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.

Objective To establish a standardized stroke aphasic depression questionnnaire hospital version (SADQ-H) in Chinese and to evaluate its reliability and validity in the application in patients with poststroke aphasia. Methods After acquiring the author's letter of attorney, we revised the English SADQ-H into Chinese version; the iupatients with poststroke aphasia who met the inclusion criteria were used as test group, and the patients without poststroke aphasia were used as control group; after evaluating the Aphasia Battery of Chinese (ABC), the test group was redivided into an auditory comprehension disorder group and a non-auditory comprehension disorder group; and all patients were assessed with SADQ-H by the trained health care workers.The patients in the non-auditory comprehension disorder group were evaluated by the Hamilton depression rating scale (HAMD) arid the Beck Depression Inventory (BDI). SADQ-H was retested in some patients 1 week later. Results The reliability test showed that the retested reliability was 0. 840, and internal consistency reliability Cronbach's α coefficient was 0.78; the validity test showed that the criterion validities were 0.590 (HAMD as criterion) and 0.495 (BDI as criterion). The accumulated variance contribution rate from factors of construct validity was 77. 123%. The discriminant validity was 2.078. Conclusions The SADQ-H in Chinese has favorable reliability and validity, and it can be used as an effective tool in the assessment of depression in patients with poststroke aphasia in China.

Adrenocortical carcinoma (ACC) is a rare disease with poor prognosis.Patients usually present with signs of steroid hormone excess (e.g.Cushing's syndrome, Conn's syndrome, virilization) or an abdominal mass.In functional cases, Cushing's syndrome is the most frequent presentation.Mitotane is still the most important single drug for ACC treatment, and it plays a role in adjuvant therapy postoperatively as well as in advanced disease.In advanced ACC, a combination of mitotane with etoposide, doxorubicin, cisplatin or streptozotocin with mitotane may be used.Targeted therapies, such as insulin-like growth factor Ⅰ (IGF- Ⅰ)receptor inhibitor and multiple kinase inhibitors like sunitinib and sorafenib hold great promises.

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.

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.

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.