VascuConNet: an enhanced connectivity network for vascular segmentation.

Medical image segmentation commonly involves diverse tissue types and structures, including tasks such as blood vessel segmentation and nerve fiber bundle segmentation. Enhancing the continuity of segmentation outcomes represents a pivotal challenge in medical image segmentation, driven by the demands of clinical applications, focusing on disease localization and quantification. In this study, a novel segmentation model is specifically designed for retinal vessel segmentation, leveraging vessel orientation information, boundary constraints, and continuity constraints to improve segmentation accuracy. To achieve this, we cascade U-Net with a long-short-term memory network (LSTM). U-Net is characterized by a small number of parameters and high segmentation efficiency, while LSTM offers a parameter-sharing capability. Additionally, we introduce an orientation information enhancement module inserted into the model's bottom layer to obtain feature maps containing orientation information through an orientation convolution operator. Furthermore, we design a new hybrid loss function that consists of connectivity loss, boundary loss, and cross-entropy loss. Experimental results demonstrate that the model achieves excellent segmentation outcomes across three widely recognized retinal vessel segmentation datasets, CHASE_DB1, DRIVE, and ARIA.

Overcoming the limitations of immunotherapy in pancreatic ductal adenocarcinoma: Combining radiotherapy and metabolic targeting therapy.

As a novel anticancer therapy, immunotherapy has demonstrated robust efficacy against a few solid tumors but poor efficacy against pancreatic ductal adenocarcinoma (PDAC). This poor outcome is primarily attributable to the intrinsic cancer cell resistance and T-cell exhaustion, which is also the reason for the failure of conventional therapy. The present review summarizes the current PDAC immunotherapy avenues and the underlying resistance mechanisms. Then, the review discusses synergistic combination therapies, such as radiotherapy (RT) and metabolic targeting. Research suggests that RT boosts the antigen of PDAC, which facilitates the anti-tumor immune cell infiltration and exerts function. Metabolic reprogramming contributes to restoring the exhausted T cell function. The current review will help in tailoring combination regimens to enhance the efficacy of immunotherapy. In addition, it will help provide new approaches to address the limitations of the immunosuppressive tumor microenvironment (TME) by examining the relationship among immunotherapy, RT, and metabolism targeting therapy in PDAC.

Trace water in a BF3·OEt2 system: a facile access to sulfinyl alkenylsulfones from alkynes and sodium sulfinates.

A highly efficient and operationally simple method for the synthesis of ß-sulfinyl alkenylsulfones through a BF3·OEt2-promoted reaction of alkynes and sodium sulfinates is developed, successfully avoiding the complicated anhydrous treatment before the reaction and greatly simplifying the reaction conditions. As a facile and selective route to the targets, it features good functional group compatibility, mild conditions, easily available starting materials, and excellent yields. Notably, the trace water in solvent plays a key role in promoting the reaction, which provides a more practical pathway for the utilization of the BF3·OEt2 catalytic system.

Response of the runoff process to meteorological drought: Baseflow index as an important indicator.

Runoff and baseflow are two hydrological elements most closely involved in water-resource management. Defining the response of runoff/baseflow to meteorological drought (MD) is helpful for designing precise drought resisting measures. Thus, Pearson correlation coefficients and mutual information scores between runoff/baseflow and MD in five sub-basins of the Weihe River Basin (WRB) were estimated on a weekly scale, and the best response times of runoff/baseflow to MD on annual and calendar months were determined according to the maximum degree of response. Furthermore, the spatial and seasonal differences in response characteristics in the WRB were discussed and the baseflow index (BFI) was introduced to further explain the propagation process of MD to runoff/baseflow. The results showed that (1) in addition to the response time, the transition sequences of MD propagating to runoff and baseflow varied across basins due to the specific basin properties; (2) Response time of runoff to MD was related to BFI value and showed significant seasonality and hydrological periodicity. In summer and autumn (wet season), the response was faster and stronger, whereas the opposite occurred in winter and spring (normal/dry season); (3) BFI values indicated the main path of drought propagation, explaining the variation in response time between basins and seasons; hence, it can be used to simply and effectively determine the propagation speed of MD to runoff. This study clarified the response characteristics of the runoff process to MD and enhanced our understanding of the drought propagation process, which is crucial for mitigating and managing drought-related hazards.

Efficient Fine Tuning for Fashion Object Detection.

