青海高原地区不同海拔世居藏族和汉族慢性心力衰竭患者血清N末端脑钠肽前体、超敏C反应蛋白及炎性因子水平变化及其与预后的关系研究

背景心力衰竭患者血清N末端脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)及炎性因子水平存在明显异常,但关于其在青海高原地区不同海拔世居藏族、汉族慢性心力衰竭患者中变化研究报道较少见。目的探讨青海高原地区不同海拔世居藏族、汉族慢性心力衰竭患者血清NT-proBNP、hs-CRP及炎性因水平变化及其与预后的关系。方法选取2013年6月—2015年6月于青海省心脑血管病专科医院住院治疗及高原健康体检中心体检的藏族、汉族慢性心力衰竭患者180例,比较不同海拔、民族患者一般资料(包括性别、年龄、体质量、收缩压、舒张压)及血清NT-proBNP、hs-CRP、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)水平;随访3年,比较不同临床特征患者3年生存率;青海高原地区世居藏族、汉族慢性心力衰竭患者预后的影响因素分析采用多因素Cox比例风险回归分析,并绘制Kaplan-Merier生存曲线以分析青海高原地区世居藏族、汉族慢性心力衰竭患者生存情况。结果不同海拔、民族患者舒张压及血清NT-proBNP、hs-CRP、TNF-α水平及不同海拔患者IL-6水平比较,差异有统计学意义(P<0.05)。不同纽约心脏病协会(NYHA)分级,血清NT-proBNP、hs-CRP、TNF-α、IL-6水平,海拔及有无高血压、糖尿病、冠心病、高原性心脏病、慢性肾衰竭、贫血患者3年生存率比较,差异有统计学意义(P<0.05)。多因素Cox比例风险回归分析结果显示,NT-proBNP〔HR=0.02,95%CI(0,0.23)〕、TNF-α〔HR=6.45,95%CI(1.47,28.25)〕及海拔{3001~4000 m〔HR=0.23,95%CI(0.06,0.89)〕,>4000 m〔HR=0.31,95%CI(0.11,0.84)〕}是青海高原地区世居藏族、汉族慢性心力衰竭患者预后的独立影响因素(P<0.05)。Kaplan-Merier生存曲线分析结果显示,血清NT-proBNP水平<258 ng/L患者3年累积生存率高于血清NT-proBNP水平≥258 ng/L者(χ2=7.824,P<0.05),血清TNF-α水平<32 ng/L患者3年累积生存率高于血清TNF-α水平≥32 ng/L水平者(χ2=13.817,P<0.01);不同海拔患者3年累积生存率比较,差异有统计学意义(χ2=55.445,P<0.01)。结论青海高原地区海拔越高则世居藏族、汉族慢性心力衰竭患者血清NT-proBNP、hs-CRP、TNF-α、IL-6水平越高,且汉族患者高于藏族患者;高血清NT-proBNP、TNF-α水平及高海拔是青海高原地区世居藏族、汉族慢性心力衰竭患者预后不良的危险因素。     

Prevalence,specificity and risk of red blood cell alloantibodies among hospitalised Hubei Han Chinese patients

Background

The prevalence, specificity and risk of red blood cell alloantibodies vary widely among different geographic areas, races, and diseases and according to different methods of study, but no data are available on the Chinese Han population, who were investigated in the present study.

Materials and methods

Antibody screening was conducted among 42,517 hospitalised Hubei Han Chinese individuals using column agglutination technology. Samples that were positive in antibody screening were subjected to antibody identification by the tube test. Clinical data, including gender, age, race, transfusion history and records of alloantibody detection, transfusion reactions or haemolytic disease of the newborn, were collected to analyse the prevalence and specificity of alloantibodies and complications associated with them.

Results

A total of 212 patients with alloantibodies were identified among 42,517 patients, yielding a prevalence of 0.50% in this study. Significantly different prevalence rates were observed according to age and sex. The most frequently identified alloantibodies were anti-E (87/212, 41.0%), anti-D (45/212, 21.2%), anti-M (41/212, 19.3%) and a combination of anti-E and anti-c (13/212, 6.1%). Haemolytic disease was observed in 13 infants with anti-D, three infants with anti-E and one infant with anti-Fy^a alloantibodies. Delayed haemolytic transfusion reactions occurred in four patients with alloantibodies.

Discussion

In hospitalised Hubei Han Chinese individuals, the overall prevalence of alloantibodies was 0.50%, with anti-E, anti-D and anti-M being the most frequently identified alloantibodies. These results indicate that anti-D and anti-E alloantibodies were major risk factors for haemolytic disease of the newborn or delayed haemolytic transfusion reactions in this study population.     

