应用PCR检测恶性淋巴瘤骨髓浸润及其临床意义

目的：检测恶性淋巴瘤（ＭＬ）的骨髓浸润（ＩＢＭ）并探讨其与临床分期、疗效和预后的关系。方法：以克隆性ＩｇＨ和ＴＣＲγ基因重排分别作为Ｂ和Ｔ细胞淋巴瘤克隆基因标志，应用ＰＣＲ基因扩增技术检测ＭＬ患者ＩＢＭ。结果：（１）３４份ＭＬ患者骨髓标本ＩＢＭ检出率为７０．６％（２４／３４），明显高于形态学检测方法（３８．６％，Ｐ＜０．０５）。（２）１９例形态学检测正常的非霍奇金淋巴瘤（ＮＨＬ）骨髓标本，ＩＢＭ阳性率５７．９％（１１／１９），其中８例Ｂ－ＮＨＬ（８／１４）检测到克隆性ＩｇＨ基因重排；５例同时还检测到克隆性ＴＣＲγ基因重排，２例Ｔ－ＮＨＬ（２／３）检测到克隆性ＴＣＲγ基因重排，无克隆性ＩｇＨ基因重排；２例免疫分型不明确ＮＨＬ患老中１例（１／２）检测到克隆性ＩｇＨ基因重排，无克隆性ＴＣＲ，基因重排。２例霍奇金病（ＨＤ）和１０例非淋巴系肿瘤骨髓ＩＢＭ均阴性。（３）Ⅲ，Ⅳ期ＮＨＬ患者ＩＢＭ检出率显著高于ＩＩ期（ｐ＜０．０１），初诊未治及复发患者也显著高于部分或完全缓解患者（Ｐ＜０．０１）。（４）ＩＢＭ阳性组ＮＨＬ２年死亡率５４．５％（６／１１），明显高于ＩＢＭ阴性（ｐ＜０．０５）。结论：ＰＣＲ方法检测ＩＢＭ有助于估     

Quox-1基因在人类白血病骨髓细胞中的表达

Ｑｕｏｘ－１是从５ｄ胚龄鹌鹑的ｃＤＮＡ文库中克隆的同源盒基因,属于ＣｌａｓｓⅠＨｏｘ基因家族的特别成员,至今未分离出其人类同源基因。用免疫细胞化学技术（ＳＰ法）检测了４２例人白血病患者骨髓细胞的Ｑｕｏｘ－１表达。结果发现１０例急性淋巴细胞性白血病（ＡＬＬ）全部阳性,染色部位在细胞核,而在慢性髓性白血病（ＣＭＬ）、慢性淋巴细胞性白血病（ＣＬＬ）、急性髓细胞白血病（ＡＭＬ,包括Ｍ１～Ｍ７）中表达低甚至不表达,这为进一步从相应肿瘤中筛选、克隆Ｑｕｏｘ－１的人类同源基因提供了可能的肿瘤模型,并为临床诊断ＡＬＬ提供了一种参考指标。     

IgH超基因家族及其相关基因在急性淋巴细胞白血病微小残留病检测中的应用

探讨免疫球蛋白超基因家族及其相关基因在急性淋巴细胞白血病（ＡＬＬ）微小残留病（ＭＲＤ）检测中的应用。方法应用免疫学和聚合酶链反应技术。对１５例ＡＬＬ进行免疫表型测定。结果发现其中１１例为Ｂ－ＡＬＬ，３例为Ｔ－ＡＬＬ。ＤＮＡＳｏｕｔｈｅｒｎ分析发现，１１例Ｂ－ＡＬＬ均有ＩｇＨ基因的重排，且有ＩｇＨ基因重排的病例均能用ＩｇＨ基因ＣＤＲ３区及Ｊ区引物得到聚合酶链反应扩增条带。对其中３例Ｂ－ＡＬＬ的ＩｇＨ基因Ｖ－Ｄ－Ｊ结合部区域进行了顺序分析，并合成了２个针对ＩｇＨＶ－Ｄ－Ｊ结合部的寡核苷酸作为探针用来检测ＭＲＤ，显示其灵敏度为１０－４。另外还对１例Ｔ－ＡＬＬ病例同时进行了ＴＣＲγ基因和ＳＩＬ－ＴＡＬ－１融合基因在ＭＲＤ检测中的比较研究，显示二者具有相同的ＭＲＤ阳性检出率，但后者的敏感度更高。结论ＩｇＨ基因重排及其ＴＣＲ基因重排、肿瘤融合基因等均可作为ＡＬＬ患者ＭＲＤ检测的特异性标记     

