Acute bronchitis is a common respiratory disease characterized by acute airway inflammation, requiring effective and safe anti-inflammatory therapies. ALC-2203 is a botanical drug candidate combining Coptidis rhizoma dry extract and ivy leaf (hederacoside C) ethanolic dry extract, designed to provide complementary anti-inflammatory and symptom-relieving effects. This study aimed to evaluate the preclinical anti-inflammatory efficacy of ALC-2203 in a lipopolysaccharide (LPS)-induced mouse model, develop a quality-controlled oral tablet formulation, and assess its clinical efficacy and safety in patients with acute bronchitis. Preclinically, acute bronchitis was induced in ICR mice via intranasal LPS administration. ALC-2203 (20, 40, and 80 mg/kg) orally administered to evaluate inflammatory cells in bronchoalveolar lavage fluid (BALF) inflammatory cells, cytokines, and lung histopathology. A 318-mg tablet formulation was developed and validated using an HPLC method for berberine quantification. Clinically, a randomized, double-blind, placebo- and active-controlled, multicenter Phase 2 trial enrolled 168 patients who received placebo, ALC-2203-2 (low dose), ALC-2203-1 (medium dose), and the active control, ALC-2203-AC (Synatura® syrup), for 7 days. The primary endpoint was the change from baseline in the Bronchitis Severity Score (BSS) at Day 7. In the mouse model, ALC-2203 reduced inflammatory cells, including macrophages, neutrophils, and lymphocytes, in BALF, thereby suppressing pro-inflammatory cytokines (i.e., TNF-α, IL-1β, and IL-6) and improving pulmonary histopathology. The tablet formulation demonstrated analytical performance, including linearity (R2 ≥ 0.999), accuracy (98–102
Allergic rhinitis (AR) is a common allergic disease with limited treatment options and potential side effects from conventional therapies. This study aimed to investigate the therapeutic effects and underlying mechanisms of abdominal acupuncture (AA) on AR. An ovalbumin (OVA)-induced AR rat model was established. After AA intervention, pathological changes in the nasal mucosal were evaluated by hematoxylin and eosin (HE) staining. Serum levels of immunoglobulin E (IgE), interleukin-4 (IL-4), IL-5, IL-13, and interferon-γ (IFN-γ) were measured by enzyme-linked immunosorbent assay (ELISA). Transcriptome sequencing was performed to identify differentially expressed genes (DEGs) and enriched signaling pathways. Rescue experiments using an estrogen maintenance model were further conducted to verify the specific mechanism of AA in AR treatment. HE staining showed that the AR model presented with ciliary loss, epithelial shedding, goblet cell hypertrophy, disordered cell arrangement and infiltration of eosinophils and other inflammatory cells in the nasal mucosa. Following AA intervention, these pathological changes were markedly alleviated, with only slight ciliary loss and a more orderly epithelial structure. ELISA results showed that AA treatment decreased IgE, IL-4, IL-5, and IL-13, while increasing IFN-γ content, thereby correcting T helper 2 (Th2) bias. Transcriptome analysis identified 49 overlapping genes that were either upregulated in AR and downregulated by AA, or vice versa. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis indicated that the estrogen signaling pathway was the most significantly enriched. ELISA further revealed significant differences in estrogen levels between the AR+AA group and AR group. In the estrogen maintenance model, AA continued to alleviate AR symptoms under high-estrogen conditions, accompanied by decreased serum IgE, IL-4, IL-5, IL-13 levels and increased IFN-γ content. These findings suggest that AA may treat AR by inhibiting the estrogen signaling axis, thereby regulating immune factor secretion. This provides a potentially theoretical basis for the treatment of AR with AA.
