冠心病患者载脂蛋白E、血管紧张素转换酶联合基因型研究

目的 :研究中国人载脂蛋白E(ApoE)基因多态性及血管紧张素转换酶 (ACE)基因插入 /缺失 (I/D)多态性与冠心病的关联。方法 :分别用PCR -RFLP及PCR技术检测了 12 9例冠心病患者及 90例健康人ApoE ,ACE基因型。结果 :冠心病组ε3 / 4基因型及ε4等位基因频率显著高于对照组 ,ε3 / 3 基因型及ε3 等位基因频率则显著低于对照组 ;ACE各基因型及等位基因频率两组间无显著差异 ;在ε4携带情况下 ,不同ACE基因型冠心病危险度不同 ,DD型 >ID型 ,而Ⅱ型似有一定的保护作用。结论 :ε4等位基因是冠心病的遗传易患因子 ;ACE基因与冠心病发病无显著关联 ,但对ε4等位基因有一定的“修饰”作用。     

早发冠心病家族史同胞的血脂水平及ApoE基因多态性分析

目的探讨血脂异常及ApoE基因多态性与早发冠心病的关系及疾病的遗传易感性.方法检测63例具有早发冠心病家族史的同胞和49例年龄、性别相匹配的健康对照者的血脂水平,聚合酶链式反应(PCR)和HhaI酶切法测定ApoE基因多态性.结果整体血脂水平上同胞组与对照组比较差异显著(P<0.01).本研究只发现3种常见ApoE基因型ε3/3、ε2/3和ε4/3,两组在基因型频率和等位基因频率分布上无统计学差异(P>0.05);两组中不同基因型亚组间血脂水平无显著差异,ε3/3基因型亚组中同胞组与对照组比较,血脂水平有显著差异(P<0.01).结论具有早发冠心病家族史的同胞具有明显的血脂代谢紊乱,但 ApoE基因多态性不是早发冠心病独立的危险因素.     

某地区哈萨克族肥胖儿童ApoE基因多态性研究

目的探讨乌鲁木齐周边地区哈萨克族儿童肥胖与载脂蛋白E(ApoE)基因多态性的关系。方法选择98例超质量/肥胖哈萨克族儿童(病例组)及88例健康者(对照组),采用聚合酶链反应-限制性片断长度多态性分析(PCR-RFLP)方法测定ApoE基因型及等位基因频率。结果 (1)病例组与对照组的基因型频率ε3/3、ε2/3、ε4/4、ε2/2和ε3/4基因型分布差异无统计学意义(P>0.05)。病例组和对照组ApoEε4等位基因频率分别为6.12%和2.87%,差异有统计学意义(P<0.05)。(2)病例组和对照组女性ApoEε4等位基因频率分别为7.44%和1.09%,差异有统计学意义(P<0.05)。结论 ApoEε4等位基因是哈萨克族肥胖的危险因素,尤在女性儿童肥胖的发病中起重要作用。     

江苏汉族人群心脑血管病患者载脂蛋白E基因研究

目的:探讨用基因测序法检测载脂蛋白E(ApoE)基因多态性及其与心脑血管疾病之间的关系。方法:应用基因测序方法检测了193例心脑血管疾病患者和100例无血缘关系的健康汉族人群ApoE基因型。结果:ε3/3基因型高血压组频率为64.3%,高血压 冠心病组为57.7%,高血压 脑血管病组为62.2%均明显低于对照组的86%(P<0.05);而ε3/4基因型频率,高血压组为21.4%,高血压 冠心病组为19.2%,高血压 脑血管病组为24.4%,均显著高于对照组的6%(P<0.05);ε4/4基因型高血压 冠心病组频率为5.1%明显高于对照组0%(P<0.05)。分析等位基因频率,高血压组和高血压 冠心病组、高血压 脑血管病组ε3等位基因频率分别为80.7%,74.4%和78.9%,明显低于对照组92.5%(P<0.05),ε4等位基因频率分别为12.1%,16.7%和14.5%,明显高于对照组的3.5%(P<0.05),差异有明显统计学意义。两组间其它各基因型无统计学差异。结论:应用基因测序方法进行ApoE基因分型是最全面、最直接、可靠的方法;ε4等位基因是心脑血管疾病共同的遗传易患因子,而ε3等位基因具有保护作用。     

