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Acupuncture therapy, rooted in traditional Chinese medicine (TCM), plays a pivotal role in both disease treatment and preventive health care. A significant challenge within this realm is precise acupoint recommendations tailored to specific symptoms, with consideration of the intricate inherent relationships between the symptoms and acupoints. Traditional recommendation methods encounter another difficulty in grappling with the sparse nature of TCM data. To address these issues, we present a novel approach called the enhanced graph convolutional network with property fusion (PEGCN), which consists of two key components, the property feature graph encoder module and the enhanced graph convolutional network module. The former extracts property knowledge of acupoints to enrich their representations. The latter integrates the GCN structure and an attention mechanism to efficiently capture the underlying relationships between symptoms and acupoints. In this paper, we apply the PEGCN model to a real-world dataset related to acupuncture therapy, and the experimental results demonstrate its superiority over the baseline models in terms of the evaluation metrics, which include Precision@K, Recall@K, and NDCG@K. This finding suggests that our model effectively addresses the challenges associated with acupoint recommendations, offering an improved method for personalized treatments in the TCM context. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol use disorder is a chronic disorder with significant limitations in pharmacological treatments, necessitating the exploration of non-pharmacological interventions. Methods: We used a model of alcohol self-administration (10% v/v) to analyze behavioral, neurochemical, and signaling mechanisms. Results: Our findings demonstrate that stimulation of the HT7 acupuncture point significantly decreased the frequency of active lever presses in rats self-administering alcohol (p < 0.05). Alcohol self-administration increased microglial activity and sigma 1 receptor expression in the habenula (Hb), while HT7 stimulation mitigated these effects, decreasing microglial activity and sigma 1 receptor levels (p < 0.05). Additionally, alcohol self-administration reduced brain-derived neurotrophic factor (BDNF) expression in the medial prefrontal cortex (mPFC) and increased tyrosine hydroxylase (TH) levels in the ventral tegmental area (VTA) (p < 0.05). HT7 stimulation reversed these alterations by increasing BDNF expression in the mPFC and decreasing TH levels in the VTA (p < 0.05). Further investigation revealed that BDNF microinjection into the mPFC inhibited sigma 1 receptor activity in the Hb, while microglial inhibition in the Hb decreased TH expression in the VTA (p < 0.05). The administration of the microglial inhibitor MINO to the Hb also reduced alcohol self-administration (p < 0.05). Discussion: These results suggest that HT7 stimulation regulates the mPFC-Hb-VTA circuit, leading to decreased alcohol-seeking behavior. Our study demonstrates that HT7 acupuncture can modulate the mPFC-Hb-VTA circuit, providing a potential non-pharmacological treatment for alcohol-seeking behavior by influencing microglial activity, sigma 1 receptor expression, and TH levels. These findings contribute to a deeper understanding of the neural mechanisms underlying acupuncture's therapeutic effects on alcohol use disorder. [ABSTRACT FROM AUTHOR]

Objective: Guanyuan (CV4), Zhongji (CV3) and Sanyinjiao (SP6) are the most frequently used acupoints for treating neurogenic bladder after spinal cord injury (SCI). However, there has been no investigation to clarify the differences in effects of these acupoints in different types of neurogenic bladder. Methods: The study was structured with a randomized, two‐phase cross over design with a washout period. A routine urodynamic examination was performed first, then, in the order of grouping, electroacupuncture was performed on CV4, CV3, and SP6, respectively，and urodynamic examination was performed to observe the changes of urodynamic indexes in real time. Results: When undergoing electroacupuncture at CV4, CV3, and SP6 in patients with neurogenic detrusor overactivity (DO), the bladder volume at the first occurrence of DO and maximum cystometric capacity increased (p < 0.05), but maximum detrusor pressure (Pdetmax) at DO decreased (p < 0.05), and the changes using CV4 and CV3 was more significantly than using SP6 (p < 0.05). And in patients with in neurogenic detrusor underactivity, there were no significant changes in maximum urinary flow rate and Pdetmax during urination (p > 0.05). Conclusion: The immediate relief effect of electroacupuncture at CV4, CV3 on DO was greater than at SP6. [ABSTRACT FROM AUTHOR]

