Transcriptional-profile changes in the medial geniculate body after noise-induced tinnitus.

Tinnitus is a disturbing condition defined as the occurrence of acoustic hallucinations with no actual sound. Although the mechanisms underlying tinnitus have been explored extensively, the pathophysiology of the disease is not completely understood. Moreover, genes and potential treatment targets related to auditory hallucinations remain unknown. In this study, we examined transcriptional-profile changes in the medial geniculate body after noise-induced tinnitus in rats by performing RNA sequencing and validated differentially expressed genes via quantitative polymerase chain reaction analysis. The rat model of tinnitus was established by analyzing startle behavior based on gap-pre-pulse inhibition of acoustic startles. We identified 87 differently expressed genes, of which 40 were upregulated and 47 were downregulated. Pathway-enrichment analysis revealed that the differentially enriched genes in the tinnitus group were associated with pathway terms, such as coronavirus disease COVID-19, neuroactive ligand-receptor interaction. Protein-protein-interaction networks were established, and two hub genes (Rpl7a and AC136661.1) were identified among the selected genes. Further studies focusing on targeting and modulating these genes are required for developing potential treatments for noise-induced tinnitus in patients.

Association between late-life depression or depressive symptoms and stroke morbidity in elders: A systematic review and meta-analysis of cohort studies.

OBJECTIVE: Whether late-life depression or depressive symptoms are a risk factor of future stroke in elders is important for prevention measures. A systematic review and meta-analysis were used to investigate the association between depression or depressive symptoms and risk of stroke in elders. METHODS: Embase, MEDLINE, PsychINFO, and Web of Science were searched for studies published from inception to January 6, 2023. Prospective cohort studies reporting quantitative estimates of the association between depression or depressive symptoms and stroke morbidity in participants aged over 60 years were included. Reviews, meta-analyses, case reports, retrospective, cross-sectional, and theoretical studies were excluded. Study screening and data extraction were conducted by two researchers independently. Random-effects meta-analysis was used to estimate pooled adjusted hazard ratios (HRs). Publication bias was evaluated via the symmetry of funnel plots and Egger tests. The Newcastle Ottawa Scale was used to assess the risk of bias. The quality of evidence of synthesis was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The primary outcome was any stroke, including non-fatal, fatal, ischemic and hemorrhagic sub-types. RESULTS: Seventeen studies of 57,761 patients in total were included in the meta-analysis. A positive association was found between depressive disorder or symptoms and stroke risk (HR: 1.39; 95% CI: 1.22-1.58; p < 0.001). CONCLUSIONS: Late-life depression or depressive symptoms are a significant risk factor for stroke in older people. Regular assessment and more effective management of associated comorbidities are recommended to reduce stroke risk.

Effects of Electroacupuncture on Gut Microbiota and Fecal Metabolites in Rats with Poststroke Depression.

Background: Poststroke depression (PSD) is the most frequent neuropsychiatric consequence of stroke. Electroacupuncture (EA) has been found to be an effective therapy for treating PSD. However, the underlying mechanisms of EA's efficacy remain unclear. This research aimed to investigate the effects of EA on alterations in gut microbiota and fecal metabolome in PSD rats. Methods: Analyses of gut microbiome and fecal metabolome were performed to identify gut microbes and their functional metabolites in a sham group, PSD group, and EA group. We conducted enrichment analysis to identify the differential metabolic pathways in three groups. Correlations between altered gut microbes and differential metabolites after EA treatment were studied. Results: PSD showed decreased species-richness/diversity indices of microbial composition, characterized by an increase in Muribaculaceae, Peptostreptococcaceae, Oscillospiraceae, Ruminococcaceae, and Clostridiaceae and a decrease in Lactobacillaceae, Lachnospiraceae, and Bacteroidaceae. Of these, the abundance of Muribaculaceae, Lactobacillaceae, Lachnospiraceae, Peptostreptococcaceae, and Clostridiaceae were reversed by EA. Furthermore, PSD was associated with 34 differential fecal metabolites, mainly belonging to steroid hormone biosynthesis, that could be regulated by EA. Conclusion: Regulation of gut microbiome and lipid metabolism could be one of the potential mechanisms for EA treatment for alleviating the depressive behaviors of PSD.

[Study on mechanisms of acupuncture underlying improvement of CUMS-induced depression in rats based on tandem mass spectrometry proteomics technique].

