Brain Source Localization and Functional Connectivity in Group Identity Regulation of Overbidding in Contest.

Contests may be highly effective in eliciting high levels of effort, but they also carry the risk of inefficient resource allocation due to excessive effort (overbidding), squandering valuable social resources. While a growing body of research has focused on how group identity exacerbates out-group conflict, its influence on in-group conflict remains relatively unexplored. This study endeavors to explore the impact of group identity on conflicts within and between groups in competitive environments, thereby addressing gaps in the current research landscape and dissecting the involved neurobiological mechanisms. By employing source localization and functional connectivity techniques, our research aims to identify the brain regions involved in competitive decision-making and group identity processes, as well as the functional connectivities between social brain areas. The results of our investigation revealed that participants exhibited activation in the bilateral frontal and prefrontal lobes during the bidding behavior before the group identity task. Subsequently, after the task, additional activation was observed in the right temporal lobe. Results from functional connectivity studies indicated that group identity tasks modify decision-making processes by promoting group norms, empathy, and blurred self-other boundaries for in-group decisions, while out-group decisions after the group identity task see heightened cognitive control, an increased dependence on rational judgment, introspection of self-environment relationships, and a greater focus on anticipating others' behaviors. This study reveals the widespread occurrence of overbidding behavior and demonstrates the role of group identity in mitigating this phenomenon, concurrently providing a comprehensive analysis of the underlying neural mechanisms.

Group membership modulates the hold-up problem: an event-related potentials and oscillations study.

This paper investigates the neural mechanism that underlies the effect of group identity on hold-up problems. The behavioral results indicated that the investment rate among members of the in-group was significantly higher than that of the out-group. In comparison to the NoChat treatment, the Chat treatment resulted in significantly lower offers for both in-group and out-group members. The event-related potentials (ERP) results demonstrated the presence of a distinct N2 component in the frontal midline of the brain when investment decisions were made for both in-group and out-group members. During the offer decision-making stage, the P3 peak amplitude was significantly larger when interacting with in-group members compared to the out-group members. The event-related potentials oscillations (ERO) results indicated that when investment decisions were made for in-group members in the NoChat treatment, the beta band (18-28 Hz, 250-350 ms) power was more pronounced than when decisions were made for out-group members. In the NoChat treatment, offer decisions for in-group members yielded a more pronounced difference in beta band (15-20 Hz, 200-300 ms) power when compared to out-group members. Evidence from this study suggests that group identity can reduce the hold-up problem and corroborates the neural basis of group identity.

Group identity modulates bidding behavior in repeated lottery contest: neural signatures from event-related potentials and electroencephalography oscillations.

A contest usually involves expenditures, termed "overbidding," exceeding the theoretical Nash equilibrium. A considerable number of studies have shown that group identity can affect decision-making and competitive behavior, thus providing a new perspective on alleviating the overbidding problem. How group identity influences brain activity when competitors bid in different groups is not yet clear, however. In this study, we implemented group identity manipulation into the lottery contest game and we recorded behavioral and electroencephalography (EEG) data at the same time. Two experimental treatments were conducted to study the effect of group identity on bidding behavior. The event-related potentials (ERP) and event-related oscillations (ERO) techniques were utilized to explore brain activity differences caused by participants' different bidding behaviors under in-group and out-group conditions. Behavioral results showed that individual expenditure was significantly lower when bidding with in-group opponents than with out-group opponents. Analyses of EEG results revealed that compared to in-group conditions, greater N2 amplitudes and theta power were found under out-group conditions. To extend previous studies, we performed supplementary analysis to explore whether enhancement of group identity had effects on conflict alleviation. Behavioral results indicated that individual expenditure was significantly lower after enhancing group identity when bidding with in-group, and EEG results showed more negative N2 amplitudes, smaller P3 amplitudes and larger theta power after enhancing group identity. Collectively, these findings indicate that group identity modulated bidding behavior, and they provide insight into a mechanism to de-escalate group conflict by enhancing group identity.

Anodal tDCS over TPJ reduces bidding in Tullock contest: Implications for social decision-making.

