?AIM: To study the changes of choroidal thickness and hemodynamic parameters in patients with diabetic retinopathy and their influencing factors.?METHODS: From January 2013 to January 2015, 100 patients (100 eyes) with type 2 diabetes were divided into 3 groups:34 patients without diabetic retinopathy ( NDR) , 36 patients with non proliferative diabetic retinopathy ( NPDR) group, and 30 patients with proliferative diabetic retinopathy (PDR). According to the results of OCT, the patients with diabetic retinopathy were divided into 2 groups: diabetic macular edema ( DME ) group ( 28 cases) , and 38 cases without diabetic macular edema. During the same period in our hospital 35 subjects for physical examination were selected as the control group. The hemodynamic parameters of the posterior ciliary artery in different groups of patients at different distance from the center of the macular were compared, analyzing influencing factors.?RESULTS:With the aggravation of diabetic retinopathy, the choroidal thickness in different distance from the center of the macular decreased. The choroidal thickness of NPDR and PDR group were thinner than that of the control group (P<0. 05). The choroidal thickness of NDR group was not different from the control group (P>0. 05). There was no significant difference in the choroidal thickness between the DME patients and non DME patients (P>0. 05). Pearson correlation analysis showed that there was no significant correlation between choroidal thickness of patients with diabetic retinopathy and diabetic duration, fasting blood glucose, HbA1c, eye axis length, systolic blood pressure and diastolic blood pressure (P>0. 05), but there was a correlation with BCVA (logMAR) (P<0. 01). EDV and PSV in NDR group and NPDR group were significantly lower than those in control group, RI was higher than that in control group. PSV and EDV in PDR group were significantly lower than those in other three groups, RI was higher than the other three groups, and the difference was statistically significant ( P<0. 05).?CONCLUSION:With the severity of retinopathy in type 2 diabetic patients, the choroidal thickness decreased, and the thickness of the choroid is beneficial in the comprehensive analysis of 2 diabetic retinopathy.

A total of 115 patients with Hoshimoto thyroiditis were classified under 2 groups: one group being treated with selenium and L-throxine (L-T4) and other group with L-T4 alone.All patients were followed up for 3 months.In the selenium treated group thyroid peroxidase antibody level was decreased in 33 patients (56%) and thyroglobulin antibody level was decreased in cases.

Objective To elucidate the relationship between serum uric acid (SUA) and cardiovascular risk factors in Shandong coastal inhabitants. Methods A random, stratified cluster sampling method was conducted. A population.based cross-sectional survey for hyperuricemia was performed and 4 988 dwellers of Shandong coast were investigated. Fasting SUA,lipid profiles,insulin concentrations,etc.,were determined by automatic biochemical analysis device and electrochemiluminescence analyzer.The investigation of general,healthy and nutritional conditions was carried out by questionnaire. Results In male and female subjects, the cardiovascular risk factors such as systolic blood pressure,diastolic blood pressure, selum ereatinine,total cholesterol.triglvceride,waist circumference and body mass index all increased with rising SUA,and the level of senlm high densitv lipoprotein fell accordingly.Homeostasis model assessment insulin resistance index (HOMA- IR) in female subjects increased by the quartile group,not in male subjects.Compared with SUA<280 μmol/L group.odds ratio(OR) values of hypertension in SUA 280-319,320-349,≥350 μmol/L groups were 1.54,1.88 and 2.70 respectively in female,and 2.29,4.15 and 4.96 for metabolic syndrome (MS).As for male,compared with SUA<280 μmol/L group OR value of hypertension in SUA ≥420 μmol/L group was 1.52,and OR values of MS of 1.41,1.87 and 3.27 occurred in SUA 320～379,380～419,≥420 μmol/L groups.After being adjusted for confounding factors,logistic stepwise regression revealed that elevated SUA was an independent risk factor for hypertension in both genders.Conclusion Elevated SUA level is closely related to the incidence and development of cardiovascular diseases,and should not be ignored in clinical practice.