OBJECTIVE: To investigate the possible mechanism of "regulating qi and relieving depression" acupuncture underlying improvement of chronic unpredictable mild stress (CUMS)-induced depression in rats by using Tandem Mass Tags(TMT) quantitative proteomics technique. METHODS: Thirty-six male SD rats were randomly divided into control, model and acupuncture groups, with 12 rats in each group. The depression model was induced by CUMS stress for 21 days. After the depression model was successfully established, the rats in the acupuncture group received manual acupuncture stimulation at "Baihui" (GV20) and "Yintang" (GV24+) for 20 min, once daily for 21 days. Open field test, sugar water preference test and forced swimming test (FST) were used to evaluate the behavioral changes. TMT quantitative proteomics was used to obtain differential proteins in the hippocampus tissue and related signaling pathways enrichment was analyzed, followed by verifying differential protein pathways by using Western blot and immunofluorescence methods. RESULTS: Behavior tests showed that on the 21st and 42nd days, the horizontal crossing times, walking distance and percentage of sugar water consumption were significantly decreased (P<0.05), while the immobility time of FST was obviously increased (P<0.05) in the model group relevant to the control group. After acupuncture intervention, the horizontal crossing times, walking distance and percentage of sugar water consumption were significantly increased (P<0.05), and the immobility time was apparently decreased (P<0.05) in the acupuncture group relevant to the model group. The TMT quantitative proteomics of hippocampus tissue displayed that of the 71 differential proteins (model group vs control group), 32 was down-regulated and 39 up-regulated in the model group; and among the above 71 differential proteins, there were 20 differential proteins between acupuncture group and model group, 15 down-regulated and 5 up-regulated in the acupuncture group (vs the model group). The expression of Mapk8ipl was up-regulated in the model group (vs the control group) and down-regulated in the acupuncture group (vs the model group). GO and KEGG enrichment analysis showed that these acupuncture-related differential proteins mainly involve the regulation of blood coagulation system, MAPK signaling pathway, etc. We selected the MAPK/JNK signaling pathway related to depression for verification. Western blot showed that the expression levels of c-JUN and phosphorylated c-JUN terminal kinase (p-JNK) proteins in the hippocampus were up-regulated in the model group relevant to the control group (P<0.05); while the expression levels of c-JUN and p-JNK proteins in the hippocampus were down-regulated in the acupuncture group relevant to the model group (P<0.05). The results of immunofluorescence showed that the mean fluorescence intensity of c-JUN and p-JNK in hippocampal CA1, CA3 and DG regions was increased in the model group relevant to the control group (P<0.05), while the mean fluorescence intensity of c-JUN and p-JNK in hippocampal CA1, CA3 and DG regions was obviously lower in the acupuncture group than in the model group (P<0.05). CONCLUSION: Acupuncture for "regulating qi and relieving depression" can significantly improve depression-like behavior in CUMS-induced depression model rats, which involves multiple targets and multiple pathways, including MAPK/JNK signaling.

Prognostic factor analysis in patients with early-stage nasopharyngeal carcinoma in the USA.

Aim: To evaluate independent risk factors specific for early-stage nasopharyngeal carcinoma (NPC). Methods: A total of 566 patients with early-stage NPC from 2004 to 2019 were identified using the Surveillance, Epidemiology and End Results database. Results: Older ages (70-79 and >80 years) were independent risk factors, with hazard ratios of 1.961 and 5.011, respectively. The hazard ratio for early-stage NPC in Asian and Pacific Islander residents (0.475) was lower than that for White residents. A tumor size <3 cm was a protective factor for overall and cancer-specific survival in the current study. Conclusion: In patients with early-stage NPC, age >70 years, race and tumor size were independent prognosticators for cancer-specific survival.

Does acupuncture treatment have satisfactory clinical efficacy for late-life depression? A systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to assess the clinical efficacy of acupuncture in late-life depression (LLD). METHODS: A comprehensive search of seven electronic databases was conducted from inception to November 2022, including the Cochrane Library, PubMed, Embase, CNKI, VIP, CBM and the Wan Fang database. All data analysis were conducted by Revman 5.3. RESULTS: A total of nine RCTs involving 603 participants were included. The meta-analysis results showed that acupuncture combined with antidepressants significantly reduced HAMD scores (MD, -3.69 [95% CI, -5.11 to -2.27], I2 =74%) and a significantly higher cure rate (RR, 1.11 [95% CI, 1.01 to 1.22], I2 = 0%) compared with antidepressants alone. However, no significant difference was found between acupuncture and antidepressants in reducing HAMD scores and improving clinical outcomes. CONCLUSIONS: Acupuncture combined or not combined with antidepressants is an effective and safe treatment for LLD.

