The effect of resveratrol on the recurrent attacks of gouty arthritis

Gouty arthritis is characterized by inflammation induced by monosodium urate (MSU) crystal deposition, which is resulted by an increase of serum urate concentration. The management of gout, especially the recurrent acute attacks of chronic gouty arthritis, is still a problem to be resolved. In this study, we aimed to develop the preventive and therapeutic effect of resveratrol on gouty arthritis. MSU was used to induce gouty arthritis in the foot pad of C57BL/6 mice. Yeast polysaccharide and potassium oxonate were used to induce hyperuricemia in Kunming mice. Resveratrol was intraperitoneal injected to the mice in the treatment group. The pad inflammation and the level of serum uric acid were investigated to estimate the effect of resveratrol in gouty arthritis. Hyperuricemia was significantly detected in the mice treated with yeast polysaccharide and potassium oxonate, and gouty arthritis was successfully induced with MSU in mice. We further identified that resveratrol inhibited pad swelling and pad 99mTc uptake in gouty mice. Moreover, serum uric acid level was also decreased by resveratrol in hyperuricemia mice. This study highlighted that resveratrol might be applied to prevent the recurrent acute attack of gouty arthritis because of its inhibition of articular inflammation and down-regulation of serum uric acid.     

血清和尿液新喋呤水平与类风湿关节炎关系的研究

类风湿关节炎 (ｒｈｅｕｍａｔｏｉｄａｒｔｈｒｉｔｉｓ,ＲＡ)是一种以关节组织慢性炎症性病变为主要表现的自身免疫性疾病 ,为了探讨ＲＡ患者体内免疫激活标志物—新喋呤与ＲＡ疾病活动性、临床疗效和其它实验室指标间的关系 ,我们采用ＥＬＩＳＡ测定了 35例ＲＡ患者血清和尿液中新喋呤水平 ,现将结果报道如下。1　材料与方法1.1　研究对象　 2 0 0 0 - 0 5～ 2 0 0 1- 0 5 35例ＲＡ患者选自我院风湿免疫科住院患者 ,符合美国风湿病学院 1987年诊断标准 ,男性 8例 ,女性 2 7例 ,平均年龄 (48 8± 16 7)岁(2 6～ 5 4岁 ) ,平均病程 (5 2…     

Inflammatory pseudotumor of the liver complicated with recurrent gouty arthritis.

Inflammatory pseudotumor (IPT) of the liver is a rare benign lesion of unknown etiology and is often accompanied by fever. Unexplained persistent fever unresponsive to antibiotics developed in a 70-year-old man suffering from intractable recurrent gouty arthritis. 67Ga-scintigraphy disclosed intense focal uptake in the upper abdomen. The lesion in the left lobe of the liver was an ill-defined hypodensity mass on computed tomographic scan and was enhanced on dynamic magnetic resonance imaging. The tumor was surgically removed and a diagnosis of IPT was made. Fever and arthritis resolved completely after surgery. Possible interaction between IPT of the liver and gouty arthritis was suggested.     

Effect of low dose daily aspirin on serum urate levels and urinary excretion in patients receiving probenecid for gouty arthritis

OBJECTIVE: To determine if low dose daily enteric coated aspirin significantly affects the therapeutic actions of probenecid with respect to serum urate levels or urinary urate excretion. METHODS: Patients with gouty arthritis taking a stable dose of probenecid for at least 3 months were enrolled in a prospective crossover study. Twenty-four hour urinary and serum uric acid levels were measured after 14 days in patients crossed over to receive probenecid alone; probenecid and aspirin 325 mg taken concomitantly; and probenecid followed by aspirin 325 mg at 6 hours. RESULTS: Eleven patients completed the crossover study. The addition of aspirin to a stable dose of probenecid had no significant effect upon serum urate levels or 24 h urinary urate excretion (p > 0.05, paired t test). CONCLUSION: Low dose daily enteric coated aspirin does not significantly interfere with the uricosuric effects of probenecid in patients with gouty arthritis.     

