基质金属蛋白酶9基因多态性与冠心病的关联性

目的：探讨基质金属蛋白酶9（MMP-9）基因C1562T、R279Q单核苷酸多态性(SNPs)与冠状动脉粥样硬化性心脏
病(CHD)的相关性。方法：258例CHD患者和183例健康体检者作为研究对象,采用酶联免疫吸附试验（ELISA）测定血清MMP-9水平,应用聚合酶链式反应-限制性片段长度多态（PCR-RFLP）方法对MMP-9基因C1562T和R279Q多态位点进行SNPs基因型检测,运用统计学软件SPSS 17.0分析等位基因和基因型频数分布。结果：CHD组患者血清MMP-9水平明显高于健康对照组（P<0.05）。CHD 组MMP-9基因C1562T多态位点CT+TT基因型和T等位基因频数（24.4%和11.8%）明显高于健康对照组（13.8%和7.3%）（P<0.05）。CHD组MMP-9基因R279Q多态位点G+GG基因型和G等位基因频数（60.2%和41.7%）与健康对照组（68.0%和41.5%）比较差异无统计学意义（P>0.05）。结论：CHD患者伴有MMP-9　的过度释放,MMP-9基因C1562T多态位点与CHD发病有关联,R279Q多态位点与
CHD发病无关联。     

基质金属蛋白酶⁃9 rs3918242、rs17576位点基因多态性与矽肺易感性的关系

目的：探讨基质金属蛋白酶（matrix metalloproteinases,MMP）?9 rs3918242、rs17576位点基因多态性与湖南郴州地区某锡矿男性接尘作业人员矽肺易感性的关系。方法：采用1∶1配对病例?对照研究方法,以确诊的186例矽肺患者为病例组,以健康接尘工人为对照组,按同年龄、同性别、同工种、相同累计接尘工龄进行配对,采用聚合酶链反应?限制性片段长度多态性（PCR?RFLP）方法检测MMP?9基因 rs3918242与rs17576两位点基因型,用酶联免疫吸附试验（ELISA）测定外周血MMP?9水平。结果：病例组MMP ?9 rs3918242位点C/C、C/T、T/T基因型频率分别为38.7%、34.4%、26.9%,C、T等位基因频率分别为55.9%、44.1%,对照组C/C、C/T、T/T基因型频率分别为57.5%、25.8%、16.7%,C、T等位基因频率分别为70.4%、29.6%,两组基因型与等位基因频率分布差异均有统计学意义（P < 0.05）,且病例组C/T、T/T基因型以及T等位基因频率均显著高于对照组。rs17576 位点基因型与等位基因频率在两组间分布的差异均无统计学意义（P > 0.05）。Ⅱ、Ⅲ期矽肺病例组T等位基因频率显著高于对照组,携带T等位基因群体外周血MMP?9水平显著高于CC基因型群体。结论：MMP ?9 rs 3918242位点基因多态性可能与矽肺发生及其严重程度有关,而rs17576位点基因多态性可能与矽肺易感性无关。     

INSIG1基因SNPrs9769506位点的多态性与2型糖尿病的关系

目的：探讨胰岛素诱导基因1（INSIG1）单核苷酸多态性（SNP）rs9769506位点的多态性与2型糖尿病（T2DM）的相关性,以期为 T2DM 的防治提供潜在的分子靶点。方法选择河南省南阳市中心医院2013年1月至2014年3月收治的 T2DM患者98例,另选取体检中心的健康体检者90例作为对照组,INSIG1基因 SNP rs9769506位点多态性检测使用实时荧光定量PCR（RT‐PCR）Taqman 分析。结果 T2DM 组 rs9769506位点 A 等位基因频率为54．1％,G 等位基因频率为45．9％,对照组 A等位基因频率为47．8％,G 等位基因频率为52．2％,两组之间差异无统计学意义（P ＞0．05）。 T2DM 组患者 rs9769506位点 A/A 、A /G 和 G/G 基因型频率分别为41．8％、24．5％和33．7％,对照组 rs9769506位点 A/A 、A/G 和 G/G 基因型频率分别为32．2％、31．1％和36．7％,A/A 基因型频率在对照组和 T2DM 组之间差异有统计学意义（P＜0．05）,而 A/G 和 G/G 基因型频率在对照组和 T2DM 组之间差异则无统计学意义（P＞0．05）。 T2DM 患者中三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL‐C）、高密度脂蛋白胆固醇（HDL‐C）表达水平在 A /A 、A/G 、G/G 基因型患者之间差异有统计学意义（P ＜0．05）,而 A/G 、G/G 基因型患者之间差异无统计学意义（P＞0．05）。结论 INSIG1基因 SNP rs9769506位点 A/A 基因型在 T2DM 患者中检出率高,对 T2DM 早期筛查及基因治疗具有临床指导意义。     

