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1.
目的探讨Phelan-McDermid综合征的临床表现及微阵列比较基因组杂交芯片技术(array CGH,aCGH)结果。方法回顾性分析1例Phelan-McDermid综合征患儿的临床资料;采用常规G显带分析染色体核型,运用aCGH检测全染色体微小改变。结果患儿染色体核型示正常女性核型,未发现染色体数目及结构异常;aCGH分析发现Chr22q13.2-qter缺失,并排除其他染色体微改变;确诊为Phelan-McDermid综合征。结论通过典型的临床表现和染色体微改变相关实验室检查可确诊Phelan-McDermid综合征;aCGH技术对于筛查该病并排除其他染色体微改变最有意义。  相似文献   

2.
目的 分别采用多重连接探针扩增技术(MLPA)与荧光原位杂交技术(FISH)对22q1 1.2微缺失综合征外周血标本患者基因缺失/重复突变的类型及变异范围进行检测,分析在22q11.2微缺失综合征诊断中二者联合应用的诊断价值.方法 采集1例仅心脏异常患儿及其父母外周血,取200 μL外周血提取DNA后采用MLPA技术对患儿及其父母的染色体22q11.2缺失的范围进行检测,取外周血1 mL进行培养,采用DiGeorge/VCFS N25(D22S75)的FISH探针对培养后的中期淋巴细胞进行杂交.结果 患儿淋巴细胞分裂中期细胞应用FISH技术检测结果为22号染色体上的DiGeorge/VCFS N25(D22S75)区杂合性缺失;MLPA验证结果显示患儿与22q11.2微缺失综合征相关的6个探针对应的片段大小位置在3100的电泳图上荧光峰值相比健康对照明显出现减半,其父母亲均在正常范围.患儿的临床表现仅有先天性心脏病,无其他异常,与其基因缺失片段长度(2.0 Mb)极不相称.结论 联合应用FISH和MLPA检测22q11.2微缺失综合征,可以明显提高诊断的准确性.22q11.2微缺失综合征的临床表现与基因缺失片段的长度无相关性.  相似文献   

3.
目的 分析发育迟缓患儿基因拷贝数变异(CNVs)与临床表现的相关性.方法 应用微阵列单核苷酸多态性(SNP array)分析技术对1例发育迟缓患儿及其临床表型正常的父母亲进行全基因组CNVs分析.结果 在患儿chr8p23.3p23.1区域发现7.9 Mb片段缺失,在chr8p23.1p11.23区域发现27.4 Mb片段重复;在患儿父亲chr7q31.1区域发现1.21 Mb重复,chrXp22.33区域发现99 kb缺失;患儿母亲未检测到CNVs改变.结论 SNP array技术有助于进一步明确发育迟缓患儿的遗传机制.  相似文献   

4.
目的 分析婴儿痉挛症患儿的临床特征,并对患儿及其父母进行遗传学检测.方法 分析2014年3月接诊的1例婴儿痉挛症患儿面部特征、体格和智力发育状况.实验室检查采用常规G显带分析患儿及父母外周血染色体核型,单核苷酸多态性(SNP)基因芯片技术检测染色体微小改变,荧光原位杂交技术(FISH)验证结果,并对其父母染色体中期分裂象进行FISH检测.结果 患儿女,7岁,语言、运动、语言发育严重迟滞,生后4个月出现癫痫发作,临床诊断为“婴儿痉挛症”.体检见消瘦,面容特殊,存在刻板样不自主动作.头颅CT平扫提示“硬膜下积液”.脑电图检查提示:痫样放电频繁;高度失律.患儿及其父母常规染色体核型分析(400条带)均显示为正常核型.SNP微阵列技术检测显示该患儿染色体5q14.3区段微缺失,缺失片段为2.03 Mb,分子核型为arr5q14.3(87 538 430 ~ 89 565 757)× 1,该区段包含MEF2C基因.选择区域特异性RP11-293 L20探针,应用FISH技术对芯片结果进行验证,确认患儿5q14.3区域存在杂合缺失.父母染色体核型正常,无5q14.3区域缺失,无插入突变.结论 患儿染色体5q14.3区段发生缺失为婴儿痉挛症的病因.患儿为新发生的5q14.3微缺失综合征,父母再次生育时,建议选择SNP芯片技术进行产前诊断.  相似文献   

