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AbstractObjectiveMethodResultsConclusionThe primary objective of this investigation was to assess the impact of acupuncture intervention and explore the intricacies of acupoint selection as a therapeutic strategy for chemotherapy-induced Anorexia (CIA).Eight electronic databases were searched to identify relevant studies on the use of acupuncture for the treatment of CIA to conduct a comprehensive meta-analysis. Following this, the Apriori algorithm, correlation analysis, and cluster analysis were performed to identify correlations between the selection of acupoints.Acupuncture significantly reduced the incidence of anorexia (RR = 0.76, 95%CI: 0.65, 0.90; I2=63%; p = 0.001; n = 503) and anorexia score (SMD=-0.33, 95%CI: −0.53, −0.14; I2=22%; p = 0.0008; n = 419), as well as preserved body mass (MD = 2.70, 95%CI: 1.08, 4.32; I2=0%; p = 0.001; n = 187) and enhanced physical strength (MD = 4.23, 95%CI: 1.90, 6.55; I2=58%; p = 0.0004; n = 377). Moreover, subgroup analysis highlighted its efficacy in managing anorexia associated with non-gastrointestinal tumors and mitigating the severity of cisplatin-induced anorexia. Meanwhile, Zusanli (ST36), Neiguan (PC6), Tianshu (ST25), Zhongwan (RN12), and Qihai (RN6) were identified as crucial acupoints in CIA management.Acupuncture holds promise as a potential non-pharmacological approach for managing anorexia during cancer chemotherapy. To provide robust evidence of its effectiveness, well-designed Randomized Controlled Trials (RCTs) with larger participant cohorts, and consistent core outcome measures are essential. [ABSTRACT FROM AUTHOR]

The objective of this research is to investigate the potential mechanisms underlying electro-acupuncture intervention in chronic prostatitis (CP). Rats were randomly divided into five groups: a control group, a model group (suffering from CP), an electro-acupuncture group, an inhibitor group, and an activator group. One day post-modeling, electro-acupuncture intervention was conducted on the electro-acupuncture group, inhibitor group, and activator group at the acupoints "Baihuan Shu" (BL 30) and "Huiyang" (BL 35). Relevant indicators were used to evaluate the efficacy. Compared with models, the electro-acupuncture group showed significantly increased horizontal and vertical movement scores and sugar water intake, and significantly decreased prostate wet weight and prostate index. Compared with the electro-acupuncture group, the inhibitor group showed significantly increased horizontal and vertical movement scores and sugar water consumption. In contrast, for the activator group, these scores and consumption levels significantly decreased, while their prostate wet weight and prostate index increased significantly. Compared with models, the expression of TLR4 and p-NF- κ B/NF- κ B proteins in the prostate tissue of electro-acupuncture group was significantly lower. In terms of the inhibitor group, they also showed a decrease in TLR4 and p-NF- κ B/NF- κ B protein expression, whilst the activator group showed an increase. Therefore, electro-acupuncture at "Baihuan Shu" (BL 30) and "Huiyang" (BL 35) can significantly enhance movement scores, vertical movement scores, and sugar water consumption in rats with CP. Moreover, it can decrease the wet weight and index of the prostate, possibly by regulating the TLR4/NF- κ B pathway. [ABSTRACT FROM AUTHOR]

Introduction: The concept of acupoints is a key defining feature of acupuncture, yet the scientific basis of acupoints remains unclear. In recent years, there has been an emerging body of animal studies demonstrating an association between cutaneous sensitivity and visceral pathophysiology, through which acupoints over the skin are sensitized in pathologic conditions. Several studies with humans have also been conducted to assess whether the sensitivity of acupoints is distinct in healthy versus clinical populations. However, no systematic review has been conducted to collate and synthesize the status and quality of human studies on this topic. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Literature search was performed by combining variations of search terms related to acupoints and pain sensitivity in PubMed, EMBASE, and Alt HealthWatch (EBSCOHost). Screening of titles and abstracts and review of full-text articles for eligibility were performed by two independent investigators. Using a predefined template, information on subject characteristics, pathologic conditions, names of assessed acupoints, and relevant main findings were extracted from the included studies. The methodological quality of included studies was assessed using a modified Newcastle-Ottawa Scale (NOS) for case-control studies. A quality assessment checklist was also developed by the present authors to examine the quality of reporting of experimental variables that were considered important for evaluating acupoint sensitivity. Results: A total of 3453 studies were identified from the database search, of which 11 met the eligibility criteria to be included in this review. Six studies examined the mechanical sensitivity of body acupoints, and the remaining five studies examined the mechanical sensitivity of auricular points. Overall, findings suggest that the sensitivity of acupoints may be distinct in healthy versus clinical populations. However, there were various potential sources of bias and substantial heterogeneity across included studies in clinical conditions and acupoints. Conclusion: There is at present insufficient evidence to support or refute that acupoints in humans are sensitized in pathologic conditions. There were various methodological issues, including small sample size and poor reporting of experimental design and variables, which limit the ability to draw a definitive conclusion on this topic. It is also largely unclear whether it is the general body regions rather than specific acupoints that may be sensitized, as most studies did not include nonacupoint location(s) for comparison. Thus, further rigorous research is warranted. [ABSTRACT FROM AUTHOR]

Chronic neck pain is a common health condition that adversely affects quality of life. Acupuncture shows promise as a potential intervention. This randomized clinical trial compares the efficacy of 2 forms of acupuncture on neck pain when compared with sham acupuncture and participants on a waitlist. Visual Abstract. Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain: Chronic neck pain is a common health condition that adversely affects quality of life. Acupuncture shows promise as a potential intervention. This randomized clinical trial compares the efficacy of 2 forms of acupuncture on neck pain when compared with sham acupuncture and participants on a waitlist. Background: Long-term effects of individualized acupuncture in persons with chronic neck pain (CNP) remain unknown. Objective: To evaluate the efficacy and safety of pressure pain, sensory-based individualized acupuncture for relieving CNP. Design: A 24-week multicenter randomized controlled clinical trial. (ChiCTR1800016371) Setting: Outpatient settings at 4 clinical centers in China from May 2018 to March 2020. Participants: 716 participants with CNP. Intervention: Participants were randomly assigned to a waiting list (WL) group or to 1 of 3 interventions, which consisted of 10 sessions over 4 weeks: higher sensitive acupoints (HSA), lower sensitive acupoints (LSA), and sham acupoints (SA) acupuncture groups. Measurements: The primary outcome was the change in the visual analogue scale (VAS) score for neck pain (range, 0 to 100) from baseline to 4 weeks, with a difference of 10 points considered the minimum clinically important threshold. The VAS was also assessed every 4 weeks through 24 weeks. Results: The modified intention-to-treat population included 683 participants. The mean baseline VAS was 50.36, 50.10, 49.24, and 49.16 for HSA, LSA, SA, and WL, respectively. Compared with a mean baseline to week 4 change of −12.16 in the HSA group, the mean changes were −10.19 in the LSA group (net difference [ND], −1.97 [95% CI, −5.03 to 1.09]), −6.11 in the SA group (ND, −6.05 [CI, −9.10 to −3.00]), and −2.24 in the WL group (ND, −9.93 [CI, −12.95 to −6.90]). The intervention effects persisted at 24-week follow-up. Limitation: Lack of complete blinding and limited generalizability. Conclusion: Individualized acupuncture interventions using high- or low-sensitivity acupuncture points were more effective in reducing CNP than SA and WL control groups sustained through 24 weeks, but the magnitude of relative improvement did not reach a minimal clinically important difference. Primary Funding Source: National Natural Science Foundation of China. [ABSTRACT FROM AUTHOR]

Objectives: To assess needle placement accuracy in the rectus abdominis (RA) muscle during dry needling (DN) without entering the peritoneum. Methods: Two physical therapists performed DN on a cadaver, making 10 attempts each to needle the RA without entering the peritoneum. Techniques followed two common DN approaches. Ultrasound verified needle depth and safety. Results: Seventy percent of attempts were recorded as safe needle placement, while 30% were unsafe. Accurate RA needle placement without peritoneal entry occurred in 55% of attempts. Discussion/Conclusion: Inadvertent peritoneal needle placement during RA DN poses risks regardless of experience. Ultrasound guidance may enhance safety and precision in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: Chemotherapy-induced neuropathy (CIN) significantly impacts cancer patients, leading to functional disability, diminished quality of life, and increased healthcare costs amid the ongoing opioid crisis. Auricular point acupressure (APA), a non-invasive and non-pharmacological alternative, has shown potential for alleviating the pain, numbness, and tingling associated with CIN. This study aims to assess the efficacy of APA for CIN symptoms and physical function and to examine the mechanisms underlying APA's effects on CIN. Methods: This is a three-arm randomized controlled clinical trial protocol. Patients aged 18 and older who are experiencing CIN are randomly assigned to one of the three groups: an APA group (in-person APA; mAPA), a sham control group (virtual APA; vAPA), and a wait-list usual care control group (UC). During the four-week program, participants in the mAPA receive an in-person APA treatment and training; the sham control participants (vAPA) receive a self-guided smartphone APA application with APA demonstration videos; and the UC participants will continue with the usual care and be re-randomized into one of the APA groups. The primary outcomes are changes in CIN symptoms and physical function. Secondary outcomes include evaluating pain sensory thresholds, motor and cognitive functioning, inflammatory signaling, brain connectivity, opioid use, and quality of life. The outcomes are measured at baseline, program completion (4 weeks), and at monthly follow-up for 3 months post-intervention. Discussion: This study will provide evidence supporting the potential viability of APA as an intervention for CIN. Trial registration: ClinicalTrials.gov, ID NCT04920097 registered on 3 June 2021. [ABSTRACT FROM AUTHOR]

