Utility of right adrenal signature veins in venous sampling for primary aldosteronism.

BACKGROUND: This study aimed to identify the appropriate signature veins for the right adrenal gland using a 3D model fused with adrenal venography images and to verify their accuracy through the selectivity index (SI) >2. METHODS: We analyzed the right adrenal venography images of 41 patients who underwent adrenal venous sampling (AVS). These images were merged with a 3D structure of the adrenal gland to identify the signature veins of the right adrenal gland. We then used the signature veins observed during adrenal venography to determine the optimal position of the catheter tip during AVS for 53 other patients. Finally, we verified the accuracy of this method according to the SI. RESULTS: We successfully fused the 3D models of 41 cases with adrenal venography images. We identified the trunk branch type as the major venous morphology in the right anterior oblique at degrees of 30 (38 cases, 92.7%). In addition, the central vein, brush vein, uvula vein, and capsular vein were identified as signature veins for the right AVS. The accuracy of AVS was 100% in the other 53 patients, as verified by an SI >2. CONCLUSIONS: Our study identified the right adrenal signature veins, including the previously overlooked uvula vein, which can be used to determine the position of the catheter tip and improve the success rate of AVS.

The majority of the venography types observed in patients in the right anterior oblique at 30 degrees during adrenal venography were trunk branch types, while irregular or hollow triangle types were infrequent.The signature veins identified during right adrenal venous sampling were the central vein, brush vein, uvula vein, and capsular vein.The right adrenal signature veins, particularly the uvula vein, which has not been given much attention in the past, can serve as a reference to verify the position of the catheter tip and enhance the success rate of adrenal venous sampling.

Combination of luteolin and lycopene effectively protect against the "two-hit" in NAFLD through Sirt1/AMPK signal pathway.

AIM: Luteolin and lycopene are common natural products, widely existing in nature, and both of which were reported to have various biological functions including anti-inflammatory, anti-obesity and anti-NAFLD. In the present study, we aimed to evaluate the therapeutic efficacy of luteolin and lycopene in combination and its latent molecular mechanisms in vitro and in vivo models of NAFLD. MAIN METHODS: Sodium palmitate (PA)-induced steatotic HepG2 cells and primary hepatocytes, and high-fat diet-induced C57BL/6J obese mice were treated with luteolin, lycopene and their combination. Metabolic parameters were measured. KEY FINDINGS: We found that luteolin (20 µM) + lycopene (10 µM) was the best therapeutic combination in PA-induced HepG2 cells, and significantly improve cell viability and lipid accumulation in PA-induced HepG2 cells and primary hepatocytes. In addition, luteolin (20 mg/kg) + lycopene (20 mg/kg) could ameliorate increased body weight and hepatocyte steatosis; regulate serum triglycerides, serum total cholesterol, hepatic triglycerides and hepatic total cholesterol; decrease serum alanine transaminase and aspartate transaminase. Furthermore, in vivo and in vitro, luteolin, lycopene and their combination had no effect on Sirt1 expression, but all of them could upregulate the expression of NAMPT, which could increase the level of NAD+, the co-substrate of Sirt1, indirectly activating Sirt1/AMPK pathway, and then inhibited lipogenesis and increased ß-oxidation, defensing the "first hit"; they also inactivated nuclear factor-κB (NF-κB) and decreased the levels of IL-6, IL-1ß and TNF-α, defensing the "second hit". SIGNIFICANCE: Thus, luteolin and lycopene in combination can effectively ameliorate "two-hit" in NAFLD through activation of the Sirt1/AMPK pathway.

The effect of vertebral artery hypoplasia in posterior circulation infarction in young patients.

Purpose Vertebral artery hypoplasia (VAH) is prevalent in the asymptomatic population and contributes to posterior circulation ischaemic events. The aims of this study were to determine whether VAH is an independent risk factor for posterior circulation infarction (PCI) stroke in young patients and to evaluate its impact on the clinical prognosis of PCI stroke in young patients. Materials and Methods The medical records of 235 young stroke patients were reviewed retrospectively. All patients underwent digital subtraction angiography (DSA). VAH was defined by a diameter of <2 mm or the absence of the lateral vertebral artery on DSA. Logistic regression analyses were performed to elucidate the independent factors associated with PCI stroke in young patients. Then, an independent two-sample t-test was performed to evaluate the clinical effect of VAH. Results Our study included 235 young patients who experienced acute ischaemic stroke, 64 of whom were diagnosed with PCI stroke and 38 of whom (16.2%) were found to have VAH. The multivariate logistic regression analysis indicated that gender and VAH were independent risk factors for PCI stroke in young patients. The independent two-sample t-test showed that among the young patients who experienced PCI stroke, the National Institute of Health Stroke Scale score was not significantly different between the patients with and without VAH. Conclusions Our study showed that VAH increases the risk of PCI stroke in young patients. However, the influence of VAH on clinical outcomes in young patients following PCI stroke is minor.