Objective To investigate the prevalence of hyperglycemia in patients with primary aldosteronism.Methods Thirty two patients diagnosed as primary aldosteronism(PA) in our hospital from 2010 to 2013 (PA group),and 40 patients as essential hypertension (EH group).Two groups were measured and compared,including blood pressure,plasma aldosterone,urine aldosterone,and plasma potassium.Oral glucose tolerance test (OGTT) was performed and homeostasis model assessment-insulin resistance index(HO-MA-IR) were calculated.Results The prevalence of hyperglycemia was 43.75％ in PA group,including 25％ patients of glucose intolerance and 18.75％ patients of diabetes mellitus,which was significantly higher than those of EH group (25％,12.5％,and 12.5％,respectively).PA group's fasting and 2-hour postprandial insulin levels and insulin resistance index were higher than that of EH group.Conclusions The present study indicated that patients with PA had a significantly high prevalence of glucose metabolism disturbance and insulin resistance.Screening test should be performed and avoid missed diagnosis.

BACKGROUND: An isodamine, a kind of alkaloid, is extracted from Anisodus tanguticus (Maxim.) Pascher and is also a good protective agent of cell. However, functional change of mitochondrion is the most sensitive index reflecting cell injury.OBJECTIVE: To study the effects of anisodamine on brain mitochondrial damage following global cerebral ischemia and reperfusion in domestic rabbits and explore its mechanism.DESIGN: Totally randomized controlled trials.SETTING: Emergency Department of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was carried out in the laboratory of Emergency Department, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, from September to December in 2002. Thirty healthy domestic rabbits of either sex were used and randomized into sham-operation group, ischemia-reperfusion group and anisodamine group with 10 rabbits in each group.METHODS: The models of complete cerebral ischemia and reperfusion injury in rabbits were established by ligation of bilateral common carotids and vertebral arteries with systemic hypotension, ischemia lasting for 20 minutes followed by 2-hour reperfusion. Anisodamine group was injected with anisodamine at a dose of 10 mg/kg body mass via femoral vein one minute before reperfusion, and lasted for 2 hours at a dose of 5 mg/hour by micro-pump. Ischemia-reperfusion group was treated with normal saline of the same volume. Sham-operation group only underwent used to determine mitochondrial respiratory functions, including respiratory control rate (RCR), the ratio of adenosine diphosphate to oxygen nicotinamide adenine dinucleotide hydrogenated (NADH) oxidase, succinate oxidase and cytochrome C oxidase were measured by the oxygenmethod of Yagi.drial calcium (Ca2+) and malondiadhyde (MDA) in cortex.reperfusion group and anisodamine group, RCR, ADP/O, OPR levels were lower than those in sham-operation group [nicotinamide adenine dinucleotide chain: RCR: 2.34±0.18,3.58±0.29,4.07±0.38,P ＜ 0.05-0.01;ADP/O: 1.77±0.10,2.23±0.14,2.41±0.17,P ＜ 0.05-0.01; OPR: (5.27±0.78),(8.03±1.30), (9.63±1.50)μkat/g, P ＜ 0.05-0.01; flavin adenine dinucleotide chain: RCR: 1.47±0.23,2.53±0.28,2.84±0.36,P ＜ 0.05-0.01;ADP/O: 0.88±0.09,1.58±0.11,1.73±0.17 ,P ＜ 0.05-0.01; OPR: (6.05±1.13),(7.47±1.40), (8.62±1.60)μkat/g,P ＜ 0.05-0.01], and those were higher in chemia-reperfusion group and anisodamine group, the activities of respiratory chain oxidase of NADH, succinate and cytochrome C were lower than those in sham-operation group [NADH: (2.62±0.35), (4.55±0.48), (5.07±0.60)μkat/g;succinate: (1.48±0.17), (1.83±0.22), (2.10±0.28)μkat/g; cytochrome C:(5.03±1.12), (7.62±1.23), (9.00±1.53)μkat/g, P ＜ 0.05-0.01], and those were higher in anisodamine group than in ischemia-reperfusion group, the content of mitochondrial Ca2+ [(2.36±0.23), (1.39±0.17),(1.22±0.12) mg/g] and MDA [(36.38±10.42), (22.69±9.56), (19.74±7.26)μmol/g,(P ＜ 0.05-0.01 )] was higher than that in sham-operation group, and it was lower in anisodamine group than in ischemia-reperfusion group (P ＜ 0.01).CONCLUSION: Anisodamine can protect the brain against ischemiareperfusion injury at the level of mitochondria by antagonism of Ca2+, inhibition of lipid peroxidation, stabilization of mitochondrial membrane, alleviation of mitochondrial damage, and improvement of motochondrial respiratory functions and the activities of enzymes of respiratory chain.

