Objective. Acupuncture has been used by rehabilitation specialists as an adjunctive treatment for the symptomatic treatment of rheumatoid arthritis (RA). This meta-analysis aims to evaluate the efficacy of acupuncture in treating patients with RA. Methods. A comprehensive search was conducted in CBM, CNKI, PubMed, CENTRAL, Web of Science, and Embase from their inception up to March 2022. All randomized controlled trials (RCTs) without the language restriction, concerning the patients with RA treated with acupuncture, were included. Two reviewers independently assessed the risk of bias with the Cochrane Risk of Bias Assessment tool. Weight mean difference (MD) and 95% CI were calculated, and data were pooled with random effects model. Results. A total of eleven RCTs involving 796 patients with RA met the established inclusion criteria. This systematic review indicated the efficacy of acupuncture as an adjunctive treatment for patients with RA. Invasive acupuncture could reduce significantly in pain (MD = -1.00, 95% CI: −1.96 to −0.05, ), health assessment questionnaire (HAQ, MD = −0.20, 95% CI: −0.30 to −0.11, ), physician global assessment (PhGA, MD = −0.98, 95% CI: −1.23 to −0.72, ), tender joint count (TJC, MD = −1.24, 95% CI: −2.11 to −0.37, ), C-reactive protein (CRP, MD = −1.81, 95% CI: −3.32 to −0.29, ), and erythrocyte sedimentation rate (ESR, MD = −3.03, 95% CI: −5.80 to −0.26, ), while compared to control group. Laser acupuncture could reduce HAQ (MD = −0.15, 95% CI: −0.28 to −0.01, ), the RA quality of life questionnaire (RAQoL, MD = −2.32, 95% CI: −4.40 to −0.25, ), CRP (MD = −35.24, 95% CI: −36.49 to −33.99, ), and interleukin-6 (IL-6, MD = −29.63, 95% CI: −49.34 to −9.92, ), while compared to control group. No adverse events associated with acupuncture were reported. Conclusion. Available evidence suggests that acupuncture is beneficial for relieving pain and ameliorating quality of life and health index in patients with RA; thereby, it should be available as an adjunctive nonpharmacological treatment in rehabilitation programmes.

To determine the effects of ankylosing spondylitis (AS)-associated hip damages on the outcome measurements after total hip arthroplasty (THA). The medical records of 122 patients with AS (181 hips) who underwent THA were retrospectively reviewed. The mean follow-up was 43.9 (32–129) months. The types and degrees of hip damages were evaluated by preoperative hip X-rays. The patients were grouped according to the satisfaction degree after the operation. Univariable and multivariable statistical analyses were conducted. The intraclass correlation coefficients for the assessment between the 2 reviewers in the study were 0.86 to 0.97. Cox regression showed that femoral head erosion severity had an effect on the recovery time of independent walking without crutches postoperatively (odds ratio = 1.467, 95% confidence interval: 1.050–2.409, P = .025). The mean time to recover independent walking in the severe femoral head erosion group was 7.3 ± 0.9 weeks, which was 4.6 ± 0.4 weeks longer than in the non-severe femoral head erosion group, as confirmed by the log-rank (Mantel–Cox) test (Chi-squared = 11.684, P = .001). The multivariable analysis showed that higher acetabular sclerosis scores correlated with lower postoperative dissatisfaction risk (odds ratio = 0.322, 95% confidence interval: 0.136–0.764). The multiple linear regression analysis showed that postoperative range of motion (ROM) improvement was affected by preoperative ROM of the hip, space narrowing degree, and ceramic-ceramic material for the weight-bearing surface (F = 179.81, P < .001), with preoperative ROM of the hip having the greatest impact. Severe femoral head erosion prolongs the recovery time of independent walking after THA. Acetabular sclerosis is not associated with poor outcomes in patients with AS-associated hip damage undergoing THA.

BACKGROUND:Limited clinical data are available on bone loss in ankylosing spondylitis (AS) patients with hip involvement, especially for bone strength. The purpose of this study was to analyze bone strength and bone turnover markers in AS patients with hip involvement. MATERIAL AND METHODS:The stiffness index (SI) calculated by quantitative ultrasound (QUS) was used to compare the bone strength between patients with AS with radiographic hip involvement (RHI-AS, BASRI-hip ≥2) and those without radiographic hip involvement (WORHI-AS, BASRI-hip ≤1). The Spearman correlation test was used to evaluate the association between SI and bone turnover markers [TP1NP, OC, ß-CTx, 25(OH)VD3, and PTH]. RESULTS:RHI-AS (BASRI-hip ≥2) patients accounted for 52.2% (177/339) of all patients. There was no significant difference in most of the basic clinical features between RHI-AS and WORHI-AS patients, except for age and BMI. After adjusting for confounding factors (age and BMI), the stiffness index (SI) of RHI-AS patients was significantly lower than that of WORHI-AS patients (ORadj=0.982, 95% CIadj=0.968~0.997, Padj=0.017). The Z scores calculated by SI were lower in RHI-AS patients (ORadj=0.802, 95% CIadj=0.679~0.949, Padj=0.01). Among the 5 bone turnover markers in the RHI-AS patients, only 25(OH)VD3 had a correlation with SI (rho=0.279, P=0.001). CONCLUSIONS:AS patients have lower bone strength once the disease progresses to include radiologic hip involvement. Treatment of vitamin D deficiency may be an effective way to improve bone strength in AS patients with hip involvement.