Establishment of a clinical diagnostic model for gouty arthritis based on the serum biochemical profile: A case-control study

The disease progression of gouty arthritis (GA) is relatively clear, with the 4 stages of hyperuricemia (HUA), acute gouty arthritis (AGA), gouty arthritis during the intermittent period (GIP), and chronic gouty arthritis (CGA). This paper attempts to construct a clinical diagnostic model based on blood routine test data, in order to avoid the need for bursa fluid examination and other tedious steps, and at the same time to predict the development direction of GA.Serum samples from 579 subjects were collected within 3 years in this study and were divided into a training set (n = 379) and validation set (n = 200). After a series of multivariate statistical analyses, the serum biochemical profile was obtained, which could effectively distinguish different stages of GA. A clinical diagnosis model based on the biochemical index of the training set was established to maximize the probability of the stage as a diagnosis, and the serum biochemical data from 200 patients were used for validation.The total area under the curve (AUC) of the clinical diagnostic model was 0.9534, and the AUCs of the 5 models were 0.9814 (Control), 0.9288 (HUA), 0.9752 (AGA), 0.9056 (GIP), and 0.9759 (CGA). The kappa coefficient of the clinical diagnostic model was 0.80.This clinical diagnostic model could be applied clinically and in research to improve the accuracy of the identification of the different stages of GA. Meanwhile, the serum biochemical profile revealed by this study could be used to assist the clinical diagnosis and prediction of GA.     

A case of recurrent hemophagocytic syndrome complicated with systemic sclerosis: relationship between disease activity and serum level of IL-18]

Hemophagocytic syndrome (HPS) is characterized by the activation of the mononuclear phagocytic system with prominent hemophagocytosis in the bone marrow and reticuloendothelial systems, and its occurrence is usually associated with variable disorders such as viral infections and malignant lymphoma. Recently, it was reported that HPS also occurred in association with underlying connective tissue disease, especially systemic lupus erythematosus. We report here a case of recurrent HPS complicated with systemic sclerosis. A 32-year-old woman had been diagnosed as systemic sclerosis since 1994. She was admitted due to unknown high fever and severe pancytopenia in 1997, and the diagnosis of HPS was determined because of hemophagocytosis in bone marrow and hyperferritinemia. Her symptoms were improved by immunosuppressive therapies including steroid pulse therapy and oral prednisolone (60 mg/day). She was followed by the treatment of oral prednisolone which was gradually tapered in our out-patient clinic. In August of 1999 high fever and severe anemia were recurred, and she was admitted again to our hospital because of the diagnosis as recurrent HPS. She had been treated with 40 mg/day of oral prednisolone and fever was immediately disappeared and hemoglobin was gradually increased. HPS is considered to be a rare complication with systemic sclerosis, and the etiology has been unknown. IL-18 is a novel cytokine which is a potent inducer of interferon-gamma, and its properties may be a proinflammatory regulation and activation of monocyte/macrophage and histiocyte through the expression of interferon-gamma. Therefore, the significance of IL-18 in the pathophysiology of HPS was recently reported. In this case, we investigated the significance of IL-18 and revealed the levels of serum IL-18 were well correlated with disease activity of HPS.     