Objective In acupuncture therapy, the accurate location of acupoints is essential for its effectiveness. The advanced language understanding capabilities of large language models (LLMs) like Generative Pre-trained Transformers (GPTs) and Llama present a significant opportunity for extracting relations related to acupoint locations from textual knowledge sources. This study aims to explore the performance of LLMs in extracting acupoint-related location relations and assess the impact of fine-tuning on GPT's performance. Materials and Methods We utilized the World Health Organization Standard Acupuncture Point Locations in the Western Pacific Region (WHO Standard) as our corpus, which consists of descriptions of 361 acupoints. Five types of relations ("direction_of", "distance_of", "part_of", "near_acupoint", and "located_near") (n  = 3174) between acupoints were annotated. Four models were compared: pre-trained GPT-3.5, fine-tuned GPT-3.5, pre-trained GPT-4, as well as pretrained Llama 3. Performance metrics included micro-average exact match precision, recall, and F1 scores. Results Our results demonstrate that fine-tuned GPT-3.5 consistently outperformed other models in F1 scores across all relation types. Overall, it achieved the highest micro-average F1 score of 0.92. Discussion The superior performance of the fine-tuned GPT-3.5 model, as shown by its F1 scores, underscores the importance of domain-specific fine-tuning in enhancing relation extraction capabilities for acupuncture-related tasks. In light of the findings from this study, it offers valuable insights into leveraging LLMs for developing clinical decision support and creating educational modules in acupuncture. Conclusion This study underscores the effectiveness of LLMs like GPT and Llama in extracting relations related to acupoint locations, with implications for accurately modeling acupuncture knowledge and promoting standard implementation in acupuncture training and practice. The findings also contribute to advancing informatics applications in traditional and complementary medicine, showcasing the potential of LLMs in natural language processing. [ABSTRACT FROM AUTHOR]

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]

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Part 2 of this article series continues with an investigation of point prescriptions from the history of Chinese medicine in which Chǐzé 尺澤 LU-5 was combined with other points to treat a variety of diseases. [ABSTRACT FROM AUTHOR]

Objectives: Osteoporosis is widely regarded as a typical aged-related disease caused by impaired bone remodeling. This research was designed to explore the protective effects of electroacupuncture (EA) on senile osteoporosis in a rat model and investigate the underlying mechanisms. Methods: Three-month-old rats were randomly selected as the youth group, and 24-month-old rats were randomly assigned to the elderly and EA groups. Rats in the EA group received 30 min of EA at bilateral SP10, ST36, K13 and GB34 daily, 5 days a week for 8 weeks. Bone mineral density (BMD), microstructure of the bone tissue, bone turnover biomarkers and expression level of autophagy-related proteins were detected. Results: Compared with the elderly group, EA treatment significantly increased BMD of the femur and ameliorated the microstructure. EA treatment increased trabecular bone volume ratio (= bone volume / total volume [BV/TV]) and trabecular number (Tb.N) and decreased trabecular separation (Tb.Sp) in senile osteoporosis rats. Compared with the elderly group, the serum N-terminal telopeptide of type I collagen (NTX1) level in the EA group was lower, and the serum procollagen type I N-terminal propeptide (PINP) concentration was higher. In addition, the expression of Beclin 1, microtubule-associated protein I light chain 3 (LC3B) and P62 was inhibited in the senile osteoporosis rats after EA treatment. Conclusions: EA can effectively alleviate aging-related bone loss and improve the microstructure of bone tissue in senile osteoporosis rats, and the regulation of autophagy might be one of the important mechanisms. [ABSTRACT FROM AUTHOR]

