BackgroundType 2 diabetes mellitus (T2DM) is one of the most common metabolic diseases worldwide. hyperuricemia (HUA) and gout are common comorbidities in T2DM patients. This systematic review and meta-analysis aimed to estimate the global prevalence of HUA and gout in patients with T2DM and to identify associated risk factors.MethodsA systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library to identify observational studies on HUA/gout in patients with T2DM. Two researchers independently performed literature screening, data extraction, and quality assessment. The quality of included studies was assessed using the Newcastle-Ottawa Scale and the AHRQ Scale. Statistical analyses were performed using Stata 12.0 software. A random-effects model was used to pool prevalence estimates, with subgroup and sensitivity analyses to explore heterogeneity. Publication bias was assessed using Egger’s test.ResultsEighty-seven studies comprising 977,573 T2DM patients were included. The pooled prevalence of HUA was 22.0% (95% CI: 20.1-24.0%, 95% PI: 4.9-39.2%), and that of gout was 6.0% (95% CI: 4.4-7.5%). Meta-regression identified geographic region as a significant source of heterogeneity, with the highest HUA prevalence in Africa and North America, and lowest in South America. Risk factors for HUA included impaired renal function, obesity, dyslipidemia, hypertension, metabolic syndrome, and alcohol consumption, while elevated HbA1c was inversely associated with HUA. Male sex was a significant risk factor for gout.ConclusionThe prevalence of HUA and gout is significantly higher in patients with T2DM than in the general population. Impaired renal function, obesity, dyslipidemia, hypertension, MetS, and alcohol consumption are the primary risk factors. Routine serum uric acid monitoring and early screening for high-risk individuals should be incorporated into the clinical management of T2DM.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261359583, identifier CRD420261359583.

This study aims to systematically evaluate the incidence of malignant tumors in rheumatoid arthritis (RA) patients and identify influencing factors, providing an evidence-based foundation for early identification of high-risk groups and individualized management. Cohort studies on tumor incidence and ifluencing factors in RA patients were searched in both Chinese and English databases from inception to July 31, 2025. Two researchers independently screened literature, extracted data, and assessed quality. Meta-analysis was performed using Stata 12.0 to calculate pooled incidence and hazard ratios (HR) with 95

BackgroundThe study of chronic gouty arthritis (CGA) is limited by the absence of animal models that faithfully mimic its chronic progression. Existing models fail to capture the transition from acute flares to chronic joint damage, highlighting the need for a more representative model.MethodsA novel CGA model was established in SD rats using a combined strategy. Chronic hyperuricemia was induced via a diet containing 2% potassium oxonate and 12% yeast. This was supplemented with twice-weekly gavage of hypoxanthine to simulate acute uric acid fluctuations, followed by intra-articular injections of monosodium urate (MSU) crystals into the ankle and plantar region. This protocol lasted 10 weeks. Rats were divided into control, model, and allopurinol treatment groups. Evaluations included serum uric acid monitoring, joint swelling and inflammation scores, hindlimb hanging tests, histopathology, micro-CT, and inflammatory cytokine assays.ResultsThe model group exhibited sustained hyperuricemia with acute fluctuations, persistent joint swelling, significantly elevated inflammation scores (P<0.0001), and reduced hanging time (P<0.0001), indicating chronic pain and functional impairment. Histology revealed synovial hyperplasia, inflammatory cell infiltration, and cartilage damage. Micro-CT confirmed significant bone erosion, evidenced by an increased bone surface/bone volume ratio (P<0.001). Serum levels of IL-1β, TNF-α, and IL-6 were significantly elevated. Allopurinol treatment effectively lowered uric acid and alleviated joint swelling and bone erosion.ConclusionThis study successfully established and systematically characterized the phenotypic features of a CGA rat model that integrates chronic hyperuricemia, acute uric acid fluctuations, and local MSU crystal deposition. Phenotypically, this model recapitulates the core features of human CGA, including joint swelling, bone erosion, and functional impairment, thereby providing an experimental platform for investigating chronic joint damage induced by multiple interacting factors.

Sini Powder is a well-known formula commonly used by clinicians to harmonize the liver and spleen. Professor Tang Xudong, who studied under the renowned physician Dong Jianhua, attaches particular importance to Professor Dong’s theory of “promoting qi flow and descending adverse qi”. Professor Tang is especially fond of using Sini Powder, and has achieved remarkable therapeutic effects by modifying it and combining it with other formulas. He has also developed and innovated its applications. Hereby, I briefly present my teacher’s experiences to share with colleagues in the field.