Objective To study the clinical efficacy of recombinant human epidermal growth factor (rhEGF) in the treatment of sacrococcygeal decubitus ulcers grade Ⅲ with direct polymerizing suture after appling rhEGF to reinforce wound bed preparation (WBP). Methods From January 2007 to October 2009, 60 patients with sacrococcygeal decubitus ulcers Grade Ⅲ, were divided into control group and treatment group. The ulcer size was 3 cm × 4 cm to 10 cm × 12 cm and all ulcers were infected for 15-70 d. Treatment group received traditional dressing change and appling rhEGF to reinforce wound bed preparation. Control group received traditional dressing change only. The operative technique that we used in two groups was direct polymerizing suture. Cure rate of stage Ⅰ and complication morbidities were analyzed. Results Cure rate of stage Ⅰ was 87% in treatment group and 70% in control group. Complication morbidities were 13% in treatment group and 30% in control group. The difference between these two groups was statistically significant (P ＜ 0.05). Conclusion Appling rhEGF to reinforce wound bed preparation before operation could make subsequent treatment more effective and improve the cure ratio of operation with decreasing complications and morbidities. And more, dissecting under fascia possesses the advantages of easiness to perform and rich blood supply.The method of appling rhEGF with direct polymerizing suture is a simple, high efficient approach for the first repairment of sacrococcygeal decubitus ulcers grade Ⅲ, especially desirable for the elderly.

ATP-Binding Cassette Transporters ; genetics ; metabolism ; Animals ; Biological Transport ; Child ; DNA Mutational Analysis ; Humans ; Hypertension, Pulmonary ; genetics ; metabolism ; Lung Diseases, Interstitial ; genetics ; metabolism ; Molecular Sequence Data ; Mutation ; Polymerase Chain Reaction ; Protein Conformation ; Pulmonary Surfactant-Associated Proteins ; genetics ; metabolism ; Respiratory Distress Syndrome, Newborn ; genetics ; metabolism

Intracranial branch atheromatous disease (BAD) was proposed by Caplan in 1989.It has been widely studied in Japan in recent years.With the application of high-resolution magnetic resonance,BAD has become a hot topic.This article reviews the concept,etiology,pathology,diagnosis and treatment of BAD as well as its relationship with ischemic stroke.

OBJECTIVETo evaluate the efficacy and safety of testosterone undecanoate (TU) in the treatment of late-onset hypogonadism (LOH) by meta-analysis.

METHODSWe searched Pubmed (until April 1, 2014), Embase (until March 28, 2014), Cochrane Library (until April 17, 2014), CBM (from January 1, 2001 to February 2, 2014), CNKI (from January 1, 2001 to February 2, 2014), Wanfang Database (from January 1, 2000 to February 2, 2014), and VIP Database (from January 1, 2000 to Febru ary 2, 2014) for randomized controlled trials of TU for the treatment of LOH. We evaluated the quality of the identified literature and performed meta-analysis on the included studies using the Rveman5. 2 software.

RESULTSTotally, 14 studies were included after screening, which involved 1 686 cases. Compared with the placebo and blank control groups, TU treatment significantly increased the levels of serum total testosterone (SMD = 6.22, 95% CI 3.99 to 8.45, P < 0.05) and serum free testosterone (SMD = 4.35, 95% CI 1.86 to 6. 85, P < 0.05) but decreased the contents of luteinizing hormone (WMD = -2.23, 95% CI -4.03 to -0.42, P < 0.05), sex hormone binding globulin (WMD = 2.00, 95% CI 1.38 to 2.63, P < 0.05). TU also remarkably reduced the scores of Partial Androgen Deficiency of the Aging Males (WMD = -9.49, 95% CI -12.96 to -6.03, P < 0.05) and Aging Males Symptoms rating scale (WMD = -2.76, 95% CI -4.85 to -0.66, P <0.05) but increased the hemoglobin level (SMD = 2.35, 95% CI 0.29 to 4.41, P < 0.05) and packed-cell volume (SMD = 4.35, 95% CI 1.36 to 7.33, P < 0.05). However, no significant changes were shown in aspertate aminotransferase, alanine transaminase, prostate-specific antigen, or prostate volume after TU treatment (P > 0.05).

CONCLUSIONTU could significantly increase the serum testosterone level and improve the clinical symptoms of LOH patients without inducing serious adverse reactions. However, due to the limited number and relatively low quality of the included studies, the above conclusion could be cautiously applied to clinical practice.

Androgens ; therapeutic use ; Hemoglobin A ; metabolism ; Humans ; Hypogonadism ; blood ; drug therapy ; Luteinizing Hormone ; blood ; Male ; Prostate-Specific Antigen ; Randomized Controlled Trials as Topic ; Sex Hormone-Binding Globulin ; metabolism ; Testosterone ; adverse effects ; analogs & derivatives ; blood ; pharmacology

OBJECTIVE To study the incidence,pathogenesis,diagnosis and treatment of laryngeal cyst after partial laryngectomy.METHODS The clinical data of 228 cases of partial laryngectomy from January 2003 to June 2009 were retrospectively analyzed,and related literature was reviewed.RESULTS Two cases were found to have laryngeal cysts after partial laryngectomy during the post-operative follow-up.One occurred after 20 months,and the other occurred after 19 months.The cyst located on the tongue surface of the epiglottic was removed by CO2 laser under suspended laryngoscope,while the one located at the subglottic area was removed via cervical approach.So far,a total of 9 cases were reported.CONCLUSION Laryngeal cyst after partial laryngectomy is uncommon.That may be the mucosa planted during the operation.It could be misdiagnosed as recurrent laryngeal carcinoma.CT or MRI is helpful for diagnosis.Operation with CO2 laser under suspended laryngoscope or via cervical approach may be chosen.

