IntroductionDiminished ovarian reserve (DOR) is known to reduce the likelihood of achieving pregnancy or live births in women undergoing in vitro fertilization and embryo transfer (IVF-ET). Acupuncture maybe effective for DOR, but current evidence remains limited and inconclusive.Methods and analysisThis study is a multicenter, randomized, placebo-controlled trial conducted on a large scale. A total of 300 women with DOR preparing for IVF-ET will be randomized 1:1 to acupuncture or placebo acupuncture. Interventions will be administered from the second menstrual cycle preceding the IVF cycle until the day of oocyte retrieval. The primary outcome is the clinical pregnancy rate (CPR) following the first embryo transfer. Secondary outcomes include various IVF-ET indicators, such as the number of follicles ≥ 14 mm, estradiol (E2) levels, and endometrial thickness on the day of human chorionic gonadotropin (hCG) administration; the number of retrieved oocytes, metaphase II (MII) oocytes, and two pronuclei (2PN) fertilizations; as well as the rates of 2PN fertilization, available embryos, high-quality embryos, implantation, cycle cancellation, biochemical pregnancy, pregnancy loss, sustained pregnancy, and live birth. Additionally, ovarian reserve indicators—including antral follicle count (AFC), basal serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and E2, and anti-Müllerian hormone (AMH)—along with scores from the Self-Rating Anxiety Scale (SAS) will also be evaluated.Ethics and disseminationThe trial has been approved by the ethics committees of all participating centers. The results will be disseminated in academic journals.Clinical Trial Registrationhttp://itmctr.ccebtcm.org.cn/, identifier ID: ITMCTR2024000021.

BACKGROUND:Acupuncture therapy provides a complementary and alternative approach to treating major depressive disorder (MDD), but its efficacy and safety have still not been comprehensively assessed. Recently published systematic reviews remain confusing and inconclusive. OBJECTIVE:This systematic review evaluated the efficacy and safety of acupuncture therapy alone or combined with antidepressants for adult patients with mild and moderate MDD. SEARCH STRATEGY:Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Science and Technology Journal Database, PubMed, Embase, and Cochrane Library were searched from their inceptions to March 2025. INCLUSION CRITERIA:Randomized controlled trials that compared acupuncture therapy with antidepressants, or acupuncture therapy plus antidepressants with acupuncture therapy or antidepressants for adult patients with mild and moderate MDD were included. DATA EXTRACTION AND ANALYSIS:Five reviewers independently extracted data from original literature using a standardized form, and the data were verified by two reviewers to ensure accuracy. Statistical meta-analyses, publication bias analyses, and subgroup analyses were performed by using Review Manager 5.3 software. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the certainty of the evidence. RESULTS:A total of 60 eligible studies including 4675 participants were included. Low-certainty evidence showed that compared with antidepressants, acupuncture therapy (standardized mean difference [SMD] = -0.57; 95% confidence interval [CI] = [-0.87, -0.27]; I2 = 86%; P = 0.006) or acupuncture therapy plus antidepressants (SMD = -1.00; 95% CI = [-1.18, -0.81]; I2 = 77%; P < 0.00001) may reduce the severity of depression at the end of treatment. Low-certainty evidence indicated that compared with acupuncture therapy alone, acupuncture therapy plus antidepressants slightly reduced the severity of depression at the end of treatment (SMD = -0.38; 95% CI = [-0.61, -0.14]; I2 = 18%; P = 0.002). Similar results were also found for acupuncture's relief of insomnia. The reported adverse effects of acupuncture therapy were mild and transient. For most of the subgroup analyses, acupuncture type, scale type, and the course of treatment did not show a significant relative effect. CONCLUSION:Acupuncture therapy may provide antidepressant effects and relieve insomnia with mild adverse effects for adult patients with mild and moderate MDD. But the certainty of evidence was very low. More high-quality, well designed, large-scale studies with long-term follow-up are needed in the future. Please cite this article as: Kuang HJ, Yang HS, Feng YX, Tang H, Fan Q, Xu YQ, Cui S, Musil R, Luxenburger H, Zhang YX, Zhao H, Zhang YQ. Efficacy and safety of acupuncture therapies for adult patients with mild and moderate major depressive disorder: A systematic review and meta-analysis. J Integr Med. 2025; 23(5):471-491.

