，平均红细胞体积76fL)，转氨酶升高（AST419U/L，ALT78U

来自日本石川县的 Fuchizaki 等近期在 Gastroenterology 杂志上发表了一篇有趣的病例，让我们一起来分析和学习吧。病例介绍患者为 78... 1880U/L，谷丙转氨酶 1096U/L，胆红素 1.21 mg/dL；C 反应蛋白 13.5 mg/dL。患者被诊断为「感染性休克；急性肾衰竭」，并开始接受

402 例 ICU 患者。排除怀孕、＜18 岁患者、延迟送入创伤中心的患者。入组者年龄 47±19 岁，75% 为男性，78% 为钝性伤，42% 有外伤性脑损伤...偶然发现 PE 者。患者入组后予 1~4 天的预防血栓形成治疗（TPX，普通肝素 5000U 皮下注射，tid；或低分子肝素 5000U 或伊诺肝素 30 mg

、呕吐。复测APTT＞200s、INR1.4（参考值0.9-1.2）、FIB1.6g/L（参考值1.7-4.5g/L），血肌酐从78umol/L上升...，与中毒表现一致。然而，APTT仍＞200s。随访2周，患者身体状况良好。凝血因子检测发现该患者Ⅻ因子异常，其数值＜0.01U/mL（参考值

U／L，谷草转氨酶 (AST) 40 U/L, TBIL 18. 6mmol/L, DBIL5. 9mmol/L，ALB 38 g/L。血脂正常，血电解质正常。AFP 637 ng／ml。凝血酶原活动度78%。HB-sAg (+),HBsAb 

2-3／Hp，有乙肝小三阳，病毒载量2*10+7，ALT100U／L，用思密达3克，每日3次，效果不佳，糖尿病人腹泻，便失禁的机制是什么？如何止 住腹泻？血糖忽高忽低

%～78 %，特异性为 82 %～87 %，阳性预测值均在 4.0 左右（图 2 和图 3）。图 2 为所有 RMI 模型均显示阳性的典型病例：患者处于绝经前期，超声显示多房性实变区，CA 125 含量为 270.6 U/ml，最终病理学证实为浆液性囊腺癌（Ⅲc 期）图 3 为所有 RMI 模型均为阴性的典型病例

，WBC 出现断崖式降低。入 ICU 后至 8 月 8 日，共补充 RBC 52U，冷沉淀 78U，血浆 8800 mL，Plt 8 个治疗单位。中午时分，患者...酶 111 U/L，谷草转氨酶 155 U/L)、胆红素高（总胆红素 41 μmol/L，直接胆红素 28 μmol/L）、蛋白偏低（白蛋白 21 g/L，球蛋白

日：患者血压下降，靠升压药物维持血压，氧合降低，WBC 出现断崖式降低。入 ICU 后至 8 月 8 日，共补充 RBC 52U，冷沉淀 78U，血浆... 109/L），肝功提示转氨酶升高 (谷丙转氨酶 111 U/L，谷草转氨酶 155 U/L)、胆红素高（总胆红素 41 μmol/L，直接胆红素 28

Fmoc-Ile-OH U-13C6，15N Fmoc-Ile-OH 1-13CP Fmoc-Pro-OH U-13C5，15N Fmoc-Pro-OH U-13C5L Fmoc-Leu-OH 15N  

78 U/L、AST 45U/L、TBIL 24.8umol/L、DBIL 9.9 umol/L；女性激素6项也基本上都恢复正常了！检查期间只使用了保肝药...胞%：39.7%，淋巴细胞%：47.4%，单核细胞%：9.5%。尿常规示：胆红素3+，尿胆原±，血3+(例假污染)。肝功能示：ALT：646U

【今日问答】抢救糖尿病酮症酸中毒时，胰岛素最佳用量为?A.4〜6 U/hB.6〜10 U/hC.10〜20 U/hD.20〜30 U/hE.30〜35 U/h解析：一般采用小剂量（短效）胰岛素治疗方案，即 0.1 U/kg·h(成人体重 4〜6 U/h)，使血清胰岛素浓度恒定达到 100-200 μU/ml（选 A

于 2009-03 体检时发现「HBsAg、HBeAb、HBcAb」阳性，当时无明显乏力、纳差、恶心、呕吐、腹胀、腹痛等不适，肝功能：ALT 80U/L,AST 44U/L，GGT 72U/L，未查 HBV DNA，予「拉米夫定」抗病毒治疗。2012-09 患者无明显诱因觉右季肋部疼痛难忍，呈针扎样，无放射，与运动、饮食、体位无关

经四川省继续医学教育委员会审定批准，由成都医学院第一附属医院主办的“介入肺脏病学应用技术讲习班”（项目编号：11-78-0302035）拟定于2011年8月19~8月21日在成都市新都区桂湖国际大酒店召开。本次培训班将邀请四川省介入性肺脏病学领域的专家通过

