The association of vitamin C,alcohol, coffee,tea, milk and yogurt with uric acid and gout

About 2500 years ago, gout was observed by Hippocrates and many people suffered severe pain and deformity. Lifestyle and diet play a significant role in gout and serum uric acid levels. Epidemiological and research studies have supported this evidence. Many recommendations and guidelines from different parts of the world mention the impact of diet on gout. Recently, new research has shown associations between vitamin C, alcohol, coffee, tea, milk and yogurt with uric acid and the risk of gout. Our review summarizes recently published research regarding dietary impact on the risk of gout and serum uric acid levels.     

中医药治疗痛风近况

痛风是临床常见的病症,严重影响患者的生存质量。近年来,痛风发病率逐年提高,而中医药对痛风具有确切的近期疗效,众医家对痛风的中医药治疗进行了较多的研究,积累了丰富的经验。本文就近5年中医药治疗痛风的最新进展予以综述。     

Ultrasound characteristics of gouty tophi in the olecranon bursa and evaluation of their reproducibility

Objectives

To describe the ultrasound characteristics of gouty tophi in the olecranon bursa and to evaluate their reproducibility.

Methods

A prospective study of the ultrasound features of 35 sites of tophi nodulations in the elbows of 31 men (mean 54.6 years). The findings were evaluated dynamically following pre-established standards. The static images were evaluated by another radiologist and were reviewed by the first examiner.

Results

The most frequent characteristics of tophi are: hyperechogenicity (91.7%), poorly defined contours (88.6%), multiple grouped nodules (85.6%) and heterogeneity (68.6%). Intra-observer agreement is almost perfect for echogenicity (K = 1.0), moderate for the involvement of the olecranon bursa (K = 0.47) and fair for other characteristics. Inter-observer agreement is substantial for the echogenicity (K = 0.65), fair for the echotexture (K = 0.27) and the presence of a perilesional hypoechoic halo (K = 0.34) and slight for other characteristics.

Conclusions

The most frequent characteristic of tophi is hyperechogenicity. The intra-observer and inter-observer concordance for echogenicity are almost perfect and substantial, respectively. Knowledge of characteristics of the tophi in the elbow and their intra and inter-observer reproducibility may assist in establishing parameters for monitoring treatment and setting up criteria for differential diagnosis of processes involving the olecraneon bursa.     

Serum lipids and lipoproteins in patients with primary gout

Summary Serum lipid and lipoprotein values of 32 male patients suffering from gout were quantitated and compared with corresponding values of a random control group which did not differ significantly with regard to age, body weight index and socio-economic status. All patients were on therapy with allopurinol which lasted on average for 6 years. The most striking differences between patients and controls were the increased triglyceride and apo B values and the decreased HDL-cholesterol (HDL-C) and HDL-phospholipid (HDL-PL) values in the patient group. The values of total cholesterol, LDL-cholesterol, apo A-I and Lp (a) were not significantly different between patients and controls. The great differences in the ratios of apo B/LDL-C, apo A-I/HDL-C and apo A-I/HDL-PL values suggest that gout is connected with changes in the chemical composition of the major lipoprotein classes. In three normolipemic individuals who were treated for 3 weeks with allopurinol no changes in lipoproteins and apolipoproteins were apparent. The results are discussed in view of the atherosclerosis risk of patients suffering from gout.     

湿性敷料在痛风结石刮除术后伤口不愈的应用

目的探讨湿性敷料用于手足痛风结石刮除术后伤口不愈合创面治疗的临床疗效。方法对2010年4月一2014年1月治疗的15例手足痛风结石刮除术后伤口不愈合创面患者,术前、术后采取药物治疗、饮食管理、生活方式改变、健康指导等综合治疗手段,控制患者血尿酸浓度。在伤口愈合的3个阶段（清创期、增生期、成熟期）根据痛风结石伤口的特点和充分考虑伤口的不同情况,选择性应用湿性敷料进行处理,观察其伤口创面的治疗效果,以及患者全身状况的恢复。结果15例患者痛风结石刮除术后不愈伤口均痊愈,平均治疗时间（40±5）d,痛风均未再复发。结论湿性敷料处理痛风结石刮除术后不愈伤口可促进创面的愈合,同时配合综合治疗手段能尽快恢复患者的健康。     

Gouty flexor tenosynovitis of the hand mimicking atypical mycobacterial infection

Abstract

A 50-year-old Japanese fish dealer presented with painful and swollen fingers. Infectious flexor tenosynovitis with Mycobacterium marinum was suspected. Range of motion was restored after tenosynovectomy and after ofloxacin and clarithromycin were administered. Two years after the operation, the patient presented again with acute inflammation in the same fingers. Histopathological examination revealed gouty tenosynovitis. The preconception that mycobacterial infection occurs often in fish dealers caused us to miss the correct diagnosis of gouty tenosynovitis.     

A hypothesis on the possible role of interferon in the initiation of acute gouty arthritis attack

There is some evidence that unidentified factors might play a role in the initial events of acute gouty arthritis. Serum interferon activity was found to be high in several arthritides; interferon stimulates the production of prostaglandin E, an established mediator of inflammation. It is postulated that interferon can play a role in the pathogenesis of an acute gouty arthritis.     

痛风方联合西乐葆及碳酸氢钠治疗痛风性关节炎32例疗效观察

[目的]观察自拟痛风方联合西药西乐葆及碳酸氢钠治疗痛风性关节炎的临床疗效。[方法]将2008年10月至2011年10月我院门诊就诊的64例痛风性关节炎患者随机分成2组,对照组32例在基础治疗上口服西乐葆胶囊和碳酸氢钠片;治疗组32例在对照组治疗的基础上,加服自拟痛风方,治疗4周后判定疗效。[结果]治疗组临床痊愈7例,显效12例,有效12例,无效1例,总有效率为96.88%;与对照组总有效率为75.0%比较,差异有统计学意义(P0.05)。[结论]自拟痛风方联合西药西乐葆及碳酸氢钠治疗痛风性关节炎可明显增强疗效,减少痛风复发和西药的副作用,降低血尿酸及血沉水平。     

痛风发病机制的研究进展

痛风是一种急性炎症性关节炎,可以完全破坏关节的完整性甚至引起重度残疾。另外,痛风能够加速动脉粥样硬化,最后导致患心血管疾病的风险增加。虽然,痛风与高血压、脑卒中以及慢性心血管疾病相关,但血清尿酸水平作为心血管疾病的独立危险因素,目前具体致病机制尚不清楚。现简要综述痛风的临床表现和目前治疗现状,以及痛风的发病机制研究进展。