Comprehensive Utilization Technology of Aronia melanocarpa.

Aronia melanocarpa fruit contains a variety of active ingredients, such as phenolic acids, anthocyanins, proanthocyanidins, etc. Relevant in vivo and in vitro studies have concluded that it has beneficial effects in terms of treating dyslipidemia, hypertension, glucose metabolism disorders, etc. This article discusses the nutritional value and food processing of Aronia melanocarpa and reviews the chemical components of Aronia melanocarpa and the pharmacological activities of related substances in order to summarize the chemical characteristics of the fruit and its development prospects. The process optimization of juice production, the impact of antioxidant capacity, and the comprehensive utilization of pomace in feed are discussed. This article provides a reference for future comprehensive application research and product development of Aronia melanocarpa.

Low phosphorus increases hepatic lipid deposition, oxidative stress and inflammatory response via Acetyl-CoA carboxylase-dependent manner in zebrafish liver cells.

Acetyl-CoA carboxylase (ACC) plays a regulatory role in both fatty acid synthesis and oxidation, controlling the process of lipid deposition in the liver. Given that existing studies have shown a close relationship between low phosphorus (P) and hepatic lipid deposition, this study was conducted to investigate whether ACC plays a crucial role in this relationship. Zebrafish liver cell line (ZFL) was incubated under low P medium (LP, P concentration: 0.77 mg/L) or adequate P medium (AP, P concentration: 35 mg/L) for 240 h. The results showed that, compared with AP-treated cells, LP-treated cells displayed elevated lipid accumulation, and reduced fatty acid ß-oxidation, ATP content, and mitochondrial mass. Furthermore, transcriptomics analysis revealed that LP-treated cells significantly increased lipid synthesis (Acetyl-CoA carboxylases (acc), Stearyl coenzyme A dehydrogenase (scd)) but decreased fatty acid ß-oxidation (Carnitine palmitoyltransferase I (cptI)) and (AMP-activated protein kinase (ampk)) mRNA levels compared to AP-treated cells. The phosphorylation of AMPK and ACC, and the protein expression of CPTI were significantly decreased in LP-treated cells compared with those in AP-treated cells. After 240 h of LP treatment, PF-05175157 (an ACC inhibitor) was supplemented in the LP treatment for an additional 12 h. PF-05175157-treated cells showed higher phosphorylation of ACC, higher protein expression of CPTI, and lower protein expression of FASN, lower TG content, enhanced fatty acid ß-oxidation, increased ATP content, and mitochondrial mass compared with LP-treated cells. PF-05175157 also relieved the LP-induced oxidative stress and inflammatory response. Overall, these findings suggest that ACC is a promising target for treating LP-induced elevation of lipid deposition in ZFL, and can alleviate oxidative stress and inflammatory response.

Two-stream vision transformer based multi-label recognition for TCM prescriptions construction.

Traditional Chinese medicine (TCM) observation diagnosis images (including facial and tongue images) provide essential human body information, holding significant importance in clinical medicine for diagnosis and treatment. TCM prescriptions, known for their simplicity, non-invasiveness, and low side effects, have been widely applied worldwide. Exploring automated herbal prescription construction based on visual diagnosis holds vital value in delving into the correlation between external features and herbal prescriptions and offering medical services in mobile healthcare systems. To effectively integrate multi-perspective visual diagnosis images and automate prescription construction, this study proposes a multi-herb recommendation framework based on Visual Transformer and multi-label classification. The framework comprises three key components: image encoder, label embedding module, and cross-modal fusion classification module. The image encoder employs a dual-stream Visual Transformer to learn dependencies between different regions of input images, capturing both local and global features. The label embedding module utilizes Graph Convolutional Networks to capture associations between diverse herbal labels. Finally, two Multi-Modal Factorized Bilinear modules are introduced as effective components to fuse cross-modal vectors, creating an end-to-end multi-label image-herb recommendation model. Through experimentation with real facial and tongue images and generating prescription data closely resembling real samples. The precision is 50.06 %, the recall rate is 48.33 %, and the F1-score is 49.18 %. This study validates the feasibility of automated herbal prescription construction from the perspective of visual diagnosis. Simultaneously, it provides valuable insights for constructing herbal prescriptions automatically from more physical information.

