抵抗素基因+299G/A多态性与T2DM并高血压病的相关性

目的研究抵抗素基因＋299G／A多态性与中国北方地区汉族人群2型糖尿病（T2DM）并高血压病的关系。方法采用聚合酶链式反应-限制性片段长度多态性技术检测北方地区汉族人群261例T2DM患者的抵抗素基因内含子2区299G／A突变。结果T2DM组GG、GA、AA基因型及G／A等位基因频率与非T2DM组比较有显著统计学差异（P〈0．01）；T2DM组GG基因型携带者空腹血糖明显高于AA基因型携带者（P〈0．05）。多元线性逐步回归分析显示，抵抗素基因＋299G／A与收缩压、舒张压无明显相关性。结论抵抗素基因＋299G／A多态性与T2DM有关．与高血压病元明显相关性。     

2型糖尿病患者肾素血管紧张素Ⅱ1型受体基因多态性与瘦素、白介素6的相关性

目的 分析2型糖尿病患者肾素血管紧张素Ⅱ1型受体基因(AGTR1)A10208G位点多态性与瘦素(LEP)、白介素6(IL-6)的关系. 方法 PCR-RFLP法检测105例伴有肥胖的2型糖尿病患者(DM-O组)、22例不伴肥胖的2型糖尿病患者(DM-N组)及224例健康人(NC组)AGTR1基因A10208G位点多态性,并测定相应指标进行分析. 结果 (1)DM-O组AG+GG基因型分布和等位基因频率显著高于NC组;(2)DM-O组、DM-N组携A等位基因患者LEP显著高于携G患者. 结论 AGTR1基因A10208G位点多态性与伴有腹型肥胖的2型糖尿病存在相关性;LEP抵抗可能是未发生AGTR1基因A10208G位点A→G突变的2型糖尿病重要发病因素之一.     

我国西部人群脂联素基因+45位点多态性与肥胖、胰岛素抵抗及2型糖尿病的相关性

目的探讨宁夏汉族人群脂联素基因＋45位核苷酸T／G多态性与肥胖、胰岛素抵抗（IR）及2型糖尿病（T2DM）的相关性。方法采用聚合酶链式反应-限制性内切酶长度多态性技术，对100例T2DM患者和101例正常对照（NC）者脂联素基因＋45位点进行基因分型；并计算BMI和HOMA-IR。结果（1）T2DM组GG基因型频率明显高于NC组（P〈0．01），G等位基因频率明显高于NC组（P〈0．01）。（2）在T2DM组中，GG＋TG基因型的BMI、HOMA-IR大于TT基因型（P〈0．01）。在NC组中，各基因型间BMI、HOMA-IR的差异无统计学意义。在T2DM组中，而BMII〉25组的GG＋TG基因型频率高于BMI〈25组（P〈0．01），G等位基因频率也高于BMI〈25组（P〈0．01）。结论脂联素基因＋45位核苷酸T／G多态性与肥胖、IR及T2DM相关。     

中国汉族人群Calpain-10基因UCSNP43多态性与2型糖尿病相关性的meta分析

对中国汉族人群Calpain-10基因UCSNP43位点多态性与2型糖尿病的相关性进行meta分析.Calpain-10基因UCSNP43位点G等位基因、GG基因型可能是中国汉族人群2型糖尿病的危险因子;A等位基因、GA基因型可能为保护因子.     

中国汉族人群Calpain-10基因UCSNP43多态性与2型糖尿病相关性的meta分析

对中国汉族人群Calpain-10基因UCSNP43位点多态性与2型糖尿病的相关性进行meta分析.Calpain-10基因UCSNP43位点G等位基因、GG基因型可能是中国汉族人群2型糖尿病的危险因子;A等位基因、GA基因型可能为保护因子.     

中国汉族人群Calpain-10基因UCSNP43多态性与2型糖尿病相关性的meta分析

对中国汉族人群Calpain-10基因UCSNP43位点多态性与2型糖尿病的相关性进行meta分析.Calpain-10基因UCSNP43位点G等位基因、GG基因型可能是中国汉族人群2型糖尿病的危险因子;A等位基因、GA基因型可能为保护因子.     

