This summer, moncler wang’s grandson was admitted to a prestigious university, the family went to a hotel in the evening to eat a seafood dinner to celebrate. The family went to a seafood dinner at the hotel to celebrate. Master Wang was also very happy and drank a lot of beer beautifully, but woke up in the middle of the night with a sudden toe pain. The company’s business is a very important part of the business. The first thing you need to do is to get to the right side of the room. The family rushed to call a cab to the hospital to see the emergency room, the doctor said it was “gout” and gave a painkilling injection to get better. Many people think that gout is the pain in the joints caused by wind and cold, but in fact, uric acid is the root cause of gout. The body has a substance called purine, which undergoes a series of metabolic changes and eventually forms uric acid. Under normal circumstances, 2/3 of the uric acid produced in the body is excreted by the kidneys and the other 1/3 is excreted from the large intestine. Uric acid is continuously produced and excreted in the body, thus maintaining a certain concentration in the blood. The uric acid contained per 100 ml of blood in a normal person is less than 6 mg in men and no more than 5 mg in women. The process of purine metabolism involves a variety of enzymes, and if purine metabolism is disturbed due to congenital abnormalities of enzymes or some factors that have not yet been identified, resulting in increased synthesis or decreased excretion of uric acid, the result will be high blood uric acid concentration, i.e. hyperuricemia, at which time uric acid in the form of crystal salts is most likely to be deposited in joints, soft tissues and kidneys, causing a foreign body inflammatory reaction in the tissues, leading to joint pain (gouty arthritis), soft tissue masses (gouty stones) and kidney stones (gouty kidney stones). Toe pain at night should be alert to gout The toes are the best site for gouty arthritis, with bunions being the most common, followed by the tarsal, ankle and finger joints, and then the metacarpophalangeal joints and wrist, elbow and knee joints. Larger joints, such as the hip and shoulder, are less likely to be involved. The main reason why gout occurs in these joints is that these small joints at the end have poor blood circulation, lower skin temperature than the trunk area, relative lack of oxygen to the tissues, and slightly lower local pH, which is conducive to blood uric acid deposition. In addition, because of the higher activity during the day, blood circulation is faster, drinking more water and urinating more, which promotes the excretion of uric acid, while at night blood circulation slows down, urination decreases, and urate deposition increases, so the most typical symptom of gout is the sudden appearance of joint pain on one side of the toe at night. If there is an acute attack of arthritis on one side of the toe, the inflammatory response develops quickly and intensely, and the pain is obvious and accompanied by significant local redness, nasal sinus cancer, swelling, pressure pain, or even a past history of similar attacks, you should be highly alert to gout, especially if you are obese and have a family history of gout. Gout attacks have triggers About half of all gout attacks have triggers, mainly overeating (especially large amounts of purine-rich foods), alcohol consumption, as well as trauma, surgery, excessive fatigue, mental stress, cold, taking certain medications (including long-term diuretics and uric acid-lowering drugs at the beginning of use), wearing tight shoes, walking a lot, and so on. Knowing these triggers and taking care of them in diet and daily life are very useful to prevent acute attacks of gout. What tests should be done for gout patients According to the current gout diagnostic criteria, finding characteristic uric acid crystals in synovial fluid and gout nodules is the “gold standard” for gout diagnosis, but in practice, most hospitals do not routinely perform this test due to difficulties in obtaining materials or conditions (polarized light microscopy is required). Gout is caused by a high concentration of uric acid in the blood, so once gout is suspected, the first step is to check the blood uric acid. Men and postmenopausal women with blood uric acid levels above 420 µM/L and premenopausal women above 350 µM/L are said to have hyperuricemia. About 5% to 12% of patients with hyperuricemia eventually develop gout. In addition, measuring the amount of uric acid in the urine 24 hours a day can help determine whether the high blood uric acid concentration is mainly due to increased synthesis or decreased excretion of uric acid. In patients with recurrent episodes of gouty arthritis, joint x-rays should be done. Routine urinalysis, urological ultrasound and radiography can help in the early detection of gouty kidney stones. In addition, because gout patients are often complicated by other metabolic disorders, such as diabetes, hyperlipidemia, hypertension and atherosclerosis, they should also have their blood lipids, blood sugar and blood pressure routinely checked. Gout patients should avoid eating foods with high purines, such as animal offal, brain, sardines and various kinds of broths and gravies, and eat less purine foods such as meat and seafood, and try to eat low or very low purine foods such as grains and cereals, eggs, milk, fruits and vegetables. The purine content of seafood varies greatly, and gout patients should not eat or eat less of seafood with high purine content (such as mackerel, wind-tailed fish, sardines, fish eggs, shrimp, tamari, etc.) and seafood with medium purine content (such as carp, cod, halibut, sea bass, pike, shellfish, eel and eel, etc.), while mackerel, herring, salmon, anchovy, tuna, white fish, lobster, crab, oyster, etc. have low purine content. The seafood with low content can be eaten appropriately. Gout patients should stop drinking. Drinking alcohol can cause gout attacks, especially beer. After drinking, on the one hand, the oxidation of ethanol leads to an increase in the concentration of lactic acid in the blood, which inhibits the excretion of uric acid by the kidneys; on the other hand, ethanol can also promote the conversion of adenine nucleotides and increase the production of uric acid; in addition, when drinking alcohol often eat a large amount of purine-rich food at the same time, which leads to an acute attack of gout. Gout patients should also pay attention to drinking water. First of all, you should drink a lot of water to ensure that the daily urine volume is not less than 2000 ml, so that it is conducive to uric acid from the urine discharge. Secondly, what water to drink is also quite delicate. The discharge of uric acid is related to the acidity of urine, uric acid is easy to discharge when urine is alkaline, while acidic urine is not conducive to uric acid discharge. Our general drinking water pH is 6.5 ~ 8.5, the pH of pure water is generally about 6.0, some mineral water pH 7, so the gout patients can choose ordinary tap water or mineral water, rather than choose slightly acidic pure water. Gout patients with good kidney function can also add baking soda tablets, 0.5 to 1 gram each time 3 times a day to alkalize urine. The target value for alkalinizing urine is a urine pH of about 6.5, too alkaline can lead to the formation of other stones.