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Objective:To evaluate postoperative biochemical and clinical remission rates in patients with unilateral primary aldosteronism and analyze related influencing factors.Methods:A total of 406 patients of primary aldosteronism with confirmed subtyping, who underwent adrenalectomy and completed follow-up in the Department of Endocrinology of the First Affiliated Hospital of Chongqing Medical University from November 2013 to March 2022 were retrospectively enrolled. Clinical and biochemical data were recorded. Postoperative clinical and biochemical outcomes were assessed according to Primary Aldosteronism Surgery Outcome(PASO) consensus.Results:Complete biochemical success was achieved in 391(96.31%) of 406 primary aldosteronism patients, while partial and absent biochemical success in only 4(0.99%) and 11(2.71%) primary aldosteronism patients; Complete clinical success was seen in 217(53.45%) patients, and partial clinical success in 189(46.55%) patients. Compared to the partial clinical success group, the complete clinical success group was younger, had a greater proportion of women, a smaller body mass index, a shorter duration of hypertension, a smaller daily defined dose value for antihypertensive medication, a higher estimated glomerular filtration rate(eGFR), and a lower proportion of family history of hypertension and diabetes mellitus. Multifactorial logistic regression analysis further showed that gender( OR=2.49, 95% CI 1.42-4.35, P=0.001), body mass index( OR=1.16, 95% CI 1.05-1.28, P=0.003), antihypertensive drug daily defined dose( OR=1.83, 95% CI 1.37-2.44, P<0.001), family history of hypertension( OR=2.16, 95% CI 1.22-3.83, P=0.008), history of diabetes( OR=2.47, 95% CI 1.15-5.29, P=0.021), and eGFR( OR=0.98, 95% CI 0.97-0.99, P=0.001) were independent factors influencing clinical prognosis of primary aldosteronism. Conclusion:The postoperative complete biochemical success is higher in patients with unilateral primary aldosteronism, but only about half of all patients achieve complete clinical success.
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Objective:To explore the application effect of the multidisciplinary diagnosis and treatment nursing in improving postoperative anxiety and depression and quality of life in patients with lateral skull base tumor, so as to provide a constructive template for the multidisciplinary diagnosis and treatment nursing.Methods:This was a prospective cohort study design. A total of 100 patients who underwent lateral skull base tumor surgery in Shandong Second Provincial General Hospital from January 2021 to April 2022 were selected as the research objects. The patients were divided into observation group and control group by random digits table method with 50 cases in each group. The control group was given routine nursing care after operation of lateral skull base tumor and routine follow-up management. The observation group received the multidisciplinary diagnosis and treatment nursing on the basis of the control group. The intervention time was 3 months. The psychological state and quality of life of the two groups before and after intervention were evaluated by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Short Form Health Questionnaire (SF-36).Results:There was no significant difference in SAS, SDS, and SF-36 scores before intervention between the two groups ( P>0.05). The scores of SAS, SDS and SF-36 after the intervention were (44.58 ± 5.61), (41.66 ± 8.48), (75.66 ± 13.65) points in the observation group, and (50.86 ± 4.91), (45.80 ± 9.32), (68.43 ± 14.34) points in the control group, there were statistically significant differences between the two groups( t values were -5.95, -2.32, 2.58, all P<0.05). Conclusions:The multidisciplinary diagnosis and treatment nursing can significantly improve anxiety, depression and quality of life of patients with lateral skull base tumor after surgery.
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Breast cancer is one of the most common malignant tumors in women, and its morbidity is increasing gradually in recent years. Precision treatment has been developed with individualized and standardized protocols according to the molecular classification of breast cancer. Targeted therapy is one of the most important methods. How to evaluate targeted therapy is the focus of attention. PET/CT plays an im-portant role in the diagnosis, staging, treatment plan and evaluation of therapeutic effect and prognosis, es-pecially in targeted therapy of breast cancer. This review summarizes the applications of PET/CT in targeted therapy of breast cancer.
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Breast cancer is one of the most common malignant tumors in women, and its morbidity is increasing gradually in recent years. Precision treatment has been developed with individualized and standardized protocols according to the molecular classification of breast cancer. Targeted therapy is one of the most important methods. How to evaluate targeted therapy is the focus of attention. PET/CT plays an im-portant role in the diagnosis, staging, treatment plan and evaluation of therapeutic effect and prognosis, es-pecially in targeted therapy of breast cancer. This review summarizes the applications of PET/CT in targeted therapy of breast cancer.
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This paper comprehensively reviewed the practice and meanings of non-invasive prenatal test (NIPT) in China and discussed the ethical issues.NIPT,as a step of prenatal diagnosis,brought conflicting values and moral economic influences.Its widely application also imposes higher requirements on policy regulation and lead to some ethical issues,including whether the client really informed consent.Genetic counselling is also crucial before and after the test.However,the subjects,doctors and medical staff have not yet fully prepared.Furthermore,this technique is relatively simple and cheap,and its application relates to many aspects.It is necessary to discuss the influence at the early stage and put forward the ethical issues that need to be paid attention to.Therefore,life ethics expert participation is extremely important,and to some extent will leadfetal and maternal supervision,management and supervision to a new level,especially with the development of NIPT and the application of whole genome sequencing (WGS).
