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Objective:To improve the clinical differential diagnosis ability of rheumatoid arthritis (RA) complicated with gout and septic arthritis (SA).Methods:The clinical characteristics, diagnosis, and treatment of one RA patient with hyperuricemia and recurrent swelling and pain in right shoulder were reported and discussed.Results:A patient, with a history of RA for 10 years, hyperuricemia for 8 years, recurrent swelling and pain in right shoulder for 1 year. RA, gout, and SA were diagnosed before, and the response was poor after symptomatic treatment. In recent 1 month, the symptom was aggravated with the formation of fistula on the right shoulder. The laboratory tests for tuberculosis T cell interferon release test (IGRA) and tuberculin (PPD) test were negative, and the CD4 + cell count decreased. The comprehensive analysis of the imaging with right shoulder showed MSU deposition on right shoulder, with bone erosion, bone destruction, bone marrow edema, joint effusion, and multiple sites of connective tissue involvement (synovial bursa, tendon sheath, tendon, and muscle) GeneXpert MTB/RIF (GeneXpert), metagenomic next-generation sequencing (mNGS) of puncture fluid and joint fluid culture prompted Mycobacterium tuberculosis complex group. He was finally diagnosed with RA, gout, and osteoarticular tuberculosis (OAT). Symptoms were relieved after symptomatic treatment. Conclusion:RA patients with hyperuricemia have recurrent single arthritis. In addition to considering for gout, the presence of OAT should also be considered. The immune functional status of the patient and drug used may interfere with the interpretation of immune function tests. It is necessary to integrate the clinical characteristics of patients, a variety of imaging examinations, and etiological detection to confirm the diagnosis and avoid misdiagnosis.
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Objective:To investigate the clinical efficacy of etocoxib combined with low-dose colchicine in the treatment of acute gouty arthritis in 37 patients.Methods:A total of 74 patients with acute gouty arthritis who received treatment in The Second People's Hospital of Liaocheng from October 2019 to October 2021 were included in this study. They were randomly assigned to undergo treatment with etocoxib alone (control group, n = 37) or etocoxib combined with low-dose colchicine (observation group, n = 37). All patients were treated for 1 week. Clinical efficacy, Visual Analogue Scale score, laboratory indicators, incidence of adverse reactions, and Quality of Life Comprehensive Assessment Questionnaire-74 score were compared between the two groups. Results:The total response rate in the observation group was significantly higher than that in the control group [95% (35/37) vs. 65% (24/37)]. At 1, 3, and 6 days after treatment, the Visual Analogue Scale score in the observation group was significantly lower than that in the control group ( t = 19.77, 15.43, 29.01, all P < 0.001). After treatment, blood uric acid, C-reactive protein, and erythrocyte sedimentation rate in the observation group was (432.26 ± 31.26) μmol/L, (16.25 ± 1.62) mg/L, (31.26 ± 1.25) mm/h, respectively, which was significantly lower than (485.26 ± 39.62) μmol/L, (45.26 ± 3.88) mg/L, (46.52 ± 2.82) mm/h in the control group ( t = 6.39, 41.97, 30.09, all P < 0.001). Quality of Life Comprehensive Assessment Questionnaire-74 score in the observation group was significantly higher than that in the control group ( t = 13.41, 17.73, 16.09, 11.77, all P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Etocoxib combined with low-dose colchicine can effectively reduce pain and inflammatory reactions in patients with acute gouty arthritis and improve quality of life, with a low incidence of adverse reactions.