[Tiaoqi Jieyu acupuncture for treatment-resistant depression: a randomized controlled trial].

OBJECTIVE: To observe the effect of Tiaoqi Jieyu (regulating qi and relieving depression) acupuncture on the clinical symptoms of treatment-resistant depression (TRD), and to explore the relationship between the acupuncture pain sensitivity and symptom's improvement. METHODS: A total of 78 patients with TRD were randomly divided into an observation group (39 cases, 3 cases dropped off) and a control group (39 cases, 4 cases dropped off). The patients in the control group were treated with medications according to the treatment plan of psychiatrists (at least one medication was 5-hydroxytryptamine reuptake inhibitor). On the basis of the control group, the patients in the observation group were treated with Tiaoqi Jieyu acupuncture, and Baihui (GV 20), Yintang (GV 24+), Yanglingquan (GB 34), Taichong (LR 3), Hegu (LI 4), Neiguan (PC 6), Yinlingquan (SP 9) and Zusanli (ST 36), etc. were selected. The acupuncture was given three times a week. Both groups were treated for 8 weeks. After 8-week treatment, the response rate of Hamilton depression scale-24 (HAMD-24) score after was evaluated in the two groups. The scores of HAMD-24 and Hamilton anxiety scale (HAMA) were compared between the two groups before treatment, after 4, 8-week treatment and 12 weeks after treatment (follow-up). After the first treatment and 8-week treatment, the visual analogue scale (VAS) score in the observation group was evaluated, and the correlation between VAS score after the first treatment and HAMD-24 score before treatment, between VAS score after the first treatment and the course of disease in the observation group was analyzed, and the correlation between difference of VAS after 8-week treatment and after the first treatment and difference of HAMD-24 score before treatment and after 8-week treatment was analyzed. RESULTS: After 8-week treatment, the response rate of HAMD-24 score in the observation group was 52.8% (19/36), higher than 17.1% (6/35) in the control group (P<0.001). Compared before treatment, the scores of HAMD-24 and HAMA in the two groups were decreased after 4-week treatment, 8-week treatment and in follow-up (P<0.05), and those in the observation group were superior to the control group (P<0.05). After 8-week treatment, the acupuncture pain VAS score in the observation group was (5.28±2.13) points, which was higher than (3.33±1.62) points after the first treatment (P<0.001). There was a negative correlation between VAS score after the first treatment and HAMD-24 score before treatment in the observation group (r =-0.486, P=0.003); there was no correlation between acupuncture pain VAS score after the first treatment and the course of disease in the observation group (P>0.05). After 8-week treatment, there was a positive correlation between the difference of VAS score and the difference of HAMD-24 score in the observation group (r =0.514, P=0.001). CONCLUSION: Tiaoqi Jieyu acupuncture could improve the depression and anxiety in patients with TRD, and the symptom's improvement is related to the recovery of acupuncture pain sensitivity.

Endoluminal Vacuum-Assisted Closure Therapy for Upper Gastrointestinal Leak, Perforation, and Fistula: A Case Series and Literature Review.

BACKGROUND: With the increasing incidence of upper digestive tract tumors, more upper digestive tract surgeries are performed each year, and surgeons have difficulty in the postoperative management of gastrointestinal anastomotic fistula. The use of a new minimally invasive technique, endoluminal vacuum-assisted closure (E-VAC), has increased the success rate of the treatment of gastrointestinal fistula. METHODS: We present 6 cases of gastrointestinal fistula treated in our hospital in 2021: 3 cases of anastomotic fistula after esophageal cancer surgery, 2 cases of anastomotic fistula after gastric cancer surgery, and one case of esophageal rupture after trauma. With E-VAC and other adjuvant treatment measures, the gastrointestinal fistulas were eventually closed or significantly reduced. RESULTS: Both local and systemic infections in all 6 patients were controlled with the use of E-VAC device, resulting in significant reduction or closure of fistulas. CONCLUSION: E-VAC devices can effectively help in the removal of the exudate and necrotic tissue around the fistula, promote the proliferation of granulation tissue, and support closure of the fistula. However, further improvements to the device are needed to improve patient comfort and operational safety.

[Pricking-cupping therapy for cervical spondylotic radiculopathy with qi stagnation and blood stasis based on Young's modulus value].

