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1.
Biosci Rep ; 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32391558

RESUMO

Accumulating studies have confirmed that MASPIN plays an essential role in NSCLC. However, results are still controversial or inconsistent. In the present study, we attempted to identify the clinical significance of MASPIN and its potential molecular roles in NSCLC. The correlation of MASPIN with prognosis and clinicopathological characteristics was assessed by meta-analysis. Additionally, the potential molecular mechanisms of MASPIN in NSCLC was also investigated through several online databases. 2,220 NSCLC patients from 12 high quality studies were included and the results indicated that upregulated MASPIN nucleus and cytoplasm expression was associated with poor OS (HR = 1.43, 95% CI = 1.01 - 2.04, P < 0.05), elevated MASPIN cytoplasm expression was associated with poor OS (HR = 1.45, 95% CI = 1.01 - 2.07, P < 0.05), DFS (HR = 1.95, 95% CI = 1.31 - 2.88, P = 0.001) and DSS (HR = 2.17, 95% CI = 1.18 - 3.99, P = 0.013). MASPIN both nucleus and cytoplasm location were associated with clinicopathological characteristics. Bioinformatics analysis validated the above results and suggested that SERPINB5 hypomethylated levels were negatively correlated with its mRNA expression. Bioinformatics analysis also revealed the 85 most frequently altered neighboring genes of SERPINB5, and GO and KEGG pathway enrichment analysis revealed 20 GO terms and 3 KEGG pathways with statistical significance. MASPIN had a statistically negative correlation with NSCLC prognosis, functioning as an oncoprotein by hypomethylation and influencing specific pathways involving the 85 genes identified herein. MASPIN might be a promising prognostic signature in NSCLC.

2.
Plant Physiol ; 2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32241879

RESUMO

Excessive application of nitrate, an essential macronutrient and a signal regulating diverse physiological processes, decreases malate accumulation in apple (Malus domestica) fruit, but the underlying mechanism remains poorly understood. Here, we show that an apple BTB/TAZ protein, MdBT2, is involved in regulating malate accumulation and vacuolar pH in response to nitrate. In vitro and in vivo assays indicate that MdBT2 interacts directly with and ubiquitinates a bHLH transcription factor, MdCIbHLH1, via the ubiquitin/26S proteasome pathway in response to nitrate. This ubiquitination results in the degradation of MdCIbHLH1 protein and reduces the transcription of MdCIbHLH1-targeted genes involved in malate accumulation and vacuolar acidification, including MdVHA-A, which encodes a vacuolar H+-ATPase, and MdVHP1, which encodes a vacuolar H+-pyrophosphatase, as well as MdALMT9, which encodes an aluminum-activated malate transporter. A series of transgenic analyses in apple materials including fruits, plantlets, and calli demonstrate that MdBT2 controls nitrate-mediated malate accumulation and vacuolar pH at least partially, if not completely, via regulating the MdCIbHLH1 protein level. Taken together, these findings reveal that MdBT2 regulates the stability of MdCIbHLH1 via ubiquitination in response to nitrate, which in succession transcriptionally reduces the expression of malate-associated genes, thereby controlling malate accumulation and vacuolar acidification in apples under high nitrate supply.

3.
J Integr Plant Biol ; 2020 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-32298027

RESUMO

BT2 is a BTB/TAZ domain protein with key roles in multiple stress responses and the plant development of Arabidopsis (Figueroa et al. 2005; Ren et al. 2007; Mandadi et al. 2009). Recent studies have demonstrated that apple MdBT2 functions as a negative regulator in diverse hormonal and environmental signal-induced anthocyanin biosynthesis, suggesting that MdBT2 integrates stress signals and anthocyanin biosynthesis.

4.
J Reprod Dev ; 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32051348

RESUMO

Changes in histone modifications always correlate with altered transcriptional activities of genes. Recent studies have shown that the mutation of certain lysine residues to methionine in the histone variant H3.3 can act as a valuable tool to reduce specific H3 methylation levels. In our study, we used the mouse spermatogenic cell line GC-2 as a model to generate cells stably expressing H3.3 K4, H3.3 K9, H3.3 K27, and H3.3 K36M. The expression of these H3.3 K-to-M mutants influenced the expression of different subsets of genes, and a total of 891 differentially expressed genes were identified through global gene expression profiling. Moreover, the H3.3 K-to-M transgenes, especially H3.3 K36M, impacted the expression of endogenous retrovirus ERVK. This study gives a global view of how different H3 modifications regulate transcriptomes in spermatogenic cell lines, and identifies potential targets of H3 modifications in male germ line.

