ObjectiveTo explore the prevalence of metabolic syndrome (MS) in patients with primary aldosteronism(PA) and the correlation with plasma aldosterone concentration. MethodsThe incidence of MS was retrospectively analyzed in 216 patients with PA from October 2008 to July 2010. Results( 1 ) The prevalence of MS was 47. 69％ in the patients with PA. As the individual components of MS, the incidence of overweight/obesity,raised blood triglyceride ( TG ) level, impaired glucose regulation ( IGR), lowered high-density lipoprotein-cholesterol ( HDL-C), and diabetes mellitus( DM ) was 51.13％, 22. 52％, 19.62％, 3.82％, and 2.94％, respectively. (2)The most common combination of MS components was overweight/obesity+high TG, followed by overweight/obesity+ lowered HDL-C, and overweight/obesity + DM, with the incidence of 35. 19％,15.74％, and 11.57％,respectively. (3) The incidence of overweight/obesity and IGR was raised progressively with the increasing plasma aldosterone level. (4) The prevalence of MS was significantly lower in Han patients (45.3％) than in Uygur ( 64. 0％ ), but higher than in Kazakh (42. 9％, both P＜0. 05 ). ConclusionsThe prevalence of MS in patients with PA was high. The prevalences of MS and its components were gradually rising with plasma aldosterone level.

ObjectiveTo investigate the characteristics of left ventricular structural damage in patients with primary aldosteronism(PA).MethodsA total of 438 inpatients with hypertension from January 2007 to June 2010 were screened for PA,and diagnosis was made in 213 PA patients and 225 patients with essential hypertension (EH).The left ventricular structure of all subjects was evaluated according to the results of echocardiographic measurements.Results The duration of hypertension and plasma aldosterone level in patients with PA were significantly higher (P＜ 0.01 ),while the serum potassium and plasma renin activity were significantly lower (P＜0.01 ) than those in patients with EH.The interventricular septum thickness,left ventricular end-diastolic dimension,left ventricular mass index (LVMI),left ventricular end-diastolic volume,and stroke volume in patients with PA were significantly higher than those in EH patients( P＜0.01 ) after the duration of hypertension was corrected.In patients with PA,the prevalence of left ventricular hypertrophy (LVH) was higher than that in EH patients ( 53.1％ vs 33.8 ％,x2 =16.57,P ＜ 0.01 ). Normal left ventricular geometry ( NG ),concentric remodeling ( CCR ),concentric hypertrophy( CCH),and eccentric hypertrophy (ECH) were found respectively in 24.9％,22.1％,22.1％,and 30.9％ of patients with PA.Multiple stepwise regression analysis showed that the seated plasma aldosterone level (β=0.43,P ＜ 0.01 ) and systolic blood pressure (β =0.45,P ＜ 0.01 ) were the main factors that influenced LVMI.The course was the main parameter that influenced relative wall thickness(β=0.011,P＜0.05 ).Conclusion The prevalence of LVH is higher in patients with PA than that in EH patients.The eccentric hypertrophy is the most common left ventricular geometrical pattern in patients with PA.

e extra-adrenal pheochromocytoma.

Objective To evaluate the safety and efficacy of combining radiofrequency ablation(RFA) with arsenious acid(AA) locally to treat liver VX2 tumor in rabbits,and to explore its mechanism.Methods Twenty-eight New Zealand White rabbits with implanted liver VX2 tumors were randomly divided into four groups: control group(n= 7),AA group(n=7),RFA group(n=7),and combination(RFA+AA) group(n=7).ALT was measured before treatment and on the day 0,day 3,day 7 and day 14 after treatment,meanwhile ultrasonic(US) examination was performed.All rabbits were killed 14 days after treatment.Vascular endothelial growth factor(VEGF) was examined by immunohistochemistry,and the relationship of VEGF and gross tumor volume was analyzed.Results Combination(RAF+AA) therapy caused little damage to hepatic function but had better inhibited tumor growth.The level of VEGF in AA,RFA and RAF+AA group was lower than that of the control group(P

