苯那普利逆转高血压患者左心室肥厚与血管紧张素转化酶基因多态性的关系

目的 探讨血管紧张素转化酶(ACE)基因多态性与高血压左心室肥厚(LVH)的关系。方法 应用多聚酶链反应(PCR)方法检测89例高血压LVH患者ACE基因型,同时测定血清ACE活性。观测给予口服苯那普利(10mg～20mg/d)6个月前后患者的坐位收缩压(SBP)、舒张压(DBP )、超声心动图左室重量指数(LVMI)的变化。结果 (1)89例高血压LVH患者中,ACE基因DD型30例(34％)、ID型43例(48％)、II型16例(18％),D和I等位基因频率分别为0.58和0.42。(2)治疗前 DD、ID、II基因型患者血清ACE水平分别为(278.10±70.32)U/L、（240.39±58.26）U/L和（138.96±66.45）U/ L,组间差异有显著性(P<0.01)。(3) 治疗前 DD基因型患者LVMI明显高于II基因型患者(P<0.05)。(4)所有患者苯那普利口服6个月后,SBP、DBP明显下降;但LVMI因基因型不同而呈现不同的变化,LVMI的下降幅度,DD型为12.4％,ID型为5.8％,II型为2.3％,DD型与ID型、II型相比,有显著性差异(P<0.05)。结论 (1)ACE基因I／D多态性可能与高血压LVH有关,基因DD型可能是高血压LVH的独立危险因子。(2)苯那普利可以显著降低高血压LVH患者的血压、逆转LVH,且以ACE基因DD型效果较好(与ID型、II型相比)。     

心肌梗塞病人及其子女血管紧张素转换酶基因型分析

1目的　探讨心肌梗塞与血管紧张素转换酶 (ACE)基因多态性缺失的关系。 2方法　分别选择心肌梗塞病人及其子女与正常人及其子女作为观察组和对照组 ,利用聚合酶链反应 (PCR)扩增外周血 ACE基因第 16内含子目的基因 ,琼脂糖凝胶电泳观察荧光带确认基因型。 3结果　心肌梗塞病人和正常人 ACE基因多态性分布频率 :DD型分别为 41.4%和 2 2 .0 % ,ID型为 31.0 %和 41.5 % ,II型为 2 7.6 %和 36 .6 % ,观察组 DD型高于对照组 ,差异有显著性 (χ2 =4.2 1,P<0 .0 5 )。心肌梗塞病人子女和正常人子女的 ACE基因型分布频率 :DD型分别为35 .3%和 18.7% ,ID型为 34.5 %和 43.8% ,II型为 30 .3%和 37.5 % ,观察组子女 DD型分布频率高于对照组 ,差异有显著性 (χ2 =4.31,P<0 .0 5 )。 4结论　 ACE基因多态性缺失是预测心肌梗塞发病的重要危险因素之一     

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.     

缺失型血管紧张素转换酶基因与重庆地区原发性高血压的关系

目的 :为探讨重庆地区原发性高血压与血管紧张素转换酶基因 (ACE)插入 /缺失 (I/D)多态性的关系。方法 :采用多聚酶链反应直接扩增ACE基因第 16内含子 ,对 114例正常人和 75例原发性高血压患者进行分析 ,得到三种基因型 :纯合插入型 (II型 )、纯合缺失型 (DD型 )、杂合型 (ID型 )。结果 :原发性高血压患者ACE基因的DD型频率明显高于正常人 (χ2=13.75 ,P <0 .0 0 5 ) ,D等位基因频率也明显高于正常人 (χ2 =14.3 ;P <0 .0 0 5 ) ,统计学分析差异有显著性意义。结论 :ACE基因的缺失型 (DD型 )可能与重庆地区原发性高血压的发病有关系     

妊娠期高血压疾病与血管紧张素转换酶基因多态性的关系

目的:探讨妊娠期高血压疾病(pregnancy induced hypertension,PIH)与血管紧张素转换酶基因多态性的关系.方法:运用多聚酶链反应技术检测54例妊娠期高血压疾病患者,100例正常妊娠妇女血管紧张素转换酶基因多态.结果:妊娠期高血压疾病患者ACE基因II、ID、DD基因型频率分别为29.6%、25.9%、44.5%,对照组II、ID、DD基因型频率分别为42.0%、39.0%、19.0%,两组D等位基因各为57.4%、38.5%.两组的DD基因型及D等位基因频率比较差异有显著性意义.结论:ACE基因多态性与妊娠期高血压疾病的发病有关.     