Contests, as economic, political, and social interactions, can stimulate high levels of effort, but they can also lead to inefficient expenditure of effort (overbidding), resulting in the wastage of social resources. Prior studies have indicated that the temporoparietal junction (TPJ) is associated with overbidding and speculating on the intentions of others during contests. This study aimed to investigate the neural mechanisms of the TPJ in overbidding and to examine changes in bidding behavior after modulating TPJ activity using transcranial direct current stimulation (tDCS). The experiment randomly allocated participants into three groups, each receiving either anodal stimulation of the LTPJ/RTPJ or sham stimulation. Following the stimulation, the participants engaged in the Tullock rent-seeking game. Our results revealed that participants who received anodal stimulation of the LTPJ and RTPJ significantly reduced their bids compared to the sham group, possibly due to enhanced accuracy in guessing others' strategies or enhanced altruistic preferences. Moreover, our findings suggest that while both the LTPJ and RTPJ are associated with overbidding behavior, anodal tDCS targeting the RTPJ is more effective than stimulation of the LTPJ in decreasing overbidding. The aforementioned revelations offer proof of the neural mechanisms of the TPJ in overbidding and provide fresh substantiation for the neural mechanisms of social behavior.

Development of the Scientific, Transparent and Applicable Rankings (STAR) tool for clinical practice guidelines / 中华医学杂志(英文版)

BACKGROUND@#This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability.@*METHODS@#This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability.@*RESULTS@#STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min.@*CONCLUSION@#The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.

Comparative Analysis of Trends and Hotspots in Medical Ethics Research at Home and Abroad from 2012 to 2022 and Its Teaching Enlightenment / 中国医学伦理学

【Objective:】 To compare and analyze the trends and hotspots in the field of medical ethics at home and abroad, and explore their teaching enlightenment for medical ethics in China. 【Methods:】 The relevant papers indexed in CNKI and Web of Science database from December 31, 2011 to December 31, 2022 were retrieved with "medical ethics" as the key word. The bibliometric method was used to compare and analyze the research trends, keyword co-occurrence, and changes of research hotspots of medical ethics at home and abroad. 【Results:】 A total of 1,187 Chinese and English papers were included. Medical ethics education and bioethics were the common research topics both domestically and internationally. The research topics in China focused on ethical teaching and the ethical principles in clinical practice, and the research hotspots in the past two years were curriculum ideological and political education, teaching practice, etc. Foreign research focused on ethical issues in clinical practice, and in the past two years, the hotspots were clinical trial ethics, informed consent, and so on. 【Conclusion:】 Medical ethics research at home and abroad has different emphasis, with domestic research being theoretical oriented and foreign research being practical oriented. By deepening the content of courses, improving the sustainable education system, and strengthening interdisciplinary cooperation, the development of ethical education in China can be promoted. This paper can provide reference for improving the education system of medical ethics in China and pointing out the direction of further research on medical ethics.

Progress in magnetic resonance imaging study of anhedonia and suicidal behavior in depression / 中华行为医学与脑科学杂志

Many studies have found a correlation between suicidal behavior (SB) and anhedonia, the main symptom of depression, in terms of both psychological and neurophysiological findings. The purpose of this review is to find the relationship between the two neuroimaging mechanisms, and to provide help for the future study of how the brain imaging changes can promote the mechanism of SB in depression patients with anhedonia symptoms. This review also emphasizes the necessity of intervention for the symptoms of anhedonia when preventing depression from committing suicide. The latest research results were reviewed about anhedonia in depression and magnetic resonance imaging of SB.The results showed that the default network, insula, lateral orbitofrontal gyrus, anterior cingulate gyrus, ventral striatum gyrus, ventral lateral and dorsolateral prefrontal gyrus, thalamus and habenula nucleus were dysfunction in depression with state anhedonia symptoms, affecting SB in terms of mood, execution, reward and aversion processing, especially the low lethal SB.

