一个中国Gilbert综合征家系的临床和遗传学特征分析

Objective To perform clinical and genetic pedigree analyses of a Chinese male patient with Gilbert's syndrome and his relatives. Methods Blood sample were collected from the proband and his relatives by liver function test, etiological examination and genetic analysis to exclude other related diseases. The phenobarbital-responsive enhancer module (PBREM) , TATA box and common mutation sites in exons of UGT1A1 gene were amplified by polymerase chain reaction (PCR) and the products screened by direct DNA sequencing. Results c. -3279T ＞ G in PBREM, TA insertion in TATA box and Gly71Arg were observed in this family. A linkage disequilibrium is also noted between c. -3279T ＞ G and TA insertion. In four affected members, three are heterozygotes and one is homozygote. The correlation between genotype and phenotype with a high serum level of unconjugated bilirubin was confirmed. Conclusion c. -3279T ＞ G in PBREM, TA insertion in TATA box and Gly71 Arg are essential for the pathogenesis of Gilbert's syndrome in this Chinese family. Gilbert's syndrome in this family is inherited in an autosomal recessive manner.     

Mutation of Arg723Gly in β-myosin heavy chain gene in five Chinese families with hypertrophic cardiomyopathy

Background Hypertrophic cardiomyopathy （HCM） is a form of cardiomyopathy with an autosomal dominant inherited disease, which is caused by mutations in at least one of the sarcomeric protein genes. Mutations in the beta-myosin heavy chain （β-MHC） are the most common cause of HCM. This study was to reveal the disease-causing gene mutations in Chinese population with HCM, and to analyze the correlation between the genotype and phenotype. Methods The exons 3 to 26 of MYH7 were amplified by PCR, and the PCR products were sequenced in five non-kin HCM patients. A 17-year-old patient was detected to be an Arg723Gly mutation carrier. Then his family was gene-screened, and the correlation between genotype and phenotype was analyzed. Results The mutation of Arg723Gly in a Chinese family with HCM was detected for the first time. With a C-G transversion in nucleotide 13 619 of the MYH7 gene, located at the essential light chain interacting region in S1, the replacement of arginine by glycine took place at amino acid residue 723. A two-dimensional echocardiogram showed moderate asymmetrical septal hypertrophy with left atria enlargement. There was no obstruction in the left ventricular outflow tract. In his family, a total of 13 individuals were diagnosed HCM and 5 of them were dead of congestive heart failure at a mean age of 66-year-old. Eight living members were all detected to carry the mutation, in which 3 developed progressive heart failure. Moreover, the heart function of the people evidently deteriorates when their age are older than 50. The mutation and the disease show co-separated. Conclusion The Arg723Gly mutation is a malignant type. In Chinese the mutation has the similar characters to the former report but has low degree malignant.     

Beta2-adrenoceptor gene variant Arg16Gly is associated with idiopathic ventricular outflow-tract tachycardia

Background Imbalance of the sympathetic nervous system was involved in the pathogenesis of idiopathic ventricular outflow-tract tachycardia （IVOT）. We aimed to investigate whether the major genetic variants in β1-and β2-adrenoceptors and GNB3 C825T were associated with IVOT and verapamil sensitive idiopathic left ventricular tachycardia （ILVT）.Methods Patients with IVOT and ILVT from December 2005 to December 2007 were consecutively enrolled into this study. Controls were randomly selected from the community-based inhabitants. Five genetic variants, Ser49Gly and Gly389Arg in the β1-adrenoceptor, Arg16Gly and Gln27Glu in the β2-adrenoceptor and GNB3 C825T, were genotyped by polymerase chain reaction-restriction fragment length polymorphism analysis.Results A total of 227 patients with IVOT and 110 patients with ILVT were included. Genotyping revealed that the 16Gly allele of Arg16Gly variant of β2-adrenoceptor was associated with a higher risk of IVOT （OR：1.40, 95% CI： 1.12-1.75,P=0.003 in the addictive model and OR：. 1.62, 95% CI： 1.14-2.31, P=0.007 in the dominant model）. Patients with Gly16Gln27 haplotype also had a higher risk of IVOT （OR： 1.38, 95% CI： 1.11-1.73, P=0.012）. Other four variants,including Ser49Gly and Arg389Gly in β1-adrenoceptor, GIn27Glu in β2-adrenoceptor and GNB3 C825T, did not differ between patients with IVOT and controls. In patients with ILVT, no significant difference was found in these five variants compared with controls.Conclusions Arg16Gly in β2-adrenoceptor is significantly associated with IVOT in Chinese Han population. Major genetic variants in β1- and β2-adrenoceptor and GNB3 C825T may not be associated with ILVT. These data suggest a different arrhythmogenic mechanism in IVOT and ILVT.     