中国人群高血压病、糖尿病及冠心病与载脂蛋白E基因多态性

目的：研究载脂蛋白E（ApoE)基因多态性与中国人群高血压病（EH）、非胰岛素依赖性糖尿（NIDDM）及冠心病（CHD）的关联。方法：250例呈不同组合的患及90例正常对照用聚合酶链反应－限制性片段长度多态性（PCR－RFLP）方法检测ApoE基因型，比较基因型及等位基因频率分布。结果：（1）NIDDM及EH组ApoE基因型及等位基因频率与正常对照无显差异；（2）CHD组无论是否并EH及／或NIDDM，ε3／3基因型及ε3等位基因频率均显低于正常对照，而ε3／4基因型及ε4等位基因频率均显主于正常对照；（3）NIDDM合并 CHD组及EH合并CHD组中ε3／3基因型及ε等位基因频率均显低于正常对照，而ε3／4基因型及ε4等位基因频率均显高于正常对照。结论：ApoE基因多态性与中国人群CHD相关。这种关联亦见于EH或NIDDM合并CHD中，但ApoE基因仅是CHD发病的遗传学基础，而与是否合并EH及／或NIDDM无关。     

载脂蛋白B、载脂蛋白E及血管紧张素原基因多态性与冠心病的关系

目的探讨载脂蛋白B、E（ApoB、ApoE）基因及血管紧张素原基因（AGT）多态性与冠心病（CHD）的相关性。方法采用基因芯片技术分析89例CHD患者和78例非CHD患者的ApoBXbaI、ApoEl12／158及AGTM235T基因多态性及等位基因频率。结果CHD组ApoBXbaI、ApoEl12／158及AGTM235T基因型分布与对照组相比差异有统计学意义（P〈0．05）。CHD组的Apo BXba I的X^＋ X^＋基因型及等位基因X’频率显著高于对照组,差异有统计学意义（P〈0．05）,ApoE112／158的ε^4/、ε^4/4基因型及等位基因￡。频率高于对照组,差异有统计学意义（P〈O．05）;CHD组AGT—TT基因型频率及T等位基因频率均明显高于对照组,差异有统计学意义（P〈0．05）。结论ApoBXbaI、ApoEll2／158和AGTM235T的基因多态性可能是中国人CHD的危险因素。ApoB Xba I等位基因X^＋;ApoE112／158的等位基因ε^4和AGT M235T基因的T等位基因是CHD的重要遗传标记。     

阿尔茨海默病与ApoE基因多态性研究

目的:探讨新疆汉族人群载脂蛋白E(ApoE)基因多态性与阿尔茨海默病(AD)的关系。方法:选择98例诊断很可能是AD的汉族患者(AD组)及103例正常对照者(对照组),应用聚合酶链反应-限制性片断长度多态性分析(PCR-RFLP)方法测定ApoE基因型和等位基因频率。结果:(1)AD组ε3/4基因型频率为25.51%,高于对照组的11.65%(P<0.05),2组ε3/3和ε2/3基因型分布差异无统计学意义。AD组和对照组ApoEε4等位基因频率分别为13.78%和6.31%,差异有统计学意义(P<0.05)。(2)AD组和对照组女性ApoEε4等位基因频率分别为14.52%和6.92%,差异亦具有统计学意义(P<0.05)。结论:ApoEε4等位基因是AD的危险因素,尤在女性AD患者的发病中起重要作用。     

