Gout, a prevalent and treatable form of crystal-induced arthritis, results from monosodium urate (MSU) crystal deposition in articular and periarticular tissues. Early diagnosis is crucial to prevent progression to chronic gouty arthritis, tophus formation, and structural joint damage. Musculoskeletal ultrasound (MUS) has emerged as a sensitive, noninvasive, and cost-effective imaging modality that enables the visualization of urate crystal deposition, evaluation of treatment response, and prediction of disease flares. This narrative review summarizes recent advances in MUS for the diagnosis and management of gout, including its integration into the 2015 ACR/EULAR classification criteria and the development of OMERACT consensus-based definitions and semi-quantitative scoring systems. Compared with dual-energy computed tomography (DECT), MUS is more accessible and radiation-free, and offers superior performance in detecting early-stage gout. MUS also provides valuable insights into comorbidities such as cardiovascular disease and chronic kidney disease. Furthermore, emerging technologies-such as superb microvascular imaging (SMI) and artificial intelligence (AI)-based deep learning-show promise in enhancing diagnostic accuracy and automation. MUS is expected to play an increasingly pivotal role in the comprehensive management of gout.

Sjögren disease (SjD) is characterized by autoimmune lymphocytic infiltration of lacrimal and salivary glands, leading to dry eye and dry mouth. This study aimed to investigate the features and diagnostic value of lacrimal gland ultrasonography (LGUS) for distinguishing SjD from undifferentiated connective tissue diseases (UCTDs). This prospective cohort study enrolled 80 patients, including 46 with SjD and 34 with non-SjD UCTDs. All participants underwent LGUS, scored according to the OMERACT guidelines for greyscale and color Doppler systems, alongside salivary gland ultrasonography (SGUS) and objective dry eye tests. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis. The ocular surface evaluation including tear break-up time (BUT), Schirmer test (ST), ocular staining score (OSS), and LGUS greyscale score of patients with SjD showed significant differences as compared with non-SjD patients, while no difference was found in morphology and color Doppler ultrasound score between the two groups. The ROC of LGUS has an AUC of 0.70 (95

OBJECTIVE:To analyze the related factors of rheumatoid arthritis (RA) patients with anemia of chronic disease (ACD) and to guide the clinical diagnosis and treatment. METHODS:A retrospective study was used to analyze the patients admitted to Department of Rheumatology and Immunology in Peking University Third Hospital from January 2013 to December 2018. Clinical data (including general conditions, joint lesions, extra-articular manifestations, and comorbidities), laboratory examinations, and treatment were collected to analyze the differences in clinical characteristics between group RA with ACD (RA-A) and group RA without ACD (RA-nA). Univariate and multivariate Logistic regression analysis was conducted to screen for relevant factors of RA with ACD. RESULTS:A total of 468 RA patients were included, including 194 cases (41.5%) in RA-A group and 274 cases (58.5%) in RA-nA group. There were no significant differences in age, gender, onset age, or course of disease between the two groups (P>0.05). The RA-A group had more joint swelling [13 (2, 14) vs. 10 (2, 11)], more tenderness [10 (2, 12) vs. 7 (2, 10)], and higher 28 joint disease activity scores (DAS28) [DAS28-CRP (C-reactive protein): 5.2±1.4 vs. 4.6±1.5; DAS28-ESR (erythrocyte sedimentation rate): 5.9±1.5 vs. 5.1±1.8] compared with the RA-nA group (P < 0.05). The incidence of pleural effusion (4.6% vs. 1.1%) and venous thrombosis (5.7% vs. 1.5%) were higher in RA-A group (P < 0.05). The platelet count, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, ESR, CRP, immunoglobulin G (IgG) in RA-A group were significantly higher than those in RA-nA group (P < 0.05). Elevated ESR and CRP levels, DAS28 > 5.1 were relevant factors for anemia in the RA patients. CONCLUSION:RA patients with ACD had more severe joint involvement, higher inflammatory indicators, and more active conditions, making them more prone to pleural effusion and venous thrombosis. High disease activity, high inflammatory status, and venous thrombosis were risk factors for RA with ACD.