CBCT analysis of condylar and occlusal plane features in skeletal Class Ⅲ malocclusion patients with mandibular asymmetry / 口腔医学

Objective@#To analyze the condylar and inclination of the occlusal plane features in skeletal Class Ⅲ malocclusion patients with mandibular asymmetry by using cone beam computed tomography(CBCT).@* Methods@#Forty eligible patients with Angle Class Ⅲ malocclusion were enrolled. All individuals were classified based on the distance from Me point to median sagittal plane. The left and right angles between OP and FH plane, the position and morphology of the condyle were measured in both groups.Then the data collected were statistically analyzed. @* Results@#Compared to the opposite side, there was a statistically significant difference(P<0.05) in angle between OP and FH plane, the anterior joint space, superior joint space, lateral joint space and condylar mediolateral diameter, with a higher proportion of joint posteriority in deviated side. Mandibular deviations were positively correlated with both the anterior joint space of the deviated side and the angle between OP and FH plane of the opposite side(P<0.01). There was no statistical difference between the left and right side of angles between OP and FH plane, the position and morphology of the condyle in skeletal Class Ⅲ patients without mandibular deviation(P>0.05); the joint was predominantly in anterior and middle position. @*Conclusion@#There is asymmetry on the left and right sides of the inclination ofocclusal plane, the position and morphology of the condyle of skeletal Class Ⅲ malocclusion patients with mandibular asymmetry. Compared with the opposite side, the deviated side has smaller angle between OP and FH plane and smaller condylar mediolateral diameter, and the condyle shows generally more posterior, inferior and inward movement in glenoid fossa. The inclination of the occlusal plane and the position of condyle are significantly and positively correlated with the distance from Me point to median sagittal plane.

Transcranial direct current stimulation of the LTPJ shifts the agent's behaviors in repeated hold-up game.

The Hold-up problem is very common in transactions with specific investment in incomplete contractual relationships, which is affected by human trusting, cooperative, altruistic behavior. Recent neuroscience studies have shown that TPJ plays an important role in social cognition and prosocial decision-making. However, most of the studies have focused on RTPJ in the right hemisphere, while few studies have focused on LTPJ in the left hemisphere. The purpose of this study is to modulate the excitability of LTPJ through transcranial direct current stimulation (tDCS) and to explore the effects of LTPJ on the investment and offer behavior of participants in the repeated hold-up game. Our results showed that cathodal stimulation significantly improved the investment rate of participants in the repeated hold-up game compared with sham stimulation. One possible explanation is that the change of LTPJ activity caused by cathodal stimulation may reduce the participants' inference ability of the others' intention, thus reducing the participants' betrayal aversion behavior, so that the participants will not reduce their investment behavior in the repeated game.

Cohort-specific serological recognition of SARS-CoV-2 variant RBD antigens

BackgroundEstimating the response of different cohorts (e.g. vaccinated or critically ill) to new SARS-CoV-2 variants is important to customize measures of control. Thus, our goal was to evaluate binding of antibodies from sera of infected and vaccinated people to different antigens expressed by SARS-CoV-2 variants. MethodsWe compared sera from vaccinated donors with sera from four patient/donor cohorts: critically ill patients admitted to an intensive care unit (split in sera collected between 2 and 7 days after admission and more than ten days later), a NIBSC/WHO reference panel of SARS-CoV-2 positive individuals, and ambulatory or hospitalized (but not critically ill) positive donors. Samples were tested with an anti-SARS-CoV-2 IgG serological assay designed with microplates coated with a SARS-CoV-2 RBD recombinant antigen. The same sample sets were also tested with microplates coated with antigens harbouring RBD mutations present in eleven of the most widespread variants. ResultsSera from vaccinated individuals exhibited higher antibody binding (P<0.001) than sera from infected (but not critically ill) individuals when tested against the WT and each of 11 variants RBD. The optical density generated by sera from non-critically ill convalescence individuals upon binding to variants antigens was different (P<0.05) from that of the WT in some variants--noteworthy, Beta, Gamma, Delta, and Delta Plus variants. ConclusionsUnderstanding differences in binding and neutralizing antibody titers against WT vs variant RBD antigens from different donor cohorts can help design variant-specific immunoassays and complement other diagnostic and clinical data to evaluate the epidemiology of new variants.

