SLC30A8、CDKN2A/2B、HHEX、TCF7L2基因多态性与中国东北汉族人2型糖尿病的关联

目的探讨SLC30A8、CDKN2A/2B、HHEX、TCF7L2基因多态性与中国东北汉族人群2型糖尿病(T2DM)的相关性。方法应用连接酶检测反应(LDR)技术对中国吉林省长春地区113例T2DM患者及107例正常对照(NC)者SLC30A8基因rs13266634位点、CDKN2A/2B基因rs10811661位点、HHEX基因rs1111875位点、TCF7L2基因rs7903146位点的SNP进行检测。结果 SLC30A8(rs13266634)CC、CT基因型的空腹胰岛素(FINS)、胰岛B细胞功能(HOMA-B)均低于TT基因型(P0.05),总胆固醇(TC)、甘油三酯(TG)均高于TT基因型(P0.05),CC基因型的空腹血糖(FPG)高于TT基因型(P0.05)。三组CC、CT、TT基因型合并心血管并发症的构成比,差异有统计学意义(P0.05)。CDKN2A/2B(rs10811661)TT、CT基因型的FINS、HOMA-B均低于CC基因型(P0.05),FPG、糖化血红蛋白(Hb A1c)、TC均高于CC基因型(P0.05),TT基因型的TG高于CC基因型(P0.05)。三组CC、CT、TT基因型合并微血管并发症的构成比差异有统计学意义(P0.05)。HHEX(rs1111875)GG、GA基因型的FINS、HOMA-B均低于AA基因型(P0.01),FPG、TC、TG均高于AA基因型,GG基因组的低密度脂蛋白胆固醇(LDL)-C高于AA基因组(P0.05)。三组GG、GA、AA基因型合并心血管并发症的构成比差异有统计学意义(P0.05)。结论 SLC30A8基因多态性位点rs13266634、HHEX基因多态性位点rs1111875与T2DM心血管并发症存在一定的相关性,CDKN2A/2B基因多态性位点rs10811661与T2DM微血管并发症存在一定的相关性。     

维吾尔族2型糖尿病与锌转运蛋白-8基因单核苷酸多态性及其交互作用的相关性分析

目的探讨锌转运蛋白-8基因(SLC30A8)的4个单核苷酸多态性(SNP)位点与维吾尔族T2DM的关联,以及SNP位点间交互作用对T2DM易感性的影响。方法选取维吾尔族T2DM患者(病例组)和健康体检者(对照组),各932名。通过体格及生化检查获得临床资料,并进行SLC30A8基因多态性检测。结果 SLC30A8基因的4个SNP中,rs13266634基因型频率、等位基因频率分布在调整协变量前后,组间比较差异均有统计学意义(P0.05);rs13266634的风险等位基因为C[P0.05,OR(95%CI):1.186(1.031~1.364)];SLC30A8基因模型分析显示,调整协变量后,两组rs13666334的加性模型[OR(95%CI):0.841(0.722~0.980)]、rs3802177的显性基因模型[OR(95%CI):0.621(0.338~0.995)]、rs3802177-rs13266634单倍型(T-T)[OR(95%CI):0.846(0.734~0.976)]比较,差异有统计学意义(P0.05);广义多因子降维法(GMDR)分析显示,各SNP位点间协变量调整前后均无交互作用(P0.05)。结论SLC30A8基因rs13666334、rs3802177与维吾尔族T2DM的易感性有关,且rs13666334位点的突变呈保护作用,其风险等位基因C有累加性,rs3802177-rs13266634单倍型(T-T)可能是维吾尔族T2DM的保护因素之一。     

SLC30 A8基因rs13266634多态性与甘肃汉族、回族2型糖尿病的相关性

目的探讨SLC30A8基因rs13266634单核苷酸多态性(SNP)在甘肃汉族、回族人群中的分布及其与2型糖尿病(T2DM)的关系。方法应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法检测汉族和回族T2DM组和对照组SLC30A8基因的基因型,同时进行人体测量学及临床指标的检测,分别采用稳态模型评估胰岛素抵抗指数(HOMA-IR)和胰岛!细胞分泌功能指数(HOMA-!)评估胰岛素抵抗(IR)和胰岛!细胞功能。结果 SLC30A8基因的基因型CC、CT和TT频率在汉族、回族T2DM组和对照组之间比较有差异(P均0.05);等位基因C、T频率在汉族、回族T2DM组和对照组之间比较亦有差异(P均0.05)。汉族C等位基因患T2DM的风险是T等位基因的1.54倍(OR=1.54,95%CI 1.09~2.16);回族C等位基因患T2DM的风险是T等位基因的1.56倍(OR=1.56,95%CI 1.09~2.22)。结论 SLC30A8基因rs13266634多态性与甘肃汉族、回族T2DM的发病相关,C等位基因可能是T2DM发病的易感基因之一。     

