Connecting atrial fibrillation to digestive neoplasms: exploring mediation via ischemic stroke and heart failure in Mendelian randomization studies.

Background: Notwithstanding the acknowledged interplay between atrial fibrillation (AF) and the emergence of digestive system neoplasms, the intricacies of this relationship remain ambiguous. By capitalizing univariable Mendelian Randomization (MR) complemented by a mediated MR tactic, our pursuit was to elucidate the causative roles of AF in precipitating digestive system malignancies and potential intermediary pathways. Method: This research endeavor seeks to scrutinize the causal clinical implications of whether genetic predispositions to AF correlate with an increased risk of digestive system malignancies, employing MR analytical techniques. Utilizing a dataset amalgamated from six studies related to AF, encompassing over 1,000,000 subjects, we performed univariable MR assessments, employing the random-effects inverse-variance weighted (IVW) methodology as our principal analytical paradigm. Subsequently, a mediated MR framework was employed to probe the potential mediating influence of AF on the nexus between hypertension (HT), heart failure (HF), ischemic stroke (IS), coronary artery disease (CAD), and digestive system neoplasms. Result: The univariable MR evaluation unveiled a notable causal nexus between the genetic inclination toward AF and the genetic susceptibility to colon, esophageal, and small intestine malignancies. The mediated MR scrutiny ascertained that the genetic inclination for AF amplifies the risk profile for colon cancer via IS pathways and partially explains the susceptibility to esophageal and small intestine tumors through the HF pathway. Conclusion: Our investigative endeavor has highlighted a definitive causative association between genetic inclination to AF and specific digestive system neoplasms, spotlighting IS and HF as instrumental mediators. Such revelations furnish pivotal perspectives on the complex genetic interconnections between cardiovascular anomalies and certain digestive tract tumors, emphasizing prospective therapeutic and diagnostic worthy of pursuit.

The causal relationship between sarcopenic obesity factors and benign prostate hyperplasia.

Background: Both benign prostatic hyperplasia (BPH) and sarcopenic obesity (SO) are common conditions among older adult/adults males. The prevalent lifestyle associated with SO is a significant risk factor for the development of BPH. Therefore, we investigated the causal relationship between SO factors and BPH. Method: The instrumental variables for SO factors were selected using the inverse variance-weighted method, which served as the primary approach for Mendelian randomization analysis to assess the causal effect based on summary data derived from genome-wide association studies of BPH. Result: The increase in BMR (OR = 1.248; 95% CI = (1.087, 1.432); P = 0.002) and ALM (OR = 1.126; 95% CI = (1.032, 1.228); P = 0.008) was found to be associated with an elevated risk of BPH. However, no genetic causality between fat-free mass distribution, muscle mass distribution, and BPH was observed. Conclusion: Our findings indicate that a genetic causal association between BMR, ALM and BPH. BMR and ALM are risk factors for BPH. The decrease in BMR and ALM signified the onset and progression of SO, thus SO is a protective factor for BPH.

The effect of acupuncture on oestrogen receptors in rats with benign prostatic hyperplasia.

The effects of acupuncture on the protein and gene expression of oestrogen receptors (ERs) alpha (α) and beta (ß) in testosterone-induced benign prostatic hyperplasia (BPH) in rats remains unclear. In this study, rats were randomly divided into four groups (n = 10 per group). The rats in the blank group did not receive any treatment, while the rats in the model group were injected intraperitoneally with testosterone propionate for 28 days to establish the BPH model and then randomly sub-divided into a control group, an acupuncture group and a finasteride group (positive control group). Dissections were performed after rats were anesthetized with isoflurane, and then the weight and volume of the prostate were then measured. The expression of ERs was detected via immunohistochemistry, western blot and real-time polymerase chain reaction. The results showed that ERα was discontinuously distributed in epithelial cells and expressed in large quantities in stromal cells, and ERß was aggregated and expressed in hyperplastic nodules. Acupuncture and finasteride could significantly improve the distribution of ERα and ERß which suggested that acupuncture and finasteride could improve BPH. There was no significant difference in ERα messenger ribonucleic acid (mRNA) expression among the groups, but the ERß mRNA expression in the finasteride group showed a significant difference compared with the control and acupuncture groups. The mechanism of the acupuncture treatment of BPH may be related to the increased transcription level of ERß mRNA in prostate tissues, the improved distribution of ERα expression in epithelial cells and the aggregation expression of ERs in hyperplastic nodules.

Effects of acupuncture treatment on postoperative gastrointestinal dysfunction in colorectal cancer: study protocol for randomized controlled trials.

