ObjectiveTo analyze the diagnostic value of gemstone spectral CT-imaging for urate crystal in joints and circum-tissues in patients with gout. MethodsBetween June 2013 and March 2014, 28 patients with gout confirmed by clinical and laboratory examination were reviewed retrospectively. The patients with peripheral joints suspected urate crystal due to gout underwent gemstone spectral CT scan on spectrum scanning gemstone spectral imaging (GSI) mode. Images were processed with GSI Viewer software. The visualization and distribution of urate crystal were noted. ResultsUrate crystal deposition in peripheral joints, tendon and ligaments of 28 patients were clearly displayed in uric acid (calcium) base images with gemstone spectral CT. The density of urate crystal in uric acid (calcium) base image was higher than that in calcium (uric acid) base image. The position of urate crystal deposition included metatarsophalangeal joint in 23 cases (82%), ankle joint in 4 cases (14%), and knee joint in 2 cases (8%), respectively, in which multi-locum suffered in 1 case. ConclusionUrate crystal deposition can be well depicted by gemstone spectral CT-imaging, which provides a new diagnosing method for gout without trauma. Gemstone spectral CT-imaging was greatly helpful for differential diagnosis of single joint sore pain.
As the largest ecosystem of human body, intestinal microorganisms participate in the synthesis and metabolism of uric acid. Developing and utilizing intestinal bacteria to degrade uric acid might provide new ideas for the treatment of hyperuricemia. The fecal samples of people with low uric acid were inoculated into uric acid selective medium with the concentration of 1.5 mmol/L for preliminary screening, and the initially screened strains that may have degradation ability were domesticated by concentration gradient method, and the strains with high uric acid degradation rate were identified by 16S rRNA sequencing method. A strain of high-efficiency uric acid degrading bacteria was screened and domesticated from the feces of people with low uric acid. The degradation rate of uric acid could reach 50.2%. It was identified as Escherichia coli. The isolation and domestication of high efficient uric acid degrading strains can not only provide scientific basis for the study of the mechanism of intestinal microbial degradation of uric acid, but also reserve biological strains for the treatment of hyperuricemia and gout in the future.
Objective To investigate the correlation between the uric acid to high-density lipoprotein cholesterol ratio (UHR) and the presence of atherosclerotic stenosis in both intracranial and extracranial arteries among patients who have experienced cerebral infarction. Methods Patients with cerebral infarction admitted to the Department of Neurology of Sichuan Provincial People’s Hospital between January 2021 and June 2024 were retrospective selected. According to the digital subtraction angiography (DSA) performance, patients were divided into cerebral atherosclerotic stenosis group and no cerebral atherosclerotic stenosis group. According to the location of atherosclerotic stenosis, patients were divided into extracranial atherosclerotic stenosis group, intracranial atherosclerotic stenosis group, intracranial and extracranial atherosclerotic stenosis group. According to the severity of atherosclerotic stenosis, patients were divided into mild group, moderate group and severe group. Clinical data and laboratory indicators were collected. Multifactorial regression was used to analyze the risk factors, Spearman correlation analysis was used to evaluate the relationship between UHR and the degree of stenosis, and the predictive value of UHR for intracranial and extracranial atherosclerotic stenosis was analyzed by the receiver operating characteristic curve. Results A total of 388 patients were included. Among them, 291 cases in cerebral atherosclerotic stenosis group and 97 cases in no cerebral atherosclerotic stenosis group; 85 cases in the intracranial atherosclerotic stenosis group, 123 cases in the extracranial atherosclerotic stenosis group, and 83 cases in the intracranial and extracranial atherosclerotic stenosis group; There were 104 cases in the mild group, 81 cases in the moderate group, and 106 cases in the severe group. The results of multiple logistic regression analysis showed that age, hypertension, UHR and uric acid were independent influencing factors associated with atherosclerotic stenosis of intracranial and extracranial arteries. Furthermore, the uric acid and UHR were also risk factors for the degree of stenosis (P<0.05). Spearman correlation analysis results showed that UHR was positively correlated with the degree of stenosis (r=0.516, P < 0.001). Receiver operating characteristic curve showed that the predictive value of UHR (area under the curve was 0.724) was superior to that of uric acid (area under the curve was 0.638) or HDL-C (area under the curve was 0.709). It also showed good predictive value for stenosis in different locations of intracranial and extracranial arteries. Conclusion UHR is an independent risk factor for intracranial and extracranial atherosclerotic stenosis with notabla predictive value
Uric acid (UA) is the final product of human purine metabolism. As one of the main antioxidants in the body, it can scavenge oxidative radicals. Under the action of oxidative-antioxidant shuttle mechanism, the antioxidant activity of UA can be reversed, causing inflammation and oxidative stress of vascular endothelial cells. Hyperuricemia (HUA) is considered to be one of the major risk factors for diabetes and diabetic nephropathy. The study of HUA in diabetic retinopathy (DR) is also a hot topic. UA can cause retinal vascular sclerosis, and affect the occurrence and development of DR by promoting oxidative stress and inducing neovascularization.