OBJECTIVE: To compare the clinical effect between pricking-cupping therapy and acupuncture-cupping therapy on cervical spondylotic radiculopathy (CSR) with qi stagnation and blood stasis, and to evaluate the trapezius muscle objectively and quantitatively with ultrasonic shear wave elastography (SWE). METHODS: A total of 70 patients with CSR of qi stagnation and blood stasis were randomly divided into a pricking-cupping group (35 cases) and an acupuncture-cupping group (35 cases). In both groups, Dazhui (GV 14), Jianjing (GB 21), C5-C7 Jiaji (EX-B 2), positive sensitive points, etc. were selected. In addition, the patients in the pricking-cupping group were treated with pricking-cupping therapy, seven-star needle was used to tap the acupoints and positive sensitive points, and cupping was added after slight bleeding. The patients in the acupuncture-cupping group were treated with conventional acupuncture and cupping. Both groups were treated once every other day, three times a week, for two consecutive weeks. The difference of Young's modulus value, pain visual analogue scale (VAS) score and neck disability index (NDI) score were observed before treatment, after the first treatment, after one-week treatment and after two-week treatment, and the efficacy was evaluated in the two groups. RESULTS: At each time point after treatment, the difference of Young's modulus value, VAS scores and NDI scores in the two groups were lower than those before treatment (P<0.001). Except for the NDI score after two-week treatment, all the indexes in the pricking-cupping group were lower than those in the acupuncture-cupping group (P<0.001). The total effective rate was 91.4% (32/35) in the pricking-cupping group, which was higher than 68.6% (24/35) in the acupuncture-cupping group (P<0.05). CONCLUSION: The pricking-cupping therapy could improve trapezius muscle elasticity, relieve pain and improve cervical function in patients of CSR with qi stagnation and blood stasis, which is more effective than acupuncture-cupping therapy.

Effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients: A single-blind randomized controlled trial.

Objective: Psychological distress such as depression and anxiety resulted from coronavirus disease 2019 (COVID-19) have attracted increasing attention. The aim of this randomized controlled trial is to evaluate the effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients. Methods: 68 participants diagnosed with COVID-19 pneumonia (18-80 years old, SDS ≥ 50, SAS ≥ 45) were recruited and randomly allocated to the auricular acupressure group and the sham auricular acupressure group by a computer-generated random number sequence from 9th June to 30th June 2022. The group allocation was only blinded to the participants. Those in the auricular acupressure group were attached magnetic beads against 4 auricular points Shenmen, Subcortex, Liver and Endocrine, while sham group used four irrelevant auricular points. Outcomes were measured by Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Depression Scale (SAS) before and after treatment in both groups through electronic questionnaire in mobile phones. Results: After treatment, statistically significant differences were found in scores of SAS in both groups (P < 0.001 in auricular acupressure group; P = 0.003 in sham group), and SDS scores reduced significantly in the auricular acupressure group (P = 0.002). Significant reduced SAS and SDS scores were achieved in the auricular acupressure group than that in the sham group (F = 4.008, P = 0.049, MD -7.70 95% CI: -9.00, -6.40, SMD -2.79 95% CI: -3.47, -2.11 in SDS; F = 10.186, P = 0.002, MD -14.00 95% CI: -15.47, -12.53, SMD -4.46 95% CI: -5.37, -3.56 in SAS). No adverse events were found in either group during the whole study. Conclusion: Auricular acupressure is an effective and safe treatment for alleviating symptoms of depressive and anxiety in patients with COVID-19. Clinical trial registration: https://www.chictr.org.cn//, identifier ChiCTR2200061351.

Pan-cancer analysis identifies NT5E as a novel prognostic biomarker on cancer-associated fibroblasts associated with unique tumor microenvironment.

Background: Ecto-5'-nucleotidase (NT5E) encodes the cluster of differentiation 73 (CD73), whose overexpression contributes to the formation of immunosuppressive tumor microenvironment and is related to exacerbated prognosis, increased risk of metastasis and resistance to immunotherapy of various tumors. However, the prognostic significance of NT5E in pan-cancer is obscure so far. Methods: We explored the expression level of NT5E in cancers and adjacent tissues and revealed the relationship between the NT5E expression level and clinical outcomes in pan-cancer by utilizing the UCSC Xena database. Then, correlation analyses were performed to evaluate the relationship between NT5E expression and immune infiltration level via EPIC, MCP-counter and CIBERSORT methods, and the enrichment analysis were employed to identify NT5E-interacting molecules and functional pathways. Furthermore, we conducted single-cell analysis to explore the potential role of NT5E on single-cell level based on the CancerSEA database. Meanwhile, gene set enrichment analysis (GSEA) in single-cell level was also conducted in TISCH database and single-cell signature explorer was utilized to evaluate the epithelial-mesenchymal transition (EMT) level in each cell type. Results: The expression level of NT5E was aberrant in almost all cancer types, and was correlated with worse prognosis in several cancers. Notably, NT5E overexpression was related to worse overall survival (OS) in pancreatic adenocarcinoma (PAAD), head and neck squamous cell carcinoma (HNSC), mesothelioma (MESO), stomach adenocarcinoma (STAD), uveal melanoma (UVM) and cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) (p < 0.01). NT5E-related immune microenvironment analysis revealed that NT5E is associated positively with the degree of infiltration of cancer-associated fibroblasts (CAFs) and endothelial cells in most cancers. Enrichment analysis of cellular component (CC) demonstrated the critical part of NT5E played in cell-substrate junction, cell-substrate adherens junction, focal adhesion and external side of plasma membrane. Finally, single-cell analysis of NT5E illuminated that EMT function of CAFs was elevated in basal cell carcinoma (BCC), skin cutaneous melanoma (SKCM), HNSC and PAAD. Conclusion: NT5E could serve as a potential prognostic biomarker for cancers. The potential mechanism may be related to the upregulated EMT function of CAFs, which provides novel inspiration for immunotherapy by targeting CAFs with high NT5E expression.

