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.     

马宝东教授治疗痛风经验

痛风是临床常见病、多发病,发病率逐年升高,发病人群逐渐年轻化。可以导致痛风性肾损害等多种并发症。马宝东教授发挥中医整体观念、辨证论治的特色,运用中医药疗法,在痛风疾病的治疗中取得较好的临床疗效。     

痛风影像学诊断方法分析及发展

痛风是由于尿酸盐沉积产生的异质代谢性疾病,严重者可导致关节残疾引起肾功能损伤,但若能早期诊断该病或可逆转.众所周知,痛风不同时期有不同的临床表现和影像学表现.一般而言,在痛风早期,其双轨征特征明显,特异性高,适合采用超声法进行检测;在痛风反复发作期及慢性期,适合采用X线平片、CT和MRI等影像技术进行检测,其中MRI能...     

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.     

针刺联合药物治疗痛风的临床观察

目的针刺联合药物治疗痛风的临床观察。方法采用随机对照的方法,将99例痛风患者随机分为针刺组、药物组、针刺联合药物组。结果3组治疗7d观察,疗效差异亦有统计学意义。针刺组与针刺加药物组（χ^2=15.28,P〈0.01）,药物组与针刺加药物组（χ^2=12.28,P〈0.01）,针刺加药物组明显优于针刺组和药物组。结论针刺联合药物组在治疗痛风的过程中,症状缓解快且不良反应少,效果显著。     

Gout Assessment Questionnaire: Initial results of reliability, validity and responsiveness

We evaluated the psychometric properties of a new gout-specific patient reported outcomes questionnaire. The Gout Assessment Questionnaire (GAQ) and the SF-36 were administered to 126 subjects in a multicenter Phase II program of febuxostat, an investigational treatment for hyperuricemia (serum uric acid >8.0 mg/dl) in patients with chronic gout. The questionnaire was administered at baseline and 1, 6 and 12 months later. The majority of subjects, mean age 54 years, were male, Caucasian and had experienced a gout flare within the last year. Seven domains were identified, all met criteria for reliability and validity. Cronbach's alpha ranged from 0.78 to 0.97. Pearson correlations between GAQ and SF-36 scales were generally low to moderate, with the highest correlation between Gout Pain and Severity and SF-36 Bodily Pain, r = 0.45. Guyatt's statistic (measure of responsiveness) ranged from 0.24 to 1.00 at 12 months. Minimal clinically important differences ranged from 2 (Gout Concern) to 10 points (Productivity). The GAQ has acceptable psychometric properties. Further research is required to confirm results, which may provide more information to improve the GAQ for use in clinical trials.     

针灸配合中药苦蝶子治疗急性痛风性关节炎

目的观察中医治疗痛风的有效治疗方法.方法中医认为痛风是痰湿内聚,瘀久化热,闭阻经脉,气血运行不畅而发病.临床上经过抽血化验尿酸增高,结合症状表现进行诊断.本文将46例痛风患者随机分为两组,中药治疗组(针刺和静点苦蝶子)和西药对照组(急性期给醋氯芬酸片,缓解期给别嘌呤醇口服).结果 治疗组总有效率95.65%,对照组总有效率82.60%,两组疗效有显著差异,治疗组疗效优于对照组.结论 针药并举安全有效,是治疗痛风的一个比较理想的方法.