不良孕产史与MTHFR基因677和1 298位点多态性的相关性

目的:探讨亚甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase,MTHFR)基因C677T和A1 298C的基因多态性与不良孕产史之间的相关性?方法:选取53例曾有不良孕产史的女性和57例正常对照,应用DNA测序的方法检测MTHFR基因677位点和1 298位点的多态性,并对其多态性分布进行统计学分析,进而分析MTHFR基因与不良孕产史的发生之间的相关性?结果:在对照组中MTHFR基因677位点突变基因型T/T有3例(占5.3%),677位点基因型C/T同时存在1 298位点基因型A/C有9例(占15.8%);在病例组中MTHFR基因677位点突变基因型T/T有9例(占17%),677位点基因型C/T同时存在1 298位点基因型A/C有18例(占34%);经统计学分析在病例组和对照组中以上两种基因型之间均存在显著性差异(P < O.O5)?结论:MTHFR基因677位点基因型T/T(即677TT)以及677位点基因型C/T同时存在1 298位点基因型为A/C(即677CT+1298AC)增加了不良孕产史的发生风险?     

亚甲基四氢叶酸还原酶基因多态性与先兆流产相关性研究

目的:探讨先兆流产与亚甲基四氢叶酸还原酶(MTHFR)基因多态性的关联性。方法:采用病例对照研究的方法,以91例先兆流产者和116例正常妇女为研究对象,利用荧光定量PCR技术,检测受检者MTHFR基因C677T、A1298C位点的单核苷酸多态性(SNP)。结果:病例组MTHFR 677TT基因型的频率为15.4%,显著高于对照组(P<0.05);病例组MTHFR 1298CC基因型的频率为5.5%,显著高于对照组(P<0.05),且MTHFR A1298C位点的分布情况在两组间差异有统计学意义(P<0.05)。结论:MTHFR C677T和A1298C基因多态性变化与先兆流产的发生具有一定的相关性。     

南宁市壮族和汉族女性MTHFR和MTRR基因单核苷酸多态性比较

目的分析南宁市壮族和汉族女性5,10-亚甲基四氢叶酸还原酶(MTHFR)C677T、A1298C及甲硫氨酸合成酶还原酶(MTRR)A66G单核苷酸多态性的分布特征。方法以南宁市948例孕检女性为研究对象,其中壮族455例,汉族493例,采集口腔黏膜上皮细胞,提取5,10-DNA,通过荧光定量PCR方法进行MTHFR和MTRR基因多态性检测。统计分析本地区壮族和汉族女性基因多态性的分布特征。结果壮族女性MTHFR C677T位点TT基因型比例为5.1%,低于汉族女性(7.7%);MTHFR A1298C位点CC基因型比例为9.2%,高于汉族女性(5.5%);MTRR A66G位点GG基因型比例为9.7%,高于汉族女性(5.5%)。MTHFR C677T和MTHFR A1298C两位点多态性在壮族和汉族女性间的分布差异无统计学意义(P>0.05),而MTRR A66G位点多态性在两民族女性间的分布差异有统计学意义(P<0.05)。结论南宁市壮族和汉族女性MTRR基因多态性分布情况不同,具有民族特异性。     

亚甲基四氢叶酸还原酶基因多态性与2型糖尿病的相关性

目的：探讨亚甲基四氢叶酸还原酶（MTHFR）基因C677T和A1298C多态性与2型糖尿病（T2DM）的关系。方法：选取106例T2DM患者（病例组）和109名健康对照个体（对照组）,采用聚合酶链反应一限制性片段多态性分别检测C677T和A1298C多态位点等位基因频率和基因型并统计分析。结果：2组MTHFR基因C677T和A1298C位点基因型和等位基因频率比较差异均无统计学意义（P〉0．05）,T2DM发病中2个突变位点之间没有协同作用（P〉0．05）。结论：MTHFR基因C677T和A1298C多态位点与T2DM的易感性无明显的相关性。     

