Evaluation of the learning state of online video courses based on functional near infrared spectroscopy.

Studying brain activity during online learning will help to improve research on brain function based on real online learning situations, and will also promote the scientific evaluation of online education. Existing research focuses on enhancing learning effects and evaluating the learning process associated with online learning from an attentional perspective. We aimed to comparatively analyze the differences in prefrontal cortex (PFC) activity during resting, studying, and question-answering states in online learning and to establish a classification model of the learning state that would be useful for the evaluation of online learning. Nineteen university students performed experiments using functional near-infrared spectroscopy (fNIRS) to monitor the prefrontal lobes. The resting time at the start of the experiment was the resting state, watching 13 videos was the learning state, and answering questions after the video was the answering state. Differences in student activity between these three states were analyzed using a general linear model, 1s fNIRS data clips, and features, including averages from the three states, were classified using machine learning classification models such as support vector machines and k-nearest neighbor. The results show that the resting state is more active than learning in the dorsolateral prefrontal cortex, while answering questions is the most active of the three states in the entire PFC, and k-nearest neighbor achieves 98.5% classification accuracy for 1s fNIRS data. The results clarify the differences in PFC activity between resting, learning, and question-answering states in online learning scenarios and support the feasibility of developing an online learning assessment system using fNIRS and machine learning techniques.

The rapid antidepressant effect of acupuncture on two animal models of depression by inhibiting M1-Ach receptors regulates synaptic plasticity in the prefrontal cortex.

BACKGROUND: It is unclear whether acupuncture has a rapid antidepressant effect and what is the main mechanism. METHODS: In this study, forced swimming stress test (FST) in mice were divided into five groups: control group, acupuncture group, scopolamine group, arecoline group, and acupuncture + arecoline group. Chronic unpredictable mild stress (CUMS) model rats were divided into six groups: naïve (non-CUMS) group, CUMS group, acupuncture group, scopolamine group, arecoline group, and acupuncture + arecoline group. Twenty-four hours after the end of treatment, FST was conducted in mice and rats. The expression of M1-AchR, AMPA receptors (GluR1 and GluR2), BDNF, mTOR, p-mTOR, synapsin I, and PSD95 in the prefrontal cortex was determined by western blot. The spine density of neurons in the prefrontal cortex was detected by golgi staining. RESULTS: The results showed that acupuncture reduced the immobility time of FST in two depression models. Acupuncture inhibited the expression of M1-AchR and promoted the expression of GluR1, GluR2, BDNF, p-mTOR, synapsin I, PSD95, and increased the density of neuron dendritic spine in the prefrontal cortex. CONCLUSIONS: The rapid antidepressant effect of acupuncture may be activating the "glutamate tide" - AMPA receptor activation - BDNF release - mTORC1 pathway activation through inhibiting the expression of M1-AchR in the prefrontal cortex, thereby increasing the expression of synaptic proteins and regulating synaptic plasticity.

Treatment of diabetic foot ulcers with external application of Chinese herbal medicine: An overview of overlapping systematic reviews.

This overview of systematic reviews (SRs) and meta-analysis (MAs) aimed to systematically collate, appraise and synthesize evidence for the treatment of diabetic foot ulcers (DFUs) with the external application of Chinese herbal medicine (CHM). SRs/MAs of external application of CHM for DFUs were collected by searching Cochrane Library, Web of science, CNKI, PubMed, VIP, Embase and Wanfang. Two independent reviewers carried out the literature selection and data extraction. Subsequently, AMSTAR-2 tool, PRISMA, and GRADE system were applied by two reviewers independently to evaluate the methodological quality, reporting quality, and evidence quality of the included studies, respectively. Eight SRs/MAs met the eligibility criteria and were included. According to AMSTAR-2, a very low methodological quality assessment was given to the included SRs/MAs due to the flaws of items 2, 4 and 7. The PRISMA system identified protocol and registration weaknesses, as well as search method weaknesses. With GRADE, no high-quality evidence was identified to support the role of external application of CHM for DFUs, and the quality of evidence for the vast majority of outcomes was rated as low or moderate. In conclusion, low- to moderate-quality evidence supports the promise of external application of CHM for the treatment of DFUs. Due to the limitations of the evidence supporting external application of CHM for DFUs, rigorously designed and larger samples of high-quality studies are needed going forward before broad recommendations can be made.