Objective To compare the rates of successful intubation between light-stylet and adjustable McCoy laryngoscope for the management of difficult airway with active oral bleeding. Method Thirty casualties traumatized with active oral bleeding were enrolled after failure of endotracheal intubation tried twice by an attending doctor with Macintosh laryngoscope. The patients were randomly( random number) divided into light-stylet (LS)group and McCoy laryngoscope(MC) group ( n = 15 in each group). The rate of successful intubation and the time consumed for intubation were recorded. Results The rate of successful intubation at the first attempt and the total rate of successful intubation in LS group were higher than those in MC group (14/15 vs. 6/15, P =0.005, 15/15 vs. 9/15, P =0.017, respectively). The time consumed for intubation was less in LS group than that in MC group (24 seconds in average,ranged from 23 ～ 34 seconds vs 48 seconds in average, ranged from 31 ～ 119 seconds, P =0.011). Conclusions The light-stylet is a novel tool for intubation in casualties with difficult airway and active oral bleeding with high success rate.

Objective To explore whether there were abnormalities of behavioral tests and CNV-like potential in stressed rats following repeatedly forced swim stress.Methods Forty male rats were randomly divided into 4 groups: the control groups (Control-1 and Control-2) and the stress groups ( Stress-1 and Stress-2).Rats in stress groups were administered to repeatedly forced swim 7 or 14 days respectively.Body weight gain, saccharin preference test and open field test were performed.After being anesthetized with urethane, CNV-like potentials were elicited by condition-test stimulus.Results Results of behavioral tests displayed less body weights (F =253.60, P＜0.001 ) and less saccharine solution intake (F= 13.67, P=0.001 ) in stressed group rats and significant effects of stress on the number of crossing squares, the duration of rearing and the number of grooming in open field test.CNV amplitudes were lower in the stressed rats than those in control (F=21.312, P＜0.01 ).Conclusion This study provides an important evidence of changes of CNV-like potential in depressed rats following repeatedly forced swim stress.Based on this study, ER Ps should be taken into consideration and applied as the useful tools in the research work of depressed animal models.

Background Oxidative damage plays an important role in pathogenesis of age-related macular degeneration( AMD ),and its mechanism is the destroy of blood-retinal barrier.Müller cells is a primary component to stabilize the inner barrier of the blood-retina.Researches showed that epidermal growth factor(EGF) can promote the proliferation and migration of animal Müller cells,but less study was found in the effect of EGF on human Müller cells. Objective The present study was to investigate the effects of EGF on the proliferation and migration of human Müller cells and its molecular mechanism. Methods Human Müller cell line MIO-M1 cells were cultured and incubated,and cultured cells were identified using glial fibrillory acidic protein (GFAP),factor Ⅷ,α-smooth muscle actin( α-SMA ),keratin and S-100.Different concentrations of EGF( 0,1,10,30,100 mg/L)was added in freeserum DMEM,and the positive rate of the cells was calculated using 5-bromo-2-deoxyuridine(BrdU) method.The cells were divided into EGF group,H2 O2 group,EGF + H2 O2 group,glucose oxidase ( GO ) group,GO + EGF group,EGF + LY294002+H2O2 group according to the different intervention,and the effects of LY294002 on the proliferation of Müller cells (A590 )were detected by colorimetric assay for cellular growth and survival( MTT assay).The scratch test of Müller cells was used to assess the influence of EGF(0,1,10,30,100 mg/L)on H2 O2-induced damage of human Müller cell.Western blot was used to detect the cell proliferation under the protection of EGF on co-cultured cells using LY294002 and H2O2 and the activation of Akt signal pathways. Results The proliferative rates of the cells were 28.0％,32.9％,39.0％ in 10,30,100 mg/L EGF groups respectively and obviously higher than those in 0,1 mg/L EGF groups (24.5 ％,26.2 ％ ).Under the H2O2 culture,GO culture,respectively,the A570 value of the Müller cell in high concentrations of EGF groups was significantly increased in comparison with lower concentrations EGF groups with the statistical significance among the groups( F=23.582,P=0.000).Compared with EGF+H2O2 group,the A570value of the Müller cells was lowed in EGF+LY294002+H2O2 group.The maximum migration rate of Müller cells was found in 10 mg/L EGF group.Western blot revealed that the presence of H2O2 reinforced the expression of Akt in Müller cells,however,pretreatment with 100 mg/L EGF antagonized the harmful effect of H2O2 on Müller cells.Meanwhile,pretreatment with EGF and LY294002 reduced the expression of Akt in Müller cells. Conclusions EGF can induce the proliferation and migration of human Müller cells with the strongest effect in 10 mg/L.100 mg/L exogenous EGF has a stronger protection to the Müiller cells against H2O2-induced cell damage by activating the PI3KAkt cell survival pathway.