OBJECTIVE:To develop an evidence-based patient version of guideline (PVG) for fibromyalgia, aiming to improve patients' understanding of disease symptoms and therapeutic options and to enhance their self-management abilities. METHODS:Following the World Health Organization Handbook for Guideline Development (2014), a multidisciplinary working group was established, including patient representatives, physicians, pharmacists, nurses, and methodologists. The process comprised (a) systematic retrieval of clinical practice guidelines and expert consensus statements to establish the evidence base; (b) integration of large language models (LLMs) with expert review to identify and refine key patient-centered concerns; (c) a three-round Delphi consensus guided by the Grading of Recommendations Assessment, Development and Evaluation approach to finalize clinical questions and formulate recommendations; and (d) evaluation of understandability using the Patient Education Materials Assessment Tool for Print Materials (PEMAT-P). RESULTS:The final PVG covers 13 clinical questions across seven domains, including disease awareness, diagnostic evaluation, pharmacological and non-pharmacological interventions, and long-term management. All recommendations were rated as strong. The guideline emphasizes the importance of pharmacological management, emotional regulation, and exercise in the comprehensive management of fibromyalgia. The PEMAT-P assessment showed an understandability score of 100%. CONCLUSIONS:Developed collaboratively by a multidisciplinary team and patient representatives, this PVG is based on 13 evidence-based fibromyalgia guidelines. Combining LLMs with expert review enhanced question generation and readability. The PVG provides a practical and accessible tool to support early self-management in fibromyalgia.

Antiphospholipid syndrome (APS) is a heterogeneous autoimmune disease with persistent antiphospholipid antibodies. This study aimed to identify unrecognized APS subgroups from multicenter cohorts (n = 760, training: n = 415; validation: n = 345). Patients are stratified through unsupervised K-means clustering analysis. Prognostic outcomes are evaluated using Kaplan-Meier survival analyses. Proteomic analysis is conducted on primary APS patients (n = 36) and healthy controls (n = 12). Key molecule insulin-like growth factor 1 is validated using ELISA. Three clusters are identified. Cluster 1 (n = 320, 42.1%) is completely consisted of females (100%), with predominant occurrence of pregnancy morbidity (88.8%) but low incidences of thrombocytopenia (18.4%) and thrombosis (15.0%), and a favorable prognosis. Cluster 2 (n = 309, 40.7%) is predominantly female (99.4%) and characterized by high thrombosis (85.8%) and thrombocytopenia (46.6%), low pregnancy morbidity (13.6%), and poor prognosis. Cluster 3 (n = 131, 17.2%) is predominantly male (99.2%), exhibiting highest thrombosis (96.2%) and moderate thrombocytopenia (32.8%), with worst prognosis. Immunological and proteomic analyses clearly differentiated three clusters. This study reveals a distinct difference between obstetric and thrombotic APS, and a sex-based distinction within thrombotic APS. Three APS subgroups display unique clinical and molecular characteristics, and marked difference in prognostic outcomes.

To evaluate the diagnostic performance and reliability of the OMERACT semi-quantitative ultrasound scoring system compared with a binary scoring system for the diagnosis of gout in a multicenter setting. This multicenter, retrospective observational study included 912 patients (457 with gout and 455 with non-gout inflammatory arthritis) from two institutions. All participants underwent standardized musculoskeletal ultrasound examinations of the hands and feet. Four elementary lesions (double contour sign, aggregates, tophus, and bone erosion) were assessed using both a binary classification (present/absent) and the OMERACT semi-quantitative scoring system (grades 0–3). Diagnostic accuracy was analyzed using receiver operating characteristic (ROC) curves against the 2015 ACR/EULAR gout classification criteria. Inter- and intra-observer reliability were assessed using weighted kappa (κ) statistics in 100 randomly selected cases. The OMERACT semi-quantitative score demonstrated superior diagnostic accuracy (AUC 0.988, 95

Hyperuricemia (HUA) is implicated in inflammation and a prothrombotic state, but its prognostic role in antiphospholipid syndrome (APS) remains uncertain. This study aims to evaluate the prognostic value of HUA in APS and identify optimal serum uric acid (SUA) thresholds for predicting adverse outcomes. All patients fulfilled the 2006 Sydney criteria for APS were followed up at Peking University People’s Hospital (2009–2022). Patients with persistent HUA were included in the HUA group. Comparative analyses were conducted between APS patients with and without HUA. Subgroup and ROC analyses were performed to evaluate prognostic value and identify optimal SUA thresholds. Among 240 primary APS patients, 45 (18.8