C20orf54基因rs3746804多态性与食管鳞状细胞癌的相关性研究

目的：探讨核黄素转移蛋白（C20orf54）基因 rs3746804位点单核苷酸多态性（SNP）与食管鳞状细胞癌（ESCC）的相关性,以期为 ESCC的防治提供潜在的分子靶点。方法收集该院2010年1月至2013年1月收治的 ESCC患者156例（ESCC组）,另选取该院体检中心的健康体检者100例作为对照组。SNP位点多态性检测使用实时（real-time）PCR分析。结果对照组 rs3746804位点C等位基因频率为48．0％,T等位基因频率为52．0％,ESCC组C等位基因频率为59．6％,T等位基因频率为40．4％,两组间差异无统计学意义（P＞0．05）。对照组 C/C、C/T和 T/T基因型频率分别为31．0％、34．0％和35．0％,ESCC组C/C、C/T和T/T基因型频率分别为46．8％、25．6％和27．6％,统计学分析显示 C/C基因型频率在对照组和 ESCC组之间差异有统计学意义（P＜0．05）,而C/T和 T/T基因型频率在对照组和 ESCC组之间差异无统计学意义（P＞0．05）。C20orf54基因rs3746804位点C/C基因型表达与患者的年龄、性别、临床分期、肿瘤分化程度无关（P＞0．05）,而在有无淋巴结转移的患者之间差异有统计学意义（P＜0．05）。结论 C20orf54基因 rs3746804位点 C/C基因型与 ESCC易感性密切相关,对 ESCC的早期筛查以及预后评估等方面具有一定的临床指导意义。     

TNFRSF4基因 rs17568多态性与2型糖尿病的相关性

目的：探讨四川南充地区汉族人 TNFRSF4基因 rs17568多态性与2型糖尿病（T2DM ）的相关性。方法应用聚合酶链反应－限制性片段长度多态性技术检测186例健康体检者和220例 T2DM 患者 rs17568多态性。酶法测定血糖（Glu ）、血清甘油三酯（TG ）、总胆固醇（TC ）及高密度脂蛋白胆固醇（HDL‐C ）。结果TNFRSF4基因 rs17568位点等位基因频率和基因型频率分布均符合 Hardy‐Weinberg 平衡定律。rs17568多态位点G等位基因频率为28.2％。两组rs17568位点G等位基因的频率差异无统计学意义（ P＞0.05）。rs17568多态位点在T2DM组和对照组中,GG、AG基因型携带者血清 HDL‐C水平较 AA基因型携带者明显升高（P＜0.05）。结论 TNFRSF4基因 rs17568多态性与T2DM无关联,但其G等位基因与血清HDL‐C水平密切相关。     

凝血酶原基因rs5896位点C＞T多态性与肾结石的 相关性

目的：探讨凝血酶原基因rs5896位点C＞T多态性与浙南地区人群肾结石的相关性。方法：采用PCR-RFLP和测序技术分析102例肾结石患者（病例组）和年龄相匹配的95例健康人群（对照组）凝血酶原基因rs5896位点,比较此位点2组间基因型频率和等位基因频率差异。结果：凝血酶原基因rs5896位点CC、CT和TT基因型频率在病例组为13.7%、50.9%和35.4%,对照组为24.2%、51.6%和24.2%,2组比较差异有统计学意义（P=0.028）;等位基因C、T频率在病例组和对照组分别为39.2%、60.8%和50.0%、50.0%,差异有统计学意义（P=0.031）。结论：凝血酶原基因rs5896位点多态性与浙南地区人群患肾结石具有关联性,rs5896位点C＞T变异可能是肾结石的易感因素。     

甲基化CpG结合蛋白-2基因多态性与女性精神分裂症患者的关联性研究

目的研究甲基化CpG结合蛋白-2（MeCP2）基因多态性与女性精神分裂症患者的关联性。方法采用基于质谱微阵列技术的基因多态性分析法对符合DSM-Ⅳ诊断标准的126例精神分裂症患者和144例正常对照组患者MeCP2基因上的4个SNP位点进行基因分型,用x。检验比较上述4个位点的基因型频率和等位基因频率的组间差异。结果MeCP2基因rsl616369位点G／A基因型分布频率（24-8％VS34．3％）组间差异有统计学意义（P〈0．05）;rs3027933位点G／C基因型分布频率（25．6％vs34．8％）组间差异有统计学意义（P〈0．05）;位点rs17435基因型．T／A分布频率（25．6％vs35．5％）组间差异有统计学意义（P〈0．05）;位点rs2239464基因型A／A分布频率（58．5％VS71.8％）,组间差异有统计学意义（P〈0．05）;单体型GCCA分布频率在病例组为0．1581,在对照组为0．2389,组间差异有统计学意义（P〈0．05）。结论女性精神分裂症患者MeCP2基因的相关基因型可能跟精神分裂症发病有相关性,MeCP2基因可能是女性精神分裂症易感基因,单体型GCCA可能是女性精神分裂症发病的保护因素。     

