一个先天性甲状腺功能亢进症家系的排除性定位分析

目的 对一个常染色体显性遗传的先天性甲状腺功能亢进症家系,进行与已知致病基因TSHR和THRB的连锁分析以确定此家系致病基因是否为这2个已知基因.方法 选择3个与TSHR和THRB紧密连锁的微卫星标记物D14S74、D3S2338和D3S1266,进行微卫星标记的基因连锁分析,采用Genemapper 3.5软件分析数据. 结果 3个微卫星标记物的LOD值均小于1,显示该家系致病基因与这3个位点均不连锁,提示该家系可能存在新致病基因. 结论 常染色体显性遗传类型的先天性甲状腺功能亢进症可能有新致病基因.     

常染色体显性遗传性先天性白内障一家系致病基因的初步定位

目的 初步定位常染色体显性遗传性先天性白内障(ADCC)一家系的致病基因。方法 收集ADCC一家系资料，在已知先天性白内障致病基因和位点附近，选择合适的短串联重复序列多态性标记(STRP)，对ADCC一家系进行连锁分析，使用Mlink软件采用对数优势记分法(LOD)计算LOD值。结果 在STRP中，D17S805、D17S1294及D17S1293与致病基因位点连锁的最大IDD值分别为2．03、2．49及2．22(重组率θ=0)。结论 该ADCC家系的致病基因初步定位在第17对染色体上；CRYBA1基因为候选基因。     

常染色体显性先天性白内障大家系致病基因定位的初步研究

目的:报道1个涉及5代17例患者的常染色体显性先天性白内障(ADCC)大家系,并进行致病基因的定位. 方法:对家系中8例患者进行眼科检查后明确临床表型,并提取所有血样的基因组DNA.首先对已报道的中国ADCC家系致病位点(9个基因的16个突变位点)进行DNA测序,然后根据已报道的17个ADCC候选基因和13个染色体区域,选取27个微卫星分子标记,应用LINKAGE软件进行连锁分析. 结果:8例患者均为先天性核性白内障.直接DNA测序未发现有已报道的中国家系基因突变.所选取的27个微卫星分子标记与该家系致病基因均不连锁. 结论:该ADCC家系致病基因不在已报道的17个ADCC候选基因和13个染色体区域,该家系中可能存在一个新的ADCC致病基因.     

应用遗传连锁分析法对伴传导功能障碍的扩张型心肌病家系致病基因的定位

目的: 对一个常染色体显性遗传扩张型心肌病(familial dilated cardiomyopathy,FDCM)家系进行基因定位。方法: 收集FDCM 家系, 对该家系成员进行详细心血管内科检查确诊为扩张型心肌病,且伴发有传导功能障碍;采集外周血3～5 mL,并抽提基因组DNA;选取与该表型相关的已定位区间CMD1A(1q21.2-q21.3),CMD1H(2q14-q22), CMD1E(3p22-p25)和CMD1F(6q22-23)内的共计18个微卫星DNA标记,在该家系中进行排除性定位分析;最后,进行全基因组扫描及连锁分析。结果：①已定位区间的18个微卫星DNA标记位点的LOD值均<-2,证实该家系与已知DCM位点不连锁;②全基因组扫描及两点连锁分析结果显示,该家系致病基因位点与遗传标记D3S1614(3q26)连锁, 在θ= 0时得到最大LOD值2.68。结论: 该家系与已知的4个DCM位点均不连锁,其致病基因位于D3S1614（3q26）附近的一个新位点。     

甘肃地区一遗传痉挛性截瘫家系致病基因的定位

目的：对中国甘肃地区一个常染色体显性遗传痉挛性截瘫家系致病基因的初步定位研究．方法：用常见的常染色体显性遗传痉挛性截瘫的3个基因区域内的10个微卫星位点D14S264、D14S75、D14S69、D14S266、D14S66、D2S2347、D2S2255、D2S2351，D15S128、GABRB3对该家系致病基因进行等位基因共享分析及连锁分析．结果：该家系致病基因在SPG4基因区域的D2S2351位点连锁(θ=0，最大LOD值为2．71)．结论：该家系致病基因在SPG4基因座，疾病基因是spastin．     