Molecular basis of von Hippel-Lindau syndrome in Chinese patients

Background  Von Hippel-Lindau (VHL) syndrome is an autosomal dominant familial cancer syndrome predisposing the affected individuals to multiple tumours in various organs. The genetic basis of VHL in Southern Chinese is largely unknown. In this study, we characterized the mutation spectrum of VHL in nine unrelated Southern Chinese families.

Methods  Nine probands with clinical features of VHL, two symptomatic and eight asymptomatic family members were included in this study. Prenatal diagnosis was performed twice for one proband. Two probands had only isolated bilateral phaeochromocytoma. The VHL gene was screened for mutations by polymerase chain reaction, direct sequencing and multiplex ligation-dependent probe amplification (MLPA).

Results  The nine probands and the two symptomatic family members carried heterozygous germline mutations. Eight different VHL mutations were identified in the nine probands. One splicing mutation, NM_000551.2: c.463+1G>T, was novel. The other seven VHL mutations, c.233A>G [p.Asn78Ser], c.239G>T [p.Ser80Ile], c.319C>G [p.Arg107Gly], c.481C>T [p.Arg161X], c.482G>A [p.Arg161Gln], c.499C>T [p.Arg167Trp] and an exon 2 deletion, had been previously reported. Three asymptomatic family members were positive for the mutation and the other five tested negative. In prenatal diagnosis, the fetuses were positive for the mutation.

Conclusions  Genetic analysis could accurately confirm VHL syndrome in patients with isolated tumours such as sporadic phaeochromocytoma or epididymal papillary cystadenoma. Mutation detection in asymptomatic family members allows regular tumour surveillance and early intervention to improve their prognosis. DNA-based diagnosis can have an important impact on clinical management for VHL families. 

     

Mutation analysis in a Chinese family with multiple endocrine neoplasia type 1

Background Multiple endocrine neoplasia type 1 （MEN1） by germline mutations of the tumor suppressor gene MEN1. with MEN1. Methods A large Chinese family with MEN1 was collected MEN1 gene were amplified and sequenced. is an autosomal dominant cancer syndrome which is caused This study aimed to identify mutations in a Chinese pedigree All of the coded regions and their adjacent sequences of the Results In this family, a heterozygous cytosine insertion in exon 10 （c.1546_1547insC） inducing a frame shift mutation of MEN1 was found in the proband and the other two suffering members of his family. This mutation was linked to a novel single nucleotide polymorphism （SNP）in intron 3 （IVS3＋18C〉T）. Conclusions The mutation in exon 10 of MEN1 gene might induce development of parathyroid hyperplasia and pituitary adenoma and cosegregate with MEN1 syndrome. The significance of the new found IVS3＋18C〉T of MEN1 needs a further investigation.     

Mutation analysis of p63 gene in the first Chinese family with ADULT syndrome

Background ADULT syndrome （acro-dermato-ungual-lacrimal-tooth syndrome） is a rare ectodermal dysplasia disorder known as autosomal dominant inheritance. Recent studies have linked p63 gene mutation to the development of this disease. However, the genetic characteristics of ADULT syndrome were still not well understood. Methods Mutation analysis of p63 gene in the first Chinese ADULT syndrome family was performed using direct DNA sequencing. Results The sequence analysis of exon 8 of p63 gene disclosed a heterozygous G〉A substitution at nucleotide 893 （R298Q） in the proband. In addition, a single nucleotide polymorphism （SNP） rs16864880 in the downstream flanking region （DFR） of p63 exon 8 was also identified in this family. The proband and the paternal side including her father exhibited the C/G genotype at this position. The C/G variant frequency in the paternal was significantly higher as compared with the maternal （6/10 vs 0/6, P=0.034）. Conclusions ADULT syndrome may be caused by the p63 gene mutation, and it might have closer genetic association with the paternal side in this family.     

