Objective To assess the effectiveness of the quotient of serum sodium to urinary sodium divided by (serum potassium) 2 to urinary potassium (SUSPPUP) in screening for primary aldosteronism (PA).Methods Among 952 patients with hypertension who had renin activity,aldosterone measurements and concomitant serum and urinary biochemistry data,204 patients were diagnosed as cases of PA and 261 as cases of essential hypertension.Diagnosis of PA was made in accordance with established laboratory criteria including renin activity and aldosterone,plasma aldosterone concentration/plasma renin activity (ARR),and saline loading test.The SUSPPUP ratio with the ARR were compared in two groups.Results The area under the curve of SUSPPUP and ARR was 0.797 and 0.796 respectively according to receiver operating characteristic curve,optimal cutoff of SUSPPUP was 1.0,the sensitivity and specificity of SUSPPUP was 98.9％ and 81％ respectively.Conclusions The SUSPPUP ratio is an inexpensive and rapid tool to assess the extent of mineralocorticoid excess,therefore,SUSPPUP ratio can be applied to screen PA in hypertensive patients.

Objective The objective of this experiment was to find out the causes and mechanisms of vocal cord granulomas,to analyze the results of different treatments and to establish an effective protocol of treatment.Methods 24 patients with vocal cord granulomas were analyzed in terms of genders,ages,occupations,etiologies,such as voicing,gastroesophageal reflux,and treatment under general anesthesia and jet-ventilation,treatments and outcomes.Results Based on different etiologies,patients were divided into 4 groups: Group I of 9 patients with pathologic phonation,Group II of 8 patients with gastroesophageal reflux,Group III of 2 patients with treatment under general anesthesia and jet-ventilation,Group IV of 5 patients with unknown causes.9 patients received operations while 8 demonstrated good prognosis and one was completely cured.The vocal cord granulomas for 11 patients disappeared,8 had reduced vocal cord granulomas,and the vocal cord granulomas for 5 patients without any treatment were gone 6 months later.Conclusion The vocal cord granulomas can be caused by many factors with gastroesophageal reflux as a main etiology.Higher recurrences were noted after surgical treatment;therefore,treatment for gastroesophageal reflux and voice therapy should be considered as major approaches.

OBJECTIVE:To evaluate the clinical efficacy and safety of letrozole combined with traditional Chinese medicine for ovulation dysfunction induced by polycystic ovarian syndrome(PCOS). METHODS: 300 PCOS outpatients were randomized to 3 groups of 100 each: clomiphene citrate (CC) group (188 cycles);urinary gonadotropin (HMG) group (104 cycles) and letrozole (LE) group (155 cycles). The occurrence rate of mature follicle,ovulation rate,pregnancy rate,abortion rate,superfoetation-terata rate,cancellation rate,incidence of no dominant follicle forming and OHSS etc were compared between the two groups after treatment. RESULTS: 30 babies were born in CC group,34 in HMG group and 43 in LE group were born. The occurrence rate of mature follicles,ovulation rate and pregnancy rate in the LE group were higher than in either CC group or HMG group(P0.05);the superfoetation rate in HMG group was higher than in CC group or LE group(P

Objectives To investigate the relationship between obstructive sleep apnea hypoventilation syndrome (OSAHS), insulin resistance (IR) and metabolic syndrome (MS), as well as to explore the possible mechanism of MS caused by OSAHS. Methods We recruited 186 hospitalized patients with hypertensions, who were divided into four groups based on their nocturnal polygraphs recordings, 35 as controls (group Ⅰ), 61 with mild (group Ⅱ), 52 with moderate (group Ⅲ) and 38 with severe OSAHS (group Ⅳ). They all underwent measurements including body height, body weight, waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), serum uric acid, creatinine, fasting plasma glucose, fasting plasma insulin, serum total cholesterol, high-density lipoprotein-cholesterul, low-density lipoprotein-cholesterol and triglyceride. Results One hundred and two patients with OSAHS (67.6 percent) also suffered of MS, 33 (86.8 percent) of them with severe OSAHS. There was no significant difference in age, gender, fasting plasma glucose, total cholesterol, high-density lipoprutein-cholesterul, low-density lipoprotein-cholesterol and triglyceride among the four groups (P>0.05). Body mass index (BMI), WC, ratio of serum uric acid to creatinine and DBP were all significantly higher in patients with severe OSAHS than those in patients with mild and moderate OSAHS and controls (P<0.01). SBP was significantly higher in patients with severe OSAHS than that in those with mild and moderate OSAHS (P<0.01). Insulin resistance was significantly severer in patients with severe OSAHS than that in those with mild OSAHS and controls (P<0.01). Results of multivariate linear regression analysis showed that insulin resistance was correlated with BMI and reversely correlated with minimal blood oxygen saturation, and minimal blood oxygen saturation reversely correlated with WC and ratio of uric acid to creatinine. Condusions Hypoxemia and obesity may promote development of insulin resistance. Patients of hypertension complicated with OSAHS tend to develop MS, particularly in those with severe OSAHS.