Cocaine is a frequently abused and highly addictive drug that damages brain health and imposes substantial social and economic costs. Acupuncture has been used in the treatment of cocaine addiction and has been shown to improve abnormal mental and motor states. This article mainly focuses on the neurobiological mechanisms involving the central nervous system (CNS) and peripheral nervous system (PNS) that underlie the effects of acupuncture in the treatment of cocaine addiction. The central dopamine system is a key player in acupuncture treatment of cocaine addiction; the ventral tegmental area (VTA)—nucleus accumbens (NAc) signaling pathway, which has a modulatory influence on behavior and psychology after chronic use of cocaine, is a significant target of acupuncture action. Moreover, acupuncture alleviates cocaine-induced seizures or acute psychomotor responses through the paraventricular thalamus and the lateral habenula (LHb)—rostromedial tegmental (RMTg) nucleus circuits. The data suggest that acupuncture can impact various cocaine-induced issues via stimulation of diverse brain areas; nevertheless, the interconnection of these brain regions and the PNS mechanisms involved remain unknown. In this review, we also discuss the effects of specific acupuncture protocols on cocaine addiction and note that variations in needling modalities, current intensities and traditional acupuncture point locations have led to different experimental results. Therefore, standardized acupuncture protocols (with respect to stimulation methods, point locations and number of sessions) may become particularly important in future studies. [ABSTRACT FROM AUTHOR]

Background: Amnestic mild cognitive impairment (aMCI) is an important window of opportunity for early intervention and rehabilitation in dementia. The aim of this study was to investigate the feasibility and effect of delivering transcutaneous electrical acupuncture stimulation (TEAS) intervention to elders with aMCI. Methods: A total of 61 aMCI patients were randomly allocated into the intervention group (receiving a 12-week TEAS) and control group (receiving health education). The feasibility outcomes included recruitment rate, retention rate, adherence rate, and an exploration of patients' views and suggestions on the research. The effective outcomes included cognitive function, sleep quality, and life quality, which were measured by the Montreal cognitive assessment scale (MoCA), auditory verbal learning test—Huashan version (AVLT-H), Pittsburgh sleep quality index (PSQI), and quality of life short-term-12 (QoL SF-12). Results: The recruitment rate, retention rate, and adherence rate were 67.35%, 92.42%, and 85.29%, respectively. Most aspects of the research design and administration of the TEAS intervention were acceptable. The quantitative analysis suggests that compared with the control group, the scores of MoCA, AVLT-H, and SF-12 (mental component summary) were significantly better (p < 0.05); however, the differences were not statistically significant in PSQI and SF-12 (physical component summary) (p > 0.05). Conclusions: The findings demonstrated that the study was feasible. TEAS awas possible for enhancing cognitive function and mental health in people with aMCI. [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: Acupuncture is frequently used to manage pediatric cerebral palsy (CP), yet updated evidence is needed to guide future research and clinical practice. Methods: Seven databases were searched from 1994 to 26 June 2023. Randomized controlled trials (RCTs) involving body, scalp, or ear acupuncture for managing CP, excluding acupoint injection, catgut embedding, electro-acupuncture, or laser acupuncture, were included. Results: Twenty RCTs with 1797 participants were analyzed. Acupuncture groups had better improvements in gross motor function measure (GMFM) scores by 5% (mean difference: 5.93, 95% CI: 3.67–8.19, p < 0.001, I2 = 57%); a 16% higher probability to yield prominent improvement in effectiveness rate (ER) (risk ratio: 1.16, 95% CI: 1.08–1.25, p < 0.001, I2 = 0%); and better outcomes in the Modified Ashworth Scale (MAS) (standardized mean difference [SMD]: 0.3, 95%, CI: 0.11–0.49, p < 0.001, I2 = 0%), the Berg Balance Scale (BBS) (SMD: 2.48; 95% CI: 2.00–2.97, p < 0.001, I2 = 72%) and ADL (SMD: 1.66; 95% CI: 1.23–2.08, p < 0.001, I2 = 91%). Studies with eight core acupoints identified from all ninety-five acupoints had better ER. Conclusions: Acupuncture, especially using core acupoints, may be effective for managing symptoms in children with CP. [ABSTRACT FROM AUTHOR]