The objective of this study was to analyze and compare the effects of different urate-lowering agents on testicular functions in men with gout in a clinical setting. In this prospective cohort study (Clinical Trial Registration Number: NCT04213534), a total of 49 male patients aged 18–45 years with gout were enrolled. They were divided into three groups and received treatment with either allopurinol, febuxostat or benzbromarone for a duration of 3 months. Semen parameters, reproductive hormones and biochemical assessments were evaluated at baseline, month 1, and month 3. Overall, 40 individuals (81.6

Arthritis & RheumatologyAccepted Articles Letters A diagnostic performance study of the 2023 ACR/EULAR classification criteria for antiphospholipid syndrome (APS) in patients from the APS Chinese Collaborative (APSCC) cohort presenting with suspected APS Qingyi Lu BMSc, Qingyi Lu BMSc Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing, China, 100044 Center of Clinical Immunology, Peking University, Beijing, China, 100044Search for more papers by this authorZhongqiang Yao MD, Zhongqiang Yao MD Department Rheumatology & Immunology, Peking University Third Hospital, Beijing, China, 100038Search for more papers by this authorYuzhou Gan PhD, Corresponding Author Yuzhou Gan PhD [email protected] orcid.org/0000-0001-8885-7452 Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing, China, 100044 Center of Clinical Immunology, Peking University, Beijing, China, 100044 To whom correspondence should be addressed to: Dr. Yuzhou Gan, Address: 11 Xizhimen South Street, Beijing, China, 100044, Tel: 86-10-88324173, Fax: 86-10-88324372, E-mail: [email protected]., Or, Dr. Chun Li, Address: 11 Xizhimen South Street, Beijing, China, 100044, Tel: 86-10-88324172, Fax: 86-10-88324178, E-mail: [email protected]., This research was supported by funding from Peking University People's Hospital Research and Development Funds (RDJP2022-12), and Peking University Clinical Scientist Training Program (BMU2023PYJH010). Yuzhou Gan was partially supported by Michigan Medicine-Peking University Health Science Center Joint Institute for clinical and translational research.Search for more papers by this authorChun Li MD, Corresponding Author Chun Li MD [email protected] Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing, China, 100044 Center of Clinical Immunology, Peking University, Beijing, China, 100044 To whom correspondence should be addressed to: Dr. Yuzhou Gan, Address: 11 Xizhimen South Street, Beijing, China, 100044, Tel: 86-10-88324173, Fax: 86-10-88324372, E-mail: [email protected]., Or, Dr. Chun Li, Address: 11 Xizhimen South Street, Beijing, China, 100044, Tel: 86-10-88324172, Fax: 86-10-88324178, E-mail: [email protected]., This research was supported by funding from Peking University People's Hospital Research and Development Funds (RDJP2022-12), and Peking University Clinical Scientist Training Program (BMU2023PYJH010). Yuzhou Gan was partially supported by Michigan Medicine-Peking University Health Science Center Joint Institute for clinical and translational research.Search for more papers by this author Qingyi Lu BMSc, Qingyi Lu BMSc Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing, China, 100044 Center of Clinical Immunology, Peking University, Beijing, China, 100044Search for more papers by this authorZhongqiang Yao MD, Zhongqiang Yao MD Department Rheumatology & Immunology, Peking University Third Hospital, Beijing, China, 100038Search for more papers by this authorYuzhou Gan PhD, Corresponding Author Yuzhou Gan PhD [email protected] orcid.org/0000-0001-8885-7452 Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing, China, 100044 Center of Clinical Immunology, Peking University, Beijing, China, 100044 To whom correspondence should be addressed to: Dr. Yuzhou Gan, Address: 11 Xizhimen South Street, Beijing, China, 100044, Tel: 86-10-88324173, Fax: 86-10-88324372, E-mail: [email protected]., Or, Dr. Chun Li, Address: 11 Xizhimen South Street, Beijing, China, 100044, Tel: 86-10-88324172, Fax: 86-10-88324178, E-mail: [email protected]., This research was supported by funding from Peking University People's Hospital Research and Development Funds (RDJP2022-12), and Peking University Clinical Scientist Training Program (BMU2023PYJH010). Yuzhou Gan was partially supported by Michigan Medicine-Peking University Health Science Center Joint Institute for clinical and translational research.Search for more papers by this authorChun Li MD, Corresponding Author Chun Li MD [email protected] Department of Rheumatology & Immunology and Beijing Key Laboratory for Rheumatism and Immune Diagnosis (BZ0135), Peking University People's Hospital, Beijing, China, 100044 Center of Clinical Immunology, Peking University, Beijing, China, 100044 To whom correspondence should be addressed to: Dr. Yuzhou Gan, Address: 11 Xizhimen South Street, Beijing, China, 100044, Tel: 86-10-88324173, Fax: 86-10-88324372, E-mail: [email protected]., Or, Dr. Chun Li, Address: 11 Xizhimen South Street, Beijing, China, 100044, Tel: 86-10-88324172, Fax: 86-10-88324178, E-mail: [email protected]., This research was supported by funding from Peking University People's Hospital Research and Development Funds (RDJP2022-12), and Peking University Clinical Scientist Training Program (BMU2023PYJH010). Yuzhou Gan was partially supported by Michigan Medicine-Peking University Health Science Center Joint Institute for clinical and translational research.Search for more papers by this author First published: 25 February 2024 https://doi.org/10.1002/art.42835 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/art.42835. AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. 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Our recent study showed that Nitazoxanide (NTZ), an FDA-approved anti-parasitic drug, prevents ovariectomy-induced bone loss by inhibiting osteoclast activity. However, there have been no investigations to determine whether NTZ has preventive potential in other bone resorbing diseases, especially rheumatoid arthritis (RA). In this study, the primary RA fibroblast-like synoviocytes (RA-FLS) and collagen-induced arthritis (CIA) murine model were used to evaluate the effect of NTZ. The results showed that NTZ potently inhibited proliferation, migration and invasion capacity of RA-FLS in a dose dependent manner by restraining cell entry into S phases, without induction of cell apoptosis. NTZ obviously reduced spontaneous mRNA expression of IL-1β, IL-6 and RANKL, as well as TNF-α-induced transcription of the IL-1β, IL-6, and MMP9 genes. In terms of molecular mechanism, NTZ significantly inhibited the basal or TNF-α-induced activation of JAK2/STAT3 (T705) and NF-κB pathway, but not MAPK and STAT3 (S727) phosphorylation. Moreover, NTZ ameliorated synovial inflammation and bone erosion in CIA mice through reducing the production of inflammatory mediators and osteoclast formation, respectively. Collectively, our findings indicate that NTZ exhibits anti-inflammatory and anti-erosive effects both ex vivo and in vivo, which provides promising evidence for the therapeutic application of NTZ as a novel therapeutic agent for RA.

