Objective:To explore the mechanism of action of"Weilingxian-Guizhi"two drugs in the treatment of gout.Method:First obtain the 15 chemical components contained in the"Weilingxian-Guizhi"drug,predict...Objective:To explore the mechanism of action of"Weilingxian-Guizhi"two drugs in the treatment of gout.Method:First obtain the 15 chemical components contained in the"Weilingxian-Guizhi"drug,predict its target points through the database,and then construct the gout-related protein-protein interaction network(PPI),and then construct the"Weiling,"the"Xian,Guizhi"drug pair"active ingredient-predicted target"network,the construction of the gout-related"Weilingxian-Guizhi"drug pair"active ingredient-potential target"network,based on the Kyoto Encyclopedia of Genes and Genomes(KEGG)biological pathway enrichment analysis and gene ontology(GO)functional enrichment analysis,to study the mechanism of action of the two drugs"Weilingxian-Guizhi"in the treatment of gout.Results:The goutrelated"Weilingxian-Guizhi"drug pair"active ingredient-potential target"network contains 14 targets.KEGG pathway enrichment analysis yields 32 pathways,and GO functional enrichment analysis yields 517 GO entries.Among them,there are 468 items related to biological processes,21 items related to molecular functions,and 28 items related to cell composition.Conclusion:The results of this study initially verified and predicted the mechanism of the"Weilingxian-Cinnamon Stick"medicine on the treatment of gout,and laid a good foundation for further revealing its mechanism of action.展开更多
Modern lifestyle and diet have increased the incidence rate of uric acid(UA)metabolism-related diseases like hyperuricemia(HUA)and gout,posing heavy economic burden to individual patients and their families and the so...Modern lifestyle and diet have increased the incidence rate of uric acid(UA)metabolism-related diseases like hyperuricemia(HUA)and gout,posing heavy economic burden to individual patients and their families and the society.UA metabolism is a complex physiological process involving the kidney,intestine,and other organs.A number of factors together regulate UA metabolism,including genetics,diet,hormones,and the gut microbiota.This review summaries the gut microbiota features in subjects with HUA and gout,and the therapeutic effects of implementing microecological therapies(probiotics,prebiotics,or fecal microbiota transplant)that target modulate the gut microbiota and its downstream metabolism on the disease.Current evidence shows that these strategies are safe and promising in alleviate inflammation,reduce UA,and restoring a healthy gut microbiota in subjects with UA metabolism-related diseases.However,most clinical data are generated by animal studies.Therefore,we propose that vigorous human intervention trials should be conducted in the future to evaluate the therapeutic effects of microecological therapies in managing HUA and gout.展开更多
To elucidate the mechanisms underlying the therapeutic effects of the herbal medicine pair Smilax Glabra and Semen Coicis in treating gout and hyperuricemia,a comprehensive analysis was conducted using network pharmac...To elucidate the mechanisms underlying the therapeutic effects of the herbal medicine pair Smilax Glabra and Semen Coicis in treating gout and hyperuricemia,a comprehensive analysis was conducted using network pharmacology and molecular docking methods.Disease-associated targets for gout and hyperuricemia were identified from the GeneCards,OMIM,Disgenet,and TTD databases,while the key active components and their corresponding targets for Smilax Glabra and Semen Coicis were obtained from the TCSMP database.The intersection of these targets enabled the construction of a protein-protein interaction(PPI)network,which was subsequently visualized and analyzed.Core targets were further subjected to Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses to elucidate the biological processes and pathways involved.Molecular docking was then employed to validate the reliability of the interactions between the active components and the identified targets.The analysis revealed that Smilax Glabra and Semen Coicis contained 15 bioactive components that interacted with 393 potential targets,while gout and hyperuricemia were associated with 660 targets in total.The primary active compounds implicated in treating these conditions included diosgenin,quercetin,and naringenin,which were found to interact with crucial hub targets such as BCL2,CASP3,and MAPK3.These interactions suggested that the herbal medicine pair modulated several biological processes,including gland development and the regulation of body fluid levels,through pathways involving membrane rafts,membrane microdomains,and nuclear receptor activities.Enrichment analyses highlighted their involvement in multiple signaling pathways,such as EGFR tyrosine kinase inhibitor resistance,phospholipase D signaling,and platelet activation.Molecular docking confirmed the strong binding affinities between the hub genes and the major active components,supporting their potential role in therapeutic efficacy.This study demonstrated that Smilax Glabra and Semen Coicis might offer a promising therapeutic strategy for gout and hyperuricemia by targeting multiple molecular components,biological functions,and pathways.The findings underscored the unique potential of traditional Chinese medicine(TCM)in managing complex diseases by leveraging synergistic effects across diverse biological mechanisms.展开更多
Curcumin,a bioactive compound extracted from Curcuma longa.L.,demonstrates significant therapeutic potential in inflammatory diseases.This study aims to explore the effects of curcumin on hyperuricemia with acute gout...Curcumin,a bioactive compound extracted from Curcuma longa.L.,demonstrates significant therapeutic potential in inflammatory diseases.This study aims to explore the effects of curcumin on hyperuricemia with acute gout and associated renal dysfunction in a mouse model.The results show that curcumin treatment alleviates ankle joint swelling,reduces inflammatory cytokines IL-1βand TNF-α,and lowers serum uric acid concentrations.High-dose curcumin notably inhibits xanthine oxidase(XOD)activity,a key enzyme in uric acid production,while it enhances the renal expression of the urate transporter ABCG2,thereby promoting uric acid excretion.Furthermore,curcumin effectively mitigates renal injury as evidenced by reduced serum creatinineand blood urea nitrogen levels and suppresses renal inflammation.At the molecular level,curcumin exerts potent antioxidant effects by lowering reactive oxygen species(ROS)levels in both cultured HK-2 human renal tubular epithelial cells and RAW264.7 mouse macrophages.The curcumin-mediated effects are associated with the disruption of NEK7-NLRP3 complex formation,leading to the suppression of the ROS/NEK7-NLRP3 inflammasome pathway.This,in turn,inhibits pyroptosis and the subsequent release of mature IL-1β.These findings suggest that curcumin not only reduces uric acid production but also modulates inflammation through ROSscavenging properties and its ability to inhibit the NLRP3 inflammasome.展开更多
