Objective To investigate the risk factors of primary gout.Methods 420 patients with primary gout were analyzed.Results Among the 420 patients,male to female ratio was 21∶1.Average onset age of female was significantly higher than that of the male,whereas,the mean disease duration was significantly shorter in female than that in male.The mean disease duration of patient with positive familial history was significantly shorter than that with negative ones.38% patients had an alcohol abuse history,and 54 percent patients had had high purin food intake.Mean weight of body was (74.7?9.9)kg,and average body mass index(BMI) was (27.3?2.6).Events of inducing acute attack included engorgement,tire,infection,operation and trauma.Conclusion Risk factors of primary gout include age,sex,inherity,food habit,hyperlipemia,renal function failure.Engorgement,tire,infection,operation,trauma and use of diuretics could induce gout acute attack.It should be taken importance to that the onset age shows a young tendency.

Objective To study the clinical features and methods of early diagnosis of juvenile ankylosing spondylitis(JAS). Methods Twenty-four cases with JAS were prospectively analyzed and followed up. Results Among these 24 cases, ratio of male to female was 11∶1.The onset age was 8 to 15 years (mean 12 years). 63% cases aged 12~15 years. 63% cases had peripheral arthritis, 25% hips involved and only 2 patients (9%) had low back pain at onset . Eleven cases (46%) fulfilled modified New York diagnostic criteria for AS and 21 cases (88%) fulfilled the Shantou diagnostic criteria for AS. Additional 3 cases (13%) fulfilled the Shantou diagnostic criteria for AS after 2 years follow-up. Conclusion 90% cases with JAS has peripheral arthritis and hip involvement at onset. The Shantou diagnostic criteria for AS has higher sensitivity than modified New York diagnostic criteria for AS.

Objective To investigate the reasonable use of triptorygium wilformed hoof F(TⅡ) and other slow acting antirheumatic drugs(SAARDs).Method Sixty-five patients with rheumatoid arthritis(RA) treated by TⅡ and SAARDs included methotrexate(MTX),sulfasalize (SSZ),azathioprine(AZA) with single or combination among them and followed-up for four years.Results One of SAARDs single therapy was favorable for most RA patients,combined use was needed only in 28 percent cases.Conclusions Based on the heterogeneity of RA, the therapeutic schadule should be altered according to the individual responses.TⅡ effecacy is higher than that of other SAARDs in treatment of patients with RA.

Objective To investigate the clinical therapeutic effect of thymosin combined with antibiotics on acute exacerbation of chronic obstructive pulmonary disease in eldly patients ,and its influence on cellular immune function.Methods 60 elderly patients with acute exacerbation of chronic obstructive pulmonary disease were select-ed,by using the method of random number table,they were divided into the treatment group (n =30)and control group (n =30).The control group was given antibiotics and conventional treatment,the treatment group was given thymosin on the basis of treatment of the control group.The clinical curative effect and the influence of the cellular immune function were compared in the two groups.Results The after treatment 1s forced expiratory volume (FEV1 ),FEV1 /FVC(%)and FEV1 /expected value (%)of the treatment group were (1.59 ±0.15)L,(58.83 ± 13.14),(76.13 ±3.21),and those of the control group were (1.31 ±0.11)L,(54.62 ±12.41),(68.74 ±3.01), the differences were statistically significant (t =7.261,6.923,8.793,all P <0.05).After treatment,the clinical symptom score and quality of life score of the treatment group were (3.71 ±0.83),(6.48 ±1.12),which were sig-nificantly lower than those of the control group [(4.71 ±0.79),(7.41 ±0.97)],the differences were statistically significant (t =4.983,4.214,all P <0.05).The total effective rate of the treatment group was 96.7%,which was significantly higher than 70.0% in the control group,the difference was statistically significant (χ2 =7.271,P <0.05).After treatment,the CD +4 ,CD +4 /CD +8 of the treatment group were (41.7 ±5.9),(1.35 ±0.49)respectively, which of the control group were (33.2 ±4.8),(1.89 ±0.65),the differences were statistically significant (t =5.107,3.142,all P <0.05).In terms of incidence of adverse reactions,the difference between the two groups was not statistically significant (P >0.05).Conclusion The clinical effect of thymosin combined with antibiotic therapy in the treatment of acute exacerbation of chronic obstructive pulmonary disease in elderly patients is remarkable,safe and reliable,and can improve the cellular immune function in patients,it is worthy of further clinical application.