SLC30A8基因多态性与2型糖尿病易感性的meta分析

目的为了探讨SLC30A8(SNP:rs13266634)基因多态性与2型糖尿病(T2DM)易感性的关系。方法通过检索PubMed和CNKI数据库中有关SLC30A8基因多态性与2型糖尿病(T2DM)易感性关联研究的文献,用漏斗图评价发表偏倚,固定效应模型和随机效应模型进行meta分析,并检验异质性Q值和I2。此过程均在软件包LaunchStata9.0上完成。结果纳入11篇文献,得到12,100个2型糖尿病病例和14,907个对照。等位基因C相对于T的整体OR值为1.13(95%CI:1.09～1.17,P=0.000),CC对TT的OR为1.29值(95%CI:1.19～1.41,P=0.000)。结论SLC30A8(SNP:rs13266634)基因多态位点与2型糖尿病(T2DM)相关。     

TAGLN2基因单核苷酸多态性与广西扶绥县肝癌高发家系遗传易感性的关系

目的探讨TAGLN2基因rs2252815和rs2789422位点单核苷酸多态性与广西扶绥县原发性肝细胞癌(以下简称"肝癌")高发家系遗传易感性的关系。方法选取广西扶绥县20个肝癌高发家系成员共79例,将其中肝癌患者20例设为肝癌高发家系肝癌组,将无肝癌的直系亲属成员59例设为肝癌高发家系非肝癌组;将10个正常对照家系的成员40例设为正常家系对照组。采用飞行时间质谱技术检测TAGLN2基因rs2252815和rs2789422位点的基因型和等位基因频率;采用非条件Logistic回归分析三组人群等位基因及基因型分布频率的差异。结果 TAGLN2基因rs2252815位点存在CC、CT和TT三种基因型,其中CC基因型19例、CT基因型47例、TT基因型51例(2例未检测出相应基因型); rs2789422位点存在CC、CT和TT三种基因型,其中CC基因型72例、CT基因型43例、TT基因型3例(1例未检测出相应基因型)。肝癌高发家系肝癌组与肝癌高发家系非肝癌组或正常家系对照组进行比较,TAGLN2基因rs2252815和rs2789422位点CC、CT、TT基因型及等位基因C、T分布频率比较差异均无统计学意义(P 0. 05)。结论 TAGLN2基因rs2252815和rs2789422位点单核苷酸多态性与广西扶绥县肝癌家系遗传易感性之间无明显相关性。     

Pitx3基因多态性与帕金森病易感性的相关性研究

目的探讨Pitx3基因多态性与帕金森病(PD)易感性的关系。方法选择江苏地区汉族的215例PD患者作为PD组,同期选择健康体检者250例作为对照组,利用多重连接酶链反应方法,检测2组Pitx3 2个单核苷酸多态性(SNP)位点rs2281983和rs3758549基因分布,分析各基因型、等位基因频率、单倍型与PD易感性的关系。结果 PD组与对照组Pitx3基因SNP位点rs2281983的CC、CT和TT基因型(6.5%vs 7.2%,42.3%vs 41.2%,51.2%vs 51.6%,χ2=0.274,P=0.717)和等位基因频率(χ2=0.159,P=0.423)分布比较,差异无统计学意义。PD组与对照组rs3758549的CC、CT和TT基因型(57.8%vs 66.4%,34.4%vs 29.2%,7.9%vs 4.4%,χ2=9.144,P=0.023)和等位基因频率(χ2=10.138,P=0.011)分布比较,差异有统计学意义。2组Pitx3基因C-C、C-T单倍型分布比较,差异无统计学意义(P>0.05);与对照组比较,PD组T-T单倍型增加PD易感性(OR=1.299,95%CI:1.003¹.863,P=0.048)。结论江苏地区汉族人群中,Pitx3基因的rs3758549位点基因型分布和等位基因频率与PD易感性之间有显著关联性,Pitx3基因的单倍型TT可能与PD易感性相关。     