Obesity is a major metabolic disorder, and effective orally administrable interventions with multi-target properties are needed. Although Pinus koraiensis needles possess diverse bioactive properties, their anti-obesity effects and underlying mechanisms remain unclear. This study evaluated the anti-obesity efficacy of P. koraiensis needle extract (PKN) in vivo and explored its molecular mechanisms using integrative network pharmacology and network-based reanalysis of publicly available transcriptomic datasets. Male C57BL/6J mice fed a high-fat diet (HFD) received oral PKN (80 mg/kg) for 12 weeks. Body composition, adipose histology, and hepatic lipid accumulation were assessed. Potential mechanisms were investigated by identifying overlapping genes between PKN-related compounds and obesity-associated genes, followed by protein–protein interaction network, clustering, enrichment, and transcription factor–target analyses using public transcriptomic data. PKN attenuated fat accumulation and epididymal adipose tissue weight in HFD-induced obese mice and reduced adipocyte hypertrophy and hepatic lipid accumulation. PKN produced a greater reduction in adipocyte diameter than Garcinia supplements. Integrative analysis identified 2619 shared target genes between PKN and obesity. As a result from clustering analysis, Cluster 4 was identified as the key hub module, and enrichment analysis highlighted cytokine response, cellular response to cytokine stimulus, and regulation of cell death. Transcription factor–target analysis suggested ILF3, HOXA10, NR3C1, and HIF1A as major putative regulators. Orally administered PKN ameliorated obesity-associated adipose and hepatic alterations in HFD-induced obese mice. These findings suggest that PKN has anti-obesity potential and may act through a multi-target regulatory framework involving inflammation- and cell death-related pathways.
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, characterized by a complex biphasic immune pattern. Contemporary perspectives emphasize that during the early stages of sepsis, excessive inflammatory responses and emerging immunosuppression coexist rather than occur sequentially. This review systematically elucidates the pathophysiological basis of this early coexisting biphasic immune pattern in sepsis, providing an in-depth analysis of the key mechanisms underlying the initial cytokine storm and the subsequent development of immune paralysis. Furthermore, it highlights precision immunotherapeutic strategies tailored to distinct immune phenotypes, encompassing immune modulation and immune stimulation approaches. The review also critically examines the major challenges in clinical translation and explores future directions in the field. By integrating current knowledge on the immunopathology of sepsis, this article aims to offer a comprehensive theoretical framework to advance the understanding of sepsis immune dysregulation and to foster the development of novel targeted therapies.
Adipose tissue serves as a key endocrine organ for dynamic lipid metabolism in the human body, in which adipocytes store and consume energy, secrete adipokines, and participate in diverse biological processes. Adipose-derived stem cells exhibit a robust capacity for adipogenic differentiation. The hypothalamus, a critical brain region within the central nervous system, regulates systemic lipid metabolism by modulating energy homeostasis, feeding behavior, immune responses, and gut microbiota equilibrium. Lipid droplets function as essential organelles within adipocytes. Collectively, adipose tissue and the hypothalamus maintain systemic lipid metabolic homeostasis. Acupuncture exerts beneficial regulatory effects on lipid metabolism by modulating the central regulatory functions of the hypothalamus, thereby influencing the neuro-endocrine-immune axis. In the process of acupuncture-mediated regulation of lipid metabolism, the autonomic nervous system serves as both an afferent and an efferent pathway, playing a pivotal role in signal transduction. This review synthesizes the current research on how acupuncture transmits stimulation signals to the central nervous system, modulates sympathetic and parasympathetic signaling, and subsequently affects the structure and function of adipose tissue to promote lipid metabolic homeostasis. However, fundamental and clinical investigations into the “neuro-endocrine-adipose tissue” axis underlying acupuncture-mediated lipid metabolism regulation require further elucidation. This article aims to systematically review the interconnected pathways through which acupuncture regulates lipid metabolism via the neuro-endocrine-adipose axis. It provides an in-depth exploration of how acupuncture stimulation, via peripheral and central neural pathways, modulates the hypothalamic–pituitary–target gland axis and the autonomic nervous system, ultimately influencing the function and interaction of white and brown adipose tissues, as well as the process of “white adipose browning.” By integrating recent research advances, this review seeks to clarify the scientific basis of acupuncture in treating lipid metabolism disorders and to propose theoretical frameworks and directions for future mechanistic studies.
