白细胞介素-6基因启动子-572C/G、-634C/G的多态性与脑梗死的研究

目的探讨脑梗死患者白细胞介素-6（IL-6）基因启动子-572C/G-、634C/G的多态性及其血清水平与脑梗死的关系。方法采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）的分析方法,检测了106例脑梗死患者和92例健康对照者IL-6基因多态性,同时采用酶联免疫吸附试验检测IL-6的血清水平。结果脑梗死组IL-6水平显著高于对照组（P〈0.05）,IL-6-572C/G基因型和等位基因频率在脑梗死组和对照组比较,差异有显著性（P〈0.05）,与健康对照组相比,发现G等位基因携带者患脑梗死的相对风险度增加1.634倍（OR=1.634,95%CI=1.135~2.468）。携带G等位基因的脑梗死患者血清IL-6水平显著高于不携带者（P〈0.05）。IL-6基因-634C/G多态性在脑梗死组和对照组之间比较差异无显著性（P〉0.05）。结论 IL-6基因-572C/G多态性与脑梗死之间存在相关关系,其中G等位基因可能是脑梗死发病的遗传易感基因;携带G等位基因的个体可能通过促进IL-6的高度表达进而增加了脑梗死的发病风险。     

白细胞介素6基因启动子-572 C/G多态性与心绞痛的相关性研究

目的探讨白细胞介素6(IL-6)基因启动子-572C/G多态性各等位基因及基因型在心绞痛患者中的分布频率,并分析其基因型及血清水平与心绞痛的关系。方法采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测121例心绞痛患者及140例对照者IL-6基因启动子-572C/G多态性,同时用ELISA法检测心绞痛和对照者血清IL-6水平。结果心绞痛组IL-6血清水平显著高于对照组(P<0.01),IL-6基因启动子-572C/G基因型频率和等位基因频率在心绞痛组和对照组间比较差异有显著性(P<0.05),等位基因频率的相对风险分析发现,G等位基因携带者患心绞痛的风险是C等位基因的1.665倍(OR=1.665,95%CI:1.089~2.544);结论IL-6基因启动子-572C/G多态性与心绞痛的发病具有相关性。     

白细胞介素6基因启动子区多态性与冠状动脉疾病的相关性研究

目的 探讨白细胞介素6(interleukin 6,IL-6)基因启动子区-174G/C、-572C/G和-634C/G多态性对冠状动脉疾病(coronary heart disease,CHD)的发病易感性.方法 严格按照诊断标准,选取无亲缘关系的CHD患者126例(CHD组)及健康对照组150例提取基因组DNA,应用聚合酶链反应-限制性片段长度多态性(PCR-polymorphism,Restriction Fragment,PCR-RFLP)技术检测-174 G/C、-572 C/G和-634 C/G 3个多态性位点的基因型;采用HaploView4.0及SPSS11.5软件分析各位点基因型、等位基因频率及组间差异.结果 -572C/G位点及-634C/G位点的基因型频率分布在CHD组与正常对照组差异均有统计学意义(P＜0.05),CHD组-572C/G位点的等位基因G频率显著高于正常对照组(P＜0.05),-634C/G位点的等位基因G频率显著高于正常对照组(P＜0.05).连锁不平衡检验结果显示,IL-6基因这3个位点处于不连锁状态,D'＜0.5.结论 IL-6基因-174G/C和-572C/G多态性可能与CHD有关,携带有-572C/G和-634C/G多态性位点G等位基因的个体可能更容易患CHD.     

白细胞介素-6基因多态性与冠心病的相关性研究及其对血脂的影响

目的 探讨白细胞介素6（IL-6） 基因启动子区基因-572位点和-634位点多态性与冠心病的关系,及其对血脂、脂蛋白、载脂蛋白水平的影响.方法 采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法,检测165例冠心病（冠心病组）患者和170名健康人（对照组） 的IL-6基因型;按常规方法测定血脂、脂蛋白、载脂蛋白水平.结果 冠心病组总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平均明显高于对照组（P均〈0.05）;IL-6基因-634位点多态性在冠心病组和对照组的分布差异无显著性（P〉0.05）,而IL-6基因-572位点多态性在两组人群中的分布差异存在显著性（P〈0.05）;等位基因频率的相对风险分析发现,G等位基因携带者患冠心病的风险是C等位基因的1.652倍[相对比值比（OR）=1.652,95%可信区间（CI）：1.137～2.401],携带G等位基因的冠心病个体血清TC水平显著高于不携带者（P〈0.05）.结论 IL-6基因-572位点多态性与冠心病的发病具有相关性,其中G等位基因是冠心病重要的遗传标记;IL-6基因-572位点多态性可能通过影响血脂水平而影响冠心病的发生.     

