Utilizing press needle acupuncture to treat mild-to-moderate COVID-19: A single-blind, randomized controlled trial.

BACKGROUND: In China, acupuncture has been employed as an adjunctive therapy for coronavirus disease 2019 (COVID-19). Press needle acupuncture is a special type of acupuncture that provides prolonged stimulation to acupuncture points and simultaneously reduces the pain associated with traditional acupuncture. This study assessed the effectiveness of integrating press needles alongside pharmacologic treatment in patients with mild-to-moderate COVID-19. METHODS: Patients hospitalized with mild-to-moderate COVID-19 symptoms between December 2022 and January 2023 were included in the study. The enrolled patients were randomly assigned to receive pharmacologic treatment alone (control group) or both pharmacologic treatment and press needle acupuncture (intervention group). Patients were evaluated for clinical outcomes, including symptom scores, deterioration rates, fever durations, and nucleic acid test results. The patients' complete blood count and C-reactive protein levels were also analyzed using venous blood samples both before and after treatment. RESULTS: Both groups exhibited a reduction in clinical symptom scores, but symptoms regressed faster in the intervention group. Nucleic acid test negativity was achieved faster in the intervention group than in the control group. The intervention group also had a lower deterioration rate. Furthermore, the increase in the lymphocyte count and decrease in C-reactive protein levels following treatment were more pronounced in the intervention group than in the control group. CONCLUSION: This study suggests that utilizing press needle acupuncture as an adjunct to pharmacologic treatment can be effective in patients with mild-to-moderate COVID-19 symptoms.

Electronic Metal-Support Interaction Induces Hydrogen Spillover and Platinum Utilization in Hydrogen Evolution Reaction.

The substantial promotion of hydrogen evolution reaction (HER) catalytic performance relies on the breakup of the Sabatier principle, which can be achieved by the alternation of the support and electronic metal support interaction (EMSI) is noticed. Due to the utilization of tungsten disulfides as support for platinum (Pt@WS2), surprisingly, Pt@WS2 demands only 31 mV overpotential to attain 10 mA cm-2 in acidic HER test, corresponding to a 2.5-fold higher mass activity than benchmarked Pt/C. The pH dependent electrochemical measurements associated with H2-TPD and in situ Raman spectroscopy indicate a hydrogen spillover involved HER mechanism is confirmed. The WS2 support triggers a higher hydrogen binding strength for Pt leading to the increment in hydrogen concentration at Pt sites proved by upshifted d band center as well as lower Gibbs free energy of hydrogen, favourable for hydrogen spillover. Besides, the WS2 shows a comparably lower effect on Gibbs free energy for different Pt layers (-0.50 eV layer-1) than carbon black (-0.88 eV layer-1) contributing to a better Pt utilization. Also, the theoretical calculation suggests the hydrogen spillover occurs on the 3rd Pt layer in Pt@WS2; moreover, the energy barrier is lowered with increment in hydrogen coverage on Pt. Therefore, the boosted HER activity attributes to the EMSI effect caused hydrogen spillover and enhancement in Pt utilization efficiency.

Oxygen vacancies in Bi2WO6 enable robust nitrate reduction reaction catalysis.

The faradaic efficiency of Bi2WO6 is 62.0% at -0.3 V vs. RHE, an improvement of 1.4- and 1.8-times relative to Bi2O3 and WO3 for the nitrate reduction reaction. In addition, the catalysis occurring on Bi2WO6 follows the pathway: *NO3-*NO2-*NO-*NOH-*HNOH-*H2NOH-*NH3, as verified by operando Raman spectroscopy and theoretical calculations.

Built-in Electric Field in 1D/2D Heterostructure Boosts Zinc Air Battery Performance.

