Yihe Kang,1,2 Quanai Zhang1,21Zhejiang Chinese Medical University Hangzhou Zhejiang People’s Republic of China; 2Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, 310005, People’s Republic of ChinaCorrespondence: Quanai Zhang, Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, 310005, People’s Republic of China, Email bangbukang@gmail.com
Sisi Yan,1,* Xin Wang,2,* Fangfang Pan,1,* Wenqin Ni,3 Ning Luo,4 Gehao Hu,3 Xiaoyi Qin,1 Chaoer Ding,1 Chao Lu,5 Nisang Chen31Department of Rehabilitation Medicine, Linping Campus, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Acupuncture, Hangzhou Linping TCM Hospital, Hangzhou, Zhejiang, People’s Republic of China; 3The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 5Department of Traditional Chinese Medicine, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Nisang Chen, Email 237247256@qq.com Chao Lu, Email luchao2301@163.comIntroduction: Pain is a common symptom among postmenopausal women with osteoporosis and can substantially impair physical function and quality of life. Transcutaneous electrical acupoint stimulation (TEAS) has been increasingly used for pain management; however, evidence regarding its effectiveness in postmenopausal osteoporosis-related pain remains limited. This study aims to evaluate the efficacy and safety of TEAS in this population.Methods and Analysis: This prospective, single-center, participant-and assessor-blinded, randomized, sham-controlled trial will enroll 146 postmenopausal women with osteoporosis-related pain. Participants will be randomly assigned to either the TEAS group or the sham TEAS group in a 1:1 ratio. All participants will receive oral calcitriol soft capsules (0.25 μg/day) for 8 weeks. The TEAS group will receive stimulation at bilateral Pishu (BL20), Shenshu (BL23), Zusanli (ST36), and Sanyinjiao (SP6) once every other day for 8 weeks, while the sham TEAS group will receive identical procedures without therapeutic electrical stimulation. The primary outcome will be the change in visual analogue scale (VAS) score from baseline to week 8. Secondary outcomes will include changes in VAS scores from baseline to weeks 4 and 12, pain responder rate, lumbar spine bone mineral density (BMD), serum osteoprotegerin (OPG), serum calcium, serum neuropeptide Y (NPY), and quality of life assessed using the Short Form-36 (SF-36). Safety outcomes will also be evaluated. Data analysis will follow the intention-to-treat principle.Ethics/Dissemination: The study has been approved by the Medical Ethics Committee of Linping Campus, Second Affiliated Hospital, Zhejiang University School of Medicine (4 June 2026; approval No.2026-011). Findings will be disseminated through peer-reviewed publications and academic conferences.Trial Registration: Registered in the International Traditional Medicine Clinical Trial Registry (ITMCTR) with the registration number ITMCTR2026002224 (https://itmctr.ccebtcm.org.cn/, 31 August 2026).Keywords: transcutaneous electrical acupoint stimulation, TEAS, postmenopausal osteoporosis, PMO, osteoporosis-related pain, study protocol
Mengna Liu,1,* Yao Ning,2,* Haishu Zhao,2 Zhi Liu,2 Yue Zhang,1 Qing Ji,2 Dapeng Gao,2 Kangli Hui,2 Lidong Zhang11Department of Anesthesiology, Jinling Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, 210002, People’s Republic of China; 2Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210002, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lidong Zhang, Department of Anesthesiology, Jinling Clinical Medical College, Nanjing Medical University, No. 305, Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu, 210002, People’s Republic of China, Tel +86-13813830315, Email ldzhang1968@163.com Kangli Hui, Department of Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 305, Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu, 210002, People’s Republic of China, Tel +86-15951899306, Email m15951899306@163.comBackground: This randomized, double-blind, placebo-controlled trial evaluated whether intraoperative subanesthetic-dose esketamine reduces postoperative opioid consumption and improves early recovery outcomes after total hip arthroplasty (THA).Methods: A total of 128 patients was randomized to receive esketamine (Group E, n = 64) or saline (Group C, n = 64). Group E received an intravenous