Comparison of bioelectrical body and visceral fat indices and anthropometric measures in relation to type 2 diabetes by sex among Chinese adults, a cross-sectional study.

Objectives: We aim to compare the efficacies of the bioelectrical indices (percentage of body fat, PBF; visceral fat area, VFA) with the conventional anthropometric measures (body mass index, BMI; waist-hip ratio, WHR) for predicting type 2 diabetes (T2D) risk by sex and to determine the sex-specific optimal adiposity indices to predict the T2D risk. Design: Cross-sectional design. Setting: Tianjin First Central Hospital and Tianjin Union Medical Center, Tianjin, China. Participants: A total of 9,332 adults (41.35% men) undergoing physical examination. Primary and secondary outcome measures: T2D was defined using the WHO's criteria: fasting blood glucose (FBG) ≥7.0 mmol/L and/or previous diagnosis of T2D. Height, weight, waist, hip, PBF, VFA, and fasting plasma glucose were measured. Results: All studied adiposity indices were associated with T2D among both males and females, and the observed associations differed by sex. The standardized aORs of BMI, WHR, PBF and VFA for T2D were 1.60 (95% CI 1.42-1.81), 1.43 (95% CI 1.25-1.64), 1.42 (95% CI 1.23-1.62) and 1.53 (95% CI 1.35-1.75) for females, and 1.47 (95% CI 1.31-1.66), 1.40 (95% CI 1.25-1.58), 1.54 (95% CI 1.36-1.74) and 1.47 (95% CI 1.31-1.65) for males, respectively. The AUCs of VFA, WHR and BMI were 0.743, 0.742 and 0.717 in women, respectively, whereas none of the indices had AUC larger than 0.70 in men. The AUCs were not significantly different between VFA and WHR, while both demonstrate larger AUCs than BMI and PBF in females (all p < 0.05). The optimal cutoff values of VFA, WHR, and BMI for T2D in women were 103.55 cm2, 0.905, and 24.15 kg/m2, respectively. Conclusion: Although BMI, WHR, and PBF and VFA as measured by bioelectrical impedance analysis (BIA) were all positively associated with T2D, their efficacy for predicting the risk of T2D differed by sex. VFA, WHR and BMI could be used as biomarkers to predict T2D risk in women, however none of the study indicators demonstrated favorable efficacy of predicting T2D risk in men.

Long-term exposure to ambient ozone at workplace is positively and non-linearly associated with incident hypertension and blood pressure: longitudinal evidence from the Beijing-Tianjin-Hebei medical examination cohort.