Acupuncture and moxibustion are effective in alleviating symptoms, but the large number of acupoints can make accurate needle placement and training difficult.To address these challenges, this study aims to develop an augmented reality (AR) acupuncture navigation system designed to improve the accuracy and intuitiveness of acupoint localization.The proposed system employs a six-point registration and positioning technique, enabling the AR navigation model to adapt to the specific characteristics of each patient.In testing, discrepancies between virtual and actual acupuncture points ranged from 0.6 mm to 3.9 mm, which is within the acceptable tolerance range for acupuncture.This AR-based system shows promise in enhancing the precision of acupuncture point localization, potentially leading to improved treatment outcomes. [ABSTRACT FROM AUTHOR]

Chronic nonspecific low back pain (CNLBP) is a leading cause of disability and remains a major burden for many public health systems. Acupuncture is a nonpharmacological treatment for CNLBP that can be effective in improving low back pain; nevertheless, its effect on improving back muscle endurance in patients with CNLBP and its duration of effect have not been studied. The goal of this study was to assess the impact of acupuncture on lower back muscle activity in CNLBP patients. This was a single-blind, randomized, crossover experimental study. Thirty female patients were randomized into Group A (15 patients) or Group B (15 patients). Patients in Group A were assigned to receive real acupuncture (RA) in the first phase and sham acupuncture (SA) in the second phase, while those in Group B received SA first and then RA, with a 1-week washout period between phases. Two-way repeated ANOVA was used to evaluate the effect of group and time on isokinetic parameters, Surface electromyography (sEMG) data, and blood data. Significant interaction effects were identified between group * time on the isokinetic parameters of the lumbar extensor muscles, sEMG values of the erector spinae, blood lactate levels, and blood ammonia levels (all p< 0.05). Compared with those of the SA group, the isokinetic parameters of the lumbar extensor muscles, sEMG values of the erector spinae, blood lactate levels, and blood ammonia levels of the RA group were significantly different (all p< 0.05). RA improves lumbar extensor endurance in patients with CNLBP and lasts approximately 9 minutes. RA can improve blood circulation to reduce blood lactic acid and blood ammonia produced during exercise. [ABSTRACT FROM AUTHOR]

Background: Pain from postoperative cesarean section stitches can cause physiological stress, thereby disrupting mobility and affecting the uterine involution process postpartum. Acupuncture at points LI4 and SP6 has been reported to stimulate uterine contractions and reduce pain. Objective: To look into how electroacupuncture (EA) stimulation works at particular places LI4, SP6, and the combination of LI4 & SP6 with frequencies of 30, 50, and 100 Hz on the increase in oxytocin levels postpartum cesarean section. Method: The number of respondents was 144 postpartum cesarean section patients who met the inclusion criteria, divided using the randomized controlled trial (RCT) method into 8 intervention and control groups. Oxytocin levels were analyzed through blood samples using the ELISA method, comparing results before and after the intervention as well as with the control group. Result: The electroacupuncture intervention group's analysis at points LI4 and SP6 showed a substantial (P<0.05) rise in oxytocin levels when compared to the control group. Conclusion: The findings of this research suggest that electroacupuncture intervention following a cesarean section can induce a rise in the levels of the hormone oxytocin. [ABSTRACT FROM AUTHOR]

Acupuncture has shown promise as a therapeutic option in temporomandibular disorders (TMD). Its benefits include pain relief, reduction of muscle tension and improvement of jaw function. Several alternative approaches, including dry needling and laser acupuncture, were also reported to improve TMD symptoms. This review aims to summarise the most recent studies available on these alternative therapies for TMD. An electronic literature search was conducted in 3 databases, PubMed, Web of Science, and Scopus, in order to identify articles on acupuncture, dry needling, or laser acupuncture. Search development, process, and two-step article selection were conducted by independent researchers. Data was extracted regarding study characteristics, population characteristics, acupuncture points or techniques used, and assessment methods for diagnosis and effects. Out of 431 identified results, 20 were selected for inclusion. We identified 11 studies on acupuncture, 3 studies on laser acupuncture and 6 studies on dry needling. Most studies showed improvement of TMD symptoms post-intervention, assessed by pain scales and maximum mouth opening. Overall, most studies showed promising results for acupuncture as an alternative, minimally invasive treatment method for TMD. When compared to controls or placebo, acupuncture, and related techniques result in significant relief of TMD symptoms. [ABSTRACT FROM AUTHOR]

Background: Depression remains one of the most prevalent psychiatric disorders, with many patients not responding adequately to available treatments. Electroacupuncture (EA), a nonpharmacologic therapy, holds great promise for alleviating depressive symptoms. In this study, RNA sequencing (RNA‐Seq) was used to identify genome‐wide alterations in the hippocampus of rats after chronic unpredictable mild stress (CUMS) and EA treatments to further elucidate the mechanism by which EA ameliorates depression to provide a basis for the clinical application of EA in stress‐related diseases. Methods: The sucrose preference test (SPT), open field test (OFT), and forced swimming test (FST) were used to investigate the ability of EA at Baihui (GV20) and Taichong acupoints (LR3) to improve depression‐like behavior in rats subjected to CUMS. Subsequently, RNA‐Seq analysis revealed transcriptomic profiles of the hippocampus of rats subjected to CUMS in which EA ameliorated depressive behavior. Finally, the expression profiles of major differentially expressed genes were tested by real‐time quantitative polymerase chain reaction (qRT‐PCR) to determine the accuracy of the RNA‐Seq results. Results: Rats subjected to CUMS exhibited depressive‐like behaviors, such as decreased sucrose consumption in the SPT (p <.001), decreased time in the central area of the OFT (p <.001), and increased immobility in the FST (p <.01). Importantly, rats subjected to CUMS and treated with EA showed increased sucrose consumption (p <.001), increased time spent in the central area of the OFT (p <.001) and decreased immobility in the FST (p <.01). Sixty‐three genes that were differentially expressed following CUMS were altered by EA; most of these were associated with immune pathways. Compared with those in the control group, the expression levels of Colla2 (p <.001), Col3a1 (p <.001), Psmb9 (p <.01), and Tap1 (p <.01) in the hippocampus of rats subjected to CUMS were lower. The changes in the expression of these genes were reversed by EA treatment. Conclusion: EA at GV20 and LR3 attenuated CUMS‐induced depression‐like behaviors by regulating the expression of specific genes such as Colla2, Col3a1, Psmb9, and Tap1. [ABSTRACT FROM AUTHOR]

Depression and chronic pain frequent co-occur, exacerbating each other's symptoms and hindering treatment. Emerging studies have highlighted abnormal gut microbiota in both conditions. Previous studies have demonstrated the clinical effectiveness of electro-acupuncture (EA) in managing these conditions, yet the underlying mechanisms remain elusive. Spared nerve injury (SNI) was employed to induce chronic pain and depression-like behavior. Rats were randomly assigned to sham SNI (SS), SNI, and EA groups. SNI surgery was performed on all rats, except those in SS group, which underwent sham SNI surgery. Then EA group received 5 weeks of EA treatment. Pain and depression-like behavior were assessed through paw withdrawal threshold, sucrose-preference test, and forced swim test. Gut microbiota composition was analyzed via 16S rDNA sequencing. Brain-Derived Neurotrophic Factor (BDNF) and acetylation-related proteins in the medial prefrontal cortex (mPFC) were evaluated through enzyme-linked immunosorbent assay and western blot. EA treatment significantly ameliorated pain and depression-like behavior. The 16S rDNA sequencing showed EA modulated gut microbiota composition, increased short-chain fatty acids (SCFAs)-producing bacteria, including Akkermansi, Ruminococcaceae and Lachnospiraceae family, particularly Akkermansia. Furthermore, EA increased BDNF, AcH3 and decreased HDAC2 in mPFC. Notably, SCFAs-producing bacteria exhibited a negative correlation with HDAC2 levels. This study exclusively investigated microbiota differences resulting from EA stimulation, without delving into the functional variations brought about by these microbial distinctions. The therapeutic effects of EA on the comorbidity of chronic pain and depression may involve the modulation of the gut microbiota, resulting in histone acetylation changes and upregulation of BDNF. • EA ameliorated pain and depression-like behaviors in SNI rats. • EA modulated the gut microbiota, increased the abundance of SCFAs-producing bacteria, particularly Akkermansia- muciniphila. • EA inhibited histone deacetylase in SNI rats. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess how acupoint catgut-embedding therapy influencesTh2-type immune response and the infiltration of CD4+ and CD8+ cells in DNCB-induced atopic dermatitis in BALB/c mice. It also conducted an initial examination of the underlying molecular mechanisms. Methods: Seventy-two mice were randomly divided intofourgroups: normal control, DNCB-induced atopic dermatitis model (AD), AD with acupoint catgut-embedding treatment (ADA), and AD with sham-acupoint catgut-embedding treatment. After DNCB challenge to induce AD, the ADA group received acupoint catgut-embedding therapy treatment at Zusanli (ST 36) and Quchi (LI 11) acupoints everyother week from day 8. Mice in the AD with sham-acupoint catgut-embedding treatment group underwent the same procedure as the ADA group but without catgut implantation. Severity was assessed using SCORAD on treatment days 1, 10, and 20. On day 18, nine miceper group were euthanized, and the remaining on day 28. Histopathological changes were observed using hematoxylin-eosin and immunohistochemistry staining. TNF-α, IL-4, IL-6, and IL-13 levels were analyzed by ELISA, and GATA3 and STAT6 protein levels by western blot. Results: After 20 days of acupoint catgut-embedding therapy treatment, mice showed reduced dermatitis scores compared to DNCB-induced AD-like mice. Significant decreases occurred in serum IL-4, IL-6, IL-13, and TNF-α levels. Skin analysis revealed marked reductions in CD4+ and CD8+ cell infiltration, as well as GATA3 and STAT6 protein levels. Conclusion: Acupoint catgut-embedding therapy may effectively alleviate atopic dermatitis by suppressing Th2 immune responses via the STAT6-GATA3 pathway and reducing CD4+and CD8+ T cell infiltration in skin lesions. [ABSTRACT FROM AUTHOR]

