Importance:Connectome-based predictive modeling (CPM) uses a data-driven whole-brain framework to identify connectivity patterns predicting clinical outcomes. However, CPM's application to acupuncture in migraine without aura (MWOA) remains novel. Objective:To evaluate the clinical efficacy of real acupuncture and sham acupuncture in MWOA, and to identify acupuncture-response brain connectivity patterns using CPM analysis of baseline functional magnetic resonance imaging (fMRI) data. Design, Setting, and Participants:This single-blinded randomized clinical trial was conducted from June 2021 to June 2023 at Beijing Hospital of Traditional Chinese Medicine in China. It enrolled participants aged 18 to 65 years who met the MWOA criteria of the International Classification of Headache Disorders, 3rd edition. Eligible participants were randomly assigned to receive real acupuncture or sham acupuncture, and underwent baseline clinical assessments and baseline fMRI scans. Data analyses were performed between October 2024 and March 2025 following intention-to-treat and per-protocol principles. Interventions:Both treatment groups received 12 sessions of 30-minute acupuncture over 4 weeks. Real acupuncture involved 8 acupoints with deqi sensation, while sham acupuncture used sham acupoints without deqi. Main Outcomes and Measures:Primary outcome was the change from baseline in monthly migraine days (MMDs) during weeks 1 to 4. Secondary outcomes included 50% or greater reduction in MMDs and change from baseline in monthly headache days (MHDs), acute medication use days, pain score (visual analog scale [VAS] score range: 0 [indicating no pain] to 10 [indicating severe pain]), disability score (6-item Headache Impact Test [HIT-6] score range: 36 to 78, with the higher scores indicating severe headache effect), and quality-of-life score (Migraine-Specific Quality of Life Questionnaire [MSQ] score range: 0 to 100, with the higher scores indicating superior quality of life) during 4 weeks. Neuroimaging analyses used fMRI data to predict outcome changes via CPM. Results:Among the 120 participants (mean [SD] age, 36.8 [10.0] years; 95 females [79.2%]), 60 were randomly assigned to real acupuncture and 60 to sham acupuncture. The change from baseline in MMDs significantly improved for the real acupuncture group compared with the sham acupuncture group (median difference, -1.0; 95% CI, -2.0 to 0; P = .02). Significant differences were also observed in MHDs (median difference, -1.0; 95% CI, -2.0 to 0; P = .01), acute medication use days (median difference, -1.0; 95% CI, -2.0 to 0; P = .02), VAS score (median difference, -1.0; 95% CI, -1.0 to 0; P = .02), HIT-6 score (mean difference, -2.9; 95% CI, -5.4 to -0.5; P = .02), and MSQ score (Role Function-Restrictive domain: median difference, 8.6; 95% CI, 3.7-14.3; P < .001; Role Function-Preventive domain: median difference, 5.0; 95% CI, 0-10.0; P = .02; Emotional Function domain: median difference, 6.7; 95% CI, 0-13.3; P = .001). CPM revealed distinct neural signatures: negative connectivity predicted VAS score reduction (r = 0.23, P = .04) and positive connectivity predicted HIT-6 score improvement (r = 0.29, P = .02). Feature selection identified robust networks (12 connections for VAS score; 120 for HIT-6 score), in which default mode network and subcortical-cerebellum (DMN-SC) hypoconnectivity and SC-motor hyperconnectivity were identified as key connectivity patterns in predictive models of VAS and HIT-6 scores, respectively. Conclusions and Relevance:This trial demonstrated acupuncture's efficacy for MWOA pain relief and functional improvement. CPM identified DMN-SC hypoconnectivity as predicting pain relief and SC-motor hyperconnectivity as predicting reduced disability, providing a personalized treatment framework. Trial Registration:Chinese Clinical Trial Registry Identifier: ChiCTR2100044251.