Objective:To study the functional connectivity (FC) and metabolic effective connectivity (MEC) patterns of the default mode network (DMN) in healthy male adults based on a novel hybrid PET/MR system.Methods:Fifteen healthy male adults with median age of 29 years were recruited locally in Xi′an from January to May 2019. All subjects went through PET/MR scan to get the whole brain 18F-fluorodeoxyglucose (FDG) PET, resting-state functional MRI (fMRI) and magnetization prepared rapid gradient echo (MPRAGE) T 1 weighted imaging data. CONN18b and statistical parametric mapping (SPM) 12 softwares were used to analyze data. The voxel-wise FC and FDG metabolic data were extracted within 4 sub-networks of DMN, which included medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC) and bilateral lateral parietal (LP). The FC and MEC between 4 sub-networks were calculated based on merged resting-state fMRI and metabolic data, and analyzed by one-sample t test separately, with Bonferroni correction. Results:FC pathways were all significant within 4 sub-networks of DMN ( t values: 6.00-7.71, all P<0.008, Bonferroni corrected). Meanwhile, there were significant bi-directional MEC between MPFC and PCC(MPFC to PCC: t=10.03; PCC to MPFC: t=3.73, both P<0.004, Bonferroni corrected), as well as between bilateral LP (LP_L to LP_R: t=5.28; LP_R to LP_L: t=4.76, both P<0.004, Bonferroni corrected). There were significant uni-directional MEC from both MPFC and PCC to bilateral LP ( t values: 3.44-6.93, all P<0.004, Bonferroni corrected). Conclusions:Special FC and MEC patterns exist within DMN. The closely interrelated MPFC and PCC play more important roles in DMN, and they may mediate LP jointly. The novel integrated PET/MR system will bring new perspective on the organization of brain networks, which may deepen the comprehensive understanding of DMN.

Objective To study the correlation between sleep quality and anxiety in patients with chronic kidney diseases (CKD).Method Toally 118 patients with CKD were investigated with Pittsburgh sleep quality index (PSQI) and self-rating anxiety scale (SAS).Results About 75.42％ (89/118) patients had poor quality of sleep.The scores by PSQI and the dimensions were higher than those of the norms (all P＜0.05),but the total scores by PSQI and the factors of sleep quality,time of falling sleep,duration of sleep,use of hypnosis drugs were all significantly lower than those of the insomnia group (all P＜0.01).35.59％ (42/118) of the patients had anxiety and the score of SAS was significantly higher than that of the national norm (P＜0.01).The total scores of PSQI,sleep quality,sleep time,sleeping time,sleep disorder,daytime function were positively related to the score of SAS (P＜0.01).Conclusions The quality of sleep is poor in the CKD patients and there is a positive correlation between the quality of sleep and the anxiety.It is necessary to strengthen the knowledge-related health education and to provide emotional support and individualized nursing services for CKD patients so as to relieve their anxiety and improve their sleep quality.

The clinical data of 330 patients with primary aldosteronism (PA) from January 2006 to March 2010 were retrospectively analyzed. The prevalence of 1, 2, and 3 stage hypertension in these subjects was 3.64％,20. 91％, and 75.45 ％, respectively. Of all PA patients, 89.09％ were young adults and 81.82％ were overweight or obese. There was a marked preponderance of male patients in the overweight or obese group ( P＜0. 01 ). The incidence of hypokalemia was 32. 12％. The concentration of serum potassium was not associated with the disease course. Logistic regression showed that the concentration of plasma aldosterone was an independent risk factor of hypokalemia in PA patients( P＜0. 01 ). 79. 09％ PA patients presented the plasma aldosterone level over 12 ng/dl and the renin activity level of less than 1 ng · ml-1 · h-1. The aldosterone-to-rennin activity ratio was ＞20 in 94.24％ of the patients with PA.

Background: Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. Methods: Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P<0.001). Most of the guidelines advocated systolic BP targets <130 mm Hg (12 guidelines, 60%) and diastolic BP targets <80 mm Hg (14 guidelines, 70%) in DM patients. Approximately half of the guidelines supported systolic BP thresholds >140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. Conclusion The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.