esketamine bolus of 0.25 mg/kg 5 minutes before skin incision, followed by a 0.25 mg/kg/h infusion until skin closure. Group C received an equivalent volume of normal saline using the same regimen. Postoperative analgesia was provided by patient-controlled intravenous analgesia with hydromorphone. The primary outcome was the cumulative hydromorphone consumption during the first 24 h after surgery. Secondary outcomes included 48-h hydromorphone consumption, Numeric Rating Scale (NRS) pain scores, quality of recovery (QoR-15), Athens Insomnia Scale (AIS), mood, and adverse events. Postoperative sleep disturbance (PSD) was assessed as an exploratory outcome.Results: The first 24-h hydromorphone consumption was significantly lower in Group E than in Group C (2.24 [2.08– 2.51] vs 3.20 [2.88– 3.40] mg, P < 0.001). Cumulative hydromorphone consumption over the first 48 h was also lower in Group E (4.40 [4.16– 4.82] vs 5.92 [5.30– 6.23] mg, P < 0.001). Group E had lower NRS scores at 6 and 24 h. On postoperative day 1, Group E exhibited higher QoR-15 scores and lower AIS scores (P < 0.05), and the incidence of PSD was significantly lower in Group E than in Group C (26.6% vs 54.7%, P = 0.001). Adverse event rates did not differ significantly between groups (P > 0.05).Conclusion: Intraoperative subanesthetic-dose esketamine reduced the first 24-h hydromorphone consumption after THA. Findings for the secondary outcomes are exploratory and require confirmation in future studies.Trial Registration: ChiCTR2600116506.Keywords: esketamine, total hip arthroplasty, opioid consumption, postoperative recovery, sleep quality
Qi Wang,1 Xinyu Zhang,1 Dan Wang,2 Yilin Chai,3 Mengyuan Li,4 Mengmeng Sun,4 Long Wang,5 Xinyan Gao,6 Hongfeng Wang71College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 2Department of Endocrinology, Metabolism and Gastroenterology, Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 3College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 4Northeast Asia Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 5Public Experimental Center, Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 6Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 7Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of ChinaCorrespondence: Hongfeng Wang, Changchun University of Chinese Medicine, No. 1035 Boshuo Road, Jingyue National High-tech Industrial Development Zone, Changchun, Jilin, People’s Republic of China, Email wanghf@ccucm.edu.cn Xinyan Gao, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, No. 16 Dongzhimen Nei Nanxiaojie, Dongcheng District, Beijing, People’s Republic of China, Email gaoxy@mail.cintcm.ac.cnBackground: Painful diabetic peripheral neuropathy (PDPN) is a complication of diabetes characterized by neuropathic pain, with metabolic dysfunction and neuroinflammation implicated in its pathophysiology. Although electroacupuncture (EA) may alleviate neuropathic pain, its broader effects in PDPN remain unclear.Methods: PDPN was induced by high-fat feeding and repeated streptozotocin injections. Two independent experiments (n = 10 mice/group) included Control, PDPN, and EA groups; Experiment 2 additionally included EA+capsaicin and EA+vehicle groups. Capsaicin was given after each of the final four EA treatments to examine transient receptor potential vanilloid 1 (TRPV1)-related responses. After model confirmation, PDPN mice were re-randomized into groups and randomly allocated within groups for subsequent analyses. EA was applied at ST36, BL13, BL20, BL23, and SP6. Pain behavior, nerve conduction, histopathology, and inflammatory and metabolic markers were assessed. Additionally, sciatic nerve transcriptomic and untargeted metabolomic data were integrated by pathway-based network analysis.Results: EA improved pain-related behavior and sciatic nerve conduction velocity. On day 75, thermal withdrawal latency (TWL) increased by 5.59 s (95% confidence interval [CI], 4.35– 6.83; Cohen’s d = 4.23) and mechanical withdrawal threshold (MWT) by 0.95 g (95% CI, 0.79– 1.12; Cohen’s d = 5.39) versus PDPN mice. EA also attenuated sciatic nerve pathological and inflammatory changes in PDPN mice, lowered dorsal root ganglion TRPV1 protein levels by 54.2% (n = 3/group), reduced spinal glial-associated inflammatory immunoreactivity, and improved