The realization of a rechargeable zinc-air battery (ZAB) is hindered by the low intrinsic oxygen evolution reaction (OER) and oxygen reduction reaction (ORR) activities. In this work, an abundant built-in electric field is noticed in a 1D/2D CoO/CoS2 heterostructure, triggering electron transfer from CoO to CoS2 associated with a downshifted d band center of the Co atom mitigating the strong electrochemical adsorption of *OH species on active sites; thereby, boosted OER and ORR performance are achieved. Namely, the OER specific activity of CoO/CoS2 is enhanced by 3.8- and 2.2-fold compared to the counterpart of CoO and CoS2, respectively. Furthermore, the kinetic current density of CoO/CoS2, a fingerprint of intrinsic ORR activity, is promoted by 46 and 6.6 times relative to CoO and CoS2. The rechargeable ZAB performance attains 215.6 mW cm-2, 1.6-times better than Pt/C-IrO2. Moreover, the superior performance remained for 600 h. Besides, the battery performance of the all-solid-state ZAB reaches 83.8 mW cm-2, revealing its promising application in wearable device.

Liver stiffness in hepatocellular carcinoma and chronic hepatitis patients: Hepatitis B virus infection and transaminases should be considered.

BACKGROUND: Liver condition is a crucial prognostic factor for patients with hepatocellular carcinoma (HCC), but a convenient and comprehensive method to assess liver condition is lacking. Liver stiffness (LS) measured by two-dimensional shear wave elastography may help in assessing liver fibrosis and liver condition. Chronic hepatitis B (CHB) is an important risk factor for HCC progression, but LS was found to be less reliable in assessing liver fibrosis following hepatitis viral eradication. We hypothesize that the status of hepatitis virus infection would affect the accuracy of LS in assessing the liver condition. AIM: To test the feasibility and impact factors of using LS to assess liver condition in patients with HCC and CHB. METHODS: A total of 284 patients were retrospectively recruited and classified into two groups on the basis of serum CHB virus hepatitis B virus (HBV)-DNA levels [HBV-DNA ≥ 100.00 IU/mL as Pos group (n = 200) and < 100.00 IU/mL as Neg group (n = 84)]. Correlation analyses and receiver operating characteristic analyses were conducted to evaluate the relationship between LS and liver condition. RESULTS: A significant correlation was found between LS and most of the parameters considered to have the ability to evaluate liver condition (P < 0.05). When alanine aminotransferase (ALT) concentrations were normal (≤ 40 U/L), LS was correlated with liver condition indices (P < 0.05), but the optimal cutoff of LS to identify a Child-Pugh score of 5 was higher in the Neg group (9.30 kPa) than the Pos group (7.40 kPa). When ALT levels were elevated (> 40 U/L), the correlations between LS and liver condition indices were not significant (P > 0.05). CONCLUSION: LS was significantly correlated with most liver condition indices in patients with CHB and HCC. However, these correlations varied according to differences in HBV-DNA and transaminase concentrations.

Development and validation of a diagnostic model for predicting cervical lymph node metastasis in laryngeal and hypopharyngeal carcinoma.

Objectives: The lymph node status is crucial for guiding the surgical approach for patients with laryngeal and hypopharyngeal carcinoma (LHC). Nonetheless, occult lymph node metastasis presents challenges to assessment and treatment planning. This study seeks to develop and validate a diagnostic model for evaluating cervical lymph node status in LHC patients. Materials and methods: This study retrospectively analyzed a total of 285 LHC patients who were treated at the Department of Otolaryngology Head and Neck Surgery, Daping Hospital, Army Medical University, from January 2015 to December 2020. Univariate and multivariate logistic regression analyses were employed to construct the predictive model. Discrimination and calibration were used to assess the predictive performance of the model. Decision curve analysis (DCA) was performed to evaluate the clinical utility of the model, and validation was conducted using 10-fold cross-validation, Leave-One-Out Cross Validation, and bootstrap methods. Results: This study identified significant predictors of lymph node metastasis in LHC. A diagnostic predictive model was developed and visualized using a nomogram. The model demonstrated excellent discrimination, with a C-index of 0.887 (95% CI: 0.835-0.933). DCA analysis indicated its practical applicability, and multiple validation methods confirmed its fitting and generalization ability. Conclusion: This study successfully established and validated a diagnostic predictive model for cervical lymph node metastasis in LHC. The visualized nomogram provides a convenient tool for personalized prediction of cervical lymph node status in patients, particularly in the context of occult cervical lymph node metastasis, offering valuable guidance for clinical treatment decisions.

