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We report a case of primary hyperparathyroidism(PHPT) with depressive symptoms as initial manifestation. Literature review was conduct to further analyze the etiology, clinical manifestations, diagnosis, treatment and prognosis of the disease. The initial symptoms of the patients was the mental system depression and kidney stones was found by physical examination. She first visited a doctor in the urology department after a kidney stones was found. Blood calcium 2.86 mmol/L was found. At second visit, a doctor from endocrinology department conducted a comprehensive examination on the patient′s coexisting mental and renal system symptoms, clearly identified, her as PHPT. The clinical manifestations of PHPT are diverse. Symptoms such as depression, anxiety, mood swings, etc. are rarely evaluated. PHPT patients with onset or accompanied by psychiatric symptoms should be paid attention to by doctors, Measures should be taken to improve the quality of life and prognosis of patients through early screening of blood calcium and parathyroid hormone for timely diagnosis.
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Objective:Our previous micro-array study revealed that long non-coding RNA (lncRNA), such as ENST00000538790 and NR_125790, were differently expressed in parathyroid carcinoma compared with those in parathyroid adenoma. Diagnostic value of lncRNAs (ENST00000538790 and NR_125790) and scoring models derived from these lncRNAs in parathyroid carcinoma were investigated in this study.Methods:Fifty-seven fresh tissue samples from patients with hyperparathyroidism were collected. Eleven patients were diagnosed with parathyroid carcinoma, while 46 patients were found with parathyroid adenoma. The expression levels of five lncRNAs (ENST00000511928, ENST00000538790, ENST00000618339, NR_125790, and ENST00000485384) were detected with realtime quantitative PCR (RT-qPCR). LncRNA scores were calculated using these lncRNAs, and their value in parathyroid carcinoma diagnosis were also assessed.Results:It was found that expression levels of ENST00000511928 and ENST00000538790 were up-regulated in parathyroid carcinoma compared with parathyroid adenoma ( P<0.05), while the levels of ENST00000618339, NR_125790, and ENST00000485384 were decreased in parathyroid carcinoma ( P<0.05). Among these lncRNAs, ENST00000538790 and NR_125790 were independent risk factors for parathyroid carcinoma ( P<0.05). Hence, "log score" and "logistic score" were calculated with ENST00000538790 and NR_125790 levels. The areas under the receiver operating characteristic curve for "log score" and "logistic score" were up to 0.935 and 0.943 respectively in parathyroid carcinoma ( P<0.05), and were found to be greater than those from single lncRNA or classic clinical indices, such as serum calcium ( P<0.05). Conclusion:LncRNA scores with lncRNA ENST00000538790 and NR_125790 may play potential role in diagnosis of parathyroid carcinoma.
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Objective@#To evaluate the clinical characteristics and preoperative predictive factors in patients with parathyroid carcinoma.@*Methods@#From January 2010 to December 2016, 150 patients with pathologically and biochemically confirmed primary hyperparathyroidism were enrolled in this study. The clinical data were reviewed to define 28 cases of parathyroid hyperplasia, 14 cases of parathyroid carcinoma (PC), and 108 cases of parathyroid adenoma (PA). The clinical characteristics between PC and PA group were compared and analyzed to explore predictive factors for PC.@*Results@#Patients in PC group were significantly younger than those in PA group (47.9±13.9 vs 57.2±14.6 years, P=0.026). The diameter of tumor in PC group was larger than that in PA group (3.6±1.8 vs 2.2±1.4 cm, P=0.005). The levels of albumin-corrected serum calcium, parathyroid hormone (PTH), and alkaline phosphatase (AKP) were all higher in PC group than those in PA group (3.4±0.6 vs 2.9±0.3 mmol/l; 1 157.1 vs 201.6 pg/ml; 168 vs 97 IU/L; all P<0.05). PC correlated with age(r=-0.241, P=0.007), albumin-corrected serum calcium (r=0.324, P<0.001), PTH levels (r=0.301, P=0.001), serum AKP (r=0.217, P=0.019) and tumor size(r=0.238, P=0.011). Receiver operator characteristic curve analysis showed that the optimum cut-off values as follows: albumin-corrected serum calcium 3.15 mmol/L, serum PTH concentration 1 011 pg/ml and tumor diameter 3.35 cm. These indicators can be helpful in the preoperative diagnosis of PC.@*Conclusions@#Patients with PC were younger than the patients with PA. Albumin-corrected serum calcium, serum PTH concentration, and tumor diameter can be helpful in preoperative diagnosis of PC.
