人体结直肠癌Ki—ras基因点突变检测

采用ＰＣＲ和寡核苷酸探针杂交技术检测了３５例结直肠癌和５例息肉活检组织Ｋｉ－ｒａｓ基因第１２位密码子的点突变，发现１０例结直肠癌具有点突变，其中ＧＧＴ－ＧＴＴ（Ｇｌｙ－Ｖａｌ）突变３例，ＧＧＴ－ＧＡＴ突变７例；１例从有突变（ＧＧＴ－ＧＴＴ）。     

PCR—SSP快速检测胰腺癌石蜡切片中K—ras基因点突变

胰腺癌第１２位点Ｋ－ｒａｓ基因点突变检出率达７２％～１００％，检测其点突变方法有数种。我们采用针对Ｋ－ｒａｓ基因点突方式设计的引物，对胰腺癌石蜡包埋组织进行多聚酶链反应（ＰＣＲ），产物借助常规电泳即可判定有无Ｋ－ｒａｓ基因突变及突变方式，无需酶切，杂交，放射性及非放射性显影等技术，研究发现：３１例胰腺癌标本有２３例存在Ｋ－ｒａｓ基因点突变，方式分别为ＣＧＴ，ＧＡＴ，ＧＴＴ，而９例正常胰腺组织，１９     

白血病中N－ras基因点突变的研究

Ｎ－ｒａｓ基因是ｒａｓ基因族其中一种，主要以点突变的方式激活。分子生物学研究提示，Ｎ－ｒａｓ的激活与白血病的发生存在一定程度的相关。此项工作取材９例急性髓细胞性白血病（ＡＭＬ）患者，以７例正常体检者为对照进行了Ｎ－ｒａｓ基因点突变的初步研究。研究样本均取自北京的三级医院，所有患者均被所在医院确诊为ＡＭＬ，其中男性４例，女性５例，平均年龄３７岁。点突变的探测方法采用等位基因特异寡核苷酸探针（ＡＳＯ）斑点杂交方法，人工合成ＡＳＯ探针４种，长度均为２０ｍｅｒ。探测对象为Ｎ－ｒａｓ基因第１２，１３位密码子Ｇ→Ａ的点突变。为验证方法的可靠性，对一例阳性发现者进行了ＤＮＡ序列分析。研究发现在９例ＡＭＬ患者中，３例发现有Ｎ－ｒａｓ第１２位密码子Ｇ→Ａ的点突变。对照中未发现相同的点突变但有１例发现携有Ｎ－ｒａｓ第１３位Ｇ→Ａ的点突变。研究结果提示，Ｎ－ｒａｓ基因点突变，尤其是第１２位密码子的点突变，与白血病病因存在一定相关性。Ｎ－ｒａｓ在正常人中的突变情况及其意义尚需进一步探索。     

PCR－SSP快速检测胰腺癌石蜡切片中K－ras基因点突变

胰腺癌第１２位点Ｋ－ｒａｓ基因点突变检出率达７２％～１００％，检测其点突变方法有数种。我们采用针对Ｋ－ｒａｓ基因点突变方式设计的引物，对胰腺癌石蜡包埋组织进行多聚酶链反应（ＰＣＲ），产物借助常规电泳即可判定有无Ｋ－ｒａｓ基因突变及突变方式，无需酶切、杂交、放射性及非放射性显影等技术。研究发现：３１例胰腺癌标本有２３例存在Ｋ－ｒａｓ基因点突变，方式分别为ＣＧＴ、ＧＡＴ、ＧＴＴ，而９例正常胰腺组织、１９例胰腺良性疾病、７例胆管癌及４例十二指肠乳头癌均未见Ｋ－ｒａｓ基因突变。该法简便、快速、特异、灵敏，易临床推广应用，可以作为胰腺病变良恶性鉴别的一种新方法。     

