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.
ObjectiveTo study the efficient expression conditions, purification, and partial enzymatic properties of His-tagged recombinant Candida utilis uricase.MethodsThe effects of isopropyl β-D-1-thiogalactopyranoside (IPTG) and lactose as inducers which were added in the end logarithmic phase were compared by the method of shake flask culture. The induction culturing time was studied with 50 L fermentor. The protein of interest was purified by Ni-Sepharose and Sephacryl S-200 HR chromatographies, and the optimal pH value, temperature, and thermal stability were also studied.ResultsThe shake flask culturing experiment results showed that IPTG was better than lactose as an inducer. In the fermentor culturing and at the end of the logarithmic growth stage, the enzyme activity of 164 U per gram bacteria and biomass of 23 grams per litter fermented solution were maximal after adding lactose for 7 hours as an inducer, i.e. the enzyme activity could be collected at 3 772 U per liter. The specific activity of purified uricase was 4.5 U/mg and the optimal pH value and temperature were 7.5 and 40℃. Additionally, the enzyme was stable at pH 6.0–10.0 and the thermal stability was below 45℃.ConclusionsIt is better to use lactose as an inducer in the process of culture. The recombinant uricase with His label can be purified by Ni-column affinity chromatography and Sephacryl S-200HR molecular sieve chromatography, and the purification process is easier than ever before. The optimum temperature, pH value, acid-base stability and thermal stability of the purified enzyme have been established to provide some experimental basis for the relationship between structure and function and practical application in the future.
Objective To evaluate the correlation between hyperuricemia (HUA) and benign prostatic hyperplasia (BPH). Methods A total of 666 elderly male patients, who had been admitted to the West China Hospital for routine physical examination in May, 2010, were included in this study. All the following indexes were collected: blood pressure, waistline, medical history, international prostatic symptom score (IPSS), serum uric acid (UA), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), 2-hour postprandial blood glucose (PBG-2), prostate-specific antigen (PSA), and prostate volume (PV) measured by ultrasound. Patients with higher level of UA more than 420 μmol/L were included into the HUA group (n=151) while the other patients with normal UA (NUA) were in the NUA group (n=515). Both the metabolic and prostate related indexes in the two groups were compared, and the correlation between HUA and each indexes were analyzed using logistic regression model. Results HUA was significantly associated with abdominal obesity (OR=1.575, 95%CI 1.059 to 2.340), hypertriglyceridemia (OR=2.78, 95%CI 1.877 to 4.118), metabolic syndrome (CDS2007) (OR=1.912, 95%CI 1.267 to 2.885), BPH (OR=1.464, 95%CI 1.465 to 1.635) and lower urinary tract symptoms (LUTS) rating (OR=1.782, 95%CI 1.173 to 1.522). Conclusion HUA is correlated with BPH, meanwhile it is highly accompanied with other risk factors of cardioascular diseases. Hereby, comprehensive medical screening should be considered when treating such patients.
Objective To investigate the risk factors of high peritoneal transport characteristics in patients with end-stage renal disease undergoing initial continuous ambulatory peritoneal dialysis. Method The clinical data of continuous ambulatory peritoneal dialysis patients who underwent initial peritoneal dialysis and catheterization in the Department of Nephrology, West China Hospital of Sichuan University from January 2011 to December 2017 and completed the peritoneal equilibration test were collected retrospectively. According to the ratio of dialysate to plasma ratio for creatinine at 4 hour [D/Pcr (4h)] in the standard peritoneal equilibration test, the patients were divided into 4 groups (low transport, low average transport, high average transport and high transport). Spearman correlation analysis was used to analyze the related factors of D/Pcr (4h). The risk factors of high peritoneal transport characteristics were analyzed by ordered multi classification logistic regression. Results A total of 647 patients were included. The average age of the patients was (45.85±14.03) years, and the average D/Pcr (4h) was 0.67±0.12. Among them, there were 89 cases (13.76%) in the high transport group, 280 cases (43.28%) in the high average transport group, 234 cases (36.17%) in the low average transport group and 44 cases (6.80%) in the low transport group. Diabetic patients with D/Pcr (4h) were higher than those without diabetes mellitus (0.72±0.12 vs. 0.66±0.12; t=−4.005, P<0.001). Correlation analysis showed that age and 24-h urine volume were positively correlated with D/Pcr (4h); serum albumin, triglyceride, potassium, calcium, magnesium, phosphorus, hemoglobin, serum uric acid and creatinine were negatively correlated with D/Pcr (4h); body surface area (BSA), high sensitivity C-reactive protein, ferritin, cholesterol, sodium, intact parathyroid hormone and estimated giomerular filtration rate had no correlation with D/Pcr (4h). Regression analysis showed that serum albumin [odds ratio (OR)=0.842, 95% confidence interval (CI) (0.809, 0.877), P<0.001], serum uric acid [OR=0.996, 95%CI (0.994, 0.998), P<0.001], magnesium [OR=0.389, 95%CI (0.156, 0.965), P=0.042], BSA [OR=3.916, 95%CI (1.121, 13.680), P=0.032] were correlated with the incidence of peritoneal high transport characteristics. Conclusion Low serum albumin, high BSA, low magnesium and low serum uric acid were independent risk factors for high transport characteristics in initial PD patients.
