Objective To evaluate the clinical characteristics, surgical treatment effect and prognostic factors of post-operative hypertension in the 2 subtypes of primary aldosteronism (PHA),aldosterone adenoma (APA) and unilateral adrenal hyperplasia (UNAH). Methods In the collection of surgical treatment of PHA from 2002-2009, 135 cases, 68 males and 67 females, with age of 26-79 years (mean, 51 years) were analyzed. Of them, there were 83 APA patients, 52 UNAH cases. All the cases with PHA were with hypertension symptoms and met the preoperative diagnosis criteria. All the patients were performed preoperatively blood biochemical and hormonal tests and CT scans. The diagnosis was confirmed by pathology. All cases undergone adrenal reserved surgery (ASS) and followed-up. According to the postoperative recovery of blood pressure was normal or still in hypertension, Logistic regression analysis and comparison between the 2 groups were carried out,the clinical data of various factors in predicting the role of postoperative blood pressure were considered. Results One hundred and thirty-five patients were operated successfully. The mean follow up was 2. 5± 1.6 years (1-7 years). There were significant decreases in both systolic blood pressure and diastolic blood pressure at final follow up compared with those before surgery. Antihypertensive requirement was decreased at final follow-up. Serum aldosterone levels, plasma renin activity and potassium levels were improved significantly. Overall, blood pressure returned to normal in 51 cases(37.8%). Other 84 cases (62.2%) continued with high blood pressure, of whom 58 cases reduced antihypertensive drug use. Patient's age over 49.5 years, hypertension duration over 6. 5 years, family history of hypertension were higher risks of postoperative continuous high blood pressure. Conclusions APA and UNAH are 2 types of PHA with similar performance of patients, surgical treatment effect. ASS can be used in the treatment of these 2 types of disease. Age, hypertension duration, family history of hypertension are independent factors predicting sustained hypertension after surgery.

Objective To investiagte the serum adiponectin concentration in preeclampsia and its relationship with serum leptin and soluble leptin receptor levels.Method The level of adiponectin,leptin and soluble leptin receptor in serum were measured by enzyme-linked immunosorbent assay(ELISA)in 38 patients with preeclampsia and 42 patients as control.The relationship of free leptin index(leptin/soluble leptin receptor) to preeclampsia was analyzed.Results There were no significant differences in maternal age,gestational age and body mass index(BMI)between two groups.But the gestational age and birth weight were significantly lower in preeclampsia than in control.The patients with preeclampsia had significantly higher levels of serum adiponectin, leptin and free leptin index(1691.7?g/ml,37.5 ng/ml and 0.95 respectively)than the control(689.4?g/ml, 19.3 ag/ml and 0.49,respectively).But there was no significant difference in serum level of soluble leptin receptor between the groups(35.0 ng/ml vs 42.2 ng/ml).Serum adiponectin was not significantly correlated with the level of leptin,soluble leptin receptor and free leptin index.Area of serum adiponectin,leptin and free leptin index in preeclampsia under the ROC curve were less than 0.5.Conclusions The patients with preeclampsia have paradoxical higher serum levels of adiponecfin and more bioavailability of leptin,suggesting these may be important factom of this complication.