淋巴系肿瘤免疫球蛋白和T细胞受体重排基因的指纹图谱特征

目的 确定淋巴系统肿瘤的免疫球蛋白（Ｉｇ）和Ｔ细胞受体（ＴＣＲ）基因重排的特征。方法 用ＰＣＲ和单链构象多态性等分析１０８例各类淋巴系统肿瘤。结果：不同患各有特征性指纹图谱。５４％的生淋巴细胞白血病（ＡＬＬ）和４３％多发发现有髓瘤（ＭＭ）存在ＩｇＨ或ＴＣＲγ双等位基因重排，６例ＡＬＬ和３例ＭＭ存在寡克隆性。结论；指纹图谱可判断恶性克隆之间的基因差异和克隆性。     

非霍奇金淋巴瘤Ig和TCR_β链基因重排与相关抗原的表达

用１４种抗人白细胞的单克隆抗体（ＭｃＡｂ）与２种多克隆抗体（ＰｃＡｂ）和人类免疫球 蛋白（Ｉｇ）基因簇重链（ＩｇＨ）ＪＨ、Ｃμ、轻链（ＩｇＬ）Ｃκ、Ｏλ以及Ｔ细胞受体β链（ＴＣＲβ）基因作为 探针，以 ＡＢＣ及 Ｓｏｕｔｈｅｒｎ印迹杂交法对１１例非霍奇金恶性淋巴瘤（ＮＨＬ）的抗原表达与 Ｉｇ基因簇、ＴＣＢβ基因重排作了研究。结果显示：抗原表达和基因重排具有非常明确的相关性（Ｐ ＝０．００２）。从ＩｇＬ的κ链重排中还显示了基因的重排早于基因的表达。研究证实基因重排的检测能更敏感地反映ＮＨＬ的亚型以及肿瘤的分化阶段。     

用微卫星寻找和定位血液系统肿瘤患者丢失的基因

目的：许多血液系统肿瘤的发生与患者染色体易位和基因丢失有关，基因丢失的部位往往存在抑癌基因。用微卫星确定是否发生基因丢失及基因丢失的位置。方法：用ＰＣＲ扩增不同染色体上常见白血病易位断裂点区域附近的１９个微卫星，变性胶凝胶电泳，以及用１１号染色体上的白血病相关ＭＬＬ基因探针做Ｓｏｕｔｈｅｒｎｂｌｏｔ杂交等方法，检测４９例血液系统肿瘤患者基因的杂合性丢失（ｌｏｓｏｆｈｅｔｅｒｏｚｙｇｏｓｉｔｙ，ＬＯＨ）及丢失部位。结果：发现１８例（１８／４９）血液系统肿瘤患者１～７个微卫星位点上存在ＬＯＨ；以１１号染色体微卫星Ｄ１１Ｓ１３０１的丢失最常见；３例（３／１０）急性髓细胞白血病（ＡＭＬ）患者在Ｄ１１Ｓ１３０１位点有ＬＯＨ，其附近有抑癌基因ＷＴ１和ＲＢＴＮ２。３（３／１３）例ＡＭＬ在Ｄ１１Ｓ１３１４有ＬＯＨ，附近有ＢＣＬ１基因。ＤＮＡ杂交检测发现仅３例ＡＭＬ有ＭＬＬ基因重排，其附近ＬＯＨ不多见。结论：急性白血病患者ＬＯＨ发生率较高，白血病患者染色体１１短臂ｐ１３区是抑癌基因丢失较常见的部位。     