乳腺癌P53基因点突变的检测

目的：探讨Ｐ５３基因点突变检测在乳腺癌预后判断中的意义。方法：应用聚合酶链反应———单链构像多态性（ＰＣＲＳＳＣＰ）方法对３５例乳腺癌患者的Ｐ５３基因位点的点突变进行检测。结果：３例出现点突变，经ＤＮＡ序列分析，１例为第１３６密码子ＣＡＡ（Ｇｌｎ）被ＣＡＧ（Ｇｌｎ）替代，１例为第２２７密码子ＴＣＴ（Ｓｅｒ）被ＧＣＴ（Ａｌａ）替代，１例为第２７３密码子ＣＧＴ（Ａｒｇ）被ＣＡＴ（Ｈｉｓ）替代。结论：Ｐ５３基因突变可能是引起乳腺癌分化不良的因素之一，并可能预示着乳腺癌预后较差。     

结核分支杆菌耐利福平基因rpoB变异机理及其检测的研究

目的 研究耐利福平株结核分支杆菌ｒｐｏＢ基因变异及其ＰＣＲ－ＳＳＣＰ检测方法。方法 ＰＣＲ法扩增ｒｐｏＢ基因,纯化克隆,大量质粒制备,经ＡＢＩ３７７系统直接测序。结果 １７例多耐药结核菌,１４侏检测出ｒｐｏＢ基因变异。４９６（Ａｒｇ）,５０７（Ｇｌｙ→Ａｓｐ）,５７９（Ａｌａ→Ｇｌｙ）和５８３（Ｐｒｏ→Ｌｅｕ）密码子变异未风报道。全部为点突变,主要是错义突变。在５１１－５３３密码子区域变异只占６６     

人口腔粘膜鳞癌中Ha－ras癌基因第12位密码子G→T突变的研究

采用聚合酶链反应和寡核苷酸探针杂交技术，检测２１例口腔粘膜鳞癌组织中Ｈａ－ｒａｓ癌基因第１２位密码子Ｇ→Ｔ突变，结果有６例存在这种点突变（２８．６％），而１０例正常口腔粘膜组织无１例发生这种突变。提示：Ｈａ－ｒａｓ癌基因第１２位密码子Ｇ→Ｔ突变可能导致口腔癌中癌基因的激活。并对点突变的临床意义进行了讨论。     

天津地区国人CETP第15外显子突变（Asp^442→Gly）频率

目的：检测胆固醇酯转移蛋白第１５外显子突变（Ａｓｐ＾４４２→Ｇｌｙ）,为探讨ＣＥＴＰ在ＡＳ发生、发展中的作用提供基础数据和参考资料。方法：利用特异设计的错配碱基引物,在ＰＣＲ扩增获得的人ＣＥＴＰ第１５外显子突变片段人工导入了－ＭｓｐＩ酶切位点,根据酶切片段的电泳图谱检测人ＣＥＴＰＡｓｐ＾４４２→Ｇｌｙ突变。结果：１３１例正常成年人中发现４例杂合子突变,突变率为３．０５％,首次证实Ａｓｐ＾４４２→Ｇ     

PCR-SSP快速检测胰腺癌Ki-ras基因点突变

ＰＣＲ－ＳＳＰ快速检测胰腺癌Ｋｉ－ｒａｓ基因点突变戴存才刘训良杜竞辉苗毅张兆松陈淑贞中华病理学杂志１９９６，２５（５）：２９６为判定有元Ｋｉ－ｒａｓ基因突变及突变方式，我们采用针对Ｋｉ－ｒａｓ基因点突变方式（ＣＧＴ、ＧＴＴ、ＧＡＴ）设计的顺序特异性引...     

成都地区β地中海贫血基因突变型及产前基因诊断初步分析

我们通过ＤＮＡ扩增和等位特异寡核苷酸探针杂交，检测了成都地区可疑β地中海贫血（简称地贫）患者３３个家系，９５人。共检出５８例、７３条染色体的β珠蛋白基因突变。其中，Ｃｏｄｏｎ１７（Ａ→Ｔ）突变２８例（３８．４％）ｌｃＯｄｏｎ４１－４２（－ＴＴＣＴ）突变２１例（２８．８％）；ＩＶＳ－Ⅱ－６５４（Ｃ→Ｔ）突变１４例（１９．０％）；ｎｔ－２８（Ａ→Ｇ）和ｎｔ－２９（Ａ→Ｇ）突变分别是６例（８．２％）和４例（５．５％）。在测知双亲β地贫突变类型的基础上，对两例β地贫风险胎儿采羊水细胞分离ＤＮＡ，用相同方法进行了产前基因诊断，获满意结果。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.