216(T→C) MIND14164(A→G)和MIND2 5178( T→C)变异率分别为3.26％、2.72％、1.71％、4％、34.9％;对照组检出3316(G→A)突变2例(0.99％)、4164 5例(0.99％)、5718(T→C)变异64例(32.3％),未检出3394、4216的点突变;两组间3394(T→C)变异率差别有统计学意义(P＜0.05);且T2DM组5178A基因型血清TC水平低于5178C基因型(P＜0.05),但TG、LDL-C、HDL-C、apoA、apoB、Lp(a)水平两组无统计学意义.结论 3394( T→C)与老年T2DM患者的易感性有一定关联,5178(T→C)变异与湖北地区老年汉族人T2DM的脂代谢相关.     

2型糖尿病相关线粒体ND1基因的荟萃分析

目的利用荟萃分析评价线粒体NDI基因点突变与2型糖尿病发病的相关性。方法通过文献检索收集1999年1月至2008年9月在中英文公共数据库检索或已经发表的线粒体NDl基因点突变与2型糖尿病相关的病例对照研究。按照本研究纳入和排除标准,筛选线粒体NDl基因G3316A、T3394C 2个点突变作为研究对象。应用STATA 9.0 SE软件对各研究进行综合分析。结果在病例对照研究中,线粒体G3316A、T3394C相对危险度合并OR值和95%CI分别为:2.70(1.39～5.24)、3.44(1.41～8.40)。结论线粒体G3316A、T3394C点突变可能与中国人2型糖尿病遗传易感性相关。     

老年2型糖尿病患者线粒体ND1基因常见突变位点的快速筛查

2型糖尿病是慢性代谢疾病，呈高龄人群高发病率的特点，尤其是持续高血糖所引发的心血管疾病、终末期肾病等并发症严重困扰着老年2型糖尿病患者。线粒体基因缺陷是其遗传易感因素之一，在诸多报道的突变位点中，以位于tRNA leu（UUR）基因3243（A—G）突变及ND1基因的3316（G→A）、3394（T→C）和3593（T→C）突变最为常见。我们以老年2型糖尿病为研究对象，     

2型糖尿病人群线粒体基因突变的研究

目前已知的几种单基因突变糖尿病(DM)中，线粒体tRNA^Leu(UUR)基因3243A→G点突变最为多见，已在不同种族中被发现。本研究对线粒体基因突变热点区域一tR—NA^Leu(UUR)基因及其邻近区域内的4个位点(np3243、np3316、np3394、np3426)进行筛查，旨在探讨线粒体基因突变在我国2型糖尿病(T2DM)患者中的存在情况。     

母系遗传糖尿病线粒体基因突变的观察

采用PCR-RFLP、DNA直接测序技术对14个有明确母系遗传史的糖尿病家系进行线粒体基因筛查。结果14例先证者及对照组均未检出A3243G等3个线粒体基因突变位点。家系成员发现携带G3316A突变，T3394C突变，三例均为健康携带者。结论G3316A突变、T3394C突变不是糖尿病的独立致病因素。     

中国人2型糖尿病人群中线粒体基因突变的发生率及其临床特点的研究

目的了解线粒体tRNALeu(UUR)nt3243A→G突变在中国人2型糖尿病人群中的精确发病率及该基因突变所导致的2型糖尿病的临床特征。方法采用PCR-RFLP技术对716例随机抽取的无亲缘关系的2型糖尿病患者进行了该突变的筛查。结果在2型糖尿病组中发现3例该基因突变携带者,代表了被筛选人群的0.4％。此外,本研究还对近年来报道的与日本人2型糖尿病相关的ND1基因nt3316G→A突变进行了筛查,在2型糖尿病组中发现16例(2.2％)突变携带者,在181例正常对照组中发现5例突变携带者(2.7％),突变的发生率在两组间无显著性差异。携带mt3316位点G→A突变的2型糖尿病组与无该突变的2型糖尿病组之间的临床特点(发病年龄,体重指数,胰岛素分泌功能)比较亦无显著性差异。结论mt3316位点G→A突变可能仅为人群中的基因多态性。     

线粒体DNA3161-3610片断基因突变与糖尿病的关系

104例糖尿病（DM）患者和50名正常无DM家族史对照者的基因测序研究显示，线粒体DNA3316G→A伴随3290 T→C、3421G→A点突变；3497C→T和3571C→T同时基因突变可能与DM发生有关。     

2型糖尿病中线粒体DNA的3316G→A和3394T→C点突变

目的　了解天津地区线粒体DNA点突变 (3 2 43A→G、3 3 16G→A、3 3 94T→C和 3 42 6A→G)与 2型糖尿病的关系。方法　对无血缘关系的 478例 2型糖尿病患者进行研究 ,同时选择 43 0例无糖尿病家族史的糖耐量正常者作为对照 ,用PCR RFLP筛选点突变。结果　 2型糖尿病组 3 3 16点突变发生率为2 .72 % (13 / 478) ,3 3 94点突变发生率为 2 .5 1% (12 / 478) ;两种点突变在对照组发生率分别为 0和 0 .47%(2 / 43 0 ) ,两组比较差异均有显著性 (P <0 .0 1或P <0 .0 5 )。 2型糖尿病组 3 42 6点突变发生率为 0 .42 %(2 / 478) ;对照组未见该突变 ,两组间差异无显著性。两组中皆未发现 3 2 43A→G突变。结论　线粒体DNA 3 3 16G→A和 3 3 94T→C突变与天津地区人群糖尿病的发病有关。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.