BACKGROUND: There is limited longitudinal evidence on the hypertensive effects of long-term exposure to ambient O3. We investigated the association between long-term O3 exposure at workplace and incident hypertension, diastolic blood pressure (DBP), systolic blood pressure (SBP), pulse pressure (PP), and mean arterial pressure (MAP) in general working adults. METHODS: We conducted a cohort study by recruiting over 30,000 medical examination attendees through multistage stratified cluster sampling. Participants completed a standard questionnaire and comprehensive medical examination. Three-year ambient O3 concentrations at each employed participant's workplace were estimated using a two-stage machine learning model. Mixed-effects Cox proportional hazards models and linear mixed-effects models were used to examine the effect of O3 concentrations on incident hypertension and blood pressure parameters, respectively. Generalized additive mixed models were used to explore non-linear concentration-response relationships. RESULTS: A total of 16,630 hypertension-free working participants at baseline finished the follow-up. The mean (SD) O3 exposure was 45.26 (2.70) ppb. The cumulative incidence of hypertension was 7.11 (95% CI: 6.76, 7.47) per 100 person-years. Long-term O3 exposure was independently, positively and non-linearly associated with incident hypertension (Hazard ratios (95% CI) for Q2, Q3, and Q4 were 1.77 (1.34, 2.36), 2.06 (1.42, 3.00) and 3.43 (2.46, 4.79), respectively, as compared with the first quartile (Q1)), DBP (ß (95% CI) was 0.65 (0.01, 1.30) for Q2, as compared to Q1), SBP (ß (95% CI) was 2.88 (2.00, 3.77), 2.49 (1.36, 3.61) and 2.61 (1.64, 3.58) for Q2, Q3, and Q4, respectively), PP (ß (95% CI) was 2.12 (1.36, 2.87), 2.03 (1.18, 2.87) and 2.14 (1.38, 2.90) for Q2, Q3, and Q4, respectively), and MAP (ß (95% CI) was 1.39 (0.76, 2.02), 1.04 (0.24, 1.84) and 1.12 (0.43, 1.82) for Q2, Q3, and Q4, respectively). The associations were robust across sex, age, BMI, and when considering PM2.5 and NO2. CONCLUSIONS: To our knowledge, this is the first cohort study in the general population that demonstrates the non-linear hypertensive effects of long-term O3 exposure. The findings are particularly relevant for policymakers and researchers involved in ambient pollution and public health, supporting the integration of reduction of ambient O3 into public health interventions.

Habitual night sleep duration is associated with general obesity and visceral obesity among Chinese women, independent of sleep quality.

Purpose: Research on the relationship between sleep duration and obesity defined using multiple anthropometric and bioelectrical indices in women remains scarce. We aimed to explore the association between sleep duration and body mass index (BMI), waist-hip ratio (WHR), body fat percentage (PBF) and visceral fat area (VFA) among females. Methods: We recruited women for medical examination using multistage cluster sampling. Sleep was assessed using Pittsburgh Sleep Quality Index (PSQI) and sleep duration was categorized into short (<7 h), optimal (7 <9 h) and long sleep (≥ 9 h). Weight and height were measured using a calibrated stadiometer. Waist circumference was manually measured. PBF, and VFA were estimated by bioelectrical impedance analysis. Data on sociodemographic characteristics and lifestyle factors were also collected and included in the logistic regression models to explore the independent association between sleep duration and obesity defined by different indices. Results: A total of 7,763 women with a mean age of 42.6 ± 13.5 years were included. The percentage of women reporting short and long sleep was 10.3 and 13.4% respectively. The mean BMI, WHR, PBF and VFA were 23.07 ± 3.30 kg/m2, 0.78 ± 0.06, 32.23 ± 6.08% and 91.64 ± 35.97cm2, respectively. Short sleep was independently associated with 35% (95% CI: 1.05-1.75) increased odds of general obesity (BMI ≥ 28 kg/cm2), and long sleep was associated with 18% (95% CI: 1.01-1.37) increased odds of visceral obesity (VFA > 100 cm2). No association was observed between sleep deprivation or excessive sleep and high WHR or high PBF. Conclusion: In women, short sleep was associated with an increased odds of general obesity, whereas long sleep was associated with an increased odds of visceral obesity. Longitudinal observations are needed to confirm this cross-sectional relationship.

Multi-focus image fusion with enhancement filtering for robust vascular quantification using photoacoustic microscopy.