Background: Pediatric surgery is associated with high levels of anxiety for both children and parents/caregivers. To mitigate anxiety, auricular acupuncture has shown its potential in the perioperative setting. Accordingly, our team developed a wearable prototype auricular laser acupuncture system, AcuHealth V1.0, as a portable acupuncture device and conducted a proof‐of‐concept evaluation with parents of children undergoing surgery. Aims: The primary aim of this study was to conduct feasibility testing of the AcuHealth V1.0 system in delivering auricular laser acupuncture. Methods: Parents of children who were scheduled to undergo outpatient surgery were randomly assigned to one of three groups: authentic acupuncture (laser beams at known anxiolytic acupoints, n = 13), sham acupuncture (non‐anxiolytic acupoints, n = 14), or a placebo control group (inactive laser, n = 14). Parent self‐reported anxiety (0–10 numerical rating scale) was assessed at baseline, pre‐intervention (once child was taken to the OR), post‐intervention, and at 30 min after the intervention. Usability and acceptability data regarding the device were assessed after the intervention. Results: Baseline data revealed no significant difference in anxiety between the three groups. Parent‐reported anxiety level at 30‐min post‐intervention as compared to baseline in the authentic group was significantly decreased (delta mean ± std = −3.58 ± 2.07) compared to both the sham acupuncture (−1.35 ± 2.65) and placebo control group (0.54 ± 1.13). Evaluation of changes in parent‐reported anxiety between groups over time using two‐way repeated‐measures analysis of variance (ANOVA) revealed a significant difference between the three groups (p = 0.001). Post hoc analysis with Scheffe test pairwise comparisons showed that at 30‐min post‐intervention compared to baseline, the authentic intervention group was significantly less anxious compared with both the sham group (p = 0.033) and the placebo control group (p = 0.001). Additionally, feedback regarding the usage of the device supported the acceptability and usability of the device with no adverse events. Conclusions: This pilot study administering laser auricular acupuncture via the AcuHealth V1.0 system decreased parental anxiety after 30 min in parents who received treatment immediately after their children were taken to the operating room with no adverse effect. [ABSTRACT FROM AUTHOR]

Recent research has extensively explored the intricate mechanisms that underlie the effectiveness of acupuncture, highlighting the importance of stimulating acupoints, the role of acupuncture techniques in managing diseases, and the interaction between meridian pathways and molecular processes. Studies have underscored the crucial role of acupuncture in activating neurons, modulating the immune system, and influencing vascular activity, all of which contribute significantly to its therapeutic benefits across a wide range of symptoms and conditions. Utilization of imaging modalities enables the identification of changes in cerebral blood flow, brain function, and regional glucose metabolism following acupuncture sessions. The interstitial fluid circulation network within meridians adheres to specific laws that facilitate the transportation of materials. Acupuncture initiates the release of neurotransmitters, neuropeptides, and immune factors, impacting pain perception, inflammation, and physiological functions. It influences the complex neuro–endocrine–immune network by activating pathways involving the nervous system, the hypothalamic-pituitary-adrenal axis, and immune responses. Moreover, acupuncture induces molecular modifications such as phosphorylation, methylation, and histone modification, leading to key molecular changes that ultimately result in anti-inflammatory effects and the regulation of immune responses. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: Urinary tract infections (UTIs) are a common medical problem and prophylaxis of recurrent UTIs is an ongoing clinical challenge. In the present study we examined whether acupuncture is able to prevent recurrent UTIs in women. Methods: This multicentre randomised controlled trial, based at a University clinic and private acupuncture clinics, recruited women suffering from recurrent uncomplicated UTIs. Participants were randomised to the acupuncture group or control group. Acupuncture therapy consisted of 12 treatments over a period of 18 weeks, using a set of predefined body and ear acupuncture points. Cranberry products were recommended to all participants as standard of care. Results: A total of 137 women were randomised (68 acupuncture, 69 control group) and occurrence of UTIs at 6 and 12 months could be assessed in 123 and 120 women respectively. Acupuncture combined with cranberry slightly increased the proportion of UTI-free women compared with cranberry alone at 6 months (59% vs 46%, p = 0.2). Between 6 and 12 months the proportion of UTI-free women was significantly higher in the acupuncture group (66 vs 45%, p = 0.03). The number of UTIs decreased from baseline to 12 months in both study groups. The number of UTIs at 12 months was significantly lower in the acupuncture group (median difference 1, p = 0.01). Conclusions: Segmental acupuncture may be an effective treatment option for women with recurrent UTIs over a longer follow-up period and may limit antibiotics use. Further studies are needed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the application value of Pelvic Inflammation No. 1 formula of transdermal meridian pointtargeted drug delivery therapy in the treatment of patients with chronic pelvic inflammatory disease (damp-heat stasis type). Methods: All patients with chronic pelvic inflammatory disease (damp-heat stasis type) visited Danzhou Hospital of Traditional Chinese Medicine from August 2017 to March 2021 and were randomly grouped, 57 patients in the control group were treated with simple Western medicine, and 57 patients in the observation group were combined with Pelvic Inflammation No. 1 formula transdermal meridian targeted transdermal medication, and the therapeutic efficacies were compared after 3 months of treatment. Results: After treatment, serum matrix metalloproteinase-9 （MMP-9）, D dimer （D-D）, IL-6 and other indexes in the observation group were lower than those in the control group, and IL-10 was higher than that in the control group, the difference was statistically significant （P<0.05）. After treatment, the carbohydrate antigen CA125 in the observation group was lower than that in the control group, and the CD4+/CD8+ and CD4+ cells in the observation group were higher than those in the control group （P<0.05）. After treatment, the score of summary of health status surveys （SF-36） in the observation group was higher than that in the control group, and the total score of TCM symptoms was lower than that in the control group （P<0.05）. The total effective rate in the observation group was 96.49%（ 55/57）, which was higher than 82.46% （46/57） in the control group （P<0.05）. Conclusion: For patients with chronic pelvic inflammatory disease （damp-heat stagnation type）, combined with Pelvic Inflammation No. 1 formula transdermal via acupoints targeted drug therapy can help to regulate inflammatory factors, regulate immune function, and improve clinical efficacy. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether transcutaneous electrical acupoint stimulation (TEAS) at PC6 could reduce hypotension after spinal anesthesia (SA) in parturients and to compare the effect of TEAS at different frequencies. Methods: From February 20, 2023, to August 29, 2023, 90 parturients scheduled for c-section under SA were randomly assigned to receive no treatment (Control), TEAS at high frequency (TEAS-HF), or TEAS at low frequency (TEAS-LF). Treatments started immediately after SA and lasted for 30 min. The primary endpoint was incidence of hypotension by 30 min after SA. Secondary endpoints included lowest systolic blood pressure (SBP) during 30 min after SA, dose of ephedrine, dose of atropine, Apgar score at 1 min, and adverse events, including nausea, vomiting, dizziness, dyspnea, and chest congestion. Results: In the TEAS-HF group, the incidence of hypotension by 30 min after SA was lower (13.3%) than in the Control (53.3%, p = 0.001; OR 1.9, 95% confidence interval [CI]: 1.2–2.8) and TEAS-LF group (40.0%, p = 0.02, OR 1.4, 95% CI: 1.0–2.0). The lowest SBP during 30 min after SA was higher in the TEAS-HF group (100.0 ± 9.4 mm Hg) than in the Control group (91.5 ± 16.5 mm Hg) and TEAS-LF group (93.9 ± 16.6 mm Hg). Patients who received TEAS showed a lower score of nausea and vomiting (both p = 0.02). Patients in the group TEAS-HF showed a lower incidence of dizziness, dyspnea, and of chest congestion than those in the other two groups. There was no difference with respect to atropine consumption and neonatal Apgar score. Conclusions: TEAS-HF at PC6 reduced hypotension after SA in parturients, while TEAS-LF did not. Trial registration: ClinicalTrials.gov (NCT05724095) [ABSTRACT FROM AUTHOR]

Objectives: Hypersensitive acupoints in specific body areas are associated with corresponding internal or visceral disorders. Back-shu points are clinically significant for the diagnosis of visceral organ disease, according to the biomechanical characteristics of the acupoints. In this study, we assessed the biomechanical characteristics and pain sensitivities of five back-shu points linked to five visceral organs in healthy participants. Methods: The study included 48 volunteer participants. A myotonometry was used to assess muscle tone and muscle stiffness at five back-shu points associated with visceral organs. Pressure was monitored using a microcontroller and a force sensor. Pain sensitivity was assessed in response to deep pressure pain produced by a constant force. Results: Substantial differences in muscle tone and stiffness were observed at the five back-shu points; muscle tone was highest at BL15, whereas muscle tone and muscle stiffness were lowest at BL23. Moreover, pain sensitivity was significantly different among the acupoints; pain sensitivity was highest at BL23. There was a significant negative correlation between muscle tone and pain sensitivity. Conclusions: We found significant differences in muscle tone, muscle stiffness, and pain sensitivity among five back-shu points associated with visceral organs, which may be attributable to anatomical variations at each point. Our findings suggest that differences at back-shu points should be considered to ensure the accurate diagnosis of visceral disease. [ABSTRACT FROM AUTHOR]

