Objective:To investigate analgesic effect of fire needle on postherpetic neuralgia(PHN)rats and its effect on IL-10/β-endorphin(β-EP)signaling pathway.Methods:Forty rats were randomly divided into 4 groups:control group,model group,fire needle group and drug group,with 10 rats in each group.PHN model was constructed by intraperitoneal injection of resin toxin.Af-ter successful modeling,fire needle group was intervened by fire needle at L4～6 Jiaji points,and drug group was intervened by intra-peritoneal injection of gabapentin.Von Frey electronic pain meter was used to measure paw withdrawal mechanical threshold(PW-MT)of rats in each group.Thermal latency of paw withdrawal(PWTL)of rats was measured by thermal radiation stimulator.Prosta-glandin E2(PGE2)and substance P(SP)in dorsal root ganglion tissues,serum IL-6,TNF-α and IL-1β levels were detected by ELI-SA.IL-10 and β-EP protein expressions in spinal cord of rats were detected by Western blot.Results:Compared with control group,PWMT of model group was decreased significantly(P<0.05),PWTL,levels of PGE2 and SP in spinal cord tissue and levels of IL-6,TNF-α and IL-1β in serum were increased significantly(P<0.05),IL-10 and β-EP protein expressions in spinal dorsal horn were decreased significantly(P<0.05).Compared with model group,PWMT of fire needle group and drug group was significantly increased(P<0.05),PWTL,PGE2 and SP in spinal cord tissue and serum IL-6,TNF-α and IL-1β levels were significantly decreased(P<0.05),IL-10 and β-EP protein expressions in spinal dorsal horn were significantly increased(P<0.05).Conclusion:Fire needle can improve pain response of PHN rats and reduce peripheral blood inflammation level,which may be related to activation of IL-10/β-EP signaling pathway.

Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

Objective:To explore the epidemiological characteristics of human metapneumovirus (hMPV) in children hospitalized for acute respiratory tract infections in Hebei, and provide a theoretical basis for the clinical diagnosis and treatment of acute respiratory tract infections in children in Hebei.Methods:Retrospectively, 41 499 children hospitalized in Hebei Children′s Hospital for acute respiratory tract infections from January 2017 to December 2021 were included to analyze the morbidity of children of different genders and ages, and in different seasons, and to statistically analyze the epidemiological data such as the positive detection rate of hMPV, the detection rates of mixed infections with other pathogens, and the clinical diagnosis.Results:The overall positive detection rate of hMPV in hospitalized children with acute respiratory infections from 2017 to 2021 was 5.94%(2 464/41 499), with the highest positive detection rate of hMPV in the age group of 3 to 4 years (7.66%, 520/6 789) and the lowest in the age group of ≥5 years (2.89%, 180/6 225), with a statistically significant difference ( P<0.001); the positive detection rates in male and female children were respectively 5.97%(1 496/25 056) and 5.94%(968/16 443), and the difference was not statistically significant ( P>0.05). The positive detection rates of hMPV from 2017 to 2021 were 5.10%(408/7 998), 9.64%(915/9 491), 4.27%(426/9 969), 5.91%(368/6 226), and 4.44%(347/7 815), respectively, and the positive detection rate of hMPV in 2018 was significantly higher than that in the other years ( P<0.001). hMPV circulated throughout the year, with obvious seasonality, with the highest positive detection rate in spring and winter.The mixed detection rate of hMPV with other respiratory pathogens was 42.74% (1 053/2 464), of which mixed detection with rhinovirus was the most common, with a mixed detection rate of 48.24%(508/1 053).Clinical diagnosis of hPMV-positive children was mostly bronchopneumonia. Conclusions:hMPV is one of the important pathogens in hospitalized children with acute respiratory infections in Hebei, which is common in children under 5 years of age and can occur throughout the year, with peak epidemics in winter and spring. Mixed infections of hMPV with other respiratory pathogens are common and can increase the risk of worsening clinical symptoms in children.