Effect of electroacupuncture on myocardial transient receptor potential channels in mice with myocardial hypertrophy. / ç”µé’ˆå¯¹å¿ƒè‚Œè‚¥åŽšå°é¼ å¿ƒè‚Œç»„ç»‡çž¬æ—¶å—ä½“ç”µä½é€šé“çš„å½±å“.

OBJECTIVES: To observe the effect of electroacupuncture (EA) at "Neiguan"(PC6) on cardiac function, cardiac morphology and transient receptor potential channel (TRPC) protein expressions in myocardial tissue of mice with myocardial hypertrophy, so as to explore its mechanisms underlying improvement of myocardial hypertrophy. METHODS: Forty-five male C57BL/6 mice were randomly divided into control, model and EA groups (15 mice/group). The myocardial hypertrophy model was established by subcutaneous injection of isoproterenol hydrochloride (15 mg·kg-1·d-1) for 14 days. The mice of the control group received subcutaneous injection of same amount of normal saline. The mice of the EA group received EA stimulation (frequency of 2 Hz, intensity of 1 mA) of bilateral PC6 for 20 min each time, once a day for 14 consecutive days. After the intervention, the body weight, tibia length and heart weight were measured. The left ventricular ejection fraction (EF), fractional shortening index (FS), left ventricular end-systolic volume (LVEV), left ventricular end-systolic internal diameter (LVID) and left ventricular posterior wall thickness (LVPW) were measured by using echocardiography for evaluating the cardiac function. The mean number and surface area of myocardial cells was detected by wheat germ agglutinin (WGA) staining, and changes of the cardiac morphology were observed under light microscopy after HE staining. The expression levels of TRPC1, TRPC3, TRPC4 and TRPC6 (TRPC1/3/4/6) in the myocardial tissue were detected by real-time quantitative PCR (qPCR) and Western blot, separately. RESULTS: Compared with the control group, the heart-body weight ratio(P<0.05) and heart-weight-to-tibia-length ratio (P<0.01), LVEV and LVID levels, the relative surface area, left ventricular area ratio, and the expression levels of cardiac TRPC1/3/4/6 were significantly increased (P<0.01, P<0.05), while the EF, FS, LVPW, number of cardiomyocytes, and the left ventricular posterior wall ratio were obviously decreased (P<0.01, P<0.05) in the model group. In comparison with the model group, the heart/body weight ratio, heart-weight-to-tibia-length ratio, LVEV and LVID levels, relative surface area, left ventricular area ratio, and the expression levels of cardiac TRPC1/3/4/6 were significantly decreased (P<0.01, P<0.05), while the EF, FS, LVPW, number of cardiomyocytes and left ventricular posterior wall ratio were significantly increased (P<0.01, P<0.05) in the EA group. H.E. staining showed disordered arrangement of cardiomyocytes and obvious myocardial interstitial inflammatory cell infiltration in the model group, and evident reduction of degree of cardiac fibrosis and interstitial edema in the EA group. CONCLUSIONS: EA of PC6 can improve the cardiac function and cardiac morphology in mice with myocardial hypertrophy, which may be related to its functions in down-regulating the expression of transient receptor potential channels.

[Extracorporeal Membrane Oxygenation Combined With Interventional Thrombectomy for Treating High-Risk Pulmonary Embolism Caused by Protein C Deficiency:Report of One Case].