This study explored the mechanism of matrine-induced apoptosis in human retinoblastoma (RB) cell. Network pharmacology and proteomics approaches were employed to screen the intersection between the pharmacodynamic targets of matrine and the pathogenic targets of RB, and to identify the key signaling pathways underlying the anti-RB effect of matrine. Cytological experiments were used to evaluate cell proliferation, apoptosis, and the expression of PI3K/AKT pathway and apoptosis-related proteins. Results showed matrine inhibited Y79 and WERI-Rb-1 cell growth time- and dose-dependently, suppressed migration, and induced apoptosis. Integrated omics analysis identified Nuclear Receptor Subfamily 1 Group D Member 2 (NR1D2) as a primary responsive target. Matrine markedly downregulated NR1D2 expression at both the mRNA and protein levels. Matrine treatment and NR1D2 interference significantly promoted apoptosis (P < 0.05), while NR1D2 overexpression antagonized the pro-apoptotic effect of matrine. Total PI3K and AKT levels were unchanged, but their phosphorylated forms were altered; matrine-induced apoptosis correlated with Bax, Cleaved Caspase-3 upregulation and Bcl-2 downregulation. Thus, matrine inhibits RB Y79 cell growth by downregulating NR1D2, inhibiting PI3K/AKT phosphorylation and inducing RB cell apoptosis.

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease that causes significant pain, functional impairment, and reduced quality of life, particularly among the aging population worldwide. While Traditional Chinese Medicine (TCM) has been widely used in clinical practice for KOA management, there has been a lack of systematic, data-driven synthesis to map the global research trends, key contributors, and core themes in this area. This study conducts a comprehensive bibliometric analysis to map the research landscape, identify trends, and forecast future directions in the application of TCM for KOA. Articles published between 2005 and 2025 were retrieved from the Web of Science Core Collection. A total of 339 relevant publications were analyzed using VOSviewer, CiteSpace, and the Bibliometric R package to assess contributions and trends related to countries, institutions, journals, authors, references, and keywords. Our study elucidates the global research landscape of TCM for KOA. Findings indicate a rapidly growing trend in publications, with China as the predominant contributor, although international collaboration remains limited. Leading contributors include authors Wang Peimin and Liu Jun, the Journal of Ethnopharmacology (publication volume), and Osteoarthritis & Cartilage .(citation impact). Research focuses on herbs such as ginger and peony, as well as on formulas such as Duhuo Jisheng Decoction. Emerging methodologies such as network pharmacology and molecular docking are clarifying the mechanisms of TCM, with future trends pointing to inflammation, oxidative stress, and apoptosis. This study provides valuable insights to guide future research and advance the modernization of TCM for KOA.

Chronic migraine is characterized by persistent trigeminal sensitization and neuroinflammation. however, the molecular mechanisms underlying its maintenance and mediate the therapeutic effects of acupuncture remian incompletely understood. A chronic migraine–like state was induced in mice by repeated dural inflammatory soup (IS), followed by electroacupuncture (EA). Behavioral hypersensitivity was assessed, and molecular changes in the spinal trigeminal nucleus caudalis (Sp5C) were analyzed using transcriptomic, biochemical, and functional approaches. Repeated inflammatory stimulation markedly increased CXCL13 and CXCR5 expression and ERK phosphorylation in the Sp5C, accompanied by mechanical allodynia, thermal hyperalgesia, glial activation, and elevated IL-6 and CCL2 levels. EA significantly attenuated pain hypersensitivity and reduced CXCL13/CXCR5 expression, ERK activation, glial reactivity, and inflammatory mediator release. EA also decreased migraine-related neuropeptides and synaptic plasticity markers, including substance P, PACAP, and NR2B. Functional manipulation experiments demonstrated bidirectional regulation of pain behaviors by CXCR5, establishing its causal role in chronic migraine–like sensitization. MicroRNA profiling identified a dysregulated miRNA signature converging on the transcription factor FOXO3, which indirectly regulated CXCR5 transcription, defining a miRNA–FOXO3–CXCR5 regulatory pathway. Our study reveals the CXCL13/CXCR5/ERK axis as a previously unrecognized pathway in migraine neuroinflammation and demonstrates electroacupuncture's multimodal therapeutic mechanisms. These findings provide: (1) novel mechanistic insights into migraine pathophysiology through CXCR5-mediated signaling, and (2) translational implications for chronic migraine treatment by targeting the CXCL13/CXCR5/ERK axis. This work establishes a foundation for future development of targeted therapies and validates electroacupuncture as a viable intervention for migraine management.