Objective To analyze the correlation of cholecystectomy and changes in intestinal microbiota composition and function by observing functional characteristics of differential microbial communities.Methods A cross-sectional study was conducted on the patients(PC group,n=73)undergoing cholecystectomy in our hospital from 2020 to 2021.Another 56 healthy age-and gender-matched individuals(HC group)without a history of cholecystectomy were subjected and served as the control group.Fecal specimens were collected from the 2 groups.16S rRNA sequencing analysis was performed to examine the changes in composition and function of intestinal microbiota.Results There were no statistical differences between the 2 groups in baseline indicators,such as gender,age,BMI,smoking and drinking history,blood pressure,heart rate,and comorbidities,but significant difference was observed in total bilirubin(TBIL)between them(P<0.01).Alpha diversity analysis showed no significant difference in Chao1,Shannon,and Simpson indices between the 2 groups.Beta diversity analysis using the Bray-Curtis distance algorithm revealed a significant difference between the 2 groups at the class and genus levels(P<0.05).The analysis of microbiota relative abundance using LEFSE showed that Enterobacteriaceae,Lactobacillales,Citrobacter,Megasphaera,Lactobacillus,Enterococcus,Akkermansia,Streptococcus,Klebsiella,and Ruminococcus_gnavus were up-regulated in the PC group,and Lachnospiraceae,Sutterellaceae,Lachnospirales,Lachnospira,and Sutterella were down-regulated.Kyoto Encyclopedia of Genes and Genomes(KEGG)functional prediction analysis indicated that significant differences were seen between the 2 groups in metabolic pathways,including ascorbic acid(vitamin C)metabolism and aldonic acid metabolism(P<0.05),tricarboxylic acid cycle(TCA cycle)(P<0.05),glutathione metabolism(P<0.05),glutamic acid metabolism(P<0.05),secondary bile acid metabolism(P<0.05),and pentose phosphate pathway(P<0.01).Conclusion Cholecystectomy is closely associated with the structural alterations in the composition of intestinal microbiota.Variations in microbiota composition and function may induce perturbations in TCA cycle and glutathione metabolism,glutamate metabolism,secondary bile acid metabolism,and pentose phosphate pathways.

Objective:To investigate analgesic effect of fire needle on postherpetic neuralgia(PHN)rats and its effect on IL-10/β-endorphin(β-EP)signaling pathway.Methods:Forty rats were randomly divided into 4 groups:control group,model group,fire needle group and drug group,with 10 rats in each group.PHN model was constructed by intraperitoneal injection of resin toxin.Af-ter successful modeling,fire needle group was intervened by fire needle at L4～6 Jiaji points,and drug group was intervened by intra-peritoneal injection of gabapentin.Von Frey electronic pain meter was used to measure paw withdrawal mechanical threshold(PW-MT)of rats in each group.Thermal latency of paw withdrawal(PWTL)of rats was measured by thermal radiation stimulator.Prosta-glandin E2(PGE2)and substance P(SP)in dorsal root ganglion tissues,serum IL-6,TNF-α and IL-1β levels were detected by ELI-SA.IL-10 and β-EP protein expressions in spinal cord of rats were detected by Western blot.Results:Compared with control group,PWMT of model group was decreased significantly(P<0.05),PWTL,levels of PGE2 and SP in spinal cord tissue and levels of IL-6,TNF-α and IL-1β in serum were increased significantly(P<0.05),IL-10 and β-EP protein expressions in spinal dorsal horn were decreased significantly(P<0.05).Compared with model group,PWMT of fire needle group and drug group was significantly increased(P<0.05),PWTL,PGE2 and SP in spinal cord tissue and serum IL-6,TNF-α and IL-1β levels were significantly decreased(P<0.05),IL-10 and β-EP protein expressions in spinal dorsal horn were significantly increased(P<0.05).Conclusion:Fire needle can improve pain response of PHN rats and reduce peripheral blood inflammation level,which may be related to activation of IL-10/β-EP signaling pathway.

Objective:To explore the epidemiological characteristics of human metapneumovirus (hMPV) in children hospitalized for acute respiratory tract infections in Hebei, and provide a theoretical basis for the clinical diagnosis and treatment of acute respiratory tract infections in children in Hebei.Methods:Retrospectively, 41 499 children hospitalized in Hebei Children′s Hospital for acute respiratory tract infections from January 2017 to December 2021 were included to analyze the morbidity of children of different genders and ages, and in different seasons, and to statistically analyze the epidemiological data such as the positive detection rate of hMPV, the detection rates of mixed infections with other pathogens, and the clinical diagnosis.Results:The overall positive detection rate of hMPV in hospitalized children with acute respiratory infections from 2017 to 2021 was 5.94%(2 464/41 499), with the highest positive detection rate of hMPV in the age group of 3 to 4 years (7.66%, 520/6 789) and the lowest in the age group of ≥5 years (2.89%, 180/6 225), with a statistically significant difference ( P<0.001); the positive detection rates in male and female children were respectively 5.97%(1 496/25 056) and 5.94%(968/16 443), and the difference was not statistically significant ( P>0.05). The positive detection rates of hMPV from 2017 to 2021 were 5.10%(408/7 998), 9.64%(915/9 491), 4.27%(426/9 969), 5.91%(368/6 226), and 4.44%(347/7 815), respectively, and the positive detection rate of hMPV in 2018 was significantly higher than that in the other years ( P<0.001). hMPV circulated throughout the year, with obvious seasonality, with the highest positive detection rate in spring and winter.The mixed detection rate of hMPV with other respiratory pathogens was 42.74% (1 053/2 464), of which mixed detection with rhinovirus was the most common, with a mixed detection rate of 48.24%(508/1 053).Clinical diagnosis of hPMV-positive children was mostly bronchopneumonia. Conclusions:hMPV is one of the important pathogens in hospitalized children with acute respiratory infections in Hebei, which is common in children under 5 years of age and can occur throughout the year, with peak epidemics in winter and spring. Mixed infections of hMPV with other respiratory pathogens are common and can increase the risk of worsening clinical symptoms in children.