遗传连锁分析法对一常染色体显性遗传性视网膜色素变性家系的基因定位研究

目的：对一个常染色显性遗传性视网膜色素变性（autosomal dominant retinitis pigmentosa,ADRP)大家系进行基因定位。方法：收集ADRP家系，对该家系成员进行详细眼科检查确诊为视网膜色素变性（retinitis pigmentosa,RP），采集外周血3－5ml并抽提DNA；采用多个已知遗传标记与该家系致病基因位点进行连锁分析。结果：两点连锁结果显示该家系致病基因位点与遗传标记1D3S1292连锁，在θ=0.1时得到最大LOD分数2．73。结论：由于D3S1292位于3号染色体长臂21区（3q21)，从而将该家系致病基因位点大致定位于3q21附近。     

一个疑似X连锁型视网膜色素变性家系的遗传连锁分析的研究

目的对一个疑似X连锁型视网膜色素变性(X-linked retinitis pigmentosa,XLRP)家系进行分析,确定其致病基因的所在位点。方法选取已知XLRP候选基因附近的微卫星位标,用多点参数分析方法计算其最大优势对数值(LOD score),并通过对家系成员单倍型分析,确定该家系致病基因所在的染色体位置。结果位于X染色体长臂的微卫星标记DXS8043与该例遗传家系间最大LOD值小于-2,其他位于X染色体短臂的11个微卫星标记与该例遗传家系LOD值保持在0.5上下,无明显的高值。单倍型结果表明该家系中2例患者兄弟(Ⅲ1、Ⅲ6)和他们的携带者母亲(Ⅱ2)在DXS8051与DXS1214之间拥有在正常成员中不存在的基因型,表明该基因型与疾病共分离,进一步确定了他们X性连锁遗传模式,并且可将致病基因初步定位于DXS8051与DXS1214之间的RP23和RP6基因。结论可以排除该例家系的致病位点与X染色体长臂上的RP24基因的连锁,高度怀疑连锁位点存在于X染色体的短臂的RP23和RP6基因,需另增加位标的信息量,以进一步缩小致病基因所在的具体范围。     

应用微卫星多态位点对X连锁型视网膜色素变性疾病进行遗传连锁分析的研究

目的应用遗传连锁分析方法对X连锁型视网膜色素变性家系进行分析,确定其致病基因的所在位点。方法在2个目前常见的X-连锁遗传位点——RP2和RP3处分别选取具有高信息量的微卫星位标,对2例疑似X连锁型视网膜色素变性家系进行遗传连锁分析。通过对家系成员的单倍型分析,并使用两点法计算其最大优势时数（LOD Score）值,确定致病基因所在的染色体位置。结果微卫星标记DXS993与2例遗传家系表型间最大LOD值分别为：〈-2和0．8;DXS 1068在2例遗传家系LOD值分别为0．4和0．8。结论RP2基因可能不是XY家系的致病性基因;在ZLK家系,怀疑疾病位点与RP2或RP3基因连锁。用遗传连锁分析方法确定致病基因所在染色体的范围起到重要的作用。     

一个肌萎缩侧索硬化家系D21S223微卫星位点遗传连锁分析

目的对重庆地区1例肌萎缩侧索硬化家系进行遗传连锁分析。方法采用位于21号染色体上的D21S223微卫星位点,经PCR扩增后进行基因型分析,应用GENEHUNTER软件包进行连锁分析。结果最大LOD值为3.06(Θ=0.10),说明该家系致病基因与21号染色体上的D21S223位点连锁。结论SOD1基因突变可能是引起该家系发病的原因。     

两例疑为X连锁型视网膜色素变性家系的单倍型分析研究

目的应用遗传连锁分析方法对X连锁型视网膜色素变性家系进行分析,定位其致病基因的所在位点.方法选取已知X连锁视网膜色素变性候选基因附近的短串联重复序列多态性标记(short tandem repeat polymorphism, STRP),即在RP2、RP3、RP6、RP23和RP24处分别选取具有高信息量的微卫星位标,对2例疑似为X连锁型视网膜色素变性家系进行遗传连锁分析;通过对家系成员的单倍型分析,并进行两点法连锁分析,确定其致病基因所在染色体的大致位置.结果 2例家系在DXS 993处得到的最大LOD值分别为:1.18和1.03;在DXS 1068处得到的最大 LOD值分别为:0.58和-2.69;在DXS 1214处得到的最大LOD值分别为:-2.33和-2.45;在DXS 8051处得到的最大LOD值分别为:-2.34和-2.51;在DXS 8043处得到的最大LOD值分别为:-2.23和-2.62.结论 ZCF家系的致病基因,可能不在RP3、RP6、RP23或RP24位点;而对于FYJ家系,我们则怀疑致病基因位于RP2位点,但也不排除与RP3连锁;用遗传连锁分析方法对确定致病基因所在染色体的范围起到重要的作用.     

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.