5.
目的 采用分子遗传学技术分析1例常规染色体核型拟诊为21/22三体的发育迟缓伴孤独症患儿,明确遗传学诊断。方法 收集患儿及其父母的外周血标本,常规提取基因组DNA,应用高分辨染色体核型分析(400-550带)检测患儿及其父母的染色体数目及结构,微阵列比较基因组杂交技术(array-CGH)筛查患儿的全基因组拷贝数变异,以荧光原位杂交技术(FISH)对异常的基因拷贝进行染色体精确定位和定量。结果 女,2岁,发育迟缓伴孤独症样表现。外侧眼角下垂、内眦赘皮。常规染色体核型检查(320带)分别为47,XX,+22和47,XX,+21。高分辨染色体核型分析显示,该患儿携带额外标记染色体(SMC),核型为47,XX,+mar dn,尚不能确定是否为21/22三体携带者,患儿父亲高分辨率核型染色体分析提示为46,XY,母亲为46,XX,提示患儿携带SMC为新生突变。array-CGH检测显示15q11.2-13.2区域微重复(chr15:22684529-30730543,8.0 Mb,hg19)。FISH验证该SMC来源于15号染色体,由15q11.2-13.2区域二倍体及双着丝粒组成。患儿最终诊断为15q11.2-13.2微重复四倍体综合征。复习文献报道的15q11.2-13.2拷贝数增加病例的临床表型,微重复四倍体综合征的主要表型有智力低下/发育迟缓(100%)、肌张力低下(92.9%)、孤独症/孤独症样表现(71.4%)和癫痫(61.5%)等。结论 15q11.2-13.2微重复四倍体综合征是患儿发生精神发育迟滞伴孤独症的遗传学基础,array-CGH能够快速、准确地检测基因组的微小失衡。  相似文献   

6.
Williams-Beuren综合征是一类常见的染色体微缺失综合征,早期诊断及干预对患儿及其家庭十分重要。本研究应用染色体核型分析技术(G显带),多重连接依赖探针扩增技术(MLPA)及微阵列比较基因组杂交技术(array-CGH)对4个家系中1例超声异常的胎儿及3例发育异常患儿行染色体核型和基因组DNA分析,为这4个家庭的再生育提供指导,为产前诊断提供依据。研究结果发现1例产前超声异常孕妇羊水及3例发育异常患儿外周血MLPA分析提示染色体7q11.23区域ELN基因探针信号降低,array-CGH检测提示染色体7q11.23区域杂合缺失。4个家系中母亲再次妊娠时取羊水细胞标本行上述检测均未发现异常。研究结果提示MLPA技术及array-CGH技术能够快速、准确地诊断Williams-Beuren综合征,为临床提供更好的遗传咨询服务。  相似文献   

7.
患儿,女,5个月,因生长发育迟缓就诊,体格检查发现体格发育落后,特殊面容(小头畸形、眼距宽、耳位偏低、鼻梁扁平、短人中)以及一侧小阴唇缺失。外周血染色体核型为46,XX,r(13)(p11q33)[82]/45,XX,-13[10]/46,XX,r(13;13)(p11q33;p11q33)[8];微阵列比较基因组杂交(aCGH)检测显示13q11q33.2区域和13q33.2q34区域分别有87.5 Mb的重复和8.2 Mb的缺失;荧光原位杂交(FISH)显示13号环状染色体长臂末端缺失。诊断为13号环状染色体综合征。该综合征临床表型多变,主要与染色体区带中遗传物质丢失的数量、部位以及不同核型嵌合比例不同等密切相关。  相似文献   