Objective To investigate the influence of non-dipper blood pressure rhythm on peripheral atherosclerosis in elderly hypertensive patients.Methods The 199 elderly hypertensive patients with 24-hour average systolic blood pressure＜140 mmHg were selected.Body mass index (BMI),glycosylated hemoglobin,blood lipids,uric acid,creatinine,Brachial ankle pulse wave velocity (baPWV),ankle arm index(ABI) and 24-hour ambulatory blood pressure monitoring were tested and calculated.The elderly patients were divided into dipper hypertensive group (n=95),and non-dipper hypertensive group (n=104).The relationships of arteriosclerosis with lifestyle and the circadian rhythm of blood pressure (non-dipper hypertension) were analyzed.Results Circadian blood pressure rhythm,age,levels of total cholesterol,triglyceride and serum creatinine,nocturia times,and smoking index were significantly related with atherosclerosis.There was a relationship between circadian blood pressure rhythm and baPWV,with the greatest standardized regression coefficient of 0.439.There were obviously linear relationships between levels of serum creatinine,nocturia times,age and ABI.There were significant differences in baPWV,ABI and smoking index between dippers and non-dippers groups [(1746.0±246.9) vs.(2115.7±321.8),(1.14±0.10) vs.(1.11±0.18),(251.8±272.8) vs.(368.5±339.9),P＜0.05 or 0.001].The multiple linear regression analysis showed that smoking index was significantly correlated with baPWV,but not correlated with blood pressure rhythm.In the ROC curve of MAP difference percentage and baPWV diagnosis result,the area under the curve was 0.8188,the optimal cut-off was 10.9％,the sensitivity was 62.5％ and the specificity was 85.7％.In the ROC curve of MAP difference percentage and AMI diagnosis result,the area under the curve was 0.7589,the optimal cut-off was 8.1％,the sensitivity was 88％,and the specificity was 61％.These results reflected that there were better consistences between MAP difference percentage and baPWV,ABI,and indirectly indicted that there was a relationship between MAP difference percentage and atherosclerosis.Conclusions We advise the elderly patients to give up the bad habits,help them control the systolic blood pressure,and advise them to adjust the medication time according to the circadian rhythm of blood pressure of every elderly hypertensive patient in order to restore the normal circadian blood pressure rhythm and delay the atherosclerotic process.

OBJECTIVETo study apoptosis-related gene expression of human villous trophoblasts exposed to 50 Hz magnetic field and to investigate the possible mechanism of human reproductive health effects caused by 50 Hz magnetic field.

METHODSCultured human villous trophoblasts were exposed to 50 Hz magnetic field at 0.4 mT for 6, 48, 72 hours. Gene expressions of Bcl-2, Bax, Caspase-3, p53 and Fas were analyzed using real-time reverse transcription polymerase chain reaction (RT-PCR) assay.

RESULTSWithin 72 hours, the average fold change for each gene was near 1.00, and there was no significant difference on expression pattern in each gene between exposure and control groups (P > 0.05).

CONCLUSION0.4 mT 50 Hz magnetic field does not affect the apoptosis-related gene expression of human villous trophoblasts in vitro.

Caspase 3 ; metabolism ; Cells, Cultured ; Female ; Gene Expression Regulation ; Humans ; Magnetic Fields ; adverse effects ; Pregnancy ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Trophoblasts ; metabolism ; Tumor Suppressor Protein p53 ; metabolism ; bcl-2-Associated X Protein ; metabolism ; fas Receptor ; metabolism

This study is to explore the activation of the Ca2+/CaM/CaN signal pathway in 5-HT-induced proliferation of rat pulmonary artery smooth muscle cells (PASMCs) and the inhibitory effect of m-nisoldipine (m-Nis) on this pathway. PASMCs were cultured with the explant technique. The proliferation of PASMCs was evaluated by MTT assay. Confocal microscopy was used to measure the change of [Ca2+]i. The mRNA expression of CaM and CaN was evaluated by RT-PCR and the activity of CaN was measured according to the instruction of kits. The results of MTT assay suggested that 5-HT (1 micromol x L(-1)) significantly induced the proliferation of rat PASMCs (P < 0.01), which was inhibited obviously by m-Nis (P < 0.05 or P < 0.01). Similarly, m-Nis inhibited 5-HT-induced elevation of [Ca2+]i (P < 0.01). The mRNA expression of CaM, CaN and the activation of CaN were also inhibited by m-Nis at different degrees (P < 0.05 or P < 0.01). Thus, the results of this study suggested that Ca2+/CaM/CaN signal pathway played an important role in 5-HT-induced proliferation of rat PASMCs, the inhibition of m-Nis on proliferation of rat PASMCs may be related to the blockage of Ca2+/CaM/CaN signal pathway by inhibiting the elevation of [Ca2+]i.
Animals ; Antihypertensive Agents ; pharmacology ; Calcineurin ; genetics ; metabolism ; Calcium ; metabolism ; Calcium Channel Blockers ; pharmacology ; Calmodulin ; genetics ; metabolism ; Cell Proliferation ; drug effects ; Cells, Cultured ; Male ; Myocytes, Smooth Muscle ; cytology ; metabolism ; Nisoldipine ; pharmacology ; Pulmonary Artery ; cytology ; RNA, Messenger ; metabolism ; Rats ; Rats, Wistar ; Serotonin ; pharmacology ; Signal Transduction