ObjectiveRheumatoid arthritis (RA) is a chronic inflammatory joint disease and the leading cause of joint-related limb disability. Traditional Chinese Medicine (TCM) offers certain advantages in RA treatment, and Tripterygium preparations are widely used due to their significant clinical efficacy. This study aimed to investigate the mechanism of action of Tripterygium Glycosides Tablets (TG) in the treatment of RA through in vivo and ex vivo experiments, providing a theoretical basis for clinical application.MethodsA collagen-induced arthritis (CIA) rat model was established, and the rats received oral administration of the corresponding drugs or distilled water for 4 weeks. The therapeutic effect and mechanism of TG on CIA rats were evaluated by comparing joint swelling severity, radiographic changes in the synovium, and alterations in the JAK/STAT signaling pathway and related inflammatory factors. Further ex vivo experiments were performed using fibroblast-like synoviocytes (FLS) as the research subject. Lentiviral infection technology was used to overexpress IGF1 or interfere with the expression of Lnc-ENST00000602558. Drug-containing serum was used for intervention. The mechanism of TG in treating RA was further elucidated by detecting changes in cell migration ability, the expression of IGF1 and Lnc-ENST00000602558, JAK/STAT pathway-related targets, and inflammatory factors.ResultsTG significantly improved joint swelling, bone and cartilage destruction in CIA rats, reduced synovial tissue hyperplasia, inhibited the JAK/STAT pathway and IGF1 in the rat joint synovium, lowered serum levels of the inflammatory factors TNF-α and IL-1β, alleviated joint damage, and delayed disease progression. Ex vivo experiments showed that the Lnc-ENST00000602558/IGF1 axis could activate the JAK/STAT pathway in FLS. When Lnc-ENST00000602558 was expressed at low levels, the regulatory capacity of TG on the Lnc-ENST00000602558/IGF1 axis and the JAK/STAT pathway was diminished.ConclusionTG may regulate the JAK/STAT pathway via the Lnc-ENST00000602558/IGF1 axis, thereby inhibiting the inflammatory response, mitigating bone and cartilage destruction, and delaying disease progression.

INTRODUCTION:Fatigue has been identified as one of the common symptoms among people who have rheumatoid arthritis (RA), which has a significant impact on their quality of life (QoL). Although fatigue has been identified as a symptom, few predictive models using clinical indicators have been developed for RA-related fatigue. This paper aims to create predictive models using machine learning (ML) algorithms. METHODS:A retrospective analysis of clinical data was conducted on 271 patients with RA from two hospitals. The patients were randomly split into a training set and an external validation set. Feature selection on the training set was performed using three different algorithms: Least Absolute Shrinkage and Selection Operator (Lasso), Boruta, and Recursive Feature Elimination using a Random Forest (RF-RFE). Subsequently, multiple models using machine learning ML) techniques such as Support Vector Machine (SVM), XGBoost, LightGBM, Artificial Neural Network (ANN), K-Nearest Neighbors (KNN), and Random Forest (RF) were developed. Model calibration, Receiver Operating Curve (ROC) analyses, Decision Curve Analysis (DCA), and SHapley Additive exPlanations (SHAP) analyses were used to evaluate the models. Moreover, an overall evaluation using ten-fold cross-validation and an external evaluation using an independent dataset were undertaken. RESULTS:The final dataset comprised 190 patients in the training group and 81 in the external validation set, with no significant differences in demographic features such as age and sex (P > 0.05). The six important predictors identified using a variety of feature selectors were CCP, ESR, lymphocyte count, MDGA, VAS for pain, and TG. In external validation, ML model classifiers such as SVM, XGBoost, and Random Forest performed better at prediction than logistic regression. DISCUSSION:This study demonstrates the potential of ML models to capture nonlinear relationships between clinical variables when predicting fatigue in RA patients. However, the modest performance metrics suggest that these findings are preliminary. CONCLUSION:A fatigue-prediction model using routine clinical parameters was developed using ML techniques. The SVM model showed potential in identifying RA patients at risk of fatigue. However, the modest performance metrics indicate the preliminary nature of these results, necessitating validation through larger, multicenter studies.