Circulating tumor cells (CTCs) play a central role in cancer metastasis by acting as seeds for dissemination to distant organs. However, upon entering the bloodstream, CTCs encounter multiple lethal challenges, including shear stress, anoikis, and immune surveillance, resulting in the survival of only a small subset of cells. Understanding how CTCs overcome these hostile conditions is critical for elucidating the metastatic process and identifying potential therapeutic targets. Accumulating evidence indicates that CTCs exhibit remarkable phenotypic plasticity and heterogeneity, enabling dynamic transitions along the epithelial–mesenchymal spectrum. In addition, CTCs can form multicellular clusters and interact with various blood components, which may enhance their survival and metastatic potential. Emerging studies also suggest that CTCs can acquire features resembling stem cells and immune cells, contributing to immune evasion and adaptability within the circulation. In this review, we discuss the key biological characteristics of CTCs and the adaptive strategies that support their persistence in the bloodstream, including plasticity, clustering, and interactions with the blood microenvironment. CTCs represent a highly adaptable and heterogeneous population that utilizes multiple survival strategies to persist in the bloodstream and contribute to metastasis. A deeper molecular exploration is required to identify the specific genes that govern critical adaptive traits, particularly those mediating cell clustering, anoikis resistance and immune evasion. Understanding of these mechanisms may provide insights into novel therapeutic approaches aimed at preventing metastatic progression, particularly in early dissemination or minimal residual disease settings. The metastatic cascade. The metastatic cascade is a multistep biological process through which cancer cells disseminate from a primary tumor to distant organs, ultimately forming secondary tumors. (1) EMT is activated, allowing cancer cells to lose intercellular adhesion and invade surrounding tissues by degrading the ECM via proteolytic enzymes such as matrix MMPs. (2) Individual tumor cells or multicellular clusters then enter the blood or lymphatic vessels in a process known as intravasation. Once in the circulation, these CTCs are exposed to hostile conditions, including mechanical shear stress, immune surveillance, and anchorage-independent stress (anoikis). (3) Surviving CTCs subsequently exit the bloodstream at distant sites through extravasation. (4) After colonizing a new tissue microenvironment, disseminated cancer cells must adapt and survive to establish micrometastases, which may eventually progress to clinically detectable macrometastases. Created with BioRender.com.
Real-world evidence on the effectiveness and safety of herbal medicines for type 2 diabetes mellitus (T2DM) remains limited despite promising results from controlled studies. This study aimed to evaluate the clinical outcomes of Hyeoldanggaesun-tang, a traditional Korean herbal formulation, in routine clinical practice. This multicenter retrospective chart review included 31 adults with T2DM who received Hyeoldanggaesun-tang continuously for 6 months across four Korean medicine clinics. Clinical and laboratory data were extracted at baseline and at 3 and 6 months. The primary outcome was change in glycated hemoglobin (HbA1c). The secondary outcomes included liver enzymes, lipid profiles, blood pressure, body mass index, and safety indicators. Mean HbA1c decreased significantly from 8.85 ± 2.01
Obstructive sleep apnea (OSA) is a common disorder closely associated with inflammation, yet the relationship between certain inflammatory biomarkers and cardiovascular mortality in OSA patients remains unclear. This study compared the predictive value of different inflammatory biomarkers for prognosis in probable obstructive sleep apnea (pOSA) patients and examined the mediating role of hematocrit (HCT) in the association between monocyte-to-lymphocyte ratio (MLR) and cardiovascular mortality. Based on data from the U.S. National Health and Nutrition Examination Survey (NHANES, 2005–2008 and 2015–2018), 6,844 pOSA patients were identified. The predictive efficacy of seven inflammatory biomarkers for 1-year cardiovascular mortality was assessed using receiver operating characteristic (ROC) curves, identifying MLR as the optimal predictor. We analyzed the 1-, 3-, and 5-year ROC curves for MLR. X-tile software determined the optimal cutoff value for MLR and grouped patients accordingly. Weighted multivariable Cox proportional hazards models, Kaplan–Meier curves, and restricted cubic spline (RCS) analyses examined the relationship between MLR and cardiovascular mortality in pOSA patients. Subgroup analyses were conducted in the fully adjusted model. Sensitivity analyses were performed to verify the robustness of the results. Statistical mediation analysis was conducted to explore the mediating role of HCT. MLR demonstrated the highest area under the curve (AUC) for predicting 1-year cardiovascular mortality in pOSA patients (AUC = 0.811). Its predictive performance gradually declined as the follow-up period lengthened. Weighted multivariable Cox analysis revealed MLR as an independent predictor of cardiovascular death (HR = 5.08, 95
Central nervous system (CNS) disorders arise from many initiating factors, yet they repeatedly culminate in shared cellular stress-response programs. We organize this phenomenon by defining a comprehensive stress adaptation network as a set of coupled sensing and eff ector loops spanning oxidative–mitochondrial control, neuroimmune regulation, excitability regulation, and proteostasis maintenance. We review how two major phytocannabinoids, cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), modulate these adaptive modules. CBD is non-intoxicating and acts as a pleiotropic modulator that shapes stress-linked signaling through diverse molecular targets, including cannabinoid receptor 1 (CB1), cannabinoid receptor 2 (CB2), and various non-cannabinoid receptors, whereas THC is an intoxicating partial agonist at CB1/CB2, with neurobehavioral effects that depend strongly on state and dose. Clinical evidence is strongest for purifi ed CBD in epilepsy and for standardized formulations of purified THC and CBD combinations in multiple sclerosis (MS) spasticity, while evidence in other neurodegenerative and sleepdisorders remains preliminary. Across these four adaptive domains, cannabinoids can alter redox tone, glial stateprograms, circuit stability, and autophagy or unfolded protein response (UPR) signaling. However, many mechanisticclaims are based mainly on preclinical systems and may vary with exposure, cell type, and disease stage. We highlight translational priorities that include standardized chemotypes and formulations, exposure–response biomarkers, cell-type-specific biomarkers and functional endpoints, and trial designs that separate symptomatic effects from disease modification.
