ATP结合盒转运子A1基因R219K的多态性与心房颤动相关性研究

目的 探讨ATP结合盒转运子A1基因(ABCA1)R219K的多态性与心房颤动(房颤)相关性.方法 选择250例房颤患者(房颤组)和250例非房颤者(对照组)为研究对象.采用聚合酶链式反应-限制性片段长度多态性测定ABCA1基因的多态性,并检测所有研究对象的C反应蛋白(CRP)和高密度脂蛋白胆固醇(HDL-C)血清浓度;比较两组不同基因型、不同等位基因的分布及CRP、HDL-C的血清浓度.结果 房颤组与对照组ABCA1 R219K RR 型、RK型、KK型基因型频率分别为42.0%、42.8 %、15.2%和34.0%、43.2%、22.8%,房颤组KK型明显低于对照组(P=0.03);房颤组与对照组R等位基因、K等位基因分布频率为63.4%、36.6%和55.6%、44.4 %,K等位基因分布频率在房颤组中较对照组明显降低(P=0.012);房颤组CRP浓度明显高于对照组(P=0.004),HDL-C浓度无明显差异;在不同基因型之间CRP、HDL-C浓度比较中发现,RR 基因型CRP 浓度显著高于KK型(P=0.013);而HDL-C浓度RR 基因型低于RK型和KK型(P 分别为 0.009、0.027).结论 房颤的炎性指标CRP显著升高;ABCA1 R219K位点K等位基因可能是房颤发生的一种保护因素.     

ABCA1基因R219K多态性在汉族与壮族人群中的分布

目的:探讨ABCA1基因R219K多态性在汉族和壮族人群中的分布.方法:采用聚合酶链-限制性片段长度多态性(PCR-RFLP)技术,对无血缘关系的健康汉族人127例和壮族人103例的ABCA1基因R219K位点G→A(Arg219Lys)进行检测,分析基因型频率和等位基因频率在两组人群中的分布,并与西方其他种族相比较.结果:ABCA1基因R219K等位基因频率在汉族分别为0.650和0.350,壮族中分别为0.631和0.369,基因型频率在汉族分别为RR=0.425,RK=0.449,KK=0.126;壮族分别为RR=0.427,RK=0.408,KK=0.165;两组人群的基因多态性分布差异无统计学意义(P＞0.05);与德国人群相比差异有统计学意义(P＜0.01).结论:ABCA1基因R219K位点多态性在中国汉族与壮族的分布无差异,而有别于德国人种,提示该基因多态性可以应用于群体遗传学和脂代谢疾病易感性的研究.     

ABCA1基因R219K多态性与广西汉族心血管疾病的关系

目的:探讨ATP结合盒转运子A1(ATP-Binding Cassette Transporter 1,ABCA1)基因R219K多态性与广西汉族心血管疾病的关系。方法:采用PCR-RFLP技术,对无血缘关系的心血管疾病人群113例和非心血管疾病人群61例的ABCA1基因R219K位点G→A(Arg219Lys)进行检测,分析其基因多态性。结果:在心血管疾病组中,除HDL比非心血管疾病组低外,其余血脂指标均高,其中TC、LDL与ApoB在两组间的差异有统计学意义(P<0.05)。广西汉族心血管疾病人群的RK型频率最高,RR型次之,KK型频率最低;心血管疾病组的KK基因型频率(0.129)低于非心血管疾病组(0.148),但差异无统计学意义(P>0.05)。RR、RK和KK三种基因型的血脂水平差异没有统计学意义(P>0.05),女性心血管疾病人群KK型的HDL比RR型的高(P>0.05),而KK型的TG和VLDL比RR型低(P<0.05)。结论:ABCA1基因R219K变异对心血管疾病可能具有保护作用,但具体保护机制及ABCA1基因R219K在心血管疾病人群中基因型分布频率也有待于更大样本的观察和进一步深入研究。     