Objective This study aimed to explore the clinical effect of acupuncture therapy for menstruation regulation and pregnancy promotion on thin endometrium in the real world. Design This study is a single-center pragmatic randomized controlled trial blinded to the statisticians. Using the "blockrand" software package, based on the age (>= 35, <35), 37 patients were randomized into an intervention group (19 cases) and a control group (18 cases). After reassignment regarding patient preference, 21 patients were included in the intervention group and 16 in the control group. Setting The trial was executed in the Specialty Outpatient Clinic, Acupuncture-Moxibustion Hospital of China Academy of Chinese Medical Sciences, from March 1, 2019, to September 30, 2020. Participants The study included 37 patients with thin endometrium and without previous acupuncture treatment. Intervention The intervention group was administered acupuncture for menstruation regulation and pregnancy promotion and a small-dose of progynova (2 mg daily), while the control group was administered a large-dose of progynova (4 mg daily). Interventions started from Day 5 of menstruation until the end of ovulation under B-ultrasound monitoring. The intervention lasted for three menstrual cycles. Measurements Primary outcomes were changes in endometrial thickness between baseline and after intervention completion and the difference between the two groups after intervention. The secondary outcomes were endometrial and subendometrial blood flow, serum estradiol levels, menstrual conditions, and adverse reactions. Results (1) Comparison of each indicator before and after intervention completion in the two groups: in the intervention group, the differences were significant in endometrial thickness, menstrual score, estradiol (E2) level in ovulatory period, the pulsatility index (PI) and resistance index (RI) of uterine artery, the ratio of peak systolic velocity to end-diastolic velocity (S/D), the endometrial vascular index (VI), flow index (FI), and vascular flow index (VFI) and volume (P < 0.01). In the control group, significant changes were observed in endometrial thickness, menstrual score, and E2 before and after the intervention (P < 0.05), and no differences were observed in uterine artery PI, RI, S/D and endometrial VI, FI, VFI, and volume (P > 0.05). Compared with the control group, the intervention group showed significant differences in endometrial thickness, menstrual score, E2, uterine artery PI, RI, S/D, and endometrial VI, FI, VFI, and volume after intervention (P < 0.01). No adverse reactions were reported in the intervention group. In contrast, the control group had two cases of nausea and gastrointestinal discomfort after medication, eight cases of breast distention during medication, and one case of breast nodules enlarged by 1 cm after trial completion. Conclusion Acupuncture for menstrual regulation and pregnancy promotion combined with a low dose of estrogen can effectively improve endometrial receptivity in patients with thin endometrium, which may be related to stimulating endogenous hormone secretion, increasing the endometrial thickness and improving blood flow. Trial registration: AMCTR-IPR-19000295. (c) 2025 World Journal of Acupuncture - Moxibustion House. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Objective: To construct a clinical prediction model of acupuncture treatment for diminished ovarian reserve (DOR) based on a machine learning algorithm to provide a clinical prediction of acupuncture for ameliorating pregnancy outcomes in DOR. Methods: We enrolled 377 DOR patients treated with acupuncture and with records of pregnancy outcomes (139 cases of pregnancy and 238 cases failed) exported from the International Patient Registry Platform of Acupuncture-moxibustion (IPRPAM). The predictive variables were determined using Spearman's correlation analysis and feature engineering methods. The model was constructed by adopting logistic regression, na & iuml;ve Bayes, random forest, support vector machine, extreme gradient boosting, the knearest neighbor algorithm, linear discriminant analysis, and neural network methods. The models were validated by the area under the curve (AUC), accuracy (ACC), and importance sequencing, and individual pregnancy prediction was conducted for the best-performing model. Results: The key factors determining pregnancy after acupuncture in patients with DOR were age, luteinizing hormone (LH) level after treatment, follicle-stimulating hormone (FSH) level after treatment, the ratio of FSH to LH (FSH/LH) after treatment, and history of acupuncture treatment. Random forest model ACC was 0.95, F beta was 0.93, Logloss was 0.30, Logloss value was the lowest, the model variables exhibited the highest accuracy and precision. Conclusion: The random forest model for the effects of acupuncture on pregnancy outcomes in patients with DOR, constructed based on the IPRPAM, presents a favorable value for clinical application. Trial registration: Registration number in the Chinese Clinical Trial Registry Center: ChiCTR220 0 062293. (c) 2025 World Journal of Acupuncture - Moxibustion House. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