原因不明复发性流产遗传性血凝因素研究

目的研究凝血因子V基因G1691A、凝血酶原基因G20210A以及5,10-亚甲基四氢叶酸还原酶(MTHFR)基因C677T和A1298C位点突变,与原因不明复发性流产易感相关性。方法采用聚合酶链式反应-限制性片断长度多态性分析方法,检测148例原因不明复发性流产者和82例正常对照的凝血因子V基因G1691A、凝血酶原G20210A以及MTHFR基因C677T和A1298C位点突变情况。结果复发性流产组和对照组,均未发现凝血因子V基因G1691A和凝血酶原基因G20210A突变;MTHFR基因C667T三种基因型在两组的总体分布存在显著性差异(P=0.012),其中复发性流产组CC基因型表达频率显著降低(P=0.005),T等位基因表达频率显著增大(P=0.004);MTHFR基因A1298C三种基因型在复发性流产和对照组总体分布无显著差异,AA/AC/CC基因型和A/C等位基因频率表达无统计学差异;MTHFR基因C677T/A1298C连锁分析发现8种连锁基因型,复发性流产组中677CC/1298AA表达频率显著降低(P<0.05),而677(CT TT)/1298CC仅在复发性流产组中表达(P<0.05)。结论中国人群复发性流产与凝血因子V基因G1691A和凝血酶原G20210A基因突变无关,而与MTHFR基因C677T和A1298C位点突变有关。     

博爱县汉族育龄女性MTHFR与MTRR基因多态性分布

目的调查博爱县汉族育龄女性叶酸代谢关键酶MTHFR C677T、A1298C与MTRR A66G基因多态性,获取本地区汉族育龄女性叶酸利用能力,为叶酸营养增补方案提供分子医学理论依据,更好地指导孕期保健。方法选取2018年3月至2019年9月在博爱县妇幼保健院进行备孕和孕期检查的448例女性作为研究对象。采集口腔黏膜上皮脱落细胞,抽提基因组DNA,使用荧光定量PCR方法检测MTHFR C677T、A1298C和MTRR A66G基因多态性。结果入组对象的基因多态性分布符合遗传平衡。汉族女性MTHFR 677CC、CT、TT的基因型频率分别为12.7%、42.2%、45.1%,C、T等位基因频率分别为33.8%、66.2%;MTHFR 1298AA、AC、CC的基因型频率分别为77.7%、19.9%、2.5%,A、C等位基因频率分别为87.6%、12.4%;MTRR 66AA、AG、GG的基因型频率分别为57.1%、38.6%、4.2%,A、G等位基因频率分别为76.5%、23.5%。汉族女性MTHFR C677T和A1298C两位点连锁有6种组合,频率最高的是TT/AA(45.1%),而后依次为CT/AA(27.7%)、CT/AC(14.5%)、CC/AC(5.4%)、CC/AA(4.9%)、CC/CC(2.5%),无CT/CC、TT/AC和TT/CC组合。MTHFR C677T和A1298C两个位点构建的单倍型存在3种组合:TA(66.2%)、CA(21.4%)、CC(12.4%),两位点间存在完全连锁不平衡(D’=1.0,r~2=0.277)。结论博爱县汉族女性叶酸代谢相关基因位点风险型MTHFR 677TT占比高,叶酸利用能力不足,需进行个体化干预及重点人群孕期管理,从而达到一级预防出生缺陷的目的。     

贵州3个民族亚甲基四氢叶酸还原酶基因的遗传多态性

目的对贵州侗族、布依族、苗族亚甲基四氢叶酸还原酶(MTHFR)基因多态性进行研究。方法应用TaqManMGB探针基因分型方法检测贵州3个民族MTHFR基因两个SNP(677及1 298位)多态位点的基因频率及基因型频率,并构建单倍型。结果 MTHFR 677C/T位点3个民族之间基因型和等位基因频率差异有统计学意义(P<0.05),其中布依族与苗族间基因型和布依族与侗族、苗族间等位基因频率差异有统计学意义(P<0.01)。MTHFR 1298A/C位点3个民族之间基因型和等位基因频率差异无统计学意义(P>0.05)。677CC/1298AA双野生型频率以布依族最低,3个民族中均未见677TT/1298CC双纯和突变及677TT/1298AC组合。3个民族中以677C-1298A(54.3%)单倍型所占平率最高。布依族和苗族两位点间存在677C/T和1298A/C连锁不平衡现象。结论 MTHFR基因677C/T和1298A/C位点在不同民族、不同地区间的分布存在明显差异。     