白细胞介素-6基因-572G/C多态性对急性冠状动脉综合征患者血浆高敏C反应蛋白的影响

目的研究白细胞介素-6（IL-6）基因-572G／C多态性对急性冠状动脉综合征患者血浆高敏C反应蛋白（hs-CRP）浓度的影响。方法采用聚合酶链反应结合限制性内切酶片段长度多态分析方法（PCR-RFLP）检测228例急性冠状动脉综合征患者的IL-6基因-572G／C多态性，用免疫比浊法测定hs-CRP浓度。结果①ST段抬高急性心肌梗死（STEMI）组hs—CRP水平明显高于非ST段抬高急性冠脉综合征（NSTEACS）组，差异有统计学意义（P〈0．05）。②IL-6基因-572G／C多态性的基因型频率：CC42．54％、GC46．92％、GG10．52％；等住基因频率：C66．01％、T33．99％。③在STEMI组中，基因型CC组hs-CRP浓度较基因型GG＋GC组高，差异有统计学意义（P〈0．05）。多因素线性回归分析结果仍显示基因型CC携带者的血浆hs-CRP水平较携带G等住基因者高（P〈0．05）。在NSTEACS组及总人群中，不同基因型组hs—CRP比较差异无统计学意义（P〉0．05）。结论IL-6基因-572G／C多态性对急性冠状动脉综合征患者血浆hs-CRP水平无影响。在STEMI患者中，基因型CC携带者的血浆hs-CRP水平较携带G等住基因者高，提示IL-6基因-572G／C多态性在较高的炎症反应状态下，会对hs-CRP的表达产生影响。     

IL-17基因多态性与支气管哮喘患儿血清TIgE、ECP的关系分析

目的分析白细胞介素(IL)-17基因多态性与支气管哮喘患儿血清总IgE(TIgE)、嗜酸性粒细胞阳离子蛋白(ECP)的关系。方法将该院2018年1—12月收治的60例哮喘患儿设为哮喘组,同期于该院行健康体检的60例健康儿童设为对照组,采用PCR-限制性片段长度多态性分析法检测2组IL-17基因多态性,采用免疫比浊法、酶联免疫吸附试验法分别检测其血清TIgE、ECP水平,比较2组IL-17基因多态性、TIgE和ECP水平及不同基因型、不同等位基因型患儿血清TIgE、ECP水平。结果哮喘组中IL-17A-152G/A位点中AA型基因频数频率、A等位基因频数频率,IL-17F 7488T/C位点中TT型基因频数频率、T等位基因频数频率,血清TIgE、ECP水平均显著高于对照组(P<0.05)。哮喘组IL-17A-152G/A位点AA型基因血清TIgE显著高于AG、GG型(P<0.05)。IL-17A-152G/A位点A等位基因携带患儿血清TIgE显著高于非A等位基因携带患儿(P<0.05)。哮喘组IL-17F 7488T/C位点不同基因型、等位基因携带者间血清TIgE、ECP与对照组比较,差异无统计学意义(P>0.05)。结论IL-17A-152G/A基因多态性与哮喘易感性有关,变异等位基因A携带患儿哮喘风险更高,尤其是突变纯合子AA基因型,野生型TT纯合子与哮喘也有一定关联性;且IL-17基因多态性虽与血清ECP均无明显关联,但血清ECP在哮喘患儿中仍明显高表达。     

IL-6基因启动子区-572C/G多态性与儿童脓毒症的相关性

目的 探讨儿童脓毒症疾病易感性及进展与白细胞介素-6(IL-6)基因启动子区-572C/G多态性间的关系。方法 回顾性选取2019年5月至2021年5月十堰市妇幼保健院收治的脓毒血症患儿117例为试验组,选取同期体检健康儿童126例作为对照组,并根据第三版脓毒症与感染性休克定义国际共识,将试验组分为脓毒症组57例和脓毒症休克组60例。检测各组受试者外周血血浆中IL-6、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)水平,采用聚合酶链式反应-限制性内切酶片段长度多态性(PCR-RELP)技术检测IL-6基因rs1800796(-572C/G)位点单核苷酸多态性(SNPs),分析以上基因多态性与脓毒症易感性及其进展的关系。结果 血浆IL-6、TNF-α和PCT水平试验组明显高于对照组(P<0.01),且试验组中脓毒症休克组高于脓毒症组(P<0.01)。IL-6基因位点rs1800796(-572C/G)的基因型CC及等位基因C频率试验组显著低于对照组(P<0.05),且试验组中脓毒症休克组显著低于脓毒症组(P<0.05);IL-6基因-572C/G位点基因型为C...     