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Objective:To explore the molecular mechanism of Danggui Niantong Decoction in the treatment of gouty arthritis (GA) based on network pharmacology and molecular docking.Methods:By selecting for the active components and targets of Danggui Niantong Decoction with TCMSP, and retrieving the GeneCards, OMIM, PharmGKB and DrugBank databases to obtain GA related targets. The potential targets of Danggui Niantong Decoction in the treatment of GA were obtained by the intersection of mappings. The regulation network of Chinese medicine compound and protein-protein interaction network of Danggui Niantong Decoction were constructed by Cytoscape software, and the targets of Danggui Niantong Decoction in the treatment of GA were analyzed by GO and KEGG enrichment by David Database. Finally, molecular docking was performed by using Autodock software.Results:There are 198 active components that could treat GA in Danggui Niantong Decoction. The key active components are Quercetin and Kaempferol. There are 46 key targets, the core targets are NFE2L2, HMOX1, PPARA, PTGS2, IL1β, CXCL8. GO enrichment suggests that the key genes are primarily involved in many biological processes such as Inflammatory response regulation, response to oxidative stress, Fatty acid metabolism process, steroid metabolism, lipopolysaccharide response and reactive oxygen species metabolism. KEGG pathway indicates that Danggui Niantong Decoction mainly acted on IL-17 signal pathway, HIF-1 signal pathway, TNF signal pathway and AGE-RAGE signal pathway. Molecular docking shows that the active components of Danggui Niantong Decoction and action target of GA can combine toghether with high efficiency, and the structure is stable.Conclusion:Danggui Niantong Decoction has multi-component, multi pathway and multi-protein characteristics. Danggui Niantong Decoction can treat GA by regulating immune inflammatory reaction and oxidative stress reaction.
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ABSTRACT Objective Gouty arthritis is characterized by painful inflammation due to the deposition of monosodium urate crystals in joint tissues. Despite available treatments, many patients experience ineffective management and adverse effects. This study evaluated a manual therapy protocol involving passive joint mobilization at the peak of inflammation in a gouty arthritis model using functional and inflammatory parameters. Methods Twenty male Wistar rats, 12 weeks old, were divided into two groups (n=10 each): Gouty Arthritis and Control Groups, which were further subdivided into treated and untreated groups (n=5 each). The Gouty Arthritis Group received intraarticular knee injection of 50µL of monosodium urate crystals, while the Control Group received 50µL of phosphate buffered saline. The treatment involved a 9-minutes session of grade III joint mobilization (according to Maitland). Nociception, grip strength, and edema were evaluated before induction (EV0), 7 hours after assessment (EV1), immediately after treatment (EV2), and 1 hour after treatment (EV3). The animals were euthanized, and synovial fluid was collected to analyze leukocyte migration. Results The model mimicked the signs of the Gouty Arthritis Group, with a decrease in the threshold of nociception and strength and an increase in edema and leukocyte count. The mobilization protocol significantly increased the nociceptive threshold and grip strength and reduced edema; however, it did not reverse the increase in leukocyte count. Conclusion Our results suggest that mobilization promotes analgesia and may modulate the inflammatory process owing to reduced edema and subtle attenuation of cell migration, which contributes to strength gain.
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Objective:To explore the three long non-coding RNA (long non-coding ribonucleic acid, the expression of lncRNA NR_002578, NR_038264 and NR_046252) in peripheral blood mononuclear cells (PBMCs) of patients with primary gout arthritis (GA) and their clinical value.Methods:Peripheral venous blood, clinical data and laboratory data were collected from 60 gout patients (including 30 AG patients in acute stage and 30 IG patients in intermittent stage) and 50 healthy subjects (HC group). Quantitative reverse transcription PCR (RT-qPCR) was used to detect the expression levels of PBMCs of 3 lncRNAs in GA and HC groups, and the differences of 3 lncRNAs expression levels in different groups were compared and the correlation analysis was conducted with clinical indicators. Receiver operating characteristic curve (ROC) was constructed to evaluate the possible efficacy of lncRNAs in gout diagnosis. The measurement data conforming to normal distribution were tested by t test or variance analysis, and non-normal distribution were tested by Mann-Whitney U test or Kruskal-Wallis H test. The comparison among the three groups was conducted by SNK. Results:① The expression of NR_002578 in GA was significantly lower than that in HC [60.2(16.8, 100.1)×10 -3vs 149.5 (92.6, 221.8)×10 -3, Z=-5.75, P<0.001], subgroup analysis showed that the expression of NR_002578 in AG was significantly lower than that in IG and HC [34.3(8.6, 72.8)×10 -3vs 88.3(47.7, 109.6)×10 -3vs 149.5(92.6, 221.8)×10 -3, H=40.12, P<0.001], and lower in IG than that in HC ( P<0.001). The expression of NR_046252 in GA was significantly higher than that in HC [6.5(2.1, 21.5)×10 -3vs 2.1(1.2, 3.5)×10 -3, Z=-4.21, P<0.001]. The expression of NR_046252 in AG and IG were higher than that of the HC group [6.3(2.0, 12.0)×10 -3vs 7.2(2.4, 30.6)×10 -3vs 2.1(1.2, 3.5)×10 -3, H=21.33, P<0.001], but there was no significant difference between the AG and IG group ( P>0.05). ② Spearman correlation analysis showed that NR_002578 expression was negatively correlated with erythrocyte sedimentation rate (ESR) ( r=-0.29, P=0.024)and hypersensitive C-reactive protein (hs-CRP) ( r=-0.35, P=0.006) in gout patients. ③ The areas under ROC curve of NR_002578 and NR_046252 for diagnosing gout were 0.819 and 0.750, respectively. Conclusion:The abnormal expression of NR_002578 and NR_046252 in gout patients suggests that NR_002578 may be involved in the pathogenesis of gout.
