甘肃汉族人群白细胞介素1α启动子(-889 C/T) 基因型与冠心病的关系

目的探讨白细胞介素-1α（IL-1α）启动子-889C/T基因型与冠心病（CHD）的关系。方法采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）检测98例CHD和131名健康者IL-1α-889C/T位点基因型。结果IL-1α-889位点在该人群中的基因型频率分布CC为183/229（79.9%）,CT为45/229（19.70%）,TT为1/229（0.04%）,等位基因C为411/458（89.70%）,T为47/458（10.30%）。CHD组CT基因型与对照组比较差异有统计学意义（P〈0.01）。心肌梗死组CT型与对照组比较差异有统计学意义（P〈0.01）,而心绞痛组中CT型与对照组比较差异无统计学意义（P〉0.05）,CHD组中CT型基因患心肌梗死的危险度是患心绞痛的2.02倍[比值比（OR）=2.02,95%可信区间（CI）：1.05-3.89,P〈0.05]。结论IL-1α启动子-889C/T位点存在基因多态性,T等位基因可能是甘肃汉族人群心肌梗死的易感基因。     

白细胞介素1α基因启动子-889位点C/T基因型与冠心病严重程度的关系

目的　探讨白细胞介素 1α(IL 1α)基因启动子 889位点C/T基因型与冠心病 (CHD)严重程度的相关关系。方法　采用聚合酶链反应 限制性片段长度多态性 (PCR RFLP)分析的方法 ,检测118例CHD患者和 184名健康者IL 1α( 889C/T)基因型 ,并用酶联免疫吸附试验检测了所有研究对象血清IL 1α水平。结果　IL 1α( 889)位点各基因型在心肌梗死组和对照组间的分布差异存在显著性(χ2 =5 96 ,P <0 0 1) ,CT基因型患心肌梗死的相对风险度约是CC基因型的 2 39倍 [比值比 (OR) =2 39,95 %可信区间 (CI) =1 17～ 4 86 ];在CHD组 ,CT基因型患者血清IL 1α水平 (13 5 1± 6 85 )ng/L显著高于CC基因型患者 (8 0 4± 4 4 7)ng/L ,P <0 0 0 1。结论　IL 1α( 889)位点CT基因型与CHD的严重程度存在相关关系 ,其机理可能是该位点DNA突变影响了IL 1α的分泌。     

白细胞介素-1α基因启动子区域C-889T多态与冠心病的相关性

目的:研究白细胞介素-1α(interleukin-1α,IL-1α)基因启动子区域-889位C→T多态与冠心病(CH D)的相关性。方法:运用M ALDI-TOF质谱检测技术,对上海地区94例血压正常的CH D患者和100名健康对照者进行C-889T多态基因分型。结果:C-889T多态的基因型分布在CH D组(CC=83、CT=11)和对照组(76、24)间差异有显著性(P=0.026)。C、T等位基因频率与对照组相比差异亦有显著性(94.15%、5.85%/88.00%、22.00%,P=0.035)。在多支病变组中,C-889T多态的基因型分布及其等位基因频率与对照组相比差异均有显著性(46、5/76、24,P=0.036;95.10%、4.90%/88.00%、22.00%,P=0.048)。结论:IL-1α基因启动子区域的C-889T多态可能是血压正常人群CH D发病的一个遗传性危险因素,并且还可能与冠状动脉粥样硬化的病变程度相关。     

