人类白细胞抗原-DRB基因多态性与儿童哮喘易感性的相关性研究

目的通过对人类白细胞抗原（HLA）-DR基因的检测,探讨哮喘儿童HLA-DRB基因型基因多态性与儿童哮喘易感性的关系。方法将元血缘关系的84名哮喘儿童（哮喘组）和168名无哮喘和特应性疾病的健康个体（对照组）纳入研究。采用Phannaeia UniCAP系统检测哮喘儿童的血清总IsE水平,同时完成l0种吸人性过敏原皮肤实验。应用基因芯片法检测HLA-DR的21个基因位点。结果支气管哮喘组HLA＊DRBl＊070X基因和HLA—DRBl＊11XX基因频率（分别为2．98％和13．69％）高于对照组（分别为0．3％和5．95％,r=6．915,P〈0．05和矿=9．478,P〈0．01）,优势比（衄）分别为10．57（95％CI1．215—91．986）和2．79（95％Cl1．429～5．449）;HLA—DRB3（52）^＊010X基因频率在哮喘组为7．14％,低于对照组的13．99％（X^2=5．854,P〈0．05）,OR为0．429（95％C10．214—0．862）。结论HLA-DRBl＊070X基因和HLA-DRBl＊11XX基因与哮喘儿童易感性相关;HLA-DRB3（52）^＊010X基因则为抗性基因。     

支气管哮喘儿童HLA-DRB1、DQB1免疫遗传学分析

目的 探讨支气管哮喘儿童HLA-DRB1、DQB1免疫遗传特征。方法 应用聚合酶链反应-序列特异性引物（PCR-SSP）方法,对随机抽取的45例支气管哮喘儿童（实验组）和45例健康儿童（对照组）进行HLA-DRB1,DQB1基因分型。结果 支气管哮喘儿童（实验组）HLA-DRB1＊0901,DQB1＊0201基因频率明显高于健康儿童（对照组）（25.56%比5.56%,χ^2=13.703,Pc〈0.012;26.67%比4.44%,χ^2=16.917,Pc〈0.007）;而HLA-DRB1＊15,DQB1＊0301基因频率明显低于健康儿童（对照组）（5.56%比22.22%,χ^2=10.452,Pc=0.012;7.78%比24.44%,χ^2=9.249,Pc=0.014）。其余等位基因的频率比较均无明显的差异。结论 HLA-DRB1＊0901,DQB1＊0201基因可能是支气管哮喘儿童的易感基因,而HLA-DRB1＊15、DQA1＊0301则可能是保护基因。     

HLA-DR基因与广西钦州市人群肺结核的相关性研究

目的探讨人类白细胞抗原HLA-DR等位基因与广西人群肺结核发病相关性,寻找与肺结核发病可能相关的HLA-DR易感基因。方法采用病例-对照研究方法,应用聚合酶链反应-序列特异性引物（PCR-SSP）技术对100名肺结核患者和105名健康对照者的HLA-DR等位基因进行分型,比较其等位基因频率（GF）并计算其比值比（OR）。结果肺结核病组中的HLA-DRB1＊14频率（12.0%）明显高于对照组（3.8%）,其差异具有显著统计学意义（χ2=4.775,P=0.029,OR=3.443）;肺结核病组中的HLA-DRB1＊13的频率（23.0%）明显低于对照组（42.9%）,其差异亦具有显著统计学意义（χ2=9.111,P=0.003,OR=0.398）。结论 HLA-DRB1＊l4基因可能与广西人群肺结核的发病密切相关,而HLA-DRB1＊13基因可能对广西人群肺结核发病具有拮抗作用。     

支气管哮喘与HLA-DRB1基因多态性关系的研究

目的：探讨人类白细胞抗原HLA-DRB1基因多态性与支气管哮喘的关系。方法：选用序列特异性引物聚合酶链反应（PCR-SSP）方法对内蒙古地区汉族支气管哮喘病人45例进行HLA-DRB1等位基因的检测,并与46例健康汉族进行比较,计算各个位点的基因分布频率,相对危险度,结果进行χ2检验,筛选有意义基因。结果：支气管哮喘组HLA-DRB1＊0901基因频率（16.67%）较对照组（5.43%）增高（P〈0.05）,相对危险度（OR）为4.100;HLA-DRB1＊0701-0702基因频率（1.11%）较对照组（10.87%）降低（P〈0.05）,OR值为0.082。结论：HLA-DRB1＊0901基因与支气管哮喘的发病相关,是内蒙古地区汉族支气管哮喘病人的易感基因,HLA-DRB1＊0701-0702基因位点是汉族支气管哮喘病人的抗性基因。     