ABCA 1 基因R219K 多态性对 格列美脲疗效的影响

目的 观察三磷酸腺苷结合盒转运体A1（ABCA 1）基因R219K 多态性对格列美脲降糖疗效 的影响,初步探讨格列美脲药效个体化差异的遗传学机制。方法 选取76 例初诊的2 型糖尿病患者,给 予格列美脲治疗12 周,检测患者治疗前后临床生化指标。对所有患者行ABCA 1 基因R219K 分型检测。 结果 ABCA 1 基因R219K 多态性存在3 种基因型。格列美脲治疗前各基因型患者的空腹血糖（FBG）、餐后 2 h 血糖（2h-BG）、糖化血红蛋白（HbA1c）水平比较,差异无统计学意义（P >0.05）。格列美脲治疗12 周后, 各基因型患者FBG、2h-BG、HbA1c 水平下降（P <0.05）;RK、KK 基因型患者的Δ2h-BG（治疗前后差值） 高于RR 基因型患者（P <0.05）;RK、KK 基因型患者2h-BG 水平低于RR 基因型患者（P <0.05）;RK、 KK 基因型患者HbA1c 水平低于RR 基因型患者（P <0.05）。结论 汉族2 型糖尿病患者中存在ABCA 1 基 因R219K 多态性,其可能与格列美脲降糖疗效有关,RK、KK 基因型患者的格列美脲降糖疗效优于RR 基因 型患者。     

ABCA1基因变异与血浆高密度脂蛋白胆固醇水平的关系

目的探讨腺苷三磷酸结合盒转运体A1（ATP-binding transporter A1,ABCA1）基因多态性与汉族人群血浆高密度脂蛋白胆固醇（high-density lipoprotein cholesterol,HDL-C）水平的关系。方法采用聚合酶链反应-限制性片段长度多态性分析技术检测376例无血缘关系的正常汉族人ABCA1基因M883I、R1587K和R219K多态性。结果研究人群中KK1587基因型者HDL-C水平明显低于RR1587和RK1587基因型者（P〈0．05）。按性别分层后,仅女性KK1587基因型者HDL-C水平低于RR1587和RK1587基因型者（P〈0．01）。一般线性模型分析显示,R1587K多态对女性个体HDL-C水平变异的贡献度为2．3％（P〈0．01）。结论ABCA1基因M883I和R219K多态与汉族人群HDL-C水平无关,但K1587等位基因以隐性作用方式与女性HDL-C水平降低有关。     

三磷酸腺苷结合盒转运子A1基因R219K多态性与血脂水平关系的研究

目的:探讨三磷酸腺苷结合盒转运子A1基因R219K多态性与血脂水平的关系,寻找冠心病的易感因素.方法:采用聚合酶链式反应—限制性片段长度多态性(PCR-RFLP)技术,对227例冠心病患者和162例非冠心病患者的ABCA1基因R219K位点G→A (Arg219Lys)进行检测,分析基因型频率和等位基因频率分布特点,以及与血脂水平的相关性.结果:与对照组比较,冠心病组RR基因型频率(42.3％)明显高于对照组(31.5％),差异有统计学意义(P＜0.05);而KK型频率(10.6％)显著低于对照组(20.7％),差异有统计学意义(P＜0.05).冠心病组中KK基因型携带者的三酰甘油(TG)水平(1.43±0.597) mmol/L低于RR基因型携带者(1.87±1.34) mmol/L(P＜0.05),KK型基因携带者高密度脂蛋白(HDL-C)水平为(1.34±0.35) mmol/L高于RR基因型携带者(1.09±0.18)mmol/L,差异有统计学意义(P＜0.05).结论:三磷酸腺苷结合盒转运子A1基因R219K多态性与血脂水平有关,是冠心病发病的易感因素之一.     

ABCA1基因R1587K位点多态性与冠心病及血脂水平的关系

目的:探讨三磷酸腺苷结合盒转运子A1(ATP binding cassette transporter 1,ABCAl)基因1587单核苷酸多态性(single nucleotide polymorphism,SNP)位点与冠心病(coronary heart disease,CHD)及血脂水平的关系.方法:采用病例对照研究,聚合酶链反应一限制性片段长度多态性(Polymerase Chain Reaction-Restriction Fragment Length Polymorphism)方法.对260例经冠状动脉造影确诊的冠心病患者和同一地区造影排除冠心病正常对照248例,进行ABCAI基因1587位点SNP分析检测,比较不同基因型与血脂水平和冠心病的关系.结果:ABCA1基因1587位点多态性有三种:RR、RK和KK型.全部检测人群中RR型占76.97%,RK型占18.11%.KK型占4.92%.冠心病组与对照组中RR、RK、KK 三种基因型频率差异无统计学意义(P>0.05);冠心病患者与正常人等位基因频率差异无显著性(P>0.05);K等位基因携带者HDL-C水平低于非携带者(P<0.01).结论:ABCA1基因1587位点多态性冠心病患病无相关性;K等位基因携带者血浆HDL-C水平低下.     

