Systemic lupus erythematosus (SLE) is a highly heterogeneous systemic autoimmune disease characterized by multi-organ involvement, recurrent flares, and chronic progression. With advances in diagnostics and therapeutics, SLE management is shifting from disease control toward long-term remission and organ protection. Incorporating recent global evidence and characteristics of the Chinese population, the National Clinical Research Center for Dermatologic and Immunologic Diseases and the Chinese SLE Treatment and Research Group (CSTAR) have developed the Chinese guidelines for the diagnosis and treatment of systemic lupus erythematosus (2025 edition). Centered on a treat-to-target strategy, the guidelines prioritize clinical remission and low disease activity as primary goals, optimizing the use of glucocorticoids, immunosuppressants, biologics, and novel therapies. Key updates include individualized management recommendations for lupus nephritis, multi-organ involvement, and antiphospholipid syndrome, alongside first-ever evidence-based recommendations on vaccination in SLE patients. By integrating large-scale domestic cohort studies and real-world data, this edition provides more precise and actionable guidance, offering significant value for standardizing and improving SLE diagnosis, treatment, and long-term management in China.

Objective To explore the association between disease activity and health utility values(HUV)in patients with rheumatoid arthritis(RA)in China,and to analyze other factors that may affect health utility values,providing a basis for individualized treatment and health management for RA patients.Methods Based on the Chinese Registry of Rheumatoid arthritis cohort,this study included 1 017 diagnosed RA patients.The EQ-5D-3L scale was used to assess the health utility values,while clinical data,disease activity,and potential influencing fac-tors(such as age,gender,and comorbidities)were collected.Tobit regression models were employed to analyze the association between disease activity and health utility values,and to investigate other potential influencing factors.Results The median health utility value for RA patients was 0.78[0.59,0.89].Patients with moderate to high dis-ease activity had significantly lower health utility values as compared to those in remission phase or with low disease activity(median 0.70 vs.0.87,P＜0.001).Tobit regression analysis showed a significant association between disease activity and health utility values(P＜0.001).Additionally,older age,female gender,use of glucocorticoids,and co-morbidity with diabetes were associated with lower health utility values(P＜0.05).Conclusions Health utility values of RA patients are closely related to disease activity,with higher disease activity leading to a significant reduction in health utility values.Early control of RA disease activity may help improve patients' quality of life.

Objective To establish a multi-state Markov model of systemic lupus erythematosus(SLE)for patients in China and to explore the transition rule of organ damage accumulation and possible factors affecting the transition between states.Methods A retrospective cohort study was conducted using the data from CSTAR.The Systemic Lu-pus International Collaborating Clinics/American College of Rheumatology Damage Index(SDI)was divided into five irreversible disease states(SDI=0,1,2,≥3,and death,marked as S0,S1,S2,S3,Death).The R"mstate"package was used for statistical analysis.Results This study included 23 926 cases of SLE patients with cumulative follow-up of 12 030 visits.Among these patients,21 070 patients had no any organ damage at baseline.At the follow-up period,the transition probabilities of organ damage of S0→S1,S1→S2,S2→S3,S3→Death were 7.01％,12.58％,10.64％,and 12.19％,respectively.The multi-state Markov model showed that age,gender,disease dura-tion,SLEDAI score,corticosteroid dosage,and involvement of major organs were associated with the transition of or-gan damage status,each 1 year increased was associated with a 2％～3％increase in risk of damage accumulation risk(P＜0.01).Also,neurological(S0→S 1:HR=1.34;S1 →S2:HR=1.53;S2→S3:HR=1.73),cardiopulmonary(S0→S1:HR=3.66;S 1→S2:HR=1.51;S2→S3:HR=1.52),renal(S0→S 1:HR=1.24)and hematological involvement(S0→S1:HR=1.24)might be the risk factors.Conclusions The probability of organ damage accumulation in SLE pa-tients increases over time.Therefore,in the early stage of the disease,the involvement of important organs needs to be minimized and the treatment strategy should be dynamically adjusted at different stages of treatment.

To identify factors associated with the recurrence of polymyalgia rheumatica(PMR) within one year.