自身免疫性肝炎与人类白细胞抗原Ⅱ类等位基因的相关性

目的探讨分析自身免疫性肝炎（autoimmune hepatitis,AI H）与人类白细胞抗原（human leucocyte antigen,HLA-DRB1）Ⅱ类等位基因的相关性,评估易感基因与AI H临床及实验室特征关系。方法采用序列特异性多聚酶链反应（polymerase chain reaction with sequence specific primers,PCR-SSP）技术,对已确诊的38例AI H患者和41例健康对照者进行HLA-DRB1等位基因分析。结果携带HLA-DRB1＊04和HLA-DRB1＊03等位基因的AI H患者出现频率（18.42%和14.47%）明显高于健康对照组（7.31%和4.87%,χ2分别为9.52和7.40,P均〈0.05）,组间比较差异有统计学意义。携带HLA-DRB1＊05等位基因在AI H患者中出现等位基因频率（5.76%）低于健康对照组（14.63%）,两组相比差异同样有显著性（χ2=5.89,P〈0.05）。携带其他等位基因的患者在与健康对照组比较中两组间出现频率虽有不同,但经较正P值后差异无显著统计学意义（χ2=0.18,P〉0.05）。HLA-DRB1＊04和HLA-DRB1＊03等位基因在AI H患者中出现的频率与临床肝硬化的表现存在着一定的联系。结论HLA-DRB1＊04和HLA-DRB1＊03等位基因与AI H有一定相关性,HLA-DRB1＊05可能为AI H的抗性保护基因。基因型的检测有助于对临床的诊断和治疗提供实验数据。     

CD40基因多态性与急性冠状动脉综合征、高血压和糖尿病的易感相关性

目的探讨CD40-E1SNP（-1C／T）和CD40-FASNP基因多态性与中国汉族人群急性冠状动脉综合征（ACS）的易感相关性。方法采用聚合酶链反应限制性片段长度多态性（PCR-RnP）和DNA测序技术,检测160例经冠状动脉造影确诊的ACS患者和92例冠状动脉造影阴性人群CD40-E1SNP（-1C／T）、CD40-FASNP基因型和等位基因频率,分析两组人群CD40基因型和等位基因频率差异,并用Logistic回归模型分析CD40基因多态性和高血压、糖尿病对ACS的影响。结果CD40-1位点c等位基因频率在ACS组与对照组分别为0．606和0．489,T等位基因频率分别为0．394和0．511,两组差异有统计学意义（P〈0．05）;ACS患者CC基因型频率（0．281）明显高于对照组（0．130）,差异有统计学意义（P〈0．01）;C等位基因显著增加ACS的患病风险（OR：1．608,95％可信区间t1．12—2．32,P：O．011）;调整年龄、性别、体重指数后,Logistic回归分析CD40基因及其与高血压、糖尿病对ACS的危害作用,单独c等位基因型OR值为1．608（95％可信区间：1．12-2．32,P〈0．05）,C等位基因-有高血压OR值为5．71（95％可信区间：1．12-29．08,P〈0．05）,C等位基因-无糖尿病OR值为1．44（95％可信区间：1．12-5．13,P〈0．01）,C等位基因-有糖尿病OR值为2．35（95％可信区间：1.47-4．82,P〈0．01）。未检测到CD40-FASNP基因多态性。结论CD40-1C／T基因多态性与ACS有相关性,C等位基因携带者合并高血压、糖尿病显著增加患ACS的危险性,而汉族人群可能不存在CD40-FASNP基因多态性。     