血尿酸与冠状动脉粥样硬化程度的关系

目的 明确血尿酸与冠状动脉粥样硬化程度之间的关系.方法 回顾性分析复旦大学附属中山医院心导管室的冠状动脉造影病例205例,将其冠状动脉病变按Gensini积分系统进行评定,将血尿酸及其他28项生理、生化指标包括总胆固醇/高密度脂蛋白胆固醇（TC/HDL-C）、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇（LDL-C/HDL-C）,载脂蛋白A/载脂蛋白B（apoA/apoB）与Gensini积分之间行二变量的Spearman相关性分析,并将血尿酸与Gensini积分之间作控制年龄、性别变量后的偏相关分析,再将Gensini积分与各危险因素作多元逐步回归分析.结果 血尿酸、白细胞计数、单核细胞计数、餐后两小时血糖、LDL-C、非高密度脂蛋白胆固醇（non-HDL-C）、apo-B、糖基化血红蛋白（HbA1c）、高敏C反应蛋白（hs-CRP）、TC/HDL-C、LDL-C/HDL-C与Gensini积分存在正相关关系,HDL-C、apoA/apoB与Gensini积分存在负相关关系.在控制年龄、性别变量后血尿酸仍与Gensini积分存在线性剂量反应关系.多元逐步回归分析显示血尿酸、吸烟指数为冠状动脉粥样硬化的独立危险因素.结论 血尿酸与冠状动脉粥样硬化程度之间存在线性剂量反应关系,血尿酸为冠状动脉粥样硬化程度的独立危险因素.     

Associations of serum estradiol level,serum estrogen receptor-alpha level,and estrogen receptor-alpha polymorphism with male infertility: A retrospective study

Estradiol regulates spermatogenesis partly via estrogen receptor-alpha (ESRα). This study aimed to analyze the associations of serum estradiol level, serum ESRα level, and ESRα gene polymorphisms with sperm quality.This retrospective study included infertile men attending the Reproductive Center, Affiliated Hospital of Youjiang Medical University for Nationalities, and a control group without a history of fertility (October, 2016 to March, 2017). Data regarding sperm quality, serum levels of estradiol and ESRα, and rs2234693C/T genotype were extracted from the medical records. Pearson/Spearman correlations (as appropriate) between estradiol level, ESRα level, and sperm quality parameters were evaluated.The analysis included 215 men with infertility and 83 healthy controls. The infertile group had higher serum levels of estradiol (147.57 ± 35.3 vs 129.62 ± 49.11 pg/mL, P < .05) and ESRα (3.02 ± 2.62 vs 1.33 ± 0.56 pg/mL, P < .05) than the control group. For the infertile group, serum estradiol level was negatively correlated with sperm concentration, percentage of progressively motile sperm, and percentage of sperm with normal morphology (r = 0.309, 0.211, and 0.246, respectively; all P < .05). Serum estradiol and ESRα levels were lower in infertile men with normozoospermia than in those with azoospermia, oligozoospermia, mild azoospermia, or malformed spermatozoa (all P < .05). Sperm concentration, percentage of progressively motile sperm, serum ESRα level, and serum estradiol level did not differ significantly among the rs2234693 CC, CT, and TT genotypes.Elevated serum levels of estradiol and possibly ESRα might have a negative impact on sperm quality and fertility, whereas single nucleotide polymorphisms at rs2234693 of the ESRα gene had little or no effect.     

Efficacy and safety of pricking-blood therapy for acute gouty arthritis: A protocol for systematic review and meta-analysis

Background:Acute gouty arthritis is a joint inflammatory reaction that affects the daily quality of patients. Previous reviews of pricking-blood therapy for acute gouty arthritis have been growing, but a systematic review is not available. This study aimed to systematically investigate the efficacy and safety of pricking-blood therapy in treating acute gout arthritis.Methods:We will search for relevant literature through Chinese and English databases, with the retrieval deadline being December 2020. Databases include PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database, Wanfang Database, and China Biomedical Literature Database. We will also manually search Chinese Acupuncture & Moxibustion, Acupuncture Research, Chinese Clinical Trial Register, and unpublished studies or references. According to the inclusion and exclusion criteria, the literature will be screened, and the data are extracted independently by the 2 researchers. The primary outcomes were the total effective rate and Visual Analogue Scale (VAS) score. RevMan 5.3.5. software will be used for statistical analysis. According to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE), each evidence of outcome quality will be appraised.Results:This study will provide a comprehensive review of current evidence for a pricking-blood therapy treatment for acute gouty arthritis.Conclusion:The efficacy and safety of picking-blood therapy in treating acute gout arthritis will be evaluated.Unique INPLASY number:INPLASY2020100094.     

