Traditional Chinese medicine (TCM) is a well-accepted therapy for atopic dermatitis (AD). However, there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD, limiting the clinical application of such combined approaches. Therefore, the China Association of Chinese Medicine initiated the development of the current guideline, focusing on key issues related to the use of TCM in the treatment of AD. This guideline was developed in accordance with the principles of the guideline formulation manual published by the World Health Organization. A comprehensive review of the literature on the combined use of TCM and Western medicine to treat AD was conducted. The findings were extensively discussed by experts in dermatology and pharmacy with expertise in both TCM and Western medicine. This guideline comprises 23 recommendations across seven major areas, including TCM syndrome differentiation and classification of AD, principles and application scenarios of TCM combined with Western medicine for treating AD, outcome indicators for evaluating clinical efficacy of AD treatment, integration of TCM pattern classification and Western medicine across disease stages, daily management of AD, the use of internal TCM therapies and proprietary Chinese medicines, and TCM external treatments. Please cite this article as: Du XR, Wu MY, Tao MC, Lin Y, Gu CY, Wu MF, Cao Y, Chen DC, Li W, Wang HW, Wang Y, Wang Y, Lu HZ, Liu X, Su XF, Li FL. Clinical practice guidelines for the diagnosis and treatment of atopic dermatitis with integrative traditional Chinese and Western medicine. J Integr Med. 2025; 23(6):641-653.
Dermatitis, Atopic/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Integrative Medicine ; Drugs, Chinese Herbal/therapeutic use* ; Practice Guidelines as Topic

In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands of deaths and chronic physical disabilities every year.This guideline aims to provide practical information to help clinical professionals evaluate and treat snakebite victims.These recommendations are based on clinical experience and clinical research evidence.This guideline focuses on the following topics:snake venom,clinical manifestations,auxiliary examination,diagnosis,treatments,and prevention.

Objective:To observe the features of posture control in patients with idiopathic normal pressure hydrocephalus (iNPH). Methods:From May, 2017 to May, 2018, patients with iNPH in our hospital (n = 13) and healthy controls (n = 15) were measured with sensory organization test on Balance Manager. The balance scores and strategy scores under six conditions were recorded and the comprehensive balance scores were calculated. Results:The balance scores decreased in the patients in the conditions of eyes-open/stable-support, eyes-close/stable-support, eyes-close/unstable-support and eyes-disturb/unstable-support compared with those of the controls (|Z| > 2.042, P < 0.05), as well as the comprehensive balance scores (Z = -3.617, P < 0.001); while the strategy scores increased in the conditions of eyes-close/stable-support, eyes-open/unstable-support, eyes-close/unstable-support and eyes-disturb/unstable-support (|Z| > 2.333, P < 0.05). Conclusion:There are balance disorders in the patients with iNPH, mainly associating with the disorders of proprioceptive and vestibular senses, and application of hip strategy.

Objective To analyze the characteristics and changing trend of injury death among elderly residents aged 65 and above in Chongqing from 2013 to 2017, and to provide a basis for formulating intervention strategies for elderly injuries. Methods Based on monitoring data of death causes of permanent residents in Chongqing from 2013 to 2017, the injury death cases of elderly residents aged 65 and above were extracted, and the mortality rate and sequence were calculated. The standard mortality rate was calculated based on the standard population composition of the sixth national population census in 2010. The Joinpoint Regression Program 4.2 software was used to analyze the death trend. Results From 2013 to 2017, the average annual crude injury mortality rate of Chongqing residents aged 65 and above was 140.89/100 000, and the standardized mortality rate was 12.57/100 000. The crude death rate of male elderly residents was higher than that of female residents in the same year (P <0.001), and the injury mortality rate increased with the age of the elderly (P <0.001). The injury mortality rate of female and all elderly residents, and elderly residents in the 75- and 85-year-old groups showed an upward trend (P<0.05). Falls, road traffic injuries, suicide, other accidental injuries and drowning were the top five causes of injury death in Chongqing, accounting for 93.16% of the total injury deaths. In the past five years, the fall mortality of elderly residents in Chongqing showed an upward trend (P < 0.05). Falling was the first cause of injury death for elderly aged 70 and above in Chongqing. The crude rate of death of elderly residents aged 85 and over was 313.52 /100 000. Conclusion The injury mortality and fall mortality of elderly residents aged 65 and above in Chongqing showed a rising trend in the past five years. It is urgent to take measures to prevent injury and falls for seniors in Chongqing.

