Metabolic disturbances such as hypertension and insulin resistence,as well as cardiovascular events are more frequent in primary aldosteronism patients than in essential hypertension patients.When the diagnosis of primary aldosteronism is made,more attention should be paid to the associated metabolic disturbances and cardiovascular events,which may benefit the prognosis of patients.

Objective To study the efficacy of gestrinone and Sanjie zhentong capsule for the adjunctive treatment of endometriesis cyst of ovary after laparoscopic operation.Methods 116 patients with ovarian endometriosis cyst after laparoscopic operation were randomly divided into three groups:A group(gestfinone and Sanjie Zhentong capsule,n=42),after operation were given gestrinone(2.5mg each time,two times per-week for 3～months)and Sanjie zhentong capsule(4 pills each time,three times everyday for 3 months);B group(gestrinone,n=38),after operation were only given gestrinone(2.5mg each time,two times per-week for 3-6 months);C group(Sanjie zhentong capsules,n=36),after operation were only given Sanjie zhentong capsules(4 pills each time,three times everyday for 3 months).All patients were followed up for 6～12 months.Results The follow-up visit rate was 96.5%(112/116).A group,B group and C group,their excellence rate was respectively 97.5%,67.6%and 65.7%,their recurrence rate was respectively 2.5%,24.3%and 22.9%.There was significant difference between A group and B group.C group(P＜0.05).Incidence rate of three groups'side effects was respectively 35.0%,29.7%and 14.3%,there was no significant difference among three groups(P＞0.05).Conclusion The efficacy of gestfinone and Sanjie zhentong capsule for the adjunctive treatment of endometriosis cyst of ovary after laparoscopic operation was better than that of the only medicine treatment.

Objective To compare the postoperative recovery of vaginal and abdominal hysterectomies of non-prolapsed uterus ,in order to offer the advantages, surgical indications and contraindieations ,surgical characteristic and diflieuhy of transvaginal hysterectomies of non-prolapsed uterus. Methods To retrospectively analyze 480 cases transvaginal hysterectomies (TVH) and 440 cases transabdominal hysterectomies (TAH) with similar indications in the corresponding period, and compare the operation duration ,blood lost during the procedure, postoperative analgesic, morbidity, recovery time of the function of intestine, activity time of getting up and hospitalization between those surgi-ca] techniques. Results There were no intraoperation and postoperative complications in group TVH. In group TAH: more blood was lost(P <0.01) ,the function of intestine recovered more slowly(P <0.01) ,more analgesic needed, more morbidity noted (P < 0.01), activity time of getting up is much longer(P < 0.01). The hospital stay after opera-tion was much shorter in group TVH(P <0.01). No statistical difference was found between the two groups in terms of the duration(P 0.05). Conclusion TVH is minimal invasive surgery that include small trauma,reduced pain, no abdomen scar and quick recovery. So the patients are happy to accept it.

Objective To investigate the expression and significance of big mitogen-activated protein kinase 1(BMK1 or ERK5)in the pancreatic acinus of diabetic rats.MethodsTwenty SD rats were randomly divided into normal control group(n=10)and streptozotocin(STZ)-induced diabetic group(n=10).At the end of 14 weeks inducement,all rats were sacrificed and venous blood and pancreatic tissues were collected.The levels of fasting blood glucose,insulin and blood fat were determined to identify the establishment of diabetic rat model.The specimens of pancreas were fixed and embedded.Hematoxylin-eosin staining was performed to observe the morphological changes.Periodic acid-Schiff(PAS)staining was carried out for the vascular changes.The expressions of type Ⅰ and Ⅳ collagen were determined by inmmunohistochemical method.BMK1/ERK5-mRNA was detected by in situ hybridization.ResultsCompared with the control,in diabetic group the vascular wall was thickening,inflammatory cells were infiltrated in perivascular area,local acinus was atrophy and the expression of type Ⅳ collagen was mainly expressed in vascular basement membrane,while type Ⅰ collagen was in local atrophy acinus tissue with inflammation(P