Pre-trained models have achieved success in object detection. However, challenges remain due to dataset noise and lack of domain-specific data, resulting in weaker zero-shot capabilities in specialized fields such as fashion imaging. We addressed this by constructing a novel clothing object detection benchmark, Garment40K, which includes more than 140,000 human images with bounding boxes and over 40,000 clothing images. Each clothing item within this dataset is accompanied by its corresponding category and textual description. The dataset covers 2 major categories, pants and tops, which are further divided into 15 fine-grained subclasses, providing a rich and high-quality clothing resource. Leveraging this dataset, we propose an efficient fine-tuning method based on the Grounding DINO framework to tackle the issue of missed and false detections of clothing targets. This method incorporates additional similarity loss constraints and adapter modules, leading to a significantly enhanced model named Improved Grounding DINO. By fine-tuning only a small number of additional adapter module parameters, we considerably reduced computational costs while achieving performance comparable to full parameter fine tuning. This allows our model to be conveniently deployed on a variety of low-cost visual sensors. Our Improved Grounding DINO demonstrates considerable performance improvements in computer vision applications in the clothing domain.

Alignment of Visible-Light Optical Coherence Tomography Fibergrams with Confocal Images of the Same Mouse Retina.

In recent years, in vivo retinal imaging, which provides non-invasive, real-time, and longitudinal information about biological systems and processes, has been increasingly applied to obtain an objective assessment of neural damage in eye diseases. Ex vivo confocal imaging of the same retina is often necessary to validate the in vivo findings especially in animal research. In this study, we demonstrated a method for aligning an ex vivo confocal image of the mouse retina with its in vivo images. A new clinical-ready imaging technology called visible light optical coherence tomography fibergraphy (vis-OCTF) was applied to acquire in vivo images of the mouse retina. We then performed the confocal imaging of the same retina as the "gold standard" to validate the in vivo vis-OCTF images. This study not only enables further investigation of the molecular and cellular mechanisms but also establishes a foundation for a sensitive and objective evaluation of neural damage in vivo.

A pectin-based photoactivated bactericide nanosystem for achieving an improved utilization rate, photostability and targeted delivery of hematoporphyrin.

Photoactivated pesticides have many advantages, such as high activity, low toxicity, and no drug resistance. However, poor photostability and a low utilization rate limit their practical application. Herein, the photosensitizer hematoporphyrin (HP) was used as a photoactivated pesticide, covalently linked with pectin (PEC) via ester bonds, to prepare an amphiphilic polymer pro-bactericide, and subsequently self-assembled in aqueous solutions to obtain an esterase-triggered nanobactericide delivery system. The fluorescence quenching effect due to the aggregation of HP in nanoparticles (NPs) enabled the inhibition of photodegradation of HP in this system. Esterase stimulation could trigger HP release and increase its photodynamic activity. Antibacterial assays have shown that the NPs had potent antibacterial capacity, almost completely inactivating bacteria after 60 min of exposure to light. The NPs had good adherence to the leaves. Safety assessment indicated that the NPs have no obvious toxic effects on plants. Antibacterial studies on plants have shown that the NPs have excellent antibacterial effects on infected plants. These results provide a new strategy for obtaining a photoactivated bactericide nanosystem with a high utilization rate and good photostability and targeting ability.

Analysis and simulation of the driving mechanism and ecological effects of land cover change in the Weihe River basin, China.

Land cover change (LCC) is both a consequence and a cause of global environmental change. This paper attempts to construct a framework to reveal the driving mechanism and ecological effects of different ecological factors under LCC and to explore the ecological characteristics of future LCC. A rule-mining framework based on a land expansion analysis strategy (LEAS) in the patch-generating land use simulation (PLUS) model was used to analyze the drivers of LCC. Neighborhood analysis and ecological effect index were used to investigate multiple ecological effects of LCC. Remote sensing-based ecological indices (RSEI) and the PLUS and stepwise regression model were introduced to explore and predict the integrated ecological effect of LCC. Focusing on the Weihe River basin, study's main drivers of LCC were precipitation, temperature, elevation, population, water table depth, proximity to governments and motorways, GDP, and topsoil organic carbon were the main drivers of LCC. Change directionality were similar for the effects of greenness and biomass formation but opposite for summertime and wintertime temperature. In addition, the conversion of land cover types to cropland had the most significant integrated ecological effect, followed by forest, grassland-shrubland, and other types. The RSEI is predicted to rise to 0.77 in 2030, and the areas where the ecological quality grade will improve and decrease are concentrated on the east and west sides of Ziwuling Mountain, respectively. The findings of this study have practical significance for land management and ecological protection.