Does urinary metabolite signature act as a biomarker of post-stroke depression?

Background: It is difficult to conduct the precise diagnosis of post-stroke depression (PSD) in clinical practice due to the complex psychopathology of depressive disorder. Several studies showed that gas chromatography-mass spectrometry (GC-MS)-identified urinary metabolite biomarkers could significantly discriminate PSD from stroke survivors. Methods: A systematic review was performed for the keywords of "urinary metabolite" and "PSD" using Medline, Cochrane Library, Embase, Web of Science, PsycINFO, Wanfang, CNKI, CBM, and VIP database from inception to 31 March 2022. Results: Four related studies were included in the review. Differential urinary metabolites including lactic acid, palmitic acid, azelaic acid, and tyrosine were identified in all the included studies. As a significant deviation in the metabolite biomarker panel, glyceric acid, azelaic acid, phenylalanine, palmitic acid, pseudouridine, and tyrosine were found in at least 2 included studies, which indicated good potential for the differentiation of PSD. Conclusion: The systematic review provided evidence that differential urinary metabolites analyzed by the GC-MS-based approach might be used as a biomarker for the diagnosis and prognosis of PSD.

Effect of Electroacupuncture Based on ERAS for Preoperative Anxiety in Breast Cancer Surgery: A Single-Center, Randomized, Controlled Trial.

BACKGROUND: To evaluate the effect of electroacupuncture (EA) based on enhanced recovery after surgery on preoperative anxiety in patients undergoing breast cancer surgery. PATIENTS AND METHODS: This was a single-center, randomized, controlled, single-blind clinical trial. Between December 2018 and 2019, 144 female undergoing breast conserving surgery were assigned to conventional (A), preoperative EA (B), intraoperative EA (C), and combination of preoperative and intraoperative EA (D) groups. Primary outcome was the self-rating anxiety scale. Secondary outcomes included visual analogue scale, quality of recovery 40, postoperative complications, and acupuncture-related adverse reactions. RESULTS: 141 patients completed the trial. Groups B and D self-rating anxiety scale were significantly lower than A and C (P < .01); the sleep quality was significantly better (P < .01). The incidence of nausea at 6 hours postoperatively was significantly lower in group D than other groups (P < .007); the incidence of vomiting at 6 hours postoperatively was better than group A (P < .007). visual analogue scale at 24 hours postoperatively was significantly different between groups A, B, and D (P < .01). Quality of recovery 40 total score at 24 hours postoperatively in group D was significantly higher than A and B (P < .05). The 72-hour postoperative emotional state was most significantly improved in group D (P < .05), while groups B and C showed interactive effect (P < .05). CONCLUSION: Preoperative EA alleviated anxiety in the preoperative waiting area, and improved sleep quality. Combination of preoperative and intraoperative EA may be more effective in improving postoperative quality of life. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1800019979. Registered on December 10, 2018. (http://www.chictr.org.cn/edit.aspx?pid=27653&htm=4).

Efficacy and safety of electroacupuncture for post-stroke depression: a randomized controlled trial.

