东方人苯丙酮尿症的分子遗传学—苯丙氨酸羟化酶基因中一终止突变与单体型4的连锁不平衡性

应用聚合酶链反应(PCR)方法扩增苯丙氨酸羟化酶(PAH)基因的每个外显子及其侧翼的内含子,并克隆到M 13载体中进行序列分析。发现中国人苯丙酮尿症(Phenylketonuria,PKU)患者的PAH基因外显子3中有1个Arg~(111)→Ter~(111)的点突变,此突变与东方人最常见的突变单体型4呈连锁不平衡。此突变占中国人PAH等位基因的10％左右,但不存在于高加索人群中,表明在种族分化过程中PAH基因位点发生了互不相关的突变事件。     

苯丙酮尿症患儿苯丙氨酸羟化酶基因外显子7突变特点及临床研究

目的:探究苯丙酮尿症(PKU)患儿苯丙氨酸羟化酶(PAH)基因外显子7突变特点及其与临床的关系.方法:选取87例PKU患儿为研究对象.聚合酶链反应-单链构象多态性(PCR-SSCP)分析PAH基因外显子7突变与基因测序,分析其与经典型、中间型及轻型PKU之间的关系.结果:87例患儿检出6种PAH基因外显子7位点突变,分别为R243Q、IVS7+2T-A、R241C、G247R、L255S、G247V,其基因频率分别为18.97％、4.02％、1.72％、1.15％、1.15％、0.57％;经典型PKU患儿检出6种突变,中间型PKU检出R243Q、IVS7+2T-A、R241C等3种突变,而轻型PKU仅检出R243Q突变;应用外显子7位点突变情况预测患儿PKU表型显示,经典型、中间型及轻型PKU预测与临床诊断一致性较高,Kappa值分别为0.818、0.781、0.935.结论:PKU患儿PAH外显子7突变主要以R243Q、IVS7+2T-A为主,其基因型与PKU表型存在相关性,有助于患儿PKU表型预测.     

吉林和辽宁地区80例苯丙酮尿症患儿苯丙氨酸羟化酶基因突变分析

背景 苯丙酮尿症(phenylketonuria,PKU)是一种常染色体隐性遗传的氨基酸代谢病,由苯丙氨酸羟化酶(phenylalanine hydroxylase,PAH)活性的部分或完全缺失引起,会使苯丙氨酸在体内蓄积,导致患儿出现神经系统等损害.PAH基因突变种类和频率存在明显的地域和种族差异.目的 分析吉林和辽宁地区苯丙酮尿症80例患儿苯丙氨酸羟化酶PAH基因的突变特征.方法 对2016 - 2018年吉林辽宁两省医院80例PKU患儿PAH基因的13个外显子及其侧翼序列,包含5'和3'端非编码区,进行一代测序点突变分析.结果 80例患儿共检出161个突变位点,占292个突变等位基因的55.14％.其中,R243Q占比最高(15.75％),IVS11-3 A>T、R413P、IVS4-1 G>A和EX6-96A>G次之,占比依次为4.11％、3.42％、3.08％和3.08％.另外5个低频突变位点Y356*、R111*、R241C、R53H a和IVS2 + 19 T>C突变频率为1％～3％.此次,我们发现PAH基因1个新的突变点F294S,位于8号外显子.结论 依据此次吉林辽宁地区80例PKU患儿PAH基因的突变特点,为该地区预防PKU出生缺陷提供理论依据.     

中国人苯丙氨酸羟化酶基因的10种新突变

目的 研究中国人苯丙氨酸羟化酶(PAH)基因突变的分子基础。方法 应用PCR／SSCP、序列分析等技术,分析中国北方地区120个经典型苯酮尿症(PKU)核心家系,对PAH基因外显子3、5、7、10、11、12进行突变基因的筛查和确定。结果 在确定的31种突变中(另文报道)有10种突变首次在中国PKU人群中发现：165T、S70del、G239D、R241fsdelG、L255S、P281L、G346R、L367fsinsC、R400S和Ivsllnt2t→c。其中4种突变G239D、R241fsdelG、R400S和Ivsllnt2t→c在国际PAH数据库末见公布(至投稿日期)。新突变显示中国人PAH基因虽以点突变为主,但存在小的碱基插入、缺失以及移码突变。新突变主要发生在外显子7中(4／10),每种突变的发生频率均很低(0．42％。1．3％)。结论 中国人PAH基因存在高度异质性和突变的多样性,外显子7是PAH基因的突变热点区域。     