Objective To systematically review the effects of fenofibrate on kidney function in various populations, so as to provide references for selecting the methods of treating hyperuricemia. Methods Such databases as PubMed (1966-2013), EMbase (1984-2013), The Cochrane Library (Issue 1, 2012), CBM (1978-2013), and CNKI (1989-2013) were electronically searched for relevant randomized controlled trials or non-randomized controlled trials on fenofibrate for treating hyperuricemia. According to the Cochrane methods, two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.0 software. Results A total of 16 studies involving 346 patients were included in total. The results of meta-analysis showed that: a) compared with the control group, the fenofibrate group had the lower serum uric acid level (WMD=48.68, 95%CI 10.02 to 87.34, Plt;0.000 01), lower Ccr (endogenous creatinine clearance) level (WMD=8.88, 95%CI 1.29 to 16.47, P=0.002), and similar serum creatinine level (WMD=1.78, 95%CI –2.86 to 6.42, P=0.45); and b) adverse reaction included gastrointestinal discomforts, skin rashes and transient increase of GPT and transaminase, most of which were mild. Conclusion Fenofibrate has good effects. Due to the low quality of the included studies, the exact effectiveness and adverse reaction need to be rigorously verified based on more multi-center, double-blind, randomized controlled trials with large sample size.
ObjectiveTo evaluate the association between extent and severity of acute coronary syndrome and uric acid, leukocytes. MethodsA retrospective analysis of leukocytes, platelets, lipids and uric acid levels were performed on 23 patients with acute myocardial infarction (AMI group), 17 patients with unstable angina (UA group), and 17 healthy subjects (controls) between January and December 2010. ResultsIn the three groups (AMI, UA, and Control), the leukocyte count was respectively (10.4±3.2)×109/L, (6.9±2.4)×109/L and (5.4±1.1)×109/L (P<0.05); neutrophil was (7.4±3.2)×109/L, (4.8±2.3)×109/L, and (3.4±0.8)×109/L (P<0.001); and uric acid was (401.4±94.3), (384.1±74.1) and (285.5±76.8) μmol/L, respectively (P<0.001). Multinomial Logistic regression showed leukocyte was a predictor for AMI (OR=1.712, P=0.003), while uric acid was not (OR=1.006, P=0.255), regarding the UA group as the reference. When the control group was using as reference, leukocyte was an independently significant factor for AMI (OR=2.942, P=0.004) and was not a significant factor for UA (OR=1.718, P=0.125); uric acid was a significant factor for AMI and UA (OR=1.027, P=0.016; OR=1.021, P=0.041). ConclusionUric acid may be associated with the chronic development of coronary heart disease, while leukocytes may play a potential role in plaque destabilization and the onset of AMI.