Accurate identification and quantification of microvascular patterns are important for clinical diagnosis and therapeutic monitoring using optical-resolution photoacoustic microscopy (OR-PAM). Due to its limited depth of field, conventional OR-PAM may not fully reveal microvascular patterns with enough details in depth range, which affects the segmentation and quantification. Here, we propose a robust vascular quantification approach via combining multi-focus image fusion with enhancement filtering (MIFEF). The multi-focus image fusion is constructed based on multi-scale gradients and image matting to improve image fusion quality by considerably achieving accurate focus measurement for initial segmentation as well as decision map refinement. The enhancement filtering identifies the vessels and handles noise without deforming microvasculature. The performance of the MIFEF were evaluated employing a leaf phantom, mouse livers and brains. The proposed method for OR-PAM can significantly facilitate the clinical provision of optical biopsy of vascular-related diseases.

Prevalence of hyperuricemia and the population attributable fraction of modifiable risk factors: Evidence from a general population cohort in China.

Data on updated hyperuricemia prevalence in Beijing-Tianjin-Hebei (BTH) region in China, which is one of the world-class urban agglomerations, is sparse. Overweight/obesity, alcohol consumption, smoking and sedentary behavior are modifiable risk factors (MRFs) for elevated serum uric acid (SUA), but their population attributable fractions (PAFs) for hyperuricemia is still unclear. Using baseline data from the BTH Physical Examination General Population Cohort, we calculated the crude- and adjusted-prevalence of hyperuricemia based on the 30,158 participants aged 18-80 years. Hyperuricemia was defined as SUA >420 µmol/L in men and >360 µmol/L in women, or currently use of uric acid lowering drugs. Overweight/obesity, alcohol consumption, smoking and sedentary behavior were considered as MRFs and their adjusted PAFs were estimated. The prevalence of hyperuricemia was 19.37%, 27.72% in men and 10.69% in women. The PAFs and 95% confidence intervals for overweight, obesity were 16.25% (14.26-18.25%) and 12.08% (11.40-12.77%) in men, 13.95% (12.31-15.59%) and 6.35% (5.97-6.74%) in women, respectively. Alcohol consumption can explain 4.64% (2.72-6.56%) hyperuricemia cases in men, but with no statistical significance in women. Cigarette smoking contributed to 3.15% (1.09-5.21%) cases in men, but a much lower fraction in women (0.85%, 0.49-1.22%). Compared with sedentary time <2 h per day, the PAFs of 2-4 h, 4-6 h, and more than 6 h per day were 3.14% (1.34-4.93%), 6.72% (4.44-8.99%) and 8.04% (4.95-11.13%) in men, respectively. Sedentary time was not found to be associated with hyperuricemia in women. These findings concluded that hyperuricemia is prevalent in this representative Chinese adult general population with substantial sex difference. Four MRFs (overweight/obesity, alcohol consumption, cigarette smoking and sedentary behavior) accounted for a notable proportion of hyperuricemia cases. The PAF estimations enable the exploration of the expected proportion of hyperuricemia cases that could be prevented if the MRFs were removed, which warrants the public health significance of life-style intervention.

Associations between night-time sleep duration and fasting glucose and ratio of triglyceride to high-density lipoprotein cholesterol among adults free of type 2 diabetes or without diagnosed type 2 diabetes: a multicentre, cross-sectional study in China.

OBJECTIVES: We aimed to assess the associations between night-time sleep duration and fasting glucose (FG), triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and body mass index (BMI) among adults free of type 2 diabetes (T2D) or without diagnosed T2D. DESIGN: Cross-sectional study. SETTING: Medical examination centres at six hospitals in Beijing-Tianjin-Hebei region, China. PARTICIPANTS: Participants were recruited via multistage, stratified cluster sampling. We included adults free of T2D or without diagnosed T2D who attended for physical examination and completed the validated questionnaire. 32 497 participants were included in the study, of whom 52.50% were men. PRIMARY AND SECONDARY OUTCOME MEASURES: FG, TG, HDL-C, height and weight were measured. RESULTS: Overall, 12.80% and 9.67% reported night sleep duration <7 hours and ≥9 hours, respectively; 6.91% had elevated FG and 3.57% had undiagnosed T2D. Sleep duration had an independent, U-shaped associated with FG (ß1 (linear term)=-0.111, p=0.047; ß2 (quadratic term)=0.008, p=0.026) with 6.9 hours of sleep associated with the lowest FG and a negative association with BMI (ß=-0.154, p<0.001). BMI mediated a U-shaped association of sleep duration with TG/HDL-C (ß1=-0.040, p=0.017; ß2=0.003, p=0.023). CONCLUSIONS: Both short and long night-time sleep was associated with elevated FG, and short sleep duration was associated with increased BMI. BMI mediated a U-shaped association between sleep duration and TG/HDL-C.