Objectives: Rapidly progressive interstitial lung disease (RPILD) in patients with dermatomyositis (DM) significantly impacts prognosis, leading to high mortality rates. Although several indicators have been demonstrated to strongly correlate with the risk of developing RPILD, their clinical utility still needs to be investigated. The objective of this study was to investigate the clinical significance of soluble CXCL16 (sCXCL16) in DM patients complicated with RPILD. Methods: Serum sCXCL16 was measured by enzyme-linked immunosorbent assay in 96 patients with DM and 55 matching healthy donors. Correlations between sCXCL16 levels and clinical features, laboratory examinations and the predictive value of baseline sCXCL16 level for RPILD were analysed. Results: The serum sCXCL16 levels were significantly higher in patients with DM (n = 96, 3.264 +/- 1.516 ng/mL) compared with healthy donors (n = 55, 1.781 +/- 0.318 ng/mL), especially in DM complicated with RPILD (n = 31, 4.441 +/- 1.706 ng/mL). The sCXCL16 levels were positively correlated with levels of serum ferritin, C reactive protein, erythrocyte sedimentation rate, lactate dehydrogenase, hydroxybutyrate dehydrogenase, and negatively correlated with peripheral lymphocytes percentage, but showed no correlation with levels of anti-melanoma differentiation-associated gene 5 antibody, Krebs von den Lungen-6 or creatine kinase. Multivariable analysis showed that elevated sCXCL16 was an independent prognostic factor for poor prognosis of RPILD in patients with DM. The 2-year survival rate was significantly lower in patients with high sCXCL16 level than in those with low sCXCL16 level. Conclusion: A higher serum sCXCL16 level was identified as a predictive biomarker of RPILD in patients with DM, and closely associated with poor prognosis.