relevant metabolic indicators. Capsaicin partially attenuated several of these EA-associated responses, providing supportive but not definitive evidence for TRPV1 involvement. Multi-omics analyses revealed exploratory associations involving lipid, energy, and redox metabolism.Conclusion: EA reduced pain hypersensitivity and improved nerve function alongside neuroinflammatory and metabolic changes in PDPN mice. And multi-omics findings generate hypotheses about metabolic processes associated with EA treatment, but their causal contributions to analgesia require further investigation.Keywords: electroacupuncture, painful diabetic peripheral neuropathy, neuroinflammation, PPARγ/SCD1, TRPV1, multi-omics
Ali Rahimi,1 Fatemeh Moghadasi,2 Ali Jadidi,3,4 Kaveh Haddadi,5 Behzad Hamedani61Department of Medical-Surgical Nursing, Clinical Research Development Unit, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran; 2Department of Nursing, Arak School of Nursing, Arak University of Medical Sciences, Arak, Iran; 3Department of Community Health Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran; 4Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran; 5Department of Neurosurgery, Clinical Research Development Unit, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran; 6Department of Medical-Surgical Nursing, Arak School of Nursing, Arak University of Medical Sciences, Arak, IranCorrespondence: Behzad Hamedani, Department of Medical-Surgical Nursing, Arak School of Nursing, Arak University of Medical Sciences, Arak, Iran, Tel +98 936 660 3297, Email hamedanibehzad166@yahoo.comIntroduction: Discectomy is associated with preoperative anxiety, alterations in vital signs, and increased postoperative pain. This study aimed to evaluate the effect of Jacobson’s Progressive Muscle Relaxation on anxiety, pain, and preoperative vital-sign measurements in patients scheduled for discectomy.Methods: This randomized clinical trial, conducted in 2025, included 106 patients scheduled for discectomy. Participants were randomly assigned to intervention and control groups using block randomization. The intervention group performed Jacobson’s Progressive Muscle Relaxation Technique twice daily for 15 minutes, starting two days before surgery and continuing for seven days post-surgery. The control group received routine perioperative care without progressive muscle relaxation. Data were collected before and after the intervention using the Spielberger State-Trait Anxiety Inventory, a vital-sign assessment form, and the Visual Analog Scale. Statistical analyses were performed using IBM SPSS Statistics version 27.Results: A total of 106 patients were randomized equally to the intervention and control groups. For the prespecified primary outcome, adjusted post-intervention state anxiety was significantly lower in the intervention group than in the control group (adjusted mean difference = − 12.02, 95% CI − 15.06 to − 8.98; F(1,103)=61.50, P< 0.001, partial η2=0.374). Adjusted post-intervention trait anxiety was also lower in the intervention group (adjusted mean difference = − 7.43, 95% CI − 10.31 to − 4.56; F(1,103)=26.38, P< 0.001, partial η2=0.204). Repeated-measures analysis demonstrated a significant group × time interaction for postoperative pain (P< 0.001). Bonferroni-adjusted between-group comparisons showed significant differences after the evening session on postoperative day 2 (P=0.008) and after both sessions on postoperative day 7 (P< 0.001). After adjustment for baseline values, significant between-group differences were also observed in systolic and diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation (all P≤ 0.012).Conclusion: Jacobson’s Progressive Muscle Relaxation was associated with lower preoperative anxiety, reduced postoperative pain, and significant differences in preoperative vital-sign measurements among patients undergoing discectomy. As state anxiety was the prespecified primary outcome, findings for pain and physiological parameters should be interpreted as secondary outcomes. JPRT may be a useful complementary non-pharmacological nursing intervention during perioperative care, although further multicenter randomized controlled trials are warranted.Keywords: progressive muscle relaxation, discectomy, pain, vital signs, jacobson
