The effect and safety of acupuncture as adjunctive therapy for STEMI patients after PCI: study protocol of a randomized controlled trial.

BACKGROUND: ST-elevation myocardial infarction (STEMI) is a common acute ischemia heart disease that causes serious damage to human health worldwide. Even though morbidity and mortality have significantly decreased by percutaneous coronary intervention (PCI), an additional cardiac protection strategy is still required. Acupuncture therapy has presented a dominant cardiac protection in many studies lately. Thus, we aim to evaluate the effect and safety of acupuncture as an adjunctive therapy in STEMI patients after PCI through a randomized controlled trial. METHODS/DESIGN: This study describes a protocol of multicenter, double-blinded, parallel-controlled, randomized controlled trial. Ninety-six patients with STEMI aged 18-85 years who undergoing PCI will be recruited from the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, The Affiliated Third Hospital of Chengdu Traditional Chinese Medicine University/Chengdu Pidu District Hospital of Traditional Chinese Medicine, and Zhaotong Municipal Hospital of Traditional Chinese Medicine. Participants will be randomly assigned (1:1 ratio) to the verum acupuncture plus basic therapy (i.e., treatment) group or the sham acupuncture plus basic therapy (i.e., control) group. These participants will be treated for 5 days and then will be followed up for 24 weeks. Any adverse events will be recorded throughout the study to evaluate safety. DISCUSSION: The present study aims to investigate the effect and safety of acupuncture for patients with STEMI after PCI and set up standardized treatment programs for acupuncture of these patients. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry (Registration ID: [ChiCTR2400081117]), on February 22, 2024.

The Causal Relationship between Angina Pectoris and Gout Based on Two Sample Mendelian Randomization.

Purpose: Two-sample Mendelian randomization (MR) was conducted to assess the causal relationship between angina pectoris and gout. Material and Methods. Based on genome-wide association studies, single nucleotide polymorphisms (SNPs) that were closely associated with gout were selected from the UK Biobank-Neale Lab (ukb-a-107) as genetic instrumental variables. Considering that gout is characterized by elevated blood uric acid levels, SNPs related to blood uric acid levels were screened from BioBank Japan (bbj-a-57) as auxiliary gene instrumental variables. SNPs closely associated with angina pectoris onset were screened from the FINN dataset (finn-b-I9_ANGINA) as outcome variables. Two-sample MR was conducted, with inverse variance weighting (IVW) of the random effects model as the primary result, along with the weighted median method (WME) and the MR-Egger regression method. To further confirm the causal relationship between angina and gout incidence, a meta-analysis was conducted on the IVW results of the ukb-a-107 and bbj-a-57. Results: The odds ratios and 95% confidence intervals of the IVW, WME, and MR-Egger results of ukb-a-107 were (OR = 33.72; 95% CI: 2.07∼550.38), (OR = 57.94; 95% CI: 2.75∼1219.82), and (OR = 96.38; 95% CI: 0.6∼15556.93), respectively. The P values of IVW and WME were 0.014 and 0.014 (both <0.05), respectively, indicating that the development of angina pectoris was significantly associated with the incidence of gout. The odds ratios and 95% confidence intervals of the IVW, WME, and MR-Egger about bbj-a-57 were (OR = 1.20; 95% CI: 1.07∼1.34), (OR = 1.19; 95% CI: 1.02∼1.38), and (OR = 1.30; 95% CI; 1.06∼1.60), respectively. The P values of IVW, WME and MR-Egger were 0.001, 0.027 and 0.017 (all <0.05), respectively, indicating a significant correlation between angina and blood uric acid levels. Scatter plots of ukb-a-107 and bbj-a-57 showed that the causal association estimates of the IVW, MR-Egger, and weighted median methods were similar and that the MR results were accurate. Funnel plots and the MR-Egger intercept of ukb-a-107 and bbj-a-57 showed the absence of horizontal pleiotropy. The leave-out sensitivity analysis results of ukb-a-107 and bbj-a-57 are stable. The meta-analysis of IVW results for ukb-a-107 and bbj-a-57 showed (OR = 1.20; 95% CI: 1.07-1.34, P=0.02), confirming that gout characterized by high blood uric acid levels significantly increases the risk of angina attacks. Conclusions: This MR study found a clear causal relationship between angina pectoris and gout, which increases the risk of angina pectoris.