The study by Lin et al delves into the clinical impact of dapagliflozin,a repre-sentative sodium-glucose cotransporter 2(SGLT2)inhibitor,on chronic heart failure complicated by hyperuricemia.This investigation highlig...The study by Lin et al delves into the clinical impact of dapagliflozin,a repre-sentative sodium-glucose cotransporter 2(SGLT2)inhibitor,on chronic heart failure complicated by hyperuricemia.This investigation highlights dapagliflo-zin’s efficacy in lowering serum uric acid levels,enhancing cardiac function,and reducing cardiovascular events.This work not only provides a comprehensive analysis of dapagliflozin’s sustained benefits in these patients but also introduces novel insights for managing chronic heart failure exacerbated by elevated uric acid.Furthermore,this review examines the potential role of SGLT2 inhibitor in the context of gout,evaluating its mechanisms and clinical application prospects in the management of hyperuricemia,thereby further enriching the medical community’s understanding of SGLT2 inhibitor.展开更多
Gout is an independent risk factor for hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease and cerebral infarction.At present,the studies on the mechanism of gout at home and abroad have mainly focuse...Gout is an independent risk factor for hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease and cerebral infarction.At present,the studies on the mechanism of gout at home and abroad have mainly focused on immune inflammation,gene polymorphism and related studies.Uric acid deposition or crystal precipitation activates phagocytes,fibroblasts and mast cells in synovium,produces IL-1β,TNF and chemokine IL-8(CXCL8),thereby activating neutrophils,urate crystal polyanion surface can be coated with immunoglobulins and other serum proteins as substrates for complement activation,complement substitution pathways and classical complement pathways to activate complements.Uric acid crystals activate inflammation-related signal transduction pathways including the activation of inflammation-related signal transduction pathway by uric acid crystals and TLRS/MyD88 signal transduction pathways.Gene polymorphism is related to inflammation and signaling pathway,EGF gene is closely related to gout inflammation,which may be involved in the regulation of gout inflammation,among which NLRP3 inflammatory signaling pathway and gene polymorphism have been deeply studied in the pathogenesis of gout,which is the main therapeutic target of anti-inflammatory and uric acid lowering.展开更多
BACKGROUND Gouty tophus is rarely reported in the head and neck areas.To the best of our knowledge,this is the first report on multiple gouty tophi in the head and neck with normal serum uric acid(SUA)levels.CASE SUMM...BACKGROUND Gouty tophus is rarely reported in the head and neck areas.To the best of our knowledge,this is the first report on multiple gouty tophi in the head and neck with normal serum uric acid(SUA)levels.CASE SUMMARY We report a case of multiple gouty tophi in the nasal dorsal and auricle regions with normal SUA levels.The patient was admitted to the hospital with a chief complaint of recurrent nasal swelling and pain for 3 years,which was aggravated for 3 d.The patient’s SUA level had been regularly reviewed in the outpatient department and had been successfully controlled for several years.Resection of the nasal masses was performed.Cartilage from the right ear cavity was used to repair the nasal defects.The pathological report confirmed a nasal gouty tophus.No recurrence or deformity was found after a 1 year follow-up.CONCLUSION Normal SUA cannot completely negate the diagnosis of gouty tophus,especially in some rare regions.展开更多
Background:The study was conducted with the interest of exploring the effects of Qingre Yangyin Chushi pill as anti-inflammatory agent in gout treatment based on the NLRP3/GSDMD coke death pathway.Methods:In this stud...Background:The study was conducted with the interest of exploring the effects of Qingre Yangyin Chushi pill as anti-inflammatory agent in gout treatment based on the NLRP3/GSDMD coke death pathway.Methods:In this study,48 male SD rats were randomly divided into 6 groups,namely model group,blank control group(BC),Qingre Yangyin Chushi pill low-dose treatment group(MSD1),medium-dose treatment group(MSD2),high-dose treatment group(MSD3),and colchicine group(PC),with eight members in each group.The BC and model groups were administered with saline twice a day.The MSD1,MSD2,and MSD3 groups were administered with Qingre Yangyin Chushi pill at a dose of 1.8 g·kg^?1,3.6 g·kg^?1,and 7.2 g·kg^?1 twice a day.The colchicine group was administered with a colchicine suspension at a dose of 0.6×10^?3 g kg^?1 twice a day for 7 days.After gavage of animals in each group for 4 days,the rats'ankle joints were injected with sodium urate suspension×3 days to induce a gouty arthritis model.Then,serum and tissue samples were collected on the third and seventh day after gavage.The synovial tissue from the rat ankle joints was taken,and immunohistochemical technique was used to detect NOD-like receptor protein 3(NLRP3),inflammatory bodies,cysteine protease-1(Caspase-1),and Gasdermin-D protein(GSDMD)expression.Image-Pro Plus image analysis system was used to measure the average integrated absorbance and calculate IHS.Integral enzyme-linked immunosorbent assay was used to determine the interleukin 1β(IL-1β)and interleukin 18(IL-18)expression of tumor necrosis factor-α(TNF-α).Western blot was used to detect NLRP3,Caspase-1,GSDMD,and apoptosis-associated speck-like protein containing a CARD(ASC)expression levels.Results:After 48 hours of modeling,compared with the PC group,the arthritis indices of the MSD1,MSD2,and MSD3 groups were insignificant(P>0.05).The levels of IL-1β,IL-18,and TNF-αwere lower in the PC and MSD2 groups compared with the BC group.However,compared with the control group,MSD1,MSD2,and PC groups had lower levels of IL-1βand IL-18.Regarding TNF-αlevels(P<0.05);compared with the PC group,the levels of IL-1β,IL-18,and TNF-αin MSD2 decreased more significantly(P<0.05).The levels of NLRP3,Caspase-1,GSDMD,ASC,IHS score,and mRNA were lower in the PC and MSD2 groups(P<0.05)compared with the control group.The MSD1 and MSD2 groups had lower levels of NLRP3,Caspase-1,GSDMD,ASC protein levels,IHS points,and mRNA levels(P<0.05)compared with the PC group.Moreover,NLRP3,Caspase-1,GSDMD,ASC protein levels,IHS points,and mRNA levels were more reduced in the MSD2 group(P<0.05).Conclusion:Qingre Yangyin Chushi pill can inhibit the activation of the NLPR3 inflammatory complex,reduce the production of GSDMD protein,regulate the occurrence of pyroptosis,reduce the expression of inflammatory factors,and thus reduce arthritis.All these processes are achieved through the NLRP3/GSDMD pathway.展开更多
Objectives: To define clinical differences in the acute phase response and serum acute phase reactants between gout, pseudogout and crystal-induced arthritis in the presence of non-articular infections (CAI). Patients...Objectives: To define clinical differences in the acute phase response and serum acute phase reactants between gout, pseudogout and crystal-induced arthritis in the presence of non-articular infections (CAI). Patients and Methods: Eleven patients with definite gout, 12 patients with pseudogout and 5 patients with CIA were included in the study. Results: The erythrocyte sedimentation rate (ESR) was significantly different between gout (68.2 ± 49.9 mm/Hr) and CIA (113.8 ± 37.2 mm/Hr) but not between gout and pseudogout (83.9 ± 45.6 mm/Hr) or between pseudogout and CIA. The C-reactive protein (CRP) was significantly increased between gout (10.1 ± 7.9 mg/dL) and pseudogout (18.9 ± 9.8 mg/dL), gout and CIA (36.5 ± 12.4 mg/dL) as well as between pseudogout and CIA. The peripheral white cell count was significantly different between gout (9.27 ± 3.7 k/μL) and CIA (16.5 ± 6.8 k/μL), and between pseudogout (8.9 ± 3.2 k/μL) and CIA. Conclusions: Measurement of ESR and CRP are helpful in crystal-induced arthritis. The CRP has more discriminating utility than the ESR in distinguishing between gout, pseudogout and CIA. Peripheral wbc is most useful for differentiating crystal-induced arthritis from CIA.展开更多