目的:系统评价行体外受精-胚胎移植过程中针灸对卵巢低反应(POR)患者妊娠结局和卵巢功能有效性的疗效.方法:计算机检索国家知识基础设施数据库(CNKI)、中文科技期刊数据库(CCD)、中国生物医学文献数据库(CBM)、中国学术期刊数据库(CSPD)、PubMed、Cochrane Library数据库,检索针灸治疗POR的随机对照试验(RCT),检索时限为建库至2021年8月31日.采用RevMan 5.4软件对纳入研究进行偏倚风险评价和数据分析,并进行GRADE证据质量评价.结果:共纳入8个RCT,包括537例患者.Meta分析结果显示:与体外受精-胚胎移植(IVF-ET)组比较,针灸+IVF-ET组可提高POR患者临床妊娠率(RR=1.58,95％CI为1.03～2.42,P=0.04),增加获卵数(MD=1.16,95％CI为0.47～1.85,P=0.001)和窦卵泡数(MD=0.93,95％CI为0.06～1.8,P=0.04),降低促卵泡素(FSH)水平(SMD=-0.29,95％CI为-0.50～-0.08,P=0.007),但2组在提高受精率、优胚率、降低促黄体素(LH)水平、提高抗米勒管激素(AMH)水平、降低促性腺激素(Gn)用量上差异均无统计学意义.结论:现有证据表明,针灸可提高接受IVF-ET助孕的POR患者临床妊娠率,增加获卵数和窦卵泡数,降低POR患者的FSH水平.由于纳入研究数量较少且存在一定的偏倚风险,本研究结论后续仍需要高质量研究进行验证.

目的 基于中国临床试验注册中心(ChiCTR)和美国临床试验注册中心(ClinicalTrials.gov)数据库,分析中医药治疗卵巢功能减退性疾病研究注册现状和不足,为今后相关临床试验注册和开展提供参考.方法 系统检索ChiCTR和ClinicalTrials.gov建库至2021年12月22日收录的中医药治疗卵巢功能减退性疾病注册临床试验,由专人进行试验筛选和数据提取,采用Excel2019录入数据并进行统计分析.结果 最终纳入41项中医药治疗卵巢功能减退性疾病注册临床试验,其中卵巢储备功能减退研究17项、早发性卵巢功能不全研究24项.注册地域涉及8个省级行政区,其中注册项数最多的是北京市和广东省,共占43.9％(18/41).经费资助来源主要为地方财政.注册试验以干预性研究为主(38/41,92.7％),研究设计以随机平行对照试验为主(32/41,78.0％).干预措施多为单纯针刺和中成药,结局指标以疗效指标为主,方法学质量有待提升.结论 中医药治疗卵巢功能障碍临床试验注册数量呈逐年上升趋势,但整体数量仍偏少.目前研究在注册细节和研究方案方面仍需优化,注册质量有待提升.

Aims:This study aimed to evaluate the effects of hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) on iron metabolism and inflammation in dialysis-dependent chronic kidney disease (DD-CKD) patients. Methods:PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov websites were searched for randomized controlled trials (RCTs) investigating HIF-PHIs versus ESAs for DD-CKD patients. Key findings:Twenty studies with 14,737 participants were included in the meta-analysis, which demonstrated no significant difference in the effect of transferrin saturation and ferritin between HIF-PHIs and the ESAs group (MD, 0.65; 95%CI, -0.45 to 1.75; very low certainty; SMD, -0.03; 95% CI, -0.13 to 0.07; low certainty). However, HIF-PHIs significantly increased the iron (MD, 2.30; 95% CI, 1.40 to 3.20; low certainty), total iron-binding capacity (SMD, 0.82; 95% CI, 0.66 to 0.98; low certainty), and transferrin (SMD, 0.90; 95%CI, 0.74 to 1.05; moderate certainty) levels when compared with the ESAs group. In contrast, the hepcidin level and dosage of intravenous iron were significantly decreased in the HIF-PHIs group compared with the ESAs group (MD, -15.06, 95%CI, -21.96 to -8.16; low certainty; MD, -18.07; 95% CI, -30.05 to -6.09; low certainty). The maintenance dose requirements of roxadustat were independent of baseline CRP or hsCRP levels with respect to the effect on inflammation. Significance:HIF-PHIs promote iron utilization and reduce the use of intravenous iron therapy. Furthermore, HIF-PHIs, such as roxadustat, maintain the erythropoietic response independent of the inflammatory state. Thus, HIF-PHIs may be an alternative treatment strategy for anemia in DD-CKD patients, where ESA is hyporesponsive due to iron deficiency and inflammation.

