The ratio of plasma aldosterone concentration to renin activity (ARR) is a sensitive parameter for screening of primary aldosteronism (PA) and for predicting prognosis after adrenalectomy in patients with PA.Study of the influencing factors for ARR,especially medications,sodium intake and posture,is of great significance for improving the screen efficacy of ARR.This paper introduces the current application of ARR in screening for PA and optimization of its determining conditions.

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The ratio of plasma aldosterone concentration to plasma renin activity (ARR) is a practical parameter in screening for primary aldosteronism (PA).However,variations of the cutoff value of ARR in different studies have been reported due to plenty of influential factors that may affect the secretions of renin and aldosterone. Lack of standardization of assays for ARR also makes direct comparisons among different studies difficult.The associated influential factors on ARR were introduced in this review.

Objective To investigate the effect of hydrogen sulfide (H2S) on the cholesterol efflux and ATP-binding cassette transporter A1 (ABCA1) expression in foam cells .Methods RAW 264 .7 macrophages were incubated with oxidized low density lipoprotein to induce foam cells .Foam cells were incubated with H2S donor sodium hydrosulfide .Cholesterol efflux from macropha-ges was tested by labed cholesterol .The cellular levels of free cholesterol (FC) ,cholesterol ester (CE) and total cholesterol (TC) were measured by high performance liquid chromatography assays .The mRNA and protein expressions of ABCA1 were detected by Real-time PCR and Western blot .Results Compared with the foam cells ,the rates of cholesterol efflux were significantly in-creased ,the levels of TC ,FC ,CE and CE/TC ratio were significantly decreased(P<0 .05) and expression of ABCA1 was signifi-cantly increased by treatment with H2S in dose-and time-dependent manner(P<0 .05) .Conclusion H2S up-regulates of expres-sion ABCA1 and promotes cholesterol efflux in RAW 264 .7 macrophage-derived foam cells .

Objective To investigate the sensitivity of BIOMED-2 primer system in adult acute lymphoblastic leukemia (AIJ,) patients Ig gene rearrangement, and to analyze their frequency, corearrangement pattern, utilization of V, D and J genes and composition of junctional regions. Methods Amplification of rearranged IgH (complete and incomplete), IgK, IgK-Kde and IgL was performed in standard PCR in 29 adult ALL patients. Monoclonal PCR products were subjected directly to DNA sequencing. Sequences were identified by comparison with all known human Ig germline sequences to analyze the recombination patterns, somatic mutations and germline gene segments usage. Results IgH, incomplete IgH, IgK, igK-Kde and Igl, rearrangements were found with positive rate of 70.8%, 12.5% , 29.2% , 25.0% and 0 of B-ALL patients, respectively. All B-ALL patients displayed at least one pattern of Ig gene rearrangements. In TALL, one of five patients was found with incomplete IgH rearrangement, two patients were found with IgK rearrangements and two patients were PCR-negative. The sequence analysis showed that the most frequently used V, D, J segments in adult B-ALL patients were from VH3/VH4 families, DH3 family and JH6 family, respectively. Four of five IgK rearrangement used VκI family. 23.5% B-ALL IgH contained scattered replacement mutations with replacement to silent substitution ratio < 1 in complementarity determining regions. Conclusion BIOMED-2 multiplex PCR analysis strategy is a reliable and useful technique in the adult BALL patients.