Introduction: Gout is defined as an arthritic condition resulting from the deposition of monosodium urate crystals in and/or around joints, following long-standing hyperuricemia. This may cause gouty arthritis in join...Introduction: Gout is defined as an arthritic condition resulting from the deposition of monosodium urate crystals in and/or around joints, following long-standing hyperuricemia. This may cause gouty arthritis in joints and tophi in soft tissues. Spinal gout is rare and never mentioned in our context. It can appear as acute back pain, radiculopathy, spinal cord compression, spondylodiscitis or neoplasic/infectious epiduritis. Our aim was to share our surgical experience and proceed of a Literature review. Cases Presentation: Between January and August 2022, two patients male were surgically cared, aged of 42 and 60 years old. The gout was unknown in the youngest and poorly followed in the eldest. There was no past medical history of tuberculosis or immunodeficiency in both. The early diagnosis retained was unspecific lumbar spondylodiscitis due to clinical features: Patients complained both of lower back pain with initial fever. It was of a progressive left L5S1 deficit with erectile defect and dysuria in the first case and a progressive paraplegia without sphincter disorders in the second case. We proceeded with a lumbar laminectomy with a biopsy on both patients. The spinal tophus was ligamentous in one case and arthro-ligamentous in the other. There was a progressive motor recovery from postoperative Day-2 till postoperative Month-1. A probabilistic antituberculosis treatment was promptly initiated postoperatively based on radioclinic features while waiting for histologic proof. The Polymerase Chain Reaction (PCR) of Mycobacterium tuberculosis was negative and the histology was of a chronic calcified osteitis with dense fibrosis in both. The anti-gout treatment was implemented after 15 days with blood test evidence. A rheumatologic follow-up was also initiated and adjuvant physio-therapy. The results were very satisfactory from 4 - 6 months with independent walking. Discussion Conclusion: Spinal Gout may be suggested in 40-male-old faced with any acute rachialgia with neuro deficit with dubious neuro-imaging.展开更多
Korean oriental medicine prescription is widely used for the treatment of gouty diseases. In the present study, we investigated anti-inflammatory effects of modified Korean herbal formulation, mixed extract of medicin...Korean oriental medicine prescription is widely used for the treatment of gouty diseases. In the present study, we investigated anti-inflammatory effects of modified Korean herbal formulation, mixed extract of medicinal herbs(MEMH), and its modulatory effects on inflammatory mediators associated with gouty arthritis. Both in vitro and in vivo studies were carried out to assess the anti-inflammatory efficacy of MEMH on monosodium urate(MSU) crystals-induced gouty inflammation. MSU crystals stimulated human chondrosarcoma cell line, SW1353, and human primary chondrocytes were treated with MEMH in vitro. The expression levels of pro-inflammatory mediators and metalloproteases were analyzed. The effect of MEMH on NFκB signaling pathway in SW1353 cells was examined. Effect of MEMH on the mR NA expression level of pro-inflammatory mediators and chemotactic factor from human monocytic cell line, THP-1, was also analyzed. The probable role of MEMH in the differentiation process of osteoblast like cells, SaO S-2, after MSU treatment was also observed. To investigate the effects of MEMH in vivo, MSU crystals-induced ankle arthritic model was established. Histopathological changes in affected joints and plasma levels of pro-inflammatory mediators(IL-1β and TNFα) were recorded. MEMH inhibited NFκB signaling pathway and COX-2 protein expression in chondrocytes. MSU-induced mR NA expressions of pro-inflammatory mediators and chemotactic cytokines were suppressed by MEMH. In MSU crystals-induced ankle arthritic mouse model, administration of MEMH relieved inflammatory symptoms and decreased the plasma levels of IL-1β and TNFα. The results indicated that MEMH can effectively inhibit the expression of inflammatory mediators in gouty arthritis, demonstrating its potential for treating gouty arthritis.展开更多
Gut dysbiosis is suggested to play a critical role in the pathogenesis of gout.The aim of our study was to identify the characteristic dysbiosis of the gut microbiota in gout patients and the impact of a commonly used...Gut dysbiosis is suggested to play a critical role in the pathogenesis of gout.The aim of our study was to identify the characteristic dysbiosis of the gut microbiota in gout patients and the impact of a commonly used uric acid-lowering treatment,febuxostat on gut microbiota in gout.16S ribosomal RNA sequencing and metagenomic shotgun sequencing was performed on fecal DNA isolated from 38 untreated gout patients,38 gout patients treated with febuxostat,and 26 healthy controls.A restriction of gut microbiota biodiversity was detected in the untreated gout patients,and the alteration was partly restored by febuxostat.Biochemical metabolic indexes involved in liver and kidney metabolism were significantly associated with the gut microbiota composition in gout patients.Functional analysis revealed that the gut microbiome of gout patients had an enriched function on carbohydrate metabolism but a lower potential for purine metabolism,which was comparatively enhanced in the febuxostat treated gout patients.A classification microbial model obtained a high mean area under the curve up to 0.973.Therefore,gut dysbiosis characterizings gout could potentially serve as a noninvasive diagnostic tool for gout and may be a promising target of future preventive interventions.展开更多
Carpal tunnel syndrome(CTS) is well recognized as the most common type of peripheral neuropathy. A rare cause of CTS is tophaceous gout. Tophi deposits can accumulate in various structures including the flexor tendons...Carpal tunnel syndrome(CTS) is well recognized as the most common type of peripheral neuropathy. A rare cause of CTS is tophaceous gout. Tophi deposits can accumulate in various structures including the flexor tendons, tendon sheaths, the carpal tunnel floor, transverse carpal ligament, and even the median nerve, causing various symptoms such as pain, numbness, and weakness. Tophi forming in the carpal canal can compress the median nerve, leading to CTS. Here, we describe a 25-year-old male with a family history of tophaceous gout who presented with typical CTS symptoms. Although he had chronic numbness in his right hand, he failed to present with any obvious pal-pable masses on his forearm or hand. However, his family history, laboratory, clinical, and magnetic re-sonance imaging findings were consistent with tophi deposits. CTS symptoms were eased through surgical removal of tophi and decompression of the median nerve. No recurrences of gout and CTS symptoms were reported at a one-year follow-up. This case shows that CTS symptoms could be the initial manifestation of tophaceous gout. In patients with a family history of gout and with CTS symptoms, imaging examinations are critical for early diagnosis and selecting appropriate treatment. Surgical removal of "covert" tophi and decompression of the median nerve is an effective option for eliminating symptoms.展开更多