Objective To understand the key points of the differential diagnosis between osteitis condensanse ilii(OCI)and early sacroiliitis.Methods From 1997 to 2004,33 cases of OCI were examined with HLA-B27 determination and sacroiliac joint CT scan,and needle biopsy was performed in some cases when needed.Data of clinical history,laboratory,CT scan,as well as pathological examination were collected and analyzed.Results Sacroiliitis was diagnosed in 17(51.5%)cases of the 33 X-ray OCI cases either by CT scan or by pathological examination.Clinical features of these 17 cases included:(1)HLA-B27 was positive in more than 80%of these cases;(2)The age in these cases was younger than that in the OCI cases;(3)About 1/3 of these cases were male,and most of the female were unmarried and nanparous;(4)Most of the cases were with the signs of sacroiliits;(5)? globulin/ ESR/CRP/alkali phosphatase were elevated in most cases.However,among OCI cases,the prevalence of HLA-B27 was similar to general population;all of the cases were female;most of them were pluripara,and few cases were with the signs of sacroiliitis or laboratory abnormalities.Conclusion In X-ray OCI,many cases might be early sacroiliitis.Attention should be paid to avoid misdiagnosis.

Objective To evaluate the clinical effect of the upper lip defect with lower cross-lip flap (Abbe-Estlander flap).Methods A total of 68 cases of upper lip defect underwent the reconstruction with cross-lip flaps.We applied Abbe flap in upper lip defect in the center,and Estlander flap in lateral upper lip defect.This method was a two-stage procedure:the first stage was to rotate flap 180 degrees into the upper lip defect and to suture with the created defect of the upper lip,with careful maintenance of blood supply from the pedicle; the second was to undertake the division of bridged pedicle and paid more attention to creation of the vermilion border.Results The flaps survived in all cases.Evaluation from 3 to 12 months after the operation showed that the shape of lips were obviously repaired with excellent aesthetic and functional results.Conclusions Abbe-Estlander flap could reconstruct anatomical features and function of the lip precisely.It seems that within certain limits (probably between one-third and one-half of total upper lip length),this flap appears to be the preferred method for upper lip reconstruction.

Objective To evaluate the value of DWI in detecting active sacroiliitis in patients with axial spondyloarthritis ( SpA) .Methods DWI and conventional MRI examinations were done oblique coronary on bilateral SIJs of 19 participants,involving 8 patients (the case group) underwent clinical and conventional MRI evaluation for axial SpA active sacroiliitis and 11 healthy volunteers(the control group).The conventional MRI,DWI,ADC,EADC images were transmitted to two experienced radiologists respectively to read ,evaluate and measure ( the ADC values and EADC values ) at the workstation under the blind method .The experimental data were inputted and analyzed by statistics software .Results In the control group ,the periarticular bone marrow in the SIJ showed hopyintense signal on the DWI image ,hypointense signal on the ADC image and hyperintense signal on the EADC image .The periarticu-lar bone marrow oedema showed hyperintense signal on the DWI and ADC images , while hopyintense signal on the EADC image.At b values of 300s/mm2 ,the ADC values of the periarticular bone marrow oedema at each side in the case group were significantly higher than those in the control group , while EADC values were lower , the difference were statistically significant(Z=-3.115,-2.814,-3.002,-3.115,-3.115,-2.714,-2.889,-3.115,all P<0.05).Conclusion DWI can directly detect the signal changes ,extent of the periarticular bone marrow oedema , and analyze the severity of oedema quantitively ,which shows the utility in determining the activity and early diagnosis .

Objective To explore the value of water -based material decomposition images for detection of bone marrow edema (BME)in sacroiliitis with energy spectral CT.Methods The sacroiliac (SI)joints of nine spondyloarthropathy patients with sacroiliitis (the research group)and eight healthy volunteers (the control group) were underwent MRI and energy spectral CT.The mixed energy image of energy spectral CT was reconstructed to be mono energy image.Then,the mono image was divided into water -based image and calcium image by material divid-ed and analyzed software.The SI para -articular marrow region water -calcium relative concentration of research group was compared with that of control group.The BME diagnosis efficiency and optimal water -based concentration of energy spectral CT was analyzed by receiver operating characteristic (ROC)curve.Then,the sensitivity,specificity, positive likelihood ratio and negative likelihood ration were calculated.Results The water -based concentration of BME in research group (1 067.43 ±10.84)g/L was higher than that of control group (1 039.43 ±8.01)g/L(t =-3.14,P =0.003).Meanwhile,the calcium -based concentration of research group (68.98 ±20.53)g/L was not different from control group (78.03 ±26.39)g/L(t =1.88,P =0.066).ROC curve showed that the diagnosis efficiency was medium as the area of under curve was 0.75.When the optimal concentration of water -based was 1 052.00g/L,the diagnosis efficiency was the best.The sensitivity and specificity was 84.00%,62.50% respectively. Conclusion There are reference value and potential clinical value with energy spectral CT water -based concentra-tion detection for diagnosis BME in patients with sacroiliitis.