Numerous patients visit Korean medical institutions for low back pain. Various acupuncture points have been suggested to treat low back pain; however, selecting the appropriate acupuncture points is challenging because their individual importance is unknown. Therefore, in this study, we aimed to investigate the effects of different acupuncture points in the treatment of low back pain. We reviewed 14 classical literatures that recorded acupuncture prescription for low back pain. We investigated the frequency of acupuncture point usage, as well as their meridians, dermatomes, and combinations. Only BL, GV, and GB were used as local acupuncture points. The BL was the most frequently used acupuncture point in all dynasties. Over time, the use of distal rather than local acupuncture points increased. The distal acupuncture points that corresponded to the L4–S1 dermatome were most used. The most frequently used acupuncture points were BL23, BL40, BL60, GV26, GB34, and ST36. When low back pain is accompanied by lower extremity symptoms, the frequency of the use of acupuncture points at the L4, L5, and S1 levels on the dermatome increased, whereas those at the L2 and S3 levels decreased. BL31–BL34, BL28–GV02, and GV26–BL40 were mainly used in combination.

Objective To investigate the application effect of transcutaneous electrical acupoint stimulation (TEAS) combined with propofol in painless gastrointestinal endoscopy. Methods A total of 105 patients who underwent gastrointestinal endoscopy were randomly divided into propofol+fentanyl group (P+F group), propofol+TEAS group (P+T group), and propofol+placebo-TEAS group (P+P group), with 35 patients in each group. All patients were induced to deep sedation by the anesthesiologist using propofol before gastroscopy; the patients in the P+F group were given intravenously injected fentanyl 50 μg before gastroscopy, those in the P+T group received placement of electrodes at the acupoints at 30 minutes before examination and were given electrical stimulation till the end of the examination, and those in the P+P group received placement of electrodes at the acupoints alone without electrical stimulation. The patients were recorded in terms of pain score and the amount of propofol used du-ring examination, the time to recovery from anesthesia after examination, and the incidence rate of adverse reactions during or after examination, as well as the degree of satisfaction among patients and physicians. Results Compared with the P+P group, the P+F and P+T groups had a significant reduction in pain score (H=23.16,P0.05), while the P+F group had significantly higher degrees of vertigo, nausea, and vomiting than the other two groups (H=40.97-44.79,P

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]

Acupuncture involves stimulating points with lower electrical impedance (EI). Understanding EI changes with needle and exercise stimuli can elucidate acupuncture mechanisms. This study included 60 subjects, divided into control (C) and acupuncture (A) groups. EI was assessed at four points: 0 (before procedures), I (after handgrip protocol [HGP]), II (after 20 minutes of rest), and III (after 20 minutes of rest in C or stimulation in A, followed by HGP in both groups). Statistical significance was set at p < 0.05. In the A group, EI was significantly reduced at HT3, shown by increased % microampere when comparing assessments I, II, and III with assessment 0 (p < 0.005). Intergroup comparisons revealed a reduced % microampere when comparing assessments II (p < 0.02) and III (p < 0.0001). Furthermore, the stimulation of an acupoint over a motor nerve branch changes the EI.

Background: Urinary retention is a postoperative problem that causes pain and discomfort for patients, even when catheters are used. The potential role of magnetic therapy in treating postoperative urinary retention through acupuncture points remains uncertain. This research aims to assess the impact of magnetic therapy on urinary retention in patients undergoing surgery. Materials and Methods: This single-blind clinical trial study was conducted in a recovery department within an operating room and subsequently in the Surgery Department of Amin Hospital. The study took place in Isfahan in 2022, with a sample of 64 patients selected using a simple random sampling method and divided equally into two groups. In the intervention group, magnet plates were applied, while the control group received iron plates at seven specific points for duration of 35 ± 5 minutes. Demographic information, the type of urinary excretion, the duration of urinary retention, and the volume of excreted urine were recorded using a researcher-made checklist for both intervention and control groups. These data were compared and subjected to descriptive and analytical statistical analysis. Results: Among the participants (N = 64), the majority were male (N = 37, 57.80%), and the mean age was 40.17 years. The Chi-square analysis revealed no significant difference between the intervention and control groups in terms of the type of urinary excretion (p = 0.106). However, the Mann–Whitney U-test demonstrated significant difference between the two groups regarding the duration required to eliminate urinary retention and the volume of excreted urine (F2,41 = 62 and F1,76 = 62; p < 0.001). Conclusions: The use of a novel approach involving magnetic therapy applied to acupuncture and reflexology points has been shown to reduce the time required for the first urination and increase the volume of urine in post-surgery patients.