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To explore the impact of gender on presentation of primary hyperparathyroidism (PHPT), clinical data of 150 histopathologically proven PHPT patients were collected and retrospectively analyzed. Most of the patients (72.0％) were parathyroid adenoma (PA), and 9.3％of them were parathyroid carcinoma (PC). In PA patients, albumin-corrected serum calcium levels (TASC) were lower in women than in men [(2.84±0.28)mmol/L vs.(3.03±0.34)mmol/L, P=0.006 ]. In all PHPT subjects, serum urea nitrogen, creatinine, uric acid levels were lower in women than in men. Bone pain was more frequent in women over 50 years old than in men (52.33％vs.29.17％, P=0.045). The incidence of PC was higher in men than in women (20.59％ vs. 6.03％, P=0.010). In conclusion, there are gender differences in the clinical presentation of PHPT. TASC was high in men with PA compared to women with PA. Bone pain was more common in the woman patients over 50 years old, and PC was more common in men.
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Objective To compare and analyze the metabolic control with the islet B cell function and the diabetic complications after a 3-year treatment in type 2 diabetic patients.Methods The T2DM patients were investigated who finished 3 years of treatment.The following measurements or determination was done:height,weight,waist,hips,blood pressure at standing and lying position,fasting glucose and insulin,glucose and insulin 2 h after taking food,HbA_1c,TC,TG,HDL-C,LDL-C,Cr,albuminuria and retinopathy.Results Totally 233 male and 178 female(56.53?10.33)yrs patients were analysized.The hypotensive,hypoglycemic and lipids agents were increased obviously and the number of the patients with insulin treatment increased too.HbA_1c was decreased,but no significant differences for the blood pressure and blood cholesterol,triglycerides after 3-year treatment.The fasting and post-meal insulin level,insulin resistance and the B-cell function index decreased significantly.Meanwhile,the patients with albuminuria and retinopathy increased from 15% and 26% to 23% and 33%.Conclusion Type 2 diabetic patients have not controlled the blood glucose,lipids and the blood pressure satisfactorily even if the agents for the blood sugar,lipids and blood pressure lowing are increased.Insulin resistance decreases but B cell function failure aggravates.The intensified therapy on the target should be paid more attention to.
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Objective To investigate the prevalence rates of diabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and related factors in the university staff. Methods 617 subjects were selected from 1 519 cases with the fasting blood glucose level ≥5.6 mmol / L in the annually physical examination among 3 851 population in a university community. All 617 subjects were taken the blood glucose and insulin test for the fasting and 2 hour after 75 g glucose intake. The fasting lipids, BUN and Cr were determined. The demographic data including height, weight, waist circumference and blood pressure was also collected. Results The numbers of normal glucose tolerance (NGT), IFG, IGT, IFG+IGT and newly diagnosed DM were confirmed in 374 (60.62%), 60 (9.72%), 59 (9.56%), 41 (6.65%) and 83 (13.45%); totally, 243 (39.38%) cases with abnormal glucose metabolism. The highest DM prevalence was found in the group with BMI ≥28 kg / m2. In the group with hypertriglyceridemia, prevalence of DM, IFG and IFG +IGT was 12.50%, 8.33% and 8.33%. In the group with hypercholesteremia and hypertriglyceridemia together, prevalence of DM, IFG+IGT, IFG and IGT was 18.87%, 7.17%, 11.32% and 12.83%. DM prevalence increased with the higher triglycerides level. No differences of HOMA-IR was found among groups of DM (0.80?0.82), IFG (0.64?0.72), IFG+IGT (0.61?0.77), IGT (0.35?0.68), but all these obviously higher than that of NGT group (0.17?0.80). No differences of HOMA-B among the IGT (3.97?0.69), NGT (3.95?0.78), IFG (3.84?0.72), IFG+IGT (3.80?0.78) groups, but all these higher than that of NGT(3.69?0.88)group. Conclusion About 40% of these subjects in the university population had their blood glucose ≥5.6 mmol/L. In these subjects with blood glucose ≥5.6 mmol/L, about 40% of them had abnormal blood glucose level, including 13.45% diabetic patients. The highest prevalence of IFG, IGT, IFG+IGT was found in the group aged 60～70, the highest prevalence of DM in the group aged 70～80 and increased paralleled with the BMI and aging, was associated with lipids disorder, particularly with hypertriglyceridemia. IR existed in the pre-diabetes state and was worst in the DM, with most severe ? cell function failure.