BACKGROUND: Postoperative gastrointestinal dysfunction (PGID) is a common complication arising from colorectal cancer surgery. Attributing factors, such as anesthesia, surgical retraction, and early intake of water, can inhibit gastrointestinal motility, causing constipation, reduction or absence of bowel sounds, nausea, vomiting, and other symptoms. Delayed recovery in gastrointestinal function can lead to intestinal obstructions or paralysis, anastomotic leaks, and other complications, affecting the patient's recovery and quality of life negatively. Due to its complex pathophysiology, treatment for PGID in colorectal patients has remained a challenge. Acupuncture is an alternative therapy commonly used for postoperative recovery. This study aims to evaluate the therapeutic efficacy and safety of acupuncture on PGID. Through the complementation of acupuncture and enhanced recovery after surgery (ERAS) protocols, the advantages of acupuncture treatments could be demonstrated to promote its application in future clinical practice. METHODS: The study design is a prospective randomized controlled trial (RCT). One hundred sixty postoperative colorectal cancer patients will be recruited from Cancer Hospital Chinese Academy of Medical Sciences (CICAMS). Subjects who fulfill inclusion criteria will be randomly assigned into the acupuncture group (AG) (n = 80) or control group (CG) (n = 80). AG will receive acupuncture treatment and perioperative care guided by ERAS protocols, and CG will only receive perioperative care guided by ERAS protocols. The intervention will begin on the first day post-surgery, continuing for 4 days, with a follow-up assessment in a month. Time of first postoperative flatus would be the primary outcome measure. Secondary outcome measures include the time of first postoperative defecation, time of first fluid intake, time of first ambulation, postoperative hospital stay, gastrointestinal reaction score, acupuncture sensation evaluation scale, laboratory tests, postoperative quality of life, readmission rate, and postoperative complications. All results are evaluated from baseline, post-treatment, and upon follow-up. DISCUSSION: The results of the study would help elucidate evidence of the therapeutic effects of acupuncture on the recovery of postoperative gastrointestinal function. The objective of the study aims for the eventual inclusion of acupuncture in the ERAS protocol, allowing for wider application in clinical practice. TRIAL REGISTRATION: ClinicalTrials.gov ChiCTR2000036351. Registered on August 22, 2020.

Altered Cerebellum Spontaneous Activity in Juvenile Autism Spectrum Disorders Associated with Clinical Traits.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder. The associations between the cerebellum and clinical traits remain unclear. We performed amplitude of low-frequency fluctuation (ALFF) analysis to explore the associations between spontaneous brain activity and clinical traits. 361 juvenile ASD patients were included from the ABIDEII database. In the ASD group, the mean ALFF values of cerebellum 4 5 were correlated with SRS awareness and communication. The mean ALFF values of cerebellum 6 and vermis 4 5 were both positively correlated with SRS total, awareness, communication, and motivation. In contrast, the mean ALFF values of vermis 1 2 were negatively correlated with SRS total, awareness, and mannerisms. Our study suggests a role of the cerebellum in functional impairments in ASD.

Composition and assembly of the bacterial community in the overlying waters of the coral reef of China's Xisha Islands.

Coral reef ecosystems are one of the most diverse and productive habitats on Earth. Microbes in the reef-overlying waters are key players in maintaining this ecosystem through regulating biogeochemical and ecological processes. However, the composition structure and assembly mechanism of microbial community in the reef-overlying waters remain largely unknown. In the present study, the bacterial communities from the overlying waters of atolls and fringing reefs as well as the surface waters of the adjacent open ocean of the Xisha Islands in the South China Sea were investigated using 16S rRNA high-throughput sequencing combined with a size-fractionation strategy. The results showed that environments of all sampling stations were similar, characterized by an almost complete lack of inorganic nutrients such as nitrogen and phosphorus. Proteobacteria, Cyanobacteria and Bacteroidetes were the dominant phyla, and Synechococcus was most abundant at the genus level in both large fraction (LF; 1.6-200 µm) and small fraction (SF; 0.2-1.6 µm) communities. Only a slight difference in community composition between LF and SF samples was observed. The bacterial communities among the three habitat types showed noticeable differences, and the bacterial composition among the atoll reefs was more varied than that among the fringing reefs. The similarity of bacterial communities significantly declined with the increasing geographic distance, and stochastic processes were more important than deterministic processes in bacterial community assembly. This study sheds lights on the bacterial biodiversity of coral reefs and the importance of stochastic process in structuring bacterial communities.