Hereditary protein C deficiency is a chromosomal genetic disease caused by mutations in the protein C gene,which can lead to venous thrombosis and is mostly related to mutations in exons 4-9 and intron 8.Fatal pulmonary embolism caused by mutations in the protein C gene is rare,and the treatment faces great challenges.This article reports a case of fatal pulmonary embolism caused by a frameshift mutation in exon 8 of the protein C gene and summarizes the treatment experience of combining extracorporeal membrane oxygenation (for respiratory and circulatory support) with interventional thrombectomy,providing a basis for the diagnosis and treatment of this disease.

The effectiveness of high-intensity laser therapy in individuals with neck pain: a systematic review and meta-analysis.

OBJECTIVES: The primary objective of this meta-analysis was to determine whether high-intensity laser therapy (HILT) was effective in improving pain intensity, cervical range of motion (ROM), functional activity, and quality of life (QOL) in individuals with neck pain. DATA SOURCES: PubMed, PEDro, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from inception to March 26, 2022. STUDY SELECTION: Randomized controlled trials (RCTs) involving HILT for neck pain were selected. DATA EXTRACTION AND DATA SYNTHESIS: Two raters were independent in data extraction. The methodological quality was evaluated using the PEDro scale, and the level of evidence was assessed using the GRADE system. RevMan5.4 was used for meta-analysis. RESULTS: Eight RCTs were included and their PEDro scores were moderate to high. Compared with placebo, HILT was effective in improving pain intensity (SMD 2.12, 95%CI 1.24 to 3.00; moderate quality evidence), cervical flexion (SMD 1.31, 95%CI 0.27 to 2.35; moderate quality evidence), extension (SMD 1.43, 95%CI 0.24 to 2.63; moderate quality evidence), right lateral flexion (SMD 1.36, 95%CI 0.15 to 2.56; low-quality evidence). There was a trend of better outcome in functional activity after HILT (SMD 1.73, 95%CI -0.05 to 3.54; low quality evidence). LIMITATIONS: There was limited information available on QOL. CONCLUSION: HILT may be considered as an adjunctive treatment modality for neck pain. There was moderate quality evidence that HILT may improve pain intensity and cervical ROM in individuals with neck pain, but there was low quality evidence that HILT was not effective in improving functional activity. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021254078 CONTRIBUTION OF THE PAPER.

Reliability of shear-wave elastography in assessing the stiffness of the nuchal fascia and the thickness of upper cervical muscles.

OBJECTIVE: To determine the reliability of shear-wave elastography (SWE)in assessing the stiffness of the nuchal fascia and the thickness of upper cervical muscles in neutral head posture (NHP) or forward head posture (FHP). METHODS: Sixteen healthy adults (mean age: 21.69 ± 1.01years, 9 females) were included. SWE mode was chosen to measure the nuchal fascia shear modulus and muscle thickness was measured in B-mode. Measurements were collected by two independent investigators on two different days. The intraclass correlation coefficient (ICC) was used to measure the relative reliability, and the standard error of measurement (SEM) were used to measure the absolute reliability. RESULTS: Intra­rater (ICC = 0.63-0.89) and inter-rater (ICC = 00.54-0.82) reliability for the nuchal fascia shear modulus were moderate to excellent. Intra­rater (ICC = 00.64-0.96) and inter-rater (ICC = 00.48-0.86) reliability for upper cervical muscles thickness were moderate to excellent. The SEM percentage oscillated from 3.27% to 13.55%. There were significant differences(P < 0.05) between NHP and FHP on nuchal fascia shear modulus, right side splenius capitis muscle thickness and left side semispinalis capitis muscle thickness, but no significant differences(P > 0.05) were observed between the right and left sides. The upper cervical muscles thickness of males was significantly thicker(P < 0.01) than females while no significant differences were observed (P > 0.05) on the nuchal fascia shear modulus. CONCLUSIONS: Ultrasound-based SWE may be a reliable tool for assessing the stiffness of the nuchal fascia and the thickness of upper cervical muscles in clinical practice. REGISTRATION NUMBER: ChiCTR2200055736.

