Discovering different acupoint combinations of manual or electro-acupuncture to treat chemotherapy-induced nausea and vomiting based on the complex networks analysis.

OBJECTIVES: The aim of this research was to find the acupoint combinations of manual and electro-acupuncture to treat chemotherapy-induced nausea and vomiting via the complex networks analysis. METHODS: We conducted searches using PubMed, ScienceDirect, MEDLINE, Ovid, spring, Wiley, EMBASE, the Chinese biomedicine database, VIP information network, and China National Knowledge Infrastructure from the establishment of the databases to the August, 2023. Information about titles, journals, interventions, and main acupoints was extracted using the self-established "acupoint for prevention CINV data base" powered by EpiData. According to the level of literature evidence and sample size, the clinical trials and weights of the outcome indicators including nausea/vomiting efficiency were combined. After identifying articles, literature processing and complex network analysis were conducted. The degree distribution of each node, the probability distribution of node degree, the node clustering coefficient, and the distance matrix are calculated by software. RESULTS: Of the 4001 screened publications, 489 were eligible after careful selection. Our result showed the acupoints ST36 and PC6 were the most common combination acupoints in both electro and manual acupuncture. In terms of efficiency, ST36, PC6, and CV12 are significantly effective acupoints for manual acupuncture, and the PC6 and ST36 are effective acupoint for electro-acupuncture. CONCLUSIONS: We found that the near-far collocation method has been commonly used for different types of acupuncture treatment in CINV. Zhongwan, Shangwan, and Liangmen have been mainly used as local acupoints, while Neiguan, Hegu, Quchi, Zusanli, Gongsun, TaiChong, and Neiguan have been mainly used as distal acupoints. From the effect analysis, acupuncture treatment of nausea manual acupuncture effect is better; acupuncture treatment of vomiting or electro-acupuncture effect is better.

Research on atrial fibrillation mechanisms and prediction of therapeutic prospects: focus on the autonomic nervous system upstream pathways.

Atrial fibrillation (AF) is the most common clinical arrhythmia disorder. It can easily lead to complications such as thromboembolism, palpitations, dizziness, angina, heart failure, and stroke. The disability and mortality rates associated with AF are extremely high, significantly affecting the quality of life and work of patients. With the deepening of research into the brain-heart connection, the link between AF and stroke has become increasingly evident. AF is now categorized as either Known Atrial Fibrillation (KAF) or Atrial Fibrillation Detected After Stroke (AFDAS), with stroke as the baseline. This article, through a literature review, briefly summarizes the current pathogenesis of KAF and AFDAS, as well as the status of their clinical pharmacological and non-pharmacological treatments. It has been found that the existing treatments for KAF and AFDAS have limited efficacy and are often associated with significant adverse reactions and a risk of recurrence. Moreover, most drugs and treatment methods tend to focus on a single mechanism pathway. For example, drugs targeting ion channels primarily modulate ion channels and have relatively limited impact on other pathways. This limitation underscores the need to break away from the "one disease, one target, one drug/measurement" dogma for the development of innovative treatments, promoting both drug and non-drug therapies and significantly improving the quality of clinical treatment. With the increasing refinement of the overall mechanisms of KAF and AFDAS, a deeper exploration of physiological pathology, and comprehensive research on the brain-heart relationship, it is imperative to shift from long-term symptom management to more precise and optimized treatment methods that are effective for almost all patients. We anticipate that drugs or non-drug therapies targeting the central nervous system and upstream pathways can guide the simultaneous treatment of multiple downstream pathways in AF, thereby becoming a new breakthrough in AF treatment research.

Research Progress on the Mechanisms of Central Post-Stroke Pain: A Review.

Central Post-Stroke Pain (CPSP) is a primary sequelae of stroke that can develop in the body part corresponding to the cerebrovascular lesion after stroke, most typically after ischemic stroke but also after hemorrhagic stroke. The pathogenesis of CPSP is currently unknown, and research into its mechanism is ongoing. To summarize current research on the CPSP mechanism and provide guidance for future studies. Use "central post-stroke pain," "stroke AND thalamic pain," "stroke AND neuropathic pain," "post-stroke thalamic pain" as the search term. The search was conducted in the PubMed and China National Knowledge Infrastructure databases, summarizing and classifying the retrieved mechanism studies. The mechanistic studies on CPSP are extensive, and we categorized the included mechanistic studies and summarized them in terms of relevant pathway studies, relevant signals and receptors, relevant neural tissues, and described endoplasmic reticulum stress and other relevant studies, as well as summarized the mechanisms of acupuncture treatment. Studies have shown that the pathogenesis of CPSP involves the entire spinal-thalamo-cortical pathway and that multiple substances in the nervous system are involved in the formation and development of CPSP. Among them, the relevant receptors and signals are the hotspot of research, and the discovery and exploration of different receptors and signals have provided a wide range of therapeutic ideas for CPSP. As a very effective treatment, acupuncture is less studied regarding the analgesic mechanism of CPSP, and further experimental studies are still needed.