Katakori refers to discomfort or dull pain around the back of the head and through the shoulders and/or shoulder blades in Japanese. It is often translated as “neck and shoulder pain” or “nonspecific neck pain,” but it is considered a culturally specific symptom that is especially prevalent in Japan. It significantly affects quality of life and labor productivity. However, standard treatments have not been established. This study aimed to evaluate the effectiveness of acupuncture for Katakori. We conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs) and quasi-RCTs on acupuncture for primary Katakori in adults according to the PRISMA 2020 guidelines. We searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Ichushi-Web for relevant articles published up to March 7, 2025. We also explored Evidence Reports of Japanese Acupuncture and Moxibustion, ClinicalTrials.gov, the International Clinical Trials Registry Platform, Japan Primary Registries Network, and our proprietary files. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. The data were synthesized using a random-effects model and are presented as forest plots (PROSPERO: CRD42021254975). Fourteen studies involving 831 participants were included in this review. The certainty of evidence was rated as very low due to the risk of bias and imprecision. Manual acupuncture was not associated with significant improvements in subjective Katakori symptoms relative to sham acupuncture. However, it was more effective than non-penetrating sham acupuncture for improving Katakori at the end of the treatment period (mean difference, −12.89 [95
This study aims to systematically analyze the effects of acupuncture as an adjunctive therapy for minimizing side effects following miscarriage, particularly focusing on pain relief and physical and emotional stability. By reviewing randomized controlled trials, the study seeks to identify effective acupuncture points and standardize their use in post-abortion care. This study systematically reviewed and analyzed randomized controlled trials on the effectiveness of electroacupuncture in managing pain after miscarriage. The review followed PRISMA guidelines, included eight databases, and focused on comparing electroacupuncture to no intervention, analgesics, or combined treatments, with outcomes centered on pain and uterine bleeding. This study reviewed 260 articles on electroacupuncture for post-abortion pain, ultimately including six studies in the qualitative analysis and three in the meta-analysis. The results suggest that electroacupuncture significantly reduces pain compared to no intervention and may be more effective than analgesics, though high heterogeneity in the data requires cautious interpretation. This study demonstrates the effectiveness and safety of electroacupuncture for managing miscarriage side effects, with a need for more diverse and standardized research.
