Whole exome sequencing combined with linkage analysis identifies a novel 3?bp deletion in NR5A1

Disorders of sex development (DSDs) encompass a broad spectrum of conditions affecting the development of the gonads and genitalia. The underlying causes for DSDs include gain or loss of function variants in genes responsible for gonad development or steroidogenesis. Most patients with DSD have an unknown genetic etiology and cannot be given an accurate diagnosis. We used whole exome capture and massively parallel sequencing to analyse a large family with 46,XY DSD and 46,XX premature ovarian insufficiency. In addition, we used a recently developed method for linkage analysis using genotypes extracted from the MPS data. This approach identified a unique linkage peak on chromosome 9 and a novel, 3 bp, in-frame deletion in exon six of NR5A1 (steroidogenic factor-1 or SF1) in all affected individuals. We confirmed that the variant disrupts the SF1 protein and its ability to bind and regulate downstream genes. NR5A1 has key roles at multiple points in gonad development and steroidogenic pathways. The variant described here affects the function of SF1 in early testis development and later ovarian function, ultimately leading to the 46,XY DSD and 46,XX premature ovarian insufficiency phenotypes, respectively. This study shows that even at low coverage, whole exome sequencing, when combined with linkage analysis, can be a powerful tool to identify rapidly the disease-causing variant in large pedigrees.     

大鼠胫骨骨折愈合过程中Ⅰ、Ⅱ型胶原蛋白的表达：失神经状态下Western blot方法测定

目的:揭示失神经骨折愈合中Ⅰ、Ⅱ型胶原蛋白表达的变化规律,探讨神经系统对骨折愈合机制的影响。方法:实验于2005-05/12在解放军第二军医大学动物实验室及细胞生物教研究室完成。40只SD大鼠按随机数字表法分成2组,每组20只。单纯左胫骨骨折组(胫骨骨折组),于左胫骨前弓状缘上0.3cm上1/3处咬断胫骨,从胫骨平台前缘插入一根直径0.8mm克氏针,制成胫骨骨折模型。T10脊髓完全性损伤并左胫骨骨折组(脊髓损伤并胫骨骨折组),在上述模型的基础上,横断切除T10段脊髓约0.3cm,制成T10脊髓完全性损伤大鼠胫骨骨折模型制备。分别于伤后1,2,4,5周采用Westernblot方法检测骨痂中Ⅰ、Ⅱ型胶原的蛋白表达。结果:40只大鼠全部进入结果分析。伤后第1周,两组Ⅰ、Ⅱ型胶原均有表达,脊髓损伤并胫骨骨折组两种胶原的表达程度均高于胫骨骨折组;伤后第2周,脊髓损伤并胫骨骨折组Ⅱ型胶原的表达达到峰值,高于胫骨骨折组(39.45±0.99,29.45±0.85,aP<0.05);伤后第4周,胫骨骨折组Ⅰ型胶原表达量达峰值,高于脊髓损伤并胫骨骨折组(31.69±1.42,26.33±1.11,aP<0.05),脊髓损伤并胫骨骨折组Ⅱ型胶原仍有高表达;伤后第5周,胫骨骨折组、脊髓损伤并胫骨骨折组Ⅰ、Ⅱ型胶原表达下降(Ⅰ型胶原2组依次为:20.32±0.56,13.57±0.44;Ⅱ型胶原2组依次为6.34±0.21,12.58±0.44)。结论:神经系统可能通过调节Ⅰ、Ⅱ型胶原的分泌而影响骨折愈合。     

感染性休克病人的血流动力学特点及意义

目的 了解感染性休克病人早期血流动力学改变的特点及预后关系。方法 临床前瞻性研究，监测感染性休克早期血流动力学改变并分析与预后的关系。结果 共连续观察48例病人，其中25例（52%）死亡。一些指标的水平在死亡者与生存者间差别较大，其中包括平均肺动脉压（MPAP)、肺动脉楔压（PAWP）、体/肺循环阻力指数（SVRI/PVRI）、左/右心做功（LCW/RCW）和左/右心每搏动（LCSW/RCSW）等血流动力学指标的氧合指数，动脉混合静脉血含氧量差（a-vDO2)、全身性为症反应综合征（SIRS）指标积分等。结论 感染性休克病情凶险，部分血流动力学指标对早期评估其预后有指标作用。     

Improvement of platelet storage conditions by using new polyolefin containers

BACKGROUND : Storage of pooled platelet concentrates (PCs) with yields above 3.0 × 10¹¹ platelets per unit in a 1-L PL-732 polyolefin container for 5 days often results in a drop in pH to below 6.0. Recently, new oxygen-permeable platelet containers (1-L PL-2410, 1-L and 1.5-L Compoflex) have been developed. The maximal platelet storage capacities of the new containers and the PL-732 were compared. STUDY DESIGN AND METHODS : Large platelet pools (n = 27) with platelet concentrations between 1.2 and 1.4 × 10¹¹ per L were made from 3 to 5 PCs prepared from buffy coats. The pools were divided in equal volumes among the PL-732 and the three new platelet containers. Platelet counts in the PCs ranged from 1.0 to 5.0 × 10¹¹ per unit. All PCs were stored on a flatbed shaker at 22 ± 2°C and evaluated on Days 1, 3, 5, and 7 by measuring platelet count, pH, pO₂, pCO₂, HCO₃-, glucose, lactate, platelet swirling, and soluble p-selectin. RESULTS : Day 7 storage of PCs (n = 6) with yields between 3.0 and 4.0 × 10¹¹ platelets in PL-732 showed mean ± SD pH values of 5.93 ± 0.05 and lactate values of 32.3 ± 7.9 mmol per L; in 4 of these 6 PCs, pH was below 6.0. In contrast, storage of these PCs in 1-L PL-2410 and 1.5-L Compoflex containers and of 2 of these 6 PCs in 1-L Compoflex containers showed pH values above 6.8. Lactate values were 15.5 ± 1.3, 15.3 ± 1.8, and 19.5 ± 4.7 mmol per L, respectively (p < 0.001 vs. PL-732). The platelet storage capacity of the new containers with platelet yields between 4.0 and 5.0 × 10¹¹ per unit (n = 6) was evaluated. Day 7 storage of these PCs in the 1.5-L Compoflex showed an average pH value of 6.74 ± 0.20; in 2 of 6 PCs, pH was below 6.8. The average pH value in the PL-2410 was 6.38 ± 0.31, and in all PCs, pH was below 6.8. Average lactate values were 17.8 ± 5.7 and 25.8 ± 5.6 mmol per L (p < 0.05), respectively. Soluble p-selectin values on Day 7 of storage increased approximately twofold in all PCs. CONCLUSION : The new oxygen-permeable containers showed platelet quality comparable to that with the PL-732 and for longer storage periods and at higher platelet counts.