Heterogeneous Acupuncture Effects of Taixi (KI3) on Functional Connectivity in Healthy Youth and Elder: A Functional MRI Study Using Regional Homogeneity and Large-Scale Functional Connectivity Analysis.

Heterogeneous neurological responses of acupuncture between different groups have been proposed by previous studies but rarely studied. The study described here was designed to explore the divergence of acupuncture at Taixi (KI3) on spontaneous activity of brain regions and functional connectivity (FC) between healthy youth and elder with functional magnetic resonance imaging (fMRI). 20 healthy young volunteers and 20 healthy elders underwent 10-minute-resting-state fMRI before acupuncture, and then acupuncture at Taixi (KI3) for 3 minutes; after withdrawing the needles, volunteers underwent a second fMRI scan for 10 minutes. Regional homogeneity (ReHo) and large-scale FC analysis using Power 264 atlas were utilized to analyze the changes of brain spontaneous activity. Compared with the resting state, the decreased ReHo after acupuncture at KI3 in both groups were concentrated in the left postcentral, right paracentral lobule, and right SMA. Moreover, the subjects in the HY group showed declined ReHo in brain regions involving the right lingual and precentral. However, those subjects in the HE group presented decreased ReHo in the right postcentral and precentral, left supramarginal gyrus and SMA, and both cingulum middle after needling in KI3. Compared with the resting state, the HY group in the postneedling state showed lower mean intranetwork FC in sensory/somatomotor and subcortical network. And the internetwork FC between sensory/somatomotor and dorsal attention had significantly decreased after acupuncture. Furthermore, the internetwork FC between subcortical and dorsal attention and between subcortical and cerebellar showed the most obvious elevations after needling in the HY group. In the elder group, both FCs of internetwork and intranetwork primarily involving sensory/somatomotor, cingulo-opercular, and dorsal attention were declined after acupuncture. These results indicated that acupuncture at KI3 had heterogeneous acupuncture effects in different age groups. Our study led to converging evidence supporting the acupuncture effect segregation of different condition subjects and supporting evidence for prevention and treatment with acupuncture in the future.

Partially randomized patient preference trial: Comparative evaluation of fibromyalgia between acupuncture and cupping therapy (PRPP-FACT).

BACKGROUND: and purpose The aim of this study was to investigate the feasibility of applying a partially randomized patients' preference (PRPP) trial in the clinical evaluation of acupuncture versus cupping therapy for fibromyalgia. MATERIALS AND METHODS: The final study included 126 participants. Participants without a treatment modality preference were randomly assigned to either the cupping therapy group or the acupuncture group. Patients with strong preferences were assigned to their treatment modality of choice. Ashi points were used for treatment. Outcome measures were both qualitative (patient expectation and satisfaction) and quantitative (drop-out rate, pain intensity, quality of life, depression assessment). RESULTS: The recruitment of the non-randomized participants was completed 8 months before the randomized participants were recruited. There was no statistical difference related to the grouping method in the adjusted drop-out rate, patient expectation, and satisfaction. CONCLUSION: The PRPP model is suitable for use in the clinical evaluation of non-pharmaceutical therapies.

The altered Granger causality connection among pain-related brain networks in migraine.

Numerous fMRI studies have confirmed functional abnormalities in resting-state brain networks in migraine patients. However, few studies focusing on causal relationships of pain-related brain networks in migraine have been conducted. This study aims to explore the difference of Granger causality connection among pain-related brain networks in migraine without aura (MWoA) patients.Twenty two MWoA patients and 17 matched healthy subjects were recruited to undergo resting-state fMRI scanning. Independent component analysis was used to extract pain-related brain networks, and Granger causality analysis to characterize the difference of Granger causality connection among pain-related brain networks was employed.Seven pain-related brain networks were identified, and MwoA patients showed more complex Granger causality connections in comparison with healthy subjects. Two-sample t test results displayed that there was the significant difference between right-frontoparietal network (RFPN) and executive control network (ECN).This study indicates that the specific intrinsic brain Granger causality connectivity among pain-related networks in MwoA patients are affected after long-term migraine attacks.

[Impacts of electroacupuncture on benign prostatic hyperplasia and the levels of estrogen and androgen in patients].

