C3AR1 is a regulatory factor associated with coagulation cascade and inflammation in sepsis.

Sepsis is a leading cause of mortality in intensive care units. Sepsis is associated with activation of the coagulation cascade and inflammation. The aim of this study was to identify coagulation-related genes in sepsis that may provide translational potential therapeutic targets. The datasets GSE28750, GSE95233, and GSE65682 were downloaded from the gene expression omnibus database. Consensus-weighted gene co-expression network analysis (WGCNA) was used to identify sepsis modules. Gene set enrichment analysis was used to identify genes enriched in the coagulation cascade. The value of hub-gene in immunological analysis was tested in the validation sets (GSE95233). The value of hub-gene in clinical prognosis was tested in the validation sets (GSE65582). One thousand one hundred seventy-six genes with high connectivity in the clinically significant module were identified as hub genes. Ten genes were found to be enriched in coagulation-related signaling pathways. C3AR1 was selected for further analysis. The immune infiltration analysis showed that lower expression of C3AR1 was associated with immune response in sepsis and could be an independent predictor of survival status in sepsis patients. Meanwhile, univariate and multivariate Cox analysis showed that C3AR1 had a significant correlation with survival. C3AR1 may become an effective biomarker for worse outcomes in sepsis patients associated with immune and coagulation cascade.

Efficacy and safety of acupuncture for the treatment of insomnia in breast cancer patients: A systematic review and meta-analysis.

BACKGROUND: Breast cancer-related insomnia is one of the most common symptoms in patients with breast cancer, and acupuncture has been increasingly used in the treatment. However, there has been no meta-analysis that specifically explores the efficacy and safety of acupuncture in treating insomnia related to breast cancer. OBJECTIVE: The aim of this review was to systematically analyze the existing literature through a meta-analysis to evaluate the effectiveness and safety of acupuncture for breast cancer-related insomnia. METHODS: Six medical databases were comprehensively searched for previous randomized controlled trials (RCTs) up to April 2024. The Pittsburgh Sleep Quality Index (PSQI) score was the primary outcome. The secondary outcomes include the Insomnia Severity Index (ISI), Sleep Onset Latency (SOL), Wake After Sleep Onset (WASO), Total Sleep Time (TST), and Sleep Efficiency (SE), and the later four outcomes were measured by Actiwatch and sleep diary, respectively. RESULTS: A total of seven articles with 434 participants were included. The meta-analysis revealed that acupuncture produced a significant improvement in the total PSQI score (MD 95 %CI = -2.16[-2.88, - 1.45], P < 0.001), but had no statistical significance on ISI scores compared with controls (MD 95 %CI = -1.53[-3.97, 0.91], P = 0.22). From the Actiwatch, there was no substantial disparity observed in the enhancement of Sleep Onset Latency (SOL) (MD 95 %CI = -6.40[-13.19, 0.39], P = 0.06), Wake After Sleep Onset (WASO) (MD 95 %CI = -1.45[-7.09, 4.20], P = 0.62), or Total Sleep Time (TST) (MD 95 %CI = 3.54 [-4.71, 11.79], P = 0.40) between the experimental group and the control group. However, a significant distinction was observed in Sleep Efficiency (SE) improvement (MD 95 %CI = 2.43 [0.14, 4.72], P = 0.04). From the sleep diary, there was a significant difference in the amelioration of SOL (MD 95 %CI = -9.15[-16.48, - 1.81], P = 0.01), TST (MD 95 %CI = 29.92 [16.74, 43.10], P < 0.001), and SE (MD 95 %CI = 4.57 [1.92, 7.23], P = 0.0007) between the experimental group and the control group. However, no significant divergence was observed in the improvement of WASO (MD 95 %CI = 4.53[-4.81, 13.87], P = 0.34). All reported acupuncture-related adverse events were mild in severity. CONCLUSIONS: Acupuncture can partially alleviate insomnia symptoms in breast cancer patients. Moreover, acupuncture is safe and may serve as a dependable alternative therapy in clinical settings. Owing to the limited number of studies included, potential biases of heterogeneous interventions, and methodological weaknesses of long-term follow-up, more high-quality RCTs with large sample sizes should be conducted to evaluate acupuncture treatment.