Purpose:Knee osteoarthritis (KOA) is a prevalent degenerative disease impacting bone and joint health. Clinical studies indicate that fire needling acupuncture can alleviate joint stiffness, pain, and dysfunction in KOA. Previous research demonstrated its efficacy in reducing pain, mitigating cartilage damage, and regulating macrophage polarization, but its effects on subchondral bone remain unclear. This study aimed to evaluate the therapeutic effects of fire needling acupuncture on subchondral bone in KOA. Methods:Sprague-Dawley rats were divided into three groups: control (CON), monosodium iodoacetate (MIA), and fire needling acupuncture (FNA) (n=6 per group). A KOA model was established using 0.3 mg/50 µL MIA, followed by acupuncture at acupoints SP10, ST34, ST35, EX-LE5, and ST36 twice weekly. Evaluations included body weight, joint diameter, weight distribution, and mechanical withdrawal threshold. Micro-CT imaging assessed tibial plateau bone mass changes. Histological evaluations used HE, Safranin O/Fast Green, and toluidine blue staining. Immunohistochemistry examined COL2, MMP9, and MMP13 expression, while macrophage polarization was analyzed using immunofluorescence for F4/80, iNOS, and Arg-1. TRAP staining assessed osteoclast activity, and immunofluorescence for CD31/Emcn and VEGF evaluated angiogenesis in subchondral bone. Results:Fire needling acupuncture significantly improved weight distribution and mechanical withdrawal thresholds, reduced synovial inflammation and abnormal changes in subchondral bone, and preserved cartilage integrity in MIA-induced KOA rats. Notably, F4/80 and iNOS expression levels decreased, while Arg-1 expression increased after treatment. Additionally, TRAP, CD31/Emcn, and VEGF expression in subchondral bone decreased following fire needling acupuncture. Conclusion:Fire needling acupuncture mitigates pain behavior, synovial inflammation, cartilage degradation, and abnormal changes in subchondral bone in MIA-induced KOA rats. The therapeutic mechanism may involve modulation of synovial macrophage polarization and subchondral bone angiogenesis. Further research is warranted to elucidate the precise molecular pathways and the interaction between macrophage polarization and angiogenesis.

BACKGROUND AND PURPOSE:Resting-state functional MRI has revealed abnormal brain activity in patients with migraine, though findings have been inconsistent. This meta-analysis utilized Seed-based d Mapping to assess variations in amplitude of low-frequency fluctuations (ALFF) and fractional amplitude of low-frequency fluctuations (fALFF). The aim was to identify common brain regions with altered spontaneous brain activity in migraine patients. METHODS:A systematic search was conducted in PubMed, Web of Science, and Embase for studies published up to August 2023, comparing spontaneous low-frequency brain activity between migraine patients and healthy controls (HCs). Jackknife sensitivity, heterogeneity, publication bias, and meta-regression analyses were performed to ensure the robustness and reliability of our findings. RESULTS:Nine studies, including 708 migraine patients and HCs, were included in the analysis. Applying a highly conservative family-wise error rate correction, no significant findings were observed. However, when a less conservative threshold was used, migraine patients exhibited increased ALFF/fALFF in the left anterior thalamus and the corticospinal tract but showed decreased values in the right middle frontal gyrus. Jackknife sensitivity analysis confirmed the reproducibility of these results, while heterogeneity analysis revealed significant variability across studies, likely due to differences in study design and patient populations. CONCLUSIONS:This meta-analysis provides a comprehensive synthesis of neuroimaging evidence, linking migraine to abnormal spontaneous brain activity in regions associated with pain processing and nociceptive emotional modulation. These findings enhance our understanding of migraine pathophysiology and highlight potential targets for neuromodulation therapies, offering new directions for future research and clinical interventions.