5.
J Exp Bot ; 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31996900

RESUMO

Teosinte branched1/cycloidea/proliferating (TCP) transcription factors (TFs) play a broad role in plant growth and development. However, the role of TCP proteins in the regulation of anthocyanin biosynthesis is rarely reported. In this study, different light intensity-induced anthocyanin biosynthesis was found to be largely dependent on the functions of MdMYB1 and MdTCP46 in apple. The expression of MdTCP46 was responsive to high light intensity, and the MdTCP46 protein promoted high light intensity-induced anthocyanin biosynthesis by enhancing the binding of MdMYB1 to its target genes through direct interactions with MdMYB1. Additionally, MdTCP46 interacted with a high light responsive BTB protein, MdBT2, which ubiquitinated MdTCP46 and mediated its degradation via the 26S proteasome pathway. These results demonstrate that the dynamic regulatory module, MdBT2-MdTCP46-MdMYB1, plays a key role in different light intensity-modulated anthocyanin biosynthesis in apple, which provides new insights for future studies on the post-transcriptional regulation of TCP proteins.

6.
J Environ Manage ; 260: 110105, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-31941635

RESUMO

Bisphenol A (BPA) is a toxic environmental pollutant commonly found in wastewater. Using non-toxic materials and eco-friendly technology to remove this pollutant from wastewater presents multiple advantages. Treatment of wastewater with clay minerals has received growing interest because of the environment friendliness of these materials. Bentonite is a 2:1 layered phyllosilicate clay mineral that can support nano-metal catalysts. It can prevent the agglomeration of nano-metal catalysts and improve their activity. In this article, a green catalytic nano zero-valent iron/bentonite composite material (NZVI@bentonite) was synthesized via liquid-phase reduction. The average size of NZVI was approximately 40-50 nm. Good dispersion and low aggregation were observed when NZVI was loaded on the surface or embedded into the nanosheets of bentonite. Degradation of BPA, a harmful contaminant widely found in wastewater at relatively high levels, by NZVI@bentonite was then investigated and compared with that by pristine NZVI through batch Fenton-like reaction experiments. Compared with pristine NZVI and bentonite alone, the NZVI@bentonite showed a higher BPA degradation ratio and offered highly effective BPA degradation up to 450 mg/g in wastewater under optimum operating conditions. Adsorption coupled with the Fenton-like reaction was responsible for BPA degradation by NZVI@bentonite. This work extends the application of NZVI@bentonite as an effective green catalyst for BPA degradation in aqueous environments.


Assuntos
Bentonita , Poluentes Químicos da Água , Adsorção , Compostos Benzidrílicos , Ferro , Fenóis
7.
Cell Death Dis ; 11(1): 46, 2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-31969557

RESUMO

Autophagy and apoptosis are two major modes of cell death. A balanced interplay between both is vital for phagocytic clearance of apoptotic testicular cells. Here, generating a SD rats model-treated with cadmium (Cd) to mimic environmental exposure on human, we show that autophagy and apoptosis present synchronous change trends in Cd-induced testicular injury/self-recovery. Further, the cross-talk of autophagy and apoptosis is investigated in four testicular cell lines (GC-1/GC-2/TM3/TM4 cells) respectively. Results reveal that Cd-exposure for five consecutive weeks induces reproductive toxicity in male rats. After one cycle of spermatogenesis within 8 weeks without Cd, toxic effects are ameliorated significantly. In vitro, we find that PI3K inhibitor 3-MA regulates apoptosis by inhibiting autophagy with mTOR-independent pathway in Cd-treated testicular cells. Conclusively, cross-talk between autophagy and apoptosis regulates testicular injury/recovery induced by Cd via PI3K with mTOR-independent pathway.