Coffee intake and risk of diabetic nephropathy: a Mendelian randomization study.

Rationale and objective: A causal relationship concerning coffee intake and diabetic nephropathy (DN) is controversial. We conducted a Mendelian randomization study to assess the causal nature of these associations. Methods: 40 independent single nucleotide polymorphisms (SNPs) associated with coffee intake were selected from the UK Biobank study. Summary-level data for diabetic nephropathy were obtained from publicly available genome-wide association studies (GWAS) and the FinnGen consortium. Inverse variance weighted (IVW), MR-Egger, and weighted median (WM) methods were used to examine a causal association. Sensitivity analyses included Cochran's Q test, the intercept of MR-Egger, MR-PRESSO, and the Outlier method. Leave-One-Out sensitivity analyses were also conducted to reduce the heterogeneity. Results: Our current study demonstrated positive associations of genetically predicted coffee intake with diabetic nephropathy (OR=1.939; P = 0.045 and type 2 diabetes with renal complications (OR = 2.787, P= 0.047). These findings were robust across several sensitivity analyses. Conclusions: This study found a positive correlation between coffee consumption and the risk of diabetic nephropathy using genetic data. For a more accurate and trustworthy conclusion, subgroup analysis on coffee intake, including preparing method, variety of coffee, and quantity, is required.

MTHFR epigenetic derepression protects against diabetes cardiac fibrosis.

BACKGROUND: Diabetes cardiac fibrosis is associated with altered DNA methylation of fibrogenic genes; however, the underlying mechanisms remain unclear. OBJECTIVES: In this study, we investigate the critical role of DNA methylation aberration-associated suppression of MTHFR in diabetes cardiac fibrosis, and the protective effects of folate on diabetes cardiac fibrosis, using cultured cells, animal models, and clinical samples. METHODS AND RESULTS: Herein, we report that DNA methylation repression of MTHFR, critically involved in diabetes cardiac fibrosis, mediates the significant protective effects of folate in a mouse model of diabetes cardiac fibrosis induced by STZ. Heart MTHFR expression was markedly suppressed in diabetes cardiac fibrosis patients and mice, accompanied by increased DNMT3A and MTHFR promoter methylation. Knockdown of DNMT3A demethylated MTHFR promoter, recovered the MTHFR loss, and alleviated the diabetes cardiac fibrosis pathology and cardiac fibroblasts pyroptosis. Mechanistically, DNMT3A epigenetically repressed MTHFR expression via methylation of the promoter. Interestingly, folate supplementation can rescue the effect of MTHFR loss in diabetes cardiac fibrosis, suggesting that inactivation of MTHFR through epigenetics is a critical mediator of diabetes cardiac fibrosis. CONCLUSIONS: The current study identifies that MTHFR repression due to aberrant DNMT3A elevation and subsequent MTHFR promoter hypermethylation is likely an important epigenetic feature of diabetes cardiac fibrosis, and folate supplementation protects against diabetes cardiac fibrosis.

Attenuation of Yersinia pestis fyuA Mutants Caused by Iron Uptake Inhibition and Decreased Survivability in Macrophages.