新疆维吾尔族ACE基因I/D多态性分析及其血清ACE水平的相关性

目的　调查新疆维吾尔族血管紧张素转换酶 (ACE)基因I/D多态性分布及其血清ACE水平的相关性。方法　通过两次聚合酶链反应测定 81例健康维吾尔族ACE基因。结果　所有被调查的 81例健康维吾尔族人ACE基因中 ,DD型占2 5 9%,DI型占 48 1%,II型占 2 5 9%,D与I等位基因出现频率均为 0 5 0。 3种基因型中 ,DD型个体ACE水平最高 ,DI型者次之 ,II型者最低 ,有统计学意义。结论　维吾尔族ACE基因DD型为 2 5 9%。ACE基因DD型与血清ACE水平显著相关 (P <0 0 5 ) ,维吾尔族ACE基因的DD型同其他民族一样可能通过影响ACE水平而导致心血管疾病发病。     

高血压与血管紧张素转换酶基因多态性及血清水平的关系探讨

目的:探讨高血压与血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性及血清中ACE水平的关系。方法:应用聚合酶链反应扩增105例高血压患者和116例健康对照者的ACE基因上的DNA片段,并同时检测血清ACE水平,比较不同基因型间这些指标的差异。结果:高血压组缺失等位基因D频率58.57%和DD基因型频率35.24%,显著高于健康对照组的37.07%和18.11%(P<0.05)。同时血清ACE水平与基因型关系依次为DD型>ID型>II型,三型之间均有显著性差异(P<0.05)。结论:ACE基因的缺失多态性及血清ACE水平与高血压有关。     

哮喘患儿血管紧张素转换酶基因多态性的初步研究

目的探讨哮喘患儿血管紧张素转换酶（angiotensin converting enzyme,ACE）的基因型及其分布。方法提取87例哮喘患儿（实验组）和58例正常儿童（对照组）外周血基因组DNA,用PCR方法检测其ACE的基因型。结果实验组基因型为缺失型纯合子DD型38例、缺失型杂合子ID型19例、插入型纯合子II型30例,对照组基因型为缺失型纯合子DD型9例、杂合子ID型18例、插入型纯合子II型31例,两组基因型构成差异有统计学意义（P〈0.05）。实验组等位基因D的频率为54.59%、I为45.41%,对照组的等位基因D的频率为31.03%、I为68.97%,两组等位基因频率差异有统计学意义（P〈0.05）。结论哮喘患儿ACE的基因型以DD型为多见,ACE的基因多态性和儿童哮喘的易感性有关,可能是儿童哮喘发生的危险性因素。     

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多态性对苯那普利治疗糖尿病肾病疗效的影响

按照血管紧张素转换酶 (ACE)基因插入 /缺失多态性不同 ,将 92例 2型糖尿病肾病患者分为II型组 31例 ,ID型组 30例及DD型组 31例。用苯那普利治疗 6个月后 ,观察治疗前后各组的尿白蛋白排泄率 (UAER)、平均动脉压 (MABP)、肌酐清除率 (Ccr)及ACE的变化。结果 :苯那普利治疗后 3组UAER、MABP、ACE均下降 ,以II型组下降幅度最大 (分别为 58.6%、2 .87kPa和 72 .3% ) ,DD型组下降幅度最小 (P <0 .0 5) ;而Ccr在DD型组下降幅度最大 ,II型组下降幅度最小 (P <0 .0 5) ;多元线性逐步回归分析显示 :ACE基因型对UAER下降率有显著回归效果(R2 =0 .72 ,P <0 .0 0 1 )。提示 :ACE基因型影响血管紧张素转换酶抑制剂 (ACEI)对糖尿病肾病的疗效 ,II基因型患者对ACEI治疗更为敏感。     

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.