8.
Plant Cell Physiol ; 61(1): 130-143, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31550006

RESUMO

As an important environment factor, light affects plant growth and development throughout life. B-BOX (BBX) proteins play key roles in the regulation of light signaling. Although the multiple roles of BBX proteins have been extensively studied in Arabidopsis, the research in apple is much less extensive. In this study, we systematically characterized the negative role of an apple BBX protein MdBBX37 in light signaling, including inhibiting anthocyanin biosynthesis and promoting hypocotyl elongation. We found that MdBBX37 interacted with MdMYB1 and MdMYB9, two key positive regulators of anthocyanin biosynthesis, and inhibited the binding of those two proteins to their target genes and, therefore, negatively regulated anthocyanin biosynthesis. In addition, MdBBX37 directly bound to the promoter of MdHY5, a positive regulator of light signaling, and suppressed its expression, and thus relieved MdHY5-mediated hypocotyl inhibition. Taken together, our investigations suggest that MdBBX37 is a negative regulator of light signaling in apple. Our study will provide reference for further study on the functions of BBX proteins in apple.

9.
Plant J ; 101(3): 573-589, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31571281

RESUMO

Drought stress induces anthocyanin biosynthesis in many plant species, but the underlying molecular mechanism remains unclear. Ethylene response factors (ERFs) play key roles in plant growth and various stress responses, including affecting anthocyanin biosynthesis. Here, we characterized an ERF protein, MdERF38, which is involved in drought stress-induced anthocyanin biosynthesis. Biochemical and molecular analyses showed that MdERF38 interacted with MdMYB1, a positive modulator of anthocyanin biosynthesis, and facilitated the binding of MdMYB1 to its target genes. Therefore, MdERF38 promoted anthocyanin biosynthesis in response to drought stress. Furthermore, we found that MdBT2, a negative modulator of anthocyanin biosynthesis, decreased MdERF38-promoted anthocyanin biosynthesis by accelerating the degradation of the MdERF38 protein. In summary, our data provide a mechanism for drought stress-induced anthocyanin biosynthesis that involves dynamic modulation of MdERF38 at both transcriptional and post-translational levels.

10.
Plant Biotechnol J ; 18(2): 337-353, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31250952

RESUMO

MYB transcription factors (TFs) have been demonstrated to play diverse roles in plant growth and development through interaction with basic helix-loop-helix (bHLH) TFs. MdbHLH33, an apple bHLH TF, has been identified as a positive regulator in cold tolerance and anthocyanin accumulation by activating the expressions of MdCBF2 and MdDFR. In the present study, a MYB TF MdMYB308L was found to also positively regulate cold tolerance and anthocyanin accumulation in apple. We found that MdMYB308L interacted with MdbHLH33 and enhanced its binding to the promoters of MdCBF2 and MdDFR. In addition, an apple RING E3 ubiquitin ligase MYB30-INTERACTING E3 LIGASE 1 (MdMIEL1) was identified to be an MdMYB308L-interacting protein and promoted the ubiquitination degradation of MdMYB308L, thus negatively regulated cold tolerance and anthocyanin accumulation in apple. These results suggest that MdMYB308L acts as a positive regulator in cold tolerance and anthocyanin accumulation in apple by interacting with MdbHLH33 and undergoes MdMIEL1-mediated protein degradation. The dynamic change in MYB-bHLH protein complex seems to play a key role in the regulation of plant growth and development.

11.
J Plant Physiol ; 244: 153089, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31812904

RESUMO

Inorganic phosphate (Pi) starvation severely affects the normal growth and development of plants. Here, a Pi-responsive gene, named MdMYB2 (MDP0000823458), was cloned and functionally identified in apple. Overexpression of MdMYB2 regulated the expression of Pi starvation-induced (PSI) genes and then promoted phosphate assimilation and utilization. The ectopic expression of MdMYB2 in Arabidopsis influenced plant growth and flowering, which was partially rescued by application of exogenous gibberellin (GA). These results indicated that MdMYB2 may be an essential regulator in phosphate utilization and GA-regulated plant growth and development.

