This study aims to compare the urate-lowering response rate of febuxostat and allopurinol in gout patient using a model-based meta-analysis. The literature search identified 22 clinical trials of gout with a total of 43 unique treatment arms that met our inclusion criteria, and a total of 6 365 gout patients were included in the study. The response rates of allopuriol and febuxostat were characterized by Tmax model and Emax model respectively, and the effect of baseline serum uric acid (sUA) and patient type on the drug effect was tested. The results showed that allopurinol can reach an average maximum response rate of 50.8% while febuxostat can reach a 100% response rate within a very short time, and the ED50 was 34.3 mg. Covariate analysis revealed that baseline sUA has a negative effect on response rate of allopurinol, and a positive effect on the predicted ED50 of febuxostat. For patients who had shown inadequate response to prior allopurinol treatment, the average response rate was about half that of the allopurinol responder patients.
Allopurinol ; therapeutic use ; Febuxostat ; Gout ; blood ; drug therapy ; Gout Suppressants ; therapeutic use ; Humans ; Thiazoles ; therapeutic use ; Uric Acid ; blood

Background Age-related cataract is the leading cause of visual impairment worldwide.To seek the effective prevention and drugs for management of cataract is important.Naphthalene-induced cataract of rat is an ideal animal model for the research of human age-related cataract,and aspirin has been proven to inhibit the development of human age-related cataract.ObjectiveThe present study is to investigate the role of aspirin on naphthalene-induced cataract.Methods Forty-five 150-160 g female SD rats were divided into three groups randomly.Naphthalene was orally taken with 0.5mg/kg per day for 3 days and then 1mg/kg per day for 70 days,and then 100mg/kg of aspirin was given per day for 70 days following four-day washout period in group A.In group B,the animals was given orally only naphthalene at the same way.No any intervention was used in group C.Naphthalene-induced cataract was examined under the slim lamp every week.The experimental animals were sacrificed and lenses were obtained in 70 days.α-Crystalline was extracted from lens homogenate and purified and identified using High Performance Liquid Chromatography(HPLC),2-dimentional electrophoresis gel and Western blot.Different abilities of α-crystalline to protect β low crystalline from aggregation were observed using ultraviolet spectrophotometer.Results Naphthalene-induced cataract formed at the third week in only naphthalene group but at the sixth week in naphthalene+aspirin group under the slim lamp.No significant difference was found in the degree of lenses opacity in the second week among these three groups(F=0.032,P=0.969).However,a statistically significant difference was seen in the degree of lenses opacity in the fourth,sixth,eighth and tenth week among these three groups(F= 5031.130,P=0.000;F=115964.000,P=0.000;F=169846.500,P=0.000;F= 195431.200,P=0.000).Themolecular chaperone-like activity was significantly higher than that of the naphthalene-induced group.Conclusion Aspirin delays the progression of lens opacification through protecting α-crystalline molecular chaperone-like activity.

Objective To observe the expression of Klotho and Na+/Pi cotransporter in high phosphorous-induced rats with 5/6 nephrectomy and its relationship with vascular calcification,as well as to investigate the effect of early intervention by sodium thiosulfate (STS) on the progression of vascular calcification.Methods Either 5/6 nephrectomy (n=21) or sham operation (n=14) was conducted on 35 Sprague Dawley rats,who were then fed with high phosphorus (HP) diet or normal phosphorus (NP) diet for 16 weeks respectively.The rats were divided into 5 groups as follows:(1) remnant kidney rats receiving HP diet (NHP,n=7),(2) remnant kidney rats receiving NP diet (NNP,n=7),(3) sham operation rats receiving NP diet (SNP,n=7),(4) sham operation rats receiving HP diet (SHP,n=7),(5) remnant kidney rats receiving HP diet with STS (THP,n=7).The treatment group was given STS intraperitoneally three times a week for 16 weeks.At the end of the 16th week,rats tail artery blood pressures were tested,serum creatinine (Scr),calcium (Ca2+),phosphorus (P3+),FGF23,iPTH and urine protein were examined.Throacic aorta and kidney were then removed.Vascular calcification was confirmed by Von kossa staining.Klotho and Pit-1 expression in aortas were determined by immunohistochemistry.Renal lesion was determined by PASM-Masson staining.Renal Klotho and NaPi-2a mRNA were determined by real time RT-PCR.Results After 16 weeks,Scr,p3+,FGF23,iPTH,uric protein and blood pressure were significantly higher in NHP than those in SNP rats (all P ＜ 0.05).PASM-Masson staining revealed typical renal pathology of chronic renal failure in NHP group.With the treatment of STS,THP rats showed significant decrease in Scr,t3+,FGF23,iPTH,uric protein and blood pressure by comparison with NHP group (all P ＜ 0.05).Significant vascular calcification was found in NHP group while NNP and SHP group occasionally had vascular calcification;THP group had marked alleviation of vascular calcification.The aorta and renal expression of Klotho decreased remarkably while expression of Pit-1 and NaPi-2a increased significantly in NHP compared with SNP group (all P ＜ 0.05).Accordingly,the aorta and renal expression of Klotho increased and Pit-1 and NaPi-2a decreased significantly in THP compared with NHP group (P ＜ 0.05).Conclusions The early intervention of sodium thiosulfate might regulate Klotho and Na +/Pi cotransporter expression in both aorth and kidney,decreasing serum phosphate,delaying progression of vascular calcification and improving renal function.

