Primary hyperaldosteronism(PA),with a high prevalence of 10%~20% in normal population,is an important cause of secondary hypertension.Compared with essential hypertension patients,PA patients have higher risks for cardiovascular and cerebrovascular complications.Early diagnosis of primary hyperaldosteronism is of great importance.This article is to discuss the prevalence,diagnosis,case confirmation,subtype classification and treatment of primary hyperaldosteronism.

Brief discussion on exchange roles of islet α-cell and β-cell in the pathogenesis of type 2 diabetes,and the possibility of HbA1C as a new marker for assessing both pancreatic islet α-cell and β-cell function,so as to provide a new perspective for clinical diagnosis and treatment of type 2 diabetes.

Adrenal hypertension is increasingly found to be one of the most important causes of hypertension. We have to overcome the difficulties caused by the complexity of adrenal medullary or adrenocortical diseases, and many objective factors. How to raise the awareness of adrenal hypertension? The effective measures are to make appropriate diagnosis in adrenal hypertension, to establish the correct clinical approach to adrenal hypertension, to open up continuously new diagnosis methods and use them in clinic, to develop multidiciplinary cooperation, and to ensure advanced diagnosis. Finally, we may improve the diagnosis of adrenal hypertension.

It has been shown that compared with metformin monotherapy, an early combination treatment of saxagliptin and metformin significantly improves glycemic control with no increase in adverse effects in type 2 diabetic patients. The efficacy and safety profiles of saxagliptin/metformin fixed dose combination products are similar to those of the two-drug combination therapy, with lower frequency of administration and better compliance. Therefore, we believe that this drug will bring benefits to more type 2 diabetic patients in China.

[Summary] The development of pituitary is a complex process involving the interactions of multiple genes.In recent years,the mutations ofHESX1,LHX3,LHX4,PITX1,PITX2,SOX,PROP1,and PIT1 have been confirmed in congenital pituitary diseases.This review summarizes the advances in the roles of these genes in pituitary development.

OBJECTIVEA study was conducted to evaluate the clinical application of sialendoscopy combined with conven tional laparoscopy in a 30 degree angle in depth salivary calculus of submandibular glands.

METHODSA total of seventeen patients were presented with repeated swelling in the unilateral submandibular area from June 2013 to August 2015. All patients underwent CT examinations of the mandible and salivary gland function imaging preoperatively. Sialoendoscopy and conventional endoscopy were applied to do intraoral lithotomy. Among the study group, thirteen cases were males and four cases were females. A total of twelve were left cases and five were right cases. Results Seventeen patients had deep positive calculus in the submandibular glands under CT. Photo technetium function was basically normal, whereas secretion of ipsilateral decreased significantly in salivary function tests. Double endoscope assisted surgeries were performed successfully through the mouth to remove the stones. The operation time was (42+21) min. There were no obvious complications in perioperative periods.

CONCLUSIONIntraoral lithotomy assisted by sialoendoscopy and conventional laparoscopy for deep stones in the submandibular glands is a new technique. This technique will possibly lead to complete avoidance of gland resection because of early deep sialolithiasis.

Endoscopy ; methods ; Face ; Female ; Humans ; Male ; Mandible ; Minimally Invasive Surgical Procedures ; Neck ; Perioperative Period ; Salivary Gland Calculi ; surgery ; Submandibular Gland ; surgery

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.

Currently,the diagnosis of malignant pheochromocytoma still faces a big challenge.Neither biochemical nor histological features can be reliably used to distinguish malignancy from benign tumors.Numerous efforts have been applied to identify novel molecular markers to predict malignancy.

The bilateral idiopathic aldosteronism (IHA) is the most common subtype of aldosteronism.Spironolactone is the primary preferred agent due to the pathophysiology of IHA and the long-standing clinical experience over years.If patients faced with severe side effects of spironolactone or poorly controlled blood pressure by this first-line treatment,additional treatment alternative to spironolactone,second antihypertensive,as well as adrenalectomy are suggested.In recent years,several new agents were developed to treat IHA,such as aldosterone synthase inhibitor and eplerenone.This review introduces these new kinds of medicine in the treatment of IHA.

Ageing of population is now a phenomenon of the world and has considerable consequences for public services.Ageing is always accompanied with dysfunction of multiple organs,including hypothalamic-pituitaryadrenal axis.Here,we summarized alterations of hormone secretion of adrenal glands in the elderly and their relationships with Alzheimer' s disease.Moreover,we discussed characteristics of pheochromocytoma,primary aldosteronism,and Cushing's syndrome in the elderly.Lack of typical manifestations usually makes difficulty in diagnosis.