12.
Biochem Biophys Res Commun ; 522(2): 422-427, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-31767152

RESUMO

During development, fertilization triggers totipotency establishment, featured by zygotic genome activation/embryonic genome activation (ZGA/EGA). Mouse embryonic stem cells (mESCs) occasionally cycle through a two-cell (2C)-like status with activated expression of Dux and its targeted ZGA genes. Here, we demonstrate that deficiency of histone variant H3.3 dramatically stimulates expression of ZGA genes in mESCs. Our analysis revealed that H3.3 directly associates with Dux locus and inhibits Dux expression, therefore it is an important upstream regulator of Dux. Our finding is further supported by transcriptome change in early mouse embryos with H3.3 knockdown. We suggest that proper H3.3 level in early embryos is important to orchestrate ZGA activity for totipotency establishment.

13.
Br J Pharmacol ; 177(9): 2058-2072, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31883107

RESUMO

BACKGROUND AND PURPOSE: ß-Caryophyllene (BCP) is a plant-derived terpenoid used as a food additive for many decades. Recent studies indicate that BCP is a cannabinoid CB2 receptor agonist with medical benefits for a number of human diseases. However, little is known about its therapeutic potential for drug abuse and addiction. EXPERIMENT APPROACH: We used pharmacological, transgenic, and optogenetic approaches to systematically evaluate the effects of BCP on nicotine-taking and nicotine-seeking behaviour in animal models of drug self-administration, electrical, and optical brain-stimulation reward. KEY RESULTS: Systemic administration of BCP dose-dependently inhibited nicotine self-administration and motivation for nicotine seeking in rats and mice. The reduction in nicotine self-administration was blocked by AM630, a selective CB2 receptor antagonist, but not by AM251, a selective CB1 receptor antagonist, suggesting involvement of a CB2 receptor mechanism. Genetic deletion of CB2 receptors in mice blocked the reduction in nicotine self-administration produced only by low doses, but not by high doses, of BCP, suggesting involvement of both CB2 and non-CB2 receptor mechanisms. Furthermore, in the intracranial self-stimulation paradigm, BCP attenuated electrical brain-stimulation reward and nicotine-enhanced brain-stimulation reward in rats. Lastly, BCP also attenuated brain-stimulation reward maintained by optogenetic stimulation of dopaminergic neurons in the ventral tegmental area in DAT-cre mice, suggesting the involvement of a dopamine-dependent mechanism in BCP's action. CONCLUSIONS AND IMPLICATIONS: The present findings suggest that BCP has significant anti-nicotine effects via both CB2 and non-CB2 receptor mechanisms and, therefore, deserves further study as a potential new pharmacotherapy for cigarette smoking cessation.

14.
Br J Pharmacol ; 177(8): 1865-1880, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31877572

RESUMO

BACKGROUND AND PURPOSE: Cannabis or cannabinoids produce characteristic tetrad effects-analgesia, hypothermia, catalepsy and suppressed locomotion, which are believed to be mediated by the activation of cannabinoid CB1 receptors. Given recent findings of CB2 and GPR55 receptors in the brain, we examined whether these receptors are also involved in cannabinoid action. EXPERIMENTAL APPROACH: We compared Δ9 -tetrahydrocannabinol (Δ9 -THC)-, WIN55212-2-, or XLR11-induced tetrad effects between wild-type (WT) and each genotype of CB1 -, CB2 - or GPR55-knockout (KO) mice and then observed the effects of antagonists of these receptors on these tetrad effects in WT mice. KEY RESULTS: Systemic administration of Δ9 -THC, WIN55212-2 or XLR11 produced dose-dependent tetrad effects in WT mice. Genetic deletion or pharmacological blockade of CB1 receptors abolished the tetrad effects produced by all three cannabinoids. Unexpectedly, genetic deletion of CB2 receptor abolished analgesia and catalepsy produced by Δ9 -THC or WIN55212-2, but not by XLR11. Microinjections of Δ9 -THC into the lateral ventricles also produced tetrad effects in WT, but not in CB1 -KO mice. CB2 -KO mice displayed a reduction in intraventricular Δ9 -THC-induced analgesia and catalepsy. In contrast to CB1 and CB2 receptors, genetic deletion of GPR55 receptors caused enhanced responses to Δ9 -THC or WIN55212-2. Antagonisim of CB1 , CB2 or GPR55 receptors produced alterations similar to those observed in each genotype mouse line. CONCLUSIONS AND IMPLICATIONS: These findings suggest that in addition to CB1 , both CB2 and GPR55 receptors are also involved in some pharmacological effects produced by cannabinoids. CB1 /CB2 , in contrast to GPR55, receptors appears to play opposite roles in cannabinoid action.