8.
15号额外标记染色体是一种罕见的染色体异常,本文报道1例15号额外标记染色体患儿,就其临床诊治经过及遗传缺陷进行研究。患儿,女,9岁半,自幼智力、运动发育落后,7岁出现乳房发育,8岁半出现癫癎发作:发作形式多样,多种抗癫癎药物控制欠佳,头颅磁共振未见异常,脑电图提示癎样放电频繁。采用G显带核型分析、荧光原位杂交(FISH)、甲基化多重连接依赖性探针扩增技术(甲基化MLPA)和微阵列比较基因组杂交(array-CGH)等多种遗传学检测手段,明确患儿存在新生的15q重复:15q11-13区域母源性拷贝数复制增加,基因组重排的形式为47,XX,+inv dup (15)(pter→q13:q13→pter)。15q11-13区域拷贝数复制增加与智力障碍、难治性癫癎伴中枢性性早熟临床表现密切相关。建议对于不明原因智力障碍伴癫癎患儿进行高分辨染色体核型分析。  相似文献   

9.
目的探讨Pallister-Killian综合征(PKS)的细胞分子遗传学特点。方法采集患儿外周血标本进行G显带染色体核型分析,单核苷酸多态性-微阵列芯片(SNP array)技术鉴定异常片段来源,运用荧光原位杂交(FISH)技术加以确认。结果女性患儿,8月龄,因精神运动发育迟缓就诊。出生后有喂养困难、肌张力低下、面容异常、后发际线低、足部畸形、双耳听力未过关等临床表现。外周血染色体G显带核型为mos 47,XX,+mar[18]/46,XX[82];芯片分析结果发现患儿12号染色体短臂嵌合重复,提示为12 p四体嵌合体;FISH检测显示有48%的细胞有4个12 p信号。结论根据临床表现,常规外周血染色体核型分析结合SNP-array及FISH检测诊断PKS。  相似文献   

10.
目的 分析不明原因智力低下(ID)和(或)生长发育迟缓(DD)患儿潜在的致病性基因组不平衡, 及其与表型的相关性, 探讨高密度微阵列比较基因组杂交技术(array-CGH)在临床分子遗传学诊断中的应用价值。方法 采用array-CGH技术对16例ID/DD患儿进行全基因组扫描分析, 并用多重连接探针扩增技术(MLPA)对检出的基因组不平衡异位进行验证。结果 16例患儿高分辨G显带核型分析均无异常。6例(38%)患儿存在基因拷贝数异常(CNVs), 其中3例CNVs为正常多态性改变; 1例CNVs涉及4p16.3区域微缺失, 考虑为Wolf-Hirschhorn综合征; 1例CNVs涉及7q11.23区域微缺失, 考虑为Williams-Beuren 综合征; 另1例CNVs临床意义不明确, 包含2个重复突变, 该突变与智力低下、脑发育迟缓、特殊面容、隐睾、牙列不齐等有关, 证实该CNVs具有临床意义。结论 通过array-CGH技术对不明原因ID/DD患儿进行全基因组扫描, 可为部分患儿明确病因诊断。该技术作为一种高通量、快速的疾病研究手段, 在ID/DD的病因诊断中具有重要的临床意义。  相似文献   

11.
There is a common progression known as the allergic march from atopic dermatitis to allergic asthma. Cetirizine has several antiallergic properties that suggest a potential effect on the development of airway inflammation and asthma in infants with atopic dermatitis. Methods. Over a two year period, 817 infants aged one to two years who suffered from atopic dermatitis and with a history of atopic disease in a parent or sibling were included in the ETAC® (Early Treatment of the Atopic Child) trial, a multi-country, double-blind, randomised, placebo-controlled trial. The infants were treated for 18 months with either cetirizine (0.25mg/ kg b.i.d.) or placebo. The number of infants who developed asthma was compared between the two groups. Clinical and biological assessments including analysis of total and specific IgE antibodies were performed. Results. In the placebo group, the relative risk (RR) for developing asthma was elevated in patients with a raised level of total IgE (≥ 30 kU/I) or specific IgE (≥ 0.35 kUA/I) for grass pollen, house dust mite or cat dander (RR between 1.4 and 1.7). Compared to placebo, cetirizine significantly reduced the incidence of asthma for patients sensitised to grass pollen (RR = 0.5) or to house dust mite (RR = 0.6). However, in the population that included all infants with normal and elevated total or specific IgE (intention-to-treat - ITT), there was no difference between the numbers of infants developing asthma while receiving cetirizine or placebo. The adverse events profile was similar in the two treatment groups. Discussion. Raised total IgE level and raised specific IgE levels to grass pollen, house dust mite or cat dander were predictive of subsequent asthma. Cetirizine halved the number of patients developing asthma in the subgroups sensitised to grass pollen or house dust mite (i.e. 20% of the study population). In view of the proven safety of the drug, we propose this treatment as a primary pharmacological intervention strategy to prevent the development of asthma in specifically sensitised infants with atopic dermatitis.  相似文献   