Influencing Factors and Humanistic Care Strategies of Treatment Compliance in Hospitalized Patients with Rheumatic Diseases / 中国医学伦理学

【Objective:】 To understand the status and influencing factors of treatment compliance in hospitalized patients with rheumatic diseases, and to provide the basis for formulating targeted measures to improve treatment compliance. 【Methods:】 From February 2021 to June 2021, a total of 488 hospitalized patients with rheumatic diseases in the First Affiliated Hospital of Xi’an Jiaotong University were selected as the research subjects by convenience sampling method. General information questionnaire and rheumatism treatment compliance questionnaire (CCQR) were used for cross-sectional investigation to analyze the influencing factors. 【Results:】 The CCQR score of hospitalized patients with rheumatic diseases was(71.52±11.43), of which 114(23.36%) patients scored ≥80 and 374(77.64%) patients scored<80. Patients with systemic lupus erythematosus had the highest CCQR score(73.14±11.37), and patients with ankylosing spondylitis had the lowest CCQR score (68.45±13.00). The results of multivariate analysis showed that gender, marital status, occupational status and family income were the main influencing factors of patients’ treatment compliance (P<0.05). 【Conclusions:】 The treatment compliance of hospitalized patients with rheumatic diseases is low, and its compliance is mainly affected by gender, marital status, occupational status and family income. Clinical medical staff should take effective intervention measures according to the specific situation of patients, implement humanistic care, and improve patients’ treatment compliance.

Risk factors and prognosis of frailty syndrome in elderly patients with acute coronary syndrome / 西安交通大学学报(医学版)

【Objective】 To investigate the risk factors of frailty syndrome in elderly patients with acute coronary syndrome （ACS） and their impact on prognosis. 【Methods】 The elderly patients with ACS aged 65 and over， who were hospitalized in the Department of Cardiology and Geriatric Cardiology of The First Affiliated Hospital of Xi’an Jiaotong University from September 2020 to February 2021， were selected in the cross-sectional survey. The patients were divided into frailty syndrome and non-frailty syndrome groups via the Chinese revised version of Tilburg Frailty Scale. We collected the patients’ activities of daily living， nutrition， depression， sleep quality， total cholesterol， triglycerides， low-density lipoprotein， and adverse events during hospitalization and within 30 days of discharge. We then performed LOG-BINOMIAL regression to analyze the risk factors of frailty syndrome. 【Results】 A total of 250 elderly ACS patients were enrolled， and 118 patients were diagnosed with frailty syndrome with 47.2% prevalence of frailty syndrome. There was a significant difference in the average score between the frailty syndrome group and the non-frailty syndrome group （11.06±2.53 vs. 5.77±1.54， P<0.01）. Multivariate regression analysis revealed that age （PR=2.01 CI： 1.81-2.22， P<0.001）， hypertension （PR=1.20 CI： 1.09-1.30， P<0.001）， chronic kidney disease （PR=1.16 CI：1.04-1.29， P=0.012）， and NT-proBNP （PR=1.20 CI： 1.07-1.35， P=0.004） were risk factors for frailty syndrome in elderly ACS patients. The incidence of arrhythmia and pulmonary infection during hospitalization and the rate of readmission within 30 days after discharge were significantly higher in the frailty syndrome group than those in the non-frailty syndrome group （P<0.05）. 【Conclusion】 There is a higher incidence of frailty syndrome in elderly patients with ACS. Older age， hypertension， chronic kidney disease and high NT-proBNP can increase the risk of frailty syndrome. In clinical practice， attention should be paid to the above factors， and reasonable intervention should be provided in time.

Modulating the activity of right temporo-parietal junction by anodal tDCS enhances the agent's repayment in hold-up game.

Hold-up problem is very common in non-contractible relation-specific investment transactions. And this problem can affect by trust, cooperation and altruism behavior of human beings. Recent neuroscience researches had explored a network of right temporo-parietal junction (rTPJ) involved in human cooperation and altruism behavior. The purpose of this study is to modulate the activation of rTPJ through transcranial direct current stimulation (tDCS), and to study the influence of rTPJ on investment and offer behavior in hold-up game. The results of our study showed that the anodal stimulation significantly increased participants' offer compared with the cathodal and sham stimulation. A possible explanation is that changes in rTPJ activity induced by anodal stimulation improve the accuracy of agents' mental reasoning and promote cooperation by influencing agents' offer behavior.