AIM: To study the effects of Huoxue Huayu and Yiqi Wenyang compound prescription (composition; ginseng, radix astragali, plantaginis semen, lignum sappan, chuanxiong, salvia miltiorrhiza, radix aconiti lateralis preparata, bitter orange, cassia twig) of TCM on the congestive heart failure in rats. METHODS:The rats were given doxorubicin hydrochloride by intraperitoneal injection to establish the model of congestive heart failure and were randomly divided into control group, congestive heart failure model group, Xinbao treatment group ( XB treatment) and Huoxue Huayu and Yiqi Wenyang compound prescription treatment group (QXYTM treatment). Normal saline, liquid medicine Xinbao and liquid medicine Huoxue Huayu and Yiqi Wenyang compound prescription were administered respectively to four groups by gavage. Radioimmunoassay, semi - quantitative RT - PCR and flow cytometry methods were used to determine the expressions of plasma atrial natriuretic peptide ( ANP) , renal medulla aquaporin - 2 ( AQP2 ) and heat shock protein70 (HSP70) in congestive heart failure rats before and after treatment. RESULTS: In congestive heart failure rats treated with Huoxue Huayu and Yiqi Wenyang compound prescription, the cardiac output and left ventricle systolic pressure increased significantly, the left ventricular end diastolic pressure decreased, and the maximum ascending and declining rate of left ventricular pressure ameliorated, thus the hemodynamics was effectively improved. Meanwhile, the level of plasma cardionatrin decreased, the abnormal expression of renal medulla AQP2 was markedly restored, and the transcription and expression of HSP70 gene were also increased. CONCLUSION: Huoxue Huayu and Yiqi Wenyang compound prescription promotes the recovery of the pathogenetic conditions of congestive heart failure in rare. The mechanism may be in association with a decrease in plasma ANP level, correction of renal medulla AQP2 abnormal expression and enhancement of HSP70 expression.

e extra-adrenal pheochromocytoma.

OBJECTIVE To investigate risk factors of bloodstream infection in ICU.METHODS From May 2007 to Aug 2007,the operation of central venous catheter and the medical attendance of 24 cases with bloodstream infection were retrospectively analyzed.RESULTS Fifteen cases with infection(62.5%) were found in 7 days;ESBLs-producing Klebsiella pneumoniae,Enterobacter,and Acinetobacter baumannii were the major pathogens.The major risk factors included severe underlying diseases,endovascular catheter operation and incorrect asepsis barrier.CONCLUSIONS The patients are severe in ICU.In order to control and prevent infection in ICU,effective measures should be taken,including taking strict aseptic treatment in central venous catheter and the medical attendance of catheters,and strengthen hygiene administration.

One hundred and fifty-six patients with primary aldosteronism(PA)and 189 patients with essential hypertension (EH) were included in this study.The value of estimate glomerular filtration rate (eGFR) was calculated by MDRD equation.The plasma levels of aldosterone,triglycerides,creatinine and fasting glucose were measured.The plasma creatine,24 hour urine albumin excretion in PA patients were higher and eGFR and plasma aldosterone were lower than those in EH patients ( all P ＜ 0.01 ).Multiple regression analysis revealed that the plasma concentrations of aldosterone ( P =0.003 ) and creatinine ( P =0.001 ) were independent predictors of eGFR.

Objective To investigate the association between KCNJ5 gene polymorphism and primary hyperaldosteronism(PA).Methods A total of 248 PA patients and 816 essential hypertension (EH) patients were enrolled in this study,TaqMan assay was used to detect the rs1221497 polymorphism of KCNJ5 gene.Results The genotypes of rs1221497 were in Hardy-Weinberg equilibrium in both PA group and EH group,the genotype frequencies ofGG,GC,CC were 208,39,1 in PA group and 631,177,8 in EH group respectively,the allele frequencies in the two groups were 455,41 and 1 439,193 respectively.The frequencies of GG genotype and G allele in PA group were significantly higher than those in EH group.Logistic regression showed that GG genotype was closely associated with PA after adjusting age.Conclusions GG genotype and G allele may contribute to the occurrence of PA.

Objective To clarify the role of pentraxin 3 (PTX3) in the development of peripheral arterial disease (PAD) in maintenance hemodialysis (MHD) patients. Methods One hundred and sixteen patients undergone MHD therapy in our center for more than 3 months were enrolled in the study. Clinical data were collected for analysis. Ankle-brachial index (ABI) was used to estimate the presence of PAD. Patients were divided into PAD group (ABI<0.9) and nonestimate the association of PAD with PTX3 as well as other potential risk factors. Results The incidence of PAD was 18.1% (21/116). Plasma level of PTX3 was significantly higher in PAD patients than that in non-PAD patients [(5.55 ±2.63) μg/L vs (2.32 ±1.29)μg/L, P<0.01].Univariate analysis showed ABI values were negatively correlated with plasma PTX3 levels (r =-0.548, P<0.01), high-sensitivity C-reactive protein (hsCRP), age, blood glucose and triglyceride. ROC curve of PAD revealed that area under curve (AUC) of PTX3 was 0.901 (P<0.01). With the cut-off value of PTX3 as 4.06 μg/L, the diagnostic sensitivity and specificity in PAD were 81.0% and 91.5%. ROC curve of PAD showed that AUC of hsCRP was 0.640 (P<0.05). With the cut-off value of hsCRP as 3.33 mg/L, the diagnostic sensitivity and specificity in PAD were 57.1% and 56.8%. Using Logistic regression, plasma PTX3 was found to be associated with PAD (0R=9.755, 95%CI:2.359-19.354, P=0.001). Conclusions The PAD incidence of MHD patients in our center is 18.1%. Plasma PTX3 level is significantly correlated with the presence of PAD in MHD patients. The sensitivity and specificity of PTX3 are higher than those of hsCRP for PAD diagnosis.