简介:AbstractPrimary aldosteronism (PA) is a common form of endocrine hypertension. The diagnostic process of PA includes a screening test, confirmatory test, and subtype classification. In this review, we have summarized the latest advances in the diagnosis of PA with regard to screening and confirmatory tests and provided some recommendations to improve clinical practice.
简介:AbstractBackground: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.
简介:Primaryesophagealadenocarcinoma(PEAC)isararemalignantdiseaseofesophagus.Becauseofitslowerincidence,theknowledgeaboutitislimitedandtherearesomeproblemsrequiringfurtherstudy.Duringrecent30years,106patientswithPEAChadbeentfeatedsurgicallyinourdepartment...
简介:Cardiovasculardisease(CVD)istheleadingcauseofdeathworldwide.ThisarticlefocusesoncurrentguidelinesfortheprimarypreventionofCVDandaddressesmanagementofkeyriskfactors.Dietarymodification,weightloss,exercise,andtobaccousecessationarespecificareaswherefocusedeffortscansuccessfullyreduceCVDriskonbothanindividualandasocietallevel.Specificareasrequiringmanagementincludedyslipidemia,hypertension,physicalactivity,diabetes,aspirinuse,andalcoholintake.Thesepreventiveeffortshavemajorpublichealthimplications.Astheglobalpopulationcontinuestogrow,healthcareexpenditureswillalsorise,withthepotentialtoeventuallyoverwhelmthehealthcaresystem.ThereforeitisimperativetoapplyourcollectiveeffortsonCVDpreventiontoimprovethecardiovascularhealthofindividuals,communities,andnations.
简介:DIAGNOSISANDTREATMENTOFMULTIPLEPRIMARYCARCINOMASZhangShuangmin张双民MaSongzhang马颂章YangDalai杨大来ChenShuguang陈曙光YangChunming杨春明Son...
简介:AIM:Toevaluatewhetherthelevelofthrombospondin-1(TSP-1)inaqueoushumorcanpredicttheprognosisoftrabeculectomyinpatientswithprimaryangle-closureglaucoma(PACG).METHODS:Thiscase-controlstudyinvolved26patientswithPACGwhoexperiencedafailedtrabeculectomy(casegroup)and78age-andsex-matchedpatientswithPACGwhounderwentsuccessfultrabeculectomy(controlgroup).AqueoushumorwascollectedatthetimeoftrabeculectomyandtestedforTSP-1andTGF-β2levelswithanenzyme-linkedimmunosorbentassaymethod.Logisticregressionmodelingwasusedtoassesstheriskfactorsforfailedtrabeculectomy.RESULTS:ThemeanTSP-1aqueousconcentrationsweresignificantlyhigherinthecasegroup(20.67±9.79ng/mL)thanthecontrolgroup(5.17±2.29ng/mL)(P<0.001).Thetransforminggrowthfactor-β2(TGF-β2)aqueousconcentrationsweresignificantlydifferentbetweenthecaseandcontrolgroup,at3633.25and1090.24pg/mL,respectively(P<0.001).LogisticregressionanalysisrevealedTSP-1levelasanindependentriskfactorforafailedtrabeculectomy(OR=3.540;95%CI=1.092-11.482).CONCLUSION:TheaqueoushumorTSP-1andTGF-β2levelsarehigherinPACGeyeswithfailedtrabeculectomythanwithsuccessfultrabeculectomyatoneyear.TheaqueoushumorTSP-1levelisanindependentriskfactorassociatedwithfailedtrabeculectomy.
简介:IntroductionAsoneofthemostfrequentlydiagnoseddevastatingdiseases,liverfailureisresponsibleforapproximatelytwomilliondeathsannuallyworldwidewithpoorprognosis1.Althoughlivertransplantationhasbeendevelopedforthemosteffectivetreatmentforliverfailure,itisfarfromdemandsforpatientsduetotheshortageofhigh-qualitydonorliversandexpensivetreatmentcosts.Currently,withthedevelopmentofcelltherapy,celltransplantationsincludingprimaryhumanhepatocytes(PHHs),humanhepatocyte-likecells(HLCs)andliverorganoidsareemergingasgreatpotentialtoolstoalleviatethisgrowingburden.
简介:客观:为王牌探索起作用的指示和主要全部的新潮的关节造形术的起作用的方法平坦骨折并且观察临床的药品effect.Methods:我们回顾地总结了并且分析创伤的条件,破裂类型,复杂并发症,起作用的时间,起作用的技术,和11patients的短期的药品效果(10男性和1女性,与42的吝啬的年龄。4年)与王牌平坦骨折经历了主要全部的新潮的关节造形术。结果;病人被跟随在上面为6-45月(吝啬的=28月)。他们手术后的新潮的关节的普通哈里斯分数是78。结论:指示的Understrict控制,有平坦骨折可以经历的王牌的病人主要全部的新潮的关节造形术,而是稳定的王牌平坦部件应该被做。
简介:Themainresultsofthispaperarestatedasfollows.LetRbeanorderringinthesemi-primaryringQ.SupposethatRsatisfiesthemaximalconditionfornilrightidealsofR,Thenwehave(i)ifanidealIofRhasafinitelengthasrightR-module,thenIalsohasafinitelengthasleftR-module;(ii)denotebyA(R)theArtinianradicalofR,andNthenilradicalofR,thenA(R)+N/N=A(R/N),ifRsatisfiesthecommutativecondi-tiononthezeroproductofprimeidealsofB.