Importance: Understanding acupuncture point microenvironments is vital for optimizing treatment efficacy. Evaluating changes in water content at these points can provide further insights into the effects of acupuncture on tissues.Objective: This study aimed to measure tissue dielectric constant (TDC) and assess changes in water content, specifically at stomach 36 (ST36, Zusanli) and spleen 6 (SP6, Sanyinjiao) acupuncture points.Methods : : In a controlled, blinded, randomized trial, 113 healthy volunteers were divided into six groups based on TDC sensor diameters (XS, M, and L): three control groups and three acupuncture groups. They were assessed at three time points: T1, baseline; T2, 20 min post-needle withdrawal; and T3, 40 min post-needle withdrawal. Electrical impedance (EI) was also analyzed. Significance level was set at p < 0.001.Results : : TDC at ST36 and SP6 significantly decreased with the XS probe at T2 and T3 compared with that at T1 (F8, 452: 54.61). TDC did not significantly vary between T2 and T3 with M and L probes. EI data indicated that the current passage increased in the SP (F2, 226: 39.32) and ST (F2, 226: 37.32) groups during T2 and T3 compared with that during T1 within their respective groups and controls.Conclusion : s and Relevance: This study demonstrated the efficacy of TDC measurements in detecting water content fluctuations at acupuncture points and their responses to needles. TDC measurements, which were validated against EI, provide valuable insights into acupuncture point microenvironments and thus help optimize treatments.

Background: Laser acupuncture is a proven non-invasive treatment with effects comparable to traditional acupuncture in different types of headaches, but there is still insufficient evidence for chronic migraine (CM) in adults. We aim to investigate the efficacy and safety of laser acupuncture (LA) as an add-on preventive therapy on CM. Methods: A single-blind randomized controlled trial was conducted from January 2022 to November 2023. CM patients with unsatisfactory pharmacological effects were randomly assigned in a 1:1 ratio to receive either LA or sham treatment over a course of 8 sessions spanning 4 weeks. The co-primary outcomes were changes in monthly migraine days (MMD) and acute headache medications usage days per month from baseline. Evaluations were taken at baseline (12 weeks before randomization), at 4th week (treatment completed), 8th week and 12th week from baseline. Results: A total of 60 patients (30 in each group) were included in the intention-to-treat analyses. Baseline headache characteristics between trial groups were similar. Compared with the sham group, the LA group had a significant reduction in MMD (5.2 vs. 1.5 days at 8th week, p = 0.015; 7.3 vs. 1.8 days at 12th week, p = 0.001), and acute headache medications usage days per month (3.1 vs. 0.4 days at 4th week, p = 0.007; 3.2 vs. 0.0 days at 8th week, p = 0.005; 3.9 vs. 0.0 days at 12th week, p < 0.001). No serious adverse event was observed in both groups. Conclusions: Laser acupuncture was effective in reducing MMD and acute headache medications usage with promising safety. Specifically, the efficacy of LA exhibited a progressively more pronounced effect within the follow-up period. We suggested that LA is a promising add-on preventive therapy for CM, and trials focused on investigating the mechanism of LA's effect and its long-term effects on CM prevention are justified. Trial registration: The study was retrospectively registered at ISRCTN.org Identifier: ISRCTN11208146 (https://doi.org/10.1186/ISRCTN11208146). The registration date: 19, January, 2024. The date of first participant registration: 04, May, 2022. [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]