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The pathogenesis of gouty arthritis contains internal cause and external cause. The deficiency of Zang Fu organs is the internal cause and the invasion of external pathogens is the external cause, which is related to the liver, spleen and kidney. In clinical treatment, we should grasp the pathological factors such as dampness, heat and blood stasis, and treat this diseaseaccording to different stages and types, anddeal with both symptoms and the root cause. Clinically, orally taken Traditional Chinese Medicine (TCM), acupuncture, collateral pricking and bleeding, and external application of TCM are the common methods to treat this disease and combining various methods together has better curative effect, which could significantly relieve the pain and alleviate inflammation with safetiness. However, the operation methods and standards of the existing studies are not unified, which needs long-term follow-up, large samples and high-quality studies.
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Background@#Patients with acute gouty arthritis experienc severe pain and often have concomitant limited joint movement. High-dose intake of anti-inflammatory analgesics often results in adverse reactions, such as nausea, vomiting, and diarrhea, and might increase the risk of gastrointestinal bleeding. In order to reduce the adverse reactions by oral intake, local use of externally useddrugs with the same active ingredients as the oral intake is an option in clinical practice. However, externally useddrugs take effect slowly and efficacy to reduce painful feelingis unsatisfactory. Therefore, it is demanding to develop a safe and effective treatment plan. In this regard, researchers have put up a hypothesis. The skin of the human body has a dense stratum corneum, which is difficult for externally used drugs to penetrate effectively; if the keratin barrier of the skin around affected joints can be broken without further damaging the skin, externally applied drugs may safely and effectively alleviate the local symptoms of acute gouty arthritis. The nano plum blossom needle is made of a modern new material. The needle body is thin and the diameter of the needle tip is only 300 nm. The needle is used clinically to break through the keratin barrier of the human skin and promote the absorption of external medicine. Therefore, this trial was designed to preliminarily evaluate the safety and effectiveness of using the nano plum blossom needle for the introduction of diclofenac diethylamine emulgel in the treatment of acute gouty arthritis.@*Methods@#A randomized controlled trial including 83 patients with acute gouty arthritis was conducted, who was assigned to three groups, the intervention group, control group 1, and control group 2 in a ratio of 2:2:1, respectively. The nano plum blossom needle was used for the introduction of diclofenac diethylamine emulgel in the intervention group; the nano plum blossom needle was used as a placebo along with the local use of diclofenac diethylamine emulgel in control group 1; and the nano plum blossom needle was used alone in control group 2. The treatments were applied once a day until the pain was completely relieved and the course of treatment lasted up to 7 days. The primary outcome measurement was the visual analog scale for evaluating the degree of pain. The secondary outcome indicators included scoring of the symptoms and signs with comprehensive consideration of the joint skin color, local tenderness, and degree of joint motion, the time and dose of emergency medication usage during trial, and adverse events.@*Discussion@#This trial couldprovide preliminary evidence for evidence-based practice of using nano plum blossom needle transdermal drug delivery technology for diclofenac diethylamine emulgel for the treatment of acute gouty arthritis, and provide a reference for sample size calculation and experimental design of future clinical trials verifying the effectiveness and safety of such a technical scheme in a larger target population.@*Registration information@#This study has been registered in the China Clinical Trial Registry Centerwith the registration code of ChiCTR-IOR-17012154.
