海南黎族、汉族高血压ACE基因多态性相关性研究

目的 研究海南黎族、汉族高血压ACE基因多态性的相关性.方法 采用聚合酶链反应(PCR)检测,对海南黎族111例高血压患者、146例黎族正常人、海南汉族106例高血压患者、97例汉族正常人的ACE基因插入/缺失(I/D)多态性检测,观察DD、DI、II基因型频率及等位基因频率,并对所有普通PCR定为DD型的样本进行插入特异性PCR检测,以减少误分型率.并调查经典危险因素.结果 海南黎族高血压组DD、DI、II基因频率分别为10.8%、37.8%、51.4%;D及I等位基因频率分别为29.7%、70.3%.正常对照组DD、DI、II基因型频率分别为13.0%、43.8%、43.2%;D及I等位基因频率分别为34.9%、65.1%.两组之间DD、DI、II基因型频率及D、I等位基因频率均无显著性差异.汉族高血压DD、DI、II基因频率为16.0%、28.3%、55.7%;D及I等位基因频率分别为30.2%、69.8%.汉族正常人DD、DI、II基因频率15.5%、44.3%、40.2%,D及I等位基因频率分别为37.6%、62.4%.两组之间DD、DI、II基因型频率及D、I等位基因频率有显著性差异(P＜0.05).黎族、汉族高血压组与正常对照组比较,体重指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)有显著性差异(P＜0.05);黎族高血压组收缩压,舒张压与正常对照组有显著性差异(P＜0.05);汉族高血压组收缩压、舒张压与正常对照组有显著性差异(P＜0.05).结论 在海南黎族高血压和黎族正常人的D等位基因频率均比I等位基因频率低;ACE基因I/D多态性与黎族高血压无显著关联;海南汉族高血压和汉族正常人D等位基因频率均比I等位基因频率低;ACE基因I/D多态性与汉族高血压的发病有相关性,是汉族高血压的主要致病基因,早期应用血管紧张素转化酶抑制剂的治疗干预.     

血管紧张素转换酶基因多态性与结直肠癌的相关性

目的:探讨血管紧张素转换酶(ACE)基因多态性在结直肠癌(CRC)发病中的作用。方法:入组120例CRC患者,采用聚合酶链反应(PCR)检测患者外周血中ACE基因多态性和等位基因分布频率,研究ACE基因缺失型(DD型)、II型和插入型(ID型)等3种基因型及I/D等位基因在CRC患者外周血中的分布频率,并与120例正常人检测结果进行对比。结果:CRC患者外周血标本中存在ACE基因插入/缺失(I/D)多态性分布,DD型、ID型和II型3种基因型的频率分别为15.00%,50.00%,35.00%,I/D等位基因分布频率分别为60.00%及40.00%;对照组的分布频率分别为16.67%,53.33%,30.00%,I/D等位基因分布频率分别为56.67%及43.33%,两组间3种基因型的分布频率无显著性差异(P>0.05)、I/D等位基因分布频率无显著差异(P>0.05)。分层分析表明,D等位基因变异与CRC低分化和远处转移相关(P<0.01及P<0.05)。结论:ACE基因I/D多态性与CRC存在一定关系,其中D等位基因异常与CRC低分化和易转移可能有关。     

内蒙古地区妊娠高血压患者ACE基因多态性研究

目的:检测内蒙古地区妊娠高血压患者ACE基因Ⅰ/D多态性与妊娠高血压的相关性。方法:采用PCR-SSP(序列特异性引物)检测80例正常妊娠组和40例妊娠高血压组ACE基因I/D基因型频率分布。结果:妊娠高血压组患者DD基因型频率高于正常妊娠组;妊娠高血压组D型等位基因频率高于对照组。结论:内蒙古地区汉族妊娠期高血压疾病的发病与ACE基因I/D多态性有相关性。     

