The Development and Functional Regulation of the Fetal Adrenal Cortex

As an important endocrine organ of the human, the adrenal cortex is responsible for the synthesis of various steroids. It is important to maintain pregnancy, promote fetal growth and nervous system development. Moreover, it is also important for the growth and development of the fetus after birth. Abnormal functional development of the adrenal cortex will induce the abnormal synthesis of steroid hormones and trigger the occurrence of related diseases. In this review, we discuss the morphological and functional development of fetal adrenal cortex and its regulatory factors in humans and rodents.

Effect of Tripterygium Vilfordii on Adrenal Cortex in Rat with Adjuvant Arthritis

This paper reports the effects of Tripterygium Wilfordii (TW) on adrenal cortex in rats with adjuvant artbritis. Forty rats were divided into 5 groups. Adjuvant arthritis (AA) models were made with complete freund's adjuvant (CFA) in groups Ⅰ-Ⅳ. Each of which was treated with sodium carboxyl methyl cellulose, TW, prednisone and cyclophosphamide respecrively.The untreated rats allocated to group,V served as normal. controls. The swelling of AA markedly subsided in groups Ⅱ,Ⅲ and Ⅳ as compasred with group I (P<0.01). whereas no significant differences were noted among groups Ⅱ, Ⅲ and Ⅳ(P>0.05).The obviously increased plasma corticosterone levels and decreased adrenal ascorbic acid levels were observed in group Ⅱ,whereas decreased plasma corticosterone levels and inereased adrenal ascorbic acid levels were noted in group Ⅲ.There was a striking comtrast between groups Ⅱand Ⅲ. The morphological changes of adrenal glands under light microseope revealed hypertrophic adrenal cortices in group Ⅱ,and atrophic adrenal cortices in group Ⅲ.The above findings snggest that that the effect promoting production of corticosterods may be one of mechanism by which TW can effectively treating autoimmune diseases.

两种激素鼓室灌注治疗重度以上突发性聋的疗效观察

近年来,越来越多的研究聚焦于鼓室内灌注激素治疗突发性聋（sudden deafness,SD）。2010年1月~2013年3月我科对99例重度以上SD患者分别给予全身或鼓室内注射激素治疗,现将治疗结果报道如下。

Cytochrome P450 family 17 subfamily A member 1 mutation causes severe pseudohermaphroditism: A case report

BACKGROUND 17α-Hydroxylase deficiency(17-OHD)is a rare form of congenital adrenal hyperplasia,characterized by hypertension,hypokalemia,and gonadal dysplasia.However,due to the lack of a comprehensive understanding of this disease,it is prone to misdiagnosis and missed diagnosis,and there is no complete cure.CASE SUMMARY We report a female patient with 17-OHD.The patient was admitted to the Department of Neurology of our hospital due to limb weakness.During treatment,it was found that the patient’s condition was difficult to correct except for hypokalemia,and her blood pressure was difficult to control with various antihypertensive drugs.She was then transferred to our department for further treatment.On physical examination,the patient's gonadal development was found to be abnormal,and chromosome analysis demonstrated karyotype 46,XY.Considering the possibility of 17-OHD,the cytochrome P450 family 17 subfamily A member 1(CYP17A1)test was performed to confirm the diagnosis.CONCLUSION The clinical manifestations of 17-OHD are complex.Hormone determination,imaging examination,chromosome determination and CYP17A1 gene test are helpful for early diagnosis.

Effect of noise exposure(85 dB) on testicular adrenocortical steroidogenic key enzymes, acid and alkaline phosphatase activities of sex organs in mature albino rats

Changes in the activities of Δ 5\|3β\|hydroysteroid dehydrogenase(HSD) in testis and adrenal gland, 17β\|hydroxysteroid dehydrogenase in testis, acid and alkaline phosphatase in testis, prostate and seminal vesicle were observed in noise exposed mature rats at the intensity of 85 dB for 8 h/day for 45 days. The results indicated that noise exposed group showed a significant diminution in the activities of androgenic key enzymes Δ 5\|3β and 17β\|HSD, acid phosphatase in testis, prostate and seminal vesicle. There was a significant elevation in the activities of adrenal Δ 5\|3β\|HSD, alkaline phosphatase in testis and other accessory sex organ in noise exposed group. Gonadosomatic, prostatosomatic and seminal vesiculo\|somatic indexes were decreased significantly in noise exposed group. Therefore, it is evident that noise exposure at 85dB exerts a deleterious effect on testicular and adrenocortical activities.

