社区人群痛风危险因素的病例对照研究

目的 探讨社区人群(20岁以上)痛风的危险因素。方法 采用1：3病例对照研究方法，进行单因素与多因素与多因素logistic回归分析。结果 经单因素筛选和多因素分析，在P=0．05水平，高尿酸(OR=8．601)、肥胖(OR=2．910)、伴有高血压病史(OR=2．330)是痛风的独立危险因素。结论 痛风是一种在遗传基础上的与环境和生活方式有关的疾病，改变生活方式、控制相关疾病可能预防或减少高尿酸血症的发生，进而减少痛风的发生。     

A Randomized Pilot Study of DASH Patterned Groceries on Serum Urate in Individuals with Gout

The Dietary Approaches to Stop Hypertension (DASH) diet reduces serum urate (SU); however, the impact of the DASH diet has not been previously evaluated among patients with gout. We conducted a randomized, controlled, crossover pilot study to test the effects of ~$105/week ($15/day) of dietitian-directed groceries (DDG), patterned after the DASH diet, on SU, compared with self-directed grocery shopping (SDG). Participants had gout and were not taking urate lowering therapy. Each intervention period lasted 4 weeks; crossover occurred without a washout period. The primary endpoint was SU. Compliance was assessed by end-of-period fasting spot urine potassium and sodium measurements and self-reported consumption of daily servings of fruit and vegetables. We randomized 43 participants (19% women, 49% black, mean age 59 years) with 100% follow-up. Mean baseline SU was 8.1 mg/dL (SD, 0.8). During Period 1, DDG lowered SU by 0.55 mg/dL (95% CI: 0.07, 1.04) compared to SDG by 0.0 mg/dL (95% CI: −0.44, 0.44). However, after crossover (Period 2), the SU difference between groups was the opposite: SDG reduced SU by −0.48 mg/dL (95% CI: −0.98, 0.01) compared to DDG by −0.05 mg/dL (95% CI: −0.48, 0.38; P for interaction by period = 0.11). Nevertheless, DDG improved self-reported intake of fruit and vegetables (3.1 servings/day; 95% CI: 1.5, 4.8) and significantly reduced total spot urine sodium excretion by 22 percentage points (95% CI: −34.0, −8.6). Though relatively small in scale, this pilot study suggests that dietitian-directed, DASH-patterned groceries may lower SU among gout patients not on urate-lowering drugs. However, behavior intervention crossover trials without a washout period are likely vulnerable to strong carryover effects. Definitive evaluation of the DASH diet as a treatment for gout will require a controlled feeding trial, ideally with a parallel-design.     

The Alpha-Defensin Prosthetic Joint Infection Test Has Poor Validity for Native Knee Joint Infection

BackgroundThe alpha-defensin test known as Synovaure has been very effective in diagnosis of prosthetic joint infections (PJIs). Being able to easily and accurately differentiate septic and inflammatory arthropathies in native joints would improve diagnostic workup and management. We tested the ability of an alpha-defensin test to distinguish septic from inflammatory or crystalline arthropathy in the native knee.Methods40 native knee joint fluid specimens were tested with cell count, fluid analysis, and culture and alpha-defensin testing. We determined the sensitivity and specificity of the alpha-defensin test using culture-positive fluid as the gold standard for septic arthropathy and positive crystals as the gold standard for crystalline arthropathy.ResultsThe Synovasure PJI test had 100% specificity for septic arthritis coupled with a 28% false-positive rate when applied to native knee aspirations. False-positive rate was 5.3 times higher in patients with crystals found in the joint fluid.ConclusionAlpha-defensin testing, in the form of the Synovasure PJI test, has a high-false-positive rate when used to distinguish septic and inflammatory arthritis in the native knee joint. Future work will need to determine the sensitivity and specificity of the newer native joint panel. Clinicians should be cognizant of the specific alpha-defensin test used when sampling native knee synovial fluid.     