OBJECTIVE: The objective of this study is to evaluate the efficacy and safety of electroacupuncture (EA) treatment for post-stroke depression (PSD). METHODS: This study was a single-center, single-blinded, parallel-arm randomized controlled trial. In total, 65 patients with PSD were randomly allocated into EA and sham EA groups. Treatment was administered at GV20, Sishencong, SP6, LR3 and BL18 in both groups. The EA group received EA treatment, while the sham EA group received sham EA treatment using the Park device. Treatment was given three times a week for 4 weeks. The primary outcome was the Hamilton Rating Scale for Depression (HRSD). Secondary outcomes included the Zung Self-Rating Depression Scale (SDS), National Institutes of Health Stroke Scale (NIHSS), Barthel Daily Living Index (BI) and depression scale of traditional Chinese medicine (TCM). Primary and secondary outcomes were assessed at baseline, week 2 after treatment, week 4 after treatment and week 8 of follow-up. Safety assessment was conducted at each visit for 4 weeks of treatment. RESULTS: Significant differences in HRSD, SDS, NIHSS, BI and TCM scale scores were found in the EA group before and after acupuncture treatment (all p < 0.001). Compared with the sham EA group, HRSD scores improved significantly in the EA group at the end of week 2 (F = 31.33, p < 0.001), week 4 (F = 35.58, p < 0.001) and week 8 after treatment onset (F = 25.03, p < 0.001). Similarly, significant improvements were observed in SDS, NIHSS and BI scores. Two participants in the EA group suffered a local hematoma, while no adverse events were reported in the sham EA group. CONCLUSION: EA appears to be an efficacious and safe treatment for PSD. According to our results, EA may alleviate depressive symptoms, and improve neurological function and capabilities with respect to activities of daily living (ADLs). TRIAL REGISTRATION NUMBER: ChiCTR-IOR-17012610 (Chinese Clinical Trial Registry).

[Effect of acupuncture on migraine without aura: a resting-state functional magnetic resonance study].

OBJECTIVE: To observe therapeutic effect of acupuncture on migraine without aura and the changes of brain functional connectivity (FC) using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: Thirty-four patients with migraine without aura were included into an observation group and treated with acupuncture at Baihui (GV 20), Xuanlu (GB 5), Shuaigu (GB 8), Taiyang (EX-HN 5), etc. Using G6805-Ⅱ electric acupuncture apparatus, the ipsilateral Fengchi (GB 20) and Shuaigu (GB 8) were connected and stimulated with continuous wave, 2 Hz in frequency and 0.1 mA to 1.0 mA in current intensity, depending on patient's tolerance. Acupuncture stimulation lasted 20 min each time, twice weekly (at the interval>2 days). A total of 6 weeks of treatment (12 times) was required. Matching the gender and age as those of the observation group, 16 healthy subjects were recruited into a control group and no any intervention was provided. The headache days, the score of visual analogue scale (VAS) for headache severity, the total score of headache symptoms, the score of migraine-specific quality of life questionnaire (MSQ), the score of self-rating anxiety scale (SAS), and the score of self-rating depression scale (SDS) were compared before and after acupuncture, and the clinical efficacy was assessed in the observation group. The data of the resting-state functional magnetic resonance were collected in the observation group before and after treatment as well as the control group at baseline. The periaqueductal gray (PAG) was taken as the seed to analyze the effect of acupuncture on the brain FC and the correlation between FC and VAS scores, headache days in the patients of migraine without aura. RESULTS: After treatment, the headache days, VAS score, the total score of headache symptoms, SAS score and SDS score were all reduced (P<0.01); and the scores of the restrictive, preventive, and emotional functional domains of the MSQ were increased (P<0.01) in the observation group compared with those before treatment. The total effective rate was 94.1% (32/34). Compared with the control group, FC between PAG and the right cerebellum Ⅷ was decreased in the observation group before treatment (P<0.05). FC of PAG with the bilateral cerebellum Ⅷ and the left precuneus was increased in the observation group after treatment compared with those before treatment (P<0.05). In the observation group, the FC intensity of PAG and the right cerebellum Ⅷ was negatively correlated with VAS score (r =-0.41, P<0.05) before treatment, while the FC intensity of PAG and the left precuneus was positively correlated with the improvement in headache days (r =0.40, P<0.05) after treatment. CONCLUSION: Acupuncture is effective on migraine without aura. The brain functional connectivity is abnormal in the patients. The effect onset of acupuncture is obtained probably by regulating the abnormal brain regions and activating brain regions relevant with pain and emotions.

Acupuncture for post-stroke depression: a systematic review and meta-analysis.