·AIM: To characterize the clinical features of ocular surface in gout patients in coastal area of Shandong Province in China. ·METHODS: A total of 380 consecutive gout patients were examined from January 201...·AIM: To characterize the clinical features of ocular surface in gout patients in coastal area of Shandong Province in China. ·METHODS: A total of 380 consecutive gout patients were examined from January 2011 to May 2011. According to the course of gout, patients were divided into group A (【5 years), B (5 -10 years) and C (】10 years). Group D (control group) was consist of 50 healthy subjects. Eyelids, lateral canthus, medial canthus, palpebral conjunctiva, sclera and cornea, anterior chamber, lens, anterior vitreous were examined by slit lamp to find whether there were deposition of uric acid crystals, ocular vascular tortuosity, redness and subconjunctival hemorrhage. The ophthalmic exams of visual acuity, intraocular pressure, fundus were used to assess any gout-related eye disease. ·RESULTS: Uric acid crystals were found in 3 patients and the positions of the deposite were in corneal stroma, corneal epithelium and superficial stroma, and sclera respectively. The incidence was 0.79% . Dilatated and tortuous blood vessels in conjunctiva and sclera surface were found in 38 (23.8% ), 40 (44.0% ), 58 (45.0% ), 9 (18.0% ) patients in groups A, B, C and D, respectively. The differences between group B and D, group C and D were statistically significant( 【0.01, 【0.01).Transparent vesicles with metal -like reflected light in subconjunctiva were seen in 26 (16.2%), 29 (31.9%), 41 (31.8%), 2 (4.00%) patients in groups A, B, C and D, respectively. The differences between A and D, B and D, C and D were statistically significant ( 【0.05, 【0.01, 【0.01). Subconjunctival hemorrhage was found in all groups, the difference among the four groups showed no statistically significance. · CONCLUSION: Gout can cause ocular surface abnormalities, such as tophi deposition, subconjunctival transparent vesicles and hemorrhage, and vascular changes. These features have important clinical significance in early detection of the gout and prevention of eye injury. ·展开更多
AIM To summarize clinical presentations and treatment optionsof spinal gout in the literature from 2000 to 2014, and present theories for possible mechanism of spinal gout formation.METHODS The authors reviewed 68 pub...AIM To summarize clinical presentations and treatment optionsof spinal gout in the literature from 2000 to 2014, and present theories for possible mechanism of spinal gout formation.METHODS The authors reviewed 68 published cases of spinal gout, which were collected by searching "spinal gout" on Pub Med from 2000 to 2014. The data were analyzed for clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, and treatment choices. RESULTS Of the 68 patients reviewed, the most common clinical presentation was back or neck pain in 69.1% of patients. The most common laboratory study was elevated uric acid levels in 66.2% of patients. The most common diagnostic image finding was hypointense lesion of the gout tophi on the T1-weighted magnetic resonance imaging scan. The most common surgical treatment performed was a laminectomy in 51.5% and non-surgical treatment was performed in 29.4% of patients.CONCLUSION Spinal gout most commonly present as back or neck pain with majority of reported patients with elevated uric acid. The diagnosis of spinal gout is confirmed with the presence of negatively birefringent monosodium urate crystals in tissue. Treatment for spinal gout involves medication for the reduction of uric acid level and surgery if patient symptoms failed to respond to medical treatment.展开更多
OBJECTIVE:To evaluate the curative effect of integrated Traditional Chinese and Western Medicine on gout,and to investigate the therapy timing and exact treatment options of integrated medicine.METHODS:Totally 860 pat...OBJECTIVE:To evaluate the curative effect of integrated Traditional Chinese and Western Medicine on gout,and to investigate the therapy timing and exact treatment options of integrated medicine.METHODS:Totally 860 patients were enrolled,including 460 patients with intermittent gout,200 patients with active Traditional Chinese Medicine(TCM)syndrome(TCM syndrome score≥6)and200 patients with stable TCM syndrome(score<6).They were randomly divided into intervention and control groups.The control group was treated according to Western Medicine guidelines.The intervention group was treated with integrated Traditional Chinese and Western Medicine.The efficacy of TCM syndrome,joint pain score,joint swelling score,ESR,C-reactive protein,serum uric acid,liver and kidney function,and the duration of remission of TCM syndrome were compared between the two groups before and after treatments.RESULTS:For the patients with stable TCM syndrome,there was no significant difference in the effective rate and inefficiency between the intervention group and the control group.For the active type,the effective rate of the intervention group is better than the control group significantly.For the stable type,there was no significant difference between the intervention group and the control group in improving the scores of joint pain and swelling,reducing the level of ESR,C-reactive protein,serum uric acid and improving liver and kidney function.For the active type,the differences between the two groups were significant.The stable stage of gout in the intervention group was longer than the control group.CONCLUSION:For the gout patients with stable TCM syndrome in the acute stage of gout,we can use TCM treatment or Western Medicine alternatively;for the patients with active TCM syndrome,the scheme of combination of Traditional Chinese and Western Medicine can be applied,with the better curative effect than any medicine alone.展开更多
OBJECTIVE:To evaluate the clinical efficacy and safety of Rebixiao(RBX)Chinese herbal tablets(CHT)and Chinese formula granules(CFG)in the treatment of acute gout arthritis(AGA).METHODS:This randomized,multicenter,doub...OBJECTIVE:To evaluate the clinical efficacy and safety of Rebixiao(RBX)Chinese herbal tablets(CHT)and Chinese formula granules(CFG)in the treatment of acute gout arthritis(AGA).METHODS:This randomized,multicenter,double-blind,controlled trial included 165 AGA patients with the damp-heat symptom pattern who were randomly divided into an RBX CHT group and an RBX CFG group and treated for 7 d at three centers.The total effective rates of the joint symptom score,Traditional Chinese Medicine(TCM)symptoms score,erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)were used to evaluate the clinical efficacy.Safety assessments were also performed.RESULTS:Of the 165 enrolled patients,147 completed the clinical observation.There was no difference in baseline between the two groups.The total effective rates of the joint symptom score were 94.36%and 97.36%,and the total effective rates of the TCM symptoms score were 95.77%and 97.36%in the CFG group and CHT group,respectively.No statistical difference was found between the two groups(P>0.05).Additionally,ESR and CRP were similar in both groups(P>0.05).Furthermore,treatment efficacy regarding TCM and joint symptoms,the ESR,and CRP were consistent within each center and among the different centers(P>0.05).In addition,the incidence of adverse events was 4.22%and 2.63%in the CFG group and CHT group,respectively,and no difference was observed between the two groups(P>0.05).CONCLUSION:RBX CFG and CHT have significant and similar efficacy in the treatment of AGA,and CFG did not increase adverse side effects.展开更多
We present a very rare case of tophaceous gout of the middle ear causing conductive hearing loss,with special emphasis on Computed Tomography presentation.
