Objective:To investigate the application value of dual-source CT urography with stellar photon detectors in the diagnosis of gout.Methods:Forty patients who were diagnosed with gout according to American College of Rheumatology Guideline for the Diagnosis of Gout and received treatment between April 2018 and May 2020 were included in the observation group. Forty patients who were concurrently diagnosed with osteoarthritis and received treatment in the same hospital were included in the control group. All patients underwent dual-source CT urography with stellar photon detectors and corresponding biochemical index detection. Blood levels of uric acid, urea nitrogen, creatinine, total cholesterol, and triglyceride were compared between the observation and control groups.Results:Blood levels of uric acid, creatinine, urea nitrogen, total cholesterol, and triglyceride in the observation group were (519.38 ± 97.91) μmol/L, (110.21 ± 18.29) μmol/L, (12.21 ± 3.29) mmol/L, (6.49 ± 1.22) mmol/L, (3.45 ± 1.89) mmol/L, respectively, which were significantly higher than those in the control group (310.45 ± 61.40) μmol/L, (86.22 ± 13.12) μmol/L, (6.82 ± 1.75) mmol/L, (4.75 ± 0.56) mmol/L, (1.98 ± 0.85) mmol/L, respectively ( t = 11.43, 6.741, 9.148, 8.198, 4.486, all P < 0.05). Dual-source CT urography with stellar photon detectors revealed that urate crystals (color coded as green) were detected in 3 and 36 patients from the control and observation groups, respectively, with the detection rate of 7.5% (3/40) and 90% (36/40), respectively. There was significant difference in urate crystal detection rate between the observation and control groups ( χ2 = 24.993, P < 0.05). In the control group, no obvious destruction of bone, tendon and ligament were observed, urate deposition, total volume of (1.023 ± 0.83) cm 3, was found in feet and knee joint of a small number of patients. In the observation group, there were 30 patients with uric acid crystals and bone destruction in the metatarsophalangeal joint ( n = 6), distal tibia ( n = 7), distal fibula ( n = 3), proximal talus ( n = 4), proximal calcaneus ( n = 6), and wrist joint ( n = 4). There were 20 patients with ligament or tendon damage, involving deltoid ligament ( n = 2), Achilles tendon ( n = 10), and extensor and flexor tendon ( n = 53). Total volume of uric acid crystals was (32.22 ± 5.83) cm 3. The volume of uric acid crystals deposited in the hand, elbow, feet and knee was (8.00 ± 4.92) cm 3, (5.32 ± 2.75) cm 3, (36.00 ± 15.54) cm 3, and (13.31 ± 9.14) cm 3, respectively. Conclusion:Dual-source CT urography with stellar photon detectors has a high sensitivity in the diagnosis of gout, can accurately locate and quantify uric acid crystals and is of high application value in the diagnosis of gout.

OBJECTIVE To investigate the effect of polymorphisms of solute carrier organic anion transporter family, member 1B3(SLCO1B3) gene on the pharmacodynamics of mycophenolate mofetil(MMF) in patients with lupus nephritis. METHODS Patients with lupus nephritis who were treated in Jieyang People’s Hospital from September 2019 to April 2021 were selected. All subjects were treated with MMF for at least 12 months, or discontinued due to poor efficacy. The efficacy of MMF was evaluated. The SLCO1B3 334T>G/699G>A(rs4149117/rs7311358) genotype was detected using Agena MassARRAY®, and the correlation between gene polymorphisms and MMF pharmacodynamics was analyzed using SPSS 25.0 software. RESULTS The genotype frequencies of SLCO1B3 334T>G/699G>A were in Hardy-Weinberg equilibrium. The probability of poor MMF treatment effect of 334GG/699AA carriers was significantly higher than that of 334TT/699AA and 334TG/699GA carriers(P<0.001); Logistic regression showed that both 334GG/699AA and urine protein>2.5 g·(24 h)−1 were the risk factors for poor MMF treatment[OR=4.038(1.731, 9.420), P<0.001; OR=4.157(1.705, 10.137), P=0.002]. Combined analysis showed that patients with both 334GG/699AA genotype and urine protein>2.5 g·(24 h)−1 were at higher risk for poor efficacy[OR=8.563(3.301, 22.216), P<0.001]. CONCLUSION SLCO1B3 334T>G/699G>A is related to the efficacy of MMF treating lupus nephritis, and 334GG/699AA carriers are more likely to result in poor efficacy.