Single-center retrospective analysis of pathological spectrum and variation of 5 652 adult renal biopsies in Xinjiang Uygur Autonomous Region from 1986 to 2020 / 中华肾脏病杂志

Objective:To investigate the pathological spectrum and variation of adult renal biopsies in People's Hospital of Xinjiang Uygur Autonomous Region from 1986 to 2020.Methods:The pathological data of 5 652 adult renal biopsies from August 1986 to December 2020 were retrospectively collected, and characteristics of pathological spectrum were analyzed. Regarding every 5 years as a research stage, the whole period was divided into 7 stages to analyze the pathological features and variation of renal biopsies. The first stage (P1) started from August 1986 to December 1990. The second stage (P2) started from January 1991 to December 1995. The third stage (P3) started from January 1996 to December 2000. The fourth stage (P4) started from January 2001 to December 2005. The fifth stage (P5) started from January 2006 to December 2010. The sixth stage (P6) started from January 2011 to December 2015. The seventh stage (P7) started from January 2016 to December 2020.Results:The age was (36.47±14.86) years old (18-83 years old) in 5 652 renal biopsies. There were 2 961 males (52.39%). There were 5 636 cases of autologous kidney biopsy and 16 cases of transplanted kidney biopsy. The descending order of incidence classified by disease types were primary glomerular disease (PGD, 4 470 cases, 79.31%), secondary glomerular disease (SGD, 994 cases, 17.64%), tubular-interstitial disease (160 cases, 2.84%), and hereditary nephropathy (12 cases, 0.21%). IgA nephropathy (IgAN, 1 573 cases, 35.19%) was the most frequent pathologic type of PGD, followed by membranous nephropathy (MN, 1 028 cases, 23.00%), mesangial proliferative glomerulonephritis (MsPGN, 878 cases, 19.64%), minimal change disease (MCD, 427 cases, 9.55%), and focal segmental glomerulosclerosis (345 cases, 7.72%). Lupus nephritis (LN, 251 cases, 25.25%) was the most common type of SGD, followed by hypertension nephropathy (193 cases, 19.42%), diabetic kidney disease (168 cases, 16.90%), purpura nephritis (138 cases, 13.88%), and ischemic nephropathy (90 cases, 9.05%). IgAN was the most common type of primary glomerulonephritis and mainly occurred in the age group of 18-59 years old. PGD was the most common glomerular disease in Han nationality (78.33%), Uygur nationality (81.72%) and other ethnic (77.15%) groups. Using Bonferroni correction method, the incidence of PGD in Uygur nationality was higher than that in Han nationality ( P<0.017). From P1 to P7, the detection rates of MN and MCD were increased in common renal pathological types, meanwhile, the ratio of MsPGN was decreased (all P<0.05). From P5 to P7, the detection rates of MN in Han nationality and Uygur nationality increased in the common pathological types of PGD, meanwhile, the ratio of MsPGN decreased (all P<0.05). LN was the most common SGD. The incidence of LN in females was higher than that in males ( P<0.001). Using Bonferroni correction method, the incidence of SGD in Uygur nationality was lower than that in Han nationality ( P<0.017). There was no significant variation in the common pathological type of SGD in Han and Uygur nationalities. Chronic rejection was the main pathological type of transplanted kidney biopsies. Conclusions:PGD is the main type of kidney disease spectrum in People's Hospital of Xinjiang Uygur Autonomous Region. IgAN is the most common PGD and mainly occurrs in the age group of 18-59 years old. As time goes by, the proportion of MN and MCD is increased, meanwhile the proportion of MsPGN is decreased significantly. LN is the most common SGD.

Application of intelligent voice call technology in the recall of lapsed blood donors / 中国输血杂志

【Objective】 To analyze and evaluate the application of intelligent voice call technology (IVCT) in the recall of lost blood donors, so as to provide references for the intelligent development of blood donor recruitment. 【Methods】 SMS, human telephone and IVCT were used to recall the lost blood donors from 2016 to 2018, and the recall results were statistically analyzed. 【Results】 20 406 blood donors were recalled from August 20 to December 30, 2020 through 1 029 human telephones, 7 571 automated calls, and 11 806 SMSs, and 4.81%(32/665), 3.44%(51/1 484) and 1.17%(138/11 806) of them responded. There was no significant difference in the recall effect between human telephones and automated calls. The one-year-lapsed blood donors responded about 3 times of those lapsed for 2~4 years (5.97/2.02). 【Conclusion】 The application of IVCT can make up for the shortages of high demand, much interference and long time consuming of human telephones, reduce the labor intensity, improve the efficiency of blood donor recruitment, and promote the recall of lapsed blood donors.

