Plasma aldosterene/renin ratio (ARR) is a sensitive screening test and parameter for primary aldosteronism(PA).The use of ARR leads to a marked increase in the detection rate of PA in the hypertensive population.However,ARR remains a nonstandardized test,and the cutoff value of ARR used in the different studies is varied.Further and systematical studies are needed to improve the accuracy of the test.

Objective To induce mouse embryonic stem(ES)cells to differentiate into insulin-secreting cells by means of a 5-step model system.Methods E14.1 mouse ES cells were cultured in the presence of leukemia inhibitory factor(LIF)for 2 days(step 1),then the cells were cultured in hanging drops to form embryonic bodies(EBs)and the resulting EBs were cultured in suspension for 6 days in the presence of basic fibroblast growth factor bFGF(step 2).Subsequently the EBs were cultured in the medium containing glucagon- like peptide 1(GLP-1),hepatocyte growth factor(HGF),nerve growth factor(NGF)and nicotinamide for 10 days(step 3).After that,the EBs were dissociated into single cells,and the cells were cultured in monolayer in the presence of GLP-1,betacellulin,activin A,bFGF and nicotinamide for 10 days(step 4).Finally,the cells were cultured in low-glucose medium containing nicotinamide for 4 days(step 5).Insulin and some other islet- related genes expressions were investigated using RT-PCR and insulin expression was also investigated by DTZ- staining and immunohistochemistry.The percentage of insulin-secreting cells was evaluated by flowcytometry and insulin concentrations were measured by RIA.Results mRNA expression of insulin became visible at step 3 and more evident at step 5.Additionally,at step 5,mRNAs of glucagon,somatostatin,pancreatic polypeptide(PP), pancreatic duodenal homeobox 1(PDX-1),beta-cell E box transactivator 2(Beta2)and neurogenin 3(Ngn3) were detected.DTZ-staining positive cells and insulin immunohistochemical staining positive cells were observed. The percentage of insulin-positive cells was(24.0?2.5)%(n=6).In the presence of 5.6 mmol/L and 25 mmol/L glucose,insulin concentrations were(0.05?0.01)?g/L and(0.13?0.02)?g/L respectively(n= 6).Conclusion E14.1 mouse ES cells can be induced to differentiate into insulin-secreting cells by the 5-step model system.Insulin-secreting cells can release insulin into culture medium when treated with glucose,and insulin concentrations increase with rising concentration of glucose.

Objective To reinvestigate the value of overnight low-dose dexamethasone suppression test in the diagnosis of Cushing syndrome.Methods Fifty-two patients with Cushing syndrome and 153 patients with simple obesity or essential hypertension in whom Cushing syndrome was excluded were studied retrospectively in order to compare the sensitivity and specificity of different serum cortisol cut-off levels in overnight 1 mg dexamethasone suppression test in the diagnosis of Cushing syndrome.Results The sensitivity of 50% of basal serum cortisol level at 8:00 and of the serum cortisol cut-off levels of 275,200,138,50 nmoL/L at 8:00 after the overnight 1 mg dexamethasone suppression test was 92.3%,92.3%,92.3%,92.3% and 100.0% respectively, and the specificity was 90.8%,98.7%,96.1%,91.5% and 78.4%,respectively.Conclusion The serum cortisol cut-off level of 50 nmol/L in the overnight 1 mg dexamethasone suppression test has very high sensitivity and can be used as a screening test for Cushing syndrome.

Objective To analyze the changes of regional cerebral blood flow (rCBF) with SPECT in depressive patients, and explore the diagnosis value of rCBF imaging for depression. Methods The rCBF imaging was detected by single emission computed tomography (SPECT) on 32 depressive patients and 10 normal subjects, and the characteristics of rCBF changes were assessed with a region-of-interest (ROI) technique. Normal MRI scans were conducted on 11 patients at the same stage. Results Abnormal rCBF was showed in 31 patients with 71 focuses that were located in the bilateral frontal lobe (9), the basal ganglia (5) and the limbic system (57), including the temporal lobe, the hippocampus, the cingulated gyms and the left insular cortex. All abnormalities presented a decreased rCBF except the basal ganglia. No differences in the incidences of abnormal rCBF were found on bilateral hemisphere (χ~2=2A09,P=0.790). Only 3 MRI-detected patients (2 with gently encephalanalosis, 1 with hippocampus atrophies) were found abnormality, while abnormal rCBF was observed in all these 11 patients. Conclusion Most depressive patients show a decreased rCBF at the cerebral limbic system, but part of them exist an increased rCBF at the basal ganglia. The changes of rCBF in depressive patients are sensitively observed by SPECT, suggesting its diagnosis values on depression.