Although canine mesenchymal stem cells (MSCs) derived from the bone marrow, adipose tissue, and umbilical cord share similar characteristics, the invasive nature of obtaining these tissues through surgical procedures can lead to health complications. Electroacupuncture (EA), a non-invasive alternative method, has been successfully used to stimulate MSC mobilization in horses and rats. However, there is limited information on EA in dogs. MSC mobilization was induced in healthy dogs using EA. Specific acupuncture sites, including GV4 + GV6, SP10 + GB39, and SP10 + LR3 were stimulated in four dogs once a week for 3 weeks. Blood samples were collected for peripheral blood stem cell (PBSC) isolation and culture. Peripheral blood stem cells derived following EA (EA-PBSCs) were characterized and compared with adipose-derived MSCs (AD-MSCs). EA-PBSCs adhered to the culture dish surface and exhibited a fibroblast-like morphology similar to that of AD-MSCs. The proliferation rate of EA-PBSCs was substantially lower than that of AD-MSCs (P < 0.05). Flow cytometry indicated that EA-PBSCs expressed CD34 and CD90 but lacked CD44 and MHC II expression. Moreover, EA-PBSCs showed osteogenic and chondrogenic abilities but not adipogenic differentiation. EA-PBSCs and AD-MSCs exhibited downregulation of immunomodulatory genes, such as interleukin-6 (IL-6), IL10, prostaglandin E2 (PGE2), hepatocyte growth factor (HGF), and indoleamine 2,3-dioxygenase (IDO), after priming with interferon-gamma (IFN-γ). This study provides promising preliminary insights into the feasibility of isolating EA-PBSCs in dogs. The distinct immunophenotype observed, CD34⁺ with low CD44 and MHC II, suggests that these cells may represent an earlier progenitor or a tissue-specific stem-like population rather than a typical MSC. Further study with refined isolation methods and more donors will be important to confirm these findings and elucidate the nature of these cells.
Acute liver injury (ALI) is a severe hepatic condition with high mortality and few therapeutic options aside from liver transplantation. Lonicera japonica Flos (LJ), a traditional herbal medicine, has been reported to have anti-inflammatory and hepatoprotective activities; however, the underlying mechanisms remain insufficiently clarified. In this study, an integrative approach was used to investigate the effects of LJ on liver injury by combining network pharmacology, molecular docking, and experimental validation. Computational analyses were used to predict the potential targets and enriched pathways of LJ-derived active compounds on ALI. These predictions were subsequently validated in lipopolysaccharide (LPS) induced ALI murine models and LPS-stimulated HepG2 cells through biochemical assays and histological staining with evaluation of HIF-1α/IL-1β signaling pathway-related molecules. Network pharmacology highlighted that the HIF-1 signaling pathway is closely related to the potential mechanism of LJ on ALI. In silico docking demonstrated that loganin and loganic acid, main components of LJ, have potentially strong binding affinities on HIF-1α. Based on these predicted results, LJ lowered serum AST and ALT, alleviated histopathological injury, and suppressed hepatic TNF-α, IL-6, and IL-1β expression in LPS-induced ALI mice. In HepG2 cells, LJ inhibited cleaved IL-1β and HIF-1α protein expression without cytotoxicity in response to LPS, thereby dampening multiple inflammatory cascades. Overall, LJ exerts hepatoprotective effects against LPS-induced ALI by targeting several interconnected pathways. These findings support LJ as a potential therapeutic candidate for inflammatory liver disease and demonstrate the value of combining computational prediction with experimental confirmation to investigate traditional herbal medicines.
Medical Education Units (MEUs) provide centralized management of curriculum development, faculty training, assessment, and quality assurance. In Korean Medicine schools, MEUs have been established per accreditation standards to support curriculum planning, quality improvement, and innovative pedagogy. However, challenges persist in governance, personnel, funding, and balancing research and service functions, with stakeholder perceptions varying by background and role, highlighting the need for systematic empirical investigation. An exploratory cross-sectional survey was conducted among faculty from 12 Korean medicine institutions. Participants rated education unit roles, prioritized tasks across necessity, urgency, and importance, and evaluated operational barriers and support needs. Data were analyzed using descriptive statistics, Plackett–Luce ranking models, and group comparisons (t tests, ANOVA, Mann–Whitney U, and Kruskal–Wallis). Eighty-two faculty from 12 Korean medicine institutions participated. Curriculum management and quality improvement were rated as top priorities, while student assessment consistently ranked lowest. Significant between-field differences emerged in curriculum management, faculty development, and program evaluation perceptions. Personnel shortages, lack of interest, and limited awareness were identified as major operational barriers. Support needs prioritized personnel and budget, whereas feasibility favored budget and policy support, highlighting a mismatch between most-needed resources and those most attainable for education unit operations. Korean medicine education units play a central role in curriculum management and quality improvement, yet operational effectiveness is constrained by personnel shortages and resource misalignment. Targeted support for staffing and strategic resource allocation is essential to enhance their functional capacity and fulfill accreditation-driven educational objectives. Not applicable (not a human interventional study).