Hydrazine-Assisted Acidic Water Splitting Driven by Iridium Single Atoms.

Water splitting, an efficient technology to produce purified hydrogen, normally requires high cell voltage (>1.5 V), which restricts the application of single atoms electrocatalyst in water oxidation due to the inferior stability, especially in acidic environment. Substitution of anodic oxygen evolution reaction (OER) with hydrazine oxidation reaction (HzOR) effectually reduces the overall voltage. In this work, the utilization of iridium single atom (Ir-SA/NC) as robust hydrogen evolution reaction (HER) and HzOR electrocatalyst in 0.5 m H2 SO4 electrolyte is reported. Mass activity of Ir-SA/NC is as high as 37.02 A mgIr -1 at overpotential of 50 mV in HER catalysis, boosted by 127-time than Pt/C. Besides, Ir-SA/NC requires only 0.39 V versus RHE to attain 10 mA cm-2 in HzOR catalysis, dramatically lower than OER (1.5 V versus RHE); importantly, a superior stability is achieved in HzOR. Moreover, the mass activity at 0.5 V versus RHE is enhanced by 83-fold than Pt/C. The in situ Raman spectroscopy investigation suggests the HzOR pathway follows *N2 H4 →*2NH2 →*2NH→2N→*N2 →N2 for Ir-SA/NC. The hydrazine assisted water splitting demands only 0.39 V to drive, 1.25 V lower than acidic water splitting.

1.7†µm sub-200 fs vortex beams generation from a thulium-doped all-fiber laser.

The pulsed 1.7 µm vortex beams (VBs) has significant research prospects in the fields of imaging and material processing. We experimentally demonstrate the generation of sub-200 fs pulsed VBs at 1.7 µm based on a home-made mode-selective coupler (MSC). Through dispersion management technology in a thulium-doped fiber laser, the stable linearly polarized VBs pulse directly emitting from the cavity is measured to be 186 fs with central wavelength of 1721.2 nm. By controlling the linear superposition of LP11 modes, cylindrical vector beams (CVBs) can also be obtained. In addition, a variety of bound states pulsed VBs at 1.7 µm can also be observed. Our finding provides an effective way to generate ultrashort pulsed VBs and CVBs at 1.7 µm waveband.

Stiffness on shear wave elastography as a potential microenvironment biomarker for predicting tumor recurrence in HBV-related hepatocellular carcinoma.

BACKGROUND: To explore the pathologic basis and prognostic value of tumor and liver stiffness measured pre-operatively by two-dimensional shear wave elastography (2D-SWE) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients who undergo hepatic resection. METHODS: A total of 191 HBV-infected patients with solitary resectable HCC were prospectively enrolled. The stiffness of intratumoral tissue, peritumoral tissue, adjacent liver tissue, and distant liver tissue was evaluated by 2D-SWE. The correlations between stiffness and pathological characteristics were analyzed in 114 patients. The predictive value of stiffness for recurrence-free survival (RFS) was evaluated, and Cutoff Finder was used for determining optimal cut-off stiffness values. Cox proportional hazards analysis was used to identify independent predictors of RFS. RESULTS: Pathologically, intratumoral stiffness was associated with stroma proportion and microvascular invasion (MVI) while peritumoral stiffness was associated with tumor size, capsule, and MVI. Adjacent liver stiffness was correlated with capsule and liver fibrosis stage while distant liver stiffness was correlated with liver fibrosis stage. Peritumoral stiffness, adjacent liver stiffness, and distant liver stiffness were all correlated to RFS (all p < 0.05). Higher peritumoral stiffness (> 49.4 kPa) (HR = 1.822, p = 0.023) and higher adjacent liver stiffness (> 24.1 kPa) (HR = 1.792, p = 0.048) were significant independent predictors of worse RFS, along with tumor size and MVI. The nomogram based on these variables showed a C-index of 0.77 for RFS prediction. CONCLUSIONS: Stiffness measured by 2D-SWE could be a tumor microenvironment and tumor invasiveness biomarker. Peritumoral stiffness and adjacent liver stiffness showed important values in predicting tumor recurrence after curative resection in HBV-related HCC. CLINICAL RELEVANCE STATEMENT: Tumor and liver stiffness measured by two-dimensional shear wave elastography serve as imaging biomarkers for predicting hepatocellular carcinoma recurrence, reflecting biological behavior and tumor microenvironment. KEY POINTS: • Stiffness measured by two-dimensional shear wave elastography is a useful biomarker of tumor microenvironment and invasiveness. • Higher stiffness indicated more aggressive behavior of hepatocellular carcinoma. • The study showed the prognostic value of peritumoral stiffness and adjacent liver stiffness for recurrence-free survival. • The nomogram integrating peritumoral stiffness, adjacent liver stiffness, tumor size, and microvascular invasion showed a C-index of 0.77.