SLC30A8基因rs13266634位点C／T多态性与1型糖尿病易患性的关系——病例对照研究及meta分析

目的评价SLC30A8基因rs13266634位点C／T多态性与1型糖尿病的关系。方法选取2008年9月至2010年11月就诊于江苏省人民医院及其25家合作单位的351例1型糖尿病患者（糖尿病组）,其中男183例,女168例,平均年龄（20±11）岁。同期于江苏省人民医院体检中心选取429名健康志愿者（健康对照组）,其中男201例,女228例,平均年龄（23±4）岁。所有研究对象均行SLC30A8基因rs13266634位点C／T多态性分析。检索Pubmed及中文期刊CNKI数据库,入选有关SLC30A8基因rs13266634位点多态性与1型糖尿病的病例对照研究,进行meta分析。结果病例对照研究表明,糖尿病组与健康对照组SLC30A8rs13266634基因分布频率无显著差异[比值比（OR）为0．96,95％可信区间（95％ CI）=0．79～1．18,P=0．71]。共有5篇文献纳入nleta分析,其中1型糖尿病患者10646例,健康对照者10242名。2组异质性检验,2为0％,异质性检验P值为0．595,无显著异质性,故采用固定效应模型进行数据合并。纳入研究的合并OR值为1．02,95％C／为0．98～1．06,P值为0．38。Begg’s检验中P值为0．155,即纳入研究无发表偏倚。结论病例对照研究及meta分析结果均表明SLC30A8基因rs13266634位点C／T多态性与1型糖尿病易患性无显著关联。     

褪黑色素受体1B基因多态性与妊娠期糖尿病的相关性研究

目的探讨我国褪黑色素受体1B(MTNR1B)基因SNP位点rs10830963和rs1387153的多态性与妊娠期糖尿病(GDM)遗传易感性的关系。方法采用病例对照研究,分别选取GDM患者(GDM组)184例和对照(NC)组235名,利用PCR-RFLP的方法测定2个SNP位点多态性分布,并进行统计学分析。结果 GDM组FPG高于NC组(P=0.039),但孕前BMI比较差异无统计学意义。SNP位点rs10830963基因型(GG,GC,CC)频率、等位基因频率与NC组比较,差异均无统计学意义(P=0.637,P=0.422)。而SNP位点rs1387153基因型(TT,CT,CC)与NC组比较,差异有统计学意义(P=0.012),且风险基因型TT的频率高于NC组(TTvs TC+CC,P=0.01)。GDM组T等位基因高于NC组(OR:1.517,95%CI:1.147~2.006,P=0.003),且该SNP位点的TT基因型的GDM患者FPG高于其他两个基因型的患者。结论 MTNR1B基因SNP位点rs10830963与GDM无相关性,而SNP位点rs1387153与GDM的易感性相关。     

FCRL5基因多态性对安徽省汉族人群强直性脊柱炎易感性及临床表现型的影响

目的 探讨FCRL5基因中rs6427384和rs12036228位点单核苷酸多态性(SNP)对强直性脊柱炎(AS)易感性和临床表现型的影响。方法 收集安徽汉族人群AS患者169例和健康对照184名,采用基于高温连接酶的连接酶检测反应( LDR)—聚合酶链反应(PCR)方法检测其FCRL5基因中rs6427384和rs12036228位点的SNP,分析比较其等位基因频率及基因型频率在患者组和对照组中的分布,并比较不同基因型AS患者的临床表现型的差别。采用x2检验和方差分析进行统计学处理。结果 AS患者组和对照人群中rs6427384位点C等位基因频率(17.3％,25.0％)和T等位基因频率(82.7％,75.0％)及rs12036228位点C等位基因频率(92.3％,87.2％)和T等位基因频率(7.7％,12.8％)分布差异均有统计学意义(P＜0.05)。FCRL5基因rs6427384位点CC、CT和TT基因型频率在AS组（3.7％、27.2％和69.1％）和对照组（3.9％、42.2％和53.9％）之间的分布差异有统计学意义(-8.7637,P=0.0 125)。AS患者组rs6427384位点各基因型间骶髂关节X线分期(x2=34.159,P=0.0001)、疾病首发症状（腰痛或外周关节炎）发生率(x2=7.254,P=0.027）、晨僵持续时间(F=4.159,P=0.018)、Bath AS疾病活动指数(BASDAI)平均积分(F=4.461,P=0.014)差异均有统计学意义。AS患者组rs12036228位点各基因型间仅在疾病首发症状上有明显不同（=6.640,P=0.036）。结论 安徽籍汉族人群AS易感性与FCRL5基因rs6427384和rs 12036228位点单核苷酸多态性有关;其基因型的不同对AS的临床表现型有影响。     

Glucose and insulin concentration in amniotic fluid and in maternal blood in early and in late pregnancy

Glucose concentration in the amniotic fluid decreases towards the end of gestation, whereas the insulin concentration increases. The ratio between fetal (amniotic fluid) glucose to maternal glucose is reduced by about 50% at the end of pregnancy, whereas the ratio of C peptide is increased four times. The higher glucose concentration in amniotic fluid in early pregnancy could be explained by a lower fetal metabolic rate in the early stage of development and a low insulin activity of the fetus.     