血管紧张素转化酶基因型及其血清活性与原发性高血压的关系

目的探讨血管紧张素转化酶(ACE)基因型及其血清活性与原发性高血压(EH)的关系.方法以人类基因组DNA为模板,应用聚合酶链式反应(PCR)技术检测120例EH组和93例正常对照组ACE基因第16内含子的插入/缺失(I/D)多态性,并按性别分组计算各组基因型和等住基因频率,另外用比色法测量各研究对象的ACE血清活性.结果男性EH组DD基因型和D等位基因频率均显著高于对照组(均P＜0.05).女性EH组DD基因型频率和D等位基因频率与对照组比较差异无统计学意义(P＞0.05);在EH组中ACE活性与对照组比较差异无统计学意义(P＞0.05);ACE血清活性在ACE基因DD,ID和Ⅱ型间有显著性差异(P＜0.05).结论EH与ACE基因I/D多态性有显著相关性,特别是男性,ACE基因DD基因型可能在EH的发生发展过程中是重要的危险因素之一.ACE血清活性与ACE基因I/D多态性有关.     

高血压血瘀证血管紧张素转换酶基因插入或缺失的多态性分析

【目的】探讨血管紧张素转换酶(ACE)基因插入或缺失(I/D)的多态性与原发性高血压血瘀证的关系。【方法】选择原发性高血压(EH)血瘀证组100例、非血瘀证组120例和正常对照组100例,采用聚合酶链反应(PCR)方法检测ACE基因I/D多态性。【结果】高血压血瘀证组的DD基因型及D等位基因频率(分别为0.410和0.590)高于高血压非血瘀证组(分别为0.250和0.467)和正常对照组(分别为0.220和0.455)(P<0.05或P<0.01),高血压非血瘀证组与正常对照组比较无显著性差异(P>0.05)。【结论】ACE基因插入或缺失(I/D)多态性与血瘀证具有相关性,D等位基因可能是血瘀证的易感基因之一。     

2型糖尿病合并冠心病与血管紧张素转化酶I基因多态性的相关性及脂质代谢的研究

目的:探讨2型糖尿病(DM)合并冠心病(CHD)与血管紧张素转化酶I(ACE)基因插入/缺失(I/D)多态性的相关性及其各基因型血脂代谢情况. 方法:采用多聚酶链反应(PCR)技术,对32例广西地区汉族2型DM合并CHD患者,88例2型DM无合并CHD患者及100名汉族正常对照的ACE基因I/D多态性及血脂进行检测.结果:2型DM合并CHD组ACE基因D等位基因及ID基因型发生频率高于正常对照组及无合并CHD组(P<0.05);I等位基因及II基因型频率低于正常对照组及无合并CHD(P<0.05).2型DM合并CHD组ID基因型组甘油三酯(TG)及总胆固醇(TC)高于正常对照组、DD基因型组及II基因型组,高密度脂蛋白胆固醇(HDL-C)低于正常对照组,低密度脂蛋白胆固醇(LDL-C)高于正常对照组(P<0.05);2型DM合并CHD DD基因型组TG、LDL-C及TC高于正常对照组(P<0.05).结论:①广西地区汉族2型DM合并CHD与ACE基因I/D多态性有关.②D等位基因及ID基因型可能为2型DM合并CHD的易感基因,I等位基因及II基因型可能为2型DM合并CHD的保护基因.③广西地区汉族2型DM合并CHD的 ID基因型者及DD基因型者易合并高甘油三酯血症及高胆固醇血症.     

