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

Neuraxial opioids, widely used in obstetric and perioperative pain management, often lead to unwanted itch, reducing patient satisfaction. While the μ-opioid receptor has been implicated in opioid-induced itch, the genetic basis for variable itch incidence remains unknown. This study examined 3616 patients receiving epidural opioids, revealing an itch occurrence of 26.55%, with variations among opioid types and gender. Analysis of the OPRM1 gene identified six single-nucleotide polymorphisms, notably rs1799971 (A118G), that correlated with opioid-induced itch. Mouse models with an equivalent A112G mutation showed reduced neuraxial opioid-induced itch and light touch-evoked itch, mirroring human findings. The 118G allele demonstrated an anti-itch effect without impacting analgesia, addiction, or tolerance, offering insights for risk stratification and potential anti-itch pretreatment strategies.
Receptors, Opioid, mu/genetics* ; Pruritus/chemically induced* ; Humans ; Analgesics, Opioid/administration & dosage* ; Female ; Male ; Animals ; Polymorphism, Single Nucleotide/genetics* ; Adult ; Mice ; Middle Aged

Objective:To investigate the clinicopathological features, genetic characteristics, and differential diagnosis of glomangiomatosis with uncertain malignant potential.Methods:Two cases of glomangiomatosis with uncertain malignant potential were collected at Henan Provincial People′s Hospital from 2013 and 2023. Immunohistochemistry and next generation sequencing (DNA-seq) were used to detect the related protein and gene variation. Patients were followed up.Results:Case 1 was male, 34 years old; and case 2 was female, 28 years old. Both had tumor recurrence in the original site. There were multiple nodules at right calf and ankle, involving superficial subcutaneous tissue and deep interfascicular muscles; some nodules were borderless and painful. Microscopically, the tumor was nodular with fibrous pseudocapsule, some had indistinct borders and diffuse infiltration to the surrounding adipose tissue. The tumor cells were round to ovoid with inconspicuous nucleoli, partly surrounding small irregularly dilated thin-walled blood vessels. The recurrent tumors showed epithelioid morphology in some of the tumor cells, with eosinophilic cytoplasm, some apparent nucleoli, mild to moderate nuclear atypia, and brisk mitotic figures. Focally, perimuscular cell differentiation was noted. The small lesion showed intravascular tumor thrombus. NGS revealed BRAF V600E mutation in case 1, and BRAF V600E mutation combined with PDGFRB gene amplification in case 2.Conclusions:Glomangiomatosis with uncertain malignant potential is a rare variant of glomus tumor. It has a unique growth pattern morphologically, BRAF V600E mutation, and invasive biological behavior.

Aim To identify the chemical components of Angelica sinensis(AS)and explore the mechanism of AS in activating blood circulation.Methods UP-LC-Q-TOF-MS was used to identify the chemical com-ponents of AS.The changes of syndrome and patholog-ical section of heart in rats were observed.Hemody-namics and proteomics were measured.Results A to-tal of 270 compounds were identified from AS.It showed that rats of Angelica sinensis group were greatly improved such as arched back,shrugged fur,huddled up and less mobile,purplish paws and tails,whitish ear margins and nasolabial lips,reduced drinking and feed-ing,and slow response to external stimuli;mildly disor-dered myocardial fibre arrangement,myofibre arrange-ment was tighter than that of model group,myocardial fibres were narrower and close to normal,and mild oe-dema,exudation,and inflammatory cell infiltration could be seen in the surrounding area;SAP was signif-icantly lower and LVSP was significantly higher in An-gelica sinensis group(P＜0.05).Proteomics showed that 62 differential proteins were screened in Angelica sinensis group compared to model,GO function were concentrated in the extracellular matrix,cytoskeletal proteins binding and protein hydrolysis negatively regu-lated.KEGG pathway were enriched in signalling path-ways such as complement and coagulation cascades,cellular focal adhesion,leukocyte transendothelial mi-gration and chemokine signalling pathways.Conclu-sions AS probably through the expression of proteins,which modulate the signalling pathways of the comple-ment and coagulation cascade reactions and the con-traction of vascular smooth muscle.