目的:分析现代针灸临床文献治疗子宫肌瘤的取穴规律及特点.方法:检索自建库起至2021年4月30日中国期刊全文数据库、万方数据库、VIP、PubMed、Embase以及Cochrane发表的针灸治疗子宫肌瘤临床文献,收集腧穴处方信息并利用中医传承辅助平台(TCMISS V2.5)进行腧穴的描述性分析、关联规则及熵聚类分析.结果:本研究共提取101首针灸处方,腧穴总使用频次为675次,累积样本量5 957例,主要归经为任脉、脾经与胃经,以阴经取穴为主;腧穴使用频次多与肝脾胃相关,注重特定穴的应用,如交会穴、募穴,局部取穴与病灶关系密切;最常用的穴对为关元、子宫和三阴交组成的腧穴交叉配伍;获取强关联腧穴组合规则216条,基于熵聚类算法获取10个核心腧穴组合及6首新腧穴处方.结论:本研究发现的取穴规律、核心组合与新方组合为针灸治疗子宫肌瘤的临床治疗带来新的启发.

Taking regulating the thoroughfare vessel and the conception vessel, tonifying liver and kidney, calming mind as the treatment principle, Tiaojing Cuyun acupuncture (acupuncture for regulating menstruation and promoting pregnancy) is commonly used in clinical treatment of diseases with ovarian function decline, and recommends full cycle acupuncture treatment. Clinical research shows that Tiaojing Cuyun acupuncture can improve menstruation and ovulation, increase the reserve function and response of ovary as well as endometrial receptivity, so as to improve the pregnancy outcome. It can also improve the related symptoms caused by negative emotions and low estrogen, and comprehensively enhance the health related quality of life in patients. The mechanism of Tiaojing Cuyun acupuncture mainly involves 2 aspects, i.e. overall regulation on hypothalamus-pituitary-ovary (HPO) axis and the local regulation on FSH/cAMP signal transduction in ovarian granulosa cells.

目的:通过数据挖掘技术分析现代针灸文献治疗早发性卵巢功能不全(POI)的取穴选用规律.方法:检索自建库至2021年3月31日中国知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、PubMed、Cochrane Library以及Embase收录的针刺治疗POI的相关文献,收集处方中的穴位信息,应用中医传承辅助系统(V2.5)进行数据挖掘.结果:共纳入文献78篇,腧穴64个,累积使用频次478次,主要归经为膀胱经、任脉、脾经等;针刺治疗常用腧穴为关元、三阴交、肾俞、子宫、足三里、太冲、中极、血海、脾俞、次髎等;注重特定穴的应用,如交会穴、募穴;常选用的腧穴组合为关元-三阴交-肾俞;基于熵聚类算法获取候选新腧穴组合9个及新腧穴处方2首.结论:针刺治疗POI取穴经脉主要以膀胱经、任脉、脾经为主,以关元-三阴交-肾俞为组方核心腧穴,以调冲任、补肝肾、调气血、安神志为针刺治疗POI方法.

目的:探讨古代文献中针灸治疗闭经的选穴规律.方法:利用《中华医典》第5版数据库检索"不月""月事不来""闭经""血枯"等30个关键词,筛选并提取针灸治疗闭经的处方条文,对数据进行整理.利用文献计量学的方法,借助古今医案云平台(V2.3)对针灸治疗闭经的选穴方案进行频次统计、社团分析、关联分析和复杂网络分析.结果:共筛选出符合要求的202条穴位处方条文,其中27条为复方,余为单穴方,共涉及38个腧穴,268频次.治疗闭经使用频次排前15位的腧穴:中极、血海、水泉、阴交、气海、关元、照海、带脉、腰俞、中髎、气冲、太冲、三阴交、合谷、会阴.复杂网络分析显示核心处方为:足三里、三阴交、肾俞、中极、血海、合谷、照海、气冲、气海、阴交.结论:针灸治疗闭经的取穴具有规律性,本研究结果可为临床提供一定的参考性,且通过数据挖掘技术探讨古籍针灸文献具有可行性.

大量基础及临床研究表明,针灸治疗早发性卵巢功能不全(premature ovarian insufficiency,POI)疗效确切,在恢复月经周期、缓解低雌激素症状、降低负性情绪、改善妊娠结局、提高生活质量诸方面,具有良好临床应用前景.欧洲《人类生殖与胚胎学会指南》[1]及《早发性卵巢功能不全的临床诊疗中国专家共识》[2]中均提及了针灸治疗POI.