中国汉族人群TNF-α-308多态性与牙周炎关系的Meta分析

目的:分析与评价中国汉族人群TNF-α-308多态性是否与牙周炎易感性相关。方法:检索中国学术期刊全文数据库、中国生物医学文献数据库、万方数据库以及PubMed数据库中在中国汉族人群中进行的TNF-α-308多态性与牙周炎相关关系的病例-对照研究,包括中文和英文文献。检索年限为1994—2011年,检索时间为2011年2月。应用Meta分析比较TNF-α-308等位基因2在病例组和对照组间的分布是否有差异。结果:共纳入5篇文献,病例组494例,对照组501例。Meta分析显示,5篇文献不存在异质性(P=0.38);TNF-α-308等位基因2与等位基因1相比,其合并OR值为2.12(95%CI 1.57～2.86),有显著差异(P<0.01)。结论:TNF-α-308多态性与中国汉族人群牙周炎易感性相关。     

新疆维吾尔族和汉族中老年人群代谢综合征的患病率调查

目的 了解新疆地区维吾尔族和汉族≥50岁人群代谢综合征现况状况,比较两民族间是否存在差异.方法 2004年7月到2007年8月,采用分层随机多级整群抽样方式、以现场问卷调查与入户调查相结合的方法,共调查8382人,其中汉族3603人(男性1590人,女性2013人)、维吾尔族4779人(男性2347人,女性2432人),进行身高、体重、腹围、血压、血糖、血脂水平等相关指标测定.结果 维、汉两民族中老年人群代谢综合征总的患病率为32.85％(男性为25.14％,女性为39.07％,P＜0.05);汉族27.70％(男性为22.53％、女性为32.09％,P＜0.05);维吾尔族为41.03％(男性为29.60％、女性为50.30％,P＜0.05);维吾尔族高于汉族(P＜0.05),女性高于男性,其中维吾尔族男性、女性代谢综合征患病率均高于汉族男性、女性(P＜0.05),两民族中维吾尔族女性代谢综合征的患病率最高.50～59岁,维吾尔族代谢综合征为33.02％,汉族为23.59％;60～69岁,维吾尔族为36.50％,汉族为34.44％;70岁以上,维吾尔族为27.65％,汉族为28.30％.结论 新疆维、汉两民族中老年人群代谢综合征的患病率存在民族间和性别间差异,维吾尔族高于汉族,女性高于男性,其中维吾尔族女性代谢综合征的患病率最高.维、汉两民族中老年人群代谢综合征患病率均有随年龄增加而增加的趋势,60～ 69岁这个年龄段代谢综合征患病率最高.     

树突状细胞免疫受体基因多态性与抗环瓜氨酸肽抗体阴性类风湿关节炎相关性研究

目的 在汉族人群中研究树突状细胞免疫受体(DICR)基因多态性与类风湿关节炎(RA)及其不同亚型的易感相关性.方法 采用病例-对照研究法,选取年龄及性别相匹配的RA患者523例和健康对照510名;采用Taqman探针法检测DCIR基因rs2377422和rs10840759位点单核苷酸多态性(SNP);检测RA患者抗环瓜氨酸肽(CCP)抗体水平,分析DCIR基因多态性与不同亚型RA相关性;采用实时荧光定量聚合酶链反应(PCR)方法,定量检测DCIR在RA患者(233例)及健康者(71名)中mRNA表达水平,并进一步分析不同DCIR基因型对DCIR表达水平的影响.统计学处理采用X检验和多因素Logistic回归检验,2组间比较采用曼-惠特尼U检验.结果 ①DCIR SNP rs2377422与汉族RA发病明显相关(等位基因:OR 1.26;95％CI 1.06～1.50,P=0.005;基因型CC与TT+TC:OR 1.34;95％CI1.18～2.06,P=0.004);②DCIR SNP rs2377422主要与抗CCP抗体阴性RA发病相关(等位基因:OR 1.46;95％CI1.10～1.93,P=0.0091;基因型CC与TT+TC:OR 1.58;95％CI1.01～2.47,P=0.043);③和健康对照相比,RA患者外周血中DCIR基因mRNA水平显著增高(0.47-0.10与0.17-0.03,U=6502,P=0.000 38),且携带DCIR rs2377422 CC基因型的RA患者,其DCIR表达水平进一步明显增高(CC与TT+TC:0.429±0.069与0.238±0.023,U=1861,P=0.002).结论 汉族人群中DCIR rs2377422多态性主要与抗CCP抗体阴性RA易感相关;RA患者DCIR基因表达水平明显增高;DCIR rs2377422多态性可明显影响DCIR基因的表达.     

