Establishment and validation of a nomogram-based predictive model for idiopathic aldosteronism / 中华内科杂志

Objective: To establish and validate a nomogram-based predictive model for idiopathic hyperaldosteronism (IHA). Methods: This cross-sectional study was conducted with the collected clinical and biochemical data of patients with primary aldosteronism (PA) including 249 patients with unilateral primary aldosteronism (UPA) and 107 patients with IHA, who were treated at the Department of Endocrinology of the First Affiliated Hospital of Chongqing Medical University from November 2013 to November 2022. Plasma aldosterone concentration (PAC) and plasma renin concentration (PRC) were measured by chemiluminescence. Stepwise regression analysis was applied to select the key predictors of IHA, and a nomogram-based scoring model was developed. The model was validated in another external independent cohort of patients with PA including 62 patients with UPA and 43 patients with IHA, who were diagnosed at the Department of Endocrinology, First Affiliated Hospital of Zhengzhou University. An independent-sample t test, Mann-Whitney U test, and χ2 test were used for statistical analysis. Results: In the training cohort, in comparison with the UPA group, the IHA group showed a higher serum potassium level [M(Q1, Q3), 3.4 (3.1, 3.8) mmol/L vs. 2.7 (2.1, 3.1) mmol/L] and higher PRC [4.0 (2.1, 8.2) mU/L vs. 1.5 (0.6, 3.4) mU/L] and a lower PAC post-saline infusion test (SIT) [305 (222, 416) pmol/L vs. 720 (443, 1 136) pmol/L] and a lower rate of unilateral adrenal nodules [33.6% (36/107) vs. 81.1% (202/249)]; the intergroup differences in these measurements were statistically significant (all P<0.001). Serum potassium level, PRC, PAC post-SIT, and the rate of unilateral adrenal nodules showed similar performance in the IHA group in the validation cohort. After stepwise regression analysis for all significant variables in the training cohort, a scoring model based on a nomogram was constructed, and the predictive parameters included the rate of unilateral adrenal nodules, serum potassium concentration, PAC post-SIT, and PRC in the standing position. When the total score was ≥14, the model showed a sensitivity of 0.65 and specificity of 0.90 in the training cohort and a sensitivity of 0.56 and specificity of 1.00 in the validation cohort. Conclusion: The nomogram was used to successfully develop a model for prediction of IHA that could facilitate selection of patients with IHA who required medication directly.

Comparison of surface markers of mesenchymal stem cells from different sources / 解剖学报

Objective To investigate the expression difference of surface markers of human umbilical cord mesenchymal stem cells (HUCMSCs), human adipose mesenchymal stem cells (ADSCs) and human fetal blood source endometrial mesenchymal stem cells (MenSCs) and the changes of surface markers with the culture generation. Methods HUCMSCs, ADSCs and MenSCs were cultured to passage 3, 6, 9 and 12. Five MSC-specific markers, CD29, CD44, CD73, CD90 and CD 105, and one HSC markers, CD45, were assessed by flow cytometry and immunofluorescence. Results The cultured MenSCs and HUCMSCs were spindle-shaped, and the ADSCs forms were mainly spindle-shaped and multiple-angular. The results of flow cytometry showed that the MSC-positive markers including CD29, CD44, CD73 and CD105 were highly expressed by at least 95% in the passage 3 HUCMSCs, ADSCs and MenSCs cells and CD45 negative expression. Specifically, CD90 levels of MenSCs of passage 3 was (72. 43 ± 0. 7 6) %, which was lower than that in HUCMSCs (99.67±0. 12)% and ADSCs (99. 70 ± 0. 15)% (P 0. 05). The results of immunofluorescence was consistent with those of flow cytometry. Conclusion With the increase of culture time, HUCMSCs, ADSCs and MenSCs are stable in high expression of CD29, CD44, CD73, CD90 and CD 105, which does not express CD45, while the CD90 expression rate of MenSCs is lower than that in HUCMSCs and ADSCs.