Hyperuricemia(HUA)is a condition associated with a high concentration of uric acid(UA)in the bloodstream and can cause gout and chronic kidney disease.The gut microbiota of patients with gout and HUA is significantly ...Hyperuricemia(HUA)is a condition associated with a high concentration of uric acid(UA)in the bloodstream and can cause gout and chronic kidney disease.The gut microbiota of patients with gout and HUA is significantly altered compared to that of healthy people.This article focused on the complex interconnection between alterations in the gut microbiota and the development of this disorder.Some studies have suggested that changes in the composition,diversity,and activity of microbes play a key role in establishing and progressing HUA and gout pathogenesis.Therefore,we discussed how the gut microbiota contributes to HUA through purine metabolism,UA excretion,and intestinal inflammatory responses.We examined specific changes in the composition of the gut microbiota associated with gout and HUA,highlighting key bacterial taxa and the metabolic pathways involved.Additionally,we discussed the effect of conventional gout treatments on the gut microbiota composition,along with emerging therapeutic approaches that target the gut microbiome,such as the use of probiotics and prebiotics.We also provided insights into a study regarding the gut microbiota as a possible novel therapeutic intervention for gout treatment and dysbiosis-related diagnosis.展开更多
文摘Objective:To explore the mechanism of action of"Weilingxian-Guizhi"two drugs in the treatment of gout.Method:First obtain the 15 chemical components contained in the"Weilingxian-Guizhi"drug,predict its target points through the database,and then construct the gout-related protein-protein interaction network(PPI),and then construct the"Weiling,"the"Xian,Guizhi"drug pair"active ingredient-predicted target"network,the construction of the gout-related"Weilingxian-Guizhi"drug pair"active ingredient-potential target"network,based on the Kyoto Encyclopedia of Genes and Genomes(KEGG)biological pathway enrichment analysis and gene ontology(GO)functional enrichment analysis,to study the mechanism of action of the two drugs"Weilingxian-Guizhi"in the treatment of gout.Results:The goutrelated"Weilingxian-Guizhi"drug pair"active ingredient-potential target"network contains 14 targets.KEGG pathway enrichment analysis yields 32 pathways,and GO functional enrichment analysis yields 517 GO entries.Among them,there are 468 items related to biological processes,21 items related to molecular functions,and 28 items related to cell composition.Conclusion:The results of this study initially verified and predicted the mechanism of the"Weilingxian-Cinnamon Stick"medicine on the treatment of gout,and laid a good foundation for further revealing its mechanism of action.
基金the National Natural Science Foundation of China(32325040)the Research Fund for the National Key R&D Program of China(2022YFD2100700).
文摘Modern lifestyle and diet have increased the incidence rate of uric acid(UA)metabolism-related diseases like hyperuricemia(HUA)and gout,posing heavy economic burden to individual patients and their families and the society.UA metabolism is a complex physiological process involving the kidney,intestine,and other organs.A number of factors together regulate UA metabolism,including genetics,diet,hormones,and the gut microbiota.This review summaries the gut microbiota features in subjects with HUA and gout,and the therapeutic effects of implementing microecological therapies(probiotics,prebiotics,or fecal microbiota transplant)that target modulate the gut microbiota and its downstream metabolism on the disease.Current evidence shows that these strategies are safe and promising in alleviate inflammation,reduce UA,and restoring a healthy gut microbiota in subjects with UA metabolism-related diseases.However,most clinical data are generated by animal studies.Therefore,we propose that vigorous human intervention trials should be conducted in the future to evaluate the therapeutic effects of microecological therapies in managing HUA and gout.
文摘To elucidate the mechanisms underlying the therapeutic effects of the herbal medicine pair Smilax Glabra and Semen Coicis in treating gout and hyperuricemia,a comprehensive analysis was conducted using network pharmacology and molecular docking methods.Disease-associated targets for gout and hyperuricemia were identified from the GeneCards,OMIM,Disgenet,and TTD databases,while the key active components and their corresponding targets for Smilax Glabra and Semen Coicis were obtained from the TCSMP database.The intersection of these targets enabled the construction of a protein-protein interaction(PPI)network,which was subsequently visualized and analyzed.Core targets were further subjected to Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses to elucidate the biological processes and pathways involved.Molecular docking was then employed to validate the reliability of the interactions between the active components and the identified targets.The analysis revealed that Smilax Glabra and Semen Coicis contained 15 bioactive components that interacted with 393 potential targets,while gout and hyperuricemia were associated with 660 targets in total.The primary active compounds implicated in treating these conditions included diosgenin,quercetin,and naringenin,which were found to interact with crucial hub targets such as BCL2,CASP3,and MAPK3.These interactions suggested that the herbal medicine pair modulated several biological processes,including gland development and the regulation of body fluid levels,through pathways involving membrane rafts,membrane microdomains,and nuclear receptor activities.Enrichment analyses highlighted their involvement in multiple signaling pathways,such as EGFR tyrosine kinase inhibitor resistance,phospholipase D signaling,and platelet activation.Molecular docking confirmed the strong binding affinities between the hub genes and the major active components,supporting their potential role in therapeutic efficacy.This study demonstrated that Smilax Glabra and Semen Coicis might offer a promising therapeutic strategy for gout and hyperuricemia by targeting multiple molecular components,biological functions,and pathways.The findings underscored the unique potential of traditional Chinese medicine(TCM)in managing complex diseases by leveraging synergistic effects across diverse biological mechanisms.
基金supported by the Fundamental Research Funds for the Central Universities(DUT24YG142).
文摘Curcumin,a bioactive compound extracted from Curcuma longa.L.,demonstrates significant therapeutic potential in inflammatory diseases.This study aims to explore the effects of curcumin on hyperuricemia with acute gout and associated renal dysfunction in a mouse model.The results show that curcumin treatment alleviates ankle joint swelling,reduces inflammatory cytokines IL-1βand TNF-α,and lowers serum uric acid concentrations.High-dose curcumin notably inhibits xanthine oxidase(XOD)activity,a key enzyme in uric acid production,while it enhances the renal expression of the urate transporter ABCG2,thereby promoting uric acid excretion.Furthermore,curcumin effectively mitigates renal injury as evidenced by reduced serum creatinineand blood urea nitrogen levels and suppresses renal inflammation.At the molecular level,curcumin exerts potent antioxidant effects by lowering reactive oxygen species(ROS)levels in both cultured HK-2 human renal tubular epithelial cells and RAW264.7 mouse macrophages.The curcumin-mediated effects are associated with the disruption of NEK7-NLRP3 complex formation,leading to the suppression of the ROS/NEK7-NLRP3 inflammasome pathway.This,in turn,inhibits pyroptosis and the subsequent release of mature IL-1β.These findings suggest that curcumin not only reduces uric acid production but also modulates inflammation through ROSscavenging properties and its ability to inhibit the NLRP3 inflammasome.
文摘The study by Lin et al delves into the clinical impact of dapagliflozin,a repre-sentative sodium-glucose cotransporter 2(SGLT2)inhibitor,on chronic heart failure complicated by hyperuricemia.This investigation highlights dapagliflo-zin’s efficacy in lowering serum uric acid levels,enhancing cardiac function,and reducing cardiovascular events.This work not only provides a comprehensive analysis of dapagliflozin’s sustained benefits in these patients but also introduces novel insights for managing chronic heart failure exacerbated by elevated uric acid.Furthermore,this review examines the potential role of SGLT2 inhibitor in the context of gout,evaluating its mechanisms and clinical application prospects in the management of hyperuricemia,thereby further enriching the medical community’s understanding of SGLT2 inhibitor.