The application status of acupuncture and moxibustion therapy for assisted reproductive field in the United States was analyzed, and the existing problems and future development directions were discussed. According to the survey on the 456 websites of assisted reproductive clinic in the United States mentioned in the report of U.S. Centers for Disease Control and Prevention (CDC), 111 clinics among 456 assisted reproductive clinics recommend and used acupuncture and moxibustion therapy, accounting for 24.3%. Acupuncture and moxibustion therapy had obvious effect, good safety and low cost, and the assisted reproductive institutions in the United States had a high degree of application and recognition to acupuncture and moxibustion therapy. However, some problems, such as immature treatment scheme, unclear mechanism and imperfect insurance policies, still existed. In the future, the advantages of Chinese traditional acupuncture and moxibustion should combine with international modern assisted reproductive technology, and multi-center and large-sample clinical randomized controlled trials and basic experimental research on the mechanism of acupuncture and moxibustion for assisted reproduction should be carried out.

Platelets may serve as a perfect peripheral source for exploring diagnostic biomarkers for Alzheimer's disease (AD); however, the molecular linkage between platelet and the brain is missing. To find the common altered and driving molecules in both brain and the platelet, we performed an integrated analysis of our platelet omics and brain omics reported in the literature, and analyzed their correlations with AD-specific pathology and cognitive impairment. By integrating the gene and protein expression profiles from 269 AD patients, we deduced 239 differentially expressed proteins (DEPs) appeared in both brain and the platelet, and 70.3% of them had consistent changes. Further analysis demonstrated that the altered brain and peripheral regulations were pinpointed into 10 imbalanced pathways. We also found that 117 DEPs, including ADAM10, were closely associated to the AD-specific β-amyloid and tau pathologies; and the changes of IDH3B and RTN1 had a potential diagnostic value for cognitive impairment analyzed by machine learning. Finally, we identified that HMOX2 and SERPINA3 could serve as driving molecules in neurodegeneration, and they were increased and decreased in AD patients, respectively. Together, this integrated brain and platelet omics provides a valuable resource for establishing efficient peripheral diagnostic biomarkers and potential therapeutic targets for AD.

目的:基于真实世界数据探讨针灸治疗早发性卵巢功能不全(POI)的疗效,分析年龄对针灸治疗POI疗效的影响.方法:通过国际针灸病例注册登记平台全面收集真实世界中针灸治疗POI的临床诊疗数据.采用多重插补法填补缺失数据,采用分层分析、多因素调整分析和倾向性评分(逆概率处理加权法)平衡混杂因素,利用广义混合相加模型拟合针灸与卵巢功能指标的量效关系曲线,分析年龄与针灸疗效的关系.结果:189例POI患者纳入分析.①总体疗效:针灸可不同程度改善POI患者血清促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)、抗苗勒氏管激素(AMH)水平,可平均提高1个窦卵泡数(AFC),并能使部分POI患者上述卵巢功能指标恢复正常;②年龄与针灸疗效的关系:针灸改善FSH水平的效果受年龄影响,31岁前效果优于31岁后;随着年龄的增长,针灸改善AFC的效果减弱,33岁前可提高2个AFC,33岁后可提高1个;其他卵巢功能指标受年龄影响不大;③孕产情况:妊娠率16.67％(16/96),其中自然妊娠比例为9.38％(9/96),体外受精妊娠比例为7.29％(7/96);活产率12.5％(12/96).结论:真实世界中,针灸可不同程度改善卵巢功能指标并使部分患者卵巢功能恢复正常,对年轻患者治疗效果更好;针灸可提高POI患者孕产率.