OBJECTIVE:To investigate whether anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes were correlated with unexplained recurrent miscarriages. METHODS:In our a single-center retrospective study, 283 patients with at least one unexplained miscarriage who visited the Third Hospital of Peking University between January 2021 and August 2023, aged between 18-40 years, and tested for anti-phosphatidylserine/prothrombin antibodies IgG or IgM subtypes, were included. The patients with either positive IgG or IgM anti-phosphatidylserine/prothrombin antibody were regarded as positive for anti-phosphatidylserine/prothrombin antibody. SPSS 26.0 software was used for statistical analysis. Chi-square test and Logistic regression analysis were used to study the correlation of anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes with unexplained recurrent miscarriages. And the diagnostic sensitivity, specificity, the positive predictive value, the negative predictive value of anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes in unexplained miscarriages was calculated with four-fold table. RESULTS:Chi-square analysis showed that anti-phosphatidylserine/prothrombin antibodies and its IgM subtypes were correlated with recurrent miscarriages (both P < 0.05), while the IgG subtype was not correlated with recurrent miscarriages (P>0.05). After adjusting with anticardiolipin antibodies, anti-β2 glycoprotein antibodies, lupus anticoagulants, antinuclear antibodies, and age by Logistic regression analysis, anti-phosphatidylserine/prothrombin antibodies were correlated with unexplained recurrent miscarriages (OR=2.084, 95%CI 1.045-4.155, P < 0.05), and anti-phosphatidylserine/prothrombin antibody IgM subtypes were correlated with unexplained recurrent miscarriages (OR=2.368, 95%CI 1.187-4.722, P < 0.05).The sensitivity of anti-phosphatidylserine/prothrombin antibody in recurrent miscarriage was 65.43%, the specificity was 48.51%, the positive predictive value was 33.76%, and the negative predictive value was 77.78%. In the patients with recurrent miscarriages with negative classical antiphospholipid antibodies, the sensitivity of anti-phosphatidylserine/prothrombin antibody was 59.09%, the specificity was 63.23%, the positive predictive value was 40.63%, and the negative predictive value was 78.40%. The sensitivity of the anti-phosphatidylserine/prothrombin antibody IgM subtype for the diagnosis of recurrent miscarriage was 65.43%, the specificity was 50.99%, the positive predictive value was 34.87%, and the negative predictive value was 78.63%. CONCLUSION:Anti-phosphatidylserine/prothrombin antibody and IgM subtype antibody are correlated with unexplained recurrent miscarriages in patients with at least one unexplained miscarriage. Whether positive anti-phosphatidylserine/prothrombin antibody or IgM subtype could predict future unexplained recurrent miscarriages warrants a prospective study.