Psychoactive drugs have anticholinergic effects, which might cause constipation; however, probiotics and traditional Chinese medicine can resolve constipation. This study aimed to examine the effect of probiotics combined with traditional Chinese medicine, acupuncture point massage, and acupuncture point application on patients with intestinal solid heat constipation. We enrolled 200 patients, randomly divided into three intervention groups and a control group. Group 1 received probiotics combined with acupressure point massage and acupuncture point application; Group 2 received probiotics combined with acupressure point massage; Group 3 received probiotics combined with acupuncture point application, while the control group received routine treatment only. After intervention, the total effective rate of the intervention groups was higher than that of the control group (52%). The constipation symptom score in the intervention groups was lower than that in the control group, and the symptom score, defecation characteristics, and defecation time of group 1 were significantly lower than those of groups 2 and 3. The Bristol defecation trait, difficulty, time, and interval were better in the intervention groups than in the control group. Combining probiotics with traditional Chinese medicine, acupressure massage, and acupuncture point application can resolve intestinal solid heat constipation caused by psychoactive drugs. [ABSTRACT FROM AUTHOR]

Background: Patients often consider bone marrow aspiration and biopsy to be one of the most painful medical procedures. The effectiveness of non‐pharmacological interventions to reduce pain during bone marrow aspiration and biopsy remains unclear. Aim: To synthesize existing evidence regarding the effectiveness of non‐pharmacological interventions in mitigating procedural pain among patients undergoing bone marrow aspiration and biopsy. Design: A systematic review and meta‐analysis of randomized controlled trials. Methods: Six electronic databases, including PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Library and Web of Science were searched from inception to July 15, 2023. The risk of bias was assessed using the Cochrane Risk of Bias Tool Version 2.0. Meta‐analysis was conducted using STATA 16. The certainty of the evidence was assessed by the GRADE approach. Results: This meta‐analysis included 18 studies derived from 17 articles involving a total of 1017 participants. The pooled results revealed statistically significant pain reduction effects using distraction (SMD: −.845, 95% CI: −1.344 to −.346, p <.001), powered bone marrow biopsy system (SMD: −.266, 95% CI: −.529 to −.003, p =.048), and acupoint stimulation (SMD: −1.016, 95% CI: −1.995 to −.037, p =.042) among patients undergoing bone marrow aspiration and biopsy. However, the pooled results on hypnosis (SMD: −1.228, 95% CI: −4.091 to 1.515, p =.368) showed no significant impact on pain reduction. Additionally, the pooled results for distraction did not demonstrate a significant effect on operative anxiety (MD: −2.942, 95% CI: −7.650 to 1.767, p =.221). Conclusions: Distraction, powered bone marrow biopsy system and acupoint stimulation are effective in reducing pain among patients undergoing bone marrow aspiration and biopsy. Patient or Public Contribution: Not applicable. Relevance to Clinical Practice: This meta‐analysis highlights the effectiveness of distraction, powered bone marrow biopsy system and acupoint stimulation for reducing pain in patients undergoing bone marrow biopsy. Healthcare professionals should consider integrating these interventions into pain management practices for these patients. Registration: (PROSPERO): CRD42023422854. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nowadays, there are increasing reports on the digitization and visualization system of acupuncture points for adults in traditional Chinese medicine, and the digitization and visualization system of acupuncture points for children in traditional Chinese medicine and the simulation system of acupuncture manipulation for Mongolian medicine training have been reported. However, there are no reports on relevant systems for children in Mongolian medicine. OBJECTIVE: To develop a simulation system of acupuncture points for children in Mongolian medicine, in the hope that it can be used for clinical teaching, manipulation practice and research on acupuncture safety. METHODS: Based on the tomographic anatomical dataset of preschool boys, a three-dimensional (3D) digital virtual anatomical model of children with multiple internal organs and tissues was constructed by using PhotoShop.2021 and Digihuman Reconstruction System software. The relevant annotation information database of 27 acupoints such as Dinghui acupoint of Mongolian medicine was compiled by the Unity database language. The Mongolian gold needle and silver needle were selected to record the acupuncture point teaching video on the 3D printed head and neck resin model of children. In Unity3D software, children’s anatomical model, acupoint annotation information database and acupuncture operation video were integrated and coded, and a 3D digital children’s Mongolian acupuncture acupoint visualization system integrating simulation acupuncture training, clinical teaching and acupuncture safety research was successfully created. RESULTS AND CONCLUSION: This study was based on real children’s specimens. In order to reduce the error of two-dimensional segmentation, the manual layer-by-layer segmentation section image method was used to ensure the accuracy of the 3D model to the greatest extent. The Digihuman Reconstruction System was used to extract and save the individual segmentation data while maximizing the accuracy of the 3D model. PhotoShop.2021 software was used to complete the 3D reconstruction of the outer skin of the head and neck of children and the internal bony structure, cervical spinal cord, blood vessels and nerves, muscles and ligaments. After 3D reconstruction, the basic morphology of each independent structure and the integrity of the overall contour were verified in MeshLab software and the final fine adjustment and anatomical position confirmation were conducted using 3-matic research 13.0 software. The real anatomical morphology of the head and neck of preschool children was successfully simulated and restored. Unity3D software was used to integrate the 3D model of children, acupuncture operation video and acupoint annotation database, and the 3D digital Mongolian acupuncture acupoint visualization system for children was successfully constructed. Based on the real continuous fault ultra-thin dataset of preschool boys in China, China’s first 3D digitization and visualization system of acupuncture points in the head and neck of children in Mongolian medicine was developed. Compared with the previous acupuncture soft works, this system is more suitable for the anatomical morphological development characteristics of Asian children, and has a high value of application in the fields of research on the safety of acupuncture in Mongolian medicine, clinical teaching and acupuncture simulation training. [ABSTRACT FROM AUTHOR]

Objective: To observe the effects of key muscle movement points acupuncture on neuroelectrophysiological indexes, lower limb motor function and daily living ability in patients with spinal cord injury(SCI). Methods: 98 SCI patients who were admitted to our hospital from December 2022 to June 2023 were divided into control group(conventional rehabilitation training and traditional acupuncture treatment, n=49) and study group (conventional rehabilitation training and key muscle movement point acupuncture treatment, n=49) according to the random number table method. The nerve electrophysiological indexes [root mean square (RMS) and median frequency (MF) of rectus femoris and anterior tibial muscle], lower limb motor function [lower limb motor score (LEMS), modified Ashworth scale(MAS)] and activity of daily living[activity of daily living score(MBI)] were compared between two groups. Results: Compared with control group 2 courses after treatment, the MAS score in study group was lower, and the rectus femoris RMS, rectus femoris MF, tibialis anterior RMS, tibialis anterior MF, LEMS score and MBI score were higher(P<0.05). Conclusion: Key muscle movement points acupuncture for SCI patients, which can improve neuroelectrophysiological indexes, promote the recovery of lower limb motor function, improve the daily living ability of patients. [ABSTRACT FROM AUTHOR]

Background: In the aftermath of the COVID-19 pandemic, nurses reported varying degrees of cognitive failure. To prioritize patient safety in clinical settings, it is important and necessary to address and mitigate the symptoms of cognitive failure among nurses. Aim: This study was conducted in Iran to evaluate the impact of ear acupressure on occupational cognitive failure in nurses. Methods: This randomized controlled clinical trial was conducted with 54 nurses who experienced cognitive failure in 2022. Sampling was performed by convenience. Fifty-six nurses who scored 40 or higher on the occupational cognitive failure questionnaire were randomly assigned to either the intervention group (28 subjects) or the sham group (28 subjects). In the intervention group, pressure was applied to the shen-men point, zero point, hippocampus, master cerebral, brain, and memory 1 and 2 of the earlobes for six weeks using Vaccaria seeds. In the sham group, a sticker without seeds was applied at the same points as in the intervention group, and no pressure was applied. Cognitive failure was assessed at the beginning of the study (T0), at the end of the intervention (sixth week of study, T1), and four weeks after the end of the intervention (tenth week of study, T2). The data were collected using contextual data questionnaires and the Occupational Cognitive Failure Questionnaire (OCFQ). The data obtained from 54 nurses (28 in the sham group and 26 in the intervention group) were analyzed by SPSS v16 using repeated-measures ANOVA. Results: The two groups had no significant differences regarding background variables. The between-group analysis revealed a significant interaction effect of time and intervention on cognitive failure (F = 60.320, p < 0.001, effect size = 0.537). The cognitive failure score in the intervention group was significantly lower at the end of the intervention and one month later than that in the sham group (p < 0.001). Within-group analysis revealed a significant difference in the cognitive failure scores of the intervention group at T0, T1, and T2 (61.231 ± 14.230, 34.000 ± 14.659, and 29.808 ± 14.266, respectively; F = 52.331, p < 0.001, effect size = 0.677). However, in the sham group, the cognitive failure score exhibited a brief but significant increase at T0, T1, and T2 (54.786 ± 11.239, 56.250 ± 10.950, and 56.000 ± 11.337, respectively; F = 6.369, p = 0.006, effect size = 0.191). Conclusion: Auriculotherapy has shown promise in improving occupational cognitive failure in nurses. It is recommended that nurses consider incorporating auriculotherapy as a complementary treatment modality, particularly through self-treatment programs, when experiencing symptoms of cognitive impairment. Trial Registration Number (TRN): IRCT20100211003329N10 Date of registration: 04/11/2022 [ABSTRACT FROM AUTHOR]

The article summarizes the results of our own scientific and practical research on biopuncture (or pharmacopuncture) – local stimulation of acupuncture points with small doses of drugs or other agents. The "object" of the work was dorsopathies at the lumbosacral level, the choice of which was explained by the widest coverage of the population, the protracted course and the severity of the consequences. In the course of the research, the addition and even potentiation of the reflex and drug links of the method under consideration was noted. In particular, favorable changes in the status of patients observed against the background of biopuncture by complex agents were accompanied by a significant improvement in the results of psychological and electrophysiological examination. In a series of studies on biopuncture with Alflutop, a significant superiority of this approach over the compared methods was manifested, in addition to clinical effects, in structurally-modifying changes in the intervertebral discs. Using the same drug, an original scheme of therapeutic action was proposed, combining the techniques of drug blockade and pharmacopuncture. Special attention should be paid to the fact that the effectiveness of biopuncture is enhanced due to the combined use of modern hardware techniques. In a series of separate studies, the efficacy of biopuncture with essential oils in dorsopathies was confirmed, largely explained by the cumulative effects. [ABSTRACT FROM AUTHOR]