基金Supported by Six Peak Talents Projects in Jiangsu Province on Clinical Application of HuRAT1 Combined with ABCG2 Gene Detection in Predicting Hyperuricemia/Gout Susceptibility(2015-WSN-089)Research Projects of Traditional Chinese Medicine of Wuxi Municipal Health Commission on Mechanisms of Bixie Drink on Neutrophils and Inflammatory Signal Transduction Pathway of NLRP3 in Gout Model Rats(ZYZL201803).
文摘Gout is an independent risk factor for hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease and cerebral infarction.At present,the studies on the mechanism of gout at home and abroad have mainly focused on immune inflammation,gene polymorphism and related studies.Uric acid deposition or crystal precipitation activates phagocytes,fibroblasts and mast cells in synovium,produces IL-1β,TNF and chemokine IL-8(CXCL8),thereby activating neutrophils,urate crystal polyanion surface can be coated with immunoglobulins and other serum proteins as substrates for complement activation,complement substitution pathways and classical complement pathways to activate complements.Uric acid crystals activate inflammation-related signal transduction pathways including the activation of inflammation-related signal transduction pathway by uric acid crystals and TLRS/MyD88 signal transduction pathways.Gene polymorphism is related to inflammation and signaling pathway,EGF gene is closely related to gout inflammation,which may be involved in the regulation of gout inflammation,among which NLRP3 inflammatory signaling pathway and gene polymorphism have been deeply studied in the pathogenesis of gout,which is the main therapeutic target of anti-inflammatory and uric acid lowering.
文摘BACKGROUND Gouty tophus is rarely reported in the head and neck areas.To the best of our knowledge,this is the first report on multiple gouty tophi in the head and neck with normal serum uric acid(SUA)levels.CASE SUMMARY We report a case of multiple gouty tophi in the nasal dorsal and auricle regions with normal SUA levels.The patient was admitted to the hospital with a chief complaint of recurrent nasal swelling and pain for 3 years,which was aggravated for 3 d.The patient’s SUA level had been regularly reviewed in the outpatient department and had been successfully controlled for several years.Resection of the nasal masses was performed.Cartilage from the right ear cavity was used to repair the nasal defects.The pathological report confirmed a nasal gouty tophus.No recurrence or deformity was found after a 1 year follow-up.CONCLUSION Normal SUA cannot completely negate the diagnosis of gouty tophus,especially in some rare regions.
基金This study was supported by the General Project of Beijing Natural Science Foundation(No.7172101)the Beijing Municipal Hospital Research and Cultivation Project(No.PZ2017015)the Beijing Hospital of Traditional Chinese Medicine Gospital-Level Project(No.YJ-201807).
文摘Background:The study was conducted with the interest of exploring the effects of Qingre Yangyin Chushi pill as anti-inflammatory agent in gout treatment based on the NLRP3/GSDMD coke death pathway.Methods:In this study,48 male SD rats were randomly divided into 6 groups,namely model group,blank control group(BC),Qingre Yangyin Chushi pill low-dose treatment group(MSD1),medium-dose treatment group(MSD2),high-dose treatment group(MSD3),and colchicine group(PC),with eight members in each group.The BC and model groups were administered with saline twice a day.The MSD1,MSD2,and MSD3 groups were administered with Qingre Yangyin Chushi pill at a dose of 1.8 g·kg^?1,3.6 g·kg^?1,and 7.2 g·kg^?1 twice a day.The colchicine group was administered with a colchicine suspension at a dose of 0.6×10^?3 g kg^?1 twice a day for 7 days.After gavage of animals in each group for 4 days,the rats'ankle joints were injected with sodium urate suspension×3 days to induce a gouty arthritis model.Then,serum and tissue samples were collected on the third and seventh day after gavage.The synovial tissue from the rat ankle joints was taken,and immunohistochemical technique was used to detect NOD-like receptor protein 3(NLRP3),inflammatory bodies,cysteine protease-1(Caspase-1),and Gasdermin-D protein(GSDMD)expression.Image-Pro Plus image analysis system was used to measure the average integrated absorbance and calculate IHS.Integral enzyme-linked immunosorbent assay was used to determine the interleukin 1β(IL-1β)and interleukin 18(IL-18)expression of tumor necrosis factor-α(TNF-α).Western blot was used to detect NLRP3,Caspase-1,GSDMD,and apoptosis-associated speck-like protein containing a CARD(ASC)expression levels.Results:After 48 hours of modeling,compared with the PC group,the arthritis indices of the MSD1,MSD2,and MSD3 groups were insignificant(P>0.05).The levels of IL-1β,IL-18,and TNF-αwere lower in the PC and MSD2 groups compared with the BC group.However,compared with the control group,MSD1,MSD2,and PC groups had lower levels of IL-1βand IL-18.Regarding TNF-αlevels(P<0.05);compared with the PC group,the levels of IL-1β,IL-18,and TNF-αin MSD2 decreased more significantly(P<0.05).The levels of NLRP3,Caspase-1,GSDMD,ASC,IHS score,and mRNA were lower in the PC and MSD2 groups(P<0.05)compared with the control group.The MSD1 and MSD2 groups had lower levels of NLRP3,Caspase-1,GSDMD,ASC protein levels,IHS points,and mRNA levels(P<0.05)compared with the PC group.Moreover,NLRP3,Caspase-1,GSDMD,ASC protein levels,IHS points,and mRNA levels were more reduced in the MSD2 group(P<0.05).Conclusion:Qingre Yangyin Chushi pill can inhibit the activation of the NLPR3 inflammatory complex,reduce the production of GSDMD protein,regulate the occurrence of pyroptosis,reduce the expression of inflammatory factors,and thus reduce arthritis.All these processes are achieved through the NLRP3/GSDMD pathway.
文摘Objectives: To define clinical differences in the acute phase response and serum acute phase reactants between gout, pseudogout and crystal-induced arthritis in the presence of non-articular infections (CAI). Patients and Methods: Eleven patients with definite gout, 12 patients with pseudogout and 5 patients with CIA were included in the study. Results: The erythrocyte sedimentation rate (ESR) was significantly different between gout (68.2 ± 49.9 mm/Hr) and CIA (113.8 ± 37.2 mm/Hr) but not between gout and pseudogout (83.9 ± 45.6 mm/Hr) or between pseudogout and CIA. The C-reactive protein (CRP) was significantly increased between gout (10.1 ± 7.9 mg/dL) and pseudogout (18.9 ± 9.8 mg/dL), gout and CIA (36.5 ± 12.4 mg/dL) as well as between pseudogout and CIA. The peripheral white cell count was significantly different between gout (9.27 ± 3.7 k/μL) and CIA (16.5 ± 6.8 k/μL), and between pseudogout (8.9 ± 3.2 k/μL) and CIA. Conclusions: Measurement of ESR and CRP are helpful in crystal-induced arthritis. The CRP has more discriminating utility than the ESR in distinguishing between gout, pseudogout and CIA. Peripheral wbc is most useful for differentiating crystal-induced arthritis from CIA.