Genetic characterization and protein stability analysis of a Chinese family with Von Hippel-Lindau disease

Background Von HippeI-Lindau disease （VHL）,a heritable autosomal dominant disease characterized by neoplasia in multiple organ systems,has rarely been reported in Asia.We genetically investigated a unique Chinese family with VHL disease and performed an analysis of the VHL protein stability.Methods Genomic deoxyribonucleic acid （DNA） extracted from peripheral blood was amplified by polymerase chain reaction （PCR） to three exons of the VHL gene in 9 members of the Chinese family with VHL disease.PCR products were directly sequenced.We estimated the effects of VHL gene mutation on the stability of pVHL,which is indicated by the free energy difference between the wild-type and the mutant protein （△△G）.Results The Chinese family was classified as VHL type 1.Three family members,including two patients and a carrier,had a T to G heterozygotic missense mutation at nucleotide 515 of the VHL gene exon 1.This missense mutation resulted in the transition from leucine to arginine in amino acid 101 of the VHL protein.There was low stability of the VHL protein （the △△G was 12.71 kcal/mol） caused by this missense mutation.Conclusions We first reported a family with this VHL gene mutation in Asia.This missense mutation is predicted to significantly reduce the stability of the VHL protein and contribute to the development of the renal cell carcinoma （RCC） phenotype displayed by this family.The genetic characterization and protein stability analysis of families with VHL disease are important for early diagnosis and prevention of the disease being passed on to their offspring.     

R25G mutation in exon 1 of LMNA gene is associated with dilated cardiomyopathy and limb-girdle muscular dystrophy 1B

Background Mutations of the LMNA gene encoding lamin A and C are associated with dilated cardiomyopathy （DCM）, conduction system defects and skeletal muscle dystrophy. Here we report a family with a mutation of the LMNA gene to identify the relationship between genotype and phenotype. Methods All 30 members of the family underwent clinical and genetic evaluation. A mutation analysis of the LMNA gene was performed. All of the 12 exons of LMNA gene were extended with polymerase chain reaction （PCR） and the PCR products were screened for gene mutation by direct sequencing. Results Ten members of the family had limb-girdle muscular dystrophy （LGMD） and 6 are still alive. Two patients suffered from DCM. Cardiac arrhythmias included atrioventricular block and atrial fibrillation; sudden death occurred in 2 patients. The pattern of inheritance was autosomal dominant. Mutation c.73C〉G （R25G） in exon 1 encoding the globular domains was confirmed in all of the affected members, resulting in the conversion of arginine （Arg） to glycine （Gly）. Conclusions The mutation R25G in exon 1 of LMNA gene we reported here in a Chinese family had a phenotype of malignant arrhythmia and mild LGMD, suggesting that patients with familial DCM, conduction system defects and skeletal muscle dystrophy should be screened by genetic testing for the LMNA gene.     

GENETIC STUDY OF 1055 CASES WITH CLEFTLIPS AND CLEFT-PALATES

All of 1055 cleft-lip and/or cleft-palate cases with their 1055 families were investigated. As the results." the incidence of siblings of propositi is 2.2% (39/1791). The incidences of the first, second and third degree relatives were 1.53% (60/3927), 0.22% (25/11359), 0.30% (31/10296) respectively. In 17 cases, either of propositi's parents had cleft, the incidence of cleft among propositi's siblings was 9.52% (2/21). In 34 cases, the incidence of rest propositi's siblings beyond those whose one sib had cleft or more is 5% (4/80), whereas both their parents were normal. Based on above, all incidences of different order relatives were higher than population ones. Furthermore, it is demonstrable that the closer the consanguinity is, the higher the incidence is, and if there was cleft in one family, the incidence increased obviously among his siblings or children, revealing apparent family tendency. In this group, the heritability is 46.80%.     

Molecular analysis for diagnosis of Marfan syndrome and Marfan-associated disorders

Marfan syndrome is a systemic disorder of connective tissue, caused by mutations in the FBN1, TGFBR1 or TGFBR2 genes. This syndrome is characterized by involvement of three major systems, skeletal, ocular, and cardiovascular. The continuing improvements in molecular biology and increasing availability of molecular diagnosis in clinical practice allow recognition of Marfan syndrome in patients with incomplete phenotypes. Additionally, molecular analyses could also be used for preimplantation genetic diagnosis. The identification of a mutation allows for early diagnosis, prognosis, genetic counseling, preventive management of carriers and reassurance for unaffected relatives. The importance of knowing in advance the location of the putative family mutation is highlighted by its straightforward application to prenatal and postnatal screening.