To explore the difference between thumb and middle finger measurements and proportional bone measurements and identify the applicable parts of thumb and middle finger measurements in each part of the body. A total of 394 healthy adults were enrolled. A high-precision electronic ruler was used to measure the lengths of their thumb and middle finger cun and the lengths of their bone proportional cun of the head–face, limbs, and trunk. The lengths of bone proportional cun were converted into a “1 cun”, which were compared with the lengths of the thumb and middle finger cun. The thumb and middle finger cun are both commonly said to be “1 cun” in length, but actual measurements revealed that the middle finger cun is significantly longer than that of the thumb cun (P < 0.001). The thumb cun is generally significantly shorter than that of the bone proportional cun (q < 0.001). However, there was no significant difference in the length of the thumb cun compared with the length of the bone proportional cun after conversion to “1 cun” at the cubital crease (olecranon) to the most distal palmar (dorsal) wrist crease, upper edge of the pubic symphysis to the base of the patella, and greater trochanter of the femur to the popliteal crease (q > 0.05). The middle finger cun is generally significantly longer than the bone proportional cun (q < 0.05 or q < 0.001). However, there was no significant difference in the length of the middle finger cun compared with the length of the bone proportional cun after conversion to “1 cun” at the suprasternal fossa (Tiantu, CV22) to the xiphisternal junction, underneath the medial tibial condyle (Yinlingquan, SP9) to the prominence of the medial malleolus, gluteal fold to the popliteal crease, popliteal crease (apex of the patella) to the prominence of the lateral malleolus, and prominence of the medial malleolus to the plantar (q > 0.05). The middle finger cun is significantly longer than that of the thumb cun. The compatibility of finger cun measurements with the proportional bone standard varies by anatomical region. These findings provide an anthropometric basis for optimizing the selection of acupoint location methods in teaching and standardization. For educational purposes and in standard-body-type individuals, our data suggest that the thumb measurement might be prioritized in regions such as the head, face, and forearm, while the middle finger measurement may be more appropriate for areas such as the upper arm and lower leg, thereby balancing operational convenience with acupoint localization accuracy.
Despite the increasing emphasis on the moral character of healthcare professionals, there remains a lack of consensus on the conceptual framework of education in medical humanities and social medicine (MHSM). The framework of health systems science (HSS), which involves four foundational domains and seven core functional domains, aims to strengthen the professional competence and social responsibility of Korean medicine education. On the basis of the HSS framework, this study aims to develop competencies in Korean medicine education for MHSM. A total of 20 experts related to Korean medicine participated in three rounds of the Delphi study and the Nominal Group Technique (NGT). The experts were basic Korean medicine professors, clinical Korean medicine professors, experts in Korean medicine education, and primary care clinicians. In Round 1, the experts answered the survey about competencies on the basis of the HSS framework. In Rounds 2 and 3, the experts rated their agreement with the competencies revised in the previous rounds. In the NGT, the competencies that had not reached a consensus in the Delphi study were subsequently reviewed by four experts, one from each category. In Round 1, five HSS domains and 11 competencies did not meet the content validity criteria. The domain names and the meaning of the domains were revised after the feedback from the expert panels was reviewed. Consensus was not achieved for three HSS domains and eight competencies in Round 2 or three HSS domains and four competencies in Round 3. After the NGT, four competencies were updated to reach a consensus on finalizing 28 final competencies. This study introduces 28 final competencies to cultivate literacy in MHSM. These final competencies are specifically set for the Foundational Domains and Core Functional Domains in the HSS framework. This study is expected to provide a basis for future research on MHSM in Korean medicine education.
While conventional pharmacologic antiemetics have recognized limitations, the evidence regarding acupuncture-assisted anesthesia (AAA) for preventing postoperative nausea and vomiting (PONV) remains inconsistent. This study specifically evaluates AAA as a standardized perioperative protocol rather than isolated acupuncture interventions, aiming to quantitatively assess its efficacy in PONV prevention. Major databases were systematically searched for all relevant studies published up to March 2025. Only trials implementing AAA as a structured component of anesthesia management were included. The meta-analysis was conducted using RevMan 5.3 software. A total of seven randomised controlled clinical trials with 775 patients were included, 389 in the AAA group and 386 in the control group. Acupuncture-assisted anesthesia reduced the incidence of postoperative nausea and vomiting (RR = 0.29, 95