中医痛风临床诊治仿真训练系统的设计与开发

中医痛风临床诊治仿真训练系统综合运用人工智能、数据库、多媒体等技术,实现了自适应生成各种痛风病例,教学的因材施教和情境性,有效解决了目前中医痛风临床诊治教学中学习者很难有机会接触各种类型的痛风病例的不足。     

子午流注火针刺法对急性痛风性关节炎的临床疗效观察

目的 选择急性痛风性关节炎患者为研究对象,基于子午流注理论采用火针治疗方式,观察临床疗效及对血清尿酸水平的影响.方法 将符合急性痛风纳入标准的60例随机分组,治疗组采用基于子午流注火针疗法,对照组采用口服依托考昔及少量秋水仙碱.疗程1周,观察对比患者治疗前后临床证候(关节疼痛、压痛、红肿及活动度)积分、疗效指数及血清尿...     

朱良春痛风方加味治疗痛风性关节炎临床观察

目的：观察痛风方治疗痛风性关节炎的疗效。方法：对36例痛风性关节炎患者采用朱良春痛风方为基本方（苍术、白术、茯苓、泽泻、萆薜等）加味治疗,每天1剂,7d为1疗程。结果：显效17例,好转15例,未愈4例,有效率88．9％。结论：朱良春痛风方治疗痛风性关节炎疗效显著。     

基于网络药理学探讨土茯苓治疗痛风的作用机制

目的运用网络药理学预测土茯苓抗痛风有效成分的作用靶点及通路。方法通过TCMSP数据库和Drugbank数据库获取土茯苓有效成分及作用靶点,并运用Cytoscape软件构建靶点间相互作用网络并进行交联分析,筛选出土茯苓治疗痛风的有效成分及作用靶点,采用MAS3.0生物分子功能系统获取通路的相关信息并制成靶点通路网络模型。结果预测得到土茯苓治疗痛风的有效成分11个和有效靶点39个,并推断其作用机制可能与脂肪细胞因子信号通路、ERbB信号通路,Toll样受体信号通路等有关,且MAPK1、RELA、PTGS2等靶点基因可能起着关键性的作用。结论基于网络药理学探讨了土茯苓治疗痛风多成分-多靶点-多通路的作用特点,为进一步开展土茯苓治疗痛风作用机制研究提供了新的思路和方法。     

新型痛风治疗药物lesinuard sodium

lesinuard sodium是一种新型的痛风治疗药物,于2008年由Ardea Biosciences公司研发。该药物主要通过抑制尿酸盐转运蛋白1（URAT1）增加尿酸的排泄来治疗痛风。URAT1被认为是存在于肾脏中用于转运尿酸盐的主要蛋白,能够将尿酸从管腔转入近曲小管上皮细胞并转化为单羧酸盐。临床研究显示,lesinuard sodium可被良好耐受,且能剂量相关性地降低血浆中的尿酸水平。主要介绍lesinuard sodium的药物概况、相关背景、合成路线、药理作用、临床前及临床试验的研究、安全性评价等方面。     

痛风性关节炎的发生与尿酸盐结晶沉积

高尿酸血症（Hypeurricemia）是痛风性关节炎的重要生化基础,但高尿酸血症者只有10%左右发展为痛风,其原因至今不明。关于痛风的研究虽有不少报道,但迄今对关节腔中尿酸盐沉积的机理尚不清楚。本文从痛风性关节炎发病机制及诱因来分析,探讨影响关节腔中尿酸盐结晶形成和沉积的因素,并提出自己的想法。     

解毒祛湿法治疗痛风30例临床观察

[目的]观察解毒祛湿法治疗痛风的临床疗效.[方法]将60例痛风患者随机分为两组.治疗组30例采用中药治疗,对照组30例口服别嘌呤醇和尼美舒利及碳酸氢钠.[结果]治疗组总有效率为93.3%,对照组总有效率为86.6%,两组总有效率比较差异无显著性,P>0.05.两组治疗前后血尿酸组内比较差异有显著性.P<0.05;两组治疗后血尿酸组间比较差异无显著性,P>0.05.[结论]解毒祛湿法治疗痛风的疗效可靠,且无明显不良反应.