BACKGROUND: Acupuncture for post-stroke depression (PSD) has been evolving, but uncertainty remains. To assess the existing evidence from randomized clinical trials (RCTs) of acupuncture for PSD, we sought to draw conclusions by synthesizing RCTs. METHODS: An exhaustive literature search was conducted in seven electronic databases from their inception dates to April 19, 2020, to identify systematic reviews (SRs) and meta-analyses (MAs) on this topic. The primary RCTs included in the SRs/MAs were identified. We also conducted a supplementary search for RCTs published from January 1, 2015, to May 12, 2020. Two reviewers extracted data separately and pooled data using RevMan 5.3 software. The quality of evidence was critically appraised with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system. RESULTS: A total of 17 RCTs involving 1402 patients were included. Meta-analysis showed that participants who received a combination of acupuncture and conventional treatments exhibited significantly lower scores on the HAM-D17, HAM-D24 and HAM-D (MD, - 5.08 [95% CI, - 6.48 to - 3.67], I2 = 0%), (MD, - 9.72 [95% CI, - 14.54 to - 4.91], I2 = 65%) and (MD, - 2.72 [95% CI, - 3.61 to - 1.82], respectively) than those who received conventional treatment. However, there was no significant difference in acupuncture versus antidepressants in terms of the 17-item, 24-item and HAM-D scales (MD, - 0.43 [95% CI, - 1.61 to 0.75], I2 = 51%), (MD, - 3.09 [95% CI, - 10.81 to 4.63], I2 = 90%) and (MD, - 1.55 [95% CI, - 4.36 to 1.26], I2 = 95%, respectively). For adverse events, acupuncture was associated with fewer adverse events than antidepressants (RR, 0.16 [95% CI, 0.07 to 0.39], I2 = 35%), but there was no significant difference in the occurrence of adverse events between the combination of acupuncture and conventional treatments versus conventional treatments (RR, 0.63 [95% CI, 0.21 to 1.83], I2 = 38%). The quality of evidence was low to very low due to the substantial heterogeneity among the included studies. CONCLUSIONS: The current review indicates that acupuncture has greater effect on PSD and better safety profile than antidepressants, but high-quality evidence evaluating acupuncture for PSD is still needed.

Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis.

BACKGROUND: Acupuncture therapy has shown promise for effectively relieving preoperative anxiety. Nevertheless, previous findings from randomized controlled trials (RCTs) are inconsistent and must be examined in detail. OBJECTIVE: This study systematically evaluates the efficacy and safety of acupuncture therapy for preoperative anxiety as well as the quality of evidence supporting this application. SEARCH STRATEGY: The China National Knowledge Infrastructure Database, Wanfang Data Journal Database, Chinese Biomedical Literature Database, Chongqing VIP, Embase, PubMed and Cochrane Library Databases were queried from their inception to 19, February 2020, using keywords such as "acupuncture therapy," "preoperative" and "anxioty." Manual searches expanded the search breadth and included conference abstracts and other reference lists. INCLUSION CRITERIA: RCTs were included in the current study if they contained a comparison between a group of anxiety patients that received acupuncture therapy and a control group that received sham acupuncture. DATA EXTRACTION AND ANALYSIS: Literature was reviewed, and various articles were selected using the NoteExpress 3.2.0 software. Two researchers independently screened and extracted data and evaluated the risk of bias in the included studies. The RevMan 5.3 software was used for data aggregation and the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) assessment was used to evaluate the quality of the study outcomes. RESULTS: Twelve studies were included in the review, containing a total of 916 patients. Meta-analysis showed that, compared with the control group, patients who received acupuncture therapy had reduced State-Trait Anxiety Inventory Scale (STAI-S) score (mean difference [MD] = -9.07, 95% confidence interval [CI] [-13.19 to -4.96], P < 0.0001) and Visual Analogue Scale (VAS) score (MD = -1.37, 95% CI [-2.29 to -0.45], P = 0.003). However, for the Hamilton Anxiety Scale (HAMA) score, there was no difference between the two groups (MD = -3.98, 95% CI [-12.89 to 4.92], P = 0.38). Further, the GRADE assessment demonstrated that the STAI-S was of moderate quality, the VAS of low quality and the HAMA of very low quality. CONCLUSION: Acupuncture therapy may be able to decrease anxiety in preoperative patients, but the results need to be further verified due to the small sample sizes and the low quality of evidence to date.

Effects of electroacupuncture therapy for depression: Study protocol for a multicentered, randomized controlled trial.