Importance: Choledocholithiasis, or bile duct gallstones, is effectively treated with surgery, which does not prevent relapse. A common adjuvant therapy is the stimulation of the Yanglingquan point (GB34). Acupoint catgut embedding (ACE), an acupoint stimulation therapy, may be a better treatment for choledocholithiasis. Objectives: To investigate the effect of ACE in stimulating GB34 on bile metabolism and its possible mechanism via metabonomics. .ASA-Methods: In this study, we used ultrahigh performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-MS/MS) to analyze the changes in bile metabolites, metabolic pathways, and liver function indicators in 16 patients with choledocholithiasis before and after ACE stimulation. Results: We identified 10 metabolites that exhibited significant differences in the bile before and after ACE, six of which significantly increased and four that significantly decreased. Moreover, six liver function indicators showed a downward trend. We identified related metabolic pathways as glycerophospholipid metabolism, steroid biosynthesis, and the citrate cycle (TCA cycle). Conclusions and Relevance: This study shows that ACE stimulation of GB34 can effectively help treat choledocholithiasis, which may be clinically applicable to ACE. [ABSTRACT FROM AUTHOR]

Importance: We compile and analyze ancient literature related to Baihui (GV20) moxibustion and summarize the development of its ancient clinical application. Observations: The Chinese Medical Classic (5th edition) was used as the search source to screen and organize articles related to Baihui moxibustion to establish a database. We created indexing norms according to study characteristics and indexed books, dynasties, literary styles, disease key words, matching acupoints, combinations, moxibustion amounts, and moxa cone sizes. SPSS version 24.0 software was used to calculate the index results. A total of 320 articles that met the requirements were finally included and were attributed to 99 ancient books, spanning from the Western Han Dynasty to the Qing Dynasty. A total of 45 keywords were used for disease evidence: the most frequent occurrences were internal medicine (primary category), limb meridians (secondary category), and head diseases (specific patterns). Conclusions and Relevance: Baihui moxibustion has been updated and developed in the literature over the ages, and the method of Baihui moxibustion is diverse. The main treatment rule of Baihui moxibustion considers the whole body and close treatment of partial diseases. Baihui moxibustion also has the rule of following meridian indications, with treatment based on syndrome differentiation and compatible application. Baihui moxibustion alone has a relatively strong effect of raising yang and lifting the sunken, which can treat the sinking of qi and deficiency. [ABSTRACT FROM AUTHOR]

Recently, several previously undiscussed concerns in acupuncture research have been brought to light. Among these, the core issue stems from the ambiguity surrounding the identity of acupoints. Hence, the question "What is the identity of acupoints?" remains of particular importance in acupuncture research. To answer this question, we reviewed the original concept of acupoints explained in Oriental medicine, from which acupuncture treatment originated, and examined scientific research on acupuncture and acupoints. We then proposed a perspective on the identity of acupoints and speculated about a possible reason for their elusive nature: qi, which congregates at and flows in and out of acupoints, might be bioelectricity, making these points inherently difficult to measure anatomically or histologically. Consequently, acupoints are suggested to be spaces where bioelectricity congregates, thus inevitably exhibiting electrical characteristics. [ABSTRACT FROM AUTHOR]

Background and Aims: The preference of beauty seekers for noninvasive, convenient, and long‐lasting effective facial cosmetic techniques with minimal downtime and recovery time is obvious nowadays. As a part of traditional Chinese medicine, acupuncture has great advantages in solving these problems. This study aims to assess the effectiveness of two distinct acupuncture techniques for facial rejuvenation in treating nasolabial folds (NFs) and marionette lines (MLs). Methods: One hundred beauty seekers who have received facial acupuncture cosmetic treatment in hospitals between June 1, 2020, and December 31, 2022, were selected randomly and inquired. Among them, 50 beauty seekers (Group Ⅰ) have received a normal facial traditional Chinese medicine acupuncture therapy, by inserting the needles perpendicularly into the acupoints. Meanwhile, another 50 beauty seekers (Group Ⅱ) were treated by needle knives, which were inserted parallelly under the dermis and basically along the meridians of Chinese medicine linked by the acupoints. The records of pain evaluation and adverse events on cases, subjective satisfactions, and objective evaluations of efficacy were summarized and statistically analyzed. Results: The efficacy of Group Ⅱ is better than Group Ⅰ. The dermatologists' assessments for NF and ML show significant differences between Groups Ⅰ and Ⅱ after one course. The mean value of subjective satisfaction also obeys the rules above. Although Group Ⅱ exhibited the highest value of mean pain intensity, the adverse events were basically mild. Furthermore, Group Ⅱ showed higher willingness for additional treatments. Conclusion: Only in terms of the wrinkle depth of NF and ML, the method of acupuncturing parallelly under the dermis by needle knife is safe and more successful. [ABSTRACT FROM AUTHOR]