     

抗流1号对发热患者预防甲型H1N1流感的临床分析

目的：研究抗流1号对197例发热患者甲型H1N1流感的预防。方法：体温T≥37.5℃的患者197例,根据患者有无接触甲型H1N1病例,分为密切接触组25例,一般接触组48例,非接触组124例。进行体格检查、查血常规和胸片,服用抗流1号中药制剂（红景天、大青叶、虎仗和贯众）,根据症状和病情给予中医辨证治疗或抗生素及抗病毒治疗,观察患者一般情况,比较治疗情况。结果：密切接触组中性粒细胞和淋巴细胞降低的患者明显多于非接触组（P〈0.01）;用抗病毒治疗的患者密切接触组与非接触组比较有显著差异（P〈0.01）,中医辨证治疗的患者密切接触组与非接触组比较有差异（P〈0.05）。结论：以扶正和清热解毒为主的抗流1号能有效的预防甲型H1N1的传播可以起到降低发病率、减轻病情,值得推广应用。     

CYP1A1、GSTM1和GSTT1基因多态性与甘肃省武威市食管癌易感性的关系

目的探讨甘肃省武威市食管癌组织中生物代谢酶Ⅰ相酶细胞色素（CYPIA1）和Ⅱ相酶谷胱甘肽转硫酶MI（GSTM1）、谷胱甘肽硫转移酶TI（GSTT1）基因多态性与食管癌的关系。方法采用PCR-RFLP、multiplex—PCR方法检测216例正常对照f血液）和189例食管癌组织中代谢酶基因CYPIA1和GSTM1、GSTT1的多态性。结果食管癌病例组与正常对照组中：CYP1A1基因MspⅠ酶切位点多态性的频率分别为74．1％和67．6％,差异无统计学意义;GSTM1纯合缺失基因型分别占58．7％和41．2％,差异有统计学意义（P〈0．05）,该基因型可能与食管癌易感性的增高有关（OR1．956）;GSTT1纯合缺失基因型分别占51．9％和43．5％,差异无统计学意义,该基因未明显增加对食管癌的易感性（OR1．169）;GSTM1、GSTT1联合缺失基因型在病例组和对照组中的频率分别为38．6％和19．6％,差异有统计学意义（P〈0．05）;同时携带CYPIA1MspⅠ多态突变基因型与GSTM1、GSTT1缺失基因型的个体患食管癌的风险增加（OR2．385,95％CI1．094-3．495）。结论单独的CYP1A1MspI多态突变基因型或者GSTT1缺失基因型与食管癌的易感性不相关;GSTM1纯合缺失基因型及其与GSTT1缺失基因型、CYP1A1MspⅠ多态突变基因型同时存在可增加个体患食管癌的风险,提示GSTM1纯合缺失基因型可能为食管癌发病的易感因素之一,且与其他缺陷基因型存在协同作用。     

结直肠癌组织中Tiam1、Fascin-1及HSPB1的表达及意义

目的探讨结直肠癌组织中Tiam1,Fascin-1及HSPB1的表达及意义。方法制作含100例结直肠癌组织的组织芯片,应用免疫组化SP法检测结直肠癌组织中Tiam1,Fascin-1及HSPB1的表达。结果组织芯片免疫组化染色后,形态可观测率为96%,并且背景清晰,对比鲜明。Tiam1表达阳性率为74%,Fascin-1表达阳性率为51%,HSPB1表达阳性率为68%,显著高于非肿瘤组织。Tiam1,Fascin-1及HSPB1表达与结直肠癌转移显著相关,伴发转移的结直肠癌组织Tiam1,Fascin-1及HSPB1阳性表达明显高于无转移者。通过相关性统计学分析,发现Tiam1与Fascin-1表达呈正相关(r=0.678,P<0.01),Tiam1与HSPB1表达呈正相关(r=0.650,P<0.01)。结论Tiam1,Fascin-1及HSPB1均与结直肠癌转移有关,Fascin-1和HSPB1的高表达可能与Tiam1的调控有关。     

RGS5和ATP1B1基因与原发性高血压的相关性研究

目的 探讨中国汉族人群中G蛋白信号调节因子5(RGS5)和ATP1B1基因功能区标签单核苷酸多态性(SNP)与原发性高血压的相关性及变异位点间的交互作用.方法 选择启动子、外显子和3'UTR区符合最小等位基因频率在中国北京汉族人群中>5%、R2 ≥0.80的SNP.对906例原发性高血压患者(EH组)进行SNP位点的基因分型,以性别和年龄与EH组匹配的894名血压正常者作为正常对照组.观察不同基因型和等位基因频率在EH组和对照组中的分布,并采用MDR软件分析各位点之间的交互作用.结果 最终3个标签SNP入选.EH组与对照组SNP位点基因型分布和等位基因频率比较差异无统计学意义(P>0.05);由2个基因SNP位点组成的单倍型,在EH组和对照组的分布比较差异也无统计学意义(P>0.05).交互作用分析显示,2个或3个位点模型比较差异均无统计学意义(P>0.05).结论 3个标签SNP与EH无明显相关性,并且可能不存在交互作用.     