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Objective To evaluate the application of the dual-energy CT (DECT) in detection of monosodium urate (MSU) crystals in gout patients.Methods The imaging and clinical data of 101 patients with suspected gout were retrospectively analyzed,including 64 cases of clinically diagnosed gout (gout group) and 37 non-gout cases (non-gout group).The DECT examination was performed for 85 joints in gout group and 42 joints in non-joint group.The value of DECT in detection of MSU crystals was evaluated with receiver operating characteristic (ROC) curve.Results There were significant differences in gender (x2=5.32,P=0.03) and blood uric acid levels (t=1.95,P=0.04) between gout and non-gout groups.The detection rate of MSU in gout group was significantly higher than that of non-gout group (x2=30.52,P＜0.001).The area under the ROC curve (AUC) of DECT in detection of was 0.74±0.05 (Mean±SE),95％CI:0.64-0.85.The sensitivity,specificity,positive predictive value and negative predictive value of the DECT in detection of gouty stone was 0.844,0.703,83.1％ and 72.2％,respectively.Conclusion The dual-energy CT has high sensitivity,specificity and reliability for the detection and diagnosis of monosodium urate crystals in joints of gout patients.
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Objective To observe the efficacy of Simiao pill combined with celecoxib in the treatment of acute gouty arthritis(AGA). Methods From January 2015 to January 2017,70 patients with AGA in the Central Hospital of Luohe were selected and randomly divided into two groups,with 35 cases in each group. The control group received celecoxib treatment,while the treatment group received Simiao pill combined with celecoxib. The treatment course was 7 days in each group. The clinical efficacy and the blood uric acid ( UA) changes were observed and compared before and after treatment. Results The total effective rate of the treatment group was 91. 4% (32/35), which was remarkably higher than 77. 1% (27/35) of the control group,the difference between the two groups was statistically significant(χ2=4. 381,P ＜0. 05). Before treatment,there was no significant difference in UA level between the treatment group and control group(P＞0. 05). After treatment,the level of UA in the treatment group was (402. 17 ± 18. 43) μmol/L,which was lower than (475. 29 ± 37. 82) μmol/L in the control group,the difference between the two groups was statistically significant (t= －11. 051,P＜0. 05). Conclusion The clinical efficacy of Simiao pill combined with celecoxib in the treatment of AGA is effective,and is worthy of clinical promotion.
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BACKGROUND/AIMS: Gout is associated with metabolic disorders that are important risk factors for cardiovascular disease and erectile dysfunction (ED). We aimed to identify independent predictors of ED in patients with gout. METHODS: From August 2014 to August 2015, male outpatients who were being treated for gout in our rheumatology clinic and healthy males without any history of inflammatory disease (control group) were studied. ED was assessed in participants using the five-item version of the International Index of Erectile Function questionnaire. Insulin resistance (IR) was estimated using the homeostatic model assessment (HOMA-IR). Logistic regression analysis was performed to determine the effect of variables on ED risk in all of the study subjects and in patients with gout. RESULTS: We analyzed 80 patients with gout and 70 healthy controls. The median age of patients with gout was 52 years and median disease duration was 120 months. Gout patients were more likely to have ED than controls (55.3% vs. 41.4%, p < 0.047). After adjustment for confounding factors, only HOMA-IR was significantly associated with ED (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.05 to 3.15). Gout patients with ED were more likely to be older (p < 0.001), have higher HOMA-IR (p = 0.048), and have lower glomerular filtration rate (p = 0.038) than those without ED. Multivariate logistic regression analysis showed that HOMA-IR was an independent predictor for ED (OR, 1.62; 95% CI, 1.03 to 2.82) in gout patients. CONCLUSIONS: IR is an independent predictor of ED in patients with gout.
