β2-肾上腺素能受体基因Gln27Glu变异与中国人2型糖尿病及相关性状的分析

目的研究β_2-肾上腺素能受体(ADRB2)基因Gln27Glu多态位点与中国人糖脂代谢及体脂分布之间的关系。方法选取302例上海地区无亲缘关系的中国人,其中糖调节正常者(NGR组)163名,2型糖尿病患者(DM组)139例。采用聚合酶链反应-限制性酶切片段多态性(PCR-RFLP)检测ADRB2基因Gln27Giu多态位点。观察各基因型和等位基因的频率分布及其与糖、脂代谢等临床指标的关系。结果①DM与NGR组的ADRB2基因Gln27Glu变异基因型频率及等位基因频率的差异均无统计学意义(P值均>0.05)。②NGR组中,Glu27等位基因携带者的总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)分别为(5.65±0.218)、(3.97±0.27)mmol/L,显著高于Glu27等位基因非携带者[分别为(5.18±0.19)、(3.30±0.10)mmol/L,P值均<0.05]。结论中国人中存在ADRB2基因Gln27Glu多态位点,其可能与中国人脂代谢相关。     

上海社区糖尿病前期及糖尿病人群视网膜病变患病率及相关危险因素分析

Objective To determine the prevalence and risk factors of diabetic retinopathy (DR) in the Diabetes Mellitus (DM) and impaired glucose regulation (IGR) population in Shanghai Community. Methods DR screening after the epidemiologic study of metabolic syndrome in Huayang and Canyang Community , Shanghai was conducted among 1300 patients with DM or IGR during June 2005 and March 2006, Digital non-mydriatic fundus photography was performed for each eye in all subjects. Other factors, including diabetes related history, BMI, WHR, fasting plasma glucose, HbAlc, serum lipid and blood pressure were also assessed. 642 patients,312 males and 330 females, aged 65 ± 13, with complete data were enrolled into the analysis. Results The prevalence of DR was 19. 9% in the diabetic population, and the prevalence of mild, moderate, severe non-proliferative retinopathy and proliferative retinopathy was 12. 0%, 5. 1%, 2. 3% and 0. 5%, respectively; the prevalence of DR in IGR reached 8. 0%. Logistic regression analysis revealed that HbA1c level and diabetes duration were both independently associated with diabetic retinopathy. Conclusion The prevalence of DR was high in both DM and IGR population. Bad blood glucose control and long diabetes duration both increased occurrence of DR.     

2型糖尿病家系一级亲人群代谢综合征患病情况及与肥胖相关指标的关系

Objective To compare the differences of metabolic syndrome (MS) prevalence by using four working definitions and their relationship with obesity-related indicators in first-degree relatives of type 2 diabetes mellitus pedigrees. Methods Totally, 2 372 first-degree relatives from 715 type 2 diabetic pedigrees were selected in this study. Complete laboratory data, including blood pressure, lipid profile and plasma glucose, were collected. The prevalence rates of MS and obesity of four definitions, as defined by National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATPⅢ) in 2005, International Diabetes Federation (IDF) in 2005,Chinese Diabetes Society (CDS) in 2004 aml Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG) in 2007,were analyzed. Results (1)The prevalence rates of MS were 45.40% ,38.74% ,25.08% and 39.29% aecording to four definitions respectively. The prevalence rates of MS were higher in females than in males by using ATPⅢ and IDF definitions (both P<0. 01). (2)The common comhinations of metabolic abnormality was dyslipidemia, hypertension, obesity and hyperglycemia by using four definitions,except in females by using CDS definition. (3)The prevalence rates of obesity were 58.18% ,58.18% ,33.90% and 42.96% acconling to the four definitions respectively. The prevalence rates of MS in obese subjects were 66.59% ,66.59% ,54.85% and 68.99% according to four definitions respectively. (4) Applying the cutoff point for abdominal obesity according to ATPⅢ, IDF and JCDCG definitions, the prevalence rates of abdominal obesity in subjects with body mass index (BMI) <25 kg/m2 were respectively 28.58% and 16.78%, being higher in females than in males(38.90% vs 15.02% ,21.01% vs 11.22% ,both P<0. 01). Conclusion (1)There is significant familial aggregation of MS and obesity,and the first-degree relatives of type 2 diabetic patients are high risk populations. (2) Waist circumference rather than BMI taken as a discriminating component of obesity in MS seems to be clinically more helpful to the early identification and prevention of MS.     