A full-range health management model based on the preventive treatment concept of traditional Chinese medicine: establishment and practice / 中华医院管理杂志

Preventive treatment of diseases is a traditional Chinese medicine (TCM) concept that conforms to the demand of modern healthcare emphasizing prevention. This concept, however, calls for close and orderly collaboration between general hospitals and primary community healthcare institutions, in order to encourage coordinated regional development. The authors described the new healthcare mode of " One Center, One Platform, and One Network" jointly built and run by Dongguan Municipal Health Bureau and Dongguan TCM Hospital. This practice has pioneered a full-range, closed-loop and one-stop service chain featuring preventive treatment. Such an innovative TCM health management system has realized information interconnection of preventive treatment, and upgraded the capacity and effectiveness of community medical services, hence expanding the number of beneficiaries.

Practice guideline for patients with osteoporosis / 中华内科杂志

In recent years, osteoporosis (OP) has become one of the main diseases affecting the health of middle-aged and elderly people in China, and the prevalence of OP has increased significantly. The clinical diagnosis and treatment guidelines for this disease are also constantly updated. The overall principles speciallyemphasise that doctors and patients need to work together to negotiate the details of the diagnosis and treatment guidelines, in order to improve the OP clinical diagnosis and treatment rate. Therefore, patients′ knowledge of the disease, understanding of clinical guidelines, and cooperation with doctors to implement diagnosis and treatment plans are very important. In this study, from the most concerned issues of the patients, we established the OP patient practice guideline working group. 14 recommendations, as the OP patient practice guidelines, are proposed in accordance with the relevant principles of the "World Health Organization guidelines development manual" and the international normative process.

Practice guidelines for patients with rheumatoid arthritis / 中华内科杂志

In recent years, the clinical guidelines for the diagnosis and treatment of rheumatoid arthritis (RA) have been constantly updated. Among the general principles, it is particularly emphasized that, in order to improve the ratio of treat to target(T2T) of RA, doctors and patients should work together to negotiate the details of the guidelines. Therefore, it is important for patients to further understand the disease and clinical guidelines of RA, and to better cooperate with doctors. This study was based on the most concerned issues of RA patients and international standard procedure of guideline study, we organized the working group and introduce the following 16 recommendations constituting the RA patients′ practice guidelines.

Practice guideline for patients with hyperuricemia/gout / 中华内科杂志

Hyperuricemia/gout is a common metabolic disease in China, which is a serious threat to people′s health. In clinical practice, the standardization of prevention and diagnosis and the rate of treat-to-target need to be improved. There is still a lack of education for the patients about the understanding of clinical guidelines, the disease knowledge and the importance of cooperating with doctors to carry out diagnosis and treatment. From the most concerned issues of the patients, we established the hyperuricemia/gout patient practice guideline working group with multidisciplinary physicians and patients. Seventeen opinions, as the hyperuricemia/gout patient practice guidelines, are proposed in accordance with the relevant principles of the "WHO guidelines development manual" , and with the international normative process, aiming to improve the patients compliance, improve the level of health management of the disease.

Practice guideline for patients with ankylosing spondylitis/spondyloarthritis / 中华内科杂志

In recent years, the clinical experts consensuses or guidelines of ankylosing spondylitis (AS)/spondyloarthritis (SpA) have been constantly updated, but to better understand and practice, patient self-participation management is one of the key points to improve the level of diagnosis and treatment. Through questionnaire survey of these patients, we screened out the most concerned issues, and established the AS/SpA patient practice guideline working group with multidisciplinary physicians and patients. Fifteen opinions, as the AS/SpA patient practice guidelines, are proposed in accordance with the relevant principles of the "WHO guidelines development manual" , and with the international normative process.