文摘Introduction: Gout is defined as an arthritic condition resulting from the deposition of monosodium urate crystals in and/or around joints, following long-standing hyperuricemia. This may cause gouty arthritis in joints and tophi in soft tissues. Spinal gout is rare and never mentioned in our context. It can appear as acute back pain, radiculopathy, spinal cord compression, spondylodiscitis or neoplasic/infectious epiduritis. Our aim was to share our surgical experience and proceed of a Literature review. Cases Presentation: Between January and August 2022, two patients male were surgically cared, aged of 42 and 60 years old. The gout was unknown in the youngest and poorly followed in the eldest. There was no past medical history of tuberculosis or immunodeficiency in both. The early diagnosis retained was unspecific lumbar spondylodiscitis due to clinical features: Patients complained both of lower back pain with initial fever. It was of a progressive left L5S1 deficit with erectile defect and dysuria in the first case and a progressive paraplegia without sphincter disorders in the second case. We proceeded with a lumbar laminectomy with a biopsy on both patients. The spinal tophus was ligamentous in one case and arthro-ligamentous in the other. There was a progressive motor recovery from postoperative Day-2 till postoperative Month-1. A probabilistic antituberculosis treatment was promptly initiated postoperatively based on radioclinic features while waiting for histologic proof. The Polymerase Chain Reaction (PCR) of Mycobacterium tuberculosis was negative and the histology was of a chronic calcified osteitis with dense fibrosis in both. The anti-gout treatment was implemented after 15 days with blood test evidence. A rheumatologic follow-up was also initiated and adjuvant physio-therapy. The results were very satisfactory from 4 - 6 months with independent walking. Discussion Conclusion: Spinal Gout may be suggested in 40-male-old faced with any acute rachialgia with neuro deficit with dubious neuro-imaging.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(Nos.2014R1A1A4A03009388&2014R1A1A2055560)a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)+2 种基金funded by the Ministry of Health&Welfare,Republic of Korea(No.HI12C1265)Hallym University Research Fund
文摘Korean oriental medicine prescription is widely used for the treatment of gouty diseases. In the present study, we investigated anti-inflammatory effects of modified Korean herbal formulation, mixed extract of medicinal herbs(MEMH), and its modulatory effects on inflammatory mediators associated with gouty arthritis. Both in vitro and in vivo studies were carried out to assess the anti-inflammatory efficacy of MEMH on monosodium urate(MSU) crystals-induced gouty inflammation. MSU crystals stimulated human chondrosarcoma cell line, SW1353, and human primary chondrocytes were treated with MEMH in vitro. The expression levels of pro-inflammatory mediators and metalloproteases were analyzed. The effect of MEMH on NFκB signaling pathway in SW1353 cells was examined. Effect of MEMH on the mR NA expression level of pro-inflammatory mediators and chemotactic factor from human monocytic cell line, THP-1, was also analyzed. The probable role of MEMH in the differentiation process of osteoblast like cells, SaO S-2, after MSU treatment was also observed. To investigate the effects of MEMH in vivo, MSU crystals-induced ankle arthritic model was established. Histopathological changes in affected joints and plasma levels of pro-inflammatory mediators(IL-1β and TNFα) were recorded. MEMH inhibited NFκB signaling pathway and COX-2 protein expression in chondrocytes. MSU-induced mR NA expressions of pro-inflammatory mediators and chemotactic cytokines were suppressed by MEMH. In MSU crystals-induced ankle arthritic mouse model, administration of MEMH relieved inflammatory symptoms and decreased the plasma levels of IL-1β and TNFα. The results indicated that MEMH can effectively inhibit the expression of inflammatory mediators in gouty arthritis, demonstrating its potential for treating gouty arthritis.
基金the Project of Zhejiang Provincial Department of Education,China(Y202045471)the Project of Wenzhou Science and Technology,China(NO.Y2020205)。
文摘Gut dysbiosis is suggested to play a critical role in the pathogenesis of gout.The aim of our study was to identify the characteristic dysbiosis of the gut microbiota in gout patients and the impact of a commonly used uric acid-lowering treatment,febuxostat on gut microbiota in gout.16S ribosomal RNA sequencing and metagenomic shotgun sequencing was performed on fecal DNA isolated from 38 untreated gout patients,38 gout patients treated with febuxostat,and 26 healthy controls.A restriction of gut microbiota biodiversity was detected in the untreated gout patients,and the alteration was partly restored by febuxostat.Biochemical metabolic indexes involved in liver and kidney metabolism were significantly associated with the gut microbiota composition in gout patients.Functional analysis revealed that the gut microbiome of gout patients had an enriched function on carbohydrate metabolism but a lower potential for purine metabolism,which was comparatively enhanced in the febuxostat treated gout patients.A classification microbial model obtained a high mean area under the curve up to 0.973.Therefore,gut dysbiosis characterizings gout could potentially serve as a noninvasive diagnostic tool for gout and may be a promising target of future preventive interventions.
文摘Carpal tunnel syndrome(CTS) is well recognized as the most common type of peripheral neuropathy. A rare cause of CTS is tophaceous gout. Tophi deposits can accumulate in various structures including the flexor tendons, tendon sheaths, the carpal tunnel floor, transverse carpal ligament, and even the median nerve, causing various symptoms such as pain, numbness, and weakness. Tophi forming in the carpal canal can compress the median nerve, leading to CTS. Here, we describe a 25-year-old male with a family history of tophaceous gout who presented with typical CTS symptoms. Although he had chronic numbness in his right hand, he failed to present with any obvious pal-pable masses on his forearm or hand. However, his family history, laboratory, clinical, and magnetic re-sonance imaging findings were consistent with tophi deposits. CTS symptoms were eased through surgical removal of tophi and decompression of the median nerve. No recurrences of gout and CTS symptoms were reported at a one-year follow-up. This case shows that CTS symptoms could be the initial manifestation of tophaceous gout. In patients with a family history of gout and with CTS symptoms, imaging examinations are critical for early diagnosis and selecting appropriate treatment. Surgical removal of "covert" tophi and decompression of the median nerve is an effective option for eliminating symptoms.
