Objective The purpose of this study was to describe the clinical and CT features in Cryptogenic organizing pneumonia(COP),and method of managemant.Methods We reviewed characteristics of clinical,laboratory,chest CT and pulmonary function test of 6 patients with histologically proven COP,and evaluated their therapeutic response to corticosteroids.Results Most patients of 6 cases manifested as a persistent nonproductive cough,exerting dyspnea,pyrexia,malaise,and weight loss clinically.Less common symptoms include pleuritic chest pain and hemoptysis.Chest CT manifestations included ground-glass opacity,consolidation,diffusing reticular infiltration of parenchyma,pleural effusion,cavitation and migration.The patients had high level of peripheral WBC number,erythrocyte sedimentation,and C-reactive protein.Pulmonary function tests showed a impairment of restrictive pattern and diffusion capacity.All but one Patients responsed well to corticosteroids.Conclusions COP is a rapidly developing pneumonia-like illness characterized by lung inflammation,The clinical doctor must always be aware of the full view of COP so as to achieve successful diagnosis.Most of the patient can recover with corticosteroids therapy.

Objective To evaluate the clinical features and various diagnostic methods for sarcoidosis.Methods The data of 28 cases with sarcoidosis confirmed by pathology were reviewed and analized,and different diagnostic methods were compared.The disease was evaluated by regular serological tests,chest X ray film,chest high resolution computed topography(HRCT),bronchofibroscopy,and pulmonary function test.Results These patients shared a typical clinical presentation,consisting of dyspnea,cough,subskin nodes,enlargement of peripheral lymphnodes and splenomegaly.Laboratory test revealed elevated serum blood sedimentation,alkali phosphatase,Angiotensin-converting,and urine calcium.The saricoidosis was confirmed by pathological biopsy for bronchial mucosa,lung tissues,peripheral lymphnodes,subskin nodes biopsies and spleen.HRCT showed its superiority to traditional X ray film examination in fingding early staging chest sarcoidosis.Conclusions Chest HRCT and bronchopulmonary biopsy through bronchofibroscopy possess significant clinical value for sarcoidosis diagnosing and staging.And extropulmonary lessions biopsy also plays a complementary role to some extent.

Objective To observe the anti-aging effect of Shenqi Wangjiang preparation on the old rats by the research on measuring serum testosterone and estradiol. Methods Measurate serum testosterone and estradiol of the old rats by the means of RIA, and observe the prevention and cure effects of Shenqi Wangjiang preparation by comparing with other groups. Result Shenqi Wangjiang preparation can enhance the serum testosterone and estradiol of the old rats. Large and middle dose have obvious effect (P

Rheumatoid diseases (RD) are a group of diseases affecting bones,joints,and the surrounding soft tissues,such as muscle,synovial membrane,tendons,fascia,nervus.The etiology and pathogenesis are complicated.Since most RD are systemic diseases,traditional imaging techniques have limited value for the diagnosis and treatment monitoring of RD.18F-FDG PET/CT can display morphologic and metabolic information simultaneously,and is considered as a potential tool for the diagnosis of RD.This review summarizes the application of 18F-FDG PET/CT in RD,such as systemic vasculitis,relapsing polychondritis and rheumatoid arthritis.

Objective To observe the radiological feature of chest X ray in SARS patients. Methods The chest films of 54 cases of SARS were reviewed in the study. The chest film features and site of lung involvement were studies in early stage, most severe stage and recovery stage. The correlation between the score of lung involvement and clinical course was also studied. Results 79.63% cases had abnormal chest films in early stage. Most of them (72.22%) were found in 3～7 days after onset. The lung involvement was most common in bilateral (88.89%) and most in middle and lower field (46.30%). Exudation and consolidation lesions showed to be dominant. The lesions progressed quickly and showed to be variable. There are 17 (31.48%) cases had second peak in X ray, the mean time of onset is 14.71 days. The chest X ray is not parallel with clinical syndrome. The absorption of lung infiltrates is correlation with glucocorticosteroids treatment in 20 patients, and the correlation is not found in 26 patients.Conclusions The chest X ray of SARS has some features and its changes can reflect the clinical situation.

OBJECTIVE:To determine the contents of fleroxacin and tinidazole in compound fleroxacin suppository METH_ODS:RP-HPLC was used,the detecting conditions:ODS-C18 column;mobile phase,0 05mol/L lemon acid-acetonitrile(65∶35),was modulated to pH=4 0 with triethylamine;flow rate 0 8ml/min;external standard method;detective wavelength 300nm RESULTS:Linear ranges were 9 92～79 36?g/ml(for fleroxacin) 20 32～162 56?g/ml(for tinidazole) respectively wh_ere the peak areas were correlative with the concentrations,r=0 9 974 and 0 9 995 The average recoveries were 101 6% and 100 1% and RSDs was 1 4% and 1 2% respectively CONCLUSION:This detecting method is simple,rapid,accurate and suitable for determination of the contents of this preparation

