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Objective:To explore the value of adrenocorticotrophic hormone (ACTH) stimulation in adrenal vein sampling (AVS) with its effect on the sampling success rate and lateralization determination.Methods:The clinical data of 54 patients with primary aldosteronism (PA) who underwent AVS in Nanjing Drum Tower Hospital from July 2018 to June 2020 were collected retrospectively. Blood samples from bilateral adrenal veins were collected simultaneously at baseline and after ACTH stimulation. The selectivity index (SI), lateralization index (LI), and relative aldosterone secretion index (RASI) were examined.Results:The concentration of serum cortisol level in left and right adrenal vein and peripheral vein increased significantly after ACTH stimulation ( P<0.001). SI of left adrenal vein increased from 18.00 (2.29, 20.29) to 34.76 (12.10, 46.86) , and the SI of right adrenal vein increased from 26.61(5.24, 31.85) to 28.40 (27.65, 56.05, P<0.001). The bilateral vein sampling success rate increased from 80%(43/54) to 93%(50/54). LI decreased from 2.85(1.78, 6.20) at baseline to 2.45(1.40, 6.10) after ACTH stimulation without significant difference( P>0.05). Eleven patients who identified unilateral secretion at baseline demonstrated bilateral after ACTH stimulation, and the RASI of these patients decreased from 0.50 (0.38, 1.25 ) to 0.37 (0.22, 0.84, P=0.019). Conclusion:ACTH stimulation significantly increased SI and the AVS success rate in patients with PA: ACTH stimulation decreased the relative aldosterone secretion in the dominant side of some patients with aldosterone producing adenoma, thus reduced the proportion of identified unilateral PA.
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Objective@#The present study investigated the prevalence of Internet addiction in Shenzhen adolescents and its predicative factors, so as to provide a reference for precisely identifying the adolescents of internet addiction and conducting intervention.@*Methods@#Cluster random sampling method was applied to select the middle school students of grade 1 in 5 middles schools in Shenzhen. Three waves of data were collected over 3 years from students in 5 secondary schools in Shenzhen. Young s 10 item Internet Addiction Test, Chinese Positive Youth Development Scale, Chinese Family Assessment Instrument, Academic Maladaptation Scale and Demographic Variables Questionnaire were used, and finally the data of 1 301 students was proved to be valid.@*Results@#The adolescents met the criterion of Internet addiction were 14.4%, 15.5% and 14.7% over past three years. The incidence of Internet addiction was stable among teenagers during the three years( F =2.53, P =0.08); The multivariate linear regression analysis showed that positive youth development, good family functioning indicators and academic maladaptation could predict the higher probability of having Internet addiction( P <0.05).@*Conclusion@#The phenomenon of Internet addiction among teenagers in Shenzhen junior middle school is common and relatively stable. The teenagers from the family of positive function, with positive development and with less academic maladaptation are less likely to suffer from internet addiction.