Objective To analyze the effect of Xiaozhi Decoction in the treatment of hyperlipidemiain different classification of physical constitution in TCM.Methods We screened 206 patients with Hyperlipidemia in our hospital and had been treated with drugs during May 2020 to March 2023.Totally 103 patients in the TCM group were treated with Xiaozhi Decoction,103 patients in the western medicine group were treated with atorvastatin.Selected total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and liver transaminase before and after a period of treatment.The non-high-density lipoprotein cholesterol(non-HDL-C)will be calculated,too.Results In the Phlegm-Dampness constitution,TC,TG,LDL-C and non-HDL-C decreased significantly all in the TCM group(P<0.05);TC,TG and non-HDL-C decreased significantly all in the western medicine group(P<0.05).The TCM group is superior to the western medicine group in TC,LDL-C,non-HDL-C(P<0.05).In the Qi-Deficiency constitution,TC,TG,LDL-C and non-HDL-C decreased significantly all in the TCM group(P<0.05);TC,LDL-C and non-HDL-C decreased significantly all in the western medicine group(P<0.05).The TCM group is superior to the western medicine group in non-HDL-C(P<0.05).In the Blood-Stasis constitution,TC,TG,LDL-C and non-HDL-C decreased significantly all in the western medicine group only(P<0.05).The western medicine group is superior to the TCM group in TC,LDL-C,non-HDL-C(P<0.05).In the Yin-Yang Harmony constitution,TC and non-HDL-C decreased significantly both in the TCM group(P<0.05).TC,LDL-C and non-HDL-C decreased significantly all in the western medicine group(P<0.05).The western medicine group is superior to the TCM group in TC,LDL-C,non-HDL-C(P<0.05).Conclusion Xiaozhi Decoction is superior to the the atorvastatin in the treatment of hyperlipidemia for the Phlegm-Dampness constitution and Qi-deficiency constitution groups.But it is not superior to the atorvastatin in the treatment of hyperlipidemia for the Blood-Stasis constitution and Yin-Yang Harmony constitution groups.

This paper discussed the clinical ideas and methods of treating diabetes by improving symptoms. Diabetes-related symptoms can affect the control of blood glucose and other metabolic indicators to varying degrees， and affect the quality of life of patients. In the clinical diagnosis and treatment of diabetes， “equal emphasis on both indicators” is suggested， meaning that quality of life indicators is as important as metabolic indicators. The patient's symptoms should be paied attention to， and the diagnosis and treatment should start from “symptom differentiation”， and emphasize the “key symptoms”. When there are many symptoms， it is advised to adopt the combined treatment mode of “syndrome cluster”， and take the principle of “treating both the root and accompanying symptoms in mild cases with multiple symptoms， and prescribing multiple formulas daily”. At the same time， the model of co-management of three disciplines of diabetes consisting of diabetes specialists， traditional Chinese medicine doctors， and health managers can help the management of diabetes symptoms.

