Development of a diagnostic model for pre-washout screening of primary aldosteronism.

PURPOSE: Primary aldosteronism (PA) diagnosis is affected by antihypertensive drugs that are commonly taken by patients with suspected PA. In this study, we developed and validated a diagnostic model for screening PA without drug washout. METHODS: We retrospectively analyzed 1095 patients diagnosed with PA or essential hypertension. Patients were randomly grouped into training and validation sets at a 7:3 ratio. Baseline characteristics, plasma aldosterone concentration (PAC), and direct renin concentration (DRC) before and after drug washout were separately recorded, and the aldosterone-to-renin ratio (ARR) was calculated. RESULTS: PAC and ARR were higher and direct renin concentration was lower in patients with PA than in patients with essential hypertension. Furthermore, the differences in blood potassium and sodium concentrations and hypertension grades between the two groups were significant. Using the abbreviations potassium (P), ARR (A), PAC (P), sodium (S), and hypertension grade 3 (3), the model was named PAPS3. The PAPS3 model had a maximum score of 10, with the cutoff value assigned as 5.5; it showed high sensitivity and specificity for screening PA in patients who exhibit difficulty in tolerating drug washout. CONCLUSION: PA screening remains crucial, and standard guidelines should be followed for patients to tolerate washout. The PAPS3 model offers an alternative to minimize risks and enhance diagnostic efficiency in PA for those facing washout challenges. Despite its high accuracy, further validation of this model is warranted through large-scale clinical studies.

[Clinical features and prognostic factors of primary gastric neuroendocrine neoplasms].

Objective: To study the clinical characteristics and classification of gastric neuroendocrine neoplasm(NEN) and prognostic factors of mixed adenoneuroendocrine carcinoma (MANEC) and gastric neuroendocrine carcinoma(NEC). Methods: A total of 148 gastric NENs were divided into type Ⅰ, type Ⅱ and type Ⅲ based on the classification of European Neuroendocrine Tumor Society (ENETS). Kaplan-Meier test and Cox regression model were used in univariate and multivariate survival analysis in 108 cases with pathological G3 gastric NEN. Results: In this study, the percentages of type Ⅰ, type Ⅱ and type Ⅲ were 25.0%(37), 3.4%(5) and 71.6%(106) respectively. Among type Ⅰ patients, 28(75.7%) lesions were located in gastric fundus or body, 29(78.4%) had bumps. Lymph node involvement was found in 4 (10.8%) patients. Twenty-six (70.3%) patients received endoscopic treatment and 11 (29.7%) with surgery. All 5 type Ⅱ patients presented lesions in gastric fundus or body, including 4 with ulcers, who were all treated by endoscope. Three type Ⅱ patients had gastrinoma, and 2 combined with multiple endocrine neoplasmⅠ. In type Ⅲ patients, 56(52.8%) showed ulcerative lesions. The majority of patients (102, 96.2%) had a single lesion, 94(88.7%) with lymph node or other organ metastasis. In this study, no deaths were reported in gastric NEN with a pathological grade of G1 or G2. The mortality rate was 38.9%(42/108) in patients with G3 NEN. Survival analysis suggested that age, metastasis of tumor were associated with poor prognosis (P=0.041, 0.025). Conclusions: Patients with gastric NEN have heterogenous clinical presentations according to gender, age, endoscopic features, infiltration and metastasis, and pathological grade. Aging and metastasis are negative prognostic factors of G3 gastric NEN.

[Short-term effect of Isobar dynamic stabilization system fixation combined with lumbar discectomy in patients with lumbar disc herniation].

Objective: To investigate the short-term effect of Isobar dynamic stabilization system fixation combined with lumbar discectomy in patients with lumbar disc herniation. Methods: From June 2015 to June 2017, 62 patients with lumbar disc herniation treated in the First Affiliated Hospital of Zhengzhou University were divided into control group and observation group according to the therapy. The 31 patients in the control group were treated with simple excision of nucleus pulposus and the 31 patients in the observation group were treated with Isobar dynamic stabilization system fixation combined with lumbar discectomy. The score of Oswestry disability index (ODI) and Japanese Orthopedic Association (JOA) score of low back pain, lumbar and adjacent stage activity, inflammatory factor levels[C reaction protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α)] were compared between the two groups before and after the operation and 6 months after the operation. The data were compared between the two groups with t test. Results: After the operation and 6 months after, the ODI scores of the two groups decreased and the JOA scores increased significantly (25.5±3.0, 27.5±3.2 vs 15.3±2.2 and 18.6±2.3, 23.3±2.9 vs 15.3±2.0), the ODI scores of the observation group was significantly lower than those in the control group; the JOA scores were significantly higher than those in the control group (t=0.04-10.19, all P<0.05). The operative time, hospital stay, intraoperative blood lose and complications rate in the observation group were all significantly lower than those in the control group. The total activity of lumbar vertebrae in the observation group was significantly higher than that in the control group after operation and 6 months after (t=37.67, 36.60, both P<0.05); the activity of adjacent segments in the observation group was significantly lower than that of the control group (t=9.28, 3.79, both P<0.05); the Pfirrmann grade was significantly lower than that in the control group (t=3.11, 5.05, both P<0.05). The levels of CRP, IL-6 and TNF-α in the two groups were lower than those before operation, and those were also significantly lower in the observation than the corresponding indexes in the control group (t=0.52-10.99, all P<0.05). Conclusion: Isobar dynamic stable system fixation combined with lumbar intervertebral disc resection can effectively improve the lumbar function and lumbar activity in patients with lumbar intervertebral disc herniation, and reduce the level of inflammation and relapse.