15.
J Phys Chem A ; 124(3): 520-528, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31877046

RESUMO

Hydrogen bond (HB) is of an important factor on theory. In this work, the effect of a solvent on the performance of a newly synthesized fluorescent probe for detecting endogenous ONOO- is studied by using four different solvent models, noted as polarizable continuum model (PCM), ONIOM, HB, and HB + PCM models, respectively, where HB contribution is thus given special attention. The theoretical results show that the absorption and emission properties of the probe are obviously influenced by the HB; for example, the HB + PCM model including both short- and long-range interactions between the solute and solvent molecules gives the exact description on the solvent effect. In particular, the responsive mechanism of the probe for sensing ONOO- is explored by analyzing the charge variations between the excited states and ground states of the free molecules and their reaction products. It is demonstrated that the mechanism is attributed to an intramolecular charge transfer, where the HB has an important contribution. Moreover, the influence of HB on a two-photon absorption cross section has been considered. Our investigation reveals that the HB has an important influence on the optical properties and responsive mechanism of the fluorescent probe, and it must be considered for theoretical calculations.

16.
BMC Pulm Med ; 19(1): 259, 2019 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-31864318

RESUMO

BACKGROUND: To promote the utilization of pulmonary function tests (PFT) through analyzing the data of PFT during the past seven years in one large teaching hospital in China. METHODS: Through a retrospective analysis, the allocation of full-time staff in PFT room, the demographic characteristics of patients, cost-effectiveness of PFT, positive rate and failure rate of PFT, adverse events were analyzed. RESULTS: 1) From 2012 to 2018, the numbers of PFT showed the trend of escalation year by year. The proportion of patients receiving PFT rose from 29.0/10,000 in 2012 to 34.7/10,000 in 2018. The best allocation of PFT room was 20-25/ person / day. 2) The number of PFT provided by Department of Pulmonary and Critical Care Medicine (PCCM) accounted for 97.2, 97.1, 97.3, 97.8, 97.8, 98.0, and 98.2% of the total cases of outpatient PFT in the same year. The top three departments in the inpatient department were Department of Thoracic Surgery, Department of General Surgery, and Department of Urinary Surgery, the total cases of PFT in these three departments accounted for 65.1, 64.4, 62.1, 63.5, 62.4, 65.3 and 69.1% of the total cases of inpatient PFT in the same year. 3) Data from 2018 showed that the revenue from PFT was about 3.7 million Chinese Yuan, and that the salary of personnel and expenditure on machine maintenance and wear were about 800,000 Chinese Yuan. 4) 58.2% of the patients who had undergone PFT had ventilatory dysfunction. 5) The average failure rate of PFT in the past seven years was 1.91%. 6) The main adverse events of PFT examination were dizziness, amaurosis, limb numbness, lip numbness and falls. The incidence rates were 0.49, 0.42, 0.41, 0.39, 0.44, 0.48, and 0.45% respectively, with an average of 0.44%. CONCLUSIONS: The number of PFT showed an upward trend in the past seven years, and the optimal staffing of PFT room was 20-25 cases per person per day. The positive rate of pulmonary dysfunction was 58.2%. The failure rate of PFT and the incidence of adverse events were very low, suggesting it is a simple and safe clinical examination. It's worthy of further popularization and promotion.