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Humans , Male , Arthritis, Gouty , Cardiovascular Diseases , Erectile Dysfunction , Glomerular Filtration Rate , Gout , Insulin Resistance , Insulin , Logistic Models , Outpatients , Rheumatology , Risk FactorsABSTRACT
The incidence of metabolic rheumatism gout has been increasing with a trend of more younger patients and atypical symptoms. Typical gout is easy to be diagnosed, but it is difficult for atypical cases. Finding uric acid crystal in articular fluid by polarizing light microscope is a gold standard of diagnosis, but it is an invasive diagnostic method and difficult to be widely used. The patients need further imaging examination for assistance of diagnosis and guide of follow-up treatment. This article reviews the research progress of different imaging methods used for diagnosis of gouty arthritis.
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Objective To explore the factors what may influence the formation of tophi by high frequency ultrasound.Methods The gouty patients who were experiencing an acute attack and were clinically diagnosed with gouty arthritis were divided into two groups:the tophi group (44 cases) and the no tophi group (101 cases) group,clinical data and ultrasound features of joints were collected.The differences of ultrasound features and clinical characteristics between the two groups were analyzed.Results ① Ultrasound features showed that synovitis (x2=8.479,P=0.004) and effusion (x2=9.740,P=0.002) of the first metatarsophalangeal joint (MTP1) were most frequently observed in the no tophi group;bone erosion of MTP1 (x2=9.593,P=0.003),double contour (DC) sign (x2=14.069,P=0.000) and bone erosion (x2=5.870,P=0.020) of ankle joint,DC sign of knee joint (x2=8.224,P=0.006) were most frequently observed in the tophi group.Hyperechoic aggregates of MTP1 (x2=9.649,P=0.003) were most frequently observed in no tophi group.(②) Logistic regression analysis showed that MTP1 was the first attacked joint [OR=9.725,95％CI(2.765,34.209),P=0.000],the multiple joints involved [OR=1.908,95％CI (1.190,3.057),P=0.007] and bone erosion of MTP1 [OR=4.339,95％CI(1.300,14.490),P=0.017] were the main risks of the formation of tophi.Synovitis of MTP1 often presented in no tophi patients [OR=0.108,95％CI(0.026,0.441),P=0.002].Conclusion High frequency ultrasound combine with clinical data is of great value for evaluating the development and treatment of gout.
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Objective@#To investigate the clinical efficacy of colchicine tablets in the treatment of patients with gouty arthritis, and to observe the effect of colchicine tablets on erythrocyte sedimentation rate(ESR), C-reactive protein (CRP) and uric acid (UA).@*Methods@#From March 2016 to March 2017, 70 patients with gouty arthritis in our hospital were randomly divided into control group and observation group according to the random number table method.The control group was treated with celecoxib capsules 0.2g, 2 times a day.The observation group was treated with colchicine tablets 0.5mg three times daily, celecoxib capsules 0.2g, 2 times a day.The visual analogue scale (VAS) was used to evaluate the degree of joint pain in two groups.The Likert scale was used to evaluate the swelling of the two groups before and after treatment.The pain relief time was recorded in both two groups.The ESR, CRP and UA were measured before and after treatment.The clinical effects and adverse reactions in the two groups were analyzed.@*Results@#After treatment, the VAS score of the observation group was (2.04±0.52)points, which was significantly lower than (3.53±1.22)points of the control group(t=6.64, P=0.00). The joint swelling score of observation group after treatment was (0.62±0.24) points, which was significantly lower than (1.21±0.33)points of the control group(t=8.55, P=0.00). After treatment, the VAS score and joint swelling score in the two groups were significantly lower than those before treatment (all P<0.05). The pain relief time of the observation group was significantly shorter than that of the control group [(1.36±0.47)d vs.(1.79±0.63)d, t=3.23, P=0.00]. After treatment, the ESR, CRP and UA levels of the observation group were (12.65±3.17)mm/h, (12.14±2.27)mg/L, (417.82±55.88)μmol/L, respectively, which were significantly lower than those of the control group [(14.77±4.22)mm/h, (14.69±3.16)mg/L, (458.93±62.74)μmol/L, t=2.37, 3.87, 2.37, P=0.02, 0.00, 0.00]. After treatment, the ESR, CRP and UA levels of the two groups were significantly lower than those before treatment (all P<0.05). The total effective rate of the observation group was 80.00%, which was obviously higher than 57.14% of the control group(χ2=7.55, P=0.02). The incidence rate of adverse reaction of the observation group was 8.57%, which of the control group was 5.71%, the difference was not statistically significant (χ2=0.21, P=0.64).@*Conclusion@#Colchicine tablets combined with celecoxib capsules in the treatment of patients with gouty arthritis can reduce ESR, CRP and UA levels, improve the degree of pain and joint swelling, and will not increase the adverse reactions.