Yersinia pestis is the etiological agent of plague, a deadly infectious disease that has caused millions of deaths throughout history. Obtaining iron from the host is very important for bacterial pathogenicity. Y. pestis possesses many iron uptake systems. Yersiniabactin (Ybt) plays a major role in iron uptake in vivo and in vitro, and in virulence toward mice as well. FyuA, a ß-barrel TonB-dependent outer membrane protein, serves as the receptor for Ybt. In this study, we examined the role of the fyuA gene in Y. pestis virulence using different challenging ways and explored the underlying mechanisms. The BALB/c mouse infection assay showed that the virulence of the mutant strains (ΔfyuA and ΔfyuAGCAdel) was lower when compared with that of the wild-type (WT) strain 201. Furthermore, the attenuation of virulence of the mutant strains via subcutaneous and intraperitoneal challenges was far greater than that via intravenous injection. Iron supplementation restored lethality during subcutaneous challenge with the two mutants. Thus, we speculated that the attenuated virulence of the mutant strains toward the mice may be caused by dysfunctional iron uptake. Moreover, ΔfyuA and ΔfyuAGCAdel strains exhibited lower survival rates in murine RAW264.7 macrophages, which might be another reason for the attenuation. We further explored the transcriptomic differences between the WT and mutant strains at different temperatures and found that the expressions of genes related to Ybt synthesis and its regulation were significantly downregulated in the mutant strains. This finding indicates that fyuA might exert a regulatory effect on Ybt. Additionally, the expressions of the components of the type III secretion system were unexpectedly upregulated in the mutants, which is inconsistent with the conventional view that the upregulation of the virulence genes enhances the virulence of the pathogens.

Electrochemical treatment for leachate membrane retentate: Performance comparison of electrochemical oxidation and electro-coagulation technology.

With the widespread use of membrane in advanced treatment of leachate, China produces a large amount of leachate membrane retentate (LMR) (≈23.4 million tons) annually, which is usually treated by incineration or recirculation in engineering, but these technologies have many drawbacks. LMR is suitable for electrochemical treatment due to its high electrical conductivity. This study compared the performances of electrochemical oxidation (EO) and electro-coagulation (EC) technology on LMR treatment under different experimental conditions, including anode material, current density, initial pH and reaction time. We found that EO optimal conditions achieved 70.1%, 83.1%, 78.7%, 98.7%, and 69.7% removal of total organic carbon (TOC), UV absorption (at 254 nm), chromaticity, ammonia nitrogen (NH3-N), and total nitrogen (TN), respectively. Compared with EO, EC exhibited a similar removal ability for orgainics and better removals of chroma, but much less performance for removing nitrogen pollutants in the same reaction time, that is, removals of NH3-N and TN were only 31.5% and 36.2%, respectively. Meanwhile, EC showed much higher instantaneous current efficiency of COD than EO under its optimal reaction time (120 min). In addition, the UV-Vis spectra and 3D fluorescence spectra indicated that EO exhibited relatively outstanding performance in decomposing dissolved organic matter (DOM) with rather complicated structures than EC. Also, the flow field-flow fractionation technique demonstrated that EO preferentially destroy humic-like, large molecular weight DOM, and converting them to smaller molecules, which resulted in more volatile organic compounds in EO samples than EC samples. While EC had little selectivity in the removal of organics, except humic-like DOM with relative small molecular. These findings can provide a theoretical basis for the electrochemical treatment of LMR.

Dual-mode detection of dopamine based on 0D/2D/2D CuInS2/ZnS quantum dot-black phosphorous nanosheet-TiO2 nanosheet nanocomposites.

In this work, we designed new dual-mode "turn-on" electrochemical (EC) and photoelectrochemical (PEC) sensors for the detection of dopamine (DA) based on 0D/2D/2D CuInS2/ZnS quantum dot (QD)-black phosphorous nanosheet (BPNS)-TiO2 nanosheet (TiO2NS) nanocomposites. QDs can not only improve the photocurrent of the developed PEC sensors, but also provide the electrochemical signal in the EC detection. BPNSs as p-type semiconductor with high conductive properties work as electron acceptors and are utilized to improve the sensitivity of the DA PEC and EC sensors. Under irradiation of visible light or the applied voltage, DA is both excited and releases electrons, realizing "turn-on" detection. The PEC sensors have a linear range of 0.1-100 µM with a lower detection limit of 0.028 µM. For the EC detection, BPNSs can accelerate electron transfer which attribute to its excellent conductivity. In the range of 1-200 µM, the working curve of DA detection by the EC sensors was established and the detection limit is 0.88 µM. Comparing the two methods, the PEC sensors have a lower detection limit, and the EC sensors have a wider monitoring range. The dual-mode sensors of EC and PEC pave an effective way for the detection in biological and medical fields.

Complementary and alternative therapies for generalized anxiety disorder: A protocol for systematic review and network meta-analysis.