Objective: To investigate the value of four-dimensional echocardiography combined with speckle tracking technique on the assessment of right heart function and prognosis in patients with pulmonary arterial hypertension (PAH). Methods: In this prospective study, 51 patients with PAH diagnosed by right heart catheterization in east hospital and south hospital of Renji hospital affiliated to school of medicine of Shanghai Jiaotong University from September 2015 to July 2017 were enrolled as PAH group from July to November 2017. Meanwhile, 26 healthy volunteers with age and sex matched with pulmonary hypertension patients were recruited as control group. The patients were aged (45.8±15.5) years old in PAH group, and there were 6 males and 45 females. The healthy volunteers were aged (45.4±14.6) years old in control group, and there were 4 males and 22 females. Two-dimensional and four-dimensional echocardiographic images were obtained to measure the structure and function of the right heart. The myocardial strain of each ventricle and atrium was measured by sparkle tracking. The patients in PAH group were followed up from July 2017 to August 2018 to observe the endpoint events including all-cause death, re-hospitalization, and clinical deterioration. Results: There were significant differences in two-dimensional echocardiographic parameters(including tricuspid annular plane systolic excursion (TAPSE), right ventricular area change fraction (FAC), and right ventricular systolic pressure (RVSP)), speckle tracking parameters (including global longitudinal systolic peak strain of left ventricle (LVGLS), global longitudinal systolic peak strain of right ventricle (RVGLS),left atrial reservoir function(LASr), left atrial conduit function (LASc), left atrial pump function (LASp), right atrial reservoir function (RASr), right atrial conduit function (RASc), and right atrial pump function (RASp)), and four-dimensional echocardiographic parameters(including right ventricular end diastolic volume (RVEDV) , right ventricular end systolic volume(RVESV), right ventricular stroke volume(RVSV), right ventricular freewall longitudinal strain(RVLSf), interventricular septum longitudinal strain(IVSLS), right ventricular ejection fraction(RVEF)) between control group and PAH group (all P<0.01 or 0.05).Spearman correlation analysis showed that RVEF was correlated with 6-minute walking distance (r=0.540, P<0.001), B-type natriuretic peptide (r=-0.545,P<0.001), New York Heart Association (NYHA) cardiac function classification(r=-0.583, P<0.001), TAPSE(r=0.595, P<0.001), LVGLS (r=-0.461, P=0.001) ,LASc (r=0.453, P=0.002) ,RASc (r=0.532, P<0.001) ,RVESV (r=-0.418, P=0.004) , RVSV (r=0.351, P=0.017) , and IVSLS (r=-0.450, P=0.002) . Pearson correlation analysis also showed that RVEF was correlated with FAC(r=0.579, P<0.001),RVSP (r=-0.442, P=0.002) ,RVGLS (r=-0.521, P<0.001) , LASr (r=0.483, P=0.001) , RASr (r=0.617, P<0.001) , RASp (r=0.513, P<0.001) , and RVLSf (r=-0.592, P<0.001) .After a follow-up of (10.4±2.7) months, there were 4 all-cause deaths, 5 re-hospitalizations and 5 clinical deterioration. Multivariate Cox regression analysis showed that increased RVEF was independent protective factor for end-point events in PAH patients (HR=0.702, P=0.043), and increased RVSP was independent risk factor for end-point events in PAH patients (HR=1.083, P=0.017). The receiver operating characteristic (ROC) curve showed that RVEF and RVSP could be used to predict the end-point events in PAH patients. The area under the curve (AUC) was 0.835(P=0.001) and 0.820(P=0.001), respectively. Conclusions RVEF measured by four-dimensional echocardiography is correlated with right ventricular function parameters measured by two-dimensional echocardiography and can be used to estimate the prognosis of PAH patients. The right atrial and left atrial function assessed by speckle tracking can also reflect the right ventricular function to a certain extent.

Objective:To investigate the changes in total radioactivity in patient body with differentiated thyroid carcinoma (DTC) after 131I treatment and the factors influencing its metabolism. Methods:The clinical data from 218 patients after DTC treatment in the Department of Nuclear Medicine, the Second Affiliated Hospital of Air Force Medical University from September 2021 to April 2022 were retrospectively analyzed. Based on administrated 131I dose, 171 patients were divided into low-dose group (≤ 3.7 GBq) and 47 into high-dose group (>3.7 GBq) . A whole body dynamic radiation monitoring system was used to measure the in vivo residual activity of 131I 24, 48 and 72 h after 131I administration and to explore their influencing factors. Results:24, 48 and 72 h after adimination of 131I, the residual activity of 131I in the low-dose group patients was significantly lower than in the high-dose group patients ( t= -7.46, -3.31, -2.01, P<0.05) . The discharge compliance rate at 24 and 48 h in the low-dose group was significantly higher than that in the high-dose group (21.0% vs. 4.3%, 98.2% vs. 89.4%, χ2 = 7.23, 5.91, P<0.05) , and all patients could meet the discharge criteria at 72 h. Univariate analysis showed that the residual 131I activity at 24 and 48 h was dependent on age, body mass index (BMI) , basal metabolism rate (BMR) and thyroid stimulating hormone (TSH) . As have been shown by multiple linear regression analysis, in the low-dose group, the older age, the higher BMR and the higher TSH level at 24 h tended to the higher 131I residual activity in the body. At 48 h, the higher BMI and the higher TSH level lead to the higher 131I residual activity in patient body. Meanwhile, in the high-dose group, the higher age and BMR at 24 h, tended to the higher in vivo131I residual activity. The influencing factors were analyzed in terms that 131I residual activity reaching 400 MBq in patient body at 24 and 36 h. The result showed that at 24 h the lower TSH level leaded to the lower 131I residual activity in patient body. At 36 h, the younger age, the lower TSH level, and the smaller 131I treatment dose tended to the lower in vivo131I residual activity. Conclusions:Age, BMI, BMR and TSH levels are the influencing factors for the change in total activity in patient body after 131I treatment of DTC. Radiation dose assessment based on the above indicators can provide a reference for adjusting the length of hospitalization time.