Objective To evaluate the clinical value of multislice-CT angiography (MSCTA)in planning for the patients undergoing deep inferior epigastric artery perforator (DIEAP) flap operations. Methods Eighteen patients were performed with a 16-slice CT scanner to evaluate the deep inferior epigastric artery perforator prior to DIEAP flap operations. Axial, multiplanar reconstruction( MPR), maximum intensity projection(MIP) and volume rendered (VR) images were analysed and the origins, calibers, courses and anatomic relationships of the deep inferior epigastric artery perforator were evaluated. The anastomosis between the superficial inferior epigastric artery and the main perforator was observed as well. The images were classified into three grades based on the vessels'appearance. A + indicated the vessel appeared clear,continuous and thick. A- indicated the vessel appeared foggy,discontinuous and thin or the vessel partly showed. B indicated no related vessel can be seen. Other 18 patients undergoing conventional abdomen-pelvis CT scans for other reasons were used for control group to compare their CT findings of the deep inferior epigastric artery perforator. Results MSCTA well showed the course of the deep inferior epigastric artery (DIEA). Of the 18 cases, 17 cases appeared as A +, another one A -. It precisely displayed the origins, subcutaneous and intramuscular courses, relations of the main perforators on all cases of showing A +. The exact points where the chosen perforator vessels emerged from the rectus abdominis muscle fascia were located precisely. The superficial inferior epigastric arteries were mostly displayed and the connection between the arteries and the largest-caliber perforator from the deep system could also be shown clearly. Strict concordance with operative findings was found in CTA. Conclusion MSCTA can precisely locate the chosen perforator vessels emerging from the rectus abdominis muscle fascia and it may be a feasible, fast, safe and effective method for preoperative evaluation of DIEAP.

Objective To analyze the characteristics of published radiology original articles in China,and compare radiology research inboard and abroad.Methods According to the Contents of Chinese Science Core Periodicals in 2012,there were 15 comprehensive radiological core periodicals in China.All of them were retrospectively surveyed,and original articles published between October 2011 and October 2012were evaluated.The following information was abstracted from each article:radiologic technique used,radiologic subspeciahy,type of research,sample size and study design.At the same time,all the original articles from two top radiology journals,Radiology and European Radiology (ER) at the same period were evaluated.Chi-square test was used to compare the composition percentage inboard and abroad.Results There were 2784 original articles published in the 15 Chinese top radiological periodicals in total The most commonly used radiologic techniques were CT (1093 of 2784,39.3％),MRI (824 of 2784,29.6％) and intervention (402 of 2784,14.4％).Radiology and ER totally published 560 original articles.MRI (265 of 560,47.3％),CT (170 of 560,30.4％) and mixed techniques (63 of 560,11.3％) were most used.In China,as much as 2572 (92.4％) articles were clinical research,115 (4.1％) was basic research,9 (0.3％) was clinical and basic research,and 83 (3.2％) was non-basic non-clinical research.The sample size of less than 10,between 10 to 50,and more than 50 was 374 (13.4％),1448 (52.0％) and 847 (30.4％) respectively.339 (12.2％) Chinese articles belonged to perspective research,and 1211 (43.5％) were retrospective.For Radiology and ER,515 (92.0％) articles were clinical research,39 (7.0％) was basic research,3(0.5％) was clinical and basic research,and 3(0.5％) was non-basic non-clinical.The sample size of less than I0,between 10 to 50,and more than 50 was 30 (5.4％),225 (40.2％) and 252 (45.0％) respectively.230 (41.1％) articles belonged to perspective research,and 202 (36.1％) ones were retrospective.Radiology and ER articles used MRI more than that published in Chinese radiology journals (x2 =666.690,P ＜ 0.01).Clinical research was the most commonly used research type both inboard and abroad (x2 =0.116,P ＞0.05).Articles of sample size more than 50 abroad were more than that of China (x2 =44.895,P ＜0.01).Perspective research was used more abroad (x2 =275.667,P ＜ 0.01),and the main research type in China was retrospective.Conclusion Chinese radiology workers might need to do more perspective and larger sample size clinical researches.