Objective To evaluate the effect of epristeride on gross hematuria secondary to transurethral resection of prostate (TURP). Methods A total of 50 patients with gross hematuria secondary to TURP were divided into two groups: 25 patients were treated with routine treatment plus 5 mg epristeride, twice a day for 3 months, while the other 25 only received routine treatment. Results At the 6-month follow-up visit, gross hematuria recurred in 63% of patients in the control group, but in only 30% of patients in the epristeride group. The difference was statistically significant (Plt;0.05). Moreover, the grade of gross hematuria was significantly lower in the epristeride group (Plt;0.05). Conclusion Epristeride appears to be effective in treating gross hematuria secondary to TURP.
目的 探讨血尿酸与胰岛素分泌和敏感性的关系。 方法 对成都市龙泉驿区2007年6月－7月间20～75岁常住自然人群565人进行人口学、腰围、臀围、血压、75 g葡萄糖耐量及胰岛素测定（0、30、120 min），血脂、血肌酐及血尿酸检测。以早期胰岛素分泌功能指数（△I30/△G30）和葡萄糖处置指数（DIo）代表胰岛素分泌功能，以Matsuda 指数代表胰岛素敏感性，分别与血尿酸进行相关性研究。 结果 男性的血尿酸与年龄呈负相关，与舒张压、葡萄糖负荷后120 min胰岛素和甘油三酯呈正相关。女性的血尿酸与甘油三酯、低密度脂蛋白、血肌酐呈正相关，与高密度脂蛋白、Matsuda指数呈负相关。无论男性和女性，均未发现血尿酸与△I30/△G30、DIo相关。 结论 女性的胰岛素敏感性下降与血尿酸升高有关。未发现血尿酸与胰岛素分泌有相关关系。
目的：分析小儿紫癜性肾炎的临床特点。方法：回顾分析两院儿科最近8年收治的小儿紫癜性肾炎180例的临床表现、实验室检查结果，治疗和预后等方面的资料。结果(1)临床以血尿蛋白尿型最多见(61/180)，其次为急性肾炎型(36/180)、肾病综合征型(31/180)和单纯血尿或蛋白尿型(25/180)。(2)重症病儿短期使用激素可改善肾脏损害。(3)所有病例均有必要长期随访。结论：小儿紫癜性肾炎绝大多数预后良好，但病情反复不愈者可发展为终末期肾脏损害，故需要长期随访。
摘要:目的:探讨胡桃夹综合征(NCS)在成年患者中的临床表现、诊断及治疗特点。方法:回顾性分析四川大学华西医院泌尿外科2001年2月至2008年11月期间收治入院的21例胡桃夹综合征患者的临床病历资料。结果:21例患者男性15例,女性6例。以血尿为最主要的症状,其中19例(9048%)为肉眼血尿,2例(952%)为显微镜下血尿。17例(8095%)患者尿中正常形态红细胞≥85%,11例(5238%)患者尿蛋白呈阳性,9例(4286%)患者彩超发现平卧位左肾静脉最宽处内径(a)与最窄处内径(b)比值均数为45±24,直立位a/b均数为81±26。15例(7143%)患者CT呈现左肾静脉受压表现,8例(3809%)患者膀胱镜检见左侧输尿管口喷血。7例(3333%)行左肾静脉下移—下腔静脉端侧吻合术,平均血管阻断时间23±554min,血尿、蛋白尿在术后消失,其余14例(6667%)行保守治疗,获得随访的5例患者中有3例血尿消失,2例患者仍有无症状性血尿和蛋白尿。结论:尿红细胞形态、肾血管彩色超声、增强CT、核磁共振(MRI)及膀胱镜检查对胡桃夹综合征的诊断具有重要价值,左肾静脉下移—下腔静脉端侧吻合术治疗胡桃夹综合征效果明确,术后并发症少。 关键词:胡桃夹综合征;左肾静脉;血尿
目的:探讨老年代谢综合征者血清尿酸与血压、甘油三脂的关系。方法:163例入选者,MS组96例,对照组67例,对二组的SUA、BMI、WC 、SBP、DBP及TG进行分析。结果:MS组SUA较对照组高。MS组男性SUA与BMI正相关、女性与WC正相关;男女性MS组及对照组SUA与SBP及TG不相关。对照组女性SUA与DBP正相关。结论:SUA对老年女性DBP的维持可能有一定作用。TG对老年人SUA的影响有限;体重及脂肪聚集部位对SUA的影响,存在性别差异。
ObjectiveTo determine the diagnosis method for an elderly male patient with hematuria by means of evidence-based practice, so as to provide references for clinical diagnosis. MethodWe searched databases including PubMed, EMbase, and The Cochrane Library up to Nov. 2014, to collect relevant diagnostic evidence for elderly patients with hematuria. ResultsCompared with MRI, CT had higher sensitivity and specificity in determination of lesion location in where the hematuria was caused by tumor. ConclusionsCT scan may be better for patients with hematuria to determine the location of lesion.