Background: Normal labor is stressful, and the intense pain and anxiety can have an adverse effect on the mother, the fetus, and the delivery procedure. This study aimed to determine how acupressure applied to multiple acupoints during normal labor affected labor pain and anxiety in primiparous women. Method: This study was a double-blinded randomized controlled trial that involved 43 primiparous women aging 20–30 years who were referred for normal labor. Subjects were randomly allocated to one of two groups: acupressure or control. Acupressure was administered to the Large Intestine 4 (LI4), Heart 7 (He-7), and Spleen 6 (SP6) acupoints in the acupressure group, whereas sham acupressure was administered to the control group. The study assessed the mothers' anxiety levels using the Spielberger Inventory questionnaire and measured their pain levels using the visual analog scale before and after the intervention. In addition, pulse rate and blood pressure were also measured. Result: In the acupressure group, both the anxiety score and pain level showed a substantial improvement (p < 0.001), but in the control group, only the anxiety score showed a significant improvement (p < 0.001). After the intervention, the difference in anxiety and pain scores between the two groups is statistically significant (p < 0.001). Furthermore, neither group's blood pressure nor pulse rate showed any significant changes (p < 0.05). Conclusion: According to the study's findings, acupressure targeting LI4, He-7, and SP6 acupoints was effective in relieving anxiety and pain during labor. Compared with the sham acupressure group, the acupressure group showed a greater decrease in both anxiety and pain levels. As such, acupressure may be recommended as an effective, affordable, and accessible technique for managing pain and anxiety during labor. This study has been registered in the database of clinical trials under the identifier Clinicaltrials.gov NCT05411289. [ABSTRACT FROM AUTHOR]

As a distinctive feature of Motion Acupuncture therapy, the treatment target of needling is the "Motion Acupuncture Point", which is dynamic and highly precise. This article provides a detailed introduction to the theoretical origins of motion acupuncture points, including traditional concepts such as "treating based on pain", Ashi points, and meridian points, as well as modern concepts like tendon-related points, tender points, and trigger points. The article proposes a selection method based on the "three steps and one process" approach to accurately locate motion acupuncture points. The application of motion acupuncture treatment using motion acupuncture needles following this method can achieve significant clinical therapeutic effects. This represents an innovation in the selection of acupuncture points in the field of acupuncture. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative pain control is a challenge in enhanced recovery after surgery (ERAS). The current study reviewed the efficacy and safety of incorporating acupoint stimulation for postoperative pain control in ERAS. Methods: Ten databases for relevant randomized controlled trials (RCTs) published in English or Mandarin Chinese were searched from 1997 to 2022. The quality of each article was appraised using the Cochrane Collaboration Risk of Bias Criteria and the modified Jadad Scale. The primary outcome was pain control, measured using the visual analog scale 24 h after surgery. Results: Eleven trials met the eligibility criteria and were included in the study. Acupoint stimulation was found more effective than control treatments in terms of pain intensity (standardized mean difference [SMD] −0.94; 95% confidence interval [CI] −1.35 to −0.53), analgesic drug consumption (SMD −1.87; 95% CI −2.98 to −0.75), postoperative nausea (PON; SMD 0.31; 95% CI 0.13 to 0.73), postoperative vomiting (POV; SMD 0.57; 95% CI 0.11 to 2.92), and PON and POV (PONV; SMD 0.29; 95% CI 0.16 to 0.53). The Zusanli (ST36) and Neiguan (PC6) were the most-used acupoints in the included trials (8/11). The reported adverse reaction was only one case of bruising. Discussion: Acupoint stimulation improved pain control in patients undergoing ERAS more than control treatments. The findings provide an evidence-based premise for incorporating acupoint stimulation into ERAS strategies. More rigorous RCTs are needed in the future. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the advantages of adding acupuncture to standard postoperative pain management for open radical prostatectomy (RP). Materials and methods: A randomized controlled trial (1:1:1) comparing routine postoperative analgesic care (control [CON]) vs the addition of press tack needle acupuncture (ACU) or press tack placebo acupressure (SHAM) for pain management after open RP was performed. A total of 126 patients were enrolled between February 2020 and April 2021. After open RP, the CON group received standard postoperative analgesia, the ACU group received long‐term acupuncture with press tacks at specific points (P‐6, Shenmen and SP‐6) along with standard analgesia, and the SHAM group received placebo press tacks at the same acupuncture points alongside standard analgesia. The primary endpoint was postoperative pain measured on a numeric rating scale, the NRS‐11, calculated as the area under the curve. The cumulative use of routine postoperative analgesics, time to first defaecation, and quality of life were analysed using the Kruskal–Wallis rank sum test, Fisher's exact test, and Pearson's chi‐squared test. Results: The ACU group reported significantly less postoperative pain compared to the SHAM (P = 0.007) and CON groups (P = 0.02). There were no significant difference in median (interquartile range) cumulative pain medication usage, time to first defaecation (CON: 37 [33, 44] h; SHAM: 37 [33, 42] h; ACU: 37 [33, 41] h; P > 0.9), or health status at discharge (EuroQol five‐dimension, five‐level general health assessment questionnaire: CON: 70 [65–83]; SHAM: 70 [60–80]; ACU: 70 [50–80]). Conclusion: Incorporating acupuncture into postoperative pain management can improve patient postoperative outcomes. [ABSTRACT FROM AUTHOR]

Background: Oesophagogastroduodenoscopy (OGDS) is the most common diagnostic procedure for upper gastrointestinal diseases. It often causes discomfort and anxiety, which are only mitigated by systemic sedation. However, sedation poses additional risks of adverse cardiopulmonary events, increased medical costs, and prolonged recovery. Transcutaneous electrical nerve stimulation of acupuncture points (Acu-TENS) is a non-invasive and innovative approach that induces analgesic effect during endoscopy. This trial is the first to be reported in English that explores the potential of Acu-TENS to increase patient tolerance during non-sedated elective diagnostic OGDS. Methods: A double-blinded randomized controlled trial involving 348 subjects was conducted at a tertiary hospital to evaluate the success rate of OGDS with Acu-TENS. Subjects aged 18–75 years scheduled for their first elective diagnostic OGDS were randomized into the intervention (Acu-TENS) and placebo arms. OGDS success was assessed based on subjects' satisfaction ratings on a Likert scale and procedure's technical adequacy. Secondary measures included subjects' willingness to undergo future OGDS under similar conditions, procedure duration, and the endoscopist's perceived ease of the procedure. Results: OGDS success rates were significantly higher with Acu-TENS (77.8%) than with the placebo (68.0%; odds ratio [OR] 1.64, 95% confidence interval [CI] 1.01–2.66, p = 0.043). Subjects who received Acu-TENS expressed higher willingness for future OGDS (78.9%) than those who received the placebo (68.6%; OR 1.71, 95% CI 1.04–2.79, p = 0.031). Procedure duration were significantly shorter in the intervention arm (6.0 min) than in the placebo arm (10.0 min; p = 0.002). No adverse effects were reported, and endoscopists perceived similar procedure ease in both arms. Conclusions: Acu-TENS improved OGDS success and enhanced patients' experiences during non-sedated OGDS. It demonstrated safety with no side effects and reduced the procedure completion time. It could be used as an adjunct in non-sedated diagnostic OGDS. [ABSTRACT FROM AUTHOR]

Objective(s): This study assessed the effects of electroacupuncture (EA) stimulation at different frequencies at the Dazhui and Baihui acupoints in the subacute phase after transient global cerebral ischemia (GCI). Materials and Methods: Rats were subjected to GCI for 25 min, followed by reperfusion for 7 days. EA at acupoints was performed at 10, 30, or 50 Hz, 1 day after reperfusion and then once daily for 6 consecutive days. Results: EA at acupoints at 10 and 50 Hz effectively down-regulated apoptosis in the hippocampal cornu ammonis 1(CA1) area and ameliorated memory deficits. Moreover, EA treatment at 10 and 50 Hz markedly increased phospho (p)-extracellular signal-regulated protein kinase 1/2 (ERK1/2), p-ERK1/2/neuronal nuclei (NeuN), p-cAMP response element-binding protein (CREB)/p-ERK1/2, B-cell lymphoma-2 (Bcl-2)/p-CREB, and X-linked inhibitor of apoptosis protein/NeuN expression levels and decreased Bcl-2 homologous antagonist/killer, second mitochondria-derived activator of caspase/direct inhibitor of apoptosis-binding protein with low pI, cytochrome c, cleaved caspase-3, and apoptosis-inducing factor expression levels. Furthermore, 10-Hz EA treatment effectively increased p-p38 mitogen-activated protein kinase (MAPK), p-p38 MAPK/NeuN, and p-CREB/p-p38 MAPK expression levels. Pretreatment with U0126 (ERK1/2 inhibitor) completely abrogated the effects of 10- and 50-Hz EA treatments on the aforementioned protein expression levels. Similarly, pretreatment with SB203580 (p38 MAPK inhibitor) completely abrogated the effects of 10-Hz treatment on the aforementioned protein expression levels. Conclusion: The effects of 10- and 50-Hz EA treatments on mitochondria-related apoptosis can be attributed to the activation of ERK1/2/p38 MAPK/CREB/Bcl-2- and ERK1/2/CREB/Bcl-2-mediated signaling, respectively, in the hippocampal CA1 area at 7 days after transient GCI. [ABSTRACT FROM AUTHOR]