Objective To investigate prevalence of associated diseases in patients with gout as well as their diagnoses and treatment. Methods Two hundreds out-patients diagnosed with gout from April to October 2008 were investigated at Peking University People's Hospital, and information collected included their general characteristics, associated diseases, diagnoses and treatment, as well as blood lipid profiles, serum creatinine, uric acid, results of routine urine tests and glomerular filtration rate estimated by MDRD formula in the past three months. Results Among patients with gout, prevalence of associated hypertension, obesity, renal calculi, coronary heart disease, cerebral infarction and diabetes were 54.5% (109/200), 23.2% (42/181), 20.0% (40/200), 12.0% (24/200), 8.0% (16/200) and 7.0% (14/200), respectively, and 53.7% (101/188) of them associated with hypertriglyceridemia, 63.7% (114/179) with impaired renal function and 15.1% (27/179) with chronic kidney disease. In acute attack of gout, 124 (62.0%) of them were treated with non-steroidal anti-inflammatory drug (NASID), 72 (36.0%) with colchicines, 12 (6.0%) with corticosteroid and 30 (15.0%) with urate-lowering drugs, respectively, and during its intermittent period, 69. 8% (81/116) of them received urate-lowering therapy with indications generally accepted internationally, but serum level of uric acid could be maintained below 0.06 g/L in only 8.6% (10/116) of them. And 73.8% (48/65) of the patients with no therapy indications also were treated with urate-lowering drugs. Conclusions The most commonly associated diseases in gout patients are hypertension, hyperlipidemia and obesity, followed by renal calculi, chronic kidney disease and coronary heart disease, and so on. At present, oral NSAID is the first choice of drugs for its acute attack. Indications for urate-lowering therapy in this hospital usually are not consistent with those by generally international acceptance, with lower therapeutic effectiveness achieved.

Objective To analyze the 5-year survival rate,causes of death and prognostic indicators of systemic lupus erythematosus (SLE).Methods A retrospective analysis was performed on 243 newly diagnosed SLE patients who Were admitted into our hospital from 1998 to 2005.The clinical features and serologic data were studied.Survival rate of SLE patients over time was studied by the Kaplan-Meier method,and prognostic indicators of mortality were studied by Cox proportional hazards models.Results The 1-,3- and 5-yr survival rate was 96%,94% and 91%,respectively.Renal failure and infection were the main causes of death,followed by lupus encephalotmthy and pulmonary hypertension.Cox regression analysis revealed that lupus nephritis and lupus encephalopathy at the diagnosis were independent risk determinants for mortality.However,age,sex,low C3 level,positive anti-dsDNA antibody,hematological abnormalities,lupus lung involvement and heart damages at diagnosis and immunosuppressant treatment had no strong association with survival.Conclusion Early diagnosis,control of SLE organ damage and infection prevention are critical to improve survival of SLE patients.

Objective To compare the value of clinical application of the ratio of urine albumin to creatinine (ACR) in the community-dwelled middle-aged and elderly at high-risk for diabetes in screening for albuminuria with casual and morning urine specimens. Methods Totally, 443 middle-aged and elderly people (234 men and 209 women) at high-risk for diabetes, with an average age of (59±8) years, were recruited from Changfeng Community of Shanghai in screening for albuminuria with casual and morning urine specimens collected on the same day, as well as another two morning urine specimens collected at an interval of two weeks, for determination of urine ACR. Albuminuria was defined as ACR equal to or more than 30 mg (albumin)/g (creatinnine) in two or more of the three urine specimens collected. Results Overall prevalence of albuminuria was 6. 3% ( 28/443 ) in the middle-aged and elderly according to diagnostic standard mentioned above, significantly higher in casual urine specimens than in morning urine specimens (14. 9% vs. 5.9%, P <0. 05). Urine ACR of casual urine specimens was significantly higher than that of morning urine (7. 1 mg/g vs. 3. 2 mg/g, P<0. 001 ). There was no significant difference in sensitivity and positive predictive value (PPV) between casual and morning urine specimens in screening for albuminuria (96. 4% vs. 92. 9%, and 99.7% vs. 99. 5%, respectively, P >0. 05). Specificity and negative predictive value (NPV) of casual urine specimens was significantly lower than those of morning urine specimens (90.6% vs. 100.0%, and 40.9% vs. 100.0%, respectively, P<0.05). The optimal cut-off value of ACR by casual urine specimens was 40. 0 mg/g in screening for albuminuria, based on receiver operating characteristic (ROC) curve, with sensitivity of 96. 4%, specificity 95.2%, PPV 57.5% and NPV 99. 8%. The middle-aged and elderly with negative albuminuria in morning urine but positive in casual urine had more risk factors for cardiovascular and chronic kidney diseases than those with negative albuminuria in both morning and casual urine specimens. Conclusions Morning urine specimen is better than casual urine for albuminuria screening in the middle-aged and elderly people with risk factors for diabetes in urban community, but casual urine used in screening for albuminuria is very convenient for collection. It is suggested that urine ACR of 40. 0 mg/g be used as an optimal cut-off value for casual urine in albuminuria screening among them.

Objective To explore an optimal cut-off value of waist circumference(WC)for identifying metabolic syndrome(MS)in middle-aged and elder residents in an urban community.Methods Database of 1558 residents aged 40-79 years at high-risk in screening for diabetes from Changfeng community,Putuo District,Shanghai during 2005 to 2007 was used to analyze sensitivity and specificity of varied cut-off values of WC for identifying two or more components of MS in men and women,respectively.Receiver operating characteristics(ROC)curve was used to explore the optimal value.Results Optimal cut-off value of WC was 85.0 cm for men and 80.0 cm for women,respectively,for identifying two or more components of MS bv ROC curve,with sensitivity of 72.3%and 74.9%,and specificity of 50.2%and 62.2%,respectively.Based on that optimal cut-off value of WC and definition of International Diabetes Federation(IOF),prevalence of MS was 38.8%in this population,40.7%in men and 37.8%in women,respectively.Conclusion The optimal cut-off value of WC was 85.0 cm in men and 80.0 cm in women,respectively,for identifying MS in the middle-aged and eldedy in an urban community of Shanghai.