Objective To observe the effects of fluvastatin on proliferation and apoptosis of HL-60 cells,and to offer the theoretical evidence for tumor treatment.Methods HL-60 cells were divided into:fluvastatin groups(0.5,5.0,10.0 and 20.0 ?mol?L-1),HL-60 control group,positive control group(treated with 10.0 ?mol?L-1ATRA).The live cell number was counted for cell proliferation assay.The growth inhibitory rate of HL-60 cells was detected using CCK-8 kit.The cell cycle distribution and apoptotic rate were measured using flow cytometry assay.Results Compared with control group,after HL-60 cells were treated with 0.5,5.0,10.0 and 20.0 ?mol?L-1of fluvastatin for 1-4 d,the number of live cells decreased in different level(P

Objective:To analyze the clinical features, imaging findings and gene test of patients with type Ⅱ Alexander disease.Methods:All the clinical data of three cases with type Ⅱ Alexander disease from August 2018 to June 2020 in the Department of Neurology, Qilu Hospital of Shandong University (Qingdao) and Qilu Hospital of Shandong University were collected, and their clinical and imaging findings were analyzed retrospectively.Results:All the three patients were middle aged and old men with a chronic progressive course, beginning with weakness of one or both lower limbs, followed by dizziness, dysarthria, dysphagia, sphincteral disturbances, constipation and orthostatic hypotension. Three patients all experienced misdiagnosis (hydrarthrosis, cerebral vascular disease, alcoholism, respectively) at early stage of the disease. Cranial magnetic resonance imaging (MRI) showed mild supratentorial periventricular leukodystrophy, which was not specific. Sagittal cranial MRI demonstrated medulla oblongata and upper cervical cord atrophy called “tadpole atrophy”, which had high suggestive value. The results of gene analysis showed heterozygous mutation of glial fibrillary acidic protein gene, which had been reported as pathogenic gene; c.1091C>T (p.A364V) in exon 6, c.722C>T (p.R258C) in exon 4 and c.197G>A (p.R66Q) in exon 1, respectively.Conclusions:Type Ⅱ Alexander disease is an autosomal dominant disease, most with point mutations, rarely with deletion mutations. Type Ⅱ Alexander disease should be suspected when a patient had signs of lower brainstem involvement such as dizziness, ataxia, pyramidal sign, autonomic dysfunction, especially when cranial MRI showed mild supratentorial leukodystrophy, and medulla oblongata and upper cervical cord atrophy.

Objective To explore the most suitable equation in accessing renal function for the elderly type 2 diabetic patients, and its clinical utility in combination with hypersensitive C-reactive protein (hsCRP). Methods The new Cystatin C-based equations for estimated glomerular filtration rate (Cys-eGFR) and conventional predictive equations were compared with isotopic GFR (iGFR) by linear regression analysis, paired t-test, Bland and Altman procedures and non-parametric receiver operating characteristic (ROC) curves. The new Cys-eGFR equation and hsCRP were also incorporated for detecting renal disease in this population. Results The new Cys-eGFR equation had a better relativity with iGFR (r= 0.767, P＜0.001), a less bias (bias: 0.0007, P＞0.05), a higher conformance (2SD: 21.56), higher sensitivity (90.7%) and specificity (88.6%) for diagnosing moderate decrease in renal function. There was a negative relationship between the new Cys-eGFR and hsCRP (r=-0.655, P＜0.01). When the new Cys-eGFR was 67.06 ml· min-1 ·1.73 m-2 and hsCRP was 5.65 mg/L, the combination of Cys-eGFR and hsCRP was better than the combination of serum creatinine and urine albumin/creatinine ratio in screening stage 3 chronic kidney disease (95%vs.46%). Conclusions The combination of new Cys-eGFR equation and hsCRP may screen an early decrease of moderate GFR.

Objective To determinate the risk factors of gout in patients with hyperuricemia.Methods Patients detected with hyperuricemia both in epidemiological survey of Shandong coastal areas in 2004 and in health examination of our hospital were followed up for three years to observe the incidence of gout, relationship of diet and gout, and changes of biochemical indicators.Results During 3 years, 102 patients (19%) out of 536 patients with hyperuricemia developed gout. Age(OR=1.046, P＜0.05), serum uric acid(OR=1.021, P＜0.05), fasting plasma glucose(OR=1.021, P＜0.05), triglyceride(OR=1.008, P＜0.05), tony crab intake ( OR=5.992, P＜0.05),and beer intake(OR=1.012, P＜0.05) were the risk factors of gout attack in patients with hyperuricemia.Conclusions Excess intake of tony crab and beer resulting in fluctuation of serum uric acid is the main risk factor of gout in patients with hyperuricemia. Correcting metabolic disorder of glucose and lipid, reducing the intake of high-purine food, and controlling the level of serum uric acid are the measures to reduce gout attack.