Association of long-term exposure to PM2.5 in workplace with fasting plasma glucose among asymptomatic adults: A multicenter study in North China.

BACKGROUND: The impacts of long-term high exposure to PM2.5 in workplace on glucose metabolism in asymptomatic working adults (AWAs) have rarely been explored. OBJECTIVES: To assess the relationship between long-term exposure to workplace PM2.5 and glucose metabolism in asymptomatic general working adults in heavily polluted regions. METHODS: We used the baseline data of the asymptomatic working participants from the Beijing-Tianjin-Hebei Medical Examination Cohort, which recruited adults undergoing medical examinations. A machine learning-based spatial-temporal model was used to estimate daily average PM2.5 concentrations in the participants' workplaces. We assessed the association of long-term PM2.5 concentrations (three years prior to the interview) and fasting plasma glucose (FPG) using generalized linear mixed-effects models (GLMM) with inclusion of potential confounders. Stratified analyses by sex, age, BMI and smoking status, and two pollutant models were further performed. RESULTS: A total of 37,619 individuals were interviewed and 28,865 were included in the analyses. The mean FPG was 5.20 (0.96) mmol/L, and the estimated three-year average concentration of PM2.5 exposure was 69.51 (6.92) µg/m3. We detected a significant association of long-term exposure to workplace PM2.5 and FPG, a 10 µg/m3 increase in the long-term workplace PM2.5 exposure was associated with 0.075 (95%CI: 0.050-0.100) mmol/L elevated FPG and 25% (OR = 1.25, 95%CI: 1.05-1.50) elevated odds of abnormal fasting glucose metabolism with control of the potential confounding. The detected association between workplace PM2.5 and FPG metabolism remained significant in males, individuals aged > 44 years, overweight and/or obese people, both smokers and non-smokers, and when NO2, SO2, O3, and CO were included in the model. CONCLUSIONS: Long-term exposure to workplace PM2.5 was associated with elevated FPG and/or odds of abnormal glucose metabolism among AWAs. Male, middle-aged, overweight and/or obese AWAs were more susceptible to workplace PM2.5 regardless of smoking status.

Association Between Habitual Night Sleep Duration and Predicted 10-Year Cardiovascular Risk by Sex Among Young and Middle-Aged Adults.

Purpose: We hypothesize the association between sleep duration and cardiovascular disease (CVD) risk varies with age category; however, evidence for the relationship between sleep duration and CVD risk among young and middle-aged adults remains scarce. This research aims to assess the association between night sleep duration and cardiovascular risk by sex among young and middle-aged Chinese adults. Patients and Methods: We used the baseline data of a cohort of adults for physical examination by stratified cluster sampling. The Framingham risk score and the Pittsburgh Sleep Quality Index were used to measure CVD risk and sleep duration, respectively. Demographic characteristics, lifestyle factors, height, weight, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were collected. We performed multiple logistic regressions to examine the association between night sleep duration and the predicted cardiovascular risk. Results: We included 27,547 participants aged 18-64 years free of CVD, cerebral stroke, and not taking lipid-lowering agents. Overall, 12.7%, and 20.4% were at medium and high predicted CVD risk, respectively; 11.9% and 12.3% reported short and long sleep, respectively. Short sleep was independently associated with 23% (95% CI: 1.08-1.40) increased odds of medium-to-high CVD risk and 26% (95% CI: 1.11-1.45) increased odds of high CVD risk among females. Whereas long sleep was independently associated with 17% (95% CI: 0.71-0.98) decreased odds of medium-to-high CVD risk among males. Conclusion: Among young and middle-aged adults, long sleep was associated with decreased odds of CVD risk in males, whereas short sleep was associated with increased odds of cardiovascular risk in females.

