黑素皮质素受体4和含钾通道四聚化结构域15基因变异与2型糖尿病及其相关性状的关联分析

目的 评价中国汉族人群黑素皮质素受体4（MC4R）基因和含钾通道四聚化结构域15（KCTD15）基因单核苷酸多态性（SNP）位点rs17782313和rs11084753与2型糖尿病、肥胖及其相关性状的关系.方法 研究对象来自北京居住的社区人群和北京大学人民医院门诊患者,2型糖尿病患者1177例（男性504例,女性673例）,非糖尿病正常对照1113名（男316名,女797名）.从正常对照人群中选择体质指数（BMI） ≥28.0 kg/m2归为肥胖组（210名）,BMI为18.5 ～ 23.9 kg/m2者归为体重正常组（389名）.采用飞行时间质谱分析法对rs17782313及rs11084753进行基因分型.各组间率的比较采用卡方检验.结果 调整年龄、性别和BMI后,在隐性、显性及相加遗传模式下,MC4R-rs17782313和KCTD-rs11084753与2型糖尿病均无相关性（均P＞0.05）.调整性别和年龄后,rs17782313在显性遗传模式下基因型与肥胖的发病相关,OR值为1.43（95％ CI 1.01 ～2.02）,P=0.042,而在相加模式和隐性模式下均未发现基因型与肥胖相关.rs11084753在三种遗传模式下与肥胖的发病均无相关性（均P ＞0.05）.正常糖耐量人群中,rs17782313和rs11084753三种基因型间年龄、BMI、腰臀比、空腹血糖、口服糖耐量试验2h血糖和空腹胰岛素差异均无统计学意义（均P＞0.05）.结论 中国汉族人群中,MC4R基因SNP位点rs17782313和KCTD15基因SNP位点rs11084753与2型糖尿病无相关性,MC4R基因SNP位点rs17782313可能与中国汉族人群肥胖相关.     

社区老年人DDAH2基因多态性与高血压的相关性研究

目的 探讨二甲基精氨酸二甲胺水解酶2(DDAH2)基因rs2272592、rs805035位点多态性及基因-环境交互作用与内蒙古包头地区人群高血压易感性之间的关系。方法 选取内蒙古包头包钢社区老年高血压患者及健康人群各282例,使用统一问卷收集研究对象的基本信息并采集外周血。外周血血细胞提取研究对象DNA,利用多重高温连接酶检测反应技术（iMLDR）检测rs805305、rs2272592位点基因多态性。采用SNPstats在线软件进行遗传模型分析;多因素条件Logistics回归法分析DDAH2基因多态性及基因-环境交互作用与高血压易感性之间的关系。结果 rs2272592位点超显性遗传模型、rs805305位点显性遗传模型为较优遗传模型（P<0.05）;多因素条件Logistics回归提示rs2272592位点G/A基因型与高血压易感性有关（P<0.05）;单因素条件Logistics回归发现rs2272592位点超显性遗传模型*睡眠总分与高血压易感性有关（P<0.05）,但调整其他环境因素后关联消失（P>0.05）。结论 rs2272592位点G/A基因型...     

IgA肾病全基因组关联分析研究

已有研究表明,遗传因素在IgA肾病发病机制中起着重要作用。近年兴起的全基因组关联分析研究(GWAS)为遗传学研究提供了新的工具和思路。中山大学附属第一医院肾内科进行了中国汉族人群IgA肾病GWAS研究,发现两个中国汉族人群特有的遗传易感位点(17p13和8p23),同时还验证了在欧美研究中发现的两个易感位点(22q12和MHC区域),并发现多个易感基因与IgA肾病各临床表型相关联。GWAS研究对于明确IgA肾病的遗传发病机制,进一步探索IgA肾病特异性治疗方法及干预新靶点具有重要的科学意义和实用价值。     

身高的遗传学研究概况

身高受遗传和环境因素共同影响,其中遗传因素对身高的影响更大。身高遗传学的基因研究,从家系单基因连锁分析到复杂疾病/性状的候选基因关联分析、全基因组关联研究,每一阶段都取得了重大成果。目前,已发现并鉴定了数百个与身高相关的遗传位点,解释了身高遗传的部分机制,但大部分相关基因位点对身高稳定精确的作用机制尚不明了,表明身高受多基因的复杂调控。该文就身高的遗传学研究概况作一综述。     