BackgroundUterine broad ligament fibroids present unique surgical challenges due to their proximity to vital pelvic structures. This study aimed to evaluate artificial intelligence (AI)-guided MRI instance segmentation for optimizing laparoscopic myomectomy outcomes.MethodsIn this trial, 120 patients with MRI-confirmed broad ligament fibroids were allocated to either AI-assisted group (n=60) or conventional MRI group (n=60). A deep learning model was developed to segment fibroids, uterine walls, and uterine cavity from preoperative MRI.ResultCompared to conventional MRI guidance, AI assistance significantly reduced operative time (118 [112.25-125.00] vs. 140 [115.75-160.75] minutes; p<0.001). The AI group also demonstrated lower intraoperative blood loss (50 [50-100] vs. 85 [50-100] ml; p=0.01) and faster postoperative recovery (first flatus within 24 hours: (15[25.00%] vs. 29[48.33%], p=0.01).ConclusionThis multidisciplinary AI system enhances surgical precision through millimeter-level anatomical delineation, demonstrating transformative potential for complex gynecologic oncology procedures. Clinical adoption of this approach could reduce intraoperative blood loss and iatrogenic complications, thereby promoting postoperative recovery.

BackgroundObesity has emerged as a major global public health challenge and poses a significant threat to human health. Despite extensive research, the mechanisms underlying its pathological progression remain elusive.AimTo systematically identify pivotal targets and underlying mechanisms affecting the pathological progression of obesity through integrated strategies.MethodsTranscriptomic and single-cell RNA sequencing (scRNA-seq) datasets were downloaded from the Gene Expression Omnibus (GEO) database. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were performed to identify obesity-associated genes. Moreover, functional enrichment analysis was conducted to elucidate potential mechanisms, and immune cell infiltration was assessed using the CIBERSORT algorithm. Then, macrophage-related genes were screened and subjected to degree centrality assessment, Least Absolute Shrinkage and Selection Operator (LASSO) regression, and random forest to identify hub genes. Furthermore, scRNA-seq was employed to systematically characterize key cell types and their gene expression profiles in the context of obesity. Finally, immunofluorescence (IF) and ELISA techniques were used to validate the expression of specific genes in the adipose tissue of obese mice.ResultsA total of 535 differentially expressed genes (DEGs) were identified, highlighting their significant role in the modulation of immune responses and inflammation. WGCNA was conducted to identify gene modules strongly correlated with obesity, and integration with differential expression analysis yielded 425 co-expressed DEGs. Pathway enrichment and immune cell infiltration analyses revealed that these genes were closely associated with the expression of macrophages. A total of 81 macrophage-related genes were further screened, and through protein-protein interaction (PPI) analysis combined with two machine learning algorithms, two hub genes (TREM2 and CXCR4) were ultimately identified. The Human Protein Atlas database and single-cell transcriptome analyses validated that TREM2 is specifically expressed in macrophages. Lastly, animal experiments verified the expression pattern of TREM2 in the adipose tissue of obese mouse models.ConclusionThis study identified TREM2 as a key effector in the regulation of obesity-related pathophysiological processes, with specific expression in macrophages. These findings collectively position TREM2 as a potential diagnostic biomarker for obesity.

This study aims to investigate the molecular mechanisms underlying the therapeutic effects of fire needling acupuncture (FNA) in alleviating knee osteoarthritis (KOA) symptoms, focusing on the SDF-1/CXCR4 signaling pathway and macrophage polarization. A KOA mouse model was established using anterior cruciate ligament transection and destabilization of the medial meniscus (ACLT + DMM) surgery. After four weeks, FNA was administered twice weekly for another four weeks. Pain behavior was assessed via weight-bearing and mechanical withdrawal thresholds. Micro-CT, histological staining, immunohistochemistry, and immunofluorescence were utilized to evaluate cartilage and subchondral bone changes, along with relevant markers. Synovial inflammation and macrophage polarization were analyzed, specifically targeting the SDF-1/CXCR4 pathway. The effects of CXCR4 modulation were assessed using AMD3100 (antagonist) and ATI-2341 (agonist). FNA treatment improved joint function, reduced pain, alleviated synovial inflammation, and mitigated subchondral bone changes. It decreased cartilage damage while upregulating COL2 and SOX9, and downregulating MMP13. The SDF-1/CXCR4 pathway was activated, leading to a shift in macrophage polarization characterized by reduced pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) and increased anti-inflammatory cytokine IL-10. M0 macrophage marker F4/80 and M1 marker CD86 were downregulated, whereas M2 marker CD206 was upregulated. The ATI-2341 group exhibited therapeutic effects similar to FNA, while the AMD3100 and AMD3100 + FNA groups showed reduced efficacy. FNA alleviates KOA by activating the SDF-1/CXCR4 pathway, modulating macrophage polarization, and reducing cartilage damage and inflammation. These findings highlight the therapeutic potential of FNA in the management of KOA.