Aim To identify the chemical components of Angelica sinensis(AS)and explore the mechanism of AS in activating blood circulation.Methods UP-LC-Q-TOF-MS was used to identify the chemical com-ponents of AS.The changes of syndrome and patholog-ical section of heart in rats were observed.Hemody-namics and proteomics were measured.Results A to-tal of 270 compounds were identified from AS.It showed that rats of Angelica sinensis group were greatly improved such as arched back,shrugged fur,huddled up and less mobile,purplish paws and tails,whitish ear margins and nasolabial lips,reduced drinking and feed-ing,and slow response to external stimuli;mildly disor-dered myocardial fibre arrangement,myofibre arrange-ment was tighter than that of model group,myocardial fibres were narrower and close to normal,and mild oe-dema,exudation,and inflammatory cell infiltration could be seen in the surrounding area;SAP was signif-icantly lower and LVSP was significantly higher in An-gelica sinensis group(P＜0.05).Proteomics showed that 62 differential proteins were screened in Angelica sinensis group compared to model,GO function were concentrated in the extracellular matrix,cytoskeletal proteins binding and protein hydrolysis negatively regu-lated.KEGG pathway were enriched in signalling path-ways such as complement and coagulation cascades,cellular focal adhesion,leukocyte transendothelial mi-gration and chemokine signalling pathways.Conclu-sions AS probably through the expression of proteins,which modulate the signalling pathways of the comple-ment and coagulation cascade reactions and the con-traction of vascular smooth muscle.

Objective:To investigate the clinicopathological features, genetic characteristics, and differential diagnosis of glomangiomatosis with uncertain malignant potential.Methods:Two cases of glomangiomatosis with uncertain malignant potential were collected at Henan Provincial People′s Hospital from 2013 and 2023. Immunohistochemistry and next generation sequencing (DNA-seq) were used to detect the related protein and gene variation. Patients were followed up.Results:Case 1 was male, 34 years old; and case 2 was female, 28 years old. Both had tumor recurrence in the original site. There were multiple nodules at right calf and ankle, involving superficial subcutaneous tissue and deep interfascicular muscles; some nodules were borderless and painful. Microscopically, the tumor was nodular with fibrous pseudocapsule, some had indistinct borders and diffuse infiltration to the surrounding adipose tissue. The tumor cells were round to ovoid with inconspicuous nucleoli, partly surrounding small irregularly dilated thin-walled blood vessels. The recurrent tumors showed epithelioid morphology in some of the tumor cells, with eosinophilic cytoplasm, some apparent nucleoli, mild to moderate nuclear atypia, and brisk mitotic figures. Focally, perimuscular cell differentiation was noted. The small lesion showed intravascular tumor thrombus. NGS revealed BRAF V600E mutation in case 1, and BRAF V600E mutation combined with PDGFRB gene amplification in case 2.Conclusions:Glomangiomatosis with uncertain malignant potential is a rare variant of glomus tumor. It has a unique growth pattern morphologically, BRAF V600E mutation, and invasive biological behavior.