BACKGROUND: Generalized anxiety disorder (GAD) is a prevalent and impairing psychiatric disorder, which is a great threat to people's mental health, and imposes a major burden on individuals, families and society. Complementary and alternative medicine (CAM) therapies is a potential treatment for GAD, however, the selection strategies of different CAM therapies in clinical practice is still unclear, and the purpose of this study is to evaluate the efficacy and acceptability of different CAM interventions using systematic review and network meta-analysis (NMA). METHODS: Based on the strategy, the authors will retrieve a total of 9 electronic databases by January 2023. After a series of screening, the 2 researchers will use Aggregate Data Drug Information System (ADDIS) and Stata software to analyze the data extracted from randomized controlled trials (RCTs) of CAM therapies for the GAD. Finally, the evidence grade of the results will be evaluated. RESULTS: This study will provide a reliable evidence for the selection of CAM therapies for GAD. CONCLUSION: The results of this study will provide references for evaluating the influence of different CAM therapies for GAD, and provide a choice basis for clinical decision-making.

Multitask Interactive Attention Learning Model Based on Hand Images for Assisting Chinese Medicine in Predicting Myocardial Infarction.

Acute myocardial infarction (AMI) is one of the most serious and dangerous cardiovascular diseases. In recent years, the number of patients around the world has been increasing significantly, among which people under the age of 45 have become the high-risk group for sudden death of AMI. AMI occurs quickly and does not show obvious symptoms before onset. In addition, postonset clinical testing is also a complex and invasive test, which may cause some postoperative complications. Therefore, it is necessary to propose a noninvasive and convenient auxiliary diagnostic method. In traditional Chinese medicine (TCM), it is an effective auxiliary diagnostic strategy to complete the disease diagnosis through some body surface features. It is helpful to observe whether the palmar thenar undergoes hypertrophy and whether the metacarpophalangeal joint is swelling in detecting acute myocardial infarction. Combined with deep learning, we propose a depth model based on traditional palm image (MTIALM), which can help doctors of traditional Chinese medicine to predict myocardial infarction. By building the shared network, the model learns information that covers all the tasks. In addition, task-specific attention branch networks are built to simultaneously detect the symptoms of different parts of the palm. The information interaction module (IIM) is proposed to further integrate the information between task branches to ensure that the model learns as many features as possible. Experimental results show that the accuracy of our model in the detection of metacarpophalangeal joints and palmar thenar is 83.16% and 84.15%, respectively, which are significantly improved compared with the traditional classification methods.

Research on accounting and detection of volatile organic compounds from a typical petroleum refinery in Hebei, North China.

A volatile organic compound (VOC) emissions inventory of the petroleum refinery in Hebei was established. This refinery emits 1859.2 tons of VOCs per year, with wastewater collection and treatment system being the largest emissions source, accounting for 59.6% individually, followed by the recirculating cooling water system (13.4%), storage tanks (11.1%), and equipment leaks (9.4%). Organized and fugitive samples were collected simultaneously for different processes of each emissions source. A total of 100 VOC species were characterized and quantified using a gas chromatography-mass spectrometry/flame ionization detection system. The VOC emissions concentrations and chemical composition of each process were quite different. Most of the processes used alkanes as the main chemome. We concluded from the composite source profile weighted by the amount of VOC emissions that the characteristic species of this petroleum refinery were ethane (15.4%), propylene (11.7%), propane (8.5%), iso-pentane (8.3%), and toluene (4.7%). The ozone (O3) formation potential (OFP) and secondary organic aerosol formation potential (SOAP) were evaluated, and the results indicated that alkenes (mainly propylene) and aromatics (mainly toluene) were the priority control compounds. This study clarifies the current status of VOC emissions in the refinery in terms of emissions intensity, emissions components, and O3 and SOA reactivity. The key emissions sources and species screened provide scientific support for reducing refined emissions from the petrochemical industry.

Transcriptome-based identification and expression characterization of RgABCC transporters in Rehmannia glutinosa.

