ABSTRACT
Von Hippel-Lindau (VHL) syndrome, also known as cerebral retinal angiomatosis, is a kind of neuroendocrine tumor. The incidence rate is high, and the heredity is very high, which can involve the retina, central nervous system, various organs and various tissue parts. This paper reports a case of VHL syndrome with hypertension and diabetes as the main manifestations, in order to improve the understanding of the disease and reduce misdiagnosis and missed diagnosis.
ABSTRACT
Objective To analyze the clinical characteristics of pheochromocytoma crisis (PCC). Meth-ods Data of 123 cases of pheochromocytoma and paraganglioma (PPGL) admitted from Apr. 2011 to Feb. 2017 were retrospectively analyzed and they were divided into crisis group and noncrisis group according to the pa-tients with or without haemodynamic instability and end-organ damage. The differences of demographics charac-teristics, presentations, laboratory tests, imaging findings, perioperative clinical conditions and pathological fea-tures were compared between the two groups. Results ①16 cases were enrolled into crisis group, among whom 5 were misdiagnosed, while 107 cases were enrolled into noncrisis group. ②Compared with noncrisis group, the incidence of headache, palpitation, sweating, the classic triad, other presentations of PPGL, severe hypertension and hypotension were higher, and more patients had paroxysmal hypertension and admitted to our hospital for paroxysmal presentations in crisis group (P<0.05). ③Leukocyte, fasting blood glucose, liver transaminases, tro-ponin and D-dimmer were higher, while estimated glomerular filtration rate(eGFR) was lower, more tumors locat-ed in the left of adrenal in crisis group(P<0.05). ④ Patients in crisis group had higher plasma free metanephrines (MNs), larger maximal tumor diameter, higher enhanced CT value in each period, more benign tumors and hem-orrhage or necrosis in the tumors, but all the differences were not significant when compared with the noncrisis group. ⑤Patients in crisis group were more likely to undergo elective surgery. However, there was no difference in the preoperative time of α-blockade, type of surgery, intraoperative and postoperative complications, mortality a-mong the two groups. Conclusions PCC is a rare endocrinological emergency with a highly variable manifesta-tions, which commonly presents with typical triad, with higher incidence of hemodynamic instability and end-organ damage. Although biochemical and imaging examinations are relatively effective in the diagnosis of PCC, the mis-diagnosis remains inappropriate high. Once the diagnosis is established, clinicians should timely start drug prepa-ration while surgical resection is the key to the treatment of PCC.
ABSTRACT
Objective@#To analyze the clinical characteristics of pheochromocytoma crisis (PCC) .@*Methods@#Data of 123 cases of pheochromocytoma and paraganglioma (PPGL) admitted from Apr. 2011 to Feb. 2017 were retrospectively analyzed and they were divided into crisis group and noncrisis group according to the patients with or without haemodynamic instability and end-organ damage. The differences of demographics characteristics, presentations, laboratory tests, imaging findings, perioperative clinical conditions and pathological features were compared between the two groups.@*Results@#①16 cases were enrolled into crisis group, among whom 5 were misdiagnosed, while 107 cases were enrolled into noncrisis group. ②Compared with noncrisis group, the incidence of headache, palpitation, sweating, the classic triad, other presentations of PPGL, severe hypertension and hypotension were higher, and more patients had paroxysmal hypertension and admitted to our hospital for paroxysmal presentations in crisis group (P<0.05) . ③Leukocyte, fasting blood glucose, liver transaminases, troponin and D-dimmer were higher, while estimated glomerular filtration rate (eGFR) was lower, more tumors located in the left of adrenal in crisis group (P<0.05) . ④ Patients in crisis group had higher plasma free metanephrines (MNs) , larger maximal tumor diameter, higher enhanced CT value in each period, more benign tumors and hemorrhage or necrosis in the tumors, but all the differences were not significant when compared with the noncrisis group. ⑤Patients in crisis group were more likely to undergo elective surgery. However, there was no difference in the preoperative time of α-blockade, type of surgery, intraoperative and postoperative complications, mortality among the two groups.@*Conclusions@#PCC is a rare endocrinological emergency with a highly variable manifestations, which commonly presents with typical triad, with higher incidence of hemodynamic instability and end-organ damage. Although biochemical and imaging examinations are relatively effective in the diagnosis of PCC, the misdiagnosis remains inappropriate high. Once the diagnosis is established, clinicians should timely start drug preparation while surgical resection is the key to the treatment of PCC.
ABSTRACT
AIM: To investigate the effects of atorvastatin calcium on vascular endothelial cells and circulating endothelial progenitor cells (CEPCs) in hypertensive rats. METHODS: Renal hypertension rat model was constructed with two-kidney-one-clip technique. Twenty-four male SD rats were randomized into hypertension group, statins group and sham-operated group (n=8 each). On the 4th week, the animals in statins group were injected with 20 mg·kg~(-1)·d~(-1) atorvastatin calcium intra-abdominally for 8 weeks. Blood pressure and blood lipid were measured at 4th and 12th week post-operation. On the 12th week, scanning electron microscopy was used to observe the damage of aortic endothelial cells. The circulatory endothelial cell count, CEPCs count, CEPCs proliferation ability, CEPCs adhesion ability and CEPCs apoptosis were also measured. RESULTS: The injury of endothelial cells in statins group was observed, milder than that in hypertension group, but worsen than that in sham-operated group. The numbers of circulatory endothelial cells in hypertension group, statin treatment group and sham-operated group were 5.9×10~6, 3.9×10~6 and 2.0×10~6 respectively, and the CEPCs apoptosis rate was 22.1%±2.1%, 13.4%±1.6 %and 7.4%±1.3%, respectively. Meanwhile, the numbers of CEPCs were 21.63±2.33, 40.38±6.00 and 65.38±2.97, respectively, the proliferative abilities of CEPCs were 0.13±0.01, 0.17±0.01 and 0.29±0.03, respectively, and the adhesion of CEPCs was 12.25±2.49, 21.50±2.20 and 28.88±2.85, respectively. CONCLUSION: (1) The severity of vascular endothelial cell injury is related to hypertension states. (2) Atorvastatin calcium has direct protective effects on endothelial cells, possibly through increasing CEPCs count, reducing CEPCs apoptosis and markedly enhancing reparation ability of CEPCs to endothelial cells.