A study published in the Annals of Internal Medicine examines the efficacy of acupuncture for chronic spontaneous urticaria (CSU). The study suggests that acupuncture may have a superior effect compared to sham acupuncture and a control intervention for CSU. However, the study's protocol may have been biased against traditional Chinese medicine (TCM), which views urticaria as caused by excess heat or accumulation of wind-damp or wind-heat. The lack of individualization in the treatment and the failure to use specific acupuncture points recommended in TCM may have affected the effectiveness of the therapy. The study also did not provide information on serum IgE levels or the response of the waitlist group. Overall, the study provides valuable data supporting the use of TCM for CSU, but some protocol changes aligned with TCM principles could have strengthened the results. [Extracted from the article]

Background: Fatigue, a major health concern among patients receiving hemodialysis, is associatedwith poor quality of life, negative emotions, and cognitive dysfunction. Acupressure is a lowcost and noninvasive traditional Chinese therapy that has been widely used in community and clinic settings. However, the beneficial effects of acupressure on various aspects of fatigue among these patients have not been systematically investigated. Purpose: This study was designed to determine the effects of acupressure on fatigue in patients receiving hemodialysis. The moderating influences of bio-sociodemographic characteristics and methodology on the association between acupressure and posthemodialysis fatigue were also examined. Methods: Four electronic databases were searched for qualified articles published between database inception and November 2, 2022. Only randomized controlled trials designed to investigate the effects of acupressure on fatigue in patients receiving hemodialysis were qualified for consideration. A random-effects model was used for data analysis. Results: Eight randomized controlled trials with 11 effect sizes and 725 participants were included in this study. In these studies, acupressure was found to have a significantly higher alleviation effect on general fatigue (g = -0.78; 95% confidence interval [-1.09, -0.48]) and the behavioral, emotional, sensory, and cognitive domains of fatigue (g = -0.51, -0.51, -0.72, and -0.41, respectively) among patients receiving hemodialysis than those in the control groups. Furthermore, the stimulation of the Shenmen acupoint was found to increase the effects ( p < .01) of acupressure on fatigue reduction significantly. Notably, the use of special equipment to perform the acupressure was not found to significantly improve outcomes ( p = .99). Conclusions/Implications for Practice: Acupressure is effective in alleviating fatigue in patients receiving hemodialysis, particularly when the Shenmen acupoint is used together with other acupoints, and is effective without the application of special equipment. Acupressuremay be adopted as a complementary therapy for fatigue alleviation in patients receiving hemodialysis. Based on the findings, healthcare providers should coach patients receiving hemodialysis with fatigue on how to use acupressure therapy appropriately to alleviate this health concern. [ABSTRACT FROM AUTHOR]

Aiming at the problems of poor accuracy and narrow applicability of the existing key acupoint mining algorithms, a high specificity acupoint mining algorithm based on a 3‐node motif is proposed by introducing higher‐order interactions between multiple acupoints in the acupoint‐disease network. Comparing this algorithm with five other acupoint importance assessment algorithms in terms of resolution, network loss, and accuracy, the results show that the key acupoints identified by this algorithm have obvious destructive effects on the connectivity of the network, which indicates that the key acupoints are the core of the topology of acupoint‐disease network and have high synergistic co‑operation with other acupoints. The stability of this algorithm ensures the reliability of the key acupoints. From the perspective of the network topology and the high synergy between acupoints, the key acupoints found by the algorithm can be used as the core acupoints in the acupoint network, helping researchers to explore targeted and highly effective combinations of acupoints. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chronic lower back pain (CLBP) is one of the most common disorders worldwide. Flash cupping has the ability to relieve CLBP; nevertheless, its impact on CLBP and the likely mechanism of action have not been studied. OBJECTIVE: The goal of this study was to assess the impact of a single, brief cupping session on CLBP and low back muscle activity using multichannel surface electromyography (sEMG). METHODS: In this randomized controlled trial, 24 patients with CLBP were enrolled and randomly assigned to the control group (treated by acupuncture) and cupping group (treated by acupuncture and flash cupping). Acupuncture was applied on the shen shu (BL23), dachang shu (BL25), and wei zhong (BL40) acupoints in both the groups. A brief cupping treatment was applied to the shen shu (BL23), qihai shu (BL24), dachang shu (BL25), guanyuan shu (BL26), and xiaochang shu (BL27) acupoints on both sides of the lower back in the cupping group. The numeric rating scale (NRS) was used to assess therapy efficacy for lower back pain (LBP) before and after treatment. Surface EMG data collected during symmetrical trunk flexion-extension movements were utilized to measure lower back muscle activity and the effectiveness of LBP therapy. RESULTS: There was no statistically significant difference (P = 0.63) in pain intensity between the two groups before and after treatment. There was a statistically significant difference (P = 0.04) between the control group and the cupping group in the sEMG topographic map parameter CoGx-To-Midline. CONCLUSION: This study established a connection between the action mechanism of flash cupping and enhanced horizontal synchronization of lower back muscular activity. [ABSTRACT FROM AUTHOR]

Background: Few reviews have addressed delirium prevention among intermediate to high‐risk older surgical patients. Aims: To map preoperative delirium prevention interventions for older surgical patients at intermediate to high risk of developing delirium, assess outcomes and identify gaps in knowledge. Design: Systematic narrative review of randomised controlled trials reported following the PRISMA checklist. Methods: A systematic search was conducted of the literature published from 1990 to October 2022 in Medline, CINAHL and Ageline and of the grey literature in Google Scholar. Randomised controlled trials were retrieved that assessed the effectiveness of preoperative delirium prevention interventions for older surgical patients at intermediate to high risk of delirium. Data were extracted using a data extraction tool, and results were tabulated. Studies were assessed for bias using the Cochrane Collaboration Risk of Bias tool. Results: Twenty‐one studies met the selection criteria including N = 5096 participants. Two studies tested cognitive training, two studies tested fascia iliaca compartment block and one study assessed femoral nerve block. Ten studies tested prophylactic medications including methylprednisolone. Five studies investigated geriatric assessment and management. One study assessed transcutaneous electrical acupoint stimulation. In the two studies testing fascia iliaca compartment block, there was a reduction in postoperative delirium for orthopaedic patients. Methylprednisolone reduced postoperative delirium in orthopaedic patients and in those undergoing gastrointestinal surgery. Results of all other interventions on the occurrence of postoperative delirium and additional outcomes including the severity and duration of delirium were inconclusive. Conclusions: Despite the promising results for fascia iliaca compartment block and methylprednisolone, there is limited knowledge regarding evidence‐based delirium prevention interventions. Most studies had small sample sizes indicating that the current evidence is exploratory. There is an urgent need for the funding and conduct of trials to test preventative interventions for older surgical patients at intermediate to high risk of developing delirium. [ABSTRACT FROM AUTHOR]

Purpose: Anxious depression (AD) is a common, distinct depression subtype. This exploratory subgroup analysis aimed to explore the effects of acupuncture as an add-on therapy of selective serotonin reuptake inhibitors (SSRIs) for patients with AD or non-anxious depression (NAD). Patients and Methods: Four hundred and sixty-five patients with moderate-to-severe depression from the AcuSDep pragmatic trial were included in analysis. Patients were randomly assigned to receive MA+SSRIs, EA+SSRIs, or SSRIs alone (1:1:1) for six weeks. AD was defined by using dimensional criteria. The measurement instruments included 17-items Hamilton Depression Scale (HAMD-17), Self-Rating Depression Scale (SDS), Clinical Global Impression (CGI), Rating Scale for Side Effects (SERS), and WHO Quality of Life-BREF (WHOQOL-BREF). Comparison between AD and NAD subgroups and comparisons between groups within either AD or NAD subgroups were conducted. Results: Eighty percent of the patients met the criteria for AD. The AD subgroup had poorer clinical manifestations and treatment outcomes compared to those of the NAD subgroup. For AD patients, the HAMD response rate, remission rate, early onset rate, and the score changes on each scale at most measurement points on the two acupuncture groups were significantly better than the SSRIs group. For NAD patients, the HAMD early onset rates of the two acupuncture groups were significantly better than the SSRIs group. Conclusion: For AD subtype patients, either MA or EA add-on SSRIs showed comprehensive improvements, with small-to-medium effect sizes. For NAD subtype patients, both the add-on acupuncture could accelerate the response to SSRIs treatment. The study contributed to the existing literature by providing insights into the potential benefits of acupuncture in combination with SSRIs, especially for patients with AD subtypes. Due to its limited nature as a post hoc subgroup analysis, prospectively designed, high-quality trials are warranted. Clinical Trials Registration: ChiCTR-TRC-08000297. [ABSTRACT FROM AUTHOR]

INTRODUCTION Acupuncture and related acupoint therapies have been widely used for smoking cessation. Some relevant systematic reviews (SRs) have been published. There is a need to summarize and update the evidence to inform practice and decision-making. METHODS Eight databases were searched from their inception to December 2023. SRs, any randomized controlled trials (RCTs) comparing acupuncture therapies with sham acupuncture, pharmacotherapy, behavioral therapy, or no treatment, were included. The primary outcome was the abstinence rate. AMSTAR-2 was employed to assess the quality of SRs. An updated meta-analysis was conducted based on SRs and RCTs. Data were synthesized using risk ratios (RR) with 95% confidence intervals (CIs). The GRADE approach was employed to assess the certainty of the updated evidence. RESULTS Thirteen SRs and 20 RCTs outside of the SRs were identified. The SRs were of low or very low quality by AMSTAR-2. Sixteen (80%) RCTs were at high risk of performance bias. Eight acupuncture and related acupoint therapies were involved. The short-term (≤6 months) abstinence rate outcome was summarized as follows. Most SRs suggested that filiform needle acupuncture or acupressure had a better effect than sham acupuncture, but the findings were inconsistent. The updated meta-analysis also suggested that filiform needle acupuncture was more effective than sham acupuncture (RR=1.44; 95% CI: 1.02-2.02; I2 = 66%; low certainty; 9 RCTs, n=1358). Filiform needle acupuncture combined with acupressure was comparable to nicotine patches (RR=0.99; 95% CI: 0.74-1.32; low certainty; 6 RCTs, n= 524). Acupressure was superior to counseling (RR=1.46; 95% CI: 1.14-1.87; I2=5%; low certainty; 8 RCTs, n=595). No serious adverse events were reported in these SRs or RCTs. CONCLUSIONS Low certainty evidence suggests that filiform needle acupuncture and auricular acupressure appear to be safe and effective in achieving short-term smoking cessation. However, long-term follow-up data are needed. [ABSTRACT FROM AUTHOR]