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Objective To explore clinical efficacy and safety of Tongfeng decoction combined with celecoxib for the acute gouty arthritis of damp-heat with blood stasis type.Methods According to the random indicator method,193 of patients with acute gouty arthritis of damp-heat with blood stasis type in our hospital from 2014 January to January 2017 were divided into control group (n=96) and treatment group (n=97).Patients of control group were treated with celecoxib,while treatment group were treated with Tongfeng decoction combined with celecoxib.The two groups were treated for 14 days.Clinical curative effect was evaluated after treatment.The joint pain score,joint function score and quality of life score of the two groups before and after treatment were compared.The BUA,ESR,DD,IL-1 and CRP of the two groups before and after treatment were compared.The adverse reactions of the two groups during the treatment were compared.Results Total effective rate of observation group was 93.81％ (91/97),which was significantly higher than the control group 73.96％ (71/96),and the difference was statistically significant (x2=14.109,P＜0.01).After treatment,the joint pain (1.1 ± 0.4 vs.2.4 ± 0.8,t=13.984),joint function score (0.7 ± 0.6 vs.1.3 ± 0.9,t=5.451) in the treatment group were lower than those in the control group (P＜0.05).The quality of life score (39.7 ± 9.3 vs.32.5 ± 8.6,t=5.623) in the treatment group were higher than that in the control group (P＜0.05).After treatment,the BUA (302.47 ± 50.72 μmol/L vs.395.21 ± 69.63 μmol/L,t=10.584),ESR (11.63 ± 4.05 mm/h vs.24.87 ± 10.49 mm/h,t=11.589),DD (0.43 ± 0.21 mg/L vs.0.95 ± 0.71 mg/L,t=6.914),IL-1 (12.03 ± 2.62 ng/L vs.19.31 ± 3.25 ng/L,t=17.140) and CRP (6.11 ± 2.40 mg/L vs.11.84 ± 5.49 mg/L,t=9.411) in the treatment group were lower than those in the control group (P＜0.05).There was no significantly difference of the adverse reaction rates of the two groups during treatment (x2=0.216,P=0.642).Conclusions Tongfeng decoction combined with celecoxib for treatment of acute gouty arthritis of damp-heat with blood stasis type showed a good efficacy and low adverse reactions,and it can improve the joint function and quality of life,reduce the BUA.
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Skillful in the treatment of gouty arthritis (GA) by integrated therapies of Chinese and Western medicine,chief physician Zhang Tang-fa proposes to ‘deal with the exterior with the needles,and attack the interior with the drugs,by integrated application of acupuncture and herbal medicine',in combination with comprehensive intervention of dietetic therapy and health education.In the treatment of GA,he adopts the syndrome differentiation based upon the pathogenic factors,in combination of syndrome differentiation based upon the six meridians,to reinforce and benefit the spleen and kidney,clear away heat and remove dampness as the therapeutic principle.By acupuncture mainly at the acupoints of the Spleen and Liver Meridians,he also proposes to select the acupoints by the theory of Na Zi Fa (earthly branch method) of Zi Wu Liu Zhu (midnight-noon ebb-flow),and to puncture the surrounding area of the involved joints shallowly by multiple needles as the major needling method,simultaneously with the reinforcing and reducing manipulations based upon the respiration.In the treatment,acupuncture and acupoint-injection are often used.In diet,low purine diet is often suggested.In health education,the patients are often instructed to understand the disease correctly,eliminate fears and cooperate with doctor's treatment positively.