BackgroundAnkylosing spondylitis (AS) is a chronic inflammatory disease that impairs physical function, reduces quality of life, and is associated with psychological burdens such as anxiety and depression. While non-steroidal anti-inflammatory drugs (NSAIDs) and biologic therapies are standard treatments, exercise therapy is crucial for maintaining mobility and function. This study aimed to comprehensively compare the effects of 12 exercise interventions on AS patients’ disease activity and chest expansion (CE) via network meta-analysis (NMA) and dose-response meta-analysis, and explore dose-dependent effects to inform personalized exercise prescriptions.MethodologyFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, randomized controlled trials (RCTs) were searched from PubMed, Cochrane Library, Embase, and Web of Science until December 31, 2024. Eligible studies included adults with American College of Rheumatology/European League Against Rheumatism (ACR/EULAR)-diagnosed AS, comparing exercise with conventional treatment/placebo/no intervention, with outcomes of Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), and CE. Two reviewers screened literature, extracted data, and assessed bias using the Cochrane Handbook. NMA and dose-response analysis (expressed as metabolic equivalents of task (MET) minutes/week) were performed (Prospero: CRD420251001511).ResultsThirty-two RCTs with 1757 participants were included. NMA showed hippotherapy simulation (HS) was most effective for reducing BASFI; aerobic exercise (AE) + Pilates was superior for BASDAI and BASMI; AE + Stretching Exercise (SE)+Supervise best improved CE. Dose-response analysis revealed non-linear relationships, with specific effective dose ranges identified for each outcome. Subgroup and sensitivity analyses confirmed result robustness.ConclusionExercise interventions, especially HS, AE + Pilates, and AE + SE + Supervise, effectively improve AS patients’ disease activity and CE. Non-linear dose-response relationships emphasize personalized prescriptions, providing evidence-based guidance for integrating exercise into AS management, with future large-scale RCTs needed to validate dose effects.

Purpose:Urate lowering therapy (ULT) is extensively utilized for managing patients with gout. This study aims to compare the efficacy of different ULTs on serum uric acid (SUC) levels, gout flares, and adverse events (AEs) in gout patients. Methods:Studies comparing the efficacy of febuxostat, allopurinol, benzbromarone, and topixostat with placebo were searched up to March 2024. Stata 15.1 and R software 4.2.3 were employed to rank the efficacy of each ULT. Results:This study included 30 studies, involving 20,040 patients. All ULTs resulted in notably lower SUC levels compared to placebo/no ULT. Febuxostat 120 mg markedly reduced SUC levels compared to allopurinol and benzbromarone 25 mg (mean difference = 2.16, 95% confidence interval [0.27, 4.06], P < 0.05). Allopurinol 200/300 mg was the best choice to reduce gout flares. In terms of AEs, the allopurinol group (300 mg) had the lowest incidence of cardiovascular and renal abnormalities. Moreover, the incidence of AEs was observed to rise with increasing doses. Future well-designed randomized control trials are required to further confirm these findings. Conclusion:The study results indicate that febuxostat is the most effective ULT drug to treat gout. It can effectively help gout patients reduce SUC levels. Researchers should pay attention to the safety of drug doses.

OBJECTIVE:To analyze deposition of sodium urate in patients with gout, and to explore predictive value of sodium urate deposition for the occurrence of refractory gout (RG) by dual-energy CT imaging technique. METHODS:A retrospective analysis was conducted on basic data of 176 gout patients admitted from March 2023 to June 2025, including 171 males and 5 females, aged from 22 to 71 years old with an average of(43.16±10.82) years old. According to diagnostic criteria, the patients were divided into RG group and non-RG group. There were 92 patients in RG group, including 90 males and 2 females, aged from 24 to 66 years old with an average of (44.62±11.12) years old;there were 84 patients in non-RG group, including 81 males and 3 females, aged from 22 to 71 years old with an average of (41.46±10.31) years old. The courses of hyperuricemia, uric acid and deposition amounts of monosodium urate(MSU) between two groups were compared. Multivariate Logistic regression was used to analyze influencing factors of RG, receiver operating curve (ROC) was plotted, and area under the curve(AUC) was calculated, in order to evaluate predictive value of MSU deposition for RG. RESULTS:The courses of hypertension and hyperuricemia and deposition amount of MSU between two groups were statistically significant (P<0.05). Logistic analysis reault showed intra-articular MSU deposition[OR=5.402, 95%CI(2.095, 13.933), P<0.01], hypertension[OR=2.724, 95%CI(1.209, 6.134), P<0.05], courses of hyperuricemia [OR=1.122, 95%CI(1.032, 1.219), P<0.01] were independent risk factors for RG. AUC of MSU deposition for predicting RG was 0.824[95%CI(0.763, 0.885), P<0.01], and sensitivity was 63%, specificity was 92.9%, and the optimal cut-off value was 0.410 cm3. CONCLUSION:MSU deposition could increase risk of RG, and the amount of MSU deposition in joint cavity could provide a reference for early identification of patients with RG.

