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

Hepatic ischemia-reperfusion injury （HIRI） is an inevitable major complication during surgical procedures such as liver transplantation and partial hepatectomy， and its prevention and treatment are hotspots and difficulties in clinical practice. This article reviews the mechanism of injury caused by energy metabolism disorders during liver ischemia-reperfusion and related treatment strategies and summarizes the current advances in metabolism-related therapies， in order to provide new ideas for further clarifying the onset mechanism of HIRI and exploring effective clinical prevention and treatment strategies for HIRI.

Objective To analyze the risk factors for catheter-associated urinary tract infection (CAUTI) in elderly critically ill patients and construct a related risk prediction model. Methods Clinical materials of 8 905 patients with catheterization in the geriatric ICU ward of Jiangsu Provincial People's Hospital from January 2014 to June 2024 were retrospectively collected. The patients were divided into infection group (n=114) and non-infection group (n=8 791) based on the occurrence of CAUTI. Multivariate Logistic regression analysis was used to identify the risk factors for CAUTI, and a Nomogram prediction model was constructed. Internal validation was performed by the receiver operating characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow goodness-of-fit test to assess the discrimination and calibration of the prediction model. Results In this study, the incidence of CAUTI in elderly critically ill patients was 2.55‰. Multivariate Logistic regression analysis showed that age, consciousness status, renal dysfunction, duration of catheterization, and the number of catheter insertions were independent influencing factors for CAUTI in elderly critically ill patients. A Nomogram model was constructed based on the results of the regression analysis. Area under the curve (AUC) of ROC curve for internal validation by the Bootstrap method was 0.802 (95%CI, 0.796 to 0.809). The calibration curve was close to the standard curve, and the predicted values were generally consistent with the actual values, demonstrating good predictive performance of the model. Conclusion Age, renal dysfunction, consciousness status, duration of catheterization, and the number of catheter insertions are independent influencing factors for CAUTI in elderly critically ill patients. Nomogram prediction model established based on these factors is simple and feasible, with reliable predictive performance.

Objective The study aimed to investigate the impact of rare earth elements(REEs)exposure on pregnancy outcomes of in vitro fertilization-embryo transfer(IVF-ET)by analyzing samples from spouses. Methods A total of 141 couples were included.Blood and follicular fluid from the wives and semen plasma from the husbands,were analyzed for REEs using inductively coupled plasma mass spectrometry(ICP-MS).Spearman's correlation coefficients and the Mann-Whitney U test were used to assess correlations and compare REE concentrations among three types of samples,respectively.Logistic models were utilized to estimate the individual REE effect on IVF-ET outcomes,while BKMR and WQS models explored the mixture of REE interaction effects on IVF-ET outcomes. Results Higher La concentration in semen(median 0.089 ng/mL,P=0.03)was associated with a lower fertilization rate.However,this effect was not observed after artificial selection intervention through intracytoplasmic sperm injection(ICSI)(P=0.27).In semen,the REEs mixture did not exhibit any significant association with clinical pregnancy. Conclusion Our study revealed a potential association between high La exposure in semen and a decline in fertilization rate,but not clinical pregnancy rate.This is the first to report REEs concentrations in follicular fluid with La,Ce,Pr,and Nd found at significantly lower concentrations than in serum,suggesting that these four REEs may not accumulate in the female reproductive system.However,at the current exposure levels,mixed REEs exposure did not exhibit reproductive toxicity.

Objective To explore the efficacy of a new anti-heart failure drug,Entresto,in the prevention of cardiotoxicity caused by doxorubicin(DOX).Methods Male adult ICR mice were randomly divided into three groups(n = 8):control group,DOX group and DOX plus Entresto group.Cardiac function of mice was measured by echocardiography.H9c2 cells were pretreated with Entresto(0-48 μmol/L)for 24 hours in the presence or absence of DOX(1 mmol/L),and then cell viability,oxidative stress,apoptosis and mitochondrial function were evaluated.Results As compared with the control group,leakage of CK,CK-MB and LDH increased significantly in the DOX group(P<0.01),and left ventricular systolic dysfunction occurred.Entresto administration reversed these changes in the DOX group.The level of ROS and the number of apoptotic cells in cardiomyocytes in the DOX plus Entresto group were lower than those in the DOX group(P<0.05).As compared with the DOX group,the level of ROS and the number of apoptotic cells in H9c2 cells decreased significantly in the Entresto plus DOX group(P<0.05),and mitochondrial membrane potential increased significantly(P<0.05).Entresto reversed the inhibitory effect of DOX on SIRT1/PGC-1α/MFN2 signaling pathway.Conclusions Entresto improves DOX-induced cardiotoxicity by inhibiting ROS-mediated oxidative stress and apoptosis,and its mechanism may be related to SIRT1/PGC-1α/MFN2 signal transduction pathway.