RATIONALE & OBJECTIVE:Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are novel, orally administered agents for anemia management in chronic kidney disease (CKD). We evaluated the cardiac and kidney-related adverse effects of HIF-PHIs among patients with CKD and anemia. STUDY DESIGN:Systematic review and meta-analysis of randomized controlled trials (RCTs). SETTING & STUDY POPULATIONS:Patients with anemia and CKD not receiving maintenance dialysis. SELECTION CRITERIA FOR STUDIES:RCTs comparing HIF-PHIs to placebo or an erythropoiesis-stimulating agent (ESA) with primary outcomes of cardiac and kidney-related adverse events (AEs). DATA EXTRACTION:Two independent reviewers evaluated RCTs for eligibility and extracted relevant data. ANALYTICAL APPROACH:Dichotomous variables were pooled using the Mantel-Haenszel method and presented as risk ratios (RRs). Subgroup analyses evaluated different intervention times and HIF-PHIs, as well as phase 2 versus phase 3 trials. The certainty of findings was rated according to GRADE criteria. RESULTS:Twenty-three studies with 15,144 participants were included. No significant difference in the risk of cardiac AEs was observed between the HIF-PHIs group and the placebo (RR, 1.02 [95% CI, 0.89-1.16]; moderate certainty) or ESA (RR, 1.06 [95% CI, 0.98-1.14]; low certainty) groups. No significant difference in the risk of kidney-related AEs was observed between the HIF-PHIs group and the placebo (RR, 1.09 [95% CI, 0.98-1.20]; moderate certainty) or ESA (RR, 1.00 [95% CI, 0.94-1.06]; low certainty) groups. The occurrence of hypertension and hyperkalemia was higher in the HIF-PHIs group than in the placebo group (RRs of 1.35 [95% CI, 1.14-1.60] and 1.25 [95% CI, 1.03-1.51], respectively; both findings had high certainty). The occurrence of hypertension was lower in the HIF-PHIs group than in the ESA group (RR, 0.89 [95% CI, 0.81-0.98]; moderate certainty). LIMITATIONS:The reporting criteria of cardiac and kidney-related AEs and dosage of HIF-PHIs were inconsistent across trials. CONCLUSIONS:The occurrence of cardiac or kidney-related AEs in the HIF-PHI groups were not different compared with placebo or ESA groups. REGISTRATION:Registered at PROSPERO with registration number CRD42021228243.

Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are a new class of oral medicines being developed for the treatment of anemia in chronic kidney disease (CKD) patients. This study aimed to compare the efficacy and safety of HIF-PHI vs epoetin and darbepoetin in CKD patients with anemia not undergoing dialysis. The PubMed, Embase, Cochrane Library, Web of Science, and clinicaltrials.gov databases were searched from inception to October 2019 for randomized controlled trials investigating different agents (six HIF-PHIs, epoetin, darbepoetin, and placebo) for treating CKD patients with anemia that did not undergo dialysis. The outcomes included a change in hemoglobin (Hb) levels and all-cause mortality. A total of 19 studies were included. Compared with the placebo, except for vadadustat (mean differences: 1.12, 95 % confidence interval [CI]: ‒0.11–2.35), the other drugs significantly increased Hb levels, with mean differences of 2.46 (95 % CI: 0.93–3.99) for desidustat, 1.81 (0.87–2.75) for enarodustat, 1.68 (0.64–2.72) for molidustat, 1.66 (0.89–2.44) for epoetin, 1.63 (0.69–2.56) for darbepoetin, 1.61 (0.99–2.22) for roxadustat, and 1.55 (0.74–2.36) for daprodustat. No differences were found in the Hb level elevations among these eight drugs. Compared with the placebo, there also was no significant association between the drugs and all-cause mortality (molidustat of RR, 0.39 [95 % CI, 0.06–2.59]; roxadustat, 0.40 (0.06–2.84); enarodustat, 0.33 (0.01–16.25); desidustat, 0.34 (0.01–17.00); epoetin, 0.50 (0.18–1.42); daprodustat, 0.54 (0.09–3.31); darbepoetin, 1.03 (0.65–1.65); and vadadustat, 1.43 (0.15–13.27)). No differences were observed in the all-cause mortality among the drugs. In conclusion, these HIF-PHIs are effective and relatively tolerant for treating anemia patients with CKD not undergoing dialysis. Further research should consider the limitations of our study to evaluate the value of these HIF-PHIs in clinical settings.

妊娠期针灸的安全性自古以来颇受争议,2019年9月20日英国妇产科杂志(BJOG)发表的"妊娠期针灸的安全性:一项回顾性队列研究"一文的研究结论为针灸是一种无不良反应的安全治疗方法.该研究是第一个国家型的大型队列研究,其结论将令国际医学界对孕期针灸更多一分信任.作者主要结合针灸相关理论和妊娠期安全性相关标准并综合目前的研究成果,就结局指标、暴露因素以及"妊娠禁穴"等方面展开探讨,以期为妊娠期针灸的安全性研究提供建议与思考.