The expert consensus on the clinical treatment of herpes zoster with fire needling was developed, and the commonly used fire needling treatment scheme verified by clinical research was selected to form a standardized diagnosis and treatment scheme for acute herpes zoster and postherpetic neuralgia (PHN), so as to answer the core problems in clinical application. The consensus focuses on patients with herpes zoster, and forms recommendations for 9 key clinical issues, covering simple fire needling and TCM comprehensive therapy based on fire needling, including fire needling combined with cupping, fire needling combined with Chinese herb, fire needling combined with cupping and Chinese herb, fire needling combined with filiform needling, fire needling combined with moxibustion, and provides specific recommendations and operational guidelines for various therapies.
Humans ; Herpes Zoster/therapy* ; Acupuncture Therapy/instrumentation* ; Consensus ; Clinical Protocols

ObjectiveTo evaluate the clinical efficacy and safety of Tongluo Mingmu capsules in the treatment of diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome. MethodA randomized， double-blind， positive-control， and multi-center clinical trial design method was used. 416 patients with diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome in four test centers were included （the ratio of the treatment group to the control group was 3∶1）. On the basis of standardized hypoglycemic treatment， the treatment group was given both four Tongluo Mingmu capsules and two Calcium Dobesilate capsule agents three times a day， while the control group were given both two Calcium Dobesilate capsules and four Tongluo Mingmu capsule agents three times a day. The course of treatment was 12 weeks. The curative effect of Tongluo Mingmu capsules was evaluated by comparing the comprehensive curative effect of diabetic retinopathy， traditional Chinese medicine（TCM） syndrome score， corrected visual acuity， fundus changes， fundus fluorescence angiography， and other curative effect indexes before and after treatment in the two groups. At the same time， general examination， laboratory examination， and adverse events were performed to evaluate the safety of the drug. ResultThe baseline demographic data and disease characteristics of the treatment group and the control group were balanced and comparable， with the difference not statistically significant. After 12 weeks of treatment， the total effective rate of the comprehensive curative effect of diabetic retinopathy in the treatment group （61.0%， 189/310） was better than that in the control group （44.1%， 45/102）， and the difference was statistically significant （χ²=8.880， P<0.01）. The total effective rate of TCM syndromes in the treatment group （88.4%， 259/293） was better than that in the control group （69.9%， 65/93）， and the difference was statistically significant （χ²=17.927， P<0.01）. The disappearance rate of dry eyes （χ²=8.305）， dull complexion （χ²=4.053）， lassitude （χ²=10.267）， shortness of breath （χ²=8.494）， and dry stool （χ²=8.657） in the treatment group was higher than that in the control group， and the difference between the groups was statistically significant （P<0.05， P<0.01）. In terms of improving corrected visual acuity （χ²=8.382）， fundus changes （χ²=6.026） ， the treatment group was significantly better than the control group （P<0.05）. During the trial， the incidence of adverse events in the treatment group and the control group was 1.3% and 2.9%， respectively. There was no significant difference between the two groups. In addition， there were no serious adverse events and adverse events leading to withdrawal in both groups. ConclusionTongluo Mingmu capsules can improve the comprehensive curative effect of diabetic retinopathy and enhance the efficacy of TCM syndromes， visual acuity， fundus changes， and fundus fluorescein angiography， with great safety. Therefore， it can provide a new alternative therapeutic drug for patients with diabetic retinopathy.

Objective To analyze the efficacy of drug-coated balloon in the treatment of hetero-geneous in-stent restenosis.Methods A total of 118 patients who received treatment and diagnosed with heterogeneous in-stent restenosis were selected as study objects,and were divided into two groups using a random table method.The experimental group(n=59)received drug-coated balloon thera-py,and the control group(n=59)received drug-eluting stent therapy.The therapeutic effects of the two different treatment methods on heterogeneous in-stent restenosis were compared.Results There was no significant difference in the incidence of in-stent restenosis in the right coronary artery,cir-cumflex artery,and anterior descending artery between the two groups(P＞0.05).There was no sig-nificant difference between the two groups in the preoperative reference vessel diameter,lesion length,lumen stenosis degree,and localized restenosis(P＞0.05).The postoperative residual ste-nosis rate in the experimental group was significantly higher than that in the control group(P＜0.05).There was no significant difference between the two groups in the preoperative lumen area,neointimal load,stent inner area,neointimal area,incidence of neoatherosclerosis and thrombus(P＞0.05).Operative lumen area of the experimental group was smaller than that of the control group(P＜0.05).No target vessel reconstruction,stent thrombosis,nonfatal myocardial infarction,or cardiac death occurred in two groups during 12 months of follow-up.Conclusion Drug-coated balloons are effective and safe in the treatment of heterogeneous in-stent restenosis,and can obtain similar effects to drug-eluting stents.

