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BACKGROUND The aim of this study is to investigate origin, gross features, microscopic features, immunohistochemical properties, and differential diagnosis of adrenal cortical adenoma (ACA) in patients ≥20 years old. METHODS The clinicopathological features of 116 cases of ACA and the immunohistochemical features of 50 cases of ACA were evaluated, and the relevant literature was reviewed. RESULTS In our cohort, 76.72% (89/116) of the cases were functional, and 27 cases had non-functional, benign adrenal adenomas. ACA presented as an island tumor with an envelope, and the mean tumor size was 3.6 cm (range 1-5 cm), with a mean tumor weight of 9.28 g (range 5-113 g). The shape of the tumor cells was consistent, and mitosis was rarely observed. Forty of the 46 patients with cortisol-secreting ACA had tumors containing granule cells. Primary aldosteronism was observed in 43 cases. Thirty-eight cases had endoscopically visible tumors, with clear cells and lipid-rich cytoplasm arranged in irregular patches or strips. Cortisol-producing ACAs were associated with atrophy of the non-tumorous cortex. Adrenocortical adenomas displayed positive immunohistochemical staining for MELAN-A, Syn (46 of 50 cases of ACA), NSE (44 of 50 cases of ACA), Vim (42 of 50 cases of ACA) and Ki-67

Background: To evaluate the effect of individualized education for patients with type 2 diabetes mellitus (T2DM). Methods: A total of 280 patients (158 males, mean age 63 ± 10 years) with T2DM were randomly divided into study and control group. Eysenck Personality questionnaire was used to assess the personality of the patients in the study group, which was provided us one-on-one counseling and individualized management plan. Group education was provided to the control group. Results: At the end of the study, the body mass index (21.5±2.5 vs 23.6±1.6 kg/m 2 , P =0.002), waist circumference (83.7±6.4 vs 85.7±7.7 cm, P =0.03), fasting blood glucose (6.0±0.8 vs 6.9±2.1 mmol/L, P =0.004), HbA1c (6.2±0.6% vs 6.9±3.1%, P =0.03), systolic blood pressure (130.1±8.8 vs 135.1±8.4 mmHg, P =0.003),triglyceride (1.21±0.66 vs 1.46±0.58 mmol/L) and low-density lipoprotein (2.36±0.44 vs 2.84±0.64 mmol/L, P =0.03) in the study group was lower than in the control group. Conclusion: Individualized diabetes education is more effective than group education in facilitating the control of type 2 diabetes. Keywords: Individualization; type 2 diabetes; health education; blood glucose; blood pressure

Qiong Bai, Xuan Lai, Ai-Hua Zhang, Xin-Hong Lu, Shun-Li Tian, Min-Hua Fan, Yue Wang, Tao WangDivision of Nephrology, Peking University Third Hospital, Beijing, People's Republic of ChinaBackground: Cardiovascular disease is more common in patients with chronic kidney disease (CKD) than in the general population. Endothelial dysfunction is an early predictor of cardiovascular events.Objective: We conducted a cross-sectional study in CKD patients to explore the association of metabolic syndrome (MetS) components with endothelial cell function.Methods: We evaluated clinical and laboratory data in 161 CKD patients from stage 1 to stage 5. Endothelial function was estimated by flow-mediated dilatation (FMD) of the brachial artery and expressed as percentage change relative to baseline diameter. MetS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III criteria.Results: Patients were grouped into two groups according to whether or not they had MetS. FMD was significantly lower in the MetS group than in the group without MetS (P = 0.012). In a Pearson's correlation analysis, FMD was significantly negatively correlated with waist circumference in women (r = –0.223, P = 0.03) and fasting blood glucose (r = –0.186, P = 0.001). Multiple linear regression analysis showed that fasting blood glucose was an independently associated factor for FMD.Conclusion: MetS and some components of MetS (waist circumference in women and fasting blood glucose) are closely associated with a decreased FMD in CKD patients.Keywords: metabolic syndrome, endothelial dysfunction, flow-mediated dilatation, chronic kidney disease