Objective To investigate correlation between serum level of uric acid (SUA) and carotid atherosclerosis in the elderly. Methods A group of 113 elder subjects were examined by high-frequency Doppler ultrasound to measure their intima-media thickness (IMT) of carotid artery and severity of atherosclerotic plaque formation. Blood levels of biochemical factors such as SUA, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), creatinine (Cr) were determined, as well as 24h urine level of albumin (UALB). Correlation between SUA, IMT and the plaque was analyzed.Results SUA in quartile positively correlated with increasing IMT and severity of plaque in the elderly. SUA correlated with IMT of carotid artery, independent from age, gender, TC, TG, HDL-C, LDL-C and Cr, and correlated with severity of plaque adjusted for age, gender, history of hypertension, TC, TG, HDL-C, LDL-C, Cr, FBS and logarithm of UALB.Conclusions Level of SUA positively correlated with IMT, and increased level of SUA was a risk factor for carotid plaque, independent from other cardiovascular risk factors and renal impairment indicators, such as age, gender, history of hypertension,blood lipid level, Cr, etc.

Objective To study problems related to drug-induced liver lesion caused by antituberculotic therapy (DLL).Methods Totally, 172 cases of DLL occurred in 1 464 patients with pulmonary tuberculosis after antituberculotic therapy, hospitalized during January 1995 to December 2002, were reviewed and analyzed retrospectively.Results Patients aged 20 to 60 years with DLL by antituberculolis therapy accounted for 70.3% of the total. Symptoms of digestive tract and change in liver function usually occurred within 8 weeks of intensive treatment (73.8%), and discontinuation of autituberculotic drugs was not needed for the mild cases, but needed for the severe cases with liver protective therapy. In total, 157 of the 172 cases (91.3%) recovered completely and 13 case improved (7.6%), two cases deteriorated and discharged, and doses of autituberculotic drugs should be reduced or stopped in 41 cases (23.8%) affecting their treatment efficacy.Conclusions DLL was liable to occur in patients of pulmonary tuberculosis with antituberculotic therapy, especially in the elderly men with body weight less than 50 kilograms, those with previous liver damage or infected with hepatotropic virus, alcohol drinking, complicated with extrapulmonary tuberculosis, with combination of isoniazid rifampicin and pyrazinamide.

Objective To identify right-sided chest lead electrocardiograph (ECG) abnormalities in acute pulmonary embolismMethods Changes of routinely recorded 12-lead and right-sided chest leads V 3R, V 4R and V 5R ECGs in 98 patients with suspected pulmonary embolism hospitalized at Ninghe County Hospital during March 1999 to October 2003 were analyzed retrospectively Parameters of both right and left-sided ECGs available were measured and comparedResults Diagnosis of acute pulmonary embolism was established in only 23 (234%) of 98 suspected patients, 18 men (78%) and 5 women (22%), with mean age of (48 ? 10) ECG changes suggestive of acute right ventricular strain were found in both right and left-sided leads in 18 (78%) of 23 patients with pulmonary embolism, and their ECG changes disappeared within 24 hours after admission or onset of symptoms with pulmonary embolism in 13 (72%) of them ST segment elevation in leads V 3R, V 4R, V 5R ,and abnormalities in standard 12-lead ECGs were found in nine (39%), and five (22%) of them with a diagnosis of pulmonary embolism had normal left-sided ECGs, but elevated ST segment and qr or QS pattern (prominent q waves) in leads V 3R, V 4R and V 5R in their right-sided ECGs Thirteen (565%) of them showed ST-segment elevated in leads V 3R, V 4R and V 5R,and 20 (87%) showed qr configuration in lead V 3RConclusions Patients with acute pulmonary embolism often show characteristic ECG changes in right-sided chest leads When pulmonary embolism is suspected, especially no typical changes in routinely-recorded standard 12-lead ECGs can be found, right-sided chest lead ECG should be performed

