Primary hyperaldosteronism(PHA) is one of the most common reasons of secondary hypertension,which usually has long history,moderate hypertension and relative high incident of vascular complications.Its other complications include hypokalemia,alkalosis,hypocalcemia and IGT et al.Screening hypertension patients using plasma aldosteronism/renin rate will greatly increase the diagnosis and improve the treatment.Treatments of PHA include surgery,medicine and intervene.

Objective To investigate the synergistic effect of calcium channel blocker on cyclosporine-induced gingival overgrowth (GO). Methods 130 renal transplant patients treated with cyclosporine were divided into group A (with calcium channel blocker) and group B (without calcium channel blocker). Demographic, pharmacologic and periodontal data were recorded. The prevalence and severity of GO were compared between the two groups. Three calcium channel blockers, including nifedipine, amlodipine and felodipine, were administered in the patients of group A. The relationships between these three calcium channel blockers and the prevalence of GO were analyzed. Results The patients receiving calcium channel blocker showed significantly higher prevalence of GO (44/73,60 % ) than those without calcium channel blocker (22/57, 39 %) (P＜0. 05). A higher proportion of mild GO (37 %) in group A was also observed than in group B (19 %, P＜0. 05). There were no significant differences in the proportions of moderate and/or severe GO between the two groups (P＞0. 05). Periodontal variables, including plaque index and papilla bleeding index, were significantly higher in GO patients than in those without GO in both two groups (P＜0. 05). In addition, the prevalence of GO in patients receiving nifedipine (77 %) was higher than in those receiving amlodipine (57 %) or felodipine (50 %). Conclusion The combination with calcium channel blocker is a risk factor of cyclosporine-induced GO and the use of nifedipine should be avoided for these at-risk patients.

Objective To investigate the semen quality and the influence of urogenital Ureaplasma urealyticum infection in pre‐conception males in Shanghai .Methods From Jan ,2014 to Nov ,2015 ,5 306 preconception males in our andrology department were received semen analysis .The difference of semen index between ages and urogenital Ureaplasma urealyticum infected or not were analyzed .Results The average pH value was(7 .27 ± 0 .14) ,the average volume was(3 .15 ± 1 .42)mL ,the average sperm concen‐trationwas(57.51±40.22)×106/mL,theaverageoftotalspermcountwas(172.83±134.90)×106 ,theaveragevitalityratioof grade(A+B) sperm was(38 .50 ± 17 .54)% ,the average motile sperm ratio was(46 .36 ± 20 .08)% ,the average of total motile sperm count was(89 .86 ± 92 .82) × 106 .Motile sperm ratio of preconception males from twenty to twenty nine was(49 .60 ± 20 .70)% ,total motile sperm count was(93 .40 ± 95 .83) × 106 ,which was greater than other ages .Ureaplasma urealyticum turned to positive in 2 311 cases was (43 .55% ) .There were statistically significant differences in total sperm count ,total motile sperm count ,sperm concentration ,vitality ratio of grade A sperm ,vitality ratio of grade(A+B) sperm ,motile sperm ratio ,seminal acid phosphatase ,seminalα‐glucosidase and seminal plasma fructose between positive and negative samples(P<0 .01) .There was differ‐ence in pH and seminal plasma zinc between positive and negative samples(P<0 .05) .Conclusion The sperm quality of preconcep‐tion males in Shanghai is not encouraging ,urogenital Ureaplasma urealyticum infection in preconception men is very important .