[Advances in prevention of pharyngocutaneous fistula after total laryngectomy].

Summary Total laryngectomy is a common method for the treatment of malignant tumors of the pharynx and larynx in China, but pharyngocutaneous fistula often happens after surgery, which burdens patients and affects postoperative recovery. At present, there are many measures to prevent pharyngocutaneous fistula, including strengthening nutrition pre-operative and post-operative, testing related indicators, controlling comorbidities, rational use of drugs, regular oral care, optimal selection of incision closure, and using of flaps and special materials during operation, etc. However, the choice of specific program needs to take care of the patient's condition, surgeon's skills and hospital conditions, and often requires multiple programs to be used together throughout the perioperative period. This article will provide a brief review of some strategies for preventing pharyngocutaneous fistula after total laryngectomy.

[Effects of metformin on papillary thyroid carcinoma in nude rats model].

Objective:To establish an subcutaneous xenotransplanted tumor model of papillary thyroid carcinoma (PTC) and investigate the role of metformin in apoptosis of PTC.Method:Model rats were randomly divided into four groups: control group, Met group and Met+DM group. The tumor volumes were recorded each week. Flow cytometry was used to detect the apoptosis rate of tumor. Immunohistochemistry was used to detect CyclinD1 and the cellular proliferative activity index PCNA and Ki-67.Result:Compared to the control group,there were a significant decrease in tumor volume and antitumor effect in Met and Met+DM groups. The apoptosis rate increased in Met and Met+DM groups. While compared with the control group, the expressions of PCNA,CyclinD1 and Ki-67 significantly decreased in Met and Met+DM groups. There was no difference between Met and Met+DM group.Conclusion:The effect of Metformin on inhibiting tumor growth were related with the imbalance of cell proliferation and apoptosis.

[Prevalence of reproductive system diseases among female workers in a city and related occupational influencing factors: an analysis of 9944 cases].

Objective: To investigate the prevalence of reproductive system diseases among female workers in a city and related occupational influencing factors. Methods: From June to September, 2016, a cross-sectional survey was used to select 9 944 female workers from six districts of Beijing and then a face-to-face questionnaire survey was performed. Univariate analysis using chi-square test and multivariate logistic regression analysis were used to investigate the risk factors for reproductive system diseases. Results: The age of 9944 female workers ranged from 18 to 65 years (mean 35.53±9.52 years) , and among them, 7 351 (73.92%) were married. The overall prevalence rate of reproductive system diseases among these 9944 female workers during the past three months was 28.29%, and the prevalence rates of hyperplasia of mammary glands, vaginitis, and hysteromyoma were 15.54%, 11.25%, and 6.77%, respectively. After adjustment for age, marital status, education level, and annual family income, the multivariate logistic regression analysis showed that frequent overtime work (odds ratio[OR]=1.119, 95% confidence interval[CI]: 1.070-1.343) , frequent night shifts (OR=1.198, 95%CI: 1.054-1.361) , standing for a long time (OR=1.197, 95%CI: 1.063-1.347) , sitting for a long time (OR=1.327, 95%CI: 1.191-1.479) , heavy workload (OR=1.429, 95%CI: 1.262-1.615) , exposure to lead (OR=1.696, 95%CI: 1.307-2.201) , exposure to mercury (OR=1.452, 95%CI: 1.086-1.940) , and exposure to ionizing radiation (OR=1.679, 95%CI: 1.424-1.980) were associated with reproductive system diseases. Conclusion: The prevalence of reproductive system diseases among female workers in Beijing is not optimistic. Reproductive system diseases are associated with frequent overtime work, frequent night shifts, standing for a long time, sitting for a long time, heavy workload, and exposure to lead, mercury, and ionizing radiation.

[Current treatment of pharyngocutaneous fistula after total laryngectomy].

Pharyngocutaneous fistula is a common and serious complication after total laryngectomy, and it will seriously affect patients' postoperative recovery. The treatment of pharyngeal fistula mainly include conservative and surgery therapy. The use of negative-pressure wound therapy and endoscopic technique to treat post laryngectomy pharyngocutaneous fistula also acquire good result in recent years. However, specific therapy options should be choose according to the type and size of the fistula, the patient's overall health condition and preoperative chemoradiotherapy etc. This article will give a review on the status of treatment of pharyngocutaneous fistula after total laryngectomy.