Gut microbiota-derived metabolite 3-idoleacetic acid together with LPS induces IL-35+ B cell generation.

BACKGROUND: IL-35-producing Bregs and Treg cells critically regulate chronic illnesses worldwide via mechanisms related to disrupting the gut microbiota composition. However, whether the gut microbiota regulates these IL-35+ cells remains elusive. We herein investigated the regulatory effects of the gut microbiota on IL-35+ cells by using genetically modified mouse models of obesity. RESULTS: We first found that gut Reg4 promoted resistance to high-fat diet-induced obesity. Using 16S rRNA sequencing combined with LC-MS (liquid chromatography-mass spectrometry)/MS, we demonstrated that gut Reg4 associated with bacteria such as Lactobacillus promoted the generation of IL-35+ B cells through 3-idoleacetic acid (IAA) in the presence of LPS. HuREG4IECtg mice fed a high-fat diet exhibited marked IL-35+ cell accumulation in not only their adipose tissues but also their colons, whereas decreased IL-35+ cell accumulation was observed in the adipose and colon tissues of Reg4 knockout (KO) mice. We also found that Reg4 mediated HFD-induced obesity resistance via IL-35. Lower levels of IAA were also detected in the peripheral blood of individuals with obesity compared with nonobese subjects. Mechanistically, IAA together with LPS mediated IL-35+ B cells through PXR and TLR4. KO of PXR or TLR4 impaired the generation of IL-35+ B cells. CONCLUSION: Together, IAA and LPS induce the generation of IL-35+ B cells through PXR and TLR4. Video Abstract.

Gender differences in the association between sleep duration and body mass index, percentage of body fat and visceral fat area among chinese adults: a cross-sectional study.

BACKGROUND: The relationship between sleep duration and anthropometric indices are still unclear. This study aimed to explore the association between sleep duration and body mass index (BMI), percentage of body fat (PBF) and visceral fat area (VFA) among Chinese adults, further to explore gender difference in it. METHODS: We analyzed part of the baseline data of a cohort study among adult attendees at two health-screening centers in China. Sleep duration was self-reported and categorized into short (< 7 h/day), optimal (7-9 h/day) and long sleep (≥ 9 h/day). BMI, PBF and VFA were assessed by bioelectric impedance analysis. Demographic characteristics, chronic diseases and medication history, physical activity, smoking and alcohol drinking behaviors were measured by an investigator-administrated questionnaire. RESULTS: A total of 9059 adult participants (63.08% were females) were included in the analysis. The participants aged from 19 to 91 years with the mean age of 45.0 ± 14.6 years. Short sleep was independently associated with elevated odds of general obesity (defined using BMI) and visceral obesity (defined using VFA) among the total study population, and gender differences were observed in these associations. Among women, short sleep was associated with 62% increased odds of general obesity (OR = 1.62, 95% CI: 1.24-2.12) and 22% increased odds of visceral obesity (OR = 1.22, 95% CI: 1.02-1.45). Among men, long sleep duration was associated with 21% decreased odds of visceral obesity (OR = 0.79, 95% CI: 0.64-0.99). No association was observed between sleep duration and PBF in both sexes. CONCLUSIONS: Sleep duration was associated with increased odds of general and visceral obesity, and this association differed between men and women. No association was observed between sleep duration and PBF among either males or females.

Comparison of bioelectrical body and visceral fat indices with anthropometric measures and optimal cutoffs in relation to hypertension by age and gender among Chinese adults.

