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Objective:To analyze the clinical value of ultrasonic examination in the diagnosis of alcoholic liver disease.Methods:From April 2015 to December 2017, 68 patients with suspected alcoholic liver disease in the Mental Health Center of Yiwu were examined by ultrasound and liver function test.The diagnostic value of ultrasound examination was analyzed.Results:Liver function examination showed that 36 cases were diagnosed as alcoholic liver disease, 32 cases were diagnosed as fatty liver, 12 cases were misdiagnosed and 12 cases missed diagnosis.Ultrasound examination showed that 47 patients were diagnosed as alcoholic liver disease, 21 patients were diagnosed as fatty liver, 1 patient was misdiagnosed and 2 patients were missed diagnosis.The sensitivity, specificity and total accuracy of routine liver function examination in diagnosis of alcoholic liver disease were 62.50%(30/48), 70.00%(14/20), 64.71%(44/68), respectively.The sensitivity, specificity and total accuracy of ultrasound in diagnosis of alcoholic liver disease were 95.83%(46/48), 95.00%(19/20), 95.59%(65/68), respectively.The sensitivity, specificity and total accuracy of ultrasonic examination in diagnosis of alcoholic liver disease were significantly higher than those of routine liver function examination (χ 2=16.168, 4.329, 20.379, all P<0.05). Ultrasound examination showed that 35 cases were alcoholic fatty liver, 8 cases were alcoholic hepatitis and 4 cases were alcoholic cirrhosis.The coincidence rate of diagnosis was 97.92%(47/48). The Kappa test value was 0.895, which indicated that the consistency was good. Conclusion:Ultrasonic examination is effective and accurate in diagnosis of alcoholic liver disease, and it can be used to diagnose the type of disease.
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Objective To summarize the clinical characteristics and management of eosinophilic esophagitis (EoE) in China and improve the recognition of clinical doctor for this disease.Methods Electronic database was searched from 1993 to 2012 for case reports of EoE in Chinese patients.Data were enrolled according to the admission criterion,which included relatively complete medical records and cases confirmed by endoscopic biopsy and/or operation pathology.Results Data of 38 patients with EoE from 6 studies were included and analyzed.There were 24 males and 14 females.The age of onset was (47.2 ± 10.9)years.The process of the disease was (1.5 ± 1.8) years.The main symptoms included dysphagia (24/38,63％) and retrostemal pain (22/38,58％).Total 19 patients (83％,19/23) had allergy history and 20 patients (80％,20/25) had elevated blood eosinophil count.Lesions located at the mid-inferior esophagus mainly.Endoscopic manifestation included hyperaemia,erosion and fragile mucosa,and others such as mucosal nodular,ulcer,plaque and white exudates (18/38,47％).Eosinophil count in esophageal mucosa was (45.8 ± 34.1) numbers/HPF.Main treatment included corticosteroid and acid inhibitory medicine.Conclusions EoE is rare in Chinese people.EoE is more common in middle-aged males with chronic onset.Dysphagia and retrosternal pain is the common symptoms.Endoscopy and biopsy pathology are the methods for definition diagnosis.Corticosteroid and acid inhibitory medicine are the main treatment.
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Based on the results of oral glucose tolerance test( OGTT )and the levels of 1-h plasma glucose ( 1 hPG),793 subjects were classified into three groups:583 with NGTN ( normal 1 hPG in OGTT),127 with NGT1 H( higher 1 hPG in OGTT) and 83 with IGT( impaired glucose tolerance).NGT1H group had large waist circumference,higher body mass index,fasting plasma glucose( FPG),triglyceride,and lower high density lipoprotein-cholesterol than those of NGTN group.NGT1 H group had higher homeostasis model assessment insulin index ( 1.2 ± 0.6),lower homeostasis model assessment β3 ( HOMA-β ) (4.5 ± 0.7 ) and insulinogenic index (2.1 ±0.7) than those of NGTN group(0.5 ±0.6,4.8 ±0.7,2.7 ±0.9,respectively,all P ＜0.05 ).HOMA-β of NGT1 H group was higher than that of IGT group(4.5 ±0.7 vs.4.4 ±0.6,P ＜0.05 ).The results indicate that 1 hPG in OGTT may identify a condition of glucose metabolic abnormalities characterized by insulin resistance and reduced β-cell function.
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Objective To evaluate the function of peripheral vessels, the change of ankle-brachial Index (ABI) and toe-brachial Index (TBI), and its related risk factors in elderly type 2 diabetic patients were observed. Methods Doppler frequency spectrum was used on lower limb of 128 type 2 diabetic patients and 103 non-diabetic people. ABI and TBI were calculated, other indexes including body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), hypersensitivity C-reactive protein(hs-CRP), triglyceride (TG), total cholesterol (TC), high density lipopretein (HDL), low density lipoprotein (LDL), fasting blood glucose(FBG), postprandial blood glucose (PPBG) and glycosylated hemoglobin (HbAlC) were measured. Results ABI and TBI were decreased in T2DM group as compared with control group (P<0.05), and hs-CRP was increased in T2DM group. With multiple stepwise regression, it showed that ABI and TBI was negatively related with age, SBP and T2DM duration, while ABI was positively correlated with HDL. In multiple logistic regression, cigarette, age, high blood pressure(HBP) and T2DM duration were independent risk factors with respective odds ratios of 1.94 (P<0.05), 2.12(P<0.01), 2.74(P<0.05) and 1.59(P<0.05), respectively. Conclusion Older age, T2DM duration, ciga-rette, hyperglycosema, HBP, low HDL and high bs-CRP play important roles in the occurrence and development of peripheral vascular dis-ease (PVD) in elderly type 2 diabetic patients. PVD of type 2 diabetic patients can be found earlier with Doppler diagnostic instrument.
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A cross-section study was designed to investigate clinical utility of lipid measures for prediction of insulin resistance(IR).A total of 793 healthy volunteers were divided to IR group or non-IR group based on the value of HOMA-IR.Area under receiver operating characteristic curve(ROC)found that TG/HDL-C was more related with IR in comparison with other lipid ratios,and could be used as a measure in predicting IR.