A survey of current prescribing practices of antiinflammatory and urate lowering drugs in gouty arthritis in the province of Ontario

We recently conducted a cross-sectional survey of the prescribing practices of rheumatologists and a random sample of family physicians. While in general there was agreement as to the preferred management of gout, family physicians were (a) more likely to use phenylbutazone, (b) more liberal in their use of allopurinol, (c) less likely to cover the introduction of allopurinol with antiinflammatory agents or to titrate the dose against the serum uric acid, or to adjust the dose according to the serum creatinine. A small number of physicians continued to routinely use urate lowering drugs in the treatment of entirely asymptomatic hyperuricemia.     

Relationship of medication adherence,serum uric acid level and diet to recurrent attacks of gout

Aim of the workTo evaluate the relationship between medication adherence, serum uric acid (SUA) levels, and diet, with recurrent gout attacks.Patients and methodsThis study included 89 patients being followed up for gouty arthritis. A self-administered, structured questionnaire was used to collect socio-demographic data, gout attacks frequency, history of acute intake of purine rich foods prior to the gouty attack, and adherence to urate-lowering therapies (ULT).Results89 patients were studied, 84 males and 5 females with a mean age of 55.4 ± 13.7 years, disease duration 12.22 ± 9.2 years and body mass index 24.67 ± 5.01. 71.9% were Malays, 20.2% Chinese, 6.7% Indians and 1.1% others. 61.8% had at least one episode of gout flare in the past 6 months. Of the 86 taking ULT, 65 (75.6%) were adherent. There was no difference in clinical characteristics between those who had high versus low adherence. High adherence to ULT was not associated with lower SUA or not having recurrent gout attacks. Having a high SUA level [OR = 2.86 (95%CI:1.52–5.39)], acute intake of purine-rich foods [OR = 2.01 (95%CI:1.09–3.73)] and obesity [OR = 1.58 (95%CI:1.09–2.32)] were significantly associated with recurrent gout attacks.ConclusionsAlthough three-quarters of patients were adherent to their ULT, it was not associated with a reduction in recurrent gout attacks or lower SUA levels. Recurrent gout attacks were associated with a high SUA and an acute intake of purine-rich foods. To reduce the burden of recurrent gout attacks, ULT may need to be intensified even in adherent patients, as well as avoiding dietary indiscretions.     

血清TRAIL水平与晚期非小细胞肺癌患者免疫治疗反应的关联性研究

［摘要］　目的　探讨血清肿瘤坏死因子相关凋亡诱导配体（TRAIL）水平与晚期非小细胞肺癌（NSCLC）患者免疫治疗反应的关联性。方法　回顾性分析2019年1月至2020年5月唐山市人民医院收治的70例晚期NSCLC患者的临床资料。在免疫治疗前24 h内采用酶联免疫吸附试验法（ELISA）测定患者血清TRAIL水平。免疫治疗反应通过客观缓解率（ORR）和临床获益率（CBR）进行评估。分析患者血清TRAIL水平与免疫治疗反应、肺功能及肺气肿、临床预后的关联性。结果　经免疫治疗后,NSCLC患者获得客观缓解23例,临床获益46例。获得客观缓解患者的血清TRAIL水平显著高于未获得客观缓解者［27.77（23.13,39.13）pg/mL vs 12.36（8.76,18.15）pg/mL;Z=4.508,P<0.001］。临床获益患者的血清TRAIL水平显著高于临床未获益者［23.13（16.99,30.63）pg/mL vs 11.75（8.76,15.56）pg/mL;Z=4.887,P<0.001］。Spearman秩相关性分析结果显示,血清TRAIL水平与1秒用力呼气容积/用力肺活量（FEV₁/FVC）呈正相关（r_s=0.288,P=0.016）,与肺气肿总比值（r_s=-0.257,P=0.032）、肺叶肺气肿比率（LER）（r_s=-0.324,P=0.006）呈负相关。多因素logistic回归分析结果显示,以血清TRAIL>27.46 pg/mL为参考,血清TRAIL<18.15 pg/mL患者经免疫治疗不能获得客观缓解和临床获益的风险显著增加（P<0.05）。ROC曲线分析结果显示,血清TRAIL水平可有效预测NSCLC患者对免疫治疗的反应（P<0.05）。TRAIL高水平组（血清TRAIL≥18.15 pg/mL）的总体生存（OS）、无进展生存（PFS）预后显著优于TRAIL低水平组（血清TRAIL<18.15 pg/mL）（P<0.05）。结论　血清TRAIL低水平与晚期NSCLC患者免疫治疗无反应以及临床预后不良有关,该指标监测有助于筛选能从免疫治疗中获益的NSCLC患者。     