【Objective】 To investigate the current situation of social anxiety in children with attention deficit hyperactivity disorder (ADHD), and to analyze the factors influencing social anxiety in ADHD children, in order to provide reference for improving the clinical management of ADHD children. 【Methods】 A total of 206 school-age children with ADHD were selected from the Children′s Psychology Clinic of Mianyang Central Hospital from January 2020 to January 2023. The relevant clinical data of the children were collected through the general data questionnaire. Children′s Social Anxiety Scale (SASC) was used to assess social anxiety, and the Social Response Scale (SRS) was used to assess social ability. The Chinese version of Swanson,Nolan and Pelham Rating Scale Ⅳ (SNAP-Ⅳ) was used to assess core symptoms. Multivariate Logistic regression analysis was used to determine influencing factors of social anxiety in children with ADHD. 【Results】 There were 128(62.14%) cases detected with social anxiety among 206 children with ADHD. The score of SASC was 14.02±4.06. The proportions of girls (χ²=6.057), comorbid autism spectrum disorder(ASD) (χ²=4.929), and main caregivers with junior high school education or below (χ²=13.345), the total score of SRS(t=5.842) and SNAP-Ⅳ(t=7.848) and the scores of all dimensions were significantly higher than those in the non-anxious group (P<0.05). Multivariate Logistic regression analysis showed that higher SRS total score(OR=5.217, 95%CI: 2.309 - 11.791), higher SNAP-Ⅳ total score(OR=4.150, 95%CI: 1.974 - 8.722), girls(OR=2.268, 95%CI: 1.423 - 3.616), primary caregivers with junior high school education or below (OR=1.527, 95%CI: 1.162 - 2.005), and comorbid ASD (OR=1.551, 95%CI: 1.209 - 1.990) were risk factors for social anxiety in ADHD children (P<0.05). 【Conclusions】 Children with ADHD have a higher prevalence rate of social anxiety. Cognitive behavioral therapy and psychological intervention should be strengthened for high-risk children to improve social ability and reduce the risk of social anxiety.

Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

Objective:To analyze the relationship between the level of erythrocyte sedimentation rate (ESR) and clinical manifestations, and to discuss the clinical significance of ESR in patients with SSc.Methods:Patients with SSc registered in Peking Union Medical College Hospital from January 2009 and May 2022 in the database of National Rheumatism Data Center (CRDC) were included. All patients fulfilled the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for SSc. The clinical features and laboratory tests were analyzed. T test was used for analyzing the mea-surement data with normal distribution, and the results were expressed as mean±SD deviation. Wilcoxon signed-rank test or Wilcoxon rank sum test were used to analyze the measurement data that did not conform to normal distribution. The results were expressed as M ( Q1, Q3). The count data were compared with Chisquare test or Fisher's exact test. Binary logistic regression analysiswas used to analyze independent variables. P val-ue<0.05 was considered to be statistically significant. Results:A total of 308 SSc patients were enrolled in the single center of Peking Union Medical College Hospital, including 280 females (90.9%), with the average age of (47 ±12) years old. SSc patients with elevated ESR combined woth anemia were more common. Compared with normal ESR group, elevated ESR group had higher incidence of pulmonary interstitial disease (80.8% vs. 67.6%, χ2=5.89, P=0.015), pulmonary hypertension (31.7% vs. 21.1%, χ2=4.20, P=0.040) and myositis(26.9% vs. 15.7%, χ2=5.54, P=0.019). In laboratory tests, anemia is highly frequent in SSc patients with increased ESR. The increase in CK, hs-CRP, IgA and IgG were more common, and the val-ues of IgA and IgG were sta-tistically higher. In antibody tests, anti-dsDNA antibody, anti-RNP antibody, anti-SSA and anti-SSB antibodies positivity were higher, and anti-Scl70 antibody positivity was less common ( P<0.05). Multivariate regression analysis indicated elevated IgG [ B=1.733, OR(95% CI)=5.657(2.839, 11.272), P<0.001], anemia [ B=1.083, OR(95% CI)=2.952(1.376, 6.333), P=0.005)], positive anti-SSA antibody [ B=1.665, OR(95% CI)=5.287 (2.367, 11.809), P<0.001] were independent factors for SSc patients with elevated ESR are more common. IgG and positive anti-SSA antibody were strong risk factor for increased ESR. Conclusion:SSc patients with elevated ESR are more commonl with anemia, elevated IgG and positive anti-SSA anti-body, which may be related to disease activity. Long-term follow-up for these patients is helpful to guide clini-cal doctors′ treatment choices.

Connective tissue diseases(CTD)are a spectrum of heterogeneous diseases with multiple organ involvements.Interstitial lung diseases(ILD)are serious complications of CTD.There is great heterogeneity in pathogenesis,clinical manifestations,and treatment of different CTD-ILD.Previous basic and clinical studies have explored the pathogenesis of CTD-ILD,and the"dual-target"treatment strategy has therefore emerged.The implementation of the"dual-target"treatment strategy helps to control CTD activity and lung inflammation in the early stage,prevent the progression of pulmonary fibrosis,and thus improve patient survival and quality of life.

Spondyloarthritis (SpA) is a group of chronic inflammatory diseases which predominantly involve spine and/or peripheral joints. SpA can be disabling and seriously affect the quality of life and function of patients. With the increasing clinical use of targeted drug therapy, precise and standardized use becomes the focus. China's first Consensus on Targeted Drug Therapy for Spondyloarthritis was developed by National Clinical Research Center for Dermatologic and Immunologic Diseases using international norms for consensus development. The consensus addresses 13 important clinical questions, ranging from principles, patient eligibility, pre-treatment screening, treatment initiation, drug selection and switch, co-medication, to adverse event monitoring of targeted drug therapy in SpA, and recommends treatment for specific patients, playing a key role in guiding clinical practices.