A randomized controlled trial of the effect of spironolactone on left ventricular mass in hemodialysis patients

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Third-generation Aromatase Inhibitor Improved Adult Height in a Japanese Boy with Testotoxicosis

In this study, we report a Japanese boy with testotoxicosis due to a heterozygous mutation [p. A572V] in the LH/CGR gene, who was the first boy treated with a third-generation aromatase inhibitor (AI) and reached his adult height in Japan. He showed accelerated growth and rapid penile growth from 3 yr of age and was diagnosed as having testotoxicosis. Combined treatment with anastrozole and spironolactone was started when he was 7 yr old and 145.8 cm (+4.45 SD) tall, at which point his bone age (BA) was 13.5 yr. His predicted adult height (PAH) was estimated to be 158.3 cm. The combined treatment was continued until he was 13 yr old and 166.5 cm tall, with his BA being 15.5 yr. He reached his adult height of 166.9 cm at 15 yr of age. Combined treatment with anastrozole and spironolactone successfully decelerated BA advancement, prolonged pubertal period and improved adult height.     

螺内酯片有关物质检测方法的优化

目的 优化螺内酯片有关物质的测定方法和供试品溶液制备方法。方法 采用Welch Materials Eclipse XB-C₁₈色谱柱(4.6 mm×250 mm,5μm),以乙腈-水(54∶46)为流动相,流速1.0 mL?min^–1,检测波长254 nm和283 nm,柱温35℃。样品以流动相为提取溶剂,超声提取。结果 主峰与各杂质峰均能良好分离。螺内酯、坎利酮分别在1.00～100.38,1.03～102.53μg?mL^–1内线性关系良好(r均为1.000),回收率分别为99.52%和99.23%。结论 本方法结果准确、重复性好、专属性强,比中国药典方法操作更简便,可为螺内酯片有关物质检测方法的优化提供参考依据。     

Prevalence of primary aldosteronism in hypertensive kidney transplant recipients: A cross-sectional study

Due to high prevalence of primary aldosteronism (PA) in the general hypertensive population, and its association with worse cardiovascular and renal outcomes, the 2016 Endocrine Society Guidelines explicitly recognize PA as a major public health issue requiring urgent attention. Its prevalence in hypertensive kidney transplant recipients (KTRs) is unknown. In this cross-sectional study, we screened KTRs with hypertension who were on ≥4 antihypertensive medications, on 3 antihypertensive medications with BP ≥ 140/90, and on potassium supplements, or were hypokalemic. 172 of 280 eligible patients successfully completed the testing. A positive screen for PA defined by an aldosterone-to-renin ratio of ≥20 and a plasma aldosterone concentration of >15 ng/dL yielded a prevalence of 15.7%. Potassium supplement requirement (52% vs 27%, P = .01) and hypokalemia (25.9% vs 4.8%, P < .01) were more common in patients who screened positive compared with those who screened negative. 67% of patients who screened positive were on potassium supplements and/or were hypokalemic. Our study is the first to systematically explore the prevalence of PA among the hypertensive KTR population, which has inherently high cardiovascular risk. Further studies are needed to determine the cardiovascular and renal risk attributable to PA, and define optimal therapy for KTRs with PA.     

The effect of spironolactone on transport of Na+, K+ and H+. A microperfusion study in rat main submaxillary duct.

The epithelium of the main excretory duct of the rat submaxillary gland was used as a target tissue for studies on the effect of a spironolactone on electrolyte transport. The spironolactone decreased net Na+ reabsorption by 27% and net K+ secretion by 23%. HCO-3 was found to be about 2-fold accumulated in the duct lumen, which was considered to result from decreased H+ion secretion. The results can be reconciled with an action of spironolactone on 1) the peritubular Na+-K+-exchange mechanism and 2) the functional coupling of Na+ entry from lumen to cell with K+ and H+ transfer from cell to lumen.     

疏血通注射液联合脑络舒通汤治疗急性脑梗死的疗效分析

目的：探讨疏血通注射液联合脑络舒通汤治疗急性脑梗死的临床疗效。方法选取急性脑梗死患者95例,随机分为研究组（n=48）和对照组（n=47）。对照组予以疏血通注射液治疗,研究组予以疏血通注射液联合脑络舒通汤治疗,分析2组治疗效果。结果治疗后研究组各症状症候积分和全血粘度(4.02±0.15)、血浆粘度(1.46±0.14)、红细胞聚集指数水平(2.36±0.47)均优于对照组,差异有统计学意义（P<0.05）。结论疏血通注射液联合脑络舒通汤治疗可显著缓解急性脑梗死的临床症状,优化患者血循环,值得临床推广应用。