Objective To isolate and culture rats liver KCS ,and to explore the effect of IRE1-XBP1 pathway on regulation of polarization in activated Kupffer cells (KCs) .Methods (1)Rat KCs were isolated by Ⅳ type collagenase digestion and gradient cen-trifugation methods .(2)KCs were transfected and randomly divided into four groups :XBP1-shRNA group ,Ctrl-shRNA group , AdV-XBP1 group and Ctrl-AdV group .(3)The transfection level of KCs XBP1 ,IL-6 ,IFN-γ ,TNF-α and IL-17 were detected by RT-PCR ;the protein expression level of JAK1 ,JAK2 ,STAT1 and STAT3 were evaluated by Western blot .(4)The changes of KCs expression type in each group were detected by flow cytometry (FCM ) and the laser confocal .(5)T cells derived from rat spleen cells were co-cultured within the 4 groups of KCs mentioned above ;T cells proliferation was measured by Brdu labeling assay .(6)T cells apoptosis was determined by Annexin V /PI FCM analysis .(7)The density of IL-6 ,IFN-γ ,TNF-α ,IL-17 and IL-10 in the su-pernatant of co culture was assessed by ELISA .Results (1)The mRNA and protein level of XBP1 were measured by RT-PCR and western blot ,those in XBP1-shRNA group were significantly reduced compared with those in the other three groups ,while in AdV-XBP1 groups ,results demonstrated entirely the opposite tendency (P< 0 .05) .(2)The expression of marker molecules on the sur-face of KCs such as M HC Ⅱ ,CD86 and CD40 in XBP1-shRNA group were significantly lower (P< 0 .05) ,but CD204 and CD206 expression were much higher compared with the other three (P< 0 .05) .However the expression tendency of these surface markers were shown the opposite results in AdV-XBP1 group (P < 0 .05) .(3)Western blot revealed the XBP1-shRNA could statistically suppress the protein levels and phosphorylation of JAK 1 ,JAK2 ,STAT1 and STAT3 ,which involved in the pro inflammatory cyto-kines regulation and KCs polarization (P< 0 .05) .But in AdV-XBP1 group ,these protein and its phosphorylation were markedly promoted (P< 0 .05) .ELISA results collaborated with Western blot .(4)3 d after co cultured with KCs transfected with XBP1-shR-NA ,the levels of T lymphocyte proliferation and pro inflammatory cytokines secretion were significantly reduced ,but the levels of T lymphocyte apoptosis and anti inflammatory cytokines secretion were remarkably enhanced (P< 0 .05) .Conclusion Blockage of IRE1-XBP1 activation could alter the phenotype of active KCs to M 2 like type and attenuated the capacity of antigen present of KCs ,while up regulated the expression of IRE1-XBP1 pathway could change the phenotype of KCs to M 1 type plus the promotion of antigen present capacity .

Hormones and epigenetic characteristics in a patient with clinically diagnosed adrenal hypoplasia congenita (AHC) were analyzed. Results indicated that plasma ACTH increased, while cortisol, testosterone, LH and FSH decreased. LH, FSH and testosterone did not sufficiently respond to GnRH or hCG stimulation. Gene analysis indicated that C368F mutation was located in exon 1 of DAX-1 gene.

Objective To discuss the diagnostic methods and therapeutical measures on acute portal vein thrombosis. Method Clinical data of 13 cases of acute portal vein thrombosis were retrospectively analyzed and its diagnosis and therapy were evaluated.Results In this group,8 cases were male and 5 were female.The average age was(54±26)years old and 6 of which had identified inducement.Diagnosis was made with enhanced CT or MRI/MRA in all cases,Among which 5 cases were treated with non-surgical method(anticoagulation and thrombolysis)and 2 died.The other 8 cases were cured with surgical procedures (thrombectomy and tube insertion for anticoagulation and thrombolysis though superior mesenteric vein).Segmental small intestinal necrosis necessitated small bowel resection in 5 cases.Conclusion Surgical procedures remain the important therapy of choice for acute portal vein thrombosis especially when bowel necrosis is suspected.

Objective To investigate the peripheral blood cytopenias in patients with portal hypertension complicated with splenomegaly. Methods The clinical data of 309 patients with portal hypertension who had been admitted to our department from January 1991 to December 2006 were retrospeetively analyzed. Results Of all patients, 278 showed peripheral blood cytopenia, ineluding 71 with paneytopenia, 48 with leukocyte and platelet decrease, 25 with erythroeyte and platelet decrease, 33 with leukocyte and erythroeyte decrease, 28 with platelet decrease, 26 with leukocyte decrease, and 47 with erythrocyte deerease. The number of blood cells increased significantly after splenectomy ( t=6.53, P<0.01). The whole blood cells of the remaining 31 patients without hematocytopenia were normal. Conclusions Patients with portal hypertension eomplieated with splenomegaly do not always accompany peripheral blood eytopenia. Peripheral blood cytopenia is one of the complications of splenomegaly, hut it dose not always appear. Splenectomy is effective in the treatment of hematocytopenia. The reason for some patients do not have peripheral blood cytopenia may be related to the slight pathological changes of spleen and severe hyperplasia of bone marrow.