ABCC multidrug resistance-associated proteins (ABCCs/MRPs), a subfamily of ABC transporters, are involved in multiple physiological processes. Although these proteins have been characterized in some plants, limited efforts have been made to address their possible roles in Rehmannia glutinosa, a medicinal plant. Here, we scanned R. glutinosa transcriptome sequences and identified 18 RgABCC genes by in silico analysis. Sequence alignment revealed that the RgABCCs were closely phylogenetically related and highly conserved with other plant ABCCs/MRPs. Subcellular localization revealed that most of the RgABCCs were deposited in vacuoles and a few in plasma membranes. Tissue-specific expression of the RgABCCs indicated significant specific accumulation patterns, implicating their roles in the respective tissues. Differential temporal expression patterns of the RgABCCs exhibited their potential roles during root development. Various abiotic stress and hormone treatment experiments indicated that some RgABCCs could be transcriptionally regulated in roots. Furthermore, the transcription of several RgABCCs in roots was strongly activated by cadmium (Cd), suggesting possible roles under heavy metal stresses. Functional analysis of RgABCC1 heterologous expression revealed that it may increase the tolerance to Cd in yeast, implying its Cd transport activity. Our study provides a detailed inventory and molecular characterization of the RgABCCs and valuable information for exploring their functions in R. glutinosa.

Phenylpropanoid-conjugated pentacyclic triterpenoids from the whole plants of Leptopus lolonum induced cell apoptosis via MAPK and Akt pathways in human hepatocellular carcinoma cells.

Our present and previous phytochemical investigations on Leptopus lolonum have resulted in the isolation of almost 30 phenylpropanoid-conjugated pentacyclic triterpenoids (PCPTs). During the continuous study on PCPTs, this kind of triterpenoid ester is considered as a natural product with low toxicity because of it's widely distribution in natural plants and edible fruits including kiwi fruit, durian, jujube, pawpaw, apple and pear. In the present work, we report the isolation, structural elucidation and cytotoxic evaluation of four new PCPTs (1-4) which obtained from L. lolonum. In addition, the possible biosynthesis pathway for 28-norlupane triterpenoid and potent effect of phenylpropanoid moiety for increasing the cytotxic effect of triterpenoids were also discussed. Among these compounds, compound 1 exhibited the highest cytotoxic effect on HepG2 cells with IC50 value of 11.87 µM. Further flow cytometry and western blot analysis demonstrated that 1 caused G1 cell cycle arrest by up-regulated the expression of phosphorylated p53 protein in HepG2 cells and induced cell apoptosis via MAPK and Akt pathways. These results emphasized the potential of PCPTs as lead compounds for developing anti-cancer drugs.

New phenylpropanoid-conjugated pentacyclic triterpenoids from the whole plants of Leptopus lolonum with their antiproliferative activities on cancer cells.

Most of Euphorbiaceae plants are considered as folk medicinal plants because of their various pharmacological effects. However, there are eight Leptopus genus plants which belong to Euphorbiaceae have never be investigated. Thus, four Leptopus genus plants were collected to study their chemical constituents and pharmacological activities. In the present work, the cytotoxicities of the extracts of four Leptopus genus plants were evaluated before phytochemical experiments. And nine new phenylpropanoid-conjugated pentacyclic triterpenoids, along with twenty-two known compounds were isolated from the whole plants of Leptopus lolonum. The structures of these new compounds were unequivocally elucidated by HRESIMS and 1D/2D NMR data. All triterpenoids were screened for their cytotoxicities against four cancer cell lines including HepG2, MCF-7, A549 and HeLa. Among these isolates, the triterpenoid with a phenylpropanoid unit showed increasing cytotoxicity on cancer cells, which suggested the importance of the phenylpropanoid moiety.

Complementary and alternative therapies for poststroke depression: A protocol for systematic review and network meta-analysis.

