Objective:To explore the value of metanephrine, normetanephrine, and some steroid hormones in the assessment of adrenal venous sampling (AVS).Methods:This retrospective study enrolled 101 patients with primary aldosteronism who underwent AVS at Peking Union Medical College Hospital between June 1, 2021, and October 1, 2024. Multiple hormones, including aldosterone, cortisol, metanephrine, normetanephrine and steroid hormone profiles, were measured in samples from the inferior vena cava and bilateral adrenal veins during AVS. Selectivity index and lateralization index were calculated based on the levels of different hormones to determine successful AVS cannulation (selectivity index≥2) and aldosterone hypersecretion lateralization (lateralization index≥2). Patients who underwent unilateral adrenalectomy were followed for at least 6 months. Clinical and biochemical outcomes were assessed according to the Primary Aldosteronism Surgical Outcome (PASO) criteria, with biochemical remission defined as achieving complete or partial biochemical remission postoperatively. The efficacy of different hormones relative to cortisol for calculating selectivity index and lateralization index was evaluated for subtype classification.Results:The age at diagnosis of the enrolled patients was (50.5±9.6) years, including 77 males. Regarding the selectivity index, five hormones including metanephrine, normetanephrine, androstenedione, 17α-hydroxypregnenolone, and dehydroepiandrosterone demonstrated significantly higher selectivity index compared to cortisol (all P<0.05). Based on the cortisol-derived selectivity index, AVS cannulation was unsuccessful in 8 patients; using the five indices, unsuccessful cannulation occurred in 2, 2, 3, 4, and 5 patients, respectively. Based on postoperative follow-up, 55 patients were identified as having unilateral surgically relievable primary aldosteronism. In identifying these patients, the performance of metanephrine, normetanephrine, androstenedione, 17α-hydroxypregnenolone, and dehydroepiandrosterone was non-inferior to cortisol, correctly identifying 95% (52/55), 93% (51/55), 91% (50/55), 87% (48/55), and 89% (49/55) of cases, respectively. However, among these patients, there were no statistically significant differences in the success rate of intubation in AVS and the ability to identify patients with unilateral primary aldosteronism between the five indicators and cortisol (all P>0.05). Using cortisol-based lateralization as the reference standard, androstenedione and dehydroepiandrosterone both achieved an accuracy of 90% (84/93) for determining the lateralized side, while 17α-hydroxypregnenolone, normetanephrine, and metanephrine achieved accuracies of 89% (83/93), 81% (74/93), and 80% (73/93), respectively. Conclusion:Metanephrine, normetanephrine, androstenedione, 17α-hydroxypregnenolone and dehydroepiandrosterone could increase the success rate of intubation in AVS, with a high ability to identify patients with unilateral primary aldosteronism, and are expected to replace cortisol as new indicators of AVS.

Objective:To explore the value of metanephrine, normetanephrine, and some steroid hormones in the assessment of adrenal venous sampling (AVS).Methods:This retrospective study enrolled 101 patients with primary aldosteronism who underwent AVS at Peking Union Medical College Hospital between June 1, 2021, and October 1, 2024. Multiple hormones, including aldosterone, cortisol, metanephrine, normetanephrine and steroid hormone profiles, were measured in samples from the inferior vena cava and bilateral adrenal veins during AVS. Selectivity index and lateralization index were calculated based on the levels of different hormones to determine successful AVS cannulation (selectivity index≥2) and aldosterone hypersecretion lateralization (lateralization index≥2). Patients who underwent unilateral adrenalectomy were followed for at least 6 months. Clinical and biochemical outcomes were assessed according to the Primary Aldosteronism Surgical Outcome (PASO) criteria, with biochemical remission defined as achieving complete or partial biochemical remission postoperatively. The efficacy of different hormones relative to cortisol for calculating selectivity index and lateralization index was evaluated for subtype classification.Results:The age at diagnosis of the enrolled patients was (50.5±9.6) years, including 77 males. Regarding the selectivity index, five hormones including metanephrine, normetanephrine, androstenedione, 17α-hydroxypregnenolone, and dehydroepiandrosterone demonstrated significantly higher selectivity index compared to cortisol (all P<0.05). Based on the cortisol-derived selectivity index, AVS cannulation was unsuccessful in 8 patients; using the five indices, unsuccessful cannulation occurred in 2, 2, 3, 4, and 5 patients, respectively. Based on postoperative follow-up, 55 patients were identified as having unilateral surgically relievable primary aldosteronism. In identifying these patients, the performance of metanephrine, normetanephrine, androstenedione, 17α-hydroxypregnenolone, and dehydroepiandrosterone was non-inferior to cortisol, correctly identifying 95% (52/55), 93% (51/55), 91% (50/55), 87% (48/55), and 89% (49/55) of cases, respectively. However, among these patients, there were no statistically significant differences in the success rate of intubation in AVS and the ability to identify patients with unilateral primary aldosteronism between the five indicators and cortisol (all P>0.05). Using cortisol-based lateralization as the reference standard, androstenedione and dehydroepiandrosterone both achieved an accuracy of 90% (84/93) for determining the lateralized side, while 17α-hydroxypregnenolone, normetanephrine, and metanephrine achieved accuracies of 89% (83/93), 81% (74/93), and 80% (73/93), respectively. Conclusion:Metanephrine, normetanephrine, androstenedione, 17α-hydroxypregnenolone and dehydroepiandrosterone could increase the success rate of intubation in AVS, with a high ability to identify patients with unilateral primary aldosteronism, and are expected to replace cortisol as new indicators of AVS.