Objective:To explore the application effect of"hospital-family integration"transitional care joint case management model in patients with diabetes mellitus.Methods:A total of 80 patients with diabetes mellitus admitted to our hospital from Jan 2023 to Apr 2024 were divided into the control group and the observation group according to random number table method,with 40 patients in each group.The control group was given routine nursing,and the observation group was given"hospital-family integration"transitional care joint case management model based on routine nursing.Blood glucose level,self-care ability and quality of life were compared between the two groups.Results:The levels of fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were lower than those in the control group(P＜0.05).The scores of Self-care Behavior Scale(SDSCA-6)and Health Survey Summary Form(SF-36)in the observation group were higher than those in the control group(P＜0.05).Conclusion:"Hospital-family integration"transitional care joint case management model is helpful to improve blood glucose management,self-care ability and quality of life in patients with diabetes mellitus.

Objective:To explore the application of short video situational teaching based on clinical pathway management cases in cardiology internship teaching.Methods:30 medical students who were interned in the Department of Cardiology of Xiangya Hospital of Central Souty University from June 2020 to May 2021 were selected as the control group, using traditional clinical teaching mode, and another 30 medical students from June 2021 to May 2022 were selected as the observation group. Short video situational teaching based on clinical pathway management cases was used to compare the performance evaluation results, satisfaction evaluation results, teaching effectiveness, improvement of critical thinking ability, and teaching method evaluation results of the two groups of students. Perform chi square test and t-test using SPSS 20.0. Results:The results showed that the performance of the observation group students in the entrance examination [theoretical: (88.25±5.14) vs. (80.23±5.34); operational: (90.36±5.23) vs. (86.58 ± 5.12)] was better than that of the control group, and the difference was statistically significant; The observation group showed statistically significant differences in teaching effectiveness compared to the control group ( P<0.05); The critical thinking ability score of the observation group students was better than that of the control group ( P<0.05); The observation group students rated the teaching methods higher ( P<0.05). Conclusions:The use of situational teaching in cardiology internships can enhance the critical thinking ability of medical students, meet clinical needs, and is worth promoting in diagnostic teaching.

Objective:To investigate the training effect of order-oriented medical students in Yunnan Province of China and related influencing factors and targeted suggestions, and to improve the training effect of order-oriented medical students in residency training bases in Yunnan Province.Methods:The stratified cluster sampling method was used to select 8 general residency training bases, and a questionnaire survey was performed among the 621 order-oriented students in these training bases. Finally, 616 valid questionnaires were collected. SPSS 26.0 was used to perform the two-sample rank sum test, the K-W test, and the ordered multinomial logistic regression analysis.Results:The training effect of the "5+3" order-oriented medical students in Yunnan Province was between generally good (48.29%) and good (45.37%). The effect of the provincial general training base is better than that of the municipal general training base, and most training students at the province level (167, 59.64%) thought that the training effect was good, while most of the training students at the prefecture or municipal level (194, 57.91%) thought that the training effect was generally good. When the teaching level of the teachers can meet the teaching work, the residential training effect of the order-oriented residential training students is well evaluated (197,68.17%). When skill training was carried out by the base at least once a month, most of the order-oriented trainees (96, 48.73%) thought that the training effect was good. The ordered multinomial logistic regression analysis showed that the nature of the base, sex, attitude towards policy, psychological state, teaching competency of teachers, perfection of the fund guarantee system, consistency of training plan with requirements, consistency of training process with requirements, and consistency of teaching activities with requirements were influencing factors for the training effect of "5+3" order-oriented medical students in residency training bases of Yunnan Province ( P<0.05). Conclusions:The training effect of "5+3" order-oriented medical students in residency training bases of Yunnan Province was between generally good and good. The training effect of bases can be improved by strengthening the construction of infrastructure, giving full play to the role of base linkage, perfecting the training plan, improving implementation and execution, building up a perfect fund guarantee system, enhancing the construction of general teaching team, emphasizing skill practice training, and implementing diversified training activities.