INTRODUCTION: As a major public health problem, depression has a negative impact on individuals and society. The aim of this well-designed trial is to evaluate the efficacy and safety of electroacupuncture (EA) treatment for depression. METHODS/DESIGN: A 3-arm parallel, nonblinded, randomized controlled trial will be performed in 4 hospitals (centers). A total of 144 participants will be divided into 3 groups: EA group, manual acupuncture (MA) group, and western medicine group. Participants in EA group and MA group will receive 12 sessions of acupuncture treatment for 4 weeks. Participants allocated to western medicine group will only take 20 mg fluoxetine orally per day for 4 weeks. The primary outcome is Hamilton Depression Scale. Secondary outcomes are Self-Rating Depression Scale, Depression Scale of traditional Chinese medicine (Depression Scale of Traditional Chinese Medicine), brain fMRI and blood biomarkers including neurotransmitters serotonin, dopamine, noradrenaline, inflammatory cytokines inerleukin (IL)-1ß, tumor necrosis factor-α, IL-6, and neurotrophin BDNF. All the outcomes will be assessed at baseline, 4 weeks after EA treatment onset and 6-month follow-up. DISCUSSION: The results of this trial will verify the efficacy and safety of EA treatment for depressive patients and provide acupuncturists and clinicians with robust clinical evidence. TRIAL REGISTRATION: Chinese Clinical Trial Registry identifier: ChiCTR1900023420. Version 1. Registered on 26 May 2019. http://www.chictr.org.cn/edit.aspx?pid=37621&htm=4.

[Rolling needle pricking-cupping therapy and traditional pricking-cupping therapy for cervical spondylosis of neck type: a randomized controlled trial].

OBJECTIVE: To compare the clinical efficacy between rolling needle pricking-cupping (RNP-C) and traditional pricking-cupping (TP-C) for cervical spondylosis of neck type. METHODS: A total of 96 patients with cervical spondylosis of neck type were randomly divided into an RNP-C group, a TP-C group and an electroacupuncture (EA) group, 32 cases in each group. Each group was treated with EA at Jingbailao (EX-HN 15), Fengchi (GB 20), Dazhui (GV 14), Jianjing (GB 21) and ashi points with continuous wave and 2 Hz of frequency; each EA treatment lasted for 20 min, once every 3 to 5 days, totaling 6 treatments. On the basis of EA treatment, the patients in the TP-C group were treated with bloodletting by seven-star needle, followed by fire cupping; the patients in the RNP-C group were treated with bloodletting by rolling needle, followed by fire cupping. The treatment was given once a week for 4 weeks. The follow-up was 1 month. Before treatment, 2 and 4 weeks into treatment and follow-up, the Northwick Park neck-pain questionnaire (NPQ) and visual analogue scale (VAS) scores were evaluated. The acupuncture pain degree was recorded at the first treatment and 2 and 4 weeks into treatment. The efficacy was evaluated after 4 weeks of treatment. RESULTS: Compared before treatment, the scores of NPQ and VAS in each group were all reduced at 2 and 4 weeks into treatment and follow-up (P<0.05). The scores of NPQ in the TP-C group and the RNP-C group were lower than those in the EA group at 2 and 4 weeks into treatment (P<0.05). The scores of VAS in the TP-C group and the RNP-C group were lower than those in the EA group at 2 and 4 weeks into treatment and follow-up (P<0.05). The differences of NPQ and VAS scores between the TP-C group and the RNP-C group at each time point after treatment were not significant (P>0.05). The acupuncture pain degree in the RNP-C group was lower than that in the TP-C group (P<0.05). The total effective rates were 79.3% (23/29) in the TP-C group and 75.0% (24/32) in the RNP-C group, which was superior to 63.3% (19/30) in the EA group (P<0.05), but there was no statistical significance between the TP-C group and the RNP-C group (P>0.05). CONCLUSION: TP-C and RNP-C could both improve the cervical pain symptoms in patients with cervical spondylosis of neck type, and improve the overall function of the cervical spine, and the curative effect is similar.

Thermal Effects of Acupuncture by the Infrared Thermography Test in Patients With Tinnitus.

Previous studies have confirmed the efficacy of acupuncture treatment for tinnitus. However, no relevant studies of the exact mechanism of acupuncture efficacy on tinnitus have been published. Enrolled participants with left-sided tinnitus received acupuncture treatment at TE3 and TE5. The acupuncture session lasted for 30 minutes. The infrared thermography (IRT) test of each participant's bilateral aural regions and visual analog scale scores were taken before and after the first acupuncture treatment session. Fifty-four participants accepted acupuncture treatment and the IRT test. The temperature differentials of both sides were reduced significantly, but the maximum, minimum, and average temperature of bilateral aural regions did not have a significant difference before and after acupuncture session. The acupuncture's effects for tinnitus were associated with the improvement of cochlear blood flow via the IRT test. We have planned a full-scale randomized controlled trial to find out more about the underlying mechanisms of acupuncture for tinnitus.