Objective To explore the establishment of a rat model of acute radiation-induced liver injury and sig-nificance of the dynamic changes of TGF-β1 expression.Methods Forty healthy 6-week old male SD rats were randomly divided into model group (n=30) and control group (n=10).The right liver of rats in the model group was given a single dose of 25 Gy 6 MV X-ray irradiation.Histopathological examination using HE staining and transmission electron microsco-py were conducted to observe the liver pathological changes in rats at 3, 5, and 10 days after irradiation, serum TGF-β1 was detected, and relevant indicators of liver function ( ALT, AST, ALP) were determined.Statistical analysis was per-formed using SPSS 17.0 software.Results At 3, 5 and 10 days after irradiation, early pathological changes in the liver cells were observed by electron microscopy, the expression of TGF-β1 was gradually increased with the time prolongation, and significant differences were found between the model group and the control group at different time points (P<0.05). The light microscopic observation of liver tissues did not show significant differences between the control group and model group.The liver ALT, AST, ALP at different time points did not show significant differences between the two groups ( P>0.05).Conclusion Electron microscopy can be used to evaluate the early changes of radiation-induced liver injury, pri-or to the alterations visible by routine light microscopy.TGF-β1 can be used to predict the degree of radiation-induced liver injury, and may be used as a sensitive serum cytokine in predicting the degree of radiation-induced acute liver injury.

Objective To investigate the gastric emptying function in patients with typeⅡdiabetic gastroparesis. Methods The gastric half-emptying time of liquid meals was measured by B-mode ultrasonography in 20 diabetic patients and 22 healthy subjects. Eleven diabetic patients with gastroparesis received cisapride at an oral single daily dose of 30 mg/d and were reexamined at the end of 4-week treatment course. Results The gastric half emptying time was (14.80±4.35) min in normal subjects and (28.00±8.94) min in diabetic patients. Significantly delayed gastric emptying was found in diabetic patients. The gastric half-emptying time was decreased from (33.64±5.05) min to (20.91±5.39) min (P<0.01) in 11 patients after cispride therapy. Conclusion The gastroparesis is common in patients with typeⅡ diabetes and cisapride has favorable effect on diabetic gastroparesis.

Objective To investigate the gastric emptying function in patients with typeⅡdiabetic gastroparesis. Methods The gastric half-emptying time of liquid meals was measured by B-mode ultrasonography in 20 diabetic patients and 22 healthy subjects. Eleven diabetic patients with gastroparesis received cisapride at an oral single daily dose of 30 mg/d and were reexamined at the end of 4-week treatment course. Results The gastric half emptying time was (14.80±4.35) min in normal subjects and (28.00±8.94) min in diabetic patients. Significantly delayed gastric emptying was found in diabetic patients. The gastric half-emptying time was decreased from (33.64±5.05) min to (20.91±5.39) min (P<0.01) in 11 patients after cispride therapy. Conclusion The gastroparesis is common in patients with typeⅡ diabetes and cisapride has favorable effect on diabetic gastroparesis.

Objective Real-time RT-PCR, cell culture and embryonated eggs culture for influenza detection were compared by analyzing the data of influenza surveillance in Shenzhen in second half of 2009.Methods 1092 clinical samples ( throat swabs ) collected during second half of 2009 were tested by realtime RT-PCR, cell culture and embryonated eggs culture, and the results were analyzed by statistical methods. Results The positive rate were 54. 21% ,27.11% and 16. 21% using real-time RT-PCR, cell culture and embryonated eggs culture, and the sensitive were 100% ,50% and 29. 9%. The lowest dilutions of virus detected by real-time RT-PCR were 10-2TCID50/ml. Conclusion The sensitive of real-time RTPCR was higher than culture and the specificity was also very high. It was more suitable for emergency detect. The sensitive of cell culture for H3N2 subtype was higher, and sensitive of embryonated eggs culture for type B was higher.

OBJECTIVETo evaluate the influence of Chinese drug Dahuang Zhechong pill on the hepatocellular function.