BACKGROUND:Insomnia causes severe health problems and poor quality of life in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis (MHD). Conventional therapies are limited due to the poor availability and opaque evidence, and electroacupuncture (EA) is considered an alternative for improving insomnia in patients with ESRD undergoing MHD. METHODS:This is a study protocol for a pilot randomized, sham-controlled, single-center, clinical trial. A total of 60 patients with insomnia in ESRD undergoing MHD will be randomly assigned to treatment group (EA, 3 sessions per week for 4 weeks), or sham group (sham EA, 3 sessions per week for 4 weeks) in a 1:1 ratio. Participants will complete the trial by visiting the research center at Week 8 for a follow-up assessment. The primary outcome is the response rate: the proportion of patients achieving a minimal clinically important difference, which is defined as ≥7 points on insomnia severity index (ISI) at Week 4 compared with baseline. Secondary outcomes include sleep diary, ISI, pittsburgh sleep quality index (PSQI), short form health survey-12 (SF-12), fatigue severity scale (FSS), 24-Hour ambulatory blood pressure, and plasma levels of C-reactive protein (CRP) and D-Dimer. DISCUSSION:This is the first standardized protocol investigating the efficacy and safety of EA for patients with ESRD undergoing MHD. This trial may provide evidence for clinical application of EA for patients with ESRD undergoing MHD. TRIAL REGISTRATION:Chinese Clinical Trial Registry (registered number: ChiCTR2300071814).

Knee osteoarthritis (KOA) is a chronic disease with a high prevalence and disability rate. Alterations in lower limb alignment and reduction in lower limb muscle strength are important factors in the progression of KOA. Although pain is the main reason for KOA patients to seek medical treatment, the presence or absence of joint deformity is one of the crucial factors influencing the prognosis and recurrence of the disease. Approximately half of KOA patients may become disabled due to the development of joint deformity. To investigate the prevalence, characteristics, and influencing factors of knee flexion contracture in patients with KOA, providing a basis for preventing and delaying the occurrence of knee joint deformities in such patients. From January 2022 to June 2022, a survey was conducted on 870 patients with KOA visiting 7 community hospitals. Patients whose knees could fully extend to 0° were categorized as the none flexion contracture (NFC) Group, while those whose knees could not fully extend to 0° were categorized as the flexion contracture (FC) Group. Data were collected on patients’ demographic characteristics, work and lifestyle habits, dietary preferences, and clinical evaluations. Compare the results of the two groups, and perform a Logistic regression analysis on the influencing factors that show differences to identify the risk factors and protective factors for joint deformity. A total of 853 patients with KOA were included in the study, with a questionnaire recovery rate of 98.05%. Among them, 308 patients were in the FC Group, with a prevalence of knee flexion contracture at 36.11%, and 545 patients were in the NFC Group. The risk factors (OR > 1) included being female, older age, higher Body Mass Index (BMI), history of knee trauma, history of osteoporosis, physically demanding occupations, living in high-rise buildings without elevators, squatting posture during defecation, disease duration, and Kellgren-Lawrence (KL) III-IV grade. Protective factors (OR < 1) included commuting by cycling or driving, regular knee exercises, and calcium supplementation. Standing occupational posture, mountain climbing or hiking activities, and KL II grade were not associated with the occurrence of joint deformity (P > 0.05). Among patients with KOA, KL III-IV grade, living in high-rise buildings without elevators, history of knee injury, and squatting posture during defecation were identified as risk factors for knee joint deformity, which should be prevented early to delay joint deformity.