AIM:This study aims to examine the ependymin-related protein 1(EPDR1)expression in various tissues from wild-type C57BL/6 mice and type 2 diabetes(db/db)mice.The impact of EPDR1 on lipid accumulation in al-pha mouse liver 12(AML12)hepatocytes was also investigated.METHODS:Western blot was used to detect EPDR1 protein expression in the heart,liver,spleen,lung,kidney,gastrocnemius,brown adipose and brain tissues of C57BL/6 mice.Western blot and immunohistochemical(IHC)staining were also used to compare EPDR1 protein expression in the liver,gastrocnemius muscle,heart and kidney tissues of db/db and C57BL/6 mice.To develop an AML12 cell lipid deposi-tion model,palmitic acid(PA)+oleic acid(OA)was used,and the cells were transfected with adenovirus overexpressing EPDR1 or treated with exogenous recombinant EPDR1 protein(rEPDR1).ELISA was conducted to determine intracellu-lar triglyceride(TG)content,and oil red O staining was employed to assess the effect of EPDR1 on lipid accumulation in AML12 cells.RESULTS:Western blot and IHC staining results revealed that EPDR1 was widely expressed in various tis-sues of wild-type mice,with the liver exhibiting the highest protein expression level.However,EPDR1 expression was down-regulated in the liver,gastrocnemius muscle,heart and kidney tissues in diabetic db/db mice compared with wild-type mice.Oil red O staining revealed that overexpression of EPDR1 in AML12 liver cells or rEPDR1 treatment led to re-duced lipid accumulation.Furthermore,the TG content significantly decreased compared with the model group(P<0.05).CONCLUSION:EPDR1 is expressed in various tissues of wild-type mice,but showed diminished expression in the liver tissues of diabetic mice.Nevertheless,enhancing the expression of EPDR1 can aid in reducing lipid accumula-tion in hepatocytes.These findings provide an experimental foundation for further exploration of the role of EPDR1 in the development of fatty liver in diabetic liver tissue.

Objective To explore the differences of regional homogeneity(ReHo)between overweight and normal weight male patients with type 2 diabetes mellitus(T2DM)during rest and their correlations with clinical features.Methods Twenty-five untreated male overweight T2DM(OW-T2DM)patients,25 untreated male normal weight T2DM(NW-T2DM)patients and 25 healthy controls(HC)were enrolled.The brain structure and resting-state functional magnetic resonance imaging(rs-fMRI)data were collected from all subjects.The brain structure and rs-fMRI data were preprocessed,and ReHo values of all brain regions were calculated for all subjects.ReHo values were compared among three groups and between groups respectively via the methods of one-way analysis of variance and two-sample t-test.To address the problem of multiple comparisons,the method of AlphaSim was performed(the threshold was set at P<0.005,the number of voxel clusters was>12).In addition,Pearson correlation analysis was performed to explore the relationships between ReHo values of the abnormal brain regions and clinical features in patients.Results(1)The brain regions showed differences of ReHo values among three groups were mainly distributed in the right hemisphere,including the superior parietal gyrus,superior marginal gyrus and superior occipital gyrus;(2)Compared with HC,NW-T2DM patients showed significantly decreased ReHo values in the right medial superior frontal gyrus,right middle cingulate gyrus and left anterior cingulate gyrus;(3)Compared with HC,OW-T2DM patients showed significantly decreased ReHo values in the bilateral postcentral gyrus and bilateral middle cingulate gyrus;(4)Compared with NW-T2DM patients,OW-T2DM patients showed significantly decreased ReHo values in the right superior parietal gyrus,right superior occipital gyrus and left cuneus;(5)ReHo values of the right medial superior frontal gyrus and right superior parietal gyrus were negatively correlated with hemoglobinA1c(HbA1c)level and body mass index(BMI),respectively,in all patients.Conclusion The occurrence of T2DM in male patients may lead to the declined activity of brain regions located in the default mode network(DMN),while overweight may further lead to decreased brain activity within the attention and visual recognition network in male T2DM patients.