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.
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.
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.
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.