Clinical Application of MRI in Coronavirus Disease 2019: A Bibliometric Analysis.

BACKGROUND: Currently, coronavirus disease 2019 (COVID-19) continues to remain in the pandemic stage, leading to severe challenges in the global public healthcare system. Magnetic resonance imaging (MRI) methods have played an important role in the diagnosis of COVID-19 and the structural evaluation of the affected organs. Reviewing and summarizing the application of MRI has significant clinical implications for COVID-19. OBJECTIVE: The study aimed to analyze literature related to the application of MRI in COVID-19 using bibliometric tools, to explore the research status, hotspots, and developmental trends in this field, and to provide a reference for the application of MRI in the clinical diagnosis and evaluation of COVID-19. METHODS: We used the Web of Science Core Collection database to search and collect relevant literature on the use of MRI in COVID-19. The authors, institutes, countries, journals, and keyword modules of the bibliometric analysis software CiteSpace and VOSviewer were used to analyze and plot the network map. RESULTS: A total of 1506 relevant articles were shortlisted through the search; the earliest study was published in 2019, showing an overall upward trend every year. The research was mainly presented as published articles. Clinical neurology was found to be the primary discipline. The United States had the highest publication volume and influence in this field. Countries around the world cooperated more closely. The Cureus Journal of Medical Science was the main periodical to publish articles. Institutes, such as Harvard Medical School, Mayo Clinic, and Massachusetts General Hospital, have published a large number of papers. Some of the high-frequency keywords were "COVID-19", "SARS-CoV-2", "magnetic resonance", "myocarditis", and "cardiac magnetic resonance imaging". The keyword clustering study showed that the current research mainly focuses on five "hot" directions. CONCLUSION: There is a need to strengthen cross-teamwork and multidisciplinary collaboration in the future to completely explore the positive role of MRI in COVID-19 and to discover breakthroughs for the challenges in the clinical diagnosis and treatment of COVID-19.

Ginkgo biloba extract (EGb-761) confers neuroprotection against ischemic stroke by augmenting autophagic/lysosomal signaling pathway.

Ginkgo biloba extract (EGb-761) is well-recognized to have neuroprotective properties. Meanwhile, autophagy machinery is extensively involved in the pathophysiological processes of ischemic stroke. The EGb-761 is widely used in the clinical treatment of stroke patients. However, its neuroprotective mechanisms against ischemic stroke are still not fully understood. The present study was conducted to uncover whether the pharmacological effects of EGb-761 can be executed by modulation of the autophagic/lysosomal signaling axis. A Sprague-Dawley rat model of ischemic stroke was established by middle cerebral artery occlusion (MCAO) for 90 min, followed by reperfusion. The EGb-761 was then administered to the MCAO rats once daily for a total of 7 days. Thereafter, the penumbral tissues were acquired to detect proteins involved in the autophagic/lysosomal pathway including Beclin1, LC-3, SQSTM1/p62, ubiquitin, cathepsin B, and cathepsin D by western blot and immunofluorescence, respectively. Subsequently, the therapeutic outcomes were evaluated by measuring the infarct volume, neurological deficits, and neuron survival. The results showed that the autophagic activities of Beclin1 and LC3-II in neurons were markedly promoted by 7 days of EGb-761 therapy. Meanwhile, the autophagic cargoes of insoluble p62 and ubiquitinated proteins were effectively degraded by EGb-761-augmented lysosomal activity of cathepsin B and cathepsin D. Moreover, the infarction size, neurological deficiencies, and neuron death were also substantially attenuated by EGb-761 therapy. Taken together, our study suggests that EGb-761 exerts a neuroprotective effect against ischemic stroke by promoting autophagic/lysosomal signaling in neurons at the penumbra. Thus, it might be a new therapeutic target for treating ischemic stroke.