Objective To analyze the efficacy of drug-coated balloon in the treatment of hetero-geneous in-stent restenosis.Methods A total of 118 patients who received treatment and diagnosed with heterogeneous in-stent restenosis were selected as study objects,and were divided into two groups using a random table method.The experimental group(n=59)received drug-coated balloon thera-py,and the control group(n=59)received drug-eluting stent therapy.The therapeutic effects of the two different treatment methods on heterogeneous in-stent restenosis were compared.Results There was no significant difference in the incidence of in-stent restenosis in the right coronary artery,cir-cumflex artery,and anterior descending artery between the two groups(P＞0.05).There was no sig-nificant difference between the two groups in the preoperative reference vessel diameter,lesion length,lumen stenosis degree,and localized restenosis(P＞0.05).The postoperative residual ste-nosis rate in the experimental group was significantly higher than that in the control group(P＜0.05).There was no significant difference between the two groups in the preoperative lumen area,neointimal load,stent inner area,neointimal area,incidence of neoatherosclerosis and thrombus(P＞0.05).Operative lumen area of the experimental group was smaller than that of the control group(P＜0.05).No target vessel reconstruction,stent thrombosis,nonfatal myocardial infarction,or cardiac death occurred in two groups during 12 months of follow-up.Conclusion Drug-coated balloons are effective and safe in the treatment of heterogeneous in-stent restenosis,and can obtain similar effects to drug-eluting stents.

Objective To investigate the correlations between lipoprotein associated phospholipase A2(Lp-PLA2),platelet aggregation rate(PAG),the ratio of mean platelet volume to platelet count(MPV/PLT)and major adverse cardiovascular events(MACE)in elderly patients with coronary heart disease(CHD).Methods The clinical data of 162 elderly patients with CHD admitted to Jianhu Hospital affiliated to Nantong University from August 2020 to September 2021 were collected retrospectively.All the patients were treated with aspirin orally and followed up for 1 year.The development of MACE within 1 year was recorded.MACE occurred in 30 patients(development group)and the other 132 patients without MACE were assigned to non-development group.Serum Lp-PLA2,PAG,and MPV/PLT were compared between the 2 groups at admission.Logistic regression was used to analyze the relationship between these parameters and MACE in elderly CHD patients.Receiver operating character(ROC)curve was used to evaluate the value of serum Lp-PLA2,PAG,MPV/PLT alone and jointly at admission in predicting MACE within 1 year.Results The proportions of patients with age≥75 years and hypertension in the development group were significantly higher than those in the non-development group(P<0.05).Serum Lp-PLA2,PAG,MPV/PLT in the development group were also significantly higher than those in the non-development group(P<0.05).Binary logistic regression analysis showed that hypertension,Lp-PLA2,PAG,and MPV/PLT were influence factors of MACE in elderly CHD patients(P<0.05).ROC curve results showed that the area under curve(AUC)values of Lp-PLA2,PAG,MPV/PLT alone or jointly were 0.832,0.817,0.841 and 0.939 in predicting MACE in elderly CHD patients.Conclusion Overexpression of Lp-PLA2,PAG and MPV/PLT are closely related to the development of MACE in elderly CHD patients.During hospitalization,the risk of MACE can be assessed by detecting Lp-PLA2,PAG,and MPV/PLT,and timely clinical intervention can be carried out.