OBJECTIVETo evaluate the correlation of venous return disturbance (VRD), bone marrow edema (BME) and the amount of joint fluid with clinical symptoms in osteonecrosis of the femoral head (ONFH).

METHODSTwenty patients (25 hips) with ONFH proved by pathology were parallelly examined by 1.5 T MR and medullograph.

RESULTIn total 25 hips VRD was observed in 16 hips with medullograph and 13 hips with the clinical symptoms (P <0.05). BME was found in 17 with MRI (P <0.01), and the was found in 15 hips with MRI (Spearman=0.949). VRD were found in 16 hydrarthrus.

CONCLUSIONONFH patients with clinical symptoms have VRD, BME and the hydrarthrus. The medullograph is of value in monitoring the development of ONFH.

Adult ; Bone Marrow ; pathology ; physiopathology ; Edema ; pathology ; Female ; Femur Head ; blood supply ; Femur Head Necrosis ; pathology ; physiopathology ; Hip Joint ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Regional Blood Flow ; physiology ; Veins ; physiopathology

OBJECTIVETo evaluate the influence of superovulation by GnRHa protocol and pregnant mare's serum gonadotropin (PMSG) alone on the expression of estrogen receptor (ER), progesterone receptor (PR) and leukemia inhibitory factor (LIF) mRNA on endometrium.

METHODSForty-five female ICR mice were randomly allocated into 3 groups:(1) GnRHa+PMSG group: alarelin was give first for desensitizing the pituitary, then superovulation with PMSG; (2) PMSG group: mice were injected with PMSG only; (3) Natural cycle group: mice were given with same volume of saline. Endometrium samples were taken at 48 hours after given hCG or ovulation (control group). ER and PR in glandular cells were detected with SP immunohistochemistry semiquantitatively. Expression of LIF mRNA on endometrium was detected with reverse transcriptase-polymerase chain reaction (RT-PCR) analysis.

RESULTThe positive rate(%) and expression intense (AU) of ER and PR on glandular epithelium cells were significantly lower in GnRHa+PMSG group and PMSG group than those in natural cycle group (all P <0.01). The expression of LIF mRNA was significantly lower in GnRHa+PMSG group and PMSG group than that in natural cycle group (all P <0.01); but the expressions of ER, PR and LIF in GnRHa+PMSG group were higher than those in PMSG group.

CONCLUSIONThe protocol with GnRHa down regulates the expressions of ER, PR and the LIF mRNA on the mice of secretive phase endometrium, suggesting it may have an adverse effect on the endometrial receptivity in mice, but it may still be better than PMSG alone.

Animals ; Clinical Protocols ; Endometrium ; metabolism ; Female ; Gonadotropin-Releasing Hormone ; analogs & derivatives ; pharmacology ; Gonadotropins ; pharmacology ; Leukemia Inhibitory Factor ; metabolism ; Mice ; Mice, Inbred ICR ; Ovulation Induction ; methods ; RNA, Messenger ; metabolism ; Random Allocation ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Superovulation ; metabolism