Background: Uremic pruritus, one of the most painful symptoms experienced by patients receiving dialysis, seriously affects patient quality of life and health, causes physical and mental damage, and increases hospitalization and mortality rates. Multi-modal therapies with evidence-based healthcare are needed to provide patients receiving dialysis with more convenient and feasible medical resources. Purpose: Relevant domestic and international research on the effectiveness and methods of non-invasive acupoint therapy in improving uremic pruritus in dialysis patients was reviewed. Discussing related knowledge can facilitate the evidence-based use of non-invasive acupoint therapy in clinical practice by clinical medical personnel. Methods: Based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses) systematic literature review and integrated analysis method, a keyword search of related articles published before September 2023 was conducted in the following databases: PubMed, Cochrane Library, Embase, Web of Science, Airiti Library, Taiwan Master and Doctoral Dissertation System, Chinese Journal Full-text Database and Wanfang Data Knowledge Service Platform. In 2019, the second version of the Risk of Bias Tool for Randomized Controlled Trials was used to evaluate research quality, after which RevMan 5.4 and Stata 14.0 suite software were used for meta-analysis. Results: Nine of the 112 articles selected, including 10 sets of data and 597 participants, were included in the metaanalysis. The results indicate non-invasive acupoint therapy significantly reduces the degree of uremic pruritus (synthetic effect size = -1.30, 95% confidence interval [-1.67, -0.93], p < .00001). Because the heterogeneity test I² = 76%, showed a high degree of heterogeneity, a subgroup analysis was performed, showing that acupoint massage combined with traditional Chinese medicine fumigation and washing, a general simple itching assessment scale, and the Chinese region achieved better effect sizes. Conclusions/ Implications for Practice: Non-invasive acupoint therapy is easy to implement, inexpensive, non-invasive, and associated with few side effects. The authors hope these findings may increase the awareness and understanding of patients with dialysis regarding the practical operation techniques of itching acupoints. According to the results of this systematic review and meta-analysis, massage of the lung and endocrine acupoints at ST-6, SP- 10, and LI-11 as well as the relevant points on the ear may be most effective in achieving urinary itching relief. Also, acupoint massage combined with traditional Chinese medicine fumigation, ST-6 far-infrared irradiation, or LI11 transcutaneous acupoint electrical stimulation can further relieve uremic pruritus in this patient population. Based on the results, acupoint massage combined with traditional Chinese medicine fumigation and washing is a complementary method of treatment for uremic pruritus that may be recommended to patients in the future. [ABSTRACT FROM AUTHOR]

Background: Approximately 30% of patients experience postoperative complications after surgery for early-stage lung cancer. However, the relationships among meridian energy during lung cancer surgery, changes in quality of life, and prognosis have not been investigated. Purpose: This study was designed to explore the associations among meridian energy, changes in quality of life, and prognosis in patients with newly diagnosed lung cancer undergoing surgery. Methods: A longitudinal, repeated-measures design was used. Basic data forms, meridian energy measurements, and a concise 12-item health status questionnaire were administered to the participants at the time of diagnosis, 2 weeks post-surgery, and 12 weeks post-surgery. During this period, changes were analyzed, and their association with postoperative risks was explored. Results: Forty-eight cases were investigated. Both meridian energy and quality of life were found to be significantly decreased 2 weeks after surgery. The high/low ratio of meridian energy, the physical component score of the Short Form 12-Item Health Survey Questionnaire, gender, cancer stage, and body mass index were identified as significantly associated with prognosis. Conclusion/Implications for Practice: The declining trends in meridian energy and quality of life during the 2 weeks after surgery in patients with lung cancer are associated with poor postoperative prognoses. Nurses may use the findings of this study to identify patients at high risk of postoperative complications and develop appropriate strategies to provide comprehensive care. [ABSTRACT FROM AUTHOR]