2D Ni-organic frameworks decorated carbon nanotubes encapsulated Ni nanoparticles for robust CN and HO bonds cleavage.

In this work, we report a robust bifunctional electrocatalyst composed of 2D Ni- organic frameworks (Ni-MOF) and nitrogen doped carbon nanotubes encapsulated Ni nanoparticles (Ni-MOF@Ni-NCNT) for CN and HO bonds dissociation. Due to the presence of Ni-NCNT, adsorption of OH- species is enhanced and CO2 binding strength is simultaneously weakened leading to a boosted urea oxidation reaction performance reflected by decrement in potential at 100 mA cm-2 by 69 mV. The loosened binding strength with CO2 specie is highlighted by in-situ electrochemical impedance spectroscopy (EIS) test and DFT calculation. Moreover, the alkaline hydrogen evolution reaction (HER) performance of Ni-MOF@Ni-NCNT is better than Ni-MOF and Ni-NCNT evidenced by the overpotential at 50 mA cm-2 decreased by 224 mV and 900 mV ascribed to the synergistic effect, in which Ni-MOF, Ni nanoparticles and Ni-Nx-C facilitates water adsorption, dissociation and adsorption/combination of hydrogen ions, respectively. The assembled HER- urea oxidation reaction (UOR) system requires only 1.33 V to reach 10 mA cm-2, 70 mV lower than water splitting driven by Pt/C-IrO2.

Pheochromocytoma crisis with refractory Acute Respiratory Distress Syndrome (ARDS), Takotsubo syndrome, emergency adrenalectomy, and need for Extracorporeal Membrane Oxygenation (ECMO) in a previously undiagnosed and asymptomatic patient, due to the use of metoclopramide.

BACKGROUND: Pheochromocytoma (PCC) crisis is a rare life-threatening endocrine emergency. The diagnosis and treatment of PCC crisis, with acute respiratory distress syndrome (ARDS) as the first manifestation, is highly challenging, and traditional PCC management strategies are no longer suitable for these patients. CASE PRESENTATION: A 46-year-old female patient was admitted to the Intensive Care Unit (ICU) following sudden-onset acute respiratory distress and subsequent initiation of mechanical ventilation via endotracheal intubation. She was initially suspected of having a PCC crisis through the bedside critical care ultrasonic examination protocol. The computed tomography examination revealed a left adrenal neoplasm of 6.5cm × 5.9cm. The plasma-free metanephrine level was 100 times higher than the reference value. These findings were compatible with her PCC diagnosis. Alpha-blockers and fluid intake were started immediately. The endotracheal intubation was removed on the 11th day after admission to the ICU. The patient progressed to severe ARDS again, and invasive ventilation and continuous renal replacement therapy were needed. Despite aggressive therapy, her condition deteriorated. Therefore, she underwent veno-arterial extracorporeal membrane oxygenation (VA-ECMO)-assisted emergency adrenalectomy after multidisciplinary discussion. Postoperatively, the patient was supported by VA-ECMO for 7days. She was discharged from the hospital on day 30 after tumor resection. CONCLUSIONS: This case highlighted the challenges in diagnosing and managing ARDS associated with PCC crisis. The traditional preoperative preparation protocol and optimal operation timing for patients with PCC are not suitable for patients with PCC crisis. Patients with life-threatening PCC crisis may benefit from early tumor removal, and VA-ECMO could maintain hemodynamic stability during and after surgery.