Transcutaneous electrical stimulation equipment is a kind of characteristic therapeutic devices developed on the basis of the integration of traditional Chinese medicine (TCM) theory and modern science and technology, which is widely used in clinical practice. Significant breakthroughs have been made in the development of related devices such as transcutaneous electrical acupoint stimulation (TEAS) devices, transcutaneous electrical nerve stimulation (TENS) devices, and transcutaneous auricular vagus nerve stimulation (taVNS) devices in recent years. Although the market for these devices is vast, there are still limitations that need to be optimized in terms of electrode materials and power supply methods, bulky instrument size, cumbersome wiring, restricted applications, and inadequate intelligent functionality. In the future, it is still necessary to further build upon the theoretical foundation of TCM acupuncture, integrate a variety of modern scientific technologies to advance the intelligence and modernization of acupuncture equipment, and thereby improving its capabilities to support clinical practice and research.

Osteoarthritis (OA) is a prevalent chronic disease, characterized by progressive joint degeneration and primarily affects older adults. OA leads to reduced functional abilities, a lower quality of life, and an increased mortality rate. Currently, effective treatment options for OA are lacking. Non-coding RNAs (ncRNAs) are functional RNAs transcribed from DNA but not translated into proteins. Among ncRNAs, small interfering RNAs (siRNAs), transfer RNAs (tRNAs), and ribosomal RNAs (rRNAs) have become significant in the field, which is intricately linked to the progression of OA and perform significant regulatory functions in transcription, post-transcription, and post-translation, making them potential biological targets for the prevention, diagnosis, and treatment of OA. This review summarizes the general functions of siRNAs, tRNAs, and rRNAs and their application in OA. The primary focus has been on regulating cartilage degradation. Other participations include regulating synovium, protecting anterior cruciate ligament cells, and diagnosis. No clinical trials were found as challenges such as effective delivery systems, immune responses, long-term effects, and interactions between therapies need to be demonstrated first.

To comprehensively summarize the clinical and pathological characteristics of primary orbital neoplastic lesions with communication, thereby providing a solid basis for the diagnosis and treatment of such conditions. A retrospective analysis of clinical cases was conducted. The clinical and pathological data of 862 patients diagnosed with primary orbital neoplasms with communication, including orbito-cranial, orbito-nasal, and orbito-crano-nasal communicating tumors, were collected. The data covered gender distribution, age at onset, presenting symptoms and signs, imaging findings, and treatment modalities. These data were systematically summarized according to pathological diagnoses. Among all primary orbito-related communication neoplasms, meningioma was identified as the most common benign tumor (11.0

Migraine is a complex neurological disorder with significant clinical variability, posing challenges for effective management. Multiple treatments are available for migraine, but individual responses vary widely, making accurate prediction crucial for personalized care. This study aims to examine the use of statistical and machine learning models to predict treatment response in migraine patients. A systematic review and meta-analysis were conducted to assess the performance and quality of predictive models for migraine treatment response. Relevant studies were identified from databases such as PubMed, Cochrane Register of Controlled Trials, Embase, and Web of Science, up to 30th of November 2024. The risk of bias was evaluated using the PROBAST tool, and adherence to reporting standards was assessed with the TRIPOD + AI checklist. After screening 1,927 documents, ten studies met the inclusion criteria, and six were included in a quantitative synthesis. Key data extracted included sample characteristics, intervention types, response outcomes, modeling methods, and predictive performance metrics. A pooled analysis of the area under the curve (AUC) yielded a value of 0.86 (95