Osteoporosis in celiac disease and in endocrine and reproductive disorders

As the increase in lifespan brings to light diseases that were previously not clinically detectable, osteoporosis has become an issue of worldwide significance. The disease is marked by a loss of bone mass; the bones become less dense, fragile and more prone to fracturing. Because it is regulated by endocrine and environmental factors, osteoporosis presents a multifactorial etiopathogenesis, with the genetic component accounting for 70% of an individual variation in bone mass density （BMD）, the principal determinant, with age, of fracture risk. Pathological conditions such as celiac disease （CD） exacerbate the process of bone loss, so that the occurrence of osteoporosis in celiac subjects is of particular note： indeed, the screening of osteoporosis patients for this disease is advisable, since it may be the only sign of undiagnosed CD. An increase in interleukin IL-1β, of the IL-1 system, in the relatives of celiac patients confirms the genetic predisposition to osteoporosis and its presence is evidence of an association between the two conditions. The direct effect on the bones of CD is secondary to poor absorption of calcium and vitamin D. In women osteoporosis is indirectly associated with early menopause and amenorrhea, and it may follow prolonged breast-feeding and frequent pregnancies, while in men it is associated with hypogonadism and GH deficit. These endocrine and non-endocrine factors exert their effects on bones by modulating the RANK/RANK-L/OPG system. An appropriate lifestyle from adolescence onwards, together with early diagnosis of and treatment for CD and primaryand secondary endocrine pathologies are important for the prevention of damage to the bones.     

Anti-malarial efficacy of pyronaridine and artesunate in combination in vitro and in vivo

Pyronaridine is a Mannich base anti-malarial with demonstrated efficacy against drug resistant Plasmodium falciparum, P. vivax, P. ovale and P. malariae. However, resistance to pyronaridine can develop quickly when it is used alone but can be considerably delayed when it is administered with artesunate in rodent malaria models. The aim of this study was to evaluate the efficacy of pyronaridine in combination with artesunate against P. falciparum in vitro and in rodent malaria models in vivo to support its clinical application. Pyronaridine showed consistently high levels of in vitro activity against a panel of six P. falciparum drug-sensitive and resistant strains (Geometric Mean IC50=2.24 nM, 95% CI=1.20-3.27). In vitro interactions between pyronaridine and artesunate showed a slight antagonistic trend, but in vivo compared to pyronaridine and artesunate administered alone, the 3:1 ratio of the combination, reduced the ED90 of artesunate by approximately 15.6-fold in a pyronaridine-resistant P. berghei line and by approximately 200-fold in an artesunate-resistant line of P. berghei. Complete cure rates were achieved with doses of the combination above or equal to 8 mg/kg per day against P. chabaudi AS. These results indicate that the combination had an enhanced effect over monotherapy and lower daily doses of artesunate could be used to obtain a curative effect. The data suggest that the combination of pyronaridine and artesunate should have potential in areas of multi-drug resistant malaria.     

Differentiation pathways in carcinogenesis and in chemo- and radioresistance

Cancer stem cells (CSCs) share many features with embryonic stem cells (ESCs) such as the ability for self-renewal and differentiation. Signaling pathways that are involved in these processes are also involved in chemo- and radioresistance (e.g. Wnt, Notch and Hedgehog pathways). This review is focused on the influence of three important differentiation pathways on carcinogenesis and on chemo- and radioresistance in ESCs and CSCs.     

Telemedicine and Advances in Urban and Rural Healthcare Delivery in Africa

Telecardiology holds great promise for Africa, from tele-echocardiography and tele-ECG s, to home monitoring and text messaging for medication adherence monitoring. The burden of disease is great and there is an extreme shortage of health professionals. Telemedicine can provide access to scarce specialist care, improve the quality of care in rural areas and reduce the need for rural patients to travel to seek medical attention. International cross border service can alleviate the shortage of doctors. But telecardiology, and telemedicine uptake in general, has been poor in Africa. Legal and ethical issues around local and cross border telemedicine have not been resolved. The literature was reviewed and obstacles to telemedicine in Africa and current telemedicine activities in Africa, are described. There are few sustained telemedicine services in Africa with the exception of tele-education. There is an expectation that mobile phones will facilitate a range of telemedicine activities in Africa. Africa needs telemedicine.