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 distribution and evolution of the risk factors for coronary heart disease (CHD) in middle-aging males, and provide the evidence for the prevention and treatment of male patients with CHD. Methods 1639 male people over 45 years old were enrolled in the study. They were divided into non- senile group (45-59 years old) and senile group (60-93 years old).The subjects over 60 years old were further divided into three groups:60-69 years old group, 70-79 years old group, 80-93 years old group. The interrelation between the risk factors of CHD and aging was analyzed. Results The prevalence rates of drinking, smoking, diastolic hypertension and low HDL-C in non-senile group were much higher than those in senile group (x2=28.80,18.35,15.72,17.84,P<0.01). In contrast, the prevalence rates of overweight, systolic hypertension, fasting hyperglycemia,postprandial hyperglycemia in senile group were significantly higher than those in non senile group. The prevalence rates of high triglyceride in non- senile group and senile group were 18.0% and 16.2% respectively(P>0.05). The prevalence rates of high cholesterol in non- senile group and senile group were 36.9% and 31.5% respectively(P>0.05). There was a significant decrease in the prevalence rates of overweight, postprandial hyperglycemia (P<0.05) and drinking,smoking, diastolic hypertension, high triglyeeride (P<0.01) in over 70-year+old males. And the prevalence rates of overweight, postprandial hyperglycemia, high triglyceride of over 80-year-old males were higher than those of over 70-year-old males (x2=10.05,4.16,5.97,P＜0.01). However,the prevalence rates of systolic hypertension of over 80-year-old males were lower than those of over 70-year-old males (X2=21.25,P＜0.01). There was no significant change in other risk factors of CHD at different ages of senile group. Conclusions For non-senile males, the important measures to treat the risk factors of CHD should include stopping smoking, restricting alcohol, eating low fat diet, changing bad life habits, controlling diastolic hypertension and modifying lipid. In contrast, for senile males, more attention should he paid to limiting total energy intake, increasing sports, losing weight, controlling systolic hypertension, hyperglycemia and modifying lipid.

Objective To observe the changes of Lipids,FBS,ISI and lipoprotein lipase in obesity-related hypertensive patients and investigate the relationship of abnormal glucose and lipid with obesity-related hypertension as well as metabolic syndrome.Methods A total of 122 obesity-related hypertensive patients and 122 matched normal individuals were enrolled.Blood pressure,BMI,WHR and serum lipids and glucose,serum and adipose tissue LPL were measured.Results The TG,FBS and INS in obesity-related hypertensive patients were significantly higher than those in normal control group(P(0.05)).Correlated analysis showed that serum LPL mass was respectively correlated with BMI(r=-0.64,P

Objective To evaluate the effect of 99m Tc-MDP on clinical and laboratory parameters in rheumatoid arthritis(RA).Methods The study was a prospective open cohort design.Clinical manifestations were recorded accordingly before and after 99m Tc-MDP intravenous infusion.Serum CRP,IL-1?,TNF-?and ESR were also measured.Results At the end point,morning stiffness,strength,index of joint tenderness,swelling,rest pain and physician assessment were all improved significantly(P

Objective:To understand the current situation of effective teaching behavior of clinical nursing teachers and analyze it.Methods:A convenient sampling method was used to conduct a questionnaire survey on nursing students and teaching teachers in Tai′an City central hospital and the Second Affiliated Hospital of Shandong First Medical University, using Cui Shasha Chinese version of Nursing Clinical Teacher Effectiveness Inventory as the research tool.Results:The score of the teachers in the "interpersonal relationship" dimension was the highest (6.32±0.89), while the score in the "nursing ability" dimension was the lowest (5.95±0.99). There was no statistically significant difference between college students and undergraduate students in the evaluation of effective teaching behaviors of teachers, while there was statistically significant difference between nursing students (including college students and undergraduate students) and teachers in all dimensions and total scores of the scale ( t values were -4.616--2.250, P<0.05 or 0.01). Teachers and students were more consistent with the 10 items with low scores than the 10 items with high scores (the total number of items was 2 and 5, respectively). Conclusions:The teaching teacher should be able to correctly identify and judge the learning needs of the internship nursing students, so that the teaching effect meets the expectations of the internship nursing students, and should be targeted when teaching internship nursing students of different educational levels as well as focusing on nursing research.