Bibliometric Analysis of Acupuncture Therapy for Cancer Pain Over the Past 10 Years.

Purpose: Cancer pain is a common symptom of cancer patients and greatly affects quality of life. Acupuncture has certain curative effects on cancer pain. The aim of this study was to analyze and visualize the current status and research trend of acupuncture treatment for cancer pain over the last 10 years and provide directions for future development. Methods: A search of the Web of Science Core Collection from 2012-01-01 to 2022-08-20 was performed to collect studies related to acupuncture therapy for cancer pain. CiteSpace was used to conduct bibliometric analysis and visualization from the perspective of the volume of annual publications, journals, nations, institutions, authors, keywords, and references. Results: A total of 302 studies were included in the analysis. The number of publications increased steadily with some fluctuations over the past decade. Integrative Cancer Therapies was the journal with the most relevant publications, and the Journal of Clinical Oncology was the most frequently cited journal. China had the highest volume of publications, and the USA contributed most to international collaboration. The most prolific institution was Memorial Sloan Kettering Cancer Center. The most productive author was Mao JJ, and the most influential author was Lu WD. "Acupuncture" was the top keyword in frequency and centrality. The references with the highest frequency and centrality were published by HE, Y, and Ting Bao, respectively. Conclusion: A stable development trend has formed in this field. The overall collaborative network needs to be strengthened. Breast cancer and multiple myeloma, electroacupuncture and bee venom acupuncture, postoperative pain, peripheral neuropathic pain syndrome, and aromatase inhibitors-associated arthralgia syndrome are research hotspots in this field. Randomized controlled trials (RCTs), evidence-based evaluations and mechanisms (cancer-induced bone pain) are research trends and frontiers.

The application of acupuncture in cardiopathy: A bibliometric analysis based on Web of Science across ten recent years.

Background: With high morbidity and mortality, cardiopathy is a major component of cardiovascular disease, causing a huge burden of disease to public health worldwide. In recent years, research on acupuncture treatment of cardiopathies has been increasing. However, no bibliometric analysis has been conducted to systematically describe the research progress and hotspots in this field. Therefore, this study aimed to conduct a bibliometric analysis of the relevant literature to explore the current status and future development of acupuncture for cardiopathies. Methods: The Web of Science (WoS) Core Collection Database was searched for literature related to acupuncture therapies for cardiopathies from 2011 to 2021. Using CiteSpace 5.8 R3, cooperation network diagrams of authors, institutions, countries and journals, keyword co-occurrences, and clustering were performed and analyzed. Results: A total of 321 studies were included. Overall, the number of annual publications increased yearly. These publications came from 31 countries or regions, of which China and the United States made the greatest contributions. In total, 333 authors from 258 institutions participated in this field, and Beijing University of Chinese Medicine and Professor Fanrong Liang were the most published institution and author, respectively. Evidence-based Complementary and Alternative Medicine published the largest number of articles, and CIRCULATION was the most commonly cited journal. Based on co-occurrences and cluster analysis of 257 keywords, three research frontiers and hotspots were identified: acupuncture for blood pressure regulation, acupuncture for coronary heart disease, and acupuncture for regulation of heart rate. In these three research frontiers, the rostral ventrolateral medulla (RVLM) and autonomic nervous system (ANS) are the most popular mechanisms. Conclusion: A stable development trend has formed in this field. Further research should focus on the role of acupuncture therapies in the treatment of hypertension or hypertensive heart disease, coronary heart disease, and arrhythmia based on the mechanisms related to the RVLM and ANS.