Objective:To explore the efficacy differences among different acupuncture frequencies for pain of temporomandibular disorders (TMD). Methods:A total of 42 patients with TMD pain were randomly divided into a low-frequency group, a medium-frequency group, and a high-frequency group, with 14 patients in each group. All groups received acupuncture treatment at bilateral Hegu (LI4) and Yanglingquan (GB34), as well as ipsilateral Tinggong (SI19), Jiache (ST6), and Xiaguan (ST7), with each session lasting 30 minutes. The low-frequency group received acupuncture once per week, the medium-frequency group received acupuncture twice per week, and the high-frequency group received acupuncture three times per week, for a total duration of four weeks. The graded chronic pain scale (GCPS) score, visual analogue scale (VAS) score, jaw functional limitation scale-20 (JFLS-20) score, and pressure pain threshold (PPT) were assessed in the three groups before and after treatment, as well as at the four-week follow-up after treatment completion. Results:Compared before treatment, GCPS and JFLS-20 scores were significantly decreased in all the groups after treatment (P<0.05), and VAS scores were significantly decreased in the high-frequency and medium-frequency groups (P<0.05), PPT values at different measurement sites were increased significantly in the high-frequency group (P<0.05). After treatment, GCPS, JFLS-20, and VAS scores in the high-frequency group were lower than those in the medium-frequency and low-frequency groups (P<0.05), while some PPT values were higher than the other two groups (P<0.05). At follow-up, GCPS, JFLS-20, and VAS scores remained significantly lower in all the groups compared to baseline (P<0.05), PPT values were increased significantly in the high-frequency and medium-frequency groups (P<0.05), with the high-frequency group showing lower GCPS, JFLS-20, and VAS scores and higher PPT values compared to the other two groups (P<0.05). Conclusion:Acupuncture three times per week is more effective in reducing TMD pain intensity compared to once or twice per week, and can also alleviate some mandibular functional impairments. The therapeutic effects persist for at least four weeks after treatment completion.

Dopamine receptor agonist (DA)-resistant prolactinoma presents a significant clinical challenge, highlighting the need for novel therapeutic strategies. Deguelin is a rotenoid compound derived from several plant species with unique antitumor effects. In this study we investigated the efficacy of deguelin on DA-resistant prolactinoma and elucidated its antitumor mechanisms. We showed that deguelin concentration-dependently inhibited cell viability, proliferation and prolactin secretion, and promoted apoptosis and cell cycle arrest in two prolactinoma tumor cell lines GH3 and MMQ. In CCK-8 assay, the IC50 values of deguelin for GH3 and MMQ were 0.1518 and 0.2381 µM, respectively. Network pharmacology analysis predicted that ornithine decarboxylase (ODC), a rate-limiting enzyme in the de novo synthesis of polyamine and responsible for converting ornithine into putrescine, was the target of deguelin. We demonstrated that deguelin directly interacted with ODC, competitively inhibiting putrescine production, and thereby reducing the levels of active Rac1. Transcriptomic analysis of deguelin-treated GH3 cells identified the PI3K/AKT signaling pathway as a crucial mediator of the action of deguelin with the inhibition of CREB3L1 playing a central role. In GH3 xenograft nude mice, administration of deguelin (4 mg/kg, i.p., every other day for two weeks) significantly inhibited tumor growth with significant reduction in both AKT phosphorylation and CREB3L1 levels in deguelin-treated xenografts. These results suggest that deguelin can be considered a therapeutic option for treating DA-resistant prolactinoma and serve as a basis for developing novel treatment approaches.

Background:Temporomandibular disorders(TMD)are the leading cause of chronic orofacial pain,which significantly affects patients' quality of life.However,the efficacy of acupuncture in the management of TMD remains unclear. Objective:This systematic review aimed to conduct a PRISMA-compliant review to critically assess the therapeutic efficacy of acupuncture as an intervention for patients with TMD. Methods:We searched nine electronic databases for randomized controlled trials on acupuncture for TMD published up to February 4,2025.Eligible studies included adults diagnosed with TMD and compared acupuncture(manual,electroacupuncture,warm,auricular,thread-embedding,or laser)with conservative treatment(positive control)or sham acupuncture(negative control).Outcomes included pain intensity,mouth opening,pressure pain threshold,and adverse events.Risk of bias was assessed using ROB 2,and certainty of evidence was evaluated using GRADE.All outcome data were analyzed using RevMan 5.4 software.Low heterogeneity was defined as I2 ≤ 50％and P ≥ 0.1,in which case a fixed-effects model was applied.High heterogeneity(I2＞50％or P＜0.1)prompted further analysis to identify its source.After excluding the influence of evident heterogeneity,a random-effects model was used for the meta-analysis.Results:Of the 2664 screened records,14 randomized controlled trials involving 476 participants met the inclusion criteria.Acupuncture significantly reduced pain intensity compared with that of negative con-trols(MD=-1.75,95％confidence interval[CI]-2.47 to-1.03;P＜0.00001;I2=60％)but showed no difference compared with that of positive controls(MD=-0.06,95％CI-0.62 to 0.50;P=0.83;I2=0％).No significant differences were observed in pain-free jaw opening,whereas acupuncture improved maxi-mum mouth opening relative to negative controls(MD=1.80,95％CI 1.62 to 1.97;P＜0.00001;I2=0％).For pressure pain threshold,two small studies suggested greater increases with acupuncture.Safety data were limited,with only one trial reporting mild adverse events in the acupuncture group. Conclusion:Based on limited evidence,acupuncture appears superior to negative controls in relieving pain associated with TMD but shows no significant advantage over positive controls.The certainty of the evidence for all outcomes,as assessed by GRADE,was low or very low.Therefore,these findings should be interpreted with caution.Future high-quality randomized controlled trials are warranted to further evaluate the role of acupuncture in the management of patients with TMD.