Context: Obstructive sleep apnea is one of the most common sleep disorders, and it is associated with several conditions, including cardiovascular diseases and neuropsychiatric events. Due to its significant burden and increasing prevalence, the treatment of obstructive sleep apnea is of great importance. Evidence Acquisition: Continuous airway pressure (CPAP) has been the standard treatment for managing clinically significant obstructive sleep apnea in recent decades. However, compliance with CPAP treatment is as low as 60% in patients with obstructive sleep apnea. Additionally, CPAP only suppresses respiratory disturbances during sleep while using the devices and does not provide a permanent resolution. Given the limitations of prevalent treatments for obstructive sleep apnea, various alternative therapies have been explored. Among these, acupuncture is a traditional yet novel treatment for obstructive sleep apnea. Acupuncture is widely accepted by many people and specialists in different fields and is commonly used to treat various conditions. Several studies have shown that acupuncture effectively improves the apnea-hypopnea index (AHI). In this review article, we conducted a comprehensive literature search to assess the impact of acupuncture on obstructive sleep apnea. Our findings suggest that acupuncture may represent an effective and safe therapy option for individuals dealing with obstructive sleep apnea. Results: Acupuncture may also assist patients with obstructive sleep apnea in enhancing their oxygen saturation and improving their sleep quality. This discovery holds particular significance for individuals with moderate to severe obstructive sleep apnea. However, it is worth noting that methodological weaknesses in most of the trials in this field may overstate the clinical efficacy of acupuncture therapy. Conclusions: Further high-quality randomized clinical trials are warranted to establish the effectiveness and safety of acupuncture for obstructive sleep apnea patients. [ABSTRACT FROM AUTHOR]

Background: To explore the effect of electroacupuncture Wushu acupoints on angiogenesis and expressions of brain-derived neurotrophic factor (BDNF), as well as to explore the possible mechanism of electroacupuncture on acute myocardial ischemia (AMI). Methods: We randomly divided 42 Sprague Dawley rats into sham AMI group, AMI group, and the heart channel groups comprising Shaochong (HT9) acupoint, Shaofu (HT8) acupoint, Shenmen (HT7) acupoint, Lingdao (HT4) acupoint, and Shaohai (HT3) acupoint groups, with 6 rats in each group. The AMI model was fabricated via hypodesmus of the left anterior descending coronary artery. After modeling, the corresponding acupoints of each group underwent electroacupuncture treatment 30 min/time, once/day for 3 consecutive days. The cardiogram obtained before and after the intervention was compared, and the pathologic changes of the myocardial tissue were observed via hematoxylin & eosin staining. The amount of serum endothelin-1, prostacycline-2, thromboxane-2, and BDNF indicators were assayed using ELISA, the number of CD31-positive cells in myocardial tissue was calculated using immunohistochemistry, and the expression levels of BDNF and TrKB was measured using western blot. Result: Compared with the sham AMI group, the ST segment on the electrocardiogram was significantly elevated (P < 0.05); the myocardial angiogenesis marker CD31 was remarkably increased (P < 0.05); serum levels of endothelin-1, prostacycline-2 and prostacycline-2/thromboxane-2 were decreased (P < 0.05), whereas serum levels of thromboxane-2 levels were increased (P < 0.05); and those of serum BDNF was decreased (P < 0.05); the protein overexpression contents of BDNF and TrKB in the myocardial tissues of HT8 acpoint and Shenmen acpoint groups were reduced (P < 0.05) in the AMI group. Compared with the AMI group, in the heart channel groups, the ST segment of electrocardiogram was dramatically reduced (P < 0.05); CD31 was dramatically elevated (P < 0.05); the serum levels of endothelin-1, prostacycline-2, and prostacycline-2/thromboxane-2 were increased (P < 0.05), thromboxane-2 levels were reduced (P < 0.05); the serum BDNF level was increased (P < 0.05); the protein overexpression levels of BDNF and TrKB in myocardial tissue of HT8 group and Shenmen group was increased (P < 0.05). Conclusion: electroacupuncture of Wushu acupoints along the heart channel may enhance myocardial ischemia by promoting overexpression of serum BDNF and activating the BDNF/TrKB pathway to promote myocardial angiogenesis. [ABSTRACT FROM AUTHOR]

Background: The purpose of the present study was to systematically delve into the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) on the quality of recovery after general anesthesia. Methods: Randomized controlled trials related to TEAS improving postoperative recovery quality were searched in Cochrane Library, Web of Science, Embase, PubMed, CNKI, VIP, Wanfang and Chinese biomedical database from the inception of each database to June 2023. After literature screening and data extraction, Stata15 software was employed for meta-analysis, and the quality of the included literature was evaluated utilizing ROB2. Results: The study included 10 articles involving 2,383 patients in total. The meta-analysis results unveiled that TEAS could improve 24-hour and 48-hour postoperative QoR-40 scores as well as 24-hour postoperative QoR-40 dimension scores [WMD = 8.52, 95%CI (5.12, 11.91), P < 0.001; WMD = 1.99, 95%CI (0.91, 3.07), P < 0.001], emotional state [WMD = 1.38, 95%CI (0.66, 2.09), P < 0.001], physical comfort [WMD = 2.99, 95%CI (1.59, 4.39), P < 0.001], psychological support [WMD = 0.63, 95%CI (0.36, 0.90), P < 0.001], and physical independence [WMD = 0.76, 95%CI (0.22, 1.30), P = 0.006]; pain [WMD = 1.81, 95%CI (0.87, 2.75), P < 0.001]; decrease 24-hour postoperative VAS pain scores [WMD = -0.84, 95%CI (-1.45, -0.23), P = 0.007] and the incidence of postoperative nausea and vomiting [RR = 0.88, 95%CI (0.81, 0.97), P = 0.006; RR = 0.62, 95%CI (0.52, 0.73), P < 0.001]. Conclusion: TEAS can improve postoperative QoR-40 scores and the quality of recovery, relieve pain, and decrease the incidence of nausea and vomiting after surgery in patients who underwent general anesthesia. Trial registration: CRD42023433959. [ABSTRACT FROM AUTHOR]

Objective: To observe the efficacy of acupuncture treatment for post-COVID-19 depression and anxiety syndrome, and to compare the differences in efficacy between the observation group (scalp acupuncture group in the prefrontal area) and the control group (sole conventional acupuncture group). Methods: A total of 236 patients were randomly divided into the observation group (118 cases) and the conventional acupuncture group (118 cases). Both groups were treated with acupuncture points including Ganshu, Jiajian, Yangjiao, Tongli, Sanyinjiao, and Neiguan, using common reinforcing and reducing manual needle techniques. The observation group additionally used a scalp acupuncture set in the prefrontal area (behavioral and emotional area), with dual needles inserted and manipulated with lifting and thrusting techniques. Both groups received treatments three times a week, each session lasting 25 min, for a total of 6 weeks. Results: Before and after treatment, the scores of (1) Hamilton Depression Scale (HAMD), (2) Self-Rating Depression Scale (SDS), and (3) Self-Rating Anxiety Scale (SAS) were significantly reduced in both groups (P < 0.05). The overall efficacy and traditional Chinese medicine syndrome improvement in both groups were effective, with the observation group having an overall efficacy rate of 98.3% and the control group 72.1%. The cure rate and overall efficacy rate of the former were significantly higher than those of the latter. ANOVA statistical analysis was used with P < 0.05, indicating a statistically significant difference in efficacy between the two groups. Conclusion: Both acupuncture methods are effective, but the observation group using additional scalp acupuncture showed significantly better efficacy than the control group. Acupuncture treatment for post-COVID-19 depression and anxiety syndrome is clinically reliable, rapid, safe, and simple. [ABSTRACT FROM AUTHOR]

This research paper evaluates the effectiveness of electro-acupuncture combined with psychological counseling in treating insomnia, compared with traditional Western medicine methods. A total of 129 inpatients from a hospital were divided into two groups: the treatment group (76 cases) and the control group (53 cases). The treatment group received electro-acupuncture tailored to specific Traditional Chinese Medicine (TCM) insomnia patterns, alongside conventional psychological counseling. The control group was administered Clonazepam. The research methodology included detailed diagnostic criteria based on TCM principles and specific acupuncture points and techniques for different insomnia patterns. The results indicated a significantly higher total effective rate of 89.5% in the treatment group compared to 60.4% in the control group. Furthermore, the study discusses the theoretical basis of TCM in treating insomnia, emphasizing the importance of balancing yin and yang and the role of emotional well-being in maintaining health. The findings suggest that electro-acupuncture, in conjunction with psychological counseling, offers a more effective and stable treatment for insomnia with fewer side effects than conventional Western medication. [ABSTRACT FROM AUTHOR]