Objective To evaluate the tests in differential diagnosis of subtypes in patients with primary aldosteronism. Methods Fifty-seven patients in the past 7 years chnically diagnosed as primary aldosteronism [22cases of aldosterone-producing adenoma (APA), 26 idiopathic hyperaldosteronism (IHA) and 9 primary adrenal hyperplasia (PAH)] were selected. The plasma potassium, basic and upright plasma renin activity, plasma and urinary aldosterone were determined. 19 patients with essential hypertension served as control. All patients with primary aldosteronism underwent adrenal CT, postural stimuhtion test (PST) and adrenal venous sampling (AVS) to differentiate the subtypes. The clinical and laboratory data were followed up during survey. Results (1) The patients with APA had higher blood pressure and aldosterone level in plasma or urine, but lower plasma potassium and plasma renin activity than those with IHA. In PAH group, these parameters were in the ranges between APA group and IHA group. For the diagnosis of APA, IHA and PAH, the coincidences were 86.4%, 73.1% and 22.2% by adrenal CT, 86.4%, 80.8% and 77.8% by the ratio of aldosterone in both sides of AVS and 95.5%,92.3% and 100.0% by the ratio of aldosterone to cortisol in beth sides, respectively. (2) The plasmaaldosterone, systohc and diastolic blood pressure were decreased after operation in the patients of APA and PAH,and no significant changes were found in patients with IHA. Conclusion The abnormal laboratory findings in patients with APA axe more evident than those in IHA. The result of PST is overlapping considerably in cases ofAPA and IHA. Adrenal venous samphng yields a high coincidence, which should be done in patients with negative CT scanning. The ratio of aldosterone to eortisol in AVS is more reliable. The clinical and laboratory data,especially plasma potassium will be improved after operation in patients with APA and PAH. But there is no change in patients with IHA during the follow-up period.

Objective To investigate the sleep quality of maintenance hemodialysis (MHD) patients and analyze its associated factors. Methods The convenience sample method was used to choose 424 MHD patients from 7 hospitals.A set of questionnaires were used in this investigation,including demographic data form,Pittsburgh sleep quality index (PSQI),restless legs syndrome (RLS),social support rate scale (SSRS),subjective global assessment (SGA),family APGAR index (APGAR) and family burden scale of disease (FBS). Results PSQI score of 395 MHD patients (93.2％) was ≥5.APGAR and social support total points were negatively correlated with sleep quality (r=-0.133,P=0.006; r=-0.105,P=0.031).Family burden total point was positively correlated with sleep quality (r=0.215,P=0.000).Nutrition (F=46.123,P=0.000),restless legs syndrome (F=9.392,P=0.000) and sleep apnea syndrome (F=5.645,P=0.001) were closely associated with sleep index scores. Conclusions Incidence of poor sleep quality in MHD patients of our study is quite high.Sleep quality of MHD patients is correlated with lots of factors,such as family concern,social support.

Objective To analyze the effects of acute depletion of liver-specific insulin signaling on secretion of apolipoprotein B (apoB) and triglyceride (TG).Methods Based on Cre-LoxP principle,a promoter of hepatic tissue specific albumin gene was inserted into upstream of the cre recombinase gene.Albumin-Cre adenovirus (Ad-CRE) and GFP adenovirus (Ad-GFP) were amplified in 293A cells and purified before intravenous administration to mice.After adenovirus infection for 2 days,4 days and 6 days,blood samples from mice were collected and hepatic tissues were frozen.The secretion rates of hepatic newly synthesized apoB and very low density lipoprotein (VLDL)-TG were determined by injection of Triton WR-1339.The levels of plasma cholesterol (TC) and TG were measured.The expressions of insulin receptor and other lipoprotein metabolism related proteins in hepatic tissues were analyzed by Western blot.Results After 2 d,4 d and 6 d of the Ad-CRE injection into mice,insulin receptor expression was reduced by 30.50％ (P＜0.05),60.12％ (P＜ 0.01) and 99.54％ (P＜0.001),and VLDL-TG secretion rate was decreased by 20.43％ (P＜0.05),33.63％ (P＜0.05) and 44.21％ (P＜0.01),respectively.Expressions of sterol regulatory binding proteins 1,fatty acid synthase,and the related proteins of VLDL-formation were decreased,but there were no changes in hepatic secretion of apoB100 and hepatic lipids.The hepatic secretion of apoB48 was increased by 35.07％ (P＜0.05) 6 d after Ad-CRE injection.Conclusions Acute depletion of hepatic insulin receptor might reduce VLDL-TG secretion in manner of time-dependent,and increase the assembly and secretion of smaller apoB-containing lipoproteins in mice liver,which is probably associated with decreased lipogenesis.