ATP结合盒转运子A1基因R219K变异对血脂的影响

目的　探讨ATP结合盒转运子A1基因 (ABCA1)R2 19K变异是否影响血脂水平。方法　 10 4 3例受试者 ,其中 6 92例脑卒中患者及 35 1名正常对照组人群。采用聚合酶链式反应 限制性片段长度多态性方法测定ABCA1基因多态性。结果　在ABCA1的RR、RK和KK 3种基因型中 ,高密度脂蛋白胆固醇 (HDL C)水平依次呈上升趋势 ,RR型 (1 3mmol/L± 0 4mmol/L)与KK型(1 4mmol/L± 0 4mmol/L)之间差异有显著意义 (P <0 0 5 ) ;甘油三酯水平依次呈下降趋势 ,相互之间差异无显著意义 ;这种效应以男性人群为主。非携带者 (RR型 )的HDL C水平与年龄呈正相关 ,携带者 (RK KK型 )的甘油三酯水平与年龄呈负相关 ,在 70岁以前年龄段 ,携带者HDL C水平高于非携带者。结论　ABCA1R2 19K变异可影响血脂水平 ,携带者 (RK KK型 )产生有益的临床血脂谱 ,以男性人群为主 ,这种作用在≤ 70岁人群尤其明显。     

ATP结合盒转运体A1基因R219K多态与冠心病的相关性研究

目的 探讨ATP-Binding cassette Transporter 1(ABCA1)基因R219K多态在中国汉族人群中的分布及其与冠心病(coronary heaa disease,CHD)的关系.方法 采用PCR-RFLP方法,对396例CHD患者和417名正常人ABCAI基因R219K多态位点进行分析.结果 对照组R219K多态K等位基因及KK基因型的频率(0.465、0.228)较CHD组(0.381、0.162)显著为高(P＜0.05);根据发病年龄分组,早发CHD组K等位基因及KK基因型频率(0.34、0.111)明显低于晚发CHD组(0.419、0.205)和对照组(P＜0.05),而在对照组和晚发CHD组间此频率差异无显著性(P＞0.05);KK基因型患者血浆甘油三酯(TG)水平较RR基因型显著降低(P＜0.05);不同基因型患者血浆高密度脂蛋白胆固醇(HDL-C)水平差异无显著性(P＞0.05).结论 ABCAl基因R219K多态与CHD存在相关性;KK基因型可能具有对抗动脉粥样硬化的作用,但这种作用不伴有血浆HDL-C水平的改变.     

冠心病与三磷酸腺苷结合盒转运子A1基因R219K多态性关联的研究

目的探讨三磷酸腺苷结合盒转运子A1(ABCA1)基因R219K多态性与冠心病发病的相关性。方法采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术,对227例冠心病患者(冠心病组)和162例非冠心病患者(对照组)的ABCA1基因R219K位点G→A(Arg219Lys)进行检测,分析基因型和等位基因频率分布特点以及与血脂、冠心病发病的相关性。结果冠心病组RR基因型频率(42.3%)明显高于对照组(31.5%),差异有统计学意义(P<0.05);而KK型频率(10.6%)显著低于对照组(20.4%),差异有统计学意义(P<0.05)。突变纯合基因(KK)携带率在急性冠状动脉综合征(ACS)组为10.1%,稳定型心绞痛(SAP)组为11.6%,对照组为20.4%,其中ACS组与对照组间差异有统计学意义(P<0.05),而SAP组与ACS组间差异无统计学意义(P>0.05)。冠心病组中KK基因型携带者的三酰甘油(TG)水平为(1.43±0.59)mmol/L,低于RR基因型携带者的(1.87±1.34)mmol/L,差异有统计学意义(P<0.05),KK型基因携带者高密度脂蛋白胆固醇(HDL-C)水平为(...     

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.