Hyperuricemia and gout have garnered increasing attention as significant health concerns in recent years, often associated with damage to multiple bodily systems. Consequently, the reduction of uric acid levels has become particularly crucial. The utilization of dietary supplements presents potential adjunctive treatment options for individuals with gout. Certain dietary supplements are purported to aid in the reduction of uric acid levels and are highly preferred by patients due to their affordability, ease of use, and accessibility. The aim of this article was to compare the efficacy and safety of dietary supplements in modulating uric acid, oxidative stress, and lipid metabolism in patients with hyperuricemia or gout, using a comprehensive network meta-analysis (NMA) approach. A comprehensive search was performed across both Chinese and English databases to identify randomized controlled trials (RCTs) examining the efficacy of dietary supplements in reducing uric acid levels. Network meta-analysis was conducted using Stata 16.0 software, while RevMan 5.3 software was employed to assess the quality of the literature and evaluate the risk of bias. A total of 30 RCTs, encompassing 44,972 patients, were conducted. The findings of the study indicated that folic acid (mean difference [MD] = -57.62 μmol/L, 95

Given the increasing incidence and disability rate of rheumatoid arthritis (RA) year by year, RA has become a common cause of disability. Danggui Niantong Decoction (DGNTD) has been shown to have therapeutic effects on RA. However, to date, its bioactive components and potential targets remain unclear. To systematically explore the potential mechanisms of DGNTD in the treatment of RA, we utilized a combination of network pharmacology, Mendelian randomization, molecular docking, and molecular dynamics simulation. We used the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database to identify DGNTD's active ingredients and potential targets, and GeneCards to screen RA-related targets. Common targets were identified via Venn analysis. We built a protein-protein interaction network and a drug-ingredient-target map with Cytoscape. Based on shared targets, we conducted gene ontology and Kyoto encyclopedia of genes and genomes enrichment analyses to reveal key pathways. To validate results, we used R for Mendelian randomization to assess core targets' correlation with RA. We used Autodock for molecular docking and GROMACS for dynamics simulations to verify complex stability. DGNTD contains 316 active ingredients and 276 potential targets. Through protein-protein interaction network analysis and drug-ingredient-target network screening, we identified 215 active ingredients and 200 common targets, with quercetin and naringenin as core active ingredients. The core targets included RAC-alpha serine/threonine-protein kinase, cellular tumor antigen p53, signal transducer and activator of transcription 3, mitogen-activated protein kinase 1, mitogen-activated protein kinase 3, and Myc proto-oncogene protein. The Kyoto encyclopedia of genes and genomes and gene ontology enrichment analyses revealed 186 signaling pathways, with core targets mainly involving the PI3K/AKT pathway, lipid metabolism, and atherosclerosis-related biological processes. After validation through Mendelian randomization, RAC-alpha serine/threonine-protein kinase and mitogen-activated protein kinase 3 may be key targets for the treatment of RA by DGNTD. The molecular docking and dynamics simulations showed that the complexes formed by the core active ingredients and key targets exhibited strong stability. DGNTD exerts its therapeutic effects on RA through the synergistic action of multiple components, targets, and pathways, with its anti-inflammatory effects and potential molecular mechanisms being particularly noteworthy and warranting further investigation.