Objective:To systematically evaluate the effects of different umbilical cord time on maternal and fetal outcomes.Methods:Meta analysis was used, CNKI, Wanfang, VIP, PubMed, The Cochrane Library, EBSCO, Web of Science database, etc. were searched. The literatures were screened according to the inclusion and exclusion criteria, and the literature quality was evaluated. Revman 5.2 software was used for data processing and analysis.Results:A total of 9 randomized controlled trials were included. Meta-analysis showed that delayed umbilical cord did not increase postpartum 2,24 h hemorrhage[mean difference ( MD)=-40.69, 95%confidence interval (CI) (-83.05-1.67), P>0.05 and MD=-10.33, 95% CI (-22.47-1.81), P>0.05] and did not prolong the third stage of labor [ MD= 0.32, 95% CI (-0.71-1.35), P>0.05] compared with conventional umbilical cord (early umbilical cord) method. 1,5 min Apgar scores for different neonatal umbilical cord time was not statistically significant[ MD=0.05, 95% CI (-0.02-0.12), P>0.05 and MD=-0.01, 95% CI (-0.04-0.03), P>0.05]. There was no significant difference in neonatal weight [ MD=72.91, 95% CI (-53.98-199.80), P>0.05]. Delayed umbilical cord could improve the newborn's 24 h capillary hemoglobin [ MD=17.69, 95% CI (13.55-21.83), P<0.01] and bilirubin peak [ MD=17.50, 95% CI (11.88-23.12), P<0.01]. Conclusions:Delayed umbilical cord and early umbilical cord did not increase postpartum hemorrhage and prolong the third stage of labor, and had no adverse effects on maternal. The peak levels of capillary hemoglobin and bilirubin in newborns were increased 24 h, but there was no significant difference in neonatal 1 min and 5 min Apgar scores and neonatal weight.

Objective To elucidate the effect of Deduhonghua-7 powder and its main components on liver fibrosis induced by carbon tetrachloride(CCl4)by regulating chemokine receptor 1(CCR1)and DNA methyltransferase 1(DNMT1).Methods C57BL/6 mice were randomly divided into blank group,model group,Deduhonghua-7 powder group(0.75 g·kg-1 Deduhonghua-7 powder),Scabiosa Atropurea group(0.75 g·kg-1 Scabiosa Atropurea)and Luteolin-L,-H groups(0.02 and 0.04 g·kg-1 Luteolin,respectively).Except the blank group,the other groups were intrabitoneally injected with 10％CC14 olive oil solution to establish liver fibrosis model,and all groups were given 0.5％CMC-Na dissolved intragastric drug once a day for 4 weeks,and blood and liver tissues were collected after the last administration.The serum CCR1,DNMT1,α-smooth muscle actin(α-smA)and precollagen Ⅲ contents were detected by enzyme linked immunosorbent assay;the CCR1,DNMT1,α-smA,Collagen Ⅰprotein expression were detected by Western blot.Result The contents of serum DNMT1 in blank group,model group,Deduhonghua-7 powder group,Luteotin-L,-H groups and Scabiosa Atropurea group were(4.56±0.69),(6.09±0.59),(5.21±0.33),(4.99±0.68),(5.03±0.45)and(5.17±0.61)pg·mL-1;the contents of CCR1 were(13.38±0.47),(11.20±0.73),(12.97±0.80),(12.89±0.75)(12.88±0.95)and(12.92±0.58)pg·mL-1;the contents of α-smA were(181.80±24.50),(281.30±26.60),(220.90±22.30),(193.70±16.10),(199.30±17.70)and(205.80±14.70)pg·mL-1;the contents of procollagen Ⅲ were(49.29±8.26),(77.56±8.61),(67.56±5.63),(55.47±7.07),(64.93±8.66)and(59.66±8.51)pg·mL-1;the relative expression levels of DNMT1 protein in liver tissues were 0.08±0.03,0.26±0.08,0.13±0.01,0.12±0.05,0.13±0.05 and 0.15±0.03;the CCR1 protein relative expression levels were 0.18±0.03,0.13±0.02,0.21±0.06,0.22±0.07,0.17±0.07 and 0.18±0.06;the α-smA protein relative expression levels were 0.03±0.01,0.27±0.11,0.09±0.05,0.12±0.08,0.09±0.07 and 0.11±0.07;the expression of Colagen Ⅰ protein were 0.09±0.04,0.65±0.22,0.28±0.12,0.26±0.19,0.30±0.22 and 0.25±0.12.The differences of above indicators between the model group and the blank group,between the Deduhonghua-7 powder group,Luteotin-L,-H groups,Scabiosa Atropurea group and the model group were statistically significant(all P＜0.05).Conclusion Luteotein is one of the pharmacodynamic substance bases of Deduhonghua-7 powder to alleviate liver fibrosis induced by CC14.It can inhibit or delay the formation of liver fibrosis through CCR1,DNMT1,α-smA and Collagen Ⅰ proteins.