Objective:To investigate the clinical characteristics and survival analysis of myelodysplastic syndromes(MDS)with RUNX1 gene mutation.Methods:Clinical data of 177 newly diagnosed MDS patients admitted to the Department of Hematology,the Second Affiliated Hospital of Air Force Military Medical University from October 1,2015 to October 31,2022 were retrospectively analyzed.Gene mutation detection was performed by second-generation sequencing technology,and clinical characteristics and prognosis of patients with RUNX1 gene mutation were analyzed.Results:A total of 30 cases(16.95％)of RUNX1 gene mutations were detected,including 15 missense mutations(50.0％),9 frameshift deletion mutations(30.0％),4 splice site mutations(13.3％),1 insertion mutation(3.3％),and 1 nonsense mutation(3.3％).Patients with RUNX1 mutations had a median age of 68.5 years at diagnosis(range:62.25-78.50 years old).There were no significantly differences between RUNX1 mutations and wild type patients in age distribution,gender,peripheral blood white blood cell count,hemoglobin level,bone marrow and peripheral blood blasts ratio,IPSS-R cytogenetics,IPSS-R stage,etc.(P＞0.05).However,there were statistically significant differences in platelet count and whether complicated karyotype.Compared with patients without RUNX1 gene mutation,patients with RUNX1 gene mutation had lower platelet count(P=0.018),and were less likely to have complicated karyotype at initial diagnosis(P=0.01).Cox proportional hazards model analysis showed that when other co variates remained unchanged,the higher the platelet count,the better the survival of patients(HR=0.995,95％CI:0.990-0.999,P=0.036);In the IPSS-M prognostic stratification,keeping other covariates unchanged,the risk of progression or death of myelodysplastic syndrome was significantly lower in the medium to high-risk and low-risk groups compared with the high-risk group(HR=0.149,95％CI:0.031-0.721,P=0.018;HR=0.026,95％CI:0.003-0.234,P=0.001).Survival analysis showed that MDS patients with RUNX1 gene mutation had worse overall survival time(P＜0.001).Patients with RUNX1 mutation had worse OS than non-mutation patients in the early WHO group.RUNX1 mutation and IPSS-M risk stratification mean OS and mean LFS were worse in low-risk patients than in non-mutated patients.Conclusion:RUNX1 gene mutation is an adverse prognostic factor in MDS patients,especially in the IPSS-M prognosis stratification group of low-risk,medium-low risk,medium-high risk and WHO classification of early patients.

Objective To investigate Aconitum sinomontanum Nakai has anti-hepatoma activity.Methods Cell experiment:HepG2 cells were divided into blank group(0.9％NaCl)and experimental-L,-M,-H groups(2,4,8 mg·mL-1 Aconitum sinomontanum Nakai).The 24,48,72 h cell proliferation activity was detected by methyl thiazolyl tetrazolium(MTT)method.Animal experiments:BALB/C mice inoculated with H22 cells were divided into model group(0.9％NaCl),cisplatin group(2 mg·kg-1 cisplatin),lappaconitine hydrobromide group(4 mg·kg-1 lappaconitine hydrobromide)and high-dose group(8 mg·kg-1 Aconitum sinomontanum Nakai).BALB/C mice were selected as control group(0.9％NaCl).After 14 days of continuous administration,the tumor inhibition rate of Aconitum sinomontanum Nakai was detected.The indexes of inflammation,liver cancer and liver function related factors in serum of mice in each group were detected by enzyme-linked immunosorbent assay(ELISA).The apoptosis protein of tumor tissue was detected by immunohistochemistry.Results The median inhibitory concentration(IC50)of trichloromethane in HepG2 cells for 24,48 and 72 h were 5.71,4.37 and 2.12 mg·mL-1,respectively.The expression levels of alpha-fetoprotein(AFP)in serum were 8.84±0.35,12.04±0.76,10.14±1.01,9.53±0.79 and 9.33±1.06 in control group,model group,cisplatin group,lappaconitine hydrobromide group and high-dose group,respectively.The tumor inhibition rates of cisplatin group,lappaconitine hydrobromide group and high-dose group were 48.40％,50.71％and 52.58％,respectively.The expression levels of B-cell lymphoma-2(Bcl-2)in model group,cisplatin group,lappaconitine hydrobromide group and high-dose group were 101.09±7.15,65.92±6.11,67.12±7.88 and 62.60±10.75,respectively;the expression levels of pro-apoptotic protein Bel-2 associated X protein(Bax)were 48.57±15.50,89.09±8.54,60.40±3.24 and 108.79±3.17,respectively.Compared with the model group,the above indexes in cisplatin group,hyperaconitine hydrobromide group and high-dose group had statistical significance(P＜0.01,P＜0.05).Conclusion Aconitum sinomontanum Nakai has significant anti-liver cancer activity,inhibits the proliferation of hepatoma cells,induces apoptosis,and thus exerts anti-hepatocarcinoma activity.