文摘·AIM: To characterize the clinical features of ocular surface in gout patients in coastal area of Shandong Province in China. ·METHODS: A total of 380 consecutive gout patients were examined from January 2011 to May 2011. According to the course of gout, patients were divided into group A (【5 years), B (5 -10 years) and C (】10 years). Group D (control group) was consist of 50 healthy subjects. Eyelids, lateral canthus, medial canthus, palpebral conjunctiva, sclera and cornea, anterior chamber, lens, anterior vitreous were examined by slit lamp to find whether there were deposition of uric acid crystals, ocular vascular tortuosity, redness and subconjunctival hemorrhage. The ophthalmic exams of visual acuity, intraocular pressure, fundus were used to assess any gout-related eye disease. ·RESULTS: Uric acid crystals were found in 3 patients and the positions of the deposite were in corneal stroma, corneal epithelium and superficial stroma, and sclera respectively. The incidence was 0.79% . Dilatated and tortuous blood vessels in conjunctiva and sclera surface were found in 38 (23.8% ), 40 (44.0% ), 58 (45.0% ), 9 (18.0% ) patients in groups A, B, C and D, respectively. The differences between group B and D, group C and D were statistically significant( 【0.01, 【0.01).Transparent vesicles with metal -like reflected light in subconjunctiva were seen in 26 (16.2%), 29 (31.9%), 41 (31.8%), 2 (4.00%) patients in groups A, B, C and D, respectively. The differences between A and D, B and D, C and D were statistically significant ( 【0.05, 【0.01, 【0.01). Subconjunctival hemorrhage was found in all groups, the difference among the four groups showed no statistically significance. · CONCLUSION: Gout can cause ocular surface abnormalities, such as tophi deposition, subconjunctival transparent vesicles and hemorrhage, and vascular changes. These features have important clinical significance in early detection of the gout and prevention of eye injury. ·
文摘AIM To summarize clinical presentations and treatment optionsof spinal gout in the literature from 2000 to 2014, and present theories for possible mechanism of spinal gout formation.METHODS The authors reviewed 68 published cases of spinal gout, which were collected by searching "spinal gout" on Pub Med from 2000 to 2014. The data were analyzed for clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, and treatment choices. RESULTS Of the 68 patients reviewed, the most common clinical presentation was back or neck pain in 69.1% of patients. The most common laboratory study was elevated uric acid levels in 66.2% of patients. The most common diagnostic image finding was hypointense lesion of the gout tophi on the T1-weighted magnetic resonance imaging scan. The most common surgical treatment performed was a laminectomy in 51.5% and non-surgical treatment was performed in 29.4% of patients.CONCLUSION Spinal gout most commonly present as back or neck pain with majority of reported patients with elevated uric acid. The diagnosis of spinal gout is confirmed with the presence of negatively birefringent monosodium urate crystals in tissue. Treatment for spinal gout involves medication for the reduction of uric acid level and surgery if patient symptoms failed to respond to medical treatment.
基金Supported by National Natural Science Foundation of China(Chinese Herbal for Heat-clearing,Detoxifying,Dampness-removing and Turbidity-dissolving in Interfering with Macrophage Autophagy Loop in Treating Gout Acute Inflammation,No.82074377the Role of Macrophage Pyroptosis in the Pathomechanism of Gout and the Intervening Mechanism of Heat-clearing,Detoxifying,Dampness-removing and Turbidity-dissolving,No.81673927)。
文摘OBJECTIVE:To evaluate the curative effect of integrated Traditional Chinese and Western Medicine on gout,and to investigate the therapy timing and exact treatment options of integrated medicine.METHODS:Totally 860 patients were enrolled,including 460 patients with intermittent gout,200 patients with active Traditional Chinese Medicine(TCM)syndrome(TCM syndrome score≥6)and200 patients with stable TCM syndrome(score<6).They were randomly divided into intervention and control groups.The control group was treated according to Western Medicine guidelines.The intervention group was treated with integrated Traditional Chinese and Western Medicine.The efficacy of TCM syndrome,joint pain score,joint swelling score,ESR,C-reactive protein,serum uric acid,liver and kidney function,and the duration of remission of TCM syndrome were compared between the two groups before and after treatments.RESULTS:For the patients with stable TCM syndrome,there was no significant difference in the effective rate and inefficiency between the intervention group and the control group.For the active type,the effective rate of the intervention group is better than the control group significantly.For the stable type,there was no significant difference between the intervention group and the control group in improving the scores of joint pain and swelling,reducing the level of ESR,C-reactive protein,serum uric acid and improving liver and kidney function.For the active type,the differences between the two groups were significant.The stable stage of gout in the intervention group was longer than the control group.CONCLUSION:For the gout patients with stable TCM syndrome in the acute stage of gout,we can use TCM treatment or Western Medicine alternatively;for the patients with active TCM syndrome,the scheme of combination of Traditional Chinese and Western Medicine can be applied,with the better curative effect than any medicine alone.
基金grants from the Traditional Chinese Medicine Department of Chongqing Municipal Health and Family Planning commission(No.2012-1-16)National Natural Science Foundation of China(Grant no.81673724)+1 种基金Chongqing Science and Technology Commission(cstc2018jxj1130084 and cstc2017jxjl130033)Chongqing Hospital of Traditional Chinese Medicine Advantageous Diseases Special Fund(No.cqszyyysbz2018004)。
文摘OBJECTIVE:To evaluate the clinical efficacy and safety of Rebixiao(RBX)Chinese herbal tablets(CHT)and Chinese formula granules(CFG)in the treatment of acute gout arthritis(AGA).METHODS:This randomized,multicenter,double-blind,controlled trial included 165 AGA patients with the damp-heat symptom pattern who were randomly divided into an RBX CHT group and an RBX CFG group and treated for 7 d at three centers.The total effective rates of the joint symptom score,Traditional Chinese Medicine(TCM)symptoms score,erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)were used to evaluate the clinical efficacy.Safety assessments were also performed.RESULTS:Of the 165 enrolled patients,147 completed the clinical observation.There was no difference in baseline between the two groups.The total effective rates of the joint symptom score were 94.36%and 97.36%,and the total effective rates of the TCM symptoms score were 95.77%and 97.36%in the CFG group and CHT group,respectively.No statistical difference was found between the two groups(P>0.05).Additionally,ESR and CRP were similar in both groups(P>0.05).Furthermore,treatment efficacy regarding TCM and joint symptoms,the ESR,and CRP were consistent within each center and among the different centers(P>0.05).In addition,the incidence of adverse events was 4.22%and 2.63%in the CFG group and CHT group,respectively,and no difference was observed between the two groups(P>0.05).CONCLUSION:RBX CFG and CHT have significant and similar efficacy in the treatment of AGA,and CFG did not increase adverse side effects.
文摘We present a very rare case of tophaceous gout of the middle ear causing conductive hearing loss,with special emphasis on Computed Tomography presentation.
文摘Hyperuricemia(HUA)is a condition associated with a high concentration of uric acid(UA)in the bloodstream and can cause gout and chronic kidney disease.The gut microbiota of patients with gout and HUA is significantly altered compared to that of healthy people.This article focused on the complex interconnection between alterations in the gut microbiota and the development of this disorder.Some studies have suggested that changes in the composition,diversity,and activity of microbes play a key role in establishing and progressing HUA and gout pathogenesis.Therefore,we discussed how the gut microbiota contributes to HUA through purine metabolism,UA excretion,and intestinal inflammatory responses.We examined specific changes in the composition of the gut microbiota associated with gout and HUA,highlighting key bacterial taxa and the metabolic pathways involved.Additionally,we discussed the effect of conventional gout treatments on the gut microbiota composition,along with emerging therapeutic approaches that target the gut microbiome,such as the use of probiotics and prebiotics.We also provided insights into a study regarding the gut microbiota as a possible novel therapeutic intervention for gout treatment and dysbiosis-related diagnosis.