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Objective To investigate the role of long noncoding RNA-AK001903 in the pathogenesis of primary gout arthritis (GA).Methods The subjects were divided into four groups:30 acute gout patients (AGA),24 non-acute gout patients (NAGA),24 healthy controls and 24 hyperuricemia (HUA).Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to examine the expression of AK001903 in peripheral blood mononuclear cells (PBMCs) from four groups.100 μg/ml monosodium (MSU) was used to stimulate the peripheral blood of NAGA and healthy control patients.Then the expression of AK001903 was detected by RT-qPCR.Kruskal-Wallis test,Mann-Whitney test,Spearman correlations were used for statistical analysis.Results The expression level of AK001903 in the AGA group (0.079±0.022) and the NAGA group (0.071±0.021) were higher than the healthy control group (0.014±0.004).There was no significant difference between the NAGA group and the NAGA group (Z=-0.655,P＞0.05).Those of the GA group (0.078±0.018) and the HUA group(0.047±0.016) was higher than the healthy control group (0.014±0.004) (Z=-2.887,Z=-4.157;P＜0.05).Compared with the control group,the expression of AK001903 in NAGA and the healthy control group which were stimulated by MSU was significantly increased.The Spearman correlation analysis found that the AK001903 expression levels in the GA groups were correlated with TG (r=0.938,P＜0.05),VLDL (r=0.873,P＜0.05),GLU9 (r=0.671,P＜0.05) and were negatively correlated with apoA1 (r=-0.661,P＜0.05).Conclusion Altered expression of AK001903 may be involved in the process of imbalance between lipid metabolism and hyperuricemia,and takes part in the pathogenesis of GA.
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Objective To explore the level of serum hypoxia-inducible factor (HIF)-1α and the effect of pantoprazole on HIF-1α in patients with gouty arthritis.Methods Subjects were divided into acute gouty arthritis (group A),intermittent gouty arthritis (group B) and healthy controls (group C).Patients in group A were divided into mild (A1) and severe (A2) subgroups according to the severity of inflammation.Levels of serum HIF-1α in the three groups,and the levels of interleukin (IL)-1β and tumor necrosis factor (TNF)-α in group A1 and group A2 were detected by enzyme-linked immunosorbent assay (ELISA).Patients in group A2 were randomly divided into three groups,saline 100 ml/twice a day,20％ pantoprazole 100 ml,twice a day and 40％ panto-prazole 100 ml,twice a day were administered respectively.After 7 days,the levels of serum HIF-1α were measured by ELISA.One-way analysis of variance (ANOVA) and two independent sample t test were conducted in this study.Results ① Levels of serum HIF-1α in group A [(48±13) ng/L] were significantly higher than those in group B [(40±12) ng/L,P＜0.01] and group C [(28±12) ng/L,F=29.838,P＜0.01].② Levels of serum HIF-1α [(56±10) ng/L],IL-1β [(51 ±13) ng/L] and TNF-α [(161 ±45) ng/L] in the experimental group A2 were higher than those in the experimental group A1 [HIF-1α:(42±11) ng/L,t=4.600,P＜0.01;IL-1β:(42±12) ng/L,t=2.552,P＜0.05;TNF-α:(122±34) ng/L,t=3.432,P＜0.01].③ Levels of HIF-1α [(26±6) ng/L],IL-1β [(23±4) ng/L],TNF-α [(92±6) ng/L] in the 40％ pantoprazole group were lower than those in 20％ pantoprazole 100 ml,twice a day group [HIF-1α:(33±4) ng/L];IL-1β:(30±5) ng/L;TNF-α:(102±7) ng/ L] and saline group [HIF-1α:(37±5) ng/L];IL-1β:(38±5) ng/L];TNF-α:(108±9) ng/L](all P＜0.05);Levels of HIF-1α,IL-1β and TNF-αin the 20％ pantoprazole group were lower than those in saline group (all P＜0.05).Conclusion ① HIF-1α may be one of the indicators of acute inflammation,which may reflect the degree of inflammation in patients with gout.② Pantoprazole can reduce the level of serum HIF-1α,IL-1β and TNF-α in patients with gouty arthritis,with a concentration dependent characterisit.