Objective To explore the spatiotemporal distribution pattern, and identify risk cluster of esophageal cancer in Huai’an City so as to provide evidence for control and prevention of esophageal cancer. Methods Data of esophageal cancer incidence at township level in Huai’an City from 2011 to 2015 was collected. Spatial autocorrelation and local indications of spatial autocorrelation (LISA) were implemented to evaluate the spatial pattern of esophageal cancer incidence. Spatial scan statistics was used to examine spatio-temporal clustering of risk areas. Results The average incidence of esophageal cancer in Huai’an from 2011 to 2015 was 67.12/10 million, the incidence of male was significantly higher than that of female. The results of Moran’s I values implyed the spatial autocorrelation at township level. The results of LISA indicated that there were local hot spots and cold spots. The significant high-risk clusters included townships in Huai’an County, Huaiyin County and Jinhu County. The low-risk clusters were located in the main urban area and Xuyi County. Conclusions There are significant spatio-temporal aggregation for the distribution of incidence of esophageal cancer in Huai’an City and same spatiotemporal high-risk clusters between male and female. Our findings have a foundation to explore the multi-factorial etiology of esophageal cancer and have vital practical value for health services and policies implementation.

Purpose: To evaluate the use of signal intensity index (SII) of skull-base invasion in nasopharyngeal carcinoma (NPC) using magnetic resonance imaging (MRI), select a best cut-off SII value to predict the outcome of NPC. Materials and Methods: One hundred and twenty-two NPC patients (92 men, 30 women) with skull-base invasion were included. All patients underwent MRI, signal intensities on T1-weighted imaging (T1WI) were measured for each invaded site and its contralateral normal counterpart. The SIIs were calculated, receiver operating characteristic curves were constructed. The optimal cut-off values were extracted. The overall survival (OS) rates of 5-year follow-up were performed. Results: Sensitivities for differentiating skull-base invasion from normal contralateral anatomy were 98.9%, 88.5% and 70.0%, and specificities were 98.9%, 96.0% and 74.4%, respectively. There were three cut-off values for differentiating invasion from normal anatomy of skull-base, 49%, 98%, and 60%. Significant difference in OS rates (84.2% vs. 57.1%, p=0.007) was seen for SII threshold values > 60% and those ≤ 60%. Conclusions: The SII might be a useful means of differentiating invasion from normal tissue at the skull-base in NPC. The cut-off value of quantitative SII at the skull-base may aid in monitoring the response to treatment of NPC patients.

OBJECTIVETo study the relationships among magnetic resonance imaging (MRI), histological findings, and insulin-like growth factor-I (IGF-I) in steroid-induced osteonecrosis of the femoral head in rabbits.

METHODSThirty rabbits were randomly divided into experimental Group A (n=15) and control Group B (n=15). The 7.5 mg/kg (2 ml) of dexamethasone (DEX) and physiological saline (2 ml) were injected into the right gluteus medius muscle twice at one-week intervals in animals of Groups A and B, respectively. At 4, 8 and 16 weeks after obtaining an MRI, the rabbits were sacrificed and the femoral head from one side was removed for histological study of lacunae empty of osteocytes, subchondral vessels, and size of fat cells under microscopy, and the femoral head from the other side was removed for enzyme-linked immunoadsorbent assay (ELISA) for IGF-I.

RESULTSAt 4, 8 and 16 weeks after treatment, no necrotic lesions were detected in Group B, while they were detected in Group A. Light microscopy revealed that the fat cells of the marrow cavity were enlarged, subchondral vessels were evidently decreased, and empty bone lacunae were clearly increased. The IGF-I levels in Group A were significantly higher than those in Group B. At 8 weeks after the DEX injection, the MRI of all 20 femora showed an inhomogeneous, low signal intensity area in the femoral head, and at 16 weeks, the findings of all 10 femora showed a specific "line-like sign". The MRI findings of all femora in Group B were normal.

CONCLUSIONMRI is a highly sensitive means of diagnosing early experimental osteonecrosis of the femoral head. However, the abnormal marrow tissues appeared later than 4 weeks when the expression of IGF-I increased. This reparative factor has an early and important role in response to steroid-induced osteonecrosis of the femoral head, and provides a theoretical foundation for understanding the pathology and designing new therapies.

Animals ; Dexamethasone ; Disease Models, Animal ; Femur Head Necrosis ; chemically induced ; metabolism ; pathology ; Insulin-Like Growth Factor I ; metabolism ; Magnetic Resonance Imaging ; Rabbits ; Steroids