ObjectiveTo investigate the effect of asymptomatic hyperuricemia on the effectiveness of arthroscopic rotator cuff repair.MethodsThe clinical data of 80 patients who underwent arthroscopic rotator cuff repair and met the selection criteria between March 2018 and December 2019 were retrospectively analyzed. According to the serum uric acid level, the patients were divided into hyperuric acid group (46 cases, the serum uric acid level was more than 417 μmol/L in males and was more than 357 μmol/L in females) and normal group (34 cases, serum uric acid level was lower than the above standard). There was no significant difference in gender, age, side, body mass index, blood glucose level, total cholesterol level, rotator cuff tear size, and preoperative shoulder motion, visual analogue scale (VAS) score, University of California-Los Angeles (UCLA) score, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and other general data between the two groups (P>0.05). The range of motion of abduction, forward flexion, and external rotation at 90° abduction were recorded and compared between the two groups before operation and at last follow-up; the improvement of shoulder pain was evaluated by VAS score; the improvement of shoulder function was evaluated by UCLA score, Constant score, and ASES score; and the shoulder joint MRI grade was evaluated according to Sugaya evaluation criteria.ResultsAll patients were followed up 9-16 months, with an average of 11.9 months; there was no significant difference in the follow-up time between the two groups (t=0.968, P=0.336). There were 2 cases of retear in the hyperuric acid group (including 1 case of severe tear) and 1 case of light retear in the normal group. The remaining patients in the two groups had no early-related complications. At last follow-up, the range of motion of the shoulder joints (abduction, forward flexion, external rotation at 90° abduction), VAS score, UCLA score, Constant score, and ASES score of the two groups were significantly improved when compared with preoperative ones (P<0.05); the above indicators in the normal group were significantly better than those in the hyperuric acid group (P<0.05). The MRI grade of the shoulder joint in the normal group was significantly better than that in the hyperuric acid group (Z=–2.000, P=0.045).ConclusionCompared with patients with normal serum uric acid level, asymptomatic hyperuricemia can lead to worse recovery after arthroscopic rotator cuff repair in patients with rotator cuff tears.
Objective To observe the correlation between homocysteine (Hcy) and serum uric acid (SUA) and retinopathy in type 2 diabetes mellitus (T2DM), preliminary study on its predictive value. MethodsA retrospective study. From January 2020 to March 2021, a total of 324 T2DM patients hospitalized in Department of Endocrinology, Cangzhou Central Hospital of Hebei Province were included. Fasting blood glucose (FBG), glycated hemoglobin (HbA1C), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), serum creatinine (Scr), blood urea nitrogen (BUN), Hcy, SUA, peripheral blood endothelial progenitor cells (EPC), circulating endothelial cells (CEC) were counted and homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. According to the absence or presence of diabetic retinopathy (DR), the patients were divided into non DR (NDR) group and DR group with 100 and 214 cases, respectively. Clinical data and laboratory biochemical indexes of the two groups were compared and observed. The logistic regression was used to analyze the independent risk factors for DR in T2DM patients. Smooth curve fitting was used to analyze the curve relationship between Hcy, SUA and DR, and ROC area (AUC) of Hcy, SUA; their combined prediction of DR in T2DM patients was calculated by receiver operating characteristic curve (ROC curve), and the predictive value of Hcy and SUA for DR in T2DM patients was evaluated. ResultsDiabetic course (t=5.380), systolic blood pressure (t=2.935), hypertension (χ2=10.248), diabetic nephropathy (χ2=9.515), diabetic peripheral neuropathy (χ2=24.501), FBG (t=3.945), HbA1C (t=3.336) and TG in DR Group (t=2.898), LDL-C (t=3.986), Scr (t=2.139), SUA (t=7.138), HOMA-IR (t=3.237), BUN (t=3.609), Hcy (t=2.363) and CEC (t=19.396) were significantly higher than those in NDR group. The difference was statistically significant (P＜0.05). EPC (t=9.563) and CPC (t=7.684) levels were significantly lower than those of NDR group, and the difference was statistically significant (P＜0.05). Logistic regression analysis showed that diabetes course, SBP, hypertension, FBG, HbA1C, LDL-C, SUA, Hcy, EPC, CPC and CEC were all independent risk factors for developing DR in T2DM patients (P＜0.05). The smooth curve fitting analysis showed that Hcy and SUA were positively correlated with the occurrence of DR. After adjusting for confounding factors, when Hcy≥15 μmol/L, the risk of DR Increased by 14% for every 1 μmol/L increase in Hcy [odds ratio (OR)=0.92, 95% confidence interval (CI) 0.88-0.98, P＜0.05]. When Hcy＜15 μmol/L, there was no significant difference (OR=0.96, 95%CI 0.92-1.08, P＞0.05). When SUA≥304 μmol/L, the risk of DR increased by 17%, every 20 μmol/L SUA increased (OR=0.80, 95%CI 0.68-0.94, P＜0.05). When SUA＜304 μmol/L, the difference was not statistically significant (OR=0.83, 95%CI 0.72-0.95, P＞0.05). ROC curve analysis results showed that the AUC values of Hcy, SUA and Hcy combined with SUA in predicting the occurrence of DR in T2DM patients were 0.775 (95%CI 0.713-0.837, P＜0.001), 0.757 (95%CI 0.680-0.834, P＜0.001) and 0.827 (95%CI 0.786-0.868, P＜0.001). Hcy combined with SUA showed better predictive efficiency. ConclusionsThe abnormal increase of Hcy and SUA levels in T2DM patients are closely related to the occurrence of DR, they are independent risk factors for the occurrence of DR. Hcy combined with SUA has high predictive value for the occurrence of DR.