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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]

Introduction: Although acupuncture is recommended by chronic obstructive pulmonary disease (COPD) treatment guidelines owing to its effects on dyspnea, the underlying neurobiological mechanisms of these effects remain unclear. This study aims to evaluate the efficacy of acupuncture in patients with stable COPD and explore the possible involvement of specific brain regions. Methods: This is a prospective, multicenter, single-blind, randomized controlled trial. A total of 90 participants will be recruited from three centers and will be randomly assigned in a 1:1 ratio to undergo acupuncture at acupoints on the disease-affected meridian (DAM) or non-acupoints on the non-affected meridian (NAM), in addition to routine pharmacological treatments. All participants will undergo 30 min of acupuncture three times a week for 8 weeks and will be followed up for 12 months. The primary outcome will be the severity of dyspnea, as measured using the Borg Dyspnea Scale and a visual analog scale at rest and after exercise. The secondary outcomes will include the multidimensional profile of dyspnea using Dyspnea-12, the modified Medical Research Council Dyspnea Scale, and the COPD assessment test; quality of life assessments using St George's Respiratory Questionnaire and the Hospital Anxiety and Depression Scale; and additional measurements of exacerbation frequency, pulmonary function, and the 6-min walking distance. Magnetic resonance imaging (MRI) will be performed before and after exercise to explore the potential neurobiological mechanisms of exertional dyspnea. Anxiety and depression will be measured and analyzed for their correlation with the activation of specific brain areas involved in dyspnea. Discussion: This randomized controlled trial aims to use a multidimensional evaluation of the efficacy of acupuncture in relieving dyspnea in patients with COPD in terms of emotion and quality of life and explore the neurobiological mechanisms underlying the effects of acupuncture on dyspnea from an imaging perspective. It is expected to provide strong evidence to support the use of acupuncture in relieving dyspnea in patients with COPD and those with aother diseases involving dyspnea. Additionally, it provides novel insights into the central mechanisms of acupuncture intervention and dyspnea. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the efficacy and safety of buccal acupuncture on postoperative analgesia, perioperative stress response and adverse events in elderly patients undergoing laparoscopic radical gastrectomy. Methods: It was a prospective, outcome assessor-blinded, randomized controlled trial, involving 90 patients aged 65-80 years who were treated with an elective laparoscopic radical gastrectomy. They were randomly assigned to buccal acupuncture group (Group B) and control group (Group C). Buccal acupuncture was applied to patients of Group B before the induction of general anesthesia, while no additional application was given to those in Group C. Patientcontrolled intravenous analgesia (PCIA) with sufentanil was postoperatively performed in both groups. Sufentanil consumption and the Visual Analog Scale (VAS) score within 48 h postoperatively were assessed as primary outcomes. Secondary outcomes included peripheral levels of stress markers, intraoperative consumptions of anesthetic drugs and postoperative recovery. Results: Patients in Group B presented significantly lower VAS scores within 24 h and less consumption of sufentanil within 48 h postoperatively (both p < 0.01). The awaking time, time to extubation and length of stay were significantly shorter in Group B than in Group C (p = 0.005, 0.001 and 0.028, respectively). Compared with Group C, stress response and inflammatory response within 24 h postoperatively were also significantly milder in Group B. Conclusion: The use of buccal acupuncture before general anesthesia induction favors the postoperative analgesic effect and recovery in elderly patients undergoing laparoscopic radical gastrectomy, the mechanism of which involves relieving postoperative stress response and inflammatory response. [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]