Objective: To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery, and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus(iNPH). Methods: Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery, and were evaluated by using 3-meter timed up and go test(TUG), minimum mental state examination(MMSE), idiopathic normal pressure hydrocephalus grading scale(iNPHGS)and modified Rankin scale(mRS)before and one year after CSF shunt procedures.The ventricular volume, brain volume, pericerebral CSF volume, total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated: the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume. Results: The scores of gait, cognitive function and urinary function were improved after surgery in iNPH patients(all P<0.05). There were no significant difference in the correlation of intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index with the severity of clinical symptoms including gait, cognitive function and urinary function before surgery, and with the degree of symptom improvement one year after surgery in iNPH patients(all P>0.05). There was no significant difference in intracranial compartment volumes between patients having improvement in mRS, TUG, MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P>0.05). Conclusions Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait, cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery, and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason, preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms.

Objective:To explore the changes of surface electromyography (sEMG) signal during gait cycle and its various phases of the lower limbs of stroke patients, to guide targeted gait rehabilitation training for stroke patients. Methods:From January to June, 2018, 20 stroke patients and 20 healthy subjects were involved in this study. All the subjects were asked to walk naturally. At the same time, the sEMG signals of bilateral tibialis anterior (TA), rectus femoris (RF), gastrocnemius medial (GM) and biceps femoris (BF) were recorded by Noraxon wireless surface electromyography acquisition system. Results:The electromyographic activities of TA, RF, GM and BF of healthy subjects changed with the activity and static periodicity during gait cycle, and the muscles of the same name alternated, and they were disturbed in stroke patients. Conclusion:The surface electromyography can reflect the gait-related muscle damage in stroke patients and can be used to guide gait rehabilitation training.

Objective To assess the liver biopsy and the clinical characteristics of inactive HBsAg carriers.Methods One hundred and ten inactive HBsAg carriers,including 76 males and 34 females aged (38.9 ± 9.4) years (21-66),underwent liver biopsy from January 2011 to September 2015,the histopathological findings and clinical features were analyzed.Among 110 cases the inflammation activity (A) was ＜ A2 in 73 cases and ≥A2 in 37 cases;the fibrosis (F) ＜ F2 in 63 cases and ≥F2 in 47 cases.The upper limits of normal (ULN) for ALT was defined as 30 U/L for men and 19 U/L for women according to World Health Organization (WHO) standard,and 50 U/L for men and 40 U/L for women according to Chinese national standard.There were 59 cases with ALT ＜ 1 × ULN of WHO standard and 110 cases with ALT ＜ 1 × ULN of Chinese standard.Results In 110 inactive HBsAg carriers,there were 100 cases (90.9％) ≥A1 and 37 cases (33.6％) ≥A2,84 cases (76.3％) ≥F1 and 47 cases (42.7％) ≥F2.The severity of A and F were both higher in males than that in females,especially that of F (U =2.162,P =0.032;x2 =5.315,P =0.021).But there were no statistical differences between WHO standard group and Chinese standard group (U =0.951,0.435;P =0.341,0.663).Along with the increase of age,the degrees of A and F aggravated (F =3.705,5.915;P =0.014,0.001).The average ages in ≥ A2 group and ≥F2 group were (41.7 ± 9.6) years and (38.7 ± 8.1) years,respectively.The independent risk factors for severity of A and F were age,gender (male) and age,respectively.Conclusion There may be histological damages of varying degree in liver tissues of most inactive HBsAg carriers,and for those aged 40 years and over,especially males screening of liver histological activity and fibrosis would be necessary.