MMP -7、MMP -9 基因多态性与结直肠癌发病的关系研究

目的 探讨癌胚抗原（CEA）、糖类抗原199（CA199）、基质金属蛋白酶-7（MMP -7）-181A/G、基质金属蛋白酶-9（MMP -9）P574R 基因多态性与结直肠癌发病的关系。方法 以500 例健康体检志愿者作为研究对象,按血清CEA、CA199 水平将其分为高表达组和正常组,并统计结直肠癌的发病率。采用聚合酶链反应- 限制性片段长度多态性方法分析MMP -7 基因-181A/G 位点、MMP -9 基因P574R 单核苷酸多态性分布频率,分析其与临床资料关系。结果 高表达组结直肠癌发病率高于正常组（P <0.05）,高表达组MMP -7 GG+AG 基因型比例多于正常组（P <0.05）,高表达组中G 等位基因频率高于正常组（P <0.05）,两组MMP -9 PP、PR+RR 基因型表达比较,差异无统计学意义（P >0.05）。结直肠癌患者MMP -7 GG+AG 基因型频率高于健康人群（P <0.05）,结直肠癌患者MMP -9 PR+RR、PP 基因型频率与健康人群比较,差异无统计学意义（P >0.05）,MMP -7、MMP -9 基因多态性与结直肠癌TNM 分期、淋巴结转移相关（P <0.05）。结论 CEA、CA199 对结直肠癌的早期诊断有一定临床价值,MMP -7 基因-181 GG+AG、MMP-9 P574R PP基因型可能与结直肠癌的发生、发展有关。     

miRNA－146a基因多态性与儿童癫痫的相关性研究

目的：探讨我国汉族儿童中miRNA－146a（miR－146a）基因SNP位点（rs2910164和rs57095329）基因多态性与癫痫和难治性癫痫（ RE）易感性的关系。方法采用病例对照研究方法,选取癫痫患儿264例（癫痫组）,其中包括RE组患儿94例,非RE组患儿170例;健康对照者303例（对照组）。利用PCR－RFLP方法检测rs2910164和rs57095329两个SNP位点的多态性分布,并进行统计分析。结果癫痫组患儿中miR－146a基因SNP位点rs57095329基因型（ GG、AG、AA）频率和SNP位点rs2910164的基因型（ CC、CG、GG）频率与对照组相比差异均无统计学意义（ P＞0.05）。在RE组中,rs57095329 SNP位点基因型频率与对照组相比差异有统计学意义（P＝0.016）,G等位基因频率显著高于对照组（OR＝1.677,95％CI：1.146～2.424, P＝0.007）;而rs2910164 SNP位点基因型以及等位基因频率与对照组相比差异均无统计学意义（P＞0.05）;且SNP位点（rs57095329）多态性与RE的发作频率无关。结论位于miR－146a启动子区域的SNP位点（rs57095329）的多态性与RE发病相关,但与RE的发作频率无关,而SNP位点（ rs2910164）与癫痫的易感性不相关。     

抑郁症患者认知功能障碍与脑源性神经营养因子基因多态性的关系

目的 探讨脑源性神经营养因子（BDNF）基因与抑郁症患者认知功能障碍的关系.方法 采用北京版蒙特利尔认知评估量表（MoCA-BJ）分别对73例抑郁症患者和66例正常人进行认知功能评定,根据MoCA-BJ得分,将抑郁症患者划分为伴认知功能障碍组（36例）和不伴认知功能障碍组（37例）;采用PCR-RFLP技术,检测BDNF基因rs6265及rs12273539两个SNPs位点的基因型.结果 3组之间rs6265位点基因型分布（x2=5.18,P=0.27）、A等位基因携带频率（x2=4.28,P=0.12）、G等位基因携带频率（x2=1.95,P=0.38）差异无统计学意义;不伴认知功能障碍组与健康对照组在rs12273539位点基因型分布,等位基因携带频率上差异无统计学意义（P＞0.05）;而伴认知功能障碍组与健康对照组的rs12273539位点基因型分布差异有统计学意义（x2=8.38,P=0.02）,C等位基因携带频率显著高于对照组（x2=5.40,P=0.02）,T等位基因携带频率低于对照组（x2=6.06,P=0.01）;注意功能在CC、CT、TT三种基因型间的分值差异具有统计学意义（P＜0.01）.结论 BDNF rs12273539（T/C）基因型与抑郁症患者认知障碍相关,伴认知功能障碍的抑郁症患者比健康对照组携带更多的C等位基因;CC基因型的抑郁症患者注意功能的损害更为严重.     

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.     

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.     

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.