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BACKGROUND@#Since the diagnostic value of aldosterone to renin ratio (ARR) calculated by plasma renin concentration (PRC) or plasma renin activity (PRA) is still inconclusive, we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA, so as to provide guidance for clinical diagnosis.@*METHODS@#We searched PubMed, Embase, and Cochrane Library from the establishment of the database to March 2021. We included studies that report the true positive, false positive, true negative, and false negative values for the diagnosis of primary aldosteronism, and we excluded duplicate publications, research without full text, incomplete information, or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.@*RESULTS@#The pooled results showed that ARR (plasma aldosterone concentration [PAC]/PRC) had a sensitivity of 0.82 (95% confidence interval [CI]: 0.78-0.86), a specificity of 0.94 (95% CI: 0.92-0.95), a positive-likelihood ratio (LR) of 12.77 (95% CI: 7.04-23.73), a negative LR of 0.11 (95% CI: 0.07-0.17), and symmetric area under the curve (SAUC) of 0.982, respectively. Furthermore, the diagnostic odds ratio (DOR) of ARR (PAC/PRC) was 180.21. Additionally, the pooled results showed that ARR (PAC/PRA) had a sensitivity of 0.91 (95% CI: 0.86-0.95), a specificity of 0.91 (95% CI: 0.90-0.93), a positive LR of 7.30 (95% CI: 2.99-17.99), a negative LR of 0.10 (95% CI: 0.04-0.26), and SAUC of 0.976, respectively. The DOR of ARR (PAC/PRA) was 155.52. Additionally, we conducted a subgroup analysis for the different thresholds (<35 or ≥35) of PAC/PRC. The results showed that the DOR of the cut-off ≥35 groups was higher than the cut-off <35 groups (DOR = 340.15, 95% CI: 38.32-3019.66; DOR = 116.40, 95% CI = 23.28-581.92).@*CONCLUSIONS@#The research results suggest that the determination of ARR (PAC/PRC) and ARR (PAC/PRA) was all effective screening tools for PA. The diagnostic accuracy and diagnostic value of ARR (PAC/PRC) are higher than ARR (PAC/PRA). In addition, within a certain range, the higher the threshold, the better the diagnostic value.
Subject(s)
Humans , Aldosterone , Area Under Curve , Hyperaldosteronism/diagnosis , Hypertension , ReninABSTRACT
Cytochrome P450 1A (CYP1A), one of the major CYP subfamily in humans, not only metabolizes xenobiotics including clinical drugs and pollutants in the environment, but also mediates the biotransformation of important endogenous substances. In particular, some single nucleotide polymorphisms (SNPs) for genes may affect the metabolic ability of endogenous substances, leading to some physiological or pathological changes in humans. This review first summarizes the metabolism of endogenous substances by CYP1A, and then introduces the research progress of SNPs, especially the research related to human diseases. Finally, the relationship between SNPs and diseases is discussed. In addition, potential animal models for gene editing are summarized. In conclusion, CYP1A plays an important role in maintaining the health in the body.
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Objective To study the effect of the long-term administration of hemocoagulasein vitro and in vivo,whether it may cause hypofibrinogenemia and changes of cytokine interleukin-6(IL-6) expression level which related to fibrinogen synthesis.Methods Totally 50 healthy subjects pooled plasma was chose in vitro experiments,which was divided into 7 groups.After that,added various of dilutions of injection hemocoagulase and incubated at 37 ℃,detected FIB concentration every 12 h.In vivo experiments,80 rats with six-week old were randomly divided into 4 groups:negative control group,high-dose group,middle-dose group,low-dose group,After 3 weeks administration,the serum level of Ⅴfactor,Ⅷ factor,PT,activated partial thromboplastin time (APTT),FIB,IL-6 was detected.Results Hemocoagulase in vitro had a strong role to reduce fibrin,and showed a significant dose-dependent and time-dependent;Hemocoagulase prolonged low-dose use might reduce the concentration of FIB in mice,but theⅤfactor,Ⅷ factor,PT,APTT,TT were not significantly affected.Compared with the negative control group,FIB and IL-6 concentration decreased in high-dose group,middle-dose group,low-dose group and had statistically significant differences (P<0.05);The level of FIB among the groups had statistically significant differences (P<0.05).The APTT of the middle and high dose groups was slightly prolonged,which was significantly different from that of the negative control group (P<0.05).Conclusion Hemocoagulase has a strong effect to reduce the concentration of fibrin,when there is a long-term medication,fibrin concentration of the patient should be closely monitored,hemocoagulase not only directly decomposed fibrin,but also may affect the synthesis of IL-6,the specific mechanism needs further study.
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Objective To establish a differently expressed genetic profile in placental tissues of pregnancy induced hypertension(PIH). Method The total RNAs were isolated from the tissues by Trizol and mRNA was purified by Midi Kit. The expression of 17 000 genes in placental tissues of 6 PIH and 5 normoten sive women were evaluated by cDNA array technique. Results Ninety-six differently expressed genes were identified in placental tissue of PIH compared with normal pregnancy cases. Seventy-eight genes were up-regulated and 18 were down-regulated. There were 6 unclassified genes, 8 unknown expressed sequence tag (EST) fragments and 3 cDNA fragments among these differently expressed genes. The differently expressed genes were involved in transcription and translation,cell differentiation,receptor,apoptosis,immune,metabolism and growth. Conclusion The cellular mechanism of PIH involves changes in genes expression in placental tissue. Microarray is a useful method to identify differently expressed genes in tissue.