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Objective To investigate the role of long noncoding RNA-AJ227913 in the pathogenesis of primary gout arthritis (GA). Methods The subjects were divided into three groups:30 acute gout patients (AGA), 30 non-acute gout patients (NAGA), 30 healthy controlsand 30 hyperuricemia patients (HUA). Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to examine the expression of AJ227913 in peripheral blood mononuclear cells(PBMCs) from four groups. 100 μg/ml monosodium urate (MSU) was used to stimulate the peripheral blood of NAGA and healthy controls patients. Then the expression ofAJ227913 was detected by RT-qPCR. Kruskal-Wallis test, Mann-Whitney test, Spearman correlations were used for statistical analysis. Results The expression level of AJ227913 in the AGA group (0.0557 ±0.0156) was higher than that in the NAGA group (0.0223±0.018) and healthy controls group (0.0038±0.0013). There was significant difference between the NAGA group and healthy controls group (P>0.05). Compared with the control group, the expression of AJ227913 in NAGA group which were stimulated by MSU was significantly increased. The Spearman correlation analysis found that the AJ227913 expression levels in GA groups were correlated with UREA (r=0.608, P<0.01), CREA (r=0.337, P<0.05), CYSC (r=0.422, P<0.01). Conclusion Altered expression of AJ227913 may be involved in the inflammatory process of GA and the balance of uricacid.
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Objective To analyze the correlation between serum leptin and osteoprotegerin with IL-6 and TNF-α in the pa-tients with gout arthritis osteoporosis .Methods Forty-eight cases of gout arthritis were selected as the research subjects (GA group) ,including 19 cases of complicating osteoporosis(OP group) and 29 cases of non-complicating osteoporosis(non-OP group) . Other 45 individuals undergoing healthy physical examination were selected as the control group .The bone mineral density (BMD) was measured by dual energy X-ray BMD absorptionmetry instrument and the levels of serum LEP ,OPG ,IL-6 and TNF-αwere de-tected by ELISA .Results The incidence rate of osteoporosis in the GA group was significantly higher than that in the control group (39 .6% vs .13 .3% ,P=0 .004) ,and BMD in various sites was significantly lower than that of the control group (P<0 .05) . The serum LEP level in the OP group was significantly increased compared with that in the non-OP group and control group(P<0 .05) ,and the OPG level was significantly decreased ,the difference was statistically significant (P<0 .05) .The serum LEP level in the non-OP group was significantly higher than that in the control group (P<0 .05) ,but the OPG level had no statistical difference between non-OP group and control group(P>0 .05) .The serum IL-6 and TNF-αlevels in the OP group were significantly higher than those in the non-OP group and control group(P<0 .05) ,and the non-OP group was significantly higher than the control group (P<0 .05) .The serum LEP level in the OP group was positively correlated with IL-6 and TNF-α(P<0 .05) ,and the serum OPG level was negatively correlated with IL-6 and TNF-α(P<0 .05) .Conclusion The serum LEP and OPG levels have abnormal change in the patients with gout arthritis osteoporosis ,which has a certain correlation with IL-6 and TNF-α.
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<p><b>OBJECTIVE</b>To study clinical curative effects of a Masquelet technology in the treatment of gouty arthritis in the first metatarsophalangeal joint.</p><p><b>METHODS</b>From February 2012 to May 2016, 7 patients with the gouth arthritis of the first metatarsophalangeal joint were treated by the Masqueket technology. There were 5 males and 2 females, ranging in age from 42 to 58 years old, with an average age of 50 years old. During the regular follow up, the bone healing was assessed by the radiographic imaging, and the orthopaedic foot and ankle Association (AOFAS) ankle function scoring system was used for comprehensive evaluation.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 6 to 8 months, with a mean of 7 months. All the wounds obtained first intention healing, and there were no complications such as wound infection, flap necrosis and other soft tissue complications. The time to bone healing was 3 to 4 months, with an average of 3.6 months. The AOFAS score was increased from preoperative 42.5±4.6 to postoperative 85.0±10.5.</p><p><b>CONCLUSIONS</b>The application of Masquelet technique in the treatment of first metatarsophalangeal joint gouty arthritis achieves obvious symptom relief, has less complications, and can effectively improve the quality of life of patients, which is a new and effective treatment.</p>