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Objective:The aim of this study was to examine the change of serum bone-derived hormones osteocalcin and lipocalin 2 (LCN2) level in patients with active acromegaly, and to further investigate the potential role of osteocalcin and LCN2 in glucose metabolism.Methods:Fifty consecutive patients diagnosed as acromegaly in Nanjing Drum Tower Hospital from December 2016 to August 2018 were recruited. Of those, 41 patients after operations with complete follow-up data were also included. 30 sex, age, and body mass index matched healthy persons as normal controls. Serum osteocalcin and LCN2 levels were compared between controls and patients with acromegaly, as well as at pre- and post- operation periods. Univariate and multivariate linear regression analyses were used to investigate the correlation between bone-derived hormones and glucose metabolism indexes and to determine the independent associations between variables.Results:Compared with normal controls, serum osteocalcin increased [(55.45±34.02 vs 19.46±6.69)ng/ml, P<0.01] and LCN2 levels decreased [(34.15±9.95 vs 57.50±29.75)ng/ml, P<0.01] in patients with acromegaly. Homeostasis model assessment for insulin resistance (HOMA-IR) was also elevated ( P<0.01), but homeostasis model assessment for β cell function (HOMA-β) and area under curve of insulin during 0-120 min of the oral glucose tolerance test (AUC INS) changed non-significantly in acromegaly compared to normal controls ( P>0.05). After operation, with the decrease of serum growth hormone (GH) and insulin-like growth factor 1 (IGF-1), serum osteocalcin level decreased [24.79(18.39, 32.59) vs 43.51(26.73, 65.66)ng/ml, P<0.01] and LCN2 level increased [(45.15±15.33 vs 37.03±9.73)ng/ml, P<0.05] significantly compare to pre-operation levels. In a multivariate linear stepwise regression analysis, lean mass was shown to be the only positive predictor for LCN2 ( β=0.44, P=0.015) and elevated serum IGF-1 was a positive predictor for osteocalcin ( β=0.512, P<0.01). In the multivariate models, low LCN2 ( β=-0.398, P=0.017) and elevated serum osteocalcin ( β=0.553, P=0.001) were predictors for AUC INS, osteocalcin was a positive predictor of HOMA- β ( β=0.519, P=0.004). GH ( β=0.294, P=0.029) and IGF-1( β = 0.428, P=0.002) were all identified as positive predictors of HOMA-IR during multivariate testing in acromegaly patients. Conclusions:Acromegaly patients had increased osteocalcin and decreased LCN2 serum levels, and corresponding alteration was detected with the correction of biochemical abnormalities. Serum osteocalcin and LCN2 were predictors of β-cell function in acromegaly patients. This study adds new evidence for the role of bone in regulating glucose metabolism in acromegaly.
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Graves'disease (GD) is the most common cause of hyperthyroidism, and its treatment includes anti-thyroid drugs (ATD), radioactive iodine therapy (RAI), and surgical treatment. ATD is the first choice for GD treatment in China, but the high recurrence rate limits its widely clinical application. The therapeutic strategy for patients with recurrent hyperthyroidism after ATD treatment is still controversial.
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Objective To lay the physiological and biochemical basis for establishing and evaluating tree shrews model of human disease. Methods There were 92 Tupaia belangeri chinensis, in which half of them were male,they were allowed to eat nothing for 12 hours, then we sampled heart blood 0.8~1.0 mL without anesthesia and put blood samples into sterilized centrifuge tube for separation and preparation of serum. Olympus AU5400 automatic biochemistry analyzer was used to measure biochemical indexes. Then 1.5~2.0 mL of urine of each tree shrew was collected and put into sterilized centrifuge tube for measuring renal function by using Combi-scan500 urine analyzer. Fianally SPSS statistics software was used to analyse the measured values, and comapared the measured values with the human reference values. Results There were significant differences in myocardial enzymes and some renal function indexes such as lactic dehydrogenase,α- hydroxybutyric, acid dehydrogenase, creatinine, uric acid, urine specific gravity and pH value between male and female Tupaia belangeri chinensis ( 0.05) . Then determination value of Tupaia belangeri chinensis, male’s and female’s, myocardial enzyme and part of the renal function indexes were compared with the human reference values. Some indexes including urea, urine specific gravity, urine, urobilinogen were in the range of human reference value, while the values of urine bilirubin, urine nitrite. lactate dehydrogenase, creatine kinase, α-hydroxybutyrate dehydrogenase, creatine kinase isoenzyme CKMB were higher than the human reference value. White blood cell, urine protein, ketone, occult blood most of them were negative as the same to human reference value, but sometimes were positive, and the positive rates respectively were 3.95%and 46.1%,39.5%,2.63%. The measured value of Vitamin C was positive that is completely opposite to human reference value, but sometimes is negative, the negative rate was 6.6%. Conclusion Urea, urine specific gravity, urine, urobilinogen, urine bilirubin, urine nitrite can be directly used as the indexes for evaluating tree shrews models of human disease, other indexes can be used as indexes for judgment of the normal physiological and biochemical basis of tree shrews.