Association between TGF-Beta1 in allograft and chronic allograft nephropathy]

OBJECTIVE: To investigate the relation between TGF-beta1 in allograft and chronic allograft nephropathy (CAN). METHODS: The levels of urine TGF-beta1 were tested in 146 recipients whose renal function were normal from September 1, 2000 to January 31, 2001. Twenty recipients with the highest level of urine TGF-beta1 were classified in group A, while 20 other recipients with the lowest level of urine TGF-beta1 were classified in group B. In these two groups biopsies were carried out in 14 cases and 12 cases respectively, and TGF-beta1 mRNA in the biopsies was measured by RT-PCR. The levels of TGF-beta1 in the blood were also measured in the two groups. Three years later, the renal function was compared between the two groups. Biopsies were carried out in renal recipients whose creatinine is higher than normal. RESULTS: The level of TGF-beta1 in the blood showed no significant difference between the two groups; 3 years after transplantation, the loss of renal function in group A was severer than that in group B. The number levels of CAN cases in group A was larger than that in group B. The expression levels of TGF-beta1 and TGF-beta1 mRNA of the allografts were higher in group A than in group B; there were statistically significant differences between the two groups. CONCLUSION: The findings suggest that there is an association between TGF-beta1 in kidneys and CAN. The level of urine TGF-beta1 after renal transplantation may predict future renal function.     

胆固醇酯转运蛋白基因多态性与肥胖及对膳食干预的影响

目的探讨胆固醇酯转运蛋白(CETP)基因多态性与肥胖的关系及其对肥胖膳食干预的影响。方法从血凝块中提取DNA,用聚合酶链反应和限制性片段长度多态性方法(PCR-RFLP)检测上海340名成年人的CETP基因TaqIB位点多态性;对研究对象进行体格检查并测定血脂;对其中的肥胖人群进行膳食干预,分析CETP基因多态性对干预效果的影响。结果(1)B1B1、B1B2和B2B2三种基因型的频率分别为35·6%、47·9%和16·5%,符合Hardy-Weinberg定律;B1等位基因为优势等位基因;肥胖组人群和正常组的基因型构成差异无显著性,控制相关影响因素后结果相同。(2)三种基因型的高密度脂蛋白(HDL)水平差异有显著性,B2B2型的HDL水平最高。控制环境影响因素后这种相关性仍然存在。(3)B1B2型膳食干预后HDL水平明显升高,这与其他基因型显著不同;控制基线HDL水平和性别因素后基因型对HDL水平改变没有影响。结论CETP-TaqIB位点B2B2基因型具有较高的血清HDL水平,成年肥胖人中此位点多态性无特殊性;基线HDL水平影响不同基因型的HDL对膳食干预的反应。     

Correlation of minimal residual disease by assessing Wilms tumor gene expression and engraftment by variable number of tandem repeats in children with leukemia posthematopoietic stem cell transplantation.

An important measure to ensure successful follow-up in patients with allogeneic stem cell transplant is to evaluate for engraftment. Recent studies have shown that detecting minimal residual disease is important in order to predict early clinical relapse. We followed 88 leukemic patients with pre- and posttransplant Wilms tumor gene (WT1) levels to predict relapse and variable number of tandem repeats (VNTR) for engraftment. We have found that high pretransplant WT1 levels correlated significantly with relapse in all patient groups, but more significantly in the acute nonlymphoblastic leukemia (ANLL) patients. Posttransplant WT1 level correlated with VNTR status such that low WT1 is associated invariably with VNTR of 100% donor origin, while high WT1 is associated with VNTR of 20%. The association is significant in all patients, specifically in ANLL patients. In this preliminary study, we demonstrate that patients harboring detectable levels of WT1 prior to stem cell transplant have a higher chance of relapse, and posttransplant WT1 and VNTR status appeared to be dependent parameters predicting relapse when present in the posttransplant period. By combining 2 highly sensitive molecular techniques, we have found that this combined technique provided us with a promising alternative for overcoming the limitations imposed by each separate procedure. More studies are necessary before we can come to any significant conclusions.     

Predicting abdominal adipose tissue in overweight Latino youth.

OBJECTIVES: 1) Examine associations between visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and anthropometric and demographic variables; 2) generate and cross-validate prediction equations for estimating VAT and SAAT in overweight Latino children. STUDY DESIGN: Cross-sectional. PARTICIPANTS: 196 overweight 8-13-year-old Latino youth. Two-thirds (n = 131) were randomly assigned to a development group to generate prediction equations for VAT and SAAT; one-third (n = 65) was used as a cross-validation group. METHODS AND PROCEDURES: Anthropometric measurements (height, weight, skinfold thicknesses, and circumferences) were performed. VAT and SAAT were measured using magnetic resonance imaging (MRI). RESULTS: The strongest univariate correlate for VAT was waist circumference (WC) (r = 0.65, p < 0.01) while the strongest correlate for SAAT was hip circumference (r = 0.88, p < 0.001). Regression analyses showed approximately 50% of the variance in VAT was explained by WC (43.8%), Tanner stage (4.2%) and calf skinfold (1.7%). Variance in the SAAT model was explained by WC (77.8%), triceps skinfold (4.2%) and gender (2.3%). Residual analyses showed no bias in either equation. Though mean differences between measured and predicted VAT and SAAT were small, there was a large degree of variability at the individual level especially for VAT. CONCLUSIONS: Both VAT and SAAT prediction equations performed well at the group level, but the relatively high degree of variability suggests limited clinical utility of the VAT equation. MRI is currently required to derive an accurate measure of VAT at the individual level.     

遗传性缺陷调查研究的伦理问题探讨

遗传调查是控制遗传性缺陷的有效途径,在此过程中应自觉遵守医学遗传服务和遗传研究的伦理准则,但尚存在一些困惑,祈盼建立适合我国国情的遗传性缺陷调查研究的伦理规定和政策.     

阿片类药物在癌痛治疗中的作用

Columba Quigley是颐养关怀治疗领域中的一位专家，她为一个以医院为基础的支持团队（a hospital based support team）工作。同时她还服务于一所颐养关怀社团和一所临终关怀医院；在那里，患者得到临终护理，延续生命并控制症状。癌症患者特别是晚期癌症患者常常伴发疼痛。此外，疼痛还是癌症患者最令人恐惧的症状。适当应用镇痛药物（特别是阿片类药物）可以有效控制绝大多数患者的癌痛。     

电视教材《中医正骨手法》的编导思路与实现

结合对卫生部科教司和人民卫生出版社招标电视教材《中医正骨手法》的编导制作过程,从教学内容、总体结构、表现方式、素材的选择和拍摄等各方面阐述了制作体会,并探讨在计算机网络技术迅速发展背景下编导医学电视教材的一些方法。     

华蟾素注射液治疗中晚期恶性肿瘤41例

[目的]观察华蟾素注射液治疗中晚期恶性肿瘤的临床疗效。[方法]对41例中晚期恶性肿瘤患者静脉滴注华蟾素注射液,采用自身前后对照观察。[结果]使用华蟾素注射液后患者临床症状改善,生存质量提高。[结论]华蟾素注射液是一种治疗恶性肿瘤有效的中药制剂。