17.
Chin J Integr Med ; 25(10): 728-735, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31782009

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of salvianolate in elderly patients with unstable angina pectoris (UAP). METHODS: A prospective double-blind randomized placebo-controlled multicenter trial in elderly patients with UAP from 13 third-grade class-A hospitals in China was performed. A total of 318 patients were randomly allocated in a 1:1 ratio to an experimental group (160 patients) and a control group (158 patients). The experimental group was treated with salvianolate for 14 days on the basis of conventional medicine, and the control group was given a placebo for 14 days with the same criteria. Follow-up was lasted 28 days in both groups. The primary endpoint was biweekly frequency of angina pectoris attacks. The secondary endpoints included biweekly dosage of nitroglycerin, the Seattle Angina Questionnaire, angina pectoris severity and duration, myocardial injury markers, high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as major adverse cardiovascular events (MACEs). Safety was assessed according to adverse events and serious adverse events. RESULTS: Baseline characteristics were similar between treatment groups. Compared with those in the control group, the frequency of biweekly angina attacks (2.92 vs . 4.08, P=0.025), the biweekly dosage of nitroglycerin, as well as the severity and duration of angina attacks (P<0.01) were reduced by salvianolate. The Seattle Angina Questionnaire score was also significantly improved in the experimental group than in the control group (P<0.05). No significant differences were observed between the two groups with respect to the incidence of MACEs. Salvianolate was well tolerated. CONCLUSIONS: Salvianolate appear to have efficacy and well tolerated for elderly patients with UAP. [ClinicalTrials.gov identifier: NCT03037047].

18.
Cell Commun Signal ; 17(1): 142, 2019 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-31699102

RESUMO

BACKGROUND: Integrin-mediated platelet-tumor cell contacting plays an important role in promoting epithelial-mesenchymal transition (EMT) transformation of tumor cells and cancer metastasis, but whether it occurs in breast cancer cells is not completely clear. OBJECTIVE: The purpose of this study was to investigate the role of integrin α2ß1 in platelet contacting to human breast cancer cell line MCF-7 and its effect on the EMT and the invasion of MCF-7 cells. METHODS: Human platelets were activated by thrombin, and separated into pellets and releasates before the co-incubation with MCF-7 cells. Cell invasion was evaluated by transwell assay. The surface integrins on pellets and MCF-7 cells were inhibited by antibodies. The effect of integrin α2ß1 on Wnt-ß-catenin pathway was assessed by integrin α2ß1-silencing and Wnt-ß-catenin inhibitor XAV. The therapeutic effect of integrin α2ß1-silencing was confirmed in the xenograft mouse model. RESULTS: Pellets promote the invasion and EMT of MCF-7 cells via direct contacting of surface integrin α2ß1. The integrin α2ß1 contacting activates Wnt-ß-catenin pathway and promotes the expression of EMT proteins in MCF-7 cells. The activated Wnt-ß-catenin pathway also promotes the autocrine of TGF-ß1 in MCF-7 cells. Both Wnt-ß-catenin and TGF-ß1/pSmad3 pathways promote the expression of EMT proteins. Integrin α2ß1-silencing inhibits breast cancer metastasis in vivo. CONCLUSIONS: The direct interaction between platelets and tumor cells exerts its pro-metastatic function via surface integrin α2ß1 contacting and Wnt-ß-catenin activation. Integrin α2ß1-silencing has the potential effect of inhibiting breast cancer metastasis.

19.
BMC Urol ; 19(1): 106, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31684918

RESUMO

BACKGROUND: Bilateral adrenal hemorrhage (BAH) is a rare but potentially catastrophic condition. Its clinical manifestation is often non-specific and sometimes difficult to be diagnosed in time. A 57-year-old woman, who presented with severe fatigue, nausea and vomiting after left hip arthroplasty due to her femoral neck fracture in a local hospital, was transferred to our medical center. Laboratory results revealed significant hyponatremia, low serum cortisol and elevated serum ACTH. Computed tomography (CT) showed a bilateral adrenal mass, measured 3.6 × 2.7 cm on the left and 3.4 × 2.3 cm on the right. Further magnetic resonance imaging (MRI) confirmed the diagnosis of BAH. The patient was prescribed with oral prednisolone acetate, 5 mg, tid, and her condition improved gradually. Nine months after, the patient was in good condition with 5 mg prednisolone acetate per day. CT revealed a clearly shrunken adrenal mass compared with 9 months ago. CONCLUSIONS: This case illustrates the difficulty in making the diagnosis of BAH with atypical presentation. Such cases necessitate greater alertness on the part of the clinician and require rapid diagnosis and prompt glucocorticoid replacement for better clinical outcomes.

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