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Objective:To analyze the risk factors of frequent gout flare, and to evaluate its susceptibility to identify patients with≥2 acute attacks per year.Methods:A total of 579 of cases gout patients with no history of taking urate lowering treatment (ULT) in recent 12 months were enrolled. The patients were divided into frequent group (gout episodes≥twice per year) and non-frequent group(gout attacks<twice per year). The clinical information was collected and relevant biochemical indices were detected.Results:There were significant differences in involvement of upper limb joints, tophi, combining hypertension and renal stone between two groups. The two groups had no statistical differences in family history, gender, history of smoking and drinking, ratios of regular exercise, and combining diabetes, hepatic insufficiency, hypertriglyceridemia, hypercholesterolemia, and overweight/obesity. There was significant differences in the number of joints involved, the history of disease duration, the level of SUA and TG[(4.66±2.54) vs (2.77±1.64), (6.68±5.11) vs (5.14±3.89) years, (525.82±132.11) vs (489.33±139.81) μmol/L, (2.51±1.94) vs (2.05±1.22) mmol/L, P<0.05 or P<0.01]; There were no statistical differences in age of onset, SBP, DBP, age of initial diagnosis, fasting blood glucose, TC, creatinine, glomerular filtration rate, AST, ALT, body mass index, waist circumference, and waist-to-hip ratio. Logistic regression analysis indicated that a large number of joints involved and higher serum uric acid level were risk factors of frequent gout attacks. The ROC curve showed that the number of joints involved had qualified performance in identifying patients with frequent gout attacks. When the number of joints involved was >2, and the sensitivity, specificity, positive predictive value and negative predictive value were 77.8%, 43.3%, 85.6%, and 56.6%, respectively, and the difference was significant. Conclusion:Higher SUA and a larger number of joints involved associate independently with frequent gout attacks. The number of joints involved at initial diagnosis>2, which can predict the frequent flare, and start ULT as earlier as possible. Patients with joints involved at initial diagnosis>2 are at greater risk of frequent gout flare.
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Objective@#To analyze the risk factors of frequent gout flare, and to evaluate its susceptibility to identify patients with≥2 acute attacks per year.@*Methods@#A total of 579 of cases gout patients with no history of taking urate lowering treatment (ULT) in recent 12 months were enrolled. The patients were divided into frequent group (gout episodes≥twice per year) and non-frequent group(gout attacks<twice per year). The clinical information was collected and relevant biochemical indices were detected.@*Results@#There were significant differences in involvement of upper limb joints, tophi, combining hypertension and renal stone between two groups. The two groups had no statistical differences in family history, gender, history of smoking and drinking, ratios of regular exercise, and combining diabetes, hepatic insufficiency, hypertriglyceridemia, hypercholesterolemia, and overweight/obesity. There was significant differences in the number of joints involved, the history of disease duration, the level of SUA and TG[(4.66±2.54) vs (2.77±1.64), (6.68±5.11) vs (5.14±3.89) years, (525.82±132.11) vs (489.33±139.81) μmol/L, (2.51±1.94) vs (2.05±1.22) mmol/L, P<0.05 or P<0.01]; There were no statistical differences in age of onset, SBP, DBP, age of initial diagnosis, fasting blood glucose, TC, creatinine, glomerular filtration rate, AST, ALT, body mass index, waist circumference, and waist-to-hip ratio. Logistic regression analysis indicated that a large number of joints involved and higher serum uric acid level were risk factors of frequent gout attacks. The ROC curve showed that the number of joints involved had qualified performance in identifying patients with frequent gout attacks. When the number of joints involved was >2, and the sensitivity, specificity, positive predictive value and negative predictive value were 77.8%, 43.3%, 85.6%, and 56.6%, respectively, and the difference was significant.@*Conclusion@#Higher SUA and a larger number of joints involved associate independently with frequent gout attacks. The number of joints involved at initial diagnosis>2, which can predict the frequent flare, and start ULT as earlier as possible. Patients with joints involved at initial diagnosis>2 are at greater risk of frequent gout flare.
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Objective To explore the clinical and pathological features of laterally spreading tumor ( LST) in colon, and the efficacy and safety of endoscopic submucosal dissection ( ESD) . Methods A total of 376 cases with 403 lesions of LST were detected by colonoscopy in the First Hospital of China Medical University from April 2014 to December 2016. The site, size and classification of all lesions were recorded. One hundred and sixty lesions in 143 patients underwent endoscopic treatment, and Their pit pattern were observed. The resected lesions were sent for pathological examination. The patients were followed up regularly after treatment. Results Among 403 cases of LST, 168 lesions ( 41. 69％) were located at rectum, which was the main site. Lesions with diameter of 10-<20 mm were of the largest number (37. 22％, 150/403). Nodular mixed type was the main morphologic type with a total of 203 lesions ( 50. 37％) . The main pathologic type was low-grade adenoma ( 65. 51％, 264/403) . The malignant potential rose with the increase of diameter of LST lesion ( P<0. 05) . Compared with the LST granular type, LST non-granular type had a higher pathologic malignant potential (P<0. 05). Among 403 lesions in 376 patients, 145 lesions in 128 patients were treated by ESD. Intraoperative bleeding occurred in 12 patients, and no delayed bleeding or perforation occurred. Among the 160 treated LST cases,Ⅳ-type pit pattern was of the largest number, up to 70. 62％ (113/160). The canceration rate of Ⅴ-type pit pattern was the highest, up to 80. 00％ (8/10). Malignant degree of pathology ( P<0. 05) and penetration degree of cancer ( P>0. 05) showed an increasing trend with the upgrade of pit pattern of LST cases. Among the 128 patients who were treated by ESD, 113 cases were regularly reexamined, and 2 cases relapsed. Others whose wounds didn′t relapse healed well. Conclusion The clinical and pathological features of colorectal LST are unique. ESD is an effective and safe treatment for LST, which can achieve radical results.