Objective To improve the understanding and diagnosis of pulmonary lymphangioleiomyomatosis (PLAM) by the comprehensive review of domestic literatures in the past ten years.Methods Three new cases with PLAM were reported and integraed with other 45 cases reported domestically in the past ten years for analysis of their clinical features.Results The newly reported three cases of PLAM were all women at child-bearing age, with initial symptom of dyspnea after activity. Two of them complicated with extra-pulmonary PLAM. All the three cases were free of chylous effusion. Forty-seven of 48 cases with PLAM were pathologically diagnozed, with ages of onset of 5~69 (mean?s of 34?10) years. Their clinical manifestations were mainly respiratory, including dyspnoea (95.8%), haemoptysis (52.1%), pneumothorax (45.8%), chylous effusion (33.3%),cough (31.3%) and chest pain (12.5%). Abnormal manifestations in abdomen, including renal mass, retroperitoneal mass and retroperitoneal lymphadenopathy, were detected in 16 cases. Thirty-nine cases had their high-resolution CT (HRCT) examined and appearance of multiple cysts distributed throughout the bilateral lung fields could be discerned in 38 of them. Obstructive ventilation disturbance could be observed in 23 of 30 cases with the data or conclusions on pulmonary function tests, and mixed ventilation disturbance in seven cases. Respiratory failure was complicated in 17 of 28 cases with the data of arterial blood gas analyses.Conclusions HRCT had confirmative value for diagnosis of PLAM. In practice, HRCT, as well as other routine abdominal and pelvic imaging examinations, should be performed in time for child-bearing-age women with progressive dyspnoea, haemoptysis, or spontaneous pneumothorax, to detect if they complicate with PLAM.

Objective To determine the si gnificance of plasma level of B-type natriuretic peptide (BNP) in patients with congestive heart failure (CHF) for differential diagnosis of their acute dyspne aMethods Totally, 130 patients with acute dyspnea were selected, including 78 patients diagnosed as CHF with left ventricular ejection fraction less than 040 and 52 patients without CHF Plasma level of BNP was m easured by a rapid, point-of-care quantitative immunofluorescent assay Results Plasma level of BNP was(732?53)ng/L in patients wit h CHF, much higher than that in those without CHF(71?34)ng/L(P

Objective To investigate the distribution of islet autoantibodies (GAD-Ab, IA2-Ab, IAA) in new-onset diabetic patients with unprovoked ketosis and their association with clinical characteristics and pancreatic ? cell function.Methods Islet autoantibodies, including GAD-Ab、IA2-Ab and IAA were detected in 161 new-onset diabetic patients with unprovoked ketosis by radioligand assay. Prevalence of positive islet autoantibodies was compared among groups with different ages, body mass indexes (BMI), severity of ketosis and fasting C peptide (FCP) levels. Clinical characteristics and pancreatic ? cell function were compared between groups with positive and negative islet autoantibodies.Results One or more kinds of islet autoantibodies were detected in 68 from the 161 subjects (42.2%), with higher prevalence of positive islet autoantibodies in the patients aged equal to or less than 20 years, of BMI equal to or less than 18.5 and with FCP equal to or less than 300 pmol/L. Younger age of onset, lower BMI, more severe ketosis and poorer islet endocrine function were found in patients with positive islet autoantibodies, as compared with those with negative ones.Conclusions In diabetic patients with unprovoked ketosis, the younger, the lower C peptide and the lower BMI they are, the higher prevalence of positive islet autoantibodies, the more possibility that they are classified as type 1A diabetes and the less possibility as type 1B diabetes or type 2 diabetes.Pancreatic ? cell function was poorer in patients with positive islet autoantibodies,which should be treated with insulin as earlier as possible.