Background:Nocturnal Leg Cramps (NLC) are prevalent in older adults, yet safe and effective non-pharmacological treatments are lacking. Fire Needle Therapy (FNT), a Traditional Chinese Medicine (TCM) technique combining thermal and mechanical stimulation, may address this gap. Methods:This prospective, randomized, participant-and assessor-blind pilot trial will enroll 68 participants (aged 50-75 years) experiencing ≥8 days of NLC monthly. Participants will receive FNT targeting the Ashi points (APs) as treatment or Sham Fire Needle Therapy (SFNT) targeting the non-Ashi points (NAPs) as control twice a week for 4 weeks (1:1 randomization). The primary outcome is the change in the number of days with NLC from baseline (week -4-0) to follow-up (weeks 5-8 and weeks 13-16). Secondary outcomes include pain severity, cramp duration, sleep quality, quality of life, and muscle stiffness assessed via ultrasound Shear Wave Elastography (SWE). Safety and compliance will be systematically monitored, with analysis following the Intention-to-Treat (ITT) principle. Discussion:This trial is the first to evaluate the efficacy of manualized FNT protocols for NLC with innovative blinding design and objective biomechanical assessments. Ethics and Trial Registration:The Research Ethics Committee of the Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University Ethics Committee has approved the study protocol (Approval No. 2024BL02-073-02). This trial was registered at the International Traditional Medicine Clinical Trial Registry (ITMCTR, http://itmctr.ccebtcm.org.cn/). Trial number: ITMCTR2024000325. Registered on August 29, 2024.

Lymphedema, which is characterized by impaired lymphatic drainage leading to tissue swelling, represents a relatively uncommon clinical entity, with an estimated prevalence of <1% being observed in the general population. Although most cases arise from postsurgical complications or filariasis, lymphoma-associated lymphedema remains an exceedingly rare manifestation, with only 19 cases documented in the medical literature prior to the present study. The current study presented a case series of 11 patients with histologically confirmed lymphoma manifesting with lymphedema, which represents the largest single-center report to date. In the present cohort spanning a time period from 2007-2024, patients who initially presented with refractory lymphedema (9 lower extremity cases, 1 upper extremity case and 1 systemic case) subsequently received a diagnosis of lymphoma via comprehensive evaluation, including imaging (100% detection rate on CT/MRI) and histopathology examinations. The median latency from edema onset to lymphoma diagnosis was 7 months (range, 1-24 months), with 72.7% (8 out of 11) of the patients demonstrating B-cell lineage predominance. The present case series underscored the notion that although lymphedema secondary to lymphoma constitutes <0.5% of all secondary lymphedema cases, it warrants consideration in patients with atypical presentations, such as rapid progression (54.5%), systemic symptoms (81.8%) or abnormal tumor markers (66.7%). The present case report findings emphasized the idea that lymphoma should be included in the differential diagnosis of unexplained lymphedema, particularly when accompanied by warning signs such as lymphadenopathy (100% imaging positivity) or hematologic abnormalities (45.5% anemia prevalence).