二乙基对硝基苯磷酯酶2基因G/A148多态性与2型糖尿病及血脂的关系

目的：了解二乙基对硝基苯磷酯酶（PON）2基因G／A148多态性与中国北方地区人群2型糖尿病的相关性及其与血脂等的关系。方法：采用配偶对的病例－对照研究设计，用聚合酶链反应（PCR）－长度多态性的方法检测PON2基因G／A148多态性。结果：PON2基因G／A148多态性的基因型频率和等位基因频率在2型糖尿病组和对照组间差异无显著性意义。与非肥胖、无G等位基因相比，肥胖无G等位基因时，发生2型糖尿病的危害险度（OR）值为2．04；肥胖有G等位基因时，OR增至3．18。在对照人群中，含G等位基因组的总胆固醇（TC）、低密度脂蛋白（LDL）及载脂蛋白B（ApoB)水平均比AA基因型组高。G等位基因对高脂血症的OR为2．48，P＝0．5。结论：在中国北方地区人群中PON2基因G／A148多态性与肥胖有协同促进2型糖尿病发生的作用。在非糖尿病人群中，此多态性与总胆固醇等血脂水平显著相关。     

抵抗素基因299G/A多态性与2 型糖尿病的相关性研究

2001年Steppan等研究罗格列酮药理作用时发现并提出抵抗素可能是连接肥胖和糖尿病(DM)之间的桥梁。迄今已发现30多个抵抗素基因多态性位点，Osawa等认为其中的内含子2区299G／A多态性可能与2型糖尿病(T2DM)某种表型相关。本研究拟探讨抵抗素基因299G／A多态性与中国汉族人T2DM的相关性。     

人尿酸盐转运子1基因多态性与中国汉族人群高尿酸血症相关性研究

目的 研究人尿酸盐转运子1(hURAT1)基因多态性与原发性高尿酸血症的相关性.方法 选择原发性高尿酸血症患者(病例组)215例,正常对照组323例.采用PCR方法分别扩增hURAT1基因第2、3、4外显子及外显子内含子交界处,分析该区域内多态性位点与原发性高尿酸血症的相关性.结果 在中国汉族人群hURAT1基因中,共发现5个多态性位点.其中,在第3内含子区发现1个新的多态性位点11 G＞A.病例组AA+AG基因型频率明显高于对照组(11.6%比3.7%,P=3.81×10-4);突变型等位基因(A等位基因)频率明显高于对照组(6.0%比1.9%,P=2.66×10-5).A等位基因构成的基因型AA+AG基因型使高尿酸血症发病风险增加了3.41倍(OR=3.41,95% CI=1.67～6.95).单倍型分析显示,包含第3内含子11 G＞A突变型A等位基因的单倍型在病例组中的频率显著高于对照组,与原发性高尿酸血症发病危险性密切相关(69.44%比30.56%,P＜0.001).结论 hURAT1基因第3内含子11 G＞A多态性与中国汉族人群原发性高尿酸血症密切相关.     

髓过氧化物酶463G／A基因多态性与急性冠脉综合征的相关性

目的研究髓过氧化物酶基因—463bp处G／A多态位性与急性冠脉综合征（ACS）的关系。方法选择急性冠脉综合征（ACS组）136人，包括急性心肌梗死58例和不稳定型心绞痛79例，对照组62人，采用病例一对照的研究方法，采用聚合酶链反应一限制性片段长度多态性技术进行髓过氧化物酶（MPO）基因463bp处G／A多态性基因型分析。结果携带至少一个等位基因的基因型（GG＋GA）患ACS的风险是A／A的2．11倍，携带G等位基因发生ACS的风险是携带A等位基因的2．20倍。结论MPO基因多态性与ACS的易感性有相关性，G等位基因可能是ACS的危险因素。     

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.     

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.     

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.     

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。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

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.     

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.