河北地区55例苯丙酮尿症患者苯丙氨酸羟化酶基因突变的检测与分析

目的 了解河北地区苯丙酮尿症(PKU)患者苯丙氨酸羟化酶(PAH)基因突变情况,分析该地区PAH基因的突变谱及突变特点.方法 联合应用PAH基因全部外显子及外显子-内含子交界区扩增测序和多重连接依赖式探针扩增(MLPA)方法,对2007年9月至2009年7月就诊的55例来自河北地区的PKU患者进行PAH基因点突变和拷贝数改变的检测.对发现大片段缺失的个体,用跨越断裂位点(Gap) -PCR-测序方法确定断裂点精确位置.结果 110个PAH等位基因中检出突变等位基因108个,突变检出率为98.2％.共发现PAH基因突变41种,涉及11个外显子,包括错义突变24种、无义突变7种、剪接位点突变7种、小的缺失1种和大片段缺失2种,其中4种错义突变(p.Pro147ku,p.Gly289Arg,p.Phe392Ser,p.Ile421Thr)和2种大片段缺失突变(- 4163_ - 406del和- 1932_+ 3402del)为国际首次报道.55例患者中以下3种突变所占比例最高:p.Arg243Gln(12.7％)、c.611A ＞G(11.8％)和c.1197A ＞T(9.1％).结论 中国河北地区PKU患者中PAH基因的突变分布广泛;突变类型大部分为单碱基替换,但是大片段缺失也占一定比例.     

广东省β珠蛋白基因簇RFLP分析及β地中海贫血基因的检测

应用5种限制性内切酶,6种β珠蛋白基因簇内探针分析广东18个β地中海贫血(简称β地贫)家系中69条染色体的限制酶切片段长度多态性(RFLP)单体型,共发现17种类型,其中最常见的单体型为1、2和3型;新发现4种单体型,其中3种与β地贫基因(β~T)相关。应用RFLP分析法可对9个家系进行产前诊断,7个家系进行50％排除诊断。用PCR(聚合酶链反应)结合寡核苷酸探针(ASO)检测法对广东地区46名患儿的β~T基因进行检测,有82个与6种β~T突变基因的ASO探针杂交,其中最常见的是41/42-TCTT、-28A→G和IVS-2nt654C→T。应用PCR结合6种ASO探针检测法,可对36个家系进行产前诊断。     

用PCR-SSCP-银染法检测苯丙酮尿症PAH基因外显子11的点突变

目的：研究内蒙古地区经典型苯丙酮尿症(PKU)苯丙氨酸羟化酶(PAH)基因突变的特点和频率，以提高该地区苯丙酮尿症(PKU)的基因诊断率。方法：应用PCR-SSCP-银染法和DNA直接测序的方法，对22例内蒙古地区PKU患者苯丙氨酸羟化酶(PAH)基因外显子11进行了检测。结果：检出一种已知突变Y356X(TAC-TAA)，突变频率为13．6％。结论：内蒙古地区PKU患者PAH基因外显子11的突变频率均高于我国的其它北方人群，也高于云南PKU患者的突变频率，这为内蒙古地区PKU患者PAH基因分析和产前诊断提供了科学依据。     

内蒙古经典型苯丙酮尿症PAH基因外显子7突变的检测及一种新突变的鉴定

目的：探讨内蒙古地区经典型苯丙酮尿症(PKU)基因突变特征，为基因诊断提供依据。方法：应用PCR-单链构象多态性分析技术和DNA直接测序的方法，对22例内蒙古地区PKU病人苯丙氨酸羟化酶(PAH)基因外显子7内突变进行了检测。结果：共检出4种错义突变；R243Q、R252Q、R261Q及G239D，1种剪接部位突变IVS7nt(2)，突变频率分别为：8／44、1／44、1／44、1／44、1／44。经与国际PAH基因突变数据库比较，确认G239D(G→A)为国际上首次发现的新突变。结论：内蒙古地区PKU病人PAH基因外显子7的突变位点、突变频率和中国东北人群相类似。但与中国南方人群PAH基因突变特点不同，这对提高内蒙古地区基因诊断率有其理论及实用价值。     

用RFLP连锁分析法对一个Becker型肌营养不良症家系突变基因的研究

作者用DMD/BMD基因位点内部DNA探针PERT87系列及XJ2.3和侧翼连锁探针754对一个Becker型肌营养不良症家系进行了RFLP单体型连锁分析,结果发现该家系三个同胞患儿携带致病基因的那条X染色体来自他们表型正常的外祖父。椐此推论,患儿外祖父在其精子发生中产生了一次EMD位点的基因突变,通过患儿母亲将BMD致病基因传递到患儿这一代,因此,患儿姨母携带致病基因的风险仅相当于该位点的自然突变率。研究结果表明,RFLP单体型连锁分析有助于追溯到BMD家系中突变基因的起源,从而对这些家系的遗传分析起重要的指导作用。     

内蒙古经典型苯丙酮尿症PAH基因外显子11突变的检测

目的：研究内蒙古地区经典型苯丙酮尿症（PKU）苯丙氨酸羟化酶（PAH）基因突变的特点和频率，以提高该地区PKU的基因诊断率。方法：应用PCR—SSCP-银染法和DNA直接测序的方法，对22例内蒙古地区PKU病人PAH基因外显子11进行了检测。站果：检出一种已知突变Y356X（TAC→TAA），突变频率为13．6％。结论：内蒙古地区PKU病人PAH基因外显子11的突变频率均高于我国的其它北方人群，也高于云南PKU病人的突变频率，这为内蒙古地区PKU病人PAH基因分析和产前诊断提供了科学依据。     

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.