Objective To investigate the clinical characteristics of systemic lupus erythematosus (SLE) and the situation of diagnosis after onset. Methods Three hundred outpatients diagnosed with SLE were investigated in the People's Hospital, the Third Hospital of Peking University, Xinjiang People's Hospital and the Affiliated Hospital from May to July 2008, including gender, age of onset, clinical manifestations and the site of first hospitalization. Results ① In the cross-sectional study, 300 SLE patients were investigated. The male-to-female ratio was 1:13. ② The most common manifestations at onset were arthritis (46.3%), rash (34.%) and fever (32.7%). Lupus nephritis was found to occur in a significantly higher frequency in male patients than female as the initial manifestation. 60.9% patients had lupus nephritis in the first year after onset. ③ 99.1% of the patients were correctly diagnosed after visiting rheumatologists. 23.7% of the SLE patients were not correctly diagnosed for more than one year after disease onset. Conclusion Arthritis, rash and fever are the most common initial clinical manifestations of SLE. Lupus nephritis is more commonly seen in male SLE patients than female at the disease onset. The diagnosis of lupus is delayed in certain proportion of patients.

Objective:To investigate the effects of metformin (MF) and vibration intervention on the improvement of bone mineral density (BMD) and glucose metabolism in diabetic rats with osteoporosis (DOP) .Methods:In this study, 125 rats were purchased, 100 rat models of diabetic osteoporosis were selected according to the random number table sampling method, and 100 rats were tested for modeling. According to the principle of random grouping, the rats successfully modeled were divided into model control groups (group MC) , metformin group (group MF) , vibration group (group V) , metformin + vibration group (group MV) . Normally fed 25 rats were blank control group (group C) . Rats in each group were treated for 20 weeks of intervention according to their own protocols. After the intervention, various samples were collected from rats in each group for BMD testing and HOME-IR testing.Results:Compared with the pre-measured BMD value of group C, the pre-measured BMD of group MC, group MF, group V and group MV were significantly reduced, respectively 0.21±0.03, 0.20±0.04, 0.20±0.03, 0.19±0.05 (g/cm 2) , P<0.05, indicating that the DOP model was successfully constructed. After 20 weeks of intervention, the BMD values of group MF, group V, and group MV were respectively 0.23±0.07, 0.24±0.05, 0.27±0.01 (g/cm 2) , significantly higher than the pre-measured value and the post-measured value of group MC, P<0.05. Comparing the changes in bone metabolism after the intervention of the patients, it was found that HOP of group MF, group V, and group MV after the intervention were 17.07±2.33, 16.95±4.22, and 15.43±3.75 (mg/g) respectively; DPD of group MF, group V and group MV were 3.26±0.09, 3.13±0.10, 2.95±0.10 (mmol/L) , respectively; The TRACP of the MF group, the V group and the MV group were 152.51±10.89, 149.67±11.05, and 143.90±10.67 (μg/L) respectively; The bone metabolism indexes of the patients were significantly lower than the pre-measured values and the post-measured values of the MC group, P<0.05. Comparing the glucose metabolism and insulin sensitivity of the patients after the intervention, it was found that FPG of group MF, group V, and group MV after the intervention were 15.32±4.98, 16.34±5.76, 19.76±5.71 (mmol/L) respectively. The FINS of group MF, group V and group MV were 25.46±6.21, 27.92±5.33, 29.85±7.22 (mmol/L) respectively. The HOME-IR of group MF, group V, and group MV were 17.39±1.37, 20.27±1.36, 26.81±1.83 (mmol/L) respectively, and all the indexes were significantly lower than those of group MC, P<0.05. Conclusion:This study believes that metformin and vibration intervention can significantly reduce blood glucose and relieve symptoms in diabetic rats with osteoporosis Insulin sensitivity, reduce bone loss, increase bone density.

Objective To establish new classification criteria for early rheumatoid arthritis (E-RA) based on large samples of early inflammatory arthritis patients and to evaluate the value of this criteria in China.Methods Patients who had arthritic complaints with disease duration less than one year were enrolled.They were divided into RA group and non-RA group according to the clinical diagnosis by experienced rheumatologists.The clinical and laboratory parameters were analyzed and those with high sensitivity or specificity were selected as the new classification criteria.Statistical analysis was carried out by using t test,x2 test and Logistic regression.Results ① A total of 803 patients with early inflammatory arthritis were included in this study.Five hundreds and fourteen patients were diagnosed as early RA and 251 were diagnosed as other rheumatic diseases,and the diagnosis of 38 patients remained unestablished by the end of follow-up.② New E-RA classification criteria were established based on the parameters with high sensitivity and/or specificity.The sensitivity of the new E-RA criteria was 84.4％,which was higher than 1987 ACR criteria (58.0％),while the corresponding specificities were similar,which were 87.4％ and 93.6％ respectively.③ Compared with the complex scoring system of 2010 ACR/EULAR criteria,the E-RA criteria was more simple and practical.The diagnostic sensitivity and specificity of E-RA criteria were higher than those of 2010 ACR/EULAR criteria reported in the literatures.④ New classification criteria based on scoring system using Logistic regression analysis was established.The sensitivity of this criteria was 86.4％,which was higher than 1987 ACR criteria (58.0％).Conclusion The diagnostic value of the E-RA criteria developed in this study for early RA is better than 1987 ACR criteria,and is more simple than 2010 ACR/EULAR criteria.It may be used as a new classification criteria for early RA diagnosis.

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.

ObjectiveTo examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis(RA) in China.MethodsSix hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the mostfrequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender(OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints(OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36(OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.ConclusionThe incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.