New Insight into Temperature Effects on Low-Rank Coal Flotation Using Diesel as a Collector.

Efficient flotation of low-rank coal is of great significance for the development of green and low-carbon cycles. Temperature is a crucial parameter of flotation, but the mechanism of its effect on flotation lacks understanding. In this paper, the mechanism was studied by kinetic flotation, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy, low-temperature liquid-nitrogen adsorption (LP-N2A), X-ray photoelectron spectroscopy (XPS), and molecular dynamics simulation. The flotation combustible recovery gradually decreases as temperature rises. Compared with 60 °C, the combustible recovery at 5 °C increases by 18.13%. The desorption energy for oil droplets decreases as the temperature rises. As a result, the oil droplets are easier to desorb at high temperatures. The SEM and LP-N2A results demonstrate that the pores and fractures of the coal sample are well developed. Also, the oil-water interfacial tension and viscosity of oil droplets decrease as the temperature rises, while the diffusion ability increases. These increase the volume of oil droplets that penetrate into the pores, resulting in poor spreadability of oil droplets on the coal surface. The average volume of bubbles gradually increases as temperature rises, which renders the flotation foam unstable and worsens the flotation. Therefore, the flotation performance is better at low temperatures.

Circulating plasma and exosome levels of the miR-320 family as a non-invasive biomarker for methamphetamine use disorder.

The neurobiological mechanism underlying methamphetamine (MA) use disorder was still unclear, and no specific biomarker exists for clinical diagnosis of this disorder. Recent studies have demonstrated that microRNAs (miRNAs) are involved in the pathological process of MA addiction. The purpose of this study was to identify novel miRNAs for the diagnosis biomarkers of MA user disorder. First, members of the miR-320 family, including miR-320a-3p, miR-320b, and miR-320c, were screened and analyzed in the circulating plasma and exosomes by microarray and sequencing. Secondly, plasma miR-320 was quantified by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) in eighty-two MA patients and fifty age-gender-matched healthy controls. Meanwhile, we also analyzed exosomal miR-320 expression in thirty-nine MA patients and twenty-one age-matched healthy controls. Furthermore, the diagnostic power was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. The expression of miR-320 significantly increased in plasma and exosomes of MA patients compared with healthy controls. The AUC of the ROC curves of miR-320 in plasma and exosomes of MA patients were 0.751 and 0.962, respectively. And the sensitivities of miR-320 were 0.900 and 0.846, respectively, whereas the specificities of miR-320 were 0.537 and 0.952, respectively, in plasma and exosomes in MA patients. And the increased plasma miR-320 was positively correlated with cigarette smoking, age of onset, and daily use of MA in MA patients. Finally, cardiovascular disease, synaptic plasticity, and neuroinflammation were predicted to be the target pathways related to miR-320. Taken together, our findings indicated that plasma and exosomal miR-320 might be used as a potential blood-based biomarker for diagnosing MA use disorder.

Anticancer and bone-enhanced nano-hydroxyapatite/gelatin/polylactic acid fibrous membrane with dual drug delivery and sequential release for osteosarcoma.

Surgical resection of osteosarcoma is always accompanied by residual metastasis of tumor cells and bone tissue defects. In this work, a novel kind of gelatin/polylactic acid (PLA) coaxial fiber membrane with a shell layer containing doxorubicin-loaded hydroxyapatite (DOX@nHAp) nanoparticles and a core layer containing Icariin (ICA) was developed for antitumor and bone enhancement at the defect site. Physical evaluation displayed that the composite membrane provided moderate hydrophilicity, enhanced tensile strength (Dry: 2-3 MPa, wet: 1-2 MPa) and elasticity (70-100 %), as well as increased specific surface area and pore volume (19.39 m2/g and 0.16 cm3/g). In SBF, DOX@nHAp in the fibers promoted biomineralization on the fiber surface. In in vitro evaluation, approximately 80 % of DOX had a short-term release during the first 8 days, followed by long-term release behavior of ICA for up to 40 days. CCK-8 results confirmed that the membrane could actively support MC3T3-E1 cells proliferation and was conductive to high alkaline phosphatase expression, while the viability of MG-63 cells was effectively inhibited to 50 %. Thus, the dual-loaded fibrous membrane with a coaxial structure and nHAp is a promising system for anticancer and defects reconstruction after osteosarcoma surgery.