Corticosurrenaloma: About a Pediatric Case

Introduction: This study aims to describe the outcome of adrenocortical cancer in children through observation. Observation: A 10-year-old girl with no previous pathological history. She presented headaches and severe hypertension with clinical and biological signs of hyperandrogenism for 6 months. An abdominal CT scan showed an encapsulated left adrenal mass without local or regional invasion or secondary location. A pheochromocytoma or adrenal neuroblastoma was first suspected. The blood pressure was stable at 130/65 mmHg under antihypertensive drugs. She underwent a complete tumor resection without any intraoperative incident. The pathologic study confirmed the adrenocortical carcinoma scored Weiss 7. The severe high blood pressure reappeared 2-year later despite antihypertensive drugs. The thoracic abdominal and pelvic CT scan showed a locally advanced tumor recurrence in the left adrenal gland with parenchymal nodes in the lungs and liver. The outcome was fatal despite medical and surgical management. Conclusion: Adrenocortical cancer is a rare tumor. It is important to hormonal testing in the presence of Cushing’s syndrome in children. It can give a strong indication of the diagnostic possibilities. Histology confirms the diagnosis. The evolution is covered by complications, in particular recurrence with life-threatening metastases.

Use of antenatal corticosteroids among infants with gestational age at 24 to 31 weeks in 57 neonatal intensive care units of China: a cross-sectional study

Background:Antenatal corticosteroids(ACS)can significantly improve the outcomes of preterm infants.This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units(NICU)and to explore perinatal factors associated with ACS use,using the largest contemporary cohort of very preterm infants in China.Methods:This cross-sectional study enrolled all infants born at 24^(+0)to 31^(+6)weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st,2019 to December 30th,2019.The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery.Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage.Results:A total of 7828 infants were enrolled,among which 6103(78.0%)infants received ACS.ACS use rates increased with increasing gestational age(GA),from 177/259(68.3%)at 24 to 25 weeks’gestation to 3120/3960(78.8%)at 30 to 31 weeks’gestation.Among infants exposed to ACS,2999 of 6103(49.1%)infants received a single complete course,and 33.4%(2039/6103)infants received a partial course.ACS use rates varied from 30.2%to 100%among different hospitals.Multivariate regression showed that increasing GA,born in hospital(inborn),increasing maternal age,maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS.Conclusions:The use rate of ACS remained low for infants at 24 to 31 weeks’gestation admitted to Chinese NICUs,with fewer infants receiving a complete course.The use rates varied significantly among different hospitals.Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.

Advances in understanding of idiopathic pulmonary fibrosis

Our understanding of idiopathic pulmonary fibrosis （IPF） has undergone major changes in recent years. IPF is the most common of the idiopathic interstitial pneumonias. It remains the most often diagnosed, accounting for 50% to 60% of all cases. It is also associated with a worse prognosis than most of the interstitial lung diseases. The number of deaths related to IPF is nearly 14 times greater than those from asbestosis, while a recent estimate has suggested prevalence in the United States ranging from 14.0 to 42.7 cases per 100 000 population, depending on the criteria used for diagnosis,

Multi-organ protection during open heart surgery

PURPOSE AND METHODS: Open-heart surgery with the use of cardiopulmonary bypass (CPB) is associated with an inflammatory cascade which contributes to the development of postoperative complications including multiple organ failure. To provide an update on the subject, we briefly review the recent English-language literature. RESULTS: During CPB, various factors have been recognized to induce a complex inflammatory response. Based on an enhanced understanding of the underlying mechanisms, therapeutic strategies have been developed to reduce this inflammatory reaction and its subsequent damaging effects. Off-pump coronary artery bypass grafting may result in less inflammatory injury as compared with the conventional maneuver, which can in turn, diminish the incidence of cardiac, renal, or neurological dysfunction. It is also clear that improving the biocompatibility of CPB materials can lead to a better patient recovery. Inasmuch as the pathophysiology involved appears to be multifactorial, it is unlikely that a single intervention could achieve the desired goal. Both pharmacologic strategies, such as steroid pretreatment, and modification of mechanical devices, such as the use of heparin-coated CPB circuits, could have important clinical implications. The balance pro- and anti-inflammatory responses may be crucial in limiting the extent of inflammatory injury. CONCLUSIONS: To date, the concept of organ protection should no longer be limited to the individual organ. Instead, investigations must be extended to focus on a systemic level.