分子流行病学再揭示人类复杂疾病遗传因素及其与环境因素相互作用发挥重要作用,为人类疾病的风险评估、预防和个性化治疗提供依据。全基因组关联分析（GWAS）为全面系统研究复杂疾病的遗传因素掀开了新的一页，为我们了解人类复杂疾病的发病机制提供了更多的线索。科学家已经在肥胖、糖尿病、冠心病、阿尔茨海默、乳腺癌、前列腺癌、肺癌、胃癌等一系列复杂疾病中进行了全基因组关联研究并找到疾病相关的易感基因，我国科学家也在银屑病、精神病和冠心病等方面开展了GWAS研究并取得成效。国家科技部最新公布了“常见重大疾病全基因组关联分析和药物基因组学研究”的863重点项目，吹响了我国大规模开展GWAS研究的号角。为了让更多的相关研究人员，特别是广大研究生了解GWAS的研究原理和方法，学会设计GWAS的研究和分析实验结果，同时在癌症领域分享海内外研究专家们的成功经验，并期待在GWAS方面进行交流合作,复旦大学和美国Van Andel 研究所将于2009年7月12-14日在上海联合举办上海分子流行病学与GWAS国际 研讨会, 期待各位同道免费参加，请有意者及时将回执返回联系邮箱。免注册费（食宿餐饮费用自理）。名额有限，报名从速！时间： 2009年7月12－14日
报到地点： 复旦大学卿云楼宾馆 上海市邯郸路220号，200433
会议地点： 复旦大学逸夫楼报告厅
联 系 人： 赵雪莹 高歌 联系电话： 021-55664495
回执邮箱： GWAS2009@gmail.com
BackgroundRecent success of genome-wide association studies (GWAS) in the U.S. and Europe has lead to the identification of a large number of genetic variants that are associated with disease risk and progression, including those for cancer and cardiovascular diseases. The discovery of these genetic markers not only improves our understanding of disease etiology, but also contributes significantly to risk prediction, early detection, and targeted treatment of diseases.Although GWAS have been used in Chinese populations to identify Chinese-specific risk-associated genetic variants for several common diseases such as breast cancer and psoriasis, many more GWAS are needed for various diseases. A better understanding of the importance of GWAS and a better knowledge of study design and data analysis of GWAS will further promote broad application of GWAS in China. This symposium which will cover genetic epidemiology and GWAS in China is organized to serve this purpose. We have invited a group of experts in this area from the U.S. and China to share their experience in GWAS, and we hope to foster an environment which will encourage an open discussion among all participants.
Objectives• To better understand the potential applications of GWAS
• To address practical issues in study design, implementation, and data analysis of GWAS
• To promote interaction and collaboration among researchers who are interested in GWAS
• To explore other important studies after GWAS: gene-environment interaction, risk prediction, and functional analyses
• To consider issues and implications related to genomic and personalize medicine
Organizing committeeThe organizing committee consists of four members:
Dr. Jianfeng Xu (Co-Chair)
Dr. Daru Lu (Co-Chair)
Dr. Li Jin (Co-Chair ,Advisor)
Dr. Qingyi Wei (Co-Chair, Advisor)
PresentationsSession I: Genetic epidemiology and GWAS of cancer
• Breast cancer in Chinese populations Xiao-ou Shu
• Genetic association studies of skin cancer Jiali Han
• Genetic variants in the MC1R gene and risk of cutaneous melanoma Qingyi Wei
• Genetic association studies of lung cancer in Chinese populations Daru Lu
• Molecular epidemiology of hepatitis, liver cirrhosis and hepatocarcinoma Gangqiao Zhou
• Molecular epidemiology of stomach cancer Weimin YeSession II: Genetic epidemiology and GWAS of other diseases
• Genetic association studies of hypertension in Chinese populations Jiang He
• GWAS of Autoimmune Diseases (Psoriasis, etc.) in Chinese populations Wei Huang
• Molecular epidemiology of diabetes in Chinese populations Weiping Jia
• Molecular genetics study of hypertension in Chinese populations Dingliang Zhu
• Molecular epidemiology of hepatitis, liver cirrhosis and hepatocarcinoma Gangqiao ZhouSession III: Post-GWAS studies
• Genetic structure of Chinese population Li Jin
• High-throughput genotyping for GWAS and fine mapping studies Siqun Lilly Zheng
• Molecular genetics study of neural tube defect Hongyan Wang
• Risk prediction using genetic variants in prostate cancer Jianfeng Xu
• Gene-environmental interaction in smoking related cancer Zuo-Feng Zhang
• Cancer Somatic Genomics Bin TehSession IV: Short presentations by participants and discussion
Registration时　　间： 2009年7月12－14日
报到地点： 复旦大学卿云楼宾馆大厅 上海市邯郸路220号 (200433)
会议地点： 复旦大学逸夫楼报告厅
联 系 人： 赵雪莹，高歌 (Shanghai, China)；Tamara Adams (U.S.)
联系电话： 21-55664495 (Shanghai, China)；336-713-7532 (U.S.)
回执邮箱： GWAS2009@gmail.com (Shanghai, China)；tsadams@wfubmc.edu (U.S.)
Invited speakers (alphabetic)• Jiali Han, Ph.D., is an Assistant Professor of Medicine at Harvard Medical School. His major research areas are:
• Genetic epidemiology of skin cancer and breast cancer
• Genome-wide association studies