Sp1和Egr-1对LCRG1基因启动子转录活性的调节研究

目的:目前LCRG1基因转录调控机制不清,现拟研究Sp1和Egr-1对人LCRG1基因启动子的转录调节. 方法:利用MatInspector软件分析LCRG1基因启动子区域内潜在的转录因子结合位点,Sp1、wtEgr-1、mtEgr-1真核表达质粒与LCRG1启动子重组质粒的共转染实验,分析其对LCRG1启动子活性的影响. 结果:生物信息学提示LCRG1基因启动子区域存在Sp1和Egr-1等位点,外源性突变型转录因子Egr-1能上调LCRG1基因启动子的活性.结论:突变型转录因子Egr-1可能参与该基因的表达调控.     

丁酸钠上调白血病K562细胞CYP1A1和1B1基因的表达

目的 研究丁酸钠(NaB)在诱导白血病K562细胞分化过程中,对细胞色素CYP1A1/1B1基因转录的作用及作用机制.因为与肿瘤发生发展密切相关,细胞色素P450s(CYPs)已经成为最有潜力的抗肿瘤药物的靶标.对于白血病细胞中这些基因表达机制的研究将有助于揭示它们在造血过程以及血液肿瘤发生中的作用.方法 丁酸钠诱导K562细胞分化,RT-PCR检测CYP1A1/1B1转录水平的变化,染色质免疫沉淀(ChIP)分析乙酰化组蛋白H3和组蛋白乙酰转移酶p300与CYP1A1/1B1启动子的结合情况.结果 丁酸钠在诱导白血病K562细胞分化过程中,促进了组蛋白乙酰转移酶p300与启动子区域的结合、升高了CYP1A1/1B1基因启动子组蛋白H3乙酰化修饰水平、上调了CYP1A1/1B1基因的转录.结论 组蛋白乙酰化修饰和组蛋白乙酰转移酶p300参与了丁酸钠诱导的白血病K562细胞CYP1A1/1B1基因的转录.     

甲型H1N1流感合并肺炎患者的护理体会

目的：探讨甲型H1N1流感合并肺炎的护理体会。方法：着重加强消毒隔离、个人防护、心理护理及健康教育等护理措施,避免各种护理并发症及院内感染的发生,确保患者在短期内出院。结果：70例甲型H1N1流感合并肺炎患者症状、体征在短期内消失,胸部X线检查结果提示肺部渗出灶明显吸收,无一例患者发生院内感染及流感等其他并发症。结论：在合理的临床治疗基础上,通过以上护理措施,甲流合并肺炎患者病情可以得到很好的控制。     

肺癌患者CYP1A1和GSTM1基因多态性检测

目的:探讨CYP1A1与GSTM1基因多态与支气管肺癌癌变的关系.方法:采用回顾性"病例-对照"方法和PCR-RFLP技术,对98例肺癌患者和136名体检健康者(对照组)进行CYP1A1与GSTM1基因多态性检测.结果:对照组和肺癌组CYP1A1 m1、GSTM1缺陷型等位基因频率分别为28%和43%、44%和61%,2组比较,差异有统计学意义(P＜0.05).CYP1A1(w1/m1、CYP1A1(m1/m1、GSTM1(缺陷型)基因型患肺癌的危险度分别升高3.18倍、2.72倍和2.16倍(P均＜0.05).GSTM1(缺陷型)和CYP1A1(w1/m1或CYP1A1(m1/m1基因型携带者患肺癌的危险度为5.62倍(P＜0.01.吸烟使GSTM1缺陷型携带者和CYP1A1 m1携带者肺癌的患病危险度较单一基因作用危险度显著增加(P＜0.05).结论:CYP1A1 m1和GSTM1缺陷型基因均是肺癌的危险因素,2者存在交互作用,且均与吸烟有协同作用.