Objective To investigate the clinical significance of D-dimer in systemic lupus erythematosus (SLE). Methods The study group comprised 261 SLE patients who were admitted in ward from 2005 to 2008 in Peking University People's Hospital Collect the clinical data to investigate the clinical significance of D-dimer. Results ( 1 ) The D-dimer levels of 56 patients were increased due to coexist reduced renal function, infections, disseminated intravascular coagulation ( DIC), liver disorders, pregnancy and injury. With the exception of above patients, 142 ( 69. 3 ) patients were increased in total 205 patients. (2)The level of D-dimer was positively correlated with SLE disease activity index( SLEDAI ) score ( r =0. 598,P =0. 000), and was associated with anti-dsDNA antibody, ESR, C-reactive protein(CRP) and complement C3 and C4. (3)D-dimer level was associated with important organ involvement. (4)All patients with thrombosis had increased D-dimer, but patients without thrombosis had normal or increased D-dimer levels. Conclusion The level of D-dimer elevates in patients with active disease or important organ involvement , it can not identify thrombosis. All patients with thrombosis had increased D-dimer levels.

Objective To explore MRI findings of intervertebral suppurative spondylitis. Methods MRI findings of intervertebral suppurative spondylitis in 12 cases proved by surgery and 6 cases defined by clinical features were retrospectively analyzed. The MRI protocol included un-enhanced conventional scan in 18 cases and contrast-enhanced scan in 11 cases. Results Of the 18 cases, single focus was found in 16 cases, and multiple loci were seen in 2 cases. MRI findings included (1) Disappearance sign of nuclear crevice in 17 cases, accumulated fluid sign of intervertebral disc in 15 cases, intervertebral disc perforation in 4 cases, and intervertebral space narrowing in 7 cases. (2) Bone destruction under end plate and marrow oedema were shown in 18 cases, 17 cases had end plate destruction, 16 cases had covered sign of end plate.(3) Paraspinal soft tissue swelling was shown in 18 cases, in which thick wall microabscess was formed in 4 cases. (4) Vertebral canal was involved in 12 cases, vertebral canal abscess was formed in 5 cases.(5) Lump enhancement was demonstrated in 4 cases, nodular enhancement in 2, and ring-like enhancement in 2, respectively. No enhancement was seen in 3 cases. Dural sac linear enhancement was shown in 6 cases, and patchy enhancement in the anterior dural sac was shown in 10 cases. Conclusion Intervertebral suppurative spondytitis had characteristic MRI findings, and the key to correct diagnosis was to combine MRI finding with clinical characteristics.

Adolescent ; Diagnosis, Differential ; Female ; Humans ; Myositis Ossificans ; diagnosis