Objective To evaluate the characteristics of quantitative monitoring of brain function during the perioperative period in elderly patients and its relationship with postoperative cognitive dysfunction (POCD).Methods Seventy ASA physical status Ⅰ or Ⅱ patients,aged ≥ 60 yr,scheduled for elective lumbar spine decompression and fusion surgery under general anesthesia,having an expected postoperative length of hospital stay ≥ 7 days,were enrolled in the study.The cognitive function was assessed by using Mini-Mental State Examination before operation and the results were normal.Fifty healthy elderly volunteers were chosen and served as control group.Cognitive function was assessed at l day before operation (D0) and 3 (D3) and 7 days after operation (D7).Z score was used to identify POCD.All the patients were then divided into POCD group or control group (group C) according to the results of diagnosis.Quantitative monitoring of brain function was carried out using a traction system,and the wavelet index (WLI),i_22 and i_20 were recorded.Results A total of 67 patients completed the study and were enrolled in the analysis,there were 9 cases in group C,and 58 cases in group POCD.The WLI was significantly decreased at D7,and no significant change was found in WLI at D3 as compared with the value at D0.The WLI was significantly lower at D7 than at D3.There was no significant difference in i_22 and i_20 between the three time points.Compared with group C,i_22 was significantly decreased at D0,and no significant change was found in i_22 at the other time points and in WLI at each time point in POCD group.Conclusion During quantitative monitoring of brain function during the perioperative period in the elderly patients,WLI is significantly decreased on 7th day postoperatively,and no significant change is found in i_20 and i_22,however,the pre-operative low i_22 value can predict the development of POCD.

Objective To investigate the killer cell immunoglobulin-like receptor (KIR) genes, KIR2DS4 and its variant KIR1D for an association with syphilis in the comparison between syphilis patients and unrelated healthy subjects. Methods One hundred and ninety syphilis patients and 192 unrelated healthy subjects were performed to determine the KIR genotypes by PCR-SSP method. The gene frequencies of KIR2DS4 and KIR1D were analyzed for an association with syphilis in the patients and healthy people who belonged to KIR gene haplotype A. Results Of 192 healthy individuals, 187 were identified with a KIR2DS4 gene. And 91 individuals were classified as homozygous haplotype A with the percent of 48.7% (91/187) in 187 KIR2DS4 positive individuals. Of 190 syphilis patients, 181 were identified with a KIR2DS4 gene. And 89 individuals were classified as homozygous haplotype A with the percent of 49.2% (89/181) in 181 KIR2DS4 positive individuals. The frequency of KIR1D/KIR1D in syphilis patients classified as haplotype A was 16.9%, and was significantly higher than that in the control group (6.6%, P=0.032). However, there was no significant difference for the frequencies of KIR2DS4/KIR2DS4 and KIR2DS4/KIR1D between the two groups (P>0.05). Conclusion KIR1D/KIR1D might be associated with syphilis in the comparison between syphilis patients and unrelated healthy controls who were classified as homozygous haplotype A.

Objective To explore the DNA damage in peripheral blood lymphocytes of rats exposed to sodium arsenite. Methods Thirty-two Wistar rats, weighing 180 - 200 g, equal male and female, were randomly divided into 4 groups, 8 in each group. Sodium arsenite 0(control) ,0.05,0.15,0.45 mg/L were given through drinking water for 30 days. Body weight and drinking water consumption were measured every day. Blood were collected and DNA damage in peripheral blood lymphocytes was examined by single cell gel electrophoresis.Results The increase of body mass[( 121.00 ± 38.57), ( 120.62 ± 42.80), ( 125.38 ± 48.68)g]and water intake [(36.9 ± 6.2), (37.9 ± 5.8), (39.3 ± 4.2)ml/d]in 0.05,0.15,0.45 mg/L sodium arsenite groups were compared with the control group[( 119.25 ± 47.27)g, (38.4 ± 5.1 )ml/d], and the difference were not significant (F = 0.040,0.828, all P ＞ 0.05). The tail ratios[46.25%(185/400) ,57.00%(228/400),64.00%(256/400)], tail lengths [(32.89 ± 17.18), (58.74 ± 36.28), (77.55 ± 35.73 ) μm]and tail moments [(6.29 ± 3.74), ( 11.20 ± 9.64),(17.30 ± 12.60)μm]in 0.05,0.15,0.45 mg/L sodium arsenite groups were significantly higher than those of the control group[39.25%(157/400), (18.73 ± 15.83),(2.61 ± 1.05)μm, all P ＜ 0.01], and the tail ratios,tail lengths and tail moments in lymphocytes increased with increased doses of arsenic concentration. Conclusions Low doses of arsenic exposure can induce DNA damage in peripheral blood lymphocytes of rats.

