Objective:To investigate the distribution of pathological types of unilateral primary aldosteronism, and to explore the clinical characteristics and prognosis of patients with different pathological types.Methods:A total of 241 patients with unilateral primary aldosteronism who underwent adrenal surgery were included in this study. The clinical data and postoperative follow-up data were collected, and the postoperative tissue sections were stained with HE and aldosterone synthase. According to the staining results, pathological types of 241 patients were classified, and the clinical characteristics and surgical prognosis of patients with unilateral primary aldosteronism were compared.Results:According to the international histopathology consensus for unilateral primary aldosteronism, among 241 patients with unilateral primary aldosteronism, 223 were classical(92.5%), 17 were non-classical(7.1%), and 1 was aldosterone producing carcinoma(0.4%). Among classical cases, 189 were aldosterone producing adenoma and 34 were aldosterone producing nodule. In the non-classical cases, 8 cases were multiple aldosterone producing nodule and 9 cases were multiple aldosterone producing nodule. Compared with the classical group, the non-classical group had a longer duration of hypertension(9.0 vs 5.0 years, P=0.062) and a lower baseline plasma aldosterone concentration(273 vs 305 pg/mL, P=0.147), but the difference was not significant. There was no significant difference between the two groups in the proportion of patients who achieved a complete biochemical response after surgery(98% vs 92.3%, P=0.281), but the proportion of patients who achieved a complete clinical response was significantly lower in the non-classical group(23.1% vs 52.9%, P=0.046). Conclusion:The pathological types of unilateral primary aldosteronism are predominantly classical, with aldosterone-producing adenoma being the most common. There were no significant differences in the clinical characteristics and postoperative biochemical remission rates between classical and non-classical patients, but the clinical prognosis of the latter was inferior to the former.

Objective:To explore the medication law and ideas of national TCM master Zhang Lei in the treatment of patients with "stagnant pulse" based on data mining.Methods:Medical records of Professor Zhang's diagnosis and treatment of "stagnant pulse" disease from 1 April 2021 to 1 August 2022 in the Third Affiliated Hospital of Henan University of Chinese Medicine were collected. Excel 2019 and IBM SPSS Modeler 14.1 were used for frequency statistics, attribute analysis of Chinese materia medica, and association rule analysis. Clustering analysis of drugs was conducted using IBM SPSS Statistics 21, and conclusion and summary were performed based on Professor Zhang's clinical diagnosis and treatment experience.Results:Totally 213 medical records were collected, including 332 prescriptions. The main syndromes involved in patients were liver depression and qi stagnation, wood and soil stagnation, etc. The prescriptions involves a total of 243 kinds of Chinese materia medica. The top 5 kinds of Chinese materia medica in terms of medication frequency ranking were Glycyrrhizae Radix et Rhizoma (163 times), Bupleuri Radix (117 times), Pinelliae Rhizoma Praeparatum cum Alumine (110 times), Poria (108 times), Scutellariae Radix (104 times). Professor Zhang's medication for treating patients with "stagnant pulse" was mainly cold and warm; the tastes were mainly sweet, bitter, and pungent; the main meridians were spleen, lung, liver, stomach, and heart; the common medicinal pair was Bupleuri Radix-Angelicae Sinensis Radix, and the basic prescription included Bupleuri Radix, Pinelliae Rhizoma Praeparatum cum Alumine, Glycyrrhizae Radix et Rhizoma, Poria, Paeoniae Radix alba, Scutellariae Radix, Angelicae Sinensis Radix, Citri Reticulatae Pericarpium, Cyperi Rhizoma. Clustering analysis yielded four core categories: category 1 Jujubae Fructus, Zingiberis Rhizoma Recens, Codonopsis Radix, Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, Pinelliae Rhizoma Praeparatum cum Alumine, Scutellariae Radix, Coptidis Rhizoma, Ostreae Concha; category 2 Massa Medicata Fermentata, Astrctylodis Rhizoma, Chuanxiaong Rhizoma; category 3 Cyperi Rhizoma, Gardeniae Fructus, Bupleuri Radix, Menthae Haplocalycis Herba, Moutan Cortex, Paeoniae Radix alba, Angelicae Sinensis Radix, Poria, Citri Reticulatae Pericarpium, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma; category 4 Coicis Semen and Rhei Radix et Rhizoma.Conclusion:Professor Zhang's treatment for "stagnant pulse" is mainly to relieve depression, emphasize the balance of cold and heat, and also take care of the healthy qi to help dispel pathogenic factors and prevent transmission of changes.

Objective To explore the advantages and disadvantages of helicopter emergency medical services of South China in the long-distance transport for critical patients.Methods A total of 30 patients who received helicopter emergency medical services by Guangdong Generral Hospital from August 2004 to December 2014 were selected as the observation group,and the other 30 patients with similar conditions who received ground emergency medical services were selected as the control group.To analyses the difference between the two groups in the disease,transport distance,transportation time,costs and compliction by χ2-test,t-test and nonparametric test according types of data.Results There were significantly difference between two groups in transport distances (km) [578.0 (313.0,707.5)vs.214.5 (101.5,313.5),P <0.05],set-up time (min) [95.7 (56.7,133.4)vs.10.7 (6.8,15.7),P <0.05],transportation time (min) [112.3 (64.3,152.4) vs.146.8 (67.8,217.5),P <0.05],costs (yuan/h) [14378.5 (9887.0,16348.5)vs.557.0 (356.5, 787.5),P <0.05]and the distance/total time value [2.8 (1.3,4.8)vs.1.4 (0.8,2.8),P <0.05]. There was no significantly difference in the incidence of complications between two groups (χ2 =0.058,P >0.05).Conclusions Helicopter emergency medical services could shorten the transportation time of critical patients on long distance transportation,and improve the efficiency of first-aid.However,there were many disadvantages that need to be improved in the helicopter emergency medical service of China.