Objective To investigate the characteristics and relevant factors of overweight and obesity in adults of the Shandong coastal area in 2009,as well as to estimate the epidemiological trends by comparing with results found in 2004.Methods A random and stratified cluster sampling of adults aged 20 years or older was conducted,and 5060 inhabitants in the cities of Qingdao,Yantai,Weihai,Rizhao,and Dongying were included.Results The standardized prevalence rates of overweight,obesity,and abdominal obesity were 33.5％,16.1％,and 40.0％respectively in 2009,with respective increase of 0.6％ (P＜0.05),2.9％ (P＜0.01),and 6.8％ (P＜0.05)compared with those in 2004; the rates for male were 37.9％,17.1％,and 44.6％ respectively in 2009,with increase of 3.7％ (P＜0.01),3.7％ (P＜0.0l),and 10.2％ (P＜0.01) respectively compared with those in 2004 ;the prevalence of abdominal obesity for female was 38.6％,with an increase of 6.6％ (P＜0.01) compared with that in 2004.The prevalence of obesity increased consistently with age,reached a peak within 50-69 years old.There was a trend of developing obesity in younger,males,while obesity became more common in postmenopausal women.In contrast with the findings in 2004,the average age,body mass index,waist circumference,triglyceride,total cholesterol,uric acid,and blood glucose levels increased significantly (P＜0.01) in 2009.Logistic regression analysis showed that aging,dyslipidemia,hypertension,hyperglycemia,hyperuricemia were positively related with obesity,and smoking was negatively related with it.Consumption of meat was related to male obesity,while carbohydrate consumption was related to female obesity.Conclusions A remarkable increase in the prevalence of obesity was found in 2009 compared with 2004,especially for the young and middle-aged men and postmenopausal women.Aging,hypertension,hyperglycemia,hyperuricemia,dyslipidaemia,and incorrect components of diet contributed to obesity.Although smoking is a negative factor for body weight,it is not suggested.