Previous studies have suggested that gamma oT cells play an important role in the pathogenesis of ankylosing spondylitis (AS). In this pilot study, the peripheral blood mononuclear cells (PBMCs) of patients with ankylosing spondylitis (AS) and healthy volunteers were stained and analyzed by flow cytometry to distinguish gamma o T cells and its subtypes, and then to report the distribution of gamma o T cells and iyts subtypes and their correlation with ankylosing spondylitis. A total of 17 patients with active AS and 10 age-and gender matched healthy volunteers were enrolled in this study, and their peripheral blood were drawn to collect mononuclear cells (PBMCs). Flow cytometry was used to analyze gamma o T cell subpopulations by measuring the surface and intracellular expressions of phenotypic markers. Serum levels of inflammatory and bone turnover markers were measured, and their correlations with subpopulations of gamma o T cells were evaluated. In patients with AS, the Vo2 fractions within gamma o T cells and CD3* T cells decreased significantly, in particular, the proportions of CD27* Vo2 T cells, CD86*CD80* Vo1 T cells, and IL17A-secreting and TNF alpha-secreting Vo1 T cells within the parental cells decreased significantly. gamma o T cells/PBMCs, Vo2 cells/gamma o T cells, and Vo2 cells/CD3* T cells were negatively correlated with CRP, whereas Vo1 cells/CD3* T cells were negatively correlated with ESR. Vo1 cells/gamma o T cells were positively correlated with CRP, gamma o T cells/PBMCs were positively correlated with beta-CTx, CD69*CD25* and IL-17A-secreting Vo1 cells were positively correlated with TP1NP, and CD69*CD25* Vo1 and Vo2 cells were positively correlated with osteocalcin. Decreases in peripheral Vo2, CD27* Vo2, CD86*CD80* Vo1, and IL17A or TNF alpha secreting Vo1 T cells are associated with AS. The correlations between gamma o T cell subpopulations and CRP and the CD69*CD25* subpopulation with TP1NP or osteocalcin suggest that an imbalance in peripheral gamma o T cell subpopulations contributes to the pathogenesis of AS.

Background: Musculoskeletal ultrasound is used in clinical practice to evaluate gout patients and is an effective imaging tool for the detection of tophi. The aim of this study was to analyze the factors associated with ultrasound‐detected tophi in gout patients and to construct a clinical model to predict its occurrence and improve the detection of hidden tophi.Methods: Data of gout patients admitted to Beijing Jishuitan Hospital from January 2015 to December 2021 were collected. The complete and detailed information from gout cases with completed musculoskeletal ultrasound was included in the analysis. Univariate and multivariate analyses were used to identify independent factors associated with ultrasound‐detected tophi. A nomogram was used to visualize the clinical predictive models.Results: Among 517 gout patients, rheumatologists found that 67 patients (13.0%) had subcutaneous tophi by visual observation, while musculoskeletal ultrasound revealed that 123 patients (23.8%) had ultrasound‐detected tophi with odds ratio [OR] (95% confidence intervals [CIs]) = 2.20 (1.81–2.67). Disease duration, upper limb joint flare (ULJF), persistent joint pain (PJP), uric acid, and homocysteine levels were independently associated with ultrasound‐detected tophi, and they had ORs (95% CIs) of 1.092 (1.050–1.136), 3.732 (2.312–6.025), 1.864 (1.086–3.200), 1.003 (1.001–1.004), and 1.015 (1.000–1.030), respectively. After balancing the complexity and accuracy of the model, Model 2 (incorporating disease duration, ULJF, PJP, and uric acid) was chosen to create a nomogram to predict the occurrence of ultrasound‐detected tophi. The nomogram had good discrimination (consistency index [C‐index] = 0.774) and excellent calibration, demonstrated by calibration curves.Conclusion: Using easily available indicators, such as disease duration, the nature of the joint pain, and uric acid levels, we successfully developed an easy‐to‐use clinical model to improve the detection of hidden tophi.