Objective This report was to discuss the efficacy and complications of non-surgical therapy for patients with early lower extremity deep vein thrombosis.Methods A total of 412 patients were treated with thrombolysis or anticoagulation in our department during January 2000 and December 2006.Their clinical data were retrospectively analyzed.Results All patients were followed up for 12 to 83 months (mean,41 months).After treatment,42 patients(10.2%)were completely recovered,331 patients (80.3%)experienced large improvement,32 patients(7.8%)had mild improvement and 7 patients (1.7%)were failed,resulting in total effective rate of 98.3%.In comparison with long clinical course group(>7 days),the recovery rate and improvement rate of short clinical course group(≤7 days)was significantly increased(11.0% vs 5.4%,χ2=4.17,P<0.05;8.7%vs 1.8%,χ2=4.96,P<0.05).Complications included bleeding(2.2%),pulmonary embolism(1.9%),cerebral accident(0.7%),post-thrombotic syndrome(84.0%)and recurrence(6.1%).Bleeding rate in patients≥60 years was significantly higher(4.3%vs 0.8%,χ2=6.82,P<0.01).Incidence of post-thrombotic syndrome was significantly increased in long clinical course group(98.2% vs 81.7%,χ2=3.67,P<0.05).Condusions Non-surgical therapy,including thrombolysis and anticoagulation,might be safe and effective for patients with early lower extremity deep vein thrombosis.Early identification and management would be helpful to improve outcomes and reduce post-thrombotic syndrome.

Objective To explore the clinical value of expression levels of serum COX-2 in patients with advanced NSCLC before and after EGFR-TKI treatment. Methods The serum was collected from 58 cases. Before and after targeted therapy , the serum COX-2 level was examined by ELISA. Meanwhile , CT scan was exercised to evaluate the treatment. Follow-up interview was done. The relationship among the change in expression level of serum COX-2 , efficacy and PFS was analyzed. Results The serum COX-2 level significantly decreased in the response group (t = 11.258, P = 0.000) and increased in the PD group (t = -7.759, P =0.000) after EGFR-TKI treatment, and not significantly changed in the SD group (t = 1.424, P = 0.170). Before treatment, the baseline serum COX-2 level in the response group was significantly higher than that in the SD group and the PD group (F = 20.852, P = 0.000 ). Before the targeted therapy, the higher the level of serum COX-2 was, the longer PFS patients would enjoy. Conclusion Detection of the serum COX-2 contributes to the judgment of therapeutic effect of EGFR-TKI and can be used as a prediction of EGFR-TKI drugs outcomes for patients with advanced NSCLC.

Objective To investigate the correlation between vibration perception thresholds test (VPT) and simple screening tests for peripheral neuropathy in the diabetes clinic in type 2 diabetic patients. Methods VPT and three simple screening tests including 10 g Semmes-Weinstein monofilament examination (SWME), vibration test by 128 Hz tuning fork, and temperature sensation test by Tip-Therm were completed in 487 Chinese patients diagnosed with type 2 diabetes aged over 30. The relationships between these simple screening tests and VPT were evaluated by Spearman correlation and observed agreement rate. Results Abnormal VPT was significantly associated with aging and fasting plasma glucose by binary logistic regression analysis. VPT was significantly correlated with SWME, temperature sensation test, vibration test by 128 Hz tuning fork, and the correlation coefficient was 0.176, 0.152 and 0.240, respectively (P<0.01);Observed agreement between VPT and three simple screening tests including SWME, temperature sensation test, vibration test by 128 Hz tuning fork was 49.5%, 59.8% and 51.1%, respectively. The percentage of abnormal results by SWME or vibration test by 128 Hz tuning fork with normal result by VPT was very low, only 2.7% and 1.2% respectively. Conclusions VPT should also be considered as a first-choice screening test for diabetic peripheral neuropathy.