May 24, 2012 by Patients’ Association Just after May 1, patients with gouty arthritis have been coming to our rheumatology department. Most of these patients are patients with recurrent attacks of joint swelling and pain, but also patients with their first attacks of joint swelling and pain. These patients are in great pain, and their quality of life is significantly reduced, even affecting their work. When they come to the clinic, most of the patients limp, and in severe cases, they need to use a wheelchair. But in one case, a 50-year-old patient did not have pain in his joints when he came to the clinic. This patient had a history of gout and hyperuricemia for 5 years, enjoyed alcohol and meat, had frequent recurrent attacks, and had kidney stones and multiple gout stones in both hands. He had been misdiagnosed as dysentery and was admitted to the urology department, where he had two surgeries to remove the stones. A year ago, he visited the Rheumatology and Immunology Department of our hospital, and our physicians explained in detail about gout and formulated a reasonable treatment plan, and his condition gradually improved after treatment. This time, the patient came to our clinic for regular outpatient follow-up, continued testing of blood uric acid level and adjustment of treatment medication. The Department of Rheumatology and Immunology of our hospital held a series of rheumatology patient meetings on May 24, focusing on gout and hyperuricemia, and explained in detail to more than 40 patients who were present the general knowledge of gout and hyperuricemia, prevention and care points and related treatment methods. Dr. Zhang Fang, deputy chief physician, introduced that hyperuricemia and gout are metabolic diseases caused by purine metabolism disorder, but the onset of gout has obvious specificity, besides hyperuricemia, it can be manifested as acute arthritis, gout stone, chronic arthritis, joint deformity, chronic interstitial nephritis and uric acid urinary tract stones. The normal standard range of blood uric acid level prevailing in China is 178-416μmol/L (3-7.0mg/dl) in men and 148.5-357μmol/L (6.0mg/dl) in women. In hyperuricemia, urate deposits in the kidneys cause nephropathy. 20% of patients with gout have chronic slow progressive kidney disease. Early diagnosis and proper treatment can reduce or stop the progression of the lesions. Hyperuricemia is not only an important biochemical basis for gout, but is also closely associated with the development of hypertension, hyperlipidemia, atherosclerosis, obesity, and insulin resistance. Although there is a lack of evidence-based medical evidence that lowering uric acid reduces the risk of cardiovascular events, it has been suggested that uric acid-lowering therapy holds promise as a new avenue of cardiovascular disease prevention and treatment. The optimal treatment plan for gout and hyperuricemia should include 2 aspects: non-pharmacological and pharmacological treatment. Appropriate lifestyle and dietary modifications are the basis for long-term treatment of gout and hyperuricemia. The main aspects include the following: avoidance of high purine diet; for obese people, low-calorie, balanced diet and increased exercise are recommended to maintain ideal body weight; strict abstinence from all kinds of alcohol, especially beer; daily water intake should be above 2000 ml to maintain urine output. Drug treatment, on the other hand, should be carried out according to clinical staging and follow the principle of individualization. It mainly includes anti-inflammatory and pain-relieving treatment in the acute stage of gout, and uric acid-lowering treatment in the remission stage. At the end of the meeting, Dr. Zhang Fang, deputy chief physician, answered the most important questions about the daily diet for gout and hyperuricemia. Dr. Zhang introduced that the content of purine in various kinds of food is as follows: offal > meat, fish > dried beans, nuts > leafy vegetables > cereals > starch and fruits. After the detailed explanation and introduction by Dr. Zhang Fang and all the rheumatologists, all the patients in this meeting expressed that they had a more comprehensive understanding of gout and hyperuricemia. Patients also learned about various problems that need to be paid attention to in their daily life, taking into account their own conditions. All the patients said that the meeting was very beneficial to them, and they hoped that the Department of Rheumatology and Immunology of our hospital would organize similar activities regularly to meet the good wishes of the patients for early recovery.