Objective Plasma renin concentration (PRC) offers advantages in processing and standardization as compared with plasma renin activity (PRA). The aim of the study is to compare the sensitivity and specificity of plasma aldosterone concentration ( PAC)/PRA (ARR) and PAC/PRC (AARR) in screening primary aldosteronism ( PA ) in hypertensive patients and to observe the influence of different postures on PRC and AARR. Method ( 1 ) PAC and PRC in the supine position and after 1-hour and 2-hour upright posture were determined in 28 patients with PA and 51 patients with essential hypertension. The diagnostic efficacies during different postures were compared according to the ROC curve analysis. (2) 31 patients with PA, 242 patients with essential hypertension, and 145 normotensitive subjects were recruited in the study. The diagnostic efficacy of AARR in screening PA from hypertensive patients was evaluate. PAC, PRA, and PRC were measured by radioimmunoassay. Results ( 1 ) The AUC of AARR in the supine position, 1-hour and 2-hour upright posture were0.950 (95% CI0.906-0.994, P<0. 01), 0.979 (95% CI0.956-1.000, P<0.01) and 0.917 (95% CI 0. 856-0. 979, P<0. 01 ) respectively. AARR of 1 -hour upright yielded the highest screening efficiency. ( 2 ) The correlation coefficient index of Log-PRA and Log-PRC was 0. 705 ( P< 0. 01, n = 418 ), whereas the correlation coefficient index of Log-ARR and Log-AARR was 0.705 (P<0.01, n=418). The AUC of ARR and AARR were 0.998 (95% CI0. 981-1. 000, P<0.01 ) and 0.957 (95% CI0. 929-0.985, P<0.01 ) respectively according to the ROC curve. The optimal cutoff of AARR during upright 1 hour was 42.36 ng · dl-1/ng ·dl-1 ( sensitivity 87.10%, specificity 93.75% ). Conclusion The screening efficacy of AARR in screening PA in hypertensive patients was comparable with ARR. AARR measured after keeping upright 1 hour yielded the highest screening efficiency. The optimal cutoff of AARR was 42.36 ng · dl-1/ng ·dl-1.

BACKGROUND: More attention has been paid upon the injury effect resulted from the decrease of superoxide dismutase(SOD) activity and increase of malonaldehyde (MDA) content in brain. Whether pig brain peptide solution can pass blood-brain barrier and penetrate into brain tissue and protect brain nerve is still found in limited cases reports. Relevant reports are still rare both in China and abroad.OBJECTIVE: To explore the effect of pig brain peptide solution on SOD activity and MDA content in brain and liver of senile model mice made by D-galactose.DESIGN: Experimental animals-based randomized and controlled experimental observation.SETTING: Institute of Senile Medical of General Hospital of Chinese PLA.MATERIALS: The experimant was made in the Institute of Senile Medical (Chinese PLA key laboratory) of General HosPital of Chinese PLA from February to April 2001. Totally 82 NH mice, weighted from 18 to 22 g, half male and half female, were provided by the Medical Experimental Animal Center of General Hospital of Chinese PLA. These mice were randomly divided into the control group, hige dose group, middle dose group, low dose group, aniracetam group (positive control group), and D-galactose group.METHODS: Each group was given drugs seperately for 6 weeks. The senile mice model was induced by D-galactose. SOD activity of each group was checked with chemiluminescence method and MDA content examined with thiobarbituric acid colourimetry method.MAIN OUTCOME MEASURES: SOD activity and MDA content of mice in each group.RESULTS: Pig brain peptide solution with high and middle doses significantly increased SOD activity[ (30.23 ± 5.23), (29.65 ± 4. 88 );(19. 84 ± 5.79), (16.75 ± 5.32) μkat/g respectively], and decreased MDA content[ (630.00 04; 8(34): 7748-50CONCLUSION: Pig brain peptide solution has obvious antioxidative effect, and has certain protective effects on brain nerve cells and liver cells of senile mice.