我国广东地区汉族人群类风湿性关节炎患者IL-6启动子基因多态性的研究

目的了解我国广东地区汉族人群白细胞介素-6(IL-6)基因启动子-572C/G和-174G/C位点单核苷酸多态性对类风湿性关节炎(RA)的影响。方法应用序列特异性引物-聚合酶链反应(PCR-SSP)检测168名体检健康者和120例RA患者的IL-6基因启动子-572和-174位点的基因型。结果我国广东地区汉族人群IL-6基因启动子-572位点存在C→G的突变,其基因型和等位基因频率分布在RA组和对照组比较差异有统计学意义(基因型频率:2χ=16.14,P=0.003;等位基因频率:2χ=16.71,P<0.001),其G等位基因在RA患者中明显低于健康对照组[比值比(OR)=0.36,95%可信区间(CI):0.21~0.61];-174位点存在G→C的突变,其基因型和等位基因分布频率在两组间差异亦有统计学意义(基因型频率:2χ=25.75,P<0.01;等位基因频率:2χ=25.99,P<0.01),其C等位基因在RA组明显高于健康对照组(OR=2.26,95%CI:1.91~2.68)。结论我国广东地区汉族人群IL-6基因启动子存在-572C/G与-174G/C的单核苷酸多态性,且这2个位点多态性与RA有关,其中IL-6-572位点的G等位基因可能对RA有保护作用,而IL-6-174位点等位基因C可能与RA发病的易感性有关。     

IL-1基因单核苷酸多态性在鼻咽癌发生发展中的作用

目的探讨IL-1α-889T/C,IL-1β-511C/T基因单核苷酸多态性与鼻咽癌易感性与复发的关系。方法采用病例对照研究,采集来自辽宁地区不同医院的鼻咽癌患者193例、正常人群231例静脉血,酚氯仿法提取基因,Taqman real-time PCR方法及SDS软件对IL-1α-889T/C,IL-1β-511C/T基因型进行分型。结果单因素分析和多因素分析均显示IL-1α-889T/T基因型与鼻咽癌易感性相关,可以显著降低鼻咽癌发生。进行病理分层后显示T/T基因型在各病理类型中均起到保护作用,IL-1β-511C/T位点的各基因型与鼻咽癌易感性不相关。经单因素及多因素进一步分析后显示,IL-1α-889T/C,IL-1β-511C/T位点各基因型与鼻咽癌复发不相关。结论 IL-1α-889T/C位点单核苷酸多态性与鼻咽癌易感性相关,T/T基因型可以降低北方汉族鼻咽癌发生风险,IL-1β-511C/T位点单核苷酸多态性与鼻咽癌易感性不相关。     

白细胞介素6基因启动子区多态性与冠状动脉疾病的相关性研究

目的 探讨白细胞介素6(interleukin 6,IL-6)基因启动子区-174G/C、-572C/G和-634C/G多态性对冠状动脉疾病(coronary heart disease,CHD)的发病易感性.方法 严格按照诊断标准,选取无亲缘关系的CHD患者126例(CHD组)及健康对照组150例提取基因组DNA,应用聚合酶链反应-限制性片段长度多态性(PCR-polymorphism,Restriction Fragment,PCR-RFLP)技术检测-174 G/C、-572 C/G和-634 C/G 3个多态性位点的基因型;采用HaploView4.0及SPSS11.5软件分析各位点基因型、等位基因频率及组间差异.结果 -572C/G位点及-634C/G位点的基因型频率分布在CHD组与正常对照组差异均有统计学意义(P＜0.05),CHD组-572C/G位点的等位基因G频率显著高于正常对照组(P＜0.05),-634C/G位点的等位基因G频率显著高于正常对照组(P＜0.05).连锁不平衡检验结果显示,IL-6基因这3个位点处于不连锁状态,D'＜0.5.结论 IL-6基因-174G/C和-572C/G多态性可能与CHD有关,携带有-572C/G和-634C/G多态性位点G等位基因的个体可能更容易患CHD.     

IL-10基因启动子区-592A/C位点多态性与HBV感染转归的关系

目的探讨汉族人白细胞介素-10(IL-10)基因启动子区-592位点单核苷酸多态性与乙型肝炎病毒(HBV)感染、转归的关系。方法采用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)方法,检测231例HBV感染者,165例HBV感染康复者和135例正常对照者IL-10基因启动子区-592A/C位点基因型。结果IL-10基因启动子区-592A/C位点基因型和等位基因在HBV感染组、HBV感染康复组和正常对照组之间的分布频率比较差异无显著性(P>0.05),在血清HBV-DHA<1×103copies/ml的HBV感染者组和HBV-DHA≥1×103copies/ml组之间的分布频率比较差异亦无显著性(P>0.05);但IL-10基因启动子区-592A/C位点AA基因型和A等位基因在慢性乙型肝炎组出现的频率明显高于HBV无症状携带组,两组之间分布比较差异有显著性(P<0.05)。结论汉族人IL-10基因启动子区-592A/C位点多态性可能与人群对HBV易感性及感染后的病毒血症水平无显著相关性,但该位点基因多态性与HBV感染后的肝脏炎症反应有关。     