BACKGROUND: Few studies have compared bioelectrical body and visceral fat indices with anthropometric measures, or evaluated their optimal cutoffs in relation to hypertension among Asians. We compared the efficiencies of bioelectrical indices (percentage of body fat, PBF; visceral fat area, VFA) with anthropometric measures (body mass index, BMI; waist-hip ratio, WHR) for hypertension and re-evaluated the optimal cutoffs of each index by age and gender. METHODS: We conducted a cross-sectional survey among 8234 adults for health examination. PBF, VFA, BMI, WHR, and data on hypertension and behaviors were collected. Receiver operating characteristic (ROC) curve and areas under curves (AUCs) were used to analyze the efficiencies of the indices for hypertension, optimal cutoffs were estimated using the Youden index. RESULTS: A total of 8234 individuals aged 21-91 with median age 44 (interquartile range [IQR] 33-56) years were included and 40.56% were men. The overall prevalence of hypertension was 27.47%. The studied indices were all associated with hypertension in all age-specific groups both among men and women except for WHR in 21-29 years old men and PBF in in 21-29 years old women. Among males, there were no statistical differences in powers of four indices for hypertension in all age-specific groups, except for 40-49 years, in which WHR was better than VFA. Among females, no differences were found among the indices in 30-39 and 70-79 years groups, while WHR was the best in 21-29 years group, VFA was better than PBF in 30-39 and 50-59 years groups, BMI was better than PBF and WHR in 60-69 years group. The optimal cutoffs of PBF, VFA, BMI and WHR ranged from 23.9 to 28.7%, 86.4 to 106.9cm2, 23.5 to 27.1 kg/m2, 0.92 to 0.96 across the age categories in males, and 32.8 to 36.3%, 75.9 to 130.9cm2, 21.9 to 26.4 kg/m2, 0.84 to 0.95 across the age categories in females, respectively. CONCLUSIONS: The obesity indices' efficiencies for hypertension varied by age and gender, and their cutoff values varied across the age categories and gender. Specific indices and cutoffs based on person's age and gender should be used to identify individuals with hypertension.

Optimized acupuncture treatment (acupuncture and intradermal needling) for cervical spondylosis-related neck pain: a multicenter randomized controlled trial.

ABSTRACT: Cervical spondylosis (CS)-related neck pain is difficult to treat because of its degenerative nature. The aim of this 9-center, single-blinded, randomized controlled trial was to evaluate the efficacy of optimized acupuncture for CS-related neck pain. Participants who met the inclusion criteria were randomized to optimized, shallow, and sham acupuncture groups (1:1:1). The primary outcome was the change from baseline in the Northwick Park Neck Pain Questionnaire score at week 4. Participants were followed up until week 16. Of the 896 randomized participants, 857 received ≥1 intervention session; 280, 286, and 291 received optimized, shallow, and sham acupuncture, respectively. A total of 835 (93.2%) participants completed the study. At week 4, significant differences (P < 0.001) were observed in the changes in Northwick Park Neck Pain Questionnaire scores between the optimized acupuncture group and both the shallow {7.72 (95% confidence interval [CI], 5.57-9.86)} and sham acupuncture (10.38 [95% CI, 8.25-12.52]) groups. The difference in the scores at week 16 between the optimized acupuncture group and the shallow (8.84 [95% CI, 6.34-11.34]) and sham acupuncture (10.81 [95% CI, 8.32-13.30]) groups were significant. The center effect indicated wide variability in the treatment effects (Cohen's d = 0.01-2.19). Most SF-36 scores were higher in the optimized acupuncture group than those in the other groups. These results suggest that 4-week optimized acupuncture treatment alleviates CS-related neck pain and improves the quality of life, with the effects persisting for minimum 3 months. Therefore, acupuncture can have positive effects on CS-related neck pain, although the effect size may vary widely.