OBJECTIVE: To discuss the therapeutic effects of electroacupuncture on benign prostatic hyperplasia and the impacts on hormone levels in the patients. METHODS: Sixty patients were randomized into an electroacupuncture group and a medication group, 30 cases in each one. In the electroacupuncture group, electroacupuncture was applied to Zhongji (CV 3) and Qugu (CV 2), once a day, 5 times a week. In the medication group, tamsulosin hydrochloride sustained-release capsules were prescribed for oral administration, 0.2 mg, once a day. The duration of treatment was 6 weeks in both of the two groups. The changes in serum testosterone (T), estradiol (E2) and E2/T, the international prostate symptom score (IPSS) and its erectile function score (ⅡEF5) and serum prostate specific antigen (PSA) as well as the adverse reactions were observed before and after treatment in the two groups. The clinical therapeutic effects were compared between the two groups. RESULTS: Before and after treatment, the differences in serum T, E2 and E2/T were not significant in the electroacupuncture group (all P>0.05); the difference in E2/T was significant in the medication group (P<0.05). The differences in serum T, E2 and E2/T were not significant between the two groups (all P>0.05). IPSS was reduced as compared with that before treatment in the electroacupuncture group (P<0.05) and was not different significantly as compared with that before treatment in the medication group (P>0.05). The difference was significant in comparison of the two groups after treatment (P<0.05), and the electroacupuncture group was better. After treatment, the symptom severity was reduced apparently in the electroacupuncture group and the overall situation was better than that in the medication group (P<0.05). ⅡEF5 score and PSA were not different significantly before and after treatment in the two groups and between the two groups (all P>0.05). The total effective rate was 60.7% (17/28) in the electroacupuncture group, apparently better than 30.8% (8/26, P<0.05) in the the medication group. CONCLUSIONS: Electroacupucnture at Zhongji (CV 3) and Qugu (CV 2) apparently relieves the symptoms in the patients and the therapeutic effects are better than the oral administration of tamsulosin hydrochloride sustained-release capsules, but electroacupuncture has not apparent impacts on serum T and E2 levels.

A case study of Ramsay Hunt Syndrome in conjunction with cranial polyneuritis.

RATIONALE: Ramsay Hunt syndrome in conjunction with cranial polyneuritis is not extensively documented, and is very easily misdiagnosed. PATIENT CONCERNS: A case of a 53-year-old male with Ramsay Hunt syndrome in conjunction with cranial polyneuritis is presented with early symptoms of vertigo, cephalalgia, and facial palsy, followed by zoster oticus 10 days later. DIAGNOSES: Diagnosis was challenging as this condition presents with multiple neuropathies, and attempting to diagnose based on clinical symptoms was often misleading. Polymerase chain reaction can be used to test for presence of the virus in the cerebrospinal fluid, followed by targeted drug therapy. INTERVENTIONS: Acupuncture, in conjunction with fire cupping, bloodletting around the afflicted region on the face, as well as oral consumption of herbal medicine and vitamins for nerve nourishment was given to treat this disease. OUTCOMES: Due to misdiagnosis resulting in delayed treatment, peripheral facial paralysis was left as the main sequelae, while other symptoms responded quickly to treatment. After a 6-month follow-up, facial palsy was still present. LESSONS: Considering that targeted antiviral therapy can be used to increase the effectiveness of treatment, early diagnosis, and timely use of medication is critical.

Comparison between herbal medicine and fluoxetine for depression: a systematic review of randomized controlled trials.

OBJECTIVE: To evaluate the effectiveness and safety of Chinese herbal medicine (CHM) versus fluoxetine on depression. DESIGN: A systematic review of randomized controlled trials (RCTs). METHODS: RCT with two parallel groups that compared CHM and fluoxetine on treatment of depression with reported decreased Hamilton Depression Scale (HAMD) and adverse events during treatment were included after searching through six electric-databases. The methodological quality of RCTs was assessed according to the Cochrane risk of bias tool. Meta-analysis was conducted using RevMan 5.3 software with pooled mean difference (MD) or risk ratio (RR) and their 95% confidence interval (CI) if no significant heterogeneity was detected. A SOF table was generated using GRADEPro software to evaluate the overall quality of the evidence. RESULTS: Twenty-six trials with 3294 participants were included in the review. Most of them had high risk of bias during conducting and reporting. The results achieved weak evidence which showed CHM had similar effect to fluoxetine (20mg/day) on relieving depression according to HAMD assessment (for primary depression: MD=-0.08, 95%CI -0.98-0.82; for secondary depression: MD=-0.36, 95%CI -1.55-0.83), but fewer incidences of adverse events than the drug (for primary depression: RR=0.31, 95%CI 0.17-0.59; for post-stroke depression: RR=0.04, 95%CI 0.00-0.25). No serious adverse event was found in neither CHM nor fluoxetine group. CONCLUSIONS: Due to the poor quality of included trials and the potential publication bias of this review, no confirmed conclusion could be draw to evaluate the effectiveness and safety of CHM for depression compared with fluoxetine.