Objective: To observe the efficacy of acupuncture for pollen allergy and compare the difference in efficacy between the special points/technique acupuncture group and the conventional points/technique acupuncture group. Methods: 1306 patients were randomly divided into two groups; one is the special points/technique acupuncture group (653 patients) and the other one is the conventional points/technique acupuncture group (653 patients). For the special points/technique acupuncture group, needles were inserted into ST7(xiaguan), to look for sphenopalatine foramen to stimulate sphenopalatineganglion, and we penetrate Mian Yan Xue to stimulate nasopalatine nerve. In addition to BL12 (feng men), BL13 (fei shu) and Mu Xue of the lung, spleen and kidney, three points were selected as BL58 (fei yang), BL10 (tian zhu) and DU14 (da zhui) to address three main symptoms of pollen allergy, i.e. stuffy nose, itchy eyes and asthma. For these points in particular, a special needling technique was used by insertion of two needles simultaneously into the same point, lifting and thrusting alternately. The conventional points/technique acupuncture group chose acupuncture points as LI4 (he gu), LI 11(qu chi), LI20 (ying xiang), DU29 (yin tang), GB20 (feng chi), BL12 (feng men), BL13 (feishu), DU23 (shangxing), EX-B1 (ding chuan) and EX-HN8 (shang ying xiang), etc. All these points were needled according to conventional tonification or dispersal technique. Patients in both groups were treated 2-3 times per week, 15 to 20 minutes per visit. Results: Both treatments are effective. However, the special points/technique acupuncture group's total efficiency is 95.7%. The conventional points/technique acupuncture group's total efficiency is 48.5%. The first group is more efficient and has much higher curable rate than the other group and the difference is statistically significant according to ANOVA. Conclusion: The treatment for pollen allergy with the special points/technique acupuncture group is significantly better than the conventional points/technique acupuncture group. Needling the sphenopalatine ganglion is fast effective and reliable. Stimulating the nasopalatine nerve is safe and simple. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of acupuncture on IVF-ET outcomes. Methods: Digital databases, including Pubmed, Embase, the Cochrane Library, the Web of Science and ScienceDirect, were searched from their inception to July 2022. The MeSH terms we used included: acupuncture, in vitro fertilization, assisted reproductive technology and randomized controlled trial. The reference lists of relevant documents were also searched. The biases of included studies were assessed by the Cochrane Handbook 5.3. The major outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). The pregnancy outcomes reported in these trials were pooled and expressed as risk ratios (RR) with 95% confidence interval (CI) in the Review Manager 5.4 meta-analysis software. Heterogeneity of the therapeutic effect was evaluated with a forest plot analysis. Publication bias was assessed by a funnel plot analysis. Results: Twenty-five trials (a total of 4757 participants) were included in this review. There were no significant publication biases for most of the comparisons among these studies. The pooled CPR (25 trials) of all the acupuncture groups (43.6%) was significantly higher than that of all the control groups (33.2%, P < 0.00001), and the pooled LBR (11 trials) of all the acupuncture groups (38.0%) was significantly higher than that of all the control groups (28.7%, P < 0.00001). Different acupuncture methods (manual acupuncture, electrical acupuncture and transcutaneous acupoint electrical stimulation), acupuncture time (before or during the time of controlled ovarian hyperstimulation and around the time of embryo transfer), and acupuncture courses (at least 4 sessions and less than 4 sessions) have respectively positive effects on IVF outcomes. Conclusion: Acupuncture can significantly improve CPR and LBR among women undergoing IVF. Placebo acupuncture can be a relatively ideal control measure. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the sole impact of blinding patients and outcome assessors in acupuncture randomized controlled trials (RCTs) on treatment effects while considering the type of outcome measures. Methods: We searched databases for the meta‐analyses on acupuncture with both blinded and non‐blinded RCTs. Mixed‐effects meta‐regression models estimated the average ratio of odds ratios (ROR) and differences in standardized mean differences (dSMD) for non‐blinded RCTs versus blinded mixed‐effects meta‐regression model. Results: The study included 96 meta‐analyses (1012 trials). The average ROR for lack of patient blinding was 1.08 (95% confidence intervals 0.79–1.49) in 18 meta‐analyses with binary patient‐reported outcomes. The average ROR for lack of outcome assessor blinding was 0.98 (0.77–1.24) in 43 meta‐analyses with binary subjective outcomes. The average dSMD was −0.38 (−0.96 to 0.20) in 10 meta‐analyses with continuous patient‐reported outcomes. The average dSMD was −0.13 (−0.45 to 0.18) in 25 meta‐analyses with continuous subjective outcomes. The results of the subgroup analysis were consistent with the primary analysis findings. Conclusions: Blinding of participants and outcome assessors does not significantly influence acupuncture treatment efficacy. It underscores the practical difficulties of blinding in acupuncture RCTs and the necessity to distinguish between trials with and without successful blinding to understand treatment expectations' effects. Enhancing blinding procedures' quality and assessment in future research is crucial for improving RCTs' internal validity and reliability. [ABSTRACT FROM AUTHOR]

Context: Post-COVID palpitation with paresthesia, commonly referred to as long COVID, presents a complex challenge affecting a significant portion of individuals recovering from acute infection. The signs and symptoms of long COVID encompass a spectrum of manifestations, ranging from physical dysfunction to emotional anxiety and cognitive impairment. The treatment of long COVID has been a challenge for the community and affects individuals' personal well-being. Case Presentation: The patient was a 60-year-old female educational assistant from a high school. She complained of post-COVID palpitation with paresthesia. She sought acupuncture treatment after several emergency visits due to palpitation attacks. She underwent several cardiovascular examinations, which revealed no significant heart condition. She was treated with traditional Qi acupuncture along with kinesiology taping along the heart channels and home self-taping. Outcomes: The Qi Acupuncture was administered, encompassing eighteen acupuncture points spanning from the foot to the head, alongside the application of 4 strips of kinesiology taping along the heart and pericardium channels. Subsequent to the acupuncture intervention, the patient attested to a cessation of palpitations. Furthermore, an observed reduction of 90% in pins/needles paresthesia sensation was noted during a subjective interview following treatment. Conclusions: This case illustrates the use Qi Acupuncture and Kinesiology taping along the heart and pericardium channels to provide a favorable short-term outcome in a patient with Post COVID Palpitation with Paresthesia. [ABSTRACT FROM AUTHOR]

The application of low-level laser therapy (LLLT) to acupuncture points may produce effects similar to that of needle stimulation in patients with temporomandibular disorders (TMD). This systematic review was conducted according to the Cochrane Collaboration guidelines and aimed to address clinical questions using the following strategy: Patient/Problem, Intervention, Comparison, and Outcome (PICO). A comprehensive literature search was performed upto April 26, 2023, across nine electronic databases (BVS, PubMed, Scopus, Embase, Web of Science, ScienceDirect, Cochrane Library, Latin American and Caribbean Health Sciences Literature (LILACS), and Google Scholar) supplemented with gray literature. The risk of bias in randomized and nonrandomized clinical trials was assessed using two tools: risk-of-bias (RoB) 2 and Risk Of Bias In Non-randomised Studies—of Interventions (ROBINS-I). Meta-analysis involved the extraction of mean and standard deviation values for spontaneous pain and mouth opening levels. Seven studies were included in this review, all of which used LLLT. The applied wavelengths ranged from 690 to 810 nm without significant variations in light emission patterns. LLLT demonstrated a significant reduction in instantaneous pain levels (standard mean difference [SMD] = 3.85; 95% confidence interval [CI] = 2.09, 5.62; p < 0.003) and an improvement in instantaneous mouth opening ability (mean difference [SMD] = -7.15; 95% CI = -11.73, -2.58; p < 0.002), with low certainty of evidence. LLLT may alleviate symptoms in patients with TMD; however, caution should be exercised when interpreting the results because of protocol variations among studies and the limited number of studies included in the meta-analysis. [ABSTRACT FROM AUTHOR]

The current framework of traditional Chinese medicine is regarded as a medical system that places the zang-fu viscera at its core, encompassing external pathways, physical aspects, orifices, manifestation(hua), and the seasonal influence. Treatment modalities, such as pharmaceuticals, acupuncture and stone-needle, and moxibustion, are considered specific clinical applications encapsulated within this theoretical system. However, a closer examination of the medical theories within Huangdi Neijing reveals that the early medical theories in the Huangdi Neijing were developed based on external treatments using acupuncture and moxibustion, as well as internal treatments with pharmaceuticals. These early theories differ from the emphasis on internal treatment of zang-fu organs advocated in subsequent periods. The primary body of medical theory in the Huangdi Neijing is rooted in somatological medicine, which was primarily formed through external treatments, including theories related to meridians, acupoints, acupuncture, and encompassing theories such as the theory of five body constituents, the theory of the transformation of exterior and interior diseases, the theory of nutrient qi and defensive qi, the theory of deficiency and excess pathogensis, and therapeutic method involving tonification and purgation. These theories exhibit certain differences from the later dominant zang-fu viscera medicine theories. The oversimplification of amalgamating these two systems' theories has result mistakes in inherent conflicts within the theory itself and a detachment from clinical practice. Thus, there is a pressing need for differentiation and a return to the original sources to reestablish a more coherent theoretical foundation. [ABSTRACT FROM AUTHOR]

Burns often cause severe pain, especially during dressing changes. This study aimed to investigate the effect of acupressure on pain during dressing changes in burn patients. This randomized clinical trial was conducted on 76 burn patients. The eligible patients were randomly assigned to the intervention and control groups after obtaining informed consent. Eligible patients were randomly assigned to the intervention and control groups by blocking. The study was conducted over two days using the same method. Before entering the dressing room, acupressure was performed in the intervention group for 10 min in acupressure points and the control group in other points. Pain intensity was measured in two groups 30 min before entering the dressing room and 15 and 30 min after leaving the dressing room using VAS. Finally, the data were analyzed using SPSS software 25th edition. Pain scores were similar for the two groups before the dressing change. The results of this study revealed a significant decrease in the patient's pain intensity mean in the test group following acupressure compared to the control group on day one which remained on day two (P < 0.05). Considering the experience of severe pain in burn patients, acupressure is recommended as a complementary method along with modern medicine to reduce these patients' pains. • Pain is one of the common problems in burn patients. • Acupressure is a feasible, useful and safe adjunctive modality for managing patients' pain after burn dressing changes. • Acupressure as a complementary therapy can reduce pain in burn patients. [ABSTRACT FROM AUTHOR]