Introduction:Gout is an inflammatory arthritis caused by the deposition of monosodium urate crystals in joints, severely affecting patients' health. However, the management of gout remains suboptimal. Current clinical treatments primarily focus on anti-inflammatory and urate-lowering medications, which are associated with potential toxicities and other limitations. Chronotherapy, based on chronobiology, has gradually demonstrated unique advantages in the treatment of various inflammatory diseases and holds promise as a safer and more effective new strategy for treating gout. Objective:This article aims to explore the biological mechanisms underlying the circadian rhythmicity of gout flares and the potential role of chronobiology-based therapeutic approaches in the treatment of gout. Methods:The referenced research articles were sourced from major scientific databases, including Google Scholar, PubMed, and Web of Science. The search strategy employed keywords such as "Gout", "Circadian rhythm", and "Chronobiology". Results:As the core inflammatory signaling pathway in gout, the NF-κB signaling pathway exhibits strong circadian rhythmicity under the regulation of circadian clock genes such as REV-ERBα. The gut microbiota may induce circadian oscillations in serum uric acid(UA) levels and trigger the rhythmic occurrence of gout flares by influencing the expression of REV-ERBα, rhythmically activating the NF-κB inflammatory signaling pathway, and altering the abundance. Therefore, the gut microbiota/REV-ERBα/NF-κB axis may be the potential biological mechanism underlying the circadian rhythmicity of gout flares. Conclusion:From the perspective of chronobiology, a chronobiology-based therapeutic approach targeting the gut microbiota/REV-ERBα/NF-κB axis-such as adjusting medication timing, dietary interventions to modulate the gut microbiota, and targeted pharmacological agents-holds promise as a novel clinical strategy for treating gout and has potential clinical value. However, the conclusions drawn in this paper lack scientific experimental and clinical validation. Therefore, exploring this therapeutic approach represent a key and promising direction for treating gout.

Standardized training for resident physicians in China has been carried out for 10 years, and various new teaching methods have been widely applied in it. The quality of internal medicine teaching is directly related to whether the trainees can master the corresponding clinical skills well and become qualified clinical physicians. The purpose of this study is to systematically evaluate the effectiveness of all teaching methods in Chinese standardized training of internal medicine residents. This study was registered in Inplasy. A comprehensive search of databases, including English and Chinese, was conducted from inception to 30 July 2023. Eligible studies included cohort study and randomized controlled trials (RCT) of all teaching methods in Chinese standardized training of internal medicine residents. A network meta-analysis (NMA) was performed using STATA 16.0. Statistical analysis was done using the mean and standard deviation. The literature quality and risks of bias was assessed using RevMan 5.3. A total of 74 articles including 5004 Chinese participants were retrieved, involving 13 interventions, of which 65 were RCT and 9 were cohort studies. This study demonstrated that, in comparison to lecture-based learning (LBL), the integration of problem-based learning (PBL) with WeChat significantly enhanced students' theoretical scores (SMD = 2.3; 95

Rheumatic and autoimmune diseases represent one of the major causes of chronic joint and muscle pain, skin ulceration, and mental depression, significantly impairing patients' physical and psychological wellbeing as well as their quality of life. Current evidence suggests that hypoxia may play a role in the pathogenesis and progression of rheumatic and autoimmune diseases and their associated complications. Hypoxia can induce pathological cellular stress, thereby triggering cell death. Hyperbaric oxygen therapy (HBOT) is a well-established, effective, and safe method for significantly increasing dissolved oxygen content in plasma and arterial oxygen partial pressure. Based on a comprehensive review of all relevant literature published in the past decade and indexed in PubMed regarding HBOT for rheumatic and autoimmune diseases, the following findings were observed: HBOT demonstrated an efficacy rate of 87.5%−100% in treating rheumatic and autoimmune diseases complicated by skin ulcers. For patients with fibromyalgia syndrome (FMS), the pain relief rate ranged from 87.5 to 100%. Additionally, HBOT exhibited favorable therapeutic effects in cases involving sensorineural hearing loss and acute macular neuroretinopathy secondary to rheumatic and autoimmune diseases. Regarding safety, adverse effects were reported in seven studies, primarily including mild barotrauma, tinnitus, headache, and claustrophobia. All adverse events resolved upon discontinuation of HBOT, and no severe adverse reactions were documented.