Ⅰ型胶原对脂肪细胞分化的影响及其分子机制初探

目的 观察不同浓度的Ⅰ型胶原(type Ⅰ collagen,Col Ⅰ)对3T3-L1前脂肪细胞诱导分化为成熟脂肪细胞的影响,初步分析其可能的作用机制.方法 3T3-L1前脂肪细胞诱导分化过程中加入不同浓度的Ⅰ型胶原:①采用MTT法检测3T3-L1前脂肪细胞的增殖;②油红O染色法观察分化成熟脂肪细胞形态学变化;③免疫印迹法测定脂肪细胞分化转录因子过氧化物酶体增殖物激活受体γ(peroxisome proliferators-activated receptorγ,PPARγ)和CCAAT增强子结合蛋白α(CCAAT/enhan-cer-binding proteinα,C/EBPα)蛋白表达水平.结果 不同浓度Ⅰ型胶原干预后,各组3T3-L1前脂肪细胞的增殖与对照组比无显著变化.随着Ⅰ型胶原浓度升高,油红O染色逐渐变浅,提示分化成熟的脂肪细胞逐渐减少.脂肪细胞分化转录因子PPARy和C/EBPα的蛋白表达水平逐渐降低,呈剂量依赖性,且浓度为10-5mol/L和10-4mol/L时与对照组比较差异有统计学意义(P＜0.05).结论 Ⅰ型胶原在本实验中不影响3T3-L1前脂肪细胞增殖,但呈剂量依赖性抑制其向成熟脂肪细胞分化,下调脂肪细胞分化转录因子PPARγ和C/EBPα的表达可能是其作用机制之一.     

酶法测定糖化血清白蛋白的初步评价

目的评估糖化血清白蛋白(GA)作为反映近期血糖控制总体水平的指标在糖尿病人群中的临床应用意义。方法对2006年5月～11月本院收治的445例2型糖尿病患者,检测空腹血糖(FPG)、餐后2小时血糖(P2hBG)、糖化血红蛋白(HbA1c)等指标,同时应用液态酶法测定GA,并行动态血糖监测系统(CGMS)监测。对GA与各监测指标的相关性进行分析。结果①对445例患者的相关性分析显示,GA与HbA1c具有良好的相关性(r=0.818,P<0.01);GA与FPG、P2hBG以及CGMS血糖平均值(MBG)呈正相关(r=0.473、0.409和0.531,P均<0.01)。②HbA1c>7.5%、6.5%≤HbA1c≤7.5%以及HbA1c<6.5%患者GA与HbA1c的相关系数r分别为0.678(P<0.01)、0.451(P<0.05)和0.151(P>0.05)。结论GA与HbA1c具有良好的相关性,尤其表现于长期血糖控制欠佳的患者。GA与长期血糖控制状况的相关性大于其与点时血糖或三日平均血糖水平的相关性。     

卵巢肿瘤干细胞研究进展

研究显示,卵巢肿瘤中存在少量具有自我更新和分化潜能的肿瘤于细胞,这些肿瘤干细胞具有耐药性,对现有的抗肿瘤治疗不敏感,尽管数量极低,却可能是卵巢肿瘤发生、发展和复发的根源.对卵巢肿瘤干细胞的研究将会加深对卵巢肿瘤的认识,进而为肿瘤发病机制的研究及临床治疗提供新的思路和方向.     

应用Excel VBA将医院检验报告快速构建成数据库

目的 使用Excel VBA(visual basic for application)将数据和注解混排的医院检验报告转变成可直接统计分析的数据库.方法 在Excel中创建工程文件"上海社区流调实验室数据库整理.xls",包括作为Microsoft Excel对象模块的工作表和模块代码窗口中的VBA程序.工作表包括①预先构建好的数据库框架工作表,名称为"上海社区流调实验室数据整理",准备存放导入的数据;②三张存放相应医院检验报告资料的工作表,依次命名为"生化室检查项目"、"尿蛋白"和"尿常规",为新建数据库的资料来源.编译、调试及运行VBA程序,进行数据的导出和导入.结果 "生化室检查项目"、"尿蛋白"和"尿常规"工作表中的数据被导出到"上海社区流调实验室数据整理"工作表中,数据库构建完成.结论 使用Excel VBA能快速将数据和注解混排的医院检验报告资料快速输出到已构建好的数据库中.     

原发性宫颈子宫内膜异位症21例并文献复习

宫颈子宫内膜异位症曾在上世纪受到广泛关注,随着临床医师对经宫颈手术时间的严格控制,该疾病已渐渐淡出人们的视线,仅有个案报道~([1-2]).近年来该病的发病率又有上升趋势.本文对同济大学附属第一妇婴保健院2004年12月-2007年10月诊治的该类疾病患者的临床病理资料进行总结,以期对其诊断和预防有所帮助.