12.
孤独症谱系障碍(autistic-spectrum disorders,ASDs)近年来患病率逐年攀升至1%左右,其症状往往伴随终生,成为严重威胁儿童健康和发展的神经发育性疾患;注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童期最常见的精神障碍,国内报道患病率为4.13%~5.83%,其症状可延续至青少年期,甚至到成年期[1]。这两类精神障碍在成年期的临床表现、共患病、治疗策略和预后与儿童期有哪些不同呢?本文通过回顾相  相似文献   

13.
During the past several decades, our understanding of the complex pathophysiology of vasoocclusion associated with sickle cell disease has improved greatly. Interaction of genes, hemoglobin molecules, red cell membrane and metabolic changes, cell-cell interactions and cell-plasma interactions, red cell adhesion to vascular endothelium, activation of coagulation, and vascular reactivity play a role in vaso occlusion. Penicillin prophylaxis of pneumococcal infections and appropriate use of blood transfusions and other supportive measures improved survival of sickle cell patients. Hydroxyurea made a major impact on sickle cell therapy when it was shown to decrease acute painful episodes, acute chest syndrome, and the need for blood transfusion in adults. Significant experience in the use of hydroxyurea has been accumulated in older children. The benefits and risks of hydroxyurea for younger children and long-term risks in all patients will be evaluated in future investigations. Other promising therapies include butyrate compounds, clotrimazole, magnesium supplementation, poloxamer 188, antiadhesion agents, anticoagulant approaches, and nitric oxide. Hemopoietic transplantation remains the only curative therapy. However, several transgenic mouse models are available for studies of gene therapy or other treatment approaches on biochemical, cellular, and pathologic effects of mutant genes.  相似文献   

14.
A 21-year-old man with granular lymphocyte-proliferative disorders (GLPD) associated with chronic active Epstein-Barr virus (EBV) infection is described. Chromosomal analyses revealed several clonal abnormalities and two of them were mainly repetitious. High copy numbers of monoclonal EBV genome were also detected in the proliferative large granular lymphocytes (LGLs), indicating the monoclonal expansion of EBV-infected LGLs. The patient had an indolent course for several years, and there was no evidence of infiltrations of his bone marrow until the end stage. At autopsy, microscopic studies revealed marked infiltrations of LGL in the liver and spleen, and the infiltrating cells were NK-cell immunophenotype. The infiltrated LGLs showed latency I.  相似文献   

15.
Human male sexual development is regulated by chorionic gonadotropin (CG) and luteinizing hormone (LH). Aberrant sexual development caused by both activating and inactivating mutations of the human luteinizing hormone receptor (LHR) have been described. All known activating mutations of the LHR are missense mutations caused by single base substitution. The most common activating mutation is the replacement of Asp-578 by Gly due to the substitution of A by G at nucleotide position 1733. All activating mutations are present in exon 11 which encodes the transmembrane domain of the receptor. Constitutive activity of the LHR causes LH releasing hormone-independent precocious puberty in boys and the autosomal dominant disorder familial male-limited precocious puberty (FMPP). Both germline and somatic activating mutations of the LHR have been found in patients with testicular tumors. Activating mutations have no effect on females. The molecular genetics of the inactivating mutations of the LHR are more variable and include single base substitution, partial gene deletion, and insertion. These mutations are not localized and are present in both the extracellular and transmembrane domain of the receptor. Inactivation of the LHR gives rise to the autosomal recessive disorder Leydig cell hypoplasia (LCH) and male hypogonadism or male pseudohermaphroditism. Severity of the clinical phenotype in LCH patients correlates with the amount of residual activity of the mutated receptor. Females are less affected by inactivating mutation of the LHR. Symptoms caused by homozygous inactivating mutation of the LHR include polycystic ovaries and primary amenorrhea.  相似文献   

