Cushing's syndrome is caused by the excessive secretion of cortisol from the adrenal cortex.Hypertension is one of the most distinguishing features of Cushing's syndrome,as it is present in about 80% of adult patients.The various pathogenetic mechanisms that have been proposed for the development of cortisol-induced hypertension in Cushing's syndrome and its management are discussed.

By integrating data of sci-tech novelty retrieaval and internet data,the paper makes a precise analysis of the potential demands,interest,interest,tendency,preferences and habits of users of novelty retrieval.From the perspective of big data technology,it analyzes the feasibility of designing targeted and deep-level services for mass user data,puts forward the framework and method of conducting deep-level and precise service recommendation based on users of sci-tech novelty retrieval,and studies the opportunity to provide these users with deep-level and precise services.

Cardiomyopathies ; congenital ; Heart Ventricles ; pathology ; Humans ; Infant, Newborn ; Male ; Myocardium ; pathology

BACKGROUND: Sodium alginate-poly-lysine can cause foreign body reaction to induce functional inactivation of the microencapsulated islets following transplantation. Can barium chloride solve this problem?OBJECTIVE: To assess the biocompat ibility of purified sodium alginate-barium chloride microcapsules and the bioactivity of the microencapsulated islets of rats.DESIGN: A randomized controlled experiments based on the experimental animals.SETTING: Department of endocrinology in a university hospital.MATERIALS: This experiment was completed in the Laboratory of Endocrinology and Department of Laboratory Animals, First Affiliated Hospital of Nanjing Medical University during July to December 2002. Specific pathogen-free SD and Wistar rats were provided by Center of Animal Experiment, Nanjing Medical University and Animal Experiment Center of Shanghai respectively.METHODS: Purified and non-purified sodium alginate-barium chloride microcapsules were prepared with one-step method using domestically made equipment. The microcapsule was transplanted intraperitoneally into normal SD rats and its biocompatibility was observed 4 weeks later. The bioactivity of the microencapsulated islets was also observed following transplantation in streptozotocin(STZ)-induced diabetic Wistar rat models.MAIN OUTCOME MEASURES: ① The recovery rate of the transplanted empty microcapsule; ② Results of bioactivity assessment of the insulin from the microencapsulated islets; ③ Histological examination.RESULTS: Four weeks after the transplantation, the recovery rate of the transplanted empty microcapsules in the purified group was higher that that in non-purified group( P > 0.05), and the purified microcapsules retained intact and smooth morphology with out causing fibrosis. The islets encapsulated by purified sodium alginate-barium chloride microcapsules showed good insulin-ecreting function in in vitro culture, without significant difference from non-microencaps ulated islets( P > 0. 05) . The islets transplanted via the microcapsules into diabetic Wistar rat models induced by STZ had a survival time over 6 weeks.CONCLUSION: The purified sodium alginate-barium chloride microcapsules have good bioactivity and tissue compatibility, which might provide a solution for the source of donor diabetic islets in the treatment of type Ⅰ diabetes.

Objective To investigate effects of volume,distribution and leakage of bone cement in ver- tebroplasty on the adjacent intervertebral bodies using an experimentally calibrated and anatomically accurate fi- nite-element model of elderly L4-L5 vertebral bodies.Methods Computed tomography(CT)scanning was done,at 1 mm intervals,on L4-L5 vertebral bodies of the lumbar spine of an old man cadaver that had no abnormal findings on rnentgenograms.The L4-L5 motion segment data were obtained from the CT scans to establish in computer a three-dimensional finite element model of L4-L5 functional spinal unit(FSU)with the software Ansys 7.0.Compressive load after virtual vertebroplasty on the damaged model,unipedicular and bipedieolar injections and leakage of cement into the intervertebral space,and the resulting endplate and disc stresses of the adjacent vertebral bodies were analyzed in various spatial distributions of the filling material and different loading conditions. An anatomically accurate finite-element model of elderly L4-L5 vertebral bodies was developed.Results The FSU study suggested that changes in stress and strain at adjacent levels were minimal.Furthermore,endplale and disc stresses of the adjacent vertebral bodies were not influenced by bone cement filling volumes or distributions except under bending,whereas asymmetric distribution and leakage of bone cement to the disk increased the stress of adjacent endplates.Conclusion Since asymmetric distribution and significant leakage of cement into the intervertebral space can increase the stresses of endplates of adjacent vertebral bodies and may lead to a fracture, symmetric placement of cement in operation should be achieved and leakage of cement avoided.

One hundred and twenty four patients with type 2 diabetes mellitus (T2DM) admitted to the Department of Endocrinology of Chuzhou First People's Hospital from April to October 2019 whose blood glucose levels were not controlled after treatment with metformin (2.0 g/d) for more than 3 months were enrolled in the study. The patients were randomly divided into oral drug group and liraglutide group with 62 cases in each group. On the basis of metformin, the oral drug group was treated with acarbose (300 mg/d); the liraglutide group was treated with liraglutide (1.2 mg/d). The course of treatment was 3 months. The body weight, fasting blood glucose (FPG), 2-h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), cholesterol (TC) and triglyceride (TG) levels were compared between the two groups before and after treatment, and the gastrointestinal symptoms and the incidence of hypoglycemia were analyzed. After 3-month treatment the body weight, FPG, 2 hPG, HbA1c of the two groups were lower than the baseline levels ( P<0.05). Compared with the oral group, the body weight, FPG, 2 hPG, HbA1c and TG in liraglutide group were more markedly decreased ( P<0.05). The gastrointestinal reaction of liraglutide group was significantly higher than that of the oral drug group, and there was no hypoglycemia in both groups. The data indicate that liraglutide combined with metformin can significantly improve the blood glucose, blood lipid and body weight of T2DM patients and no hypoglycemia occurs during the treatment.