降钙素基因相关肽与冠状动脉病变关系的探讨

目的：了解血清降钙素基因相关肽（CGRP）与冠心病的关系。方法：用断面调查的方法收集经冠状动脉造影确诊的冠心病患者119例,非冠心病患者78例及同期健康体验39例,测定CGRP水平。结果：冠状动脉粥样硬化病变的发生与年龄,吸烟及糖尿病明显相关,与CGRP的降低明显相关。多因素分析证实糖尿病,年龄,吸烟的OR均大于1,差异并有显著性;CGRP的OR小于1。用前进法观察糖尿病,年龄,吸烟的偏回归系数的变化证实这几个因素是冠脉病变的独立危险因素;CGRP是冠脉病变的独立保护因素。结论：罹患糖尿病,年龄大和吸烟是导致冠心病重要而各自独立的危险因素。CGRP是冠状动脉病变的独立保护因素。     

血清CA125水平与充血性心力衰竭关系初探

目的探讨充血性心力衰竭(CHF)患者血清中CA125水平与心功能的关系。方法169例CHF患者符合纽约心脏病学会心功能分级标准,分为心功能Ⅱ~Ⅳ级组,根据超声心动图检查结果,将入选者分为左心室(左室)正常组(左室舒张末期容积≤55 mm)和左室增大组(左室舒张末期容积>55 mm)。用免疫放射分析法测定血清CA125水平。并选择20名正常人作为对照组。结果CHF患者CA125血清浓度明显高于正常对照组(P<0.01),心功能Ⅲ、Ⅳ级的血清浓度高于Ⅱ级(P<0.01)。左室增大组较左室正常组CA125血清浓度显著升高(P<0.01),CA125的血清浓度与心力衰竭患者的CHF严重程度和心脏左室增大呈正相关(P<0.01)。结论CA125可能是又一个与CHF相关的非创伤性指标。     

血清趋化素水平与代谢综合征的相关性研究

目的 探讨血清趋化素（Chemerin）水平与MS的相关性. 方法 选取非MS（Non-MS）组57例,MS组117例及健康对照（NC）组90名,按Chemerin水平从低到高分为Ter1、Ter2和Ter3亚组.所有研究对象行75 g OGTT和胰岛素释放试验,检测血脂、血清Chemerin、高敏C反应蛋白（hsC-RP）等相关生化指标. 结果 MS组血清Chemerin水平高于Non-MS组和NC组（P＜0.01）.从Ter1到Ter3亚组,BMI、WC、WHR、SBP、FPG、2 hPG、HbA1 c、FIns、HOMA-IR、TG、hsC-RP水平依次升高,HDL-C水平依次降低,MS的患病率依次增加（P＜0.05）.Chemerin与BMI、WC、WHR、SBP、FPG、2 hPG、HbA1 c、FIns、2 hIns、HOMA-IR、TG及hsC-RP呈正相关（P＜0.05）,与HDL-C、胰岛β细胞功能指数（HOMA-β）呈负相关（P＜0.01）.Logistic逐步回归分析显示,Chemerin是MS的独立危险因素（OR=2.197,P＜0.01）.受试者工作曲线（ROC）曲线提示Chemerin预测MS的界值为72.4 ng/ml.结论 Chemerin与MS的发生相关,可作为MS的独立预测指标之一.