OBJECTIVE： To evaluate the literature quality of systematic reviews/Meta-analysis of oral administration of traditional Chinese medicine （TCM） in the treatment of lumbar disc herniation （LDH） using radar plot， and to provide scientific and effective evidence for clinical use of medicine. METHODS： Retrieving CNKI， VIP， Wanfang database， CBM， PubMed， Cochrane library and Embase during the establishement of database to Oct. 1st， 2018， the literatures about systematic reviews/Meta-analysis of oral administration of TCM in the treatment of LDH were collected. After data extraction of literatures met inclusion criteria， the quality literatures were evaluated from 6 aspects of radar plot （year of publication， design type， AMSTAR methodological quality evaluation， PRISMA reprot quality evaluation， homogeneous， publication bias risk）. The average score of rank number was calculated. Moreover， Excel 2010， Adobe Illustrator CC and other software were used to draw and optimize the radar plot. RESULTS： A total of 6 qualified literatures were included； average score of rank number of 6 aspects were 3.83， 4.67， 3.83， 3.67， 6.00， 4.67， scoring 4.56 in average. Multivariate evaluation of radar plot showed that 2 studies had higher qualities and only 1 study had lower qualities relatively. However， problems could be found such as information selection bias， inclusion and exclusion criteria， publication situation， limitations， project registration. CONCLUSIONS： The literature quality of systematic review/Meta-analysis of oral administration of TCM in the treatment of LDH need to be improved， starting with strengthening methodological quality and reporting quality. Radar plot is a visual and effective method of graphic evaluation， which is worth popularizing and applying in the future.

Objective To compare the effects of combined aerobic and resistance training(RT)versus aerobic training (AT) alone on glucose control and risk factors for complications in type 2 diabetic patients.Methods The database was retrieved from PubMed,EMBASE,the Cochrane Library and SportDicus.The randomized controlled trials (RCTs) of CT versus AT on type 2 diabetic patients were included.The data were analyzed with RevMan5.1.Results Six RCTs were included.The meta-analysis showed that compared with AT,CT improved glucose control,blood lipids,and decreased abdoninal fat.The difference of CT versus AT on blood pressure was not found.Conclusions The impact of CT on type 2 diabetic patients is better than AT.

OBJECTIVETo study the correlation of Pinellia ternata agglutinin (PTA) and toxicity of P. ternata raphides and to find out the toxic mechanism of P. ternata.

METHODPTA has obvious effect of pro-inflammation. The model of rats peritonitis was used to study the dose-toxicity and time-toxicity relationship of the effect by detecting the releases of inflammatory mediators PGE2 in the exudates. The model of Draize rabbit eye test was applied to determine the correlation of PTA and toxicity of raphides by pathological examination.

RESULTPTA enhanced the content of PGE2 and protein in rats peritoneal cavities concentration dependently. With PTA concentration increased, PTA enhanced the inflammation induced by raphides to rabbit eyes, but PTA alone had no toxicity response.