In order to implement the requirements of the document Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovation of Traditional Chinese Medicine,accelerate the promotion of the construction of a healthy China,adhere to the equal importance of Chinese and Western medicines,promote the mutual complementarity of traditional Chinese medicine and Western medicine and coordinated development,strengthen the academic exchanges and cooperation of Chinese and Western medicine in the field of preventing and controlling gout,and cultivate the high-caliber young clinical talents,the China Association of Chinese Medicine(CACM)organized the 48th Salon on Clinical Advantageous Diseases in Beijing on 21 March 2025,focusing on the combined Chinese and Western medicine diagnosis and treatment strategy of gout,bringing together experts in Chinese and Western medicine and interdisciplinary fields,and reaching specific recommendations and consensus on the combined Chinese and Western medicine diagnosis and treatment of gout through in-depth discussion.On this basis,under the leadership of the CACM,gout diagnosis and treatment problems were analyzed from the perspective of gout occurrence and development law,focusing on the advantages and characteristics of Chinese medicine and combined Chinese and Western medicine in gout diagnosis and treatment,and proposing scientific research and technological layout of gout in the following aspects:(1)Improvement of gout staging and identification system,(2)optimization of Chinese medicine to prevent and treat gout and drug research and development,(3)improvement of indicators for post-treatment assessment of gout,(4)research on early warning system of Chinese and Western medicine,(5)construction of gout co-morbidities spectrum and Chinese medicine theoretical system,(6)research on co-morbidities mechanism of gout,(7)chronic disease grassroots health management,and at the same time,it also puts forward the proposed layout and direction of the research,the expected goal and value and the priority of the proposed funding.Therefore,this article is based on the gout Chinese medicine advantageous disease series salon,proposed gout scientific and technological research paradigm,in order to help the high-quality development of traditional Chinese medicine.

BACKGROUND:The study was designed to systematically evaluate the efficacy and safety of Fuzheng-Buyi formula in treating castration-resistant prostate cancer (CRPC). METHODS:A computer-based search were conducted in the databases, including CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, and the Cochrane database to identify all randomized controlled trials. The studies investigating the efficacy and safety of Fuzheng-Buyi formula combined with Western medicine for the treatment of CRPC were included from January 1st, 2010 to December 31st, 2023. The quality of the included studies was evaluated according to the Cochrane Handbook manual, and meta-analysis was performed using Review Manager 5.3 and R Studio 4.2.3 software. RESULTS:In this study, a total of 18 trials were included, encompassing a population of 1093 patients diagnosed with CRPC. The results of the meta-analysis showed that the combination of Fuzheng-Buyi formula and Western drugs was more effective in increasing the overall efficacy rate (risk ratio = 1.31, 95% confidence interval [CI] [1.17, 1.46], P < .00001), decreasing Traditional Chinese Medicine syndrome score (mean difference [MD] = -4.40, 95% CI [-6.10, -2.70], P < .00001), and quality of life scale (physiological condition MD = -2.31, 95% CI [-3.13, -1.48], P < .00001; social well-being MD = 1.26, 95% CI [0. 59, 1.94], P = .0002; emotional well-being MD = -2.04, 95% CI [-2.96, -1.12], P < .00001; functional well-being MD = -3.18, 95% CI [2.11, 4.26], P < .00001; others should be paid to MD = -3.15, 95% CI [-4.93, -1.37], P = .0005) compared with the Western medicine alone. And the incidence of adverse events was significantly lower in the combination treatment group compared with Western medicine group (risk ratio = 0.58, 95% CI [0.46, 0.73], P < .00001). CONCLUSION:The combination of Fuzheng-Buyi formula and Western medicine was more effective in improving the clinical efficacy and quality of life of CRPC patients, with lower incidence of adverse events compared with Western medicine alone.

Abstract Aims Growing clinical evidence suggests that not all patients with rheumatoid arthritis (RA) benefit to the same extent by treatment with tripterygium glycoside (TG), which highlights the need to identify RA‐related genes that can be used to predict drug responses. In addition, single genes as markers of RA are not sufficiently accurate for use as predictors. Therefore, there is a need to identify paired expression genes that can serve as biomarkers for predicting the therapeutic effects of TG tablets in RA. Methods A total of 17 pairs of co‐expressed genes were identified as candidates for predicting an RA patient's response to TG therapy, and genes involved in the Lnc‐ENST00000602558/GF1 axis were selected for that purpose. A partial‐least‐squares (PLS)‐based model was constructed based on the expression levels of Lnc‐ENST00000602558/IGF1 in peripheral blood. The model showed high efficiency for predicting an RA patient's response to TG tablets. Results Our data confirmed that genes co‐expressed in the Lnc‐ENST00000602558/IGF1 axis mediate the efficacy of TG in RA treatment, reduce tumor necrosis factor‐α induced IGF1 expression, and decrease the inflammatory response of MH7a cells. Conclusion We found that genes expressed in the Lnc‐ENST00000602558/IGF1 axis may be useful for identifying RA patients who will not respond to TG treatment. Our findings provide a rationale for the individualized treatment of RA in clinical settings.