Objective To explore the effects and possible mechanisms of ophthalmic acupuncture combined with tail moxibustion on the behavior and hippocampus in rats with post-stroke cognitive impairment.Methods Seventy-five male SD rats were randomly divided into the sham operation group (15 rats) and the modeling group (60 rats) using the random number table method. A modified suture-occluded method was used to replicate the occlusion model of the middle cerebral artery in the modeling group,whereas only the right carotid artery was exposed in the sham operation group. After modeling,48 rats with post-stroke cognitive impairment were selected using the Morris water maze experiment,and were randomly divided into the model group,the ophthalmic acupuncture group,the tail moxibustion group and the ophthalmic acupuncture+tail moxibustion group using the random number table method,with 12 rats per group. The sham operation group and the model group were bound with no intervention;the ophthalmic acupuncture group was needled once a day in the bilateral "liver area","kidney area","heart area",and "spleen area",leaving the needle for 30 min;the tail moxibustion group was given mild-warm moxibustion on the area between "Changqiang" (GV1) and the tip of the tail for 20 min,once a day;the ophthalmic acupuncture+tail moxibustion group was given the above-mentioned ophthalmic acupuncture and tail moxibustion interventions simultaneously. After 7 days of intervention,the behavior of the rats was detected. Hematoxylin and eosin staining was used to observe the pathological changes in the hippocampus;the malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in the hippocampus were detected by colorimetric method;Western blotting was used to detect the protein expressions of Kelch-like ECH associated protein 1 (KEAP1),phosphoglycerate mutase 5 (PGAM5),apoptosis-inducing factor mitochondria associated 1 (AIFM1),nuclear factor erythroid 2-related factor 2 (Nrf2),and heme oxygenase-1 (HO-1) in the hippocampus of rats;and real-time fluorogenic quantitative PCR was used to determine the mRNA expressions of KEAP1,PGAM5,AIFM1,Nrf2,and HO-1 in the hippocampus. Results Compared with the sham operation group,the escape latency in the model group was prolonged,and the crossing platform number was decreased (P<0.05);the number of neurons in the hippocampal CA1 area was significantly decreased,with a disordered arrangement and irregular morphology,and necrotic neurons were observed;the SOD activity in the hippocampus was decreased,while the MDA content was increased (P<0.05);the protein and mRNA expressions of KEAP1,PGAM5,and AIFM1 were increased,while the protein and mRNA expressions of Nrf2 and HO-1 were decreased (P<0.05). Compared with the model group,the escape latency of rats in the ophthalmic acupuncture+tail moxibustion group was shortened,and the crossing platform number was increased (P<0.05);the loss of neurons in the hippocampal CA1 area of the rat was significantly reduced,and the cell morphology was more plump;SOD activity in the hippocampus was increased,and MDA content was decreased (P<0.05);and the protein and mRNA expressions of KEAP1,PGAM5,and AIFM1 were decreased,while the protein and mRNA expressions of Nrf2 and HO-1 were increased (P<0.05).Conclusion The combination of ophthalmic acupuncture and tail moxibustion can be used to treat rats with post-stroke cognitive impairment,and its mechanism may be related to alleviating oxidative stress damage and oxeiptosis in the hippocampus,thereby improving the degree of hippocampal neuronal damage and enhancing the cognitive ability of rats after stroke.

Objective:To investigate the safety of early antiplatelet therapy for non-cardioembolic mild stroke patients with thrombocytopenia.Methods:Data of acute ischemic stroke patients with baseline National Institutes of Health Stroke Scale(NIHSS)score≤3 and a platelet count<100×109/L were obtained from a multicenter register.Those who required anticoagulation or had other contraindications to antiplatelet therapy were excluded.Short-term safety outcomes were in-hospital bleeding events,while the long-term safety outcome was a 1-year all-cause death.The short-term neurological outcomes were evaluated by modified Rankin scale(mRS)score at discharge.Results:A total of 1868 non-cardioembolic mild stroke patients with thrombocytopenia were enrolled.Multivariate regression analyses showed that mono-antiplatelet therapy significantly increased the proportion of mRS score of 0-1 at discharge(OR=1.657,95%CI:1.253-2.192,P<0.01)and did not increase the risk of intracranial hemorrhage(OR=2.359,95%CI:0.301-18.503,P>0.05),compared with those without antiplatelet therapy.However,dual-antiplatelet therapy did not bring more neurological benefits(OR=0.923,95%CI:0.690-1.234,P>0.05),but increased the risk of gastrointestinal bleeding(OR= 2.837,95%CI:1.311-6.136,P<0.01)compared with those with mono-antiplatelet therapy.For patients with platelet counts≤75×109/L and>90×109/L,antiplatelet therapy significantly improved neurological functional outcomes(both P<0.05).For those with platelet counts(>75-90)×109/L,antiplatelet therapy resulted in a significant improvement of 1-year survival(P<0.05).For patients even with concurrent coagulation abnormalities,mono-antiplatelet therapy did not increase the risk of various types of bleeding(all P>0.05)but improved neurological functional outcomes(all P<0.01).There was no significant difference in the occurrence of bleeding events,1-year all-cause mortality risk,and neurological functional outcomes between aspirin and clopidogrel(all P>0.05).Conclusions:For non-cardioembolic mild stroke patients with thrombocytopenia,antiplatelet therapy remains a reasonable choice.Mono-antiplatelet therapy has the same efficiency as dual-antiplatelet therapy in neurological outcome improvement with lower risk of gastrointestinal bleeding.