TGF-β1-509 C/T基因多态性与类风湿性关节炎相关性研究

目的 探讨转化生长因子-β1(TGF-β1)基因启动子-509C/T多态性与贵州汉族人群类风湿性关节炎(RA)的相关性.方法 采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术,分析90例RA患者及95例正常对照组的TGF-β1基因启动子-509C/T多态性.结果 RA组与正常对照组-509C/T基因型频率分布有显著差异(P＜0.05),-509 CC基因型RA组高于对照组(33.3%vs 21.1%),而-509TT型明显低于正常对照组(21.1%vs 36.8%);RA患者组-509位点的等位基因频率与正常对照组也有显著差异(P＜0.01),RA组C等位基因频率显著高于对照组(56.1%vs42.1%),T等位基因频率低于对照组(43.9%vs 57.9%).结论 TGF-β1基因启动子-509C/T多态性与贵州汉族人群类风湿性关节炎显著相关.     

白细胞介素-18启动子基因在云南基诺族、傣族、僾尼族人群中的遗传多态性

目的:分析云南省西双版纳地区基诺族、傣族和僾尼族人群白细胞介素-18(IL-18)启动子基因多态性的分布情况.方法:运用PCR-测序的方法检测三民族人群IL-18启动子G-137C、C-607A和G-656T位点基因型及等位基因频率.结果:(1)基诺族人群G-137C位点基因型与等位基因分布频率与其他两民族显著不同,差异有统计学意义(P值均为0.000).(2)C-607A与G-656T完全连锁,C-607A(G-656T),位点基因型与等位基因分布频率三民族人群相比均有统计学差异(均P<0.05).结论:IL-18启动子G-137C、C-607A和G656T多态性位点基因型和等位基因分布频率具有民族、种族差异.     

IL-6-634C/G和-597G/A基因多态性与宿迁地区冠心病的相关性

摘要:目的探讨宿迁地区白 细胞介素6(IL-6)基因启动子区域-634C/G .-597G/A 多态性与冠心病( coronary heart disease,CHD)的关系。方法选择宿迁市第一人民 医院2022年1月至9月就诊的248例CHD患者(CHD组)以及126例体检健康人群(健康人对照组),应用聚合酶链-限制性片段长度多态性法(PCR-RFLP)检测各组IL-6基因多态性位点和基因型,并进行Hardy-Weinberg平衡检验,采用Logistie 回归方法分析基因多态性与CHD之间的关系。进一步检测各组三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1) 、载脂蛋白B(apoB).总胆固醇(TC)、葡萄糖(Glu)、C反应蛋白(CRP)、糖化血红蛋白( HbA1c)、IL-6等生化指标的表达水平。结果生化指标检测结果表明, 与健康人对照组比较,CHD组TG、TC、LDL-C、apoB、Clu、CRP、HbAlc和IL-6水平显著升高( P<0.05),而HDL-C、apoA1水平明显降低(P<0.05)。Logistie 回归结果显示,与CC基因型相比, IL-6-634C/G中的CG和GG基因型与CHD的发病风险相关,其校正OR(95%CI)分别为2.068( 1.410~ 3.032)和6.674(2.034~21.900)。CHD组和健康人对照组CC、CG和GG基因型频率分别为47.9%、39.9%、12.2%和76.2%、21.5% .2.3%,C、G等位基因频率分别为74.7%、25.3%和82.9%、17.1%;与C等位基因相比,携带G等位基因患者发生CHD的风险更高,且基因型和等位基因频率在两组间的差异均有统计学意义(P均<0.05)。IL-6-597G/A基因多态性与CHD易感性无关。结论宿迁地区人 群CHD患者风险与IL-6-634C/G 基因多态性相关,而与IL-6-597G/A基因多态性无关。     