风湿免疫疾病是导致关节疼痛、功能障碍的重要原因,严重影响患者身体健康及生活质量.目前认为其发病机制与自主神经,尤其是迷走神经介导的免疫炎症反应关系密切.迷走神经刺激术(vagus nerve stimulation,VNS)是众所周知的激活神经调节系统的有效且安全的方法,2011年开始被用于治疗风湿免疫疾病中的纤维肌痛综合征,后又用于辅助治疗类风湿关节炎、系统性红斑狼疮及风湿性多肌痛.根据在Pubmed中检索到的VNS治疗风湿免疫疾病相关的所有文献,我们观察到,VNS能够将甲氨蝶呤治疗失败的类风湿关节炎患者美国风湿病学院病情改善20%达标率提高至70.0%～71.4%;在纤维肌痛综合征患者疼痛缓解率为58.34%～100%;在系统性红斑狼疮及风湿性多肌痛患者中也能够明显缓解关节疼痛、疲乏等不适.在安全性方面,所有文献中仅有1例患者出现颈部疼痛无法耐受植入型VNS,其余均未报道严重不良反应,常见的不良反应有变声、伤口感染、局部疼痛等.目前的研究结果提示VNS在风湿免疫疾病的治疗中是较新的尝试,同时表明VNS在风湿免疫疾病治疗中具有良好的应用前景和独特的优势.

目的 系统评价针刺治疗干燥综合征的临床疗效.方法 计算机检索针刺治疗干燥综合征随机对照试验文献,检索时限为各数据库建库至2022 年3 月1 日,使用RevMan 5.4 进行Meta分析.结果 共纳入10 篇文献,包括725 例患者.结果 表明相较常规治疗方法,针刺可提高临床总有效率,增加唾液流率、Schirmer试验差异具有统计学意义(P<0.05);2 组ESSRPI差异无统计学意义(P>0.05).结论 针刺治疗干燥综合征患者临床疗效较好,未来需要大样本、多中心的随机对照试验进一步验证.

Objective: In the treatment of acute gouty arthritis（AGA）, western medicine is mostly used for anti-inflammatory and analgesic purposes to control the blood uric acid level, but some patients are still at risk of poor control and recurrent attacks. Chinese medicinal prescriptions, potent in resisting inflammation and relieving pain, are able to stabilize the blood uric acid level, reduce acute attacks, and improve the clinical efficacy of western medicine. However, there is a lack of evidence to support their use as evidence-based medicine. This study employed network Meta-analysis（NMA） to evaluate the efficacy and safety of common Chinese medicinal prescriptions in the treatment of AGA, aiming to provide evidence-based medical evidence for the clinical use of Chinese medicinal prescriptions in the treatment of AGA. Method: Chinese and English databases were searched for prospective cohort studies and randomized controlled trials（RCTs） on Chinese medicinal prescriptions against AGA from database inception to December 1, 2022. Stata software and Review Manager were used for statistical analysis. Result: Forty-four papers with 3 564 cases involved were included in the current NMA. In terms of reducing blood uric acid, the cumulative probability results showed that Mahuang Lianyao Chixiaodou Tang showed optimal efficacy（87.60%）. In terms of relieving joint pain, Danggui Niantongtang and Guizhi Shaoyao Zhimutang showed optimal efficacy（92.00% and 82.30%）. In terms of improving erythrocyte sedimentation rate（ESR）, Simiaowan was superior to other prescriptions（87.00%）. In terms of reducing C-reactive protein（CRP）, Simiaowan and Baihutang modified with Guizhitang showed superior efficacy（76.00% and 66.10%）. In terms of safety, except for the basic treatment group, Mahuang Lianyao Chixiaodou Tang had the lowest probability of adverse events, and Danggui Niantongtang had the highest probability of adverse reactions during treatment. According to the results of cluster analysis, Mahuang Lianyao Chixiaodou Tang and Simiaowan are effective and safe. Conclusion: According to the results of NMA, Chinese medicinal prescriptions can assist in the treatment of AGA and improve the effectiveness of western medicine. For patients with AGA, clinicians can choose Mahuang Lianyao Chixiaodou Tang or Simiaowan as an auxiliary drug for routine western medicine treatment.