OBJECTIVE: To investigate the surgery management of glottic carcinoma with high-frequency electrotome. METHOD: Twenty cases of patients with glottic carcinoma were treated by cordectomy under micro-laryngoscopy with high-frequency electrotome. RESULT: The 20 patients were followed up from 5 months to 6 years, retained good laryngeal function and structure: 1 case had local recurrences after 6 months, underwent total laryngectomy, and now no recurrence had been found: 19 cases (mild adhesions of vocal cords formed in 2 cases) had no local recurrence nor lymph node metastasis. CONCLUSION It is unnecessary to invest in expensive equipment in the cordectomy under micro-laryngoscopy with high frequency electrotome under general anesthesia and the result is satisfactory.
Aged ; Electrosurgery ; instrumentation ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; instrumentation ; methods ; Male ; Microsurgery ; Middle Aged ; Treatment Outcome

Objective To evaluate the clinical application of liver shear wave velocity (SWV) in comparison with common serum score systems [AST to platelet ratio index (APRI),Forns,S index and FIB-4] in assessment of liver fibrosis in patients with chronic hepatitis.Methods A total of 237 chronic hepatitis patients with liver fibrosis confirmed by liver biopsy,who were admitted in Ningbo Second Hospital during October 2010 and April 2013,were enrolled in the study.Liver shear wave velocity were measured by acoustic radiation force impulse (ARFI),and the score of APRI,Forns,S index and FIB-4 were calculated based on the measurement of serum markers.Liver fibrosis stages were classified as S0-S4 according to the Scheuer scoring system,and stages ≥ S2 were identified as significant liver fibrosis.The diagnosis value of SWV,4 common score systems and their combination for significant liver fibrosis was evaluated by receiver operating characteristic curve (ROC).Results A significant linear correlation was found between SWV and the stage of fibrosis (r =0.46,P ＜ 0.01).The areas under the ROCs of SWV and 4 common score systems (APRI,Forns,S index and FIB-4) for the diagnosis of significant liver fibrosis were 0.758 (0.696-0.821),0.727 (0.662-0.793),0.777 (0.717-0.836),0.747 (0.684-0.810) and 0.737 (0.673-0.802),respectively.The area under the ROC of the combined prediction nodel established with Logistic regression was 0.810.Conclusion Liver shear wave velocity measured by ARFI is of clinical value in noninvasive assessment of liver fibrosis,and the prediction accuracy can be improved when it is combined with other noninvasive indices.

OBJECTIVETo study the correlation between the lung pixel indexes of multi-slice spiral CT (MSCT) and pulmonary function test (PFT), and to explore the CT features of histograms of lung attenuation.

METHODSMSCT scan and pulmonary function test (PFT) were separately performed in 127 subjects within one week. The total lung was scanned with MSCT at full inspiration, full expiration, and normal respiration. The lung pixel indexes were measured by Pulmo pulmonary quantitative software. These indexes include PI(-910Huin), PI(-960HUEX), PI(-910Huin), PI(-960Huex), PI(-910(Hun), PI(-960Hun), PI(910Huex/in), and the histograms of lung attenuation.

RESULTSCorrelation existed between all the lung pixel indexes of MSCT and PFT. PI(-910Huex/in showed the best correlation with FEV1/FVC (r = 0.901, P < 0.01). Three distribution patterns were found in the histograms of lung attenuation of total lung, including double-peak distribution (n = 28), similar normal distribution (n = 81), and partial distribution (n = 18).

CONCLUSIONThe lung pixel indexes of MSCT have significant correlation with PFT and can be used to assess the pulmonary function.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Respiratory Function Tests ; Tomography, Spiral Computed