An introduction to the telemedicine service of the hospital in its web-based hospitalprogram which covers theweb-based healthcare center,and thehealthcare cabin to interact with the center remotely.The center operates on the telehealth management platform based on cloud computing, offering remote monitoring,health assessment,health management,follow-up,online consultation,pre-registration and mobile payment.Theweb-based hospitalcan simplify the medical service flow,alleviate the complaints incurred by concentrated quality medical resources,influx of patients and limited physical space of tertiary hospitals,and the tense doctor-patient relationship as well.

AIM: To study the effect of wild-type p53 gene on the differentiation, apoptosis and expression of scavenger receptor CD36 in U937 cells. METHODS: Recombinant adenovirus vector with wild-type p53 gene was constructed and used to transfect U937 cells. With the expression of wild-type p53 gene following adenoviral infection, transfected U937 cells were largely promoted to differentiate into macrophages. RESUITS: Trypanblue-staining test demonstrated that the percentage of positive cells increased from (14.2±5.5)% to (64.6±9.2)% and nitroblue tetrazolium (NBT) reduction test reached similar results (6.3±1.8)% vs (49.7±12.6)%. Furthermore, CD36 mRNA was up-regulated as confirmed by RT-PCR. The increased expression level of CD 36 was also detected by flow cytometry analysis. CONCLUSION: These results suggest that wild-type p53 gene can affect U937 cells differentiation and apoptosis, up-regulate expression of scavenger receptor CD36. It may have a potential significance on atherogenesis.

Objective To evaluate the molecular mechanism of 11 beta-hydroxysteroid dehydrogenase type 1 (11 β-HSD1)in tumor necrosis factor-α (TNF-α) induced insulin resistance.Methods The optimal concentration and incubation time of TNF-α for treating HepG2 cells were selected.Real-time polymerase chain reaction(PCR)and Western blot analysis were used to explore the effect of TNFα on the mRNA and protein expression levels of 11β-HSD1,glucocorticoid receptor (GR),phosphoenolpyruvate carboxylase(PEPCK)and glucose 6-phosphatase(G6Pase).Glucose(GO) Assay Kit was used to determine the level of gluconeogenesis.Liver/Muscle glycogen assay kit,PAS/Glycogen Stain kit were used to detect glycogen synthesis.The expression of AKT/GSK pathway was analyzed by Western blot analysis.In addition,HepG2 cells were pre-treated with BVT2733,a specific inhibitor of 11β-HSD1,before exposure to TNFα The expression of AKT/GSK pathway,the level of gluconeogenesis and glycogen synthesis were analyzed.Results The expression of 11β-HSD1 was increased along with the increasing concentration of TNF-α,showing a dose-dependent effect.When HepG2 cells treated with the optimal dose of TNF-α 10 μg/L for 24 hours,the levels of GR,gluconeogenesis and gluconeogenesis-related genes PEPCK and G6Pase were increased,while conversely,the levels of phosphorylation of AKT and GSK,and glycogen synthesis were decreased.However,all the above effects induced by TNF-α in HepG2 cells were greatly reversed by BVT2733 pre treatment.Conclusions 11 β-HSD1 participates in TNF-α-induced insulin resistance in HepG2 cells,and BVT2733 could significantly improve insulin sensitivity.