16.
17.
OBJECTIVE: To ascertain the profile of cases of measles seen at a general hospital during a recent outbreak that occurred despite a measles vaccination program. METHODOLOGY: A retrospective study from January 1991 to March 1998. All patients with measles (ICD code 055. 9) seen at the emergency unit or as inpatients were included. RESULTS: There were 87 cases identified. The diagnosis was clinical in all and proven serologically in 71%. Eighty-five per cent of the cases occurred between January 1997 and March 1998. There was a bi-modal age distribution with peaks in the very young (相似文献   

18.
The aim of the study was to explore psychological factors and autonomic activity in children with recurrent abdominal pain and to compare them with those in a control group of healthy children. The Personality Inventory for Children was used for assessment of developmental, emotional and psychosocial factors in 25 children with recurrent abdominal pain (age, 7-15 y). Parasympathetic and sympathetic functions in these children and in 23 healthy control subjects (age, 7-13 y) were also investigated, non-invasively using a computerized polygraph. Vagal tone (parasympathetic function) was indexed by calculation of respiratory sinus arrhythmia in beats/min. Skin conductance (sympathetic function) was recorded by the constant current method. On the Personality Inventory for Children, 16 patients had high scores on somatic concern. Several patients had scores in the clinical range for depression, withdrawal and anxiety, but the mean scores for these personality profile scales were well within the normal range of healthy children. Interestingly, there was a spike on the L (Lie)-scale for most of the patients and 15 patients had scores above or close to the clinical cut-off value. As compared with the scores in healthy children, vagal tone and sympathetic tone were normal. Conclusion: Many children with recurrent abdominal pain have scores in the clinical range for depression, withdrawal, anxiety and L-scale indicating coping problems, denial and a trend towards somatic concern that may contribute to the evolution of abdominal pain. Autonomic nerve activity was not disturbed in these children.  相似文献   

19.
Inhibition of the function of pulmonary surfactant in the alveolar space is an important element of the pathophysiology of many lung diseases, including meconium aspiration syndrome, pneumonia and acute respiratory distress syndrome. The known mechanisms by which surfactant dysfunction occurs are (a) competitive inhibition of phospholipid entry into the surface monolayer (e.g. by plasma proteins), and (b) infiltration and destabilization of the surface film by extraneous lipids (e.g. meconium-derived free fatty acids). Recent data suggest that addition of non-ionic polymers such as dextran and polyethylene glycol to surfactant mixtures may significantly improve resistance to inhibition. Polymers have been found to neutralize the effects of several different inhibitors, and can produce near-complete restoration of surfactant function. The anti-inhibitory properties of polymers, and their possible role as an adjunct to surfactant therapy, deserve further exploration.  相似文献   

20.
The World Health organisation recommends breast feeding infants for the first six months of life. When this breast feeding does not occur either through parental choice or medical need, infant formulas will be required. There is a bewildering array of formulas on the UK market for many different requirements. When faced with an unsettled infant many parents (and healthcare professionals) will experiment with the infant formula available and then attend the paediatric clinic looking for help and advice. It is therefore essential that paediatricians understand what milks are available and what the key differences between different products are. This review attempts to provide a simple guide through many of the formulations currently available in the UK; and offers advice for the dietary management of the child with extra calorie requirements, infants with cow's milk protein allergy, gastro oesophageal reflux disease, apparent unresolved hunger and infantile colic. Whatever the underlying condition, there is likely to be an infant formula that is suitable in this generation of ever expanding formulations.  相似文献   

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