CONCLUSIONPTA had obvious effect of pro-inflammation. The toxic mechanism of P. ternata was PTA induced inflammation only when the raphides pierce into the organization.

Agglutinins ; chemistry ; toxicity ; Animals ; Eye ; drug effects ; Inflammation ; chemically induced ; Male ; Pinellia ; chemistry ; Rabbits ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study and compare the changes of toxicity of Euphorbia pekinensis, E. kansui and E. ebracteolata before and after being prepared by vinegar.

METHODSmall intestinal accentuation of mice and peritoneal macrophage NO release experiments were assessed to investigate the changes of toxicity of the three Chinese Medicines of Euphorbia before and after being prepared.

RESULTE. pekinensis, E. kansui and E. ebracteolata and vinegar can obviously promot small intestinal accentuation and peritoneal macrophage NO release with the intensity of toxicity in the order of E. kansui > E. pekinensis > E. ebracteolata. After being prepared with vinegar, the toxicity of the three medicines decreased obviously compared to crude one.

CONCLUSIONE. pekinensis, E. kansui and E. ebracteolata can induce inflammation and accelerate enterokinesis. After being prepared with vinegar, the irritation on Euphorbia decreased obviously.

Acetic Acid ; chemistry ; Animals ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; toxicity ; Euphorbia ; chemistry ; toxicity ; Female ; Intestine, Small ; drug effects ; metabolism ; Macrophages, Peritoneal ; drug effects ; metabolism ; Male ; Medicine, Chinese Traditional ; Mice ; Mice, Inbred ICR ; Nitric Oxide ; analysis ; metabolism ; Plant Roots ; chemistry ; toxicity ; Toxicity Tests

OBJECTIVETo explore new toxicity-reducing methods of Pinellia Rhizoma prepared by ethanol and the latest technical parameters.

METHODPinellia Rhizoma is prepared with ethanol. The orthogonal experimental design was adopted for investigating amount of ethanol, preparing time, ethanol concentration and preparing temperature. The optimal technology was determined by the comprehensive score of toxicological indicators of PGE2 content of rat celiac percolate, with the rabbit conjunctival irritation test as the intuitive validation on toxicology reduction. The pharmacodynamics validation was used to determine the reasonability of the preparation process.

RESULTThe optimal technology was that Pinellia Rhizoma was prepared by 75% ethanol at the temperature of 60 degrees C by 4 days, and then dried. The effect of relieving cough, reducing sputum and anti-inflammatory of Pinellia Rhizoma is not reduced after prepared by ethanol.

CONCLUSIONThe optimal technology of Pinellia Rhizoma prepared by ethanol is simple and reasonable that it can be used as the new method to reduce toxicity and keep efficacy of Pinellia Rhizoma.

Animals ; Anti-Inflammatory Agents ; chemistry ; isolation & purification ; pharmacology ; Cough ; drug therapy ; Desiccation ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Ethanol ; chemistry ; Female ; Hot Temperature ; Male ; Mice ; Mice, Inbred ICR ; Pinellia ; chemistry ; toxicity ; Plants, Medicinal ; chemistry ; toxicity ; Rabbits ; Rats ; Rats, Sprague-Dawley ; Rhizome ; chemistry ; toxicity ; Sputum ; drug effects ; Technology, Pharmaceutical ; methods ; Time Factors ; Toxicity Tests

Objective To assess the effects of artificial cordyceps sinensis(Jin shuibao) on the numbers of podocytes and epithelial-mesenchymal transition in diabetic rats.Methods Diabetes was induced by intraperitoneal injection of low dose streptozocin.Sprague-Dawley rats were randomly divided into three groups:control group (CON),diabetic model group(DM),and artificial cordyceps sinensis treatment group(CS).After intervention for 8 weeks,the numbers of podocytes were estimated hy immunohistochemistry.The expressions of nephrin,desmin,and monocyte chemoattractant protein-1 (MCP-1) were detected.Results Compared with control group,DM group showed significantly decreased podocyte numbers and nephrin mRNA,with increased desmin and MCP-1 levels(P＜0.05).While the numbers of podocytes and nephrin mRNA were increased,and the expressions of desmin and MCP-1 were decreased in CS group as compared with those in DM group (all P＜0.05).Conclusions Artificial cordyceps sinensis notably improves epithelial-mesenchymal transition of podocytes,and increases the number of podocytes in diabetic rats.