6 mmol/L) and treated with ACEI and spirolactone were included in this study. Patients were followed up for at least one month after admission. Results The mean age of the patients (9 males, 13 famales) was (72?11) years old. Four of them were diabetics. On admission, the serum potassium was (7.3?0.8) mmol/L and serum creatinine was (318.2?150.3) ?mol/L; these values were significantly higher than the most recent laboratory measurements (4.5?0.6) mmol/L and (159.1?114.9) ?mol/L, respectively obtained (11?4) weeks before admission. Out of these patients, 19 suffered from acute renal failure and the main causes were dehydration (n=11) and severe heart failure (n=8). The mean daily dosage of spironolactone was (48?27) mg. Among them 11 were concomitantly treated with other drugs that might cause hyperkalemia, and finally 1 patient died and 8 patients were treated by hemodialysis. Conclusions A combination treatment of ACEI and spironolactone should be considered with caution and serum potassium level should be monitored closely in patient with renal insufficiency, hyperkalemia, severe heart failure, diabetes, especially in those elder patients. Daily dosage of spironolactone should not be over 20 mg.

Objective To observe the changes of left atrial dimension and f unction before and after cardioversion for atrial fibrillation (AF) and the rela tion between dimension and function.Methods Among 94 cases,34 ca ses who had spontaneous cardioversion converted to sinus rhythm,60 cases were ra ndomly grouped into 31 cases with drug cardioversion and 29 cases with direct-c urrent shock.Left atrial diameter,volume and A-wave velocity were measured to e valuate left atrial dimension and function using Dopplor echocardiogram in all c ases before and after cardioversion.Results After conversion,Lef t atrial diameter and volume decreased remarkably (P

Although guidelines and expert consensuses have been published on the diagnosis and treatment of cholestatic liver disease recently in China and the rest of the world, many problems still exist in the biochemical standard for the diagnosis of cholestasis; for example, there are substantially different diagnostic criteria for cholestasis of various causes. This brings confusion to clinical doctors and is not good for research. This article analyzes common parameters in cholestasis and points out the problems in diagnosis. It is recommended to organize in-depth discussions and set standard for the diagnosis of cholestasis, in order to provide a more reliable basis for clinical research on cholestasis.

Background and objectiveComputed tomography-guided needle biopsy (CTNB) is a well-established and commonly used technique for diagnosing pulmonary nodules with high accuracy and safety. Needle-tract implantation after CTNB has been reported in various reports. The aim of this study is to evaluate whether preoperative CTNB affected the distant metastasis and overall survival in pathological stage I-II lung cancer patients.Methods A total of 1,234 patients with pathological stage I-II non-small cell lung cancer were collected. 113 patients received preoperative CTNB, and 1,121 patients did not receive any biopsy before surgical resection. Propensity score-matching method was adopted to balance observed co-variates between two groups, 113 pairs were matched.Cox regression analysis andKaplan-Meier estimates were used to process survival analysis.Results Distant metastasis free survival (DMFS) was significantly poorer in the preoperative CTNB group than in the non-biopsy group (P=0.032). But there was no difference in the overall survival between the two groups (P=0.086). Conclusion CTNB increased the risk of distant metastasis, not increasing the risk of mortality.