新疆艾滋病高发区维汉民族干部教师和医生婚姻及性态度性行为和艾滋病知识的调查分析

目的了解新疆艾滋病高发区维吾尔族和汉族的干部、教师和医生,对婚姻及性的态度、性行为和艾滋病知识知晓率的情况及差异,为该地区的艾滋病预防和干预策略的制定提供参考依据。方法选择新疆伊犁州和乌鲁木齐市艾滋病高流行区街道/社区机关、中小学和医院中,18～60岁已婚的维吾尔族和汉族的干部、教师、医生进行抽样问卷调查。结果共调查769人(维吾尔族491人、汉族278人),平均年龄为36.98岁。对待婚姻的态度,64.9%的调查对象认为婚姻是神圣的;91.7%不同意或很不同意女性为了生活而卖淫的说法;80%认为女性保持贞操很重要或重要;60.6%认为多次结婚、多次离婚是件丢人的事情;对婚前性行为,58.2%持抵制态度;对"一夜情",72.5%持抵制态度;对同性恋,88.3%持抵制态度;对以上7个问题维汉族态度差异有统计学意义(P<0.01)。93.5%的调查对象结过一次婚;对待男人找暗娼行为,80.6%认为是不光彩的行为;对待与多人有性关系,82.5%认为是一件见不得人的事情;以上3个问题维汉族态度差异无统计学意义(P>0.05)。婚前性行为(32.6%)、婚外性行为(11.6%)、每周性行为次数(34.2%的1次、31.5%的2次)和有婚外性行为时使用安全套的原因(防病占53.4%),以上4个问题维汉族差异有统计学意义(P<0.05)。初次性行为的年龄(平均为25.22岁)、发生婚外性行为的场所主要是宾馆(占63.4%)、发生婚外性行为时安全套使用情况(每次都用占55.7%)和不使用安全套原因(主要是没有快感占41.8%),此4个问题维汉族差异无统计学意义(P>0.05)。维吾尔族艾滋病知识知晓率为92.4%,汉族为93.6%,维汉族差异没有统计学意义(P>0.05);发生婚外性行为每次都用安全套者的艾滋病知识知晓率为91.83%,有时用的知晓率为91.84%,从不使用的知晓率为92.08%,三者间差异无统计学意义(P>0.05)。结论新疆艾滋病高发区维汉民族干部、教师和医生对待婚姻及性的态度和性行为存在一定的开放程度,但是维吾尔族相对于汉族较保守,此类人群的艾滋病知识知晓率较高,应根据此类人群和不同民族的特征,有的放矢地开展艾滋病的健康教育和行为干预。     

Forensic characteristics and phylogenetic analysis of both Y-STR and Y-SNP in the Li and Han ethnic groups from Hainan Island of China

Hainan Island is the southernmost and smallest Chinese province, isolated from the mainland. The Li and Han ethnic groups account for over 98% of the population on the island. However, the Li ethnic group is an indigenous community of Hainan Island, with great differences in culture, language and origin with respect to the Han, the largest ethnic group. Here, we studied these two ethnic groups from the perspective of the Y-chromosome single nucleotide polymorphisms (Y-SNPs) and short tandem repeats (Y-STRs) to unravel their forensic and phylogenetic characteristics. A total of 302 unrelated male samples from the Li and Han ethnic groups in Hainan Island were genotyped by a combination of three separate typing systems (next-generation sequencing and pyrosequencing for the Y-SNPs and capillary electrophoresis for the Y-STRs), a previously developed high-resolution panel containing 141 Y-SNPs and 27 Y-STRs. The haplotype diversity of the Li ethnic group reached 0.9997, and 49 terminal haplogroups were observed in the Li and Han ethnic groups. Haplogroup O1b1a1a1a1a1b-CTS5854 was the most predominant haplogroup, including 44.12% of Li individuals. Median-joining trees showed little gene flow between the Li and Han individuals, as well as between the Li and other ethnic groups in Hainan Island. Our results indicated that 1) in contrast with the Han ethnic group, a low degree of genetic diversity was observed in the Li ethnic group; 2) there was limited gene flow between the Li and Han ethnic groups; and 3) founder effect was identified in the Li ethnic group in Hainan Island.     

Genetic polymorphisms of 20 STR loci in a Chaoshan group from Jieyang,China

We obtained allelic frequencies and forensic parameters of 20 short tandem repeat (STR) loci (D3S1358, FGA, D5S818, D7S820, CSF1PO, D16S539, D19S433, vWA, D8S1179, D18S51, D13S317, TPOX, TH01, D2S1338, D12S391, D1S1656, D21S11, D6S1043, Penta D, Penta E) from 529 unrelated individuals in Jieyang Han population using PowerPlex® 21 (Promega, Madison, Wi, USA). The relationship between the Jieyang Han group and other Han populations was studied and the results showed that the Jieyang Han population had the closest genetic relationship with the Fujian Han population.     

TNFSF4基因rs3850641多态性与2型糖尿病的相关性研究

目的：探讨四川南充地区汉族人TNFSF4基因rs3850641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于2014年7月至2015年6月选取的190例正常对照者和218例T2DM患者(T2DM组)的rs3850641多态性。葡萄糖氧化酶法测定两组受检者的血糖(Glu)水平,氧化酶法测定两组受检者的血清甘油三酯(TG)、总胆固醇(TC)及高密度脂蛋白胆固醇(HDL-C)水平。结果 TNFSF4基因rs3850641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;rs3850641多态位点G等位基因频率为0.161;T2DM组和对照组之间rs3850641位点等位基因的频率差异无统计学意义[0.163(71/168) vs 0.158(60/190),P>0.05];对照组和T2DM组rs3850641位点G基因型携带者的血糖水平分别高于各组AA基因型携带者的血糖水平[(4.72±1.43) mmol/L vs (4.50±1.30) mmol/L、(6.44±2.45) mmol/L vs (6.23±2.16) mmol/L],差异均有统计学意义(P<0.05)。结论 TNFSF4基因rs3850641多态性与T2DM无关联,但其G等位基因与血糖水平相关。