Objective Helicobacter pylori（ ）， To investigate the infection status of HP and analyze the correlation between HP Methods infection and serum bilirubin in railway drivers. A total of 2 731 railway drivers in Zhengzhou locomotive depot were - selected as study subjects using judgment sampling method. Carbon 13 urea breath test was used to evaluate the HP infection ， status. The metabolic indexes of HP positive group and HP negative group were compared and the relationship between HP Results （ ） ， infection and serum bilirubin was analyzed. The HP infection rate was 42.3% 1 156/2 731 . The older the age the ， （ ）， （ P ） longer the work years and the higher the body mass index BMI the higher the HP infection rate all <0.01 . The infection （P ） rate of HP in married people was higher than that in unmarried people <0.01 . The HP infection rate of smokers was higher - （P ） - ， than that of non smokers <0.01 . Compared with the HP negative group fasting blood glucose and serum levels of total ， （ - ）， （ ） - cholesterol low density lipoprotein cholesterol LDL C triglyceride and homocysteine Hcy were increased in the HP （ P ） （ - ）， ， positive group all <0.05 . The serum levels of high density lipoprotein cholesterol HDL C total bilirubin direct bilirubin （ ） - （ P ） DBIL and indirect bilirubin were lower than those in HP negative group all <0.05 . Logistic regression analysis showed that （ P ） HP infection was associated with low serum total bilirubin and low DBIL all <0.01 after adjusting for the confounding effects ， ， ， ， ， ， ， - ， - ， of age work years marital status smoking history fasting blood glucose total cholesterol triacylglycerol LDL C HDL C Conclusion ， ， ， and Hcy. The age work length BMI smoking and marital status are the influencing factors of HP infection in railway drivers. HP infection is associated with low levels of total bilirubin and DBIL.

OBJECTIVETo study mechanical affect of knee joint of reasonable positioning of femoral tunnel during knee posterior cruciate ligament (PCL) double-bundle reconstruction and graft fixation after reconstruction by virtual reality interactive technology and evaluate the biomechanical response of knee after reconstruction by finite element analysis.

METHODSKnee specimens from five fresh frozen cadavers were used. Computer simulations and biomechanical experiments were used in this study. Experiments on flexion and extension movements of the knee joint were performed on specimens of fresh human knee joint. Laser three dimensional scanning was used to record and calculate the indexes of movements. Three-dimensional models of knee joint bone structure were then reconstructed on computer with the experimental data. Simulations of flexion and extension movements were carried out on the models to show the spatial positions of femur and tibia and label the attachment sites of PCL. Ten test points in the anterior,posterior, proximal, distal at the femoral attachment area of anterior and lateral bundle (ALB) and postoperior medial bundle (PMB) were selected and the central points of tibial en attachment areat anchored. The distance btween each two points of two article surface was calculated and contacted by software of Geomagic. Model was import software Ansys, adopting the tetrahedron unit a finite element model of complex tibial and femoral was set up to simulat human walking in one leg,on this condition the the joint surface force of model under weight impact load were analyzed.

RESULTSThe three-dimensional models could demonstrate the spatial positions of the bone structure of the knee in different flexions and extensions. The models could be used to measure the spatial distance between 2 points on the femoral and tibial planes by software Geomagic. There was significantly difference among the length changes of anterolateral bundle and posteromedial bundle at every fixed point with different flexion angles (P<0.05), so the fixed angle with different points. The length changes of anterior lateral bundle's A2, A1 and posterior medial bundle's B3, B1 points were (1.35±0.19) mm, (5.41±1.22) mm, (1.95±0.04) mm and (5.23±2.21) mm, respectively. The A2 and B3 points' length changes were the less, and that of the Al and B1 points were the more. It had no significant difference between the length changes of anterior lanteral bundle's A2 and A3 point (P=0.913>0.05). All of the maximal length changes of anterior lateral bundle's A2, A3 and postterior medial bundle's B3 points were less than 2 mm.

CONCLUSIONThe models of knee joint were builded through computer technology and it can be measure the lenth of cruciate ligament with software Geomagic exactly. The femoral tunnel for the PCL double-bundle reconstruction should be located as follows: ALB at the middle point of upper edge of femoral attachment site (proximal point),while PMB at the middle point of femoral attachment site (proximal point). This model provides a satisfactory method for the evaluation of the biomechanical response of knee after cruciate ligament reconstruction.

Adult ; Aged ; Biomechanical Phenomena ; Computer-Aided Design ; Female ; Femur ; surgery ; Humans ; Knee Joint ; physiology ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reconstructive Surgical Procedures ; methods

With the advent of Twenty-First century, more and more genome-wide association studies (GWAS) showed that idiosyncratic adverse drug reactions (ADRs) were closely related with human leukocyte antigen (HLA) alleles, such as the associations of abacavir-HLA-B*5701, allopurinol-HLA-B*5801, and carbamazepine-HLA-B*1502, etc. To explore the mechanisms of these idiosyncratic drug reactions, hapten hypothesis, danger signal hypothesis, pharmacological interaction (P-I) concept and autoimmune mechanism are proposed. In this paper, recent GWAS studies on the HLA-mediated adverse drug reactions and underlying mechanism are reviewed in detail.

The potential effect of donor CD4+ CD25+ regulatory T ceLls on the suppression of rejection for allogenetic islet transplantation in vivo was investigated. CD4+ CD25+ regulatory T cells were generated by magnetic activated cell sorting and were ailogeneically transfered with islet transplantation in streptozotocin-induced diabetic BALB/cByJ mice. The results showed that allogeneic CD4+ CD25+ regulatory T cells prolong islet graft survival and normoglycemia in transplanted allogeneic diabetic mice.