血管紧张素转换酶基因插入或缺失多态性与飞行员原发性高血压的相关性

目的探讨血管紧张素转换酶（ACE）基因插入或缺失（I/D）多态性和飞行员原发性高血压的相关性,为飞行员原发性高血压的预防提供依据。方法用聚合酶链反应（PCR）扩增检测48例飞行员原发性高血压患者和50例飞行员健康对照者的ACE基因I/D多态性。结果飞行员高血压组ACE DD基因型（25%）和D等位基因频率（0.47）显著高于健康对照组（分别为8%和0.30）。结论 ACE DD基因型和D等位基因与飞行员原发性高血压病相关。     

2型糖尿病合并高血压与血管紧张素转化酶I基因多态性的相关性及其脂质代谢的研究

目的:探讨广西汉族2型糖尿病(DM)合并高血压与ACE基因I/D多态性的相关情况及其与血脂代谢的关系.方法:采用多聚酶链反应(PCR)技术,对81例广西地区汉族2型DM无合并高血压患者和39例2型DM合并高血压患者及100名汉族正常对照的ACE基因插入/缺失(I/D)多态性及血脂进行检测.结果:2型DM合并高血压组ACE基因各等位基因及基因型频率与正常对照组及无合并高血压组比较均无统计学意义(P＞0.05).2型DM合并高血压DD基因型组及ID基因型组甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)高于正常组,高密度脂蛋白胆固醇(HDL-C)低于正常组(P<0.05);II基因型组TG、TC及LDL-C低于DD基因型组及ID基因型组(P<0.05),与正常组对照组比较无统计学意义,HDL-C高于DD基因型组及ID基因型(P<0.05);ID基因型组TG高于正常组、DD基因型组及II基因型组(P<0.05).结论:广西地区汉族2型DM合并高血压与ACE基因I/D多态性无关联.2型DM合并高血压DD基因型及ID基因型者与正常人比较更易患高甘油三酯血症、高总胆固醇血症及高低密度脂蛋白胆固醇血症, II基因型者不易患高脂血症; ID基因型者更易患更高甘油三酯血症.     

高血压脑梗死患者血管紧张素转换酶基因多态性分析

目的 探讨血管紧张素转换酶（ACE）基因多态性与高血压脑梗死发病的关系。方法 采用聚合酶链反应技术（PCR），对158名健康成人和50例原发性高血压、90例高血压脑梗死患者ACE基因插入／缺失（I／D）多态性进行检测，并且非条件Logistic回归筛选出与高血压脑梗死发病相关的因素。结果 DD基因型、D等位基因频率高血压脑梗死组高于正常对照组（P＜0.01)和高血压组（P＜0.05)。发病年龄在60岁以上者，DD基因型、D等位基因频率高血压脑梗死组高于高血压组和正常对照组（P＜0.05、P＜0.01)；而60岁以下起病者，DD基因型、D等位基因频率高血压脑梗死组则与高血压组、正常对照组无差别（均P＞0.05)，而高血压组D等位基因频率高于正常对照组（P＜0.05)。ACE DD基因型是高血压脑梗死独立的危险因素，发现高血压时间是高血压脑梗死的保护因素。结论 ACE DD基因型携带者发生高血压脑梗死的危险性增高，早期发现及治疗高血压对降低高血压患者脑梗死发生有意义。     

高血压病患者ACE I/D基因多态性与胰岛素抵抗的关系

目的 研究高血压病患者血管紧张素转换酶(angiotensin converting enzyme ,ACE)基因 I/D多态性与胰岛素抵抗的关系.方法 用PCR方法检测300例汉族原发性高血压(essential hypertension ,EH)患者ACE基因 I/D多态性,并做空腹血糖、空腹胰岛素(fasting insulin ,FIN)检测,根据ACE基因 I/D多态性分组比较胰岛素抵抗情况,再根据胰岛素抵抗情况分组比较I/D多态性分布情况.结果 DD和ID型的胰岛素抵抗指数(HOMA-IR)显著高于Ⅱ型, DD型FIN显著高于Ⅱ型.EH胰岛素抵抗组DD型频率显著高于EH无胰岛素抵抗组.EH胰岛素抵抗组D等位基因频率显著高于EH无胰岛素抵抗组.结论 高血压病患者胰岛素抵抗情况与ACE基因I/D多态性有关,D等位基因为胰岛素抵抗的危险因素.     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.