PCR扩增IgH和TCR_β基因重排在检测淋巴细胞白血病微小残留病中的应用

利用ＩｇＨ和ＴＣＲ＿β克隆性基因重排原理，用多聚酶链反应（ＰｏｌｙｍｅｒａｓｅＣｈａｉｎＲｅａｃｔｉｏｎ．ＰＣＲ）技术检测小儿急性淋巴细胞白血病（ＡＬＬ）骨髓和外周血共１３例。结果：ＡＬＬ初治的２例患儿ＰＣＲ检测全部呈现阳性特异性单带。ＡＬＬ完全缓解（ＣＲ）的１１例患儿中阳性７例，阴性４例，其中２例骨髓移植（ＢＭＴ）患儿移植前ＰＣＲ阳性，移植后转为阴性。１例自体骨髓移植（ａｕｔｏ－ＢＭＴ）患儿于移植后２个月时ＰＣＲ检测又重新出现阳性，但临床无复发现象。４例对照者ＰＣＲ均为阴性。结果表明ＰＣＲ技术具有简便、快速、敏感、特异性强等优点，在检测微小残留（ＭＲＤ）中具有广阔前景。     

Quox—1基因在人类白血病骨髓细胞中的表达

Ｑｕｏｘ－１是从５ｄ胚岭鹌鹑的ｃＤＮＡ文中克隆的同源盒基因,属于Ｃｌａｓｓ １ Ｈｏｘ基因家族的特别成员,至今未分离出其人类同源基因。用免疫细胞化学技术（ＳＰ法）检测了４２例人白血病患者骨髓细胞的Ｑｕｏｘ－１表达,结果发现１０例急性淋巴细胞性白血病（ＡＬＬ）全部阳性,染色部位在细胞核,而在慢性髓性白血病（ＣＭＬ）、慢性淋巴细胞性白血病（ＣＬＬ）,急性髓细胞白血病（ＡＭＬ,包括Ｍ１￣Ｍ７）中表达低甚     

Southern印迹技术检测人9种恶性淋巴瘤细胞系IgCλ基因的重排

用Ｓｏｕｔｈｅｒｎ印迹技术分析人９种恶性淋巴瘤细胞系，并与正常胚系ＤＮＡ相比，胚系ＤＮＡＩｇＣλ基因表现为１４ｋｂ、８ｋｂ、５ｋｂ片段，而Ｓｕ－ＤＨＬ－２、Ｎｕ－ＤＨＬ－１、Ｒａｊｉ、ＳＢ、Ｄａｕｄｉ细胞系表现为重排，８３９２细胞系表现为部分缺失。仅Ｓｕ－ＤＨＬ－４、Ｓｕ－ＤＨＬ－５、ＰＡ－３表现为胚系结构。每种细胞系个体的特异性重排是其恶性克隆起源的基因标志。这对于了解Ｂ淋巴细胞肿瘤生成、发展、     

人类巨细胞病地人胚肺细胞HOX基因表达的影响

应用半定量ＲＴ－ＰＣＲ技术研究人胚肺（ＨＥＬ）细胞ＨＯＸ基因的表达状态及人类巨细胞病毒（ＨＣＭＶ）对ＨＥＬ细胞ＨＯＸ基因表达的影响。结果发现：ＨＥＬ细胞表达ＨＯＸＢ７基因;ＨＣＭＶ感染后,其表达上调;用全反式维甲酸（ＡＴＲＡ）处理ＨＥＬ细胞,ＨＣＭＶ对ＨＯＸＢ７基因表达的上调作用更强。提示ＨＣＭＶ可能通过影响ＨＯＸＢ７基因的表达导致胚胎发育畸形。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.