Poly(ß-amino ester) Dual-Drug-Loaded Hydrogels with Antibacterial and Osteogenic Properties for Bone Repair.

In this study, we developed a poly(ß-amino ester) (PBAE) hydrogel for the double release of vancomycin (VAN) and total flavonoids of Rhizoma Drynariae (TFRD). VAN was covalently bonded to PBAE polymer chains and was released to enhance the antimicrobial effect first. TFRD chitosan (CS) microspheres were physically dispersed in the scaffold, TFRD was released from the microspheres, and osteogenesis was induced subsequently. The scaffold had good porosity (90.12 ± 3.27%), and the cumulative release rate of the two drugs in PBS (pH 7.4) solution exceeded 80%. In vitro antimicrobial assays demonstrated the antibacterial properties of the scaffold against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). Besides these, cell viability assays indicated that the scaffold had good biocompatibility. Moreover, alkaline phosphatase and matrix mineralization were expressed more than in the control group. Overall, cell experiments confirmed that the scaffolds have enhanced osteogenic differentiation capabilities. In conclusion, the dual-drug-loaded scaffold with antibacterial and bone regeneration effects is promising in the field of bone repair.

Differential expression profiling of tRNA-Derived small RNAs and their potential roles in methamphetamine self-administered rats.

Transfer RNA-derived small RNAs (tsRNAs) are a novel class of short, non-coding RNAs that are closely associated with the pathogenesis of various diseases. Accumulating evidence has demonstrated their critical functional roles as regulatory factors in gene expression regulation, protein translation regulation, regulation of various cellular activities, immune mediation, and response to stress. However, the underlying mechanisms by which tRFs & tiRNAs affect methamphetamine-induced pathophysiological processes are largely unknown. In this study, we used a combination of small RNA sequencing, quantitative reverse transcription-polymerase chain reaction (qRT‒PCR), bioinformatics, and luciferase reporter assays to screen the expression profiles and identify the functional roles of tRFs and tiRNAs in the nucleus accumbens (NAc) of methamphetamine self-administration rat models. A total of 461 tRFs & tiRNAs were identified in the NAc of rats after 14 days of methamphetamine self-administration training. Of those, 132 tRFs & tiRNAs were significantly differentially expressed: 59 were significantly upregulated, whereas 73 were significantly downregulated in the rats with methamphetamine self-administration. Decreased expression levels of tiRNA-1-34-Lys-CTT-1 and tRF-1-32-Gly-GCC-2-M2, as well as increased expression levels of tRF-1-16-Ala-TGC-4 in the METH group compared with the saline control were validated by using RT‒PCR. Then, bioinformatic analysis was performed to analyse the possible biological functions of tRFs & tiRNAs in methamphetamine-induced pathogenesis. Furthermore, tRF-1-32-Gly-GCC-2-M2 was identified to target BDNF using the luciferase reporter assay. An altered tsRNA expression pattern was proven, and tRF-1-32-Gly-GCC-2-M2 was shown to be involved in methamphetamine-induced pathophysiologic processes by targeting BDNF. The current study provides new insights for future investigations to explore the mechanisms and therapeutic methods for methamphetamine addiction.

Association of GABA receptor delta subunit gene variations with increased risk of methamphetamine dependence.

OBJECTIVE: Evidence reveals that γ-aminobutyric acid (GABA) receptors are involved in the development of methamphetamine (METH) dependence. The GABA receptor delta subunit gene (GABRD) might be a good candidate gene for METH dependence. In a case-control study, we investigated the association between the single nucleotide polymorphisms (SNPs) in GABRD and METH dependence in a Chinese Han population. METHODS: A total of 300 METH dependent patients and 300 age and sex matched normal control subjects were recruited. Four SNPs (rs13303344, rs4481796, rs2376805, and rs2229110) in GABRD were determined with the TaqMan genotyping assay. The association of the SNPs with METH dependence was assessed. RESULTS: Only the allele frequency of rs2376805 significantly differed between the patients and controls (P = 0.030). The G allele frequency of rs2376805 was higher in the METH dependent group than in the controls (odds ratio = 1.332, 95 % CI: 1.028-1.724). This association was found in females but not in males. In females, the frequencies of genotype and allele at rs2376805 significantly differed between the patients and controls (P = 0.025, 0.022, respectively); the rs2376805 G allele may also be a risk factor for METH dependence (odds ratio = 1.548, 95 % CI: 1.063-2.257). The haplotype ACGT frequency significantly differed between the patients and controls in total subjects (P = 0.008, odds ratio = 1.815, 95 % CI: 1.183-2.782), as well as in females (P = 0.005, odds ratio = 2.702, 95 % CI: 1.313-5.562). In females only, the METH craving score was significantly lower in patients harboring the G allele at rs2376805 than in those harboring the homozygous AA genotype (P = 0.044). CONCLUSION: The preliminary results indicate that GABRD rs2376805 is associated with METH dependence, especially in females.