Objective To investigate Aconitum sinomontanum Nakai has anti-hepatoma activity.Methods Cell experiment:HepG2 cells were divided into blank group(0.9％NaCl)and experimental-L,-M,-H groups(2,4,8 mg·mL-1 Aconitum sinomontanum Nakai).The 24,48,72 h cell proliferation activity was detected by methyl thiazolyl tetrazolium(MTT)method.Animal experiments:BALB/C mice inoculated with H22 cells were divided into model group(0.9％NaCl),cisplatin group(2 mg·kg-1 cisplatin),lappaconitine hydrobromide group(4 mg·kg-1 lappaconitine hydrobromide)and high-dose group(8 mg·kg-1 Aconitum sinomontanum Nakai).BALB/C mice were selected as control group(0.9％NaCl).After 14 days of continuous administration,the tumor inhibition rate of Aconitum sinomontanum Nakai was detected.The indexes of inflammation,liver cancer and liver function related factors in serum of mice in each group were detected by enzyme-linked immunosorbent assay(ELISA).The apoptosis protein of tumor tissue was detected by immunohistochemistry.Results The median inhibitory concentration(IC50)of trichloromethane in HepG2 cells for 24,48 and 72 h were 5.71,4.37 and 2.12 mg·mL-1,respectively.The expression levels of alpha-fetoprotein(AFP)in serum were 8.84±0.35,12.04±0.76,10.14±1.01,9.53±0.79 and 9.33±1.06 in control group,model group,cisplatin group,lappaconitine hydrobromide group and high-dose group,respectively.The tumor inhibition rates of cisplatin group,lappaconitine hydrobromide group and high-dose group were 48.40％,50.71％and 52.58％,respectively.The expression levels of B-cell lymphoma-2(Bcl-2)in model group,cisplatin group,lappaconitine hydrobromide group and high-dose group were 101.09±7.15,65.92±6.11,67.12±7.88 and 62.60±10.75,respectively;the expression levels of pro-apoptotic protein Bel-2 associated X protein(Bax)were 48.57±15.50,89.09±8.54,60.40±3.24 and 108.79±3.17,respectively.Compared with the model group,the above indexes in cisplatin group,hyperaconitine hydrobromide group and high-dose group had statistical significance(P＜0.01,P＜0.05).Conclusion Aconitum sinomontanum Nakai has significant anti-liver cancer activity,inhibits the proliferation of hepatoma cells,induces apoptosis,and thus exerts anti-hepatocarcinoma activity.

Objective:To investigate the surgical treatment strategies of brachial plexus schwannomas protruding from the foraminal area to the thoracic outlet through anterior cervical approach, and to evaluate the curative effect.Methods:The clinical data of 8 patients treated in Beijing Friendship Hospital Affiliated to Capital Medical University from July 2016 to December 2020 who underwent supraclavicular cervical "barb" incision for protruding into the thoracic outlet through anterior cervical approach were retrospectively collected, including 5 males and 3 females, aged (50.75±11.14) years old, ranging from 31-66 years old. And the key points of the operation, postoperative complications and postoperative follow-up were analyzed. Measurement data with normal distribution were represented as mean±standard deviation( ± s), count data were described as numbers. Results:The tumors in all 8 cases were totally resected.The amount of bleeding during operation was (35.00±14.14) mL. No surgical complications such injury of pleura, aspneumothorax and hemothorax, except 2 cases which developed local sensory disturbance that improved that after neurotrophic treatment and hormonotherapy. All 8 patients were followed up by outpatient or telephone for 1-5 years, and cervical MRI review showed no tumor recurrence in situ.Conclusions:The anterior cervical approach with "barb type" incision above the neck clavicle is effective in excision of schwannomas protruding into the thoracic outlet, with less intraoperative injury, less blood loss, fast postoperative recovery.