To investigate whether anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes were correlated with unexplained recurrent miscarriages.In our a single-center retrospective study, 283 patients with at least one unexplained miscarriage who visited the Third Hospital of Peking University between January 2021 and August 2023, aged between 18-40 years, and tested for anti-phosphatidylserine/prothrombin antibodies IgG or IgM subtypes, were included. The patients with either positive IgG or IgM anti-phosphatidylserine/prothrombin antibody were regarded as positive for anti-phosphatidylserine/prothrombin antibody. SPSS 26.0 software was used for statistical analysis. Chi-square test and Logistic regression analysis were used to study the correlation of anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes with unexplained recurrent miscarriages. And the diagnostic sensitivity, specificity, the positive predictive value, the negative predictive value of anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes in unexplained miscarriages was calculated with four-fold table.Chi-square analysis showed that anti-phosphatidylserine/prothrombin antibodies and its IgM subtypes were correlated with recurrent miscarriages (both P < 0.05), while the IgG subtype was not correlated with recurrent miscarriages (P>0.05). After adjusting with anticardiolipin antibodies, anti-β2 glycoprotein antibodies, lupus anticoagulants, antinuclear antibodies, and age by Logistic regression analysis, anti-phosphatidylserine/prothrombin antibodies were correlated with unexplained recurrent miscarriages (OR=2.084, 95%CI 1.045-4.155, P < 0.05), and anti-phosphatidylserine/prothrombin antibody IgM subtypes were correlated with unexplained recurrent miscarriages (OR=2.368, 95%CI 1.187-4.722, P < 0.05).The sensitivity of anti-phosphatidylserine/prothrombin antibody in recurrent miscarriage was 65.43%, the specificity was 48.51%, the positive predictive value was 33.76%, and the negative predictive value was 77.78%. In the patients with recurrent miscarriages with negative classical antiphospholipid antibodies, the sensitivity of anti-phosphatidylserine/prothrombin antibody was 59.09%, the specificity was 63.23%, the positive predictive value was 40.63%, and the negative predictive value was 78.40%. The sensitivity of the anti-phosphatidylserine/prothrombin antibody IgM subtype for the diagnosis of recurrent miscarriage was 65.43%, the specificity was 50.99%, the positive predictive value was 34.87%, and the negative predictive value was 78.63%.Anti-phosphatidylserine/prothrombin antibody and IgM subtype antibody are correlated with unexplained recurrent miscarriages in patients with at least one unexplained miscarriage. Whether positive anti-phosphatidylserine/prothrombin antibody or IgM subtype could predict future unexplained recurrent miscarriages warrants a prospective study.

OBJECTIVE:To analyze the clinical features of overweight and obese rheumatoid arthritis (RA)patients, and the relationship between body mass index (BMI) and disease characteristics.METHODS:The demographic data, extra-articular manifestations, comorbidities, and disease activity of RA patients admitted to the Rheumatology and Immunology Department of Peking University Third Hospital from January 2015 to December 2020 were collected, and the above characteristics of overweight and obese RA patients were retrospectively analyzed. According to the WHO, BMI≥30 kg/m2 referred to obese individuals, 25≤BMI < 30 kg/m2 referred to overweight individuals, 18.5≤BMI < 25 kg/m2 referred to normal individuals, BMI < 18.5 kg/m2 referred to reduced body mass individuals. t test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non-normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency < 5, Chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency < 1. Analyzing whether overweight or obesity was associated with comorbidities using Logistic regression adjusted confounding factors.RESULTS:A total of 481 RA patients were included in this study, with an average BMI value of (23.28±3.75) kg/m2.Of the patients, 31 cases (6.5%) were with BMI < 18.5 kg/m2, 309 cases (64.2%) with 18.5≤ BMI < 25 kg/m2, amounting to 340 cases (70.7%). There were 119 overweight individuals (25≤ BMI < 30 kg/m2, 24.7%) and 22 obese individuals (BMI≥30 kg/m2, 4.6%), totaling 141 (29.3%).The proportion of the overweight and obese RA patients suffering from hypertension (57.4% vs. 39.1%, P < 0.001), diabetes (25.5% vs. 15.0%, P=0.006), hyperlipidemia (22.7% vs. 10.9%, P=0.001), fatty liver (28.4% vs. 7.4%, P < 0.001), osteoarthritis (39.0% vs. 29.4%, P=0.040) was significantly higher, and the proportion of the patients with osteoporosis(59.6% vs. 70.9%, P=0.016) and anemia (36.2% vs. 55.6%, P < 0.001) was significantly lower. However, there was no difference between the two groups in coronary heart disease (5.7% vs. 7.6%, P=0.442), cerebrovascular disease (6.4% vs. 8.8%, P=0.372) and peripheral atherosclerosis (9.2% vs. 7.6%, P=0.565).The median C-reactive protein (CRP, 1.52 mg/dL vs. 2.35 mg/dL, P=0.008), median erythrocyte sedimentation rate (ESR, 34.0 mm/h vs. 50.0 mm/h, P=0.003), pain visual simulation score (VAS) (3.66±3.08 vs. 4.40±2.85, P=0.011), and 28 joint disease activity scores (DAS-28, 5.05±1.60 vs. 5.45±1.52, P=0.010) in the overweight and obese RA group were all lower than those in the normal and reduced weight groups. Multivariate regression analysis showed that overweight and obesity was an independent risk factor for hypertension, diabetes, hyperlipidemia and fatty liver, and had protective effects on osteoporosis and anemia.CONCLUSION:In RA patients, RA disease activity is lower in overweight and obesity patients. Overweight and obesity is associated with hypertension, diabetes and hyperlipidemia, but not with cardiovascular and cerebrovascular diseases.