METHODThirty-seven patients with hepatocirrhosis and twelve normal controls were performed the hepatobiliary scintgraphy with Tc-99m labeled ethylene hepatobiliary iminodiacetic acid (99 mTc-EHIDA), and the biochemical examination of hepatic function. There was 19 cases repeated the imaging after 6 months treated with chineses drug. By the three compartmental model configurations, the function parameters of hepatocellular extraction and excretion were calculated.

RESULTIn the hepatocirrhosis groups, the hepatocellular uptake peak time and mean residence index were higher than those in normal controls (P < 0.01). Compared to normal controls, the uptake index, uptake speed index and descendent speed index were decreased markedly (P < 0.05). After treatment for 6 months with Chinese drug, the level of serum transaminase, globulin and bilirubin was lower than that before treatment. The uptake peak time and mean residence index decreased notably after treatment for 6 months (P < 0.01), and the uptake index increased, (P < 0.05).

CONCLUSIONChinese drug Dahuang Zhechong pill may improve the hepatocellular function and liver function status in patients with hepatocirrhosis.

Adult ; Bilirubin ; blood ; Drugs, Chinese Herbal ; pharmacology ; Globulins ; metabolism ; Hepatocytes ; drug effects ; metabolism ; Humans ; Liver Cirrhosis ; blood ; drug therapy ; metabolism ; Liver Function Tests ; Male ; Middle Aged ; Transaminases ; blood

OBJECTIVETo study the clinical features and histopathology of the neuroendocrine carcinoma (NEC) of the breast.

METHODSTwenty-two cases of NEC of the breast were analysed by morphology and immunohistochemistry using synaptophysin, chromogranin A, NSE, CD56, estrogen receptor (ER), progesterone receptor (PR), HER2, EGFR, CK5/6, CK14, p63, E-cadherin, p120, p53 and Ki-67 staining. HER2 gene amplification was detected by fluorescence in situ hybridization (FISH) for cases with HER2 protein expression 2+. The diagnosis of breast NEC relies on the expression of neuroendocrine markers expression in more than 50% of tumor cells, and no evidence of neuroendocrine carcinoma in any other parts of the body at the same time.

RESULTSThe patients aged from 31 to 96 years (mean 65.2 years), and all were female but one. Amongst the 22 patients studied, the NECs were in the left breast in 15 cases (68.2%) and in the right breast in seven cases (31.8%); the tumor size was 0.5 to 5.5 cm (mean 2.7 cm). Lymph node metastasis was found in six cases. Basing on the morphologic features, these 22 cases were categorized into six subtypes including nine cases of solid cohesive, six of mucinous, three of solid papillary, two of small cell, one of large cell and one of alveolar variants. Immunohistochemically, the expression rate of markers was 100% (22/22) for synaptophysin, 12/13 for NSE, 54.5% (12/22) for chromogranin A, and 5/16 for CD56. Also, 90.5% (19 of 21) of cases expressed ER, 81.0% (17 of 21) of cases expressed PR, and none expressed EGFR, CK5/6, CK14 and p63. HER2 protein over-expression (3+) and gene amplification was not detected in any case. All cases (19/19) were positive for membrane staining for E-cadherin and p120. p53 expression was seen in 6 of 17 cases. Ki-67 labeling index was less than 3% in 9.5% (2/21) of the cases, 3% to 20% in 66.7% (14/21) of the cases and more than 20% in 23.8% (5/21) of the cases. Both cases of HER2 (2+) did not show gene amplification by FISH. On the basis of immunophenotypes, most of the breast NECs were of the luminal molecular subtype, but not HER2-overexpression or basal-like subtypes.

CONCLUSIONSNEC of breast more likely occurs in elderly patients and in the left breast than the right breast. The most common morphology is the solid cohesive subtype, followed by the mucinous variant.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; classification ; metabolism ; pathology ; surgery ; Breast Neoplasms, Male ; classification ; metabolism ; pathology ; surgery ; Cadherins ; metabolism ; Carcinoma, Neuroendocrine ; classification ; metabolism ; pathology ; surgery ; Chromogranins ; metabolism ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Mastectomy ; methods ; Middle Aged ; Phosphopyruvate Hydratase ; metabolism ; Prognosis ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Synaptophysin ; metabolism