加拿大法裔人群中与肥胖相关的高血压的全基因组连锁分析

原发性高血压是一种由多种机制共同作用的多基因疾病。由肥胖导致的病理改变是与其相关的一个信号通路。我们主要研究高血压的一个亚型——肥胖相关的高血压，以寻找其致病基因。我们入选了55个有两个患病同胞或者更多患者的家系，他们均来自于地理位置偏远的加拿大法裔人群，其中15个家系的肥胖发病率较高（≥70％）。我们在所有的高血压家系和有高肥胖发病率的高血压家系中利用多位点连锁分析方法进行全基因组扫描（GeneHunter 2．1；位点密度：10cm）。在所有55个家庭的扫描中，我们在1号染色体和11号染色体上分别发现了两个连锁值显著（LOD score=2．5）的位点D1S1597和D11S1999。我们对仅患有肥胖高血压的家系进行扫描，在1号染色体的同一区域内发现连锁值最显著（LOD score=3．1）的一个位点是D1S1597。然后我们又D1S1597周围的其他遗传标记进行基因分型，得到了一个连锁更加显著的位点D1S2672（LOD score=3．5）。与肥胖高血压相关的许多候选基因都位于这个区域，其中包括肿瘤坏死因子受体2（tumor necrosis factor receptor 2）和心房利钠肽基因（atrial natriuretic peptide genes）。这些结果表明，研究临床定义明确的高血压亚型可能有助于寻找、鉴定复杂性疾病的致病基因，例如本研究中利用肥胖相关的高血压亚型。     

我国北方汉族人群甲状腺腺瘤相关基因单核苷酸多态性与2型糖尿病的关联研究

目的 评估甲状腺腺瘤相关基因（THADA）与中国北方汉族人群2型糖尿病（T2DM）的相关性。方法以1050例T2DM患者和1030名糖耐量正常者（NGT）为研究对象,采用病例一对照研究设计,对THADA基因区的5个单核苷酸多态性（SNPs）位点：rs13026309、rs13029250、rs13022691、rs4952986、rs6739828进行基因分型,通过Logistic回归、线性回归分析等位基因变异与T2DM及其相关性状的关联。结果女性NGT人群在相加遗传模式下调整年龄、性别和BMI后,rs4952986位点与FIns（P=0．0095）、HOMA—IR（P=0．0123）、HOMA-β（P=0．0089）相关。结论THADA基因的rs4952986位点在中国北方汉族女性人群中,与胰岛素抵抗、胰岛素分泌功能相关,所选的5个位点未发现与T2DM相关。     

遗传因素在原发性高血压发病中的新进展

2009年以来"全基因组关联分析"(GWAS)发现了一些血压/高血压的遗传易感位点。在此基础上识别致病基因变异、阐明它们在血压调节或高血压发病中的作用和机制,GWAS后研究更为艰巨。GWAS发现的易感位点,对血压水平及高血压发病风险的贡献很小,"遗传性缺失"(missing heritability)已成为复杂性状疾病遗传学研究的重大挑战。罕见基因变异、表观遗传、外显子组测序和全基因组测序等新策略能否挽回遗传性缺失,人们寄以希望。尽管对GWAS的评价不一,医学基因组学时代已经到来,阐明高血压发病的分子遗传机制、发现新的药物治疗靶点是今后努力方向。     

上海地区胰升糖素样肽1受体基因多态性与2型糖尿病相关

目的研究胰升糖素样肽1受体(GLP1R)基因的单核苷酸多态性(SNP)与上海地区汉族人群2型糖尿病的相关性。方法选取上海地区无亲缘关系的2型糖尿病患者360例及正常对照313名,其中糖尿病患者分为肥胖组192例(BMI>28kg/m2,且仅用口服降糖药治疗)及非肥胖组168例(BMI<25kg/m2,且用胰岛素治疗),采用等位基因特异的实时PCR,对GLP1R基因位点rs2268657进行基因分型,并通过相关分析,研究该位点与2型糖尿病的相关性。结果GLP1R基因rs2268657位点AA、AG、GG基因型频率在对照人群中分别为0.086,0.447,0.446;在非肥胖糖尿病组中分别为0.155,0.375,0.470,在肥胖糖尿病组中分别为0.109,0.500,0.391。在正常人基因型AA频率与非肥胖糖尿病组相比差异有统计学意义(OR=1.939,P<0.05),而与肥胖糖尿病组相比差异无统计学意义。结论GLP1R基因多态性位点rs2268657可能与胰岛素分泌不足为主的2型糖尿病有关。     

高糖负荷和高升糖指数的膳食增加心血管病的危险

既往研究表明，膳食升糖指数和糖负荷与血脂异常、糖尿病和肥胖等心血管病危险因素有关，但它们与心血管病的关系尚不明确，特别是在以中等糖负荷膳食为主的人群和肥胖人群中的特点尚有待阐明。荷兰学者Beulens等的研究发现，在以中等糖负荷膳食为主的女性中，高膳食糖负荷和升糖指数可增加心血管病的危险，尤其在超重和肥胖的女性中更为明显。     

GNB3基因C825T多态性与心血管疾病

GNB3基因C825T多态位点的发现已有五年历程，它在不同种族中的分布不同。由于G蛋白在信号转导过程中起“分子开关”作用，介导许多血管活性及增殖有关的细胞内效应，所以该位点的多态性与心血管疾病的关系受到广泛关往。目前已确定该位点与白种人高血压、肥胖显著相关。在亚洲人群的研究资料较少，目前缺乏它与高血压、肥胖相关的证据。它与左室肥厚、冠心病发生的关联性尚存争议。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.