Objective To investigate the span and frequency of physical symptoms of panic attack in patients with panic disorder.Methods Panic symptoms presented at the time of panic attacks were assessed and categorized in forty-eight consecutive outpatients with panic disorder during August 2000 to November 2002.Results Palpitations (44/48,91.7%), shortness of breath (36/48,75.0%), sweating (34/48,70.8%), feel suffocated (33/48,68.8%), faint (31/48,64.6%), dizziness (27/48,56.3%) and fear of dying (27/48,56.3%) were the most frequent symptoms reported by the patients with panic disorder. If categorized according to system, the most frequent symptoms were presented in cardiovascular, neurological, respiratory and autonomic nervous systems of patients with panic disorder.Conclusions Physical symptoms varies when panic attack occurs. Panic disorder was often misdiagnosed and underdiagnosed because of wide and non-specific spectrum of physical symptoms.

Objective To investigate clinicopathologic characteristics of malignant tumors initiated with cervical lymph nodes enlargement.Methods Clinical and pathological data of 887 cases with cervical malignant tumors kept in the college during January 1998 to December 2003 were analyzed for their histological patterns and primary site of metastatic carcinoma.Results Cervical cancer with lympb nodes metastasis was mostly seen at age of 51~60 years (182/837,21.74%), and much more common in men than in women. Major metastatic carcinomas in cervical lymph nodes originated from the nasopharynex, lung, thyroid, stomach and esophagus (591/671,88.08%), with 60.66%(407/671)of squamous cell carcinoma mostly from the nasopharynex, lung, or esophagus (380/407,93.37%). There was significant difference in the site, size, number, quality, appearance of lymph nodes, course of disease, and clinical manifestations between lymphoma and metastatic cancer.Conclusions Cervical metastatic carcinomas in Guangdong mainly originated from the nasopharynx. Some specific immunohistochemical markers, CT, MRI and ultrasonic technology played a very important role in diagnosis for lymphoma and determination of primary site of metastatic cancer.

A total of 203 hypertensive patients with established health files received standard disease management for 1 year. We found that the patients who underwent grade 2 or 3 management showed statistically significant difference in exercise, salt and oil restriction, body mass index (BMI), waist to hip ratio, blood pressure, and blood-lipid from baseline (all P < 0.05). Hypertension awareness, behavior improvement, and disease control had statistically significant difference from baseline in all the patients (P < 0.05 or P < 0.001). After one year's intervention, the patient number in each grade was largely changed. Our study suggests that hierarchical hypertension management might be practical and effective in communities.

Objective To evaluate salmeterol/fluficasone combined with N-acetylcysteine in treatment of stable chronic obstructive pulmonary disease (COPD). Methods Sixty patients with stable COPD were randomized into treatment group(n = 30) and control group(n = 30). Patients in control group were given salmeterol/fluticasone twice per day ; while patients in treatment group in addition to salmeterol/ fluticasone, also took N-acetylcysteine 0.6 g three times per day. The course of treatment lasted for four weeks. Pulmonary function was measured in all patients; interleukin-8 (IL-8), tumor necrosis factor α (TNF-α), superoxide dismntase (SOD) and malondialdehyde (MDA) in blood serum and induced sputum were determined. The white cell count and classification in sputum smear was examined and the quality of life (QOL) of patients was evaluated. Results FEV1, FEV1 %, QOL evaluation, IL-8, TNF-α, white cell count and the percentage of neutrophil granulocytes in induced sputum after treatment were significantly improved compared with those before treatment in control group (P <0.05 or P <0.01). FEV1, FEV1%, QOL evaluation, SOD and MDA in blood serum, IL-8, TNF-α, SOD and MDA, total white cell count, the percentage of neutrophil granulocytes and macrophage in induced sputum after treatment were significantly improved in treatment group (P <0. 05 or P <0.01). The differences in SOD and MDA in blood serum and the percentage of neutrophil granulocytes in induced sputum smear between treatment group and control group were staffsticaUy significant (93 ± 8) × 10-6 U/L, (4. 0 ± 1.0) × 10-3 mmol/L and 0. 5 ± 0. 3 vs (85 ± 10) ×10-6U/L,(4.2±1.1) ×10-3mmol/Land0.6±0.2; allP<0.05. Conclusion Combination of salmeterol/fluticasone and N-acetylcysteine has better therapeutic results in treatment of airway inflammation of stable COPD.