BACKGROUND: Recent studies have found that hyperuricemia and gout are closely correlated with the occurrence and development of diabetes, coronary heart disease, hypertension and cerebrovascular diseases. It is of significance to investigate their prevalence so as to find way of early interventions.OBJECTIVE: To determine the prevalence and risk factors of gout and hyperuricemia among residents above 20 years old in Shandong coastal area.DESIGN: A randomized, stratified cluster sampling survey.SETTING: Department of Endocrinology, Affiliated Hospital of Qingdao University Medical College.PARTICIPANTS: A random, stratified cluster sampling was conducted in Shandong coastal area including Qingdao,Yantai, Weihai, Rizhao and Dongying. Residents lived in these areas for 5 years or more, aged between 20 to 80 years, were selected, and they were surveyed by family as a unit.METHODS: A randomized, stratified cluster sampling survey was conducted. The prevalence of gout and hyperuricemia were investigated among about 5 000 residents in Qingdao, Yantai, Weihai, Rizhao and Dongying. The serum uric acid, lipids, glucose and creatinine were detected with Sysmex chemix-180 total automatic biochemical analyzer. Those with uric acid higher than reference level were reexamined by collecting fasting blood sample on the third day. The comparison between rates was taken with the Chi-square test, means between two groups with the t test, means between multiple groups with analysis of variance, correlation between dependent and independent variables with logistic regression analysis.MATN OUTCOME MEASURES: Prevalance of hyperuricemia; Level of serum uric acid; Prevalence of gout in patients with hyperuricemia; Influencing factor of hyperuricemia.RESULTS: This investigation planned to include 5 500 subjects while in fact 5 003 subjects were investigated and the response rate was 91%, in which males were 2 395 (47.87%) and females were 2 608 (52.13%). ① The prevalence of hyperuricemia was 13.19% with standardized rate of 13.27% according to the Shandong population in 2000; The pevalence was higher in males than in females (18.32%, 8.56%, x2=108.52, P＜ 0.01). The risk in males was 2.5 times higher than that in females (OR =2.5). The prevalence of gout was 1.14% with standardized rate of 1.10%; and the prevalence in males was higher than that in females (1.94%, 0.42%, x2=30.38, P ＜ 0.01). The risk in males was 5.3 times higher than that in females (OR =5.3). ②The average value of serum uric acid in normal males was higher than in normal females [(343.40±84.54), (258.90±70.90) μmol/L, t =48.03, P ＜ 0.01]. It was obviously higher in male patients with hyperuricemia than in female ones [(469.43±48.08), (399.73±104.91) μmol/L, t =11.70, P ＜ 0.01]. It was higher in male patients with gout than in female ones [(502.44±106.76), (403.48±52.72) μmol/L, t =2.07, P ＜ 0.05]. ③The prevalence of gout in patients with hyperuricemia was 8.34%. ④ The prevalence of hyperuricemia and gout were climbing up with age after 40 years old in females and those elder than 70 years old were of high risk; while in males,the prevalence of hyperuricemia and gout increased with age before 60 years old and those aged 50-59 years were of high risk, yet after 60 years, it climbed up with age again. Nevertheless, the mean ages of hyperuricemia and gout in females were older than male. The average episode ages of hyperuricemia and gout in females were later than in males respectively by 7.5 and 8.5 years. ⑤ Non-conditional Logistic regression analysis showed that drinking frequency,drinking quantity, the quantity and frequency of seashell intake, BUN, Cr, TG, TC, BMI and WHR were the independent risk factors of male patients with hyperuricemia [OR =1.016-30.217, 95%C/ (1.010-1.023)-(9.955-214.869)]; while HDL-C and heavy physical labour were the protective factors (OR =0.492, 95%C/ 0.339-0.713; OR =0.755, 95% CI 0.575-0.991).As for females, age, hypertension, the quantity of seashell food intake, BUN, Cr, TG, WHR and light physical labour were the independent risk factors of hyperuricemia [OR =1.022-27.34, 95%CI (1.006-1.040)-(9.955-214.869)]. Similarly, HDL-C was a protective factor (OR =0.428, 95%CI0.223-0.820).CONCLUSION: ① The prevalence of hyperuricemia and gout are different between genders: ② The risk factors of hyperuricemia and gout among residents in Shandong coastal area include the high intake of marine products such as seashell foods, less physical activity, abdominal obesity and kidney insufficiency, as well as the existence of metabolic syndrome. Drinking is also involved in the increased prevalence in males, and age in females. ③ Higher risk for hyperuricemia and gout are noticed in all age groups in males, whereas in females after 50 years old.

Objective To investigate the computed tomography (CT) features of autoimmune pancreatitis (AIP).Methods The CT imaging data of 33 patients with AIP confirmed by pathology and/or steroid therapy were retrospectively analyzed.Image analysis including the shape of pancreas, density of lesion, contrast enhancement, the changes of pancreatic duct and biliary duct, peripancreatic appearances and adjacent organ involvement.T test was performed for statistical analysis.Results Among 33 patients with AIP, 23 cases (70%) with pancreatic parenchyma diffuse enlargement, eight cases (24%) with partial enlargement and two cases (6%) with normal pancreas.The lesions appeared hypoattenuating or isoattenuating on plain CT scan.After contrast-enhanced scan, the average CT values of lesions were (75.7±17.0) Hu at arterial phase, which was lower than that of venous phase (90.7±12.0) Hu, and the difference was statistically significant (t=3.378,P=0.002).The lesions demonstrated as progressive enhancement at venous phase.Among 33 patients, the main pancreatic duct was visible in six patients (18%).Sixteen patients (48%) presented with intrahepatic and extrahepatic biliary tract dilatation caused by intrapancreatic common bile duct stenosis.Thickened envelope-like structure around the lesions, presenting as capsule sign was seen in 14 patients (42%).Extra-pancreatic organ involvement was found in seven patients including three cases of kidney involvement.After treated with steroid, seven patients repeated CT which showed different degrees of improvement.Conclusion The main CT findings of AIP are diffuse and partial enlargement of pancreas with progressive enhancement at venous phase, envelope-like structure around pancreas, and stenosis of intrapancreatic common bile duct, which are important in the diagnosis and differential diagnosis of AIP.