BACKGROUND: Poststroke depression (PSD) is an important complication of stroke, resulting in increased disability and mortality, which is a great threat to stroke survivors and public health. Complementary and alternative medicine (CAM) therapies is widely used in the treatment of PSD, However, the selection strategies of different CAM approaches in clinical practice is still not clear, and the purpose of this protocol is to compare the efficacy and acceptability of different CAM therapies using systematic review and network meta-analysis. METHODS: According to the strategy, the authors will retrieve a total of seven electronic databases by August 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chinese Scientific Journals Database, and Wan-fang databases. The network meta-analysis will be performed using Aggregate Data Drug Information System 1.16.8 and Stata 13.0 software. In addition, the Cochrane Collaboration's tool is employed for the methodological quality, and the quality of evidence will be evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation system. RESULTS: This study will provide a reliable evidence for the selection strategy of CAM therapies for PSD. CONCLUSION: The results of this study will provide references for evaluating the effects of different CAM therapies on PSD, and provide decision-making references for clinical practitioners, patients, and health policy makers. ETHICS AND DISSEMINATION: This study does not require ethical approval. the results will be disseminated through a peer-reviewed publication. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/TNGH6.

Traditional Chinese medicine for mild cognitive impairment: A protocol for systematic review and network meta-analysis.

BACKGROUND: Mild cognitive impairment (MCI) is an intermediate stage between normal aging and Alzheimer disease, which is the most common form of dementia in the world. In clinical practice, traditional Chinese medicine (TCM) interventions have been administered for MCI, However, there is still uncertain about what strategy of TCM interventions treatment should be preferred in clinical practice. This study aims to evaluate the efficacy and acceptability of different TCM therapies through systematic review and network meta-analysis. METHODS: According to the strategy, the authors will retrieve a total of 7 electronic databases by August 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chongqing VIP, and Wan-fang databases. After a series of screening, 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from the randomized controlled trials of TCM therapies for MCI. The primary outcome of this study is the improvement of cognitive function and the secondary outcome is the activities of daily living, clinical efficacy, and adverse events, and the quality of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument. RESULTS: This study will provide a reliable evidence for the selection of TCM therapies in the treatment of MCI. CONCLUSION: This study will generate evidence for different TCM therapies for MCI and provide a decision-making reference for clinical research. ETHICS AND DISSEMINATION: This study does not require ethical approval. The results will be disseminated through a peer-reviewed publication. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/JV9KG.

Treatment of dysphagia after stroke with acupuncture and related therapies: A protocol for systematic review and network meta-analysis.

BACKGROUND: Dysphagia is a common complication after stroke, with high disability rate and high fatality rate. Although several clinical studies and evidence-based medicine have demonstrated the efficacy of acupuncture in the treatment of dysphagia after stroke, there are significant differences in study design and intervention methods. The objective of this study is to compare the efficacy and safety of different acupuncture and related therapies in the treatment of dysphagia after stroke, so as to provide a superior clinical program. METHODS: We will search 7 databases for randomized controlled trials of acupuncture-related therapies for dysphagia after stroke, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chinese Scientific Journals Database, and wan-fang databases, from the date of the establishment of each database to March 31, 2020. The network meta-analysis will be implemented through Aggregate Data Drug Information System 1.16.8 and Stata 13.0 software. Clinical Efficiency, videofluoroscopic swallowing study score and Kubota Drinking Water Test grade will be the primary outcomes, Swallowing disorder specific quality of life score, Standardized Assessment and Adverse effects will be evaluated as secondary outcomes. Mean differences or odds ratios will be used for statistical analysis. We will ensure the reliability of the results through node-split model and heterogeneity analysis. In addition, methodological quality will be evaluated based on the Cochrane Collaboration's tool, and the quality of evidence will be evaluated according to the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS: This study will provide a reliable evidence for the selection of acupuncture and related therapies for dysphagia after stroke. CONCLUSION: The results of this study will provide references for evaluating the influence of acupuncture and related therapies for dysphagia after stroke, and provide decision-making references for clinical research. ETHICS AND DISSEMINATION: This study did not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/TAHND.