Spatiotemporal variations of water conservation function based on EOF analysis at multi time scales under different ecosystems of Heihe River Basin.

Water conservation function is a critical terrestrial ecosystem service in providing water supply and achieving water security, which has raised concerns under the pressure of climate change. However, the knowledge of variance on multi-time scale, spatiotemporal dynamic, and ecosystem variance of water conservation is insufficient. In this paper, the annual, monthly, and daily scales of water conservation and the spatiotemporal pattern of monthly water conservation were estimated based on the SWAT model from 2010 to 2020 in the Heihe River Basin (HRB). Additionally, EOF (Empirical orthogonal function) analysis was conducted to decompose the time series of water conservation function distribution into temporal coefficients and spatial patterns. The HRB was categorized into six representative ecosystems with three slope grades to illustrate the variance of water conservation function. The annual water conservation depth (WC) slightly decreased (-10.36 mm/10a) from 2010 to 2020, the monthly WC was dominated by the effects of seasonal variation, and the daily WC was highly nonlinear. The high variability and importance region is mainly located in the upstream and the central area of midstream, which deserves more attention for ecological management and priority protection. Moreover, the forest ecosystem is of the highest resilience and great ecological significance, which increased risk of reduced water conservation under the lack of precipitation. Even in a forest-dominated basin, water conservation can be impacted by other ecosystems with the strong influence of human activities. Our results provide scientific evidence for the improvement of water conservation capacity and making the adapted land use policy in Yellow River basins.

Association between rs1799971 in the mu opioid receptor gene and methadone maintenance treatment response.

OBJECTIVE: Genetic variations can affect individual response to methadone maintenance treatment (MMT) for heroin addiction. The A118G variant (rs1799971) in the mu opioid receptor gene (OPRM1) is a potential candidate single nucleotide polymorphism (SNP) for personalized MMT. This study determined whether rs1799971 is related to MMT response or dose. METHODS: We recruited 286 MMT patients from a Han Chinese population. The rs1799971 genotype was determined via TaqMan genotyping assay. The genetic effect of this SNP on MMT response or dose was evaluated using logistic regression. A meta-analysis was performed to merge all available data to evaluate the role of rs1799971 in MMT using RevMan 5.3 software. RESULTS: No statistical significance was observed in the association between the OPRM1 rs1799971 and MMT response or dose in our Chinese cohort. Meta-analysis indicated that the OPRM1 A118G variation was not significantly associated with MMT response or dose requirement. CONCLUSION: The results suggest that rs1799971 in OPRM1 might not play a critical role alone in influencing MMT response or dose.

The Impact of Different Rose Bengal Formulations on Corneal Thickness and the Efficacy of Rose Bengal/Green Light Corneal Cross-linking in the Rabbit Eye.

PURPOSE: To examine central corneal thickness (CCT) changes during in vivo rose bengal-green light corneal cross-linking (RG-CXL) and compare the CXL efficacy of different rose bengal formulations. METHODS: After epithelium removal, the right eyes of rabbits were immersed in rose bengal solution prepared by different solvents (water, phosphate buffered saline, dextran, and hydroxypropyl methylcellulos [HPMC]) for 2 or 20 minutes, then the rose bengal distribution in the corneal stroma was analyzed by confocal fluorescence detection. During the RG-CXL process, the CCT was measured at seven time points. The left eyes served as the untreated control group. Corneal enzymatic resistance and corneal biomechanics were tested to compare the RG-CXL efficacy. RESULTS: The rose bengal infiltration depths were 120 and 200 µm for the 2- and 20-minute groups, respectively. CCT increased significantly after infiltration, then decreased significantly in the first 200 seconds of irradiation and decreased slowly for the next 400 seconds. The CCT of the 20-minute groups was significantly thicker than that of the 2-minute groups (P < .0001). All RG-CXL treatments improved the corneal enzymatic resistance and corneal biomechanics, with the effects being greater in the 20-minute groups. The inclusion of 1.1% HPMC in the rose bengal formulation helped to maintain CCT during irradiation while not affecting either the infiltration of rose bengal or the efficacy of RG-CXL. CONCLUSIONS: Within the range studied, RG-CXL efficacy increased with infiltration time. The incorporation of a 20-minute infiltration of 0.1% rose bengal-1.1% HPMC into the RG-CXL procedure may further improve the safety of the treatment and its prospects for clinical use. [J Refract Surg. 2022;38(7):450-458.].