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BACKGROUND:Previous studies have shown that different doses of ionizing radiation may have some impact on maturation and immune function of dendritic cells. OBJECTIVE:To evaluate the effect of 18 F-FDG with different concentrations on maturation and immune function of dendritic cells from human peripheral blood mononuclear cells in vitro. METHODS:Human peripheral blood mononuclear cells-derived mature dendritic cells were divided into five groups:PBS, 92.5×10 4, 185×104, 370×104, 740×104 Bq/mL 18 F-FDG were separately added into each group. Dendritic cells were col ected 24 hours later. Apoptosis rate, phenotypic expression (CD1α, CD80, CD83, CD86, HLA-DR), ability of mixed lymphocyte reaction and expression of macrophage inflammatory protein 1αand monocyte chemotactic factor-1 in cellculture supernatant were detected. RESULTS AND CONCLUSION:Apoptosis rate, phenotypic expression of CD86, ability of mixed lymphocyte reaction and expression of monocyte chemotactic factor-1 were down-regulated after culture in 740×10 4 Bq/mL 18F-FDG. However, 18F-FDG at other concentrations had no influence on maturation and immune function of dendritic cells. This study demonstrates that low-concentration 18F-FDG has little influence on apoptosis, maturation, antigen presentation, and migratory capacity of dendritic cells, and it may be selected at an appropriate concentration as a label for dendritic cells in vitro.
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Objective To evaluate and compare the normal value of glomerular filtration rate (GFR) in different modalities of single photon emission computed tomography (SPECT). Methods Fifty normal volunteers were divided into 4 groups (aged 20-29, n=14;30-39, n=10;40-49, n=14;50-, n=12). All of the volunteers underwent renal dynamic imaging with MPR SPECT, and single renal GFR value as well as total GFR value was calculated, respectively. The data were compared with GFR values obtained from Starcom 400AC/T SPECT (aged 20-29, n=6;30-39, n=11;40-49, n=7;50-, n=9). Single t test was used to testify the difference of the mean value between the two modalities of SPECT. Results The mean value of single renal GFR in each group of MPR SPECT was (51.03±11.12) ml, (48.44±11.13) ml, (47.79±7.71) ml and (46.54±12.28) ml,while of Starcom 400AC/T SPECT was (57.92±9.03) ml, (57.34±10.33) ml, (55.30±8.51) ml and (44.12±7.94) ml, respectively, and the total renal GFR in each group of MPR SPECT was (102.13±18.33) ml, (96.62±19.90) ml, (95.54±13.04) ml and (92.85±22.83) ml, of Starcom 400AC/T SPECT (115.86±16.51) ml, (113.14±17.71) ml, (110.54±11.13) ml and (88.12±14.41) ml, respectively (all P<0.05). The mean value of single renal GFR was (48.51±10.50) ml and (52.92±10.61) ml, respectively, while the mean value of total renal GFR was (97.04±18.16) ml and (105.63±18.72) ml, respectively (all P<0.05). Conclusion GFR standard value obtained from different SPECT renal dynamic imaging is varied. It is necessory to establish GFR standard value for each type of SPECT.
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Objective To study the relationships of hemoglobin(Hb)level with the levels of neurohormones,and cytokines,and the effect of them on ventricular remodeling in patients with congestive heart failure(CHF). Methods Hb level,serum angiotensinⅡ(Ang Ⅱ ),tumor necrosis factor-α(TNF-α),nitric oxide(NO),soluble intereellular adhesion molecule-1(sICAM-1)and B-type natriuretic peptide(BNP)were measured in 121 CHF patients.The left ventrieular ejection fraction (LVEF)from echocardiography,left ventricular mass index(LVMI),and mean wall stress(MWS)were calculated. Results The levels of Ang Ⅱ,TNF-α,NO,siCAM-1,BNP[(144.5±64.1)ng/L,(92.3±6.4)ng/L,(65.2±4.2)μmol/L,(253.6±26.0)μg/L,(1294.0±223.0)ng/L]and LVMI,MWS in the anemia group of CHF patients were higher than those in the non-anemia group[(76.7±48.5)ng/L,(55.6±10.2)ng/L,(42.1±11.9)μmol/L,(237.18±33.26)μg/L,(437.0±115.0)ng/L,all P＜0.01].With the increase of anemia severity,the levels of AngⅡ,TNF-α,NO,siCAM-1,BNP and LVMI,MWS were significantly increased.There were negative correlations between Hb level and the 1evels of AngⅡ,TNF-α,NO,siCAM-1,BNP,LVMI,MWS(r=-0.8173,-0.8509,-0.6001,-0.6692,-0.6283,-0.8604,-0.8733,all P＜0.01),and negative correlations between LVMI,MWS and Hb levels and LVEF(P＜0.01). Conclusions Neurohormones and cytokines play roles in ventrieular remodeling and anemia in CHF aggravates the severity of ventricular remodeling.