To explore the clinical risk factors of cerebral artery stenosis in young persons with cerebral infarction. Methods From January 2013 to December 2016, 90 youth persons with cerebral infarction in our hospital were divided into stenosis group and non-stenosis group. The possible risk factors of vascular stenosis were statistically analyzed. Results There were 59 cerebral artery stenosis patients in all 90 cases. The incidence was 65. 6％. Univariate analysis showed that there was significant difference in gender, smoking, drinking, hypertension, diabetes, uric acid and blood lipid in patients of stenosis group and non arterial stenosis group(P＜0. 05). Multivariate Logistic regression analysis showed that smoking, drinking, hypertension, diabetes, hyperuricemia and dyslipidemia were the main risk factors (P＜0. 05). Conclusion Cerebral artery stenosis is an important factor of cerebral infarction in youth persons. Smoking, drinking, hypertension, diabetes, hyperuricemia, dyslipidemia are the risk factors. We should have reasonable diet, give up smoking and alcohol, exercise moderately, adopt a healthy lifestyle, control blood pressure, blood sugar, blood lipid levels, thereby reducing the risk of cerebral infarction in youth persons.

Objective:To evaluate the value of plasma aldosterone concentration (PAC)/renin concentration (PRC) ratio (ARR) combined with aldosterone, renin, and sodium/potassium ratio in the diagnosis of primary aldosteronism (PA).Methods:From January 2017 to October 2019, 105 patients were admitted to our hospital and diagnosed as PA and essential hypertension (EH) by clinical manifestations, laboratory examination and surgical pathological biopsy.The optimum cut-off point of ARR, PRC, PAC, plasma sodium-potassium ratio were determined by the Receiver Operating Characteristic (ROC). The sensitivity, specificity and Youden index at the optimum cut-off point were calculated in a separate test. By means of diagnostic test, the best cut-off points of ARR were tested in series with the best cut-off points of PRC, PAC and serum sodium/potassium ratio, respectively, and their specificity were calculated.Results:The area under the AUC of supine ARR was greater than that of vertical ARR (0.966 vs 0.946, Z= 1.380, P= 0.168), but there was no statistical difference. The optimum cut-off point of supine ARR was 28.64(pg/ml)/(pg/ml), with a sensitivity of 92.4% and specificity of 90.5%. The sensitivity of the combined PRC test was 79.0% and the specificity was 94.3%. The sensitivity of the combined PAC test was 65.7% and the specificity was 95.2%. The sensitivity of the combined serum sodium/potassium ratio was 50.5% and the specificity was 96.2%. The optimal cut-off of vertical ARR was 22.10 (pg/ml)/(pg/ml), with 91.4% specificity and 85.7% specificity. The sensitivity of vertical ARR combined with PRC was 78.1%, specificity was 89.5%. The sensitivity of combined PAC was 74.3%, specificity was 92.4%, and the sensitivity of combined sodium/potassium ratio was 50.5%, specificity was 95.2%. Conclusions:There was little difference in the diagnostic performance of PA between vertical and supine ARR values. The specificity of PA screening by ARR alone was high, and the specificity and accuracy of PA diagnosis could be improved by combining PRC, PAC and sodium/potassium ratio.

ObjectiveTo investigate the possible mechanisms of modified Xiaoyao Powder （逍遥散） in the treatment of hyperprolactinemia （HPRL） with liver constraint and spleen deficiency. MethodsNinety-six female SD rats were randomly divided into a normal group （n=16） and a modeling group （n=80）. In the modeling group， rats were subjected to chronic unpredictable stress combined with intraperitoneal injection of metoclopramide to establish a rat model of HPRL with liver constraint and spleen deficiency. The 80 successfully modeled rats were randomly divided into a model group， a high， medium， and low-dose group of modified Xiaoyao Powder， and a bromocriptine group， with 16 rats in each group. The high， medium， and low-dose groups of modified Xiaoyao Powder were orally administered doses of 60， 30， and 15 g/（kg·d） respectively， the bromocriptine group was orally administered bromocriptine tablets at a dose of 1 mg/（kg·d）， and the normal group and model group were orally administered 10 ml/（kg·d） of normal saline for 14 consecutive days. ELISA was used to detect serum prolactin （PRL） level； immunohistochemistry was used to determine the expression of tumor necrosis factor-alpha （TNF-α） and tyrosine hydroxylase （TH） in the hypothalamus； Western blot was used to detect the protein expression of tumor necrosis factor receptor 1 （TNFR1） in the hypothalamus； Real-time PCR was used to detect the mRNA expression of receptor interacting protein kinase 3 （RIP3） in the hypothalamus； immunofluorescence was used to detect the co-expression of RIP3 and dopamine neurons in the hypothalamus. ResultsCompared with the normal group， the serum PRL levels were increased in the model group， and the expression of hypothalamic TNF-α， TNFR1， RIP3 mRNA， and the co-expression of RIP3 with dopamine neurons were significantly increased， while TH expression was decreased （P＜0.05 or P＜0.01）. Compared with the model group， the expression of hypothalamic TNF-α was decreased in the bromocriptine group and low-dose group of modified Xiaoyao Powder， and the expression of TH was significantly increased in the medium and high-dose groups of modified Xiaoyao Powder and the bromocriptine group. The serum PRL levels， hypothalamic TNFR1 and RIP3 mRNA expression， and the co-expression of RIP3 with dopamine neurons were significantly decreased in all dose groups of modified Xiaoyao Powder and the bromocriptine group （P＜0.05 or P＜0.01）. Compared with the bromocriptine group， the serum PRL level were significantly increased in the high and low-dose groups of modified Xiaoyao Powder， TH expression was significantly increased in the medium-dose group of modified Xiaoyao Powder， hypothalamic RIP3 mRNA expression was decreased in the low-dose group of modified Xiaoyao Powder， and the co-expression of RIP3 with dopamine neurons was significantly increased in the high-dose group of modified Xiaoyao Powder （P＜0.01）. ConclusionModified Xiaoyao Powder can regulate the programmed cell death of hypothalamic dopamine neurons， affect DA expression， and regulate PRL levels， which may be one of its mechanisms in the treatment of HPRL with liver constraint and spleen deficiency.