Objective: To investigate the effect of clopidogrel on antiplatelet therapy in patients with coronary artery disease (CAD) combining chronic kidney disease (CKD) in order to provide a medication reference in clinical practice. Methods: We retrospectively investigated 423 CAD patients with coronary angiography (CAG) conifrmed diagnosis in our hospital from 2014-01 to 2014-09. According to the value of eGFR, the patients were classiifed into 2 groups:CAD+ CKD- group,n=257 patients with eGFR ≥ 90 ml/(min?1.73 m2), including 182 male and 75 female at the mean age of (60.39 ± 11.09) years, and CAD+CKD+ group,n=166 patients with eGFR < 90 ml/(min?1.73 m2), including 107 male and 59 female at the mean age of (65.80 ± 10.84) years. The patients were treated either by aspirin 0.1 g/d with clopidogrel 75 mg/d for at least 7 days, or by PCI operation with the load of aspirin 0.3g and clopidogrel 300 mg. The thrombelastography was conducted to examine and compare the inhibitory rates of ADP receptor and arachidonic acid (AA) pathway in platelet between 2 groups. Results: The inhibitory rate of platelet ADP receptor in CAD+CKD- group (64.9 ± 27.2) % was higher than that in CAD+CKD+ group (56.6 ± 27.4) %,P=0.039. Based on clinical standard of platelet’s ADP and AA inhibitory rates, in CAD+CKD- group, there were 24/257 (9.4%) of patients only insensitive to clopidogrel, in comparison with 25 (9.7%) of patients only insensitive to aspirin,P=0.99. While in CAD+CKD+ group, there were 21/166 (12.7%) of patients only insensitive to clopidogrel, in comparison with 11 (6.6%) of patients only insensitive to aspirin,P= 0.045. Conclusion: Clopidogrel has decreased effect on anti-platelet therapy in CAD patients combining with CKD, such patients have reduced sensitivity to relevant medication.

Objective To observe the protective effect of Apelin-13 on the cerebral ischemia-reperfusion injury (CIRI), and to explore the possible mechanism in rat model. Methods Fifty male SD rats were randomly divided into five groups:sham group, CIRI model group and Apelin-13 (0.1, 1.0 and 10.0 μg/kg) treatment groups. The model of CIRI was established by filament. After 2 h ischemia, the focal middle cerebral artery was followed by 72 h reperfusion. Apelin-13 was administrated by intracerebroventricular injection 30 minutes before reperfusion. The score of neural function was estimated in different time points. The 2,3,5-triphenyl tetrazolium chloride (TTC) dye was used to calculate the volume and percentage of cerebral infarction. The endoplasmic reticulum stress (ERS) protein markers including glucose-regulated protein 78 (GRP78) and CCAAT/enhancer binding protein homologous protein (CHOP) in cerebral cortex were measured by Western blot assay. Results Compared with the sham group, the score of neural function was significantly increased, the infarct rate was reached(47.63 ± 5.81)%and the protein expressions of GRP78 and CHOP were significantly up-regulated in CIRI model group (P＜0.05). There were no significant differences in these data between the CIRI model group and 0.1 μg/kg Apelin-13 treatment group (P＞0.05). Compared with the CIRI group, the neural function defect was significantly improved, the muscle strength was significantly enhanced and the infarct rate was significantly decreased, and the protein expressions of GRP78 and CHOP were significantly down-regulated in the 1.0 and 10.0 μg/kg Apelin-13 treatment groups (P＜0.05). Conclusion Apelin-13 protects the cerebral ischemia-reperfusion injury in rat model, which may be related with the inhibition of endoplasmic reticulum stress.

ObjectiveTo observe the clinical efficacy of acupuncture at cranial sutures (cranial acupuncture) plus rehabilitation training in treating cerebral infarction.MethodSixty patients with cerebral infarction were randomized into an acupuncture-rehabilitation group (cranial acupuncture plus rehabilitation training) and a rehabilitation group (dryrehabilitation training), 30 cases in each group, to respectively receive cranial acupuncture plus rehabilitation training and dry rehabilitation training. The Fugl-Meyer Assessment (FMA) and Barthel Index (BI) were adopted to respectively evaluate the motor function of limbs and activities of daily living (ADL); the content of hypersensitive C-reactive protein (hs-CRP) was also observed before and after treatment for the evaluation of therapeutic efficacy.ResultThe acupuncture-rehabilitation group wassuperior to the rehabilitation group in improving the motor function and ADL, and down-regulating the hs-CRP content (P<0.05).ConclusionCranial acupuncture plus rehabilitation training is the optimal protocol in treating cerebral infarction, and it canproduce a more significant efficacy than dry rehabilitation training.