A One-Step Electrochemical Aptasensor Based on Signal Amplification of Metallo Nanoenzyme Particles for Vascular Endothelial Growth Factor.

In this study, a one-step electrochemical aptasensor was developed to detect the biomarker vascular endothelial growth factor (VEGF), an important protein in the pathogenesis of many retinal diseases, including age-related macular degeneration, diabetic retinopathy, retinopathy of prematurity, and retinal vein occlusion. The aptamer has a good affinity and can rapidly identify and capture VEGF based on its unique structure. We designed a VEGF aptasensor based on the aptamer recognition and complex metallo nanoenzyme particles as an electron exchange center and bridge between capture DNA and electrode. The aptamers maintained the hairpin structure to avoid nonspecific surface adsorption and expose the capture sequence outwards when the target was inexistent. Conversely, the aptamers opened the hairpin structure to release space to accomplish binding between VEGF and DNA, resulting in increased impedance. The performance of the electrochemical aptasensor is detected by electrochemical impedance spectroscopy (EIS). The limit of detection by EIS was as low as 8.2 pg ml-1, and the linear range was 10 pg ml-1-1 µg ml-1. The electrochemical aptasensor also showed high specificity and reproducibility.

Engineering Hibiscus-Like Riboflavin/ZIF-8 Microsphere Composites to Enhance Transepithelial Corneal Cross-Linking.

Riboflavin-5-phosphate (RF) is the most commonly used photosensitizer in corneal cross-linking (CXL), but its hydrophilicity and negative charge limit its penetration through the corneal epithelium into the stroma. To enhance the corneal permeability of RF and promote its efficacy in the treatment of keratoconus, novel hibiscus-like RF@ZIF-8 microsphere composites [6RF@ZIF-8 NF (nanoflake)] are prepared using ZIF-8 nanomaterials as carriers, which are characterized by their hydrophobicity, positive potential, biocompatibility, high loading capacities, and large surface areas. Both hematoxylin and eosin endothelial staining and TUNEL assays demonstrate excellent biocompatibility of 6RF@ZIF-8 NF. In in vivo studies, the 6RF@ZIF-8 NF displayed excellent corneal permeation, and outstanding transepithelial CXL (TE-CXL) efficacy, slightly better than the conventional CXL protocol. Furthermore, the special hibiscus-like structures of 6RF@ZIF-8 NF meant that it has better TE-CXL efficacy than that of 6RF@ZIF-8 NP (nanoparticles) due to the larger contact area with the epithelium and the shorter RF release passage. These results suggest that the 6RF@ZIF-8 NF are promising for transepithelial corneal cross-linking, avoiding the need for epithelial debridement.

Acupuncture combined with traditional Chinese medicine preparation for the treatment of marrow suppression after chemotherapy: A protocol for systematic review and meta-analysis.

BACKGROUND: From the perspective of evidence-based medicine, the efficacy and safety of combined therapy for marrow suppression after chemotherapy is still unclear. Given that there is no high-quality meta-analysis to incorporate existing evidence, the purpose of this protocol is to design a systematically review and meta-analysis of the level I evidence to ascertain the efficacy and safety of acupuncture combined with traditional Chinese medicine preparation for marrow suppression after chemotherapy. METHODS: The following databases will be searched electronically by keyword combination mode: 4 British literature databases including PubMed, EMBASE, Scopus, and Cochrane Library, and 4 Chinese literature databases, including Chinese national knowledge infrastructure, VIP, and Wan fang database. The randomized controlled trials on acupuncture plus traditional Chinese medicine preparation for marrow suppression after chemotherapy will be included. The primary outcome is the elevation of hemoglobin, platelets, leukocytes, and neutrophils. The other outcomes include clinical symptoms, quality of life, and absolute value of reticulocyte. Risk bias analysis of the studies will be performed independently by 2 reviewers using the Cochrane Risk of Bias Assessment Tool. RESULTS: The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. CONCLUSION: This protocol will provide a reliable theoretical basis for the following research.