IL-10基因启动子区-592C/A多态性与童支气管孝喘易感性研究

目的 探讨白介素10基因（IL-10）启动子区-592C/A多态性与潍坊地区汉族人群儿童支气管哮喘发病的关系.方法应用PCR-RFLP方法,对70例支气管哮喘患儿（哮喘组）和70例健康儿童（对照组）IL10基因-592C/A多态性进行检测,计算基因型和等位基因频率,采用X2检验进行组间比较.结果 两组人群IL-10基因-592C/A多态性分布具有明显差异,CC,CA,AA基因型频率哮喘组分别为5.7％,41.4％,52.9％,对照组分别为15.7％,54.3％,30.0％（X2=8.85,P＜0.05）;C和A等位基因频率哮喘组为26.4％和73.6％,对照组为42.9％和57.1％（X2=8.34,P＜0.01）;哮喘组AA基因型和A等位基因频率明显高于对照组.与CC基因型和C等位基因比较,携带AA基因型和A等位基因的儿童发生支气管哮喘的相对风险明显增加,OR值分别为4.85（95％CI：1.25～18.86）（P＜0.05）和2.09（95％CI：1.27 ～3.45） （P ＜0.01）.结论 IL-10基因-592C/A多态性与儿童支气管哮喘病的发生有关联,A等位基因可能是易感基因.     

包头地区寻常型银屑病与HLA-DRB1*07等位基因的相关性研究

目的 探讨包头市汉族寻常型银屑病患者与HLA-DRB1＊07等位基因的相关性。方法 采用聚合酶链反应-序列特异引物（PCR-SSP）法，检测60例寻常型银屑病患者及80名健康对照者的等位基因频率。并相互比较。结果 ①HLA-DRB1＊07与包头市汉族寻常型银屑病患者具有明显的相关性（P〈0．01，OR=2．72）②HLA-DRB1＊07在Ⅰ型、Ⅱ型寻常银屑病患者中分布无差异（X^2=0．16,P〉0．05）。结论HLA-DRB1＊07可能是寻常型银屑病易感基因或与易感基因相连锁。     

HLA-DRB1基因多态性与慢性乙型肝炎病毒感染的相关性研究

目的研究HLA-DRB1等位基因与HBV感染慢性化的相关性。方法用PCR-SSP方法对陕西地区汉族慢性乙肝患者108例与正常对照108人以及慢性乙型肝炎表面抗原携带者32人进行HLA—DRB1等位基因分型比较，并进行HLA-DRB1等位基因分型与HBV复制状态相关性分析。结果陕西地区汉族人HLA—DRB1等位基因以DR-B1＊04（16．2％），DRB1＊09（12．5％），DRB1＊12（11．6％），DR-B1＊15（13．4％）最为常见；病例组HLA—DRB1＊03的等位基因频率（10．6％）明显高于健康对照组（3．7％），（OR=3．10；P〈0．05）；HLA—DKB1＊07等位基因频率病例组（17．6％）明显高于健康对照组（9．3%，（OR=2．09；P〈0．05）；DRB1＊07基因位点在HBV高复制状态多见（OR=2．22；P〈0．05）。结论HLA—DRB1＊03、HLA—DRB1＊07与陕西地区汉族人HBV感染后的慢性化相关联。该研究提示HLA-Ⅱ类基因与HBV感染慢性化有关联。     

广西东兰县壮族长寿老人HLA-DRB1基因的多态性研究

目的：探讨人类白细胞抗原-DRB1（HLA-DRB1）基因与长寿的相关性。方法：应用聚合酶链式反应-序列特异引物（PCR—SSP）对东兰县150名90岁以上长寿老人（90～105岁）和143名当地健康、无血缘关系、随机抽样的成年人（20～76岁）进行HLA-DRB1基因分型并进行相应等位基因频率的比较。结果：长寿组HLA—DRB1＊1201-1202等位基因频率（10．56％）明显高于对照组（5．39％）（P=0．0239,OR=1．9067）;其余各相应等位基因频率之间的比较差异无统计学意义（均P〉0．05）。另外,在HLA—DRB1座位各等位基因中,长寿组和对照组均以HLA-DRB1＊1501等位基因的频率最高,分别为29．76％、24．74％;其次为HLA—DRB1＊1601-1602等位基因,分别为17．94％、20．23％。结论：在东兰县壮族人群中,HLA—DRB1＊1201—1202与长寿高度关联,可能通过某种未知的机制影响人类的衰老及寿命。     

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.