Objective To observe the long term effects of arthroscopic knee debridement and reconstructing operation for treating osteoarthritis in patients with Kaschin-Beck disease. Methods Thirty-one cases of patients with Kaschin-Beck disease were followed for 6 years after operation of articular clearing by arthroscope. Index of pain, symptoms of self-evaluation, range of motion, walking distance, standing test by affected leg when bending at 30° or 60° were recorded and compared with the preoperative results. Results Twenty-four cases were followed up for 6 years. Six years after operation the pain index(3.38 ± 2.87) was dramatically decreased compared to that before operation (6.88 ± 1.45, t = 5.30, P ＜ 0.05). Patients symptoms markedly improved by subjective self-evaluation was 70.83% (17/24), the effective rate was 100% (24/24). The number of cases that could stand up when leg bending at 30° or 60° were 21,18 cases, respectively, compared with that of preoperative of 14, 11 cases, respectively, the difference was statistically significant(x2 = 5.17,4.27, all P ＜ 0.05). Six years after operation the walking distance(3 cases ＜ 1 km, 11 cases 1 - 5 km and 10 cases ＞ 5 km) were greatly improved compared to the results before operation (12 cases ＜ 1 km, 9 cases 1 - 5 km and 3 cases ＞ 5 km, U = 2.88, P ＜0.05). Six years after operation the knee activity[(132.25 ± 14.52)°] remained at the same level, compared with that of preoperative [(131 .58 ± 14.68) °], the difference was not statistically significant (t = 0.16, P ＞ 0.05) .Conclusions The method of arthroscopic joint debridement to cure Kaschin-Beck disease knee osteoarthritis can significantly reduce pain, improve function and walking distance, with more stable long-term satisfactory outcome.

This study deals with colony expansion characteristics, biomass increment and Na accumulation in mycelia of three ectomycorrhizal fungi ( Boletus edulis, Xerocomus chrysenteron and Gomphidius viscidus ) under treatment of Na2SO4 and NaCl. The experimental results showed that no impact was observed from Na2SO4 and NaCl treatments on the growth mode of the mycelia, but the biomass increment of X. chrysenteron and G. viscidus was significantly restrained under 0.1 mol/L Nacl. Under the treatment of Na2SO4, biomass increment of X. chrysenteron is significantly higher than the control, but the biomass of G. viscidus is lower than that of the control, and no significant impact was measured on growth of B. edulis under both treatments of Na2 SO4 and NaCl. The experiment also indicated that Na accumulation in mycelia varied significantly among the three tested strains, highest Na accumulation was measured in X. chrysenteron under treatment of NaCl, while under the treatment of Na2SO4 , accumulation of Na in B. edulis is much higher than the other two strains.

The thermostability of the inulinase was studied in this resea rc h. Some alcoholic materials and thickening agent could enhance the thermostabli lity of the inulinase. Using glycerol、xanthic pastern and though orthogonal ex periments of three elements and three levels, a satisfying protective agent, whi ch included glycerin(6%), xanthan gum(0.6%) and CaCl_2 (100mmol/mL) and ha d a significant effect on the enhancement of the inulinase thermostability, was acquired.

Objective To investigate the treatment values of precise target delineation of chest MRI for lung cancer Methods From August 2011 to February 2015 , 45 non-small cell lung cancer patients were given chest CT scans and MRI scans before radiotherapy , and then active target tumor delineation , then related influencing factors were analyzed. Results All patients completed CT scans and MRI positioning. For patients that it was difficult to identify lung tissue lesions caused by lung cancer through CT , their MRI imaging showed high signal and the boundaries between the tumor and surrounding normal tissue became relatively clear. Meanwhile , 20 patients of borders were diagnosed by CT , while 25 by MRI; 36 patients with lymph node metastasis were diagnosed by CT while 40 by MRI. The difference was statistically significant (P<0.05). Univariate logistic regression analysis showed that pathological type and atelectasis were the influence factors for CT and MRI tumor target delineation differences (P<0.05), and multivariate logistic regression analysis showed the atelectasis was the main factor (P<0.05). Conclusion Compared with CT, breast MRI can precisely delineate target to improve the accuracy of target localization before radiotherapy. It can help determine lymph node metastasis and avoid the impact of atelectasis then ensure the accuracy of radiotherapy.