ABSTRACT
BACKGROUND:The quantity and function reduction of circulating endothelial progenitor cells(CEPCs)indicate that vascular endothelial repair capacity reduces in hypertension patients,but the impact of statins on the CEPCs is still not very clear.OBJECTIVE:To investigate the effects of atorvastatin calcium on endothelial cells and CEPCs in renovascular hypertensive rats.DESIGN,TIME AND SETTING:Randomized controlled animal experiment was performed in Chongqing Key Laboratory ofNeurology from June 2008 to Febmary 2009.MATERIALS:Totally 24 SD male rats of SPF grade,and atorvastatin calcium was produced by Lipitor,Pfizer Inc.with batch number of 65837003.METHODS:The renovascular hypertension was induced with 2-kindey and 1-clip method in 16 SD rats,which were then randomly divided into two groups:hypertensive group(n=8)and statins group(n=8).control group(n=8)underwent the same operation,without silver slip.At 4 weeks after model construction,statins group was treated with atorvastatin calcium MAIN OUTCOME MEASURES:At 4 and 12 weeks of the experiment.three groups of rats were measured blood pressure and blood lipids;at 12 weeks,the thoracic aortic endothelial cells continuity was investigated through hematoxylin-eosin stain;the quantity,proliferation,adhesion and migration capacity of CEPCs were determined.RESULTS:At 4 and 12 weeks of the experiment,there was no significant differences in the systolic pressure between statins RESULTS:At 4 and 12 weeks of the experiment,there was no significant differences in the systolic pressure between statins group group and model group,which were dramatically high than control group(P＞0.01):the blood lipids in the statins group was not changed.In the model group,rat aortic endothelial cells were greatly damaged;the injury of CEPCs was dramatically relieved in the model group.Compared with statins group and control group,the number of CEPCs was significantly decreased,the capacities of proliferation,adhesion and migration were also significantly reduced in the model group(P＜0.01);moreover,statins group was inferior to control group in terms of these capacities.with significant differences among three groups(P＜0.01).CONCLUSION:Renovascular hypertensive rats thoracic aortic endothelial calls are severely damaged,CEPCs decline in the humber and function;atorvastatin calcium can increase the number of CEPCs and improve the function of CEPCs.
ABSTRACT
Objective To investigate effect of Xuezhikang capsule (a statin product from Chinese Herbs)or pravastatin (a chemosynthesis statin) combined with antihypertensive drugs on the serum levels of NO,ET,hs-CRP,IL-1 and TNF-? in essential hypertensive (EH) patients.Methods Thirty healthy individuals were enrolled as normal control.One hundred and fifty EH patients admitted in our departments from Dec.2006 to Jun.2008 were enrolled and randomly divided into 3 groups,the antihypertensive drugs treatment group (ATH group,n=50),the pravastatin treatment group (PRA group,n=50) and the Xuezhikang treatment group (XZK group,n=50).Patients in the 3 groups were treated with routine antihypertensive drugs,in addition,pravastatin (20 mg every night) and Xuezhikang (0.6 g/time,twice a day) were given to PRA group and XZK group respectively.Serum NO,ET,hs-CRP,IL-1 and TNF-? were detected before and after eight-week treatment.Results Compared with healthy individuals,serum NO was decreased (P
ABSTRACT
Objective To investigate the relationship between Lys198Asn and Taq Ⅰ polymorphisms of endothelin-1 gene and essential hypertension in Chongqing residents.Methods Polymorphisms of Lys198Asn and TaqⅠ were detected in the blood samples from 86 patients with essential hypertension(HT) and 138 normotensive controls(NT) by sequence specific primer-polymerase chain reaction(SSP-PCR) and PCR-restriction fragment length polymorphism(PCR-RFLP).Results In the BMI
ABSTRACT
<p><b>OBJECTIVE</b>To observe reversal of ventricular remodeling by the protein kinase C inhibitor Scutellarein in spontaneously hypertensive rats (SHRs).</p><p><b>METHODS</b>Twelve SHRs were randomly divided into two groups. Scutellarein and saline (10 mg x kg(-1) x d(-1)) were given by intraperitoneal injection to two groups of rats separately. Systolic blood pressure (SBP) and ventricular weight index (LVW/BW, RVW/BW) were measured. A polarization microscope and an image analyzer system (IAS) were used to observe changes in cardiovascular structure and to count the content of cardiac muscle interstitial collagen.</p><p><b>RESULTS</b>The pathologic changes in the left ventricle in the Scutellarein group rats (SHR(D)) improved to varying degrees, including hypertrophy of the cardiac muscle and collagen volume fraction.</p><p><b>CONCLUSION</b>Scutellarein can reverse ventricular remodeling, improve myocardial stiffness and protect heart cardiac muscle.</p>