Objective To analyze the effects of hyperuricemia (HUA) on the prevalence of dyslipidemia in the elderly. MethodsA total of 5 990 elderly people with complete and important variables from the China Health and Retirement Longitudinal Study (CHARLS) public database in 2015 were extracted. Their blood lipids, related physiological and biochemical indices, and basic demographic information were collected. The effects of HUA on the prevalence of dyslipidemia in the elderly were analyzed using the probit model, and empirical analysis was performed using the propensity score matching method (PSM). Results Among the 5 990 subjects, 13.6% of the elderly had HUA and the prevalence of dyslipidemia was 37.5%. After correcting the endogeneity among variables, the probability of dyslipidemia in elderly patients with HUA increased by 9.5%-11.7% (P<0.01), in which the probability of high triglyceridemia (TG), high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), and low high-density lipoprotein cholesterol (HDL-C) increased by 10.4%-11.5% (P<0.01), 2.7%-3.8% (P<0.01), 1.7%-2.3% (P<0.05), and 4.3%-4.9% (P<0.05), respectively. Conclusion HUA is associated with various types of dyslipidemia, among which its relationship with high TG and low HDL-C is strong. Targeted interventions should be taken for elderly HUA patients, aiming to reduce the rate of dyslipidemia and promote the goal of "healthy ageing" in China.
Objective To study the relationship between the levels of plasma fibrinogen, serum bilirubin, uric acid and mild stenosis of coronary artery. Methods Patients with suspected myocardial ischemia who underwent coronary angiography in our hospital were divided into the coronary artery mild stenosis group and the normal control group according to the result of coronary arteriongraphy between April 2007 to May 2009. Logistic regression was used to identify the risk factor of mild stenosis of coronary artery. Results Two-hundred and seventy-nine patients involving 191 patients with mild stenosis of coronary artery and 88 patients with normal coronary artery were included. The factors of gender, age, history of hypertension or diabetes mellitus, smoking history, systolic blood pressure, levels of plasma fibrinogen and serum creatinin were significantly different between the two groups. Multivariate logistic regression models found that the factors of age (OR=1.084, 95%CI 1.040 to 1.129, Plt;0.001), hypertension (OR=3.025, 95%CI 1.462 to 6.261, P=0.003), diabetes mellitus (OR=2.519, 95%CI 1.066 to 5.951, P=0.035), smoking history (OR=5.412, 95%CI 2.186 to 13.401, Plt;0.001), plasma fibrinogen (OR=1.748, 95%CI 1.059 to 2.885, P=0.029), serum bilirubin (OR=0.599, 95%CI 0.418 to 0.858, P=0.005), and high-density lipoprotein (HDL) cholesterol (OR=0.219, 95%CI 0.049 to 0.985, P=0.048) were independently associated with mild stenosis of coronary artery. By contrast, the level of serum uric acid was not associated with mild stenosis of coronary artery. Conclusion Except for traditional risk factors, levels of fibrinogen and bilirubin are independent risk factors of mild stenosis of coronary artery.
目的 探讨不同性别IgA肾病患者合并高尿酸血症的临床及肾脏病理特点。 方法 采用回顾性研究方法，将2008年1月－2010年12月收治的226例经肾活检确诊的原发性IgA肾病患者分为男性高尿酸血症组、男性尿酸正常组、女性高尿酸血症组及女性尿酸正常组4组，统计分析4组的临床指标及病理指标。 结果 高尿酸血症患病率男性（21.7%）高于女性（11.9%），差异有统计学意义（P＜0.01），尿检异常型患病率男性（14.6%）高于女性（4.0%），差异有统计学意义（P＜0.01），女性LeeⅢ级的患病率（7.1%）高于男性（5.8%），差异有统计学意义（P＜0.01）；男性高尿酸血症组的尿素氮高于尿酸正常组（P＜0.05），女性高尿酸血症组的血尿素氮、血肌酐、胱抑素C、舒张压、甘油三酯比尿酸正常者明显增高（P＜0.01），女性高尿酸血症组的高密度脂蛋白明显高于男性组（P ＜0.01）。 结论 高尿酸血症是IgA肾病的危险因素，可导致更严重的肾功能损害及肾脏病理损害，这种影响在不同性别中存在差异。