Visiting rights only: the diplomas in nursing in the UK in the interwar period

The aim of this article is to explore the institution and organisation of the diplomas in nursing at the universities of Leeds and London, which were established in 1921 and 1926, respectively. It will be argued that the success of these courses for the individuals who undertook them, and the profession as a whole was ultimately limited. It is accepted that the purpose of the diplomas was at least in part for the nursing elite to maintain their grip on the leadership. Nevertheless, the institution of the courses, when few women in general attended university, identifies a 'radicalness' within the profession, which has rarely been considered. Moreover, that there was a body of nurses capable of university level education challenges previous assumptions.     

Pitfalls in the Care of the Psychiatric Patient in the Emergency Department

Background

Care of the psychiatric patient in the Emergency Department (ED) is evolving. As with other disease states, there are a number of pitfalls that complicate the care of the psychiatric patient.

Objective

The purpose of this article is to update Emergency Physicians concerning the pitfalls in caring for the psychiatric patient, and possible solutions to deal with these pitfalls.

Discussion

The article will address the burden of the psychiatric patient, staff attitudes, medical clearance process, treatment of the agitated patient, suicidal patients, and admission decisions.

Conclusions

Alternative care resources, collaboration with Psychiatry, staff education, improvement in the medical clearance process, proper use of restraint and seclusion, and appropriate choice of medication for agitated patients can help avoid some of the top pitfalls in the care of the psychiatric patient in the ED.     

Changes in the parameters of the rhythms of the electrolyte-excreting function of the kidneys in women in relation to the seasons of the year

The characteristics (period, mesor, amplitude) of the rhythms of urinary excretion of sodium, potassium, chlorine, calcium, magnesium, and phosphorus were examined in normal women during various seasons. The urine was collected for 5 days with 4-hour intervals. The rhythms were detected and their parameters established with the use of mathematical methods for the assessment of the tested curve fragments repetitions and by the least squares nonlinear method. The rhythms of renal urinary and electrolyte excretion were found very smooth, particularly so in the fall and winter. The circadian rhythms have been found the most stable during all the seasons. Examinations of individual electrolyte excretion have shown that Na and K excretion is more stable all the year round and therefore this parameter is the most informative for the detection of disorders in renal electrolyte excretion.     

Choosing the choices in the USA: examples in the maternity area

The concept of choice has featured prominently in both the recent united Kingdom (UK) health care reforms and in the debate relating to the care of childbearing women. An invitation to the USA facilitated contemplation of the health care system on which the recent UK reforms have been modeled. The impact of the health system on mother's choices was a source of particular interest. The implications for midwives, their practice and their relationships with their clients and colleagues emerge clearly. It may be that the United States' model of health care does not answer the needs of the UK.     

Change in the drug-metabolizing function of the liver in patients in the postoperative period in relation to the type of anesthesia]

Anesthesia-dependent changes in pharmaco-metabolic liver function have been studied in patients operated on for cosmetic facial defects. It has been established that the postoperative period in patients subjected intraoperatively to general combined anesthesia and controlled lung ventilation was characterized by inhibited drug metabolism in the liver, which required correction of the drug doses to reduce the risk of side and toxic effects of pharmacotherapy. Patients operated on under local procaine anesthesia had no considerable changes in pharmaco-metabolic liver function in the postoperative period.     

论护士长在医院成本核算管理中的作用

成本核算是我国经济增长方式从粗放型向集约型转变,加强医院经济管理的一种趋势。笔者仅就护士长在医院成本核算管理中如何发挥作用进行探讨。加强内部管理,协调管理的诸要素,以节约降耗,挖掘潜能为基础,严格计划、控制,从而实现大价值、高功效、低成本的管理目标。