• Gene-environment interaction• Jiang He, M.D. Ph.D., is a Professor and Chair of Epidemiology, Tulane University School of Public Health., U.S.A. His major research areas are:
• Genetic epidemiology of hypertension
• Gene-nutrition interaction of cardiovascular disease• Wei Huang, Ph.D., is a Professor and Executive Deputy Director of Chinese National Human Genome Center at Shanghai, China. Her major research areas are:
• Genetic susceptibility to autoimmune diseases, cardiovascular diseases and cancer.
• Genome-wide association studies
• Genetic variants and association study• Weiping Jia M.D., is a professor of endocrinology at Shanghai Institute of Diabetes, Shanghai No.6 People’s Hospital, Shanghai Jiaotong University, Her major research area is:
• Molecular endocrinology and diabetes• Li Jin, Ph.D, is a Professor of Genetics and vice President of Fudan University, China. His major research areas are:
• Genetic and molecular epidemiology of lung cancer and glioma
• Genetics of metabolism diseases
• Genetic markers for population genetics• Daru Lu, Ph.D, is a Professor of Genetics and Vice Dean of School of Life Sciences, Fudan University, China. His major research areas are:
• Genetic and molecular epidemiology of lung cancer and glioma
• Genetics of metabolic disease• Xiao-ou Shu, M.D, Ph,D, is a Professor of Medicine in the Department of Medicine at the Vanderbilt University School of Medicine, U.S.A. Her major research areas are:
• Genetic and lifestyle predictors of cancer and other chronic diseases
• Cohort study methodology
• Incorporating biomarkers in risk prediction• Bin Teh, M.D, is a Distinguished Scientific Investigator at Van Andel Institute, U.S.A. His major research areas are:
• Translational cancer research
• Gene expression profiling
• Cancer genome high-throughput sequencing• Hongyan Wang, Ph.D, is a professor of genetics at School of Life sciences, Fudan University, China. Her major research area is:
• Molecular genetics and epidemiology of birth defects (deformity of neural tube, congenital heart disease, etc.)• Qingyi Wei, M.D, Ph.D, is a Professor of Epidemiology at The University of Texas M. D. Anderson Cancer Center, U.S.A. His major research areas are:
• Molecular epidemiology of DNA repair, apoptosis, and skin cancer and head and neck cancer
• Genetic susceptibility to cancer
• DNA repair and apoptosis phenotype markers• Jianfeng Xu, M.D, Dr.PH, is a Professor of Epidemiology and Cancer Biology and Director of the Center for Cancer Genomics at Wake Forest University School of Medicine, U.S.A. His major research areas are:
• Genetic epidemiology of prostate cancer
• Genome-wide association and fine mapping analysis
• Risk prediction using genetic markers and other clinicopathologic variables• Zuo-Feng Zhang, M.D., Ph.D, is a Professor of Epidemiology at UCLA School of Public Health, U.S.A. His major research areas are:
• Molecular epidemiology of smoking-related cancers
• Confirmation studies of SNPs identified in genome-wide association studies in smoking-related cancers
• Gene-environmental interaction between genetic markers and environmental factors• S. Lilly Zheng, M.D, is a Professor of Medicine and Director of the Genotyping Laboratory at Wake Forest University School of Medicine. U.S.A. Her major research areas are:
• High-throughput genotyping and sequencing
• Genetic epidemiology of prostate cancer• Gangqiao Zhou, Ph.D, is a Professor of Medical Genetics and Genomics in National Academy of Military Medical Science. His major research area is:
• molecular and genetics of complex diseases• Dingliang Zhu, M.D, is a professor of cardiology at Shanghai Institute of Hypertension, Shanghai, China. His major research area is:
• Molecular and genetics of cardiovascular diseases• Weimin Ye, Ph.D, is a Professor of Medical Epidemiology at Karolinska Institutet, Sweden. His major research areas are: Etiology of upper gastrointestinal diseases
• Topic of presentation: Molecular epidemiology of stomach cancer

【今日问答】抢救糖尿病酮症酸中毒时，胰岛素用量为？A.4〜6 U/hB.6〜10 U/hC.10〜20 U/hD.20〜30 U/hE.30〜35 U/h解析 :一般采用小剂量（短效）胰岛素治疗方案，即0.1 U/kg·h(成人体重4〜6 U/h)，使血清胰岛素浓度恒定达到100-200μU/ml（选A

【今日问答】抢救糖尿病酮症酸中毒时，胰岛素用量为 ？A.4〜6 U/hB.6〜10 U/hC.10〜20 U/hD.20〜30 U/hE.30〜35 U/h解析 :一般采用小剂量（短效）胰岛素治疗方案，即0.1 U/kg·h(成人体重4〜6 U/h)，使血清胰岛素浓度恒定达到100-200μU/ml（选A