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.
目的 探讨成都地区高尿酸血症发生的危险因素。 方法 收集2009年10月-2010年4月在四川大学华西医院体检中心进行健康体检的36 639人的临床资料,对资料进行单因素分析和多因素logistic回归分析。 结果 进行健康体检的36 639人,其中男21 175人,女15 464人。高尿酸血症患者5 233例,患病率为14.3%。年龄>50岁、男性、饮酒、糖尿病、高血压病、甘油三酯增高、低密度脂蛋白增高和血清肌酐水平增高与高尿酸血症的发生有关。Logistic回归分析显示男性(OR=13.300,P=0.000)、饮酒(OR=4.219,P=0.009)、糖尿病(OR=3.609,P=0.024)是发生高尿酸血症独立危险因素。 结论 成都地区高尿酸血症的患病率略高于全国平均水平,临床治疗和护理高尿酸血症的患者时应积极控制与高尿酸血症发生密切相关的危险因素。
目的 探讨中老年人群血清尿酸水平与代谢综合征(MS)及其各组分的关系。 方法 采用横断面研究,对2007年49~80岁成都成华区711例人群进行调查,并测量身高、体重、血压、空腹血糖、三酰甘油、高密度脂蛋白、低密度脂蛋白、血清尿酸等指标,采用SPSS 16.0软件分析尿酸与MS及MS各组分之间的关系。 结果 在中老年人群中,MS的发生率为25.60%,高尿酸血症的发生率为21.24%。女性MS、腹型肥胖、高三酰甘油血症和低高密度脂蛋白胆固醇血症的发生率均明显高于男性。尿酸与腰围、收缩压、三酰甘油、舒张压、高密度脂蛋白水平的相关系数分别为0.311、0.140、0.118、0.106和?0.147,均有统计学意义(P<0.05)。男、女性尿酸与腰围的相关系数分别为0.173和?0.321,均有统计学意义(P<0.05)。男、女性尿酸与空腹血糖的相关系数分别为?0.049和0.183,均有统计学意义(P<0.05)。 结论 血清尿酸水平与MS及其各组分关系密切,血清尿酸水平和MS及其各组分间的关系存在性别差异。
【摘要】 目的 探讨血尿酸水平、颈动脉斑块与冠心病之间的关系。 方法 收集2006年1月-2009年12月拟诊为冠心病的住院患者280例,冠状动脉造影检查冠状动脉狭窄程度gt;50%的194例为冠心病组,冠状动脉无狭窄或狭窄程度lt;50%的86例为对照组;冠心病组又分为单支、双支、多支病变亚组。分别测定冠心病组与对照组颈总动脉与颈动脉分叉处内膜中层厚度(IMT)、等级评分、Crouse积分、血尿酸浓度。结果 与对照组相比,冠心病组颈总动脉与颈动脉分叉处IMT、等级评分、Crouse积分、血尿酸浓度均高于对照组,差异有统计学意义。在冠心病组,随病变分支的增多,颈动脉超声检查指标与血尿酸随之升高(Plt;0.05或0.01)。 结论 颈动脉IMT、等级评分、Crouse积分、血尿酸浓度与冠心病相关,是冠心病的独立危险因素。【Abstract】 Objective To investigate the relationships between serum uric acid levels, carotid artery plaque and coronary heart disease (CHD). Methods 194 patients with CHD and 86 nonCHD patients were selected through coronary angiography in patients with essential hypertension. CHD group was divided into three subgroups including a single branch, doublebranch and multivessel disease. Intimamedia thickness (IMT) of carotid artery and carotid bifurcation, grade score, Crouse score, serum uric acid concentrations were detected in patients with coronary heart disease and control group. Results IMT of carotid artery and carotid bifurcation, grade score,crouse score, serum uric acid concentrations were higher in CHD group than that in control group, and the difference was statistically significant. In the CHD group, ultrasound parameters of carotid artery and serum uric acid increased with the increase in branch lesions (Plt;005 or 001). Conclusions Carotid IMT, grade score, Crouse score, serum uric acid concentration relate to coronary heart disease, which is an independent risk factor for coronary heart disease, respectively.
目的:探讨老年代谢综合征者血清尿酸与血压、甘油三脂的关系。方法:163例入选者,MS组96例,对照组67例,对二组的SUA、BMI、WC 、SBP、DBP及TG进行分析。结果:MS组SUA较对照组高。MS组男性SUA与BMI正相关、女性与WC正相关;男女性MS组及对照组SUA与SBP及TG不相关。对照组女性SUA与DBP正相关。结论:SUA对老年女性DBP的维持可能有一定作用。TG对老年人SUA的影响有限;体重及脂肪聚集部位对SUA的影响,存在性别差异。