镇江市汉族女性MTHFR和MTRR基因多态性分布研究

目的:探讨镇江市汉族女性亚甲基四氢叶酸还原酶(MTHFR)C677T?A1298C及甲硫氨酸合成酶还原酶(MTRR)A66G基因多态性的分布特征?方法:采用横断面调查研究方法,以镇江市2 885例汉族女性为对象,采集口腔黏膜上皮细胞,提取基因组DNA,采用Taqman-MGB技术,进行MTHFR和MTRR基因多态性检测?统计分析基因多态性的分布特征,并与已报道的其他地区的数据进行比较?结果:镇江市汉族女性的MTHFR 677TT纯合突变基因型频率为21.8%,高于海南和德阳地区,低于潍坊和郑州地区(P < 0.01)?MTHFR 1298CC纯合突变基因型频率为3.5%,低于德阳和海南地区(P < 0.01);与潍坊和郑州地区的差异无统计学意义(P > 0.05)?MTRR 66GG纯合突变基因型频率为6.0%,低于海南地区(P < 0.01);与潍坊?郑州?德阳地区的差异均无统计学意义(P > 0.05)?结论:镇江市汉族女性具有不同于其他地区的MTHFR和MTRR基因多态性分布特征?     

MTHFR C677T基因多态性与复发性自然流产的相关性研究

目的探讨亚甲基四氢叶酸还原酶（methylenete trahydrofolate reductase,MTHFR）基因C677T位点多态性与复发性自然流产的关系。方法采用PCR-限制性片段长度多态性（PCR-RFLP）方法检测141例复发性自然流产患者和160例有正常妊娠史的妇女MTHFRC677T基因多态性。结果复发性自然流产患者MTH-FRC677T位点三个基因型多态性与对照组有显著性差异（χ2=18.33,P〈0.01）;带有TT基因型的个体发生复发性流产的危险度明显增高（OR=8.44,95%CI：2.376-30.007）。结论 MTHFR C677T纯合突变与宁夏汉族复发性自然流产相关,可能是复发性流产的遗传易感性因素。     

原因不明复发性流产遗传性血凝因素研究

目的 研究凝血因子V基因G1691A、凝血酶原基因G20210A以及5,10-亚甲基四氢叶酸还原酶(MTHFR)基因C677T和A1298C位点突变,与原因不明复发性流产易感相关性.方法 采用聚合酶链式反应-限制性片断长度多态性分析方法,检测148例原因不明复发性流产者和82例正常对照的凝血因子V基因G1691A、凝血酶原G20210A以及MTHFR基因C677T和A1298C位点突变情况.结果 复发性流产组和对照组,均未发现凝血因子V基因G1691A和凝血酶原基因G20210A突变;MTHFR基因C667T三种基因型在两组的总体分布存在显著性差异(P=0.012),其中复发性流产组CC基因型表达频率显著降低(P=0.005),T等位基因表达频率显著增大(P=0.004);MTHFR基因A1298C三种基因型在复发性流产和对照组总体分布无显著差异,AA/AC/CC基因型和A/C等位基因频率表达无统计学差异;MTHFR基因C677T/A1298C连锁分析发现8种连锁基因型,复发性流产组中677CC/1298AA表达频率显著降低(P＜0.05),而677(CT+TT)/1298CC仅在复发性流产组中表达(P＜0.05).结论 中国人群复发性流产与凝血因子V基因G1691A和凝血酶原G20210A基因突变无关,而与MTHFR基因C677T和A1298C位点突变有关.     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.