Nickel-doped iridium echinus-like nanosheets for stable acidic water splitting.

Nickel-doped iridium echinus-like nanosheets (NiIr-ENS) have a superior acidic oxygen evolution reaction (OER) activity with a TOF of 1.72 s-1 at an overpotential of 300 mV, 8.6-fold higher than that of IrO2.

Morphological and Coordination Modulations in Iridium Electrocatalyst for Robust and Stable Acidic OER Catalysis.

Proton exchange membrane water splitting (PEMWS) technology has high-level current density, high operating pressure, small electrolyzer-size, integrity, flexibility, and has good adaptability to the volatility of wind power and photovoltaics, but the development of both active and high stability of the anode electrocatalyst in acidic environment is still a huge challenge, which seriously hinders the promotion and application of PEMWS. In recent years, researchers have made tremendous attempts in the development of high-quality active anode electrocatalyst, and we summarize some of the research progress made by our group in the design and synthesis of PEMWS anode electrocatalysts with different nanostructures, and makes full use of electrocatalytic activity points to increase the inherent activity of Iridium (Ir) sites, and provides optimization strategies for the long-term non-decay of catalysts under high anode potential in acidic environments. At this stage, these research advances are expected to facilitate the research and technological progress of PEMWS, and providing some research ideas and references for future research on efficient and inexpensive PEMWS anode electrocatalysts.

Effect of Repetitive Peripheral Magnetic Stimulation on Patients With Low Back Pain: A Meta-analysis of Randomized Controlled Trials.

OBJECTIVE: The purpose of this meta-analysis was to investigate the effects of repetitive peripheral magnetic stimulation (rPMS) on pain intensity, functional mobility, and kinesiophobia in individuals with low back pain (LBP). DATA SOURCES: The PubMed, Physiotherapy Evidence Database, Embase, Cochrane Library, and Web of Science databases were systematically searched from inception until November 25, 2022. STUDY SELECTION: Eligible randomized controlled trials contained information on the population (LBP), intervention (rPMS), and outcomes (pain intensity, functional mobility, and kinesiophobia). Participants in the rPMS intervention group were compared with those in sham or other control groups. Two independent researchers searched for, screened, and qualified the articles. DATA EXTRACTION: Two independent researchers extracted key information from each eligible study. The authors' names, year of publication, setting, total sample size, rPMS parameters, baseline/mean difference (MD), and 95% confidence interval (CI) were extracted using a standardized form, and the methodological quality was assessed using the Physiotherapy Evidence Database score and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. DATA SYNTHESIS: Of 733 studies identified, 6 randomized controlled trials (n = 139) were included for meta-analysis. Compared with sham rPMS or other therapy, rPMS showed significant efficacy in reducing pain intensity (visual analog scale: MD, -1.89; 95% CI, -3.32 to -0.47; P<.05; very low-quality evidence). Significant efficacy was also found in terms of functional disability (Oswestry Disability Index: MD, -8.39; 95% CI, -13.65 to -3.12; P<.001; low-quality evidence). However, there was no statistically significant between-group difference on the Tampa scale of kinesiophobia (MD, -1.81; 95% CI, -7.60 to 3.98; P>.05; very low-quality evidence). CONCLUSIONS: This meta-analysis found very low- to low-quality evidence that rPMS can be used to reduce pain intensity and improve functional disability in individuals with LBP. However, no significant effect of rPMS on kinesiophobia was found.