In this study, we studied the performance of the 2022 American College of Rheumatology (ACR)/ European Alliance of Associations for Rheumatology (EULAR) classification criteria for Takayasu's arteritis (TAK) as compared to the 1990 ACR classification criteria in a Chinese population. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and the area under the receiver operating characteristics curve (AUC) of the above two criteria were compared. The sensitivity (92.6%), positive predictive value (95.6%), negative predictive value (94.6%), accuracy (95.0%) and AUC (0.981) of the 2022 criteria were superior to those of the 1990 criteria (45.7%, 91.5%, 70.5%, 75.0% and 0.874, respectively), and the difference of AUC was statistically significant ( Z = 5.362, P < 0.001). In addition, we included new imaging modalities in the 1990 criteria, whose sensitivity, positive predictive value, negative predictive value, accuracy and AUC were significantly improved, but still lower than those of the 2022 criteria, the difference in AUC was also statistically significant ( Z = 2.023, P = 0.043). The 2022 criteria for TAK exhibited superior performance compared with the 1990 criteria and may be more appropriate for the Chinese population. Incorporating additional imaging modalities could enhance the classification performance of the 1990 criteria even further.

血栓栓塞性疾病的栓塞和出血风险并存已成为临床困境.疾病的多元化与药物更迭使抗栓治疗日益复杂和专业化,单一学科已不能胜任疑难病例的抗栓治疗.为更好地整合医疗资源,确保患者从规范化抗栓治疗中获益,北京大学第三医院突破学科间壁垒,组建了以心内科为主体,联合药剂科、检验科、神经内科、急诊科、消化科、心脏外科、呼吸科、介入血管外科、神经外科、风湿免疫科和血液科等12个科室参与的抗栓诊治专业团队,致力于制定合理的抗栓策略,着力解决临床血栓性疾病抗凝、抗血小板治疗中的关键问题,旨在探索一个"以心房颤动患者为中心"的多学科联合诊疗和精细化管理模式.

目的:评价泪腺超声造影联合DeVita评分法在干燥综合征(SS)中的诊断价值.方法:选取在医院风湿免疫科就诊的26例SS患者纳入SS组,同期行健康体检者24名纳入健康对照组,应用常规超声扫描检查,得出两组的DeVita评分;应用超声造影(CEUS)检查,分别获得两组超声造影时间-强度曲线(CEUS-TIC)的上升速率(WiR)、下降速率(WoR)、峰值强度(PI)、平均强度(MI)、总TIC曲线下面积(tAUC)、强化曲线下面积(iAUC)、廓清曲线下面积(oAUC)等,比较两组常规超声及超声造影表现的差异,以及超声造影参数的差异.分析泪腺CEUS和De Vita评分及其联合诊断SS的效能.结果:SS组的De Vita评分、WiR、WoR、PI、MI、tAUC、iAUC和oAUC均高于健康对照组,差异均有统计学意义(x2=29.712,t=2.657,t=2.282,t=3.953,t=4.310,t=3.949,t=3.284,t=3.827;P<0.05).泪腺CEUS联合DeVita评分诊断SS的AUC为0.979,95％可信区间(95％CI)为0.932～1.000,灵敏度和特异度分别为100％和95.8％,约登指数为0.958,优于DeVita评分法及泪腺CEUS单独应用的诊断效能.结论:泪腺CEUS有助于SS的诊断,与DeVita评分法联合应用可提高SS的诊断效能,为临床治疗提供依据.