[Metformin induced apoptosis of papillary thyroid carcinoma BCPAP cells].

Objective:To investigate the role of metformin in inducing apoptosis of papillary thyroid carcinoma BCPAP cells. Method:Using MTT methods to detect effects of metformin on cell proliferation of BCPAP in different concentrations (0 mmol/L, 1 mmol/L, 5 mmol/L, 10 mmol/L, 20 mmol/L) and time course (0 h, 4 h, 8 h, 16 h, 24 h, 48 h). The experiment was divided into four groups: Con, Met, Met+Sal and Met+DM, flow cytometry to detect the rate of apoptosis of BCPAP. Then detect the protein expressions of CHOP, GRP78 and Caspase-12 of 4 groups by Western blot. Result:Compared with the experimental control group, the percentage of cell proliferation index significantly decreased in metformin (0-20 mmol/L and 0-48 h) treatment group. Compared with the experimental control group, the percentage of apoptosis cells significantly increased in metformin treatment group. Compared with the control group, the protein expressions of GRP78, CHOP and Caspase-12 were significantly increased in Met group; While compared with the Met group, the protein expressions of GRP78, CHOP and Caspase-12 were significantly inhibited in the Met+Sal group. Conclusion:Metformin can induced availably BCPAP cell apoptosis by activating endoplasmic reticulum stress mechanism.

Cooled perch effects on performance and well-being traits in caged White Leghorn hens.

We assessed the effects of chilled water cooling perches on hen performance and physiological and behavioral parameters under "natural" high temperatures during the 2013 summer with a 4-hour acute heating episode. White Leghorns at 16 wk of age (N = 162) were randomly assigned to 18 cages (n = 9) arranged into 3 units. Each unit was assigned to one of the 3 treatments through 32 wk of age: 1) cooled perches, 2) air perches, and 3) no perches. Chilled water (10°C) was circulated through the cooled perches when cage ambient temperature exceeded 25°C. At the age of 27.6 wk, hens were subjected to a 4-hour acute heating episode of 33.3°C and plasma corticosterone was determined within 2 hours. Egg production was recorded daily. Feed intake and egg and shell quality were measured at 5-week intervals. Feather condition, foot health, adrenal and liver weights, plasma corticosterone, and heat shock protein 70 mRNA were determined at the end of the study at 32 wk of age. The proportion of hens per cage perching, feeding, drinking, panting, and wing spreading was evaluated over one d every 5 wks and on the d of acute heat stress. There were no treatment effects on the measured physiological and production traits except for nail length. Nails were shorter for cooled perch hens than control (P = 0.002) but not air perch hens. Panting and wing spread were observed only on the day of acute heat stress. The onset of both behaviors was delayed for cooled perch hens, and they perched more than air perch hens following acute heat stress (P = 0.001) and at the age 21.4 wk (P = 0.023). Cooled perch hens drank less than control (P = 0.019) but not air perch hens at the age 21.4 wk. These results indicate that thermally cooled perches reduced thermoregulatory behaviors during acute heat stress, but did not affect their performance and physiological parameters under the ambient temperature imposed during this study.

Synergism between arsenic trioxide and cyclopamine in the inhibition of PC3 cell survival via the Hedgehog signaling pathway.

Previous studies have shown that Hh signaling is overexpressed in the development and progression of prostate cancer (PCa), suggesting that Hh pathway inhibitors might be an effective strategy in the treatment of PCa. The combination of chemotherapeutic agents is one of the main approaches in cancer treatment, with the objective of improving efficacy. In the present study, we examined the effect of combing arsenic trioxide (ATO), a useful agent for Hedgehog-driven cancers, and cyclopamine (CYA), a classic Hh pathway inhibitor, on the suppression of PC3 cells (i.e., an androgen-independent PCa cell line). The combination of ATO and CYA more effectively inhibited the proliferation of PC3 cells than either single agent alone. In a xenograft mouse model, the combination of ATO and CYA significantly reduced tumor weight and volume in nude mice that were implanted with PC3 cells. The combination of ATO and CYA in PC3 cells resulted in a more distinct mode of Hh pathway inhibition and strengthened the S phase arrest. The present results indicate that a combination of ATO and CYA may be a rational strategy for treating PCa.

A novel HLA-DRB1*15 allelic sequence isolated from the Han population of Guangdong, China.

A novel DRB1*15 allele, DRB1*1516, has been identified in a Guangdong Han individual. Its sequence was confirmed by sequencing of polymerase chain reaction products and clones. This allele differed by one nucleotide from DRB1*150101 at position 220 (G-->A), resulting in an amino acid substitution from Gly to Arg at codon 45.