Complementary and alternative therapies for post-traumatic stress disorder: A protocol for systematic review and network meta-analysis.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a psychiatric disorder. While bringing psychologic pain to patients, it also damages their social function, which is a great threat to people's life and health. Complementary and alternative medicine (CAM) therapies have been used clinically to treat PTSD; however, the selection strategies of different CAM interventions in clinical practice is still uncertain, and the purpose of this study is to evaluate the efficacy and acceptability of different CAM therapies using systematic review and network meta-analysis. METHODS: According to the strategy, the authors will retrieve a total of 7 electronic databases by June 2020. After a series of screening, the 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from randomized controlled trials of CAM therapies for the PTSD. Finally, the evidence grade of the results will be evaluated. RESULTS: This study will provide a reliable evidence for the selection of CAM therapies for PTSD. CONCLUSION: The results of this study will provide references for evaluating the influence of different CAM therapies for PTSD, and provide decision-making references for clinical research.

Efficacy and safety of acupuncture in treating post-traumatic stress disorder: A protocol for systematic review and meta-analysis.

BACKGROUND: Post-traumatic stress disorder (PTSD) acts as a complex mental illness in which individuals are prone to long-lasting mental disorders after suffering traumatic events. PTSD is usually accompanied by some comorbidities, such as depressive disorder and sleep disorder, which seriously threaten patients' life and health. Evidences showed that acupuncture could remarkably relieve the symptoms of PTSD patients. The review aims at assessing the safety and effectiveness exhibited by acupuncture for treating PTSD patients. METHODS AND ANALYSIS: The literature identified by searching 8 English electronic databases and 5 Chinese electronic databases from their inception to April 20, 2020 will be incorporated into the study. Two researchers will independently take charge of the research selection, the data extraction, as well as the assessment on research quality. The primary outcomes will be total PTSD symptoms, measured by different instruments including interviews and self-report measures. Data analysis will be performed via the RevMan 5 software, and Grading of Recommendations Assessment, Development, and Evaluation will help to assess the evidence level. A heterogeneity x test, the Higgins' I test as well as visually inspecting the forest plot will help to investigate the heterogeneity of data. A sensitivity analysis and subgroup analyses will assist in investigating the sources of heterogeneity. ETHICS AND DISSEMINATION: The review neither assesses the individual information of patients nor impacts their rights, so it is not necessary for it to be approved by ethical institution. The article will be published in a peer-reviewed journal and present at relevant conferences. OSF REGISTRATION NUMBER:: https://osf.io/dc3js.

The Impact of Intraoperative Hypothermia on Blood Loss and Allogenic Blood Transfusion in Total Knee and Hip Arthroplasty: A Retrospective Study.

BACKGROUND: Total joint arthroplasty (TJA) usually leads to substantial blood loss, which may cause allogenic blood transfusion. Hypothermia occurring during operation has been reported to increase blood loss and transfusion rates in nonorthopedic cohorts. However, the relationship between intraoperative hypothermia and blood loss remains controversial in patients undergoing orthopedic surgeries. The aims of this study were to investigate the incidence of hypothermia and identify the impact of intraoperative body temperature and hypothermia on blood loss and transfusion rates in total knee and hip arthroplasty (TKA and THA, respectively). METHODS: This retrospective study enrolled 616 consecutive patients, who underwent primary unilateral TKA or THA at our institution during the period from April 2012 to July 2014. The occurrence of a temperature below 36°C during the operation was documented to identify the incidence of hypothermia. Univariate analysis was performed to find the risk factors for hypothermia. Multiple regression analysis and multivariate logistic regression analysis were employed to explore the association of intraoperative temperature and hypothermia with intraoperative blood loss and perioperative blood transfusion. RESULTS: The incidence of intraoperative hypothermia was 13.5%, 14.0%, and 13.1% in TJA, TKA, and THA, respectively. Intraoperative temperature (P = 0.045, P = 0.006) and hypothermia (P = 0.042, P < 0.001) were associated with intraoperative blood loss and perioperative transfusion in TKA. Intraoperative temperature (P = 0.002) was negatively related to the amount of blood loss, and hypothermia (P = 0.031) was the independent risk factor for transfusion in THA. CONCLUSION: Intraoperative hypothermia is associated with increased blood loss and transfusion rates in TJA. Efforts should be made to maintain normothermia during operation in these patients.