IL-6基因多态性与精神分裂症的相关性研究

目的探讨IL-6—572C／G和-174G／C基因多态性在精神分裂症发病中的作用及对血浆IL-6水平的影响。方法采用病例-对照研究,运用PCR—RFLP检测了104例精神分裂症组和101例对照组的IL-6—572和-174位点基因型和等位基因频率;用ELISA测定72例精神分裂症组和77例对照组血浆IL-6浓度。结果在精神分裂症组中IL-6—572位点CC,CG和GG基因型频率分别为50％,42．3％和7．7％;对照组中CC,CG和GG基因型频率分别为61．4％,33．7％和4．9％。IL-6基因型频率和等位基因频率在研究组与对照组之间差异无统计学意义（Х^2=2．80,P〉0．05;Х^2=2．7,P〉0．05）。IL-6—174位点在精神分裂症组与对照组全部为GG基因型。血浆IL-6水平在各基因型及等位基因间差异无统计学意义（P〉0．05）。结论IL-6基因启动子区-572位点在本研究人群中存在多态性,而IL-6基因启动子区-174住点在本研究人群中不存在该多态性。IL-6基因-572C／G多态性与精神分裂症不存在关联,IL-6基因多态性在精神分裂症中发病的作用还有待进一步研究。IL-6基因-572C／G和-174G／C多态性与血浆IL-6水平无关,其在精神分裂症血浆IL-6水平增高中的作用还有待进一步研究。     

青岛地区哮喘患者IL-6基因启动子-634C/G位点多态性研究

目的:了解白细胞介素-6(interleukin-6,IL-6)基因启动子区域单核苷酸多态位点-634C/G与青岛地区汉族人群过敏性哮喘的相关性.方法:采用聚合酶链反应-限制性片段长度多态性分析方法对青岛地区479例健康个体和481例过敏性哮喘患者IL-6基因启动子-634C/G多态性进行观察.结果:过敏性哮喘组与健康对照组CC、CG和GG基因型以及C和G等位基因频率分布均无统计学差异,携带GG、CG、CC基因型个体哮喘患病风险依次递增.结论:IL-6基因启动子-634C/G位点多态性与青岛地区人群过敏性哮喘发生无相关性,但携带CC等位基因型的个体过敏性哮喘的发病风险可能增加.     

IL-6-634C/G和-597G/A基因多态性与宿迁地区冠心病的相关性

摘要:目的探讨宿迁地区白 细胞介素6(IL-6)基因启动子区域-634C/G .-597G/A 多态性与冠心病( coronary heart disease,CHD)的关系。方法选择宿迁市第一人民 医院2022年1月至9月就诊的248例CHD患者(CHD组)以及126例体检健康人群(健康人对照组),应用聚合酶链-限制性片段长度多态性法(PCR-RFLP)检测各组IL-6基因多态性位点和基因型,并进行Hardy-Weinberg平衡检验,采用Logistie 回归方法分析基因多态性与CHD之间的关系。进一步检测各组三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1) 、载脂蛋白B(apoB).总胆固醇(TC)、葡萄糖(Glu)、C反应蛋白(CRP)、糖化血红蛋白( HbA1c)、IL-6等生化指标的表达水平。结果生化指标检测结果表明, 与健康人对照组比较,CHD组TG、TC、LDL-C、apoB、Clu、CRP、HbAlc和IL-6水平显著升高( P<0.05),而HDL-C、apoA1水平明显降低(P<0.05)。Logistie 回归结果显示,与CC基因型相比, IL-6-634C/G中的CG和GG基因型与CHD的发病风险相关,其校正OR(95%CI)分别为2.068( 1.410~ 3.032)和6.674(2.034~21.900)。CHD组和健康人对照组CC、CG和GG基因型频率分别为47.9%、39.9%、12.2%和76.2%、21.5% .2.3%,C、G等位基因频率分别为74.7%、25.3%和82.9%、17.1%;与C等位基因相比,携带G等位基因患者发生CHD的风险更高,且基因型和等位基因频率在两组间的差异均有统计学意义(P均<0.05)。IL-6-597G/A基因多态性与CHD易感性无关。结论宿迁地区人 群CHD患者风险与IL-6-634C/G 基因多态性相关,而与IL-6-597G/A基因多态性无关。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.