湿热体质与平和体质原发性血脂异常者ApoE基因多态性研究

目的:研究中医湿热体质与平和体质血脂异常者载脂蛋白E(ApoE)基因多态性的关系。方法:采用聚合酶链反应(PCR)方法及基因测序技术检测30例湿热体质血脂异常者(实验组)和30例平和体质血脂异常者(对照组)的ApoE基因型和等位基因频率,分析两种体质与ApoE基因多态性的相关性。结果:(1)实验组中共检出五种基因型ε2/ε3、ε2/ε4、ε3/ε3、ε3/ε4、ε4/ε4,频率分别为:10%、10%、36.66%、16.67%、26.67%;对照组检出四种基因型ε2/ε3、ε2/ε4、ε3/ε3、ε3/ε4;频率分别为:13.33%、6.67%、66.67%、13.33%。在实验组中,以ε3/ε3基因型最多,其次为ε4/ε4基因型;对照组中也是以ε3/ε3基因型最多,其次为ε2/ε3、ε3/ε4基因型。本实验观察组和对照组均未检出ε2/ε2基因型。实验组人群ApoE等位基因频率为:ε2 10.00%、ε350.00%、ε4 40.00%;对照组人群ApoE等位基因频率为:ε2 10.00%、ε3 80.00%、ε4 10.00%。(2)实验组和对照组ApoE六种基因型和ApoE三种等位基因分布有差异,且差异有统计学意义(P<0.05)。实验组ApoE基因型ε4/ε4频率明显高于对照组(χ2=9.231,P<0.05);ε3/ε3频率明显低于对照组(χ2=5.406,P<0.05)。而ε2/ε3、ε2/ε4、ε3/ε4分布差异无统计学意义(P>0.05)。实验组ApoE等位基因ε4频率明显高于对照组(χ2=7.200,P<0.05);ε3频率明显低于对照组(χ2=5.934,P<0.05),差异有统计学意义。结论:原发性血脂异常平和质和湿热质者在ApoE基因型和等位基因分布上有差异。ApoE基因型ε4/ε4和等位基因ε4具有更明显的湿热体质倾向,可能更易于形成湿热体质血脂异常或其与湿热体质血脂异常关联的可能性大。ApoE基因型ε3/ε3和等位基因ε3具有更明显的平和质倾向,可能更易于形成平和质血脂异常或其与平和质血脂异常关联的可能性大。     

ApoE基因多态性与血脂水平的相关性

目的: 分析ApoE基因多态性与血脂异常的关系.方法: 对高血脂患者72(男46,女26)例,正常对照95(男46,女49)例进行空腹TC,TG,HDL-C,LDL-C检测及ApoE基因型检测.结果:ApoE等位基因频率在两组人群中的分布有相同趋势,等位基因ε3频率最高,血脂正常组为80.5%,血脂异常为76.8%,是我国人群中最常见的等位基因,ε2和ε4相对较少.男女两性间等位基因频率无显著性差异.ApoE基因型与血脂水平有相关性,不论血脂异常或正常,不同基因型间血清TC,LDL-C由低到高依次为ε2/3<ε3/3<ε3/4,HDL-C则相反,为ε3/4<ε3/3<ε2/3.结论:ApoE基因多态性与血脂水平显著相关.     

2型糖尿病患者脂蛋白脂酶基因S447X和载脂蛋白E基因多态性与冠心病的关系

目的探讨2型糖尿病患者脂蛋白酯酶(LpL)及载脂蛋白E基因(ApoE)与冠心病的关系。方法采用聚合酶链反应-限制性片段长度多态性(PCR-PFLP)技术分别检测2型糖尿病并冠心病组(110例)及对照组(116例)LpL、ApoE基因型。结果2型糖尿病并冠心病组LpL/S447XX突变频率低于对照组(P<0.05);2型糖尿病并冠心病组ε3/3和ε4/3频率分别为41.2%和37.3%,分别明显低于对照组ε3/3(频率70.7%)和高于对照组ε4/3(频率21.6%),P均<0.01。ε4等位基因频率为28.2%,明显高于对照组(13.4%,P<0.01)。结论LpL/S447XX突变降低2型糖尿病并发冠心病患者的遗传易感性,而ApoE/ε4等位基因增高2型糖尿病并发冠心病患者的遗传易感性。     

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.