Objective: To investigate the impact of blood pressure and age on arterial stiffness in general population. Methods: Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (n=11 608), 45-59 years group (n=12 757), above 60 years group (n=5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension). Multiple linear regression analysis was used to analyze the association between systolic blood pressure (SBP) with baPWV in the total participants and then stratified by age groups. Multivariate logistic regression model was used to analyze the influence of blood pressure on arterial stiffness (baPWV≥1 400 cm/s) of various groups. Results: (1)The baseline characteristics of all participants: 35 350 participants completed 2010, 2012 and 2014 Kailuan examinations and took part in baPWV examination. 2 237 participants without blood pressure measurement values were excluded, 1 569 participants with history of peripheral artery disease were excluded, we also excluded 1 016 participants with history of cardiac-cerebral vascular disease. Data from 29 367 participants were analyzed. The age was (48.0±12.4) years old, 21 305 were males (72.5%). (2) Distribution of baPWV in various age groups: baPWV increased with aging. In non-hypertension population, baPWV in 18-44 years group, 45-59 years group, above 60 years group were as follows: 1 299.3, 1 428.7 and 1 704.6 cm/s, respectively. For hypertension participants, the respective values of baPWV were: 1 498.4, 1 640.7 and 1 921.4 cm/s. BaPWV was significantly higher in hypertension group than non-hypertension group of respective age groups (P<0.05). (3) Multiple linear regression analysis defined risk factors of baPWV: Multivariate linear regression analysis showed that baPWV was positively correlated with SBP(t=39.30, P<0.001), and same results were found in the sub-age groups (t-value was 37.72, 27.30, 9.15, all P<0.001, respectively) after adjustment for other confounding factors, including age, sex, pulse pressure(PP), body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), smoking, drinking, physical exercise, antihypertensive medications, lipid-lowering medication. (4) Multivariate logistic regression analysis of baPWV-related factors: After adjustment for other confounding factors, including age, sex, PP, BMI, FBG, TC, smoking, drinking, physical exercise, antihypertensive medication, lipid-lowering medication, multivariate logistic regression analysis showed that risks for increased arterial stiffness in hypertension group were higher than those in non-hypertension group, the OR in participants with hypertension was 2.54 (2.35-2.74) in the total participants, and same results were also found in sub-age groups, the ORs were 3.22(2.86-3.63), 2.48(2.23-2.76), and 1.91(1.42-2.56), respectively, in each sub-age group. Conclusion SBP is positively related to arterial stiffness in different age groups, and hypertension is a risk factor for increased arterial stiffness in different age groups. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.

Objective: To evaluate the efficacy and safety of maintenance therapy with reduced dose of rhTPO in the patients with primary immune thrombocytopenia (ITP) who attained stable platelet (PLT) counts after daily administration of rhTPO. Methods: Treatment was started with a daily administration of rhTPO (300 U/kg) for 2 consecutive weeks. Patients who attained stable PLT≥50×10⁹/L were enrolled to maintenance therapy starting with every other day administration of rhTPO, then adjusted dose interval to maintain platelet count (30-100) ×10⁹/L. Results: A total of 91 eligible patients were enrolled. Fourteen patients discontinued the study due to noncompliance (12/14) and investigator decision (2/14) . Among 77 patients who completed the study, 38 patients with the administration of rhTPO at every other day or less could maintain PLT≥30×10⁹/L for 12 weeks. The percentage of patients with a platelet response (PLT≥30×10⁹/L) at 4^th week, 8^th week and 12^th week of maintain therapy was 92.6% (63/68) , 82.7% (43/52) and 85.0% (34/40) , respectively. Median platelet counts remained in the range of (70-124) ×10⁹/L. The overall incidence of rhTPO-related adverse events was 7.7%. All the adverse events were generally mild. Conclusion Extending the dose interval of rhTPO is feasible to maintain stable platelet count in the patients with ITP, but the optimal dose interval is uncertain and might vary with individuals.

Objective: To study the risk factors for prevalence of acute myocardial infarction (AMI) in young and middle-aged population. Methods: A prospective cohort study was conducted in 110100 subjects at the age of (18-98) years who received physical examination in Kailuan Group from 2012-06 to 2014-10. Based on the limitations of male≤53 years and female≤63 years, a total of 62367 subjects were enrolled in our study. The subjects were followed-up for 2 years by the end point event of AMI to analyze the risk factors ofAMI occurrence. Results: According to AMI occurrence at the follow-up period, the subjects were divided into 2 groups: AMI group, n=56 and Control group, n=62152. Compared with Control group, AMI group had increased BMI, SBP, DBP and elevated blood levels of LDL-C, TG; AMI group also showed the higher ratios of subjects with the history of diabetes and taking anti-hypertension medication. Cox proportional hazard regression analysis indicated that age (RR=1.37), male (RR=60.54), LDL-C (RR=1.12), and TG (RR=5.93) were the risk factors forAMI occurrence in young and middle-aged population, allP<0.05. Conclusion: Age, male gender, blood levels of LDL-C, and TG were the risk factors for AMI occurrence in young and middle-aged population.

Objective To investigate the effect of comprehensive intervention including education, lifestyle intervention and drug intervention for patients with hypertension in Kailuan community. Methods Employees who took part in the health checkup of Kailuan Group, Ltd. from June 2008 to June 2009 were enrolled in this study. The changes of hypertension awareness, treatment and control rates and cardiovascular health behaviors and factors have been observed in the follow-up. Results A total of 5 361 patients with hypertension were enrolled. After a period of 2 years of follow-up, the treatment rate and up to standard rate hypertension were significantly increased compared to pre-intervention (11.90%vs. 100.00%;0.82% vs. 36.93%. P<0.01). After comprehensive intervention, the average score of ideal cardiovascular health behaviors and factors increased from (6.85 ± 1.90) to (7.52 ± 1.92) (P<0.01). Conclusion Comprehensive intervention is an effective means for the prevention and control of hypertension in the community.